, ' 'y , f v, "/ / ; ( / ... V- .'■ V .. \.. - 'n \N ’■■rrs : ' •: v V ; c"* /• •“< s 3 s~-<. * r'' ...... ......\..v " - - ' f'K v • ... v „ V V !, , v A TEXT-BOOK FOR TRAINING SCHOOLS FOR NURSES INCLUDING PHYSIOLOGY AND HYGIENE AND THE PRINCIPLES AND PRACTICE OF NURSING p. m. Wise, m.d. Medical Superintendent, St. Lawrence State Hospital; Editor of the State Hospitals Bulletin ; Professor of Psychiatry, University of Vermont; Member of the American Medico-Psychological Association, etc. WITH AN INTRODUCTION £'|. | Ph jpiJftnlin-Ehref and Superintendent of the McLean Hospital, Boston, Mass. V0 IfQP'&LUMES G. P. PUTNAM’S SONS NEW YORK 27 WEST TWENTY-THIRD STREET LONDON 24 BEDFORD STREET, STRAND finttittrbother |)ws8 1896 Copyright, 1896 BY G. P. PUTNAM’S SONS Ube fttrtcfcerbocfeer press, •flew Jfforfe CONTENTS. CHAPTER PAGE I.—Local Applications ; Poultices ; Fomenta- tions, ETC I II.—Counter-Irritants ; Cupping ; Leeches . . 6 III. —Enemata ; Suppositories 13 IV. —Bandages and Bandaging 21 V.—Bandaging (Continued) ; Splints 33 VI.—Fractures, Dislocations, and Sprains . . 39 VII.—Fever ; Inflammation 48 VIII.—Haemorrhage 55 IX.—Wounds ; Burns and Scalds ; Emergencies . 64 X.—Anaesthesia, Anaesthetics .... 72 XI.—Surgical Nursing ; Operations ... 79 XII.—Poisons, Bites, Stings, etc 86 XIII. —Asphyxia ; Artificial Respiration ... 94 XIV. —Convulsions, Apoplexy, Coma, Syncope, etc. . 101 XV.—Nervous Diseases 108 XVI.—Insanity 116 XVII.—Forms of Insanity 126 XVIII.—Observation and Care of the Insane in House- holds : 137 XIX.—Duties of a Hospital Nurse for the Insane . 145 IV CONTENTS. CHAPTER PAGE XX.—Baths and Bathing 154 XXI.—Massage XX-II.—Medicines and their Administration . . 172 XXIII.—Forcible Feeding ; Food for the Sick . . 182 XXIV.—Special Medical Cases 19° XXV.—Children’s Diseases 2°4 XXVI.—Convalescence ; Signs of Death ; Care of the Dead 2I4 XXVII.—Pregnancy ; Physical Signs and Symptoms ; Abortion ; Miscarriage ; etc. . . . 219 XXVIII.—Preparation for Labor; Necessity for Anti- septic Care ; Parturition ; etc. . . .227 XXIX.—Care of the Infant 239 XXX.—Gynaecological Nursing . . . .245 Appendix 253 Glossary 277 General Index 3°7 ILLUSTRATIONS. NUMBER PAGE 1— Ice-Coil with Flexible Rubber Tube .... 5 2— Preparation for Venesection 12 3— Showing Figure-of-8 Applied to Foot, and Spiral Applied to Leg 24 4— Mode of Making Reverses 24 5— Showing Commencement of Capelline Bandage (Cantlie) ......... 25 6— Showing Completion of Capelline Bandage (Cantlie) 25 7— 4-Tailed Bandage Applied to Back of the Head . 26 8— Posterior Figure-of-8 Bandage of Chest ... 26 9— Spica Bandage to Right Shoulder .... 27 10— Spica Bandage to Left Shoulder .... 27 11— Spica Bandage to Groin 27 12— Gauntlet Bandage 28 13— Demi-Gauntlet Bandage ... 28 14— Spiral-Reverse Bandage for the Arm, Completed . 30 15— Spica Bandage of Foot 31 16— Modified Figure-of-8 Bandage of Lower Extremity 31 17— Bandage of Scultetus 32 17A—Axillary Cravat 33 18— Showing a Trap in a Plaster-of-Paris Dressing . 35 V VI ILL USTRA TIONS. NUMBER PAGE 19— Arm Sling, Including Elbow 36 20— Sling to Support the U pper Arm .... 36 21— Extension Splint for Thigh (Cantlie) .... 37 22— Extension Apparatus at Foot of the Bed . . 38 23— Provisional Dressing for Fracture .... 41 24— Eptemporized Angular Splint for Arm ... 43 25— Graduated Compress ....... 58 26— Pettit’s Tourniquet 58 27— A Tourniquet Made from a Handkerchief and a Stick 58 28— Pad and Flexion to Check Haemorrhage ... 61 29— Plugging the Nares 63 30— Sutures 66 31— Irrigating Apparatus . 67 32— Ether Inhaler 75 33— Siphon Irrigation 83 34— Sylvester’s Method ; Inspiration .... 95 35— Sylvester’s Method ; Expiration .... 95 36— Howard’s Method ; To Free the Lungs ... 96 37— Posture in Some Forms of Massage .... 165 38— Attitude in Cerebro-Spinal Fever .... 205 A TEXT-BOOK FOR TRAINING SCHOOLS FOR NURSES. A TEXT-BOOK FOR - TRAINING SCHOOLS FOR NURSES. CHAPTER I. LOCAL APPLICATIONS \ POULTICES, ETC. A poultice (cataplasm) is a mixture of certain sub- stances with hot water into a mass of even consistence, for an application to some part of the body, and is chiefly used as a means of applying warmth and moisture. Its effect is to soften the tissues and relax the tension of the skin. Poultices may be made from linseed meal, bread, flour, starch, slippery-elm bark, spices, and various other materials. The requisite is that the material shall be capable of conveying moist heat to the parts, and not be especially irritating to the skin. Einseed meal1 is commonly used, as it is cheap and convenient, contains some oil, and retains the heat. The poultice should be several inches larger than the 1 To make a linseed-meal poultice, the meal should be stirred slowly and evenly in a saucepan of boiling water, and then boil for a moment afterward, while stirring briskly, until it is free from lumps. When finished it should be smooth paste that will not drop from the dish. This should bespread evenly upon a piece of muslin the proper size, not to exceed half an inch in thickness. A margin of cloth should be left to turn in. The surface should be spread with sweet oil or vaseline to prevent it from sticking. Some thin material should then cover it and fold over the edges. It can then be rolled up and covered with a towel to retain the heat. 2 TEXT-BOOK FOR NURSES. inflamed area, and covered with rubber, oiled silk, paper, or other material that will retain the heat and moisture. It can be secured in place by a roller or many-tailed bandage. As a rule it should be renewed every 2 to 4 hours. It should be applied as hot as it can be borne, and should not be allowed to become cold and stiff. A poultice should never be used again. Starch makes an admirable poultice on account of its bland qualities, and is particularly adapted for skin diseases. It should first be mixed with cold water and then with boiling water to make a thick paste. Then it should be applied in the same manner as a linseed poultice. Charcoal, mixed with bread or linseed meal, being antiseptic, is a desirable dressing for putrid and gan- grenous sores. It is, however, a dirty and discoloring substance, and for this reason is objectionable. It is not as advantageous as the yeast poultice.1 A11 ice poultice is sometimes desirable in the absence of ice-bags. It is made by spreading a layer of cracked ice between two layers of bran and confining the whole in a bag. When the bran is soaked and the water be- gins to run through, it must be renewed. Fomentations or stupes are cloths soaked in hot water or medicaments, or heated dry for application to the surface of the body. They are employed to keep up the vitality of the parts, particularly in contused wounds, and applied to affected parts to relieve pain 1 Mix yeast with water at blood heat in equal proportions by weight, stirring in wheat flour to the combined weight of the former. It should be left in a warm place to rise, and applica- tion should be made during the fermenting process, in a loose bag. LOCAL APPLICATIONS. 3 from muscular spasm.1 They can be covered with oiled silk to keep in the heat. Moist heat has a more penetrating effect than dry heat. In acute inflammations that have a tendency to suppurate, moist heat appears to hasten the process. It relaxes the tissues, dilates the capillaries, and increases the activity of the white blood corpuscles. Where the application is not to be prolonged, hot, moist fomenta- tions are used, but where it is to be applied for some time, poultices are preferable. Dry heat by hot flannels or dry fomentations are sometimes used in inflamed joints and in colic. Dry heat does not relax the tissues. Salt-bags and bran- bags made very hot are also used, especially when heat is applied about the head for earache, etc. Salt re- tains the heat for a long time. Hot-water bottles or rubber bags containing from one-half to two gallons are very useful for applying dry heat. They should always have a flannel covering, and a good plan is to have flannel sacks into which they can be slipped be- fore they are applied. Turpentine shipes are made by sprinkling a half drachm of the spirits of turpentine over the surface of the hot, wet flannel before applying it. It may cause vesication if allowed to remain too long in contact with the skin. If the patient complains of severe burning 1 Flannel is the best material for hot fomentations or stupes. Two pieces should be provided, double the required size. They should be dipped in boiling water and wrung out by the use of sticks, as dry as possible ; small compresses may be wrung out by a lemon squeezer; or, they may be put in a towel and the towel twisted, the purpose being to have them applied as hot as possible. They should also not be wet enough to run off on the bedding. There should be one preparing while the other is in use. 4 TEXT-BOOK FOR NURSES. of the skin after the use of turpentine, it can be smeared with vaseline. Laudanum may also be added, or the cloth may be steeped in a decoction of hops, chamomile, etc. Cold applications, aside from the general application of cold, as in baths, are very important at times, in the treatment of inflammations and to check the deter- mination of blood to a part. The important precau- tion necessary in their use is that the cold be sustained, regular and not excessive. Cold acts in contracting the walls of the capillaries, thus lessening the amount of blood supplied to the part. The use of cold in haem or rh age has been treated elsewhere. Cold-water dressings are applied by bringing the cold water either directly in contact with the body or apply- ing it by means of a rubber bag or coils. The temper- ature of the water may vary from cool to ice-water. Cold compresses may be made by several thicknesses of lint wrung out of cold water and changed frequently. The water should be kept at an even temperature. If colder applications are needed, one compress can rest upon a block of ice while the other is in use, and they can be changed frequently. Care should be taken not to wet the bedding or the clothing of the patient. Ice-bags, either of rubber or made from bladders, is an effectual way of applying the greatest degree of cold. Rubber bags are provided now in almost every shape desired, to fit the head, or long and narrow to fit the spine. The bag should not be filled or it will be clumsy, and the air should be expelled from the bag. The ice should be broken into pieces not more than one inch square, and the supply should be renewed from time to time. If it is not desired to have the greatest LOCAL APPLICATIONS. 5 degree of cold and to preserve the ice, sawdust or bran can be mixed with it. If an intense cold be desired, a little common salt can be mixed with the ice. A cloth cover may be made for the ice-bag, and it can then be fastened to the pillow. It is also well to protect the skin by a layer of moist lint. A good way to break ice is to put it into a stout canvas bag or cloth and pound it. A very uniform and effectual means of apply- ing cold to a limb is by the coil (Fig. i). A flexible tube of rubber half an inch in diameter is wrapped about the limb like a spiral bandage and held in place by a small roller. One end of the tube is placed in a pail filled with cold wrater, and the water flows through the tubing and escapes into an- other pail. In this way also cold can be applied to the head, breast, and almost any part by sewing the tubing in circles on a piece of cloth or rubber. FIG. I.—ICE-COIL WITH FLEXIBLE RUBBER TUBE. CHAPTER II. COUNTER-IRRITANTS ; CUPPING ; EEECHES. Counter-irritants are agents which by their irritant action increase the flow of blood to one part, and thus attract it from another part. They first cause con- gestion, and if continued cause inflammation, and are used to relieve similar states in other parts. An irri- tant to the surface causes dilatation of the capillaries where it is applied, and through reflex nervous action contraction of the capillaries in other parts. They may be divided into rubefacients, vesicants, suppurants, cauterants, but this division is arbitrary, as any of the several classes may effect the several re- sults desired by limitation of their application ; hence, a rubefacient may cause vesication if applied for a suffi- cient length of time, etc. Counter-irritants may produce a mild irritation or reddening of the surface, which quickly passes off, and, if continued, a more permanent congestion ; if pushed further, inflammation is produced, and the next de- gree is vesication, or blistering. Counter-irritation is seldom carried beyond the latter degree, but it may be, resulting in sloughing and necrosis of the adjacent tissues. They are usually applied over or near the seat of the disease, but are sometimes applied to a remote part; 6 CO UN TER-IRRITA N TS. 7 such as a mustard foot-bath for the relief of pain in the head or abdomen. The principal rubefacients are mustard, ammonia, turpentine, capsicum, and pitch. Still milder counter- irritants may be gained by the use of spices in poultices or from the various liniments. The most commonly used irritant is mustard, and this is usually mixed with from one to three times its weight of flour or linseed meal and mixed into a paste with tepid water. It is spread evenly upon a piece of muslin which should be sufficiently large to fold over and cover the poultice. Tepid water is used because hot water reduces the strength of the mustard. The feeling of cold when it is applied soon passes away. It should not be left on any longer than necessary to gain the desired result, which may be expected in from ten to twenty minutes. A blister made wdtli mustard is very painful and difficult to heal. In unconscious pa- tients, particular care must be given, as the patient is unable to notify the nurse, and a blister resulting in such a case would be evidence of neglect. For children, the proportion of mustard should be smaller, and mixed with linseed meal instead of flour. The addition of an ounce of glycerine, or the white of an egg, in mixing the mustard will usually prevent a blister. When the mustard is removed and it is desired to continue the irritation, a linseed-meal poultice can be applied. The smarting can be relieved by anointing the part with vaseline and dusting with rice powrder or fine starch. Mustard leaves and prepared mustard plasters, now sold in drug stores, are convenient, but are not equal to the mustard plaster described above. When an immediate effect is desired, ammonia is to 8 TEXT-BOOK FOR NURSES. be preferred as a rubefacient. A piece of lint or a folded handkerchief dipped in strong ammonia and laid upon the skin of the patient acts instantly. Such an appli- cation to the nape of the neck will often rouse a patient from a profound state of coma. In opium poisoning, and wherever a sudden revulsive is needed, this agent is to be preferred. Capsicum mixed into a paste, with from 5 to 10 times its weight of flour, spread like a mustard plaster, is effective ; or red pepper spread upon the inside of two pieces of flannel and applied as a stupe acts quickly and effectively. Turpentine is usually applied in the form of stupes. In addition to the sprinkling of turpentine on the hot fomentation, a tablespoonful may be mixed with a pint of boiling water and the flannel wrung out of this. A very mild rubefacient is the pitch plaster, espe- cially that of Canada pitch. It is chiefly employed in chronic bronchitis and in muscular rheumatism. The tincture of iodine is an effectual rubefacient, the objec- tion to it being the great discoloration it produces. It is painted over the affected part with a camel’s-hair brush, and the application may be repeated two or three times. Chloroform is usually used in liniments but may be used alone. If left on too long it will blister. The vesicant (blister) usually employed is cantha- rides. It should always be applied to the sound skin, and if it is tender some thin substance should be placed over the skin before the application of the blister, pref- erably oiled tissue-paper. The physician directs the location for the blister and the size of the plaster. The skin should be thoroughly cleaned with soap and water, CO UN TER-IRR1TA N TS. 9 or alcohol. If there is much hair it should be shaved off. The plaster should be secured in its place by narrow strips of adhesive plaster, but a roller is pref- erable if the parts admit of its application. Whatever is applied should be loose, to leave room for the blister to rise. The blister should rise in from four to eight hours. If it is not formed in ten hours, remove the plaster, and apply a hot linseed poultice, or the poultice may be applied over the plaster. In removing the plaster, care should be taken not to break the skin, and it should be cleaned off, using oil, and all adhering particles removed. After the blister is well filled, make a small opening for the fluid to escape, catching it in a pledget of cotton. The skin must not be re- moved. The physician may direct that the fluid shall be left in the blister. Dress the sore with oxide of zinc, either in powder sprinkled on, or with the oint- ment applied on lint and kept in place with an adhe- sive strap. Cantharides sometimes produces a serious condition of the urinary apparatus, particularly if there exists any kidney disease, or the blister is put on in the region of the kidneys. Blisters have also been said to have pro- duced premature labor. Cantharides is sometimes used in the form of a liquid mixed with collodion, and called cantharidal col- lodion. The space to which it is to be applied should be bordered with vaseline to prevent it from spreading, and it should then be applied with a camel’s-hair brush, and afterwards covered with lint or absorbent cotton. Chloroform and ammonia can be used to raise a quick blister. A piece of lint or cotton saturated with either is placed upon the skin and covered with any- TEXT-BOOK FOR NURSES. thing that will prevent evaporation. Care should be taken in blistering patients with feeble circulation. Croton oil rubbed into the skin with a piece of flannel (not exceeding 5 drops) produces an eruption of vesi- cles, and is a powerful irritant. It is now seldom used. Leeches are spindle-shaped worms, with suckers at each extremity, used in medicine to abstract blood from the body. They are only used when a small quantity of blood is to be removed locally, and as the same result can be obtained by wet cupping, they are now seldom ordered. There are two varieties, the American and foreign, and thejr can be distinguished by the stripes upon the back, the former having but two and the latter six. A leech will draw three or four times its own weight of blood. They are found in stagnant water and must be kept in covered jars ventilated at the top. The jar should be half filled with water, with a layer of mud on the bottom. They should never be used twice. Before leeches are applied, the skin should be thor- oughly cleansed with soap and water and alcohol, and thoroughly dried. The leech also should be clean. It can then be put in a medicine glass or a glass tube, head downwards and placed upon the part. Sometimes leeches are sluggish and refuse to take hold. Touch- ing the spot with cream, or drawing a drop of blood with a pin, may start them. They should never be applied over a blood-vessel, but preferabty over a bony part, so that in case of troublesome bleeding, pressure can be made over the part. A leech should be left on from a half to one hour ; when filled they will drop off, or if it is desired to take them off sooner, the application of a little salt will loosen them. They should never be CO UN TER-IRRITA N TS. removed by force. After the leech is removed, if it is desired that the bleeding should continue, hot fomen- tations or poultices can be applied ; or if the bleeding is to be checked, a compress or application of ice will accomplish it ; or, if it is obstinate, touch the point with a solution of iron, or a stick of lunar caustic. Cupping may be wet or dry. The former acts as a counter-irritant and removes the blood, and the latter is a counter-irritant only. It is accomplished by glasses made for the purpose, but when they are not to be had, wineglasses or small tumblers can be used. For dry cupping there is needed a spirit-lamp, a saucer of alco- hol, a probe with a wad of cotton tied on the end, and towels. The cups should be perfectly dry. Take the probe, dip it in the alcohol and light it, and let it burn for several seconds in the inverted glass, or swab the glass with it, then withdraw the light and instantly apply the cup. As the air begins to cool, the skin will be sucked up into the glass and the blood will be drawn toward the surface. Care must be exercised not to let the cup get so heated as to burn the patient, and see that no burning alcohol is left in the cup to run down on the skin. They should be left on five minutes. To remove them, insert a probe at the edge of the glass and let the air enter. Poultices are sometimes applied after their removal. Wet cupping is effected in the same manner, except that the skin is scarified, either by a scarificator or a lancet before the cups are applied. The skin should be cleansed and afterwards washed with carbolic solution. After sufficient blood is with- drawn bleeding can be checked in the usual way ; a lint compress can be placed over the wound and held with a roller. 12 TEXT-BOOK FOR NURSES. Venesection consists in opening a vein, and it is the operation by which blood is removed from the body. It is usually performed at the bend of the elbow. The patient’s arm should be carefully cleansed and washed with an antiseptic. A few turns of a roller should be applied around the middle of the arm tight enough to make the veins stand out below. The patient grasps a broomstick or similar article and works his fin- gers on it (Fig. 2). Then the superficial vein at the elbow is steadied with the thumb and the point of the lancet beneath it, and cut quickly outward, making a free opening. When a suf- ficient amount of blood is withdrawn, the thumb is placed over the wound and the bandage is removed. The wound is then washed with bi-chloride, and a com- press of sterilized gauze is applied and held by a roller, which should envelop the whole upper extremity. Do not disturb the dressing for five days. FIG. 2.—PREPARATION FOR VENESECTION. CHAPTER III. ENEMATA ; SUPPOSITORIES. An enema (plural, enemata) is a rectal injection of a fluid for remedial or nutritive purposes. They are also termed clysters and lavements. The varieties of enemata are purgative, antispas- modic, astringent, emollient, anthelmintic, stimulat- ing and nutrient. To give an enema, the patient should be placed upon his left side 1 for the purpose of retaining the liquid by gravity, after the bed has been protected by a rubber sheet, etc. Care must also be taken to have a vessel at hand in case the enema is not retained. Fill the syringe with the liquid by passing it through several times (air should never be allowed to remain in the syringe), then oil the nozzle and insert it very gently upwards and slightly backwards. After it is partly introduced, allow the point to swerve slightly towards the left, following the axis of the rectum. The force used should be no greater than the natural weight of the syringe. If there is an obstruction, discharge the syringe slightly, remove it, and wait for the rectum to unload ; or it may be necessary to remove some of the faecal matter to introduce the syringe. The patient should not be uncovered to administer an enema. 1 The rectum is directed to the left, to join with the descend- ing colon on the left side of the abdomen. 13 14 TEXT-BOOK FOR NURSES. Syringes are of various patterns, but the common bulb syringe of rubber, with a hard rubber or metallic tube, answers every purpose. For a small medicated enema, the piston syringe is preferable, as the liquid can be measured with greater accuracy. A soft rubber tube can be introduced high into the colon to which a bulb syringe may be attached by slipping the tube over the nozzle of the syringe. Ordinarily a small size soft rubber feeding tube will suffice, but if it has a tendency to double on itself, a No. 12 elastic male catheter may be used, softening it by immersion in hot water before using ; this is termed a high enema. The enema can also be introduced by gravity {douche), the liquid being contained in a vessel a few feet above the patient, and connected to the nozzle by a rubber tube. A simple enema is used for cleansing and laxative purposes, and consists of a light suds made with com- mon or castile soap, or pure water may be used. It should be warm (950 F.), neither hot nor cold, as the extremes of temperature cause too active peristalsis. Plenty of time should be taken to give an enema. The flow should be slow and steady ; any sudden discharge of fluid in the rectum causes an intense desire to expel it. If there is distress, the flow should be checked for a moment until it passes away. When the desire to expel the fluid seems uncontrollable, pressure against the anus for a few moments will relieve it. In this way a large quantity of fluid may be thrown into the colon.1 After the requisite amount has been intro- 1 It was demonstrated by Haller in 1767 that an enema could be forced through the entire alimentary canal and be ejected from the mouth. ENEMA TA ; SUPPOSITORIES. 15 duced, gently remove the tube, and allow the water to run out of the syringe. By continuing the compress against the part, the enema may be retained for some minutes. For laxative purposes, olive oil, glycerine, and a solution of inspissated ox-gall is used. The latter is an admirable remedy, and is never disappointing. About one and one-half drachms of ox-gall is dissolved in eight ounces of water. Use a tablespoon in removing the ox-gall, and allow it to remain in the water until the gall is dissolved. Solutions should be made as they are needed, as they will not keep. When oil is injected it should be followed by a soapsuds enema in about half an hour. A glycerine enema is made by mixing a tablespoonful of glycerine with the same amount of water, and is given with a piston syringe. As glycerine causes an irritation of the mucous membrane it excites peristaltic action, and a subsequent water enema will not be re- quired. Purgative enemata act by exciting peristaltic action along the entire intestinal canal. An enema consists of from one to four pints for adults, and from two to six ounces for children. When purgative enemata act in consequence of their stimulant or irritant properties, or through ab- sorption into the system, they are not necessarily large. They are used only when purgatives by the mouth irritate the stomach. The habitual use of enemata is to be deprecated, as they have a ten- dency to remove the mucus which lubricates the intes- tinal tract. The following are the ones most generally in use: 16 TEXT-BOOK FOR NURSES. (1) Aloes, 3ii; Carbonate of potassa, grs. xv; Barley water, half a pint. (2) Olive oil, §i; Sulphate of magnesia, § ss ; Senna, § ss; Boiling water, Oi. Infuse the senna one hour in the water, then dissolve the salt, add the oil, and mix by stirring. (3) Turpentine, § ss ; Rochelle or Epsom salts, § i ; Warm soapsuds, Oi. Dissolve the salt and mix the turpentine. (4) Common salt, § ii; Warm gruel, § xii. Add oil or molasses, mix and inject. This is not only laxa- tive but nutritive. Gaseous enemata are sometimes used to remove ob- structions higher up in the bowel by pressure. They are given by first injecting a solution of bicarbonate of soda, followed by a solution of tartaric acid and pre- venting the escape of the gas from the rectum. They are to be used only under medical direction. Antispasmodic enemata are used in convulsive dis- orders when remedies cannot be given by the mouth. They are also very effective. Hydrate of chloral is said to be more certain in its action -when given by the rectum than through the stomach. In puerperal con- vulsions and in the epileptic status it has no substitute. Dissolve 30 grains in about 4 ounces of water and inject, using preferably a piston syringe of that size. Tinctures, or alcoholic preparations should not be given in an enema if avoidable. It is necessary to give a slightly larger dose by the rectum than by the mouth. ENEMA TA ; SUPPOSITORIES. 17 Anthelmintic enemata are given for the removal of thread or seat-worms. These worms have their chief abiding place in the caecum, but cause distress when they reach the sensitive parts about the rectum. If an enema is designed to be curative, it must reach the caecum. A strong solution of salt and water, or quas- sia, or cinchona and water, or a drachm of turpentine rubbed in the yolk of an egg and mixed in 8 ounces of water, should be injected from time to time until the worms are destroyed. Astringent enemata are used for the relief of diar- rhoea and dysentery, to arrest haemorrhage, to cure ulceration, etc. Of mineral astringents, alum, sul- phates of copper and zinc, and sugar of lead are pre- ferred ; and of vegetable astringents gallic or tannic acid are those generally used. The medicine should be well diluted, not exceeding 2 grains to i ounce of water. For arresting haemorrhage copious enemata of ice-cold water are useful. For allaying irritations of the mucous membrane of the colon, clysters of starch,1 gum, flaxseed tea, etc., are useful. To this may be added io to 20 drops of the aqueous extract of opium. Nutritive enemata are intended for the nourishment of the body, and this process is termed rectal alimentation. It is resorted to only when the patient is unable to swal- low, or the stomach will not retain or assimilate the food.* It is maintained that the food injected in the colon passes up into the small intestine where it is digested 1 This should be made thin enough to pass readily through the syringe. 