Whenever a napkin is removed, the parts protected by it must be well cleansed by sponging with a little soap and water, and

then thoroughly powdered, so as to prevent the skin becoming sore. This rule

holds good even if the napkin has only been soiled with urine, though it is of

course still more necessary when, there has been also an action of the bowels.

It is part of a nurse's duty to wash and dress the child during the time she

stays in the house, and she should, for this purpose, be provided with a large

soft flannel apron, which must be carefully dried each time it is used.

DR. CHASE'S RECIPES.

294

The child's clothing should be warm without being heavy, and should fit

loosely so as to allow the organs free play, and the blood to flow unhindered.

The body-binder should be of flannel, as it is impossible to prevent its being

soiled with the urine, and flannel, when wetted, does not chill the skin so much

as other materials.

None but patent safety-pins should be used about a baby,

and even for them it is better to substitute two or three stitches wherever it is

possible.

The medical attendant must always be informed, when he makes his first

after-visit,

whether the infant has passed urine and whether the bowels have

acted; also as to any marks or other peculiarities that may have been noticed.

The state of the eyes, too, should be narrowly watched, and any unhealthy

appearance or the least sign of discharge at once reported.

It is most undesirable to give a newly-born child butter and sugar, or other

similar compound.

For the first twelve hours at least, and indeed for a much

longer time, the child will take no harm if left unfed. The proper course,

however, is to apply it to the breast a few hours after birth that is, as soon as

The breasts will

the mother has recovered a little from the fatigue of labor.

probably not fill with milk for twenty-four or thirty-six hours, or even a little

longer; but there is generally a little thick secretion of creamy fluid, called

colostrum, much earlier than this, of which it is good for the mother to be

—

relieved, and which acts as a gentle laxative

upon the child.

The early appli-

cation of the child to the breast also helps to form the nipples, and renders the

flow of milk easy from the first;

less readily if

it,

it

it teaches the child

how to suck, a lesson learnt

has previously been fed with a spoon; and, lastly, it provides

in the majority of cases, with all the food it requires during the first day or

two, and obviates the necessity of artificial feeding.

The child should be put to the breast with clock-like regularity. Until the

flow is fairly established, the interval should be four hours; afterwards, for the

first month,

an hour and a half or two hours in the daytime and four hours in

In tlie daytime the child may be awakened at the feeding-hour; in

Many infants

the night he should on no account be disturbed out of his sleep.

the night.

will sleep continuously for six hours in the night, and suffer no harm from the

long fast.

If it is important that a child should be fed as often as is here stated, it

important that he should not be fed oftener. Young infants very

soon learn habits of regularity, and, besides, their stomachs need rest between

is no less

our own case, except that, of course, the intervals

Many women put the child to the breast whenever it

cries, forgetting that this is the only way in which it can express its sense of

their meals,

just as in

required are shorter.

discomfort, from whatever cause arising, and that it

crying because it is in pain, or because

hunger.

its

is quite as likely to be

napkin wants changing, as from

It is important from the first to apply the child to each breast in turn.

When the secretion of milk is long delayed, and it becomes consequently

necessary to feed the infant, the proper food is good cow's milk, boiled, so as

to prevent its being a carrier of

infection, then

mixed with about an equal

NUESma.

quantity of "water, and sweetened.

295

Bread and oatmeal gruel are not fit food

They irritate the stomach and bowels and cause griping

In short, during the first month of life no other food than the

for newly-born infants.

and flatulence.

mother's milk or diluted cow's milk should be given, except under medical

advice.

When the mother has not enough milk to satisfy the child, nursing may be

combined with hand-feeding, which is generally preferable to hand-feeding

The additional food should consist of good milk, boiled, diluted with

alone.

an equal quantity of water and sweetened. After the first month the quantity

of added water requires to be gradually lessened.

In case the mother cannot nurse her child, tlie next best way of feeding it

is to obtain a good, healtliy wet-nurse, whose child is not much older than the

one she is to nurse. The medical attendant should always be consulted in

regard to the health and suitability of a wet-nurse, before she is engaged.

It may be that a wet-nurse cannot be obtained, and tlien hand-feeding

becomes necessary. For this purpose good milk (from one cow if possible),

boiled, diluted, and sweetened, as already directed, is for the first few months

all the food that is required.

Arrowroot, cornstarch, and bread are all unsuitable at this tender age, and afford far less nourishment than milk.

