In contagious diseases, and in blood-poisoning, thorough ventilation is imperatively required; for only when the poison of the disease is sufficiently diluted with atmospheric air, does it lose its power and become inoperative. The room should also be divested of all superfluous furniture carpets, bed-hangings, etc. The light from the windows should be subdued, noise shut out, and unnecessary talking forbidden.
2. The Bed. A spring mattress, or a frame, made of fine chainwork, with a horse-hair mattress over it, is the best kind of bed; it is sufficiently soft, and the heat may be regulated by the coverings. In a sanitary point of view, a feather-bed is most objectionable, for after being slept upon from year to year, even by a person in health, it becomes foul and impure. But if the body be diseased, especially if the disease be an infectious one, the feathers imbibe the poison, and may become the means of further dissemination. Feather-beds should be everywhere superseded by mattresses; or, at least, the feathers should be purified at regular intervals, and after every case of infectious disease. Feathers may be purified by exposing them to the highest degree of heat they will bear without scorching. Such instances as the following are far from uncommon: A severe and fatal case of Small-pox, Typhus, or Scarlet-Fever occurs in a family; and there properly arises a strong prejudice against the bed on which the patient died. The correct course would be to burn it; but too frequently it goes to the broker, who after, perhaps, renovating its exterior a little, sells the pest-laden bed to carry contagion, and perhaps death, to its future owners.
3. Cleanliness. The personal and bed linen, including the blankets, should be frequently changed, and all matters discharged from the body immediately removed. The patient’s body should be sponged over as completely as possible at suitable intervals with tepid or cold water, as may be most agreeable to his feelings, and quickly dried with a soft towel. Vinegar and water may now and then be substituted for simple water. Vinegar is often very grateful to fever patients. One part of dilute acetic acid to six parts of hot water makes an excellent lotion. It may be used thrice daily in fever, and is very refreshing if used in the morning, for patients in consumption. Rapid sponging of the whole surface of the body should never be omitted in fever; it reduces the excessive heat, soothes the uneasy sensations of the patient, and is indispensable in maintaining that cleanliness which is so desirable in the sick-room. Frequent washing with soap and water also tends to prevent the occurrence of bed-sores, by keeping the skin in a healthy condition. The mouth should be frequently wiped out with a soft wet towel, to remove the sordes which gather there in severe forms of fever.
4. Beverages. As a beverage, especially in mild cases of disease, and at the commencement of all fevers, pure water, toast-and-water, gum-water sweetened with a little sugar’ 1 Gum- water is prepared by adding one ounce of Gum-Arabic, and about half an ounce of loaf-sugar, to one pint of hot water. Gum is a mild nutritive substance, admirably adapted to inflammation of the mucous membranes, as in Catarrh, Bronchitis, Inflammation of the Bladder, etc. or barley-water, lemonade, soda-water, and other effervescing drinks, or grape-juice, orange-juice, or jelly, is nearly all that is necessary. Tea and coffee, of ordinary strength, are often pleasant stimulants, and may be given in moderate quantities. If given in too large or frequent doses they may prevent sleep. But to relieve thirst, cold water is best and most pleasant, and no patient ought to be refused this. In acute fever, cold water is like the “Balm of Gilead.” Both internally and externally, it is an agent of supreme importance, and acts favourably by lowering the excessive temperature, and also as a tonic, giving vigour and tone to the relaxed capillaries in which the morbid, action probably chiefly goes on. The use of water will prove a valuable adjunct to the medicinal treatment prescribed, and will accelerate those favourable changes which are hoped for.
5. Diet. In most cases of acute disease, no solid food is admissible: simple water, or milk-and-water, gum, rice, or barley-water, grape, or orange-juice, or jelly, together with Liebig’s Extract of Beef, being quite sufficient. This extensively used and extremely valuable article of the invalid’s dietary, is the extracted juice of meat, and, by the addition of hot water, instantly makes agreeable and nutritious beef-tea. There are many varieties. Under other conditions the diet is varied as follows: 1 See the Author’s “Essentials of Diet.”
Milk Diet. This include all kinds of light puddings, made with milk. Arrow-root, gruel, tapioca, rice or sago, boiled in milk; milk-and-bread, etc. Also tea or cocoa, and bread-and-butter.
