HYGIENE OF INFANCY AND CHILDHOOD

No characteristic of the Caucasian mind is more marked, and none more
universally affects his actions than a constant, gnawing suspicion that
the things going on around him are not being done in the proper way, and
consequently an irrepressible desire to experiment, and if possible, to
change everything. Such a spirit is unquestionably the basis of what we
call progress, and, in so far as it conduces to the health and happiness
of mankind, is entitled to our most hearty commendation. On the other
hand, it cannot be denied that too often we endeavor to bring about
changes with but an imperfect understanding of the basic principles at
issue, and naturally, under such circumstances, our efforts are crowned
with anything but success. In other words, an enlightened investigation
of the whys and wherefores of any existing state of affairs may and
often does, lead to improvement, while, on the other hand, ignorant
meddling is likely to be followed by disastrous consequences.

Nowhere do we see the bad results of false conceptions more marked than
in our treatment of infants and children.

     Particularly do young infants suffer in this way, as they are
     pounced upon as soon as they enter the world by every old "granny"
     and negro "mammy" in the neighborhood, and plied with abominable
     concoctions that would be productive of homicide if we were to
     attempt forcibly to administer them to grown men, and whose only
     effect on the defenseless little sufferer is to cause colic and
     indigestion. Many times has the writer seen a wee, tiny little
     mortal, who was too young and weak to even protest, bundled up with
     a mountain of flannels in the hottest weather of July and August.
     True to the superstition that the warmer we kept an infant the
     better, too frequently we see them confined to hot stuffy rooms
     when they should be out in the sunshine, or under the trees.
     Instead of being allowed to gain health and strength in the
     forests, which are the schoolhouses of nature, the miserable little
     wretch is later sent to a public school as soon as he or she can be
     trusted to go alone on the streets, and the tiny victim too
     frequently contracts diphtheria, scarlet fever, whooping-cough,
     measles, or some other disease as a reward of merit. Truly we see
     to it that the helpless innocents early realize the truth of the
     melancholy and hopeless biblical lament that "man's days here are
     few and full of trouble."

We should rear our children with as little interference as possible,
allowing them the utmost freedom compatible with their safety, and
permitting them to do those things that nature and instinct demand. Above
all let them sleep as much and as long as they will, insist that they
live in the open air, and encourage them in every possible way to perfect
their physical education by those active amusements that they
instinctively prefer. After they have established a sound and rugged
constitution ample time will be left for them to develop mentally.

_Feeding of Nursing Infants._--The most important thing in connection
with the feeding of infants is to always remember that nature has
provided in their mother's milk, when sufficiently abundant and normal in
quality, everything in the way of food and drink that they require.
During the three days that usually intervene between birth and the coming
of the milk in the mother's breast, infants may be given from time to
time small quantities of pure water, but under no circumstances should
anything else be allowed. During this period the child may be put to the
breast four or five times in the twenty-four hours, for, while it gets
but little in the way of nourishment, there is even at this time a watery
fluid secreted in the breast that goes far towards supplying everything
that the infant needs for the time being.

A child should never nurse longer than twenty minutes at one time. It is
likewise of importance that the time of nursing be strictly regulated.

Particularly during the first year it is of the utmost importance to
watch with an intelligent eye the growth and development of the child.
Where the milk agrees with it it has a good color and gains regularly in
weight; it cries but little, and is good natured, and thoroughly
contented. Should it, on the other hand, lose weight, appear fretful and
listless, and sleep badly, there is something wrong, and the mother
should at once have her milk examined by a competent physician.

In case the mother does not give sufficient nourishment there is no
objection to partially feeding the infant on modified cow's milk--the
method of the preparation of which will be considered later on.

Where colic occurs it generally means that the infant is getting a diet
too rich in albuminous foods, which should be corrected by advising the
mother to take an abundance of out-door exercise, and to avoid all causes
of worry so far as is possible.

Vomiting freely is a very common occurrence in small children, and is
usually the result of too much food being taken at a time. It also
occurs, particularly some time after feeding, as a result of indigestion,
which is frequently the consequence of the milk being too rich in fats.
Wherever an infant shows signs of trouble it is well to advise the mother
to use a diet less rich in meats, and to caution her against over-eating.

Children should be weaned at the end of their first year. This had best
be brought about gradually, by, in the beginning, feeding the child once
daily, and then gradually increasing the frequency, at the same time
proportionately leaving off the nursing. Where children are not thriving,
it is often a good practice to wean earlier, in which case modified cow's
milk, taken from a bottle, must be substituted.