Now and then a child is found with whom fresh milk does not agree, the

curdy character of the stools showing that it is only partially digested. Should

a change of dairy not suffice to set matters right, it will be desirable to try the

concentrated Swiss milk, which, though greatly inferior to fresh milk, is the

best of

tion,

all artificial

substances.

Failing success with this, a malted prepara-

known as Mellin's Food for Infants, may be tried, at any rate until the

digestive powers become sufficiently improved to return to milk.

The custom of using feeding-bottles with India-rubber tubes has become

exceedingly prevalent.

These tubes are difficult to keep clean, and a mere drop

or two of milk left adhering to the bottle or tube will often be sufficient to turn

Hence have arisen flatulence and indigestion, and much

Another objection to the use of tubes is, that nurses

are tempted to place children in the cot with the bottle of milk by their side

and the tube in their mouth, a practice which is highly objectionable on several

grounds.

It does away with all regularity in feeding, and is very liable to

cause the milk to be turned sour owing to the heat given off from the child's

body.

Feeding-bottles without tubes, and fitted with teats only, have the

advantage of requiring to be held in the nurse's hand, and are on every account

the next supply sour.

sickness and suffering.

to be preferred.

There should always be two, for alternate use, one being kept

under water while the other is in actual use. Immediatetly after the child has

had a meal, the bottle must be thoroughly washed in warm water.

It is an unnecessary and injurious practice to administer castor-oil to the

newly -born. The first milk (or colostrum) from the mother's breast generally

relaxes the bowels sufficiently, and if not, no aperient should be administered

except under the advice of the medical attendant.

Children should not sleep in the same bed with an adult, but should, from

the first, be placed in their own separate cot. Attention to this rule would

I>B.

296

CEASE'S RECIPES.

annually save many lives which are now sacrificed. The number returned

every year as having been found dead in bed is astounding. Sometimes both

mother and child fall asleep, while the child is at the breast, whereupon the

child's face gets pressed so closely against the mother's body that both nose and

mouth are covered, breathing becomes impossible, and the child is smothered;

sometimes fatal asphyxia is produced by the child nestling down in the bed and

going to sleep with its head completely covered by the bedclothes; and sometimes, though of course very rarely, the cause of death in these cases is overThese dangers are best avoided by letting the child sleep by itself.

lying.

During the first month or two a healthy child sleeps the greater part of

both day and night.

Children should not be allowed to form the habit of being put to sleep on

the nurse's lap, but should be placed in their cot awake, and soothed to sleep

This is a lesson learnt without difficulty, if taught from the earliest

there.

days.

On no account should any kind of soothing medicine be given, except

under medical advice.

Young babies require to be kept very warm, and yet need abundance of

fresh air. Nursery windows should be opened very frequently, and the room

kept pure and wholesome. After the first two or three weeks children should

be carried in the arms out of doors every day in fine weather. In winter they

should be well wrapped up, and in summer the head should be carefully protected from the rays of the sun.

When the navel-string is an unusually long time in separating, no force is

to be used; all will go on properly if left to Nature.

Separation having taken

round piece of linen should be covered with a little vaseline or

simple ointment, and applied to the navel. If the process be accompanied or

followed by bleeding, the medical attendant should be informed without delay,

place, a small

as children occasionally die

from this cause.

He should also be told if, after

the separation, the navel is found to project more than usual.

It is by no means an unfrequent occurrence for the breasts of newly-born

children to become swollen and inflamed, and sometimes they are even found

In either case the nurse must careto contain a few drops of milk-like fluid.

fully avoid rubbing or squeezing them.

The swelling will gradually disappear,

—

and the fluid become absorbed under soothing treatment as, for example, the

ordinary water dressing; whereas rough manipulations, such as have just been

mentioned, increase the inflammation, and are apt to result in the formation of

abscess.

The appearance of a number of little white spots on the tongue, inside the

known in the nursery as " the

thrush," is an almost certain sign that the child's food is in some way unsuit.

lips and cheeks, and on the roof of the mouth,

able,

and ought, therefore, invariably to be reported to the medical attendant.

In the meantime the affected places should be painted several times a day with

glycerine of borax, by means of a camel-hair brush.

NUBSma.

297

MANAGEMENT OF THE MOTHER AFTER LABOR: Treatment During the First Few Hours — The Lochia — Necessity

of the Level Posture — Care when First Sitting-up — Change

of Room — Going out of Doors — Changing the Linen — The

Binder— Washing, &c.— Avoidance of Excitement— Occupation —Diet — The Bowels —Flooding —Rigors — Suckling

Sore Nipples —Abscess of Breast—Dispersion of Milk in the

Event of Not Suckling.

