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An Essay upon Nursing
and the Management of Children,
from their Birth to Three Years of Age

By a Physician

[William Cadogan, 1711-1797]

In a Letter to one of the Governors of the Foundling Hospital

Published by Order of the General Committee for
transacting the Affairs of said Hospital
.

The Third Edition

London:
Printed for J. Roberts in Warwick Lane.
MDCCXLIX.

[Price 6 d.]

 

Note from the Webmaster: The original, sometimes erratic, spelling and punctuation have been retained, with the exception that the character "s" has been substituted for the late middle English "f" where appropriate to make the essay easier to read.


Title page thumbnail

Title page of the Third Edition, 1749. Scanned from microfilm on loan from NLM. Original document in the holdings of the Yale University Medical Library. 650 KB GIF.

Coat of arms thumbnail

Coat of arms on the verso; significance unclear (possibly the governor to whom the essay was addressed?). 350 KG GIF.

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First page of the essay. 570 KB GIF.


Sir,

It is with great Pleasure I see at last the Preservation of Children become the Care of Men of Sense: It is certainly a Matter that well deserves their Attention, and, I doubt not, the Publick will soon find the good and great Effects of it. The Foundling Hospital may be of more Use to the World, than was perhaps at first imagin'd by the Promoters of it; it will be a Means not only of preventing the Murder of many, but of saving more, by introducing a more reasonable and more natural Method of Nursing. In my Opinion, this Business has been too long fatally left to the Management of Women, who cannot be supposed to have proper Knowledge to fit them for such a Task, notwithstanding they look upon it to be their own Province. What I mean, is a Philosophic Knowledge of Nature, to be acquired only by learned Observation and Experience, and which therefore the Unlearned must be incapable of. They may presume upon the Examples and transmitted Customs of their Great Grand-mothers, who were taught by the Physicians of their unenlighten'd Days; when Physicians, as appears by late Discoveries, were mistaken in many things; being led away by hypothetical Reasonings to entertain very wild Conceits, in which they were greatly bewilder'd themselves, and misled others to believe, I know not what strange unaccountable Powers in certain Herbs, Roots, and Drugs; and also in some superstitious Practices and Ceremonies; for all which Notions, there being no real Foundation in Nature, they ought to be looked upon as the Effects of Ignorance, or the Artifices of designing Quacks; who found their Account, by pretending to great Knowledge in these occult Qualities, and imposing upon the Credulous. The Art of Physick has been much improv'd within this last Century; by observing and following Nature more closely, many useful Discoveries have been made, which help us to account for Things in a natural Way, that before seem'd mysterious and magical; and which have consequently made the Practice of it more conformable to Reason and good Sense. This being the Case, there is great room to fear, that those Nurses who yet retain many of these traditional Prejudices, are capitally mistaken in their management of Children in general, and fancying that Nature has left a great deal to their Skill and Contrivance, often do much harm, where they intend to do good. Of this I shall endeavor to convince them, by shewing, how I think Children may be cloath'd, fed, and managed with much less Trouble to their Nurses, and infinitely greater Ease and Comfort to the little ones.

The Foundlings under the Care of the Hospital, I presume, will be bred in a very plain, simple Manner: They will therefore infallibly have the more Health, Beauty, Strength, and Spirits; I might add Understanding too, as all the Faculties of the Mind are well known to depend upon the Organs of the Body; so that when these are in good Order, the thinking Part is most alert and active; the contrary, when they are disturbed and diseased. When these Advantages appear in Favour of Children so brought up, as I am confident in time they will, it may serve to convince most Nurses, Aunts, Grand-mothers, &c. how much they have hitherto been in the wrong, what Mischief is done to Children, and what Multitudes are destroyed or spoiled, as well by cramming them with Cakes, Sweetmeats, &c. till they foul their Blood, choak their Vessels, pall the Appetite, and ruin every Faculty of their Bodies; as by cockering and indulging them, to the utter Perversion of their naturally good Temper, till they become quite froward and indocile.

