{"1": {"fulltext": "", "height": "4320", "width": "2696", "jp2-path": "careofchildinhea00oppe_0001.jp2"}, "2": {"fulltext": "LIBRARY OF CONGRESS.\\nChap........ Copyright No...\\nUNITED STATES OF AMERICA.", "height": "4304", "width": "2860", "jp2-path": "careofchildinhea00oppe_0002.jp2"}, "3": {"fulltext": "", "height": "4348", "width": "2720", "jp2-path": "careofchildinhea00oppe_0003.jp2"}, "4": {"fulltext": "6H)", "height": "4292", "width": "2912", "jp2-path": "careofchildinhea00oppe_0004.jp2"}, "5": {"fulltext": "THE CARE OF THE CHILD\\nIN HEALTH", "height": "4360", "width": "2708", "jp2-path": "careofchildinhea00oppe_0005.jp2"}, "6": {"fulltext": "", "height": "4320", "width": "2932", "jp2-path": "careofchildinhea00oppe_0006.jp2"}, "7": {"fulltext": "THE CARE OF THE CHILD\\nIN HEALTH\\nBY\\nNATHAN OPPENHEIM\\nA.B. (Habv.), M.D. (Coll. P. S., N.Y.)\\nATTENDING PHYSICIAN TO THE CHILDREN S DEPARTMENT\\nOF MT. SINAI HOSPITAL DISPENSARY\\nAUTHOR OF THE DEVELOPMENT OF THE CHILD\\nAND THE MEDICAL DISEASES OF CHILDHOOD\\nTHE MACMILLAN COMPANY\\nLONDON: MACMILLAN CO., Ltd.\\n1900\\nAll right* reserved", "height": "4340", "width": "2732", "jp2-path": "careofchildinhea00oppe_0007.jp2"}, "8": {"fulltext": "TWO COPihi. .Jt-OEIVED,\\nlibrary uf C\u00c2\u00bbngr Q t%\\nOffice of the\\nMAY 2 1900\\nUlster of Copyrltfiit^\\nSECOND COPY, x\\no\\n59105\\nCopyright, 1900,\\nBy THE MACMILLAN COMPANY.\\nKToriwooti $regg\\nJ. S. Cushing Co. Berwick Smith\\nNorwood Mass. U.S.A.", "height": "4288", "width": "2904", "jp2-path": "careofchildinhea00oppe_0008.jp2"}, "9": {"fulltext": "Co mg lister\\nC. L. G.", "height": "4336", "width": "2732", "jp2-path": "careofchildinhea00oppe_0009.jp2"}, "10": {"fulltext": "", "height": "4352", "width": "2952", "jp2-path": "careofchildinhea00oppe_0010.jp2"}, "11": {"fulltext": "CONTENTS\\nCHAPTER PAGE\\nI. Introductory 1\\nII. The Pregnant Woman 23\\nIII. The B art s Outfit and Nursery 47\\nIV. Feeding 70\\nV. Bathing Ill\\nVI. Sleep .128\\nVII. Exercise 146\\nVIII. Clothing from the Time of Infancy 163\\nIX. Habits 180\\nX. Relation of Parents to Children 204\\nXL Education 225\\nXII. Defective Children 251\\nXIII. Common Diseases 270", "height": "4324", "width": "2724", "jp2-path": "careofchildinhea00oppe_0011.jp2"}, "12": {"fulltext": "", "height": "4360", "width": "2924", "jp2-path": "careofchildinhea00oppe_0012.jp2"}, "13": {"fulltext": "THE CARE OF THE CHILD\\nIN HEALTH\\nCHAPTER I\\nINTRODUCTORY\\nIt is not hard to imagine the glow of enthu-\\nsiasm with which a young man begins his\\ncollege life, enters a profession, or starts a\\nbusiness. All the traditions of his vocation,\\nall the prospects of success, and the expecta-\\ntions of a useful development of his faculties\\ncombine to make a state of mind that becomes\\ncapable of surmounting obstacles, providing a\\nrational outlet for natural energy, of giving a\\nguiding point by which his various impulses\\nare directed. His intellectual status and the\\nusefulness of his future work may be measured\\nnot so much by their separate effects and acts\\nas by the informing spirit which controls them.\\nSuch things have an inevitable sequence of\\naction, on account of which the superior man,\\nB 1", "height": "4348", "width": "2720", "jp2-path": "careofchildinhea00oppe_0013.jp2"}, "14": {"fulltext": "2 THE CARE OF THE CHILD IN HEALTH\\nthe person of high mind and character, selects\\nan admirable field of work, or such a field as\\nis susceptible of being dignified by the exercise\\nof thorough work and preparation, of thought-\\nful attention to details, of a large grasp of the\\ninherent potentialities of the vocation, which\\nmarks it off from the sordid and petty affairs\\nof ordinary, petty life. Great results are not\\nobtained by a preternatural flash of wondrous\\ninspiration. On the contrary, they rest upon\\nunremitting toil, upon tireless industry, upon\\nan endless struggle with adverse conditions,\\nthe conquering of which means a great step\\ntoward the final evolution of civilization.\\nThis is the basis of genius, and a careful\\nexamination of the works of any great man will\\nshow how scrupulously he has met the demands\\nof the situation. Leonardo da Vinci was will-\\ning to grind his own colors, and make his own\\npaints in order to obtain the desired effects\\nand in the wide range of activities in which\\nhe was proficient there was no detail too small\\nor too burdensome to be carefully mastered.\\nWilliam Morris, who was great in both poetry\\nand art, in order to produce works of beauty\\nbecame a printer, a dyer, a weaver. There was\\nno labor too commonplace, no outlay of time", "height": "4356", "width": "2912", "jp2-path": "careofchildinhea00oppe_0014.jp2"}, "15": {"fulltext": "INTRODUCTORY 3\\ntoo great, no course of study and investigation\\ntoo exhaustive, for his industry. Such men\\nhave achieved the great things of the world,\\nand no one who is unwilling to recognize the\\ntruth of their methods is able to lead a really\\nprofitable life. Such a life cannot be passed\\nin an atmosphere of carelessness, of disregard\\nof duty, of a perpetual avoidance of burdens.\\nWhatever truth there is in this view has a\\nuniversal, not a particular, application; and\\nmen in every walk of life must recognize it in\\ntheir work, or lacking this recognition must\\nfail. Every citizen of the world has his share\\nof work to do and problems to solve and the\\ntrue judge of whether the doing and the solv-\\ning are successful is not entirely the opinion of\\nexisting authority, but rather the ideal, based\\nupon the most objective conception of the\\nworker s intention, as well as his performance.\\nA vigorous sense of responsibility is, after all\\nhas been said, at the root of a really profitable\\ncareer. Expediency must have no part in it,\\nand makeshift devices must necessarily end in\\nsome form of worthlessness. The inner spirit\\nof a piece of work is as worthy of scrupulous\\nattention as the outer form. The one stands\\nfor everlasting principle, while the other repre-", "height": "4332", "width": "2724", "jp2-path": "careofchildinhea00oppe_0015.jp2"}, "16": {"fulltext": "4 THE CARE OF THE CHILD IN HEALTH\\nsents the adaptation of that principle to the\\nexigencies of practical circumstances. And the\\nperfect blending of these two factors rounds\\nout a life-work as well as a character. It\\nmust be said that an appreciation of this truth\\nis oftener found among men than among women.\\nSuch a statement is hard to make; it really\\nhurts in the saying, especially if one has a\\nnormal respect for the many excellences of the\\nwomanly character. But an impartial observa-\\ntion of life necessarily leads one to this conclu-\\nsion; and what one sees must be said.\\nThere could not be a better demonstration of\\nthe unprejudiced truth of this idea than may\\nbe had from recognizing the methods which\\nwomen employ in caring for their children.\\nSuch methods constitute a fair standard of com-\\nparison because they are the principal occupa-\\ntion of a majority of the really useful women in\\nthe world. Those women who are regarded as\\nfortunate have as their vocation and life-work\\nthe bearing and the rearing of offspring. They\\ngrow up from girlhood with the hope and the\\nbelief that such work will be their future call-\\ning. Every other employment is frankly re-\\ngarded as subsidiary, as a temporary means of\\ngain or occupation, which is to be gladly and", "height": "4340", "width": "2932", "jp2-path": "careofchildinhea00oppe_0016.jp2"}, "17": {"fulltext": "INTRODUCTORY 5\\nunhesitatingly relinquished when the great\\nopportunity presents itself. This great oppor-\\ntunity usually seems so natural and inevitable\\nthat its demands are supposed to work them-\\nselves out in quite an irresponsible fashion,\\nfully as irresponsible as the choice of a spouse\\ncommonly is. On the other hand, the necessi-\\nties of competition demand a certain amount\\nof preparation for obtaining even a low grade\\nof commercial work, and, for a similar reason,\\na fair amount of effort is demanded to hold the\\nposition. Naturally enough, women recognize\\nthis fact, even if they have not thought about the\\nmatter very much but they go no farther than\\nthe barest demands of competition, because they\\nrecognize, and the world at large recognizes,\\nthat the ordinary commercial employments are\\nfor them scarcely more than a temporary means\\nof gain or occupation. At the same time, the\\ncorollary of the proposition is that household\\nand maternal duties are their permanent work,\\nfor which they are peculiarly designed and\\nadapted, and in which they are expected, in the\\nscheme of nature, to find their greatest gratifi-\\ncation as well as usefulness.\\nA recent writer in a popular American maga-\\nzine, in expressing the discontent of the women", "height": "4340", "width": "2756", "jp2-path": "careofchildinhea00oppe_0017.jp2"}, "18": {"fulltext": "b THE CARE OF THE CHILD IN HEALTH\\nof to-day, cries out: Give us labor! For\\ncountless ages, for thouands, millions it may\\nbe, we have labored. When man first wan-\\ndered, the naked, newly erected savage, and\\nhunted and fought, we wandered with him;\\neach step of his was ours. Within our bodies\\nwe bore the race, on our shoulders we carried\\nit; we sought the roots and the plants for its\\nfood; and when man s barbed arrow or hook\\nbrought the game, our hands dressed it. Side\\nby side, the savage man and the savage woman,\\nwe wandered free together and labored free\\ntogether. And we were contented. She then\\ngoes on to explain that as uncivilized conditions\\nchanged to civilized, the woman had less and\\nless work to do, until to-day the race is in\\ndanger of degeneracy on account of her weak-\\nness, her lack of occupation, her unsatisfied con-\\ndition of mind, and her increasing parasitism.\\nThis cry for work is, in a certain way, aston-\\nishing, for the common belief has been that one\\nof the main tendencies of the modern woman\\nwas away from the field of hard, manual labor,\\naway from the personal performance of house-\\nhold duties which naturally constitute the\\nquoted writer s work. And this belief is\\nvery commonly held among various classes in", "height": "4352", "width": "2972", "jp2-path": "careofchildinhea00oppe_0018.jp2"}, "19": {"fulltext": "INTRODUCTORY 7\\nsociety at large. It is often stated to be at the\\nroot of the increasing difficulty in supporting a\\nhousehold. At all events, we see that mar-\\nriages are being contracted at a later age than\\nformerly and with more difficulty that house-\\nholds are conducted on a more extravagant plan\\nthan was ever customary that less work is done\\nby mistresses, and that the spread of luxury is\\never increasing. It is claimed that children are\\nno longer willing, in planning the externals of\\ntheir prospective careers, to begin where their\\nparents began, and to go through the same\\nlaborious course of financial evolution. On\\nthe contrary, they want to begin where their\\nparents left off, evidently believing that a\\nchange in external circumstances and the de-\\ntails of social environment in the direction of\\nsimplicity was not to be endured, and meant\\na fall in public estimation.\\nAn additional fact of interest is the change\\nthat has gradually been taking place in com-\\nmercial life. There is a growing competition,\\nthere is an increasing development of business\\nmethods which requires more energy, more\\ncapital, more industry for the successful prose-\\ncution of a business enterprise than ever before.\\nThe successful business is falling more and", "height": "4356", "width": "2684", "jp2-path": "careofchildinhea00oppe_0019.jp2"}, "20": {"fulltext": "8 THE CARE OF THE CHILD IN HEALTH\\nmore into the hands of groups of wealthy capi-\\ntalists, or into those of one unusually active\\nman who often represents a group or syndicate.\\nAs a result, many persons who formerly con-\\nducted individual enterprises must now be con-\\ntent to accept salaried positions whose pay is\\nnot great, either actually or prospectively. The\\nmost characteristic thing which one can say is\\nthat the plan of specialization is extending into\\nevery business and into the individual depart-\\nments thereof; and that while there are a few\\nplaces which are highly remunerative, the gen-\\neral salary does not tend to increase, the indi-\\nvidual wage cannot be expected to grow larger.\\nThus, as the result of the centralization of re-\\nsponsibility as well as capital, a larger and larger\\nproportion of the possible situations are subor-\\ndinate. Such positions must from their nature\\nrequire less of the qualities of the proprietor\\nand more of the qualities of the employee. They\\nmust be administered by persons who have com-\\nparatively little personal connection with the\\nintimate policy and welfare of the enterprise,\\nwho may be as useful to one firm as another, and\\nwho are ready to change from one to another\\naccording to the demands of a passing necessity\\nor the whims of personal preference.", "height": "4392", "width": "2976", "jp2-path": "careofchildinhea00oppe_0020.jp2"}, "21": {"fulltext": "INTRODUCTORY 9\\nThis has made the opportunity for thousands\\nof women to participate in business life. They\\nfeel the constant impulse to increasing luxury,\\ntheir needs are not so easily satisfied as formerly\\nby the wage-earning head of the family, and\\nduring the interregnum between the period of\\ntheir entire dependence and the equally distinct\\nperiod when by marriage they believe that entire\\nindependence must come, they endeavor to\\npiece out their possibilities of enjoying life, of\\ngratifying their desire for petty luxury, and,\\npossibly, for the present large necessities of life,\\nby obtaining subordinate positions. They are\\nable to accept less pay than the wage-earning\\nhead of the family, because their needs are less.\\nAnd at the same time, on account of the divi-\\nsions and subdivisions of specialized business,\\nthey are able to do the work almost as well, or\\nfully as well as he does. Many of these posi-\\ntions being subordinate, having comparatively\\nlittle responsibilitjr, being merely functional\\ndemand no more than a special, narrow prepara-\\ntion, for which the ordinary woman, whose\\nneeds are immediate and whose prospects are\\nliable at any time to undergo a radical change,\\nis almost as well fitted as her brother. He, on\\nthe other hand, knows that he must continue", "height": "4360", "width": "2684", "jp2-path": "careofchildinhea00oppe_0021.jp2"}, "22": {"fulltext": "10 THE CARE OF THE CHILD IN HEALTH\\nfor the rest of his life to be a wage-earner; and\\nhis prospects, in all likelihood, will never\\nchange unless he, by his own power and re-\\nsourcefulness, is able to bring the change about.\\nWhen the woman comes to marry, as she\\nnaturally and inevitably hopes to do, she finds\\nthat her husband s income does not permit the\\nsame indulgences to which she has become\\naccustomed. They are certainly not possible\\nwithout the exercise of rigid economy, personal\\nwillingness to do many pieces of work in the\\nhousehold, intimate knowledge of all the de-\\ntails of household management, and a full\\nexperience of all the homely details that make\\nfor the family s prosperity or lack of prosperity.\\nIt is really rare that the woman tries in a sys-\\ntematic way to familiarize herself with and to\\nperfect herself in all these details. Her cook-\\ning is done as it was learned, by haphazard, by\\nrule of thumb, by the patchwork knowledge\\nwhich comes from indiscriminate attempts and\\nunregulated experience. She has no acquaint-\\nance with the physiology of nutrition, and is\\nutterly unable to regulate her meals so that the\\nmaximum of strength is distributed at a mini-\\nmum cost. She knows very little about fabrics,\\nabout dressmaking but she needs costly clothes", "height": "4360", "width": "2876", "jp2-path": "careofchildinhea00oppe_0022.jp2"}, "23": {"fulltext": "INTRODUCTORY 11\\nor imitations of such clothes. She knows noth-\\ning about the care of her children, about the\\nrules which will increase their measure of\\nhealth, strength, and useful training; but she\\nfeels the necessity and the fitness of handing\\nthe care of these children over to nurses and\\nteachers. She has, in short, lost the sympathy\\nfor a plain, modest, hard-working, homely life,\\nwithout at the same time being capable of pro-\\nviding a more efficient plan of work than her\\ngrandmothers possessed.\\nIn the wealthier classes the situation is as\\nbad, or possibly worse. Girls are willing to\\ncontract marriage without much thought of their\\nprobable responsibilities, and wish even less\\npreparation and training for their certain duties.\\nI believe that there is no exaggeration in the\\nstatements about their wishing to begin their\\nactive life in circumstances which are equiva-\\nlent to those obtained by their parents after a\\nlong period of effort. Of course there are\\nexceptions, as there always are to any broad\\ngeneralization. But the statement, as a rule,\\nholds good. Manners of living are undoubtedly\\nmore extravagant than ever before, fashions of\\ndress are more extravagant than ever before,\\nthe amount of personal work which is supposed", "height": "4340", "width": "2660", "jp2-path": "careofchildinhea00oppe_0023.jp2"}, "24": {"fulltext": "12 THE CARE OF THE CHILD IN HEALTH\\nto be done by the wife and mother is smaller\\nthan ever before. These customs are to be\\ncommonly found among the women of the more\\nfortunately situated classes, and they necessitate\\nlarger numbers of servants, lessened attention\\non the part of the mistress, greater expense and\\nwastefulness in the management of the house.\\nAnd as the natural energy of these women must\\nfind some outlet, it shows itself in distortions\\nfrom its normal manifestations, which have been\\ncalled all manner of hard names by one part of\\nthe community and all manner of fine names by\\nanother. These fads do not call for great praise\\nor great blame, any more than neurasthenia or\\nindigestion should be praised or blamed. They\\nshould be regarded as the natural expressions of\\ncertain conditions of life and if these manifes-\\ntations are unsatisfactory and burdensome, relief\\nmay be obtained by changing the conditions\\nwhich produced them.\\nThe inevitable result of these tendencies is a\\nprogressive increase in the burdens of the whole\\nhousehold. Difficulties are piled upon the\\nman, and dissatisfaction becomes the lot of\\nthe woman. He suffers from care, worry, and\\nthe lack of opportunity to cultivate the finer\\nand gentler parts of his nature. She becomes", "height": "4360", "width": "2908", "jp2-path": "careofchildinhea00oppe_0024.jp2"}, "25": {"fulltext": "INTRODUCTORY 13\\nmore artificial, more worldly, more self-seeking\\nthan she formerly was or than she ought to be.\\nEach comes to have a separate world, which\\nhas few points of contact with that of the other.\\nConcord gives way to discord, intimate affection\\nto indifference; and, finally, the end of the\\nmatter is strife or unhappiness. Under such\\ncircumstances it is easy to understand the recent\\ncry that marriage is a failure for nothing but\\nfailure can attend any enterprise which is not\\nfounded upon mutual understanding, common\\neffort, and a common purpose. It makes very\\nlittle difference whether the enterprise is in the\\nway of commercial management or domestic\\nmanagement; the salient rules that govern the\\none may with equal justice be applied to the\\nother. In both there is the strongest need to\\nrecognize fundamental requirements, to prepare\\nfor the efficient administration of them, and to\\nundertake the working out of such requirements\\nto their logical results which an elevated ideal\\ndemands.\\nThe problem which the present time has to\\nsolve is the adaptation of its domestic conditions\\nto the changed circumstances of commercial life.\\nWe must revert to the state where the women\\nof a household had as active a share in its for-", "height": "4348", "width": "2676", "jp2-path": "careofchildinhea00oppe_0025.jp2"}, "26": {"fulltext": "14 THE CARE OF THE CHILD IN HEALTH\\ntunes as men, where the women s responsible\\npositions and occupations were as sharply de-\\nfined as men s, where natural energy had as\\nwholesome a method of expression in one as in\\nthe other. The woman of to-day is a more\\nintelligent creature than her predecessor and\\nancestress of the eighteenth or seventeenth cen-\\ntury. She has larger needs, a larger range of\\npotentialities, and an enlarged outlook. These\\nopportunities are fine things in their way, but\\nthey bear with them their commensurate share\\nof responsibility. The woman of to-day has\\ngreater privileges than ever before; but also\\nshe must know that her duties should likewise\\nbe interpreted in a more developed and more\\nstrenuous manner. Instead of giving less of\\nherself to her duties, she ought to give more\\nshe ought to bring to her work an increased\\nzest, a more logical method, a greater efficiency\\nthan was formerly expected. There must be a\\ndistinct correspondence between what she ex-\\npects to give and what she expects to get. The\\ndemands of the past, instead of being lessened,\\nought in all likelihood to be increased, for in\\nno other way can the progress of the world be\\nfurthered. The spirit of the present time de-\\nmands thoroughness of preparation, intensity,", "height": "4352", "width": "2944", "jp2-path": "careofchildinhea00oppe_0026.jp2"}, "27": {"fulltext": "INTRODUCTORY 15\\nand devotion to principle in a greater degree\\nthan at any other period. And women must\\nparticipate in this movement to as great an\\nextent as men. The well-meant efforts of many\\nwomen to increase the family s income, and to\\nobtain an outlet for their own activity by plung-\\ning into business enterprises cannot go to much\\nfurther lengths without evil consequences.\\nFor the stability of the home and domestic in-\\nstitutions will inevitably be adversely affected.\\nWomen must, in the final analysis, be the ones\\nwho set the standard of the home and the ideals\\nand practices which they represent are the pat-\\nterns by which the household will be guided.\\nThe further inquiry about what means may\\nbe employed to remove the disabilities and the\\nhardships of women in particular and families\\nin general will be best answered by considering\\ncertain fundamental facts, and holding to cer-\\ntain elementary truths; and when these facts\\nand truths have been ascertained, the next step\\nconsists in adapting the current conditions of\\nlife to them. We must recognize that domestic\\ncareers exist, and have their value in the scheme\\nof existence, just as surely as commercial or\\nprofessional careers. They are not the simple\\npursuits that the general public so commonly", "height": "4356", "width": "2652", "jp2-path": "careofchildinhea00oppe_0027.jp2"}, "28": {"fulltext": "16 THE CAKE OF THE CHILD IN HEALTH\\ntakes them to be, but, on the contrary, demand\\nas thorough preparation and as intelligent study\\nas any other work. The objects which they are\\nintended to serve are among the worthiest and\\nthe most vital which can occupy human atten-\\ntion, for they include not only the comfort and\\nthe social progress of the family, but its very\\nexistence as well. In former times, when the\\nopportunities which women possessed of going\\nout into the world and mingling in its struggle,\\nits successes, and failures, were very limited or\\ndid not exist, there was no choice for them but\\nto stop at home and devote themselves to the\\noccupations which the home provided. In those\\ntimes they wove the cloth which clothed the\\nfamily; they made the candles that illuminated\\nthe house; they preserved the fruits and the\\nmeats that were to last over the hard season of\\nwinter. The man had one work in the outer\\nworld, the woman had another in the inner.\\nAs customs changed, as labor-saving inven-\\ntions grew in number and complexity, the bal-\\nance became disturbed, the unprotected position\\nof men forced them to observe the changes and\\nkeep in consonance with them. The compara-\\ntively protected and isolated position of women\\nallowed them to go on in much the same chan-", "height": "4360", "width": "2920", "jp2-path": "careofchildinhea00oppe_0028.jp2"}, "29": {"fulltext": "INTRODUCTORY 17\\nnels as before, and did not necessitate as prompt\\nand entire a conformity to the new methods.\\nAs the result of inventions and new methods,\\nwealth increased; but the demands of business\\nand professional life became greater, and the\\nstandards set for success became higher. Men\\nacquiesced with comparative readiness in the\\nnew demands and the new standards, and thus\\nthe business part of the world has gone on with\\nno more than temporary disturbances and inter-\\nruptions. There are many persons now living\\nwho well remember the hardships and indus-\\ntrial disorders that arose from the extensions of\\nrailroads into territory where the carrying trade\\nhad previously been done by sail-power, horse-\\npower, or man-power. And the consequent\\nchanges occasioned local hardships, local up-\\nheavals, local dissatisfaction. But these were\\nno more than temporary phases which in the\\ncourse of a few years passed away, and were\\nreplaced by other and superior industrial con-\\nditions. The hardships gave way to ease, the\\nupheavals to quiet, the dissatisfaction to con-\\ntent. The business life of these localities\\nincreased and flourished, for the business men\\nsaw the futility of stupid resistance, they\\nrecognized the demand for newer plans of work,", "height": "4356", "width": "2636", "jp2-path": "careofchildinhea00oppe_0029.jp2"}, "30": {"fulltext": "18 THE CARE OF THE CHILD IN HEALTH\\nthey welcomed the prospect of greater outlays\\nof specialized skill.\\nLet us ask in all fairness whether similar\\nchanges, and free acquiescence in their neces-\\nsity, have come about in household manage-\\nment. And in making the inquiry I am not\\nimpelled by any manner of sex-feeling or\\nsex-jealousy. For I recognize to the full the\\nvaluable parts of women s character, their pos-\\nsibilities of self-sacrifice, their generous will-\\ningness to respond to worthy appeals, and their\\nfund of devotion to a worthy cause. At the\\nsame time, it is quite clear that they have not\\nparticipated fully enough in the spirit of the\\nage which calls for a clear-sighted view of the\\nexigencies of everyday life. They, as well as\\nmen, know that a woman s work has always\\nbeen and must always be connected with the\\nhome. The best exponents of the sex have\\nnever attempted to deny this, and at most have\\njustified the taking up of business careers and\\nthe desertion of home life on the plea of para-\\nmount necessity. The whole excuse is that the\\nman is not able to accomplish enough alone, is\\nnot able to make enough money to support the\\nfamily on the scale that has become common\\nand that therefore the girls and the women must", "height": "4360", "width": "2980", "jp2-path": "careofchildinhea00oppe_0030.jp2"}, "31": {"fulltext": "INTRODUCTORY 19\\nleave their homes to help them. In the mean-\\nwhile much of the necessary work is done by\\nvarious servants, who, in turn, want to help\\ntheir families.\\nAnother and more logical solution of the diffi-\\nculty is possible. The woman must recognize\\nand conform to the greater demands for special-\\nized work. Since being a wife and mother is\\nher best and natural profession, she must fit\\nherself for its duties and she must clearly have\\nin mind the greater needs and the more compli-\\ncated duties which the present time demands.\\nShe need not weave cloth for clothes, she need\\nnot dip candles, she need not collect potash and\\nfat for soap-making. But she has other work\\nthat requires a greater degree of study and\\npreparation for its learning. She must know\\nthat these times require a keener intellect and\\na greater energy than any former period in the\\nworld s history, and she must fit herself to\\ndevelop such qualities in her husband and chil-\\ndren. These things cannot be learned after she\\nhas become a wife, for then, and before then,\\nthey must have been in active working. Long\\nbefore she assumes these tremendously important\\nduties, she ought to know how the greatest\\namount of nutrition is to be obtained from the", "height": "4360", "width": "2660", "jp2-path": "careofchildinhea00oppe_0031.jp2"}, "32": {"fulltext": "20 THE CAKE OF THE CHILD m HEALTH\\nsmallest expenditure of time and money, what\\nnutrition means, and how it may be obtained\\nand conserved. She must know what work is\\nto be done in a household, how and when it is to\\nbe done, as well as every advanced method by\\nwhich one may augment the health, comfort,\\nand pleasure of the family. She ought to know\\nwhat health is and what sickness is, how one\\nleads into the other, and the wonderful changes\\nthat can be accomplished with a knowledge of\\nhygiene, and sanitation, and elementary biol-\\nogy. She must have information of her pro-\\nspective duties as a mother, so that the birth\\nof a child may be an occasion for rejoicing\\nrather than a harbinger of extravagant outlay,\\nlargely increased household expenses, and\\ndomestic disorder. She must know what the\\nchild s growth entails, what demands will be\\nmade upon her store of information and inge-\\nnuity. She must, most of all, be prepared to\\ntake entire charge of her offspring, recognizing\\nthat this is the proper and natural outlet for her\\nself-sacrifice, her willingness to respond to\\nideals, and her devotion to worthy causes.\\nMoreover, she must constantly have the convic-\\ntion that she is morally responsible for all these\\nfacts and conditions; that the burden of duty", "height": "4360", "width": "2944", "jp2-path": "careofchildinhea00oppe_0032.jp2"}, "33": {"fulltext": "INTRODUCTORY 21\\nweighs upon her just as heavily as if she were\\nworking under a written contract. Indeed, she\\nought to feel the responsibility even more keenly\\nthan any form of mercantile agreement could\\nmake her realize. As matters now stand, the\\nwoman, as soon as she marries, is apt to feel that\\nshe is answerable to no one, and that there is\\nno standard for her work except the one which\\nshe chooses to elect. But as surely as such a\\nplan would work disaster in business affairs,\\njust so certainly must it produce domestic\\nirregularity, disorder, and failure.\\nThe proper sphere for women is not to fight\\nin the outer world for a miserable wage in\\ndollars. Her potentialities are too fine for that,\\nand in submitting herself to the consequent\\ncompetition she is losing too much. She is\\nmuch more able to save at home, to prevent\\ncountless occasions of waste, to raise the\\nstandard of healthfulness, of self-reliance, and\\nusefulness in her husband and children, so that\\nthe burden of support is not too heavy for a man\\nto bear. If she accomplish that, if she can ac-\\nquire a good enough sense of proportion so that\\nthe foolish tendencies to artificial extrava-\\ngances of methods and household manners are\\nkept within bearable limits, she will do a great", "height": "4360", "width": "2620", "jp2-path": "careofchildinhea00oppe_0033.jp2"}, "34": {"fulltext": "22 THE CARE OF THE CHILD IN HEALTH\\ndeal to end the competition between the sexes.\\nSuch competition is unnatural, unprofitable, not\\nsusceptible of a desirable outcome. The cry,\\nGive us labor! is right; for no one can live\\nwithout work, and enough work. But let us be-\\nware lest we look far off for this opportunity to\\nexpend our energies and develop our characters,\\nwhile we are unmindful of the opportunities\\nwhich lie immediately before us, so close, in\\nfact, that we stumble over and tread upon them.\\nThe change must come, not from without the\\nhousehold, but from within it; not by the\\nwoman s entering into competition with her\\nfather, husband, and brother in sorts of work\\nwhere she must necessarily occupy an unde-\\nsirable position, but by increasing her value at\\nhome, by diminishing the amount of needless\\nwaste in a word, by fitting herself for her\\nvocation as carefully as she would if she wished\\nto employ her male relatives in a commercial\\nlabor of value and responsibility. As much as\\nhome-content is better than home-discontent, as\\nmuch as peace is better than discord, as much\\nas real prosperity is better than artificial show,\\nso much is the true training of women better\\nthan what is so commonly given. Give us\\nlabor! is a good enough cry; but Let us do\\nthe labor that is within our hands is a better.", "height": "4344", "width": "2932", "jp2-path": "careofchildinhea00oppe_0034.jp2"}, "35": {"fulltext": "CHAPTER II\\nTHE PREGNANT WOMAN\\nThe pregnant woman is the centre of the\\nworld s progress; she must regard herself as\\nendowed with a great responsibility, whose\\npleasures are as sweet, and whose possibilities\\nfor good are as vast as those of any position in\\nlife. She should look upon herself not only as\\nthe giver of a living pledge to her husband,\\nbut also as the transmitter of humanity itself,\\nof all its endeavors, hopes, and aspirations.\\nHer function, while on the one hand private\\nand domestic, is on the other a matter of world-\\nnote, of the upbuilding of the race and the\\nworking out of every right-minded dream of\\nthe poet and philosopher. She must realize that\\nin this matter, as in every other in human\\naffairs, there is a necessity for exact prepara-\\ntion, for the discernment of elements of strength\\nand weakness, and for the recognition of the\\nmethods which will increase the advantages and\\ndecrease the disadvantages of the situation.\\n23", "height": "4360", "width": "2596", "jp2-path": "careofchildinhea00oppe_0035.jp2"}, "36": {"fulltext": "24 THE CARE OF THE CHILD IN HEALTH\\nThe pregnant woman should recognize that\\none of the best preparations for the efficient\\nfuture of her child is the efficient present care of\\nherself. In this condition the welfare of both\\nis so closely interwoven that a point of separa-\\ntion between them cannot reasonably be made.\\nDuring this preparatory period the child is\\ngrowing and developing, is laying the founda-\\ntion for the future blossoming of mind and\\nbody, just as surely as in the later times when\\nhe requires meat and drink, shoes and caps,\\ngowns and books. From the very moment of\\nconception he begins to be a human being with\\ndefinite needs; and carelessness of his welfare\\nduring his prenatal existence is fully as inex-\\ncusable as ignorant and stupid ordering of his\\naffairs after birth. His various physical re-\\nquirements and functions have as distinct an\\nexistence at one time as at the other. Instead\\nof breathing through his lungs, he breathes\\nthrough the maternal placenta instead of ab-\\nsorbing food from his stomach and intestines\\ninto his blood, he is nourished directly by the\\nblood of his mother. If her blood is poorly\\noxygenated and nourished he feels the effect\\nimmediately and intimately. And in propor-\\ntion to his extreme feebleness and immaturity", "height": "4328", "width": "2940", "jp2-path": "careofchildinhea00oppe_0036.jp2"}, "37": {"fulltext": "THE PREGNANT WOMAN 25\\nhe must necessarily be well or ill influenced.\\nBut the main fact that physiological activity\\nexists is as true of one time as the other.\\nNothing can possibly be more important, from\\nthe standpoint of the collective welfare as\\nwell as that of the individual, than a dis-\\ncriminating knowledge of the relations of\\nparent and child; in other words, of heredity.\\nThe general belief that descent acts in some\\nblind and unchangeable manner is not only\\nwrong, but also infinitely mischievous. While\\nthe oft-quoted aphorism that a child s training\\nshould begin two hundred years before his birth\\nmay be true enough, nevertheless a highly\\nimportant fact which calls for an equal amount\\nof consideration is that the immediate progeni-\\ntors have a great part in the matter of a child s\\nhealth and strength and that, most of all, the\\nnourishment which the mother can and does\\ngive before his birth will have much to say in\\ndeciding what manner of person he may grow\\nto be. And when one speaks of health and\\nstrength, the terms have so wide an application\\nthat they include the vitality of bone, muscle,\\nand nerve tissue, of body and mind.\\nThus the prospect of the child s birth must\\nbe a matter of constant thought and preparation,", "height": "4360", "width": "2612", "jp2-path": "careofchildinhea00oppe_0037.jp2"}, "38": {"fulltext": "26 THE CAKE OF THE CHILD IN HEALTH\\nnot only in the way of providing for his physi-\\ncal requirements, but also in so disposing of\\nthe mother s forces and energies that she will\\nundergo the minimum of wear and tear while\\nobtaining the maximum of normal activity.\\nShe must maintain a calm and placid mind,\\nshould try to develop a cheerful manner of\\nlooking at the world, must endeavor to see the\\nbeauty of life and all its relations. In olden\\ntimes the Greeks decorated the rooms of preg-\\nnant women with beautiful statues, that the\\nmind, dwelling on the images of strength and\\nloveliness, might obtain a more favorable im-\\npression than it formerly had, and thus would\\nhand on to the new-born child a heritage of a\\nlike nature. While the physiological ideas\\ninvolved in this custom may have been misty,\\nnevertheless, there was a large element of prac-\\ntical truth in it; for the woman who realizes\\nthat she can to a notable extent, by controlling\\nand regulating her physical and mental condi-\\ntion, mould the body and mind of her unborn\\nchild, has progressed to an appreciable extent\\nin the direction of being an ideal mother. Such\\na woman will keep a strict account of her\\nthoughts and emotions, will try to encourage\\nbeautiful and worthy ideas and ideals, will", "height": "4352", "width": "2912", "jp2-path": "careofchildinhea00oppe_0038.jp2"}, "39": {"fulltext": "THE PEEGNANT WOMAN 27\\nendeavor to make her everyday life square with\\nthese theoretical conceptions, and similarly\\nwill eliminate unfavorable acts and their con-\\nsequences. Nothing that in any way affects\\nher will be considered as trivial, for every fact,\\nwhether it is great or small, has its commensu-\\nrate influence. Similarly, no burden of pains-\\ntaking will be too great for her strength; for\\nshe is the beginning of generations that may\\nchange the face of the world. The stimulant\\nfor good of such a course is not to be overesti-\\nmated; it will serve as a pillar of cloud by day\\nand a pillar of fire by night to guide and re-\\nstrain; it will keep alive the sense of respon-\\nsibility and promote the conviction that the\\npregnant woman is one of the real makers of\\nthe world and its destinies. Viewed in this\\nlight, the condition represents a great oppor-\\ntunity whose importance, as far as the welfare\\nof the community is concerned, is not exceeded\\nby that of any profession or vocation in the\\nworld.\\nIt is noteworthy that a belief in prenatal\\neffects upon the child has from times imme-\\nmorial been more or less prevalent, although as\\ncommonly interpreted it has no foundation in\\nfact. The so-called maternal impressions are", "height": "4360", "width": "2604", "jp2-path": "careofchildinhea00oppe_0039.jp2"}, "40": {"fulltext": "28 THE CARE OF THE CHILD IN HEALTH\\nno more than fortuitous thoughts and accidents\\nwhich are supposed to leave their impress in\\nsome indelible manner upon the child. Thus,\\nas an example, a woman may be frightened by\\nthe sight of an ugly or deformed person, by an\\naccident, by some chance blow, fall, or misstep\\nin other cases she may have had bad dreams\\nwhose grotesqueness haunts her even during\\nthe waking hours in yet others, she may have\\nheard some shocking news, or may even be\\nafflicted by an equally disturbing train of\\nthoughts which fascinate her by their persis-\\ntence and ugliness. In almost all cases the\\napprehensions are ill founded and should re-\\nceive no attention. It is a noteworthy fact that\\nthe most fanciful and easily alarmed women\\nencounter the greatest number of alarming\\nsights and accidents, and are afflicted with the\\nmost stubborn obsessions. Nevertheless, these\\nvery women in the greatest number of cases\\nbear children who show no marks of injuries\\nand where such abnormalities appear, their oc-\\ncurrence can usually be explained on other and\\nmore reasonable grounds. If one wishes to\\nstate the matter in the form of a general rule,\\none should say that the growth of a child before\\nbirth is as regular and as fully subject to physio-", "height": "4352", "width": "2908", "jp2-path": "careofchildinhea00oppe_0040.jp2"}, "41": {"fulltext": "THE PREGNANT WOMAN 29\\nlogical laws as after birth, and that on account\\nof the protecting circumstances of the foetus,\\nordinarily trivial accidents rarely produce im-\\nportant results; moreover, the main factor in\\nthe infant s development is the normal nutri-\\ntion of the mother, her healthful activity, and\\nthe wise regulation of her daily life.\\nThus a woman in the course of a visit or an\\nafternoon walk may see a cripple or an invalid,\\nor may be startled by some animal; in other\\ncases she may inflict some slight injury upon\\nherself, or may encounter another person who\\nhas undergone an accident. In such cases it is\\nno uncommon experience for her to begin a\\ncourse of worry, of self-tormentings, of belief\\nin the possibility that her child may bear in his\\nbody or mind the likeness of these events. As\\na matter of plain fact she is doing more harm by\\nthe worry than the thing which she fears can\\never accomplish. For if such a transitory con-\\ncept could have any power, then similarly every\\nact and experience of her daily life would be\\nfaithfully portrayed in her offspring. Such a\\nconnection would result in a child that was a\\nveritable patchwork, a freak, or a monstrosity.\\nIt is absolutely opposed to every rational inter-\\npretation of ordinary children as we see them", "height": "4360", "width": "2612", "jp2-path": "careofchildinhea00oppe_0041.jp2"}, "42": {"fulltext": "30 THE CARE OF THE CHILD IIST HEALTH\\nfrom day to day. If a defect does finally\\nappear, its origin assuredly has a more logical\\nbasis than such fleeting cloud-shadows. There\\nmust rather be some more organic defect present\\nin the child s nourishment, which is translated\\ninto a local or general manifestation, according\\nto the various circumstances of the case. This\\nis normally regulated by the mother s general\\ncondition rather than fortuitous impressions\\nwhich come from without.\\nThere is an additional and noteworthy\\nthought which if fairly considered ought to\\nclear up one s ideas about maternal impres-\\nsions. If a passing emotion or impulse of an\\nunfavorable nature can injure the unborn child,\\nwhy should not every happy emotion or impulse\\nbenefit him If the sight of a cripple can blast\\nhis growth, why should not the sight of a finely\\nformed person benefit him If the hearing of\\nbad news can depress the future gayety of his\\nmind, why should not the reception of good\\nnews equally elevate it Practically always\\none hears of injurious maternal impressions,\\nnever of helpful; and. this irrational lack of\\nconsistency merits some common-sense think-\\ning. One can always offset the bad impres-\\nsions by possible good ones, so that the result", "height": "4344", "width": "2916", "jp2-path": "careofchildinhea00oppe_0042.jp2"}, "43": {"fulltext": "THE PKEGNANT WOMAN 31\\nof the comparison is equality. This is really\\nthe normal view to take; and it has the further\\nadvantage of imparting a healthy control of\\nmind and body.\\nSuch control involves an intelligent oversight\\nof all the ordinary faculties and functions.\\nThe pregnant woman ought to have a diet\\nwhich, although liberal, excludes articles of food\\nthat are hard to digest or have small nutritive\\nproperties. Thus, all fried foods, made\\ndishes and salads, greasy and fatty preparations,\\nand pastries should be avoided; coffee and tea\\nmay be taken in moderate quantities, and light\\nand effervescent whines may similarly be advised.\\nThe ordinary meats, fish, fresh vegetables, and\\nfruits must constitute the meals rather than\\ndainties, relishes, and the usual articles that a\\nfickle, capricious, and sometimes morbid appe-\\ntite may seek. In fact, this element of nor-\\nmality should be the keynote of her daily\\nroutine. Instead of searching for, recognizing,\\nand exaggerating abnormal factors, she should\\nin every possible manner repress them. Her\\ncondition is not an unnatural one on the con-\\ntrary it is one that is physiologically charac-\\nteristic of her whole being. This view will\\ntend to dispel many of the perplexing doubts", "height": "4356", "width": "2628", "jp2-path": "careofchildinhea00oppe_0043.jp2"}, "44": {"fulltext": "32 THE CARE OF THE CHILD IN HEALTH\\nconcerning the arrangement of her time. The\\nday may well be begun by a pleasantly cool\\nshower- or plunge-bath on arising. This bath,\\nsince it lasts for a very few minutes, and since\\nit should be followed by a brisk rubbing of the\\nbody, is not too severe for even a delicate or\\nnervous person. Then there will be a greater\\nzest to the appetite, and the light breakfast of\\nfruit, cereal, eggs, and chops will be more\\neagerly welcomed than otherwise. After\\nbreakfast, and as soon as household duties per-\\nmit, she may take a walk, the length and ra-\\npidity of which are proportioned to her energy\\nand vigor. The remainder of the morning may\\nbe devoted to her ordinary domestic work.\\nAfter lunch she should take a nap for about an\\nhour, which may be followed by another walk,\\ndrive, or visiting. In the evening the ordinary\\ndomestic recreations may pass the time, and\\noccasionally she may see a play at the theatre\\nor hear a concert. Especially on such occasion\\nshe must resist the temptation to remain up\\nlate, for sufficient sleep is one of the main fac-\\ntors in a healthful life, most of all for a woman\\nwho has to supply nerve energy not only for\\nherself, but for her unborn child as well. The\\nproverb qui dort dine applies to such a person", "height": "4348", "width": "2940", "jp2-path": "careofchildinhea00oppe_0044.jp2"}, "45": {"fulltext": "THE PREGNANT WOMAN 33\\nwith more force than in all likelihood to any-\\nother; and its good effects will be seen in les-\\nsened emotional disturbances, fewer nervous\\nmanifestations, and rarer complaints of inordi-\\nnate fatigue.\\nSuch a general scheme as the above may\\nseem difficult of accomplishment to some women\\nwho believe that the demands of their house-\\nhold and growing family take up all their avail-\\nable time. While in some cases reasons of\\ndomestic economy prevent as much liberty as\\none might desire, nevertheless, in most homes\\neven those that are supported on moderate\\nincomes the wife s time and energies are often\\nunnecessarily frittered away in a poorly arranged\\nplan of work and superintendence. Indeed,\\none of the greatest needs in the ordinary house-\\nhold is a carefully arranged system by which\\neach certain piece of work is made to begin and\\nend at its fixed time, where there is the ex-\\nchange of duties between different members of\\nthe family or between different servants, where\\nevery routine need is provided for in a schedule\\nthat should be as direct and businesslike as\\nthe working of a successful factory or mercan-\\ntile establishment. If this is done, and I know\\nby experience that it is not impossible or un-", "height": "4356", "width": "2620", "jp2-path": "careofchildinhea00oppe_0045.jp2"}, "46": {"fulltext": "34 THE CARE OF THE CHILD IK HEALTH\\nreasonably difficult, the increased opportunities\\nfor exercise, recreation, and care of self which\\nthe ordinary wife and mother may find at her\\ncommand will be sufficient and gratifying.\\nWherever there is an accumulation of duties\\nand work, or the presence of several persons\\nwith their various needs and desires, there must\\nbe a controlling discipline, which will regulate\\nconflicting interests, prevent loss of time, and\\npromote good feeling and ease of temper.\\nDoubtless there is no place where wise manage-\\nment can be better demonstrated than in the\\nordinary household.\\nOf all the subjects of preparation which the\\npregnant woman must consider, none is more\\nsusceptible of intelligent management than her\\nmethod of dressing. If this matter is poorly\\narranged she will experience discomfort, un-\\ndergo unnecessary expense; she may suffer in\\nhealth and surely will present an ungraceful,\\nuncouth, and, possibly, immodest appearance.\\nBut such undesirable conditions need not ex-\\nist, and, indeed, may with the help of proper\\ncostumes be replaced by those that are con-\\nvenient, healthful, and seemly. Clothing\\nmay, unfortunately, cover one s nakedness, and\\nyet suggest too much of the form it may pro-", "height": "4352", "width": "2908", "jp2-path": "careofchildinhea00oppe_0046.jp2"}, "47": {"fulltext": "THE PREGNANT WOMAN 35\\ntect the body from heat and cold, and yet the\\nprotection may be partial or unevenly distrib-\\nuted; it may decorate, and yet not beautify.\\nKnowing these things we must try to select and\\nmake the clothing of the pregnant woman with\\na view to providing a sufficient lightness,\\nwarmth, freedom of movement, and a due\\nregard for appearances. While in ordinary cir-\\ncumstances it is not desirable either to follow\\nthe changing modes too slavishly or to neglect\\nthem so completely as to make the impression\\nof eccentricity, in the special period of preg-\\nnane} a woman should subordinate the usual\\nobedience to the current styles to the reasonable\\ndemands of health and convenience of herself\\nand her child.\\nThe underwear should be of wool, the thick-\\nness of which must be suited to the season for\\nthis reason she should have three different\\nweights the lightest for summer, the medium\\nfor spring and autumn, the heaviest for winter.\\nSome people prefer for underwear the so-called\\nnatural wool, others choose a mixture of three-\\nquarters wool and one-quarter silk or cotton;\\nof late a tendency to choose a linen mesh has be-\\ngun to make itself felt, and also some reform-\\ners have been endeavoring to discredit the use", "height": "4360", "width": "2628", "jp2-path": "careofchildinhea00oppe_0047.jp2"}, "48": {"fulltext": "36 THE CARE OF THE CHILD IN HEALTH\\nof wool and substitute cotton in its place.\\nAfter the whole matter has been thoroughly dis-\\ncussed, and there is no necessity for repeating\\nall the lengthy details here, a white or gray\\nwool, with or without a partial admixture of silk\\nor cotton, will be found to give the greatest\\namount of satisfaction. The form of the gar-\\nments should be what is now popularly called\\nunion, that is, the shirt and drawers should\\nbe woven together into one piece. When new\\nsuits of this pattern cannot be readily obtained,\\nthe separate garments may be fitted and sewed\\ntogether so that a fair substitute results. In\\nthis way one can lessen the amount of weight\\nthat otherwise would hang on the hips and, at\\nthe same time, slightly decrease the unsightly\\nand unnecessarily thick layers of clothing which\\naccentuate the outlines of the protuberant abdo-\\nmen.\\nIn the matter of underskirts, a rational mod-\\neration must control one s choice. Especially\\nmust their number be not too great. In ordi-\\nnary cases they need at most be no more than\\ntwo, a fairly short flannel and a mediumly long\\nmuslin one. They must be sufficiently full,\\nand, instead of being closed by means of but-\\ntons, may be fitted to the changing form by a", "height": "4356", "width": "2904", "jp2-path": "careofchildinhea00oppe_0048.jp2"}, "49": {"fulltext": "THE PREGNANT WOMAN 37\\nbroad band to which a draw-string is attached.\\nThis draw-string should be in two parts, one to\\ncontrol the back and the other the front. Both\\nshould issue from their pockets at the side,\\nwhere they may be tied without making a\\nnoticeable lump. In place of drawing them\\nvery tightly and thereby holding them fast,\\nthe band of the skirt may be supported from\\nthe waist or corset cover or by straps which\\nhang from the shoulders. If additional warmth\\nfor the lower extremities is desired, it may be\\nobtained by equestrian tights made of a knitted\\nfabric, which, while being very comfortable,\\nare not bulky. The stockings should be suf-\\nficiently warm and must be held up by side\\nsupporters, and not by garters, which are se-\\ncured to the waist instead of by the common\\ndevice of an abdominal band. The corset waist\\nis one of the most important garments, and de-\\nserves the most careful thought and attention.