Caption: "Woman, and a Boy running after her."
"The Boy wears a Necklace of Runtees, in his right hand is an Indian Rattle, and in his left a roasting Ear of Corn. Round his Waste is a small string, and another brought cress thro his Crotch, and for decency a soft skin is fastn'd before."

See: Robert Beverley, The History and Present State of Virginia, In Four Parts. London: Printed for R. Parker, MDCCV. 8–9.

The manner of the Indians treating their young Children is very strange, for instead of keeping them warm, at their first entry into the World, and wrapping them up, with I don't know how many Cloaths, according to our fond custom; the first thing they do, is to dip the Child over Head and Ears in cold Water, and then to bind it naked to a convenient Board, having a hole fitly plac'd for evacuation; but they always put Cotton, Wool, Furr, or other soft thing, for the Body to rest easy on, between the Child and the Board. In this posture they keep it several months, till the Bones begin to harden, the Joynts to knit, and the Limbs to grow strong; and then they let it loose from the Board, suffering it to crawl about, except when they are feeding, or playing with it.

While the Child is thus at the Board, they either lay it flat on its back, or set it leaning on one end, or else hang it up by a string fasten'd to the upper end of the Board for that purpose. The Child and Board being all this while carry'd about together. As our Women undress their Children to clean them and shift their Linnen, so they do theirs to wash and grease them.

The method the Women have of carrying their Children after they are suffer'd to crawl about, is very particular; they carry them at their backs in Summer, taking one Leg of the Child under their Arm, and the Counter Arm of the Child in their Hand over their Shoulder; the other Leg hanging down, and the Child all the while holding fast with its other Hand; but in Winter they carry them in the hollow of their Match-coat at their back, leaving nothing but the Child's Head out, as appears by the Figure.

The World Images site, a project of California State University, is designed for simplicity of use if not aesthetic elegance. It is a utilitarian database well suited to teachers, professors, or students looking for presentation images licensed for educational use on a comprehensive range of subjects including photography, painting, illustration, and material culture with global geographic representation.

The image collections are arranged as thumbnail panes on the home page, each hyperlinked to a list of portfolios that indicate how many images each contains. The site holds an archive of 72,000 images organized into 867 portfolios, and a tutorial shows how to create Community Portfolios. Users can browse the collection using keywords, artists, topics, titles, regions, or periods in quick or advanced search modes. Search results can be viewed as titles with hyperlinked acquisition numbers, as thumbnail images with titles, or as small or zoomable images with their metadata.

Categories include institutional collections in the database, faculty collections, course materials, and a collection of image portfolios correlated to required history topics in the California Educational Standards for grades 4–10. Since these curricular requirements are fairly common across the U.S., and in world history beyond the U.S., this is a valuable resource for teachers.

World Images is rich in images related to children and youth. The "People and Portraits" portfolio contains three sub-categories on children with a total of 1,094 images, some overlapping. They include Children to 1500 (234), Children 1500-2000 (544), and Children of the World (316).

The first is fairly inclusive geographically, but includes many images from Western traditions. The second is almost entirely European and American, and the third includes North and South American, African, Asian, and European children's photos and a few artworks and artifacts. Much of the third collection is the work of photographer Kathleen Cohen.

The following search terms returned images on children and youth: "children" (1000), "childhood" (80), "girl" (382), "boy" (555 items), "infant" (119), and "family" (858). The metadata provided with each image includes title, artist or maker, historical period, region or country of origin, copyright holder of the image, and/or museum holding the object. The individual object view also shows what other collections include the object, and links to other objects by the same artist or unknown generic maker from that culture. The photographs are labeled with title, year, location, and photographer, but nothing further, though some of the titles are very descriptive.

The information associated with World Images is thus limited, providing no further contextualization, nor are there links to descriptive information on museum sites where some are housed, for example. For this reason, the works of art found through this website are starting points for research about children in history rather than destinations. Some images, however interesting, remain mysterious.

