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Title: Advice to a wife and mother in two parts
Embracing advice to a wife, and advice to a mother

Author: Pye Henry Chavasse

Release date: October 15, 2023 [eBook #71887]

Language: English

Original publication: Philadelphia: J. B. Lippincott & Co., 1881

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WIFE AND MOTHER IN TWO PARTS ***

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ADVICE
TO A

WIFE AND MOTHER.
IN TWO PARTS.
EMBRACING

ADVICE TO A WIFE,
AND

ADVICE TO A MOTHER.

BY
PYE HENRY CHAVASSE.

SEVENTEENTH EDITION.

PHILADELPHIA:
J. B. LIPPINCOTT & CO.
1881.

ADVICE TO A WIFE
ON THE

MANAGEMENT OF HER OWN HEALTH,
AND ON THE

TREATMENT OF SOME OF THE COMPLAINTS

INCIDENTAL TO

PREGNANCY, LABOR, AND SUCKLING;
WITH AN

INTRODUCTORY CHAPTER ESPECIALLY ADDRESSED TO A YOUNG WIFE.

BY

PYE HENRY CHAVASSE,
FELLOW OF THE ROYAL COLLEGE OF SURGEONS OF ENGLAND; FELLOW OF THE
OBSTETRICAL SOCIETY OF LONDON; FORMERLY PRESIDENT OF QUEEN’S COLLEGE
MEDICO-CHIRURGICAL SOCIETY, BIRMINGHAM; AUTHOR OF “ADVICE TO A MOTHER
ON THE MANAGEMENT OF HER CHILDREN.”

“Thy wife shall be as the fruitful vine upon the walls of thine house.”

SEVENTEENTH EDITION.

PHILADELPHIA:
J. B. LIPPINCOTT & CO.

1881.

TO

MY BIRMINGHAM PATIENTS,
MANY OF WHOM I HAVE ATTENDED FOR A PERIOD OF UPWARDS
OF THIRTY YEARS; SOME OF WHOM, HAVING USHERED INTO
THE WORLD, I AFTERWARD ATTENDED IN THEIR OWN
CONFINEMENTS; AND FROM ALL OF WHOM I HAVE RECEIVED
SO MUCH CONFIDENCE, COURTESY, AND KINDNESS,

This little Volume is Dedicated,

BY THEIR SINCERE FRIEND,
PYE HENRY CHAVASSE
Priory House, Old Square,
Birmingham.

PREFACE.

The sale of copies of this book is now to be reckoned by its tens of
thousands! The last, the Seventh Edition, comprising five thousand copies,
has been rapidly exhausted; a new Edition, the Eighth, is now urgently
called for; and as the sale of the work is so enormous, and so extending, my
worthy Publishers have deemed it advisable to publish of this edition at
once seven thousand copies,—thus making of the two last editions alone
twelve thousand copies; the two last editions being, in fact, equal to twelve
ordinary editions! Moreover, this book has made me troops of friends, thus
proving how much such a work was needed, and how thoroughly my
humble efforts have been appreciated.
I have, in the Introductory Chapter especially addressed to a Young
Wife, had some plain and unpalatable truths to tell; but it is absolutely
necessary for a surgeon to probe a serious and deep-seated wound to the
bottom before he can perform a cure; he is sometimes compelled to give
pain before he can cure pain; he is frequently obliged to administer bitter
medicine before sweet health can be restored. I have not shrunk from my
duty; I have not uttered an “uncertain sound:” but have, without fear or
favor, boldly spoken out, and have proclaimed what I have deemed to be the
truth; the vital importance of my subject must excuse my plain-speaking
and earnestness. When a person is on the edge of a precipice, and is ready at
any moment to topple over, the words of warning must not be in the tones
of a whisper, bland and gentle, but in the voice of thunder, bold and
decisive. I have had to discourse on matters of the greatest moment to the
well-being of wives; and have, therefore, in order not to be
misapprehended, had to call things by their right names—the subject being
of far too much importance to write in a namby-pamby style, or to use any
other language than that of the plainest English.
The Introductory Chapter is, I trust, greatly improved; many of the
quotations are either curtailed, or are altogether suppressed, in order to
make room, without materially increasing the size of the book, for much

new and important matter. The remaining pages have all been carefully
revised and corrected, and made more clear, and additional advice, where
needed, has been supplied. I therefore hope that this edition will be still
more worthy of its great and extending success, and be the humble
instrument of sowing broadcast through our land advice most necessary for
wives to know; and at the same time be the means of dispelling prejudices
which, in the lying-in room, are even, in this our day, most rife and
injurious.
Barren wives! delicate wives! unhealthy wives! are the order of the day
—are become institutions of the country—are so common as not to be
considered strange, but to be, as a matter of course, as part and parcel of our
everyday life! Should such things be? I emphatically say No! But then a
thorough change, a complete reformation, must take place in the life and
habits of a wife. It is no use blinking the question; the truth, the whole truth,
must come out, and the sooner it is told the better. Oh! it is sad that the
glorious mission of a wife should, as it often does, end so ingloriously!
Broken health, neglected duties, a childless home, blighted hopes, misery,
and discontent. What an awful catalogue of the consequences of luxury, of
stimulants, of fashion, of ignorance, and of indolence—the five principal
wife and babe destroyers! Sure I am that the foregoing melancholy results
may, in the generality of cases, by timely and judicious treatment, be
prevented.
This is an age of stimulants—’tis the curse of the day; wine, in excess,
instead of being an element of strength, is one of weakness; instead of
encouraging fecundity, is one of its greatest preventives. A lady who drinks
daily five or six glasses of wine, is invariably weak, low, hysterical, and
“nervous,”—complaining that she can neither eat, nor sleep, nor take
exercise; she is totally unfit for the duties and responsibilities of either wife
or mother. I shall endeavor in the following pages to prove the truth of these
bold assertions.
Many young married ladies now drink as much wine in a day as their
grandmothers did in a week; and which I verily believe is one cause of so
few children, and of so much barrenness among them. It is no use: the
subject is too important to allow false delicacy to stand in the way of this
announcement; the truth must be told; the ulcer which is eating into the
vitals of society must be probed; the danger, the folly, the wickedness of the

system must be laid bare; the battle must be fought; and as no medical man
has come forward to begin the conflict, I myself boldly throw down the
gauntlet, and will, to the best of my strength and ability, do battle in the
cause.
It is the abuse and not the use of wine that I am contending against. I am
not advocating teetotal principles—certainly not. The one system is as
absurd and as wrong as the other; extremes, either way, are most injurious
to the constitution both of man and woman. The advice of St. Paul is
glorious advice: “Use a little wine for thy stomach’s sake and thine often
infirmities;” and again, when he says, “be temperate in all things.” These
are my sentiments, and which I have, in the following pages, so earnestly
contended for.
A lady who “eats without refreshment, and slumbers without repose,” is
deeply to be pitied, even though she be as rich as Crœsus, or as beautiful as
Venus! Nothing can compensate for the want of either sleep or appetite; life
without proper appetite and without refreshing sleep will soon become a
wearisome burden too heavy to bear. It is high time, when there are so
many of the Young Wives of England, alas! too many, who daily “eat
without refreshment,” and who nightly “slumber without repose,” that the
subject was thoroughly looked into, and that proper means were suggested
to abate the calamity. One of the principal objects of this book is to throw
light upon the subject, and to counsel measures to remedy the evil.
The large number of barren wives in England has, in these pages, had my
careful and earnest consideration. I have endeavored, to the best of my
ability, to point out, as far as the wives themselves are concerned, many of
the causes, and have advised remedies to abate the same. It is quite time,
when the health among the wives of the higher classes is so much below
par, and when children among them are so few, that the causes should be
thoroughly inquired into, and that the treatment should be extensively made
known. The subject is of immense, indeed I might even say, of national
importance, and demands deep and earnest thought and careful
investigation, as the strength and sinews of a nation depend mainly upon the
number and healthfulness of her children.
Barren land can generally, with care and skill, be made fertile; an
unfruitful vine can frequently, by an experienced gardener, be converted
into a fruit-bearing one; a childless wife can often, by judicious treatment,

be made a child-bearing one. Few things in this world are impossible:
“where there is a will there is generally a way;” but if there be a will, it
must be a determined and a persevering will; if there be a way, the way,
however rough and rugged, must be trodden,—the rough and rugged path
will, as she advances onward, become smooth and pleasant.
It is not the poor woman, who works hard and who lives hard, that is
usually barren—certainly not: she has generally an abundance of children;
but it is the rich lady—the one who is indolent, who lives luxuriously, and
fares sumptuously every day—who leads a fashionable, and therefore an
unnatural life—who turns night into day, who at night breathes
suffocatingly hot rooms, who lives in a whirl of excitement, who retires not
to rest until the small hours of the morning,—such a one is the one that is
frequently barren; and well she might be,—it would be most strange if she
were not so. One of the objects of this book will be to point out these
causes, and to suggest remedies for the same, and thus to stem the torrent,
and in some measure to do away with the curse of barrenness which in
England, at the present time, so fearfully prevails.
I have undertaken a responsible task, but have thrown my whole energy
and ability into it; I therefore have no excuse to make that I have not
thought earnestly and well upon the subject, or that I have written
unadvisedly; my thoughts and studies have for years been directed to these
matters. I earnestly hope, then, that I have not written in vain, but that the
seeds now sown will, in due time, bring forth much fruit.
Although my two books—Advice to a Wife and Advice to a Mother—are
published as separate works, they might, in point of fact, be considered as
one volume—one only being the continuation of the other. Advice to a Wife,
treating on a mother’s own health, being, as it were, a preparation for
Advice to a Mother on the management of her children’s health; it is quite
necessary that the mother herself should be healthy to have healthy
children; and if she have healthy offspring, it is equally important that she
should be made thoroughly acquainted how to keep them in health. The
object of Advice to a Wife and Advice to a Mother is for that end; indeed,
the acquisition and the preservation of sound health, of mother and of child,
have, in both my books, been my earnest endeavor, my constant theme, the
beginning and the ending, the sum and the substance of my discourse, on
which all else beside hinges.

I again resign this book into the hands of my fair readers, hoping that it
may be of profit and of service to them during the whole period of their
wifehood; and especially during the most interesting part of their lives—in
their hour of anguish and of trial; and that it may be the humble means of
making a barren woman “to be a joyful mother of children.”
PYE HENRY CHAVASSE
Priory House, Old Square,
Birmingham.

CONTENTS.

PAGES
Dedication iii
Preface to Eighth Edition v–x
Introductory Chapter 13–102

PART I.
On Menstruation 103–116

PART II.
On Pregnancy 117–198

PART III.
On Labor 199–254

PART IV.
On Suckling 255–300

Index 301–309

Advice to a Wife.
A good wife is Heaven’s last, best gift to man—his angel and minister of graces innumerable—his
gem of many virtues—his casket of jewels. Her voice is sweet music, her smiles his brightest day, her
kiss the guardian of his innocence, her arms the pale of his safety, the balm of his health, the balsam
of his life; her industry his surest wealth, her economy his safest steward, her lips his faithful
counselors, her bosom the softest pillow of his cares, and her prayers the ablest advocate of Heaven’s
blessings on his head.—Jeremy Taylor.

Of earthly goods, the best is a good Wife;
A bad, the bitterest curse of human life.—Simonides.

INTRODUCTORY CHAPTER.

1. It may be well—before I enter on the subjects of menstruation, of
pregnancy, of labor, and suckling—to offer a few preliminary observations,
especially addressed to a Young Wife.
2. My subject is health—the care, the restoration, and the preservation of
health—one of the most glorious subjects that can be brought before a
human being, and one that should engross much of our time and of our
attention, and one that cannot be secured unless it be properly attended to.
The human frame is, as every one knows, constantly liable to be out of
order; it would be strange, indeed, if a beautiful and complex instrument
like the human body were not occasionally out of tune:
“Strange that a harp with a thousand strings
Should keep in tune so long.”

3. The advice I am about to offer to my fair reader is of the greatest
importance, and demands her deepest attention. How many wives are there
with broken health, with feeble constitutions, and with childless homes!
Their number is legion! It is painful to contemplate that, in our country,
there are far more unhealthy than healthy wives! There must surely be
numerous causes for such a state of things! A woman, born with every
perfection, to be full of bodily infirmities! It was ordained by the Almighty
that wives should be fruitful and multiply! Surely there must be something
wrong in the present system if they do not do so!
4. It will, in the following pages, be my object to point out many of the
causes of so much ill health among wives; ill health that sometimes leads to
barrenness; and to suggest remedies both for the prevention and for the cure
of such causes.
5. It is an astounding and lamentable fact, that one out of eight—that
twelve and a half per cent. of all the wives of England are barren, are
childless! A large majority of this twelve and a half per cent. might be made

fruitful, if a more judicious plan of procedure than is at present pursued
were adopted.
6. My anxious endeavors, in the following pages, will be to point out
remedies for the evil, and to lay down rules—rules which, I hope, my fair
reader will strenuously follow.
7. My theme, then, is Health—the Health of Wives—and the object I
shall constantly have in view will be the best means both of preserving it
and of restoring it when lost. By making a wife strong, she will not only, in
the majority of cases, be made fruitful, but capable of bringing healthy
children into the world. This latter inducement is of great importance; for
puny children are not only an anxiety to their parents, but a misery to
themselves, and a trouble to all around! Besides, it is the children of
England that are to be her future men and women—her glory and her
greatness! How desirable it is, then, that her children should be hardy and
strong!
8. A wife may be likened to a fruit tree, a child to its fruit. We all know
that it is as impossible to have fine fruit from an unhealthy tree as to have a
fine child from an unhealthy mother. In the one case, the tree either does not
bear fruit at all—is barren—or it bears undersized, tasteless fruit,—fruit
which often either immaturely drops from the tree, or, if plucked from the
tree, is useless; in the other case, the wife either does not bear children—she
is barren—or she has frequent miscarriages—“untimely fruit”—or she
bears puny, sickly children, who often either drop into an early grave, or, if
they live, probably drag out a miserable existence. You may as well expect
“to gather grapes of thorns, or figs of thistles,” as healthy children from
unhealthy parents!
9. Unhealthy parents, then, as a matter of course have unhealthy children;
this is as truly the case as the night follows the day, and should deter both
man and woman so circumstanced from marrying. There are numerous
other complaints besides scrofula and insanity inherited and propagated by
parents. It is a fearful responsibility, both to men and women, if they be not
healthy, to marry. The result must, as a matter of course, be misery!
10. If a wife is to be healthy and strong, she must use the means—she
must sow before she can reap; health will not come by merely wishing for
it! The means are not always at first agreeable; but, like many other things,
habit makes them so. Early rising, for instance, is not agreeable to the lazy,

and to one fond of her bed; but it is essentially necessary to sound health.
Exercise is not agreeable to the indolent; but no woman can be really strong
without it. Thorough ablution of the whole body is distasteful and
troublesome to one not accustomed to much washing—to one laboring
under a kind of hydrophobia; but there is no perfect health without the daily
cleansing of the whole skin.
11. But all these processes entail trouble. True: is anything in this world
to be done without trouble? and is not the acquisition of precious health
worth trouble? Yes, it is worth more than all our other acquisitions put
together! Life without health is a burden; life with health is a joy and
gladness! Up, then, and arouse yourself, and be doing! No time is to be lost
if you wish to be well, to be a mother, and to be a mother of healthy
children. The misfortune of it is, many ladies are more than half asleep, and
are not aroused to danger till danger stares them in the face; they are not
cognizant of ill health slowly creeping upon them, until, in too many cases,
the time is gone by for relief, and ill health has become confirmed—has
become a part and parcel of themselves; they do not lock the stable until the
steed be stolen; they do not use the means until the means are of no avail:
“Our remedies oft in ourselves do lie,
Which we ascribe to Heaven: the fated sky
Gives us free scope; only doth backward pull
Our slow designs, when we ourselves are dull.”[1]

12. Idleness is the mother of many diseases; she breeds them, feeds them,
and fosters them, and is, moreover, a great enemy to fecundity. Idleness
makes people miserable. I have heard a young girl—surrounded with every
luxury—bemoan her lot, and complain that she was most unhappy in
consequence of not having anything to do, and who wished that she had
been a servant, so that she might have been obliged to work for her living.
Idleness is certainly the hardest work in the world.
13. It frequently happens that a lady, surrounded with every luxury and
every comfort, drags out a miserable existence; she cannot say that she ever,
even for a single day, really feels well and strong. This is not to live—
“For life is not to live, but to be well.”[2]

14. If a person be in perfect health, the very act of living is itself
thorough enjoyment, the greatest this world can ever bestow. How needful

it therefore is that all necessary instruction should be imparted to every
Young Wife, and that proper means should, in every way, be used to insure
health!
15. The judicious spending of the first year of married life is of the
greatest importance in the making and in the strengthening of a wife’s
constitution, and in preparing her for having a family. How sad it is, then,
that it is the first twelve months that is, as a rule, especially chosen to mar
and ruin her own health, and to make her childless! The present fashionable
system of spending the first few months of married life in a round of
visiting, of late hours, and in close and heated rooms, calls loudly for a
change. How many valuable lives have been sacrificed to such a custom!
How many miscarriages, premature births, and still-born children, have
resulted therefrom! How many homes have been made childless—desolate
—by it! Time it is that common sense should take the place of such folly!
The present system is abominable, is rotten at the core, and is fraught with
the greatest danger to human life and human happiness. How often a lady
is, during the first year of her wifehood, gadding out night after night,—one
evening to a dinner party, the next night to private theatricals, the third to an
evening party, the fourth to the theater, the fifth to a ball, the sixth to a
concert, until in some cases every night except Sunday night is consumed in
this way,—coming home frequently in the small hours of the morning,
through damp or fog, or rain or snow, feverish, flushed, and excited—too
tired until the morning to sleep, when she should be up, out, and about.
When the morning dawns she falls into a heavy, unrefreshing slumber, and
wakes not until noon, tired, and unfit for the duties of the day! Night after
night—gas, crowded rooms, carbonic acid gas, late hours, wine, and
excitement are her portion. As long as such a plan is adopted the preacher
preacheth but in vain. Night after night, week after week, month after
month, this game is carried on, until at length either an illness or broken
health supervenes. Surely these are not the best means to insure health and a
family and healthy progeny! The fact is, a wife nowadays is too artificial;
she lives on excitement; it is like drinking no wine but champagne, and, like
champagne taken in excess, it soon plays sad havoc with her constitution.
The pure and exquisite enjoyments of nature are with her too commonplace,
tame, low, and vulgar. How little does such a wife know of the domestic
happiness so graphically and sweetly described by that poet of the
affections, Cowper:

“Fireside enjoyments, home-born happiness,
And all the comforts that the lowly roof
Of undisturb’d retirement, and the hours
Of long uninterrupted evening, know.”

16. A fashionable lady might say, “I cannot give up fashionable
amusements; I must enjoy myself as others do; I might as well be out of the
world as out of the fashion.” To such a one I reply, “I myself am not a
fashionist—it is not in my line; and as in the following pages I have to tell
some plain unvarnished truths, my advice to you is, close this book at once
and read no more of it, as such a work as this cannot be of the slightest use
to you, however it might be to one who values health ‘as a jewel of great
price’—as one of her most precious earthly possessions.” Really the subject
is assuming such a serious aspect that it behooves a medical man to speak
out plainly and unreservedly, and to call things by their right names.
Fashion is oftentimes but another name for suicide and for baby-slaughter
—for “massacre of the innocents!” God help the poor unfortunate little
child whose mother is a votary of fashion, who spends her time in a round
and whirl of fashionable life, and leaves her child to the tender mercies of
servants, who “gang their ain gait,” and leave their little charge to do the
same. Such a mother is more unnatural than a wild beast; for a wild beast,
as a rule, is gentle, tender, and attentive to its offspring, scarcely ever for a
moment allowing its young to be out of its sight. Truly, fashionable life
deadens the feelings and affections. I am quite aware that what I have just
now written will, by many fashionable ladies, be pooh-poohed, and be
passed by as “the idle wind.” They love their pleasures far above either their
own or their children’s health, and will not allow anything, however
precious, to interfere with them; but still I have confidence that many of my
judicious readers will see the truth and justness of my remarks, and will
profit by them.
17. A round of visiting, a succession of rich living, and a want of rest
during the first year of a wife’s life, often plays sad havoc with her health,
and takes away years from her existence. Moreover, such proceedings often
mar the chances of her ever becoming a mother, and then she will have real
cause to grieve over her fatuity.
18. A French poet once sung that a house without a child is like a garden
without a flower, or like a cage without a bird. The love of offspring is one
of the strongest instincts implanted in woman; there is nothing that will

compensate for the want of children. A wife yearns for them; they are as
necessary to her happiness as the food she eats and as the air she breathes.
If this be true—which, I think, cannot be gainsayed—how important is our
subject,—one of the most important that can in this world engage one’s
attention, requiring deep consideration and earnest study.
19. The first year of a married woman’s life generally determines
whether, for the remainder of her existence, she shall be healthy and strong,
or shall be delicate and weak; whether she shall be the mother of fine,
healthy children, or—if, indeed, she be a mother at all—of sickly,
undersized offspring—
“Born but to weep, and destined to sustain
A youth of wretchedness, an age of pain.”[3]

If she be not a parent, her mission in life will be only half performed, and
she will be robbed of the greatest happiness this world can afford. The
delight of a mother, on first calling a child her own, is exquisite, and is
beautifully expressed in the following lines—
“He was my ain, and dear to me
As the heather-bell to the honey-bee,
Or the braird to the mountain hare.”[4]

20. I should recommend a young wife to remember the momentous
mission she has to fulfill; to ponder on the importance of bringing healthy
children into the world; to bear in mind the high duties that she owes
herself, her husband, her children, and society; to consider well the value of
health—“The first wealth is health;”[5] and never to forget that “life has its
duties ever.”[6]
21. A young married lady ought at once to commence to take regular and
systematic out-door exercise, which might be done without in the least
interfering with her household duties. There are few things more conducive
to health than walking exercise; and one advantage of our climate is, that
there are but few days in the year in which, at some period of the day, it
might not be taken. Walking—I mean a walk, not a stroll—is a glorious
exercise; it expands the chest and throws back the shoulders; it strengthens
the muscles; it promotes digestion, making a person digest almost any kind
of food; it tends to open the bowels, and is better than any aperient pill ever
invented; it clears the complexion, giving roses to the cheeks and brilliancy

to the eye, and, in point of fact, is one of the greatest beautifiers in the
world. It exhilarates the spirits like a glass of champagne, but, unlike
champagne, it never leaves a headache behind. If ladies would walk more
than they do, there would be fewer lackadaisical, useless, complaining
wives than there at present are; and, instead of having a race of puny
children, we should have a race of giants. Walking exercise is worthy of all
commendation, and is indispensable to content, health, strength, and
comeliness. Of course, if a lady be pregnant, walking must then be
cautiously pursued; but still, walking in moderation is even then absolutely
necessary, and tends to keep off many of the wretchedly depressing
symptoms, often, especially in a first pregnancy, accompanying that state. I
am quite sure that there is nothing more conducive to health than the
wearing out of lots of shoe-leather and that leather is cheaper than physic.
22. Walking is even more necessary in the winter than in the summer. If
the day be cold, and the roads be dirty, provided it be dry above, I should
advise my fair reader to put on thick boots and a warm shawl, and to brave
the weather. Even if there be a little rain and much wind, if she be well
wrapped up, neither the rain nor the wind will harm her. A little sprinkling
of rain, provided the rules of health be followed, will not give her cold.
Much wind will not blow her away. She must, if she wishes to be strong,
fight against it; the conflict will bring the color to her cheek and beauty to
her eye.
23. Let her exert herself; let her mind conquer any indolence of the body;
let her throw off her lethargy—it only requires a little determination; let her
be up and doing; for life, both to man and woman, is a battle, and must be
fought valiantly.
24. Bear in mind, then, that if a lady is to be healthy, she must take
exercise, and that not by fits and starts, but regularly and systematically. A
stroll is of little use; she must walk! And let there be no mistake about it, for
Nature will have her dues: the muscles require to be tired, and not to be
trifled with; the lungs ask for the revivifying air of heaven, and not for the
stifling air of a close room; the circulation demands the quickening
influence of a brisk walk, and not to be made stagnant by idleness.
25. This world was never made for idleness; everything around and about
us tells of action and of progress. Idle people are miserable people; idle
people are diseased people; there is no mistake about it. There is no

substitute in this world for exercise and for occupation; neither physic nor
food will keep people in health; they must be up and doing, and buckle on
their armor, and fight, as every one has to fight, the battle of life! Mr. Milne,
the master of the North Warwickshire hounds, lately, at a hunt dinner,
pithily remarked “that fox-hunting was the best physic for improving a bad
constitution.” I am quite sure, with regard to the fair sex, that an abundance
of walking exercise and of household occupation is decidedly the best
physic for improving a lady’s constitution, more especially if she have, as
unfortunately too many of them have, a bad one; indeed, an abundance of
walking exercise and of household occupation will frequently convert a bad
into a good constitution.
26. Moreover, there is not a greater beautifier in the world than fresh air
and exercise; a lady who lives half her time in the open air, in God’s
sunshine, and who takes plenty of walking exercise, has generally a clear
and beautiful complexion—
“She looks as clear
As morning roses newly washed with dew.”[7]

27. Do not let me be misunderstood: I am not advocating that a delicate
lady, unaccustomed to exercise, should at once take violent and long-
continued exercise; certainly not. Let a delicate lady learn to take exercise,
as a young child would learn to walk—by degrees; let her creep, and then
go; let her gradually increase her exercise, and let her do nothing either
rashly or unadvisedly. If a child attempted to run before he could walk, he
would stumble and fall. A delicate lady requires just as much care in the
training to take exercise as a child does in the learning to walk; but exercise
must be learned and must be practiced, if a lady, or any one else, is to be
healthy and strong. Unfortunately, in this our day the importance of exercise
as a means of health is but little understood and but rarely practiced;
notwithstanding, a lady may rest assured that until a “change comes o’er the
spirit of her dreams,” ill health will be her daily and constant companion.
28. A lady should walk early in the morning, and not late in the evening.
The dews of evening are dangerous, and are apt to give severe colds, fevers,
and other diseases. Dew is more likely to cause cold than rain—
“The dews of the evening most carefully shun—
Those tears of the sky for the loss of the sun.”[8]

29. A breath of wind is not allowed to blow on many a fair face. The
consequence is, that her cheek becomes sallow, wan, “as wan as clay,” and
bloodless, or if it has a color it is the hectic flush, which tells of speedy
decay!
30. Sitting over the fire will spoil her complexion, causing it to be
muddy, speckled, and sallow. The finest complexion in a lady I ever saw
belonged to one who would never go, even in the coldest weather, near the
fire: although she was nearly thirty years of age, her cheeks were like roses,
and she had the most beautiful red and white I ever beheld; it reminded me
of Shakspeare’s matchless description of a complexion:—
“’Tis beauty truly blent, whose red and white
Nature’s own sweet and cunning hand laid on.”

31. Sitting over the fire will make her chilly, nervous, dyspeptic, and
dispirited. It will cause her to be more chilly, and thus will make her more
susceptible of catching cold; and it will frequently produce chilblains. If she
be cold, the sitting over the fire will only warm her for the time, and will
make her feel more starved when she leaves it. Crouching over the fire, as
many do, is ruination to health and strength and comeliness! Sitting over the
fire will make her nervous: the heat from the fire is weakening beyond
measure to the nerves. It will disorder and enfeeble her stomach—for
nothing debilitates the stomach like great heat—and thus make her
dyspeptic; and if she be dyspeptic, she will, she must be dispirited. The one
follows the other as surely as the night follows the day.
32. If sitting over the fire be hurtful, sitting with the back to the fire is
still more so. The back to the fire often causes both sickness and faintness,
injures the spine, and weakens the spinal marrow, and thus debilitates the
whole frame.
33. A walk on a clear, frosty morning is as exhilarating to the spirits as
the drinking of champagne—with this difference, that on the day following
the head is improved by the one, but not always by the other. Simple
nature’s pleasures are the most desirable—they leave no sting behind them!
34. There is nothing like a long walk to warm the body and to make the
blood course merrily through the blood-vessels. I consider it to be a great
misfortune that my fair countrywomen do not use their legs more and their
carriages less. “As to exercise, few women care to take it for mere health’s

sake. The rich are too apt to think that riding in a close varnish-smelling
carriage ought to be a very good substitute for muscular struggles in the
open air.”[9]
35. Unfortunately this is an age of luxury. Everything is artificial, and
disease and weakness, and even barrenness, follow as a matter of course. In
proof of my assertion that this is an age of luxury, look at the present
sumptuous style of living: carriages rolling about in every direction; dining-
tables groaning under the weight of rich dinners, and expensive wines
flowing like water; grand dresses sweeping the streets, almost doing away
with the necessity for scavengers. I say, advisedly, streets; for green fields
are, unfortunately, scarcely ever visited by ladies. We are almost, in
extravagance, rivaling ancient Rome just before luxury sapped her strength
and laid her in ruins!
36. If a lady has to travel half a mile she must have her carriage. Strange
infatuation! Is she not aware that she has hundreds of muscles that want
exercising? that she has lungs that require expanding? that she has nerves
that demand bracing? that she has blood that needs circulating? And how
does she think that the muscles can be exercised, that the lungs can be
expanded, that the nerves can be braced, and that the blood can be properly
circulated, unless these are all made to perform their proper functions by an
abundance of walking exercise? It is utterly impossible!
37. Does she desire to be strong? Then let her take exercise! Does she
hope to retain her bloom and her youthful appearance, and still to look
charming in the eyes of her husband? Then let her take exercise! Does she
wish to banish nervousness and low spirits? Then let her take exercise!
There is nothing standing still in Nature: if it were, creation would languish
and die. There is a perpetual motion! And so must we be constantly
employed (when not asleep), if we are to be healthy and strong! Nature will
not be trifled with; these are her laws[10]—immutable and unchangeable, and
we cannot infringe them with impunity:
“Labor is life! ’Tis the still water faileth;
Idleness ever despaireth, bewaileth;
Keep the watch wound, for the dark night assaileth;
Flowers droop and die in the stillness of noon.
Labor is glory! The flying cloud lightens;
Only the waving wing changes and brightens;
Idle hearts only the dark future frightens;
Play the sweet keys, would’st thou keep them in tune!”

38. If a newly-married woman be delicate, as, unfortunately, too many
are, she may be made to bear exercise well, provided she begins by taking a
short walk at first—be it ever so short—and by gradually increasing it until
she be able to take a tolerably long one. She might find it irksome at the
beginning, and might be inclined to give it up in despair; but if she value
her health and happiness, let me urge her to persevere, and she may depend
upon it that she will be amply rewarded for her trouble.
39. A delicate lady frequently complains of cold feet; she has neither
sufficient food nor sufficient exercise to keep them warm. Walking and
plenty of nourishment are the best remedies she can use to warm them. If
they be cold before retiring to rest—a frequent cause of keeping her awake
—let her walk briskly for half an hour, before undressing for the night,
about either the hall, or the landing, or a large room.
40. Some ladies declare that they are always cold, their feet especially,
which are as cold as ice! The fact is, they not only do not take exercise
enough, but they do not take nourishment enough—breakfast especially—to
keep them warm. Many ladies really and truly half starve themselves; they
consider it to be vulgar to eat much, and to satisfy their appetite! they deem
it low to take a long walk: every poor woman can do that! it is much more
easy and pleasant to loll back in an easy carriage, and to be rolled along!
Truly; but if carriage exercise be more agreeable, is it as healthful?
Certainly not: there is very little exercise in riding in a carriage; but every
organ, muscle, nerve, and blood-vessel of the body is put into beneficial
action by walking. Walking is essential to health; there is no substitute for
it; there certainly is no perfect health without it.
41. The reason why my fair countrywomen take so much opening
medicine is the want of exercise. How truly it has been said that “physic,
for the most part, in nothing else but the substitute of exercise and
temperance.”
42. I consider it to be a grievous misfortune for any one—man, woman,
or child—who cannot, without the frequent taking of physic, keep their
bowels regular. When such is the case there is something wrong, very
wrong, about her system and about her proceedings, and the sooner the
matter is inquired into and rectified the better. The necessity of a constant
swallowing of opening medicine is a proof of chronic ill health, and will in
time injure her constitution beyond remedy. I cannot speak too strongly on

this subject; I have, in my professional experience, seen so much mischief
and misery caused by the frequent swallowing of opening pills, that I
should not do my duty if I did not raise my voice against the abominable
custom. Why, many ladies make a practice, during the whole of their lives,
of taking two or three times a week opening pills! The bowels, they say,
will not act without them; but I maintain that if they would resolutely
refrain from swallowing them, and adopt the rules of health laid down in
these pages, they would be able altogether to dispense with them, to their
great benefit and delectation. But then the rules of health require trouble
and perseverance—(and what that is worth having does not?)—while the
swallowing of a couple of pills might be done quickly, and with very little
trouble; but although the frequent taking of pills gives at the time but little
trouble, they cause much trouble afterwards! Look, then, at the results of
each system, and decide accordingly! It has been said that “gluttony kills
more than the sword;” my conviction is, that the constant taking of opening
medicine kills more than gluttony and the sword combined! The abuse of
aperients is one of the crying evils of the day, and who so proper as a
medical man to raise his voice to suppress, or at all events to lessen, the
evil?
43. If a lady be costive, and is in consequence inclined to take a dose of
physic, let me advise her to take instead a long walk, which will in the
majority of cases do her vastly more good; and if requiring repetition, the
one is far more agreeable, and the effects are much more likely to be lasting
than the other. Exercise, I am quite sure, is, as a rule, in the long run much
more effectual and beneficial than opening physic.
44. A newly-married wife ought to be cautious in the taking of horse
exercise. As long as she be not pregnant, horse exercise is very beneficial to
health, and is a great enjoyment; but the moment symptoms of pregnancy
develop themselves, she must instantly give it up, or it will probably cause
her to miscarry.
45. Let her breathe the pure air of heaven, rather than the close
contaminated air either of an assembly or of a concert-room. The air of an
assembly or of a concert-room is contaminated with carbonic acid gas. The
gas-lights and the respiration of numbers of persons give off carbonic acid
gas, which gas is highly poisonous.

46. The truth of this assertion is patent to every one who will observe the
effects that a large assembly, more especially in the evening, when the gas
or candles are flaring away, has on the system; the headache, the
oppression, the confusion of ideas, the loss of appetite, the tired feeling,
followed by a restless night—all tell a tale, and loudly proclaim that either
an assembly or a concert-room is not a fit place for a young wife desirous of
having a family.
47. Let a young married lady attend well to the ventilation of her house.
She may depend upon it that ventilation, thorough ventilation, will prove
one of the best friends she has in the world. Let her give directions to her
servant to have early every morning every window in the house opened, as
the morning air is fresher and sweeter than it is later in the day. “For
ventilation, open your windows both at top and bottom. The fresh air rushes
in one way, while the foul makes its exit the other. This is letting in your
friend and expelling your enemy.”[11] This opening of the window, top and
bottom, of course applies only to the rooms that are unoccupied:—in an
occupied room in hot weather one sash only—the lower, as a rule, is best—
ought to be opened. If the upper be lowered when the room is occupied, the
cold air is apt to strike on the top of the head, and to give cold.
48. Let her give orders that every chimney in the house be unstopped,
and let her see for herself that her orders have been obeyed; for servants, if
they have the chance, will stop up chimneys, as they are fully aware that
dust and dirt will come down chimneys, and that it will give them a little
extra work to do. But the mistress has to see to the health of herself and of
her household, which is of far more consequence than either a little dirt or
extra work for her servants.
49. She may rest assured that it is utterly impossible for herself and for
her family to have perfect health if the chimneys are allowed to be stopped.
I assert this fearlessly, for I have paid great attention to the subject. If the
chimney be stopped, the apartment must necessarily become contaminated
with carbonic acid gas, the refuse of respiration, which is, as I have before
stated, a deadly poison.
50. Chimneys, in many country houses, are permanently and hermetically
stopped: if we have the ill-fortune to sleep in such rooms, we feel half-
suffocated. Sleep, did I say? No! tumble and toss are the right words to
express the real meaning; for in such chambers very little sleep do we get,

—unless, indeed, we open the windows to let in the air, which, in such an
extremity, is the only thing, if we wish to get a wink of sleep, we can do!
Stopped-up bedroom chimneys is one and an important reason why some
persons do not derive the benefit they otherwise would do of change of air
to the country.
51. I unhesitatingly declare that ninety-nine bedrooms out of every
hundred are badly ventilated; that in the morning, after they have been slept
in, they are full both of impure and of poisoned air. I say, advisedly, impure
and poisoned air, for the air becomes foul and deadly if not perpetually
changed—if not constantly mixed, both by day and by night, with fresh,
pure, external air. Many persons, by breathing the same air over and over
again, are literally “poisoned by their own breaths!” This is not an
exaggerated statement—alas, it is too true! Let every young wife remember
that she requires just as much pure air in the night as in the day; and if she
does not have it, her sleep will neither refresh her nor strengthen her, but
that she will rise in the morning more weary than on the previous night
when she retired to rest.
52. The way to make a house healthy, and to keep off disease, is by
thorough ventilation—by allowing a current of air, both by day and by
night, to constantly enter and to sweep through the house, and every room
of the house. This may be done either by open skylight or by open landing
windows, which should always be left open; and by allowing every
chamber window to be wide open during the day, and every chamber door
to be a little open both by night and by day, having a door-chain on each
door during the night to prevent intrusion.
53. Let her, if she can, live in the country. In a town, coal fires—
manufactories, many of them unhealthy—confined space—the exhalations
from the lungs and from the skin of the inhabitants, numbers of them
diseased,—all tend to load the air with impurities. Moreover, if in the town
she desire a walk, it is often itself a walk, and a long one too, before she can
get into the country—before she can obtain glimpses of green fields and
breathe the fresh air; hence walks in the town do but comparatively little
good. In the country her lungs are not cheated: they get what they want—a
good article, pure air—and the eye and heart are both gladdened with the
beauties of nature. I consider the following remark of Dr. Grosvenor, in his
excellent Essay on Health, very pertinent. He observes: “Hence it is that

one seldom sees in cities, courts, and rich houses, where people eat and
drink, and indulge in the pleasure of appetite, that perfect health and athletic
soundness and vigor which is commonly seen in the country, in the poor
houses and cottages, where nature is their cook and necessity is their
caterer, where they have no other doctor but the sun and fresh air, and no
other physic but exercise and temperance.”
54. Cold air is frequently looked upon as an enemy, instead of being
contemplated as, what it really is to a healthy person, a friend. The effect of
cold upon the stomach is well exemplified in a walk in frosty weather,
producing an appetite. “Cold air,” says Dr. Cullen, “applied with exercise, is
a most powerful tonic with respect to the stomach; and this explains why,
for that purpose, no exercise within doors, or in close carriages, is so useful
as that in the open air.”
55. Hot and close rooms, soft cushions, and luxurious couches must be
eschewed. I have somewhere read, that if a fine, healthy whelp of the bull-
dog species were fed upon chicken, rice, and delicacies, and made to lie
upon soft cushions, and if, for some months, he were shut up in a close
room, when he grew up he would become unhealthy, weak, and spiritless.
So it is with a young married woman; the more she indulges, the more
unhealthy, weak, and inanimate she becomes—unfit to perform the duties
of a wife and the offices of a mother, if, indeed, she be a mother at all!
56. Rich and luxurious ladies are less likely to be blessed with a family
than poor and hard-worked women. Here is, to a vengeance, compensation!
Compensation usually deals very justly both to man and womankind. For
instance, riches and childlessness, poverty and children, laziness and
disease, hard work and health, a hard-earned crust and contentment, a
gilded chamber and discontent—
“These are ofttimes wedded as a man and wife,
And linked together, hand in hand, through life.”

Riches seldom bring health, content, many children, and happiness; they
more frequently cause disease, discontent, childlessness, and misery.[12]
Riches and indolence are often as closely united as the Siamese twins,
disease and death frequently following in their train. “Give me neither
poverty nor riches” was a glorious saying of the wisest of men. Rich and
luxurious living, then, is very antagonistic to fecundity. This might be one
reason why poor curates’ wives and poor Irish women generally have such

large families. It has been proved by experience that a diet, principally
consisting of milk, buttermilk, and vegetables, is more conducive to
fecundity than a diet almost exclusively of meat. In illustration of my
argument, the poor Irish, who have usually such enormous families, live
almost exclusively on buttermilk and potatoes; they scarcely eat meat from
year’s end to year’s end. Riches, if it prevent a lady from having children, is
an evil and a curse, rather than a good and a blessing; for, after all, the
greatest treasures in this world are “household treasures”—healthy
children! If a wife be ever so rich, and she be childless, she is, as a rule,
discontented and miserable. Many a married lady would gladly give up half
her worldly possessions to be a mother; and well she might—children are
far more valuable. I have heard a wife exclaim with Rachel, “Give me a
child, or I die.”
57. If a young wife be likely to have a family, let her continue to live
heartily and well; but if she have been married a year or two without any
prospect of an increase, let her commence to live abstemiously on fresh
milk, buttermilk, bread, potatoes, and farinaceous diet, with very little meat,
and no stimulants whatever; let her live, indeed, very much either as a poor
curate’s wife, or as a poor Irish woman is compelled to live.
58. It is not the poor woman that is cursed with barrenness—she has
often more mouths than she can well fill; but the one that frequently labors
under that ban is the pampered, the luxurious, the indolent, the fashionable
wife; and most assuredly, until she change her system of living to one more
consonant with common sense, she will continue to do so. It is grievous to
contemplate that oftentimes a lady, with every other temporal good, is
deficient of two earthly blessings—health and children; and still more
lamentable, when we know that they frequently arise from her own seeking,
that they are withheld from her in consequence of her being a votary of
fashion. Many of the ladies of the present day, too, if they do bear children,
are, from delicacy of constitution, quite unable to suckle them. Should such
things be? But why, it might be asked, speak so strongly and make so much
fuss about it? Because the disease is become desperate, and delays are
dangerous—because children among the higher ranks are become few and
far between; and who so proper as a medical man to raise his voice to
proclaim the facts, the causes, and the treatment? I respectfully inquire of
my fair reader, Is fashion a wife’s mission? If it be not, what is her mission?
I myself have an idea—a very ancient and an almost obsolete one—that the

mission of a wife is a glorious mission, far removed from fashion and from
folly. A fashionable wife, after a fashionable season, is frequently hysterical
and excitable, and therefore exhausted; she is more dead than alive, and is
obliged to fly to the country and dose herself with quinine to recruit her
wasted energies. Is such a wife as this likely to become a joyful mother of
children? I trow not. Her time is taken up between pleasure and excitement
to make herself ill, and nursing to make herself well, in order that she may,
at the earliest possible moment, again return to her fashionable pursuits,
which have with her become, like drinking in excess, a necessity. Indeed, a
fashionable life is a species of intoxication. Moreover, wine-drinking in
excess and a fashionable life are usually joined together. Sad infatuation,
destructive alike to human life and human happiness—a road that often
leads to misery, disappointment, and death! These are strong expressions,
but they are not stronger than the subject imperatively demands—a subject
which is becoming of vital importance to the well-being of society, and, in
the higher ranks, even to its very existence, and which must, ere long,
engross the attention of all who love their country. Fashion is a sapper and
miner, and is ever hard at work sapping and undermining the constitutions
of its votaries. Something must be done, and that quickly, to defeat its
machinations, otherwise evils will, past remedy, be consummated.
59. I consider thorough ablution of the body every morning one of the
most important means of health to a young wife; “while the poor, in the
matter of washing, are apt to think that they can put off till Saturday what
ought to be performed every day, and that they can wind up the week by a
good wash with impunity.”[13] There is nothing more tonic and invigorating
and refreshing than cold ablution. Moreover, it makes one feel clean and
sweet and wholesome; and you may depend upon it, that it not only
improves our physical constitution, but likewise our moral character, and
makes our minds more pure and holy. A dirty man has generally a dirty
mind!
60. The ewers and basins in our own country are, for the purposes of
thorough ablution, ridiculously small, while on the Continent they are still
smaller. They are of pigmy dimensions—the basins being of the size of an
ordinary slop-basin, and the ewer holding enough water to wash a finger.
How can persons with such appliances be either decently clean, or sweet, or
thoroughly healthy? It is utterly impossible. Many people on the Continent

have a dread of water—they labor under a species of hydrophobia: hence
one reason why the ewers and basins are of such dwarfish proportions.
61. A young wife ought to strip to the waist, and then proceed to wash her
face after the manner so well described by Erasmus Wilson in his work on
Healthy Skin. He says: “Fill your basin about two-thirds full with fresh
water; dip your face in the water, and then your hands. Soap the hands well,
and pass the soaped hands with gentle friction over the whole face. Having
performed this part of the operation thoroughly, dip the face in the water a
second time, and rinse it completely; you may add very much to the luxury
of the latter part of the process by having a second basin ready with fresh
water to perform a final rinsing.... In washing the face you have three
objects to fulfill: to remove the dirt, to give freshness, and to give tone and
vigor to the skin.” Now for the remaining process of ablution. Having well
rubbed her neck with her soaped hands, she ought thoroughly to bathe her
neck, her chest, and arms, by means of a large sponge dipped in cold water
—the colder the better. She cannot cleanse her own shoulders, back, and
loins with a sponge—she cannot get to them. To obviate this difficulty, she
ought to soak a piece of flannel, a yard and a half long and half a yard wide,
folded lengthways, in cold water, and throwing it over her shoulders, as she
would a skipping-rope, she should for a few times work it from right to left
and from left to right, “and up and down, and then athwart,” her loins and
back and shoulders. This plan will effectually cleanse parts that she could
not otherwise reach, and will be most refreshing and delightful. She should
then put both her hands, her forearms, and her arms into the basin of water
as far as they will reach, and keep them in for a few seconds, or while she
can count fifty. The wet parts should be expeditiously dried. Then, having
thrown off her remaining clothes, and merely having her slippers on, she
ought to sit for a few seconds, or while in the winter she can count fifty, or
while in the summer she can count a hundred, either in a sitz-bath,[14] or in a
very large wash-hand basin—called a nursery-basin[15] (sold for the purpose
of giving an infant his morning bath)—containing water to the depth of
three or four inches. While sitting either in the bath or in the basin, she
ought in the winter time to have either a small blanket or a woolen shawl
thrown over her shoulders. If she has any difficulty in getting in and out of
the basin, she should place a chair on each side of the basin; she can then,
by pressing upon the chairs with her elbows, arms, and hands, readily do so.

62. If a lady be too delicate to take a sitz-bath, or if a sitz-bath should not
agree with her, then she ought every morning to use the bidet, and, while
sitting over it, she should well sponge the parts with the water, allowing the
water for a few seconds to stream over them. Every lady should bear in
mind that either the sitz-bath or the bidet, every morning of her life (except
under certain circumstances), is absolutely essential to her comfort and her
well-being.
63. At first, until she become accustomed to the cold (which she will do
in a few days), she ought to use the water tepid, but the sooner she can use
cold water, and that plentifully, the better—as it will greatly contribute to
her health and strength. But, as I said before, the process ought to be
quickly performed, as it is the shock in bracing and in strengthening the
system that does so much good.
64. When a lady is very delicate, it may, during the winter, be necessary
to put a dash of warm water into the bath, in order to take off the extreme
chill; but, as she becomes stronger, she will be able to dispense with the
warm water, as the colder the water is, provided she can bear it, the more
good it will do her.
65. If her loins or her back are at all weak, the addition either of a large
handful of table salt, or of a small handful of bay salt, or of a lump of rock-
salt,[16] dissolved in the water in the sitz-bath, will be of great service to her.
66. The feet and the legs ought every morning to be bathed—not by
standing in the water, but, on the completion of the washing of the other
parts of the body, by putting one foot at a time for a few seconds (not
minutes) in the basin containing the water (the basin for that purpose being
placed on the floor), and well and quickly washing the foot, either with a
flannel or with a sponge, and well cleansing with the finger and thumb
between each toe, and allowing the water from the sponge or flannel to
stream into the basin from the knee downwards. All this, of course, must be
done expeditiously; and care ought to be taken, after such ablution, to well
dry with a towel between each toe. The washing of the feet as above
directed will be a great refreshment, and will be most beneficial to health,
and will be a means of warding off colds, of preventing chilblains, and of
preserving the feet in a sweet and healthy state. The feet ought to be kept as
clean, if not cleaner, than the hands. Parts that are not seen should be kept
cleaner than parts that are seen. Filth is apt to gather in covered up places.