When a Man takes upon him to contradict received Opinions and Prejudices sanctified by Time, it is expected he should bring valid Proof of what he advances. The Truth of what I say, that the Treatment of Children in general is wrong, unreasonable and unnatural, will in great measure appear, if we but consider what a puny valetudinary Race most of our People of Condition are; chiefly owing to bad Nursing, and bad Habits contracted early. But let any one, who would be fully convinced of this Matter, look over the Bills of Mortality; there he may observe, that almost half of the Number of those, that fill up that black List, die under five Years of Age: So that Half the People that come into the World, go out of it again before they become of the least Use to it, or themselves. To me, this seems to deserve serious Consideration; and yet I cannot find, that any one Man of Sense, and publick Spirit, has ever attended to it at all; notwithstanding the Maxim in every one's Mouth, that a Multitude of Inhabitants is the greatest Strength and best Support of a Commonwealth. The Misconduct, to which I must impute a great Part of the Calamity, is too common and obvious to engage the Idle and Speculative, who are to be caught only by very refined Researches; and the busy Part of Mankind, where their immediate Interest is not concerned, will always overlook what they see daily: It may be thought a natural Evil, and so is submitted to without Examination. But this is by no means the Case; and where it is entirely owing to Mismanagement, and possibly may admit of a Remedy, it is ridiculous to charge it upon Nature, and suppose, that Infants are more subject to Disease and Death than grown Persons; on the contrary, they bear Pain and Disease much better, Fevers especially, (as is plain in the Case of the Small-Pox, generally most favourable to Children) and for the same Reason that a Twig is less hurt by a Storm than an Oak. In all the other Productions of Nature we see the greatest Vigor and Luxuriancy of Health, the nearer they are to the Egg or the Bud: They are indeed then most sensible of Injury, and it is Injury only that destroys them. When was there a Lamb, a Bird, or a Tree that died because it was young? These are under the immediate Nursing of unerring Nature, and they thrive accordingly. Ought it not therefore to be the Care of every Nurse and every Parent, not only to protect their Nurselings from Injury, but to be well assured that their own officious Services be not the greatest the helpless Creatures can suffer?

In the lower Class of Mankind, especially in the Country, Disease and Mortality are not so frequent, either among the Adult, or their Children. Health and Posterity are the Portion of the Poor, I mean the laborious: The Want of Superfluity confines them more within the Limits of Nature: Hence they enjoy Blessings they feel not, and are ignorant of their Cause. The Mother who has only a few Rags to cover her Child loosely, and little more than her own Breast to feed it, sees it healthy and strong, and very soon able to shift for itself; while the puny Insect, the Heir and Hope of a rich Family lies languishing under a Load of Finery, that overpowers his Limbs, abhorring and rejecting the Dainties he is crammed with, till he dies a Victim to the mistaken Care and Tenderness of his fond Mother. In the Course of my Practice I have had frequent occasion to be fully satisfied of this, and have often heard a Mother anxiously say the Child has not been well ever since it has done puking and crying. These Complaints, tho' not attended to, point very plainly to their Cause. Is it not very evident, that when a Child rids its Stomach several times in a Day, that it has been over-loaded? when it cries, from the Incumbrance and Confinement of its Cloaths, that it is hurt by them? While the natural Strength lasts (as every Child is born with more Health and Strength than is generally imagined) it cries at, or rejects the superfluous Load, and thrives apace: that is, grows very fat, bloted, and distended beyond measure; like a House-Lamb. But in Time, the same oppressive Cause continuing, the natural Powers are overcome, being no longer able to throw off the unequal Weight; the Child, now not able to cry any more, languishes and is quiet. The Misfortune is, these Complaints are not understood; it is swaddled and cramm'd on, 'till after Gripes, Purging, &c. it sinks under both Burdens into a Convulsion Fit, and escapes any further Torture. This would be the Case with the Lamb, was it not killed when it is full fat.

That the present Method of Nursing is wrong, one would think needed no other Proof that the frequent Miscarriages attending it, the Death of Many, and ill Health of Those that survive. But the persuading you of it may be a needless Task; if you have ever thought about it, I doubt not but you are already convinced it is so. However, since you desire my Sentiments upon the Subject, taking it for granted you think with me, that most of our Nurses are got into a wrong Method, I will endeavour, in as few Words as possible, to tell you what I think a right one.

