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Full text of "The nurse's guide, and family assistant : containing friendly cautions to those who are in health : with ample directions to nurses and others who attend the sick, women in child-bed, &c."

Surgeon General's Office 

I lfflMM» If 



1^: 




THE 

NURSE'S GUIDE, 
FAMILY ASSISTANT; 

OB 

COxMPANION FOR A SICK CHAMBER. 



A. FINEEY, 

Nortli Kast Corner of Chesnut and Fourth Streets, Philadelphia; 

IMS recejXtlt published, 

ENGRAVINGS of the ARTERIES, by Charles Bell, 12 co- 
loured Plates, royal 8vo. 

ENGRAVINGS of the BONES, MUSCLES, and JOINTS, 
by John Bell, 34 Plates, quarto. 

ENGRAVINGS of the NERVES, by Charles Bell, 9 Plates, 
quarto. 

The above valuable Plates are all accompanied with co- 
pious letter-press Explanations. 

FAITHHORN on LIVER COMPLAINTS and BILIOUS 
DISORDERS. 

BENNETT'S LETTERS to a YOUNG LADY. 

DICTIONARY of QUOTATIONS, 3d Edition. 

Dr. Adam Smith's THEORY of MORAL SENTIMENTS. 

An Elegant CLASSICAL ATLAS, comprising the most useful 
Maps in Wilkinson's Atlas Classica. 



THE NURSE'S GUIDE, 



AND 

FAMILY ASSISTANT; 

CO.VTAIHING 

FRIENDLY CAUTIONS 
TO THOSE WHO AIIE IN HEALTH : 

WITH 

AMPLE DIRECTIONS TO NURSES AND OTHERS. 
WHO ATTEND TEIE SICK. W©]ff!|E|f 3N 
CHILD-BED, &€: 



BY _y 
ROBERT WALLACE JOUJVSOK, M.D. 



THE SECOtfr AMEniCAN EDITION, CORRECTED — WITH AN 
INTERESTING APPENDIX FROM "THE DUBLIN 
HOSPITAI, HEPOHTS." 



PHILADELPHIA: 

PUBLISHED BY ANTHONY FINLEY, 

NOnTU EAST CORNER OF CHESNUT AND EOl'RTH STREETS 

A. Small, Printer. 

1819. 



Eastern District of Pennsylvania, te wit: 



Be it REMiiMBEHED, That on the thirty-first day 
of October, in the forty-thircf year of the In- 
«»»•»»« dependence of the United States of America, 
;L. S. J A. D. 1818, Anthony Finley, of the said 
••««»•» district, hath deposited in this office the title 
of a book, the right whereof he claims as pro- 
prietor, in the words following, to wit : 
♦'The Nurse's Guide, and Family Assistant; containing 
Friendly Cautions to Those who are in Health : witli 
Ample Directions to Nurses and Others, who attend, 
the Sick, Women in Child-Bed, &c. By Robert 
Wallace Johnson, M. D. The Second American 
Edition, corrected — with an interesting Appendix 
from " the Dublin Hospital Reports." 
In conformity to the act of the congress of the United 
States, intituled "An act for the encouragement of learn- 
ing, by securing the copies of maps, charts, and books, to 
the authors and proprietors of such copies during the 
times therein mentioned." And also to the act, entitled 
" An act supplementary to an act entitled ' An act for the 
encouragement of learning, by securing the copies of 
maps, charts, and books, to the authors and proprietors 
of such copies iluring the times therein mentioned,' and 
extending the benefits thereof to the arts of designing, 
engraving and etching historical and other prints." 

D. CALDWELL, 
Clerk of the Eastern District of Pennsylvania. 



PREFACE 



TO THE FIRST AMERICAN EDITION. 



IT is with great satisfaction the Edi- 
tor presents to the Public, the follow- 
ing valuable requisite for a sick room. 
It is not to one description of persons 
alone it will prove useful, but to every 
class of Society. As long as sickness 
is a concomitant of humanity, so long 
will this, or some work of a similar 
nature, retain its estimation. Its value 

A 3 



H PREFACE, 

may not be perceived by persons in 
health, but when sickness finds access 
to ^ome beloved friend, this little 
treatise will be regarded with plea- 
sure. The qualifications and duties 
of a Nurse, (so essential to the wel- 
fare of the sick), are here detailed, by 
a man, whose long experience in the 
practice of physic, amply qualified him 
to pen them. The prescription of 
medicine and of diet belongs exclu- 
sively to the Physician; the adminis- 
tration of them is committed to the 
Nurse. Her qualifications therefore ' 
should be great, to be entrusted with 
such a charge, on which, perhaps., the 
life of a patient may depend. How 
few are qualified need not be told! — 
How few understand the preparation 
of the various articles of diet recom- 



PREFACE. 



Vii 



mended to the convalescent! These 
are condensed in this excellent little 
manual, whose utility will be most ap- 
preciated by those, whose situation 
about the sick, best qualifies them to 
judge. The Physician who orders 
the various articles of diet, is frequent- 
ly ignorant, as well as the family, of 
the mode of preparing them ; but by 
means of this treatise, one uniform 
method will be attained, which is of 
vast importance; and ignorance will 
no longer be a cloak for omissions. 

Some parts of this little treatise 
may be regarded as unnecessary, sudi 
for instance, as that which reprobates 
the use of stays, as this fashion does 
not now exist; but, as we see similar 
fashions again rising into existence, 



v'uL 



TREFACE. 



the Editor thinks it right to retain it, 
as bearing testimony against their fu- 
ture introduction, to the destruction 
of hundreds of the loveliest portion of 
the Creation. 



CONTENTS. 



CHAPTER I. 

Of our Person?, . - _ _ page 13 

CHAPTER n. 
Of our Dress, - - _ _ _ 

CHAPTER m. 
Of our Diet ia a State of Health, - - - 35 

CHAPTER IV. 
Directions to Nurses, - - . . 54 

CHAPTER V. 

Of Things to be observed relating to the Chamber, 61 

CHAPTER VI. 
Concerning the Bed, and shifting the Patient, - 70 



X 



CONTENTS. 



CHAPTER VII. 



OfDietforthe Sick, 




PAGE 83 


To make Sage Tea, Balm Tea, &c. &c. 


- 


91 


Rose Tea, 


- 


92 


Oatmeal Tea, 


- 


92 


Bran Tea, 


- 


93 


Linseed or Flaxseed Tea, 


- 


93 


Malt Tea, 


- 


94 


Camomile Tea, 


- 


94 


White Wine Whej', 


- 


95 


Vinegar Whey, 


- 


97 


Treacle Posset, 


- 


97 


Lemonade, 


- 


97 


Orangeade, 




9« 


Emperial Drink, 




99 


Oxycrate, 




99 


Barley Water, 




100 


Bran Decoction, 




100 


Buttered Water, or what the Germans call Egg 


Soup, 




101 


Water Gruel, 




102 


Rice Gruel, 




102 


White Caudle, 




103 


Brown Caudle, 




104 


Panado, - - - 




.105 


Sago, - 




106 


Salop, - 




106 


White Drink, 




107 


Rennet Whey, 




107 


Vulnerary Drink, 




109 


Pectoral Drink, 




110 


Elder-Berry Syrup, 




110 


Syrup of Turneps, 




111 


Oatmeal FKimmery, 




111 



CONTENTS. 



xi 



' Potatoe Flummery, 


PAGE lis 


Bread Soup, 


114 


Soup Meagre, 


114 


Green Pease Soup, 


116 


Mutton Broth, 


118 


Do. with Barley or Rice, 


lU 


Beef Broth, 


12& 


Chicken Broth 


120 


Eel Broth, 


122 


Boiled Chicken, 


122 


Stewed Chicken, 


124 


Boiled Pigeon, 


125 


Pigeon Stewed in Paste, 


12G 


Boiled Partridge, 


126 


Boiled Flounder, 


i2r 


Bread Pudding, 


128 


Do. without Eggs, 


129 


Batter Pudding, 


130 


iiice Pudding, 


131 


Do. without Eggs, 


131 


Apple Pudding, 


132 


Potatoe Pudding, 


133 


Tapioca Jelly, 


134 


Arrow Boot, - - 


135 


Blanc Manger, 


136 


Hartshorn Jelly, 


137 


Calves Feet Jelly, 


139 


Isinglass Jelly, 


140 



CHAPTER VIII. 
Of Administsring Diet, 



141 



Xii CONTENTS. 

CHAPTER IX. 

Of Administering Medicines, - - page 1£U 

Preswiptions for Clysters, - - - 165 

Of the Treatment of Burns and Scalds, - - 167 

Appexdix — containing Additional Instructions for the 

Nurses of a Feter HospiTAi,, - - 169 



CHAP. I. 

Of our Persons. 

The greatest blessings that Man 
can enjoy in this world, appear to be 
a native riglit form of Body, — a good 
state of Health, and a salubrious and 
sufficient supply of every necessary 
to support the innocent comforts of 
Life. 

Through our state of action here, 
we are often subjected to impressions 
and sensations apparently very repug- 

B 



Of our Persons. 



nant to our Nature and Interest; — yet, 
by exercising properly tliat degree of 
reason which is given to us by our 
Creator, all, or most of those evils, 
become alleviated, and many of them 
are entirely w^arded off. On the con- 
trary, should we incautiously admit 
some Habits or Customs, although at 
first appearing very harmless, yet in 
process of time they are found to pro- 
duce very pernicious effects ; — ^let us, 
therefore, be as watchful and cautious 
as we can, of every thing that is hkely 
to become a custom or habit, and, to 
this purpose, we shall begin with a 
few particulars to be observed respect- 
ing our persons, and in the power of 
every one of us to perform. 

The surface of our bodies should 
ever be kept as clean as possible from 



Of our Persons. 



15 



all filth, putrid or infectious matter, by 
water ablution, ^c. In the course of 
every week, or two, at farthest, the 
hard crust, or horny scales which 
usually gather on the feet, should be 
carefully scraped off, and the nails cut 
so short as to become even with the 
ends of the toes. The best time to 
perform this is just before going to 
bed, and as every person knows that 
warm water, soap, and bran, are to be 
used in this operation, and the feet 
well dried and kept warm afterwards, 
no more need be said on this occa- 
sion. 

Although these little matters, here 
described, may seem very insignificant 
to some persons, yet, if neglected to 
be used, let them remember their er- 
l ors when they become crippled by 



Of our Persons. 

rheumatic pains, accumulations of gou- 
ty matter, corns, long nails, ^c. 

Our Breath is the next thing to be 
considered. When it becomes fetid, 
it is not only noxious and offensive to 
ourselves, but more so to others who 
either lie, sit, or stand near us. It 
may arise from diseased lungs, or 
even from the teeth, without any fault 
in the person's conduct so afflicted. 
But in general we are the cause of it, 
by neglecting to clean away from the 
gums and teeth, the remains of ev- 
ery meal, and not duly washing our 
mouths. We may cause it also by 
overloading our stomachs with ali- 
ments, especially those which either 
go soon into fermentation, or a high 
state of putrefaction. — This I have ob- 
served to be the case, as it appeared 



Of our Persons. 

to me, from the steams arising from 
those, who, but a little time before, 
seemed much satiated with such food; 
and from being so well acquainted with 
their constitutions, as not to believe 
that any fetor could arise from either 
their teetli or lungs. 

However, as this nuisance of a hor- 
rid fetidness of the breath, generally 
arises from our own indolent and nas- 
ty (hspositions, let us use the best 
means we know of to remove it. As 
a leading hint to this end, I shall beg 
leave to relate the simple and easy 
method that I have used for myself 
above sixty years, and recommended 
to others, wherever I could use the 
freedom. It is simply this, the ob- 
servance of cleaning my teeth well, 
immediately after each time of eating, 

B 2 



Of our Persons. 

from any such parts of the food, as 
remained or lodged in the grooves 
formed by the joining of the teeth, or 
hollow spaces near their roots, and the 
gums, by means only of a goose quill, 
cut shelving, and not so sharp at the 
point as to hurt the gums ; and now 
and then I have cleaned tlie teeth 
with cream of tartar, so as to prevent 
any scurf or extraneous substance ad- 
hering to them. 

About forty years ago it became a 
professional practice to clean teeth 
with powders and liquids, kept as se- 
crets,~to scale, as it was called, the 
teeth, — to make and place artificial 
ones, — and to transplant natural ones 
from one person to another. I pre- 
sume we should allow every endea- 
vour for improvement to be laudable ; 



Of our Persons. 



19 



but as our efforts often run from one 
extreme to the other, so they did in 
this ; for, instead of being satisfied with 
such an easy and safe method as that 
of mine, al)ove described, they intro- 
duced the practice of rubbing the teeth 
often with materials, in order to make 
them white, that soon destroyed the 
natural enamel, and then the substance 
of the tooth itself* — Some evils also 
arose from transplanting, that afford- 
ed sufficient reason for totally discon- 
thiuing the use of that practice. 

" The very best dentifrice uhich can be employed, is the 
powder of charcoal, and Peruvian bark, in equal quantities. 
Tiie former is a powerful preventive from putrefaction, and 
the latter is useful from its tonic property. It is easily made, 
and is not expensive. — Am. En. 



Of our Persons. 



In addition to what has been said 
by the respectable Author of this trea- 
tise, we may be allowed here, to call 
the attention of parents to the neces- 
sity of daily employing the fine-tooth 
comb on their childrens' heads ; not 
merely to preserve them from tlie 
annoyance of vermin, which may l)c 
taken from their playmates or school- 
fellows ; but also, to prevent sores and 
other inconveniences that may occur 
from an accumulation of the dandrifF, 
which, uniting with the perspiration 
from the head, forms a compact crust, 
not easily removed, and whicli, even- 
tually, obstructs the perspiration, and 
often gives rise to eruptions behind 
the ears, ^c. and sometimes even to 
more dangerous evils. — Am, Ed. 



SI 



CHAP. II. 

Of our Dress. 

Our dress should ever be kept 
as clean and dry as possible, for, by 
neglect in this, a fetidness, if not pu- 
trefaction, will take place; mephitic 
air, and tlie miasms of several infec- 
tious diseases will be collected, and 
retained, and even cause a malignant 
atmospliere around the person, so as 
not only to endanger his own hfe, but 
that of others who come near him. 
It is no wonder, therefore, that fevers 



Of our Dress, 

of a malignant nature happen often in 
camps, prisons, or any other houses or 
rooms where many people either sit 
or sleep together, especially as the 
steams arising from both their bodies 
and clothes, must there be very pow- 
erful, o 

We should likewise observe to co- 
ver our bodies equally, and thicker or 
thinner, according to the weather or 
climate where we are. How ridi- 
culous now appear men of almost ev- 
ery age with bald heads, a thick roll 
of muslin or linen about their necks, 
some, with two under, and as many 
upper vests, yet with thin breeches, 
stockings, and shoes, or boots! — all 
subjecting themselves to diseases 'of 
different kinds! — O, brave fashions! 
you are very good friends to physic, 



Of our Dress. ^3 



^•c. ^c. — The use of garters is also 
pernicious, as thereby the actions of 
the tendons and blood vessels are con- 
lined and injured. 

