XXVI.

CARE OF THE SICK.

It is interesting to notice in the histories of our Lord the prominent place given to the care of the sick. When he first sent out the apostles, it was to heal the sick as well as to preach. Again, when, he sent out the seventy, their first command was to "heal the sick," and next to say, "the kingdom of God has come nigh unto you." The body was to be healed first, in order to attend to the kingdom of God, even when it was "brought nigh."

Jesus Christ spent more time and labor in the cure of men's bodies than in preaching, even, if we subtract those labors with his earthly father by which family homes were provided. When he ascended to the heavens, his last recorded, words to his followers, as given by Mark, were, that his disciples should "lay hands on the sick," that they might recover. Still more directly is the duty of care for the sick exhibited in the solemn allegorical description of the last day. It was those who visited the sick that were the blessed; it was those who did not visit the sick who were told to "depart." Thus are we abundantly taught that one of the most sacred duties of the Christian family is the training of its inmates to care and land attention to the sick.

Every woman who has the care of young children, or of a large family, is frequently called upon to advise what shall be done for some one who is indisposed; and often, in circumstances where she must trust solely to her own judgment. In such cases, some err by neglecting to do any thing at all, till the patient is quite sick; but a still greater number err from excessive and injurious dosing.

The two great causes of the ordinary slight attacks of illness in a family, are, sudden chills, which close the pores of the skin, and thus affect the throat, lungs, or bowels; and the excessive or improper use of food. In most cases of illness from the first cause, bathing the feet, and some aperient drink to induce perspiration, are suitable remedies.

In case of illness from improper food, or excess in eating, fasting for one or two meals, to give the system time and chance to relieve itself, is the safest remedy. Some-times, a gentle cathartic of castor-oil may be needful; but it is best first to try fasting. A safe relief from injurious articles in the stomach is an emetic of warm water; but to be effective, several tumblerfuls must be given in quick succession, and till the stomach can receive no more.

The following extract from a discourse of Dr. Burne, before the London Medical Society, contains important, information: "In civilized life, the causes which are most generally and continually operating in the production of diseases are, affections of the mind, improper diet, and retention of the intestinal excretions. The undue retention of excrementitious matter allows of the absorption of its more liquid parts, which is a cause of great impurity to the blood, and the excretions, thus rendered hard and knotty, act more or less as extraneous substances, and, by their irritation, produce a determination of blood to the intestines and to the neighboring viscera, which ultimately ends in inflammation. It also has a great effect on the whole system; causes a determination of blood to the head, which oppresses the brain, and dejects the mind; deranges the functions of the stomach; causes flatulency; and produces a general state of discomfort."

Dr. Combe remarks on this subject: "In the natural and healthy state, under a proper system of diet, and with sufficient exercise, the bowels are relieved regularly, once every day." _Habit_ "is powerful in modifying the result, and in sustaining healthy action when once fairly established. Hence the obvious advantage of observing as much regularity in relieving the system, as in taking our meals." It is often the ease that soliciting nature at a regular period, once a day, will remedy constipation without medicine, and induce a regular and healthy state of the bowels. "When, however, as most frequently happens, the constipation arises from the absence of all assistance from the abdominal and respiratory muscles, the first step to be taken is, again to solicit their aid; first, by removing all impediments to free respiration, such as stays, waistbands, and belts; secondly, by resorting to such active exercise as shall call the muscles into full and regular action; [Footnote: The most effective mode of exercising the abdominal and respiratory muscles, in order to remedy constipation, is by a continuous alternate contraction of the muscles of the abdomen, and diaphragm. By contracting the muscles of the abdomen, the intestines axe pressed inward and upward, and then the muscles of the diaphragm above contract and press them downward and outward. Thus the blood is drawn to the torpid parts to stimulate to the healthful action, while the agitation moves their contents downward. An invalid can thus exercise the abdominal muscles in bed. The proper time is just after a meal. This exercise, continued ten minutes a day, including short intervals of rest, and persevered in for a week or two, will cure most ordinary cases of constipation, provided proper food is taken. Coarse bread and fruit are needed for this purpose in most cases.] and lastly, by proportioning the quantity of food to the wants of the system, and the condition of the digestive organs.