After the patient has been

made comfortable

in the

manner already

described, it is above all things desirable that she should have several hours of

undisturbed

rest,

and, if possible, sleep.

There used to be a curious notion

prevalent amongst nurses that a \roman ought not to be allowed to fall asleep

This is altogether a mistake; sleep is to be encouraged

by every possible means. To this end the room should be kept exceedingly

In this way the

quiet, and the blinds drawn dov?n so as to subdue the light.

patient will be best enabled to recover from the exhausting effects of labor.

In the meantime the nurse should keep an eye on the patient's face, and if she

observe that it is becoming unusually pale, she must at once ascertain whether

there is any flooding.

For the first few days the patient will suffer more or less from after-pains,

which only require to be brought under the notice of the medical attendant in

As a rule, no after-pains

case they are very severe or interfere with sleep.

directly after delivery.

occur after a first confinement.

The Proper Food to be given directly after labor is a cup of tea, gruel,

or warm milk; but if the patient prefers to wait a little before taking anything

at all, there is no harm in allowing her to follow her inclination.

When the

from her exhaustion, the

child should be applied to the breast.

The nipples can be drawn out much

better before the breasts become filled with milk than afterwards.

Not more than six hours should elapse after labor before the patient is

reminded to pass water. She should not be allowed to wait until she feels a

desire to do this for, under these circumstances, the bladder may be quite full

without the patient having any inclination to empty it. At the end of six

patient has had a few hours' rest, and has recovered

hours, then, if

it

has not been already asked

for, the slipper-pan

should be

passed, a little hot water having previously been poured into it and the vessel

itself

warmed before the fire.

If she finds herself unable to use the slipper-pan,

she may be allowed to turn herself gently on to her hands and knees, in which

position she will almost always succeed, an ordinary chamber utensil being in

in that case substituted for the slipper-pan.

Should she, even after changing

her position, still be unable to pass urine, she 'must not make forcing efforts,

but lie down again, rest a little, and then make a further attempt. The patient

herself frequently imagines that she has passed urine, when she has not; hence

the nurse, knowing

this,

must not be satisfied without seeing for herself th?

contents of the vessel after its removal.

DB. CHASE'S RECIPES.

298

Should no urine be passed during the first twelve hours, something to aid

the patient to do so must be given, as recommended elsewhere; and probably it

will be necessary to call a doctor to draw it off

by means of the catheter.

For the first few hours after delivery the vagina and external genital organs

are very sore and painful, and the discharge consists of pure blood.

Ten or

twelve napkins are required during the twenty-four hours succeeding labor.

On the second day the discharge becomes less, and each day the quantity dimin-

ishes, the discharge itself

fluid,

and

gradually changing from pure blood to a thick dark

serum, like soiled water. The discharge always

lastly to a thin

possesses a peculiar and distinctive odor, but

if

the odor become offensive the

medical attendant should be informed. Similarly he should be told if,' after

having once ceased to consist of pure blood, the discharge should again assume

that character.

The discharges after labor are termed the lochia; they sometimes last only

a few days, and at other times continue for three or four weeks. They vary,

too, in quantity in different women, even when they are quite natural and

When they have passed through the changes I have named, they

ought presently to cease, and if, instead of doing so, they continue, and if,

healthy.

especially, they become purulent in character

—

that is, if they contain matter

an abscess an examination is necessary and the medical attendant

must be informed.

On the other hand, it is not very unusual for the lochia to cease rather

early and suddenly, and although this often causes alarm both to patient and

nurse, it need not do so provided there is no other sign of ill-health, such as

like that of

—

shivering, thirst, and feverishness.

For the first three days after confinement a patient should on no account

be raised to a sitting posture lest an attack of flooding should come on, or fainting and even sudden death occur. There is not the same danger in allowing

her to turn on to the hands and knees; indeed, I have already said that this

posture may be resorted to in the event of any difficulty in using the slipperpan in the ordinary way.

After the first three days, provided all is going on favorably, this rule as to

the level position may be relaxed a little, by allowing the patient to be propped

up by means of pillows or a bed-rest while she is taking food. At all other

times, however, she must continue to lie down until the ninth day, when she

may be assisted or carried to a couch and allowed to remain upon it for an hour

or an hour and a half. At first very little dressing ought to be attempted on

these occasions, the patient being protected from cold by wearing a warm

dressing-grown, or by having a good blanket thrown over her. The length of

time she is allowed to be out of bed may be increased day by day; and on the

twelfth or thirteenth day she may be fully dressed.

