PEARLS OF WISDOM, GEMS OF KNOWLEDGE FOR ALL. COMMON SENSE PRESCRIPTIONS AND PRACTICAL INFORMATION. A SYSTEMATIC TREATMENT IN THE DOMESTIC PRACTICE OF MEDICINE, BY PAUL BARRINGTON JONES, M. D. COPYRIGHT APPLIED FOR. SOLD BY THE AUTHOR AND HIS AGENTS ONLY KANSASCITY : WBA I2B0 PAUL BARRINGTON JONES, M. D., AUTHOR AND PUBLISHER. THIS LITTLE BOOK IS DEDICATED TO OUR INESTIMABLE FRIEND, MR. J. J. HUGHES. THE AUTHOR. PREFACE. The object of placing this little book before the heads of families, and non-professional persons, is to furnish them with a few useful hints and suggestions for those who may be sick as well as to those who have the care of the sick. In the practice of over twenty years, by the bed-side of the sick and misfortunate, we have long since been impressed with the necessity of some kind of a little cheap book which we might place in the hands of every family, which would not only instruct them how to keep well but give them some useful information that would enable them to properly care for the sick, that thousands of lives might be saved from the g'ave, especially in the case of little children. As the doctor visits from house to house we find many persons thrown into the sick room to care for them, who are exceedingly anxious to know more of their duty. This book is not intended to take the place of a doctor when one is really needed, but more especially to instruct you to do many things that are highly necessary for you to know as well as the doctor, together with much other useful information, such as I know will be highly prized by every household. THE AUTHOR. A Good Nurse. We begin this little book with the above caption and commence to talk plainly of the duties and qualifications of the nurse, for we believe that the cure of the patient depends largely upon the quality and intelligence as well as the adaptation of the nurse; indeed, the great man Valpau once said, "It is the good nurse that saves the sick." Take this view of the matter, the question of her or his duties and qualifications should not be passed over lightly, but should engage our earnest attention. Some writer has made the statement that "Nurses are like poets and artists —were born, not made." Evidently there are some gifts that are very essential to a good nurse; but we believe that some qualifications may be acquired, and that a little training will often compensate for the lack of natural endowments. The reason that we have so few good nurses is, because the majority know but little about those things which go to make up what a good nurse should be. 1. A nurse should be of middle age. If she is young, she is apt to be thoughtless, wild and heedless; if she or he is old, they may be deaf, or stupid, or in trouble. But a good nurse should be always able to hold herself or himself in subjection, and some old mothers may have all the freshness and acuteness of earlier years. But no matter who the nurse is, she should always wear a cheerful face, no matter how grave the case may be; she should be gentle, kind and obliging; she should always keep calm, not get excited ; she must have a pleasant voice, a gentle touch, a light step, and a knowledge of cooking for the sick. Such a person is invaluable. 2. She should be honest —honest with the patient and with the physician. 3. Now, if the patient can have no confidence in the nurse, then the sick-room is no place for such a person; or if the conduct is such as to lead the physician to conclude that his orders have not been 8 PEARLS OF WISDOM, followed, it is certainly a very unfortunate place to occupy; however,, no person should employ a physician unless they have confidence in him, after which they should understand his directions; then see to it that you faithfully carry out his orders. Some nurses are very selfopinionated, and they fancy that they know far better than the medical man; and in order to carry out their measures they resort to a species of dishonesty. Such a nurse should be scrupulously avoided, for she ought to know that under the circumstances the patient is made to suffer and perhaps die. A quackish nurse, who gives medicines not ordered by the physician, is an abomination. 4. A nurse must have sobriety. Every nurse should be cheerful and pleasant. Some people are always in a constant giggle or titter; the grin of childish levity and thoughtless noise, and roaring laughter, should be avoided : in short, no person should be allowed in the sick room who cannot control themselves. The next quality should be firmness; every nurse should be resolute but not rude. She is not expected to yield to the patient every request, unless it comes within the bounds of reason and common sense; everything that is expected to be done she must do cheerfully and kindly, as well as carefully, then after it is done the patient will have confidence in her and praise her for it, and for the exercise of a good judgement. 5. The next quality is patience. A very large degree of patience is required, for the reason that sick persons are very often irritable and restless, and sometimes well persons get a touch of it; remember that. Have you not often felt yourself a little ashamed of your own irritability sometimes ? I have. Then how would you expect it otherwise with those who are compelled to lie in bed and suffer pain for days, and perhaps weeks, and be deprived of their liberty to even walk about the house? Therefore, it does not matter how sorely tired and worn-out the nurse may be, it does not furnish an excuse for getting out of patience. She should possess gentleness, in case of a broken limb, painful back, or rheumatism, etc., where it becomes necessary to change the clothing. This requires a good deal of gentleness. The patient should not be handled with an unsteady hand; the holds that secure firmness, strength and gentleness will secure confidence in the invalid and make him feel secure. If you are to do the work, do it with gentleness and not with jerks and