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M A L AT HI M A H A DE VA N
DATA
P ROF E S S ION A L S
AT WORK
KIRSTEN BENZEL, SURVEYMONKEY · TRACY BOGGIANO, BROADVINE
JES BORLAND, MICROSOFT CORPORATION · JASON BRIMHALL, DATABASE MASTERS
TIM COSTELLO, BRINDLE CONSULTING LLC
MINDY CURNUTT, MINDY CURNUTT AND ASSOCIATES CONSULTING
KEVIN FEASEL, CHANNELADVISOR CORP. · ARGENIS FERNANDEZ, PURE STORAGE
KENNETH FISHER, AEGON · JOSEPH FLEMING, STRAIGHTPATH SOLUTIONS
DREW FURGIUELE, IGS · MATT GORDON, DMI
GINGER GRANT, DESERT ISLE GROUP · VICKY HARP, MICROSOFT CORPORATION
KATHI KELLENBERGER, SIMPLE TALK, REDGATE SOFTWARE
ANDY LEONARD, ENTERPRISE DATA AND ANALYTICS
KENDRA LITTLE, RED GATE SOFTWARE · STEPH LOCKE, LOCKE DATA
ANDY MALLON, SENTRYONE · JOHN Q. MARTIN, SENTRYONE
JIMMY MAY · JOHN MOREHOUSE, DENNY CHERRY & ASSOCIATES CONSULTING
MARLON RIBUNAL, JUSTENOUGH SOFTWARE · JOSEPH SACK, MICROSOFT CORPORATION
JULIE SMITH, INNOVATIVE ARCHITECTS INC. · JONATHAN STEWART, SQLLOCKS LLC
DAVE WALDEN
DATA PROFESSIONALS
AT WORK
Malathi Mahadevan
Data Professionals at Work
Malathi Mahadevan
Raleigh, NC, USA
ISBN-13 (pbk): 978-1-4842-3966-7 ISBN-13 (electronic): 978-1-4842-3967-4
https://doi.org/10.1007/978-1-4842-3967-4
Library of Congress Control Number: 2018960288
Copyright © 2018 by Malathi Mahadevan
This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or
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if they are not identified as such, is not to be taken as an expression of opinion as to whether or
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date of publication, neither the authors nor the editors nor the publisher can accept any
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Printed on acid-free paper
To my soul sisters, Shanthi and Chitra
Contents
About the Author �� vii
Foreword �� ix
Acknowledgments�� xiii
Introduction�� xv
Chapter 1: Mindy Curnutt, CEO, Mindy Curnutt and Associates Consulting�� 1

Chapter 2: Julie Smith, Business Intelligence Consultant, Innovative
Architects Inc.��11
Chapter 3: Kenneth Fisher, Senior Database Administrator, Aegon��23
Chapter 4: Andy Leonard, Chief Data Engineer, Enterprise Data
and Analytics ��33
Chapter 5: Jes Borland, Premier Field Engineer, Microsoft Corporation��49
Chapter 6: Kevin Feasel, Engineering Manager, ChannelAdvisor Corp.��63
Chapter 7: Ginger Grant, Principal Consultant, Desert Isle Group ��79
Chapter 8: Vicky Harp, Principal Program Manager Lead,
Microsoft Corporation ��91
Chapter 9: Kendra Little, Product Evangelist, RedGate Software��107
Chapter 10: Jason Brimhall, Principal Consultant, Database Masters��119
Chapter 11: Tim Costello, Data Architect, Brindle Consulting LLC ��129
Chapter 12: Andy Mallon, Product Manager, SentryOne��147
Chapter 13: Steph Locke, Data Science Consultant, Locke Data ��159
Chapter 14: Jonathan Stewart, Business Intelligence Consultant,
SQLLocks LLC��171
Chapter 15: Joseph Sack, Principal Program Manager, Microsoft Corporation��183
Chapter 16: John Q. Martin, Product Manager, SentryOne��197
Chapter 17: John Morehouse, Consultant, Denny Cherry &
Associates Consulting��207
Chapter 18: Kathi Kellenberger, Editor, Simple Talk, Redgate Software ��219
Chapter 19: Argenis Fernandez, Principal Data Storage Architect,
Pure Storage��227
vi Contents
Chapter 20: Kirsten Benzel, Senior Database Engineer, SurveyMonkey��245

Chapter 21: Tracy Boggiano, Database Superhero, Broadvine��255
Chapter 22: Dave Walden, Cloud Architect��263
Chapter 23: Matt Gordon, Data Platform Solution Architect, DMI ��273
Chapter 24: Jimmy May, Storage Architect��287
Chapter 25: Drew Furgiuele, Senior Database Administrator, IGS��303
Chapter 26: Marlon Ribunal, SQL System Support Engineer,
JustEnough Software��317
Chapter 27: Joseph Fleming, Senior Consultant, StraightPath Solutions��331
Index��347
About the Author
Malathi Mahadevan is a senior database
engineer with more than 20 years of experience
working with data, primarily using Microsoft
SQL Server and related technologies. She has
worked in many industries, such as health care,
finance, and consulting, to name a few. Mala has
volunteered with the SQL Server community by
arranging free training and seminars for the past
15 years. She is a recipient of the PASSion award
for outstanding volunteer from the Professional
Association of SQL Server (PASS). She blogs
frequently at http://curiousaboutdata.com
and is active on Twitter as @sqlmal. Mala is also
a featured blogger on SQLServerCentral.com
and has written several articles for the site.
Foreword
We are living in an era in which data professionals are experiencing a
Cambrian-like explosion in their diversity, importance, and value in the work-
place. The Cambrian explosion was an event approximately 541 million years
ago in the Cambrian period when most major animal phyla appeared in the
fossil record. Following that, a multitude of important, world-changing phe-
nomena have happened, such as the establishment of almost all major animal
phyla, diversification. Speciation accelerated at lightning speed, and the earth
soon bristled with life in every nook, niche, and cranny of the planet. The old
world of simple, single-celled organisms and the occasional colony-creature
gave way to environments full of complex, large, and colorful life forms not
very unlike our world today.
In the same way, where there were once a mere handful of professions in an
industry known as “data processing,” we are evolving to a world in which even
the single, distinct job of yesteryear known as “programmer” has splintered
and speciated into dozens of distinct careers. Just as with the example of early
life forms, the behaviors and patterns used by early programmers are now
divided into a wide range of assorted and distinct groups—from front-end
Java programmers, to iOS game developers, to agile managers and scrum mas-
ters, to Azure stateless programmers, to back-end SQL Server developers. All
distinct. All relying on different skills to succeed in their environments. But
that is just one example of many careers in a world that has transitioned from
the old days of data processing; an antiquated world focused on computer-
izing and speeding only the work of scientists and accountants, into the new
world of information technology, in which we are embarking on a mission of
complete digital transformation of all forms of human activity.
So where does that leave the data professional?
This book will answer that question for you on two main levels.
The first way in which this book functions is to offer a distillation of the institu-
tional knowledge of our industry’s best minds. To date, institutional knowledge
is still a weakness in our industry. Frequently, our teams are small. There are
relatively few members on data-centric teams—say a team of database admin-
istrators (DBAs), even within large corporations and organizations. As a result,
there is little time to document and accumulate the shared experiences and best
practices of our profession into a codified resource for future team members.
x Foreword
Teammates come and go, taking their knowledge and experiences with them.
What they knew that made the organization run well and thrive left with them.
And the remaining staff must now contend with huge gaps in their knowledge,
muddle through challenges for which they have no previous experience, and
encounter new and unforeseen circumstances that put them under duress and
enormous stress. It’s not pretty when a key teammate leaves and the remain-
ing teammates don’t know how to do what s/he did for the organization.
On the other hand, institutional knowledge is a kind of shared knowledge that
bolsters and improves the team’s performance and the wider organization
as a whole. It can take many forms, from frameworks, to specific step-by-
step process, to finding the best tools for the job, to tips on how to navigate
specific relationships within the organization that facilitate best results when
implementing a given project. Institutional knowledge, when properly shared
across a team, lessens learning curves, helps you avoid pitfalls, and enables
you to exploit the successes of others so that you can be both more efficient
and more effective. Institutional knowledge can also provide a way forward in
uncertain times; essentially, they can provide a process to follow. When the
leader is out of the picture, you now have an answer to the question “What
do I do now?” offering you not only a set of steps to follow, but an expectation
of what priorities to follow.
The second way in which this book functions is to share the stories—com-
plete with protagonists and antagonists—of the human journey to achieve
mastery in a profession in which there are still many trails to be blazed. These
stories can help the newcomer decide if this is a professional path you would
like to follow. For those already on this path, these stories will help you assess
your own experiences and, where appropriate, will enable you to incorporate
the victories (and mistakes) of the interviewees of this book into your own
corpus. That process of incorporation will, in turn, elevate your own mastery
and the trajectory of your career.
When people decide to pursue a career as an aircraft pilot, they are embark-
ing on a professional career in which there is a checklist for literally every
conceivable problem scenario. There are many professions like that in today’s
world. That’s not the world of a data professional. Data professionals are
much more like the creative classes of writers, artists, composers, and archi-
tects. There are many shades of gray in this profession. What works well for
one DBA might not work for another. Combining one group of people to
deliver a well-defined project may produce an entirely different result com-
pared to a different group of people. These stories help you to see the human
element and the art-like beauty that is inherent in this very creative class.
You will see, in these pages, our writers struggle like characters in a drama
out of literature, not only with their environment or with an adversary, but
also with themselves. Overwork, burnout, imbalances in family life and work
life—all of these are relevant to the profession. You will see, in these pages,
Foreword xi
where our writers have moments of epiphany and then, by incorporating their
revelations, achieved breakthrough performance in their career. You will see,
in these pages, times of community joined and enjoyed, and of community
missed. You will see, in these pages, the influence of many of the luminaries
of our profession who, whether physically or virtually, helped train up these
writers as if they were in an apprentices-master relation of previous eras. The
human journey, then, is the second major offering of this book.
I encourage you to read on and learn from these stories, as you would from
any book about technology. But I also exhort you to read them as human
stories, of people who strove and struggled and, eventually, succeeded. Learn
from them and make their forward progress part of your own.
Kevin Edward Kline