The temperature of the

room must be regulated most carefully when the patient first leaves her bed, it

being much more important for the room to be well warmed then, than during

the time she remained in bed.

Should there be a suitable sitting-room on the same floor, the patient may

take advantage of it as early as the fourteenth day; the lying-in chamber being

NURSING.

299

meanwhile thoroughly freshened by opening the windows, spreading out the

bedclothing, and leaving the mattress or bedding uncovered for some hours.

If, on the other hand,

the only available room is downstairs, it will be prudent

to postpone the change for a few days longer.

If it happens to be mild, bright' summer weather, and the patient's recovery

has been rapid and satisfactory, the medical attendant may, in an exceptional

case, consent to her taking a short walk or drive, at the end of three weeks.

After confinement a patient's linen requires to be frequently changed, both

and her own comfort. The patient must on no account be

allowed to sit up or make any exertion while the clothes are being changed;

for health's sake

the nurse must take off the soiled clothing by drawing down the sleeves from

one arm, gathering up the clothes on that side into a handful, passing them

gently over the head, and then drawing off the sleeves from the opposite arm.

The clean linen, well aired, must then be put on as the patient lies.

The first binder should always be placed next to the patient's skin; after

the first twenty-four hours this is a matter of less consequence. Each morning

during the first week a clean binder should be applied with moderate tightness,

the nurse re-adjusting it from time to time during the day in case it should

become wrinkled or loose.

The patient's hands and face should be washed, and her hair straightened,

as far as is possible without raising her, every morning.

The hands and face

having been attended to, the external genitals should be thoroughly cleansed

over a bed-bath by means of a sponge and some water. In the absence of a

bed-bath, a large slipper bed-pan may be made to answer the purpose, and if

neither is obtainable, the patient must be made to turn on to the left side, with

the thighs close to the edge of the bed, and the knees drawn up, when, the bed

being duly protected by means of a rubber and warm folded sheet, the nurse

can proceed with the sponging in the manner ordinarily adopted immediately

For the first few days, while the lochia are somewhat abundant,

after labor.

it is well

to repeat this process again in the evening.

Should the nurse while bathing the patient, discover a wound or raw surface, or any unusual swelling, she must quietly mention it to the doctor at his

next visit; and so, too, if she finds any piles protruding. In the event of the

patient complaining of severe pain from piles, the nurse must frequently foment

the part, or apply a bread-poultice, until she receives instructions from the

medical attendant.

Vaginal injections and douches are only to be used under medical direction.

The mind requires rest equally with the body.

No painful news, or other

The visits of

must be entirely forbidden, except in the case of

exciting or disturbing influences, should be allowed to reach her.

friends to the lying-in room

those who have obtained special permission.

It should never be forgotten that a peculiar and distressing form of mental

derangement is liable to attack lying-in patients. Hence, if a nurse finds her

patient irritable in temper and difficult to manage, she must avoid anything like

contention or direct contradiction.

By a firm, quiet, decided manner, a good

nurse will be able to carry her point without exciting her patient.

DR. CEASE'S RECIPES

300

As the patient grows a little stronger, there can be no objection to her

occupying herself while in bed, if she is wishful to do so, with a little plain

sewing or fancy work, and now and then with a little reading, so as to make

the time pass more agreeably.

With regard to diet, many medical practitioners have rules of their own,

which the nurse must always be prepared loyally to carry out. It is not now

generally thought necessary for patients to be restricted to tea and gruel for a

whole week. When a nurse is left to her own discretion she will find her

patients recover their strength most rapidly by being allowed some variety in

Boiled milk should always enter largely into

their food from the beginning.

An occasional cup

the dietary of a woman who intends to suckle her child.

of good black tea is generally very grateful, with or without a little biscuit,

toast, or bread-and-butter.

From the first, beef-tea, chicken, mutton, or veal

broth, rice-caudle, milk or oatmeal gruel, and other simple fluids, are perfectly

allowable.

If all is going on well, and the bowels have acted, there is no harm

—in case the patient expresses a desire for more solid food—in giving, even on

the second or third day, a slice of chicken, or tender roast beef, or a mutton

The diet, indeed, at this time needs to be nutritious and plentiful, while

chop.

may safely be regulated very much according to the patient's inclinaNo stimulants of any sort, however, must be given, except under medi-

its kind

tion.

cal direction.

