Norman Douglas - "Alone"

Hurlo Thrumbo (pseudonym) - "The Merry Thought: or the Glass Window and Bog House Miscellany"

T. W. Lumb - "Authors of Greece"

Fredrika Bremer - "Strife and Peace"

Annual Bibliography of Commonwealth Literature 2007
This paper argues that discourses of love in Ghanaian market literature for youth offer a view into complex negotiations of agency and empowerment. Drawing on Deborah Durham's notion of youth as "social `shifters'" and Francis Nyamnjoh's conception of the "interconnectedness" of agency, I take Ghanaian market literature as one specific case of how African literature for youth foregrounds questions of continuity and change as African societies enter into increasingly complex global relations. In this literature for youth, received notions of love, often constructed out of impressions from American pop and hip hop music, carry new notions of agency that compete with existing "domesticated" forms. Authors like Ike Tandoh and Evelyn Tay employ discourses of love to offer youth alternative avenues for empowerment in a context of socio-economic disenfranchizement. In a creative process of "straddling", this writing both reveals and reproduces the contradictions that obtain in youth configurations of agency.

The Mother and Her Child

W >> William S. Sadler >> The Mother and Her Child





TREATMENT OF DIARRHEA

Simple diarrhea in the older child of two or three years is treated as
follows: Take away all solid foods. Give a big dose of castor oil,
thoroughly wash out the bowel by warm water containing a level
teaspoon of salt and a level teaspoon of baking soda to the pint, and
put the child to bed in a quiet room. Boil all milk for ten minutes
and thicken it with flour that has been browned in the oven; feed this
to the child at five-hour intervals. After each bowel movement, no
matter how often they come, the colon should be washed out with the
salt and soda enema as before mentioned.

Bear in mind that the child is losing liquids, and so, after the
bowels have moved, boiled water should be given by mouth, or a cupful
of water can often be retained if it is introduced into the rectum
slowly under very low pressure. Twenty-four or forty hours should
clear up a case of simple diarrhea, and on returning to food it should
be dry toast and boiled milk. For the younger baby, withhold all milk
and give barley water or rice water for the first twenty-four hours,
returning to milk very gradually and slowly.

For the more severe types, such as the dysentery containing mucus and
blood, everything that has been done for the simple diarrhea should be
done; the baby should be kept very quiet, while castor oil should be
promptly administered. Food is withheld and the bowels are carefully
irrigated after each movement with the salt and soda solutions. After
the bowels have moved from the castor oil, then bismuth subnitrate,
which has been dissolved in two ounces of water, should be given--one
or two teaspoons every three hours. This will naturally turn the bowel
movements dark.

Under no circumstances should any other medicines be given without the
physician's knowledge, as it is at such times as this that many
"would-be friends" advise laudanum, paregoric, and other opiates. The
skin must be kept warm, and fluids must replace those that have been
carried off in the many stools. Water may be given by an enema, by
water drinking, and in such rare cases as cholera infantum, when water
cannot be retained on the stomach, it often becomes necessary to
inject it under the skin (hypodermoclysis) so that it may go at once
to the wasted tissues and perhaps save the baby's life.

Give the baby ten days or two weeks to return to normal condition, and
under no circumstances hurry the feeding of milk, as a second attack
may occur much more readily than the first; may more profoundly
overcome the baby and result in death.


RUPTURE

A protrusion of a loop or portion of intestine through a weakened
abdominal muscle--which grows larger when baby cries and smaller when
he is lying down in a relaxed condition--is known as rupture or
hernia, and is of common occurrence in infancy. It is often seen at
the navel and sometimes in the groin as early as the second week.

Hernia is always dangerous and should never be neglected. The
physician will protect the navel by a special support with adhesive
plaster which is carefully renewed twice a week, and if worn for
several months usually entirely corrects the condition. A comfortable
truss made from skeins of white yarn will amply protect a groin
hernia. The condition should always be taken seriously and receive
immediate treatment.


PROLAPSE OF THE BOWEL

Occasionally, as the result of severe straining in constipation, the
rectum protrudes sometimes one-half inch, and in rare instances two or
three inches. The placing of a young child upon a toilet chair and
insisting upon severe straining sometimes results in such a protrusion
of the rectum. This may be avoided by the application of vaseline to
the rectum or by the use of the gluten or glycerine suppositories
which cause the hardened masses to make their way out easily. Someone
has suggested that if the buttocks are supported by a board placed
over the toilet seat with a two-inch opening so that severe straining
of the rectal muscles is impossible, the prolapse of the rectum will
not recur.

