CHAPTER XIX.
CARE OF THE SICK.
It is interesting to notice in the histories of our Lord the prominent place given to the care of the sick. When he first sent out the apostles, it was to heal the sick as well as to preach. Again, when he sent out the seventy, their first command was to “heal the sick,” and next to say, “the kingdom of God has come nigh unto you.” The body was to be healed first, in order to attend to the kingdom of God, even when it was “brought nigh.”
Jesus Christ spent more time and labor in the cure of men’s bodies than in preaching, even if we subtract those labors with his earthly father by which family homes were provided. When he ascended to the heavens, his last recorded words to his followers, as given by Mark, were, that his disciples should “lay hands on the sick,” that they might recover. Still more directly is the duty of care for the sick exhibited in the solemn allegorical description of the last day. It was those who visited the sick that were the blessed; it was those who did not visit the sick who were told to “depart.” Thus are we abundantly taught that one of the most sacred duties of the Christian family is the training of its inmates to care and kind attention to the sick.
Every woman who has the care of young children, or of a large family, is frequently called upon to advise what shall be done for some one who is indisposed, and often in circumstances where she must trust solely to her own judgment. In such cases, some err by neglecting to do any thing at all till the patient is quite sick; but a still greater number err from excessive and injurious dosing.
The two great causes of the ordinary slight attacks of illness in a family are, sudden chills, which close the pores of the skin, and thus affect the throat, lungs, or bowels; and the excessive or improper use of food. In most cases of illness from the first cause, bathing the feet, retiring to a warm bed, and some hot aperient drink to induce perspiration, are suitable remedies.
In case of illness from improper food, or excess in eating, _fasting_ for one or two meals, to give the system time and chance to relieve itself, is the safest remedy. Sometimes a gentle cathartic of castor-oil may be needful; but it is best first to try fasting. A safe relief from injurious articles in the stomach is an emetic of warm water; but to be effective, several tumblerfuls must be given in quick succession, and till the stomach can receive no more.
The following extract from a discourse of Dr. Burne, before the London Medical Society, contains important information: “In civilized life, the causes which are most generally and continually operating in the production of diseases are, affections of the mind, improper diet, and retention of the intestinal excretions. The undue retention of excrementitious matter allows of the absorption of its more liquid parts, which is a cause of great impurity to the blood, and the excretions, thus rendered hard and knotty, act more or less as extraneous substances, and, by their irritation, produce a determination of blood to the intestines and to the neighboring viscera, which ultimately ends in inflammation. It also has a great effect on the whole system; causes a determination of blood to the head, which oppresses the brain and dejects the mind; deranges the functions of the stomach; causes flatulency; and produces a general state of discomfort.”
Dr. Combe remarks on this subject: “In the natural and healthy state, under a proper system of diet, and with sufficient exercise, the bowels are relieved regularly once every day.” _Habit_ “is powerful in modifying the result, and in sustaining healthy action when once fairly established. Hence the obvious advantage of observing as much regularity in relieving the system, as in taking our meals.” It is often the case that soliciting nature at a regular period, once a day, will remedy constipation without medicine, and induce a regular and healthy state of the bowels. “When, however, as most frequently happens, the constipation arises from the absence of all assistance from the abdominal and respiratory muscles, the first step to be taken is, again to solicit their aid; first, by removing all impediments to free respiration, such as stays, waistbands, and belts; secondly, by resorting to such active exercise as shall call the muscles into full and regular action;[7] and lastly, by proportioning the quantity of food to the wants of the system, and the condition of the digestive organs.
[7] The most effective mode of exercising the abdominal and respiratory muscles, in order to remedy constipation, is by a continuous alternate contraction of the muscles of the abdomen and diaphragm. By contracting the muscles of the abdomen, the intestines are pressed inward and upward, and then the muscles of the diaphragm above contract and press them downward and outward. Thus the blood is drawn to the torpid parts to stimulate to the healthful action, while the agitation moves their contents downward. An invalid can thus exercise the abdominal muscles in bed. The proper time is just after a meal. This exercise, continued ten minutes a day, including short intervals of rest, and persevered in for a week or two, will cure most ordinary cases of constipation, provided proper food is taken. Coarse bread and fruit are needed for this purpose in most cases.
“If we employ these means systematically and perseveringly, we shall rarely fail in at last restoring the healthy action of the bowels, with little aid from medicine. But if we neglect these modes, we may go on for years, adding pill to pill, and dose to dose, without ever attaining the end at which we aim.