\\nIt must be strong, light, pliable; if the seams\\nare somewhat heavier than the rest of the gar-\\nment, it will, in spite of the drag of the skirts\\nand stocking supporters, keep its shape. Its\\nshoulder pieces will hang the weight from the\\nshoulders, where it will be least felt. In place\\nof this corset waist some women prefer an", "height": "4360", "width": "2620", "jp2-path": "careofchildinhea00oppe_0049.jp2"}, "50": {"fulltext": "38 THE CAHE OF THE CHILD IN HEALTH\\nempire corset, which is so narrow that it makes\\nno pressure on the abdomen, but supports the\\nbreasts sufficiently well. If such a corset is\\nworn, the waist may be somewhat lighter than\\nthe usual corset waist and somewhat heavier\\nthan the ordinary corset cover; for one must\\nremember that the empire corset is not designed\\nto support either skirts or stockings, which,\\ntherefore, must be fastened to the waist. The\\nordinary corset should, without the slightest\\nhesitation, be laid aside for the period of preg-\\nnancy and lactation. I do not care to begin a\\ndiscussion of corsets for ordinary occasions, for\\nmost women under such circumstances will per-\\nsist in using them without regard for their\\nunhygienic influences. Although no competent\\nobserver doubts that they may and do bring\\nabout harmful results, nevertheless, as long as\\nthey help to improve appearances and make\\ndresses set better, they will in all likelihood\\ncontinue to be worn. But when a woman is\\npregnant, a further and vastly weightier factor\\ncomes into the equation the future welfare of\\nher child. The question ceases to be a merely\\nacademic one of hygiene or aesthetics, but comes\\nto represent a modified degree of physical and\\nmental development or, stated differently, the", "height": "4348", "width": "2908", "jp2-path": "careofchildinhea00oppe_0050.jp2"}, "51": {"fulltext": "THE PKEGNANT WOMAN 39\\nmoral, intellectual, and material efficiency in\\nthe child s various future spheres of activity.\\nIt is the same idea that applies to all the details\\nof preparation for his birth, and the effort to\\nfree him from as many disabilities as possible.\\nThe only difference is one of degree no matter\\nwhat may be the divergence of opinion about\\nother details, everybody who is familiar with\\nthe subject believes that at this time the ordi-\\nnary corset should be laid aside, for the inter-\\nvisceral pressure and the restricted opportunities\\nfor free movement are facts of radical impor-\\ntance. The usual excuse that the woman s back\\nneeds the support of a corset, is not sufficient;\\nfor a strong waist or the comparatively harm-\\nless empire corset will give enough support.\\nAt the same time, a much better plan would be\\nto exercise the weakened muscles of the back,\\nand thus increase their strength to such a point\\nthat artificial support is not needed.\\nThe outer dress and the methods of designing\\nit so that it will best conceal the necessary\\ndeformities are commonly matters of supreme\\nimportance to the usual woman, and rightly so.\\nFor at this period of her married life there are\\nmany occasions when the ordinary peace and\\nquiet of the household are disturbed, and human", "height": "4360", "width": "2628", "jp2-path": "careofchildinhea00oppe_0051.jp2"}, "52": {"fulltext": "40 THE CARE OF THE CHILD IN HEALTH\\nnature is often so frail that it will willingly\\nsuffer inconveniences from a graceful, well-\\ngowned w^oman that it would tolerate grudg-\\ningly from one who was dowdy, awkward, or\\nunpleasing. At the same time, the necessity\\nof frequently altering the size of the skirts or\\nof obtaining new ones is apt to make the attempt\\nto look as well as possible a somewhat costly\\none. For this reason, if for no other, it is\\nadvisable to prepare for this period as efficiently\\nas possible. The main requirements are to get\\nrid of the belt or any horizontal lines about the\\nbody and to emphasize the vertical lines in the\\ncostume. For this reason a street dress may be\\nmade in the empire style, if one desires to have\\nseparate waist and skirt. The waist should\\nbe made with a loose, falling front like the\\nfedora or matinee waist. The skirt\\nshould be cut with all its breadths of equal\\nlength, and should be full enough to allow of\\nbeing let out as far as may be required. The\\nextra length in the front, as well as the back,\\nmay be hidden in tucks or folds, and as occasion\\ndemands may be let out. This garment should\\nnot be closed in the back with buttons or hooks,\\nbut preferably may be shirred to fit the form by\\ntwo draw-strings, one for the front and the", "height": "4340", "width": "2888", "jp2-path": "careofchildinhea00oppe_0052.jp2"}, "53": {"fulltext": "THE PREGNANT WOMAN 41\\nother for the back, which issue and are fastened\\nat the sides. Another good plan is to make\\ntwo side openings to the skirt instead of one\\nbehind. These plackets should be from twenty\\nto twenty-four inches in length. The waist-\\nband is to be broad and elastic and msij be in\\nseparate pieces for the front and back, having\\nlong ends for tying. When the wearer dons\\nthe skirt, she ties the long ends of the rear\\nwaistband in front, and then fastens those of\\nthe front waistband in the rear. Naturally the\\ngarment must be made full enough to conform\\nto the increasing size. And if it is heavy, it\\nmay, when so desired, be supported by straps to\\nthe waist or from the shoulders. A still further\\nplan, which I have found to give satisfactory\\nresults, is to make the skirt full at the waist,\\nclosing it in the usual manner behind. Over\\nthe placket a broad single or double box-pleat\\nis laid, which must be tacked to the waistband\\nabove and to the skirt below the placket. As\\nthe abdomen increases in size, this box-pleat\\nmay be shifted more and more from its original\\nposition, so that it fills up the empty space\\nbetween the two sides of the opening. For\\nhouse wear, wrappers which are loose in front\\nshould be worn the back may be given a fair", "height": "4360", "width": "2612", "jp2-path": "careofchildinhea00oppe_0053.jp2"}, "54": {"fulltext": "42 THE CARE OF THE CHILD IN HEALTH\\ndegree of grace by means of a watteau fold or\\npleat.\\nFor walking purposes a sufficiently long cape\\nor cloak should always be used, to the rigid\\nexclusion of the tight jacket or coat. Not only\\nwill the general appearance be improved, but\\nalso an added degree of comfort will be ob-\\ntained. Finally, the costume majr be com-\\npleted by the addition of heavj fairty broad\\nshoes that permit of planting the foot comfort-\\nably and strongly upon the ground. The usual\\nbelief that a light, thin shoe is easier to walk in\\nis an undoubted fallacy. Especially is this\\ntrue when the shoe is made on an artificially\\nshaped last, with the plain purpose in view of\\nmaking a certain dainty appearance rather than\\ngiving the protection that wind, weather, and\\nthe hard condition of the pavements demand.\\nA small vamp, a narrow toe, a thin sole, and a\\nhigh heel that is placed too far forward are all\\nconditions that make for disability in walking.\\nOn account of them the foot cannot be planted\\nfull upon the ground, the muscles of the legs\\nand back cannot relax and contract in a normal\\nmanner, and the weight of the body is not\\nproperly distributed. As a result the woman\\ncomplains of pains in the back and thighs. She", "height": "4356", "width": "2924", "jp2-path": "careofchildinhea00oppe_0054.jp2"}, "55": {"fulltext": "THE PREGNANT WOMAN 43\\ntakes insufficient exercise, and tissue-change\\nas well as nutrition is defective. These dis-\\nabilities can be removed by wearing a shoe\\nthat is long and broad enough, that has a\\nstrong, heavy sole, large enough vamp, and a\\nlow heel that is placed sufficiently far back to\\ndistribute the body weight where it can be best\\nborne.\\nThere is one detail of dressing connected\\nwith walking in bad weather which I consider\\nof no little importance. It concerns the use of\\nwaterproof leggings that must come to or\\nabove the knee. The exposure and discomfort\\nthat come with wet skirts are usually sufficient\\nto keep indoors a woman who otherwise would\\ngladly take her regular exercise in spite of rain,\\nsnow, or hail. Therefore, in bad or threaten-\\ning weather I always advise my patients to wear\\nsuch leggings, for I know that a prolific source\\nof catching cold is thus removed, and that they\\ncan with impunity face a storm which otherwise\\nwould be prohibitory. There is nothing essen-\\ntially injurious in walking in rain or snow,\\nprovided that one is properly clothed. On\\nthe contrary, the brisk glow that follows the\\nstruggle with the weather is commonly exhil-\\narating. With sufficient protection, with the", "height": "4360", "width": "2612", "jp2-path": "careofchildinhea00oppe_0055.jp2"}, "56": {"fulltext": "44 THE CARE OF THE CHILD IK HEALTH\\nprospect of wet skirts flapping about chilled\\nand wet lower limbs removed, the majority of\\nwomen, who otherwise would be mewed up in-\\ndoors to their undoubted detriment, will gladly\\ntake their daily walk.\\nAnother bar to comfort and the taking of exer-\\ncise, which is fortunately not very common, is\\na very large, prominent, or pendulous abdomen.\\nIt will be sufficient to suggest the use of an ab-\\ndominal band which goes under and supports\\nthe abdomen, and closes in the small of the\\nback it may be supported and held in place by\\nstraps across the shoulders. Its ends may be\\nfairly narrow, but its middle portion must be\\nbroad and of a hollow shape, which will adjust\\nitself accurately to the outline of the body.\\nIf this device is properly adjusted the wearer\\nwill obtain enough relief to change a painful\\nand laming pregnancy to a comparatively com-\\nfortable one. It is by such small details that\\nmany disadvantages are overcome and, in gen-\\neral, one may say that life as a whole is no\\nmore than a massing of such details, each of\\nwhich is worthy of conscientious attention. In\\nthe preparation for a child s birth there is a\\nparamount opportunity to exhibit fidelity to an\\nideal, thoroughness of preparation, wise fore-", "height": "4360", "width": "2896", "jp2-path": "careofchildinhea00oppe_0056.jp2"}, "57": {"fulltext": "THE PREGNANT WOMAN 45\\nthought, and a broad comprehension of ultimate\\npossibilities.\\nWhile the pregnant woman is arranging all\\nthese details, it will be wise for her to prepare\\nfor the lying-in. The things which she needs,\\nwhile not numerous or expensive, are too im-\\nportant to be neglected. She should have at\\nleast two or even three agate or china-ware\\nbasins, and one or two large pitchers or ewers\\nfor the use of the physician. Also there should\\nbe a pound carton of absorbent cotton and some\\nclean gauze or cheese-cloth with which the nurse\\nmay make napkins or pads for the mother. The\\ncheese-cloth should be washed, dried, and cut\\ninto pieces about eighteen inches in length by\\ntwelve inches in breadth. The cotton may be\\ncut into pieces about nine inches long, six\\ninches wide, and one inch thick. When the\\ncheese-cloth is folded about the cotton, one has\\nan ideal napkin that is convenient, comfortable,\\nand cheap. To insure surgical cleanliness,\\nthese napkins, as soon as they are made, should\\nbe packed in a strong piece of muslin or a\\ntowel, which is then to be securely pinned up,\\nplaced in an oven, and baked for about twenty\\nor thirty minutes. The package should not be\\nopened until after the child is born.", "height": "4360", "width": "2620", "jp2-path": "careofchildinhea00oppe_0057.jp2"}, "58": {"fulltext": "46 THE CARE OF THE CHILD IN HEALTH\\nThe abdominal binder may be made from one\\nor two thicknesses of unbleached muslin; it\\nshould be large enough to span and overlap\\nthe woman s girth, while in breadth it should\\nextend from a short distance below the breasts\\ndown to and even below the hips. To secure it\\nin place one should have a few large safety-pins.\\nThe careful woman, in order to protect the\\nmattress, will obtain two pieces of rubber\\nsheeting, one of which is large enough to cover\\nthe whole mattress, while the other is no more\\nthan half as big. The first is to be securely\\nfastened all about the edges, but the second is\\nto be used loose. Immediately after the child\\nhas been born, the smaller may be removed,\\nwhile the other prevents any overflow or drip-\\nping of fluid from soiling the mattress. In the\\ncourse of a day, or when the physician thinks it\\nsafe, the second may likewise be discarded.\\nIn addition there should be a plentiful supply\\nof towels, a baby s bath-tub, which the physician\\nmay need in resuscitating a partially asphyxi-\\nated child, a piece of narrow, strong tape (which\\nis to be sterilized by boiling) for tying the cord,\\na bottle of carbolic acid or tablets of bichloride\\nof mercury for making solutions, and a bottle of\\nboracic acid solution for washing the baby s eyes.", "height": "4356", "width": "2964", "jp2-path": "careofchildinhea00oppe_0060.jp2"}, "59": {"fulltext": "CHAPTER III\\nTHE BABY S OUTFIT AND NURSERY\\nLong before the baby is born, his outfit should\\nhave been obtained in its entirety. If one waits\\nuntil the pregnancy is about to end, there will\\nusually be so much of a hurry in procuring the\\nvarious articles, in struggling with transient\\nattacks of indisposition, and making the various\\npreparations for the mother s needs, that some\\nthings may be forgotten or neglected, or in the\\nhurry a compromise be made and inferior or less\\nconvenient garments and utensils be accepted\\nthan otherwise. One should go about prepar-\\ning the layette as a matter of love and not\\nmerely of duty or necessity. Into every little\\nskirt or band some affection, some wholesome\\naspiration should be put; under such auspices\\ncare and work lose their tediousness, and every\\nhour of labor becomes sanctified as a partial\\npreparation for the doing of useful deeds and\\nthe thinking of wholesome thoughts.\\nThere are a few general rules which should\\n47", "height": "4360", "width": "2628", "jp2-path": "careofchildinhea00oppe_0061.jp2"}, "60": {"fulltext": "48 THE CAKE OF THE CHILD IN HEALTH\\ncontrol the making and the choice of clothing.\\nThe garments must be warm, light, and entirely\\nwithout harshness. Infants need more warmth\\nthan adults, and a lack of it depresses their\\nphysical condition more than one would usually\\nsuppose. And not only must there be sufficient\\nwarmth, but, also, it must be evenly distributed.\\nA baby whose chest is overloaded and whose\\nlegs are bare cannot be expected to keep up a\\nnicely balanced thermal equilibrium, but, on\\nthe other hand, is apt to fall into congestive\\ndisturbances. The fabric of which the gar-\\nments is made must be as soft and bland as\\npossible, for the delicacy of a young baby s skin\\nis not to be estimated by our mature standards.\\nIts delicacy seems at times almost pathological,\\nand only by forethought and scrupulous care are\\nskin disorders, with their resulting acute suffer-\\ning, avoided. In addition to these fundamental\\nrequirements, one should remember that a child\\nin arms depends for a large part of his exercise\\nupon the freedom to move arms and legs at will\\ntherefore his clothes must be free enough to\\navoid constriction and all manner of rigorous\\nbinding. There must be as few pins used as\\npossible, and even the number of buttons and\\nbuttonholes must be kept down to the minimum", "height": "4356", "width": "2948", "jp2-path": "careofchildinhea00oppe_0062.jp2"}, "61": {"fulltext": "THE BABY S OUTFIT AND NURSERY 49\\nin order to allow the girth of the garments to\\nbe adapted to the requirements of growth.\\nTheir place is well filled by tapes and draw-\\nstrings, which plainly have many advantages\\nand few objectionable features. Lastly, there\\nmust be a sufficient number and variety of\\ngarments to allow as frequent changes as the\\nrequirements of health and convenience de-\\nmand.\\nA proper outfit for a well-cared-for child\\nshould contain at the least the following\\narticles\\n1 hamper or bassinet or 2 wrappers,\\nbasket. 3 coats.\\n2 pieces of diapering. 1 shawl.\\n3 flannel bands. 2 caps.\\n4 shirts. 1 pair of knit tights.\\n6 pairs of stockings. 4 bibs.\\n2 pairs of booties. Safety-pins, large and\\n4 barrow coats or pin- small, in sufficient\\nning blankets. number. And, lastly,\\n4 nightgowns. a box of fine talcum\\n4 slips. dusting powder.\\nAlthough this list should not be abbreviated,\\nit may be indefinitely enlarged. Not only are\\nthere many variations in quality, but the num-", "height": "4360", "width": "2628", "jp2-path": "careofchildinhea00oppe_0063.jp2"}, "62": {"fulltext": "50 THE CARE OF THE CHILD IN HEALTH\\nber of pieces may be increased according to the\\nfancy and means of the parents. The main\\nadvantage of an increased quantity, outside of\\nreasons of luxury, is the smaller number of\\nwashings through which each piece must go,\\nand the consequently lessened amount of\\nshrinkage and injury that necessarily follows.\\nI have made no attempt to mention all the dif-\\nferent varieties of garments because such detail\\nis unnecessary and would, in addition, create\\nthe impression that many more articles are\\nrequired than are really essential. Moderation\\nin providing the layette is by all means desir-\\nable, since it may have much to do with fixing\\nthe standard according to which the dressing of\\nthe child will be gauged for years to come.\\nThe mother should keep before her eyes the fact\\nthat the child, much sooner than she is apt to\\nfancy, absorbs ideas of station and scale of liv-\\ning, and that the habit of luxury is more easily\\nformed than discarded. She must recognize\\nfrankly and definitely her present and probable\\nfuture economical scope, and as a matter of\\nconvenience keep well within reasonable limits.\\nFor such reasons, as well as the equally im-\\nportant one of good taste, she should try to\\nmake the layette reasonably inexpensive, good", "height": "4356", "width": "2888", "jp2-path": "careofchildinhea00oppe_0064.jp2"}, "63": {"fulltext": "THE BABY S OUTFIT AND NUBSERY 51\\nin qualitj not overburdened with ornamenta-\\ntion, and frankly serviceable.\\nOne of the first articles which may be obtained\\nis a hamper or bassinet. One of liberal size is\\nto be recommended, and preferably should have\\none or more portable trays if it rests upon cas-\\ntors it can be so easily moved about that its use-\\nfulness is materially enhanced. Such a hamper\\nhas many advantages over the ordinary dressing\\nbasket, since it can contain the whole outfit,\\nand thus saves much time that would be wasted\\nin going to and fro in search of the various gar-\\nments, while simultaneously it promotes habits\\nof neatness and order. In the hamper each sort\\nof clothes should be placed in a certain position\\nwhich, when once found to be practical, must\\nbe always maintained. It is an excellent plan\\nto have the hamper divided horizontally by a\\ntray, which not only may separate different\\nsorts of articles but also may be of considerable\\nuse in carrying garments from one place to\\nanother.\\nThe material for diapers may be cotton or\\nlinen, and should be bought by the piece.\\nAlthough the linen is somewhat more expen-\\nsive than the cotton, nevertheless it remains so\\nmuch softer and shrinks so much less that its", "height": "4360", "width": "2628", "jp2-path": "careofchildinhea00oppe_0065.jp2"}, "64": {"fulltext": "52 THE CARE OF THE CHILD IN HEALTH\\nadvantages overweigh the added cost. The\\ndiapers may be cut in three sizes, and one\\nshould progress from the small to the larger as\\nthe child grows. Convenient sizes are squares\\nof sixteen inches, eighteen inches, and twenty-\\nfour inches. A sufficient quantity of these\\nshould be provided, because every diaper should\\nbe thoroughly washed and aired after being used,\\neven if it has been no more than dampened and\\nsince it is often possible that the washing can-\\nnot be promptly done, there must be enough\\nclothes to serve for at least two or two and a\\nhalf days. It is wise to provide a covered pail\\nto contain the soiled diapers until they can be\\nwashed, for they should not be thrown with the\\nother clothes of the baby or of the rest of the\\nfamily.\\nFor the first three or four months the child\\nshould wear an abdominal band, w T hich after\\nthat time may, unless there are special indi-\\ncations for continuing its use, be discarded.\\nThree are usually sufficient one for the\\nnight, one for the day, and the remaining one\\nfor change. They are often made of plain\\nflannel, but a better and preferable quality is\\nmade of soft knitted wool, of cashmere, or of\\na mixture of wool and silk. It is rarely neces-", "height": "4360", "width": "2884", "jp2-path": "careofchildinhea00oppe_0066.jp2"}, "65": {"fulltext": "THE BABY S OUTFIT AND NURSERY 53\\nsary to make them more than six inches wide,\\nand one should not commit the mistake of buy-\\ning some of those recently devised which extend\\nto the armpits, thus tending to restrict the easy\\nplay of the chest walls and the contained\\norgans. The main reason for putting a band\\non an infant is not entirely for warmth, as is so\\ncommonly believed, but rather to prevent a\\nhernia, or rupture of the navel. The custom of\\nusing these bands for the whole of the baby s\\nfirst year is to a certain extent a superfluity;\\nthe main purpose will have been attained at the\\nend of two or three months, for after that period\\nthere is not much danger of an umbilical hernia.\\nThe little shirts that go next to the skin\\nshould be supplied in two weights, if the mother\\nwishes to get no more than is absolutely neces-\\nsarjr, but in three if her means permit a some-\\nwhat greater expenditure. These garments are\\ncommonly of too small a size, and are not cut\\nwith the view of their inevitable shrinkage and\\nthe child s natural growth. They should have\\nlong sleeves, and instead of being fastened by\\nbuttons may advantageously be closed with\\ntapes. In most cases the buttons are so small\\nthat after a little use the holes become unduly\\nlarge, and, consequently, the garment is open", "height": "4360", "width": "2628", "jp2-path": "careofchildinhea00oppe_0067.jp2"}, "66": {"fulltext": "54 THE CARE OF THE CHILD IIST HEALTH\\nquite as often as closed. These shirts may be\\nmade of wool, of a mixture of wool and silk, or\\nof cashmere, all of which may be bought in\\nvarious thicknesses from a fairly heavy material\\nto the thinnest gauze. They must extend from\\nthe neck to below the buttocks, so that there is\\nno likelihood of their shrinking to or beyond\\nthe edge of the diaper. It is scarcely necessary\\nto say that those used during the day must be\\nchanged for others at night. The first, after\\nbeing thoroughly aired, may be used on the\\nfollowing day.\\nIn regard to the stockings there are two main\\nobservations that require attention they must\\nbe of the proper weight, and by all means\\nshould be sufficiently long. The first require-\\nment is easily satisfied, for every well-stocked\\nshop has a large enough assortment to allow a\\nselection for the different seasons. The ques-\\ntion of length is not so easily settled, because\\nalmost all the stockings that one finds for sale\\nare decidedly short. There is no doubt that\\nthey should extend sufficiently high upon the\\nleg to allow of being pinned to the diaper. On\\nmost children, as usually dressed, they fall\\ndown about the ankles soon after being drawn\\non, and thereby leave a part of the leg quite", "height": "4360", "width": "2856", "jp2-path": "careofchildinhea00oppe_0068.jp2"}, "67": {"fulltext": "THE BABY S OUTFIT AND NURSERY 55\\nbare. The natural results of exposure and an\\nunequal distribution of heat are not only hard\\nto avoid, but also the habit is commonly apt to\\npromote congestive disturbances. In addition\\nto the stockings, the child, as soon as there is a\\nchill in the air, should wear little knitted shoes,\\nusually called booties. These, also, may be\\nof two weights and should be changed suffi-\\nciently often to keep them sweet and wholesome.\\nTo complete the list of underclothes we need\\nfour or more barrow coats, popularly called\\npinning blankets. In former times these con-\\nsisted of a band of variable width joined to a\\nlong skirt of flannel. It has always been and\\nmust always be one of the principal garments,\\nsince it covers most of the body; and, if prop-\\nerly made, it gives warmth, does not hinder the\\nchild s movements, and is easily manipulated.\\nTo make it a perfect garment its upper portion\\nshould be changed and lengthened, and its skirt\\nshortened. Instead of a band, the form should\\nbe that of a sleeveless coat, and the skirt should\\nextend no lower than a few inches below the\\nbaby s feet. The habit of clothing an infant\\nin very long dresses is a thoroughly unneces-\\nsary one there is no excuse for it, but, on the\\ncontrary, there are distinct reasons against it.", "height": "4348", "width": "2612", "jp2-path": "careofchildinhea00oppe_0069.jp2"}, "68": {"fulltext": "56 THE CARE OF THE CHILD IN HEALTH\\nSuch skirts are expensive, clumsy, and hard to\\nmanipulate. They add materially to the\\namount of the weekly wash, and, by their\\nweight, especially if heavily embroidered, re-\\nstrict the child s movements and help to make\\nan unnecessary burden for the nurse or mother.\\nMy objections to them were crystallized about\\nsix years ago, when I saw a somewhat weak\\ninfant, of about five months of age, whose leg\\nhad been broken by the twisting of a weighty,\\nheavily worked, and unusually long skirt.\\nThis accident, to be sure, is a very rare one\\nbut the fact remains that, although rare, it is\\nnevertheless possible. The only thing that\\none can urge in justification of long skirts is\\ntheir supposedly decorative effect; but the\\nvalue of even this is very doubtful, and at best\\nshould not be regarded as important. The\\nbarrow coat, then, in its abbreviated form and\\nfastened in front with tapes instead of buttons,\\nmakes an easily adjusted, comfortable, and\\nwell-nigh indispensable garment, which con-\\ntributes much to maintaining an even degree\\nof heat. In extremely cold weather a modified\\ncoat containing sleeves may be used.\\nOutside of the barrow coat comes the white\\ndress, or slip, made of cambric or nainsook.", "height": "4360", "width": "2880", "jp2-path": "careofchildinhea00oppe_0070.jp2"}, "69": {"fulltext": "THE BABY S OUTFIT AND NURSERY 57\\nNo especial directions concerning its form\\nneed mention, excepting the emphatic sugges-\\ntion that it must not be unreasonably long; in\\nfact, it should be only long enough to cover the\\nbarrow coat. The various slips may be made of\\ndifferent qualities of material and ornamented\\nwith the various decorations with which every\\nwoman is familiar. It is not out of place to\\nadvise simplicity rather than lavishness in this\\nmatter; for the baby may look sweet and dainty\\nwithout being made to imitate an overdressed\\nlay figure or a gaudy fashion-plate.\\nA very useful garment is a warm wrapper,\\nmade of cashmere, flannel, or any plain material\\nwhich may be tufted. It is designed to wear\\nat night, early in the morning, after the bath,\\nor whenever the child needs a warm, comfort-\\nable dress that may be put on and off with the\\nleast delay. It must be long enough to cover\\nthe feet comfortably, large and long in the\\nsleeves, and sufficiently snug in the neck to\\nprevent gaping. It may be closed at the neck\\nand on the chest by ribbons or cords, and about\\nthe waist may have a heavier cord which will\\nkeep the free edges from falling apart. Such\\na wrapper may at an emergency be used as an\\nauxiliary nightgown, although the ordinary", "height": "4348", "width": "2636", "jp2-path": "careofchildinhea00oppe_0071.jp2"}, "70": {"fulltext": "58 THE CARE OF THE CHILD IN HEALTH\\nnight-dresses should be made in different\\nweights to suit the seasons. Thus, they may-\\nrange from cambric and nainsook to flannel and\\nknitted goods. They should be large and\\nroomy, long enough to keep the feet thoroughly\\nwarm, and closed with tape or ribbons instead\\nof pins or buttons.\\nVery little more need be said about the\\nlayette, excepting a few minor suggestions.\\nThus, one often sees an external diaper made\\nof stockinet or other rubber material. The use\\nof such an article is to be condemned on the\\nground that it sets a premium on laziness and\\nlack of attention, that it is provocative of irri-\\ntations and disorders of the skin, and that its\\nlogical effect resembles closely that of a poul-\\ntice. This is easy to understand when one\\nconsiders that a poultice is designed to main-\\ntain artificial heat and moisture on a selected\\npart of the body, which is exactly what the\\nimpervious diaper-cover is bound in some de-\\ngree to do. There are rare occasions, such as\\nwhen the child appears in a public place, on\\nwhich a contrivance like this may be used for\\nan hour or two. But these occasions ought to\\nbe very rare, and even then with sufficient care\\nthe child can be kept in an unobjectionable", "height": "4360", "width": "2892", "jp2-path": "careofchildinhea00oppe_0072.jp2"}, "71": {"fulltext": "THE BABY S OUTFIT AND NURSERY 59\\ncondition with no more than his usual clothing.\\nAnother suggestion may be made concerning\\nbibs. The use of these articles is to save the\\nfront of the slips from being soiled with food\\nand saliva. They should, therefore, be made\\nof a closely woven material which does not\\nreadily absorb and hold moisture. A sodden\\nbib may possibly be the means of dampening\\nand chilling the chest, and thus give rise to a\\nbronchitis or other related disorders. A useful\\nbib for hand-fed babies may be made by folding\\nup its lower margin to form a wide pocket into\\nwhich drippings of food may run and be held.\\nSuch a bib must naturally be made of an imper-\\nvious material, and should be removed shortly\\nafter feeding has been completed.\\nNow that the baby s outfit is completed, one\\nshould consider the problem of selecting a room\\nfor the nursery and furnishing it in a comfort-\\nable, hygienic, and attractive manner. The\\nsunniest room in the house ought to be chosen,\\nfor babies like flowers need plenty of sunshine\\nand air. A southern exposure is to be pre-\\nferred to any other, for under such conditions\\nthe requirements are most apt to be met. The\\nbest facilities for ventilation are essential, and,\\nat the same time, are not hard to provide.", "height": "4356", "width": "2596", "jp2-path": "careofchildinhea00oppe_0073.jp2"}, "72": {"fulltext": "60 THE CARE OF THE CHILD IX HEALTH\\nEvery day the windows must be left open for a\\nsufficient time, both in winter and summer, to\\ninsure the thorough airing of the room. And\\nwhile they are closed the entrance of fresh air\\nmay be insured by one or more of several\\nmethods of ventilation. The heating of the\\nroom should be so devised as to contribute some\\nassistance to this end. The method which\\ngives the best results is that of a grate fire,\\nproperly guarded by high, strong fenders. A\\ngood stove that is heavy enough to prevent\\noverturning, especially if it is surrounded by a\\nwire guard, is also a very useful means at the\\nsame time it does away with the large amount\\nof dust and dirt that a grate fire is bound to\\ncause. A Franklin burner also has many\\nadvantages, especially as it is very clean. The\\nmost objectionable method is the ordinary steam\\nheat, which clearly ought not to be allowed in\\nany well-appointed nursery. In the other\\nmethods the rarefaction of the air caused by\\nthe heat and the draught of the chimney bring\\na corresponding amount of fresh air into the\\nroom through the crevices and joints of the\\nwindows and doors, and thus serves our pur-\\npose more actively than one would suppose.\\nA more direct way of ventilation is through", "height": "4360", "width": "2900", "jp2-path": "careofchildinhea00oppe_0074.jp2"}, "73": {"fulltext": "THE BABY S OUTFIT AND NTTRSEEY 61\\nsome device connected with the window. One\\nof the simplest and best of these consists of\\nlowering the upper sash about six inches and\\nfilling the open space with a plain piece of\\nboard. The window is then closed at top and\\nbottom, but open in the middle. The cold air\\nis directed, by the situation of the opening, to\\nthe upper part of the room, whence, on account\\nof its weight, it gently descends and produces\\nno draught. Another way is that of the old-\\ntime ring ventilator, which is set in a pane of\\nglass in any of the windows. This gives the\\nminimum of trouble, but it is not so easily con-\\ntrolled as the first device. There are yet other\\nmethods, such as the box ventilator, which is\\nattached to a permanent opening at the top or\\nbottom of the window, and is opened or closed\\nby a sliding panel or similar device. By such\\nmeans it is always possible to have pure, fresh\\nair in the room; and one must see to it, as a\\nprime necessity, that there should never be a\\nstuffy, close, or unpleasant atmosphere in this\\nmost important part of the house. While we\\nare working on the windows we may order the\\niron gratings for the lower half, which are de-\\nsigned to prevent the child from leaning too far\\nout or falling to the ground. This prevention", "height": "4344", "width": "2636", "jp2-path": "careofchildinhea00oppe_0075.jp2"}, "74": {"fulltext": "62 THE CARE OF THE CHILD IIsT HEALTH\\nis, naturally, superfluous in the first year of\\nlife but it is well, so long as one is fitting up\\na nursery, to make it complete and thus save\\nthe trouble of making additions later on. A\\nfurther detail is the supplying of two sets of\\nroller shades or blinds for the windows, one of\\na light color and the other of a dark blue or\\ndark green holland. The latter is to be used\\nin darkening the room at whatever time of day\\nthe bahy may be sleeping. As will be seen\\nlater on, this is a matter of some importance.\\nThe floor may be made of hard wood and cov-\\nered with skin rugs, or of the ordinary soft pine\\npainted and similarly covered. The rugs are\\ndesigned to give warmth even more than for\\ntheir decorative effect. Their greater cleanli-\\nness is the reason for preferring them over car-\\npets, and, therefore, they must not be so large\\nas to render an easy and frequent removal into\\nthe air difficult. Fur rugs make a desirable\\ncovering for parts of the floor, especially as they\\nserve, when the child is old enough to like\\nstories, as a basis for all sorts of tales concern-\\ning animals, strange lands, and adventures.\\nSome able mothers prefer a covering of fine\\nJapanese matting in place of the polished or\\npainted floor, on the ground of its greater", "height": "4360", "width": "2908", "jp2-path": "careofchildinhea00oppe_0076.jp2"}, "75": {"fulltext": "THE BABY S OUTFIT AND NURSERY 63\\nwarmth, greater sureness for the foot, and\\nalmost equal ease in being kept clean. If a\\nfew mats or rugs are strewn here and there, its\\nattractiveness is considerably increased. The\\ncovering of the side walls and ceiling deserve\\nthe expenditure of thought and taste, for they\\nhave much to do with deciding the character of\\nthe room and the first formative impression upon\\nthe child s eyes. Some good, attractive, ele-\\nmental color should be selected as the main\\nnote in the decoration and should be logically\\nand tastefully carried out in the wall, ceiling,\\nand even the furniture.\\nBut before the decorations are begun one\\nshould rehearse clearly what sanitary demands\\nmust be answered in this part of the room.\\nThese are scrupulous cleanliness, lack of incli-\\nnation to acquire disease germs as well as dirt,\\nand ease in renovation. Obviously, the best\\nsurface for such purposes is a smooth, hard,\\nand waterproof one. Therefore, the walls and\\nceiling should be covered with an oil color,\\nwith or without a coat of varnish, or with a\\npaper which may be varnished. For this pur-\\npose one can now buy some very desirable\\npapers with an attractive pattern showing chil-\\ndren at play, animals sporting and at rest, or", "height": "4356", "width": "2644", "jp2-path": "careofchildinhea00oppe_0077.jp2"}, "76": {"fulltext": "64 THE CARE OF THE CHILD IN HEALTH\\npretty sketches of landscape. Some are even\\nmade with a hard, glossy finish which permits\\nwashing. This is one of the essential features\\nof every nook and cranny of a well-appointed\\nnursery, for by this means we are able to dimin-\\nish or prevent the likelihood of various sick-\\nnesses. When the wall-paper is of a decorative,\\nthickly covered pattern, little or no additional\\nornamentation is needed from pictures but if\\npictures are hung up, they must likewise be of\\nsuch a nature that they may with impunity be\\nwashed, or of so little value that on proper pro-\\nvocation they may be destroyed. These articles\\nare of secondary importance, and with a suf-\\nficiently decorative paper need be supplied in\\nsmall quantities or not at all. The main ob-\\njection to them lies in the possibility which\\nthey furnish of collecting dust and harboring\\ngerms of disease and fermentation. A similar\\nobjection may be made against curtains and\\nportidres, the use of which has the additional\\nobjection of increasing the danger of fire. But\\nif they are a part of the furnishing, they must\\nnot be placed in close proximity to a gas-jet, a\\nstove, or an open fire of any sort.\\nThe furniture must follow the same rule of\\nsanitary impeccability. Every piece of it,", "height": "4360", "width": "2864", "jp2-path": "careofchildinhea00oppe_0078.jp2"}, "77": {"fulltext": "THE BABY S OUTFIT AND NURSERY 65\\nbesides being light and strong, must offer little\\nopposition to being scrubbed or cleansed. For\\nthis purpose the use of enamel paints in any\\ndesired colors is highly to be recommended.\\nThus the chairs should be of wood or wicker,\\npainted white or any other light color and if\\nupholstery is desired it may be supplied in the\\nform of cushions, which are to be kept in place\\nby ribbons or tapes. If a sofa or lounge is to\\nhave a place in the room, it should be of simi-\\nlar material and similarly covered. The cush-\\nions should be covered with a waterproof fabric,\\nwith or without an additional slip cover of\\nchintz, cretonne, denim, or similar wash goods.\\nIn this way one can insure the maximum of\\ncomfort, convenience, and cleanliness with the\\nminimum of expense, unnecessary work, and\\ndanger of harboring infection. This general\\nplan need not be confined to the pieces here\\nmentioned, but to every article that is sus-\\nceptible of such treatment.\\nThe other essentials are a bath-tub, a wash-\\nbasin, a toilet chair, a screen, and an ice-box.\\nThe bath-tub must be small enough to be moved\\nabout with ease, as well as to occupy no ex-\\ntravagant amount of space when not in use.\\nOne of the best models is made of a large pouch", "height": "4348", "width": "2652", "jp2-path": "careofchildinhea00oppe_0079.jp2"}, "78": {"fulltext": "66 THE CARE OF THE CHILD IN HEALTH\\nof rubber cloth suspended from a rectangular\\nwooden frame, which is supported upon col-\\nlapsible legs. This tub is inexpensive, easily\\nhandled, and sufficiently high to enable the\\nmother, while sitting comfortably on a chair,\\nto give the bath quickly and thoroughly. In\\nthis respect it has a decided advantage over the\\nordinary type of metal tub, which is so low that\\nit makes the bathing of the child a matter of\\nconsiderable discomfort for the mother or nurse.\\nOf course, it can be raised by means of a chair\\nor a bench but such a device is really a clumsy\\none. In those favored houses where there is a\\nwell-heated bath-room attached to the nursery,\\nthe large bath-tub may be covered in part by a\\ntemporary wooden grating upon which the\\nbaby s tub may rest. This prevents the dis-\\ncomfort of the low position, it does away with\\nthe danger of splashing the floor, rugs, and\\nfurniture with water, and, if the small tub is\\nfilled by means of rubber pipes attached to the\\nfaucets, requires the least trouble in prepara-\\ntion. But as in most cases the bath-room is\\nnot connected with the nursery and, in addi-\\ntion, is almost always colder in winter than the\\nother rooms in the house, it generally cannot be\\nused for this purpose.", "height": "4356", "width": "2856", "jp2-path": "careofchildinhea00oppe_0080.jp2"}, "79": {"fulltext": "THE BABY S OUTFIT AND NURSERY 67\\nThe wash-basin is used for all washings other\\nthan full baths it may be in the form of the\\nordinary basin, but a better type is where it is\\ndivided by a partition which makes two com-\\npartments, one for hot and the other for cold\\nwater. The partition should have a handle\\nattached to its upper margin by which the basin\\nmay be carried with ease. The toilet chair\\nshould be made of painted wood or wicker, so\\nthat it cannot be injured by frequent and\\nthorough scrubbings. It should form a part of\\nthe first outfit, for its use, as will be later on\\nshown, need not be deferred as long as the\\npresent custom demands. The screen should\\nbe a serviceable article, not designed for dec-\\noration alone, and will be found very useful in\\nshielding the child while he is asleep, being\\nbathed, or being dressed. It also should be\\nmade of waterproof material which permits of\\nas frequent washing as scrupulous cleanliness\\ndemands it must be strong, light, and not too\\nlarge to render its constant handling in any\\nway burdensome. The rule must be made and\\nsteadfastly enforced against using the screen,\\nor, in fact, any other piece of furniture in the\\nnursery, for the drying of soiled or damp diapers\\nand other garments. Such a habit is to be", "height": "4360", "width": "2692", "jp2-path": "careofchildinhea00oppe_0081.jp2"}, "80": {"fulltext": "68 THE CARE OF THE CHILD IN HEALTH\\nheartily discouraged, for it tends to permit or\\nsanction laziness and lack of cleanliness, which\\nare often followed by skin diseases or other\\ntroubles of the child s buttocks and body in\\ngeneral. Whenever any of the garments has\\nbeen in any way soiled, no matter how slight\\nthe soiling may be, it should be thoroughly\\nwashed and rinsed in the kitchen or laundry,\\ndried, aired, and ironed before being used. It\\nis so easy to disregard this rule, the tempta-\\ntions especially to a careless nurse are so\\ncommon, and the consequences may be so much\\nout of proportion to the seemingly trivial nature\\nof the offence, that no exceptions should be\\nallowed.\\nThe ice-box is meant to hold the unused food\\nof a hand-fed infant, or that of a somewhat older\\nchild who is yet too young to be fed on the\\nvaried diet that comes with later years. It may\\nbe made of tin or zinc, and must be so light\\nthat its weight offers no objection to frequent\\nwashings and airings. Its partitions must be\\nremovable, for at least once a week they should\\nbe taken out, and the whole structure thoroughly\\nscrubbed and allowed to dry in the sunshine.\\nAn ice-box that is not surgically clean is a\\nfruitful source of the spoiling or fermenta-", "height": "4348", "width": "2820", "jp2-path": "careofchildinhea00oppe_0082.jp2"}, "81": {"fulltext": "THE BABY S OUTFIT AND NURSERY 69\\ntion of food; and if such fermentation did not\\nexist, a large proportion of the diseases of in-\\nfancy would be unknown. The conscientious\\nobservance of these details, and others like\\nthem, is the very basis of an uneventful and\\nsuccessful conduct of the infant s career. The\\nimportance of the matter may be estimated\\nfrom the fact that the child during this period\\nis going through one of the crises of his life,\\nthat the formative character of the first months\\nhas much to say about what he is later on\\ngoing to be, and that efficient administration\\nof all the minutiae of babyhood should in\\norder to form a correct conception of their\\nvalue be translated into forms of the thoughts\\nand deeds, the physical and mental state, of the\\nfuture man and woman, as well as those who are\\ndependent upon them. The man who said that\\nhe would rather write the songs of a people than\\nmake their laws, had enough imagination to see\\nbeyond the border-line of facts; but his pro-\\njected empire would have been vastly increased\\nif he could have made a choice of the customs\\nand habits of young children.", "height": "4344", "width": "2676", "jp2-path": "careofchildinhea00oppe_0083.jp2"}, "82": {"fulltext": "CHAPTER IV\\nFEEDING\\nThe problem of feeding a child is not a par-\\nticularly difficult one if the mother understands\\nclearly what the baby needs and how to make\\nthe various changes and modifications that a\\nnormal development necessarily entails. Most\\nof all it is important to grasp a few fundamental\\nprinciples which are at the basis of nutrition.\\nThis question of nutrition is one of the main\\nsubjects of thought and effort that an intelligent\\nmother has to reckon with; it constantly re-\\nappears in one form or another, touching upon\\nand involving one interest after the other. In\\nthe last analysis it stands for most of what we\\nwant a child to be the personification of vigor\\nand strength of body united with vigor and\\nstrength of mind. There is little doubt that\\nmental action is closely bound up with physical\\ncompetency, in the same way that we know\\nquite positively that disturbed action of the body\\nis usually, if not always, associated with dis-\\n70", "height": "4348", "width": "2900", "jp2-path": "careofchildinhea00oppe_0084.jp2"}, "83": {"fulltext": "FEEDING 71\\ntorted function of the mind. These two factors\\nstand to each other in the relation of comple-\\nmentary parts of an intricate machine and their\\ninterdependence is as inevitable as it is inti-\\nmate. Thus the fact of feeding a child comes\\nto have a higher significance than merely satis-\\nfying his hunger; we may go even farther, and\\nsay that the feeding of a child means much more\\nthan the feeding of an adult. For in the latter\\nthe desired object is merely to maintain the set-\\ntled equilibrium of the matured organism, to\\ncontinue a settled condition. In the former.\\nhowever, it has the additional burden of sup-\\nplying new elements of growth in order to\\nchange an unstable to a stable equilibrium, of\\nmaking something exist where formerlv it did\\nnot exist, of changing tissue to so great a de-\\ngree as to be equivalent to a difference in kind.\\nThe feeding of an infant should be restricted\\nto the mother s milk. If this natural food is\\nsufficient in quantity and quality it forms the\\nideal nourishment. All the needs of the or-\\nganism are fulfilled, at very little danger of the\\nfood s possessing an improper composition or\\nbeing contaminated with germ life or impurities.\\nXaturally this is a matter of paramount impor-\\ntance and demonstrates how perfectly nature", "height": "4360", "width": "2708", "jp2-path": "careofchildinhea00oppe_0085.jp2"}, "84": {"fulltext": "72 THE CARE OF THE CHILD IN HEALTH\\nadapts means to ends. In addition, however,\\nthere is another factor of salient importance\\nwhich makes the nursing of the child by the\\nmother a matter of the greatest value; for the\\nexceedingly intimate relations tend to promote\\nthe bond between parent and child, the mother\\nwith every nursing period recognizes that the\\nlittle one is a very part of herself, and that a\\nvery part of herself is contributing to make and\\nmaintain his life. The resulting sympathy is\\nand must be exquisitely intimate and gives the\\npossibility of insight into the child s physical\\nand mental being which otherwise cannot be\\nobtained. As far as the baby is concerned, who\\nshall say that he is not mightily influenced by\\nthe fluid which means life to him, by the won-\\nderfully close relations with the one who nurses\\nhim, by the unconscious absorption of char-\\nacteristics which make up the family person-\\nality! Such influences are at the bottom of\\nthe belief that blood is thicker than water and\\nto their cohesive force the tremendous power\\nof child- and parent-relationship is due. The\\nwoman who suckles her baby enjoys a great\\nopportunity, for which she ought to be deeply\\ngrateful, to assist in moulding him into the form\\nthat he ultimately will assume; and nothing but", "height": "4336", "width": "2892", "jp2-path": "careofchildinhea00oppe_0086.jp2"}, "85": {"fulltext": "FEEDING 73\\nabsolute necessity should induce her to throw\\naway this great privilege.\\nIn some cases, however, on account of physi-\\ncal incompetency or sickness, she is compelled\\nto forego her privilege and duty. When this\\nnecessity has been demonstrated as a fact, she\\nshould promptly acquiesce in it, as she should in\\nany other misfortune. Once that the milk has\\nbeen shown to be too deficient for its purpose,\\nthe child should be weaned and a substitute food\\nbe given in its place. There should be no hesi-\\ntation or compromise in this, nor should the baby\\nbe fed in part on an artificial food and in part\\non the breast. For if the mother s milk is\\nmarkedly imperfect, it continues so to be,\\nwhether an artificial food is or is not added; and\\nthe result is apt to be a continued state of\\nimperfect nutrition. This is apt to be the case\\nwhere the mother is of an overnervous, hys-\\nterical disposition, if she is markedly unhappy, if\\nshe is thoroughly exhausted, or if she regulates\\nthe factors of rest, diet, exercise, and relaxation\\nso poorly that a normal secretion of milk is out\\nof the question. Here the quality of the milk\\nmay be so bad or it may vary so widely from\\nday to day that a gradual but real starvation\\nmust necessarily be present.", "height": "4356", "width": "2684", "jp2-path": "careofchildinhea00oppe_0087.jp2"}, "86": {"fulltext": "74 THE CARE OF THE CHILD IN HEALTH\\nAn exception should be made of those cases,\\nwhich are to be distinguished by the physician,\\nwhere the error in the constitution of the milk\\nis merely temporary, or due to some passing\\ncondition in the mother. Thus the total quan-\\ntity may be too small, although the quality is\\ngood; in this case an increase in the amount of\\nliquids in her diet will often remedy the fault.\\nIn other cases the quantity may be too great,\\nbut it can be reduced by the opposite means of\\nreducing the amount of fluids consumed. If\\nthe milk is too watery, its relative amount of\\nsolids may be increased by taking less exercise,\\ndecreasing the quantity of fluids consumed and\\nshortening the intervals between the feedings.\\nIf the milk is not watery enough, a desirable\\neffect may be produced by reversing these sug-\\ngestions. The amount of cream or fat in it may\\nbe increased by adding more meat to the diet,\\nand lessened by eating less meat. The proteids\\nare increased by a more sedentary life, and\\ndecreased by adding largely to the amount of\\nexercise. These rules are naturally meant to\\napply to cases of minor disturbances, and, if\\nthey are carried out with the aid of a competent\\nphysician, will undoubtedly be of considerable\\nuse. In general, however, the wisest course for", "height": "4352", "width": "2856", "jp2-path": "careofchildinhea00oppe_0088.jp2"}, "87": {"fulltext": "FEEDING 75\\na nursing mother to pursue is to eat regularly\\nand liberally of a sensible diet that includes\\nsoups, meats, fresh vegetables, eggs, and meats;\\nshe should avoid pastries, hot breads, con-\\ndiments, and articles that her ordinary expe-\\nrience and knowledge have demonstrated to be\\nindigestible. Milk especially should have an\\nimportant place in the daily dietary, and in ad-\\ndition may be the basis of a light meal that\\nshould be taken before retiring for the night.\\nIn many ways it is superior to the ordinary\\nalcoholic drinks, whose value as milk producers\\nis apt to be overestimated.\\nWhen, in spite of well-directed efforts to\\nconform to a normal and rational plan of diet,\\nexercise, and self-control, the supply of milk is\\nunsatisfactory, a choice must be made between\\nhand-feeding and a wet-nurse. Theoretically\\nthe latter has much to recommend her, but prac-\\ntically her selection has many weighty objec-\\ntions. In most cases she is the victim of\\nunhappiness, ill-treatment, or viciousness very\\noften she comes from a decidedly unfavorable\\nclass of society; her habits either secret or\\navowed are commonly bad, and the change\\nfrom comparative poverty to the luxury that is\\nlavished on her for the sake of her foster-child", "height": "4356", "width": "2700", "jp2-path": "careofchildinhea00oppe_0089.jp2"}, "88": {"fulltext": "76 THE CARE OF THE CHILD IN HEALTH\\nis apt to be demoralizing. Too commonly one\\nsees such a woman ignorant, lazy, and wrong-\\nheaded elevate herself into the position of a\\npetty tyrant, who domineers over the whole\\nhousehold by means of her influence with the\\nchild, and the common fear of interfering with\\nhis food supply. The position naturally lends\\nitself to the possibility of abuses, and the\\ntemptation for an undisciplined woman to take\\nadvantage of it is certainly strong. Besides\\nall this, the psychical effects of the intimate\\nrelation are of undoubted, even if indefinite,\\nimportance, and offer a constant menace to the\\nmother s peace of mind. Of course, if an\\nunobjectionable person could be obtained, one\\nwho was between twenty and thirty years of\\nage, who was quite healthy, with an entirely\\ngood milk supply, whose habits were unim-\\npeachable, who had had a previous child,\\nwhose temper was even and well controlled,\\nwhose disposition was peaceful and affection-\\nate, and whose outside connections were not\\nembarrassing, the problem of substitute feeding\\nwould offer less difficulty than is usually\\nencountered.\\nPractically, the only other method that re-\\nmains, if we discard the wet-nurse, is the use of", "height": "4348", "width": "2848", "jp2-path": "careofchildinhea00oppe_0090.jp2"}, "89": {"fulltext": "FEEDING 77\\nordinary cow s milk which has been sufficiently\\nmodified to make it approximate as closely as\\npossible to mother s milk. Occasionally an\\nattempt is made to use goat s milk or ass s milk;\\nbut the difficulty in obtaining it is so great, the\\nsupply is necessarily so limited (one ass giv-\\ning no more than one-half pint to one pint per\\nday), and the composition would nevertheless\\nso clearly need modification, that we can, as a\\nrule, get more satisfactory results from good,\\npure, cow s milk. Having decided that this is\\nto be the basis of the food, one is then con-\\nfronted by the vexing question of boiling it or\\nleaving it raw, of sterilizing, pasteurizing, or\\npeptonizing it. The original objection to raw\\nmilk was not at all a chemical, but merely a\\nhygienic one. Physicians came to know that\\nit often served as the carrier of disease germs.