As the child grows older the toenails thicken, and often in their trimming they are cut so closely at the corners that sometimes a condition results known as ingrowing nails. Such are very painful and must receive special attention. First of all, the nail is cut squarely, and after scraping it thin the corner is lifted and cotton so placed under it that the nail's downward and inward growth is stopped.

SPINAL CURVATURE

Curvature of the spine is more common than is usually thought. The most frequent variety of it is the lateral curvature. One shoulder is lower than the other, and the hips are therefore uneven. Rickets, during infancy, is the most common cause of spinal curvature.

Improper sitting at school—sitting on the edge of the seat—or carrying heavy loads are often contributing factors to the production of lateral curvatures. Only the muscles and ligaments enter into this deformity, hence the treatment should be started early and should consist of:

1. Stretching exercises.

2. Hanging from the rounds of a ladder securely fastened to the wall.

3. Certain applications of hot fomentations to the spinal muscles for their relaxation.

4. Firm cushion placed under one or other of the hips to encourage the re-establishment of muscular poise.

5. Special supervision of the case.

POTT'S DISEASE

Pott's disease, or tuberculosis of the bone, often results in an angular spinal deformity. This curvature, unlike the lateral curvature, is a sequela of an actual disease of the bones. It is always very serious and demands early treatment from skilled hands. Early in the disease there is a peculiar stiff, tottering gait. The little child holds the spine rigidly, and in picking up objects from the floor bends the knees instead of the spine. If the trouble is in the upper spine, the shoulders are held high and the head is stiffly poised, it is never rotated; in looking about the entire body turns.

Medical aid should be secured early. The X ray not only locates the difficulty but also determines the extent of the process. If the spine be put to perfect rest, outdoor life begun, a diet rich in fats established, the results are often wonderfully successful.

Another tubercular condition is seen in the much dreaded hip-joint disease which parents should always be on the lookout for. The earliest symptoms are crying out in the night suddenly, unnatural standing on one leg (to relieve the strain on the diseased hip) and so-called "growing pains." Call in a physician very early and institute proper treatment. A posterior curvature of the spine is often associated with a bad case of rickets. It is of temporary duration, and usually clears up when the symptoms of rickets have been eradicated. It involves only the back muscles—not the vertebral bones.

The young mother is often very much concerned over the misshapen head of the child as a result of a prolonged labor; and it does seem quite miraculous to see a head, more nearly resembling an egg than anything else, become beautifully round and shapely by the end of two or three days.

Protruding ears may be encouraged to lie more flatly by the wearing of a specialized bonnet at night. When the babies are too young to turn themselves they should be turned first to one side and then the other, while care should always be exercised in properly straightening out a curled under ear or an overlapping ear.

RHEUMATISM

While we so often regard rheumatism an adult disease, nevertheless, children do suffer its aches and pains as well as the fever which so often attends the inflammatory type. The so-called "growing pains" are often of rheumatic origin.

Diseased tonsils not only are often—very often—the avenue of entry of infectious microorganisms that cause one type of rheumatism, but many forms of valvular heart disease are also directly traceable to these same diseased tonsils. The treatment consists in giving proper attention to the tonsils, even removal if necessary—and if the child is old enough. All other possible causes should be located and removed; the child should have absolute rest in bed with brisk cathartics and a liquid diet (no meat broths). The diet should consist more of alkalinizing foods as shown in the special table in the appendix. Medicinal alkalines are often given when the urine shows a very high acid reaction.

SCURVY

Scurvy, seen in children who subsist on "prepared foods," is manifested by tender legs and swollen gums which have a tendency to bleed easily. Pallor, loss of appetite, and insomnia accompany the condition. The treatment of scurvy is change of diet from "patent foods" to fresh cow's milk, with the addition of orange juice, daily. In older children the food must be very nutritious; out of door life, salt glows, friction baths (see appendix), and the taking of large amounts of fats are all essential to the cure.

ADENITIS—ENLARGED GLANDS

Enlarged glands, or what our grandmothers used to call "kernels" in the throat are often the result of inflammation in the mouth or throat, and occur in connection with many of the childhood diseases, notably diphtheria, scarlet fever, and scarlatina.

Glands appearing in the back of the neck may be occasioned by pediculli (lice), ring worm, or eczema, while those seen in the neck just back and below the ears may come from mastoiditis (inflammation of the middle ear) or adenoids.

Glands felt under the arm enlarge because of trouble or infection in the breast, hand, or arm; while glands in the groin are usually due to some infection of the feet, legs, or abdomen.

These glands usually disappear when the general health and well-being of the child is improved by:

1. Outdoor life. 2. Morning dry-friction rub to the skin. 3. Good liberal diet, including plenty of fats. 4. No feeding between meals. 5. The salt glow and general tonic treatment (see appendix). 6. The oil rub at night.

RICKETS

Rickets (a disease of the bones) often follows in the wake of faulty feeding and unhygienic surroundings. The bones lack a proper amount of lime salts and other elements. Development in general, especially that of the bones, is greatly interfered with.

Bowlegs, prominent square brow, enlarged perspiring head, weakness, and often tenderness of the flesh, are notable signs of the disease. The treatment varies little from that of scurvy, and will be provided in detail by the attending physician.

MALARIA

Children often suffer from malarial parasites. Sudden rise of fever on regular days (sometimes daily, every two days or every three days) should demand a careful medical examination including the examination of the blood where the offending organism is seen in the red blood cells. We recently saw a little girl who happened to have an earache and was about to be operated on for ear trouble, when examination of the blood revealed the fact that she was suffering from malaria.

TUBERCULOSIS

In the routine examination of adult patients, the X ray observations of the lungs often reveal deposits of lime salts which tell the story of a successful fight against tuberculosis (Fig. 16). And while it may seem surprising, we believe beyond a doubt that most of us have had some varying degree of tuberculosis while young—the unrecognized battle has been fought—and these small monuments of lime salts alone remain to tell the interesting story.

The pity of it is that whole armies of little folks fall in this struggle against disease, for it is one of the common and fatal diseases of childhood. Fresh-air schools, playgrounds, and free school lunches are saving hundreds of children from the ravages of this disease each year.

Tuberculosis is strictly a house disease, hence the little tubercular patient must seek outdoor life. All avoidable exposure to the disease must be denounced, and public sentiment must continue to be aroused to the hygienic betterment of the tenement districts and basement homes. The sanitary drinking cup and the bubble fountain must be encouraged, as must also the proper ventilation of all places where crowds assemble, be it the schoolroom, the theater, or the church.

SYPHILIS

While tuberculosis is known as the "great white plague," syphilis and gonorrhea constitute the "great black plague," which seen in the little folks is pitiable indeed, leading us to realize that surely "the children's teeth have been set on edge" because of the careless eating of sour grapes by the parents. Syphilitic parents who have not been properly treated, should think many times before they take upon themselves the awful responsibility of bringing into the world a tainted child. Proper mercurial treatment should be instituted at once not only for the child but also in the case of both parents.



CHAPTER XXXIV

ACCIDENTS AND EMERGENCIES

In this chapter we wish to instruct the mother or the caretaker in doing the one thing needful for every one of the more common household accidents and emergencies while waiting for the doctor.

In every household there should be found an accident and emergency "kit" of necessary paraphernalia for the quick application of the one necessary medicine, dressing, etc. This "kit" should contain baking soda for burns, bandages and sterile gauze for cuts or tears, together with adhesive plaster, needle and thread, etc.

INSECT BITES AND STINGS

Far greater harm is often done the skin by the subsequent scratching of the insect bite with dirty finger nails than by the bite itself; and so it is very important that we remember to allay quickly the intense itching by the application of ammonia water or camphor. Almost instantly the itching is stopped, and the added "scratching" irritation to the already injured skin is thus avoided.

By the aid of a magnifying glass, and often by the naked eye, we may detect the stinger which has been left behind by the greedy guest, and which should be removed by a pair of tweezers. Ice-water compresses will stop the swelling and even an old-fashioned mud dressing, which was used and appreciated by our great grandmothers, is a thing not to be despised.

If the much admired shrubbery be removed one hundred feet away from the porch, mosquitoes would trouble the household less. It has been demonstrated in many localities that clearing away the near-by clumps of shrubbery permits the family to sit on unscreened porches unharmed. Mosquitoes multiply rapidly in stagnant pools of water, but if oil is poured over these stagnant waters the increase of mosquitoes is abated, and their total extinction is not unheard of in swampy districts receiving such care.

Whenever baby is out of doors where mosquitoes, flies, or other insects are to be found, he should be properly protected from such pests by mosquito netting stretched over a frame eighteen inches above his face, for we can think of nothing more uncomfortable than a mosquito netting dragging over a sweaty baby's face. The fact that mosquitoes, flies, roaches, and other insects are carriers of tuberculosis, infantile paralysis, typhoid fever, cholera, yellow fever and malaria, as well as a host of minor ailments, should make us the more anxious for either their extermination or the protection of our children from their greedy bites and stings.

