University of Virginia Library

Management of the Child.

The management of the new-born child is so intimately connected with the treatment of the mother in the pueperal state that the subject would not seem complete without a brief consideration of the treatment of the babe. Although the savage mother is not wanting in love for her offspring, the treatment of the child from the very first moment is one well suited to fit it for the hardships of its future life. Even among those people where kindness is shown the little stranger, where he is well cared for, and not left to starve in isolation with the mother, as among some of the Russian tribes, he receives at once a hint of the exposure to which he may be subjected in the future. As an ancient chronicle and "Early History of Virginia'' says, in speaking of the original inhabitants of that country: "The manner in which they treat their young children is very strange, for instead of keeping them warm at their first entry into the world, and wrapping them up in I don't know how many cloths, according to our fond custom, the first thing they do is to dip the child over head and ears in cold water, and then to bind it naked to a convenient board, having a hole fitly placed for evacuation, but they always put cotton wool or other soft things for the body to rest on between

the child and the board. In this posture they keep it several months, till the bones begin to harden, the joints to knit, and the limbs to grow strong. Then they loosen it from the board, and suffer it to crawl about, except when they are feeding or playing with it. While the child is thus on the board, they either lay it flat on its back, set it leaning on one end, or hang it up by a string fastened to the upper end of the board, the child and board being all the while carried about together. As our women undress their children to clean and wash their linen, so they do theirs to wash and grease them. The method the women have of carrying their children after they are suffered to crawl about is very particular. They carry them at their backs in summer, taking one leg of the child under their arm, and the counter-arm of the child in their hand over the shoulder, the other leg hangs down, and the child all the while holding fast with its other hand. But in winter they carry them in the hollow of their match-coat at their back, leaving nothing but the child's head out.'' The child is tucked away in an equally peculiar manner by some of the Polar tribes of Russia; until it begins to crawl it is placed in a fur sack, and carried by a strap about the mother's forehead. Later it is sewed up in a fur garment of one piece; for the sake of cleanliness a doorway is left in the posterior portion, which is opened from time to time as necessity demands, but the garment is not once removed or changed until outgrown by the child.

Among the Sioux, Crows, Creeks, and other of our Indians, the mother plunges into the stream with her child immediately after delivery, or, if no running water is at hand, at least dips the child in cold water as soon as it is born; salt water is used by some people who live upon the sea shore, also by the Kalmucks, who wrap the child in furs as soon as it has had a salt-water bath. A cold-water bath seems to be the customary initiation of the new-born child into the troubles of this world; it is the case among most of the Negro tribes, among the people of Bolivia, of Ceram, and of the Andaman Islands, and in some parts of India; in others, in Southern India, for instance, the child is washed in tepid water; so also in Syria, and, as a rule, by those people who are advanced in civilization.

Usually the child is bathed immediately after delivery, but

in Southern Arabia at least two hours are permitted to pass by, during which the child is wrapped in soft warm cloths, then it is washed and anointed. This is also the custom of numerous African tribes, some waiting for several hours, others performing the ceremony at once; some use fat, others, such as the Wakamba, Somal, Wanika, and other tribes use fresh butter. The Masai and the Waswaheli throw a slightly acid and astringent powder, made from the fruit of the adansonia tree, over the child, to facilitate cleansing, just as we use oil or fat. The Cheyennes and Arapahoes envelop the child as soon as it is born in dry horse manure, and do not wash it for several days. The Umpquas wrap it in dirty rags, and also put it away without washing. In India, in Africa, and among the American Indians, there are many tribes who bathe their children for at least one year. In Syria, in India, and in Africa, there are many who anoint the children regularly, often after every bath, and great attention is paid to the kneading and stretching of the limbs and joints, with the view of making the child straight and strong, and stimulating the healthy development of the muscles. Some strap the child or have various methods of bundling it, so as to carry it conveniently. Some, like the Chinooks, of Oregon, compress the head to shape it in a peculiar way. This method of kneading and stretching the child is well described in a paper on the inhabitants of the Andaman Islands (Zeitschft. für Ethnologie, 1877, p. 51). There it is usually done by the father, who warms the palm of his right hand, presses firmly upon the temples and upon the base of the nose, whilst the left hand fixes the lower jaw; then the wrists and elbows and the septum of the nose are compressed between the thumb and index finger, and so on quite a number of manipulations are performed.

