A practical treatise on the management and diseases of children / by Richard T. Evanson and Henry Maunsell.
- Evanson, Richard Tonson, 1800-1871.
- Date:
- 1843
Licence: Public Domain Mark
Credit: A practical treatise on the management and diseases of children / by Richard T. Evanson and Henry Maunsell. Source: Wellcome Collection.
Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)
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![at different times, and in different countries, induced them to abandon this guide, by persuading them that external cold would fortify the constitutions of their children, as it does those of adults. To this distinguished physiologist we are indebted for the observations, that the heat of mature infants at birth, is from 3° to 5° less than that of adults — varying between 93° and 95°; that the heat of premature infants is still less ; and that the power of producing heat being, in all young animals, at its minimum at birth, they have not the same capability, as adults, of resisting a diminution of their temperature, from exposure to cold. From Dr. E.'s discoveries, indeed, we are fully warranted in concluding that the philosophers of whom he speaks are in the wrong; and that nature has, with her usual wis- dom, conferred a proper instinct upon mothers, in teaching them to keep their offspring warm. It is for us, therefore, immediately upon taking charge of the newly-born child, to have it well wrapped up in soft, warm flannel; to take care that, in cold weather, it shall be dressed in the neighbourhood of a comfortable fire ; and that, during the operation, it shall not be unnecessarily exposed to cold.* When we examine more carefully the body of the infant, we shall find that it is more or less covered with a white, greasy, or curd-like substance. This is denominated the vernix caseosa, and appears to be provided for the purpose of defending the tender skin from the in- jurious effects of the warm, aqueous fluid in which it floats while in its mother's womb. After birth this coating has no useful purpose to serve; and would be injurious, by obstructing the pores of the skin, and by intercepting the vivifying influence of the air of which we have already spoken.t It is, therefore, advisable to remove it; and, accordingly, the first act of the nurse is, to wash the new-born child. The washing should be performed with warm water, and a fine sponge, and as the soft bones of the infant render it unfit to bear much pressure from the hands, the operation will be most safely and • The views of Dr. Edwards have been practically confirmed by some observaf tions of Dr. Milne Edwards, and Dr. Villerme. It is the custom in France, to convey infants, within a few hours of their birth, to the office of the mayor of the commune, in order that their birth may be registered ; and Drs. E. and V. discovered that the proportion of deaths, within a very limited period after birth, compared with the total births, was much greater in winter than in summer, — in the northern and colder, than in the southern and warmer departments, — and in parishes where the inhabitants were scattered over a large surface of ground, than in others, where they were more closely congregated round the mayor. t If any authority were wanting for the removal of the vernix caseosa, we have it in the practice, which obtains universally among animals, of lickino- their offsprin? immediately after birth. [Note to 1st Edition.] ° In a note by the German translator of this work, we find Oesterlen ((Etlol. und rathol der Krankheiien neugeborner Kinder. Heidelberger Klinische Annalen Iter Band Istes Heft 1831), quoted in support of a different view of this subject. This author, It appears, is of opinion that the chief use of the vernix caseosa is found subsequent to birth, and that it is designed to protect the skin from the overstimulating effects of the oxygen of the atmosphere. He states that premature children have a smaller quantity of this covering than those born at the full time, and that the deficiency is in proportion to the immatureness. Such has not been the result of our observations, nor have we noticed the ill consequences which he attributes to the removal of tlie verntx caseosa, viz., aphthae, jaundice, and ophthalmia. [Note to 4th Edition.]](https://iiif.wellcomecollection.org/image/b21118346_0036.jp2/full/800%2C/0/default.jpg)