DOG BITES AND SNAKE BITES

Dogs, cats, rats, or mice bite at any time of the year, and provision should always be made for ample protection against such accidents.

Such a wound should always be squeezed or sucked until it has bled freely, and then be cauterized by a red-hot iron or touched with an applicator that has been dipped in sulphuric acid or nitric acid. A subsequent dressing of Balsam Peru is healing. The dog should be watched, and if it shows signs of hydrophobia the bitten child should be promptly taken to the nearest Pasteur Institute for treatment.

In the case of snake bites the same sucking and cauterizing treatment is indicated, with the additional tying of a handkerchief or cord a few inches above the wound to stay the progress of the blood and to keep the poison out of the general circulation. A solution of twenty-per-cent permanganate of potash should be used to wash the wound.

The popular administration of large draughts of whiskey is of no benefit, for the secondary depressant effect of alcohol increases the body's poison burden, and those who survive do so in spite of the whiskey, and not because of it.

SWALLOWING FOREIGN BODIES

Small articles such as buttons, safety pins, thimbles, coins, etc., are often swallowed by little folks, and if they lodge in the throat and the child struggles for his breath the treatment is as follows: grasp him by the heels and turn him upside down while a helper briskly slaps him on the back. The foreign body generally flies across the room. If it is lodged high up in the throat it may often be dislodged by the thumb and finger. If it cannot be reached and it will not go down, lose no time in seeking an X-ray laboratory where its exact location may quickly be discovered and proper measures instituted for its removal.

A troublesome fish bone is easily dislodged by swallowing a half-chewed piece of bread which carries it down to the stomach. Cathartics and purgatives are not to be given; in due time the object will appear in the stool. In all instances it is well to locate its exact position by the X ray—that there may be assurance that it will do no harm.

It is surprising what large objects can be swallowed. One old gentleman swallowed his false teeth, and a six months old baby swallowed, or at least had lodged in its throat, a silver dollar.

All detachable parts should be removed from toys that are given to babies, such as the whistle from rubber animals, the button eyes of wool kittens and dogs, and other such removable parts.

FOREIGN BODIES IN THE EYE

To begin with, do not get "panicky," but carefully, painstakingly, and patiently do the following:

1. Rub the well eye until the tears flow plentifully in both eyes.

2. Blow the nose on the injured eye side, closing the other side. This often encourages the tears to wash the foreign speck down through the tear duct, into the nose and out into the handkerchief (in case the child is old enough to follow such instruction). If the foreign body be sharp, as a piece of steel or flint is likely to be, it may be driven right into the eyeball. Seek a physician who will drop medicine into the eye to deaden the pain and then if it cannot be gently rubbed off the eyeball, a magnet will promptly remove it.

An eye bath of warm boracic acid is always comforting and never does harm, so that may be given while waiting for the doctor to come, if the object seems to be beyond the reach of family help.

If an alkaline, such as lime, be blown into the eye it is very painful, but much relief may be obtained by gently pouring into the eye, by means of a medicine dropper or eye cup, warm water to which has been added a little vinegar or lemon juice. Likewise, acid in the eye produces much pain. In this instance, an eye bath of a weak soda solution is indicated.

FOREIGN BODIES IN EAR AND NOSE

Insects that have crawled into the ear may be suffocated by dropping sweet oil or castor oil into the ear, which, after twenty minutes, should be washed out by gentle syringing with warm water from a fountain syringe, hung one foot above the child's head.

Peas, beans, shoe buttons, or beads are sometimes put into the ear and nose by adventurous or experimenting children.

The shoe button or bead will not swell as does the pea or the bean, and may often be safely washed out. If it is causing no pain and will not drop out in case of the ear, or will not be easily blown out in case of the nose, see your physician at once. He has in his possession just the necessary instruments for its immediate removal.

Peas and beans swell, and consequently cause greater discomfort the longer they are in; do not poke at any foreign body lodged either in the nose or the ear, for the ear drum may thus be injured, while in the former case it may be pushed into one of the accessory sinuses.

EARACHE

One of the most comforting and highly effectual forms of heat for an aching ear is a four-candle-power carbon electric light on an extension cord that permits the light to come in close contact with the ear. A shade is made from a piece of stiff letter paper that fits the socket snugly and flares out to a three inch opening, which should extend below the point of the bulb one inch. This shade holds all the heat and light and directs it into the aching ear.

In every well-ordered household there will be found a three-per-cent solution of carbolic acid and glycerine of which one drop should be put into the aching ear, and then the external heat, mentioned above, should be applied. A bag of warm salt, a hot water bag, or a warm plate will provide external heat if an electric light is not available. Do not put laudanum or other remedies into the ear, other than are herein suggested, without your physician's knowledge.

Earache is always serious, and since it is usually indicative of trouble which, if left untreated, may cause deafness, it demands thorough treatment from skilled hands.

Running ears invariably need medical attention and should never be neglected.

NOSEBLEED

If the nose bleeds whenever it is cleansed, more than likely there is an ulcer on the septum which will continue to bleed if left untreated. The physician should heal the ulcer, and the child should be taught always to vaseline the nostril before cleansing it.

In case of persistent nosebleed, put the child to bed with the head elevated. Pressure should be put on the blood vessels going to the nose by placing two fingers firmly on the outer angles of the nose on the upper lip, while a helper may put firm pressure at the root of the nose at the inner angle of each eye. An ice bag may be placed at the back of the neck, and another piece of ice held on the forehead at the root of the nose. If these measures do not stop the flow of blood a few drops of adrenalin may be put into the nose and repeated in five minutes if necessary. As the bleeding begins to stop, as well as during the bleeding, all blowing of the nose is forbidden as it will only cause the bleeding to start afresh. It sometimes helps to hold a piece of ice in the hands.

CUTS AND TEARS

A cut with smooth edges, if deep, should be allowed to bleed freely, should be washed in boracic acid solution, and its edges held together by a stitch which is usually put in by a physician; but if treatment is to be given at home, the hands of the nurse must be thoroughly washed and the thread and needle boiled for twenty minutes. If the physician has been sent for, make firm pressure over the wound by bandaging tightly with a dressing of sterile gauze dipped in boracic acid solution.

In case of a slight cut, make it bleed freely, then wash in boracic-acid solution and apply sterile gauze held in place by a binder. If no odor or pain follows, let alone for two or three days, when a new dressing is applied.

A physician should be called in case of ragged wounds or tears, as such usually leave bad scars. Cleanse carefully, leaving no dirt in the wound, cause it to bleed, if possible, and apply a sterile gauze compress wet in boracic-acid solution, bandaged on as directed above. Zinc ointment may be applied to surfaces that have been skinned. All dressings on dirty wounds should be changed daily.

Blood poisoning may readily follow a wound, hence the utmost cleanliness should prevail. The hands of the attendant, the dressings, the surrounding skin, must all be clean. The bowels should be kept open, and under-feeding rather than over-feeding is indicated.

If a needle be needed to open a sore or boil, always disinfect the part and surrounding area by painting with tincture of iodine, and heat the needle to red heat through a flame before it touches the sore.

In case of cuts or wounds of the eyeball apply a compress of sterile gauze wet in boracic acid, held on by a bandage, and go immediately to a good eye specialist.

PUNCTURED WOUNDS AND SLIVERS

Wounds made by pins, needles, fishhooks, tacks, and splinters are always very painful and great care must be exercised to force bleeding freely, which helps to wash out infection, as more than likely microbes entered with the instrument or sliver when the wound was made.

Fishhooks are exceedingly troublesome, as they often occasion the enlarging of the wound to get them out, especially if they have gone in beyond the barb.

Slivers are easily broken off, so great care is needed in their removal. A pair of tweezers is convenient for seizing the protruding portion, while all side movements are avoided lest it break off in the flesh, in which case it may be gotten out with a needle that has been sterilized in a flame.

All puncture wounds should be dressed with the wet, sterile compress, covered over with wax paper and bandaged loosely; this encourages cleanliness and favors healing.

BRUISES

If left untreated, bruises swell, become highly discolored, and in the process of healing pass through the dark blue, green, and yellow stages. The treatment is as follows: Apply hot and cold alternately—the heat should be as hot as can be borne and left on very hot for three minutes, then ice water compresses should be applied for one minute, then hot again—these changes should continue for an hour, and if carried out immediately after the injury all discolorations and most of the swelling may be avoided. Witch-hazel compresses are comforting. If discoloration has taken place, the application of hot compresses will often hasten its disappearance.

FRACTURES AND DISLOCATIONS

While there is very little a member of the family or a non-medical friend can do in case of a fracture, and while it is unwise to offer suggestions relative to the setting of bones, yet it is highly important that both the family and friends know how properly to support a broken leg while carrying a disabled person into the house or to near-by medical aid.