2 Well attested cases are on record where life has been sus- tained for months and years by rectal alimentation alone. 18 TEXT-BOOK FOR NURSES. and absorbed.1 Whatever the process may be, it is a well-known fact that undigested food placed in the colon will sustain life. Nutritive enemata should not be given oftener than once in 4 hours, and should not exceed 6 ounces in amount. It is always better to start digestion of matters injected by adding pepsin in the requisite amount. The injection should be carried beyond the rectum (sigmoid flexure) when it is possible to do so. This may be effected when the instructions given for adminis- tering a high enema are followed. Instead of using a syringe, a funnel can be used and the liquid forced in by gravity. It is also a safe precaution to wash out the rectum with a simple warm-water clyster, removing the remainder of the old enema before giving the fresh one. The instruments should be carefully cleaned each time and then allowed to remain in some antiseptic solution. Various kinds of food can be used, but they should be concentrated and nourishing.11 Milk and eggs3 are always appropriate, and strong extract of beef-tea.4 1 An Italian physician reported the fact that a man vomited a suppository which had previously been introduced into the rec- tum ; and many other similar instances are reported. 2 An excellent formula is known as “Leube’s pancreatic-meat emulsion.” It is prepared by taking 5 ounces of finely scraped meat chopped very fine, add 1 y2 ounces finely chopped pancreas free from fat, and 3 ounces lukewarm water. Stir this to the consistency of a thick pulp. 3 Take one whole egg, 15 grains common salt, 3 ounces pep- tonized milk, and mix ; or 3 ounces of peptonized milk and the whites of 2 eggs. 4 Rennie’s formula is a bowl of good beef-tea, to which is added half a pound of lean, raw beefsteak pulled into shreds. At 990 F. add 1 drachm of fresh pepsin and % drachm of diluted hydrochloric acid. Let it remain before the fire for 4 hours, stir- ring frequently. It is better to have it too cold than too hot. Fggs may also be added, but should be well beaten. ENEMA TA ; SUPPOSITORIES. 19 Pure beef juice may be given in quantities from \ to 11 ounces per day. Stimulant enemata consist of the introduction of some form of alcoholic beverages, but alcohol is very irritating to the mucous membrane, and it should be given only when absolutely required. In shock or col- lapse, brandy and hot water be administered as high up as possible. The hips may be raised by pillows to assist in passing the sigmoid flexure. Syringes, before being put away, should be thor- oughly cleansed and dried. Hang them up by one end to let the water run out, and to let the air cir- culate through them. If hard-rubber piston syringes leak as the result of shrinkage, allow them to soak in hot water for a time. A good syringe for medi- cated and nutrient enemata, is the bag syringe, which consists of a rubber bag attached to a nozzle. The nozzle should always be warmed and oiled before being inserted. A suppository is a solid medicated compound, for the purpose of introducing remedies into the rectum, vagina, or urethra. Its consistency is such, that while retaining its shape at ordinary temperatures, it melts at the temperature of the body. The basis of supposi- tories is cocoa fat (oil of theobroma). Suppositories serve, therefore, the same purpose as enemata. De- pending upon the cavity for which they are intended, their shapes are conical or cylindrical in form. Frequently they are ordered for their local effect alone, and the most common contain some preparation of opium. To introduce a suppository it is first oiled, or slightly warmed by the hand, and introduced without force. In 20 TEXT-BOOK FOR NURSES. giving a rectal suppository care should be taken to get it beyond the sphincter. For laxative purposes in children, soap cut to the proper shape and molasses candy are given as supposi- tories. Glycerine mixed with gelatine is now made to perfection and is very useful as a laxative, the irritation by the glycerine causing peristalsis. CHAPTER IV. BANDAGES AND BANDAGING. Bandages are strips of fabric used in surgery for the purpose of protecting, or compressing a part, or for holding in place dressings and applications. They are classified as simple, compound, and immova- ble ; and according to their form of application they are classed as : (1) Circular, circular turns about a part. (2) Figure-of-8, turns crossing each other like 8. (3) Oblique, making oblique turns. (4) Recurrent, returning each time to the point of starting. (5) Spiral, each turn covering part of the last. (6) Spiral reverse, reversing the bandage to make it fit closer. (7) Spica, turns arranged like the husks on an ear of corn.1 The chief points to be considered in applying a bandage are : (1) The purpose of the bandage. (2) The class of the bandage and its material. 1 Gould's Medical Dictionary. 21 TEXT-BOOK FOR NURSES. 22 (3) The part to which it is to be applied. (4) The best method of application.1 The materials from which bandages are made are, in the order of their importance, muslin (bleached or un- bleached), surgical gauze, flannel, and rubber. A simple bandage is a strip of fabric from half an inch to eight inches in width and from three to twelve yards in length, evenly and tightly rolled upon itself. This is called a roller bandage. A compound bandage consists of two or more strips, and may be either a double roller bandage, or consists of a number of strips fastened to each other, or a single piece partly divided (many-tailed bandage). An immovable bandage is one that is combined with some material that becomes hard and immovable, such as starch, plaster-of-Paris, dextrin, silica, tripolith, etc. These are used as supports to replace splints. In private practice a nurse can improvise bandages, by taking sheets and tearing them in strips of the proper width. To get the necessary length, the strips must be neatly joined at the ends by stitching, laying the two ends flat upon each other, and not turning the edges. A bandage that will be wet, must be of material that will not shrink, and should therefore be made of cloth that has been washed. A bandage that is pliable can be adjusted with greater nicety than one containing a dressing. If muslin is used it should be torn and the ravellings all removed. Gauze and flannel must be cut, and care must be exercised to have it cut by the thread. A thread may be drawn out as a guide. 1 Principles and Practice of Nursing.—Hampton. BANDAGES AND BANDAGING. 23 Bandages may be rolled by hand, or upon bandage rollers. In rolling by hand, fold a piece of the band- age upon itself to make a small roll and then use the palm of the hand in rolling down the thigh ; or, hold the roll in the left hand, the bandage passing between the thumb and forefinger, and exerting the necessary pressure, while the roll is turned with the right hand. Wide bandages can be rolled on round sticks about half an inch in diameter. A bandage cut on the bias is more elastic and will permit a firmer pressure. Flannel is sometimes used in this way upon swollen parts. The requisites for proper bandaging are : (1) It must be even without wrinkles. (2) Pressure must be exact, neither too loose, nor tight enough to check the circulation. (3) It must cause neither pain nor discomfort. (4) It must gain the object in view.1 The width of bandages depends upon the parts to which it is to be applied. If for the trunk or for large dressings, the bandage may be from six to eight inches in width ; for the lower extremity, from three to four inches ; for the upper extremity and head, two to three inches ; and for the fingers, one inch. Bandaging should always be commenced at the point farthest from the trunk. The roller should be held firmly in the hand and close to the part, and should not be unwound faster than is necessary. If for any reason a part of the bandage is taken off for a better 1 The art of bandaging cannot be learned theoretically. After learning the principles of bandaging, it is only by prac- tice that this important function of the nurse can be perfected. The tendency of beginners is to wind a bandage too tight. 24 TEXT-BOOK FOR NURSES. adjustment, it should be rolled up before beginning again. In completing a bandage, fold the end underneath and pin it, taking necessary care that the bandage should draw equally at both edges, and that the point of the pin is covered ; or, the bandage can be split and wound in opposite directions and tied. The spiral and the figure-of-8 (Fig. 3) are the forms, in various combinations, that are generally used. A simple spiral goes round the part and at each turn overlaps the form- er about one-third of its width. If the part is not straight, but increases in diameter, like the forearm and leg, then reverses must be made. To reverse, place the finger at the lower edge of the bandage to pre- vent its slipping (Fig. 4), and turn the bandage over, changing its direction as much as necessary to get an equal pressure and still permit a proper lapping. Reverses can be made as often as is neces- sary, usually at every turn on the calf of the leg. If the nurse is right-handed, the bandage should be put on from left to right. The roller should have its outer side to the part until reverses begin. The figure-of-8 is easier of application when once perfectly learned. This is the winding alternately FIG. 3.—SHOWING FIGURE-OF- 8 APPLIED TO FOOT, AND SPIRAL APPLIED TO LEG. FIG. 4.—MODE OF MAKING REVERSES. BANDAGES AND BANDAGING. 25 above and below some point, at each turn overlapping the previous one, as in the spiral bandage. The spiral and the figure-of-8 may be used in combination (Kg- 3)- The Head.—For retaining dressings upon the scalp, the figure-of-8 bandage is the most useful (Fig. 5) ;1 FIG. 5.—SHOWING COMMENCE- MENT OF CAPELLINE BANDAGE. (Cantlie). FIG. 6.—SHOWING COMPLETION OF CAPELLINE BANDAGE. (Cantlie). and the circular for the forehead. The transverse-re- current (capelline) bandage is useful to cover the entire vertex (Fig. 6).a The 4-tailed bandage3 of the head 1 Commence above the ear and carry it forward over the eye- brows and around the back of the head as high as possible. Keep winding it round, but at each turn go higher in front and lower behind until the necessary surface is covered. 2 This is a double roller. Take a roll in each hand, standing behind the patient, and begin by placing the intervening strip low down upon the forehead. Pass the rolls around the head to the occipital protuberance, where they meet. Pass the rolls, and while one continues to go round the head the other passes backwards and forwards over the vertex until the whole is covered. 3 A piece of cloth 8 inches wide and long enough to pass over the head and under the chin, is torn from each end towards the middle, leaving 3 to 4 inches. The whole piece is placed upon the top of the head, the back tails are brought around and tied under the chin, and the front tails are brought around and tied at the nape of the neck. 26 TEXT-BOOK FOR NURSES. (Fig. 7) is sometimes better where careful pressure is not required. The 6-tailed bandage is much like the for- mer, except that it is torn in three strips at either end, and placed sideways upon the head; the middle strips are brought under the chin and tied. The crossed bandage of the jaw 1 is used for retaining dressings upon the side of the face, and in fracture of the neck or the lower jaw. The V-bandage2 is useful for retaining dress- ings on the lips and chin. The Trunk.—The circular and figure-of-8 on the neck and axilla 3 is used to retain dressings upon the shoulder or in the axilla. This can be crossed on the chest or back as required. The anterior figure - of - 8 draws the shoulder forward and retains dressings on FIG. 7.—4-TAILED BANDAGE AP- PLIED TO BACK OF THE HEAD. FIG. 8.—POSTERIOR FIGURE-OF-8 BANDAGE OF CHEST. 1A roller 2 inches wide, 5 yards long, is given two turns around the head, from right to left if for the left angle of the jaw, and vice versa. On reaching the back of the head the second time, bring it down obliquely under the ear and jaw on the sound side and up over the affected side and around the head again. At each turn make it overlap. Terminate it by two turns around the head after reversing. 2 A roller 2 inches wide, 4 yards long, is started by two turns horizontally about the head. At the second turn bring the bandage around under the ear and across the chin, lower or upper lip, whichever required, and backward over the occipital bone. Then make alternate turns over the forehead and over the face, and terminate on the occiput by pinning. 3 A roller 2'/z inches wide, 7 yards long, is started by two turns around the upper right arm near the shoulder, after which it is carried obliquely across the front of the chest towards the left BANDAGES AND BANDAGING. 27 the chest, and the posterior draws the shoulders back. The suspensory bandage of the breast1 is used to sup- port and compress the breasts in mammary disease. It FIG. 10.—SPICA BANDAGE TO LEFT SHOULDER. FIG. 11.—SPICA BANDAGE TO GROIN. FIG. 9.—SPICA BANDAGE TO RIGHT SHOULDER. requires a great deal of practice to apply this bandage successfully. The spica bandage of the shoulder (Figs. 9, 10)2 is useful for retaining the shoulder in place after dislocation and for dressings. The spiral bandage * is axilla, over the shoulder of the same side, back across the front of the chest, through the right axilla, over the shoulder and re- peating. Protect the axillae by cotton compresses. *Take a roller 3 inches wide, 8 to 10 yards long, and com- mence by making a turn from the opposite shoulder-blade over the shoulder under the affected breast, back over the shoulder. After two turns, make alternate turns around the chest and over the shoulder, overlapping each turn until the breast is covered. Both breasts can be covered by continuing the bandage when it passes around the chest over the back and opposite shoulder, then alternating at each turn somewhat like a figure-of-8. 2 A roller 3 inches wide, 10 yards long, is secured by two circular turns around the upper arm ; carry the roller from the outer surface obliquely across the front of the chest, if for the right side, and across the back if for the left side, through the axilla aud back to the starting place ; then repeat the turns until the shoulder is covered. 3 A roller 3 inches wide, 9 yards long, commencing in front of the waist and making several turns around the body. Then carry the bandage upward, overlapping at each turn about one- half of the previous one, until the axilla is reached. Then carry the roller over the back to the opposite shoulder and ter- minate down the front of the chest. 28 TEXT-BOOK FOR NURSES. used to hold dressings to the chest, and as a temporary dressing, in fractures of the ribs or sternum. It must not be too tight to interfere seriously with respiration. The spica bandage of the groin (Fig. n),1 either single or double, is used to hold dressings to wounds in the groin, or to make pressure. It is frequently used for temporary retention of hernia. The Hand.—The fingers usually require a simple FIG. 12.—GAUNTLET BANDAGE. FIG. 13.—DEMI-GAUNTLET BAND. AGE. spiral bandage2 either for dressings or retaining splints. When all the fingers are covered it is called the gaunt- 1 A roller lyi inches wide, 7 yards long, is commenced in front of the thigh and given several turns around the thigh. It is then carried obliquely across the abdomen to the upper part of the pelvis, around the back, to and around the thigh to the groin. Carry it around the thigh once and then repeat, over- lapping at each turn. For a double spica the roller should be 9 yards long. Proceed as for a single bandage except instead of crossing the back obliquely, cross straight to the other pelvis and come down over the abdomen to reach the opposite thigh, alternating at each turn. 2 A roller 1 inch wide, 1% yards long, is given several turns about the wrist and then carried across the back of the hand to the tip of the finger by oblique turns. The finger is then cov- ered by spiral turns until the base is reached, when the roller is carried over the back of the hand and terminated by several turns at the wrist. BANDAGES AND BANDAGING. 29 let bandage (Fig. 12)1 and its chief use is in case of wounds and fractures. It is not used for scalds and burns as formerly, as separate dressings for the fingers are less painful and easier to replace. The demi-gaunt- let (Fig. 13)3 is a bandage for the palm or dorsal sur- face of the hand for retaining dressings when the fingers do not require bandaging. The spica band- age3 for the thumb is used with splints in fractures and dislocations. The Arm.—For the wrist, to compress the joint or to retain dressings, the circular and figure-of-8 are used. This is an easy bandage to apply. The figure-of-8 for the elbow 4 is the most useful bandage. It can also be 1A roller i inch wide, 3 yards long, started at the wrist in the same way as for a single finger, but carried first to the tip of the thumb which it covers by spiral turns. It is then brought back to the wrist and given another turn and applied to the in- dex finger in the usual way. When all the fingers are covered, the bandage is terminated by several turns around the hand and wrist. 2 A roller 1 inch wide, 4 yards long, is started at the wrist by several turns and is then carried across the back of the hand through the space between the thumb and index finger. Then carry the roller back to the wrist on the palmar surface and make a turn around the wrist; then carry across the hand to the base of the next finger and repeat until the hand is cov- ered, ending at the wrist. 3 A roller 1 inch in width and 3 yards in length is started in the same way as for the fingers. It is then carried over the back of the thumb to the nail, where it is given a turn, and is then carried over the back of the hand to the wrist and given a turn. This is repeated, but coming lower on the thumb at each turn until it is covered. End with a circular turn about the wrist. 4 The roller should be 2 inches wide and 4 yards long. Commence upon the forearm below the elbow, and make two circular turns while the arm is slightly flexed. Then carry obliquely across the inside of the elbow and make one turn above it. Then carry across and make a circular turn below, repeating until the elbow is covered. 30 TEXT-BOOK FOR NURSES. used in connection with bandaging of the lower and upper arm. The spiral-reverse bandage for the arm (Fig. 14),1 either for the whole arm or above or be- low the elbow, is the one generally used in fractures and dislocations, and to re- tain dressings. In making reverses they should always be in line, and made upon the anterior aspect of the limb. The Foot.—It must be determined first whether the bandage is to cover the heel. If so, either the spica (Fig. 15) or American' (Fig. 16) bandage is the form to use. If the heel is not to be covered, the bandage may be started above the ankle several turns, brought down across the dorsum of the foot to the toes, and then ascending by spiral reversed turns, reversing upon the top of the foot. FIG. 14.—SPIRAL-REVERSE BAND- AGE FOR THE ARM, COMPLETED. : 1 Have a roller inches wide, and 7yardslong. First make two turns about the wrist. Then carry across the back of the hand, and make a circular turn at the second joints of the fingers and ascend the hand by several turns as far as the thumb. Cover the base of the thumb and the wrist by several figure-of-8 turns. Then carry the bandage up the forearm by spiral-reversed turns, making the reverse upon the front of the arm, until the elbow is reached. The elbow can then be covered by figure-of- 8, as in the preceding bandage. If it is desirable to continue the bandage up the arm, it should be 10 yards in length. 2 The roller should be inches wide and 7 yards long. Make two circular turns above the ankle. Carry obliquely across the top of the foot to the joint of the great toe, then make spiral or spiral-reversed turns, ascending the foot to above the instep, and carry the roller over the point of the heel and back to the top (dorsum) of the foot; thence beneath the instep to one side of the heel, up over the instep to the other side of the heel, thence up in front of ankle continuing up the leg. BANDAGES AND BANDAGING. 31 The Leg and Thigh.—The bandages to be selected for the lower extremity are in form about the same as for the upper, but in size should be about half an inch wider and correspondingly longer. For the knee the FIG. 15.—SPICA BANDAGE OF FOOT. FIG. l6.—MODIFIED FIGURE-OF-8 BANDAGE OF LOWER EX- TREMITY. figure-of-8 is the best adapted, and should be applied as for the elbow, commencing the bandage above the knee. Sometimes it is necessary to bandage both knees together.1 1 Select a roller inches wide and 7 yards long. Place the knees together with a compress between them. Then start by making two turns upon the thigh several inches above the knee, and carry the roller across the back of both knees to the leg of the opposite side, making a circular turn about both legs below the knees. Carry the bandage on the second turn above the knees to cross the other, and repeat, gradually ascending from below, and descending from above until the knees are covered. Finish by carrying the bandage snugly up and down between the legs. 32 TEXT-BOOK FOR NURSES. Stumps, after amputation, require bandaging, the best form to use being the recurrent.1 The bandage of Scultetus (Fig. 17) is a compound bandage consisting of a number of pieces 2 to 3 inches wide and long enough to go one and one-third times about the part. They are put under the part so that one piece will overlap and secure the other. The last piece is secured by pins. This bandage possesses the advantage that single soiled strips can be renewed without changing the whole bandage. It is also useful in operations, such as excisions, where the parts should not be disturbed. If a thread is passed through each strip in the cen- tre, it is known as Pott ’s bandage. FIG. 17. — BANDAGE OF SCULTETUS. 1 A roller inches in width, 5 to 7 yards in length. Start a few inches above the stump, and carry the bandage over the end of it and upward on the opposite side of limb, return to the point of starting in the same manner, and continue until the stump is sufficiently covered. Then reverse and secure the bandage by several circular turns. CHAPTER V. BANDAGING (Continued); SPEINTS. Square pieces of muslin or handkerchiefs are used for the temporary dressing of wounds and fractures. A handkerchief may be modified to produce many in- genious bandages. The forms in which the handkerchief can be used are the square, oblong, and triangle. The cravat is made from the triangle by folding the handkerchief upon itself lengthwise. The axillary cravat (Fig 17a) is use- ful to hold dressings in the axilla. Barton's handkerchief is em- ployed to make extension in case of fracture of the leg or thigh. A handkerchief is folded into a narrow cravat and placed around the heel over the foot, thence around the instep. Rubber bandages are made from strips of rubber sheeting, from 1 to 4 inches in width and from 3 to 6 yards in length. This is made into a roller. They are chiefly used where it is desirable to have a FIG. 17A.—AXILLARY CRAVAT. 33 34 TEXT-BOOK FOR NURSES. very elastic pressure over the part, such as in varicose veins of the leg and in chronic ulcers where strapping is indicated. The rubber rollers are applied in the same manner as indicated for muslin rollers, except that the rubber, on account of its elasticity, need not be reversed. Care must be taken not to stretch the bandage too tightly. The bandage is terminated by two tapes sewed to the extremity, which are passed around the part and tied. Rubber bandages cannot be worn continuously, as they do not allow evaporation of the skin secre- tions. They should be taken off at night and hung up to dry. Immovable bandages, fixed dressings, or hardened bandages are made from a variety of substances, which are incorporated in or upon fabric to stiffen it. Plaster-of-Paris is more commonly used. It should be extra-calcined ; if moist or of inferior quality it will not set rapidly or firmly. There are several ways of applying this dressing, but the most convenient method is Sayre’s,1 which is the use of bandages which have been saturated wTith the plaster and moistened while being applied. Another way is to first apply neatly to the part a flannel or mus- lin bandage that will not shrink ; over this is placed a layer of cheese cloth or other loose material. Some plaster-of-Paris is then mixed with water to the con- sistency of cream and painted or plastered over the 1 The material used is some loose fabric such as cheese-cloth or netting or crinoline, which is cut into strips from 2 to 3 inches in width. These are laid flat and plaster-of-Paris is dusted over them and rubbed in. The strips are then loosely rolled up. They must be kept in sealed jars, or they will be- come moist and unfit to use. BANDAGING. 35 whole surface. Another layer of the loose material is put over this and the plaster is applied again, and thus repeated until the proper thickness is gained. Care should be taken that all bony prominences are protected by pads of cotton. Sometimes strips of tin, zinc, or pasteboard are put in the layer of the bandage to increase the stiffness. The interrupted plaster dressing is used where a por- tion of the limb is to be ex- posed. An iron rod can be placed across such parts with its extremities connected to wire. The wire can then be incorporated in the bandages and covered with plaster. The starch bandages are made by the application of starch mucilage,1 either with a brush or by hand, over the outer surface of the bandage as it is applied to the limb. Pieces of pasteboard soaked in starch are placed between the layers of bandage. This bandage dries very slowly, requiring from twenty-four to forty-eight hours before it becomes firm. Besides the materials described, gum and chalk, sili- cate, paraffine, and glue are used for fixed dressings, but they do not possess any advantages over starch and plaster-of-Paris. FIG. 18.—SHOWING A TRAP IN A PLASTER-OF-PARIS DRESSING. 1 Starch mucilage is made by mixing starch with cold water to make it the consistency of cream ; then as the mixture is stirred boiling water is gradually added to it until it becomes a clear, thickish mucilage. 36 TEXT-BOOK FOR NURSES. Sometimes, as in compound fractures, there are sur- faces that must be left exposed, and there must be an opening made in the bandage. This is termed trap- ping (Fig. 18). To accomplish this, before applying the bandage a compress of lint is placed over the wound, and this marks the place where the bandage is completed. The projection can be cut around after the bandage is partially hard. For removing plaster-of-Paris from the hands, put a FIG. 19.—ARM SLING, in- CLUDING ELBOW. FIG. 20.—SLING TO SUP- PORT THE UPPER ARM. tablespoonful of carbonate of sodium in a basin of water. Adhesive plaster is occasionally used for the support of a limb in place of the bandage. The plaster should be cut lengthwise of the roll. For strapping the ex- tremities, the strips should be an inch and a half wide and sufficiently long to lap a few inches. The plaster is warmed by holding the white side over a flame, or applying it to any warm surface. The hair should be shaved off before applying. Adhesive strips are used in preference to bandages in the case of fractured ribs. Slings are made from handkerchiefs, square pieces SPLINTS. 37 of muslin, and rollers, and are used to support the limbs in fractures or wounds. A sling for the arm may include the elbow or not (Fig. 19). It usually does when pressure is to be exerted on the shoulder. If the upper arm is to be supported, the slings should support the wrist only (Fig. 20). Splints are used to retain bones in position after fracture until union occurs. They may be of wood, tin, lead, copper, gutta-percha, pasteboard, or sole leather. Wood makes the simplest and best splint, either white pine or basswood, giving sufficient strength and at the same time being light. They are usually made from boards half an inch in thickness, planed down, and with rounded edges. Before being applied they should be well padded with cotton, wool, oakum, or hair, and in some cases bags filled with bran are used between the limb and the splint. Pasteboard, or binder’s board, is first soaked in boil- ing water, after being cut to the proper size, and when soft is padded with a layer of cotton and secured by a bandage. When it dries it becomes hard and retains its shape. Gutta-percha made from sheets from tV to } inch in FIG. 21.—EXTENSION SPLINT FOR THIGH (Cantlie). 