:.' " n-r. "'ri;"-fe'"^if|i!| ■lit I VfB&WiSi iH-.i^^isli liaiiijiilaM^ SSL ;.;■■■ :,;^ !»!»;' M ;l-r t;;!Hm!l "'■■■ ■ :'.'V'::,,::i';|'"'v: n #» f ^ £ PRINTED AND SOLD BY JOHN ]£lOREN? No. 88 CHESNUT STREET. 18Q4. ANNS* \ CONTENTS. Page INTRODUCTION ... 1 CHAP. I. Hints to Women before Marriage . 5 CHAP. II. Rules of Conduct during Pregnancy . 18 CHAP. III. A few Remarks on Childbirth . 63 CHAP. IV. Of the Nurfing and Rearing of Children 84 Sect. I. Of the Influence of Air on the Health and Lives of Children . 85 Sect. II. Of Warm and Cold Bathing . 96 Sect. III. Of Children's Dress . . 107 Sect. IV. Of the Injury done to Children by the too early and unnecessary Use of Medicines • . • 142 Sect. V. Of the Feod proper for Children 163 Sect. VI. Of Exercise and Rest during In- CONTENTS. Of Dwarfi^hnefs and Deformity . 195 CHAP. VI. Baneful Effects of Parental Tendernefs, or what may be called an extremely delicate and enervating Education . . 207 CHAP. VII. Of Employments unfavourable to the Growth aad Health of Children . . 233 CHAP. VIII. Of Accidents . 249 CHAP. IX. Of Foundling Hofpitats, and other Charita- ble Inftitutions for the Rearing of Poor or Deferted Children .... 266 CHAP. X. Sketch of a Plan for the Prefervation and Improvement of the Human Species 283 APPENDIX.....297 INTRODUCTION. THE prefervation of the lives of infants was the firft fubject. I wrote upon at the open- ing of my medical career; after forty years practice, I now refume it with increafed zeal and pleafure,—zeal, prompted by a juft fenfe of its importance,—and pleafure, arifmg from the hope of its beneficial and lading effects. I am fure of being liftened to with kind atten- tion by the tender and rational mother, while I am pointing out to her the certain means of preferving her own health, oflecur- ing the attachment of the man (he holds dear, and of promoting the health, flrength, and beauty of her offspring. She will not take alarm at the idea of medical advice, when I tell her that my object, is to enable her to do without medicine, and to obtain every defira- ble end without any painful facrifice. The path along which I propofe to conduct her is plain and eafy, the profpe6ls all round are delightful, and it leads to the pureft fources of happinefs. The more I reflect, on the fituation of a mother, the more I am (truck with the ex- B 2 INTRODUCTION. tent of her powers, and the ineftimable value of her fervices. In the language of love, women are called angels; but this is a weak and a filly compliment; they approach nearer to our ideas of the Deity: they not only create, but fuftain their creation, and hold its future deftiny in their hands: every man is what his mother has made him, and to her he mufl be indebted for the greatefl bleffing in life, a healthy and a vigorous constitution. But while I thus fpeak of the dignity of the female character, it mufl be underftood, that by a mother I do not mean the woman who merely brings a child into the world, but her who faithfully difcharges the duties of a pa- rent,—whofe chief concern is the well-being of her infant,—and who feels all her cares amply repaid by its growth and activity. No fubfequent endeavours can remedy or correct. the evils occafionedby a mother's negligence; and the fkill of the phyfician is exerted in vain to mend what fhe, through ignorance or inat- tention, may have unfortunately marred. Several books have been written on the cure of difeafes incident to children. The natural effect of fuch publications is to excite INTRODUCTION. terror, and to prompt mothers and nurfes to keep dofvng poor infants with drugs on every triding occafion, and to place more reliance on the efficacy of medic:ne than on their own bed endeavours. One of the objefts which I have in view is to relieve mothers from ground- less fears,—to teach them how to prevent dif- eafes that are almod always the confequences of mifmanagement,—to infpire them with the fulled confidence in proper nurfing, and with drong prejudices againd the ufe of medicines, which do mifchief twenty times for once that they do good. Quackery in the nurfery is not the only er- ror in which'l fhall endeavour to undeceive mothers. The want of proper indruclions at an early period of life betrays them into a variety of fatal midakes reflecting their own health, as well as that of their children. Thefe midakes, and the means of rectifying them, form a considerable part of the follow- ing work. The language is adapted to every capacity, it being of confequence that every woman fhould underftand it; and the rules laid down are practicable in every condition, except that of cheerlefs poverty. With the hope of removing this exception, I (hall point 4 INTRODUCTION. out the mod effectual method of aflifting women fo circumdanced; and I do not know any manner, in which humanity, charity, and patriotifm can be more laudably exerted, or even a part of the public revenue more ufefully employed, than in enabling mothers to bring up a healthy and hardy race of men, fit to earn their livelihood by ufeful employments, and to defend their country in the hour of danger. ADVICE TO MOTHERS. CHAP. I. HINTS TO WOMEN BEFORE MARRIAGE. THE defire of preferving and improving perfonal beauty, which difcovers itfelf at an early period in the female bread, is wifely defigned by nature for the bed and mod im- portant ends ; it is a powerful check on ex- ceffes of every kind, and is the drongeft in- citement to cleanlinefs, temperance, moderate exercife, and habitual good-humour. All that is neceffary is to convince young people that thefe are the true means of rendering them lovely, becaufe they are the only means of fecuring the enjoyment of health, the very effence of beauty; indead of fourly difcourag- ing fo natural a wifh, let us point out the way to its full accomplifhment, and thus prevent many amiable women from taking a wrong road, and from dedroying both health and beauty by an abfurd purfuit of the latter alone. 6 HINTS TO WOMEN One of the fird truths to be imprefled upon the minds of young women is, that beauty cannot exid without health, and that the one is abfolutely unattainable by any practices in- confident with the other. In vain do they hope to improve their fkin, or to give a lively rednefs to their cheek, unlefs they take care to keep the blood pure, and the whole frame active and vigorous. Beauty, both of fhape and countenance, is nothing more than vifible health,—the outward mirror of the date of things within,—the certain effe6t of good air, cheerfulnefs, temperance, and exercife. There is nothing, perhaps, fo pernicious to women as the ufe of creams, and pades, and powders, and lotions, and numberlefs other contrivances to bleach the fldn, or to produce an artificial white and red. All of them act with double injury, not only in dedroying the furface which they were expected to beautify, but in poifoning the habit, and caufing a fatal neglect of the great prefervatives of life itfelf. A blotch or a pimple, however offensive to the eve. gives timely notice of the impure date of the fluids, and of the kind efforts of nature to expel the noxious matter. Ought not thefe efforts then to be aflided by a judicious plan BEFORE MARRIAGE. J of diet and regimen, indead of throwing back the impurity into the blood, and converting the very means of health into the feeds of in- fection and difeafe ? Befides, lead or mercury is the chief ingredient in all thofe boaded cof- metics, and, being abforbed through the fkin, cannot fail to occafion cramps, fpafms, con- vulsions, colics, and the incurable train of ner- vous and consumptive complaints. Beauty is impaired, and health too often dedroyed, by other abfurd practices, fuch as drinking vinegar to produce what is called a genteel or flender form, and avoiding exposure to the open air, for^fear of its injuring the fancied delicacy of a fine dun. * Vinegar, ufed as fauce and in moderate quantities, ferves to correct the putrefcent tendency of various ar- ticles of food, and is equally agreeable and wholefome; but when fwallowed in draughts for the purpofe of reducing plumpnefs, it proves highly injurious, caufing excessive per- foration, relaxing the bowels, imparting no fmall degree of acrimony to the blood, and very much enfeebling the whole fydem. The dread of open air is dill more ridiculous and detrimental. Look at the healthy texture of the milkmaid's fkin, and at the rofes ever 8 HINTS TO WOMEN blooming on her cheek, and then consider whether the open air can be unfavourable to beauty. The votaries of fafhion may affect to defpife thafe natural charms, and to call them vulgar: the heart of man feels their irrefidible attraction, and his underdanding confirms him in fo jud a preference. Surely, the languid fickly delicacy produced by confinement, can- not be compared to the animated glow of a face often fanned by the refrefhing breeze! The woman, therefore, who feels a lauda- ble wifh to look well, and to be fo in reality, mud place no confidence in the filly doctrines, or the deceitful arts, of fafhion. She mud confult nature and reafbn, and feek for beau- ty in the temple of health; if fhe looks for it elfewhere, fhe will experience the mod morti- fying difappointment: her charms will fade ; her conditution will be ruined ; her hufband's love will vanifh with her fhadowy attractions; and hef nuptial bed will be unfruitful, or curfed with a puny race, the haplefs victims of a mother's imprudence. She cannot tranf- mit to her children what fhe does not herfelf poffefs; weaknefs and difeafe are entailed up- on her poderity; and, even in the midd of wedded joys, the hopes of a healthy and vigo- rous iffue are bladed for ever. BEFORE MARRIAGE. 9 The only way to prevent fuch evils is, to pay a due regard to thofe rational means of promoting health which I have already hinted at,—temperance, exercife, open air, cleanli- nefs, and good-humour. Thefe fubjects are pretty fully difcuffed in my " Domeflic Medi- cine ;" yet a few remarks may be proper on the prefent occafion. In laying down rules of temperance, I do not wish to impofe any redraint on the mode- rate ufe of good and wholefome food or drink: but under thefe heads we mud not include fpi- rituous liquors; relaxing and often-repeated draughts of hot tea and coffee; faded, fmoke- dried, and highly-feafoned meats; fait fifh ; rich gravies ; heavy fauces; almod indigedi- ble padry; and four unripe fruits, of which women in general are immoderately fond. We pity the green-fick girl, whofe longing for fuch trafh is one of the caufes as well as one of the effects of her difeafe ; but can any wo- man, capable of the lead reflection, continue to gratify a perverfe appetite by the ufe of the mod pernicious crudities? Fruit, in the fea- fon of its maturity, is no lefs falutary than de- licious. By plucking and eating it before it is ripe, you defeat the benignant purpofes of c 10 HINTS TO WOMEN nature, and will feverely feel her refentment. The morning is the bed time to eat fruit, when the domach is not loaded with other aliment. Even in the evening I had rather fee it intro- duced, than the enervating luxuries of the tea- table, or the dill worfe preparations for a sup- per of animal food. A meal of this fort fhould not be made twice in one day. After a hear- ty dinner, a long interval is neceffary before nature can require, or even bear without in- jury, another fubltantial repad. Suppers are doubly prejudicial on account of the latenefs of the hour, and the danger of going to bed with a full domach. Apoplexies are often occafioned by fuch inconsiderate and unfea- fonable indulgence, but its certain effects are redles nights, frighful dreams, broken and un- refrefhing flumbers, an incapacity of early ri- sing next morning, head-achs, palenefs of af- pect, and general relaxation. WThoever fets any value on health or beauty, will always make very light repads at night, and will go to bed early; that is to fay, never later than ten or eleven o'clock, in order to enjoy fweet repofe, and to rife betimes, with renovated drength and alacrity, to the pleafures and du- ties of the enfuing day. BEFORE MARRIAGE. H Pure air and moderate exercife are not of lefs importance than food and drink. Women are much confined by their domedic employ- ments and fedentary purfuits : for this very rcafon they ought to go out frequently, and take exercife in the open air,—not in a clofe carriage, but on foot or on horfeback. When prevented by the weather from going abroad, dancing, provided it be not continued to fa- tigue, is the mod cheerful and healthy amufe- ment within doors. The only fedentary di- versions proper for women are playing on fome mufical indrument, finging, and reading aloud delightful pieces of poetry or eloquence-. Young ladies and mothers fhould wholly re- sign the card-table to old maids, who can on- ly injure their own health, and who have no tadc for any other mode of focial intercourfe. It may feem a little drange that I diould think it in any fort necceffary to recommend cleanlinefs to the fair fex : I am far from in- tending to convey the mod didant infinu- ation of their negligence in this refpect ; I on- ly wifh to heighten their ideas of its utility, and to point out farther methods of increas- ing its benefits. They are rather too fparing of water, from an apprehension bf its injuring 12 HINTS TO WOMEN the skin, or giving it a disagreeable roughnefs. This is a great midake. Pure water may be truly considered as a fountain of health, and its frequent ufe is the bed means of improving the fkin and drengthening the whole frame. The offices performed by the fkin are of great- er importance than mod people imagine. It is not merely a covering or fhield to guard the fine organs of feeling from irritation or ex- ternal injury, but one of the grand outlets ad- mirably contrived by nature for expelling the noxious and superfluous humours of the body. The perfpirable matter thus thrown out will of itfelf clog the pores, and relax the fkin, unlefs care is taken to promote its eafy efcape by keeping the entire furface of the body per- fectly clean, well-braced and eladic, which can only be done by frequent wafhing, and indantly wiping the parts dry. Thofe who have not a bath to plunge into, fliould wafh the face, neck, hands, and feet, every morning and night; and experience will foon convince them, that, the more they accudom them- felves even to this partial application of clean water, the more comfortable and enlivening they will find it. If mifguided tendernefs has produced an extreme delicacy of habit as well as of fkin, it will be proper to ufe lukcv.-arm BEFORE MARRIAGE. 13 water for fome time; and then gradually to diminifh its temperature, till cold water can be employed, not only with fafety, but with benefit. As a prefervative of health, it is far more bracing and more invigorating than warm water, though the latter may be often advifeable in cafes of particular infirmity, in- difpofition, or difeafe. All women of delicacy and good fenfe are sufficiently attentive to remove any outward foil or vifible dirt from their perfon ; but they do not all know, that a vapour, too fine to be perceived by the eye, is condantly iffuing from the pores, the little orifices or mouths of which mud therefore be kept clean and un- obdructed. For the fame reafon, the linen and interior articles of drefs fhould be often changed, as they become impregnated with the perfpirable matter, and, when foul, would not only prevent the efcape of any more, but would even have a part of what they had re- ceived re-abforbed by the fkin, and thrown back into the fydem. The whole drefs alfo fhould be loofe, and as light as may be found confident with due warmth, fo as not to in- creafe perfpiration too much by its heavinefs, 14 HINTS TO WOMEN nor to check either that or the free circula- tion of the blood by its preffure. Among many improvements in the modern fafhions of female drefs, equally favourable to health, to graceful eafe and elegance, the dif- continuance of days is entitled to peculiar ap- probation. It is, indeed, impossible to think of the old draight waidcoat of whalebone, and of tight lacing, without aftonifhment and fome degree of horror. We are furprifed and fliocked at the folly and perverfenefs of employing, as an article of drefs, and even as a perfonal ornament, what mud have, checked youthful growth—what mud have produced didortions and deformity—besides occasion- ing various irregularities and difeafes. I need not point out the aggravated mifchief of fuch a preffure on the breads and womb in a date of pregnancy ; but I mud notice a defect very prevalent among young women of the prefent day in London, who, though they have not worn days, may be fairly prefumed to inherit from their mothers fome of the pernicious effects of fuch a cudom. The injury to which I allude, is the want of nipples. This unnatural defect feems to have \ BEFORE MARRIAGE. 1^ Originated from the ufe of laced days ; and as children fb often rcfemble their parents in out- ward form, it is not improbable that the daugh- ter may bear this mark of a mother's impru- dence, and may even tranfmit it to her own female children. Where days have never been ufed, the want of a nipple is as extraor- dinary as the want of a limb ; and no mother is found thus difqualified from difchargingone of her mod facred duties. But, in London, the indances are too frequent to be afcribed to accident, and cannot, perhaps, be accounted for more satisfactorily than in the manner here fuggeded. In my fummary of the means of promoting health and beaut), cheerfulnefs or good hu- mour is mentioned the lad, though certainly it is not the lead in point of efficacy. It has the happied influence on the body and mind; it gives a falutary impulfe to the circulation of the blood, keeps all the vital organs in eafy and agreeable play, renders the outward de- portment highly pleafing, while the perpetual sunshine within fpreads a fafcinating lovelinefs over the countenance. Its oppofite, peevifh- nefs, or ill humour, embitters life, faps the conditution, and is more fatal to beauty than l6 HINTS TO WOMEN the fmall-pox, becaufe its ravages are more certain, more difguding, and more permanent. Such are the chief points which I wifh to imprefs upon the minds of women before mar- riage. Objects of fo much importance in every dage or period of life, are defer ving of pe- culiar regard when an union of the fexes is propofed. It is little fhort of intentional murder on the part of a weak, languid, nerv- ous, or deformed woman to approach the marriage-bed. Improper paffions may urge her to become a wife; but fhe is wholly unfit to become a mother. She rifks her own life, —fhe difappoints the natural wifhes of a hufband,—and fhould fhe have children, her puny, fickly offspring, as I before obferved, will have little caufe to thank her for their wretched exidence. The evil is not confined to her own family; fociety at large is materi- ally injured; its well-being depends on the vigour of the members that compofe it; and univerfal experience has fully proved, that the frame of a hufbandman or a hero is not to be moulded or cherifhed in the womb of debi- lity, and that the bold eagle will never be brought forth by the timid dove. :% BEFORE MARRIAGE. IJ I cannot conclude thefe hints without add- ing a few words on the choice of a hufband. Having endeavoured to prove that health is fo indifpenfable a requifite in females before marriage, they may well fuppofe that I deem it no lefs neceffary in the other fex. I am always forry to fee that precious blessing facri- ficed in an alliance with infirmity, or youth and beauty configned to the frozen arms of age. Mifery mud be the inevitable confe- quence of fuch unnatural matches. But I fear that my remondrances will have little effea in redraining the undue exercife of pa- rental authority, or in attempting to open the eyes of a woman to her certain dedruction, when fhe suffers herfelf to be dazzled by the fplendor of riches, or charmed by the found of an empty title. D l8 RULES OF CONDUCT CHAP. II. RULES OF CONDUCT DURING PREGNANCY. AFTER what I have already faid on the fubject of health, I hope I need not make ufe of any new arguments to convince women of its increafed importance the moment they conceive,—a moment from which they may begin to date the real perfection of their being. Nature has now entered upon her grandeft work, and nothing is wanting but the mother's care to complete it. The exertions of this care are not left to whim, to caprice, or even to the drong impulfes of parental love. The felf-prefervation of the mother is made de- pendent on the proper difcharge of her duty; her own health, her drength, her very life are clofely entwined with the well-being of the embryo in her womb ; nor can die be guilty of the lead neglect, without equal danger and injury to both. I am forry to think that any awful warning' mould be neceffary to check the commiffion of fo wicked an outrage upon nature, as an attempt to procure abortion. This can never DURING PREGNANCY. ig be effected without either the probable death of the mother, or the certain ruin of her con- ftitution: the dimulants which are ufed to force the womb prematurely to difcharge its facred depofit, mud inflame the parts fo as to caufe a mortification; or will convulfe and en- feeble the whole fydem in fuch a manner as to leave no chance of future health or enjoy- ment to the dedroyer of her own child. In the ancient hidory of the Jews, we read of two harlots warmly contending for a living child. How different is the cafe with our women of that defcription!—Their wifh, if they conceive, is to prevent or to dedroy the life of the embryo, even at the riflt of their own. Is a monder of this fort to be pitied, when, in the execution of her fhocking pur- pofe, fhe brings on thofe deadly fymptoms which mud foon clofe her guilty career? The unnatural mother, however, is not al- ways the only monder concerned in thofe fcenes of horror : her bafe feducer is too often the advifer of the defperate refolution, and crowns his guilty joys with double murder! Another ruffian, fome male or female practi- tioner in midwifery, is alfo engaged in the hellifh plot, and lends a hand to perpetrate $0 RULES OF CONDUCT the foul-deed, alike regardlefs of the mother's danger, and deaf to the cries of infant blood! I never read, without fliuddering, any adver- tifement of temporary retreats or pretended accommodations for pregnant ladies: I always view it as a wTicked allurement to unfortunate ^omen, and as a daring hint from fome ready affaffm of innocence. It is not long fince one of thofe wretches .was convicted of killing both mother and child; and I have myfelf feen a great number of embryos exhibited by a man, who, I firmly believe, obtained them in this way. The dread of public fhame or of private fcorn, though no excufe for murder, may urge the victim of feduction to commit a crime at once fo abominable and fo dangerous. But is it poflible that a married woman fhould madly and wickedly attempt to procure abor- tion, merely from an apprehenfion of a large family, or to avoid the trouble of bearing and bringing up children? Can fhe hope to tade the joys, and yet dedroy the fruits of love? What a frantic idea!—The fame poifon puts an end to both. And in vain does fhe flatter herfelf that her guilt is concealed, or that no law exids to punifh it. The laws of nature DURING PREGNANCY. 