For instance, in the case of a fractured leg below the knee, if a couple of flat boards three inches wide be tied about the leg with two pocket handkerchiefs, the ends of the fractured bone will not rub against each other and the pain will be much less in carrying. In this way all danger of causing the broken bones to protrude and thus "compounding" the fracture is also avoided. And also, if there is no near-by ambulance, a good emergency stretcher may be improvised out of two or three buttoned vests with two poles, rakes, or brooms run through the armholes—one vest under the shoulders and one under the hips and still another under the fracture. An injured person may in this way be carried for miles quite comfortably.

Two people may fashion a seat out of their four hands on which the disabled child may sit with his arms about the necks of his two friends. If the fractured end of the bone penetrates the flesh it is then known as a compound fracture and the utmost cleanliness must prevail—as in dressing other wounds. An X ray laboratory should always be sought, where convenient, to ascertain if the ends of the bones are in good position.

In dislocations, the bone has slipped out of place at the joint. Medical aid should be called to replace the bone, while hot applications may be used in the meantime.

SPRAINS

All sprains (a twist or straining of a joint) should promptly be put into a very hot bath and held there for thirty minutes. If this is impossible, then a rubber tube or a handkerchief is tied snugly between the sprain and the trunk of the body. Almost instantly the pain, which is often intense and severe, is very much lessened. The hot-water bath is very hot, and the joint should be very red on taking it out. Immediately following the bath the injured joint is wrapped in a very cold wet compress, which is next completely covered by silk, gutta-percha, mackintosh, or many thicknesses of newspaper—anything that will hold all the heat in—as the cold compress is quickly heated up. Lastly, a bandage of heavy flannel completely covers the whole—compress, impervious covering, etc.

The joint is now elevated for three hours, when it is again immersed in a very hot bath and then again the cold compress is applied. This is continued every three hours, except during sleep, for two days, after which it may be done morning and evening. Massage is now administered every three hours, first four inches below the injury then four inches above it, while in a day or so the joint itself may be gently rubbed with well-oiled hands. By the end of one week the patient begins to use the injured member.

In the case of a sprained ankle a properly applied adhesive strap bandage will give no end of relief and support. Various liniments may be applied, but usually the good obtained is from the thorough rubbing which always accompanies their use according to directions.

Sprains treated as above directed will often liberate the child in one-third the usual time generally allotted for its healing.

FROST BITES AND CHILBLAINS

Keep the child who has frozen some part of his body in a cool room, and rub the frost-bitten part with snow or ice water, or wrap it up in cold water compresses.

The return to heat must be slow indeed, else much pain may be experienced; blisters followed by discoloration, and even mortification, may set in. You may be surprised some morning on awakening to find your child's hand twice its normal size and very red, because it was out from under the cover a good share of the night exposed to Jack Frost. Do not bring it to heat quickly but immerse it in cold water, gradually and slowly raising the temperature of the bath until it is warm and comfortable.

The intense itching and burning of a chilblain may often be relieved by painting with iodine or triple chloride of iron (Monsel's solution). Soap liniment has also been suggested, as well as alternate applications of hot and cold water. Chilblains are troublesome, painful, and their yearly recurrence is often very annoying.

SWALLOWING POISONS

Poisons of an acid nature, such as hydrochloric, sulphuric, nitric, or oxalic acids, are neutralized by alkalines, such as magnesia, chalk, soda, and soap, followed by soothing drinks or sweet oil.

Remember that carbolic acid is not an acid, and is not antidoted with alkalines. The swallowing of carbolic acid should be quickly followed by diluted alcohol, and if this drug is not ready at hand many of the numerous alcoholic patent medicines will do just as well. Epsom salts should be given in abundance.

Poisons of an alkaline nature, such as lye, washing soda, ammonia, etc., are antidoted with vinegar or lemon juice, followed by soothing drinks or sweet oil.

A complete table of poisons and their antidotes will be found in the appendix.

Poison ivy, as soon as detected, should be treated as follows: Thoroughly scrub the affected part with tincture of green soap and hot water, which often prevents the trouble developing. Clean pieces of gauze may be wrung out of lime water and placed over the inflamed and much swollen surface, keeping them very wet. At night an ointment of zinc oxide may be applied over a painting of "black wash" (to be obtained at drug stores). Poison (trifoliolate, or three-leaved) ivy resembles Virginia Creeper, and all nurses and caretakers should be able to recognize it.

Another treatment for poison ivy which is said to be very efficient is as follows: Moisten a bit of cotton with a ten-percent solution of carbolic acid and apply to the affected area—then immediately (about one-half minute) wipe off this carbolic acid with another piece of cotton saturated with alcohol.

Matches, roach powders, fly poisons, washing fluids, lye, paris green, antiseptic tablets, and pieces of green paper, should all be kept out of the child's reach; and, in case of accidental swallowing of any of them, the physician should be sent for at once, and with the message "Come!" should be given the name of the poison swallowed—if it is known.

After the antidote is given, soothing drinks are usually administered, such as raw white of egg, milk, flaxseed tea, slippery elm, etc.

Complete rest in bed is always essential, and external heat is necessary for the body chills easily as the child grows weak.

Toothache may be temporarily relieved by applying an ice bag below the jaw, thus diminishing the flow of blood to the tooth, and a hot-water bottle to the cheek, which causes the skin vessels to fill with blood, thus relieving the tension in the vessels of the tooth.

If there is a cavity, a small piece of cotton moistened with oil of cloves and packed well into it may give much relief.

Children and adults should make a bi-annual pilgrimage to the dentist, who seeks out beginning cavities, early treatment of which will prevent these dreadful aches and later ill health.

BURNS

Burns and scalds are not at all uncommon with children, whose eagerness to explore and desire to investigate often leads them into trouble.

1. The simple reddening of the skin—slight burns and sunburn—simply needs protecting oil, or equal parts of oil and lime water, and is to be covered with sterile gauze.

2. The burns which destroy the outer layer of the skin, producing a blister, are treated much as a wound would be treated. The blister, if larger than a half dollar, should be opened near the edge with a needle which has been passed through a flame. The serum should be pressed out and the parts protected by a piece of gutta-percha that has been disinfected with some antiseptic solution; this covering keeps the dressings from sticking, thus avoiding the destruction of the new-forming tissues.

3. When the tissues are injured in the more severe burns, the surrounding flesh is carefully disinfected with boracic-acid solution, and the same dressing applied as described for the "blister burns." Balsam Peru is a healing balm for burns of this classification.

If a child's clothes catch on fire he is instantly to be thrown on the floor and any heavy woolen fabric, such as a curtain, table spread, blanket, or rug, is to be thrown over him (beginning at the neck) and the flames thus smothered. The clothing is now cut off, and if more than one-third of the body is burned the child should be taken to the hospital for constant care; and if more than one-half of the body is injured recovery is doubtful. Great care should be taken in keeping the unburned portion of the body warm, as there is a great tendency for the child to become very cold as he weakens from both the nervous shock and from the absorption of toxins.

Acid chemical burns are treated with baking soda, except in the case of carbolic acid (misnamed), which is treated with alcohol; alkaline chemical burns are dressed in vinegar or lemon juice compresses.

Methods for restoring the drowned should be understood by every man, woman, and youth. These methods are more fully taken up in works devoted to emergencies and will not be discussed in detail at this time.

FAINTING

Consciousness is quickly restored to the fainting child by lowering the head—laying him flat on the floor—while an assistant raises the legs perpendicularly. Cold dashes of water may be slapped on the chest with a towel, while the face is bathed or sprinkled with cold water. Consciousness is usually quickly restored by the above suggestions, in connection with plenty of fresh air.

A sudden blow on the head occasionally results in a severe condition known as concussion of the brain. There is a partial or complete loss of consciousness lasting from a few moments to an hour or two. Pallor of the skin and a sense of bewilderment accompany concussion of the brain.

Rest, quiet, and darkness should prevail until the physician arrives and makes an examination. External heat to the extremities may be applied, but no stimulants are to be administered until so ordered by the physician.

It is wise to seek medical advice in the case of odd or unusual behavior after a fall on the head.



CHAPTER XXXV

DIET AND NUTRITION

Most interesting is the study of the food as it passes through the processes of digestion, absorption, assimilation, and oxidation—all definite and important parts of the great cycle through which everything we eat passes on its way from the table to the tissues. Elimination is the last step in nutrition, and is the process by which the body rids itself of the broken down cells and other poisonous and useless wastes. These various phases of bodily nutrition may be expressed in a single term—metabolism.

What we eat and how much we eat must be carefully planned, for our body temple is really made of what we eat. If you were erecting a beautiful mansion you would not think of allowing cheap, trashy, and inferior building materials to enter into the construction of your home. Neither should you permit unfit and inferior materials to become a part of the daily dietary of your little boy or girl, thus to become a part of their bodily structure.

