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NATIONAL LIBRARY OF MEDICINE
             Washington
Founded 1836
U. S. Department of Health, Education, and Welfare
             Public Health Service
 
 
 
 
 
 
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Sfi&.-'^f'itf  ,  ^'e/c-*-   ^              ':~J
Nurses  Journal
COMPILED FROM THE NOTES OF
HELENA  F,  RICHTER,
          A TRAINED NURSE.


Graduate of " The Woman's Hospital," State of Illinois,

            CHICAGO. ILL.
   "Any book on Nursing, clearly and sensibly written, ought
to be a successful book, so long as there are sick people to be
taken care of."
                  E. C.  DUDLEY, M. D.,
          Prof, of Gynacconology, Chicago Medical College.
" A perfect woman nobly planned
 To warn, to comfort, and command;
 And yet of spirit still and bright,
 With something of an angel's light."
            —Wordsworth.
k

                   JAN 2*18!&J
Pressor S. I. Bradbury & Sons,  '^f/y  ,    Id0,/
    7S-S2 Fifth Avenue.    ^^P * F W k $ W y1!**
CHICAGO:
      1884.

..■• '^CAU?y 
      wy

      S73-K




     COMPILED BY
META  WELLERS.
  Entered according to Act of Congress, in the year 1884, by


         MBS. H, F. KICHTEE SPALDING,


In the Office of the Librarian of Congress at Washington, D. C.
          PUBLISHED BY

HELENA F. EICHTEE SPALDING,

    7§ Fifth Ave., Chicago, III.
 
DEDICATION.
           A NURSE'S JOURNAL,
A BOOK CONTAINING FULL AND EXPLICIT INSTRUCTIONS FOR NURSING
     THE SICK, PREPARING FOOD FOR THE SICK, SUGGESTIONS
             TO NURSES, VALUABLE HINTS, ETC.
                      — TO—

THE EMINENT SURGEON AND PHYSICIAN, CHIEF OF THE MEDICAL STAFF
      OF THE WOMAN'S HOSPITAL OF THE STATE OF ILLINOIS,

                  W.  H. BYFOED,

        THIS VOLUME IS RESPECTFULLY DEDICATED BY

                                    THE AUTHOE 
 
TABLE OF CONTENTS.
                                            Page
Preface .....................................   7
Professional Nurses..........................  11
Instruction to Nurses........................  17
Treatment of Individual Cases...............  31
Valuable Hints..............................  75
Glossary—Questions.........................  89
Glossary—Answers..........................  95
Preparing Food for the Sick.................. 113
Dishes for the Sick.......................... 115
Drinks for the Sick.......................... 125
Weights and Measures....................... 129
Testimonials................................ 131
General Index............................... 133 
 
PREFACE.
  The author of this little work, Helena F. Eichter
Spalding, is the  daughter of a Methodist minister.
She was born in Berlin, Prussia, 1846, and is a lineal
descendant on the paternal side of the famous Jean
Paul Eichter.   She was but three months old when
her father came  to this country.  When called to
the ministry  he gave up a lucrative business and
traveled as an itinerant minister, first, over the East-
ern States, and later as a circuit rider over the North-
western States,  exposed to the  storms of  winter,
poor food and insufficient  shelter for  himself and
horse among the pioneer settlers.  He was at the
bedside of the dying, cheering them  as they de-
scended into the valley, and said the last prayer over
their lonely graves.  To the living he proclaimed
the Gospel, either in the district school-house or at
their homes, in  their native tongue.   The  meagre
salary lie received scarcely sufficed to  support his
large family, and Helena was early thrown upon her
own resources.
  She engaged at an early age in teaching wherever
her father's work called him.  Devotion to her work
made her  a successful teacher.   Conscientiousness
was ever her leading trait of character. 
Vlll
PREFACE.
  When the civil war broke out she was seized with
an irresistible desire to become a hospital or field
nurse.  From this she was deterred on account of
her age, being too young for the work.
  Her  father not only ministered to  the spiritual
wants of his flock, but, also, to their physical.
  A chest of medicine and numerous medical works
ranged alongside of his theological works.  He was
as frequently called upon for diseases of the body as
for the soul.  The looking up of symptoms and writ-
ing out prescriptions was not unfrequently left to
Helena; she, in consequence, became  familiar with
medical terms and the nature and treatment of dis-
eases, thus fitting herself for her chosen  work.   In
the arduous profession of teaching she became fa-
miliar and in contact with all classes of people, and
learned self-control and patience, the chief requisites
of a good nurse.  Dr. Byford said: " The  same qual-
ities that made you a successful teacher  will make
you a good nurse."
  As soon as " The Womans'  Hospital of  the State
of Illinois " was opened she entered it,  and was  one
of the first graduates from it.  She served her term
in the hospital where she was  a favorite with  the
patients, who always begged for her, preferring her
above  others.   In  utter forgetfulness of self  she
stood faithfully by them through painful operations,
or sat with them through the silent watches of  the
night,  quietly  repeating to the  restless, sleepless
sufferer little gems  of poetry or passages of scrip- 
PREFACE.
ix
ture whilst smoothing the pillow or administering
with tender solicitude the medicine or cordial. Many
who may read  this book will no doubt recall her
hopeful smile and soothing care.
  That these pages may strengthen, inspire and more
fully prepare noble women who devote their lives in
order to become ministering angels to suffering hu-
manity, is  the  earnest wish of the compiler of this
little volume.
                                The Compiler. 
 
PROFESSIONAL NURSES.
  Woman is by nature adapted to nursing and car-
ing for the sick.  Her quick intuition, ready sym-
pathy and patience, all fit her for her work.  The
most ancient physicians or healers of all countries
were women.  This, no  doubt, resulted from the
fact that they were the priestesses of the heathen
gods, at whose altars  the remedy for every disease
or plague which fell upon mankind was sought, be-
cause disease was regarded as a punishment of the
gods.  A  diagnosis was given in the form of a
prophecy, and they became  familiar with the vari-
ous ills that afflicted the people, and found  reme-
dies for the same in the roots and herbs found in
their primeval forests.  The  people in turn adored
them as superior beings, the '''wound-healing fairies"
who, ever young and  beautiful, were borne on the
wings of  the wind, and appeared at the side of the
sufferers who called upon them.
  With the advent of Christianity they were super-
ceded by the  Sisters of Charity, that with an heroic
devotion to duty, have ever been the first upon the
field of battle, and the last to desert a city stricken
by a plague.
  The vow of " Chastity, poverty and obedience," 
Xll            PROFESSIONAL nurses.
renders her invulnerable to temptation or hardship,
and  superior  to every  emergency.  The  future
never disturbs her, for when too old to serve she re-
tires to the Mother's Home to end her days.
  With the history and labors of Florence Night-
ingale we are all familiar.  She  may be considered
in one sense as the founder of The Training-Schools
for Nurses.
  In 1873 the Bellevue Training-School for  Nurses
was founded and Dr. W.  Gill Wylie, who went to
Europe, brought a letter from Miss Nightingale in
which she set forth her ideas upon the management
of a school for nurses.
  Many oppositions  were encountered before the
enterprise succeeded;  the patients were  of  the
worst class,  and the duties of the nurse too ardu-
ous, it was believed by many physicians, for refined
educated women to undertake.
  The plan  developed by Miss  Nightingale,  and
adopted subsequently, demanded good education,
strong constitution, freedom from physical defects,
including  those of hearing and sight and unexcep-
tional references,  on the part of  the applicant, con-
sequently  but few made application, and many of
the same  were  found incompetent for the work.
The course  of training includes dressing wounds,
bathing and caring for helpless patients,  making
beds,  managing  positions, preparation and man-
agement  of  bandages, making  rollers  and lining
of splints,  and  administering  anaesthetics.  She 
PROFESSIONAL  nurses.
xm
must also learn to cook and serve delicacies to the
patient.
  In order to complete the course and receive a di-
ploma, still  more is required, viz :  Exemplary de-
portment, patience, industrv and obedience.  The
nurses are boarded and lodged free  of charge dur-
ing the course and receive a small sum monthly to
defray their actual expenses.
  When the school was first opened only the female
wards were supplied  with nurses,  but  as disease
makes no  distinction of sex, it was  found impossi-
ble to complete the nurse's training and  education
without practice among sick men, so, early in its
career, the male wards were included.
  A few  years ago a  Training-School for Nurses
was opened in connection with  the Cook County
Hospital, in Chicago,  and several graduates from
Bellevue were placed as  head nurses in  charge of
the work.   The same  opposition had to  be over-
come ; passing through the male wards the nurses
were  hissed by the patients, but they knew their
work and  performed it so well that the  school is
now in a flourishing condition.
  " The Woman's Hospital of the State of Illinois "
is especially devoted to the treatment of the  dis-
eases peculiar  to women, irrespective of creed or
color;  to the  clinical instruction of students of
medicine; "to  the practical  training of  nurses.'''
At  the expiration of a course a diploma signed by
the medical staff is awarded, and the nurse is quali- 
XIV           PROFESSIONAL NURSES.

fied for all the duties which come within her pro-
vince.
  In course of time it is hoped trained nurses will
be introduced into all the County Poor Houses
and  other charitable institutions  of  the land  so
that cleanliness and comfort, instead  of squalor
and neglect, may cheer the poor and forsaken.
  The profession of the  trained nurse will rise in
public estimation  so soon as  her services become
more thoroughly known. The time is at hand when
the Sairy Gamps, and " old granny nurses " must
"fold up their tents like Arabs and  quietly steal
away."
  The success and reputation of the physician and
surgeon depends largely upon the nurse, and  no
eminent surgeon will perform an operation without
the aid of a trained nurse.  Medical skill is useless
against incompetence and neglect.
                       Meta Wellers,
                                 Chicago, 111. 
 
 
INSTRUCTIONS TO  NURSES.
  The nurse should be provided with a hypodermic
syringe, catheter of a soft flexible nature, or a sil-
ver one, a clinical thermometer, rectal tube, sur-
gical scissors and forceps, dropper, measuring glass,
glass tubes for drinking, and absorbent cotton suffi-
cient for making tampons.  The end of the  cathe-
ter should be rubbed with sweet oil, or vasaline, be-
fore  used, and  thoroughly cleansed in carbolated
water immediately after.
  It should be inserted with the greatest  care and
removed gently; not with a sudden jerk.
  In the use of the hypodermic syringe be careful
not to pierce much below the  cuticle. Pinch the
skin up firmly between the fingers, then insert the
needle obliquely as far as the  first incision marked
on the needle.
  If the patient is too sick to have the thermome-
ter placed under the  tongue,  in order to  ascertain
the temperature, place it under the arm-pit.
  Before using the rectal tube be careful to oil it
well and cleanse thoroughly in carbolated water.
  In administering medicines always use the meas-
uring  glass  or  dropper.  Never awaken a patient
      2 
18
A NURSE'S  JOURNAL.
out  of a sound sleep, unless by the order of the
physician.   A sound sleep is  better than medicine.
  It is much better to feed a patient through a tube
if the food is in a liquid form than with a spoon.
  A silver spoon with  a perforated bottom and a
long handle is an  excellent  thing.  Many nurses
provide themselves with one.  They may be had at
any first-class drug store.
  Always serve the food neatly on a tray covered
with a spotless cloth,  and put the gruel or broth in
a pretty china  dish; it will relish better.  Do not
taste of anything you may be preparing in the pres-
ence  of the  patient, it frequently  sickens  the
patient, and the food, if taken, will do more harm
than good.
  Be careful to follow to the letter the instruction
.of the attending physician.
  In preparing medicines be  careful  to  disguise
powders as much as possible, and prepare liquids in
such a manner as to make them as little disgusting
as possible.   There is much  more art  in covering
powders than is generally supposed, any medicine
is less nauseous taken  in  a  liquid than in a half-
covered powder.  Make yourself acquainted  with
the good and bad effects of the medicines that are
being taken by the  patient, that you  may  exercise
discretion in the administration of them.
  Be always ready to humor a sick person in every-
thing that  will do them no harm; never  think of
your own trouble,  you  are paid to serve the sick. 
INSTRUCTIONS TO  NURSES.
19
A person with a gloomy, morose disposition is un-
fit to take charge of the sick.  A nurse soured by
trouble, carrying on her  face the traces of a life
sorrow, is wholly unfit for her office.   Such a dis-
position will affect a sick or nervous patient most
unfavorably.   Sympathy is a quality to  be appre-
ciated in a nurse but rare judgment must be exer-
cised in the expression of  it.
  Avoid gush.  If the patient's nervous restlessness
shows itself  too much, in undue talking, the nurse
must be quiet; avoid conversation.
  If inclined to despondency she may tell cheerful
stories.
  Turn and shake up the pillows as often as they
become heated.  Keep the bed clothes in order, and
in numberless trifles make the sufferer comfortable.
It is only those who have lain for weary months on
beds of suffering who  will understand and appre-
ciate these minute details of  instruction to nurses.
The sick  are easily affected by outside influences,
and by the manner of those who  wait  upon them.
A pair of  squeaking shoes or a  rustling dress may
drive a patient to the edge of distraction, and the
labor and exaggerated effect made by the nurse to be
quiet are as hard to bear as the  squeak and rustle
combined.
  Avoid taking hold of the bed-posts: Patients who
are suffering from nervous diseases often suffer acute
agony from persons merely supporting themselves
by the posts or leaning against the bed, or over the 
20
A NURSE'S  JOURNAL.
foot-boards.  Eocking back and forth in a rocker is
often distressing to an invalid,  who cannot avoid
watching the motion of the  chair without closing
the eyes, and often becomes half crazed before speak-
ing of it.  Motions of the body, trotting of the feet,
scraping the throat, blowing  the nose, picking the
teeth,  must  be  strenuously avoided by the  nurse.
The more quiet the nurse the better.
  Eeading in a low, well modulated voice, combing
the hair, gently rubbing the forehead or the palms
of the hand, will quiet a patient and induce sleep
when anodynes fail.
  None but the  medicines in use should be in the
sick room, and those out of the patient's sight.
  All offensive clothing,  etc., etc., should be imme-
diately removed.  Offensive odors may be removed
by burning  coffee, cubeb berries, or pouring a few
drops of vinegar on  a hot shovel.
  Fumigation or disinfectants should not be used in
the sick room.  As a  general  thing whatever has a
tendency to poison the atmosphere should be imme-
diately removed; discharges of the patient, etc.
  For cleansing basins chloralum is excellent.  Cop-
peras placed in  a jar, or dish, purifies the air, and
absorbs all odors.
  Soiled  linen should be sprinkled with carbolated
water before it is sent to the wash.  In cases of
abscesses where iodoform is used, the disagreeable
odor may be overcome by putting a  vanilla bean in
it.  Split the bean. 
INSTRUCTIONS TO NUItSES.
21
  The passages of a patient must be immediately re-
moved after evacuation and the linen changed every
two or three days.  The clothes should be well aired
and thoroughly dried before using; when possible
well sunned.
  In  diseases of long  standing and in  contagious
diseases, the  whole bed  and bedding  should  be
changed once or twrice during the disease.
  No food of  any kind should be kept in a sick room
or in its vicinity.
  Unless disagreeable to a patient light should be
freely admitted, especially the  sunlight.
  Above all, the nurse should follow out implicitly
the directions of  the physician, and not take it
upon herself  to make any changes  or  prescribe any
remedies or give other directions, unless absolutely
necessary.  She should not conceal from the phy-
sician any  changes which have been  made in  the
management  of the patient during his  absence.
  Many times difficulty is experienced in changing
the bed linen with a  patient in bed, though nothing
is easier when one  understands how to  proceed.
Move the patient  as far as possible to  one side of
the bed, and  remove all but  one  pillow.   Untuck
the lower sheet and  cross-sheet and push them to-
wards the middle of the bed.   Have  a sheet  ready
folded or rolled the wrong way, and lay it on  the
mattress, unfolding it enough to tuck in.  Have the
cross-sheet prepared and roll it also, laying it over
the under one and tucking it in, keeping  the unused 
22
A NURSE'S JOURNAL.
portions of both still rolled.  Move the patient over
to the side thus prepared for him, the soiled sheets
can then be drawn out and the clean ones com-
pletely unrolled and tucked in  on the  other side.
The coverings used need not be  removed while this
is being done; they can be pulled out from the foot
of the bed and wrapped about the patient.  To take
off the upper sheet remove, spread and place clean
sheets  over the blankets, securing the upper edge
to the  bed with a couple of pins, then stand at the
foot of the bed and draw out the soiled sheet and
blankets; replace the latter and put on spread; lastly,
change pillow cases.
  Air  cushions may be propped under the patient
when change of position is desired, or the rubber bed
pan may be blown up and placed under  the patient.
Cushions of  horse hair will answer the purpose.
  In giving injections or douches, gradually increase
the temperature;  the same caution must be taken
with sitz bath.  In  giving a sitz bath be careful to
cover the shoulders of the patient to  avoid colds.
In giving enemas use " Eichter's Syringe," as the
quantity can be estimated to a nicety.  It holds ex-
actly six ounces.  It can be had at E. H. Sargent's,
125 State  street,  Chicago, who is the sole  agent
for it.

                  BATHING.
  Never uncover the patient more than is absolutely
necessary  when giving a bath in bed.  Bathe under- 
INSTRUCTIONS TO NURSES.          23
neath the bed clothes, rubbing gently and quickly.
The temperature of the water must be governed by
the feelings of  the patient.  The best time for giv-
ing a bath is in the morning.

                 POULTICES.
  Poultices are of various kinds, and must be soft
and moist,  and  sufficiently thick not to run over the
surrounding parts.   They  must be  applied warm
and removed before dry.
  They are used for several purposes:  to scatter
tumors, to  hasten suppuration, or the formation  of
matter; to lessen inflammation, for stimulating and
to check mortification.
  If a  soothing effect is desired poultices made  of
slippery-elm, bread, flaxseed or any substance which
will retain moisture and warmth may be used.
  For stimulating poultice mustard and carrot poul-
tices may be mentioned.
  To make  a carrot poultice boil two or three car-
rots until soft, then mix with a small  quantity of
elm bark or flour.   Used for ulcers or tumors of a
painful character.
  Charcoal  poultice: Take one ounce of bread and
five ounces of hot water; let it stand for ten min-
utes near a fire, then add powdered flaxseed, five
drachms; powdered charcoal, two drachms, and form
a soft poultice.   This is applied to ulcers and  sores
which emit an offensive odor.
  Slippery-elm  poultice: This is made of powdered 
24
A NURSE'S  JOURNAL.
elm bark and sufficient hot water to form a soft mass.
Useful whenever a softening or soothing effect is
desired.  Cheese cloth is the best for poultices.

              FOMENTATIONS.
  These may be either warm or cold; the object is
to diminish inflammation and swelling.  They may
be made of arnica or calendula tincture.
  They should be used in the proportion of ten to
twenty drops of the tincture to half a pint of water.
Cloths dipped in the mixture and frequently wTrung
out are applied and frequently changed.
  Fomentations may also be prepared of hops, tansy
and wrormwood, each equal parts.
  Hops maybe used by dipping, a bag containing
them into hot water and applying to parts affected.
Keep closely covered.