"If we employ these means, systematically and perseveringly, we shall rarely fail in at last restoring the healthy action of the bowels, with little aid from medicine. But if we neglect these modes, we may go on for years, adding pill to pill, and dose to dose, without ever attaining the end at which we aim."

"There is no point in which a woman needs more knowledge and discretion than in administering remedies for what seem slight attacks, which are not supposed to require the attention of a physician. It is little realized that purgative drugs are unnatural modes of stimulating the internal organs, tending to exhaust them of their secretions, and to debilitate and disturb the animal economy. For this reason, they should be used as little as possible; and fasting, and perspiration, and the other methods pointed out, should always be first resorted to."

When medicine must be given, it should be borne in mind that there are various classes of purgatives, which produce very diverse effects. Some, like salts, operate to thin the blood, and reduce the system; others are stimulating; and others have a peculiar operation on certain organs. Of course, great discrimination and knowledge are needed, in order to select the kind which is suitable to the particular disease, or to the particular constitution of the invalid. This shows the folly of using the many kinds of pills, and other quack medicines, where no knowledge can be had of their composition. Pills which are good for one kind of disease, might operate as poison in another state of the system.

It is very common in cases of colds, which affect the lungs or throat, to continue to try one dose after another for relief. It will be well to hear in mind at such times, that all which goes into the stomach must be first absorbed into the blood before it can reach the diseased part; and that there is some danger of injuring the stomach, or other parts of the system, by such a variety of doses, many of which, it is probable, will be directly contradictory in their nature, and thus neutralize any supposed benefit they might separately impart.

When a cold affects the head and eyes, and also impedes breathing through the nose, great relief is gained by a wet napkin spread over the upper part of the face, covering the nose except an opening for breath. This is to be covered by folds of flannel fastened over the napkin with a handkerchief. So also a wet towel over the throat and whole chest, covered with folds of flannel, often relieves oppressed lungs.

Ordinarily, a cold can be arrested on its first symptoms by coverings in bed and a bottle of hot water, securing free perspiration. Often, at its first appearance, it can be stopped by a spoonful or two of whisky, or any alcoholic liquor, in hot water, taken on going to bed. Warm covering to induce perspiration will assist the process. These simple remedies are safest. Perspiration should always be followed by a towel-bath.

It is very unwise to tempt the appetite of a person who is indisposed. The cessation of appetite is the warning of nature that the system is in such a state that food can not be digested. When food is to be given to one who has no desire for it, beef-tea is the best in most cases.

The following suggestions may be found useful in regard to nursing the sick. As nothing contributes more to the restoration of health than pure air, it should be a primary object to keep a sick-room well ventilated. At least twice in the twenty-four hours, the patient should be well covered, and fresh air freely admitted from out of doors. After this, if need be, the room should be restored to a proper temperature, by the aid of an open fire. Bedding and clothing should also be well aired, and frequently changed; as the exhalations from the body, in sickness, are peculiarly deleterious. Frequent ablutions of the whole body, if possible, are very useful; and for these, warm water may be employed, when cold water is disagreeable.

A sick-room should always be kept very neat and in perfect order; and all haste, noise, and bustle should be avoided. In order to secure neatness, order, and quiet, in case of long illness, the following arrangement should be made. Keep a large box for fuel, which will need to be filled only twice in twenty-four hours. Provide also and keep in the room or an adjacent closet, a small, tea-kettle, a saucepan, a pail of water for drinks and ablutions, a pitcher, a covered porringer, two pint bowls, two tumblers, two cups and saucers, two wine-glasses, two large and two small spoons; also a dish in which to wash these articles; a good supply of towels and a broom. Keep a slop-bucket near by to receive the wash of the room. Procuring all these articles at once, will save much noise and confusion.

Whenever medicine or food is given, spread a clean towel over the person or bed-clothing, and get a clean handkerchief, as nothing is more annoying to a weak stomach than the stickiness and soiling produced by medicine and food.

Keep the fire-place neat, and always wash all articles and put them in order as soon as they are out of use. A sick person has nothing to do but look about the room; and when every thing is neat and in order, a feeling of comfort is induced, while disorder, filth, and neglect are constant objects of annoyance which, if not complained of, are yet felt.