Teachers wanting to illustrate already researched lectures or activities with licensed images will find this site a rich resource, especially if the lack of detailed information on the images is not a problem. Interesting objects from the collection can stimulate fruitful discoveries of available research on the web or from books and articles. For example, an image of an ancient baby bottle led to a trove of online information about infant feeding through the centuries.

Teachers can also create thematic collections that can be used for primary source investigations. A number of art images show punishment of children's misbehavior, for example, and children at play, as well as infant equipment from various times and places. These images can be used as exercises in examining primary sources as if they were "found objects" at a site or in an archive.

World History Sources at the Center for History and New Media has extensive lessons, exercises, and scholarly models for analyzing primary sources, including photographs, that could provide tools for working with the rich sources available on this website. A feature called "You be the Historian" could be adapted to interrogating the images from the World Images collections, and would reveal much about childhood by investigating questions to ask, and suggesting how to find answers.

1. Abbot, Mary. Life Cycles in England, 1560-1720: Cradle to Grave. London: Routledge, 1996.
   Includes chapters on children and youth and primary written and visual sources with suggestions for their use.
2. Beier, Lucinda. Sufferers and Healers: The Experience of Illness in Seventeenth-century England. London: Routledge, 1988.
   Focuses on the patients and those who treated them, from housewives to bonesetters to surgeons. Includes an analysis of the casebook of Joseph Binn, a London surgeon and some of his younger patients.
3. Ben-Amos, Ilana Krausman. Adolescence and Youth in Early Modern England. New Haven: Yale University Press, 1994.
   Discusses the shorter life span of pre-modern people and why youth was so important as a result. Themes include the physical and emotional effects of being an apprentice or a servant. Not an easy read.
4. Houlbrooke, Ralph A. The English Family, 1450-1700. New York: Longman, 1984.
   A classic work on the importance of understanding family structure in this period as the context to disease and death. Includes a chapter on children.
5. Pollock, Linda. Forgotten Children: Parent-Child Relations from 1500-1900 Cambridge University Press, 1983.
   A controversial work that argues against the idea that there was little concept of a childhood in the past and that life for the young was a brutal experience. Discusses the treatment of sick children and youth.

by Sharon Cohen
(Suggested writing time: 50 minutes)

Directions
The following question is based on the documents included in this module. This question is designed to test your ability to work with and understand historical documents.

Drawing on specific examples from the sources in the module, write a well- organized essay of at least five paragraphs in which you answer the following question:

• To what extent did parents in early modern England try not to become too attached to their children, as infant and child mortality was so high?

Write an essay that:

• has a relevant, clear thesis that answers the question,
• uses at least six of the documents,
• analyzes the documents by grouping them in as many appropriate ways as possible. Does not simply summarize the documents individually, and
• takes into account both the sources of the documents and the creators' points of view.

You may refer to relevant historical information not mentioned in the documents.

Be sure to analyze point of view in at least three documents or images.

What additional sources, types of documents, or information would you need to have a more complete view of this topic?

Grateful acknowledgment is made to the following institutions for primary sources:

• Fordham University,
• Irwin Publishing,
• Neonatology on the Web,
• The New York Public Library, Astor, Lenox and Tilden Foundations, and
• Wellcome Library.

About the Author

Lynda Payne, Ph.D., RN, Sirridge Missouri Endowed Professor in Medical Humanities and Bioethics and Associate Professor of History, University of Missouri-Kansas City. She is the author of With Words and Knives: Learning Medical Dispassion in Early Modern England, and is currently researching and writing a monograph on the 18th-century surgeon Percivall Pott.

About the Lesson Plan Author

Sharon Cohen teaches AP World History and IB Theory of Knowledge at Springbrook High School in Maryland. She regularly presents papers on world history pedagogy at the annual conferences of the World History Association, the American Historical Association, the National Council for Teaching History, and the National Council for the Social Studies, served on the College Board's AP World History Development Committee, contributed articles to the online journal World History Connected, and published curriculum units in world history for the College Board and the online model world history project World History For Us All.