                  BLISTEES.
  Mustard poultices should be mixed with the white
of an egg to prevent blistering.  After removing a
poultice anoint the parts with olive oil or vasaline.
Always place cheese cloth over the poultice to. avoid
soiling the clothing of the patient.
  At night where a fire may not be handy, or in hot
weather, an alcohol lamp may be found serviceable.
Most professional nurses are provided with one.   It
can be folded up into a very small compass.
  Blisters are very painful, and many a patient who
has  borne  severe illness with fortitude, becomes 
INSTRUCTIONS TO NURSES.
25
 frantic from the burning, scalding  sensation of a
 blister.  When  a blister  is ripe prick it near the
 center with a needle and sw,ab the  water up with
 absorbent cotton; do not allow the water to run
 over the edges.   Make a thin cheese-cloth bag and
 fill it with powdered elm; dip it in water  and lay on
 the burning parts;   this will  give  instant relief.
 Change  as  soon as  it becomes  heated, or put the
 thin part of a cabbage leaf into the oven  to wither,
 roll it with a rolling-pin.   Eemove before it becomes
 dry.
  In applying iodine  anoint with  sweet oil or vasa-
 line to prevent itching; and cover with cheese-cloth
 to prevent soiling and staining patient's  garments.
 Use safety pins.

                  PLASTEES.
  In removing plasters be careful not to tear from
 the wound but toivards the wound.
  If the plaster  does not adhere  readily, rub the
 back of it with alcohol.
  In removing a large plaster, wet it slightly,  then
 remove quickly.

         BANDAGES AND .EOLLEES.
  Bandages and rollers must be made of linen or
cotton sheeting  about four fingers in width.  Eoll
together tightly to apply more readily.
  In bandaging an arm or leg commence with the
fingers or toes and work upwards. 
26
a nurse's  journal.
  Bandages must not  be tight enough to prevent
circulation.
  Splints may be made of thin pieces of boards  or
heavy pasteboard.
  The bandage may be saturated from time to time
with arnica lotion or cold water, as directed by the
attending physician.

              THE  SICK EOOM.
  The  nurse should dress in wash material, and
wear white aprons and list slippers.
  She should be even tempered, cheerful and oblig-
ing ;  be scrupulously neat in her person and tidy in
her general habits, possess tact, be quiet and firm,
painstaking and reliable,  and follow  out implicitly
the direction of the attending physician.
  The nurse should always be calm, cool  and col-
lected ; be  able to subdue all unpleasant feelings,
manifesting only a spirit of kindness towards the
patient.
  Self  control is  of the  highest  importance when
dangerous symptoms arise.
  The nurse should be healthy, not liable to sudden
attacks of sickness.
  Much can be done by the nurse to  hasten  or re-
tard the recovery of the patient.
  It is extremely difficult to know exactly what diet
to give to a sick person, very often a slight error in
this respect will bring on a fatal result.  The patient
frequently desires what must be withheld. 
INSTRUCTIONS TO NURSES.
27
  Note every thing given the patient for the in-
spection of the physician.
  The cap is the badge of the profession and should
always be worn when on duty.  Dress the hair as
simply as possible.  When sitting up at night with
a patient be sure to have something provided to eat;
it  will  save  unnecessary exhaustion.  Eemember
that sick people are not necessarily idiotic or im-
becile,  therefore do  not  try to persuade  them,
when they complain, that their ailments are im-
aginary.
  Never relate  your experiences to  the  patient
you  are nursing; professional secrecy on the part
of the nurse is absolutely necessary. The  trust
that is placed  in  her hands must  never be be-
trayed.  Do not  whisper  in the sick room,  or
tell the patient that the doctor said "nothing,"
he will not believe it; better the worst than vague
apprehensions.   Make the family as  little trouble
as possible.
  Every nurse should provide herself with a flannel
wrapper to wear at night.
  Over sleeves of white muslin or oil cloth will be
found serviceable when assisting in surgical opera-
tions.
  Every nurse should be provided with  a pair of
thin rubber gloves,  useful when handling poisonous
substances, cases of syphilis, etc.
  When called to  a  contagious disease take such
articles of clothing as may be destroyed. 
28
a nurse's journal.
  Disinfect thoroughly before leaving the  patient
valise included.
  Great care is necessary in taking such articles as
will be  needed, brushes, combs, etc.  Never bor-
row.  Upon returning from a case take out of the
valise all soiled articles and put it in readiness for
another case; the nurse, like the doctor, should be
ready at a moments call.
  When exposed to infection it will be found an ex-
cellent plan to wash the  face and hands in spiced
vinegar before entering the room ■ this has proved
an efficient safeguard in times of plague.
  Small tufts of  cotton  dipped in vinegar and
placed in the nostrils prevent  contagion.  The lit-
tle  germs or  seeds of disease lodge in the cotton
instead of being  inhaled  into  the  system.  The
mouth should be closed as much as possible.
  Depressing  emotions render  one more likely to
take an infectious disease.  Cheerfulness is a great
safeguard.
  Keep a careful record of every case, thus giving
the medical attendant all the facts possible.
  The form I have  adopted is simple and pro-
nounced excellent by Doctors  Dudley and  Byford,
and others.  I append one day's record: 
INSTRUCTIONS TO NURSES.
29
                     CASE 38.


             Mrs. A., Monmouth, III.

  Disease, Tumor, (Ovarian.  Fibro Cystic.) Treat-

ment.  Operation and the following treatment:

"Time.
 3:30
 6:05
 9:00
 9:30
 11:00

 1:00
 2:10
 3:50

 5.00
 5:45
 6:15
 7:45
 8:45
 9:45
 11:00
 11:15
     Wednesday, No . 9th 1881. p. m.
Hypodermic of Morphine, ^ gr..............................j 5:10
Hypodermic of Morphine. % gr..............................
Egg nogg 2 tablespoonfuls ^ brandy.....................
Catheter...................................................................
Egg nogg 2 tablespoonfuls.
     Thursday. Nov. 10th, a. m.
Egg nogg 2 tablespoonfuls........................................
Egg nogg 1 tablesnoonful........................................
Enema of Beef Ext. and Brandy, equal parts, 2
 tablespoonfuls.....................................................
Catheter
Enema Ext. of Beef and Brandy, as before
Hypodermic of Morphine M gr.
Egg nogg 2 tablespoonfuls.
Enema.
Egg nogg 2 tablespoonfuls.
Catheter.
Egg nogg 2 tablespoonfuls.
Time.	Pui.se.
5:10	100
7:15	100
8:10	100
11:40	100
2:10	112
5:45	120
9:00	116
Tempt.
 76^4°
 99J4°
 my~°
 1003
101s

low
                 VENTILATION.

  It is of the utmost importance that the air of the
sick room be gradually but continually replaced by
pure air.
  There is little  danger, with ordinary precaution,
of taking cold when in bed;  a draught need not be
created  by opening windows and  doors.   The bot-
tom of  the sash may be  pulled  up a little and the
nurse  must  try to  keep the air as pure as possible
by removing everything that  would cause  an im-
pure condition.   A tin of  water may be  placed on
the stove so that the air may not  become too  dry.
Where the room is  heated by hot  air place a basin
of water near the register.
  The only way to be positive of  the  temperature
of the  sick  room is by a  thermometer.   The best 
30             a nurse's journal.

temperature is 60°, if, however,  the patient feels
chilly at this temperature it may be raised to 65°.
In fevers the temperature may be kept  as low as
50°.  About 65° is the most agreeable temperature
for a consumptive patient.
  It is of great importance to  keep the  sick room
perfectly clean;  to  do this have as little furniture
in it as possible.
  Cause  as little dust to be raised as possible;
sprinkle the floor with wet tea-leaves and use brush
broom as lightly as possible.
  In most cases sunlight should be freely admitted.
  In few cases,  such as inflammation of  the brain,
light increases the pain.
  The sick room should be  kept  quiet.  Dropping
things,  slamming  doors or any  sudden startling
noises annoy the patient.
  Miss Nightingale says, " Unnecessary noise, or
noise that creates expectation in  the mind, is that
which hurts the patient."
  Do not ply a patient with unnecessary  questions,
such as,  Shall  I close the door?   Would you  like
a drink ?  Will you have something to eat ?
  Do what needs to  be done as quietly as possible. 
TREATMENT OF INDIVIDUAL CASES,
           extracts from my journal.

                   May 5th.
  I have just been summoned to my first case in the
hospital.  What the first  client  is to the lawyer,
the first call to the physician, the first  case is to
the nurse.  Trepidation, anxiety to  excel, fear of
failure, are strangely blended  together.   At times
the question arises, am I fitted for the work?
  I found my patient—a Swedish lady—awaiting a
surgical operation which was to  take place at  2 P.
M.  I gave the patient  a bath and an enema; then
made preparations for the  operation.
  Provided hot water, carbolated water, bowls and
pitchers, sponges, and  a liberal supply of towels,
and ether cup.  Next proceeded  to prepare the bed
for the patient.  Put on rubber sheeting to protect
mattress.  Supplied myself with an extra amount
of sheets.
  Finally put the patient to bed to await the arrival
of the surgeons.
  After the operation I put the patient to bed with
hot water baths to the feet and thighs to prevent a
chill. After a short time the patient awoke with a 
32             a nurse's journal.
 terrible feeling of nausea.  Bits of ice put into her
 mouth relieved her.
   The case proved a very trying one; the patient
 was of a nervous temperament;  but knowing that
 all beginnings are hard, I bore up bravely and had
 the  pleasure of seeing the patient  return  to  her
 home cured.
                May 19th, 1880.
   A new arrival!  The patient  is a  sweet  young
 girl  from the  country.   She is suffering from  the
 painful disease known as hemorrhoids.   Pain  has
 left  its traces on  her face.  When  told that an
 operation was necessary  she shrank from it.   My
 heart went out towards her, and I did my best to
 ameliorate her sufferings.
   While under  the  influence of ether  her mind
 wandered and she was in her western home.
   Owing to the fact that the patient was of a sweet,
 unselfish disposition, my rest was not as  broken as
 is the usual result in operations of this kind.  I
 experienced the pleasure  of  seeing her improve
 rapidly.  I  take much pleasure in keeping exact
 records of symptoms, etc., for the inspection of the
 physician.  It is in this, that the professional nurse
 is distinguished from the Sairy Gamps of the  old
 school.
  Mrs. H., the wife of a minister, a delicate, nerv-
ous little woman, proved a  very hard case.   She
suffered from  lacerated  perinseurn,  which is very 
         TREATMENT OF INDIVIDUAL CASES.       33

painful.  Narcotics and  nervines had  little or no
effect, so I had to resort to my own ingenuity.
  One of the most difficult things was to keep her
quiet. Epst for me was well nigh impossible.  My
couch was  the operating chair, from which I  was
called every few moments.  At  times  my patience
was sorely  tried; the sharp rebuke was on my lips,
but I managed to control myself.
  Calling for a drink, the question is,  how  shall it
be given ?  The patient must not be raised.   I found
some glass tubes in the  dispensary;  placing  the
glass in her arm pit, with the tube in it, it  became
a convenient, easy process.   Eubbing her hands
eased her,  and reading to her sometimes diverted
her mind from herself for a short period.   *  *  *
  Across the room was another sufferer, a model
patient.  She was a beautiful blonde, and her golden
hair when braided reached below her waist.  It  was
so glossy and smooth that it never tangled.
  Her case was hopeless; she suffered from cancer
of the uterus; the last thing had been done for her;
the neck of the uterus had been entirely removed.
At her bed-side I learned lessons of endurance and
patience.   She never called for anything; had to be
asked  whether she  would have this  or  that.   I
strove to  anticipate her wants.  Constant  dis-
charges made watchfulness on the part  of the nurse
necessary,  and the use of carbolated water a neces-
sity.
3 
34             a nurse's journal.
               August 28th, 1879.
  I must go out for a walk, in order to brace up for
the work awaiting me.   *   *  My patient, Mrs. B.,
was carried in from her carriage; she is a woman of
rare beauty, equisitely dressed in pure white.  She
is suffering from a fibroid tumor in the  neck of  the
uterus.   She pulled her hair in  agony.   No relief
is possible until  to-morrow  afternoon, when  the
operation is to take place.   She  was favorably  im-
pressed with me;  besought the Doctor that I might
be allowed to nurse her.  Appreciation is a wonder-
ful  stimulant.  I will do  my utmost for her;  she
shall have no lack of care.

                  August 29th.
  No  opiates could  be  administered internally,  as
she was unable to retain them on her stomach.
  Eubbing is the only thing that gives relief;  the
Massage treatment.
  During the operation congestion of the  brain
took place, from the effects  of the ether and  the
state of the patient. The operation was attended
by the  staff  and performed  by  Dr. Byford.  The
case is a critical one, and. great watchfulness on  the
nurse's part is necessary.  All inflammation must
be kept down by carbolated douches given four and
five times a day; flax-seed poultices must be made
and rest is not to be thought of until the patient is
out of danger. 
TREATMENT OF INDIVIDUAL CASES.       35
                September 30th.
  My patient  improves rapidly,  and I have  my
reward in seeing her happy; she will soon go to her
home fully restored to health and happiness.
                November 2nd.
  One of the patients, a Mrs.  G., who has been an
invalid for 12 years, sent for me to dress two setons,
one on each side of the abdomen.
  She is suffering from spinal complaint, and  has
that yearning, suffering look common to sufferers
with spinal ailments.
  In dressing a seton  I  put on a soft covering of
lint well moistened with warm water and removing
it as often as it gets cold.   I try not to rub; the sore
parts cultivate a light touch.
  After removing the setons, fly blisters were  laid
across the abdomen to draw out the inflammation.
The blisters I  dressed with cabbage leaves,  remov-
ing frequently, as they bruise as soon as dry.
              OVAEIAN  TUMOE.
                November 9, 1880.
  Treatment—Operation—Weight of tumor 65 lbs.
  I made the following preparations for the  case
which proved a severe one, as  numerous extracts
from my book will show.
  After the operation, pyemia (blood poisoning) set
in and an abscess formed directly  above  the in-
cision. 
36              a nurse's journal.
  Pieces of flesh dropped from the limbs.   No food
could be taken by the patient.  Enemas had to be
given with great care.
Eequisites for Ovariotomy.
Sheets..................2
Towels.................6
Wash Bowls.........2
Slop Jars...............2
Basin....................1
Bath Tub..............1
Oilcloth..............1
Hot Water Bottles
Carbolated Water
Pins.
Scissors........................1
Lint
Cotton.
Sponges Small...% doz.
Sponges Large............4
Brandy.
Flannel Bandages......2
Adhesive Plaster.
Carbolic Water, 3 per cent.
Alcohol for Aspirator 1 pint.
Hot Water for Aspirator.
' CARBOLATED WATER.
1 per cent. 3 drachms Carbolic Acid
  to 1 quart of water.
3 per cent. 8 drachms of Carbolic Acid
  to 1 quart of water.
  The room and bed to be occupied by the patient
should be scrupulously clean, and be well fumigated
and purified with sulphur a day or two before the
patient is put in it.
  The wood work and floor should be washed with
a solution  of carbolic acid, also the  bed of the pa-
tient sprinkled with it.
  The furniture should consist of a few chairs and
wash stand, the ventilation be strictly  attended
to.   I have taken  heavy colds in not wearing the
proper clothing, which  should  be warm, in nursing
a case of Ovariotamy.
  Great care must be taken in feeding the patient,
as the clothing cannot be changed until the stitches
are removed.  I prefer a spoon-tube and  drinking
cup with a spout.
  The catheter in this as in similar cases should be
cleansed in a solution  of  carbolated  water, or dis-
eases may be conveyed  from one patient to another.
  Have  the bed well protected, especially around
the patient, with cheese cloth  or absorbent cotton 
TREATMENT  of individual cases.       37
that may be  frequently removed without stirring
the patient; if the bedding  should become  soiled
sprinkle with  carbolated water.   In getting  adhe-
sive plaster ready, warm it over a lamp or around a
bottle of hot water.   Keep the mind of the patient
cheerful;  never talk  die.  By being cheerful and
hopeful one may inspire  hope in the patient.   I
get  very  little  rest  and  sometimes   fear my
strength may give out before I get through with
my patient.
  Constant attendance, as may  be seen from the
account of the case, is necessary.
  The  profession  of a  trained nurse is an arduous
one.  The following is from the report kept for the
physician's inspection:
                     No. 5.
Time.	Sunday, November 13, A. M.	Time.	Pulse.	Tempb.	Respe.
A. M.	Slept 25 minutes. Catneter.				
2:15					
2:20	Egg nog 10 tablespoonfuls.				
2.40	Hypodermic of morphine J4 gr.				
2:45	Quinine capsules, iv gr.				
3:15	Catheter.				
3:20	Beef tea, % of a cup,				
7:20	Catheter.	7.25	96	99y2°	16
7:25	Egg nog, 8 tablespoonfuls.				
8:00	Quinine capsules.				
9:00	Hypodermic of morphine, % gr.				
9:50	Beef tea.				
10:45	Catheter.	10	92	99 4-5°	
10:05	Egg nog.				
11:40	Beef tea.				
12:00	Quinine capsules.	12	96	100c	
P.M.					
1:00	Egg nog, 1 tumbler full.				
4:00	Milk porridge.	3	96	100 2-5°	16
4:15	Quinine capsules, 4 gr. Slept 1 hour.				
5:00	Urinated.	6	94	99 1-5°	
 
38             a nurse's journal.
No. 5.—Continued.
Time. Monday, December 5, A. M.		Time.	Pulse.	Tempk.	Respr.
7:10	Urinated frequently during the night. Egg nog during the daw Bowels moved by an injection Sponge bath of alcohol and water. Dressed wound and abscess. Tincture of iron after each meal. Urinated. Egg nog. Hypodermic of morphine.	7	81	98 3 5°	
           Saturday, December 10th.
  Patient feeling better, sores less painful.  Urine
clear and less frequent, appetite good.  Treatment
of the wounds and abscess as directed by the phy-
sician.   Wounds look better.
                January 8, 1881.
  Patient discharged,  well.  Physician expresses
himself well pleased with  my nursing, but  fears
that on account of my sympathizing too much with
those  in  my  charge  I may wear out my own
strength.
        CANCEE OF THE UTEBUS.
                 March 18, 1881.
  Treatment—Operation, March  4th.
  A  cancer case is peculiarly hard to take care of
in consequence of the  offensive discharges.  My
patient is unable to keep  opiates of any  kind  on
her stomach, I must therefore resort to means of
my own.  Bathing her face  and hands in  warm
water seems to have a soothing effect. 
         TREATMENT  of individual cases.       39