It is interesting to see that the same variations exist in regard to their customs as to the time of applying the child to the breast which we find among civilized people. Thus among the Kanikars and several other tribes of Southern India the child is applied at once to the breast, as is done by some of our Indians. In Alaska it is customary to suckle the child as soon as it has vomited for the first time; among the Kalmucks the new-born is given a piece of raw mutton to suck, and is not permitted to take the breast for several days. Upon the Andaman Islands it is customary for any neighbor or

friend who is suckling to nurse the new-born child for a day or two until its mother's milk appears. In Southern India, the child is fed on boiled honey until the third day, and not until then is the mother allowed to suckle it. In Transvaal, a soft mush is fed to the child for the first three days, and in Loango the same custom prevails, and the people seem to know the qualities of colostrum, at least they make a difference between the milk of the first days and that which afterwards serves for the nourishment of the child. The negroes of Loango hold a suckling child just as the Caucasian mother does, and it seems that the breast is only given at certain times.

As regards the period of suckling, the time seems to vary greatly, yet it is governed by about the same circumstances among all primitive people as it is among our Indians. As a rule, the child is nursed as long as the mother's milk lasts, or until another conception takes place; at all events, the children are nursed unreasonably long. Thus the Kanikars suckle the child for three to five years; the inhabitants of the Sierra Leone often until the child can walk; those of Australia, from one to three years, according to circumstances; the Alaskans, from ten to thirty months; the Tartars and Esthonians, for a very long period, not only limited as it is among our Indians by another conception, but they suckle the child until the next confinement forces them to make room for a younger offspring. The Arabians seem to nurse for a period of perhaps two years; the Waswaheli, from one to two years; in the eastern portions of Africa, it is the custom to nurse as long as the mother's milk will last, and often during the next pregnancy. A child which is nursed during such a period is called an external twin.

For the purpose of weaning the child, it is customary in Southern Arabia to smear myrrh or asafetida upon the nipple. The Somal use the fresh juice of aloe leaves for the same purpose, and in Zanzibar, cayenne pepper or the gum of the aloe is applied. In case that the breasts are inflamed during the process of weaning, the natives of Southern Arabia press out the accumulated milk and cover the breasts with a poultice of soft mud or clay.

I have already remarked that insufficient or inferior food is frequently a source of injury to the puerperal woman when isolated during her period of uncleanliness, as it is often the

cause of sickness and death of the child. This is especially the case among some of the Russian tribes. Convulsions occur frequently among the children who are partially fed with heavy bread which has been first chewed by the mother; then berries of various kinds are given the infants, not even always ripe; they are kept in a filthy condition, and take frequent colds by the use of the steam baths so common among those people. Coarse food and constitutional syphilis are the causes of early death among many of the Tartars. In Alaska, the fat of some sea animal is the first food which is given the infant. The Masai and several other tribes of Africans put a little fresh butter, which is especially prepared for this purpose, into the child's mouth after the second day. Among the Wakikuyu the child, after the tenth day, receives chewed bananas, which have been mixed with the saliva of the mother, in addition to the butter. The Wakamba give the infant, very soon after birth, a little mush, and the Somal make them take a little of the juice of the myrrh daily after the sixth month has been reached. In case of the death of the mother, the Wakikuyu and Waswaheli raise the child upon goat's milk; other tribes employ nurses, others feed the child upon mush and other food common among them. The Kossacks think wine a necessary addition to the food, even of suckling infants. In Siam, honey and rice-water is given from the first days, and the soft pulp of the banana is crammed into the little mouth. Dr. Shortt tells us that, in Southern India, the child is fed on boiled honey after the third day, when the mother is allowed to suckle it, and if the external parts are cold, five drops of the milk hedge (Euphorbia Firucalli) are given it. On the third day, it is rubbed with sweet oil, bathed in warm water, and half a pie-weight of garlic, one-quarter pie-weight of black pepper heated in a kin-weight of castor oil is given, and repeated every second day. Some give castor oil every morning for the first, once a day for the second, and every other day for the third month. From the third day the mother suckles the child; if unable to do so, it is brought up on goats', cows', or asses' milk.

