Medical-Anthropological Observations about Rostock and its Inhabitants (1807)

A. F. Nolde

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The fact that, after subtracting twin births, the number of persons who have died in childbirth is 1 to 781/7, and with respect to the total of all deaths about 1 to 64, is indeed crushing. The reason for this can be found nowhere else than in the neglected or wrong treatment of the women in labor or in childbed. […]

Before turning to another matter, I would like to add quite a few things about the physical constitution of the children, […] In this context, I distinguish quite consciously the children born into a lawful marriage from the illegitimate ones. Indisputably, in the physical constitution of the latter and in their treatment lies the reason for the great mortality among them, and it is certainly significant enough to have an adverse effect overall. I believe to be able to assume without reservations that barely one fourth of them reach the end of the initial childhood years. The mothers impregnated out of wedlock are mostly from the lower classes. These usually seek services as wet nurses in order to avoid losing any livelihood altogether: for their lovers either do not give them enough to enable them to live on it with their child, or they probably outright desert the poor woman, whom they have assured marriage or given other promises. Thus, the mother accommodates her child with other people, putting it, as the phrase goes here, either ‘on the breast’ or ‘on the spoon.’ In the former case, the substitute mother breastfeeds her own child at the same time, and naturally she nurses the other child only once her own is already satisfied. […] If, however, such a child is put only on the spoon, it will only receive the food just mentioned [potatoes as well as flour and water porridge]. […] Added to this is, in most cases, a high degree of filth and uncleanliness that spoils everything completely. […] Most of the time, they get bloated bellies with constipation or foul smelling and exhausting diarrheas; they waste away to skeletons in their faces, on their arms and legs; they scream and whimper incessantly, so you would have to be made of stone not to feel moved deeply by such a pitiful and miserable sight. […] However, indifferent mothers like these do not see such a thing; otherwise they would impossibly prefer comfort and amusement over the sweet mother’s duty to nurse her own children.

By contrast, the majority of children born in a legitimate marriage generally not only enjoy very good health – for some exceptions occur here as everywhere else – but also distinguish themselves by a beauty peculiar to this age. […]

Most of the local mothers follow the equally beneficial and rewarding natural instinct to breastfeed their newborn babies. Even the women from the higher classes hardly represent an exception to this. With impartial love of truth, I confess publicly here that I encountered more than one tender mother who was barely able to calm down when urgent circumstances prevented her from performing this sacred duty as mother, hardly willing to decide, with heavy heart and tearful eyes, to hire a wet nurse or feed her child by the spoon. […]

Those who breast-feed their children themselves or keep wet nurses for them will wean them, for the most part, in the course of a year, or when they have nearly reached this target. As a rule, they are prepared for this already by giving them all sorts of conditioning or improper food on the side. After this period, however, one becomes altogether less concerned about paying attention to the age of the children when selecting meals. At that point, they usually have to eat anything that is served at the table, […]. It is understood that they eat quite their fill, and the physician always has to make special allowances for that in case the children become ill. Things are done in a similar way with respect to beverages. Sometimes the children drink water, sometimes beer, but quite often one already makes them used to coffee and wine early on, sometimes giving them so much of the latter that it goes to their head. […]

A second essential requisite of our animal organization is the air, whose influence on the child’s body has already been indicated so decidedly, […]. As long as the children cannot leave the nursery, or at least have to spend much time in it, the parents should above all else take care to give them a rather wholesome nursery. However, people indeed think about this too rarely yet. Even if I do not wish to say anything here about the lowly tradesman or laborer, who have to limit themselves to a very small and cramped dwelling in the first place, […]: the more prosperous and distinguished inhabitants could surely do more for the health of their children on this account than actually takes place. By virtue of the furnishings of the local gabled houses, a great many nurseries are shifted to the back buildings, where it is certainly the quietest and calmest. By contrast, these rooms usually have the windows facing toward a small, confined, and presumably also dirty yard; therefore, most of the time, they also lack sufficient light, and if the windows are opened from time to time, they still do not receive in this way any pure and healthy air. Moreover, on the whole, the windows are opened only rarely; in the wintertime, people dry the children’s damp laundry on the stove, allowing the air to be polluted and spoiled in an often really irresponsible manner by the rest of the domestics staying in such rooms, eating, drinking, sleeping, and performing other business there. […]