21 are never violated with impunity; and, in the cafes alluded to, the criminal is made at once to feel the horrors of late remorfe, and the keened pangs of a torn, difordered, and in- curable frame. But fuppofe that a mifcarriage brought about by fuch detedable means did not endan- ger the health and life of the mother, fuppofo that an act held in fuch jud abhorrence, both by earth and heaven, could poffibly efcape punishment: fuppofe a woman, deaf to the cries of nature, incapable of tender emotions, and fearlefs of any immediate sufferings in her own perfon.—I have one argument more to make her dop her murderous hand : perhaps the embryo, which fhe is now going to dedroy, would, if cherished in her womb, and after- wards reared with due attention, prove the fweeted comfort of her future years, and re- pay all her maternal care with boundlefs gra- titude. It may be a daughter to nurfe her in her old age, or a fon to fwell her heart with joy at his honourable and fuccefsful career in life. I only wifh her to paufe for a moment, and to consider, that, by the wilful extinction of the babe in her womb, all her faired hopes are extinguished alfo, and that the prefent 22 RULES OF CONDUST danger is aggravated by the certainty of future defpair. A wifh to prevent even one act of fo much horror has induced me to dwell on this unplea- fant part of my subject. But folly, ignorance, and carelefsnefs, are often productive of as fatal effects as a criminal defign ; and though I may not be able to redrain the latter, yet I hope the former may be corrected by better information. With this view, I fhall make fome farther remarks on the great prefervatives of health mentioned in the preceding chapter. The general rules there laid down hold good in every condition of life; but a date of preg- nancy requires a greater degree of care and judgment in their practical application. Cheerfuinefs, or good-humour, which be- fore was placed lad in the order of difcuflion, mud now take the lead, being fuperior to all other confiderations during pregnancy. In this date, more than in any other, the changes of bodily health feem to be almod wholly un- der the influence of the mind; and the mother appears well or ill, according as fhe gives way to pleafant or to fretful emotions. I admire that fragment of ancient hidory, in which we DURING PREGNANCY. 23 are informed, that the eadern fages, while their wives were pregnant, took care to keep them condantly tranquil and cheerful, by fweet and innocent amufements, to the end, that, from the mother's womb, the fruit might receive no impressions but what were pleafing, mild, and agreeable to order. So fine a leffon of wifdom, and of parental, as well as conju- gal love and duty, cannot be too clofely ftu- died, or too diligently carried into practice, by the hufband who fets any value on his wife's health,—who wifhes to fecure her affec- tion and gratitude,—and who pants for the exquisite happinefs of being the father of a lively, well-formed, and vigorous child. It is during pregnancy alfb that every wo- man fhould be doubly attentive to preferve the utmod fweetnefs and ferenity of temper,—to difpel the glooms of fear or melancholy,—to calm the rising guds of anger,—and to keep every other unruly paffion or defire under the deady controul of mildnefs and reafon. The joy of becoming a mother, and the anticipa- ted pleafure of prefenting a fond hufband with the deared pledge of mutual love, ought na- turally to increafe her cheerfulnefs, and would certainly produce that effect, were not thofe 24 RULES OF CONDUCT emotions too often checked by a falfe alarm at the fancied danger of her fituation. It is therefore of the utmod importance to con- vince her, that her terrors are groundlefs ;— that pregnancy is not a date of infirmity or danger, but affords the dronged presumption of health and fecurity ;—that the few inflan- ces die may have known of mifcarriage or of death, were owing to the improper conduct of the women themfelves, besides being too inconsiderable to be compared with the count- lefs millions of perfons in the like condition, who enjoy both then and afterwards a great- er degree of health than they ever before ex- perienced ;—and, ladly, that the changes which fhe feels in herfelf, and her quick per- ceptions of uneafinefs, are not fymptoms of weaknefs, but the confequences of an increafed fenfibility of her womb, and timely warnings of the effects of indifcretion or intemperance. A late writer on this fubject very jud- ly obferves, that, when fuch an increafe of fenfibility takes place in a woman of a very irritable frame and temper, it mud certainly aggravate her former complaints and weak- ness, and produce a variety of feverifh ef- * DURING PREGNANCY. 25 fects. She grows more impatient and fret- ful : her fears as well as her angry paffions, are more readily excited : the body neceffarily suffers with the mind: debility, emaciation, and many hectic fymptoms, follow. But the only rational inference to be drawn from thefe facts is, that the feelings are more acute in a date of pregnancy; and that agy previous in- difpofition, either of body or mind, now re- quires a more than ordinary degree of care and tendernefs. Though the chilling influence of fear, and the depressions of melancholy, are very inju- rious to the mother's health and to the growth of the fatus in her womb ; yet anger is a dill more formidable enemy. It convulfes the whole fydem, and forces the blood into the face and head with a great impetuofity. The danger is increafed by the ufual fulnefs of the habit in pregnancy. When the blood runs high and rapid, a veffel may burd, and in fuch a part as to terminate, or bring into great pe- ril, the exidence of both the mother and the child. Cafes often occur of the burding of a blood-veffel in the brain, occasioned by a vio- lent guft of paffion. How much more likely E 26- RULES OF CONDUCT is it to rupture thofe tender veffels that con- nect the mother and child ! Yet to the latter this is certain death. I knew a female who had the aorta, or great artery, fo didended that it forced its way through the bread-bone, and rofe externally to the fize of a quart bottle. This extraordinary didention was chiefly owing to the violence ©f her temper. I have alfo met with a mod fhocking indance of a fighting wo- man, who, in the paroxyfm of rage and revenge, brought forth a child, with all its bowels hang- ing out of its little body. There is no doubt but that passionate women are mod subject to abortions, which are oftener owing to out- ward violence or internal tumult, than to any other caufe. An accident of this fort is the more alarming, as the woman who once mif- carries, has the greated reafon ever after to dread the repetition of the fame misfortune. Cards, or any kind of gaming, at all times, thewordofamufements, fhould be particularly avoided during pregnancy. The temper is then more liable to be ruffled by the changes of luck, and the mind to be fatigued by con- dant exertions of the judgment and memory. Old maids, as I before obferved, are the only clafs of females who may be allowed to fpend DURING PREGNANCY.. 27 fome of their tedious hours in fuch abfurd and fuch unhealthy padimes. Without entering into farther details, it will be eafy for the fenfible mother to apply the principle here laid down to every paffion and propenfity which may tend to excite painful emotions of the mind, and to impair in the fame degree the health of the body. She mud learn to keep even natural defires within due bounds, led pleafure itfelf, if immoderately indulged, may produce the fame effect as pain. Among many excellent hints to pregnant la- dies contained in a Latin poem trandated by Dr. Tytler, we meet with the following jud admonition: Subdue defires ; nor let your troubled mind, Immod'rate love, or fear, or sadness find : Give not yourselves ev'n to the nuptial joy, Or aught that may your ftrength or peace deftroy. And again, Curb each loose defire, Left added fuel quench the former fire : Left ye fhould lofe the fruits of pleasure gone, And love itself undo what love had done. The enjoyments of the table mud alfo be kept under the nice controul of moderation, 28 RULES OF CONDUCT in a date of pregnancy. Any excefs, or any deficiency of proper fupplies, will now be mod feverely felt. The well-being of both the mother and child will depend on her pur- fuing a happy medium between painful re- draint or unneceffary felf-denial, on the one hand, and the indulgence of a depraved or intemperate appetite on the other. But, as the natural defire of aliment increafes with the growth and increafing wants of the child, it will be proper to consider thofe variations as they appear in the different dages of preg- nancy ; and to diew how far it may be alfo advifeable to gratifv the involuntary, and often very wild and whimsical defires, which are known by the name of longings. Before I enter into particular details con- cerning the diet of pregnant ladies, I mud beg' leave to urge with increafed earnednefs my former general prohibition againd drong liquors, unripe fruits, padry, and all forts of food that are high-feafoned, inflammatory, or hard of digedion. If thefe are improper before marriage, they mud be doubly pernicious afterwards, when they may not only injure the mother's health, but poifon, infect, or im- poverifh the fountain of life and nutriment, DURING PREGNANCY. 29 whence her child is to derive support, Every female, therefore, will fee the importance of guarding againd bad habits or the indulgence of a vitiated tade at an early period; that fhe may not have any painful redraints to subject herfelf to when a mother, or be then under the neceffity of making any great change from her former mode of living. I have already laid it down as a fixed princi- ple, that a date of pregnancy i not a date of infirmity or difeafe, but of mere led fenfibility; and that the changes which a woman then feels in herfelf, though fometimes accompa- nied with a little pain or uneafinefs, are but notices of her situation, or warnings againd indifcretion or intemperance. Let us now apply this principle to the regulations of diet, and we fhall find it to be the mod unerring guide to pregnant women in all their conduct, but more efpecially in the choice and quantity of their food and drink. The whole term of pregnancy may be di- vided into two nearly equal parts, the one com- prehending the four months that immediately follow conception, and the other, the remain- ing five months that precede delivery. Dur- 30 RULES OF CONDUCT ing the firfl period, when there is in moft women a drong tendency to an extreme ful- nefs of the habit, nature gives the plained cautions againd improper indulgence, by a weaknefs of the domach, frequent returns of naufea and vomiting, head-achs, codivenefs, and the other fymptoms and effects of indiges- tion. It is a very abfurd and a very fatal midake, to fuppofe that women are then in greater need of nourifhing things; when, on the contrary, in confequence of the ceafing of the menfes, and the redundancy of blood in the fydem, the dricted temperance is not only proper, but abfolutely neceffary to prevent illnefs. When this is neglected,—when no regard is paid to the hints of the date of the domach and of the whole habit, fo kindly given by nature,—bleeding becomes the only expedient to fave the life of the thoughtlefs or obdinate glutton; but fhe fhould remember, that it is her own intemperance which renders that operation advifeable. The alledged or fancied wants of the child may be urged as a plea for fome little excels, or an incitement to more than ordinary gra- tification ; but the frivolity of fuch an excufe will appear, upon considering, that the fcetus, DURING PREGNANCY. gt for the fird two months, does not exceed a hen's egg in fize, and that its growth for the next two months, even till the afcent of the womb, or the ufual time of quickening, is fo fmall as to require very little nourifhment. This is amply fuppliedfrom the natural fulnefs of the fydem before noticed, without the dan- gerous aid of the mother's intemperance. It requires but a moments reflection on the part of any woman of common fenfe, to be con- vinced that what diforders herfelf mud injure the contents of her womb; and that the in- jury is the greater, in proportion to the deli- cacy and flow expanfion of thofe contents. To overflep the bounds of temperance in the early ftage of pregnancy, from an idea of the embryo's wanting fuch supplies, would be almod as frantic as to drown an infant for the purpofe of quenching its fuppofed third, or to gorge it even to burding, in order to fatisfy the cravings of imaginary hunger. But the abfurd notion of the embryo's wants has been attended with incalculable mifchief of another kind;—it has given a fanction to the mod whimsical and the mod pernicious defires. Green-fick girls do not indulge in fuch filly and fuch hurtful fancies 32 RULES OF CONDUCT as many pregnant women: yet the propen- sities of the former are checked by the force of ridicule, of argument, or of authority; while the Longings of the latter bid defiance to all - control; and it is even deemed the height of cruelty not to gratify them in their wilded extent. To the candid difcuffion of this very intereding part of my subject, I hope I need not requed the ferious attention of every fe- male reader. One of the natural confequences of concep- tion is the ceafing of the menfes, which is ac- companied with a redundancy of blood greater or lefs in proportion to the previous fulnefs of the habit. Such a fwell in the vital dream gives rife to feverifh appearances: fuch as heat in the palms of the hands, flufhings in the face, and a flight head-ach. But the domach is mod affected by the changes which then take place in the womb and the whole habit. It is often didurbed by the complaints already defcribed,—naufea, vomiting, heart-burn, and the like. Thefe, as I faid before, are not fymptoms of indifpofition or difeafe, the mod healthy woman being as subject to them in the early months of pregnancy as thofe who are delicate and infirm. It is thus that every DURING PREGNANCY. 33 mother receives timely notice of her situation, with proper warnings not to overcharge her domach, when its powers of digedion are fo weak, and a fulnefs of the habit is fo manifest. Unhappily all pregnant women are not alike difpofed to attend to thofe kind intima- tions of nature: and, perhaps, many of them do not know, that the uneafinefs arising from the above caufes would be removed by per- feverance in a temperate cooling diet. They think they ought to eat more, indead of lefs, in their new date; and torture their invention to find out fomething to conquer the fqueam- ifhnefs of their appetite. This is a very fruit- ful fource of whims and fancies, the indulgence of which is almod always injurious. It can- not indeed be otherwife ; as the weaknefs or diminution of any woman's ufual appetite, on fuch occafions, is not owing to a mere diflike of common or ordinary food, but to a real un- fitnefs of the domach to receive much of any food. What then are we to expect, when things equally improper, perhaps, both in quantity and quality, are forced upon it, to satisfy fome artificial craving, or fome imaginary want? As foon as a woman begins to confult her caprice, indead of attending to nature, fhe is F 34 RULES OF CONDUCT fure to be encouraged in abfurdity by old nurfes, or female goffips, who take a delight in amufing her credulity by the relation of many wonderful and alarming injuries, faid to have been done to children, through the unfa- tisfied defires of their mothers. Every fairy tale, however repugnant to common fenfe, gains implicit belief; for reafon dares not in- trude into the regions of fancy: and were a man bold enough to laugh at fuch fictions, or to remondate with a pregnant woman on the danger of giving way to any of her extrava- gant wifhes, he would certainly be considered as a conceited fool, or an unfeeling monder. Argument is lod, and ridicule has no force, where people pretend to produce a hod of facts in fupport of their opinion. Every wo- man, who brings into the world a marked child, can immediately affign the caufe: yet no mother was ever able, before the birth, to fay with what her child would be marked; and I believe it would be equally difficult afterwards, without the aid of fancy, to difcover in a flefh- mark any refemblance to the object whence the impreflion had been fuppofed to originate. On examining various indances of flefh- marks, and other dreadful events, said to be DURING PREGNANCY. 35 caufed by difappointed longings, it has ap- peared that mod of them were the effects of obdructions, of preffure, or fome external injury; and that none could be fairly traced to the influence of imagination. Similar accidents are obfervable in the brute fpecies; and even in plants unconfcious of their propa- gation or exidence. It is alfo well known, that feveral children are born with marks on their fkin, though their mothers never experi- enced any longings ; and that, in other cafes, where women had been refufed the indulgence of their longings, no effect was perceptible in the child, though the mother's imagination had continued to dwell on the fuhject for a considerable time. The doctrine of imagination, like every thing founded in abfurdity, confutes itfelf by being carried too far. The fame power of marking or disfiguring the child is afcribed to the fudden terrors and the ungratified cravings of pregnant women. The abettors of this doctrine are not even content with a few fpecks or blemifhes on the fkin, but maintain that the mother's imagination may take off a leg or an arm, or even fra£ture every bone in the child's body. I have feen a child born 36 RULES OF CONDUCT without a head; but it was not alledged that the mother had been prefent at the beheading of any perfon, or had ever been frightened by the fpectacle of a human body deprived of its head. If (hocking fights of this kind could have produced fuch effects how many headlefs babes had been born in France during Ro- bespierre's reign of terror! In order to fhew that the fancy, however agitated or drongly impreffed with the dread of any particular object, cannot damp its re- femblance, or even the fmalled feature of it on the child in the womb, Doctor Moore re- lates the following dory of a remarkable oc- currence within the fphere of his own know- ledge :— " A lady, who had great aversion to mon- kies, happened unfortunately, durino- the courfe of her pregnancy, to vifit in a family where one of thofe animals was the chief fa- vourite. On being fliewed into a room, fhe feated herfelf on a chair, which dood before a table upon which the favourite was already placed : he, not naturally of a referved dif- pofition, and rendered more petulent and wanton by long indulgence, fuddenly jumped DURING PREGNANCY. 37 on the lady's fhoulders. She fcreamed, and was terrified; but on perceiving who had treated her with fuch indecent familiarity, fhe actually fainted ; and through the remaining courfe of her pregnancy, die had the mod painful conviction that her child would be de- formed by fome fhocking feature, or perhaps the whole countenance of this odious mon- key. " The pangs of labour did not overcome this impression, for in the midd of her pains fhe often lamented the fate of her unfortunate child, who was doomed through life to carry about a human foul in the body of an ape. When the child was born, fhe called to the midwife with a lamentable voice for a fight of her unfortunate offspring, and was equally pleafed and furprifed when fhe received a fine boy into her arms. After having en- joyed for a few minutes all the rapture of this change to eafe and happinefs from pain and mifery, her pains returned, and the midwife informed her that there was dill another child. ' Another !' exclaimed fhe, * then it is as I ' have dreaded, and this mufl be the monkey ' after all.' She was however, once more hap- pily undeceived; the fecond was as fine a boy 38 RULES OF CONDUCT as the fird. I knew them both :—they grew to be dout comely youths, without a trace of the monkey in either their faces or difpofi- tions." Having before enlarged on the dangerous effects of the paffions, and of fear in particular during pregnancy, it cannot be fuppofed that I look upon frightful objects, fcenes of horror, or any other caufes of a hidden fhock, as matters of indifference. On the contrary, Iwould have them very carefully avoided as they have often cauled abortion, or otherwife injured the health both of the mother and child* though they cannot difcolour the fkin, de- range the limbs, or alter the fhape of the lat- ter. It is from this filly apprehension, in con- feqnence of any fright, that I wifh to relieve the minds of credulous and timid poor wo- men, who may do themfelves a real injury bv the dread of an imaginary evil. * I knew an inftance of a mother, who not only loft the fatus through a fright, but was otherwife fo much af- fected as never to enjoy an hour's health. I cannot there- fore too ftrongly cenfure the frantic impulfe which fo often urges pregnant women, and nurfes with infants at the breaft, to rufh among crowds at a dreadful fire, an execution, or any other mocking fpe<5tacle. DURING i -GNANCY. 39 It was precifely with the fame view that I endeavoured to expofe the abfurdity of be- lieving that flefh-marks on a child were the confequences of his mother's fancies or unfa- tisfied longings. This filly doctrine has been the caufe of great uneafinefs in many families, and has done much mifchief to feveral preg- nant women, fometimes by giving a sanction to the indulgence of their moft improper whims, and at other times by making them pine for extravagant and unattainable gratifi- cations. It is another great midake to fuppofe, that the prevalence of fuch a belief can anfwer any one good purpofe. Surely the fictions of ig- norance, fuperdition, or impofturc, are not neceflary to fecure to women in a date of pregnancy thofe kind compliances, and that tendernefs of treatment, which their fituation requires. The fond hufband will embrace with eagernefs every opportunity of supply- ing the real wants of the wife now doubly dear to him, and even of anticipating her filent widi for any rational enjoyment. But fhe fhould alfo know, that the tyranny of caprice will prove no lefs injurious to herfelf than difagreeable to others. 40 RULES OF CONDUCT Let not pregnant ladies imagine that I am for confining the fphere of indulgence within very narrow limits. I fhould be more inclined toenlage than to contract its boundaries, as far as nature and reafon would allow. I would not even be particularly drift, except in ca- fes of evident, danger. While I difcouraged capricious defires, or improper whims and fancies, I would didinguifh them from real and involuntary longings, which are fome- times occasioned by that weaknefs and difor- der of the domach fo ufual, as I before ob- ferved, for three or four months after concept tion. There can be no doubt as to the caufe of fuch longings; for a similar effect is known to take place at other times, and not only in women, but in men, when their domachs are weakened or difordered by intemperance, ill- nefs, or any accident. I have often met with cafes of this kind in fevers, epilepsies, and o- ther nervous difeafes ; and where the craving often recurred, or deadily continued, I have always directed that it fhould be indulged, though the object of defire might not appear confident with die regimen commonly pre- scribed in thofe complaints. When the long- ings are involuntary, and the feelings acute, a patient may differ much from difappointment DURING PREGNANCY. 