The Villees, another of the tribes of Southern India (Transacts. London Ethnolog. Soc., 1865, III.), give the child for the first two or three days a preparation of black pepper, neem bark, jaggery, garlic and onions, several pots full of which are made at once and slowly dished out. In Old Calabar, the child

is first rubbed over with fine sand, then with soap and water; the acid juice of an Ammomum is squeezed into its mouth, and a supply of tepid water follows, and for the first three days, during which it is not allowed to suck, it gets nothing but water, and later, although the mother has an abundance of milk and the child is well able to suck, a large quantity of water is given at least once a day. Every morning whilst the child is washed, water is thrown into its mouth continually for several minutes, the child gasping and struggling. This, they say, is done to distend the abdomen and make it capacious to take plenty of food, to hasten growth. If the mother is away, the child is kept quiet by filling with water, and they deem this cheap liquid very useful in this respect; although too much water is rarely taken, it may prove injurious, and possibly the enlarged spleen, which is very common among children in this country, and not among adults, may be traced to the over-dose of water.

The Kanikars begin to give rice-water the third month. The child which is nursed from three to five years, gradually, from the third month on, receives other food, but it is not until its seventh year that it eats with the rest of the family. The Vedas simply suffer the child to die if the mother's milk does not suffice, as no other woman dare nurse it, and cow's milk rarely succeeds. After the daily bath, the babe is anointed with oil and turmeric, and rubbed and kneaded in accordance with certain rules, as we have related of other tribes.

Just as adults are treated with the herbs of the country in their various diseases, so the children are made to put up with them. Teething is furthered in Russia by the use of the fresh juice of the lemon sweetened with sugar, or the gums of the child are smeared with the blood which comes from the comb of a black rooster which has been repeatedly scratched and irritated with a comb. In case of restlessness, a decoction of poppy seed is given the child after it has been carried to the ordinary roosting-place of the chickens and kept there for a while. In case of convulsions, a decoction of Gentiana pneumonanthe or the root of Valeriana phec is used. The powder of Origanum, starch, or lint is applied in case of soreness of the skin, and there are many other equally efficacious remedies in use, many of them most amusing and of extreme interest to the ethnologist, but beyond this of little or no value.

These, and many other practices and remedies which I have described, are peculiar, many are more or less efficacious, most of them harmless, few injurious: some are amusing—I can safely say amusing in speaking of such simple, ignorant people, but they should not be too severely condemned for their child-like beliefs, and we can little afford to cast ridicule upon them if we reflect but a moment upon the many equally silly remedies, still firmly believed in by so many, in the midst of our boasted civilization and the wonderful development attained by medical science. Every physician, to his intense disgust, now and then meets with the wonderful concoctions or mystic devices of some sage and knowing old dame, who confides them to her suffering friends: teas and herbs innumerable; an onion carried in the pocket until shriveled to cure a corn; half a potato carefully buried in the ground to destroy warts; a sheet of paper worn upon the chest for the relief of rail-road sickness. In Germany, whilst stationed in a small village as surgeon during the Franco-Prussian war, I was called by a wealthy family to see the driver, who was lying abed, suffering intensely from a fall from a tree, with possible fracture of the femur.

Unwillingly he submitted to an examination; but although a devoted family servant, the authority of his mistress was not sufficient to force him to follow any of my directions, and upon returning on the following day I found that a shepherd had been called from a village miles away. Peasants from near and far sought the advice of this shepherd, who had inherited his gifts from his father and grandfather, who had been shepherds before him, and had practiced the healing art. A red string had been tied about the contused limb, and within a certain time this was to be removed and the broken limb would be healed! Fortunately it was but a contusion, and the man suffered no serious consequences.

Prayers to certain saints will cure sterility: others heal broken and rheumatic limbs: the chapels sacred to particular saints, in the churches of Italy, Spain, many parts of France and southern Germany, are frequently decorated with splints,

crutches and other appliances used by the sick, which have been thrown aside by the suffering owners, and there preserved as a token of gratitude to the saint by whose intercession they have been cured. Other cures are performed by the relics of saints, by miraculous waters; we all remember the waters of Lourdes, and the intense excitement created by their wonderful qualities; among others their healing powers, for which they were sought by innumerable pilgrims.