The moment the mother observes the slightest protrusion of the rectum
she should quickly put it back and have the child lie down and move
the bowel in the diaper. Very severe cases require a physician's
attention, but if prompt and quick measures are taken on the first
appearance it may be quickly corrected and serious consequences be
avoided.

In this connection we might mention a condition which sometimes babies
are born with--the absence of the rectal opening. If the baby's bowels
do not move for the first two days, surgical interference is more than
likely necessary. Often the external opening alone is missing.
Sometimes there is a complete closure or atresia of the lower part of
the colon.


BLEEDING FROM THE NAVEL

There should be no hemorrhage from the umbilical stump after it has
been properly tied, but occasionally a bit of blood is found upon the
dressing and a second tying of the cord stump is necessary. The cord
drops off in eight or ten days, and the umbilicus that is left may be
moist or it may bleed slightly; if such is the case, great care should
be exercised in bathing this ulcer that has been left behind. It
simply should be touched with alcohol, a bit of boric acid powder
applied, and a small piece of sterile gauze be placed over it. In the
course of two or three days it will entirely heal. Care should always
be exercised in washing the umbilicus. Extensive hemorrhage from this
portion of the body is rare, but it does happen occasionally and is a
severe condition which demands surgical attention.

If the umbilicus remains moist and foul smelling, general blood
poisoning of the infant may easily follow. Thorough dusting with boric
acid powder, with possibly a little oxide of zinc, will usually effect
a cure promptly, but should the condition continue, which it does only
in rare instances, the doctor may have to cauterize it.




CHAPTER XXVIII

CONTAGIOUS DISEASES


Never under any circumstances knowingly expose a child to any of the
so-called "childhood diseases." The old method of "have the child get
them as quickly as possible and get over them," has laid the
foundation for many chronic disorders later in life. For instance, eye
troubles and running ears are often the sequelae of measles; chronic
coughs, tuberculosis and bronchitis frequently follow in the wake of
whooping cough; heart disorders follow diphtheria, while kidney
disease often follows in the course of scarlet fever.


CATCHING DISEASE

Under all circumstances keep the children away from these dangerous
childhood diseases. When a contagious disease breaks out in a school
and the little fellow has, along with the other pupils, been exposed
to it, begin at once systematically to keep the nose and throat very
clean with such well-known sprays as the champhor-menthol-albolene
spray, which should be used in the nose morning, noon, and night.
Throat gargles, such as listerine, or equal parts of alcohol and
water, help to keep the throat in condition to resist the microbic
invasion.

During this anxious time of patient waiting the bowels should move
every day and the food should be cut down at least a third. In other
words, moderate eating and a clean bowel tract go a long way toward
keeping a child well and preparing him for an attack of disease. The
skin at this time should be kept well bathed and free from the
accumulated skin secretions which clog up the sweat glands and
otherwise lower the vitality.

Stuffy, close rooms, where the ventilation is poor, not only harbor
disease germs, but also lower the vitality of the child. Never take
your child into a household where there is any form of sickness, for
it may turn out to be a contagious disease--no matter how it began, it
must be remembered that many contagious diseases, in their earlier
stages, much resemble a simple cold.

Measles come on rather gradually, and one might suspect that the child
was simply suffering from a severe cold in the head.

Scarlet fever usually begins with a sore throat, while chickenpox has
very few initial symptoms; usually the first thing noted is the rash
itself. Diphtheria begins with a sore throat, while whooping cough
begins very insidiously.

The most important thing is to keep children away from people who are
sick, and if a contagious or infectious disease is prevalent in the
neighborhood discourage the mingling of the children in hot, illy
ventilated rooms. Put a stop to "parties" and all similar gatherings.
Let the little folks have good books, plenty of toys, in a
well-ventilated room, and the more they keep to themselves at this
particular time the better they are off.


THE SPREAD OF CONTAGION

It is possible to "stamp out" any known disease if only proper
cooperation takes place and certain sanitary regulations are
maintained. It is within the memory of most of our readers when yellow
fever was put to flight and the cause of malaria discovered. We
learned to screen our camps and no longer did our soldiers contract
the fever; while the simple covering of stagnant pools with oil,
together with proper screenage, stopped the ravages of malaria.