ASSIMILATION OF FOOD

Following the process of digestion in the stomach and intestine, the nutritive food elements are absorbed through the wall of the bowel by the wonderfully adapted little villus, and distributed by various routes to the uttermost parts of the body. The sugars (all starches are changed into sugar) are carried in the portal blood stream to the liver, where they are actually stored away in the form of glycogen which, in a most intelligent manner, is dealt out to the body from hour to hour as it is needed for fuel. If all the sugar, after a hearty meal, were poured into the circulation at once, the blood stream would be overwhelmed and the kidneys would be forced to excrete it in the urine. This unnecessary waste is avoided by the liver's storing sugar after each meal and dealing it out to the body as required.

Likewise, the proteins also pass through the liver on their way to the body. Just what action the liver exerts upon proteins is not wholly known at the present writing. The digested fats are absorbed at once by the lacteals, the beginning of the intestinal lymphatic system, by which they are carried to the large veins at the root of the neck and there emptied into the blood stream. We have now traced our various food elements through the processes of digestion and absorption in the alimentary tract, some going through the liver, and others through the lymphatic system, until they circulate in the blood stream itself.

It is from these food substances, circulating in the blood stream, that the various cells of the body must assimilate into themselves such portions as they require for purposes of heat and energy and for the repair of their cell substance. This specialized work of cell assimilation converts the dissolved watery food in the blood into solid tissues, exactly reversing the process of digestion.

With a most profound intelligence, each of these body cells and tissues, bone and nerve fiber, muscle and organ, selects from the blood stream just its supply or portion of the food elements requisite to its upbuilding and maintenance. The mysteries of assimilation are effected by means of chemical substances called "enzymes," similar to those found in the digestive organs, but acting in an entirely different manner, in that they build up solids out of liquids instead of converting solids into liquids.

ELIMINATION OF BODY WASTES

Metabolism consists of a twofold role—an upbuilding and a tearing down process. After the food is all digested, absorbed, and assimilated, having become a part of the bodily organ, bone, muscle, and nerve fiber, then begins the work of tearing it down—of liberating its heat and energy—to be followed by its elimination from the body through the sweat glands, uriniferous tubules of the kidneys, etc. The carbohydrates (starches and sugars), together with the fats, are completely burned up in the body and are then eliminated in the form of water (thrown off through the sweat) and carbonic acid gas given up by the lungs.

The proteins, or nitrogenous foods, are not so completely burned up in the body. The ashes which result from their combustion are not simple substances like the water and CO_{2} of the carbohydrates. This protein ash is represented by a number of complicated substances, some of which are solid (protein clinkers), which accumulate in the body and help to bring about many diseases, such as gout, headache, fatigue, biliousness, etc.

These protein ashes and clinkers are further acted upon—split up and sifted—by the liver, and are finally eliminated by the kidneys in the form of urea, uric acid, etc. The body being unable to store up protein, is often greatly embarrassed when one eats more of this substance than is daily required to replenish the waste of the body, for it must all be immediately split up in the system, and the over-abundant and irritating ashes must be carried off by the eliminating organs. Now, the overeating of sugars, starches, or fats, is not such a serious matter, as they may be stored in the liver and subsequently used; and even if they are eaten in excess of what the liver can care for they accumulate as fat or add extra fuel to the fires of the body, their ashes being carried off in the form of such harmless substances as water and carbon dioxide (CO_{2}); but the overeating of protein substances is always a strain on the body and should be avoided.

ELEMENTS OF NUTRITION

There are seven distinct elements entering into the composition of human foods—protein, starch, sugar, fat, salts, cellulose, and water, not to mention enzymes, vitamines, and other little-known chemical principles. These elements are all variously concerned in the nourishment, energizing, and warming of the body.

PROTEINS

The proteins are the structure builders of the body. While starches, fats, and sugars may be compared to the coal that feeds the locomotive, the proteins represent the iron and steel that are used from time to time to repair the engine and replace its worn parts. The essential chemical difference between starch and protein is that the latter contains nitrogen and a small amount of sulphur and phosphorus. The most common forms in which protein is used for food are the glutens of the grains, the legumes, nuts, cheese, the white of egg, and lean meat.

STARCHES

The starches are by far the most abundant of all elements in human food. They enter largely into the composition of nearly all plants and seeds. Under the influence of the sunlight, the green-colored plants gather up the CO_{2} of the air and, with the water absorbed from the ground, build up starch. The plant takes all the carbon from which starch is made from the air, but while the atmosphere contains almost eighty per cent of nitrogen, the plant is unable to use it; it must secure its nitrogen from the decaying refuse of the soil. Thus the plant utilizes the waste products found in air and earth in the building of its food substances.

Starch exists in the form of small granules. Since each little starch granule is surrounded by a woody envelope of cellulose, it becomes necessary to cook all starches thoroughly in order to burst this cellulose envelope and thus enable the saliva to begin, and other secretions to continue, the work of digestion.

FRUIT SUGARS

The sugar of fruits represents a form of food requiring practically no digestion; while the sugar found in beets, the cane plant, and the maple tree, must be acted upon by the digestive juices of the intestine before their absorption can take place. During the winter, the maple tree stores its carbohydrates in its roots in the form of starch. With the advent of spring Mother Nature begins the digestion of this starch—actually turns it into sugar—and in the form of the sweet sap it finds its way up into the tree trunk to be deposited in the leaves and bark in the form of cellulose, a process very similar to that performed by digestion in the human body, where starch by digestion is first turned into sugar, and afterwards deposited in another form in the liver and muscles.

Dextrine is a form of sugar resulting from thoroughly cooking or partially digesting starch. There are about twenty-five stages or forms of dextrine between raw starch and digested starch or fruit sugar. Dextrine is found in the brown-colored portions of well-toasted bread.

FATS

Fat is a combination of glycerine and certain fatty acids. As a food, it is derived from both the animal and the vegetable kingdom. Animal fat consists of lard, suet, fat meat, etc., while fat of animal origin is represented by cream, butter, and the yolks of eggs. The vegetable fats are found in nuts, especially the pecan, cocoanut, Brazil, and pine nuts; also in the grains, particularly oats and corn. The peanut also contains a considerable amount of fat. Of the fruits, the banana and strawberry contain a trace of fat, while the olive is the only fruit rich in fat.

As a food, fat is used in three forms. The emulsified form is represented by cream, olive oil, and nuts. When the tiny globules of fat, which are each surrounded by a little film of casein, are crushed—united into a solid mass—we have a free fat. This form is represented by butter and other animal fats. Another form is fried fat—fat which has been chemically changed by heat with the development of certain irritating acids.

MINERAL SALTS

The mineral elements comprise but a small part of human food as regards weight, but they are extremely important to the health of the child as well as the adult. As found in the food, they are not in the form of mineral salts, like common table salt. The salts of food are living salts, organic or organized salts, such as are found in the growing plant. These salts are of great value to the various fluids of the body, and also as stimulants to nerve action, but more particularly in the work of building up the bones.

Salts are found largely in the cereals. A small amount is also found in vegetables, particularly the potato, as well as in most fruits.

CELLULOSE

Cellulose represents the great bulk of all vegetables and fruits. It is digested by most animals, but in man it is digested only to the extent of about thirty per cent. The presence of a large amount of cellulose in the food enables us often to satisfy the appetite without injury from overeating. It serves to give bulk to the food, and thereby possibly acts as a preventive to constipation.

WATER

Water fills an important place in the nutrition of the body. The food changes in connection with digestion, assimilation, and elimination, can take place only in the presence of water. Water constitutes from fifteen to ninety-five per cent of the various foods. The watery juices of vegetables and fruits consist largely of pure, distilled water, in which fruit sugar is dissolved, with added flavoring substances. Water is absolutely essential to the performance of every vital function connected with human metabolism.

ANIMAL HEAT

The source of heat in the animal body was the subject of much superstitious speculation on the part of ancient scientists. It is now known that animal heat is derived from the food we eat by means of a peculiar process of vital oxidation—effected in the presence of oxygen—by the action of water and enzymes upon the food elements absorbed by the living cell. This process of oxidation liberates the heat and energy stored by the sun in the food, and thus the body is kept warm by this constant combustion of the digested foodstuffs. The starches and sugars, together with the fats, represent food elements which serve as the body's fuel. By this means we are able to maintain a constant body temperature of almost one hundred degrees.

The average human body produces enough heat every hour to raise two and one-half pounds of water from the freezing point to the boiling point. This is equivalent to boiling about seven gallons of ice-water every twenty-four hours. Differently expressed, the body gives off each hour the same amount of heat as a foot and a half of two-inch steam coil. This is the same amount of heat which would be produced by burning about two-thirds of a pound of coal.