A nurse should not give opening medicine on her own responsibility. The

medical attendant will order what is necessary and state when it is to be

given. Very often, instead of medicines, he will prescribe a simple enema of

soap and water.

—

Flooding after Delivery. Whenever an attack of flooding comes on

during the period of lying-in, the nurse must at once send for the medical

attendant, stating cleaiiy her reasons for sending, in order that he may know

what will be required. In the meantime she must unfasten the binder, and

make firm pressure with her outspread hand on the womb, which she will have

no difficulty in finding, as it will not yet have returned to its natural size and

position.

She must also apply cloths dipped in cold water, or in vinegar

and water, to the external genitals, keeping them applied not longer than a

minute or two at a time. Where the flow is great it will be right for the nurse

to try to check it by taking a dry napkin and pressing it firmly with her hand

against the external parts, while the other hand is still engaged in compressing

the womb from above. The patient must, of couse be kept all this time strictly

lying down, with the head and shoulders low, and cool, fresh air must be

admitted through the open window.

The occurrence of a shivering fit, especially if it is a severe one, or is followed by others, ought always to be regarded seriously. No time should

be lost in acquainting the doctor, and the nurse must meanwhile do all in her

power to produce a feeling of returning warmth in her patient. With this

object, a warm bottle should be put to her feet, an additional blanket thrown

over her, and a cup of warm tea administered. This event is often the sign of

NUMSING.

301

approaching illness that, when it has shown itself, the patient should be watched

with the utmost anxiety.

The secretion of milk is not usually established until the second or third

day; now and then, however, it makes its appearance earlier. This event is

sometimes accompanied with a little constitutional disturbance, which soou

When the breasts are becoming so full and hard as to be painful,

subsides.

great relief will be aiiorded by fomenting them every few hours, and supporting them, in the meantime, as in a sling, by a handkerchief tied over the opposite shoulder. (See page 193.) This condition will generally soon subside if the

Nurses must beware of meddling too

child be applied at regular intervals.

much with the breasts, and especially avoid rubbing them, except under special

The nipples and surrounding parts should be

direction from the doctor.

carefully washed each time the child leaves the breast, and should be excluded

from the air by covering them with a small piece of linen rag on which a little

vaseline or simple ointment has been spread.

As soon as it becomes clear that the supply of breast-milk is insufficient,

it is unwise to keep putting

the child to the breast, as this only produces irrita-

tion and is very liable to set up inflammation

and abscess.

Similarly, if the

nipples are extremely sore, so that, even when they are protected by a nippleshield, the application of the child is attended each time with intense pain, or

if

they are so depressed that neither the efforts of the child nor the cautious

use of the breast-pump will draw them out, it is running a great risk of exciting breast-abscess to persevere beyond twenty-four hours in an attempt to

suckle.

If the nurse notices a patch of redness on a patient's breast, and finds that

the skin at that spot is painful and tender to the touch, she should take means

to acquaint the medical attendant as soon as possible, for an abscess has actuit should be opened with as little delay as possible, lest it spread

and become much more formidable.

ally formed;

—

Still-Born. When the child is still-born, or when, from any other cause,

going to be suckled, there is often great anxiety expressed about the

it is not

dispersion of the milk.

It is astonishing, however,

absorbed if left to Nature.

arising

how quickly it becomes

If the patient will only submit to the discomfort

from the fullness of the breasts for a few hours, without insisting on

their being partially emptied from time to time by the use of the breast-pump,

or other similar means, whereby the breasts are stimulated to fresh secretion and

the evil is aggravated, she will soon have the satisfaction of finding them softer

and less painful, and will be amply rewarded for her patience.

Should the

feeling of tension be excessive, it will be best relieved

by hot fomentations

applied every few hours; if not excessive, the application for a few days of

belladonna plasters with a hole in the centre for the nipple, is often all that is

necessary.

In ordering these plasters the nurse should furnish the druggist

with paper patterns showing the size required.

IFOOID IFOI?- THE sick:.

THE SICK-ROOM.—Its Location — A Good Nurse— Pi esb

A-ir—Iiight- Warmth — Cleanliness — Quiet — Food, Drink and

Delicacies, and the Faithful Administration of Medicines, are

of the utmost importance, aud will each receive consideration.