But what requires more serious at- 
tention is, to avoid w^earing any kind 
of dress tight about the neck; for, by 
such a custom, the reflux of the blood 
and other fluids from the head will 
be obstructed ; consequently the brain 
may become inflamed, and so much 
injured as to cause mania, apoplexy, 

But, while we are thus paying at- 
tention to ourselves, let us not be so 
unfriendly as to forget the dress of the 
Fair Sex. The great variety of ingeni- 
ous taste and splendour displayed in 
their caps, hats, bonnets, robes, and 



g4 Of owr Dress. 

jewels, deserve our admiration as well 
as encouragement, so far as is consis- 
tent with their circumstances and de- 
partments in life. But, when we con- 
sider some other parts of their dress, 
it gives us real pain, instead of plea- 
sure, to behold their unhappy situa- 
tions, usually brought on by their vain 
mothers and teachers; for although 
they are known to have been born 
with the most beautiful and perfect 
shapes, yet, unsatisfied with this great 
kindness of nature, the young lady, 
even in her growing state, is put into 
a coat of armour,*— the spine of her 
back is confined from its growth and 
natural movements, by a steel fetter, 
called a monitor, — her chin is held 

• What is here so warmly urged against stays, is equally ap- 
plicable toihe present detestable and JesiracftDe fashion of wear- 
ing corsets, by wliich so many of our young ladies are Imrried 
into eternity. — Am. Ed. 



Of our Dnsn. 25 

up by a prop of steel also,— and the 
stays usually stiffened with whale- 
bone, encompasses her thorax and up- 
per regions of the abdomen. 

What are the consequences? — Not 
any shapes superior or even equal to 
those of Nature, as the vain parent 
expected, but on the contrary, worse 
ones ; and what is really melancholy, 
an injured constitution, the bad effects 
of which often continue through her 
life. Now, seeing these consequences 
may arise from an officious and im- 
prudent application of art; — let us 
take a view of some of Nature's ope- 
rations in the case before us, when 
left to herself. In order to these, we 
observe the spines of all children be- 
fore birth are curved like the segment 
of a circle, the hands and knees ap- 
c 



2Q Of our Dress. 

preaching each other; and that after 
birth, to the usual state of maturity, 
Nature being still employed to unfold 
herself, the spine, especially the upper 
part of it (the lower part towards the 
loins making a little curve in an op- 
posite direction), does not become 
straight of itself in many instances, 
yet by exertion of the person himself, 
aided by instruction, his body becomes 
upright, as may be seen daily aa.ongst 
military men. 

We learn, also, from the testimony 
of those who have visited the nation* 
of almost every part of this globe, that, 
excepting where stays, and such things 
as above described, are used, there is 
scarcely a woman to be found, either 
distorted, crooked, afflicted with a can- 
cer in the breast, or an umbilical rup- 
ture, ^5c. Now, as it is too true that 



OJ our Dress. 27 

such cases do frequently occur in this 
country, it behoves us to know, how 
far the apparatus above described can 
be concerned in producing them. 

We have taken notice of the posi- 
tion and curvation of the spine in the 
embryo as well as in the infant state 
(see, if you please, plate V. fig. 1 3 and, 
14, in my System of Midwifery), while 
Nature is unfolding herself; and which, 
in some cases, is not effected till the 
age of maturity: a full liberty for the 
natural gro^vth and movements of the 
body has been hinted at also, and the 
rareness of deformity in those nations 
where art is least used. Now, take 
one child, for instance, that has a bul- 
ging out of one shoulder more than 
the other, (generally caused by the 
nurse having usually carried her on 



Of our Dress. 

one arm, or suckled at one breast); 
another child who stoops or bends the 
head, and upper part of the spine for- 
ward ; another child who is perfectly 
well formed and upright; and upon 
each of these (for the latter according 
to the present fashion is not excused), 
place the coat of armour before men- 
tioned, consisting of stays, and steel 
monitor on the back, and the steel prop 
under the chin; we will suppose now 
that the mother applies the stays to 
keep the child's body straight, and to 
fashion it as she wishes it to be ; — the 
monitor (as it is called), is also to bring 
the bulged shoulder square with the 
other, and hold the spine upright at 
the same time; — that the chin prop 
is to keep the head up; — and that, in 
respect to the last or third case, those 
means are only used to prevent the 



Of our Dress. 29 

child's g;oing out of her original right 
natural form. 

All these particulars having been 
preiTiised, let us now attend to the 
effects of the application, of such an 
apparatus, (improperly by me called 
a coat of armour, because, as it may 
appear hereafter, the body is not de- 
fended from injury by it). The stays 
make a com pressure, as before ob- 
served, upon the thorax and upper 
part of tlie abdomen, the lateral ex- 
pansion of those parts, accordingly as 
Nature requires in her growing state, 
is herel)y counteracted, — the circular 
cavity of the thorax, naturally formed 
by the ribs with the sternum and the 
spine, is confined in its proper expan- 
sion, and generally becomes spheroidi- 
cal, consequently one shoulder, and 
c 2 



gQ Of our Dress. 

the breast opposite to it on the other 
side, projects or bulges out; — tlie ex- 
ternal muscles also are not only check- 
ed in their growth, but thrown out 
of their natural line of action, so tliat 
they must act according to such al- 
tered and confined directions. The 
heart, lungs, liver, stomach, and, in 
short, the whole viscera, must sustain 
a check upon their expansion, and the 
natural circulation of the fluids through 
them. 

It may be observed here, that un- 
der this use of stays, and the previous 
conduct of nursing, the projections of 
one shoulder and the opposite breast, 
as above stated, generally take place ; 
— the monitor and chin prop are then 
called in for assistance, and when ap- 
plied, the anteiior side of the whole 



Of our Dress, 



31 



spine, (commonly called the back 
bone,) and muscular and tendinous 
parts of the body also, are put upon 
the stretch to be brought to a straight 
line, and this even before nature can 
be unfolded : and, if the confinement 
about the shoulders is not carefully 
attended to at the same time, a stop 
is put to this intention of extension, 
tiie anterior sides of the spinal joints 
are opened by the efforts of such ex- 
tension, and the protuberances on the 
posterior side of the vertebrae coming 
to approach or rest, each one upon 
the other, may readily slip aside, and 
throw the wliole of the spine from 
the straight line attempted, and force it 
into lateral and opposite curvatures 
from side to side, as often may be 
seen. How far the particulars here 
described can be admitted as causes 



32' Of our Dress. 

for the frequent distortions of body 
appearing amongst the women of our 
country, we shall leave the public to 
judge, and turn next to the adult state, 
through which the use of stays is still 
continued, to the hurt of thousands. 

That women, as well as ourselves, 
may, by custom, become insensible of 
impressions which, in their effects are 
injurious, the continued use of stays is 
a proof — By their compressure on 
the upper part of the thorax, the glan- 
dular substance of the breasts become 
too often so affect^ed as to end in a 
confirmed cancer. — By tlieir compres- 
sure below the breasts, hysterics may 
be produced ; and in married women, 
or those who have borne several 
children, uml:)ihcal ruptures, proci- 
dentia uteri, quandoque ani, each of 



Of our Dress. 33 

whicli, althous;]i not curable, by either 
medicines or bandages, yet can be re- 
lieved, to the ease and comfort of the 
patient, by leaving entirely off the use 
of stays. For these many reasons re- 
cited, I most solemnly protest against 
the use of all stays and of every other 
stiff or hard substance worn upon the 
thorax and abdomen of women. 

This bold protest may probably be 
thought very assuming in me, who 
have received many civilities from the 
fair sex, am still in their favour, and 
would be exceedingly miserable by the 
loss of it; — but should they retort a 
little, as I think they may, and ask 
mc ^what they should wear?' 1 would 
advise them, for the sake of their ease, 
convenience, and safety, to wear vests, 
Hke those called riding habits, which 



34 Of our Dress. 

dress well becomes women of all 
ranks. Such ladies as attend the 
court, assemblies, concerts, ^'c. may 
easily, instead of the upper yest, be 
adorned with gowns, and other splen- 
did attire, suitable to that degree of 
distinction which belongs to them. 

But, whilst thus expressing my good 
wishes to the Ladies, I must not forget 
to caution them against the use of all 
manner of paints on their faces, such 
being not only pernicious to their 
health but character also ! — as the ap- 
pearance of such may give reason for 
an impeachment of their chastity, 
which, once lost, can never be re- 
gained. 



So 



CHAP. III. 

Of Things to be obsei^ed respecting the 
Diet taken in our State of Health. 

Having §aid what was intended 
concerning the external mode of treat- 
ing our bodies, we shall now observe 
some things respecting the use and 
abuse of aliments, beginning with the 
manner still practised in treating in- 
fants. 

It is greatly to be lamented that many 
thousands of children seem to be lost 



36 

by overcharging their stomachs with 
food at one time (whether by breast- 
milk or any otlier aUmcnt it matters 
not) ; a sufficient interval to allow the 
digestive powers to complete their 
office is not duly attended to, conse- 
quently, another quantity of food, too 
much for the capacity of the stomach 
and other digestive organs, is added, 
before the former is digested. This 
inconsiderate method being often re- 
peated, the child must be either de- 
stroyed soon, or, having so strong a 
constitution as to sustain such forcins:, 
his stomach and other primary diges- 
tive organs will become so enlarged, 
as to admit of a greater quantity of 
food at a time, and so on, till, by 
habit, he becomes a mere glutton. 
Should the frame of his body bear all 
this forcing, as he grows up, the ap- 



Of Did, 37 

petite will coincide with the custom, 
and he will, probably, not only become 
a jolly fellow, in eating very copious- 
ly, but in drinking too ; and to such 
excess, that a fever of the high inflam- 
matory kind, will, most hkely, take 
him off very speedily. 

Rut, supposing not so bad an event, 
and that his constitution is still so very 
lirm, as to bear several more such 
shocks with impunity, as probably he 
may tliink, yet great mischief must 
take place ; for, his digestive powers 
and organs having thereby been 
biought repeatedly on such violent 
stretches as to impede their natural 
actions, and all the fluids also disturb- 
ed in their timely and natural secre- 
tions, circulations, and excretions, a 
portion of the earthy or indigestible 

D 



38 Of Diet. 

parts of the food taken, must accumu- 
late, and even concrete, as very com- 
monly happens, in the liver and gall- 
bladder, to cause a jaundice, ^c. 
in the kidneys and urinary bladder, 
so as to form stones there ; and such 
otlier earthy parts as are conveyed by 
the capillary vessels to the surface of 
the body, will be there collected, on 
the hands and feet, so as to form 
(what is called) a real gout. 

The strong man's case having been 
brought thus far, he is usually con- 
gratulated by those about him, and 
often advised to drink brandy, or some 
other strong hquor, to keep the gout 
out of his stomach, and being used to 
live well, he readily follows their ad- 
vice ; till finding himself grow very 
feeble, the stomach palled, the body 



Of Did. 39 

wasting, the hands and feet crippled, 
he tlien sends for the doctor, although, 
most likely having before detested the 
thoughts of physic. — But, alas! the 
proper time of taking it is past, — the 
disease is confirmed, — the whole con- 
stitution is quite broken, — the powers 
of medicine, or any other means which 
the most able physician can prescribe, 
are now not sufficient to save him. — 
Whereas, had his appUcation been 
made at first, the cure might have 
been easily effected. 

By the short description above 
given, without much physiology, I 
have reason to hope, it appears that a 
native good constitution may be ruin- 
ed, by admitting and following ill 
habits in the mode of living. It has 
long appeared to me, from strict in- 



40 

quiry into the cause and nature of our 
diseases, that most of them are of our 
own creation. I say most of them, 
for there are malignant fevers, and 
other disorders wliich arise from some 
pecuhar bad quaUty in the air, in dif- 
ferent seasons of the year, and in dif- 
ferent countries, that it is not in hu- 
man power to prevent, and, at best, 
very difficult to cure. — There are dis- 
eases also, called hereditary, as for 
instance,, scrophula, the king's evil, 
and gout; but as these originate from 
our own errors in general, they may 
be eradicated in a few generations, by 
good management. That they do ori- 
ginate from our own errors appears 
from adding some other impure hu- 
mours to those above described, and 
the diseases produced by this combi- 
nation being not so easily cured, as 



Of Diet. 41 

in simple, gouty, and scrophiilous 
cases. 

But confining ourselves to the for- 
mer very fasliionable disorder (al- 
though the king's evil is still to be at- 
tended to), I shall beg leave to men- 
tion an idea that occurred to me, and 
has been mentioned many years by 
me wherever I could do it consistent- 
ly, viz. that the gout appeared to me 
to originate fi'om eating and drinking 
too mucli, and at the same time, nei- 
ther using exercise nor work in pro- 
portion; it was therefore curable, as 
well as other diseases, by die use of 
timely and proper means. 

Tlie strong man's case, as I have 
called it before, and indeed all others 
arising from a pletliora, give indica- 

D 3 



42 Of Diet 

tions of their own cure, by early 
bleeding, purging, and other evacuants 
judiciously advised, and administered 
according to the age, the habit of the 
body, and other circumstances of the 
patient; and by these simple means, 
the gouty fit will, in general, be soon 
removed. After this is obtained, the 
patient must lessen the quantity of 
his diet, from that which he had be- 
fore accustomed himself to. He 
should keep his body well and equal- 
ly covered, not omitting to wear wool- 
len stockings next the skin, with any 
other sort over them, and his shoes 
or boots should have very thick soles. 

The approach of another fit is gene- 
rally indicated by a want of appetite, 
a fuller and quicker pulse than usual 
in its natural state, several darting 



Of Diet. 4,g 

pains in different parts of the body, 
and then increasing on the parts for- 
merly affected. There is usually also, 
a stiffness or confinement of motion 
throu2;li many of the external muscles 
and tendons of the body, all or most 
of which symptoms give him notice 
enough to send in time for medical 
assistance. But as some have im- 
bibed a violent fear of, and prejudice 
against bleeding, that is very difficult 
to be overcome, (and yet, v^ithout the 
prudent use thereof, and of the other 
means above hinted, I am convinced 
the gout cannot be cured), — let me, 
therefore, request him not to be afraid 
of the means ad\1sed by his Physician. 

While I am enforcing these few 
hints, which I hope may be for the 
good of others, I shall beg leave to 



44j 

mention my own case, and the treat- 
ment thereof, which I have reason to 
beheve saved me from a consumption, 
in the former part of my hfe, and from 
being crippled witli the gout in the 
latter part of it; especially, as a brief 
history of the means used, may lead 
to the cure of other persons threaten- 
ed with such disorders. 