You perceive, Sir, by the Hints I have already dropp'd, what I am going to complain of is, that Children in general are over-cloath'd and over-fed, and fed and cloath'd improperly. To these Causes I impute almost all their Diseases. But to be a little more explicit, The first great Mistake is, that they think a new-born Infant cannot be kept too warm; from this Prejudice they load and bind it with Flannels, Wrappers, Swathes, Stays, &c. commonly called Cloaths; which all together are almost equal to its own Weight; by which means a healthy Child in a Month's Time is made so tender and chilly, it cannot bear the external Air; and if, by any Accident of a Door or Window left carelessly open too long, a refreshing Breeze be admitted into the suffocating Atmosphere of the Lying-in Bed-chamber, the Child and Mother sometimes catch irrecoverable Colds. But what is worse than this, at the End of the Month, if things go on apparently well, this Hot-bed Plant is sent out into the Country, to be rear'd in a leaky House, that lets in Wind and Rain from every Quarter. Is it any Wonder the Child never thrives afterwards? The Truth is, a new-born Child cannot well be too cool and loose in its Dress; it wants less Cloathing than a grown Person, in proportion; because it is naturally warmer, as appears by the Thermometer; and would therefore bear the Cold of a Winter's Night, much better than any adult Person whatever. There are many Instances both ancient and modern of Infants exposed and deserted, that have lived several Days. As it was the Practice of ancient Times, in many Parts of the World, to expose all those, whom the Parents did not care to be encumber'd with; that were deformed or born under evil Stars; not to mention the many Foundlings pick'd up in London Streets. These Instances may serve to shew, that Nature has made Children able to bear even great Hardships, before they are made weak and fickly by their mistaken Nurses. But besides the Mischief arising from the Weight and Heat of these Swaddling-cloaths, they are put on so tight, and the Child is so cramp'd by them, that its Bowels have not room, nor the Limbs any Liberty, to act and exert themselves in the free easy Manner they ought. This is a very hurtful Circumstance, for Limbs that are not used, will never be strong, and such tender Bodies cannot bear much Pressure: The Circulation restrained by the Compression of any one Part, must produce unnatural Swellings in some other; especially as the Fibres of Infants are so easily distended. To which doubtless are owing the many Distortions and Deformities we meet with every where; chiefly among Women, who suffer more in this Particular than the Men. I would recommend the following Dress: a little Flannel Waistcoat without Sleeves, made to fit the Body, and tie loosely behind; to which there should be a Petticoat sew'd, and over this a kind of Gown of the same Material, or any other that is light, thin, and flimsy. The Petticoat should not be quite so long as the Child, the Gown a few Inches longer; with one Cap only on the Head, which may be made double, if it be thought not warm enough. What I mean is, that the whole Coiffure should be so contrived, that it might be put on at once, and neither bind nor press the Head at all: The Linnen as usual. This, I think, would be abundantly sufficient for the Day; laying aside all those Swathes, Bandages, Stays, and Contrivances, that are most ridiculously used to close and keep the Head in its Place, and support the Body. As if Nature, exact Nature, had produced her chief Work, a human Creature, so carelessly unfinish'd, as to want those idle Aids to make it perfect. Shoes and Stockings are very needless Incumbrances, besides that they keep the Legs wet and nasty, if they are not changed every Hour, and often cramp and hurt the Feet: A Child would stand firmer, and learn to walk much sooner without them. I think they cannot be necessary 'till it runs out in the Dirt. There should be a thin Flannel Shirt for the Night, which ought to be every way quite loose. Children in this simple, pleasant Dress, which may be readily put on and off without teazing them, would find themselves perfectly easy and happy, enjoying the free Use of their Limbs and Faculties, which they would very soon begin to employ, when they are thus left at Liberty. I would have them put into it as soon as they are born, and continued in it, till they are three Years old; when it may be changed for any other more genteel and fashionable; tho' I could wish it was not the Custom to wear Stays at all; not because I see no Beauty in the Suguar-loaf Shape, but that I am apprehensive, it is often procur'd at the Expence of the Health and Strength of the Body. There is an odd Notion enough entertained about Change, and the keeping of Children clean. Some imagine that clean Linnen and fresh Cloaths draw, and rob them of their nourishing Juices. I cannot see that they do any thing more than imbibe a little of that Moisture which their Bodies exhale. Were it as is supposed, it would be of service to them; since they are always too abundantly supplied, and therefore I think they cannot be changed too often, and would have them clean every Day, as it would free them from Stinks and Sournesses, which are not only offensive, but very prejudicial to the tender State of Infancy.