Likewise, many of the woeful tragedies of infant summer diarrhea and
dysenteries have been tracked to the so-called "innocent house fly."
We have all learned--only recently--that if we move the manure pile
once in seven days the hatching of the maggots may be prevented, and
so millions, yes trillions, of these carriers of disease may never be
born.

If there is one sweet morsel above another for this fly pest it is
tubercular sputum or feces, and from these feasts they go directly to
walk over baby's hands, crawl over his cheek, and wash their feet in
his milk. Proper screenage will prevent such contamination of food,
such opportunities for carrying disease.

Sunshine, hot water, soap, and fresh air, are the best ordinary
every-day disinfectants. It is possible so to conduct the treatment of
a contagious or infectious disease that no other member of the family
may contract it. A few simple but very important hints are:

1. Door knobs are one of the very greatest avenues of
contagion--disinfect them.

2. Cleanse the hands both before and after attending to the sick;
first, scrub with stiff brush, soap and water, then dip in alcohol.

3. An epidemic of sore eyes may be stopped by absolute "hand
disinfection" and using separate towels.

4. Do not go visiting when you have a "common cold."

5. Kissing is one of the best ways of spreading many diseases.

6. In cases of contagious and infectious diseases completely cover all
excretions from the body with lime.

7. Country homes would be as healthy as city homes if the privies and
stables were screened.

8. In the country, the well water should be boiled; one infected well
may be the cause of the death of a score of beautiful children.


INCUBATION PERIODS

The incubation period of scarlet fever is from one to seven days.

Measles, ten to twenty days.
Whooping cough, from one to two weeks.
Chicken-pox, fourteen to sixteen days.
German measles, seven to twenty-one days.
Diphtheria, any time from one to twelve days.
Mumps, from one week to three weeks.

Of all the diseases, measles and chicken-pox are probably the most
contagious. In scarlet fever and diphtheria, close contact is
necessary for exposure, while whooping cough can actually be
contracted in the open air, young babies being particularly
susceptible.


TYPHOID FEVER

Typhoid fever is a disease of the small intestine. Typhoid germs
accumulate in the little lymph nodes of the small intestines and that
is the reason why we often have so many hemorrhages from the
bowel--actual ulcerations take place--and if an ulcer is situated in
the neighborhood of a blood vessel hemorrhage may result.

Typhoid fever begins rather insidiously with a slight debility and
loss of appetite, but if a temperature record is kept the fever will
be found to rise from one-half to a degree higher each day. A steady
climb in the temperature curve is noted until the end of the first
week, when it remains for a week, possibly 103 or 104 F. After one
week it begins slowly to decrease and, if all goes well, the early
part of the fourth week usually finds the temperature about normal. It
is exceedingly important that the child be kept in bed during the
entire course of the disease. The bed pan must be used at each bowel
movement or urination.

_First Week Treatment._ During this week the child may feel quite
well, but he should be kept in bed and sustaining treatments
begun--such as wet-sheet packs and cold frictions to the skin (during
which time there should always be external heat to the feet). The diet
must be full and nourishing, but all pastries and "knicknacks" should
be avoided. Abundance of fresh fruit that has been well washed before
paring, eggs, pasteurized milk, baked potatoes, and toasted bread may
be taken at regular periods--with an interval of not less than five
hours between meals.

The bowels should be opened in the beginning of the disease with a
liberal dose of castor oil, after which daily colonic irrigations
should be employed. These enemas should be given at least once a day,
the temperature being about that of the body, with a smaller terminal
enema about five degrees cooler at the close of each bowel cleansing.

_Second Week Treatment._ The normal temperature at this time is no
longer 98.6, it is 101.5 F. This fever is essential to the curative
and defensive processes of the body; and while we do not care to have
the fever fall below 101.5, at the same time nothing is to be gained
by allowing the fever to go up much above 102.5 or 103 degrees F. And
so, during the second week, while the disease is at its height, we
make frequent use of the wet-sheet pack, always remembering that the
extremities must be kept warm and never permitting the skin to become
blue or mottled while the cold treatment is being administered. Since
the real disease is localized in the small intestine, we will now
describe a very important treatment for the diseased bowel--and one
which is also very useful in combating high temperature.