FUEL VALUE OF FOODS

Expressed in terms of English weight, the fuel value of the three different food elements would be:

1 ounce of carbohydrates 127.5 calories 1 ounce of proteins 127.5 " 1 ounce of fat 289.2 "

It will be observed that fat contains more than twice as much heat as the carbohydrates. This is due to the fact that fat contains more carbon than either starch or sugar. Next to fats, starches and sugars are the most important fuel elements. Protein is a very extravagant form of food for fuel purposes. Proteins are the most expensive elements of human food; they are incompletely burned in the body, and inasmuch as they leave behind distressing and disease-producing ashes, it is clearly evident that only sufficient amount of proteins should be eaten each day to supply the demand of the body for repairs. We should depend more largely upon the carbohydrates and fats for heat and energy.

A large part of our food is required to furnish heat to take the place of that lost by radiation from the skin, and this is why children require more food than adults—they have a larger skin surface in proportion to their weight, and therefore lose more heat by radiation, and it is for this reason that the food for the growing child must be wisely and carefully selected.

DIET FOR CHILD TWO TO THREE YEARS OLD

Breakfast, 7-8 A. M.: Fruit; cooked or toasted cereal served with thin cream; a soft boiled or coddled egg; bread (two or more days old) and butter; plenty of milk.

Dinner, 12-1: Soups; creamed vegetables—tomato, corn, peas, and celery; any two of potatoes—creamed, mashed, or baked—carrots, beets, spinach, peas, cornlet, squash, cauliflower, asparagus tips, string beans; protein dish—the puree of dried beans, peas, or lentils; macaroni or carefully selected meats; dessert—apples, baked or sauce—or other fruits, junket, custard, milk.

Supper, 5-6 P. M.: Fruit, bread (bran bread if constipated); milk; porridge, with rich milk or milk toast; sweetened graham crackers.

FOODS ALLOWED CHILDREN OF FOUR YEARS AND OLDER

Protein Dishes: Purees of dried peas; lentils; beans; macaroni; eggs—soft boiled, poached, scrambled, or omelette; meats—steak, chops, chicken, turkey, broiled fish.

Cereals: All the toasted-flake foods; toasted and not too fresh bread, including both graham and bran; hominy; corn meal; oatmeal; farina; rice; barley; tapioca; sago, etc.

Soups: Creamed vegetable soups of all kinds and broths.

Vegetables: Potatoes; all the small green vegetables; lettuce; stewed celery; beets; squash; cauliflower, etc.

Fruits: All, if stewed or baked. Raw fruits—pears, peaches, ripe apples, berries, oranges, persimmons, grape-pulp without seeds, etc.

Desserts: Custard; jellos; junkets; home-made ice cream; sponge cake; baked fruits with whipped cream, etc.

FOODS TO BE AVOIDED BY YOUNG CHILDREN

1. Doughy breads, griddle cakes, insides of muffins, hot biscuits, etc.

2. Fried meats, such as sausage, oysters, pork, ham, veal, salt fish, corned beef, dried beef, etc.

3. Foods that are hot when they are cold—such as catsup, horse radish, mustard, highly spiced pickles, sauces, etc.

4. Rich pastries, puddings, unripe fruit, salted peanuts, and highly concocted dishes.

5. Certain salads, containing coarse but easily swallowed foods, with highly seasoned sauces.

6. Tea, coffee, and all alcoholic beverages.

7. Soft candies, chocolate creams, bon-bons, patties, etc.

Average normal children crave sweets, and since their normal food is about seven per cent sugar it is not to be wondered at. There are many forms of pure, hard candies which may be taken by the three-year-old child. They are stick candy, fruit tablets, sunshine candies, and other varieties which may be sucked.

All soft candies, such as chocolate creams, bon-bons, patties, etc., are to be avoided. Hard candies, taken along with the desserts at meal time, in no wise injure the normal stomach of the healthy child.

The other members of the family should set a correct example by sucking the hard candies rather than chewing them; for if the hard candies are allowed to dissolve slowly in the mouth they produce a weak solution of sugar, which does not interfere with digestion as do the strong and concentrated sugar solutions which result from chewing chocolate creams, bon-bons, etc.

Candy, cookies, sandwiches, or bits of cake should never be allowed between the meals.

EATING BETWEEN MEALS

Children who do not eat well at the breakfast table, if given a "piece" at 10 A. M., will not be ready for the 12 o'clock meal; and then another "piece" at 2 P. M. interferes with the normal appetite at 6 P. M. Digestion is disturbed, the nervous system irritated, and a "puny child" is often the result.

Bring the three-or-four-year-old to a well-selected breakfast some time between 7 and 8 A. M. Then nothing—absolutely nothing—but water must pass the lips between that breakfast hour and the 12 o'clock meal, which should be a good one. Then the interval until 5 or 6 P. M. is passed in the same manner. At the evening meal the appetite is again whetted: and a good appetite always means good gastric juice to digest the meal. And so, good mother, guard carefully the interval between meals if you would have good digestion and good health for the little folks.

DAILY FOOD REQUIREMENT

The following table, taken from The Science of Living,[B] shows the minimum of calories or food units required by boys from five to fourteen years of age and girls from five to twelve:

BOYS

Skin Daily Age Height in Weight in Surface in Calories or Years Inches Pounds Sq. Ft. Food Units

5 41.57 41.09 7.9 816.2 6 43.75 45.17 8.3 855.9 7 45.74 49.07 8.8 912.4 8 47.76 53.92 9.4 981.1 9 49.69 59.23 9.9 1043.7 10 51.58 65.30 10.5 1117.5 11 53.33 70.18 11.0 1178.2 12 55.11 76.92 11.6 1254.8 13 57.21 84.85 12.4 1352.6 14 59.88 94.91 13.4 1471.3

GIRLS

Skin Daily Age Height in Weight in Surface in Calories or Years Inches Pounds Sq. Ft. Food Units

5 41.29 39.66 7.7 784.5 6 43.35 43.28 8.1 831.9 7 45.52 47.46 8.5 881.7 8 47.58 52.04 9.2 957.1 9 49.37 57.07 9.7 1018.5 10 51.34 62.35 10.2 1081.0 11 53.42 68.84 10.7 1148.5 12 55.88 78.31 11.8 1276.8

[B] Sadler, William S., The Science of Living; or, The Art of Keeping Well. A. C. McClurg & Co.



CHAPTER XXXVI

CARETAKERS AND GOVERNESSES

Because of her versatile adaptability to the management of details, woman, all through the ages, has willingly and happily sacrificed herself upon the altar of service. It is not in the province of this chapter to go into the details of the tribal life of the early hordes and clans that came from the north and from the east to establish civilization in the cities of Rome and Britain—space forbids. In this chapter we wish to hold up a picture to the mother, a picture which may speak volumes to her soul; one which perhaps she may ruthlessly throw away—nevertheless, we propose to exhibit it.

HOMEMAKING VS. HOUSEKEEPING

A newspaper woman in my office recently told me a story of a mother who finished her high-school education, took some work in a university, and who yielded to the earnest pleas of her lover-classmate through grammar school, high school and college—and married him. To this happy family there came a number of beautiful children. The mother willingly, lovingly, cared for them during their helpless infancy—made their clothes, managed their meals, opened the door for them as they came home from school, met them with a cheery story, listened to their problems, helped them with their lessons—but all through it, first, last and all the time, she also managed the entire home. She dusted the furniture, changed the curtains, looked after the linen, mended the clothes, and even pressed the trousers of her "rapidly rising" husband that he might go out into his "club life" and enjoy the evenings with his associates. The duties of the day so wearied her, and the night vigils with the sick child,—looking after the little coughs, the uncovered shoulders, getting the drinks of water and performing a dozen other details—that she was too weary to accompany her husband to the dance, to the theater, to the social gathering or to ladies' night at the club; and so, in the course of a dozen years, the mother had grown old, and quite naturally she had grown "home centered." Her world's horizon was the walls of her home. She was happy and quite contented in her children's smiles, in the cheery "how do you do" of her husband, in the fact that that gravy was good or that steak was fried to the king's taste.

She was happy and contented until one day when the awakening blow came. In the attic she and her thirteen-year-old son, who was just entering high school, were looking through an old chest when she drew forth some examination reports and some old school cards—holding them up side by side. One set of the cards bore the father's name and the other set the mother's maiden name. In great surprise the boy exclaimed, "Why, mother, I never knew you studied algebra and Latin; why, mother, I never knew you were educated." Her eyes were immediately opened, the scales fell off, she was awakened to the fact that her own son was coming to regard his mother as somewhat inferior, in intellectual attainments, to the father—that she was considered in that home as a mere domestic. True, the steak had been broiled well, the pudding was exquisite, the children's clothes were always in order, the husband's trousers were always beautifully pressed, his ties were cleaned as well as a cleaner could clean them; but where did she stand in her boy's mind and where was she in her husband's mind?

"Do you notice how trim and nice Mrs. Smith always looks? Her clothes are always in the latest style, and she combs her hair so becomingly." Such remarks as this from the well-meaning husband cut keenly, and it is well that they do, for often it is only such remarks that wake up our "home mother."