\\nThus, tuberculosis, typhoid fever, diphtheria,\\nand other sicknesses have spread, so that almost\\nall the disorders that afflict cows, the farm-\\nhands, and the milk handlers have been, at one\\ntime or another, attributed to the use of the\\nunboiled fluid. Moreover, if the cans and pails\\nare not kept scrupulously clean, various degrees\\nof fermentation occur that give rise to diarrhceal\\ntroubles and low forms of poisoning. In order", "height": "4356", "width": "2684", "jp2-path": "careofchildinhea00oppe_0091.jp2"}, "90": {"fulltext": "78 THE CARE OF THE CHILD IN HEALTH\\nto avoid such contingencies, the practice of\\nboiling the milk in order to kill the germs came\\ninto use. Before a long time passed, physicians\\nbegan to notice that while the amount of germ\\ndisease decreased, the number of cases of mal-\\nnutrition decidedly increased; and, promptly\\nenough, the cause was traced to the alteration\\nin the character of the milk produced by the\\nboiling. This alteration consisted of coagula-\\ntion and increased difficulty in digesting the\\nalbumin, changes in the milk-sugar, and\\nchanged relations of the emulsion in which the\\nfats were suspended. The result was, that\\nchildren were taking a food that was materially\\ndifferent from what it originally was supposed\\nto be, and on account of which they ceased to\\nthrive.\\nIn order to do away with these evil effects,\\nbut at the same time to kill the germs, the\\nprocess of sterilization was devised. This con-\\nsists of subjecting the milk to a temperature of\\n212 F. for a comparatively long time. Most\\ngerms were thus destroyed, while it was hoped\\nthat the milk would nevertheless be good.\\nExtended experience showed that a sterile milk\\ncould disappoint our expectations of its nour-\\nishing powers, and that many children who had", "height": "4352", "width": "2820", "jp2-path": "careofchildinhea00oppe_0092.jp2"}, "91": {"fulltext": "FEEDING 79\\nbeen carefully fed in this way became afflicted\\nwith scurvy as well as less pronounced forms of\\nmalnutrition. Then a further change was made\\nby reducing the amount of heat to 167\u00c2\u00b0 F. and\\ncutting down the length of exposure to it this\\nprocess, called pasteurization, was intended to\\nundo the evils of sterilization, as sterilization\\nwas intended to reform those of boiling. Unfor-\\ntunately there are observers who find bad results\\nfrom the use of pasteurized milk, and who are\\ntherefore forced to go back to sterilization, or to\\nstrike at the root of the whole trouble by insist-\\ning upon an uncontaminated milk, which they\\nrefuse to alter by heat. There is no doubt that\\nsuch milk has marked advantages over all\\nothers, but until of late it could not be had.\\nIn recent times, however, state inspection of\\ncattle has done much to clear tuberculosis from\\nthe herds, and there are a number of dairy-farms\\nwhere the animals, their stalls, the utensils, the\\nclothes and the hands of the milkers and milk\\nhandlers are kept so clean that the danger\\nof infection is reduced to a minimum. In\\naddition, also, to such care in collecting and\\nhandling it, the milk should before it leaves\\nthe farm be poured into bottles, which then are\\nto be packed in ice or in refrigerated compart-", "height": "4356", "width": "2684", "jp2-path": "careofchildinhea00oppe_0093.jp2"}, "92": {"fulltext": "80 THE CARE OF THE CHILD IN HEALTH\\nments, and thus kept at a low temperature until\\nit is delivered to the consumer. The essence\\nof the precautions is to have milk from a\\nhealthy, well-fed cow or herd of cows, w T hich\\nhas not been allowed to be contaminated by im-\\npure contact or air.\\nBut even if the milk is quite pure, it is not,\\non account of its chemical composition, ready\\nfor use. Both cow s milk and human milk\\ncontain the same elements, but not in the same\\nrelative proportions. These elements we know\\nas proteids, or albuminous matter, fats (com-\\nmonly called cream), sugar, mineral salts, and\\nwater. An analysis of them shows their relation\\nclearly\\nHuman milk. Cow s milk.\\nFat 3.50% 3.50%\\nMilk-sugar 6.50 4.30\\nProteids 1.50 4.00\\nMineral salts 0.15 0.70\\nWater 88.35 87.00\\nThe main difference, as we can easily see, lies\\nin the proportion of proteids the smaller varia-\\ntions in the sugar and salts are of no great\\nimportance. And not only is the percentage of\\nproteids greater in cow s milk, but also the\\ncharacter of the material is different. Before it\\ncan be digested, it becomes coagulated by the", "height": "4360", "width": "2840", "jp2-path": "careofchildinhea00oppe_0094.jp2"}, "93": {"fulltext": "FEEDING 81\\nacid and the gastric juice into a comparatively-\\nhard mass; in human milk, however, it is\\nchanged into fine, soft flakes, which, on account\\nof their form, offer a larger surface to the digest-\\ning agents, and thus are easily and quickly\\nchanged into the ultimate condition in which\\nsuch material is absorbed into the circulation.\\nThe main problem, then, has always been to\\nmodify the milk in such a way that the proteids\\nwould be reduced by one-half or more, while the\\nother constituents remained practically the\\nsame. It was for this purpose that milk\\nlaboratories have been established in some of\\nthe large Eastern cities, whose business it is to\\nprepare milk for infants according to the formula\\nwhich the physician submits to them. While\\nthis is the easiest way to obtain a properly\\nmodified milk, it is, unfortunately, out of the\\nreach of most families for the two good reasons\\nof locality and expense. The great need is\\nto spread the knowledge of how to modify the\\nmilk at home without too much trouble and\\nexpense.\\nAlthough it is not feasible to give all the\\ndirections necessary for modifying milk to suit\\nthe various needs of children whose digestive\\nsystems are in an abnormal condition, it is dis-", "height": "4348", "width": "2700", "jp2-path": "careofchildinhea00oppe_0095.jp2"}, "94": {"fulltext": "82 THE CARE OF THE CHILD IN HEALTH\\ntinctly desirable to describe an easy method of\\npreparing a suitable milk for a healthy child.\\nTo do this, one needs nothing more than the\\ncream of good milk and a definite solution of\\nmilk-sugar. If a bottle of milk be placed on\\nthe ice for five hours, the cream will rise in such\\nan amount as to constitute 8% of the whole; if\\nit is allowed to stand six hours, it will consti-\\ntute 12%. The cream, after having been\\nallowed to rise, should be decanted off into a\\nclean bottle, and used according to the follow-\\ning directions. The milk-sugar may be made\\nin a solution with boiled or distilled water by\\nany druggist or at home. In the following\\nmixtures a 7% sugar solution and a 10% sugar\\nsolution are employed. For a child of two\\nmonths or less, we may prepare a mixture con-\\ntaining the small proteid percentage which his\\nage calls for in the following proportion\\nFat 3%\\nSugar 6\\nProteids 1\\nTo make such a mixture one should use one\\npart of the 12% cream and three parts of a 7%\\nsugar solution. Mix well.\\nFor a child from three months to one year of", "height": "4360", "width": "2820", "jp2-path": "careofchildinhea00oppe_0096.jp2"}, "95": {"fulltext": "FEEDING 83\\nage, one may increase the amount of proteids,\\nas in this formula\\nFat 3.5%\\nSugar 6.0\\nProteids 1.2\\nIn making this mixture, one should take one\\npart of the 12% cream and two and one-half\\nparts of a 7% sugar solution. This, likewise,\\nmust be well mixed.\\nFor the two months succeeding the first year,\\nthe proteids may be yet further increased, as\\nFat 4%\\nSugar 7\\nProteids 2\\nThis is made by mixing equal parts of the\\n8% cream and a 10% sugar solution.\\nA sufficient quantity of the desired mixture\\nmay be made to serve for twenty-four hours.\\nIt should immediately be poured into as many\\nbottles as there are feedings, each bottle should\\nbe corked with a plug of aseptic absorbent cot-\\nton, and all should then be put on ice. Each\\none before being used should be warmed by being\\nimmersed in hot water, the cotton plug removed,\\nthe nipple should then be adjusted, and the\\npreparations are thus completed. If any milk\\nremains in a bottle, it must under no circum-", "height": "4360", "width": "2684", "jp2-path": "careofchildinhea00oppe_0097.jp2"}, "96": {"fulltext": "84 THE CAKE OF THE CHILD IN HEALTH\\nstances be used again, but should immediately\\nbe thrown away. As one can easily see, it is\\nnot hard to know exactly how much to prepare\\ntherefore there could then be no waste, and the\\nwork will be done at one time and quickly.\\nAll this is easily determined by making out a\\nplan of the number of feedings per day, the\\ntime of each, the quantity of each, and the total\\nquantity, as follows\\nScheme for feeding an Infant, with Intervals and\\nQuantities\\nINTERVALS\\nBETWEEN\\nFEEDINGS\\nAMOUNT IN\\nEACH BOTTLE\\nNUMBER OF\\nFEEDINGS\\nPER DAY\\nTOTAL\\nAMOUNT\\n1 week\\n2 hours\\n1 ounce\\n10\\n10 ounces\\n2 weeks\\n2\\nlh ounces\\n10\\n15\\n3\\n2\\n2\\n10\\n20\\n2 months\\n2\\n21\\n10\\n25\\n2|\\n2\\\\\\n3\\n9\\n27\\n3\\n2|\\nSh\\n8\\n28\\n4\\n3 M\\n4J\\n7\\n29\\n5\\n3\\n41\\n7\\n31*\\n6\\n3\\n51\\n6\\n33\\n7\\n3\\n6|\\n6\\n39\\n8\\n3|\\n7\\n6\\n42\\n9\\nSh\\n7\\n6\\n42 w\\n10\\n31\\n81\\n5\\n42|\\n11\\n3i\\n81\\n5\\n44\\n12\\n3i\\n9\\n5\\n45\\n13 and 14 mo.\\n4\\n10\\n5\\n50", "height": "4360", "width": "2820", "jp2-path": "careofchildinhea00oppe_0098.jp2"}, "97": {"fulltext": "FEEDING 85\\nLet us take a few examples and see how easily\\nthe work is done. Suppose we wish to prepare\\nthe food for a baby six days old. We need\\nten ounces of milk, which is made up of\\none part of 12% cream, or 2J oz.\\nand three parts of 7% sugar solution, or 7 J oz.\\nTotal, 10 oz.\\nAs for this time of life there should be ten\\nfeedings per day, the mother had best have the\\nten bottles ready when the mixture is made;\\nthey may all be filled at one time, stoppered,\\nand put on the ice until needed.\\nAgain, suppose the child is six months of age.\\nFor this period there should be thirty-three\\nounces of food, which would be composed of\\none part of 12% cream, or 9J oz.\\nand two and one-half parts of 7% sugar solution,\\nor 23f oz.\\nTotal (approximate), 33 cz.\\nSince there are to be six feedings, six bottles\\nmust be prepared, each containing five and\\none-half ounces.\\nAgain, suppose we want to prepare the milk\\nfor a baby of twelve months. The quantity\\nis to be forty-five ounces. We then need", "height": "4360", "width": "2692", "jp2-path": "careofchildinhea00oppe_0099.jp2"}, "98": {"fulltext": "86 THE CARE OF THE CHILD IN HEALTH\\none part of the 8% cream, or 22J oz.\\nadd one part of a 10% sugar solution, or 22J oz.\\nTotal, 45 oz.\\nThis quantity is to be divided into five\\nbottles, each of which contains nine ounces.\\nAs in the other cases, all the bottles are to be\\nstoppered with aseptic cotton, and placed upon\\nice until used.\\nOne more detail may be required in some\\ncases: the normal reaction of human milk is\\nslightly alkaline. Since cow s milk is fre-\\nquently neutral or slightly acid, we may add a\\nsmall quantity of lime-water to make the desired\\nchange. The necessity of the change is ascer-\\ntained by dipping a small piece of red litmus\\npaper, which any druggist or chemist will\\nsupply, in the cow s milk and finding that it\\nis turned somewhat blue. A neutral reaction\\ngives no change at all, while an alkaline milk\\nwill change blue litmus paper red. If the milk\\non several testings has shown itself acid or\\nneutral, the lime-water may regularly be added\\nin the proportion of from 3% to 5% to the water\\nin which the milk-sugar is to be dissolved.\\nA most important detail of hand feeding is\\nthe care of the bottles and nipples. If they are\\nnot scrupulously clean, particles of milk adhere", "height": "4360", "width": "2820", "jp2-path": "careofchildinhea00oppe_0100.jp2"}, "99": {"fulltext": "FEEDING 87\\nto them, decompose, and give rise to a large\\nnumber of gastric and intestinal diseases, such\\nas vomiting, diarrhoeas, and summer complaint.\\nIn most cases such disorders ought not to exist,\\nand the child who suffers frequently from them\\nhas a just cause of complaint against the mother.\\nSuch cleanliness is insured by scrubbing, boil-\\ning, and rinsing the bottles, nipples, and all the\\nutensils which are used in the daily preparation\\nof the milk. Each bottle as soon as it is used\\nshould be thoroughly washed with soap and\\nwater and a bottle cleaner it ought then to be\\nboiled for from twenty to thirty minutes, and,\\nfinally, put in a solution of borax until it is\\nwanted the next morning. Before being used,\\nit should be thoroughly rinsed with hot water.\\nThe nipples, as soon as a feeding has ended,\\nshould be drawn on to a finger, scrubbed with\\na brush, soap, and water; they may then be\\nturned inside out, replaced on the finger, and\\nagain scrubbed. They may, as the next step, be\\nthoroughly washed in hot water, and, finally, be\\nthrown in the borax solution until used again,\\nwhen they must be well rinsed. These nipples,\\nin order to be easily manipulated, should have a\\nplain, conical shape, somewhat like a dunce s\\ncap, and should be made of plain black rubber,", "height": "4360", "width": "2768", "jp2-path": "careofchildinhea00oppe_0101.jp2"}, "100": {"fulltext": "88 THE CARE OF THE CHILD IN HEALTH\\nwith an aperture that is not too large. The\\nbottle should preferably be tubular in form,\\nwith gradations which mark the ounces and\\nhalf ounces blown into the side. All attempts\\nat decreasing the labor involved in feeding the\\nchild, by air vents in the nipple, rubber tubes\\nconnecting the nipple and bottle, and variation\\nin the shape of the bottle on account of which it\\nneed not be held, are bad, and ought to be dis-\\ncouraged. Such devices make surgical cleanli-\\nness impossible, they promote laziness, diminish\\nthe rightful attention which the child deserves\\nand demands, and serve as prolific sources of\\nserious sickness. The feeding of a child is\\nimportant enough to call for the nurse s undi-\\nvided attention, and anything which interferes\\nwith this duty must sooner or later have vi-\\ncious results. During the process the child\\nshould be held in the arms, and the bottle\\nmust be so inclined that the nipple is almost\\nfull; in this manner the flow of milk can easily\\nbe regulated to suit the baby s capacity to\\ndrink, while at the same time the possibility\\nof sucking on an empty nipple is obviated.\\nThe habit of permitting a child to take a frac-\\ntion of his food, to sleep or play or become\\nirritated by a bad position, and then to begin", "height": "4360", "width": "2820", "jp2-path": "careofchildinhea00oppe_0102.jp2"}, "101": {"fulltext": "FEEDING 89\\nnursing again after the milk has become more\\nor less chilled and stale, must not be tolerated.\\nYet another method of feeding is that which\\ndoes away entirely with bottles and nipples,\\nand substitutes in their place a cup and tea-\\nspoon. This change has much to recommend\\nit, for it does away with the labor of keeping\\nthe bottles and nipples clean, and simultan-\\neously diminishes the danger of infection of\\nthe gastro-intestinal track. Likewise it pre-\\nvents too rapid nursing, as well as wind\\nsucking the feeding is completed at one\\nsitting, and the child s habits in general are\\nbetter kept under control. One of its main\\nadvantages is the ease with which it allows\\nweaning to be accomplished. In this period of\\nthe child s life the main difficulty lies in replac-\\ning the bottle with a spoon, and everybody\\nknows the disturbances which are apt to result.\\nUnder the circumstances suggested above, these\\ndisturbances would not exist, and the baby\\nwould go from one stage of his youthful career\\nto the succeeding with almost no evidences of\\nstruggle.\\nSomething ought to be said concerning the\\nuse of the proprietary foods which are so exten-\\nsively advertised and widely employed in all", "height": "4356", "width": "2740", "jp2-path": "careofchildinhea00oppe_0103.jp2"}, "102": {"fulltext": "90 THE CARE OF THE CHILD IN HEALTH\\nclasses of society. If one wishes to make a\\ngeneral statement, one is quite safe in con-\\ndemning them all along the line. They really\\nhave no good reason for existence outside of\\nthe purely commercial one which gives profit-\\nable employment to their manufacturers. The\\nartificial food has never been made which can\\nadequately take the place of pure, fresh milk,\\nproperly modified. The fact that hundreds of\\nchildren have grown and thrived upon them has\\nlittle to do with the question for many children\\nare so vigorous that they will thrive upon all\\nmanner of food-stuffs which we know are meant\\nfor older stomachs. As I heard a bright woman\\nonce remark, There are some babies that you\\ncan t kill. In regard to such children the\\nquestion is not how well the little ones develop\\non this or that food, but rather, how much\\nbetter they would have developed on a properly\\nmodified milk. To such origins we can trace a\\nlarge proportion of all cases of rickets, infantile\\nscurvy, and a seemingly endless series of obsti-\\nnate cases of malnutrition and malassimilation.\\nThe various foods may be divided into certain\\nclasses, whose methods of manufacture are not\\nradically dissimilar. Thus, the Liebig foods,\\nsuch as Horlick s Food, Mellin s Food, Malted", "height": "4340", "width": "2820", "jp2-path": "careofchildinhea00oppe_0104.jp2"}, "103": {"fulltext": "FEEDING 91\\nMilk, and Hawley s Food, represent a combina-\\ntion of flours which have been treated with\\ndiastase until the starch is changed into forms\\nof sugar, called maltose and dextrine. The\\nmilk foods, such as Nestle s, the various Swiss\\nfoods, and Gerber s Food, represent condensed\\nmilk which has been sweetened and supple-\\nmented with dextrinized flour. The farinaceous\\nfoods, such as Ridge s Food, Imperial Granum,\\nRobinson s Patent Barley, and Hubbell s Pre-\\npared Wheat, usually consist of a combination\\nof flours, the starch of which has been partly\\nconverted into sugar. Carnrick s Soluble Food\\nconsists for the most part of sugar and starches\\nLactopreparata has about the same composition,\\nbut in it milk-sugar replaces a part of the starch.\\nLactated Food is composed mostly of sugars and\\nstarches. The Peptogenic Milk Powder of\\nFairchild consists of pancreatin, lactose, and\\nalkaline milk salts. The condensed milks\\nrepresent ordinary cow s milk which has been\\nevaporated in a vacuum, sterilized, and sweet-\\nened with cane sugar. The unsweetened\\nvariety can also be obtained.\\nThe main fact to be kept in mind is that,\\nwhether such foods approximate more or less\\nclosely to natural milk, they must and do", "height": "4352", "width": "2760", "jp2-path": "careofchildinhea00oppe_0105.jp2"}, "104": {"fulltext": "92 THE CARE OF THE CHILD IN HEALTH\\nnecessarily lose something of their vitality, of\\ntheir nutritive value, in going through the\\nprocess of handling and manufacture. Not\\ncounting the fact that they are commonly over-\\nrich in proteids, and that they vary in the per-\\ncentage of fat, they are not as wholesome, not\\nas invigorating as fresh milk. There are secrets\\nin the products of cell activity which we have\\nnever been able to discover, and among them is\\nthat profound problem of trying to imitate this\\nresult of nature s work which is so familiar to\\nus, and at the same time so inscrutable in the\\nmystery of its making. This is at the basis of\\nall our failures at making an artificial food;\\nand until the problem is solved Ave should use\\nthe artificial foods, such as are commonly sold,\\nonly as a last resort.\\nClosely connected with this matter is the\\nsubject of weaning. The change from the\\nbreast to the bottle is commonly synonymous\\nwith domestic disturbances, with unquiet\\nnights and days. In many, if not in most\\ncases, the natural difficulties of the situation\\nare emphasized and exaggerated by a lack of\\nconviction and a want of firmness in the par-\\nents. This vacillation is an unfortunate char-\\nacteristic of many mothers, and has a strong", "height": "4360", "width": "2868", "jp2-path": "careofchildinhea00oppe_0106.jp2"}, "105": {"fulltext": "FEEDING 93\\ntendency to diminish authority; at the same\\ntime it has the equally important some people\\nthink more important effect of lessening the\\nfunctional activity of the stomach.\\nAs was shown on page 82 the feeding should\\ntake place at regular intervals, and nothing\\nshould be allowed to interfere with this regu-\\nlarity; even if the child is asleep, he may with\\nprofit be wakened when the proper time for\\nnursing comes. If this course is pursued he\\nwill not only contract habits of regularity but\\nalso will sleep more quietly in the intervals\\nand at night. A little firmness of intention\\nmay be demanded of the mother to inaugurate\\nand carry out such a plan, but the reward in the\\nway of increased rest and comfort for both\\nmother and child will amply repay the effort.\\nIt will be noticed that the amount of time\\nlaid out by the schedule for each day does\\nnot cover four-and-twenty hours; in the re-\\nmainder the child is not supposed to receive\\nany food at all, on the double principle of\\ngiving the child s stomach an opportunity to\\nrest and at the same time developing a habit\\nwhich permits both mother and child to sleep.\\nThe period of rest should be confined to the\\nmiddle of the night, and will usually be man-", "height": "4348", "width": "2788", "jp2-path": "careofchildinhea00oppe_0107.jp2"}, "106": {"fulltext": "94 THE CARE OF THE CHILD IN HEALTH\\naged with ease if the schedule during the day-\\nis carefully maintained. When weaning is\\ncalled for, the strict habit thus developed will\\nbe found to be of marked value. Under ordi-\\nnary, normal circumstances the transition\\nshould take place when the child is one year\\nold, and in most cases the process ought to\\nbe gradual rather than abrupt. One of the\\nbreast feedings may be replaced by a hand\\nfeeding then, one or two days later, two hand\\nfeedings may be substituted, and thus one may\\ncontinue until the breast is left untouched.\\nDuring all this time, the integrity of the night\\nmust be kept untouched. The mother should\\nbe steadied by the conviction that one ill-timed\\nyielding is apt to break up the habit of weeks,\\nand that while thereby gaining a few minutes\\nof peace she loses many hours of rest.\\nUnder some circumstances, such as preg-\\nnancy, wearing out of the milk supply, or\\nacute sickness of the mother, the change may\\nhave to be made before the beginning of the\\nsecond year. In the last-mentioned contin-\\ngency, where the necessity for artificial feed-\\ning is no more than temporary, the milk may\\nbe prevented from drying up by the consistent\\nuse of the breast-pump. In the other events", "height": "4352", "width": "2888", "jp2-path": "careofchildinhea00oppe_0108.jp2"}, "107": {"fulltext": "FEEDING 95\\nthe best course of action is to recognize the\\nnecessity of the case, and to make the change\\nwithout too prolonged waiting. On the other\\nhand, when the normal nursing period closes in\\nthe latter half of the summer, the child may be\\nkept at the breast, so long as the quality and\\nquantity of the milk are sufficient, for a short\\nadditional period, in order to reduce the possible\\ndangers of gastric infection that are greatest\\nduring the hot weather. This prolongation of\\nbreast feeding must be made with the full\\nknowledge that the quality of the milk is apt\\nsuddenly to deteriorate, as well as the fact that\\nin the beginning of the second year the diet\\nnormally calls for a food-composition and food-\\nbulk which human milk cannot supply. Finally,\\nwhen the child has definitely been taken from\\nthe breast, the flow of milk may be checked by\\ntightly bandaging the breasts, or wearing a\\nstrong, sleeveless waist which has been snugly\\nfitted to the form, and may be tightly pinned.\\nDuring the second year the foundation of the\\nfood must be good, wholesome, cow s milk.\\nAfter the fourteenth month of age, most healthy\\nchildren are able to digest it in its plain,\\nunmodified form; but if any difficulty remains,\\nit is almost always on account of the large", "height": "4340", "width": "2768", "jp2-path": "careofchildinhea00oppe_0109.jp2"}, "108": {"fulltext": "96 THE CARE OF THE CHILD IN HEALTH\\nquantity of proteids. In such a case the use of\\nthe last modification, given on page 81, is to\\nbe continued. An additional element may now\\nbe supplied in the way of the various cereals\\nthese are to be made into a thin gruel or jelly,\\nstrained, and mixed with milk. When the\\nlittle one has demonstrated his ability to digest\\nthese articles, clear soups, from which the fat\\nhas been removed, may now and then form a\\npart of the diet; next a well-baked apple, stewed\\nprunes, and orange juice may by degrees be\\nallowed. As the middle of the year approaches,\\nhe may eat a piece of zwieback, well-toasted,\\nstale wheat bread, or toasted biscuit which has\\nbeen dipped in milk. The next step takes him\\nto where he may have a poached or soft-boiled\\negg^ scraped rare beef, and stale bread. Natur-\\nally, all these things are not to be given at one\\nmeal. At this time it is unnecessary to strain\\nthe cereals as thoroughly as in the earlier\\nmonths.\\nAs a summary, one may lay out such a menu\\nfor a healthy child of fifteen months\\n6.30 a.m., cup of milk with toast or zwieback.\\n10.00 A.M., strained oatmeal with milk;\\ntoasted or crisp biscuit; orange juice; stewed\\nor baked apple.", "height": "4340", "width": "2904", "jp2-path": "careofchildinhea00oppe_0110.jp2"}, "109": {"fulltext": "FEEDING 97\\n1.30 p.m., clear soup, chicken, beef, or\\nmutton broth; piece of stale or toasted bread.\\n5.00 p.m., cup of milk; crisp soda biscuit or\\nzwieback.\\n7.00 p.m. (just before going to sleep), cup of\\nmilk.\\nThe question of feeding this growing child is\\nnow becoming a very active one. The mother\\nmust keep to the golden mean between too strict\\nand too liberal a diet, for the one is about as\\nbad as the other. She must know that there are\\ndefinite needs to be subserved which must be\\nclosely understood. Good intentions alone are\\nnot sufficient, nor is the mere fact of a bounti-\\nful supply of food the only thing to be desired.\\nShe must know that the uses of food are vari-\\nous: to make new tissue, to repair waste of\\ntissue, to act as fuel, to supply a reserve force\\nfor future emergencies, and to act as a guard\\nagainst the exhaustion of tissue or the stored-up\\nsupplies of other food derivatives. In order to\\ndo this, certain elements of food must be present\\nin sufficient amount, and must be thoroughly\\ndigested. The great difficulty in infantile life\\nlies in the way of this sufficient assimilation.\\nThus the diet should be made up of fats, pro-\\nteids, sugars and starches, mineral salts, and", "height": "4328", "width": "2764", "jp2-path": "careofchildinhea00oppe_0111.jp2"}, "110": {"fulltext": "98 THE CARE OF THE CHILD IN HEALTH\\nwater. The fats go to make up fatty tissue,\\nand at the same time serve as fuel the proteids,\\nalso called nitrogenous foods, are used to make\\nmuscular and tendinous tissue, and likewise to\\ngive heat; the sugars and starches go to make\\nfatty tissue and to give heat. The mineral\\nsalts have various chemical uses that require no\\nspecial mention. In infancy, the carbohydrates\\nand fats hold a very important place, since they\\nserve to develop bodily heat and to produce\\nfat. As the child increases in age, the proteids\\nmust occupy a more important position, since\\nthey are the basis of muscular growth which\\nprogressively becomes more necessary. As\\nexamples of these various kinds we may select\\nas representing the proteids, eggs, meats, milk,\\nfish, gluten of wheat. As examples of fats we\\nmay mention butter, fat of meat, sweet oil,\\nolive oil, the oils in some cereals. Among the\\ncarbohydrates are sugars and starches as they\\noccur alone and in combination, as, for instance,\\nin such vegetables as potatoes, and in cereals.\\nThese various foods, while different in com-\\nposition and process of assimilation, have the\\nsame general function of supplying energy in\\nthe form of muscular power and heat; and\\nalthough the amount of potential energy con-", "height": "4360", "width": "2912", "jp2-path": "careofchildinhea00oppe_0112.jp2"}, "111": {"fulltext": "FEEDING 99\\ntained in the fats is equal to the combined\\namounts in the proteids and carbohydrates,\\nnevertheless the needs of the youthful body and\\nits faculty of absorption render the change from\\nthe small proteid percentage of infancy to the\\nlarger one of later childhood necessarily slow.\\nFor in the earlier period the predominant need\\nof the organism lies in the combination of heat\\nand protection rather than the various forms of\\nmore active energy; and as the child increases\\nin development, the augmented action of body\\nand mind calls for additional fuel that is\\ndesigned to subserve these functions. As the\\nneed for so-called concentrated foods increases,\\nthe added means for helping in digesting them,\\nsuch as the cutting and grinding action of the\\nteeth and the additional caustic nature of the\\ngastric secretion, simultaneously come into\\nexistence. The gastric juice of infancy has\\nlittle corrosive action; it is not capable of dis-\\nsolving cell envelopes, and its development\\ninto its later form is very gradual. Morever,\\nwhen that later and more potent form is reached,\\nevery effort must be made to keep the food as\\npure and as normal as possible. Thus there is\\nno need for the pungent and aromatic spices,\\nsince these things are used as whips to drive a\\nU of Q t", "height": "4344", "width": "2776", "jp2-path": "careofchildinhea00oppe_0113.jp2"}, "112": {"fulltext": "100 THE CARE OF THE CHILD IN HEALTH\\njaded appetite and digestion; there are strong\\nobjections against preserved, pickled, smoked,\\nand dessicated articles, for they have been\\nchanged from their normal condition on account\\nof economical reasons or because the adult\\npalate longs for a greater variety than more\\nnutritious food gives; likewise, cakes, pies,\\nand fresh breads are undesirable, not on account\\nof their chemical constitution, but because their\\nphysical condition permits of the formation in\\nthe stomach of a large, soggy mass, the exterior\\nof which only is affected by the gastric secre-\\ntions, while the interior remains unchanged;\\nbran bread may often be profitably substituted\\nfor wheat bread, but the first as well as the second\\nshould not be used until it is stale coffee and\\ntea are also to be forbidden, since they contain\\nalmost no nourishment, but, on the other hand,\\nhave alkaloids whose action on the nervous sys-\\ntem is unnecessary and undesirable for children.\\nAgain, fried foods of all sorts must not be\\nallowed, outside of any consideration of what\\nthey contain, on the ground that the rapid\\ncooking, the high degree of heat used, and the\\ntough coating of deteriorated fat produce an\\nenvelope which is hard to digest, while the\\ninner portion is usually affected in unequal", "height": "4360", "width": "2904", "jp2-path": "careofchildinhea00oppe_0114.jp2"}, "113": {"fulltext": "FEEDING 101\\ndegrees in its various planes. The object in\\ncooking food is to produce chemical changes\\nwhich promote ease of digestion, greater poten-\\ntial solubility and assimilation, the develop-\\nment of extractives and aromatic substances in\\nthe food, and the stopping of fermentative\\naction and bacterial life. These results are\\nbest obtained by boiling, baking, roasting,\\nand broiling; and, as a rule, they must be\\nthoroughly enough conducted to have the\\nresulting changes take place through the\\nwhole substance of the food.\\nIn making out the plan for the feeding after\\nfifteen months, we may reduce the number of\\nmeals to four, and at the same time increase\\nthe number of articles, as in the following\\nBreakfast, 7 A.M. Cup of hot milk; stale\\nbread or toast with butter; well-cooked oatmeal\\nwith cream or milk, but no sugar.\\nLunch, 11 a.m. Cup of hot milk with bread\\nor toast and butter; in place of the bread or\\ntoast one may give zwieback or crisp biscuit.\\nDinner, 2.30 p.m. Cup of clear meat soup or\\nbroth from which the fat has been skimmed. A\\nvery small portion of scraped beef or beefsteak,\\nor the bone of a lamb chop on which the child\\nmay bite and suck. He may have a piece of", "height": "4352", "width": "2768", "jp2-path": "careofchildinhea00oppe_0115.jp2"}, "114": {"fulltext": "102 THE CARE OF THE CHILD IN HEALTH\\nbread, or baked or mashed potatoes and meat\\njuice. For a sweet he may eat a small bit of\\ncurds and whey, custard, junket, rice pudding,\\nor bread pudding. Of course all these dishes\\nare not supposed to be given at one meal; the\\nmother is supposed to make an intelligent choice,\\nand vary the menu from time to time.\\nSupper, 6.30 p.m. Cup of hot milk with\\nbread and butter.\\nFrom the age of one and one-half to three\\nyears the bill of fare may read as follows\\nBreakfast, 7 a.m. Clear juice of an orange,\\nor the pulp of a baked apple, or apple sauce, or\\nstewed prunes; hot milk; well-cooked oatmeal\\nor cracked wheat or rice stale bread or toast\\nwith butter. When the child is two years old\\nhe may have the half of a soft-boiled or poached\\negg; at two and one-half years of age he may\\nget a whole egg.\\nLunch, 11 a.m. Hot milk; stale bread and\\nbutter, or zwieback, or crisp biscuit.\\nDinner, 2 p.m. Plate of clear meat soup or\\nbroth from which the fat has been skimmed. A\\nsmall piece of roast beef, broiled steak, or lamb\\nchop, breast of chicken, or bone of chicken or\\nlamb chop. Whatever meat he receives must\\nbe scraped or cut into very small pieces.", "height": "4356", "width": "2912", "jp2-path": "careofchildinhea00oppe_0116.jp2"}, "115": {"fulltext": "FEEDING 103\\nBread and butter; baked, mashed potatoes with\\nmeat juice; boiled rice with cream, rice pud-\\nding, bread pudding, curds and whey, junket,\\ncustard, stewed prunes with or without rice.\\nSupper, 6.30 p.m. Hot milk with bread and\\nbutter; milk toast.\\nAfter the child is over three years old his diet\\nmay be gradually enlarged. The meals should\\nbe reduced to three but it will often be neces-\\nsary to give a hungry youngster a glass of milk\\nat half after ten in the morning, and possibly\\nagain at three in the afternoon. All foods\\nmust be plain, without other seasoning than\\nsalt; there should be no fried foods, made\\nsalads, no pickles or other relishes, no cakes,\\npies, coffee, tea, beer, or wines. The breakfast\\nmay be about half after seven o clock, and\\nshould consist of fruit (orange, baked banana,\\nbaked apple, or stewed prunes), well-cooked\\noatmeal, cracked wheat, hominy, rice, or farina\\nboiled, poached, or scrambled eggs; hot milk;\\nstale bread or toast with butter. Now and then\\nthe eggs may be replaced by a piece of broiled\\nfish, which is not very fat, or a chop. Robust\\nchildren often appreciate and thrive on corn\\nmeal, but their delicate brothers and sisters\\nsometimes have trouble in digesting it.", "height": "4352", "width": "2784", "jp2-path": "careofchildinhea00oppe_0117.jp2"}, "116": {"fulltext": "104 THE CARE OF THE CHILD IN HEALTH\\nThe dinner should be at midday, and should\\nalways begin with a dish of clear soup, without\\nfat, or a meat broth. There may then be some\\nsort of broiled, roasted, or baked fish; or the\\nsoup may be followed by roast beef, chopped\\nbeef which has been broiled, broiled beefsteak,\\nbroiled lamb chops, roast lamb, boiled mutton,\\nchicken, turkey, or squabs. One or two vege-\\ntables, such as baked or mashed potatoes, well-\\nboiled spinach, puree of peas, young cauliflower,\\nyoung beans, young carrots, stewed celery, or\\nboiled rice, may be allowed with the meat. A\\nglass of milk should always accompany the\\nmeal, which may end with rice pudding, rice\\nand stewed prunes, or apple sauce, bread pud-\\nding, farina pudding, sago pudding, junket,\\ncurds and whey, custard, or one of the fruits\\nmentioned in the menu for breakfast When\\nthe little one comes to be four or five years of\\nage he may receive a portion of clear jelly,\\ngelatine, preserved pears, peaches, apricots, or\\nstrawberries. And I have found that a bit of\\ngood cream cheese with a crisp soda biscuit is\\nwell liked and well digested by growing chil-\\ndren incidentally I may say that the nutritive\\nvalue of this cheese is high.\\nThe supper may be taken at six o clock, and", "height": "4356", "width": "2896", "jp2-path": "careofchildinhea00oppe_0118.jp2"}, "117": {"fulltext": "FEEDING 105\\nshould always be very light and simple. It\\nmay be made up of milk with bread and butter\\nor soda biscuits, milk toast, a dish of rice,\\nfarina, or hominy with milk, or any of the vari-\\nous milk soups. Baked or stewed apples or\\napple sauce, if they have not formed part of the\\nother meals, are very good to end the supper.\\nThe matter of diet has at times an important\\ninfluence not only upon the child s general\\nhealth but also upon certain physical and men-\\ntal functions. In this connection one can men-\\ntion no more weighty factor than the condition\\nwhich is commonly called habitual constipation.\\nChildren are often troubled by it, and as a curi-\\nous fact the disorder seems sometimes to run in\\nfamilies. On the other hand, the habits of\\nvarious members of one family may not at all\\nresemble each other; and also the condition of\\nan individual child may vary from one time to\\nanother. The whole problem rests upon sev-\\neral possible causal factors; and while diet is\\nan important one of them, nevertheless the\\nothers should have some mention in order to\\ngive a comprehensive view of their respective\\nvalues.\\nThe very fact of childhood bears with it a\\ncertain tendency to constipation. For in the", "height": "4352", "width": "2820", "jp2-path": "careofchildinhea00oppe_0119.jp2"}, "118": {"fulltext": "106 THE CARE OF THE CHILD IN HEALTH\\nearly months of life the undeveloped pelvis has\\nnot room enough for the many coils of intestines\\nwhich therefore are confined to the abdominal\\ncavity. Here the yielding walls give no proper\\npoint of resistance, and therefore the muscular\\nfibres are unable to exert themselves to advan-\\ntage. An additional hindrance is the mainte-\\nnance of any position during defecation other\\nthan a crouching one. A third reason is the\\ncongenital or acquired weakness of the intes-\\ntinal muscular fibres which naturally are unable\\nto do their requisite amount of work.\\nSuch conditions can be and often are exagger-\\nated by poorly devised meals, irregular times of\\neating, and a too rapid and insufficient chewing\\nof the food. The choice of food is always im-\\nportant, even in infancy. If an artificial\\nfood is the diet, it must be made to simulate in\\nits physical and chemical composition mother s\\nmilk. If breast milk is the food, and if on\\nanalysis it proves to be deficient in fat, then\\nthe requisite amount of cream may be given\\nafter each feeding. If the milk be too rich in\\nproteids, the daily life, diet, and exercise of\\nthe mother or nurse must be so regulated\\nthat the excretion becomes normal. If the\\nmilk for any reason remains abnormal, it is", "height": "4360", "width": "2928", "jp2-path": "careofchildinhea00oppe_0120.jp2"}, "119": {"fulltext": "FEEDING 107\\nmuch better in the long run to wean the child\\nwithout delay. 1\\nOlder children should have such foods as are\\nnot too fine. Bread which is made from the\\nwhole wheat, graham bread, corn bread, and\\nrye bread are better than that made from the\\nthoroughly bolted wheat flour. Any fresh ten-\\nder meat among those mentioned earlier in this\\nchapter as desirable may be allowed. The\\ndesserts should usually be made of fresh or\\nstewed fruits. The milk which the child\\ndrinks should be unboiled, and must contain a\\nlarge percentage of cream. Both cream and\\nbutter are of considerable use in such a diet.\\nChildren over four years may have moderate\\namounts of good cream cheese. The diet\\nshould not include dried or canned foods, but\\nin their place fresh foods must be used. In\\naddition to such a plan, the child may be encour-\\naged to drink liberal quantities of water. These\\nmeasures reinforced by exercise, massage, pos-\\ntural treatment, and occasional medical over-\\nsight are capable of correcting almost any case\\nof habitual constipation.\\nWhen a child is directed to drink liberal\\n1 Oppenheim Medical Diseases of Childhood, The\\nMaemillan Company.", "height": "4352", "width": "2820", "jp2-path": "careofchildinhea00oppe_0121.jp2"}, "120": {"fulltext": "108 THE CARE OF THE CHILD IN HEALTH\\namounts of water, the reservation must be kept\\nin mind that the water should be pure. Under\\nordinary circumstances, especially in large\\ncities, this quality is not easily obtained. It\\nis really rare to find a water supply that can\\nunreservedly be praised, and too often it ought\\nto be condemned. As a result of this state of\\naffairs, parents should see to it that the water\\nwhich their little ones drink has been made\\nacceptable and harmless. They can insure\\nboth palatability and safety by a proper method\\nof filtration, which is not very hard to obtain.\\nThe filter must be attached to the supply pipe\\nof the house, and not to a faucet. It must be\\nso devised that no pressure is exerted by the\\ncommon water supply upon the filtering medium,\\nfor the process must be one of slow percolation.\\nMoreover, the apparatus must be of such a kind\\nthat the filtering membrane can easily be re-\\nmoved, cleansed, or renewed.\\nThere is no doubt that by such a device a\\ncertain amount of the acute specific fevers as\\nwell as a respectable proportion of diarrhoeal\\ntroubles may be avoided or diminished. Its use\\nis the logical extension of our ideas of asepsis\\nand the application of them to important\\nalthough ordinary facts of life. But such facts", "height": "4352", "width": "2932", "jp2-path": "careofchildinhea00oppe_0122.jp2"}, "121": {"fulltext": "FEEDING 109\\nare the very ones that ought to receive our most\\ncareful attention, for they serve as the founda-\\ntion of the more attractive features of our\\ncareers.\\nFrom the earliest possible time the habit of\\neating slowly and chewing the food very\\nthoroughly must be insisted upon. If this is\\nbegun at an early enough age, it is easily\\nlearned and will prove to be a valuable acqui-\\nsition for later years. If the child eats with\\nan attendant or with the rest of the family, he\\nshould be allowed to talk to a reasonable\\nextent; speech should be regulated, not for-\\nbidden. For with children, as well as adults,\\nthe act of speaking causes useful breaks in the\\nsteady course of masticating and swallowing\\nfood; it allows the gastric contents to be well\\nmixed with the secretions of the stomach, and\\nat the same time it provides an atmosphere of\\nreasonable enjoyment that a child may claim\\nas well as his elders. The rule that children\\nshould be seen and not heard is capable of too\\nstrict an interpretation that lends itself very\\nreadily to petty domestic tyranny. So long as\\nthere is a reasonable and healthy discipline in\\nthe household, every child should be allowed to\\ntalk, to take part in the family life, to feel", "height": "4340", "width": "2820", "jp2-path": "careofchildinhea00oppe_0123.jp2"}, "122": {"fulltext": "110 THE CARE OF THE CHILD IN HEALTH\\nthat he is an integral part of the home circle,\\nand to realize that his words even if they be\\nnot heavy with wisdom will receive the con-\\nsideration and attention which abiding love\\nand a mild tolerance dictate. The ordinary\\nchild, whose environment provides suitable\\nexamples of self-restraint and good manners,\\nlearns in a surprisingly short time how to con-\\ntrol himself within sufficient bounds to be\\nreckoned as a human being, and not as a more\\nor less untamed animal.", "height": "4360", "width": "2892", "jp2-path": "careofchildinhea00oppe_0124.jp2"}, "123": {"fulltext": "CHAPTER V\\nBATHING\\nThe necessity of cleanliness is not the only\\nreason for systematic bathing and although\\ncleanliness is a sufficient reason, it is comforting\\nto know that at the same time and by the same\\nmeans a beneficial effect may in other respects be\\nexerted upon the body. This fact holds good for\\npersons of all ages; and in some ways the young\\nchild will receive a greater aid from the wise\\nuse of water than his parents. In him the\\nprocess of tissue-change is especially active,\\nsecretion and excretion are naturally brisk, and\\nthe skin, which has an important part to play\\nin all people, is in him particularly important.\\nOne must keep in mind certain plain facts about\\nthe skin, for it is more than a mere exterior\\nfinish to the body. In addition it is a most\\nvaluable organ of sensation, upon whose exact\\nworking much of our general physical safety\\ndepends, while at the same time it serves as the\\nactive agent of some of our most massive and\\nill", "height": "4344", "width": "2820", "jp2-path": "careofchildinhea00oppe_0125.jp2"}, "124": {"fulltext": "112 THE CARE OF THE CHILD IN HEALTH\\nsatisfactory pleasures. Besides this, it is an in-\\ndispensable excretory organ, without which the\\nlife of the body could not be continued. By\\nthis means the organism relieves itself of a large\\namount of water, of carbonic acid, of urea, and\\ndoubtless of other matters; it seems quite certain\\nthat even bacteria may be thus excreted. In\\nthe process of draining off waste products, the\\nskin bears a close relation to the kidneys there\\nis a marked similarity between the chemical\\ncomposition of the sweat and the urine, while\\nmore than a few observers have noticed the\\nresemblance between the anatomical structure\\nof the skin and one of the essential portions\\n(the glomerulus) of the kidney. Yet another\\nfunction is that of a heat regulator, by which\\nheat is freely radiated when the temperature is\\nhigh, and kept within the body when the tem-\\nperature is low. For this reason burns cover-\\ning three-fourths of the surface are fatal; and\\nphysicians are thoroughly familiar with the\\nseemingly strange fact that extensive burns so\\ninterfere with the distribution of heat that\\nserious congestions of the internal organs occur,\\nand may be followed by the formation of ulcers.\\nThese facts are in themselves sufficient to\\nshow the necessity of keeping the skin active", "height": "4360", "width": "2864", "jp2-path": "careofchildinhea00oppe_0126.jp2"}, "125": {"fulltext": "BATHING 113\\nand clear but they are not all that ought to be\\nmentioned. If it is true that the outer surface\\nof the body acts as a sense organ, as an excre-\\ntory organ and as a heat regulator, it is equally\\ntrue that it exerts a considerable effect upon the\\ncirculation of the blood and is therefore a sort\\nof skin-heart. It is a noteworthy fact that\\nalmost a third of the blood is contained in the\\nsuperficial vessels, and this large amount of\\nfluid is directly influenced by the dilatations\\nand contractions of the capillaries. The arte-\\nries are by no means mere passive conducting\\ntubes; on the contrary they have a keenly sen-\\nsitive nerve supply which causes them to con-\\ntract when only a little blood should be in them,\\nand again to expand when they ought to hold\\nmuch blood. By the activity of the layers of\\nmuscle fibres they can and do help to propel the\\nblood through the capillary vessels, for the large\\namount of fluid at so great a distance from the\\ncentral pumping station which we call the heart\\nmight otherwise be moved Avith difficulty. It\\nis not an exaggeration of the facts in the case\\nto say that the functional value of these vessels\\nis fully as great as that of the vessels of the\\nlungs, or the stomach, or the kidneys. Each\\nset has its work to do, and the efficiency of the", "height": "4324", "width": "2820", "jp2-path": "careofchildinhea00oppe_0127.jp2"}, "126": {"fulltext": "114 THE CARE OF THE CHILD IN HEALTH\\nbody as a whole depends on the satisfactory\\nmanner in which each discharges its duties.\\nThe simplest and most natural means to in-\\nsure the health and activity of the skin is by the\\ncommon-sense use of pure soap and water accord-\\ning to certain well-known rules. No help is\\nneeded from the many powders, creams, oils, and\\nlotions which are sold in such great quantities.\\nIn most cases one does not know the composition\\nof these articles. They may contain inert or\\nharmful ingredients, while they frequently\\nenough serve to clog up the skin, and in a va-\\nriable degree diminish its efficiency. For very\\nyoung babies a simple dusting powder may be\\nused in the folds produced by the large amount\\nof fat, since by this means the inevitable friction\\nand the resulting local irritation are obviated or\\ndiminished. But even in this case, the mother\\nshould clearly understand that the powder has\\nno reason for existence excepting to prevent\\nlocal chafing; it is not meant to strengthen\\nthe skin, to absorb urine, or to exert any in-\\nfluence upon the general condition of the child.\\nIf irritation of the skin occurs, especially about\\nthe buttocks, the cause usually lies in some in-\\nternal disorder and cannot be cured by a powder.\\nAll children should be bathed daily, and the", "height": "4360", "width": "2880", "jp2-path": "careofchildinhea00oppe_0128.jp2"}, "127": {"fulltext": "BATHING 115\\nhabit of bathing that is usually begun almost\\ndirectly after birth should be continued through\\nthe whole of the little one s life. For the first\\nsix months the temperature of the water may\\nbe about 100\u00c2\u00b0 F. The bath may be given about\\nnine or half after nine o clock in the morning,\\nand should come immediately before rather than\\nimmediately after a nursing. The general\\nstatement holds good that the longer the inter-\\nval between a bath and the preceding meal, the\\nsmaller is the possibility of unfavorably influ-\\nencing the digestion of food; for it is well\\nknown that the stomach when it receives food\\ndraws a large quantity of blood from the surface\\ninto its vessels, and the bath, by dilating these\\nsuperficial arterioles, defeats the very condition\\nupon which the integrity of digestion depends.\\nTherefore, in infancy the bath may be given an\\nhour and a half after the nursing, and in later\\nlife about two hours and a half after the last\\nmeal. Before the baby is put into the water\\none must be sure that there are no draughts in\\nthe room, that the windows are carefully closed,\\nunless the weather is very warm, and for added\\nsafety that the screen protects the locality of\\nthe bath-tub from the direction of any possible\\nexposure. In cool or cold weather the tub", "height": "4320", "width": "2820", "jp2-path": "careofchildinhea00oppe_0129.jp2"}, "128": {"fulltext": "116 THE CAKE OE THE CHILD IN HEALTH\\nshould be placed in front of the fire, so that the\\nwet skin may receive as little chilling as pos-\\nsible. The person who bathes the child should\\nwear a large apron, made preferably of some\\nsoft, thick material, one of the best of which is\\nTurkish toweling. This should not interfere\\nwith the use of a large Turkish towel with\\nwhich to dry the baby; this towel must be\\nthoroughly clean and warm before being used,\\nand should not be employed for more than two\\nsuccessive days without being washed. There\\nshould be enough water in the tub to cover\\nthe baby s chest, and as the little one reclines\\nin the tub the attendant s left hand should sup-\\nport his back, her forearm should hold up his\\nhead, while her right hand does the washing.\\nAs soon as the child is immersed, his head may\\nbe dampened with water that is slightly cooler\\nthan the water which surrounds his body. A\\npure, unscented white soap should be used\\nrather than the expensive fancy toilet soaps,\\nwhich are in many ways undesirable. The\\nwashing may be done with the bare hand or\\nwith a fine sponge, and should start at the face\\nand proceed to the feet. The eyelids should\\nbe carefully cleansed and all secretions removed\\nfrom the corners and the eyelashes the ears may", "height": "4360", "width": "2880", "jp2-path": "careofchildinhea00oppe_0130.jp2"}, "129": {"fulltext": "BATHING 117\\nbe thoroughly washed, but without sticking any-\\npointed object into their canal; the mouth may\\nbe washed with a fine piece of linen and a solu-\\ntion of boric acid; especial attention must be\\ngiven to all folds, creases, the buttocks, and\\nwherever two skin surfaces touch each other.\\nIn little girls the two outer lips of the vulva\\nshould be separated and cleansed, and in little\\nboys the foreskin of the penis should be drawn\\nback twice or thrice in a week, and the parts\\nthoroughly cleansed of any trace of urine or\\nsmegma. As soon as the washing is completed,\\nthe child should be rinsed off with fresh water\\nthat is slightly cooler than that of the bath.