41 or delay: and cafes frequently occur of per- fons who recovered from the mod hopelefs state, after having difobeyed the doctor's com- mands, and been freely indulged in what they had fo ardently desired. I do not fay that the cure was abfolutely effected by the ufe of the forbidden food or drink ; but I am convinced from repeated obfervations, that the drong and hidden appetite for fuch food or drink, how- ever drange it might feem, was a fymptom of a favourable change in the complaint, and a fure indication of returning health. On the fame principle, therefore, that rigid • prohibitions or denials might be attended with much pain in a date of pregnancy, a date of exquisite fenfibility, I drongly recommend a fpeedy compliance not only with what may be deemed the natural and reafonable defires of the mother, but even with all her involun- tary longings, which do not evidently. arife from caprice, and are not directed to things of a noxious quality. I would pay little re- gard, for inftance, to the whim of fuch a lady as is reprefented by Smollet, longing for a hair from her hufband's beard, and, what was woffe, wanting to have the pleafure of pluck- G 42 RULES OF CONDUCT it out herfelf; or to the more difguding wifh of another lady, defcribed by Addison, who longed to partake with a flock of carrion- crows, which fhe faw feading on the flefh of a dead horfe. It would be alfo carrying my plan of com- pliance too far to let a pregnant woman live chiefly on unripe fruits, raw onions, or any other acid and acrimonious fubdances; which could not fail to injure her own health and that of her child. An opinion prevails that a woman in fuch a ftate can diged every thing fhe likes or longs for ; but, fuppofing this to be true, it does not follow that living on trafh, or on improper articles of food or drink, will not be detrimental to the fcetus in her womb. Slight or momentary deviations from the rules of wholefome diet or drift temperance may be occafionally allowed, but perverfe habits are never to be indulged. I hope therefore it will not be deemed need- Ufsly fever t to recommend, in the early period of pregnancy, a becoming check on absurd or pernicious defires, and a moderate ufe of fuch things as have been always found to agree with the domach and conditution. I do not DURING PREGNANCY. 43 infift upon a total change from former modes of living; but, unlefs the appetite be very much vitiated, it will direct women at that time to what is mod proper and falutary. They have generally a diflike to animal food; and, if induced to eat it freely, from a midaken notion of their being then in greater need of fuch aliment, they are fure to differ fome in- convenience. On the contrary, their natural relifh for ripe fruits and boiled vegetables may be fafely gratified. Milk, jellies, veal-broths, and the like liquids, which afford eafy nourifh- ment, being converted into chyle without any great effort of the domach, are alfo very al- lowable. Should a particular defire for folid animal fubdances be felt at dinner, frefh meat of the young and tender kind, veal, lamb, capons, pigeons, pheafants, and partridges, may now and then afford an innocent and grateful variety. But I mud again beg, that temperance may always preside at the table; and that the refinements of cookery may never be exerted to raife a fade appetite by artificial provocatives. While I am thus tracing the boundaries of rational indulgence, which fhould not be over* pepped by thofe who have it in their pow- 44 RULES OF CONDUCT er to command every gratification, I fee alio the necessity of fome admonitions to women whofe narrow circumdances may appear to require no additional redraint. It has been very truly obferved, that, in the lowed claffes of fociety, efpecially in great cities, we often meet with a fort of luxury more bane- ful than any which prevails in high life,— a luxury that confids in the immoderate ufe of drong liquors; to which the mifcar- riages, the fevers, and the death of fo many poor married women in London and other populous towns mud be afcribed. There is nothing, in faft, fo pernicious to the mother, and to the foetus in her womb, as drinking ardent fpirits, efpecially when carried to ex- cefs. It is adminidering poifon to the embryo, and is certainly a fpecies of murder. The tade of fuch perfbns is not more de- praved with regard to their drink than their food. The latter perverfenefs is indeed very frequently the confequence of the former. Spirituous liquors dedroy the natural appetite, and leave no relifh but for bacon, or other falted and fmoke-dried meats, fait fifh, or red herrings, than which nothing can be much DURING PREGNANCY. 45 more dimulating, inflammatory, and indigefti- ble. But fuppofe that their fondnefs for this word of aliment is not always the effeft of fwallowing liquid fire, but of habit; and that the domach, drengthened by the hardy em- ployments of fome of thofe poor women, may be able to diged any thing; why fhould its powers be exerted in fuch unproductive ef- forts ? A greater quantity of food is certainly requifite, in proportion to the greater quantity of labour; but let that food be of the mod wholefome kind. Plenty of vegetables, with the addition of a little frefh meat, will satisfy every natural craving, and will afford both the mother and child the pured fupplies of health and vigour. After the fourth month of pregnancy, the growth of the foetus becomes very rapid, and the demands for nourifhment, made by a thriving child on the conditution of its mo- ther, are proportionally drong and mceffant. Nature now, with wonderful care, invigorates the organs of digedion to anfwer thofe in- creafing demands. The domach is no longer fo apt to be difordered as before; its functions are performed with eafe and effeft; and a more liberal mode of living is not only allow- I,.fc 46 RULES OF CONDUCT able, but neceflary. All the redraint which fhould be impofed is a little attention to the quality of the food. Provided it be cooling and nutritious, it may be ufed freely, and as often as the appetite requires. I need not repeat what I have already faid in favour of ripe fruits, boiled vegetables, milk, jellies, veal- broth, and animal fubdances of the young and tender kind. The bill of fare may be enlarged rather than com rafted at this time; and vari- ety may be allowed to prefent her fweeted dores to the tade and fancy, but without the aid of any pernicious feafoning. I have jud hinted at the propriety of in- dulging the appetite as often as the defire of food is drongly felt. It is even advifeable to prevent importunate cravings. Emptinefs is more to be dreaded in the advanced dages of pregnancy than a little excefs. Indead, there- fore of continuing my former prohibition againd fuppers, I would now recommend agreeable repasts, confiding of bifcuits, fruit, oyders, eggs not boiled hard, or any other light food and eafy of digedion. But meat fuppers mud never follow a late or hearty dinner: an unfeafonable load would opprefs the domach: moderate fupplies, on the con- DURING PREGNANCY. 47 trary, are neceflary to fatisfy the child's ftre- nuous demands for fudenance, which do not ceafe even by night. Thefe, if neglected, will caufe uneafy fenfations in bed, and often prevent deep. It is judly remarked by Dr. Den man, when fpeaking of this reflleffnefs, which is generally troublefome towards the conclufion of pregnancy, that thofe women who fuffer mod from it, though reduced in appearance, bring forth ludy children, and have eafy labours. But if the mother has little uneafinefs, and grows corpulent during pregnancy, the child is generally fmall; and if the child fhould die before the time of par- turition, the inquietude entirely ceafes. In the firfl cafe, as this judicious writer obferves, the abforbing powers of the child feem too ftrong for the parent; but, in the latter, the retaining powers of the parent are dronger than the abforbing ones of the child; fb that, on the whole, it appears natural that women ftiould become thinner when they are preg- nant. One direction more is neceflary with regard to fuppers. They fhould never be later than nine o'clock, after which an hour may be fpent in cheerful converfation, as the befl « 48 RULES OF CONDUCT means of preparing for the enjoyment of found repofe. I hope that the cudom of going to bed early, and of rifing early, which is one of the bed prefervatives of health at all times, will be particularly adhered to during preg- nancy. Women in this condition fhould not, upon any account, be tempted to fit up after ten, and they will find no difficulty in rifing at fix, though, towards the conclusion of then- term, they may fafely remain an hour longer in bed every morning. In my former hints to women before mar- riage, I pointed out the peculiar importance of open air and frequent exercife to females, who, in general, fpend too much of their time in domestic and fedentary employments. I recommended a variety of active diversions both without doors and within, according to the date of the weather. I would have young ladies dance and jump about as much as they pleafe, and as nature wifely prompts. But, when they become wives and mothers, their deportment mufl'be different, or they will rifk the lofs of the embryo in their womb,—a lofs always attended with irreparable injury to their own health. Mifcarriages are often oc- cafioned by great bodily exertions, though in DURING PREGNANCY. 49 the form of amufement, as well as by the draining efforts of hard labour. It was not without the j uded reafon that Hippocrates forbade dancing and all violent exercife during pregnancy: he himfelf had been witnefs to a foetus being dropt on the dage by a performer in the dancing line. Let not pregnant wo- men then attempt to vie with other females in the lively dance: the former fhould even avoid all crowded affemblies, whether gay or ferious; for, befides the impurity of the air in fuch places, of the bad effects of which they are very fufceptible, they are expofed to great danger from any accidental preffure. I have known a lady to fuffer abortion in confe- quence of an elbow at entering a church door. How much more likely is this to happen at balls, at play-houfes, and other places of amufement, which are commonly more fre- quented than places of worfhip! When I fay that violent exertions and hard labour are apt to occafion mifcarriages, I do not mean to recommend indolence and inacti- vity to pregnant women. This would be running into the oppofite extreme, which is dill more dangerous than the other. Indo- lence in pregnancy is not only one of the H 50 RULES OF CONDUCT great c?.ures of abortion, but of the puerperal, or childbed fever-, fo fatal to delicate mothers. A woman who lives fully, and neglefts exer- cife, cannot Atil to bring on a plethora, or a fuK nefs of the habit and redundancy of humours, which mud be productive of very bad effects. T'iie whole frame becomes languid: all the vital oi-6a:v; feem to lofe their energy: the powers of the womb in : articular, are en- feebled or perverted; and though a mifcarriage fhould not take place, the labours are fure to be long, fevere, and dangerous ; and the off, fpring puny and deformed. In order, there t fore, to fee u re the bleffings of a happy delivery and a healthy child, a pregnant woman ought to take every day a moderate degree of exer- cife, fuch as fhe has been mod accudomed to, only ufing lefs exertion, and guarding againft fatigue. Some writers on midwifery have aflerted, that, in the early months of pregnancy, the exercife fhould be very moderate, but might be fafely increafed in the latter months. The abfurdity of fuch a notion has been very ably expofed by the faired reafoning, and the in- controvertible evidence of fafts. DURING PREGNANCY. 51 The example of the brute fpecies has firfl been referred to, as, in every thing that ref- pefts the prefervation of life, their indinft is more unerring than the fanciful fpeculations of man. It is obfervable of the quadrupeds in our fields and parks, that the mod frifky of them, when pregnant, aflume a grave and deady deportment: their natural fondnefs for going together in herds and flocks is fuf- pended; and, if left to their own inclinations, they gradually leflen their ufual exercife as they advance in pregnancy. The fame thing is Well known to be equally true of wild animals. In a date of pregnan- cy, they take no more exercife than is necef- fary to procure their food. If forced to great- er exertions in felf-defence, or when hard purfued, they often drop their young; and though beads of prey have no claim to pity, yet furely the harmlefs and timid hare ought not in that date to be worried, merely to gra- tify a cruel or inconsiderate fportsman's fond- nefs for the chafe. It is dill more inexcufable to over-load, or to drain by ill-timed labour, a mare in foal, which has frequently caufed a premature expulsion of her young. j2 RULES OF CONDUCT From thefe remarks on the inffinftive con- duct of brutes, a very wife leffon has been drawn for the guidance of pregnant women. They are not, for fome time after conception, more fenfible of fatigue than at any other pe- riod, nor have they any certain proofs of their own condition. What then, it has been reafonably afked, should direft them to make any change in their cudomary exercifes ? Thefe may be continued but never to a vio- lent or immoderate degree, for at lead four months, not only with fafety, but with the ut- mod benefit. When the contents of the womb begin to increafe very perceptibly, the fame degree of exercife, which pregnant wo- men before enjoyed with pleafure, will now make them faint and weary ;—a drong hint to diminifli it. Their own feelings will direft them better than the caprice of others ; and no fubtlety of argument fhould induce them to believe, that nature in this cafe alone devi- ates from her uniform courfe of aftion, and requires them to exert themfelves more in proportion as they are lefs capable of it ; or, in plainer words, to run the fader the greater weight they carry. Slow, fhort walks in the country, or gentle motion in an open carriage, mud be far better suited to the advanced pe- DURING PREGNANCY. 53 riod of pregnancy, by uniting the advantages of frefh air with thofe of agreeable and faluta- ry exercife. In order to leave no doubt upon this sub- ject, an appeal has been made to fafts, and particularly to the experience of women who follow very hard occupations in the country. They feel no inconvenience from the ufual employments in the early months of pregnan- cy, and require no indulgence, but a little a- batement of their toil when they become un- wieldy. They know nothing of artificial pre- cepts, which would teach them to invert the order of nature. Temperance and moderate exercife, proper periods of labour and of red, the country air, and the cheering influence of a contented mind, infure to them the continu- ance of health in every dage, an exemption from the common difeafes of pregnancy, an eafy lying-in, and a fpeedy recovery from child-bed. The vigour alfo of their offspring is judly proverbial. It would be painful to contrad with this picture the enervating effects of indolence and luxury in high life, or the truly pitiable condi- tion of poor married women in manufafturing 54 RULES OF CONDUCT towns, and in great cities. The confined impure air which they breathe in thefe places, relaxes the frame and dedroys its activity. What they eat, what they drink, is ofen improper, fometimes pernicious. . Their meals and their hours of red are equally irregular. The vic- tims of poverty are feldom able to procure the means of fcanty subsidence, without the sacri- fice of neceflary fleep. T heir condition is real ly more diflreffmp; than that of female flaves in the Wed Indies. Thefe experience a little mercy when pregnant, their owners being ac- tuated by the double impulfes of felf-intered, and of humanity towards breeding women : but, in London, the wretched hireling expe- riences no lenity on account of her pregnan- cy ; fhe is even obliged to conceal her fitua- tion as much as fhe can, in order to get em- ployment; and has often no alternative but to perifh with famine, or to run the rifk of mifcarrying by continued exertions at the wafhing-tub, or at fome other toilfome work, for fixteen or eighteen hours, according to the caprice of the fordid views of her unfeel- ing employer. To impofe fuch talks on the hungry and didreffed,—to caufe abortion by oppreffive labour,—under whatever pretence DURING PREGNANCY. 55 the inhuman midrefs may drive to judify her own conduct,—is certainly murder! Though my former remarks on drefs may be eafily applied to a date of pregnancy, yet this is a matter of fo much concern to mothers and to their children, that I hope my female readers will pardon me for troubling them with fome farther obfervations on the fubjeft. Before marriage, errors in drefs can only in- jure their own health, or disfigure their per- fons; but, after conception, the form, the health, and the very exidence of the child, will greatly depend upon the mother's drefs. Indeed, were I to aflign a caufe .not only for the diminutivenefs, debility, and didortion of infants, but for thofe flefh-marks which are fuperditioudy afcribed to difappointed long- ings, I fhould be much more inclined to im- pute thefe evils to preffure upon the womb, than to the alleged influence of the mother's fancy. The gradual afcent of the womb, af- ter the fourth month, is wifely defigned' by nature, to acquire more fpace for eafy growth and expansion. But her benignant purpofes are defeated, if the body be girded by tight bandages, or fqueezed within the narrow cir- cle of a whalebone prefs. g6 rules of conduct I need not dop to explain a thing in itfelf fo obvious, as the operation of fuch fatal checks on the increafing fize of the foetus ; but how they fhould be productive of flefh- marks and deformity may require fome little illudration. It is well known that young trees and plants, and, in a word, vegetables of every kind, when confined in their growth, get dif- torted, or take on a bad fhape ; and that the tender bark as well as the fruit will be marked, if they fuffer the lead compreffion or redraint. Why should not compreffion have similar effects on the foetus in the womb, where it is almod in the date of a jelly ? The great wonder is, that it fhould ever efcape bearing the marks of a tight-laced mother's indifcretion. The doctrine here laid down does not reft folely even upon the faired reafoning by ana- logy, but is fupported by fafts. Nations that go almoft naked are flrangers to flefh-marks and deformities, except what may arife from accidental injury, or external violence. But in proportion as men remove from a date of nature, and falfe refinement introduces, as per- fonal ornaments, tight and oppreffive incum- brances of drefs, we fee a pigmy or deformed DURING PREGNANCY. 57 race crawl about, to publifii their mother"s folly, and to reproach them with having thwarted or cramped nature in her opera- tions. In my " Domedic Medicine," as well as in a former part of the prefent work, I felt great pleafure in paying a jud compliment to the tafte and good fenfe of the ladies, fo admira- bly difplayed in the prefent fafhions of drefs. The high-heeled fhoes, in which they ufed to totter about as upon dilts, and the tight-laced days, which gave them the appearance of in- fects cut almod afunder in the middle, are happily exploded ; the poet's fiction is rea- alized,—the philofopher's wifh is gratified, in feeing Beauty arrayed by the Graces; and health, eafe, and elegance, alike confulted in the dreffes of our fair country-women. But as fafhion is very changeable;—as there is nothing, however ridiculous or hurtful, to which it cannot give a fanftion;—and as the return to old abfurdities and old prejudices may be dreaded unlefs the propriety and im- portance of the prefent reform are drongly impreffed upon the mind, I fhall endeavour to, i rjH RULES OF CONDUCT heighten thefe by a view of the dreadful evils which arofe from the former fydem of tight bandages, and of diff and cumbrous clothing. It is not many years fince the fugar-loaf fhape was universally admired, and the fmall waid, though contrary to nature, was looked upon as the didinguifhing mark of elegance. Hufbands ufed often to make it their boad, that, when they married their wives, they could fpan them round the middle. It was then thought that nothing could produce a fine fhape but tight lacing, though it never failed to have the contrary effeft. Not only deformity without meafure, but death itfelf was often the confequence. Ladies were known to drop down lifelefs in the dance, when no other caufe could be afligned but the tightnefs of the drefs. Mifcarriages were fre- quently occasioned by the fame caufe; and various other injuries to the foetus mud have far exceeded all power of calculation. Yet, during the prevalence of fo drange an infatuation, while deformity was deemed beau- ty, ali remonftiances on the fubject would have proved unavailing. It would then have been ufelefs to c-mplov fuch arguments as now DURING PREGNANCY. 59 carry conviction to the unprejudiced mind. We may at prefent obferve, with the hope of being lidened to, that nature, when left to herfelf, gives every animal, except thofe that are formed for fwiftnefs, a prominency about the middle. If this is not only com- preffed, but the belly fqueezed clofe to the back-bone, obdruftions of the vifcera muft enfue; and no great knowledge of the human frame is neceffary to fatisfy any perfon, that fuch obltruftions mud prove fatal to health. When the veflels that take up and convey the nourifhment to the body, have their functions by any means impeded, the whole fydem mud fuffer, and at length perifh by a gradual de- cay. But nothing can fo effectually impede the functions of thofe foft parts as preffure. The domach becomes incapable of perform- ing the grand office of digedion: the midriff is forced upwards: the cavity of the ched is thereby leflened, and diffident room is not left for a proper play of the lungs. A diffi- culty of breathing, coughs, and pulmonary consumptions are the natural confequences. All thofe dangers occasioned by tightnefs round the waid, are obvioufly increafed dur- ing pregnancy, when the heart, the lungs, the 60 RULES OF CONDUCT domach, and all the adjoining parts are in a date of tender fympathy with the womb; and when the growth of the foetus neceflarily re- quires more room, as before obferved, for eafy expanfion. To confine it at that period mufl inevitably produce weaknefs, deformity, or abortion. " Remember," fays the ingenious author of P^edotrophia, ■Remember, not to gird too tight Your swelling waift, tho' pleafing to the fight; Nor, for a fhape, within the ftraiten'd womb, Like Gallic mothers, the poor child entomb.— But young Englifh wives have often been guilty of the fame fatal imprudence, not, in- deed, fo much for the fake of " a fhape," as from impulfes of falfe modedy, and for fear of appearing either indecent, or too proud of the happy proofs of their fecundity. I hope, however, that the days of folly and of abfurdity in thofe refpefts are pad; and that the evils, which were then fo frequent, will operate as a warning againd any poflible redoration of that mod awkward and mod pernicious contrivance called flays. Let me alfo very earnedly forbid the ufe of tight neck- laces, tight garters, or any ligatures which may DURING PREGNANCY. 