One very important particular in the case of those who are delicate in constitution, as well as in the case of the sick, is the preservation of warmth, especially in the hands and the feet. The _equal_ circulation of the blood is an important element for good health, and this is impossible when the extremities are habitually or frequently cold. It is owing to this fact that the coldness caused by wetting the feet is so injurious. In cases where disease or a weak constitution causes a feeble or imperfect circulation, great pains should be taken to dress the feet and hands warmly, especially around the wrists and ankles, where the blood-vessels are nearest to the surface and thus most exposed to cold. Warm elastic wristlets and anklets would save many a feeble person from increasing decay or disease.

When the circulation is feeble from debility or disease, the union of carbon and oxygen in the capillaries is slower than in health, and therefore care should be taken to preserve the heat thus generated by warm clothing and protection from cold draughts. In nervous debility, it is peculiarly important to preserve the animal heat, for its excessive loss especially affects weak nerves. Many an invalid is carelessly and habitually suffering cold feet, who would recover health by proper care to preserve animal heat, especially in the extremities.

The following are useful directions for dressing a blister. Spread thinly, on a linen cloth, an ointment composed of one third of beeswax to two thirds of tallow; lay this upon a linen cloth folded many times. With a sharp pair of scissors make an aperture in the lower part of the blister-bag, with a little hole above to give it vent. Break the raised skin as little as possible. Lay on the cloth spread as directed. The blister at first should be dressed as often as three times in a day, and the dressing renewed each time. Hot fomentations in most cases will be as good as a blister, less painful, and safer.

Always prepare food for the sick in the neatest and most careful manner. It is in sickness that the senses of smell and taste are most susceptible of annoyance; and often, little mistakes or negligences in preparing food will take away all appetite.

Food for the sick should be cooked on coals, that no smoke may have access to it; and great care must be taken to prevent, by stirring, any adherence to the bottom of the cooking vessel, as this always gives a disagreeable taste.

Keeping clean handkerchiefs and towels at hand, cooling the pillows, sponging the hands with water, (with care to dry them thoroughly,) swabbing the mouth with a clean linen rag on the end of a stick, are modes of increasing the comfort of the sick. Always throw a shawl over a sick person when raised up.

Be careful to understand a physician's directions, and _to obey them implicitly_. If it be supposed that any other person knows better about the case than the physician, dismiss the physician, and employ that person in his stead.

It is always best to consult the physician as to where medicines shall be purchased, and to show the articles to him before using them, as great impositions are practiced in selling old, useless, and adulterated drugs. Always put labels on vials of medicine, and keep them out of the reach of children.

Be careful to label all powders, and particularly all _white powders_, as many poisonous medicines in this form are easily mistaken for others which are harmless.

In nursing the sick, always speak gently and cheeringly; and, while you express sympathy for their pain and trials, stimulate them to bear sill with fortitude, and with resignation to the Heavenly Father who "doth not willingly afflict," and "who causeth all things to work together for good to them that love him." Offer to read the Bible or other devotional books, whenever it is suitable, and will not be deemed obtrusive.

Miss Ann Preston, one of the most refined as well as talented and learned female physicians, in a published article, gives valuable instruction as to the training, of nurses. She claims that every woman should be trained for this office, and that some who have special traits that fit them for it should make it their daily professional business. She remarks that the indispensable qualities in a good nurse are common sense, conscientiousness, and sympathetic benevolence: and thus continues:

"God himself made and commissioned one set of nurses; and in doing this and adapting them to utter helplessness and weakness, what did he do? He made them to love the dependence and to see something to admire in the very perversities of their charge. He made them to humor the caprices and regard both reasonable and unreasonable complainings. He made them to bend tenderly over the disturbed and irritated, and fold them to quiet assurance in arms made soft with love; in a word, he made _mothers!_ And, other things being equal, whoever has most maternal tenderness and warm sympathy with the sufferer is the best nurse." And it is those most nearly endowed by nature with these traits who should be selected to be trained for the sacred office of nurse to the sick, while, in all the moral training of womanhood, this ideal should be the aim.

Again, Miss Preston wisely suggests that "persons may be conscientious and benevolent and possess good judgment in many respects, and yet be miserable nurses of the sick for want of training and right knowledge.

"_Knowledge_, the assurance that one knows what to do, always gives _presence of mind_--and presence of mind is important not only in a sick-room but in every home. Who has not known consternation in a family when some one has fainted, or been burned, or cut, while none were present who knew how to stop the flowing blood, or revive the fainting, or apply the saving application to the burn? And yet knowledge and efficiency in such cases would save many a life, and be a most fitting and desirable accomplishment in every woman."