I never heard that any of my ances- 
tors were troubled with the gout ; no 
seeds of it, therefore, can be supposed 
to have remained with me. From 
my youth I was subjected to coughs 
and defluxions from my lungs, but 
usually without fevers. — Wlien about 
the age of twenty-six, my cough and 
excretion of mucus increased very 
greatly, and my body became wasted 
90 much in the course of two years, 



Of Diet. 45 

that I began to reconcile myself to that 
awful close of life which seemed to 
approach me; — nay, when walking 
throu h the streets of the town where 
I resided, I often heard the people be- 
hind me say, " Ah, poor man, he is not 
long for this world!" 

I had bled sometimes from the arm, 
and taken mcd cincs by the advice of 
my medical teachers, and several 
other eminent practitioners; but the 
cough, and spitting of a mucus, some- 
times tainted wit!i blood, continued, 
though I do not remember to have ob- 
served any purulent matter. In my 
studies, having met with an autlior, 
(1 think Doctor Dover) recommending 
bleeding in very small quantities, and 
frequentlyjn consumptive cases, I took 
the hint, and bled myself from four to 



46 ^* 

six ounces at a time, in four weeks run- 
ning, alternately from each arm, and 
finding my lungs greatly relieved, I 
rei)eated tlie operation in this manner 
twice the next month, to six ounces 
at a time. I continued, also, the use 
of the pectorals advised me, and took 
an aperient once or twice a week. By 
these means I found myself gradually 
reheved, and therefore persevered in 
bleeding myself, about eight ounces 
at a time, once every month, during 
the space of twelve years, and for four 
years afterward about the same quan- 
tity every six weeks; amounting in 
the whole to, as nearly as I could cal- 
culate, twelve gallons, between the 
twenty-sixth year of my age, as before 
mentioned, and that of it at forty-two. 
— ^After this time, to that of my fiftieth 



Of Diet. 47 

year, I bled only al)out six times in 
the year. 

During all this time, I went through 
great fatigue of body and mind, in 
every branch of medical practice, yet 
my health recovered, the cough and 
defluxion gradually abated, and quite 
left me, excepting when I caught cold, 
which I was much subjected to by 
being called often out of bed, at night, 
to attend in cases of midwifery, a part 
of my medical practice. 

Finding my health thus recovered, 
1 indulged more freely in eating and 
drinking (though never to excess) and 
in the use of a carriage exercise in- 
stead of others. Ere long I felt wander- 
ing pains through the muscular parts, 
which soon fixed on one hip with such 



48 0/ ^ie^- 

violence, that I could neither turn in 
bed, nor bear the weight of the clothes 
on the part affected. Convinced that 
my case v^^as of the inflammatory kind, 
I bled, and took an aperient; but the 
pain still raging and descending to the 
knee, I sent for my late valuable friend 
Doctor Lewis, who, being convinced, 
also, that the case was as I had thought, 
advised me to be bled again and take 
cooling medicines. I must observe 
here, that my blood was at this time 
sizy, in which state I had not seen it 
before. I was bled again; in about 
ten days the pains, which were still 
excessive, extended to the other side, 
and soon afterwards both hands and 
feet began to swell, upon which the 
pains in the hips and knees grew more 
tolerable, and a gouty redness appear- 
ed on the fingers and toes, which con- 



Of Diet. 49 

vinced the Doctor, and another friend, 
a Physician, and myself, that the case 
was now reduced to a real gout ; — it 
was, therefore, treated as such, and I 
recovered perfect health. 

I have had slight attacks since that 
fit, but by bleeding at the first onset, 
and the use of a few medicines, my 
liealth has always been restored in 
about a week's time; excepting an 
attack near six years ago in Scotland, 
when at a gentleman's house, situated 
higli, on the soutli side of two rivers, 
which united a little towards the east 
of it ; and thougli it was a strong stone 
building, yet I felt it remarkably cold, 
during my stay there, in the months 
of November and December. In this 
situation I lived most plentifully in 

£ 



50 0/ Diet. 

respect to diet, ^c. but had not my 
usual degree of exercise. 

Here I was seized in a similar way 
to my first attack, only that the gout 
appeared sooner on my feet and 
hands. — I began with taking blood 
from my arm, as usual, and found it 
sizy ; — then took such medicines as I 
thought my case required, by which 
means I grew daily better; — but the 
first day that I could get on shoes, 
very urgent business calling me to 
return to my home at Brentford^ al- 
though the ground had been covered 
very deep with snow for some time, 
and there was a frost, I set out in the 
latter week of December, travelled 
day and night, excepting part of one 
day, and arrived at home the first of 
January, 1788, so exceedingly ill, that 



Of Diet. 



51 



I almost despaired of recovery. By 
uneasy sensations and pains which I 
felt over all the body, and great ina- 
bility of muscular motion, I concluded 
that the extreme cold which I had 
undergone must have prevented the 
excretions of the gouty matter, and 
fixed it so as not to be removed. 
Notwithstanding this dilemna, I bled 
myself again, to the astonishment of 
several medical practitioners, as well 
as of my own family, and finding the 
blood sizy, as I expected it must be, 
I left off the use of wine and every 
other fermented liquor for some 
weeks. My diet consisted of boiled 
meats, weak broths, puddings, vegeta- 
bles, water, and rennet whey; and 
for medicines, such as I had used 
before. 



g2 

I have no doubt the above treatment 
will appear very strange to some, 
and, mdeed, I should not have ven- 
tured to recommend it to others, — 
lest, not meeting with the success I 
hoped for, much censure most likely 
would have fallen upon me. — HoWr 
ever, I survived all those trials, and 
have not been confined by the gout 
since. But, on account of frequent 
overcharges of blood and mucus, op- 
pressing my lungs, by receiving what 
is called cold, I have been obhged to 
bleed three or four times every year 
since my fiftieth year, before mention- 
ed, the whole amount, from my twen- 
ty-sixth year, being as near as I can 
calculate, equal to twenty gallons, I 
hope, therefore, the candid reader 
will forgive me in declaring here my 
thankfulness to God, for bringing me 



Of Diet. 53 

on this 25th of May, 1793, in the se- 
venty-third year of my age, and in bet- 
ter licalth than that I usually enjoyed 
in the early part of life.* 

• The venerable and respectal)le Author of this little trea- 
tise, is, it is believeil, yet living and in perfect health The 

above observations may serve to eradicate the foolish and un- 
founded prejuilices against blood-letting : — for although much 
harm may have been done by its indiscriminate etn|)joyment 
we should not object to the use of a rnmedy, from evils arising 
from its abuse. — Am. F,n. 



54 



CHAP. IV * 

Directions to J^urses. 

As it is the Physician's business to 
heal the sick, it can hardly be sup. 
posed, that any endeavour which con- 
duceth to heahh, can either be deem- 
ed a thing below him, or unworthy 
of public acceptance ; I venture there- 
fore again, on a subject, which, so far 
as I know, has never been attempted 

* This Chapter cannot be too closely attended to by every 
person who is interested m the welfare of the sick. — Am. Ed. 



Directions to JWirses. 55 

by any other person, though it is 
twenty-six years since the first edition 
of this work was printed. 

What I mean principally, is a col- 
lective view of such things as ought 
to be undersood by those whose office 
it is to nurse tlie sick: An office, 
which, if well known, and rightly per- 
formed, is most certainly of great 
benefit to mankind, how triffing so- 
ever it may appear; on the contrary, 
when it is either neglected, or badly 
executed, the most fatal consequences 
often arise. To prove the truth of 
these assertions, I shall only appeal 
to every sensible Phyician, whether, 
when the plan prescribed by him hath 
been punctually observed, he has not 
commonly seen the disease either 
yielding readily to the remedies, or 



g 5 Directions to JVwrses. 

terminating in its usual period, with- 
out any mysterious or difficult symp- 
tom arising through the course of it? 
Whereas, on the contrary, when his 
plan hath been altered, as for instance, 
when the medicines have not been 
taken at the appointed times, when 
improper diet has been given instead 
of that directed, when the air in the 
room, and many other circumstances, 
have not been properly attended to, 
whether he has not then known the 
disease to be aggravated, and fre- 
quently diverted from its natural 
course (if I may be allowed the ex- 
pression), so that new symptoms have 
arisen, and very often a new disease, 
which adding force to the former, tlie 
power of medicine hath been resisted, 
nature has been overcome, and death 
has ensued, even in cases, where, if 



Directions to JVurscs. 

110 such errors had been committed, 
there was the highest proliabiUty of 
the patient's recovery. This is what 
I appreliend few will deny; the mis- 
takes indeed are commonly conceal- 
ed artfully by the nurse, who is too 
often imprudently influenced and sup- 
ported by the patient: Horrid indis- 
cretion! I must tell them, that the lat- 
ter sports with no less than life ; and 
tlie former, not only .with that, but 
character and conscience also. For 
these reasons, I could wish the heads 
of families would deign to peruse this 
work with serious attention ; not only 
because they will be forewarned of 
dangers, but being enabled also to 
judge (when sick) how they are treat- 
ed by their nurses, they may know 
liow to reward them accordingly, as 



58 Directions to J^urses. 

their office hath been well or ill dis- 
charged. 

Before we go farther upon this sub- 
ject, it may be necessary to observe, 
that none should be nurses, unless 
they are possessed of the following 
qualities, viz. honesty and fidelity; 
without which, they will not only in- 
jure others, but themselves also. 

Sobriety is also essential. To be 
intoxicated with liquor is a disgrace 
to every woman, but unpardonable 
in those who are intrusted with the 
lives of others. Let nurses be aware 
of this shameful vice, and never give 
way to it, even though at one time they 
may be exhilarated with joy, and at 
another time depressed with care and 
fatigue; if they do, they will not only 



Directions to JK'urses. 59 

endanger the patient, but infallibly lose 
their characters, (almost as effectually 
as if void of the above virtues) which 
once lost, may never be regained, 
though their future maintenance may 
depend entirely on a good name. The 
more equal and cheerful tliey are in 
their dispositions the better, provided 
always that they keep tlieir proper 
distances; and never incommode the 
patient with idle chitchat, disagreeable 
subjects, or any thing that can occa- 
sion sudden surprise.* 

They must learn to be very quick 
and expert in the execution of their 
office, yet without bustle or noise; 
the track may be easily kept when 



• Tliis caution is of the highest importance! an excessive and 
indiscreet l(i<iuaclty is suRitiont to overbalance every other qua- 
lification in a nurse. — Am. Ed. 



(50 Directions to JV'urses. 



once got into, and the objects to be 
attended to are but few, as, for in- 
stance, those which are compreli end- 
ed in the following chapters. 



01 



CHAP. V. 

Of Things to be observed relating to 
' the Chamber. 

It being a well known fact, that 
the life of every animal depends as 
mucli on air as on diet ; and its health 
also, as much on the goodness of the 
former, as on tliat of the latter;* 
care tlierefore should be taken, what 
sort of air and rooms we usually ei- 

• Thus it ■vvas expressed in my first publication ; since which 
time, the great benefit of breathing pure vital air, has been so 
folly pointed out by the learned and most indefatigable Doctor 
Priestley, and some other very eminent philosophers, as to 
confirm my ideas on the subject. To their writings I think it 
my duty, therttore, to refer the reader. 

P 



OJ Thitigs 



thcr sit or sleep in, but more espe- 
cially so, when confined by sickness. 

Hot climates require such rooms 
as are high and spacious. In this 
country one sixteen feet long, fourteen 
broad, and ten high, is reckoned a 
good size, particularly for a bed- 
chamber; the length and breadth be- 
ing more or less, the ceiling ought 
never to be lower : if higher, or coved, 
the better, as thereby the foul air will 
have space to ascend, and make way 
for an influx below of that which is 
fresh and pure. 

It should be kept as clean as possi- 
ble from eveiy sort of mephitic air, 
or putrid matter. If it is situated so 
as to receive the rays of the sun 
some hours every day, the better. 



Relating to the Chamber. 

The bed should never be placed 
between the door and the chimney, 
if it can be avoided ; for in this situa- 
tion, the air on the side next the fire 
will be rarified, and that from the 
door will come with so much force 
upon the bed, as to endanger the pa- 
tient: a screen therefore in such cases 
must be so placed as to prevent the 
cold air from rushing directly upon 
the bed. Even supposing no fire, 
yet if the bed is thus situated, the 
air in most rooms will pass so forci- 
bly towards the chimney, as to affect 
the patient; though not so much as 
in the former case ; yet it is not ad- 
visable to stop up the chimney. place.* 

Whenever a fire is required, it 



• In many of the (lisrases to which we are liable, it would 
be far preferable to place the bed in the middle of the chamber. 

Am. Ed. 



04 Of 

should be kept equally up; though in 
a weaker or stronger degree, accord- 
ing to the nature of the disease, the 
season of the year, and state of the 
weather. The room being brought 
to a due heat, should never cool sud- 
denly, nor the fire be permitted to go 
entirely out; for the air must be kept 
always in a state as sweet and tem- 
perate as possible : This seldom or 
never can be so well known by the 
patient as by others. The nurse, in 
this respect, must be directed by the 
medical person who attends ; and in 
his absence by her own senses, or 
by those of others, who coming from 
the open air^ will be sensible if any 
thing in the room is offensive or dis- 
agreeable. 

When the foul air is to be changed, 



Relating to the Chamber. 

or the room cooled, the door must 
be opened awhile, and if that be in- 
sufficient, a window also; during which 
time the patient must be so covered, 
or screened, as the torrent of cold 
ah' come not violently upon him. 

If the disease be the small-pox, and 
the weather very hot, it is often need- 
ful to keep a window open day and 
night during the whole course of the 
disease; but in this case the nurse 
must take care that the patient doth 
not lie in a violent stream of air, by 
keeping either the door or another 
window open at the same time, unless 
it l)e for a minute or two, when the 
smell in the room becomes extreme- 
ly powerful. In short, be the disease 
as it may, the air in the room should 
never be tainted with any smoke, 
F 2 



66 <y 

dust, putrid or offensive smell, if 
they possibly can be avoided.* 

The floor now and then must be 
sprinkled with lavender-water or vin- 
egar, especially before it is swept; 
but it must be Avashed with great cau- 
tion during the month of child-bed, 
and in the course of a fever, unless 
the patient is able to be removed into 
another room, till it is perfectly dried. 

A daily change of roses and some 
other herbs, as, for instance, lavender, 
sweet-marjoram, sage, thyme, balm, 
mint, southernwood, rue, feverfew, 
^c. may be placed in the room, and 

• As far as respects the Small-pox, it is to be hoped the 
preceding remark may be soon rendered altogether unnecessa- 
ry by the invaluable introduction of the Vaccine. If the small- 
pox is however unfortunately introduced, there is no reason for 
not opening all the windows in hot weather. — ^Am. Ed, 



Relating to the Chamber. 67 

such as are most agreeable smelled 
to by the patient. When faint, some 
lavender-water, or the steams of warm 
vincj»;ar, may be applied to the nose; 
but smelling salts, as they are called, 
and volatile spirits, such as those of 
hartshorn, ^c. must be used ^vith cau- 
tion, for they are often pernicious. 

If the nurse deviates from the above 
plan, it ouglit to be by the advice of 
tlic Physician, who, knowing the case, 
it may be reasonably supposed, will 
direct what is most suitable for the 
cure. 

