The Works of Aristotle - [Of Distempers of New-Born Children]

[Of Distempers of New-Born Children]

 

IN new born children there are so many distempers they are subject to, that daily experience shows us there are not above half the children that are born which live till they are three years old; which is occasioned, as well because of the tenderness of their bodies as the feebleness of their age, which hinders them from expressing the inconvenience they labour under, any otherwise than by their cries. The business of this chapter therefore shall be to discover the indispositions to which they are subject, with the remedies proper for them.

 

SECT. I. Of Gripes and Pains in the Bellies of young Children.

THIS I mention first, as it is often the first and most common distemper which happens to little infants after their birth, many children being so troubled and pained therewith, that it causes them to cry night and day, and at last to die of it. The cause of it for the most part comes from the sudden change of their nourishment; for having always received it from the umbilical vessels whilst in their mother's womb, they come on a sudden to change not only the manner of receiving it, but the nature and quality of what they receive as soon as they are born; for instead of putrefied blood only, which was conveyed to them by means of the umbilical vein only, they are now obliged to be nourished with their mother's milk, which they suck with their mouths, and from which are engendered many excrements, causing gripes and pains, and that not only because it is not so pure as the blood with which it was nourished in the womb, but because the stomach and intestines cannot yet make a good digestion, being unaccustomed to it. It is also caused sometimes by a rough phlegm, and sometimes by worms, for physicians affirm that worms have been bred in children even in their mother's belly.

The remedy therefore must be suited according to the cause. If it proceed from the too sudden changes of nourishment, the remedy must be to forbear giving the child suck for some days, lest the milk be mixed with phlegm, which is then in the stomach corrupt; and at first it must suck but little, until it be accustomed to digest it. If it be the excrements in the intestines, which by their long stay increase these pains, give them at the mouth a little oil of sweet almonds and syrup of roses; if it be worms, lay a cloth dipped in oil of wormwood, mixed with ox-gall, upon the belly; or a small cataplasm, mixed with the powder of rue, wormwood, coloquintida, aloes, and the seeds of citron, incorporated with ox-gall, and the powder of lupines. Or give it oil of sweet almonds, with sugar candy, and a scruple of aniseed; it purgeth new born babes from green choler and stinking phlegm; and if it be given with sugar-pap, it allays the griping pains of the belly. Also anoint the belly with oil of dill, or pelitory stamp, with oil of camomile, to the belly.

 

SECT. II. Of Weakness In new born Infants.

WEAKNESS is an accident that many children bring into the world along with them, and is often occasioned by the Labour of the mother; by the violence and length whereof they suffer so much that they are born with great weakness, and many times it is difficult to know whether they are alive or dead, their body appearing so senseless, and their faces so blue and livid, that they seem to be quite choked; and even after some hours, their showing any signs of life is attended with so much weakness, that it looks like a return from death, and that they are still upon the borders of this kingdom.

In this case, the best way to help the infant is to lay him speedily in a warm bed and blankets, and carry him to the fire, and then let the midwife sup a little wine, and spout it into his mouth, repeating it often if there be occasion. Let her apply linen to the breast and belly dipped in wine, and let the face be uncovered, that he may breathe the more freely; also let the midwife keep its mouth a little open, cleanse the nostrils with small linen tents dipped in white wine, that so he may receive the smell of it, and let her chafe every part of his body well with warm cloths, to bring back the blood and spirits, which being retired inwards, through weakness, often puts him in danger of being choked. By the application of these means the infant will insensibly recover strength, and begin to stir his limbs by degrees, and at length to cry, which, though it be but weakly at first, yet afterwards, as he breathes more freely, will cry stronger and stronger.

 

SECT. III. Of the Fundament being closed up in a new Born

Infant.

ANOTHER defect that new born infants are liable to is, to have their fundaments closed up, by means whereof they can neither evacuate the new excrements engendered by the milk they suck, nor that which was amassed in their intestines whilst in their mother's belly, which is certainly mortal without a speedy remedy. There have been some female children who have had their fundament quite closed, and yet have avoided the excrements of the guts by an orifice, which nature to supply that defect had made within the neck of the womb.

For the cure or remedy of this, we must take notice that the fundament is closed two ways; either by a single skin, through which one may discover some black and blue marks, proceeding from the excrements retained, which, if one touch with the finger, there is a softness felt therein, and thereabout it ought to be pierced; or else it is quite stopped by a thick fleshy substance, in such sort that there appears nothing without by which its true situation may be known. When there is nothing but the single skin which makes the closure, operation is very easy, and the children may do very well; for then an aperture or opening may be made with a small incision knife crossways, that it may the better receive a round form, and that the place may not afterwards grow together, taking great care not to prejudice the sphincter, or muscle of the Rectum. The incision being thus made, the excrements will certainly have issue. But if by reason of their long stay in the belly, they are become so dry that the infant cannot void them, then let a small clyster be given to moisten and bring them away; afterwards put a linen tent into the new made fundaments, which at first had best be anointed with honey of roses, and towards the end with a drying cicatrizing ointment, such as Unguentum Album, or Pomphilix, observing to cleanse the infant of his excrements, and dry it again as soon and as often as he evacuates them, that so the apertion may be prevented from returning into a malignant ulcer.