_The Cooling Enema._ The temperature of this enema begins one degree
higher than that of the body (supposing the body temperature to be
103, the temperature of the enema would start at 104 F.). This is
allowed to flow into the colon and out again, under low pressure,
without disturbing the patient, by means of a glass tube connection
(See Fig. 15). The temperature is quickly brought down to 100, then to
98, then to 90, usually finishing up at 80 or 85 F. The water is
allowed to enter the rectum slowly through a soft rubber catheter (not
a hard rectal point), and as it comes out it will be noted that the
water is very warm, sometimes registering 105, and it is needless to
add that if the water goes in at 80 and comes out at 105 F., much heat
has been taken from the body; and so, of all the treatments we have to
suggest for typhoid fever, the one just mentioned is possibly the most
important. When it is necessary to keep up this enema for an hour or
two, the cool water may cramp the bowels, but this may be entirely
obviated by applying hot compresses to the abdomen.

Another treatment of great importance in this second week is the cold
abdominal compress. Much fever is occasioned in the abdomen because it
is the seat of disease, and the much dreaded hemorrhages which often
cause the death of the patient are usually avoided by the use of
abdominal compresses--wrung out of water at 55 F.--the temperature of
ordinary well water--and changed every twenty minutes.

[Illustration: Fig. 15. The Cooling Enema]

I recall one mother in my dispensary practice who was so poor she
could not afford a nurse, her only helper being a son twelve years
old. A nurse went to the house twice each day and taught this lad of
twelve years to give his mother the cooling colonic irrigation; he was
also taught to warm up the abdomen by a hot application and afterwards
to apply the cold compresses. The mother made a good recovery.

During this second week the diet should be sustaining. It should
consist of boiled milk, eggs, fresh fruit and fresh fruit juices,
dextrinized grains (hard toast, toasted corn flakes, shredded wheat
biscuits, etc.). The mouth should be kept scrupulously clean, for in
all the infectious and contagious diseases there is always the
possibility of gangrene in the mouth if it is neglected.

_Third Week Treatment._ This is the week we look for hemorrhage from
the bowel unless the abdomen has been well treated during the second
week; and even so, the cool compresses to the abdomen will be
continued well into the third week--also the daily or semi-daily
enema. The skin is kept in good condition with soap washing and
friction baths, and a fairly liberal diet is maintained. During the
whole course of the disease the skin is never allowed to get blue or
mottled, being quickly restored to the normal red color by the mustard
sheet bath, the short hot-blanket pack, or the dry-blanket pack with
hot-water bottles. Under no circumstances let the child leave the room
or his bed for at least another week.


MUMPS

Infants are rarely affected with mumps. It is a disease of the
salivary glands and (as a rule) is usually preceded by pain between
the ear and the angle of the jaw, accompanied in a short time by
swelling and temperature. It is distinctly contagious even during the
incubation period. There is much tenderness on pressure, and chewing
is difficult and may be impossible. It usually occurs on the face and
only one side may be affected. The bowels should be kept open, the
mouth should be kept clean, and the side of the face should be
protected by a layer of cotton held in place by bandages.

Hot fomentations may be applied if the pain is severe. The electric
light bulb on an extension cord, that was mentioned in connection with
earache, is very comforting in this condition.

Isolation should be maintained for ten days or two weeks after all
symptoms have disappeared.


SCARLET FEVER

Scarlet fever is one of childhood's most dreaded diseases because of,
first, its long quarantine; second, its terrible possibilities of
contagion; and, third, its sequelae.

Absolute quarantine is necessary until ten days after the last signs
of desquamation have disappeared.

This disease is always alarming because of the possibilities of its
sequelae--the danger of pneumonia, inflammation of the ears, abscesses
of the glands of the neck, and nephritis (inflammation of the
kidneys).

Scarlet fever is highly contagious at any time during its onset and
course. Among the first symptoms of the disease are sore throat,
swollen glands, fever, etc. Vomiting on a street car or at the movie
may spread the disease to more than one child who might otherwise have
escaped. One child who may have only a very light form of the disease
may give it to another child in the most severe form. Any such group
of classic symptoms--vomiting, fever, rapid pulse, and sore
throat--should cause any parent immediately to isolate the little
sufferer for several days--awaiting the "rash"--which usually puts in
its appearance after three or four days of increasing temperature.

This rash has an appearance "all of its own," unlike any other.
Because the fine "meal-like" red points are in such close proximity,
the skin assumes a smooth "lobster red" color that is never to be
forgotten. After three days of increasing redness, the color begins
slowly to fade, and after four or five days of this fading a peculiar
peeling takes place, whose scales vary in size from a small fleck to
casts of the whole of the soles of the feet and the palms of the
hands.