6l reftrain the eafy motion of the limbs, or ob- druft the free circulation of the blood and juices. I fliould farther obferve, that it is not enough to have difcontinued the high-heeled fhoe, unlefs the fhape of the foot and toes is a little attended to. Triding as this circum- dance may appear, the neglect of it has often been attended not only with pain, with cramps, and with corns, but with many dill more didreffing confequences. Of thefe I fhall have occasion to fpeak more fully in my obfervations on the drefs of children. To fum up in a few words the chief part of my advice on this subject to pregnant women, and to the fair fex in general, I need ufe but a fingle affertion, that a flowing drefs, fuf tained by the fhoulders, and gently com- preffed by a zone round the middle, with only as much tightnefs as is neceffary to keep the clothes in contact with the body, ever was, and ever will be, the mod healthy, comfort- able, and truly elegant habit that. females can wear, or fancy invent. The hints concerning cleanlinefs, which are given in the lad chapter, will be found no lefs ufeful after marriage than before, with 62 RULES OF CONDUCT, &C. this fingle exception, that, during pregnancy, lukewarm water is preferable to cold, not only for a total immerfion of the body, but alfo for partially bathing the upper and lower ex- tremities, more efpecially the latter. I have, indeed, known many pregnant women, who always ufed cold water on thefe occafions, and who plunged into the fea two or three times a week during the dimmer months, without injury. Yet I think their example too bold, and too dangerous, to be recom- mended to general imitation. A F*EW REMARKS, &C. CHAP. III. ~ A FEW REMARKS ON CHILDBIRTH. THERE is not any part of medical fci- ence which has been cultivated with greater affiduity, and finally with greater fuccefs, than midwifery. The errors of ignorance, the rafh- nefs of prefumption, the amufing theories of ingenious fancy, have at length given way to the unerring dictates of reafon and experience. By thefe it has been clearly proved, that, in every healthy and well-formed fubjeft, the powers of nature alone are fully adequate to the accomplifhment of her greated work, the prefervation of the human fpecies; and that the bufy interference of man is more likely to didurb and impede than to affid her efforts. Whatever differences of opinion may prevail on other points merely fpeculative, all well-in- formed practitioners are now agreed in this. that the regular procefs of a labour mud ne- ver be hurried on by artificial means, nor interrupted by the meddling hand of indif- cretion or orficioufneft. .64 A FEW REMARKS It is painful to reflect on the numbers that mud have perifhed, while a contrary method was purfued. People had taken it into their heads, that a woman in labour -could not ufe too much exertion on her own part, nor be too much aided by others, to quicken delive- ry. In the poem before referred to, this no- tion is inculcated in the form of medical pre- cept. The poor woman is there desired, u To grasp some strong support with all her pow'r, " T' increase her efforts in that painful hour." A happy revolution has now, however, ta- ken place in the fydem of midwifery ; and the mod eminent profeffors have made it the fird object of their public duty to reprobate the abominable cudom of giving affiflance, as it was called, by dilating the internal and external parts artificially ; and of exciting pa- tients, not only by the dronged perfuafions, but by the dimulus of hot cordials, to help themfelves, as they termed it, and to exert all their voluntary force beyond the diftates of nature; "as if," fays Dr. Den man, " a la- bour was a trick to be learned, and not a re- gular procefs of the conftitution." ON CHILDBIRTH. 65 Though the writer now quoted, and many others of no lefs celebrity have omitted no- thing of importance in their directions both to midwives and lying-in women, yet as their books, from being deemed works of profef- fional fcience, are feldom read by the latter, I fhall feleft a few of their modufeful remarks, and exhibit them in the plained form I can, to guard women in labour againd the fatal confequences of their own errors, on the im- proper advice which may be given them by others. On the fird figns of approaching labour, pregnant women are too apt to take alarm, and indantly prepare as for a work of the greated toil and danger. Their fears are as groundless as their preparation is unneceffary. If they have nothing to injure their health during the previous date of pregnancy, they may rely with perfect confidence on the ad- mirable refources of nature. When left to herfelf, her efforts are always adapted to the conditution of the patient, and to the date of thofe delicate and acutely fenfible parts, which would fuffer the greated injury from sudden or ill-timed violence. All that is required of women in labour, is a becoming fubmiflion K 66 A FEW REMARKS to her courfe of operations. The deps, by which fhe advances to her great end, are fometimes dow, but always fafe; and fhe is not to be hurried or didurbed, with impunity. It is true in almod every fituation, but particularly in childbirth, that thofe who are mod patient actually fuffer the lead. If they are refigned to their pains, it is impoffible for them to do wrong ; but if, from too much eagernefs to fhorten thofe pains and to haden the final effect, a woman fhould keep in her breath, and drain with all her might to in- creafe, as fhe may imagine, the indinftive ac- tion of the womb, the confequences mud al- ways be injurious, and often fatal. In the fird place, fuch improper efforts of the patient may exhaud her drength, fo as to render her incapable of undergoing the necef- fary fatigue which attends the complete ex- pulfion of the child. On the other hand, if the parts are not duly prepared, violence is more likely to tear than to dilate them ; and accidents of this kind have often occasioned a fever, or have rendered a woman miferable for the remainder of her life. ON CHILDBIRTH. 67 The imprudence of taking hot and cordial nourifhment during labour, is no lefs repre- hensible. In plethoric habits, it mud have a feverifh effeft: in any conditution, it is at that time a dangerous dimulant. The nature of the principle, which fhould actuate the womb, Ls immediately changed ;—the pains are ren- dered diforderly and imperfect ;—and the foundation of future mifchief and difficulties, in fome form or other, is invariably laid. A labour may be fo flow, or of fuch long dura- tion as to render a little refrefhment from time to time neceffary ; but this fhould al- ways be of a mild and cooling quality, the very reverfe of inflammatory food or fpiritu- ous liquors. I have already intimated, that, in all ordina- ry cafes, the chief duty of a midwife is to let nature take her regular courfe without bufy interference;—to redrain, rather than encou- rage the exertions of the patient's drength ;— and, when thefe may be involuntarily carried too far from the impulfe of acute pain, to refifl them by the application of fome equivalent force. But I am very forry to add, that the contrary method is too often purfued, efpeci- ally by practioners in country-places, where 68 A FEW REMARKS the patients are fo widely fcattered, that dif- patch is the fird object of confideration, and the maxims of improved fcience as well as the diftates of humanity are difregarded from dronger views of intered. The moment an order comes for the man-midwife, he* packs up his bag of tools, which may be judly called the indruments of death : he mounts his horfe, and gallops away, refolved to haden the procefs by all practicable means, that he may be the fooner ready to attend to another call. At whatever da ore of labour he arrives, he fpurs on nature with as much eagernefs as he had before fpurred on his horfe, though the clofely entwined lives of the mother and her offspring may be endangered by his precipi- tancy. Yet fuch, perhaps is the impatience of the poor woman herfelf, and fuch very often the ignorance of the by-danders, that the quicker he is in getting through his work, if no obvious injury be done at the moment, the greater reputation he undefervedly ac- quires, and the more he enlarges the fphere of his murderous practice. Indruments are fometimes neceffary, but they fhould be ufed as feldom as possible. ON CHILDBIRTH. 69 One method of preventing the evils which mud always arife from the hurry of profeflion- al men, would be to pay them more liberally for their patient attendance. They have no- thing but the full employment of their time to trud to for the means of dip port: and it is jud that they fhould have an adequate com- penfation for fo valuable a facrifice. But as this cannot be generally expected, I would re- commend the cheaper encouragement of fe- male midwives, none of whom, however, ought to be permitted to praftife, without a regular licence, obtained—not by money— but by proofs of real qualifications. Such perfons could fpare more time, and would be found much fitter affidants to lying-in wo- men, than any furgeon, whatever may be his fkill or talents. I do not infid on the point of delicacy, but of abfolute fafety, being per- suaded that hundreds of lives are dedroyed for one that is preferved by the ufe of indru- ments in a labour. At fuch times alfo, it is highly improper to admit any perfon but the midwife and a dif- creet nurfe into the apartment. To fay no- thing of the noxioufnefs of the breath and JO A FEW REMARKS 4 perfpiration of feveral people in a clofe room, the officious folly, the filly tattle, the incon- siderate language, the fluftuating hopes and fears of fo many goffips, mud be productive of the very word effects. Let me, therefore, conjure pregnant women never to comply with the requed, however well-meant, of their female friends, to be fent for at the moment of labour ;—they are fure to do fome harm ; —it is impoffible they can do any good. The patient will find quietnefs and compofure, of far greater fervice than the noify rallying round her of her friends, to awaken and che- rifh the idea of danger. After delivery, when repofe is the chief redbrative of fatigued nature, and when the purity of the air in the patient's chamber is the bed prefervative from fever, the exclufion of vifitants mud be dill more drongly infided upon. The whifper of fond congratulation , from the man fhe holds dear, and whom die has made happy, is all that fhould be allowed even for a moment. With the fame view of quieting any dutter of the fpirits, and of pre- venting the uneafinefs which a mother natu- rally feels from the cries of her child, the ope- ration of wafhing and dressing the infant ON CHILDBIRTH. 71 fhould for a few days be performed in an ad- joining room. As the pains of labour, however regular in its progrefs and happy in its iffue, mud pro- duce fome irritation of the fydem, and a ten- dency to fever, external quietnefs, and perfect compofure of mind as well as of body, are certainly the fird objefts. But our care fhould be extended to fome other points alfo. Too much attention cannot be paid to cleanlinefs: all impurities are to be indantly removed. It is equally neceffary to change the linen often, on account of its retaining the perfpirable mat- ter, which would foon be thrown back into the habit, and there produce the word effects. Whenever the weather permits, the upper fafhes of the windows are to be let down a little to admit the frefh air; yet fo as not to expofe the patient to its direft current, for fear of checking the gentle and falutary per- foration, which naturally follows the fatigue of a labour, and is defigned to abate any in- flammatory or febrile fymptoms. It would be no lefs dangerous to think of increafing or of forcing this natural difcfiarge by large fires, a load of bed-clothes, clofely drawn curtains, or the dill more pernicious heat of caudle im- 72 A FEW REMARKS pregnated with fpices, wine, or fpirits. A fever is almod fure to be the confequence of fuch ill-judged expedients, in whatever manner they may aft. Sometimes they will put a total dop to perfpiration, though they fet the body on fire, and thus produce the very evil which they were foolifhly employed to pre- vent. At other times they caufe fo profufe and violent a fweat, as mud not only exhauft the drength of the patient, and frequently dedroy the power of fuckling her child, but prepare the way for the ready attacks of a fever upon the lead expofure to cold., A temperate degree of warmth, therefore, will bed promote that difpofition both to sleep and to perfpire, which every woman feels after labour. The fires fhould be fuited to the feafon, or rather to the date of the weather, and made barely sufficient to counteract the effects of cold, and of dampnefs or moidure. The drinks fhould be mild and diluting; and the bed-clothes fhould be light and porous, to favour the efcape of the perfpirable matter, while they afford a comfortable covering. A due regard to this regulation is the more ne- ceffary, as the patient mud not be in a hurry to quit her bed, even when fhe may fancy ON CHILDBIRTH. 73 her drength and fpirits perfectly recovered. She fhould be informed, that the womb does not refume its natural date for two or three weeks; and that her lying in bed for that time is mod conducive to fo defirable a purpofe. A fofa is very convenient to recline upon, while her bed is at any time adjuding, or to afford fome relief from & long continuance in the fame position. But I would by no means advife fitting up in a chair, or removal into another room for the reception of company, till the end of the third week, and then only in cafe of the mod perfect confcioufnefs of health and vigour. The opposite extreme of too much indul- gence is, indeed, more prevalent. It is a la- mentable truth, that numbers of women, after having been fafely brought to bed, are killed by imaginary kindnefs. They are fmothered, indead of being kept moderately warm. The action of heat from without, is increafed within by inflammatory food and drink. Nei- ther of thefe fhould be in any cafe allowed. Women of drong and full habits have nothing to fear from emptinefs or fatigue; but may be ifaid to invite danger and difeafe by impro- per gratifications of the palate, They fhould L J4 A F£W REMARKS. confine themfelves for at lead three or four days, to barley-water, gruel, and beef-tea. Very weak and delicate women may be allow- ed fomething more nutritious, fuch as calves- feet jellies, or veal and chicken broths, which are much better fuited to the weaknefs of their domaehs, and will fooner afford the wanted nourifhment than folrd animal fubdances. If the rules of temperance before laid down have been followed during pregnancy, the pa- tient will be easily reconciled to abdemious living for a few days. Indeed, the relaxed date of the domach at this time commonly prevents any natural craving for animal food. But, if a woman has been unhappily accuf- tomed to luxuries, or if foups fhould disagree with her, fhe may be indulged in a little fifh, a little boiled veal or chicken, and bread pud- ding. Every fucceeding day will render fuch indulgence fafer. Hot fpices, however, and ardent fpirits in any form or mixture, are to be abfolutely prohibited during the whole time of lying-in. Wine itfelf is liable to do much mifchief till every fymptom of fever or in- flammation difappears; and, even then, fhould be very fparingly ufed, not more than a glafs ON CHILDBIRTH. 75 or two being allowable at the principal meal only. But though quietnefs, repofe, the admiflion of frefh air, ftnct cleanlinels, and a temperate cooling regimen, mud contribute very much to prevent fever, and to promote a woman's fafe and fpeedy recovery from childbed; yet all thefe prudent meafures will often fail, without her own faithful difcharge of one of the mod facred duties of a mother, that of fuckling her infant. Unlefs the milk, which is ready to gufh from her nipples, finds the proper vent, it will not only didend and in- flame the breads, but excite a great degree of fever in the whole fydem. Every attempt to difperfe it by artificial means, being an aft of flagrant rebellion againd nature, is as dange- rous to the mother herfelf, to fay nothing of her child, as an attempt to procure abortion. The evident determination of the blood to the breads, for the wifed and mod benignant pur- pofe, can never be repelled with fafety. It is either deposited upon fome other part, there to produce inflammation; or, if purgatives and fudorifics are ufed to carry it off by dif- ferent outlets, the violence of their aftion mud j6 A FEW REMARKS be attended with dangerous fhocks, even to the firmed habit. It may be faid, that triere are indances without number, of mothers who enjoy perfect health, though they never fuckled their chil- dren. I positively deny the affertion; and maintain, on the contrary, that a mother, who is not prevented by any particular weaknefs or difeafe from difcharging that duty, cannot neglect it without material injury to her con- ditution. The fame midwives who would affid her in procuring a mifcarriage, if fhe wanted it, may now alfo undertake to difperfe her milk with the utmod eafe and fafety. Let her not trud to the wicked delusion. The mifchief is not the lefs certain from its being perhaps, unperceived at the time; and cruelty to one child, often deftroys the power of pro- creating another. If we take a view of all animated nature, it is fhocking to find, that woman fhould be the only monder capable of withholding the nu- tritive fluid from her young. Such a monder, however, does not exid among favage nations. They cannot feparate the idea of bringing forth a child, from the neceffity of giving it ON CHILDBIRTH. 77 fuck. The wives of the American favages are faid to extend this mark of motherly ten- dernefs and folicitude even to infants that die upon the bread. After having bedowed up- on them the rites of burial, they come once a day for fever«d weeks, and prefs from the nip- ple a few drops of milk upon the grave of the departed fuckling. I have feen a drawing taken from nature by a gentleman at Botany Bay: it reprefented a female of that country, after having opened one of her veins, and made an incifion in the naval of her fickly child, endeavouring to transfufe her blood into its body, and hoping thereby to redore its health, and to prolong its exidence. Obfervation and experience had taught her, that the umbi- lical cord, or naval-dring, was the medium through which thefoetus, while in the womb, received nourifhment from its mother: fhe fancied, therefore, that fhe could transfufe her blood through the fame channel, and renovate a life which was dearer to her than her own! Let the mother in civilized fociety, who, from motives of felfifh eafe and imaginary pleafure, denies her infant the vital dream with which fhe is abundantly fupplied for its fudenance, think of the poor favage, and dart with hor- ror at her own unnatural depravity. 78 A FEW REMARKS It is alfo a great midake on the part of fuch felfifh mothers, to fancy that they can take more pleafure by abandoning their infants to the care of hirelings. Some of them may be callous to all reproaches of confcience for the. frequent difeafes of thofe children; but leaving moral fentiment and natural tendernefs out of the quedion, pleafure is infeparably connected with the enjoyment of health; and I have al- ready fhewn how much this is endangered by a mother's unwillingnefs to become a nurfe. I need not repeat what I faid of the inflamma- tion and fuppuration of the bread; but my hint on barrennefs, as one of the probable confequences of an attempt to difperfe the milk, may be farther enforced by obferving, that the womb is the part mod likely to be af- fected in fuch cafes: the repelled humour has often been deposited on that delicate organ, and has there produced deep-feated and fre- quently incurable ulcers. Many indances of this fort, as well as of other diforders arifmg from the fame caufe, and equally fatal to fe- cundity, gave rife to my former affertion, how- ever harlh it may found in the ear of fafliionr able perverfenefs. W ' ON CHILDBIRTH. jg But I can with equal confidence affure the fond parent, faithful to her trud, and eager to cherifh her infant with the vital fluid which nature has kindly given her for that purpofe, that nothing elfe can fo effectually promote her recovery from childbed, the fpeedy return of good health, and the long continuation of that invaluable blefling. Besides, all nurfes concur in declaring, that the aft itfelf is at- tended with fweet, thri'ling, and delightful fenfations of which thofe only who have felt them can form any idea. I have already admitted, that a mother may be prevented from giving fuck, by fome par- ticular weaknefs or diforder; and in touching on the fame fubjeft in another work, I ob- ferved that women of delicate conditutions, fubjeft to hyderic fits, or other nervous af- fections, made very bad nurfes. Led that remark might give too great a fcope to ex- cufes, on the ground of pretended weaknefs or delicacy, I added, that every mother who could, ought certainly to perform fo tender and agreeable an office. I now go farther, and maintain, that every woman who is not able and willing to difcharge the duties of a mother, has no right to become one. The f 80 A FEW REMARKS fame perfonal defect, or conditutional infirmi- ty, which may difqualify her for nurfing, ought to be confidered as an equally drong difqualification for marrying. But if, after marriage, any fubfequent difeafe or accident fhould render the difcharge of a mother's firft duty impracticable or dangerous, fhe is, in fuch cafes only blamelefs for calling in the aid of another to fuckle her child. In the next chapter, I fhall have occasion to fpeak of the falutary effects of the mothers milk on the new born infant. The aim of my prefent obfervations is to convince lying- in women, that the free and natural difcharge of that precious current is effential to their own health and fafety. But as fome young mothers, however well-inclined, may be dif- couraged fromperfeveringin their attempts to give fuck, by the difficulty, awkwardnefs, or pain, attending the fird experiments, I fhall fubjoin for their direction in fuch cafes, a few rules laid down by the mod approved writers on midwifery. The fird advice given by thofe eminent praftioners is, to put the child to the bread as foon after delivery and due repofe as the * ON CHILDBIRTH. 