HIVES.—Hives, or urticaria, is often seen in young children, It is generally caused by indigestion. It is not a serious disease, but it is uncomfortable and makes a baby cross. The eruption is bright red in color, and appears in blotches or wheels.
Treatment.—Give the child a laxative like magnesia or citrate of magnesia, or epsom salts and cream of tartar, of each two ounces. Dose, one-half teaspoonful in water every three hours until the bowels move freely. (One-year-old).
To relieve the itching.—Sop the spots with warm water, and a little soda, or an entire bath can be given of this if the eruption is extensive.
RUPTURE in a Baby. (Navel).—Take a strip of oxide of zinc adhesive plaster about one and one-half inches wide and long enough to reach three-fourths around the baby's body. Fasten one end of this to one side of the abdomen and with the other hand gently push the rupture back; bring the skin on either side of the navel together so that it will meet and hold the rupture. Bring the plaster tightly across the abdomen, across the navel and attach it firmly to the other side; change this dressing every few days and continue treatment until healed.
COLDS in Babies.—Many babies seem to take cold without any cause. It is often due to the fact that the room is too warm, or they are clothed too warmly; they get easily overheated and feel the slightest draught of air. If it is in his nose and it is stopped up, twist a piece of cotton on a small wooden piece like a tooth-pick and dip it into olive oil and put it into the nostrils a short distance. If necessary, buy a nose syringe with a soft rubber tip, and use it twice daily. The following solution is good: one-half teaspoonful of boric acid powder, one ounce of glycerin, and eight ounces of warm water. Mix. Place the child on your lap, head against your chest, bend his head well forward and syringe one nostril and then the other. Camphor cream is a good remedy. For a cough and much wheezing use a mustard plaster. Take one part mustard, six parts flour and mix it into a smooth paste with a little cold water, spread it between two layers of muslin, warm it and moisten with a little water if necessary, and put it on the upper part of the breastbone. Leave it on only long enough to redden the skin (five to six minutes). Put it on just before baby goes to bed. A drop of camphor every three hours is often good for a cold at the beginning. Aconite in small doses is also very good.
[ALL ABOUT BABY 621]
MOTHERS' REMEDIES. Colds, Catnip Tea for.—"Give a little sweetened catnip tea, then grease well with camphor and lard." This is a very simple and effective remedy, especially for small babies.
(See "Colds" under General Department for more Mothers' Remedies,)
Early signs of sickness.—When a baby who persistently refuses his food is drowsy at unusual times, fretful, feverish, and is uncomfortable, the mother should look in baby's mouth, for sore throat or tonsils, or on his body for rashes. Undress the baby and put him to bed in a quiet room away from the rest of the family, and if he is hot and restless give him a sponge bath with one teaspoonful of bicarbonate of soda to a basin of luke-warm water. Give him also an enema to move his bowels, especially if they are not regular. Dilute his usual food with water or barley water to one-half the usual strength. If he is old enough to eat solid food, stop it. A dose of a teaspoonful of castor oil is safe to give until the doctor comes. Give him water to drink for he is thirsty. Take his temperature.
CARING FOR BURNS, BRUISES, CUTS, WOUNDS, ETC., IN BABY.
For Burns.—Keep away the air from the burn. Dust soda on the burn if the skin is not too much broken, and wrap it up in clean linen. Olive oil, linseed oil, is better, or cream should be put on if it is more severe. Then a layer of clean linen and then a thin layer of cotton wool. It must not be too warmly dressed. An ointment called pineoline is excellent for burns.
For a bruise or bump.—Apply cloths hot or cold,—you can do this with flannel wrung out of very cold or hot water. Ice may be wrapped up in cotton and put on the part.
Cuts.—Wash it with clean cold water, and bind it up with clean linen. If it bleeds much, let it bleed for a few seconds, and then stop it with a pad of clean linen pressed firmly on the part and held there until it stops.
SPLINTERS.—Remove them and dress as for any other wound.
POISONING.—Children will get hold of poison, and mother had better have antidotes, etc., to use in case of necessity. Rat poison, fly poison, matches, etc.
Treatment.—First use emetics; mustard and luke-warm water or one teaspoonful of alum in a glass of luke-warm water; a little salt and warm water; ten to fifteen drops syrup of ipecac, and then warm water. For fly poison, give one-half ounce of olive oil in same amount of lime-water, and repeat it every five or six minutes, for five or six doses, and then white of an egg, and keep child warm. Antidote for arsenic is freshly precipitated, sesquioxide of iron. Go to druggist and tell him to prepare it; tell him what it is wanted for, and give this in doses of an ounce at a time as the oil was given.
For poisoning from sucking matches.—Vomit the child freely, but do not give anything oily, as milk or egg, as this dissolves the phosphorus.
[622 MOTHERS' REMEDIES]
Oxalic acid is sometimes used for cleaning purposes, and mistaken for epsom salts. Give an emetic and lime-water.
For carbolic acid.—Give an emetic, and then white of an egg and epsom salts.
Overdose of soothing syrup.—Keep baby awake, slap with wet towel, etc.; or walk him about if he is old enough, inject strong black coffee in the rectum. Keep up the strength with stimulants.
PROPRIETARY FOODS.
These foods are sometimes of temporary use. As many of them contain very little fat, they may be used in cases of illness where fat cannot be borne. Some of these contain malt sugar, and when the baby is constipated this kind is useful when added to milk. Others can be made up of water only, and are useful and handy where it is impossible to obtain fresh milk. In cases of diarrhea the flour foods made up with water are very useful. Milk at that time acts as a poison. Some of the best foods on the market are the following—Condensed milk, Mellin's food, Horlick's Malted milk, Nestle's food, Imperial granum, Just's food, Carnrick's soluble food, Ridge's food, peptogenic milk powder, Lactated food, Eskay's, Albumenized food, cereal milk, Borden's food.
For constipation in a child.—One to two teaspoonfuls of Mellin's food, added to each bottle of his usual modified milk formula will often help a great deal. As soon as the bowels move naturally it should be gradually diminished until after four or six weeks, the child can do without it.
Condensed milk and Malted milk.—These can be prepared with water only, and so are best to use on a long journey. Give the baby one or two meals daily a week or two before the journey. Discontinue when at the end of the journey.
Imperial Granum.—This is often useful in acute diarrhea, when milk cannot be given. Mix the proportion as given on the box with water into a smooth paste, then add a pint of boiling water and boil for fifteen or twenty minutes.
Peptogenic Milk Powder.—This may be used for a short time during or after acute illness; you can add it to the formula used as directed on the package.