It is a misfortune to the poor, that 
the ceilings of their houses are gene- 
rally very low, and that they are often 
obliged to have several beds in the 
same room j but what is worse (though 



68 



Of Tilings 



usually owing to their own sloth and 
dirty disposition), their linen being 
foul, and other filth being suffered to 
remain in the room, the air becomes 
tainted with the putrid steams: so 
that if a person falls ill, suppose of a 
fever, in itself not malignant, yet, by 
giving hartshorn-spirits, or Venice- 
treacle, ^c * in order to force sweats, 
as is too often the case, the disease is 
not only increased, but often changed 
so much, that it becomes at last a 
putrid or malignant, and frequently 
an infectious fever. For these rea- 
sons, the sick person's room should 
be kept very clean, and as few sleep 
in it as possible. People surely may 
be cleanly, though ever so poor. 



• This practice is become nearly in disuse, since my fii>t 
publication. 



Itelating to the Chamber. gg 

The floor should also be sprinkled 
with vinegar, or strewed with herbs, 
as l)cfore directed; by which precau- 
tion, the infection will probably be 
nipt in the bud, and hence many lives 
saved, wliich otherwise would fall a 
sacrifice. 



ro 



CHAP. VI. 

Of what is to be observed concerniiig 
the Bed, mid Shifting the Patient, 

§ 1. Of the bedstead there is lit- 
tle to be said, but the posts should be 
high that the tester may allow an as- 
cension of the foul air. 

It is extremely needful to have the 
bed and bedding always as clean as 
possible, and the newer they are the 
better; for old ones contract a putri- 
dity not only from the stagnated air 



Cuncci ning the Bed, <^'c. y \^ 

wliich tlicy contain, but from the exu- 
dations of those persons who have 
lain in them. 

Silk or worsted curtains imbibe a 
humidity, which, together with the 
dust, occasions mustiness ; such there- 
fore as can be washed, whenever they 
are not clean, are certainly the best, 
as for instance, those whicli consist 
of linen or cotton, or of both. 

J 2. Some people (sick or well), 
accustom themselves to have the cur- 
tains drawn. This is a pernicious 
habit, for the air being thus confined, 
becomes replete not only with wliat is 
expired from tlie lungs, but likewise 
witli a portion of the effluvia from the 
rest of the body: hence, in a short 
time, they draw in a considerable part 



Concerning the Bed, 

of the excrementitious particles of 
their own bodies.* 

The air thus contaminated, is so 
noxious to a person who comes from 
the fresh air, that upon opening the 
curtains, when visiting such patients, 
I have often been almost suffocated . 
I therefore wish that people would 
adopt such a method as the following, 
namely, to pin the curtains close to 
the head of the bed ; and from thence, 
when the weather is warm, to extend 
them downwards to near the middle, 
and when it is cold, to the feet-posts 
only, without any opening on the sides, 
by wliich means the air will not come 
directly upon the person's head, but 

• This article is worthy of the most serious attention, espe« 
cially in a sick chamber. Miliary fevers, &e. are less frequent 
now, in consequence of t^ pernicious custom being less pre- 
valent.—AM. Ed. 



and Shifting the Patient. 

gradually round, to afford a supply of 
fresh, and at the same time, to per- 
mit an escape of that which is foul.* 

Every feather bed should have one 
mattress over, and another under it ; 
for ^vitllout this precaution any person 
may become faint and languid. Let 
the mattresses be made v^^ith clean 
horse hair, or with straw, as other 
materials may become foetid or putrid. 

§ 3. The bed, at the begining of an 
illness, should be made as smooth as 
possible, but always higher at the head 
than at the feet ; and clean Hnen, (not 

• The utmosi)licre of a chamber of persons in health becomes 
so I'ontaminated, as to be disagreeable to any one entering it from 
the fresh air; how much more so then must this be the case, 
when sickness tends in various additional ways to destroy its pu- 
rity! — Am. Ed. 

G 



Concerning the Bed, 

such as has once been used,* of which 
some have a mighty notion, but such 
as is well dried) must be laid upon it ; 
the patient then may go into it, and 
being covered with such a quantity 
of clothes as accustomed to when in 
health, the curtains must be drawn 
only as before directed.! 

Facts evince it, that light is condu- 
cive to health as well as to life ; it is 
therefore an error (as I humbly con- 
ceive) to darken bedchambers, espe- 
cially those of the sick. If indeedj^ 
the patient is light-headed, or delirious, 
the fewer objects that are presented 

• This practice of prefering linen once used, is now, I hope, 
quite discarded. 

■|- If curtains are used at all, it would certainly be preferable 
never to draw them lower than to the middle of the bedstead. 
All the advantage they afford of keeping out the cold, or rather 
of retaining the heat, is better attained by additional covering. 

Am. Ed. 



and Shifting the Patient. lyg 

to liis view the better; or if his eyes 
are affected, as in the small-pox, mea- 
sles, ^^c. the light must then be ob- 
scured; but in other cases its rays 
should be freely admitted. 

J 4. In cases of women in labour, 
when the bed is to be got ready for 
delivery, it must be first prepared as 
above directed, and then the following 
linen added, namely, take two sheets, 
double them lengthways, lay them one 
above the other across the bed, over 
the under sheet, and tuck in their 
ends on each side, below the bedding. 
Or, instead of these, take one sheet, 
fold it twice, stitch a tape to each 
corner, then lay this sheet across, up- 
on tlio under sheet, and tie it tightly 
to the bedstead on each side by the 
tapes. In this manner the bed must 



<yQ Concerning the Bed, 

remain after the delivery. But to 
keep it perfectly clean during that 
operation, the following conveniences 
must be added also : 

§ 5. Place a basil skin* upon 
the cross sheet, and over it two sheets 
four times folded, one upon the other, 
the uppermost with its end hanging 
over the right side of the bed ; upon 
these the patient must lie, and over 
her another sheet being laid across, 
below the upper sheet, with that end 
wliich is towards the right side of the 
bed turned back over the coverings 
and pinned, every thing then will be 
kept clean and in proper order. If 
the weather be hot, or the labour vio- 
lent, the upper coverings must be ac- 



* This is a species of leather ; a piece of oiled silk will an- 
swer as well. — Am. Ed. 



and Shifting the Patient. iy>y 

€ordingly lessened, until the operation 
is ended. 

5 6. When the patient is deli- 
vered and has rested awhile, she must 
be dressed with the suitable apparel; 
the sheet which lay across above her, 
and tliose whicli were doubled below, 
together with the basil skin, must be 
taken away, and then she will remain 
very comfortably, in the clean linen 
with which the bed was before pre- 
pared. 

After this time she may remain in 
bed till the beginning of the third day? 
and then be taken up in the following 
manner : 

Before she rises, the room must be 
in a moderate degree warmed, and a 

G 2 



7S Concerning the Bed, 

chair placed by the side of the bed, 
with a blanket or quilt over it; she 
then must be taken up, with the linen 
in which she lay, and being covered 
up, either sit in the chair, or, if faint, 
be laid back as before directed, till 
the bed is prepared anew, and her 
dress also changed as occasion re- 
quires. This being done, she must 
repair to bed, and continue there till 
the fifth day, when she may dress, 
and sit up about an hour, or more, 
every day, if no illness forbid it; but 
if she is feverish, she ought not to ])e 
taken up even now, unless by consent 
of the Physician who attends, for as 
he can judge of the case, he will know 
if it may be done or not. 

After the first week, (no indisposi- 
tion forbidding) she may rise every 



and Shijlhig the Patient. >yg 

day, and sit up longer, or lie upon a 
couch for a while, and then sit up 
again. 

During the first three weeks she 
should avoid the fatigue of many vi- 
sitors as much as possible, and those 
whom slie receives ought not to stay 
long in the room, lest thereby she be 
incommoded.* 

J 7. Whenever a s'ck person is 
taken up till the bed is made, the 
above method should be observed, be 
tlie disorder wliat it niav, unless it is 
a fracture in some part of the lower 
limbs; if so, tlie surgeon must be pre- 
sent, to take care that the bones are 



• This advice is highly important ; many Monien suffer ex- 
Ircnicly, and even induce daiitjerous and fatal illness, by exert- 
ing ihcinselves iu-ematurely. — Aai. Eu. 



80 Concerning the Bed, 

not disturbed, and the callus conse- 
quently not injured. 

It is of great moment to the sick, 
to have their linen shifted so often, 
that it may never become foul or of- 
fensive. 

I shall here repeat a remark which 
I made in the first publication of this 
work, respecting the small-pox ; it is 
as follows : 

"There is a custom remaining 
" among the common people, in res- 
" pect to the small-pox, which is real- 
" ly to be lamented, it is this : they 
" will not shift their linen till the pus- 
" tules are dried. Whoever will give 
" themselves but time to reflect, must 
" be convinced, that no disease, (pu- 



and Shifting Hit Patient, 8^ 

trid fevers excepted) requires more 
" cleanliness in nursing than the small- 
"pox, especially confluent kind. 

" I must own, that in such cases, I 
" hav e used all the arguments in my 
" power, to enforce the necessity of 
" admitting the fresh air, and of shift- 
" ing the linen, ^^c. yet sometimes the 
" obstinacy (I cannot help calling it 
" the cruelty) of nurses, nay, some- 

times that of the neighbours also, 
"has been so great, as to prevent 
" their complying ; and to my farther 
" mortification, I have in such cases 
" known the patient sink, and even 
" die, under the influence of the mor- 
" bid steams arising fi om his own 
" body, and the filthy clothes around 
"him; whereas, if he had been kept 

clean, and the pure air admitted as 



gg Concerning the Bed, Sfc. 

" advised, I have been perfectly con- 
" vinced, in my own mind, that he 
" must have done well. I cannot, 
" therefore, but heartily wish that 
this preposterous and detestable 
" custom may be speedily exploded." 

Since the above remark it gives 
me great pleasure to find, now, that 
the admission of fresh air, frequent 
change of clean linen, and, in short, 
every other sort of cleanliness in the 
chambers of the sick of every descrip- 
tion, are better attended to than be- 
fore. 



83 



CHAP. VII. 

Of Diet for the Sick. 

The health of the human body 
having a great dependence upon the 
quantity and quality of the blood and 
juices, and it being plain that all those 
aliments whicli preserve and maintain 
a just temperament, and a due quan- 
tity of these, are beneficial to health, 
wliereas such as have a contrary ten- 
dency, are to be reckoned unwhole- 
some ; a particular regard is therefore 
to be had to the choice of our diet, 
even whilst we are in perfect health. 



g4j ^if ^^^^ S^^ '^'^ Sick. 

The prevailing fashion at present is, 
to make one repast consist of a varie- 
ty of dishes. This mode, whilst ob- 
served with moderation, is laudable, 
for such a meal will digest sooner, 
and with less uneasiness to the sto- 
mach, than one consisting only of one 
dish ; even supposing the quantity eat- 
en is not quite so much as that of 
the former. And moreover, there is 
reason to believe (as I was long ago 
informed by an ingenious friend,* 
who has made many experiments up- 
on living animals relative to digestion) 
that the chyle is always the same, let 
the substance from which it is pro- 
duced, be either vegetable, or animal; 
that when it appears to be in any res- 
pect different, it is owing to its bein,^ 
mixt with such substances as are in- 



* Mr. John Hunter, 



Of Diet for the Sick. 



85 



digestible in the stomach, such as the 
Juice of madder, ^c. and that every 
thing tliat goes perfectly through the 
digestive fermentation, constantly pro- 
duces a substance that is alike in all 
paits. 

But then we must suppose, that the 
materials which constitute each of 
tlicse meals, are not spoilt in the dress- 
ing; tliat is to say, that neither by a 
dissimilar commixtion, nor by the ac- 
tion of the fire, they are rendered 
cither acrimonious, or totally effete, 
hence improper for nutrition; for I 
am apt to think, that this happens too 
often, even in the most fashionable 
metbod of dressing victuals. 

If we take but a cursory view of the 
present state of cookery, we shall 

H 



86 



Of Diet for the Sick. 



find that many of those dishes which 
are reckoned the most elegant, con- 
sist of above twenty articles, some 
near forty, and many of them, though 
very incongruous and insignificant, ex- 
tremely expensive ; nay, an incredible 
quantity of the most wholesome food 
is often destroyed in the production 
of one trifling article, which, when 
obtained, serves for little else, than to 
render some heterogeneous farrago 
(though agreeable to the palate) more 
improper for nutrition. 

Can we reflect on all this, and not 
wonder how the opulent, whom we 
may suppose to be the most reasona- 
ble part of the community, can be 
thus imposed upon ; not only in being 
made the instruments of enhancing 
the price of provisions, especially now, 



Of Diet for the Sick. §7 

wlien its exorbitancy is still so justly 
com])lained of; but in habituating 
themselves to the use of such aliments 
as are better suited for the mainte- 
nance of diseases than for that of life. 

Whoever indeed is nice in the gra- 
tification of his palate, may enjoy some 
pleasure whilst he feeds on these de- 
licacies, which consist, usually, first, 
of a great variety of animal kinds, and 
are then succeeded by different pas- 
tries, confections, and fi uits; but then 
let me ask him, do they not often 
tempt him to exceed the bounds of 
moderation, by eating so copiously, 
that he soon finds his intellects are 
obscured, that his stomach is op- 
pressed, and that his whole body is 
indisposed? Has he not known some 
of his acquaintance who have com- 



88 Of ^^^^ fo^ tli^ 

monly fared so luxuriously, either die 
apoplectic, or linger on with gouty 
pains, ^c? 

In short, though it cannot be suppo- 
sed that this exuberant way of eating 
(which prevails remarkably, even 
now, amongst the middle ranks of 
people), has been introduced, by ei- 
ther any particular person Or nation, 
with a design to hurt us, yet this ob- 
servation, I presume, may be made 
upon it, viz. that there was never a 
custom better suited to enfeeble, and 
at last to destroy, the constitutions of 
British subjects, even at the expense 
of their own fortunes. 

A volume might be written, and 
very usefully too, upon this head, but 
leaving it to some splendid pen, I shall 



Of Diet for the Sick. gg 

return to the purpose intended, name- 
ly, to describe the preparations of 
such aHments as are most proper for 
tlie sick; with an intention that the 
nurse (who ought to be the cook with 
respect to this part of diet), may have 
rules to go by ; and that the Physician 
or medical person who attends, may 
not only have a monitor to assist him, 
in some respect, in choosing such as 
are suitable to the. case before him, 
l)ut that the preparation itself may be 
rendered more certain than it too 
often happens, when verbal directions 
arc given only. 

hi preparing of all kinds of ali- 
ments, it is essentially necessary to 
be very cleanly, but more especially 
in that for sick people, whose sto- 
machs arc often so greatly weakened 
H 2 



go Of Diet for the Sick. 

and disordered by the disease, as to 
put the Physician to his utmost in- 
vention in finding out by way of diet, 
what is agreeable to the natural pow- 
ers, and suitable to the case. 