\\nHe may then be rolled up in the towel and\\nrubbed with the hand. As soon as he is well\\ndried, he is to be stripped once more and\\nthoroughly rubbed with the bare hand; if\\nthere is any necessity for using alcohol in\\nthese frictions, the family physician will give\\nthe order. The buttocks and opposing surfaces\\nmay then be powdered, the clothing adjusted\\nas quickly as is convenient, and the child\\nsnugly placed in his crib. He is now ready\\nfor his meal, after which, if he is in good\\nhealth, he will sleep so sweetly, look so dainty\\nand rosy, and awake so refreshed, that the", "height": "4332", "width": "2820", "jp2-path": "careofchildinhea00oppe_0131.jp2"}, "130": {"fulltext": "118 THE CARE OF THE CHILD IN HEALTH\\noperation of bathing must necessarily be re-\\ngarded as a joy.\\nDuring the rest of the day, some additional,\\nbut partial, washings are needed. After each\\nfeeding the mouth may be lightly cleansed with\\na fine cloth and a solution of boric acid or borax\\nand with the removal of each diaper the but-\\ntocks should be carefully washed, rinsed, dried,\\nand powdered. Again at evening, before the\\nchild is put to sleep for the night the face,\\nbuttocks, and creases of the body may be lightly\\nsponged and thoroughly dried. These are the\\ngeneral rules that govern an infant s care for\\nthe greater part of the first year; but in sum-\\nmer a little more attention is needed. Nothing\\nafflicts and depresses a baby more surely than\\nintense heat and humidity, in some cases to\\nsuch an extent as to be a clearly understood\\ncause of weakness, loss of strength and appe-\\ntite, and even of active disease. To guard\\nagainst these contingencies we may use two,\\nthree, or even four sponge baths in the course\\nof a hot day; and in a close and heavy night,\\nwhen even strong adults are unable to sleep,\\nwe can soothe and put the tormented baby into\\na quiet slumber by a liberal use of lukewarm\\nwater. The common fear that more than one", "height": "4348", "width": "2892", "jp2-path": "careofchildinhea00oppe_0134.jp2"}, "131": {"fulltext": "BATHING 119\\nbath per day is weakening should be regarded\\nas idle and superstitious; in most cases where\\nan error is made it is more apt to be on the side\\nof too little rather than too much washing.\\nFrom the second year the temperature of the\\ndaily bath may be somewhat reduced the child\\nwill then be able to enjoy water of 85\u00c2\u00b0 or 80\u00c2\u00b0 F.\\ninstead of 100\u00c2\u00b0 or 95\u00c2\u00b0. The bath must con-\\ntinue to be given in the morning, but instead\\nof waiting until half after nine o clock it may,\\nif the mother wishes, be given on arising. The\\nmain difference is one of heat, for if the weather\\nis at all cool most houses are too chilly to bathe\\nan infant early in the morning When the bath\\nis completed, the child s skin maybe rubbed more\\nvigorously than one may do with the younger\\ninfants. For this purpose the mother may use\\nthe bare hand or a Turkish towel that is not too\\nharsh. The friction should be long enough and\\nbrisk enough to cause the skin to react in a\\nthorough manner; the surface should be in a\\nfine blush, should feel warm and full of life,\\nand the little one ought to be lively and happy.\\nSince at this time of life the bladder and rec-\\ntum should be under fairly good if not perfect\\ncontrol, there will be less necessity for repeated\\nwashings during the day. In the evening,", "height": "4328", "width": "2772", "jp2-path": "careofchildinhea00oppe_0135.jp2"}, "132": {"fulltext": "120 THE CARE OF THE CHILD IN HEALTH\\nhowever, before the baby is put to bed, he should\\nreceive the light sponge bath in order that all\\nthe creases and folds of the skin may be\\nthoroughly sweet and clean. Likewise, at this\\nstage of development, when in most cases the\\nteeth are steadily making their appearance, the\\nmother should begin the use of the tooth-brush.\\nThis brush must, of course, be very soft, and\\nin using it one must have a light touch; and\\nso long as these requirements are observed\\nthere is a full justification for thus cleansing\\nthe teeth. In most cases the tooth-brush is\\nnot used until a considerably later period. But\\nthis is not necessary or rational; a single tooth\\nhas the same right to the benefit of cleanliness\\nthat ten have, and the same arguments are\\napplicable to the one as to the many. The\\nmother must, however, remember that the\\nmucous membrane of the gums is exceedingly\\ndelicate, and cannot well endure violent rub-\\nbing. A bland powder, such as precipitated\\nchalk, may be used, and may be applied morning\\nand night.\\nAt three and a half years of age the tempera-\\nture of the bath may be reduced to 70\u00c2\u00b0 F., and\\nthen by easy stages to 65\u00c2\u00b0 or 60\u00c2\u00b0. The fric-\\ntion following it should continue to be satis-", "height": "4348", "width": "2928", "jp2-path": "careofchildinhea00oppe_0136.jp2"}, "133": {"fulltext": "BATHING 121\\nfactory in both duration and force, although the\\nlength of time spent in the water need not be\\nat all long. In fact, as soon as we begin to\\nmake the water cool, the duration of exposure\\nshould be correspondingly short. There may,\\ntherefore, be a need of one or two hot baths per\\nweek, which are most conveniently given in the\\nevening. It is undesirable to give them after\\nthe evening meal, because the child would\\nhave to remain awake too late in order to allow\\na sufficient interval to elapse between the meal\\nand the bath. The best plan is to bathe him\\ndirectly before supper, then to put him to bed,\\nwhere he may be fed with safety and comfort.\\nHe will immediately fall into the deep and\\nunruffled sleep of childhood, which will be\\nmade all the sweeter on account of his clear and\\nactive skin and his satisfied appetite.\\nIt is a good plan to begin with children of\\nabout four or four and a half years of age the\\npractice of cool effusions or douche baths. The\\nbeginning should always be made in the late\\nspring or early summer, when the warm air\\nmakes the impact of the water both bearable\\nand welcome but when once begun it should\\nbe continued through the whole year, being\\nintermitted only in the event of sickness. To", "height": "4352", "width": "2776", "jp2-path": "careofchildinhea00oppe_0137.jp2"}, "134": {"fulltext": "122 THE CARE OF THE CHILD IN HEALTH\\nprepare this bath one should begin by allowing\\nabout ten inches of warm water to run into the\\ntub, the object of which is to keep the child s\\nfeet thoroughly warm. Then water directly\\nfrom the faucet may rapidly be thrown over\\nhim. This may be done in two or three differ-\\nent ways. The water may be allowed to run\\nover him from an overhead douche, it may be\\nthrown over him from two or three full pitchers,\\nor it may be sprinkled through a rubber tube, to\\nthe end of which a douche nozzle is attached.\\nA good variation of the last method consists in\\nusing a large sprinkling-pot. The use of the\\npitchers has much to recommend it: the tem-\\nperature of the water is easily regulated, the\\nforce of the impact is likewise controlled, and\\nthe time consumed by it is exceedingly small.\\nThe douching need consume no more than a\\nminute or two, but the final friction may cover\\nfrom five to ten minutes. If, after being\\ndressed, the child is warm, rosy, and comfort-\\nable, the bath is doing good; if he looks blue,\\ncold, depressed, and is shivering, he is not being\\nhelped, but rather is suffering from too long an\\nexposure or too low a degree of temperature.\\nIt is often surprising to see how quickly a\\nchild of no more than six years will become", "height": "4356", "width": "2864", "jp2-path": "careofchildinhea00oppe_0138.jp2"}, "135": {"fulltext": "BATHING 123\\nused to this treatment, and how readily he\\nwill welcome the use of cold water even when\\nthe weather is cold.\\nYet another method that has given satisfac-\\ntion to many mothers is the familiar tub-bath,\\nwhich is commonly used in England. The\\nwater is drawn into the tub at least two hours\\nor even in the evening before it is to be used.\\nDuring this period it assumes the temperature\\nof the room, and therefore gives very little\\nshock at all, excepting in a very cold room.\\nUnder the latter circumstances the duration of\\nthe bath is momentary, and immediate and brisk\\nfriction is needed to insure a good reaction. If\\nthis tubbing is selected to be the daily habit,\\nthere will be a necessity for one or two hot\\nbaths per week at evening to insure the thorough\\ncleanliness of the skin. Into either the hot or\\nthe cold bath one may dissolve sea salt, accord-\\ning to one s fancy or belief in its virtues. This\\nbelief is widespread, and is held by many physi-\\ncians as well as laymen. Its physiological basis\\nis not easy to recognize, since it certainly does\\nnot inhere in any absorption of the salt through\\nthe skin. Such absorption is exceedingly\\ndifficult and can be accomplished only under\\nexceptionally favorable circumstances. If this", "height": "4360", "width": "2820", "jp2-path": "careofchildinhea00oppe_0139.jp2"}, "136": {"fulltext": "124 THE CARE OF THE CHILD IN HEALTH\\nwere not true, we should receive the character-\\nistic effects of all the various substances, both\\nharmful and harmless, by which we are con-\\nstantly surrounded. The cook, in the course\\nof preparing a single dinner, comes into contact\\nwith various articles which, if thej were directly\\nabsorbed through the skin, would have a marked\\neffect upon her physical condition. Thus, she\\nmajr handle acetic acid in vinegar and hydro-\\nchloric or sulphuric acid in cleaning fluids;\\nthe alkaline salts of soda or the neutral common\\ntable salt; bland and soothing starches or sharp\\nand irritating condiments and spices; clean,\\nsterile water, and bacteria-laden fruits, meats,\\nand cheese. Nevertheless, as every one knows,\\nshe is not at all influenced, simply because of\\nthe impermeable barrier of her skin, that valu-\\nable excretory, but not assimilative organ. In\\nthe same way the painter, the dyer, the chem-\\nist, and a host of other workers who are bound\\nto come in contact with drugs and chemicals,\\nare efficiently protected.\\nThus, one can easily see, without going into\\nthe technicalities of physiology, how the bene-\\nficial effect of artificial salt baths is not founded\\nupon a question of absorption. Most of all it\\nis rational to suppose that if such absorption is", "height": "4356", "width": "2912", "jp2-path": "careofchildinhea00oppe_0140.jp2"}, "137": {"fulltext": "BATHING 125\\nnecessary, it would be an easy matter to admin-\\nister these salts internally. Some observers\\nhave thought that the salty solution, although\\nnot absorbed, acted as a local stimulant and\\ncaused the skin to act more briskly than it\\notherwise would. This theory is at best of\\ndoubtful value. In all likelihood the chief\\nvalue of the procedure lies in the greater care,\\nthoroughness, and regularity of the bath and all\\nits accessories which the directions of the family\\nphysician or the special condition of the child\\nnecessitate. Doubtless, if the same care were ex-\\nercised, even without the addition of salt to the\\nwater, equally good results could be obtained.\\nThis question is quite different from that of\\nbathing in the salt water of the ocean here the\\nexercise in the open air, the inevitable struggle\\nwith the moving water, the playing in the sand,\\nthe sense of freedom, the exhilaration, and the\\nbuoyancy of mind as well as body that sea bath-\\ning gives, have the possibility of benefiting the\\nchild in quite a different way from what the\\nordinary bath at home can do. The difference\\nis analogous to that between exercising with\\nchest weights at home or playing a game of\\nbase-ball or foot-ball in a field the first may give\\nstrength of muscle, and thus lead to greater", "height": "4336", "width": "2744", "jp2-path": "careofchildinhea00oppe_0141.jp2"}, "138": {"fulltext": "126 THE CARE OF THE CHILD IN HEALTH\\nfunctional activity of the whole body but the\\nsecond gives both health and strength in a more\\ndirect and inevitable manner. Bathing at home\\nis not only desirable, but also necessary; bath-\\ning in the sea is, in addition, a tonic for mind\\nand body. There is no reason why a child\\nshould not partake of its benefits in the same\\nway that an adult does. The one precaution\\nwhich the mother should observe is the possi-\\nbility of a rapid chilling and a consequent gen-\\neral depression. A child of five years of age\\nmay safely be taken into the water, but as soon\\nas his lips and finger-tips begin to turn blue\\nand his teeth begin to chatter, he must be\\nremoved, rubbed briskly, and well dried and\\nwarmed. Besides the mere act of bathing he\\nshould be allowed to play about in the sand,\\nbefore he takes his dip, as long as he wishes.\\nLet him dig, build houses, make mud pies, and\\nget himself as dirty as his heart desires; let\\nhim have unrestrained liberty, encourage him\\nto use whatever investigating and constructive\\nability he may possess in the mobile medium of\\nthe sand; let him be warmed in spirit as well\\nas in body, and he will find a different sort of\\nhealth and strength from what he obtains at\\nhome, and at the same time will lay up", "height": "4340", "width": "2912", "jp2-path": "careofchildinhea00oppe_0142.jp2"}, "139": {"fulltext": "BATHING 127\\nmemories of enjoyment. A child from his\\nearliest age should be made familiar with\\nwater, should be taught to regard the bath as\\na treat and a pleasure, should be accustomed to\\nresort to it just as readily when exhausted as\\nwhen dirty. Doubtless, it would not be far\\nfrom the rigid truth to say that the civili-\\nzation of a people is measured by the amount\\nof water which they use for their personal\\nneeds. And it is comforting to know that one\\ncan scarcety use too much water. This rule\\nshould be impressed upon every youthful mind\\nuntil its workings may become manifest in the\\nunconscious impulses that go to make what we\\ncall second nature.", "height": "4344", "width": "2772", "jp2-path": "careofchildinhea00oppe_0143.jp2"}, "140": {"fulltext": "CHAPTER VI\\nSLEEP\\nThe main business of a young child, outside\\nof eating, is sleeping; one might state the\\nmatter somewhat differently and say that the\\nprincipal necessities of a child are absorbing\\nnourishment and obtaining rest. In health the\\nfaculty of the latter is, to a certain extent, self-\\nregulating: a normal child may easily overeat;\\nhe practically never oversleeps. Of the two\\nfunctions in question, the second is sometimes\\nregarded as the more important; for he can go\\nwithout food for a longer time and with less\\nexhaustion than he can spare sleep. And\\nreasoning in this wa}^, if one wishes to compare\\nthe respective values of eating and sleeping,\\none would have to decide that sleeping is the\\nmore vital. This principle of sleep, or rest,\\nmay be found in the normal action of every\\npart of the body. Thus, for example, the heart,\\nwhich seems to be working ceaselessly, has a\\nwell-known period of rest, amounting to about\\n128", "height": "4356", "width": "2868", "jp2-path": "careofchildinhea00oppe_0144.jp2"}, "141": {"fulltext": "SLEEP 129\\none-half second between each relaxation and\\ncontraction of its muscular tissue. One would\\nbe quite exact in saying that during this period\\nthe heart sleeps. The muscles of breathing have\\na similar period of rest, that amounts to about\\ntwo seconds, during which they also may rightly\\nbe said to sleep. If one cares to push one s\\nobservations yet further, one will clearly recog-\\nnize that the same rule may be noticed in\\nregard to all muscular action, and, indeed, all\\nthe various functions of the body. There must\\nbe a definite period of rest for each part of the\\norganism, which will be all the more profitable\\nif the laws concerning it are clearly understood\\nand logically carried out.\\nOne of the first things to understand is that\\nany part of the body at rest demands less stimu-\\nlation and a smaller blood supply than when it\\nis working. As an example, we all know that\\nif we exercise an arm in an active way, it imme-\\ndiately feels wider awake than it did before, it\\nobtains a sensation of warmth, it is even some-\\nwhat larger in circumference than it otherwise\\nwould be. The reasons for these changes are\\nthe active wear and tear, the rapid tissue-\\nchange, and the increased amount of blood in\\nthe part; and when the period of exercise has", "height": "4348", "width": "2820", "jp2-path": "careofchildinhea00oppe_0145.jp2"}, "142": {"fulltext": "130 THE CARE OF THE CHILD IN HEALTH\\npassed and the member is at rest, fatigue takes\\nthe place of activity, the added warmth and\\nincreased size fade away as the amount of blood\\nis gradually equalized throughout the body. A\\nsimilar set of facts is true for the stomach;\\nwhen it obtains food, the pale hue of its mucous\\nmembrane becomes both deeper and brighter,\\nthe tissue may be seen to be heavier and more\\nturgid than it formerly was, and a keen activity\\ntakes the place of somnolence. But as soon as\\nthe work is done, the conditions of activity have\\nno longer any reason for existence and the organ\\nreverts to a state of sleep. The brain has a\\nstrictly analogous group of circumstances dur-\\ning the waking hours, and sometimes when\\nsleep is imperfect, it is working with more or\\nless industry, it draws to itself a large amount\\nof blood to carry on its functions, it actually\\nincreases in size, and assumes a brighter hue\\nthan it had during rest. This continues until\\nfatigue sets in, or until the person falls asleep.\\nThen a temporary anaemia results, the color of\\nthe brain becomes lighter, its increase in size\\npasses away, and its chemical changes fall to\\nthe minimum.\\nThese facts give us a clear idea of the con-\\nditions which we should provide for the sleep-", "height": "4344", "width": "2888", "jp2-path": "careofchildinhea00oppe_0146.jp2"}, "143": {"fulltext": "SLEEP 131\\ning child: there should have been a reasonable\\namount of active exercise, sufficient to fatigue,\\nbut not exhaust him; during the period\\nimmediately before retiring he should have\\nundergone no great excitement, for unusual\\ncommotion would naturally tend to produce\\ncerebral congestion rather than ansemia; his\\nsleeping room should be dark and comfortably\\ncool, since such an environment leads to mental\\ncalm and opposes active disturbance; the air\\nshould be clean and pure, in order to allow a\\nsatisfactory oxygenation of the blood; the body\\nand clothes must be fresh and clean, for these\\nfactors help the processes of excretion, and,\\nnegatively, are fully as important as proper\\nbreathing the sleeping time should come within\\na reasonably short period after the last meal,\\nfor where the stomach contains and is actively\\ndigesting food it draws into its blood-vessels a\\ncomparatively large amount of blood, thus creat-\\ning some degree of anemia of the brain. The\\ntime-honored aphorism which advises exercise\\nafter a meal has less truth than is commonly\\nsupposed; on the contrary, the best thing that\\none can do is to rest. And the heavier the\\nmeal, the greater is the necessity for resting.\\nEven if one knew nothing about the physiology", "height": "4348", "width": "2820", "jp2-path": "careofchildinhea00oppe_0147.jp2"}, "144": {"fulltext": "132 THE CARE OF THE CHILD IN HEALTH\\nof the question, one s experience in feeling\\ndrowsy after having eaten well, and the com-\\nmon knowledge that animals regularly wish to\\nsleep after eating any substantial amount, would\\ninevitably direct one s thoughts in the right\\ndirection. The same course of reasoning that\\nforbids bathing directly after eating counsels\\nsleeping after eating.\\nThe younger the child, the more easily does\\nhis brain become fatigued, and the greater is\\nhis need for rest. This fact every one knows\\nfrom practical experience and thus we know,\\nboth theoretically and practically, that during\\nthe first three months of life he should spend\\nnine-tenths of the whole day in sleep; from\\nthree to six months he will be awake for six or\\nseven hours in the next quarter year he will\\nusually sleep about one hour less, and when he\\nis in the second year, twelve hours at night and\\nabout two hours in the day will satisfy his\\nneeds. The practice of taking a nap after the\\nnoon hour is a thoroughly good one, and should\\nbe continued as long as the child s activities\\nand duties permit. This will generally be not\\nlonger than his seventh year, although this age\\ncreates no natural limit to the practice. On\\nthe contrary, the unceasing activity of early", "height": "4348", "width": "2852", "jp2-path": "careofchildinhea00oppe_0148.jp2"}, "145": {"fulltext": "SLEEP 133\\nchildhood makes some such rest highly desir-\\nable, and the result will necessarily be a\\nstronger body, a better disposition, and firmer\\nnerves than otherwise. The fact of taking this\\nnap should not in any way interfere with the\\nrule of early retiring children of one and a half\\nor two years should regularly go to bed at half\\nafter six, or, at the latest, at seven o clock;\\nthose of three, four, and five years may remain\\nup an additional half-hour. Thereafter the\\nincrease over this time must be made very\\nslowly, so that at thirteen or fourteen years of\\nage the hour of retiring is no later than half\\nafter eight o clock. There is absolutely no\\njustification for the long hours which growing\\nchildren are so commonly allowed to have,\\nmost of all in large cities. Such children are\\nvery apt to show some manifestation of pre-\\ncocity which is commonly destined to assume\\na vicious or, at best, an unfortunate aspect.\\nIn regard to the sleeping garments, the same\\ngeneral rules which were suggested in describ-\\ning an infant s outfit hold good. In summer\\nthey may be made of muslin, cambric, and nain-\\nsook; in winter such material may be replaced\\nby some of the various forms of pure wool, of\\nmixtures of wool and silk, or of a fine brand of", "height": "4348", "width": "2820", "jp2-path": "careofchildinhea00oppe_0149.jp2"}, "146": {"fulltext": "134 THE CARE OF THE CHILD IN HEALTH\\nCanton flannel. They must be large enough to\\ndo away with constricting effects, they are pre-\\nferably closed with tapes, and should never be\\nfastened with pins. The skirts may extend to\\nthe feet, or one or two inches below them; but\\nthe use of the really long skirts is to be depre-\\ncated. If the child is weak or has so poor a\\ncirculation that his feet are often cold, one can\\ncontribute to his comfort and well-being by\\nputting a hot water-bottle at the soles of his\\nfeet. Such children are the ones that cause\\nconcern on account of their liability to throw\\noff the covers and thus expose themselves.\\nThis can easily be prevented by sewing tapes to\\nthe corners of the blankets, which are thus to\\nbe fastened to the posts or the railings of the\\nbed. For children of two and a half years or\\nmore the nightgown may give way to the union\\nsuit, the legs of which are lengthened into the\\nform of stockings. These suits may be made\\nof wool or Canton flannel, and there should be\\na large enough supply to render unnecessary\\ntoo frequent washings. These older children,\\nas their younger brothers, may have the lightest\\nfabrics for their summer garments. A child\\nthus clothed, lying on a hair mattress, very\\nlightly covered with a sheet in hot weather,", "height": "4360", "width": "2884", "jp2-path": "careofchildinhea00oppe_0150.jp2"}, "147": {"fulltext": "SLEEP 135\\nand with woollen blankets in the winter, in a\\ncool, dark, quiet, and well-ventilated room,\\nshould sleep a sweet and refreshing sleep.\\nThere are certain objectionable practices in\\ncommon use that are important enough to merit\\na special mention. One of these is the habit\\nof rocking and singing a child to sleep. This\\nform of infantile tyranny is quite without\\nreason, it destroys domestic discipline, makes\\nthe infant captious and exacting, and is undoubt-\\nedly burdensome to the mother. A healthy\\nbaby of good habits will go to sleep if he is\\nmerely placed in his crib at the proper time and\\nwith the proper environment. If he does not\\nfall asleep readily, the cause lies either in bad\\ntraining or in bad health. The first is to be\\nremedied by the mother, and should be as cer-\\ntainly done as she would live up to any other\\nimportant principle of conduct; the second, if\\nit certainly exists, should be adequately treated\\nby a competent medical man. At all events,\\nthe child, the mother, and the household at\\nlarge must understand the circumstances of the\\ncase and the necessity of self-restraint and firm-\\nness. Especially must the mother be on her\\nguard against this abuse after an acute sick-\\nness, for then the ordinary rules of feeding may", "height": "4348", "width": "2860", "jp2-path": "careofchildinhea00oppe_0151.jp2"}, "148": {"fulltext": "136 THE CARE OF THE CHILD IIST HEALTH\\nhave necessarily been put aside, the child may\\nbe irritable and tormented by the so-called\\nfalse hunger of invalids, and within a short\\ntime the bad habit is formed. But as soon as\\nconvalescence sets in, the child ought to be\\nsubjected once more to his salutary discipline,\\nto which he will submit if he sees sufficient firm-\\nness of purpose in his parents and attendants.\\nAnother related abuse is the employment of\\nan empty rubber nipple or a sugar teat to\\nkeep the baby quiet by allowing him to suck on\\nit; some women go so far as to allow sucking\\non one of their fingers, on a coin which is held\\nby a string, or a piece of ivory, or any other\\nconvenient material. Thus to take advantage\\nof the infant s sucking reflex is not nearly so\\nclever as it may appear at first glance. In all\\nbut the very youngest it produces an excessive\\nquantity of saliva; it is a common cause of\\nmucous erosions; it causes the bad habit of\\ndepending upon continuous sucking for putting\\nthe child asleep, or amusing him, or even for\\nkeeping him quiet. One of its worst faults is\\nthe fact that its lack of surgical cleanliness\\nmust and often does result in sickness, for by\\nthis means various forms of germ-life are put\\ninto the baby s mouth. The comforter may", "height": "4356", "width": "2900", "jp2-path": "careofchildinhea00oppe_0152.jp2"}, "149": {"fulltext": "SLEEP 137\\nhave dropped in the bed, on a chair, or on the\\nfloor, and as soon as the child cries it is imme-\\ndiately put back in his mouth without even the\\npreliminary of washing. Finally, it leads to\\nthe habit of thumb sucking and the attendant\\nevils.\\nSome families, especially those whose first\\nhabits of housekeeping have been acquired in\\nEurope, use feather-beds as the main covering\\nfor their children in the winter nights. It is\\nunnecessary to mention more than the uneven\\ndistribution of the feathers, and therefore of the\\nheat, and the impossibility of thoroughly airing\\nthe feathers to show how unadvisable this cus-\\ntom is. Better protection can more easily be\\nobtained by light but comfortable blankets, the\\nwarmth of which is spread evenly over the\\nwhole bed; such covering can easily be increased\\nor decreased, it is easily manipulated, and easily\\nkept clean. A further objection should be made\\nto the habit of sleeping in one position during\\nthe whole night; from the first day of life the\\nchild should be placed on the side, and from\\ntime to time should be changed from one side\\nto the other. It is unnecessary and undesirable\\nto produce a one-sided pressure upon the head,\\nmost of all in infancy, when the bones are so", "height": "4340", "width": "2820", "jp2-path": "careofchildinhea00oppe_0153.jp2"}, "150": {"fulltext": "138 THE CARE OF THE CHILD IN HEALTH\\nsoft as to be moulded by a continued pressure\\nupon one spot. Likewise, the custom of main-\\ntaining a light in the bedroom during the whole\\nnight should be abolished for it tends to make\\nsleep less sound, and develops a fear of darkness.\\nOf the two, the second danger is to be the more\\navoided, since by such factors the whole char-\\nacter may be injuriously affected. Finally, the\\nmother should so arrange the blankets that the\\nchild s hands are always outside of them; if\\nthis custom is cultivated in early childhood, it\\nmay in later years save the child from falling\\ninto certain bad habits, which will be men-\\ntioned in a later chapter.\\nIf these suggestions are carried out, the\\nchildren who do not rest quietly will be few.\\nNevertheless, there will always be some com-\\nplaints on this score, so that it is desirable to\\nsay a few words concerning it. In young\\nchildren the causes which lead to insomnia are\\nsickness and pain, over-excitement and nervous-\\nness, and, finally, bad feeding. The factors of\\nsickness and pain should be so easily recognized\\nand understood that no mention need be made\\nof them. Great excitement and nervousness\\nare legitimate causes which, although common\\nenough, have no good reason for existence for", "height": "4360", "width": "2944", "jp2-path": "careofchildinhea00oppe_0154.jp2"}, "151": {"fulltext": "SLEEP 139\\nthe life of a baby should be as monotonous as\\npossible, it should be protected from all com-\\nmotion, and should in all ways be well shielded\\nfrom surprises. Such a child ought to have no\\npart in domestic celebrations, rejoicings, or occa-\\nsions of emotional disturbance. Since he is too\\nyoung to know the import of events, he need\\nnot participate in them. A disregard for these\\nsuggestions can easily bring about so perturbed\\na state of mind and body that the necessary\\nconditions of sleep are not easily obtained. But\\nthe most common cause of disturbed sleep is\\nsome form of gastric or intestinal derangement\\nwhich, in the majority of cases, follows improper\\nfeeding. The manner of occurrence is simple\\nenough for any one to understand certain arti-\\ncles of food are taken into the stomach, but, on\\naccount of their indigestibility, or weakness\\nand fatigue of the stomach, they are not fully\\nchanged nor properly prepared for absorption.\\nAs the result, products of partial digestion are\\nformed, the gastric contents decompose and\\ngive rise to gases and matters of fermentation\\nand putrefaction. These are absorbed in vari-\\nous degrees, and act as the means of a low form\\nof poisoning. At the same time, the working\\nof the body is sufficiently impeded to prevent", "height": "4356", "width": "2820", "jp2-path": "careofchildinhea00oppe_0155.jp2"}, "152": {"fulltext": "140 THE CARE OF THE CHILD IN HEALTH\\nthe draining off of the waste matter. The situa-\\ntion, finally, amounts to a lack of nourishment\\neven if the food be plentiful, combined with\\nthe formation and retention in the system of\\ntoxic agents. Some of the symptoms of this\\ncondition are greater or less pain, a deficient or\\ncapricious appetite, restlessness and nervous\\nirritability, congestion of one or more parts,\\nmental depression and uneasiness. In conse-\\nquence of these abnormalities, the child is\\nplainly unable to be quiet or to sleep; every\\nmember of his body may be tingling with its\\nnervous tension, his mind instead of being calm\\nand peaceful is harried by frightful images,\\nunnatural and grotesque impressions, and a\\nlowering of its ordinary tone, which in an\\nadult would be translated as black despair.\\nHe, of course, is unable to sleep; or, if he\\nshould happen to doze, his sleep is no more\\nthan a fitful, unrefreshing, unsatisfactory lack\\nof consciousness from which he is apt suddenly\\nto start in terror.\\nSuch a condition is one of the commonest\\ncauses of nightmare. The pitiable spectacle of\\na child s awaking from a seemingly sound sleep\\nwith cries of abject fear is enough to touch a\\ncallous heart. There is no doubt that the little", "height": "4360", "width": "2924", "jp2-path": "careofchildinhea00oppe_0156.jp2"}, "153": {"fulltext": "SLEEP 141\\none suffers as acutely as if the fancied horrors\\nwere real; and that in itself would be enough\\nto call for a wise regulation of his body and\\nmind, which would have the end in view of\\nobliterating his suffering. But as a matter of\\nfact, very much more than suffering is thus\\nentailed. These pathological effects produce\\ndecidedly harmful impressions on his mind,\\nthey rob him of his mental freedom and bravery,\\nthey may render him self-conscious, effeminate,\\ndeceitful, and, possibly, degenerate. If he\\nsuffers from night-terrors of a different origin,\\nsuch as central nervous disturbances, or eye-\\nstrain, the results may be similar in kind,\\nalthough frequently less in degree. But under\\nall circumstances and whatever their origin may\\nbe, they should never be lightly passed over.\\nThey are worthy of the most serious attention.\\nBut even if markedly pathological effects are\\nnot manifested, there may be many conditions\\nwhere sleep is not perfect or where all of the\\nbrain is not at rest. The ordinary phenomenon\\nof falling asleep means no more than that the\\nmajor part of the brain is at rest. One or more\\nareas may be more or less awake, and partially\\nprepared to show their characteristic activity.\\nThe various functions of the body are controlled", "height": "4328", "width": "2816", "jp2-path": "careofchildinhea00oppe_0157.jp2"}, "154": {"fulltext": "142 THE CAKE OF THE CHILD IK HEALTH\\nby definite centres in the nervous system of\\nbrain and spinal cord, in the same way that the\\nvarious mental concepts have their respective\\nlocalities in the brain. Any one of these dif-\\nferent areas, or a group of them, may be partly\\nawake, may become stimulated even though the\\nchild is asleep. The result of such activity\\nexpresses itself in what we call dreams. And\\nin so far as the areas in question are fully awake\\nand stimulated, just so far is the consequent\\ndream vivid. And the wandering, discon-\\nnected, and irrational character of dreams is\\ndue to the fact that the will and the reason are,\\nunder such conditions, in less than their usual\\nstate of control the state that is known by the\\nname of consciousness. And since the mental\\nprocesses of young children are under less logi-\\ncal restraint than those of adults, the dreams of\\nchildren seem less unreal, partake more of the\\nnature of actuality than those of mature per-\\nsons do. Thus, one can easily understand that\\ndreams have a real significance, that they mean\\nimperfect sleep, and that if the physician could\\nhave a sufficiently profound knowledge of local-\\nization of cerebral action, he would be able on\\nhearing the recital of the dream to describe the\\npart of the brain which was involved, and even", "height": "4384", "width": "2940", "jp2-path": "careofchildinhea00oppe_0158.jp2"}, "155": {"fulltext": "SLEEP 143\\nthe extent of its distribution. Perfect sleep is\\ndreamless, unruffled, sweetly restful and if a\\nchild does not sleep in this manner, he has a\\nright to demand or, stated differently, the\\nresponsibility of the parents should stimulate\\nthem to seek a searching inquiry into the\\nfacts of the case and an attempt to right what-\\never abnormal conditions may be found.\\nA sharply differentiated form of this partial\\nawakening is familiar to everybody under the\\nname of somnambulism. Here the brain is able\\nto stimulate such a train of reflex action in the\\nnervous system as is essential for progression,\\nand at the same time the sense of muscular exer-\\ntion, which is doubtless situated in the cere-\\nbellum, is doubtless awake. Simultaneously\\nthat part of the brain whose function is to\\nrecognize impressions is not sufficiently awake\\nto collate and know what is taking place.\\nThere is plainly a wide gap between the physi-\\ncal experience of walking through rooms, down\\nstairways, and out into the street, on the one\\nhand, and, on the other, the orderly placing of\\nmemories, ideas, and conscious reasoning con-\\nnected with them that characterizes such actions\\nin times of lucid wakefulness. And when once\\nthe philosophy of these phenomena is clearly", "height": "4336", "width": "2820", "jp2-path": "careofchildinhea00oppe_0159.jp2"}, "156": {"fulltext": "144 THE CARE OF THE CHILD IN HEALTH\\nunderstood, there is always the possibility of\\nsufficiently perfecting the ordinary action of the\\nbody so that it may work clearly, uninter-\\nruptedly, and peacefully. Dreams and som-\\nnambulism are not the wild and wayward fancies\\nthat they are so commonly supposed to be on\\nthe contrary, they are as rigid and inevitable\\nas any other manifestation of natural forces.\\nThe lesson of the whole matter is that one\\nshould not be satisfied with a child s sleep\\nunless it is quiet, serene, and refreshing. Any\\ninterruption which occurs regularly or fre-\\nquently should be investigated until the cause\\nhas been found; and then one should not be\\nsatisfied until the abnormal condition has been\\nremoved. For example, a child may snore, or\\nsleep with an open mouth, or pick the nose, or\\ntalk incoherently, or throw himself about, or be\\ntormented by depressing dreams, or awake with\\na feeling of exhaustion. Such things are com-\\nmon, and always have an unfavorable signifi-\\ncance. The cause may be adenoid vegetations,\\nor an abnormal and devious nasal septum, or\\nmarked nervous irritability, or disordered di-\\ngestion. But no matter what it is, it should\\nbe patiently sought for and finally corrected.\\nUntil that has been done, the little one cannot", "height": "4360", "width": "2868", "jp2-path": "careofchildinhea00oppe_0160.jp2"}, "157": {"fulltext": "SLEEP 145\\nobtain the rest and recuperation which he\\nneeds and must have. And negligence in this\\nrespect is more than mere carelessness for it\\nmeans a deprivation of normal nutrition that\\nmay cause a life-long want of energy or\\nstrength.", "height": "4336", "width": "2820", "jp2-path": "careofchildinhea00oppe_0161.jp2"}, "158": {"fulltext": "CHAPTER VII\\nEXERCISE\\nThe subject of exercise, especially for chil-\\ndren, is one that everybody believes in, but few\\nfollow out in a systematic fashion. Everybody\\nknows that it is not only advisable, but neces-\\nsary; and when it is neglected, the cause is in\\npart carelessness and in part a halting appre-\\nciation of how widespread its influences are.\\nUsually parents believe that exercise is a good\\nenough thing, but that there is no special need\\nfor directing it, and that, in addition, children\\nwill regulate the matter for themselves. Besides\\nall this, they commonly believe that the best\\nway to dispose of a child s time is to fill the day\\nas full as possible with the various duties which\\nwill adequately claim his attention and keep\\nhim quiet, and trust to his ingenuity and\\nnatural lawlessness to assert the normal activity\\nbetween times which all young animals inevita-\\nbly possess. This statement may seem somewhat\\n146", "height": "4360", "width": "2868", "jp2-path": "careofchildinhea00oppe_0162.jp2"}, "159": {"fulltext": "EXERCISE 147\\ncrude and harsh but if parents will look at the\\nmatter frankly, they will recognize that it states\\nthe matter with a reasonable amount of truth.\\nIn most households there is little or no intelli-\\ngent attention paid to this subject, and in some\\nthe whole subject is consciously put aside\\nbecause it seems too closely connected with\\nwhat is coarse, gross, or violent. As a matter\\nof fact, such a judgment is very far from the\\ntruth; it reverses the true relations of facts,\\nand tends to dwarf one of the best aids which\\nwe possess for the development of a nicely bal-\\nanced mental as well as physical equilibrium.\\nWe must clearly understand that every part\\nof the body is susceptible of steadily improving\\nactivity. This is usually well understood in\\nregard to the muscles but it is equally appli-\\ncable to the bones, the nerves, and the special\\norgans. One is very apt to think of the bony\\nskeleton as being the foundation and permanent\\nframework of the softer tissues but in reality\\nthe contrary is the fact. For by the strain and\\npull of the growing muscles the bones are pulled\\nin one way and another according to the line of\\nmaximum force. During the early years, and\\nuntil they have become consolidated by advanc-\\ning development, they are susceptible of an in-", "height": "4340", "width": "2820", "jp2-path": "careofchildinhea00oppe_0163.jp2"}, "160": {"fulltext": "148 THE CARE OF THE CHILD IN HEALTH\\ndefinite amount of change. The effect upon the\\nnerves is equally great indeed, this influence\\ncannot easily be overestimated. In many chil-\\ndren these structures are exceedingly unstable,\\nare subject to many variations in the way of over-\\nexcitement and a one-sided irritability. These\\neffects may be evident at any age the babe in the\\ncradle may show them by restlessness, nervously\\ndisturbed sleep, nervously capricious appetite,\\nand a deficient repose of disposition which can-\\nnot be attributed to a discernible organic\\ndisorder of the body. In older children the\\ncondition may show itself by bad temper, a poor\\nadaptability to normal rules of conduct and\\nself-restraint, and the development of abnormal\\ncharacteristics. In some cases this may take\\nthe form of viciousness, in others, that of an\\nuneven precocity or backwardness. While it\\nis true that such conditions exist at times con-\\ngenitally, and are thus very hard to remove, it\\nis likewise true that they may follow a con-\\ngested, an impoverished, or an irritated state of\\nthe nervous system.\\nSuch a tendency is easily created by the\\nnecessities and the inevitable conditions of\\ncivilized life, especially in large cities. It is\\nnot hard to understand why this should be so,", "height": "4360", "width": "2884", "jp2-path": "careofchildinhea00oppe_0164.jp2"}, "161": {"fulltext": "EXERCISE 149\\nif we take into account the noise, the hurry, the\\nforced restraint of school and drawing-room,\\nthe imperfect methods of ventilation and heat-\\ning, and the premature experiences that so fre-\\nquently are the rule rather than the exception\\namong a large proportion of growing children.\\nWhen, in addition to these factors, the child s\\nexercise is limited or badly arranged, the neces-\\nsary metabolism or tissue-change must be cur-\\ntailed or deflected from its rightful course, and\\nthe consequent development must as surely be\\nmore or less unnatural. The same train of\\nreasoning is as applicable to the special senses\\nas to the nerves and the muscular tissues. The\\nsight, taste, hearing, touch, and smell are all\\ncapable of a gradual, healthy, and profitable\\nunfolding; or they may become distorted,\\nblunted, overexcited, or abnormal. And in\\norder to help along the favorable and discourage\\nthe unfavorable course, a wise regulation of the\\ndaily exercise is of great help. Viewed in this\\nway, exercise is more than a means to increase\\nstrength; it should rather be regarded as a\\nnecessity for the growth of normal activity.\\nIn infancy the sorts of possible exercises are\\nlimited, but, nevertheless, are adequate. The\\nmuscles and nerves are so weak and the control", "height": "4340", "width": "2820", "jp2-path": "careofchildinhea00oppe_0165.jp2"}, "162": {"fulltext": "150 THE CARE OF THE CHILD IN HEALTH\\nby means of the will is so rudimentary that\\nmore than this limited amount could not be\\nendured. Nature has evidently taken this fact\\ninto account when she provided for the constant\\nactivity of a healthy baby, which takes the form\\nof seemingly purposeless and random move-\\nments of hands and arms and body. Physiolo-\\ngists translate this by saying that the centres\\nof inhibition, which restrain and control mus-\\ncular movements, are, in young babies, poorly\\ndeveloped or undeveloped; moreover, this\\ndevelopment comes somewhat slowly and only\\nin proportion to the growth of the whole body\\nand its functions. 1 The inevitable result is\\nthat whenever the little one is awake he is\\nunconsciously tossing his arms and kicking his\\nlegs about in order to strengthen their budding\\npower. This shows a reason why his clothes\\nshould not be too long, heavy, and binding,\\nwhy he should not be pinned and swathed up\\nlike a mummy. The little limbs must have\\nevery opportunity of unrestrained freedom for\\npreparation against the time when he is able to\\nput them to well-directed use. This exercise\\nis increased by the unavoidable motion involved\\n1 See The Development of the Child, by Nathan\\nOppenheim. The Macmillan Company, 1898.", "height": "4360", "width": "2876", "jp2-path": "careofchildinhea00oppe_0166.jp2"}, "163": {"fulltext": "EXERCISE 151\\nin wheeling him in his carriage and carrying him\\nabout in one s arms. While such motion may-\\nbe gentle, it is, nevertheless, important, and\\ncompares closely to that which an invalid obtains\\nwhen he is taken out driving or in a roller\\nchair. The additional fact that this exercise is\\ntaken in the open air increases its value very\\nmuch. Finally, the rubbing which he receives\\nafter his bath is of no inconsiderable impor-\\ntance, and fills out the sum of his exercise.\\nWhile these things are of salient importance\\nfor him, one should guard against exaggerations\\nof them. As an instance, the habit of tossing\\na baby into the air, or throwing him violently\\nabout for the purpose of amusing him, is a case\\nin point. The resulting disturbance may at\\nany time be harmful, causing vomiting,\\ndiarrhoea, and lack of nervous equilibrium.\\nAs soon as the child passes the age of infancy,\\nhis exercise gradually becomes more varied and\\nprolonged. While he is less than three years\\nof age, it naturally consists of no more than\\nbeing taken to walk, or being wheeled in his\\ngo-cart. And these should be done as much as\\npossible in the air. In fact, the more of his\\ntime he spends in the air, the greater will be\\nthe likelihood of ultimate robustness. Out-", "height": "4348", "width": "2820", "jp2-path": "careofchildinhea00oppe_0167.jp2"}, "164": {"fulltext": "152 THE CARE OF THE CHILD IN HEALTH\\nside of the time devoted to the necessary factors\\nof care, such as bathing, eating, dressing, and\\nsleeping, the whole day should be spent out of\\ndoors. Thoroughly bad weather will naturally\\ncreate an exception to this rule, although cold\\nor cloudy days are too easily interpreted as being\\nstay-at-home times. Heavy rains, winds, and\\nsnow-storms, or intense heat are the only reason\\nfor shutting children within four walls. And\\nwith increasing age the amount of time spent\\nat home becomes progressively smaller. The\\nthree-years-old child may dig in the sand or\\nthe dirt, may make little caves and nests and\\nthe well-beloved mud pies. The mother should\\nhave no fear of dirt; she may allow him so to\\ncover himself from head to feet, if he will.\\nAs long as he is properly dressed in stout,\\ncoarse slips, or even overalls, he is easily and\\nrapidly cleaned when meal-time comes.\\nAt the age of five years the permissible range\\nbecomes much wider. If he is forced to stop\\nindoors, light calisthenics and dumb-bell exer-\\ncises may wisely be begun. If these are con-\\nducted with the accompaniment of a story,\\nsimple music, or concerted action, they become\\namusing as well as beneficial. Only the sim-\\nplest motions should be employed. They must", "height": "4360", "width": "2888", "jp2-path": "careofchildinhea00oppe_0168.jp2"}, "165": {"fulltext": "EXERCISE 153\\nnot be continued for too long a time, and under\\nno circumstances ought they be allowed to in-\\nvolve strain. At this period the child may\\ntake longer walks in the open, and his carriage\\nand manner of walking should, if necessary, be\\ncorrected. The habit of standing erect, walking\\nwith the toes turned out, and allowing the hands\\nto hang easily, is formed more easily at this age\\nthan later on. The locality of the walks should,\\nwhenever possible, be selected in or toward the\\ncountry or a park; and an earnest attempt\\nshould be made to familiarize the child with\\nfacts of nature. It is fully as easy to acquaint\\nhim with these facts as with those of the streets.\\nWithin a very short time this growing child\\nmay be taught to swim. In most cases a boy or\\ngirl of six years will learn the art more easily\\nand quickly than those of fifteen; the younger\\nchild, if he has the advantage of example, is\\noften more confident and more trustful than the\\nolder, and at the same time he is young enough\\nto have retained some of the imitative faculty\\nof the youthful animal. Swimming, if kept\\nwithin reasonable bounds, is one of the best\\nexercises that a child can have. It need not\\ninvolve over-exertion, it brings all the muscles\\nof the body into play, and the fatigue which it", "height": "4348", "width": "2784", "jp2-path": "careofchildinhea00oppe_0169.jp2"}, "166": {"fulltext": "154 THE CARE OF THE CHILD IN HEALTH\\nbrings on may immediately be counteracted at\\nany time by floating. While the child is in the\\nprocess of learning, he should be taught to dive,\\nto swim on his back, to swim when partly and\\nwholly clothed, and to help a drowning person.\\nAt the same time he may be instructed how to\\nsupport himself if he is seized with a cramp;\\nbut he must always be warned against remain-\\ning a long time in the water, for this is one of\\nthe commonest causes of such an accident. In\\nmost cases fifteen minutes are as long as he\\nneed remain in the water, while in the begin-\\nning of the season a shorter time is advisable.\\nThe common use of the bicycle has made this\\nform of exercise familiar to young boys and\\ngirls. Children of six, seven, and eight years\\nnow freely indulge in it, and usually with\\nbenefit. There are a few suggestions in regard\\nto its employment that may profitably be kept\\nin mind. In the first place, a bicycle ride\\nshould not be too long in extent nor too rapid\\nin rate. I have often enough seen compara-\\ntively young children ride ten, fifteen, or more\\nmiles at a stretch at the rate of ten or more\\nmiles an hour; and in a number of cases I have\\ntreated them for abnormal conditions which\\nthereby resulted. Bicycling, when thus carried", "height": "4360", "width": "2928", "jp2-path": "careofchildinhea00oppe_0170.jp2"}, "167": {"fulltext": "EXERCISE 155\\nto excess, should be regarded as violent exer-\\ntion, and must not be participated in by any\\npersons except those who are fitted, by strength\\nand training, to withstand the strain. Rapid\\nriding is apt to produce a tired condition of the\\nheart muscle, with the attendant weakening of\\nthe circulation and liability to respiratory dis-\\norders. Another item is the height of the\\nsaddle and the plane of elevation in which it\\nrests. When the child sits in the saddle with\\nhis legs extended, the lower pedal should touch\\nthe sole of the corresponding foot; and the pedal\\nshould support the ball rather than the instep\\nof the foot. Very often one may have consid-\\nerable trouble in adjusting the saddle, and the\\ntrouble comes, for the most part, from the irri-\\ntation which the peak, or pommel, causes. This\\npart, on account of the pressure which it exerts\\non the perineum, is the main objection to the\\nordinary commercial article, and should be abol-\\nished. If it is tipped up a favorite position\\nfor many children the weight of the body\\nrests upon the perineum, and may injure some\\nof the near-by delicate structures. If it is\\ntipped down, the child slides forward, and must\\nuse part of his strength in supporting instead of\\npropelling himself. The best position, there-", "height": "4360", "width": "2780", "jp2-path": "careofchildinhea00oppe_0171.jp2"}, "168": {"fulltext": "156 THE CARE OF THE CHILD IN HEALTH\\nfore, is when the saddle is quite level, and not\\ntoo far back. If the saddle is thus arranged,\\nif the bicycle is not too heavy, and if the handle-\\nbar is high enough to make the child sit up\\nfairly straight, the exercise obtained by this\\nmeans will almost always be beneficial to a\\nhealthy boy or girl.\\nAn exercise that is usually recommended for\\nits social and aesthetic, rather than health-\\ngiving reasons, is dancing. Nevertheless, if\\nmoderately practised, it may benefit the body\\nin a variety of ways. Although the lower part\\nof the body is the one most employed, never-\\ntheless the whole organism is, to some extent,\\nbrought into play; the finer movements and\\nthose used in maintaining an exact balance are\\nespecially brought out, so that while the circu-\\nlation is being stimulated, and a healthy glow\\nis made to pervade the body, the child s grace-\\nfulness and lightness of movement are being\\ndeveloped. The fact that this exercise is gen-\\nerally conducted under circumstances of fes-\\ntivity and sociability gives the added advantage\\nof keen enjoyment to it, and thus materially\\npromotes its value. Besides all this, it maybe\\nenjoyed by both boys and girls, and therefore is\\nespecially to be commended. There can be no", "height": "4360", "width": "2884", "jp2-path": "careofchildinhea00oppe_0172.jp2"}, "169": {"fulltext": "EXERCISE 157\\ngreater mistake than the belief that dancing is\\na mere accomplishment whose purpose is no\\nmore than decorative. It is all this, but much\\nmore besides. Gentle exercise has its uses as\\nwell as that which is violent and especially for\\nthose children who are endowed with a large\\namount of animal spirits it may be exceedingly\\nvaluable. The necessary formality and court-\\nesy which boys are forced by this exercise to\\nshow to their sisters and girl friends has an\\ninfluence that is all for good.