Principal Program Manager, SentryOne
Microsoft Most Valuable Professional (MVP)
since 2003; PASS Founder Board Member,
President (2004-2008), Lifetime Achievement
Award (2010)
Acknowledgments
My thanks should go, in no small measure—to the SQL Server community,
fondly called SQL Family. My thanks to all who are part of it but some are
special because they have been part of my journey and helped me in special
caring ways. Their support and wise counsel has helped me stick with com-
munity work. Those special people happen to be Kevin Kline, Karla Landrum,
Joseph Sack—and the PASS organization in general. Thank you for being there
for me.
A sincere thank you to fellow geeks and beloved friends who are no longer
around—Tom Roush, Robert Davis and Dave Ingram. Your lives and your love
for what you did will continue to inspire us all.
I must thank Kathi Kellenberger, for encouraging and inspiring me on my writ-
ing goals—This book would not have happened without her.
Thank you for the kind and considerate people at Apress who went through
so many iterations of this with patience and diligence—Rita Fernando, Kim
Burton-Weisman, and Jonathan Gennick, it was a privilege working with you.
Last but not the least, the people in my family: my second mother and beloved
aunt, Rajam—your persistence, creativity, and hearty laughter are my greatest
inspiration. And the two people I love the most, my soul sisters, Shanthi and
Chitra.You mean everything to me. Thank you for your love and support.
Introduction
I started my career as a database architect maintaining entity relationship
diagrams for a software company many years ago. I maintained such diagrams
for all of their customers. I made changes as their systems changed, printed as
necessary, and created new ones when new databases came up. I sat through
meetings, discussing database schema, normalization, and so on. Back in those
days, every software development team had an architect like me. A few years
later, things changed. Developers started designing their own schemas. Fancy
graphical user interfaces began to maintain them. Architects were deemed a
luxury and not a necessity. Many people like me turned to programming to
sustain our jobs.
Then, more database administration jobs started to come up, and I took one
of them. There was no roadmap to a career in data back then; everyone just
figured it out as they went along. To some extent, it is like that now too. But
now, there are a lot more people who have walked this path. We have a bet-
ter idea now of how things can change, and which skills we may need to brace
ourselves for change.
We are also aware that there are many possible tracks to follow in the vast
area of working with data. Each track has possibilities of a different kind - for
example, a business intelligence track may lead to a career in data science, and
a database administration track may lead you to become a cloud architect.
None of these are guaranteed paths, of course; life is a complicated journey
and anything may lead anywhere. But, a track is a good guideline to follow,
because there are people who have followed them and have been successful
at what they do.
I’ve had the good fortune of knowing many talented, successful people as a
result of being part of the SQL Server community. A few of these people are
in this book. The people I’ve interviewed are rock stars at what they do. They
are also very giving and generous, as I have known personally from many years
of being in the community. Their stories will help anyone looking to become a
DBA, BI professional, data architect, or database developer/engineer by offer-
ing tips and suggestions on how to be better at what they do. If you are read-
ing this, my guess is that you are a person with a career in data or looking to
become one.
xvi Introduction
There is no set way to read a book like this. You may know some of these
people from their blogs or Twitter tags, and then chose to read their stories.
Consider what kind of “track” you are on, and pick the right chapter to read.
The following are some guidelines for this.
Are you a DBA or looking to be one?
The DBAs interviewed in this book are Andy Mallon (Chapter 12), Drew
Furguiele (Chapter 24), Ken Fisher (Chapter 3), Marlon Ribunal (Chapter 26),
and Tracy Boggiano (Chapter 21). Read their stories to understand how they
got to be great at what they do.
Are you an experienced DBA and looking to move on to consulting?
Jason Brimhall (Chapter 10), Jes Borland (Chapter 5), Joe Fleming (Chapter
27), John Morehouse (Chapter 16), and Mindy Curnutt (Chapter 1) are DBAs
who have graduated to become successful consultants.
Are you a person with considerable experience under your belt and
looking to be an architect, or are you an architect looking to be a
better architect?
Argenis Fernandez (Chapter 19), Jimmy May (Chapter 24), and Dave Walden
(Chapter 22) are among the most respected data architects who have shared
their stories.
Are you already dabbling in business intelligence or looking to learn
more about BIML, data visualization, and so on?
There are no better people than Andy Leonard (Chapter 4), Julie Smith
(Chapter 2), Jonathan Stewart (Chapter 14), Kirsten Benzel (Chapter 20), and
Tim Costello (Chapter 11) to understand this path.
Are you leaning toward data science and analytics as a possible
career choice?
Learn from Kevin Feasel (Chapter 6), Steph Locke (Chapter 13), Ginger Grant
(Chapter 7), and Matt Gordon (Chapter 23) on how they got there!
Are you looking at being a product manager after having gained
some mastery over a product, or perhaps certain features of a
product?
Learn from some of the best product managers—Joseph Sack (Chapter 15),
Vicky Harp (Chapter 8), and John Martin (Chapter 15)!
Lastly, are you looking to do something totally different, like teach
or become a tech editor?
Kendra Little (Chapter 9) and Kathi Kellenberger (Chapter 18) can share their
stories in this regard.
Introduction xvii
This is just a very rough guideline. Keep in mind that all of these people have
had a mix of skills over the course of their journeys, as we all do. It is worth
reading all of their stories to understand what led them to where they are
now. I hope you learn and grow from them as I did. Happy reading!
CHAPTER
Mindy Curnutt
CEO, Mindy Curnutt and Associates Consulting
Mindy Curnutt has been working with data
since the early 1990s and with SQL Server
specifically since 1997. She is CEO of Mindy Curnutt &
Associates Consulting. She is Vice President of
Strategic Partnerships for the nonprofit startup
Girls + Data (www.girlsanddata.org), where
she is responsible for fundraising, social media
promotion, and strategically advancing the company’s
mission to encourage young women to pursue
careers in data analytics. Mindy also owns Kirbson
Direct, LLC, an umbrella over two other companies
Stampola (www.stampola.com) and BBQ Bud
(www.bbqbud.com). Stampola manufactures rubber stamps and silicone molds.
BBQ Bud designs, manufactures, and imports novelty barbeque accessories.
Mindy holds a BA in business economics from the University of California, Santa
Barbara. She is president of the board for the North Texas SQL Server User Group.
She served five years on the PASS Summit Program Committee—three of them as
a manager. Mindy has been awarded the Microsoft Data Platform MVP designation
four times. She has been PASS Volunteer of the Month twice. Mindy is a co-author of
three books: Let Her Finish: Voices from the Data Platform (CreateSpace, 2017), SQL
Server 2017 Administration Inside Out (Microsoft Press, 2018), and Microsoft SQL
Server 2012 Step by Step (Microsoft Press, 2014). She provided insight as a subject
matter expert for the SQL Server 2012 and 2014 certification exams.
© Malathi Mahadevan 2018

M. Mahadevan, Data Professionals at Work,
https://doi.org/10.1007/978-1-4842-3967-4_1
2 Chapter 1 | Mindy Curnutt: CEO, Mindy Curnutt and Associates Consulting
An avid hobbyist, Mindy enjoys crocheting animals and figures (amigurumi), making
soap from oil and lye for Riley Roo Soap Company (www.rrsoap.com), baking
things for her two children, Riley and Kimball, and playing guitar and performing at
the Sons of Hermann Hall in Dallas, Texas, with her husband, Chris. You can find
Mindy online at www.mindycurnutt.com or on Twitter as @sqlgirl.
Mala Mahadevan: Describe your journey into the data profession.
Mindy Curnutt: I started my college experience at UC Santa Barbara as
a nuclear engineering major. That lasted about a semester. I had imposter
syndrome. There were very few females in the classes, and I was also one of
very few Caucasians in the classes. Granted, the material was difficult, but I
was also intimidated by being different from everyone else.
To make things worse, I did not know how to study. See, I had breezed through
high school with very little effort required. When I got to college, it became
very apparent that I didn’t actually know how to study! I ended up getting
some pretty low grades that first semester, and it really freaked me out. This
was in addition to the whole impostor syndrome problem. Other students in
my dorm hall were taking fun classes that I did not get to take because I was in
the engineering school. I was interested in archaeology and old music history
classes, and so on. I decided to drop out of the engineering school and enroll
in the art school so that I could take these more interesting classes and be
more comfortable.
Over the next few years, I ended up changing my major multiple times. Then
it came time to graduate. I was pressured by my grandmother because she
felt I wasn’t going to be graduating with a degree that was marketable. She
kept asking me, “What are you going to do for a living?” At the last minute, I
changed my major once again and ended up getting a degree in economics. It
was actually very interesting—much to my surprise! Statistics was one of the
classes I had to take, and I ended up receiving the highest grade of my entire
college career and out of the entire class in that subject. Before taking that
class, I didn’t even know what statistics were. It was really strange. Right there
was probably the first clue that I was going to end up in the data field.
So, I graduated with a degree in economics, but right about then [1991], the
economy wasn’t very good and I could not get a job for the life of me. I sent
out hundreds of résumés. I did not want to live at home with my parents. I
ended up getting a job in the accounting department of a car dealership. From
there, I ended up moving back to Napa Valley, where I was from. I got a job
working for an economist, helping him create supply-and-demand reports for
the wine grape industry. I did a lot of data entry, charts, and graphs using Lotus
1-2-3 in DOS. I don’t even remember what the database platform was. It was
some DOS-based, DB2 type of thing. I also did a lot of mean, median, and
statistical variation. We were making charts using a dot matrix printer that
had these different colored pens I had to insert into clamps. That was my first
work with databases and computer hardware.
Data Professionals at Work 3
Then I traveled with a music band to Alaska and found my way to Seattle.
That’s a long story, not for here. Seattle is where I ended up getting into SQL
Server. I worked for a furniture manufacturing company, and I developed a
just-in-time manufacturing system for them using Access 2.0. They bought
another system to manage things, which ran on SQL server 6.5. I migrated
the database that I had written to the new SQL Server platform. I was sent
to training on SQL Server, and it just turned into a whole career. It was not
planned, but in hindsight, I ended up doing the database stuff because I was just
naturally drawn to it and good at it. I like organizing things. I like numbers. I like
making sense of data. I like puzzles. A match made in heaven.
Mala: Describe a few things that you wish you knew when you started your
career that you do know now and would recommend to people.
Mindy: I did not reach out to the SQL community and get involved in the SQL
family early enough. I really only did that in the last ten years. The community
has grown a lot in the last decade, but there are a lot of people that you look
to—especially the old-timers. People like Kevin Kline, Kimberly Tripp, Kalen
Delaney, Allen White, and Aaron Bertrand have been around for twenty years
or more. I haven’t. They’ve known each other a long time. I didn’t religiously go
to the conferences. I didn’t make sure that people knew me. That association
with other people who are peers who do the same sort of work that you do
is super important to building your brand.
Mala: Yeah, I was like that too. I am one of the old-timers, but nobody even
knew I existed for a very long time. I just did not know how to do that.
Mindy: Yeah, exactly right. There is a huge career opportunity out there. It is
a good thing for you to get to know other people who work in the same field
that you do. In the SQL community, there are some really good people who
can help you get to where you need to be. I’ve heard that some of the other
communities are not the same way. This is a very special community—the
#SQLFamily. That is something that I wish I could go back to the younger me
and say, “Get involved.”
Mala: Describe a day in your professional life.
Mindy: I now work for myself. I’ve been self-employed successfully now for
six months. Today it’s New Year’s Eve. I am actually comparing side-by-side
traces of the exact same database with the exact same replay on different
versions of SQL. I forget what day of the week it is now. I work when I have
some work to do. And when I don’t have work, I don’t work. On a typical
day, I get up and make breakfast for the kids, see my son off to school. My
husband takes my son to school or my son rides his bike. My daughter is in
high school, so she goes to school an hour later. I sit down in my pajamas—my
hair still completely a disaster—with my coffee. Then I start checking e-mail
and catching up to see what happened. I get started on projects. Around
lunchtime, I’ll get a shower, wash my hair, take the dog for a walk. The kids
come home about 3:30, and then they’ve got to be carted to a lesson of some
sort. Then at night, I usually do some more work—sometimes with a glass of
wine! It is very different from when I was working for a corporation. I don’t
have as many meetings. I’ve actually been able to set time aside and do some
online classes too. In my life, I’ve gotten to the point where I have networked
enough and have created demand, which allows me to be self-employed. It’s
been pretty nice.
Mala: So glad to hear that. I hope to get there someday. What are some
trends in this line of work that you’re watching for?
Mindy: Thirty to thirty-five percent of what I do is performance tuning. SQL
Server 2017, with its self-tuning abilities, is something I look forward to. I like
that it can track parameter sniffing on its own. And that it can automatically
adjust using execution plans tailored to specific parameters and performance
over time. The building of that kind of artificial intelligence into the database
engine is awesome.
If you are using Azure SQL Database, you don’t need to worry about backups.
You don’t need to worry about setting up all the high availability and disaster
recovery. It is all built in, which eliminates some of the need for what I do. I
am working with the real estate industry. I worked with the trucking industry
for the past several years. A lot of those companies still aren’t on SQL Server
2016. There aren’t even in 2012. Even though a new version of the on-prem
SQL engine seems to be coming out every single year, a lot of people are on
older versions and are not moving forward as quickly.
Still, I do need to start focusing on modernizing and upgrading my skill set to
where the world is headed. I’m interested in expanding my skill set in visual
analytics. I have an accounting background and own two other businesses
besides this. I understand what business owners want to see. I understand
budgets. I understand that revenues drive things. I get the connection between
the data that we’re collecting and the data that we aren’t collecting. What we
should be collecting isn’t there right now. And I know what we could be doing
with that information if it were available. Like what kind of dashboards we
can provide to give better visibility to the business owners and the business
drivers. That’s where I want to go with this technical knowledge. I’m not just
somebody who’s got data skills and makes cool Power BI stuff. I can come in
and be a full consultant that not only understands your data platform needs
and what’s going on with your databases, but how can you use that data. Also,
I provide information on what other data you can collect that you are not
collecting, and what you can do with that data as a company. I’m going to be
in my fifties soon, so I think that that’s a good place for me to go because it’s
very advisory.
Mala: Very interesting. Getting to fifty changes your perspective on a lot of