67. The moment she has finished her bath she ought quickly to dry
herself. I should recommend her to use as a towel the Turkish rubber: it will
cause a delightful glow of the whole body.
68. The whole of the body, except the hair of the head, is, by the above
method, every morning thoroughly washed. The hair of the head ought
occasionally, even with soap and water, to be cleansed, to keep it clean and
sweet and wholesome; for nothing is more dirty if it be not well attended to
than human hair, and nothing is more repulsive than a dirty head.
69. Brushing of the hair, although beneficial both to the hair and health,
will not alone thoroughly cleanse the hair and scalp.
70. Some ladies attempt to clean their hair by simply washing it either
with rosemary or with rosewater, or with other washes; but there is no more
effectual way of doing it than occasionally by a flannel and soap and water.
71. Bathing in the sea during the season, provided no grease has been
previously used, is very good for the hair; it both strengthens the roots and
beautifies the color.
72. I should advise my fair reader not to plaster her hair either with
grease or with pomade, or with other unknown compounds: many of them
are apt to make the head dirty, scurfy, and sore.
73. It might be said that it is utterly impossible for a lady to keep her hair
tidy, unless she uses some application to it. If such be the case, either a little
best olive oil or scented castor oil, or cocoanut oil, may, by means of an old
tooth-brush, be applied to smooth the hair.
74. If the hair should fall off, either a little cocoanut oil or a little scented
castor oil, well rubbed every night and morning into the roots, is an
excellent dressing. These are simple remedies, and can never do any harm,
which is more than can be said of many quack nostrums, which latter often
injure the hair irreparably.
75. The best carpet, either for a bath-room or for a dressing-room, is
kamptulicon, as the water spilt upon it after the use of a bath or ablution
can, by means of a flannel, be readily absorbed; the window ought then to
be thrown wide open, and the room will quickly be dried.
76. It would be well for her, when practicable, to have, after she has
finished dressing, a quarter of an hour’s walk, either in the garden or in the
grounds, in order to insure a reaction, and thus to induce a healthy glow of

the circulation, and to give her an appetite for her breakfast. A quarter of an
hour’s walk before breakfast is more beneficial to health than an hour’s
walk after breakfast.
77. If a lady have not been accustomed to a thorough ablution, as just
directed, of her whole body, let her, if possible, before commencing, take a
trip to the coast, and have a few dips in the sea; after which she might at
once go through the processes above advised with safety, comfort, and
advantage; but whether she be able to bathe in the sea or not, she must, if
she is to be strong and healthy, gradually accustom herself to a daily
ablution of the whole of her body. The skin is a breathing apparatus, and
unless it be kept clean it cannot properly perform its functions. It might be
said, it will take time and trouble daily to cleanse the whole of the skin: it
will; but no more than ten minutes, or a quarter of an hour, to go through
the whole of the above processes of bathing and of drying the skin. The
acquisition of health takes both time and trouble; but nothing worth having
in this world is done without it! There is no royal road to health; but
although the path at first might be a little rugged and disagreeable, it soon
becomes from practice smooth and pleasant!
78. Oh, if my fair reader did but know the value of thorough cold water
ablutions, she would not lose a day before giving the plan I have above
recommended a trial. It would banish all, or nearly all, her little ailments
and nervousness; it would make her dispense with many of her wrappings;
it would, in the winter time, keep her from coddling and crudling over the
fire; it would cause her to resist cold and disease; it would, if she were
inclined to constipation, tend to regulate her bowels; it would strengthen her
back and loins; it would make her blooming, healthy, and strong; and it
would pave the way, and fit her, in due time, to become a mother, and the
mother of fine, hearty children! My reader must not fancy that I have
overdrawn the picture; I have painted it from the life. “I only tell what I do
know, and declare what I do believe.” Let me urge but a trial, and then my
fair inquirer will have cause to be thankful that she had been induced to
carry out my views, and I shall rejoice that I have been the means of her
doing so. Hear what a physician and a poet, a man of sound sense and of
sterling intellect, says of the value of ablution. He speaks of warm ablution,
which certainly is, at the beginning of using thorough ablution, the best; but
the sooner cold can be substituted for warm the better it will be for the
health and strength and spirits of the bather:

“The warm ablution, just enough to clear
The sluices of the skin, enough to keep
The body sacred from indecent soil.
Still to be pure, even did it not conduce
(As much as it does) to health, were greatly worth
Your daily pains; it is this adorns the rich;
The want of it is poverty’s worst foe.
With this external virtue age maintains
A decent grace! without it, youth and charms
Are loathsome.”[17]

79. With regard to diet.—Although I have a great objection (which I
either have or will particularize) of a young wife taking rich food and many
stimulants, yet I am a great advocate for an abundance of good wholesome
nourishment.
80. The meager breakfasts of many young wives (eating scarcely
anything) is one cause of so much sickness among them, and of so many
puny children in the world.
81. Let every young wife, and, indeed, every one else, make a substantial
breakfast. It is the foundation meal of the day; it is the first meal after a long
—the longest fast. The meager, miserable breakfasts many young wives
make is perfectly absurd; no wonder that they are weak, “nervous,” and
delicate. A breakfast ought, as a rule, to consist either of eggs or of cold
chicken, or of cold game, or of bacon, or of ham, or of cold meat, or of
mutton-chops, or of fish, and of plenty of good bread, and not of either hot
buttered toast, or of hot rolls swimming in butter; both of which latter
articles are like giving the stomach sponge to digest, and making the
partaker of such food for the rest of the day feel weak, spiritless, and
miserable. If she select coffee for breakfast, let the half consist of good
fresh milk; if she prefer cocoa, let it be made of new milk instead of water;
if she choose tea, let it be black tea, with plenty of cream in it. Milk and
cream are splendid articles of diet. Let her then make a hearty breakfast,
and let there be no mistake about it. There is no meal in the day so
wretchedly managed, so poor and miserable, and so devoid of nourishment,
as an English breakfast. Let every young wife, therefore, look well to the
breakfast, that it be good and varied and substantial, or ill health will almost
certainly ensue.[18]
82. A meager unsubstantial breakfast causes a sinking sensation of the
stomach and bowels, and for the remainder of the day a miserable

depression of spirits. Robert Browning truly and quaintly remarks that
“A sinking at the lower abdomen
Begins the day with indifferent omen.”

83. It frequently happens that a young wife has no appetite for her
breakfast. She may depend upon it, in such a case, there is something wrong
about her, and that the sooner it is rectified the better it will be for her
health, for her happiness, and for her future prospects. Let her, then, without
loss of time seek medical advice, that means may be used to bring back her
appetite. The stomach in all probability is at fault; if it be, the want of
appetite, the consequent sensation of sinking of the stomach, and the
depression of the spirits are all explained; but which, with judicious
treatment, may soon be set to rights.
84. If the loss of appetite for breakfast arise from pregnancy—and
sometimes it is one of the earliest symptoms—time will rectify it, and the
appetite, without the necessity of a particle of medicine, will shortly, with
its former zest, return.
85. A young married woman’s diet ought to be substantial, plain, and
nourishing. She must frequently vary the kind of food, of meat especially,
as also the manner of cooking it. Nature delights in variety of food, of air,
and of exercise. If she were fed, for some considerable period, on one kind
of meat, she could scarcely digest any other; and in time either a disordered
or a diseased stomach would be likely to ensue. I have sometimes heard,
with pain and annoyance, a patient advised to live on mutton-chops, and to
have no other meat than mutton! Now this is folly in the extreme. Such an
unfortunate patient’s stomach, in the course of time, would not be able to
digest any other meat, and after awhile would have a difficulty in digesting
even mutton-chops, and wretched and ruined health would to a certainty
ensue.
86. Three substantial and nourishing meals a day will be sufficient. It is a
mistaken notion to imagine that “little and often” is best. The stomach
requires rest as much as, or more than, any other part of the body; and how,
if food be constantly put into it, can it have rest? There is no part of the
body more imposed and put upon than the human stomach:
“To spur beyond
Its wiser will the jaded appetite,—
Is this for pleasure? Learn a juster taste,

And know that temperance is true luxury.”
87. It is a mistaken notion, and injurious to health, for a young wife, or
for any one else, to eat, just before retiring to rest, a hearty meat supper:
“Oppress, not nature sinking down to rest
With feasts too late, too solid, or too full.”

88. How often we hear a delicate lady declare that she can only eat one
meal a day, and that is a hearty meat supper the last thing at night; and who,
moreover, affirms that she can neither sleep at night, nor can she have the
slightest appetite for any other meal but her supper, and that she should
really starve if she could not have food when she could eat it! The fact is,
the oppressed stomach oppresses the brain, and drives away sleep, and
appetite, and health. The habit is utterly wrong, and oftentimes demands
professional means to correct it.
89. How is it that sometimes a lady who has an excellent appetite is,
notwithstanding, almost as thin as a rake? It is not what she eats, but what
she digests, that makes her fat. Some people would fatten on bread and
water, while others would, on the fat of the land, be as thin as Pharaoh’s
lean kine. Our happiness and our longevity much depend on the weakness
or on the soundness of our stomachs: it is the stomach, as a rule, that both
gauges our happiness and that determines the span of the life of both men
and women. How necessary it is, then, that due regard should be paid to
such an important organ, and that everything should be done to conduce to
the stomach’s welfare,—not by overloading the stomach with rich food; not
by a scanty and meager diet; but by adopting a middle course, betwixt and
between high living and low living—the juste milieu. We should all of us
remember that glorious saying—those immortal words of St. Paul—“Be
temperate in all things.”
90. Where a lady is very thin, good fresh milk (if it agree) should form an
important item of her diet. Milk is both fattening and nourishing, more so
than any other article of food known; but it should never be taken at the
same meal (except it be in the form of pudding) with either beer or wine:
they are incompatibles, and may cause disarrangement of the stomach and
bowels. Milk would often agree with an adult, where it now disagrees, if the
admixture of milk with either beer or wine were never allowed.
91. Let me advise my fair reader to take plenty of time over her meals,
and to chew her food well; as nothing is more conducive to digestion than

thoroughly masticated food. No interruptions should be allowed to interfere
with the meals; the mind, at such times, should be kept calm, cheerful, and
unruffled, for “unquiet meals make ill digestions.”
92. Many persons bolt their food! When they do, they are drawing bills
on their constitutions which must inevitably be paid! The teeth act as a mill
to grind and prepare the food for the stomach; if they do not do their proper
work, the stomach has double labor to perform, and being unable to do it
efficiently, the stomach and the whole body in consequence suffer.
93. The teeth being so essential to health, the greatest care should be
taken of them: they should be esteemed among one’s most precious
possessions.[19]
94. With regard to beverage, there is, as a rule, nothing better for dinner
than either toast and water, or, if it be preferred, plain spring water—
“Naught like the simple element dilutes;”[20]

and after dinner, one or two glasses of sherry. A lady sometimes, until she
has had a glass of wine, cannot eat her dinner; when such be the case, by all
means let a glass of wine be taken,—that is to say, let her have it either just
before or during dinner, instead of after dinner; or let her have one glass of
sherry before or during dinner, and one glass after dinner.
95. A young wife sometimes has a languid circulation, a weak digestion,
and constipated bowels; then, a glass of sherry during dinner and another
glass after dinner is beneficial; and however much she might dislike wine,
she should be induced to take it, as the wine will improve her circulation,
will strengthen her digestion, and will tend to open her bowels. But let me
urge her never, unless ordered by a medical man, to exceed the two glasses
of wine daily.
96. If wine does not agree, and if she require a stimulant, a tumblerful
either of home-brewed ale or of Burton bitter ale ought, instead of water, to
be taken at dinner. But remember, if she drink either beer or porter, she
must take a great deal of out-door exercise; otherwise it will probably make
her bilious. If she be inclined to be bilious, wine is superior to either beer or
porter.
91. Brandy ought never to be taken by a young wife but as a medicine,
and then but rarely, and only in cases of extreme exhaustion. It would be a
melancholy and gloomy prospect for her to drink brandy daily; she would,

in all probability, in a short time become a confirmed drunkard. There is
nothing, when once regularly taken, more fascinating and more desperately
dangerous than brandy-drinking. It has caused the destruction of tens of
thousands both of men and of women!
98. A wife ought not, if she feel low, to fly on every occasion to wine to
raise her spirits, but should try the effects of a walk in the country, and
“Draw physic from the fields in draughts of vital air.”[21]

99. An excitable wife is a weakly wife: “excitement is the effect of
weakness, not of strength.” Wine in large quantities will not strengthen, but,
on the contrary, will decidedly weaken; the more the wine, the greater the
debility and the greater the excitement—one follows the other as the night
the day. A person who drinks much wine is always in a state of excitement,
and is invariably weak, low, and nervous, and frequently barren. Alcoholic
stimulants in excess are “a delusion and a snare,” and are one of the most
frequent causes of excitement, and therefore both of weakness and of
barrenness. Alcohol, pure and undiluted, and in excess, is a poison, and is
ranked among the deadly poisons; if a person were to drink at one draught
half a pint of undiluted alcohol it would be the last draught he or she would
ever, in this world, drink,—it would be as surely fatal as a large dose of
either arsenic or strychnine! Brandy, whisky, gin, and wine are composed of
alcohol as the principal ingredient; indeed, each and all of them entirely
owe their strength to the quantity of alcohol contained therein. Brandy,
whisky, gin, and wine, without the alcohol, would, each one of them, be as
chip in porridge—perfectly inert. Brandy and wine, the former especially,
contain large proportions of alcohol, and both the one and the other, in
excess, either prevents a woman from conceiving, and thus makes her
barren, or if she do conceive, it poisons the unborn babe within her; and it
either makes him puny and delicate, or it downright kills him in the womb,
and thus causes a miscarriage. If he survive the poison, and he be born
alive, he is usually, when born, delicate and undersized; if such a one be
suckled by such a mother, he is subjected, if the mother can nurse him,
which in such cases she rarely can, to a second course of poisoning; the
mother’s milk is poisoned with the alcohol, and the poor unfortunate little
wretch, having to run the gantlet in the womb and out of the womb, pines
and dwindles away, until at length he finds a resting-place in the grave! If
you wish to make a dog small, give him, when he is a puppy, gin; the

alcohol of the gin will readily do it: this is a well-known fact, and is, by
dog-fanciers, constantly practiced. If you desire, in like manner, to make a
Tom Thumb of a baby, give him the milk of a mother or of a wet-nurse who
imbibes, in the form of wine or of brandy or of gin, alcohol in quantities,
and the deed is done! Gin-drinking nursing mothers, it is well known, have
usually puny children; indeed, the mother drinking the gin is only another
way of giving gin to the babe—an indirect instead of a direct route, both
leading to the same terminus. Brandy was formerly sold only by the
apothecary; brandy is a medicine—a powerful medicine—and ought only to
be prescribed as a medicine; that is to say, but seldom, in small and in
measured quantities at a time, and only when absolutely necessary: now it is
resorted to on every occasion as a panacea for every ill! If taken regularly,
and in quantities, as unfortunately it frequently now is, it becomes a
desperate poison—a pathway leading to the grave! It is utterly impossible
for any person to hold in the mouth, for five minutes at a time, a mouthful
of neat brandy without experiencing intense suffering: if it has this fearful
effect on the mouth, what effect must this burning fluid, when taken in
quantities, have upon the stomach? Injury, most decided injury to the
stomach, and, through the stomach, disease and weakness to the remainder
of the body! Brandy is a wonderful and powerful agent: brandy has the
effect, if taken in excess and for a length of time, of making the liver as
hard as a board. Brandy in large quantities, and in the course of time, has
the power of making the body marvelously big—as big again; but not with
firm muscle and strong sinew, not with good blood and wholesome juices—
nothing of the kind; but of filling it full, even to bursting, with water!
Brandy has the power of taking away a giant’s strength, and of making him
as helpless as a little child! Habitual brandy-drinking poisons the very
streams of life! It would take more time and space than I have to spare to
tell of the wonderful powers of brandy; but unfortunately, as a rule, its
powers are more those of an angel of darkness than those of an angel of
light! If the above statements be true (and they cannot be contravened), they
show the folly, the utter imbecility, and the danger, both to mother and to
babe, of dosing a wife, be she strong or be she delicate, and more especially
if she be delicate, with large quantities either of wine or of brandy. Brandy,
gin, and whisky act on the human economy very much alike; for, after all, it
is the quantity of alcohol contained in each of them that gives them their
real strength and danger. I have selected brandy as the type of all of them,

as brandy is now the fashionable remedy for all complaints, and,
unfortunately, in too many instances the habit of drinking it imperceptibly
but rapidly increases, until at length, in many cases, that which was
formerly a teaspoonful becomes a tablespoonful, and eventually a
wineglassful, with what result I have earnestly endeavored faithfully to
portray. Avoid, then, the first step in regular brandy-drinking: it is the first
step that ofttimes leads to danger, and eventually to destruction!
100. I am quite convinced that one cause of barrenness among ladies of
the present day is excessive wine-drinking. This is an age of stimulants, and
the practice is daily increasing. A delicate lady is recommended to take
three or four glasses of wine daily. It seems for the moment to do her good,
and whenever she feels low she flies to it again. The consequence is, that
she almost lives upon wine, and takes but little else besides! Who are the
fruitful women? Poor women who cannot afford to drink stimulants; for
instance, poor Irish women and poor curates’ wives, who have only,
principally, water and milk and buttermilk to drink.
101. There is decidedly, among the higher ranks, more barrenness than
formerly, and one cause of it, in my opinion, is the much larger quantity of
wine now consumed than in the olden times. Many ladies now drink as
many glasses of wine in one day as their grandmothers drank in a week;
moreover, the wineglasses of the present day are twice the size of old-
fashioned wineglasses; so that half a dozen glasses of wine will almost
empty a bottle; and many ladies now actually drink, in the day, half a dozen
glasses of wine!
102. In the wine-growing and wine-drinking country of France,
barrenness prevails to a fearful extent; it has become there a serious
consideration and a State question. Wine is largely consumed in France by
ladies as well as by gentlemen. The usual and everyday quantity of wine
allowed at dinner at the restaurants of Paris, for each lady, is half a wine
quart bottle-full—a similar quantity to that allowed for each gentleman.
Where a gentleman and a lady are dining together, and have a bottle of wine
between them, it is probable that the former might consume more than his
own share of the wine; but whether he does or not, the quantity the lady
herself drinks is sadly too much either for her health or for her fruitfulness.
I am, moreover, quite convinced that the quantity of wine—sour wine—

consumed by French wives is not only very antagonistic to their fertility,
but likewise to their complexions.
103. Wine was formerly a luxury, it is now made a necessary of life.
Fruitful women, in olden times, were more common than they are now.
Riches, and consequently wine, did not then so much abound, but children
did much more abound. The richer the person, the fewer the children.
104. Wine is now oftentimes sucked in with a mother’s milk! Do not let
me be misunderstood; wine and brandy, in certain cases of extreme
exhaustion, are, even for very young children, most valuable remedies; but I
will maintain that both wine and brandy require the greatest judgment and
skill in administering, and do irreparable mischief unless they are most
carefully and judiciously prescribed. Wine ought to be very rarely given to
the young; indeed, it should be administered to them with as much care and
as seldom as any other dangerous or potent medicine.
105. Statistics prove that wine-bibbing in England is greatly on the
increase, and so is barrenness. You might say there is no connection
between the two. I maintain that there is a connection, and that, the alcohol
contained in the wine (if wine be taken to excess, which unfortunately it
now frequently is) is most antagonistic to fruitfulness.
106. It is surprising, nowadays, the quantity of wine some few young
single ladies, at parties, can imbibe without being intoxicated; but whether,
if such ladies marry, they will make fruitful vines is quite another matter;
but of this I am quite sure, that such girls will, as a rule, make delicate,
hysterical, and unhealthy wives. The young are peculiarly sensitive to the
evil effects of overstimulation. Excessive wine-drinking with them is a
canker eating into their very lives. Time it is that these facts were
proclaimed through the length and breadth of our land, before mischief be
done past remedy.
107. Champagne is a fashionable and favorite beverage at parties,
especially at dances. It is a marvel to note how girls will, in quantities,
imbibe the dangerous liquid. How cheerful they are after it; how bright their
colors; how sparkling their eyes; how voluble their tongues; how brilliant
their ideas! But, alas! the effects are very evanescent—dark clouds soon
o’ershadow the horizon, and all is changed! How pale, after it, they
become; how sallow their complexions; how dim their eyes; how silent
their tongues; how depressed their spirits—depression following in an

inverse ratio to overstimulation; and if depression, as a matter of course,
weakness and disease! Champagne is one of the most fascinating but most
desperately dangerous and deceptive drinks a young girl can imbibe, and
should be shunned as the plague! Young men who witness their proceedings
admire them vastly as partners for the evening, but neither covet nor secure
them as partners for life. Can they be blamed? Certainly not! They well
know that girls who, at a dance, imbibe freely of the champagne-cup, and
who at a dinner party drink, as some few are in the habit of drinking, four or
five, or even six, glasses of wine,—that such wives as these, if ever they do
become mothers (which is very doubtful), will be mothers of a degenerate
race. It is folly blinking the question; it is absolutely necessary that it be
looked boldly in the face, and that the evil be remedied before it be too late.
108. There is an immense deal of drinking in England, which, I am quite
convinced, is one reason of so few children in families, and of so many
women being altogether barren. It is high time that these subjects were
looked into, and that the torrent be stemmed, ere it o’erflow its banks, and
carry with it a still greater amount of barrenness, of misery, and of
destruction.
109. It might be said that the light wines contain but little alcohol, and
therefore can cause, even if taken to excess, but slight injurious effects on
the constitution. I reply, that even light wines, taken in quantities, conduce
to barrenness, and that, as a rule, if a lady once unfortunately takes to
drinking too much wine, she is not satisfied with the light wines, but at
length flies to stronger wines—to wines usually fortified with brandy, such
as either to sherry or to port wine, or even, at last, to brandy itself! I know
that I am treading on tender ground, but my duty as a medical man, and as a
faithful chronicler of these matters, obliges me to speak out plainly, without
fear or without favor, and to point out the deplorable consequences of such
practices. I am quite aware that many ladies have great temptations and
great inducements to resort to wine to cheer them in their hours of
depression and of loneliness; but unless the danger be clearly pointed out
and defined, it is utterly impossible to suggest a remedy, and to snatch such
patients from certain destruction.
110. I am quite convinced of one thing, namely, that the drinking of much
wine—be it light as claret, or be it heavy as port—sadly injures the
complexion, and makes it muddy, speckled, broken-out, and toad-like.

111. It is high time that medical men should speak out on the subject, and
that with no “uncertain sound,” before mischief be done past remedy, and
before our island become as barren of children as France unfortunately now
is.
112. If a lady be laboring under debility, she is generally dosed with
quantities of wine—the greater the debility the more wine she is made to
take, until at length the poor unfortunate creature almost lives upon wine.
Her appetite for food is by such means utterly destroyed, and she is for a
time kept alive by stimulants; her stomach will at length take nothing else,
and she becomes a confirmed invalid, soon dropping into an untimely
grave! This is a most grievous, and, unfortunately, in this country, not an
uncommon occurrence. Much wine will never make a delicate lady strong
—it will increase her weakness, not her strength. Wine in excess does not
strengthen, but, on the contrary, produces extreme debility. Let this be borne
in mind, and much misery might then be averted.
113. Remember I am not objecting to a lady taking wine in moderation—
certainly not; a couple of glasses, for instance, in the day, of either sherry or
claret, might do her great good; but I do strongly object to her drinking, as
many ladies do, five or six glasses of wine during that time. I will maintain
that such a quantity is most detrimental both to her health and to her
fecundity.
114. The effect of the use of wine is beneficial; but the effect of the abuse
of it is deplorable in the extreme. Wine is an edge-tool, and will, if not
carefully handled, assuredly wound most unmercifully. I have not the
slightest doubt that the quantity of wine consumed by many ladies is one
cause, in this our day, of so much delicacy of constitution. It is a crying evil,
and demands speedy redress; and as no more worthy medical champion has
appeared in the field to fight the battle of moderate wine-drinking, I myself
have boldly come forward to commence the affray, fervently trusting that
some earnest men may join me in the conflict. I consider that the advocates
for a plentiful supply of alcoholic stimulants are wrong, and that the
upholders of total abstinence principles are equally wrong; and that the only
path of health and of safety lies between them both—in moderation. A
teetotaller and an advocate for a plentiful supply of alcoholic drinks are
both very difficult to please; indeed, the one and the other are most
intemperate. I am aware that what I have written will be caviled at, and will

give great offense to both extreme parties; but I am quite prepared and
willing to abide the consequences, and sincerely hope that what I have said
will be the means of ventilating the subject, which is sadly needed. It is the
violence and obstinacy of the contending parties, each of whom is partly
right and partly wrong, that have long ago prevented a settlement of the
question at issue, and have consequently been the means of causing much
heart-burning, misery, and suffering. The Times once pithily remarked that
it would be well if the two combatants were “to mix their liquors.”
115. A young wife ought to rise betimes in the morning, and after she be
once awake should never doze. Dozing is both weakening to the body and
enervating to the mind. It is a species of dram-drinking; let my fair reader,
therefore, shun it with all her might. Let her imitate the example of the
Duke of Wellington, who, whenever he turned in bed, made a point of
turning out of it; indeed, so determined was that illustrious man not to allow
himself to doze after he was once awake, that he had his bed made so small
that he could not conveniently turn in it without first of all turning out of it.
Let her, as soon as she is married, commence early rising; let her establish
the habit, and it will for life cling to her:
“Awake! the morning shines, and the fresh field
Calls us; we lose the prime, to mark how spring
Our tender plants; how blows the citron grove,
What drops the myrrh, and what the balmy reed;
How Nature paints her colors; how the bee
Sits on the bloom.”[22]

116. It is wonderful how much may be done betimes in the morning.
There is nothing like a good start. It makes for the remainder of the day the
occupation easy and pleasant—
“Happy, thrice happy, every one
Who sees his labor well begun,
And not perplexed and multiplied
By idly waiting for time and tide.”[23]

117. How glorious, and balmy, and health-giving, is the first breath of the
morning, more especially to those living in the country! It is more
exhilarating, invigorating, and refreshing than it is all the rest of the day. If
you wish to be strong, if you desire to retain your good looks and your
youthful appearance, if you are desirous of having a family, rise betimes in
the morning; if you are anxious to lay the foundation of a long life, jump

out of bed the moment you are awake. Let there be no dallying, no
parleying with the enemy, or the battle is lost, and you will never after
become an early riser; you will then lose one of the greatest charms and
blessings of life, and will, probably, not have the felicity of ever becoming a
mother; if you do become one, it will most likely be of puny children. The
early risers make the healthy, bright, long-lived wives and mothers. But if a
wife is to be an early riser, she must have a little courage and determination;
great advantages in this world are never gained without; but what is either
man or woman good for if they have not those qualities?
118. An early riser ought always to have something to eat and drink, such
as a little bread and butter, and either a cup of tea or a draught of new milk,
before she goes out of a morning; this need not interfere with, at the usual
hour, her regular breakfast. If she were to take a long walk on an empty
stomach, she would for the remainder of the day feel tired and exhausted,
and she would then, but most unfairly, fancy that early rising did not agree
with her.
119. The early morning is one of the best and most enjoyable portions of
the day. There is a perfect charm in nature which early risers alone can
appreciate. It is only the early riser that ever sees “the rosy morn,” the
blushing of the sky, which is gloriously beautiful! Nature, in the early
morning, seems to rejoice and be glad, and to pour out her richest treasures:
the birds vie with each other in their sweetest carols; the dew on the grass,
like unto myriads of diamonds, glittering and glistening, and glinting in the
rays of the sun; occasionally the cobwebs on the shrubs and bushes, like
exquisite lace sparkling with gems; the fresh and matchless perfume and
fragrance of the earth and flowers;—these, one and all, are gloriously
beautiful to behold, and can only be enjoyed to perfection in the early
morning, while the majority of people, during the choicest periods of their
existence, are sweltering, and dozing, and deteriorating both in body and
mind, on beds of down, when they ought to be up, out, and about! Can it be
wondered at, when such weakening and enervating practices are so much in
vogue—for luxury is the curse of the day—that there are so many barren
wives in England? It looks, on the first blush, that many of the customs and
practices of the present day were to cause barrenness; for, assuredly, if they
had been instituted on purpose, they could not have performed their task
more surely and successfully.

120. It might be said that the dews of the morning are dangerous! The
dews of the early morning are beneficial to health, while the dews of the
evening are detrimental. How truly the poet sings—
“Dew-drops are the gems of morning,
But the tears of mournful eve!”[24]

121. Early rising imparts health to the frame, strength to the muscles, and
comeliness to the countenance; it clears the brain, and thus brightens the
intellect; it is a panacea for many of the ills of life, and, unlike many
panaceas, it is both simple and pleasant in its operation; it calms the
troubled breast; it gives a zest to the after-employments and pleasures of the
day; and makes both man and woman look up from “nature’s works to
nature’s God!”
122. Early rising rejuvenizes the constitution: it makes the middle-aged
look young, and the old look middle-aged; it is the finest cosmetic in the
world, and tints the cheeks with a bloom the painter emulates, but in vain!
On the other hand, late rising adds years to the looks, fills the body with
aches and pains, and the countenance with crow-feet and wrinkles; gives a
yellowness and pimples to the face, and depression to the spirits. Aged
looks and ill health invariably follow in the wake of late rising.
123. If a mistress rise early the servants are likely to follow suit: a lazy
mistress is almost sure to have lazy servants; the house becomes a
sluggard’s dwelling! Do not let me be misunderstood; I do not recommend
any unreasonable hours for rising in the morning; I do not advise a wife to
rise early for the sake of rising early: there would be neither merit nor sense
in it; I wish her to have her full complement of sleep—seven or eight hours;
but I do advise her to go to bed early, in order that she might be up every
morning at six o’clock in the summer, and at seven o’clock in the winter. I
maintain that it is the duty of every wife, unless prevented by illness, to be
an early riser. This last reason should have greater weight with her than any
other that can possibly be brought forward! All things in this world ought to
be done from a sense of duty; duty ought to be a wife’s and every other
person’s pole-star!
124. There is a wonderful and glorious object in creation which few, very
few, ladies, passing strange though it be, have ever seen—the rising of the
sun! The few who have seen it are, probably, those who have turned night
into day, who are returning home in the early morning, jaded and tired, after

dancing the whole of the previous night. These, of course, cannot enjoy, and
most likely do not even see, the magnificent spectacle!
125. I am not advising my fair reader to rise every morning with the
rising of the sun—certainly not; but if she be an early riser, she might
occasionally indulge herself in beholding the glorious sight!
126. “The top of the morning to you” is a favorite Irish salutation, and is
very expressive and complimentary. “The top of the morning”—the early
morning, the time when the sun first rises in his majesty and splendor—is
the most glorious, and health-giving, and best part of the whole day; when
nature and all created beings rejoice and are glad:
“But mighty Nature bounds as from her birth,
The sun is in the heavens, and life on earth;
Flowers in the valley, splendor in the beam,
Health in the gale, and freshness in the stream.”[25]

127. Let a young wife, if she be anxious to have a family and healthy
progeny, be in bed betimes. It is impossible that she can rise early in the
morning unless she retire early at night. “One hour’s sleep before midnight
is worth three after.” Sleep before midnight is most essential to health, and
if to health, to beauty; hence, sleep before midnight is called beauty-sleep.
The finest cosmetic is health!
128. She ought to pay particular attention to the ventilation of her
sleeping apartment, and she herself, before leaving the chamber in the
morning, ought never to omit to open the windows; and in the summer, if
the room be large, she should during the night leave, for about six or eight
inches, the window-sash open. If the room be small it will be desirable to
have, instead of the window, the door (secured from intrusion by a door-
chain) unclosed; and to have, as well, either the skylight or the landing
window open. There ought by some means or other, if the inmates of the
room are to have sweet and refreshing sleep, to be thorough ventilation of
the sleeping apartment. I have no patience to hear some men assert that it is
better to sleep in a close room—in a foul room! They might, with equal
truth, declare that it is desirable for a healthy person to swallow every night
a dose of arsenic in order to prolong his life! Carbonic acid gas is as truly a
poison as arsenic! If there be a dressing-room next to the bedroom, it will
be well to have the dressing-room window, instead of the bedroom window,
open at night. The dressing-room door will regulate the quantity of air to be

admitted into the bedroom, opening it either little or much as the weather
might be cold or otherwise.[26] The idea that it will give cold is erroneous; it
will be more likely, by strengthening the system and by carrying off the
impurities of the lungs and skin, to prevent cold.
129. Some persons, accustomed all their lives to sleep in a close, foul
room—in a room contaminated with carbonic acid gas—cannot sleep in a
fresh, well-ventilated chamber, in a chamber with either door or window
open: they seem to require the stupefying effects of the carbonic acid gas,
and cannot sleep without it! If such be the case, and as sleep is of such vital
importance to the human economy, let both window and door be closed, but
do not, on any account, let the chimney be stopped, as there must be, in a
bedroom, ventilation of some kind or another, or ill health will inevitably
ensue.
130. It is madness to sleep in a room without ventilation—it is inhaling
poison; for the carbonic acid gas, the refuse of respiration, which the lungs
are constantly throwing off, is a poison—a deadly poison—and, of course,
if there be no ventilation, a person must breathe this carbonic acid gas
mixed with the atmospheric air. Hence the importance, the vital importance,
of either an open chimney or of an open window, or of both. The chimney,
then, even if the window be closed, ought never to be stopped; and the
window, either of the bedroom or of the dressing-room, should not be
closed, even in the night, unless the weather be either very wet or bitterly
cold. I should strongly recommend my fair reader, and, indeed, every one
else, to peruse the good and talented Florence Nightingale’s Notes on
Nursing. They ought to be written in letters of gold, and should be indelibly
impressed on the memory of every one who has the interest of human life
and happiness at heart. Florence Nightingale declares that no one, while in
bed, ever catches cold from proper ventilation. I believe her; and I need not
say that no one has had more experience and better opportunities of judging
about what she writes than this accomplished authoress.
131. I fearlessly assert that no one can sleep sweetly and refreshingly
unless there be thorough ventilation of the chamber. She may have, in an
unventilated apartment, heavy, drowsy, deathlike sleep, and well she might!
She is under the stupefying effects of poison; the carbonic acid gas, which
is constantly being evolved from the lungs, and which wants a vent, but
cannot obtain it, is, as I have before remarked, a deadly poison! She may as

well take every night a stupefying opiate, as breathe nightly a bedroom
charged with carbonic acid gas; the one would, in the long run, be as
pernicious as the other. To show the power of carbonic acid gas in sending
people to sleep, we have only to notice a crowded church of an evening;
when, even if the preacher be an eloquent man, the majority of the
congregation is fast asleep,—is, in point of fact, under the soporific
influence of the carbonic acid gas, the church being at the time full of it.
Carbonic acid gas is as certain, if not more certain, to produce a heavy
deathlike slumber as either numbing opium or drowsy poppy.
132. I moreover declare that she cannot have sweet refreshing sleep at
night unless during the day she take plenty of exercise, and unless she has
an abundance of active, useful occupation.
133. Occupation—active, useful occupation—is the best composing
medicine in the world; and the misfortune of it is that the wealthy have little
or no occupation to cause them to sleep. Pleasure they have in abundance,
but little or no real occupation. “The sleep of a laboring man is sweet,
whether he eat little or much: but the abundance of the rich will not suffer
them to sleep.”[27]
134. Sleep is of more consequence to the human economy than food.
Nothing should therefore be allowed by a young wife to interfere with
sleep. And as the attendance on large assemblies, balls, and concerts sadly,
in every way, interfere with sleep, they ought, one and all, to be sedulously
avoided.
135. As exercise is very conducive and provocative of sleep—sound,
sweet, childlike sleep—exercise must be practiced, and that not by fits and
starts, but regularly and systematically. She ought, then, during the day,
with exercise and with occupation, to tire herself, and she will then have
sweet and refreshing sleep. But some ladies never do tire themselves except
with excitement; they do not know what it is to be tired either by a long
walk or by household work. They can tire themselves with dancing at a ball;
poor fragile creatures can remain up the whole night waltzing, quadrilling,
and galloping, but would be shocked at the idea and at the vulgarity of
walking a mile at a stretch! Poor creatures, they are to be pitied; and, if they
ever marry, so are their husbands. Are such wives as these likely to be
mothers, and if they are, are their offspring likely to be strong? Are such

wives as these likely to be the mothers of our future warriors, of our future
statesmen, and of our other worthies—men of mark, who,
“Departing, leave behind them
Footprints on the sands of time!”

136. Sleep is the choicest gift of God. Sleep is a comforter, a solace, a
boon, a nourisher, a friend. Happy, thrice happy, is a wife who can sleep
like unto a little child! When she is well, what a comfort is sleep; when she
is ill, what a soother of pain is sleep; when she is in trouble, what a precious
balm is sleep!
137. Hear what our noblest poet, Shakspeare, says of sleep:
“Sleep that knits up the raveled sleeve of care,
The death of each day’s life, sore labor’s bath,
Balm of hurt minds, great nature’s second course
Chief nourisher in life’s feast.”

138. A luxurious, idle wife cannot sleep; she, night after night, tumbles
and tosses on her bed of down. What has she done during the day to tire
herself, and thus to induce sleep? Alas, nothing! She in consequence never
experiences
“Tired nature’s sweet restorer, balmy sleep.”

For, after all, out-door exercise and useful occupation are the best
composing medicines in the world! Encompassed as she is with every
luxury—partaking of all the delicacies of the season, of the richest viands,
and of the choicest wines—decked out in costly apparel—reclining on the
softest cushions—surrounded with exquisite scenery, with troops of friends,
and with bevies of servants;—yet, notwithstanding all these apparent
advantages, she is oftentimes one of the most debilitated, complaining,
“nervous,” hysterical and miserable of mortals. The causes of all these
afflictions are—she has nothing to do; she is overwhelmed with prosperity;
she is like a fire that is being extinguished in consequence of being
overloaded with fuel; she is being killed with overmuch kindness; she is a
drone in a hive where all must work if they are to be strong and well, and
bright and cheerful; for labor is the lot of all and the law for all, for “God is
no respecter of persons.” The remedies for a lady affected as above
described are simple and yet efficacious—namely, simplicity of living, and
an abundance of out-door exercise and of useful occupation. It would have

been to the manifest advantage of many a fair dame if she were obliged to
put down her close carriage, and were compelled to walk instead of drive.
Riding in close carriages nurse many ailments which walking would banish;
a brisk walk is the best tonic and the most reviving medicine in the world,
and would prevent the necessity of her swallowing so much nauseous
physic. Nature’s simple remedies are oftentimes far superior and far more
agreeable than any to be found in the Pharmacopœia. It would have been a
blessing to many a rich, indolent, and luxurious lady if she had been born in
a lower rank—in one in which she had been compelled to work for her
daily bread; if she had been, she would, in many instances, have been far
happier and healthier than she now is. Indolence and luxury kill more than
hard work and hard fare ever did or ever will kill. Indolence and luxury are
slow poisons; they destroy by degrees, but are in the end as certain in their
deleterious effects as either arsenic or deadly nightshade—
“Come hither, ye that press your beds of down,
And sleep not; see him sweating o’er his bread
Before he eats it. ’Tis the primal curse,
But softened into mercy—made the pledge
Of cheerful days, and nights without a groan.”

139. I must not forget to speak of the paramount importance in a dwelling
of an abundance of light—of daylight. Light is life, light is health, light is a
physician! Light is life: the sun gives life as well as light; if it were not for
the sun, all creation would wither and die. There is “no vitality or healthful
structure without light.”[28] Light is health: it strengthens the frame, it cheers
the heart, and tints the cheeks with a roseate hue! Light is a physician: it
drives away many diseases, as the mists vanish at the approach of the sun;
and it cures numerous ailments which drugs alone are unable to relieve.
140. Look at the bloom on the face of a milkmaid! What is it that tints
her cheeks? An abundance of light. Behold the pallid, corpselike
countenance of a factory girl! What blanches her cheek? The want of light,
of air, and of sunshine.
141. A room, then, ought to have large windows in order that the sun
might penetrate into every nook and corner of the apartment. A gardener
thoroughly appreciates the importance of light to his flowers; he knows,
also, that if he wishes to blanch some kinds of vegetables—such as celery
and sea-kale—he must keep the light from them; and if my fair reader
desires to blanch her own cheeks, she ought to keep the light from them;

but, on the other hand, if she be anxious to be healthy and rosy, she must
have plenty of light in her dwelling.
142. The want of light stunts the growth, dims the sight, and damps the
spirits. Colliers, who a great part of their lives live in the bowels of the
earth, are generally stunted; prisoners, confined for years in a dark dungeon,
frequently become blind; people who live in dark houses are usually
melancholic.
143. Light banishes from rooms foulness, fustiness, mustiness, and
smells. Light ought therefore to be freely allowed to enter every house, and
be esteemed as the most welcome of visitors. Let me then advise every
young wife to admit into her dwelling an abundance of light, of air, and of
sunshine.
144. Some ladies, to keep off the sun, to prevent it from fading the
furniture, have, in the summer time, all the blinds of the windows of the
house down. Hence they save the fading of their furniture, and, instead of
which, they fade their own and their children’s cheeks. Many houses, with
all their blinds down, look like so many prisons, or as if the inmates were in
deep affliction, or as if they were performing penance; for is it not a
penance to be deprived of the glorious light of day, which is as exhilarating
to the spirits as, and much more beneficial than, a glass of champagne?
145. It is a grievous sin to keep out from a dwelling the glorious
sunshine. We have heard of “a trap to catch a sunbeam:” let the open
windows be a trap, and a more desirable prize cannot be caught than a
sunbeam. Sunbeams, both physical and metaphorical, make a house a
paradise upon earth!
146. Let me strongly caution the newly made wife against the evil effects
of tight lacing. The waist ought, as a rule, to be from twenty-seven to
twenty-nine inches in circumference; if, therefore, she bind and gird herself
in until she be only twenty-three inches, and, in some cases, until she be
only twenty-one inches, it must be done at the expense of comfort, of
health, and happiness. If stays be worn tightly, they press down the contents
of the lower part of the belly, which might either prevent a lady from having
a family, or might produce a miscarriage.[29]
147. Let her dress be loose, and be adapted to the season. She ought not
to adopt the fashion of wearing in the morning warm clothes with long
sleeves, and in the evening thin dresses with short sleeves. “It is hopeless to

battle with fashion in matters of dress; women will never believe that their
bonnets, neck-wrappers, or huge petticoats (until they go out of fashion) can
have anything to do with headaches, sore throats, or rheumatism; but they
ought to know that the more they swathe themselves, the more tender and
delicate they are likely to be. If they wish to withstand cold, they should
accustom themselves to bear it.”[30]
148. If a young wife be delicate, and if her circulation be languid, a
flannel vest next the skin, and in the daytime, should, winter and summer,
be worn. Scarlet is, in such a case, a favorite color, and may be selected for
the purpose.
149. It is important that it should be borne in mind that the wearing of
flannel next the skin is more necessary in the summer than in the winter
time. A lady in the summer is apt, when hot, either from the weather or
from exertion, to get into a draught to cool herself, and not wearing flannel
next the skin, she is almost sure at such times to catch a cold. Now, flannel
being a bad conductor of heat, keeps the body at a tolerably equal
temperature, and thus materially lessens the risk. When it is considered that
many of the diseases afflicting humanity arise from colds, the value of
wearing flannel next the skin as a preventive is at once apparent.
150. Never was there such a time as the present when dress was so much
thought of. Grand dresses now sweep our dirty streets and thoroughfares;
rich velvets, silks, and satins are as plentiful as dead leaves in autumn.
“There is so much to gaze and stare at in the dress, one’s eyes are quite
dazzled and weary, and can hardly pierce through to that which is clothed
upon.” Dress is become a crying evil; many ladies clothe themselves in
gorgeous apparel at the expense of household comforts, and even of
household necessaries:
“We sacrifice to dress, till household joys
And comforts cease. Dress drains our cellars dry,
And keeps our larder lean—puts out our fires,
And introduces hunger, frost, and woe,
Where peace and hospitality might reign.”[31]

151. It might be said, What has all this to do with the health of a wife? I
reply, much. The customs, habits, and luxuries of the present day are very
antagonistic both to health and fecundity.