38 TEXT-BOOK FOR NURSES. thickness becomes soft when soaked in boiling water, and adapts itself to the shape of the part. Care must be taken not to let it become too soft. Sole leather is treated in the same way, and makes an excellent splint. The immovable dressings act as splints and obviate the necessity of any other material. In fractures of the lower extremity the fracture-box is a splint generally used, and consists of a piece of board 18 to 20 inches long, with a foot- board secured at one end. To the sides of the board are attached boards with hinges. The extension splint is a long board reaching from below the foot nearly to the axilla (Fig? 21). It is arranged to stretch the limb (extension) in frac- tures and avoid shortening, as well as to retain the fractured bones in posi- tion. Extension is also afforded by attaching a weight to the foot by a cord that hangs over the foot of the bed (Fig. 22). FIG. 22—EXTEN- SION APPARATUS AT FOOT OF THE BED. CHAPTER VI. FRACTURES, DISLOCATIONS, AND SPRAINS. A fracture is the breaking of a bone either by some force from the outside or by muscular action. Fractures are classified as complete, incomplete, simple, compound, comminuted, and impacted. A complete fracture is one in which the bone is com- pletely broken across. An incomplete fracture is one in which the bone is broken a part way across, the remaining part of the bone bending instead of breaking. This is also known as “ greenstick ” fracture (see vol. i., p. 4). In a simple fracture there are but two fragments and the external skin is not ruptured. In a compound fracture there is an open wound ex- posing the seat of the fracture to the air. Comminuted fractures are those in which the bone is broken into more than two pieces. In an impacted fracture one fragment is driven into the other and becomes fixed. The direction of the fracture may be transverse, that is, when the bone is broken directly across ; or oblique, when the line of fracture is diagonally across the bone ; or longitudinal, when the line of fracture is lengthwise of the bone. 39 40 TEXT-BOOK FOR NURSES. Fractures are the most common injuries of bones, and in the majority of cases in which an accident is followed by some deformity of the body, fracture exists. In addition to the deformity, the usual signs of a frac- ture are pain, disability, feeling the displaced fragments of bone, a grating sensation caused by rubbing of the broken ends together, called crepitus, and swelling and discoloration. All of these symptoms may not exist. Sometimes a bone is fractured in which there is no marked displacement, and the deformity is slight. There is nearly always pain and inability of the patient to move. In case of a suspected fracture the patient should be placed in as comfortable a position as possible until medical aid arrives. In the meantime, however, the clothing covering the part can be removed, and this should be gently done, ripping up the seams rather than moving the patient. Any movement of the in- jured part while the ends of the bone are not in appo- sition, has a tendency to tear the soft tissues, and may rupture a blood-vessel. In lifting a person with a fracture, the injured part should rest upon the hands in such a manner as to relieve any strain at the point of fracture. Where medical aid is not available, the nurse should compare the two limbs to ascertain the degree of de- formity. By very careful extension the bones may be brought into apposition and give the patient great relief. If the fracture is compound, the wound must be cleansed with the greatest care and thoroughness, and there must without any doubt be entire cleanliness of the ruptured tissues before they are restored to position. A solution of carbolic acid, i to 40, or some other in- FRACTURES, DISLOCATIONS, AND STRAINS. 41 nocuous (non-poisonous) disinfectant should be used to irrigate the parts thoroughly. All loose fragments of bone must be removed, and in case of haemorrhage it must be controlled either by securing the broken vessel or by tourniquet. Provisional care of a fracture awaiting medical aid, should consist of support, especially if muscular spasm has a tendency to displace the broken fragments. Sometimes, also, fractures occur at localities where treatment cannot be properly con- ducted, and for transportation of the patient some provisional arrange- ment is required. In fractures of the upper extremity or shoulder, the arm can be bound to the side by some article of clothing, but in frac- tures of the lower extremity the parts should be surrounded by a binder made of any fabric at hand, and there should be applied to the side of the limb strips of wood, shingles, strips of bark, or any material of the proper stiffness (Fig. 23). Umbrellas, broomsticks, or canes can be used for the pur- pose. The parts must be arranged in some manner so they will not move about. The nasal bones are frequently fractured by direct blows or falls, and these fractures are sometimes fol- lowed by profuse haemorrhages, which may require plugging of the nares to control. The lower jaw is sometimes fractured and results in great deformity. A satisfactory temporary dressing is FIG. 23.—PROVISIONAL DRESSING FOR FRAC- TURE. 42 TEXT-BOOK FOR NURSES. the 4-tailed bandage. During treatment the mouth becomes very offensive, and the nurse must make fre- quent applications of solutions of boric acid or other aseptic mouth wash. Fractures of the ribs are more frequent than any other bones of the trunk. The most common seat of the frac- ture is near the angle of the rib. These fractures are usually dressed by enveloping the injured side of the chest with strips of adhesive plaster, 2Y/2 inches in width and long enough to extend from the spine to the middle of the chest. Provisional dressing is afforded by a strong binder of stout muslin. The pelvis is sometimes fractured, but this injury is apt to be complicated by serious injury of the abdomi- nal organs. Temporary care of these fractures requires flexing of the thigh and supporting of the legs upon pillows. The vertebra are sometimes fractured, and this injury is a very serious one, on account of the liability of in- jury to the spinal cord. Where a fracture of the spine is suspected, the greatest care must be exercised in moving the patient. A water-bed is desirable, and great care must be taken to keep the patient clean, —especially the parts exposed to pressure. Fractures of the skull, in which depression of bone occurs, are usually accompanied with cerebral symp- toms. The outer table of the skull may be crushed, making a marked depression, without breaking of the inner table. This is not serious. The clavicle is frequently fractured, and it may be complete or incomplete. The deformity may be reduced by placing the patient upon his back with the head slightly raised, and bringing the arm to the side of FRACTURES, DISLOCATIONS, AND STRAINS. 43 the chest. A good temporary dressing is the 4-tailed bandage.1 The scapula may be fractured in any of its parts. Temporary dressings may be made by putting a folded towel in the axilla and binding the arm to the chest by a roller in spiral turns around the chest, supporting the forearm in a sling. Fractures of the arm should be dressed temporarily in any way to reduce the deformity and to give the patient the greatest ease. An extemporized splint is required for support, tied firmly with handkerchiefs or strips of muslin (Fig. 24). Fracture of the lower end of the radius is a very common fracture, caused by falling upon the hand. It is usually accompanied with dislo- cation of the ulna, and is called Colies's fracture. The deformity is a peculiar drop of the wrist known as the goose-neck deformity. Provisional care of this fracture is best given by a narrow sling for the wrist, with the hand resting upon the ulnar side.' Fractures of the bones of the hands are best cared for temporarily by placing a roller 1% inches thick in the hand,- and winding a bandage loosely above it. A fracture of the neck of the femur is very common FIG. 24.—EXTEMPORIZED ANGULAR SPLINT FOR ARM. 1 Take a piece of muslin 2 yards long, 14 inches wide. Cut a hole in the centre about 4 inches from the margin, to receive the elbow. Then split the bandage into 4 tails in the line of the hole and within 6 inches of it. Place a folded towel in the axilla, the elbow in the hole, and carry the lower tails across the chest and back and tie about the neck on the opposite side. Carry the remaining tails around the chest and tie.— Wharton. 44 TEXT-BOOK FOB NURSES. in old people after a fall. In addition to pain, the foot is thrown outwards, and there is some shortening of the leg, without other deformity. This fracture is usually treated by extension (Figs. 21, 22), but in persons over seventy years of age, rest in bed is the only treatment required. In all fractures of the lower extremity extension is employed, unless the fracture is transverse. Frequently immovable bandages are employed. Pott's fracture is a fracture of the fibula near the ankle, and is very common, resulting from a wrrench or severe muscular action. It is frequently mistaken for a sprained ankle. It can be recognized by the foot turning outwards. In the care of fractures, the nurse must attend particularly to all parts subjected to pres- sure. Any unusual redness indicates irritation, and the part should be temporarily relieved from pressure and bathed with diluted alcohol. A dislocation (out of joint) is the displacement of the bones forming a joint. It may be simple, or complete, or complicated; it may also be old or recent. A simple dislocation is one in which the bones are displaced without* any injury to the surrounding tissues. It is complete when the bones are entirely separated from each other. A compound dislocation is one in which the skin is ruptured and the air communicates with the joint, as in compound fracture. In a complicated dislocation, in addition to the dis- placement of the bones, there is a fracture, or a wound of the vessels, nerves, or muscles. A recent dislocation is one in which inflammatory FRACTURES, DISLOCATIONS, AND STRAINS. 45 changes have not had sufficient time to seriously in- terfere with the reduction of the joint, and vice versa an old dislocation is one that has existed for some time and in which adhesio?is do not allow an easy reduction. A dislocated joint always presents a deformed appearance, and the bone that is out of joint will cause a projection or swelling. These injuries are usually very painful, and they are frequently very difficult to reduce. A nurse can do but little, much less than with a fracture, to make the patient comfortable. The part can be supported and cold applications can be applied to keep the swelling down, but little else can be done in the absence of the physician. Some disloca- tions may "be easily reduced and may be attempted by the nurse, such as the following, viz.: The lower jaw may have either one or both condyles thrown out of place. This dislocation is very evident from the deformity produced and it cannot be mis- taken.1 The clavicle may be put out of joint at either end ; if at the shoulder end, there is a well-marked lump at the top of the shoulder, and the shoulder is flattened.8 The reduction of the sternal end of the clavicle is not easy and should not be attempted by the nurse. The humerus may be thrown out of joint downward, forward, or backward. It is best reduced by a series iTo reduce, protect the thumbs with a handkerchief wrapped about them ; place them over the lower molar teeth and press the angles of the jaw downward while elevating the chin with the fingers. The jaw should be fixed for a week with a 4-tailed bandage. 2 To reduce, place the knee against the spine and draw the shoulders backward, pressing the displaced clavicle into place. The reduction is generally easy, but if it does not return after a short trial await the arrival of the physician. 46 TEXT-BOOK FOR NURSES. of movements that cause the muscles to act in throw- ing the head of the bone into position, but it can also be reduced by extension—placing the heel of the operator in the axilla and pulling the arm downward. Dislocation of the elbow backward can be reduced by placing the bend of the elbow over the knee and making pressure. Other dislocations of the arm require complicated manipulation. Dislocation of the fingers can usually be reduced by extension. Displacement of the bones of the lower extremity are more complicated than those of the upper and the dislocations are more frequently compound. In these grave injuries, operative measures are often required. The same precautions to avoid infection are necessary as in compound fractures. The subsequent treatment of dislocations is fre- quently as prolonged as in case of a fracture, and the same general rules apply. A joint that has been dislocated must not be left in one position too long, for fear of anchylosis.1 This is more to be feared where the violence has been great. Careful passive move- ments of the joint are necessary, at least once daily, after the first week, to prevent adhesions and per- manent stiffness. A sprain is the stretching or laceration of ligaments about joints. It may be caused by a twist or a blow either direct or indirect. The symptoms are severe pain, disability of the joint, and severe swelling, with discoloration from effusion of blood. For sprains that are not severe, hot applications, entire rest, and a firmly 1 Union of bones forming a joint, creating a stiff joint. FRACTURES, DISLOCATIONS, AND STRAINS. 47 applied bandage are sufficient. A lotion of lead-water and laudanum reduces swelling and pain to some ex- tent. Sometimes a plaster-of-Paris bandage is useful to give support to the joint, but this should not be ap- plied if the swelling is great. In sprains of the larger joints no attempt to use the limb should be made under a week. Afterwards the patient should be en- couraged to use the joint, or passive movements should be practised to prevent stiffness. In old sprains no treatment is as effectual as well-applied massage. CHAPTER VII. FEVER ; INFLAMMATION. Fever (from the Latin febris, and this from fervere, “to be hot”) is an elevation of the body temperature beyond the limits of health. In order that an elevation of temperature may be considered as fever, it must con- tinue for several hours, and not be the result of ex- cessive external heat or muscular exercise. Fever is classed as continuous, remittent, and inter- mittent. In continuous fever the range is constant and remains steadily above the normal line with but slight changes. A remittent fever is characterized by distinct par- oxysms, in which the temperature rises and falls, but does not reach the healthy standard. In intermittent fever the temperature reaches a high point, and then falls to the normal, or below it. These changes usually occur periodically. There are usually three stages of fever, known as the invasion, the fastigium, and the decline or defervescence. The first of these is usually preceded by a period called “ the incubation,” during which the poison in the sys- tem works to produce its particular symptoms. These stages may vary in duration from a few hours to a week or more. The temperature, as shown by the ther- 48 FEVER; INFLAMMATION. 49 mometer, determines the character and duration of the several stages. A fever may decline in two ways, either by crisis or lysis. If it drops rapidly to normal, as is usual in pneumonia, it is called crisis. If the decline is very gradual, becoming less and less each day, as in typhoid fever, it terminates by lysis. Fever is usually caused by the entrance into the body of disease germs, or micro-organisms, and the condition produced by them. A fever of purely nervous origin has been described, but it is rare. Even in injuries the existence of fever is proof that suppuration is going on in the wound. In modern surgery, where operations are carefully performed under aseptic precautions, it is the exception to have an elevation of temperature that can be called a fever. Fever heat is produced by the increased oxidation, or consumption, of the blood and tissue elements. This is shown in the increase of waste products in the bodily excretions and exhalations.1 As previously stated, the temperature of the body changes about one degree in the course of twenty-four hours, the average being 98.6° F.a ; the highest tem- perature in health occurring about 4 p. m., and the lowest between midnight and morning. The range of temperature in health, therefore, may be between 97.40 1 The amount of carbonic acid in the expired air is markedly increased, in fever, particularly in the stage of invasion. Also the quantity of urea is increased. 2 Fractions of a degree should always be expressed in tenths ; then the necessity of using a denominator is avoided, and the decimal point expresses the value. Some thermometers have the degrees divided in fourths, but they are usually divided in fifths ; each mark then indicates .2. 50 TEXT-BOOK FOR NURSES. and 99.6°. But if a morning temperature recorded 99.6°, it would be considered abnormal, while the same temperature in the afternoon would not be. The daily drop in the temperature occurs in the morning. In disease the temperature may rise to 107.6°, and may fall as low as 950. This range is considered within the limits compatible with life. The height of the thermometric record is the measure of the height of the fever, and the height of the fever corresponds usu- ally to the intensity of the disease. A high tempera- ture lasting but a short time does not always indicate danger. It is the high fever maintained for days that gives evidence of the severity of the disease. A subnormal temperature, or one below the standard of health, indicates depression of the vital forces. Thus in severe haemorrhages, in shock produced by injury, in chronic wasting diseases, in certain forms of paraly- sis, a subnormal temperature may exist. Especially in states of collapse, when there is almost a suspension of the vital forces, the drop in temperature becomes ex- treme, reaching sometimes as low as 950. Should it go below this point there is no hope of recovery. The record made by the thermometer depends upon where the temperature is taken. It is usual to allow a difference of .6 (six-tenths) of a degree between the temperature taken in the axilla and that under the tongue, the latter being the higher; and the tempera- ture taken in the rectum is about as much higher than that taken in* the mouth. It is important, therefore, that the nurse should take the temperature continuously in one place, for purposes of comparison ; or, if a change is necessary, it should be plainly stated upon the clinical record. FE VEK ; INFLAMMA TION. 51 A chill, or rigor, which is often the first indication of an oncoming disease, is produced by a very rapid rise in temperature. There is a spasmodic contraction of the capillaries on the surface of the body. The patient feels dull and shivers, and sometimes shakes violently. This feeling is increased upon moving, or upon expos- ing the body to the air. If the temperature is taken at this time, it will be found to be higher than normal. In children, the onset of a fever is frequently char- acterized by a convulsion—one or more, the spasm taking the place of the chill in the adult. After the chill, which lasts from a few minutes to an hour or more, there is a period of dry, burning heat (the hot stage), and this may be followed by a slight or copious perspiration which relieves the burning sensa- tion in a degree. The temperature will probably be found to continually rise during this period. Should the fever rise slowly there is no chill, but a gradually increasing feeling of heat, and a feeling of tiredness and soreness of the body. There is usually thirst, anorexia (loss of appetite), at times vomiting, increased pulse and respiration, with the other symp- toms noted above. The tongue is usually more or less heavily furred, and the bowels constipated. Much depends upon the nature of the disease to which the fever belongs. At the close of the stage of invasion, there are usually special symptoms which indicate the nature and class of the disease. The nurse may cover patients in a chill, and cool the room during the stage of heat, but moderately in both cases. A cold compress may be applied to the head without injury. After a period of severe sweat- 52 TEXT-BOOK FOR NURSES. ing, the patient’s linen should be changed after the room is properly wanned, the skin dried during the change, and where possible the patient should be removed to another bed. Thirst is always an accompaniment of fever, particu- larly in the stage of invasion. From the increased difficulty of breathing, and the dried mouth, patients usually lie with the mouth open. As a rule, the use of cold water is admissible. In fatal cases the temperature frequently rises several degrees shortly before death. As the result of shock, however, as in the perforation of the bowel in typhoid fever, the temperature falls abruptly to or below nor- mal, the decline being accompanied by great restless- ness, a cold sweat, and sometimes by delirium or coma. Death may occur at any stage of a fever from blood- poisoning, or later from the effects of high temperature. It is now generally believed that fever is a means by which nature endeavors to destroy disease germs. It has been demonstrated that the tubercle bacillus does not grow at a temperature above 105.8°, and this applies to some other diseases. The danger in fever is usually indicated by the changes of temperature; thus, it is unfavorable when the evening temperature is high and the morning drop is slight. In other words, a high morning temperature is more unfavorable than a high evening temperature. A temperature above 104° F. is unfavorable. A decline of fever without a corresponding fall in the pulse-rate does not indicate improvement. A rapid rise, especially in the later stages of the fever, indicates danger, chiefly from complication or relapse. A rapid and decided de- cline, unless at the time for a crisis, is frequently the FEVER; INFLAMMATION. 53 indication of a collapse. The nurse should understand indications so that any important change may at once be reported to the physician. The temperature may often be fairly gauged by the feel of the skin to a skilful nurse. A nurse should endeavor to educate the hands to distinguish changes in temperature in this way. This will often suffice be- tween the periods of using the thermometer, to ascertain any change. But it must also be remembered that the skin is not always a reliable index of the body temperature. The principal treatment to reduce a fever, at the present day, is the application of water to the body (hydrotherapy). This includes both the internal and external administration of water. (The use of Baths will be treated in a separate chapter.) Inflammation is the movement of blood to a part of the body, in great excess, causing redness, swelling, heat, and pain. In a part open to inspection affected by inflammation these four signs always exist. Inflammation of the internal organs is chiefly detected by pain increased by pressure or motion, and general vascular excitement causing more or less fever. When more blood goes to one part of the body than is needed, or than there is in corresponding parts, it is hypereemia, or congestion. When the blood-vessels are distended, the elements of the blood do not exchange in the tissues, and the capillaries are dammed up. This is called stasis. There is more fibrin than the tissues can take up and it is deposited in the tissues, and this is called plastic lymph, or exudation. Inflamma- tion is well illustrated by the application of a mustard plaster to the skin. Its first effect is stimulating. It 54 TEXT-BOOK FOR NURSES. warms and reddens the skin ; if allowed to remain, the skin grows warmer and redder and some pain is produced. This is the stage of irritation. Now, if the mustard is withdrawn, these symptons will all subside, but if not, then the irritation increases and inflamma- tion occurs. There is redness, swelling, heat, and pain, and subsequently exudation (in the blister that is raised). If the exudation is reabsorbed after the swelling and redness subside, it is called resolution. When arterial blood is obstructed, there is exudation of lymph ; and when venous blood is obstructed, the exu- date is serum. When inflammation does not terminate by resolution, the exudate degenerates into pus, and this is called suppuration. The simplest example of this is an ordinary vesicle of the skin. There is a point of swelling,—red, painful, and hot. The swell- ing is caused by the exudate. It may pass away, “ dry up ” (reabsorbed) ; or it may go on to degene- ration and pus is formed, and we call it a boil. When the pus gathers at one spot, we say the boil has pointed. CHAPTER VIII. HEMORRHAGE. Hcemorrhage is the escape of blood from a wounded or ruptured blood-vessel. It may be arterial, venous, or capillary ; and is further classified as : (1) Primary, that is haemorrhage which occurs at the time the wound is made ; (2) Intermediary, when occurring at the time of re- action, or about 24 hours after the injury ; and (3) Secondary, bleeding which occurs after 48 hours, or at any time subsequent to this period until the wound is healed. Arterial haemorrhage may be distinguished by the bright crimson color of the blood, by its spurting out in jets with a pulsation and with considerable force, and by the bleeding occurring from the side of the wound nearest the heart. Venous bleeding is marked by the sluggishness of the flow, the dark or purple color of the blood, an ab- sence of pulsation, and the greater bleeding from the part of the wound farthest from the heart. Capillary haemorrhage is the oozing of blood, and occurs when the skin is cut. The blood is red in color, comes in a brisk, free stream, with a continuous flow, and comes from all parts of the cut surface. 55 56 TEXT-BOOK FOR NURSES. Haemorrhage may be from all three sources at once. It may also be active, passive, traumatic, symptomatic, critical, and vicarious. Active haemorrhages are those in which the determi- nation of blood to the part precedes the bleeding ; pas- sive, those in which the coats of the vessels are inefficient and congestion forces the blood through them. Traumatic haemorrhages are those produced by wounds; symptomatic, those occurring during the course of a disease, as bleeding from the nose in typhoid fever, bleeding from the lungs in pulmonary consumption, etc. ; critical, the occasional termination of serious diseases, such as yellow fever, etc.; vicarious, that which substitutes a physiological haemorrhage, such as spitting of blood on suspension of the menses, bleeding of the nose on arrest of bleeding from piles, etc. The extent of the haemorrhage depends upon the size of the injured vessel, the manner in which it is cut, and the state of the circulation at the time. An artery cut across will bleed more severely than one cut the length of the vessel ; an incised (sharp cut) wound more than a lacerated (crushed) wound, and a puncture more than an artery completely severed. Haemorrhage usually occurs unexpectedly, and may therefore be classed as an emergency. For this reason the nurse must be fully prepared to combat, or at least should have a knowledge of the various means for con- trolling it. The constitutional symptoms of haemorrhage, when it is severe, should be carefully watched for, as they in- dicate the degree of danger. The pulse gives a certain indication of the heart’s condition, the lips have a HEMORRHAGE. 57 “ bloodless appearance, and the countenance is anxious. Jsually the pupils are dilated and the patient is restless ; the extremities are cold ; the respirations are shallow ; there is more or less vertigo, and the patient has difficulty in speaking. These symptoms increase in intensity to unconsciousness and collapse. Fainting has a tendency to arrest bleeding, and is therefore desirable. When the haemorrhage is internal, the symptoms given above are a pretty sure index of its rate and continuance. There are no occasions more disconcerting or appall- ing than a sudden, unexpected haemorrhage, and none which call for more coolness and self-control on the part of the nurse. She should always carefully analyze the symptoms and ascertain the character and source of the bleeding, and not act impulsively, but with reason. Haemorrhage may be arrested b}r natural or artificial means. By natural process it is controlled : (1) By coagulation ; the clotted blood forming a plug, which dams the flow from the vessel. (2) By a reduction of the heart’s force, as in fainting. By artificial means as follows : (1) By pressure on the vessel either at point of injury or behind it, to shut off the flow. (2) By elevation of the parts. (3) Tying (ligature) of the injured vessel. (4) Application of heat or cold, and of remedies that coagulate the blood. (5) By twisting or torsion of the vessel. When pressure is made upon an artery to stop bleed- ing, it should be above the wound, or between it and the heart. Temporary pressure may be made with the 58 TEXT-BOOK FOR NURSES. fingers upon the ruptured end of the bleeding vessel or above it, in the arteries near the surface. A graduated pad (Fig. 25) can be bound with a roller over the artery as near the wound as possible, and if this is too deep to be reached, then over the main trunk supplying it. A tourniquet is an instrument to compress the blood- vessels to control haemorrhage. It consists of two metallic plates with a thumb-screw and a strap (Fig. FIG. 25.—GRADUATED COMPRESS. FIG. 26.—PETTIT’S TOURNIQUET. FIG.27.—A TOURNIQUET MADE FROM A HAND- KERCHIEF AND A STICK. 26). A pad is placed over the vessel under the strap which surrounds the limb, and the strap is then tightened up by the tliumb-screw. An improvised tourniquet can be made with a handkerchief twisted around a limb or any stick, with hard substance over the site of the vessel (Fig. 27). Bear in mind HEMORRHAGE. 