things. It did for me. I used to value job security most. I now am looking more
and more at what I want to enjoy doing. I realized in a very real way that my
time is limited, and if I want to do what I enjoy, it is now.
Describe a few things that a database professional should follow as best
practices.
Mindy: The number-one best practice is knowing how to restore your system.
I can’t even tell you how many people can’t do that one thing. And they aren’t
even aware of the danger that presents or the severity of the situation. It may
sound like beating a dead horse, but people lose their data all the time. I was
at a company the other day and I asked the guy, “Do you know where your
backup is?” He said, “Well, we have somebody who takes care of that.” I asked,
“Who?” And he said, “We have an offsite IT company, and they’ve assured me
that that’s all taken care of.” I asked him, “Are they keeping copies offsite?” He
said, “I don’t really know.” Incredible. You’ve got to know.
Mala: I worked for a private hosting company once. They had horror stories
of people like that. They don’t know that they need to know—until their stuff
is actually completely lost.
Mindy: Yeah. You have to start asking the questions. How long could you live
without this data? Would your company be out of business, or you could you
hold your breath for a week and survive with no access to your systems? How
bad of a hit would it be if it took two weeks?
It’s not just database corruption. It can be fire or theft. Or even somebody
going outside and severing all the fiber optic lines into the building accidentally
with a backhoe. I’ve seen that happen. Yeah. “Well, actually our database is fine
but we have absolutely no Internet.” That can be a problem.
I even have a story of a guy who got really mad, came in and kicked the server
room door in, poured gasoline on servers, and lit them. That is unlikely, but
you could have a cable cut by an outsider, or some sort of a major grid failure,
or something where you don’t have electricity. You have a generator, but it can
only run for a day. To me, that’s the number-one best practice: be recoverable.
The second is to be organized. What I find for myself—and I still struggle
with this—is that sometimes I’m moving so fast that I don’t document exactly
everything that I’m doing. And I find that if I force myself to do stuff with
a script instead of using the GUI [graphical user interface], then I have it
documented. The script self-documents exactly what took place. No question
of did I check that box or did I not check that box in the script. Also, if you if
you’re doing it via script, you can reuse it. That saves you time the next time.
Have an organized library. I have a laptop, four different e-mail accounts, and
some VMs [virtual machines] out on Azure. I’ve also got external drives all
over the place—in this backpack or that purse. If I’m looking for just the right
script, I better know where I put it. Having a system and being organized is
the way to go.
Another best and worst practice–especially as you get higher up in your
career–is to learn to delegate. I have been a lot better at that in the last three
or four years. At a certain point in your career, if you have people that work
for you, you recognize their strengths. If they have strengths in areas that you
know you’re weak or not as strong, then take advantage of their strengths!
Lean on them, right? I mean, if they are really good at scripting stuff, or they’re
really good at error handling, or they’re really good at just being consistent
about stuff—and I’m not, then find ways to use their strengths to better the
whole team. You don’t have to do everything yourself.
Mala: Describe your experiences with cloud adoption.
Mindy: I’m starting—more and more—to consolidate my stuff out into the
cloud. Five years ago, I would have all my stuff on my laptop, and then I had
my laptop backed up to the cloud using Mozy or Carbonite, or something
like that. But now I’m trying to be really good about putting my stuff out in
the cloud. If you are a consultant, you want to have templates for things—
contracts, SOWs [statement of work], scripts, assessments, etc. Things need
to be consistent, locatable, and branded. You need customer folders and
documentation. What rate did you quote? What timeframe did you say? And
being organized is so valuable.
I’ll admit that one of my worst habits is shooting from the hip. So, it’s a battle,
and I have to be very pragmatic. Sometimes I thank myself, and sometimes
I really disappoint myself when I can’t find things—when I should have just
slowed down and been more methodical. I’ve started using the cloud as a
universal place to organize all my things, so I can find them no matter where I
am or what device I’m using. The cloud has enabled me to be more organized
and more consistent with my internal system of “things” I use in my work.
I think you were really asking about cloud adoption in the sense of SQL
on-prem versus Azure data platform offerings, but the cloud storage for all
the documents, files, and systems that I’ve amassed over the years and that I
use in my career were the first things that came to mind when you asked that
question.
I have seen a lot of enthusiasm for people wanting to “go to the cloud.” When
I’m talking about the cloud, I’m talking specifically about the data platform
being in the cloud. I think people are still confused. I think they want to do it
[move to the cloud] because they think they should do it, but they can’t tell you
why. I don’t think everyone wants to do it for the right reasons. Historically,
an application’s database platform might be Oracle, or SQL Server, or DB2,
or whatever—and be on-prem. With these newer IoT data streams and data
connecting through many APIs, having one database platform as the “be all and
end all” is no longer realistic.
You may have two, three, four, or five different types of data platforms supporting
your architecture. You may have some stuff that is relational and normalized.
You may have some stuff that is just static logs, and other stuff that is has graph-
like relationships. You may have some stuff that you’re saving “just in case”
but currently serves no purpose. It is a combination of data sources, types,
variability, longevity, stasis, and velocity. That’s a new world for many of us.
Many people want to move to the cloud because they think that’s the future.
They are right about that, but they’re prematurely trying to push everything
up there just so that they can say that their company is “in the cloud.” I’m
seeing a lot of that. I hope there is not going to being a backlash. In many cases,
the platform is decided upon before they even know what the problem is.
Mala: What are your thoughts on agile and database administration?
Mindy: Have tools. You have to have the database in some sort of source code
control with a toolset, or you’ll make yourself crazy with agile. My experience
working for a software vendor is that you have to know what version of the
database goes with the build. And if you can’t do that, then I don’t know how
you’re going to manage working with agile.
Mala: What are some of your favorite tools and techniques?
Mindy: SentryOne Plan Explorer is my favorite tool, hands down. I could be
an evangelist for that tool all day long.
One of the techniques that I actually teach—but I’ve never seen anyone else
demonstrate—is to do a wide-open extended event capture or trace, and
then write a script that detects time between the completion of an event and
the start of the next event. The missing time shows the time that the user or
process is experiencing that is not time spent on SQL Server. You won’t find
that figure calculated anywhere in wait stats or in any of the many monitoring
performance tools out there. I call it “reading between the lines.”
Mala: What are your favorite books, blogs, and other means of learning?
Mindy: I read a lot of books at the same time. When I’m going to go to bed,
I’ll just read a half of a chapter or a chapter of a book. I don’t read fiction. The
4-Hour Workweek by Tim Ferris [Harmony, 2009] is an awesome book. You
can read this in tiny chunks. The chapters are all independent. It talks about
how to delegate things, and that you don’t have to do everything yourself
to be successful. It suggests batching your tasks, like read your e-mail twice
a day. Don’t read your e-mail all day long, every second as it comes in. That
is super inefficient and makes you crazy! All that context switching wastes
an enormous amount of time. The suggestions in that book are meant to help
you take your forty-hour workweek down to half that or even less, but still
get the same amount done.
Switch by Chip Heath and Dan Heath [Crown Business, 2010] is another self-
help book. It is about how to change things when changing things is hard.
A good book on public speaking is Steal the Show by Michael Port [Mariner
Books, 2016]. It talks about how to do good speeches and job interviews.
I have also been meaning to read “PowerShell in a month of lunches”. It’s been
on my desk for six months now. I’ve had a lot of people telling me it’s great.
Admittedly, I’m not a big blogger, and I don’t follow too many blogs.
Mala: What do you recommend by way of stress management–handling long
hours on the job and staying motivated?
Mindy: Exercise is a big thing for me. I try to take my dog for a walk every
day. I use a Fitbit to track my steps. There is a really large SQL community of
people that use the Fitbit. You can do a week challenge with them. It keeps
pinging you and showing you that now you’re in seventh place or something,
and you have to get up and start moving or you’re going to be the loser!
We can get fiercely competitive with each other on who won the week or
weekend challenge.
I need quiet time where I’m not plugged into any electronic devices too.
When I’m walking, I don’t even listen to music. I just walk. I need that sort
of downtime where I’m just listening to myself breathe, and hanging with my
dog. And sort of focusing on what’s happening inside, because there’s so much
digitally every day that just keeps us just spinning.
Mala: What are typical questions that you ask in an interview? What do you
expect of a new DBA?
Mindy: If somebody is claiming that they’re a DBA, and they have all this
experience, the résumé looks great and all that. The first question that I would
ask is, “In the latest version of Azure DB, what’s the maximum number of
clustered indexes that you can have per table?”
Mala: Ha!
Mindy: Yes! So if they don’t immediately do what you just did, then they’re
not really a DBA. We can just stop the interview right now.
If we get past that, I basically like to give somebody two or three problems.
They have an hour. And I’m not going to be looking over their shoulder. Here’s
a computer and here’s Google. I want to see what solution you come up with.
And maybe there’s no absolute right answer. Here is a query. Can you make
it run faster? How do they go about doing that? Did they figure out that it
only runs slowly when you give it certain parameters first and then the other
parameters second? I basically want to see that somebody can think on their
feet and have tenacity, common sense, decent skills, and can problem solve.
If you are managing a team, it is also really important to make sure that you’re
adding somebody who is going to have a synergy with the team. If you are a
DBA and you are called in on a night call with two people, you have to trust
and like them. Right? That they’re not a jerk when they are tired or whatever.
Personality is a part of it.
Mala: Oh, absolutely. Yeah.
I think that you already answered the last question I had planned. Is there
anything more you’d like to say on community, and why you recommend being
involved with the community?
Mindy: Go out and get speaking experience. If you live in a large metropolitan
area, there are a dot-net user groups. There are all sorts of developer user
groups that would probably love to have you come and talk about indexes and
how they work. I spoke with three different user groups in Dallas this year
that I didn’t even know existed beforehand.
Mala: Can you share a funny story from your life?
Mindy: I was fifteen years old, so it was like 1984 I guess. I lived in Calistoga,
which is the most northern town in Napa Valley. Robin Williams had a home
somewhere mid-valley. My friend Laurie and I were headed home from an
event in town. She had a Ford Galaxy convertible that her grandma had given
her. We had the top down—California weather, always nice. As we drove by a
motel on the outskirts of town, we heard a lot of ruckus and laughter echoing
into the night. It was odd since that motel was normally really quiet and dark.
Laurie pulled over, and we parked and walked around the back of the motel
to see what all the noise was about. There was Robin Williams standing on
a picnic table giving an impromptu concert to about twenty people. We sat
down on the lawn and enjoyed about fifteen minutes of him just ripping joke
after joke after joke, like lightning.
Afterward, Laurie and I went up to meet him and get his signature. I didn’t
have any paper on me except for my provisional driver’s license. I wasn’t
sixteen yet. I held that up for him to sign on. He saw my name was Melinda
and asked me point blank, “Do you go as Mindy?” I said yes. Next thing you
know, he’s gone crazy and grabs me in a headlock and starts walking around
announcing, “Hey? It’s Mork and Mindy! Nanu, nanu!” And doing all this Mork
& Mindy stuff, acting all “Morkish.” Everyone was laughing. During that time,
anytime someone heard that my name was Mindy, I’d get some kind of Mork
& Mindy comment. So this was really over the top since it was Robin Williams
himself doing it to me.
Mala: Wow, what a fascinating story! Thanks, Mindy.
Key Takeaways
• Be involved in the community. Go out and get speaking
experience. Find user groups in your area to go to, and
volunteer to share what you know.
• Be recoverable with your data—anything can happen.
• Define the problem before deciding on the platform.
Don’t find out the hard way that you picked the wrong
platform.
• Be organized. Script what you do so that you know what
you did, and save it for future use and reference.
• Have tenacity. Be trustworthy.
Favorite tools: SentryOne’s Plan Explorer, SQL Server Extended Events
Recommended books: Switch by Chip Heath and Dan Heath, Learn Windows
PowerShell in a Month of Lunches by Donald Jones and Jeffrey Hicks, Steal the
Show by Michael Port, The 4-Hour Workweek by Tim Ferris
Recommended training/conferences: SQLSaturday, PASS Summit
CHAPTER
Julie Smith
Business Intelligence Consultant, Innovative
Architects Inc.
Julie Smith has been moving and bending data
for 15 years using varied tools such as Microsoft
Access, MySQL, SQL Server, Azure Data Factory,
Azure SQL Database, and Power BI. She has built
and designed increasingly complex BI (business
intelligence) solutions for organizations across mul-
tiple industries in her role as a business intelligence
consultant at Innovative Architects in Atlanta,
Georgia.
Julie earned a BA in theater and speech from
the University of South Carolina. She worked as a
costume technician and an actor for several theaters in Atlanta before discovering a
love and talent for data. Julie has been a Microsoft Data Platform MVP since 2013.
She is a frequent speaker at user groups and technical conferences such as PASS
Summit. She blogs at datachix.com and microblogs as @juliechix on Twitter. She
contributed several chapters of Microsoft SQL Server 2012 Bible (Wiley, 2012).
Julie lives in Atlanta with her two sons, Edmund and Gareth Wright. She is also
building a tiny house in North Carolina with the love of her life, Jim Christopher.
© Malathi Mahadevan 2018

