Lariam (Mefloquine)
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TAKING CARE OF CHILDREN: THE “DELICATE” CHILD
For many years I have been sceptical about children who were too “delicate” to do this, that, and the other thing. ‘Way back in my youth one of the boys of the village, whose family was comfortably fixed, was so delicate that he “could not eat” beefsteak. This was ridiculous. Beefsteak is one of the most easily digested foods that we have.
A country medical officer a long way from these parts has written about the matter and rather blamed the doctors for their part. He thinks that they have been especially wrong in the way they have made diagnoses in children. The parents will tell the doctor that the child has had “breathlessness on effort since infancy.” It is a perfectly normal thing for a child to run about until out of breath, but the physician who has been told of the breathlessness may have heard a heart murmur and advised the parents that the child must be restricted in his exercise. Perhaps in the old days physicians were justified in worrying about heart murmurs but modern studies with electrocardiograms and other scientific devices have shown us that many heart murmurs are of no importance whatever. The son of one of my doctor friends had an unusually loud heart murmur, yet he has climbed the Matterhorn and even more difficult mountains and is still going strong.
Children have been kept away from school for long periods because of bronchitis and worry as to whether they were tuberculous. With X-rays and modern diagnostic methods it can be determined pretty certainly whether or not a child is tuberculous. If he is, he needs much more definite treatment than being kept away from school. In nearly all such cases absence may contribute nothing to health while interfering with success in school.
But though a tuberculous condition does demand specific treatment, normal people are entitled to certain normal pains, among which stomach-ache can be a normal diagnosis. I wonder how many times we children were given Jamaica ginger and hot water, nicely sweetened, for stomach-ache. Not so dangerous as a cathartic. I knew one little girl, an only child, who had many attacks of stomach-ache until her mother finally realized that she had been babied too much, and this was her way of preventing absences from her doting mama. All this is no argument against taking care of sick children, but being delicate is no diagnosis and does not need much treatment.
If one were to list the branches of medicine according to the degree of development of the individuals concerned, the order could well be: veterinary medicine, pediatrics, and the medicine of adults, with this latter including old adults as well as middle-aged ones. The child is mighty close to what we refer to as dumb animals. As far as the young child himself is concerned, the mind is very little, if any more, developed, and the body much less. The problems of the pediatrician have to be solved with little help or hindrance from the patient.
The pediatrician demands and expects more from the nurse than does the physician caring for grownups. The ideal nurse should be the mother. Recently, in fact, The Lancet, the old and wise medical magazine published in London, has urged that even when children are taken to the hospital for operations, they should be nursed by their mothers.
*11/276/5*