But, in accord-

ance with the design of this work, the essentials only will be pointed out, the

minor details, or little things, must be left to the judgment and " common sense''

of the nurse or head of the household, to be met as best they can by the conveniences at hand or the means of obtaining them.

I.

Location of the Sick-room.

—In summer,

sick-room be on the north side of the house

;

if it be possible, ^et the

in winter, upon the south

avoid the mid-day heat of summer and the cold blasts of winter.

— to

And also, if

there is a room in the house having a fire-place, give it the preference, as' it is

considered the best means of aiding ventilation and providing artificial warmth

when needed.

And, if the windows do not admit of lowenng the upper sash as

well as to raise the lower ones, prepare them at once to allow this movement.

Further on, you will see, under the heads of " How to Produce the Temperature of Sick-rooms," and " Ventilation of Sick-rooms," where the necessity of

this is fully explained.

—

A

II.

Good Nurse. We have so often heard the expression: "If

Mr. Blank had not had the best of nursing, he would never have got well."

Knowing that very much depends upon it, I say, get the best nurse that

your means can obtain; then see and know for yourselves that they carry out

your, or the physician's directions faithfully; for a physician's prescriptions, nor

your own desires or directions, are of any account unless they are faithfully followed: But, of course, much of the details must be left to the nurse, hence the

necessity of getting one of sound judgment and considerable experience, if

possible.

—

Fresh Air. Although fresh air is essential in a sick-room, yet a

must not be allowed to strike upon the patient; hence the necessity, in

small rooms especially, of having the means of raising and lowering the sash,

III.

draft

either for ventilation or to reduce the temperature.

The temperature of the

sick-room, in all ordinary cases of diseases, had better be kept as near 60° to 65°

Fah. as possible, by opening or closing windows, or by raising the

lessening

let

it

me say,

— either, or both, — as the necessity of the case requires.

the day has gone past

" night-air " has any weight

of the year requiring

it,

— pure

is

when

the great

fire

or

And,

"bug-a-boo" against

night-air, properly managed in the season

far better than the stifled or suffocating air of

302

FOOD FOR THE SICK.

80S

a close sick-room; ventilate and reduce the temperature always as needed,

Keep the air pure by carrying out of the

and, of course, with proper care.

room any and all vessels de chambre as soon as used, no matter how small the

discharge may be.

Never bring a slop-bucket into the sick-room, as the pour-

ing out, rinsing, etc., is not only very contaminating to the air, but annoying to

the patient.

IV.

Light.

— If a room for the sick has been chosen which will allow

proper ventilation and fresh air, as needed, through the windows, the light can

easily be governed by the curtains; and it is only necessary to say: allow all the

light that is agreeable to the patient; and, except in nervous or eye diseases, but

little

exclusion of light will be necessary, unless the room

is

on the south or

western side of the house, which is not desirable, generally.

V. "Warmth.. — Under this head it will be necessary to include the temperature of the patient's surface as well as that of the room. The warmth or

temperature of the room being about 60° to 65° Fah. if the limbs are cold, rub

them with the dry naked hand, or wrap in hot, dry woolen cloths, or place hot

bricks, or bottles or jugs, filled with hot water, or, what is still better, small

bags of dry, hot sand, made for this purpose, whichever is most convenient or

Comfort is to be sought, no matter how

necessary to keep them comfortable.

much labor and trouble it causes; for, unless a genial warmth can be main-

On the other hand, in fevers and

health will seldom be regained.

inflammatory diseases, the surface must be cooled by means of sponging with

cool or cold water with a little whiskey, or what is better, whiskey with bay-inim in

it—sponging sufficiently often to keep down extreme heat. Especially overtained,

come all extremes of heat or cold.

—

VI. Cleanliness. It is claimed that " cleanliness is next to Godliness."

Whether this be a fact or not, it is absolutely necessary, if it is desired to restore

the patient to health in the least possible time, that not only the sick-room be

kept clean, but the bed, bed-clothing and wearing apparel be kept neat and

clean;

and the patient, also, must have such frequent washings or spongings as

will keep the pores of the skin open, that the general exhalations, perspiration

sensible or insensible, as when sick an odor, also, may not only pass readily

through the pores, but to provide, in disease, for tlie escape not only of a lf.i^er

amount than usual but that of a more offensive and injurious character, if left

to be re-absorbed from the surface or clothing.

VII.

Quiet.

If the patient is very sick, absolute quiet is very essential.