Meat Diet. When this is ordered, meat should be taken twice daily; but for breakfast, eggs may sometimes be substituted. In many hospitals, the daily allowance of meat is 3/4 lb., including bone. In other respects ordinary diet may be taken.
Extraordinary Diet. In hospitals, this includes meat, fish, poultry, etc.; also wine, brandy, or porter, as specially ordered by the doctor. The quantity of spirits, wine, or beer to be taken by a patient, should be regulated by the special order of a medical man, and none taken unless so ordered. Stimulants should also always be discontinued when the cause for which they were prescribed ceases to exist.
Different diseases and different constitutions, however, require varied kinds of food. Thus, in cases of Diarrhoea, fruits and vegetables should be avoided, while a confined state of the bowels is sometimes benefited by the free use of these articles; also when febrile symptoms are present, meat, eggs, butter, and other stimulating food, should be omitted, and the diet restricted more particularly to fruits and farinaceous articles, or, as before stated, to water and mucilaginous drinks alone. For further remarks on diet, see the article. “Dyspepsia.”
6. Regularity of Feeding. Another point of great importance is, that nourishment should be administered with strict regularity; in very extreme cases of prostration, every half-hour or hour both day and night. Frequently the functions of digestion and assimilation are so greatly impaired, that a large quantity of nourishment must be given to sustain the patient till the disease has passed through its stages. “Little and often” is the golden rule for a patient’s diet.
7. Food not to be kept in the sick-room. Miss Nightingale’s suggestion on this point is so important, but, we regret to observe, so often disregarded, that we venture to repeat and enforce it here. It is this do not keep the food, drink, or delicacies, intended for the patient, in the sick-room, or within his sight. The air of the apartment is liable to deteriorate them, and the continuous sight of them to occasion disgust. Rather take up for him, at the fitting time, and by way of surprise, two or three teaspoonfuls of jelly, several segments of an orange, or as many fresh grapes as he may consume at once. Or, if it be appropriate to his condition, a small cup of beef-tea covered with one or two narrow slips of toasted bread, is very much preferable to inviting him to swallow even a less quantity from a basinful that has been kept for hours within the reach of the patient’s hand and eye.
8. Moderation in convalescence. Relapses are very liable to occur from indulging the appetite too freely during convalescence; and, therefore, toast and black tea, jellies, light bread-puddings, white fish, mutton-broth, Extract of Meat, a small quantity of tender chicken, broiled mutton etc., may only be allowed in great moderation, but never to the capacity of the appetite till the tongue is clean and moist, and the pulse, skin, and temperature have become natural. Even then, extreme moderation should be exercised, as the appetite is often excessively craving.
5. Baths, etc.
WARM OR HOT BATH.
The patient should be immersed in warm water up to the neck, and directly afterwards a towel or sponge, squeezed out of cold water, applied to the head; the cold towel or sponge may be applied for about three minutes, but the patient kept in the bath for ten or fifteen minutes. The temperature of the water for a hot-bath should be about 98*F. to 102*F, or what can be agreeably borne by the bared elbow, and for a warm-bath about 95*F. A thermometer is, however, the best guide to the heat; and as they are not expensive, one should be kept in every family. The temperature should be fully maintained, by addition of hot water carefully poured down the side of the bath, till the patient is taken out. The bath should be given in front of a good fire, and a warmed blanket be in readiness to wrap the patient in directly he leaves the bath. The hot-bath is of great service in Convulsions, Tetanus, etc.; it draws the blood from the over- loaded brain to the general surface of the body. It is also useful in simple or severe febrile diseases; in spasmodic affections of the bowels, or bladder; in Prurigo, etc.
LICENTIATE OF THE ROYAL COLLEGE OF PHYSICIANS; MEMBER OF THE ROYAL COLLEGE OF SURGEONS; LICENTIATE IN MIDWIFERY, LONDON AND EDINBURGH, ETC. PHYSICIAN TO THE READING AND BERKSHIRE HOMOEOPATHIC DISPENSARY.
Author of "The Stepping Stone to Homeopathy and Health,"
"Manual of Homoeopathic Treatment". Editor of "The Homoeopathic World."