But now if the fundament be stopped up in such a manner that neither mark nor appearance can be either seen or felt, then the operation is much more difficult; and even when it is done, the danger is much more of the infant's escaping it. And then if it be a female, and that it sends forth its excrements by the way I have mentioned before, it be better not to meddle, than, by endeavouring to remedy an inconvenience, run an extreme hazard of the infant's death. But when there is no vent for the excrements, without which death is unavoidable, there the operation is justifiable.

The operation in this case must be thus: Let the operator, with a small incision knife that hath but one edge, enter into the void place, and turning the backs of it upwards within half a finger's breadth of the child's rump, which is the place where he will certainly find the intestine, let him thrust it forward, that it may be open enough to give free vent to the matters there contained, being especially careful of the sphincter; after which, let the wound be dressed according to the manner directed.

 

SECT. IV. Of the Thrush, or Ulcers in the Mouth of an Infant.

THE thrush is a distemper that children are very often subject to, and it arises from bad milk, or from foul humours in the stomach; for sometimes, though there be no ill quality in the milk itself, yet it may corrupt in the child's stomach because of its weakness, or some other indisposition, in which, acquiring an acrimony instead of being well digested, there arise from thence biting vapours, which forming a thick viscosity, do thereby produce this distemper. It is often difficult, as physicians tell us, because it is seated in hot and moist places, where the putrefaction is easily augmented, and for that the remedies supplied cannot lodge there, being soon washed away with spittle. But if they arise from too hot a quality in the nurse's milk, care must be taken to temper and cool, prescribing her cool diet, bleeding and purging her also, if there he occasion.

Take lentils husked, powder them, and lay it upon the child's gums: or take melidium in flower, half an ounce, and with oil of roses make a liniment. Also wash the child's mouth with barley and plantain water, and honey of roses, or syrup of dry roses, mixing with them a little verjuice, or juice of lemons, as well to loosen and cleanse the vicious humours which cleave to the inside of the child's mouth as to cool those parts which are already over-heated. This may be done by means of a small fine rag fastened to the end of a little stick, and dipped therein, wherein the ulcers may be gently rubbed, being careful not to put the child to too much pain, lest an inflammation make the distemper worse. The child's body must be also kept open, that the humours being carried to the lower parts, the vapours may not ascend, as it is usual for them to do when the body is costive and the excrements too long retained. If the ulcers appear malignant, let such remedies be used as do their work speedily, that the equal qualities that cause them being thereby instantly corrected, their malignity may be prevented; and in this case touch the ulcers with plantain water sharpened with the spirits of vitriol, for the remedy must be made sharp, according to the malignity the distemper. It will not be unnecessary to purge these ill humours out of the whole habit of the child by giving half an ounce of succory with rhubarb.

 

SECT. V. Of Pains in the Ears, Inflammation, Moisture, etc.

THE brain in infants is very moist, and hath many excrements which nature cannot send out at its proper passages: they get often to the ears, and there cause pains, flux of blood, with inflammation, and matter with pain; as in children is hard to be known having no other way to make it known but by constant crying; you will also perceive them ready to feel their ears themselves, but will not let the other touch them if they could help it; and sometimes you may discern the parts about the ears to be very red.

These pains, if let alone, are of dangerous consequences, because they may bring forth watching and epilepsy, for the moisture breeds worms there, as fouls the spongy bones, and by degrees incurable deafness.

To prevent all those ill consequences, allay the pain with all convenient speed, but have a care of using strong remedies. Therefore only use warm milk about the ears, with the decoction of poppy tops, or oil of violets; to take away the moisture, the honey of roses, and let aquamellis be topped into the ears; or take virgin's honey half an ounce, red wine two ounces, alum, saffron, saltpetre, each a dram mix them at the fire; or drop in hempseed oil with a little Wine.

 

SECT. VI. Of Redness and Inflammation of the Buttocks, Groin, and Thighs of a young Child.

IF there be not great care taken to change and wash the child's bed as soon as it is fouled with the excrements, and to keep the child very clean, the acrimony will be sure to cause redness, and beget a smarting in the buttocks, groin, and thighs of the child, which, by reason of the pain, will afterwards be subject to inflammations, which follow the sooner, through the delicacy and tenderness of their skin, from which the outward skin of the body is in a short time separated and torn away.

