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reference to the quantity of light admitted into a sick-room? 990. What effect have calls on the sick? 991. What is said of the custom of calling and conversing with the sick during the intervals of daily labor? 428

Illustration. While attending a Miss B., of N. H., sick of fever, I pronounced her better, withdrew medicine, directed a simple, low diet, and the exclusion of all visitors. In the evening I was sent for to attend her. There was a violent relapse into the disease, which continued to increase in severity until the fourth day, when death terminated her sufferings. I learned that, soon after I gave directions that no visitors be admitted into her room, several particular friends were permitted to enter the chamber and talk with the sick girl. Their conversation produced a severe headache; and, to use the language of the patient, “it seemed as if their talk would kill me;” and it did kill her.

992. No solid food should be taken in the first stages of disease, even if the affection is slight. The thirst can be allayed by drinking cold water, barley-water, and other preparations of an unstimulating character. It is wrong to tempt the appetite of a person who is indisposed. The cessation of a desire for food, is the warning of nature, that the system is in such a state that it cannot be digested.

993. When a patient is recovering from illness, the food should be simple, and in quantities not so great as to oppress the stomach. It should also be given with regularity. “Eat little and often,” with no regard to regularity, is a pernicious practice.

994. When a physician attends a sick person, he should have the special management of the food, particularly after the medicine has been withdrawn and the patient is convalescent. The prevailing idea that every person may safely advise relative to food, or that the appetite of the convalescing person 429 is a competent guide, is dangerous; and cannot be too much censured.

Give an illustration. 992. What suggestion relative to food in the first stages of disease? How can the thirst be allayed? 993. When the patient is convalescent, how should the food be given? What is said of the practice of eating “little and often”? 994. Who should have the special management of food when medicine is withdrawn? What idea prevails in the community?

Illustration. In 1832, I attended a Miss M., sick of fever. After an illness of a few days, the fever abated, and I directed a simple, unstimulating diet. Business called me from the town two days. During my absence, a sympathizing, officious matron called; found her weak, but improving; and told her she needed food to strengthen her; and that “it would now do her good.” Accordingly, eggs and a piece of beefsteak were prepared, and given to the convalescent girl. She ate heartily, and the result was a relapse into a fever more violent than the first attack.

995. It is very important in disease that the skin be kept clean. A free action of the vessels of this part of the body exerts a great influence in removing disease from the internal organs, as well as keeping them in health. If the twenty or thirty ounces of waste, hurtful matter, that passes through the “pores” of the skin in twenty-four hours, are not removed by frequent bathing and dry rubbing, it deranges the action of the vessels that separate this waste matter from the blood, and thus increases the disease of the internal organs.

Illustration. Mrs. M. R., of N., Mass., was afflicted with disease of the lungs and cough. This was accompanied with a dry, inactive condition of the skin. As medicine had no salutary effect in relieving her cough, she was induced by the advice of the clergyman of the parish to enter upon a systematic course of bathing twice every day. Soon the skin became soft, its proper functions were restored, the disease of the lungs yielded, and the cough disappeared.

996. Every sick person should breathe pure air. The purer the blood that courses through the body, the greater the 430 energy of the system to remove disease. The confined vitiated air of the sick-chamber, not unfrequently prolongs disease; and in many instances, the affection is not only aggravated, but, even rendered fatal, by its injurious influences.

Give an illustration of the evil effects attending such an idea. 995. Does the skin exert a great influence in removing disease from the internal organs, as well as in keeping them in health? Give an illustration 996. Why should every sick person, particularly, breathe pure air?

Illustrations. 1st. In 1833, I was called, in consultation with another physician, to Mr. H., who was much debilitated, and delirious. For several successive days he had not slept. His room was kept very warm and close, for fear he would “take cold.” The only change that I made in the treatment, was to open the door and window, at a distance from the bed. In a short time, the delirium ceased, and he fell into a quiet slumber. From this time he rapidly recovered, and the delirium was probably the result of breathing impure air.

2d. Formerly, every precaution was used to prevent persons sick of the small-pox from breathing fresh air. When Mrs. Ramsay had this disease in Charleston, S.C., her friends, supposing that life was extinct, caused her body to be removed from the house to an open shed. The pure air revived the vital spark. The result probably would have been different, had she been kept a few hours longer in the vitiated air.

997. The influence of habit should not be disregarded in the removal of disease. If food or drink is to be administered, however small in quantity or simple its quality, it should be given at or about the time when the ordinary meals were taken in health.

