Hardening of the body is only justified where overanxious parents pamper the child; otherwise anannic children require indulgent care. They should not be persuaded to take long walks or to play games which require much exercise. Gymnastic exercises, which frequently cause. trouble, should be discarded. After the requisite degree of strength has been gained, which is well indicated by the gain in body weight, it is advisable to take brisk walks even in cold winter weather, and to warm the hands and feet by brisk movements at play. Then also gymnastic exercises are indicated. Swimming or cold frictions frequently exacer bate the trouble considerably, because the child is not nourished well enough to stand the loss of body heat, so that no reaction of the vessels takes place. In these cases it is better to prescribe friction with coarse towels which are gradually and carefully replaced by rubbing with eau de Cologne or brandy and finally by a wet sheet. The child should be rubbed immediately on being taken out of the bed, and afterwards be placed back into bed for a few minutes. Rubbing may also take place after a warm bath, hut the chief concern is that the child invariably be warm after the treatment. Later on it is well to let the children splash about with their feet in cold water. Many authors recommend sweat. baths in the case of very young chlorotic children.
Great attention should be paid to sufficient nutrition. Five meals should he kept up. Before getting up in the morning and in the evening some milk may be given to the child in bed. Before going to school the child should partake of a proper meal plenty of albumin (milk, buttered bread, and if possible, egg or meat). Then also the second breakfast will usually be eaten, and in many schools provision is made for allowing the children a glass of good cool milk. Before dinner rest is desirable. Generally speaking, the child may eat what ever it likes, so long as it eats.
Personal taste may be gratified by allowing caviar, small quanti ties of sardines, ginger, pickled melon; older children may have a piece of herring, sardines, cucumbers, salads which may be dressed with lemon (beans, tomatoes, celery, asparagus, endives, green salads; in dressing leaf salads great cleanliness should he observed). By these dishes and plenty of sauces, and by coating meat dishes with fruit jams, meat can be more easily administered. In the case of younger children who can not masticate well, the meat. should be cut into very small pieces or mashed. For this purpose meat cutting machines, scissors, mastica tors, etc., have been invented. Food containing a high percentage of iron is preferable (see Table on p. 135). Vegetables can be cooked very nicely with butter, cream is also well borne, especially with strawberries (caution on account of decomposition after standing); ninny children are fond of linseed oil (with potatoes). For "fattening' maybe recom
mended, oatmeal, red grits, jellies; honey is very nutritious (1 table spoonful equal to 73 calories). Older children are given for a few weeks (only to stimulate the appetite) a little wine (sweetened claret, a liquor glass to half a wineglassful twice a day), a glass of malt beer (2-3 per cent. alcohol, 7.5-10 per cent. malt extract).
Proprietary foods should only be given if the ordinary food cannot be administered in sufficient quantities. Only few fat preparations are suitable for continued use; oil of sesamum and codliver oil (twice daily a teaspoonful to a tablespoonful), the latter also in the form of ossin strochein (a combination with the egg albumin, in tablespoonful closes) also effervescent oil are generally well liked. Moreover, chocolate or cocoa containing oleic acid is well assimilated according to Zuntz, and finally lipanin (olive oil with 6 per cent. oleic acid, in teaspoonful to desertspoonful closes) though this is expensive. Of carbohydrates may be mentioned: oats-cocoa, Theinhardt's hygiama, malt extract (50 to 55 per cent. sugar, 10 to 15 per cent. dextrin, 5 per cent. albumin, 1 tablespoonful of 20 Gm. is equal to 60 calories), also to be recommended as a mixture with milk is Loflund's maltsoup extract, or crystallized (Tirunnengraber) with S3 per cent. carbohydrates, 5 per cent. albumin; 1 tablespoonful equals S5 calories); of albuminoid preparations: puro (meat juice with 33 per cent. albumin, 19.16 per cent. extract); of milk albumin preparations: plasnion (cheap), nutrose, sanatogen, with SO to 90 per cent. albumin, the latter also with 5 per cent. glycero-phosphate of sodium, all soluble or miscible in cold water; also the inexpensive roborat with 94 per cent. vegetable albumin, free from nuclein, misci ble in water, suitable for mixing with flour for making bread (up to 40 per cent.) somatose (albumose with SO per cent. of soluble albumin) is also on the market in liquid form, it is expensive and in large quantities causes diarrinea. Generally albuminous preparations are not liked for a long-continued period, but have the great advantage of containing albumin in concentrated form. Meat juice (freshly made with Klein's meat juice squeezer, also on the market as Valentine's meat juice, etc.) and meat extract may he given as appetizers, but have little nutritive value.
Medicinal therapy can only be attended with success, if the entire hygienic measures have been regulated in accordance with the princi ples laid-down above. At all events the administration of iron for sev eral weeks in succession is always advisable as soon as anfemia has once been established.