"We are slow to learn the mighty influence of common agencies, and the greatness of little things, in their bearing upon life and health. The woman who believes it takes no strength to bear a little noise or some disagreeable announcements, and loses patience with the weak, nervous invalid who is agonized with creaking doors or shoes, or loud, shrill voices, or rustling papers, or sharp, fidgety motions, or the whispering so common in sick-rooms and often so acutely distressing to the sufferer, will soon correct such misapprehensions by herself experiencing a nervous fever."

Here the writer would put in a plea for the increasing multitudes of nervous sufferers not confined to a sick-room, and yet exposed to all the varied sources of pain incident to an exhausted nervous system, which often cause more intolerable and also more wearing pain than other kinds of suffering.

"An exceeding acuteness of the senses is the result of many forms of nervous disease. A heavy breath, an unwashed hand, a noise that would not have been noticed in health, a crooked table-cover or bed-spread may disturb or oppress; and more than one invalid has spoken in my hearing of the sickening effect produced by the nurse tasting her food, or blowing in her drinks to make them cool. One woman, and a sensible woman too, told me her nurse had turned a large cushion upon her bureau with the back part in front. She determined not to be disturbed nor to speak of such a trifle, but after struggling _three hours_ in vain to banish the annoyance, she was forced to ask to have the cushion placed right."

In this place should be mentioned the suffering caused to persons of reduced nervous power not only by the smoke of tobacco, but by the fetid effluvium of it from the breath and clothing of persons who smoke. Many such are sickened in society and in car-traveling, and to a degree little imagined by those who gain a dangerous pleasure at the frequent expense of the feeble and suffering.

Miss Preston again remarks, "It is often exceedingly important to the very weak, who can take but very little nutriment, to have that little whenever they want it. I have known invalids sustain great injury and suffering; when exhausted for want of food, they have had to wait and wait, feeling as if every minute was an hour, while some well-fed nurse delayed its coming. Said a lady, 'It makes me hungry now to think of the meals she brought me upon that little waiter when I was sick, such brown thin toast, such good broiled beef, such fragrant tea, and every thing looking so exquisitely nice! If at any time I did not think of any thing I wanted, nor ask for food, she did not annoy me with questions, but brought some little delicacy at the proper time, and when it came, I could take it.'

"If there is one purpose of a personal kind for which it is especially desirable to lay up means, it is for being well nursed in sickness; yet in the present state of society, this is absolutely impossible, even to the wealthy, because of the scarcity of competent nurses. Families worn down with the long and extreme illness of a member require relief from one whose feelings will be less taxed, and who can better endure the labor.

"But alas! how often is it impossible, for love or money, to obtain one capable of taking the burden from the exhausted sister or mother or daughter, and how often in consequence they have died prematurely or struggled through weary years with a broken constitution. Appeal to those who have made the trial, and you will find that very seldom have they been able to have those who by nature or by training were competent for their duties. Ignorant, unscrupulous, inattentive--how often they disturb and injure the patient! A physician told me that one of his patients had died because the nurse, contrary to orders, had at a critical period washed her with cold water. I have known one who, by stealth, quieted a fretful child with laudanum, and of others who exhausted the sick by incessant talking. One lady said that when, to escape this distressing garrulity, she closed her eyes, the nurse exclaimed aloud, 'Why, she is going to sleep while I am talking to her.'

"A few only of the sensible, quiet, and loving women, whose presence everywhere is a blessing, have qualified themselves and followed nursing as a business. Heaven bless that few! What a sense of relief have I seen pervade a family when such a one has been procured; and what a treasure seemed found!

"There is very commonly an extreme susceptibility in the sick to the _moral atmosphere_ about them. They feel the healthful influence of the presence of a true-hearted attendant and repose in it, though they may not be able to define the cause; while dissimulation, falsehood, recklessness, coarseness, jar terribly and injuriously on their heightened sensibilities. 'Are the Sisters of Charity really better nurses than most other women?' I asked an intelligent lady who had seen much of our military hospitals. 'Yes, they are,' was her reply. 'Why should it be so?' 'I think it is because with them it is a work of self-abnegation, and of duty to God, and they are so quiet and self-forgetful in its exercise that they do it better, while many other women show such self-consciousness and are so fussy!"