_Artificial Feeding._--While it is true that children often thrive for a
time on the various baby-foods with which the market is so abundantly
supplied, it is, nevertheless, the case that where fed in this way they
are very apt to develop rickets or scurvy, and not uncommonly show
evidences of bad nutrition in loss of weight and strength, becoming
peevish and fretful, and sleeping badly.

Much better than any of the artificial foods is properly modified cow's
milk, which, with care, may be prepared in such a manner as to take the
place of mother's milk in the vast majority of instances. In order,
however, that this be successfully carried out, much care and attention
is necessary.

     At this point it is well to stress the fact that the mother's milk
     differs from that of the cow in some quite important particulars,
     and it is only by intelligently taking these differences into
     consideration that it is possible for us to prepare an artificial
     food that will be satisfactory. Principal among these differences
     are that cow's milk contains three times as much albuminous
     material as that of the human being, and that it is less rich by
     about half in milk-sugar; furthermore, the former is acid in
     reaction, while the latter is neutral, or faintly alkaline. It will
     be seen, then, that in order to prepare a modified cow's milk that
     will approximate that of the human being it is necessary to dilute
     it with water sufficiently to cause the albumin to approach in
     proportion that of mother's milk, and at the same time some alkali
     must be added to neutralize the excessive acidity. Modified milk
     prepared, however, from the whole cow's milk, would contain much
     less fat than is desirable, so that we must use in making it the
     upper third of the whole milk after it has been allowed to remain
     undisturbed for a number of hours; in other words, in making
     modified cow's milk we use a large proportion of the cream, with a
     less amount of the other constituents.

     The following table for calculating the proper proportion of milk
     to be used at the various periods of the infant's life may be
     recommended, as it gives quite as satisfactory results as those
     that are more elaborate; it also gives the frequency of feeding and
     the proper amounts that should be used. The table was devised by
     Dr. C. E. Boynton, of Atlanta, Georgia.

                   Fat      Quantity         No. of
                percentage  ounces at     feedings in    Intervals
                 desired.   feeding.       24 hours.      by day.

     Premature     1.00      1/4 to 3/4      12-18      1 to 1-1/2 hrs.
     1-4  day      1.00    1     to 1-1/2      6-10     2 to 4   "
     5-7    "      1.50    1     to 2         10        2        "
     2-   week     2.00    2     to 2-1/2     10        2        "
     3-     "      2.50    2     to 2-1/2     10        2        "
     4-8    "      3.00    2-1/2 to 4          9        2-1/2    "
     2-   month    3.00    3     to 5          8        2-1/2    "
     4-     "      3.50    3     to 5-1/2      7        3        "
     5-     "      3.50    4     to 6          7        3        "
     6-10 month    4.00    5     to 8          6        3        "
     11-  month    4.00    6     to 9          5        4        "
     12-    "      4.00    7     to 9          5        4        "
     13-    "      4.00    7     to 10         5        4        "

     In making calculations from this table it is assumed that the milk
     from the upper third of the bottle, after it has been allowed to
     sit for at least four hours, contains 10% of fat, and this is
     therefore called 10% milk. The calculation is made as follows:--10%
     milk is to the fat percentage desired, as the amount which we wish
     to make up is to X. For example, if we wish to prepare twenty
     ounces of milk for an infant two months old, we will note by
     referring to the table that 3% is the amount of fat that is
     desirable for a milk for a child of this age, and the formula will
     be constructed as follows:--

       10:3::20:X.   X = 60/10.   X = 6.

     Six ounces is then the amount of 10% milk that must be used for
     making twenty ounces of modified milk,--this being mixed with one
     ounce of lime-water and thirteen ounces of boiled water. It should
     never be forgotten that while milk modified by the foregoing
     formula is suitable for most children, it is by no means always
     satisfactory, and we may, therefore, be compelled to do a
     considerable amount of experimenting in some cases before arriving
     at the correct formula.

     Suppose the infant is twelve months old, we would get according to
     the rules just stated the following equation:--

       10:4::20:X.   X = 80/10.   X = 8.

     Eight ounces would then be the amount of milk required for
     preparing twenty ounces of modified milk for an infant of this age.