[NURSING DEPARTMENT 625]
NURSING DEPARTMENT
Including
Care of the Sick and the Sick Room
FOODS, FORMULAE, DELICACIES FOR SICK ROOM, HOW TO PREPARE THEM; DIET IN FEVERS AND OTHER DISEASES, SECURED FROM TRAINED NURSES, PHYSICIANS AND HOSPITALS.
Every Phase of Nursing Given in Detail and in Plain Mothers'
Language, including Latest Sanitary Care and Science.
VENTILATION.—The sick room should be ventilated without any draught hitting the patient. The patient's bed should be placed out of the line of air currents. If this is not possible he must be protected by means of screens, the head of the bed being especially guarded. That draughts are dangerous is founded on fact no less than is the modern idea that an abundance of fresh air is necessary and helpful. A nurse has been guilty of gross neglect of duty when the patient contracts pneumonia through exposure to too severe currents of air. A simple way to ventilate a private room is to raise the lower sash of window six inches and place a board across the opening below; the air will then enter between the two sashes and be directed upward, where it becomes diffused and no one in the room is subjected to a draught. In a room where there is only one window a pane of glass may be taken out and a piece of tin or pasteboard may be so placed that the current will be directed upwards; or a window can be opened in an adjoining room which fills with fresh air and the door of the sick room opened afterwards to admit the air; or, the patient may be covered up, head and all, for a few minutes two or three times a day, while all the windows are thrown open, The room should be thoroughly warmed before it is so thoroughly ventilated.
[624 MOTHERS' REMEDIES]
TEMPERATURE OF THE ROOM.—This should be regulated by a thermometer suspended at a central point in the room. The temperature should be regulated according to the nature of the disease and the comfort of the patient. In fevers it should be lower, varying from 55 to 60 degrees F., but in bronchial troubles it should be kept about 70 degrees F. The mean temperature should be kept about 60 degrees to 70 degrees. It should be raised or lowered gradually, so that the patient will not be overheated or chilled.
LIGHT.—The patient should have plenty of light and sunshine, but do not let the sun or light shine directly upon the face.
CARE OF THE DISCHARGES (Excreta).—This is very important. Sputa, dirty vessels, soiled dressings and linen are prolific sources of impure air.
Sputum Cups.—These should be of glazed earthenware, without any corners or cracks and provided with a simple moveable cover when in use. They should be sterilized for one hour in every twenty-four hours.
Bed Pans and Urinals.—These should be washed out thoroughly. Allow boiling hot water to run on them for some time before they are put away after being cleansed.
Soiled Dressing and Linen.—These should be received in covered basins or in paper bags and at once carried away and destroyed or disinfected, or put in a metal dressing can and closely covered until the contents can be cared for at the earliest possible time. Vomited matter or the discharges from the bowels and the urine should always be covered in the vessel either with a lid, towel or rubber cloth. The rubber is better than the cloth as it keeps in the odor and can be scrubbed and disinfected.
If the patient is too sick to use a sputum cup, the expectoration can be received in a paper handkerchief or a piece of cheese cloth and placed in a small paper bag and burned at once.
SOILED AND STAINED LINEN.—These should be put away in a covered receptacle that contains enough disinfectant solution to keep them moist. They are removed as soon as possible to the wash room to be cleaned and sterilized.
Sterilization.—This term is usually employed when heat is used to sterilize.
Disinfection.—This is the term used when chemicals are relied upon to purify (sterilize).
Heat and Chemicals are much aided by sunshine, light and fresh air, especially that of high dry climates.
[NURSING DEPARTMENT 625]
The germs (bacteria) are destroyed by dry or moist heat, the latter used in the form of steam. Dry heat is not so penetrating and requires a longer time and some goods are destroyed when exposed in it long enough to destroy the germs.
In order to destroy these organisms it is thought to be necessary to expose whatever is to be sterilized to the steam at 200 degrees F. for three successive days for thirty minutes or more each day, and during the interval to keep them in a room with a temperature of 60 degrees F.
A SIMPLE METHOD OF STERILIZING.—Put the articles (small articles) in an ordinary kitchen steamer; closely cover it and place it over a pot of boiling water. If you wish you can add two parts of carbonate of sodium to each ninety-eight parts of water.
Germicides are chemicals used to destroy germs.
Disinfectants are chemicals used to arrest and prevent their development.
These disinfectants should always be fresh.
Carbolic acid is one of the most efficient and most frequently employed of the known chemical disinfectants. It comes to us in the form of white crystals and dissolves in water, glycerin, or alcohol.
Watery solutions cannot be made stronger than five per cent. Solutions weaker than this will not destroy all germs, but on account of its irritating qualities the weaker solutions are employed when used for the skin and mucous membranes. How to make a five per cent or one to twenty solution:
A bottle containing the crystals is placed in hot water until they are melted (or you can buy this dissolved product). Then take one part of the acid and add it to nineteen parts of boiling water and shake this vigorously until all has been thoroughly dissolved and mixed. To make a 1, 2, 3 or 4 per cent solution, you take 1/100 or 1/50 or 1/33 or 1/25 of acid.
Corrosive Sublimate or Bichloride of Mercury.—Tablets can be bought at any drug store containing the desired strength, and are better to use. This is a powerful irritant poison and must be used carefully. Tablets of the strength of 1-1000 and 1-2000 are most often employed for germicide action. The weaker solutions 1-5,000 or 1-10,000 were used to wash out the cavities. It is not now used much for that purpose; it stains clothing and corrodes instruments.
Milk of Lime is considered very valuable and safe to use in vessels to receive evacuations from the bowels. It should be freshly made or it is useless. Equal parts should be stirred up with the contents of the bed pan and this must be let stand at least one hour. This is the best way to disinfect stools.
To Prepare Milk of Lime.—The milk of lime is made by adding one part of slaked lime to four parts water.
Chloride of Lime (Chlorinated lime) is also a very good disinfectant. It has a bad odor and unless it is very fresh, is not reliable.
[626 MOTHERS' REMEDIES]
Boric acid disinfectant. This property is not very marked, but it is not irritating. The standard solution is five per cent. The weaker solutions are used to clean cavities, for superficial wounds, and to wash out the bladder.
The standard or saturated solution is made by using one part of the acid in crystal form to nineteen parts of water; or, this saturated solution can be easily made by putting a large quantity of the crystals in a filter and pouring the quantity of boiling water over them slowly until all are dissolved. Strain the solution to get rid of the excess of crystals or it can be allowed to cool when the liquid can be poured off.
Normal salt solution is made by using one teaspoonful of salt to a pint of water.