knocks, as if you were mad and did not care. 6. The sixth qualification is cleanliness. The nurse should not only keep herself clean but she should keep the room clean, neat and sweet. Little filthy things about the room, sticking in the corners, so often spoils the appetite of the patient; never allow the dressings of wounds GEMS OF KNOWLEDGE FOR ALL. 9 or burns to remain in the room; let every vessel be kept empty and clean, ready for use at a moment's warning; then you can let in a little fresh air, by opening a window or door. Remember this must be attended to. Bad air is poisonous. The food not eaten should be taken out of sight; the drinking water should be changed often, as water gathers impurities directly. Be clean in everything you do, and you will be amply rewarded for it. KINDS OF NURSES. Some good-hearted people never become good nurses ; they seem too awkward and tired, hence they are always overwhelmed in difficulties. They are good-natured creatures, don't mean anything bad, but they can't help it. Here she comes all loaded down with good things; both hands are full. She goes up stairways, stepping upon the bottom of her dress until she dropsa plate or two, or spills the tea, or goes down herself. She manages to get up after a while, and spreads the remainder before the patient. She then cuts the bread and butters it with a knife that has previously been used to cut an onion or spread a mustard plaster, and says, "Now, dear, I will go go back and make some more tea." The- patient asks for a drink of water before she goes. She says " yes, dear," and runs off and gets a glass brim full, puts her hand under the patient's head, bends his or her neck, and turns the water down on the outside all over the breast and clothing. Then she wonders why in the world Tie don't drink better. She lights the lamp, turns the wick up, takes a bit of paper, makes a flash, throws the paper on the floor and stamps it out with her foot. The fire wants fixing ; she turns on so much fuel that it all runs down and over the floor; to terrify the patient she leaves the stove door open till the house is filled with smoke. The braid of her dress is loose ; she catches that on the chairs and drags them after her. Her lingers are tied up with a rag and rolled with a black string ; they have been scalded by hot water which she undertook to turn into the teapot. She brings another plate of food directly, and declares to the patient that she knows he will die if he don't eat something; so that the patient is annoyed and gets nervous, fever comes on and he gets no sleep the live-long night. Such a woman is the best in the world, and she does the very best she knows; but she makes a very poor nurse. 10 PEARLS OF WISDOM, THE LAZY NURSE. This kind " putters,,' dreams and drawls ; she never begins ; she never ends. She has neither system nor smartness ; no accurate idea of anything; if you undertake to tell her anything her mind wanders off, and she will begin to talk to you about a dozen different subjects. She starts off, to do something you tell her to do, as if she was in a great hurry, but her intellect seems to have left her, and lo! she has forgotten what you told her. She feebly moans her monotones, and brings you the wrong article. I feel sorry for this one. THE CRUEL NURSE. This kind will do her duty, but she does it by law and that without mercy. She will cany out the doctor's orders, but it lacks the right spirit. She fixes the medicine at the right time, and it must be taken forthwith. She changes the clothes no matter how it hurts. A little tenderness and compassion would improve this kind most wonderfully. THE CARELESS NURSE. This one forgets to give the medicine at the right time ; also forgets the patient in many particulars. The soiled dishes are scattered around the room, and she lets the food stand for hours at the bedside after the patient has partaken of all he wants. The bed is full of crumbs and seldom made up ; the fire burns low or goes out; the ashes are strewn all over the hearth. She means well and she does the very best she knows. Still she makes a very poor nurse. THE FUSSY NURSE. Now- this one is liable to overdo everything. She intends to have everything just right. She runs in and out every few minutes —here she goes hither and yonder. She tires the patient nearly to death w r ith her interrogations. " Now how do you feel ? Won't you have a drink ? Can't you eat something?" She raises his head, then tucks the bed- GEMS OF KNOWLEDGE FOR ALL. 11 ¦clothes in here and there. She pins back the curtains; then she sweeps the floor. She brings the medicine, fixes the eatables; always on the go. She is too good to sit still, and yet her very goodness is damaging to the patient. She ought to be more quiet and take things more easy. THE DISHONEST NURSE. The very worst of ail is the dishonest nurse. I have known some such nurses, who would eat all the food and drink all the wine, turn out the medicine, and then try to make me believe the patient took all I had left. But these poor creatures are very few, and we thank the Lord for it- THE TATTLING NURSE. A Tattler is an abomination, a w r eariness to the flesh. Of all the nurses this one is the first to be shunned. She is a curse and a great damage to all who are around her. She keeps the patient and everybody else in a perfect stew and worry. No person under her eye can feel secure. But thank the Lord, for humanity's sake, w r e seldom see this kind. Every nurse should be a person who has good judgment and a full exercise of his or her senses ; should have: Sight —To read directions, and sometimes to read to amuse the patient. Hearing —To catch the faintest whisper, and to avoid a great effort in speaking. Feeling —To determine the change in temperature in the room, the heat of the body, the moisture or dryness of the skin, and to know w'hen applications are to be made —when they are too cold or too hot —to see that all drafts are avoided when