     In preparing modified milk according to the formulas just given, it
     must be remembered that in all instances only that portion is to be
     used which collects in the upper third of a bottle of milk that has
     been allowed to sit undisturbed in a refrigerator for at least four
     hours. The lime-water is for the purpose of correcting the acidity
     of the milk.

     It is of much importance to select the milk from a healthy cow in
     all instances where it is to be fed to infants, and where possible,
     it should be examined by a competent laboratory man in order to
     determine if it answers the proper requirements. The writer has
     often seen milk from apparently healthy cows, which seemed in every
     way good, that showed on microscopic examination pus cells and a
     harmful germ (streptococcus).

     It is not desirable to have a milk for this purpose that is too
     rich in fats, and for this reason a cow of the ordinary mixed breed
     is more satisfactory than the blooded Jerseys or Alderneys.

     Not only is it essential to get the proper kind of milk, but the
     utmost care is necessary in handling it. It should, of course, be
     as free as possible from every source of contamination, and should
     be strained thoroughly as soon as milked. It should then be
     bottled, and chilled at once by being placed in cold water, and
     after being properly sealed, should be placed in a refrigerator at
     a temperature of about 50°F., where it should remain undisturbed
     for four hours before the top portion is skimmed off for making the
     modified milk.

     After the modified milk has been prepared it should be returned to
     the refrigerator, where it should be kept until required for
     feeding. It is best not to use milk that has been in the
     refrigerator longer than twenty-four hours, or at most forty-eight
     hours, and then only if kept at a proper temperature. The modified
     milk should be poured directly from the receptacle in which it is
     kept into the feeding-bottle, and the latter should then be placed
     in warm water until its content is milk-warm, at which time it is
     ready to be given to the child.

It is highly necessary in feeding infants by the bottle to remember that
cleanliness in everything connected with the process only makes success
possible, and in no particular does this apply with greater force than in
connection with the proper care of the bottle and nipple. In every case
immediately after use they should both be put in water, which should then
be brought to a boiling temperature, and both should then be kept in a
saturated solution of boric acid. The nipple, after being placed on the
bottle, should not come in contact with anything but the infant's mouth.
Bottles that have no neck are much to be preferred to others, as they can
be readily cleansed. There is on the market at the present time a bottle
called the "Hygeia," which possesses the necessary qualifications in a
perfectly satisfactory way.

When children who have nursed at the mother's breast reach the age of
weaning it is of importance to remember that they cannot eat without
digestive disturbances the modified cow's milk of a strength that would
otherwise correspond to their age; they should invariably under such
circumstances begin with a milk prepared by the formula used for a child
several months younger, after which the proportion of milk may be
gradually increased until it is used in a pure state.

During very warm weather it is well to reduce the amount of fat by using
the whole milk instead of the top portions, as heretofore described. The
same precaution should be followed where children have acute diseases,
and the total quantity taken should be less than under ordinary
circumstances. Where infants have acute indigestion, accompanied by
vomiting and diarrhoea, all milk should be for the time withheld,--boiled
water being substituted; some hours later barley water may be given, but
no milk for at least twenty-four hours. Where children have loss of
appetite, it is well to give less cream, and the intervals between food
should be increased.

_Sterilized (Pasteurized) Milk._--During epidemics of dysentery,
diarrhoea, typhoid fever, scarlet fever, and diphtheria, as well as in
those instances where it is suspected that the cow is not healthy, or
where the milk has to be kept for considerable periods of time, it is
well to sterilize it by heating. The most effective method of
accomplishing this is by boiling the milk for an hour or so, but
inasmuch as it is believed to be then not quite so wholesome as when less
heat is employed, a process known as _pasteurization_ is frequently used;
this consists in heating the milk for thirty minutes to from 155° to
160°F.,--such temperatures killing all of the ordinary germs, but not
altering the milk so completely as when it is boiled.

_Peptonized Milk._--It now and then happens that children fail to thrive
where all of the precautions heretofore referred to have been strictly
adhered to, and under such circumstances good results are frequently
secured by subjecting the milk to a process known as _peptonization_.
This consists in the addition of a digestive ferment, obtained from the
pancreas of lower animals, together with ordinary cooking-soda. In
carrying out the process the milk, whether whole or modified, is placed
in a clean bottle, and the peptonizing powder added after having been
rubbed up with a teaspoonful of milk. The container is then placed in a
pitcher of water at a temperature of 110°F., which is about as warm as
the hand can bear comfortably, and is here left for from ten to twenty
minutes if only partial peptonization is desired, or for a couple of
hours should it be wished to complete the process. The peptonized milk
may be prepared at each feeding, or the whole amount for the day may be
made at one time in the morning; in the latter case, where it is desired
to have the milk only partially peptonized, the ferment should be
destroyed by boiling after it has been allowed to act for from ten to
twenty minutes.