  Very light flax seed poultices across the bowels
relieve her.
  Little  squares of cheese cloth filled with cotton
laid around the patient keep the bedding clean and
can be removed frequently.
  The patient must not be moved.  Before putting
the cloths about her I sprinkle with them carbolated
water.  Then dry perfectly.
  The patient is in constant danger from hemor-
rhage.
                   April 2nd.
  The patient, a lady of  fine mind, is very fond of
reading.  She has traveled much and is well versed
in literature.  She realizes that a well  stored mind
is a treasure-trove even in sickness.  Mind is supe-
rior to matter, and the patient is never discouraged;
has entire confidence in Dr. Byford.
                    May 1st.
  My patient is improving rapidly.
  Though glad to know that she can soon return to
her beautiful home, I  shall miss her.   Caring for
and nursing her back to life has been a privilege.
                 May 15, 18—.
  I copy a portion of my patient's letter; it will be
a comfort to look back upon when tired and dis-
couraged :
" My Dear Miss Eichter:
  " I have not forgotten the dear patient being who 
40
a nurse's journal.
 so kindly administered  to  my wants.  I am gradu-
 ally becoming stronger.  I do so want to become
 well once more.  Have your lines fallen in pleasant
 places this time?  I hope  so.  I shall never forget
 your  self-sacrificing  care, and whenever you are
 tired  my home is yours to rest in and I will make
 you comfortable. Wishing you success in your noble
 work, I remain, sincerely.
                                    Li ___________ "

             PELVIC ABSCESS.
                October 2, 18—.
  The patient was etherized and pus drawn from
 the abscess.
  Two drainage tubes were inserted which must be
 constantly cleansed  by injection through them.
 The case  is peculiarly .sad as recovery is well-nigh
 hopeless, and  the sufferer beautiful.in mind and
 body.
                October 5, 18—.
  Temperature frequently runs  up  to 103.  Dis-
 charges from the bowels are terrible.   I purify the
room in various ways.  Keep jar  with copperas in
 always on hand.  About the body of  the patient I
place oakum (tarred rope) picked  to shreds.
                 November 15.
  Patient  very low.  To-day she sank so rapidly
that I thought she was  dying.  No one at hand to
send for physician.
  I forced her mouth open  and gave her some whis- 
          TREATMENT of individual  cases.       41

 key, which  revived her a little, then gave her the
 white of an egg beaten to a froth.  When the phy-
 sician arrived she had rallied enough to speak.
                  November 18.
   I have not been sufficiently careful with myself;
 a  little scratch on my hand has come in contact
 with discharges from the abscess and I am sick.
   The doctor pronounced it blood-poisoning.  After
 this I shall  wear thin rubber gloves when handling
 the patient.
                  December 1.
   Contrary to all expectation  my patient is appa-
 rently recovering, and I must leave her to other
 care than mine, for my own strength is exhausted,
 and absolute rest imperative.
   One cannot be too cautious when nursing severe
 cases.   Careless exposure is " Flying in the face of
 Providence." A nurse must  hoard  her  strength
 and guard against unnecessary exposure.
                 March 15, 1882.
  Nursing in private families is, in some respects,
 more  difficult than nursing hospital patients.  The
 esteem of the family must be gained and maintained,
 the household regulations must be taken into con-
 sideration ; needful articles  are at time unattainable.
 Visitors will  intrude, and it is sometimes difficult
 to carry out the physician's instructions in regard
to diet, etc.   Great tact is necessary to avoid con-
flicts.  My little alcohol lamp that I always carry 
42             a nurse's journal.
with me has proved a great convenience.  Can heat
water on it for sponge baths or broth.
       TYPHOID MALAKIAL  FEVER.
  A typhoid malarial  fever case.  Patient restless
and very nervous.  Added to this  a small babe must
be weaned.
  Great difficulty in taking medicines is experienced
by patient; throat sore; constant  changes;  sponge
baths; hot water bottles to extremities after chills;
the room constantly purified by carbolated water,
burning coffee, etc.
  Disease—Typhoid malarial fever.
Time.	Treatment—Saturday, March 18, P. M,	Time.	Pulse.	Tempr.
2:00 3:00 . 3:30 3:45 4:00 4:20 5:15 6:00 6:15 6:10 6:15 7:30 8:15 10:00 10:30 11:00	Quinine, 1 teaspoonful. Quinine, 1 teaspoonful. Three teaspoonfuls of port wine. Breast pump. Quinine, 1 teaspoonful. . Carbolic acid (as disinfectant.) Milk Port wine, % wine glass. Medicine, powder. Vomited a little. Urinated (scanty). Milk. Medicine, powder Slept % hour. Sponge bath: Slept 1 hour. Port wine. Milk.	2:10 4:40 7:00	110 110 120	101 2-5ths 104^ 102 2-5ths
Time.	Sunday, March 19, A. M.		Pulse. 100 100 101	TEMPR,
12:00 1:25 2:25 4:10 4:30 6:15 7:00 7:30 8:00 9:00 9:10 ](»:00 ll:i.O 10:45 11:00 11:30 11:15	Vomited a little. Urinated; slept % hours. Milk; slept thirty minutes. Digitatalis. Milk. Urinated Quinine mixture, 1 teaspoonful. Milk; breast pump. Quinine mixture 1 teaspoonful. Quinine. Alcohol sponge bath. Milk. Port wine, 1 wine glass. / Urinated. Vomited, the mhk. Quinine mixture, 1 teaspoonful. Urinated.			101 l-5th 101 2-5th 101 2-5th 102 2-5th
 
          treatment  of individual cases.       43

                     May 20.
   Patient doing  nicely.   Had  a hard time to get
 the  hair  combed.   Proper  care had  not  been
 taken to braid the hair before the patient was too
 low.

                 ERYSIPELAS.
                  May 22, 18—.
   Have just returned home for a rest, for rest after
 labor is sweet.  A rap at  the  door, a  note  with
 "Come at  once  to No.—, erysipelas in  the face."
 Such a face!  Anything but comely to look  upon.
 Good work must be done  here or failure will be the
 result.   Temperature of  patient very high,  room
 very small; ventilation must be  attended because
 the air is vile.   The bed stands near the only window
 in the room.  Covered the patient up with an extra
 blanket, head  and all.  Let the  air pass over the
 bed ten minutes.  The patient  suffers from  a dis-
 tressing pain in the stomach; put  on old-fashioned
 mustard poultice, not forgetting the white of an
 egg to  prevent blistering. Vomiting being one of
 the features of the disease, it becomes distressing
 to patient and fatiguing to nurse.  Placing a bowl
 large enough to cover mouth  and chin, placing
 patient  on  the  side, with  towel under bowl, makes
 it easier for  both of us.
  All discharges  and  cloths must be removed at
once, and all bowls and vessels cleansed  with  car-
bolated  water. 
44             a nurse's journal.

  Cloths wrung out  of  sugar of lead soothe the
patient.
                   May 23d.
  Ten p. m. : Pulse, 100; temperatuie, 103°. Patient
very restless.  One morphine pill.  Urine very dark;
vomiting continues.
  One p. m.: Pulse, 112; temperature, I04f°.  The
disease  has reached  its crisis.  A teaspoonful of
mead to-day. Patient very irritable; as the symptom
is a favorable one I  will hail it as a good omen;
smile and " dinna weary."
  Things look hopeful and I feel repaid, " For some
must watch while others sleep," etc.  Patient takes
little naps.  Pulse, 102; temperature, 102^°. Dipped
cloth in olive oil and laid it  across the bowels for
soreness.   The face  looks better;  application of
cosmoline.
                  May 25th.
  Here is another enemy to encounter:  " I want to
scratch!"   It  is a comfort,  doubtless, to scratch
where it itches, but I must reason, implore, and in-
duce the patient to keep " hands off."  Fortunately
the ruling passion in woman  to be beautiful will do
more than  anything else.
  Temperature, 101|°; pulse, 90.
  Will now apply something  more agreeable than
cosmoline,  wash of borax.
  Shall now have to tempt the stomach with  some-
thing nice: 
TREATMENT OF INDIVIDUAL CASES.        45
        " With dispatchful looks in haste
        She turns, on hospitable thoughts intent,
         What choice to choose for delicacy best;
        What order, so contrived as not to mix;
        Taste not welljoined, inelegant but bring
        Taste after taste with kindliest change."
  Shall give some nice milk  toast; will prepare  it
myself.
  Cloth on face changed frequently.  Patient coughs,
weak lungs.  Applied belladona plaster between the
shoulders.  Patient  craves  tomatoes, with lemon
juice;  approved by physician.  Doctor very much
pleased with patient's progress.
  Nine a. m.  Slept three hours, during which I took
a nice little nap myself.

                    May 29th.
  Patient able to  sit up; appetite good.  Shall leave
to-morrow, feeling that work faithfully done never
fails of its reward.
 ACUTE INFLAMMATOEY EHEUMATISM.
                  May 30, 18—.
  At home.   Have unpacked valise.  A nurse must
sleep like a warrior, " with his martial cloak around
him;" be ready at a moment's warning.
  A case of inflammatory rheumatism is the next.
A young gentleman away from home and friends  is
lying in a dark hall bed-room.  I prevailed upon
the landlady to move  him to a sunny, comfortable
chamber.  Gave him drinks of hot lemonade.  The 
46
a nurse's journal.
glass urinal, and rubber cushion  to change the po-
sition, prove invaluable in this case.
  Wednesday patient much improved.   Give  al-
cohol sponge baths, being careful not to remove the
cover more than is absolutely necessary.   Have the
alcohol  as  warm  as possible, and  asing  the flesh
brush briskly afterwards.
  The patient  speaks  of  home and  a  Christian
mother  and her early teachings.  This is the first
time in his life that disease has laid him low, and
he yearns for sympathy and care.

               OVARIOTAMY.
                 June 1st, 18—.
  After a ride of  about sixteen hours and nothing
to eat since six o'clock P. M. the previous day,  for
we relied on the dining car, which  had  that day,
Sunday, been left behind for repairs.
  No time to eat,  as  the  operation  will take
place half  an  hour after the arrival of  the train.
To put things in readiness, attend to the wants of
the patient, learn  the ways of the house,  was all I
could do.
  The patient, a tall, auburn-haired, sharp, visaged
person,  on whose face the traces of pain were
visible.
  The day was hot; the case complicated; a great
many  adhesions.   The  surgeons  worked hard.
Etherizing fell  to  me,  which was  anything but a
pleasant task on a full stomach. 
TREATMENT OF INDIVIDUAL CASES.       47
  Formed an ether cup out of a newspaper in the
form of a cornucopia, with a small opening  at the
pointed end, fitting the other end over the nose and
mouth, filled it up with handkerchiefs. Patient be-
came much exhausted; gave brandy hypodermically
during the operation.  At last the physicians have
done their duty, and mine begins in earnest; they
will leave and I must  report, and if necessary dis-
patch if dangerous symptoms manifest themselves.
  Vomiting sets in,  which is extremely dangerous
in this case; the retching must be avoided.  Gave
Hoffman's anodyne and bits of ice.
  7:30, used catheter well oiled; 8:00, egg nog
after my recipe, by enema, one tablespoonful; 8:30,
egg  nog, enema; pulse 80; 8:35, hypodermic  of
morphine, sulp.;  9:30 vomited, enema, egg nog
given with rubber syringe.  Patient  becomes con-
scious and restless.
  Insert the rectal tube to carry off flatulence.
  10:00, morphine hypodermically;  10:30, enema,
egg nog one teaspoonful; 11:20, vomited.
  11:25, catheter; an evacuation of the  bowels;
placed cotton and cheese cloth about the  patient,
which I can remove easily and  destroy at once by
burning.
                 Monday A. M.
  Pulse 84; treatment as before.  I shall look for  a
rise in temperature.   Have not an ice cap; shall
have to use cloths wrung out of ice water.  A piece
of oil-cloth must be placed under patient's  head. 
48             a nurse's journal.

  Pulse 99;  temperature 1001?';  10: 45,  aconite.
Patient took eight teaspoonfuls of milk porridge;
stomach retained it.   Pulse  100;  temperature
100 4-5; perspiration warm.  Not as yet able to
urinate without use of catheter.  Opened bandages
which are  of flannel  and dressed wound for the
first time;  looks  well;  apphed iodoform;  put on
clean compresses.
  Begin the milk  diet;  patient slept three-fourths
of an hour.  Added lime water to  the milk.
  1 P. M., morphine; 1:10, catheter; a slight rise
in temperature; shall renew the ice cloths.  It re-
duces the temperature noticeably.   Added a  little
of my prepared flour to the making a thin gruel.
                  Wednesday.
  Dressed wound; used castile soap and  carbolated
water; inserted a  small drainage tube into the in-
cision.
  Patient  is annoyed with a tickling sensation in
the throat; gave lemon juice and bits of ice.
                Thursday A. M.
  Temperature  100^°;  vaginal  discharge;   gave
a  carbolated  douche;  used  fountain  syringe;
medicines nearly the same;  discontinued the acon-
ite, and added quinine sulph.
                 Friday, 1 P. M.
  A slight rise in temperature; renew the aconite;
dressed wound; looks better.   In dressing a wound 
         treatment  of individual  cases.       49

I always find it necessary to have  everything  that
may  be  required  ready  for the occasion.  I  feel
the need of sleep.   I think I can now trust my
charge in the hands of some one for a short  nap.
Later.  Having been shown  an up-stairs  room, I
soon sunk into a slumber from which I was aroused.
I discovered that I was not the only  occupant of
the bed; tried a bed in the adjoining room with the
same result.  Nothing left me but  to lie  down  on
a couch near my patient; the country is low  and
sandy and I soon find there is no rest for me.  The
flea is like Addison's definition of infinity, " It has
its center everywhere and circumference nowhere."

                    Monday.
  Have  added  beef  tea, made after one  of  my
recipes.  Pulse 82; temperature 99  4-5  degs.  2: 30,
alcohol sponge bath; discontinue use of catheter.

                Saturday A. M.
  Pulse 80;  temperature 99 1-5.   Patient able  to
drink a whole glass of milk.  I add rice, (steamed;)
no change in medicines, but the quantity lessened.
  P. M., temperature 2 degs. less than  in the morn-
ing ; beef tea and a small piece of toast; dress  the
wound; find the  syringe of my  invention just  the
thing.  No discharge from the wound.
  The garments of the patient, which  consist  of a
red flannel gown with a  white night dress over  it,
have not been changed since the operation, as the
      4 
50
a nurse's journal.
patient could not be stirred.   The stitches from the
wound are also to  be  removed  to-morrow.   Shall
hasten to give the clean  garments a thorough air-
ing by the stove, leaving them there till to-morrow.

                  Monday, a. m.

  The apprehension of having the stitches removed
has increased the patient's temperature.
  Give alcohol sponge bath, then change the gar-
ments, a work so  much  dreaded by old  fashioned
nurses, not saying anything about  the victim, the
poor patient.
  I find the task comparatively easy. Placing both
garments together (sleeve into sleeve), ripping the
gowns down the front  if not open, sewing them to-
gether on the patient, or pinning  them together
with safety pins.
  I now slip both sleeves  on at once, push the gar-
ment underneath, then go to the other side and put
in the other arm.   The work is accomplished, the
patient feels  relieved.  After the patient is rested,
remove the  flannel bandages, wash and  dress the
wound.
  Patient in good spirits;  give a small dose of mor-
phine  to remove  pain caused  by removing the
stitches.
                 Tuesday, a. m.
  My patient ate  a good breakfast, consisting of
poached eggs on toast, tea and  milk.  Patient ap- 
         treatment of individual cases.       51

pears restless, shall have to attend  to moving the
bowels; can do so now with safety.  Use my rectal
syringe, giving  about  a tablespoonful of sweet oil.
  Patient relieved.  Examined the wound; found a
place where it had not united properly;  shall insert
a small  rubber  tube, suppuration has taken place
where it has not united.  Inject carbolated water
through the drainage tube, a discharge of pus, re-
new the aconite, because I observe a rise in temper-
ature.
                  Sunday, a. m.
  A change for the better; no discharge from the
wound; appetite  good.  Breakfast  of  squab  on
toast.
               Tuesday, June 27.
  Have moved the patient to a pleasant room;
pleasant surroundings  are a great comfort and help
to a sick, but  more particularly to  a convalescent
person.
  Patient is able  to sit up a little;  medicines dis-
continued.
                  Friday, July.
  Preparing to leave;  appreciate the thought.  I
long to be once more where the wicked (fleas) cease
from troubling and the weary may be at rest.
                OBSTETEICS.
             July 3d, 2 o'clock, a. m.
  Rain pouring; am rudely awakened by the sum- 
52
a nurse's journal.
mons to come at  once to a case that I have been
engaged for.   The  life of  a nurse is not an enviable
one, self denial is  the order of  the day.  Begin  at
once to get the bed in  readiness, spread an extra
quilt over the mattress, over which I spread a large
piece of rubber sheeting, pinning it on to the mat-
tress with  safety pins; over this place the sheet,
over this  place a comfortable double, on top  of
which  lay  a sheet folded in three thicknesses,  in
shape of a napkin.   After these have  been removed
the patient has a clean, comfortable bed.
  Put  as light clothes on top as possible,  give the
patient a bath, some light nourishment, braid the
hair in two braids and move  the bowels.
  For  the  new-comer I select soft flannels and un-
starched gowns. On a  chair I place work box, with
thread, scissors, small safety pins and  lint.   Have
ready,  also, vaseline, lard  in a  saucer, and borax
Do not forget baby blankets.  Secure the Fountain
syringe, with lot of water near  the bed; have also
some ice in readiness.
  I find compresses of cheese cloth filled with cot-
ton to place under  patient very handy;  they can be
easily removed and  burned when soiled.   Have
donned my soft apron, made of  Canton flannel.
  I receive the new arrival in a  soft, warm blanket,
near the fire, wipe its face with soft cloth, lubricate
it quickly with lard (warmed), then lay it in a warm
spot and hasten to  the mother.  Must next attend
to the bandaging of the mother, not forgetting the 
treatment of individual  cases.
53
 compress.  After  the patient has rested I give a
 carbolic douche.
   The baby now claims my care; the work of wash-
 ing and dressing  must be quickly done.  A  very
 little, if any, water  should be used the first time.
 Wash the mouth with  a little water and borax.
 Wipe the body with a dry, soft cloth.   Dress the
 navel by cutting a hole  large enough for the  cord
 to be drawn through.  It should  consist of several
 thicknesses of soft  linen, cut in a square, so  that
 it can be folded over  the  navel cord, like an envel-
 ope.  Oil with  sweet oil, lard, mutton  tallow or
 vasaline.  Put on bandages  and dress in a flannel
 gown.  Make the patient more comfortable, remov-
 ing the soiled  compresses, etc.  It is now  time to
 turn to  the new arrival and give it its first meal.  It
 is a wee  tiny one, weighing only five and a  half
 lbs., and is  very weak;  it will have a struggle in-
 deed for existence.  I lubricate the nipple and put
 the babe to the  breast, but it is too weak to nurse;
 nothing remains but to feed it  with a spoon, warm-
 ing a little of the  mother's milk over my alcohol
 lamp.
  I fear that it is tongue tied, and call the physi-
 cian's attention to  it.   He  agrees  with me  and
 loosens the tongue, which helps matters somewhat.
 The mother has a surplus of  milk, which must be
drawn off  by the breast pump; great  care is neces-
sary.
  Shall  have to report the fact that the infant's 
54
A. NURSE S JOURNAL.
bowels have not moved, the  meconium has  not
passed off.  P. M.—There has been  a  small  dis-
charge from the infant but not sufficient, so I give
the medicine as  directed by physician.  The child
is very restless suffering from colic;  I  give  a small
quantity of anise tea.   Wash the naval carefully
and  keep it well lubricated.  The mother's  diet so
far has been light, nutricious food.
  I continue the use of douches.   A natural evacu-
ation of  the bowels.  The naval cord drops  off;
both mother and child doing well.  The  mother is
able to sit up for a short time.  Received an urgent
call  to a very sick patient; must  leave my patient
in the hands of  an old-time nurse for  a few days.
The patient I go to cannot recover.
  Monday, A. M.—I return to my old charge.  "0,
change, stupendous change!" A look of relief on the
mother's face and a "I am so glad you have  come,"
expresses all.  I hardly know whether to pity or
censure the old fashioned nurse as she  ties up  her
bundle and departs.  I take a whole day to tidy up
the room, cleanse the nursing bottle (we had to re-
sort to it) and wash the baby which is sore, chaffed;
—its breasts arc inflamed and I apply a drop of cam-
phor and sweet oil at once.   The mother  has a sore
breast, brought on by improper use of the breast
pump; a small abscess has  gathered near the nip-
ple.  Powdered the  child with browned flour.   By
the  physician's  advice  the child is now  fed  on
diluted cow's milk.  The mother is slowly recover- 
TREATMENT  of  individual cases.       55
ing from her  relapse,  and able to sit up a httle
again.
  The  closest imitation to the mother's  milk is
made as follows:
  Dissolve a tablespoonful of loaf sugar  in  three
cups of water, boil it  down  to  two, then add  one
cup of  fresh milk.  Care must be taken not to give
an infant too much; a child is injured more by being
overfed than by not being fed enough.  Because it
worries and cries  a little do not  imagine  that it is
starving  and must be immediately stuffed.   As a
general rule  a healthy child, two  or three weeks
old, requires a pint of breast milk, or other equally
nutricious food, during the twenty-four hours.
  Infants should not  be jolted or handled  about
after a meal.
  If a nursing bottle is used, care must be taken to
keep it perfectly sweet; wash it with hot water sev-
eral times a day.
  When feeding a child support it in an easy semi-
recumbent position, upon the lap or arm.   Keep it
perfectly quiet at least thirty or forty minutes after
it has been fed.

