Part 31
Corrosive sublimate is, perhaps, the most powerful germicide known, a solution of one part in a thousand, or a little more than a drachm to a gallon of water, being amply sufficient for all practical purposes. It does not injure or stain wood, varnish, paint, plaster or ordinary fabrics, and if the ceiling be whitewashed with a genuine lime wash, and the walls, floors, doors and furniture of the room be washed down with the mixture, no microbes can possibly escape. It attacks metals, but iron bedsteads are protected by the enameling.
Poisonous as corrosive sublimate is, the danger from it is easily guarded against. The smallest dose of it known to have proved fatal, even to a child, would require no less than a quarter of a pint of the solution of one in a thousand parts. A mouthful of this would not cause more than temporary discomfort, while the taste would prevent a second being swallowed. Still, as a further safeguard it might be well to add a little laundry bluing to give color to the mixture, and a little wood alcohol to give it a smell. Then with a proper poison label on it surely no one would be endangered by it.
PERIOD OF ISOLATION OR QUARANTINE
A person who has had any infectious disease and has been thoroughly disinfected, with his clothes, may be allowed to mix freely with his fellows, in school, for instance, after the following periods. Scarlet fever: Not less than eight weeks from the appearance of the rash, provided peeling has completely ceased, and there be no sore throat. Six weeks is not enough, as there are cases of direct infection after seven weeks when all symptoms have entirely disappeared. Measles and German measles: In three weeks, provided all peeling and coughing have ceased. Smallpox and chickenpox: A fortnight after the last scab has fallen off; the hair, in case of smallpox, having been cut short and scrubbed with carbolic soap or soft soap. Mumps: Four weeks from the attack if all swelling has disappeared. Whooping-cough: Six weeks from recognition of the whoop if the cough has entirely lost its spasmodic character, or four weeks if all cough whatever has ceased. Diphtheria: In a month if convalescence be complete, there being no trace of sore throat or discharge from the nose, eyes, etc. Ringworm: When the whole scalp, carefully examined in a good light, shows no stumpy broken hairs or scaly patches.
It has been very difficult to impress upon communities and individuals the extreme importance of strict obedience to the foregoing rules. There is an unfortunate tendency in too many instances for households to fail in guarding their neighbors from contact with their own members who are convalescing from disease. Even such common and simple diseases as whooping-cough, chickenpox, mumps and others that are considered especially to belong to children, frequently prove fatal to those who are susceptible to them, and it is truly wicked to permit by carelessness such an infection to reach a school or elsewhere where weaker children may suffer as a result.
COMMON SENSE IN THE SICK ROOM Ventilation, Light, Temperature and Furnishings—Care of the Patient—His Temperature and Pulse—Bed Sores—The Characteristics of Fever—Simple Household Remedies—What to Put in a Remedy Cupboard—How to Keep the Baby Well
To every living person air must be furnished every moment if life is to be preserved. The vital element of the air is oxygen gas, the life-giving medium, and this is diluted with nitrogen, because the oxygen itself, breathed alone, would be too stimulating for our lungs. In the delicate cells of the lungs the air we have inhaled gives up its oxygen to the blood, thus purifying it, and receives in turn carbonic acid gas and water, foul with waste matter, which the blood has absorbed during its passage through the body and which we now exhale. The blood is red when it leaves the heart, pure. It returns to the heart purple from the impurities it has picked up, and by the oxygen is once more changed to red.
Manifestly if this process is so important to a person in health, it must be doubly so to one who is sick. The impurities of a sick room consist largely of organic matter, including in many instances enormous numbers of the disease germs themselves. If we uncover a scarlet fever patient in the direct rays of the sun a cloud of fine dust may be seen to rise from the body, the dust which carries the contagion itself. In an unventilated place this is but slowly scattered or destroyed, and for many days it retains its poisonous qualities. “The effect of rebreathing the air cannot be overestimated,” says Martin W. Curran of Bellevue Hospital, New York City. “We take back into our bodies that which has been just rejected, and the blood thereupon leaves the lungs bearing, not the invigorating oxygen, but gas and waste matter, which, at the best, is disagreeable to the smell, injurious to the health, and may contain the germs of disease.”
Fortunately rooms may be ventilated by means of windows in several different ways with little risk of draught. For instance, the lower sash of the window may be raised three or four inches, and a plain bar of wood an inch in thickness, extending the whole breadth of the window, may be put below the window sash, entirely filling the space. By this means the air current enters above, between the two sashes in an indirect line, and it is gradually diffused through the room without a draught. Here is a simpler way of doing the same thing. Take a heavy piece of paper or cloth, about twelve inches wide, and long enough to reach across the window. Tack it tightly at both ends and the lower edge to the frame, and raise the lower sash of the window a few inches. The air entering will be diverted by the cloth. If the air is very cold it must not be admitted at the bottom of the room, but from the top of the window, and should be directed toward the ceiling so as to fall and mix gradually with the warmer air of the room.
