American Red Cross Text-Book on Home Hygiene and Care of the Sick by Isabel McIsaac (best large ereader TXT) đź“–
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Trays, dishes, tray cloths, and napkins for the patient must be absolutely clean and as attractive as possible. Cracked or chipped dishes should not be used. Individual sets of dishes for the sick may be purchased, and their convenience makes them well worth their price. Paper napkins may be used in many cases to save laundry work; clean white paper is always superior to soiled linen.
Before the tray is brought to the bedside, everything should be arranged so that the patient can eat in comfort. It is bad management to let the soup cool while the patient's pillows and table are being adjusted. In setting the tray great care should be devoted to placing the articles conveniently, and to the appearance and garnishing of the food. Careful serving requires more thought, but little if any more actual time than slovenly serving. Dishes should not be so full that food is spilled in transit; hot dishes should be covered; hot dishes should reach the patient hot, and cold dishes cold. Liquid nourishment in a glass or cup should be served on a small tray or plate covered with a doily. Neither glass nor cup should be held by the rim.
It is not uncommon to overload trays and to serve everything at once in order to save steps, but a patient is ordinarily more interested in a meal that is served in courses unless very long intervals elapse between. Moreover, if the meal is served in courses he is not tempted to eat dessert first and then to refuse the rest of the meal. If food is given sufficiently often it is safer to err on the side of serving too little at a time rather than too much, since the sight of large amounts of food is often disgusting.
The patient's likes and dislikes should be considered as far as possible, but most patients should not be consulted about their menus beforehand. Great variety in one meal is not necessary; it should be introduced by varying successive meals. An article that has been especially disliked should not be served a second time, unless it can be disguised beyond a possibility of detection. An article of food to which a patient objects should be removed at once; one may appear disappointed if it seems wise, but should never argue. When patients persistently refuse necessary nourishment a difficult situation is presented; persuasion and every form of ingenuity must be used, and the doctor's coöperation enlisted. When, for example, a strict milk diet is ordered for a patient who announces that he never takes milk in any circumstances the situation may seem hopeless but it is not necessarily so.
—Helpless and weak patients must be assisted to eat or drink. A napkin should first be placed under the patient's chin. The attendant should place her hand under the pillow, raise the head slightly, and hold the glass to his lips with her other hand. An ordinary tumbler can be used by a patient lying down if it is not more than a quarter full, or a special feeding cup may be purchased. Bent glass tubes may be used for cool liquids; they should be washed immediately after use. A child who can sit up sometimes takes more nourishment if it is given through a soda water straw.
If the patient must be fed with a spoon care should be taken that the liquid is not too hot, but the attendant should not blow upon it to cool it. It should be given from the point of a spoon placed at right angles to the lips, and plenty of time between mouthfuls should be allowed. A swallow should not be given at the moment when the patient is drawing the breath in. Great patience is required if a helpless person is to be fed acceptably. The attendant should sit by the bedside rather than stand, should present at least the appearance of having unlimited time, and should endeavor not to deprive the patient in any way of the satisfaction he may derive from his nourishment.
EXERCISES What needs of the body do food substances supply? Give an outline of the digestive process. Describe the effect of different mental states upon digestion, and give examples of the ways by which a knowledge of these effects may be utilized in feeding patients. Why is the problem of nourishing the body of especial importance in sickness? Name the four ordinary classes of diet for the sick, and mention all the articles you can belonging to each class. Why is constipation a common ailment among patients confined to bed, and what attempts should be made to overcome it by the diet? Why is it necessary for sick persons to drink water freely, and what efforts should the attendant make to encourage them to do so? Describe the proper serving of a patient's tray. How should helpless patients be assisted to eat? FOR FURTHER READING Health and Disease—Roger I. Lee, Chapter II. The Human Mechanism—Hough and Sedgwick, Chapters VIII, XIII, XIX. Notes on Nursing—Florence Nightingale, Pages 63-79. How to Live—Fisher and Fisk, Chapter II. Bodily Changes in Pain, Hunger, Fear and Rage—Cannon, Chapter I. Food for the Invalid and the Convalescent—Winifred S. Gibbs. Practical Dietetics—Pattee, Chapters IV, V. Feeding the Family—Rose. Diet in Health and Disease—Friedenwald and Ruhrah. Feeding Children from Two to Seven Years Old—New York City Department of Health. American Red Cross Text Book on Home Dietetics—Ada Z. Fish. Emergency Cooking—Pamphlet 708, American Red Cross. War Diet in the Home—Pamphlet 706, American Red Cross. Red Cross Conservation Food Course for Children and Special Classes—Pamphlet 705, American Red Cross. CHAPTER XMEDICINES AND OTHER REMEDIES
—Modern medical practice increasingly emphasizes diet, baths, exercises, and other hygienic measures in the treatment of sickness. Drugs are given far less than they were a generation ago; yet medicines are still the most familiar of all remedies, and the most abused by those who persist in treating themselves. Misuse of medicine even by intelligent people is astonishingly common.
