Introduction to Puériculture – Caron 1865

Machine translation from the original French manuscript, preserving the paragraph structure and marking page breaks (from the 1865 pagination) to aid citation.

INTRODUCTION TO PUÉRICULTURE AND THE HYGIENE OF EARLY INFANCY
[INTRODUCTION A LA PUÉRICULTURE ET L’HYGIÈNE DE LA PREMIÈRE ENFANCE]

By A. CARON

Doctor of Medicine of the Faculty of Paris, physician to the prisons of the Seine, member of the Société de médecine pratique and of several French and foreign scientific medical societies.

Principiis obsta, / Sero medicina paratur. [Resist the beginnings; too late is the remedy prepared. — Ovid]

PARIS — At the Author’s, 22, Rue du Bouloi — 1865
[Second title-page variant: Imprimerie Dubuisson & Cie, Rue Coq-Héron, 5]

INTRODUCTION TO PUÉRICULTURE AND THE HYGIENE OF EARLY INFANCE [p. 3]

If France has now become the classic land of science, letters, and the arts, one will not be able to say that this is owing to the encouragement and protection she grants to authors, to inventors, and to all who labor! For, among us, no sooner does some idea, some innovation of any kind, come to light, than everyone is ready to criticize it, to make sport of it, even before having taken the trouble to examine, to study the question at issue; and—a still more extraordinary thing—it is that an old principle, a routine practice universally shown to be inadequate, backward, completely false, has the force of law: men cling to it, they hold fast to it, though it should compromise the present and the future; nor do they much trouble themselves to learn whether these things must be prejudicial to the constitution, to the health of generations to come.

Prejudice, and ignorance perhaps, have long laid it down as a principle that one could not, that one ought not, concern oneself with the child except from the day of its birth; experience is now proving that if anyone sought to demonstrate the consequences of this blind and antiphysiological routine, he would expose himself to all the rigors of this social autonomy.

[p. 4] And yet, to answer the sensitivities of certain persons and the sarcasms of some others, we shall at once give them proof that, long before us, men understood the need, the necessity, of attending to the conditions of the viability of the human egg, before it has become embryo, fœtus, or child. Have the physiologists, the practitioners, then forgotten the precepts they daily counsel to individuals tainted with constitutional maladies, with specific affections, which they know must have their repercussions, near or far, upon the future, upon the health of the child to be born of such parents!

Have the learned societies, the academies, then vainly and childishly debated these important questions of consanguinity only to display the erudition and the particular merit of a few privileged colleagues? Have the authorities, then, so benevolently set themselves to react against such habits, against such tendencies, out of pure spirit of opposition? Assuredly they have yielded to considerations more philosophical, more physiological, and the experience of every day is there to justify all this solicitude and the administrative measures they have prompted.

All this leads us to conclude—by anticipation, reserving a more peremptory proof for what follows—that the health of man, that the future and the physiological constitution of our children, ought to preoccupy us well before the term of childbirth. This too is what has led us to give to these special studies the designation of Puériculture.

It is, moreover, universally demonstrated and accepted that the birth of a child is, for every family, [p. 5] an important event; that it is, for young mothers, an occasion to turn to good account those instincts, those sentiments which nature has placed in the heart of every woman.

For them a new existence begins, with new and more serious obligations, commanded by the duties of motherhood.

The affection they must have for their children—fruit of a lawful love—prescribes that they provide for all their needs; that they shield them from the vicissitudes of temperature, from the consequences of that original weakness which at every instant compromises their native viability; that they rid them of those products of excretion which, day by day, come to stimulate maternal solicitude. It is that affection, too, which lays upon them the duty of preparing for them the new elements of a nourishment in harmony—physically, chemically, and physiologically—with the delicacy of the organs and the physiogenic aptitudes of this period of life.

The whole of these new obligations constitutes, it is true, a special science, destined for young mothers and for professional wet-nurses.