CARE AND DISINFECTION OF AN INFECTED ROOM.—Carpets, upholstered furniture, hangings, bric-a-brac, or any personal clothing, the color of which may be destroyed by disinfection, should have been removed from the room at the beginning of the disease.
DAILY CARE OF THE ROOM BY THE NURSE.—The furniture should be wiped off with a damp cloth and the floor swept with a broom covered with a damp cloth wrung out of a 1-20 (five per cent) carbolic acid solution; besides this the floor must be rubbed thoroughly with a damp cloth every second or third day. If the disease is contagious a damp sheet kept moist should be hung in the line of the air currents. Cloths that are used daily should be washed in hot soap suds and when not in use left to soak in carbolic acid solution 1-20 (five per cent).
After the patient has recovered from an infectious disease he should receive a hot soap and water tub or sponge bath, thorough washing of the hair and irrigation of the ears included, followed by a thorough sponging with a one per cent carbolic acid or corrosive sublimate (1-10,000) solution. The finger-nails and toe-nails should be cut close and cleaned underneath.
A nasal douche is given, and the mouth should be washed with listerine or a saturated (five per cent) solution of boric acid. The patient is then wrapped in clean sheets or clothes and taken in another room. Then the bedding and clothing are made ready for sterilization.
DISINFECTION OF THE ROOM.—Brush off the mattress, wrap it in a damp sheet wrung out of a twenty per cent solution of carbolic acid, and send to the sterilizer. The clothes are steamed and sent to the wash room. When there is no sterilizer the bed must be soaked in a 1-20 (five per cent) carbolic solution, afterwards boiled and the mattress ripped apart and boiled or burned.
[NURSING DEPARTMENT 627]
DISINFECTING THE ROOM.—Arrange all articles that are left in the room so as to expose them the best to the fumigating substance. To disinfect with formalin, close the room tightly, seal all cracks and openings with paste and paper. Place an alcohol lamp in a metal dish in the center of the room. Put in a receptacle over the lamp three fluid ounces of a forty per cent solution of formaldehyde; have a dish of water in the room for some time; moisten the air of the room, light the lamp and then close the room up tight for twenty-four hours, until the dust has settled; then enter gently so as not to disturb the dust and wipe off everything in the room with a cloth wrung out of a corrosive sublimate (1-1000) solution. Floors, woodwork, furniture, bedstead must be so washed or wiped, and use for crevices pure carbolic acid, applying it with a brush. The walls should be washed down with the 1-1000 corrosive sublimate solution. Then leave the windows wide open. Sulphur fumigation is not considered so certain in its results.
HOW TO TREAT SPUTUM FROM TUBERCULOUS PATIENTS.—Sputum is dangerous when it is dry. The sputum cups should be of china or paper, so that they may be either boiled or burned. There should be no crevices. The cup should be kept covered and the sputum moist so that none of the germs on the sputum becoming dry may escape into the air of the room. The china vessel should be frequently cleaned and, before the contents are thrown away, the germs must be destroyed by putting the sputum in a two per cent solution of carbonate of soda for one hour. The paper cups and contents must be burned before the contents have time enough to become dry. In infectious diseases, all discharges from the nose, mouth, bowels and bladder should be received in a china vessel containing carbolic acid or milk of lime.
In Diphtheria the expectoration, discharge from the nose and vomited matter should be received in paper napkins and burned at once in the room, or if this is impossible, boiled before being taken from the room.
Use the same treatment for the discharges in Scarlet fever. Two sets of cups should be kept and boiled in the soda solution before being used. All vessels, tubes or cups that are used for the mouth in diphtheria, syphilis, or cancer should be kept in a 1-40 solution of carbolic acid and boiled before being used by another patient.
Bed-pans used in cases of cancer, dysentery, typhoid fever and, in short, in all infectious diseases, are to be soaked in a 1-20 (five per cent) carbolic acid solution and boiled before again coming into general use.
Sheets and clothing stained with typhoid fever discharges must be washed out at once, or soaked in a disinfectant solution and steamed before being sent to the laundry. Also the bedding and clothing in any infectious or malignant disease should always be put to soak, at once, in a 1-20 (five per cent) carbolic acid solution, or else steamed or boiled before being brought again into general use.
The urine needs the same attention as the bowel discharges in typhoid fever.
Coughing in diphtheria, lung tuberculosis, scarlet fever, etc., sets free infectious germs. These may be received in the person of the attendant, or on the bedding and furniture. Care should be taken when attending such cases.
[628 MOTHERS' REMEDIES]
CARE OF THE MOUTH AND TEETH.—A weak solution of borax or listerine is very good. One-half ounce of listerine to a glass of water to be used by the patient as often as he desires to rinse his mouth. Lemon juice in solution is very good. For cracks in the mouth, vaselin or cold cream is good. A few drops of oil of peppermint can be added, or oil of wintergreen.
For spongy and sore gums.—A few drops of tincture of myrrh added to pure water may be used. Colorless golden seal in the same way is pleasant and successful.
Cloths for washing the teeth and mouth are made in small squares of gauze or old linen. They are best to use since they can be burned immediately after being used. Wrap one of the squares around the first finger, dip it into the mouth-wash and insert in the mouth. Go over the whole cavity, the cloth being passed along the gums and behind the wisdom teeth, thence over the roof of the mouth, inside the teeth and under the tongue. Use more than one piece for all this. This is very necessary in typhoid fever. If the tongue is badly coated, it can be soaked and gently scraped. A good mouth-wash for general use is the following:
Glycerin 1 dram Soda 10 grains 5% solution of Boric Acid 1 ounce
BED SORES. Prevention and care of.—Very fat flabby people or thin emaciated patients are liable to suffer from bed sores. They result from constant friction or pressure on a certain spot or spots and when the body is poorly nourished. Moisture, creases in the under sheets, night gown, crumbs in the bed and want of proper care and cleanliness also are causes.
Bed-sores due to pressure occur most frequently upon the hips and lower back, the shoulders and heels; those from friction, in the ankles, inner parts of the knees, or the elbows and back of the head. In patients suffering from dropsy, paralysis or spinal injuries, or when there is a continuous discharge from any part of the body, the utmost care must be taken to prevent bed sores.
Treatment. Preventive.—Cleanliness and relief from pressure. Bathe the back and shoulders with warm water and soap night and morning and afterwards rub with alcohol and water equal parts. Dust the parts with oxide of zinc or stearate of zinc powder, or bismuth mixed with borax; all are good. If there is much moisture due to sweating or involuntary stools or urine, castor oil should be well rubbed in addition. The sheets must be kept smooth and dry under the patient.
