Thomas Phaer's "The Boke of Chyldren," widely considered to be the first book of pediatric medicine, is a fascinating window into sixteenth-century life. First published in 1544, Phaer's book describes the various medical problems children might encounter in their first few years, along with the remedies parents might try.
The first thing readers will be likely to notice is Phaer's creative spelling. For example, he spelled his own name at least five different ways. English spelling wasn't standardized until long after Phaer's book was first printed, but reading any strange-looking words out loud will generally make their meaning clear. Readers who do so will be rewarded with some hilariously outdated advice. For example, mixing the child's feces with honey is no longer an accepted approach to curing tonsillitis. But most importantly, the fears and uncertainties underlying Phaer's medical advice are very similar to the fears and uncertainties parents of today's parents.
What follows are six lessons that modern parents can take from this 473-year-old book of parenting advice.
Like many parenting books that eventually followed his, Phaer's book opens by focusing on breastfeeding. First, he shares "remedyes appropriate to the encreasyng of mylke in the brestes," including recipes for three simple soups. The first includes parsnip and fennel in chicken broth. Women who couldn't find the necessary fresh produce could make a broth with mint, cinnamon, and mace. And if none of those spices were available, women could always turn to a beef tongue broth with dried and powdered earthworms.
That's right. Earthworms.
Many of Phaer's remedies include ingredients that would be unpalatable to many of today's parents. That was probably true for parents of his own time as well, which is one reason why honey is featured so prominently in many of the recipes. But even the most stomach-turning of remedies suggest that the poorest of parents could do something useful for their children using the ingredients most readily available.
Turning to dessert, there is also a sort of lactation rice pudding recipe that calls for breadcrumbs, fennel, and sugar, topped off with wine, a suggestion that alcohol has long been recommended for milk production, even though its effectiveness is disputed.
Phaer also recommends many individual ingredients thought to improve milk production, among them dill, anise, fresh cheese, honey, goat's milk, lettuce, saffron, and cow dung (sheep dung is also fine).
473 years after Phaer's book was published, many breastfeeding mothers still swear by fenugreek-filled lactation cookies. Although the cookies are a considerably tastier option than many of Phaer's recommended recipes, there's no strong evidence that either the old or the new recipes do anything to increase milk production.
Phaer describes sleep as "the nouryshment and foode of a suckyng chylde, and as much requisyte as the very tete." If sleep is nourishment, there must have been a lot of undernourished babies around in Phaer's time, because he devotes a good amount of space to discussing sleep problems.
Like today's parents, who cite problems with feeding, swaddling, room temperatures, sleep schedules, or a host of other issues, Phaer reaches for explanations to describe poor baby sleep. Phaer claims that bad sleep comes from bad milk, tainted either by the woman who produced it or by spoilage. Sleep is also affected by the quantity of milk, which can lead to "vapoures and fumes aryse into the head and infect the brayne, by reason wherof the chyld can not slepe but turneth and vexeth it selfe with cryeng."
One additional reason children might not be sleeping is nightmares, so Phaer offers strategies for children with "terry ble dreames and feare in the sleape." One source of nightmares is a full stomach, so parents should "take hede that the chylde slepe not wyth a full stomake, but to beare it aboute wakynge tyll parte be dygested." Phaer also discourages over-rocking children, advice echoed in modern parenting books that discourage parents from over-stimulating children before bedtime.
To help children sleep, Phaer recommends drops of violet oil and vinegar for the forehead and nostrils. He also advises parents to use, if they can get their hands on it, "syruppe of poppye" as a sleep aid, a strategy that seems as unnecessarily aggressive as doping modern kids with Benadryl.
If Phaer's description of baby sleep problems is indicative of 16th-century babies more generally, perhaps modern parents can rest a bit easier in the knowledge that sometimes, babies are just bad sleepers.
In his entry for "colycke and rumblynge in the guttes," Phaer describes symptoms that probably look quite familiar to parents reading nearly 500 years later: "The sygnes thereof are too well knowen, for the chylde can not rest but cryeth and fretteth it self." Phaer attributes colic to "wynde" caught in various bodily organs, identifiable by "the noyse and romblyng in the guttes, hyther and thith- er, declareth the chylde to be greved with wynde in the bellye and colik."
Phaer's remedy is to avoid meats, beans, butter, eggs, and similar foods, advice not so different from the advice given to parents of gassy children 500 years later. Although we're no longer administering oil and wax plasters to children's bellies, the sales of gas drops and other similar remedies suggest we are just as concerned with their gastrointestinal traffic now as then.
Given our current popular wisdom to provide gas drops, or burp babies, or avoid eating particular foods to keep them out of breast milk, it would appear that modern parents have been as ineffective at stopping babies' crying as their 16th-century ancestors. The lack of strong evidence connecting burping and colic, as well as the limited evidence that gas pains are as painful as parents imagine them to be, suggests that what we might be "remedying" when we treat children's gassiness is more our own fear that our children are in pain than the children's actual pain.
Phaer writes that parents should expect to see teeth at around seven months, the emergence of which may cause the child to be "sore vexed wyth sondrye dyseases and peynes, as swellynge of the gummes and jawes, unquyete cryenge, fevers, crampes, palsies, fluxes, reumes, and other infyrmities."
Phaer's first remedy for teething is to rub rabbit brains on the gums, along with chicken grease or honey, but he concedes that any one of those items alone is okay, so if you're testing out Phaer's remedies you might start with just the honey. Mary Poppins must have been a student of Phaer's, because in "The Boke of Chyldren" there is a spoonful of sweetness for every affliction.
The notion of rubbing some kind of analgesic on the gums of teething children persists today. Phaer also recommends a teething device, made out of silver, bone, or coral and "hanged about the necke wheruppon the chylde shulde oftentymes labour his gummes." Although those teethers were ornate, their hanging calls to mind the pacifier clips many parents use today.
In Phaer's case and in ours, we're probably still making too much of teething. Phaer's connection between teething and disease was hardly new for his time, as Hippocrates was making similar claims nearly 2,000 years earlier. The equation of teething and illness has been so strong throughout history that in 1842, teething was listed as the cause of death for 4.8% of all London children who died before their first birthday. And modern parents continue to suspect that teething causes all sorts of problems today, even when there is very little correlation between reported symptoms and actual teething.
Whether the cause is eating, sleeping, winding, or teething, most of Phaer's remedies are directed at stopping a child's crying. His entry for bloodshot eyes, a condition which Phaer says comes about from too much crying, is one such example: "When the eye is bloodshotten and redde, it is a synguler remedye to put in it the bloode of a yonge pigion or a dove or a partryche, eyther bote from the byrde or els dried and made in pouder as subtyle as maye be possyble."
Perhaps modern parents could learn a thing from this remedy. Imagine responding to a tantrum by putting dove blood in your kid's eye. That might very well be the end of the tantrum because he'll know his tears were why you sacrificed that dove.
These days, your pediatrician would probably discourage you from trying Phaer's remedies. Parents shouldn't treat watery eyes with powdered snail shells or earaches with a worm paste cooked in the rind of a pomegranate. But Phaer's book is so much more than the remedies themselves. It's about ritual, and about knowing what to do in the face of uncertain situations. In offering 16th-century parents medical advice in their common tongue, Phaer was giving them the confidence that they could intervene on their children's behalf.
If our baby care books are read by curious parents another 20 generations from now, perhaps they'll also be comforted that we were so concerned with our babies' seemingly constant crying. It's possible they will think our attempts at soothing or healing are as misguided as we think Phaer's remedies were. But perhaps they'll also smile with the recognition that, hundreds of years before their own babies were born, parents were just as befuddled as they are now.
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