The Feeding of Children properly is of much greater importance to them than their Cloathing. We ought to take great Care to be right in this material Article, and that nothing be given them, but what is wholesome and good for them, and in such Quantity, as the Body calls for towards its Support and Growth; not a Grain more. Let us consider what Nature directs in the Case: If we follow Nature, instead of leading or driving it, we cannot err. In the Business of Nursing, as well as Physick, Art is every Destructive, if it does not exactly copy this Original. When a child is first born, there seems to be no Provision at all made for it; for the Mother's Milk seldom comes till the third Day; so that according to Nature, a Child would be left a Day and a half, or two Days, without any Food; to me a very sufficient Proof that it wants none: It is born full of Blood, full of Excrements, its Appetites not awake, nor its Senses opened; and requires this intermediate Time of Abstinence and Rest, to compose and recover the Struggle of the Birth, and the Change of Circulation, (the Blood running into new Channels,) which always put it into a little Fever. However extraordinary this may appear, I am sure it is better it were not fed at all, for it sleeps almost the whole Time, and when the Milk is ready for it, would be hungry, and suck with more Eagerness; which is often necessary, for it seldom comes out freely at first. At least I would prevail thus far, that the Child be not awaked out of its Sleep to be fed, as is commonly done. This is the constant Course of Nature, which is very little attended to, and never followed. The general Practice is, as soon as a Child is born, to cram a Dab of Butter and Sugar down its Throat, a little Oil, Panada, Caudle, or some such unwholsome Mess. So that the set out wrong, and the Child stands a fair Chance of being made sick from the first Hour. It is the Custom of some to give a little roast Pig to an Infant; which, it seems, is to cure it of all the Mother's Longings. I wish these Matters were a little more enquired into, for the Honour of the Sex; to which many Imperfections of this kind are imputed, which I am sure it does not lie under. When a child sucks its own Mother, which, with a very few Exceptions, would be best for every Child, and every Mother, Nature has provided it with such wholsome and suitable Nourishment; supposing her a temperate Woman, that makes some Use of her Limbs; it can hardly do amiss. The Mother would likewise, in most hysterical, nervous Cases, establish her own Health by it, tho' she were weak and sickly before, as well as that of her Offspring, For these Reasons I could wish, that every Woman that is able, whose Fountains are not greatly disturbed or tainted, would give Suck to her Child. I am very sure that forcing back the Milk, which most young Women must have in great abundance, may be of fatal Consequence: Sometimes it endangers Life, and often lays the Foundation of many incurable Diseases. The Reasons that are given for this Practice are very frivolous, and drawn from false Premises; that some Women are too weak to bear such a Drain, which would rob them of their own Nourishment. This is a very mistaken Notion; for the first general Cause of most People's Diseases is, not want of Nourishment, as is here imagined, but too great a Fulness and Redundancy of Humours; good at first, but being more than the Body can employ or consume, the whole Mass becomes corrupt, and produces many Diseases. This is confirmed by the general Practice of Physicians, who make holes in the Skin, perpetual Blisters, Issues, &c. to let out the Superfluity. I would therefore leave it to be consider'd, whether the throwing back such a Load of Humour, as a Woman's first Milk, be most likely to mend her Constitution, or make her Complaints irremediable. The Mother's first Milk is purgative, and cleanses the Child of its long hoarded Excrement; no Child therefore can be deprived of it without manifest Injury. By degrees it changes its Property, becomes less purgative, and more nourishing; and is the best and only Food the Child likes, or ought to have for some time. If I could prevail, no Child should ever be cramm'd with any unnatural Mixture, 'till the Provision of Nature was ready for it; nor afterwards fed with any ungenial alien Diet whatever, the first three Months: for it is not well able to digest and assimilate other Aliments sooner. There is usually Milk enough with the first Child; sometimes more than it can take: It is poured forth from an exuberant, overflowing Urn, by a bountiful Hand, that never provides sparingly. The Call of Nature should be waited for to feed it with any thing more substantial, and the Appetite ever precede the Food; not only with regard to the daily Meals, but those Changes of Diet, which opening, increasing Life requires. But this is never done in either Case, which is one of the greatest Mistakes of all Nurses. Thus far Nature, if she be not interrupted, will do the whole Business perfectly well; and there seems to be nothing left for a Nurse to do, but to keep the Child clean and sweet, and to tumble and toss it about a good deal, play with it, and keep it in good Humour.

But now the Child (I mean when it is about three Months old) requires more solid Sustenance, we are to enquire what, and how much, is most proper to give it. We may be well assured, there is a great Mistake either in the Quantity or Quality of Children's Food, or both, as it is usually given them; because they are made sick by it. As to Quantity, there is a most ridiculous Error in the common practice, for it is generally supposed, that whenever a Child cries, it wants Victuals; and it is accordingly fed ten, twelve, or more times in a Day and Night. This is so obvious a Misapprehension, that I am surprized it should ever prevail. If a Child's Wants and Motions be diligently and judiciously attended to, it will be found that it never cries but from Pain: Now the first Sensations of Hunger are not attended with Pain; accordingly a Child (I mean this of a very young one) that is hungry, will make a hundred other Signs of its Want, before it will cry for Food. If it be healthy and quite easy in its Dress, it will hardly ever cry at all. Indeed these Signs and Motions, I speak of, are but rarely to be observed; because it seldom happens that Children are ever suffered to be hungry. In a few, very few, whom I have had the Pleasure to see reasonably nursed, that were not fed above two or three times in four and twenty Hours, and yet were perfectly healthy, active and happy; I have seen these Signals, which were as intelligible as if they had spoke.