These particular kinds of knowledge have, for centuries, been designated under the title of the hygiene of the newborn, or of early infancy. They ought, most certainly, to form part of the physical and philosophical education of woman; but, by a sentiment of puritanism that nothing can justify, it daily comes about that young mothers, and more particularly wet-nurses, are wholly ignorant of the first elements of this science, entirely relegated to books of medicine, and which, for that reason, is explained and demonstrated nowhere, neither to nor by physicians, [p. 6] nor even to midwives, who would have so great a need of it.

So that, in every family, at the critical moment, young mothers are reduced to conducting their maternal education by the gossip of women who believe themselves sufficiently qualified—by the impunity in which they have been encouraged by the child who has grown up amid that want of order and physiological management that presided over its upbringing.

It is under the sway of these prejudices that people prefer to condemn the young mother to an ignorance often perilous, sometimes culpable, rather than to initiate her into the elements of a relative and applied physiology. It is also to spare her sensibilities and her future illusions that, from the age of eight to ten years, an effort is made to break her of the instinctive and cherished sentiments of the little girl, causing her to give up those particulars of a pastime, of a favorite amusement—the care of a beloved doll; at that age, parents and friends, governesses, and so on, everyone seems to vie in efforts to prove to her that such distractions are no longer seasonable. It is a universal conspiracy to seek to deceive the young girl about her own constitution, about her physiological and social destiny. Her eyes and ears are shut upon a host of essential questions, which she seeks all the more to penetrate the more mysteriously they seem to be hidden from her.

The puritanical exteriors, the peculiar proprieties of which families and teachers believe themselves to be giving proof on this occasion, scarcely deceive any but those who invoke them; for children, instinctively driven to penetrate these mysteries, to inform themselves on these [p. 7] physiogenic questions, almost never fail to have recourse to knowledge more or less erroneous, but popular—that of friends or of subordinates who, less scrupulous because still more ignorant, transmit to them only prejudices, only gossip, thus perpetuating, from generation to generation, the most dangerous principles, the most antiphysiological, and too often the most immoral!

It is one of the first and most elementary questions of the hygiene of early infancy that a young mother should be in a state to bathe, to clean, and to dress her child. Physicians are there to tell us how many young women who, as little girls, were so expert in the art of tending their dolls, are now awkward, incapable of rendering the slightest service to their own children at the moment of birth. One might certainly count the number of those who are in a condition to present the breast properly to the child that calls for it.

The want of experience, the fumblings to which this improvidence, this defect of apprenticeship condemns them, do not fail to compromise very seriously the viability of the child, at the same time that they create for the mother difficulties often insurmountable. It is amid all these administrative vicissitudes of domestic economy that the child’s health is impaired, that its physiological functions become perverted, and that there begins for it that problematic existence which justifies that sad sentence: that life is, under these conditions, a chronic malady which begins with the child and ends only with it.

Were we to wish to review all the principal questions of the hygiene of early infancy which [p. 8] young women ought all to know thoroughly, even before becoming mothers, we should greatly exceed the limits of this introduction.

To present but one of the most striking—because it is among the most capital in the life of the child—we shall put it to young mothers, to wet-nurses, and finally to physicians themselves: who will ever be able to resist the desire to present the breast or the bottle to the child that cries, by appealing to the anatomical and physiological considerations which alone are capable of justifying the new doctrine we profess?

What young mother, and above all what wet-nurse, knowing the particular capacity of the newborn’s stomach, its degree of elasticity or of resistance to the column of liquid which, from the mammary gland or from the bottom of the bottle, is about to bear upon the surface of the ventricle [of the stomach], will be in a position to resist that maternal sentiment which drives every woman to suppose that the child’s cry can be, and must be, only a cry of the need for food?

But let us hasten to add that mothers and nurses are only too much encouraged by prejudices, by popular sayings, and unhappily also by certain practitioners, who—having forgotten the anatomical and physiological conditions of digestion in the child at the breast, taking no account of the presence or absence of certain organs peculiar to this period of life—believe themselves authorized to maintain that the newborn child digests more rapidly and more completely than another all the foods entrusted to its stomach.