sponging or bathing the patient. Smelling —To detect all effluvias or impurities that are in the room. Taste —To determine the seasoning of the food. A careful exercise of all the natural faculties, with a study of the principles of nursing, ought to make a competent person to care for the sick. 12 PEARLS OF WISDOM, The Room for the Sick. It is not every family who have a choice of rooms, but under all circumstances we must do the best w r e can. A room should be selected that is light and cheerful. The head of the bed should be placed to the north, if possible, as the currents of electricity in nature run from north to south. If the patient has some kind of fever or brain disorder, or some nervous disease, let the room be in some quiet part of the house, away from the family. If it is a bone broken or fracture from the result of some accident, then the patient should be near the rest of the family, for in such cases it is very often amusement for the patient to watch the movements of the rest. Avoid a room that is exposed to any kind of effluvia. Have the windows so that they can be let down at the top. The less furniture in the room the better, especially if the disease be infectious. Before putting the patient in the room see to it that it has been well aired, warmed and dried. First, light the fire and see that the chimney draws well. The best bed is a hair mattress, but clean straw r or husks will answer very well. Remember that feather beds are not healthy; besides they are inconvenient, especially if the patient has a broken bone or fractured leg, and in w T ounds and burns —the patient is apt to sink down into holes. When the patient is to be changed and the party cannot get up, you can get the patient on the edge of the bed ; now roll up against the patient all the bed clothes that you intend to change, have your clean sheets and blankets all ready ; now spread them on the bed smooth and straight; now get your patient to roll over carefully on the clean sheets; now take off the dirty clothes, and then spread out the other half of the clean change. Now r , don't you see, you have it all done nicely. If it is necessary to scour the room to purify it, wash it with hot water, after first adding a few cents' worth of chloride of lime, or some crude carbolic acid. Then dry the room thoroughly and it is ready. 13 GEMS OF KNOWLEDGE FOR ALL Food and Drinks for the Sick. It will be necessary for you to know how to prepaie certain kinds of foods which the doctor may order for the patient. It is well that you should understand a few general principles that should govern the administration of food. First, then, solid food is seldom admissable, especially during acute diseases of any kind, for the reason that the stomach and digestive organs are not in a condition to furnish the fluids necessary for its comminution; hence, instead of digesting, it simply lies there and decomposes, wdiich will give rise to irritation, and hence it will produce other serious complications. Second. The more severe the disease the more delicate and lighter the food should be diluted. Thus, in a high grade of fever or inflammation we should give whey, beef tea, extract of beef, milk punch, toast water, mutton broth, tapioca, chicken broth. Third. When there is great exhaustion, then the food should be all the more concentrated, and very nutritious. Then let us give the Extract of Beef, or beef essence as it is sometimes called, concentrated chicken or mutton broth, milk and cream. Fourth. In fevers or inflammatory diseases, give the food at the period of the day or night in which there is least vascular and nervous excitement, and never force it upon the patient if suffering from a high grade of fever. Fifth. Never give food in severe pain. Sixth. Then if the tongue is coated with a yellow coat, and bad taste in the mouth, with a feeling of weight and oppression in the stomach, it is better not to give food ; or if given it should always be in a liquid form. Seventh. When the digestion is impaired and it becomes necessary to sustain life with food, it should be given in small quantities and at regular intervals, like medicine, every two or three hours. Eighth. In convulsions much care is required in keeping the patient from eating too much. 2 14 PEARLS OF WISDOM, Recipes for Cooking. BEEF TEA. Take one pound of nice, tender steak, remove the fat, chop veryfine, put it in a pint of cold water, stir it and let it soak one hour, then bbil it ten minutes, strain it and season to suit the taste of the patient or your own judgment in case of great exhaustion and great debility of the digestive organs- EXTRACT OF BEEF. Take a Scotch ale stone bottle (it is best), scald it out so that you know it is clean; take one pound of nice, tender and fat beef steak ; after removing the fat, chop it up fine, season it with a little salt and pepper, put it in the bottle, cork it up tight, then tie the cork down so that you know that it will not fly out with the heat and steam ; now place the bottle into a pot of water and boil it for three hours. Remember you cannot cook it too much. When done and mostly used up the remaining liquor can be pressed out, then the bottle can be refilled with fresh meat and cooked for the next day. This preparation is very rich, with nutritious element; two tablespoonf uls at a dose for an adult is sufficient, repeated every two or three hours. A little can be poured out at a time and warmed on the stove as it is required. Keep the bottle well corked; if it is left open the extract will lose much of its strength, as well as its flavor. CHICKEN JELLY. Take half a raw chicken, pound it well with a mallet, bones and all, cover it over with cold water ; heat it slowly in a covered vessel, let it simmer till the meat is thoroughly cooked, then strain the liquor through a coarse cloth ; now season it to taste, return it to the stove and let it simmer ten minutes longer, skim it when cool and give it to the patient.