“There is no point in which a woman needs more knowledge and discretion than in administering remedies for what seem slight attacks, which are not supposed to require the attention of a physician. It is little realized that purgative drugs are unnatural modes of stimulating the internal organs, tending to exhaust them of their secretions, and to debilitate and disturb the animal economy. For this reason, they should be used as little as possible; and fasting, and perspiration, and the other methods pointed out, should always be first resorted to.”
When medicine must be given, it should be borne in mind that there are various classes of purgatives, which produce very diverse effects. Some, like salts, operate to thin the blood, and reduce the system; others are stimulating; and others have a peculiar operation on certain organs. Of course, great discrimination and knowledge are needed, in order to select the kind which is suitable to the particular disease, or to the particular constitution of the invalid. This shows the folly of using the many kinds of pills, and other quack medicines, where no knowledge can be had of their composition. Pills which are good for one kind of disease might operate as poison in another state of the system.
It is very common in cases of colds, which affect the lungs or throat, to continue to try one dose after another for relief. It will be well to bear in mind at such times, that all which goes into the stomach must be first absorbed into the blood before it can reach the diseased part; and that there is some danger of injuring the stomach, or other parts of the system, by such a variety of doses, many of which, it is probable, will be directly contradictory in their nature, and thus neutralize any supposed benefit they might separately impart.
When a cold affects the head and eyes, and also impedes breathing through the nose, great relief is gained by a wet napkin spread over the upper part of the face, covering the nose except an opening for breath. This is to be covered by folds of flannel fastened over the napkin with a handkerchief. So also a wet towel over the throat and whole chest, covered with folds of flannel, often relieves oppressed lungs.
Ordinarily, a cold can be arrested on its first symptoms by coverings in bed and a bottle of hot water, securing free perspiration. Often, at its first appearance, it can be stopped by a spoonful or two of hot whisky, or any alcoholic liquor, in hot water, taken on going to bed. Warm covering to induce perspiration will assist the process. These simple remedies are safest. Perspiration should always be followed by a towel-bath of cool water in a warm room or by a fire.
It is very unwise to tempt the appetite of a person who is indisposed. The cessation of appetite is the warning of nature that the system is in such a state that food can not be easily digested. When food is to be given to one who has no desire for it, beef-tea is the best in most cases.
The following suggestions may be found useful in regard to nursing the sick: As nothing contributes more to the restoration of health than pure air, it should be a primary object to keep a sick-room well ventilated. At least twice in the twenty-four hours, the patient should be well covered, and fresh air freely admitted from out-of-doors. After this, if need be, the room should be restored to a proper temperature by the aid of an open fire. Bedding and clothing should also be well aired, and frequently changed, as the exhalations from the body, in sickness, are peculiarly deleterious. Frequent ablutions of the whole body, if possible, are very useful; and for these warm water may be employed, when cold water is disagreeable.
A sick-room should always be kept very neat and in perfect order; and all haste, noise, and bustle should be avoided. In order to secure neatness, order, and quiet, in case of long illness, the following arrangements should be made: Keep a large box for fuel, which will need to be filled only twice in twenty-four hours. Provide also and keep in the room or an adjacent closet, a small tea-kettle, a saucepan, a pail of water for drinks and ablutions, a pitcher, a covered porringer, two pint bowls, two tumblers, two cups and saucers, two wine-glasses, two large and two small spoons; also a dish in which to wash these articles; a good supply of towels, and a broom. Keep a slop-bucket near by to receive the wash of the room. Procuring all these articles at once will save much noise and confusion.
Whenever medicine or food is given, spread a clean towel over the person or bed-clothing, and get a clean handkerchief, as nothing is more annoying to a weak stomach than the stickiness and soiling produced by medicine and food.
Keep the fire-place neat, and always wash all articles and put them in order as soon as they are out of use. A sick person has nothing to do but look about the room; and when every thing is neat and in order, a feeling of comfort is induced, while disorder, filth, and neglect are constant objects of annoyance which, if not complained of, are yet felt.