              SCARLET  FEVEE.
                December 5, 18—.
  Dressed in clothing that may be destroyed, I find
myself quarantined in a bed room of a fourth story
building at the bed-side of a little boy who has scar-
let  lever. 
56
a nurse's journal.
  The temperature  is  102|°,  the child is  very
restless, the fever high.
  Give medicines as directed.  Turn the bed which
faces the light around.  Ventilate the room  and
keep the sufferer's lips moistened with water, have
tied a cloth to a stick with which  I swab  the
mouth.
  Disinfect the room by wringing cloths out of the
solutions prepared for the purpose, and hang them
over chairs.   The glands are very much swollen;
an ointment is applied outwardly.  Use an inunc-
tion of cosmoline to the whole body three times a
day.
  P. M.—Temperature 101|°.  Urinates frequent-
ly.  I use the glass urinal, do not wait for the child
to make its wants known, he  is too sick.  Diet,
toast-water, gruel, (arrow-root).   Keep the room an
even temperature, consult therm'ometer constantly.
  The child must be closely watched night and day.
  At last the  fever reaches  its  crisis; the anxious
mother awaits the physician's arrival with a dread
apprehension; she has no communication with us.
All that is needed is sent up on a tray and left at the
door.
  12 A. M.—There is a change,  pulse and temper-
ature much lower; the child takes a small portion of
cracker soup.
  I continue the inunction  of  cosmoline. twice a
day; the glands of the neck  are still swollen; con-
tinue the use of the ointment. 
         TREATMENT OF INDIVIDUAL CASES.        57

  11:00 P. M.—A movement of the bowels; obliged
to leave the patient alone and descend three flights
of narrow stairs in the rear.  Throw a carbolated
spray of water over my clothing, pour chlorine into
the vessel  and then make my descent.   As  the
bowels are very loose, these journeys are frequent.
  3:00 P. M.—Temperature  100£°.  He  begins to
realize that mamma is not present; we will have a
scene now; he tries to call, but  the little voice is
too feeble.  I  quiet him with a promise of a drum
from mamma.   Children are not apt to forget prom-
ises, so I must send for one.   Shall have to be firm
and kind; there is a constant rise and fall in tem-
perature.
  Quinine is added to the medicines. Milk toast
and broths are given,  also a sweet  baked apple.
Swab the mouth three or four times a day.   Tem-
perature 99£0.   Have amused him by telling him a
bear story; am in for it now. Eecite the story of
" Cock Eobin  and Jenny Wren" twenty times  a
day; I wish almost I had never known it; however
there are two weeks longer that he must be kept in
bed and amused.  Sing little songs to him, build
houses, etc. Now he wants a menagerie; fools-cap
paper is sent up on the tray and left at the door.  I
draw the outlines, and then proceed to cut out dogs,
cats, monkeys, foxes, tigers  and lions, not forget-
ting Jumbo and the baby elephant.  Proceed to pin
them  on the wTall near the little one's bed.  An old
hen and chickens follows up the rear, and the  boy 
58
a nurse's journal.
is happy.  A pair  of jumping Jacks, which I had
the forethought to bring with  me, completes the
show.
   Give him his first bath and change his garments.
Use alcohol and water.
   With an extra wrap around him he can now sit
up in bed.  The appetite is good;  he craves food;
even cries for it;  generally for such things as he
must not have.
   The tray containing my meals is sent up and he
asks:   " What have you got; I want some, too!"
A promised story pacified him pro tern.
   To properly regulate the diet  is a very important
part of the treatment.  Ordinarily the  patient will
care very little for food at the height of the fever.
When, however, he desires something, he may be
allowed to eat rice flour or arrow root  gruel, tapi-
oca, farina, toast water, ice water, or flax seed tea.
A very refreshing drink is .made by adding straw-
berry,  raspberry or other fruit syrup  to the cold
water.
  As he grows better and convalescence progresses,
he may be allowed milk toast and very light broths.
Too great attention cannot be  given to  the  diet.
Because the patient loudly complains that he is not
allowed sufficient to eat, do not  yield to his en-
treaties.  It is of the utmost  importance that the
patient should not be allowed to go out  of his room
too soon, or be exposed in any way.  Flannel should
be worn next  to the skin for a long time  after the 
TREATMENT OF INDIVIDUAL  CASES.       59
attack.  The greatest precaution is necessary in
order to avoid  the  evil effects which  this fever
leaves.
       CATAEEHAL  CONSUMPTION.
                 January, 1883.
  A hopeless case, yet the patient may live  several
weeks.  Will do all I can and make her as comfort-
able as possible.   She is a lovely woman; her beau-
tiful blue eyes  look  imploringly to me for help.
Although it is mid-winter, the windows are up as
high as possible, and  yet she must be fanned, for
the fever is high. I bathe her frequently to reduce
the temperature.
  She is a mere  skeleton, and I utter a prayer as I
touch the emaciated form.  My touch is soothing
to her; no one but I can make the bed, or do any-
thing for her.
  She  is very  hopeful; intends to go  south  and
amidst the  orange groves regain her health  again.
"Will you go with me, she asks; you shall be one
of us?"  Hope,  sweet hope,  which gives  freedom
to the captive, health to the sick,  victory to the
defeated and wealth to the beggar, does not desert
her.
  Let her hope; she is a Christian and prepared to
go to a land where the flowers bloom eternally and
sickness and death are no more.
  She expectorates profusely.  I  use cheese  cloth
and burn the cloths up when soiled. 
60
a nurse's journal.
  Everything is done, but the fever increases  and
the patient grows weaker.
  Medicines become obnoxious to her and I study
to disguise them as much as possible.  The appetite
is good, and all she asks for is granted.  Beef blood
is ordered; I add milk and taste it first  myself; she
does not detect what it is; says it is good.
  The weather is pleasant to-day and  the  patient
longs to be about; she is restless; she is  dressed and
walks half  way across  the room.  *****
Her physician is sent for; she realizes now that her
end is near; she is conscious to the last and my ear
catches the broken messages of cheer to her hus-
band, parents and sisters.  Her pupils in her Sab-
bath school  class she remembers also.   " Death
loves a shining mark."  Take charge of  the corpse;
get it in readiness for the undertaker,  who is de-
layed.   Gloves should be worn in handling a corpse;
the hands washed in  carbolated water  afterwards.
Tie up the  chin,  close the eye and shape the mouth;
raise the head and shoulders higher than the  rest
of the  body.
  Cleanse  the bowels  with  an injection;  fill the
rectum and vagina with  cotton.  Double a sheet
and put it on like a diaper.  The undertaker arrives;
after putting  on the undergarments, I leave  the
body to him.
     *   I have been called upon to take charge of
the motherless little one, a beautiful little boy of
four months, who has been in grandma's hands up 
         TREATMENT  OF INDIVIDUAL CASES.       61

to this time.  I see at a glance what is about to
take placo; the eyes are fixed in one position; the
whites only are visible.   The face is distorted by
spasmodic contortions of the muscles; the fingers
are drawn into the palms of the hands.
  I hasten to do all I can; prepare a warm bath and
put the child into it; add  a  little mustard.  Pour
cold water on the head  until the  spasm  is over.
Wrap  the  child in blankets without stopping to
wipe  it off.  Give an injection of sweet  oil  and
castile soap when the child has rested awhile.
  The physician's arrival confirms my  fears; the
case is hopeless; the child has not been well from
its birth, and  lives but a few hours longer.
  The physician approves of the management, but
human skill is useless.
  The babe is placed in the coffin of the beautiful
dead, who has been bride, wife and mother the short
space of one year.

LACEEATED PEEINEUM CEEVIX UTEEI.
                March 4th, 1883.
  This case differs from  any that I have  nursed be-
fore, inasmuch that there were two surgical opera-
tions performed  instead of one—Cervix  Uteri first.
  The operation was a success, and the physician
and nurse  dismissed in due course of time.   Impru-
dence on  the part of the patient, who  took  long
walks and climbed stairs, which she concealed from
her physician, laid her low again. 
62             a nurse's  journal.
  She is  extremely nervous,  and during the  last
operation almost hysterical.  All precautions must
be taken in regard to chills; vomiting sets in from
the effects of ether, and retching must be avoided.
Bits of ice are given.  A roll of several comforta-
ble quilts is placed under the knees for a prop,  and
the knees are pinned  together with a towel  and
safety pins, placing a compress between the knees
to prevent rubbing.
  The room is darkened, and after vomiting ceases
I give  deoderized  tincture of opium at short in-
tervals;  3.20  catheter; 7.40 beef tea, a small por-
tion.
  Carbolated douches given on a rubber bed pan.
  10 P. M.—Hemorrhage from the uteris has taken
place.
  Physician was called to another patient, and may
not  return until  very late.   The  patient  is in
danger.
  I at once raise  the  foot of the bed, remove  the
pillow from underneath her head,  and lay cloths
across the abdomen, wrung out of ice water, until
the rubber compress arrives which has been sent
for.  Fill the compress  with small pieces of ice;  not
sufficiently full to  make it heavy.  Place flannel
next to the patient, then cover the  compress with
flannel also.
  11 A. M— Patient is  kept on opiates, as she must
lie perfectly still. Douches of tepid water are given
(carbolated). 
TREATMENT OF INDIVIDUAL CASES.       63
                Wednesday, 1.30.
  Hemorrhages continue.   Tampons of iron sulph.
and small pieces of ice are to be inserted into the
vagina.
  The greatest care must be taken not to move the
patient, on account of the stitches of the perineum;
the clots  also must be carefully removed from the
wound, the stitching well syringed, then apply vas-
eline on absorbent cotton to the wound, pressing it
with a pair of forceps closely about the stitches.
  Catheter very  painful;  urethra very much  in-
flamed; am careful not to let the urine run over the
wound, therefore syringe well  after every  evacua-
tion of the bladder. The less the catheter can be
used the better.
  Sponging with warm water over the urethra often
encourages the  flow; the dripping of water into a
basin often assists encouraging a natural, almost in-
voluntary evacuation.
  The patient is very much reduced, as the hemor-
rhages continue.   All the preventatives and reme-
dies continued.
  11.30 A. M.—Temp. 101°.  Sulph. acid and qui-
nine is added to  the medicines;  steak rare; add
toast to her diet.
  Milk and lime water is given as follows:  10.30,
milk; 11, milk; 12.40, milk;  2.30, milk.  Tempera-
ture low.  Careful watching alone can carry her
through. 
64
a nurse's  journal.
                 Thursday, 16th.
  The hemorrhage has ceased.  Temp. 100°. Pulse
110.   With careful  feeding she will  regain  her
strength.  Oysters on the shell,  with  lemon juice.
Opiates lessened.
  The  contracting of the wound is very painful;  it
does not look very well,  but will hope for the best;
there is less inflammation in the urethra.
  Temp. 1003-5°.   Pulse 105.
  Diet, egg nog, toast and beef tea.
  Notice a rise in temperature again,  renew ice
compresses, and give a very warm douche.  Find a
place where the union is not perfect; shall look for
a discharge which soon takes place.  It can be over-
come with faithful syringing and the use of cerates.
                 Saturday, A. M.
  Catheter used for  the last time.   Things look
hopeful; patient has borne up bravely.  Stitches are
to be removed in a day or two; move the bowels
with injections of sweet oil, a tablespoonful at in-
tervals of an hour each, until bed time.
  Give a cathartic, and in the morning renew the
oil and water injections.
  Stitches  successfully removed; keep  the knees
tied  for a few days longer,  but the patient may be
turned from side to side.
                  April 12th.
  Menstruation takes place.  After this patient may
sit up in bed, and gradually sit up in a chair. 
         TREATMENT OF INDIVIDUAL CASES.       65

  Diet must be nutricious.  Massage treatment is
used daily, beginning  with 20  minutes  rubbing,
and  increasing the time as the patient  becomes
stronger.
  Alkathrepta instead of tea or coffee.
  Patient is up and around, speaks of going home,
which  she will be able to do in a few days.  A suc-
cessful issue of a long, hard case, amply repays me
for my toil.

            PUEEPEEAL FEVEE,
               OR CHILD BED FEVER.
                 April 10,  18—.
  A  very critical case, child still born; had been
dead three weeks before   delivery.   A  destitute
woman, no home, could not be  kept where she was
confined, so was brought a mile and a half in a car-
riage, a day after delivery.  I was  sent for to  take
care  of her;  nothing  had  been done; it became a
question of life and death.
  The  patient had been a robust, healthy, person.
Fever high, breasts caked, blood  poisoning had set
in.   Gave highly carbolated douches and put flax
seed poultice  across the abdomen; continued the
same treatment night  and day,  without intermis-
sion.
  Used the breast pumps  three  and four times  a
day,  after which rubbed the breasts with alcohol
and camphor.  Aconite, as  prescribed by attending
      5 
66             a nurse's  journal.

physician, to allay the fever.  Bowels  moved by
cathartics.  Only very light nourishment given.
  Faithful watching and close attention to douches
and breast pump, pulled her through, and she left
us quite restored to her former health.

   CHEONIC INFLAMMATION  OF  THE
                  BLADDEE.
  The patient is able to be up and around, but re-
quires a great deal of  attention;  hot douches are
"given twice a day.  The temperature of the water
can be gradually increased.  By  the use of ther-
mometer the heat may be regulated.
  By placing a piece  of absorbent cotton outside
of the vagina and perineum, thus allowing the hot
water to pass over instead  of  coming into contact
with the  parts, will ameliorate the burning  sensa-
tion.
  Paint the chest and abdomen with  iodine  mixed
with  alcohol,  as  directed by physician.  As  this
stains the clothing, care must be taken  in  apply-
ing it.
  Always set the bottle containing it on  a saucer,
or piece of stiff paste board, so as not  to stain furni-
ture.
  Apply the mixture  with a camel's hair brush;
lengthen the handle by tying it to a stick.
  Apply carefully only to  those  parts where  it is
needed. 
.   TREATMENT OF INDIVIDUAL CASES.       67
INFLAMMATION OF THE  BLADDEE AND
                   RECTUM.
  This proved a very long and tedious case; patient
has not been able to walk for a long time; the dis-
ease is very painful; the neck of  the bladder  is
dilated.  Anaesthetics are administered, after which
the two dilators are worn for one hour every morn-
ing.
  Before inserting they  must be carefully oiled with
cosmoline;  they  are kept in place by a  bandage
fastened around the waist; a spoonful of cosmoline
was  also injected into the rectum through a tube.
Sitz baths of two hours' duration each  were given
twice a day.  I began the baths  with the tempera-
ture of the water agreeable to the patient;.covered
the hips with a woolen blanket, wrapped around the
patient, and firmly fastened to the tub; added w7ater
to the bath as hot as could be borne by the patient.
This must be carefully watched; test the heat by a
thermometer; cloths wrung out of cold water may
be placed to the  head,  if the patient  feels at  all
faint.  Never expose the body to draughts; remove
the cold water  by  working  under  the  blanket; a
vaginal douche was given while sitting in the bath,
which helped to allay the inflammation of the blad-
der.
  The  treatment  proved  slow  and wearisome to
nnrse, as well as patient, but " a constant dripping
wears a stone." 
68
a nurse's journal.
                DIPHTHEEIA.
  In some  cases the disease comes  on gradually,
while in others it is malignant from  the first, and
sometimes  closely resembles scarlet fever.  As it is
contagious, nurses should use the greatest  precau-
tion.   What is to be done must be  done quickly,
as soon as the child complains of the throat feeling
sore, the neck stiff, and general  exhaustion.  It is
a great mistake to put off sending for a nurse.   I
very much dislike to take a case.  The first stages
of the disease must be properly managed.  By not
using proper disinfectants from the outset, many a
nurse has become a victim of the dread disease her-
self.
  Watch carefully the temperature and pulse, which
ranges from 120 to 150 per minute.
  In  cases of high fever, give  the  patient  small
pieces of ice.
  Care must be taken by  the nurse to inhale as
little of the fumes as possible Vvhen  standing over
vessels in which the patient has vomited.