Physicians, less than others, ought to forget that the presence of the thymus, the insufficiency of the parotid, [p. 9] lingual, buccal, and other glands, that the complete absence of the teeth and of many other secretory organs of the digestive tube, impose upon children of this age a nourishment whose qualities and proportions cannot be compared with those of later ages; that in the child at the breast, quite as much as in the adult, digestions are subject to conditions of activity and of repose without which the elaboration of the products they furnish lacks those physiological qualities which alone can concur in a regular and sound assimilation, in the building up of a solid and strong constitution. We shall refrain from extending our observations to the minutiae of execution relative to the composition of the bottle, admitting the case in which a young mother, legitimately prevented, might wish herself to complete the holy and noble task imposed upon her by her social condition or by ill-health. But we shall only ask ourselves where she is to enlighten herself with the lights indispensable to this new mode of feeding; for is there at present, in science or elsewhere, practical data, within the reach of young mothers and nurses, capable of putting them in a position to realize by themselves this new mode of the physical education of the child?

It will not be disputed that these are so many questions of the hygiene of early infancy which cannot be carried out, cannot be applied, without a certain discernment and without having been previously discussed and demonstrated! Can it be proved to us that, in the present state of the education reserved to woman—to her who must one day contribute to the propagation of the species—she may find somewhere the elements of that [p. 10] knowledge, of those practical studies, without which she can never be more than an imperfect mother, and too often a culpable one? Sad consequences of her ignorance—and all this from the fear of exposing her to a disillusion which, so it is said, would be a motive for turning her away from, or deterring her from, the duties of motherhood.

Is it, then, more moral, more philosophical, to deceive young girls, young women, until the day when—condemned to accept without reserve the new conditions imposed upon them by social and conjugal laws—they must, of absolute necessity, accept that struggle, that self-abnegation which, at the same stroke, tears away the veil and brings them face to face with the sad and all too material exigencies of reality!

What use is it, then, to conceal from the young girl, from the young woman, that she is one of the most important factors of reproduction; that it is she who holds within her the physiological product, the egg which must one day constitute the embryo, the fœtus, the human being who personifies us; that it is to the regular and continuous manner in which all the metamorphoses of the first periods are effected, to the quality of the elements of assimilation which we draw from the constituent parts of the maternal blood, that we owe the good or bad constitution we may present at our birth.

What better arguments to engage young girls, young mothers, to submit themselves to all the exigencies of a physiological life—to watch, by anticipation, over the building up and the preservation of that sacred fruit which must one day reward her for so many sacrifices, by drawing tighter the first bonds of a legitimate and holy union?

Why, then, leave young girls, young [p. 11] mothers, in ignorance that the menstrual periods coincide with the periodic and physiological evolution of an ovule? Is it in order to encourage them to follow these errings, these antiphysiological practices which drive them to violate the simplest, but the most serious, laws of the hygiene of these circumstances—to give themselves over to those incendiary practices whose aim is to disturb these physiological acts (cold baths, iced foot-baths, imprudences of every kind), capable of deranging and of suspending these important functions; to authorize them, in other circumstances, to oppose themselves to the legitimate and regular development of the fecundated fruit; to prepare for it, always through their ignorance, the elements of an insufficient, incomplete nutrition, often even of bad quality? Witness those young women who let themselves go to feeding, during the first months of pregnancy, on salad, unripe acid fruits, indigestible foods, often even harmful substances, dangerous to themselves?

Why leave them in ignorance that the compression of the abdominal and thoracic cavity can and does, directly or indirectly, compromise the viability of the child they carry;

That their own original constitution, and that of the spouse they have chosen or who has been imposed upon them, must necessarily have repercussions upon the health and constitution of the child to whom they are about to give life (Marriage, heredity, atavism);

That the relative or absolute state of health of the father and mother at the moment of fecundation deserves also to be studied with care, from the anatomical and physiological point of view;

That the activity of the mother’s physiological functions during all the periods of gestation must [p. 12] very seriously preoccupy the family and the physicians; that it is important to forewarn and to shield the young mother from all the physical or moral, and above all physiogenic, causes which might trouble or suspend the regularity of the digestive or assimilative functions (Cause of arrests of development, of monstrosities); an incontestable source of rickets and of scrofula.