There are many Faults in the Quality of their Food: It is not simple enough. Their Paps, Panada's, Gruels, &c. are generally enriched with Sugar, Spice, and sometimes a Drop of Wine, neither of which they ought ever to taste. Our Bodies never want them: they are what Luxury only has introduced, to the Destruction of the Health of Mankind. It is not enough that their Food be simple, it should be also light. Several People, I find, are mistaken in their Notions of what is light; and fancy that most kinds of Pastry, Puddings, Custards, &c. are light, that is, light of Digestion. But there is nothing heavier in this Sense than unfermented Flour and Eggs boil'd hard, which are the chief Ingredients of those Preparations. What I mean by light, to give the best Idea I can of it, is any Substance that is easily separated, and soluble in warm Water. Good Bread is the lightest Thing I know; the Power of due Fermentation, in which consists the whole Art of making it, breaks and attenuates the tenacious Parts of the Flour, so as to give it these Qualities I mention, and make it the fittest Food for young Children. Cows Milk is also simple and light, and very good for them; but it is injudiciously prepared: it should not be boiled, for boiling alters the Taste and Property of it, destroys its Sweetness, and makes it thicker, heavier, and less fit to mix and assimilate with the Blood. But the chief Objection is, that their Food is wholly vegetable; the bad consequence of which is, that it will turn sour in their Stomachs. The first and general Cause of all the Diseases of Infants, is manifestly this ascescent Quality of all their Food. If any of these vegetable Preparations I have named, be kept in a Degree of Heat equal to that of a Child's Stomach it will become sour as Vinegar in a few Hours time. These Things are therefore very improper to feed a Child wholly with. Some Part of its Diet should be contrived to have a contrary Tendency; such as we find only in Flesh, which is the direct opposite to Acid, and tends to Putrefaction. In a due Mixture of these two Extremes, correcting each other, consists that Salubrity of Aliment our Nature seems to require. As we are partly carniverous Animals, a Child ought not to be fed wholly upon Vegetables. The Mother's Milk, when it is perfectly good, seems to be this true Mixture of the animal and vegetable Properties, that agrees best with the Constitution of a Child; readily passes into good Blood, requiring but a gentle Exertion of the Powers of Circulation to break and subdue its Particles and make them smooth and round, and easily divisible. I would advise therefore, that one half of Infants Diet be boiled light Broths, with a little Bread or Rice boiled in them; which last is not so ascescent as any other kind of Meal or Flour. These Broths should be made with the Flesh of full grown Animals, because their Juices are more elaborate; especially if they had never been confined to be fatted. The Juices of a young Ox, taken from the Plough, make the finest flavour'd and most wholsome Soup. I believe it is for the same Reason, the Flesh of all wild Animals has a lighter Taste than that of tame, saginated ones; and is therefore most agreeable to the Palates of the Luxurious; but this is to be understood of those Creatures that feed on Corn or Herbage. The other Part of Childrens Diet may be a little Bread and Water boiled almost dry, and then mixed with fresh Milk, not boiled. This, without Sugar, Spice, or any other pretended Amendment whatever, would be perfectly light and wholesome, of sufficient Nourishment, something like Milk from the Cow, with the additional Strength and Spirit of Bread in it. Twice a Day, and not oftner, a sucking Child should be fed at first; once with the Broth, and once with the Milk thus prepared. As to the Quantity at each Time, its Appetite must be the Measure of that; its Hunger should be satisfied, but no more; for Children will always eat with some Eagerness full as much as they ought: Therefore it must be very wrong to go beyond that, and stuff them till they spue, as the common Method is. They should not be laid on their Backs to be fed, but held in a fitting Posture, that swallowing may be easier to them, and that they may the more readily discover when they have had enough. When they come to be about six Months old, and their Appetite and Digestion grows strong, they may be fed three times a Day; which I think they ought never to exceed their whole Lives after. By Night I would not have them fed or suckled at all, that they might at least be hungry in the Morning. It is this Night-feeding that makes them so over-fat and bloated. If they be not used to it at first, and perhaps awaked on purpose, they will never seek it; and if they are not disturbed from the Birth, in a Week's time they will get into a habit of sleeping all, or most part of the Night very quietly; awaking possibly once or twice for a few Minutes, when they are wet and ought to be changed. If it be thought necessary to give them any thing between Meals, a little Milk and Water is best. Their meals, and in my Opinion their sucking too, ought to be at stated Times, and the same every Day; that the Stomach may have Intervals to digest, and the Appetite return. The Child would soon be quite easy and satisfied in the Habit; much more so, than when taught to expect Food at all times, and at every little Fit of Crying and Uneasiness. Let this Method be observed about a Twelvemonth, when, and not before, they may be weaned; not all at once, but by insensible Degrees; that they may neither feel, nor fret at the want of the Breast. This might be very easily manag'd, if they were suffer'd to suck only at certain Times. If this Plan of Nursing were literally pursued, the Children kept clean and sweet, tumbled and toss'd about a good deal, and carried out every Day in all Weathers; I am confident, that in six or eight Months time most Children would become healthy and strong, would be able to sit up on the Ground without Support, to divert themselves an Hour at a time, to the great Relief of their Nurses, would readily find the use of their Legs, and very soon shift for themselves.

