CHAPTER XIV
HYGIENE AND SANITATION IN THE SICK ROOM
In case of incoördination in the body there are always existing conditions which require educated adaptation. It is the study of these conditions to which the sickroom hygiene and sanitation must be directed.
We will first consider the environment necessary for the normal expression of life in the body. Unhindered transmission of mental impulses alone will not give us the processes of metabolism. To have normal metabolism in the body oxygen must be carried to the tissue cells and there must be an uninterrupted transmission of mental impulses. Nutrition is derived from the food taken into the body and oxygen from the air is breathed into the lungs. The mental impulses are transformed in the brain by Innate Intelligence and transmitted by efferent nerves; hence the necessity for a proper amount of food, a sufficient supply of pure air and unhindered transmission. But the nutrient elements contained in the food are not in a state to be utilized by the tissue cells when taken into the body; therefore it is necessary that the food be broken up by the process of digestion that it will be rendered usable by the tissue cells.
This process of digestion requires a great expenditure of internal energy or, in other words, a functional activity of the mental impulses. Thus it is seen that the body as a machine must be supplied with the material necessary to keep it in repair and running order, and that this material is taken in and prepared within the body for bodily use.
Not only must provision be made for supplying the body with the proper amount of food, but attention must be given to a proper supply of oxygen for the lungs. This seems a very simple thing to do, and it is simple under natural conditions, but when we consider the unnatural conditions that have been created by man and under which the human race in civilized countries is living, it becomes a problem that requires great engineering skill. The ventilation of great buildings, streets and subways is no small problem and yet if the processes of metabolism are to be maintained in the body ventilation must be given attention.
If these internal processes are to be maintained there must also be a certain environmental condition which will enable Innate Intelligence to bring them about. The temperature, humidity, and atmospheric pressure are all important in their proper relationship. Innate Intelligence is capable of adapting the body to extremes in these different environmental conditions, but the transition from one degree to another, such as temperature, must take place gradually to allow sufficient time for the adaptative changes.
It will be observed that these changes take place more or less gradually in Nature, but man is inclined to pass from one extreme into another without thought of time needed for adaptation. For example he passes from a highly heated room into one with a very low temperature, or comes from compressed air chambers, where the air pressure is greater than the normal, into the normal atmospheric pressure without sufficient precaution to the sudden change. These sudden changes not only draw very heavily upon the adaptative forces of the body, but actually interfere with the normal functional activity of Innate Intelligence and produce subluxations. The more natural the environment, the less energy will be required to bring about adaptation and maintain the equilibrium of the functions. Even though the environment is perfect, there must be a current of mental impulses sufficient to produce adaptative action. When there is an interference with the transmission of mental impulses to such an extent that this adaptation can not take place there will be lack of function.
An environmental condition that will require as little adaptative energy as possible should be maintained. There should, therefore, be some attention given to the sick room, not that the hygienic and sanitary measures will in any sense cure the dis-ease, but that the forces in the body may not be used up and dissipated because of an environment that requires an abundance of force for adaptation.
The patient’s weakness in many incoördinations is purely adaptative on the part of Innate Intelligence to prevent the patient from continuing at work or doing other things that would require an expenditure of the adaptative energies of the body. In other words, it is for the purpose of conserving the energies that are needed in the reparatory and restorative processes necessary to bring about coördination.
For the above reason it is necessary to give attention to the sick room in maintaining a condition to which Innate may easily bring about intellectual adaptation and not draw upon the reserve carrying capacity of the nerves.
The expression of Innate Intelligence through the educated brain has functions to perform that are quite as essential and important in their way as are the functions produced by the expression of Innate Intelligence through the innate brain. Here is an illustration of what is meant: Innate Intelligence sends mental impulses to the liver and produces bile independent of educated brain. But if a man is walking across the street and falls to the ground unconscious he will be mutilated by traffic unless some one picks him up and protects him. Innate is still in the body of the unconscious man, but is not being expressed through the educated brain. The Innate is powerless to protect that body from harm—it requires the expression of an Innate Intelligence through the educated brain of some other person to bring about an adaptation to circumstances and protect the unconscious man. In this case the educated mind of one individual is substituted for that of the other and the desired end is accomplished. This educated function could not be expressed in the unconscious man because of the inability of Innate Intelligence to be functioning through the educated brain.
The functions of the educated mind as pertaining to the expression of life in the body have to do mostly with the environment. It is, therefore, within the scope of Chiropractic to study the environmental conditions in order that the best interests of Innate Intelligence in the expression of life in the body be protected.
Reference has already been made to the fact that adaptation to environment requires an expenditure of energy in case of incoördination. When an individual is sick there is need for conservation of energy to the fullest degree. At this time there must be no unnecessary drain upon the body in order that all forces may be centered upon the one thing—restoration. This leads us to a consideration of removing every unnecessary demand upon Innate for expenditure of energy so that all the forces may be utilized in the process of restoration.
There are a number of points to be considered in the care of the sick room where the patient is confined to his bed. There should be an even temperature maintained at all times and great care taken that the room is never overheated. The degrees at which temperature is to be maintained will be governed somewhat by the character of the incoördination. In conditions involving the respiratory tract the room may be kept quite cold. The temperature of the sick room may vary from 50° F. to 70° F. according to the incoördination.
One of the most important features in the sick room is proper ventilation and the elimination of dust and odors. The patient at all times should be provided with an abundant supply of pure air free from dust and other impurities. The room should be so ventilated as to eliminate objectionable drafts. This may be accomplished by placing screens in front of open windows or stretching a gauze over the opening in the window which will admit the air but not rapid enough to produce a draft.