That, finally, during the last months of pregnancy, young women and families must occupy themselves with the preliminary questions relative to childbirth, assuring themselves in advance of the sensibility of the galactogenic organs (the mammary glands), preparing them prudently for the activity that awaits them.

If, by considerations of social or commercial propriety, of health or of illness, the young woman is not to continue the work that nature has allotted to her; if, I say, she is not to nurse her child herself, the mode of upbringing to be followed will be discussed and settled some time before the child’s birth, so as to make choice of a wet-nurse, or to enlighten herself personally as to the rules and conditions of artificial feeding by the bottle. It is also during this last period that the young woman must provide herself with everything intended for the layette, including the cradle and all that pertains to the hygiene of the child during the first days of birth.

The only reasons capable of convincing young women, young mothers, of the importance and utility of all these practical obligations can proceed only from an appreciation of the physiological laws which command them.

It is, then, in a special, deep, and reasoned study of all these questions that one may hope [p. 13] to lead young mothers to a more reasonable and more legitimate observance of the duties of motherhood.

All these physical, physiological, and philosophical observations being bound to comprehend all the transformations of which the human egg is susceptible from its origin—that is to say, from the day of its first ovular organization in the maternal womb, up to and including fecundation and gestation—it was no longer possible to keep for these studies the designation generally consecrated: the hygiene of the newborn or of early infancy.

We were therefore obliged to have recourse to a more specific and, above all, more characteristic designation.

In giving the preference to the substantive puériculture, we never thought to offend the ears of our colleagues; and, whatever a certain Latinist turned anatomist may have said of it, this neologism constitutes neither a solecism nor a barbarism; for we find in the Latin dictionary: Colere Deum, to honor God; colere patrem, to respect, to love one’s father; colere puerum or pueros may well, in its turn, characterize the whole of the care indispensable to our anatomical and physiological building-up.

And the choice of puer seems to be justified by the considerations that precede.

In effect, the substantive (infans) seemed to restrict us to the study of the physical and physiological conditions of the child who does not speak—from in fari—and we have just demonstrated that our studies applied to many other periods, some of them anterior to the child, while, on the other hand, we pursued our physiological observations up to the end of the first [p. 14] dentition; in this last circumstance, the child has already begun the exercise of its vocal organs; it speaks, and can no longer be designated by this expression of infans.

In short, the designation puériculture permits us to embrace more broadly all the epochs, all the anatomical and physiological periods of our organic development. It sums up, better than any other, the whole of the special knowledge—of physics, chemistry, meteorology, anatomy, and physiology—whose study, methodical and reasoned application, can most efficaciously concur in the free and easy development of our species. Under these new conditions, puériculture—once physicians and families have better appreciated and understood its particulars—will constitute a veritable science, which will complete the gaps in the hygiene of the newborn or of early infancy, the hygiene of pregnancy and of women in childbed, and will comprehend them all. It is then that it will be able to render important services to the study of physiology, and more particularly to therapeutics, by illuminating the questions of pathogeny. At that time, too, it will no longer awaken anyone’s sensibilities, and one will place at the frontispiece of the course the following legend:

PUÉRICULTURE IS TO THE HEALTH OF CHILDREN WHAT AGRICULTURE IS TO THE FERTILITY OF THE SOIL

[p. 15] The synoptic table which follows will bring out still better the necessity and full utility of this new teaching; it will enable everyone to judge the results to which we aspire.

ORDER OF THE WEEKLY CONFERENCES, PUBLIC AND RESERVED Given at the Cercle des Sociétés savantes, 3 quai Malaquais, and 22 rue du Bouloi, on Mondays and Fridays, at 3 o’clock.