One very important particular in the case of those who are delicate in constitution, as well as in the case of the sick, is the preservation of warmth, especially in the hands and the feet. The _equal_ circulation of the blood is an important element for good health, and this is impossible when the extremities are habitually or frequently cold. It is owing to this fact that the coldness caused by wetting the feet is so injurious. In cases where disease or a weak constitution causes a feeble or imperfect circulation, great pains should be taken to dress the feet and hands warmly, especially around the wrists and ankles, where the blood-vessels are nearest to the surface and thus most exposed to cold. Warm elastic wristlets and anklets would save many a feeble person from increasing decay or disease.
When the circulation is feeble from debility or disease, the union of carbon and oxygen in the capillaries is slower than in health, and therefore care should be taken to preserve the heat thus generated by warm clothing and protection from cold draughts. In nervous debility it is peculiarly important to preserve the animal heat, for its excessive loss especially affects weak nerves. Many an invalid is carelessly and habitually suffering cold feet, who would recover health by proper care to preserve animal heat, especially in the extremities. Hot fomentations in most cases will be as good as a blister, less painful, and safer.
Always prepare food for the sick in the neatest and most careful manner. It is in sickness that the senses of smell and taste are most susceptible of annoyance; and often, little mistakes or negligences in preparing food will take away all appetite.
Food for the sick should be cooked on coals, that no smoke may have access to it; and great care must be taken to prevent, by stirring, any adherence to the bottom of the cooking vessel, as this always gives a disagreeable taste.
Keeping clean handkerchiefs and towels at hand, cooling the pillows, sponging the hands with water, (with care to dry them thoroughly,) swabbing the mouth with a clean linen rag on the end of a stick, are modes of increasing the comfort of the sick. Always throw a shawl over a sick person when raised up.
Be careful to understand a physician’s directions, and _to obey them implicitly_. If it be supposed that any other person knows better about the case than the physician, dismiss the physician, and employ that person in his stead.
It is always best to consult the physician as to where medicines shall be purchased, and to show the articles to him before using them, as great impositions are practiced in selling old, useless, and adulterated drugs. Always put labels on phials of medicine, and keep them out of the reach of children.
Be careful to label all powders, and particularly all _white powders_, as many poisonous medicines in this form are easily mistaken for others which are harmless.
In nursing the sick, always speak gently and cheeringly; and, while you express sympathy for their pain and trials, stimulate them to bear all with fortitude, and with resignation to the Heavenly Father, who “doth not willingly afflict,” and “who causeth all things to work together for good to them that love him.” Offer to read the Bible or other devotional books, whenever it is suitable, and will not be deemed obtrusive.
Every woman should be trained for the office of nurse to the sick, and some who have special traits that fit them for it should make it their daily professional business. The indispensable qualities in a good nurse are common sense, conscientiousness, and sympathetic benevolence.
Persons may be conscientious and benevolent, and possess good judgment in many respects, and yet be miserable nurses of the sick for want of training and right knowledge.
“_Knowledge_, the assurance that one knows what to do, always gives _presence of mind_—and presence of mind is important not only in a sick-room but in every home. Who has not known consternation in a family when some one has fainted, or been burned, or cut, while none were present who knew how to stop the flowing blood, or revive the fainting, or apply the saving application to the burn? And yet knowledge and efficiency in such cases would save many a life, and be a most fitting and desirable accomplishment in every woman.”
“We are slow to learn the mighty influence of common agencies, and the greatness of little things, in their bearing upon life and health. The woman who believes it takes no strength to bear a little noise or some disagreeable announcements, and loses patience with the weak, nervous invalid who is agonized with creaking doors or shoes, or loud, shrill voices, or rustling papers, or sharp, fidgety motions, or the whispering so common in sick-rooms and often so acutely distressing to the sufferer, will soon correct such misapprehensions by herself experiencing a nervous fever.”
Here the writer would put in a plea for the increasing multitudes of nervous sufferers not confined to a sick-room, and yet exposed to all the varied sources of pain incident to an exhausted nervous system, which often cause more intolerable and also more wearing pain than other kinds of suffering.
“An exceeding acuteness of the senses is the result of many forms of nervous disease. A heavy breath, an unwashed hand, a noise that would not have been noticed in health, a crooked table-cover or bed-spread, may disturb or oppress; and more than one invalid has spoken in my hearing of the sickening effect produced by the nurse tasting her food, or blowing in her drinks to make them cool. One woman, and a sensible woman too, told me her nurse had turned a large cushion upon her bureau with the back part in front. She determined not to be disturbed nor to speak of such a trifle, but after struggling _three hours_ in vain to banish the annoyance, she was forced to ask to have the cushion placed right.”
