PART III CARE OF CHILDREN (Part 5)

anything else, often let pass those motions tiveness °f Nature when she calls them but gently ; and so they, neglecting the seasonable offers, do by degrees bring themselves into an habitual costiveness." The remedy suggested is the holding the child daily to an hour for action, and thus establishing the regularity in which Nature rejoices in all her works. We do not mean that these evils are inevitable in the school life of a child, but it is true that a general survey and examination of the health of Schools pupils shows that a surprising proportion has chronic signs ofew disease of more or less serious nature, that head- advance acnes are universal, that, in short, Civilization has no advance to show as regards the physical condition of her children. The Spartans gave their youth first and foremost the gift of vigorous bodies, trained by endurance to perfect control, to a thorough enjoy- ment of life through spontaneous self-activities and expression. When our system of education accom- plishes that for the physical, it will be time to point with pride to the gain in mental development of the children under its guardianship. The nervous breakdown in college dates back to pressure in the elementary school, systematic pres- sure, persistently applied. If all schools were like the worst, the evils would be such crying ones that parents would demand a change, and it would come. FOOD AND EXERCISE 335 The number of schools of the better sort is in- creasing, and as the experimentation succeeds the popular prejudice against learning made joyous will disappear, and the normal training of children will sort 0f not be limited to the few, but will be the natural ?^°e0^sin heritage of all. IV POINTS ON HYGIENE Toughening "—Baths— The Teeth— Footwear— Dress Cold baths and cold rooms may tend to make chil- dren less resistant to disease "TOUGHENING" THE process of "toughening children" is a very mistaken one, failing utterly of its purpose in nearly all cases. Generalization in the treatment of children is not rational, and cold baths and exposure to all kinds of weather indoors and out are not uni- versally helpful. The cold bathing, unless a child has vigorous, abounding health and a nervous system that enjoys the shock, tends to debilitate rather than to stimulate, and with increased nervousness come loss of appe- tite and sleeplessness. Exposure in cold sleeping-rooms, instead of making a very little baby less liable to throat and chest affections, often leaves him more susceptible to colds, catarrh, and sore throat, and this susceptibility increases the severity of many of the infectious dis- eases of childhood. In exceedingly inclement weather very little -chil- dren should not be taken out. The air in their sleeping-rooms must be fresh, and they must be so ventilated that it is changing constantly, but widely opened windows and atmosphere perceptibly chilled are conditions which are likely to make children less resistant rather than more so. The extreme is quite as much to be condemned. (336) POINTS ON HYGIENE 337 To keep a human being protected like a hothouse flower indoors, to wrap the throat and indeed the Weaken- whole body in fur, and to make impossible free exer- too much cise out in the air is to make sure a weakening of protectl0n vitality which leads to practically the same results, along perhaps more direct paths. The individual must be considered, and the process of hardening must be gradually established, with little attempt at radicalism till after the child is capable of indepen- dent motion. BATHS Bathing in disease, and its relation to the func- tions of the skin, have been described. Its impor- The daily tance in health is no less to be considered. The daily bath ought to be as much a part of the day's routine as the care of the hair, and children will so regard it if it is given them as regularly after they are grown as when they are babies. In summer a child who has been vigorously play- ing all day needs a warm cleansing bath at night, The bath because the perspiration has been secreted so plenti- siee^,re fully and the oil-glands have also poured out their fluid in abundance. This has been mixed with the dust, which collects upon the surface of the body, sometimes in a perceptible amount, but always enough to need removal with warm water and soap. A bath should not be given immediately after a meal, but if children have their suppers at five or half-past, there is time for the little frolic which always seems to have its place before bedtime, and the bath will quiet the nerves and relax the muscles for restful sleep. In the winter the bath is useful to stimulate the circulation, to increase the heat of the body, and to jointer render the child, if possible, less susceptible to cold. i5 Vol. 3 338 CARE OF CHILDREN For this reason the cool or tepid plunge in the morn- ing is of especial value. If he is of normal health, and is gradually accustomed to the cool water, he will learn to like the shock and will especially enjoy the glow and tingling warmth of the reaction. A cold bath must be given with care, for unless a child is very vigorous the shock will be too great, and no good will result. Children enjoy the feeling of the air on their bodies, and if the household is one which will admit bath of it, they should be given the chance each day for a brisk run about through the rooms of comparatively even temperature, without the restraint of clothes. As long as children are unconscious of their bodies there is no reason why they should not have that freedom, and it is made