                 March 5, 1883.
  Patient is delirious; pry open the mouth to give
medicines.   Swab the  mouth  frequently.   Diet,
milk, beef tea, egg nog and brandy.
  Foot baths and spirit vapor baths  given.   For
foot bath I use bath tub or any similar vessel.   If
the patient is very weak, use large pan; put it into 
         TREATMENT of individual cases.       69

the bed, placing oil cloth under it; put the feet into
it; put a  quilt rolled  up as a support under the
patient's knees;  stimulants may be added to the
water, such as salt, cayenne pepper,  mustard, etc.
For a spirit vapor bath  remove the patient's cloth-
ing; put on simply a night  dress or wrap in  sheet.
Seat  the  patient on  a wooden-bottomed chair; a
board may be placed  on an open-bottomed  chair.
Throw a large coverlid or blanket around him from
behind, covering the back of the head and body, as
well as the chair; pass another around him in front;
pin at the neck.  The blankets must reach to the
floor so as to retain the vapor. Put twro or  three
tablespoonfuls of liquor, whiskey, brandy or alcohol,
in a saucer  or tin vessel.   Then light a  piece of
paper, apply the flame to the liquor and as soon as
it burns,  let  down the blanket,  which has  been
raised to  light it.   When consumed, put  more
liquor in as before, being careful to put no liquor in
while it is burning.  Continue this until the patient
perspires freely, which will generally be in five or
ten minutes.
  Another very safe way is to fill the saucer or basin
with common  salt, then saturate  with liquor and
light; no danger of spilling the fluid.
  If the  patient feels faint during the operation,
sprinkle a little water in his face and let him hold a
httle ice in his mouth.  As soon as perspiration is
profuse, wrap the  blankets about  the patient and
put him to bed.  After two or three  hours remove 
70
a nurse's  journal.
the extra clothing gradually that he may cease per-
spiring.
                 PNEUMONIA.
  Treatment: The  patient is  very chilly followed
by a fluttering of heat.  Eubbed with alcohol dilu-
ted with hot water; placed bottles filled with hot
water about the patient.   Hot drinks were admin-
istered and the room properly ventilated; pure air
is essential.  Severe coughing. Place flannels and
a warm plate on the chest; do not raise the patient
to expectorate, use pieces  of cheese cloth.  Placed
hot flax-seed poultices across the  chest, also not
allowing them  to cool; oiled the chest frequently
with goose oil.
  A. M.—Coughing severe, fever high, patient rest-
less, apt to increase.  Odors from the kitchen irri-
tate patient's cough; obliged  to stop up key-holes
with wads of paper,  Lemonade freely given.
  Patient is not  allowed to speak, merely nods in
reply.  With careful nursing, which in  a case of
pnuemonia is as important as the medicine, the pa-
tient will rally in time.
  Used the urinal and bed pan, avoided lifting the
patient, or exposing the body to draughts.

     CEEEBEO SPINAL MENINGITIS.
                 Spotted  Fever.
  The  patient,  a boy of  thirteen, returned from
school complaining of feeling cold; within an hour's
time became unconscious. 
         TREATMENT  OF INDIVIDUAL CASES.       71

  High fever ensued, pulse accelerated, purple spots
appear on the surface of the body, lips parched and
dry,  the  muscles become dry  and rigid, and the
head is drawn back.  Stupor and deafness follow.
Mustard poultices are placed across the stomach,
and the body rubbed with stimulants.  The patient
is next wrapped up in a blanket wrung  out of hot
water, and hot  water bottles laid on either side  of
the blankets.
  A  deadly odor made the use of disinfectants nec-
essary.  Medicines  administered regularly as  pre-
scribed.   Perspiration reduced the pulse.  Urine
carefully preserved for inspection.
   At first the  patient was constipated, but after
cathartics had  been administered stools were invol-
untary.
   Cloths were  kept underneath the patient and a
soft  rubber urinal attached around the waist:
   The patient  has  come out of his stupor and is
very sensitive to noise, screams at every sound, or
at the least touch.
   Lips moistened constantly with water and a little
lemon juice.
   Noise from the streets deadened by bark.  Silence
reigns supreme where a soul  hovers between life
and  death.
   Long, watchful, sleepless nights.
   The patient  recovers very slowly, improvement
scarce perceptible.
   I  shall always remember the  countenance of my 
72             A NURSE'S JOURNAL.
 patient when he heard and recognized the bugle of
 the fish monger.
  He must have fish, the fish was granted.   It was
 carefully boiled and lightly seasoned.
  Gradually recovering, he had to learn to walk
 again like a child; the hearing remained somewhat
 impaired for a long time.
  Nurses  must in fever cases note and report all
 symptoms  to  attending physician.  When a pa-
 tient is disposed to lie on his back all the time it is
 a sign of muscular debility.
  If he manifests no desire to change position it
 denotes general prostration.
  Picking the  bed clothes, involuntary twitching of
 the muscles,  during a  protracted fever, is  a sign
 that the patient is sinking.
  Contraction and expansion of the nostrils denotes
 congestion of the lungs.
  Usually the pulse beats five times during one
 respiration.
  The normal temperature of  the body ranges from
 98° to 99° F.
  The maximum from 1 to 6 P. M.
  The minimum from 2 to 6 A. M.
  The greater the deviation from this standard the
 greater the severity of the disease.
  In the early stages  of acute disease the animal
heat is increased and should be diminished by bath-
ing and cooling drinks.
  In the latter stages  of disease the  temperature 
          TREATMENT OF INDIVIDUAL  CASES.       73

 becomes diminished and the condition of the sys-
 tem is favorable  to congestions which are most
 likely to occur between 2 and 6 o'clock A. M., when
 the vital powers are lowest.  The patient then be-
 comes cold and feeble and  he has what is termed a
 " sinking spell," and perhaps dies.
  It is during these hours that the well trained
 nurse  will be  active in putting hot bottles to the
 feet, hot water at the  thighs and  armpits, and by
 rubbing, putting  on  additional covering, and  by
 giving stimulating drinks, and  her vigilance often
 saves the life of the patient.  A nurse ignorant of
 these facts gets sleepy and inattentive  at  these
 hours, and the patient's life is jeopardized.

                  PAEALYSIS.
  Paralytic patients are often very  hard to handle,
 especially  if most of the body  is  stricken.   The
 first and second strokes are  often not fatal, and the
 patient may live for years in a helpless condition.
  The  symptoms  are  often similar to apoplexy.
 The skin must be kept clean by  sponge  baths, and
 if the patient is not able to swallow food,  enemas
 must  be given.  The use  of electricity,  massage
 treatment, are beneficial.  The bowels must be kept
 open,  giving injections of castile  soap and sweet
 oil daily.  Keep the patient's mind as cheerful  a.s
possible;  don't  hint another stroke, and hang it
 over him suspended by a single hair, like the sword
 of Damocles. 
74             A NURSE'S JOURNAL.
                  MEASLES.
  .Mothers should know how to take care of their
children when they have  the measles.  That  they
do not, is obvious from the fact that so many  chil-
dren are afflicted during a life-time with weak eyes
or some other infirmity in consequence of ill-nurs-
ing during that time.  The eyes, which are weak at
that time, should be carefully shaded from the light.
  Cold water should  be given.  The diet should be
light, milk,  cracked  wheat,  tapioca, toast water.
My last experience was with a family of six  chil-
dren; they needed close watching in order to pre-
vent them from taking  cold by  throwing off bed
clothes.  Medicines were given according to direc-
tions.  Slippery elm  and flax seed tea were freely
given to allay the cough.   The bowels were regu-
lated by giving them roasted apples and  the juice
of stewed prunes.
  For the itching, cosmoline inunctions.  The run
of the disease is usually from seven to twenty days. 
VALUABLE  HINTS.
  The  unpleasant feeling from  etherizing,  which
often falls to the lot of the nurse, may be  counter-
acted by using spirits of vinegar.
  Nursing bottles may be cleansed by using shot
and a little washing soda.
  Medicines left in glasses should always be covered
and set in a dark place; spoons should never be in
it; wash immediately after using.
  If  there  be  a stationary wash basin  in the in-
valid's room from which gases escape, throw some
copperas into it, and let the water run a little if it
does not  annoy the patient.
  Gas burners are very trying to a patient's eyes;
darken the side towards the  patient with a large
palm leaf fan, or a newspaper.
  The heat from the fire  may annoy a patient; if
so, a screen made of laths covered with stiff paper
such as is used in  deafening walls  will answer the
purpose very well.
  Use a candle in dressing wounds, or wnen using
the catheter. 
76             a nurse's journal.
   The light may then be held as close as necessary
 without danger.
   If a large quantity of crushed ice is needed, put
 it in a strong cloth and break against a stone or the
 side of the house.
   If the patient wants a piece, take a large shawl
 or hat pin, with which ice two feet thick may be cut
 as a diamond cuts glass.
   Knit shoes that come up over the ankle, with felt
 soles, are easy to put on, and very warm, should be
 worn by the nurse.
  Hoarhound syrup is made by taking a good pinch
 of  the  herb,  add three  teaspoonfuls   of water,
 sweeten with honey, add the juice of half a lemon.
  Brushes are cleansed by putting a few drops of
 aqua ammonia into the water.
  Nurses are refreshed when exhausted  by a  cam-
 phor bath, using the flesh brush.
  Cocoanut oil should never be used unless strictly
 fresh.  Allow the  physician to  inspect it if at all
doubtful.

  Never use your fingers when forceps can be used.
  In cases of violent nose bleeding, place  a piece of
brown paper, paper such as  is  used for  wrapping,
under the upper lip; let the person hold it  there
firmly. 
VALUABLE HINTS.              77
  For burns weak alum water is a useful remedy.
  A child's clothes should be light and loose.  Flan-
nel should always be worn  over the bowels.  Keep
its  mouth  washed to  prevent  brash; use tepid
water.
  Never try to bend  the  body or straighten the
limbs of a child while in a spasm.
  Never put hot water to the head.
  Sponges for use at all surgical operations should
be perfectly new and scalded with hot  water until
all the  sands are washed out.  Then rinsed  with
hot water.
  Use  thread No. 36  to tie the umbilical cord.
Binders twelve inches in width; compresses under-
neath the size of a towel.
  If necessary  that evacuation be left for inspec-
tion of physician,  remove it from the patient's
room, cover and set in cool, dark place.
  Never annoy a patient with useless brushing and
dusting.  Have a place for everything clean as you
go.  Spend your spare time in amusing the patient,
arranging a bouquet, or changing the position of a
picture, etc.  Useless noises should be  avoided in
the sick room,  such as squeaking doors or shoes
Handling coal is very irritating to a nervous person.
Announce to the patient that you are about to  re-
plenish the  fire.  Do  not  startle  with unexpected 
78
a nurse's  journal.
noises.  If very sick, do the coal about  to be put
on up  in paper;  then put in  at once without
noise.   Doors and chairs may be oiled.  These are
small things, but out of them spring great evils.
   Never wipe on the patient's towel.
   Nurses will find the pallet knife  used by artists
handy in spreading salves or cerates on cotton or
lint.
   Nurses should take a proper  quantity of food, a
good bath, and sleep in a warm bed in a cool room.
   If a pus-pan cannot be had in dressing ulcers and
abscesses use absorbent cotton to take up the dis-
charges and water.
   In preparing a patient for an operation dress the
feet in buttoned shoes; they keep the ankles warm
—bare feet are out of the question.
   Chills may be prevented by having plenty of hot
water ready in bottles to put around the patient.
  Never use  cold applications without laying flan-
nel of several thicknesses underneath to prevent  a
sudden chill.
  Bottles washed in suds and rinsed in alcohol, are
ready for use again.

  Bottled beer, porter, wine, or any bottled drinks,
should be placed in cold water,  if  there  is no ice
box or cellar. 
VALUABLE HINTS.
79
  The temperature of a healthy body is 98°.  Sweat-
ing will open pores and often break up a fever.
  Two tablespoonfuls  of the compound spirits of
ammonia added to a basin of water will remove the
unpleasant odor of perspiration and  leave the skm
clean and fresh.
  Sun baths are of great value to patients and con-
valescents.
  Expose  the back to  the rays of the  sun in a sit-
ting or reclining position.
  A good deal of attention should  be given, by the
nurse, to keep her hands nice  and soft.  A coarse,
harsh hand is irritating to a patient.
  Changing from hot to cold water is very trying to
the hands.  Sweet oil rubbed thoroughly into the
skin and washed off with white castile  soap in the
morning is very beneficial.   Glycerine with a few
drops of carbolic acid is nice for red  hands.
  The use of  an electric brush will often  cure a se-
vere headache.
  Bathe a broken limb with flannels wrung out of
hot water, stretching on a marble slab or table, and
send for physician.
  Oil cloth aprons are the best when assisting at a
surgical operation; they can  be cleansed in carbo-
lated  water. 
80
a nurse's  journal.
  Study the arrangement of flowers; put them into
pretty vases; if they have short stems, into a glass
dish, saucers or plates; add  salt or bicarbolate of
soda to  the water, they will keep longer.
  To fill a dish with sand or moss is also a nice way,
keeping it moistened.
  A flannel bag filled with salt, heated quite hot,
will relieve tooth ache, neuralgia or any disease in
which warmth is requisite.
  Clear, cold coffee  will often allay vomiting.
  A soothing effect, where the  patient is nervous,
may be  produced by emersing the hands in water,
or letting water drip on the wrists.
  Canton flannel napkins are best for infants; they
are  soft  and the infant is less liable to take cold.
  Headache, if caused  by some derangement of the
stomach; is often cured by taking a teaspoonful of
powdered charcoal.
  Nurses should partake of  a mid-night luncheon
when up all night.
  The skin and  pulp of a raisin is good for tender
nipples,  also,  a wash of borax.  It is well to wear a
piece of crash towel next to the breast, it serves to
harden the nipple.
  A child's mouth should he washed immediately
after nursing, with  a soft  piece of cloth.  It  pre-
vents thrush. 
VALUABLE HINTS.
81
  The  antidote for poisonous food is an emetic of
warm water, with mustard or common salt in it.
  Do not delay an operation by any neglect of du-
ties on your part.
  All visits to the sick room should be made in the
morning while the patient is fresh.
  Cleanse a wound thoroughly; the smallest foreign
substance often produces serious results.  Bleeding
from a wound may often be checked  by applying a
piece of ice to it.
  Open the lower windows  frequently to secure
proper ventilation.
  A sick headache is often cured by taking a piece
of lemon, or a teaspoonful of the juice  before eating.
  Do not imagine your duty done when the patient
is out of danger, it is then that it begins.
  Select a room for the sick with grate or fire place
in it if possible.  In summer a lighted candle set
in serves to carry off foul odors.
  A hot room may be cooled by wringing out sheets
and hanging them ever the windows and doors; this
process is resorted to in India.
  One hour of sleep to a patient is worth more than
all the medicines.
  A nurse may lighten her burdens by keeping on
6 
82
a nurse's journal.
the good side of the servants.  She should be care-
ful not to make them useless work.
  Any person waiting on the  sick snould  be  able
upon  the first visit of the  physician to give an in-
telligent idea of the progress, if any, of the patient,
whether the fever be of a remittent or intermittent
character.  Also symptoms  of chills  as  found or
absent; their frequency.    Perspiration,  cold or
warm.  Aches in any part  of the body.  Tempera-
ture.  Time or space in which the symptoms have
existed.
  Water kept in a room any length of time is unfit
for use.
  Avoid shocks; do not bathe in cold water when
the body is very warm; regulate the temperature
to the condition of the patient.
  Cleanse the ears with a soft cloth; never use any-
thing sharp.

  In case of fainting, place the person perfectly flat
on the back, so  that the head may be below  the
level of the  body.   Fainting arises by a lack of
blood to the brain and inaction of the heart.
  A kerosene lamp should never be turned  down in
a sick room, the combustion is not perfect and the
atmosphere becomes vitiated by the unconsumed
oil vapors. 
VALUABLE HINTS.
83
  The temperature of a new born babe is 98J- degs.
A nurse should bear this in mind and not give an
infant a bath in a room of 50 degs. Never use any-
thing but safety pins about a child's clothing.
  Bruises on the fleshy  part of the body generally
cause very  little trouble;  but  sprains  about  the
joints are sometimes very serious. The first thing
is to avoid  inflammation.  Keep  the joint cool by
showering cold water on  it.  Wrap the joint in
cloths saturated with salt water.  If  an artery has
been severed and  blood comes out in  jets or leaps,
tie a handkerchief around the limb by two corners,
put a stick between and twist it to stop  the bleed-
ing; meanwhile send for physician.
  If red flannel night gowns are to be worn next to
the skin, especially  in surgery,  it is  well to have
them washed, as the coloring  often irritates the
skin, and becomes the source of great discomfort.
  A child does not suffer for want of food for six or
eight hours  after  birth.
  Milk, if given to invalids, must be perfectly fresh.
  For costiveness knead the bowels lightly; for dis-
tension wear bandages.
  Many children  become slightly hump-backed or
round shouldered in consequence of sleeping with
the head raised on a high pillow.
  A professional  nurse  who performs the duties  of 
84
a nurse's journal.
her calling simply for remuneration, must be to the
sick a disagreeable person; but if one fulfills her
blessed calling for the love of the work, she becomes
indeed a ministering angel in the guise of a working
woman.  Sympathy is a divine attribute which none
of us possess in too eminent a degree.
  If you are the invalid's attendant, you may often
be wounded  by reproachful, harsh words,  or per-
emptory orders.  Indignities may at times be offered,
bear in  mind that if your calling  does not ennoble
you, you may almost sanctify it by doing your duty
well.
  Steak preserved  on  ice for several days is im-
proved ; becomes more tender.
  The disagreeable tickling in the throat, the hack-
ing cough and even bleeding at the lungs is amel-
iorated by one or two pinches of salt.
  The use of animal food enriches the blood.
  Hiccough is relieved by administering a lump of
sugar saturated with vinegar.
  Little children should not be encouraged  to walk
too early;  the weight of their bodies is great for
the limbs.

  Invalids and aged people should exercise before
eating, in order to aid  digestion, and  promote ap-
petite. 
valuable hints.               85
  Lemon tea will sometimes relieve hay fever; add
flax seed to it.
  Sick persons are not all alike and the peculiari-
ties of each must be studied.   Listen to a patient's
vagaries, but do not encourage them.
  Hope is one of  the best tonics.
  A substitute for sea bathing is obtained by adding
sufficient sea salt in a bath tub of water; it should
be rain water.  The salt can be had at any  first
class drug store.  It comes in pound boxes.
  The patient's teeth should be kept clean by the
nurse.  Spread a towel under the chin, have ready
a glass of tepid  water, with  a glass tube; brush
lightly, rinse the mouth.  If the patient is too weak
wipe the mouth and teeth with small towel or soft
sponge. All medicines that tarnish the teeth should
be taken through a tube.
  A nurse's pin ball is made  by cutting two round
pieces of velvet, filling the sides with emery.  Then
cover with velvet, join the two parts together with
cross-stitch, put pins all around, and suspend to the
belt of the apron or girdle.
  The needle used in hypodermic syringe may be
sharpened and brightened by the emery in it. 
86             a nurse's journal.
    POISONS AND THEIE ANTIDOTES.
  In cases of poisoning the first thing to be done is
to produce vomiting, so as to eject the poison from
the stomach as soon as possible.
  Tepid water drank in large quantities and often
repeated will produce vomiting.
  Snuff or mustard  mixed with  salt, or  mustard
mixed in warm water and drank freely.
  Tickling the throat with straw or feather.
  Poisoning by clams, lobsters, etc., give an emetic,
followed by a dose of salts.  Let the patient drink
freely of strong coffee, sugar and water, or a solu-
tion of camphor.
  When a person nas been rendered insensible by
poisonous gases he should be stripped at once and
cold water dashed over the  body. Fill the lungs
with fresh air, and treat as a  person under apparent
death from drowning.  Give stimulants, brandy or
wine.
  In poisoning by camphor give black coffee.
  Nitrate of silver may be neutralized by drinking
freely of common salt dissolved in water.
  In poisoning by tin, or any salt of tin, use sugar,
white of egg, milk and flour.
  In poisoning by tartar emetic give very strong tea. 
VALUABLE HINTS.               87
  In poisoning by aconite give stimulants, whisky,
brandy, externally and internally.
  In poisoning by arnica give vinegar.
  In poisoning by opium, belladona,  nux vomica,
morphine, laudanum, etc., give an emetic, followed
by  cold water dashed over the person, and  strong
coffee or vinegar  diluted with water.
  The person  should be made  to walk rapidly be-
tween two persons.
  If insensible, rub, pound, roll.  The  stomach
pump should also be used.
  Poisoning by acids, such as sulphuric, nitric, mu-
riatic and phosphoric acid, use soap suds or wood
ashes.
  In poisoning by lead, or any salt of lead, give large
doses of epsom salts or plaster of Paris mixed with
water.
  Iodine may be  neutralized by starch, wheat flour,
or  arrow root taken in  large quantities.  This may
be  followed by a  mixture of vinegar and water. 
WEIGHTS AND MEASURES.
fl m j—One minim.  This is the smallest drop and
     may be accurately obtained by dropping from
     a hypodermic syringe.
gr j—One grain.
3 j—One scruple=20 grains.
3 j—One  drachm=60 grains.
I ss—Half ounce=4 drachms.
? j—One  ounce=8 drachms.
ft> j—One pound=16 ounces.
fl 3 j—One fluid drachm=60 minims.
fl 1 ss—Fluid half ounce=4 fl drachms.
fl 1 j—One fluid ounce=8 fl drachms.
fl 0. j—One pint=20 fl ounces.
fl G. j—One gallon=8 pints.