59 that what is needed is a strap, a pad, and a means of tightening it. Acupressure was formerly much employed. It consists of thrusting a long pin through the skin and beneath the vessel, thus making pressure upon it. The most certain means of permanently arresting haemorrhage is by tying the severed end of the vessel by ligature. In operations this is the usual proced- ure, but in accidental injuries, the time required and the difficulty of finding the vessel require a readier method. The contractile nature of arteries causes them to shrink when divided, and they are drawn in from the surface of the 'wound. By using a sharp tooth forceps and following the jet of blood, the artery can usually be seized. The best ligatures are properly pre- pared sterilized catgut or silk. The materials to be prepared for the surgeon are ligatures, sponges, for- ceps, scissors, rollers, lint for compresses, etc. Styptics are remedies that cause the contraction of blood-vessels and check bleeding by reducing the size of the apertures, and also assist in coagulating the blood and thus plugging the vessel completely. The best styptic is cold, but, aside from cold and heat, Monsel's solution of iron is effective. It can be applied with a brush or a pledget of cotton. Among other styptics, perchloride and subsulphate of iron, alum, tannic acid, vinegar, and common salt are well known but not always reliable. Cold is the oldest and best known styptic. Expo- sure to the air alone, after removing all clots, fre- quently stops troublesome bleeding from wounds that bleed continuously in a slow oozing manner. Fanning the wound sometimes has a good effect. 60 TEXT-BOOK FOR NURSES. Compresses dipped in ice-water, and ice itself either applied directly to the wound, or indirectly in bladders or rubber bags, may be tried. Heat is of no value unless it is as great as can be borne. Hot water at a temperature of about 1250 F. to 130° F., which is the greatest heat bearable by the back of the hand, allowed to run in a stream upon the wound, has the advantage of being styptic and at the same time stimulating, while cold is depressing. The actual cautery 1 is the most powerful and certain of all styptics. This leaves a charred surface which is antiseptic, and when this surface comes off it leaves a healthy granulating wound. It is used chiefly after operations and seldom in emergencies. Torsion is the twisting of the end of a divided vessel by a forceps. This is applicable only to the smaller arteries, but is very reliable. The force of the blood sent to a part is much in- fluenced by gravity, hence, elevation of the injured part is helpful in the arrest of bleeding. This is always within the power of the nurse to do. Rest is also an aid. Get the patient into the proper position and in- sist upon quiet. By flexion and pads behind joints bleeding can often be very well controlled (Fig. 28). This is also a simple procedure easily improvised. The constitutional treatment after immediate danger is past, is very important. Patients cannot be stimu- lated freely on account of the danger of recurrence of the haemorrhage, yet exhaustion is sometimes very great. In anaemia, when the blood is of poor quality, 1 The actual cautery is a wire or a piece of iron brought to a white heat. HEMORRHAGE. 61 it does not coagulate readily, and the loss is doubly felt by the patient, while the danger of the bleeding recurring is greater than usual. Stimulation should be with small and repeated doses of wine, and the diet should be dry and light. Venous haemorrhages sometimes result from a blow or strain, or in reducing a dislocation. If a large vein is ruptured, a dangerous loss of blood may ensue. There is a possibility of air gaining an entrance into a broken vein. An elevated position with compresses and bandages will stop bleeding from superficial veins. Capillary haemorrhage is never of much importance ex- cept in the case of “ bleeders.” It can nearly always be checked by styptics, preferably cold. After operations, and par- ticularly amputations where several large arteries have been divided, careful observation is necessary for the first forty-eight hours. If the dress- ings become deeply stained, the surgeon should be in- formed. The pulse responds to haemorrhage readily and is a guide for the nurse. Awaiting the arrival of the doctor in case of consecutive haemorrhage, the nurse should use the means at hand for its control. Elevation, compression at the point of bleeding and along the line of the artery by pads and bandaging and cold, are available means. A dangerous result of haemorrhage sometimes is syn- cope of a profound character through loss of blood to the brain and consequent loss of function, or paralysis. FIG. 28.—PAD AND FLEXION TO CHECK HAEMORRHAGE. 62 TEXT-BOOK FOR NURSES. It may then be necessary to supply the brain with blood at the expense of other parts of the body, and this is done by bandaging the extremities with Bsmarch’s rubber bandage, or by rollers very tightly applied. When consciousness is restored and breath- ing becomes natural, the bandages may be taken off gradually. Blood in the urine indicates bleeding in the kidneys, bladder, or the passages from either, and is called hcematuria. The character of it indicates the source of the bleeding and should be carefully observed and re- ported. Thus, if from the kidneys, the urine will be colored throughout; if from the bladder, the bleeding follows micturition, etc. Epistaxis is bleeding from the nose. It is common in young persons and is usually harmless, and sometimes gives relief from head symptoms, such as dizziness, headache, etc. In older persons it is a more serious symptom. For checking it, posi- tion is often all that is required. Hold the chin up and elevate the arm on the side of the bleeding ; loosen tight clothing about the neck ; apply ice, or ice-water to the back of the neck and forehead ; inject, or have snuffled up a solution of salt or alum. If the bleeding is persistent, it may become necessary to plug the nares. The best procedure when the articles are avail- able is a soft rubber catheter threaded through the eye like a needle ; then pass the threaded end through the nostril into the throat and pull the thread out of the mouth with a forceps or hook ; then tie to it a FIG. 29.—PLUGGING THE NARES. HALMORRHA GE. 63 pledget of cotton or a small sponge and draw it up to the nares; tie the strings over a plug in the anterior opening (Fig. 29). Bleeding from the stomach is accompanied by vomit- ing of the blood, called licematemesis. The vomit has the appearance of coffee-grounds. Quiet is absolutely necessary ; small pieces of ice may be swallowed ; ice, or ice-bags over the stomach are helpful. Stomach bleeding should not be mistaken for swallowed blood. Intestinal haemorrhage (enterorrhagia) is usually symptomatic, frequently a result of the ulcerations of Peyer’s glands in typhoid fever. The application of cold in some form and absolute quiet are necessary, and if possible elevation of the abdomen. Cold may be applied by ice-water enemata, ice introduced in the rectum (especially in bleeding piles), or by ice-bags to the abdomen. Bleeding from the lungs is called h&moptysis. It is distinguished by its bright red color and frothiness. Death seldom results immediately, even when large vessels are involved, but the indications are very serious. The patient should be placed in a horizontal position and kept perfectly quiet; small pieces of ice may be swallowed ; an ice-bag may be applied to the chest, and the patient must be enjoined not to speak or swallow food. An old popular remedy is swallowing a spoonful of dry salt, but the danger from vomiting overcomes any possible benefit. Uterine haemorrhage will be considered in the chapter on obstetrics. CHAPTER IX. WOUNDS ,• BURNS AND SCALDS ; EMERGENCIES. A wound is defined as a solution of continuity of the soft parts ; which means a rupture of the soft tissues, including the skin or mucous membranes. Wounds are classified as incised, lacerated, contused, punctured, poisoned, and gunshot. An incised wound is a smooth, clean cut, and is usu- ally made by some sharp-cutting instrument. It is the most favorable wound for quick healing. A lacerated wound is one in which the edges are torn and ragged, and in which the vitality of the injured parts is often seriously impaired. These wounds are more painful, but the haemorrhage is more easily con- trolled. In contused wounds the injury to the fleshy parts, or bruising, is much more extensive than in lacerated wounds. It occasions swelling and discoloration from extravasation of the blood. If the vitality of the part is completely destroyed, ulceration separates the dead tissue and it sloughs away. Punctured wounds are inflicted by sharp-pointed in- struments. They are sometimes dangerous from their depth, a lack of free exit for discharges, and deep injuries of vessels which give rise to concealed haemor- rhages. 64 WOUNDS; BURNS AND SCALDS. 65 Poisoned wounds are caused by the absorption through a cut or laceration of infected or poisonous fluids, fre- quently from a dead body (dissection wounds). Gunshot wounds are produced by missiles, and are of the nature of contused and lacerated wounds. Contusions or bruises differ from contused wounds in the fact that the skin is not broken, although there may be extensive laceration of the tissues, and much more swelling than if the skin permitted the exudation to escape.1 Wounds may heal either, (i) by first intention, which means the growing together of two clean cut surfaces without suppuration, or by primary union. (2) By granulation, or the filling up of a wound by new tissue, which has a red, granular appearance, and is bathed with healthy pus ; these two granulating surfaces, being brought together, unite. (3) Under a scab formed by dried lymph, which seals the wound from the air, and underneath which the new skin forms. A cicatrix (plural, cicatrices) is the contracted new formation over the site of a wound ; it seldom regains the full vitality of the original part. In dressing of wounds the first thing to do is to irri- gate them thoroughly with an antiseptic solution and to remove any dirt or blood-clots. After the haemor- rhage has been controlled, if the wound is deep, drain- age tubes or a few strands of sterilized liorse-hair should be introduced to the bottom of the wound, 1 When not too severe they may be dressed by applying sev- eral thicknesses of lint saturated with lead water, or a solution composed of muriate of ammonia, grs. xx.; laudanum and alcohol each, f 3 i ; water, f§ i. 66 TEXT-BOOK FOR NURSES. allowing it to protrude from the lower part of it. If the edges can be brought well together with superficial sutures, drainage will not be required. If the wound is not deep, interrupted sutures (Fig. 30) of cat- gut, silver wire, or silk, can be introduced.1 If the wound be a deep one in- volving the muscles, deep (hidden) sutures of cat- gut must be applied. The subsequent dressing is the dusting of the surface with aristol or iodoform, a piece of protective somewhat larger than the wound dipped in 1 to 40 carbolic solution placed over it; then is applied a pad of antiseptic gauze soaked in the car- bolic solution, and over this a pad of dry sterilized gauze overlapping the wet by a few inches. A few layers of bichloride cotton are then put on and the whole secured by an antiseptic gauze bandage. If properly done, the dressing need not be disturbed until the wound is healed, but usually it is better to remove the stitches at the end of a few days. The greatest care must be exercised with the instru- FIG. 30.—SUTURES. A, India-rub- ber suture ; B, continued suture C, interrupted sutures ; D, hare- lip suture ; E, button suture. 1 In applying the suture, the edges of the wound should be held with the finger, or forceps, and the needle, previously threaded, thrust through the skin from one-fourth to one-half inch from the edge ; the curved needle then passes from within outward through the tissues of the opposite flap at the same distance from the edge. If the suture is silk or catgut, it should then be tied ; if wire, twisted, and then cut off. They must not squeeze the edges of the wound, and should be placed so as to bring the parts accurately together. WOUNDS/ BURNS AND SCALDS. 67 ments used about a wound. Needles, scissors, forceps, etc., should be cleansed with soap and w7ater to remove the oily surface left on them, and then be laid in a i to 20 carbolic solution for at least ten minutes. After use and before being put away they should be cleaned and thoroughly dried. In the case of lacerated wounds, if the edges are very ragged, or so much crushed as to have their vitality destroyed, they may be trimmed with a pair of scissors to get surfaces that will unite. If the edges are badly crushed, it may be advisable not to suture them, but to bring them together with a few strips of isinglass plaster moistened with bichloride solution. It takes longer for a lacerated wound than an incised wound to heal. In lacerated wounds caused by machinery, par- ticularly of the extremities, a satis- factory method of treatment is b}' continued irrigation (Fig. 31).1 If no foreign body or dirt re- mains in a punctured wound, it heals rapidly. Sometimes it is necessary to open a punctured wound (make an incised wound) in order to clean it properly. If bleeding from a wound is obstinate, the bleeding vessel must be found and treated as laid down in the chapter on Haemorrhage. FIG. 31.—IRRIGATING APPARATUS. 1 Continued irrigation of a wound can be arranged by sus- pending a vessel over the wound, with lamp-wick or a skein of thread with one end in the liquid and one end suspended over the vessel. A rubber cloth under the part is arranged to lead the liquid into another vessel. The liquid should be a warm solution of bichloride, i to 5000, or 1 to 10,000, or carbolic acid, 1 to 60. 68 TEXT-BOOK FOR NURSES. In redressing a wound the old dressings must be irrigated until they come off easily. In removing ad- hesive plaster, traction should be made from both sides, and it is safer to protect the edges of the wound with new strips before removing the old. The remains of plaster can be removed by alcohol or ether. When the dressings are taken from a wound they should be put in a vessel and removed at once from the ward or room, and should be burned, particularly if they are soiled by discharges. All dressings must be washed and thor- oughly disinfected before being used again. A wound should never be left exposed. If it cannot be dressed, cover it with gauze or lint saturated in antiseptic. A wound should always be gently cleaned with warm antiseptic before applying new dressings. In granulating wounds there is an absorbing surface that it is difficult to keep free from infection. The granulations, too, must be kept in a healthy state. They may be too active, grow too rapidly (proud flesh), and in such case they must be checked by the applica- tion of lunar caustic (nitrate of silver) ; if they are pale and inactive, they need stimulating by some application, preferably balsam of Peru. If germs can be kept from a wound, it is said to be aseptic; if not, the wound is said to be infected. Burns and scalds are injuries to the tissues produced by heat. If by dry heat, it is termed a burn, and if by moist heat, a scald. They are classified as burns or scalds of the first, second and third degrees, according to the depth they have penetrated, but they are dan- gerous more in proportion to the extent of surface affected than to their depth. Burns of the first degree affect only the superficial skin, and there is a reddening WOUNDS; BURNS AND SCALDS. 69 and slight swelling. Sometimes the cuticle separates. If the burn is deeper, or of the second degree, it involves the true skin, and blisters will be formed containing clear or bloody serum. If the burn involves the tissues beneath the skin, it is of the third degree ; the vitality of the part is destroyed and it gradually sloughs off leaving a wound which heals by granulation. The immediate and serious danger from burns and scalds involving considerable extent, is from shock. Burns are usually fatal where one-third of the surface of the body is burned. Shock is a complete prostration of the vital powers, and is manifested by dulness and apathy, a pale surface covered with cold perspiration, cold extremities, feeble pulse, low temperature, and muscular weakness. Sometimes death results at once from a failure of the patient to rally, and usually the recovery from shock is slow. For the treatment of shock, keep the patient’s head low ; give hot tea, coffee, and stimulants ; put hot bottles to the extremities, and aid the circulation by friction and heat. Next in importance to shock is the exclusion of air from the burned surface. When the burn is superficial, the application of lint saturated with a solution of bi- carbonate of soda, or sprinkling the powder of the same over the burn, and then wrapping the part in moist gauze and a layer of cotton held in place by a roller, will relieve the pain. If soda is not at hand, flour may be used. In burns of the second degree, carron oil ’ spread on lint and laid over the surface ; or rubber tissue perforated, covered with cotton and kept in place by a bandage, affords relief. Carron oil needs frequent 1 Equal parts of lime-water and olive oil. 70 TEXT-BOOK FOR NURSES. changing. Blisters should be opened near their edges and the serum soaked up by absorbent cotton. Lint then soaked in a soda solution 1 can be laid over the surface ; or zinc ointment, bismuth ointment, or car- bolized oil. The most reliable antiseptics—carbolic acid, corrosive sublimate, and iodoform—cannot be used on account of the danger of absorption. Creolin is said to be as efficient as carbolic acid and not poisonous. Aristol can be dusted over the surface or used as oint- ment. If suppuration or sloughing occurs, the wound must heal by granulation. Frequently overgrowth of granulation (proud flesh) must be checked with nitrate of silver. If the surface deprived of skin is large, skin grafting is resorted to. The cicatrix caused by a burn tends to contract and sometimes causes great deformity. To counteract this, splints are sometimes used. Powder burns should be treated in the usual way, but care should be taken to pick out the small masses of powder with a needle, or permanent spotting will result. The after-treatment for wounds should be support- ing, but the diet should be guarded and light. A complication of severe burns is brain disturbance,—in children, convulsions. Pneumonia is especially liable to occur, and ulceration of the small intestine (seldom under the tenth day). Scalding of the air passages is serious. Inhaling the steam from lime-water may be soothing. Continuous w7arm-water baths are recom- mended in burns of the third degree. In burns from acids, the surface should be drenched with water to dilute the acid, and alkaline solutions applied ; they are afterwards treated like other burns. 1 Soda bicarb. 3 i ; water § i. WOUNDS; BURNS AND SCALDS. 71 The emergencies, both surgical and medical, are treated under the respective injuries. A nurse in the absence of a physician, is usually called upon to take charge of the case. It is sometimes difficult to deter- mine how far she should proceed in directing treat- ment ; but the best rule to govern her should be to give the patient such treatment, the lack of which until the doctor’s arrival would be to the patient’s dis- advantage. Whatever is done should be tentative, with the expectation that it may be reversed by the physician ; and a nurse should anticipate this and not place herself in a false position. If a nurse is in doubt about the best procedure, make the patient as comfort- able as possible and await the doctor. The greatest aid will be in keeping cool and keeping others so by example. See that the patient has fresh air and is not surrounded by a crowd ; or have the patient carried to the nearest house, if injured out-of-doors. If shock is great, proper treatment for it should be commenced at once ; also for fainting. In case of a fracture do not allow any attempt at reduction if a physician is availa- ble, but arrange the part to make the patient as com- fortable as possible. If the fracture is compound and the bone protrudes, do not return it until the wound is thoroughly cleaned and disinfected. If the ribs are fractured a broad bandage fastened snugly around the chest will give the patient comfort. In injuries to the head with suspected fracture, keep the patient in a quiet place and apply cold to the head. In case of a dislocation and the diagnosis is plain to the nurse, an effort at reduction can be made at once. With wounds, the surfaces should be cleaned, the haemorrhage ar- rested, and the edges of the wound brought together. CHAPTER X. ana diarrhoea, gastric ulcer. Dermatol gr. 5-10 Antiseptic. Substitute for iodo- form. Black Haw (Viburnum) 3l-i Tonic. Uterine Sedative. Used to prevent abortion. Fluid extract of f 3 j-i In painful menstruation. Black Wash See Hydrargyrum. Blood Root See Sanguinaria. Blue Ointment ) Blue Mass -> See Hydrargyrum. Borax (sodii boras) gr. 5-3° Antiseptic. Mouthwash; thrush, gargle; foul ulcers. Boroglyceride Externally A ntiseptic. Diluted 5-20#. Bromoform m. 1-5 A ncesthetic. Whooping cough ; externally in foul ulcers. Bromides See Potassium, Sodium, Am- monium. Buchu (Leaves) gr. 15-30 Stimulant. Diuretic. Tonic. Fluid extract of m. 15-30 Chronic inflammation of blad- Tincture of f 3 1-2 der and urethra. Buckthorn (Frangula) 31-2 Cathartic. In chronic constipa- Fluid extract of 31-2 tion. Caffeine (Thein) gr. i-5 Nerve Stimulant. Hypodermic- ally in opium poisoning. Citrate of Calabar Bean gr. 2-8 In headaches. (Physostigma) gr. 1-2 Sedative. Laxative. Acts on spinal Physostigmine gr. tou's1® cord. In tetanus ; strychnine poisoning ; general paralysis. Contracts pupil. Calomel See Hydrargyrum. 260 TEXT-BOOK FOR NURSES. NAMES AND FORMS. DOSES. USES. Calcium (metal) See Eime. Camphor (gum) gr. 3-20 Stimulant. Anodyne. To relieve Water of spasm or cramp. In painful Spirits of f 3 menstruation ; cholera ; colic; diarrhoea ; headache. The spirit inhaled in syncope. Hope’s mixture f 3 i-4 In diarrhoea. Monobromate of gr. 2-jo Einiment of Cannabis Indica Externally Rubefacient. (Indian hemp) gr- 2-5 Anodyne. Hypnotic. I11 migraine ; Solid Ext. of (pills) ori* 1 3 ST- neuralgia ; irritable bladder; Fluid Ext. of m. 2-5 tetanus; delirium tremens. Tincture of Cantharides (Spanish m. 5-30 Action somewhat like opium. fly) Externally Vesicant. To produce blisters Collodion of for any purpose. Capsicum (red pepper) gr. 1-8 Local stimulant. Irritant. Car- Tincture of m. 5-20 minative. Sluggish stomach ; Fluid Ext. of m. 1-8 diarrhoea ; colic ; gargle in ton- sillitis. Cardamom (fruit) gr. 10-15 Aromatic. As flavoring ; in flat- Tincture of f3 1-2 ulent colic. Compound tinct. of f 3 2-4 Cascara Sagrada 3i-i Tonic Cathartic. In chronic con- Fluid Ext. of f3i-i stipation. Castor Oil f?H Cathartic. Good for children. Carbolic Acid See Acid. Catechu (extract) gr. 10-30 Astringent. In diarrhoea. Chalk See Eime. Chamomile (flowers) 3J-2 Aromatic stimulant. Used in in- fusion (tea) Charcoal (animal) Absorbent. Antiseptic. In poison- ing. In poultices on foul wounds. Internally in heart- burn and indigestion. Chloral, Hydrate gr. 5-20 Hypnotic. Sedative. In insomnia ; convulsions ; tetanus ; strych- nine poisoning ; epilepsy, etc. Chloralamid gr. 10-30 Hypnotic. Safer than chloral. Chlorodyne m. 3-10 Anodyne. To be used with cau- tion. Powerful. Chloroform m. 5-30 Ancesthetic. Anodyne. Used by inhalation chiefly. Cimicifuga (snake-root) gr. 1-5 Tonic. Anodyne. In heart dis- Fluid Ext. of f 3 J-i ease ; amenorrhoea ; muscular Tincture of m-2 rheumatism ; neuralgia ; dys- menorrhoea ; lumbago. APPENDIX. NAMES AND FORMS. DOSES. USES. Cinchona (Peruvian bark) gr. 10-60 Antiperiodic. Tonic. Antipyretic. Infusion of fj 1-2 In relaxed condition of the Fluid Fxt. of m. 10-60 mucous membranes ; gastric Tincture of f 3 i-4 catarrh ; malarial fevers ; peri- Comp, tinct. of f 3 i-4 odic neuralgia. Quinine, Sulphate gr. 1-20 Citrine Ointment See Hydrargyrum. Coca (leaves) 31-4 Stimulant. Tonic. In debility, Fluid Fxt. of f3 1-4 muscular exhaustion ; nervous Wine of fi 4-2 disorders ; indigestion. Cocaine, hydrochlorate gr- 4-2 Local anesthetic in from 2 to 10 % solution. The cocaine habit formed by habitual use. Used hypodermatically. Cod Fiver Oil f3 1-6 Nutritive. Tonic. Can be given in emulsion or “sandwich.” Codeine See Opium. Collodion Fxternally Protective. Forms a film over the surface. Volatile. Colocynth (fruit) gr. 2-8 Tonic cathartic. Powerful hy- Fxtract of gr- 4-2 dragogue. In dropsy. Used in comp, cathartic pills. Conium (fruit) gr. 2-5 Nerve sedative. In spasmodic Fluid Fxt. of m. 2-5 affections — chorea, tetanus, whooping-cough, etc. Focally to painful ulcers. Copaiba (balsam) f 3 4-2 Diuretic. Expectorant. Bladder troubles ; gonorrhoea. Copper (cuprum) gr. 2-20 Emetic. Fxternally to old ulcers. Sulphate of gr- 4-4 Astringent. In diarrhoea and nervous affections. Corrosive Sublimate See Hydrargyrum. Creasote m. 4-10 Antiseptic. In phthisis; vomit- ing ; flatulence. Creolin m. 1-5 Antiseptic. Used chiefly exter- nally ; in douche or enema. Solutions of 4 to J %. Croton Oil m. 4-2 Cathartic. Very violent. Focally as a vesicant. Cubebs (fruit) 3 4-i Aromatic. Stimulant diuretic. Fluid Fxt. of f 3 4_I Expectorant. In chronic bron- Tincture of f 3 5-3 chitis ; nasal catarrh ; cystitis. Dandelion (roof) 31-4 Bitter tonic. Laxative. In liver Solid Fxt. of gr. 5-30 troubles. Fluid Fxt. of f 3 1-4 262 TEXT-BOOK FOR NURSES. NAMES AND FORMS. DOSES. USES. Digitalis (leaves) gr. 5-3 Heart stimulant. Diuretic. Slows Fluid Ext. of m. 2-3 and strengthens heart-beats. Infusion of f 3 i-4 heart disease ; dropsy. Its ac- Tincture of m. 5-30 tion accumulates. Digitaline gr. bV sis Hypod. Uncertain in action. Dover’s Powder See Opium. Elaterium (resin) gr- hi Hydragogue Cathartic. In ascites ; Flaterin gr- 5V15 dropsy ; cerebral congestion. Epsom Salt See Magnesia. Ergot of Rye 3 4-1 Excito-motor. Stimulates the Solid Ext. of gr- 5-i5 contraction of uterus. Checks Fluid Ext. of f 3 haemorrhages. For cerebral Wine of f 3 1-4 hyperaemia. Ergotin for use hypodermically. Ether, Sulphuric m. 5-30 Stimulant. A nccsthetic. Chiefly by inhalation. Spirits of nitre f3}-2 Diuretic. Diaphoretic. Suppres- sion of urine. Hoffman’s anodyne m. 5-60 Anodyne. Stimulant. Neuralgia; colic. Eucalyptus (leaves) 3 i-2 A ntiperiodic. In malaria. Fluid Ext. of f3j-2 Tonic. Antiseptic. In chronic catarrhs. Eupatorium (boneset) 3i-r Bitter tonic. Diaphoretic. Colds and fevers. Ferrum See Iron. Gallic Acid See Acid. Gamboge gr- i-5 Hydragogue cathartic. In dropsy. Gelsemium (root) gr. 5-10 Sedative. In inflammations and Fluid Ext. of m. 5-10 fevers ; insomnia ; neuralgia ; Tincture of fzi-i puerperal convulsions. Gentian (root) gr- 5-3° Bitter tonic. A stomach tonic. Solid Ext. of gr. 2-10 Mixed with other bitters and Fluid Ext. of m. 5-30 iron. Tincture of f 3 1-4 Ginger (bark) gr. 5-i5 Aromatic stimulant. Mild stimu- Tincture of f3 i-l lant in sluggish digestion. Glauber’s Salt See Sodium. Glycerine m. 5-60 Preservative. Solvent. In enema and suppository. Guaiac (resin) gr. 5-3° Alterative. Diaphoretic. In rheu- Tincture of f 3 J-i matism, gout, quinsy, sciatica, Ammoniated tincture of f 3 £-1 syphilis. Guaiacol m. 2-10 Antiseptic. Uses same as creasote; Hamamelis (Witch Astringent. Tonic. Used in Hazel) haemorrhages, haemorrhoids, Fluid Ext. of f3J-2 and congestions. Used as a wash in bruises, or diluted in leucorrhoea. APPENDIX. 263 NAMES AND FORMS. DOSES. USES. Hemlock. See Conium. Henbane See Hyoscyamus. Hive Syrup See Scilla. Hoffman’s Anodyne See Ft her. Humulus (Hops) Tincture of f 3 1-2 Anodyne. Diaphoretic. Tonic. In indigestion, sleeplessness, fevers. Fxternally as a poultice. Hydrargyrum (Mer- Metallic mercury is not employed cury) as a remedy, except in gray Gray powder gr. $-10 powder and blue pill, when it is Blue pill gr. $-15 mechanically divided into a Blue ointment Fxternally very fine powder. White precipitate “ Mercury as an Alterative, Purga- Corrosive Sublimate gr- 0O_rs tive, and Antiphlogistic. It is Calomel gr- l-io the chief remedy in syphilis. Donovan’s Solution m. i-io Salivation is most easily pro- Citrine ointment Fxternally duced by Blue Pill and Calomel. Red Iodide of gr. 0*0_T*0 Corrosive Sublimate is a power- Turpeth mineral gr. 2-4 ful disinfectant, and internally Black wash Fxternally it is used in inflammations, membranous croup, etc. Cal- omel is a mild cathartic. Tur- peth mineral in croup as an emetic. Hydrastis (Golden sea!) gr. 5~6o Bitter Tonic. Antiperiodic. In Fluid ext. of m. 5-60 dyspepsia and malaria. Hydrastine gr. $-$ Hemostatic. In uterine hsemor- Hyoscyamus (leaves) gr- 5-15 rhages. Solid ext. of gr. 2-2 Hypnotic. Sedative. Anodyne. Fluid ext. of m. 5-15 In insomnia, mania, nervous Hyoscyamine gr. 00-00 cough, spasmodic affections. Hyoscine gr- T50-100 Hypophosphites Tonic. Restorative. In debility Syrup of f 3 1-2 and wasting diseases ; tubercu- losis ; rickets ; nervous diseases. Iodine Alterative. Antiseptic. In syph- Iodide of potassium gr. 5-6° ilis, scrofula, and glandular en- Tincture of m. 1-5 largements; the tincture is Ointment of Fxternally used as a counter-irritant. For Lugol’s Solution m. i-io internal use the salt is pre- ferred. Iodoform gr. i-3 Alterative. Antiseptic. Used most Ointment ot Fxternally externally as an application to wounds and ulcers. 