In some cases of incoördinations involving the eyes it is advisable to maintain a subdued light in the room. This may be obtained during the day by drawing the shade part way down and during the night by placing shades over the lamps or electric lights. If the eyes are very sensitive to light an unnecessary adaptation may thus be avoided, thus enabling Innate to use her forces in a more desirable way.
Changing Sheets.
In severe cases some attention should be given to the furniture and hangings, not so much because of any special benefit to the patient, but for the convenience of the attendants and to insure a better sanitary condition by eliminating everything that would tend to catch dust and dirt and matter given off into the breathing zone.
Lifting Patient with Draw Sheet.
The bed and bedding should be kept clean and fresh. The patient should be placed between sheets and not between blankets even in the winter time. The top cover on the bed should be white or of a light color. All soiled linen should be removed immediately and the pillows should be kept well aired. If the patient is weak, or for other reasons must be handled by attendants, a draw sheet will be a great convenience; a sheet may be folded about three times for this purpose and placed under the patient’s hips on top of the bed sheet. This may be used to turn the patient, move the patient from one side of the bed to the other, or it may be found of service in placing him on the adjusting bench. This draw sheet may be left under the patient without discomfort. At all times care should be exercised that the sheet, draw sheet and covers are kept free from wrinkles. The bed clothes should be changed in such a way as to disturb the patient as little as possible. One-half of the bed should be changed at a time and the patient moved over on the clean sheet with the aid of the draw sheet. It is not expected that the chiropractor will find it necessary to do all these things himself; indeed, if the patient is ill enough to require this kind of care there should be a nurse on the case. However, even though he is not going to do these things himself, he certainly ought to know how they should be done.
Draw Sheet in position for lifting patient to adjusting table.
If the patient is forced to use a bed pan, great care should be exercised that the bed clothes and clothing of the patient are not soiled. If they are they should be immediately changed or at least as soon as practicable. The disposal of the excreta is of vital importance. It should be removed from the sick room immediately. From a hygienic standpoint the fecal matter, urine and sputum should be disinfected with a 10% solution of formalin and allowed to stand for an hour, or by adding bichloride to make a solution of one to one thousand. The fecal matter should be placed in a receptacle and enough hot water added to cover it, then a cup of unslacked lime added and this allowed to stand covered for a couple of hours before throwing into the sewer.
The patient confined to the bed should receive proper care. His hands and face should be bathed and he should be given a sponge bath. This may be done without disturbing the patient materially and may add greatly to his comfort. If the incoördination is in the fever family there will be no danger of the patient taking cold, but if it is not a febrile dis-ease, great care must be taken to prevent this complication. Everything possible should be done to add to the comfort of the patient and to create a pleasant and cheerful atmosphere about the sick room.
Lifting a patient with draw-sheet to place on adjusting table.
In discussing hygienic measures to be used in so-called communicable dis-eases, it must be understood that these measures are in no sense considered to be curative. If subluxations were adjusted as soon as produced there would be no occasion for such considerations, for man would remain immune and there would be no communicable dis-eases. Since subluxations are not always adjusted as soon as produced, but remain and become chronic and dis-ease is allowed to gather great momentum before adjustments are given, it becomes necessary to bring about an adaptation educationally to the incoördination. During the course of the dis-ease certain hygienic measures should be used in order to maintain a proper environmental condition.
Patient adjusted and ready to be lifted to the bed with draw-sheet.
The so-called communicable dis-eases are quarantinable and should be reported to the proper health authorities in the states requiring such procedure, in compliance with the law. There are certain sanitary and hygienic measures that should be used from a standpoint of pure cleanliness and common decency. The hygienic measures ordinarily recommended may be summed up as follows: The stools, urine, sputum and other excretions should be thoroughly disinfected. The urine may be disinfected by adding bichloride to make a solution of one to one thousand or by adding 10% formalin and allowing the solution to stand for an hour or so. It is more difficult to disinfect fecal matter. The masses should be thoroughly broken up and disinfected with bleaching powder, 3%. A 5% solution of carbolic acid may be used or formalin 10%. Another easy and effective way is to add enough hot water to cover the entire stool and then add a cup of unslacked lime or about one-fourth as much lime as bulk. The receptacle should then be covered and allow to stand for a couple of hours. In this way there will be enough heat generated by the lime to destroy the microörganisms. The sputum should be burned.
It is recommended that the bed linen, towels and handkerchiefs used by the patient be disinfected by immersing for at least an hour in a solution of bichloride of mercury, one to one thousand, a 5% solution of carbolic acid, or 10% solution of formalin.
Chiropractically the cause of the so-called communicable dis-eases is interference with the transmission of mental impulses, which results in lack of function. Where there is an interference with the functions resulting in abnormal metabolism there is always an accumulation of waste products and poisons. The accumulation of the waste products and the correspondingly lowered resistance in these structures provide a fertile field for the growth and development of the bacteria that are found in the particular incoördination. These germs are present as scavengers for the sole purpose of consuming the waste material and these bacteria will disappear as soon as the subluxated vertebrae are adjusted and the tissues become normal, for they can not live on normal tissue and will be excreted as waste. However, if there are subluxations which interfere with the transmission of mental impulses resulting in lack of functions in the body and microörganisms are allowed to enter the body, the abnormal tissues will furnish them with food and a proper culture medium in which to develop. From a chiropractic standpoint the best prophylaxis is adjustments to restore transmission to normal and the germs will find no food or fertile field in which to develop and will be excreted as so much material that can not be used in the metabolism of the body.
Under chiropractic adjustments the incoördination (so-called contagious dis-ease) will not run its full course; as a matter of fact, the recovery may be so rapid that the patient will be sick only a very few days. Under adjustments there will be no complications or sequelæ and for this reason there is not the necessity for hygienic measures to the same extent as under ordinary treatment, but during the time the patient is sick hygienic measures should be observed.