Part 11

In using galvanism a good battery and outfit are essential. First, it is necessary to have a milliampere meter, an instrument to measure the strength of current used. The quantity of electricity used should be measured the same as the quantity or dosage of drugs prescribed. Another essential instrument is the rheostat, by which the current strength may be gradually increased or decreased without interrupting the current. The electrodes which are attached to the poles of the battery may be metal, metal covered with sponge, cotton, etc., preferably cotton, which may be renewed with each application, thus avoiding the possibility of infection, always present in the use of a sponge-covered electrode, which cannot be changed with each application.

In the use of galvanism we may speak of two different methods. First, what is called cerebral galvanism, second general. By experimentation it has been clearly demonstrated that all the deeper tissues and organs of the body, such as the brain, spinal cord, liver, etc., may be influenced by galvanism. In cerebral galvanism the object is to influence the brain and spinal cord. In applying it to the head, a sponge or cotton-covered electrode 4-5” in diameter may be used. The positive electrode is applied to forehead, the negative at nape of neck, using a current of 5-10 milliamperes for from five to fifteen minutes, care being taken not to suddenly make or break the current, as this would produce a disagreeable shock to the patient. The circulation of the brain may be affected also by placing an electrode at the nape of the neck, and a smaller electrode (1-2” in diameter) passed up and down along the border of the sternocleidomastoideus muscle, using a current of 3-5 milliamperes. Galvanism used in this way is beneficial in such conditions as cerebral anemia, neurasthenia, insomnia, etc. In applying to the spine, one electrode may be used at the upper and the other at the lower part of the spine; or a large-sized electrode may be placed over the abdomen, and the other electrode moved up and down the spine without breaking or interrupting the current, the strength of which may be from 10-20 milliamperes, and the duration of each application varied to suit the condition of the patient. This treatment is indicated in such disorders as neurasthenia, infantile spinal paralysis, locomotor ataxia, etc.

General galvanization may be given by placing a large-sized electrode at the spine, over the abdomen, or at the soles of the feet, the other electrode, smaller in size, being passed over the entire surface of the body without interrupting the current, which may be from 5-8 milliamperes. This procedure will stimulate the peripheral circulation, elimination, and nutrition. The muscles may be exercised by using an interrupted current of sufficient strength only to cause contraction. General galvanization is very beneficial in such conditions as neurasthenia requiring the rest treatment, convalescence from various diseases, paralysis, multiple neuritis, etc. In the use of electricity it should be remembered that patients show idiosyncrasies as in the use of drugs, so that each case should be given the amount of electricity best suited to individual peculiarities. Unless this point be kept in mind, we will be surprised to find at times that the use of electricity aggravates the patient’s condition.

Faradism, or the induced current, is characterized by a high electromotive force and a low amperage or quantity. It is an interrupted current, and from the secondary coil it is an alternating current. It cannot be used like the galvanic for electrolytic-cataphoric purposes. Its effect upon the body is almost entirely mechanical; also unlike the galvanic, there is practically no polarity. It cannot be used to affect the deep-lying structures, such as the brain, spinal cord, etc. The current-strength is not measured by a milliampere meter. It will produce muscular contraction only through the motor nerve supplying the muscle. This is a point to be remembered. Its use is confined largely to exercising muscles and stimulating peripheral circulation, and is useful in such conditions as paralysis where the cause of the paralysis is in the brain (because where the lesion producing the paralysis is in the spinal cord or peripheral nerves the muscle will not contract when faradism is applied), and in convalescence and all conditions requiring exercise which cannot be obtained actively. In applying this form of electricity (if the object be to stimulate circulation), the strength of the current should be regulated to suit the feelings of the patient. The technic is practically the same as described above for general galvanization. If we wish to exercise the muscle, then that current should be used which is just strong enough to produce muscular contraction and no stronger, care being necessary not to over-stimulate and exhaust the muscle. As a means of muscular exercise only this current is preferable to galvanism, being easier of application and less likely to produce harm.

Franklinic, or static electricity, is seldom administered by a nurse unless in a hospital or in a physician’s office. The current is produced by machines of various makes, such as glass and mica. The plates vary in diameter from twenty inches to three feet or more, and in number from two to sixteen or more. Its current then generated is characterized by an enormously high electromotive force, but a very minute quantity or amperage. Unlike the other two forms of current described, its use does not necessitate the removal of clothing. It may be used by placing the patient on an insulated platform and charging him with this current of high electromotive force, which very markedly stimulates circulation; or it may be used by applying or drawing sparks directly from the patient’s body, in this manner producing counterirritation, stimulating circulation, relieving localized pains, etc. It has been found useful in such conditions as chorea, neurasthenia, muscular rheumatism, lumbago, chronic inflammation of nerves, etc.