The nurse, therefore, must not 
only be cleanly in her person, as ob- 
served before, and in the materials 
which she uses, but she must take 
care that the vessels in which they are 
dressed, are either silver or iron, or 
if copper, very well tinned, and kept 
as perfectly clean as possible. 



OJ Diet for the Sick. 



91 



SAGE-TEA. 

Take of • .' ' . 

The leaves of gixien sage, plucked 
. from the stalks and washed clean, 

half an ounce ; " , . 

Loaf sugar one ounce; 
Outer rind of lemon-peel, undried, a 

quarter of an ounce; 
Boiling water, twp pints. • • 
Infuse them in a deep vessel for half • 

an hour, and then .s.train off the tea. 
When the sage is dried, it must be 

used in a less proportion than that 

above. 

In the same manner teas may be 
made of balm, rosemary, southern- 
wood, ^'c. the lemon-peel being omit- 
ted, oi- not, and the sugar lessened or 
increased, as occasion requires. 



9^ 



Of Did for the Sick. 



ROSE-TEA. 

Take of 

Red rose-buds, the white lieels being 
taken off, lialf an ounce ; 

White-wine vinegar, three spoonsful; 

Double refined sugar one ounce ; 

Boihng water, two pints. 

Infuse them in a white stone or por- 
celain vessel, well covered, for two 
hours, and then strain oft' the tea. 

When the roses are dried, a quarter 
of an ounce will be sufficient. 

OATMEAL-TEA. 

Take of 
Oatmeal one handful ; 
Boiling water, one gallon. 
Mix them in a deep pan, and when 

they have stood about half an hour, 



Of Diet for the Skk. 93 

or until the meal is subsided, strain 
off the tea. 

BRAN-TEA. 

Take of 

Bran, fresh ground, two handsful; 
Common treacle, one spoonful; 
Boiling water, six pints. 
Mix them well, and when they have 

stood covered, about three or four 

hours, strain off the tea. 

LINSEED or FLAX-SEED TEA. 

Take of 
Linseed, whole, one ounce ; 
Double refined sugar one ounce and 

a half; 

Lemon-juice, two ounces; 
Boiling water two pints. 



Of Diet for the Sick. 

Infuse them in a stone or porcelain 
vessel, for some hours, and then 
strain off the liquor. 

An ounce of liquorice shaved, may 
sometimes be used instead of the su- 
gar. 

MALT-TEA. 

Take of 
Ground malt, one pint ; 
BoiUng water, three pints. 
Stir them well together, and let the 

mixture stand, close covered, for 

three hours, after which strain off 

the liquor. 

CAMOMILE-TEA. 

Take of 
Camomile flowers, one handful ; 
Boihng water, one gallon. 



Of Diet for the Sick. gg 

When they have stood covered up 
about half an hour, strain off the 
tea. 

If the drinking this tea is to 
strengthen the stomach, it must be 
made stronger, as for instance, about 
a quarter of an ounce to a pint. 

WHITE-WINE WHEY. 

Take of 

New milk, two pints ; 

Water, one pint; 

White-wine, one gill. 

Put the milk and water into a sauce- 
pan, well tinned, and set them up. 
on a clear fire, and when they be- 
gin to boil, throw in the wine. Boil 
them about fifteen minutes, during 
which time as the curd, or cheesy 



90 Of Diet for the Sick. 

part collects, take it off with a 
spoon, and if the whey is not clari- 
fied enough* with this quantity of 
wine, add a spoonful or two more; 
then boil it a little longer and skim 
it, by which means, it will become 
sufficiently fine, and then it may be 
poured into a basin for use. 



When it is to be made weaker, it 
must be boiled longer, that is, till the 
spirituous part of the wine flies olf 
But when it is to be made stronger, 
or when it is to be prepared with sor- 
rel juice, cyder, or cream of tartar, ^c. 
directions will be given accordingly 
by the Physician who attends. 



" Or it maybe clarified thus, beat the white of an egg, let 
the whey cool, mix them together, boil them for a minute or 
two, and then strain off the whey through a cloth. 



Of Did for the Sick. 



97 



VINEGAR WHEY.— Am. Ed. 

Is made in the same maimer as 
the wine whey, using vinegar instead 
of wine. 

TREACLE POSSET.— Am. Ed. 

Take of 

Milk one pint, put it on the coals till 
it just begins to boil, then add two 
or three table spoonsful of treacle, 
or molasses, stirring the milk as it 
is poured in. When mixed it is 
fit for use. 

LEMONADE. 

Take of 

The outer rind of fresh lemon-peel, 

about one drachm; 
Lemon-juice, one ounce; 



gg Of Diet for the Sick. 

Double refined sugar, two ounces; 
Boiling water, a pint and a half. 
When they have stood in a stone or 

porcelain basin, about ten minutes, 

strain off the liquor. 

ORANGEADE. 

Take of 

The fi^esh outer rind of Seville orange, 
one drachm; 

Orange-juice, two large spoonsful and 
about one half; 

Double-refined sugar, one ounce, and 
about three quarters, or enough to 
make it of an agreeable sweetness; 

BoUing water, one quart. 

When they have stood in a white 
stone or porcelain vessel, about 
ten minutes, strain off the liquor. 



Of Diet for the Sick. 



99 



THE EMPERIAL DRINK. 

Take of 

Cream of tartar, one drachm ; 

The outer rind of fresh lemon or 
orange peel, half a drachm; 

Loaf sugar, one ounce ; 

Boiling water, two pints. 

When they have stood in a white 
stone or porcelain vessel about ten 
minutes, strain off the liquor. 

OXYCRATE. 

Take of 

White wine vinegar, four spoonsful; 
Virgin honey, an ounce and a half; 
Spring water, one quart. 
Mix them together in a white stone 
or porcelain vessel. 

If honey disagrees with the patient, 



100 



Of Diet for the Sick. 



this drink may be sweetened with su- 
gar instead of it. 

BARLEY WATER. 

Take of 
Pearl-barley, two ounces; 
Water, two quarts. 

Wash the barley first well with some 
cold water, then pouring on about 
half a pint of water, boil it a httle 
while, and this water, which will 
be coloured, being thrown away, 
put the barley into the quantity of 
water above directed, first made 
boiling hot, boil away to half, and 
then strain off the hquor. 

BRAN DECOCTION. 
Take of 

Bran, newly ground, two handsful; 



OJ" Diet for the. akk. 101 

Water, three quarts. 

Boil till only two quarts remain; 
then strain off the liquor, and add 
to it a quarter of a pound of the 
best honey. 

BUTTERED WATER, or what the 
Germans call EGG SOUP. 

Take of 
W^ater, one pint; 
The Yolk of an Egg ; 
Butter, the bigness of a small walnut ; 
Sugar, enough to make it agreeably 

sweet. 

Beat up the yolk witli the water, 
and then add the butter and sugar. 

Stir it all the time it is upon the fire; 
when it begins to boil, pour it to and 
fro between the saucepan and mug 
till it is smooth and well frothed, 
and then it will be fit to drink. 
I 2 



103 



Of Diet for the Sick. 



WATER GRUEL. 

Take of 
Oatmeal, two large spoonsful ; 
Water, one quart. 

Mix them well, and boil them about 
ten or fifteen minutes, stirring 
often ; then strain the gruel through 
a sieve, and add sugar and salt 
enough to make it agreeable to the 
taste. When it is designed as a 
meal, dissolve in it a little butter, 
and then add bread and nutmeg 
as occasion requires. 

RICE GRUEL. 

Take of 
Ground rice, two ounces ; 
Cinnamon, a quarter of an ounce ; 
Water, four pints. 

Boil them above half an hour, the 



Of Diet for the Sick. ^ q 3 

cinnamon being put in near the lat- 
ter end of tlie decoction; then strain 
the gruel through a sieve, and add 
of double-refined sugar, (sugar of 
roses, or syrup of quinces), enough 
to make it agreeable to the patient's 
taste. 

When this is to be used as a meal, 
the rice must be boiled al)ove an 
hour, in only a quart of water, with 
half the quantity of cinnamon 
thrown in towards the latter end 
of tlie decoction, and then wine 
added, as occasion requires. 

WHITE CAUDLE. 

Take of 
Oatmeal, two spoonsfid : 
Water, one quart ; 
Mace, two or three blades ; 
Three or four cloves. 



104 Of Diet for the Sick. 

Mix them well together, boil them 
about fifteen minutes, stirring often, 
then add a few shces of the outer 
rind of a lemon ; when the mixture 
has boiled about fifteen minutes, 
strain it through a sieve. 

As it is used, add to it white wine, 
grated nutmeg, and double-refined 
sugar, enough to make it agreeable 
to the patient. Toasted bread is 
to be added likewise, as her appe- 
tite requires. 

BROWN CAUDLE. 

Boil the gruel as above, with three 
spoonsful of the oatmeal, then 
strain it, and add a quart of good 
mild ale ; boil it again, and then as 
it is used, add toasted bread, nut- 
meg, and sugar, as before direct- 
ed. 



Of Diet for the Sicky 105 

Some approve of a little wine in 
this also, but then less ale must be 
used in the first composition. Others 
like a few shces of ginger, some 
Jamaica pepper, or both, with the 
above ingredients, but if the patient 
is feverish these had better be left out. 

PANADO. 

Take of 
Bread, one ounce ; 
Mace, one blade ; 
Water, one pint. 

Boil them without stirring, till they 
mix and turn smooth, then add a 
little grated nutmeg, a small piece 
of butter, and sugar enough to make 
the mixture agreeable. 

When butter is not approved of, two 
spoonsful of wine may be used in 
its stead. 



Of Diet for the Sick. 



SAGO. 

Take of 
Sago, one large spoonful ; 
Water, about three quarters of a pint. 
Boil them gently, stirring often, till 

the mixture is smooth and thick; 

then add two spoonsful of wine, a 

little nutmeg, and sweeten it to the 

taste. 

SALOP. 

Take of 

Salop, finely powdered, a tea spoon- 
ful- 
Water, half a pint. 

Mix the Salop well in a cup of the 
water, then add the rest, and put 
the mixture into a saucepan, set it 
over a clear fire, and keep it con- 



Of Diet for the Sick. iQy 

tinually stirring, till it acquires the 
consistence of a jelly ; add to it a 
large spoonful of wine, a little nut- 
meg, and sweeten it to the patient's 
palate. 

THE WHITE DRINK. 

Take of 

Burnt hartshorn, prepared, two oun- 
ces; 

Gum Arabic, an ounce and a half; 

Water, three pints. 

Boil the water away to a quart, and 
then strain. 

Wine and sugar may be added, as oc- 
casion requires. 

RENNET WHEY. 

Take of 
New milk, one quart; 
Rennet, a large spoonful. 



108 ^^^^ M 

Put the milk into a saucepan, and 
when it is a little more than milk 
warm, mix the rennet with it ; keep 
it on the fire in a gentle degree of 
heat, till the curd, which as it sepa- 
rates from the serous part and col- 
lects, is taken off with a spoon, and 
then the whey will be lit for use. 



The rennet is prepared thus : Take 
a calve 's bag, with the curd in it, (that 
is the duodenum replete with congeal- 
ed chyle) pick the hairs entirely out, 
and wash the curd, and hkewise the 
bag, very clean with water, then put 
the curd into the bag again, with near 
half a pound of salt, and let them 
stand in a clean glazed pan about a 
week; then take three pints of water 
and one pound of salt, boil and skim 
until the hquor comes to two pints, 



Of Did fur ihe Sick. 



109 



set it by, aiKl when it is cold, pour it 
upon tlic bag in tlie pan. When it 
has stood thus about a week longer, 
the brine or liquor (now called ren- 
net) will be fit for use, and keep good 
for several months, 

N. B. Whoever has not an op- 
portunity of making this, may obtain 
it from the pastry-cooks, who gene- 
rally prepare it right, and keep it by 
them. 



THE VULNERARY DRINK. 
Take of 

Ground-ivy, colts-foot, and liquorice, 

each one ounce; 
Elecampane, half an ounce. 
Boil them in four pints and a half of 

water, to four pints, and then strain 

otf the liquor. 

K 



110 



0/ Diet for the Sick. 



THE PECTORAL DRINK. 

Take of 

Common barley and raisins stoned, 

each two ounces; 
Liquorice root, half an ounce 
Water, two quarts. 

Boil the water first with the barley, 
then add the raisins, and afterwards 
near the latter end of the boihng, 
the liquorice. The decoction then 
will be fully completed, when one 
quart only of the liquor will be 
left after straining. 

ELDER-BERRY SYRUP.— Am. Ed. 

To a pint of the juice of the berries 
add a pound of the best Muscova- 
do sugar, and boil it until it be- 
comes a syrup, carefully taking off 
the scum as long as any rises. 



of Diet for the Sick. m 

One or two table spoonsful of this 
syrup added to a pint of water makes 
a wliolesome pleasant beverage. 

SYRUP OF TURNEPS.— Am. Ed. 

Pare and slice tlie tiirneps, placing 

brown sugar between every slice; 

let them stand a few hours and the 

syrup will collect. 

This simple syrup has been found 
very useful in coughs. 

OATMEAL FLUMMERY. 

Take of 

Oatmeal (or grits), what quantity you 
please; put it into a broad deep 
pan, cover it over with water, stir 
them well together, and when they 
have stood about twelve hours, 



il2 Di^tjor the Sick 

pour off the water so long as it 
runs clear, that is, till it comes to 
the mealy part; then pour on a 
larger quantity of fresh water, mix, 
and let them stand twelve hours 
more; then pour olfthe clearest part 
of this also, and repeat the process 
again about twelve hours after- 
wards. When the oatmeal has 
been thus macerated about tliirty- 
six hours, the clear water being 
poured off and thrown away, the 
thick or mealy part must be strain- 
ed through a hair sieve, and put 
into a well tinned saucepan; this 
being done, let it be well stirred 
while it boils, upon a clear fire, un- 
til it acquires a thick consistence; 
it is then to be taken off the fire, 
and poured into dishes, and when 
cold turned out upon plates and 



Of Diet for the Sick^ 



113 



eat with milk, or rather with wine and 
sugar, or cyder and sugar. 

POTATOE FLUMMERY. 

Take of 

Potatoes, one pound. 

Boil them gently in a sufficient quan- 
tity of water, till they are brittle or 
tender; then take them out of the 
water, and peel the skins entirely 
olf. When this is done, add salt 
enough to season them, mash them 
well, and put them into a saucepan 
again, with a quarter of a pint of 
milk and two ounces of butter; 
warm them a httle, during which 
time let them be well mixed, and 
beat fine and smooth with a spoon. 
The mixture then, which may be 
called flummery, will be fit for 

K ^ 



114 



Of Diet for the Sick. 



use, and may be eat either by itself, 
or with bread. 

BREAD SOUP. 

Take 

The upper crust of a roll, the drier 
the better; cut it into pieces, and 
put it into a saucepan, with a pint 
of water, and a piece of butter 
about half as big as a walnut ; boil 
them well, every now and then 
stirring and beating them, till the 
bread is mixed; then season the 
soup with a very little salt, and 
pour it into a basin. 

