CARE OF THE SICK



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.