impossible by remarks which they feel though they do not understand. Children's scalps collect dust and their hair re- andqthor- quires shampooing much more often than that of pooingham" adults. If the hair is short it is very easily kept clean, but it must not be neglected, because an accu- mulation of dirt may lead to disease, and if a little borax or alcohol is added to the last rinsing water the hair dries quickly and there will be no danger of catching cold. THE TEETH Teething usually begins at six months. It may if teething be delayed until the second year, with no other sign of consider*1 arrested development, and the order in which the teeth the ,chil4's come may vary in every way without any indication of digestion illness, and with no bad effects upon the system. Parents, however, should be sure that the food contains the proper elements for the nourishment of the child, and that it is being properly digested. The food is often responsible for disorders that are at- POINTS ON HYGIENE 339 tributed to teething. If the teeth are delayed in their appearance, or if the gum is unusually hard and fibrous, so that they have unusual difficulty in pierc- ing it, there will be nervous irritation and there may be functional disorders, but if the food is suitable the symptoms are not the same as those produced by intestinal trouble. The diarrhoea that is sometimes caused by diffi- cult dentition can be distinguished from that brought _ ° ° Symptoms about by intestinal irritation. In difficult dentition in difficult there will be great fretfulness and acute pain, with spasmodic movements of the muscles of the face, the gums will be swollen and red, and the appetite will be variable. The child troubled with indigestion wishes to bite and chew anything put into the mouth. One suffering with pain from swollen gums will not bring them together upon anything. If the teeth are re- sponsible for the condition, lancing the gums will give immediate relief. The teeth appear in groups, making a division in time which allows a rest between their appear- ances. Changes in food, weaning, or any such break 0f tefthUpS in regularity may best be arranged for one of these periods of rest. A table which may be accepted as representing the usual order is as follows : I. 6 — 8 months 2 middle lower incisors II. S — io months 4 upper incisors ttt to r. rv,™Tr1c j 4 lateral lower incisors III. 12-14 months J J first molars IV. 18 — 20 months 4 canines V. 28—32 months 4 second molars The first set of teeth numbers twenty. The four middle teeth in both jaws are called incisors, the next 0fU?her four on either side the incisors, both upper and lower, first set are canines. The remaining eight are molars. 340 CARE OF CHILDREN The importance of care of the temporary teeth is not appreciated, and they are too often allowed to become decayed, and thus of no use to the child. The what evil evils of this are twofold. The presence of a decayed toothaye tooth in the mouth means that the micro-organisms may do which cause the decay are spreading their poison to other teeth, through the roots to the permanent tooth which is to take its place, and leaving an effect upon the general digestive tract. In the second place a tooth which contains a cavity is incapacitated from its share in mastication. A child will adjust himself to conditions if a How bad remedy for them is not forthcoming, so that often teeth affect ne wjh cease complaints of an aching- tooth because a child s r ° mastication he has adopted the plan of giving it no work to do. If there are decayed teeth on both sides of the mouth this frequently means that food is swallowed prac- tically without mastication. Habit is strong in all the acts of our daily life, and such a one established would inevitably lead to imperfect digestion. The teeth are intended for use, and the mastica- tion of solid food keeps them in a healthy condition, and is one of the best helps toward cleaning them. The pain of decayed teeth also affects the nerves in a way that is exceedingly bad for a child's devel- opment. If the temporary teeth are decayed and neglected the permanent ones which follow are almost sure "to Care of the be imperfect. When a tooth is lost the gum shrinks first set an(j t^e Space tnat t^e secon(i tooth is to occupy changes in shape. It is then very likely to be out of place, and will very probably crowd the other teeth. The greater probability is that the decay of the first tooth is communicated to the second, and to its neigh- bors as well. POINTS ON HYGIENE 341 Children should have early instruction in the care of the teeth. While they are very young they The sort of can be taught to rinse the mouth thoroughly, and use and the use of the toothbrush will interest them, in the usTit° beginning at least, because of its novelty and as being a sign manual of increasing ability. Such a brush as that called the prophylactic is the most sanitary and effective. Its bristles are of unequal lengths, and a tuft of longer ones at one end penetrates well be- hind and between the teeth. The curved shape of the handle makes it fit the jaw better than the straight brush. The toothbrush should be used over the surface of the teeth with a downward motion on the upper J^uesiJ00th" teeth and an upward motion on the lower teeth, which causes the bristles to pass between them. The food arid the motion of the lips, tongue, and cheeks over the surface of the teeth prevents the accumulation of organic substances and the development of micro- organisms, and it is between the teeth that decay begins. Dental floss may be used additionally