Children and youth in early modern England (1500-1800) were subject to many diseases and physical hardships. From the great epidemic diseases of bubonic plague and smallpox, to more common illnesses such as measles and influenza that still afflict children today, sickness put children and youth at great risk. With no knowledge of bacteria or antibiotics, and surgery performed without anesthesia or even hand washing, there were few remedies for childhood illnesses beyond a nourishing diet and keeping the patient warm. Even surviving an illness could have permanent consequences, for example, scarlet fever left many children blind and deaf, and measles could cause severe scarring and facial bone loss.

One measurement of health in early modern England is revealed in the statistics of the number of deaths kept by church parishes. From these records historians have gleaned that infant mortality (death during the first year of life) was approximately 140 out of 1000 live births. The average mother had 7-8 live births over 15 years. Unidentifiable fevers, and the following list of diseases, killed perhaps 30% of England's children before the age of 15 – the bloody flux (dysentery), scarlatina (scarlet fever), whooping cough, influenza, smallpox, and pneumonia.

Death from disease was higher in urban than in rural areas. Early modern cities were widely, and often rightly, regarded as deadly environments. They contained large concentrations of population who were often poorly fed and housed. "Crowd diseases" such as typhus, smallpox, and tuberculosis prospered, and bubonic plague epidemics periodically swept through dense urban populations. In 1563, 1603, 1625 and 1665, about one fifth of the population of London died in plague outbreaks. In 1665, one of the deadliest years, 80,000 people died in the capital city. Of this number, historians estimate that at least 45,000 of the victims were under the age of 15.

Besides diseases, accidents were common sources of sickness, disability and death for children and youth. From surveys of coroners's inquests, drowning in wells and bathtubs, was the most reported accidental death in children under the age of 5. Accidents were also reported connected to the work in which children were engaged beginning around age 8. Children cracked their skulls while fetching water, were trampled by horses while ploughing, or dropped and injured while under the care of siblings. Boys, unless they were from the noblest of families, were expected to serve an apprenticeship. They were often placed in dangerous crafts such as tanning, blacksmithing, or serving on ships, where chemical poisonings, fires, and war injuries were frequent occurrences. There are also accounts in diaries of the period of youthful pranks leading to injury, for example, hiding gunpowder in candles so they blew up when lit.

Throughout this period the primary place where sick children and youth were cared for was in the home, and the principal healers were women – mothers, daughters, wives, and servants. Powder burn remedies —applying a mixture of poultry fat and dung—were commonly included in home receit (remedy/recipe) books kept by the mistress of the household. Women developed considerable professional knowledge after the rise of the printing press in 1500 and the publication of books that had been only in the hands of physicians. Both herbal and chemical medicines were described as suitable for the young in family receit books, such as dried dill in honey for a cough, and iron filings in beer for paleness of the skin.

Children were rarely treated by the small and expensive elite of university-trained physicians to whom adult patients turned for a prognosis and not for a cure. Their remedies were also considered too drastic for children as they largely consisted of rectal purging (laxatives), bloodletting (cutting a vein open with a lancet), and forced vomiting (emetics). These treatments were based on an ancient Greek medical theory that the body was composed of four substances, or humors, created from the digestion of food. The four humors were choler or yellow bile, phlegm or mucus, black bile, and blood, and all had properties of being hot/cold and dry/wet. If the humors were balanced – neither too strong nor too weak – you were healthy. The hot and wet humor of blood and the hot and dry humor of yellow bile were believed to be naturally stronger in the young. Occasionally if these humors were not weakened and released from the body in the form of sweat, tears, urine, feces, or even sneezing, physicians would give children emetics to make them vomit or let blood through "cupping." Heated glass, bone, or brass cups would be placed upon skin that had been scratched or scarified with a knife. Blood would then flow gently from these wounds due to the creation of a vacuum by the heated cup.