In New Caledonia the sterile woman buys from the medicine man some shapeless puppet, destined to share her couch and to exert its influence in favor of her pregnancy; in Brittany (Corré) a statue of Saint Quignole still exists, in front of which such women as are desirous of children are accustomed to strike their stomachs. Whom shall we ridicule?

These simple people have many laughable customs—so have we, in the midst of this era of enlightened progress—but many of the curative means adopted by primitive people are so simple, sound and rational, that we learn to respect them and to study their methods with more than idle curiosity: thus, among the Arabs the colicky baby is given, not some narcotic soothing syrup, but oil, or the breast of a neighbor who is in better condition, until mother and child have improved; in India, where, as well as in all southern climates spasmodic nervous affections are frequent, especially tetanus neonatorum, the entire body of the child is thoroughly anointed for nine days after birth with an oily, greasy, substance in order to avoid the evil effects of cold air or sudden atmospheric change; to escape these dangers they also cover the umbilical with a certain adhesive plaster, after cutting the cord.

Every people has its own idea of beauty, and in accordance with this they endeavor to mould the body of the newborn: his head is flattened, his nose slit or the ears elongated, to conform to the æsthetic views of the particular people.

The Flathead mother begins to compress the yielding cranium of the infant from the very first, that he attain the type of beauty which is the standard of this particular tribe of Indians. Similar customs prevailed among the ancient

Peruvians, where, however, a high, conical skull was produced, as well as the flat and narrow long head. Among the Caraïbes, and upon some of the Polynesian islands, the custom still prevails.

The Oriental races prefer a well rounded head, as shaped by a tightly encircling band, so as better to fit the turban. The Arabs give a globular form to the head of the new-born by compressing and kneading the lateral regions, from below upward, with the palm of the hand. Even in France the remnants of a similar custom, which but recently was practiced in Normandy, still exist; it is the high, circular constriction of the child's head formerly also found in the vicinity of Toulouse.

The Chinese mother of the upper classes begins early to compress the feet of her girl baby, that their diminutive proportions may enforce her claims to beauty and society fame. "The result of this persistent pressure[5] is the atrophy of the bones and soft parts of the foot; the forcing upwards and backwards of the tarsus, the displacing of the calcaneus, whose axis approximates to that of the tibia.''—(Corre.)

The Slavonian women, of Russia, give their babies a more general stretching and rectifying of all organs: upon the second or third day the nurse takes the little body to the oven or the bath room, and switches it well, then soaps it, whilst a wise woman presses the head to rights by working it from all sides, cleanses the skin with salt water, puts the nose in good shape, stretches hands and feet, seizing the little victim by the left hand and right foot and vice versa; finally he is seized by both feet, suspended head down, and well shaken so as to get the intestines in place, and take internal ruptures away from the kidneys.

Few peoples are so general in their efforts, as almost all have some peculiar organ which they seek to develop in accordance with their particular æsthetic craze. Most African tribes affect long pendulous breasts; some constrict the mammæ just below the areola, so as to give the appearance

of a small hemisphere superimposed upon a larger one. Some like a long pendulous lower lip, and others a thick upper lip; whilst the natives of Madagascar affect excessively long nymphæ.

These types of beauty are attained by tedious, long-continued efforts, whilst others are produced more rapidly; such as opening in nose and ears and lips for ornaments, tattooing, and various marks and incisions upon the body common among different tribes and peoples.

Other mutilations to which the infant is subjected are dictated by religious superstition; yet the original cause is often long forgotten, and custom alone remains to account for the practice. Among the most ancient of these is circumcision, which has been in use by the laws of Judaism and Islamism; but it is a biblical error to suppose that it existed among all people. Certain traces of this operation have indeed been observed among the Mexicans-a simple incision upon one side of the fraenum. The incision of the prepuce is practiced among the Milanesians, New Caledonians and the Polynesians. Partly inaugurated for hygienic purposes, and perhaps desirable on account of the considerable development of the prepuce of the Semitic races, circumcision, which was considered a symbol of the alliance with the Almighty, has finally degenerated among the Jewish people into a routine practice not always exempt from danger— infection may follow, hemorrhages and malformation. I have myself seen an infection of this kind, accompanied by well marked shankers, and followed by serious constitutional disturbances.