\\nThis fact brings to mind the limitations\\nunder which girls usually are placed in the\\nattempt to gain a sufficient degree of strength\\nand grace. At the same time, their need of\\nvigorous exercise is fully as great as that of\\ntheir brothers. The fashion of weak and help-\\nless women has passed away, and we shall be\\nfortunate if it never returns. A girl deserves\\nas serious a preparation for future work and\\nlife as a boy and the fact that her work and life\\nare to be different from his has no bearing upon\\nthe necessity for development. She can be fully\\nas maidenly, sympathetic, and useful with a\\nstrong body as with a weak one; and in the\\nfavorable instead of the unfavorable condition\\nshe certainly will gain in health and strength,", "height": "4360", "width": "2784", "jp2-path": "careofchildinhea00oppe_0173.jp2"}, "170": {"fulltext": "158 THE CARE OF THE CHILD IN HEALTH\\nself-confidence, and ability to discharge her\\nfuture duties as wife and mother. When she\\ntakes her exercise she must be properly and fitly\\ndressed. Her skirts should not be too many,\\ntoo heavy, nor too tight. Her shoes should be\\nlarge, strong, and heavy enough to give an\\nefficient support to the feet and ankle and the\\nevil day when she is forced to wear corsets must\\nbe put off as long as possible. This article of\\ndress is absolutely unnecessary for young girls\\nwhose physical development is such as to render\\nconstriction of the waist and support of the\\nbreasts superfluous. The evils that it may and\\nvery often does create are undoubted, and\\nought to be sufficient to impress a reasonable\\nmind with their sufficiency. With abdominal\\nand back muscles weakened, with abdominal\\nand pelvic viscera squeezed and pushed out of\\nplace, a girl must inevitably be balked in her\\nnormal evolution and the attainment of her\\nrightful growth. When the corset is replaced\\nby a strong waist, without bones or stays, she\\nis prepared to participate in many sports and\\nexercises that are, for the most part, handed\\nover to her brothers.\\nIn selecting exercises for children of ten or\\nmore years, those should be preferred that", "height": "4360", "width": "2888", "jp2-path": "careofchildinhea00oppe_0174.jp2"}, "171": {"fulltext": "EXERCISE 159\\nactively employ the mind as well as the body.\\nFor this reason fencing is highly desirable. It\\ngives abundant movement, may be made as\\ngentle or as violent as the capabilities of the\\nperson permit, and simultaneously develops\\nthe finer as well as the heavier movements, exer-\\ncises the eye as well as the arm, and brings in\\nthe element of emulation. For somewhat simi-\\nlar reasons tennis is a fine game, although it\\nmust be plaj^ed much more vigorously if the\\nchild aims to excel in it. Basket-ball is also a\\ngood game, and involves the very desirable\\nfactor of concerted action. This is a most use-\\nful element, for it develops a wholesome disci-\\npline, a salutary subordination to authority, a\\nconstant watchfulness to take advantage of\\nopportunities. The so-called team-play of\\nbase-ball and foot-ball gives an undoubted value\\nto those who play the game skilfully; and it is\\nunfortunate that girls have not more amuse-\\nments which tend to further such qualities.\\nThe two games mentioned are thoroughly com-\\nmendable for boys who have the requisite\\nstrength and activity but the spirit of strenu-\\nous striving must be brought out, and each\\nplayer must be drilled to use determination and\\nspirit, to work at every point in the game, to", "height": "4360", "width": "2820", "jp2-path": "careofchildinhea00oppe_0175.jp2"}, "172": {"fulltext": "160 THE CARE OF THE CHILD IN HEALTH\\nstruggle and fight against defeat. Such\\nreasons of personal influence make the train-\\ning that comes from sparring and wrestling an\\ninfluence of much good. This influence stands\\nfor physical bravery, endurance, fearlessness,\\nthe careful estimating of an opponent s ability,\\nas well as an increase of the body s strength\\nand quickness. Such things are a real gain\\nover the benefits which one derives from riding,\\ndriving, or even golf; although these sports\\nhave their value for the small number in the\\ncommunity whose wealth makes the item of\\ncost unimportant.\\nBut whatever games are played must be par-\\ntaken of with the double object of the pleasure\\nwhich they are able to give and the training of\\nmind and body which they as surely provide.\\nThe parents should make the selection of these\\ngames and sports a matter of careful attention,\\nthey should participate in them (and thus\\nobtain, in most cases, valuable training for\\nthemselves), and supervise them as carefully\\nas they would select clothes to wear and books\\nto read. When children of any age take their\\nexercise, they should be properly dressed in\\nstrong, plain garments which they need not fear\\nto soil or tear. Their sense of physical free-", "height": "4388", "width": "2848", "jp2-path": "careofchildinhea00oppe_0176.jp2"}, "173": {"fulltext": "EXERCISE 161\\ndom must be unrestrained, and they should be\\nencouraged to let loose all the physical energy\\nthat characterizes the young animal. When\\ntheir time of exercise is over, they should bathe,\\nchange their clothes, and adopt the more con-\\ntrolled manner of their ordinary hours. A\\nrapid sponge or shower bath, followed by a\\nbrisk rub for a few minutes will bring out the\\nappearance and feeling of bounding health and\\ncontent, the enjoyment of a vigorous appetite,\\nand the repose of a sweet sleep.\\nIn every home where children are there\\nshould be some substitute for a gymnasium;\\nand whenever they are forced to stop indoors\\nthey should be encouraged to use whatever\\ndevices are at hand. Any room, whether it is\\nan attic or bed room, nursery or play room, will\\nserve our purpose. The only stationary fixture\\nwhich we need is a pair of flying rings. If in\\naddition there is a horizontal bar, a striking\\nbag, or a set of parallel bars, or all of them, the\\nopportunities for diversified exercises are much\\nincreased. Swinging clubs and dumb-bells are\\nalways easily obtained, and the use of them\\nshould be encouraged. All of these things are\\nas valuable for girls as for boys, and both of\\nthem can profitably employ them at times when", "height": "4360", "width": "2820", "jp2-path": "careofchildinhea00oppe_0177.jp2"}, "174": {"fulltext": "162 THE CARE OF THE CHILD IN HEALTH\\nthey may not row, skate, or disport themselves\\nin other ways in the open. By all means every\\nchild must be made to feel that his body is as\\nworthy of attention as his mind, and that the\\npleasures which may thereby be attained are\\nboth laudable and dignified.", "height": "4360", "width": "2820", "jp2-path": "careofchildinhea00oppe_0178.jp2"}, "175": {"fulltext": "CHAPTER VIII\\nCLOTHING FKOM THE TIME OF INFANCY\\nThere is a fairly well-fixed rule which con-\\ntrols the materials and the fashion of an infant s\\nclothes; tradition and experience have settled\\nwhat this may be, and the variations from it are,\\nas a rule, small and unintentional. But as the\\nchild grows older and stronger, mothers feel\\nthat they have a wider range of choice, and a\\nsmaller need to adhere to a fixed standard.\\nMoreover, the differences between the rich and\\nthe poor are then more plainly evident than in\\nthe younger children, not only on account of the\\nrapidity with which clothes are outgrown, but\\nalso because there are so many fabrics on the\\nmarket from which clothes are made. The\\nbelief has grown that the most expensive gar-\\nments are necessarily the most serviceable, the\\nhealthiest, and the best. Thus, indecision\\nfollows lack of information, and a certain\\namount of inconvenience, or even hardship,\\nmay be undertaken for the sake of a supposed\\n163", "height": "4356", "width": "2820", "jp2-path": "careofchildinhea00oppe_0179.jp2"}, "176": {"fulltext": "164 THE CARE OF THE CHILD IN HEALTH\\nnecessity to give a child certain costly kinds of\\ngarments.\\nFor such reasons it may be advantageous to\\nconsider what the various fabrics are and what\\nwork they are meant to do. Their main func-\\ntion, outside of providing a decent covering for\\nthe body and furnishing decorative effects, is to\\nafford protection against cold and heat and the\\nmain part of the problem consists in regulating\\nthe amount of heat which is given off from the\\nbody in cold weather. The importance of this\\nquestion may be estimated from the fact that\\nmore than 80% of the heat which is generated\\nin the body is given off from the skin and\\nif additional inroads are made by badly selected\\nclothing, the effects upon the health and vitality\\nmust necessarily be great. This dissipation of\\nheat takes place through the well-known pro-\\ncesses of radiation, conduction, and evaporation\\nof moisture. Radiation acts mainly when the\\nbody comes in contact with cold objects, such\\nas cold clothing, bedding, or furniture. Con-\\nduction is most active when the surrounding\\nair, whether it is hot or cold, is in brisk motion.\\nBoth conduction and radiation accomplish their\\npurpose most thoroughly when the wind is cold,\\nharsh, and strong. Evaporation stands for the", "height": "4384", "width": "2856", "jp2-path": "careofchildinhea00oppe_0180.jp2"}, "177": {"fulltext": "CLOTHING FROM THE TIME OF INFANCY 165\\nvolatilizing of the moisture that is given off on\\nthe body surface in winter it amounts to very\\nlittle, but in summer it may be considerable.\\nThe object sought for in wearing winter cloth-\\ning is so to regulate the factors of radiation and\\nconduction that the body maintains its normal\\nand comfortable amount of heat; and of these\\ntwo factors conduction is the really important\\none.\\nCommon experience has demonstrated that\\nwool is the best protection against cold, but the\\nreason why it is efficient is not so well under-\\nstood. There is much loose talk commonly\\nheard about good conductors and poor con-\\nductors, that one fabric is heating and\\nanother chilling. As a matter of plain fact\\nthere is very little difference between the\\norganic constitution of the various fabrics as\\nfar as their power of conduction is concerned.\\nAlso, it is practically a matter of indifference\\nwhether the material is of animal origin, like\\nwool or silk, or of vegetable origin, like cotton\\nand linen. And whether the wool is one of the\\nso-called natural or copyrighted articles, or\\nthe muslin is more or less finely bleached, is,\\nfor the most part a matter of indifference. The\\ncommonly heard argument that the natural", "height": "4360", "width": "2820", "jp2-path": "careofchildinhea00oppe_0181.jp2"}, "178": {"fulltext": "166 THE CARE OF THE CHILD IN HEALTH\\nwools are necessarily better than other brands\\nbecause they tend to copy the state of nature\\ninvolves striking fallacies; in the first place,\\nwe do not in our ordinary matters of life seek\\nto imitate the ways of nature: we want our\\nfood cooked, not raw, as animals take it; we\\nwant to sleep in comfortable houses, not in the\\nopen we seek to be guided by reason, and not\\nby instinct. Because wool comes from the\\nsheep s back is no reason why it necessarily\\nexcels other fabrics as a means of protection.\\nIn fact, where the whole pelt is used, as in fur\\ncoats, much more warmth than is usual may be\\nobtained by wearing the wool toward the body\\nand the skin toward the weather.\\nThe real difference between the various fabrics\\nconsists in the way they are woven. If the\\nmaterial in question is so made that it con-\\ntains a fairly large amount of air between its\\nfibres, it keeps out cold better than if it were\\ntight and smooth; for still air is an excellent\\nnon-conductor, and under such circumstances\\nit serves a useful and active purpose. Here is\\nwhere the true advantage of wool may be seen\\nfor it is so made that its fibres are loosely com-\\nbined, the rough ends protrude more or less,\\nand touch the skin in a multitude of fine points.", "height": "4360", "width": "2800", "jp2-path": "careofchildinhea00oppe_0182.jp2"}, "179": {"fulltext": "CLOTHING FROM THE TIME OF INFANCY 167\\nAs a result, there are strata of still air between\\nthe body and the cold. For similar reasons it\\nis wise to have successive layers of thin cloth-\\ning rather than one very thick garment, even\\nalthough the latter is equal in weight to or\\nexceeds the weight of the combined suits. The\\nmethod of dressing used by the Chinese is in\\nthis way highly to be commended, for they use\\nthe same kinds of garments in all seasons, but\\nvary the number of them to suit the needs of\\nthe weather. If cotton, flax, and silk could be\\nso woven as to present the same physical con-\\nditions as wool, they would also partake of simi-\\nlar excellences if instead of being very smooth\\nand tightly woven, they were rougher, looser,\\nand possessed of more irregularities, their use-\\nfulness as clothing would be equally great.\\nIndeed, imitations of wool, which attempt to\\ngive the physical peculiarities of their proto-\\ntypes, have been, and are, giving much satis-\\nfaction. And people with sensitive and irritable\\nskins derive both comfort and benefit from fab-\\nrics which are made wholly of cotton or of wool\\nmixed with cotton or silk.\\nIn addition to this advantage of physical con-\\nformation, wool has the fine characteristic of\\nbeing able to absorb more moisture than cotton,", "height": "4360", "width": "2820", "jp2-path": "careofchildinhea00oppe_0183.jp2"}, "180": {"fulltext": "168 THE CARE OF THE CHILD IN HEALTH\\nsilk, or linen. It is capable of taking up more\\nthan its own weight of water without immedi-\\nately losing its elasticity. Evaporation does\\nnot take place so readily from it as from the\\nother fabrics mentioned, and, consequently, it is\\nless liable when it is wet to chill the skin. On\\nthe other hand, woollen fabrics have a decided\\ndisadvantage in the way they react to washing\\nand ironing. The action of washing and rub-\\nbing causes the long, curty fibres to break,\\nbecome hard and rough, so that the whole gar-\\nment is finally harsh, feltlike, and shrunken.\\nWhile this can be in part avoided by care in\\nwashing, by the use of lukewarm or cool water\\nin place of hot, and by waving the garment in\\nthe water instead of rubbing it, nevertheless,\\nit is always more refractory in its conduct than\\ncotton goods. The latter, on account of their\\nlightness, their ease of manipulation, their\\nsmoothness, and the fact of conducting heat\\nwell, are the proper materials for summer\\ngarments. In the list of available fabrics for\\nclothing, rubber cloth, oil cloths, oil silks, and\\nmackintosh cloth should have no place. They\\nprevent all beneficial movement of air, render\\nevaporation impossible and create a chilled,\\nclammy layer of moisture next to the body that", "height": "4360", "width": "2872", "jp2-path": "careofchildinhea00oppe_0184.jp2"}, "181": {"fulltext": "CLOTHING FROM THE TIME OF INFANCY 169\\nmakes the probability of taking cold imminent.\\nFinally, the comfort of the clothing can be\\nmodified to an appreciable extent by means of\\ntheir color: for we know experimentally that\\ncertain colors take up more heat than others,\\nand that this characteristic makes itself plainly\\nfelt in garments of different hues. Thus we know\\nwith certainty that black holds more than twice\\nas much warmth as white, and that the interme-\\ndiate points are held by yellow, green, red, and\\nblue. The exact order would read as follows\\nWhite Bright red\\nLight yellow Dark green\\nDark yellow Pale blue\\nPale green Black\\nIf we wish to summarize all these facts, we\\nmay say that winter clothing should be made of\\nwool, or of mixtures of wool and cotton, or wool\\nand silk that imitate the physical form of wool-\\nlen fabrics that they should be soft and downy\\nrather than hard or feltlike; that they should\\nbe in thin, light layers rather than in one thick,\\nheavy material; that they should not be too\\nloose; and that their color should be red, dark\\ngreen, blue, or black. In summer they should\\nbe made of cotton, muslin, or silk, should be in\\nas few layers as possible, should be very loose,", "height": "4332", "width": "2764", "jp2-path": "careofchildinhea00oppe_0185.jp2"}, "182": {"fulltext": "170 THE CARE OF THE CHILD IN HEALTH\\nand that their color should be white, yellow,\\nor pale green. Rubber material should never\\nbe used for clothing, nor should that fabric\\nknown as stockinet find a place in a child s\\nunderclothes, or mackintosh in his overcoats.\\nWaterproofed woollen goods have less objec-\\ntions to their use, for they admit of a moderate\\npassage of air. In the future they will doubt-\\nless be used much more than they have been in\\nthe past.\\nThe form of the clothing should be as simple,\\nas light, and loose as a sensible regard for\\nappearances permits. The general plan may\\nwith slight modifications be used for all ages up\\nto the time of puberty. Thus, as soon as the\\nchild is old enough to have acquired habits of\\ncleanliness, he may wear the so-called union\\nunderclothes; these as was stated in a previous\\nchapter, consist of shirt and drawers united in\\none garment. For the autumn and spring a\\nmedium weight should be used, and for winter\\none may select either a heavy weight, or two\\nlighter garments may be worn at one time.\\nFor summer the woollen wear may well be dis-\\ncarded for muslin or cambric; but in this event\\nsufficient changes must be made to prevent the\\nwearing of sodden clothes. The stockings in", "height": "4360", "width": "2844", "jp2-path": "careofchildinhea00oppe_0186.jp2"}, "183": {"fulltext": "CLOTHING FROM THE TIME OF INFANCY 171\\nwinter should be woollen, long enough to reach\\nwell above the knee, and should have a fast\\nblack dye. In summer they may be of cotton,\\nsilk, or cotton mixture, and should be white or\\none of the light colors. The practice of having\\nshort socks on young children, which is unfor-\\ntunately continued by some mothers into cool\\nweather, should not be countenanced. The legs\\nhave the same reason for being covered as any\\nother portion of the body, and may likewise be\\ninjuriously affected by inequalities of temper-\\nature, draughts, and other congestive influences.\\nThe same reasons forbid the exposure of a child s\\nchest; and even in very warm weather it is\\nadvisable to have the whole body covered.\\nThere is no doubt that young children may\\nsuffer acutely from the heat, and every rational\\neffort must be made to keep them as comfortable\\nas possible. But this can be done by lessening\\nthe number, weight, and tightness of the gar-\\nments, instead of cutting out parts which right-\\nfully should remain.\\nOver the undershirt comes a waist to which\\nthe shirts and stocking-supporters may be at-\\ntached. This waist is often corded for the sake\\nof giving it a fairly permanent shape, and\\nshould be made of the various fabrics that be-", "height": "4328", "width": "2756", "jp2-path": "careofchildinhea00oppe_0187.jp2"}, "184": {"fulltext": "172 THE CARE OF THE CHILD IN HEALTH\\nlong to different seasons. Thus, in summer it\\nmay be muslin, but it must be thin enough for\\ncomfort; in spring and autumn it may be made\\nof coutil, and in winter two layers of light\\ncoutil or a sufficient thickness of flannel are\\ndesirable. This garment should be high in\\nthe neck and long in the sleeves, and may be\\nfastened with good-sized buttons. In the lower\\nband there should be a series of worked slits\\nwhich resemble a buttonhole; and through\\nthem a strong and broad tape may be drawn, to\\nwhich buttons are to be sewed. These buttons\\nare meant to support the two little skirts, one\\nof which should be of flannel, and the other of\\nmuslin, cambric, or nainsook. The weight of\\nthe flannel skirt must naturally be regulated by\\nthe season, and in very hot weather it may be\\nlaid aside. For ordinary children in good health,\\nno abdominal band is at all necessary, and the\\nuse of it in summer may give an irritating feel-\\ning of heat and discomfort. Under the usual\\ncircumstances there is no more reason for wear-\\ning a knitted band on the abdomen than one\\nover the lungs or about the throat.\\nThe outer garments come next in order, and\\nrequire no special mention; for from what has\\nbeen said the mother can easily deduce what", "height": "4360", "width": "2864", "jp2-path": "careofchildinhea00oppe_0188.jp2"}, "185": {"fulltext": "CLOTHING FROM THE TIME OF INFANCY 173\\ntheir requirements are. It is hardly necessary\\nto say that young boys knickerbockers should\\nbe buttoned on to the waist in place of the\\ntwo skirts which girls wear. Boys usually\\nwear a loose waist, or a sailor waist which has\\na deep enough fall over and below the waist\\nline to hide all traces of band or buttons. All\\nthe changes which fashion and individual taste\\nmay suggest are usually harmless in their\\neffects so long as they are not allowed to in-\\nterfere with the characteristic necessities of\\nproper material, ease, and looseness of cut,\\nsuspension of all weight from the shoulders, and\\nabsence of binding or constricting garments\\nor appurtenances, as, for instance, in the way\\nof garters. The round garter should never be\\nworn, for its evil effects are peculiar to itself,\\nwhile its advantages are better obtained by the\\nsuspension elastics which are fastened from the\\nside of the waist. The clothing must be suited\\nnot only to the season, but also to the uses\\nwhich it may be called upon to serve. Thus,\\nin times of play, the child should wear such gar-\\nments as will not in any way interfere with his\\nentire liberty of both mind and body. If he is\\ndaintily and expensively dressed, he will nat-\\nurally be restrained in his running, jumping,", "height": "4340", "width": "2768", "jp2-path": "careofchildinhea00oppe_0189.jp2"}, "186": {"fulltext": "174 THE CARE OF THE CHILD IN HEALTH\\nfalling, digging, delving, building, and number-\\nless other exercises which are his by right and\\nchoice. Therefore his play-suit must be easily\\nwashable, strong, and with a fairly smooth sur-\\nface. A good quality of denim answers the\\npurpose excellently; and if it is made in the\\nform of overalls, it will give much satisfaction to\\nboth parents and children. Little girls as well\\nas boys may wear them, and the only change\\nfrom the usual form that need be made is a\\nwidening about the waist and buttocks, so that\\nthe skirts may be tucked in and be well pro-\\ntected. A child thus clothed has an exhil-\\narating sense of freedom; he does not fear to\\nexpress all unrestrained effervescence that is\\ncharacteristic of his age, and his possibilities of\\nenjoyment are proportionately enlarged. In\\ngeneral terms, one may say that it is a good\\nplan to use old clothes, as long as they last, for\\nnursery use, for use in country and park. In\\ncities, when children are allowed to go to a\\npark, they are commonly overdressed or over-\\ndecorated; they may look more genteel or more\\nprosperous, but they do not have as good a time\\nnor do they derive as much benefit from their\\nexercise as if they were plainly or even some-\\nwhat roughly clothed.", "height": "4360", "width": "2852", "jp2-path": "careofchildinhea00oppe_0190.jp2"}, "187": {"fulltext": "CLOTHING FROM THE TIME OF INFANCY 175\\nA noteworthy part of the costume is the shoe\\nfor on the choice of it depends much of the\\nchild s activity, freedom of movement, and\\ngrace of carriage. It is a really remarkable\\nfact that in this detail of clothing, which can so\\neasily be properly planned and executed, there\\nshould be so many poorly designed articles.\\nNothing can be easier than to observe carefully\\nthe formation of the foot, to obtain its natural\\noutline, and then to adapt the shoe to these\\nelemental requirements. Nevertheless, a cor-\\nrectly made shoe is not easy to find, and manu-\\nfacturers continue to make the same faulty styles\\nthat were in use many years ago. Even in a\\nbaby s shoe these misconceptions may be seen\\nand whatever attempts at reform have been made\\nare, in most cases, makeshifts. If one will\\nblacken the sole of the baby s foot, and then\\ntake its imprint on white paper, one will readily\\nsee that it forms the approximate outlines of a\\ntriangle, the apex of which is at the heel more-\\nover, when the foot is placed upon the ground,\\nit has a tendency to spread out somewhat in the\\nfashion of a duck s foot. From the toes and\\nthe fore part of the foot the fine motions of\\nbalancing are accomplished, and the carriage\\nand walk are controlled. This part, therefore,", "height": "4336", "width": "2760", "jp2-path": "careofchildinhea00oppe_0191.jp2"}, "188": {"fulltext": "176 THE CAKE OF THE CHILD IN HEALTH\\nshould have the maximum of freedom, if the\\nfunction of the member is to be fully developed.\\nIn addition, until the muscles have obtained a\\nuseful measure of strength there should be as\\nlittle restraint put upon them as possible.\\nDuring the weeks and months while the child\\nis learning to walk he needs all the aids that\\nhe can naturally obtain to help him in balanc-\\ning; and, therefore, a broad, flexible fore part\\nof the foot is much more useful than a narrow,\\nrigidly held one can ever be. Thus, one can\\neasily recognize the need, during infancy, of a\\nsoft, soleless shoe, or bootie, and during the\\nperiod when the child is learning to walk, of a\\nsoft, loose shoe that is narrow at the heel and\\nvery broad at the toes in short, one that is\\nmade and shaped like a moccasin.\\nAs the child grows older and his muscles\\ngrow stronger, he will, if he is in health, begin\\nto walk of his own accord. And in almost\\nall cases he needs no artificial helps or aids. If\\ncertain muscles, or groups of muscles, are unde-\\nveloped or lacking in native strength, it is not\\nwise immediately to use supports. The defec-\\ntive muscles should be made strong by properly\\nselected exercise rather than weakened by props,\\nwhich take away the work that they ought to", "height": "4360", "width": "2892", "jp2-path": "careofchildinhea00oppe_0192.jp2"}, "189": {"fulltext": "CLOTHING FROM THE TIME OF INFANCY 177\\ndo. There is no doubt at all that weakened\\nfunctional activity can be strengthened by\\nproperly directed attention, and such is the\\nproper method to be adopted. If the mother is\\nnot able to do this by passive motion, massage,\\nand simple exercises, she should obtain the\\nrequisite information from an expert. For this\\nreason it is unwise to use the so-called ankle-\\nshoes, which have the paralyzing effect of a\\ncorset. They stifle the free play of the muscu-\\nlar structures; and if the part eventually\\nbecomes strong, it is not on account of, but in\\nspite of the artificial support. Naturally, this\\ndecision applies to cases of mere muscular weak-\\nness, and not to those of pathological deformity.\\nWith ankle-shoes and braces put out of the way,\\nthe shoe must be adapted to the form of the foot\\ninstead of the foot being adapted to the shoe.\\nThe sole should never be too thin, the front of\\nthe shoe must be very broad, the heel and\\ncounter should be reasonably small; the high-\\nest part of the arch of the instep should be\\ntoward the inside of the foot, from which to\\nthe outer edge there is a moderately sharp\\nincline. Such a shoe may not look decorative\\nto eyes that are accustomed to sharp toes and\\nbroad heels but it has the greater advantage of", "height": "4360", "width": "2776", "jp2-path": "careofchildinhea00oppe_0193.jp2"}, "190": {"fulltext": "178 THE CARE OF THE CHILD IN HEALTH\\nbeing useful and comfortable, of giving a firm\\nfoundation for the sole, while it provides\\nsufficient protection to the whole foot.\\nThe leather which is used in the making of\\nthe shoe should be kid, calf, or similar skin\\nthat is thoroughly porous. Patent leather, en-\\namelled leather, and other waterproof material\\nshould never be used. They make the skin\\nwet and cold, tender and irritable; and their\\nonly extenuation is their decorative effect.\\nHigh overshoes or rubber boots have a certain\\namount of justification because they are worn\\nfor no more than short and separated intervals,\\nfor during those times they adequately protect\\nthe feet from cold and moisture. But as soon as\\nthe child enters the house, they should be\\nremoved and the feet should be thoroughly\\ndried. Before putting on rubber boots the feet\\nshould be covered with felt slippers.\\nWhile a child s clothing should be comfort-\\nable, becoming, and of a good quality, it ought\\nnever be too pretentious in style nor lavish\\nin its decorations. A child should give the\\nimpression of unspoiled simplicity, should stand\\nfor a developing personality that is innocent\\nand pure enough to be untouched by the garish\\nvanity and class distinctions of the older world.", "height": "4360", "width": "2860", "jp2-path": "careofchildinhea00oppe_0194.jp2"}, "191": {"fulltext": "CLOTHING FROM THE TIME OF INFANCY 179\\nNot only do his clothes influence the estimation\\nwhich other people form of him, but even more,\\nthey affect the opinion in which he is apt to\\nhold himself. One of the best ways to make\\nhim vain, conceited, and petty is to overdress\\nhim, to fasten his attention on his external\\ndecorations. In this way such details come to\\ntake the place of an important ideal, and simul-\\ntaneously to exclude, in a proportionate degree,\\nthe growth of ideals of real value. A reason-\\nable pride in decent and dignified dress is a\\ngood thing; the abuse of such pride is a very\\nbad thing. The potentialities of a child are so\\ngreat that interference with their best fruition\\nshould be undertaken with fear and trembling.\\nA child is apt to seem pretty and doll-like, in\\nall likelihood he is pleasing to the casual eye,\\nwhen he is decked out in gewgaws until he\\nresembles a lay figure but such characteristics\\nfade away into woful triviality when one con-\\nsiders that in the bespangled breast may beat a\\nheart of future greatness, and under the berib-\\nboned cap may lie a brain that will give out\\nlarge thoughts. If dress is the index of the\\nman, it certainly has some influence in describ-\\ning the formative surroundings of the child.", "height": "4360", "width": "2772", "jp2-path": "careofchildinhea00oppe_0195.jp2"}, "192": {"fulltext": "CHAPTER IX\\nHABITS\\nMatthew Arnold used to say that conduct\\nwas three-fourths of life. But he might have\\ngone farther and said that all of conduct was\\ncontained in habit; indeed, he would have been\\nstrictly within reasonable bounds if he had\\nclaimed that habit constituted nine-tenths of\\nlife. It is the factor that controls both thought\\nand deeds it takes the place that instinct holds\\nin animals, and with every increase in the com-\\nplexity of life it augments its power. We usu-\\nally think of it as the controlling force in a few\\nof the Avell-settled customs of daily routine;\\nbut, as a matter of fact, its range of influence is\\ninfinitely wider. The manner of dressing, of\\nwashing, of eating, of walking the posture and\\ncarriage of the body, the peculiar character of\\nphysical expression; tricks of speech, the point\\nof view that designates how conduct is directed,\\nthe decision which governs most questions of\\nethics, morals, and religion, all these and more\\n180", "height": "4360", "width": "2820", "jp2-path": "careofchildinhea00oppe_0196.jp2"}, "193": {"fulltext": "HABITS 181\\nfall within the legitimate confines of that great\\nforce which we call habit. Many of the traits\\nwhich commonly come under the heading of\\nheredity and, practically, all of the effects of\\nenvironment are really matters of habit. And\\nit is often difficult to say whether any existing\\ncharacteristics, outside of the organic conforma-\\ntion, has not originated in the ceaseless repeti-\\ntion of acts and thoughts that gradually and\\nunconsciously changes impressions upon plastic\\ninfancy and childhood into the fixed and\\ncharacteristic habits of maturity.\\nThe question of plasticity is an important\\none, and the younger the child the more impor-\\ntant is the place it holds. For in such persons\\nnothing is fixed, everything is potential. The\\nbrain is not in its mature form, it has not acted\\nas the pathway of numberless nerve-currents,\\neach one of which comes from one definite place\\nand goes to another. According to the forces\\nwhich may be brought to bear upon it, these\\nnerve-currents may be sent in one direction or\\nanother, they may form various intersections,\\nand they may assume various degrees of inten-\\nsity and emphasis. Brain tissue follows the\\nrule of all physical substances in being suscep-\\ntible to certain impressions which, when indefi-", "height": "4344", "width": "2820", "jp2-path": "careofchildinhea00oppe_0197.jp2"}, "194": {"fulltext": "182 THE CARE OF THE CHILD IN HEALTH\\nnitely repeated, predispose the constituent\\nparticles of such substances to react in a definite\\nand inevitable manner. Thus, a piece of paper\\nthat is once folded has ever afterward a tendency\\nto fall into the same crease; and the sureness\\nwith which it falls into that crease is measured\\nby the number of times the process is repeated.\\nA piece of wood that is once polished is more\\nand more easily made smooth and shiny it\\nhas acquired the habit of being polished. A\\nroad that has been ridged by a heavy wagon-\\nwheel has acquired the habit of containing ruts,\\nand every similar impulse tends to make the\\nruts deeper and the habit more pronounced.\\nIn animals similar processes exist, but in\\ngreater complexity. Leaving out of account\\nfor the moment the factors of obvious training,\\nwe know that the whole organism may and does\\ntake on certain phases that, by reiteration,\\nbecome permanent. A dog may become so\\naccustomed to a certain sort of food that he\\nwill really faint from hunger, or even starve,\\nrather than eat a different sort. A horse may,\\nas a matter of routine handling, have been\\nspoken to and soothed by the driver s voice and\\nvocal expression, and if this method of control\\nis suddenly altered, he may become uninanage-", "height": "4360", "width": "2820", "jp2-path": "careofchildinhea00oppe_0198.jp2"}, "195": {"fulltext": "HABITS 183\\nable and temporarily worthless. And in pro-\\nportion to the place in organic development\\nwhich an animal or person occupies, his organ-\\nization is plastic. Human beings, as a whole,\\nhave this plasticity in a marked degree, and\\nmost of all in their earlier months and years.\\nThus, an infant may be regarded as no more\\nthan a bundle of potentialities, which is another\\nway of saying that his final, crystallized form\\nrepresents a bundle of more or less firmly set\\nhabits. This crystallizing process begins at no\\nexactly definite time. It certainly is in action\\ndirectly after the child s birth, and may, in\\naddition, begin before birth in the various\\ndegrees of the child s nutrition, which predis-\\npose him to receiving and interpreting certain\\nnervous impulses. A baby may, on account of\\nunder- or over-nutrition obtain a corresponding\\nability to react to certain impressions, and this,\\nin turn, may have an important share in the\\nresponsibility of building up his future life.\\nTherefore, an attempt to shape the child s habits\\nought to begin with a wise and sufficient atten-\\ntion to the mother during her pregnancy, or\\neven before.\\nAt all events, after the little one has come\\ninto the world, the question of habit-formation", "height": "4360", "width": "2820", "jp2-path": "careofchildinhea00oppe_0199.jp2"}, "196": {"fulltext": "184 THE CAKE OF THE CHILD IN HEALTH\\nimmediately becomes a burning one. Nothing\\ncan possibly be more important than it is, for\\nit is a factor that is always active. This sweep-\\ning ideal must never lose its hold on parents\\nminds, and the more thoroughly they embody\\nit and live it out in their conduct, the more\\ndeeply will they influence their children s\\ndevelopment. They must be constantly on the\\nwatch for acts and tendencies that mark the\\nbeginning of a habit, and must as constantly\\nbe prepared to encourage the good and discour-\\nage the bad. The start is the important thing,\\nfor more can then be done in one direction or\\nanother than at any other time of life. A clear\\nconception of what constitutes good and bad\\nhabits must be formed, and then the conduct\\nmust, as far as possible, be made to square with\\nthat conception. And not only is such a course\\nbeneficial in regard to the particular matters in\\nquestion, but also it has a definite use in pro-\\nmoting a disciplined and orderly budding out\\nof the faculties that have been latent.\\nFor instance, one of the first things in the\\nway of habits that a baby must learn is to lie\\nquiet when he is awake and not nursing. The\\npractice of carrying a child about, of tossing\\nhim in the air, of rocking and dandling him, is", "height": "4360", "width": "2896", "jp2-path": "careofchildinhea00oppe_0200.jp2"}, "197": {"fulltext": "HABITS 185\\nabsolutely superfluous. There can be only two\\nexcuses for it: either the child is sick in some\\ndegree, and thus is restless and feels pain, or\\nhis relatives and attendants desire to amuse him\\nand themselves by treating him as if he were a\\ndoll to be played with. If the first supposition\\nis true, then he should without delay receive\\nsuch medical treatment as will restore his\\nhealth; if the second is the case, then the\\nchild is being trained to be restless, desirous\\nof excitement, wanting in repose. These\\nare some of the unfavorable characteristics of\\nour time, and are responsible to no small extent\\nfor the wear and tear from which the modern\\nperson suffers. The custom of adding to the\\nbaby s tossing by making uncouth noises, pull-\\ning grotesque faces, and cutting capers in order\\nto make him laugh is likewise unnecessary and\\ndoubtless harmful. To a child of this tender\\nage everything is new, and the ordinary events\\nof his little existence are certainly novel. The\\ncontortions and gymnastics that people com-\\nmonly believe amuse him must certainly be\\nexciting for his small mind, must carry him\\naway from the perfect restfulness which consti-\\ntutes the best atmosphere for the full develop-\\nment of his body and mind. At this period of", "height": "4360", "width": "2804", "jp2-path": "careofchildinhea00oppe_0201.jp2"}, "198": {"fulltext": "186 THE CARE OF THE CHILD IN HEALTH\\nhis life he should vegetate, he should nurse,\\nsleep, breathe, and fulfil his primary physical\\nfunctions. And everything else is beyond the\\nmark.\\nThe circumstances of nursing and sleeping\\nshould be as simple and as natural as a due\\nrespect for sanitary and hygienic laws permits.\\nNot only need he not be rocked to sleep, nor\\nwalked up and down the room to make him\\nquiet, but also he should not be temporarily\\nsoothed by means of sugar teats, empty rubber\\nnipples, rubber comforters or pacifiers.\\nThe habit of using these articles is a thoroughly\\nbad one, and should by all means be abolished.\\nAll infants possess the sucking reflex in so\\nacute a degree that, as a rule, very little is\\nneeded to develop exaggerations and distortions\\nof it. Thus, one may start some of the vicious\\nsucking habits, such as finger sucking, clothes\\nsucking, attempting to use any and every article\\nfor this purpose. By such means the fingers\\nmay become wasted and shrunken, and the\\nmouth lose its shape; in addition, the habit\\nof tongue sucking (doubling the fore part of\\nthe tongue back toward the pharynx and then\\nsucking), or even tongue swallowing, may be\\nthus encouraged. Possibly the most imminent", "height": "4360", "width": "2908", "jp2-path": "careofchildinhea00oppe_0202.jp2"}, "199": {"fulltext": "HABITS 187\\ndanger of all is the likelihood of infecting the\\ncontents of the stomach and intestines with\\nharmful bacteria. There is little doubt in my\\nmind that a noteworthy proportion of the cases\\nof summer derangements of these organs, of\\nunexpected diarrhoeas and vomitings, and even\\nsome cases of bronchitis are so caused. For\\nwhether the child sucks on his fingers, or on\\nthe corner of a pillow, or a rubber pacifier,\\nor a home-made sugar teat, the result may be\\nmuch the same: he takes repeatedly into his\\nmouth articles that are not surgically clean,\\nthat may be polluted with pathogenic germs,\\nand that, therefore, may threaten the child s\\nnutrition, health, or even life.\\nWhile such training is in its nature prohibi-\\ntive and, therefore, negative, a bit of positive\\nhabit formation may be begun at a very early\\nage. Most children, as a rule, do not develop\\nhabits of cleanliness until an unnecessarily pro-\\ntracted period. This time often extends to the\\nfifteenth month, the eighteenth month, and even\\nthe twentieth month. No mention need be\\nmade of children who do not obtain control of\\nthe bladder and rectum until they are two and\\na half or three years of age, for they are either\\npathologically deficient in control or suffering", "height": "4360", "width": "2820", "jp2-path": "careofchildinhea00oppe_0203.jp2"}, "200": {"fulltext": "188 THE CARE OF THE CHILD IN HEALTH\\nfrom actively bad training. One may find that\\nthe bladder sphincter is somewhat harder to\\ntrain than that of the rectum; but both are\\nsufficiently amenable to constructive teaching.\\nIf from the third or, at the latest, the fourth\\nmonth the child be supported on the chamber\\nvessel at regular intervals, and especially if he\\nis held in the crouching position that is essen-\\ntial to real ease in defecation, he will in a sur-\\nprisingly short time respond in a satisfactory\\nmanner. These intervals should be decided by\\nthe approximate times when the spontaneous\\nmovements have appeared. At first it will be\\nnecessary to make the intervals at least four\\ntimes a day; in a short time three will be\\nenough, and, in most cases, the child will end\\nby having two regular movements daily. Of\\ncourse, one cannot expect success immediately\\nin this any more than in other important\\nmatters. But a logical persistence will, within\\ntwo or three months, give a gratifying result.\\nTo control urination will take a considerably\\nlonger time; although it is not hard to convince\\nsensible parents, if they follow out the plan,\\nthat an element of regularity will soon appear,\\nand that their work will thereby be lessened\\nwhile the baby s comfort is materially increased.", "height": "4348", "width": "2900", "jp2-path": "careofchildinhea00oppe_0204.jp2"}, "201": {"fulltext": "HABITS 189\\nThe habit of regularity should be employed\\nin all the details of the day s routine: the child\\nshould awake or be awakened at a certain hour;\\nhis feeding must come at a definite time, and if\\nat that time he is asleep he must be roused;\\nthe time of his bathing should likewise be fixed;\\nhis trips into the open air demand an equal care-\\nfulness in short, the child s whole life should\\nbe laid out by the clock. This will be his first\\nlesson in obedience, which should represent a\\nrecognition of a necessary law of conduct. The\\nquestion of obedience should have something\\nlogical in it, and the source of that logical\\nquality must be in the demands of the parent.\\nThere is really no reason why parents should\\nnot be entirely logical in their demands even\\nyoung children respond to a conscientious man-\\nner of forming one s opinions as well as to arbi-\\ntrary and thoughtless ruling. And if they can\\nbe subjected to some carefully ordered plan in\\nthe changing affairs of their daily life, there\\nwill certainly be less friction and commotion\\nthan otherwise. At all events, however, they\\nmust learn to obey; and obedience that comes\\nreadily and spontaneously is worth more than a\\ntardy and partial compliance. They must from\\nthe very first realize that the controlling power", "height": "4360", "width": "2820", "jp2-path": "careofchildinhea00oppe_0205.jp2"}, "202": {"fulltext": "190 THE CARE OF THE CHILD IN HEALTH\\nresides in the parents, and that whatever power\\nexists is being humanely and deliberately exer-\\ncised. At the same time, they must know that\\nhumane and deliberate principles are thoroughly\\nconsistent with firmness. This firmness pre-\\nsupposes so much forethought, self-denial, and\\nstruggle against indulgent affection that it may\\noccasionally be difficult to embody in action.\\nBut whether or no it is hard, it must assuredly\\nbe acted out. No child is benefited by over-\\nindulgence, and most children find their best\\npreparation for mature life in a consistent dis-\\ncipline that demands unqualified obedience to\\nreasonable rules of conduct.\\nWhile the habit of obedience is a valuable\\none, it must not be expressed in such rigid\\nforms as to lead to the evils of exaggeration.\\nA child that is ruled and governed too much is\\napt to have a cowed and deceitful mind. The\\nlogical outcome is an imitation of the harsh\\nqualities of cruelty and tyranny. Children,\\nsomewhat like savages, fall very easily into\\nthese vices, partly on account of thoughtless-\\nness, and partly because their faculty of imag-\\nination is not well directed. No matter what\\nthe nature of the predisposition may be, we all\\nknow that it exists. To restrain his tendency", "height": "4360", "width": "2892", "jp2-path": "careofchildinhea00oppe_0206.jp2"}, "203": {"fulltext": "HABITS 191\\nwhile conserving the normal amount of aggres-\\nsiveness and independence may be a difficult\\ntask; but no matter how difficult it is, it should\\nbe undertaken with as devout a sense of obliga-\\ntion as the parents can command. A cruel\\nchild, although answering closely to a natural\\ntype, is, and must be, thoroughly offensive to\\nthe best aspirations of a civilized parent; and\\nwith every manifestation of such a tendency a\\ndefinite retrogression from a laudable spiritual\\ncondition has been made. A healthy spiritu-\\nality is not necessarily God-given; its origin\\nmay be distinctly earthly. Not counting the\\ncases of special predisposition toward it, the\\nquality exists, in some degree, in all persons.\\nExtraneous circumstances according to their\\nnature encourage or discourage it. And one\\nof the factors that most surely make it wither\\nis the utter disregard for another s personality,\\nwhich we call cruelty.\\nViciousness rarely appears in a single form,\\nand an unfortunate habit is usually founded\\nupon so many different factors that various\\nrelated habits increase by a simultaneous con-\\nstruction. As an example, one may cite the\\nclose relationship between cruelty and cow-\\nardice. Some of the constituent factors of the", "height": "4356", "width": "2820", "jp2-path": "careofchildinhea00oppe_0207.jp2"}, "204": {"fulltext": "192 THE CARE OF THE CHILD IN HEALTH\\nformer, such as seeking an advantage over per-\\nsons who are unable to resist or defend them-\\nselves, fear of discovery, secretiveness, and a\\ndisposition to evade consequences, are likewise\\ncharacteristic components of the latter. In fact,\\nthe relation between the two is so intimate that\\nthe existence of one is often a safe indication\\nof the other. As a matter of practical experi-\\nence, the habit of fear, of being cowardly, is in a\\nnormal child quite unnecessary. It grows from\\nrepeated impressions which are generally made\\nupon the mind of the child for the purpose of\\nenforcing discipline. To the charge of com-\\nmitting this weak and vicious mistake, parents\\nas well as nurses must often plead guilty. We\\nare too much in the habit of attributing to the\\nignorant nurse-maid the practice of frighten-\\ning children by stories of ghosts, the black\\nman, the boogy man, and the mythical\\npoliceman who is supposed to take bad little\\nboys and girls away. And, as a matter of real\\nexperience, many mothers do the same thing.\\nIn addition they bolster up the habit by express-\\ning fears in their own person; and this leads\\nto the same inevitable result. The woman who\\nis afraid to go into dark rooms and places, who is\\nafraid of the thunder or the lightning, who falls\\ni", "height": "4360", "width": "2884", "jp2-path": "careofchildinhea00oppe_0208.jp2"}, "205": {"fulltext": "HABITS 193\\ninto a paroxysm of terror at the sight of a mouse\\nor a rat, who shivers and cries at the touch of\\na caterpillar or a beetle, who fears dogs, cats,\\ncows, or other harmless animals, is much to\\nblame in making her children timid, suspicious,\\nweak-souled, and apprehensive. Cowardice\\nand bravery may be congenital qualities but\\nmore often they represent an acquired tendency,\\na condition of mind that has grown up from\\nsmall beginnings, a process of evolution that\\ntends to become crystallized in the matured\\nperson, who finds himself unable to escape from\\nthe stigmata of early training.\\nWhat is true of cowardice, of cruelty, of obe-\\ndience, of regularity, is equally true of the\\nother habits which lend distinctiveness to the\\nindividual character. Courtesy is taught with\\ndifficulty to grown-up children, and it is as\\nhard to assume good manners after childhood has\\npassed into youth as it is to acquire a clean-cut\\ntaste in regard to dress or household decoration.\\nWith most people the impress that is made upon\\nthem in their early years lasts for the greater\\npart of their lives, and in many cases forever.\\nThey may, with the passing years, obtain\\nworldly experience, they may acquire the polish\\nwhich social intercourse and thought give;", "height": "4360", "width": "2820", "jp2-path": "careofchildinhea00oppe_0209.jp2"}, "206": {"fulltext": "194 THE CARE OF THE CHILD IN HEALTH\\nnevertheless, the common rule demonstrates\\nthat they rarely obtain the perfect ease, repose,\\nand finished culture of manner which distin-\\nguish the man who is born and brought up in a\\nhome of refinement and good breeding. The\\npeasant s cottage may contain as many sterling\\nvirtues as exist in a house which has sheltered\\ngenerations of scholars and gentlemen; but\\npeasants come forth from the former, and gen-\\ntlemen from the latter. We are too apt in the\\npresent day the time of the so-called common\\npeople to deride the advantages of birth and\\nto exalt unduly the rough and ready manner\\nthat, fortunately enough, may sometimes go\\nhand in hand with sterling and manly qualities\\nbut the fact remains that the habit of gracious\\nand modest bearing, of sweet-toned and har-\\nmonious demeanor, cannot be put on like a\\ngarment. One must grow into it, one must\\nincorporate it as an integral part of oneself, one\\nmust breathe it in as one breathes the air that\\ncleanses the blood.\\nYet another habit that grows with the child s\\ngrowth is his use of language, and the accent\\nthat marks his speech. As the parents talk, so\\nwill the child talk. The ear becomes so habitu-\\nated to certain sounds and inflexions, the eye", "height": "4360", "width": "2892", "jp2-path": "careofchildinhea00oppe_0210.jp2"}, "207": {"fulltext": "HABITS 195\\nbecomes so used to certain motions of the lips\\nand face, the muscles of the tongue and lips\\nbecome so accustomed to certain movements,\\nthat they finally come to act in these ways as a\\nsort of second nature. Parents who are scru-\\npulous of the exactness of their phrases, of the\\ncorrectness of their grammar, of the purity of\\ntheir expression, are providing a daily training\\nthat will be of invaluable assistance to their\\noffspring. Colloquial speech must be taken\\nseriously, for the child is unable to distinguish\\nbetween good and bad usage. Slovenly Eng-\\nlish is as good in his ears as exact English, and\\nthe only absolute standard for him is present\\nusage. It is as easy in early childhood to\\nobtain a large and carefully differentiated\\nvocabulary as a small and undiscriminating\\none but the difference between the two in later\\nlife, when success depends to so large a degree\\nupon spoken intercourse, is very great. In\\nchildhood the acquirement of language and its\\nrefinements is a matter of unconscious develop-\\nment; later on it is an act of conscious effort\\nwhich consumes both time and energy. For\\nsuch reasons parents must watch their words,\\nthe framing of their sentences, and the faith-\\nfulness with which the words express their", "height": "4360", "width": "2820", "jp2-path": "careofchildinhea00oppe_0211.jp2"}, "208": {"fulltext": "196 THE CARE OF THE CHILD IN HEALTH\\nmeaning, as they would their acts and the inter-\\npretation which children would naturally place\\nupon them.\\nSo far we have been considering general\\nhabits, which have much to do with giving\\ncharacter to speech. In addition there are par-\\nticular and peculiar habits which, although they\\nhave a more individual bearing, are worthy of\\ncareful attention. The usual habit of speech is\\nan approximately even flow of words which more\\nor less closely express the child s meaning.\\nBut there are exceptions where the flow of words\\nmay not be even, or where they express little or\\nno meaning. Some children have difficulty in\\nuttering the syllables of words. The trouble\\nis not plainly associated with particular sounds,\\nbut rather with the clear, sharp, and unob-\\nstructed attack with which syllables and words\\nare begun and the continuity which binds them\\ntogether. No more than the first sound is\\nmade, and this is repeated with growing rapidity\\nand embarrassment as the speaker s nervous\\nspasm increases; finally, the whole word may\\ncome out as if forced by a strong effort against\\nan obstacle. This habit is what people call\\nstuttering. It has no connection with defects\\nof the speech organs, but rather should be", "height": "4360", "width": "2908", "jp2-path": "careofchildinhea00oppe_0212.jp2"}, "209": {"fulltext": "HABITS 197\\nregarded as a combination of nervous poverty,\\nlack of self-control, and, in many cases, imita-\\ntion. It has no more reason for existence than\\nother habits of defective speech, such as drawl-\\ning, hurrying, senseless and wearisome repe-\\ntitions of sounds, words, or phrases, or the\\nprolonged use of babyish pronunciations. The\\nstutterer can be cured of his fault both easily\\nand quickly, if he is taken in hand at the out-\\nbreak of the habit. He must be made to speak\\nslowly and evenly; he must, as soon as he starts\\nto stutter, be stopped, quieted, and told to\\nbegin again. He must be faithfully drilled in\\nrepeating words and sentences until ease of\\nspeech is as inevitable as lack of ease formerly\\nwas. The parent or teacher must be patient,\\ngentle, and persevering and outbreaks of tem-\\nper will do more to confirm the bad habit than\\ncan be undone by half a dozen lessons.