M. Mahadevan, Data Professionals at Work,
https://doi.org/10.1007/978-1-4842-3967-4_2
12 Chapter 2 | Julie Smith: Business Intelligence Consultant,
Innovative Architects Inc.
Mala Mahadevan: Describe your journey into the data profession.

Julie Smith: I graduated from college with a degree in theater, and I did
theater for five years, mostly costuming. Then I realized that I wasn’t making
enough money to support the children I wanted to have. I’m from Erie,
Pennsylvania, originally, and I had watched my dad go from being a welder in
a shop who took his love of personal computers—he had a TRS-80—over
about three or four years to turn himself into a programmer. So, I had that in
my family background, and I knew it could be done.
As I was doing theater and making costumes, I got a job as an administrative
assistant. I was the only person at my job who liked using Crystal Reports.
They used Crystal Reports for something, and I got into the guts of Crystal
Reports and said, “Hmm, this is something that I could do.” So, after doing
that for a little while, I declared, “I want to make a change. I want to do data.”
I really didn’t even know what all it meant, but I just said, “I want to do data.”
This was back when you still looked for jobs in a paper newspaper. I saw an
ad for instructor at New Horizons Computer Learning Centers. I thought to
myself,“I can teach and this would be a great way to learn what I need to know
to make this transition.” They liked the fact that I had a theater background
because they thought it would make me a good teacher. I got the job. They
started everyone out on Excel and Word—the productivity stuff. I was a little
bossy-pants, and I said, “No, I’m only going to do Access. At the time, it was
a desktop database.” Since the Access class was regarded as difficult, there
were fewer of the desktop instructors who would teach it, so I got my way.
I couldn’t teach SQL Server at New Horizons. So, I said, “Well, Access is the
closest thing to data,” so I insisted on teaching the Access classes. I taught
them for a little while, and then I used what I had learned to get a job as a
reports analyst at a law firm.
Over the next several years, I paid for my own training. I went to New
Horizons as a student and took the SQL Server training, so I did this hybrid
thing. After four years at the law firm doing Access, a man named Mark Fugel
took a chance on me, and I got my first SQL Server development job. That
was in 2006, and from there, I went from junior to mid-level and took on the
ETL job at that place. That’s how it all started. I am so grateful to him for giving
me that chance.
Mala: Wow. Does your theater background still help you in teaching?
Julie: I don’t think that the theater background helps me in presenting. I
think that the reason that I love doing theater is the same reason that I love
presenting. So, it’s just kind of like, “Well, take Julie and put her in a theater
background, and she’s going to enjoy acting. If you put her in a data background,
she’s going to enjoy giving presentations and trying to make people laugh.” I do
get a kick out of making people giggle.
Mala: Describe a few things you wish you knew when you started your
career that you know now and that you would recommend to people who
are newbies.
Julie: Because I came in from a different background, I was really insecure
about my knowledge. I see that with people because I’ve mentored a few
people who are trying to make a transition from admin or reports analyst into
more technical roles. I think that we all let the fact that we don’t have technical
knowledge haunt us. I would urge you to rest easy on the fact that the most
important thing is marrying the technical knowledge with understanding
business needs and understanding what’s going on and really solving the
problem. I think that that has served me well, even though I didn’t consciously
know that that was what I was doing. I’ve always been a person who can go in
and say, “Well, what’s going on here?”
I had a boss once who said, “In order to be able to automate something, you
have to be able to do it manually first.” I’ve been in situations where people
are like, “We’re going to automate X process,” and it’s like, “Well hold on, what
are you doing?” There’s not even an understanding of what you’re actually
trying to do and little understanding of how to do it manually. You have to do
it manually and then figure out how to automate it.
I think people who are senior understand that and will maybe even
unconsciously navigate that without knowing that’s what they’re doing. But
people will say, “Oh, should I just go get this certification?” I’m like, “Well, you
can get that certification. it certainly won’t hurt you. It’s great to have that
knowledge. But don’t lean on it or don’t think that you’re not ready to be
effective at work just because you don’t have it.”
Mala: That is true. So, do you recommend that people become certified?
What is your take on certification, generally?
Julie: I haven’t had a certification in a while, and that’s probably not a good
thing. I think, right now, the technology is changing so fast, at least in the
Microsoft stack, that I don’t know how the certifications can keep up. Again,
it won’t hurt you, but there’s a chance that you’re being tested on stuff that’s
going to be out of date by the time you take the test.
Mala: What’s a typical day in your life as a professional?
Julie: I have different types of days. Some days I am head down in development
for my own projects. Some days I have client meetings for presentations or
just check-ins. I do a lot of hands-on development still. I also run a team for my
client, and I am a team lead at Innovative Architects. I get pinged a lot by other
projects at IA for architectural consults. I balance my day with answering,
guiding, and leading the decisions on the technology for my client and also for
other projects at Innovative Architects. I do something I would call “informal
agile,” which is basically just gathering requirements for a small project and
14 Chapter 2 | Julie Smith: Business Intelligence Consultant,
Innovative Architects Inc.
working on it, and then getting it in front of the client for feedback as soon as
possible. I have feedback sessions with the client. “Does this work? Is this what
you need? Yes, no?” Then we go from there and just plan the projects and do
that in an informal agile way.
Mala: What are some interesting trends that you are following in technology?
Julie: We are moving to cloud technology, and that is snowballing. Most of
my career has been doing SQL Server Integration Services. The thing that’s
exciting to me is the emergence of artificial intelligence and what it’s doing
to that field. There are products that are using big data technology and
Spark. They’re able to take what used to be totally manual processes and
requirements gathering, and do data cleansing. So, there are products out
there—the Trifacta and Paxata, and now Azure Databricks—that are based
on these two technologies. They really help because they do data cleansing
automatically, just based on algorithms that are internal. It doesn’t necessarily
take a person to say every iteration, every version of a word.
You’re in Kentucky, right?
Mala: Yeah.
Julie: Yeah, so Kentucky with a space after it, Kentucky with a period, KY, all of
those variations. Or maybe even seeing that the problem isn’t that it’s just the
word Kentucky—it’s a bunch of words. It would take all that and just cleanse
it automatically with almost no human intervention.
Mala: That’s awesome. Are you using any of those things now?
Julie: I’m not using them in my work currently. I have evaluated them, and I
always go back to them because it’s just so exciting. But I joke frequently that
I was happy to have my role change. I said I was happy to be out of an ETL
job because the yucky parts of the job became automated. You know, because
extract-transform-load data transformation is a lot of drudgery in many ways,
no matter what. It’s kind of the riskiest part of the business intelligence stack.
Things often fail in the extract-transform-load process of a data warehouse
project. So, I’m happy to have help. I’m happy to move on to cubes and other
parts of the stack.
Mala: So that’s interesting. I was just hearing on a podcast yesterday that
SSAS [SQL Server Analysis Services] has more of a future now compared to
SSIS [SQL Server Integration Services].
Julie: Interesting.
Mala: Yeah. I don’t know the complete details, but I thought what you said
seemed to fit in that. Because quite a lot of SSIS packages I’ve seen deal with
data cleansing. If that can be automated via off-the-shelf packages, then people
would probably prefer that compared to doing it by setting up packages.
Julie: Yeah, a data lake is another methodology that is going to change data
integration. So maybe we’ll be using SSIS just to move files to a data lake and
do less of the hardcore transforming inside SSIS. So, you might still use it. We
might just not use it to do the transformation work.
Mala: Interesting.
Julie: We’re always going to need batch tools to move data around.
Mala: Right, right. Describe a few things that a BI professional should know
as best practices.
Julie: There are a few things I want people to know as a BI professional. I want
you to understand the Kimball methodology. I want you to be familiar with
data lake methodologies. And, at this point, I do think that people need to be
very familiar with analytics technologies. When I say “analytics,” there are two
ways to interpret it. You’ve got predictive analytics, which is machine learning
and artificial intelligence. But “analytics” also refers to visualizing data. Like the
visualizations in Power BI or Tableau.
Mala: One of the much sought-after skills now is data visualization. What
has been your approach to this and how do you recommend learning more
about it?
Julie: Great question. A project I’m working on now was my first foray into
using visualization. There are tons of resources available online—courses, blogs.
There are books. Coming to the project with a history of data integration, I
found the amount of information about visualization overwhelming. I focused
on the basics.
I watched Dan Appleman’s Data Visualization for Developers course on
Pluralsight. I found a few “pillars” that I could cling to there. I mainly used four
main types of visualizations based on the recommendations in the course: bar
or column, line, scatter, and tables. Lines are great for one value that changes
over time. Scatter is used when the data over time has outlier tendencies
that are important to see. Tables are helpful to communicate actual numeric
figures. And bars or columns are great for almost everything else. If you start
there, you can get fancy later, but these are great basics. Then just practice,
practice, practice.
Mala: Simple stuff, yeah. What are some recommended best practices in the
BI world that you like and recommend?
Julie: So, I feel like our best practices are changing. There are people out
there showing us how to use the technology. For Power BI, Guy in a Cube
is amazing because they give you short videos on how to do this. By the
way, that’s how I learned SSIS— from Brian Knight’s videos. They’re not even
available anymore. I don’t know what they’re called, but Brian Knight used to
have these ten-minute videos. This is back in like 2007. I watched those, and I
Another random document with
no related content on Scribd:
He should after he is weaned. He will rest more comfortably, and
his sleep will be more refreshing.
192. Supposing a child should not sleep well, what ought to be
done? Would you give him a dose of composing medicine?
Certainly not. Try the effects of exercise. Exercise in the open air is
the best composing medicine in the world. Let the little fellow be well
tired out, and there will be little fear of his not sleeping.
193. Have you any further observations to make on the subject of
sleep?
Send a child joyful to bed. Do not, if you can possibly help it, let
him go to bed crying. Let the last impressions he has at night be of
his happy home, and of his loving father and mother, and let his last
thoughts be those of joy and gladness. He will sleep all the sounder if
he be sent to bed in such a frame of mind, and he will be more
refreshed and nourished in the morning by his sleep.
194. What is the usual cause of a child walking in his sleep, and
what measures, during such times, ought to be adopted to prevent
his injuring himself?
A disordered stomach in a child of nervous temperament is usually
the cause. The means to be adopted to prevent his throwing himself
out of the window are to have bars to his chamber casement, and if
that be not practicable, to have either nails or screws driven into the
window-sash to allow the window to open only for a sufficient space
for ventilation, and to have a screw window-fastening, in order that
he cannot, without difficulty, open the window; to have a trusty
person to sleep in his room, who should have directions given not to
rouse him from his sleep, but to gently lead him back to his bed,
which may frequently be done without awaking him; and to consult a
medical man, who will adopt means to put his stomach into order, to
brace his nerves, and to strengthen his general system. A trip to the
coast and sea bathing, in such a case, is often of great service.
SECOND DENTITION.
195. When does a child begin to cut his SECOND set of teeth?
Generally at seven years old. He begins to cut them at about that
time; but it should be borne in mind (so wonderful are the works of
God) that the second crop of teeth in embryo is actually bred and
formed from the very commencement of his life, under the first tier
of teeth, but which remain in abeyance for years, and do not come
into play until the first teeth, having done their duty, loosen and fall
out, and thus make room for the more numerous, larger, stronger,
and more permanent teeth, which latter have to last for the
remainder of his existence. The first set is sometimes cut with a great
deal of difficulty, and produces various disease; the second, or
permanent teeth, come easily, and are unaccompanied with any
disorder. The following is the process: one after another of the first
set gradually loosen, and either drop out, or with little pain are
readily pulled out; under these, the second—the permanent teeth—
make their appearance, and fill up the vacant spaces. The fang of the
tooth that has dropped out is nearly all absorbed or eaten away,
leaving little more than the crown. The first set consists of twenty;
the second (including the wise teeth, which are not generally cut
until after the age of twenty-seven) consists of thirty-two.
I would recommend you to pay particular attention to the teeth of
your children; for, besides their being ornamental, their regularity
and soundness are of great importance to the present as well as to
the future health of your offspring. If there be any irregularity in the
appearance of the second set, lose no time in consulting an
experienced and respectable dentist.
DISEASE, Etc.
196. Do you think it important that I should be made acquainted