Worried parents consulted surgeons, trained through apprenticeship, for broken limbs, ruptures, and the bladder stone. The latter was caused by the early modern diet, which was rich in gravel. Boys were often operated on for the stone by surgeons in this period with a mortality rate of 30%. The operation was called a lithotomy and took about three to five minutes to perform. No anesthesia was used, instead surgeons relied on the child fainting from pain and being out during the extraction of the stone. Most often, parents turned first to family, friends, and neighbors, for medical advice, even the local blacksmith for a fee would set bones in humans as well as animals.As the specialty of pediatrics (from the Greek for child and healing) had yet to emerge, children were treated as small adults in hospitals and kept in the same wards as adult men and women. Some charitable institutions were opened in the early modern period, for example, the Children's Hospital in Norwich in 1621, but they tended to be more for children who were abandoned by their parents or orphaned, than for sick youngsters. The largest institution for orphans was the Foundling Hospital in London, opened in 1741. There were also medical discoveries that helped children and youth in this period, most notably, inoculation and vaccination for smallpox.

Starting in the 1960s several scholars have argued that early modern parents tried not to invest too much emotion (or money) in a child until it reached an age where survival was likely. High birth rates, accompanied by high death rates for children under the age of ten years old, meant that family life was fragile and uncertain. Yet the parent-child relationship seems to have been as strong in the early modern period as in any other age, and former ideas of emotional indifference before the eighteenth century are now widely questioned by scholars. Most of the population had a hard struggle for existence but children were cared for as much as conditions would allow. The harrowing grief of mothers and fathers who lost children to disease or accident is indeed all too apparent in diaries and letters of the period.

I have found that the best way to teach about sickness and health from centuries ago is to not to focus on the biology and statistics of diseases but to focus on the suffering and the impact of illness on a person's life. I have had students write about their own experience of illness until the age of 18, and then had them compare and contrast that with the common illnesses a child and youth would have experienced in early modern England. Students have also researched how medical conditions of children and youth would be diagnosed and treated by a variety of healers. They took into consideration wealth and poverty, class status, gender, and whether they were living in a city or in the countryside. Finally, I have had success with using visuals to illustrate not just medical care and treatment but environmental conditions. If you have students imagine life without modern conveniences such as electricity, gas, sewers, clean water, cars, and so forth (the list is long), their understanding and interpretation of images of early modern children and youth grows as they take into account the context of health, hygiene, and illness.

Discussion Questions

• What were the common illnesses of children and youth in early modern England? What remedies were suggested and by whom? Can you describe some of the changes in medical treatment during this period? (Classification and description of diseases, inoculation and vaccination).
• Some historians have argued that children and youth had a miserable existence and that parents in early modern England tried not to become too attached to their children, as infant and child mortality was so high. Can you use the sources to argue for and against this thesis? (Teeth pulling, Gin Lane, Infanticide Trial versus The Graham Children and the Evelyn Diary).

Lesson Plan: Health in England (16th–18th c.)

by Sharon Cohen

Time Estimated: three 45-minute classes

Objectives

1. Students will be able to identify possible connections between the lack of modern conveniences and health, hygiene, and illness among children in early modern England.
2. Students will be able to debate the extent to which parents demonstrated attachment to children in a period of high mortality for infants and young children.

Materials

• Printouts of primary sources sufficient for each student to have a full set of the texts and images in the Health in England Teaching Module. 1
• Highlighters
• Index cards

Day One

Hook
Ask students to imagine life without modern conveniences such as electricity, sewers, and clean water by listing ten possible effects on health, hygiene, and illness. Then, with a partner, have them predict which of those effects were common among children in early modern England. Make a class list of these predictions to post for comparison later.