The remedy of this is twofold; that is to say, first, to keep the child cleanly, and in the second place, to take off the sharpness of its urine. As to keeping it cleanly, she must be a sorry nurse that needs be taught how to do it, for if she lets it have but dry, clean, and warm beds and clouts, as often and as soon as it has fouled and wet them, either by its urine or excrements, it will be sufficient; and as to the second, the taking off the sharpness of the child's urine, that must be done by the nurse's keeping a cooling diet, that her milk may have the same quality; and therefore she ought to abstain from all things that may heat it. But, besides these, cooling and drying remedies are requisite to be applied to the inflamed parts; therefore let the parts be bathed with plantain water, with a fourth of lime water added to it, each time the child's excrements are wiped off; and if the pain be very great, let it only be fomented with lukewarm milk. The powder of a pot to dry it, or a little mill dust strewed upon the parts affected, may be proper enough; and it is used by several women. Also Unguentum Album, or Diapampholigos, spread upon a small piece of Leather, in form of a plaster, will not be amiss.

But the chief thing must be the nurse's taking great care to wrap the inflamed parts with fine rags when she opens the child, that those parts may not be gathered and pained by rubbing them together.

 

SECT. VII. Of Vomiting in young Children.

VOMITING in children proceeds sometimes from too much milk, and sometimes from bad milk, and is often from a moist loose stomach for as dryness retains, so looseness lets go. This is for the most part without danger in children; and they that vomit from their birth are the lustiest; for the stomach, not being used to meat, and milk being taken too much, crudities are easily bred, or the milk is corrupted; and it is better to vomit these up than to keep them in; but if vomiting last long, it will cause an atrophy or consumption for want of nourishment.

To remedy this, if it be from too much milk, that which is emitted is yellow and green, or otherwise ill-coloured and stinking; in this case mend the milk, as has been showed before; cleanse the child with honey of roses, and strengthen its stomach with syrup of milk and quinces made into an electuary. If the humour be hot and sharp, give the syrup of pomegranates, currants, and coral; and apply to the belly the plaister of bread, the stomacb ceret, or bread dipped in hot wine; or take oil of mastich, quinces, mint, wormwood, each half an ounce; of nutmegs; by expression, half a dram, chymical oil of mint, three drops. Coral hath an occult property to prevent vomiting, and is therefore hung about their necks.

 

SECT. VIII. Of breeding Teeth in young Children.

This is a very great and yet necessary evil in all children, having variety of symptoms joined with it; they begin to come forth, not all at a time, but one after another, about the sixth and seventh month; the fore teeth coming first, then the eye teeth, and last of all the grinders; the eye teeth cause more pain to the child than any of the rest, because they have a very deep root: and a small nerve, which makes the eye move. In the breeding of their teeth, first they feel an itching in their gums, then they are pierced as with a needle, and pricked by the sharp bones, whence proceed great pains, watching and inflammation of the gums, fever, looseness, and convulsions, especially when they breed their eye-teeth.

The signs when children breed their teeth are these: 1. It is known by their time, which is usually about the seventh month. 2. Their gums are swelled and they feel a great heat there, with an itching, which makes them put their fingers in their mouth to rub them, from whence a moisture distils down into the mouth, because of the pain they feel there. 3. They hold the nipple faster than before. 4. the gum is white where the tooth begins to come; and the nurse in giving them suck finds the mouth hotter, and that they are much changed, crying every moment, and cannot sleep, or but very little at a time. The fever that follows breeding of teeth comes from choleric humours, inflamed by watching, pain and heat. And the longer teeth are breeding, the more dangerous it is, so that many in the breeding of them die of fevers and convulsions.

For remedy, two things are to be regarded; one is, to preserve the child from the evil accidents that may happen to it by reason of the great pain; the other, to assist as much as may be the cutting of the teeth, when they can hardly out the gums themselves.

For the first of these, i.e., the preventing these accidents to the child, the nurse ought to take great care to keep a good diet, and to use all things that may cool and temper her milk, that so a fever may not follow the pain of the teeth. And to prevent the humour from falling too much upon the inflamed gums, let the child's belly be kept always loose by gentle clysters, if he be bound; though oftentimes there is no need of them, because they are at those times usually troubled with a looseness, and yet for all that clysters may not be improper neither.