What seems particularly important to me, however, is that one removes the servants, who have such an adverse influence in many ways on the younger and older children, from the nurseries, and that, in addition, one makes a greater effort toward cleanliness overall. […]

As soon as the children have grown up to the point when they can walk, they usually like to escape the air of the closed room. Then they run around between the houses or in front of the doors, and most likely they are sent into the fresh air as well. The children of those parents that I group among the lowest class of inhabitants, and probably also those of the tradesmen, are generally in the habit of spending the entire day on the streets, in which situation they seem to feel just fine. However, in spite of this, I cannot condone this loitering around on the streets, and the police ought not to tolerate it. For even without considering that children who lack supervision learn all sorts of evil habits from each other, they all too easily run the danger of falling, being kicked, pushed, and run over. […]

However, even the more distinguished and well-to-do parents are still too negligent and unconcerned in this respect. Frequently, one relies too much on the wet nurse or child minder, oneself looking after the small and older children much too little as one worries that domestic duties will suffer because of it, or that one would have to do without any amusements away from home. Yet I am aware of many a praiseworthy exception to this; even in our parts, there are mothers who strive to fulfill the entire extent of their duties even in this respect, only parting company from the children reluctantly in the most extreme emergency. As much as they deserve praise on this account, they, too, sometimes err in this respect in two ways. Either they are too timid and worried regarding their children’s health; they keep them away from the open air, for which every child strives instinctively, immediately fearing the most dangerous consequences from any stiff breeze; they pamper the children more yet in the case of even the most insignificant indispositions, tormenting them with medicines etc. However, this is precisely a method by which they deprive the children of their health, shaping them into greenhouse plants that in future will become a burden on society. Alternatively, they are equally unable to stay away from pleasures and their beloved children, taking them along to social gatherings, meetings, concerts, plays, balls, and masquerades, only to have them under their supervision all the time; in this, though, they do not consider how little they are capable of carrying out this good intention, and how easily on such occasions their children are not only corrupted morally but also suffer damage to their bodies, falling down, becoming hot or catching cold, especially when in the course of balls even small children are granted admission to every dance.

As much as such mothers may err, however, they do err with good intentions, betraying at least by their behavior that they know how necessary good supervision is to children. Of this fact, by contrast, there seems to be no awareness at all among those mothers who leave their children entirely to the wet nurses and child minders, or they have probably stifled their sense of duty toward them already. […] In that case, however, it happens quite often that the parents find their child, whom they left in good health, in a sick state, having to call the doctor, who in turn only rarely learns about the true cause of the illness, unless his knowledge of the family directs him to suspect it.

However, even more than all of these items, one matter deserves the keenest attention by parents and particularly by the mothers to their wet nurses and child minders themselves, whom one not only often sees kissing and hugging the children in their care with lustful feelings but whom I myself have sometimes noticed more than distinctly to have their hands frequently underneath the children’s clothes out of lustfulness, there seeking to excite sensations that ought to have slumbered for a long time yet. In this way, such moral monsters lay the groundwork for so many moral and physical ailments due to the circumstance that every gratifying stimulus the children have experienced once encourages them to repeat it themselves. […] Since this pernicious children’s plague – for this name it deserves almost more justifiably so than the smallpox – is indeed not so rare at all here in Rostock but produces enough examples for physicians among smaller and older children of both sexes, I deem it all the more a duty to speak about it and on this occasion make all mothers not only suspicious toward any wet nurse and child minder but at the same time urge them to take their own supervision of their children seriously. […]