998. Again, the usual time when the patient was in the habit of retiring for sleep should be observed, and all preparation necessary for the sick-room during the night should be made previous to this hour. Efforts should also be made to evacuate the waste matter of the digestive and urinary organs at the period which habit has formed in health. This is not 431 only a remedial agent in disease, but often precludes the necessity of laxative or drastic cathartics.

Are not diseases prolonged, and even rendered fatal, from breathing the impure, vitiated air of the sick-chamber? Give illustration 1st. Give illustration 2d. 997. What is said respecting the influence of habit in removing disease?

999. Medicine is sometimes necessary to assist the natural powers of the system to remove disease; but it is only an assistant. While emetics are occasionally useful in removing food and other articles from the stomach that would cause disease if suffered to remain, and cathartics are valuable, in some instances, to relieve the alimentary canal of irritating residuum, yet the frequent administration of either will cause serious disease.

1000. Although medicine is useful in some instances, yet, in a great proportion of the cases of disease, including fevers and inflammations of all kinds, attention to the laws of health will tend to relieve the system from disease; more certainly and speedily, and with less danger, than when medicines are administered.

1001. Thomas Jefferson, in writing to Dr. Wistar, of Philadelphia, said, “I would have the physician learn the limit of his art.” I would say, Have the matrons, and those who are continually advising “herb teas,” and other “cure-alls,” for any complaint, labelled with some popular name, learn the limits of their duty, namely, attention to the laws of health. The rule of every family, and each individual, should be, to touch not, taste not of medicine of any kind, except when directed by a well-educated and honest physician, (sudden disease from accidents excepted.)

999. What is said of the use of medicine? 1000. Of its use in fevers and many other cases of disease? 1001. What remark by Thomas Jefferson to Dr. Wistar? What should matrons learn? What should be the rule of every person in regard to taking medicine? What exception?

432 CHAPTER XLIX. DIRECTIONS FOR NURSES.

1002. The nurse requires knowledge and practice to enable her to discharge aright her duty to the patient, as much as the physician and surgeon do to perform what is incumbent on them. Woman, from her constitution and habits, is the natural nurse of the sick; and, in general, no small portion of her time is spent in ministering at the couch of disease and suffering.

1003. As the young and vigorous, as well as the aged and the infirm, are liable to be laid upon the bed of sickness, by an epidemic, or imprudent exposure, or by some accident, it is therefore necessary that the girl, as well as the matron, may know how she can render services in an efficient and proper manner. No girl should consider her education complete who is not acquainted with the principles of the duties of a general nurse and a temporary watcher.

1004. It is to be regretted, that while we have medical schools and colleges to educate physicians, there is no institution to educate nurses in their equally responsible station. In the absence of such institutions, the defect can be remedied, to some extent, by teaching every girl hygiene, or the laws of health. To make such knowledge more available and complete, attention is invited to the following suggestions relative to the practical duties of a nurse.

1002. Does the nurse require knowledge and practice in her employment, as well as the physician? Who is the natural nurse of the sick? 1003. What, then, is incumbent on every girl? 1004. Should there be schools to educate nurses, as well as physicians and surgeons?

433

1005. Bathing. The nurse, before commencing to bathe the patient, should provide herself with water, two towels, a sponge, a piece of soft flannel, and a sheet. The temperature of the room should also be observed.

1006. When the patient is feeble, use tepid or warm water. Cold water should only be used when the system has vigor enough to produce reaction upon the skin. This is shown by the increased redness of the skin, and a feeling of warmth and comfort, after a proper amount of friction. Before using the sponge to bathe, a sheet, or fold of cloth, should be spread smoothly over the bed, and under the patient, to prevent the bed-linen on which the patient lies from becoming damp or wet.

1007. Apply the wet sponge to one part of the body at a time; as the arm, for instance. By doing so, the liability of contracting chills is diminished. Take a dry, soft towel, wipe the bathed part, and follow this by vigorous rubbing with a crash towel, or, what is better, a mitten made of this material; then use briskly a piece of soft flannel, to remove all moisture that may exist on the skin, and particularly between the fingers and the flections of the joints. In this manner bathe the entire body.

1008. The sick should be thoroughly bathed, at least twice in twenty-four hours. Particular attention should be given to the parts between the fingers and toes, and about the flections of the joints, as the accumulation of the excretions is most abundant on these parts. In bathing, these portions of the system are very generally neglected. The best time for bathing, is when the patient feels most vigorous, and freest from exhaustion. The practice of daubing the face and hands with a towel dipped in hot rum, camphor, and vinegar, 434 does not remove the impurities, but causes the skin soon to feel dry, hard, and uncomfortable.

1005. What should a nurse provide herself with, before bathing a patient? 1006. When

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