\\nA related habit that is often confounded with\\nstuttering is stammering. This shows itself in\\nan inability to pronounce individual syllables or\\nsounds readily and distinctly. It may be the\\nresult of imitation alone, but often that effect is\\naugmented by nervous poverty and exhaustion.\\nThere may, likewise, be some defect or disability\\nof the organs of speech which limits the func-", "height": "4352", "width": "2820", "jp2-path": "careofchildinhea00oppe_0213.jp2"}, "210": {"fulltext": "198 THE CARE OF THE CHILD IN HEALTH\\ntional activity. Thus, the child may have a\\ntongue-tie, or hare-lip, and cleft palate or the\\npharyngeal tonsil may be hypertrophied, and,\\nas a result, the normal development and shape\\nof the nose and upper jaw may be arrested or\\ndeflected. This small list is no more than a\\npart of what may exist, but it is capable of\\nshowing how varied may be the influences\\nwhich interfere with ordinary speech. There-\\nfore, when a child begins to stammer he should\\nfirst be taken to a skilled physician for examina-\\ntion and, if necessary, treatment. After that,\\none may begin with careful instruction in cor-\\nrect speech. Instead of purely physical dis-\\nabilities or the influence of bad example, there\\noccasionally occurs a case of defective speech\\nhabit that is due to nothing except mental and\\nnervous deficiency. As an example, one may\\ntake the curious phenomenon of echolalia, in\\nwhich the child will repeat again and again a\\nword or phrase that has happened to strike his\\nattention. Such manifestations, and those more\\nstartling ones, like functional aphasia, should be\\nimmediately referred to the skilled specialist.\\nIn the same manner that a child may contract\\nbad habits of speech, he may also learn unfor-\\ntunate customs in other respects. At times the", "height": "4360", "width": "2916", "jp2-path": "careofchildinhea00oppe_0214.jp2"}, "211": {"fulltext": "HABITS 199\\norigin of them is mysterious, and their persist-\\nence is often equally noteworthy. In this cate-\\ngory one may include the vicious practice of\\nnail biting, the evils of which are so plain that\\nthey need no demonstration. The children\\nwho practice it are almost always nervously\\ndepressed, or even congenitally asthenic; and\\ntherefore, outside of any measures which one\\nmay adopt to discourage them, the broader idea\\nof the systemic need of treatment should always\\nbe kept in mind. To paint the nails with\\nbitter solutions in order to give a bad taste to\\nthem is good enough in its way, but it does not\\ngo as deeply into the matter as it ought, nor\\ndoes it search out the root of the trouble. This\\nattempt at a radical rather than a provisional\\ncure falls in line with the main thesis of this\\nchapter: that habits are the expression of\\nrepeated impresses upon the mind, and to make\\nor unmake them one must steadily keep before\\none s eyes the fundamental laws of psychology\\ninstead of a merely unreasoning encouragement\\nof this manifestation or an irrational dis-\\ncouragement of that symptom.\\nThe need of a definite plan is especially to\\nbe seen in such a deplorable habit as that of\\nmasturbation. This is an especially good", "height": "4356", "width": "2820", "jp2-path": "careofchildinhea00oppe_0215.jp2"}, "212": {"fulltext": "200 THE CARE OF THE CHILD IN HEALTH\\nexample, because it must seem to everybody\\nunnatural, destructive, and utterly vicious. It\\nis more common than parents are usually will-\\ning to confess, and in many instances it flour-\\nishes for years before the mother discovers it.\\nIn many cases which have come under my notice\\nthe practice existed from a very early age, and\\nsome have begun very shortly after infancy.\\nSuch children should not be regarded as natu-\\nrally depraved and vicious, nor should their\\nunfortunate habit be hidden and left unex-\\nplored. On the contrary, all the details and\\naspects of the case must be fully investigated,\\nand a searching inquiry into the probable cause\\nof the defect must be made. A mere forbidding\\nof the practice or the infliction of a punishment\\nis neither rational nor effective one can hope\\nfor much greater ultimate success if one will\\ncarefully and patiently try to pick out the factor\\nthat is making the undesirable impressions upon\\nnerve-cells. In some cases it is a deformity or\\nphysical peculiarity, such as a long and tight\\nforeskin in a boy, or an adherent clitoris in a\\ngirl; in others it is the bad example of vicious\\nnurses or companions in yet others it may be\\nsome lesion in the central nervous system. In\\nthe first case, surgical measures will give relief;", "height": "4360", "width": "2900", "jp2-path": "careofchildinhea00oppe_0216.jp2"}, "213": {"fulltext": "HABITS 201\\nin the second, changed environment, firm but\\nkind correction, and tireless watchfulness will\\nbe of distinct service; and in the third, medical\\ntreatment or the use of hypnotism may diminish\\nor obliterate the evil. But in every case one\\nof the main factors is the recognition of what a\\nhabit really is, as well as the earnest attempt to\\nprovide a cure that is as insistent and stead-\\nfast as the impressions which it is intended to\\nremove.\\nIf one would embody such an ideal in the\\nstandards that are placed before children, the\\nbenefit which they would obtain must be really\\ngreat. The habits of persistence, of concentra-\\ntion, of self-control, are unquestionably suscep-\\ntible of being taught and being learned. And\\nin most cases this method is the surest means\\nof inculcating such characteristics. A few ex-\\nceptional persons may arrive at the same result\\nspontaneously or by experience but as a rule,\\nthe most reliable way of obtaining desirable\\nmental conditions is the slow and positive one\\nof imitative habit. In the little affairs of a\\nchild, he can, in his small way, exhibit quali-\\nties that will in later times make him a better,\\nstronger man than the average, and the world a\\nbetter one for his having lived in it. There is", "height": "4348", "width": "2848", "jp2-path": "careofchildinhea00oppe_0217.jp2"}, "214": {"fulltext": "202 THE CARE OF THE CHILD IN HEALTH\\nno reason why his youthful disposition should\\nbe allowed to vacillate in its native unsteadi-\\nness; and at the same time these habits need\\nbring no burden of crushing discipline upon\\nhim. On the contrary, if he sees these habits\\nin his environment, in the characters of his\\nparents and guardians, and in the applications\\nof stories and tales to ordinary life, he will,\\nunconsciously or sub-consciously, take them to\\nhimself as he takes any less laudable conceptions\\nof conduct. The habits of a child or a youth,\\nlooked at from this view-point, are not entirely\\ndue to himself; and whatever praise or blame\\nthey provoke belong only in part to him. The\\nparents and guardians are fully as responsible\\nas he, and possibly more responsible than he.\\nIf he is industrious, law-abiding, and decent in\\ndemeanor, they may feel a reasonable amount of\\nself-congratulation. If he is deceitful, lazy,\\nand vicious, they should look well into their\\nown lives for the controlling factors. They do\\nonly a part of their duty if their external life\\nis what the world calls respectable while their\\nprivate and intimate deeds and thoughts are\\nfaulty. A child cares very little about respect-\\nability; he is strikingly direct in forming his\\nideas and estimations. And what affects him", "height": "4360", "width": "2940", "jp2-path": "careofchildinhea00oppe_0218.jp2"}, "215": {"fulltext": "HABITS 203\\nmost is intrinsic intentions rather than extrin-\\nsic appearances. The care of a normal child\\nconsists of much more than providing shelter,\\nfood, clothing, and conventional instruction;\\nfully as much, it includes the living of such\\nlives by the parents as will approximate in the\\nclosest possible degree to the ideal which they\\nhope to see in him. The parents must look to\\nit that their days must be times of high think-\\ning, of clean and pure living, of strenuous en-\\ndeavor, of devotion to what they consider noble\\nand fine for by means of their offspring they\\nproject their own individualities upon the\\nworld. They may be satisfied to have low\\naims for themselves but they have no right to\\nimpose similarly poor aspirations upon their\\nchild, and condemn him to a grovelling exist-\\nence.", "height": "4360", "width": "2820", "jp2-path": "careofchildinhea00oppe_0219.jp2"}, "216": {"fulltext": "CHAPTER X\\nRELATION OF PARENTS TO CHILDREN\\nThe proper care of a child is a method of\\nhigher education for the parents. The subject-\\nmatter is so various, the attention to details is\\nso exact, and the self-devotion is so constant,\\nthat one cannot be far wrong in calling it the\\nhighest education. This standpoint, if logi-\\ncally adhered to, will create a distinction\\nbetween the poorer methods of rearing children\\nthat were in use in the past and the better ones\\ntoward which the thought of to-day is moving.\\nIn past times children were taught to regard\\nthemselves as being troublesome, stupid, with-\\nout knowledge, judgment, or tact. The rule\\nthat children should be seen and not heard car-\\nried its crushing influence through all their\\nlittle lives. They were excluded from family\\nand social functions, they were allowed to take\\nno more than a very small part in the domestic\\ncouncils and confidences, and their personal\\naffairs were deemed too unimportant to admit\\n204", "height": "4360", "width": "2900", "jp2-path": "careofchildinhea00oppe_0220.jp2"}, "217": {"fulltext": "RELATION OF PARENTS TO CHILDREN 205\\nof much notice. In a word, they were made to\\nfeel that their existence demanded an excuse,\\nand that assertion of their individualities was\\nalmost domestic treason. In families of limited\\nmeans they were made to work beyond their\\ncapacity, and their duties were turned into bur-\\ndens among the wealthy the custom of handing\\nthem over to the care of nurses and governesses,\\nso that the parents saw little of them, and had\\nless to do with their rearing, was almost univer-\\nsal. If one looks at such customs objectively\\nand frankly, one would think that children were\\nsome sort of semi-civilized animal, whose nat-\\nural wildness required strong measures for its\\ncontrol, and whose companionship was to be\\nendured and not desired.\\nWe have come to regard these things some-\\nwhat differently now. We realize that children\\nare fully as human as their elders, that they\\nhave hopes and aspirations, fears and doubts,\\njoys and sorrows, in much the same way as their\\nparents. It is true that their lack of experience\\ngives them a deficient sense of proportion, and\\nthat their ignorance of worldliness leads them\\nto make curiously literal interpretations of\\npersons and things. But these characteristics\\nare in many ways advantages rather than dis-", "height": "4360", "width": "2820", "jp2-path": "careofchildinhea00oppe_0221.jp2"}, "218": {"fulltext": "206 THE CARE OF THE CHILD IN HEALTH\\nadvantages. The children are placed in their\\nparents hands not only helpless, but also\\nunformed; not only dependent, but also claim-\\ning progressively greater attention; not only\\npossessing possibilities of good, but also possi-\\nbilities of evil. The choice of these alternatives\\ndoes not lie with them, but with the parents.\\nThe children must submit to whatever decision\\nis made for them, and the unfolding of their\\nlives depends upon the fitness of the father and\\nmother to direct, encourage, and repress the\\nvarious characteristics that have need of such\\ncontrol.\\nIn order to do this work, thoughtfulness and\\ndevotion are absolutely essential. Good inten-\\ntions are a meagre foundation for the noble\\nsuperstructure of requirements which the cir-\\ncumstances demand. A woman might as well\\ntry to substitute good intentions for a knowledge\\nof cooking when preparing a meal, or a man for\\nthe ordinary information of commercial forms\\nwhen trying to conduct a business. Intuitive\\nfeeling and hearsay instruction are a poor\\nenough makeshift for a knowledge of how to\\nfeed and clothe and dress a child but when they\\npresume to dictate the manner of building up a\\ndefinitely good relation between child and", "height": "4360", "width": "2884", "jp2-path": "careofchildinhea00oppe_0222.jp2"}, "219": {"fulltext": "RELATION OF PARENTS TO CHILDREN 207\\nparent, as well as the formation of a clear,\\nhealthy atmosphere in the home, the task imme-\\ndiately becomes greater than reasonable expec-\\ntation can hope to see fulfilled. So long as this\\nis true, there is an obligation for the parent to\\nconsider the subject in all its aspects, and to\\nascertain how far he must progress beyond his\\nexisting limitations in order to satisfy the\\nrightful claims of the situation.\\nFirst of all, he should consider what the child\\nis, what he ought to become, and what are the\\nmeans at hand to bring about the desired end.\\nThe little one comes unformed, unwitting of\\nevery fact of life, absolutely ignorant of what\\nthis world, in all its myriad manifestations,\\nreally is. These things and many more he must\\nlearn from his parents and the environment\\nwhich they provide. What they are to teach\\nhim is not only what they have learned, but\\nwhat they themselves are. And the environ-\\nment means much more than the apartments in\\nwhich they live and the furniture which they\\nuse; in addition, it means the spirit which\\npervades the home, the intentions that lie at\\nthe basis of their action, and the self-control\\nby which they maintain a nice equilibrium of\\nheart and mind in all the varying and trying", "height": "4356", "width": "2820", "jp2-path": "careofchildinhea00oppe_0223.jp2"}, "220": {"fulltext": "208 THE CARE OF THE CHILD IN HEALTH\\ncircumstances that are incidental to ordinary\\nlife. This conception includes within its\\nbounds all people the rich and poor, the igno-\\nrant and the learned, the resident of the city\\nand the dweller in the country. It embodies a\\ntruth of human nature which is so broad that it\\nadmits of universal application. By such a\\nmethod of reasoning we arrive at a wide gener-\\nalization, which is the beginning and the end\\nof the art of wise parenthood: the influence of\\nparents is the direct reflection of their lives and\\nthoughts. Here is a field where deceit cannot\\nlong abide, where in the long run honesty\\ncounts for a quality of unlimited value, where\\nsacrifice to a healthy ideahbrings its rewards in\\nprogressively increasing amounts.\\nIt is very hard to deceive a child, although\\nhe is young and simple. Indeed, even at the\\nearliest age, and when he is far from being capa-\\nble of analysis, he shows a marked adaptability\\nin receiving impressions. His plasticity is so\\ngreat that it assumes the likeness of an active\\ninfluence, as a sponge fills out with the water\\nin which it floats. Therefore, the time to begin\\nforming a child s disposition or character is\\nreally at birth, or even before birth. Do the\\nparents wish him to be kind-hearted, gentle,", "height": "4360", "width": "2884", "jp2-path": "careofchildinhea00oppe_0224.jp2"}, "221": {"fulltext": "RELATION OF PARENTS TO CHILDREN 209\\nfrank, and honest; do they wish him to be\\ndeferential to women, sturdy to the world,\\nhearty and unselfish in his manner to compan-\\nions? Then they themselves must consider\\nwhat these qualities are, they must incorporate\\nthem in their own thoughts and acts, and finally,\\nthey must demonstrate them in the big and the\\nlittle details of everyday life.\\nIn order to clear the ground for more particu-\\nlar considerations, another preliminary fact\\nmust be disposed of. The place and importance\\nof the nurse-maid are commonly exaggerated.\\nShe is regarded as being more necessary than\\nshe really is, and, in the ordinary case, she is\\ntoo much depended upon as well as too much\\ncourted. In the families of the poor, or those\\nof ordinary means, the choice is made from the\\nleast experienced and helpful girls; for the\\nparents believe that anybody is good enough to\\nwheel a baby-carriage or carry the baby. In\\nthe wealthiest families a somewhat more sophis-\\nticated person is demanded; but the sophisti-\\ncation usually concerns matters of externals\\nrather than real fitness. It is undoubtedly true\\nthat the large majority of these servants have\\nvery little real fitness for their work. They\\nhave received no real and efficient training,", "height": "4356", "width": "2820", "jp2-path": "careofchildinhea00oppe_0225.jp2"}, "222": {"fulltext": "210 THE CARE OF THE CHILD IN HEALTH\\nthey are commonly ignorant, and the most\\nfavorable thing that one can say for them is\\nthat they may be actuated by a decent amount\\nof good intentions. The incongruity of the\\nwhole situation is remarkably striking: the mis-\\ntress of the house will often assume the personal\\ncare and supervision of her fine china or a fine\\npicture, and she would never think of putting\\na piece of old lace in the custody of a chance\\nservant; but a child is evidently considered\\nless valuable or less susceptible to injury.\\nSince every mother naturally believes that her\\nbaby is the most precious thing on earth, the\\nconclusion naturally follows that she does not\\nrealize how intimately he may be and is influ-\\nenced by early companionship.\\nThis touches the very root of the whole\\nmatter: the child is susceptible to impressions\\nof one sort or another from the earliest age.\\nThat is the time when the forming of his char-\\nacter and his distinctive traits begins. The\\nmere fact that he does not immediately demon-\\nstrate the effects has little to do with the case.\\nAn illustration of a similarly slow but sure\\neffect may be seen in the unconscious growth\\nof speech. A very young infant who hears a\\ncertain language or dialect is naturally uncon-", "height": "4360", "width": "2892", "jp2-path": "careofchildinhea00oppe_0226.jp2"}, "223": {"fulltext": "RELATION OF PARENTS TO CHILDREN 211\\nscious of its character is tic peculiarities, but,\\nnevertheless, within a few weeks or months he\\nbegins with inevitable certainty to use that\\nlanguage or dialect. If this were the place to\\ngo into the discussion of the physiology of\\nnerve-impressions, it would be no difficult\\nmatter to demonstrate how the same rule applies\\nto the other factors involved in growth. And,\\nwithout argument, any one can see that what\\nis true of learning words and accent is, in a\\nsimilar way, true of the elements of conduct; it\\nis no more than another step to recognize that\\nthe elementary parts of conduct the motives,\\nfeelings, and passions of the person may like-\\nwise be transmitted. And thus we arrive at\\nthe conclusion that the earliest companionship\\nof a child is a matter of grave importance. To\\nplace such responsibility upon an uninstructed,\\nuncultured, unthinking young girl is reckless\\nit is wilful extravagance of the worst sort it\\nmeans throwing away the opportunity of pro-\\nducing the highest results, of making the closest\\nbonds between child and parent, and really\\ninvites indifference, misunderstanding, and\\ndivision of purposes to be permanent residents\\nin the home.\\nThe care and rearing of a child are matters of", "height": "4360", "width": "2820", "jp2-path": "careofchildinhea00oppe_0227.jp2"}, "224": {"fulltext": "212 THE CARE OF THE CHILD IN HEALTH\\nsuch importance that the mother alone should\\nbe intrusted with them. It is not out of the\\nway for her to take an assistant to do the rough\\nwork, the fetching and the carrying. But the\\npersonal part of the service belongs only to her.\\nShe is the one who will ultimately reap the\\nrewards of good or bad training, and she is like-\\nwise the one who must provide the essentials\\nof that training. She must enter into the prob-\\nlem so earnestly that her duties will at the\\nsame time be pleasures. Even if she were so\\nabnormally constituted that parental love did\\nnot impel her to work out all the possibilities\\nof the situation to their full extent, neverthe-\\nless, there is a sufficient field for the exercise\\nof finished powers of observation, of fertile\\nsuggestion, of ready tact, of logical reason-\\ning enough to busy a thoroughly active\\nmind.\\nFrom the earliest months she must live with\\nher child; she should wash him, nurse him, put\\nhim to sleep, take him in the air for his exercise.\\nAs he grows older she must provide and direct\\nhis amusements, from the earliest time, when\\nevery sound and sight are new facts to his\\nunfolding senses, to the period when his pleas-\\nures and duties resemble those of adults. She", "height": "4360", "width": "2904", "jp2-path": "careofchildinhea00oppe_0228.jp2"}, "225": {"fulltext": "RELATION OF PARENTS TO CHILDREN 213\\nmust guard him from careless or rough handling,\\nmust enforce a kind but firm discipline, must\\nteach him to be dependent upon her more than\\nupon any other person in the household. At this\\ntime the father cannot expect to take a large\\nshare in the baby s training, for the necessities\\nof his business will keep him away during most\\nof the little one s waking hours, and, in addi-\\ntion, he cannot be expected to have the deft\\ntouch and the intuitive knowledge of an infant s\\nneeds that a normal mother possesses. But he\\ncan be of decided use in maintaining a quiet,\\npeaceful, cheerful atmosphere in the home; he\\ncan give efficient help by keeping tempers\\nunruffled and minds cheerful and, most of all,\\nhe can develop a spirit of courtesy, of sweetness\\nof manner, even of chivalry. Such things are\\nmore than mere counsels of perfection; they\\nshould rather be called practical directions for\\nthe building up of strong nerves, normal bodies,\\nand healthy minds. And the man who con-\\nscientiously endeavors to embody them will find\\nthat they react upon him, and serve to ennoble\\nhis own disposition.\\nWhen the child is old enough to run about,\\nhe should live a large part of the day in the air,\\nand all confinement must be reduced to the", "height": "4360", "width": "2852", "jp2-path": "careofchildinhea00oppe_0229.jp2"}, "226": {"fulltext": "214 THE CARE OF THE CHILD IN HEALTH\\nminimum. To follow this idea to its fullest con-\\nclusions, he should, if possible, be taken to a\\nhome in the country or the suburbs. While it\\nis obviously impossible for the large majority of\\npeople to have a home in both city and country,\\nit is plainly feasible for almost anybody who is\\nsufficiently thoughtful of the interests of his\\noffspring to reside where the houses are not\\npacked together, where there is an abundance\\nof air and light, where there is no continuous\\nrumble and roar of a big city s traffic. The\\nmodern means of communication are so excel-\\nlent that a man who works in the heart of a\\ngreat city may reach his home outside of that\\ncity s limits without undergoing too much\\nstrain and exertion. People of limited means\\ncan live as well and as cheaply in the suburbs\\nor country as in town, and at the same time\\nhave advantages of healthfulness, quiet, and\\nrecreation which can in no other way be ob-\\ntained. The strongest objection that can be\\nurged against a country or suburban home is\\nthe one of overcoming the city habit or the leav-\\ning of a social circle both of which are of\\nlittle importance in comparison to the benefits\\nto be obtained by the change.\\nAfter this matter has been settled, the parents", "height": "4388", "width": "2896", "jp2-path": "careofchildinhea00oppe_0230.jp2"}, "227": {"fulltext": "RELATION OF PARENTS TO CHILDREN 215\\nmust make up their minds that the family must\\nbe united, not only in the sense of mutual affec-\\ntion, but also in daily interests, in studies, in\\npleasures. Of all these items the one of pleas-\\nures most concerns the growing child. It\\nstands, in his estimation, for the greater part of\\nlife, and by means of it his parents must come\\nclosely in touch with him. Many of their own\\namusements may have to be thrown over they\\nmay go less to the theatre, may indulge less in\\nsocial pleasures, they may have less personal\\nquiet than they formerly had; but the exchange\\nwill be a richly profitable one. There is no\\nreason why parents should not find as interest-\\ning material in their own children as they do in\\nstrangers or acquaintances; there is no reason\\nwhy they should not take as lively an interest\\nin the conversation of their offspring as they do\\nin that of their neighbors or their ministers,\\ntheir doctor or their lawyer. Often the little\\nones are not too deficient in the reasoning\\nquality, and commonly they possess more than\\nthe adult share of lively imagination. At all\\nevents, parents can find in intimate intercourse\\nwith their children much to learn, much to\\nstimulate them and keep them fresh, much to\\nlend a zest to life. They can thus review their", "height": "4360", "width": "2820", "jp2-path": "careofchildinhea00oppe_0231.jp2"}, "228": {"fulltext": "216 THE CAKE OF THE CHILD IN HEALTH\\nyouth, and, by combining the spontaneity of the\\nlittle ones with their own more mature powers,\\nthey need have no fear of growing old, or of find-\\ning time hang heavily on them.\\nTo do all this there must be similar objec-\\ntive points in the domestic life for the various\\nmembers of the family. Each one must feel\\nthat there are certain duties and pieces of work\\nwhich he must perform, and that every other\\none has obligations which are arranged accord-\\ning to his capacity. Children, even those of a\\nvery youthful age, can understand this to a sur-\\nprising extent. In almost all instances they\\nrespond remarkably well to appeals, especially\\nthose which are made by conduct and example,\\nrather than words, to their sense of justice and\\nfair play. And, from the earliest possible time,\\neach boy or girl must feel that he is a factor in\\nthe household, that he can and does render\\nsome sort of valuable aid, that he is a respon-\\nsible person whose presence is worth being\\ntaken into account. The value of his actual\\nwork may be little, but that of his potential\\naccomplishment is truly great. And no time\\nis too soon to teach him to live on a high plane.\\nSuch teaching can easily and naturally be com-\\nbined without any stiffness of attitude in the", "height": "4360", "width": "2880", "jp2-path": "careofchildinhea00oppe_0232.jp2"}, "229": {"fulltext": "RELATION OF PARENTS TO CHILDREN 217\\nordinary affairs of the day. When the father\\nreturns from his work he may participate in con-\\nversations, games, or readings in which he may\\ningeniously weave amusement and instruction.\\nAnd if he feels that he has insufficient funds of\\nthought and experience for the task, let him set\\nout as a serious matter to obtain what is lack-\\ning. Children are tolerant critics, and fre-\\nquently are satisfied with a wholesome intention\\neven when performance is bungling.\\nOn half-holidays and Sundays he should be\\nwith his little ones in the open; in summer\\nthere are rambles in the woods, in the fields,\\nalong the roads, he may suggest fishing, flower-\\npicking, butterfly-hunting excursions and\\nmany a time he will find that the questions\\nwhich are thrown at him will encourage him\\nto increase his store of knowledge. In autumn\\nthey may go nut-gathering, leaf -collecting. In\\nwinter there are skating, coasting, snow-ball-\\ning, the construction and manning of snow\\nforts, and all the other sports that are dear to\\nchildren s hearts. And in all of them he\\nshould take a hearty part, while at the same\\ntime he acts as a judge, a moderator, an ex-\\nample of fairness, of chivalry, and of courage.\\nThe girls as well as the boys should be his", "height": "4352", "width": "2856", "jp2-path": "careofchildinhea00oppe_0233.jp2"}, "230": {"fulltext": "218 THE CARE OF THE CHILD IN HEALTH\\ncompanions, and they need have no distinctly-\\nseparate lives until they are about twelve\\nyears old. They have as keen a need as their\\nbrothers for strong bodies and free minds, and\\nuntil the approach of puberty they should not\\nbe too forcibly reminded of the difference in sex.\\nThis question brings up the weighty matter\\nof how the parents may control the dawning\\nknowledge of what sex is, and what the mean-\\ning of puberty is. In most families the subject\\nis avoided, and both girls and boys are allowed\\nto find out for themselves the changes that sep-\\narate the child from the youth. The main rea-\\nsons which govern such a policy of laissez-faire\\nare the parents unwillingness from consider-\\nations of modesty to touch on the subject too\\nprematurely, and the general unfitness which\\nthey usually feel to handle the details in a sat-\\nisfactory way. The first reason is not well\\ngrounded, because the question of modesty con-\\nsists largely in how the communications are\\nmade and no one doubts that a father or a\\nmother will use much more delicacy, will try\\ninfinitely harder to give the requisite infor-\\nmation, than servants, young companions, or\\nchance acquaintances. In most cases when\\nparents are forced to explain, they find that", "height": "4360", "width": "2884", "jp2-path": "careofchildinhea00oppe_0234.jp2"}, "231": {"fulltext": "RELATION OF PARENTS TO CHILDREN 219\\ntheir children have already a surprising and\\noccasionally an appalling amount of knowledge.\\nAnd the impressions which are the first to be\\nreceived are commonly the last to be lost. The\\nquestion of inability or unfitness to state the\\ndetails is a more practical one, but it is by no\\nmeans unsurmountable. A man or woman of\\nfair intelligence, culture, and tact ought after\\nsome thought to be able to inform the child of\\nhow he is constructed, how his body and mind\\ndevelop, and how the development fits into\\nthe scheme of nature. If this is impossible the\\nfamily physician is usually able to supply the\\ndeficiency. Commonly he has a sufficient knowl-\\nedge of natural history to give, in the course\\nof a walk or a series of walks, a rapid account\\nof the development of plants, with illustrations\\nfrom the flowers and trees which he encounters;\\nthen to progress to the growth and generation\\nof fishes, then of animals, and finally of human\\nbeings. And by the exercise of good judgment\\nand a fair amount of delicacy he cannot only\\npresent the subject in a pure light, but also he\\ncan impress the child s mind with the idea of\\nmaternal self-sacrifice, devotion, and love which\\nare the necessary factors of the mother s relation\\nto her offspring. Thus, instead of this com-", "height": "4360", "width": "2820", "jp2-path": "careofchildinhea00oppe_0235.jp2"}, "232": {"fulltext": "220 THE CAKE OF THE CHILD IN HEALTH\\nmunication being the cause of misgiving and\\ndread, it may easily be turned into an oppor-\\ntunity of cementing ties of affection and pro-\\nmoting in the child s mind the sense of life-long\\nobligation.\\nThis is the spirit that should underlie the\\nintercourse between parent and child, a spirit\\nof carefulness, of frankness, of willing teaching,\\nand equally willing learning. The child must\\nunder no circumstances be forced to feel that in\\nany respect the full sympathy and cooperation\\nof his parents are lacking. He must be made\\nto believe that there is no concern so trivial, no\\nsecret so profound, no event so momentous that\\nhis parents are not the first to recognize and\\nappreciate his emotions, his natural or acquired\\nimpulses, his triumphs and defeats. He must\\nbe made to feel that his home is the place where\\nhe is most welcome, where he can obtain most\\nenjoyment. The opportunity of having fun is\\none of the mainsprings of youthful life, for it\\nrepresents the possibility of the easy and pleasant\\ndischarge of youthful energy, of the exercise of\\nexpanding capabilities. Therefore it is in this\\ndirection that as much of the home life as possible\\nshould be directed; and at the same time the nec-\\nessary duties which every person, according to", "height": "4384", "width": "2916", "jp2-path": "careofchildinhea00oppe_0236.jp2"}, "233": {"fulltext": "RELATION OF PARENTS TO CHILDREN 221\\nhis age, should undertake must be so bound up\\nwith these pleasant features, that a flush of enjoy-\\nment spreads over the whole course of the day.\\nIt is not hard to apply the same plan to the\\ncompanionships which every child is bound to\\nmake. Let him feel that his friends are wel-\\ncome, let him invite them to take part in his\\nwalks, games, and his rainy afternoons in-doors.\\nThe parents should become acquainted with these\\nchildren, should exercise a wise choice among\\nthem, not so much by condemning some as by\\npraising others. Among children even more\\nthan among adults the generalization holds true\\nthat those of like disposition and training will\\nflock together for children have less of the\\nulterior and worldly to influence their choice.\\nAnd if they are well directed, their companions\\nare apt to be unobjectionable. At all events\\nthese friends are, as far as is feasible, to be taken\\ninto the family circle; they must be made to feel\\nthe heartiness of sentiment, the frankness, the\\nlack of suspicion and prejudice that characterize\\nthe ideal home. They should be invited to par-\\nticipate in the games, rambles, and excursions\\nthat the children of the house enjoy, they must\\nbe encouraged to form clubs of various sorts,\\nthey must be instructed in what ways to direct", "height": "4360", "width": "2820", "jp2-path": "careofchildinhea00oppe_0237.jp2"}, "234": {"fulltext": "222 THE CARE OF THE CHILD IN HEALTH\\ntheir attention, and how to maintain a sense of\\ngood fellowship and chivalry. In all these\\nenterprises the heads of the house must take\\npart not for a single day may they allow their\\ninterest to flag. This last admonition is, in a\\nway, unnecessary for if they have carried out\\nsuch a plan during their children s early years\\nthe habit will have grown so strong, the enjoy-\\nment will have been so keen, and the freshness\\nof their later years will be so striking that the\\npossibility of adopting a different mode of life\\nis barely possible.\\nThe gist of the matter lies in the doctrine of\\nunselfishness. It is only by giving up the\\nnarrow, egoistic traits in one s character that\\none can develop a strong tendency toward gen-\\nerosity in one s children it is only by extin-\\nguishing whatever of the boor is in one that\\nchivalry in one s offspring can be elicited it is\\nonly by crushing out the sullen and sulky parts\\nof oneself that the full joy and beauty of life\\ncan be brought out in others. Children are\\nexquisitely human, delicately sensitive to im-\\npressions, acute in detecting shams. And if\\none hopes to make them loving and lovable,\\nrespecting and respectable, brave and gentle,\\none must as a fundamental preliminary live out", "height": "4396", "width": "2904", "jp2-path": "careofchildinhea00oppe_0238.jp2"}, "235": {"fulltext": "RELATION OF PARENTS TO CHILDREN 223\\nthese qualities in one s own life, and simultane-\\nously try to crush out their antitheses. A child\\nmay be deceived once or twice or thrice but\\nhe cannot be fooled for years; he knows and\\ncares nothing about expediency, but acts out\\nthe thoughts and emotions which his environ-\\nment awakens. The parents are the head and\\nthe centre of that environment, their animus is\\nthe greatest force which forms the growing\\ncharacter, and their success as rearers of off-\\nspring are usually to be measured by the intrinsic\\nworth of their own souls. We have been told\\nthat men who desire immortality must, by a con-\\nscious effort, throw off the characteristics of\\nmortality; and it is fully as true that those who\\nwish to live again in children of noble minds\\nmust first of all lose the traits which seem to\\nwise men ignoble. This constant training in\\nthe search of an ideal is one of the finest things\\nthat human minds can conceive, this strenuous\\neffort to stamp out the vicious parts of one-\\nself is the real salvation in this world. It may\\nbe a good enough thing to try to save one s\\nsoul, especially if the saving be not too exclu-\\nsive but it is far better to try to mould one s\\nlife so that one s children may be saved. The\\nstandard of effort has happily changed within", "height": "4360", "width": "2820", "jp2-path": "careofchildinhea00oppe_0239.jp2"}, "236": {"fulltext": "224 THE CARE OF THE CHILD IN HEALTH\\nthe last two or three centuries. Men do not,\\nas formerly, seek a selfish beatitude they have\\nsubstituted for that a broader charity, a more\\ninclusive love. And whatever they owe to\\ntheir children is better expressed in terms of\\ndaily life and immediate home influence than\\ndistant deeds of valor and pauperizing obedience\\nto heavenly laws which bear the smell of earth.\\nIt is a good thing to change the tense of our\\nendeavors: to strive for present happiness and\\njoy and love, instead of looking for some future\\nbliss which stands out in a black background of\\nothers damnation.", "height": "4400", "width": "2820", "jp2-path": "careofchildinhea00oppe_0240.jp2"}, "237": {"fulltext": "CHAPTER XI\\nEDUCATION\\nEducation, as we commonly know it, is a\\npurely formal matter that is encouraged for the\\ndouble purpose of conventionality and conven-\\nience. We take it for granted that every person\\nshould receive a school training that is the\\ncustom of the time, and unconsciously we con-\\ncede the rightfulness of it. We likewise be-\\nlieve it is a profitable thing to have, because it\\nmakes the possessor more capable of advance-\\nment in the world than he otherwise would be.\\nThe added reason of obtaining an education for\\nits own sake, for the purpose of obtaining cul-\\ntural influences, is often regarded as superfluous\\nor at best as rightfully belonging to youth and\\nadult life, and more especially to those persons\\nof demonstrated ability or of fortunately large\\nfinancial resources. Very often the cultural\\nelement is regarded as a detriment, because it is\\nsupposed to render the possessor less hardy and\\naggressive than he otherwise would be, and\\nq 225", "height": "4360", "width": "2820", "jp2-path": "careofchildinhea00oppe_0241.jp2"}, "238": {"fulltext": "226 THE CARE OF THE CHILD IN HEALTH\\ntherefore less able to fight his way through the\\nworld. Since there is plainly some error in-\\nvolved in these views, and especially as there\\nseems to be no common factor which unites\\nthem, it is worth while to examine the subject\\nand attempt to clear the way for the forming of\\nmore worthy opinions.\\nThe discussion rests mainly upon the ques-\\ntions involved in what constitutes a desirable\\ncourse of instruction, what is the age when\\ninstruction should begin, and what should be\\nthe order of the prescribed studies. All this\\ntakes for granted the elementary facts that all\\nchildren need to be taught, and that the teach-\\ning of comparatively young children should be\\nthe same in all classes of society without regard\\nto future work. For, whether the child is des-\\ntined to be a banker, a merchant, a clergyman,\\nor a bookkeeper, he needs the primary training\\nwhich will serve to shape his mental growth in\\na healthful and profitable fashion. In consid-\\nering the present methods one is immediately\\nimpressed with the idea that with most people\\nthe first year or two of schooling are really not\\nintended for any more serious purpose than to\\noccupy the child s attention, and to keep him\\nquiet. What he learns in the lowest primary", "height": "4388", "width": "2848", "jp2-path": "careofchildinhea00oppe_0242.jp2"}, "239": {"fulltext": "EDUCATION 227\\ngrade is the merest conventionality, which, on\\naccount of his extreme immaturity, means abso-\\nlutely nothing to him more than learning a cer-\\ntain number of sounds by rote. Whether he\\nlearns the alphabet in the old-fashioned way or\\nthe phonetic sounds in the newer fashion, the\\nsame idea holds good. If instead of being\\nstarted in the primary grades at five or six years\\nof age, he is put in the kindergarten at three\\nand a half, four, or five years, the same remark\\nmay truthfully be made. Children are sent to\\nthis latter institution to be amused, to play with\\nothers of their age, to be exercised in songs\\nand games. The instruction whatever there\\nis of it really is a secondary consideration.\\nIndeed, that part which pretends to some merit\\nin the way of formal instruction is least worthy\\nof commendation.\\nSince this has already been treated in another\\nplace l it need not be taken up here. It will be\\nsufficient to say that if amusing the child and\\noccupying his attention are the desired objects,\\nthey can best be obtained by the mother. She\\nis the person who knows the little one most\\nthoroughly, and she ought, more than any mer-\\n1 The Development of the Child, by Nathan Oppen-\\nheim, The Macmillan Company, 1898.", "height": "4360", "width": "2820", "jp2-path": "careofchildinhea00oppe_0243.jp2"}, "240": {"fulltext": "228 THE CARE OF THE CHILD IN HEALTH\\ncenary person, to be able to sympathize with\\nhim, to recognize his needs as well as his pecul-\\niarities. The main objection that can be urged\\nagainst her undertaking this work is ignorance\\nof its technique. That objection is easily over-\\ncome by learning the principal practices of the\\nkindergartnerin. This would not necessarily\\nbe a heavy task, and certainly it does not\\nrequire the same amount of time that the learn-\\ning of a profession or a complicated business\\ndemands. On the other hand, if it is really of\\nuse in helping the child s development, its\\nvalue is notably greater than any ordinary pro-\\nfessional or business career. Under all circum-\\nstances, the first years of a child s life should\\nbe spent in the companionship and under the\\ncontrol of the mother, who should endeavor to\\nacquire sufficient training to give her confi-\\ndence in her fitness for the work.\\nThis preparation should not be left until the\\nchild is old enough to attend the kindergarten,\\nbut rather should be acquired long before he is\\nborn. The mother must be ready to instruct\\nher child as soon as he is susceptible of instruc-\\ntion. This time is never fixed. In some chil-\\ndren it begins at the age of a few weeks, in\\nothers when they are a few months old. At all", "height": "4400", "width": "2876", "jp2-path": "careofchildinhea00oppe_0244.jp2"}, "241": {"fulltext": "EDUCATION 229\\nevents, it does not logically begin at the usual\\nschool age. There is only one way in deciding\\nwhat the right time is, and that is by deciding\\nwhat we mean by education. Is it to prepare\\nthe child to support himself, to give him the\\nmeans to become a bread-winner? Then the\\ntraining should come comparatively late, when\\nhis body, as well as his mind, is sufficiently\\nmatured to hold a recognizably approximate\\nrelation to its final and adult form. Is it to\\nserve as mental training, to fit the child s\\nintelligence for its later problems? Then\\nthe methods and curriculum must be changed,\\nmust be adapted to the stage of the child s\\ndevelopment and his personal traits. Is it to\\namuse him, to keep him occupied and out of\\nmischief? Then the widest liberty of choice\\nmust be the rule; rigid duties do not exist,\\nstrict teleological calculations are superfluous,\\nand most of the routine of the ordinary school\\nlife is not required. In all likelihood the\\nmajority of mothers would not say that the\\nearliest teaching was to be guided by any one\\nof these plans, and probably they would be of\\nthe opinion that the training should include all\\nthree.\\nBut such catholicity is too comprehensive.", "height": "4352", "width": "2828", "jp2-path": "careofchildinhea00oppe_0245.jp2"}, "242": {"fulltext": "230 THE CARE OF THE CHILD IN HEALTH\\nIt prescribes more than an ordinary child should\\nabsorb, or is able to absorb. We must recog-\\nnize as thoroughly as may be that he represents\\na varying condition, a course in evolution from\\nan almost rudimentary to a highly complex\\nstate. In his earliest condition the only teach-\\ning which should be given him is the teaching\\nof precept and example. This is the time when\\nhe should learn the lessons of imitation, such\\nas speaking one or more languages, funda-\\nmental rules of manner, and elementary ideas\\nof morals and ethics. Likewise, one may create\\na slowly growing, but really cumulative, effect\\nin general aesthetics and in the growth of\\nspecial tastes by arranging the nursery and\\nthe most frequented rooms of the house in ac-\\ncordance with the impression that is desired.\\nFormal instruction by the ordinary didactic\\nmethods should not be employed, and the habit\\nof teaching babies to recite the alphabet, to\\ncount, to recite little poems and stories, has no\\ngood reason for justification. The common\\nexcuse that these things are not taught, but\\nrather picked up by the child on account of\\nhis unusual aptitude is generally a figment of\\nthe imagination instead of cold fact. Very\\noften it is possible that the mother may con-", "height": "4388", "width": "2852", "jp2-path": "careofchildinhea00oppe_0246.jp2"}, "243": {"fulltext": "EDUCATION 231\\nsciously not do the teaching; but if she does\\nnot, then the nurse or some relative does. It\\ndoes not require much perspicacity to recognize\\nthat whatever teaching is to be done belongs in\\nthe earliest age to the creating of general and\\nmassive impressions there should be little or\\nno attempt to particularize, to impart details,\\nnor to elicit exactness. By setting an example,\\nby creating an atmosphere which is honestly\\nfashioned in the way we wish the child to grow,\\nand by honestly endeavoring to embody in our\\neveryday lives the ideal which we want the\\nchild to absorb, is the simplest and best train-\\ning for the under-kindergarten age.\\nWhile the demands of the time do not allow\\nthe child to go without formal instruction of\\nsome sort, one should certainly keep in mind\\nthe tendency toward a premature beginning.\\nThis is to be feared for the double reason that\\nmany teachers are becoming disposed to accept\\nchildren who are under the kindergarten age,\\nand that some unwise parents want to see some\\neducational result which the teaching is sup-\\nposed to bring about. But at this early age\\nvery little excepting the most general employ-\\nment should be given. Games, songs, and con-\\nversations may be very useful, especially if they", "height": "4360", "width": "2820", "jp2-path": "careofchildinhea00oppe_0247.jp2"}, "244": {"fulltext": "232 THE CARE OF THE CHILD IN HEALTH\\nare not too heavily laden with a didactic import.\\nAttempts to explain the meaning of occupations,\\nwhich the games may typify, are very apt to be\\nuseless, if only for the reason that the child-\\nmind is unable to grasp the fundamental facts\\nand necessities for them. The main objective\\npoint in the games and conversations is the\\ndirecting of the imagination and the emotions\\nwithin such limits as may define what mature\\npersons call the normal, the righteous, and the\\ngenerous. At the early age in question the\\nchild is probably receptive to such training, but\\nscarcely to any other. His sense organs are\\nnot well matured, and with the passage of suffi-\\ncient time they will develop far enough to be\\nsusceptible of keen cultivation. The apprecia-\\ntion of the differences between colors, of various\\ndegrees of hardness and weight, of tenacity and\\nresistance of one object and another, may well\\nbe left to a future time, to the experience which,\\ncomes with added years. And all efforts to\\ndevelop the reasoning powers are yet more\\nfutile, for the fact of pure intelligence can\\nscarcely be called existent in the brain which\\nlacks many of the anatomical features that later\\nin life are bound to appear. But the control of\\nthe emotions, conduct, and the imagination is", "height": "4396", "width": "2892", "jp2-path": "careofchildinhea00oppe_0248.jp2"}, "245": {"fulltext": "EDUCATION 233\\nan elementary principle that comes into being\\nwith the first flourishing of human life, and\\ncontinues to a greater or less extent while life\\ncontinues. This is the true function of the\\nkindergarten, and if rightly administered it\\nmay be of the highest importance. The ability\\nto restrain anger is infinitely more valuable than\\nskill in passing colored wools through holes in\\na piece of cardboard; and learning to be cheer-\\nful, frank, and honest is not to be compared\\nwith ability to weave strips of colored paper.\\nTeaching the motions which a blacksmith uses\\nat the forge may be interesing enough, if noth-\\ning better is at hand; but it certainly is less\\nvaluable than guiding the mind by practical and\\ninteresting illustrations toward the beauties of\\nfilial and parental love, of the obligation of\\nduty, of the excellences of normal subordination.\\nThe functions of the kindergarten are largely\\nconcerned with ethics. The relation of the\\nchild to society at large depends upon the ethi-\\ncal sense of the community, of which he, in\\ntime, must form an active member. The task\\nof acquiring a healthy, normal, ethical feeling\\nis a difficult one, but it may be taught as surely\\nas other modes of personal expression. The\\nlearning of such tendencies belongs to the period", "height": "4360", "width": "2820", "jp2-path": "careofchildinhea00oppe_0249.jp2"}, "246": {"fulltext": "234 THE CARE OF THE CHILD IN HEALTH\\nof early childhood, when the impressions which\\nare most easily received are the general and\\nmassive ones. And while they are being\\nacquired the child undergoes no danger of\\nbeing harmed by a routine that is not fitted for\\nthe degree of his evolution. There is no pos-\\nsible danger of straining weak eyes, of filling\\nthe immature head with temporary and ofttimes\\nuseless memories, or of giving to artificial edu-\\ncational concepts the all-important place that\\nreally should be held by ideas of duty and\\ndependence.\\nIn the primary school a notable change could\\nlikewise be made with advantage to the child s\\ngrowth of mind and the amount of his informa-\\ntion. Under the present circumstances the\\nnumber of subjects in the curriculum is too\\ngreat, the subjects themselves are not carefully\\nenough selected, and their relative importance\\nhas not been rightfully determined. Parents\\nhave been going in the same path that their\\nancestors took, in believing that one subject\\nwas as valuable and as necessary as another, and\\nthat the knowledge which is desirable for a\\nyouth or an adult must likewise be desirable for\\na child. In this way the daily routine has been\\noverburdened; and as the requirements of the", "height": "4400", "width": "2908", "jp2-path": "careofchildinhea00oppe_0250.jp2"}, "247": {"fulltext": "EDUCATION 235\\ntimes have increased, the increased load has\\nbeen put upon the young child, the representa-\\ntive of the weakest part of life. Thus, instead\\nof lessening his work, the authorities, spurred\\non by a mistaken sense of duty, have been\\nenlarging it. They have reasoned that because\\nthe man must know arithmetic, the young boy\\nmust as early as possible take it up; that\\nbecause the one must know how to spell cor-\\nrectly, the other must as soon as possible load\\nhis memory with combinations of sound that\\nusually mean nothing to him; that because the\\nformer should speak correct English, the latter\\nmust be tormented with the abstract rules of\\ntheoretical grammar that never yet have made\\nhim see the error of his youthful speech.\\nAs a mattter of fact, the studies should be\\narranged according to the child s state of men-\\ntal growth; topics which are beyond his years\\nshould be put to one side until such times when\\nhe is easily able to master them, and his general\\nwork should be made as inviting as possible,\\nrather than the opposite. As an example, one\\nmay quote the case of arithmetic, probably the\\nworst offender in the whole list. The intelli-\\ngent study and comprehension of this subject\\nare obtained only in the presence of considerable", "height": "4360", "width": "2820", "jp2-path": "careofchildinhea00oppe_0251.jp2"}, "248": {"fulltext": "236 THE CARE OF THE CHILD IN HEALTH\\nintellectual power of a certain sort. It repre-\\nsents abstractions that are difficult to grasp;\\nand it becomes of use, both as mental train-\\ning and as matter of information, only when\\nit is plainly grasped as an abstraction. In\\nall other circumstances the act of learning\\nnumbers, or arithmetic, is merely memorizing,\\na parrotlike performance that is both weaiy-\\ning and debilitating. The child that begins\\nto stud) arithmetic at five or six years of\\nage really wastes both time and energy for the\\nnext five or six years. For if the subject were\\nbegun when he had reached the age of eleven\\nor twelve, he would, under proper instruction,\\nprogress as far in one and a half or two years as\\nhe would under the other plan have taken about\\nseven to accomplish. Here is a clear waste of\\ntime, but it is exceeded by the waste of mental\\nenerg}^, interest, and spontaneity, which is of\\nmuch more account.