Is there any reason why every Protestant woman should not be trained for this self-denying office as _a duty owed to God?_ We can not better close this chapter than by one more quotation from the same intelligent and attractive writer: "The good nurse is an artist. O the pillowy, soothing softness of her touch, the neatness of her simple, unrustling dress, the music of her assured yet gentle voice and tread, the sense of security and rest inspired by her kind and hopeful face, the promptness and attention to every want, the repose that like an atmosphere encircles her, the evidence of heavenly goodness, and love that she diffuses!" Is not such an art as this worth much to attain?

In training children to the Christian life, one very important opportunity occurs whenever sickness appears, in the family or neighborhood. The repression of disturbing noises, the speaking in tones of gentleness and sympathy, the small offices of service or nursing in which children can aid, should be inculcated as ministering to the Lord and Elder Brother of man, who has said, "Inasmuch as ye have done it unto one of the least of these my brethren, ye have done it to me."

One of the blessed opportunities for such ministries is given to children in the cultivation of flowers. The entrance into a sick-room of a smiling, healthful child, bringing an offering of flowers raised by its own labor, is like an angel of comfort and love, "and alike it blesseth him who gives and him who takes."

A time is coming when the visitation of the sick, as a part of the Christian life, will hold a higher consideration than is now generally accorded, especially in the cases of uninteresting sufferers who have nothing to attract kind attentions, except that they are suffering children of our Father in heaven, and "one of the least" of the brethren of Jesus Christ.

## CHAPTER XXVII.

ACCIDENTS AND ANTIDOTES.

Children should be taught the following modes of saving life, health and limbs in cases of sudden emergency, before a medical adviser can be summoned.

In case of a common cut, bind the lips of the wound together with a rag, and put on nothing else. If it is large, lay narrow strips of sticking-plaster obliquely across the wound. In some cases it is needful to draw a needle and thread through the lips of the wound, and tie the two sides together.

If an artery be cut, it must be tied as quickly as possible, or the person will soon bleed to death. The blood from an artery is a brighter red than that from the veins, and spirts out in jets at each beat of the heart. Take hold of the end of the artery and tie it or hold it tight till a surgeon comes. In this case, and in all cases of bad wounds that bleed much, tie a tight bandage near and above the wound, inserting a stick into the bandage and twisting as tight as can be borne, to stop the immediate effusion of blood.

Bathe bad bruises in hot water. Arnica water hastens a cure, but is injurious and weakening to the parts when used too long and too freely.

A sprain is relieved from the first pains by hot fomentations, or the application of very hot bandages, but entire rest is the chief permanent remedy. The more the limb is used, especially at first, the longer the time required for the small broken fibres to knit together. The sprained leg should be kept in a horizontal position. When a leg is broken, tie it to the other leg, to keep it still till a surgeon comes. Tie a broken arm to a piece of thin wood, to keep it still till set.

In the case of bad burns that take off the skin, creosote water is the best remedy. If this is not at hand, wood-soot (not coal) pounded, sifted, and mixed with lard is nearly as good, as such soot contains creosote. When a dressing is put on, do not remove it till a skin is formed under it. If nothing else is at hand for a bad burn, sprinkle flour over the place where the skin is off and then let it remain, protected by a bandage. The chief aim is to keep the part without skin from the air.

In case of drowning, the aim should be to clear the throat, mouth and nostrils, and then produce the natural action of the lungs in breathing as soon as possible, at the same time removing wet clothes and applying warmth and friction to the skin, especially the hands and feet, to start the circulation. The best mode of cleansing the throat and month of choking water is to lay the person on the face, and raise the head a little, clearing the mouth and nostrils with the finger, and then apply hartshorn or camphor to the nose. This is safer and surer than a common mode of lifting the body by the feet, or rolling on a barrel to empty out the water.

To start the action of the lungs, first lay the person on the face and press the back along the spine to expel all air from the lungs. Then turn the body nearly, but not quite over on to the back, thus opening the chest so that the air will rush in if the mouth is kept open. Then turn the body to the face again and expel the air, and then again nearly over on to the back; and so continue for a long time. Friction, dry and warm clothing, and warm applications should be used in connection with this process. This is a much better mode than using bellows, which sometimes will close the opening to the windpipe. The above is the mode recommended by Dr. Marshall Hall, and is approved by the best medical authorities.