152. She must not coddle, nor should she muffle up her throat with furs.
Boas are the most frequent cause of sore throats and quinsies, and therefore
the sooner they are discarded the better. “And this is perfectly true, though
few seem to be aware of the fact. Relaxed throats would be rare if cold
water was more plentifully used, both externally and internally, and
mufflers were laid aside.”[32]
153. If my gentle reader will freely use cold water ablutions, she will find
that she will not require nearly so much clothing and muffling up. It is those
who use so little water who have to wear so much clothing; and the
misfortune of it is, the more clothes they wear the more they require. Many
young people are wrapped and muffled up in the winter time like old folks,
and by coddling they become prematurely old—frightened at a breath of air
and at a shower of rain, and shaking in their shoes at an easterly wind!
Should such things be?
154. Pleasure, to a certain degree, is as necessary to the health of a young
wife, and every one else, as the sun is to the earth—to warm, to cheer, and
to invigorate it, and to bring out its verdure. Pleasure, in moderation,
rejuvenizes, humanizes, and improves the character, and expands and
exercises the good qualities of the mind; but, like the sun, in its intensity it
oppresseth drieth up, and withereth. Pleasures kept within due bounds are
good, but in excess are utterly subversive of health and happiness. A wife
who lives in a whirl of pleasure and excitement is always weakly and
“nervous,” and utterly unfitted for her duties and responsibilities.
155. Let the pleasures of a newly-married wife, then, be dictated by
reason, and not by fashion. She ought to avoid all recreations of an exciting
kind, as depression always follows excitement. I would have her prefer the
amusements of the country to those of the town, such as a flower-garden,
botany, archery, croquet, bowls,—everything, in fact, that will take her into
the open air, and will cause her to appreciate the pure, simple, and exquisite
beauties of nature. Croquet I consider to be one of the best games ever
invented: it induces a lady to take exercise which perhaps she would not
otherwise do; it takes her into the open air, it strengthens her muscles, it
expands her chest, it promotes digestion, it circulates her blood, and it gives
her an interest in the game which is most beneficial both to mind and body.
156. Oh, that my countrywomen should prefer the contaminated and foul
air of ball and of concert-rooms, to the fresh, sweet, and health-giving air of

the country!
157. Let me in this place enter my strong protest against a young wife
dancing, more especially if she be enceinte. If she be anxious to have a
family, it is a most dangerous amusement, as it is a fruitful source of
miscarriage; and the misfortune is, that if she once have a miscarriage, she
might go on again and again, until her constitution be severely injured, and
until all hopes of her ever becoming a mother are at an end.
158. The quiet retirement of her own home ought then to be her greatest
pleasure and her most precious privilege. Home is, or ought to be, the
kingdom of woman, and she should be the reigning potentate. England is
the only place in the world that truly knows what home really means. The
French have actually no word in their language to express its meaning:
“That home, the sound we English love so well,
Has been as strange to me as to those nations
That have no word, they tell me, to express it.”[33]

159. Cheerfulness, contentment, occupation, and healthy activity of mind
cannot be too strongly recommended. A cheerful, happy temper is one of
the most valuable attributes a wife can have. The possession of such a virtue
not only makes herself, but every one around her, happy. It gilds with
sunshine the humblest dwelling, and often converts an indifferent husband
into a good one. Contentment is the finest medicine in the world; it not only
frequently prevents disease, but, if disease be present, it assists in curing it.
Happy is the man who has a contented wife! A peevish, discontented
helpmate (helpmate, save the mark!) is always ailing, is never satisfied, and
does not know, and does not deserve to know, what real happiness is. She is
“a thorn in the flesh.”
160. One of the greatest requisites, then, for a happy home is a cheerful,
contented, bright, and merry wife; her face is a perpetual sunshine, her
presence is that of an angel; she is happy in herself, and she imparts
happiness to all around her. A gentle, loving, confiding, placid, hopeful, and
trusting disposition has a great charm for a husband, and ought, by a young
wife, to be assiduously cultivated—
“For gentleness, and love, and trust
Prevail o’er angry wave and gust.”[34]

161. Every young wife, let her station be ever so exalted, ought to attend
to her household duties. Her health, and consequently her happiness,
demand the exertion. The want of occupation—healthy, useful occupation
—is a fruitful source of discontent, of sin,[35] of disease, and barrenness. If a
young married lady did but know the importance of occupation—how much
misery might be averted, and how much happiness might, by attending to
her household duties, be insured—she would appreciate the importance of
the advice. Occupation improves the health, drives away ennui, cheers the
hearth and home, and, what is most important, if household duties be well
looked after, her house becomes a paradise, and she the ministering angel to
her husband. But she might say—I cannot always be occupied; it bores me;
it is like a common person: I am a lady; I was not made to work; I have
neither the strength nor the inclination for it; I feel weak and tired, nervous
and spiritless, and must have rest. I reply, in the expressive words of the
poet, that—
“Absence of occupation is not rest,—
A mind quite vacant is a mind distress’d.”[36]

“If time be heavy on your hands,” are there no household duties to look
after, no servants to instruct, no flower-beds to arrange, no school children
to teach, no sick-room to visit, no aged people to comfort, no widow nor
orphan to relieve?—
“Nor any poor about your lands?
Oh! teach the orphan boy to read,
Or teach the orphan girl to sew—
Pray Heaven for a human heart.”[37]

162. To have nothing to do is most wretched, wearisome, and destructive
to the mind. The words of Martin Luther on this subject should be written in
letters of gold, and ought to be kept in constant remembrance by every man
and woman, be they rich or poor, lettered or unlettered, gentle or simple.
“The mind,” said he, “is like a mill that cannot stop working; give it
something to grind, and it will grind that. If it has nothing to grind, it grinds
on yet, but it is itself it grinds and wears away.”
163. A lady in this enlightened age of ours considers it to be horribly low
and vulgar to strengthen her loins with exercise and her arms with
occupation, although such a plan of procedure is recommended in the Bible

by the wisest of men,—“She girdeth her loins with strength, and
strengthened her arms.”[38]
164. A husband soon becomes tired of grand performances on the piano,
of crotchet and worsted work, and of other fiddle-faddle employments; but
he can always appreciate a comfortable, clean, well-ordered, bright,
cheerful, happy home, and a good dinner. It might be said that a wife is not
the proper person to cook her husband’s dinner. True; but a wife should see
and know that the cook does her duty; and if she did, perchance, understand
how the dinner ought to be cooked, I have yet to learn that the husband
would for such knowledge think any the worse of her.
165. A grazing farmer is three or four years in bringing a beast to
perfection, fit for human food. Is it not a sin, after so much time and pains,
for an idiot of a cook, in the course of one short hour or two, to ruin, by vile
cookery, a joint of such meat? Is it not time, then, that a wife herself should
know how a joint of meat ought to be cooked, and thus to be able to give
instructions accordingly?
166. A boy is brought up to his profession, and is expected to know it
thoroughly; how is it that a girl is not brought up to her profession of a
wife; and why is it that she is not taught to thoroughly understand all
household duties? The daughters of a gentleman’s family in olden time
spent an hour or two every morning in the kitchen and in the laundry, and
were initiated into the mysteries of pastry and pudding-making, of
preserving fruit, of ironing, etc. Their mothers’ and their grandmothers’
receipt-books were at their finger-ends. But now look at the picture; the
daughters of a gentleman’s family of the present day consider it very low
and horridly vulgar to understand any such matters. It is just as absurd to
ask a lady to play on the piano who has never been taught music as to ask a
wife to direct her servants to perform duties which she herself knows
nothing about. The duties of a wife cannot come either by intuition or by
instinct more than music can. Again I say, every lady, before she be
married, ought to be thoroughly taught her profession—the duties of a wife;
she then would not be at the tender mercies of her servants, many of whom
are either unprincipled or inefficient.
167. Do not think that I am overstating the importance of the subject. A
good dinner—I mean a well-cooked dinner (which, be it ever so plain, is
really a good dinner)—is absolutely essential to the health, to the very

existence of yourself and your husband; and how, if it be left to the tender
mercies of the present race of cooks, can you have it? High time it is that
every wife, let her station be either high or low, should look into the matter
herself, and remedy the crying evil of the day. They manage these things
better in Sweden. There the young ladies of wealthy families cook—
actually themselves cook—the dinners; and instead of their considering it a
disgrace, and to be horridly low and vulgar, they look upon it as one of their
greatest privileges! And what is the consequence? A badly-cooked dinner is
rare, and not, as it frequently is in this country, of frequent occurrence; and
“peace and happiness” reign triumphant. It is a pity, too, that we do not take
a leaf out of the book of our neighbors the French. Every woman in France
is a good cook; good cookery with them is the rule—with us it is the
exception. A well-cooked dinner is a blessing to all who partake of it; it
promotes digestion, it sweetens the temper, it cheers the hearth and home.
There is nothing tries the temper more than an ill-cooked dinner; it makes
people dyspeptic, and for a dyspeptic to be sweet-tempered is an utter
impossibility. Let me, therefore, advise my fair reader to look well into the
matter; either the gloom or the sunshine of a house much depends upon
herself and upon her household management. It might be said—What a
poor creature a man must be to require so much attention. Truly, if his
health be not looked after, if his comforts be not attended to, he is indeed a
poor creature!
168. Every young wife should be able—ought to be instructed by her
mother or by some competent person—it should be a part of her education
—to teach and to train her own servants aright. Unfortunately, in the present
day there is too much cant and humbug about the instruction of the lower
orders, and domestic servants among the rest. They are instructed in many
things that are perfectly useless to them, the knowledge of which only
makes them dissatisfied with their lot and tends to make them bad servants.
Among other useless subjects taught them are the “ologies.” It would be
much more to the purpose if they were thoroughly instructed in all
household duties, and “in the three R’s—reading, ’riting, and ’rithmetic,”—
in obedience to their mistresses, and in simplicity of demeanor and dress.
The servants themselves would be immensely benefited by such lessons.
169. A “blue-stocking” makes, as a rule, a wretched wife; it would be far
better for the health of her husband, of herself, and her family, if, instead of
cultivating Latin and Greek, she would cultivate her household duties, more

especially a thorough knowledge of the culinary department. “A man is, in
general, better pleased when he has a good dinner upon his table than when
his wife speaks Greek.”[39]
170. As soon as a lady marries, the romantic nonsense of school-girls will
rapidly vanish, and the stern realities of life will take their place, and she
will then know, and sometimes to her grievous cost, that a useful wife will
be thought much more of than either an ornamental or a learned one.
171. It is better for a young wife, and for every one else, to have too
much than too little occupation. The misfortune of the present day is, that
servants are made to do all the work, while the mistress of the house
remains idle. Remains idle! Yes; and by remaining idle, remains out of
health! Idleness is a curse, and brings misery in its train! How slow the
hours crawl on when a person has nothing to do; but how rapidly they fly
when she is fully occupied! Besides, idleness is a frequent cause of
barrenness. Hard-worked, industrious women are prolific; while idle ladies
are frequently childless, or, if they do have a family, their children are puny,
and their labors are usually both hard and lingering. We doctors know full
well the difference there often is between the labor of a poor hard-worked
woman and of a rich, idle lady: in the one case the labor is usually quick
and easy; in the other, it is often hard and lingering. Oh, if wives would
consider betimes the importance of an abundance of exercise and of
occupation, what an immense amount of misery, of pain, of anxiety, and
anguish they might avert! Work is a blessed thing; if we do not work we pay
the penalty—we suffer “in mind, body, and estate.” An idle man or an idle
woman is an object of the deepest pity and commiseration.
172. Longfellow, in his Song of the Blacksmith, beautifully and
graphically describes the importance and the value of occupation; and as
occupation is as necessary to a woman as to a man, I cannot resist
transcribing it:

“Toiling—rejoicing—sorrowing,
Onward through life he goes;
Each morning sees some task begin,
Each evening sees its close;
Something attempted, something done,
Has earned a night’s repose.”

173. Truly may it be said that “occupation earns a night’s repose.” It is
the finest composing medicine in the world, and, unlike an opiate, it never
gives a headache; it never produces costiveness; and never, by repetition,
loses its effect. Sloth and restlessness, even on down, are generally bed-
fellows:
“Weariness
Can snore upon the flint, when rusty sloth
Finds the down pillow hard.”

174. The mind, it is well known, exerts great influence over the body in
promoting health, and in causing and in curing disease. A delicate woman is
always nervous; she is apt to make mountains of molehills; she is usually
too prone to fancy herself worse than she really is. I should recommend my
gentle reader not to fall into this error, and not to magnify every slight ache
or pain. Let her, instead of whining and repining, use the means which are
within the reach of all to strengthen her frame; let her give battle to the
enemy; let her fight him with the simple weapons indicated in these pages,
and the chances are she will come off victorious.
175. There is nothing like occupation, active occupation, to cure slight
pains—“constant occupation physics pain”—to drive away little ailments,
and the dread of sickness. “The dread of sickness,” says Dr. Grosvenor, “is
a distemper of itself, and the next disposition to a many more. What a
bondage does this keep some people in! ’Tis an easy transition from the fear
and fancy of being sick to sickness indeed. In many cases there is but little
difference between those two. There is one so afraid of being ill that he
would not stir out of doors, and for want of air and exercise he contracts a
distemper that kills him.”
176. What a blessed thing is work! What a precious privilege for a girl to
have a mother who is both able and anxious to instruct her daughter, from
her girlhood upwards, in all household management and duties!
Unfortunately, in this our age girls are not either educated or prepared to be

made wives—useful, domesticated wives. Accomplishments they have
without number, but of knowledge of the management of an establishment
they are as ignorant as the babe unborn. Verily, they and their unfortunate
husbands and offspring will in due time pay the penalty of their ignorance
and folly! It is, forsooth, unladylike for a girl to eat much; it is unladylike
for her to work at all; it is unladylike for her to take a long walk; it is
unladylike for her to go into the kitchen; it is unladylike for her to make her
own bed; it is unladylike for her to be useful; it is unladylike for her to have
a bloom upon her cheek like unto a milkmaid![40] All these are said to be
horridly low and vulgar, and to be only fit for the common people! Away
with such folly! The system of the bringing up of the young ladies of the
present day is “rotten to the core.”
177. If a young married lady, without having any actual disease about
her, be delicate and nervous, there is no remedy equal in value to change of
air—more especially to the sea-coast. The sea breezes, and, if she be not
pregnant, sea-bathing, frequently act like magic upon her in restoring her to
perfect health. I say, if she be not pregnant; if she be, it would, without first
obtaining the express permission of a medical man, be highly improper for
her to bathe.
178. A walk on the mountains is delightful to the feelings and beneficial
to the health. In selecting a sea-side resort, it is always, where it be
practicable, to have mountain-air as well as the sea breeze. The mounting of
high hills, if a lady be pregnant, would not be desirable, as the exertion
would be too great, and, if she be predisposed, might bring on a
miscarriage; but the climbing of hills and mountains, if she be not enceinte,
is most advantageous to health, strengthening the frame, and exhilarating to
the spirits. Indeed, we may compare the exhilaration it produces to the
drinking of champagne, with this difference,—it is much more beneficial to
health than champagne, and does not leave, the next morning, as
champagne sometimes does, either a disagreeable taste in the mouth or
headache behind,—
“Oh, there is a sweetness in the mountain-air,
And life, that bloated ease can never hope to share!”[41]

179. Bugs and fleas.—This is a very commonplace subject, but like most
commonplace subjects is one necessary to be known, as these pests of
society sometimes destroy the peace, comfort, and enjoyment of a person

when away from home. Many ladies who travel from home are made
miserable and wretched by having to sleep in strange beds—in beds
infested either with bugs or with fleas. Now, it will be well for such ladies
never to go any distance from home without having four things in their
trunks with them, namely: (1) A box of matches, in order, at any moment of
the night, to strike a light, both to discover and frighten the enemies away.
(2) A box of night-lights. Bugs never bite when there is a light in the room.
It would therefore be well, in an infested room, and until fresh lodgings can
be procured, to keep a night-light burning all night. (3) A packet of “La
Poudre Insecticide,” manufactured in France, but which may be procured in
England: a preparation which, although perfectly harmless to the human
economy, is utterly destructive to fleas. (4) A 4 oz. bottle of oil of
turpentine, a little of which, in case of a discovery of bugs in the bed,
should be sprinkled between the sheets and on the pillow. The oil of
turpentine will, until fresh lodgings can be procured, keep the bugs at a
respectful distance. Care should be observed while sprinkling the sheets
with the turpentine not to have (on account of its inflammability) a lighted
candle too near the bed. I know, from experience, that bugs and fleas are,
when ladies are away from home, a source of torment and annoyance, and
am therefore fully persuaded of the value and importance of the above
advice.
180. If it be not practicable for her to visit the sea-coast, let her be in the
fresh air—in the country air. Let her mornings be spent out of doors; and if
she cannot inhale the sea breezes, let her inhale the morning breezes—
“The skies, the air, the morning’s breezy call
Alike are free, and full of health to all.”[42]

181. Cheerfulness and evenness of temper ought, by a young wife, to be
especially cultivated. There is nothing that promotes digestion, and thus
good health, more than a cheerful, placid temper. We know that the
converse is very detrimental to that process; that violent passion takes away
the appetite, deranges the stomach, and frequently disorders the bowels.
Hence it is that those who attain great ages are usually of an even, cheerful
temper. “Our passions are compared to the winds in the air, which, when
gentle and moderate, let them fill the sail, and they will carry the ship on
smoothly to the desired port; but when violent, unmanageable, and

boisterous, it grows to a storm, and threatens the ruin and destruction of
all.”[43]
182. A young wife is apt to take too much opening medicine; the more
she takes, the more she requires. Hence she irritates the nerves of the
stomach and bowels, and injures herself beyond measure. If the bowels are
costive, and variety of food, and of fruit, and of other articles of diet, which
I either have or will recommend in these pages, together with an abundance
of air, and of exercise, and of occupation, will not open, then let her give
herself an enema; which she can, without the slightest pain or annoyance,
and with very little trouble, readily do, provided she has a proper apparatus
for the purpose, namely, a “self-injecting enema apparatus,”—one made
purposely for the patient, either to administer it to herself, or to be
administered to her by another person. A pint of cold water is as good an
enema as can be used, and which, if the first should not operate, ought in a
few minutes to be repeated. The clyster does nothing more than wash the
bowels out, removing any offending matter, and any depression of spirits
arising therefrom, and neither interfering with the stomach nor with the
digestion.
183. Until she become accustomed to the cold, she might for the first few
mornings slightly warm the water; but gradually she should reduce the
temperature of it until she use it quite cold. A cold water is more bracing
and strengthening to the bowels, and more efficacious in action, than a
warm water enema.
184. It will, during pregnancy and after a confinement, be safer to use a
tepid than a cold water enema.
185. No family ought to be without a good enema apparatus, to fly to in
any emergency. Many valuable lives have been saved by means of it, and
having it always in good order and at hand.
186. By adopting the dictates of reason and of common sense, many of
the nervous, useless, lackadaisical, fine ladies will be unknown; and we
shall have instead blooming wives, who will in due time become the
mothers of hardy, healthy, happy children.
187. In the foregoing pages the burden of my song has been health—the
preservation of health—the most precious of God’s gifts, and one that is
frittered and fooled away as though it were but of little value. Health ought
to be the first consideration of all, and of every young wife especially, as,

when she is married, her life, her health is not altogether her own, but her
husband’s and her family’s. Oh! it is a glorious gift, a precious boon, to be
in the enjoyment of perfect health, and is worth a little care and striving for.
188. In concluding the first division of my subject, let me entreat my fair
reader to ponder well on what I have already said; let her remember that she
has a glorious mission; let her thoroughly understand that if good habits and
good rules be not formed and followed during the first year of her
wifehood, they are not at all likely to be instituted afterwards. The first year,
then, is the golden opportunity to sow the seeds of usefulness; to make
herself healthy and strong, and to cause her to be a blessing, a solace, and a
comfort to her husband, her children, and all around her.
189. Menstruation, during a period of about thirty years, plays a
momentous part in the female economy; indeed, unless it be in every way
properly and duly performed, it is neither possible that such a lady can be
well, nor is it at all probable that she will conceive. I therefore purpose
devoting an especial chapter to its due and careful consideration.

PART I.
MENSTRUATION.

190. There are two most important epochs in the life of a woman—
namely (1) the commencement, and (2) the close of menstruation. Each is
apt, unless carefully watched and prevented, to bring in its train many
serious diseases. Moreover, unless menstruation be healthfully and properly
performed, conception, as a rule, is not likely to take place: hence the
importance of our subject.
191. Menstruation—the appearance of the catamenia or the menses—is
then one of the most important epochs in a girl’s life. It is the boundary line,
the landmark, between childhood and womanhood; it is the threshold, so to
speak, of a woman’s life. Her body now develops and expands, and her
mental capacity enlarges and improves. She then ceases to be a child, and
she becomes a woman. She is now for the first time, as a rule, able to
conceive.
192. Although puberty has at this time commenced, it cannot be said that
she is at her full perfection; it takes eight or ten years more to complete her
organization, which will bring her to the age of twenty-three or twenty-five
years; which perhaps are the best ages for a woman, if she have both the
chance and the inclination, to marry.
193. If she marry when very young, marriage weakens her system, and
prevents a full development of the body. Besides, if she marry when she be
only eighteen or nineteen, the bones of the pelvis—the bones of the lower
part of the belly—are not at that time sufficiently developed; are not
properly shaped for the purpose of labor; do not allow of sufficient space
for the head of the child to readily pass, as though she were of the riper age
of twenty-three or twenty-five. She might have in consequence a severe and
dangerous confinement. If she marry late in life, say after she be thirty, the
soft parts engaged in parturition are more rigid and more tense, and thus
become less capable of dilatation, which might cause, for the first time, a

hard and tedious labor. Again, when she marries late in life, she might not
live to see her children grow up to be men and women. Moreover, as a rule,
“the offspring of those that are very young or very old lasts not.”
Everything, therefore, points out that the age above indicated—namely,
somewhere between twenty and thirty—is the most safe and suitable time
for a woman to marry.
194. Menstruation generally comes on once every month—that is to say,
every twenty-eight days; usually to the very day, and frequently to the hour.
Some ladies, instead of being “regular” every month, are “regular” every
three weeks.
195. Each menstruation continues from three to five days; in some for a
week; and in others for a longer period. It is estimated that, during each
menstruation, from four to six ounces is, on an average, the quantity
discharged.
196. A lady seldom conceives unless she be “regular,” although there are
cases on record where women have conceived who have never been
“unwell;” but such cases are extremely rare.
197. Menstruation in this country usually commences at the ages of from
thirteen to sixteen, sometimes earlier; occasionally as early as eleven or
twelve; at other times later, and not until a girl be seventeen or eighteen
years of age. Menstruation in large towns is supposed to commence at an
earlier period than in the country, and earlier in luxurious than in simple
life.[44]
198. Menstruation continues for thirty, and sometimes even for thirty-five
years; and, while it lasts, is a sign that a lady is liable to become pregnant—
unless, indeed, menstruation should be protracted much beyond the usual
period of time. As a rule, then, when a woman “ceases to be unwell,” she
ceases to have a family; therefore, as menstruation usually leaves her at
forty-five, it is seldom, after that age, that she has a child.
199. I have known ladies become mothers when they have been upwards
of fifty years of age. I myself delivered a woman in her fifty-first year of a
fine healthy child. She had a kind and easy labor, and was the mother of a
large family, the youngest being at the time twelve years old.[45] “Dr.
Carpenter, of Durham, tells us that he has attended in their confinements
several women whose ages were fifty. ‘I well recollect a case occurring in
my father’s practice in 1839, where a woman became a widow at forty-nine

years of age. Shortly afterwards she married her second husband, and
within twelve months of this time gave birth to her first child. These cases
belong to the working classes. But I know of two others, where
gentlewomen became mothers at fifty-one with her first child, the other
with her eighth. I can say nothing of how they menstruated, but I know of a
virgin in whom the catamenia appeared regularly and undiminished up to
and at the end of sixty.’ Dr. Powell says that he last year attended a woman
in her fifty-second year; and Mr. Heckford, that he attended a woman who
stated her age to be at least fifty. Mr. Clarke, of Mold, states that he has
attended several women whose ages were upwards of forty-four, and that he
lately delivered a woman of her first child at forty-eight. Mr. Bloxham, of
Portsmouth, delivered at fifty-two, in her first confinement, a woman who
had been married thirty-five years.”[46]
200. In very warm climates, such as in Abyssinia and in India, girls
menstruate when very young—at ten or eleven years old; indeed, they are
sometimes mothers at those ages.[47] But when it commences early, it leaves
early; so that they are old women at thirty. “Physically, we know that there
is a very large latitude of difference in the periods of human maturity, not
merely between individual and individual, but also between nation and
nation—differences so great that in some southern regions of Asia we hear
of matrons at the age of twelve.”[48] Dr. Montgomery[49] brings forward some
interesting cases of early maturity. He says: “Bruce mentions that in
Abyssinia he has frequently seen mothers of eleven years of age; and
Dunlop witnessed the same in Bengal. Dr. Goodeve, Professor of
Midwifery at Calcutta, in reply to a query on the subject, said: ‘The earliest
age at which I have known a Hindu woman bear a child is ten years, but I
have heard of one at nine.’”
201. In cold climates, such as Russia, women begin to menstruate late in
life, frequently not until they are between twenty and thirty years old; and,
as it lasts on them thirty or thirty-five years, it is not an unusual occurrence
for them to bear children at a very advanced age—even so late as sixty.
They are frequently not “regular” oftener than three or four times a year,
and when it does occur the menstrual discharge is generally sparing in
quantity.
202. The menstrual fluid is not exactly blood, although, both in
appearance and in properties, it much resembles it; yet it never in the

healthy state clots as blood does. It is a secretion from the womb, and, when
healthy, ought to be of a bright-red color, in appearance very much like
blood from a recently cut finger.[50]
203. The menstrual fluid ought not, as before observed, to clot. If it does,
a lady, during menstruation, suffers intense pain; moreover, she seldom
conceives until the clotting has ceased. Application must therefore, in such
a case, be made to a medical man, who will soon relieve the above painful
symptoms, and, by doing so, will probably pave the way to her becoming
pregnant.
204. Menstruation ceases entirely in pregnancy, during suckling, and
usually both in diseased and in disordered states of the womb. It also ceases
in cases of extreme debility, and in severe illness, especially in
consumption; indeed, in the latter disease—consumption—it is one of the
most unfavorable of the symptoms.
205. It has been asserted, and by men of great experience, that sometimes
a woman menstruates during pregnancy. In this assertion I cannot agree; it
appears utterly impossible that she should be able to do so. The moment she
conceives, the neck of the womb becomes plugged up by means of mucus;
it is, in fact, hermetically sealed. There certainly is sometimes a slight red
discharge, looking very much like menstrual fluid, and coming on at her
monthly periods; but being usually very sparing in quantity, and lasting
only a day or so, and sometimes only for an hour or two; but this discharge
does not come from the cavity of, but from some small vessels at, the
mouth of the womb, and is not menstrual fluid at all, but a few drops of real
blood. If this discharge came from the cavity of the womb, it would
probably lead to a miscarriage. My old respected and talented teacher, the
late Dr. D. D. Davis,[51] declared that it would be quite impossible during
pregnancy for menstruation to occur. He considered that the discharge
which was taken for menstruation arose from the rupture of some small
vessels about the mouth of the womb.
206. Some ladies, though comparatively few, menstruate during suckling;
when they do, it may be considered not the rule, but the exception. It is said,
in such instances, that they are more likely to conceive. Many persons have
an idea that when a woman, during lactation, menstruates, the milk is both
sweeter and purer. Such is an error. Menstruation during suckling is more
likely to weaken the mother, and consequently to deteriorate the milk. It

therefore behooves a parent never to take a wet nurse who menstruates
during the period of suckling.
207. A lady sometimes suffers severe pains both just before and during
her “poorly” times. When such be the case, she seldom conceives until the
pain be removed. She ought therefore to apply to a medical man, as relief
may soon be obtained. When she is freed from the pain, she will, in all
probability, in due time become enceinte.
208. If a married woman have painful menstruation, even if she become
pregnant, she is more likely, in the early stage, to miscarry. This is an
important consideration, and requires the attention of a doctor.
209. If a single lady, who is about to be married, have painful
menstruation, it is incumbent on either her mother or a female friend to
consult, two or three months before the marriage takes place, an
experienced medical man, on her case; if this be not done, she will most
likely, after marriage, either labor under ill health, or be afflicted with
barrenness, or, if she do conceive, be prone to miscarry.
210. The menstrual discharge, as before remarked, ought, if healthy, to be
of the color of blood—of fresh, unclotted blood. If it be either too pale (and
it sometimes is almost colorless), or, on the other hand, if it be both dark
and thick (it is occasionally as dark, and sometimes nearly as thick, as
treacle), there will be but scant hopes of a lady conceiving. A medical man
ought, therefore, at once to be consulted, who will in the generality of cases,
be able to remedy the defect. The chances are, that as soon as the defect be
remedied, she will become pregnant.
211. Menstruation at another time is too sparing; this is a frequent cause
of a want of family. Luckily a doctor is, in the majority of cases, able to
remedy the defect, and by doing so will probably be the means of bringing
the womb into a healthy state, and thus predispose her to become a mother.
212. A married lady is very subject to the “whites;” the more there will be
of the “whites” the less there will usually be of the menstrual discharge;—
so that in a bad case of the “whites” menstruation might entirely cease, until
proper means be used both to restrain the one and to bring back the other.
Indeed, as a rule, if the menstrual discharge, by proper treatment, be
healthily established and restored, the “whites” will often cease of
themselves. Deficient menstruation is a frequent cause of the “whites,” and

the consequent failure of a family; and as deficient menstruation is usually
curable, a medical man ought, in all such cases, to be consulted.
213. Menstruation at other times is either too profuse or too long
continued. Either the one or the other is a frequent source of barrenness, and
is also weakening to the constitution, and thus tends to bring a lady into a
bad state of health. This, like the former cases, by judicious management
may generally be rectified; and being rectified, will in all probability result
in the wife becoming a mother.
214. When a lady is neither pregnant nor “regular,” she ought
immediately to apply to a doctor, as she may depend upon it there is
something wrong about her, and that she is not likely to become enceinte[52]
until menstruation be properly established. As soon as menstruation be duly
and healthily established, pregnancy will most likely, in due time, ensue.
215. When a lady is said to be “regular,” it is understood that she is
“regular” as to quality, and quantity, and time. If she be only “regular” as to
the time, and the quantity be either deficient or in excess, or if she be
“regular” as to the time, and the quality be bad, either too pale or too dark;
or if she be “regular” as to the quality and quantity, and be irregular as to
the time, she cannot be well; and the sooner means are adopted to rectify the
evil, the better it will be for her health and happiness.
216. There is among young wives, of the higher ranks, of the present
time, an immense deal of hysteria; indeed it is, among them, in one form or
another, the most frequent complaint of the day. Can it be wondered at?
Certainly not. The fashionable system of spending married life, such as late
hours, close rooms, excitement, rounds of visiting, luxurious living, is quite
enough to account for its prevalence. The menstrual functions in a case of
this kind are not duly performed; she is either too much or too little
“unwell;” menstruation occurs either too soon, or too late, or at irregular
periods. I need scarcely say that such a one, until a different order of things
be instituted, and until proper and efficient means be used to restore healthy
menstruation, is not likely to conceive; or, if she did conceive, she would
most likely either miscarry, or, if she did go her time, bring forth a puny,
delicate child. A fashionable wife and happy mother are incompatibilities!
Oh, it is sad to contemplate the numerous victims that are sacrificed yearly
on the shrine of fashion! The grievous part of the business is, that fashion is
not usually amenable to reason and common sense; argument, entreaty,

ridicule, are each and all alike in turn powerless in the matter. Be that as it
might, I am determined boldly to proclaim the truth, and to make plain the
awful danger of a wife becoming a votary of fashion.
217. Many a lady, either from suppressed or from deficient menstruation,
who is now chlorotic, hysterical, and dyspeptic, weak and nervous, looking
wretchedly, and whose very life is a burden, may, by applying to a medical
man, be restored to health and strength.
218. As soon as a lady “ceases to be after the manner of women”—that is
to say, as soon as she ceases to menstruate—it is said that she has “a change
of life;” and if she does not take care, she will soon have “a change of
health” to boot, which, in all probability, will be for the worse.
219. After a period of about thirty years’ continuation of menstruation, a
woman ceases to menstruate; that is to say, when she is about forty-four or
forty-five years of age, and, occasionally, as late in life as when she is forty-
eight years of age, she has “change of life,” or, as it is sometimes called, a
“turn of years.” Now, before this takes place, she oftentimes becomes very
“irregular;” at one time she is “regular” before her proper period; at another
time either before or after; so that it becomes a dodging time with her, as it
is so styled. In a case of this kind menstruation is sometimes very profuse;
at another it is very sparing; occasionally it is light colored, almost
colorless; sometimes it is as red as from a cut finger; while now and then it
is as black as ink.
220. When “change of life” is about, and during the time, and for some
time afterwards, a lady labors under, at times, great flushings of heat; she,
as it were, blushes all over; she goes very hot and red, almost scarlet; then
perspires; and afterwards becomes cold and chilly. These flushings occur at
very irregular periods; they might come on once or twice a day, at other
times only once or twice a week, and occasionally only at what would have
been her “poorly times.” These flushings might be looked upon as rather
favorable symptoms, and as an effort of nature to relieve itself through the
skin. These flushings are occasionally, although rarely, attended with
hysterical symptoms. A little appropriate medicine is for these flushings
desirable. A lady while laboring under these heats is generally both very
much annoyed and distressed; but she ought to comfort herself with the
knowledge that they are in all probability doing her good service, and that

they might be warding off, from some internal organ of her body, serious
mischief.
221. “Change of life” is one of the most important periods of a lady’s
existence, and generally determines whether, for the rest of her days, she
shall either be healthy or otherwise; it therefore imperatively behooves her
to pay attention to the subject, and in all cases when it is about taking place
to consult a medical man, who will, in the majority of cases, be of great
benefit to her, as he will be able to ward off many important and serious
diseases to which she would otherwise be liable. When “change of life”
ends favorably, which, if properly managed, it most likely will do, she may
improve in constitution, and may really enjoy better health and spirits, and
more comfort, then she has done for many previous years. A lady who has
during the whole of her wifehood eschewed fashionable society, and who
has lived simply, plainly, and sensibly, and who has taken plenty of out-
door exercise, will, during the autumn and winter of life, reap her reward by
enjoying what is the greatest earthly blessing—health!

PART II.
PREGNANCY.

SIGNS OF PREGNANCY.

222. The first sign that leads a lady to suspect that she is pregnant is her
ceasing to be unwell. This, provided she has just before been in good health,
is a strong symptom of pregnancy; but still there must be others to
corroborate it.
223. The next symptom is morning sickness. This is one of the earliest
symptoms of pregnancy; as it sometimes occurs a few days, and indeed
generally not later than a fortnight or three weeks, after conception.
Morning sickness is frequently distressing, oftentimes amounting to
vomiting, and causing a loathing of breakfast. This sign usually disappears
after the first three or four months. Morning sickness is not always present
in pregnancy; but, nevertheless, it is a frequent accompaniment; and many
who have had families place more reliance on this than on any other
symptom.
224. A third symptom is shooting, throbbing, and lancinating pains, and
enlargement of the breasts, with soreness of the nipples, occurring about the
second month; and in some instances, after the first few months, a small
quantity of watery fluid, or a little milk, may be squeezed out of them. This
latter symptom, in a first pregnancy, is valuable, and can generally be relied
on as conclusive that the female is pregnant. It is not so valuable in an after
pregnancy, as a little milk might, even should she not be pregnant, remain
in the breasts for some months after she has weaned her child.
225. The veins of the breast look more blue, and are consequently more
conspicuous than usual, giving the bosom a mottled appearance. The breasts
themselves are firmer and more knotty to the touch. The nipples, in the
majority of cases, look more healthy than customary, and are somewhat

elevated and enlarged; there is generally a slight moisture upon their
surface, sufficient in some instances to mark the linen.
226. A dark-brown areola or disk may usually be noticed around the
nipple,[53] the change of color commencing about the second month. The tint
at first is light brown, which gradually deepens in intensity, until, toward
the end of pregnancy, the color may be very dark. Dr. Montgomery, who
has paid great attention to the subject, observes: “During the progress of the
next two or three months the changes in the areola are in general perfected,
or nearly so, and then it presents the following characters: a circle around
the nipple, whose color varies in intensity according to the particular
complexion of the individual, being usually much darker in persons with
black hair, dark eyes, and sallow skin, than in those of fair hair, light-
colored eyes, and delicate complexion. The area of this circle varies in
diameter from an inch to an inch and a half, and increases in most persons
as pregnancy advances, as does also the depth of color.” The dark areola is
somewhat swollen. “There is,” says Dr. Montgomery, “a puffy turgescence,
not only of the nipple, but of the whole surrounding disk.”
227. A fourth symptom is quickening. This generally occurs about the
completion of the fourth calendar month; frequently a week or two before
the end of that period; at other times a week or two later. A lady sometimes
quickens as early as the third month, while others, although rarely, quicken
as late as the fifth, and, in very rare cases, the sixth month.
228. It will therefore be seen that there is an uncertainty as to the period
of quickening, although, as I before remarked, the usual period occurs
either on, or more frequently a week or two before, the completion of the
fourth calendar month of pregnancy.
229. A lady at this time frequently either feels faint, or actually faints
away; she is often either giddy, or sick, or nervous, and in some instances
even hysterical. Although, in rare cases, some women do not even know the
precise time when they quicken.
230. The sensation of “quickening” is said by many ladies to resemble
the fluttering of a bird. “Quickening” arises from the ascent of the womb
higher into the belly, as, from its increased size, there is not room for it
below. The old-fashioned idea was that the child was not alive until a
woman had quickened. This is a mistaken notion, as he is alive, or “quick,”
from the very commencement of his formation.

231. Hence the heinous and damnable sin of a single woman, in the early
months of pregnancy, using means to promote abortion: it is as much
murder as though the child were at his full time, or as though he were
butchered when he was actually born!
232. An attempt, then, to procure abortion is a crime of the deepest dye,
viz., a heinous murder! It is attended, moreover, with fearful consequences
to the mother’s own health; it may either cause her immediate death, or it
may so grievously injure her constitution that she might never recover from
the shock. If these fearful consequences ensue, she ought not to be pitied:
she richly deserves them all. Our profession is a noble one, and every
qualified member of it would scorn and detest the very idea either of
promoting or of procuring an abortion; but there are unqualified villains
who practice the damnable art. Transportation, if not hanging, ought to be
their doom. The seducers, who often assist and abet them in their nefarious
practices, should share their punishment.
233. Flatulence has sometimes misled a young wife to fancy that she has
quickened; but, in determining whether she be pregnant, she ought never to
be satisfied with one symptom alone; if she be, she will be frequently
misled. The following are a few of the symptoms that will distinguish the
one from the other: in flatulence, the patient is small one hour and large the
next; while in pregnancy the enlargement is persistent, and daily and
gradually increases. In flatulence, on pressing the bowels firmly, a rumbling
of wind may be heard, which will move about at will; while the
enlargement of the womb in pregnancy is solid, resistant, and stationary. In
flatulence, on tapping—percussing—the belly there will be a hollow sound
elicited as from a drum; while in pregnancy it will be a dull, heavy sound,
as from thrumming on a table. In flatulence, if the points of the fingers be
firmly pressed into the belly, the wind will wobble about; in pregnancy they
will be resisted as by a wall of flesh.
234. The fifth symptom is, immediately after the quickening, increased
size and hardness of the belly. An accumulation of fat covering the belly has
sometimes led a lady to suspect that she is pregnant; but the soft and
doughy feeling of the fat is very different to the hardness, solidity, and
resistance of pressure of pregnancy.
235. The sixth symptom is pouting or protrusion of the navel. This
symptom does not occur until some time after a lady has quickened; indeed,

for the first two months of pregnancy the navel is drawn in and depressed.
As the pregnancy advances, the navel gradually comes more forward. “The
navel, according to the progress of the pregnancy, is constantly emerging,
till it comes to an even surface with the integuments of the abdomen [belly];
and to this circumstance much regard is to be paid in cases of doubtful
pregnancy.”[54]
236. Sleepiness, heartburn, increased flow of saliva, toothache, loss of
appetite, longings, excitability of mind, a pinched appearance of
countenance, liver or sulphur-colored patches on the skin, and likes and
dislikes in eating,—either the one or the other of these symptoms frequently
accompany pregnancy; but, as they might arise from other causes, they are
not to be relied on further than this—that if they attend the more certain
signs of pregnancy, such as cessation of being “regular,” morning sickness,
pains and enlargement of and milk in the breasts, the gradually darkening
brown areola or mark around the nipple, etc., they will then make assurance
doubly sure, and a lady may know for certain that she is pregnant.[55]

CLOTHING.

237. A lady who is pregnant ought on no account to wear tight dresses, as
the child should have plenty of room. She ought to be, as enceinte signifies,
incincta, or unbound. Let the clothes be adapted to the gradual development
both of the belly and the breasts. She must, whatever she may usually do,
wear her stays loose. If there be bones in the stays, let them be removed.
Tight lacing is injurious both to the mother and to the child, and frequently
causes the former to miscarry; at another time it has produced a crossbirth;
and sometimes it has so pressed in the nipples as to prevent a proper
development of them, so that where a lady has gone her time, she has been
unable to suckle her infant, the attempt often causing a gathered bosom.
These are great misfortunes, and entail great misery both on the mother and
the child (if it has not already killed him), and ought to be a caution and a
warning to every lady for the future.
238. The feet and legs during pregnancy are very apt to swell and to be
painful, and the veins of the legs to be largely distended. The garters ought
at such times to be worn slack, as tight garters are highly injurious, and, if
the veins be very much distended, it will be necessary for her to wear a

properly-adjusted elastic silk stocking, made purposely to fit her foot and
leg, and which a medical man will himself procure for her.

ABLUTION.

239. A warm bath in pregnancy is too relaxing. A tepid bath once a week
is beneficial. Sponging the whole of the body every morning with
lukewarm water may with safety and advantage be adopted, gradually
reducing the temperature of the water until it be used quite cold. The skin
should, with moderately coarse towels, be quickly but thoroughly dried.
240. Either the bidet or sitz-bath[56] ought every morning to be used. The
patient should first sponge herself, and then finish up by sitting for a few
seconds, or while, in the winter, she can count fifty, or while, in the
summer, she can count a hundred, in the water. It is better not to be long in
it; it is a slight shock that is required, which, where the sitz-bath agrees, is
immediately followed by an agreeable glow of the whole body. If she sits in
the water for a long time she becomes chilled and tired, and is very likely to
catch cold. She ought, until she become accustomed to the cold, to have a
dash of warm water added; but the sooner she can use quite cold water the
better. While sitting in the bath she should throw either a woolen shawl or a
small blanket over her shoulders. She will find the greatest comfort and
benefit from adopting the above recommendation. Instead of giving, it will
prevent cold, and it will be one of the means of warding off a miscarriage,
and of keeping her in good health.
241. A shower-bath in pregnancy gives too great a shock, and might
induce a miscarriage. I should not recommend, for a lady who is pregnant,
sea-bathing; nevertheless, if she be delicate, and if she be prone to miscarry,
change of air to the coast (provided it be not too far away from home), and
inhaling the sea breezes, may brace her, and ward off the tendency. But
although sea-bathing be not desirable, sponging the body with sea water
may be of great service to her.

AIR AND EXERCISE.

242. A young wife, in her first pregnancy, usually takes too long walks.
This is a common cause of flooding, of miscarriage, and of bearing down
of the womb. As soon, therefore, as a lady has the slightest suspicion that
she is enceinte, she must be careful in the taking of exercise.
243. Although long walks are injurious, she ought not to run into an
opposite extreme; short, gentle, and frequent walks during the whole period
of pregnancy cannot be too strongly recommended; indeed, a lady who is
enceinte ought to live half her time in the open air. Fresh air and exercise
prevent many of the unpleasant symptoms attendant on that state; they keep
her in health; they tend to open her bowels; and they relieve that sensation
of faintness and depression so common and distressing in early pregnancy.
244. Exercise, fresh air, and occupation are then essentially necessary in
pregnancy. If they be neglected, hard and tedious labors are likely to ensue.
One, and an important, reason of the easy and quick labors and rapid
“gettings about” of poor women, is the abundance of exercise and of
occupation which they are both daily and hourly obliged to get through.
Why, many a poor woman thinks but little of a confinement, while a rich
one is full of anxiety about the result. Let the rich lady adopt the poor
woman’s industrious and abstemious habits, and labor need not then be
looked forward to, as it frequently now is, either with dread or with
apprehension.
245. Stooping, lifting of heavy weights, and overreaching ought to be
carefully avoided. Running, horse exercise, and dancing are likewise
dangerous—they frequently induce a miscarriage.
246. Indolence is most injurious in pregnancy. A lady who, during the
greater part of the day, lolls either on the sofa or on an easy-chair, and who
seldom walks out, has a much more lingering and painful labor than one
who takes moderate and regular open-air exercise, and who attends to her
household duties.
247. An active life is, then, the principal reason why the wives of the
poor have such quick and easy labors, and such good recoveries; why their
babies are so rosy, healthy, and strong; notwithstanding the privations and
hardships and poverty of the parents.
248. Bear in mind, then, that a lively, active woman has an easier and
quicker labor, and a finer race of children, than one who is lethargic and
indolent. Idleness brings misery, anguish, and suffering in its train, and

particularly affects pregnant ladies. Oh, that these words would have due
weight, then this book will not have been written in vain. The hardest work
in the world is having nothing to do! “Idle people have the most labor;” this
is particularly true in pregnancy; a lady will, when labor actually sets in,
find to her cost that idleness has given her most labor. “Idleness is the badge
of gentry, the bane of body and mind, the nurse of Naughtiness, the step-
mother of Discipline, the chief author of all Mischief, one of the seven
deadly sins, the cushion upon which the Devil chiefly reposes, and a great
cause not only of Melancholy, but of many other diseases, for the mind is
naturally active; and, if it be not occupied about some honest business, it
rushes into Mischief or sinks into Melancholy.”[57]
249. A lady sometimes looks upon pregnancy more as a disease than as a
natural process; hence she treats herself as though she was a regular invalid,
and, unfortunately, she too often makes herself really one by improper and
by foolish indulgences.

VENTILATION—DRAINAGE.

250. Let a lady look well to the ventilation of her house; let her take care
that every chimney be unstopped, and during the daytime that every
window in every unoccupied room be thrown open.
251. Where there is a skylight at the top of the house, it is well to have it
made to open and to shut, so that in the daytime it may, winter and summer,
be always open; and in the summer time it may, day and night, be left
unclosed. Nothing so thoroughly ventilates and purifies a house as an open
skylight.
252. If a lady did but know the importance—the vital importance—of
ventilation, she would see that the above directions were carried out to the
very letter. My firm belief is that if more attention were paid to ventilation
—to thorough ventilation—child-bed fever would be an almost unknown
disease.
253. The cooping-up system is abominable; it engenders all manner of
infectious and of loathsome diseases, and not only engenders them, but
feeds them, and thus keeps them alive. There is nothing wonderful in all
this, if we consider but for one moment that the exhalations from the lungs

are poisonous! That is to say, that the lungs give off carbonic acid gas (a
deadly poison), which, if it be not allowed to escape out of the room, must
over and over again be breathed. That if the perspiration of the body (which
in twenty-four hours amounts to two or three pounds) be not permitted to
escape out of the apartment, must become fetid—repugnant to the nose,
sickening to the stomach, and injurious to the health. Oh, how often the
nose is a sentinel, and warns its owner of approaching danger!
254. Truly the nose is a sentinel! The Almighty has sent bad smells for
our benefit to warn us of danger. If it were not for an unpleasant smell, we
should be constantly running into destruction. How often we hear of an
ignorant person using disinfectants and fumigations to deprive drains and
other horrid places of their odors, as though, if the place could be robbed of
its smell, it could be robbed of its danger! Strange infatuation! No; the
frequent flushings of drains, the removal of nuisances, cleanliness, a good
scrubbing of soap and water, sunshine, and the air and winds of heaven, are
the best disinfectants in the world. A celebrated and eccentric lecturer on
surgery,[58] in addressing his class, made the following quaint and sensible
remark: “Fumigations, gentlemen, are of essential importance; they make so
abominable a stink that they compel you to open the windows and admit
fresh air.”
255. It is doubtless, then, admirably appointed that, we are able to detect
“the well-defined and several stinks;” for the danger is not in them,—to
destroy the smell is not to destroy the danger; certainly not! The right way
to do away with the danger is to remove the cause, and the effect will cease;
flushing a sewer is far more efficacious than disinfecting one; soap and
water and the scrubbing-brush, and sunshine and thorough ventilation, each
and all are far more beneficial than either permanganate of potash, or
chloride of zinc, or chloride of lime. People nowadays think too much of
disinfectants and too little of removal of causes; they think too much of
artificial, and too little of natural means. It is a sad mistake to lean so much
on, and to trust so much to, man’s inventions!
256. What is wanted, nowadays, is a little less theory and a great deal
more common sense. A rat, for instance, is, in theory, grossly maligned; he
is considered to be very destructive, an enemy to man, and one that ought to
be destroyed—every man’s hand being against him. Now, a rat is, by
common sense, well known to be, in its proper place—that is to say, in

sewers and in drains—destructive only to man’s enemies—to the organic
matter that breeds fevers, cholera, diphtheria, etc.; the rat eats the pabulum
or food which would otherwise convert towns into hot-beds of terrible
diseases. That which is a rat’s food is often a man’s poison; hence a rat is
one of the best friends that a man has, and ought, in his proper place, to be
in every way protected; the rat, in drains, is the very best of scavengers; in a
sewer he is invaluable; in a house he is most injurious; a rat in a sewer is
worth gallons of disinfectants, and will, in purifying a sewer, beat all man’s
inventions hollow; the maligned rat, therefore, turns out, if weighed by
common sense, to be not only one of the most useful of animals, but of
public benefactors! The rat’s element, then, is the sewer; he is the king of
the sewer, and should there reign supreme, and ought not to be poisoned by
horrid disinfectants.
257. If a lady, while on an errand of mercy, should in the morning go into
a poor person’s bedroom after he, she, or they (for oftentimes the room is
crowded to suffocation) have during the night been sleeping, and where a
breath of air is not allowed to enter—the chimney and every crevice having
been stopped up—and where too much attention has not been paid to
personal cleanliness, she will experience a faintness, an oppression, a
sickness, a headache, a terribly fetid smell; indeed, she is in a poisoned
chamber! It is an odor sui generis, which must be smelt to be remembered,
and will then never be forgotten! Pity the poor who live in such styes—not
fit for pigs! For pigs, styes are ventilated. But take warning, ye well-to-do
in the world, and look well to your ventilation, or beware of the
consequences. “If,” says an able writer on fever in the last century, “any
person will take the trouble to stand in the sun and look at his own shadow
on a white plastered wall, he will easily perceive that his whole body is a
smoking dunghill, with a vapor exhaling from every part of it. This vapor is
subtle, acrid, and offensive to the smell; if retained in the body it becomes
morbid, but if reabsorbed, highly deleterious. If a number of persons,
therefore, are long confined in any close place not properly ventilated, so as
to inspire and swallow with their spittle the vapors of each other, they must
soon feel its bad effects.”[59]
258. Not only should a lady look well to the ventilation of her house, but
either she or her husband ought to ascertain that the drains are in good and
perfect order, and that the privies are frequently emptied of their contents.
Bad drainage and overflowing privies are fruitful sources of child-bed fever,

of gastric fever, of scarlatina, of diphtheria, of cholera, and of a host of
other infections and contagious and dangerous diseases. It is an abominable
practice to allow dirt to fester near human habitations; more especially as
dirt, when mixed with earth, is really so valuable in fertilizing the soil. Lord
Palmerston wisely says that “dirt is only matter in the wrong place.”
259. A lady ought to look well to the purity of her pump-water, and to
ascertain that no drain either enters or percolates, or contaminates in any
way whatever, the spring; if it should do so, disease, such as either cholera,
or diarrhœa, or dysentery, or diphtheria, or scarlet fever, or gastric fever,
will, one or the other, as a matter of course, ensue. If there be the slightest
danger or risk of drain contamination, whenever it be practicable, let the
drain be taken up and be examined, and let the defect be carefully rectified.
When it be impracticable to have the drain taken up and examined, then let
the pump-water, before drinking it, be always previously boiled. The
boiling of the water, as experience teaches, has the power either of
destroying or of making innocuous the specific organic fecal life poison,
which propagates in drain contamination the diseases above enumerated.

