and irritable; and, sometimes has a slight bowelcomplaint. The arm, about the eighth day, is generally much inflamed—that is to say, red, hot, and swollen-for an inch or two around the vesicles.

44. Do you approve of giving the infant medicine after vaccination; more especially if he be a little feverish?

No: as it would be likely to work off some of its effects. I do not like to interfere with vaccination, but to allow it to have full power upon the constitution. If he be slightly feverish, it will subside in two or three days, without the administration of medicine.

45. Have you any directions to give respecting the arm AFTER vaccination ?

The only precaution necessary is, to take care that the arm be not rubbed, otherwise the vesicles may be prematurely broken, and the efficacy of vaccination may be lessened.

46. If the arm be much inflamed after vaccination: what should be done?

Smear a little cream on the inflamed part, frequently, by means of a feather or camel's-hair brush. This simple remedy will afford great relief and comfort.

47. Have the goodness to describe the proper appearance of the arm, after the falling-off of the scab ? "A perfect vaccine scar should be of small size, circular, and marked with radiations and indentations."*

* Dr. George Gregory.

DENTITION.

48. At what time does dentition commence? The period at which it commences is uncertain. As a general rule, it may be said, that an infant begins to cut his teeth at seven months old. Some have cut teeth at three months; indeed, there are instances on record of infants having been born with teeth. King Richard the Third is said to have been an example. Shakspere notices it thus:—

"YORK.-Marry, they say my uncle grew so fast

That he could gnaw a crust at two hours old;
'Twas full two years ere I could get a tooth.
Grandam, this would have been a biting jest."
Act 2, sc. 5.

Where children are born with teeth, those teeth generally drop out. On the other hand, teething, in some children does not commence until they are eighteen months or two years old; and, in rare cases, not until they are three years old. There are cases recorded of adults who have never cut any teeth-an instance of the kind came under my own observation.

49. What is the number of the first set of teeth, and in what order do they generally appear?

The first or temporary set consists of twenty. The first set of teeth are usually cut in pairs; those in the lower-jaw generally preceding the upper for a longer or shorter period. The two lower front cutting-teeth usually make their appearance first, next the two upper ones to correspond, then the remainder

of the lower lateral cutting-teeth, followed by the remainder of the upper lateral cutting-teeth, then the first grinders in the lower-jaw, afterwards the first upper-grinders, then the lower corner pointed or canine-teeth, after which, the upper corner or eyeteeth, then the second-grinders in the lower-jaw, and lastly, the second-grinders of the upper-jaw. Of course, they do not always appear in this order: nothing is more uncertain than teething. A child seldom cuts his second-grinders until after he is two years old. He is, usually, two years in cutting his first set of teeth from the time they first appear; therefore, as a general rule, a child of two-years old has sixteen, and, one of two-years-and-a-half old, twenty teeth. The following table drawn up by Bell, in his Treatise on the Teeth, gives a tolerably accurate idea of the time and order in which the first or temporary set of teeth appear :

From 5 to 8 months, the four central incisores.

It may be well to explain, that the incisores mean the cutting-teeth, the cuspidati the pointed-teeth, and the molares the grinding-teeth.

50. If a child be feverish, irritable, or otherwise poorly, and the gums be hot, swollen, and tender, are you an advocate for their being lanced?

Certainly, as, by doing so, the child will, in the generality of instances, be almost instantly relieved.

51. But, it has been stated that lancing of the gums hardens them?

It has a contrary effect. It is a well-known fact, that a part which has been divided gives way more readily than one which has not been. Again, the tooth is bound down by a tight membrane, which, if not released by lancing, frequently brings on convulsions. It may be necessary, if the symptoms be urgent, to repeat the lancing from time to time. Of course, it would be the height of folly to lance an infant's gums unless they be hot, swollen, and the tooth or teeth be near at hand. It is not to be considered a panacea for every infant's ill; although, in those cases, where lancing of the gums is desirable, the beneficial effect is, sometimes, almost magical.

52. How should lancing of a child's gums be performed?

your

child's

Of course, the proper person to lance gums is your Medical man. But, if perchance, you should be miles away and out of the reach of a medical man, it would be well for you to know how the operation should be performed. Well then, let the child lie upon his back, on the nurse's lap, and let the nurse take hold of his hands, in order that he may not interfere with the operation. Then, if it be the upper-gum that requires lancing, you should go to the head of the child, looking over, as it were, and into the child's mouth, and then steady the gum with the index-finger of your left hand; then, you should take hold of the gum-lancet with your right hand, holding it as if it were a table-knife at dinner, and cut firmly

down the inflamed and swollen gum, and down to the tooth, until the edge of the gum-lancet grates on the tooth. Each incision should extend along the ridge of the gum to about the extent of each expected tooth. If it be the lower-gum that requires lancing, you should go to the side of the child, and steady the side of the jaw with the fingers of the left hand and the gum with the left thumb, and then perform the operation as before directed. Although the lancing of the gums requires a long description to make it intelligible to a non-professional person, it is, in point of fact, a simple affair, and gives but little pain.

53. If teething causes convulsions, what should be done?

The first thing to be done (after sending for your Medical-man) is to freely dash cold water upon the face, and, as soon as warm water can be procured, to put the child into a warm-bath* of 98 degrees Fahrenheit. If a thermometer be not at hand, the mother should plunge her own elbow into the water; a comfortable heat for the elbow will be the proper heat for the infant. The child should remain in the bath for a quarter of an hour, or, until the fit be at an end. After coming out of the bath the body should be wiped with a coarse towel; and the child should then be placed in a warm blanket. The gums should be lanced, and cold vinegar and water should

* For the precautions to be used in putting a child into a warmbath, see the answer to question on "Warm Baths."

† No family, where there are young children, should be without Fahrenheit's thermometer.