If it be asked whether I mean this of Children in general, and that weakly Ones born of unhealthy Parents should be treated in the same Manner; I answer, that it is not so common for Children to inherit the Diseases of their Parents, as is generally imagined; there is much vulgar Error in this Opinion; for People that are very unhealthy seldom have Children, especially if the bad Health be of the female Side; and it is generally late in Life when chronick Diseases take place in most Men, when the Business of Love is pretty well over: Certainly Children can have no Title to those Infirmities, which their Parents have acquired by Indolence and Intemperance long after their Birth. It is not common for People to complain of Ails they think hereditary, until they are grown up; that is, until they have contributed to them by their own Irregularities and Excesses, and then are glad to throw their own Faults back upon their Parents; and lament a bad Constitution, when they have spoiled a very good one. It is very seldom that young Children are troubled with Family Distempers: Indeed, when we find them affect with scrophulous, venereal, or high scorbutick Complaints, we may reasonably conclude the Taint to have been transmitted to them; but these Cases are very rare, in Comparison of the many others that are falsly, and without the least Foundation, imputed to Parents, when the real Cause is either in the Complainants themselves, or bad Nursing, that has fixed them early in wrong Habits. In one Sense many Diseases may be said to be hereditary, perhaps all those of male Formation; by which I mean not only Deformity and Distortion, but all those Cases where the Fibres and Vessels of one Part are weaker in Proportion that the rest; so that upon any Strain of the Body, whether of Debauch or too violent Exercise, the weak Part fails first, and disorders the whole. Thus Complaints may be produced similar to those of the Parent, owing in some measure to the Similitude of Parts, which possibly is inherited, like the Features of the Face; but yet these Diseases might never have appeared, but for the immediate acting Cause, the Violence done to the Body. Most Distempers have two Causes; the one, a particular State of the Solids and Fluids of the Body, which dispose it to receive certain Infections and Impulses; the other, the Infection or Impulse itself. Now what I contend for is, that tho' this predisponent State or Habit of the Body be heritable, yet the Diseases incident to these wretched Heirs may be avoided, by preventing the active Cause; which may be done in many Cases by a due Attention to the Non-naturals, as they are called; in plainer Words, by a regular, temperate Life: in Children, by good Nursing. Therefore I conclude, that instead of indulging and enfeebling yet more, by the common Methods, Children so unhappily born; that which I am recommending, together with the wholsome Milk of a healthy Nurse, is the best, the only Means to remedy the Evil, and by which alone they may by degrees be made healthy and strong. And thus, in a Generation or two of reasonable, temperate Persons, every Taint and Infirmity whatever, the King's Evil, and Madness not excepted, would be totally wore out.

The plain natural Plan I have laid down, is never followed; because most Mothers, of any Condition, either cannot, or will not undertake the troublesome Task of suckling their own Children; which is troublesome only for want of proper Method; were it rightly managed, there would be much Pleasure in it, to every Woman that can prevail upon herself to give up a little of the Beauty of her Breast to feed her Offspring. There would be no fear of offending the Husband's Ears with the Noise of the squalling Brat. The Child, was it nurs'd in this Way, would be always quiet, in good Humour, ever playing, laughing, or sleeping. In my Opinion, a Man of Sense cannot have a prettier Rattle (for Rattles he must have of one kind or other) than such a young Child. I am quite at a loss to account for the general Practice of sending Infants out of Doors, to be suckled, or dry-nursed by another Woman, who has not so much Understanding, nor can have so much Affection for it, as the Parents; and how it comes to pass, that People of good Sense and easy Circumstances will not give themselves the Pains to watch over the Health and Welfare of their Children; that possibly would take much more with a Shrub or Flower; especially as the Love of Posterity is so natural to Mankind. I would earnestly recommend it to every Father to have his Child nursed under his own Eye, to make use of his own Reason and Sense in superintending and directing the Management of it; nor suffer it to be made on of the Mysteries of the Bona Dea, from which the Men are to be excluded. I would advise every Mother that can, for her own sake, as well as her Child's, to suckle it. If she be a healthy Woman, it will confirm her Health; if weakly, in most Cases it will restore her. It need be no Confinement to her, or Abridgment of her Time: Four times in four and twenty hours will be often enough to give it Suck; letting it have as much as it will take, out of both Breasts, at each time. It may be fed and dress'd by some handy, reasonable Servant, that will submit to be directed; whom likewise it may sleep with. No other Woman's Milk can be so good for her Child; and dry-nursing I look upon to be the most unnatural and dangerous Method of all; and, according to my Observation, not one in three survives it. To breed a Child in this artificial Manner, requires more Knowledge of Nature, and the animal Oeconomy, than the best Nurse was ever Mistress of, as well as more Care and Attention than is generally bestow'd on Children: the Skill of a good Physician would be necessary to manage it rightly. I am very glad this is not the Method of the Hospital: I believe there is not the least Colour of Objection to any Part of the Management of that most useful and excellent Charity, as far as it depends on the Directors of it. Sending the Children out to Country Nurses, under the Care of Inspectors, is undoubtedly the best Method they could take; but how far these Nurses and their Inspectors (who, I suppose, are to be some good Gentlewomen in the Neighbourhood) may be persuaded out of their old Forms, to treat their Nurselings a little more reasonably, is matter of much Doubt. I fear they will be too tenacious of their Prejudices, as well as opinionated of their Skill, to be easily convinced they are in the wrong; and who shall undertake the Task? However, I despair not of seeing a Reformation one day or other; and to contribute to it as much as lies in my Power, I will give you my Opinion as to the Precautions, necessary to be taken, in the Choice of these Nurses; and likewise a few Reasons why the Children, entrusted to their Care, should be treated somewhat differently from those, who are nursed in a more natural way, and suck their own Mothers. I make no doubt, but great Care is taken, that the Nurses, recommended to the Hospital, be clean and healthy Women. But this is not enough, the Preference should be given to the middle-aged; because they will have more Milk than the very young, and more and better than the old. This is a material Consideration, as I suppose, they have each her own Child to suckle besides. Those between twenty and thirty are certainly of the best Age. But what I think of the utmost Consequence is, that great Regard should be had to the Time of their Lying-in, and those procured, if possible, who have not been brought to bed above two or three Months. The Reason of this is, that Nature intending a Child should suck about a Twelvemonth, the Milk seldom continues good much longer. About that Time, Women in general, though they give Suck, are apt to breed again; some indeed, that are very sanguine, will breed sooner; these, notwithstanding their Milk, are apt to be troubled with the Catamenia, which disturb it greatly; and therefore are not so proper to be made Nurses of. But, whether they breed or not, it is my Opinion, that after a Year's Time, or thereabouts, however it may agree with a Child that has sucked it from the first, their Milk will become stale and vapid, at least very unfit for a new-born Infant; that if it be deprived of its own Mother's Milk, ought undoubtedly to have what is most like it: the newer it is, the more suitable in all respects to its tender Nature. Yet it is a common thing for a Woman to suckle two or three Children successively with the same Milk.