Nurses probably will never be called upon to use the _x_-ray, but this most wonderful manifestation of electro-force has recently taken a prominent position as a diagnostic and therapeutic agent. Parts of the human body heretofore only revealed by the use of the knife or post mortem are now plainly discernible during life through the use of this force. The field of its therapeutic application is a large one, and disorders which have been considered incurable or difficult of cure by other means now yield readily to the _x_-ray.

FOOD CONSTITUENTS.

=The Wise Combination of Food.=—In order that each meal may be planned to meet the needs of the body it is necessary that it contain protein, fat, carbohydrate, mineral matter, and water. Some flavor foods should enter into each meal.

Flavor is important because it stimulates the appetite and because it stimulates the flow of digestive fluids and thus aids digestion. Such foods are only injurious when they are used to excess. In that case the nerves which control the flow of digestive fluids are overstimulated and at last become weakened. Avoid the use of too many flavors at one meal.

SOURCE AND USE OF CHIEF FOOD CONSTITUENTS.

Chief functions in the body.

{ Meats { { Fish { Build tissues. { Eggs { I. { Milk { Protein { Cheese { Repair daily waste { Peas { of tissue. { Beans { Give heat energy. { Gluten in flour {

{ Butter { { Cream { Give heat energy. { Fat of meats { II. { Cheese { Fats { Oil in nuts { { Olive oil { { Egg yolk { { Corn oil { Produce fat. { Seed oils {

{ { Cane { { { Beet { Give heat energy. { { Maple { { Sugars { Malt { { { Sugar of milk { { { Sugar of fruit { { { III. { { Cereals { Carbohydrates { { Flours { { { Peas, Beans { { Starches { Corn { { { Potatoes { { { Some other { Produce fat. { { vegetables { { { Celluloses { Vegetables } Give bulk. { { Fruits } { { Aid in formation of { Fruit acids { bone. { { Enter into composition { { of every living { { cell and body { { liquids. { { Useful in the blood { { (carrier of body’s { { oxygen). { { Necessary to maintain { { osmotic pressure. IV. { { Govern contraction Mineral { { of muscles, salts { { including those { { of the heart. { { Help to maintain { { neutrality of the { { blood (increase { { alkalinity). { { Assist in digestion. { { Assist in the removal { { of waste. { { Unite with harmful { { products found in { Vegetables { body and render { { them harmless.

{ { Solvent for food. { In all vegetables { Carries food to { { blood. V. { { Carries off waste. Water { { Helps to regulate { { temperature. { In all animal foods { Aids digestion. { { Aids tissue building.

=Overuse of Carbohydrates.=—If too much sugar and starch are eaten, fermentation may take place and interfere with digestion. Too much sugar and starch overworks the liver.

Because sweet foods have the quality of satisfying the appetite very readily they should not be taken to satisfy hunger, but should rather be eaten after sufficient body building and body regulating foods have been taken to meet the body’s need for such foods. The custom of serving the sweet food at the last of the meal is in harmony with this dietetic principle.

It is important that children should form sane habits of eating sweet foods. The practice of using large amounts of sugar on cereals, cooked fruits, and in beverages should be discouraged.

The overuse of sugar irritates the lining of the digestive tract. This is caused by the abstraction of water from the mucous lining. Sugar is one-sided in its value, consequently it is much wiser to obtain a high percentage of heat from foods which serve other purposes as well.

=Protein Foods.=—The first class of foods, the proteins, includes those which have tissue building for their chief purpose. They are essential for maintenance and for body growth, as they are the only source of nitrogen. Therefore they are necessary for the growing child and for the athlete in the development of strong, vigorous muscles. The more easily digested protein foods are advised for the tubercular patient whose muscles and tissues have become debilitated by disease.

Proteins are required by each individual, but in varying amounts, to suit age, occupation, condition of system, and climate. The value of a mixed protein diet is urged by the best authorities rather than the diet which contains but one protein food.