NECESSITY OF OCCASIONAL REST.

260. A lady who is pregnant ought, for half an hour each time, to lie one
or two hours every day on the sofa. This, if there be either a bearing down
of the womb, or if there be a predisposition to a miscarriage, will be
particularly necessary. I should recommend this plan to be adopted
throughout the whole period of the pregnancy: in the early months, to
prevent a miscarriage, and, in the latter months, on account of the increased
weight and size of the womb.
261. There is, occasionally, during the latter months, a difficulty in lying
down; the patient feeling as though, every time she makes the attempt, she
should be suffocated. When such be the case, she ought to rest herself upon
the sofa, and be propped up with cushions, as I consider rest at different
periods of the day necessary and beneficial. If there be any difficulty in
lying down at night, a bed-rest, well covered with pillows, will be found a
great comfort.

DIETARY.

262. An abstemious diet, during the early period of pregnancy, is
essential, as the habit of body, at that time, is usually feverish and
inflammatory. I should therefore recommend abstinence from beer, porter,
and spirits. Let me, in this place, urge a lady, during her pregnancy, not to
touch spirits, such as either brandy or gin; they will only inflame her blood,
and will poison and make puny her unborn babe; they will only give her
false spirits, and will depress her in an increased ratio as soon as the effects
of the brandy or of the gin have passed away. She ought to eat meat only
but once a day. Rich soups and highly-seasoned stews and dishes are
injurious.
263. A lady who is enceinte may depend upon it that the less stimulants
she takes at these times the better it will be both for herself and for her
infant; the more kind will be her labor and her “getting about,” and the
more vigorous and healthy will be her child.
264. It is a mistaken notion that she requires more nourishment during
early pregnancy than at any other time; she, if anything, requires less. It has
often been asserted that a lady who is pregnant ought to eat very heartily, as
she has two to provide for. When it is taken into account that during
pregnancy she “ceases to be unwell,” and therefore that there is no drain on
that score; and when it is also considered how small the ovum containing
the embryo is, not being larger for the first two or three months than a hen’s
egg, it will be seen how futile is the assertion. A wife, therefore, in early
pregnancy, does not require more than at another time; if anything, she
requires less. Again: during pregnancy, especially in the early stages, she is
more or less sick, feverish, and irritable, and a superabundance of food
would only add fuel to the fire, and would increase her sickness, fever, and
irritability. Moreover, she frequently suffers from heartburn and from
indigestion. Can anything be more absurd, when such is the case, than to
overload a stomach already loaded with food which it is not able to digest?
No, let nature in this, as in everything else, be her guide, and she will not
then go far wrong! When she is further advanced in her pregnancy,—that is
to say, when she has quickened,—her appetite generally improves, and she
is much better in health than she was before; indeed, after she has
quickened, she is frequently in better health than she ever has been. The

appetite is now increased. Nature points out that she requires more
nourishment than she did at first; for this reason, the fœtus is now rapidly
growing in size, and consequently requires more support from the mother.
Let the food, therefore, of a pregnant woman be now increased in quantity,
but let it be both light and nourishing. Occasionally, at this time, she has
taken a dislike to meat; if she has, she ought not to be forced to eat it, but
should have instead, poultry, game, fish, chicken-broth, beef-tea, new milk,
farinaceous food, such as rice, sago, batter puddings, and, above all, if she
has a craving for it, good sound, ripe fruit.
265. Roasted apples, ripe pears, raspberries, strawberries, grapes,
tamarinds, figs, Muscatel raisins, stewed rhubarb, stewed pears, stewed
prunes, the inside of ripe gooseberries, and the juice of oranges, are, during
pregnancy, particularly beneficial; they both quench the thirst and tend to
open the bowels.
266. The food of a pregnant woman cannot be too plain; high-seasoned
dishes ought, therefore, to be avoided. Although the food be plain, it must
be frequently varied. She should ring the changes upon butcher’s meat,
poultry, game, and fish. It is a mistaken notion, that people ought to eat the
same food over and over again, one day as another. The stomach requires
variety, or disease, as a matter of course, will ensue.
267. Light puddings, such as either rice, or batter, or suet-pudding, or
fruit puddings, provided the paste be plain, may be taken with advantage.
Rich pastry is highly objectionable.
268. If she be plethoric, abstinence is still more necessary, or she might
have a tedious labor, or might suffer severely. The old-fashioned treatment
was to bleed a pregnant patient if she were of a full habit of body. A more
absurd plan could not be adopted! Bleeding would, by causing more blood
to be made, only increase the mischief; but certainly it would be blood of an
inferior quality, watery and poor. The best way to diminish the quantity of
blood is to moderate the amount of food, to lessen the supplies.

SLEEP.

269. The bedroom of a pregnant lady ought, if practicable, to be large and
airy. Particular attention must be paid to the ventilation. The chimney

should on no account be stopped. The door and the windows ought in the
daytime to be thrown wide open, and the bedclothes should be thrown back,
that the air might, before the approach of night, well ventilate them.
270. It is a mistaken practice for a pregnant woman, or for any one else,
to sleep with closely-drawn curtains. Pure air and a frequent change of air
are quite as necessary—if not more so—during the night as during the day:
and how can it be pure, and how can it be changed, if curtains are closely
drawn around the bed? Impossible. The roof of the bedstead ought not to be
covered with bed furniture; it should be open to the ceiling, in order to
prevent any obstruction to a free circulation of air.
271. The bed must not be loaded with clothes, more especially with a
thick coverlet. If the weather be cold, let an extra blanket be put on the bed,
as the perspiration can permeate through a blanket when it cannot through a
thick coverlet.
272. A lady who is pregnant is sometimes restless at night—she feels
oppressed and hot. The best remedies are:—(1) Scant clothing on the bed.
(2) The lower sash of the window, during the summer months, to be left
open to the extent of six or eight inches, and during the winter months, to
the extent of two or three inches; provided the room be large, the bed be
neither near nor under the window, and the weather be not intensely cold. If
any or all of these latter circumstances occur, then (3) the window to be
closed and the door to be left ajar (the landing or the skylight window at the
top of the house being left open all night, and the door being secured from
intrusion by means of a door-chain.) (4) Attention to be paid, if the bowels
be costive—but not otherwise—to a gentle action of the bowels by castor
oil. (5) An abstemious diet, avoiding stimulants of all kinds. (6) Gentle
walking exercise. (7) Sponging the body every morning—in the winter with
tepid water, and in the summer with cold water. (8) Cooling fruits in the
summer are in such a case very grateful and refreshing. (See paragraph
264.)
273. A pregnant woman sometimes experiences an inability to lie down,
the attempt occasionally producing a feeling of suffocation and of faintness.
She ought, under such circumstances, to lie on a bed-rest, which must, by
means of pillows, be made comfortable; and she should take, every night at
bedtime, a teaspoonful of sal-volatile in a wineglassful of water.

274. Pains at night, during the latter end of the time, are usually frequent,
so as to make an inexperienced lady fancy that her labor was commencing.
Little need be done; for unless the pains be violent, nature ought not to be
interfered with. If they be violent, application should be made to a medical
man.
275. A pregnant lady must retire early to rest. She ought to be in bed
every night by ten o’clock, and should make a point of being up in good
time in the morning, that she may have a thorough ablution, a stroll in the
garden, and an early breakfast; and that she may afterwards take a short
walk either in the country or in the grounds while the air is pure and
invigorating. But how often, more especially when a lady is first married, is
an opposite plan adopted! The importance of bringing a healthy child into
the world, if not for her own and her husband’s sake, should induce a wife
to attend to the above remarks.
276. Although some ladies, during pregnancy, are very restless, others are
very sleepy, so that they can scarcely, even in the day, keep their eyes open!
Fresh air, exercise, and occupation are the best remedies for keeping them
awake.

MEDICINE.

277. A young wife is usually averse to consult a medical man concerning
several trifling ailments, which are nevertheless, in many cases, both
annoying and distressing. I have therefore deemed it well to give a brief
account of such slight ailments, and to prescribe a few safe and simple
remedies for them. I say safe and simple, for active medicines require
skillful handling, and therefore ought not—unless in certain emergencies—
to be used except by a doctor himself.
278. I wish it, then, to be distinctly understood that in all serious attacks,
and in slight ailments if not quickly relieved, a medical man ought to be
called in.
279. A costive state of the bowels is common in pregnancy; a mild
aperient is therefore occasionally necessary. The mildest must be selected,
as a strong purgative is highly improper, and even dangerous. Calomel and
all other preparations of mercury are to be especially avoided, as a

mercurial medicine is apt to weaken the system and sometimes even to
produce a miscarriage.
280. An abstemious diet, where the bowels are costive, is more than
usually desirable, for if the bowels be torpid, a quantity of food will only
clog and make them more sluggish. Besides, when labor comes on, a loaded
state of the bowels will add much to a lady’s sufferings as well as to her
annoyance.
281. The best aperients are castor oil, salad oil, compound rhubarb pills,
honey, stewed prunes, stewed rhubarb, Muscatel raisins, figs, grapes,
roasted apples, Normandy pippins, oatmeal and milk gruel, coffee, brown
bread and treacle, raw sugar (as a sweetener of the food), Du Barry’s
Arabica Revalenta.
282. Castor oil, in pregnancy, is a valuable aperient. Frequent and small
are preferable to occasional and large doses. If the bowels be constipated
(but certainly not otherwise), castor oil ought to be taken regularly twice a
week. The best time for administering it is early in the morning. The dose is
from a teaspoonful to a dessertspoonful.
283. The best ways of administering it are the following: Let a wineglass
be well rinsed out with water, so that the sides may be well wetted; then, let
the wineglass be half filled with cold water, fresh from the pump. Let the
necessary quantity of oil be now carefully poured into the center of the
wineglass, taking care that it does not touch the sides; and if the patient
will, thus prepared, drink it off at one draught, she will scarcely taste it.
Another way of taking it is, swimming on warm new milk. A third and a
good method is, floating on warm coffee; the coffee ought, in the usual way,
to be previously sweetened and mixed with cream. There are two
advantages in giving castor oil on coffee: (1) it is a pleasant way of giving it
—the oil is scarcely tasted; and (2) the coffee itself, more especially if it be
sweetened with raw sugar, acts as an aperient; less castor oil, in
consequence, being required; indeed, with many patients the coffee,
sweetened with raw sugar, alone is a sufficient aperient. A fourth and an
agreeable way of administering it is on orange-juice—swimming on the
juice of one orange.
284. Some ladies are in the habit of taking it on brandy and water; but the
spirit is apt to dissolve a portion of the oil, which afterwards rises in the
throat.

285. If salad oil be preferred, the dose ought to be as much again as of
castor oil; and the patient should, during the day she takes it, eat either a fig
or two, or a dozen or fifteen of stewed prunes, or of stewed French plums,
as salad oil is much milder in its effects than castor oil.
286. Where a lady cannot take oil, one or two compound rhubarb pills
may be taken at bedtime; or a Seidlitz powder early in the morning,
occasionally; or a quarter of an ounce of tasteless salts—phosphate of soda
—may be dissolved in lieu of table salt, in a cupful either of soup, or of
broth, or of beef-tea, and be occasionally taken at luncheon.
287. When the motions are hard, and when the bowels are easily acted
upon, two, or three, or four pills made of Castile soap will frequently
answer the purpose; and if they will, are far better than any ordinary
aperient. The following is a good form:
Take of—Castile Soap, five scruples;
Oil of Caraway, six drops:

To make twenty-four pills. Two, or three, or four to be taken at bedtime, occasionally.[60]

288. A teaspoonful of honey, either eaten at breakfast, or dissolved in a
cup of tea, will frequently comfortably and effectually open the bowels, and
will supersede the necessity of taking aperient medicine.
289. A basin of thick Derbyshire oatmeal gruel, made either with new
milk or with cream and water, with a little salt, makes an excellent luncheon
or supper for a pregnant lady; it is both nourishing and aperient, and will
often entirely supersede the necessity of giving opening medicine. If she
prefers sugar to salt, let raw sugar be substituted for the salt. The occasional
substitution of coffee for tea at breakfast usually acts beneficially on the
bowels.
290. Let me again urge the importance of a lady, during the whole period
of pregnancy, being particular as to the state of her bowels, as costiveness is
a fruitful cause of painful, of tedious, and of hard labors. It is my firm
conviction that if a patient who suffers from constipation were to attend
more to the regularity of her bowels, difficult cases of labor would rarely
occur, more especially if the simple rules of health were adopted, such as:
attention to diet—the patient partaking of a variety of food, and allowing
the farinaceous, such as oatmeal and the vegetable and fruit element, to
preponderate; the taking of exercise in the open air; attending to her

household duties; avoiding excitement, late hours, and all fashionable
amusements.
291. Many a pregnant lady does not leave the house—she is a fixture.
Can it, then, be wondered at that costiveness so frequently prevails?
Exercise in the fresh air, and occupation, and household duties are the best
opening medicines in the world. An aperient, let it be ever so judiciously
chosen, is apt, after the effect is over, to bind up the bowels, and thus to
increase the evil. Now, nature’s medicines,—exercise in the open air,
occupation, and household duties,—on the contrary, not only at the time
open the bowels, but keep up a proper action for the future: hence their
inestimable superiority.
292. Where a lady cannot take medicine, or where it does not agree with
her, a good remedy for constipation in pregnancy is the external application
of castor oil—castor oil as a liniment—to the bowels The bowels should be
well rubbed every night and morning with the castor oil. This, if it succeed,
will be an agreeable and safe method of opening the bowels.
293. Another excellent remedy for the costiveness of pregnancy is an
enema, either of warm water or of Castile soap and water, which the patient,
by means of a self-injecting enema apparatus, may administer to herself.
The quantity of warm water to be used is from half a pint to a pint; the
proper heat is the temperature of new milk; the time for administering it is
early in the morning, twice or three times a week. The advantages of
clysters are, they never disorder the stomach—they do not interfere with the
digestion—they do not irritate the bowels—they are given with the greatest
facility by the patient herself—and they do not cause the slightest pain. If
an enema be used to open the bowels, it may be well to occasionally give
one of the aperients recommended above, in order, if there be costiveness,
to insure a thorough clearance of the whole of the bowels.
294. If the bowels should be opened once every day, it would be the
height of folly for a pregnant lady to take either castor oil or any other
aperient. She ought then to leave her bowels undisturbed, as the less
medicine she takes the better. If the bowels be daily and properly opened,
aperients of any sort whatever would be highly injurious to her. The plan in
this, as in all other cases, is to leave well alone, and never to give physic for
the sake of giving it.

295. Diarrhœa.—Although the bowels in pregnancy are generally
costive, they are sometimes in an opposite state, and are relaxed. Now, this
relaxation is frequently owing to their having been too much constipated,
and nature is trying to relieve itself by purging. Such being the case, a
patient ought to be careful how, by the taking of chalk and of astringents,
she interferes with the relaxation.
296. The fact is, that in all probability there is something in the bowels
that wants coming away, and nature is trying all she can to afford relief.
Sometimes, provided she is not unnecessarily interfered with, she succeeds;
at others, it is advisable to give a mild aperient to help nature in bringing it
away.
297. When such be the case, a gentle aperient, such as either castor oil or
rhubarb and magnesia, ought to be chosen. If castor oil, a teaspoonful or a
dessertspoonful, swimming on a little new milk, will generally answer the
purpose. If rhubarb and magnesia be the medicine selected, then a few
doses of the following mixture will usually set all to rights:
Take of—Powdered Turkey Rhubarb, half a drachm;
Carbonate of Magnesia, one drachm;
Essence of Ginger, one drachm;
Compound Tincture of Cardamoms, half an ounce;
Peppermint Water, five ounces and a half:

Two tablespoonfuls of the mixture to be taken three times a day, first shaking the bottle.

298. The diet ought to be simple, plain, and nourishing, and should
consist of beef-tea, of chicken-broth, of arrow-root, and of well-made and
well-boiled oatmeal gruel. Meat, for a few days, ought not to be eaten; and
stimulants of all kinds must be avoided.
299. If the diarrhœa be attended with pain in the bowels, a flannel bag
filled with hot table salt, and then applied to the part affected, will afford
great relief. A hot-water bag, too, in a case of this kind, is a great comfort.[61]
The patient ought, as soon as the diarrhœa has disappeared, gradually to
return to her usual diet, provided it be plain, wholesome, and nourishing.
She should pay particular attention to keeping her feet warm and dry; and,
if she be much subject to diarrhœa, she ought to wear around her bowels,
and next to her skin, a broad flannel belly-band.
300. Heartburn is a common and often a distressing symptom of
pregnancy. The acid producing the heartburn is frequently much increased
by an overloaded stomach. The patient labors under the mistaken notion

that, as she has two to sustain, she requires more food during this than at
any other time; she consequently is induced to take more than her appetite
demands, and more than her stomach can digest;—hence heartburn,
indigestion, etc. are caused, and her unborn babe, as well as herself, is
thereby weakened.
301. An abstemious diet ought to be strictly observed. Great attention
should be paid to the quality of the food; greens, pastry, hot buttered toast,
melted butter, and everything that is rich and gross, ought to be carefully
avoided.
302. Either a teaspoonful of Henry’s magnesia, or half a teaspoonful of
carbonate of soda—the former to be preferred if there be constipation—
should occasionally be taken in a wineglassful of warm water. If these do
not relieve—the above directions as to diet having been strictly attended to
—the following mixture ought to be tried:
Take of—Sesquicarbonate of Ammonia, half a drachm;
Bicarbonate of Soda, a drachm and a half;
Water, eight ounces:

To make a mixture. Two tablespoonfuls to be taken twice or three times a day, until relief be
obtained.

Chalk is sometimes given in heartburn, but as it produces costiveness, it
ought not in such a case to be used.
303. Piles are a common attendant upon pregnancy. They are small, soft,
spongy, dark-red tumors, about the size either of a bean or of a cherry—
they are sometimes as large as a walnut—and are either within or around
the fundament; they are then, according to their situation, called either
internal or external piles—they may be either blind or bleeding. If the
latter, blood may be seen to exude from them, and blood will come away
every time the patient has a stool; hence the patient ought to be as quick as
possible over relieving her bowels, and should not at such times sit one
moment longer than is absolutely necessary.
304. When the pile or piles are very large, they sometimes, more
especially when she has a motion, drag down a portion of the bowel, which
adds much to her sufferings.
305. If the bowel should protrude, it ought, by means of the patient’s
index finger, to be immediately and carefully returned, taking care, in order
that it may not scratch the bowel, that the nail be cut close.

306. Piles are very painful and are exceedingly sore, and cause great
annoyance, and frequently continue, notwithstanding proper and judicious
treatment, during the whole period of pregnancy.
307. A patient is predisposed to piles from the womb pressing upon the
blood-vessels of the fundament. They are excited into action by her
neglecting to keep her bowels gently opened, or by diarrhœa, or from her
taking too strong purgatives, especially pills containing either aloes or
colocynth, or both.
308. If the piles be inflamed and painful, they ought, by means of a
sponge, to be well fomented three times a day, and for half an hour each
time, with hot chamomile and poppy-head tea;[62] and at bedtime a hot
white-bread poultice should be applied.
309. Every time after and before the patient has a motion, she had better
well anoint the piles and the fundament with the following ointment:
Take of—Camphor (powdered by means of a few drops of
Spirits of Wine), half a drachm;
Prepared Lard, two ounces:

Mix, to make an ointment.

310. If there be great irritation and intense pain, let some very hot water
be put into a close stool, and let the patient sit over it. “In piles attended
with great irritation and pain, much relief is often obtained by sitting over
the steam of hot water for fifteen or twenty minutes, and immediately
applying a warm bread-and-milk poultice. These measures should be
repeated five or six times a day (Greeves).”[63]
311. If the heat be not great, and the pain be not intense, the following
ointment will be found efficacious:
Take of—Powdered Opium, one scruple;
Camphor (powdered by means of a few drops of
Spirits of Wine), half a drachm;
Powdered Galls, one drachm;
Spermaceti Ointment, three drachms:

Mix.—The ointment to be applied to the piles three times a day.[64] Or the compound Gall
Ointment (B.P.) may, in the same manner, be applied.
312. If the heat and the pain be great, the following liniment will be
found useful:
Take of—French Brandy,
Glycerin, of each, half an ounce:

Mix.—The liniment to be frequently applied, by means of a camel’s-hair pencil, to the piles, first
shaking the bottle.

313. The bowels ought to be kept gently and regularly opened, either by
taking every morning one or two teaspoonfuls of compound confection of
senna, or by a dose of the following electuary:
Take of—Sublimed Sulphur, half an ounce;
Powdered Ginger, half a drachm;
Cream of Tartar, half an ounce;
Confection of Senna, one ounce;
Simple Syrup, a sufficient quantity:

To make an electuary. One or two teaspoonfuls to be taken early every morning.
314. Magnesia and milk of sulphur is an excellent remedy for piles:
Take of—Carbonate of Magnesia,
Milk of sulphur, of each, three drachms;

Mix.—To make nine powders. One to be taken early every, or every other morning, mixed in half
a teaspoonful of new milk.

315. Remember, in these cases, it is necessary to keep the motions in a
softened state, as hard lumps of stool would, in passing, give intense pain.
316. If the confection of senna and the other remedies do not act
sufficiently, it may be well to give, once or twice a week, a teaspoonful or a
dessertspoonful of castor oil.
317. In piles, if they are not much inflamed, and provided there be
constipation, a pint of tepid water, administered early every morning as an
enema, will be found serviceable. Care and gentleness ought, of course, to
be observed in introducing the enema pipe (but which only requires
ordinary care), in order not to press unduly on the surrounding piles.
318. The patient ought to lie down frequently in the day. She will derive
great comfort from sitting either on an air-cushion or on a water-cushion
about half filled with water, placed on the chair; for sometimes she is
unable to sit on an ordinary seat.
319. In piles, the patient ought to live on a plain, nourishing, simple diet,
but should avoid all stimulants; any food or beverage that will inflame the
blood will likewise inflame the piles.
320. Piles in pregnancy are frequently troublesome, and sometimes resist
all treatment until the patient is confined, when they generally get well of

themselves; but still the remedies recommended above will usually afford
great relief, even if they do not effect a cure.
321. Swollen legs from enlarged veins (varicose veins).—The veins are
frequently much enlarged and distended, causing the legs to be greatly
swollen and very painful, preventing the patient from taking proper walking
exercise. Swollen legs are owing to the pressure of the womb upon the
blood-vessels above. Women who have had large families are more liable to
varicose veins than others. If a lady marry late in life, or if she be very
heavy in her pregnancy—carrying the child low down—she is more likely
to have the veins to distend.
322. The best plan will be for her to wear an elastic silk stocking,[65]
which ought to be made on purpose for her, in order that it may properly fit
the leg and foot. It will draw on like a common stocking. She ought to wear
a gauze stocking next the skin, and the elastic stocking over it, as the gauze
stocking can then, from time to time, be washed, as can likewise the foot
and leg. Moreover, the gauze stocking will be more comfortable next the
skin than the elastic stocking.
323. If the varicose veins should be very painful, she had better apply to
a medical man, as it may be necessary, in such a case, to have them
enveloped in mild plasters, and then rolled.
324. If the feet and legs be cold as well as swollen, a domette[66] bandage,
two inches and a half wide and eight yards long, nicely applied to each leg,
from the toes to the knee, will be found a great comfort. One great
advantage that domette has over calico is that it will keep in its place for
days, while calico will be loose in an hour or two.
325. Stretching of the skin of the belly is frequently, especially in a first
pregnancy, distressing, from the soreness it causes. The best remedy is to
rub the bowels, every night and morning, with warm camphorated oil, and
to apply a broad flannel belt, which should be put on moderately but
comfortably tight. The belt ought to be secured in its situation by means of
properly adjusted tapes.
326. If the skin of the belly, from the violent stretching, be cracked, the
patient had better dress the part affected, every night and morning, with
equal parts of simple cerate and of lard—lard without salt—well mixed
together, spread on lint; which ought to be kept in its place by means of a

broad bandage, similar to the one used in confinements, and which is
described in a subsequent paragraph (Bandage after Confinements).
321. Pendulous belly.—A lady sometimes, from being at these times
unusually large, suffers severely; so much so, that she cannot, without
experiencing great inconvenience, move about. This, where a patient is
stout, and where she has had a large family of children, is more likely to
occur, and especially if she has neglected proper bandaging after her
previous confinements.
328. She ought in such a case to procure, from a surgical-instrument-
maker, an elastic abdominal belt, made purposely for pendulous bellies,
which will, without unduly pressing on the belly, be a support. It is a good
plan to have the belt made either to lace behind or with straps and buckles,
in order to accommodate the belly to its gradually increasing size.
329. If the patient be delicate, and if she has a languid circulation, she
ought, instead of the elastic belt, to apply a broad flannel belly-band, which
should go twice around the bowels, and must be put on moderately and
comfortably tight.
330. The patient, before the approach of labor, ought to take particular
care to have the bowels gently opened, as during that time a costive state of
them greatly increases her sufferings, and lengthens the period of her labor.
I say a gentle action is all that is necessary; a violent one would do more
harm than good.
331. Toothache is a frequent complaint of pregnancy; and I wish to
caution my gentle reader not to have, during the time she is enceinte, a
tooth extracted; miscarriage or premature labor has frequently followed the
extraction of a tooth.
332. If the tooth be decayed, the hollow ought to be filled with cotton
wool, soaked either in oil of cloves, or in equal parts of oil of cloves and of
chloroform, and which should be frequently renewed; or with what I have
found an excellent remedy, a little alum dissolved in chloroform.[67] A bit of
cotton wool placed in the ear of the affected side will oftentimes relieve the
toothache arising from a decayed tooth. This simple remedy ought always
to be tried before resorting to more active treatment. If the above remedies
do not relieve, soak a small ball of cotton wool in chloroform, and insert it
inside the ear, and let it remain there until the pain be relieved; let it be from

time to time renewed. I have frequently found in toothache the above plan
most efficacious, and to afford relief when other means have failed.
333. Creasote (spirits of tar) is sometimes applied, but of all remedies it
is the worst for the purpose. I have known it, when thus used, severely
injure and decay the whole of the remaining teeth: one case in particular I
remember, of a gentleman who, by the frequent use of creasote, for the
relief of toothache, lost the whole of his teeth!
334. If the teeth be not decayed, especially if the stomach be disordered,
let an aperient be taken. The state of the bowels ought always to be attended
to, as toothache is frequently relieved, and when the tooth is not decayed,
cured by a dose of opening medicine. Let the sides of the face be well
fomented with hot chamomile and poppy-head tea, and let a piece of crumb
of bread (but not crumbed bread) be soaked for five minutes in boiling
milk, and be frequently placed inside the mouth, between the cheek and
gum; and let a large hot bread poultice be applied at bedtime to the outside
of the face.
335. If the above does not have the desired effect, a piece of brown paper,
the size of the palm of the hand, soaked in brandy, and then well peppered
with black pepper, should be applied outside the cheek, over the part
affected, and kept on for several hours. It ought from time to time to be
renewed. This simple and old-fashioned remedy will sometimes afford great
relief. It is in these cases preferable to a mustard poultice, as it is less
painful, and neither blisters nor injures the skin.
336. If the pepper plaster does not afford relief, a ginger plaster should be
tried:
Take of—Powdered Ginger,
Flour, of each one tablespoonful;
Water, a sufficient quantity:

To be well mixed together, adding the water drop by drop (stirring it the while) until it be of the
consistence of paste. Let it be applied at bedtime, on linen rag, outside the cheek, and let it
remain on all night, or until the pain be relieved.

337. If the tooth be not decayed, and if the pain of the face be more of a
neuralgic (tic-douloureux) character, the following pills will frequently
afford great relief:
Take of—Sulphate of Quinine, twenty-four grains;
Powdered Extract of Liquorice, six grains;
Treacle, a sufficient quantity:

To make twelve pills. One to be taken three times a day.

338. The teeth, in pregnancy, are very apt to decay: I have known several
patients, each of whom has lost a tooth with every child!
339. Morning sickness.—It is said to be “morning,” as in these cases,
unless the stomach be disordered, it seldom occurs during any other part of
the day. Morning sickness may be distinguished from the sickness of a
disordered stomach by the former occurring only early in the morning, on
the first sitting up in bed, the patient during the remainder of the day feeling
quite free from sickness, and generally being able to eat and relish her food
as though nothing ailed her.
340. Morning sickness begins with a sensation of nausea early in the
morning, and as soon as she rises from bed she feels sick and retches; and
sometimes, but not always, vomits a little sour, watery, glairy fluid; and
occasionally, if she has eaten heartily at supper the night previously, the
contents of the stomach are ejected. She then feels all right again, and is
usually ready for her breakfast, which she eats with her usual relish. Many
ladies have better appetites during pregnancy than at any other period of
their lives.
341. The sickness of a disordered stomach unaccompanied with
pregnancy may be distinguished from morning sickness by the former
continuing during the whole day, by the appetite remaining bad after the
morning has passed, by a disagreeable taste in the mouth, and by the tongue
being generally furred. Moreover, in such a case there is usually much
flatulence. The patient not only feels but looks bilious.
342. If the stomach be disordered during pregnancy, there will, of course,
be a complication of the symptoms, and the morning sickness may become
both day and night sickness. Proper means ought then to be employed to
rectify the disordered stomach, and the patient will soon have only the
morning sickness to contend against; which latter, after she has quickened,
will generally leave of its own accord.
343. Morning sickness is frequently a distressing, although not a
dangerous complaint. It is only distressing while it lasts, for after the
stomach is unloaded, the appetite generally returns, and the patient usually
feels, until the next morning, quite well again, when she has to go through
the same process as before.

344. It occurs both in the early and in the latter months of pregnancy;
more especially during the former, up to the period of quickening, at which
time it usually ceases. Morning sickness is frequently the first harbinger of
pregnancy, and is looked upon by many ladies who have had children as a
sure and certain sign. Morning sickness does not always occur in
pregnancy; some women, at such times, are neither sick nor sorry.
345. A good way to relieve it is by taking, before rising in the morning, a
cup of strong coffee. If this should not have the desired effect, she ought to
try an effervescing draught:
Take of—Bicarbonate of Potash, one drachm and a half;
Water, eight ounces:

Two Tablespoonfuls of this mixture to be taken with one of lemon-juice every hour, while
effervescing, until relief be obtained.

346. A glass of champagne, taken the overnight, I have sometimes found
to be the best remedy, and, if it has the desired effect, it certainly is the most
agreeable.
347. I have known, too, cider, where other things have failed, to succeed
in abating morning sickness.
348. Sometimes, until the whole contents of the stomach be brought up,
she does not obtain relief from her sickness. She had better, when such is
the case, drink plentifully of warm water, in order to encourage free
vomiting. Such a plan, of course, is only advisable when the morning
sickness is obstinate, and when the treatment recommended above has
failed to afford relief.
349. The morning sickness, during the early months, is caused by
sympathy between the stomach and the womb; and during the latter months
by pressure of the upper part of the womb against the stomach. As we
cannot remove the sympathy and the pressure, we cannot always relieve the
sickness; the patient, therefore, is sometimes obliged to bear with the
annoyance.
350. The bowels ought to be kept gently opened, either by a Seidlitz
powder taken early in the morning, or by one or two compound rhubarb
pills at bedtime, or by the following mixture:
Take of—Carbonate of Magnesia, two drachms;
Sulphate of Magnesia, one ounce;
Peppermint water, seven ounces:

A wineglassful of this mixture to be taken early in the morning, occasionally, first shaking the
bottle.

351. Great attention ought in such a case to be paid to the diet; it should
be moderate in quantity, and simple in quality. Rich dishes, highly-seasoned
soups and melted butter must be avoided. Hearty meat suppers ought not on
any account to be allowed. There is nothing better, if anything be taken at
night, than either a teacupful of nicely-made and well-boiled oatmeal gruel,
or of arrow-root, or of Arabica Revalenta. Any of the above may be made
either with water, or with new milk, or with cream and water.
352. It is an old saying, and, I believe as a rule, a true one, “that sick
pregnancies are safe,” more especially if the sickness leaves, which it
generally does, after she has quickened. The above remarks, of course, do
not include obstinate, inveterate vomiting, occasionally occurring in the
latter period of pregnancy, and which not only takes place in the morning,
but during the whole of the day and of the night, and for weeks together,
sometimes bringing a patient to the brink of the grave. Such a case,
fortunately, is extremely rare. Another old and generally true saying is, “that
females who have sick pregnancies seldom miscarry.”
353. Means to harden the nipples.—A mother, especially with her first
child, sometimes suffers severely from sore nipples. Such suffering may
frequently be prevented, if for six weeks or two months before her
confinement, she were to bathe her nipples, every night and morning, for
five minutes each time, either with eau de Cologne, or with brandy and
water, equal parts of each. The better plan will be to have the brandy and
water in a small bottle ready for use, and putting a little each time into a
teacup, using it fresh and fresh. A soft piece of fine old linen rag should be
used for the purpose of bathing. All pressure ought to be taken from the
nipples; if the stays, therefore, unduly press them, either let them be
enlarged or let them be entirely removed. The nipples themselves ought to
be covered with a soft linen rag, as the friction of a flannel vest would be
apt to irritate them. Let me recommend every pregnant lady, more
especially in her first pregnancy, to adopt either the one or the other of the
above plans to harden the nipples; it might avert much misery, as sore
nipples are painful and distressing; and prevention at all times is better than
cure.
354. The breasts are, at times, during pregnancy, much swollen and very
painful; and, now and then, they cause the patient great uneasiness, as she

fancies that she is going to have either some dreadful tumor or a gathering
of the bosom. There need, in such a case, be no apprehension. The swelling
and the pain are the consequences of the pregnancy, and will in due time
subside without any unpleasant result. The fact is, great changes are taking
place in the breasts; they are developing themselves, and are preparing for
the important functions they will have to perform the moment the labor is
completed.
355. Treatment.—She cannot do better than, every night and morning, to
well rub them with equal parts of eau de Cologne and of olive oil, and to
wear a piece of new flannel over them; taking care to cover the nipples with
soft linen, as the friction of the flannel may irritate them. The liniment
encourages a little milky fluid to ooze out of the nipple, which will afford
relief.
356. If stays be worn, the patient should wear them slack, in order to
allow the bosoms plenty of room to develop themselves. The bones of the
stays ought all to be removed, or serious consequences might ensue.
357. Bowel complaints, during pregnancy, are not unfrequent. A dose
either of rhubarb and magnesia, or of castor oil, are the best remedies, and
are generally, in the way of medicine, all that is necessary.
358. The diet at such times ought to be simple, small in quantity, and
nourishing. Farinaceous food, such as rice, tapioca, sago, Du Barry’s
Arabica Revalenta, and arrow-root, are particularly beneficial. Green
vegetables and fruits, especially stone fruits and uncooked fruits, ought to
be avoided.
359. The surface of the body—the bowels and feet particularly—ought to
be kept warm. If a lady suffer habitually from relaxation of the bowels, let
her, by all means, wear a flannel vest next the skin.
360. The bladder.—The patient during pregnancy is liable to various
affections of the bladder. There is sometimes a sluggishness of that organ,
and she has little or no inclination to make water. There is, at another time,
a great irritability of the bladder, and she is constantly wanting to pass
urine; while, in a third case, more especially toward the latter period of the
time, she can scarcely hold her water at all,—the slightest bodily exertion,
such as walking, stooping, coughing, sneezing, etc., causing it to come
away involuntarily; and even in some cases, where she is perfectly still, it
dribbles away without her having any power to prevent its doing so.

361. A sluggish state of the bladder is best remedied by gentle exercise,
and by the patient attempting, whether she want or not, to make water at
least every four hours.
362. Irritability of the bladder.—The patient ought, during the day, to
drink freely of the following beverage:
Take of—Best Gum Arabic, one ounce;
Pearl Barley, one ounce;
Water, one pint and a half:

Boil for a quarter of an hour, then strain, and sweeten either with sugar candy or lump sugar.

363. The bowels ought to be gently opened with small doses of castor oil.
The patient must abstain from beer, wine, or spirits, and should live on a
mild, bland, nourishing diet.
364. Where the patient cannot hold her water there is not a great deal to
be done, as the pregnant womb by pressing on the bladder prevents much
present relief. The comfort is, as soon as the labor is over, it will cure itself.
She ought frequently in the day to lie down either on a horse-hair mattress
or on a couch. She should drink but a moderate quantity of liquid, and if she
has a cough (for a cough greatly increases this inability to hold the water),
she ought to take the following mixture:
Take of—Compound Tincture of Camphor, half an ounce;
Compound Spirits of Lavender, half a drachm;
Oxymel of Squills, six drachms;
Water, six ounces and a half:

Two tablespoonfuls of this mixture to be taken three times a day.
365. Fainting.—A delicate woman, when she is enceinte, is apt either to
feel faint or to actually faint away. When it is considered the enormous
changes that, during pregnancy, take place, and the great pressure there is
upon the nerves and the blood-vessels, it is not at all surprising that she
should do so. There is one consolation, that although fainting at such times
is disagreeable, it is not at all dangerous, unless the patient be really
laboring under a disease of the heart.
366. Treatment.—If the patient feel faint, she ought immediately to lie
down flat upon her back, without a pillow under her head; that is to say, her
head should be on a level with her body. The stays and any tight articles of
dress—if she has been foolish enough to wear either tight stays or tight
clothes—ought to be loosened; the windows should be thrown wide open;

water ought to be sprinkled on her face; and sal-volatile—a teaspoonful in a
wineglassful of water, or a glass of wine ought to be administered.
Smelling-salts must be applied to the nostrils. The attendants—there should
only be one or two present—should not crowd around her, as she ought to
have plenty of room to breathe.
367. She must, in the intervals, live on a good, light, generous diet. She
should keep early hours, and ought to sleep in a well-ventilated apartment.
The following strengthening medicine will be found serviceable:
Take of—Sulphate of Quinine, twelve grains;
Diluted Sulphuric Acid, half a drachm;
Syrup of Orange-peel, half an ounce;
Water, seven ounces and a half:

Two tablespoonfuls of the mixture to be taken three times a day.

If she be delicate, a change either to the country, or, if the railway journey
be not very long, to the coast, will be desirable.
368. A nervous patient during this period is subject to palpitation of the
heart. This palpitation, provided it occur only during pregnancy, is not
dangerous; it need therefore cause no alarm. It is occasioned by the pressure
of the pregnant womb upon the large blood-vessels, which induces a
temporary derangement of the heart’s action. This palpitation is generally
worse at night, when the patient is lying down. There is, at these times,
from the position, greater pressure on the blood-vessels. Moreover, when
she is lying down, the midriff, in consequence of the increased size of the
belly, is pressed upward, and hence the heart has not its accustomed room to
work in, and palpitation is in consequence the result.
369. The best remedies will be either half a teaspoonful of compound
spirits of lavender or a teaspoonful of sal-volatile in a wineglassful of
camphor julep,[68] or a combination of lavender and of sal-volatile:
Take of—Compound Spirits of Lavender, one drachm;
Sal-Volatile, eleven drachms:

Mix.—A teaspoonful of the drops to be taken occasionally in a wineglassful of water.
370. These medicines ought to lie on a table by the bedside of the patient,
in order that they may, if necessary, be administered at once. Brandy is in
these cases sometimes given, but it is a dangerous remedy to administer
every time there is palpitation; while the lavender and the sal-volatile are
perfectly safe medicines, and can never do the slightest harm.

371. Mental emotion, fatigue, late hours, and close rooms ought to be
guarded against. Gentle out-door exercise, and cheerful but not boisterous
company are desirable.
372. Cramps of the legs and of the thighs during the latter period, and
especially at night, are apt to attend pregnancy, and are caused by the womb
pressing upon the nerves which extend to the lower extremities. Treatment.
—Tightly tie a handkerchief folded like a neckerchief round the limb a little
above the part affected, and let it remain on for a few minutes. Friction by
means of the hand either with opodeldoc or with laudanum (taking care not
to drink it by mistake) will also give relief. Cramp sometimes attacks either
the bowels or the back of a pregnant woman; when such is the case, let a
bag of hot salt, or a hot-water bag,[69] or a tin stomach warmer filled with
hot water and covered with flannel, or a stone bottle containing hot water,
wrapped in flannel, be applied over the part affected; and let either a stone
bottle of hot water or a hot brick, which should be incased in flannel, be
placed to the soles of the feet. If the cramp of the bowels, of the back, or of
the thighs be very severe, the following mixture will be serviceable:
Take of—Compound Tincture of Camphor, one ounce;
Dill Water, five ounces:

A wineglassful of this mixture to be taken at bedtime occasionally, and to be repeated, if
necessary, in four hours.

373. “The whites,” during pregnancy, especially during the latter months,
and particularly if the lady has had many children, are frequently
troublesome, and are, in a measure, owing to the pressure of the womb on
the parts below causing irritation. The best way, therefore, to obviate such
pressure, is for the patient to lie down a great part of each day either on a
bed or on a sofa.
374. She ought to retire early to rest; she should sleep on a horse-hair
mattress and in a well-ventilated apartment, and she must not overload her
bed with clothes. A thick, heavy quilt at these times, and indeed at all times,
is particularly objectionable; the perspiration cannot pass readily through it
as through blankets, and thus she is weakened. She ought to live on plain,
wholesome, nourishing food; but she must abstain from beer and wine and
spirits. The bowels ought to be gently opened by means of a Seidlitz
powder, which should occasionally be taken early in the morning.

375. The best application will be, to bathe the parts with warm fuller’s
earth and water, in the proportion of a handful of powdered fuller’s earth to
half a wash-hand-basinful of warm water; and the internal parts ought,
night and morning, to be bathed with it. If the fuller’s earth should not have
the desired effect, an alum injection[70] ought, every night and morning, by
means of an india-rubber vaginal syringe,[71] to be syringed up the parts; or
fifteen drops of solution of diacetate of lead should be added to a quarter of
a pint of lukewarm water, and be used in a similar manner as the alum
injection.
376. Cleanliness, in these cases, cannot be too strongly urged. Indeed,
every woman, either married or single, ought, unless special circumstances
forbid, to use either the bidet or a sitz-bath. If she has not the “whites,” or if
she has them only slightly, cold, quite cold water is preferable to tepid. I
should advise, then, every lady, both married and single, whether she has
the “whites” or not, a regular sitz-bath[72] every morning (except during her
“poorly times”)—that is to say, I should recommend her to sit every
morning in the water (in cold water) for a few seconds, or while she can
count a hundred; throwing the while either a small blanket or shawl over
her shoulders, but having no other clothing on except slippers on her feet.
She should, for the first few mornings, make the water lukewarm; but the
sooner she can use it cold—quite cold—the more good it will do her.
377. If the above plan were more generally followed, women of all
classes and ages would derive immense benefit from its adoption, and many
serious diseases would be warded off. Besides, the use of the sitz-bath, after
a time, would be a great comfort and enjoyment.
378. Where a lady suffers severely from the “whites,” she ought to visit
the coast. There is nothing in such cases that generally affords so much
relief as the bracing effects of sea-air. Of course, if she be pregnant, she
ought not to bathe in the sea, but should, every night and morning, bathe the
external parts with sea water.
379. When the patient has been much weakened by the “whites,” she will
derive benefit from a quinine mixture[73]—a dose of which ought to be taken
twice or three times a day.
380. Irritation and itching of the external parts.—This is a most
troublesome affection, and may occur at any time, but more especially
during the latter period of the pregnancy; and as it is a subject that a lady is

too delicate and too sensitive to consult a medical man about, I think it well
to lay down a few rules for her relief. The misery it entails, if not relieved,
is almost past endurance.
381. Well, then, in the first place, let her diet be simple and nourishing;
let her avoid stimulants of all kinds. In the next place, and this is a most
important item of treatment, let her use a tepid salt and water sitz-bath.[74]
382. The way to prepare the bath is to put a large handful of table salt
into the sitz-bath, then to add cold water to the depth of three or four inches,
and sufficient hot water to make the water tepid or lukewarm. The patient
must sit in the bath; her slippered feet being, of course, out of the water, and
on the ground, and either a woolen shawl or a small blanket being thrown
over her shoulders: which shawl or blanket ought to be the only covering
she has on the while. She should remain only for a few seconds, or while
she can count, in the winter, fifty, or the summer, a hundred, in the bath.
Patients generally derive great comfort and benefit from these salt and
water sitz-baths.
383. If the itching, during the daytime, continue, the following lotion
ought to be used:
Take of—Solution of Diacetate of Lead, one drachm;
Rectified Spirits of Wine, one drachm;
Distilled Water, one pint:

To make a lotion. The parts affected to be bathed three or four times a day with the lotion. Or the
parts may be bathed two or three times a day with equal parts of vinegar and water.

384. The external parts, and the passage to the womb (the vagina), in
these cases, are not only irritable and itching, but are sometimes hot and
inflamed, and are covered either with small pimples, or with a whitish
exudation of the nature of aphtha (thrush), somewhat similar to the thrush
on the mouth of an infant; then the addition of glycerin to the lotion is a
great improvement, and usually gives immense relief. Either of the
following is a good lotion for the purpose:
Take of—Biborate of Soda, eight drachms;
Glycerin five ounces;
Distilled Water, ten ounces:

To make a lotion. The part affected to be bathed every four hours with the lotion, first shaking the
bottle.
Or,
Take of—Solution of Diacetate of Lead,

Rectified Spirits of Wine, of each, one drachm;
Glycerin, five ounces;
Rose Water, ten ounces and a half:
To make a lotion. To be used in the same manner as the preceding one.

MISCARRIAGE.