  A common sized wine glass holds half  a gill.
  A common sized tumbler holds half a pint.
  Four common sized tea cups of liquid are equal
to one quart.
  A drachm is equal to one teaspoonful.
  Two drachms are equal to a dessertspoonful.
  One-half ounce is equal to a tablespoonful. 
GLOSSARY—QUESTIONS.
  1.—How do  you count the pulse, and what are
the number of  beats per minute ?
  2.—How many respirations are there per minute,
and how should they be taken ?
  3.—What is  the normal temperature of the body
in health ?
  4.—Where should the temperature be taken?
  5.—When  is the most accurate  time to take the
temperature ?
  6.—Why should temperature be taken?
  7.—Give a diagnosis of  the appearance of  the
tongue in disease?
  8.—Describe the tongue in tubercular disease?
  9.—The tongue cleaning from the edges denotes
what?  From the middle?  If raw or dark colored?
  10.—What is the aspect of the face in abdominal
and venal diseases ?
  11.—What are  the  marked  expressions of  the
face in diseases of the brain ?
  12.—Define the difference between diarrhoea and
dysentery?
  13.—Locate the kidneys and their use?
  14.—Mention some of the  foreign substances
found in the urine. 
90             a nurse's journal.

  15.—In cases of vomiting how should it be noted
and reported ?
  16.—How should expectoration be noted and re-
ported ?
  17.—In  administering food what should be ob-
served?
  18.—Define a wound.  What is proud flesh?
  19.—How should a wound heal?
  20.—What are the favorable  signs of an abscess
wound ?
  21.—Define healthy wounds?
  22.—When do wounds indicate extreme danger?
  23.—How may pus be divided and defined.
  24.—Define enema.  What should be the temper-
ature  of an enema?
  25.—Do anesthetics reduce the temperature?
  26.—What precautions are necessary at an opera-
tion.
  27.—How may bed-sores be prevented?
  28.—How may stains be removed from the  skin
caused by the use of adhesive plaster?
  29.—In syringing a deep cavity how may the force
of the water be moderated or broken ?
  30.—Define antiseptic;  mention some antiseptic
dressings.
  31.—What is the abdomen, and what does it con-
tain?
  32.—Define acute.
  33.—What are anodynes?
  34.—What are aperients? 
GLOSSARY—QUESTIONS.
91
  35.—What is the medical term for long duration ?
  36.—What is the chemical term for water?
  37.—Define circulation.
  38.—Define  compress.
  39.—Define coma.
  40.—Define  crisis.
  41.—Define decoction.
  42.—Define diabetes.
  43.—Give the medical term for recognizing symp-
toms.
  44.—Define diphtheria.
  45.—What are the most dangerous symptoms of
diphtheria?
  46.—How may  an  amputated  limb  be  sup-
ported?
  47.—In chicken-pox what is the period of incuba-
tion?
  48.—Where  does the rash or eruption show itself?
What is the run of  the disease?  What are the
after effects ?
  49.—Define the term malignant.
  50.—What are  the distinctions between measles
and scarlet fever?
  51.—What is the period of incubation in scarlet
fever ?
  52.—What the period in measles?
  53.—What is the temperature?
  54.—State the temperature in scarlet fever.
  55.—Where does  the  eruption  first appear in
measles?   In scarlet fever? 
92
a nurse's journal.
  56.—What are the evil effects of scarlet fever?
 Of  measles?
  57.—How may hemorrhage of a limb be arrested?
  58.—What is a tonic?
  59.—Define typhoid fever?   How may it be dis-
 guished from typhus ?
  60.—How may poison be taken into the  system?
  61.—How many cubic inches of air does a healthy
 man consume in a minute ? In twenty-four hours ?
  62.—Define the difference between venous and
 arterial blood ?
  63.—How is a room best ventilated?
  64.—When burns occur near a joint what should
 be taken to prevent contraction?
  65.—How are leeches apphed?
  66.—Define tenismus?
  67.—What is a probe?
  68.—What is a pessary?
  69.—Define a tent?
  70.—What is the name of a surgical instrument
used in examining the bladder ?
  71.—Define a speculum?  A scalpel?
  72.—Name some of the dangers connected with
obstetrics?
  73.—What should be done  in cases  of apparent
death of  a new born infant ?
  74.—Give  the comparative  facility  of digesting
articles of diet? viz:  rice, sugar, tapioca,  barley,
stale bread,  new bread, cabbage, oysters,  salmon,
venison, beef, roast pork, raw eggs ? 
              GLOSSARY—QUESTIONS.            93

  75.—Of what chemical elements is the human
body composed?  How many are there?
  76.—Define paroxysm?
  77.—How should purgative medicines be given?
  78.—What precaution must be used in bandaging
a foot or arm ?  A new born babe ?
  79.—In the  absence of  a syringe  how may an
enema be given ?
  80.—Mention the several forms of enemas?
  81.—In opening and dressing felons, abscesses,
and wTounds, what is of vast importance?
  82.—Define chlorine gas?
  83.—Define caustic?
  84.—What is croup?
  85.—What  can be done in cases  of persistent
vomiting ?
  86.—Define rheumatism and gout?
  87.—What are varicose veins?
  88.—State the symptoms of an overdose of the
following  medicines,  viz:  Opium,  strychnine,
arsenic, carbolic acid, belladona, chloral, mercury?
  89.—Define menorrhagia?
  90.—In cases of profuse menorrhagia what means
should be resorted to ?
  91.—Mention some of  the  disorders connected
with pregnancy.
  92.—In giving baths what precautions are  neces-
sary?
  93,—What should be done in case of fainting? 
94             a nurse's journal.
   94.—What color of flannel is best adapted for
 infants' wear?
   95.—When is the most favorable time to wean a
 child?
   96.—How are obstructions removed from the ear?
   97.—How may sleep be produced without the aid
 of medicines?
   98.—How should a frozen ear, toe, or nose, be
 treated?
   99.—How may corpulence be reduced?
   100.—Define  congestion.
   101.—Name  the worms that infest the  human
 system.
   102.—Define  incysted tumors.
   103.—Locate the heart.
  104.—Locate the spleen.
  105.—What is the medical term for fevers?
  106.—What  are  the leading quahties of  a  good
nurse?
  107.—Is nursing a paying profession?
  108.—What is the acceptable age for candidates?
  109.—How is instruction given to nurses in the
training schools?
  110.—What is necessary for a person  to do in
order to gain admission to a training-school  ?
  111.—What is the time of service?
  112.—Do nurses receive any remuneration during
the time of probation ? 
GLOSSARY—ANSWERS.
   1.—In  a healthy person the  pulse  beats  from
 sixty to  eighty  per minute,  with even force and
 volume.  In counting  the beats the three fingers
 should  be laid lightly  on the artery, so that the
 artery may beat against them.
   2.—There are sixteen per minute, beating evenly
 and gently; they should be taken by placing the
 hand on  the chest just below  the  breast  bone,
 counting  the respirations; be  governed by the eye
 as to the nature and style.
  3.—It varies from 98° to 99° and  may  register
 100.
  4.—In the mouth underneath the tongue, in the
 rectum, or the arm pit, which  registers  1°  less.
 The register  should always be shaken down to 95°
 before taking the temperature  of a patient.
  5.—In the  morning before 9 o'clock  and in the
 evening between five and six o'clock, but it may be
 taken oftener if desired.
  6.—Its  use is indispensable  as the  temperature
 of the body is of great value in infectious diseases,
 and wherever there  is any danger  or suspicion of
 an eruptive fever in incubating. In case it registers
100°, isolation would be  in place. 
96
a nurse's  journal.
   7.—Watch  steadily the mode of  protruding it;
 a one sided movement indicates paralysis, a trem-
 ulous movement indicates  fever,  also cerebral
 disease.
   8.—In tubercular its appearance is often bright
 red, glazed, hard and  dry, dangerous prostration
 when it changes  to a brown  or black hue.  In bil-
 ious  fever it is  covered  with a yellowish coating
 and a white coating in cases of inflammatory dis-
 eases ; in scarlet  fever a white coating dotted with
 red resembling the color of strawberries.
   9.—Eapid  recovery.  Interrupted, tedious,  the
 progress is not good, especially if the crust formed
 is readily removed and leaves a raw surface.
   10.—The eyes  are keen and hollow, the jaws and
 cheeks are thin and sharpened, the  look pinched,
 and the face wears a starved expression.
   11.—The gradual creeping on of unconsiousness in
 the acute  stages, the  want of speculation  in the
 eye, expression of pain, the brows are knit, the ab-
 sense of soul in the whole face; in the chronic form
 stupor,  a dull  expression of the  eyes, lethargy and
 an unmeaning smile, want of  light.
  12.—Diarrhoea  is  a slight catarrh of the bowels,
 uncontrolable  desire to stool, which is sometimes
 accompanied  by  pain.   Dysentery  is  a serious
 catarrh  of the bowels attended with great pain and
prostration.   The evacuations  are  streaked with
blood and  contain  mucus.  In  serious  cases the
passages are involuntary. 
GLOSSARY—ANSWERS.
97
  13.—Two organs situated in the lumbar regions
on each side of the spine secreting the urine.
  1L—Albumen in scarlet fever, dropsy, diphtheria
and diseases of the kidneys, blood in  inflammation
of the bladder, sugar phosphates in diabetes.
  15.—Whether it consists of  undigested  food,
phlegm, bile or  blood.  In  some cases it has  the
appearance of coffee.
  16.—Whether  easily coughed up, if  offensive,
whether streaked with blood or of a rust color.
  17.—If it causes discomfort, nausea or vomiting;
pain if easily satisfied, craving, fickle, or taken with
a relish.
  18.—An  external injury to the soft parts of  the
body.   Granulations  that  are  brilliant  in color,
marked and puffed in  appearance.
  19.—Slowly from the bottom.
  20.—When the wound begins to pucker and  the
center of the abscess to depress.
  21.—When the edges unite at once or when  the
wound opens, pus is secreted, the process of repair
is carried on by granulations not too marked.
  22.—When of a livid, purphsh hue and a dead in-
active appearance.
  23.—Matter, the result of inflammation divided
into  laudable or healthy  pus of whitish  green,
moderately thick, not offensive; ichorous or un-
healthy pus dark brownish green, containing shreds
of tissue and fibrous, clotted and offensive.  Caseous
consisting  of thick clots,  stringy hke curds, not
      7 
98
A NURSE'S JOURNAL.
easily discharged from the cavity, and  purulent or
offensive pus of a dangerous character.
  24.—Food or medicine in a liquid form, thrown
up into  the  bowels, 96°  to 100° or  about the tem-
perature of  the body, never below it, observing
to expel the  air by warm  water  and oiling the
tube.
  25.—They do.
  26.—The head of  the patient should be raised,
and the body  laid in a convenient posture, the
throat open and free, observing to expose as little
of the  body as possible, the temperature of the
room being from 65° to 70° even heat.
  27.—In some cases they are almost unavoidable
where the skin becomes weakened and  stretched
over the large joints of the body  and gives way,
and the cartilaginous structure over the  bones are
exposed, otherwise they show shameful neglect.
Thoroughly  drying the  skin after washing, by not
allowing adhesive plasters or bed clothes to wrinkle,
and by  brushing all particles of crumbs from un-
derneath the patient.  To  avoid pressure use the
rubber bed pan, or cushion pillows made of hair;
oakum,  shreded pads of cotton, with circular hole
for props are useful.  Water matresses are the best
in paralytic  cases, but as they are expensive thick
sheep skins  may be  placed  underneath the sheet.
Peruvian balsam is a good dressing, spread on lint
evenly with  a pallet knife.
  28.—By using turpentine. 
GLOSSARY—ANSWERS.
99
  29.—A piece of soft rubber tubing maybe fastened
or drawn over the end of the syringe.
  30.—A medical term used for any substance hav-
ing the property to prevent putrifaction, carbolized
gauze, charcoal poultices and oakum.
  31.—It contains the internal organs of generation,
the large and small intestines, etc.   It is the largest
cavity in the body.
  32.—A medical term applied to a disease attended
with violent symptoms.
  33.—Medicines to allay pain.
  34.—Medicines which act gently on the bowels.
  35.—Chronic.
  36.—Aqua.
  37.—The  movement  of  the blood through the
veins and arteries.  The impure blood  is brought
by the veins to the heart, by the heart it is driven
through the lungs  where it is converted into bright
arterial blood,  again returning to the heart  to  be
driven through the arteries to the extremities.
  38.—A soft pad folded, used to make pressures  on
any part  of the body.
  39.—An unnatural state of insensibility; sound
sleep.
  40.—A sudden change in acute diseases.
  41.—A preparation made by boiling in a fluid.
  42.—A disease of  the kidneys attended with  an
immoderate flow7 of urine.
  43.—Diagnosis.
  44.—A contagious disease  affecting the mucous 
100
a nurse's journal.
membrane of the mouth and throat, often deposit-
ing a false membrane on mouth on fauces, attended
with great depression.
  45.—Danger from suffocation, also paralysis.
  46.—By using a support of about 3 or 4 lbs. weight
over the foot of the bed, and fastened to the stump
by a cord or strap, this  will avoid the distressing
starting.
  47.—About 14 days.
  48.—On the trunk in isolated spots, thence spread-
ing over the entire body.   About a fortnight.   The
critical days being the  third  and ninth.  Weak
eyes.
  49.—A term applied to fevers and growths to de-
scribe the deadly nature of the disease.
  50.—Measles are  always preceded by catarrhal
symptoms, cough, running from the nose, sneezing
etc., which does not take place in scarlet fever.  In
scarlet fever, the rash is smooth to the touch, and
is spread over the whole body, and of a bright color
resembling a boiled lobster.   In measles the rash
appears  in  spots resembling flea  bites  which are
slightly elevated from the surface and in patches
resembling the shape of half  moons. The eruptions
are not as bright as in scarlet  fever, being more of
a raspberry hue.  In scarlet  fever, the rash makes
its appearance on the second day, and is always ac-
companied by sore throat.
  51.—It varies from three to ten days.
  52.—About two weeks. 
GLOSSARY—ANSWERS.
101
  53.—From  100°  to 102° and in some cases it has
reached the temperature of 103°.
  54— From 100° to 104°.
  55.—On the neck and face.  On the  chest and
back and  in passing the hand over the skin the
blood rushes back to it.   The tongue is dry and of
a mahogany color.
  56.—Inflammation of the internal ear, from which
there is  a purulent  discharge, resulting in partial or
entire deafness, scrofulous swelhng of the  glands
of the neck, chronic inflammation  of  the eyes,
dropsy which may affect  the head, chest  or the
whole body, (this  generally takes place the  first
month;) sometimes the poison settles in  the joints
causing  rheumatism,  bronchitis,  pneumonia and
weak lungs.
  57.—Sponge the  wound with cold water so as to
see clearly from whence the blood comes, then
moisten absorbent  cotton  or a sponge, press firmly
on the wound; if  it comes from an artery it will
spurt  out.  If the  wound is so situated that pres-
sure can be made,  do  so by placing a pad or com-
press over the wound and  bandage the limb firmly,
the bandage should be between the heart and wound.
If this does not  stop it, astringents must be used,
such as  tannic acid, perchloride of iron, or gallic
acid.  In case of a divided artery,  place a finger  on
the spot; the patient should be kept very quiet, till
the physician arrives.
  58.—A medicine  to strengthen or give tone. 
102
a nurse's journal.
  59.—Typhoid fever  is a disease of a contagious
character, the result of poison introduced into the
system by foul air, improper food and ill ventilated
rooms.  It has an eruption of rose-colored spots
disappearing  on  pressure, great  prostration.  The
poison introduced into the system causes great in-
testinal disturbances and extreme emaciation.  The
eruption fades in two or three days;  diarrhoea of a
brick dust color, tenderness and swelhng of the ab-
domen.  It runs its course in about twenty-eight
to twenty-nine days,  the same as in typhus which
is a mere putrid fever assuming the form of spotted
fever, caused by dense, ill ventilated habitations,
poverty and foul air.   This disease sets in with vom-
iting,  weariness, shivering, pain in  the head  and
back, delirium; the eruptions differ from typhoid,
being brown,  small and close together on the trunk.
The stools and urine  dark and offensive.  In some
serious cases the brown spots run into livid blotches;
the pulse is very rapid.
  60.—Through the lungs,  by  inhalation, through
the skin or by the anus, or by swallowing.
  61.—About 32 inches—46.037 in.
  62.—One has been exposed to the air from whence
it has drawn its supply of oxygen, the other has
parted with the oxygen.
  63.—By lowering one-half window about three
inches from the  top, or by having one or more of
the window panes perforated.
  64.—Keep the part extended during the formation 
GLOSSARY—ANSWERS.           103
of the cicatrix, for it will form a band, causing a
great deal of trouble and pain, besides  disfiguring;
if it occurs in  a limb, a weight might be  attached.
  65.—If they do not bite readily, leave them out
of the water;  handle  them  carefully, having the
hands cold; they may be induced to bite by using a
little blood, and sometimes milk or porter.  Avoid
placing them  on a vein, as it  is often difficult to
control the bleeding.   Do not disturb them while
they are settled, or try to pull  them off, as a tooth
may be left in the wound.  They will drop off when
satisfied.  When they drop off have ready a basin of
cold salt water, a sponge, lint and strappings.  The
leeches may be used again by dropping them into a
basin of  salt, as they will vomit the blood.  Place a
piece  of ice on the wound to stop the bleeding if
profuse; if necessary use styptics.  It is dangerous
to  apply them to  the  mouth, rectum or vagina,
without the use of a proper  glass used in leeching.
   66.—A constant desire to evacuate the  bowels
 without  any  discharge,  and accompanied  with
 straining.
   67 _a surgical instrument used for  exploring
 wounds.
   68.—An instrument made of wood, glass, ivory or
 gutta percha; it is used in  supporting the uterus.
 " 69.—A roll of lint, sponge or  sea weed, used for
 dilating an opening
   70.—A sound.
   71.—A funnel-shaped instrument, used for view- 
104            a nurse's journal.
 ing internal parts or distending their openings.  A
 knife used in dissecting.
   72.—Hemorrhage, laceration and puerperal fever.
 Lacerations  are  common  and should be guarded
 against.
   73.—Place the child in  such a position that the
 circulation will be unimpeded, cleansing the mouth
 and nostrils, wrap the body in soft, warm flannels,
 proceed to rub the  spinal column, hands and feet
 with the palm of the hand; this  will hasten circu-
 lation.  The cord may then be cut and tied.  If no
 signs of life are manifested put into a warm bath to
 which spirits may be added; continue the rubbing.
 Pour cold water upon the chest, or inflate the lungs
 with  artificial air.  Place a silk handkerchief over
 the infant's mouth, close the nose and breathe evenly
 and gently; when inflated compress the chest gently.
 Electricity may be resorted to by  placing one end
 of the pole to the upper part of the spine, the other
 pole at the breast bone.
  74.—Boiled rice, one hour;  sago,  one  hour  and
 forty-five minutes; tapioca and.barley, two hours;
 stale  bread, two hours;  new bread, three hours;
 boiled cabbage, four hours; oysters, two and one-
 half hours; venison chops, one hour and a half; beef,
 three hours; roast pork, five and one-quarter hours;
 raw eggs,  two hours. The above  is the time  re-
 quired for  a healthy person.
  75.—Fourteen, viz: Oxygen and hydrogen gases
uniting to form water, carbon which gives heat, ni- 
               GLOSSARY—ANSWERS.            105

