Adventures of Tom Sawyer | Page 6

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 centre 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 truss or bandage; which latter appliances sometimes gall, and do more harm than they do good.
20. _If an infant have 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 skilful 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 But if this under-strap is to be superseded, the truss must be made exactly to fit the child--to fit him like a ribbon; which is a difficult thing to accomplish unless it be fashioned by a skilful 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 ensured. 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 ran 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 the 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, discontinue by all means the use of flannel caps.
22. _What kind of a 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, &c.) 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 whooping-cough, whilst still very young, it is safer to resume the belly-band." [Footnote: Communicated by Sir Charles Locock to the Author.]
24. _Have you any remarks to make on the clothing of on infant_?
A babe's clothing ought to be light, warm, loose, and free