Activity
Students will read the primary sources looking for any connections between the lack of modern conveniences and health, hygiene, and illness among children. One strategy to help with close reading is to help the students generate lists of typical words they might find in the text, and then encouraging them to underline or highlight the words associated with a lack of conveniences (such as lack of clean water for drinking or washing) and circle or highlight the words associated with symptoms of illness (complexion, fever, fits, pain, sweat, swollen, shivers, blisters) and treatments (ointment, medicine, bloodletting, fasting, bed rest). Have the students turn in their annotated sources. Check to make sure they found most of the key words. If not, show them to the students the next day.

Day Two: Debate Prep

Return the annotated sources and ask students to share with a partner the words that appeared the most often.

With partners, have students try to translate those words into lists:

• identifying the common illnesses of children and youth in early modern England and
• identifying the remedies suggested and by whom.

They should write these analyses of the sources in the margins.

Students prepare for a debate on whether parents in early modern England tried not to become too attached to their children, as infant and child mortality was so high.

Day Three: The Debate

Debate Directions
Divide the class into two groups (pro and con).

Assign each student a specific speaking role in the debate.

• Each group has a different student make the opening statement and the closing statement.
• Each group has six main pieces of evidence delivered by six different students.
• Each group also assigns six students to critique the evidence delivered on the basis of the authority or reliability and perspective of the source.
• That's 28 student roles. Adjust as necessary for the size of the class. If the class is larger, assign students to critique the arguments and evidence used overall in the debate and then report on their assessment at the end.

Differentiation

Some strategies for supporting and challenging students are already included in the lesson. For struggling readers, the sources might need to be translated into modern English, and perhaps even analyzed together as a class. The preparation for the debate for students still learning how to construct and support arguments might take an extra day, so the teacher can speak individually with each student to guide the framing of the arguments and selection of evidence to support the main points. To challenge students further, it might be possible for them to find additional evidence not included in this module, even perhaps going beyond the borders of England to compare the attitudes and practices toward children's health in other places.

One of the most comprehensive online collections of Egyptian material culture, the Eternal Egypt website provides invaluable information and photos of many thousands of artifacts from all historical eras of the Egyptian past. Fortunately for scholars and educators of childhood, there is an easy-to-use portion of the website devoted to games and toys, bringing to life the leisure pursuits of children who have lived in Egypt through history.

The Games and Toys component of the Eternal Egypt website is an easy-to-navigate collection of 21 artifacts, mostly from the Pharaonic era, used as toys or games by children of the past. Visitors may click on any artifact to be taken to a new page dedicated to explaining the toy or game in question. Expert information is provided, including the era of the toy, the materials from which it was made, where it was discovered, and in which museum or collection it currently resides. Clear images are provided as well, along with descriptions of the toy in question and explanations about how it might have been used. A handy zoom feature allows viewers to explore the item up close, making small details very clear. Moreover, IBM Text-to-Speech technology has been integrated into the site, making it possible to listen to descriptions while you are exploring the zoom imagery. These are the same descriptions given to visitors of the Egyptian Museum of Cairo, giving remote viewers a similar experience to those fortunate enough to encounter these artifacts first-hand.

Each page also provides links for more information about the time during which the toy was made and enjoyed, as well as the technique used for manufacturing it and the materials from which it was created. For example, the "child's spinning toy" from the 18th Dynasty allows modern children to compare and contrast their own spinning tops by interacting with those of ancient Egyptian children. Maps and timelines are also provided, as well as key topics for further exploration of the society and history of the toy’s era. All of these features are fantastic teaching tools and will serve educators well. Students and teachers may also register to create and store their own "collections" of artifacts on the website. This allows visitors to save items most interesting to them and helps them curate their own virtual museum of Egyptian artifacts.

An interesting classroom exercise might include an examination of the popular themes of historical Egyptian toys. For example, students visiting the site will quickly notice that monkeys and other primates were popular themes for historical children's entertainment. They may compare their own society's fascination in primate-themed toys and try to determine the reasons for this similarity. Another productive exercise may be to recreate some of the popular toys of the past—such as Senet and Backgammon—in a classroom setting, giving students a hands-on experience related to the pastimes of their historical counterparts.

