Читать книгу The Physical Training of Children - Pye Henry Chavasse - Страница 7

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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 directions 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.