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