A Nurse ought to have great Regard to her Diet: It is not enough that she be sober and temperate, her Food should consist of a proper Mixture of Flesh and Vegetables: She should eat one hearty Meal of Flesh-meat every Day, with a good deal of Garden-stuff, and Bread. Thin Broth or Milk would be best for her Breakfast and Supper. Her Drink should be small Beer, or Milk and Water; but upon no Account should she ever touch a Drop of Wine or strong Drink, much less any kind of spiritous Liquors: Giving Ale or Brandy to a Nurse is, in effect, giving it the Child; and it is easy to conclude what would be the Consequence.

The Children, likewise, thus sent out, require a particular Treatment. The Plan I would lay down, could I prevail, should be that of Nature, excluding Art and foreign Aid entirely. But when this is broke in upon, a little adventitious Skill becomes indispensibly necessary; that if we are not perfectly right in following closely the Design of Nature, we may co-operate a little, and not be totally wrong in counter-acting it, as is too often the Case. What I mean is, that every Child, not allowed the Mother's first Milk, whether it be dry-nursed, or suckled by another Woman, should be purged in a Day or two after the Birth; and this purging continued for some time; not by the regular Doses of Physick, that may operate all at once; but some lenient Laxative should be contrived, and given two or three times a Day, so as to keep the Child's Body open for the first nine Days, or Fortnight; lessening the Quantity insensibly, 'till it be left off. It should be so managed, that the Operation of the artificial Physick may resemble that of the natural. This is so material, that for want of it, most Children within the first Month break out in Pimples all over; the Nurses call it the red Gum, and look upon it to be a natural thing, and that the Children will be unhealthy that have it not. So indeed they will be in all likelihood, and it is better that these Foulnesses, which become acrid and hot by remaining too long in the Body, should be discharged through the Skin, than not at all, or that they should be lodged in the Blood, or fall upon the Vitals, to lay the Foundation of numberless future Evils: but it is chiefly owing to the Neglect of this Method at first. A Child that sucks its own Mother, unless it be greatly over-fed , or kept too hot, will never be troubled with this Humour at all. If the Children that are brought to the Hospital be not above a Month old, and it be found, upon Enquiry, that they have no suck'd their own Mothers, something of this kind prescribed them would not be too late, nor improper. The following Form may be used: Take Manna, Pulp of Cassia, of each half an ounce; dissolve 'em in about three ounces of thing Broth. Let the Child take two spoonfuls three times a Day, varying the Quantity according to the Effect; which at first ought to be three or four Stools in four and twenty Hours.

Orders should be given these Nurses to keep the Children awake by Day, so long as they are disposed to be so, and to amuse them and keep them in good Humour all they can; not to lull and rock them to sleep, or to continue their Sleep too long; which is only done to save their own Time and Trouble, to the great Detriment of the Childrens Health, Spirits, and Understanding. With regard to Feeding them, as it is not likely they should have Milk enough to support two, their own, and the Hospital Child, it is best they should begin immediately according to the Method I have recommended, if they and their Inspectors can be persuaded to think it right; which, however, I would not have understood so strictly, but it might sometimes be a little varied, preserving only the Intention. I would advise, however, if it be thought proper, now and then to give them a little Bread and Butter, that the Butter be perfectly sweet and fresh, and allowed but in very small Quantity; otherwise it will be apt turn bitter and rancid in the Stomach, and foul all the Juices of the Body. A child might be allowed any kind of mellow Fruit, either raw, stewed, or baked; Roots of all Sorts, and all the Produce of the Kitchen Garden. I am sure all these things are wholsome and good for them, and every one else, notwithstanding the idle Notion of their being windy, which they are only to very debauched Stomachs; and so is Milk; but no Man's Blood wants the cleansing, refreshing Power of Milk more than his, whole Stomach, used to inflammatory things of high Relish, will not bear the first Chill of it. To Children, all this kind of Food, taken in Moderation, is perfectly grateful and salutary. Some may think that they carry into the Stomach the Eggs of future Worms; but of this I am not very apprehensive; for I believe there are few things we eat or drink, that do not convey them. But then they can never be hatch'd in a healthy Inside, where all the Juices are sweet and good, and every Gland performs its Office; the Gall in particular would destroy them; Bullocks Gall has been found to be a good and safe Vermifuge. It is my Opinion, we swallow the Eggs of many little Animals, that are never brought into Life within us, except where they find a fit Nest or Lodgment in the acid Phlegm, or vitiated Humours of the Stomach and Bowels. Were these totally discharged every Day, and the Food of yesterday employed or thrown off to the last Grain, no Worms could ever harbour in our Vitals. As soon as the Children have any Teeth, at six or eight months they may by degrees be used to a little Flesh-meat; which they are always very fond of, much more so at first, than of any Confectionary or Pastry Wares, with which they should never debauch their Taste.