[ NURSING DEPARTMENT 629]
Redness of the skin may be the first symptom of this trouble. This may be followed by a dark color under the skin, and when the cuticle finally comes off the underlying tissues are found broken down and sloughing. Any skin scraped or worn off—abrasion—should be carefully washed and a small pad of cotton smeared with olive oil and stearate of zinc placed over it and kept there with collodion painted over it; or white of egg painted over the sore is sometimes very beneficial; also equal parts of castor oil and bismuth make an excellent dressing. Rubber rings or cotton rings over the part relieve the pressure. Changing the position is often beneficial.
Treatment of the Sore Proper.—Sponge with clean soft cloths, with a solution of boric acid or one per cent solution of carbolic acid and the cavity packed with iodoform gauze, or iodoform, or aristol ointment, over which apply a layer of borated cotton. Dress the sore daily. If it sloughs apply hot boric acid dressings every four hours and follow with an application of castor oil and balsam of Peru. When it is better treat as any other sore.
BATHS.
A hot bath temperature is from 100 to 112 degrees F. or higher.
A warm bath temperature is from 90 to 100 degrees F.
A tepid bath temperature is from 70 to 90 degrees F.
A cool bath temperature is from 65 to 70 degrees F.
A cold bath temperature is from 33 to 65 degrees F.
The entire bath should not last longer, when given in bed, than fifteen or twenty minutes. A few drops of water of ammonia or a little borax will help much in getting the patient clean and disguise the bad odor of the perspiration. A little alcohol or Eau de Cologne will be found refreshing. Cold damp towels should never be employed here. The water should be pleasantly warm and changed a few times during the bath. A glass of hot milk can be taken after the bath is given, if the patient feels exhausted, and if the feet are cool a hot fruit can is applied.
Foot Baths in Bed.—The patient should lie on her back, with the knees bent and place her feet in the tub, which is placed lengthwise in the bed on a rubber sheet spread across the lower part of the bed for protection. A mustard foot bath can be given the same way except that the knees and foot bath are enclosed in a blanket. These are often given for severe colds, with head symptoms (headaches), when it is desired to draw the blood from the head. Hot water alone will do this, but the mustard hastens the action. The mustard should be mixed with a small amount of water before being added to the bath. The amount will depend upon the sensitiveness of the patient. The feet may remain in the bath for fifteen to twenty minutes, the water kept at the same temperature or made warmer by adding more hot water from time to time. They are wiped gently afterward and tucked snugly in blankets.
[630 MOTHERS' REMEDIES]
Hot Bath, Hot Air, Vapor, and Steam Bath.—Given for sweating purposes. Fill the tub half full of water at 100 degrees F. and draw it to the bedside if necessary. Lift the patient into the tub and gradually increase the temperature by the thermometer to 110 degrees and 112 degrees F. Maintain it at this point for twelve or fifteen minutes. After this the patient is lifted out into a prepared bed on which a long rubber is spread with three or four hot blankets over it; these are wrapped all around the patient, tucked in closely about the neck and watched continually to see that no air enters. Give plenty of water to drink, as it promotes perspiration and helps in that way to cast off the impurities. Keep this up for an hour if possible, and then the patient is gradually uncovered, sponged under a blanket with alcohol and water and the wet blankets removed. Cloths wrung out of cold water are applied to the head during this bath. The pulse should be closely watched for any indication of faintness, when the patient should be put to bed, immediately. This bath should not be given during menstruation or pregnancy.
Warm Baths (90 degrees to 100 degrees F.) are frequently given to children for convulsions. They should be placed in the tub and cold applied to the head, while the body is washed and rubbed.
Local baths and packs.—For sprains, a foot bath. For menstrual pain, a sitz bath. The patient sits in the bath with only the thighs and part of the body immersed, while the upper part of the body and the feet are protected with blankets. Sitting on a cane-seated chair over a steaming pail with a blanket around the neck and body gives a good bath for pain during menstruation.
Salt-water bath. Tonic action.—Nine to fourteen pounds of sea salt to fifty gallons of water will redden the skin and give an exhilarating effect.
Dry Salt Bath sent us with Mothers' Remedies.—"To a basin of water put a big handful of salt, take a Turkish towel and soak it in the salt water, wring out and let dry. The salt will adhere to the towel. Use to rub the body. A tepid bath should be taken next day to remove the salt."
Starch bath.—Add eight ounces of laundry starch to each gallon of water.
This allays skin irritation.
Bran bath.—Put the bran in a bag and allow this to soak in warm water for an hour before being used; or it may be boiled for an hour and then the fluid drained and added to the bath water.
Sponge bath.—Water and soap should be ready. Clothes to be put on, well aired and at hand. Then remove the patient's clothes and wrap him in an old blanket, expose only the part being washed at a time, wash and dry this part. Begin with the face and neck, then the chest, abdomen, arms and back, and lastly the lower extremities. Warm the water at least twice. Then put on his clean, well aired clothes and into a clean bed, and the patient will bless you.
[NURSING DEPARTMENT 631]
Alcohol sponge bath.—This is given the same way, only sixty per cent alcohol is used and the parts are allowed to dry themselves.
Tub bath (common).—Prepare everything as to heat, etc. Then carry the patient or assist him to the tub. Soap him all over and pour water over him from a large pitcher. The temperature of the water depends upon the disease. One person should continually rub the patient in typhoid fever to keep up the circulation while the water is being poured over him. A hot drink is given before and after these baths and the patient is wrapped immediately in warm flannel.
Patients are frequently put into a tub with a water temperature of 85 to 90 degrees, and then the water temperature decreased by adding cold water. This bath must be carefully given.
The cold pack.—It is used to reduce fever, delirium and extreme nervousness and to induce sleep. Cover the bed with a rubber sheet or oilcloth, and over this a blanket. Wring a sheet out of cold water and place this over the blanket. Lay the patient on this sheet and wrap it around him so that every surface has the wet sheet next to it. Tuck the sheet in well at the neck and feet. Fold the outer blanket over the patient and tuck it in. Lay a wet towel over the head, or he can be enveloped loosely in blankets and allowed to remain twenty minutes to an hour, only ten to fifteen minutes by the tucked-in method and then dried and put to bed.
The hot pack.—This is given in the same manner except that the patient is wrapped first in a blanket wrung out of boiling water. More covering is put over the patient than in a cold pack, and something cold is applied to the head.
EXTERNAL APPLICATIONS.