If a person is once admitted to the sick-room who is found to annoy the patient

by long talking, or, in fact in any manner, they must not only be asked to retire

but never be admitted again.

What is necessary to say, speak in a mild but

perfectly distinct voice, and never allow whispering in a sick room for any purpose whatever. If there are any secrets to be kept from the patient, no hint of

them, or whispering about them, should ever occur in his hearing; yet if it is

believed the patient can not live very long, I would most certainly inform them

'tis cruel and unjust to withhold it.

of thia belief

Any continuous noise.

—

—

DB. CHASE'S RECIPES.

304

although slight in itself, soon becomes annoying to any nervcms person, and

few sick persons, indeed, who do not soon become more or less

there are but

Be firm, but kind, in all your relations with the sick.

nervous.

Give them to

understand you know best, and what you know to be best to do you are going

to do and what you know they ought not to do, you are not going to allow

them to do, but in all the kindness possible, and their acquiescence may soon

;

be expected. Rustling silks, squeaking shoes and the rattling of dishes must

not be allowed in a sick-room.

Food, Drink and Delicacies.

While the patient's condition

and substantial food, and the usual drink, as tea

and coffee, not too strong, it is best they should have them; but with the weak

and debilitated the delicacies must take their place; and I desire to call especial

attention to, and to give my sanction and advice, that if any special thing 'is

craved, be it food or drink, I would most positively allow it, in moderation.

We have all heard of the cravings, in olden times, of fever patients for cold

having been obtained stealthily

water, and the cures brought about from its

VIII.

will allow them to use plain

against the commands of the physician

;

but there has recently come to my

knowledge a case wherein the life of a typhoid fever patient was saved by

drinking two quarts of hard cider, which he had craved and repeatedly called

for, and when he got hold of the pitcher he would not let it go until it was

empty. I do not call this, however, "in moderation," but the patient was

stouter in his desperation than the nurse and the physician who had allowed it

to be brought, so no one could have been blamed even if it had killed rather

than cured the patient. Do not understand this, however, even in desperate

A small glass, and often, as long as the craving

cases, to be a pattern drink

continues, would be the safer plan with any drink.

But both food and

drink should be given regularly in reasonable quantities. And to aid the

—

nurse or family in

this,

the following recipes, or receipts, may be resorted ta

with confidence

" Disinfectants."

and

general

satisfaction.

To

purify

sick-rooms,

see

BEEF TEA, ESSENCES OP BEEF, ARTICLES OP DIET,

DRINKS, ETC., FOR THE SICK.

1.

Beef Tea.-^Take lean beef, %, lb.

;

cold water, %, cup; a little salt,

—

Directions Cut the beef into small bits % or %

inch squares^and see that no particle of fat adheres to it; put into a bottle with

the water and cork, placing the bottle in a pan of cold water upon a stove, and

pepper, mace, or nutmeg.

as soon as it reaches the boiling-point, move it back, but keep it near the boiling-

point for 2 hours; then strain, pressing out the juices, and season with a little

salt and a sprinkle of

pepper, mace or nutmeg, as preferred by the patient.

2.

Beef Tea—Improved Flavor, by Broiling. — Take a nice steak

particles of burned

Have a gridiron, perfectly clean —

and remove

the

all

steak

fat.

all

may easily be removed from the bars by placing it in hot water a few

minutes when first taken from the fire; then scrape, or what is better, use a stiff

Have a very nice fire of coals, and place the

brush, kept for this purpose.

FOOD FOR TBE 3ICK.

305

steak upon the gridiron and broil, as usual, till it is ready to turn; then take

off, having at least a qt. bowl with 1 pt. of boiling-hot water In it, and keep it

standing by the fire, or on the back part of the stove, to keep it hot.

Place the

steak, when the first side is nicely broiled, in this bowl of hot water, and press

—

—

knife and fork a stiff spoon is the best to extract the juices of the

Kepeat this broiling and pressing several times, turning the steak each

it with the

meat.

and strength of the steak are extracted; and if, at the

cut into squares of an inch or a little more, and each piece

time, till all the jjaices

last,

the steak

is

its virtue, or strength, vdU all be obtained.

It

looks much like wine of itself; but still, if a teaspoon or so of wine is added to

pressed in a lemon-squeezer,

what may be taken at any one time, it will not injure the most delicate stomach,

but will be borne, even by a delicate stomach, better than bread-water, while it,

of course, is much more nourishing; and, if properly seasoned, as suggested in

No. 1, it will be relished by the patient much more so from the broiling.