385. If a premature expulsion of the child occur before the end of the
seventh month, it is called either a miscarriage or an abortion; if between
the seventh month and before the full period of nine months, a premature
labor.
386. There is a proneness for a young wife to miscarry, and woe betide
her, if she once establish the habit! for it, unfortunately, often becomes a
habit. A miscarriage is a serious calamity, and should be considered in that
light; not only to the mother herself, whose constitution frequent
miscarriages might seriously injure, and eventually ruin; but it might rob
the wife of one of her greatest earthly privileges, the inestimable pleasure
and delight of being a mother!
387. Now, as a miscarriage may generally be prevented, it behooves a
wife to look well into the matter, and to study the subject thoroughly for
herself, in order to guard against her first miscarriage; for the first
miscarriage is the one that frequently leads to a series. How necessary it is
that the above important fact should be borne in mind! How much misery
might be averted; as, then, means would, by avoiding the usual causes, be
taken to ward off such an awful calamity. I am quite convinced that in the
majority of cases, miscarriages may be prevented.
388. Hence the importance of a popular work of this kind, to point out
dangers, to give judicious advice, that a wife may read, ponder over, and
“inwardly digest,” and that she may see the folly of the present practices
that wives—young wives especially—usually indulge in, and thus, that she
may avoid the rocks they split on, which make a shipwreck of their most
cherished hopes and treasures.
389. Let it then be thoroughly understood,—first, that a miscarriage is
very weakening—more weakening than a labor; and, secondly, that if a lady
has once miscarried, she is more likely to miscarry again and again; until, at

length, her constitution is broken, and the chances of her having a child
become small indeed!
390. Causes.—A slight cause will frequently occasion the separation of
the child from the mother, and the consequent death and expulsion of the
fœtus; hence the readiness with which a lady sometimes miscarries. The
following are the most common causes of a young wife miscarrying: Taking
long walks; riding on horseback; or over rough roads in a carriage; a long
railway journey; overexerting herself, and sitting up late at night. Her mind,
just after marriage, is frequently too much excited by large parties, by balls,
and concerts.
391. The following are, moreover, frequent causes of a miscarriage:
Falls; all violent emotions of the mind, passion, fright, etc.; fatigue;
overreaching; sudden shocks; taking a wrong step either in ascending or in
descending stairs; falling down stairs; lifting heavy weights; violent drastic
purgatives; calomel; obstinate constipation; debility of constitution;
consumptive habit of body; fashionable amusements; dancing; late hours;
tight lacing; indeed, anything and everything that injuriously affects either
the mind or the body.
392. The old maxim that “prevention is better than cure” is well
exemplified in the case of a miscarriage. Let me, then, appeal strongly to
my fair reader to do all that she can, by avoiding the usual causes of a
miscarriage which I have above enumerated, to prevent such a catastrophe.
A miscarriage is no trifling matter; it is one of the most grievous accidents
that can occur to a wife, and is truly a catastrophe.
393. Threatening or warning symptoms of a miscarriage.—A lady about
to miscarry usually, for one or two days, experiences a feeling of lassitude,
of debility, of malaise, and depression of spirits; she feels as though she
were going to be taken “poorly;” she complains of weakness and of
uneasiness about the loins, the hips, the thighs, and the lower part of the
belly. This is an important stage of the case, and one in which a judicious
medical man may, almost to a certainty, be able to stave off a miscarriage.
394. More serious, but still only threatening symptoms of a miscarriage.
—If the above symptoms are allowed to proceed, unchecked and untended,
she will, after a day or two, have a slight show of blood; this show may
soon increase to a flooding, which will shortly become clotted. Then,
perhaps, she begins for the first time to dread a miscarriage! There may at

this time be but little pain, and the miscarriage might, with judicious
treatment, be even now warded off. At all events, if the miscarriage cannot
be prevented, the ill effects to her constitution may, with care, be palliated,
and means may be used to prevent a future miscarriage.
395. Decided symptoms of a miscarriage.—If the miscarriage be still
proceeding, a new train of symptoms develop themselves; pains begin to
come on, at first slight, irregular, and of a “grinding” nature, but which soon
become more severe, regular, and “bearing down.” Indeed, the case is now
a labor in miniature; it becomes le commencement de la fin; the patient is
sure to miscarry, as the child is now dead, and separated from its connection
with the mother.
396. The most usual time for a lady to miscarry is from the eighth to the
twelfth week. It is not, of course, confined to this period, as during the
whole time of pregnancy there is a chance of a premature expulsion of the
contents of the womb. A miscarriage before the fourth month is at the time
attended with little danger; although, if neglected, it may forever injure the
constitution.
397. There is, in every miscarriage, more or less of flooding, which is the
most important symptom. After the fourth month it is accompanied with
more risk; as the further a lady is advanced in her pregnancy, the greater is
the danger of increased flooding; notwithstanding, under judicious
treatment, there is every chance of her doing well.
398. A medical man ought in such a case always to be sent for. There is
as much care required in a miscarriage as, or more than, in a labor.
399. If bearing down, expulsive pains—similar to labor pains—should
accompany the flooding; if the flooding increase, and if large clots come
away; if the breasts become smaller and softer; if there be coldness, and
heaviness, and diminution in the size of the belly; if the motion of the child
(the patient having quickened) cannot be felt; if there be “the impression of
a heavy mass rolling about the uterus [womb], or the falling of the uterine
tumor from side to side in the abdomen [belly] as the patient changes her
position;”[75] and if there be an unpleasant discharge, she may rest assured
that the child is dead, and that it is separated from all connection with her,
and that the miscarriage must proceed, it being only a question of time. Of
course, in such a case—if she has not already done so—she ought
immediately to send for a medical man. A miscarriage sometimes begins

and ends in a few days—five or six; it at other times continues a fortnight,
and even in some cases three weeks.
400. Treatment.—If a patient has the slightest “show,” she ought
immediately to confine herself either to a sofa or she should keep in bed. A
soft feather bed must be avoided; it both enervates the body and predisposes
to a miscarriage. There is nothing better for her to sleep on than a horse-hair
mattress. She either ought to lie flat upon her back or should lie upon her
side, as it is quite absurd for her merely to rest her legs and feet, as it is the
back and the belly, not the feet and the legs, that require rest.
401. Let her put herself on a low diet, such as on arrow-root, tapioca,
sago, gruel, chicken-broth, tea, toast and water, and lemonade; and
whatever she does drink ought, during the time of the miscarriage, to be
cold. Grapes, at these times, are cooling and refreshing.
402. The temperature of the bedroom should be kept cool; and, if it be
summer, the window ought to be thrown open; aperient medicines must be
avoided; and if the flooding be violent, cold water should be applied
externally to the parts.
403. Let me strongly urge upon the patient the vast importance of
preserving any and every substance that might come away, in order that it
may be carefully examined by the medical man.
404. It is utterly impossible for a doctor to declare positively that a lady
has miscarried, and that all has properly come away, if he have not had an
opportunity of examining the substances for himself. How often has a lady
declared to her medical man that she has miscarried, when she has only
parted with clots of blood! Clots sometimes put on strange appearances, and
require a practiced and professional eye to decide at all times upon what
they really are.
405. The same care is required after a miscarriage as after a labor;
indeed, a patient requires to be treated much in the same manner—that is to
say, she ought for a few days to keep her bed, and should live upon the diet
I have recommended after a confinement, avoiding for the first few days
stimulants of all kinds. Many women date their ill state of health to a
neglected miscarriage; it therefore behooves a lady to guard against such a
catastrophe.
406. A patient prone to miscarry, ought, before she become pregnant
again, to use every means to brace and strengthen her system. The best plan

that she can adopt will be TO LEAVE HER HUSBAND FOR SEVERAL MONTHS, and
go to some healthy spot; neither to a fashionable watering-place nor to a
friend’s house, where much company is kept, but to some quiet country
place; if to a healthy farm-house so much the better.
407. Early hours are quite indispensable. She ought to lie on a horse-hair
mattress, and should have but scant clothing on the bed. She must sleep in a
well-ventilated apartment. Her diet should be light and nourishing. Gentle
exercise ought to be taken, which should alternate with frequent rest.
408. Cold ablutions ought every morning to be used, and the body should
be afterward dried with a coarse cloth. If it be winter, let the water be made
tepid and let its temperature be gradually lowered until it be used quite cold.
A shower-bath is, in these cases, serviceable; it braces and invigorates the
system, and is one of the best tonics that she can use.
409. If she be already pregnant it would not be admissible, as the shock
of the shower-bath would be too great, and may bring on a miscarriage; but
still she ought to continue the cold ablutions.
410. A lady who is prone to miscarry, ought, as soon as she is pregnant,
to lie down a great part of every day; she must keep her mind calm and
unruffled; she should live on a plain diet; she ought to avoid wine and
spirits and beer; she should retire early to rest, and she must have a separate
sleeping apartment. She ought as much as possible to abstain from taking
opening medicine; and if she be actually obliged to take an aperient—for
the bowels must not be allowed to be constipated—she should select the
mildest (such as either castor oil or lenitive electuary or syrup of senna),
and even of these she ought not to take a larger dose than is absolutely
necessary, as a free action of the bowels is a frequent cause of a
miscarriage.
411. The external application of castor oil as a liniment, and as
recommended at page 144, is a good and safe remedy for a patient prone to
miscarry; and if sufficiently active, is far preferable to the mildest aperient.
Another great advantage of the external application of castor oil is, it does
not afterward produce constipation as the internal administration of castor
oil is apt to do. If the external application of castor oil in the manner
advised at page 144 should not have the desired effect, then an enema—a
clyster of warm water, a pint—ought, in the morning, two or three times a
week to be administered.

412. Gentle walking exercise daily is desirable: long walks and
horseback exercise ought to be sedulously avoided. A trip to the coast,
provided the railway journey be not very long, would be likely to prevent a
miscarriage; although I would not, on any account, recommend such a
patient either to bathe or to sail on the water, as the shock of the former
would be too great, and the motion of the vessel and the sea-sickness would
be likely to bring on what we are anxious to avoid.
413. As the usual period for miscarrying approaches (for it frequently
comes on at one particular time), let the patient be more than usually
careful; let her lie down the greatest part of the day; let her mind be kept
calm and unruffled; let all fashionable society and every exciting
amusement be eschewed; let both the sitting and the sleeping apartments be
kept cool and well ventilated; let the bowels (if they be costive) be opened
by an enema (if the external application of castor oil, as before
recommended, be not sufficient); let the diet be simple and yet be
nourishing; let all stimulants, such as beer, wine, and spirits, be at this time
avoided; and if there be the slightest symptoms of an approaching
miscarriage, such as pains in the loins, in the hips, or in the lower belly, or
if there be the slightest show of blood, let a medical man be instantly sent
for, as he may, at an early period, be able to ward off the threatened mishap.

FALSE LABOR PAINS.

414. A lady, especially in her first pregnancy, is sometimes troubled with
spurious labor pains; these pains usually come on at night, and are
frequently owing to a disordered stomach. They affect the belly, the back,
and the loins; and occasionally they extend down the hips and the thighs.
They attack first one place and then another; they come on at irregular
intervals; at one time they are violent, at another they are feeble. The pains,
instead of being grinding or bearing down, are more of a colicky nature.
415. Now, as these false pains more frequently occur in a first pregnancy,
and as they are often more violent two or three weeks toward the
completion of the full time, and as they usually come on either at night or in
the night, it behooves both the patient and the monthly nurse to be
cognizant of the fact, in order that they may not make a false alarm and

summon the doctor before he is wanted, and when he cannot be of the
slightest benefit to the patient.
416. It is sometimes stated that a woman has been in labor two or three
weeks before the child was born! Such is not the fact. The case in question
is one probably of false pains ending in true pains.
417. How, then, is the patient to know that the pains are false and not
true labor pains? False labor pains come on three or four weeks before the
full time; true labor pains at the completion of the full time; false pains are
unattended with “show;” true pains generally commence the labor with
“show;” false pains are generally migratory—changing from place to place
—first attacking the loins, then the hips, then the lower portions, and even
other portions of the belly—first one part, then another; true pains generally
begin in the back; false pains commence as spasmodic pains; true pains as
“grinding” pains; false pains come on at uncertain periods, at one time a
quarter of an hour elapsing, at others, an hour or two hours between each
pain; at one time the pain is sharp, at another trifling; true pains come on
with tolerable regularity, and gradually increase in severity.
418. But remember—the most valuable distinguishing symptom is the
absence of “show” in false labor pains, and the presence of “show” in true
labor pains. It might be said that “show” does not always usher in the
commencement of labor. Granted; but such cases are exceedingly rare, and
may be considered as the exception and not the rule.
419. Treatment.—A dose of castor oil is generally all that is necessary;
but if the pains still continue, the patient ought to be abstemious, abstaining
for a day or two from beer and from wine, and rubbing the bowels every
night at bedtime either with camphorated oil, previously warmed, or with
laudanum (taking care not to drink it by mistake). Either hot salt, in a
flannel bag, or a hot-water bag applied every night at bedtime to the bowels,
frequently affords great relief.
420. If the pains be not readily relieved she ought to send for a medical
man. A little appropriate medicine will soon have the desired effect.
421. These false labor pains might go on either for days, or even for
weeks, and at length may terminate in real labor pains.

PERIOD OF GESTATION—“THE COUNT.”

422. The period of gestation is usually[76] two hundred and eighty days—
forty weeks—ten lunar or nine calendar months.
423. It will be well for a lady, in making her “count,” to commence her
“reckoning” about three days after the last day of her being “unwell.” The
reason we fix on a woman conceiving a few days after she has “ceased to be
unwell” is that she is more apt to do so soon after menstruation than at any
other time.[77]
424. A good plan to make the “reckoning” is as follows: Let forty weeks
and a few days, from the time specified above, be marked on an almanac,
and a lady will seldom be far from her calculation. Suppose, for instance,
the last day of her “ceasing to be unwell” was on January the 15th, she may
expect to be confined very near October 23d.
425. Another plan, and one recommended by Dr. Tanner, to make the
“count,” is the following: “To effect this readily, we cannot do better than
follow the plan of most German obstetricians, who learn the probable day
of delivery thus: the date of the last menstruation being given, they
calculate three months backward and add seven days. For example, suppose
the 20th January to be the last day of the last menstrual period, labor will be
due about the 27th October—i.e. on the 280th day.”[78]

BEING OUT IN THE RECKONING.

426. A lady, sometimes, by becoming pregnant while she is suckling, is
put out of her reckoning; not being unwell at such time, she consequently
does not know how to “count.” She ought, in a case of this kind, to reckon
from the time that she quickens—that is to say, she must then consider
herself nearly half-gone in her pregnancy, and to be within a fortnight of
half her time; or, to speak more accurately, as soon as she has quickened,
we have reason to believe that she has gone about one hundred and twenty-
four days: she has therefore about one hundred and fifty-six more days to
complete the period of her pregnancy. Suppose, for instance, that she first
quickened on May the 17th, she may expect to be confined somewhere near
October the 23d. She must bear in mind, however, that she can never make
so correct a “count” from quickening (quickening takes place at such
various periods) as from the last day of her being “unwell.”

427. A lady is occasionally thrown out of her reckoning by the
appearance, the first month after she is enceinte, of a little “show.” This
discharge does not come from the womb, as that organ is hermetically
sealed; but from the upper part of the vagina, the passage to the womb, and
from the mouth of the womb, and may be known from the regular
menstrual fluid by its being much smaller in quantity, by its clotting, and by
its lasting generally but a few hours. This discharge, therefore, ought not to
be reckoned in the “count,” but the one before must be the guide, and the
plan should be adopted as recommended in page 186, paragraph 423.

“IS IT A BOY OR A GIRL?”

428. It has frequently been asked, “Can a medical man tell, before the
child is born, whether it will be a boy or girl?” Dr. F. J. W. Packman, of
Wimborne, answers in the affirmative. “Queen bees lay female eggs first,
and male eggs afterward. In the human female, conception in the first half
of the time between menstrual periods produces female offspring, and male
in the latter. When a female has gone beyond the time she calculated upon,
it will generally turn out to be a boy.”[79] It is well to say generally, as the
foregoing remarks are not invariably to be depended upon, as I have had
cases to prove. Notwithstanding, I believe that there is a good deal of truth
in Mr. Packman’s statement.

MONTHLY NURSE.

429. It is an important, a most important, consideration to choose a nurse
rightly and well.
430. A monthly nurse ought to be middle-aged. If she be young, she is apt
to be thoughtless and giggling; if she be old, she may be deaf and stupid,
and may think too much of her trouble. She should have calmness and self-
possession. She must be gentle, kind, good-tempered, and obliging, but firm
withal, and she should have a cheerful countenance. “Some seem by nature
to have a vocation for nursing; others not. Again, nursing has its separate
branches; some have the light step, the pleasant voice, the cheering smile,
the dextrous hand, the gentle touch; others are gifted in cookery for the

sick.”[80] The former good qualities are essential to a monthly nurse, and if
she can combine the latter—that is to say, “if she is gifted in cookery for the
sick”—she will, as a monthly nurse, be invaluable. Unless a woman have
the gift of nursing, she will never make a nurse. “Dr. Thynne held that sick-
nurses, like poets, were born, not made.”[81]
431. She ought neither to be a tattler, nor a tale-bearer, nor a “croaker,”
nor a “potterer.” A tattler is an abomination; a clacking tongue is most
wearisome and injurious to the patient. A tale-bearer is to be especially
avoided; if she tell tales of her former ladies, my fair reader may depend
upon it that her turn will come.[82] But of all nurses to be shunned as the
plague is the “croaker,” one that discourses of the dismal and of the
dreadful cases that have occurred in her experience, many of which, in all
probability, she herself was the cause of. She is a very upas-tree in a house.
A “potterer” should be banished from the lying-in room; she is a perpetual
worry—a perpetual blister! She is a nurse without method, without system,
and without smartness. She potters at this and potters at that, and worries
the patient beyond measure. She dreams, and drawls, and “potters.” It is
better to have a brusque and noisy nurse than a pottering one—the latter
individual is far more irritating to the patient’s nerves, and is aggravating
beyond endurance. “There is one kind of nurse that is not uncommon in
hospitals [and in lying-in rooms], and that gives more trouble and worry
than all the others together, viz., the ‘pottering’ nurse. Of all nuisances,
defend us from a potterer.... The woman always has the very best intentions
in the world, but is totally devoid of method and smartness. You never
know when she has begun anything, and you certainly will never know
when she has finished it. She never does finish it, but she sometimes leaves
off.... She seems incapable of taking in a complete and accurate idea of
anything, and even while you are speaking to her it is easy to see that her
attention cannot be concentrated, and that her mind is flying about among
half a dozen subjects. If she is in the least hurried, she loses what little
intellect she ordinarily possesses, moans feebly in a sotto voce monotone,
fetches the wrong articles, does the wrong thing at the wrong time, and is
always in the way.”[83]
432. Some monthly nurses have a knack of setting the servants at
loggerheads, and of poisoning the minds of their mistresses toward them.
They are regular mischief-makers, and frequently cause old and faithful

domestics to leave their situations. It will be seen, therefore, that it is a
momentous undertaking to choose a monthly nurse rightly and well.
433. Fortunately for ladies the class of nurses is wonderfully improved,
and the race of Sairey Gamp and Betsey Prig is nearly at an end.
434. She ought to be either a married woman or a widow. A single
woman cannot so well enter into the feelings of a lying-in patient, and has
not had the necessary experience. Moreover, a single woman, as a rule, is
not so handy with an infant (more especially in putting him for the first time
to the breast) as a married woman.
435. She must be sober, temperate, and healthy, and free from deafness
and from any defect of vision. She should have a gentle voice and manner,
but yet be neither melancholy nor hippish. She ought to be fond of children,
and must neither mind her trouble nor being disturbed at night. She should
be a light sleeper. “Scrupulous attention to cleanliness, freshness, and
neatness” in her own person, and toward the lady and the infant, are most
important requisites.
436. A fine lady-nurse that requires to be constantly waited upon by a
servant is not the one that I would recommend. A nurse should be willing to
wait upon herself, upon her mistress, and upon the baby with alacrity, with
cheerfulness, and without assistance, or she is not suitable for her situation.
437. As the nurse, if she does her duty, devotes her time, her talent, and
her best energies to the lady and infant, a mistress ought to be most liberal
in the payment of a monthly nurse. A good one is cheap at almost any price,
while a bad one, though she come for nothing, is dear indeed. A cheap nurse
is frequently the ruin of the patient’s and of the baby’s health, and of the
peace of a household.
438. The monthly nurse ought to be engaged early in the pregnancy, as a
good nurse is caught up soon, and is full of engagements. This is most
important advice. A lady frequently has to put up with an indifferent nurse
from neglecting to engage her betimes. The medical man at the eleventh
hour is frequently besought to perform an impossibility—to select a good
nurse; and which he could readily have done if time had been given him to
make the selection. Some of my best nurses are engaged by my patients as
early as two or three months after the latter have conceived, in order to
make sure of having their favorite nurses. My patients are quite right; a
good nurse is quite of as much importance to her well-doing as a good

doctor; indeed, a bad nurse oftentimes makes a good doctor’s efforts
perfectly nugatory.
439. It is always desirable, whenever it be possible, that the doctor in
attendance should himself select the monthly nurse, as she will then be used
to his ways, and he will know her antecedents—whether she be sober,
temperate, and kind, and that she understands her business, and whether she
be in the habit of attending and of following out his directions, for
frequently a nurse is self-opinionated, and fancies that she knows far better
than the medical man. Such a nurse is to be scrupulously avoided. There
cannot be two masters in a lying-in room; if there be, the unfortunate
patient will inevitably be the sufferer. A doctor’s directions must be carried
out to the very letter. It rests with the patient to select a judicious medical
man, who, although he will be obeyed, will be kind and considerate to the
nurse.
440. A monthly nurse ought to be in the house a week or ten days before
the commencement of the labor, in order that there may be neither bustle
nor excitement, and no hurrying to and fro at the last moment to find her;
and that she may have everything prepared, and the linen well aired for the
coming event.
441. She must never be allowed, unless ordered by the medical man, to
give either the patient or the baby a particle of medicine. A quacking
monthly nurse is an abomination. An infant who is everlastingly being
drugged by a nurse is sure to be puny and delicate.
442. A monthly nurse ought to understand the manner of putting on and
of tightening the bandage after a confinement. This, every night and
morning, she must do. The doctor generally does it the first time himself,
viz., immediately after the labor. It requires a little knack, and if the nurse
be at all awkward in the matter, the medical man will only be too happy to
show her the way, for he is quite aware the support, the comfort, and the
advantage it will be to his patient, and he will be glad to know that the nurse
herself will be able to continue putting it on properly for some weeks—for
at least three weeks—after the lying-in.
443. If nurses better understood the proper method of bandaging patients
after their labors, there would not be so many ladies with pendulous bellies
and with ungainly figures. It is a common remark that a lady’s figure is
spoiled in consequence of her having had so many children. This, provided

efficient bandaging after every confinement had been properly resorted to,
ought not to be. But then, if a monthly nurse is to do those things properly,
she ought to be properly trained, and many of them have little or no
training; hence the importance of choosing one who thoroughly knows and
will conscientiously do her duty.
444. A monthly nurse who thoroughly understands her business will
always have the lying-in room tidy, cheerful, and well ventilated. She will
not allow dirty linen to accumulate in the drawers, in corners, and under the
bed; nor will she allow any chamber utensil to remain for one moment in
the room after it has been used. If it be winter, she will take care that the fire
in the grate never goes out, and that it is never very large, and that the room
is kept as nearly as possible at one temperature—namely, at 60° Fahrenheit.
She will use her authority as a nurse, and keep the other children from
frequently running into the room, and from exciting and disturbing her
mistress; and she will make a point of taking charge of the baby, and of
keeping him quiet while the mother, during the day, is having her necessary
sleep.
445. A good monthly nurse fully comprehends and thoroughly
appreciates the importance of bathing the external parts concerned in
parturition every night and morning, and sometimes even oftener, for at
least two or three weeks after a confinement. And if the medical man deem
it necessary, she ought to understand the proper manner of using a vaginal
syringe. If the nurse be self-opinionated, and tries to persuade her mistress
not to have proper ablution—that such ablution will give cold—she is both
ignorant and prejudiced, and quite unfit for a monthly nurse; and my advice
is, that a lady ought on no account to engage such a person a second time.
446. In another part of this work I have entered fully on the vital
importance of ablution after a confinement, and I need not say more than
again to urge my fair reader to see that the monthly nurse properly carries it
out, and that, if there be any objections made to it by the nurse, the medical
man be appealed to in the matter, and that his judgment be final. Assured I
am that every doctor who understands his profession will agree with me,
that the regular ablution of the parts after a labor is absolutely
indispensable. The nurse, of course, will take care to guard the bed from
being wet, and will not expose the patient unnecessarily during the process;
she will be quick over it, and she will have in readiness soft, warm, dry

towels to speedily dry the parts that have been bathed. The above is most
important advice, and I hope that my fair inquirer will engage a monthly
nurse that will do her duty in the matter.
447. Before concluding a list of some of the duties of a monthly nurse,
there are four more pieces of advice I wish to give both to a wife and to a
monthly nurse herself, which are these: (1) Never to allow a nurse, until she
be ordered by the doctor, to give either brandy, or wine, or porter, or ale to
the patient. (2) I should recommend every respectable monthly nurse to
carry about with her an india-rubber vaginal syringe. One of the best for the
purpose is Higginson’s syringe,[84] which is one constructed to act either as
an enema apparatus, or, by placing the vaginal pipe over the enema pipe, as
a vaginal syringe. She will thus be armed at all points, and will be ready for
any emergency. It is an admirable invention, and cannot be too well known.
(3) I should advise a monthly nurse while on duty, whatever she may do at
other times, to doff her crinoline. A woman nursing a baby with a stuck-out
crinoline is an absurdity, and if it were not injurious both to the mother and
to the infant (as the nurse in crinoline cannot do her duty either to the one or
to the other) she would be a laughable object. A new-born baby pillowed in
steel! (4) I should recommend every monthly nurse, while in the lying-in
room, to wear either list slippers or the rubber slippers, as creaking shoes
are very irritating to a patient. “Nurses at these times should wear slippers
and not shoes. The best slippers in sick-rooms are those manufactured by
the North British Rubber Company, Edinburgh: they enable nurses to walk
in them about the room without causing the slightest noise; indeed, they
may be called ‘the noiseless slipper’—a great desideratum in such cases,
more especially in all head affections of children. If the above slippers
cannot readily be obtained, then list slippers—soles and all being made of
list—will answer the purpose equally as well.”[85]

PART III.
LABOR.

THE PRECURSORY SYMPTOMS OF LABOR.

448. A day or two before the labor commences, the patient usually feels
better than she has done for a long time; she is light and comfortable; she is
smaller, and the child is lower down; she is more cheerful, breathes more
freely, and is more inclined to take exercise, and to attend to her household
duties.
449. A few days, sometimes a few hours, before labor commences, the
child “falls,” as it is called, that is to say, there is a subsidence—a dropping
—of the womb lower down the belly. This is the reason why she feels lighter
and more comfortable, and more inclined to take exercise, and why she can
breathe more freely.
450. The only inconvenience of the subsidence of the womb is that the
womb presses on the bladder, and sometimes causes an irritability of that
organ, inducing a frequent desire to make water.
451. The subsidence—the dropping—of the womb may then be
considered one of the earliest of the precursory symptoms of the labor, and
as the herald of the coming event.
452. She has, at length, slight pains, and then she has a “show,” as it is
called; which is the coming away of a mucous plug, which, during
pregnancy, had hermetically sealed the mouth of the womb. The “show” is
generally tinged with a little blood. When a “show” takes place, she may
rest assured that labor has actually commenced. One of the early symptoms
of labor is a frequent desire to relieve the bladder.
453. She has now “grinding pains,” coming on at uncertain periods;
sometimes once during two hours, at other times every hour or half hour.
These “grinding pains” ought not to be interfered with; at this stage,
therefore, it is useless to send for a doctor; yet the monthly nurse should be

in the house, to make preparations for the coming event. Although, at this
early period, it is not necessary to send for the medical man, nevertheless, it
is well to let him know that his services might shortly be required, in order
that he might be in the way, or that he might leave word where he might
quickly be found.
454. These “grinding pains” gradually assume more regularity in their
character, return at shorter intervals, and become more severe. About this
time, shivering, in the majority of cases, is apt to occur, so as to make the
teeth chatter again. Shivering during labor is not an unfavorable symptom;
it proves, indeed, that the patient is in real earnest, and that she is making
progress.
455. She ought not, on any account, unless it be ordered by the medical
man, to take brandy as a remedy for the shivering. A cup either of hot tea or
of hot gruel will be the best remedy for the shivering; and an extra blanket
or two should be thrown over her, which ought to be well tucked around
her, in order to thoroughly exclude the air from the body. The extra clothing
should, as soon as she is warm and perspiring, be gradually removed, as she
ought not to be kept very hot, or it will weaken her, and will thus retard her
labor.
456. Sickness frequently comes on in the beginning of the labor, and may
continue during the whole process. She is not only sick, but she actually
vomits, and she can keep little or nothing on her stomach.
457. Now, sickness in labor is rather a favorable symptom, and is usually
indicative of a kind and easy confinement. There is an old saying that “sick
labors are safe.” Although they may be safe, they are decidedly
disagreeable!
458. In such a case there is little or nothing to be done, as the less an
irritable stomach is meddled with the better. The sickness will probably
leave as soon as the labor is over. Brandy, unless prescribed by the medical
man, ought not to be given.
459. She must not, on any account, force down—as her female friends or
as a “pottering” old nurse may advise to—“grinding pains:” if she do, it will
rather retard than forward her labor.
460. She had better, during this stage, either walk about or sit down, and
not confine herself to bed; indeed, there is no necessity for her, unless she
particularly desire it, to remain in her chamber.

461. If, at the commencement of the labor, the “waters should break,”
even if there be no pain, the medical man ought immediately to be sent for;
as, in such a case, it is necessary that he should know the exact presentation
of the child.
462. After an uncertain length of time, the character of the pains alters.
From being “grinding,” they become “bearing down,” and are now more
regular and frequent, and the skin becomes both hot and perspiring. These
may be considered the true labor pains. The patient ought to bear in mind
then that “the true labor pains are situated in the back and loins; they come
on at regular intervals, rise gradually up to a certain pitch of intensity, and
abate as gradually; it is a dull, heavy, deep sort of pain, producing
occasionally a low moan from the patient; not sharp or twinging, which
would elicit a very different expression of suffering from her.”[86]
463. As soon as the pains assume a “bearing down” character, the
medical man ought to be in attendance; if he be sent for during the early
stage, when the pains are of a “grinding” character, and when they come on
“few and far between,” and at uncertain intervals (unless, as before stated,
“the waters should break” early), he can do no good; for if he attempt in the
early stage to force on the labor, he might do irreparable mischief.
464. Cramps of the legs and of the thighs are a frequent, although not a
constant, attendant on labor. These cramps come on more especially if the
patient be kept for a lengthened period in one position; hence the
importance of allowing her, during the first and the second stages of labor,
to move about the room.
465. Cramps are generally worse during the third or last stage of labor,
and then, if they occur at all, they usually accompany each pain. The poor
patient, in such a case, has not only to bear the labor pains but the cramp
pains! Now, there is no danger in these cramps; it is rather a sign that the
child is making rapid progress, as he is pressing upon the nerves which
supply the thighs.
466. The nurse ought to well rub, with her warm hand, the cramped parts;
and, if the labor be not too far advanced, it would be well for the patient to
change her position, and to sit on a chair, or, if she feel inclined, to walk
about the room; there being of course an attendant, one on each side, to
support her the while. If either a pain or a cramp should come on while she
is thus moving about, let her instantly take hold of the bedpost for support.

467. I observe, in a subsequent paragraph, that in a case of labor, a four-
post mahogany bedstead without a foot-board is preferable to either a brass
or an iron bedstead. It will now be seen that this was one of my reasons for
advising the old-fashioned bedstead; as the support of a bedpost is
oftentimes a relief and a comfort. The new-fashioned mahogany bedsteads
made with fixed foot-board, and both the iron and brass bedsteads with
railings at the foot, are each and all, during the progress of labor, very
inconvenient; as the patient, with either of these kinds of bedsteads, is not
able to plant her feet firmly against the bedpost—the foot-board of the
former and the railings of the latter being in the way of her doing so. The
man who invented these new-fangled bedsteads was an ignoramus in such
matters.
468. Labor—and truly it may be called “labor”[87]—is a natural process,
and therefore ought not unnecessarily to be interfered with, or woe betide
the unfortunate patient.
469. I firmly believe that a woman would stand a much better chance of
getting well over her confinement without assistance, than if she had been
hurried with assistance.
470. In a natural labor very little assistance is needed, and the doctor is
only required in the room occasionally, to ascertain that things are going on
rightly. Those ladies do best, both at the time and afterward, whose labors
are the least interfered with. Bear this in mind, and let it be legibly written
on your memory. This advice, of course, only holds good in natural
confinements.
471. Meddlesome midwifery cannot be too strongly reprobated. The duty
of a doctor is to watch the progress of a labor, in order that, if there be
anything wrong, he may rectify it; but if the labor be going on well, he has
no business to interfere, and he need not be much in the lying-in room,
although he should be in an adjoining apartment.
472. These remarks are made to set a lady right with regard to the proper
offices of an obstetrician; as sometimes she has an idea that a medical man
is able, by constantly “taking a pain,” to greatly expedite a natural labor.
Now, this is a mistaken and mischievous, although a popular notion.
473. The frequent “taking of a pain” is very injurious and most unnatural.
It irritates and inflames the passages, and frequently retards the labor.

474. The occasional, but only the occasional, “taking of a pain” is
absolutely necessary to enable the medical man to note the state of the
parts, and the progress of the labor; but the frequent “taking of a pain” is
very objectionable and most reprehensible.
475. As a rule, then, it is neither necessary nor desirable for a medical
man to be much in a lying-in room. Really, in a natural labor, it is surprising
how very little his presence is required. After he has once ascertained the
nature of the case, which it is absolutely necessary that he should do, and
has found all going on “right and straight,” it is better, much better, that he
retire in the daytime to the drawing-room, in the night season to a bedroom,
and thus to allow nature time and full scope to take her own course without
hurry and without interference, without let and without hindrance. Nature
hates hurry and resents interference.
476. The above advice, for many reasons, is particularly useful. In the
first place, nature is not unnecessarily interfered with. Secondly, it allows a
patient, from time to time, to empty her bladder and bowels,—which, by
giving more room to the adjacent parts, greatly assists and expedites the
progress of the labor. Thirdly, if the doctor is not present he is not called
upon to be frequently “taking a pain,” which she may request him to do, as
she fancies it does her good and relieves her sufferings; but which frequent
taking of a pain in reality does her harm, and retards the progress of the
labor. No; a doctor ought not to be much in a lying-in room. Although it
may be necessary that he be near at hand, within call, to render assistance
toward the last, I emphatically declare that in an ordinary confinement—
that is to say, in what is called a natural labor—the only time, as a rule, that
the presence of the doctor can be useful, is just before the child is born;
although he ought to be in readiness, and should therefore be in the house
some little time before the event takes place. Let the above most important
advice be strongly impressed upon your memory. Oh! if a patient did but
know what a blessed thing is patience, and, in an ordinary labor, the
importance of non-interference!
477. Bear in mind, then, that in every well-formed woman, and in every
ordinary confinement, nature is perfectly competent to bring, without the
assistance of man, a child into the world, and that it is only an ignorant
person who would, in a natural case of labor, interfere to assist nature.[88]
Assist nature! Can any thing be more absurd? As though God in his

wisdom, in performing one of his greatest wonders and processes, required
the assistance of man! It might with as much truth be said that in every case
of the process of healthy digestion it is necessary for a doctor to assist the
stomach in the process of digesting the food! No; it is high time that such
fallacies were exploded, and that common sense should take the place of
such folly. A natural labor, then, ought never to be either hurried or
interfered with, or frightful consequences might, and in all probability will,
ensue. Let every lying-in woman bear in mind that the more patient she is,
the more kind and the more speedy will be her labor and her “getting
about.” Let her, moreover, remember, then, that labor is a natural process—
that all the “grinding” pains she has are doing her good service, are dilating,
softening, and relaxing the parts, and preparing for the final or “bearing
down” pains; let her further bear in mind that these pains must not, on any
account whatever, be interfered with either by the doctor, by the nurse, or by
herself. These pains are sent for a wise purpose, and they ought to be borne
with patience and resignation, and she will in due time be rewarded for all
her sufferings and anxieties by having a living child. Oh, how often have I
heard an ignorant nurse desire her mistress to bear down to a “grinding”
pain, as though it could do the slightest good! No, it only robs her of her
strength and interferes with the process and progress of the labor. Away
with such folly, and let nature assert her rights and her glorious prerogative!
It might be thought that I am tedious and prolix in insisting on non-
interference in a natural labor, but the subject is of paramount importance,
and cannot be too strongly dwelt upon, and cannot be too often brought, and
that energetically, before the notice of a lying-in woman.
478. Fortunately for ladies, there is great talent in the midwifery
department, which would prevent—however anxious a patient may be to
get out of her trouble—any improper interference.[89]
479. I say improper interference. A case sometimes, although rarely,
occurs, in which it might be necessary for the medical man to properly
interfere and to help the labor; then the patient must leave herself entirely in
the hands of her doctor—to act as he thinks best, and who may find it
necessary to use promptness and decision, and thus to save her an amount
of unnecessary lingering pain, risk, and anxiety. But these cases,
fortunately, are exceptions—rare exceptions—and not the rule.

480. It is, then, absolutely necessary, in some few cases, that a medical
man should act promptly and decisively; delay in such emergencies would
be dangerous:
“If it were done when ’tis done, then ’twere well
It were done quickly.”

481. There are times, and times without number, when a medical man is
called upon to do but little or nothing; and there are others—few and far
between—when it is imperatively necessary that he should do a great deal.
He ought at all times to be, as gentle as a lamb, but should, in certain
contingencies, be as fearless as a lion!
482. Should the husband be present during the labor? Certainly not; but
as soon as the labor is over, and all the soiled clothes have been put out of
the way, let him instantly see his wife for a few minutes, to whisper in her
ear words of affection, of gratitude, and consolation.
483. The first confinement is generally twice the length of time of an
after one, and usually the more children a lady has had, the quicker is the
labor; but this is by no means always the case, as some of the after labors
may be the tedious, while the early confinements may be the quick ones.
484. It ought to be borne in mind, too, that tedious labors are oftentimes
natural labors, and that they only require time and patience from all
concerned to bring them to a successful issue.
485. It may be said that a first labor, as a rule, lasts six hours, while an
after labor probably lasts but three. This space of time, of course, does not
usually include the commencement of labor pains, but the time that a lady
may be actually said to be in real labor. If we are to reckon from the
commencement of the labor, we ought to double the above numbers—that
is to say, we should make the average duration of a first labor twelve; of an
after labor, six hours.
486. When a lady marries late in life—for instance, after she has passed
the age of thirty—her first labor is usually much more lingering, painful,
and tedious, demanding a great stock of patience from the patient, from the
doctor, and from the friends; notwithstanding which, if she be not hurried
and be not much interfered with, both she and the baby generally do
remarkably well. Supposing a lady marries late in life, it is only the first

confinement that is usually hard and lingering; the after labors are as easy
as though she had married when young.
487. Slow labors are not necessarily dangerous; on the contrary, a patient
frequently has a better and more rapid recovery, provided there has been no
interference, after a tedious than after a quick confinement—proving
beyond doubt that nature hates hurry and interference. It is an old saying,
and, I believe, a true one, that a lying-in woman must have pain either
before or after a labor; and it certainly is far preferable that she should have
the pain and suffering before than after the labor is over.
488. It is well for a patient to know that, as a rule, after a first
confinement she never has after pains. This is some consolation, and is a
kind of compensation for her usually suffering more with her first child.
489. The after pains generally increase in intensity with every additional
child. This only bears out, in some measure, what I before advanced,
namely, that the pain is less severe and of shorter duration before each
succeeding labor, and that the pain is greater and of longer duration after
each succeeding one.
490. The after pains are intended by nature to contract—to reduce—the
womb somewhat to its non-pregnant size, and to assist clots in coming
away, and therefore ought not to be needlessly interfered with. A judicious
medical man will, however, if the pains be very severe, prescribe medicine
to moderate—not to stop—them. A doctor fortunately possesses valuable
remedies to alleviate the after pains.
491. Nature—beneficent nature—ofttimes works in secret, and is doing
good service by preparing for the coming event, unknown to all around. In
the very earliest stages of labor pain is not a necessary attendant.
492. Although pain and suffering are the usual concomitants of
childbirth, there are, nevertheless, well-authenticated cases on record of
painless parturition.[90]
493. A natural labor may be divided into three stages. The first, the
premonitory stage, comprising the “falling” or subsidence of the womb, and
the “show.” The second, the dilating stage, which is known by the pains
being of a “grinding” nature, and in which the mouth of the womb
gradually opens or dilates until it is sufficiently large to admit the exit of the
head of the child, when it becomes the third, the completing stage, which is
now indicated by the pains being of a “bearing down” expulsive character.

494. Now, in the first or premonitory stage, which is much the longest of
the three stages, it is neither necessary nor desirable that the patient should
be confined to her room; on the contrary, it is better for her to be moving
about the house, and to be attending to her household duties.
495. In the second or dilating stage, it will be necessary that she should
be confined to her room, but not to her bed. If the drawing-room be near at
hand, she ought occasionally to walk to it, and if a pain should come on the
while, lie on the sofa. In this stage it is not at all desirable that she should
keep her bed, or even lie much on it. She is better up and about, and
walking about the room.
496. In the first and the second stages she must not, on any account,
strain or bear down to the pains, as many ignorant nurses advise, as, by
robbing her of her strength, it would only retard the labor. Besides, while
the mouth of the womb is dilating, bearing down cannot be of the slightest
earthly use—the womb is not in a fit state to expel its contents. If by
bearing down she could (but which fortunately she cannot) cause the
expulsion of the child, it would, at this stage, be attended with frightful
consequences—no less than the rupture of the womb! Therefore, for the
future, let not a lady be persuaded, either by any ignorant nurse or by any
officious friend, to bear down until the last or the complete stage, when a
gentle bearing down will assist the pains to expel the child.
491. In the third or completing stage, of course it is necessary that she
should lie on a bed, and that she should, as above advised, bear gently down
to the pains. The bearing down pains will indicate to her when to bear
down.
498. If, toward the last, she be in great pain, and if she feel inclined to do
so, let her cry out,[91] and it will relieve her. A foolish nurse will tell her that
if she make a noise, it will do her harm. Away with such folly, and have
nothing to do with such simpletons!
499. Even in the last stage, she ought never to bear down unless the pain
be actually upon her; it will do her great harm if she does. In bearing down,
the plan is to hold the breath, and strain down as though she were straining
to have a stool.
500. By a patient adopting the rules just indicated, much weariness might
be avoided; cramp, from her not being kept long in one position, might be
warded off; the labor, from her being amused by change of room and scene,

might be expedited; and thus the confinement might be deprived of much of
its monotony and misery.
501. Nurses sometimes divide a labor into two kinds—a “back labor,”
and a “belly labor.” The latter is not a very elegant, although it might be an
expressive, term. Now, in a “back labor,” the patient will derive comfort by
having her back held by the nurse. This ought not to be done by the bare
hand, but let the following plan be adopted: Let a pillow be placed next to
the back, and then the nurse should apply firm pressure, the pillow
intervening between the back and the nurse’s hand or hands. If the above
method be followed, the back will not be injured, which it otherwise would
be by the pressure of the hard hand of the nurse. Where the bare hand alone
has been applied, I have known the back to continue sore and stiff for days.
502. During the latter stage of labor, the patient ought always to beep her
eyelids closed, or the straining might cause an attack of inflammation of the
eyes, or, at all events, might make them bloodshot.
503. Let a large room, if practicable, be selected for the labor, and let it
be airy and well ventilated; and, if it be summer, take care that the chimney
be not stopped. If the weather be intensely hot, there is no objection to the
window being from time to time a little opened.
504. The old-fashioned four-post mahogany bedstead is the most
convenient for a confinement, and is far preferable either to brass or to iron.
The reasons are obvious: in the first place, the patient can, in the last stage
of labor, press her feet against the bedpost, which is often a great comfort,
relief, and assistance to her. And secondly, while she is walking about the
room, and “a pain” suddenly comes on, she can, by holding the bedpost,
support herself.
505. If there be a straw mattress and a horse-hair mattress, besides the
bed, let the straw mattress be removed; as a high bed is inconvenient, not
only to the patient, but to the doctor.

PREPARATIONS FOR LABOR.

506. I should strongly urge a patient not to put everything off to the last.
She must take care to have in readiness a good pair of scissors and a skein
of whity-brown thread. And she ought to have in the house a small pot of

fresh lard—that is to say, unsalted lard,[92] that it may be at hand in case it is
wanted. Let everything necessary both for herself and the babe be well aired
and ready for immediate use, and be placed in such order that all things
may, without hurry or bustle, at a moment’s notice, be found.
507. Another preparation for labor, and a most important one, is,
attending to the state of the bowels. If they are at all costive, the moment
there is the slightest premonitory symptom of labor, she ought to take either
a teaspoonful or a dessertspoonful (according to the nature of her bowels,
whether she be easily moved or otherwise) of castor oil. If she object to
taking the oil, then let her have an enema of warm water, a pint,
administered. By adopting either of the above plans she will derive the
greatest comfort and advantage. It will prevent her delicacy from being
shocked by having her bowels opened, without her being able to prevent
them, during the last stage of labor; and it will, by giving the adjacent parts
more room, much expedite the confinement and lessen her sufferings.
508. The next thing to be attended to is the way in which she ought to be
dressed for the occasion. I would recommend her to put on her clean night-
gown, which, in order to keep it clean and unsoiled, should be smoothly and
carefully rolled up about her waist; then she ought to wear over it a short
bed-gown reaching to the hips, and have on a flannel petticoat to meet it,
and then she should put on a dressing-gown over all. If it be winter, the
dressing-gown had better either be composed of flannel or be lined with
that material. The stays must not be worn, as they would interfere with the
progress of the labor.
509. The valances of the bed, and the carpet, and the curtains at the foot
of the bed, had better all be removed; they are only in the way, and may get
soiled and spoiled.
510. “The guarding of the bed.”—This is done in the following way:
Cover the right side of the bed (as the patient will have to lie on her left
side), with a large piece—a yard and a half square—of waterproof cloth, or
bed-sheeting, as it is sometimes called, which is sold for the purpose;[93]
over this, folded sheets ought to be placed. If a waterproof cloth cannot be
procured, an oil-cloth table-cover will answer the purpose. Either of the
above plans will effectually protect the bed from injury.
511. The lying-in room should be kept not hot, but comfortably warm; if
the temperature of the room be high, the patient will become irritable,

feverish, and restless.
512. Every now and then, in order to change the air, let the door of the
room be left ajar; and if, in the early periods of the labor, she should retire
for awhile to the drawing-room, let the lying-in room window be thrown
wide open, so as to thoroughly ventilate the apartment, and to make it fresh
and sweet on her return. If the weather be very warm, the lower sash of the
window may for a few inches be opened. It is wonderful how refreshing to
the spirits, and how strengthening to the frame, a well-ventilated room is to
a lying-in patient.
513. Many attendants are not only unnecessary but injurious. They excite
and flurry the patient, they cause noise and confusion, and rob the air of its
purity. One lady friend besides the doctor and the monthly nurse is all that
is needed.
514. In making the selection of a friend, care should be taken that she is
the mother of a family, that she is kind-hearted and self-possessed, and of a
cheerful turn of mind. At these times all “chatterers,” “croakers,” and
“potterers” ought to be carefully excluded from the lying-in room. No
conversation of a depressing character should for one moment be allowed.
Nurses and friends who are in the habit of telling of bad cases that have
occurred in their experience must be avoided as the plague. If nurses have
had bad cases, many of them have probably been of their own making; such
nurses, therefore, ought on every account to be shunned.
515. During the progress of the labor, boisterous and noisy conversation
ought never to be permitted; it only irritates and excites the patient.
Although boisterous merriment is bad, yet at such times quiet, cheerful, and
agreeable conversation is beneficial.
516. A mother on these occasions is often present; but of all persons she
is the most unsuitable, as, from her maternal anxiety, she tends rather to
depress than to cheer her daughter. Though the mother ought not to be in
the room, it is, if practicable, desirable that she should be in the house. The
patient, in the generality of cases, derives comfort from the knowledge of
her mother being so near at hand.
517. Another preparation for labor is to soothe her mind by telling her of
the usual safety of confinements, and by assuring her that, in the generality
of instances, it is a natural process; and that all she has to do is to keep up
her spirits, to adhere strictly to the rules of her doctor, and she will do well.