=Overuse of Protein Foods.=—It is true that a high percentage of illness is caused by an accumulation of wastes in the body. It is also true that protein foods leave a higher percentage of waste material in the body than any other class of foods. It follows, then, that an overuse of protein foods overworks the excretory organs and tends to weaken them. The weakened excretory organs are unable to take care of the waste products, and as a result the system is affected by poisonous wastes which are produced by putrefaction in the intestines. A person in this condition is more liable to have rheumatism, gout, kidney and liver diseases than one in normal condition.

A SHORT STUDY OF PROTEIN FOODS

Some common forms. Some sources.

Albumen Eggs Casein Milk Myosin, fibrin, and elastin Meat Gluten Wheat Tuberin Potato Legumin Peas and beans Excelsin Brazil nuts Zein Corn

_Milk_ contains a small amount of protein. In a glass of about 12 tablespoons of milk there is less than 1 tablespoon of protein.

_Egg_ contains nearly as much protein as lean meat.

=Value of Fruit and Vegetables.=—Vegetables contain protein, starch, sugar, cellulose, mineral matter, water, and undetermined substances.

Fruits contain (chiefly) sugar, cellulose, mineral matter, and water.

_Water_ removes wastes, lubricates tissues, aids in forming secretions, helps to equalize the temperature.

_Acids_ help to maintain the alkalinity of the blood—stimulate the appetite.

_Mineral salts_—

Build bone. Help to make blood alkaline. Aid in digestion. Aid in excretion. Build red blood-cells. Build nerve tissue. Build cells.

_Cellulose_ exercises muscular lining of digestive tract.

_Note._—Good authority makes the statement that the housekeeper is wise who pays as much for milk, vegetables, and fruit as for meat, eggs, and fish.

=Use of Eggs.=—Eggs serve as a meat substitute.

Eggs require the addition of carbohydrates and some fruit or vegetables to form a well-planned meal.

=Digestibility of Eggs.=—Raw eggs are more easily digested when beaten. They are often prescribed when a nutritious, highly concentrated diet is desired, and in cases of tuberculosis, some forms of anemia, and various wasting diseases.

_Effect of Heat._—Egg albumen begins to coagulate at 134° F. and becomes jelly-like at 160° F.

=Preservation of Eggs.=—1. _Water-glass (Sodium Silicate)._—Nine quarts of boiled water (cooled) to 1 quart of water-glass. Eggs will keep in this solution three and a half months.

_Note._—A good grade of water-glass should be of the consistency of molasses. If heavier than this the water-glass should be diluted to the right consistency, as the eggs should sink.

Eggs may be added to the solution from day to day as gathered. Do not wash. If the nests are clean the eggs will not need washing. Keep in a stone jar in a cool place just above the freezing-point. Do not use the solution the second year. The water-glass may be obtained in the dry or liquid form, and dissolved in either hard or soft water.

2. _Lime Solution._—Piece of lime size of lemon. Pour 1 gallon of boiling water over it. Let stand until cold. Add 1½ cups of salt.

3. _Paper Wrapping._—Wrap perfectly fresh eggs in paper and keep in cool place. This is not as effective as Methods 1 and 2, but keeps eggs for a short time.

THE PREPARATION OF FOODS FOR THE SICK.

TO PEPTONIZE MILK.

1. Pepsin, grs. xx; Cold water, ℥iv; Milk, Oj.

2. Pancreatin, grs. v; Soda bicarbonate, grs. xv.

3. Peptonizing powder, grs. xx; Warm water, ℥j; Milk, Oj.

=Directions.=—Place the contents of one of the vials into a well-cleaned quart bottle. Pour upon it a gill of cool water and shake the mixture thoroughly. Then add to the mixture a pint of fresh milk and place the bottle in a vessel containing water as hot as can be borne by the hand without discomfort. Let it stand, with occasional shaking, for ten to twenty minutes, or until it has acquired a slightly bitter taste, when it should be removed from the hot water and placed upon the ice or in a cool place, to check digestion and keep from spoiling. If it is not quickly cooled the digestion will continue and the milk become too bitter to be palatable.

Milk thus peptonized may be sweetened if the patient desires it. It may also be flavored with wine or rum as desirable.

=Cold Process.=—This consists in adding to the milk the peptonizing powder as above, using cool water and milk, and then placing the mixture upon ice without warming it at all.

N. B.—If it be found that the milk ferments after following the above directions, boil the milk first, let cool, and then peptonize. “_The bacteria in uncooked milk cause fermentation when pepsin is added._”

PEPTONIZED BEEF.