General and Local.—For dry heat, for warmth alone, hot bags, bottles and cans are used. Hot flannels are sometimes used for inflamed joints. Make the flannel very hot, wrap in heated paper or cloth and apply quickly; cover all with a layer of cotton, wool and oiled muslin.
For neuralgia and earache, salt bags are used.
Fill flannel bags with salt, heat as hot as can be borne, and cover it so as to retain the heat after it is applied to the ear.
For moist heat.—This is more penetrating and has a more pronounced effect than dry heat. It also hastens suppuration when it cannot be prevented in acute inflammation like quinsy, etc.
For local pains, fomentations, stupes and poultices are used. Poultices are best for deep-seated pain or continuous inflammation.
[632 MOTHERS' REMEDIES]
Linseed meal poultice.—Stir the meal slowly and evenly in boiling water; boil this mixture for several minutes and stir briskly all the time, and when thick enough it is well beaten with a spoon to remove lumps. If this is properly done it will be a light smooth paste, just stiff enough to drop away from the spoon. Use a muslin or coarse cloth and spread the poultice on this to the depth of one-half inch, leaving one inch space to turn in. Put vaselin over the surface, thin, and cover with a thin layer of gauze or thin cloth. Turn the edges over and roll in a towel to keep it warm and carry to patient. Keep them warm,—one should never be removed until another is ready to be put on. The skin should always be wiped dry before another is applied. Oiling the poultice prevents irritation of the skin and pimples. Cover the poultice loosely if possible with a layer of cotton-wool and oiled muslin to retain the heat and moisture longer. It should be changed every three hours at least. Apply hot and never keep on when it is cold. It should never be used a second time.
Starch Poultice.—This is used in skin diseases for its soothing properties. Mix the starch first with a little cold water and then add enough boiling water to make a thick paste, which is then spread on muslin covered with a layer of gauze.
The Jacket Poultice. For lung affections.—Two layers of thin muslin are shaped so as to fit closely around the neck and under the arms and come over the chest and back, low enough to cover the lungs. Three sides are now closed, and the prepared linseed is poured into the bag and regularly distributed. Close the open end and then apply. Cover it with wool and oiled silk and keep in place with safety pins or tapes which are tied under the arms and over the shoulders. When changing the poultice be careful not to expose the patient. A cotton-wool jacket should be worn a few days after the poultice has been discontinued.
Cold is applied either by means of the cold bath or by compresses, pack, sponging, coils or ice.
Cold Compresses are made by using two or three thicknesses of lint or linen wrung out of cold water or ice water and applied over the inflamed part, and changed frequently. A little vaselin may be rubbed on to prevent the skin from becoming irritated. They are very useful where little weight can be borne. If iced compresses are used a small block of ice partially wrapped in flannel is placed in a basin; there should be two compresses, one of which is kept on ice while the other is on the patient.
Compresses are very good in the early stage of tonsilitis, quinsy, sore throat, laryngitis and croup.
Ice-bags (India Rubber).—With these, cold can be best applied and with less trouble. These are made in different shapes. For instance helmet-shaped to fit the head and long and narrow for the spine.
Crush the ice in small pieces and mix in it a little common salt,—never fill the rubber bags more than half full; expel the air as much as possible by pressing before screwing on the top. Always place a layer of lint, cotton or thin cloth between the skin and the bag. The extreme cold is not only painful but liable to irritate the skin, and may cause frost-bites. Its effect should be watched carefully. Sometimes the weight causes discomfort. In such cases suspend the bag. For the head, fasten a bandage to the neck of the bag and pin the two ends to the pillow just high enough to allow the cap (bag) to barely touch the head. Care should be taken to refill the ice-bags before the ice has melted. At times a piece of ice is wrapped in moist lint or old linen and passed gently over the head in order to cool the head.
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For Appendicitis.—There should be quite a thickness of cloth between the ice bag and the skin. The latter must not become too cool. In this disease this bag is a great reliever of the pain and generally used.
Ice Poultices.—In some cases these are better than the ice bag for the reason that they fit the body better. They are usually made of two parts of crushed ice to one of linseed meal or bran, together with a small amount of salt. Make two bags of oiled silk,—one should be smaller than the other. Close all sides but one, with adhesive plaster. Fill the smaller bag two-thirds full of ice, close and slip it into the larger bag.
Ice Water Coils.—These can be bought. They can also be made from rubber tubing. Sew this upon a piece of rubber cloth in circles about one inch apart for five or six rounds; leave a yard or two of tubing at each end to be used as a siphon, A large pan of ice water is raised above the patient into which one weighted end of the tubing is placed, with a funnel inserted into it, covered with gauze to prevent clogging, while the other end is laid in a second basin on the floor which receives the water. The upper pan must be kept filled. This is very good for delirium in brain fever, etc., when applied to the head and also good for bleeding from the bowels in typhoid fever. The stream of water can be regulated if necessary by a stop-cock.
Lotions.—Lotions are medicated moist applications, and may be either hot or cold.
Counter—Irritants are agents applied externally to produce irritation or inflammation in order to relieve a diseased condition in an adjacent or deep-seated part of the body. Mustard foot-bath relieves pain in the head by drawing the surplus blood away from the head. The mildest mustard counter-irritant is the mustard poultice. It can be made with one part mustard to six of linseed meal. Never use boiling water with mustard.
Mustard Poultice.—Use of ground mustard, one-fourth to one-eighth of the amount of meal used. Make into a paste and stir this into the linseed, after it has been prepared for the poultices. The white of an egg is used in this poultice as it may keep the poultice from blistering.
Yeast Poultices.—These stimulate ulcers, gangrene and sloughing conditions. Mix eight ounces of soft yeast with as much water. Add enough flour to make a sponge, but not too stiff. It should be kept warm until fermentation begins; then apply every day. Finely powdered charcoal can also be added.
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For Soothing Effect.—Hop bags or bran bags, dipped in hot water, may be applied, protected and kept in place with a bandage.
Spice Poultice.—This is very good for pain in abdomen in children especially. Equal parts of ground cinnamon, cloves, allspice and ginger, one-quarter part cayenne pepper, if needed very strong. Place all together in a flannel bag and spread equally. Wet with alcohol or brandy. When dry, re-wet. This is a mild warming dressing.
Spice Poultice from a Stanlyton, Va., Mother.—"Take one teaspoonful each of mustard, ginger, black pepper, cinnamon, cloves, nutmeg, or as many ground spices as one has in the kitchen; mix them well in a bowl while dry, adding boiling water slowly and stir constantly until it is of the consistency of soft putty; spread between soft thin cloths and apply to the affected parts as hot as the patient can bear it. When it is cool heat it again and apply."