to Pental 0 J J floss versus make sure that no food has lodged there, and is much wooden better than wooden toothpicks, which are very liable to splinter and leave behind more harm than they remove. A tooth-powder is useful, though not absolutely essential, if the cleansing process is regularly and carefully carried on. A very good formula for powder powder to be made in the household is as follows : One part white castile soap, two parts precipitated chalk, with powdered orrisroot to flavor it. Shave the soap in thin flakes, and dry it for a day or two before using. Proportions and flavoring can be varied. Children can be accustomed to visits to the 342 CARE OF CHILDREN The teeth should be regularly examined by a good dentist The per- manent teeth When a tooth aches Care of the teeth dentist's so that there need not be that frantic terror at the thought that often keeps a parent from giving them the proper care in that regard. Too often stories of agonies suffered are retailed to their ears. This should never be allowed, and the regular visits for examination will remove many of the alarms. The permanent teeth number thirty-two. At about six years of age four of these teeth, the molars, appear just behind the temporary molars. Four more come about six years later, still further back on the jaw, and the eight bicuspids take the place of the eight temporary molars. This early appearance of the first permanent teeth should be understood, for often it is considered that they are first teeth, and they are allowed to decay. When the pain in a tooth is caused by the pres- ence of a foreign body on a live pulp, removal of the cause relieves the pain, but when there seems to be no especial reason for it the treatment is different. The cavity should be carefully washed out with tepid water or with water and peroxide of hydrogen in equal parts, dried, with absorbent cotton, and a tiny bit of the cotton, soaked in equal parts of carbolic acid and oil of cloves, placed in the cavity. A five per cent solution of carbolic should be used, and care must be taken not to get it on the surrounding gum, since it will be liable to burn any tissue it touches. Compound tincture of benzoin applied in the same way may also relieve. The necessity of immediate care of diseased teeth can not be too strongly emphasized. If the teeth are properly brushed as they are coming in, the loss of teeth in adult life is very unusual. "Gum-boils," ab- scesses, and decay of teeth, aside from the pain, which must be nervously debilitating, are constantly POINTS ON HYGIENE 343 introducing poisons into the system, which negative any measures taken toward hygiene of the digestive organs, and imperfect digestion is incompatible with normal development. FOOTWEAR Troubles with the feet, either from corns, from tenderness in the soles, or from difficulty in getting Careful ig shoes, are common enough among attention comfortablv fitting shoes, are common enough among to the adults, so that the need of careful attention to the feet ^f feet in childhood must be recognized. We have spoken children of the cartilaginous state of the bones in infancy. That condition and the fact that the foot and ankle are composed of a number of very small bones make it possible to compress the feet in childhood and cause them to grow misshapen or even deformed, without severe pain. The fad of bare feet and legs had for its inspira- tion the reasonable revolt from the unhygienic treat- ment that childhood had received in this regard, but it was extreme, and may be modified on more rational lines. The freedom is admirable, but the exposure is not always wise. Warmth of the extremities is what we emphasize as necessary to protect a baby from colds, and the intestinal disorders which so often follow. The first shoes should be soft kid moccasins, made of ooze or undressed kid, with no stiffness in the ^gfirst sole, and fastened with a soft lacing up the front. These are sold by any firm dealing in children's furnishings, but are much more cheaply made at home. To make them is very pretty work, and the pattern can be enlarged as the foot grows, so that there need be no danger of pinching the feet. A child can often wear these from the time he 344 CARE OF CHILDREN begins to walk until he is three years old, a stouter kid being chosen as he becomes more vigorous. They ensure an absolutely natural position of the foot, quite as truly as no shoe at all, and they offer ample Need of a protection from cold and dampness on the one hand, moccasin , r , ,. , , , . , protection and irom the dirt and sharp objects that experience to the feet nas provec[ are a source 0f danger to children allowed to go with legs and feet uncovered. The baby who is only creeping, or whose walks are confined to his nursery, does not run the second risk, but older chil- dren do, and cuts from sharp stones or pieces of glass, or the more dangerous wounds from rusty nails have been sources of such serious illness that the protec- tion of feet and legs ought to be appreciated. Almost every child when he begins to stand or The nat- walk will hold the feet either at a direct right angle, urai posi- from a iine drawn down the front of the leer, or tion of &' the feet slightly turned in. The prints of his feet show a series of almost parallel lines. It is only when he has grown considerably older that he adopts the "toeing-out" position, which he acquires either from imitation or by definite instruction. The natural position should not be interfered with. He may ac- Values of the quire habits, like standing with the weight resting posi ion on