Beyond the section on Games and Toys, there are additional resources available through the search function. A search on "child" yields 112 results; "girl" returns 33 items and "boy" returns 23.

This site is a fantastic resource for educators who want to infuse their classrooms with a sense of humanity. Teaching the past—particularly the ancient past of a foreign country—can be a challenge, but by integrating the material culture of entertainment, and especially that of children, teachers can better humanize their subjects for their students. Eternal Egypt is a wonderful resource for those educators and scholars who would like to get "up close and personal" with the material culture of the Egyptians in the comfort of their own classrooms.

Read a review of the entire Eternal Egypt website on World History Matters, http://chnm.gmu.edu/worldhistorysources/d/241.html.

The New York Public Library Digital Collections is a vast database of material primarily, but not exclusively, documents 19th- and 20th-century life in the U.S. The collections are principally visual sources, and include digitized versions of such material as rare prints and photographs, scanned images from books, sound files, and moving images.

Several collections are especially useful to historians of children and childhood, including the Mid-Manhattan Library Picture Collection Online. This collection contains 30,000 digitized images from books, magazines, and newspapers as well as original photographs, prints, and postcards, mostly created before 1923. A keyword search for children in this collection, for instance, connects users to 85 images, while girl links to 48 different images.

Also useful to historians is the NYPL Digital Gallery, which provides access to over 550,000 images digitized from primary sources and printed rarities, including illuminated manuscripts, vintage posters, illustrated books, and printed ephemera. The subject index lists nearly 300 subject headings related to children that demonstrate enormous spatial, temporal, and subject breadth. Entries vary from Children — Africa and Children — Soviet Union to Child labor and Children — Clothing & dress — England — 1860-1869.

One interesting collection includes two groups of 50 cigarette cards. In the late 19th and early 20th centuries, tobacco manufacturers issued these trade cards to stiffen cigarette packaging and advertise brands. This collection includes several subsets depicting children, such as Children with rosy cheeks and Children of all nations. In the latter, we see national stereotypes crystallized. England is a blonde youth in a school-boy uniform, while Mexico is a peasant. Canada is not present at all!

The cigarette card images illustrate one of the fascinating ways in which instructors and students could use material from the New York Public Library Digital site. In his 1962 publication, Centuries of Childhood, Philippe Ariès presented the provocative claim that childhood was an invention of the post-medieval world. Historians studying children and childhood continue to debate this idea and larger notions of how parents and broader social institutions treated children and conceived of childhood across time. Our own era recoils at the association of children and childhood with the tobacco industry, yet tobacco manufactures in the past century promoted an association of their product with children and childhood with no hesitation.

In other cases, we see advertisers depicting children as small adults, rather than emphasizing a particularly distinctive era of childhood. See, for example, this Easter trade card from L. Prang & Co.

Instructors and students could study the use of children in advertising across time and by various industries. In addition to the cigarette cards, a subject search within the Digital Gallery of children and advertising yields a further 333 illustrations. These and other images available in the Digital Gallery can be used to examine the changing associations that Western (and world) societies have created with childhood in different periods, and to what different purposes they have used these associations.1

Instructors might wish to consider the limitations of the sources pertaining to childhood available at this website. Common to most sources treating this topic, is the fact that children are perhaps the most voiceless of all possible historical subjects. (The sources children generated to depict their realities are all but non-existent.) We are always dealing with outsiders' views, looking in at (or more often, literally down upon) them. In all of these sources, what we almost always witness is a viewer's construction of children and childhood. In the images contained in this site, however, the degree to which this construction occurs ranges from the blatant, as in this 1874 Children’s Aid Society advertisement to the more subtle Some typical Cuban faces - Santiago, Cuba 1899.

This latter photograph illustrates another shortcoming of many of these sources: the absence of expansive information about the context in which they were created or which they depict. Often, we know no more than the date on which an image was generated. Therefore, history teachers would likely wish to preview the sources they select for students to use and to present relevant background information about production and purpose of the source whenever possible.