8l drength of the mother will permit, care hav- ing been previoufly taken to wafh the breads with a little warm milk and water, in order to remove the bitter, vifcid fubdance, which is furnifhed round the nipple to defend the parts from excoriation or forenefs. When the woman has never nurfed before, the nip- ples at fird are fometimes not sufficiently prom- inent to afford a proper hold for the child. The ends alfo of the fmall tubes through which the milk pafles, are contracted, to prevent its flowing out fpontaneoufly. From thefe cir- cumdances, as well as from the inexpert- nefs both of the mother and the infant, fome pain and difficulty may arife. But the com- mon practice of having the breads drawn by an old child, or fome grown perfon, is deemed improper, becaufe the degree of violence ufed on thefe occasions will often irritate and in- flame the parts, and frighten the woman a- gaind the renewal of fuch painful experiments. Much gentler means will produce the defired effect. The breads fhould be fomented with flannels dipt in warm water ; and then a glafs or ivory cup, mounted on a bag of eladic gum, ought to be applied in fuch a manner to the nipple, that it will draw it out gently . M 82 A FEW REMARKS and gradually, while, by moderate preflure on the fides of the bread with the hands, the milk will be pufhed forward. In obdinate cafes, indruments of more attractive power may be ufed, though with caution, for fear of injuring the bread. If the difficulty be not owing to a flatnefs of the nipple (upon the principal caufe of which I before hazarded a conjecture), but to a little rigidity of the milk-veffels, nothing more is neceffary than the warm fomentation above recommended. The fliffnefs or con- tractions of the ends of thofe fine tubes will gradually yield to the natuial efforts of the infant. They will foon become draight, fo as no longer to impede the egrefs of the milk, which is drawn into them by the fuftion. Impatience, or exceflive eagernefs, in thefe cafes, as in all others, defeats its own end. The attempts at fird fhould neither be too often repeated, nor too long continued ; and when the child is put to the bread, the mo- ther ought to be fupported by pillows in bed, in a reclining podure, and with due precau- tions againd catching cold. ON CHILDBIRTH. 8$ Such are the diftates of enlightened prac- tice, of which I am happy, to avail myfelf, as an additional incitement to mothers not to flirink from their duty. A little pain is eafily furmounted, and is followed by lading plea- fure. I mud not omit another caution given by the fame writers, in cafe of any particular forenefs of the nipples, always to procure the bed medical aflidance, as the modes of treat- ment purfued by ignorant perfons are, in thefe indances more efpecially, no lefs injuri- ous than absurd. 84 OF THE NURSING AND CHAP. IV. OF THE NURSING AND REARING OF CHILDREN. EVERY thing is perfect, fays Rosseau, as it comes out of the hands of God; but every thing degenerates in the hands of man. This is particularly true of the human fpecies. If the mother during pregnancy, has not dif- fered any injury from accident, or from her own imprudence ; and if, after the acceffion of labour, neither fhe nor the midwife has didurbed or impeded the efforts of nature: the offspring of drong and healthy parents is fure at the birth to be well-formed, healthy, and vigorous. Any indances to the contrary are fo rare and extraordinary, as almod to leave fome doubt of the poffibility of fuch an event: yet it appears from the bed calcula- tions, that at lead one half of the children born, die before they are twelve years old. Of the surviving half at that period, how ma- ny perifh before they attain to maturity ! How many others are dunted in their growth, diftorted in their figure, or too much enfee- REARING OF CHILDREN. 85 bled ever to enjoy the real fweets of life! What a train of ills feem to await the pre- cious charoe, the moment it is taken out of the hands of nature ! But as the moft of thefe calamities are the confequences of mif- management or neglect, I fhall endeavour to fhew how they may be prevented by tender and rational attention. SECTION I. Of the influence of Air on the Health and Lives of Children. The fird want of a new born infant is clear- ly manifeded by its cries, not arising from any fenfe of pain, but from a dimulus or impulfe to expand the lungs, and thereby open a free paffage for the circulation of the blood, and for admission of air, fo effential to the exifl- ence of every living creature. While the child lay in the womb, its lungs were in a collap- fed or fhriveiled date : it received all its fup- plies through the medium of the naval-dring. But at its birth a very obvious change takes place. The pulfation or throbbing of this cord fird ceafes at the remoted part, and then 86 OF THE NURSING AND by dow degrees, nearer and nearer to the child, till the whole dring becomes quite flac- cid, all circulation being confined to the bo- dy of the infant. It is then that the cries of a healthy child are heard; in confequence of which the air rufhes into the lungs; their tubes and cellular fpaces are dilated ; the bo- fom heaves ; the cavity of the ched is en- larged ; and the blood flows with the utmoft eafe. But as the air paffes out, the lungs again collapfe, and the courfe of the blood receives a momentary check, till a frefh in- flux or infpiration of air in concurrence with the aftion of the heart and arteries, renews the former falutary procefs, which never ceafes during life. The air thus inhaled, after imparting its vi- tal properties to the whole frame, takes up the perfpirable matter condantly iffuing from the interior surface of the lungs, and carries off, on its expulsion, a considerable part of the noxious and superfluous humours of the body. Its purity is of courfe dedroyed, and, in confequence of being frequently breathed, it becomes unfit for the purpofe of refpiration. In a confined place, therefore, it is not air we inhale, but our own effluvia; and every other REARING OF CHILDREN. 87 caufe, which tends to wade or pollute the air, renders it in fome degree injurious to the drength and health of thofe who breathe it. In this account of one of the mod import- ant of the vital funftions, I have avoided the minute details of anatomical fcience, which would, indeed, have made it more accurate, but lefs intelligible to the generality of my fe- male readers. I thought it far better to ex- plain to them, in as familiar language as I could, the caufe of an infant's cry at the mo- ment of its birth, with the hope of rendering them attentive to the purity of what nature fo drenuoudy demands. The quality of the air we breathe, is of much greater confequence than our food or drink, at every period of life, but particularly in infancy, a date of the ut- mod delicacy and weaknefs. Good air braces, bad air relaxes, the tender frame; the former is a fource of health and vigour, the latter of infirmity arid difeafe. It fhould therefore be the fird object of a pregnant woman's care, to fecure, at lead for the time of her lying-in, a wholefome fituation. Indead of flying from the country to town, as many d©, die fhould fly from town to the 88 OF THE NURSING AND country. If her circumflances will not admit of this, fhe mud fix her abode in as open and airy a dreet as fhe can, and at as great a dif- tance as poflible from noife, from tumult, and from thofe nuifances which contaminate the atmofphere of great cities. Let her apart- ments be lofty and fpacious, dry rather than warm, and expofed to the fun's morning rays, I have already explained the importance of cleanlinefs, and of occasionally letting down the upper fafhes of the bed-room windows in fine weather, to admit frefh air, and to prevent fever. An attention to thefe points is not lefs neceffary on the newT-born infant's account, than on his mother's. Let not the fird air he breathes be foul from confinement, too much rarefied by heat, or charged with any noxious exhalations. The mild temperature to which he has been ufed in the womb, renders it very proper to preferve for fome time the fame moderate degree of warmth in his new place of refidence. But he is not, on that account, to be roaded before a great fire, or kept panting in deam and pollution. If the room be kept properly ventilated and free from impurity, the infant will foon get hardy enough to be taken out intc*the open REARING CHILDREN. 89 air, not only without the lead danger, but with the greated advantage; provided always that the feafon of the year, and the date of the weather, encourage fuch early experiments. A month fpent within doors, is confinement long enough in almod every cafe; and the nurfery is then to be frequently exchanged for green fields and funny eminences. There your child will drink, as it were, the vital dream pure from its fource; he will draw in at every breath frefh fupplies of drength and alacrity; while the bracing aftion of the air on the furface of his body, will give a degree of firmnefs unattainable by any other means. In the courfe of a few months, the date of the weather need not be much regarded; and its unfavourable changes, unlefs the heat or cold be intenfe, mud not operate as a check on thofe daily excurfions from the nurfery. Our climate is very fickle; we fhall fuffer much from its rapid variations, if we are not freely expofed to them in early life; do not therefore facrifice the future comfort and fafety«*f the grown man, to midaken tender- nefs for the infant. If your child be accuf- tomed from the cradle to go out in all wea- thers, he will have nothing to fear from the 9° OF THE NURSING AND bleak north or the fultry fouth, but will bear every change of feafon, of climate, and of at- mofphere, not only without danger, but with- out pain or inconvenience. What is here faid of the importance of frefh air, and of frequent expofure to all forts of weather, in early life, mud derive additional weight from a consideration of the bad effects of confinement and of unwholefome air upon children. This part of the fubjeft is pretty fully difcufled in my " Domedic Medicine." I there explained the reafon why fo few of the infants that are put into hofpitals or parifh work-houfes live. Such places are generally crowded with old, fickly and infirm people, by which means the air is rendered fo ex- tremely pernicious, that it becomes a poifon to young children. I alfo took notice of one of the word afflictions of poverty in great towns, where the poorer fort of inhabitants live in low, dirty, confined houfes, to which the frefli air has hardly any accefs. Though grown people, who are hardy and robud, may live in fuch situations, yet they generally prove fatal to their offspring, few of whom arrive at maturity, and thofe who do are weak and deformed. REARING CHILDREN. Ql While I was confidering the hard lot of the poor, mod of whofe children perifh, becaufe the wretched parents are not in a condition to take them often out into the open air, I could not but obferve that the rich were without any excufe for neglefting fo effential a part of their duty. It is their bufinefs to fee that their children be daily carried abroad, and that they be kept in the open air for a sufficient time. This will always fucceed better, if the mother goes along with them. Servants are often negligent in thefe matters, and allow a child to fit or lie on the damp ground, indead of leading or carrying it about. The mother furely needs air as well as her children; and how can fhe be better employed than in at- tending them? In the fame chapter, I had farther occafion to cenfure a very bad, though a very prevail- ing cudom, of making children deep in fmall apartments, or crowding two or three beds into one chamber. Indead of this, the nurfery and the fleeping-rooms ought always to be the larged and mod airy apartments in the houfe. When children are diut up in fmall rooms, the air not only becomes unwholefome, but the heat relaxes their folids, renders them de- 92 OF THE NURSING AND licate, and difpofes them to colds, and many other diforders, particularly of the convulsive kind. All medical men, who have had much practice in the treatment of children, agree in opinion, that convulfion-fits, of which fo many infants die, are to be chiefly afcribed to a con- fined and impure air. I wifh to imprefs this truth on the minds of mothers and nurfes, to make them fenfible of the danger of fmall or clofe rooms, and of the pernicious folly of co- vering an infant's face in bed, or the front of its cradle, and thereby making it breathe the fame air over and over all the time it fleeps. It may be of no lefs confequence to repeat and enforce my cautions to parents againd fending their children, while very young, or in- deed at any age, to crowded fchools, the atmof- phere of which is really a floating mafs of putrid effluvia. The breath and perfpiration of fo many perfons in a room, even supposing them all to be in good health, mud wade and corrupt the air, dedroy its vital properties, and of courfe render it wholly unfit for the fupport of animal life. But fhould any one child happen to be difeafed, all the red are very likely to catch the infection. When I fee a poor baby, before it can well walk, car- REARING CHILDREN. 93 ried in a nurfe's arms^o fchool, I really feel dronger emotions of pity, and of alarm for its fafety, than if I had feen it conveyed to a ped- houfe. In the latter place, children would be kept feparate, and proper means would be ufed to prevent the fpreading of contagion: in the former, all are thrown together, and there remain with relaxed lungs, open pores, and deamino; bodies, fo as to render it almod impoffible for any to efcape. As thoufands of children die every year the victims of difeafes caught at fchools, and as the health and conditutions of dill greater num- bers are irretrievably ruined by the confine- ment and the bad air of fuch places, parents mud not be offended at the feeming harfhnefs of my language in reprobating fo abfurd, fo cruel, and fo unnatural a practice. I know that as foon as children begin to run about, they require the mod watchful care to pre- vent mifchief. Will any mother urge this as a reafon for being tired of them, and for con- fining, as it were in docks, that redlefs acti- vity which is wifely defigned by nature to pro- mote their growth and vigour? Will fhe, from a wifh to save herfelf fome trouble, or to gain time for other bufinefs infinitely lefs 94 Of THE NURSING AND important, fend her little babes to fchool, un- der the filly pretence of keeping them out of harm's way ?, I hope what I have already faid is diffident to convince perfons of common underftanding, that they cannot be expofed to greater harm, than by being fixed to a feat in the midd of noxious fleam for fix or feven hours a day, which fhould be fpent in the open air and cheerful exercife. Should it be alledged, that children are fent young to fchool, from a becoming zeal for their early improvement, I need only reply, that learning, however defirable, is too dearly bought at the expence of the conflitution. Befides, learning can never be acquired by fuch prepoderous means. Confinement and bad air are not lefs injurious to the mind, than to the body; and nothing fo effectually pre- vents the growth of the intellectual faculties, as premature application. Sending a child to fchool in his nurfes arms, is the fure way to make him an idiot, or to give him an uncon- querable difgud to books : the only book he fhould then look at, is the great volume of na- ture. This is legible at every age, and is as gratifying to a child as to a man: it abounds with the mod ^delightful and mod ufeful REARING CHILDREN. 95 information: it is equally conducive to plea* fure, health, and knowledge. A thoufand abfurdities in the fafhionable modes of education prefent themfelves now to my view ; but I mud only take notice of er- rors in the phyfical treatment of children; and furely no errors of this fort can be more reprehensible, than that which I have been jud defcribing. Debility of body and mind is the certain confequence of fending very young children to fchool; and of fending them, at any age, to crowded or confined fchools. The terms of indruftion are in ge- neral fo low, that a mader or miflrefs of a fchool is obliged to take a great number of fcholars, in order to get a living; and can feldom afford to rent a fpacious room in an open and elevated fituation. Yet not only this is as abfolutely neceffary for health, but a large play-ground alfo ; where even day-fcho- lars fhould be permitted to go out frequently to tade the frefhnefs of the vital breeze. The plants of genius and of manhood cannot flou- rifh but by frequent expofure to the enliven- ing rays of the fun. OF THE NURSING AND SECTION II. Of warm and cold bathing. In obferving the regular fucceflion of an infant's wants, after the fupply of air procured by it's fird cries, it's feeming uncieanlinefs at- tracts our notice. The fkin appears covered with a flippery glue, which foon dries and forms a fort of fcurf. This fhould be waflied off very gently with a foft fponge and warm water, having a little foap diffolved in it. Nurfes, in general, are as eager to remove every fpeck of it, as if it was the moft offenfive impurity, though it is perfectly harmlefs, and will eafily come away in three or four wafh- ings, without the danger of hard rubbing, or the aid of improper, and fometimes very in- jurious, contrivances. Ointments or greafy fubffances cannot fail to fill up the little orifi- ces of the pores, and to put 'a dop to infenfi- ble perfpiration. Spirits of any kind are dill worfe, on account of their inflammatory ef- feft. Even Galen's advice to fprinkle the child's body with fait, that the glutinous mat- ter may be more effectually rubbed off, is at bed unneceffary. I have no particular ob- REARING OF CHILDREN. 97 jeftion to the modern improvement on that hint, which confifts in diffolving fait in the warm bath, with a view of giving it the agree- able dimulus, as well as the cleanfing and bra- cing properties of fea-water; but I would not encourage any folicitude in this refpeft, as the eafied and fimpled mode of proceeding will fully anfwer the desired end. In the hardy ages of antiquity, we are told that the Germans ufed to plunge their new- born infants into the freezing waters of the Rhine, to inure them betimes to the fevere cold of their native country. I need not take any pains to point out the danger of following fuch an example in our times, when mothers and nurfes are too apt to run into the oppo- site extreme of unnerving effeminacy. Iq. this, as in every thing elfe, the golden mean is the line of wifdom—the line to be purfued by rational affeftion:>,It would be extremely hazardous to dip the tender body of a child, reeking- from the womb, in cold water, and tq keep it there during the neceffary operation of washing; but the ufe of the cold bath may be fafely brought about by degrees in five or fix months after the birth, and will then be 0 9$ OF THE NURSING AND found not only one of the bed means of pro- moting health and drength, but of prevent- ing alfo many of the mod didreffing com- plaints to which children are fubjeft. The following method I can confidently recom- mend, having had frequent opportunities of obferving its falutary effects. The temperature of the bath proper for a new-born infant, fhould approach nearly that of the situation which he has jud quitted. It is proper to acquaint thofe who may not have an indrument to afeertain the degree of heat, that abfolute precision in that refpeft is by no means neceffary ; their feelings will inform them with sufficient exaftnefs when the water is rather warmer than new milk : a little folu- tion of foap, as I before obferved, is all that ia wan ted to increafe its foftnefs and its purify- ing effect. The operation of wafhing fhould be performed in a veffel large enough to allow room for the expanfion of the infant's limbs, and for eafily difcovering any defect in its ftructure, or any accident which may have happened to it during labour: either may be often remedied by timely care, but may be- come incurable through delay or neglect. '] lie child fhould not be kept in the bath REARING OF CHILDREN. 99 longer than five or fix minutes ; and the mo- ment it is taken out, it fhould be wrapped up in a foft warm blanket, and there kept for a few minutes in a date of gentle motion. I would not have any difference made, ei- ther in the temperature of the bath, or the time of the infant's continuance in it, for the fird month. The uncleannefs of young chil- dren renders frequent wafhing neceffary. It fliould be the fird object of attention in the morning, and the lad at night ; but it fhould not be performed with a full domach, even when the child receives all its fupplies from the bread. This is the only caution which need be added to thofe already given concerning gentlenefs in the manner of wafhing, fpace enough in the bathing-veffeJ, and drift care to wipe the child dry, and wrap it warm the in- dant it is taken out of the bath, when expofure to cold would be doubly dangerous, from the natural delicacy of the infant, and from the immediately preceding warmth and the open- nefs of the pores. After the fird month the warmth of the water may be leffened, but almod impercept- ibly fo as to guard againd the rifk of fudden 166 OF THE NURSING AND changes or too rafh experiments. The mild- iiefs of the weather and the evident increafe of the child's ffrength, mud betaken into con- sideration ; for, though cold water is very fet- Viceable in bracing weak and relaxed habits, yet, if tried too foon, its dimulus on the furface may be too drong, and the powers of reaftion within too weak, fo that the word confequences may follow. Thefe will be prevented by a gradual diminution of the temperature of the water, and by clofe attention to it's affects, when reduced nearer and dill nearer to a date of coldnefs. If immerfion in the bath be quick- ly followed by a glow all over the body, and a perceptible livelinefs in the child, we may be fure that the water has not been too cold for his conditution, and that we have pro- ceeded With due care. But fhould it produce chilnefs, evident languor, and depreflion, we mud make the water a little warmer next time, and not venture upon the cold bath till we are encouraged by more favourable appear- ances* It would tend rather to increafe than to clear up the doubts of mothers and nurfes, were I to enter into a detail of all the infirm* ities and difeafes, in which the cold bath would REAttING OF CHILDREN. 101 be ferviceable or injurious, not. only during infancy, but at a more advanced period of life. There are marry nice didinftions in a variety of complaints, where the greated medical fkill and experience are neceffary, to decide on the propriety or impropriety of reforting to fo pow- erful, but at the fame time fo hazardous, a rem- edy. I mud, however, forbid its ufe in com- plaints of the bowels ; affections of the lungs ; eruptions on the infant's fkin; and in cafes of extreme weaknefs, indicated by the before- mentioned fymptoms of chilnefs and apparent lofs of drength and fpirits after immerfion. With fuch redraints on indifcreet rafhnefs, it is hardly poffible that a woman can do wrong in purfuing the plan which I have pointed out, for reducing the warmth of the water by very flow and almod imperceptible degrees, till it can be employed quite cold with fafety and benefit. There is no doubt but a great deal of mif- chief has refulted from the too early and inju- dicious ufe of the cold bath. I perfectly agree with Dr. Underwood in his equally fenfi- ble and humane remark, that " to fee a little infant, three or four days old, the offspring perhaps of a delicate mother, who has not ^ 102 OF THE NURSING AND drength even to fuekle it, wafhed up to the loins and bread in cold water, expofed for feveral minutes, perhaps in the midd of win- ter (when children are more inclined to difeafe than thofe born in dimmer) itfelf, in one con- tinued fcream, and the fond mother covering her ears under the bedclothes, that die may not be didreffed by its cries, has ever druck me as a piece of unneceffary feverity, and fa- vours as little of kindnefs, as plunging an infant a fecond or third time into a tub of water, with it's mouth open and gafping for breath, in the old-fafhioned mode of cold bathing : both of which often induce cramps and pains in the bowels, and weaknefs of the lower extremities, but rarely an in- creafe of drenprth. I hope the advice which I have given reflec- ting the proper temperature of the bath du- ring the firft months of infancy will operate as a check on the " unneceffary feverity" fo judly censured in the fird part of this obferva- tion. But the error pointed out in the " old- fafhioned mode of cold bathing, may not be fo eafily correfted, unlefs fome drong and clear reafons are assigned for difcontinuing the dan- gerous part of that practice. REARING OF CHILDREN. 