SOUP MEAGRE. 



Take of 
Butter, half a pound ; 
Put it into a deep stew-pan, place it 



Of Diet for the Sick. 115 

upon a gentle fire till it melts, 
shake it about, and let it stand till 
it has done making a noise; have 
then ready six middling onions 
peeled and cut small, throw them 
in, and shake them about. Take 
a bunch of celery, clean Avashed 
and picked, cut it in pieces about 
an inch long, a large handful of 
spinage, clean washed and cut 
small, a little bundle of parsley chop- 
ped fine, shake all these together, in 
the pan for about a quarter of an 
Jiour, then sprinkle in a little flour. 
When they are stirred again, pour 
into the stew-pan two quarts of boil- 
ing water, then take of the diy 
hard crust of bread broken into 
pieces, one handful ; of beaten pep- 
per a tea spoonful ; of mace three 
hladcsj beat fine ; put these into the 



116 Of Diet for the Sick. 

mixture and boil them gently half 
an hour: take all now from the fire, 
beat up the yolks of two eggs and 
stir them in, then add a spoonful 
of vinegar, and the soup will be fit 
for use. 

The vinegar may be left out if it dis- 
agrees with the patient, or is incon- 
sistent with the medicinal plan ob- 
served in the cure. t 

GREEN PEASE SOUP. 
Take of 

Young green pease, half a pint; 
Two large cabbage lettuces, washed 

clean and cut into slices; 
Three middling sized onions, cut also 

into pieces; 
Beaten black pepper, a tea spoonful, 

or more if required; 



Of Diet for the Sick. 



117 



Water, one quart ; 

Salt enough to make it agreeable. 

Put all these into a saucepan, and set 
them upon a gentle clear fire ; co- 
ver the saucepan, and let them 
stew a full hour, then add two 
ounces of fresh butter, mixed up 
with flour: stir all wxll together, 
and when they have boiled about 
fifteen minutes longer, the soup 
will be well prepared. 

This soup may happen to be too 
flatulent for a stomach which is very 
weak; but when the valetudinarian 
begins to recover health, especially 
before animal food is to be allowed, 
it will in some cases be found useful 
as well as agreeable, for which reason 
it is inserted here. 



118 



Of Diet for the Sick, 



MUTTON BROTH. 

Take of 

A loin of mutton, one pound ; 

Water, three pints. 

Put them into a saucepan, and set it 
upon a clear fire, throw in a little 
salt, and as the scum rises take it 
carefully off with a spoon; then 
add a little onion, if there is no ob- 
jection to it, and two blades of 
mace. Boil till the meat is very 
tender, then take it out, pour the 
broth into a basin, and when cold, 
skim the fat part which is congealed 
on the surface, entirely off; after 
which a part of the broth may be 
warmed and given to the patient 
as often as needful. A little boiled 
rice may be added here occasion- 
ally. 



Of Diet for the Sick. 



119 



MUTTON BROTH, either with BAR- 
LEY or RICE. 

Take of 

Scotcli bailey, or rice, two large 

spoonsful ; 
Water, one quart. 

When they have boiled for half an 
hour, pour tlie water entirely off, 
and add three pints of fresh water, 
one pound of lean scrag of mutton, 
and a little salt. Boil again, and 
take the scum off as it rises ; this 
being done, throw in one onion of 
a middh'ng size, two turneps shced, 
and a little parsley; lilen having 
boiled till the meat is tender, the 
broth will be fit for use. 

If the rice is washed before it is 
boiled, the water need not be chang- 
ed afterwards. 



130 



Of Diet for the Sick. 



BEEF BROTH. 

Take of 

Lean beef, as clear of fat as possible, 
a quarter of a pound ; 

Water, a pint and a half; 

Salt, sufficient to season it. 

When it begins to boil, skim it for five 
minutes, then add about two blades 
of mace, and continue the boiling 
ten minutes longer, which being 
done, the broth may be poured into 
a basin for use. 

CHICKEN BROTH. 

Take 

A middling sized chicken, divide it 
into two parts, take the skin and 
fat entirely off, put one half into a 
saucepan, with a quart of water, 



Of Diet for the Sick. f^i 

seasoned with a little salt; as the 
scum rises take it off, then add a 
blade or two of mace, and a crust 
of bread, and when boiled about 
three quarters of an hour in all, the 
broth will be fit for use. 

ANOTHER WAY. 

Take 

The fleshy part of the legs of a chick- 
en Avithout skin, fat, or bones; put 
it into a small saucepan with a pint 
and a half of water seasoned with 
salt; boil, and as the scum rises, 
which ^vill not be much, take it off; 
then add a blade of mace, a httle 
bundle of parsley, and a crust of 
bread ; when they have boiled about 
half an hour, the parsley may be 
taken out, and the broth will be 
fit for use. 

1. 



122 Of Oietfor the Sick. 



EEL BROTH. 

Take 

Six small eels washed clean, and the 
skin stript off ; cut them into pieces 
about an inch and a half in length, 
put them into a pint and a half of 
water, with a little salt; when they 
begin to boil, take off the scum as 
it rises. This being done, add two 
blades of mace, six whole pepper 
corns, and a little parsley, then let 
them stew about half an hour, and 
the broth will be fit for use. 
This is placed here instead of vi- 
per-broth. The Physician will direct 
when it is proper to be taken. 

BOILED CHICKEN. 

Take 

Thin slices of bread, pour upon them 
some of the chicken broth as before 



0/ Diet for the Sick. 1S3 

l)repared, and then lay the chicken 
as then boiled over them. 
Let this be eaten without any other 
sauce. 

When the appetite is more recover- 
ed, and the case permits, it may be 
dressed as follows : 

Take 

Half a chicken, wash it clean from 
the blood, and put it into a saucepan 
witli a quart of boilin;^ water, sea- 
soned with a sufficient quantity of 
salt. As the scum rises, take it 
olf, and when the chicken has been 
boiled about half an Iiour, it may 
be laid upon a plate, over such sip- 
pets as above directed, and the lean 
parts of it eaten either with those, 
or with parsley and butter sauce. 



124* Of ^^^^ f^^ Sick, 



STEWED CHICKEN. 

Take 

A good chicken, and half boil it, then 
lay it upon a pewter or silver dish, 
cut off the wings and legs, separate 
their joints ; then take olf the breast 
bone, and if enough of liquor does 
not drain from the fowl, add a few 
spoonsful of the broth. Put in a 
blade of mace and a little salt, co- 
ver the whole up close with an- 
other dish, set it over a stove, or 
chafing dish of coals, let it stew till 
the chicken is enough done, and 
then serve it up hot to the table, 
in that dish in which it was stew- 
ed. 

N. B. Rabbits, partridges, and moor- 
game, may be dressed the same 
way. 



Of Diet for the Sick. 



125 



BOILED PIGEON. 

Take 

One pigeon, drawn, skinned, and 
washed very clean ; boil it in a suf- 
ficient quantity of milk and water, 
that is, about half a pint of each, 
for fifteen minutes. When thus 
prepared, it may be taken out, and 
eat witli the following sauce. 

Take 

The liver parboiled, bruise it fine, witli 
a Httle parsley boiled, and finely 
chopped; melt some butter, and 
mix a little of it first with tlie liver 
and parsley, then add the rest, and 
pour the whole upon the pigeon. 



42.6 Of I^ictfor the Sick. 



A PIGEON stewed in Paste. 
Take 

A pigeon drawn and washed clean, 
season it with pepper and salt, in- 
close it in puff paste ; tie the whole 
in a cloth, that the paste does not 
break, and then boil it in water an 
hour and a half. When the bag is 
untied, and it is put upon a plate, 
a little gravy sauce may be used 
with it ; or if that is not agreeable, 
let it be eaten with the gravy only 
which is contained in itself and the 
paste. 

BOILED PARTRIDGE. 

Take 

One partridge, drawn and washed ve- 
ry clean, put it into a saucepan 
with a quart of boiling water, sea- 



Of Diet for the Sick. \ 

soned with a little salt ; take off the 
scum as it rises, and let the boiling 
continue about ten or fifteen mi- 
nutes, by which time the partridge 
being done enough, may be eaten 
with the following sauce : 

Take 

The crumb of a French roll; 

Water, half a pint ; 

Pepper, about six corns; 

A piece of onion, if no objection to it ; 

And a little salt. 

Boil it to a smooth consistence, then 
add about the bigness of a walnut 
of butter, and when mixed it will 
be ready for use. 

BOILED FLOUNDER. 

Put the flounder into a stew-pan, ^vith 
a sufficient quantity of boiling water, 



128 



Of Diet for the Sick. 



seasoned with a little salt ; take off 
the scum, and continue the boiling 
about ten minutes; then take the 
flounder out, and when it has lain 
awhile upon a fish-plate to drain, 
it may be eaten with parsley and 
butter sauce. 

BREAD PUDDING. 

Take of 

Crumbs of bread, about half a pound; 
New milk, about three quarters of a 
pint. 

Pour the milk boiling hot upon the 
bread, and let it stand about an hour 
covered close up; then add the 
yolks of two eggs, well beaten; a 
little grated nutmeg ; about a spoon- 
ful of rose-water ; a little salt, and 
sugar also, if agreeable; beat the 
bread well, and mix the whole to- 



Of Diet for the Sick. 

getlier with a spoon, 'fie it then 
close up in a clean linen cloth, and 
when the water boils, put it in ; boil 
about three quarters of an hour, 
then take it out, lay it upon a plate, 
pour over it some melted butter 
mixed with a little mountain wine, 
if there is no objection, and sprinkle 
a little sugar over all. 

BREAD PUDDING without Eggs. 
Take 

A French roll, pour over it half a pint 
of boiling milk, cover it close, and 
let it stand till it has soaked up the 
milk, tie it then up hghtly in a clotli, 
and boil it a quarter of an hour» 
When it is laid upon a plate pour 
a httle melted butter over it. If 
there is no objection, some moun- 
tain wine may be mixed with the 



130 Of Diet for the Sick. 

butter, and the whole sprinkled 
over also with powdered sugar. 

BATTER PUDDING. 

Take of 

Flour, six spoonsful; 

Milk, one pint ; 

Salt, half a tea-spoonful ; 

Beaten ginger, nutmeg, and tincture 
of saffron, each a tea-spoonful. 

This pudding may be eat as the pre- 
ceding, with a little melted butter, 
wine, and sugar. 

When eggs are allowed, the yolks 
of three, and the white of one, must 
be beaten well together, then mixed 
with the above ingredients, and boiled 
about an hour. 



Of Diet for the Sick. 



131 



RICE PUDDING. 

Take of 

Ground rice, one ounce and a half. 

Put it into a pint of milk, and let it 
boil till it is pretty thick, stirring it 
all the time; then pour it into a 
pan ; stir in a quarter of a pound of 
sweet beef suet, chopped very fine, 
and two ounces of sugar. When 
it is cold, grate in half a nutmeg, 
and beat up three eggs, with a 
spoonful of sack. Mix all well to- 
getlier, and pour it into a dish, first 
rubbed over with a little butter, and 
then bake it. 

RICE PUDDING without Eggs. 

Take of 
Rice, two ounces. 



133 Diet for the SicK 

Boil it in a pint of milk, stir it that it 
does not burn; when it begins to 
be thick take it off, let it stand till 
it is a little cool, then mix well in, 
two ounces of butter, half a nutmeg 
grated fine, sugar enough to make 
it agreeably sweet,- pour it into a 
proper dish, first rubbed over with 
a little butter, and bake it. 

APPLE PUDDING. 

Take 

Three middling sized apples, pared, 
and cut in quarters, with the cores 
taken out; lay them in a good puff 
paste of about half an inch in thick- 
ness. When the paste is closed 
up, tie it tightly in a cloth, put it 
into boiling water, and when boiled 
an hour, take it out, put it upon a 



Of Did for llie Sick. 



133 



plate, open it at the top, and then 
put in a little butter, and sugar 
enough to make it agreeable to the 
palate. 

POTATOE PUDDING. 

Take of 

Potatoes, one pound. 

Boil them and take the skins entirely 
off, tlicn beat them in a mortar; 
mix in four ounces of melted but- 
ter, tic the whole up in a cloth Avell 
floured, and boil it again for about 
half an hour; wlicn it is turned out, 
and laid upon a plate, pour some 
melted butter, mixed with two 
spoonsful of white wine, and one 
spoonful of orange juice, over it. A 
little powdered sugar also may be 
sprinkled over all. 

M 



134 



Of Diet Jor the Sick. 



TAPIOCA JELLY. 

Take of 

That fine vegetable substance, called 
Tapioca, two table spoonsful, or in 
weight one ounce. 

Mix it with one pint and a half of 
pure spring water; and, when it 
has stood cold an hour, then boil 
it about an hour, with a clear gen- 
tle fire, stirring it well, until it is 
dissolved and becomes transparent. 
Near the end of the boiling, add 
two tea-spoonsful of lemon juice, a 
little of the peel, one tea spoonful 
of common salt, and sugar suffi- 
cient to suit the taste ; strain it off 
through a sieve, add three or four 
spoonsful of white wine, a little nut- 
meg finely grated, mix well, and 
then it will be fit for use. 



Of Diet for the Sick. ' 135 

Should wine be disagreeable to the 
patient, milk may be used in place of 
it, especially lor children. 

Tapioca, as appears to me, is a 
gummy exudation of some tree, al- 
though, the only account of it yet ob- 
tained from the Brazils, whence it is 
imported to Lisbon and London, is, 
that it is a root. 

However, when prepared as above 
directed, it is both an agreeable and 
nutritive aliment. 



ARROW ROOT.— Am. Ed. 

Take of 

The powder a large tea spoonful; 
mix it in a gill of sweet milk, and 
pour the mixture into near a pint 
of boiling water, stirring it for a 
few minutes, when it will be fit for 



136 OJ Dietfor the Sick. 

use. Sweetened with loaf sugar 
it is an agreeable nutriment for chil- 
dren afflicted with complaints of the 
bowels. 

If made with a larger proportion of 
the powder and milk, and seasoned 
with nutmeg or cinnamon, it is adapt- 
ed to the diseases of the stomach and 
bowels in adults. 

BLANC MANGER. 

Take of 

Isinglass sliced, one ounce. 

Infuse it in cold water twelve hours, 
pour the water off, and then put 
the isinglass into a quart of new 
milk, with three or four of the com- 
mon laurel leaves fresh gathered; 
set it upon a clear fire, stir it very 
often until the isinglass is dissolved, 
and then strain it through a hair 



Of Diet for the Sick. 1 37 

sieve. Add of double refined sugar, 
tnough to make it agreeably sweet, 
and two spoonsful of orange flower 
water; these being well mixed, 
when it has stood about a quarter 
of an hour, pour it into proper 
cups, first wet. When cold turn it 
out upon plates, as it is to be used, 
and stick into it some small pieces 
of blanched almonds. It may be 
eaten with sugar and wine, ^c. 