264 TEXT-BOOK FOR NURSES. NAMES AND FORMS. DOSES. USES. Ipecac (root) gr. 1-30 Emetic in large doses; Expec- Fluid ext. of m. 1-5 torant in small doses ; when Dover’s Powder See Opium combined with opium it is Syrup of m. 5-60 Diaphoretic. Syrup used for Wine of m. 1-60 children in croup and bron- chitis. Used in cough mixtures. Wine in small (drop) doses checks vomiting. Iron (Ferrum) Quevenne’s iron gr- i-5 Tonic. Astringent. A restorative Acetated tinct. of m. 5-30 for the blood, increasing the Basham’s mixture f 3 1-4 number of red blood discs and Carbonate of gr. 2-10 the proportion of haemoglobin. Vallet’s mass gr- i-5 The chloride and sulphate are Solution of Chloride m. 2-10 astringent and hcemostatic. The Tincture of “ m. 5-60 iodide is used where the effects Citrate of gr- i-5 of iodine are wanted. Dialyzed Citrated wine of f 3 1-2 iron is used in arsenical poison- Ammonia Citrate and gr- i-5 ing. The albuminate is most Quinia “ “ gr. 2-10 easily assimilated. Strychnia “ “ gr- i-3 Hypophosphite of gr. 2-10 Iodide of gr- 5-i5 Syrup of Iodide of m. 5-30 Ferric hydrate 3 1-4 Sulphate of gr. 1-2 Monsel’s Solution m. 2-10 Iron alum gr. 2-10 . Valerianate of gr. i-3 Griffith’s mixture f 3 2-4 Wine of f 3 1-2 Dialyzed m. 10-30 Albuminate of gr. 10-30 Jalap (root) gr. 5-20 Hydragogue Cathartic. Used in Extract of gr. 2-8 dropsy; at commencement of fevers; inflammation. Jamaica Dogwood gr. 15-30 Narcotic. Sedative. In neuralgia; Fluid ext. of m. 15-30 whooping cough ; mania. Juniper (berries) 3i-i Stimulant diuretic. In action like Oil of m. 2-10 turpentine. In dropsy ; catarrh Spirits of f 3 J-i of the bladder. Kino (juice) gr- 5-30 Astringent. In diarrhoeas ; as a Tincture of fZi-2 gargle. Kola (nut) gr. 5-60 Stimulant. Similar to coffee in Tincture of f3i-2 action. In heart disease. Kousso (flowers) 32-4 Anthelmintic. To remove tape* Fluid ext. of f 3 1-4 worm. APPENDIX. 265 NAMES AND FORMS. DOSES. USES. Laudanum See Opium. Lead (metal) Astringent. Sedative. Internally Sugar of (acetate) gr. i-5 in haemorrhages. Usually ex- Goulard’s ext. Externally ternally to irritable ulcers and in skin diseases. Leptandra (root) 3 J-i Tonic laxative. In liver disorders; Leptandrin gr. i-3 constipation. Lime (calcium) Caustic. Disinfectant. Lime water Lime water f 3.1-8 is used to correct acidity in Carron oil Externally diarrhoeas, vomiting. Carron oil used in burns and scalds. Liquorice Root (powd.) Expectorant. Used in cough mix- Brown mixture i 3 i-4 tures ; to conceal the taste of Compound powder 3i-2 quinine; comp, powder con- tains senna and is a mild lax- ative. Lithium (metal) Diuretic. Antacid. In gout ; uric Bromide ot gr. 5-20 acid diathesis ; a strong alkali. Citrate of gr. 5-20 Lobelia (leaves) gr. i-io Emetic. Expectorant. Narcotic. Fluid Ext. of m. i-io Too harsh for general use ; used Tincture of m. 5-30 as antispasmodic ; in asthma and bronchitis. Magnesia gr. 5-60 Antacid. Laxative. Diuretic. Sul- Carbonate of 3J-2 phate or Epsom Salt is cathar- Epsom salt 5 J—1 tic ; in acidity, fevers, dropsies, dysentery, etc. Male Fern (bark) 3 4-2 Anthelmintic. To destroy tape- Oil of f 3 J-i worm. Menthol See Peppermint. Mercury See Hydrargyrum. Morphine See Opium. Myrrh (resin) gr- 5-3° Stimulant tonic. In anaemia; Tincture of m. 15-60 amenorrhoea ; catarrh, etc. Naphtol (from coal tar) Externally Antiseptic. Neither poisonous nor corrosive. Nitre See Potassium. Nitro-Glycerin gr* Spirits of m. 1-3 Heart stimulant. In nervous dis- eases depending upon arterial tension ; in heart diseases. Nux Vomica (seed) gr. 1-4 Bitter tonic. Stimulant. In ner- Fluid Ext. of m. 1-4 vous diseases ; dyspepsia ; con- Tincture of m. 5-20 stipation ; paralysis. 266 TEXT-BOOK FOR NURSES. NAMES AND FORMS. DOSES. USES. Opium (juice) gr. i-2 Stimulant. Anodyne. Hypnotic. Laudanum m. 3-20 Narcotic. Stimulant in small Paregoric m. 3-f 3 4 doses ; it increases perspiration Dover’s Powder gr. 3-15 but checks other secretions; Black drop m. 3-20 after effects are headache, nau- Wine of m. 3-20 sea and constipation. Used to Morphine gr. J-i relieve pain and spasm. Ox Gall gr. 5-15 Tonic. Laxative. In constipation. Pancreatin gr- 5-15 Digestant. Aids to digest starches and fats. Paraldehyde f 3 j-i Hypnotic. Diuretic. Less power- ful but safer than chloral. Paregoric See Opium. Peppermint (leaves) . Aromatic Stimulant. In flatu- Oil of m. 1-5 lence, colic, nausea. Menthol Spirits of m. 5-15 applied locally for neuralgia, Menthol Externally headache. Pepsin Digestant. Aids stomach diges- Saccharated gr. 5-60 tion. Peroxide of Hydrogen Externally Disinfectant. Locally in diph- theria, wounds. Peru Balsam m. 10-30 Stimulant. To indolent ulcers. Phenacetine • gr. 2-10 A ntipyretic. A nodyne. Phenol See Acid, Carbolic. Phosphorus gr. Toff-^5 Nerve stimulant. As a restorative Oil of m. 1-5 tonic. Used in the form of hypophosphites. Phosphoric acid See Acid. Physostigma See Calabar Bean. Pilocarpus gr. 5-60 Diaphoretic. In acute catarrh and Fluid Ext. of m. 5-60 inflammations. Pilocarpine gr- £-1 Hypodermically. PODOPHYLLIN Potassium (metal) gr. l-i Cathartic. In liver torpor ; con- stipation. Acetate of gr. 5-6° The action of potash salts depends Cream of Tartar 3 £-4 largely upon their combination ; Bromide of gr. 5-60 they are nearly all laxative; Carbonate of gr. 5-3° chlorate is an alterative and de- Chlorate of gr. 3-20 odorizer; nitrate is diuretic; Citrate of gr- 5-30 bromide is a nervous sedative, Rochelle Salt 5 4-i and especially efficient in epi- Seidlitz powder lepsy ; iodide is alterative. Nitrate of (nitre) gr. 5-20 Sulphate of 3 i-4 Iodide of gr. 5-60 Permanganate of gr. £-2 APPENDIX. 267 NAMES AND FORMS. DOSES. USES. Prussic Acid See Acid Hydrocyanic. Prunus Virginiana Quassia (wood) See Wild Cherry. Fluid Ext. of f 3 j-i Bitter tonic. Anthelmintic. Used Tincture of f3i-2 in dyspepsia and diarrhoea; Infusion of f l 1-2 enema of infusion for thread worms. Quinine . See Cinchona. Red Cedar . See Juniper. Red Precipitate . See Hydrargyrum. Rhubarb (root) gr. 3-3° Tonic. Laxative. Astringent. In Fluid Ext. of f3 j-i small doses tonic; in larger Syrup of f 3 i (child) doses laxative ; in diarrhoea, Tincture of f3 i-4 dyspepsia, liver troubles, and constipation. Rochelle Salt . See Potassium. Saccharin gr. i-8 A ntiseptic. Used as a sweetening agent in diabetes ; is 280 times sweeter than sugar. Salicin gr. 5-3° Tonic. Antiperiodic. In rheuma- tism ; malaria. Salol gr. 5-3° Antiseptic. In vomiting, diar- rhoea, etc. Saltpetre See Potassium Nitrate. Santonin gr. 1-5 Anthelmintic. To remove round worms. Sarsaparilla (root) 3l-i Tonic. Alterative. Very feeble Fluid Ext. of l3l-i powers. Scilla (Squill) gr- i-5 Diuretic. Expectorant. Emetic. Vinegar of m. 10-45 It slows the pulse and increases Syrup of f 3 j—I urine. In bronchitis, croup, Hive Syrup m. 5-30 and dropsy. Hive syrup con- tains tartar emetic. Seidlitz Powder See Potassium. Senna (leaves) 3 1-3 Cathartic. Efficient and safe. Fluid Ext. of f 3 1-3 Syrup of Black draught Serpentaria (Virginia f 5 i-2i snake-root) gr. 10-30 Stimulant. Tonic. In diphtheria; Fluid Ext. of m. 10-30 bronchitis ; low fevers, etc. Tincture of f 3 5-2 268 TEXT-BOOK FOR NURSES. NAMES AND FORMS. doses. USES. Sodium (metal) Benzoate of gr. 5-60 Action is quite similar to potas- Bicarbonate of gr. 5-60 sium salts. They are feebler Borax gr- 5-3° alkalies ; and are better toler- Bromide of gr. 5-60 ated by the stomach ; they are Iodide of gr. 5-3° eliminated more slowly, hence Phosphate of gr- 5-11 are not as diuretic. The benzo- Salicylate of gr. 5-30 ate and borax ar& antiseptic; bro- Glauber’s salt 3 1-8 mide is sedative; the citrate, nitrate, phosphate, and Glau- ber’s salt are laxative; the salicylate is useful in rheu- matism. SOMNAI m. 15-30 Hypnotic. Sedative. Action simi- lar to chloral. Spigelia (pink-root) • 3J-2 Anthelmintic. Combined with a Fluid Ext. of f3i-2 cathartic to expel round worms Worm-tea f?i-5 (Ascarides). Squill See Scilla. Stillingia (root) 3 j-i Alterative. In large doses emetic Comp. Syrup of f 3 1-8 and cathartic ; in liver troubles, scrofula, syphilis. Stramonium gr. i-5 Narcotic. Anodyne, heaves used Fluid Ext. of m. 1-3 as fumigator in asthma ; action Tincture of m. 5-30 similar to Belladonna. Strophanthus (seeds) Tincture of m. 2-10 Heart stimulant. Diuretic. Acts on the heart like digitalis, but does not affect blood-vessels. Strychnine gr. si5-35 Bitter tonic. Nerve stimulant. Ac- tion same as nux vomica, from which drug it is obtained. Sulphonal gr. 5-3° Hypnotic. Acts slowly ; safer than chloral. Sulphur (brimstone) Flowers of 3 i-i Laxative. Alterative. In chronic Iodide of gr. 1-4 rheumatism ; neuralgia ; skin diseases, etc. Tansy (leaves) 3i-i Emmenagogue. Anthelmintic. Oil of m. 1-3 Dangerous in large doses. Tar (from pine) 3j-i Externally in skin diseases ; atom- Syrup of S 3 1-4 ized in catarrh, bronchitis, etc., Oil of Externally in the form of syrup. Taraxacum (dandelion) 3 1-4 Bitter tonic. Diuretic. Laxative. Solid Ext. of Fluid Ext. of gr. 5-3° f 3 1-4 In liver disorder ; dyspepsia. Tartar Emetic See Antimony. APPENDIX. 269 NAMES AND FORMS. DOSES. USES. Theine Similar to Caffein. Thymol gr-1-15 Antiseptic. To inhale and in oint- ments. Tolu (balsam) m. 10-30 Stimulant Expectorant. Syrup of f 3 i-i Trional gr. 5-20 Hypnotic. Acts quicker than sulfonal. Turpentine * Oil of m. 5-30 Stimulant. Diuretic. Cathartic. Liniment of Fxternally In typhoid conditions ; intesti- nal ulcerations ; externally a counter-irritant. Turpeth Mineral See Hydrargyrum. Valerian (root) gr. 10-30 Stimulant. Antispasmodic. In Fuid Fxt. of m. 10-30 chorea ; hysteria ; headaches; Ammoniated tincture of Veratrum Viride (bark f 3 5-2 nervous disorders. and root) gr. 1-5 Sedative. Reduces the pulse in Tincture of Viburnum (black haw) m. 2-10 force and frequency ; similar to aconite. Fluid Fxt. of f3 J-i Tonic. Uterine sedative. Used to prevent abortion. Warburg’s Tincture f 3 2-6 A ntiperiodic. A compound tinct- ure of quinine. Wild Cherry (bark) 3 4-1 Bitter tonic. Contains prussic acid Syrup of f 3 1-4 which makes it sedative. In coughs; dyspepsia. Xylol gr. 15-45 Antiseptic. Yerba Santa (leaves) gr. 15-30 Stimulant Expectorant. In Fluid Fxt. of Zinc m. 15-30 chronic coughs. Oxide of gr. i-5 Astringent. Tonic. In nervous Phosphide of gr. diseases—hysteria, epilepsy, etc. Sulphate of gr. 2-3° Sulphate and acetate act as Valerianate of gr- i-3 astringents. In weak solutions applied to inflamed mucous surfaces. 270 TEXT-BOOK FOR NURSES. ALIMENTARY PREPARATIONS FOR THE SICK. Light Drinks. Toast Water.—A slice of stale bread, y2 inch thick, toasted brown'; pour upon it a pint of boiling water ; cover closely and cool ; strain it. A slice of lemon may be added. Rice Water.—Boil 2 ounces of rice in 2 quarts of water an hour and a half; add sugar and nutmeg, or salt, to taste. Used in diarrhoea, dysentery, etc. Bareev Water.—Wash 2 ounces pearl barley with cold water ; boil in pints water for 20 minutes in a covered dish ; strain, sweeten, and add lemon if permitted. Egg Water.—Into pint ice-water gently stir the whites of 2 eggs ; sugar or salt to taste. AppeE Water.—To y2 dozen sour apples, sliced, add y2 ounce sugar and a quart of boiling water. Cover closely and cool; strain. Acacia Drink.—Make a solution of an ounce of gum aca- cia in a pint of boiling water ; add juice of a lemon, an ounce of sugar, and a wine-glass of sherry ; cool and ice. Feaxseed Lemonade.—3 tablespoonfuls whole cleaned flax- seed, 2 tablespoonfuls of sugar iu a pint of boiling water ; steep for an hour ; strain and add lemon to taste. Serve cold. Panada.—Made same as toast, except that the toast remains and the mixture is seasoned to taste. Bran Tea.—Steep a pint of bran (preferably wheat) in a quart of boiling water for an hour ; strain and season to taste. Corn Tea.—Roast sweet corn kernels and grind coarsely as for coffee. To a cupful add 2 cups boiling water and steep. Season. Rhubarb Water.—Cut up a stalk of rhubarb into thin slices and cover with a cupful of boiling water ; let it stand until cold, and add a tablespoonful of sugar ; strain. Lemonade.—Squeeze out the juice of a lemon, and add a table- spoonful of sugar ; mix with ice-water and strain ; rub the rim of the glass with a slice of lemon peel and allow it to float. Tamarind WtaTER.— Add a pint of hot water to a table- spoonful of preserved tamarinds and set aside to cool; strain. APPENDIX. 271 Imperiae Drink.—A tablespoonful of cream of tartar, juice of a lemon, and 2 tablespoonfuls of sugar added to a quart of boiling water and allowed to stand until cool, then serve ice- cold. Frozen Preparations. Ice Cream.—Boil 1 pint of milk ; mix y cup of sugar, a tablespoonful of flour, and a saltspoonful of salt together; add 1 egg and beat well; add the boiling milk and pour all back into the boiler; cook twenty minutes, stirring often; then cool. When cold add a quart of cream, and sugar if necessary ; flavor and strain ; freeze. For freezing mixture use 1 part rock salt and 3 parts fine ice. Sherbet.—Soak a tablespoonful of gelatine in y cup cold water 20 minutes ; add y2 cup boiling water, juice of 6 lemons, a pint of sugar, and 3 cups cold water ; strain and freeze. Frozen Beef-Tea.—Place the required amount of beef-tea in a bottle in a freezer, and freeze as for ice-cream. Useful in cholera infantum, etc. To Keep Ice.—Cut a piece of clean flannel 8 inches square ; put this over the top of a tumbler, pressing the flannel down half-way; then tie it fast ; put ice in the flannel ; lay on the top another piece of flannel. Beef preparations. Beef-Tea (No. i).—To y2 pound lean beef cut fine, add y pint cold water, and soak 12 hours. Remove the meat and simmer 2 hours in % pint of cold water ; strain and pour the hot liquor upon the cold liquor in which the meat was soaked. If the whole of the beef is desired, the meat is dried, powdered in a mortar and mixed with the liquor. Beef-Tea (No. 2).—To 1 pound lean beef, cut fine, add 1 pint cold water and 5 drops muriatic acid ; put it into a jar ; place the jar in a kettle of water at no0 F., and keep in that temperature 2 hours ; strain and season. Peptonized Beef-Tea.—Add 10 grains of pepsin and several drops of muriatic acid to half a pound of lean beef cut up fine ; put in a jar and cover with 6 ounces cold water; let it stand at 272 TEXT-BOOK FOR NURSES. a temperature of about 90° F. for two hours, frequently agita- ting it; strain and serve cold. It should be made at least twice a day. Broiled BEEE Essence.—Broil half a pound round steak until the juice flows (3 minutes) ; cut into small pieces; squeeze the juice into a warm bowl; salt and serve. By adding half a cup of warm water it makes a beef-tea. Bouillon.—Take beef-tea while moderately hot; beat up an egg and add the beef-tea gradually, while stirring, and season. Beef-Tea with Oatmeal.—A cupful of strong beef-tea added to tablespoonful of oatmeal gruel mixed in 2 of boiling water, then bring to the boiling point; salt and serve with toast or crackers. Beef Essence.—A pound of lean beef without fat, cut very fine, is placed in ajar and corked or sealed tightly ; the jar is set in a kettle of cold water and boiled for 3 hours ; strain and season. Other Meats and Molluscs. Chicken Broth.—Clean, skin, and cut up the chicken, breaking the bones with a hammer; remove the fat; cover with cold water, adding a tablespoonful of salt and a salt- spoonful of pepper ; simmer for 3 or 4 hours until the chicken is tender ; strain, remove the fat. Rice can be cooked with it if desired, and if allowed the best of the meat can be returned to the broth. Mutton Broth.—Two pounds of lean mutton without fat or skin is boiled in 3 pints of cold water, heating slowly for 2 hours ; then is added a teaspoonful of salt and a pinch of pep- per ; when the meat is in shreds strain, and when cool remove the fat; if desired, while the broth is boiling, add 2 tablespoou- fuls of rice. Oyster Broth.—Mince finely a pint of oysters ; let them simmer in pint of cold water for 15 minutes over a slow fire ; skim, strain, and season. Oyster Broth No. 2.—Melt a tablespoonful of butter in a sauce-pan and add 2 tablespoonfuls of flour, mixing well ; add a cup of hot milk and mix ; add another cup of milk and APPENDIX. 273 bring to boiling point; add 1 pint oysters with liquor ; boil until done and season. Oyster Stew. —Carefully select and clean 1 quart oysters by adding l/z cup cold water ; drain and boil the liquor, remov- ing the scum ; when clear put in the oysters ; let them simmer until they grow plump and the edges curl; then add 1 pint hot milk, 1 tablespoonful of butter, salt and pepper to taste. Ceam Broth.—Eet from 3 to 6 clams, according to size, stand in boiling water till the shells open ; drain out the liquor, add an equal quantity of boiling water, a teaspoon ful of pow- dered cracker, a little butter, and season. Preparation oe Eggs. Boiled Eggs.—Get the water in a saucepan to a boiling point; then put in the eggs and note time ; keep just at or be- low boiling point; an egg to be cooked soft should be in boil- ing water 3 minutes; but it is better to have it in water just below the boiling point for 8 minutes, when the egg will be cooked throughout more uniformly. Dropped Eggs.—Toast a slice of bread for each egg, and trim neatly ; have a shallow pan nearly full of salted and boil- ing water ; break each egg carefully into the water; dip the water over them with a spoon, and when a film has formed on the yolk and the white is firm, take each up with a skimmer, drain and place on the toast; do not allow the water to boil; put a bit of butter and a little salt and pepper on each egg. Egg Broth.—Pour a pint of boiling water on an egg well beaten up with half a teaspoouful of sugar, stirring well to keep it from curdling; season and serve hot. Egg-nogg.—Beat up 1 egg with 1 even tablespoonful of sugar ; add 1 tablespoonful of whiskey, or brandy, or sherry wine ; add cup of cream or milk ; grate a little nutmeg on surface. Or, beat the white of an egg to stiffness ; stir into it a tablespoonful of sugar ; then the yolk of the egg ; a tablespoon- ful each of ice-water, milk, and wine ; lightly stir. Hot Egg-nogg.—The yolk of an egg and a tablespoonful of sugar are beaten together and stirred into a pint of milk at the boiling point; add a tablespoonful of brandy or whiskey and grate a little nutmeg on top. 274 TEXT-BOOK FOR NURSES. CUSTARD.—Scald 1 pint of milk ; beat 3 eggs well, add 3 tablespooufuls of sugar and a little salt; pour on hot milk and boil in a water bath until thick; strain, cool, and add 1 tea- spoonful of flavoring. OMELET.—Beat 4 eggs slightly; add 4 tablespoonfuls milk, Yz teaspoonful salt, a little pepper, and mix well, cook in a hot buttered pan, lifting up with a fork the cooked egg from the center and let the uncooked flow in ; continue this until the whole is of a creamy consistency ; fold over and turn out. Egg Lemonade.—2 tablespoonfuls of sugar is beaten up with an egg thoroughly and then mixed with 3 tablespoonfuls of cold water and the juice of a lemon ; put broken ice in the glass and fill with ice-water. Egg and CoFEEE.—An egg and a tablespoon ful of sugar are well beaten together and boiling coffee is gradually added, stir- ring ; add hot cream. Milk Preparations. Milk Toast.—Toast six slices of bread; melt a large table- spoonful of butter to which add i tablespoonful of cornstarch and mix well ; pour on this slowly hot milk, stirring and beat- ing until smooth, and add l/2 a teaspoonful of salt; pour this over the toast and keep hot until served. Rice; Milk. —Boil a tablespoonful of rice for an hour and a half in a pint of fresh milk, then rub it through a fine sieve; add a teaspoon ful of sifted sugar and boil again for a few minutes. Milk Punch.—Add 2 teaspoonfuls of sugar and an ounce of brandy or whiskey to half a pint of cold milk ; stir till sugar is dissolved ; some nutmeg can be grated on top, if desired. EGG Milk.—Shake up in a bottle the whites of 2 eggs, a pint of milk and a pinch of salt; serve cold. Eime;-Water and Milk.—Take a wineglassful of clear lime-water and two wineglassfuls of fresh milk.' To be used when the stomach is irritable. Almond Milk.—Boil a Y pound fine pounded sweet al- monds in a quart of water ; cool and strain through a cloth and sweeten ; it only keeps a few hours. Sago Milk.—Soak a tablespoonful of sago in 4 of cold water APPENDIX. 275 over night; boil in a water bath with a quart of milk until the sago is quite dissolved ; sweeten and serve, hot or cold. POSSETT.—To a cupful of milk at the boiling point add a tablespoonful of molasses, stirring well ; then boil, strain, and serve. Miscellaneous. Wine; Whey.—Add a wineglassful of sherry to y a pint of boiling milk ; strain, and serve hot; it may be sweetened if desired. Arrow Root.—Mix a tablespoonful of arrow root with cold water to make a paste ; to a pint of boiling water, stir in the arrow root and boil a few minutes ; sweeten. If desired, brandy, whiskey, or wine may be added, or half milk may be used. The flavor may be improved by adding a little lemon or orange peel before boiling. Peour GruEE.—To 2 teaspoonfuls of flour add a salt spoon- ful of salt and make it into a thin paste with cold water; stir into it i cup of boiling water and boil for 5 minutes ; strain and thin with a little milk ; sweeten if desired. If for a fever patient, lemon juice may be added. If for diarrhoea, a small stick of cinnamon may be boiled with the gruel. Indian Mead GruEE.—Mix a tablespoonful of flour, 2 tablespoonfuls of corn meal, and a teaspoonful of salt together ; make into a thin paste with cold water and put quart of boiling water ; boil 1 hour, stirring often ; thin with milk or cream. OaTmeae GruEE.—1 cup oatmeal, teaspoonful salt, one quart boiling water ; boil in a water bath for 2 or 3 hours. Wine Jeeey.—Soak yi box gelatine in y2 cup cold water until soft; add 1 pint boiling water, 1 cup sugar, juice of 1 lemon, and 1 cup of sherry; stir well, strain, and cool. Tapioca.—Cover 2 tablespoonfuls of tapioca with a teacupful of cold water and soak for 3 hours ; put it into a pint of boiling water and boil until clear; sweeten and add nutmeg or wine, if desired. Beanc-mange.—Soak a half cup of Irish moss 15 minutes; put into a water bath with one quart of milk ; boil until the milk thickens; when cooled, strain ; add a salt spoonful of 276 TEXT-BOOK FOE NURSES. salt and a teaspoonful of flavoring and serve cold with sugar and cream. Boiled Rice.—Wash a cup of rice thoroughly and put it into a kettle containing 2 quarts of boiling water ; boil rap- idly, skimming often until the rice is tender; stir with a fork, so as to preserve the kernels entire ; drain and dry the rice in the strainer ; season and serve with milk or cream. Coffee.—Scald the coffee-pot; allow a heaping tablespoon- ful of coffee for each cup of boiling water ; slightly beat up i egg and add the coffee and crushed shell mixed with % of a cup of cold water ; put this in the hot coffee-pot, add the boil- ing water and boil 5 minutes; keep it hot but not boiling for 10 minutes; in serving pour the coffee upon the sugar and cream. Tea.—Allow a teaspoonful of tea to each y2 pint of water; scald and heat the tea-pot, which should be earthen ; put in the tea, add water freshly boiled, and keep hot but not boiling for from 3 to 5 minutes. A GLOSSARY OF TECHNICAL WORDS AND TERMS. ABDOMINAL respiration, respi- ration carried on by the dia- phragm and abdominal mus- cles. ABDUCTION, movement from the middle line. Ablution, cleansing by washing. abnormal, contrary to natural law ; morjpid. abolition, complete suspen- sion. abortion, premature expulsion of foetus. abrasion, excoriation of skin. ABSCESS, cavity containing pus. absorption, taking up of one body by another. abstraction, blood letting. accommodation, power of ad- justing the eye to different distances. acetic acid, acid of vinegar. achilles tendon, common ten- don of the muscles of the back of the leg. acoustic, relating to sound. ACRID, burning, pungent. actual cautery, the use of white-hot iron. Acupressure, compression of arteries by needles. acute, rapid, severe. adduction, movement toward the middle line. adhesion, union of two surfaces. adhesive, sticky, tenacious. adipose, fatty. adolescence, between puberty and maturity. adult, of full size and strength. adulteration, mixture with in- ferior ingredients. afferent, towards the centre. affinity, relationship, attrac- tion. afflux, flow to a part. affusion, pouring upon. after-birth, placenta and mem- branes. after-pains, post-partum pains. agglutinate, joining together. agoraphobia, dread of open spaces. agraphia, inability to express ideas in writing. albumen, white of egg. albuminoid, resembling albu- men. ALBUMINURIA, presence of albu- men in urine. alcoholism, excessive use of alcohol. 277 278 GLOSSARY. ALIENATION, mental derange- ment. alimentary, nourishing. alkali, a substance combining with an acid to form a neutral salt. ALKALOID, resembling alkali. alopecia, loss of the hair. alterative, medicines that al- ter nutrition and excretion. alveolus, bony socket of a tooth. AMAUROSIS, partial or total blind- ness. amenorrhcea, irregularity of menstruation. AMNESIA, loss of memory for words. amorphous, non-crystallized. amputation, removal of a part of the body. amyl nitrite, a volatile fluid producing vascular dilatation. AMYLACEOUS, starch-like. ANEMIA, deficiency of red cor- puscles in blood. anesthesia, state of insensi- bility. analgesia, insensibility to pain. analogous, conforming to. analysis, resolution into ele- ments. anasarca, general dropsy. anastomosis, the junction of vessels. anchylosis, a stiff joint. aneurism, dilatation of an ar- tery. ANGINA, sense of suffocation. ANGINA PECTORIS, oppression about the heart. angular, pertaining to an angle. ANHYDROUS, not containing water. ANIMALCULE, microscopic or- ganisms. ankle CLONUS, spasmodic con- traction of ankle joint. annular, ring like. ANODYNE, medicine relieving pain. anomalous, unusual. anorexia, loss of appetite, antagonist, a drug neutralizing another. anteflexion, bending forward. anteversion, turning forward. amthelmintic, remedy against worms. Anthony’s fire, erysipelas. ANTHRAX, carbuncle. antidote, counteracting a poi- son. antifebrile, reducing fever. antiperiodic, opposed to pe- riods. antiphlogistic, agent reducing inflammation. antipyretic, reducing tempera- ture. antiseptic, preventing putre- faction. antispasmodic, counteracting spasms. antitoxin, remedy for diph- theria. antrum, a bone cavity. anus, extremity of rectum. GLOSSARY. 279 AORTA, the main arterial trunk. apathy, want of feeling. aperient, laxative, opening. aperture, an opening, orifice. apex, summit or top. APHASIA, loss of power of speech. APHONIA, loss of voice. APHTHAE, small white ulcers of mouth. apices, plural of apex. apncea, breathlessness. apomorphine, a powerful em- etic. Apoplexy, a sudden paralysis. appendicitis, inflammation of vermiform appendix. AQUA, water. * aqueous, watery. AREOLA, a ring-like discoloration. AROMATIC, spicy, fragrant. arthritic, pertaining to a joint. articular, pertaining to a joint. ARTICULATION, the sounds of speech ; a joint. ascites, dropsy of the abdomen. asepsis, absence of septic mat- ter. asphyxia, non-oxygenation of blood. asthenia, loss of strength. astringent, producing contrac- tion of tissue. ataxia, incoordination of mus- cles. Atomizer, instrument for redu- cing liquid spray. ATROPHY, wasting of a part. auditory, pertaining to organs of hearing. AURA, peculiar sensation before a fit. auscultation, listening to sound of organs. automatic, not voluntary. autopsy, post-mortem examina- tion. auxiliary, aiding, assisting. axilla, the arm-pit. BACILLUS, the most important group of bacteria. bacteria, micro-organisms ; mi- crobes. biceps, two-headed, applied to muscles. bilateral, having two equal sides. biliary, pertaining to bile. bland, mild, non-irritating. bleb, a large blister. bolus, a pill-like mass. bougie, a round instrument for dilating urethra. bouillon, a broth or soup. bright’s disease, inflammation of the kidneys. bronchitis, inflammation of bronchial tubes. buccal, pertaining to the cheek. bulla, a large blister. bursa, a small sac between mov- able parts. buttocks, the rump or gluteal region. CACHEXIA, depraved condition of nutrition. cadaver, the dead body. 280 GLOSSARY. calcareous, having the nature of lime ; stony. CALCULUS, stone-like concretion. calisthenics, a system of light gymnastics. callous, hard, indurated. caloric, heat. cancellous, resembling lattice work. CAPILLARY, a minute blood ves- sel. capsule, membranous sack en- closing a part. carcinoma, cancer or malignant tumor. CARDIAC, pertaining to the heart. caries, ulceration of bone. carotid, great arteries of neck. CARPUS, the wrist. CARTILAGE, gristle. caseous, having the nature of cheese. cataclysm, a sudden shock. catalepsy, spasms with loss of will and muscular rigidity. catamenia, menstruation. cataplasm, a poultice. CATARACT, destruction of lens of the eye. catarrh, inflammation of mu- cous membrane. cathartic, a purgative medi- cine. catheterization, emptying bladder with catheter. cautery, a substance for de- stroying a part. cavity, a hollow, as in the lungs. cellular, composed of cells. CENTIGRADE, having ioo de- grees. CENTIMETRE, the hundredth part of a metre. centrifugal, receding from the centre. cephalalgia, pain in the head. cephalic, pertaining to the head. CERATE, substance with wax as a basis. CEREBELLUM, inferior part of the brain. cerebral, relating to the brain. cerebrasthenia, cerebral neu- rasthenia. CEREBRO-SPINAL, relating to the brain and spine. CEBEBRUM, chief portion of the brain. cervical, pertaining to the neck. cervix, the neck. chalybeate, containing iron. CHEYNE - STOKES RESPIRATION, form of dyspnoea with in- creased respiration followed by temporary arrest. chilblain, inflammation of skin, due to cold. chlorosis, green sickness of young girls. chorea, St. Vitus’ dance. CHRONIC, long continued. CHYLE, milky fluid of intestinal digestion. chyme, food that has undergone gastric but not intestinal diges- tion. GLOSSARY. cicatrix, scar or mark of a wound. CIRCULATION, passage of blood through the body. CIRCUMSCRIBE, clearly defined. classification, systematic ar- rangement. clavicle, collar bone. climacteric, critical periods in life. CLINICAL, pertaining to a sick bed. clonic, spasms with alternate relaxation. clyster, an enema. COAGULUM, a clot of thickened blood. COCCYX, last bone of the spinal column. COHESION, a sticking together. COLIC, spasmodic pain in the abdomen. collapse, a failure of the vital powers. Collodion, solution of gun-cot- ton in ether. coma vigil, delirium with open eyes. comatose, in a condition of coma. condyle, a rounded eminence. confluent, a running together. congenital, existing from birth. congestion, flow of blood to a part. conjunctiva, mucous mem- brane of the eye. constipation, a sluggish action of the bowels. CONTAGION, transfer of specific disease. continuity, uninterrupted con- nection. contractility, power of con- tracting or shortening. contra-indicated, forbidden by peculiarity of disease. CONTUSION, a bruise from a blow. convalescence, period of re- covery after disease. convolution, folding upon it- self. CONVULSION, involuntary con- traction, spasm, fit. co-ordination, harmonious ac- tion of muscles. cornea, transparent anterior part of eyeball. corpulency, obesity, largeness of body. corpuscle, minute body, cell. corrosive, substance that eats away or destroys. cortex, external gray layer of brain. CORTICAL, pertaining to the cortex. coryza, running at the nose, nasal catarrh. costal, pertaining to the ribs. costive, affected with constipa- tion. counter-irritation, superfi- cial irritation of body. coup-de-soleil, sun-stroke. COXALGIA, pain in the hip joint. cranial, pertaining to the cra- nium. 282 GLOSSARY. CRANIUM, the skull. crepitus, grating of fractured bones. Cribriform, perforated like a sieve. crisis, turning-point in a disease. critical, pertaining to a crisis. CROUP, inflammation of air pas- sages with dyspnoea. cul-de-sac, passage without an outlet. curriculum, course of study. CUTANEOUS, pertaining to the skin. cuticle, the epidermis or scarf- skin. CYANOSIS, blue discoloration of skin. CYST, a sac containing fluid. CYSTITIS, inflammation of the bladder. debility, weakness. decoction, preparation obtained by boiling. decomposition, putrefaction. decubitus, bedsore. decussate, to intersect. defecation, evacuation of bow- els. - defervescence, abatement of fever. DEFORMITY, physical distortion. degeneration, deterioration of structure. deglutition, act of swallowing. dejection, discharge of faeces. deliquescence, liquefaction from water of atmosphere. delusion, false judgment. dementia, mental incapacity. demulcent, mucilaginous sub- stances. dental, pertaining to teeth. deodorizer, a disinfectant de- stroying smells. depletion, diminishing of a body fluid. depression, a depressed condi- tion. derivative, to draw from. dermatitis, inflammation of the skin. desiccation, process of drying. desquamation, scaling of the cuticle. DETERMINATION, direction to a part. development, progression tow- ard maturity. diabetic, pertaining to diabetes. diagnosis, recognition of dis- ease. diaphoresis, production of perspiration. diaphragm, muscular wall be- tween thorax and abdomen. diastole, dilatation of the heart. diathesis, constitutional predis- position to disease. dicrotic, double beating. dietetic, pertaining to diet. digastric, having two bellies. digestion, conversion of food for assimilation. digital, pertaining to fingers or toes. GLOSSARY. 