As to the other, which is to assist in cutting of the teeth, that the nurse must do from time to time, mollifying and loosening them, by rubbing them with her finger dipped in butter of honey, or let the child have a virgin's wax candle to chew upon; or anoint the gums with the mucilage of quince made with mallow water, or with the brains of a hare, also foment the cheeks with the decoction of Althaea, and camomile flower and dill, or with the juice of mallows and fresh butter. If the gums are inflamed, add juice of nightshade and lettuce. I have already said, the nurse ought to keep a temperate diet. I will now add, that barley broth, water gruel, raw eggs, prunes, lettuce, and endive, are good for her; but let her avoid salt, sharp, biting, and peppered meats, and wine.

 

SECT. IX. Of the Flux of the Belly, or Looseness in Infants.

IT is very common for infants to have the flux of the belly, or looseness, especially upon the least indisposition; nor is it to be wondered at, seeing their natural moistness contributes so much thereto; and if it be extraordinary violent, such are in a better state of health than those that are bound. This flux, if violent, proceeds from divers causes: as, 1. From breeding of teeth, and is then commonly attended with a fever, in which the concoction is hindered, and the nourishment corrupted. 2. From watching. 3. From pain. 4. From stirring of the humours by a fever. 5. When they suck or drink too much in a fever. Sometimes they have a flux without breeding of teeth, from outward cold in the guts or stomach, that obstructs concoction. If it be from teeth it is easily known, for the signs in breeding teeth will discover it. If it be from external cold, there are signs of other causes. If from a humour flowing from the head, there are signs of a catarrh, and the excrements are frothy. If crude and raw humours are voided, there is wind belching, and phlegmatic excrements. If they be yellow, green, and stink, the flux is from a hot and sharp humour. It is beat in breeding teeth when the belly is loose, as I have said before; but if it be too violent, and you are afraid it may end in consumption, it must be stopped; and if the excrements that are voided be black, attended with a fever, it is very bad.

The remedy in this case has a principal respect to the nurse, and the condition of the milk must chiefly be observed; the nurse must be cautioned that she eat no green fruit, nor things of hard concoction. If the child suck not, remove the flux with purges, such as leave a blooding quality behind them; as syrup of honey of roses, or a clyster. Take two or three ounces, with an ounce or two of syrup of roses, and make a clyster. After cleansing, if it proceed from a hot cause, give syrup of dried roses, quinces, myrtles, with a little Sanguis Draconis. Also anoint with oil of roses, myrtles, mastich, each two drams, with oil of myrtles and wax; make an ointment. Or take red roses, moulin, each a handful, cypress roots, two drams; make a bag, boil it in red wine, and apply it to the belly. Or, use the plaister of bread, or stomach ointment. If the cause be cold, and the excrements white, give syrup of mastich, and quinces, with mint-water. Use outwardly, mint, mastich, cummin; or take rose seeds, an ounce, cummin, aniseeds, each two drams; with oil of mastich, wormwood, and wax, make an ointment.

 

SECT. X. Of the Epilepsy, and Convulsions in Children.

THIS is a distemper that is the death of many young children, and proceeds from the brain first, as when the humours are bred in the brain that cause it, either from the parents, or from vapours, or bad humours that twitch the membranes of the brain; it is also sometimes caused from other distempers, and from bad diet; likewise the toothache, when the brain consents, causes it, and so does a sudden fright. As to the distemper itself, it is manifest, and well enough known where it is; and as to the cause whence it comes, you may know by the signs of the disease whether it comes from bad milk, or worms, or teeth: if these are all absent, it is certain that the brain is first affected; if it comes with the small pox or measles, it ceaseth when they come forth, if nature be strong enough.

For the remedy of this grievous and often mortal distemper, give the following powder to prevent it to a child as soon as it is born: Take male peony roots, gathered in the decrease of the moon, a scruple, with leafgold make a powder; or take peony roots a dram, peony seeds, mistletoe of the oak, elk's hoof, man's skull, amber each a scruple, musk two grains; make a powder. The best part of the cure is taking care of the nurse's diet, which must not be disorderly by any means. If it be from corrupt milk, provoke a vomit, to do which hold down the tongue, and put a quill dipped in sweet almonds down the throat. If it comes from worms, give things as will kill the worms. If there be a fever, respect that also, and give coral smaraged and elk's hoof. In the fit, give epileptic water, as lavender water, and rub with oil of amber, or hang a peony root, elk's hoof, and smaraged, about the neck.

As to a convulsion, it is when the brain labours to cast out that which troubles it; the matter is in the marrow of the back, and fountain of the nerves; it is a stubborn disease, and often kills. For remedy whereof, in the fit, wash the body, especially the back bone, with decoction of Althaea, lily-roots, peony and camomile flowers, and anoint it with man's and goose grease, oils of worms, orris, lillies, foxes, turpentine, mastich, storax, and calamint. The sunflower is also very good, boiled in water, to wash the child.

 

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