Mother's Flour and Water Poultice.—"Make a thick poultice of flour and water; bake soft and apply hot. Have another ready for change, if necessary. This is good for any pain."
Poultice of Peach Tree Leaves from our Mother's List.—"Put a handful of peach leaves in a vessel and let boil well; add enough meal to thicken, spread between thin muslin cloth and apply to parts affected. This is a splendid poultice."
Mild Plaster for Children.—"Two teaspoonsful of flour, three teaspoonsful of mustard, a little fresh lard and a few drops of turpentine, Mix up with warm water."
Fomentations.—This is the best way to apply moist heat, but it is troublesome, as they should be changed very frequently, at least every ten minutes when heat is required. They should never be left on until they are cold and clammy. Sheets of lamb's wool make the best material. Cut these layers into sizes required and encase them in a gauze cover over which is put a layer of oiled silk. Coarse old flannel or an old blanket will do well. Take two layers of the flannels, dip in the boiling water and wring. Two should be at hand. Dry the skin first and then put on the flannel. It should be covered with enough material to keep in the heat and moisture. Hops, etc., can be put into the water.
Turpentine Stupes.—This is prepared the same way, except turpentine is added. After the flannel has been wrung out, add from ten to twenty drops of turpentine, or add two or three teaspoonfuls of turpentine to one pint of boiling water and put the flannel in it and wring out and apply. Put a towel over the stupe. This is especially for gas in the bowels.
Mustard Stupe.—Put a tablespoonful of mustard in one pint of hot water. Make a paste of the mustard before it is put into the hot water, to avoid forming lumps; never use boiling water. Wring the flannel out after it has been in this solution and apply to the part.
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Mustard Plaster.—This is made of different strengths, depending upon the length of time it is desired to keep it on and the sensitiveness of the skin.
1. Equal parts of mustard and flour. 2. One of mustard and two of flour. 3. One of mustard and three or four of flour. White of an egg added makes it better and not so blistering.
A paste is made with warm water and spread between the layers of muslin and left on no longer than ten minutes. When the skin is red remove the plaster. This is used when you wish a quick counter-irritation.
Mustard Plaster.—This is made stronger, 1 to 2 to 3 parts meal.
Mustard leaves or Sinapisms may be bought at a drug store. They are no better than you can make. Use plasters.
Capsicum and Belladonna Plasters.—May be bought. In applying, heat the back of the plaster slightly; the face of the gauze is pulled off and the plaster placed where wanted. To remove soak first with alcohol.
Spice plaster.—Mix two teaspoonfuls each of ginger and cloves with a teaspoonful of cayenne pepper, one tablespoonful of flour, enough brandy or water to make a paste. Spread this between two layers of muslin.
For Turpentine and Mustard Stupes see above.
Tincture of iodine, chloroform and liniments are also counterirritants, also castor oil, and pure tartar emetic, and cartharides.
Cupping, Wet and Dry.—This is sometimes used to relieve inflammations of the eye, lung or kidney, or even muscular pains like lumbago. Wine-glasses will do as well as any you can buy.
Dry cupping.—Take a piece of wire, wrap a small piece of cotton about the end, dip this in alcohol, light it and swab the inside of the glass, remove and apply the glass. The heat causes the air to expand and it is driven off and the partial vacuum formed is filled by the skin and tissues over which the glass is placed. The edges of the cup must not be warm enough to burn the patient. Six or seven cups may be applied at one time and allowed to remain five minutes, after which they are removed by pressing the flesh around the edge and inserting the finger there so as to let in the air.
Linseed meal poultices can be applied afterwards to keep up the work begun.
Wet cupping.—Scrub the skin with hot water and soap, wash off with a five per cent (1-20) carbolic acid solution. Make a few cuts over the parts desired with a clean knife and apply the cup prepared in the way above directed. Remove the blood and check the bleeding, if necessary, by sponging. Place a pad on the part and hold this in place by a bandage or adhesive strap.
Blistered Skin. To dress.—Puncture the lower part with a clean instrument and catch the fluid on absorbent cotton. Dress it with oxide of zinc ointment or vaselin on lint or clean linen and strap on. It is best not to remove the skin from a blister at the first dressing.
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HOW TO DETERMINE THE DOSE FOR CHILDREN.
We have endeavored to always give the dose throughout this book as we recognized the lack of accurate and detailed information regarding the administering of medicines as one of the weak features in practically all home medical books. If we have overlooked a few instances we wish to provide for such omissions by giving the table of doses generally used by nurses as a basis for determining the dose of any medicine she may be using for a particular age.
Rule usually followed.—For children under twelve years of age. Make a fraction. Use the age of the child for the upper number, numerator. The number below the line, denominator, is twelve, added to the age of the child. For example: If your child is two years old you would begin by placing two as numerator, thus 2/, then you add 2 + 12 = 14 and place 14 below the line and you have 2/14 or 1/7. You then take 1/7 of the adult dose for your two-year-old child. If the dose for an adult is 21 drops, a child of two years is given 3 drops, etc.
DOSE IN DROPS FOR DIFFERENT AGES.
If the dose is a spoonful or 60 drops for an adult, the other doses would be correct for the ages given below:
21 and over 60 drops
15 years about 33 drops A few more or less if robust or weakly
12 " " 30 drops "
10 " " 27 drops "
8 " " 24 drops "
6 " " 20 drops "
5 " " 17 drops "
4 " " 15 drops "
3 " " 12 drops "
2 " " 8 drops "
1 " " 4 drops "
Exceptions to this rule are calomel and castor oil, when half an adult dose can be given between 12 and 18.
Opium is dangerous to children and old people and should be administered by a physician or trained nurse.
"Lest We Forget."
COMMON TABLES OF MEASURES.
APOTHECARIES' WEIGHT.
Apothecaries' Weight is used in prescribing and mixing medicines
Table.
20 grains equal 1 scruple
3 scruples " 1 dram
8 drams " 1 ounce
12 ounces " 1 pound
The pound is the same as the pound Troy. Medicines are bought and sold in quantities by Avoirdupois Weight.