In this place should be mentioned the suffering caused to persons of reduced nervous power not only by the smoke of tobacco, but by the fetid effluvium of it from the breath and clothing of persons who smoke. Many such are sickened in society and in car-traveling, and to a degree little imagined by those who gain a dangerous pleasure at the frequent expense of the feeble and suffering.
“It is often exceedingly important to the very weak, who can take but very little nutriment, to have that little whenever they want it. I have known invalids sustain great injury and suffering; when exhausted for want of food, they have had to wait and wait, feeling as if every minute was an hour, while some well-fed nurse delayed its coming. Said a lady, ‘It makes me hungry now to think of the meals she brought me upon that little waiter when I was sick—such brown thin toast, such good broiled beef, such fragrant tea, and every thing looking so exquisitely nice! If at any time I did not think of any thing I wanted, nor ask for food, she did not annoy me with questions, but brought some little delicacy at the proper time, and when it came I could take it.’
“If there is one purpose of a personal kind for which it is especially desirable to lay up means, it is for being well nursed in sickness; yet in the present state of society this is absolutely impossible, even to the wealthy, because of the scarcity of competent nurses. Families worn down with the long and extreme illness of a member require relief from one whose feelings will be less taxed, and who can better endure the labor.
“But, alas! how often is it impossible, for love or money, to obtain one capable of taking the burden from the exhausted sister or mother or daughter, and how often in consequence they have died prematurely or struggled through weary years with a broken constitution. Appeal to those who have made the trial, and you will find that very seldom have they been able to have those who by nature or by training were competent for their duties. Ignorant, unscrupulous, inattentive—how often they disturb and injure the patient! A physician told me that one of his patients had died because the nurse, contrary to orders, had at a critical period washed her with cold water. One is known who, by stealth, quieted a fretful child with laudanum, and of others who exhausted the sick by incessant talking. One lady said that when, to escape this distressing garrulity, she closed her eyes, the nurse exclaimed, aloud, ‘Why, she is going to sleep while I am talking to her.’
“A few only of the sensible, quiet, and loving women, whose presence everywhere is a blessing, have qualified themselves and followed nursing as a business. Heaven bless that few! What a sense of relief pervades a family when such an one has been procured; and what a treasure seemed found!
“There is very commonly an extreme susceptibility in the sick to the _moral atmosphere_ about them. They feel the healthful influence of the presence of a true-hearted attendant and repose in it, though they may not be able to define the cause; while dissimulation, falsehood, recklessness, coarseness, jar terribly and injuriously on their heightened sensibilities. ‘Are the Sisters of Charity really better nurses than most other women?’ asked an intelligent lady who had seen much of our military hospitals. ‘Yes, they are,’ was the reply. ‘Why should it be so?’ 'I think it is because with them it is a work of self-abnegation, and of duty to God; and they are so quiet and self-forgetful in its exercise that they do it better, while many other women show such self-consciousness and are so fussy!”
Is there any reason why every Protestant woman should not be trained for this self-denying office as _a duty owed to God_?
We can not better close this chapter than by one more quotation from an intelligent and attractive writer: “The good nurse is an artist. Oh the pillowy, soothing softness of her touch, the neatness of her simple, unrustling dress, the music of her assured yet gentle voice and tread, the sense of security and rest inspired by her kind and hopeful face, the promptness and attention to every want, the repose that like an atmosphere encircles her, the evidence of heavenly goodness and love that she diffuses!” Is not such an art as this worth much to attain?
In training children to the Christian life, one very important opportunity occurs whenever sickness appears in the family or neighborhood. The repression of disturbing noises, the speaking in tones of gentleness and sympathy, the small offices of service or nursing in which children can aid, should be inculcated as ministering to the Lord and Elder Brother of man, who has said, “Inasmuch as ye have done it unto one of the least of these my brethren, ye have done it to me.”
One of the blessed opportunities for such ministries is given to children in the cultivation of flowers. The entrance into a sick-room of a smiling, healthful child, bringing an offering of flowers raised by its own labor, is like an angel of comfort and love, “and alike it blesseth him who gives and him who takes.”
A time is coming when the visitation of the sick, as a part of the Christian life, will hold a higher consideration than is now generally accorded, especially in the cases of uninteresting sufferers who have nothing to attract kind attentions, except that they are suffering children of our Father in heaven, and “one of the least” of the brethren of Jesus Christ.