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CHAPTER X.

HINTS FOR THE MOTHER'S EARLY DETECTION OF DISEASE IN THE CHILD.

LIFE is soon extinguished in infancy. At this epoch any disease is formidable, and must be met most promptly. It is either sudden and active in its assaults, or comes with slow and insidious approach. Its first signs are not always visible to an unpractised eye; it may have made dangerous advances before the mother's mind is awakened to its presence; and medical aid may be solicited when remedies and advice are no longer of any avail. It is, therefore, highly important that a mother should possess such information as would enable her to detect disease at its first appearance, and thus insure for her child timely medical assistance, and spare herself those painful but unavailing regrets which a suspicion of neglect would infallibly awaken. This knowledge it will not be difficult for her to obtain. She has only to become familiar with those indications which constitute health, and she will for the most part be able to detect the first appearances of disease.

The condition of the sick child sometimes becomes suddenly worse-for example, when the lungs are the seat of disease-so that in a case in which in the morning perhaps there was no ground for anxiety, by mid-day it becomes one of peril-the child

gasping for breath. Let not the parent draw an unjust inference here, and fancy that the medical attendant has overlooked the approaching danger. He saw the little patient in the morning, and pronounced the case to be doing well, and five hours have only passed and the child appears dying. Yes, this may happen, and yet the opinion given may have been perfectly correct. It would be difficult to explain to an unprofessional person how this may occur-she must be satisfied to know that such sudden and rapid alarming changes may arise, and that even under the most experienced professional treatment. Why do I write this? Because, only yesterday, I was called in great haste to the case of a young child under the charge of a medical brother, who was suffering from hoopingcough combined with inflammation of the lungs, in which what I have described took place; and it was as much as I could do to convince the parents that the previous treatment had been such they could not understand how the child should be doing so well but a few hours before, and then, in so short a time, have seemed next death; the inference of wrong treatment here, however, would have been as unjust as ungene

rous.

Sect. 1.-Signs of Health.

The signs of health are to be found, first, in the healthy performance of the various functions of the body; the regular demands made for its supply neither in excess nor deficiency; and a similar regularity in its excretions both in quantity and appearance.

If the figure of the healthy infant is observed, something may be learnt from this. There will be perceived such an universal roundness in all parts of

the child's body, that there is no such thing as an angle to be found in the whole figure; whether the limbs are bent or straight, every line forms a portion of a circle. The limbs will feel firm and solid, and unless they are bent the joints cannot be discovered.

The tongue, even in health, is always white, but it will be free from sores-the skin cool-the eye bright -the complexion clear—the head cool—and the abdomen not projecting too far the breathing regular and without effort. When awake, the infant will be cheerful and sprightly, ready to laugh, and loving to be played with. When asleep, it will appear calm, every feature composed, its countenance displaying an expression the reverse of unhappiness.

Sect. 2.-Signs of Disease.

Just in proportion as the above appearances are present and entire, health may be said to exist; and just in proportion to their partial or total absence disease will have usurped its place. We will, however, for the sake of clearness, examine the signs of disease as they are manifested separately in the countenance - the gestures-in sleep-in the stools—in the cry-and in the breathing and cough.

The Countenance.-In health the countenance of a child is expressive of serenity in mind and body; but if the child be unwell, this expression will be changed, and in a manner which, to a certain extent, will indicate what part of the system is at fault.

The brows will be contracted if there is pain, and its seat is in the head. This is frequently the very first outward sign of anything being wrong, and will occur at the very onset of disease; if, therefore, remarked at

an early period, and proper remedies used, its notice may possibly prevent one of the most fearful of infantile complaints- Water in the Head.' But if this sign be passed by unheeded, and the above disease be threatened, soon the eyes will become fixed and staring -the head hot, and moved uneasily from side to side upon the pillow, or lie heavily upon the nurse's armthe child will start in its sleep, grinding its teeth, and awake alarmed and screaming-its face will be flushed, particularly the cheeks (as if rouged)—its hands hot, but feet cold-its bowels obstinately costive, or its motions scanty, dark-coloured, and foul.

If the lips are drawn apart, so as to show the teeth or gums, the seat of the pain is in the belly. This sign, however, will only be present during the actual existence of suffering; if, therefore, there be any doubt whether it exists, press upon the stomach, and watch the effect on the expression of the countenance. If the pain arise simply from irritation of the bowels excited by undigested matter, it will be temporary, and the sign will go and come just as the spasm may occur, and slight remedial measures will give relief. If, however, the disease be more serious, and inflammation ensue, this sign will be more constantly present, and soon the countenance will become pale, or sallow and sunken— the child will dread motion, and lie upon its back with the knees bent up to the belly-the tongue will be loaded--and in breathing, while the chest will be seen to heave with more than usual effort, the muscles of the belly will remain perfectly quiescent.

If the nostrils are drawn upwards and in quick motion, pain exists in the chest. This sign, however, will generally be the accompaniment of inflammation of the chest, in which case the countenance will be dis

colowed the eye rearing and the treading will be differt and inmed; and the child's mote of respiration be vedel, de dem will be observed to be manoved wife de bely quietly heaves wish every inspirati

be

Comaritions are generally preceded by some changes in the userance. The upper ip will be drawn up, and is occasionally thrish or brid. Then there Tay slight squinting or a ingia wasion of the eye upon fts own anis; alternate finsking or paleness of the face; and sudden animation followed by languor. These premonitory signs will sometimes manifest themselves many hours, may days, before the amark occurs; and if noticed in time, and suitable medical aid resorted to, the occurrence of a fit may be altogether prevented.

The state of the eyes should always be attended to. In health they are clear and bright, but in disease they become dull and give a heavy appearance to the countenance; though after long-continued irritation they will assume a degree of quickness which is very remarkable, and a sort of pearly brightness which is better known from observation than it can be from description. The direction of the eyes, too, should be regarded, for from this we may learn something. When the infant is first brought to the light, both eyes are scarcely ever directed to the same object; this occurs without any tendency to disease, and merely proves that regarding one object with both eyes is only an acquired habit. But when the child has come to that age when the eyes are by habit directed to the same object, and afterwards it loses that power, this circumstance alone may be looked upon as a frequent prelude to disease affecting the head.

The Gestures.-The gestures of a healthy child are