103 Women fhould therefore be informed that the immediate effeft of immerfion in cold water, at any age, is a fudden contraftion of the pores and blood-veffels of the fkin, and a general repulfion or throwing back of the fluids towards the internal parts. The chil- ling fenfation excites the mod vigorous efforts of the organs of life, perticularly the heart and arteries, to increafe the heat within the body, and refid the fhock given to the furface. This is what is called action and re-action, the degree of the latter being always in propor- tion to the violence of the former, and to the drength of the conditution. Hence arifes that delightful glow, which follows the fird impreflion of cold; and, fo far, the full play of the vital organs is as pleafant as it is falutary. But, as the increafed heat foon paffes off from the body, if it be continued in the water, or taken out and direftly plunged into it again, the animal powers are liable to be ex- hauded by inceffant or repeated efforts to produce more heat, and to overcome the ac- tion of the external cold. Grown perfons have often experienced the fatal confequences of too long a day in the water. What then mud the effects of a fecond and third dip be 104 OF THE NURSING AND upon the tender and delicate frame of an in* fant,whofe vital power is proportionally fee- ble? Besides the rifk of extinguifhing the faint fparks of life, an accumulation of hu- mours in the head, dagnations of the blood ^n other parts, and convulfion fits, are very likely to take place. But though none of thefe melancholy circumdances fhould hap- pen at the moment, a floppage of growth, and a puninefs of habit, mud certainly follow fo inconfiderate an abufe of the very means Bed calculated, under proper management, to promote health, expanfion, and vigour. In cafes of previous indifpofition, or difeafe, where the cold bath may be prefcribed as a remedy, the danger to a poor infant mud be dill greater from an injudicious mode of pro- ceeding. I took no fmall pains in my " Do^ medic Medicine," to expofe the whims and prejudices of nurfes in this refpeft. They would be objefts of ridicule, were they not often attended with the mod ferious confe- quences. I fhould fmile, for indance, at the remains of fuperditious weaknefs, in believing that the whole virtue of the water depends upon its being confecrated to a particular I REARING OF CHILDREN: 105 faint, were it not that mod of thofe holy -wells, as they are called, are very unfit for bathing, and, what is worfe, that the child is kept too long in the water, and that due attention is not paid to friction and warmth afterwards. Some of thofe filly women place their confi- dence in a certain number of dips, as three feven, or nine, though every dip after the fird, at each time of bathing, not only defeats the hope of benefit, but increafes the drong pro- bability of much mifchief. This may indeed be avoided, by dipping the infant only once at a time ; but, even in that cafe, the magical number of dips is very insufficient for any de- sirable purpofe. I have alfo known nurfes who would not dry a child's fkin after bath- ing, led it fhould dedroy the effects of the wa- ter ; others will even put cloths dipt in the water upon the child, and either put it to bed, or fuffer it to go about in that condition. This is fometimes done with impunity by grown perfons, who refort to the famous fpring at Malvern in Gloucederfhire, for the cure of particular complaints of the cutaneous clafs ; but it would be little fhort of frenzy to make fuch an experiment upon children. p 106 OF THE NURSING AND The only way of fecuring to an infant all the falutary effects of the cold bath, without the lead poflibility of harm, is to prepare him for it in the flow and cautious manner before recommended. This may be accomplifhed, under favourable circumdances, in five or fix months. Rain or river water is fitter for the purpofe of bathing, than pump or fpring wa- ter; though the latter, in cafe of neceflity, may be ufed, after having been expofed for fome hours to the fun or the atmofphere. The child mud not be dipped when its body is hot, or its domach full, and fhould be put only once under the water at each time of bathing. All the benefit, as before obferved, depends upon the fird fhock, and the re-action of the fydem. In order to prevent a fudden and drong determination of the blood to the head, it is always advifeable to dip the child with this part foremod, and to be as expeditious as poffible in wafhing away all impurities. I have been already fo particular in my direc- tions to have the young bather indantly wiped dry, and wrapped up in a foft warm blanket that I need not repeat them ; but I mud add another injunction, which is, not to put the child to bed, but to keep it for fome time in < REARING OF CHILDREN. IO7 gentle motion, and to accompany the whole procefs with lively finging. It is of far grea- ter importance that mod people may be aware of, to affociate in early life the idea of pleafure and cheerfulnefs with fo falutary an operation. During the ufe of the lukewarm bath, the whole body is to be immerfed in it every night as well as morning. But, when recourfe is had to cold bathing, it mud be ufed in the manner above prefcribed in the morning only. At night, it will be enough to wafh the lower parts ; and even for this purpofe a little warm water may be added to the cold in fevere wea- ther. Every danger will thus be avoided; every benefit will be fecured; and the habit of perfon- al cleanlinefs being rendered familiar in child- hood, will be retained through life, and will contribute very much to its duration and en- joyment. SECTION III. Of Children's Drefs. There is not any part of my profeflional labours which I review with greater pleafure, than my exertions in early life to refcue infants «■•* 108 OF THE NURSING AND from the cruel tortures of fwathing, of rollers, and of bandages. When I fird ventured to take up the fubjeft, about half a century ago, it certainly required the ardour, the courage, the enthufiafm of youth, to animate my opposi- tion, not only to the prevalence of cudom and the dubbornefs of old prejudices, but to the doctrines of the Faculty themfelves. Abfurd as we may now think the practice of fwaddling and wrapping up a child, till it was as diff as a log of wood; the arguments in favour of a loofe and eafy drefs, which I made ufe of in my Inaugural Differtation*, were vehement- ly combated by the mod eminent men, who at that time taught medicine in the University of Edinburgh. The reform which has since taken place, though not carried to the extent that it ought to be, is an encouragement to ufe lefs referve in condemning the remains of fo pernicious a fydem. It cannot be deemed a matter of adonifh- ment, while medical men declared themfelves advocates for fuch a mode of clothing, that it * De infantum vita confervanda. < "* REARING OF CHILDREN. 100 fhould be carried to the mod dangerous excefs by ignorant, bufy, or felf-conceited women. They fancied that the fhape, beauty, and health of the infant depended wholly on the expertnefs of the perfon employed in dreffing it. The mid-wife was to new-mould the head, and to fhape every limb, according to her own fancy, and then to retain the parts, in the form fhe gave them, by clofe preffure. Her dupid prefumption was farther encouraged by the vanity of parents, who, too often desi- rous of making a fhow of the infant as foon as it was born, were ambitious to fee it made up in perfect trim, and to have as much finery heaped upon it as poffible. Thus it came to be thought as neceffary for a midwife to ex- cel in bracing and dreffing an infant, as for a furgeon to be expert in applying bandages to a broken limb ; and the poor child, as foon as it came into the world, had as many rollers and wrappers applied to its body, as if every bone had been fractured in the birth; while thofe cruel ligatures were often fo tight, as not • only to gall and wound its tender frame, but even to obdruft the motion of the heart, lungs, and other organs neceffary for life. 4** 110 OF THE NURSING AND In the progrefs of folly and vice, when the influence of depraved fociety had extinguifhed in the breads of many mothers every fpark of natural affection, and had prompted them to abandon their children to the care of hirelings, the mercenary nurfe was glad, for the fake of her own eafe, to follow what Physicians taught and midwives praftifed. The infant was kept fwathed in the form of an Egyptian mummy, as incapable of motion as the latter, and al- mod as deditute of every fymptom or indica* j tion of life, except its unavailing cries. Though dwarfifhnefs, deformity, difeafes, or death, * mud have frequently been the confequence, *^ yet the nurfe efcaped all blame, as the banda- ges prevented any limbs from being broken; and the poor victim bound hand and foot, might be thrown any where, and there left with the utmod indifference, while fhe attend- ed to her private concerns. The only thing relating to the drefs of in- fants which feemed to arife from any tender- nefs, was a regard to its warmth: unfortunate- ly this was carried too far: and children differ- ed from the quantity, as well as from the tight- nefs of their clothes. Every child has fome degree of fever after the birth; and if it be loaded REARING OF CHILDREN. Ill with two many clothes, the fever mud be in- creafed, often to fuch a degree, from the con- currence of other caufes of heat, as to endan- ger the life of the infant. Even though no fever fhould be excited, the greated debility mud be the confequence of keeping a child in a date of perpetual wade by exceflive perfpi- ration. Befides, in fuch a condition, a child is liable to catch cold upon expofure to the lead breath of air; and its lungs, relaxed by heat, and never fufficiently expanded, are apt to remain wTeak and flaccid for life, fo that every cold will have the mod alarming tenden- cy, and probably terminate in an adhma, or a confumption. All the former evils, arising from the falla- cy of medical theories, from the prefumption of midwives, the folly of parents, the unwil- lingnefs of fome mothers to do their duty in becoming nurfes, the felfifh views of hirelings, and the quite oppofite, though no lefs fatal fuggedions of mifguided tendernefs, were far- ther ao-o-ravated by the imperious diftates of fafhion. Reafon, experience, and true tade, would have long fince triumphed over filly fpeculations, ignorance, and caprice, had not every confideration been facrificed to prevail- • 112 OF THE NURSING AND ing forms; fo that from the infant in its fwad- dlirig-clothes, to its grand-mother in her fhroud, drefs mud be wholly regulated by the eti« quette of fafhion. Againd this fpecies of hi- therto unfhaken tyranny, I fhall therefore point the chief force of my arguments; after a few more driftures on the abfurdity and per- nicioufnefs of the other caufe,—of tight and oppressive clothing,—which has really inflict- ed deeper wounds on population, than famine, pedilence, and the fword. To begin with the error of phyficians : it is almod inconceivable, how any fetof men, who profeffed to be the admirers and followers of nature, fhould have been fo totally blind to her obvious mode of proceeding in the pre- fervation of infant life. She forms the body foft and flexible, to facilitate its future growth: fhe furrounds the foetus in the womb with flu- ids, to prevent its receiving any injury from unequal preffure, and to defend it againd eve- ry thing that might in the lead cramp or con- fine its motions: fhe adapts the fame means to the fafe delivery of the child, all whofe bones are fo gridly and elaftic as to yield with sur- prising pliancy to every obdruftion in the aft of labour, and afterwards to refume their pro- REARING OF CHILDREN. 113 per form, unlefs redrained or didorted by the bufy interference of man. Yet people of pre- tended fcience have been bold enough to af- fert, that a child, when it comes into the world, is almod a round ball; and that it is the nurfes part to affifl nature in bringing it to a proper fhape. We fhould rather fay, let the med- dling hand be amputated, which dares to offer violence to the works of nature. If, through the inexpertnefs or impatience of the midwife, any of the child's delicate limbs have been fractured or put out of joint, they will re- quire immediate care and proper bandages: but let not prefumptuous folly attempt to mend what nature has made perfect, or per- verfely confine what was formed for the ut- mod freedom of motion and expanfion. I have often had occasion to obferve, that the indinft of brutes is an unerring guide in whatever regards the prefervation of animal life. Do they employ any artificial means to mould the limbs of their young, or to bring them to a proper fhape ? Though many of thefe are extremely delicate when they come into the world, .yet we never find them grow weak or crooked for want of fwaddling-bands. Is nature lefs kind or lefs attentive to the hu- Q 114 OF THE NURSING AND man fpecies ? Surely not: but we take the bufinefs out of nature's hands, and are judly, punifhed for our arrogance and temerity. This argument may be rendered dill more unanfwerable by an appeal to the conduct of thofe nations that approach neared to a date of nature. They have no idea of the necefli- ty of rollers or bandages to drengthen the imaginary weaknefs, or to bring to a proper fiape the imaginary deformities of their infants. They allow them from their birth the full ufe of ever}' organ; carry them abroad in the open air; wash their bodies daily in cold wa- ter; and give them no other food or phyfic but the truly medicinal and nutritive fluid, with which the mothers are benignantly sup- plied by nature. Such management tends to render their children fo drong and hardy, that by the time our puny infants get out of the nurfes' arms, theirs are able to fhift for them- felves. I referve fome remarks on the perfect fhape of thofe favages for a didinft chapter, in which I mean to contrad it with the dwarf- ifhnefs and deformity of civilized nations. Indead of confidering a child at its birth as a round ball, which ought to be brought to a REARING OF CHILDREN. "5 proper fhape by a midwife's or a nurfe's afli- dance, I would have both thefe defcriptions of people look upon its little body as a bun- dle of foft pipes, replenifhed with duids in continual motion, the lead doppage of which is attended with imminent danger. Tight preffure always weakens, and may fometimes fufpend, with deadly effeft, the action of the heart, the lungs, and all the vital organs; it impedes the circulation of the blood, and the equal didribution of nourifhment to the differ- ent parts of the body: it didorts the pliant bones, cramps the mufcular powers, prevents growth, and renders the whole frame equally feeble and misfhapen. Even were reafon filent on thofe points, and were we unwarned of the bad effefts of fwathes and fillets by pad experience, hu- manity ought to redrain us from putting a helplefs innocent to the mod cruel torture, fqueezing its tender body into a prefs at the indant of its releafe from former confinement, and loading it with chains as the fird mark of our attention. I have often been adonifhed at the infenfibility of midwives and nurfes to the cries of infants while dreffing;—cries that feldom ceafed till the powers of the poor Il6 OF THE NURSING AND creatures were exhauded. Yet fo far from feeling any emotion of pity, it is ufual for the midwife or the nurfe to fmile at fuch cries, and to endeavour to perfuade the mother, if within hearing, that the violence of the fcream is a fubjeft of joy, not of forrow, as it pro- claims the child's health and vig-our. I have already explained the caufe and important purpofe of a new born-infant's fird cry, to promote refpiration and circulation. The loudnefs of that cry is indeed a proof of the drength of the child's lungs ; but every fub- fequent cry is the language of pain, the ex- preflive tone of irritation and fuffering. If you do not indantly attend to it, you may be guilty of murder. Think of the immenfe number of children that die of convulsions foon after the birth; and be affured, that thefe are much oftener owing to galling pref fure, or fome external injury, than to any in- ward caufe. I have known a child feized with convulfion fits foon after the midwife had done fwaddling it, and immediately re- lieved by taking off the rollers and bandages, A loofe drefs prevented the return of the dif- eafe ; and though this will not always cure fits produced by tight clothing, as the effect of the injury may continue after the removal REARING OF CHILDREN. 117 of the caufe, yet it is one of the neceflary means of relief, it being impoffible that a pa- tient can recover, as long as the caufe which fird gave rife to the diforder continues to aft. It may be proper in this place to give as clear, fimple, and concife an account as I can of the nature of convulsions, that midwives and nurfes may learn to fhudder at the idea of occafioning, by their mifconduft, the mod fatal, as well as the mod frequent difeafes in- cident to childhood. The heads of infants being proportionably larger, and the nervous fydem more extended, than in grown perfons, their nerves are more fufceptible of irritation; and convulfion fits are the confequences of keen irritation, however excited. The great Boerhaave was of opinion, that mod of the diforders of children might be ranged under the clafs of convulsions. It is certain that all the different caufes of uneafinefs to a child form but one general or undiflinguifhed fen- fation of pain, which he has alfo but one way of expreffing, namely, by his cries; and if thefe are not attended to, and no relief is or can be given, acute and unmitigated pain commonly produces a fit. If any dronger reafon need be urged for immediately attend- u8 OF THE NURSING AND ing to an infant's cries, it is that they are ai- mod always owing to mifmanagement. I admit, that the mod incurable convul- sions are thofe which proceed from fome ori- ginal fault in the drufture of the brain itfelf, whence the nerves iffue. But fuch cafes fel- dom occur, though the brain has unquefiion- ably been often injured, and convulsions oc- cafioned, by a midwife's prefumptuous at- tempts to model the fcull of the new-born in- fant. I have already hinted at this detedable praftice, and fhall prefently make fome farther remarks on its baneful prevalence, and its horrid effefts. Children are alfo fubjeft to convulfions from cutting the teeth with difficulty, or from a feverifh irritation of the fydem at the ap- proach of the fmall-pox, meafles, and other eruptive difeafes. I am far from being dif- pofed to blame nurfes for what they cannot prevent; though I believe that the dangerous fymptoms, which often attend teething in particular, are chiefly, if not wholly owino- to the previous improper and enervating treat- ment of the child. The other convulfions REARING OF CHILDREN. 11Q here alluded to generally go off as the erup- tive difeafe, of which they may be called the forerunners, makes its appearance. There is another caufe of convulfions, for which midwives and nurfes flatter themfelves that they are not in any fort blameable, I mean acute pain in the domach or bowels. But whence does this pain arife ? either from the tight preffure of thofe parts ; from the re- laxing effeft of a hot and impure atmofphere; or from fome acrid fubdance in the fhape of food or of phyfic conveyed into the domach, and irritating the alimentary canal. If you attend to the directions before given on the fubjeft of air, wafhing, and cleanlinefs ;—if you pour nothing down the infant's throat but the wholefome, unvitiated juice, defigned for him by nature ;—if you flacken, indead of bracing your wrappers round his body ; you may depend upon it that his domach and bowels will never be fo difordered as to oc- cafion convulfions. The only part of an infant's drefs or cov- ering which may be applied pretty clofe, is a broad piece of thin flannel round the naval, to guard againd any protrusion there, from 120 OF THE NURSING AND the accidental violence of the child's cries. But take care not to make the preffure too tight, or you will not only hurt the bowels, but, perhaps, caufe in another place a much worfe rupture than to that which your pre- caution is directed. This is what happens in many similar cafes, when people aft from narrow or contracted views of the fubjeft, and in their eagernefs to prevent fome trifling and merely poffible inconvenience, too often oc- casion irreparable mifchief. Again, then, let me caution midwives and nurfes againd re- taining any part of the old fydem of tight fwathing, as the injury it mud do is certain, and the good or inconvenience, to which it may feem adapted, is imaginary. I am now fpeaking of its immediate bad effefts, in fqueezing the infant's delicate body, fretting his tender fkiri, keeping his little limbs in a date of painful confinement, exciting his cries, and, by all thefe caufes of nervous irritation, throwing him into convulfions. The female who can hear and fee thefe effefts of her own folly, and will yet perfid in it, after it is pointed out, certainly does not deferve the name of a mother. REARING OF CHILDREN. 121 But the mod censurable part of the ufual conduct of midwives and nurfes dill remains to be minutely examined and reprobated. It is not enough for them to keep up the fhow of helping nature, as they call it during the procefs of a labour, though fhe has been truly faid to difdain and abhor affflance ; but they prefume to mend her work after delive- ry, and to give a more proper form to the heads of new-born infants. The midwife will tell you, that the foft bones of a child's fcull are often fo difplaced and fqueezed to- gether in coming into the world, that the head would be fhapelefs and frightful, were it not for her improving touches. Another reafon is afligned by the nurfe for her med- dling. She takes alarm at the imperfect in- dentation of the bones on the crown of the head, and not only drives to prefs them clofer and to brace them by means of fillets, but is careful to keep the head warmly covered, to prevent the poor baby, as fhe fays, from catching his death by the expofure of thofe open parts to the air. Deformity is the lead of the evils that attend fuch afts of adonifh- ing: infatuation. The delicate texture of the brain is peculiarly liable to be affected ; and though neither convulfions nor any other R i22 OF f HE NURSING AND perceptible complaint may immediately fol- low, yet a weaknefs of underftanding, or a di- minution of the mental powers, is often the confequence, and defeats all the efforts of the bed education afterwards. The oflification or growing hardnefs of the bones of a child, and particularly thofe of the fcull, is incomplete in the womb, to favor the purpofes of eafy and fafe delivery. In confe- quence of their foftnefs and pliancy, they ad- mit of being fqueezed together, and even of lapping over without injury, foas to make the head conform to the fhape and dimenfions of the parts through which it is to be expelled. They will foon refume their proper place, if left to the kind management of nature, and not tampered with by the profane finger of a con- ceited midwife or a filly nurfe. As to the opening or imperfect indentation of the bonesr of the fcull, it is owing to the fame caufe, and defigned for the fame impor- tant purpofe, to facilitate the birth of the in- fant. The free aftion of the external air is then neceffary to promote the firmnefs and compactnefs of thofe bones, and to make REARING OF CHILDREN. 