To a quarter-pound of finely minced, raw lean beef add a half-pint of cold water; cook over a slow fire to boiling and boil for a few minutes, stirring constantly from the beginning. Pour off the liquor and set it aside; rub the meat to a paste and put it into a clean glass jar or bottle with the liquor and a half-pint of cold water; add

Extractum pancreatis, 20 grs.; Soda bicarbonate, 15 grs. Mixed thoroughly into one powder.

Shake all well together and stand in a warm place, about 110° to 115° F., for three hours, stirring or shaking occasionally, then _boil quickly_, strain, or clarify with white of egg in the usual manner; season to taste.

This final boiling is essential; if omitted, digestion will progress until the food is spoiled.

For the great majority of cases it is not necessary to strain the peptonized beef, for the portions remaining undissolved are so softened under the action of the extractum pancreatis that they are diffused in an almost impalpable condition—in a form readily susceptible to digestion in the body.

Chicken meat, alone or mixed with an equal portion of beef, may be prepared in the same way.

A cereal gruel of wheat, arrowroot, etc., may be incorporated with the beef, thus giving a food combination that is often highly desirable.

The gruel is prepared in the usual manner, the dry cereal mixed perfectly smooth with cold water and cooked slowly in a double boiler until gelatinized. Four ounces of this gruel may be added to the meat paste, liquor, water and peptonizing powder as directed above, and the further details of the process carried out just as with the beef alone.

The extractum pancreatis will at the same time digest both the meat and starch (of the gruel). The broth with the cereal is more agreeable than when made of meat alone.

The peptonized beef or peptonized beef and cereal may also be made into a jelly.

PEPTONIZED OYSTERS.

To a half-dozen large oysters with their juice add a half-pint of cold water; heat in a saucepan to boiling, and boil briskly for a few minutes; pour off the broth and set it aside.

Mince the oysters finely and reduce to a paste with a potato-masher in a wooden bowl; put in a glass jar with the broth and add:

Extractum pancreatis, 15 grs.; Soda bicarbonate, 15 grs. Mixed thoroughly into one powder.

Let the jar stand in hot water or in a warm place, where the temperature is not above 115° F., for an hour and a half. Then pour into a saucepan, stir in a half-pint of milk and heat slowly to boiling-point. Season to taste and serve hot.

The boiling is essential—to prevent further digestion and keep the broth from spoiling.

If heated gradually the milk will be sufficiently digested before the mixture boils.

The very small bits of oyster that remain undissolved may be strained out, or rejected in eating the soup, but are rarely unacceptable to the stomach.

GUM ARABIC WATER (ACACIA).

Dissolve 1 ounce of gum arabic in 1 pint of boiling water; add 2 teaspoonfuls of sugar, a wine-glass of sherry or juice of 1 lemon. Good for poison cases.

LIME WATER.

Into 2 quarts of water place a lump of unslaked lime the size of an egg. After standing awhile, stir thoroughly and pour off the solution; add fresh water and keep covered.

ARROWROOT WATER.

Moisten 1 teaspoonful of arrowroot with cold water; smooth into a paste; add 1 pint of boiling water and boil five minutes, stirring continuously.

ALBUMIN WATER.

Beat lightly the white of 1 egg; stir into a glass of water; sweeten if permissible.

OATMEAL WATER.

Teaspoonful of oatmeal to a quart of water. Boil down to a pint; then strain.

BARLEY WATER.

Wash in cold water 2 ounces of pearl barley. Boil five minutes; then drain. Pour on 2 quarts of boiling water and boil down to a quart. Flavor with thinly cut lemon rind; add sugar to taste. Strain only at patient’s request.

RICE WATER.

Wash 2 tablespoonfuls of cleaned rice; put in a granite saucepan with a quart of boiling water; simmer until the rice is softened and partially dissolved; strain; add salt. May be served either warm or cold.

TOAST WATER.

Put into a pitcher 3 slices of dark brown toast; pour in a quart of boiling water and cover closely. When cold strain. Wine and sugar may be added.

COFFEE.

1. Best mixture, 2 parts Java to 1 part Mocha. Grind roasted beans just before using. Fair strength, 1 tablespoonful of coffee to 1 pint of water. With the ground coffee, mix white of 1 egg and a little cold water. Pour over it boiling water; simmer five minutes and steep for ten minutes.

2. Scald a granite coffee-pot. Mix cup of coffee, 1 egg, half-cup of cold water; add 6 cups of boiling water and boil three minutes. Remove to the back of the stove and add a half-cup of cold water. Let settle for ten minutes.

WHITE-OF-EGG LEMONADE.