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1 grain equals 1 drop or 1 minim
60 grains or drops " 1 teaspoonful
1 teaspoonful " 1 fluid dram
8 drams (or 8 teaspoonfuls) make 1 fluid ounce
2 tablespoonfuls make 1 fluid ounce
1/2 fluid ounce is a tablespoonful
2 fluid ounces is a wineglassful
4 fluid ounces is a teacupful
6 fluid ounces is a coffee cup
16 ounces (dry or solid) is a pound
20 fluid ounces is a pint
MEDICINE CHEST.—More important than the furnishing of the house is the medicine chest. If you are beginning housekeeping let this be your first consideration. Do not put it off because it is a little trouble and costs a few dollars. Yon would not think of leaving your front room or your "spare room" half furnished. Your health is of vastly more importance than the looks of your best rooms. There may come a time when you cannot secure the doctor for several hours or get into a drug store. Be prepared for this emergency and either fix up a home-made box with shelves, etc., or buy a regular medicine chest; in either case have a lock to it and the key where you can find it but where the children cannot reach it.
We give below a few of the necessaries and you will of course add to this list. One mother writes that she went to the store and bought several tiny little bells and tied one of these bells around the neck of each of the bottles in her medicine chest that contained poison. There was no danger of her getting the wrong bottle in the dark. Contents of the Medicine Chest.
Ten cents worth of Alum.
A small bag of Burnt Alum.
A small bottle of Castor Oil.
A small vial of Bichloride of Mercury Tablets.
A box of Boric Acid Powder.
A $mall bottle of Glycerin:
A bottle of Extract of Witch-hazel
A small bottle of Syrup of Ipecac.
A bottle of Whisky and one of Brandy.
A box of English Mustard.
Medicine glass.
A small box of Cold Cream.
Soft rubber Ear Syringe.
A Clinical Thermometer.
An Eye Stone.
A pad, pencils, and labels.
A small bottle of Carbolic Acid.
A roll of Adhesive Plaster.
A small box of Pineoline Salve.
A bottle of Arnica.
Hung near the chest should be a fountain syringe with the rubber catheter for use in irrigating the bowels and a hot water bag.
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HOW TO CARE FOR THE DEAD.
The limbs should be straightened before the body becomes stiff (rigor mortis). The eyes should be closed and the jaws held in position by means of a support placed firmly under the chin; for this a roller bandage or a small padded piece of wood is generally used. Of course if the person has worn false teeth, and they have been taken out during the last hours, they should be replaced immediately after death. The nostrils, mouth, rectum, and vagina should be packed with absorbent cotton to prevent the escape of discharges after death. After this bathe the body, if so desired by the relatives, with a two per cent watery solution of carbolic acid, and if there are any wounds they should be covered with fresh cotton and neatly fastened with a bandage. The hips may be enclosed in a large triangular binder; the knees are held together by a broad bandage; the hair should be brushed smoothly, and finally stockings and a simple nightgown should be put on. If the case be one of the infectious diseases, wrap the body in a sheet wrung out of a five per cent watery solution of carbolic acid and this sheet should be kept damp.
The room where death occurs should be tidied and regulated to make it look natural and comfortable. The undertaker can be sent for as soon as desired by the family. But if such care as directed has been given, the undertaker need not be hurried.
ENEMA.—Enemata (Injections).—There are various methods used for injecting fluids into the body. When they are introduced into the intestines, we speak of giving enemata (enema is the singular). They are named according to their purpose.
1. Simple laxative or purgative enemata.
2. Nutritive enemata for the purpose of nourishment.
3. Sedative enemata for local or systemic quieting effects.
4. Astringent enemata to check bleeding and diarrhea, like hot water, ice water, solution of alum or nitrate of silver.
5. Emollient (soothing) enemata for soothing irritated and painful mucous membrane; starch and drugs are also used.
6. Antispasmodic enemata to relieve flatulence such as the turpentine enemata.
7. Anthelmintic (against worms) for destroying worms; salt, turpentine and quassia are used.
8. Antiseptic or germicidal enemata used in dysentery.
9. Stimulating enemata, like hot water, hot strong coffee, hot whisky and water, salt water.
10. To relieve thirst, water one pint or normal salt solution (one dram to a pint of water) and injected high up.
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ENEMATA are given either high or low.
A high enemas thrown high up into the bowel.
A low enema is injected into the rectum only, through a hard rubber tip to a syringe.
Directions.—There are many ways of giving a simple enema.
Position.—A good way is to place an adult patient on his left side, with the knees bent up close. Protect the bed with a rubber sheet and towel under the patient. The basin of water can be placed on the rubber sheet and the enema given under cover.
Amount.—An adult person will take one to four pints. A child one-half to one pint. For an infant about two ounces will do.
What material? A simple enema can be made with good castile soap or good brown soap and water, temperature about 95 degrees F. When ready for use make into a good suds.
Syringe.—Use a bulb syringe, see that the syringe is filled full to the nozzle before the nozzle is put into the bowel. Any air left in the syringe will pass into the bowel and cause pain. Oil the nozzle with vaselin or sweet oil and then gently put the nozzle into the rectum. It is better to introduce an oiled finger through the sphincter muscle and pass the nozzle along the finger and gently into the bowel. It should be in the bowel two or three inches. Do not attempt to force the nozzle through any obstruction. Introduce the water slowly in a gentle and steady stream. The main object is to distend the rectum by means of the water, thereby producing reflex stimulation. The worm-like movement of the bowels results, thus bringing about an evacuation. The patient should retain it for ten or fifteen minutes to get the best results. A folded towel placed against the anus will assist the patient in resisting the desire to expel the water. A large amount should be given in one-half hour if the first one does not produce the desired result.
Sometimes a laxative enema is necessary.—Olive oil or glycerin or castor oil may be used.
For olive oil, six ounces may be given in a hard rubber syringe; this is seldom successful unless followed by a soap suds enema in one-half hour.
Glycerin enema, one-half ounce with equal quantity of warm water 95 degrees F., and give with a hard rubber syringe. This generally proves successful, without an additional soap suds enema.
For infants and children the contents of a straight medicine dropper will be sufficient.
Glycerin irritates the mucous membrane, and it is best that we add an equal amount of olive oil.
If these enemata fail it will be necessary to use purgative enemata. These are made by adding drugs, such as turpentine, rochelle or epsom salts or castor oil in certain proportions to the simple enema. In giving castor oil and water it is necessary first to mix the oil with the yolk of an egg and then add the warm soap suds.
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1. Formula.—
Castor Oil 2 ounces
Turpentine 1/2 ounce
Mix thoroughly and inject with hard rubber syringe, followed in one-half hour by a quart of soap-suds.
2. Formula.—
Turpentine 1/2 ounce
Rochelle Salts 1 ounce
Mix with warm soap-suds, one pint.
The buttocks and anus should be washed off with warm water after turpentine has been used in the enema.
3. Molasses and Laxative Enema.—Mix from two to ten ounces, according to age, with one pint of soap suds and inject slowly.