trogen which  makes  muscle and  gives strength.
The brain and nervous system receives vigor and
vitality from phosphorus; calcium or lime found in
the bones, chlorine and sodium, which united  form
chlorate  of sodium or common  salt; iron, which
gives color to the blood; sulphur-fluorine, potas-
sium, magnesium and silicon.
  76.—A sudden  and violent increase in the symp-
toms of any disease.
  77.—On an empty stomach.
  78.—A bandage perfectly applied  should feel firm
to the grasp, have no wrinkles, the  turns should be
made in the center of the limb and at an even dis-
tance from the folds.  W'hen applied over dressing
it should not l?e very tight as it will cause pain.
  A tight bandage around an infant should never be
allowed to impede circulation and  development of
the body.  Uneasiness is caused by tight bandag-
ing.
  79.—By placing one end of an india rubber  tube
into a  jug and raising it high.  This may be  used
in cases of emergency, where a quick action of the
bowels is necessary and a syringe  is not at hand.
The enema should always be of the temperature of
the body.
  80.—The simplest is of warm water and castile
soap, of about  a pint in quantity; glycerine and cas-
tor oil may be added.  Castor oil, turpentine and
salt to the quantity of water are used to promote
action of the bowels. 
106           a nurse's journal.
  For conveying nutriment to the body egg nogg
may be used; also, beef tea, brandy with arrow root,
port wine; the preparations  are  one  egg  to two
ounces of port wine, or one of brandy.  Gruel may
also be  given.  To allay pain enemas of opium of
about 15 to 20 drops are given with  starch.
  81.—The thorough cleaning and dipping of instru-
ments required in dressing and removing the pus,
use solution of carbolic acid of at least 100 per cent.
  82.—An antiseptic agent used to disinfect.
  83.—A substance which destroys tissue like a burn.
  84.—A cough of a noisy character, inflammation
of the wind pipe and suffocation.   As this complaint
comes on very suddenly medical aid must be sum-
moned at once.
  Let me give a few hints in cases of sudden emer-
gency.  Place the  child in warm  bath, but before
doing so give an enema of castile soap and water,
also an emetic of warm water and mustard, or salt
and tepid water.  The idea is to cleanse  the stom-
ach and throat and to get up a free action of the
skin.  After this takes place,  remove the child from
the bath, keep the throat warm by putting flax seed
poultice on it  and covering with flannel wrung out
of hot water.  Sponges wrung out of hot  water will
often allay spasms.
  85.—Small pieces of  ice may  be  given where
blood is vomited.  Cloths wrung out  of  ice water
and vinegar may be placed on the pit of  the  stom-
ach.  Soda water; champagne may be given where 
GLOSSARY—ANSWERS.
107
blood is not vomited.  The patient must he flat on
the back.
  86—Gout is a painful disease in the joints, mostly
in the hands and feet, affecting the internal organs.
Eheumatism is a disease of the blood, affecting the
muscles and joints.  The  joints swell, are acutely
tender and very stiff.  The  disease is often attended
with fever in the acute form, affecting the internal
organs.
  87.—They are diseased veins (chiefly those in the
leg) which become extended and knotted, impeding
the circulation of the blood.  This is a disease com-
mon in pregnancy.
  88. — From opium,  uncontrollable  drowsiness,
coma and contracted pupils.  Strychnine, cramps,
involuntary twitchings of  the limbs, spasms of the
throat and aching of the back.  Arsenic, vomiting,
constipation, pain in  the stomach, burning heat of
the mouth and fauces.  Carbolic acid, burning heat
of the mouth, throat and stomach, and intense pain
across the abdomen.  Belladona,  pupils dilated,
sight  dim, throat  and mouth dry, purging,  stupor,
giddiness and pain in the head.   Chloral, failure of
heart action, cold extremities, stupor.   Mercury, a
sudden flow of saliva, the gums spongy, teeth loose,
cramps, green evacuation from the bowels.
  89.—An immoderate flow of the menses.
  90. — Cloths  wrung  out of vinegar and water
should be applied to the abdomen, or ice compresses
laid across it.  Vaginal douches  of tepid or cold 
108            a nurse's journal.
water.   The  head should  be  lowered,  the hips
raised,  or blocks may be put under the foot of the
bed; in extreme case, tamponning or plugging must
be resorted to;  absorbent cotton or strips of linen
may be used. Stimulating drinks must be avoided,
also mental excitement.
  91. — Morning  sickness,  varicose  veins,  piles,
swelling of the feet, constipation, toothache, diar-
rhoea, heart-burn, sour stomach, palpitation of the
heart,  cough, hysteric fits, incontinence of urine,
hemorrhage,  miscarriage.
  92.—First, the  sanction of the attending physi-
cian is absolutely necessary.  Second, the temper-
ature  of the water  required in giving the bath
should be 90° to 92° for a warm bath.  Third, do not
leave a patient alone in a bath, as weak and delicate
are apt to faint.  Fourth, have in  readiness the
patient's slippers, as  the feet should always receive
the first attention; next, a warm blanket should be
thrown around the entire  body.  Fifth, in giving
an alcoholic bath, be careful to  shield the legs from
the heat of the alcohol lamp. This is done by plac-
ing blankets  of suitable thickness on the chair or
stool, and letting a portion hang down.  Sixth, giv-
ing an internal bath or douche; the heat must be
governed by  the feelings of the patient, which may
be gradually increased.
  93.—The patient should be  laid flat, with  the
head depressed below the feet;  the clothes  around
the throat and chest loosened; plenty of fresh air 
GLOSSARY—ANSWERS.
109
should be admitted around the patient.  The face
and chest may be sponged with cold water ; if this
does not suffice, and fainting is a want of blood to
the brain, a direct current may be sent by raising
the body by the  feet ; mustard poultices may be
applied to the feet if the fainting is caused by hem-
orrhage.   If caused by hemorrhage,  avoid stimu-
lants ;  otherwise administer them.
  If  fainting is caused by anaesthetics,  keep  the
head very low.
  94.—White flannels.
  95.—In the spring or fall of  the year.  This may
take place between twelve and eighteen months.
  96.—Syringe  the ear with warm water.  Do not
attempt to use anything sharp or blunt unless it be
a thin  silver wire  made in shape of a  hoop.  While
using syringe lie  on the side  of the  head with the
ear down; use oil.
  97.—A warm bath may be taken about ten or fif-
teen minutes before retiring.  Use the flesh brush
briskly for about twenty minutes.  The eyes  should
be kept closed.
  98.—Do not go  near heat, but apply at once snow
or ice  water.  If  this is not done there is danger of
mortification.  After  the frost is  drawn out apply
warmth gradually. Annoint with vasoline or cos-
moline.
  99___Do not  eat fattening food and never quite
satisfy the appetite; sleep only five to six hours, on
a hard bed;  a daily use of the flesh  brush, especi- 
110
a nurse's journal.
ally over the joints; this will render  the flesh firm
and hard.
  100.—An undue  accumulation of fluids  in  their
proper vessels.
  101.—The stomach worms, tape worm and the pin
worms.  The stomach worm often causes convul-
sions  and fits.  The tape worm infests the intes-
tines, takes up the most nourishing part of the food.
Pin worms are always found in the colon and anus.
Children suffering  from them are restless, starting
suddenly in  their sleep, gnashing their teeth, fetid
breath, griping pains in the bowels and want of  vi-
tality ; a pinched look.
  102.—Fluids enclosed in a sac.   Tumors may be
malignant and non-malignant.   They are of an ab-
normal growth.
  103.—A muscular cavity  in  the  thorax lying
slightly to the  left side,  and is divided into four
chambers, viz:  Eight ventricle  and left ventricle,
and left auricle and right auricle.
  104.—It lies on the left side underneath the stom-
ach; it is a cake-shaped organ.
  105.—Febris.   Medicines  that  allay fevers are
termed Febrifuge.
  106.—Observation  or quickness  of perception;
truthfulness, gentleness,  memory.   If lacking this
happy  faculty a pencil and note book must be  re-
sorted to.  Attention to details, keeping careful rec-
ords, etc.
  107.—Webster said, "There is always room in the 
Ill
GL 0 SS ARY—ANSWERS.
top story of any profession," and as that of nursing
is comparatively new and the sick are always with
us, there is perhaps more room for capable women
in that vocation than in many others.  Some grad-
uates become superintendents of small hospitals,
where the salary is $590 per annum and board.  The
earnings of a nurse are from $20 to  $30 per week
and board.  Traveling expenses paid.
  108.—From twenty-five to thirty.
  109.—The teaching  is given by visiting and resi-
dent physicians and surgeons at the bed-side of the
patient, and by the  superintendent  and assistant
superintendent and head nurses  Lectures, recita-
tions and demonstrations will take place  from time
to time, and examinations at  stated periods.
  110.—The rules are very similar in all the training
schools  of the United States.  Any one wishing to
enter should apply by letter or  in person  to  the
superintendent of the training school.  If approved
the applicant is accepted on probation.  When a
candidate applies by letter for admission she is re-
quired to answer questions furnished to her, with
blanks for replies.  The candidate applying for ad-
mission should send letter from a minister, testify-
ing to her moral character, and  one from a physi-
cian,  certifying that she is in good health.  She is
expected to read well  aloud, to write well and leg-
ibly, to  keep accurate accounts,  and to write cor-
rectly from dictation. She must be an  agreeable,
lady-like person. 
112
a nurse's journal.
  111.—The term of  service varies from  sixteen
months to two years.  In the largest schools it is
two years.
  112.—In  Philadelphia $5 is paid per month for
personal expenses for  the first six months,  $10 for
the second and $16 for the second year.   In Chi-
cago $8  a  month the first year, $12  the  second.
New York City Hospital School $10 for the first six
months, $15 for the second, $16 for the third.  The
pupils are usually allowed a certain number of pieces
washed, free of  expense, and are absolutely  free
from expense during the term of training.   There
are seventeen or more training schools for nurses
in the United States. 
PREPARING FOOD FOR  THE SICK.
   It is in this department that the trained nurse by
 her skill and efficiency shows her superiority in the
 sick room.  The broths, slops and indigestible food
 prepared for the sick have killed thousands.  People
 worn out by disease must have nutritious food, pre-
 pared in  the  most  appetizing manner.  All soups
 should be made of lean meats, and the flavor and
 nutritious properties of the meat be  retained and
 increased by skillful preparation.
   It is not to be wondered at that the ordinary in-
 sipid preparations, are not only not relished  by the
 sick, but loathed by them.
   The ordinary help cannot be trusted to prepare
 even toast for the sick, which if not served  hot  to
 the patient, is  positively injurious.  In  the  first
 stages of disease, of course nothing but liquid food
 can be given, and nurses will find numerous recipes
 for broths, gruels, etc.  All  have been  tested and
 found excellent. No small amount of trouble arises
 with  patients when convalescent. What shall be
 done ? A relapse is certain if the wrong articles be
 given, yet the patient craves  and must have solid
food.   That prepared for the table  is  not  unfre- 
114
a nurse's journal.
quently too rich or altogether unfit  for a stomach
impaired by sickness.  To meet this want a number
of dishes may be prepared in such a manner that
will prove perfectly wholesome, and not in the least
injurious.
  Many of the recipes are suggestive, the nurse can
vary them ad infinitum.  Knowing the fundamen-
tal rules one may  exercise tact and ingenuity in
preparing  healthy  and palatable  dishes.   Young
women who have had no  previous instruction in
the culinary art will find them invaluable.  Those
who  have done house work but who have had no
experience in "cooking for  sick folks" can see at a
glance what will be required. 
DISHES  FOR THE  SICK.
                    BEEF TEA.
   Take one pound of beef, take off all  the skin and
fat, and put it in a  pint and a half  of cold water.
Let it  boil  for five minutes,  then  take the beef
out and cut into small pieces.  Put  it again in the
same liquor and let it boil ten minutes longer with
a pinch of salt, then pour it into a fine  cloth  and
press all the juice from it.
                 ANOTHER RECIPE.
  Beef tea made of the best round steak should be
put in an earthen jar, and left in the oven, with  a
small amount of water, until the juice  is extracted,
or place in a glass jar over boiling water.  Pass  a
piece of stale bread over it before serving.  Always
observe this caution  in serving beef tea.
                 INDIAN GRUEL.
  Take  one quart of boiling water and stir in two
or three tablespoonfuls of finely-sifted Indian meal,
previously mixed with a little cold water.  Salt to
the taste and let it boil for fifteen or twenty min-
utes.
                 BARLEY WATER.
  Upon one ounce of pearl or common  barley, after 
116
a nurse's journal.
it has been well washed in cold water, pour a pint
of boihng water and then boil for five minutes; the
water must  then  be strained off  and thrown away.
Then pour on a  quart of boiling water and let it
boil down to one pint, and strain  off. x
  The water thus  made will be clear and  mucilag-
inous.  May be flavored.
                  ARROW ROOT.
  Put two teaspoonfuls of  the powder into a basin,
mix them smooth with a few teaspoonfuls of cold
water, and  let another person pour boiling water
over the mixture, while you  continue to stir  the
starchy substance; thus prepared it can be used as
gruel; a httle wine may be added.
                OAT-MEAL GRUEL.
  Boil a pint of water in a saucepan; when boiling
mix with two teaspoonfuls of oat-meal, half a pint
of milk, and a little salt.  Let it  simmer for thirty
minutes,  then strain, sweeten, and add a little nut-
meg.
                    CAUDLE.
  Beat up  an  egg with a wineglassful of sherry,
and add to it half a pint of hot gruel; flavor with
lemon, nutmeg, or sugar.
                  MILK PUNCH.
  Into a tumblerful of milk put one or two table-
spoonfuls  of brandy, whisky,  or Jamaica  rum.
Sweeten and grate nutmeg on top. 
DISHES FOR THE SICK.
117
                ESSENCE OF BEEF.
  Cut  a pound  of beef,  free from fat, into small
pieces; put it in a stone jar with a cover, without
water.   Fasten the cover down well with  a  double
bladder.  Stand the jar in a saucepan of hot water.
Let it  simmer from  four to  six hours.  There will
then be found a teacupful of juice.  Teaspoonful at
a time.
                  FLOUR  GRUEL.
  Tie up one pound of flour tightly in a cloth,  put
it in a  sauce pan of cold water, and boil for five or
six hours.  When taken out it will be a hard ball.
Pare off the outside rind when needed for use;
scrape   off enough for use and  mix with  boihng
milk to the thickness of gruel.
  An excellent food in diarrhoea.
                  EGG  GRUEL.
  Boil  two eggs from one to three hours, until hard
enough to grate, then boil new  milk  and thicken
with the eggs; a pinch of salt.  Excellent for weak
stomachs.
           APPLES—STEAMED  AND  BAKED.
  A nice way to prepare apples:  Steam sweet  ap-
ples, cut in slices and  sprinkle sugar over  them;
then brown quickly in the oven.
                QUAIL ON TOAST.
  Cut the birds open down the back; salt  and pep- 
118            A NURSE'S  JOURNAL.
per and dredge with flour.  Break down the breasts
with the carving knife so they will be flat.   Then
place in the oven with a little water and butter, and
cover up tightly until nearly done.  Then fry to a
light brown in hot butter.   Have ready  the  toast
made of baker's bread, slightly buttered.  Put it on
a platter; in this place the quail.  In the  pan make
a gravy lightly thickened and pour over the gravy.
               FRESH MEAT BALLS.
  Chop up the best round steak very fine; salt and
add a few cracker crumbs; beat up an egg; mix with
it; then make into small  balls; fry quickly in half
butter and lard so as  to retain the juice of the
meat.

  Eice, oat meal, sago, tapioca, and all farinaceous
substances are best steamed in milk or water.