518. Tell her that “sweet is pleasure after pain;”[94] tell her, too, of the
exquisite happiness and joy she will feel as soon as the labor is over, as
perhaps the greatest thrill of delight a woman ever experiences in this world
is when her babe is first born. She, as if by magic, forgets all the sorrow and
suffering she has endured. “A woman when she is in travail hath sorrow,
because her hour is come; but as soon as she is delivered of the child, she
remembereth no more the anguish, for joy that a man is born into the
world.”[95] Keble, in the Christian Year, well observes:
“Mysterious to all thought,
A mother’s prime of bliss,
When to her eager lips is brought
Her infant’s thrilling kiss.”

Rogers, too, in referring to this interesting event, sweetly sings:
“The hour arrives, the moment wished and feared;
The child is born, by many a pang endeared!
And now the mother’s ear has caught his cry—
Oh! grant the cherub to her asking eye!
He comes—she clasps him; to her bosom pressed,
He drinks the balm of life, and drops to rest.”

519. The doctor, too, will be able to administer comfort to her when he
has “tried a pain” or has “taken a pain,” as it is called, and when he can
assure her that it “is all right and straight”—that is to say, that the child is
presenting in the most favorable position, and that everything is progressing
satisfactorily. He will, moreover, be able to inform her of the probable
duration of the labor.
520. Let me in this place urge upon the patient the importance of her
allowing the medical man to inquire fully into her state. She may depend
upon it that this inquiry will be conducted in the most delicate manner. If
there be anything wrong in the labor, it is in the early stage, and before the
“waters have broken,” that the most good can be done. If a proper
examination be not allowed to the medical man whenever he deems it right
and proper (and a judicious doctor will do it as seldom as he can), her life,
and perhaps that of her child, might pay the penalty of such false delicacy.
521. French brandy, in case it is wanted, ought always to be in the house;
but let me impress upon the minds of the attendants the importance of
withholding it, unless it be ordered by the doctor, from a lying-in woman.
Numbers have fallen victims to brandy being indiscriminately given. I am

of opinion that the great caution which is now adopted in giving spirits to
women in labor is one reason, among others, of the great safety of the
confinements of the present day, compared with those of former times.
522. The best beverage for a patient during labor is either a cup of warm
tea, or of gruel, or of arrow-root. It is folly in the extreme, during the
progress of labor, to force her to eat: her stomach recoils from it, as at these
times there is generally a loathing of food, and if we will, as we always
ought to, take the appetite as our guide, we shall never go far wrong.
523. A patient during labor ought frequently to make water; by doing so
she will add materially to her ease and comfort, and it will give the adjacent
parts more room, and will thus expedite the labor. I wish to call attention to
this point, as many ladies, especially with their first children, have, from
false delicacy, suffered severely from not attending to it; one of the ill
effects of which is inability after the labor is over to make water without the
assistance of the doctor, who might in an extreme case deem it necessary to
introduce a catheter into the bladder, and thus to draw the water off.
524. I recommended, in a previous paragraph, that the doctor ought to
have either the drawing-room or a bedroom to retire to, in order that the
patient may, during the progress of the labor, be left very much to herself,
and that thus she may have full opportunities, whenever she feels the
slightest inclination to do so, of thoroughly emptying either her bladder or
her bowels. Now, this advice is of very great importance, and if it were,
more than it is, attended to, would cause a great diminution of misery, of
annoyance, and suffering. I have given the subject great attention; as I have
had large experience in midwifery practice; I therefore speak “like one
having authority,” and if my advice in this particular be followed, this book
will not have been written in vain.
525. If the patient, twelve hours after the labor, and having tried two or
three times during that time, is unable to make water, the medical man
ought to be made acquainted with it, or serious consequences might ensue.

CHLOROFORM IN HARD AND IN LINGERING LABOR.

526. Mothers and doctors are indebted to Dr.—now Sir James—Simpson
for the introduction of chloroform, one of the greatest and most valuable

discoveries ever conferred on suffering humanity.
527. Sulphuric ether was formerly used to cause insensibility to pain; but
it is far inferior to chloroform, and is now, in this country, very seldom
employed; while the inhalation of chloroform, especially in cases of hard
and of lingering labor, is every day becoming more general, and will do so
still more extensively as its value is better understood, and when, in well-
selected cases, its comparative freedom from danger is sufficiently
appreciated.
528. Chloroform, then, is a great boon in midwifery practice; indeed, we
may say with Dr. Kidd,[96] that in labor cases “it has proved to be almost a
greater boon than in the experimental and gigantic operations of the
surgeon.” It may be administered in labor by a medical man with perfect
safety. I have given it in numerous instances, and have always been
satisfied with the result.
529. The inhalation of chloroform causes either partial or complete
unconsciousness, and freedom from pain either for a longer or for a shorter
time, according to the will of the operator. In other words, the effects might
with perfect safety be continued either for a few minutes, or from time to
time for several hours; indeed, if given in proper cases, and by a judicious
medical man, with immense benefit.
530. Chloroform is more applicable and useful in a labor—more
especially in a first labor—when it is lingering, when the pains are very
severe, and when, notwithstanding the pain, it is making but little progress,
—then chloroform is a priceless boon.
531. Chloroform, too, is very beneficial when the patient is of a nervous
temperament, and when she looks forward with dread and apprehension to
each labor pain.
532. It might be asked,—Would you give chloroform in every case of
labor, be it ever so easy and quick? Certainly not: it is neither advisable nor
expedient, in an ordinary, easy, quick labor, to administer it.
533. The cases in which it is desirable to give chloroform are all
lingering, hard, and severe ordinary labors. In such I would gladly use it.
But before administering it, I would, as a rule, wait for at least six hours
from the commencement of the labor.

534. Oh, the delightful and magical effects of it in the cases here
described! the lying-in room, from being in a state of gloom, despondency,
and misery, is instantly transformed, by its means, into one of cheerfulness,
hope, and happiness!
535. When once a lying-in woman has experienced the good effects of
chloroform in assuaging her agony, she importunately, at every recurrence
of “the pain,” urges her medical man to give her more! In all her subsequent
confinements, having once tasted the good effects of chloroform, she does
not dread them. I have frequently heard a lady declare that, now (if her
labor be either hard or lingering) she can have chloroform, she looks
forward to the period of childbirth with confidence and hope.
536. It might be asked,—Does the inhalation of chloroform retard the
patient’s “getting about”? I emphatically declare that it does not do so.
Those who have had chloroform have always, in my practice, had as good
and as speedy recoveries as those who have not inhaled it.
537. One important consideration in the giving of chloroform in labor is,
that a patient has seldom, if ever, while under the effects of it, been known
to die; which is more than can be said when it has been administered in
surgical operations, in the extraction of teeth, etc. “I know there is not one
well-attested death from chloroform in midwifery in all our journals.”[97]
538. One reason why it may be so safe to give chloroform in labor is, that
in the practice of midwifery a medical man does not deem it needful to put
his patient under the extreme influence of it. He administers just enough to
ease her pain, but not sufficient to rob her of total consciousness; while in a
surgical operation the surgeon may consider it necessary to put his patient
under the full influence of chloroform: hence the safety in the one, and the
danger in the other case. “It is quite possible to afford immense relief, to
‘render the pains quite bearable,’ as a patient of mine observed, by a dose
which does not procure sleep or impair the mental condition of the patient,
and which all our experience would show is absolutely free from danger.”[98]
539. There is another advantage in chloroform,—the child, when he is
born, is usually both lively and strong, and is not at all affected by the
mother having had chloroform administered to her. This is a most important
consideration.
540. The doctor, too, as I before remarked, is deeply indebted to Sir J.
Simpson for this great boon: formerly he dreaded a tedious and hard labor;

now he does not do so, as he is fully aware that chloroform will rob such a
lying-in of much of its terror and most of its pain and suffering, and will in
all probability materially shorten the duration of the confinement.
541. Chloroform ought never to be administered, either to a labor patient
or to any one else, except by a medical man. This advice admits of no
exception. And chloroform should never be given unless it be either in a
lingering or in a hard labor. As I have before advised, in a natural, easy,
everyday labor, nature ought not to be interfered with, but should be
allowed to run its own course. Patience, gentleness, and non-interference
are the best and the chief requisites required in the majority of labor cases.

HINTS TO ATTENDANTS IN CASE THE DOCTOR IS
UNAVOIDABLY ABSENT.

542. It frequently happens that after the first confinement the labor is so
rapid that the child is born before the doctor has time to reach the patient.
543. It is consequently highly desirable—nay, imperatively necessary—
for the interest and for the well-doing both of the mother and of the baby,
that either the nurse or the lady friend should, in such an emergency, know
what to do and what NOT to do. I therefore, in the few following paragraphs,
purpose, in the simplest and clearest language I can command, to enlighten
them on the subject.
544. In the first place, let the attendants be both calm and self-possessed,
and let there be no noise, no scuffling, no excitement, no whispering, and
no talking, and let the patient be made to thoroughly understand that there is
not the slightest danger; as the principal danger will be in causing
unnecessary fears both as to herself and her child. Tens of thousands are
annually delivered in England, and everywhere else, without the slightest
assistance from a doctor,[99]—he not being at hand or not being in time; and
yet both mother and child almost invariably do well. Let her be informed of
this fact—for it is a fact—and it will be a comfort to her and will assuage
her fears. The medical man, as soon as he arrives, will soon make all right
and straight.
545. In the mean time let the following directions be followed: Supposing
a child to be born before the medical man arrives, the nurse ought then to

ascertain whether a coil of navel-string be around the neck of the infant; if it
be, it must be instantly liberated, or he might be strangled. Care should be
taken that he has sufficient room to breathe, that there be not a “membrane”
over his mouth;[100] and that his face be not buried in the clothes. Any mucus
about the mouth of the babe ought, with a soft napkin, to be wiped away, or
it might impede the breathing.
546. Every infant, the moment he comes into the world, ought to cry; if
he does not naturally, he should be made to do so by smacking his buttocks
until he does cry. He will then be safe:
“We came crying hither.
Thou know’st, the first time we smell the air
We waul and cry.”[101]

547. If the doctor has not arrived, cheerfulness, quietness, and presence
of mind must be observed by all around; otherwise, the patient may become
excited and alarmed, and dangerous consequences might ensue.
548. If the infant should be born apparently dead, a few smart blows
must be given on the buttocks and on the back; a smelling-bottle ought to
be applied to the nostrils, or rag should be singed under the nose, taking
care that the burning tinder does not touch the skin; and cold water must be
freely sprinkled on the face. The navel-string, as long as there is pulsation
in it, ought not to be tied.
549. The limbs, the back, and the chest of the child ought to be well
rubbed with the warm hand. The face should not be smothered up in the
clothes. If pulsation has ceased in the navel-string (the above rules having
been strictly followed, and having failed), let the navel-string be tied and
divided,[102] and then let the child be plunged into warm water—98° Fahr. If
the sudden plunge does not rouse respiration into action, let him be taken
out of the warm bath, as the keeping him for any length of time in the water
will be of no avail.
550. If these simple means should not quickly succeed, although they
generally will, Dr. Marshall Hall’s Ready Method ought in the following
manner to be tried: “Place the infant on his face; turn the body gently but
completely on the side and a little beyond, and then on the face, alternately;
repeating these measures deliberately, efficiently, and perseveringly, fifteen
times in the minute only.”

551. Another plan of restoring suspended animation is by artificial
respiration, which should be employed in the following manner: Let the
nurse (in the absence of the doctor) squeeze, with her left hand, the child’s
nose, to prevent any passage of air through the nostrils; then let her apply
her mouth to the child’s mouth, and breathe into it, in order to inflate the
lungs; as soon as they are inflated, the air ought, with the right hand, to be
pressed out again, so as to imitate natural breathing. Again and again, for
several minutes, and for about fifteen times a minute, should the above
process be repeated; and the operator will frequently be rewarded by
hearing a convulsive sob, which will be the harbinger of renewed life.
552. Until animation be restored, the navel-string, provided there be
pulsation in it, ought not to be tied. If it be tied before the child has
breathed, and before he has cried, he will have but a slight chance of
recovery. While the navel-string is left entire, provided there be still
pulsation in it, the infant has the advantage of the mother’s circulation and
support.
553. If Dr. Marshall Hall’s Ready Method and if artificial respiration
should not succeed, he must be immersed up to his neck in a warm bath of
98° Fahrenheit. A plentiful supply of warm water ought always to be in
readiness, more especially if the labor be either hard or lingering.
554. Should the child have been born for some time before the doctor has
arrived, it may be necessary to tie and to divide the navel-string. The
manner of performing it is as follows: A ligature, composed of four or five
whity-brown threads, nearly a foot in length and with a knot at each end,
ought, by a double knot, to be tightly tied, at about two inches from the
body of the child, around the navel-string. A second ligature must, in a
similar manner, be applied about three inches from the first, and the navel-
string should be carefully divided midway between the two ligatures. Of
course, if the medical man should shortly be expected, any interference
would not be advisable, as such matters ought always to be left entirely to
him.
555. The after birth must never be brought away by the nurse: if the
doctor has not yet arrived, it should be allowed to come away (which, if left
alone in the generality of cases, it generally will) of its own accord. The
only treatment that the nurse ought in such a case to adopt is, that she apply,
by means of her right hand, firm pressure over the region of the womb: this

will have the effect of encouraging the contraction of the womb, of
throwing off the after birth, and of preventing violent flooding.
556. If the after birth does not soon come away, say in an hour, or if there
be flooding, another medical man ought to be sent for; but on no account
should the nurse be allowed to interfere with it further than by applying
firm pressure over the region of the womb, and not touching the navel-
string at all; as I have known dangerous, and in some cases even fatal,
consequences to ensue from such meddling.

REST AFTER DELIVERY.

557. A lady ought never to be disturbed for at least an hour after the
delivery; if she be, violent flooding might be produced. The doctor, of
course, will make her comfortable by removing the soiled napkins, and by
applying clean ones in their place.
558. Her head ought to be made easy; she must still lie on her side;
indeed, for the first hour let her remain nearly in the same position as that in
which she was confined—with this only difference, that if her feet have
been pressing against the bedpost, they should be removed from that
position.

CLOTHING AFTER LABOR.

559. She ought, after the lapse of an hour or two, to be moved from one
side of the bed to the other. It ought to be done in the most tender and
cautious manner. She must not, on any account whatever, be allowed to sit
erect in the bed. While being moved, she herself should be passive—that is
to say, she ought to use no exertion, no effort, but should, by two attendants,
be removed from side to side; one must take hold of her shoulders, the other
of her hips.
560. A patient, after delivery, usually feels shivering and starved; it will
therefore be necessary to throw additional clothing, such as a blanket or
two, over her, which ought to envelop the body, and should be well tucked
around her; but the nurse ought to be careful not to overload her with
clothes, or it might produce flooding, fainting, etc.; as soon, therefore, as

she is warmer, let the extra clothing be gradually removed. If the feet be
cold, let them be wrapped in a warm flannel petticoat, over which a pillow
should be placed.
561. A frequent change of linen after confinement is desirable. Nothing is
more conducive to health than cleanliness. Great care should be taken to
have the sheets and linen well aired.

REFRESHMENT.

562. A cup of cool, black tea, directly after a patient is confined, ought to
be given. I say cool, not cold, as cold tea might chill her. Hot tea would be
improper, as it might induce flooding.
563. As soon as she is settled in bed, there is nothing better than a small
basin of warm gruel.
564. Brandy ought never, unless ordered by the medical man, to be given
after a confinement. Warm beer is also objectionable; indeed, stimulants of
all kinds must, unless advised by the doctor, be carefully avoided, as they
would only produce fever, and probably inflammation. Caudle is now
seldom given; but still, some old-fashioned people are fond of
recommending it after a labor. Caudle ought to be banished the lying-in
room; it caused in former times the death of thousands.

BANDAGE AFTER A CONFINEMENT.

565. (1) This consists of thick linen, similar to sheeting, about a yard and
a half long, and sufficiently broad to comfortably support the belly. It ought
to be put on moderately tight; and should be retightened every night and
morning, or oftener, if it become slack. (2) Salmon’s Obstetric Binder is
admirably adapted to give support after a confinement, and may be obtained
of any respectable surgical-instrument-maker.
566. If there be not either a proper bandage or binder at hand—(3) a yard
and a half of unbleached calico, folded double, will answer the purpose.
The best pins to fasten the bandages are the patent safety nursery-pins. The
binder requires no pins.

567. A support to the belly after labor is important: in the first place, it is
a great comfort; in the second, it induces the belly to return to its original
size; and lastly, it prevents flooding. Those ladies, more especially if they
have had large families, who have neglected proper bandaging after their
confinements, frequently suffer from enlarged and pendulous bellies, which
give them an unwieldy and ungainly appearance.

POSITION.

568. The way of placing the patient in bed.—She ought not, immediately
after a labor, under any pretext or pretense whatever, to be allowed to raise
herself in bed. If she be dressed, as recommended at paragraph 508, her
soiled linen may readily be removed; and she may be drawn up by two
assistants—one being at the shoulders and the other at the legs—to the
proper place, as she herself must not be allowed to use the slightest
exertion.
569. Inattention to the above recommendation has caused violent
flooding, fainting, bearing down of the womb, etc., and in some cases even
fatal consequences.

THE LYING-IN ROOM.

570. The room to be kept cool and well ventilated.—A nurse is too apt,
after the confinement is over, to keep a large fire. Nothing is more injurious
than to have the temperature of a lying-in room high. A little fire, provided
the weather be cold, to dress the baby by, and to encourage a circulation of
the air, is desirable. A fire-guard ought to be attached to the grate of the
lying-in room. The door must occasionally be left ajar, in order to change
the air of the apartment; a lying-in woman requires pure air as much as any
other person; but how frequently does the nurse fancy that it is dangerous
for her to breathe it!
571. After the affair is over, the blinds ought to be put down, and the
window curtains should be drawn, in order to induce the patient to have a
sleep, and thus to rest herself after her hard work. Perfect stillness must
reign both in the room and in the house.

572. It is really surprising, in this present enlightened age, how much
misconception and prejudice there still is among the attendants of a lying-in
room; they fancy labor to be a disease, instead of being what it really is—a
natural process; and that old-fashioned notions, and not common sense,
ought to guide them.
573. The patient should, after the labor, be strictly prohibited from
talking; and noisy conversation ought not to be allowed; indeed, she cannot
be kept too quiet, as she may then be induced to fall into a sweet sleep,
which would recruit her wasted strength. As soon as the baby is washed and
dressed, and the mother is made comfortable in bed, the nurse ought alone
to remain; let every one else be banished the lying-in room. Visitors should
on no account, until the medical man gives permission, be allowed to see
the patient.

THE BLADDER.

574. Ought a patient to go to sleep before she has made water?—There
is not the least danger in her doing so (although some old-fashioned person
might tell her that there is); nevertheless, before she goes to sleep, if she
have the slightest inclination she should respond to it, as it would make her
feel more comfortable and sleep more sweetly.
575. Let me urge the importance of the patient, immediately after
childbirth, making water while she is in a lying position. I have known
violent flooding to arise from a lying-in woman being allowed, soon after
delivery, to sit up while passing her water.
576. The “female slipper”[103] (previously warmed by dipping it in very
hot water and then quickly drying it) ought, at these times, and for some
days after a confinement, to be used. It is admirably adapted for the
purpose, as it takes up but little room and is conveniently shaped, and
readily slips under the patient, and enables her to make water comfortably,
she being perfectly passive the while. It should be passed under her in front,
and not at the side of the body.
577. If there be any difficulty in her making water, the medical man
must, through the nurse, be immediately informed of it. False delicacy
ought never to stand in the way of this advice. It should be borne in mind

that, after either a very lingering or a severe labor, there is frequently
retention of urine,—that is to say, that although the bladder may be full of
water, the patient is, without assistance, unable to make it.
578. After the patient, while lying down, trying several times to pass her
water, and after, allowing twelve or fifteen hours to elapse, and not being
able to do so, it will be well for her to try the following method: Let the pot
de chambre be well warmed, let the rim be covered with flannel, let her,
supported the while by the nurse, kneel on the bed, her shoulders being
covered with a warm shawl; then let her, with the pot de chambre properly
placed between her knees on the bed, try to make water, and the chances are
that she will now succeed.
579. If she does not, twenty-four hours having elapsed, the doctor must
be informed of the fact; and it will then be necessary, absolutely necessary,
for him, by means of a catheter, to draw off the water. It might be well to
state that the passing of a catheter is unattended with either the slightest
danger or pain; and that it is done without exposing her, and thus without
shocking her modesty.

THE BOWELS.

580. The bowels are usually costive after a confinement. This confined
state of the bowels after labor is doubtless a wise provision of nature, in
order to give repose to the surrounding parts—especially to the womb; it is
well, therefore, not to interfere with them, but to let them have perfect rest
for three days. Sometimes before the expiration of the third day the bowels
are relieved, either without medicine or merely by the taking of a cupful of
warm coffee. If such be the case, all well and good; as it is much better that
the bowels should be relieved without medicine than by medicine; but if,
having taken the coffee, at the end of the third day they are not opened, then
early on the following—the fourth—morning, a dose of castor oil should be
given in the manner recommended at paragraph 281. Either a teaspoonful or
a dessertspoonful, according to the constitution of the patient, will be a
proper dose. If, in the course of twelve hours, it should not have the desired
effect, it must be repeated. The old-fashioned custom was to give castor oil
on the morning after the confinement; this, as I have before proved, was a
mistaken plan.

581. After a lying-in, and when the bowels are not opened either
naturally or by the taking of a cupful of warm coffee, if medicine be given
by the mouth, castor oil is the best medicine, as it does not irritate either the
patient’s bowels, or, through the mother’s milk, gripe the infant. Aperient
pills, as they most of them contain either colocynth or aloes, or both,
frequently give great pain to the babe, and purge him much more than they
do the mother herself; aperient pills, therefore, after a confinement ought
never to be taken.
582. If the patient object to the taking of castor oil, let the nurse, by
means of an enema apparatus, administer an enema. This is an excellent,
indeed the best, method of opening the bowels, as it neither interferes with
the appetite nor with the digestion; it does away with the nauseousness of
castor oil, and does not, in the administration, give the slightest pain. If the
first enema should not have the desired effect, let one be given every
quarter of an hour until relief be obtained. One of the best for the purpose is
the following:
Take of—Olive oil, two tablespoonfuls;
Table salt, two tablespoonfuls;
Warm oatmeal gruel, one pint;

To make a clyster.

Another capital enema for the purpose is one made of Castile soap
dissolved in warm water.
583. If the patient object both to the taking of the castor oil and to the
administration of an enema, then the following draught will be found
useful; it will act kindly, and will neither gripe the mother nor the child:
Take of—Concentrated Essence of Senna, half an ounce;
Syrup of Ginger, one drachm;
Distilled Water, seven drachms:

To make a draught. To be taken early in the morning.
If in twelve hours the above draught should not have the desired effect
(although, if the essence of senna be good, it usually does long before that
time), let the draught be repeated. If the bowels be easily moved, half of the
above draught is generally sufficient; if it be not so in twelve hours, the
remainder should be taken. But let every lying-in woman bear in mind that
as soon as her bowels will act, either naturally or by the taking of a cupful

of warm coffee, without an aperient, not a particle of opening medicine
should be taken.
584. But, after all that can be said on the subject, there is no better
method in the world for opening a lying-in patient’s bowels, when costive,
than (if the cup of coffee be not sufficiently powerful) by giving her an
enema, as advised in a previous paragraph. An enema is safe, speedy,
painless, and effectual, and does not induce costiveness afterward, which
castor oil, and all other aperients, if repeatedly taken, most assuredly will.
585. An enema, then, is an admirable method of opening costive bowels,
both during suckling and during pregnancy, and deserves to be more
universally followed than it now is; fortunately, the plan just recommended
is making rapid progress, and shortly will, with ladies at such times, entirely
supersede the necessity of administering aperients by the mouth.
586. Aperients, after a confinement, were in olden times, as a matter of
course, repeatedly given both to the mother and to the babe, to their utter
disgust and to their serious detriment! This was only one of the numerous
mistakes and follies that formerly prevailed in the lying-in room.
Unfortunately, in those days a confinement was looked upon as a disease,
and to be physicked accordingly. A better state of things is happily now
dawning.
587. When the patient’s bowels, for the first few days after the
confinement, require to be opened, she ought to use either the French bed-
pan or the bed-pan of the Liverpool Northern Hospital. Either the one or the
other of these pans is a great improvement on the old-fashioned bed-pans,
as they will readily slip under the patient, and will enable her, while lying
down and while she is perfectly passive in bed, to have her bowels relieved,
which at these times is very desirable. The French bed-pan or the bed-pan
of the Liverpool Northern Hospital is admirably adapted for a lying-in
room; indeed, no lying-in room ought to be without either the one or the
other of these useful inventions. “A flannel cap for the toe-part, held on by
strings round the heel, will afford considerable comfort to the patient.”[104]

“CLEANSINGS”—ABLUTIONS.

588. The “Cleansings.”—This watery discharge occurs directly after a
lying-in, and lasts either a week or a fortnight, and sometimes even longer.
It is, at first, of a reddish color; this gradually changes to a brownish hue,
and afterward to a greenish shade; hence the name of “green waters.” It has
in some cases a disagreeable odor. A moderate discharge is necessary; but
when it is profuse, it weakens the patient.
589. Some ignorant nurses object to have the parts bathed after delivery;
they have the impression that such a proceeding would give cold. Now,
warm fomentation twice a day, and even oftener, either if the discharge or if
the state of the parts requires it, is absolutely indispensable to health, to
cleanliness, and comfort. Ablutions, indeed, at this time are far more
necessary than at any other period of a woman’s existence.
590. There is nothing better for the purpose than a soft sponge and warm
water, unless the parts be very sore; if they be, a warm fomentation, two or
three times a day, of marshmallows and chamomile,[105] will afford great
relief, or the parts may be bathed with warm oatmeal gruel, of course
without salt. In these cases, too, I have found warm barm (yeast) and water
a great comfort, and which will soon take away the soreness. The parts
ought, after each fomentation, to be well but quickly dried with warm, dry,
soft towels.
591. If the internal parts be very sore, it may be necessary, two or three
times a day, to syringe them out, by means of an india-rubber vaginal
syringe,[106] with either of the above remedies. Hence the importance of
having a good monthly nurse, of having one who thoroughly understands
her business.
592. Let the above rules be strictly followed. Let no prejudices and no
old-fashioned notions, either of the nurse or of any female friend, stand in
the way of the above advice. Ablution of the parts, then, after a
confinement, and that frequently, is absolutely required, or evil results will,
as a matter of course, ensue.

REST AND QUIETUDE.

593. A horizontal—a level—position for either ten days or a fortnight
after a labor is important. A lady frequently fancies that if she supports her

legs, it is all that is necessary. Now, this is absurd; it is the womb and not
the legs that requires rest; and the only way to obtain it is by lying flat
either on a bed or on a sofa: for the first five or six days, day and night, on a
bed, and then for the next five or six days she ought to be removed for a
short period of the day either to another bed or to a sofa; which other bed or
sofa should be wheeled to the side of the bed, and she must be placed on it
by two assistants, one taking hold of her shoulders and the other of her hips,
and thus lifting her on the bed or sofa, she herself being perfectly passive,
and not being allowed to sit erect the while. She ought, during the time she
is on the sofa, to maintain the level position.
594. She ought, after the first nine days, to sit up for an hour; she should
gradually prolong the time of the sitting; but still she must, for the first
fortnight, lie down a great part of every day. She should, after the first
week, lie either on a sofa or on a horse-hair mattress.
595. The above plan may appear irksome, but my experience tells me that
it is necessary, absolutely necessary. The benefit the patient will ultimately
reap from it will amply repay the temporary annoyance of so much rest.
Where the above rules have not been adopted, I have known flooding,
bearing down of the womb, and even “falling” of the womb, frequent
miscarriages, and ultimately ruin of the constitution, to ensue.
596. “Falling of the womb” is a disagreeable complaint, and the
misfortune of it is, that every additional child increases the infirmity. Now,
all this might, in the majority of cases, have been prevented, if the
recumbent posture for ten days or a fortnight after delivery had been strictly
adopted.
597. If a patient labor under a “falling of the womb,” she ought to apply
to a medical man, who will provide her with a proper support, called a
pessary, which will prevent the womb from “falling down,” and will
effectually keep it in its proper place.
598. It is only a medical man, accustomed to these matters, who can
select a pessary suitable for each individual case. A proper kind of, and
duly-adjusted, pessary is a great comfort to a patient, and will enable her
both to take her proper exercise and to follow her ordinary employments;
indeed, if a suitable pessary be used, it is so comfortable that the patient
often forgets that she is wearing one at all. Those pessaries ought only to be
employed that can be removed every night, as there is not the least

necessity for a patient to sleep in one, as the womb does not usually come
down when the patient is lying down. Moreover, a pessary ought to be kept
perfectly clean, and unless it be daily removed it is utterly impossible to
keep it so. It is a great comfort and advantage to a patient to be able both to
introduce and to remove the pessary herself, which, if a proper kind be
employed, she can, when once taught, readily do.
599. If “falling of the womb” be early and properly treated, there is a
good chance of a patient being perfectly cured, and thus of being able to
dispense with a pessary altogether.

DIETARY.

600. For the first day the diet should consist of nicely made and well-
boiled gruel, arrow-root and milk, bread and milk, tea, dry toast and butter,
or bread and butter; taking care not to overload the stomach with too much
fluid. Therefore, either a cupful of gruel, or of arrow-root, or of tea, at a
time, should not be exceeded, otherwise the patient will feel oppressed; she
will be liable to violent perspiration, and there will be a too abundant
secretion of milk.
601. For the next—the second day.—Breakfast,—either dry toast and
butter, or bread and butter, and black tea. Luncheon,—either a breakfast-
cupful of strong beef-tea,[107] or of bread and milk, or of arrow-root made
with good fresh milk. Dinner,—either chicken or game, mashed potatoes,
and bread. Tea, the same as for breakfast. Supper,—a breakfast-cupful of
well-boiled and well-made gruel, made either with water or with fresh milk,
or with water with a tablespoonful of cream added to it.
602. If beef-tea and arrow-root and milk be distasteful to the patient, or if
they do not agree, then for luncheon let her have either a light egg pudding
or a little rice pudding instead of either the beef-tea or the arrow-root.
603. On the third and fourth days.—Similar diet to the second day, with
this difference, that for her dinner the patient should have mutton—either a
mutton-chop or a cut out of a joint of mutton, instead of the chicken or
game. The diet ought gradually to be improved, so that at the end of four
days she should return to her usual diet, provided it be plain, wholesome,
and nourishing.

604. The above, for the generality of cases, is the scale of dietary; but of
course every lying-in woman ought not to be treated alike. If she be weak
and delicate, she may from the beginning require good nourishment, and
instead of giving her gruel, it may, from the very commencement, be
necessary to prescribe good strong beef-tea, veal-and-milk broth,[108]
chicken-broth, mutton-chops, grilled chicken, game, the yelk and the white
of an egg beaten up together in half a teacupful of good fresh milk, etc.
Common sense ought to guide us in the treatment of a lying-in as of every
other patient. We cannot treat people by rule and compass; we must be
guided by circumstances; we can only lay down general rules. There is no
universal guide, then, to be followed in the dietary of a lying-in woman;
each case may and will demand separate treatment; a delicate woman, as I
have just remarked, may, from the very first day, require generous living;
while, on the other hand, a strong, robust, inflammatory patient may, for the
first few days, require only simple bland nourishment, without a particle of
stimulants. “And hence the true secret of success rests in the use of common
sense and discretion—common sense to read nature aright, and discretion in
making a right use of what the dictates of nature prescribe.”[109]

BEVERAGE.

605. For the first week, either toast and water, or barley-water and milk,
[110]
with the chill taken off, is the best beverage. Wine, spirits, and beer,
during this time, unless the patient be weak and exhausted, or unless
ordered by the medical man, ought not to be given. All liquids given during
this period should be administered by means of a feeding-cup; this plan I
strongly recommend, as it is both a comfort and a benefit to the patient; it
prevents her from sitting up in bed every time she has to take fluids, and it
keeps her perfectly still and quiet, which, for the first week after
confinement, is very desirable.
606. When she is weak, and faint, and low, it may, as early as the first or
second day, be necessary to give a stimulant, such as either a tumblerful of
home-brewed ale or a glass or two of wine daily; but, as I before remarked,
in the generality of cases, either toast and water, or barley-water and milk,
for the first week after a confinement, is the best beverage.

607. After a week, either a tumblerful of mild home-brewed ale or of
London or Dublin porter, where it agrees, should be taken at dinner; but if
ale or porter be given, wine ought not to be allowed. It would be well to
keep either to ale or to porter, as may best agree with the patient, and not to
mix them, nor to take porter at one meal and ale at another.
608. Barreled, in this case, is superior to bottled porter, as it contains less
fixed air. On the whole, however, I should prefer home-brewed ale to porter.
Either old, or very new, or very strong ale, ought not, at this time, to be
given.
609. Great care is required in the summer, as the warm weather is apt to
turn the beer acid. Such beer would not only disagree with the mother, but
would disorder the milk, and thus the infant. A nursing mother sometimes
endeavors to correct sour porter or beer by putting soda in it. This plan is
objectionable, as the constant taking of soda is weakening to the stomach
and impoverishing to the blood. Moreover, it is impossible, by any artificial
expedient, to make either tart beer or porter sound and wholesome, and fit
for a nursing mother. If beer or porter be sour, it is not fit to drink, and
ought either to be thrown away or should be given to the pigs.
610. Sometimes neither wine nor malt liquor agrees; then, either new
milk and water, or equal parts of fresh milk and barley-water, will generally
be found the best beverage. If milk should also disagree, either barley-
water, or toast and water, ought to be substituted.

CHANGE OF ROOM.

611. The period at which a lying-in woman should leave her room will,
of course, depend upon the season, and upon the state of her health. She
may, after the first fourteen days, usually change the chamber for the
drawing-room, provided it be close at hand; if it be not, she ought, during
the day, to remove—be either wheeled or carried in a chair—from one
bedroom to another, as change of apartment will then be desirable. The
windows, during her absence from the room, ought to be thrown wide open;
and the bedclothes, in order that they may be well ventilated, should be
thrown back. She should, at the end of three weeks, take her meals with the
family; but even then she ought occasionally, during the day, to lie on the
sofa to rest her back.

EXERCISE IN THE OPEN AIR.

612. The period at which a lady, after her confinement, ought to take
exercise in the open air, will, of course, depend upon the season, and upon
the state of the wind and weather. In the winter, not until the expiration of a
month, and not even then unless the weather be fine for the season. Carriage
exercise will at first be the most suitable. In the summer she may, at the end
of three weeks, take an airing in a carriage, provided the weather be fine,
and the wind be neither in an easterly nor in a northeasterly direction. At the
expiration of the month she may, provided the season and weather will
allow, go out of doors regularly, and gradually resume her household duties
and employments.

PART IV.
SUCKLING.

THE DUTIES OF A NURSING MOTHER

613. A mother ought not, unless she intend to devote herself to her baby,
to undertake to suckle him. She must make up her mind to forego the so-
called pleasures of fashionable life. There ought, in a case of this kind, to be
no half-and-half measures; she should either give up her helpless babe to
the tender mercies of a wet-nurse, or she must devote her whole time and
energy to his welfare—to the greatest treasure that God hath given her.
614. If a mother be blessed with health and strength, it is most unnatural
and very cruel for her not to suckle her child—
“Connubial fair! whom no fond transport warms
To lull your infant in maternal arms;
Who, blessed in vain with tumid bosoms, hear
His tender wailings with unfeeling ear;
The soothing kiss and milky rill deny
To the sweet pouting lip and glistening eye!
Ah! what avails the cradle’s damask roof,
The eider bolster, and embroidered woof!
Oft hears the gilded couch unpitied plains,
And many a tear the tasseled cushion stains!
No voice so sweet attunes his cares to rest,
So soft no pillow as his mother’s breast!—
Thus charmed to sweet repose, when twilight hours
Shed their soft influence on celestial bowers,
The cherub Innocence, with smile divine,
Shuts his white wings, and sleeps on beauty’s shrine.”[111]

615. Oh, if a mother did but know the joy that suckling her infant
imparts, she would never for one moment contemplate having a wet-nurse
to rob her of that joy—
“The starting beverage meets the thirsty lip;
’Tis joy to yield it, and ’tis joy to sip.”[112]

616. Lamentable, indeed, must it be, if any unavoidable obstacle should
prevent a mother from nursing her own child!

THE BREAST.

617. As soon as the patient has recovered from the fatigue of the labor—
that is to say, in about four or six hours—attention ought to be paid, more
especially in a first confinement, to the bosoms.
618. In a first confinement, there is, until the third day, but very little
milk; although there is usually on that day, and for two or three days
afterward, a great deal of swelling, of hardness, of distention, and of
uneasiness of the breasts, in consequence of which, in a first confinement,
both care and attention are needed.
619. If there be milk in the breast, which may be readily ascertained by
squeezing the nipple between the finger and the thumb, the infant should, at
first, be applied—not frequently, as some do, but at considerable intervals,
say until the milk be properly secreted—every four hours; when the milk
flows, the child ought to be applied more frequently, but still at stated times.
620. To wash away any viscid mucus from the nipple, or any stale
perspiration from the bosom, let the breasts and the nipples, before applying
the baby, be first sponged with a little warm water, and then be dried with a
warm, dry, soft napkin; for some infants are so particular that unless the
breasts and the nipples be perfectly free from mucus and from perspiration,
they will not suck. If after the above cleansing process there be any
difficulty in making him take the bosom, smear a little cream on the nipple,
and then immediately apply him to it.
621. If the breasts be full, hard, knotty, and painful, which they generally
are two or three days after a first confinement, let them be well but tenderly
rubbed every four hours, either with the best olive oil (a little of which
should, before using it, be previously warmed, by putting a little of the oil
in a teacup on the hob by the fire) or with equal parts of olive oil and of eau
de Cologne, which should be well shaken up in a bottle every time before it
be used.
622. On the third day, more especially after a first confinement, the
breasts are apt to become very much swollen, painful, and distended. If

such be the case, it might be necessary, for a few days, to have them drawn,
once or twice daily, by a woman who makes it her business, and who is
usually called either a breast-drawer, or, in vulgar parlance, a suck-pap. A
clean, sober, healthy, respectable woman ought to be selected. There is, in
nearly every large town, one generally to be found who is at the head of her
profession. Such a one should be chosen.
623. If the bosoms be more than usually large and painful, in addition to
assiduously using the above liniment, apply to the breasts, in the intervals,
young cabbage-leaves, which should be renewed after each rubbing. Before
applying them, the “veins” of the leaves, with a sharp knife, must be cut
smooth, level with the leaf. It will require several, as the whole of the breast
ought to be covered. The cabbage-leaves will be found both cooling and
comfortable. Each bosom should then be nicely supported with a soft folded
silk handkerchief, going under each breast and suspending it; each
handkerchief should then be tied at the back of the neck, thus acting as a
kind of sling.
624. The patient ought not, while the breasts are full and uncomfortable,
to drink much fluid, as it would only encourage a larger secretion of milk.
625. When the milk is at “its height,” as it is called, she ought every
morning, for a couple of mornings, to take a little cooling medicine—a
Seidlitz powder—and, every four hours, the following effervescing mixture:
Take of—Bicarbonate of Potash, one drachm and a half;
Distilled Water, eight ounces:

To make a mixture. Two tablespoonfuls to be taken, with two tablespoonfuls of the Acid Mixture,
every four hours, while effervescing.
Take of—Citric Acid, three drachms;
Distilled Water, eight ounces:
Mix.—The Acid Mixture.

The best way of taking the above effervescing medicine is to put two
tablespoonfuls of the first mixture into a tumbler, and two tablespoonfuls of
the acid mixture into a wineglass, then to add the latter to the former, and it
will bubble up like soda-water; she should instantly drink it off while
effervescing.
626. In two or three days, under the above management, the size of the
bosoms will decrease, all pain will cease, and the infant will take the breast
with ease and comfort.

627. Second and succeeding confinements.—If the breasts are tolerably
comfortable (which in the second and in succeeding confinements they
probably will be), let nothing be done to them except, as soon as the milk
comes, at regular intervals applying the child alternately to each of them.
Many a bosom has been made uncomfortable, irritable, swollen, and even
sometimes gathered, by the nurse’s interference and meddling. Meddlesome
midwifery is bad, and I am quite sure that meddlesome breast-tending is
equally so. A nurse, in her wisdom, fancies that by rubbing, by pressing, by
squeezing, by fingering, by liniment, and by drawing, she does great good,
while in reality, in the majority of cases, by such interference she does great
harm.
628. The child will, in second and in succeeding confinements, as a rule,
be the best and the only doctor the bosoms require. I am quite convinced
that, in a general way, nurses interfere too much, and that the bosoms in
consequence suffer. It is, of course, the doctor’s and not the nurse’s
province in such matters, to direct the treatment; while it is the nurse’s duty
to fully carry out the doctor’s instructions.
629. There is nothing, in my opinion, that so truly tells whether a nurse
be a good one or otherwise, as the way she manages the breasts; a good
nurse is judicious, and obeys the medical man’s orders to the very letter;
while, on the other hand, a bad nurse acts on her own judgment, and is
always quacking, interfering, and fussing with the breasts, and doing on the
sly what she dare not do openly: such conceited, meddlesome nurses are to
be studiously avoided; they often cause, from their meddlesome ways, the
breasts to gather.
630. Let the above advice be borne in mind, and much trouble, misery,
and annoyance might be averted. Nature, in the majority of cases, manages
these things much better than any nurse possibly can do, and does not, as a
rule, require helping. The breasts are sadly too much interfered and messed
with by nurses, and by nurses who are, in other respects, tolerably good
ones.

STATED TIMES FOR SUCKLING.

631. A mother ought to suckle her baby at stated times. It is a bad habit to
give him the bosom every time he cries, regardless of the cause; for be it

what it may—over-feeding, griping, “wind,” or acidity—she is apt to
consider the breast a panacea for all his sufferings. “A mother generally
suckles her infant too often—having him almost constantly at the bosom.
This practice is injurious both to parent and to child. For the first month he
should be suckled about every hour and a half; for the second month, every
two hours; gradually, as he becomes older, increasing the distance of time
between, until at length he has the breast about every four hours. If he were
suckled at stated periods he would only look for it at those times, and be
satisfied.”[113]
632. A mother frequently allows her babe to be at the bosom a great part
of every night. Now, this plan is hurtful both to her and to him; it weakens
her, and thus enfeebles him; it robs them both of their sleep; and generates
bad habits, which it will be difficult to break through; it often gives the
mother a sore nipple and the child a sore mouth.
633. It is surprising how soon an infant, at a very early age, may, by
judicious management, be brought into good habits; it only requires, at first,
a little determination and perseverance: therefore a nursing mother ought at
once to commence by giving the child the breast at stated periods, and she
should rigidly adhere to the times above recommended.
634. A mother should not, directly after taking a long walk, and while her
skin is in a state of violent perspiration, give her baby the bosom; the milk
being at that time in a heated state, will disorder the child’s bowels, or it
may originate in him some skin disease, and one which it might be difficult
to cure. She ought, therefore, before she gives him the breast, to wait until
the surface of her body be moderately cool. Let her be careful the while not
to sit in draughts.

CLOTHING.

635. A nursing mother ought to have her dress, more especially her stays,
made loose and comfortable.
636. A gathered breast sometimes arises from the bones of the stays
pressing into the bosom; I should, therefore, recommend her to have the
bones removed.

637. If a lady be not in the habit of wearing a flannel waistcoat, she ought
at least to have her bosoms covered with flannel, taking care that there be a
piece of soft linen over the nipples.
638. I should advise a nursing mother to provide herself with a
waterproof nursing apron, which may be procured either at any baby-linen
establishment or at an india-rubber warehouse.

DIETARY.

639. A nursing mother ought to live plainly; her diet should be both light
and nourishing. It is a mistaken notion that at these times she requires extra
good living. She ought never to be forced to eat more than her appetite
demands; if she be, either indigestion, or heartburn, or sickness, or
costiveness, or a bowel complaint will ensue. It is a folly at any time to
force the appetite. If she be not hungry, compelling her to eat will do her
more harm than good. A medical man, in such a case, ought to be consulted.
640. The best meats are mutton and beef; veal and pork may, for a
change, be eaten. Salted meats are hard of digestion; if boiled beef,
therefore, be eaten, it ought to be only slightly salted. It is better, in winter,
to have the boiled beef unsalted; it is then, especially if it be the rump,
deliciously tender. Salt, of course, must be eaten with the unsalted meat.
High-seasoned dishes are injurious; they inflame the blood, and thus they
disorder the milk.
641. Some persons consider that there is no care required in the selection
of the food, and that a nursing mother may eat anything, be it ever so gross
and unwholesome; but, if we appeal to reason and to facts, we shall be
borne out in saying that great care is required. It is well known that cow’s
milk very much partakes of the properties of the food on which the animal
lives. Thus, if a cow feed on swedes, the milk and the butter will have a
turnipy flavor. This, beyond a doubt, decides that the milk does partake of
the qualities of the food on which she feeds. The same reasoning holds good
in the human species, and proves the absurdity of a nursing mother being
allowed to eat anything, be it ever so gross, indigestible, or unwholesome.
Again, either a dose of purgative medicine given to her, or greens taken by
her at dinner, will sometimes purge the baby as violently, or even more so,
than it will herself.