_Feeding after the First Year._--As the infant is weaned other food
should be gradually added; this should still consist largely of milk, to
which some time later may be added gruels prepared from well-cooked oats
or barley, beef-juice, or the white of an egg slightly cooked. The
various broths may also be allowed. Children relish very much all
fruit-juices, and they may be given in moderation without harm, and even
with benefit in many cases. As the child grows older, the various cereals
should form a greater and greater proportion of its diet, but due care
should be exercised in always seeing to it that they are thoroughly
cooked; in order to be digestible for children such substances should be
cooked at least three or four hours before eaten.

_General Hygiene of Infant Life._--In order for children to be healthy,
the greatest regularity is necessary in their habits. They should arise
at a certain hour in the morning and go to bed at a fixed time at night.
Their clothing should be loose, and not too tight fitting, and should at
all times correspond to the state of the weather. Nothing is more common,
and nothing produces irritability, loss of sleep, and even serious
general disturbances in infants, more frequently than too much clothing.
It is generally customary to use from the time of birth and during the
period of infancy a flannel band around the child's abdomen. Just how
this acts is not clear, but there seems good reason for the belief that
in some unexplained way the practice has the effect of warding off
intestinal disturbances, and is, therefore, to be recommended.

Napkins should be changed when soiled, and then should be immediately
placed in water, in which they should remain until washed out; under no
circumstances should they be left lying around the nursery.

When the weather permits, the child should be kept as much out-of-doors
as is possible. For the first few days of the infant's life, particularly
if the weather be cool, it should, of course, be kept indoors, but even
then free access of air should be allowed. There is no objection whatever
to the infant sleeping out-of-doors--in fact, where this is feasible, it
generally shows improvement as soon as the practice is commenced. When
out-of-doors, it is of course necessary to see that the sun does not
shine directly into the infant's face, and wetting should, of course, be
avoided; also the hood of the carriage should be arranged to prevent
strong winds from blowing on the child.

The nursery should be well aired, a window being left up at night except
during severe weather.

_Sleep._--Nothing is more important for the proper development of a child
than for it to have an abundance of sleep. During the first few months of
its life it sleeps practically all of the time--the period becoming
gradually lessened as it grows older. Infants should be suffered to sleep
just as much as is possible, it being not only unjustifiable but
absolutely criminal to interfere with them in this particular in the
slightest degree. Not only is it necessary that infants have all the
sleep that they desire, but it is true throughout childhood, a fact to
which many foolish parents seem utterly oblivious. How often do we see a
child scarcely more than an infant aroused in the morning and sent off to
school, and how frequently do we hear misguided parents boast of their
inflexible rules in enforcing such evil practices. Truly man comes hard
by the knowledge that nature is much wiser than he, and the vast majority
never learn the fact at all.

As soon as the child is able to crawl, it should be placed on a clean
quilt or blanket on the floor, and allowed to move about to its heart's
content. When it is able to walk, allow it to run about and play to its
full capacity--as in such exercises consists the great school of its
physical being, the school upon which will depend its strength and
health in after life. Allow the child to keep up his play as long as he
has any inclination to do so, and never be so foolish as to confine him
in the house when he wishes to be out under the blue heavens, for here
only will it be possible for him or her to develop into a real man or
woman. Allow this to go on until the child of its own accord comes and
asks to be taught other things, for not until then is its outside
education nearing completion, and not until then is it possible for him
to take interest in and learn things connected with books. No boy should
ever be sent to school before he is twelve or fourteen years of age;
girls, on account of their maturing earlier, may begin a couple of years
sooner.

The whole science and art of properly raising children consists in
feeding them good clean food in proper amounts, in never allowing them to
be awakened, and in permitting them to play in the open air to their
hearts' content.