The influence of the sun’s rays upon the nervous system is very marked. That room is the healthiest to which the sun has freest access. The sick room should be kept looking bright and cheerful, unless the disease be one that requires the eyes to be specially guarded from the light. The eyes are weaker, however, in all sickness, and the bed should be turned so that the patient does not look directly toward the bright light of the open window.
The proper temperature for a sick room is sixty-eight degrees above zero. In the hot days of summer when this temperature is greatly exceeded, or the air is too dry, hang some thin muslin, soaked in ice water, across the opening in the windows, which will moisten the air, cool the room, and keep out many particles of floating dust. If the floor of the sick room is carpeted and the illness is serious, cover the carpet with sheets and sprinkle on them a weak solution of carbolic acid at intervals. The sheets can be changed as often as necessary. The cleanest wall is one that is painted, which can be washed and disinfected in any way desired. Nurses consider papered walls the worst ones, and plastered the next, but the latter can be made safe by frequent lime washings and occasional scraping.
Have as little furniture as possible in the sick room, and all of this of wood, metal or marble, kept clean by being wiped with a cloth wrung out of hot water. A small, light table should be placed for the patient’s use, from which he may reach his own glass of water. The bed should not be placed with one of the sides against the wall, as a nurse should be able to attend to a patient from either side.
CARE OF THE PATIENT
In all cases where the patient is too ill or forbidden to sit up in bed, a feeding cup with a curved spout should be used. The nurse’s hand should be passed beneath the pillow, and the head and pillow gently raised together. Where there is extreme prostration a glass tube, bent at a right angle, one end of which is placed in the cup containing the food and the other in the patient’s mouth, will enable him to take liquids with scarcely any effort.
If the patient is in a state of delirium, or unconscious, endeavor to arouse him somewhat before giving him his food. Sometimes merely putting the spoon in his mouth is enough, but at other times you will require to get it well back on the tongue. In such cases, watch carefully to see that the liquid is swallowed before attempting to give a second spoonful.
When it comes to the convalescent patient the food is no less important than during the time of illness. Serve it on a tray, covered with a fresh napkin, have the dishes and spoons clean and shining, and be careful not to slop things into the saucers. Take the tray from the room as soon as the meal is ended, for uneaten food sometimes becomes very obnoxious to the sick person if it remains in sight. To provide food for the sick which is both suitable and attractive sometimes requires great care, judgment and patience, but the effort is worth all the trouble it costs. The aim should be to give what will be at the same time easy to digest and of nutritive value after it is digested. In another department of this work will be found many recipes adapted for invalids.
Medicine should be given at regular hours, and careful attention should be paid to the directions as to the time when the doses are to be given, as, for instance, before or after meals. The exact quantity ordered should be given, as even a slight error may defeat the results intended. Never give any medicine without looking at the label, being absolutely certain that you have the right one. Never allow a bottle to stand uncorked, for many mixtures lose their strength when exposed to the air.
TEMPERATURE AND PULSE
We follow Mr. Curran again in his clear statement of the importance of temperature in disease. Every household should have a clinical thermometer to use in taking the temperature of the patient in the event of sickness. The average normal temperature in adults is from 98.4 to 98.6 degrees. There is a daily variation of sometimes 1.5 degrees, the highest point being reached in the evening. Exercise, diet, climate and sleep cause deviation from the standard. Almost every disease, however, carries with it an abnormal variation in temperature. If the rising temperature does not always show what the disease is, it does show what it probably is not. For instance, a rapid rise of three of four degrees above the healthy standard does not mean typhoid fever, but may mean measles or scarlet fever, and in whooping-cough and smallpox, the highest temperature precedes those diseases from two to four days. In diphtheria there is this rise before anyone thinks of looking at the throat. Increase of temperature calls for cooling remedies, external and internal, and degrees of temperature below the standard require warming and sustaining treatment.
An increase of temperature beginning each day a little earlier is a bad sign; one beginning later promises well. A decrease of fever beginning each day earlier is a good sign, but if later each day, is a bad one. A very high temperature, say 105 degrees, is dangerous in itself, but more so if it has come on gradually as the last of a series. A fall of temperature below normal is far more dangerous than a much greater corresponding rise. One degree below normal is more an indication of a bad condition than two and one-half above normal. In convalescence if there is no rise of temperature after eating there is no nourishment secured from the food; if there is a sudden or high rise of more than one degree the food was too stimulating or bulky. To be beneficial in convalescence food must increase the temperature a quarter to half a degree and this must almost subside when digestion is over, though leaving a gradual improvement in the average daily temperature.