123 them prefs into each other, and form futures for the perfect defence of the brain, not only againd blows and bruifes, but colds and de- fluxions. Warm and tight covering directly counterafts all thefe benignant intentions of nature, and renders the fcull a very weak fhield for the fecurity of its precious contents. The curious didinction made by Herodo- tus, in the field of battle, between the fculls of the Egyptians and the Perfians, has often been quoted to illudrate and confirm this doc- trine. That hidorian having vifited the fcene of aftion, where the flain of thofe two nations had been feparated, fays that on examining their remains, he found the fculls of the E- gyptians fo firm that the larged dones could hardly crack them, while thofe of the Per- fians were fo thin and weak as to be eafily fractured by a fmall pebble. After dating the fact, he accounts for it by obferving, that the Egyptians were accudomed from their in- fancy to go bareheaded; wherea* the Perfians, on the contrary, always wore thick tiaras. Thefe were like the heavy turbans which they dill ufe, and which fome travellers think the air of the country renders neceffary. I be- lieve with Rousseau, that the generality of -* 124 OF THE NURSING AND mothers will pay more regard to the sugges- tion of fuch travellers than to the remark of the judicious hidorian, and will fancy the air of Perfia to be universal. In opposition, however, to filly conceits and prejudices, I mud affure my female readers, that there is no part of the human frame which fuffers more from heat and preffure than the head, and none of courfe which ought to be kept cooler and lefs encumbered. A thin, light cap, flightly fadened with a bit of tape, fhould conditute the whole of an infant's head- drefs, from the moment of its birth till the increafed growth of the hair renders auy other protection unneceffary. As foon as nature fupplies your child with this bed of all cover- ings, never think of any thing more, even when you take him out into the open air, unlefs rain or intenfe heat or cold fhould make the occasional ufe of a very light and eafy hat advisable. I mud alfo forbid the ufe of day-bands to keep the poor infant's head as fixed and immoveable as if it were placed in a pillory. One would fuppofe that our heads were fo badly fecured by the Author of our being, that they would fall off if they were not held fad by thofe pernicious contriv- of nature: hence they enjo)^ bleffings they feel not, and are ignorant of their caufe. The mother, who has only a 302 APPENDIX. few rags to cover her child loofely, and little more than her own bread to feed it, fees it healthy and drong, and very foon able to fhift for itfelf; while the puny infeft, the heir and hope of a rich family, lies languifhing under a load of finery that overpowers his limbs, abhorring and rejefting the dainties he is crammed with, till he dies a viftim to the midaken care and tendernefs of his fond mo- ther. In the courfe of my praftice, I have had frequent occafion to be fully fatisfied of this; and have often heard a mother anxiouf- ly fay, the child has not been well ever fince it has done puking and crying. Thefe complaints, though not attended to, point very plainly to their caufe. Is it not very evident when a child rids its stomach feveral *times in a dav, that it has been overloaded?—When it cries, from the incumbrance and confinement of its cloaths, that it is hurt by them ? While the natural drength lads,' (as every child is born with more health afid drength than is gene- rally imagined,) it cries at or rejects the fuper- fluous load, and thrives apace ; that is, grows very fat, bloated, and distended beyond mea- fure, like a houfe-lamb. But in time, the fame oppreflive caufe continuing, the natural powers are overcome, being no longer able APPENDIX. 303 to throw off the unequal weight; the child, now not able to cry any more, languifhes and is quiet. The misfortune is, thefe complaints are not underdood ; it is fwaddled and cram- med on, till, after gripes, purging, &c. it finks under both burdens into a convulfion-fit, and efcapes any farther torture. This would be the cafe with the lamb, were it not killed when full fat. " That the prefent mode of nurfing is wrong, one would think needed no other proof than the frequent mifcarriages attending it, the death of many, and ill-health of thofe that furvive.**** What I am going to complain of is, that children in general are over-cloath- ed and over-fed; and fed and cloathed im- properly. To thefe caufes I impute almoft all their difeafes. But to be a little more ex- plicit. The fird great midake is, that they think a new-born infant cannot be kept too warm: from this prejudice they load and bind it with flannels, wrappers, fwathes, days, &c. which all together are almod equal to its own weight; by which means a healthy child in a month's time is made fo tender and chilly, it cannot bear the external air; and if, by any accident of a door or a window left carelefcly 304 APPENDIX. open too long, a refrefhing breeze be admit- ted into the suffocating atmofphere of the ly- ing-in bed-chamber, the child and mother fometimes catch irrecoverable colds: but, what is worfe than this, at the end of the month, if things go on apparently well, this hot-bed plant is fent out into the country to be reared in a leaky houfe, that lets in wind and rain at every quarter. Is it any wonder the child never thrives afterwards? The truth is, a new-born infant cannot well be too cool and loofe in its drefs: it wants lefs cloath- ing than a grown perfon in proportion, be- caufe it is naturally warmer, as appears by the thermometer, and would therefore bear the cold of a winter's ni^ht much better than any adult perfon whatever. There are many indances, both ancient and modern, of infants expofed and deferted, that have lived feveral days; as it was the praftice in ancient times, in many parts of the world, to expofe all thofe whom the parents did not care to" be encumbered with; that were deformed, or born under evil dars; not to mention the ma- ny foundlings picked up in London dreets. Thefe indances may ferve to fhew, that na- ture has made children able to bear even great hardftiips, before they are made weak APPENDIX. - 305 and fickly by their midaken nurfes. But, be- fides the mifchief arifmg from the weight and heat of thefe fwaddling-cloaths, they are put on fo tight, and the child is fo cramped by them, that its bowels have not room, nor the limbs any liberty, to aft and exert themfelves in the free eafy manner they ought. This is a very hurtful circumdance; for limbs that are not ufed will never be drong, and fuch tender bodies cannot bear much preffure : the circulation redrained by the compreffion of any one part, mud produce unnatural fwel- lings in fome other, efpecially as the fibres of infants are fo eafily didended. To which, doubtlefs, are owing the many didortions and deformities we meet with every where; chief- ly among women, who fuffer more in this par- ticular than the men. " If nurfes were capable of making jud ob- fervations, they might fee and take notice of that particular happinefs, which a child fhews by all its powers of expreffion, when it is newly undreffed. How pleafed, how delight- ed it is with this new liberty, when indulged for a few minutes with the free ufe of its legs and arms! But this is not to.lad long : it is r r 306 APPENDIX. fwaddled up as before, notwithdanding its cries and complaints. " I would recommend the following drefs : a little flannel waidcoat, without deeves, made to fit the body, and tie loofely behind; to which there fhould be a petticoat fewed, and over this a kind of gown of the fame material, or any other that is light, thin, and flimfy. The petticoat fhould not be quite fo long as the child, the gown a few inches longer; with one cap only on the head, which may be made double, if it be thought not warm enough. What I mean is, that the whole coiffure fhould be fo contrived, that it might be put on at once, and neither bind nor press the head at all : the linen as ufual. This I think would be abundantly fufficient for the day ; laying afide all thofe fwathes, bandages, days, and contrivances, that are mod ridiculoufly ufed to clofe and keep the head in its place, and fupport the body.. As if nature, exact na- ture, had produced her chief work, a human creature, fo carelessly unfinifhed as to want thofe idle aids to make it perfect. Shoes and dockings are very needlefs incumbrances, be- fides that they keep the legs wet and nady if they are not changed every hour, and often APPENDIX. 307 cramp and hurt the feet: a child would stand firmer, and learn to walk much fooner, with- out them. I think they cannot be neceffary till it runs out in the dirt. There fhould be a thin flannel fhirt for the night, which ought to be every way quite loofe. Children in this simple, pleafant drefs, which may be readily put on and off without teazing them, would find themfelves perfectly eafy and happy, en- joying the free ufe of their limbs and faculties, which they would very foon begin to employ when thus left at liberty. I would have them put into it as foon as they are born, and con- tinued in it till they are three years old ; when it may be changed for any other more genteel and fafhionable: though I could wifh it was not the custom to wear days at all ; not be- caufe I fee no beauty in the fugar-Ioaf fhape, but that I am apprehenfive it is often procur- ed at the expence of the health and strength of the body. There is an odd notion enough entertained about change, and the keeping of children clean. Some imagine that clean li- nen and frefh clothes draw, and rob them of their nourifhing juices ; I cannot fee that they do any thing more than imbibe a little of that - moidure which their bodies exhale. Were it, as is fuppofed, it would be of fervice to them; 308 APPENDIX. since they are always too abundantly suppli- ed, and therefore I think they cannot be chan- ged too often, and would have them clean every day; as it would free them from dinks and fourneffes, which are not only offenfive, but very prejudicial to the tender date of in- fancy. " The feeding of children properly, is of much greater importance to them than their clothing. We ought to take great care to be right in this material article, and that nothing be given them but what is wholefome and good for them, and in fuch quantity as the body calls for towards its fupport and growth; not a grain more. Let us confides what na- ture directs in the cafe : if we follow nature, indead of leading or driving it, we cannot err. In the bufinefs of nurfing, as well as phyfic, art is ever dedruftive, if it does not exactly copy this original. When a child is fird born, there feems to be no provision at all made for it; for the mother's milk, as it is now managed, feldom comes till the third day ; fo that, according to this appearance of nature, a child would be left a day and a half, or two days, without any food. Were this really the cafe, it would be a fufficient proof that it APPENDIX. 309 wanted none ; as indeed it does not immediate- ly ; for it is born full of blood, full of excre- ment, its appetites not awake, nor its fenfes opened ; and requires fome intermediate time of abdinence and red to compofe and recover the druggie of the birth, and the change of circulation (the blood running into new chan- nels) which always put it into a little fever. However extraordinary this might appear, I am fure it would be better that the child was not fed even all that time, than as it general- ly is fed ; for it would fleep the greated part of the time, and, when the milk was ready for it, would be very hungry, and fuck with more eagernefs; which is often neceffary, for it fel- dom comes freely at firft. But let me endea- vour to reconcile this difficulty, that a child should be born thus apparently unprovided for : I fay apparently, for in reality it is not fo. Nature neither intended that a child fhould be kept fo long faffing, nor that we fhould feed it for her. Her design is broke in upon* and a difficulty raifed that is wholly owing to mistaken management. The child, as foon as it is born, is taken from the mother, and not fuffered to fuck till the milk comes of itfelf; but is either fed with drange and im- proper things, or put to fuck fome other wo- 310 APPENDIX. man, whofe milk flowing in a full dream, overpowers the new-born infant, that has not yet learned to fwallow, and fets it a coughing, or gives it a hiccup: the mother is left to druggie with the load of her milk, unaffided by the fucking of the child. Thus two great evils are produced, the one a prejudice to the child's health, the other the danger of the mother's life; at lead the retarding her reco- very, by caufing what is called a milk fever ; which has been thought to be natural, but fo far from it, that it is entirely owing to this mifconduft. I am confident from experience, that there would be no fever at all, were things managed rightly; were the child kept without food of any kind till it was hungry, which it is impoflible it fhould be jud after the birth, and then applied to the mother's breaft : it would fuck with drength enough, after a few repeated trials, to make the milk flow gradu- ally, in due proportion to the child's unexer- cifed faculty of fwallowing, and the call of its stomach. Thus the child would not only pro- vide for itfelf the bed of nourifhment, but, by opening a free paffage for it, would take off the mother's load, as it increafed, before it could opprefs or hurt her ; and therefore ef- feftually prevent the fever, which is caufed APPENDIX. 3" only by the painful didenfion of the lacteal veffels of the breads, when the milk is inju- dicioufly fuffered to accumulate. Here let me defcribe a cafe of pure nature, in order to illudrate this material point yet farther. When a healthy young woman lies in of her fird child, before the operations of nature have been perverted by any abfurd practices, her labour would be drong, and, as I have chofen to indance in the cafe of a fird child, perhaps-difficult; but in a few minutes after her delivery, die and her child, if it be not in- jured, would fall in a fweet deep of fix or fe- ven hours : the mother, if no poifonous opi- ate has been unneceffarily given her, would awake refrefhed, the child hungry. A little thin broth with bread, or fome fuch light food, fhould be then given her ; and foon after the child be put to fuck. In one hour or two the milk would infallibly flow; and, if nothing elfe be given it, the child would grow strong, and fhe recover perfectly in a few days. This is the constant courfe of nature, which is very little attended to, and never followed. The general practice is, as foon as a child is born, to cram a dab of butter and fugar down its throat, a little oil, panada, caudle, or fome fuch unwholefome mefs. So that they fet out 312 APPENDIX. wrong, and the child dands a fair chance of bein^ made fick from the fird hour. It is the cudom of fome to give a little road pig to an infant, which, it feems, is to cure it of all the mother's longings. Much nonfenfe has been propagated, and believed, about women's longings, without any foundation in truth and nature. I wifh thefe matters were a little more inquired into for the honour of the fex, to which many imperfections of this kind are im- puted, which I am fure it does not lie under. " Hence I may be afked, what is to be done with a child born fick, that, indead of deep- ing, cries inceffantly from the birth, and is hardly to be quieted by any means ? Let good care be taken that it is not hurt by the dref- fing, or rather let it not be dreffed at all, but wrapped up in a loofe flannel. If, notwith- danding this precaution, it dill continues cry- ing ; indead of feeding it, for it is certainly a prepoderous thing to think of feeding a child becaufe it is fick, though poffibly this may dop its mouth for a little while, let it be applied to the mother's bread, perhaps it may bring the milk immediately, which would be the bed medicine for it in fuch a cafe ; or the nipple m its mouth may quiet it, though it does not APPENDIX. 3*3' bring it. And it is certainly better it fhould be quieted without food than with it, which mud neceffarily make it worfe. Sometimes indeed the child may be fo very ill, that it will not even attempt to fuck. In fuch a cafe, which I think can happen but rarely, let the phyfic I fhall recommend a little farther on, where children are unavoidably to be dry- nurfed, be given, a little every hour, till it takes effect, dill attempting to bring it to fuck the mother's milk, which is the bed phyfic or food it can take. " When a child fucks its own mother, which, with a very few exceptions, would be bed for every child and every mother, nature has provided it with fuch wholefome and fuit- able nourifhment, supposing her a temperate woman that makes fome ufe of her limbs, it can hardly do amifs. The mother would like- wife, in mod hyderical nervous cafes, edablifh her own health by it, though fhe were weak and fickly before, as well as that of her off- spring. For thefe reafons I could wifh, that every woman that is able, whofe fountains are not greatly didurbed or tainted, would give fuck to her child. I am very fure that forcing back the milk, which mod young women mud s s 314 APPENDIX. have in great abundance, may be of fatal con- fequence: fometimes it endangers life, and often lays the foundation of many incurable difeafes. The reafons that are given for this praftice are very frivolous, and drawn from falfe premifes ; that fome women are too weak to bear fuch a drain, which would rob them of their own nourifhment. This is a very midaken notion ; for the fird general caufe of mod people's difeafes is, not want of nou- rifhment, as is here imagined, but too great fulnefs and redundancy of humours ; good at fird, but being more than the body can em- ploy or confume, they dagnate, degenerate, and the whole mafs becomes corrupt, and produces many difeafes. This is confirmed by the general praftice of physicians, who make holes in the fkin, perpetual bliflers, if- fues, &c. to let out the fuperfluity. I would therefore leave it to be considered, whether the throwing back fuch a load of humour, as a woman's fird milk, be mod likely to mend her conditution, or make her complaints ir- remediable. The mother s fird milk is pur- gative, and cleanfes the child of its long-hoard- ed excrement; no child, therefore, can be deprived of it without manifed injury. By degrees it changes its property, becomes lefs APPENDIX. 315 purgative, and more nourifhing ; and is the bed and only food the child likes, or ought to have for fome time. If I could prevail, no child fhould ever be crammed with any un- natural mixture, till the provision of nature was ready for it; nor afterwards fed with any ungenial alien diet whatever, at leaft for the firft three months : for it is not well able to digest and affimilate other aliments fooner. I have feen very healthy fine children, that never ate or drank any think whatever but the mother s milk for the firft ten or twelve months. Nature feems to direft this, by giv- ing them no teeth till about that time. There is usually milk enough with the firft child; fometimes more than it can take : it is pour- ed forth from an exuberant, overflowing urn, by a bountiful hand that never provides fpar- ingly. The call of nature fhould be waited for to feed it with any thing more fubflantial, and the appetite ever precede the food; not only with regard to the daily meals, but thofe changes of diet, which opening, increafing life requires. But this is never done in either cafe, which is one of the greated midakes of all nurfes. Thus far nature, if fhe be not inter- rupted, will do the whole bufinefs perfectly well ; and there feems to be nothing left for 3*6 APPENDIX. a nurfe to do, but to keep the child clean and fweet, and to tumble and tofs it about a good deal, play with it, and keep it in good humour. " When the child requires more folid fufle- nance, we are to inquire what, and how much is mod proper to give it. We may be well affured there is a great midake either in the quantity or quality of children's food, or both, as it is usually given them; becaufe they are made fick by it; for to this midake I cannot help imputing nine in ten of all their difeafes. As to quantity, there is a mod ridiculous error in the common praftice ; for it is generally fuppofed, that, whenever a child cries, it wants victuals ; and it is accordingly fed ten, twelve, or more times in a day and night. This is fo obvious a mifapprehenfion, that I am furprifed it fhould ever prevail. If a child's wants and motions be diligently and jndicioufly attended to, it will be found that it never cries but from pain : now the firft fenfations of hunger are not attended with pain ; accordingly a child (I mean this of a very young one) that is hungry, will make a hundred other signs of its want, before it will cry for food. If it be healthy and quite eafy in its drefs, it will hardly ever cry at all. In- APPENDIX. 317 deed thefe figns and motions I fpeak of are but rarely to be obferved ; becaufe it feldom happens that children are ever fuffered to be hungry. In a few, very few, whom I have had the pleafure to fee reafonably nurfed, that were not fed above two or three times in four and twenty hours, and yet were perfect- ly healthy, aftive, and happy, I have feen thefe fignals, which were as intelligible as if they had fpoken. " There are many faults in the quality of their food : it is not simple enough. Their paps, panadas, gruels, &c. are generally en- riched with fugar, fpice, and fometimes a drop of wine, neither cf which they ought ever to tade. Our bodies never want them : they are what luxury only has introduced, to the dedruftion of the health of mankind. It is not enough that their food be simple, it fhould be alfo light. Several people I find, are mif- taken in their notions of what is light; and fancy that mod kinds of padry, puddings, cuftards, &c. are light, that is, light of digef- tion. But there is nothing heavier in this fenfe than unfermented flour and eggs boiled hard, which are the chief ingredients of thofe preparations. What I mean by light, to give 318 APPENDIX. the bed idea I can of it, is any fubdance that is eafily feparated, and foluble in warm water. Good bread is the lightest thing I know: the power of due fermentation, in which confids the whole art of making it, breaks and atten- uates the tenacious particles of the flour fo as to give it thefe qualities I mention, and make it the fitted food for young children. Cows milk is alfo fimple and light, and very good for them; but it is injudicioufly prepa- red ; it fhould not be boiled; for boiling al- ters the tade and property of it, dedroys its fweetnefs and makes it thicker, heavier, and lefs fit to mix and affimilate with the blood. But the chief objection is, that their food is wholly vegetable, the bad confequence of which is, that it will turn four in their dom- aehs. The firft and general caufe of all the difeafes of infants is manifedly this acefcent quality of all their food. If any of thefe ve- getable preparations I have named, be kept in a degree of heat equal to that of a child's domach, it will become four as vinegar in a few hours time. Thefe things are therefore very improper to feed a child wholly with. Some part of its diet fhould be contrived to have a contrary tendency; fuch as we find only in flefh, which is the direft oppofite to APPENDIX. 