_Teething._--Teething is a subject which has at all times interested both
doctor and layman, and in its supposed relation to all kinds of
disorders of infancy has undoubtedly exercised an influence over the
popular imagination out of all proportion to its real importance. Too
often it has happened that this perfectly normal, and usually by no means
serious, process, has been held responsible for grave diseases in
children--diseases which in reality were the consequence of neglect
and mismanagement in the far more serious matters of food, sleep,
out-of-door exercises, and general hygiene. It cannot, however, be
denied--particularly in respect to nervous children--that teething
appears occasionally to induce unpleasant disturbances, such as
fretfulness, broken sleep, digestive disorders, and occasionally fever;
as a rule such symptoms persist only for a few days, if the infant be
properly looked after. The treatment should consist in lancing the gums
should they become much swollen, and the withholding of the usual amount
of food, particularly where intestinal disturbances occur. The ages at
which the teeth usually come are as follows:

  2  Middle Lower Teeth                5 to  9 months.
  4  Upper Front Teeth                 8 to 12 months.
     Remaining Lower Front Teeth      12 to 18 months.
  4  Front Jaw Teeth                  12 to 18 months.
     Stomach Teeth (Canine)           18 to 24 months.
     Eye Teeth (Canine)               18 to 24 months.
  4  Back Jaw Teeth                   24 to 30 months.

_Bowel Diseases._--Digestive disturbances, accompanied by diarrhoea, are
the bane of infancy, and are responsible for a very large part of the
frightful mortality among babies. The subject, therefore, is one of
tremendous importance, but is so complicated that the limits of this
little volume will only permit its being touched upon.

As already mentioned, indigestion accompanied by looseness of the bowels
may be and often is the result of milk being used from diseased cows, or
it may be the consequence of such carelessness in handling it that
disease-producing bacteria are later allowed to contaminate it. It should
also never be forgotten that where children are eating artificially
prepared food improper mixing of the different components may result in
serious disturbances, and we should, therefore, exercise the utmost care
always in seeing to it that the food is prepared strictly according to
the table which has already been given--not forgetting that in a certain
number of instances we can go by no rule, and will have to experiment
until we ascertain the proper proportion of the ingredients.

After a diarrhoea begins we should at once reduce the quantity of fat in
the milk that is being given to the infant, and if the trouble be at all
severe it is best to take it off of all food for twenty-four hours, and
substitute boiled water or barley-water. As soon as the trouble is
checked we may then begin to feed cautiously with largely diluted milk,
and, gradually increasing its strength, in the course of a few days
return to the food that was being given before the disturbance occurred.
A dose of calomel or castor oil in the beginning of diarrhoeal troubles
often has a very salutary effect; the parent should not hesitate to
administer this if a doctor is not at hand.

In warm climates during the time of teething children very commonly
develop chronic diarrhoeal conditions which often end fatally; wherever
possible the parent should under such circumstances at once remove the
little sufferer to a colder climate where recovery is generally rapid and
complete. Even the most careful nursing under the most competent
physician is often fruitless in combating disorders of this character as
long as the infant remains in a warm climate.

_Colic._--Colic is always due to indigestion, and is the result of the
food undergoing fermentative changes, with the production of gases. This
goes on even under normal conditions to a certain extent, but when it is
excessive the intestines become greatly distended, and pain of a severe
or even agonizing character is produced.

In the treatment of this condition warm applications should be made to
the abdomen, and as quickly as possible an enema (injection), consisting
of a few ounces of warm solution of salt water should be given; the salt
should be in the proportion of a level teaspoonful to the quart of water.
Parents will find the little ear syringe, which may be purchased at any
drug store, a most satisfactory instrument for giving enemas to infants,
as they do not hold too much, and being soft, are incapable of tearing
the delicate tissues of the child. It is of the utmost importance to
remember that the salt solution should be tepid, yet not sufficiently hot
to scald the infant. As the water when given in this way is expelled very
quickly the enemas may be repeated any number of times desired.

Where these measures fail, a physician should be sent for at once, but in
the meantime if it be evident that the infant is suffering very much, a
small dose of paregoric may be given; it should not however be forgotten
that opiates are exceedingly hurtful to nervous children, and that
soothing syrups and other mixtures containing drugs of this class should
be avoided.

_Constipation._--Constipation among very young children generally passes
off as the food becomes richer, but should it occur at a later time, the
trouble may be more difficult to remedy. Of first importance is having
the bowels of the infant move at a certain time each day, which may be
quickly accomplished in many little children by placing them upon a small
chamber daily at a given hour; usually the baby very quickly learns what
this procedure means, and in this way a regular habit is established
which is of the utmost value to the child throughout its infancy, and
every effort, therefore, should be made to bring it about as quickly as
possible.