Among Mussulman people circumcision is obligatory, although the Koran says nothing of it. The Arabs of Algiers practice it towards the fifth year; the Kabyles towards the sixth or eighth year; the Turks towards the eighth. In Africa it exists here and there, but is not universal. In Rio Nunez circumcision has been practiced at twenty-five and thirty years, and an old inhabitant gives a curious explanation of the reason for the operation, which is that the gland, always uncovered and exposed to continual irritation, loses

its sensibility, which necessitates a lengthening of the act of copulation and the enjoyment of the pleasure. This is a peculiar view, in opposition to the belief of those who advise the operation for the sake of morality—in opposition to St. Jerome, who teaches that the removal of the prepuce, in diminishing the voluptuous sensation, preserves man from too great an abandonment to sexual pleasures—in opposition to Moses, who by this operation endeavors to prevent the results of too ardent an imagination.

Circumcision, if we may so call it, among girls consists in several operations:

First, a simple excision of the clitoris, at the eighth or ninth year, upon the coast of Guinea; at the first appearance of the courses in old Calabar.

The child is placed upon the knees of a woman, the legs are well separated, the labia separated, and the slightly developed clitoris seized between two pieces of bamboo used like forceps, drawn forward and cut off with a razor; hemorrhage is slight, and, if necessary, is stopped by the alternate use of hot and cold water.

Second, excision of the nymphæ, only practiced on account of hypertrophy or degeneration, to which the negress is subject.

Third, excision of the nymphæ and the clitoris upon the adult; and, influenced by the belief that it is a guarantee of chastity, done upon such women as are proud of or anxious for a proof of their virtue.

Fourth, the excision of the large lips, alone or with the preceding operations.

The Hottentots remove a testicle from boys at the ninth or tenth year, with the idea of preventing the conception of twins. The Mika operation among Australians is peculiar, performed for the purpose of limiting the number of productive males. This consists in an incision in the lower part of the urethra, near the scrotum, so that the spermatozoa are ejected through this opening, outside the vagina, and not within the canal.—(Corre.)

Ethnological differences in regard to the growth and development

of the child I have not been able to determine, with the material at my disposal, notwithstanding the variety of statements made. I can hardly venture an assertion more definite than this, that the new-born among primitive peoples seem, if anything, more inclined to preserve and develop hereditary taints and diseases by reason of the long period of nursing, which, as I have previously stated, varies from two to three and even five years, and is evidently a matter which has attracted the attention of ancient lawgivers, by reason of its marked effect upon the development of the race. Upon the Slave-Coast the nursing mother is sent for three years away from her husband into the interior, to avoid cohabitation and properly raise her child. Should she approach a male, it is supposed that the evil spirit will carry away the milk and kill the babe. In Rio-Nunez the banished wife, knowing the path her faithful spouse will take, selects herself a substitute to fill her place in the heart of her loving lord during the period of nursing.

The Arabs are not so careful as to avoid cohabitation completely while nursing, nor has the Prophet expressly forbidden it, although he intimates that sexual congress is not compatible with healthy nursing. Their law renders the suckling of the babe obligatory for the mother, except in case of sickness, or absence of milk, even after repudiation by her husband; it is so unjust as to oblige her to keep a wet nurse in case of her own inability to nurse, without allowing her any claims upon the father of the child.

The dread of an increase in the family, misery, poverty, and the difficulty of obtaining food, explains the long period of nursing among all these peoples; the child is suckled for years beyond the time indicated by nature, in the hope of thereby preventing a farther conception, or because food for one more mouth cannot be provided. The child is scantily fed upon an inferior milk, draining away the mother's strength and energy, whilst a little properly prepared food, animal or vegetable, would rapidly build up the skinny little one and save the mother.

It is this long continued assimilation of a tainted mother's

milk which enfeebles the nursling, and makes him an easy victim to any one of the numerous diseases which endanger the earlier years of life.