3^9 acid, and tends to putrefaction. In a due mixture of thefe two extremes, correcting each other, confids that falubrity of aliment our nature feems to require. As we are part- ly carnivorous animals, a child ought not to be fed wholly upon vegetables. The mo- ther's milk, when it is perfectly good, feems to be this true mixture of the animal and ve- getable properties, that agrees bed with the conditution of a child, readily paffes into good blood, requiring but a gentle exertion of the powers of circulation to break and fubdue its particles, and make them fmooth and round, and eafily divisible. I would advife therefore, that one half of infants' diet, be thin light broths, with a little bread or rice boiled in them; which lad is not fo acefcent as any o- ther kind of meal or flour. Thefe broths fhould be made with the flefh of full-grown animals, becaufe their juices are more elabo- rate; efpecially if they have never been confined to be fatted. The juices of a young ox, taken from the plough, make the fined davoured and mod wholefome foup. I believe it is for the fame reafon, the flefh of all wild animals has a higher tade than that of tame, fagina- ted ones, and is therefore mod agreeable to the palate of the luxurious : but this is to be 320 APPENDIX. underdood of thofe creatures that feed on corn or herbage. The other part of child- ren's diet may be a little toaded bread and water boiled almod dry, and then mixed with frefh milk not boiled*. This, without fugar, fpice, or any other pretended amendment whatever, would be perfectly light and whole- fome, of fufficient nourifhment, fomething like milk from the cow, with the additional ftrength and fpirit of bread in it. Twice a day, and not oftener, a fucking child fhould be fed at firft ; once with the broth, and once with the milk thus prepared. As to the quantity at each time, its appetite muft be the meafure of that. Its hunger fhould be fatisfied, but no more; for children will al- ways eat with fome eagernefs full as much as they ought: therefore it muft be very wrong to go beyond that, and duff them till * The London bakers are suspe&ted of putting allum in their bread, which would be very pernicious to infants. Therefore rusks, or the biscuits called tops-and-bottoms, or rice, may be used instead of it. These will not turn sour so soon as common bread; which quality is undoubt- edly an objection to using much of it, especially when children are weakly. The safest and best method in my opinion is, not to feed them at all; at least till they are six or eight months old. The finest children I ever saw lived wholly upon sucking till after that age. APPENDIX. 321 they fpew, as the common method is. They fhould not be laid on their backs to be fed, but held in a fitting podure, that fwal lowing may be easier to them, and that they may the more readily difcover when they have had enough. When they come to be about ten or twelve months old, and their appetite and digef- tion grows drong, they may be fed three times a day; which I think they ought never to exceed their whole lives after. By night I would not have them fed or fuckled at all, that they might at lead be hungry in a morning. It is this night- feeding that makes them fo over-fat and bloat- ed. If they be not ufed to it at firft, and, perhaps, awaked on purpofe, they will never feek it; and if they are not difturbed from the birth, in a weeks time they will get into a habit of deeping all or mod part of the night very quietly, awaking poffibly once or twice for a few minutes, when they are wet, and ought to be changed. Their meals, and, in my opinion, their fucking too, ought to be at dated times, and the fame every day; that the domach may have intervals to diged, and the appetite return. The child would foon be quite eafy and fatisfied in the habit; much morefo than when taught to expect food at all times, and at every little fit of crying or unea- t t 322 APPENDIX. finefs. Let this method be obferved about a twelve-month, when, and not before, they may be weaned; not all at once, but by infenfible degrees; that they may neither feel, nor fret ta, the want of the bread. This might be very eafily managed, if they were fuffered to fuck only at certain times. Were this plan of nurfing literally purfued, the children kept clean and fweet, tumbled and toffed about a good deal, and carried out every day in all weathers, I am confident, that, in fix or eight months time, mod children would become healthy and drong, would be able to fit up- on the ground without fupport, to divert themfelves an hour at a time, to the great re- lief of their nurfes; would readily find the ufe of their legs, and very foon fhift for them- felves. "If it be afked, whether I mean this of child- ren in general, and that weakly ones, born of unhealthy parents, fhould be treated in the fame manner; I anfwer, that it is not fo com- mon for children to inherit the difeafes of their parents, as is generally imagined: there is much vulgar error in this opinion; for people that are very unhealthy feldom have children, efpeci- ally if the bad health be of the female fide ; and it is generally late in life when chronic APPENDIX. 323 difeafes take place in moft men, when the bu- finefs of love is pretty well over : certainly children can have no title to thofe infirmities which their parents have acquired by indo- lence and intemperance long after their birth. Is it not common for people to complain of ails they think hereditary, till they are grown up; that is, till they have contributed to them by their own irregularities and exceffes, and then are glad to throw their own faults back upon their parents, and lament a bad consti- tution when they have fpoiled a very good one. It is very feldom that children are troubled with family didempers. Indeed, when we find them affected with fcrophulous or venereal complaints, we may reafonably conclude the taint to have been trafmitted to them; but thefe cafes are very rare, in comparifon of the many others that are falfely, and without the lead foundation, imputed to parents; when the real caufe is either in the complain- ants themfelves, or bad nurfing, that has fixed them early in bad habits. In one fenfe, many difeafes may be faid to be hereditary, perhaps all thofe of malformation, by which I mean not only deformity and didortion, but all thofe cafes where the fibres and veffels of one part are weaker in proportion than the red; 324 APPENDIX. fo that upon any drain of the body, whether of debauch or too violent exercife, the weak part fails fird, and diforders the whole. Thus complaints may be produced similar to thofe of the parent, owing in fome meafure to the fimilitude of parts, which poffibly is inherited like the features of the face; but yet thefe dif- eafes might never have appeared, but for the immediate acting caufe, the violence done to the body. Mod didempers have two caufes: the one, a particular date of the folids and fluids of the body, which difpofe it to receive certain infections and impulfes; the other, the infection or impulfe itfelf. Now what I con- tend for is, that though this predifponent date or habit of the body be heritable, yet the dif- eafes incident to thefe wretched heirs may be avoided by preventing the aftive caufe; which may be done in many cafes by a due atten- tion to the non-naturals, as they are called; in plainer words, by a temperate, aftive life; in children, by good nurfing. Therefore I conclude, that, indead of indulging and en- feebling: vet more bv the common methods, children fb unhappily born, what I am re- commending, together with the wholefome mi Ik of a healthy nurfe, is the bed, the only means to remedy the evil, and by which a- APPENDIX. 325 lone they may by degrees be made healthy and drong. And thus, in a ganeration or two of reafonable temperate perfons, every taint and infirmity whatever, the king's evil and madnefs not excepted would be totally worn out. " The plain natural plan I have laid down is never followed, becaufe mod mothers, of any condition, either cannot, or will not un- dertake the troublefome talk of fuckling their own children; which is troublefome only for want of proper method: were it rightly ma- naged, there would be too much pleafure in it, to every woman that can prevail upon her- felf to give up a little of the beauty of her bread to feed her offspring; though this is a midaken notion, for the breads are not fpoil- ed by giving fuck, but by growing fat. There would be no fear of offending the hufband's ears with the noife of the fqualling brat. The child, was it nurfed in this way, would be al- ways quiet, in good humour, ever playing, laughing, or fleeping. In my opinion, a man of fenfe cannot have a prettier rattle (for rat- tles he mud have of one kind or other) than fuch a young child. I am quite at a lofs to ac- count for the general praftice of fending in- 326 APPENDIX. fants out of doors, to be fuckled or dry-nur- fed by another woman, who has not fo much underdanding, nor can have fo much affeftion for it, as the parents ; and how it comes to pafs, that people of good fenfe and eafy cir- cumdances will not give themfelves the pains to watch over the health and welfare of their children, but are fo carelefs as to give them up to the common methods, without confider- ing how near it is to an equal chance that they are dedroyed by them. The ancient cudom of expofing them to wild beads, or drowning them, would certainly be a much quicker and more humane way of difpatching them. There are fome, however, who wifh to have children, and to preferve them, but are mif- taken in their cares about them. To fuch on- ly I would addrefs myfelf, and earneflly re- commend it to every father to have his child nurfed under his own eye ; to make ufe of his own reafon and fenfe, in fuperintending and directing the management of it; nor fuf- fer it to be made one of the myderies of the Bona Dea, from which the men are to be ex- cluded. I would advife every mother that can, for her own fake as well as her child's, to fuckle it: if fhe be a healthy woman, it will confirm her health ; if weakly, in mod APPENDIX. 327 cafes it will redore her. It need be no con- finement to her, or abridgment of her time : four times in four and twenty hours will be often enough to give it fuck; letting it have as much as it will fuck out of both breads at each time. It may be fed and dreffed by fome handy reafonable fervant, that will sub- mit to be directed; whom, likewife, it may fleep with. No other woman's milk can be fo good for her child; and dry-nurfing I look upon to be the mod unnatural and dangerous method of all ; and, according to my obfer- vation, not one in three furvives it. To breed a child in this artificial manner, requires more knowledge of nature and the animal cecono- my, than the bed nurfe was ever midrefs of, as well as more care and attention than is ge- nerally bedowed on children : the fkill of a good phyfician would be neceffary to manage it rightly." ******** The Doftor is here led to ftate his opinion as to the precautions neceffary to be taken in the choice of hired nurfes, and his reafons why the children entruded to their care fhould be treated fomewhat differently from thofe who are nurfed in a more natural way, and fuck their own mothers. He does not deem it e- 328 APPENDIX. nough that hired nurfes fhould be clean and healthy : he looks upon their age as a mate- rial confideration. " Thofe," he fays, " be- tween twenty and thirty are certainly of the best age ; becaufe they will have more milk than the very young, and more and better than the old. But what,*' he thinks, " of the utmost confequence is, that great regard fhould be had to the time of their lying-in, and thofe procured, if poffible, who have not been brought to bed above two or three months." He judly obferves, that " nature intending a child fliould fuck about a twelve-month, the milk feldom continues good much longer ;" and he adds, with a dill greater degree of evi- dence, " that, if a new-born infant be de- prived of its own mother's milk, it ought un- doubtedly to have what is mod like it: the newer it is, the more fuitable in all refpefts to its tender nature.*5 ***** . After cenfuring a very common praftice with poor women, who, if they can get nurfe- children, will fuckle two or three of them fucceffively with the fame milk, he proceeds thus : " A nurfe ought to have great regard to her diet: it is not enough that die be fober and temperate ; her food fhould con- APPENDSX. 329 fid of a proper mixture of flefh and vegeta- bles : fhe fhould eat one hearty meal of un- falted flefh-meat every day, with a good deal of garden-duff, and a little bread. Thin broth or milk would be bed for her breakfad and dipper. Her drink fhould be finall-beer, or milk and water; but on no account fhould fhe ever touch a drop of wine or drong drink, much lefs any kind^of fpirituous liquors : gi- ving ale or brandy to a nurfe is, in effeft, giving it to the child ; and it is eafy to con- clude what would be the confequence." * * * This equally candid and judicious writer does not enter upon his promifed defcription of the treatment proper for children put out to nurfe, without again reminding his readers, that the plan, which he would lay down, could he prevail, would be that of nature, ex- cluding art and foreign aid entirely. " But," he adds, " when this is broke in upon, a lit- tle adventitious fkill becomes indifpenfibly ne- ceffary ; that, if we are not perfectly right in following clofely the defign of nature, we may co-operate a little, and not be totally wrong in counteracting it, as is too often the cafe. What I mean is, that every child, not allow- ed the mother's firft milk, whether it be dry- u u 330 APPENDIX. nurfed or fuckled by another woman, fhould be purged in a day or two after the birth, and this purging continued for fome time ; not by regular dofes of phyfic that may operate all at once, but fome lenient laxative fhould be contrived,' and given two or three times a day, fo as to keep the child's body open for the firft nine days, or fortnight; leffening the quantity infenfibly, till it be left off. It fhould be fo managed, that the operation of the ar- tificial phyfic may refemble that of the natu- ral. This is fo material, that, for want of it, moft with children in the firft month break out in pimples all over : the nurfes call it the red- gum, and look upon it to be a natural thing, and that the children will be unhealthy that have it not. So indeed they will be in all likelihood ; and it is better that thefe foulnef- fes, which become acrid and hot by remain- ing too long in the body, fhould be difcharged through the fkin, than not at all: or that they fhould be lodged in the blood, or fall upon the vitals, to lay the foundation of number- lefs future evils ; but it is chiefly owing to the negleft of this method at firft. A child that fucks its own mother, unlefs it be great- ly over-fed, or kept too hot, will never be troubled with this humour at all." * * * * APPENDIX. 331- The following is the form of the gentle pur- gative which the Doftor recommends to fuch infants as have been deprived of the falutary operation of their mothers' milk : "" Take manna, pulp of caflia, of each half an ounce: diffolve them in about - three ounces of thin broth. Let the child take two fpoonfuls three times a day, varying the quan- tity according to the effeft; which, at fird, ought to be three or four dools in four and twenty hours." Among other rules for the conduct of hired nurfes, this experienced phyfician particular- ly enjoins fuch women " to keep the children awake by day, as long as they are difpofed to be fo, and to amufe and keep them in good humour all they can; not to lull and rock them to deep, or to continue their deep too long ; which is only done to fave their own time and trouble, to the great detriment of the children's health, fpirits and underdanding," ***** Here he refers to his former ob- fervations on the changes to be gradually made in the diet of children, when they come to require more folid fudenance than bread- 332 APPENDIX. milk ; and he takes occafion to introduce the following remarks : " A child may be allowed any kind of mel- low fruit, either raw, dewed, or baked, roots of all forts, and all the produce of the kitchen- garden. 1 am fure all thefe things are whole- fome and good for them, and every one elfe, notwithdanding the idle notion of their being windy, which they are only to very debauched flomachs ; and fo is milk : but no man's blood want's the cleanfing, refrefhing power of milk, more than his, whofe domach, ufed to inflam- matory things of high relifh, will not bear the fird chill of it. To children, all this kind of food, token in moderation, is perfectly grateful and falutary. Some may think that they carry into the domach the eggs of future worms: but of this I am not very apprehen- five; for I believe there are few things.we eat or drink that do not convey them. But then they can never be hatched in a healthy infide, where all the juices are fweet and good, and every gland performs its office : the gall, in particular, would dedroy them: bullocks' gall has been found to be a good and fafe ver- mifuge. It is my opinion, we fwallow the eggs of many little animals, that are never APPENDIX. 333 brought to life within us, except where they find a fit ned or lodgment in the acid phlegm Or vitiated humours of the domach and bow- els. Were thefe totally difcharged every day, and the food of yederday employed in nou- rifhment, and the superfluity thrown off to the lad grain, no worms could ever breed or har- bour in our vitals. As foon as the children have any teeth, at fix or eight months, they may by degrees be ufed to a little flefh-meat; which they are always very fond of, much more fo at firft, than of any confectionary or padry wares, with which they fhould never debauch their tade." I have elfewhere enlarged on the fatal effefts of thefe palatable poifons ; and I am not with- out hopes that tender and rational mothers will pay fome little attention to my warnings. A reform in this article alone-—the total dif- ufe of padry in the diet of young children— will go a great way towards preventing manv of the word complaints to which they are sub- jea. From the above remarks on the proper food of infants, the Doftor makes a very na- tural transition to the confideration of their 334 APPENDIX. difeafes. He begins with exposing the ab- furdity of popular errors and popular prejudi- ces with refpeft to teething. " Breeding teeth," he fays, " has been thought to be, and is fatal to many children ; but I am confident this is not from nature, for it is no difeafe, or we could not be well in health till one or two and twenty, or later. Teeth are breeding the greated part of that time ; and it is my opinion, the lad teeth give more pain than the fird, as the bones and gums they are to pierce are grown more firm and hard. But, what- ever fever, fits, or other dangerous fymptoms feem to attend this operation of nature, healthy children have fometimes bred their teeth with- out any fuch bad attendants ; which ought to incline us to fufpeft the evil not to be natural, but rather the effeft of too great a fulnefs, or the corrupt humours of the body put in agi- tation by the dimulating pain the tooth cau- fes in breaking its way out. This, I believe, never happens without fome pain, and poffi- bly a little fever; but if the blood and juices be perfectly fweet and good, and there be not too great a redundancy of them, both will be but flight, and pafs off imperceptibly, with- out any bad confequence whatever. The chief intention of the method I am recom- APPEN'DIX. 335 mending is, to preferve the humours of the bodv in this date ; and therefore, if it fuc- ceeds, children fo managed will breed their teeth with lefs pain and danger than are com- monly obferved to attend this work of na- ture." In fupport of this opinion, I can date from my own experience, that I have never known cutting the teeth, as it is called, attended with any pain of an alarming nature, except in ca- fes of previous difeafe, mifmanagement or bad nurfing. Fevers, convulfion-fits, and other dangerous fymptoms, are always, upon fuch occafions, the confequences of an extreme ful- nefs of the habit, a vitiated date of the blood and juices, fome conditutional weaknefs, or a great irritability of the nervous fydem. The ufe alfo of corals, and the like hard fubdan- ces, by rendering the gums callous, mud op- pofe additional refidance to the burding tooth, and greatly increafe the acutenefs of the pain. But the doctor's text requires no com- ment. I fhall therefore refume my quotation from his valuable pamphlet. " As I have faid," continues he, " that the fird and general caufe of mod of the difeafes 336* APPENDIX. infants are liable to, is the acid corruption of their food, it may not be amifs jud to men- tion an eafy and certain remedy, or rather preventive, if given timely, at the fird ap- pearance of predominating acid; which is ve- ry obvious, from the crude white or green dools, gripes and purgings, occasioned by it. The common method when thefe fymptoms appear, is to give the pearl-julep, crabs-eyes, and the tedaceous powders; which, though they do abforb the acidities, have this incon- venience in their effeft, that they are apt to lodge in the body, and bring on a codivenefs very detrimental to infants, and therefore re- quire a little manna, or fome gentle purge, to be given frequently to carry them off. In- dead of thefe, I would recommend a certain fine infipid powder, called magnefia alba, which, at the fame time it corrects and fweet- ens all fourneffes rather more effeftually than the tedaceous powders, is likewife a lenient purgative, and keeps the body gently open. This is the only alkaline purge I know of, and which our difpenfatories have long wanted. I have taked it myfelf and given it to others, for the heart-burn, and find it to be the bed and mod effeftual remedy for that complaint. It may be given to children from one to two APPENDIX. 337 drams a day, a little at a time in all their food, till the acidities be quite overcome, and the concomitant fymptoms difappear entirely. I have often given it with good and great effect, even when the children have been far gone in difeafes firft brought on by prevailing acid. " It is always eader to prevent difeafes than to cure them ; and as neither children, nor indeed grown perfons, are ever feized with chronic difeafes fuddenly, the progrefs of de- caying health being perceptibly gradual, it is no difficult matter for a phyfician of common fkill to obferve the firft dep towards illnefs, and to foretell the confequence, in all thofe whofe habit of life is well known to him. But to parents and nurfes in general, thefe obferva- tions may not occur. I will therefore point out a few certain figns and fymptoms, by which they may be affured, that a child's health is decaying, even before it appears to be fick. If thefe are negfefted, the evil in-