Certain articles are often kept in the house for cooking or medical purposes, and sometimes by mistake are taken in quantities that are poisonous.

_Soda, saleratus, potash,_ or any other alkali can be rendered harmless in the stomach by vinegar, tomato-juice, or any other acid. If sulphuric or oxalic acid are taken, pounded chalk in water is the best antidote. If those are not at hand, strong soapsuds have been found effective. Large quantities of tepid water should be drank after these antidotes are taken, so as to produce vomiting.

_Lime_ or _baryta_ and its compounds demand a solution of glauber salts or of sulphuric acid.

_Iodine_ or _Iodide of Potassium_ demands large draughts of wheat flour or starch in water, and then vinegar and water. The stomach should then be emptied by vomiting with as much tepid water as the stomach can hold.

_Prussic acid_, a violent poison, is sometimes taken by children in eating the pits of stone fruits or bitter almonds which contain it. The antidote is to empty the stomach by an emetic, and give water of ammonia or chloric water. Affusions of cold water all over the body, followed by warm hand friction, is often a remedy alone, but the above should be added if at command. _Antimony_ and its compounds demand drinks of oak bark, or gall nuts, or very strong green tea.

_Arsenic_ demands oil or melted fat, with magnesia or lime water in large quantities, till vomiting occurs.

_Corrosive Sublimate_, (often used to kill vermin,) and any other form of mercury, requires milk or whites of eggs in large quantities. The whites of twelve eggs in two quarts of water, given in the largest possible draughts every three minutes till free vomiting occurs, is a good remedy. Flour and water will answer, though not so surely as the above. Warm water will help, if nothing else is in reach. The same remedy answers when any form of copper, or tin, or zinc poison is taken, and also for creosote.

_Lead_ and its compounds require a dilution of Epsom or Glauber salts, or some strong, acid drink, as lemon or tomatoes.

_Nitrate of Silver_ demands salt water drank till vomiting occurs.

_Phosphorus_ (sometimes taken by children from matches) needs magnesia and copious drinks of gum Arabic, or gum water of any sort.

_Alcohol_, in dangerous quantities, demands vomiting with warm water.

When one is violently sick from excessive use of _tobacco_, vomiting is a relief, if it arise spontaneously. After that, or in case it does not occur, the juice of a lemon and perfect rest, in a horizontal position on the back, will relieve the nausea and faintness, generally soothing the foolish and over-wrought patient into a sleep.

_Opium_ demands a quick emetic. The best is a heaping table-spoonful of powdered mustard, in a tumblerful of warm water; or powdered alum in half-ounce doses and strong coffee alternately in warm water. Give acid drinks after vomiting. If vomiting is not elicited thus, a stomach pump is demanded. Dash cold water on the head, apply friction, and use all means to keep the person awake and in motion.

_Strychnia_ demands also quick emetics.

The stomach should be emptied always after taking any of these antidotes, by a warm water emetic.

In case of bleeding at the lungs, or stomach, or throat, give a tea-spoonful of dry salt, and repeat it often. For bleeding at the nose, put ice, or pour cold water on the back of the neck, keeping the head elevated.

If a person be struck with lightning, throw pailfuls of cold water on the head and body, and apply mustard poultices on the stomach, with friction of the whole body and inflation of the lungs, as in the case of drowning. The same mode is to be used when persons are stupefied by fumes of coal, or bad air.

In thunderstorms, shut the doors and windows. The safest part of a room is its centre; and where there is a feather-bed in the apartment, that will be found the most secure resting-place.

A lightning-rod if it be well pointed, and run deep into the earth, is a certain protection to a circle, around it, whose diameter equals the height of the rod above the highest chimney. But it protects _no farther_ than this extent.

In case of fire, wrap about you a blanket, a shawl, a piece of carpet, or any other woolen cloth, to serve as protection. Never read in bed, lest you fall asleep, and the bed be set on fire. If your clothes get on fire, never run, but lie down, and roll about till you can reach a bed or carpet to wrap yourself in, and thus put out the fire. Keep young children in woolen dresses, to save them from the risk of fire.