Breeding Teeth has been thought to be, and is, fatal to many Children; but I am confident this is not from Nature: for it is no Disease, or we could not be well in Health 'till one or two and twenty, or later. Teeth are breeding the greatest Part of that Time; and it is my Opinion, the last Teeth give more Pain than the first, as the Bones and Gums, they are to pierce, are grown more firm and hard. But whatever Fever, Fits, or other dangerous Symptoms seem to attend this Operation of Nature, healthy Children have sometimes bred their Teeth without any such bad Attendants; which ought to incline us to suspect the Evil not to be natural, but rather the Effect of too great a Fulness, or the corrupt Humours of the Body put into Agitation by the stimulating Pain the Tooth causes in breaking its way out. This, I believe, never happens without some Pain, and possibly a little Fever; but if the Blood and Juices be perfectly sweet and good, and there be not too great a Redundancy of them, both will be but slight, and pass off imperceptibly, without any bad Consequence whatever. The chief Intention of the Method I am recommending is to preserve the Humours of the Body in this State; and therefore if it succeeds, Children so managed will breed their Teeth with less Pain and Danger than are commonly observed to attend this Work of Nature.

As I have said that the first and general Cause of most of the Diseases Infants are liable to, is the acid Corruption of their Food; it may not be amiss just to mention an easy and certain Remedy, or rather Preventative, if given timely, at the first Appearance of predominating Acid; which is very obvious from the green Stools, Gripes, and Purgings occasioned by it. The common Method, when these Symptoms appear, is to give the Pearl Julep, Crab's Eye, and the testaceous Powders, which, tho' they do absord the Acidities, have this Inconvenience in their Effect, that they are apt to lodge in the Body, and bring on a Costiveness, very detrimental to Infants, and therefore require a little Manna, or some gentle Purge to be given frequently to carry them off. Instead of these, I would recommend a certain fine insipid Powder, called Magnesia alba, which at the same time that it corrects and sweetens all Sournesses, rather more effectually than the testaceous Powders, is likewise a lenient Purgative, and keeps the Body gently open. This is the alkaline Purge I know of, and which our Dispensatories have long wanted. I could wish it was more universally received among us, and think it well deserves the Rank in our Books of Pharmacy, which it already has in some foreign ones. I have taken it myself, and given it to others for the Heart-burn, and find it to be the best and most effectual Remedy for that complaint. It may be given to Children from one to two drams a day, a little at a time, in all their Food, 'till the Acidities be quite overcome, and the concomitant Symptoms disappear entirely. I have often given it with good and great Effect, even when the Children have been far gone in Diseases first brought on by prevailing Acid.

There are some other little Niceties that, were they observed in the nursing of Children, would be of some Use to them; such as putting them soon upon their Legs, in order to forward their walking; accustoming them to use both Hands alike; for employing one more than the other, will not only make the Hand and Arm so used, but also that Side of the Body, bigger than the other. This is sometimes the Cause of Crookedness. It would likewise not be amiss to forward their speaking plain, by speaking plain distinct Words to them, instead of the Namby Pamby Stile, and giving them back their own broken inarticulate Attempts; by which means, I believe, some Children scarcely speak intelligibly at seven Years of Age, I think they cannot be made reasonable Creatures too soon.

These few loose Thoughts on the Subject of Nursing Children, I send you for your private Satisfaction, if they be lucky enough to give you any. I have neither Time or Patience to think of Form and Order, or supporting them by affected Demonstrations taken from mechanical Principles and Powers. All I have endeavour'd is to be intelligible and useful; and therefore I have avoided, as much as possible, all Terms of Art; together with learned Quotations, as often produced out of Vanity, and to shew deep Reading, as for the sake of Proof. If you think it may be of any Use to publish this Letter, I am not unwilling it should appear; if not, do with it what you please. I deliver it up as a Foundling to be disposed of as you think proper. I shall only add by way of Persuasive to those who may be inclined to make Trial of the Method I recommend, that I am a Father, and have already practised it with the most desirable Success.

FINIS


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Created 5/18/97 / Last modified 5/18/97
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