with the symptoms of the SERIOUS diseases of children?
Certainly. I am not advocating the doctrine of a mother treating
serious diseases; far from it; it is not her province, except in certain
cases of extreme urgency where a medical man cannot be procured,
and where delay might be death; but I do insist upon the necessity of
her knowing the symptoms of disease. My belief is, that if parents
were better informed on such subjects, many children’s lives might
be saved, much suffering might be averted, and much sorrow might
be spared. The fact is, the knowledge of the symptoms of disease is,
to a mother, almost a sealed book. If she were better acquainted with
these matters, how much more useful would she be in a sick-room,
and how much more readily would she enter into the plans and views
of the medical man! By her knowledge of the symptoms, and by
having his advice in time, she would nip disease in the bud, and the
fight might end in favor of life, for “sickness is just a fight between
life and death.”[218]
It is really lamentable to contemplate the amount of ignorance that
still exists among mothers in all that appertains to the diseases of
children; although, fortunately, they are beginning to see and to feel
the importance of gaining instruction on such subjects; but the light
is only dawning. A writer of the present day makes the following
remarks, which somewhat bear on the subject in question. He
observes: “In spite of the knowledge and clear views possessed by the
profession on all that concerns the management of children, no fact
is more palpable than that the most grievous ignorance and
incompetency prevail respecting it among the public. We want some
means of making popular the knowledge which is now almost
restricted to medical men, or at most, to the well-educated
classes.”[219]
In the earlier editions of this work, I did not give the treatment of
any serious diseases, however urgent. In the three last editions I have
been induced, for reasons I will presently state, to give the treatment
of some of the more urgent serious diseases, when a medical man
cannot instantly be procured, and where delay might be death.
Sir Charles Locock, who has taken a kind interest in this little
work, has given me valid reasons why a mother should be so
enlightened. The following extracts are from a letter which I received
from Sir Charles on the subject, and which he has courteously
allowed me to publish. He says: “As an old physician of some
experience in complaints of infants and children, I may perhaps be
allowed to suggest that in a future edition you should add a few
words on the actual treatment of some of the more urgent infantile
diseases. It is very right to caution parents against superseding the
doctor, and attempting to manage serious illness themselves; but
your advice, with very small exceptions, always being ‘to lose no time
in sending for a medical man,’ much valuable and often irremediable
time may be lost when a medical man is not to be had. Take, for
instance, a case of croup: there are no directions given at all, except
to send for a medical man, and always to keep medicines in the
house which he may have directed. But how can this apply to a first
attack? You state that a first attack is generally the worst. But why is
it so? Simply because it often occurs when the parents do not
recognize it, and it is allowed to get to a worse point than in
subsequent attacks, when they are thoroughly alive to it. As the very
best remedy, and often the only essential one, if given early, is a full
emetic, surely it is better that you should give some directions as to
this in a future edition, and I can speak from my own experience
when I say that an emetic, given in time, and repeated to free
vomiting, will cut short any case of croup. In nine cases out of ten
the attack takes place in the evening or early night, and when
vomiting is effected the dinner of that day is brought up nearly
undigested, and the severity of the symptoms at once cut short.
Whenever any remedy is valuable, the more by its being
administered in time, it is surely wiser to give directions as to its use,
although, as a general rule, it is much better to advise the sending for
medical advice.”
The above reasons, coming from such a learned and experienced
physician as Sir Charles Locock, are conclusive, and have decided me
to comply with his advice, to enlighten a mother on the treatment of
some of the more urgent diseases of infants and of children.
In a subsequent letter addressed to myself, Sir Charles has given
me the names of those urgent diseases which he considers may be
treated by a mother, “where a medical man cannot be procured
quickly, or not at all;” they are—Croup; Inflammation of the Lungs;
Diphtheria; Dysentery; Diarrhœa; Hooping-cough, in its various
stages; and Shivering Fit. Sir Charles sums up his letter to me by
saying: “Such a book ought to be made as complete as possible, and
the objections to medical treatment being so explained as to induce
mothers to try to avoid medical men is not so serious as that of
leaving them without any guide in those instances where every delay
is dangerous, and yet where medical assistance is not to be obtained
or not to be had quickly.”
In addition to the above, I shall give you the treatment of
Bronchitis, Measles, and Scarlet Fever. Bronchitis is one of the most
common diseases incidental to childhood, and, with judicious
treatment, is, in the absence of the medical man, readily managed by
a sensible mother. Measles is very submissive to treatment. Scarlet
Fever, if it be not malignant, and if certain rules be strictly followed,
is also equally amenable to treatment.
I have been fortunate in treating Scarlet Fever, and therefore think
it desirable to enter fully into the treatment of a disease, which is
looked upon by many parents, and according to the usual mode of
treatment, with just cause, with great consternation and dread. By
giving my plan of treatment fully and simply, and without the
slightest reservation, I am fully persuaded, through God’s blessing,
that I may be the humble means of saving the lives of numbers of
children.
The diseases that might be treated by a mother, in the absence of a
medical, man, will form the subject of future Conversations.
197. At what age does Water on the Brain usually occur, and how
is a mother to know that her child is about to labor under that
disease?
Water on the brain is, as a rule, a disease of childhood; after a child
is seven years old it is comparatively rare. It more frequently attacks
delicate children—children who have been dry-nursed (especially if
they have been improperly fed), or who have been suckled too long,
or who have had consumptive mothers, or who have suffered
severely from teething, or who are naturally of a feeble constitution.
Water on the brain sometimes follows an attack of inflammation of
the lungs, more especially if depressing measures (such as excessive
leeching and the administration of emetic tartar) have been adopted.
It occasionally follows in the train of contagious eruptive diseases,
such as either small-pox or scarlatina. We may divide the symptoms
of water on the brain into two stages. The first—the premonitory
stage—which lasts four or five days, in which medical aid might be of
great avail; the second—the stage of drowsiness and of coma—which
usually ends in death.
I shall dwell on the first—the premonitory stage—in order that a
mother may see the importance without loss of time of calling in a
medical man:
If her child be feverish and irritable, if his stomach be disordered,
if he have urgent vomitings, if he have a foul breath, if his appetite be
capricious and bad, if his nights be disturbed (screaming out in his
sleep), if his bowels be disordered, more especially if they be
constipated, if he be more than usually excited, if his eye gleam with
unusual brilliancy, if his tongue ran faster than it is wont, if his cheek
be flushed and his head be hot, and if he be constantly putting his
hand to his head, there is cause for suspicion. If to these symptoms
be added, a more than usual carelessness in tumbling about, in
hitching his foot in the carpet, or in dragging one foot after the other;
if, too, he has complained of darting, shooting, lancinating pains in
his head, it may then be known that the first stage of inflammation
(the forerunner of water on the brain) either has taken or is about
taking place. Remember, no time ought to be lost in obtaining
medical aid; for the commencement of the disease is the golden
opportunity, when life might probably be saved.
198. At what age, and in what neighborhood, is a child most
liable to Croup, and when is a mother to know that it is about to
take place?
It is unusual for a child until he be twelve months old to have
croup; but, from that time until the age of two years, he is more liable
to it than at any other period. The liability after two years gradually,
until he be ten years old, lessens, after which time it is rare.
A child is more liable to croup in a low and damp, than in a high
and dry neighborhood; indeed, in some situations, croup is almost an
unknown disease; while in others it is only too well understood.
Croup is more likely to prevail when the wind is either easterly or
northeasterly.
There is no disease that requires more prompt treatment than
croup, and none that creeps on more insidiously. The child at first
seems to be laboring under a slight cold, and is troubled with a little
dry cough; he is hot and fretful, and hoarse when he cries.
Hoarseness is one of the earliest symptoms of croup; and it should be
borne in mind that a young child, unless he be going to have croup, is
seldom hoarse; if, therefore, your child be hoarse, he should be
carefully watched, in order that, as soon as croup be detected, not a
moment be lost in applying the proper remedies.
His voice at length becomes gruff, he breathes as though it were
through muslin, and the cough becomes crowing. These three
symptoms prove that the disease is now fully formed. These latter
symptoms sometimes come on without any previous warning, the
little fellow going to bed apparently quite well, until the mother is
awakened, perplexed, and frightened, in the middle of the night, by
finding him laboring under the characteristic cough and the other
symptoms of croup. If she delay either to send for assistance, or if
proper medicines be not instantly given, in a few hours it will
probably be of no avail, and in a day or two the little sufferer will be a
corpse!
When once a child has had croup the after-attacks are generally
milder. If he has once had an attack of croup, I should advise you
always to have in the house medicine—a 4 oz. bottle of ipecacuanha
wine, to fly to at a moment’s notice;[220] but never omit, where
practicable, in a case of croup, whether the attack be severe or mild,
to send immediately for medical aid. There is no disease in which
time is more precious than in croup, and where the delay of an hour
may decide either for life or for death.
199. But suppose a medical man is not IMMEDIATELY to be
procured, what then am I to do? more especially, as you say, that
delay might be death.
What to do.—I never in my life lost a child with croup where I was
called in at the commencement of the disease, and where my plans
were carried out to the very letter. Let me begin by saying, Look well
to the goodness and purity of the medicine, for the life of your child
may depend upon the medicine being genuine. What medicine?
Ipecacuanha wine! At the earliest dawn of the disease give a
teaspoonful of ipecacuanha wine every five minutes, until free
vomiting be excited. In croup, before he is safe, free vomiting must
be established, and that without loss of time. If, after the expiration
of an hour, the ipecacuanha wine (having given during that hour a
teaspoonful of it every five minutes) is not sufficiently powerful for
the purpose—although it generally is so (if the ipecacuanha wine be
good)—then let the following mixture be substituted:
Take of—Powdered Ipecacuanha, one scruple;
Wine of Ipecacuanha, one ounce and a half:
Make a Mixture. A teaspoonful to be given every five minutes, until free

vomiting be excited, first well shaking the bottle.
After the vomiting, place the child for a quarter of an hour in a
warm bath.[221] When out of the bath give him small doses of
ipecacuanha wine every two or three hours. The following is a
palatable form for the mixture:
Take of—Wine of Ipecacuanha, three drachms;
Simple Syrup, three drachms;
Water, six drachms:
Make a Mixture. A teaspoonful to be taken every two or three hours.