Temperature from 106 degrees upward and from 95 degrees downward is extremely dangerous and virtually a sign of fatal ending. As the temperature increases or decreases from normal toward these extremes, it consequently becomes more threatening. Temperature should be taken by placing the bulb of the clinical thermometer in the rectum or under the tongue.
There is a close connection between the temperature and the pulse, both of which guide the judgment in matters of health. The pulse is most rapid at birth, and becomes constantly slower until old age, ranging from a maximum at the beginning of 130 to 150 pulsations a minute to a minimum at the end of life of 50 to 65 pulsations. The average pulse through the period of adult life is from 70 to 75 beats per minute. It is considered that every rise of temperature of one degree above normal corresponds with an increase of ten beats of the pulse per minute.
We have already spoken of the importance of the bath in health. Baths have their equal importance in sickness, and their direct effect upon many diseases. All the vital organs are affected through the skin, and by keeping it in a healthy condition the circulation of the blood, the action of the kidneys and bowels and all the digestive processes are promoted, many diseases warded off, and the assimilation of food aided. In many fevers, for instance, a sponge bath with water a few degrees cooler than the normal temperature of the body will give great comfort and relieve and reduce the temperature materially. A warm bath with water about at the temperature of the body, or a degree or two less, produces no shock to the system but makes the pulse beat a little faster and causes a little more activity of circulation.
Put bran enough in the water to make it milky, and the bath will assist in softening the skin, when it is dried and flaky. Put in a pound of rock salt to every four gallons of water and you will find the bath useful in invigorating feeble constitutions.
=Thirst is Nature’s Signal= that the system needs an increased supply of water just as truly as appetite shows need for food. It is relieved not only by water but by barley water, toast water and similar drinks, by small pieces of ice held in the mouth, and by drinks made from the juices of fruit. Care must be used, however, in the employment of these apparently harmless things, or injury may follow from taking them to excess.
=Bed Sores= are the inflamed spots which occur on the body, often as a result of carelessness during a long illness. They are not likely to occur if the bedding is kept smooth and free from wrinkles and the patient kept dry, his position varied as frequently as possible, and the proper bathing not neglected. If such sores threaten there are several remedies which will help to prevent them. Alcohol, brandy or glycerine rubbed over the parts exposed to pressure, after washing in the morning and evening, will serve to harden the place where applied. A solution of nitrate of silver, painted on threatened but unbroken skin as soon as it becomes red, will prevent sores. In the early stages of bed sores apply a mixture of equal parts of rectified spirits and white of egg. Put it on with a feather and renew as it dries till an albuminous coating is formed. For bed sores occurring in typhoid and other fevers an excellent prescription is composed of two parts of castor oil and one of balsam of Peru, which are spread on pieces of lint, laid on the sore and covered with a linseed poultice to be changed three or four times a day.
=The Characteristics of Fever= are a rising of the temperature, and, as a rule, increased rapidly of the circulation as shown by the pulse, and alterations in the secretions of the body, which are usually diminished. Fever diet consists in giving the patient plenty of milk, arrowroot or broth, composing a light, easily-digested fluid diet, every three hours, day and night. If milk alone is used the patient can take from three to five pints in twenty-four hours. The general treatment recommended for fevers consists in sponging off the body of the patient under the bed clothes with cool water three or four times a day, keeping him lightly covered, the room well ventilated, and its temperature from sixty-eighty to seventy degrees. He should be given plenty of cooling drinks in small quantities from fear of overloading his stomach, but frequently repeated even if he has to be coaxed to take them. The secretions of the kidneys and bowels must be kept up by such medicines as are prescribed by the physician in charge.
SIMPLE HOUSEHOLD REMEDIES, HERBS AND OTHERWISE
Those who live in the city, where a doctor can be summoned in a few minutes, if needed, cannot realize how important it is that the farmer’s wife should keep a supply of simple remedies on hand and know how to use them. It is a good plan to have an herb bed in one corner of the garden, where catnip, thoroughwort, camomile, hoarhound, pennyroyal, etc., can be grown. These are nature’s remedies and are often just as effective and always safer than strong drugs. Almost all kinds of herbs should be gathered while in blossom and tied up in bunches until dry. Then put them in bags, keeping each kind separate, and labeling them. The bags keep them clean and the labels enable one to find them quickly. In the springtime when one feels languid and miserable, a cup of boneset or thoroughwort tea, taken several mornings in succession, will arouse the sluggish liver and make quite a difference in one’s feelings.