PUÉRICULTURE — DEFINITION

• Physiological studies of man and woman before and during marriage.
• Marriage from the hygienic, physiological, and social point of view.
• The organs of generation in man and woman.
• Fecundation, its physiological conditions.
• The ovary, the ovule, the embryo, the fœtus.
• The relative hygiene of the different periods of gestation: digestion, respiration, circulation.
• Determination of the particular mode of education to be put into practice.
• Maternal, foreign [i.e., wet-nurse], or artificial rearing.
• Particular care for the mother who wishes to nurse herself.
• Choice of the wet-nurse.
• Study and composition of the bottle.
• Trousseau, layette, cradle of the child.

[p. 16] HYGIENE OF EARLY INFANCY, OR OF THE NEWBORN

• Reception of the child, toilet, baths, clothing, first drink, putting to bed.
• Feeding: by the mother, by the wet-nurse, or by the bottle.
• Physiological studies of each mode of rearing.
• The child’s meal; studies of digestion, circulation, and respiration in the newborn.
• Exercise, gymnastics, walks, sleep, according to age.
• Appearance of the teeth:
  • 1st period — first 4 teeth
  • 2nd period — first 8 teeth
  • 3rd period — first 12 teeth
  • 4th period — first 20 teeth
• Comparative physiological studies of each period.
• Weaning.

[Colophon: Paris. — Printed by Dubuisson & Cie, rue Coq-Héron, 5]

Publications by the Same Author

• Avantages de la Méthode naturelle du mouvement, appliquée au traitement des déviations de la taille. [Advantages of the Natural Method of Movement, applied to the treatment of deformities of the figure] Journal des connaissances médico-chirurgicales, avril 1841.
• Les inconvénients du café au lait comme aliment. [The Drawbacks of Coffee with Milk as a Food] Journal médico-chirurgical (Malgaigne), 1850.
• Nouvelle théorie de la phlébite et de l’infection purulente. [A New Theory of Phlebitis and of Purulent Infection] Journal Observation (Michéa), 1850.
• De l’emploi thérapeutique interne de l’acide hydrochlorique. [On the Internal Therapeutic Use of Hydrochloric Acid] Journal médico-chirurgical (Malgaigne), 1852.
• Traitement du choléra-morbus par le vin de Colombo composé. [Treatment of Cholera-morbus by Compound Colombo Wine] In-8º, 1854.
• Hygiène des nouveau-nés. [Hygiene of the Newborn] In-8º, 1858.
• Le Code des jeunes mères. [The Code of Young Mothers] Vol. in-8º, 1859. [printed “1589,” evidently a typesetter’s error]
• L’art de se passer de médecin. [The Art of Doing Without a Doctor] Journal l’Initiateur, 1860.
• Le moyen de se soigner soi-même. [The Means of Treating Oneself] Journal l’Initiateur, 1860.
• De l’éducation des jeunes mères et des nourrices. [On the Education of Young Mothers and of Wet-Nurses] Journal l’Initiateur, 1861.
• Projet de révision de l’ordonnance du 20 juin 1842. [Project for the Revision of the Ordinance of 20 June 1842] Dans le but d’instruire les nourrices et d’améliorer le sort des nouveau-nés.
• Nouvelle considérations pratiques sur le café au lait. [New Practical Considerations on Coffee with Milk] Opinion Nationale, 1864.
• Réponse sur le café au lait à M. L. Figuier. [Reply on Coffee with Milk to M. L. Figuier] Journal La France, 1864.

Sous presse [In press]: Traité théorique et pratique de Puériculture. [Theoretical and Practical Treatise on Puériculture]

Pour paraître prochainement [Forthcoming]: Nouveau Traité des maladies scrofuleuses. [New Treatise on Scrofulous Diseases]

Translation notes: The term puériculture is left untranslated throughout, since Caron is coining/defending it as a neologism and the whole passage on pp. 13–14 turns on its Latin etymology (colere + puer). “Éducation étrangère” in the syllabus means rearing by a wet-nurse (literally “foreign/outside” rearing), not education abroad. On the publications list, “1589” for Le Code des jeunes mères is plainly a typesetter’s transposition of 1859. Note also that this title page bears two states (author’s address at 22 rue du Bouloi vs. the Dubuisson imprint), which the scan shows both of.

Last Updated on 08/13/26