But remember, the emetic which is given at first is pure
ipecacuanha wine, without a drop of either water or of syrup.
A large sponge dipped out of very hot water, and applied to the
throat, and frequently renewed, oftentimes affords great relief in
croup, and ought during the time the emetic is being administered in
all cases to be adopted.
If it be a severe case of croup, and does not in the course of two
hours yield to the free exhibition of the ipecacuanha emetic, apply a
narrow strip of Smith’s tela vesicatoria to the throat, prepared in the
same way as for a case of inflammation of the lungs (see the
Conversation on the treatment of inflammation of the lungs). With
this only difference, let it be a narrower strip, only one-half the width
there recommended, and apply it to the throat instead of to the chest.
If a child has a very short, fat neck, there may not be room for the
tela, then you ought to apply it to the upper part of the chest—just
under the collar bones.
Let it be understood that the tela vesicatoria is not a severe
remedy, that the tela produces very little pain—not nearly so much as
the application of leeches; although, in its action, it is much more
beneficial, and is not nearly so weakening to the system.
Keep the child from all stimulants; let him live on a low diet, such
as milk and water, toast and water, arrow-root, etc.; and let the room
be, if practicable, at a temperate heat—60° Fahrenheit, and be well
ventilated.
So you see that the treatment of croup is very simple, and that the
plan might be carried out by an intelligent mother. Notwithstanding
which, it is your duty, where practicable, to send at the very onset of
the disease for a medical man.
Let me again reiterate that if your child is to be saved the
ipecacuanha wine must be genuine and good. This can only be
effected by having the medicine from a highly respectable chemist.
Again, if ever your child has had croup, let me again urge you always
to have in the house a 4 oz. bottle of ipecacuanha wine, that you may
resort to at a moment’s notice in case there be the slightest return of
the disease.
Ipecacuanha wine, unfortunately, is not a medicine that keeps
well; therefore, every three or four months a fresh bottle ought to be
procured either from a medical man or from a chemist. As long as
the ipecacuanha wine remains clear, it is good; but as soon as it
becomes turbid it is bad, and ought to be replaced by a fresh supply.
An intelligent correspondent of mine makes the following valuable
remarks on the preservation of ipecacuanha wine: “Now, I know that
there are some medicines and chemical preparations which, though
they spoil rapidly when at all exposed to the air, yet will keep
perfectly good for an indefinite time if hermetically sealed up in a
perfectly full bottle. If so, would it not be a valuable suggestion if the
Apothecaries’ Hall, or some other London firm of undoubted
reliability, would put up 1 oz. phials of ipecacuanha wine of
guaranteed purity, sealed up so as to keep good so long as unopened,
and sent out in sealed packages, with the guarantee of their name. By
keeping a few such ounce bottles in an unopened state in one’s
house, one might rely on being ready for any emergency. If you think
this suggestion worth notice, and could induce some first-rate house
to carry it out, and mention the fact in a subsequent edition of your
book, you would, I think, be adding another most valuable item to an
already invaluable book.”
The above suggestion of preserving ipecacuanha wine in ounce
bottles, quite full, and hermetically sealed, is a very good one. The
best way of hermetically sealing the bottle would be to cut the cork
level with the lip of the bottle, and to cover the cork with sealing-wax,
in the same manner wine merchants serve some kinds of their wines,
and then to lay the bottles on their sides in sawdust in the cellar. I
have no doubt, if such a plan were adopted, the ipecacuanha wine
would for a length of time keep good. Of course, if the wine of
ipecacuanha be procured from the Apothecaries’ Hall Company,
London (as suggested by my correspondent), there can be no
question as to the genuineness of the article.
What NOT to do.—Do not give emetic tartar; do not apply leeches;
do not keep the room very warm; do not give stimulants; do not omit
to have always in the house either a 4 oz. bottle, or three or four 1 oz.
bottles of ipecacuanha wine.
200. I have heard Child-crowing mentioned as a formidable
disease; would you describe the symptoms?
Child-crowing, or spurious croup, as it is sometimes called, is
occasionally mistaken for genuine croup. It is a more frequent
disorder than the latter, and requires a different plan of treatment.
Child-crowing is a disease that almost invariably occurs only during
dentition, and is most perilous. But if a child laboring under it can
fortunately escape suffocation until he has cut the whole of his first
set of teeth—twenty—he is then, as a rule, safe.
Child-crowing comes on in paroxysms. The breathing during the
intervals is quite natural—indeed, the child appears perfectly well;
hence the dangerous nature of the disease is either overlooked, or is
lightly thought of, until perhaps a paroxysm worse than common
takes place, and the little patient dies of suffocation, overwhelming
the mother with terror, with confusion, and dismay.
The symptoms in a paroxysm of child-crowing are as follows: The
child suddenly loses and fights for his breath, and in doing so makes
a noise very much like that of crowing; hence the name child-
crowing. The face during the paroxysm becomes bluish or livid. In a
favorable case, after either a few seconds, or even, in some instances,
a minute, and a frightful struggle to breathe, he regains his breath,
and is, until another paroxysm occurs, perfectly well. In an
unfavorable case, the upper part (chink) of the windpipe remains for
a minute or two closed, and the child, not being able to breathe,
drops a corpse in his nurse’s arms. Many children, who are said to
have died of fits, have really died of child-crowing.
I have entered thus rather fully into the subject, as many lives
might be saved if a mother knew the nature of the complaint, and the
great necessity, during the paroxysms, of prompt and proper
measures. For, too frequently, before a medical man has had time to
arrive, the child has breathed his last, the parent herself being
perfectly ignorant of the necessary treatment; hence the vital
importance of the subject, and the paramount necessity of imparting
information, in a popular style, in a work of this kind.
201. What treatment, then, during a paroxysm of Child-crowing
should you advise?
The first thing, of course, to be done is to send immediately for a
medical man. Have a plentiful supply of cold and of hot water always
at hand, ready at a moment’s notice for use. The instant the
paroxysm is upon the child, plentifully and perseveringly dash cold
water upon his head and face. Put his feet and legs in hot salt,
mustard, and water; and, if necessary, place him up to his neck in a
hot bath, still dashing water upon his face and head. If he does not
quickly come round, sharply smack his back and buttocks.
As soon as a medical man arrives, he will lose no time in
thoroughly lancing the gums and in applying other appropriate
remedies.
Great care and attention ought, during the intervals, to be paid to
the diet. If the child is breathing a smoky, close atmosphere, he
should be immediately removed to a pure one. In this disease,
indeed, there is no remedy equal to a change of air—to a dry, bracing
neighborhood. Change of air, even if it be winter, is the best remedy,
either to the coast or to a healthy farm-house. I am indebted to Mr.
Roberton, of Manchester (who has paid great attention to this
disease, and who has written a valuable essay on the subject[222]), for
the knowledge of this fact. Where, in a case of this kind, it is not
practicable to send a child from home, then let him be sent out of
doors the greater part of every day; let him, in point of fact, almost
live in the open air. I am quite sure, from an extensive experience,
that in this disease, fresh air, and plenty of it, is the best and
principal remedy.
202. When is a mother to know that a cough is not a “tooth-
cough,” but one of the symptoms of Inflammation of the Lungs?
If the child has had a shivering fit; if his skin be very hot and very
dry; if his lips be parched; if there be great thirst; if his cheeks be
flushed; if he be dull and heavy, wishing to be quiet in his cot or crib;
if his appetite be diminished; if his tongue be furred; if his mouth be
burning hot and dry;[223] if his urine be scanty and high-colored,
staining the napkin or the linen; if his breathing be short, panting,
hurried, and oppressed; if there be a hard, dry cough; and if his
skin be burning hot; then there is no doubt that inflammation of the
lungs has taken place.
No time should be lost in sending for medical aid; indeed, the hot,
dry mouth and skin, and short hurried breathing would be
sufficient cause for your procuring immediate assistance. If
inflammation of the lungs were properly treated at the onset, a child
would scarcely ever be lost by that disease. I say this advisedly, for in
my own practice, provided I am called in early, and if my plans are
strictly carried out, I scarcely ever lose a child from inflammation of
the lungs.
You may ask—What are your plans? I will tell you, in case you
cannot promptly obtain medical advice, as delay might be death.
The treatment of Inflammation of the Lungs, what to do.—Keep
the child to one room, to his bedroom, and to his bed. Let the
chamber be properly ventilated. If the weather be cool, let a small
fire be in the grate; otherwise, he is better without a fire. Let him live
on low diet, such as weak black tea, milk and water, and toast and
water, thin oatmeal gruel, arrow-root, and such like simple
beverages, and give him the following mixture:
Take of—Wine of Ipecacuanha, three drachms;
Simple Syrup, three drachms;
Water, six drachms:
Make a Mixture. A teaspoonful of the mixture to be taken every four hours.