             OYSTERS ON THE SHELL.
  Vinegar is  frequently  injurious;  lemon juioe  is
preferable.
                  OYSTER STEW.
  In making oyster stews for patients use  cream in-
stead of butter.
                 CHICKEN JELLY.
  Boil a chicken in sufficient water to cover it un-
til the meat drops  from the bones; then  pour the
liquor through a sieve into  the mold or form.  Sea-
son to taste and do not allow it to boil too long,  as 
DISHES FOR THE SICK.           119
it becomes tasteless.  Calf's foot jelly is  made  in
the same manner.
                 MUTTON BROTH.
  Boil a nice piece of mutton with a handful of pearl
barley for several hours;  strain through fine sieve,
being careful to remove every particle of grease.
                     MEATS.
  All meats for patients should be broiled or roasted.
                CHAMPAGNE  JELLY.
  Half a package of Cox's Gelatine; pour upon it
half a pint of  cold water; let it soak  half an hour.
Add the juice of one lemon and half the rind.  A
pint of sugar and  a pint of champagne; mix all
thoroughly together and add a pint of boiling water.
Stirring well  all the time, strain through a flannel
bag or Turkish towel, and pour into molds.  Other
wines may be used if preferred.
                CORN STARCH JELLY.
   Pint of boiling water; 2£ tablespoonfuls of corn
 starch moistened with cold water; put in pinch of
 salt; half a tea cup of sugar; can be flavored if  de-
 sired.  Pour the mixture into boiling water; boil five
 minutes; stir all the time;  milk  may  be used in-
 stead of water if desired.
                     POTATOES.
   Potatoes are best baked; break open;  never  cut
 with a knife.   Mash with a fork. 
120            a nurse's journal.
                  VEGETABLES.
  When vegetables  are  given  to   convalescent
patients, use cream instead of butter.
                SNOW FLAKE FOOD.
  Take sufficient quantity of the food,  (prepared
pop corn;) mix with milk to the required thickness;
sweeten to the taste.
                  LEMON JELLY.
  The juice and grated rind of a lemon; half a cup
of sugar; quarter of a cup of butter, and the yolks
of two eggs; place the ingredients in the fire, stir-
ring all the time; it is jelly in about ten minutes.
                 ORANGE  JELLY.
  Soak one  package of gelatine  in  half a pint of
water for an hour; add juice of three lemons;  two
pounds of sugar; one quart of boiling water; add a
pint of orange juice.   Set on ice to cool.
               ORANGE MARMALADE.
  Orange is especially nice for invalids.  Grate the
yellow rind of two to each dozen oranges; then peel
them; cut the  fruit in small pieces and remove all
seeds.  Put  into a porcelain kettle, heat gradually
and boil gently ten minutes.   Stir  in the grated
rind and remove from the fire.  When cool sift it,
and to each pint add one pound of sugar.   Eeturn
to the kettle, heat slowly, and stir constantly until
the sugar is dissolved.  Let it boil gently, stirring 
DISHES FOR THE SICK.
121
occasionally for three-quarters  of an hour.  When
done, pour into jelly glasses; when cold, sprinkle
with sugar and tie paper over.  Never stir with an
iron spoon; if too stiff to use a silver spoon use a
wooden spoon.
                 PINE  APPLE  JAM.
  Peel and grate the fruit; to each pint allow one
pound of sugar;  boil  gently three-quarters  of  an
hour, stirring frequently.
                   GRAPE  JAM.
  Pick  and wash the  grapes; they should not be
over ripe.  Put them in a porcelain kettle and  set
it over a slow fire.  Break the grapes with a potato
masher.  When warm, but not hot (scalded fruit
with seed in gives a strong, unpleasant flavor),  re-
move from the fire, cool a little and sift through a
coarse sieve.   To each pint allow three-quarters of
a pound of sugar.  Eeturn to the kettle and boil
half an hour.  Put in fruit jars.
               BRAIN FOOD PUDDING.
  One quart of milk, one teacupful of molasses, two
eggs, a teaspoonful of salt, six teaspoonfuls of brain
food, and a little nutmeg, cinnamon and clove; mix
the brain food with a little of the milk and scald the
rest.  When boiling hot stir in the brain food; stir
rapidly two or three minutes, then add the molasses
and spice, last add the eggs well beaten  and pour
into a  buttered pudding dish; bake an hour and a
half in a moderate oven. 
122
a nurse's  journal.
                 WHEAT MUFFINS.
  One and one-half cups of fine granulated wheat,
one and one-half cups of milk, one egg, a teaspoon-
ful of cream of tartar, one-half teaspoonful of soda,
salt.  Bake fifteen minutes.
                GLUTEN  MUFFINS.
  One egg, two cups  of  milk, two cups of crude
gluten, half a teaspoonful of salt, and two teaspoon-
fuls of cream tartar.  Heat the roll pans  before
buttering, pour in the batter and bake fifteen minutes
in a quick oven.
            GRANULATED OAT  MUFFINS.
  One cup of granulated oats, one cup of cold-blast
flour, two cups of milk, one egg, two tablespoonfuls
of sugar, half a teaspoonful of salt, a teaspoonful of
soda,  and two of cream tartar.  Bake twenty min-
utes.
  For all the muffins the roll pans should be heated
before buttering; the quahty of the muffins depends
largely on  this.
                 POACHED EGGS.
  Fill sauce pan half full of water; add salt; break
open the eggs carefully and  drop into the boiling
water.  Skim with the skimmer as soon as the whites
are set, lift out with the  skimmer, drain off every
particle of  water.   Butter slightly; serve on toast
hot. 
DISHES FOR THE SICK.
123
                   ASPARAGUS.
  Boil in seasoned water; when done chop fine, add
butter, thicken with  a  little flour; pour  over hot
toast.
               SPINACH  OR GREENS.
  Pick over nicely, boil in seasoned water, chop fine,
add butter and pepper, serve on hot toast.  Garnish
with sliced or grated eggs.
                   WHITE FISH.
  Select the best, boil till done, add a little butter,
thicken with a httle flour stirred in milk; add a little
parsely  chopped fine and a slice or two of lemon.
                  SPRING TROUT.
  Eoll in flour or  cracker crumbs; fry in a little
batter to a nice brown.
                  BLANC MANGE.
  Take  ripe  cherries,  blackberries or  any juicy
berry.  Put  in porcelain  kettle  when  warm; not
boiling; strain out the juice; put back into the
kettle and thicken with corn starch.  Put into cups
and let  it cool.
  Some of the juice sweetened  may  be used  as
sauce, or nice sweet cream seasoned.
                   IRISH MOSS.
  To one-half ounce of  Irish moss add one quart of
water: soak it a httle while; then drain the water
off.  Boil until it  thickens; then strain through 
124
a nurse's journal.
sieve into jelly cups; season to taste.  Flavor with
lemon.
                TOMATO CUSTARD.
  To half a pint of tomatoes add one pint of milk,
twTo eggs, and sweeten to the taste.  Bake in small
custard cups, and sprinkle sugar over the top.  May
be steamed or baked.  To be eaten cold.
  A salted herring nicely freshened and eaten with
shced lemon makes a nice relish.
  Oysters may be steamed in their own liquor, and
served on toast.  Brush the edges with a knife.
  Serve food on warm plates. 
DRINKS FOR THE SICK.
                BARBERRY WATER.
  Barberry water is made by pouring a cupful of
boihng water on a  large spoonful of barberry pre-
serves ;  makes an excellent drink to use in case of
fevers.  It is  said to be almost a  cure for scarlet
fever.
                  TOAST WATER.
  Cut a slice of stale bread half an inch thick, and
toast it  brown without scorching;  pour over it a
pint of boiling water.   Cover closely  till  it cools;
then pour off and strain.

                   RICE WATER.
  Take of rice two ounces; water two quarts; boil
it for an hour and a half; then add sugar and nut-
meg to the taste.
                   WINE WHEY.
  Boil half a pint of milk, and while boiling add a
wineglassful of sherry  wine.  Strain through mus-
lin or a sieve to separate the  curd.   Sweeten to
taste. 
126            a nurse's journal.
                COOLING DRINKS.
  Take two or three lumps of sugar and one lemon.
Eub the sugar on the rind, squeezing out the juice;
then add a pint of iced water, or better still, one or
two bottles of soda water.

                   ANOTHER.
  Put half an ounce of cream of tartar, the juice
of one lemon, and two tablespoonfuls of sifted sugar
into a jug and pour a  quart  of boiling water over
them.  Cover till cold.
  Excellent in dropsy.
                   EGG NOG.
  To a tumblerful of milk add one egg, well beaten;
sweeten to taste.  Tablespoonful of brandy, whisky
or port wine.
  A nice  drink is  made of  the juice of berries—
blackberries,  raspberries, strawberries, etc.   Add
the juice of one lemon, a little water and bits of ice.

                  LEMON  TEA.
  Pour a quart of water on the rind of two lemons;
when cool add a lump  of ice and  the  juice of the
lemons; sweeten to the taste.
                 CRUST COFFEE.
  Take the crust of bread; break  in small pieces;
toast very brown; then grind in a coffee mill and
prepare like coffee.  Very nutritious. 
DRINKS FOR THE SICK.
127
                      TEA.
  Never let tea boil, but let it steep from three to
five minutes; cover closely.
                  LEMON  SYRUP.
  This is made by slicing lemons and paring off the
rind;  place a layer in a deep dish, sprinkle with
sugar, put on another layer of lemons, adding more
sugar; then cover  closely and set the dish over a
kettle of boiling water and steam until the juice is
extracted.   This is very nice in case of fever or
colds.
              SHERRY WINE PUNCH.
  To one ounce  of sherry wine add equal parts of
lime water and milk.   This is very good, if taken
for a sour stomach. 
 
WEIGHTS AND  MEASURES.
 G 11—One drop.
 fl m j—One minim, or the sixtieth part of a fl 3.
         This is the  smallest drop and may be ac-
         curately obtained  by dropping  from a
         hypodermic syringe.
  gr j—One grain.
  3 j—One scruple=20 grains.
   3 j—One drachm=60 grains.
  1 ss—Half ounce=4 drachms.
   ! j—One ounce=8 drachms.
   ft> j—One pound=16 ounces.
 fl 3 j—One fluid drachm=60 minims.
fl I  ss—Fluid half ounce=4 fl drachms.
 fl 1 j—One fluid ounce=8 fl drachms.
 fl O. j—One pint=20 fl ounces.
fl G. j—One gallon=8 pints.

  A common sized wine glass holds half a gill.
  A common sized tumbler holds half  a pint.
  Four common sized tea cups of  liquid are equal
to one  quart.
  A drachm is equal to one teaspoonful.
  Two drachms are equal to a dessertspoonful.
  One-half ounce is equal to a tablespoonful. 
 
TESTIMONIALS.
                     Chicago, August 27, 1884.
Mrs. Eichter Spalding:
  Nursing is certainly now a profession, and text
books for instruction  will be constantly needed.
I shall expect that yours being the latest, will be
the best.
         Very truly yours,
                 Dan'l  T. Nelson, M.  D.
                              2400 Indiana Ave.

                      Chicago, August 21, 1884.
Mrs. Eichter Spalding:
  Dear Madam:—I do not  know  how  I can do
justice in a space like this to the importance of
your book.   A knowledge of this subject  is so im-
portant that every one ought to be acquainted with
the best methods of helping the sick and  suffering.
  With the present habits of life and the hereditary
entailment of diseased conditions,  nearly all have
to suffer more or less.
  Therefore,  all ought to  be  taught how to help
that suffering, so as to sooth and relieve the pains
and afflictions of others, to act the good Samaritan
wherever the occasion requires, to  give  a drop of 
132              TESTIMONIALS.
water to cool the  parched tongue,  to  change the
aching body so as to get some rest, are acts that
can be done so as to be very much more valuable
when done rightly.  I am glad that  you are going
to teach such a useful and necessary acquirement
as how to nurse the  sick, and wish  you abundant
success.
         I remain, yours very truly,
                   T.  T. Oliver, M.  D.
                        3305 Cottage Grove Ave. 
GENERAL  INDEX.
                                                     Page
Title.....................................................................,......      1
Copyright ..*..................................................................      2
Dedication....................................................................      3
Contents.......................................................................      5
Preface........................................................................    7-9
Professional Nurses..................................................   11-14
Instruction to Nurses................................................   17-28
    Bathing....................................................................     22
    Poultices...................................................................     23
    Fomentations...........................................................     24
    Blisters.....................................................................     24
    Plasters.....................................................................     25
    Bandages and Rollers...............................................     2,5
    The Sick Room—General Instructions..................... "26-28
Treatment of Individual Cases................................   31-74
    Ovarian Tumor—Fibro Cystic...................................     29
    Ventilation...............................................................   29-30
    My First Cases.........................................................     31
    Ovarian Tumor.........................................................     35
    Requisites for Ovariotomy.........................................     36
    Cancer of the Uterus................................................     38
    Pelvic Abscess...........................................................     40
    Typhoid Malarial Fever............................................     42
    Erysipelas.................................................................     43
    Acute Inflammatory Rheumatism............................     45
    Ovariotomy...............................................................     46
    Obstetrics—Child-birth..............................................     51
    Scarlet Fever............................................................     55
    Catarrhal Consumption.............................................     59
    Lacerated Perineum Cervix Uteri.............................     61 
134                 GENERAL  INDEX.
                                                     Page
Treatment of Individual Cases—Continued.
    Puerperal Fever........................................................      65
    Chronic Inflammation of the Bladder.......................      66
    Inflammation of the Bladder and Rectum................      67
    Diphtheria................................................................      68
    Pneumonia...............................................................      70
    Cerebro Spinal Meningitis........................................      70
    Paralysis.................................................................      73
    Measles.....................................................................      74
Valuable Aint^.........................................................   75-85
Poisons and  their Antidotes....................................   86-87
Glossary—Questions...................................................   89-94
Glossary—Answers.....................................................  95-112
Preparing Food for the Sick.................................... 113-114
Dishes for the Sick................................................... 115-124
    Beef Tea..................................................................     115
    Indian Gruel............................................................     115
    Barley Water............................................................     115
    Arrow Root.............................................................     116
    Oat Meal Gruel.........................................................     116
    Caudle......................................................................     116
    Milk Punch..............................................................     116
    Essence of Beef.........................................................     117
    Flour Gruel..............................................................     117
    Egg Gruel.................................................................     117
    Apples—Steamed and Baked....................................     117
    Quail on Toast..........................................................     117
    Fresh Meat Balls......................................................     118
    Oysters on the Shell..................................................     118
    Oyster Stew..............................................................     118
    Chicken Jelly...........................................................     118
    Mutton Broth...........................................................     119
    Meats........................................................................     119
    Champagne Jelly......................................................     119
    Corn Starch Jelly......................................................     119
    Potatoes....................................................................     119
    Vegetables................................................................     120 
GENERAL INDEX.                 135
                                                     Page
Dishes for the Sick— Continued.
   Snow Flake Food......................................................     120
   Lemon Jelly............................................................     120
   Orange Jelly............................................................     120
   Orange Marmalade...................................................     120
   Pine Apple Jam........................................................     121
   Grape Jam...............................................................     121
   Brain Food Pudding.................................................     121
   Wheat Muffins.........................................................     122
   Gluten Muffins.........................................................     122
   Granulated Oat Muffins............................................     122
   Poached  Eggs...........................................................     122
   Asparagus.....,........................................................     123
   Spinach or Greens.....................................................     123
   White Fish...............................................................     123
   Spring Trout............................................................     123
   Blanc Mange............................................................     123
   Irish Moss.................................................................     123
   Tomato Custard........................................................     124
Drinks for the Sick................................................... 125-127
   Barberry Water........................................................     125
   Toast Water..............................................................     125
   Rice Water...............................................................     125
   Wine Whey..............................................................     125
   Cooling Drinks.........................................................     126
   Egg Nogg.................................................................     126
   Lemon Tea...............................................................     126
   Crust Coffee............................................................     126
   Tea...........................................................................     127
   Lemon Syrup...........................................................     127
   Sherry Wine Punch..................................................     127
Weights and Measures.............................................     129
Testimonials................................................................     131 
 
     RICHTER'S

BAG  SYRINGE,
         ----FOE----
  Rectal and Enema Purposes.

       VERY VALUABLE IN
SURGICAL  OPERATIONS,
         ----FOB----
Cleansing Wounds, Ulcers, Tumors.

    HOLDS SI2£ OUiTCES.
BECOMMENDED BY ALL SURGEONS
      AND PHYSICIANS.
E. H. SARG-ENT & CO., Agents,
      125 State Street,
            CHICAGO, ILL 
    E.   H.  SARGENT  &  CO,
                   ---MAKERS of---

Surgical   Instruments,
     125 STATE  ST.,  CHICAGO.
   Manufacture the following named useful articles for Invalids.
              DR. DICKINSON'S

DOUCHE   BED   PAN.
   The essential requisites of a Bed Pan for Gynaecologi-
cal and Obstetrical patients:—

  The Bed Pan should comfortably support the patient.
  Should be so constructed that the discharges will not flow back to
wet and soil the patient, her clothing and the bedding.
  Should be so constructed  that the  chamber is readily  emptied,
cleansed and disinfected of fecal discharges.
  Should be self-discharging for the copious douche taken in the re-
cumbent position.
  Should not interfere with  the insertion of the catheter, vaginal or
rectal tubes, etc., when in position.
  Should heat quickly. Should be  simple in construction, not easily
broken, cracked or rusted, and light in weight.
  Should prevent forcibly expelled urine from soiling the bedding.
  Should permit the douche to be discharged from either side of the
bed.  Should prevent local discharges from entering the rubber dis-
charge tube. Should be easily placed  under the patient.
  Dickinson's Bed Pan BEST answers ALL these requirements. 
       »■  DICKINSON'S  BED   PAN.-*

Supports the patient comfortably.
    The top is a scoop shape flange, which extends up the small of the
back and slopes to the center from all sides, so that no pillow or other
rest need be placed under the patient.  Fits the patient.

Is self-discluuying for the copious vaginal and  uterine  douche in
  the recumbent position.
    A metalic tube, with flexible rubber tube attached, is screwed to
a side opening in the pan.   The rubber tube hangs  over the side of
the bed into a jar or other receptacle for the purpose, otherwise the
care and attention of the attendant or nurse is required  to remove,
empty  and replace a pan  several times, or a large pan sufficient to
hold a gallon or more of water be used, which is heavy to remove.

Prevents the water from flowing  back on the patient.
    The top, which extends up the back and supports the wate*-, slopes
down and forward into the chamber of the pan and not down and
back on to the bed clothes.

The douche can be discharged from either side of the pan, as is
  most convenient at the time.
    Patients do not always he on the same side of the bed, and all
beds do not head the same way.

The discharge openings have caps to close them tightly.
    When the pan is not in use for the douche, remove the discharge
attachment, close the opening, and the pan is ready at a moment's no-
tice for urine or alvine discharges without soiling  a flexible rubber
tube.

Alvine discharges are readily turned out and the pan cleansed and
  disinfected with facility.
    The whole chamber, top, bottom and sides, is open to view.  No
projecting lips are over the chamber, for under them it is  difficult to
dense and disinfect. The top is flush with the sides all around.

Urine forcibly expelled does not soil the bedding.
    The front is sufficiently high to prevent it.

Catheter, vaginal, rectal  and other  tubes may be inserted, when
  necessary, witli the pan in position.
    The front edge is far enough forward not to be in the way.

Can be readily warmed.
    A bed pan should never be cold to the patient.

7s light and not easily broke)).

Can be readily placud under gynaecological  and  obstetrical pa-
  tients. 
Sargent's Rubber Douche-Pan.
    Our Rubber Douche-Pan, is a convenient and comfortable pan
for the same purposes as the foregoing, being  flexible it is preferred
by some to any metal or crockery vessel.  It is made of Pure Rubber
and in the best manner.
    Price, $5.00 each.

                            The Rubber  Hot Water Bottle,

                              Is found of great service and ben.
                           efit in many cases.  They are made
                           of  several sizes, 1, 2, 3 and 4 quart
                           capacity.


   TEE  ii  mm PILLOW.

  Suitable for hot or cold water, is made of the
same material as the Bottle, and serves a useful
purpose, being larger and better  adapted for
same purposes than the Bottle, presenting a
flat surface when filled, instead of an oval form.
  Size 14x18 inches.  Price, $4.50 each.

All varieties of the best

     Rubber Surgical Goods and  Apparatus for Invalids,
            kept in stock. Also a full assortment of

Ear  Trumpets,   Crutches, Bandages,  Braces,   Trusses,
   Invalid Chairs and Surgical Instruments generally,

                        FOR SALE BY

      B.  H.  S-A.:E^3E2S^X,  Ss  CO.,
                      DRUGGISTS,

                           125 State Street, CHICAGO.
o 8  *\  8 
 
 
 
 
 
NATIONAL LIBRARY OF MEDICINE
NLH D5EE73L43  1
:
NLM052273439