HARTSHORN JELLY. 

Take of 

Hartshorn sliavings, half a pound; 
Water, three pints; 
White sugar-candy in powder six 
ounces ; 

Mountain wine, a quarter of a pint; 
Orange or lemon-juice, one ounce; 
Boil the hartshorn with the water, by 

M 3 



a gentle heat, in a silver, or well 
tinned vessel, till two parts arc 
wasted; strain out the remaining 
Mquor, add to it the other ingre- 
dients, and boil the whole over a 
gentle fire, to the consistence of a 
soft jelly. 

If half a pint of this jelly is dissolv- 
ed in a quart of barley water, it makes 
an excellent drink in some cases ; but 
when neither wine nor acids are to 
be allowed, the following method may 
be used. 

Take of 

Hartshorn shavings half a pound; 

Barley-water, four quarts. 

Boil away to half, then strain, and add 

sugar enough to make it of an 

agreeable sweetness. 



Of Diet for the Sick. 



139 



CALVES- FEET JELLY. 

T3oil two calves-feet in one gallon of 
water till it comes to a quart, then 
strain it, and when it is cold skim 
the fat entirely off, and take the 
jelly up clean; if there is any set- 
tling at the bottom leave it. Put 
the jelly into a saucepan, with a 
pint of mountain wine, half a pound 
of loaf sugar, the juice of four large 
lemons, and the white of six or 
eight eggs, beat up with the whisk ; 
mix all well together, set the sauce- 
pan upon a clear fire, and stir the 
jelly till it boils. When it has boil- 
ed a few minutes, pour it through 
a flannel bag till it runs clear. Have 
now ready a large China basin, 
with some lemon peel in it cut as 
thin as possible, let the clear jelly 



i 40 ^ Diet for the Sick. 



nin upon them while warm, and 
from these it will acquire both an 
amber colour and an agreeable fla- 
vour. Afterwards it may be pour- 
ed into glasses. 

ISINGLASS JELLY. 

Take of 

Isinglass, one ounce ; 

Water, one quart; 

Cloves, a quarter of an ounce. 

Boil to a pint, and then strain the li- 
quor through a flannel bag, upon 
four ounces of double refined su- 
gar, and one gill of mountain wine. 
When they are well mixed pour 
the jelly into glasses. 



Ill 



CHAP. Vllf. 

Of administering Diet. 

In the cure of diseases, experience 
proves how much depends upon the 
proper choice and administration of 
diet. 

We see one scries of disorders^ 
wlicrein the appetite, either from a 
bad liabit, or from some morbid affec- 
tion, craves such things chiefly as liave 
a tendency to heighten the disease. 



Mministering Diet, 

Another series, in which the pa- 
tient's whole fabric being fully engag- 
ed, and struggling with the disease in 
order to conquer it, the stomach, (till 
in that conflict nature gets the better), 
loathes every kind of aliment, except 
such as is fluid, and that only which 
consists of pure water alone, or such 
as is mixed with some vegetable in- 
gredient; nay sometimes, even this 
too, as for instance, when the stomach 
is either diseased in its substance, or 
is loaded with morbid humours, or 
when the disease has vanquished na- 
ture, ^c. 

And we see, in a third class, the 
stomach not affected, but dispensing 
with all kinds of food ; yet these being 
taken indiscriminately, the disease is 



Jldministering Viet. ^43 

not only nursed, but the medicines, 
which usually are the most efficacious 
in curing it, arc rendered entirely in- 
effectual. 

To give a particular explanation of 
those diseases, and of the effects men- 
tioned, is not my business here; they 
are so very well known to every pro- 
ficient in physic, that it may reasona- 
bly be concluded, whenever a Physi- 
cian directs a plan of diet, he first 
considers the past and present state 
of the patient, the state of the disease, 
and the qualities of the medicines 
which he prescribes. 

It behoves the patient therefore to 
regard his rules, the nurse to see them 
punctually observed, and both, to be 



j^4j4! Mministering Diet. 

cautious how they deviate from them ; 
as fatal consequences may sometimes 
arise, from what may seem to have 
been but a trifling variation. The diet 
which is chosen, must be prepared 
either as directed in the preceding 
chapter, or as the Physician shall oi'- 
der; who, judging of the case before 
him, will make such alterations as he 
finds needful. 

In most diseases, especially in the 
small pox and putrid fevers, the pa- 
tient's mouth should be well washed, 
before any thing is taken into the sto- 
mach ; and the cleaner it is kept in the 
intervals, the better. 

The stomach must never be op- 
pressed with much at a time; about 



Mministering Diet. £45 

half a pint is enough, and that should 
be repeated only as nature indicates. 
This will generally be known by the 
patient's desire of, or dislike to it. I 
say generally, for in some cases where 
there is great weakness, insensibility, 
or both, the patient may not be able 
to give such indications. And there 
are other cases, (especially fevers 
wliich terminate badly), where the pa- 
tient's thirst is insatiable. In either 
of these exigencies, the nurse must 
proceed with discretion; that is, in the 
former, she must rouse the patient 
every hour or two, and give a cup-full, 
or half a pint of such drink as direct- 
ed ; and in the latter, she must be cau- 
tious, and allow but sparingly, till the 
physician or apothecary can be con- 
sulted. 

N 



14i6 



Jldministering Viet. 



It is a vulgar error, and a very com- 
mon one too, that a sick person is to 
be supported by rich broths, by jellies, 
or by solid meat itself. The outcry 
is, that the Doctor will starve him. 
Hence the relations (I must not call 
them friends) combine; tlie nurse (I 
am sorry to say it) becomes sometimes 
a confederate ; a nourishing and com- 
fortable thing, as it is called, is soon 
invented ; the deadly mess is dressed, 
and the unhappy patient is crammed 
in opposition to appetite, even tliough 
it may happen, that his constitution 
shudders at it! What is the conse- 
quence? It is this, such broths and 
jellies (allowing them sometimes to be 
relished) do not nourish, but serve to 
increase the febrile heat, which, per- 
haps, at this time is too great already 



Mminislenng Diet- 

and the chylopoietick organs being 
not yet able to digest any solid food, 
if meat is eaten, it must remain in the 
stomach and intestines, and oppress 
them, till, at last corrupting, the dis- 
ease is heightened by this new addi- 
tion of heat and putrefaction. 

Nurses take care! If you indulge 
relations, at the expense of the pa- 
tient's life, how will you satisfy your 
conscience afterwards ? 

When you are obliged to act by 
yourselves, you are justifiable in act- 
ing to the best of your judgment; but, 
when a physical person is concerned, 
whom you see watchful of every step 
whicli nature takes, and ready to give 
the necessary aid as soon as indicated, 



Administering Diet. 



you may certainly rest satisfied with 
only such as he allows; even though 
after the disease is conquered, and 
the appetite begins to crave, he directs 
you to give but sparingly for several 
days. 

Tliere are mistakes also with res- 
pect to lying-in women, which I can- 
not but take notice of, as for instance : 
First, It is often urged that the good 
woman may have some chicken even 
the day she is delivered ; and some 
who have a very athletic constitution 
will take it too, and yet get off with 
impunity. But then, how often do we 
see women, after such repasts, seized 
with a fever, faintings, violent disor- 
ders in tlie bowels ; then with a purg- 
ing, and sometimes with other symp- 



Mministering Diet. f^g 

tonis whicli are still more dangerous] 
Solid meat therefore should never be 
eaten before the third or fourth day, 
and then but very sparingly, till after 
the milk fever subsides, and the bow- 
els have been duly relieved from in- 
durated frt^ccs. Secondly, those who 
do not suckle the child, are common- 
ly debarred from drink during the milk 
lever, whereby the blood not being 
duly supplied, the milk (if not the 
whole fluids,) becomes thick and vis- 
cid, and forms obstructions in the 
breasts, ^'c. which often prove trou- 
blesome, if not dangerous. As in the 
former cases, so in these, it is always 
best to be directed by the medical 
person wlio attends. 

N 2 



150 



Administering Diet. 



The attentive perusal of the pre^ 
ceding instructive chapter, is strongly 
recommended to the consideration of 
every person concerned in the wel- 
fare of the sick. — Am. Ed. 



151 



CHAP. IX. 



Mministering Medicines. 



THE whole world hath seen, 
and still must be convinced, how 
much the cure of diseases depends; 
upon a right choice and administration 
of medicines; it is also well known, 
that the former wholly, and the di- 
rectory part of the latter, belongs pro- 
perly to him who has made physic 
his study as well as profession, and 
therefore not to be treated of here; 



±52 Mminislering Medicines. 

But, as the executive part of the 
latter is left commonly to the nurse, 
and sometimes to the patient, a few 
cautions (it is presumed) may be of- 
fered, wliich, errors arising either 
from neglect or whim, and committed 
every day, render necessary. 

We may reasonably allow (as was 
observed with respect to diet) that 
the Physician will consider carefully, 
firet, whatever relates to the disease, 
the constitution, ^c. of the patient; 
secondly, the nature and powers of 
the medicines he prescribes; and 
thirdly, the most elegant form or 
manner of composition, in which 
they can be given. It therefore may 
as reasonably be concluded, that those 
medicines should be taken punctually 
according to his directions, and not 



Jidministering Uledicines, 153 

altered without his knowledge, for 
every trifling symptom that may arise 
in the course of the disease, or for 
such whims as may arise in the pa- 
tient's fancy. If there is any material 
change expected to happen before 
his next visit, he will commonly give 
notice thereof, and directions how to 
act accordingly ; but whether he does 
or not, he ought always to be consult- 
ed before his plan is altered; for 
cases may happen, wherein if but one 
medicine is neglected, it can never 
be administered again properly, and 
consequently the patient may either 
be lost, or greatly injured. 

There are circumstances with res- 
pect to some persons, and symptoms 
attending some diseases, which cannot 
be omhted here, seeing, tlmt the for- 



154 



Mministei'iug Medicines. 



mer subject those persons, especially 
when sick, to great difficulty in con- 
forming to the requisites of cure ; and 
that the latter give them mistaken 
notions ; as for instance, some people 
are unfortunately prompted, or per- 
mitted in their youth to indulge cer- 
tain fears and apprehensions, especi- 
ally the fair sex, who, being thus en- 
slaved to such, are thereby subjected 
to hystericks, and miscarriages, ^'c. 
Others being bred up with strong pre- 
judices, and an excessive like or dislike 
of certain tilings, cannot be persuaded 
to comply with what is thought the 
properest method of cure, namely, a 
particular regimen, bleeding, vomiting, 
blistering, 6)*c. and thus their lives are 
often endangered, if not lost. Or if 
they survive, the cure is not only pro- 
crastinated, but the future part of their 



Administering Jfediciiies. 

lives often rendered very miserable, 
by some consequent disease remain- 
ing fixed in the constitution. 

The symptoms which give ])irth 
to mistaken notions, are such as fol- 
low : 

First, retchings and vomitings, which 
are variously produced, as for instance, 
from pregnancy; from the miasma of 
sundry fevers; from diseases in the 
substance of tlic stomach itself, or 
some otlier of the viscera, with which 
that organ simpathises by means of 
nerves; from morbid humours accu- 
mulating within it, and vellicating its 
inner coat so nuicli as to bring on 
spasms ; or from errors in eating and 
drinking, ^^c. 



igg Administering Medicines. 

These complaints, arising from the 
above causes, are very common, and 
sometimes continue awhile after the 
stomach has been properly washed; 
so that the medicines prescribed, 
though ever so good, or so well 
adapted, are nauseated, and some- 
times rejected. This to the Physician 
is no ways strange, for having investi- 
gated the disease, he discovers the 
cause; but not being so well known 
to the patient, and to the attendants, 
a prejudice arises directly against the 
medicines, which being taken for the 
cause, the remainder of what was or- 
dered is condemned and set aside. 
"What is the consequence ? Why it 
commonly happens, that on the next 
visit the Physician finds the disease 
to be less alleviated than he expected. 



»3dministcrivg Medicines. 

nay, perhaps worse, than if no medi- 
cines had been taken at all; and to 
his farther mortification, lie often per- 
ceives either the patient, the attend- 
ants, or both, disgusted so much with 
him, that he experiences more diffi- 
culty in curing their distempered 
minds, than in removing the disease 
for which he Avas employed. 

Secondly, When acidities, or other 
bad humours affecting the first pas- 
sages, are to be gradually corrected 
or altered, it is not unusual for a com- 
motion, and then a tiatulency to arise, 
and occasion an uneasiness in the sto- 
mach, ^5C. immediately after each dose 
of the medicine is taken. Now, al- 
though these proceed neither from an 
error in the prescriber, nor in the 
medicine, but are effects medically 
o 



158 



^Administering Medicines. 



produced till the humours are correct- 
ed and expelled, they both nevertlie- 
less sufler commonly the same cen- 
sures as hath been observed in cases 
of retching and vomiting. 

Thirdly, Through the course of 
many diseases, particularly fevers, it 
commonly happens, that the patient 
hath Uttle or no inclination to eat, till 
nature has gained the victory. But 
this not being rightly understood by 
either him or his attendants, an out- 
cry is made, that lie w^ill never have 
an appetite whilst he takes medicines. 
Hence the remonstrances of the Phy- 
sician are over-ruled, and the reme- 
dies are discontinued; yet the appe- 
tite doth not recover, nor does the 
case grow better, but rather worse. 
The reason is obvious, if they would 



Jdmnistering Medicines. ^gg 



but only obsei-ve, that as the disease- 
is cured, the appetite in consequence 
will revive. 

Fourthly, as the cure of diseases 
which are very stubborn, hence te- 
dious, requires usually a long course 
of medicines, even of those whose 
operations can be known but obscure- 
ly, if at all, by the patient, he is there- 
fore out of humour, and becomes ei- 
ther irregular in the use of the reme- 
dies, or leaves them entirely oft". Be- 
sides, the disease being still uncured, 
he quarrels with his Physician, (though 
perhaps he has been conducted by 
him through the most difficult stages 
of his illness), and not uncommonly 
sends for another, who, if not so 
honest as to undeceive him, enjoys 



160 Jldministering Medicines, 

the honour which was due to the for- 
mer. 

It is too common a case for some 
persons to be very soon prejudiced 
with the conduct of others, and even 
for trifles, to mistrust their abilities 
wholly; sometimes not scruphng to 
go so far as to reproach them unfair- 
ly, though their character (which is 
a jewel of much value to a medical 
man) may be injured by it. But set- 
ting this aside, it is here wished that 
they would befriend themselves, by 
attending to the truths above hinted ; 
and steadily persevere in the use of 
such means as are offered, for the 
sake only of their own lives and future 
healths. 

By these observations, I do not 



Mministering Medicines. i6l 

mean to skreen any unskilful or im- 
proper use that may be made of me- 
dicine, or to raise it into higher esteem 
than what it deserves; on the contra- 
ry, it is my real opinion, that he who 
knows his business best, will make it 
his constant care to heal with fewest 
medicines; and will always be most 
ready to resign his patient to diet 
alone, so soon as he knows it can be 
done with safety. 