Dear reader, I want you to ponder this story. I wish to say to the mother who has started out upon a career in life, who has prepared herself for teaching school, for a business career, for story writing, for millinery, for lecturing, or has perhaps graduated in a domestic science course, that she makes the mistake of her life in settling down, just because she has taken another's name, to be perfectly satisfied with becoming the household domestic, the household mender, the household cook.

MOTHERS IN THE PROFESSIONS

I have in my acquaintance scores of mothers in the professions, newspaper women, women who have carved out brilliant careers for themselves, women who have taught school for twenty years while their children have been growing up, women physicians who have risen in the esteem of all their professional brothers and sisters, women who have conducted cooking schools, who have occupied positions of trust in hospitals and in every walk of life, and who have successfully reared children at the same time.

You will pardon me for being personal when I say that since our own little fellow was six weeks old his clothes have been washed and mended and his food has been prepared by earnest and honest women who had not fitted themselves for the career which this boy's mother had chosen. His mother went to her office, cared for her patients, kept up by the side of her husband in the battle of life. All the time there was a woman at home just devoted to that little fellow.

A newspaper woman recently told me her story—a story which should impress everyone of my readers as it did myself, and she, like many other mothers in the professions, leaves her home as the little fellow goes to school. His hands have been washed, his bowels have moved, his hair has been combed, his breakfast has been eaten by the side of his mother—she has directed it all. He goes forth to the schoolroom and she goes forth to her profession. All through the day she lovingly keeps in mind these children that are growing up. She works the harder, real love entering into everything she does, because she is not merely earning the bread that goes into their mouths, but is forming a character not only for herself but, because of her broadened horizon, is instilling into their little minds the possibilities of their own career, their own opportunity to enter into the world's work as real world workers.

I contend that the mother in a profession has many blessings that the mother who remains at home never has. The mother who remains at home has a viewpoint that is often quite likely, wholly unconsciously, of course, to become small, to become narrow, to become focused upon small details; on the other hand, the mother whose mind and whose heart are so full of the affairs of the office, of the newspaper article she has just written, or the lecture she has just given or is about to give, or the meeting that she is to preside over, is quite likely to become somewhat irritated sometimes if the little fellow doesn't stand quietly to have his hair combed, she is quite likely to "feel rushed;" but under all circumstances, dear reader, whether this mother be a home mother or in a profession, never, never must she allow mental panic to seize her. Ever must we keep in mind that these little ones are just children—children that are still in the developmental stage.

WORK OUTSIDE THE HOME

And now for the home mother. I believe it is necessary and of paramount importance that she get away from her children (if possible) several hours each day; that she provide for them a caretaker who can relieve the children of her or relieve her of the children, whichever way you may look at it, for we are inclined to think that the children often tire of the mother just about as often as the mother tires of the children. I would have the woman who remains at home, whose husband is able to provide outside help for the heavy work of the house, enter into some uplifting neighborhood work, social settlement work, church work, wholesome club work—anything but bridge and whist and gambling games. I would have them bring into the nursery a woman who is cheery, who is capable of teaching games, of entertaining and amusing these little folks under their own roof.

The woman who has graduated from high school, who has a diploma to teach, I would have take a school or, at least, do substitute work. She will be happier—far happier—continuing along the lines for which she has prepared herself, even if all the money she earns be used to pay the help. Some women are especially fitted for the important work of mother and homemaker, and such wives will find for themselves a worthy career in the home and its neighborhood activities. Each woman must find a field of action suited to her own temperament, education, experience, talents, and opportunities.

SELECTING A CARETAKER

For a caretaker, the professional or business woman should not select an ignorant servant girl; that would be a great mistake—a crime—a violation of the law that should govern the training of these little people who have come to us to be reared and cared for and fitted to occupy their place among the world's workers. As a rule, one soul does not possess the qualifications for scrubbing and laundry work and also the firm but gentle ministering qualifications necessary for a successful caretaker. They do not combine as a rule. It has been my experience, as a mother with a profession, and that of many others of my acquaintances, that an art student or a music student makes a splendid caretaker. There are hundreds and hundreds of genteel women, with winning manners and beautiful dispositions, who may be obtained to sew on the buttons, wash the faces, and change the clothes of our darlings while we are carrying forward in the world the great work for which we have fitted ourselves during the long struggles of our teens and early twenties.

The young woman who is brought in to care for the child should be above the usual "servant" class. She must eat in our dining-room, she should be welcome in the living-room or sun parlor, and be treated as a respected member of the family. Her salary is usually not large for she realizes that she is given something in that home—something that money cannot buy.

THE UP-TO-DATE MOTHER

Now this young woman (the caretaker) wants to hold her position, and so she is very anxious to carry out in detail the laws and rules that are laid down by the mother. Mother can keep abreast with the world, mother has time to read periodicals that keep her in touch with the great, wide, pulsating affairs of life. She is able to meet more women worth while, and with her husband attend lectures, musicals, theaters, and other places for intellectual culture.

Anyone of my readers need not look four blocks from her home to find a mother who is run down at the heel, whose dresses are calico, whose hat is five or six years old, whose black silk dress (the only one she ever had) is worn shiny or threadbare, who works and saves every penny that she can that her children may look well; and, even when the husband does invite her to go out with him, he will often be confronted with this remark: "John, I would like to go, but really my clothes are a little bit shabby." The world is just full of such women, with their very hearts being eaten out of them for the want of a beautiful gown, a beautiful hat or a pretty pair of evening shoes, and they might have them every one if they would be willing to allow the duties of the household to be presided over by a woman that cannot do the things the mother can do, while she goes out and accrues a number of dollars each week which will more than provide for the things that her soul desires so that she may go well dressed by the side of her husband in quest of that very necessary intellectual culture and social diversion.

The wife of a prominent judge, in my office just this week, said to me that she believed that most of our social and domestic uneasiness was due to the fact that fathers and mothers and children went out together so seldom. The father goes to his club, the children go to their little gatherings, and mother usually stays at home; although of late, she is beginning to realize the value of the women's clubs.

QUALIFICATIONS OF THE GOVERNESS

The caretaker should not be too old. It is a very great blessing if there is an older sister in the family who can come in and assist with this work, or if there is an aunt. If one is to be selected from the open market, then we suggest a woman in her late teens or early twenties whose heart is full of play, whose face is sunny, and who is young enough to appreciate and like the becomingness of youthful dress. It is needless to say she should be free from tuberculosis and other diseases. She should be trustworthy enough not to administer soothing syrups because the children won't sleep, or to give candy when mother has forbidden her, or to teach the children bad habits of any sort.

It is impossible to exercise too much care in the selection of this substitute mother, and when you do find one it is often wise not to keep her too long. A year or so is plenty long enough for any person to be with our children. It is only necessary for anyone to walk out into the public parks and casually listen to the conversations of many of the "chewing-gum caretakers" to discover with what carelessness some people select caretakers for their children. The language they use is not only ungrammatical but oftentimes both slangy and profane. The flirtations carried on with many of the park policemen and bystanders lead us to feel that many people arrive at the idea that their little folks "will grow up some way." If the caretaker is a student, a young woman of culture, and is kept with the family, she will be found to be more circumspect and dependable. Her gentleman friend, if she has one, should be allowed to come to the home. She does not have to meet him out in the park any more than a sister would have to go away from home to meet a friend; and, to my mind, everything centers around the viewpoint of the mother as she selects this caretaker, for if she is her social equal it puts her in a different place entirely to the well-meaning but ignorant servant girl to whose care is often intrusted the lives of the little people.

HINTS FOR THE CARETAKER

There are a number of hints we wish to bring together in this chapter for the mother to suggest to the caretaker. For instance, here is a group that one author gives us:

BABY IS HAPPY BECAUSE

He is dry. He is healthy. His food is right. He has sleep enough. His meals are on time. He is dressed properly. He is bathed regularly. His habits are regular. His bowels move regularly. He has fresh air day and night. He is not dosed with patent medicines. He is not excited by frequent handling. He is not annoyed by flies or other insects.

THINGS BAD FOR BABIES

Candy. Pacifiers. Thumb-sucking. Soothing syrups. Patent medicines. Waterproof diapers. Moving picture shows. Sucking on empty bottles. Being kissed on the mouth. Play of any sort after feeding. Sleeping in bed with the mother. Whiskey or gin for supposed colic. Sneezing or coughing in the face. Irregular or too frequent feedings. Sleeping on the mother's breast while nursing. Spitting on handkerchief to remove dirt from baby's face. Allowing a person with a cough or a cold to hold the baby. Violent rocking, bouncing, and rollicking play at any time. Dirty playthings, dirty nipples, dirty bottles, dirty floors. Allowing any person with tuberculosis to take care of the baby. Testing the temperature of the baby's milk by taking the nipple in the mouth.