283 dilatation, expansion of vessel or organ. diluent, agent increasing fluid- ity. diplopia, double vision. dipsomania, uncontrollable de- sire for alcohol. discrete, separate, distinct. disinfectant, agent destroying germs. dislocation, displacement of joints. dispensary, where drugs are kept. DISSECTION, separation of the parts of a body. dissolution, death. distal, away from the centre. diuresis, excessive secretion of urine. dorsal, pertaining to the back. drainage, removal of pus. drastic, powerful purgative. dropsy, effusion of fluid into tissues. duodenum, first part of small intestines. DURA MATER, outer membrane of brain. dysentery, inflammation of large intestine. dysmenorrhcea, painful men- struation. dyspepsia, imperfect digestion. dysphagia, inability to swallow. DYSPNCEA, difficult breathing. ecchymosis, extravasation of blood. ECLAMPSIA, rapid convulsive mo- tion. ecstasy, trance-like state. eczema, inflammation of skin. edible, suitable for food. efferent, outward from the centre. effleurage, stroking toward the centre. efflorescence, redness of skin. effusion, fluid in a body or cavity. ejection, casting out. ELIMINATION, excretion. elixir, sweetened aromatic preparation. EMACIATION, loss of flesh. EMANATION, that which proceeds out of a body. embolism, obstruction of blood- vessel by a clot. embrocation, a fomentation or liniment. emetic, an agent causing vomit- ing. EMMENAGOGUE, agent stimulat- ing menstrual flow. emollient, agent softening tis- sue. emphysema, distention of tissues with air. empyema, pus in the pleura. emulsion, milky fluid with oil and water. encephalic, pertaining to the brain. endemic, a local epidemic. endocardium, lining membrane of heart. 284 GLOSSARY. enema, a rectal injection. energy, power or force of the organism. enervate, to weaken. ENGORGEMENT, vascular conges- tion. enteralgia, pain in the bowels. enteric, pertaining to the intes- tines. enteritis, inflammation of in- testines. environment, surrounding in- fluences. ephemeral, lasting but a day. epidemic, common to many peo- ple. epidermis, outer layer of skin. epigastric, over the stomach. epiglottis, the cover of the larynx. EPILEPSY, nervous disease with convulsions. epileptiform, resembling epi- lepsy. [nose. epistaxis, bleeding from the epithelium, external layer of the skin. erosion, an ulceration. erratic, irregular. eructation, belching. eruption, a breaking out. erythema, a blush or redness of the skin. ESCHAROTIC, substance produc- ing a dry slough. ETHERIZATION, administration of ether. etiology, study of causes of dis- ease. EUTHANASIA, easy death. EVACUATION, defecation. exacerbation, increased sever- ity of symptoms. EXANTHEMATOUS, pertaining to eruptions of skin. excision, act of cutting away. excoriation, abrasion of the skin. excrement, the faeces. excrescence, abnormal out- growth on the body. excreta, natural discharges of the body. exhalation, vapor given off by the body. exhaustion, great loss of vital power. exophthalmus, protrusion of eyeballs. expectorant, promoting secre- tion of mucus. expectoration, coughing ; spit- ting up. exsanguine, bloodless. extirpation, entire removal of the parts. EXTRAVASATION, effusion of fluid into the tissues. extremity, a limb or termina- tion. EXUDATION, oozing out of fluid. faradic, the induced electrical current. farinaceous, having the nature of flour. fascia, fibrous membrane cover- ing muscles. GLOSSARY. 285 FAUCES, the throat. FEBRICULA, a slight fever. febrile, pertaining to fever. fecundity, power of producing young. femur, the thigh bone. fermentation, decomposition produced by organisms. ferric, of the nature of iron. ferruginous, containing iron. fetid, an offensive smell. fibrilla, a small fibre or fila- ment. fibrin, substance coagulating in blood. fibroid, having a fibrous struct- ure. fibula, small bone of leg. filament, thread-like structure. filiform, thread-like. filtration, process of straining. fissure, a groove or cleft. fistula, abnormal tube-like passage. flaccid, soft, flabby. flatulence, presence of gas in intestines. FLATUS, gas in alimentary canal. flexible, that which may be bent. flexion, process of bending. flexor, muscle that bends a part. FLUCTUATION, wave-like motion. focus, principal seat of disease. FOLLICLE, a small secretory cav- ity. fomentation, to apply hot liquids to body. fontanelle, space in the cra- nium at birth. foramen, a passage or opening. formication, a crawling sensa- tion of the skin. formula, a concise statement. FOSSA, a depression or furrow. fracture, breaking of a bone. friable, easily pulverized. friction, act of rubbing. frontal, pertaining to the an- terior part. fumigation, disinfectant vapor. function, special action of a part. fusiform, spindle-shaped. fusion, liquefying a solid. GALACTAGOGUE, promoting flow of milk. . GALL, the bile. GALVANISM, electricity induced by chemical reaction. ganglion, a lymphatic gland. A nervous centre. gangrene, mortification of tis- sue. gargle, wash for the throat. gaseous, the nature of gas. GASTRALGIA, pain in the stom- ach. GASTRIC, pertaining to the stom- ach. gavage, forced feeding. generate, to beget, produce. genital, of the organs of gener- ation. germicide, agent destroying germs. 286 GLOSSARY. gestation, pregnancy. GLAIRY, slimy. GLANDULAR, pertaining to a gland. GLOBULAR, shaped like a globe. glottis, space in the larynx. glucose, grape sugar. gluteal, pertaining to the but- tocks. GLYCOSURIA, sugar in the urine. goitre, enlargement of thyroid gland. GONORRHOEA, contagious inflam- mation of genitals. GRADUATE, a glass vessel marked for measurements. granulation, small elevations on a healing surface. gravel, sand-like deposit in the urine. groin, depression between thigh and trunk. GULLET, canal from mouth to stomach. gumma, gummy tumor. gustatory, pertaining to sense of taste. guttural, pertaining to throat. gymnastic, systematic exercise. gynecology, of the diseases of women. gyration, turning in a circle. GYRUS, a convolution. hallucination, a false percep- tion. haunch, hips and buttocks. H/EMATiN, red coloring matter of blood. haematin in the urine. hemoglobin, coloring matter of red corpuscles of the blood. hemoptysis, spitting of blood ; bleeding from lungs. HEMORRHAGE, flow of blood from vessels. HEMORRHOIDS, piles. hemostatic, arresting haemor- rhage. hebetude, dulness of senses. hemianesthesia, loss of sensi- bility on one side. hemianopsia, blindness of one half of vision. hemicrania, neuralgia of half of the head. hemiplegia, paralysis of one side of the body. hepatic, pertaining to the liver. hepatization, liver-like sub- stance. hereditary, constitutional ten- dency. hermetic, sealed; air-tight. hernia, protrusion of bowel. herpes, skin disease with ves- icles. hiccough, spasmodic inspiration. hives, an eruption of the skin. hospitalism, morbid influence of a hospital. humerus, large bone of the up- per arm. humidity, moisture of the at- mosphere. HUMOR, fluid part of the body. HYALINE, glassy, crystallized. GLOSSARY. 287 HYDRAGOGUE, causing watery discharges. hydrocarbon, compound form of hydrogen and carbon. hydrocephalus, dropsy of the brain. hydrogen, a light gaseous ele- ment. hydrophobia, fear of water. HYDROTHERAPEUTICS, the USe of water as a remedy. hydrothorax, dropsy of the chest. hygiene, the science of health. hyperemia, morbid flow of blood to a part; congestion. hyperesthesia, excessive sen- sibility. hyperidrosis, excessive sweat- ing. hypermetropia, far-sightedness. hypertrophy, abnormal in- crease of a part or organ. hypnotic, remedy causing sleep. hypnotism, artificial somnam- bulism, hypochondriasis, morbid anx- ieties regarding health. HYPODERMATIC, underneath the skin. hypogastric, pertaining to low- er abdomen. hypoglossal, under the tongue. hysteralgia, pain in the womb. hysterectomy, excision and re- moval of the womb. hysteria, paroxysms of ab- normal sensations. ichor, an acrid discharge. icterus, jaundice. idiocy, extreme mental deficien- cy, from lack of development. idiopathic, primary or inde- pendent. idiosyncrasy, individual pecul- iarity. ileum, lower half of small in- testine. illusion, a false perception. imbecile, feeble in mind. immersion, plunging into a liquid. immobility, state of being fixed. immunity, freedom from infec- tion. impacted, wedged in. impervious, not permitting a passage. impotence, lack of sexual power. inanition, exhaustion from star- vation. incision, act of cutting into. incoherent, disconnected ; con- fused. incompatible, not capable of being united. incontinence, involuntary evac- uation. inco-ordination, lack of mus- cular harmony. incubation, period between ex- posure and beginning of disease index, the first finger. indication, a sign. indigestion, dyspepsia. indisposition, any slight ail- ment. 288 GLOSSARY. indurated, hardened. inertia, sluggishness. infection, communication by disease germs. inferior, lower. infiltrate, to ooze into a tissue. inflation, distended with air. influenza, a contagious ca- tarrhal fever. infusion, a watery solution. ingestion, introduction of food into the body. ingredient, any part of a com- pound. inguinal, pertaining to the groin. inhalation, in-breathing of va- por. inherited, derived from an an- cestor. inhibitory, having the power to restrain ; voluntary. injection, forcing liquid into a cavity. innervation, discharge of ner- vous force. inoculation, introduction of a virus into the system. inorganic, without organized structure. insanity, mental derangement. insensible, without the sense of feeling. insolation, sunstroke. insoluble, incapable of solution. insomnia, inability to sleep. inspiration, drawing in of air to the lungs. inspissated, thickened by evap- oration. insufflation, blowing of pow- der into a cavity. INTEGUMENT, the skin. intellect, the mind or reason- ing power. intercostal, between the ribs. INTERCURRENT, occurring be- tween. intermission, interval between paroxysms. intermittent, occurring at in- tervals. internal, on the inside. interosseous, between bones. interstices, spaces or intervals. intestinal, pertaining to the in- testines. intolerance, great susceptibil- ity to drugs. INTRACAPSULAR, within the cap- sule of a joint. INTRACRANIAL, within the skull. intubation, insertion of tube in larynx. intussusception, slipping of one part of intestine into an- other. inunction, rubbing in an oint- ment. invalid, one who is not well. invasion, onset of a disease. inversion, turning inside out; or upside down. involuntary, independent of the will. involution, rolling or turning in. iris, colored membrane of the eye. GLOSSAR V. 289 irrigation, constant application of water. irritation, excitement; stimu- lation. isolate, to separate one from another. JACKSONIAN EPILEPSY, epilepti- form convulsions of limited extent. jactitation, restlessness. JAUNDICE, yellow coloration of the skin. JEJUNUM, upper two-fifths of the small intestines. JUGULAR veins, large veins of the neck. KIDNEY, the organ secreting urine. kinetic, that which produces mo- tion. kleptomania, a morbid desire to steal. KOUMISS, fermented milk. labarraque’s solution, a solu- tion of chlorinated soda, LABIA, the lips. laboratory, a place for experi- mental work. labyrinth, the internal ear. laceration, rendering; tearing. lachrymal, pertaining to tears. lactagogue, agent inducing milk secretion. LACTATION, time of suckling. lacteal, pertaining to milk. lactin, sugar of milk. lactose, lactin. LACUNA, small cavities in bones. lamella, a thin plate or scale. LAMINA, a thin layer or scale. LANCET, a two-edged surgical knife. lancinate, to pierce or incise. lancinating, piercing ; darting. laparotomy, an abdominal in- cision. laryngeal, pertaining to the larynx. laryngitis, inflamation of the larynx. laryngoscope, an instrument for examination of the larynx. larynx, upper part of windpipe ; organ of voice. lassitude, weakness ; exhaus- tion. latent, concealed ; not mani- fest. lateral, pertaining to the side. LAUDANUM, tincture of opium. LAVAGE, washing out of the stom- ach. LAXATIVE, a mild purgative. leech, a blood-sucking worm. lenticular, pertaining to the lens. leper, one affected with leprosy. leprosy, malignant disease of skin. lesion, change from injury or disease. lethargy, a condition of drow- siness. leucocyte, a white blood cor- puscle. GLOSSAR Y. 290 leucocythemia, abnormal in- crease in the white corpuscles. leucocytosis, increase in the number of white cor- puscles. leucorrhea, whitish discharge from the vagina. levator, a muscle that elevates a part. ligament, a band of fibrous tissue. ligature, material used for tying. linear, pertaining to a line. LINGUAL, shaped like the tongue. LINIMENT, a liquid ointment for external use. lint, prepared linen for dressing wounds. liquefaction, conversion into liquid. liquor, a liquid solution. LITHIASIS, formation of a calcu- lus. lithotomy, incision into the bladder for stone. litmus, blue pigment turned red by acids. livid, black and blue. lobar, pertaining to a lobe. lobe, rounded division of an organ. LOBULE, a small lobe. local, limited to a part. localization, determining the seat of a disease. lochia, vaginal discharge after labor. lockjaw, tetanus. locomotion, animal movement. locomotor ATAXY, tabes dor- salis ; disease of spinal cord. LOINS, lower part of back. longevity, long life. lotion, solution for external use. lozenge, a sweet medicated tab- let. lubrication, making smooth or slippery. LUCID, clear ; unobscured. LUMBAGO, pain in the loins. lumbar, pertaining to the loins. LUNACY, insanity. lunar CAUSTIC, silver nitrate in stick. lunatic, one affected with in- sanity. luxation, dislocation; out of joint. lying-in, being in childbirth. LYMPH, fluid in lymphatics. lymphangitis, inflammation of the lymphatics. lymphatic, pertaining to lymph. lysis, gradual decline of a dis- ease. maceration, steeping in fluid. macrocephalus, having a large head. macroscopic, visible to the naked eye. macula, a spot or small patch. malady, any illness or disease. malaise, a feeling of uneasiness or discomfort. malar, pertaining to the cheek- bone. GLOSSARY. 291 malaria, the specific cause of ague. malformation, abnormal shape or structure. malignant, virulent ; fatal. malingerer, one feigning injury or illness. MALPOSITION, abnormal positio.n of a part. mamma, the breast. mammary, pertaining to the breasts. mania, delirium or madness. MANIA A POTU, delirium tremens. MANIACAL, having the nature of madness. manicure, a chiropodist. manipulation, manual treat- ment. marasmus, a wasting or emacia- tion. marginal, pertaining to, or at the border of. marrow, fatty substance of a long bone. masculine, of the male gender. massage, methodical pressure of the body. mastication, the process of chewing. materia MEDICA, substances used as medicines. • matter, physical substance ; pus. maturation, ripening, maxillary, pertaining to the jaws. measles, rubeola. MEATUS, a passage ; opening. median, middle or mesial. medicament, a medicine. medicine, a remedial agent. medium, surrounding conditions. medulla, fatty substance in various cavities. medullary, pertaining to the medulla. megrim, hemicrania ; sick head- ache. meibomian glands, sebaceous glands of the eyelids. melancholia, depression of spirits ; gloominess. membrana tympani, the drum- membrane of the ear. membranous, having the nature of a membrane. meniere’s disease, disease of the semicircular canals of the ear, with vertigo. meninges, membranes of the brain and spinal cord. meningitis, inflammation of the meninges. menopause, end of the menstrual life. menorrhagia, excessive men- strual flow. menses, monthly flow from the womb. menstrual, pertaining to men- struation. MENSTRUATION, function of the female producing menstrual flow. MENSTRUUM, a solvent. mental, pertaining to the mind. mercurial, pertaining to mer- cury. 292 GLOSSARY. mesenteric, pertaining to the mesentery. mesentery, peritoneal attach- ment of the small intestines. mesial, same as median. mesmerism, hypnotism. metabolism, change in the con- dition of cells ; nutrition. metacarpus, bones in the palm of the hand. [change. metamorphosis, structural metastasis, change in the seat of disease. metatarsus, bones in the arch of the foot. metre, unit of measure of the metric system. metritis, inflammation of the uterus. miasm, noxious emanation. microbe, a micro-organism. microcephalous, having a small head. micrococcus, a genus of germs. micro-organism, a minute liv- ing body. microscope, an instrument to examine minute objects. micturition, act of voiding urine. midriff, the diaphragm. migraine, sick headache. miliary, like millet seeds. minim, about a drop ; of a fluid drachm. miscarriage, abortion. mitral, left valve of the heart. mobility, property of being easily moved. molar teeth, back grinding teeth. molecule, smallest quantity of a substance. MONOCULAR, pertaining to one eye. monomania, insanity on one . subject. monoplegia, paralysis of a single limb. MONSTROSITY, a deformed foetus. morbid, pertaining to disease. morphinism, state produced by morphine used excessively. mortification, gangrene ; pu- trefaction. mortuary, a morgue. motor, applied to muscles mov- ing apart. mucilage, a thick viscid liquid. mucus, secretion of mucous membrane. multipara, a woman who has borne several children. multiple neuritis, inflamma- tion of many nerves. mumps, inflammation of the parotid. murmur, a low sound heard in auscultation. muscle, contractile tissue. muscular, pertaining to muscle. mutilation, loss of a membrane or organ. myalgia, pain in the muscles. mydriasis, abnormal dilatation of the pupil. myelitis, inflammation of the spinal cord. GLOSSARY. 293 MYOPIA, near-sightedness. myxcedema, a disease with mucus-like dropsy. birth-mark ; a congeni- tal, cutaneous blemish. narcosis, anaesthesia from nar- cotics. narcotic, a hypnotic allaying pain. nasal, pertaining to the nose. nasal fossae, the nasal passages. nates, the buttocks. NAUSEA, sickness at the stomach. nauseous, producing nausea. necrosis, death of tissue. neoplasm, new growth of tumor. NEPHRECTOMY, excision of kid- ney. nephritis, inflammation of the kidneys. nervous, pertaining to nerves. NEURAL, pertaining to nerves. neuralgia, pain in a nerve. NEURASTHENIA, exhaustion of nerve force. neuritis, inflammation of a nerve. neurosis, nervous affection with- out lesion. neutralize, to render negative. nidus, a cluster. nightmare, horror during sleep. nitrogen, a colorless, gaseous element. nocturnal, pertaining to the night. nodule, a small knob or excres- cence. normal, according to rule or type. nostalgia, homesickness. NOSTRILS, the nares. noxious, harmful; poisonous. nucleus, a vesicular body in a- cell. nut-gall, used in medicine as an astringent. nutrient, nutritious substance. nutriment, anything that nour- ishes. nutritive, affording nutrition. nystagmus, jerking movement of the eyeballs. obese, condition of fatness. obesity, fatness, corpulency. objective, preceptible to the senses. oblique, slanting. observation, examination and recognition of symptoms. obstetrics, care of women dur- ing child-birth. occiput, the back part of the head. occlusion, blocking up of an opening. ocular, pertaining to the eye. odontalgia, toothache. odontoid, resembling a tooth. ointment, a soft, fatty, medi- cated mixture. oleaginous, having the nature of oil. oleate, oleic acid and a base. olecranon, head of the ulna. olfaction, the sense of smell. 294 GLOSSAR V. olfactory, pertaining to ol- faction. omentum, peritoneum covering the viscera. opacity, non-transparency. opaque, impervious to light. operation, surgical procedure. ophthalmia, inflammation of the conjunctiva. ophthalmologist, an oculist. ophthalmoscope, instrument to examine the inside of the eye. opiate, an opium preparation. opisthotonos, spasmodic ri- gidity in which the trunk is thrown backward. oppression, sense of pressure. optic, pertaining to vision. oral, pertaining to the mouth. orbicular, circular. orbit, bony cavity for the eye- ball. [being. organism, a living, organized orifice, mouth or entrance. ORTHOPCEDIC, correction of de- formity. OS, the mouth. A bone. OSCILLATION, a tremulous mo- tion. osmosis, diffusion of fluids through membranes. osseous, bony ; resembling bone. ossification, formation of bone. osteitis, inflammation of bone. OS uteri, mouth of womb. otitis, inflammation of the ear. oval, egg-shaped ; elliptical. OVARIOTOMY, excision of an ovary. ovary, organ of generation in the female. oxaluria, presence of calcium oxalate in urine. oxidation, conversion into an oxide. oxygen, one of the gaseous ele- ments. OXYGENATION, saturation with oxygen. ozcena, fetid nasal discharge. ozone, antiseptic and oxidizing agent. PABULUM, anything nutritive. PACHYDERMATOUS, thick- skinned. PACHYMENINGITIS, inflammation of the dura mater. palate, roof of the mouth. palliative, mitigating ; reliev- ing. pallor, paleness. palmar, pertaining to the palm. palpation, exploration with the hand. palpitate, to flutter, or beat ab- normally fast. palsy, loss of sensation or volun- tary motion. panacea, a cure-all. panada, bread soaked in water. pancreas, the sweetbread. pang, a sharp momentary pain. papilla, small conical eminence. papule, small elevation of the skin. paracentesis, tapping of a body cavity. GLOSSARY. 295 paralysis, loss of sensation or voluntary motion. paralysis AGITANS, paralysis with constant tremor of muscles. paralytic, pertaining to paraly- sis. PARANOIA, chronic form of in- sanity with delusions. paraplegia, paralysis of lower half of body. parasite, organism infesting the body. paregoric, a camphorated tinc- ture of opium. parenchyma, essential substance of an organ. parenchymatous, pertaining to parenchyma. paresis, slight paralysis. paresthesia, a morbid or ah tered sensation. parietal, pertaining to a wall. parotid, a gland under the ear. paroxysm, a spasm or fit. parturient, the condition of being in labor. parturition, the act of giving birth to young. passion, intense emotion. passive, not active. pasteurization, destruction of microbic life. patella, a round bone in front of the knee. pathogenic, causing disease. pathognomic, characteristic, pe- culiar to. [eases. PATHOLOGY, the science of dis- patient, a sick person. PATULOUS, expanded ; open. pectoral, pertaining to the breast. pediatrics, medical treatment of children. pedicle, the stalk or attachment of a tumor. pediluvium, a foot-bath. peduncle, a supporting part. pellicle, a thin membrane. pelvic, pertaining to the pelvis. pelvis, bony basin of the trunk. penetrating, entering beyond the surface. pepsin, the digestive principle of gastric juice. perception, conscious impres- sions through the senses. percolation, process of filtra- tion. PERCUSSION, diagnosis by strik- ing the body. perforation, an opening or penetration. pericardium, membranous sac around the heart. perineum, space between the thighs. period, an interval of time. periosteum, nutritive membrane surrounding bones. periphery, the circumference. peristalsis, vermicular motion of the bowels. peritoneum, serous membrane lining abdomen. peritonitis, inflammation of the peritoneum. 296 GLOSSAR Y. perivascular, surrounding a vessel. pernicious, highly destructive; fatal peroxide, an oxide with highest amount of oxygen. perspiration, sweat. pertussis, a contagious disease with a convulsive whooping- cough. pes, a foot. pessary, instrument placed in the vagina to support the uterus. pestilence, a plague, petechia, purple spots on the skin. petrous, resembling stone. peyer’s glands, clustered glands in the small intestine. phagocytosis, destruction of microbes by the action of white corpuscles. phalanges, bones of the fingers and toes. pharmacy, the science of drugs. PHARYNGEAL, pertaining to the pharynx. pharyngitis, inflammation of the pharynx. pharynx, space behind the mouth. phenol, carbolic acid. phenomenon, a symptom. phlebitis,inflammation of a vein. phlebotomy, opening of a vein ; venesection. PHLEGMASIA, inflammation. phosphate, a salt of phosphoric arid PHOTOPHOBIA, dislike or dread of light. phrenic, pertaining to the dia- phragm. phthisis, pulmonary consump- tion. PHYSICAL, pertaining to the body. physiognomy, reading character ' by the face. pia mater, vascular membrane of brain and cord. pigment, organic coloring mat- ter. pipette, a small graduated tube for taking up liquids. placebo, an inert drug given to satisfy patients. placenta, the after-birth. plantar, pertaining to the sole of the foot. PLASMA, fluid part of the blood. plastic, capable of being moulded. pledget, a small, flat compress of lint. plethora, abnormal fulness of the blood vessels. pleura, serous membrane en- veloping the lungs. pleurisy, inflammation of the pleura. pleurodynia, pain in the inter- costal muscles. PLEURO-PNEUMONIA, inflamma- tion of the pleura and lung. plexus, a network of veins or nerves. pneumatic, pertaining to gaseous fluids. GLOSSARY. 297 pneumogastric, pertaining to lungs and stomach. pneumonia, inflammation of the lungs. pneumothorax, gas or air in the pleural sac. pollution, masturbation ; be- fouling. POLYPUS, a tumor found in the nose, ear, rectum, etc. polyuria, excessive secretion of urine. POPLITEAL,pertaining to the ham. pore, a small opening in the skin. porous, having pores. post-mortem, after death. POST-PARTUM, after parturition. POTION, a draught. pott’s fracture, fracture of the fibula. poultice, a soft, external appli- cation. precipitate, a substance sepa- rated by precipitation. predisposition, a natural ten- dency. pregnancy, the condition of be- ing with child. premonitory, indicating the on- set of disease. prescription, a formula written by a physician. primipara, woman pregnant with her first child. PRINCIPLE, essence of a body. probang, a rod with a sponge attached. PROBE, a small instrument for ex- amining wounds. prodrome, a forerunner or sign of a disease. prognosis, prediction of course and end of disease. PROLIFIC, fruitful. prominence, any conspicuous protuberance. PROSTATE GLAND, neck of the bladder in the male. prostration, extreme nervous exhaustion. protective, an antiseptic dress- ing for wounds. protuberance, a projecting part. PROUD-FLESH, excessive granu- lations. prurigo, skin disease with great itching. pruritis, intense itching. PSOAS, the loins. psoriasis, skin disease with scale formation. psychiatry, treatment of mind diseases. psychical, pertaining to the mind. psychoses, diseases of the mind. ptomaines, putrefactive animal alkaloids. ptosis, drooping of the upper eyelid. ptyalism, excessive secretion of saliva. puberty, age of capability of re- production. pubes, anterior portion of the pelvis. pubic, pertaining to the pubes. PUERILE, pertaining to childhood. 