Problems of sickness and health would be enormously clarified if the uses and limitations of drugs were more generally understood. Many people still believe that every disease can be cured by a drug if only the doctor is clever or lucky enough to think of the right one to give. Such beliefs result naturally enough from centuries of faith in charms and magic, and occasionally are confirmed by remarkable cures apparently brought about by drugs, but really pure coincidence or the result of suggestion.
It is a fact that a few medicines are known which if rightly used actually do cure certain diseases. An example of their action is the curative effect of quinine in malaria. Such medicines, unfortunately, are few. In the great majority of cases medicines do not cure disease; their beneficial action is ordinarily indirect and is due to their power either to increase or to check certain processes within the body.
It is here that the abuse of drugs comes in. Disordered bodily processes give rise to symptoms of disease; and it is the symptoms of disease, not the disease itself, that trouble the patient. A patient with typhoid, for example, is not conscious of the toxins in his blood, but of headache, weakness, and fever; the man with eyestrain is not aware of an imperfectly shaped lens, but of headache and indigestion. What the patient wants is to have his symptoms relieved; in some cases they can be controlled by drugs, and the sufferer then considers himself cured. But the original condition persists: it may in the meantime be improving, but it may on the other hand be growing worse.
Not infrequently it is best to check symptoms, and to check them by means of drugs. When they should be checked, only a thoroughly trained physician is qualified to decide. The question is not one for amateurs, since the whole practice of medicine, including the prescription of drugs, constantly becomes more nearly an exact science. People should obtain and follow expert advice in regard to health as they would in regard to other affairs of life. The constant self-dosing practised by thousands of people is harmful and unintelligent; it is, however, no less irrational to go to the other extreme and refuse to take medicine prescribed by a competent doctor.
—Amateur dosing either of oneself or of others is dangerous in more ways than one. In the first place, time is lost. Moreover, symptoms are characteristic; checking or altering them increases the difficulty of finding the real trouble. The man with eyestrain who takes one drug to stop his headache and another to "cure" his stomach, is simply delaying the time when properly adjusted glasses will relieve both. In this case the result may not be serious; but such a loss of time in finding the trouble and beginning proper treatment might prove fatal in the case of tuberculosis.
Another objection to amateur prescription of medicine is the fact that most drugs have more than one effect. In addition to their main action they have others, subordinate or ordinarily less marked. These minor effects may be serious in some cases. Many headache remedies, for example, affect the heart; a dose that is harmless for a normal person may be strong enough to injure seriously a person with a weak heart. A doctor, and a doctor only, is competent to decide when and in what quantity medicines will be beneficial, because he alone understands both the condition of the patient and all the possible effects of the drug.
In no circumstances should medicine prescribed for one person be taken by another. This rule seems obvious enough; yet every day people pass on their pet remedies to friends. Some medicines deteriorate after standing, and others grow stronger; nevertheless, medicine supposed to have cured a cough or a tonic supposed to have strengthened some member of the family after an attack of grippe is cheerfully administered months later to another member of the family, who, to make matters worse, may differ in age, strength, and probably in the nature of his sickness. Drugs are expensive, and it is considered economical to use them up; measured by lost time and impaired health such practices may be anything but thrifty.
Cathartics, tonics, and various drugs to relieve pain and sleeplessness are among the remedies most commonly taken without medical advice. Enough has already been said about constipation to indicate proper hygienic treatment, but another warning should be given against habitual use of cathartics. Many of these drugs are irritating; even when not irritating, they are harmful, since the body depends more and more upon the drug to do for it what it should be enabled to do for itself, by remedying the original cause of the trouble. Licorice powder, cascara, saline cathartics such as Seidlitz powders and Rochelle Salts and some others are harmless for occasional use, if occasional is not too liberally interpreted.
Tonics are poor substitutes for proper diet, rest, and fresh air. Using them may be likened to beating a tired horse; the horse goes faster, but he is not really stronger. In some emergencies the horse must go faster and there is nothing to do but beat him, and in some cases the tonic should be given; these, however, are cases for a doctor to decide. People persist in taking tonics because they are unwilling or unable to rest, or otherwise to change
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