Nutritive Enemata.—Food is given by the bowel when the stomach cannot retain it. It is then called Nutritive Enemata. They should be given only from four to six times in twenty-four hours and the quantity given at one time should not exceed four ounces. It must be introduced high up in the bowel, about ten inches, and therefore they should be given through a rectal tube made of heavy rubber one-quarter inch in diameter and at least eight inches of it should be inserted in the bowel. After it has been oiled the tube is gently inserted in a backward, upward, direction and a glass funnel is attached to the outer end. The enema has been already mixed in a small pitcher and gently poured (very slowly) into the funnel, which is then raised so that the contents will go slowly through the tube into the bowel. The patient is protected from drops by a folded towel underneath him. Then the tube is slowly withdrawn. The tube should then be cleansed by allowing warm water to run through it, and then kept in a one per cent solution of boric acid. Food given by enemata should be very nourishing and concentrated. The following are excellent formulas:
Formula 1.—
One whole Egg
Table Salt 15 grains
Peptonized Milk 3 ounces or 3/8 of a cup
Brandy 1/2 ounce
Formula 2.—
White of two Eggs
Peptonized Milk 2 ounces or 1/4 of a cup
The whole amount should never exceed four ounces. The addition of salt aids the absorption of the egg. Brandy, and whisky are very irritating and should be given only every other time.
The fresh raw milk can be used, if it is impossible to have it peptonized.
After a nutritive enemata the patient should lie quietly on his back for twenty or thirty minutes.
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Turpentine enemata for distention may be given according to the following formula:
Mucilage of Acacia 1/2 ounce
Spirits of Turpentine 10 drops
This should be administered high up in the bowel.
Astringent Enemata. To check diarrhea.—They should be given slowly and injected high up, and they should be retained as long as possible.
Starch and Laudanum.—Boil the starch as if to be used in the laundry and dilute with luke-warm water, until it is thin enough to pass through a tube. Take of this three ounces. This can be given alone in mild cases; but if there is much pain and straining add ten to fifteen drops of laudanum to the starch water or thirty to forty drops of paregoric. This dose is for an adult.
Stimulating Enemata. 1. Black coffee.—One-half to one pint of strong coffee, injected as hot as possible. It should be strained before using. This is frequently given in poison cases.
2. Salt Enemata.—Two teaspoonfuls to one quart of hot water is mildly stimulating; one-half to one ounce of brandy or whisky may be added.
DOUCHES.—By this term is generally meant a jet of fluid directed with a certain amount of force upon a limited external or internal surface, for cleansing, stimulating purposes and to relieve inflammation. Three common douches are the ear (aural), the vaginal and the rectal.
The Vaginal Douche. For cleansing.—A one per cent solution of carbolic acid is often used in one to three quarts of water.
To allay inflammation.—A hot solution of the temperature of 105 degrees to 115 degrees is given, and three or six quarts may be used. Allow the stream to flow before the nozzle is inserted so as to have the warm temperature instead of cold at the start, and the nozzle should be introduced up towards the posterior vaginal wall. The fountain syringe bag should not be raised more than six to twelve inches above the patient who is lying down with her hips raised on pillows and her knees drawn up. Medicines can be used in all the douches.
Rectal douche.—This is to relieve piles and reduce inflammation. Hot or cold as needed. A rectal tube or fountain syringe is used.
Ear (aural) douche.—This is used for earache and inflammation. Salt or boric acid is generally used in the warm water. It should be allowed to flow in slowly and gently.
How to use a bed pan.—When you are placing the pan, you should slip one hand under the buttocks and then place the flat end of the pan under the buttocks. It should always be warm. Raise the patient in the same way before attempting to remove it. Do not pull it out.
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TEMPERATURE (Fever).—A thermometer is necessary in taking the temperature. They can be bought for from fifty cents up. The temperature is taken by putting the thermometer under the tongue, in the arm-pit and in the rectum. For children it should be placed in the rectum or in the arm-pit or groin. Allow it to remain from two to five minutes. This depends upon the time limit of the thermometer. The normal temperature is 98-6/10 degrees F. This varies, some people are normal at times at 99 or 98 degrees. The temperature in the arm-pit is lower by 3/10 of a degree, but that in the rectum is 1/2 degree higher than that taken in the mouth. The normal point on the thermometer is marked by an arrow. The mercury in the tube must always be down to that at its highest point, before the thermometer is placed and the highest point the mercury goes indicates the height of the temperature (fever). If you take it in the rectum, that should be free from feces. Oil the thermometer and gently insert it into the bowel for one and one-half inches and hold the stem.
Under the Tongue.—Place the point under the tongue and instruct the patient to close his lips over the thermometer. He can also hold the stem with his fingers, It should never be taken here right after a cold drink. Unconscious patients may bite through the instrument, so care must be taken with them.
Arm-pit.—Wipe the part thoroughly dry and place the point directly in the arm-pit. Then place the elbow against the body and the hand on the chest pointing to the opposite shoulder. When ready to take it out move the arm away from the body and take the thermometer away gently for it sticks sometimes and you will cause pain if you draw it away quickly. The instrument should be cleansed in tepid mild salt solution.
PULSE.—Average in men, sixty to seventy. In women, sixty-five to eighty. Children ninety to one hundred to one hundred and twenty. Different authors vary. In men it is generally seventy to seventy-two. In women seventy-two to seventy-five.
It is better taken sitting. It is faster when walking, slower when lying down. I always take the pulse in the left arm unless there is a deformity there. I use my right hand with the third finger toward the elbow. By using the first three fingers you can find out different things about the pulse. Some people are very nervous and such an one will make your arm ache when feeling the pulse. The pulse should be regular, even beats, in health. Sometimes you can feel it best on the temple or on the neck.
RESPIRATION (Breathing).—In an adult the average is eighteen per minute. In a child the average is twenty to twenty-four. Respiration is the act of taking in (inspiration), and giving out (expiration) air by the lungs.
THE TONGUE.—This is coated in dyspepsia and fevers,—some healthy persons always have a coated tongue.
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In Ulcers of the stomach there is no coating.
In high fevers, the tongue may also be red and cracked as well as coated in some parts.
A dark brown or blackish coating indicates a serious condition in acute diseases.
Strawberry tongue is seen in Scarlet Fever.
Cankered tongue and month may be due to local conditions, or to stomach, liver and bowel disorders.
In Peritonitis the tongue is generally dry and red (beefy).
Cholera Infantum.—At first coated, then dry and reddish.
Constipation.—Tongue is generally coated.
Biliousness.—Yellowish dirty coating.