298 GLOSSAR Y. puerile respiration, child-like respiration. puerperal, pertaining to child- birth. pulmonary, pulmonic, pertain- ing to the lungs. PULSATION, a beating or throb- bing sensation. pulse, impulse of the arteries. pulverization, act of reducing to a powder. punctate, having many points, dotted. PUNCTURE, a wound made by a pointed instrument. pungent, acrid, penetrating. pupil, the round opening of the eye. pupillary, pertaining to the pu- pil. purgation, evacuation of the bowels. purulent, having the character of pus. pus, the fluid product of suppura- tion. pustule, a small, purulent pap- ule. putrefaction, organic decom- position ; decay. PUTRID, showing putrefaction ; rotten. PYA2MIA, septicaemia with abscess formations. pyloric, pertaining to the py- lorus. pylorus, lower orifice of the stomach. [ing pus. pyogenic, developing or secret- PYOTHORAX, pus in the pleural cavity. pyramidal, shaped like a pyra- mid. •pyretic, pertaining to fever. pyrexia, elevation of tempera- ture ; fever. pyriform, pear-shaped. pyromania, insanity tending to incendiarism. pyrosis, gastric burning pain with eructations. quadriceps, a large muscle of thigh ; with four parts. qualitative, pertaining to qual- ity. quantitative, pertaining to quantity. quarantine, debarring persons from infected places. QUINSY, an acute severe inflam- mation of the tonsils with fever. quotidian, intermittent fever with daily paroxysm. RABIES, corresponding to hydro- phobia in man. RACHITIS, rickets. radius, the small bone of the forearm. ramification, branching of an organ or part. reaction, responsive action ; ac- tion of reagent. rectum, lower part of the large intestines. recuperation, return to health. reflection, bending back of a part. GLOSSAK Y. 299 REFLEX, involuntary action from nerve stimulus. regeneration, new growth or repair of lost tissues. regimen, the methodical use of food. regurgitation, an eructation or throwing back. relapse, recurrence of a disease during convalescence. relaxation, diminution of ten- sion. remission, the period of abate- ment in fever. remittent, alternately abating and returning. renal, pertaining to the kid- neys. resection, excision of a portion of bone. resolution, absorption. resorption, absorption of mor- bid deposits. respiration, inspiration and ex- piration of air by the lungs. respiratory, pertaining to res- piration. resuscitation, the bringing to life of an asphyxiated person. retina, internal membrane of eye, the expansion of optic nerve. retraction, shortening. RETROFLEXION, a bending or flexing backward. retroversion, turning back. rheumatism, adiseasewith fever, pain, inflammation, and swell- ing of the joints. RHEUMATOID, resembling rheu- matism. rhinitis, inflammation of the nasal mucous membrane. rickets, inflammation of the spine. RIGOR, coldness ; stiffness ; rigid- ity. rigor mortis, rigidity after death. RUBEFACIENT, an agent that red- dens the skin. rubeola, measles. RUGA, a wrinkle. sacchariferous, containing su- gar. sacculated, divided into sacs. sacrum, large triangular bone above coccyx. saint Anthony’s fire, erysipe- las. saline, salty. saliva, secretion of the salivary glands. salt-rheum, chronic eczema. salubrious, healthful. sanguine, bloody ; hopeful. SANGUINEOUS, bloody. sanitary, pertaining to health. sapid, savory. saponaceous, having the nature of soap. SARCOMA, a tumor of connective tissue. saturation, holding in solution all capable of being contained. savory, having a pleasant odor or taste. 300 GLOSSAX Y. scabies, the itch. scapula, the large flat bone of the shoulder. scarfskin, the epidermis. scarification, making small in- cisions on a part. schizomycetes, bacteria. sciatica, neuralgia of the sciatic nerve. SCIRRHUS, a hard form of cancer. sclerotic, hard, indurated. SCORBUTUS, scurvy. scourge, any severe epidemic disease. SCROFULA, a constitutional con- dition with tubercular ten- dency. scrofulous, affected with scrofula. SCROTUM, the pouch containing the testes. scultetus, bandage of, a many- tailed bandage. scurvy, a disease due to defi-. cient and improper diet. sebaceous, pertaining to fat or suet. SECONDARY hemorrhage,haem- orrhage after operation. secretion, function of glands. secretory, performing secre- tion. sedative, soothing. sedentary, occupied in sitting. sediment, matter settling from a liquid. segment, a small piece. semi-circular canals, curved passages of the internal ear. SEMILUNAR VALVES, valves of the aorta and pulmonary ar- tery. SENILITY, weakness of old age. SENSATION, corporeal feeling. SENSORY, pertaining to sensation. SEPSIS, putrefaction. septicaemia, absorption of sep- tic products. septic, relating to putrefaction. SEQUELA, supervening disease. serous, having the nature of serum. serrated, notched like a saw. sialagogue, agent increasing flow of saliva. sibilant, hissing, wheezing. SIGH, a prolonged, deep inspira- tion. [disease. simulation', counterfeiting of sinapism, a mustard plaster. sinuous, wavy, winding. SINUS, canal leading to an ab- scess. Cavity within a bone. sitophobia, insanity, with ab- horrence for food. SITZ-BATH, bath in a sitting pos- ture. slavering, dribbling of saliva. SLOUGH, separated dead matter in an ulceration. snuffles, catarrhal discharge from the nose. soluble, capable of being dis- solved. SOLUTION, diffusion of a solid in a liquid. solvent, an agent capable of dissolving substances. GLOSSARY. 301 somnolent, inclined to sleep. soporific, an agent inducing sleep ; hypnotic. sordes, collection about the teeth. SPASM, a convulsive muscular contraction. spatula, blade for spreading ointments. specific, peculiar, special. specific gravity, weight of a substance compared with that of water. SPIRAL, screw-like. spirillum, a genus of bacteria. spleen, oval viscus behind the outer end of the stomach. splint, support for the ends of a fractured bone. spongy, porous. spontaneous, taking place with- out aid or volition. sporadic, occurring in isolated cases. SPRAIN, violent straining of ligaments. sputum, expectorated matter. squamous, scabby. sterility, the condition of be- ing barren. STERILIZATION, destruction of germs by heat. sternum, the flat bone of the breast. stertorous, breathing with a so- norous sound. stethoscope, a tube for convey- ing sounds in auscultation. sthenic, strong, active. stimulants, agents increasing functional activity. stimulus, anything exciting an organ. stomatitis, inflammation of the mouth. strabismus, eye-squint. strangulated hernia, hernia so compressed as to be irre- ducible. strangury, painful urination in drops. streptococcus, micrococci in chains. stricture, a contraction of a duct or tube. structure, composition of an organ. strumous, scrofulous. stupor, the condition of insensi- bility. styptic, an astringent; haemo- static. subacute, of moderate severity. subjective, internal ; pertaining to one’s self. SUBLIMATE, corrosive, bichlo- ride of mercury ; an antiseptic. sublingual, beneath the tongue. subsultus, morbid tremor or twitching. sudoriferous, carrying sweat. suffocation, stoppage of respi- ration. suicide, to kill one’s self. superficial, confined to the surface. superior, the upper part. SUPINE, lying flat, or on the back. 302 GLOSSARY. suppository, solid medicine for introduction in rectum or vagina. suppression, retention. suppuration, the formation of pus. SUSPENDED ANIMATION, tempo- pary cessation of vital func- tions. SUTURE, in surgery, a stitch. SWOON, faint. sympathetic, series of ganglia in body. symphysis, junction of bones. symptom, phenomenon or sign of disease. symptomatic, pertaining to a symptom. synchronous, occurring at the same time. syncope, swooning or fainting. synovia, lubricating fluid of a synovial membrane. synovitis, inflammation of a synovial membrane. syphilis, a chronic, infectious venereal disease. syringe, an instrument for in- jecting fluids. systematic, methodical. systemic, pertaining to a system. SYSTOLE, contraction of the heart and arteries. TABES DORSALIS, degeneration of spinal cord; locomotor ataxy. TACHYCARDIA, abnormal rapid- ity of the heart. TACTILE, pertaining to the sense of touch. taenia, intestinal worms. talipes, club-foot. TAMPON, a plug of lint or cot- ton, etc. tapping, taking effusion from a cavity. tarsus, the instep. tartar, a deposit from saliva upon the teeth. TAXIS, manual reduction of a hernia. temperament, individual pecu- liarity. temperature, intensity of heat. temporal, pertaining to the temple. TENACULUM, a hook-shaped in- strument. TENDON, white fibrous tissue, the attachment of muscles. tenesmus, rectal pain with spas- modic straining. tenotomy, section of a tendon. tension, strain of an organ. tertian, intermittent paroxysm occurring every third day. TETANUS, a disease with spas- modic and continuous contrac- tion of the muscles. thein, active principle of tea ; caffein. theomania, religious mania. therapeutics, the application of remedies. thermic, pertaining to heat. THERMIC FEVER, heatstroke. GLOSSARY. 303 thermometer, an instrument for measuring intensity of heat. thigh, upper portion of the leg. thigh-bone, the femur. THORACIC, pertaining to the chest. THORAX, the cavity above the abdomen. thrombosis, formation of a thrombus. thrombus, blood-clot in a vessel. thyroid GLAND, glandular body at the upper part of trachea. TIBIA, inner and larger bone of the leg. tic douloureux, spasmodic facial neuralgia. tincture, an alcoholic solution of medicinal substance. tinea, a skin disease, from fungi. TINNITIS AURIUM, ringing in the ears. tissue, any web-like structure. tolerance, capacity of enduring a drug. TONIC, promoting nutrition and tone. tonsillitis, inflammation of the tonsils. topography, description of re- gions of the body. tormina, griping pain in the bowels. torpor, abnormal inactivity. torsion, a twisting. tourniquet, an instrument to compress arteries. toxaemia, poisoned state of the blood. toxic, poisonous. trachea, the wind-pipe. tracheotomy, incision of the trachea. TRACTION, a drawing or pulling. trance, a form of catalepsy. TRANSFUSION, transfer of blood into the veins. TRANSUDATION, oozing of a fluid through the pores of the skin. transverse, lying across. traumatic, pertaining to a wound. tremor, involuntrary trembling of the body. trephine, a cylindrical saw for entering the skull. triceps, a muscle with three origins. trichiniasis, disease caused by trichina in the body. TRICUSPID, having three points, as the right valve of the heart. trismus, lockjaw. trocar, a sharp instrument for paracentesis. TROPHIC, pertaining to nutrition. truss, an apparatus to hold a hernia in place. TUBE, a pipe-like structure in the body tubercle, a small nodule of granular cells. tubercular, pertaining to tuber- cles. tuberculosis, infectious disease due to specific bacillus. tumefaction, swelling of a part. tumor, a swelling. 304 GLOSSARY. TURGESCENCE, swelling of an organ. TURGID, swollen. tympanites, gaseous distension of the abdomen. tympanitic, drum-like. tympanum, the middle-ear cav- ity, and membrane. typhoid, resembling typhus. typical, characteristic. ulcer, an open sore. ulceration, process of ulcer formation. ulna, large bone of the forearm. umbilicus, the navel. undulatory, moving like waves. UNGUENT, an ointment. [side. unilateral, affecting but one urate, combination of uric acid with a base. urea, chief solid constituent of urine. UR/emia, toxic condition of the blood from accumulation of urea. ureter, a tube carrying urine from kidney to bladder. urethra, the excretory canal of the bladder. uric acid, an acid normally found in urine. urinalysis, analysis of urine. urinary, pertaining to the urine. urine, fluid secreted by the kid- neys. urinometer, instrument for find- ing specific gravity of urine. urticaria, nettle-rash. uterine, pertaining to the ute- rus. uterus, the womb. uvula, a soft body pendent from the free border of the palate. vaccination, inoculation with vaccine to protect against small-pox. VACCINE, lymph from a cow-pox vesicle. vaccinia, cow-pox, a vesicular disease of cows. vacuum, a space exhausted of air. VAGUS, the pneumogastric nerve. VALVE, fold across a canal ob- structing passage in one direc- tion. vapor, the gaseous form of a substance. vaporization, conversion of a substance into a vapor. VARICELLA, chicken-pox. varicose, affected with varix. VARIOLA, small-pox. varioloid, a modified form of small-pox. varix, a venous dilatation. vascular, pertaining to vessels. vaso-motor, causing motion in vessels. vehicle, medium oi adminis- tration. vein, a vessel returning the blood to the heart. venereal, pertaining to sexual intercourse. venesection, opening a vein. GLOSSARY. 305 VENOUS, pertaining to a vein. ventilation, the supplying of fresh air. ventricle, as of the heart. vermicular, worm-like. vermiform, having a shape like a worm. vermifuge, an agent expelling intestinal worms. version, turning of the fcetus in utero. vertebra, a bony segment of the spinal column. VERTEBRAL COLUMN, the spinal column ; the back bone. vertebrate, having vertebrae. vertex, superior region of the skull. VERTIGO, giddiness; dizziness. vesical, pertaining to the blad- der. VESICLE, a small blister or sac. vessel, a tube to convey the fluids of the body. viability, ability to live. vial, a vessel or bottle. vibration, a swinging back and forth. vicarious, taking the place of another. VILLI, small projection of mu- cous membrane of small intes- tines. vinous, having the nature of wine. vinum, wine. virulent, having the nature of a poison. virus, a morbid product. viscera, the contents of the body cavities. viscid, glutinous, ropy. vision, sight. visual, pertaining to vision. vital, pertaining to life. vocal, pertaining to the voice. volatile, readily evaporating. voluntary, under the control of the will. vomit, to eject from the stomach. VORACIOUS, having an insatiable appetite. vulva, the external female geni- tals. wet-nurse, a woman who suckles the child of another. wet-pack, reducing temperature by wrapping in a wet sheet. wind-pipe, trachea. XYPHOID, sword-like. yawning, deep inspiration; gaping. yeast, a minute, fungous fer- ment. zero, point from which ther- mometers are graded. zygoma, the arch formed by the cheek bones. zymotic, pertaining to a patho- genic microbe. GENERAL INDEX OF VOES. I. AND II. Abdomen, in pregnancy, ii, 224 Abdomen, massage of, ii, 169 Abdominal breathing, i, 209 Abortion, ii, 220 Absorbent cotton, ii, 84 Absorption of poisons, ii, 86 Accessory food, i, 65 Accommodation, i, 141 Acetic acid, ii, 89 Acid burns, ii, 70 Acid glands, i, 89 Acid poisons, ii, 88 Acids, how taken, ii, 178 Acid vapor bath, ii, 161 Aconite, ii, 90 Action of poisons, ii, 86 Active movements, ii, 170 Acts of insane, ii, 148 Actual cautery, ii, 60 Acute insanity, ii, 132 Acute meningitis, ii, 205 Adhesive plaster bandage, u.,36 Adulterated food, i, 71 iEsthesiometer, i, 150 Affusion of water, ii, 162 Afterbirth, ii, 225 After-pains, ii, 235 Agraphia, i, 130 Ague, ii, 193 Air baths, ii, 160 Air cells, i, 50 Air, composition of, i, 152 Air cushions, i, 203 Air, impure, i, 155 Air, impurities of, i, 155 Air mattresses, i, 203 Air, need of, for an individual, i, 156 Air, renewal of, i, 155 Air, source of, i, 160 Air-tight room, i, 155 Albumen in urine, ii, 199 Albuminoids, i, 60, 64 Alcohol, i, 62 Alcohol, a poison, ii, 90 Alcoholic coma, ii, 104 Alcohol in enemata, ii, 19 Alimentation, i, 58 Alimentation, forced, ii, 183 Alkaline baths, ii, 161 Alkali poisons, ii, 88 Alternating insanity, ii, 131 Altitude, high, climate of, i, 57 Alum in bread, i, 72 American bandage, ii, 30 Ammonia, ii, 89 Ammonia, application of, ii, 7 Amnesia, i, 30 Amniotic fluid, ii, 224 Amusement of insane, ii, 149 Anaemia, i, 44 Anaesthesia, i, 208; ii, 72, in Anaesthesia, dangers from, ii. 76 Anaesthesia, signs of, ii, 75 Anastomosis, i, 40 Anilm, ii, 90 Animals, exhalations of, i, 160 Anthelmintic enema, ii, 17 Anthrax, i, 173 Antidotes, ii, 87 Antimony, ii, 89 Antisepsis in labor, ii, 227 Antiseptic gauze, ii, 66 Antiseptics, i, 177 Antispasmodic enema, ii, 16 308 GENERAL INDEX. Antitoxins, i, 175 Anxious dread, ii, 114 Aphasia, i, 130 Aphonia, i, 130 Apnoea, ii, 216 Apoplexy, ii, 103 Appendicitis, ii, 199 Appetite, i, 57 Appetite, recovery of, ii, 214 Aqueous humor, i, 140 Arachnoid, i, 114 Arm, bandages for, ii, 29 Arm bone, see Humerus Arm, fracture of, ii, 43 Arms, massage of, ii, 169 Arsenic, ii, 89 Arterial sclerosis, i, 209 Arteries, i, 39 Arthritis, ii, 197 Articulations, i, 11 Articulation, disorder of, ii, 135 Artificial feeding, ii, 182 Artificial respiration, ii, 94 Artificial ventilation, i, 159, 160, 165 Asepsis for operation, ii, 79 Aseptic dressings, ii, 70 Aseptic wounds, ii, 68 Asiatic cholera, ii, 194 Asphyxia, i, 56; ii, 94, 216 Asphyxia of insane, ii, 153 Asthenia, ii, 216 Astringent enemata, ii, 17 Ataxic gait, ii, no Atheromatous arteries, i, 209 Atmosphere, i, 152 Atomizer for cologne, i, 194 Atropine, ii, 91 Attendants, rules for, ii, 145 Attitude in meningitis, ii, 205 Attitude of the insane, ii, 125, 149 Attitude to be observed, i, 194 Audition, i, 142 Auditory nerve, i, 142 Aurae, ii, 103 Aural vertigo, ii, no Aureolas, ii, 222 Auricles, see Heart Auscultation, i, 210 Automatic activity of brain, i, 126 Automatic reflex, i, 119 Bacilli, i, 171 Back, massage of, ii, 169 Bacteria, i, 171 Bandage requisites, ii, 22 Bandages, ii, 21 Barton’s bandage, ii, 33 Bathing infants, ii, 239 Bathing the insane, ii, 148, 154 Baths and bathing, ii, 154 Baths for insane, ii, 141,148,154 Baths, time for, ii, 155 Bed, arrangement of, i, 192 Bed bath, ii, 154 Bed-bugs, i, 198 Bed, care of, ii, 216 Bedding for insane, ii, 152 Bedding, how to disinfect, i, 186 Bed for lying-in, ii, 229, 230 Beds and bed-making, i, 197 Bedsores, i, 119 ; ii, 111 Bedsores in typhoid, ii, 193 Bedsores of insane, ii, 151, 152 Bedstead, iron, i, 198 Bedvessels in infectious dis- eases, 1, 186 Beef, i, 75 Belladonna, ii, 91 Belonephobia, ii, 115 Bichloride cotton, ii, 84 Bichloride of mercury, i, 179 ; ii, 80 Bichloride gauze, ii, 84 Bile, i, 95, 96 Bilious diathesis, i, 66 Bilious fever, ii, 194 Binder, ii, 234 Bites, from insane, ii, 152 Bites, poisonous, ii, 92 Bladder, i, 46 Bladder paralysis, ii, 111 GENERAL INDEX. 309 Bladder in parturition, ii, 237 Bladder, washing out, ii, 250 Blankets, i, 200 Bleaching sponges, ii, 83 Blisters, ii, 8 Blisters from burns, ii, 70 Blood, the, i, 42 Blood, circulation of, i, 35 Blood discs, i, 42 Blood-letting, see Venesection Blood of insane, ii, 152 Blood poisoning, ii, 197 Blood-vessels in muscles, i, 23 Blue mass, ii, 90 Blue vitriol, ii, 89 Boiling for sterilizing, ii, 83 Bones, i, 1 Bones, changes in, ii, 111 Bones in the young, ii, 204 Borderland of insanity, ii, 132 Boric acid, i, 23, 180 Bowels, before operation, ii, 80 Bowels, discharges from, i, 221 Bowels, haemorrhage from, ii, 63 Bowels in insanity, ii, 139, 149 Bowels in pregnancy, ii, 223 Bowels, irritation of, ii, 210 Brain, i, 106, 108 Brain cells, disorder of, ii, 117 Brain, disease of, ii, 108, 111 Brain, dropsy in, ii, 204 Brain, functions of, i, 123 Brain, inflammation of, ii, 128, 205 Brains, as food, i, 75 Bran bags, ii, 3 Bran baths, ii, 161 Bread, adulterated, 1, 71 Breast, bandage, ii, 27 Breasts after labor, ii, 236 Breasts in pregnancy, ii, 222 Breathing, i, 48 Brick, porosity of, i, 153 Bright’s disease, ii, 199 Bromide, ii, 91 Bronchi, i, 50 Bronchi, inflammation of, ii, 209 Brucin, ii, 91 Bruises, ii, 65 Brushes, ii, 168 Burns, ii, 68 Butter, i, 79 Buttocks, massage of, ii, 169 Caecum, i, 97 Calcutta, Black Hole of, i, 155 Caffein, i, 81 Calomel, ii, 90 Calomel baths, ii, 161 Camp fever, ii, 193 Camphor a poison, ii, 91 Candles, impurities from, i, 153 Cannabis Indica, ii, 91 Canning food, i, 72 Capillaries, i, 40 Capillaries, cold on, ii, 4 Capillary haemorrhage, ii, 55 Cantharidal collodion, ii, 9 Cantharides, ii, 9 Capsicum poultices, ii, 8 Capsules, ii, 174 Carbohydrates, i, 60 Carbolic acid, i, 179 Carbolic acid as anaesthetic, ii, 78, 228 Carbolic acid as a poison, ii, 86, 88 Carbolized gauze, ii, 84 Carbonic acid, i, 153 Carbonic oxide, ii, 98 Carpets, i, 191 Carpus, i, 12 Carron oil, ii, 69 Cartilage, i, 16 Castor-oil sandwich, ii, 178 Castors for beds, i, 198 Catalepsy, ii, 103 Cataplasms, ii, 1 Catarrhal dysentery, ii, 198 Catgut, to preserve, ii, 84 Catgut sutures, ii, 66 Catheterization, ii, 237, 245 310 GENERAL INDEX. Causes of insanity, ii, 119 Caustics, ii, 89 Cells of brain, i, 124 Cerates, ii, 174 Cereals, i, 80 Cerebellum, i, 108, in Cerebellum, disease of, ii, no Cerebral apoplexy, ii, 104 Cerebral neurasthenia, ii, 113 Cerebro-spinal meningitis, ii, 205 Cerebro-spinal system, 1, 106 Cerebrum, i, 108 Changing soiled bedding, i, 202 Charcoal dressings, ii, 2 Charcoal, fumes of, ii, 98 Charts, 1, 219 Cheerfulness, ii, 142 Cheese, 1, 79 Cheese-cloth dressings, ii, 184 Chest, see Thorax Chest bandage, ii, 27 Chest, massage of, ii, 169 Cheyne-Stokes breathing, i, 210; ii, 104 Chicken-pox, ii, 207 Chilblains, ii, 107 Childbed fever, ii, 227 Childbirth, ii, 220 Childhood, ii, 204 Childhood, nursing in, ii, 212 Children’s diseases, ii, 204 Chills, ii, 51 Chills and fever, ii, 193 Chloral hydrate a poison, ii, 9i Chlorides, 1, 181 Chlorine, i, 181 Chloroform, ii, 75, 91 Chloroform as a vesicant, ii, 8 Chlorosis, i, 146 Choking of insane, ii, 153 Cholera, ii, 194 Cholera, germ of, i, 175 Cholera infantum, ii, 210 Cholera morbus, ii, 195 Choreic insanity, ii, 136 Choreic spasms, i, 223 Choroid coat, i, 139 Chronic mania, ii, 129 Chyle, i, 45 Cicatrices, ii, 65 Cicatrix, from burns, ii, 70 Circular bandage, ii, 21 Circular insanity, ii, 131 Circulation in massage, ii, 163 Citric acid, ii, 89 Civilization, ii, 119 Classification of insanity, ii, XI7 Clavicle, i, 10 Clavicle, dislocation of, ii, 45 Clavicle, fracture of, ii, 42 Cleanliness an antiseptic, i, 183 Climate, i, 156 Clinical record following operation, ii, 85 Clinical records, i, 215 Clinical records for the insane, ii, 148 Clock for sick-room, i, 193 Clonic spasm, i, 223 Clothing of demented, ii, 151 Clothing of nurse, i, 192 ; ii, 79 . Clothing for convalescents, ii, 215 Clothing for infant, ii, 241 Clothing for labor, ii, 230 Clothing for the old, ii, 142 Clothing in pregnancy, ii, 223 Clysters, ii, 13 Coal gas, ii, 91 Cocaine, a poison, ii, 91 Cocaine hydrochlorate, ii, 77 Cocoa, i, 81 Cocoa in suppositories, ii, 19 Cod-liver oil sandwich, ii, 178 Coffee, i, 81 Cold applications, ii, 4 Cold baths, ii, 154, 157 Cold compresses, ii, 4 Cold, exposure to, ii, 107 Cold to preserve food, i, 73 GENERAL INDEX. 311 Cold-water dressings, ii, 4 Colic, ii, 210 Colic of infancy, ii, 244 Collapse, enemata in, ii, 19 Colon, i, 97 Colon, absorbing property of, ii, 17 Colostrum, ii, 240 Coma, ii, 216 Coma in meningitis, ii, 205 Coma of apoplexy, ii, 104 Combustion, results of, i, 155 Comma-bacillus, i, 174 Complexion, i, 28 Compound dislocations, ii, 44 Compound fractures, ii, 39 Conception, ii, 219 Confection, ii, 174 Confinement, ii, 220 Confinement, insanity of, ii, 143 Confluent variola, ii, 195 Congestive fever, ii, 194 Conscious life, i, 123 Consciousness during opera- tion, ii, 82 Constipation, ii, 212 Constipation in convulsions, ii, 109 Constipation in insanity, ii, 139. 149 . Constipation in pregnancy ii, 223 Consumption, ii, 203 Contagion, ii, 195 Continuous fever, ii, 48 Contused wounds, ii, 64 Contusions, ii, 65 Contractility, i, 18 Contractures, ii, 109 Convalescence, ii, 214 Convulsions, i, 109; ii, 101 Convulsions, enema in, ii, 16 Convulsions in meningitis, ii, 205 Convulsions in pregnancy, ii, 223 [102 Convulsions, treatment of, ii, Cooking of food, i, 76 Cooling sick-room, i, 170 Co-ordination, ii, no Copper, ii, 89 Copper, sulphate of, i, 76, 181 Copperas, ii, 90 Cord, tying of, ii, 233 Cornea, i, 139 Cornea, ulceration of, ii, 211 Corn use, i, 114 Corrosive poisons, ii, 87 Corrosive sublimate, i, 178 ; ii, 90, 228 Cortex, i, 109 Cortex, lesions of, ii, 134 Cough, ii, 203 Cough, character of, i, 211 Cough, paroxysmal, ii, 208 Counter-irritants, ii, 6 Counter-irritation in massage, ii, 167 Counterpanes, i, 200 Cranial nerve, i, 121 Cranium, i, 5 Cranks, ii, 132 Crepitus, i, 48 Craving appetite, ii, 224 Creolin, ii, 70, 229 Crisis, ii, 49 Critical patient, ii, 216 Croton oil, ii, 10 Croup, ii, 209 Croupous pneumonia, ii, 202 Crumbs in bed, ii, 216 Crystalline lens, i, 140 Cumulative drugs, ii, 179 Cupping, ii, 11 Cushions, for chairs, i, 195 Cutaneous hyperaesthesia, ii, 150 Cutaneous sensation, ii, 111 Cuticle, i, 25 Cutis vera, i, 25 Cystitis, ii, 250 Daily amount of food, i, 67 Dead, care of, ii, 217 Dead, care of infectious, i, 187 312 GENERAL INDEX. Death, proof of, ii, 97 Death, signs of, ii, 216 Decomposition of body, ii, 217 Decoration, ii, 173 Decubitus, ii, 111 Deep muscles, i, 19 Defervescence, ii, 48 Degeneracy, ii, 132 Deglutition, i, 86 Delirious mania, ii, 128, 140 Delirious melancholia, ii, 129 Delirium, acute, ii, 128 Delirium, food in, ii, 183 Delirium in typhoid, ii, 193 Delirium tremens, ii, 144 Delusions, ii, 121 Delusions, care of, ii, 150 Delusions, exalted, ii, 135 Delivery, ii, 220 Demented, care of, ii, 151 Demoniacal possessions, ii, 117 Dentine, i, 34 Deodorizer, i, 177 Depression, ii, 121 Derma, i, 26 Desquamation, i, 26; ii, 206 Diabetes, ii, 104, 201 Diaphoretics, ii, 200 Diaphragm, i, 24 Diarrhoea, enema for, ii, 17 Diarrhoea in children, ii, 210 Diastole, i, 38 Diathesis, i, 65 Dicrotic pulse, i, 209 Diet, i, 65 Dietary for forced feeding, ii, 186 Diet for insane, ii, 150 Diet for sick, ii, 186 Diet in infancy, ii, 242 Diet in parturition, ii, 237 Diet in pregnancy, ii, 223 Diffusion of gases, i, 161 Digestion, i, 57, 84 Digestion in rectal feeding, ii, 18 Digestion, rules for, i, 99 Digestion, time of, i, 99 Digitalis, a poison, ii, 91 Dilatation, stage of, ii, 231 Diphtheria, ii, 208 Diphtheria germs, i, 174 Diphtheria, palsy in, ii, 109 Dipsomania, ii, 133 Direct radiation, i, 166 Direct-indirect radiation, i, 167 Discrete variola, ii, 195 Disease germs, i, 172 Disinfectants, i, 197 Disinfectants, how to keep, i, 185 Disinfectants in labor, ii, 228 Disinfecting ovens, i, 178 Disinfection for operation, ii, 82 Disinfection of dead, ii, 217 Dislocations, ii, 44, 71 Dissection wounds, ii, 65 Distilled liquors, i, 64 Diuretics, ii, 200 Dizziness, ii, 105 Dogs, bites from, ii, 93 Dorsal position, ii, 246 Doses, measure of, ii, 179 Douche, ii, 14, 162 Douche for insane, ii, 148 Douche in labor, ii, 239 Down coverlets, i, 202 Drainage, ii, 65 Drainage tubes, ii, 84 Draughts, cause of, i, 162 Draw sheets, i, 201 Dreaming, i, 133 Dressings for wounds, ii, 65, 84 Drink, i, 65 Dronomania, ii, 133 Dropsy, ii, 200 Dropsy in pregnancy, ii, 223 Drowning, ii, 94, 96 Drugs, deterioration of, ii, 179 Dry heat, ii, 3 Dumb ague, ii, 194 Duodenum, i, 94 GENERAL INDEX. 313 Dura mater, i, 113 Dyes, a poison, ii, 91 Dysentery, ii, 197 Dysentery, enema for, ii, 17 Dyspepsia, ii, 201 Dyspnoea, i, 209 Ear, i, 142 Earache, ii, 100 Ear-drum, see Tympanum Ear, foreign matter in, ii, 100 Ear, inflammation of, ii, 207 Ear symptom, i, 144 Eating, rules for, i, 98 Eccentricity, ii, 132 Eclampsia, ii, 223 Education, i, 125 ; ii, 119 Effleurage, ii, 166 Effusion in chest, ii, 202 Eggs, i, 80 Eggs in rectal feeding, ii, 18 Egoism, ii, 123 Elbow, dislocation of, ii, 46 Elbow bone, i, 11 Electricity, death from, ii, 107 Elixirs, ii, 172 Embolus, i, 44 Embolus in brain, ii, 108 Embryo, ii, 220 Emergency, ii, 71, 152 Emetics for poison, ii, 87 Emotions, i, 127 ; ii, 123 Emulsion, ii, 173 Enamel, i, 34 Encephalon, i, 108 Endermic medication, ii, 174 Endocardium, i, 37 Envelop bath, ii, 158 Epidemic cholera, ii, 194 Epidemic dysentery, ii, 198 Epidermic medication, ii, 174 Epidermis, i, 25 Epiglottis, i, 52 Epilepsy, ii, 103 Epileptic insanity, ii, 136 Epileptic status, ii, 16 Epileptics, care of, ii, 143 Epistaxis, ii, 62 Ergotism, i, 71 Erotomania, ii, 133 Eructation, i, 92 Eruption from croton oil, ii, 10 Eruption in disease, ii, 206 Eruptions, i, 214 Erysipelas, ii, 196 Ether, ii, 74 Eustachian tube, i, 143 Exalted delusions, i, 135 Examination in labor, ii, 231 Examination of the insane, ii, 148 Excess of food, i, 68 Excitement, ii, 121 Excreta, how to disinfect, i, i85 Excretion, i, 46 Exercise, i, 22 Exercise in insanity, ii, 141 Exercise in pregnancy, ii, 223 Exercise on temperature, i, 102 Exhaustion, feeding in, ii 183 Exhaustion in insanity, ii, 140 Expectoration, i, 210 Expiration, i, 53 Expulsion, stage of, ii, 231 Extension, i, 19 ; ii, 168 Extraction of air, i, 168 Extracts, ii, 172 Eyeball, i, 139 Eye, foreign bodies in, ii, 99 Eyes of infants, ii, 210, 241 Eyes, straining of, ii, 2x5 Eye symptoms, i, 144 Face, bones of, i, 6 Facial expression, i, 212 Facial nerve, i, 122 Faeces, i, 47, 98 False croup, ii, 209 Farsightedness, i, 142 Fastidium, ii, 48 Fat as a heat producer, i, 103 Fatigue, ii, 113 Fats, i, 61 314 GENERAL INDEX. Fear of things, ii, 114 Feather beds, i, 199 Feeding infant, ii, 240 Feeling, ii, 116 Feigning symptoms, i, 206 Femur, i, 12 Fermentation of food, ii, 210 Fermentation test, ii, 201 Fetor after labor, ii, 235 Fever, i, 104 ; ii, 48 Fever cot, ii, 159 Fever symptoms, ii, 51 Fever, treatment of, ii, 53 Fibres of brain, i, 112 Fibrin, i, 42 Fibula, i, 13 Finger bones, i, 12 Fire places, i, 161 First intention, healing by, ii, 65 Fish, i, 76 Fish, poisonous, ii, 90 Fissures, brain, i, 109 Fits, see Convulsions Fixed ideas, ii, 114 Flagellation, ii, 168 Flannel bandage, ii, 22 Flexion, i, 19; ii, 168 Flues, ventilating, i, 167 Foetus, ii, 220 Fomentation, ii, 2 Fontanelles, i, 6 Food, i, 6, 59 Food, bacteria in, i, 175 Food for insane, ii, 140, 150 Food for the old, ii, 142 Food for the sick, ii, 189 Food, fermentation of, ii, 210 Food in convalesence, ii, 214 Food in infancy, ii, 212 Food in melancholia, ii, 141 Food in sick-room, i, 192 Food in pregnancy, ii, 222 Food, nutritive value of, i, 74 Foot, bandage for, ii, 30 Foot-bath, ii, 160 Forcible feeding, ii, 182, 140 Forearm, bones of, i, 12 Fore-brain, see Cerebrum Forced ventilation, i, 165 Foreign matter in eye, ii, 99 Forms of massage, ii, 164 Forms for records, i, 216 Fountain pen, i, 216 Fowler’s solution, ii, 89 Fractures, ii, 39, 71 Fractures of insane, ii, 153 Freckles, i, 28 Freezing, death from, ii, 107 Friction, ii, 166 Fright in convulsions, ii, 101 Frigorific mixture, ii, 78 Frostbite, ii, 107 Fruit, i, 81 Fumigation, i, 188 Fungi, i, 171 ; ii, 92 Funis, ii, 225 Functional paralysis, ii, 108 Furnaces, hot air, i, 165 Furniture, i, 179, 191 Furniture in operating room, ii, 81 Gall bladder, i, 96 Game, i, 75 Ganglionic system, i, 106 Gaseous enema, ii, 16 Gas, impurities from, i, 154 Gastric juice, i, 90 Gastric vertigo, ii, no Gastritis, ii, 201 Gastro-intestinal irritation, ii, 92 Gauze dressings, ii, 84 General paralysis, ii, 134, 142 General sensibility, i, 150 Genitals in labor, ii, 231 German measles, ii, 206 Germicide, i, 177 Gestation, ii, 219, 221 Glanders, i, 174 Glottis, oedema of, ii, 98 Gloves, for massage, ii, 168 Glucose, i, 60 Glycerine, ii, 15 Glycerine suppositories, ii, 20 GENERAL INDEX. 