642. Even the milk of a healthy wet-nurse acts differently, and less
beneficially, upon the child than the mother’s own milk. The ages of the
mother and of the wet-nurse, the ages of her own and the latter’s infant, the
constitutions of the one and of the other, the adaptability of a mother’s milk
for her own particular child—all tend to make a foster-mother not so
desirable a nurse as the mother herself. Again, a mother cannot at all times
get to the antecedents of a wet-nurse; and, if she can, they will not always
bear investigation.
643. With regard to the ages of the mother and of the wet-nurse—for
instance, as a wet-nurse’s milk is generally a few weeks older than the
mother’s own milk, the wet-nurse’s milk may, and frequently does, produce
costiveness of the bowels of her foster-child; while, on the other hand, the
mother’s own milk, being in age just adapted to her babe’s, may and
generally does keep her own infant’s bowels regular. The milk, according to
the age of the child, alters in properties and qualities to suit the age,
constitution, and acquirements of her baby—adapting itself, so to speak, to
his progressive development. Hence the importance of a mother, if possible,
suckling her own child.
644. A babe who is suckled by a mother who lives grossly is more prone
to disease, particularly to skin and to inflammatory complaints, and to
disease which is more difficult to subdue.
645. Do not let me be misunderstood: I am not advocating that a mother
should be fussily particular—by no means. Let her take a variety of food,
both animal and vegetable; let her from day to day vary her diet; let her ring
the changes on boiled and stewed, on grilled and roast meats; on mutton
and lamb and beef; on chicken and game and fish; on vegetables, potatoes,
and turnips; on broccoli and cauliflower, on asparagus and peas (provided
they are young and well boiled), and French beans. “The maxim of the
greatest importance in reference to the materials of human food is, mixture
and variety—a maxim founded, as has been stated, upon man’s omnivorous
nature. Animal and vegetable substances, soups and solid meat, fish, flesh,
and fowl, in combination or succession, ought, if due advantage is to be
taken of the health-sustaining element in food, to form the dietary of every
household.”[114]
646. But what I object to a nursing mother taking are—gross meats, such
as goose and duck; highly-salted beef; shell-fish, such as lobster and crab;

rich dishes; highly-seasoned soup; pastry, unless it be plain; and cabbages
and greens and pickles, if found to disagree with the baby; and any other
article of food which is either rich, or gross, or indigestible, and which,
from experience, she has found to disagree either with herself or with her
child. It will be seen, therefore, from the above catalogue, that my
restrictions as to diet are limited, and are, I hope, founded both on reason
and on common sense.
647. A moderate quantity—say a tumblerful—either of fresh mild ale or
of porter will generally be found the best beverage both for dinner and for
supper. There is much more nourishment in either ale—home-brewed—or
in porter, than in wine; therefore, for a nursing mother, either ale or porter is
far preferable to wine. Wine, if taken at all, ought to be used very sparingly,
and then not at the same meal with the porter or ale. In the higher ranks of
life, where a lady is in the habit of drinking wine, it is necessary to continue
it, although the quantity should not be increased, and ought never to exceed
a couple of glasses—dry sherry being the best wine for the purpose.
648. A nursing mother is subject to thirst. When such be the case, she
ought not to fly either to beer or to wine to quench it; this will only add fuel
to the fire. The best beverages will be either toast and water, milk and water,
barley-water, barley-water and new milk (in equal proportions), or black
tea, either hot or cold. Cold black tea is a good quencher of thirst.
649. A lady who is nursing is at times liable to fits of depression. Let me
strongly urge the importance of her abstaining from wine and from all other
stimulants as a remedy; they would only raise for a time her spirits, and
then would depress them in an increased ratio. Either a drive in the country,
or a short walk, or a cup of tea, or a chat with a friend, would be the best
medicine. The diet should be good and nourishing; plenty of bread and
plenty of meat should be her staple food, in addition to which Du Barry’s
Arabica Revalenta, made either with fresh milk or with cream and water, is,
in these cases, most useful and sustaining. The best time for taking it is
either for luncheon or for supper. A lady subject to depression should bear
in mind that she requires nourishment, not stimulants,—that much wine and
spirits might cheer her for the moment, but will assuredly depress her
afterward. Depression always follows overstimulation; wine and spirits
therefore, in such a case, if taken largely, are false and hollow friends. It is
necessary to bear the above facts in mind, as there are many advocates who

strongly recommend, in a case of this kind, a large consumption of wine
and brandy. Such men are, at the present moment, doing an immense deal
of mischief; they are, in point of fact, inducing and encouraging
drunkenness.
650. Spirits—brandy, rum, gin, and whisky—are, during suckling,
injurious; I may even say that they are insidious poisons to the parent, and,
indirectly, to the child.
651. When an infant is laboring under an inflammatory complaint, a
nursing mother ought not to take stimulants, such as either ale or wine. In a
case of this kind, toast and water will, for her dinner, be the best beverage,
gruel for her supper, and black tea—not coffee, as it would be too
stimulating—both for her breakfast and tea.

FRESH AIR AND EXERCISE.

652. Out-door exercise during suckling cannot be too strongly insisted
upon; it is the finest medicine both for babe and mother. Whenever the
weather will admit, it must be taken. It is utterly impossible for a nursing
mother to make good milk, unless she do take an abundance of exercise and
breathe plenty of fresh air.
653. Whatever improves the health of the mother, of course at the same
time benefits the child: there is nothing more conducive to health than an
abundance of out-door exercise. It often happens that a mother who is
nursing seldom leaves her house; she is a regular fixture; the consequence
is, both she and her babe are usually delicate and prone to sickness.
654. A mother ought not, immediately after taking exercise, to nurse her
infant, but wait for half an hour. Nor should she take violent exercise, as it
would be likely to disorder the milk.
655. Carriage exercise, if the weather be hot and sultry, is preferable to
walking; if that be not practicable, she ought to have the windows thrown
wide open, and should walk about the hall, the landings, and the rooms, as
she would by such means avoid the intense heat of the sun. Although
carriage exercise during intensely hot weather is preferable to walking
exercise, yet, notwithstanding, walking must, during some portion of the
day, be practiced. There is no substitute, as far as health is concerned, for

walking. Many ailments that ladies now labor under could be walked away;
and really it would be a pleasant physic—far more agreeable than pills and
potions!

THE POSITION OF A MOTHER DURING SUCKLING.

656. Good habits are as easily formed as bad ones. A mother, when in
bed, ought always to suckle her child while she is lying down. The sitting
up in bed, during such times, is a fruitful source of inflammation and of
gathering of the breasts. Of course, during the day the sitting-up position is
the best. Let me caution her not to nurse her baby in a half-sitting and half-
lying posture; it will spoil her figure, disturb her repose, and weaken her
back.

THE TEMPER.

657. Passion is injurious to the mother’s milk, and consequently to the
child. Sudden joy and grief frequently disorder the infant’s bowels,
producing griping, looseness, etc.; hence, a mother who has a mild, placid
temper generally makes an excellent nurse, on which account it is a
fortunate circumstance that she is frequently better-tempered during
suckling than at any other period of her life; indeed, she usually, at such
times, experiences great joy and gladness.
658. The happiest period of a woman’s existence is, as a rule, when she
first becomes a mother. “The pleasure of the young mother in her babe is
said to be more exquisite than any other earthly bliss.”[115]
659. It is an old and, I believe, a true saying, that the child inherits the
temper of his mother or of his wet-nurse. This may be owing to the
following reasons: If the mother or the wet-nurse be good-tempered, the
milk will be more likely to be wholesome, which will, of course, make him
more healthy, and consequently better-tempered.
660. While, on the other hand, if the mother or the nurse be of an
irritable, cross temper, the milk will suffer, and will thus cause
disarrangement to his system; and hence ill health and ill temper will be

likely to ensue. We all know the influence that good or bad health has on
the temper.
661. An important reason, then, why a nursing mother is often better-
tempered than she is at other times is, she is in better health, her stomach is
in a healthier state:
“A good digestion turneth all to health.”[116]

There is an old and a true saying, “that it is the stomach that makes the
man,” and if the man, the woman:
“Your stomach makes your fabric roll,
Just as the bias rules the bowl.”[117]

662. Hear what Shakspeare says of the functions of the stomach. The
stomach is supposed to speak (and does it not frequently speak, and in very
unmistakable language, if we will but only listen to its voice?):
“True is it, my incorporate friends, quoth he,
That I receive the general food at first
Which you do live upon: and fit it is;
Because I am the store-house and the shop
Of the whole body: But if you do remember,
I send it through the rivers of your blood,
Even to the court, the heart,—to the seat o’ the brain;
And, through the cranks and offices of man,
The strongest nerves, and small inferior veins,
From me receive that natural competency
Whereby they live: And though that all at once,
You, my good friends, though all at once cannot
See what I do deliver out to each;
Yet I can make my audit up, that all
From me do back receive the flour of all,
And leave me but the bran.”

Coriolanus, act i. sc. 1.

OCCUPATION.

663. I strongly recommend a nursing mother to attend to her household
duties. She is never so happy, nor so well, as when her mind is moderately
occupied at something useful. She never looks so charming as when she is
attending to her household duties—

“For nothing lovelier can be found
In woman, than to study household good.”[118]

664. I do not mean by occupation the frequenting of balls, of routs, or of
parties: a nursing mother has no business to be at such places; she ought to
devote herself to her infant and to her household, and she will then
experience the greatest happiness this world can afford.
665. One reason why the poor make so much better nursing mothers than
the rich is the former having so much occupation; while the latter, having
no real work to do, the health becomes injured, and in consequence the
functions of the breasts suffer; indeed, many a fashionable lady has no milk
at all, and is therefore compelled to delegate to a wet-nurse one of her
greatest privileges and enjoyments.
666. What would not some rich mother give for the splendid supply of
milk—of healthy, nourishing, life-giving milk—of the poor woman who has
to labor for her daily bread!
667. What is the reason that wealthy ladies so frequently require wet-
nurses? The want of occupation! And from whom do they obtain the supply
of wet-nurses? From the poor women who have no lack of occupation, as
they have to labor for their daily food, and have in consequence the riches
of health, though poor in this world’s goods—
“For health is riches to the poor.”[119]

Bear this in mind, ye wealthy, and indolent, and pampered ladies, and
alter your plans of life, or take the consequences, and still let the poor
women have the healthy, the chubby, the rosy, the laughing children; and
you, ye rich ones, have the unhealthy, the skinny, the sallow, the dismal
little old men and women who are constantly under the doctor’s care, and
who have to struggle for their very existence! “Employment, which Galen
calls ‘nature’s physician,’ is so essential to human happiness, that Indolence
is justly considered as the mother of Misery.”[120]
668. Occupation, then—bustling occupation, real downright work, either
in the form of out-door exercise, or of attending to her household duties—a
lady, if she desire to have a good breast of milk, ought to take; if, in point of
fact, she wishes to have healthy children. For the Almighty is no respecter
of persons. And he has ordained that work shall be the lot of man and of
woman too! It is a blessed thing to be obliged to work. If we do not work,

we have all to pay a heavy penalty, in the form of loss of both health and
happiness. “For work is the grand cure of all the maladies and miseries that
ever beset mankind—honest work, which you intend getting done.”[121]
669. A mother who is listless and idle, lolling either the greater part of
every day in an easy-chair, or reclining on a sofa in a room where a breath
of air is not allowed to enter, usually makes a miserable and a wretched
nurse. She is nervous, dyspeptic, and emaciated; having but little milk, and
that little of a bad quality, her baby is puny, pallid, and unhealthy, and
frequently drops into an untimely grave. Occupation, then, with fresh air
and exercise, is indispensable to a mother who is suckling.

AILMENTS, Etc.

670. The Nipple.—A good nipple is important both to the comfort of the
mother and to the well-doing of the child.
671. One, among many, of the ill effects of stays and of corsets is the
pushing-in of the nipples; sore nipples, and consequent suffering, are the
result. Moreover, a mother thus circumstanced may be quite unable to
suckle her infant; and then she will be severely punished for her ignorance
and folly; she will be compelled to forego the pleasure of nursing her own
children, and she will be obliged to delegate to hirelings her greatest
privilege! Ladies who never wear stays have much better nipples, and more
fully-developed bosoms; hence such mothers are more likely to make better
nurses to their babies. There is no doubt that the pressure of the stays on the
bosom tends both to waste away the gland of the breast (where the milk is
secreted), and to cause the nipple either to dwindle or to be pushed in, and
thus to sadly interfere with its functions. I should strongly advise every
mother who has daughters old enough to profit by it, to bear this fact in
mind, and thus to prevent mischief when mischief might be prevented, by
not allowing them, when young, to wear stays.
672. Treatment of very small and drawn-in nipples.—The baby ought to
suck through the intervention of an india-rubber teat fastened on a boxwood
shield, or through an india-rubber teat and shield, made entirely of india-
rubber.[122] The india-rubber teat must, before it is used, be softened by
dipping it in warm but not in hot water. I have known many mothers able to
suckle their children with this contrivance who otherwise would have been

obliged either to have weaned them, or to have procured the assistance of a
wet-nurse. The above aid, in the generality of instances, will enable the
infant to suck with ease. After this has for a time been used, the nipples will
be so improved as to render the continuance of it unnecessary. Of course I
do not advise the use of an india-rubber teat until a fair trial has been given
by applying the babe at once to the nipple; but if he cannot draw out the
nipple, then, rather than wean him, or than employ a wet-nurse, let the teat
be tried.
673. Remember, as soon as the nipple be sufficiently drawn out, which in
all probability it will in a few days, the teat ought to be dispensed with. In
such a case, when the infant is not at the breast, Dr. Wansbrough’s Metallic
Nipple Shields should be worn. Small and bad nipples have, by the wearing
of these shields, frequently been drawn out and made good ones; the dress
will suffice to keep them in their places.
674. Sore nipples.—If a lady, during the latter few months of her
pregnancy, were to adopt the plan recommended at page 162, paragraph
353, sore nipples, during the period of suckling, would not be so prevalent
as they now are.
675. A sore nipple is frequently produced by the injudicious custom of
allowing the child to have the nipple almost constantly in his mouth. Stated
periods for suckling, as recommended at paragraph 631, ought to be strictly
adopted. Another frequent cause of a sore nipple is from the babe having
the thrush. It is a folly to attempt to cure the nipple without at the same time
curing the mouth of the infant.
676. Treatment.—One of the best remedies for a sore nipple is the
following powder:
Take of—Biborate of Soda, one drachm;
Powdered Starch, seven drachms:

Mix,—A pinch of the powder to be frequently applied to the nipple.

677. Dr. A. Todd Thomson’s—my old preceptor—remedy for sore nipple
is a very good one; it is as follows:
Take of—Finely-powdered Gum Arabic, half an ounce;
Powdered Alum, five grains:

To be well mixed together in a mortar to make a powder, of which a pinch should either be
sprinkled over the nipple, or it may be applied to the part by means of a camel’s-hair brush

every time directly after the child has done sucking. Let the brush, covered with the dry
powder, gently sweep over the sore nipple.
As there is nothing in either of the above powders injurious to the infant,
the powder, before applying him to the breast, ought not to be wiped off;
indeed, either the one or the other of the powders (the former one
especially, as it contains borax) is likely to be of service in preventing or in
curing the sore mouth of the child.
678. If the above powders should not have the desired effect (efficacious
though they usually are), “a liniment composed of equal parts of glycerin
and of brandy” (say a vial containing two drachms of each) ought to be
tried, which must be shaken up just before using. It should, by means of a
camel’s-hair brush, every time directly after the baby has been suckled, be
painted on the nipple. A piece of either old soft cambric or lawn, about the
size of the palm of the hand, snipped around to make it fit, ought then to be
moistened in the glycerin and the brandy, and should be applied to each of
the sore nipples, and worn (until they are cured) whenever the child is not at
the breast. These applications will be found of much service and of great
comfort, and will act as nipple shields, protecting and healing the nipples. A
soft sponge of warm water may be gently applied to the nipple just before
putting the child to the bosom.
679. If the above remedies should not succeed in curing the sore nipple,
then she ought to try Dr. Wansbrough’s Metallic Nipple Shield (as
recommended previously for small and drawn-in nipples), and should,
whenever the babe is not sucking, constantly wear it on the nipple. It is very
cooling and healing, and keeps off all pressure from the clothes. It will
frequently cure a sore nipple when other remedies have failed. The shield
may be procured of any respectable surgical-instrument-maker.
680. Cracked and fissured nipples.—Sometimes the nipple is sore from
having either cracks or fissures upon it. These cracks or fissures may attack
any part of the nipple, but are very apt to form where the nipple joins the
breast; and, when very severe, an ignorant nurse, who is always fond of
dealing in the marvelous, declares that the child has nearly bitten the nipple
off! Treatment.—Now, the best remedy for a cracked and fissured nipple is
for the infant, until the cracks and fissures are cured, to suck through the
intervention of an india-rubber teat and shield; and every time, directly after
the babe has been put to the nipple, to apply to the parts affected either neat
brandy or the glycerin and brandy liniment, as I have before recommended.

When the child is not at the breast, Dr. Wansbrough’s Nipple Shields should
be worn; the dress will keep them in their places.
681. Another cause of a sore nipple is from the mother, after the babe has
been sucking, putting up the nipple wet. She, therefore, ought always to dry
the nipple—not by rubbing it, but by dabbing it with either a soft cambric or
lawn handkerchief, or with a piece of soft linen rag (one or other of which
ought always to be at hand), every time directly after the infant has done
sucking, and just before applying either of the above powders or liniment to
the nipple.
682. When the nipple is very sore, a mother, whenever the child is put to
the bosom, suffers intense pain. This being the case, she had better suckle
him through the intervention of an india-rubber teat, properly fastened on a
shield, as before recommended. See page 276, paragraph 672. But she
ought never to use an india-rubber teat unless it be absolutely necessary—
that is to say, if the nipple be only slightly sore, she should not, on any
account, apply it; but there are cases where the nipple is so very sore that a
mother would have to give up nursing if the shield and teat were not used;
these, and very small and drawn-in-nipples, are the only cases in which an
india-rubber teat and shield is admissible.
683. A nursing mother is sometimes annoyed by the milk flowing
constantly away, making her wet and uncomfortable. All she can do under
such circumstances is to wear nipple-glasses, and to apply a piece of flannel
to the bosom, which will prevent the milk from chilling her, and will thus
do away with the danger of her catching cold, etc.
684. The breast.—A mother ought, before applying the infant to the
bosom, to carefully ascertain if there be milk. This may readily be done by
squeezing the nipple between the finger and the thumb. If there be no milk,
she must wait until the milk be secreted, or serious consequences both to
her and to him might ensue: to the former, inflammation and gathering of
the bosom, and sore nipples; to the latter, thrush, diarrhœa, and eruptions on
the skin.[123]
685. If there be a supply of milk in the breast, and if still the child will
not suck, the medical man’s attention ought to be drawn to the fact, in order
that he may ascertain whether the child be tongue-tied; if he be, the mystery
is explained, and a trifling, painless operation will soon make all right.

686. If the bosoms be full and uneasy, they ought, three or four times a
day, to be well although tenderly rubbed with olive oil and eau de Cologne
(equal parts of each, mixed in a vial). Some nurses rub with their fingers
only. Now, such rubbing does harm. The proper way to apply friction is to
pour a small quantity of the oil and eau de Cologne—first shaking the bottle
—into the palm of the hand, the hand being warm, and then to well rub the
breasts, taking care to use the whole of the inside of the hand.
687. After the bosoms have been well rubbed, each ought to be nicely
supported with a large, soft, folded silk handkerchief; each handkerchief
must pass under each breast and over the shoulders, and should be tied at
the back of the neck, thus acting as a sling.
688. If the bosoms be very uncomfortable, young cabbage-leaves (with
the “veins” of each leaf cut level to the leaf) ought, after each application of
the oil and eau de Cologne, to be applied; or a large warm white-bread-and-
milk and olive oil poultice ought to be used, which must be renewed three
or four times a day. The way to make the poultice is as follows: A thick
round of bread should be cut from a white loaf; the crust should be
removed, the crumb ought to be cut into pieces about an inch square, upon
which boiling-hot new milk should be poured; it ought to be covered over
for ten minutes; then the milk should be drained off, and the olive oil—
previously warmed by placing a little in a teacup on the hob—should be
beaten up by means of a fork with the moistened bread until it be of the
consistence of a soft poultice. It ought to be applied to the bosom as hot as
it can comfortably be borne.
689. Gathered breast.—A gathered bosom, or “bad breast” as it is
sometimes called, is more likely to occur after a first confinement and
during the first month. Great care, therefore, ought to be taken to avoid such
a misfortune. A gathered breast is frequently owing to the carelessness of a
mother in not covering her bosoms during the time she is suckling. Too
much attention cannot be paid to keeping the breasts comfortably warm.
This, during the act of nursing, should be done by throwing either a shawl
or a square of flannel over the neck, shoulders, and bosoms.
690. Another cause of a gathered breast arises from a mother sitting up in
bed to suckle her baby. An infant ought to be accustomed to take the bosom
while he is lying down; if this habit be not at first instituted, it will be

difficult to adopt it afterward. Good habits may be taught a child from the
very earliest period of his existence.
691. A sore nipple is another fruitful cause of a gathered breast. A mother,
in consequence of the suffering it produces, dreads putting the baby to it;
she therefore keeps him almost entirely to the other bosom. The result is,
the breast with the sore nipple becomes distended with milk, which, being
unrelieved, ends in inflammation, and subsequently in gathering.
692. The fruitless attempt of an infant, to procure milk when there is very
little or none secreted is another and a frequent cause of a gathered bosom.
Dr. Ballard, in his valuable little work before quoted, considers this to be
the principal cause of a gathered breast; and, as the subject is of immense
importance, I cannot do better than give it in his own words, more
especially as he has the merit of originating and of bringing the subject
prominently before his professional brethren. He says: “This (mammary
abscess or gathered breast) is another form of disease entirely referable to
the cause under consideration [fruitless sucking]. In the case last related, the
formation of mammary abscess [gathered breast] was only just prevented
by arresting any further irritation of the breast by suckling; and since I have
kept careful notes of my cases, I have observed that in all instances of
abscess there has been abundant evidence of a demand being made upon the
gland for a supply of milk beyond that which it had the power of secreting.
If the child only has been kept to the breast, then it has suffered with
disordered bowels; but in the majority of cases an additional irritation has
been applied; the commonly-received doctrine that a turgid breast is
necessarily overloaded with milk, leads mothers and nurses to the use of
breast-pumps, exhausted bottles, or even the application of the powerful
sucking powers of the nurse herself, to relieve the breasts of their supposed
excess; and it is this extraordinary irritation which, in the majority of cases,
determines the formation of an abscess [gathering]. Sometimes these
measures are adopted to remove the milk when a woman is not going to
suckle, and then an abscess not unfrequently is established. I have
previously alluded to the mistake into which mothers and nurses are led by
the appearance of a swollen breast; it is not evidence that the gland can
secrete freely, and it is in this turgid state that the excessive irritation tells
most severely. This hyperæmic [plethoric] condition seems to be a step
toward inflammation, and the irritation supplies that which is wanting to
complete the process. If a woman will only remove the child from the

breast directly the act of sucking produces pain, she may be pretty sure to
avoid abscess. So long as the milk can be obtained there is no pain.” The
above most valuable advice deserves great attention, and ought to be strictly
followed.
693. How is a patient to know that she is about to have a gathered
bosom?—There are two forms of gathered breast; one being of vast and the
other of trifling importance. The first, the serious one, consists of gathering
of the structure of the gland of the breast itself; the latter, merely of the
superficial part of the bosom, and ought to be treated in the same manner as
any other external gathering, with warm poultices.
694. In the mild or superficial kind of gathered bosom, the mother may
still persevere in suckling her child, as the secreting portion of the breast is
not at all implicated in the gathering; but in the severe form, she ought not,
on any account whatever, to be allowed to do so, but should instantly wean
her child from the affected side. The healthy breast she may still continue to
nurse from.
695. The important form of a gathered breast I will now describe: A
severe gathered bosom is always ushered in with a shivering fit. Let this
fact be impressed deeply upon my reader’s mind. This shivering is either
accompanied or followed by sharp lancinating pains of the bosom. The
breast now greatly enlarges, becomes hot, and is very painful. The milk in
the affected bosom either lessens or entirely disappears. If the child be
applied to the breast (which he ought not to be), it gives the mother intense
pain. She is now feverish and ill; she loses her strength and appetite, and is
very thirsty.
696. A medical man must, at the very onset of the shivering fit, be sent
for; and he will, in the generality of instances, be able to prevent such a
painful and distressing occurrence as a gathered breast. If twelve hours be
allowed to elapse after the shivering has taken place, the chances are that
the gathering cannot altogether be prevented; although even then it may, by
judicious treatment, be materially lessened and ameliorated.
697. We sometimes hear of a poor woman suffering dreadfully for
months, and of her having a dozen or twenty holes in her bosom! This is
generally owing to the doctor not having been sent for immediately after the
shivering; I therefore cannot too strongly insist, under such circumstances,
upon a mother obtaining prompt assistance, not only to obviate present

suffering, but, at the same time, to prevent the function of the breast from
being injured, which it inevitably, more or less, will be, if the important
form of gathering be allowed to take place.
698. When a nursing mother feels faint, she ought immediately to lie
down and to take a little nourishment; either a crust of bread and a draught
of ale or of porter, or a glass of wine, or a cup of tea with the yelk of an egg
beaten up in it, either of which will answer the purpose extremely well.
Brandy, or any other spirit, I would not recommend, as it will only cause, as
soon as the immediate effects of the brandy are gone off, a greater
depression to ensue; not only so, but the frequent taking of brandy might
become a habit—a necessity which would be a calamity deeply to be
deplored!
699. A mother is sometimes faint from suckling her child too often, she
having him almost constantly at the bosom. So long, of course, as she
continues this foolish practice, she must expect to suffer from faintness.
700. Aperients, etc. during suckling.—Strong purgatives, during this
period, are highly improper, as they are apt to give pain to the infant as well
as to injure the mother. If it be absolutely necessary to give an aperient, the
mildest, such as a dose of castor oil, should be chosen.
701. If she cannot take oil, then she should apply it externally to the
bowels as a liniment, as recommended at page 144.
702. An enema, either of warm water, or of gruel, oil, and table salt,[124]
applied by means of a good self-injecting enema apparatus, is in such a case
an excellent—indeed, the very best—method of opening the bowels, as it
neither interferes with the digestion of the mother nor of the child.
703. The less opening medicine, whatever be the kind, a mother who is
suckling takes, the better will it be both for herself and for her babe. Even
castor oil, the least objectionable, during suckling, of aperients, if she once
begin to take it regularly, the bowels will not act without it, and a wretched
state of things is established. No, if the bowels will not act, an enema is by
far the best remedy; you can never do any harm, either to the mother or to
the babe, by the administration of an enema; it will neither induce future
constipation, nor will it interfere with the digestion of the mother, nor with
the bowels, nor with the health of the infant.
704. When a lady who is nursing is habitually costive, she ought to eat
brown instead of white-bread. This will, in the majority of cases, enable her

to do without an aperient. The brown bread may be made by mixing one
part of bran and three parts of fine wheaten flour together, and then making
it in the usual way into bread. Treacle instead of butter on the brown bread
increases its efficacy as an aperient.
705. Either stewed prunes or stewed French plums are an excellent
remedy to prevent constipation. The patient ought to eat, every morning, a
dozen or fifteen of them. The best way to stew either prunes or French
plums is the following: Put a pound, either of prunes or of French plums,
and two tablespoonfuls of raw sugar, into a brown jar; cover them with
water, put them into a slow oven, and stew them for three or four hours.
Both stewed rhubarb and stewed pears often act as mild or gentle aperients.
Muscatel raisins, eaten at dessert, will oftentimes, without medicine, relieve
the bowels.
706. A Bee-master in The Times, or, as he is usually called, The Times
Bee-master, has satisfactorily proved that honey—pure honey—is most
wholesome and beneficial to the human economy. He recommends it to be
occasionally eaten in lieu of butter for breakfast. Butter, in some localities,
and in some seasons of the year, is far from good and wholesome.
707. The Germans are in the habit of eating for breakfast and for tea a
variety of fruit jams instead of butter with their bread. Now, if the bowels
be costive, jam is an excellent substitute for butter. The Scotch, too,
scarcely ever sit down either to breakfast or tea without there being a pot of
marmalade on the tables. English ladies, in this matter, may well take a leaf
out of the books of the Germans and of the Scotch.
708. A basinful of gruel, made either with Robinson’s Patent Groats, or
with the Derbyshire oatmeal, sweetened with brown sugar, every night for
supper will often supersede the necessity of giving opening medicine. A
tumblerful of cold spring water—cold from the pump—taken early every
morning, sometimes effectually relieves the bowels. Coffee ought to be
substituted for tea for breakfast, as coffee frequently acts as an aperient,
more especially if the coffee be sweetened with brown sugar. A glass of
sherry should be taken every day during dinner, as, if the bowels be
sluggish, it sometimes stimulates them to action. I should strongly
recommend a patient, in such a case, to eat a great variety of food, and to let
the vegetable element predominate. Much meat encourages constipation.

Fruit—Muscatel raisins especially—farinaceous food, coffee, and a variety
of vegetables, each and all incite the bowels to do their duty.
709. Although a nursing mother ought, more especially if she be costive,
to take a variety of well-cooked vegetables—such as potatoes, asparagus,
broccoli, cauliflower, French beans, stewed celery, and turnips; she should
avoid eating greens, cabbages, and pickles, as they would be likely to affect
the baby, and might cause him to suffer from gripings, pain, and
“looseness” of the bowels.
710. The “wet compress” is another excellent method of opening the
bowels. The way of applying it is as follows: Fold a large napkin a few
thicknesses until it is about half a foot square; then dip it in cold water and
place it over the bowels; over which apply either oilskin or gutta-percha
skin, which should be, in order to exclude the air, considerably larger than
the folded napkin. It should be kept in its place by means of either a bolster-
case or a broad bandage, and must be applied at bedtime, and ought to
remain on for three or four hours, or until the bowels be opened.
711. Let me again—for it cannot be too urgently insisted upon—strongly
advise a nursing mother to use every means in the way of diet, etc., to
supersede the necessity of the taking of opening medicine, as the repetition
of aperients injures, and that severely, both mother and child. Moreover, the
more opening medicine a person swallows, the more she requires; so that if
she once get into the habit of regularly taking aperients, the bowels will not
act without them. What a miserable existence, to be always swallowing
physic!
712. If a lady, then, during the period of suckling, were to take systematic
exercise in the open air; to bustle about the house and to attend to her
household duties; if she were to drink, the moment she awakes in the
morning, a tumbler of cold water, and every day during dinner a glass of
sherry; if she were to substitute brown bread for white bread, and coffee for
tea at breakfast, and brown for white sugar; if she were to vary her food,
both animal and vegetable, and partake plentifully of sound ripe fruit; if she
were to use an abundance of cold water to her skin; if she were,
occasionally, at bedtime, to apply a “wet compress” to her bowels, and to
visit the water-closet daily at one hour; if she were—even if the bowels
were not opened for four or five days—not to take an aperient of any kind
whatever, and avoid quacking herself with physic; in short, if she would

adopt the above safe and simple remedies, which are in the reach of all, she
would not suffer so much from costiveness, which is frequently the bane,
the misery, and the curse of her existence! But then, to get the bowels into a
proper and healthy state, it would take both time and trouble; and how
readily can a couple of pills be swallowed, and how quickly they act, and
how soon they have to be repeated; until at length the bowels will not act at
all unless goaded into action, and the pills become a necessity! Oh, the folly
and the mischief of such a system!

WEANING.

713. There is an old saying, “that a woman should carry her child nine
months, and should suckle him nine months.” It is well known that the first
part of the old adage is correct, and experience has proved the latter to be
equally so. If a babe be weaned before he be nine months, he loses that
muscular strength which the breast-milk alone can give; if he be suckled
after he be nine months, he becomes flabby, weak, and delicate. “It is
generally recognized that the healthiest children are those weaned at nine
months complete. Prolonged nursing hurts both child and mother; in the
child, causing a tendency to brain disease, probably through disordered
digestion and nutrition; in the mother, causing a strong tendency to deafness
and blindness. It is a very singular fact, to which it is desirable that attention
were paid, that in those districts of Scotland—viz., the Highland and insular
—where the mothers suckle their infants from fourteen to eighteen months,
deaf-dumbness and blindness prevail to a very much larger extent among
the people than in districts where nine or ten months is the usual limit of the
nursing period.”[125]
714. The time, then, when an infant ought to be weaned.—“This, of
course, must depend upon the strength of the child, and upon the health of
the mother: nine months on an average is the proper time. If she be delicate,
it may be found necessary to wean him at six months; or if he be weak, or
laboring under any disease, it may be well to continue suckling him for
twelve months; but after that time the breast will do him more harm than
good, and will, moreover, injure the mother’s health.”[126]
715. If he be suckled after he be twelve months old, he is generally pale,
flabby, unhealthy, and rickety; and the mother is usually nervous,

emaciated, and hysterical. A child who is suckled beyond the proper time,
more especially if there be any predisposition, sometimes dies either of
water on the brain, or of consumption of the lungs, or of mesenteric disease.
716. The manner in which a mother ought to act when she weans her
child.—“She must, as the word signifies, do it gradually—that is to say, she
should by degrees give him less and less of the breast, and more and more
of artificial food; she ought, at length, only to suckle him at night; and
lastly, it would be well for the mother either to send him away, or to leave
him at home, and for a few days to go away herself.”[127]
717. “A good plan is for the nurse to have in the bed a half-pint bottle of
new milk, which, to prevent it from turning sour, has been previously
boiled, so as to give a little to the child in lieu of the breast. The warmth of
the body will keep the milk of a proper temperature; and will supersede the
use of lamps, of candle-frames, and other troublesome contrivances.”[128]
718. If the mother be not able to leave home herself, or to send her child
from home, she ought then to let the child sleep in another room, with some
responsible person—I say responsible person, for a baby must not be left to
the tender mercies of a giggling, thoughtless young girl.
719. If the mother, during the daytime, cannot resist having her child in
the room with her, then I should advise her to make a paste of aloes—that is
to say, let her mix a little powdered aloes with a few drops of water, until it
be of the consistence of paste—and let her smear it on the nipple every time
just before putting him to the breast; this will be quite enough for him; and
one or two aloe applications to the nipple will make him take a disgust to
the bosom, and thus the weaning will be accomplished. A mother need not
be afraid that the aloes will injure her baby; the minute quantity he will
swallow will do no harm; for the moment he tastes it, the aloes being
extremely bitter, he will splutter it out of his mouth.
720. Another application for the nipple, to effect weaning, is wormwood.
There are two ways of applying it, either (1) by sprinkling a very small
pinch of powdered wormwood on the nipple; or (2) by bathing the nipple
with a small quantity of wormwood tea just before applying the babe to it—
either the one or the other of these plans will make him take a dislike to the
breast, and thus the weaning will be accomplished. Wormwood is
excessively bitter and disagreeable, and a slight quantity of it on the nipple
will cause an infant to turn away from it with loathing and disgust—the

wormwood, the minute quantity he will taste, will not at all injure him.
Wormwood was in Shakspeare’s time used for the purpose of weaning:
“And she was wean’d,—I never shall forget it—
Of all the days of the year upon that day:
For I had then laid wormwood to my dug [breast],
Sitting in the sun under the dove-house wall,
My lord and you were then at Mantua:
Nay, I do bear a brain: but, as I said,
When it did taste the wormwood on the nipple
Of my dug, and felt it bitter, pretty fool!
To see it tetchy, and fall out with the dug.”[129]

721. The best way of “drying up the milk” is to apply to each breast soap
plaster (emplastrum saponis), spread on soft pieces of wash-leather, the
shape and size of the top of a hat, with a round hole the size of a shilling in
the middle of each to admit the nipple, and with a slit from the center to the
circumference of each plaster to make a better fit. These plasters ought to be
spread by a chemist.
722. When the child is once weaned, the breasts ought not to be drawn,
as the drawing of them would cause them to secrete larger quantities of
milk; if, therefore, the bosoms be ever so full or uncomfortable, a mother
ought to leave them alone; she should wait patiently, and the milk will
gradually diminish, and will at length disappear.
723. The drawing of the bosoms, during weaning, either by means of a
breast-pump, or by the mouth, or by other like contrivances, has frequently
caused gathered breasts. If not drawn, they scarcely, if ever, gather.
724. The foregoing plan of “drying up the milk” will generally in five or
six days assuage the milk away; but if, at the end of three days, the bosoms
still continue full and uncomfortable, the plasters should be removed, and
the breasts ought, every four hours, to be well but tenderly rubbed with
equal parts of olive oil and of eau de Cologne; the nurse supporting the
bosom, during such friction, with her other hand.
725. Let me impress the above important advice on a nursing mother’s
mind; it might save a great deal of after-suffering and misery.
726. It might be well to state that, after the child has been weaned, the
milk does not always entirely leave the breast, not even for weeks, and, in
some cases, not even for months; it is not of the slightest consequence, and
requires no treatment to get rid of it.

727. A mother ought, during the period of weaning, to live abstemiously,
and should drink as little as possible. In many cases, it is necessary to give,
every morning, for two or three mornings, a few doses of mild aperient
medicine, such as either a Seidlitz powder, or a teaspoonful of Henry’s
magnesia and a teaspoonful of Epsom salts in half a tumbler of warm water.
728. Symptoms denoting the necessity of weaning.—A mother sometimes
cannot suckle her child; the attempt bringing on a train of symptoms
somewhat similar to the following: singing in the ears; dimness of sight;
aching of the eyeballs; throbbing in the head; nervousness; hysterics;
tremblings; faintness; loss of appetite and of flesh; fluttering and palpitation
of the heart; feelings of great exhaustion; indigestion; costiveness; sinking
sensations of the stomach; pains in the left side; great weakness and
dragging pains of the loins, which are usually increased whenever the infant
is put to the bosom; pallor of the countenance; shortness of breath; swelling
of the ankles.
729. Of course, every mother who is suffering from suckling does not
have the whole of the above long catalogue of symptoms! But if she has
three or four of the more serious of them, she ought not to disobey the
warnings, but should discontinue nursing; although it may be necessary, if
the babe himself be not old enough to wean, to obtain a healthy wet-nurse
to take her place.
730. Remember, then, that if the above warning symptoms be
disregarded, dangerous consequences, both to parent and child, might be the
result. It might either throw the mother into a consumption, or it might
bring on heart disease; and, in consequence of his not being able to obtain
sufficient or proper nourishment, it might cause the infant to dwindle and
pine away, and, eventually, to die of water on the brain.
731. Soon after nine months’ nursing, “the monthly courses” generally
return. This is another warning that the babe ought immediately to be
weaned, as the milk will lessen both in quantity and in nourishment, and the
child in consequence will become delicate and puny, and every day he is
suckled will lose, instead of gain, ground. I have known many children,
from protracted suckling, smaller at twelve months than they were at nine
months; and well they might be, as, after nine months, the mother’s milk
usually does them harm instead of doing them good, and thus causes them
to dwindle away.

732. At another time, although the above train of symptoms does not
occur, and notwithstanding she may be in perfect health, a mother may not
be able to suckle her baby. Such a one usually has very small breasts, and
but little milk in them, and if she endeavor to nurse her infant, it produces a
violent aching of the bosom. Should she disregard these warnings, and
should still persevere, it might produce inflammation of the breast, which
will probably end in a gathering.
733. An obstinate sore nipple is sometimes a symptom denoting the
necessity of weaning.—When the nipples are, and, notwithstanding
judicious treatment, persistently for some time continue, very sore, it is
often an indication that a lady ought to wean her baby. Long-continued,
obstinate sore nipples frequently occur in a delicate woman, and speak, in
language unmistakable, that the child, as far as the mother herself is
concerned, must be weaned. Of course, if the infant be not old enough to
wean, when practicable a wet-nurse ought to take the mother’s place. If the
above advice were more frequently followed than it is, gathered breasts,
much suffering, and broken health would not so frequently prevail as they
now do.
734. If a mother be predisposed to consumption; if she has had spitting of
blood; if she be subject to violent palpitation of the heart; if she be laboring
under great debility and extreme delicacy of constitution; if she has any of
the above complaints or symptoms, she ought not on any account to suckle
her child, but should by all means procure a healthy wet-nurse.
735. Occasionally a mother suckles her infant when she is pregnant. This
is highly improper, as it not only injures her own health, and may bring on a
miscarriage, but it is also prejudicial to the baby, and may produce a
delicacy of constitution from which he might never recover.

In conclusion, I fervently hope that this little book will, through God’s
blessing, be to my fair reader, during the whole period of her wifehood, a
friend in her need, a guide in her difficulties, and a silent but trusty
counselor in all things pertaining to her health. I sincerely trust that it will
give her as much pleasure in the reading of these pages as it has given me in
the writing of them.

INDEX.

Ablution after labor, 245.
among the poor, 41.
manner of young wife performing, 42.
morning, 41.
in pregnancy, 124.
thorough, 41.
Abortion, 174.
the procuring of, 120.
Accoucheur, the duties of, 206.
Advice to a monthly nurse, 196.
After birth should never be brought away by nurse, 233.
After pains, 212.
Age at which menstruation commences, 105.
Age, best, to marry, 104.
Ages of mother and wet-nurse, 265.
Ailments of pregnancy, 140.
during suckling, 236.
Air, cold, the value of, 37.
pure in bedroom, 34.
Air and exercise in pregnancy, 125.
during suckling, 268.
and occupation, 126.
Ale and porter, sour, 253.
more nourishing than wine, 266.
Alcohol a deadly poison, 57.

in brandy and in wine, 57.
Aloe paste in weaning, 295.
Amusements of a young wife, 20.
Aperient pills after confinement, 241.
Aperients in pregnancy, 140.
the abuse of, 244.
before labor, 155.
immediately after, improper, 241.
during suckling, 287.
on frequent, 99.
Appetite, bad, 51.
and leanness, 54.
Applications for hair, 47.
Armstrong on ablution, 49.
Articles wanted at labor, 216.
Artificial respiration, 232.
Assisting nature, on, 209.

Bad breast, 282.
Bandage after confinement, 236.
Barley-water and new milk, 251.
Barren wives, 14.
diet of, 38.
number of, 14.
Barrenness and fashion, 68.
in higher ranks, 60.
Bathing feet, 45.
shoulders and back, 42.
whole body, 42.

Bay salt, 45.
Bearing down pains, 202.
of womb, 247.
Beauty-sleep, 72.
Bed, “the guarding of,” 218.
Bed-pan, the best kind of, 244.
Bedroom for pregnant female, 137.
ventilation of, 73.
Bedstead, a four-post, in labor, 216.
Beef-tea, how to make (note), 249.
“Being out in reckoning,” 187.
Beverage after labor, 251.
the best for young wife, 55.
for mother whose child is ill, 268.
Bidet should be regularly used, 124.
Bladder, irritability of, 164, 199.
importance of attending to, 233.
in pregnancy, 164.
sluggishness of, 164.
state of, after confinement, 239.
“Blue-stocking,” as a wife, 93.
Bosom after labor, 259.
Bowels to be opened before labor, 155.
if regular, no aperient required, 145.
Bowel complaints of pregnancy, 145.
Bowels, state of, after labor, 241.
Boy or girl?, 188.
Brandy to be in the lying-in room, 222.
on the use of, during labor, 222, 235.

Bran-bread as an aperient, 289.
Breakfast for young wife, 50.
a meager, 50.
Breast-drawer, 258.
during suckling, 260, 282.
Breast, full and uneasy, 282.
in second and in succeeding confinements, 259.
painful during pregnancy, 162.
gathered, 282.
causes of, 283.
importance of early treatment, 286.
shivering fit in, 286.
symptoms of, 286.
two forms of, 285.
Breast-pump, ill effects of, 296.
Bringing up of girls, 96.
Bugs and fleas, 97.
Business of a wife, 90.

Calomel dangerous in pregnancy, 140.
Carbonic acid gas in crowded rooms, 33, 86.
Carpet for bath-room, 47.
Carriage exercise, on the abuse of, 29.
Castor oil, the dose and manner of administering, 141.
external use of, 144.
Caudle should be banished lying-in room, 236.
“Caul,” a child’s (note), 230.
Cause, one, of small families, 60.
“Ceasing to be unwell,” 117.
to menstruate, 115.

Champagne-cup, 63.
Change of air for delicate wife, 96.
“Change of life,” 115.
“Change of life,” great importance of not neglecting, 115.
of room after labor, 253.
Cheerful wife, 87.
Cheerfulness during labor, 220.
and occupation, 87, 93.
Child born before arrival of medical man, 228.
should be gradually weaned, 294.
Childless house, 14.
Chimney, on stopping, 35.
Chloroform in hard and lingering labor, 225.
Chlorosis and hysteria, 113.
Circulation, languid, 30, 55.
Cleanliness of body, 41.
“Cleansings,” 245.
Clever wife a fortune, 90.
Clothing in pregnancy, 123.
after labor, 234.
during suckling, 262.
Clysters, 242, 288.
Coffee as an aperient, 142, 290.
Complexion, a fine, 25, 27.
Contentment, 87.
Cook, an idiot of a, 90.
Cookery, good and careful, 89.
Costiveness during pregnancy, 140.

a cause of hard labor, 143.
“Count,” 185.
the German method of making, 187.
a good plan to make the, 186.
Country, on living in the, 36, 137.
Cramp of the bowels, 168.
Cramps of the legs and thighs in pregnancy, 168, 203.
Creasote in toothache, 156.
“Croakers,” during labor, 190, 219.
Croquet, best of games, 85.
Crying out, when in pain, 214.
Curates’ wives, 38.

Dancing, danger of young wife, 86.
Dangers of wine-drinking, 56.
of early marriages, 104.
Daylight, importance of, 79.
Depression of spirits during suckling, 267.
Derbyshire oatmeal gruel, 143.
Dews of morning and evening, 26, 70.
Diarrhœa in pregnancy, 145.
Dietary of a young wife, 49.
pregnant female, 134.
after labor, 249.
Diet during suckling, 263.
of lying-in women, 249
of young wife, 49.
Digestion, a good, 271.

Dirt in wrong place, 132.
Difficulty of lying down in pregnancy, 138.
of making water, 223.
Dinners and tempers, 92.
Disinfectant, 129.
Dissipation and barrenness, 14.
Domette bandages, 153.
Dozing, ill effects of, 67.
Drainage, 132.
Dress for labor, 217.
for young wife, 82.
“Drying up the milk,” 296.
Duration of menstruation, 105.
Duties of a nursing mother, 255.
of a wife, 92.

Early Maturity, 106.
riser needs refreshment, 68.
rising and early to bed, 71.
a cosmetic, 70.
a duty, 71.
good effects of, 70.
Early rising rejuvenizes, 70.
Economy, domestic, 87.
Employment “nature’s doctor,” 274.
Enceinte, the origin of the word (note), 113.
Enema apparatus, 100, 197.
for costiveness, 100.
for lying-in patient, 242.

Enemata of tepid water, 152.
Ewers and basins, Liliputian, 41.
Exercise for a young wife, 23.
a necessity, 24.
before breakfast, 47.
best aperient, 144.
for the delicate, 25.
immense importance of, 23.
in close carriages, 29.
in pregnancy, 125.
during suckling, 268
fresh air and occupation during pregnancy, 126.
in open air after labor, 254.
promotes sleep, 78.

False labor pains, 183.
Fainting in pregnancy, 165.
Faintness during suckling, 287.
“Falling of the womb,” 247.
Falling off of hair, 47.
Fashion and barrenness, 38.
Fashionable system of spending married life, 18.
Fat and pregnancy, how to distinguish between, 121.
Feet, cold, exercise the remedy for, 30.
and legs, bathing, 45.
Females who have sick pregnancies, 161.
“Female slipper,” 239.
Fire-guard on lying-in room grate, 237.
Fire, ill effects of sitting near, 27.
Flannel, 218.

next skin, 83.
Flatulence and “quickening,” 121.
Fleas and bugs, 97.
Fœtal circulation (note), 122.
Folly of shutting out light, 79.
Food, variety of, necessary, 265.
French bed-pan, 244.
cookery, 91.
plums, stewed, 289.
Friend, the choice of, during labor, 219.
Fruit useful in pregnancy, 136.
Fruitful women, 60.
Fruit tree, a simile, 15.
Fruitless suckling, 283.
Fumigations, 129.

Garters, ill effects of, in pregnancy, 123.
Gathered breasts, 282.
causes of, 283.
importance of early treatment, 286.
German breakfast, 289.
Gestation, period of, 185.
Ginger plaster, 157.
Girl or boy?, 188.
Greens, cabbages, and pickles, 290.
“Guarding of the bed,” 218.

Hair, on washing, 46.
Health, a beautifier, 23.
importance of, 101.
of wives, 13.
worth trying for, 17.
Heart, palpitation of, during pregnancy, 167.
Heartburn in pregnancy, 147.
Hints to attendants, 228.
to mother when infant is ill, 268.
Home known only in England, 86.
Honey, on the wholesomeness of, 289.
Hot-water bag, 147, 168.
House, a healthy, 36.
Household duties, 86.
good, 272.
Hysteria, 113.
Husband in lying-in room, 210.

Idle ladies, 78.
people, 25.
Idleness brings misery, 127.
effects of, 17.
India-rubber teat and shield for drawn-in nipple, 276.
for sore nipple, 280.
Indolence, the ill effects of, in pregnancy, 126.
Infant born apparently dead, 230.
the period of suckling an, 293.
the cry of an, 230.
Introductory Chapter, 13.

Irish women, poor, 38.
Irritation and itching, 172.

Jam as an aperient, 89.
Jeremy Taylor’s description of a wife, 13.