Be careful that you go to a respectable chemist, in order that the
quality of the ipecacuanha wine may be good, as the child’s life may
depend upon it.
If the medicine produces sickness, so much the better; continue it
regularly until the short, oppressed, and hurried breathing has
subsided, and has become natural.
If the attack be very severe, in addition to the above medicine, at
once apply a blister, not the common blister, but Smith’s tela
vesicatoria—a quarter of a sheet, which ought to be fastened on to a
piece of sticking-plaster, taking care to apply the tela vesicatoria
(which is on paper) to the warmed plaster, so as to securely fasten
the tela vesicatoria on the sticking-plaster. The plaster should be
rather larger than the blister, so as to leave a margin. Any respectable
chemist will understand the above directions, and will prepare the
tela ready for use. If the child be a year old, the blister ought to be
kept on for three hours, and then a piece of dry, soft linen rag should
be applied for another three hours. At the end of which time—six
hours—there will be a beautiful blister, which must then, with a pair
of scissors, be cut, to let out the water; and then let the blister be
dressed, night and morning, with simple cerate spread on lint.
If the little patient be more than one year, say two years old, let the
tela remain on for five hours, and the dry linen rag for five hours
more, before the blister, as above recommended, be cut and dressed.
If in a day or two the inflammation still continue violent, let
another tela vesicatoria be applied, not over the old blister, but let a
narrow slip of it, on sticking-plaster, be applied on each side of the
old blister, and managed in the same manner as before directed.
I cannot speak too highly of Smith’s tela vesicatoria. It has, in my
hands, through God’s blessing, saved the lives of scores of children.
It is far, very far superior to the old-fashioned blistering plaster. It
seldom, if the above rules be strictly observed, fails to rise; it gives
much less pain than the common blister; when it has had the desired
effect, it readily heals, which cannot always be said of the common
fly-blister, more especially with children.
My sheet-anchors, then, in the inflammation of the lungs of
children, are, ipecacuanha wine and Smith’s tela vesicatoria. Let the
greatest care, as I before advised, be observed in obtaining the
ipecacuanha wine genuine and good. This can only be depended
upon by having the medicine from a highly respectable chemist.
Ipecacuanha wine, when genuine and good, is, in many children’s
diseases, one of the most valuable of medicines.
What, in a case of Inflammation of the Lungs, NOT to do.—Do not,
on any account, apply leeches. They draw out the life of the child, but
not his disease. Avoid—emphatically let me say so—giving emetic
tartar. It is one of the most lowering and death-dealing medicines
that can be administered either to an infant or to a child! If you wish
to try the effect of it, take a dose yourself, and I am quite sure that
you will then never be inclined to poison a baby with such an
abominable preparation! In olden times—many, many years ago—I
myself gave it in inflammation of the lungs, and lost many children!
Since leaving it off, the recoveries of patients by the ipecacuanha
treatment, combined with the external application of Smith’s tela
vesicatoria, have been in many cases marvelous. Avoid broths and
wine, and all stimulants. Do not put the child into a warm bath, it
only oppresses the already oppressed breathing. Moreover, after he
is out of the bath, it causes a larger quantity of blood to rush back to
the lungs and to the bronchial tubes, and thus feeds the
inflammation. Do not, by a large fire, keep the temperature of the
room high. A small fire, in the winter time, encourages ventilation,
and in such a case does good. When the little patient is on the
mother’s or on the nurse’s lap, do not burden him either with a
heavy blanket or with a thick shawl. Either a child’s thin blanket, or a
thin woolen shawl, in addition to his usual night-gown, is all the
clothing necessary.
203. Is Bronchitis a more frequent disease than Inflammation of
the Lungs? Which is the most dangerous? What are the symptoms
of Bronchitis?
Bronchitis is a much more frequent disease than inflammation of
the lungs; indeed, it is one of the most common complaints both of
infants and of children, while inflammation of the lungs is
comparatively a rare disease. Bronchitis is not nearly such a
dangerous disease as inflammation of the lungs.
The symptoms.—The child for the first few days labors under
symptoms of a heavy cold; he has not his usual spirits. In two or
three days, instead of the cold leaving him, it becomes more
confirmed; he is now really poorly, fretful, and feverish; his
breathing becomes rather hurried and oppressed; his cough is hard
and dry and loud; he wheezes, and if you put your ear to his naked
back, between his shoulder-blades, you will hear the wheezing more
distinctly. If at the breast, he does not suck with his usual avidity; the
cough, notwithstanding the breast is a great comfort to him, compels
him frequently to loose the nipple; his urine is scanty, and rather
high-colored, staining the napkin, and smelling strongly. He is
generally worse at night.
Well, then, remember if the child be feverish, if he have symptoms
of a heavy cold, if he have an oppression of breathing, if he wheeze,
and if he have a tight, dry, noisy cough, you may be satisfied that he
has an attack of bronchitis.
204. How can I distinguish between Bronchitis and Inflammation
of the Lungs?
In bronchitis the skin is warm but moist; in inflammation of the
lungs it is hot and dry: in bronchitis the mouth is warmer than usual,
but moist; in inflammation of the lungs it is burning hot: in
bronchitis the breathing is rather hurried, and attended with
wheezing; in inflammation of the lungs it is very short and panting,
and is unaccompanied with wheezing, although occasionally a very
slight crackling sound might be heard: in bronchitis the cough is long
and noisy; in inflammation of the lungs it is short and feeble: in
bronchitis the child is cross and fretful; in inflammation of the lungs
he is dull and heavy, and his countenance denotes distress.
We have sometimes a combination of bronchitis and of
inflammation of the lungs, an attack of the latter following the
former. Then the symptoms will be modified, and will partake of the
character of the two diseases.
205. How would you treat a case of Bronchitis?
If a medical man cannot be procured, I will tell you what to do:
Confine the child to his bedroom, and if very ill, to his bed. If it be
winter time, have a little fire in the grate, but be sure that the
temperature of the chamber is not above 60° Fahrenheit, and let the
room be properly ventilated, which may be effected by occasionally
leaving the door a little ajar.
Let him lie either outside the bed or on a sofa; if he be very ill,
inside the bed, with a sheet and a blanket only to cover him, but no
thick coverlid. If he be allowed to lie on the lap, it only heats him and
makes him restless. If he will not lie on the bed, let him rest on a
pillow placed on the lap; the pillow will cause him to lie cooler, and
will more comfortably rest his wearied body. If he be at the breast,
keep him to it; let him have no artificial food, unless, if he be thirsty,
a little toast and water. If he be weaned, let him have either milk and
water, arrow-root made with equal parts of milk and water, toast and
water, barley-water, or weak black, tea, with plenty of new milk in it,
etc.; but, until the inflammation has subsided, neither broth nor
beef-tea.
Now, with regard to medicine, the best medicine is ipecacuanha
wine, given in large doses, so as to produce constant nausea. The
ipecacuanha abates fever, acts on the skin, loosens the cough, and, in
point of fact, in the majority of cases will rapidly effect a cure. I have
in a preceding Conversation[224] given you a prescription for the
ipecacuanha wine mixture. Let a teaspoonful of the mixture be taken
every four hours.
If in a day or two he be no better, but worse, by all means continue
the mixture, whether it produce sickness or otherwise; and put on
the chest a tela vesicatoria, prepared and applied as I recommended
when treating of inflammation of the lungs.[224]
The ipecacuanha wine and the tela vesicatoria are my sheet-
anchors in the bronchitis, both of infants and of children. They
rarely, even in very severe cases, fail to effect a cure, provided the
tela vesicatoria be properly applied, and the ipecacuanha wine be
genuine and of good quality.
If there be any difficulty in procuring good ipecacuanha wine, the
ipecacuanha may be given in powder instead of the wine. The
following is a pleasant form:
Take of—Powder of Ipecacuanha, twelve grains;
White Sugar, thirty-six grains:
Mix well together, and divide into twelve powders. One of the powders to be put
dry on the tongue every four hours.
The ipecacuanha powder will keep better than the wine, an
important consideration to those living in country places;
nevertheless, if the wine can be procured fresh and good, I far prefer
the wine to the powder.
When the bronchitis has disappeared, the diet ought gradually to