\\nEqual fault may be found with the studjr of\\ngrammar. It is too theoretical, too abstract,\\nand, in addition, it exerts no influence on the\\nscholar s language. It is a type of wrong and\\ndifficult methods of teaching: the use of the\\nabstract before the concrete has been used and\\nunderstood. A boy may learn every rule con-", "height": "4392", "width": "2876", "jp2-path": "careofchildinhea00oppe_0252.jp2"}, "249": {"fulltext": "EDUCATION 237\\ncerning subject and object, predicate and adjec-\\ntive; but the language which he uses will be\\nwhat he has been hearing. On the other hand,\\nhe may be absolutely ignorant of rule or excep-\\ntion and in the same manner he will take his\\nspeech from the people with whom he passes his\\ntime. The children of cultured parents will\\nspeak correctly and with a good accent; the\\nchildren of crude parents will speak incorrectly\\nand with a bad accent. And a pile of grammars\\nas high as a house will never change these\\nfacts. The only time when the study of gram-\\nmar may be expected to do real good is when\\nthe student is old enough to have an active self-\\ncontrol and analysis, when his self-conscious-\\nness is great enough to restrain his acts, speech,\\nand even his thoughts. Then, when pride is\\nawake and ambition is stirring, when self-inter-\\nest has aroused all the energy of endeavor, the\\nstudy of grammar may be both profitable and\\nuseful. In earlier times it is, like arithmetic,\\nas useless as it is burdensome.\\nIn all likelihood the conservative reformer\\nmay find fault with the use of the spelling-\\nbook. The learning of the literal composition\\nof a word is a form of memory which is made\\nup of repeated visual and auditory impressions.", "height": "4360", "width": "2780", "jp2-path": "careofchildinhea00oppe_0253.jp2"}, "250": {"fulltext": "238 THE CARE OF THE CHILD IN HEALTH\\nSuch impressions are most easily received and\\nretained if they occur in connection with known\\nfacts and ideas, such as are obtained in the\\ncourse of reading an interesting narrative; and\\nthe hardest way to acquire them is the bare and\\nunassociated act of memory. The act of learn-\\ning the appearance of isolated words and memo-\\nrizing the separate sounds that constitute them\\nis a thoroughly laborious one and the results\\ndo not justify the expenditure of time and\\nenergy expended. If this study were postponed\\nuntil the faculty of observation had been fairly\\nwell exercised, and until experience in reading\\nhad made a comparatively large number of words\\nfamiliar to eye and ear, the process of knowing\\nhow those words looked and sounded would be\\nmuch more easily and rationally acquired. If\\nwe follow such a method of thinking to its ap-\\nplication in other directions, we shall be forced\\nto lay less stress than we now do on the early\\nteaching of penmanship according to a rigid\\ncopy. When the fingers and eyes are inexpe-\\nrienced and weak, the recognition of the essen-\\ntial points in writing are apprehended with\\ndifficulty and expressed very poorly. More-\\nover, minute and slavish copying is hard on the\\nyoung child s undisciplined faculties. There", "height": "4408", "width": "2864", "jp2-path": "careofchildinhea00oppe_0254.jp2"}, "251": {"fulltext": "EDUCATION 239\\nis a general rule in human development which\\ncovers the fact that the inhibitory centres are\\namong the latest to attain flourishing strength;\\nif this idea is translated into more common\\nphraseology it might read: the power to restrain\\ncomes later than the ability to act or express\\nmotion. This statement corresponds to the\\ncommon experience of children in the hardship\\nof exact imitation of a small copy. Not only\\ntheoretically, but also practically, it would be\\neasier for a young child to learn to draw simple\\nand large objects free-hand than to acquire\\nfacility in neat and graceful writing.\\nThe study of geography is taken up too early\\nin the routine of school work; and, as a result,\\nthe effects which it produces upon the ordinary\\nchild s mind is a confused one, a matter of ill-\\nassorted patches. A young boy or girl is un-\\nable to appreciate the striking nature of the\\nearth s rotundity, of the correct inter-relation-\\nship of parallels of latitude and longitude as\\ndepicted on maps, of the physical disposition\\nof land and sea. The usual plane maps mean\\nvery little to such a scholar, whose imagination\\nis not sufficiently trained to translate the plane\\nsurface into terms of the shape and form of the\\nearth. The boundaries of the various coun-", "height": "4360", "width": "2820", "jp2-path": "careofchildinhea00oppe_0255.jp2"}, "252": {"fulltext": "240 THE CARE OF THE CHILD IN HEALTH\\ntries are learned as rigid divisions, in the\\nsame artificial way that one house is marked\\noff by its walls from another. No efficient\\nmeans are generally used to convey a satisfac-\\ntory conception of these political communities,\\ntheir distinctive traits, their resources and in-\\ndustries, their physical relations to one another,\\nand the main facts of information concerning\\ntheir peoples. The true view of a country, in\\nthe light of its organic growth, is practically\\nnever held by young school children.\\nIt is easy enough to verify these statements.\\nIn order to do so parents should occasionally\\nvisit their children s classes. I have done this\\nfairly often, and have always had profitable\\nexperiences. One of the occasions which im-\\npressed me was a visit to a public school in\\nNew York City, where I listened to a boy of\\nabout eight years, who, in the course of his\\nrecitation, said that Pennsylvania was the\\ncapital of Philadelphia, and that George Wash-\\nington was a brave British general. When\\nthe teacher was asked whether that was a\\ntype of all the recitations, she retorted, What\\ncan you expect of a child of eight At\\nother times and in other schools I have heard\\nrecitations that were no more exact, and I have", "height": "4384", "width": "2820", "jp2-path": "careofchildinhea00oppe_0256.jp2"}, "253": {"fulltext": "EDUCATION 241\\nalways murmured to myself the exclamatory\\nquotation given above. Although the illustra-\\ntion may seem an extreme one, nevertheless, it\\ndoes not misrepresent the mental condition of a\\nlarge part of the primary scholars in regard to\\nthis subject. In some respects it is character-\\nistic of what an observer will meet in most of\\nhis visits.\\nGeography, then, like the other studies men-\\ntioned, does not belong in the curriculum of the\\nprimary grade. But, if it is to be retained, its\\npresent form and method of teaching should be\\naltered. It would be quite in place to teach\\nyoung children what the physical divisions of\\nland and water are, what the differences in cli-\\nmate are, what the characteristic occupations\\nand manner of life are that belong to each, and\\nwhat sort of people is to be found in each. All\\nthis should be taught in a practical fashion\\nrather than by words alone. If a large room\\nwere fitted up to represent continents, islands,\\npeninsulas, oceans, lakes, and rivers; if the\\ndifferent zones were depicted in gross present-\\nments with satisfactory examples of their inhab-\\nitants, their occupations, the fauna, the flora,\\nand the distinctive geological formation, the\\nchild s mind might be pleasantly occupied,", "height": "4360", "width": "2780", "jp2-path": "careofchildinhea00oppe_0257.jp2"}, "254": {"fulltext": "242 THE CARE OF THE CHILD IN HEALTH\\nas it would be with a story, and some funda-\\nmental information might be imparted that\\nwould require comparatively little discrimina-\\ntion, little rote memorizing, and almost no\\nfatigue. Upon such a foundation a solid\\nsuperstructure of geographical information\\nmight be built when the child is twelve, thir-\\nteen, or more years of age, which would be\\ndurable and at the same time easily reared.\\nIf the ordinarily intelligent parent will take\\nthe trouble to examine the course of study in\\nthe primary grade, and if he will allow himself\\nto think fearlessly and unrestrainedly, he will\\nsoon be convinced that many of the studies may\\nnot only without detriment, but also with bene-\\nfit, be dropped. And when he has reached this\\nconclusion, he will invariably want to know\\nwhat is to fill the gaps. This is not hard to\\ndecide upon, so long as the general condition of\\nthe child is understood. One must keep in\\nmind the scholar s disinclination to bear long-\\ncontinued restraint, his lack of concentration,\\nlack of mental self-control, his inability to deal\\nwith abstractions, the lack of the reasoning\\nfaculty, his deficient store of memories and as-\\nsociations, and his love of novelty and change.\\nAll this would require the teaching to be as little", "height": "4404", "width": "2820", "jp2-path": "careofchildinhea00oppe_0258.jp2"}, "255": {"fulltext": "EDUCATION 243\\nformal as possible, would diminish the desira-\\nbility of rigid recitations from memory, would\\nincrease the amount of narrative work, and of\\ninstruction that was susceptible of the story-\\ntelling form. Languages that were taught by\\nthe so-called natural method wxmld have a more\\nimportant place, and would be taken up at an\\nearlier age than is now the custom; and all\\nstudies that could be prosecuted in the practical\\nmanner which was suggested when speaking\\nof geography, would have a welcome. In addi-\\ntion, some studies should be held out of doors,\\nor on roof-gardens, with which schoolhouses\\ncould easily be provided. The teaching should\\nbe made a pleasure, a form of instructive recrea-\\ntion, of useful pastime that involves movement,\\nfrequent change of occupation and subject, and\\nof the vigorous exercise of the imagination.\\nIn this connection it is pertinent to speak of\\nthe ethical and religious, as well as the so-called\\ncommon education for it is hard to separate the\\nthree, unless one means creed when one says\\nreligion. Ethical training may be regarded\\nas defining the attitude which a person holds\\ntoward his fellow-men; religious training as\\ndefining the attitude which he holds toward the\\nDeity or his conception of the Deity. The one", "height": "4360", "width": "2776", "jp2-path": "careofchildinhea00oppe_0259.jp2"}, "256": {"fulltext": "244 THE CARE OF THE CHILD IN HEALTH\\nis a material relation illumined with a spiritual\\nglow, the other is an expression of a spiritual\\neffort that is dulled and weakened by the mate-\\nrial self of the believer. Both are modes of\\nprojecting the personality, of expressing a men-\\ntal impulse which varies according to circum-\\nstances of environment and opportunity\\npossibly of natural disposition. Both have a\\nsoft and mellow hue which at times makes it\\nhard to distinguish between them; and under\\nall circumstances the penumbra which they\\nthrow impinge upon one another, causing a\\nblending which cannot be called by one name\\nor another. Under such an aspect they are\\nadmirable, most of all when they originate in a\\nspontaneous or purposeful movement of one s\\nmind, which is no more than a reflection of one s\\nbest intentions.\\nUnfortunately, the usual interpretation of\\nreligion does not very closely coincide with this.\\nOn the other hand, it is often no more than a\\nhard distortion of it, which involves many\\nunfavorable traits in its developed form. And\\nthe mental attitude of a child is such as to show\\nthese unfavorable traits in a repulsive light.\\nThe child is unable to grasp the full spiritual\\nimport of religion, he sees none of its possible", "height": "4404", "width": "2840", "jp2-path": "careofchildinhea00oppe_0260.jp2"}, "257": {"fulltext": "EDUCATION 245\\nexcellences of typification, none of its poten-\\ntialities of endeavor, none of the opportunities\\nof restfulness, of hope, and of satisfied longing.\\nInstead, he grasps no more than a complicated\\nsystem of admonitions and commands, which is\\ncommonly exercised with the expectation of\\npossessing a correctional value. The behests\\nof religion are for him negative in their nature\\nthey prescribe what he may not do and even if\\nthey are put in a positive form, they stand for\\nthe negation of what he wants to do. His idea\\nof the Deity is a purely anthropomorphic one.\\nHe conceives of God as a huge man whose power\\nto punish bad children is frightful, and whose\\npromise to reward good children bears no imme-\\ndiate likelihood of fulfilment in a form that is\\nappreciable. As a result, the control which\\nsuch an influence comes to have over him may\\nbe aptly compared to the terror inspired by a\\nthreat to call the black man, the big police-\\nman, or the boogy man. It is a low form of\\nsuasion, a confession of inability in the parents\\nto control their child s behavior, and a reliance\\nupon means of restraint that are equally deroga-\\ntory to them and debasing to him. The forms\\nof religion he regards as a mere show or display,\\nto be put on the same plane as any other exhi-", "height": "4360", "width": "2812", "jp2-path": "careofchildinhea00oppe_0261.jp2"}, "258": {"fulltext": "246 THE CAKE OF THE CHILD IN HEALTH\\nbition that is attractive when it is novel, and\\ntiresome when it is no longer new. For him\\nthe rite of baptism holds no meaning, the eleva-\\ntion of the host a deeply impressive ceremony\\ncarries no significance; he sees the accom-\\npaniments of fine buildings, notable congrega-\\ntions of men and women, and the imitation\\nby all of a formula which he cannot under-\\nstand.\\nThis factor of imitation is one of the main\\ntraits with which we must reckon in our efforts\\nto produce a commendable moral or spiritual\\ntone. This plainly does not apply to the teach-\\ning of a creed; for such a matter has no uni-\\nversal truth or fitness. The teaching of one sect\\nis fully as likely to be desirable or undesirable\\nas another. And a formula that fits the needs\\nof one person may bear quite the opposite re-\\nlation to his brother or his neighbor. More-\\nover, we can never know whether the creed\\nin question has a final value in the potential\\ndevelopment of a certain child, or whether it\\nmay not act as a hindrance to him, whether\\nit is not an artificial creation which, in later\\nyears, may provoke the sentiments of rebel-\\nlion, distrust in his estimate of his parents\\nhonesty, and discord with the whole idea of", "height": "4392", "width": "2912", "jp2-path": "careofchildinhea00oppe_0262.jp2"}, "259": {"fulltext": "EDUCATION 247\\nspiritual control. But in the sphere of ethics,\\nof pure morals, there exists a field for instruc-\\ntion that is perfect in its possibilities. It is\\napplicable to every family, to every community,\\nto every nation. It is the standard of conduct\\nby which the civilized world marks its progress\\nfrom a lower to a higher grade of organized cul-\\nture. Above all, it is a code which applies as\\nwell to the ignorant as the enlightened, to the\\nadult as to the child, to all creeds and all\\npeoples. It is the gist of all religions, without\\nwhich they represent no more than a mere shell\\nthat is hard, unyielding, and unpalatable. A\\nchild may be unable to appreciate the esoteric\\nsymbolism of the immaculate conception, or the\\nTrinity, the doctrine of total depravity, or the\\nregenerating power of baptism; but he surely\\nis capable of knowing the import of the golden\\nrule, of mercy, of charity, of good intention, of\\nhonesty, and of kindly deeds. He may be infi-\\nnitely far from highly appreciating the worth of\\na torturing hell, of infant damnation, of escha-\\ntology, of demonology, or angelology; but he\\ncertainly, and without much delay, can recog-\\nnize the power of virtue, of forbearance, of\\nloyalty, of truth, and of modesty. The one is\\nan abstraction which belongs to a later age,", "height": "4360", "width": "2768", "jp2-path": "careofchildinhea00oppe_0263.jp2"}, "260": {"fulltext": "248 THE CARE OF THE CHILD 1ST HEALTH\\nwhen the reason should make its choice of\\nbeliefs that are to act as the immaterial guide\\nto a definite tendency of spiritual life. The\\nother is or may be represented as a concrete\\nformation of acts that may be learned as any\\nother method of conduct, the repeated perform-\\nance of which inevitably tends to create a\\nmental condition that is its analogue.\\nAnd one of the principal advantages of such\\ntraining is the necessity of the parents and\\nguardians to live up to a similar standard.\\nSuch conduct is learned by example and prac-\\ntice more than by preaching. A man may be a\\npillar of the church, but if his daily life is not\\nentirely in accord with his theoretical profes-\\nsions, he will create upon his child the bad\\neffect of insincerity in place of the desired\\neffect of holiness. This is undoubtedly at the\\nroot of the strange and seemingly unnatural\\ndeviations from a much emphasized plan of life,\\nwhich every one has noticed in the families of\\ncertain ministers and other pious people. The\\nparents may be good enough men, as men go\\ntheir professions and public acts may be highly\\ncommendable, and to the eyes of their little\\nworld they may seem to be models of thought\\nand action. But in their private and intimate", "height": "4360", "width": "2924", "jp2-path": "careofchildinhea00oppe_0264.jp2"}, "261": {"fulltext": "EDUCATION 249\\nlives one usually may find the elements of cant,\\nof insincerity, of make-believe, of a weak grasp\\non material and immaterial things, of mild\\nregrets and halting endeavor.\\nThis brings to a clear focus the idea of edu-\\ncating a child. It is not necessary to cram his\\nhead with many facts, most of which he cannot\\nuse, and for which he is not prepared. Nor is\\na rigid curriculum, which may merit our respect\\non account of its antiquity, necessarily the best.\\nMost of all it is futile to gauge a child s needs\\nby an adult s. The child s business is no more\\nthan to prepare for his work and his struggles\\nin life; but the adult s is to grapple with the\\nwork and the struggles in an aggressive, mas-\\nterful, and intelligent manner. The best\\nfoundation for an efficient training is the pos-\\nsession of a vigorous mind and body that have\\nnot been divorced from their native strength by\\nartificial methods which have been devised upon\\na misapprehension of what the child s condition\\nreally is. The child should not be forced into\\na Procrustean mould rather he should be nour-\\nished, he should be strengthened, and his bud-\\nding functions should be guided within the\\nlimits of their own natural channel. His imi-\\ntative faculty must be used instead of his", "height": "4360", "width": "2736", "jp2-path": "careofchildinhea00oppe_0265.jp2"}, "262": {"fulltext": "V\\n250 THE CARE OF THE CHILD IN HEALTH\\nreason for the former is present from the ear-\\nliest age, while the latter is the gradual growth\\nof his later development. The education of a\\nchild, considered from this standpoint, means\\nthe continuous education of every member of the\\nwhole race. It stands for the development of\\nevery better feeling of which man is capable,\\nof the self-restraint that marks him off from\\nlower orders of animal life, of the hope, and the\\nliving in the future, that is an index of his best\\naspirations. The true teacher is the parent,\\nwho should be as unwilling to resign this func-\\ntion as he would to lose his most precious birth-\\nright. Parenthood includes within its wide\\nconfines the teacher s place as surely as it\\nincludes the generator s, the protector s, and\\nthe advisor s. And too much may not with\\nsafety be left to bought assistance.", "height": "4360", "width": "2924", "jp2-path": "careofchildinhea00oppe_0266.jp2"}, "263": {"fulltext": "CHAPTER XII\\nDEFECTIVE CHILDREN\\nIt would be out of place in a book on the care\\nof the normal child to describe and discuss all\\nthe marked deficiencies which exist in idiocy,\\ninsanity, and radical perversions from the nor-\\nmal; but between the two extremes there are\\na large number of degrees of imperfection which\\nare commonly misunderstood, neglected, or hid-\\nden. Indeed, one might truly say that parents\\ncan have no logical idea of what a normal child\\nis unless at the same time they possess some\\nknowledge of what is meant by abnormality.\\nThis is a matter in which the greatest frank-\\nness should be used; for in order to correct\\nthe deficiencies, one must thoroughly under-\\nstand their causation, nature, extent, and\\nprobable outcome. It is undoubtedly true\\nthat most families that have a deficient child\\nhide the fact as much as possible, believing that\\nby such means they are preventing the outside\\nworld from interfering with his future work\\n251", "height": "4360", "width": "2748", "jp2-path": "careofchildinhea00oppe_0267.jp2"}, "264": {"fulltext": "252 THE CARE OF THE CHILD EST HEALTH\\nand prospects. Most of all, they fear that the\\nreputation of having a defective in the family\\nwould interfere with the estimation in which\\nthe world holds the other children, would\\ndiminish their opportunities of forming advan-\\ntageous commercial and matrimonial engage-\\nments.\\nThis wish for secrecy is its own worst enemy.\\nIt perpetuates a blind belief in the unchange-\\nable nature of a defect, of its probable existence\\nin the whole family, of the likelihood of its\\nreappearance in offspring. Moreover, it deters\\nfrom seeking advice and relief, and of necessity\\ncauses the condition to remain unchanged.\\nThis is infinitely unfortunate, for there is no\\ndoubt that many of the defects and their sequels\\ncan be ameliorated, even if they cannot abso-\\nlutely be cured. The methods are not gener-\\nally understood, for the double reason that too\\nlittle discrimination is commonly employed in\\nascertaining the cause and the exact amount of\\ndamage, and because the treatment is neither\\nradical nor startling, but slow, long drawn out,\\nand, possibly, discouraging. Nevertheless, so\\nlong as there is a rational hope of ultimate\\nimprovement, the parents have a duty to per-\\nform in using every possible means to obtain it.", "height": "4360", "width": "2932", "jp2-path": "careofchildinhea00oppe_0268.jp2"}, "265": {"fulltext": "DEFECTIVE CHILDREN 253\\nIn trying to understand the facts of physical\\nand mental defectiveness, one must, first of all,\\nrecognize its modes of occurrence. The injury\\nmay be congenital or may occur after birth.\\nThe congenital cases include microcephalus,\\nhydrocephalus, cretinism, birth-paralysis, gen-\\neral disturbance of nervous equilibrium, and a\\nwide range of intellectual hebetudes associated\\nwith the tuberculous diathesis, or certain low\\nforms of development which are known by the\\nname of mongol or kalmuc. In micro-\\ncephalus the brain is much smaller than usual;\\nits arrangement of convolutions is too simple,\\nand its texture is doubtless coarser than it ought\\nto be. The skull is small, it tends to come to\\na point at the top, and possesses a receding\\nforehead and a flattened occipital portion. The\\nchin, as a rule, recedes sharply, and the gen-\\neral expression is one of vacuity and weakness.\\nThis condition has no sharply defined limits,\\nbut exists in so many grades that not a few\\nmicrocephalic children are susceptible of enough\\nimprovement to give them a bearable position\\nin the world. Under this heading one would\\nplace those children in whom some part of the\\nbrain is absent, atrophied, or impaired. The\\nscope is thus very wide, and actually should be", "height": "4360", "width": "2744", "jp2-path": "careofchildinhea00oppe_0269.jp2"}, "266": {"fulltext": "254 THE CARE OF THE CHILD IN HEALTH\\nmade to include persons who are said to be\\nslightly backward, not over bright, or\\nsimple-minded.\\nCongenital hydrocephalus means a brain\\nthat at birth contains a relatively large quantity\\nof water or serum. The head is large, especially\\nabove the upper level of the ears, the forehead\\nis high and bulging, the occipital portion may\\nbe notably increased, the fontanelle remains\\npatent, and the bones of the skull are very soft\\nand yielding. The abnormal amount of fluid\\ncauses general pressure, retards growth, inhibits\\nnutrition, and prevents normal functioning.\\nThe result is a curious combination of a huge\\nhead and a really small brain. Associated with\\nthis deformity is a general weakness of the\\nbody, a liability to wasting diseases, and a\\ncomparatively small resistance against convul-\\nsions and other cerebral symptoms which are\\ndue to pressure.\\nCretinism is a remarkable condition which\\noccurs endemically in certain localities of Swit-\\nzerland and France. In the last few years an\\nincreasing number of cases have appeared in\\nthis country. The disease is associated with an\\natrophy or absence of the thyroid gland, and\\nhas as its apparent symptoms a dwarfing of the", "height": "4384", "width": "2928", "jp2-path": "careofchildinhea00oppe_0270.jp2"}, "267": {"fulltext": "DEFECTIVE CHILDREN 255\\nbody and mind, thick and flabby skin, a protu-\\nberant belly, a large and projecting tongue,\\nbroadly set and full eyes, undeveloped face, and\\nthick cranial bones. The subjects of congenital\\ncretinism do not seem to have much vitality,\\nand easily fall into conditions of marked weak-\\nness. The sporadic cases are oftener seen in\\nthis country than the congenital, and have a\\nbetter chance of life. But the general dwarfing\\nis fully as marked in the former as in the latter,\\nso that a cretin of twenty years of age may look\\nno more than six, eight, or ten years old. In\\nall these cases the wonderful improvement\\nwhich modern methods of treatment have made\\npossible is a standing rebuke to those who\\ndespair of helping defectives.\\nBirth-paralysis results when some part of the\\nbody has, during or shortly before parturition,\\nbeen subjected to long-continued pressure.\\nThere is a widespread belief among anxious\\nmothers that the obstetric forceps is responsible\\nfor a large proportion of these unfortunate con-\\nditions. As a matter of fact the opposite is true.\\nThe instrument shortens the duration of tedious\\nlabors for hours or even days, thereby reducing\\nthe amount of danger. Moreover, if it is prop-\\nerly used, the amount of strain which it puts", "height": "4360", "width": "2752", "jp2-path": "careofchildinhea00oppe_0271.jp2"}, "268": {"fulltext": "256 THE CARE OF THE CHILD IN HEALTH\\nupon the child is not great enough to be in-\\njurious. A labor that is long drawn out, that\\ndepresses the mother s physical resources to or\\npast the point of toleration, has an equally bad\\neffect upon the child. And he will feel these\\nunfortunate conditions in proportion to the\\nweakness and immaturity of his organism. In\\nthe obstetric forceps we have an immediate\\nmeans of relief, whose value cannot be too\\nhighly estimated.\\nThe tubercular diathesis is responsible for a\\nlarge proportion of the deficiencies in children.\\nThe process is one of general impoverishment,\\nof weakened cerebral circulation, of depraved\\nnutrition. There is no classic form which it\\nassumes, nor is there any limit at which it must\\nnecessarily stop. Just as the arms and legs\\nmay waste away, the power of digestion dimin-\\nish, and the general vitality sink to a low level,\\nin the same way the mental force may decrease\\nuntil the intellectual status is a pitiable one.\\nIn somewhat analogous ways a defective cir-\\nculation, which is dependent upon some form\\nof congenital heart disease, may occasion an\\nimpoverishment of the cerebral tissues that\\nshows itself in some degree of feeble-mindedness\\nas well as muscular weakness. Yet another", "height": "4388", "width": "2928", "jp2-path": "careofchildinhea00oppe_0272.jp2"}, "269": {"fulltext": "DEFECTIVE CHILDREN 257\\ntype which doubtless originates in perverted or\\ndeficient nutrition is the so-called mongol or\\nkalmuc; it gets its name from the resemblance\\nto the designated races which the facial appear-\\nance suggests, and may be regarded as an in-\\nstance of arrested development. The head is\\nnot large, and the transverse diameter is almost\\nas long as the longitudinal. The eyes are apt to\\nbe obliquely placed, and shaped like an almond;\\nthe hair is harsh and wiry, the skin is coarse,\\nthe tongue is rough and marked by transverse\\nfurrows. Such children represent a condition\\nof general incompleteness, which may be illus-\\ntrated in a partial way by such local deficiencies\\nas cleft palate, hare-lip, and the many rarer de-\\nformities that result from unfinished growth.\\nUnder the heading of non-congenital defi-\\nciencies, the main causes of impaired growth\\nare the results of violence, disease, nervous\\nshock, and serious or long-continued poisoning.\\nThe traumatic cases may follow a blow or fall\\non the head or spine; those dependent upon\\ndisease are the ones that have suffered from\\nmeningitis, scarlet fever, and other disorders\\nthat may affect the brain and its membranes,\\nas well as the organs of special sense. Nervous\\nshock may follow marked terror or fright, such", "height": "4360", "width": "2732", "jp2-path": "careofchildinhea00oppe_0273.jp2"}, "270": {"fulltext": "258 THE CARE OF THE CHILD IN HEALTH\\nas is produced by ghost stories, imminent injury,\\npretended apparitions of the boogy man, or\\neven confinement in the dark. The philosophy\\nof these cases is hard to understand, especially\\nas we have no standard by which to ascertain\\nthe amount of disturbance, nor even do we\\nknow in what organic changes that disturbance\\nresides. We are in an almost equally poor way\\nconcerning the so-called toxic cases, such as\\nfollow a large use af alcohol, opium, and other\\npowerful drugs. And the most that we can\\nsafely conclude is that in some way the circula-\\ntion is weakened, nutrition becomes perverted,\\nand local or general starvation follows.\\nWhen we look at these conditions in large\\nnumbers, we are generally able to recognize\\nsome common factors which may reasonably\\nhave acted as the exciting and active cause.\\nAnd there is a great need for a clear view of\\nthe subject in order that the blame will be\\nrightly placed, and also that there shall not be\\na false opinion hanging upon the efforts to im-\\nprove or cure. For such a reason there is some\\nkeen pleasure in being able to condemn the\\nlikelihood of maternal impressions having\\nan appreciable share in the causality. The\\ntenacity with which this reputed factor main-", "height": "4384", "width": "2924", "jp2-path": "careofchildinhea00oppe_0274.jp2"}, "271": {"fulltext": "DEFECTIVE CHILDREN 259\\ntains its hold upon the popular belief and\\nimagination is truly remarkable. And at the\\nsame time there are almost no good reasons to\\nfortify the belief. If it were possible by a\\nsingle impression upon the mother s mind dur-\\ning the period of pregnancy to give an enduring\\ncharacter to the child s body or mind, or both,\\nan easy way would simultaneously have been\\ndiscovered to influence every unborn child. If\\nthe sight of some startling animal, the news of\\nsome striking event, the appearance of some\\nunfortunate cripple, can blight or harm the\\nfoetus, why should it not be possible to direct\\none child to be a musician, another to be an\\norator, another to be a mechanician, by allowing\\nthe mother to hear respectively a burst of music\\nor a powerful speech, or giving her the oppor-\\ntunity to witness a fine piece of mechanical\\ningenuity Since in every household the busi-\\nness of the family head is apt to take up a large\\npart of the wife s attention and thoughts, there\\nought to be as an inevitable consequence an\\nalmost certain bending of the children s minds\\nin the way of the father s business. But as a\\nmatter of fact we know that a minority of all\\nchildren adopt their father s vocation; and\\nwhen they do, it is rather because of unusual", "height": "4360", "width": "2744", "jp2-path": "careofchildinhea00oppe_0275.jp2"}, "272": {"fulltext": "260 THE CARE OF THE CHILD IN HEALTH\\nadvantages which the inertia of the parent s\\nsuccess may give them than a congenital liking.\\nLet us go yet further and inquire whether, even\\nin cases of marked preference of the parents\\nfor a certain business or profession, the children\\ndo not show a smaller amount of love or ability\\nfor the work in question Perhaps of all voca-\\ntions the one that tinges most strongly every\\ncircumstance of the family s household and\\ngeneral life is the ministerial. And yet it is\\ncomparatively rare to find a preacher s son\\nloving the life and work of a preacher, and\\nlonging to adopt them. Indeed, in the various\\ncallings it is a comparatively common thing to\\nfind that a man s family evince no taste for his\\noccupation, or at most that their approbation is\\nno more than toleration.\\nThe plain fact is that the whole subject of\\nparental impressions is very misty, without\\nwell-defined limits, or clearly understood laws.\\nVigorous parents, who are well nourished, are\\nvery likely to bear vigorous offspring. And\\npersons of weak vitality, especially if thej^ are\\npoorly nurtured, generally have weakened chil-\\ndren. We are able to hand on to our children\\na legacy of our physical constitution and pecu-\\nliarities, or those of our ancestors; or possibly", "height": "4388", "width": "2924", "jp2-path": "careofchildinhea00oppe_0276.jp2"}, "273": {"fulltext": "DEFECTIVE CHILDREN 261\\nthe combination of the innumerable factors in\\nheredity may give a resultant which is different\\nfrom any one of them. The main element in\\nall cases is the quantity and quality of nutri-\\ntion; and the influence of adventitious effects\\nlies in the way of increasing or decreasing that\\nnutrition, of keeping it within straight or\\ncrooked lines. It is not radically different\\nfrom the manner in which children may be\\nmanipulated and influenced after birth.\\nMaternal impressions usually come in the\\nform of a single thought, or perception, or\\nshock; but we rarely find that such a single\\nevent can do much toward making or marring\\nthe mind of a child. If the opposite were true,\\nit would be hard to find a normal or healthy\\nperson for the exigencies of ordinary life make\\nthe occurrence of some sort of shock or unde-\\nsirable maternal impression practically unavoid-\\nable. So strong, indeed, is the tendency of\\nnature to revert to a healthy type, that the soli-\\ntary infraction of physiological law is not often\\nvisited by the penalty of mental abnormality\\nand if we only look back far enough we shall\\nprobably find that such a culmination is reached\\nby the gradations of repeated transgressions.\\nThis statement bears at once a hope and a warn-", "height": "4360", "width": "2744", "jp2-path": "careofchildinhea00oppe_0277.jp2"}, "274": {"fulltext": "262 THE CARE OF THE CHILD IN HEALTH\\ning. One single act may not be exceedingly-\\nimportant in itself, but that act may be the\\nindividual expression of a general tendency\\nwhich must, with each repetition, exaggerate\\nthe tendency to recurrence, or the producing of\\nthe characteristic effects.\\nThis idea is regularly proved in our common\\nexperience. We know quite definitely that\\na tuberculous ancestry diminishes a child s\\nvitality to such an extent as to create a pre-\\ndisposition to contracting local or general\\ntuberculosis; at the same time we know that\\na single instance of tuberculosis in a father, or\\nmother, or grandparent, does not inevitably\\nassure the breaking out of the disease in a child\\nor grandchild. Likewise, although we know\\nthat a majority of defective children have a his-\\ntory of tuberculous ancestry, the fact of a single\\ncase of the disease does not at all mean that\\nevery child who descends from such a stock\\nmust be feeble or abnormal in mind. And,\\nalso, in the same way that we know the possi-\\nbility of building up and developing the body\\nof a child with a tuberculous predisposition, so,\\nlikewise, we may reason that the weak-minded\\noffspring of a family which is similarly con-\\ntaminated may be carried past the limits of", "height": "4360", "width": "2800", "jp2-path": "careofchildinhea00oppe_0278.jp2"}, "275": {"fulltext": "DEFECTIVE CHILDREN 263\\nintellectual poverty into the confines of com-\\nparative intellectual prosperity.\\nAlmost the same train of thought applies to\\nthe defectives whose disabilities have been\\ntraced to parental or ancestral tendencies\\ntoward drunkenness. Not every drunken\\nparent procreates an idiot; but when inherited\\nnervous instability from this or other causes is\\nintensified in the next generation by inju-\\ndicious marriage, or by unfavorable environ-\\nment, instances of mental degeneracy are apt\\nto occur. A single occasion of excessive\\ndrinking would in all probability have very\\nlittle to do with depressing a future child s\\nmental or physical constitution; but habitual\\nexcesses, in parents or ancestors, or even the\\nhabitual use of alcohol to more than a very mod-\\nerate degree, might bring about the most un-\\nfortunate results. If it did occur, the rational\\ncause would not be the mysteriously blighting\\neffects of alcohol in itself, but rather the gradual\\nand steady deterioration of nervous equilibrium\\nwhich excesses entail. Since the use of alcohol\\nlends itself easily to excess, more so than most\\ndrugs or foods, inordinate and unusual drink-\\ning has come to bear its present bad reputation.\\nIn analogous ways unfortunate circumstances", "height": "4356", "width": "2724", "jp2-path": "careofchildinhea00oppe_0279.jp2"}, "276": {"fulltext": "264 THE CARE OF THE CHILD IN HEALTH\\nduring gestation, such as poor maternal health\\nor a violent accident, may operate. These\\nfactors are efficient only in the degree in which\\nthey are able to lower the child s nutrition, as\\nwell as the source from which that nutrition has\\nits origin. Similarly we can account for the\\noccasionally evil results of consanguineous mar-\\nriages: here the simple fact of relationship is\\nnot the all-important consideration. In fact,\\nthere are many instances of comparatively close\\nintermarriage, such, for instance, as those of\\nfirst cousins, whose offspring have been suffi-\\nciently normal. But such marriages have a\\ntendency to exaggerate whatever weaknesses of\\nbody or brain and whatever environmental\\npeculiarities the family may have.\\nQuite a different principle comes into play\\nwhen the deficiency follows disease. Here\\nan inflammatory process is at work which causes\\norganic changes in the nervous system. Thus\\na lobar pneumonia may be followed by a men-\\ningitis, and on account of it the meningeal\\nmembranes may be thickened, their blood-vessels\\nmay be congested, the products of inflammation\\nmay accumulate in considerable amounts, and,\\nconsequently, there is a continuous nervous\\nirritation, the normal development is impeded,", "height": "4360", "width": "2836", "jp2-path": "careofchildinhea00oppe_0280.jp2"}, "277": {"fulltext": "DEFECTIVE CHILDREN 265\\nand symptoms of corresponding intensity may\\nappear. In an entirely different set of cases a\\nnew growth, perhaps of syphilitic origin, may\\npress upon the surrounding brain tissue; or,\\nagain, a minute fragment of bone, which has\\nbeen broken off by some accident, may pierce\\nthe cerebral structures, and cause mental defi-\\nciency, convulsions, and similarly alarming\\nmanifestations. It is obviously unnecessary to\\ngo through the whole list of possibilities and all\\ntheir myriad aspects; the great thing which\\nwe must keep in mind is that commonly enough\\nthere is an ascertainable cause, and that the\\nfinding of it is the first step to a logical method\\nof improvement. Likewise, as the knowledge\\nof cerebral localization and functions grows,\\nthere is an increasing chance of knowing what\\narea is affected, of finding means to increase its\\nefficiency, or so far developing some other por-\\ntion that it may, in part at least, attend to the\\nneglected work.\\nThe outlook, in all these various cases, dif-\\nfers according to the particular circumstances\\ninvolved. As far as a very general rule may\\ngo, one may safely say that the congenital cases\\noffer a better opportunity for successful treat-\\nment than the acquired ones do. For in the", "height": "4360", "width": "2728", "jp2-path": "careofchildinhea00oppe_0281.jp2"}, "278": {"fulltext": "266 THE CARE OF THE CHILD EST HEALTH\\nfirst class there is generally an unfinished con-\\ndition, a state of incompleteness, that is, as\\nit were, waiting for an adequate force to give\\nthe needed impetus toward normal growth. If\\nthe weakened brain has not been allowed to\\nremain too long unhelped, there is a distinct\\npossibility of improvement. On the other hand,\\nthe second series presents a more discouraging\\nstate of affairs for instead of there being merely\\na negative condition, there is a positive organic\\nchange that may be almost insurmountable.\\nNevertheless, expert information should be\\nobtained in regard to every case, and under no\\ncircumstances should any deficiency, excepting\\ncapital ones, be accepted as irremediable.\\nThus, as an example, let us take the case of\\na young child who has been afflicted with deaf-\\nmutism after scarlet fever. A part of that\\ndisease is a severe inflammation of the throat.\\nAs a sequel to this disorder an inflammation of\\nthe Eustachian tube may begin, which develops\\ninto some form of middle-ear disease, the result\\nof which is deafness. The child, consequently,\\nis unable to hear himself or other persons speak,\\nhe forgets the sound of words, and, finally, is\\nunable to use them at all. In children under\\ntwo years of age, the normal limit at which", "height": "4384", "width": "2900", "jp2-path": "careofchildinhea00oppe_0282.jp2"}, "279": {"fulltext": "DEFECTIVE CHILDREN 267\\nspeech may be expected, the sounds may never\\nhave been sufficiently learned, so that deafness\\neven more readily than in older children causes\\nmutism. Such patients are often thought to\\nhave suffered an injury to the brain but as a\\nmatter of fact the trouble is a purely local one,\\nand may occasionally be relieved or compen-\\nsated for by appropriate special instruction, or,\\nin some few cases, by treatment of the ear. This\\nis by no means the only instance in which a hope-\\nful persistence may be of the greatest benefit.\\nIt is unfortunate that most cases of defective\\nmental condition cannot be treated at home.\\nAs a rule, the treatment is so wide, it should\\ninclude the oversight of so many parts of the\\nchild s life, that observation and control must\\nbe undivided. And each factor may be so\\nimportant that it should not be left to the lib-\\neral interpretation that it usually would receive\\nin the ordinary household. Moreover, such a\\nhousehold is primarily designed for the needs,\\ncomforts, and pleasures of normal persons; it\\ncan only with difficulty subordinate its natural\\nusefulness to the needs of an abnormal child.\\nThese needs are incessant, they must be watched\\nday and night. Thus the diet in such cases is\\nvery important, for a poorly developed or weakly", "height": "4360", "width": "2720", "jp2-path": "careofchildinhea00oppe_0283.jp2"}, "280": {"fulltext": "268 THE CARE OF THE CHILD IN HEALTH\\nbalanced brain is more easily affected by an\\nimperfect digestion and assimilation than a\\nnormal pne. The exercise is likewise very\\nimportant, and must be designed for the par-\\nticular child in question. The instruction\\nmust by all means have the special character\\nwhich the condition of the child demands, and\\nit should be prosecuted under the direction of\\nexpert medical, as well as pedagogical, control.\\nEven the child s amusements should be carefully\\nregulated and prescribed. In fact, there is no\\nitem of his whole existence that is too small to\\nrequire careful and conscientious direction.\\nThe ordinary nurse-maid is unable to do all\\nthis intelligently and faithfully. In most\\ncases she is a somewhat rudimentary person\\nherself, whose real and suitable function would\\nbe as the keeper rather than the nurse of chil-\\ndren. While it is true enough that most\\nchildren would be benefited by having less\\nexpensive clothes and a better qualified nurse,\\nnevertheless, in a case of a defective child the\\nrequirements are so great that a capable person\\nis under ordinary circumstances very hard to\\nobtain. The natural choice must therefore be\\nsome form of institution which may not have the\\ndisadvantages of the usual large asylum in the", "height": "4380", "width": "2864", "jp2-path": "careofchildinhea00oppe_0284.jp2"}, "281": {"fulltext": "DEFECTIVE CHILDREN 269\\ngreat cities. The proper institution must be\\nsituated in the country, in a community of its\\nown it must be built on the cottage or colony\\nplan, where only a small number of children\\nlive in one home, and, therefore, are under the\\ndirection of one cottage-mother. The amuse-\\nments, the exercises, the instruction in fact,\\nthe general life of the child should be passed,\\nas far as possible, in the open air under circum-\\nstances which do not bring abnormal children\\nin competition with normal boys and girls,\\nwhich would allow an elastic grading, which\\nwould decrease to the last degree the morbid\\ninfluences that are inseparable from the stress\\nand strain of ordinary life. In addition, the\\ncorps of attendants and instructors should be\\nselected for the especial work in hand on other\\nprinciples of choice than those which unfortu-\\nnately are too often in vogue. The abnormal\\nchild is so frequently met, he represents under\\npresent conditions so much of a loss to himself\\nand the world, and his prospects of usefulness\\nare so limited, that any change is apt to be for\\nthe better. And if the improvements are able\\nto elevate the condition of only a small percent-\\nage, the gain to the world would of necessity be\\nimmeasurably great.", "height": "4360", "width": "2712", "jp2-path": "careofchildinhea00oppe_0285.jp2"}, "282": {"fulltext": "CHAPTER XIII\\nCOMMON DISEASES\\nNo child can be expected to go through life\\nwithout some deviations from the normal con-\\ndition of health; and a general understanding\\nof how the main deviations show themselves is\\nof so much help in obtaining a return to health\\nthat every mother should have some information\\non the subject. It is not desirable that she\\nshould make an absolute diagnosis and conduct\\nthe treatment without skilled help on the con-\\ntrary, no matter how much experience she may\\nhave had in her household, she cannot expect\\nto have the acquaintance with sickness that a\\ntrained physician possesses. At the same time\\nthere is a very important place in the care of\\nchildren for the intelligent mother who has\\nsufficient knowledge to prevent her from falling\\ninto simple errors, to give her the calmness of\\nmind in the presence of disease that is so valu-\\nable for her child s comfort and welfare, and to\\ncontribute to her own comfort, efficiency, and\\n270", "height": "4360", "width": "2820", "jp2-path": "careofchildinhea00oppe_0286.jp2"}, "283": {"fulltext": "COMMON DISEASES 271\\nability to care for her household. There are\\nthe best of reasons why she should have some\\ngeneral knowledge of the principal varieties of\\nsickness, how they occur, what their general\\ncourse is, and what the logical way of regard-\\ning them is. The knowledge is not especially\\nhard to assimilate, and it will undoubtedly\\njustify itself.\\nThe first thing to know and always to keep\\nin mind is that disease never comes without a\\ndefinite cause, it never happens. A child\\nmay fall and break his arm, or may be struck\\nwith a ball or a stone, and thus injured; such\\naccidents may occur to any one, even if every\\nreasonable precaution for his safety has been\\nconscientiously observed. But the disorders\\nknown as definite diseases do not happen in this\\nmanner; in a large majority of the ordinary\\ncases sickness results from the combination of\\ntwo factors a lessened physical resistance and\\nvitality in the child on the one hand, and, on\\nthe other, the attack by agents of disease that\\nare lying in wait for the opportunity to find\\nsuitable conditions of growth. The deficient\\nresistance and vitality may be congenital or ac-\\nquired, but usually they arise from errors in the\\ngeneral mode of life, or in the failure to obtain", "height": "4360", "width": "2704", "jp2-path": "careofchildinhea00oppe_0287.jp2"}, "284": {"fulltext": "272 THE CARE OF THE CHILD IN HEALTH\\nthe requisite degree of health after sickness.\\nThere is no doubt that some children have\\nreceived the heritage of weakness, of suscepti-\\nbility to pathological conditions but such chil-\\ndren are in the minority. Even in the case of\\nthe diseases that were commonly supposed to be\\nhereditary, the fulfilment of the sinister promise\\nis often the result of personal circumstances.\\nNo disease has had a worse reputation in this\\nrespect than tuberculosis. It has been so wide-\\nspread, so persistent, and so merciless, that its\\noccurrence in one member of a family threw a\\nshadow of doubt upon the physical stability of\\nevery other member. It may have appeared as\\npulmonary consumption, as scrofula, as disease\\nof the bones but under all circumstances it has\\ncast a blight upon the confidence which the\\naffected families had in themselves, as well as\\nthat which the public had in them.\\nAs a matter of cold fact, the heredity of tuber-\\nculosis has of late years been doubted and prac-\\ntically disproved. And we have found that the\\nwhole of the matter is contained in the word\\npredisposition. The child of tuberculous\\ndescent is not born with the germs of the disease\\nin him; but his forbears, on account of the\\nravages which the disease accomplished in", "height": "4388", "width": "2820", "jp2-path": "careofchildinhea00oppe_0288.jp2"}, "285": {"fulltext": "COMMON DISEASES 273\\ntheir bodies, have handed on to their offspring\\na weakened vitality, especially to the disease in\\nquestion. The tubercular condition has sub-\\ntracted something from the sum of their physi-\\ncal assets, and they bequeath no more than they\\npossess. But and this is a factor of mighty\\nimport the human organism has a wonder-\\nful quality of elasticity, a natural tendency to\\nrevert to health, as in a staple commercial\\nenterprise the natural process of physical de-\\nvelopment always leans toward improvement,\\ntoward recovery from misfortunes, if abnormal\\nlosses are curtailed. Thus, although a child\\nmay be born with a tuberculous history, he is\\nalmost always susceptible of such development\\nof health and strength that his predisposition\\nwill be overcome, and he will go through life\\nunscathed.\\nThe same idea is true concerning other dis-\\neases which are commonly regarded as hered-\\nitary. People at large are very apt to regard\\nsuch disorders as cancer, as insanity, as rheuma-\\ntism, as heart disease, in the light of family\\nfailings which necessarily constitute a standing\\nmenace against the health and the potential\\nactivity of each individual concerned. But\\nthis is not the best way of regarding these", "height": "4356", "width": "2748", "jp2-path": "careofchildinhea00oppe_0289.jp2"}, "286": {"fulltext": "274 THE CARE OF THE CHILD IN HEALTH\\ncomplaints. At their worst they can leave no\\nmore persistent trace than tuberculosis, which\\ncan be guarded against and overcome. In all\\nthese instances a hopeless pessimism is entirely\\nout of place. There is, very probably, a weak-\\nened general resistance, or a weakened resist-\\nance to the attacks of the disease in question.\\nBut that fact should stimulate the affected fami-\\nlies to vigorous efforts whose object is the\\nattainment of such robust health that the\\nindividual as well as the family weakness is\\npractically obliterated.\\nThe second factor in the causation of disease\\nis the one of outside agency. This is usually\\nof one sort, although it may have many phases.\\nThe deleterious influence of unfavorable envi-\\nronment is so well known that it scarcely needs\\nelaboration. Everybody is so thoroughly ac-\\nquainted with the ordinary effects of injudicious\\neating and drinking, poorly arranged clothing,\\nirregular habits of rest, recreation, and activity,\\nand deficient measures of hygiene, that an ex-\\ntended mention of them is unnecessary in this\\nplace. But another phase of the question that\\nof the invasion of germ life or the micro-organ-\\nisms of disease is not so clearly understood.\\nThese bacteria are, for the most part, exceedingly", "height": "4388", "width": "2820", "jp2-path": "careofchildinhea00oppe_0290.jp2"}, "287": {"fulltext": "COMMON DISEASES 275\\nlow forms of animal life that exist in great quan-\\ntities wherever civilization flourishes. There is\\na vast number of these organisms, some of which\\nare of use, some of which are harmless, and\\nsome dangerous to life. The useful ones may\\nbe concerned in those processes of fermentation\\nwhich are so extensively employed in many\\ncommercial and domestic activities; the harmful\\nones are active causes of disease. The one sort\\nmay be concerned in the making or the marring\\nof food-stuffs the other in the destruction of\\ntissue or the production of poisonous matters or\\ntoxines, the objective manifestations of which\\nwe call the symptoms of disease. But with all\\nof them there must be certain attendant cir-\\ncumstances, the existence of which precedes\\ntheir development and growth. These are the\\npresence of moisture, warmth, and a suitable\\nculture ground.