—

3.

Essence of Beef. — The real essence, or nourishing properties of

beef, is obtained the same as directed in No.

1, except that no water is to be put

into the bottle, and the boiling may need to be continued an hoxir or two longer;

then the juice or essence pressed out, and a little wine added when desired or

needed; also a touch of salt and pepper; or, if mace or nutmeg is preferred,

there is no reasonable objection that can be offered against their use.

Remarks. The foregoing are the plans which have been heretofore followed in extracting the strength or essence from beef for the sick. But as the

science of medicine, especially the chemical department thereof, advances, it

has been prolific in improvements, among w^hich that of not boiling, but steeping, either in cold water, or using heat only of a moderate degree, or not above

100° to 135°, so as not to cook the albuminous (like white of egg) portions of

the meat in making beef tea, or extracting its juice.

New

Process.—Beef tea, if rightly

4. Beef Tea for the Sick—

made, may be received with benefit by a stomach which would reject any

nourishment but skill in preparing it. is not universal among nurses. The two

following receipts may be relied on as among the best that can be devised:

Beef Tea (with moderate warming up after cold steeping). Take 1 lb.

of the best beef; cut in thin slices and scrape the meat fine; put with a saltspoon of salt into 1 pt. of cold water contained in an earthen bowl, and let the

mixture stand 2 or 3 hours, stirring it frequently; then place it in the same vessel covered, on the back part of the range or stove, and let it come very gradually to a blood-heat and no more.

It has been found that 135° of heat does not

set or cook the albumen

blood-heat is only 98°.

Any higher temperature

;

—

—

would injure the nutriment, or nourishing properties; then strain it through a

fine sieve or muslin bag, and it is ready for use.

The making of beef tea is not

Some chemists tliink it better to be

made without heat, with the addition of the muriatic acid, which is a component

a cooking process, but a steeping process.

part of healthy gastric juice, as follows:

5

Beef and Other Meat Teas Without Heat.

fresh beef, mutton, poultry or

20

—

Take % lb. of

game (the lean part only), minced very fine;

DR. CHASE'S RECIPES.

306

place it in 14 ozs. of soft cold water (2 or 3 tablespoons less than 1 pt.) to which

has been added a pinch or about 18 grs. of table salt, and three or four drops of

muriatic acid

;

stir all with a wooden spoon, (on account of the acid,

iron) and set it aside for 1 hour, stirring

gauze, or a sieve, and

it

which rusts

occasionally; then strain it through

wash the residue left on the sieve by means of 5 addi-

tional ozs. of cold soft water, pressing it so that all the soluble matter will be

removed from the residue; mix the two strainings and the Extract is ready for

It should be drunk freely every two or three hours.

Remarks. The properties taken from these last two receipts are largely borne

out by a well known article made at Richmond, Va., by Mann. S. Valentine,

called " Valentine's Preparation of Meat Juice," which, in using, is not to be

heated above 130° F., and that only upon a water-bath to avoid the possibility ot

use.

—

over-heating

—the preferable way being to use

it

cold, even with ice when this

by him to be crumbled into the Meat

Juice as a savory diet for the sick, as one becomes able to digest more solid

This, of course will hold good with any of the above or other juicy

food.

The

foods, or soups, or essences, etc., prepared from any meats whatever.

greatest objection that can be raised against Valentine's Meat Juice is its cost.

is desirable.

Stale bread is recommended

He claims to have concentrated the strength, or virtues, of 4 lbs. of beef

into a 2 oz. bottle which, usually, retails at

prevent

its

use by the sick poor

— the sick

$1.25,

rich,

which would

certainly

of course, can indulge it.

But from its array of testimonials from the most popular physicians in America

and Europe, and by those connected with insane asylums, hospitals, etc., it

must have proven an exceedingly valuable preparation and I will close my

remarks upon this subject by saying I have not referred to it for the benefit of

the manufacturer (for he knows not of this reference at all), nor am I paid for

it, only as it may do good to the people in observing the value of the cold process, as it may be called, of the last two receipts, and being " posted," as the

saying is, upon the best ways or plans of preparing food for the sick. This

Meat Juice was on exlubition and received awards at the International Exhibition in '76 at Philadelphia, and in '78 at Paris, and although he does not give its

mode of preparation in his circulars, yet this must have been given to the commissioners at these exliibitions, for the awards were:

" For excellence of the method of its preparation,