be improved—rice, sago, tapioca, and light batter pudding, etc.; and
in a few days, either a little chicken or a mutton-chop, mixed with a
well-mashed potato and crumb of bread, should be given. But let the
improvement in his diet be gradual, or the inflammation might
return.
What NOT to do.—Do not apply leeches. Do not give either emetic
tartar, or antimonial wine, which is emetic tartar dissolved in wine.
Do not administer either paregoric or syrup of poppies, either of
which would stop the cough, and would thus prevent the expulsion of
the phlegm. Any fool can stop a cough, but it requires a wise man to
rectify the mischief. A cough is an effort of nature to bring up the
phlegm, which would otherwise accumulate, and in the end cause
death. Again, therefore, let me urge upon you the immense
importance of not stopping the cough of a child. The ipecacuanha
wine will, by loosening the phlegm, loosen the cough, which is the
only right way to get rid of a cough. Let what I have now said be
impressed deeply upon your memory, as thousands of children in
England are annually destroyed by having their coughs stopped.
Avoid, until the bronchitis be relieved, giving him broths, and meat,
and stimulants of all kinds. For further observations on what NOT to
do in bronchitis, I beg to refer you to a previous Conversation we had
on what NOT to do in inflammation of the lungs. That which is
injurious in the one case is equally so in the other.
206. What are the symptoms of Diphtheria, or, as it is sometimes
called, Boulogne sore-throat?
This terrible disease, although by many considered to be a new
complaint, is, in point of fact, of very ancient origin. Homer, and
Hippocrates, the father of physic, have both described it. Diphtheria
first appeared in England in the beginning of the year 1857, since
which time it has never totally left our shores.
The symptoms.—The little patient, before the disease really shows
itself, feels poorly, and is “out of sorts.” A shivering fit, though not
severe, may generally be noticed. There is heaviness, and slight
headache, principally over the eyes. Sometimes, but not always, there
is a mild attack of delirium at night. The next day he complains of
slight difficulty of swallowing. If old enough, he will complain of
constriction about the swallow. On examining the throat the tonsils
will be found to be swollen and redder—more darkly red than usual.
Slight specks will be noticed on the tonsils. In a day or two an
exudation will cover them, the back of the swallow, the palate, the
tongue, and sometimes the inside of the cheeks and the nostrils. This
exudation of lymph gradually increases until it becomes a regular
membrane, which puts on the appearance of leather; hence its name
diphtheria. This membrane peels off in pieces; and if the child be old
and strong enough he will sometimes spit it up in quantities, the
membrane again and again rapidly forming as before. The discharges
from the throat are occasionally, but not always offensive. There is
danger of croup from the extension of the membrane into the
windpipe. The glands about the neck and under the jaw are generally
much swollen; the skin is rather cold and clammy; the urine is scanty
and usually pale; the bowels at first are frequently relaxed. This
diarrhœa may or may not cease as the disease advances.
The child is now in a perilous condition, and it becomes a battle
between his constitution and the disease. If, unfortunately, as is too
often the case—diphtheria being more likely to attack the weakly—
the child be very delicate, there is but slight hope of recovery. The
danger of the disease is not always to be measured by the state of the
throat. Sometimes, when the patient appears to be getting well, a
sudden change for the worse rapidly carries him off. Hence the
importance of great caution, in such cases, in giving an opinion as to
ultimate recovery. I have said enough to prove the terrible nature of
the disease, and to show the necessity of calling in, at the earliest
period of the symptoms, an experienced and skillful medical man.
207. Is Diphtheria contagious?
Decidedly. Therefore, when practicable, the rest of the children
ought instantly to be removed to a distance. I say children, for it is
emphatically a disease of childhood. When adults have it, it is the
exception, and not the rule. “Thus it will be seen, in the account
given of the Boulogne epidemic, that of 366 deaths from this cause,
341 occurred among children under ten years of age. In the
Lincolnshire epidemic, in the autumn of 1858, all the deaths at
Horncastle, 25 in number, occurred among children under twelve
years of age.”[225]
208. What are the causes of Diphtheria?
Bad and imperfect drainage;[226] want of ventilation; overflowing
privies; low neighborhoods in the vicinity of rivers; stagnant waters;
indeed, everything that vitiates the air and thus depresses the
system, more especially if the weather be close and muggy; poor and
improper food; and last, though not least, contagion. Bear in mind,
too, that a delicate child is much more predisposed to the disease
than a strong one.
209. What is the treatment of Diphtheria?
What to do.—Examine well into the ventilation, for as diphtheria is
frequently caused by deficient ventilation, the best remedy is
thorough ventilation. Look well both to the drains and to the privies,
and see that the drains from the water-closets and from the privies
do not in any way contaminate the pump-water. If the drains be
defective or the privies be full, the disease in your child will be
generated, fed, and fostered. Not only so, but the disease will spread
in your family and all around you.
Keep the child to his bedroom and to his bed. For the first two or
three days, while the fever runs high, put him on a low diet, such as
milk, tea, arrow-root, etc.
Apply to his throat every four hours a warm barm and oatmeal
poultice. If he be old enough to have the knowledge to use a gargle,
the following will be found serviceable:
Take of—Powdered Alum, one drachm;
Simple Syrup, one ounce;
Water, seven ounces:
To make a Gargle.
The best medicine for the first few days of the attack, is one of the
following mixtures:
Take of—Chlorate of Potash, two drachms;
Boiling Water, seven ounces and a half;
Syrup of Red Poppy, half an ounce:
To make a Mixture. A tablespoonful to be taken every four hours.

Or,
Take of—Diluted Sulphuric Acid, one drachm;
Simple Syrup, one ounce and a half;
Infusion of Roses,[227] four ounces and a half;
To make a Mixture. A tablespoonful to be given every four hours.

As soon as the skin has lost its preternatural heat, beef-tea and
chicken broth ought to be given. Or if great prostration should
supervene, in addition to the beef-tea, port wine, a tablespoonful
every four hours, should be administered. If the child be cold, and
there be great sinking of the vital powers, brandy and water should
be substituted for the port wine. Remember, in ordinary cases, port
wine and brandy are not necessary, but in cases of extreme
exhaustion they are most valuable.
As soon as the great heat of the skin has abated and the debility
has set in, one of the following mixtures will be found useful:
Take of—Wine of Iron, one ounce and a half;
Water, three ounces and a half:
To make a Mixture. A tablespoonful to be taken every four hours.

Or,
Take of—Muriated Tincture of Iron, half a drachm;
Water, three ounces:
To make a Mixture. A tablespoonful to be taken three times a day.

If the disease should travel downward, it will cause all the
symptoms of croup, then it must be treated as croup; with this only
difference, that a blister (tela vesicatoria) must not be applied, or the
blistered surface may be attacked by the membrane of diphtheria,
which may either cause death or hasten that catastrophe. In every
other respect treat the case as croup, by giving an emetic, a
teaspoonful of ipecacuanha wine every five minutes, until free
vomiting be excited, and then administer smaller doses of
ipecacuanha wine every two or three hours, as I recommended when
conversing with you on the treatment of croup.
What Not to do.—Do not, on any account, apply either leeches or a
blister. If the latter be applied, it is almost sure to be covered with
the membrane of diphtheria, similar to that inside of the mouth and
of the throat, which would be a serious complication. Do not give
either calomel or emetic tartar. Do not depress the system by
aperients, for diphtheria is an awfully depressing complaint of itself;
the patient, in point of fact, is laboring under the depressing effects
of poison, for the blood has been poisoned either by the drinking
water being contaminated by fecal matter from either a privy or from

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196. Do you think it important that I should be made acquainted

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Make a Mixture. A teaspoonful to be taken every two or three hours.

Make a Mixture. A teaspoonful of the mixture to be taken every four hours.

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To make a Mixture. A tablespoonful to be given every four hours.

To make a Mixture. A tablespoonful to be taken every four hours.

To make a Mixture. A tablespoonful to be taken three times a day.

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