For sprains, bruises and rheumatism steep tansy in vinegar, having it almost boiling hot; wring woolen cloths out of it and apply, changing often. Plantain grows almost everywhere and is very useful as a medicine. A strong tea made of the leaves or a poultice made of them and applied quite hot to the cheek will relieve facial neuralgia, A tea made of the seeds and taken in tablespoonful doses every ten minutes is good for sick stomach.
If it is desirable to preserve plant remedies make a strong decoction by steeping in water kept just below boiling point half an hour. Strain it and to one pint of the liquid add one gill of alcohol. Put it in bottle, cork tightly and it will retain its virtues as long as desired.
Many fruits and vegetables possess valuable medicinal properties. Tomatoes, either canned or fresh, are a pleasant remedy for constipation. Blackberry cordial is an old and well-tried remedy for diarrhea and dysentery. To prepare it get the fresh berries; mash them with a potato masher and let them stand several hours; then strain out the juice. To one quart of juice add one pound of granulated sugar and one heaping teaspoonful each of cloves, cinnamon, allspice and nutmeg. All the spices except the nutmeg should be tied in a cheesecloth sack before they are put in. Boil until it is a rich syrup; put it in bottles and seal while hot.
Many housewives who have used borax in various ways have never known its value as a medicine. It is almost the only antiseptic and disinfectant known that is entirely safe to use. Clothes washed in borax water are free from infection, and can be worn again without fear of contagion. A solution of ten grains of borax to one ounce of pure soft water is an excellent lotion for sore eyes. Apply it two or three times a day until it strengthens and heals them. Half a teaspoonful of borax and a pinch of salt dissolved in a cupful of water and used frequently as a gargle will cure sore throat.
A heaping tablespoonful of table salt or two of mustard stirred into a glass of warm water will start vomiting as soon as it reaches the stomach, which is one of the best remedies known for poisoning. A teacupful of very strong coffee will nullify the effects of opium, morphine or chloroform.
WHAT TO PUT IN A REMEDY CUPBOARD
In every house there should be a remedy cupboard. We do not mean the ordinary medicine chest with innumerable bottles huddled together, but a well-stocked emergency cupboard, easy of access, and containing simple remedies for the many aches and pains of humanity. Such a medicine chest is considered by some as one of the most important pieces of furniture in the house. It should be more like a little cupboard than a chest. It may be made of a rather shallow box, fitted with shelves, and there should be a door which fastens with a lock and key. The key should be kept by the mother, so that no one can go to the chest without permission. It should be fastened rather high up against the wall. In this chest should be kept everything that experience has proven to be essential in the treatment of such emergency cases as most mothers have to deal with.
No household is conducted without an occasional accident or bruise; burns and ugly cuts are all of frequent occurrence where there are children. If there is a place where one can always find some soft medicated cotton, bandages of different widths, absorbent gauze and a bottle of some antiseptic solution, it will prevent the frantic running about when such articles are needed and save to the sufferer many throbs of pain. To be thoroughly satisfactory the emergency cupboard must be kept in perfect order and systematically arranged. For instance, in one compartment keep the every-day remedies for coughs and colds, such as quinine and listerine, croup kettle, atomizer and a compress and flannel bandages.
There should be prepared mustard plasters, rolls of court plaster, salves, liniments, lotions, laudanum, pills, porous plasters, castor oil, sulphur, salts, camphor, and in fact everything that is needed should be found here, and in this way many times the cost of the chest will be saved in doctors’ bills. Everything should be carefully labeled and so arranged that things can almost be found in the dark.
HOW TO KEEP THE BABY WELL
Many young mothers are anxious to learn all they can about the physiology and hygiene of babyhood. Hours of anxiety might be spared them if they could only profit by the experience of those who have raised large families.
Babies’ hands and feet frequently become cold in a room where older people are quite comfortable. This is sometimes caused by having the clothing too tight. Keep the temperature of the room as near seventy degrees as possible and have it well ventilated, but do not allow the little one to lie in a draught, or an attack of colic may be the result. Take him out in the fresh air frequently if the weather is good, but when the wind is blowing and the air is damp the best place for the baby is in the nursery. It is never safe to expose him to all kinds of weather in order to get him used to it, for it may cost his life.
Give the baby a bath every day in hot weather, never having the water cool enough to cause him to catch his breath, nor warm enough to make him cry. He will soon learn to enjoy it. “My baby will laugh and clap his hands every time he is put in the water,” says one happy mother, “and after a few minutes’ bath and a good rubbing he is ready for a long, refreshing sleep.”
If the baby’s head becomes covered with a yellow coating rub vaseline well into the scalp, and after it has remained four or five hours take a fine comb and carefully comb it all off; wash thoroughly with soft water and good toilet soap as often as may be necessary to keep the scalp white and healthy. The vaseline loosens the scurf and makes it easy to comb out.