In Chayenne white women often take black nurses, and it is well known that the children nursed by them frequently become thin, feeble and languishing, and above all are much more subject to disease; this is undoubtedly due to the fact that the negress of Chayenne so frequently carries the germs of one or more of the constitutional diseases to which the blacks are subject. If the child of a healthy mother is so affected by this necessity of life, how much more fatal a carrier of disease must it be for the nurse's own child!

Mortality among the negroes is great; many die upon the first day from hemorrhage from the navel, or from exposure to cold.[6] In Darien, families are often scarcely able to raise one child out of twelve: in China and Japan the death rate is terrible. Rachitis is not known in the warmer climates: scrofula seems to exist among the Africans, and more so among the blacks of the Antilles; in China and Japan it is very common; among the Malay and Indo-Chinese races scrofula is common, also in the Algerian and Moorish villages; the Arabs treat the disease by encircling the neck with brier leaves, or a mixture of grenate bark and clean barley. At Tonga terrible lacerations upon the neck, also seen upon the Oceanic Islands, syphilis, lepra and small-pox are common among the people.

The Arabs pay more attention than most others to their children, but how do they endeavor to strengthen them? By all sorts of odd brewings, such for instance as (the only nourishment in three or six days) an egg cooked an entire night in vinegar, and so on. In Spetza and Hydra a peculiarly painful, feverish disease, named ponos (pain), which has for its basis consumptive tendencies, appears towards the end of the first year, rarely towards the third or fourth,

more common among boys than girls, seizing more particularly upon the children of consumptive parents with lymphatic, weak constitutions. Typhoid fever, yellow fever, cholera, malaria, all exist.

Among all races the young seem particularly given to the eruptive fevers. Variola—which is particularly bad for children, removes a terrible number among the North American Indians, Arabs, Persians, Chinese and Japanese; many even fight against it by inoculation with matter from already affected subjects, as has often been seen by Dr. Corre upon the eastern coast of Africa. In Arabia the virus, which is an object of public sale, is inoculated by an ordinary needle; and in all nations it seems to have been observed that inoculated variola is always less severe than the spontaneous variety. The Arabs see an especial advantage in the fact that it is accompanied by a much smaller number of pustules. In India the English have again brought among the natives the ancient practice of inoculation, known to the ancient inhabitants and described in a Sanscrit book. The Chinese have accepted vaccination; and also the Japanese. In Boke the French surgeons have not been able to establish vaccination, having attempted it with tubes imported from France, as the natives compared these negative results with the beautiful pustules which resulted from their own inoculation of variola matter, not considering that the effect was as good with much slighter annoyance. The Arabs did not take kindly to vaccination, believing that it was merely a means of marking their children with the insignia of their conquerors, declaring that they would rather cast their babes into the sea than allow the sign to be impressed on them, so that they might be known at any time, to be taken away from their family for baptism.

An ethnological influence upon the appearance of the pustule, and its shape, form and size, seems hardly possible; excepting the difference in thickness of the skins of various races; the pustules develop in the same manner when they are under the same climatic influences, still some believe that they are smaller among the blacks than the whites. Climatic influences

are greater and the pustules are smaller in hot climates than in temperate or cold. In Cochin China the pustule presents upon the fifth day the appearance it has with us upon the eighth, and gives an excellent lymph upon that day. In India, and especially in Indo-China, it has been remarked that at certain periods of excessive dryness, or excessive humidity, the vaccination would not succeed. Strange to say, the author has vaccinated unsuccessfully a large number of children in one village, and upon the following day with good success children of the same age and kind with the same matter in another. Could it be possible that these children could have acquired an immunity from the fact that an epidemic of variola had existed in the village upon the preceding year?

Scarlatina is common among other races. Grippe is rare in hot climates. Diphtheritis, however, is frequent there; in Algeria it is very common. Umbilical hernia is common among the new-born of the black races; if it does not exist at the moment of birth it appears soon afterwards: possibly a persistence of the embryonic state. Convulsions and eclampsia are very common. Vertigo, congenital and accidental, is very common among all colored races. The same is true of cicatricia and hypertrophy