The addition of malted milk or Mellin's Food may also have the effect of
diminishing constipation;--the result being brought about by the maltose
contained in these preparations. The same thing may be accomplished by
substituting for a part of the milk sugar in the baby's food a similar
quantity of maltose. Milk of magnesia may be used in preparing the baby's
food in the place of lime-water, with the result oftentimes of relieving
a tendency to constipation.

_Croup._--By croup is meant a spasmodic condition which usually affects
children at night, and is in no way to be confounded with that really
dangerous disease, membranous croup, or diphtheria, to which so many
children fall victims.

Spasmodic croup is a condition which has as its basis digestive
disturbances, and is almost always relieved as soon as the stomach is
emptied. Vomiting may be brought about by making the child swallow a
small quantity of mustard stirred up in water, or by the use of ipecac.
Such severe and extremely unpleasant remedies are rarely necessary,
however, since the disease may be in almost all instances at once
relieved by placing around the victim's throat a cloth wrung out of cold
water, which may itself be covered by a dry bandage to prevent the bed
from getting wet. Children will usually go to sleep in a few minutes
after the cold cloth is applied, and suffer no ill consequences as a
result of its remaining around their throats throughout the night. Where
the croup is very severe the little sufferer's feet may be placed in hot
water, in addition to the cold cloth around the neck--the combination
practically always resulting in the rapid relief of the unpleasant
symptoms.

Great care should be exercised in the diet of children who are subject to
croup, as by intelligent supervision the tendency to this very annoying
trouble may be in a short time entirely overcome.

_Nervousness._--Children of neurotic parents, particularly where they are
reared in cities, are exceedingly prone to nervousness in one form or
another. The condition is undoubtedly often due to heredity, but may be
induced in otherwise healthy children by unhygienic surroundings and
improper food. Infants exhibiting symptoms that indicate trouble of this
kind should not be played with, and every care should be exercised to so
direct their lives that the trouble may be gradually overcome. In all
cases where nervousness persists an intelligent physician should be
consulted.

_Vaccination._--The only safe method that we possess of preventing
small-pox is by means of vaccination. Its great value has been so
thoroughly tested that the writer does not deem it necessary to go into a
discussion as to its merits. A child should be vaccinated in at least
three places during its early infancy,--there being no danger in doing
the operation immediately after birth. Persons ignorant of aseptic
surgery should not do this operation, but should always call in the
services of some person prepared to do the work in a cleanly manner.
Either the leg or the arm may be selected; and children should be
revaccinated whenever small-pox breaks out in the community.

_Kissing Babies to be Avoided._--Kissing infants in the mouth is a very
bad practice, as in this way disease may be quite innocently conveyed to
them. The public should be taught to understand that it is not
infrequently the case that bacteria may be present in the mouths of
individuals who are quite immune to their ill effects, and who are,
therefore, perfectly well, but who may, by conveying them to others,
particularly children, induce in them serious disease. When caressed in
this way at all children should be kissed upon their necks or feet, and
never in their mouths or on their hands.

_Juvenile Contagious Diseases._--Children are peculiarly prone to a class
of highly contagious diseases, the exact nature of which is not yet
understood, and we possess therefore little knowledge as to the proper
means of preventing their spread. Practically all that is known about
them is that they are conveyed by contact, or even by the air,
particularly where a child suffering from one of them is placed in a
confined place with another who is susceptible; these diseases likewise
may be carried by means of clothing and other articles that have been in
close contact with a child suffering with any of them. The lesson of
importance to be learned, therefore, is that if we wish our children to
escape maladies of this class we should not permit their indiscriminate
association with others. As these diseases cease to be a serious menace
after children have passed through their earlier years it does not at a
later time matter so much as to whether they are exposed to them or not.
As a general thing children develop these affections in from ten to
fifteen days after having been exposed, though one of the most severe of
them, scarlet fever, may make its appearance as early as twenty-four
hours after it is contracted. These diseases are usually ushered in by a
severe headache, pains in the head, back, and limbs, high fever, and
oftentimes a chill. As soon as a child develops such symptoms the advice
of a competent medical man should be at once sought, and the little
sufferer should be at once completely isolated.

In concluding, the writer would particularly exhort parents to obey to
the letter the instructions of their physicians, and never under any
circumstances to dose their helpless off-spring with patent or
proprietary medicines, which contain no man knows what, and which
unquestionably are often highly injurious, especially to children.