\\nIn the human body heat and moisture are\\nalways present and the suitable culture\\nmedium exists in some condition of local or\\ngeneral loss of vitality or tone. The body\\nwhen in a perfectly healthy state has a won-\\nderful faculty of warding off disease, because\\nit has a quality which does not allow the\\npeculiar reaction which makes the favorable", "height": "4360", "width": "2716", "jp2-path": "careofchildinhea00oppe_0291.jp2"}, "288": {"fulltext": "276 THE CARE OF THE CHILD IN HEALTH\\nculture medium. A really healthy person does\\nnot contract consumption, or typhoid fever, or\\nmeasles, or erysipelas, or lobar pneumonia not\\nbecause he escapes contact with the provoca-\\ntive germs, but because the condition of his\\nbody does not favor their growth. A person\\nwhose general strength is intact and whose\\nrespiratory mucous membranes are quite nor-\\nmal is in no danger of consumption a child\\nwho is similarly disposed, whose nutrition is\\nunimpaired, whose excretion is normally active,\\ndoes not contract whooping cough, scarlet\\nfever, or mumps a baby whose vitality is\\nnot depressed, whose alimentary tract is in a\\nvigorous, healthy condition, whose food is\\nproperly controlled in regard to quality, quan-\\ntity, and purity, and who is kept sweet and\\nclean, has no likelihood of suffering from\\nsprue, stomach troubles, summer complaint,\\nor cholera infantum. The equation is one\\nthat is not hard to understand, for the fac-\\ntors are quite evident. And where the patho-\\nlogical process has once begun, no one is able\\nto say where it will stop.\\nThe characteristic effect of all these diseases\\nis the production of some sort of poison, which\\nvaries according to the manner and source of", "height": "4396", "width": "2820", "jp2-path": "careofchildinhea00oppe_0292.jp2"}, "289": {"fulltext": "COMMON DISEASES 277\\nits production and its particular nature. The\\ntoxines that are developed during an attack of\\ndiphtheria are quite different from those which\\nfollicular tonsillitis produces, and the poison-\\nous effects of typhoid fever bear very little\\nrelation to those of summer complaint. This,\\nnaturally, does not prevent two or more of\\nthese diseases and their respective toxines from\\nbeing simultaneously present in the body, and\\nthey often are. Thus it is no very rare thing\\nfor typhoid fever to be complicated by pneu-\\nmonia, or diphtheria by broncho-pneumonia,\\nor lobar pneumonia by meningitis. Indeed,\\nthe presence of one disease, by weakening the\\nbody s vital tone, makes the process of con-\\ntracting further diseases more easy than it\\notherwise would be. And at the same time\\none can easily see that the outlook, on account\\nof the added wear and tear, is correspond-\\ningly more gloomy. But the essential nature\\nof these various infections is so different that\\nattempts have for some time been made to find\\nwhether one might not be used to antagonize\\nanother. So far this line of work has not been\\nvery successful.\\nBut another method of treatment has been\\ndiscovered which in the future will unques-", "height": "4388", "width": "2756", "jp2-path": "careofchildinhea00oppe_0293.jp2"}, "290": {"fulltext": "278 THE CAKE OF THE CHILD IN HEALTH\\ntionably be developed to wonderful limits.\\nThis method recognizes the poison as the main\\npart of the disease, and regards the external\\nsymptoms as merely concomitant facts. Under\\nthe name of the antitoxic serum the world\\nhas become familiar with this view in the treat-\\nment of diphtheria. The philosophy of it is\\nseemingly simple, and consists in the effort to\\nfamiliarize the body with the specific toxines\\nby means of injections of them in an attenu-\\nated form. Diphtheria is not the only disease\\nin which it is being used. For generations\\nwe have been employing an analogous treat-\\nment, which is called vaccination, to ward off\\nthe possible attacks of smallpox. And of\\nlate, intelligent efforts have been made to pro-\\nduce antitoxic serums for lobar pneumonia,\\ntetanus (lockjaw), yellow fever, erysipelas,\\nblood poisoning, and similar diseases. The\\nsuccess has been variable, depending upon the\\nability to obtain the specific micro-organisms in\\npure cultures, upon the experimenters ability\\nto obtain suitable culture media, and other\\nrelated facts in the technique. The main idea\\nthat is of use to us in this connection is that\\nmost diseases have as their principal factor\\nthe direct or indirect production of toxines or", "height": "4396", "width": "2836", "jp2-path": "careofchildinhea00oppe_0294.jp2"}, "291": {"fulltext": "COMMON DISEASES 279\\npoisons which have a dangerous effect upon\\nthe body in proportion to their virulence.\\nThe lesson is of universal application in the\\ntreatment of disease, and applies with the great-\\nest force to the care of children. In all their\\nsicknesses the first step to take is the thorough\\nemptying of the stomach and intestines by\\nmeans of cathartics and one of the principal\\ndetails of treatment is the use of such medicines\\nand therapeutic measures during the process of\\nthe disease as will keep up a moderate but\\neffectual excretion through the lungs, the in-\\ntestines, the kidneys, the glands, and the skin.\\nExcretion by means of the lungs is promoted\\nthrough the inhalation of pure air, and the\\naction of a vigorous circulation; that by means\\nof the intestines through medicines, special\\nfoods, and water that by means of the glands\\nthrough medicines and that by means of the\\nskin through medicines, the action of heat, and\\nthe use of water. It is obviously impossible to\\ndefine and describe all these various agencies,\\nfor that would be tantamount to converting\\nthis book into a treatise on materia mediea and\\nthe practice of medicine. But out of the mass\\nof details we may select a few fundamental facts\\nin treatment that are of paramount importance", "height": "4360", "width": "2724", "jp2-path": "careofchildinhea00oppe_0295.jp2"}, "292": {"fulltext": "280 THE CARE OF THE CHILD IX HEALTH\\nin the task of restoring ailing children to\\nhealth.\\nAll medicines should be as few in number\\nand as simple in combination as possible. All\\nopiates should be used for children with great\\ncaution, and opium or its derivatives such as\\nmorphine should practically never be used,\\nexcepting under unusual circumstances where a\\nphysician believes them necessary. This rule\\napplies with especial force to the employment\\nof sleeping mixtures, soothing syrups, and teeth-\\ning syrups which depend for their effect upon\\nbrutally stupefying the child, without regard to\\nthe serious consequences that the drugging may\\nentail.\\nIn sickness the food should almost always be\\nfluid, should be easily digested, and never given\\nin large amounts. It is well to remember that\\nthe amount of nourishment which the child\\nobtains from his food depends less upon the\\nquantity which he swallows than upon the\\namount which he digests and assimilates. The\\nhabit of forcing a child to eat against his will\\nis thus a bad one, for he is rarely benefited by\\nfood which he does not care to take. During\\nan acute sickness he does not need a great deal\\nof nourishment; and in chronic disorders one", "height": "4392", "width": "2860", "jp2-path": "careofchildinhea00oppe_0296.jp2"}, "293": {"fulltext": "COMMON DISEASES 281\\ncan manage by means of tonic medicines, a good\\nchoice of food, as well as a dainty preparation\\nof it, to increase his appetite. It ought not to\\nbe hard to understand that food may have as\\ndefinite a composition and physiological effect\\nas drugs, and that a similar care should be em-\\nployed in its use. Under all circumstances the\\nattending physician should be asked to specify\\nthe exact kinds of food, the manner of prepara-\\ntion, the quantity, and the intervals of feeding.\\nThis is fully as important in most cases as the\\ngiving of certain prescriptions the whole ques-\\ntion of diet for ailing children has not been\\nreceiving the serious attention which it merits.\\nAnother subject which is almost equally\\nimportant is that of bathing and the action of\\nwater in sickness. The use of this agent is not\\nnearly common enough, nor need it be regarded\\nwith the distrust and apprehension that solici-\\ntous mothers so often feel in connection with\\nthe treatment of a delicate child. It provides\\nour most excellent methods of lowering a high\\ntemperature, very much better than any coal-tar\\nproduct or fever powder that has ever been dis-\\npensed. It is almost as good for raising a sub-\\nnormal temperature; and at the same time it is\\nnoticeably useful as a diaphoretic, as a means of", "height": "4360", "width": "2724", "jp2-path": "careofchildinhea00oppe_0297.jp2"}, "294": {"fulltext": "282 THE CARE OF THE CHILD IN HEALTH\\nrelieving local congestions, as a controller of\\ndefective circulation, and as a capable agent\\nof stimulation. In any sickness the treatment\\nmay well begin with the administration of a\\nwarm bath in addition to the cathartic and\\nthereafter the child should be regularly bathed\\nat least once a day. The details of duration of\\nbath, temperature of the water, and solution of\\nmedicinal substances in the water, will be in-\\ncluded in the directions of the attending physi-\\ncian. During the course of the sickness no other\\nmeans will give the same satisfactory results in\\nthe reduction of temperature; and the graduated\\nbath of 100\u00c2\u00b0 F. reduced to 80\u00c2\u00b0 F., the cool sponge\\nbath, and the wet pack will always give far\\nbetter results than any other antipyretic. In\\naddition, the value of an ice-bag to an aching\\nhead, or to a nervously excited heart, is too\\nwell known to need special mention. Likewise,\\nhot- water bags or bottles to the extremities are\\nboth valuable and comforting when the child is\\nsuffering from a chill or from a poor circulation.\\nEven in the eruptive fevers or in diseases of the\\nlungs, the daily warm bath will contribute ease,\\ncomfort, and a more rapid progression toward\\nhealth.\\nIn considering the ordinary diseases to which", "height": "4388", "width": "2820", "jp2-path": "careofchildinhea00oppe_0298.jp2"}, "295": {"fulltext": "COMMON DISEASES 283\\nchildren are subject, one inevitably divides them\\ninto a few distinct groups, according to the\\nfunctional divisions of the body. Such a view\\nis very useful in determining the treatment\\nwhich they should receive. For usually a dis-\\nease cannot be regarded as a distinct entity and\\nseparated from every other disease. Thus the\\ndisorders of the alimentary track include those\\nof the mouth, the stomach, and intestines and\\ncommonly one leads to another. A child may\\nhave an attack of sprue or thrush which always\\nbegins in the mouth. It originates in a lack of\\ncleanliness, and if the defect is not remedied\\nthe parasitic growth may spread to the stomach,\\nand convert a trivial disorder into a serious one.\\nIn the same way, the disorders of the stomach\\nmay, and commonly do, lead to derangement of\\nthe intestines. And it requires no more than\\na cursory view of them to show how true this is.\\nMost of the gastric disorders in children are\\nfunctional that is, they result from interfer-\\nences with the normal work and action of the\\norgan, and occur without the presence of defi-\\nnite organic changes. As an example, let us\\ntake the case of an ordinary attack of indiges-\\ntion. Such a state generally follows over-\\neating, or eating food which the stomach is", "height": "4360", "width": "2712", "jp2-path": "careofchildinhea00oppe_0299.jp2"}, "296": {"fulltext": "284 THE CARE OF THE CHILD IN HEALTH\\nunable to digest. In well-grown children it\\ncommonly follows excesses such as are com-\\nmitted during holidays, parties, large dinners,\\nor any occasion when they are allowed to eat\\ncakes, pies, fruits, and candies. In infants it\\nmay be caused by excessive quantities of milk,\\nor milk of an improper composition. The food,\\nnot being changed and absorbed, remains in\\nthe stomach, irritates it, undergoes fermen-\\ntation and putrefaction. From this process\\npoisonous products are formed which bring on\\nvarious degrees of intoxication. Consequently\\nwe see such symptoms as gastric pain, fever,\\nlack of appetite the organism tries to free\\nitself from the harmful influences by vomit-\\ning or even by diarrhoea. And this imme-\\ndiately suggests the proper treatment, which\\naccords perfectly with the general principle\\nmentioned above. Our first duty is to stop\\nthe food, to give liberal cathartics to clear away\\nthe offending matter, and then to keep the\\npatient as quiet and the nourishment as simple\\nas possible in order to allow him to regain his\\nphysical tone. The fever may be safely and\\nefficiently dispelled by baths and in many\\ncases very little or no additional treatment is\\nrequired.", "height": "4392", "width": "2820", "jp2-path": "careofchildinhea00oppe_0300.jp2"}, "297": {"fulltext": "COMMON DISEASES 285\\nIn a comparatively small proportion of cases\\nthere is a real inflammation of the mucous mem-\\nbrane of the stomach. Here the pain, vomit-\\ning, fever, headache, and prostration do not\\ncome on so suddenly, but rather result from\\nrepeated attacks of functional disorders, or\\npossibly from the absorption of notable quan-\\ntities of toxic materials. Although the disease\\nis comparatively severe and prolonged, never-\\ntheless the treatment is to be conducted on\\nsimilar lines. The organ is to be thoroughly\\nemptied, the diet is to be restricted to such\\neasily digestible foods as milk, or clear soups\\nwithout fat. The same principles of rest and\\ntemperature-reduction hold good in this case\\nas in the other; but there may be a necessity\\nfor the employment of other methods. It may\\nbe necessary to wash out the stomach, to pre-\\nscribe bismuth, or dilute hydrochloric acid, or\\nan alakli, such as the bicarbonate of soda.\\nThese agents need the experience and skill of\\na physician, and never otherwise should they\\nbe used.\\nThe disorders of the intestines may like-\\nwise be functional or organic. The first may\\nfollow similar conditions of the stomach, may\\noriginate from analogous causes even when", "height": "4360", "width": "2696", "jp2-path": "careofchildinhea00oppe_0301.jp2"}, "298": {"fulltext": "286 THE CARE OF THE CHILD IN HEALTH\\nthe stomach is not involved, or may result from\\ngerm infection of the intestinal contents. The\\ncourse of the disease is apt to be longer than\\nthat of gastric disorders, partly because the con-\\ndition is of slower growth, and partly because\\nthe intestines are hard to clear out. The same\\ngeneral plan of emptying the intestine by\\nmeans of cathartics is used, and sometimes is\\nsupplemented by washing or flushing the lower\\nbowel with a large quantity of boiled water by\\nmeans of a rubber tube and a fountain syringe.\\nThis is the main part of the treatment in the\\nsummer diarrhoeas of children but it may be\\naided, and its benefits increased, by the restric-\\ntion of the food to clear soups and broths, and\\nthe administration of bismuth and tonics. In\\nthese conditions the need of tonics is unques-\\ntionably great, for the loss of flesh and strength\\nis always marked. Full baths or sponge baths\\nare of use, but all further details of treatment\\nmust be supplied by the attending physician.\\nThe organic diseases of the intestines are\\ncommonly called inflammation of the bowels,\\nand are very serious diseases. Not only is the\\ndigestive and excretory function seriously inter-\\nfered with or abolished, but also there is a very\\nlarge amount of pain and prostration. The", "height": "4360", "width": "2756", "jp2-path": "careofchildinhea00oppe_0302.jp2"}, "299": {"fulltext": "COMMON DISEASES 287\\nintensely sensitive intestinal walls are swollen,\\ncongested, and infiltrated with new elements;\\nand every movement of the body and every bit\\nof motion which the intestines undergo produce\\nkeen agony. The treatment of these conditions\\nis too complicated to have a place in this\\nchapter. The inflammations of the peritoneum,\\nor membrane which lines the abdominal cavity,\\nare of much the same nature, they have some-\\nwhat related symptoms and treatment, and\\nlikewise are scarcely susceptible of interesting\\nexploration for the general reader.\\nSo much of late years has been said about\\nappendicitis that some description of it is de-\\nsirable. It is commonly spoken of as a new\\ndisease but in reality there is nothing new\\nabout it, excepting that we are now able to recog-\\nnize and treat it, while formerly it ran its course\\nunrecognized. The appendix is a small process,\\nshaped like the finger of a glove, which is given\\noff from the large bowel. It is a blind pouch,\\nsituated in the lower right side of the abdomen,\\nand is evidently a vestigial structure which\\nserves no useful purpose. On account of any\\ninjury from violence, or the irritation of in-\\ntestinal contents, it may fall into a state of\\ninflammation. This condition constitutes a fer-", "height": "4360", "width": "2728", "jp2-path": "careofchildinhea00oppe_0303.jp2"}, "300": {"fulltext": "288 THE CARE OF THE CHILD IN HEALTH\\ntile culture ground for germ life, the natural out-\\ncome of which is the production of pus. If this\\nhappens, one of two things occurs the abscess\\nmay be shut in by adhesions, and may gradually\\nbe absorbed; or it may break, and flood the per-\\nitoneal cavity with pus. From the first con-\\ndition the patient may recover, but the disease\\nwill in all likelihood occur again and again until\\nthe second condition exists. The usual outcome\\nof this is death. The disease should be re-\\ngarded as an internal abscess which, if it is al-\\nlowed to break, causes an active blood-poisoning.\\nEvery abscess, no matter where it occurs,\\ndemands opening and the draining off of its\\npoisonous contents and in appendicitis there is\\nno exception to the rule. In case the abscess\\nis shut in by adhesions, the operation may be\\npostponed until the first acute symptoms have\\npassed. But then it should be performed with-\\nout delay. The removal of the appendix is\\nalways a conservative matter, for it removes\\na danger whose gravity cannot be well over-\\nestimated.\\nAnother group of organs which is the seat\\nof many common disorders is the respiratory\\nsystem. This includes the nose, larynx, trachea,\\nlungs, bronchi, and pleura. The purposes and", "height": "4360", "width": "2820", "jp2-path": "careofchildinhea00oppe_0304.jp2"}, "301": {"fulltext": "COMMON DISEASES 289\\nphysical conditions of this system naturally con-\\ntrol the disabilities to which its various parts\\nare subject. Its work consists in drawing into\\nthe intimate structure of the lungs a certain\\namount of air, from which the oxygen may be\\ntaken, sucked through the wonderfully fine\\nblood-vessels into the blood, where it burns up\\nthe impurities, and allows the blood stream to\\nreturn, cleansed and rejuvenated, to the heart.\\nIn the nose the air is filtered and warmed it\\nis conducted by way of the throat to the trachea\\nor wind-pipe, then to the large bronchi, which\\ndivide into progressively small ramifications\\nthat resemble the branches of a tree. In the\\nthroat there are two glands called tonsils, and\\nin the back of the nose is a third one, called the\\npharyngeal tonsil, whose function is to lubricate\\nthe surrounding mucous membrane. These\\ntonsillar tissues may become enlarged as the\\nresult of atmospheric irritations or the action of\\ndisease, so that the available space through\\nwhich the air passes is markedly decreased.\\nThe enlargement of the throat or f aucial ton-\\nsils is familiar to every one but that of the\\nthird or pharyngeal tonsil, while it occurs fre-\\nquently, is not by any means so well known.\\nOne is very apt to be accompanied by the other.", "height": "4360", "width": "2736", "jp2-path": "careofchildinhea00oppe_0305.jp2"}, "302": {"fulltext": "290 THE CARE OF THE CHILD IN HEALTH\\nAt all events, the inevitable result is that the\\namount of air that reaches the lungs is dimin-\\nished, the oxygen is correspondingly decreased\\nin quantity, and the burning up of impurities\\nin the blood is lessened in equal amount. Here,\\nagain, we come to a condition of intoxication,\\nof poisoning, which shows itself in poor nutri-\\ntion and development, in lessened resistance to\\ndisease, in abnormal conditions of mind. Some\\nof the apparent symptoms are tonsillar hyper-\\ntrophy, and especially the enlargement of the\\npharyngeal tonsil, mouth-breathing, snoring\\nduring sleep, broadening of the bridge of the\\nnose, and a constant recurrence of coughs and\\ncolds in the head. There is one and only one\\nsure remedy for this condition removal of the\\noffending growths.\\nThere is a certain disease of the faucial ton-\\nsils that is sufficiently interesting to require a\\nspecial mention and it acquires a part of its\\ninterest from its liability to be mistaken for\\ndiphtheria. This disease, on account of its\\nmanner of occurrence, is called follicular ton-\\nsillitis. At the beginning the follicles become\\ndeeply inflamed as the result of germ infec-\\ntion, and their mouths are filled with small\\nplugs of membrane. The tonsil now looks", "height": "4388", "width": "2820", "jp2-path": "careofchildinhea00oppe_0306.jp2"}, "303": {"fulltext": "COMMON DISEASES 291\\nred, large, and studded with small patches or\\ndots of cream-colored membrane. If these\\npatches are large in number they may coa-\\nlesce, and form a continuous membrane. The\\nbehavior of the sickness is alarming there is\\nincreasing difficulty in swallowing, there is\\ngreat depression and general pain, and the tem-\\nperature mounts to startling heights, as high as\\n105\u00c2\u00b0 F. or even more. The severity of the\\nsymptoms is, curiously enough, not at all in con-\\nsonance with the danger of the disease for the\\nchildren practically always recover, and are\\nvery little the worse for their sickness, with the\\nexception of a temporary weakness. This dis-\\nease, which in its extrinsic character bears a\\nresemblance to diphtheria, is in reality not at\\nall like it. The latter is a serious disorder, has\\na moderate or low temperature, not so much\\npain, and its membrane may appear on any part\\nof the throat or nose as well as on the tonsils\\nbut if it does begin on the last named structures,\\nit steadily spreads to the adjacent parts. The\\ntreatment of follicular tonsillitis is simple, and\\nis really directed most of all to the relief of the\\ngeneral distress. It consists in the adminis-\\ntration of a brisk cathartic, followed by the ad-\\nministration of small doses of phenacetine and", "height": "4360", "width": "2740", "jp2-path": "careofchildinhea00oppe_0307.jp2"}, "304": {"fulltext": "292 THE CARE OF THE CHILD IN HEALTH\\nsaiol in frequent doses a cleansing spray to the\\nthroat and an ice-bag to the neck will increase\\nthe patient s comfort and hasten recovery. But\\nwhile the treatment of this disorder is simple\\nenough, one should not undertake it unless the\\ndiagnosis is quite correct. No one but a medi-\\ncal man should assume the responsibility of\\nmaking the distinction between follicular ton-\\nsillitis and diphtheria, and even he may at\\ntimes be enough in doubt to need the aid of\\na bacteriological culture.\\nColds in the head are irritations or inflam-\\nmations of the mucous membranes of the nose.\\nThey may follow harsh atmospheric conditions,\\nexposure to draughts, or attacks by certain\\ngerms. Although they are not in themselves\\nserious, they cause considerable discomfort and\\nopen a way to more dangerous disorders. They\\nmay be mitigated or driven away by the use\\nof cathartics, hot baths, and continuously spray-\\ning the nose with an alkaline, antiseptic solution,\\nsuch as may be obtained at any drug-shop. If\\nthey are neglected, they commonly extend along\\nthe nose to the throat, and then into the large\\nbronchi, where they start an inflammation called\\nbronchitis. When they settle in the throat,\\nthey often affect the larynx, and produce symp-", "height": "4396", "width": "2820", "jp2-path": "careofchildinhea00oppe_0308.jp2"}, "305": {"fulltext": "COMMON DISEASES 293\\ntoms of cough, hoarseness, and loss of voice.\\nSometimes the larynx becomes so sensitive that\\nsmall irritations bring on a spasm which we call\\ncroup. This condition is temporarily relieved\\nby the inhalation of steam, the application of\\nheat to the neck, and the use of hot baths.\\nThe medical treatment, which is important,\\nmust be left to the attending physician.\\nIn the treatment of bronchitis the parents\\nmust by all means free themselves from certain\\ntime-honored beliefs which should be called\\nsuperstitions. Children suffering from this\\ndisease need not be swathed in blankets and\\npads until they resemble mummies, they need\\nnot be kept unwashed during the course of the\\nsickness, and they will not be killed by a breath\\nof fresh air. On the contrary they should be\\nkept comfortably warm, but not hot they may\\nwith advantage have a warm bath morning and\\nnight and the sick-room should always be well\\nventilated. One should keep in mind that most\\nof these cases are examples of germ infection,\\nand that they require a vigorous excretion, a\\nsatisfactory stimulation, and a bland soothing of\\nthe cough and pain. The same requirements\\nare needed in lobar pneumonia, which must be\\ntreated as an acute, infectious disease. Here", "height": "4388", "width": "2772", "jp2-path": "careofchildinhea00oppe_0309.jp2"}, "306": {"fulltext": "294 THE CARE OF THE CHILD IN HEALTH\\nthe chief danger is not primarily due to the\\ncough or the interference with the breathing,\\nbut rather to the strain which is put upon the\\nheart by the impeded circulation and the poison-\\nous effect of the characteristic germs. Therefore\\nthe treatment is one of excretion and stimu-\\nlation, the drawing off of waste products, and\\nthe maintaining of strength until the disease\\nhas subsided. The use of plasters, poultices,\\nand pneumonia jackets serves no good end,\\nbut on the other hand may easily delay\\nrecovery, or increase the danger of the dis-\\nease.\\nBroncho-pneumonia is a compound disease\\nmade up of a combined attack of a bronchi-\\ntis and a pneumonia. This also is practically\\nalways caused by the invasion of micro-organ-\\nisms and the essential nature of the complaint\\nis the same, in general ways, as the separate\\ndisorders. The danger, especially for infants,\\nis an imminent one, and cannot well be over-\\nrated. The successful treatment of this con-\\ndition, with its exhausting inroads upon the\\nchild s vitality, calls for the exercise of the phy-\\nsician s best efforts. And while the parents\\nmay not hope to do more than appreciate the\\ngravity of the situation, their intelligent efforts", "height": "4388", "width": "2800", "jp2-path": "careofchildinhea00oppe_0310.jp2"}, "307": {"fulltext": "COMMON DISEASES 295\\nto carry out his directions may make his task\\neasier and possibly more successful.\\nWith any of these diseases an attack of\\npleurisy may be associated, or it may occur\\nalone. This inflammation has certain points of\\nresemblance to that of the peritoneum. Both\\ndiseases attack serous membranes, both may\\nbe simple, or characterized by the presence of\\nserum or water, or by the additional factor\\nof pus. In the simple, or dry, form the main\\nrequirement is the easing of pain and the main-\\ntenance of strength in the serous form there is\\nthe additional necessity of eliminating the fluid.\\nThis serum, if moderate in amount, may be\\ndisposed of by absorption or may call for the\\noperation of tapping or draining the chest.\\nBut the third form, which is characterized by\\nthe presence of pus, is really a large abscess, and\\ndemands an immediate incision in the chest\\nwall, the evacuation of the pus, and the con-\\ntinued drainage of the cavity until all septic\\nmatter has been thoroughly removed.\\nThere is only one other class of diseases that\\nshould be considered in this place, and that is\\nthe eruptive fevers, such as measles, scarlet\\nfever, chicken-pox, typhoid fever. Each one\\nis caused by a specific germ, and represents", "height": "4360", "width": "2724", "jp2-path": "careofchildinhea00oppe_0311.jp2"}, "308": {"fulltext": "296 THE CARE OF THE CHILD IK HEALTH\\na form of poisoning. Here again the main\\nnecessities which the treatment must meet are\\nsustaining the patient s strength, getting rid of\\nwaste products, diminishing as much as possi-\\nble the amount of work which the body has to\\ndo, and relieving the unpleasant symptoms in\\nevery possible direction. One can easily see\\nhow important it is to clear the alimentary\\ntrack, to use frequent baths, to allow enough\\ndrinking water for the quenching of thirst and\\nthe flushing out of the kidneys, to make the\\ndiet as nutritious and as easily digestible as\\npossible, and at the same time to maintain as\\nhigh a degree of strength as the patient s cir-\\ncumstances will permit. The mucous mem-\\nbranes of the nose, throat, and eyes must be\\nkept as clean as possible. For this reason they\\nshould be douched and bathed as often as cir-\\ncumstances demand and as a reward the\\nparents will have a much smaller percentage\\nof complications in these and the neighboring\\nparts to contend with. There is no need for\\nthe various teas that formerly were so plenti-\\nfully used nor for the burdensome swathing in\\nmany flannels that is almost as hard to bear as\\nthe disease itself; the patients must be made\\ncomfortably cool, should be allowed to drink a", "height": "4380", "width": "2820", "jp2-path": "careofchildinhea00oppe_0312.jp2"}, "309": {"fulltext": "COMMON DISEASES 297\\nsufficient quantity of pure water, and should\\nbe kept in a cool, dark room, where their nerv-\\nous irritability will have the least provocations\\nto get beyond control. In all these diseases\\nrigid isolation of the patient is most important,\\nand the parents must willingly cooperate with\\nthe physician in checking the spread of the\\nsickness. In many homes, in the presence of\\na contagious disease, the custom exists of put-\\nting the uncontaminatecl children in the sick\\nroom or even in the bed of the patient in order\\nto have the sickness become general, and thus\\nbe done with it. The practice is most heartily\\nto be condemned. It increases the amount of\\nsickness and the risk of unfortunate results,\\nwhile it gives no positive assurance that the\\nchildren will be protected against future at-\\ntacks. Indeed, these illnesses may occur more\\nthan once in the same child, and do so with a\\nfair amount of frequency. In addition, such\\nlax ideas make the whole plan of rational isola-\\ntion void, they foster the belief in the necessity\\nof sickness, and really have no rational thought\\nto justify them. In the whole matter of sick-\\nness, the tendency of endeavor should be in\\nthe way of directness, common sense, and\\nplain thinking. The care of the sick child", "height": "4360", "width": "2700", "jp2-path": "careofchildinhea00oppe_0313.jp2"}, "310": {"fulltext": "298 THE CARE OF THE CHILD IN HEALTH\\nis really that of his healthy brother, some-\\nwhat developed in a special direction to meet\\nspecial exigencies. In both there is need of\\ndevotion, clear-sightedness, patience, and self-\\ndenial. And in both the rewards of successful\\neffort are doubtless more satisfactory and prof-\\nitable than those in any other sort of work.\\nNot every one has the privilege of partici-\\npating in such work but those who have the\\nopportunity should call themselves fortunate.\\nTo such is intrusted the making of the present\\nand the future. The mother, if she only knew\\nthe length and breadth of her possible influ-\\nence, might be the grand and beneficent figure\\nin our society. Her body and mind are the\\npatterns of future generations by her thoughts\\nand deeds she can control and modify the effects\\nof long-past times. Her aspirations and ideals\\nare the standards by which the world is moved.\\nHer life, no matter how hard and common-place\\nit may be in its outer aspects, is capable of\\nbeautiful expression. Real sordidness inheres\\nin the characteristic spirit of one s heart and\\nsoul, rather than in the physical environment\\nof one s daily activity. Viewed in this light\\nthe ordinary, and possibly monotonous, care of\\na child may take on a great significance. His", "height": "4360", "width": "2800", "jp2-path": "careofchildinhea00oppe_0314.jp2"}, "311": {"fulltext": "COMMON DISEASES 299\\nclothing, his bathing, his food, his rest, his\\nexercise, become matters of paramount impor-\\ntance. To watch the blossoming of his body\\nand mind gives an indication of munificent\\npotentialities, a vision of never-ending develop-\\nment. To control these things is to have a\\nsovereign power over events both great and\\nsmall. This is the greatest career in the\\nworld it provides boundless opportunities for\\nthe exercise of thoughtfulness, wisdom, affec-\\ntion, careful preparation, and discretion. Its\\nrewards are as great as its opportunities and\\nthe proportion between these opportunities,\\nwhen they are rightly used, and these rewards\\nis exact and never-failing.\\nThe contemplation of such conditions is truly\\ninspiring, for the range of the ideal mother s\\nactivity is scarcely to be limited. There is no\\nchance of business failure, no likelihood of un-\\nappreciated or misunderstood motives, no possi-\\nbility of crushing competition. On the contrary,\\nthe active creator of a wise environment, the\\nsteadfast disciple of adequate methods of child-\\nrearing must necessarily live in an atmosphere\\nof altruistic endeavor, of normal strength, of\\nsatisfied desires, of the consciousness of definite,\\nhuman ambitions whose ends are always worthy.", "height": "4352", "width": "2748", "jp2-path": "careofchildinhea00oppe_0315.jp2"}, "312": {"fulltext": "300 THE CARE OF THE CHILD IN HEALTH\\nThe air of strenuous, long-continued devotion\\nis a healthy one for human beings, and the\\ndevelopment which it perforce entails lies all\\nin the way of ideal growth. This is the foun-\\ndation of civilization, the very essence of the\\nbest part of our modern culture. Those who\\nwilfully neglect such a career not only are\\nlacking in sense of duty, but also map out for\\nthemselves a life of pettiness, of unprofitable\\nstruggling, of unsatisfying pleasures. Here is\\na difference such as exists between beauty and\\nugliness, between right and wrong, between\\nlife and death.", "height": "4392", "width": "2796", "jp2-path": "careofchildinhea00oppe_0316.jp2"}, "313": {"fulltext": "INDEX\\nAbdomen, pendulous, 44.\\nAbdominal band, 52.\\nAdenoid vegetations as cause\\nof defective sleep, 44.\\nAfternoon nap, 132.\\nAlcohol, 258.\\nAlcohol rubbings, 117.\\nAnkle shoes, 177.\\nAntipyretics, 281-282.\\nAntitoxines, 278.\\nAphasia, functional, 198.\\nAppendicitis, 287.\\nArithmetic, study of, 235-236.\\nArtificial foods, 89-92.\\nBaby s outfit, 47.\\nBacteria, 274-276.\\nconditions for growth of, 275.\\nBand, abdominal, 52.\\nBarrow coat, 55.\\nBase-ball, 159.\\nBasket-ball, 159.\\nBassinet, 51.\\nBath, in eruptive fevers, 282.\\nsponge, 282.\\ntemperature of, 115.\\ntime for, 115.\\nBath apron, 116.\\nBathing, 111.\\nat three and one-half years,\\n120.\\nBathing, freedom from draughts\\nduring, 115-116.\\nin second year, 119.\\nin sickness, 281.\\nin summer, 118.\\nmethod, 116.\\nBath-tub in nursery, 65-66.\\nBib, infant s, 59.\\nBicycle saddle, 155.\\nBicycling, 154.\\nBirth-paralysis, 255.\\nBladder, control of, 187, 188.\\nBlanket, pinning, 55.\\nBoogy man, 192, 245.\\nBooties, 55.\\nBottles, nursing, care of, 86-87.\\nBronchitis, 293.\\nBroncho-pneumonia, 294.\\nC\\nCancer, heredity of, 273.\\nCape for pregnant women, 42.\\nCarbohydrates, function of, 98.\\nCarnrick s Soluble Food, 91.\\nCattle, inspection of, 79.\\nChanging ideals of women, 10-\\n11.\\nmethods in commercial life,\\n7.\\nChicken-pox, 295-296.\\nChinese method of dressing,\\n167.\\nCleanliness of nursery, 65.\\nCloak for pregnant women, 42.\\n301", "height": "4336", "width": "2724", "jp2-path": "careofchildinhea00oppe_0317.jp2"}, "314": {"fulltext": "302\\nINDEX\\nClothing, color of, 169.\\nfor children, 163.\\nfor play, 174.\\nfor sensitive skins, 167.\\nfor summer, 169.\\nfor winter, 169.\\nfunction of, 164.\\nCold in throat, 292-293.\\nColds in head, 292.\\nColors of clothing, 169.\\nComforter, artificial, 136.\\nComforters, 186-187.\\nCommon diseases, 270.\\nCompanions, 221.\\nConcentration, 201.\\nCondensed milk, 91.\\nConditions for sleep, 131.\\nConduction, 164.\\nConsanguineous marriages, ef-\\nfects of, 264.\\nConstipation, habitual, 105.\\nControl of bladder and rectum,\\n187-188.\\nCool baths, 121.\\nCooperation of parents and\\nchildren, 220.\\nCorsets for pregnant women,\\n37, 39.\\nuse of, during exercise, 158.\\nCorset waists for pregnant\\nwomen, 37.\\nCotton, nature of, 167.\\nCountry, living in, 214.\\nCourtesy in children, 193.\\nCowardice in children, 191-192.\\nCreed, 246.\\nCretinism, 254-255.\\nCruelty in children, 190.\\nD\\nDancing, 156.\\nDa Vinci, Leonardo, example,\\nof, 2.\\nDeaf-mutism, 266.\\nDecoration of nursery, 63.\\nDefective children, 251.\\ncause of, 253.\\ninstitution for, 269.\\nDeflected nasal septum as\\ncause of disturbed sleep,\\n144.\\nDevotion of parents, 206.\\nDiaper, material for, 51.\\nsize of, 52.\\nDiaper-cover, impervious, 58.\\nDiet for child of fifteen months,\\n96.\\nDifficulties in home making,\\n12-13.\\nDisease, always has a cause,\\n271.\\neffects of, 276.\\nDiseases of stomach and intes-\\ntines, 283.\\nDomestic careers, 15-16.\\nDouche baths, 121.\\nDreams, 142.\\nDress, simplicity in, 178-179.\\nDressing, Chinese, method of,\\n167.\\nDriving, 160.\\nDrunkenness, inherited, 263.\\nDuty of father, 212-213.\\nE\\nEars, cleanliness of, 117.\\nEcholalia, 198.\\nEconomy of time in arranging\\ndaily work, 33.\\nEducation, 225.\\nage for, 225-228, 229.\\nby example, 230.\\nfor children under kinder-\\ngarten age, 231.\\nin kindergarten, 232-234.\\nin primary school, 234.", "height": "4380", "width": "2800", "jp2-path": "careofchildinhea00oppe_0318.jp2"}, "315": {"fulltext": "INDEX\\n303\\nEducation, of the home, 230.\\nplan of, 242-243, 249.\\nEffect of disease, 276.\\nElements of food, 98.\\nEnlarged tonsils, 290.\\nEnthusiasm in work, 1-2.\\nEnvironment, meaning of, 207.\\nEquestrian tights for pregnant\\nwomen, 37.\\nEthics, 243.\\nEvaporation, 164-165.\\nExcretion, in medical treat-\\nment, 279.\\nExercise, 146.\\na necessity, 148-149.\\nfor child of five years, 152.\\nfor child of ten years, 159.\\nfor child of three years, 151.\\nfor girls, 157.\\ngirls costume for, 158.\\nof infants, 150.\\nExposure of nursery, 59.\\nEyelids, cleanliness of, 116.\\nFabrics, difference between va-\\nrious, 166.\\nFamily pleasures, 217.\\nFats, function of 98.\\nFear, of darkness, 192.\\nof lightning and thunder,\\n192-193.\\nFeather beds, use of, 137.\\nFeeding, during second year,\\n95 et seq.\\nfor child over three years, 103.\\nfor child of one and one-half\\nyears to three years, 102.\\nfor child over fifteen months,\\n101.\\ninfant, by teaspoon, 89.\\ninfant, intervals, 84.\\ninfant, quantities, 84.\\nFeeding in sickness, 280-281.\\nof infant, 70.\\nFencing, 159.\\nFermentation of food, 284.\\nFever powders, 281.\\nFiltered water, 108.\\nFlax, nature of, 167.\\nFloor of nursery, 62.\\nFollicular tonsillitis, 291.\\nFood and sleep, comparative\\nvalue of, 129.\\nFood, best, for infant, 71.\\nelements of, 98.\\nFoods, artificial and proprie-\\ntary, 89-92.\\nFoot-ball, 159.\\nFun, love of, 220.\\nFunction of the pregnant wo-\\nman, 23.\\nFurnishing of nursery, 59.\\nG\\nGarters, round, 173.\\nGastric disorders, 283.\\nGastric juice in infancy, 99.\\nGeography, study of, 239-241.\\nGerber s Food, 91.\\nGerms, 274-276.\\nGhost stories, 192.\\nGolf, 160.\\nGrammar, study of, 236-237.\\nGymnasium at home, 161.\\nH\\nHabit, and heredity, 181.\\nand plasticity, 181.\\nforce of, 180.\\nof being quiet, 184.\\nof cleanliness, 187-188.\\nof nail biting, 199.\\nHabits, 180.\\nof courtesy, 193.", "height": "4348", "width": "2760", "jp2-path": "careofchildinhea00oppe_0319.jp2"}, "316": {"fulltext": "304\\nINDEX\\nHabits, of cowardice, 191.\\nof cruelty, 190.\\nof obedience, 189.\\nof regularity, 189.\\nof restlessness, 184-185.\\nof speech, 194-195.\\nof sucking, 186.\\nof tastefulness, 193.\\nof tongue sucking, 186.\\nof tongue swallowing, 186.\\nof tyranny, 190.\\ntime for forming, 184.\\nHabitual constipation, 105.\\nHamper, 51.\\nHawley s Food, 91.\\nHeart disease, heredity of, 273.\\nHeat depression, relieved by\\nbaths, 118.\\nHernia, umbilical in infants,\\n53.\\nHome gymnasium, 161.\\nHorlick s Food, 90-91.\\nHour for retiring, 133.\\nHubbelPs Prepared Wheat, 91.\\nHydrocephalus, congenital, 254.\\nIce-box for nursery, 65, 68.\\nImitation, 246.\\nImperial Granum, 91.\\nImpressibility of children, 210-\\n211.\\nInebriety, inherited, 263.\\nInefficiency of women in house-\\nhold, 10.\\nInfant-feeding, intervals, 84.\\nquantities, 84.\\nInherited weakness, 272.\\nInsanity, heredity of, 273.\\nInsomnia, 138.\\nInspection of cattle, 79.\\nIntestinal disorders, 285.\\nIrrigating bowels, 286.\\nIsolation in communicable dis-\\nease, 296.\\nK\\nKalmuc type, 253, 257.\\nKindergarten, 232-234.\\nKnickerbockers, boys 173.\\nKnowledge of sex, 218.\\nLactated food, 91.\\nLactopreparata, 91.\\nLanguage, study of, 243.\\nLaryngitis, 292.\\nLate age of marriage, 7.\\nLayette, list of articles in, 49.\\nLeather for shoes, 178.\\nLeggings for pregnant women,\\n43.\\nLiebig foods, 90-91.\\nLife-work of women, 4-5.\\nLight in sleeping-room, 138.\\nLime-water in milk modify-\\ning, 86.\\nList of articles in layette, 49.\\nLobar pneumonia, 293-294.\\nLong dresses for infants, 55-56.\\nLying-in, utensils for, 45.\\nM\\nMackintosh for clothing, 168.\\nMalted milk, 91.\\nManagement of household\\nduties, 33-34.\\nMastication, slow, 109.\\nMasturbation, 199, 201.\\nMaternal duties, necessity of, 5.\\nMaternal impressions, 27-30,\\n258.\\nMatting for nursery, 62.\\nMeasles, 295-296.", "height": "4360", "width": "2820", "jp2-path": "careofchildinhea00oppe_0320.jp2"}, "317": {"fulltext": "INDEX\\n305\\nMedicines, 280.\\nMellin s Food, 90-91.\\nMicrocephalia, 253.\\nMilk, analysis of human and\\ncow s, 80.\\nas carrier of infection, 79.\\ncow s, boiled, 77-78.\\ncow s, cleanliness of utensils,\\n77.\\ncow s, raw, 77.\\ncow s, sterilized, 77-78.\\nhuman, physiological value\\nof, 71-72.\\nlaboratories, 81.\\nmodification of, 81-86.\\nmodification of, with lime-\\nwater, 86.\\nMoccasins for children, 176.\\nModification of milk, 81-86.\\nMongol type, 253, 257.\\nMorris, William, example of, 2.\\nMother, as educator, 227-228.\\nduty of, 211-212.\\nfunction of, 298-300.\\nMother s milk, value of 71.\\nwhen deficient, 73.\\nMouth, cleanliness of, 117.\\nN\\nNail-biting, 199.\\nNap, afternoon, 132.\\nNatural wool, 165.\\nNavel, rupture of, in infant, 53.\\nNeed of rest greatest in young\\nchildren, 132.\\nNervous shock, 257-258.\\nNestle s food, 91.\\nNightgown, infant s, 57-58.\\nNightgowns, 133.\\nNight lamp, 138.\\nNightmare, 140.\\nNight terrors, 141.\\nNipples, care of, 87-88.\\nNitrogeneous foods, 98.\\nNose-picking, 144.\\nNurse-maids, function of, 209.\\nNursery, bath-tub in, 65-66.\\ncleanliness of, 65.\\ndecoration of, 63.\\nexposure of, 59.\\nfloor of, 62.\\nfurnishing of, 59.\\nice-box for, 65, 68.\\nmatting for, 62.\\nrugs for, 62.\\nscreen for, 65, 67.\\nthe, 47.\\ntoilet chair in, 65.\\nventilation of, 60.\\nwall-paper for, 63.\\nwash-basin for, 65, 67.\\nNursing, position of infant dur-\\ning, 88.\\nNursing-bottles, care of, 87-88.\\nO\\nObedience, 189.\\nObstetric forceps, value of, 255.\\nOpiates, 280.\\nOpium, 258.\\nOutfit, for infant, 47.\\nlist of articles for, 49.\\nOveralls for girls and boys,\\n174.\\nOver-indulgence, 190.\\nPacifiers, 136, 186, 187.\\nParalysis, birth-, 255.\\nParental impressions, 260.\\nParent, the true teacher, 250.\\nPartial sleep, 141.\\nParticipation in family life, 216.\\nPasteurized milk, 77, 79.", "height": "4360", "width": "2724", "jp2-path": "careofchildinhea00oppe_0321.jp2"}, "318": {"fulltext": "306\\nINDEX\\nPendulous abdomen, 44.\\nPenmanship, 238.\\nPeptogenic Milk Powder, 91.\\nPersistence, 201.\\nPinning blanket, 55.\\nPlasticity of children, 208.\\nPleurisy, 295.\\nPneumonia, lobar, 293-294.\\nPosition during sleep, 137.\\nPrecocity, a cause of, 133.\\nPregnancy, 23.\\nPregnant women, arrangement\\nof duties of, 32.\\ncape and cloak for, 42.\\ncorsets and corset waists for,\\n37, 39.\\ndiet of, 31.\\ndressing for, 34.\\nequestrian tights for, 37.\\nleggings for, 43.\\nshoe for, 42.\\nskirts for, 40, 41.\\nstockings for, 37.\\nunderclothes for, 35.\\nunderskirts for, 36.\\nwaists for, 40, 41.\\nwrappers for, 41.\\nPre-marital training, 19, 20.\\nPrenatal effects, 27, 30.\\nPreparation for child-birth,\\n25-26.\\nPrimary school, 234.\\nProprietary foods, 89-92.\\nProteids, function of, 98.\\nPutrefaction of food, 284.\\nRadiation, 164.\\nRaw milk, 77.\\nRectum, control of, 187-188.\\nRegularity in habits, 189.\\nRelation between unborn child\\nand mother, 24-25.\\nRelation of parents to children,\\n204.\\nReligious training, 243.\\nRespiration, function of, 289.\\nRespiratory diseases, 289-295.\\nResponsibility, for children s\\nhabits, 202-203.\\nin men and women, 4.\\nsense of, 3.\\nRetiring, time for, 133.\\nRheumatism, heredity of, 273.\\nRidge s Food, 91.\\nRiding, 160.\\nRobinson s Patent Barley, 91.\\nRocking child asleep, 135.\\nRubber cloth for clothing, 168.\\nRubber shoes, 178.\\nRugs for nursery, 62.\\nRules for infant s garments, 48.\\nRupture of navel in infant, 53.\\nSalt baths, 123.\\nScarlet fever, 295-296.\\nSchool, primary, 234.\\nScreen for nursery, 65, 67.\\nSea baths, 125.\\nSelf-control, 201.\\nSex, knowledge of, 218.\\nShock, nervous, 257-258.\\nShoes, ankle, 177.\\nfor children, 175, 177.\\nknitted, for infants, 55.\\nfor pregnant women, 42.\\nrubber, 178.\\nSickness, cause of, 271.\\nSilk, function of, 111, 113.\\nnature of, 167.\\nSimple domestic conditions,\\nnecessity of, 13-14.\\nSinging child asleep, 135.\\nSkirts, infant s, 53.\\nfor children, 172.", "height": "4360", "width": "2736", "jp2-path": "careofchildinhea00oppe_0322.jp2"}, "319": {"fulltext": "INDEX\\n307\\nSkirts for pregnant women,\\n40-41.\\nSleep, 129.\\nand food, comparative value\\nof, 129.\\nconditions for, 131.\\npartial, 141.\\nphysiology of, 129-130.\\nposition during, 137.\\nSleeping garments, 133.\\nSleeping mixtures, 280.\\nSlip, infant s, 56, 57.\\nSnoring, 144.\\nSoap for infant s use, 116.\\nSomnambulism, 143.\\nSoothing syrups, 280.\\nSparring, 160.\\nSpecialization in work, 8.\\nSpeech, habits of, 194-195.\\nnormal limit of acquiring,\\n266.\\nSpelling, study of, 237-238.\\nSphere, women s, 21.\\nSpices, use of, 99.\\nSponge bath, 282.\\nSponge baths in hot weather,\\n118.\\nSprue, 283.\\nSucking habits, 186.\\nSucking reflex, 136.\\nSugars, function of, 98.\\nSugar teat, 136.\\nSugar teats, 186, 187.\\nSummer clothing, 169.\\nStammering, 197, 198.\\nStarches, function of, 98.\\nSterilized milk, 77-78.\\nStockings, for children, 171.\\nfor pregnant women, 37.\\ninfant s, 54.\\nStuttering, 196, 197.\\nSwimming, 153.\\nSwiss foods, 91.\\nTable manners for children,\\n109.\\nTalking in sleep, 144.\\nTeeth, care of, 120.\\nTeething syrups, 280.\\nTennis, 159.\\nThrush, 283.\\nThumb sucking, 137.\\nToilet chair in nursery, 65.\\nTongue sucking, 186.\\nTongue swallowing, 186.\\nTonsil, pharyngeal, 289.\\nTonsillar hypertrophy, 290.\\nTonsillitis, follicular, 291.\\nTonsils, 289.\\nenlarged, 290.\\nToxines, 275, 277.\\nTreatment, general, of disease,\\n279.\\nTub-bath, 123.\\nTubercular diathesis, 256.\\nTuberculosis, 272.\\nheredity of, 272.\\nTyphoid fever, 295, 296.\\nTyranny in children, 190.\\nU\\nUmbilical hernia in infant,\\n53.\\nUnborn child, 24.\\nUnderskirts for pregnant\\nwomen, 36.\\nUnderwear, for children, 170,\\n171.\\nfor pregnant women, 35, 36.\\nUnion in family, 214, 215.\\nUnion underwear, 170.\\nUnselfishness, 222.\\nUtensils for lying-in, 45.", "height": "4360", "width": "2788", "jp2-path": "careofchildinhea00oppe_0323.jp2"}, "320": {"fulltext": "308\\nINDEX\\nVentilation of nursery, 60.\\nVermiform appendix, 287.\\nVocation, women s, 4-5.\\nVulva, cleanliness of, 117.\\nW\\nWaist for children, 171.\\nWaists for pregnant women, 40,\\n41.\\nWalking, correct, 153.\\nWall-paper for nursery, 63.\\nWash-basin for nursery, 65, 67.\\nWashing, occasional, of child,\\n118.\\nWashing out bowel, 286.\\nWater filter, 108.\\nWaterproofed wools, 170.\\nWeaning, 92, 95.\\nWet-nurse, 75-76.\\nWet pack, 282.\\nWinter clothing, 169.\\nWomen s life-work, 4-5.\\nWomen s sphere, 21.\\nWomen s work usually subor-\\ndinate, 9.\\nWool, absorbability of, 187.\\nnatural, 165.\\nuse of, 165, 168.\\nwashing of, 168.\\nWrapper for infant, 57.\\nWrappers for pregnant women,\\n41.\\nWrestling, 160.\\nWriting, 238.", "height": "4360", "width": "2740", "jp2-path": "careofchildinhea00oppe_0324.jp2"}, "321": {"fulltext": "THE DEVELOPMENT OF THE\\nCHILD\\nBy NATHAN OPPENHEIM, M.D.\\ni2mo. Cloth. $1.25 net\\nThe Development of the Child, by Nathan Oppenheim, is a most\\nvaluable contribution to a subject of universal importance and interest.\\nThe book is written from full knowledge, and it is practical; it should be\\nstudied by every parent, and if its wise counsels were followed the child\\nwould be the happier and the better for it. Dr. Oppenheim gives the best\\nand the soundest of advice, he is always scientific, even when he is opposing\\nsome of the cherished isms of our day, and his book stands in the very front\\nrank as a lucid, well-reasoned, and trustworthy guide on the development of\\nthe child. Boston Saturday Evening Gazette.\\nThis is an exceedingly helpful book. Its conclusions are intended by\\nthe author to be based upon extended observations and some experiments,\\nand the impression is given the reader that it is so based. Such is\\nthe wholesomeness of the discussion of the place of the primary school in\\nthe development of the child, and the place of religion therein, of the\\nvalue of the child as a witness in court, of the development of the child\\ncriminal, of the child s development as a factor in producing the genius and\\nthe defective, of the effect of institutional life upon the development of the\\nchild, and of the profession of maternity, that the book can be commended\\nmost heartily.\\nIt is a book with a mission for mankind. The author has a great pur-\\npose, and his treatment is both scholarly and original. So often these studies\\nare merely recreations of men or women with fads, who, lacking the inspi-\\nration of scholarship and the training of thinking, drift aimlessly in their\\nobservations, that it is refreshing to find scholarship, thought, and purpose\\ncombined in a great mission. Journal of Education.\\nTHE MACMILLAN COMPANY\\n66 FIFTH AVENUE, NEW YORK", "height": "4356", "width": "2652", "jp2-path": "careofchildinhea00oppe_0325.jp2"}, "322": {"fulltext": "THE MEDICAL DISEASES OF\\nCHILDHOOD\\nBy NATHAN OPPENHEIM,\\nA.B. (Harv.), M.D. (Coll. P. S., N. Y.),\\nAttending Physician to the Children s Department of Mt. Sinai Hospital\\nDispensary; author of e The Development of the Child.\\nWith one hundred and one original illustrations in half tone,\\nand nineteen temperature, pulse, and respiration charts. Cloth, 8vo.\\nThe Medical Diseases of Childhood is a book that repre-\\nsents the most modern view of its subject. It aims to take a middle\\nplace between the unwieldy and poorly digested syndicate works\\non the one hand, and on the other the older type of book that lacks\\na satisfactory pathology and a logical plan. It seeks to work out a\\nmodern view of pathogenesis, to connect the lesions with the\\nsymptoms, and to suggest a reasoning relationship between these\\nfactors and a simple method of treatment. An unusually valuable\\nand interesting feature of the book is in the matter of illustrations.\\nThey consist of more than a hundred photo-micrographs, done in\\nhalf-tone, that are both original and striking. They have a far\\ngreater didactic value than the ordinary pictures of instruments or\\ngross representations of patients, and are in themselves deserving\\nof cordial recognition.\\nComments of the press on Dr. Nathan Oppenheim s former work:\\nDr. Oppenheim shows himself a careful and judicious investi-\\ngator, and is happily free from the hasty generalization which makes\\nuseless so much of the literature dealing with the facts of child life.\\nJournal of Pedagogy,\\nIt is difficult to restrain one s enthusiasm when speaking of\\nit. The Outlook,\\nHis book should be read by all who are interested in the\\nproper education and training of children. They will find in it a\\ngood deal of original thought and many valuable suggestions.\\nNew York Herald.\\nTHE MACMILLAN COMPANY\\n66 FIFTH AVENUE, NEW YORK", "height": "4360", "width": "2748", "jp2-path": "careofchildinhea00oppe_0326.jp2"}, "323": {"fulltext": "", "height": "4360", "width": "2596", "jp2-path": "careofchildinhea00oppe_0327.jp2"}, "324": {"fulltext": "", "height": "4388", "width": "2700", "jp2-path": "careofchildinhea00oppe_0328.jp2"}, "325": {"fulltext": "", "height": "4360", "width": "2640", "jp2-path": "careofchildinhea00oppe_0329.jp2"}, "326": {"fulltext": "MAY 121900", "height": "4360", "width": "2792", "jp2-path": "careofchildinhea00oppe_0330.jp2"}, "327": {"fulltext": "", "height": "4348", "width": "2584", "jp2-path": "careofchildinhea00oppe_0331.jp2"}, "328": {"fulltext": "", "height": "4449", "width": "2920", "jp2-path": "careofchildinhea00oppe_0332.jp2"}}