315 Glycosuria, ii, 201 Gouty diathesis, ii, 66 Graduates, ii, 180 Grandeur, delusions of, ii, 135 Granulation, ii, 65 Gristle, see Cartilage Gullet, see Oesophagus Gums, condition of, i, 223 Gunshot wound, ii, 65 Gynaecological nursing, ii, 245 Habits of insane, ii, 149 Habitual tremor, i, 223 Hacking, ii, 167 Hsematuria, ii, 62 Haemoptysis, ii, 63 Haemorrhage, ii, 55 Haemorrhage after operation, ii, 85 Haemorrhage, enemata in, ii, 17 Haemorrhage in typhoid fever, ii, 192 Haemorrhage of brain, ii, 104, 108 Haemorrhage post-partum, ii, 234 Haemorrhage, treatment of, ii, 57 Hair, i, 29 Hair, care of nurse’s, ii, 79 Hair, changes in, ii, 111 Hair of insane, ii, 149 Hall’s method, ii, 95 Hallucinations, i, 139 ; ii, 131 Hand bandage, ii, 28 Hand, bones of, i, 12, Handkerchief bandages, ii, 33 Hands of masseur, ii, 163 Hanging, ii, 97 Head, bandage for, ii, 25 Head, fracture of, ii, 71 Head, massage of, ii, 170 Head, muscles of, i, 19 Healing of wounds, ii, 65 Hearing, dangers to, i, 144 Hearing, hallucinations of, ii, 122 Hearing in anaesthesia, ii, 77 Hearing, sense of, i, 142 Heart, i, 35 Heart in chloroform narcosis, 77 Heart in massage, ii, 163 Heart, movements of, i, 38 Heat of the air, i, 156 Heat of the body, i, 101 Heat stroke, ii, 106 Heat test for albumen, ii, 200 Heat, to destroy germs, i, 178 Heller’s test, ii, 200 Hemianaesthesia, ii, hi Hemiplegia, ii, 108 Henbane, a poison, ii, 91 Hepatic flexure, i, 98 Heredity, ii, 119 Hernia infantile, ii, 241 Hibernation, i, 105 Hiccough, i, 24 High enemata, ii, 14 Hind-brain, see Cerebellum Hip-bath, ii, 160 Homicidal insanity, ii, 132 Hospital nurse, ii, 145 Horse-hair for drainage, ii, 84 Hot-air bath, ii, 160 Hot bath, ii, 154, 160 Hot-water bags, ii, 81 Hot-water bottles, ii, 3 Hot water for warming, i, 167 Howard’s method, ii, 96 Humidity, i, 153 Hunger, i, 57 Hydrargyrum, see Mercury Hydrocephalus, ii, 204 Hydrophobia, ii, 93 Hydrothorax, ii, 202 Hygiene of pregnancy, ii, 224 Hygiene of ward, ii, 152 Hyoscyamus, a poison, ii, 91 Hyperacute mania, ii, 128 Hyperaemia, ii, 53 Hypersemia of brain, i, 135 Hyperaesthesia, i, 150, 208; ii, 112 [150 Hyperaesthesia, cutaneous, ii, 316 GENERAL INDEX. Hypermetropia, i, 142 Hypnotics, i, 135 Hypodermatic injection, ii, 78 Hvpodermic medication, ii, 175 Hypodermics, use of, ii, 176 Hysteria, ii, 103 Hysterical anaesthesia, ii, in Hysterical breast, ii, 112 Hysterical contracture, ii, 109 Hysterical paralysis, ii, 108 Ice, as an anaesthetic, ii, 78 Ice-bags, ii, 4 Ice, enemata, ii, 17 Ice, how to keep, ii, 186, 271 Ice-cream, ii, 271 Ice coils, ii, 4 Ice poultices, ii, 2 Ideas, i, 127 Idiocy, ii, 136 Idiosyncrasy, ii, 180 Ileo-caecal valve, i, 97 Ileum, i, 94 Illusion, ii, 123 Imbecility, ii, 136 Immovable bandages, ii, 34 Imperial drink, ii, 271 Impulsive insanity, ii, 133 Incised wounds, ii, 64 Incoherence, ii, 127 Incompatibility, ii, 178 Incomplete fracture, ii, 39 Indian gruel, ii, 275 Indian hemp, ii, 91 Incubation of fever, ii, 48 Indigestion, ii, 201 Indigestion in insomnia, i, 136 Indirect radiation, i, 166 Infancy, ii, 204 Infancy, bowels in, ii, 210 Infant at birth, ii, 232 Infant, care of, ii, 239 Infant feeding, ii, 240 Infant, preparation for, ii, 229 Infantile cholera, ii, 210 Infantile convulsions, ii, 101 Infantile paralysis, ii, 111, 205 Infection in operation, ii, 80 Inflammation, i, 104 ; ii, 53 Inflammatory rheumatism, ii, 197 Infusion, ii, 173 Inhaler, ii, 76 Inhibition, i, 120 Injection, hypodermatic, ii, 175 . Injection, see Bnemata Injuries to insane, ii, 153 Innervation, loss of, ii, 216 Inorganic food, i, 61 Insane acts, ii, 123 Insane, bones of, ii, in Insane, care of, ii, 145 Insane in household, ii, 137 Insane, sick-room for, ii, 138 Insane, strangulation of, ii, 98 Insanity, ii, 116 Insanity, causes of, ii, 114 Insanity, forms of, ii, 126 Insects, poisonous, ii, 92 Insolation, ii, 106 Insomnia, i, 134 Inspiration, i, 53 Intellectual disorder, ii, 121 Intelligence, i, 124 Intermediary haemorrhage, ii, 55 Intermittent fever, ii, 48, 193 Intermittent pulse, i, 208 Interrupted sutures, ii, 66 Instruments for massage, ii, 168 Instruments in gynecology, ii, 247 Instruments, sterilizing of, ii, 83 . Intestine, large, i, 97 Intestine, small, i, 93 Intoxication, ii, 104 Intubation, ii, 210 Intuition, i, 129 Involuntary muscles, i, 17 Inward fits, ii, 102 Iodine, ii, 90 Iodine, a rubefacient, ii, 8 GENERAL INDEX. Iris, i, 140 Iron, i, 61 Iron, how to give, ii, 178 Iron, preparations of, ii, 90 Irregular pulse, i, 208 Irrigating apparatus, ii. 67. Irrigation of wound, ii, 82 Irritant poisons, ii, 86, 89 Isolation of insane, ii, 150 Jacksonian epilepsy, ii, 134 Jail fever, ii, 193 Jaw, dislocation of, ii, 45 Jaw, fracture of, ii, 41 Jejunum, i, 94 Joints, i, 11, 14 Kidneys, i, 46 Kidneys, disease of, ii, 199 Kidneys, effect of cantharides on, ii, 9 Kidneys, excretion from, i, 222 Kite-tail tampon, ii, 250 Kleptomania, ii, 133 Kneading, ii, 167 Knee, bones of, i, 13 Knee-chest position, ii, 246 Knowing, ii, 116 Koumiss, i, 79 ; ii, 186 Labarraque’s solution, i, 181 ; ii, 228 Labor, beginning of, ii, 230 Labor, preparation for, ii, 227 Labor, see Confinement Labyrinth, i, 143 Lacerated wounds, ii, 64 Lachrymal gland, i, 141 Lactose, i, 77 Lamps, impurities from, i, 156 Larynx, i, 51 Laudanum, ii, 91 Lavage, ii, 185, 250 Lavements, ii, 13 Laxative enemata, ii, 15 Laxatives, ii, 178 Lead, ii, 90 Leather splints, ii, 38 Leeches, ii. 10 Leg, bandage for, ii, 31 Leg, fracture of, ii, 44 Legs, massage of, ii, 169 Leguminosa, i, 81 Lemonade, ii, 270 Leucocytes, i, 43 Ligaments, i, 15 Ligatures, ii, 59, 84 Light drinks, ii, 270 Light in sick-room, i, 193 Light for sick, ii, 215 Lightning stroke, ii, 107 Lime, as poison, ii, 89 Lime-water in milk, ii, 274 Liniments, ii, 174 Linseed-meal poultices, ii, 201 Lips, color of, i, 209 Liver, i, 95 Liver, massage of, ii, 170 Lobar pneumonia, ii, 202 Lobes of brain, i, 110 Local anaesthesia, ii, 77 Local baths, ii, 161 Local paralysis, ii, 109 Lochia, ii, 237 Lock-jaw germ, i, 174 Locomotor ataxia, ii, no Loeffler bacillus, ii, 208 Lower extremity, bones of, i, Lower extremity, muscles of, i, 21 Lozenges, ii, 174 Lucid insanity, ii, 133 Lungs, i, 48 Lungs, consumption of, ii, 203 Lungs, haemorrhage from, ii, 63 Lungs, inflammation of, ii, 202 Lye, as poison, ii, 89 Lying-in period, ii, 221 Lying-in room, ii, 227 Lymph, i, 44 Lysis, ii, 49 318 GENERAL INDEX. Malaria, ii, 193 Malarial air, i, 163 Malignant small-pox, ii, 195 Mania a potu, ii, 144 Mania, forms of, ii, 126 Maniacal, care of, ii, 138 Marrow, i, 4 Marshall Hall’s method, ii, 94, 97 Massage, ii, 163 Massage in insanity, ii, 142 Masseur, ii, 163 Masseuse, ii, 163 Matches, ii, 90 Mattress, hair, i, 198 Mattress, woven wire, i, 197 Mattress protector, i, 200 Measles, ii, 206 Measures, ii, 253 Measuring, ii, 180 Meals for the sick, ii, 186 Meat, infected, i, 68 Meat, poisonous, ii, 91 Meat, preparation, ii, 272 Mechanical feeding, ii, 182 Medicated baths, ii, 161 Medicated enemata, ii, 14 Medicine closet, ii, 179 Medicines, administration of, ii, 172 Medicines, introduction of, ii, 174 Medicines, table of, ii, 257 Medulla oblongata, i, 108, 111 Meibomian glands, i, 141 Melancholia, ii, 129 Melancbolics, care of, ii, 140 Membranous croup, ii, 209 Meninges, i, 113 Meningitis, acute, ii, 205 Meningitis, cerebro-spinal, ii, 205 Menstruation, ii, 221 Mensuration, i, 210 Mental faculties, ii, 116 Mental pains, ii, 142 Mercurial baths, ii, 161 Mercury, ii, 90 Metabolism, i, 46, 104 Metacarpus, i, 12 Metatarsus, i, 12 Metric system, ii, 254 Micrococci, i, 171 Micro-organisms, i, 171 Milk, i, 77 Milk baths, ii, 161 Milk in rectal feeding, ii, 18 Milk mixture, ii, 242 Milk of the mother, ii, 236 Milk preparation, ii, 274 Milk-sugar, i, 78 Mind cure, ii, 108 Mind, decay of, ii, 151 Mind, derangement of, ii, 116 Mind, direction of, ii, 149 Mind, location of, i, 123 Miscarriage, ii, 220 Mixtures, ii, 172 Modification of diet, i, 65 Moist heat, ii, 3 Moisture in air, i, 156 Molasses suppository, ii, 20 Mollities ossium, i, 4 Molluscs, i, 77 ; ii, 272 Monoplegia, ii, 109 Moral causes of insanity, ii, 120 Morning sickness, ii, 221 Morphia before anaesthesia, ii, 73 Morphine, ii, 91 Motility, disorders of, ii, 125 Motor nerve, i, 116 Mouldy flour, i, 71 Mouth, i, 84 Mouth, care of, ii, 216 Mouth, in children, ii, 211 Movements for massage, ii, 166 Mucin, i, 84 Mud baths, ii, 161 Muguet, ii, 211 Multiparae, ii, 235 Multiple neuritis, ii, 112 Multiple palsy, ii, 109 Mumps, i, 85 ; ii, 208 Muriatic acid, ii, 89 GENERAL INDEX. 319 Muscles, i, 17 Muscles, contractility of, ii, 217 Muscles, control of, ii, 109 Muscular excitement, ii, 121 Muscular sense, i, 22, 150 Mushrooms, ii, 92 Mustard foot-bath, ii, 160 Mustard poultices, ii, 7 Mutton, i, 75 Mutton broth, ii, 272 Myopia, i, 142 Mysophobia, ii, 1x5 Nails, i, 28 Nails, changes in, ii, 111 Narcosis, ii, 77 Nasal feeding, ii, 184 Nasal fossae, i, 7, 147 Natural ventilation, i, 161 Nausea in pregnancy, ii, 221 Nearsightedness, i, 142 Neck, muscles of, i, 21 Nerves, i, 106, 115 Nerves, inflammation of, ii, 112 Nervous diseases, ii, 112 Nervous exhaustion, ii, 112 Nervous invalids, ii, 132 Nervous system, i, 106 Neuralgia, ii, 114 Neurasthenia, ii, 113 Neuritis, i, 149 ; ii, 1x2 Neurotic poison, ii, 86, 89 Nicotine, ii, 91 Nipples, artificial, ii, 243 Nipples in childbirth, ii, 236 Nitric acid, ii, 89 Nitric-acid test, ii, 200 Nitrogen in air, i, 152 Nitrogenous foods, i, 60 Nose, i, 147 Nose-bleed, ii, 62 Nose, foreign bodies in, ii, 100 Nose, fracture of, ii, 41 Nurse, care of self, i, 190 Nursing of critical cases, ii, 216 Nurse in parturition, ii, 228 Nursing the insane, ii, 137, 145 Nursing of children, ii, 212 Nutrition, i, 101 Nutrition in massage, ii, 163 Nutrition of insane, ii, 150 Nutritive enemata, ii, 17 Nux vomica, ii, 91 Oatmeal, ii, 275 Obscenity, acts of, ii, 124 Objective sensations, i, 127 Objective symptoms, i, 206 Observation of insane, ii, 145 Observation of symptoms, i, 205 ; ii, 138 Obstetrics, chloroform in, ii, 77 Occupation of insane, ii, 149 Odor institutional, i., 169 Odors, to destroy, i, 177 Oesophagus, i, 87 Oils, i, 61 Oils, how taken, ii, 178 Ointments, ii, 174 Oleates, ii, 174 Olecranon, i, 11 Olfaction, i, 147 Olive oil, ii, 15 Omelet, ii, 274 Oniomania, ii, 133 Operating table, ii, 81 Operation, preparation for, ii, 73, 80 Ophthalmia neonatorum, ii, 210 Opisthotonus, ii, 205 Opium, a poison, ii, 91, 104 Orbit, i, 7, 143 Organic paralysis, ii, 108 Oscalcis, i, 13 Osinnominata, i, 14 Osmosis, i, 41 Otitis media, ii, 207 Ovens for disinfecting, i, 178 Overall for operation, ii, 79 Over-eating, ii, 102 Ovum, ii, 220 Oyster broth, ii, 272 Oysters, i, 76 320 GENERAL INDEX. Oyster stew, ii, 273 Oxalic acid, ii, 89 Ox-gall enemata, ii, 15 Oxygen in air, i, 152 Ozone, i, 154 Packing, ii, 158 Pain, abolishing of, i, 150 Pain as a symptom, i, 207 Pain in insomnia, i, 135 Pain, sense of, i, 150 Palpitation, ii, 114 Palsy, see Paralysis Panada, ii, 270 Pancreas, i, 95 Pancreatic juice, i, 95 Papillae, i, 26 Paralysis, ii, 108 Paralysis, infantile, ii, 205 Paranoia, ii, 132 Paraplegia, ii, 109 Paregoric, ii, 91 Paresis, ii, 134 Paris green, ii, 89 Parotid gland, i, 85 Parotitis, ii, 208 Paroxysmal mania, ii, 129 Parturition, ii, 220, 227, 232 Passive movements, ii, 170 Pasteboard splint, ii, 37 Pasteurization, ii, 243 Patella, i, 14 Pathogenic germ, i, 171 Pea-soup stools, ii, 191 Pelvic organ, ii, 245 Pelvis bones, i, 14 Pelvis, fracture of, ii, 42 Pepsin, i, 91 Pepsin in enemata, ii, 18 Peptinized beef-tea, ii, 271 Peptinizing milk, ii, 244 Perception, i, 129 Percussion, i, 210; ii, 167 Perforating ulcer, ii, hi Pericardium, i, 36 Periodical mania, ii, 129 Periosteum, i, I Peristalsis, i, 89, 93; ii, 14 Peritonitis, ii, 198 Permanganate of potash, i, 181 Pernicious fever, ii, 194 Persecution, delusions of, ii, 122 Persecution, insanity of, ii, 132 Perspiration, i, 47 Pertussis, ii, 208 Pessaries, ii, 249 Petrissage, ii, 167 Peyer’s glands, i, 94 Phagycytosis, i, 176 Phalanges, i, 12 Pharynx, abscess of, ii, 98 Phosphate of lime, i, 61 Phosphide of zinc, ii, 90 Phosphorus, ii, 90 Phthisis, ii, 203 Physical basis, delusions with, ii, 123 Physical causes, ii, 120 Physical exercise, ii, 170 Physical insomnia, i, 134 Physiognomy, i, 212 Pia mater, i, 113 Pickles, i, 72 Pigment, i, 28 Pillows, i, 200 Pills, ii, 174 Piston syringe, ii, 19 Pitch plaster, ii, 8 Placebo, ii, 180 Placenta, ii, 225 Placenta, expulsion of, ii, 234 Plasma, i, 42 Plasters, ii, 174 Plaster of Paris bandage, ii, 22, 34 Pleurae, i, 52 Pleurisy, ii, 202 Pneumonia, ii, 202 Pneumonia after burns, ii, 70 Pneumonia bacillus, i, 173 Pneumogastric, i, 122 Pneumothorax, ii, 202 Poison, delusions of, ii, 123 Poisoned wounds, ii, 65 GENERAL INDEX. 321 Poisoning, vertigo in, ii, no Poison oak, ii, 90 Poisonous medicines, ii, 178 Poisons, ii, 86 Poisons, how kept, ii, 179 Poisons with antidotes, ii, 88 Poison vines, ii, 90 Pork, i, 75 Position in anaesthesia, ii, 74 Position in gynaecology, ii, 246 Posset, ii, 275 Post-partum haemorrhage, ii, 234 Posture in massage, ii, 164 Potash, a poison, ii, 89 Potatoes, 1, 81 Potential energy, i, 104 Pott’s bandage, ii, 32 Pott’s fracture, ii, 44 Poultices, ii, 1 Poultry, i, 75 Powder burns, ii, 70 Powders, ii, 174 Pregnancy, duration of, ii, 222 Pregnancy, signs of, ii, 219, 221 Premature delivery, ii, 220 Preservation of food, i, 72, 76 Pressure, ii, 167 Primary haemorrhage, ii, 55 Prop for bed, ii, 215 Propulsion of air, i, 168 Protective, ii, 66, 84 Prussic acid, ii, 89 Psychical, i, 123 Psychical insomnia, i, 134 Ptomaines, ii, 92 Ptyalism, i, 85 Puerperal convulsions, ii, 101 Puerperal fever, ii, 227 Puerperal insanity, ii, 143 Puerperal period, ii, 221 Puerperal peritonitis, ii, 198 Pulmonary tuberculosis, ii, 203 Pulse, i, 38 Pulse after bathing, ii, 157 Pulse, how to feel, i, 208 Pulse in insanity, ii, 151 Pulse, to record, i, 218 Punch, ii, 274 Punctation, ii, 167 Punctured wounds, ii, 64 Pulley, ii, 168 Pupils, i, 140, 151 Pupils in brain disease, ii, 104 Purgative enema, ii, 15 Purgatives, ii, 178 Purulent eyes, ii, 210 Pus, i, 173 Pus, absorption of, ii, 197 Putrefaction, ii, 217 Putrid sore throat, ii, 208 Pylorus, i, 87 Pyaemia, ii, 197 Pyothorax, ii, 202, Pyromania, ii, 133 Questions, not to ask, i, 193 Quickening, ii, 212 Rabies, ii, 93 Rachitis, see Rickets Radial pulse, i, 208 Radiation, for warming, i, 208 Radius, i, 12 Rain bath, ii, 162 Rales, i, 209 Rapid eating, i, 86 Rash, in measles, ii, 206 Reading in bed, ii, 215 Reading rest, i, 192 Reasoning mania, ii, 133 Reaumur scale, ii, 253 Receiving the insane, ii, 148 Recovery from disease, ii, 214 Recovery from insanity, ii, 128 Rectal alimentation, ii, 17,140 Rectal paralysis, ii, 111 Rectum, i, 98 Recurrent bandage, ii, 21 Recurrent mania, ii, 129 Reflex action, i, 119 Reflex disorders, ii 116 Refraction, i, 141 Refrigerator, temporary, ii, 186 322 GENERAL INDEX. Refusal of food, ii, 140 Remittent fever, ii, 48, 193 Respiration, i, 48, 155, 209 Respiration, artificial, ii, 93 Respiration in anaesthesia, ii, 76 Respiration, qualities of, i, 209 Respiration, taking of, i, 209 Respiratory sense, i, 55 Rest cure, ii, 114 Restraint of insane, ii, 140 Resuscitation in narcosis, ii, 74 Retarded pulse, i, 209 Retina, i, 139 Rheumatic diathesis, ii, 179 Rheumatic fever, ii, 197 Rheumatism, ii, 197 Rhubarb-water, ii, 270 Ribs, i, 9 Ribs, fracture of, ii, 42, 71 Rice milk, ii, 274 Rice water, ii, 270 Rickets, ii, 204 Rigor mortis, ii, 217 Rigors, ii, 51 Rolando, fissure of, i, no Roots, i, 12, 81 Rose, ii, 196 Rose rash, ii, 191 Rotation, ii, 168 Rotheln, ii, 206 Roulette, ii, 168 Rubber bandages, ii, 33 Rubber hot-water bags, ii, 3 Rubber nipples, ii, 243 Rubber sheets, i, 201 ; ii, 229 Rubefacients, ii, 7 Rubeola, ii, 206 Rugae of stomach, i, 94 Russian baths, ii, 162 Sacrum, i, 8 Sago milk, ii, 274 Saliva, i, 85 Salt-bags, ii, 3 Santonin, ii, 90 Sausage poisoning, i, 71 Sawdust dressings, ii, 84 Sawing, ii, 167 Scabs, ii, 65 Scalds, ii, 68 Scalp, i, 30 Scapula, i, 10 Scapula, fracture of, ii, 43 Scarf-skin, see Epidermis Scarificator, ii, 11 Scarlatina, see Scarlet fever Scarlet fever, ii, 207 Sciage, ii, 167 Screens, i, 179 Scultetus bandage, ii, 32 Sebaceous glands, i, 27 Seclusion, ii, 150 Secondary haemorrhage, ii, 55 Secousses, ii, 168 Secundines, ii, 231 Self-consciousness, i, 129 Semicircular canals, i, 143 Senile insanity, ii, 142 Sensation, i, 127 Sensation, loss of, ii, 104 Sensibility, disorders of, ii, 123 Sensory nerve, i, 115 Sensory organs, i, 138 Sensory paralysis, ii, hi Sensory symptoms, ii, 112 Septicaemia, ii, 197 Serum of blood, i, 43 Sewer gas, i, 155 Sexual neurasthenia, ii, 113 Shaking, ii, 168 Sheets, i, 200 Shell-fish, i, 76; ii, 90 Sherbet, ii, 270 Ship fever, ii, 193 Shock, ii, 69 Shock, enemata in, ii, 19 Shoulder, dislocation of, ii, 45 Show, ii, 230 Shower bath, ii, 162 Sick-room, i, 189 Sick-room for insane, ii, 138 Sick-room ventilation, i, 169 Sight, i, 140 GENERAL INDEX. 323 Sight, hallucinations of, ii, 122 Sigmoid flexure, i, 98 Silk for sutures, ii, 84 Silk sutures, ii, 66 Silk-worm gut, ii, 84 Simple bath, ii, 154 Simple enema, ii, 14 Sim’s position, ii, 246 Siphon irrigation, ii, 83 Sitz bath, ii, 160 Skin, i, 25 Skin, bathing for, ii, 161 Skin, color of, i, 213 Skin, disease of, ii, in Skin, eruption on, ii, 206 Skin in pregnancy, ii, 223 Skin of infants, ii, 241 Skin, scraping of, ii, 168 Skull, i, 5 ; ii, 42 Sleep, i, 131 Sleep chart, i, 216 Sleep, disordered, ii, 124 Sleeplessness, i, 134, 136 Sleep of infants, ii, 241 Sleep-walking, see Somnam- bulism Slings, ii, 36 Smallpox, ii, 195 Smell, hallucinations of, ii, 122 Smell, sense of, i, 145 Smoking to preserve food, i, 73 Snake bites, ii, 92 Sneezing, i, 148 Snoring, i, 55 Soapsuds enema, ii, 14 Soap suppositories, ii, 20, 212 Soda as poison, ii, 89 Sodium chloride, i, 61 Solution, hypodermatic, ii, 175 Somnambulism, i, 129 Sordes, ii, 191 Sore nipples, ii, 236 Sound, organ for, i, 143 Sounds in sick-room, i, 192 Spanking, ii, 167 Spasm as a symptom, i, 223 Spasmodic croup, ii, 209 Special cases, ii, 188 Special senses, i, 138 Special senses, disorder of, ii, 124 Speculum, use of, ii, 246, 248 Speech, i, 130 Speech, embarrassment of, ii, :35 Speech, incoherent, ii, 127 Speech of insane, ii, 149 Spica bandage, ii, 21 Spice poultices, ii, 7 Spider massage, ii, 169 Spinal apoplexy, ii, 109 Spinal cord, i, 114 Spinal cord, inflammation of, ii, 205 Spinal cord lesions, ii, 111 Spinal irritation, ii, 112 Spinal nerves, i, 121 Spinal neurasthenia, ii, 113 Spine, i, 8 Spiral bandage, ii, 21 Spirillse, i, 171 Spleen massage, ii, 170 Splenic flexure, i, 98 Splints, ii, 37 Sponge hath, ii, 154 Sponges, how to use, ii, 85 Sponges, to bleach, ii, 83 Spores, i, 171 Spotted fever, ii, 205 Sprains, i, 16 ; ii, 46 Sprue, ii, 211 Sputum in infectious disease, i, 183, 186 Sputum in pneumonia, ii, 202 Squills, syrup of, ii, 89 St. Anthony’s fire, ii, 196 Starch, i, 60 Starch, bandage, ii, 35 Starch baths, ii, 161 Starch for poultices, ii, 2 Starvation, disease of, ii, 193 Stasis, ii, 53 324 GENERAL INDEX. Steam baths, ii, 161 Steam for warming, i, 166 Sterilization, i, 183 Sterilization of instruments, ii.83 Sterilized milk, ii, 242 Sterilizing for parturition, ii, 228 Sternum, i, 9 Stertorous breathing, i, 221 ; ii, 104 Stethoscope, i, 54 Stews, ii, 273 Stimulant enemata, ii, 19 Stimulants in insanity, ii, 140 Stings, poisonous, ii, 92 Stomach, i, 87 Stomach, inflammation of, ii, 201 Stomach in poisons, ii, 88 Stomach tube, ii, 184 Stomach washing, ii, 185 Stools in typhoid, ii, 191 Stoves, dangers from, i, 168 Strangulation, ii, 94, 97 Strangury, ii, 9 Straw beds, i, 199 Striae in gestation, ii, 224 Strigil, ii, 168 Stroking, ii, 166 Strychnine, action of, i, 120 Strychnine, as a poison, ii, 86, 9i Stupes, ii, 2 Styptics, ii, 59 Subcutaneous medication, ii, 175 Subjective sensation, i, 127 Subjective symptoms, i, 206 Sublingual glands, i, 85 Submaxillary glands, i, 85 Subnormal temperature, ii, 50 Sudoriparous, see Sweat Suffocation, i, 55 Sugar in urine, ii, 201 Sugar of lead, ii, 90 Sugars, i, 60 Suicidal, care of, ii, 138 Suicide, ii, 141 Suicide, impulse to, ii, 133 Suicide in hospital, ii, 151 Sulphur baths, ii, 161 Sulci, i, 108 Sulphuric acid, ii, 89 Sulphurous acid, i, 180 Suu baths, ii, 161 Sunstroke, ii, 106 Superficial muscles, i, 19 Suppositories, ii, 19, 174, 212 Suppuration, i, 172 ; ii, 54 Surgical cleanliness, ii, 80, 251 Surgical nursing, ii, 79 Surprise bath, ii, 162 Sutures, ii, 66 Sweat, i, 27, 47 Sweating in fever, ii, 194 Swedish movements, ii, 163, 170 Sweeping, best way of, i, 184 Sweet-breads, i, 75 Sylvester’s method, ii, 94 Symbols, ii, 256 Sympathetic system, i, 106, i*7 Symptoms, observation of, i, 205 Symptoms of insanity, ii, 120 Syncope, ii, 102, 105 Synovial membrane, i, 15 Syringes, ii, 14 Syringe, hypodermatic, ii, 175 Syrup, ii, 173 Systole, i, 38 Tabes dorsalis, ii, no Table for sick-room, i, 195 Tablets, ii, 174 Tablet triturate, ii, 174 Taction, i, 149 Tamarind water, ii, 270 Tampons, ii, 249 Tape-worm, i, 69 Tapioca, ii, 275 Tapotement, ii, 167 Tarsus, i, 13 Tartar emetic, ii, 89 GENERAL INDEX. 325 Tartaric acid, ii, 89 Taste, i, 145 Taste, hallucination of, ii, 122 Tea, i, 82 ; ii, 276 Teeth, i, 31 Teeth, condition of, i, 223 Teething, ii, 212 Teething in convulsions, ii, 109 Temperature, alcohol on, i, 63 Temperature after operation, ii, 35 Temperature as a symptom, i, 211 Temperature chart, i, 219 Temperature for massage, ii, 166 Temperature in health, i, 102 Temperature in mania, ii, 104 Temperature, mode of taking, i, 211 Temperature of bath, ii, 154 Temperature of room for an operation, ii, 81 Temperature of sick-room, ii, 216 Temperature of wards, ii, 150 Temperature, subnormal, ii, 50 Tendo Achilles, i, 23 Tendons, i, 17, 18 Tension of pulse, i, 220 Tepid bath, ii, 154 Termination of mania, ii, 129 Test for albumen, ii, 200 Tetanus, i, 174 Thein, i, 82 Theobromin, i, 81 Thermic fever, ii, 106 Thermometer, clinical, i, 103 Thermometer in sick-room, i, 163 Thermometer, register of, i, 211 Thermometer scale, ii, 253 Thermometer, test of, i, 211 Thigh bone, see Femur Thigh, fracture of, ii, 43 Thirst, i, 58 Thomsen’s disease, ii, 109 Thoracic respiration, i, 209 Thorax, i, 9 Thought echo, ii, 122 Throat in scarlatina, ii, 207 Throat, putrid sore, ii, 208 Thrombus, i, 44 Thrombus in brain, ii, 108 Thrush, ii, 211 Tibia, i, 13 Tin, ii, 90 Tinctures, ii, 172 Toast water, ii, 270 Tobacco, ii, 91 Toe bone, i, 13 Toleration of drugs, ii, 179 Tongue, i, 86 Tongue, condition of, i, 213 Tongue, indications of, ii, 140 Tonic spasm, i, 223 Tonsils, abscess of, ii, 98 Touch, see Taction Tourniquet, ii, 58 Trachea, i, 50 Trachea, obstruction of, ii, 98 Tracheotomy, ii, 210 Traction, ii, 168 Traumatic erysipelas, ii, 196 Traumatic peritonitis, ii, 189 Treatment of fever, ii, 53 Treatment of haemorrhage, ii, 57 Tremor as a symptom, i, 223 Trichiniasis, i, 68 Tripe, i, 75 Triturates, ii, 174 Troches, ii, 174 Trophic functions, i, 118 Trophic lesions, ii, no Trommer’s test, ii, 201 True croup, ii, 209 Trunk bandage, ii, 26 Trunk, muscles of, i, 21 Truthfulness, i, 205 Tube feeding, ii, 183 Tubercle bacilli, i, 173, 178 Tuberculosis, ii, 203 Tuberculosis, cause of, i, 70 326 GENERAL INDEX. Tuberculosis dysentery, ii, 198 Tuberculosis, heredity of, i, 174 Turkish baths, ii, 162 Turpentine enema, ii, 17 Turpentine stupe, ii, 3 Twisting, ii, 168 Tympanum, i, 142 Typhoid fever, ii, 188 Typhoid-fever bacillus, i, 173 Typhus fever, ii, 193 Ulna, i, 11 Umbilical cord, ii, 225, 229 Unconscious cerebration, i, J34 Unconsciousness, ii, 104 Upper extremity,bones of, i, 12 Upper extremity, muscles of, i, 21 Uraemia, ii, 105, 223 Uraemic convulsions, ii, 101 Ureters, i, 46 Urethra, i, 46 Urine, i, 46 Urine after operation, ii, 85 Urine as a symptom, i, 222 Urine, examination of, ii, 199 Urine in anaesthesia, ii, 73 Urine in insanity, ii, 139, 152 Urine, retention of, ii, hi Urinometer, i, 222 Utensils for medicine, ii, 180 Uterine support, ii, 249 Uterus after labor, ii, 233 Vaccination, ii, 195 Vaginal douche, ii, 246 Vapor baths, ii, 161 Vapor in the air, i, 153 Varicella, ii, 207 Variola, ii, 195 Varioloid, ii, 196 Vaso-motor nerves, i, 118 Veal, i, 75 Vegetable foods, i, 71, 80 Vegetables, exhalation from, i, 162 Vegetarianism, i, 66 Veins, i, 40 Venesection, ii, 12 Venous blood, i, 40 Venous haemorrhage, ii, 55 Ventilating beds, L, 203 Ventilation, i, 158 Ventilation, artificial, i, 159 Ventilation, forced, i, 159 Ventilation, natural, i, 159 Ventilation of wards, ii, 150 Ventricles, see Heart Verdigris, ii, 89 Vermilion, ii, 90 Vermin, body, ii, 149 Vertebrae, i, 8 Vertebrae, fracture of, ii, 42 Vertigo, ii, 105, no Vesicant, ii, 8 Vesicle, see Eruption Vibration, ii, 167 Villi, i, 94 Visceral neurasthenia, ii, 113 Vision, i, 141 Visits to sick, ii, 215 Vitreous humor, i, 140 Vitriol, ii, 88, 90 Vocal chords, i, 51 Volition, ii, 116 Volition, see Will Volitional insanity, ii, 133, 254 Volitional tremor, i, 223 Voluntary muscles, i, 17 Vomiting, i, 92 Vomiting after feeding, ii, 185 Vomiting in anaesthesia, ii, 73, 85 . Vomiting in pregnancy, ii, 221 Vulvar dressing, ii, 234 Wafers, ii, 177 Wagner, corpuscles of, i, 149 Wail covering, i, 194 Ward, medicines on, ii, 179 Warm bath, ii, 154 Warming houses, i, 164 Water, i, 62 Water in air, i, 153 GENERAL INDEX. 327 Water in the head, ii, 204 Water mattresses, i, 204 Water, prepared, ii, 270 Weaning, ii, 236 Weight chart, i, 219 Weight of air, i, 156 Weight of insane, ii, 148 Weights, ii, 253 White lead, ii, 90 White vitriol, ii, 90 Whooping cough, ii, 208 . Will, i, 129 Willing, ii, 116 Windpipe, i, 50 Wine, medicinal, ii, 173 Wine of antimony, ii, 89 Wines, i, 64 Wine whey, ii, 275 Word blindness, i, 130 Worm medicine, ii, 90 Worms, enema for, ii, 17 Wounds, ii, 64 Wounds, irrigation of, ii, 67 Wounds, treatment of, ii, 67 Wrist, bandage for, ii, 29 Yeast poultices, ii, 2 Zinc chloride, i, 184 Zinc oxide on blisters, ii, 9 Zinc, phosphide of, ii, 90 U fteyMSoofc for XTrainino Schools for IRurses. By P. M. Wise, M.D., President of the New York State Lunacy Commission ; Medical Superintendent St. Law- rence State Hospital; Editor of the State Hospitals Bulletin ; Professor of Psychiatry, University of Ver- mont ; Member of the American Medico-Psychological Association, etc. With an introduction by Dr. Edward Cowles, Physician-in-Chief and Superintendent McLean Hospital. Two volumes, i6°, illustrated, sold separately, each . . . . . . . . $1-25 This work will, it is believed, supply a present need for training schools. It is distinctly a text-book for training schools as distin- guished from a text-book for nurses, and its arrangement provides for all the recitations in a two years’ course. The first volume is divided into thirty recitations or chapters, and includes anatomy, physiology, hygiene (and allied subjects—the atmosphere, ventila- tion, etc.), the sick-room, infection and disinfection, observation of symptoms, clinical recording, etc. Its arrangement is based upon a graded system of teaching; the first volume being adapted for the first year’s course. The second volume completes the course and provides for every subject usually taught by recitation in schools for nurses, leaving no requirement for auxiliary books. In fact the two volumes furnish completely all the requirements of the training school for a text-book. A voluminous appendix gives a table of medicines with their doses, action, etc. ; tables of weights and measures ; a complete glossary of technical terms, etc., which will make the work a valuable book of reference for the nurse. This text-book has been adopted by the ten State Hospitals of New York, representing approximately four hundred pupils. Dr. G. Alder Blumer (the medical superintendent of the Utica State Hospital) says: “It is an admirable piece of work. It is written very clearly, and in language which can be very readily understood by the nurse. It covers the whole ground, and contains a great deal of matter not to be found in other books, and with the adoption of this book other text-books will not be required for the training school.” G. P. PUTNAM’S SONS, New York and London flXateria 3XXcdtca A Text=Book of Materia Medica for Nurses. Compiled by Lavinia L. Dock, graduate of Belle- vue Training School for Nurses, late superintendent of nurses, Illinois Training School for Nurses, etc. Second edition, revised and enlarged. Seventh thousand. 120 ..... $1-25 “ The work is interesting, valuable, and worthy a position in any library.”—JV. Y. Medical Record. “ It is written very concisely, and little can be found in it to criticise unfavorably, except the inevitable danger that the student will imagine after reading it that the whole subject has been mastered. The subject of therapeutics has been omitted as not a part of a nurse’s study, and this omission is highly to be commended. It will prove a valuable book for the purpose for which it is intended.”—N. Y. Medical Journal. An Aid to Materia Medica. By Robert H. M. Dawbarn, M.D., Professor of Operative Surgery and Surgical Anatomy, New York Polyclinic. Third edition, revised and enlarged by Woolsey Hopkins, M.D. 12° ... $1.00 G. P. PUTNAM’S SONS NEW YORK AND LONDON