During the height of the disease, the throat is very red, the tonsils
are not only inflamed, but covered over with white patches, the head
aches and the tongue possesses a peculiar coating through which peep
the red points of the swollen papillae, presenting the classic
"strawberry tongue" of scarlet fever.

After ten days the fever disappears and the "real sick" stage of the
disease is in the past.

Each morning of the ten previous days a small dose of Epsom salts is
usually administered and the itching, which so often accompanies the
rash, is relieved by carbolized-water sponge baths.

The nose, throat, and ears receive daily care--sprays to the nose and
gargles to the throat, as well as special swabbing to the tonsils.

The physician in charge of the case will note the urinary findings,
guard the heart and kidneys, prevent the spreading of the scales of
desquamation by frequent rubbing of the skin with oil, and otherwise
work for the future well-being of the patient.


MEASLES

Measles, one of the most common diseases of childhood, is not to be
regarded lightly, for very often its sequelae--running ears, weak
eyes, and bronchial coughs--may prove very serious and troublesome.
Tuberculosis of the lungs not infrequently follows in the wake of
measles. The early symptoms of measles are so mild that often the
child is out of doors, at school, or about his usual play, until the
second or third day of the fever. He was supposed merely to be
suffering from a simple "cold in the head."

On the third or fourth day the patient begins heavy sneezing and wears
a stupid expression; and it is then that the mother ascertains that
his temperature is perhaps 101 to 102 F. He is put to bed and the next
day the rash usually appears. The rash is peculiar to itself, not
usually mistaken for anything else, being a purplish red, slightly
elevated, flattened papule, about the size of a split pea. The
coughing, which is very annoying, usually remains until about the
seventh or eighth day--at which time the fever also disappears.

The bowels must be kept open; a daily bath be given--in which has been
dissolved a small amount of bicarbonate of soda (simple baking
soda)--after which an oil rub should be administered. The nose should
be frequently sprayed with three per cent camphor-menthol-alboline
spray, while the throat is gargled with equal parts of alcohol and
water. The feet should be kept warm by external heat, while the
physician in charge may order additional attention to the chest, such
as a pneumonia jacket, etc.

Care should be taken to guard against "catching cold," for bronchitis
or pneumonia is quite likely to develop in many cases of measles. The
eyes should be protected by goggles and the room should be darkened;
under no circumstances should the little patient be allowed to read.
Carelessness in this respect may mean weakened eyesight all the rest
of his life. Until two weeks after the rash has disappeared, the
little fellow should be kept by himself, for the desquamation keeps up
almost continuously during this time.

The food during the course of the disease is a liquid and soft diet.
Children should never be allowed to go to a party or gathering with a
cold in the head; the mothers of a group of small children will never
forget the time that one certain mother allowed her little fellow to
attend a party with "simply a cold in the head." He laughed, talked,
and sneezed during the afternoon and when he went home the rash
appeared that night, while eight of the ten exposed children came down
with measles during the next two weeks.


CHICKENPOX

The incubation period of chickenpox is from ten to seventeen days. It
is a mild disease, with a troublesome rash consisting of widely
scattered pimples appearing over the scalp, face, and body. These
pimples soon became vesicles (small blisters), which in turn quickly
become pustular, afterwards drying up with heavy crust formation.
Severe itching which attends these pustules may be greatly allayed by
either the daily carbolic-acid-water bath or a baking-soda bath. The
itching must be relieved by proper measures, for if the crust is
removed from the top of the blebs by scratching, a scar usually
results. The bowels should be kept open, the diet should be soft.
Rigidly isolate, for chickenpox is highly contagious.


SMALLPOX

This disease occurs oftenest during the cold season. It spares no one
unless vaccinated, attacking children and adults alike. The early
symptoms are: headache, pain in the back, high fever, vomiting, and
general lassitude. In many respects these resemble the symptoms of the
grippe, while on the third day the eruption appears. The pimples are
hard and feel like shot under the skin. Within a day or two these
shotlike pimples have grown and pushed themselves beyond the skin into
little conical vesicles which soon turn to pus. By the eighth or ninth
day crusts are formed over the vesicle, beginning to fall off about
the fifteenth day.

Patients are quarantined usually eight weeks and when a case of
smallpox in the home breaks out everyone in the family should be
revaccinated. The strictest isolation is important from the first of
the disease.

We will not enter into the treatment of smallpox, for medical aid is
sought at once and usually the patient is removed to a special
isolation hospital.

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