In our parts, most children begin to walk toward the end of their first year, many at a later time as well. However, only among parents from the lower classes, they learn it in a natural way, that is, by crawling and by their own attempts to keep upright and move from one spot to the next. Anyone keeping a wet nurse or a child minder, though, tends to provide them with a cushioned ‘fall hat’ and a walking harness, by means of which they often learn to walk only by very caricature-like movements. […] But all of these methods of teaching children to walk are actually not useful at all. The child squeezes its chest too much, gets in the habit of a strange gait, and is not secured from falling down, falling at least the more often when left to its own devices. Recently, however, I have found quite frequently even among more distinguished parents that they allow their little ones to learn walking in a more natural way. […]

[…] Parents of a somewhat more delicate disposition send their children, as soon as they can walk at all, to kindergartens, thinking that they are under supervision there and do not burden them while attending to domestic affairs. With respect to the group of mothers forced to provide and prepare their food without any further support, probably having to leave the house to go work, one may well grant this reason. But when even mothers from the higher classes send their still very small children to school immediately to get rid of them for a few hours and to breathe easy during this time for once, I do indeed not know what to say about it. […] Any mother who really sends her children to school in order to exempt herself from their supervision for a few hours, I accuse outright of having no idea of education.

In the schools intended for such small children, no attention is actually paid to them learning anything. […] However, not only are they kept in such schools from the physical movement so essential to them and thus accustomed to the sedentary lifestyle, which ought not to be the case; but in addition, they have to sit for several hours a day in a cramped room, breathing in enclosed, foul air; they are exposed to the danger of getting vermin, even becoming ill, especially when coming from the open air into these confined, stuffy rooms […].

Gymnastic exercises have not become established among the children of more distinguished individuals. To be sure, the boys sometimes go outdoors to kick the ball; but in part they are left alone in this, lacking any supervision, and in part they enjoy this pleasure only for a brief period during the year; and the little girls do not participate in this activity at all. […] If I were to include dancing in the gymnastic exercises as well, that activity is cultivated very much in our parts, but in a way that I as a physician cannot sanction. […] However, instead of primarily taking care to teach children who still have sufficient suppleness to turn them into anything, though lacking the firmness and strength required by the usual dances, good posture and a sure gait, people are merely pleased about them having learned all fashionable dances within a few months. Now if, to complete the scenario, several families join up on hot summer’s days to have their children dance together, there is probably nothing more to fear than a harmful overheating that must become all the more dangerous for the health of these little ones if they go home immediately after such a ball, when they catch cold quite easily as I know from experience.

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We are surrounded nearly on every side by water, and therefore in the summertime one can very easily find a spot for swimming. […] Now probably no physician will object to swimming itself; but that the boys do so without supervision, left to their own resources, deserves so much the more a sharp reprimand […].

As much as swimming is a means to promote cleanliness, in this respect particularly benefiting the boys from the lower classes very much, I do nevertheless have to note that one sees the children of the more distinguished people not only dressed very well and with clean garments most of the time but that in recent years, more frequently than in the first years of my stay here, people bathe even the smallest children, continuing this for as long as it is somehow possible. Since the time when our most gracious sovereign founded the Doberan Public Baths and one witnesses many foreigners travelling there every year to restore their health, even more effort seems to go into bathing the children.

Even though physical punishment may not be avoided under all circumstances in the course of children’s upbringing, one can probably not deny that these are frequently overdone. Many local families have methods to bring the children to obey and keep order without blows, and who would not be convinced of the fact that it is possible by friendly conduct, patience and reasonable treatment, from which I would not exclude sharp seriousness and other remedies leading to humanity, to gain the children’s trust much more reliably and achieve far more than by beating? […] However, in this respect, too, I have, almost always, seen the fact confirmed that blows only cause embitterment or at the most, forced obedience, while not actually improving and promoting humanity among people. […]