The use of clysters is often of great 
moment, and as their administration 
is commonly now resigned to the 
nurse, it behoves her therefore to be 
very expert in this part of her office ; 
for if she is not, the patient is not on- 
ly disgusted, but is often injured. For 
these reasons she ought always to 
have in readiness an armed pipe, tl;ie 
o 2 



IQ^ Jldministcring Medicines. 

point of whicli should be matle 
smooth, and as free as possible from 
any edge or roughness, that may cause 
pain or uneasiness. 

As to the operation, if she is not 
perfectly skilled in it, she may do it 
in the following manner : 

The bed being prepared with a 
sufficiency of cloaths to keep it dry, 
the patient must be placed on the left 
side across it, with the knees forwards, 
and then covered decently; the clys- 
ter being likewise prepared, and 
brought to that moderate degree of 
heat, called milk warm, must be pour- 
ed into the bladder, and secured, by 
tying the opening; which being done, 
and the pipe anointed, the whole must 
be placed in tlie bed, near to the pa- 
tient. The nurse now must pass the 



Jldminislering Medicines. 

])oiiit of her left fore finger (the nail 
being cut sliort) close to the anus, or 
a little ^vithin it, and then slide the 
})il)c along this finger, till the greatest 
part of it is eiitirely introduced. In 
doing this the pipe must be directed a 
little backwards, taking care not to 
push it against any part so much as to 
cause pain. When thus introduced, 
its outer end must be held fast with 
one hand, whilst >vith the other she 
takes hold of the string, and pulls out 
the cork ; when this is done, the blad- 
der must l)e grasped with both hands, 
and tlie contents forced up, keeping 
the pipe in its place at the same time. 
When the clyster has been pressed 
out of the bladder, the pipe must be 
witlidrawn, and that directly, especi- 
ally if there ensues a forcing; the pa- 
tient mu^t get upon the chair, and as- 
sist himself, as occasion requires. 



164 ddmmistering Medicines. 

Some use a syringe for this purpose, 
with a flexible leather tube fixed be- 
tween the cylinder and pij)e; by whicli 
means it is rendered so convenient, 
that the patient may use it himself. 

There is also another syringe inven- 
ted, with two such tubes, each of which 
is supplied with a value in opposite 
directions, so that when one pipe is 
placed in the fluid, and the other in 
the anus, a large quantity may be 
thrown up; nay, I have known above 
a gallon thus injected, in order to 
reach the part of the intestinal tube 
which was obstructed. This syringe 
is very useful, but as it should be em- 
ployed only by a skilful surgeon, a 
farther account of it here would be 
needless. 

And, moreover, there is an instru- 



Mministcring Medicines^ -£05 

mcnt with a flexible tube, ^c. for con- 
veying the fumes of tobacco into the 
intestines; which operation belongs 
properly to surgery also. 



'flic following prescriptions for Cltsters, it is presumed may 
be found useful, as the ingredients are generally at hand, or 
are easily to be procured ; and it sometimes happens, that the 
attendants upon the sick are quite ignorant of their composi- 
tion. It is to be understood that these are intended for Adults. 

Am. Ed, 



CLYSTERS. 
1. 

Take of 

Molasses, half a gill ; 

Olive oil or castor oil, one or two ta- 
ble spoonsful; 

Salt, a table spoonful; 

Water, half a pint ; mix. 



j^gg Administering Medicines. 



2. 

Gruel, half a pint to a pint ; 
Salt, one or two table spoonsful : 
Oil, the same; mix. 

3. 

Water, one pint; 

Oil, two table spoonsful ; 

Salt, a table spoonful ; mix. 

4. 

Camomile tea, half a pint to a pint; 
Oil, one or two table spoonsful ; 
Glauber salts, from one to two table 
spoonsful. 

5. 

Infusion of senna leaves, half a pint to 
a pint ; 

Oil and salt, of each a table spoonful. 
6. 

Milk, half a pint to a pint; 
Oil and molasses, each a table spoon- 
ful. 



Administering Medicines. 



16,7 



7. 

Warm water alone ; a pint will make 
a tolerable clyster, or mixed with 
two table spoonslUl of salt. 



Th(^ follow in_ij Accoiuit of the treatment for Scalds and BuRJfs, 
accidents which so fi-cqueiilly happen in families, must prove 
ati acceptable appcnibige to this little useful Family Book. 
Experience proves it forsupei-ior to scraped potatoes, lime wa- 
ter, and many other common applications. It is extracted 
fi-om the Philadklpiii A .Medical Museum, under the direc- 
tion of .loiiN Rkdman Coxe, M. D. to whom the Public, and 
particularly Parents, arc much indebted for the publication, 
lie recommends, for the sake of sufl'erers in sucli cases, that 
the liniment be kept constantly prepared, and at hand. For 
a pai'ticuhir detail respecting its effect, the Editor begs leave 
to refer to the Museum. — Am. Ed. 

Scalds and Burns. 

Apply, immediately, linen wet with 
spirits of turpentine, and repeat, as it 
dries. 



If the burn is bad, after applying 



1 68 Jldministering Medicines. 

the above, prepare a liniment as fol- 
lows. 

Take common rosin as miicli as 
you please. Melt it with al)out a 
fourth of its size of hog's lard or mut- 
ton suet, or fresh butter, and tlicn add 
as much spirits of turpentine as will 
make it, when cold, of the consistence 
of thick honey. Apply this pretty 
freely on rags, to the parts burned, 
even if the skin is oK If blisters have 
risen, snip them and let the water out 
first. 

If spirits of turpentine are not at 
hand, use spirits of wine, brandy, whis- 
key, ^^c. If applied w^arm, it willbe 
preferable. 



169 



APPENDIX. 



Additional Instructions for the Kurses 
of a Fever Hospital. 

[The following Instructions for Nurses arc taken from a Me- 
•lical Rci)ort of the Hardwickc Fever Hospital, by J. Ciietne, 
M.O. F.R.S. &c. published in the first volume of the " Dub- 
lin Hospital Ueporls."] 

1 . The nurses are not only to con- 
form, in every respect, with the regu- 
lations established for the government 
of the house, but are also to instruct 
the visitors and patients in such things 
as relate to tlieir conduct. 

p 



170 



APPENDIX. 



2. When a patient arrives in any 
of the wards, the deputy, or assistant 
nurse must wash his face and neck, 
hands and arms, and feet and legs, 
with soap and milk-warm water. The 
nurse shall then give him an hospital 
shirt and night-cap, put him to bed, and 
have his clothes, without delay, sent 
to the woman whose business it is to 
see them pifrified. She shall then 
carry the label, which belongs to his 
bed, to the porter, that the name of 
the patient, the number of days he 
has been sick, and the date of his ad- 
mission, may be written upon it with 
chalk. 

3. When a patient is admitted after 
the visit, the nurse shall give him, as 
soon as he is settled in bed, one or 
two of the common purgative pills, 



APPENIiiX. 



171 



according to his age; and in three or 
four hours after, if he has not had a 
stool, she shall give him one or two 
table-spoonsful of the common pur- 
gative mixture. The mixture must 
be repeated every three hours, until 
his bowels are moved. 

4. At the first visit the nurse shall 
report to the physician the number 
and nature of the stools, the condition 
of the urine, the appearance of the 
skin, with respect to spots, pimples, 
or purple blotches, sores, bruises, or 
inflammations, the existence of ver- 
min or itch, and every other thing 
wliich may throw light on the nature 
of his disease. 



N. B. Patients from the Lunatic 



i72 



APPENDIX. 



wards, and cliildreii, must be stript 
naked and examined. 

5. At every succeeding visit, the 
nurse will also report the nature of 
the patient's stools and urine, more 
especially with respect to any defi- 
ciency in either. If the stools or 
urine contain blood, matter, or slime, 
they must be preserved in the water 
closet, that the physician may inspect 
them. 

6. The nurse shall daily examine, 
with her hand, the bellies of all fe- 
males and chOdren, and report any 
unusual fulness or tenderness about 
the stomach or bladder. She shall 
also daily examine the backs of all 
patients who are in a stupid state, wlio 



APPENDIX. 178 

Iiave been long ill, or who have pur- 
ple blotches on any other part of the 
body, that she may report the first 
appearance of fretting of the skin, or 
discolouration about the back or hips. 
In such patients, she shall pay particu- 
lar attention to the appearance and 
warmth of the feet. She shall report 
any shivering fit or perspiration, which 
may have taken place between the 
physician's visits. 

7. It is the duty of the nurse to 
pay great attention to the state of the 
patient's mouth. She shall frequently 
supply him with drink, when he is not 
able to assist himself, and take care, 
when he is, that the vessel from which 
lie drinks is placed commodiously 
within his reach, and is never empty; 
and when his tongue and gums arc 



174 



APPENDIX. 



covered with a brown or dark crust, 
she must have them wiped with a bit 
of fine flannel, moistened, with salt 
and water, two or three times a day ; 
or if this cannot be accomphshed, slie 
must put a thin slice of lemon, without 
the rind, in his mouth. The patient 
is often unable to swallow, from the 
dry and shrivelled state of his tongue ; 
before offering him drink, the nurse 
shall put a tea-spoonful of lemon-juice 
and water into his mouth, after which 
she must wait a minute or two, until 
the scum upon his tongue is softened, 
and then he will often drink with 
ease. 

8. When, during great derange- 
ment of mind, a patient insists upon 
leaving his bed, the nurse must en- 
deavour to calm hiiji ; or if that should 



APPENDIX. 



175 



fail, she may speak with authority, but 
slie is not, on any account, to use for- 
cible restraint. She must wrap his 
legs in a blanket, put on his bed-gown, 
and permit him to sit on his bed, or 
even to go to the fire, till the violence 
of his derangement shall abate. Wlien 
indulged in this manner, he will, in 
general, soon retui'n to his bed of his 
own accord. Patients, in fever, have 
perished in consequence of a struggle 
with their attendants, who, from a mis- 
taken sense of duty, have endeavour- 
ed forcibly to detain them in bed, 
when they persisted in their efforts to 
leave it; whereas, had they been hu- 
moured, no injury would have arisen, 
provided they had been suflRciently 
covered.* 



• Shortly after I took charge of the hospital, in saveral in- 
stsncfs, the nianiucal paroxysms of fever, with determination to 



176 



APPENDIX. 



9. In the event of any sudden at- 
tack of pain, vomiting, purging, hic- 

the brain, was aggravated by coertion, and hence I was led to 
give the above directions. The following excellent passage will 
be found in Grant's chapter on the Synochus Putris. "As sooa 
as the delirium comes on, the pain subsides, or at least the 
patient does not complain of pain, or seem to feel any ; but re- 
plies in a hurried manner, when asked how he does, that he is 
very well ; according to the observation of a French physician, 
'•Quand le malade repond, je me porte bien, ce seul mot sufFit, 
ill n'est pas phis it lui." " When the patient answers that he " is 
very well," this alone convinces me that he is no longer him- 
self." In all these cases, the patient endeavours to get out of 
bed, to sit up, or even to walk about from one room to another ; 
but unhappily the attendants are solicitous to confine him to bed, 
and to load him with bed-clotlies : nay, he is frequently kept 
struggling for two or three days together, with two strong people 
Ijing upon him continually. Now, to prevent all this misery, I 
know no method equal to what is here recommended ; namely, 
let the patient have his clothes put on, and be placed in an easy 
chair ; let his head be shaven, washed with vinegar, and covered 
with a linen cap. When lie is tired of tiie erect posture, let 
him lie along on a couch, or upon the bed, with his head high. 
Let his diet be cooling, and his body kept open by clysters, re- 
peated occasionally. Let this method be persisted in till his de- 
lirium goes off ; or till the pulse subsides, and he seems exhaust- 
ed ; then, perhaps he will begin to doze, or slumber on his chair, 
which will do him no harm. W^hen the tongue is moist, the 
body open, the pulse soft, and the patient seems sinking, then, 
and not till then, let the head be covered with a blister, give him 
amphor julep with spiritus mindcreri and diajjhoretic antimo- 
ny. After these operations, if he is inclined to go into bed, let 



APPENDIX. 



177 



cup, stoppage of urine, frenzy, faint- 
ing, or convulsions, taking place in the 
absence of the physician, the nurse 
must immediately procure the assist- 
ance of the apothecary. 

10. When the nurse perceives any 
sudden increase of illness, she must, 
without loss of time, send for the apo- 
thecary, and also for the clergyman 
of the persuasion to which the patient 
may belong. 

11. The patient's face and hands 
are to be washed with milk-warm 
water, every morning, by tlie deputy- 

iMin lie down; nntl if he should remain quiet, or fall asleep, or 
even if a sweat should come on, let him remain in bed. But if, 
iiotwithstnndiiig, the violent delirium should return, let him bo 
taken up and triated as formerly. By this method, I have re- 
covered a great number of people when 1 was suffered to con- 
duel them ; and I <lo believe some have perished by an opposKc 
irtntmcnt , that m'v^hi have been saved. 



178 



APPENDIX. 



nurse. And when he is no longer 
able to assist himself, his head, when 
shaved, his face, breast, hands, and 
arms, must be frequently sponged with 
vinegar and water. 

12. The sheets and the shirts or 
the shifts must be changed at the stat- 
ed periods appointed by the matron. 
When a bed is unsettled, or a patient's 
head uncomfortably low, or when his 
feet are pushed from under the bed- 
clothes, he must be raised in bed, and 
the bed, bolster and clothes shook up 
and smoothed. Before the patients 
are settled for the night, the beds are 
all to be smoothed, or made by the 
deputy-nurse, and clean utensils pla- 
ced by the bed. At all times, wet or 
dirty sheets or bedding are to be re- 
moved without loss of time. No foul 



APPENDIX. 



170 



or dii ty linens arc to be left in the 
wards or closets. 

43. Before the convalescents go 
to bed for the night, the sheets, blan- 
kets, and quilts, are to be thrown back 
for a couple of hours, that the sheets 
may be exposed freely to the air. 

14. When the patients are unable 
to reacli the water-closet, the close- 
stool is instantly to be emptied, and 
the floor between the beds sprinkled 
with vinegar. 

15. The prescription book must 
be conveyed by the nurse to the apo- 
thecary, immediately after the phy- 
sician's visit. She must not receive 
any medicine from the shop, which 
is not properly labelled and directed. 



130 



APPENDIX. 



16. When a patient has an allow- 
ance of wine, porter, or punch, one 
of the printed labels, setting forth the 
quantity, must be hung upon the wall 
over his bed. 

17. When a death takes place, be- 
fore nine o'clock at night, or after six 
in the morning, the nurse shall imme- 
diately go to the apothecary, and ob- 
tain an order for a coffin. 

18. The corpse, with a skreeu 
drawn round the bed, is to lie un- 
touched for two hours after death; it 
must then be removed, without fur- 
ther delay, to the dead house. 



THE END. 



MtoL. Wtst, 
J Us