In every neighborhood there is to be found the delicate child, and everywhere anxious mothers are putting forth every effort to improve the condition of their puny boys and girls. In carefully looking over the puny child, we see an underweight little creature with pale skin, and as he comes to the table everybody notes that he refuses more or less food.

DIET AND HYGIENE

As we give the child a closer examination we find that certain lymph glands are enlarged, possibly adenoids are present in the post-nasal pharnyx, and, in many instances, there are badly diseased tonsils. Usually the puny child is constipated, hands and feet are cold, and he jumps and starts at any unusual noise, thus showing a tendency to nervousness. One of the first things necessary is to take this little one to a good specialist and if necessary have the adenoids and tonsils removed. This having been done, the diet should be carefully looked into. There should be served him for breakfast a generous bowl of dextrinized grains with a good portion of diluted cream, a glass of rich milk, a baked potato, and fruit. For lunch at twelve o'clock he should be given a glass of malted milk with egg, or eggnog, six or eight dates or three or four figs, a handful of pecan kernels, and perhaps a lettuce sandwich. For dinner at half past five, another nourishing meal of baked potatoes, a protein dish of either cheese and macaroni or eggs or meat, a generous fruit salad, a glass of rich milk, and bread and butter, should be enjoyed.

There is no class of little folks who eat between meals more often than do these delicate children, for mothers painstakingly endeavor to feed these children all they can possibly take; so one mother thoughtlessly went about it something like this: the half past seven breakfast having been only touched—nibbled at—with the ten o'clock hour came this request: "Mother, I am so hungry, I want something to eat." Eagerly the mother prepared either a meat sandwich or a jelly sandwich and possibly a glass of milk.

When it was time for the twelve o'clock dinner hour, or lunch hour, again the well-filled plate was refused, the appetite having been satisfied at ten o'clock. Having taken very little nourishment at noon, by half past two the plaintive plea again came to the mother ears: "May I have a piece?" and again the well-meaning mother gave him the desire of his heart. So the day passed, the dinner making the fifth time food was taken into the stomach, and in all probability there was eaten a cookie in between. The reader can readily see that the digestion was consequently very much disturbed, fermentation occurred, decomposition of food took place in the digestive tract, with its result—constipation.

IMPROVING THE APPETITE

Not a morsel should pass the lips of any child, and particularly our delicate child, between meals. Let him come to the table at half past seven or eight o'clock, and if he does not want to eat tell him frankly that that is all he is to receive until twelve—and stick to it. Nothing more than water or fruit juices should be taken between meals.

It may be necessary to create an appetite for the three meals we have just described, and as we now take up the outdoor hygiene we would not forget that some simple treatment should be instituted each day in a well-heated bathroom or bedroom. Roller skating or ice skating, hoop-rolling, rope-skipping, and Irish mail, or a coaster, all furnish splendid exercise for the delicate child. Under no circumstances should he be allowed to remain all the time in the house; and so pleasing recreations must be provided for him out of doors. The sand pile should not be forgotten, flower-bed making, raking the lawn, a polished coasting board fastened in a slanting position to an upright which can be mounted by means of a ladder, create splendid outdoor sports for these children.

THE DAILY PROGRAM

Take the child into a warm bathroom each morning and let him stand in six inches of well-warmed water. With a rough mitten made out of either mohair, crash, or turkish towel, the entire body should now be rubbed until it is pink. This procedure is known as a dry-friction rub. Do not stop until the skin is pink, particularly the arms and legs, for the back and chest usually get pink quickly. Then with simply a cold dash of water to the feet, dry them well and allow him to dress. Twenty minutes before the meal hour, let him get out of the house and roller skate around the square as many times as he can in twenty minutes, or let him race and have a royal good time in the fresh morning air and then after this forced oxygen intake let him come in to breakfast.

And now for school, and as we say "school," we regret that there are not more "open-air schools." Some day the American people, more particularly the American mothers, will awaken to the fact that we need more schools with simply window space rather than so many closed glass windows. Some day we will send our children with sweaters, leggings, stockinet caps, mittens, even in the cool days of spring and fall, to "open-air schools," and in the cool fresh air they will think better and work faster and make wonderful progress in both studies and appetites.

The particularly delicate child, under treatment, will not spend the whole day in school. In all probability the forenoon session only will be attended, after which the half-past-twelve or one-o'clock meal that has been previously described will be given him. Now if the appetite is variable, arrange a little surprise for him by serving this meal on the porch or in the living-room by the open grate, or out under the trees. In all probability such a meal will be taken eagerly, particularly if the mother will read a pretty story. Now the afternoon is to be spent in doing a number of different things. We would like a pleasant walk, a visit to the park, hoop-rolling, roller-skating, rope-skipping, ice-skating, outdoor sliding, anything that will take our little fellow out of doors to increase his oxygen intake until possibly the half-past-three hour is reached, when he should come into the house and lie down and prepare for the treatment for that particular day.

TREATMENT SUGGESTIONS

Twice a week he should be given a salt glow (described in the Appendix). Twice a week he should be given a thorough soap shampoo (also described in the Appendix). After each of these baths a special rub should be administered to the spine, and as there is so often spinal curvature in these children, certain stretching movements of the spine are valuable, together with hot fomentations (see Appendix) over the spinal centers. These are wonderful stimulants to the delicate child and should precede the salt glow twice a week. Every afternoon a hot-and-cold foot bath may be given to create a better circulation. The feet are put in hot water from three to five minutes (as hot as can be borne), and then they are quickly plunged into the coldest water obtainable for three seconds, then back into the hot water, and vice versa, until three changes have been made, always finishing the treatment with the cold dip. On the three remaining days of the week at half past three, the child will simply relax in the hammock or on the porch couch while the mother aids in the relaxation by a pleasant story. We would suggest that on Monday the salt glow be administered; Tuesday a rest is taken; Wednesday the soap shampoo is to be administered; Thursday another rest; Friday a salt glow; Saturday another rest, and Sunday the shampoo, etc.

Before going to bed at night, with the mother's hands well oiled with either olive or sweet oil, the circulation is again stimulated by the heavy friction rub.

Constipation is taken care of along the same lines as mentioned elsewhere in this book.

It is surprising to see how often these delicate children are infested by worms, and while a great deal of dependence cannot be put in that single symptom "grinding the teeth at night," or "pallor around the mouth," yet we do believe that many a delicate child continues to suffer from worms many years. It is a very simple procedure to obtain a specimen of the stools. A cathartic should be given and after usual free-bowel movement, the second time the child desires to go to stool this should be saved and taken to the laboratory for a careful search for worm eggs which are usually in evidence if worms infest the child. The treatment for worms is described elsewhere in this work.

We have seen scores of young people between the ages of eight and eleven who, before treatment, were pale, listless, under weight, irritable and cross, after three months of such treatment as has been outlined gain six to ten pounds and look as ruddy as their healthiest neighborhood friends. It is perfectly marvelous to notice how a child will put on from six to eight pounds in a short period, at the same time overcoming his irritableness and fretfulness. I am more and more inclined to believe that most bad children are sick children—are undernourished children—and it behooves us American mothers and fathers to give proper attention to this undernourished child, call a halt, and devote three months to giving him the help that he needs. He did not ask to come into this world; and it is "up to us" to give this child what he deserves—for every child in this world has a right to be well born, to be well fed, and to be well reared.