Labor, 199.
the easy and the hard, 94.
rapid, directions concerning, 228.
symptoms of, 199–215.
treatment of, 216–254.
Lavements in pregnancy, 144.
Leather cheaper than physic, 24.
Legs, the swollen, of pregnancy, 152.
Length of time of first labor, 210.
of an after labor, 210.
Life is to be well, 18.
Light, effects of, 79.
is life, 79.
Little ablution—much clothing, 84.
Lively women and easy labors, 127.
Luxurious idle wife, 77.
Luxury, an age of, 28.
ill effects of, 38.
Lying-in room, 237.
temperature of, 237.

Maid-servants and the “ologies,” 92.
Marmalade as an aperient, 290.

Marshmallow and chamomile fomentation (note), 245.
Martin Luther on work, 89.
Mastication, thorough, 54.
Materials of food should be mixed and varied, 265.
Means to strengthen, 16.
Meddlesome breast-tending, 260.
midwifery reprobated, 205.
Medical men, 209.
Medicines in pregnancy, 140–173.
opening, danger of, 99.
Menstrual fluid, 111.
Menstruation, 103.
accompanied with “the whites,” 112.
before marriage, 111.
during 30 years, 102.
painful, 111.
dangers of, 111.
profuse, 112.
sparing, 112.
too pale or too dark, 111.
when not properly performed, 111.
Milk at its “height,” 259.
the best way of “drying up” the, 296.
flowing away constantly, 280.
very fattening, 54.
Miscarriage, 174.
care required after, 178.
causes of, 175.
consequences of a neglected, 178.
flooding in, 177.
prevention of, 179.
symptoms of a threatened, 176.

treatment of, 179.
usual time of taking place, 177.
Misconception and prejudice, 238.
Mission, the glorious, 101.
Monthly nurse, 189–198.
Morning sickness, 117, 158.
Mothers predisposed to consumption, 300.
who cannot suckle, 299.
unnatural, 255.
Mountain-air, 97.
Mufflers and sore throats, 84.
Mutton-chops, folly of living entirely on, 52.

Nature in early morning, 68.
Navel, pouting of, as a sign of pregnancy, 122.
Navel-string, the manner of tying, 233.
not to be tied until the child breathes, 232.
Nipple, cracked and fissured, 279.
during suckling, 257.
means to harden, 162.
great importance of hardening, 162.
retraction of, 275.
shields, 276.
sore, 277.
an obstinate, 299.
washing of, and breast, 257.
wet, 280.
shields, Wansbrough’s, 279.
Nose, a sentinel, 129.
Nurse, monthly, 189–198.
importance of choosing a good, 189.

on wearing crinoline, 197.
on wearing slippers instead of shoes, 198.
Nursery-basin, 43.
Nursing, prolonged, danger of, 293.
apron, 263.

Oatmeal, Derbyshire, 143.
gruel as a fomentation, 245.
Occupation, 87, 272.
fresh air, and exercise, 272.
Offspring of very young and very old, 104.
Olive oil as an aperient, 142.
Opening medicine, 99.

Pains, “bearing down,” 203.
before and during menstruation, 111.
“grinding,” 200.
at night in pregnancy, 139.
Painless parturition, 212.
Palpitation of the heart in pregnancy, 167.
Passion, the ill effects of, during suckling, 270.
Pendulous belly of pregnancy, 154.
Pepper plaster, 157.
Period of gestation, 185.
of taking exercise, 254.
Pessaries, 248.
Physic, a substitute for exercise, 31.
best, is exercise, 25.
Piles in pregnancy, 148.

Pleasure and health, 85.
Plethoric pregnant females, 136.
Poisoned by one’s own breath, 35.
Porter and ale for a nursing mother, 266.
Position after delivery, 237.
of a mother during suckling, 270.
of patient after labor, 237.
“Pottering” nurse, 190.
Poultice, a bread and milk and sweet oil, 282.
Precursory symptoms of labor, 199.
Pregnancy, 117.
duration of, 185.
a natural process, 127.
period of, 185.
signs of, 117.
Preliminary observations, 13.
Preparation for health, 47.
for labor, 216.
Profession of a wife, 90.
Prolific mothers (note), 105.
Proper time for a patient to sit up after labor, 246.
to send for medical man, 200, 203.
to send for the nurse, 200.
Protrusion of the bowels, 149.
Prunes, stewed, 289.
Puberty, period of (note), 105.
Pump-water, contamination, 132.
on boiling, 133.
on purity of, 132.

“Quickening,” 120.
flatulence mistaken for, 121.
Quiet after confinement, 246.

Rain and wind, exercise in, 24.
Rats in drains and sewers, 130.
“Reckoning,” to make the, 186.
Refreshment after labor, 235.
Remedies to prevent costiveness, 291.
Respiration, artificial, 232.
Rest after delivery, 234.
in pregnancy, 133.
and quietude after labor, 246.
Restlessness at night, 138.
remedies for, 138.
Rich ladies, 38.
Rising of the sun on seeing the, 71.
Rock-salt, 45.
Rules for a female prone to miscarry, 180.
for barren wife, 14.
of health, 99.

Sea-bathing, in pregnancy, 125.
Sea water good for hair, 46.
Servants taught the “ologies,” 92.
Shivering during labor, 201.
“Show,” a sure sign of labor, 200.
Shower-bath in pregnancy, 125.

Sick pregnancies, 161.
Sickness during labor, 201.
Signs of the fœtal circulation (note) 123.
of pregnancy, 117.
Sitting over fire, 27.
with back to fire, 27.
Sitz-bath, the value of, 44, 124, 172.
Skin of the abdomen cracked, 154.
Skylight the best ventilator, 128.
Sleep in pregnancy, 137.
the choicest gift, 77.
the value of, immediately after labor, 238.
for young wife, 78.
Sleepiness of pregnant females, 138.
Sleeplessness of pregnant females, 138.
Slipper bed-pan, 239, 244.
Sluggard’s dwelling, 71.
“Smoking dunghill,” a, 131.
Sore nipples, 277.
Spirits during suckling, 268.
Spurious labor pains, 183.
Stages of labor, 213.
Stays should not be worn during labor, 218.
Stocking, elastic, 153.
Stomach, functions of, 271.
Subsidence of the womb before labor, 199.
“Suck-pap,” 258.
Suckling, 255.

when female is pregnant, 300.
Suppers, hearty meal, 52.
Support to bowels after confinement, 236.
Swedish ladies, 91.
Swollen legs in pregnancy, 152.
Symptoms of labor, 199.
denoting necessity of weaning, 298.

Table of duration of pregnancy, 185.
Taking, the frequent, of physic, 31.
Teat, india-rubber, and shield, 276.
Teeth frequently decay in pregnancy, 156.
and gums, 55.
Temperature of a lying-in room, 237.
“The top of the morning,” 72.
Things which will be wanted at a labor, 216.
Tic-douloureux, 157.
Tight lacing injurious to a young wife, 81.
ill effects of, in pregnancy, 123.
Time when a child should be weaned, 293.
Toothache in pregnancy, 155.
remedies for, 156.
Tooth extraction, the danger of, in pregnancy, 155.
“Trap to catch sunbeam,” 81.
True labor pains, 202.
“Trying of a pain,” 221.
“Turn of years,” 115.

Unladylike, on being, 96.
Urine, retention of, 240.

Vaginal syringe, 196.
Veal-and-milk broth, 251.
Veins, enlarged, of the leg, 152.
Ventilation, importance of, 33, 128.
manner of performing, 34.
of lying-in room, 254.
thorough, 36.
Visitors in a lying-in room, 238.

Walk before breakfast, 47.
in frosty weather, 28.
Walking glorious exercise, 23.
Warm ablutions after labor, 245.
baths for infants apparently still-born, 231.
Water poisoned by drains, 132.
Waters, “the breaking of the,” 202.
Weaning, 292.
Weaning an infant, the method of, 294.
Wellington, the Duke of, 67.
Westmoreland and Cumberland poor women, 229.
Wet-nurses’ and mother’s milk, 265.
Whining and repining, 95.
“Whites” during pregnancy, 169.
cause miscarriage, 112.
when not pregnant, 112.

Wife, a domestic, 90.
educated to be useful, 90.
instructing servants, 92.
the mission of a, 22.
the profession of a, 90.
young, 13.
Wine, abuse of, 57.
bibbing causes barrenness, 57.
drinking of, 55.
in France, 61.
on children taking, 61.
much injures complexion, 64.
during suckling, 267.
Womb, bearing down of, 247.
Work, a cure for many ailments, 93.
Wormwood on nipples in weaning, 296.

ADVICE TO A MOTHER
ON THE

MANAGEMENT OF HER CHILDREN,
AND ON THE

TREATMENT ON THE MOMENT
OF

SOME OF THEIR MORE PRESSING ILLNESSES AND
ACCIDENTS.

BY

PYE HENRY CHAVASSE,
FELLOW OF THE ROYAL COLLEGE OF SURGEONS OF ENGLAND; FELLOW OF THE
OBSTETRICAL SOCIETY OF LONDON; FORMERLY PRESIDENT OF QUEEN’S COLLEGE
MEDICO-CHIRURGICAL SOCIETY, BIRMINGHAM; AUTHOR OF “ADVICE TO A WIFE ON
THE MANAGEMENT OF HER OWN HEALTH.”

“Lo, children and the fruit of the womb are an heritage and cometh of the Lord.”

SEVENTEENTH EDITION.

PHILADELPHIA
J. B. LIPPINCOTT & CO.
1881.

TO

Sir CHARLES LOCOCK, Bart., F.R.S.,
FIRST PHYSICIAN-ACCOUCHEUR TO HER MAJESTY THE QUEEN.

Dear Sir Charles:

Your kind and flattering approval of this little Book, and your valuable
suggestions for its improvement, demand my warmest gratitude and
acknowledgments, and have stimulated me to renewed exertions to make it
still more complete and useful, and thus more worthy of your approbation.
You have greatly added to my obligation, by allowing me to indicate
those passages of the work that you considered required correction,
addition, and improvement. On reference to these pages, it will be at once
perceived how greatly I am indebted to you, and how much I have profited
by your valuable advice.
I have the honor to remain,
Dear Sir Charles,
Your faithful and obliged servant,
PYE HENRY CHAVASSE.

Priory House, Old Square,
Birmingham.

PREFACE.

The sale of this book is enormous; where hundreds were formerly
disposed of, thousands are now sold; and the sale still increases with
increasing velocity.
The book has been a great success: I had the good fortune, some thirty
years ago, to turn up new ground—to hit upon a mine, which I have, ever
since, even until now, worked with my best energy and ability. One cause of
the immense success this work has achieved is, that it treats of some
subjects which, although they be subjects of vital importance to the well-
being of children, all other works of a kindred nature do not even touch
upon.
I have, during the last thirty years, been constantly on the watch to give a
mother additional and useful advice on the management of her children; so
that, in point of fact, this present edition consists of more than treble the
quantity of information contained in the earlier editions. The quantity is not
only increased, but the quality is, I trust, greatly improved.
The last edition, comprising five thousand copies, has been rapidly
exhausted: to supply the increased and increasing demand, seven thousand
copies of this—the Ninth Edition—are now published. The enormous, and,
for a medical work, unusually large sale, is most gratifying to me as well as
to my worthy publishers.
I have taken great pains to improve the present edition: much new matter
has been introduced; several paragraphs have been abridged; some portions
have been rewritten—as my extended experience has enabled me to enter
on many of the subjects more fully, and, I trust, more usefully; and the book
has been throughout thoroughly revised.
Lord Chesterfield, in writing to his son, once said: “If I had had longer
time, I would have written you a shorter letter.” Now, I have found time
both to curtail some of the passages of this work, and to remove many,
indeed, a large majority of the quotations from the text. I have,

consequently, been able to fill up the various spaces with much original,
and, I trust, useful matter; and thus, without materially increasing the bulk
of the book, to keep it within reasonable bounds. The notes and annotations
of Sir Charles Locock are, however, perfectly intact—they are too valuable
either to be omitted, or to be, in the slightest degree, curtailed.
The writing, revising, improving, and enlarging of this, and of my other
work—Advice to a Wife—have, for upwards of a quarter of a century, been
my absorbing occupation—my engrossing study. I have loved, and
cherished, and tended the two books as though they were my children; and
have, in each successive edition, always striven to bring them, as nearly as
my abilities would allow, to a state of completeness—to make them, in fact,
a perfect Vade-mecum for Wives and Mothers. I might truly say, that the
occupation has ever been to me a source of pure and unalloyed enjoyment.
The correction of the pages has often cheered me when I have been in grief
or in trouble, and has soothed me when, in my profession, I have been
either harassed or vexed: truly, I have had my reward! My fervent desire is,
that some portion of the pleasure and comfort I have derived from the
writing of these books may be experienced by my readers. If it be only a
tithe of what I myself have felt, I shall be more than amply rewarded for my
pains.
P. H. C.

CONTENTS.

PART I.—INFANCY.
PAGE
Preliminary Conversation 1013
Ablution 1016
Management of the Navel 1024
Clothing 1028
Diet 1032
Vaccination 1056
Dentition 1062
Exercise 1075
Sleep 1077
The Bladder and the Bowels 1084
Ailments, Disease, etc. 1085
Concluding Remarks on Infancy 1119

PART II.—CHILDHOOD.
Ablution 1120
Clothing 1123
Diet 1132
The Nursery 1150
Exercise 1172
Amusements 1177
Education 1183
Sleep 1188
Second Dentition 1194
Disease, etc. 1195
Warm Baths 1294
Warm External Applications 1295
Accidents 1297

PART III.—BOYHOOD AND GIRLHOOD.
Ablution, etc. 1318
Clothing 1327
Diet 1332
Air and Exercise 1337
Amusements 1341
Education 1347
Household Work for Girls 1355
Choice of Profession or Trade 1355
Sleep 1359

On the Teeth and the Gums 1364
Prevention of Disease, etc. 1366

Index 1403

Advice to a Mother.

PART I.—INFANCY.
I hardly know so melancholy a reflection, as that Parents are necessarily the sole directors of the
management of Children; whether they have, or have not judgment, penetration, or taste, to perform
the task.—Greville.
Man’s breathing Miniature!—Coleridge.

PRELIMINARY CONVERSATION.

1. I wish to consult you on many subjects appertaining to the
management and the care of children,—will you favor me with your advice
and counsel?
I shall be happy to accede to your request, and to give you the fruits of
my experience in the clearest manner I am able, and in the simplest
language I can command—freed from all technicalities. I will endeavor to
guide you in the management of the health of your offspring;—I will
describe to you the symptoms of the diseases of children;—I will warn you
of approaching danger, in order that you may promptly apply for medical
assistance before disease has gained too firm a footing;—I will give you the
treatment on the moment of some of their more pressing illnesses—when
medical aid cannot quickly be procured, and where delay may be death;—I
will instruct you, in case of accidents, on the immediate employment of
remedies—where procrastination may be dangerous;—I will tell you how a
sick child should be nursed, and how a sick room ought to be managed;—I
will use my best energy to banish injurious practices from the nursery;—I
will treat of the means to prevent disease where it be possible;—I will show
you the way to preserve the health of the healthy,—and how to strengthen
the delicate;—and will strive to make a medical man’s task more agreeable
to himself,—and more beneficial to his patient,—by dispelling errors and
prejudices, and by proving the importance of your strictly adhering to his
rules. If I can accomplish any of these objects, I shall be amply repaid by
the pleasing satisfaction that I have been of some little service to the rising
generation.

2. Then you consider it important that I should be made acquainted with,
and be well informed upon, the subjects you have just named?
Certainly. I deem it to be your imperative duty to study the subjects well.
The proper management of children is a vital question,—a mother’s
question,—and the most important that can be brought under the
consideration of a parent; and, strange to say, it is one that has been more
neglected than any other. How many mothers undertake the responsible
management of children without previous instruction, or without
forethought; they undertake it as though it may be learned either by
intuition or by instinct or by affection! The consequence is, that frequently
they are in a sea of trouble and uncertainty, tossing about without either rule
or compass; until, too often, their hopes and treasures are shipwrecked and
lost!
The care and management, and consequently the health and future well-
doing of the child, principally devolve upon the mother; “for it is the
mother after all that has most to do with the making or the marring of the
man.”[130] Dr. Guthrie justly remarks that—“Moses might never have been
the man he was unless he had been nursed by his own mother. How many
celebrated men have owed their greatness and their goodness to a mother’s
training!” Napoleon owed much to his mother. “‘The fate of a child,’ said
Napoleon, ‘is always the work of his mother;’ and this extraordinary man
took pleasure in repeating, that to his mother he owed his elevation. All
history confirms this opinion.... The character of the mother influences the
children more than that of the father, because it is more exposed to their
daily, hourly observation.”[131]
I am not overstating the importance of the subject in hand when I say that
a child is the most valuable treasure in the world, that “he is the precious
gift of God,” that he is the source of a mother’s greatest and purest
enjoyment, that he is the strongest bond of affection between her and her
husband, and that
“A babe in a house is a well-spring of pleasure,
A messenger of peace and love.”[132]

In the writing of the following pages I have had one object constantly in
view—namely, health—
“That salt of life, which does to all a relish give;
Its standing pleasure, and intrinsic wealth,

The body’s virtue, and the soul’s good fortune—health.”

ABLUTION.

3. Is a new-born infant, for the first time, to be washed in warm or in cold
water?
It is not an uncommon plan to use cold water from the first, under the
impression of its strengthening the child. This appears to be a cruel and
barbarous practice, and is likely to have a contrary tendency. Moreover, it
frequently produces either inflammation of the eyes, or stuffing of the nose,
or inflammation of the lungs, or looseness of the bowels. Although I do not
approve of cold water, we ought not to run into an opposite extreme, as hot
water would weaken and enervate the babe, and thus would predispose him
to disease. Lukewarm rain water will be the best to wash him with. This, if
it be summer, should have its temperature gradually lowered, until it be
quite cold; if it be winter, a dash of warm water ought still to be added, to
take off the chill.
It will be necessary to use soap—Castile soap being the best for the
purpose—it being less irritating to the skin than the ordinary soap. Care
should be taken that it does not get into the eyes, as it may produce either
inflammation or smarting of those organs.
If the skin be delicate, or if there be any excoriation or “breaking-out” on
the skin, then Glycerin soap, instead of the Castile soap, ought to be used.
4. At what age do you recommend a mother to commence washing her
infant in the tub or in the nursery-basin?[133]
As soon as the navel-string comes away.[134] Do not be afraid of water,—
and that in plenty,—as it is one of the best strengtheners to a child’s
constitution. How many infants suffer, for the want of water, from
excoriation!
5. Which do you prefer—flannel or sponge—to wash a child with?
For the first part of the washing a piece of flannel is very useful—that is
to say, to use with the soap, and to loosen the dirt and the perspiration; but
for the finishing-up process, a sponge—a large sponge—is superior to
flannel, to wash all away, and to complete the bathing. A sponge cleanses
and gets into all the nooks, corners, and crevices of the skin. Besides,

sponge, to finish up with, is softer and more agreeable to the tender skin of
a child than flannel. Moreover, a sponge holds more water than flannel, and
thus enables you to stream the water more effectually over him. A large
sponge will act like a miniature shower-bath, and will thus brace and
strengthen him.
6. To prevent a new-born babe from catching cold, is it necessary to wash
his head with brandy?
It is not necessary. The idea that it will prevent cold is erroneous, as the
rapid evaporation of heat which the brandy causes is more likely to give
than to prevent cold?
7. Ought that tenacious, paste-like substance, adhering to the skin of a
new-born babe, to be washed off at the first dressing?
It should, provided it be done with a soft sponge and with care. If there
be any difficulty in removing the substance, gently rub it, by means of a
flannel,[135] either with a little lard, or fresh butter, or sweet oil. After the
parts have been well smeared and gently rubbed with the lard, or oil, or
butter, let all be washed off together, and be thoroughly cleansed away, by
means of a sponge and soap and warm water, and then, to complete the
process, gently put him for a minute or two in his tub. If this paste-like
substance be allowed to remain on the skin, it might produce either an
excoriation or a “breaking-out.” Besides, it is impossible, if that tenacious
substance be allowed to remain on it, for the skin to perform its proper
functions.
8. Have you any general observations to make on the washing of a new-
born infant?
A babe ought, every morning of his life, to be thoroughly washed from
head to foot; and this can only be properly done by putting him bodily
either into a tub, or into a bath, or into a large nursery-basin half filled with
water. The head, before placing him in the bath, should be first wetted (but
not dried); then immediately put him into the water, and, with a piece of
flannel well soaked, cleanse his whole body, particularly his armpits,
between his thighs, his groins, and his hams; then take a large sponge in
hand, and allow the water from it, well filled, to stream all over his body,
particularly over his back and loins. Let this advice be well observed, and
you will find the plan most strengthening to your child. The skin must, after
every bath, be thoroughly but quickly dried with warm, dry, soft towels,

first enveloping the child in one, and then gently absorbing the moisture
with the towel, not roughly scrubbing and rubbing his tender skin as though
a horse were being rubbed down.
The ears must after each ablution be carefully and well dried with a soft
dry napkin; inattention to this advice has sometimes caused a gathering in
the ear—a painful and distressing complaint; and at other times it has
produced deafness.
Directly after the infant is dried, all the parts that are at all likely to be
chafed ought to be well powdered. After he is well dried and powdered, the
chest, the back, the bowels, and the limbs should be gently rubbed, taking
care not to expose him unnecessarily during such friction.
He ought to be partially washed every evening; indeed it may be
necessary to use a sponge and a little warm water frequently during the day,
namely, each time after the bowels have been relieved. Cleanliness is one of
the grand incentives to health, and therefore cannot be too strongly insisted
upon. If more attention were paid to this subject, children would be more
exempt from chafings, “breakings-out,” and consequent suffering, than they
at present are. After the second month, if the babe be delicate, the addition
of two handfuls of table salt to the water he is washed with in the morning
will tend to brace and strengthen him.
With regard to the best powder to dust an infant with, there is nothing
better for general use than starch—the old-fashioned starch made of
wheaten flour—reduced by means of a pestle and mortar to a fine powder;
or Violet Powder, which is nothing more than finely-powdered starch
scented, and which may be procured of any respectable chemist. Some
mothers are in the habit of using white lead; but as this is a poison, it ought
on no account to be resorted to.[136]
9. If the parts about the groin and fundament be excoriated, what is then
the best application?
After sponging the parts with tepid rain water, holding him over his tub,
and allowing the water from a well-filled sponge to stream over the parts,
and then drying them with a soft napkin (not rubbing, but gently dabbing
with the napkin), there is nothing better than dusting the parts frequently
with finely-powdered Native Carbonate of Zinc. The best way of using this
powder is, tying up a little of it in a piece of muslin, and then gently
dabbing the parts with it.

Remember excoriations are generally owing to the want of water—to the
want of an abundance of water. An infant who is every morning well soused
and well swilled with water, seldom suffers either from excoriations or from
any other of the numerous skin diseases. Cleanliness, then, is the grand
preventive of, and the best remedy for, excoriations. Naaman the Syrian
was ordered “to wash and be clean,” and he was healed, “and his flesh came
again like unto the flesh of a little child, and he was clean.”[137] This was, of
course, a miracle; but how often does water, without any special
intervention, act miraculously both in preventing and in curing skin
diseases!
An infant’s clothes, napkins especially, ought never to be washed with
soda; the washing of napkins with soda is apt to produce excoriations and
breakings-out. “As washerwomen often deny that they use soda, it can be
easily detected by simply soaking a clean napkin in fresh water and then
tasting the water; if it be brackish and salt, soda has been employed.”[138]
10. Who is the proper person to wash and dress the babe?
The monthly nurse, as long as she is in attendance; but afterward the
mother, unless she should happen to have an experienced, sensible,
thoughtful nurse, which, unfortunately, is seldom the case.[139]
11. What is the best kind of apron for a mother, or for a nurse to wear,
while washing the infant?
Flannel—a good, thick, soft flannel, usually called bath-coating—apron,
made long and full, and which of course ought to be well dried every time
before it is used.
12. Perhaps you will kindly recapitulate, and give me further advice on
the subject of the ablution of my babe?
Let him by all means, then, as soon as the navel-string has separated from
the body, be bathed either in his tub, or in his bath, or in his large nursery-
basin; for if he is to be strong and hearty, in the water every morning he
must go. The water ought to be slightly warmer than new milk. It is
dangerous for him to remain for a long period in his bath; this, of course,
holds good in a tenfold degree if the child has either a cold, or a pain in his
bowels. Take care that, immediately after he comes out of his tub, he is well
dried with warm towels. It is well to let him have his bath the first thing in
the morning, and before he has been put to the breast; let him be washed
before he has his breakfast; it will refresh him and give him an appetite.

Besides, he ought to have his morning ablution on an empty stomach, or it
may interfere with digestion, and might produce sickness and pain. In
putting him in his tub, let his head be the first part washed. We all know,
that in bathing in the sea, how much better we can bear the water if we first
wet our head; if we do not do so, we feel shivering and starved and
miserable. Let there be no dawdling in the washing; let it be quickly over.
When he is thoroughly dried with warm dry towels, let him be well rubbed
with the warm hand of the mother or of the nurse. As I previously
recommended, while drying him and while rubbing him, let him repose and
kick and stretch either on the warm flannel apron, or else on a small blanket
placed on the lap. One bathing in the tub, and that in the morning, is
sufficient, and better than night and morning. During the day, as I before
observed, he may, after the action either of his bowels or of his bladder,
require several spongings of lukewarm water, for cleanliness is a grand
incentive to health and comeliness.
Remember it is absolutely necessary to every child from his earliest
babyhood to have a bath, to be immersed every morning of his life in the
water. This advice, unless in cases of severe illness, admits of no exception.
Water to the body—to the whole body—is a necessity of life, of health, and
of happiness; it wards off disease, it braces the nerves, it hardens the frame,
it is the finest tonic in the world. Oh, if every mother would follow to the
very letter this advice, how much misery, how much ill health, might then
be averted!

MANAGEMENT OF THE NAVEL.

13. Should the navel-string be wrapped in SINGED rag?
There is nothing better than a piece of fine old linen rag, unsinged; when
singed, it frequently irritates the infant’s skin.
14. How ought the navel-string to be wrapped in the rag?
Take a piece of soft linen rag, about three inches wide and four inches
long, and wrap it neatly round the navel-string, in the same manner you
would around a cut finger, and then, to keep on the rag, tie it with a few
rounds of whity-brown thread. The navel-string thus covered should,

pointing upward, be placed on the belly of the child, and must be secured in
its place by means of a flannel belly-band.
15. If, after the navel-string has been secured, bleeding should (in the
absence of the medical man) occur, how must it be restrained?
The nurse or the attendant ought immediately to take off the rag, and
tightly, with a ligature composed of four or five whity-brown threads, retie
the navel-string; and to make assurance doubly sure, after once tying it, she
should pass the threads a second time around the navel-string and tie it
again; and after carefully ascertaining that it no longer bleeds, fasten it up in
the rag as before. Bleeding of the navel-string rarely occurs, yet, if it should
do so—the medical man not being at hand—the child’s after-health, or even
his life, may, if the above directions be not adopted, be endangered.
16. When does the navel-string separate from the child?
From five days to a week after birth; in some cases not until ten days or a
fortnight, or even, in rare cases, not until three weeks.
17. If the navel-string does not at the end of a week come away, ought
any means to be used to cause the separation?
Certainly not; it ought always to be allowed to drop off, which, when in a
fit state, it will readily do. Meddling with the navel-string has frequently
cost the babe a great deal of suffering, and in some cases even his life.
18. The navel is sometimes a little sore after the navel-string comes
away; what ought then to be done?
A little simple cerate should be spread on lint, and be applied every
morning to the part affected; and a white-bread poultice, every night, until it
be quite healed.
19. What are the causes of a rupture of the navel? What ought to be
done? Can it be cured?
(1.) A rupture of the navel is sometimes occasioned by a meddlesome
nurse. She is very anxious to cause the navel-string to separate from the
infant’s body, more especially when it is longer in coming away than usual.
She, therefore, before it is in a fit state to drop off, forces it away. (2.) The
rupture, at another time, is occasioned by the child incessantly crying. A
mother, then, should always bear in mind that a rupture of the navel is often
caused by much crying, and that it occasions much crying; indeed, it is a
frequent cause of incessant crying. A child, therefore, who, without any

assignable cause, is constantly crying, should have his navel carefully
examined.
A rupture of the navel ought always to be treated early—the earlier the
better. Ruptures of the navel can only be cured in infancy and in childhood.
If it be allowed to run on until adult age, a cure is impossible. Palliative
means can then only be adopted.
The best treatment is a Burgundy pitch plaster, spread on a soft piece of
wash-leather about the size of the top of a tumbler, with a properly adjusted
pad (made from the plaster) fastened on the center of the plaster, which will
effectually keep up the rupture, and in a few weeks will cure it. It will be
necessary, from time to time, to renew the plaster until the cure be effected.
These plasters will be found both more efficacious and pleasant than either
a truss or an elastic bandage; which latter appliances sometimes gall, and do
more harm than they do good.
20. If a child has a groin rupture (an inguinal rupture), can that also be
cured?
Certainly, if, soon after birth, it be properly attended to. Consult a
medical man, and he will supply you with a well-fitting truss, which will
eventually cure him. If the truss be properly made (under the direction of an
experienced surgeon) by a skillful surgical-instrument-maker, a beautiful,
nicely fitting truss will be supplied, which will take the proper and exact
curve of the lower part of the infant’s belly, and will thus keep on without
using any under-strap whatever—a great desideratum, as these under-straps
are so constantly wetted and soiled as to endanger the patient constantly
catching cold. But if this under-strap is to be superseded, the truss must be
made exactly to fit the child—to fit him like a ribbon; which is a difficult
thing to accomplish, unless it be fashioned by a skillful workman. It is only
lately that these trusses have been made without under-straps. Formerly the
under-straps were indispensable necessaries.
These groin ruptures require great attention and supervision, as the
rupture (the bowel) must, before putting on the truss, be cautiously and
thoroughly returned into the belly; and much care should be used to prevent
the chafing and galling of the tender skin of the babe, which an ill-fitting
truss would be sure to occasion. But if care and skill be bestowed on the
case, a perfect cure might in due time be insured. The truss must not be
discontinued until a perfect cure be effected.

Let me strongly urge you to see that my advice is carried out to the very
letter, as a groin rupture can only be cured in infancy and in childhood. If it
be allowed to run on, unattended to, until adult age, he will be obliged to
wear a truss all his life, which would be a great annoyance and a perpetual
irritation to him.

CLOTHING.

21. Is it necessary to have a flannel cap in readiness to put on as soon as
a babe is born?
Sir Charles Locock considers that a flannel cap is not necessary, and
asserts that all his best nurses have long discarded flannel caps. Sir Charles
states that since the discontinuance of flannel caps infants have not been
more liable to inflammation of the eyes.
Such authority is, in my opinion, conclusive. My advice, therefore, to
you is, by all means discontinue the use of flannel caps.
22. What kind of belly-band do you recommend—a flannel or a calico
one?
I prefer flannel, for two reasons—first, on account of its keeping the
child’s bowels comfortably warm; and, secondly, because of its not chilling
him (and thus endangering cold, etc.) when he wets himself. The belly-band
ought to be moderately but not tightly applied, as, if tightly applied, it
would interfere with the necessary movement of the bowels.
23. When should the belly-band be discontinued?
When the child is two or three months old. The best way of leaving it off
is to tear a strip off daily for a few mornings, and then to leave it off
altogether. “Nurses who take charge of an infant when the monthly nurse
leaves are frequently in the habit of at once leaving off the belly-band,
which often leads to ruptures when the child cries or strains. It is far wiser
to retain it too long than too short a time; and when a child catches hooping-
cough while still very young, it is safer to resume the belly-band.”[140]
24. Have you any remarks to make on the clothing of an infant?
A baby’s clothing ought to be light, warm, loose, and free from pins. (1.)
It should be light, without being too airy. Many infants’ clothes are both too

long and too cumbersome. It is really painful to see how some poor little
babies are weighed down with a weight of clothes. They may be said to
“bear the burden,” and that a heavy one, from the very commencement of
their lives! How absurd, too, the practice of making them wear long clothes.
Clothes to cover a child’s feet, and even a little beyond, may be desirable;
but for clothes, when the infant is carried about, to reach to the ground, is
foolish and cruel in the extreme. I have seen a delicate baby almost ready to
faint under the infliction. (2.) It should be warm, without being too warm.
The parts that ought to be kept warm are the chest, the bowels, and the feet.
If the infant be delicate, especially if he be subject to inflammation of the
lungs, he ought to wear a fine flannel, instead of his usual shirts, which
should be changed as frequently. (3.) The dress should be loose, so as to
prevent any pressure upon the blood-vessels, which would otherwise
impede the circulation, and thus hinder a proper development of the parts. It
ought to be loose about the chest and waist, so that the lungs and the heart
may have free play. It should be loose about the stomach, so that digestion
may not be impeded; it ought to be loose about the bowels, in order that the
spiral motion of the intestines may not be interfered with; hence the
importance of putting on a belly-band moderately slack; it should be loose
about the sleeves, so that the blood may course, without let or hindrance,
through the arteries and veins; it ought to be loose, then, everywhere, for
nature delights in freedom from restraint, and will resent, sooner or later,
any interference. Oh that a mother would take common sense, and not
custom, as her guide! (4.) As few pins should be used in the dressing of a
baby as possible. Inattention to this advice has caused many a little sufferer
to be thrown into convulsions.
The generality of mothers use no pins in the dressing of their children;
they tack with a needle and thread every part that requires fastening. They
do not even use pins to fasten the baby’s napkins. They make the diapers
with loops and tapes, and thus altogether supersede the use of pins in the
dressing of an infant. The plan is a good one, takes very little extra time,
and deserves to be universally adopted. If pins be used for the napkins, they
ought to be the Patent Safety Pins.
25. Is there any necessity for a nurse being particular in airing an
infant’s clothes before they are put on? If she were less particular, would it
not make him more hardy?

A nurse cannot be too particular on this head. A baby’s clothes ought to
be well aired the day before they are put on, as they should not be put on
warm from the fire. It is well, where it can be done, to let him have clean
clothes daily. Where this cannot be afforded, the clothes, as soon as they are
taken off at night, ought to be well aired so as to free them from the
perspiration, and that they may be ready to put on the following morning. It
is truly nonsensical to endeavor to harden a child, or any one else, by
putting on damp clothes!
26. What is your opinion of caps for an infant?
The head ought to be kept cool; caps, therefore, are unnecessary. If caps
be used at all, they should only be worn for the first month in summer, or
for the first two or three months in winter. If a babe take to caps, it requires
care in leaving them off, or he will catch cold. When you are about
discontinuing them, put a thinner and a thinner one on, every time they are
changed, until you leave them off altogether.
But remember, my opinion is, that a child is better without caps; they
only heat his head, cause undue perspiration, and thus make him more
liable to catch cold.
If a babe does not wear a cap in the day, it is not at all necessary that he
should wear one at night. He will sleep more comfortably without one, and
it will be better for his health. Moreover, night-caps injure both the
thickness and the beauty of the hair.
27. Have you any remarks to make on the clothing of an infant, when, in
the winter time, he is sent out for exercise?
Be sure that he is well wrapped up. He ought to have under his cloak a
knitted worsted spencer, which should button behind; and if the weather be
very cold, a shawl over all; and, provided it be dry above, and the wind be
not in the east or in the northeast, he may then brave the weather. He will
then come from his walk refreshed and strengthened, for cold air is an
invigorating tonic. In a subsequent conversation I will indicate the proper
age at which a child should be first sent out to take exercise in the open air.
28. At what age ought an infant “to be shortened?”
This, of course, will depend upon the season. In the summer, the right
time “for shortening a babe,” as it is called, is at the end of two months; in
the winter, at the end of three months. But if the right time for “shortening”

a child should happen to be in the spring, let it be deferred until the end of
May. The English springs are very trying and treacherous; and sometimes,
in April, the weather is almost as cold, and the wind as biting, as in winter.
It is treacherous, for the sun is hot, and the wind, which is at this time of the
year frequently easterly, is keen and cutting. I should far prefer “to shorten”
a child in the winter than in the early spring.

DIET.

29. Are you an advocate for putting a baby to the breast soon after birth,
or for waiting, as many do, until the third day?
The infant ought to be put to the breast soon after birth; the interest, both
of the mother and of the child, demands it. It will be advisable to wait three
or four hours, that the mother may recover from her fatigue; and then the
babe must be put to the breast. If this be done, he will generally take the
nipple with avidity.
It might be said that at so early a period there is no milk in the breast; but
such is not usually the case. There generally is a little from the very
beginning; which acts on the baby’s bowels like a dose of purgative
medicine, and appears to be intended by nature to cleanse the system. But,
provided there be no milk at first, the very act of sucking not only gives the
child a notion, but, at the same time, causes a draught (as it is usually
called) in the breast, and enables the milk to flow easily.
Of course, if there be no milk in the breast—the babe having been
applied once or twice to determine the fact—then you must wait for a few
hours before applying him again to the nipple, that is to say, until the milk
be secreted.
An infant who, for two or three days, is kept from the breast, and who is
fed upon gruel, generally becomes feeble, and frequently, at the end of that
time, will not take the nipple at all. Besides, there is a thick cream (similar
to the biestings of a cow), which, if not drawn out by the child, may cause
inflammation and gathering of the bosom, and, consequently, great
suffering to the mother. Moreover, placing him early to the breast
moderates the severity of the mother’s after pains, and lessens the risk of
her flooding. A new-born babe must not have gruel given to him; as it

disorders the bowels, causes a disinclination to suck, and thus makes him
feeble.
30. If an infant show any disinclination to suck, or if he appear unable to
apply his tongue to the nipple, what ought to be done?
Immediately call the attention of the medical man to the fact, in order
that he may ascertain whether he be tongue-tied. If he be, the simple
operation of dividing the bridle of the tongue will remedy the defect, and
will cause him to take the nipple with ease and comfort.
31. Provided there be no milk AT FIRST; what ought then to be done?
Wait with patience: the child (if the mother has no milk) will not, for at
least twelve hours, require artificial food. In the generality of instances,
then, artificial food is not at all necessary; but if it should be needed, one-
third of new milk and two-thirds of warm water, slightly sweetened with
loaf sugar (or with brown sugar, if the babe’s bowels have not been
opened), should be given, in small quantities at a time, every four hours,
until the milk be secreted, and then it must be discontinued. The infant
ought to be put to the nipple every four hours, but not oftener, until he be
able to find nourishment.
If, after the application of the child for a few times, he is unable to find
nourishment, then it will be necessary to wait until the milk be secreted. As
soon as it is secreted, he must be applied, with great regularity, alternately
to each breast.
I say alternately to each breast. This is most important advice. Sometimes
a child, for some inexplicable reason, prefers one breast to the other, and the
mother, to save a little contention, concedes the point, and allows him to
have his own way. And what is frequently the consequence?—a gathered
breast!
We frequently hear of a babe having no notion of sucking. This “no
notion” may generally be traced to bad management, to stuffing him with
food, and thus giving him a disinclination to take the nipple at all.
32. How often should a mother suckle her infant?
A mother generally suckles her baby too often, having him almost
constantly at the breast. This practice is injurious both to parent and to
child. The stomach requires repose as much as any other part of the body;
and how can it have it if it be constantly loaded with breast-milk? For the

first month, he ought to be suckled about every hour and a half; for the
second month, every two hours,—gradually increasing, as he becomes
older, the distance of time between, until at length he has it about every four
hours.
If a baby were suckled at stated periods, he would only look for the
bosom at those times, and be satisfied. A mother is frequently in the habit of
giving the child the breast every time he cries, regardless of the cause. The
cause too frequently is, that he has been too often suckled—his stomach has
been overloaded; the little fellow is constantly in pain, and he gives
utterance to it by cries. How absurd is such a practice! We may as well
endeavor to put out a fire by feeding it with fuel. An infant ought to be
accustomed to regularity in every thing—in times for suckling, for sleeping,
etc. No children thrive so well as those who are thus early taught.
33. Where the mother is MODERATELY strong, do you advise that the infant
should have any other food than the breast?
Artificial food must not, for the first three or four months, be given, if the
parent be moderately strong; of course, if she be feeble, a little food will be
necessary. Many delicate women enjoy better health while suckling than at
any other period of their lives.
34. What food is the best substitute for a mother’s milk?
The food that suits one infant will not agree with another. (1.) The one
that I have found the most generally useful, is made as follows: Boil the
crumb of bread for two hours in water, taking particular care that it does not
burn; then add only a little lump sugar (or brown sugar, if the bowels be
costive), to make it palatable. When he is five or six months old, mix a little
new milk—the milk of ONE cow—with it, gradually, as he becomes older,
increasing the quantity until it be nearly all milk, there being only enough
water to boil the bread; the milk should be poured boiling hot on the bread.
Sometimes the two milks—the mother’s and the cow’s milk—do not agree;
when such is the case, let the milk be left out, both in this and in the foods
following, and let the food be made with water instead of with milk and
water. In other respects, until the child is weaned, let it be made as above
directed; when he is weaned, good fresh cow’s milk MUST, as previously
recommended, be used. (2.) Or, cut thin slices of bread into a basin, cover
the bread with cold water, place it in an oven for two hours to bake; take it
out, beat the bread up with a fork, and then slightly sweeten it. This is an

excellent food. (3.) If the above should not agree with the infant (although,
if properly made, they almost invariably do), “tous-les-mois”[141] may be
given. (4.) Or, Robb’s Biscuit, as it is “among the best bread compounds
made out of wheat-flour, and is almost always readily digested.”—Routh.
(5.) Another good food is the following: Take about a pound of flour, put
it in a cloth, tie it up tightly, place it in a saucepanful of water, and let it boil
for four or five hours; then take it out, peel off the outer rind, and the inside
will be found quite dry, which grate. (6.) Another way of preparing an
infant’s food, is to bake flour—biscuit flour—in a slow oven, until it be of a
light fawn color. (7.) An excellent food for a baby, is baked crumbs of
bread. The manner of preparing it is as follows: Crumb some bread on a
plate; put it a little distance from the fire to dry. When dry, rub the crumbs
in a mortar, and reduce them to a fine powder; then pass them through a
sieve. Having done which, put the crumbs of bread into a slow oven, and let
them bake until they be of a light fawn color. A small quantity either of the
boiled, or of the baked flour, or of the baked crumb of bread, ought to be
made into food in the same way as gruel is made, and should then be
slightly sweetened, according to the state of the bowels, either with lump or
with brown sugar.
(8.) Baked flour sometimes produces constipation; when such is the case,
Mr. Appleton of Budleigh Salterton, Devon, wisely recommends a mixture
of baked flour and prepared oatmeal,[142] in the proportion of two of the
former and one of the latter. He says: “To avoid the constipating effects, I
have always had mixed, before baking, one part of prepared oatmeal with
two parts of flour; this compound I have found both nourishing, and
regulating to the bowels. One tablespoonful of it, mixed with a quarter of a
pint of milk, or milk and water, when well boiled, flavored, and sweetened
with white sugar, produces a thick, nourishing, and delicious food for
infants or invalids.” He goes on to remark: “I know of no food, after
repeated trials, that can be so strongly recommended by the profession to all
mothers in the rearing of their infants, without or with the aid of the breast,
at the same time relieving them of much draining and dragging while
nursing with an insufficiency of milk, as baked flour and oatmeal.”[143]
(9.) A ninth food may be made with “Farinaceous Food for Infants,
prepared by Hards of Dartford.” If Hards’ Farinaceous Food produces
costiveness—as it sometimes does—let it be mixed either with equal parts

or with one-third of Robertson’s Patent Groats. The mixture of the two
together makes a splendid food for a baby. (10.) A tenth, and an excellent
one, may be made with rusks, boiled for an hour in water, which ought then
to be well beaten up by means of a fork, and slightly sweetened with lump
sugar. Great care should be taken to select good rusks, as few articles vary
so much in quality. (11.) An eleventh is—the top crust of a baker’s loaf,
boiled for an hour in water, and then moderately sweetened with lump
sugar. If, at any time, the child’s bowels should be costive, raw must be
substituted for lump sugar. (12.) Another capital food for an infant, is that
made by Lemann’s Biscuit Powder. (13.) Or, Brown and Polson’s Patent
Corn Flour will be found suitable. The Queen’s cook, in his recent valuable
work,[144] gives the following formula for making it: “To one
dessertspoonful of Brown & Polson, mixed with a wineglassful of cold
water, add half a pint of boiling water; stir over the fire for five minutes;
sweeten lightly, and feed the baby; but if the infant is being brought up by
the hand, this food should then be mixed with milk—not otherwise.”
(14.) The following is a good and nourishing food for a baby: Soak, for
an hour, some best rice in cold water; strain, and add fresh water to the rice;
then let it simmer till it will pulp through a sieve; put the pulp and the water
in a saucepan, with a lump or two of sugar, and again let it simmer for a
quarter of an hour; a portion of this should be mixed with one-third of fresh
milk, so as to make it of the consistence of good cream.
When the baby is five or six months old, new milk should be added to
any of the above articles of food, in a similar way to that recommended for
boiled bread.
(15.) For a delicate infant, lentil powder, better known as Du Barry’s
“Revalenta Arabica,” is invaluable. It ought to be made into food, with new
milk, in the same way that arrow-root is made, and should be moderately
sweetened with loaf sugar. Whatever food is selected ought to be given by
means of a nursing-bottle.
If a child’s bowels be relaxed and weak, or if the motions be offensive,
the milk must be boiled. The following (16.) is a good food when an infant’s
bowels are weak and relaxed: “Into five large spoonfuls of the purest water
rub smooth one dessertspoonful of fine flour. Set over the fire five
spoonfuls of new milk, and put two bits of sugar into it; the moment it boils,
pour it into the flour and water, and stir it over a slow fire twenty minutes.”

Where there is much emaciation, I have found (17.) genuine arrow-root a
very valuable article of food for an infant, as it contains a great deal of
starch, which starch helps to form fat and to evolve caloric (heat)—both of
which a poor, emaciated, chilly child stands so much in need of. It must be
made with good fresh milk, and ought to be slightly sweetened with loaf
sugar; a small pinch of table salt should be added to it.
I have given you a large and well-tried infant’s dietary to choose from, as
it is sometimes difficult to fix on one that will suit; but remember, if you
find one of the above to agree, keep to it, as a baby requires a simplicity in
food—a child a greater variety.
Let me, in this place, insist upon the necessity of great care and attention
being observed in the preparation of any of the above articles of diet. A
babe’s stomach is very delicate, and will revolt at either ill-made, or lumpy,
or burnt food. Great care ought to be observed as to the cleanliness of the
cooking utensils. The above directions require the strict supervision of the
mother.
Broths have been recommended, but, for my own part, I think that, for a
young infant, they are objectionable; they are apt to turn acid on the
stomach, and to cause flatulence and sickness; they sometimes disorder the
bowels and induce griping and purging.
Whatever artificial food is used ought to be given by means of a bottle,
not only as it is a more natural way than any other of feeding a baby, as it
causes him to suck as though he were drawing it from the mother’s breast,
but as the act of sucking causes the salivary glands to press out their
contents, which materially assists digestion. Moreover, it seems to satisfy
and comfort him more than it otherwise would do.
The food ought to be of the consistence of good cream, and should be
made fresh and fresh. It ought to be given milk-warm. Attention must be
paid to the cleanliness of the vessel, and care should be taken that the milk
be that of ONE cow,[145] and that it be new and of good quality; for if not, it
will turn acid and sour, and disorder the stomach, and will thus cause either
flatulence or looseness of the bowels, or perhaps convulsions.
The only way to be sure of having it from one cow, is (if you have not a
cow of your own) to have the milk from a respectable cow-keeper, and to
have it brought to your house in a can of your own (the London milk-cans
being the best for the purpose). The better plan is to have two cans, and to