THINGS TO REMEMBER

Keep baby out of dust. Don't cover his face. Don't rock him to sleep. Keep baby away from crowds and sick people. Don't neglect a sore throat or a running ear. His health, growth, and happiness depend largely upon you. Cats and dogs have no place about a baby. They carry disease. The baby is not a toy or a plaything, but a great responsibility. Don't wipe out baby's mouth. It tends to cause ulcers and thrush.

OVERCOMING BAD HABITS

There are a few bad habits which older children fall into such as lip-sucking or thumb-sucking or finger-sucking which not only narrow and deform the upper jaw, but likewise deform the hand itself. They should be stopped at the earliest opportunity by pinning the sleeve to the bedding or putting mittens on the hand or putting a slight splint on the anterior bend of the elbow. Some children suck their handkerchiefs, or bite holes in their aprons and neckties.

Children often bite their finger nails, and a habit of this kind fully developed during early childhood often remains with them throughout life; whenever a nervous spell seizes them they instantly begin to bite their finger nails. Other people pick their nose when nervous, so during very early childhood these habits should be discouraged. One mother helped her little son by beautifully manicuring his nails for him each week. Another child was cured by old-fashioned spanking. The finger tips may be painted with tincture of aloes, or dipping the tips of the fingers in strong quinine water will sometimes help. I know of nothing better for the adolescent child than to teach him how properly to manicure his own nails. Another bad habit that children often get into is stooping or allowing the shoulders to become rounded. Shoulder braces are not indicated in these cases. The children should be allowed to enter the gymnasium or the father should take off his coat and vest and go through gymnasium stunts with the boy. The mother can do the same for the girl. It is often the case that round-shouldered children are near sighted. The child really has to stoop to see things. When a child holds his head to one side constantly on looking at objects, astigmatism, an error of eyesight, is usually indicated. An eye specialist should be consulted, the eyes examined, and properly fitted eye glasses should be worn.

Just as early as possible in the life of the little child he should be taught to blow his nose, to spit out the coughed up mucus from his lungs, to hold out his tongue for inspection and to allow his throat to be examined. He should be taught to gargle, and to regard the physician as one of his best friends. Attention to these minor accomplishments will make it very easy indeed for the physician in case of illness.



CHAPTER XXXVII

THE POWER OF POSITIVE SUGGESTIONS

A child is the most imitative creature in the world. Before he is out of pinafores he tries to talk and act just like his elders. It is because of this inherent tendency to say and do those very things which he hears others say and do, that, if faith-thoughts are early and constantly suggested to the unfolding mind of the child they will assist greatly in evolving a character of joy, confidence, and courage. On the other hand, if fear-thoughts are continuously sown in the young mind they will eventually distort the emotions, deform the conceptions, and wholly demoralize the health and life activities of the growing child. Within the limitations of the possibilities of hereditary endowment, and in view of this wonderful imitative nature, we are able to make of a child almost anything we desire; not "an angel," in the ordinary acceptation of the term, but a child who knows his place and possesses the power of normal self-control.

EARLY FEARS

From two to six years of age, when the imagination is most plastic and vivid, when the child's imitative instinct is so unconsciously automatic, is the most effective and opportune time to initiate good habits and lay the foundations for the later development of a strong and noble character. "Baby's skies are Mamma's eyes" is just as true as it is poetical. While a tired and worn-out mother, exhausted by a multitude of harrassing household cares, may be pardoned for her occasional irritability, nevertheless the little one unconsciously partakes of her spirit. When the mother is happy the child is happy. When Mother is sick and nervous the child is impatient and irritable.

It is unfortunate that this very time of a child's life, when we can do practically anything we choose with him, is the very time when so many parents fill the child's mind with the unhealthful fear-thoughts. "The bogie man'll get you if you don't mind Mamma," or, "I'll get the black man to cut your ears off," or, "the chimney sweep is around the corner to take bad little boys," are familiar threats which are so frequently made to the little folks. These efforts to terrorize the young child into obedience never fail to distort the mind, warp the affections, and, more or less permanently, derange the entire nervous system. The arousal of fear-thoughts and fearful emotions in the mind of the growing child is very often such a psychologic and a physiologic shock to the child that the results are sometimes not wholly eradicated in an entire lifetime.

Just see how far we carry this unwholesome introduction of fear-thoughts—even to the Almighty. Thousands of us remember being told as a child that "God don't like naughty boys," or, "God will send the bad man to get you if you don't be good." Thus, early in life, an unwholesome fear of the Supreme Being is sown in the mind of the child, and, as time passes, these false fears grow and come so to possess the mind and control the emotions that in adult life this early teaching comes to mold the character and shape the religious beliefs of the individual.

To the child who has been reared to dread God, who has come to look upon the Creator as an ever present "threat," how is it possible to convey the beautiful teaching of His fatherhood?

FEAR OF NOISES

How frequently some unusual noise leads a parent to say: "Keep still! What was that? Did you hear that noise?" The little folks of the family are startled, their eyes grow large and their faces pale, while they cling to the frightened mother. Of course, investigation usually shows that the strange and alarming noise was merely the slamming of a cellar door, the rattling of a curtain in the wind, some one walking about downstairs, or the action of the new furnace regulator in the basement. But meantime the harm is done to the children—fear, the worst enemy of childhood, has been unconsciously planted in the mind by the thoughtless and nervous parent.

FEAR OF DARKNESS

Consider for a moment the thousands of children who are early taught an abnormal fear of the dark. Even when the child is absolutely free from such a fear, when sent into a dark room some member of the family will thoughtlessly remark, "Do you think it is quite right to send that child into that dark room? Suppose something should happen." The child quickly catches the suggestion that something is supposed to be or happen in the dark, and in his mind is sown the seed of fear.

When our boy was about two years old he was carried one night to the window by a caretaker, and as they looked out into the darkness the young woman said, "Boo! dark!" The little fellow shuddered, drew back and repeated, "Boo! dark! Boo! dark!"

That night, as was our custom after the evening story, we tucked him in his little bed, turned out the light, and saying, "Sweet dreams, Darling," closed the door. Imagine our surprise to hear, "Mamma, Mamma, Willie 'fraid of dark, Willie 'fraid of dark," and it was with difficulty that he was induced to go to sleep in the dark. Immediate inquiry revealed the occasion of his fears, and the next night we set about to eradicate the fear of darkness from the little fellow's mind.

For ten successive nights we took his hand, and, leading him into a dark room, said, "Nice dark, restful dark; we go to sleep in the dark; we're not afraid of the dark, no." Each night, save one, we were met with, "No, no, naughty dark. Willie 'fraid of dark." On the tenth night as we entered the room as usual, repeating, "Nice dark, restful dark; we go to sleep in the dark; we're not afraid of the dark, no," his little mind responded. Suggestion had at last routed fear and given birth to faith. We had won! But it had taken ten nights of constant work to undo one moment's work of a thoughtless girl. Every night since he has gone to sleep in the dark without a murmur.

THE FOLLY OF MAKING THREATS

Threats only show weakness on the part of the disciplinarian. Most school teachers early learn the folly of making threats. When I was teaching school I recall that a number of slate pencils had been dropped on the floor one afternoon. Thoughtlessly I threatened, "Now the next child that drops a pencil will remain after school and receive punishment!" My fate! The weakest, most delicate girl in the room was the next to drop her pencil, and she was a pupil with a perfect record in deportment. The reader can imagine my embarrassment. I had threatened punishment, and so had to get out of the predicament as best I could. This experience effectually cured me of making such foolish threats.

Most of us live to regret the threats we make. "Your father will thrash you when he comes home tonight," or, "You'd better not let your father see you doing that," or, "You wouldn't behave that way if your father was here," etc., are common threats which we hear directed at headstrong and willful boys. What is the result? Do such threats cause the love of the child for his father to increase? They make the child actually afraid of his father.

"I'll 'bust' your brains out," said a four-year-old to his pet lion, because it wouldn't stand up. Now it should be remembered that these things do not originate in the minds of the boy and girl. They only repeat the things they hear others say. It betrays both cowardice and ignorance to undertake to secure obedience by such threats as "I will box your ears if you don't mind," etc.

Obedience that is worth anything at all is only secured by suggestion and love, never by promises of reward or threats of punishment.

CHILDREN WHO ARE CALLED "COWARDS"

Recently we overheard a little fellow say, "Father says I'm the only coward in the whole family." Looking him straight in the face we said to him: "You're not a coward. Such a fine boy as you couldn't possibly be a coward." The boy was greatly amazed, and, as we left him, he was saying over to himself, "I'm not a coward. She said I'm not a coward," finally adding, "She said I couldn't be a coward." This one thought, repeated to him several times and turned over and over in his mind, eventually overthrew the false fears instilled by his father.

A short time ago the daily papers contained the story of the ten-year-old son of a New York business man who drew his few dollars from the savings bank, boarded a train for Chicago, and, after three days of amusement and loneliness, his money all gone, was found in a hotel bitterly weeping. His identity was revealed, the parents were notified at once, and the boy was sent on the first train back to his home. On the way to the station he sobbed out through his tears, "Well, my brother can't call me a coward any more, anyway." Who knows but that this everlasting taunting of the child with the accusation of being a baby or being a coward has much to do with many such escapades and other daring exploits on the part of the juveniles who are chafed by such unjust insinuations? Those of us who are acquainted with the vice and crime of a great city can imagine just what might have happened if this boy had been a little older, if his heredity had not been so good, if his money hadn't run out, if he had been able to remain in the big city long enough to make undesirable acquaintances.

Many criminals have confessed behind prison bars that when they were children they were called cowards. After a while they actually came to believe that they were cowards, and in their efforts to acquire courage and demonstrate their bravery they were led to desperate and even criminal acts. They prowled around the dark alleys just to convince themselves that they were not afraid, that they were not cowards, and there they made the acquaintance of the criminals who led them into new and dangerous paths. Even if a child enters this world handicapped by heredity, let us not lessen his chances of success by adverse suggestion.

Faith-thoughts, thoughts of bravery and of courage, may just as easily be instilled into the mind of the normal child as thoughts of fear and cowardice. A child should never have suggested to him that he is afraid. He should be constantly assured that he is brave, loyal, and fearless. The daily repetition of these suggestions will contribute much to the actual acquirement of the very traits of character that are thus suggested. This does not mean that a child should not be taught caution and forethought.

THE GIRL WHO WOULD "TURN OUT BAD"

Parents do not begin to realize how fearfully dangerous is this habit of constantly reiterated negative suggestion. Let me illustrate by an actual incident: A beautiful girl in a near-by state grew up quietly in the little village until she was eighteen years of age, when suddenly she decided to run away from home, declaring she was old enough to do as she pleased. She confided in one of her girl friends that she was going to Chicago, and had made all arrangements to lose herself in the "redlight" district. All that this girl friend said had not the slightest influence. As the train bore her away to the city and to ruin, a social worker in Chicago was wired to meet her at a suburban station. The girl was met, taken from the train and whisked in a cab to the home of a Christian woman. So possessed was this girl with the idea of throwing herself away that the captain of police was asked to talk to her; but the combined efforts of the police captain, a magistrate, and several Christian people could not persuade her to recall her threat. She declared she would kill herself if her parents were notified. This siege lasted for ten days. Then she finally broke down, saying: "I simply can't help it. All my life my mother has told me that I was going to turn out bad. No matter what would happen at home, if I broke a dish or went out with the young people and remained away ten minutes later than I was told to, it would always be thrown up to me. 'Oh, some day you'll turn out bad.' I have heard it until I am sick of it, and something within seems to push me on and on, telling me I must turn out bad."

Of course the girl was persuaded to believe that these were only fear-thoughts; that she was a beautiful, virtuous girl, that she simply had received the wrong training, that she couldn't possibly turn out bad. She was thus saved by the sympathy and advice of understanding friends, was subsequently married and is today the mother of a splendid boy.

WHAT HEALTHY FAITH-THOUGHT WILL DO

Here is another story which illustrates what healthy faith-thought will do. A young man was not long ago selected for the highest position within the gift of a large religious organization. When he was a lad his parents held this thought constantly before his mind: "David, if you will be a good boy, if you will do what is right, you may some day be President of the General Assembly." He became a minister of the Gospel, a very successful one, and subsequently married a young woman who was also much interested in religious work. She continued to encourage him in this ambition, saying: "David, preach the best sermons you can; make an effort to bring many souls to Christ, and some day I believe you will be President of the General Assembly." The man presided over the General Assembly of his denomination, not one term, but term after term. He kept his eye long fixed on that particular aim, and by faith he won it.

THE POWER OF SUGGESTION

To see how powerful suggestion may be in a child's life take this incident that every parent knows: The little one trips and tumbles. Mamma says, "Oh, did you fall? Well, never mind; come here, I'll kiss it. There, now it's well." Immediately the child goes back to his play perfectly happy. One little fellow was taught that when he fell he should get up at once, rub the bump, and say, "That didn't hurt." All through his career the bumps and the hardships of life were met with the same pluck. On the other hand, a thoughtless caretaker will excitedly jump and catch up the slightly injured child, coddle it, rock it, pet it—and the crying continues indefinitely. This early training in meeting minor hurts and obstacles lasts throughout the lifetime. Pluck and grit are lacking. The behavior of the man in the face of difficulties is foreshadowed by the attitude of the child toward his petty trials and bumps.

Successful child training follows in the path of positive suggestion. Impatient words and careless threats of punishment can only contribute to the wrong training of the young mind.

When is the best time to suggest to the child? Catch the little fellow when he is happiest, when he is overjoyed and filled with glee; for it is at such times that the suggestions offered will meet with the least resistance.

Teach the children through the spirit of play and through the medium of the story. The boy or girl in the story always can have a clean face, always close the doors quietly, and otherwise so conduct himself or herself as to constitute a powerful positive suggestion for good. The story-child always says, "All right, Papa," "All right, Mamma," when corrected.

BEDTIME A GOOD TIME TO SUGGEST

The "going-to-bed time" is the time par excellence for suggestion in early childhood. After the play time, the study time, and the evening story, when all is quiet, in the peacefulness of the darkness, while you are seated in a low chair close beside the little bed, with your hand in his, repeat over and over again the positive suggestions which you desire to take root in the mind and bear fruit in the character. Again and again tell the little fellow that he is the noblest and bravest of boys, that he loves truth and hates deceit. No matter what disturbs him, if it is the lessons at school or a wrong habit, first think out exactly what you desire him to be or to do, and firmly, but quietly, tell it over and over to him.

As a concrete example: Suppose Henry, at three-and-a-half years of age has to be coaxed or almost forced to eat. Say to him: "Now, Henry, you are a good little boy. Papa and mamma love you dearly. If you are going to grow up to be a big man you must not forget to eat; so tomorrow when you go down to the table you will eat everything mamma or nurse puts before you. It won't be necessary for papa to feed you at all; you will eat the potatoes, the gravy, the toast, and the cereal, and drink your milk. You will make mamma very happy, and papa will be proud of you; and then after dinner we will have a good romp, and you will soon grow up to be big enough to have a velocipede and a watch." After two or three evenings of this suggestion you will be surprised to see there is a great difference in his eating.

Take the timid little girl who is unable to recite well at school, who is shy, and has great difficulty with her lessons. At the going-to-sleep time sit by the side of her bed and tell her that tomorrow she will have her lessons better, that she will not any more be afraid, that she will get up and recite without the least fear in her heart. By constantly repeating these suggestions she will be given confidence, and in most cases it will result in effecting the deliverance of the child from her bondage to fear. Never tell her that she is shy or that she cannot do things. Constantly tell her that she is a successful girl with a strong character, and that she is going to make a very useful and courageous woman. Hold high aims and ideals before her. Suggestion cannot atone for all the defects of character which may be inherited, but it can do much to help such unfortunate little ones gracefully bear their burdens.

NEVER ACCUSE CHILDREN OF DISHONESTY

Never tell children that you suspect they are dishonest or untruthful. Be very slow to accuse and suspect them of falsehood or theft. Tell them over and over again they are the best boys and girls in the world; that they are going to make the noblest of men and women; that they love honesty and truth. Even when you discover them in minor faults do not make the mistake of unduly magnifying and emphasizing the error. As soon as possible direct the thoughts and attention of the wrongdoer away from his error, and focus his thoughts and attention on the high goal you expect him to reach. This will not be construed as doing away with proper punishment for persistent faults after the more ideal methods seem to have failed.

A patient recently called us to see her little girl, and as we made ready to make the examination the mother said: "Now, Mary, stop your playing and come and be undressed and let the doctor look at you."

"I don't want to stop playing," murmured Mary.

"But you must come. You know you don't feel well at all, your cheeks are so red. Now swallow and see if it don't hurt. Now try again. I know you don't feel well." By the time we had begun our examination Mary began to succumb to her mother's suggestions, and began to feel a trifle indisposed. She was being made temporarily ill by the unwise and unfortunate suggestions of the overanxious mother. The examination revealed that there was nothing whatever the matter with her.

IT IS EASY TO FORM GOOD HABITS

Let us get the truth firmly into our minds as parents that it is just about as easy to form a good habit as a bad habit, just about as easy to acquire helpful, happy thoughts as those that are injurious; and we can do it, if we will but see to it that our children early form correct and proper habits of thinking and acting. While the children are taught proper respect for authority, let fear be an unknown word to them. Don't let a thought of the fear of insanity, of haunted houses, of drafts, of this and of that enter into your home. Instead, live in the glorious sunshine of strong, healthy, faith-thought, and a supreme happiness will come into your life, and you will give a legacy to your children for which they will "rise up and call you blessed."