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be used in all the douches.

Rectal douche.—This is to relieve piles and reduce inflammation. Hot or cold as needed. A rectal tube or fountain syringe is used.

Ear (aural) douche.—This is used for earache and inflammation. Salt or boric acid is generally used in the warm water. It should be allowed to flow in slowly and gently.

How to use a bed pan.—When you are placing the pan, you should slip one hand under the buttocks and then place the flat end of the pan under the buttocks. It should always be warm. Raise the patient in the same way before attempting to remove it. Do not pull it out.

[642 MOTHERS' REMEDIES]

TEMPERATURE (Fever).—A thermometer is necessary in taking the temperature. They can be bought for from fifty cents up. The temperature is taken by putting the thermometer under the tongue, in the arm-pit and in the rectum. For children it should be placed in the rectum or in the arm-pit or groin. Allow it to remain from two to five minutes. This depends upon the time limit of the thermometer. The normal temperature is 98-6/10 degrees F. This varies, some people are normal at times at 99 or 98 degrees. The temperature in the arm-pit is lower by 3/10 of a degree, but that in the rectum is 1/2 degree higher than that taken in the mouth. The normal point on the thermometer is marked by an arrow. The mercury in the tube must always be down to that at its highest point, before the thermometer is placed and the highest point the mercury goes indicates the height of the temperature (fever). If you take it in the rectum, that should be free from feces. Oil the thermometer and gently insert it into the bowel for one and one-half inches and hold the stem.

Under the Tongue.—Place the point under the tongue and instruct the patient to close his lips over the thermometer. He can also hold the stem with his fingers, It should never be taken here right after a cold drink. Unconscious patients may bite through the instrument, so care must be taken with them.

Arm-pit.—Wipe the part thoroughly dry and place the point directly in the arm-pit. Then place the elbow against the body and the hand on the chest pointing to the opposite shoulder. When ready to take it out move the arm away from the body and take the thermometer away gently for it sticks sometimes and you will cause pain if you draw it away quickly. The instrument should be cleansed in tepid mild salt solution.

PULSE.—Average in men, sixty to seventy. In women, sixty-five to eighty. Children ninety to one hundred to one hundred and twenty. Different authors vary. In men it is generally seventy to seventy-two. In women seventy-two to seventy-five.

It is better taken sitting. It is faster when walking, slower when lying down. I always take the pulse in the left arm unless there is a deformity there. I use my right hand with the third finger toward the elbow. By using the first three fingers you can find out different things about the pulse. Some people are very nervous and such an one will make your arm ache when feeling the pulse. The pulse should be regular, even beats, in health. Sometimes you can feel it best on the temple or on the neck.

RESPIRATION (Breathing).—In an adult the average is eighteen per minute. In a child the average is twenty to twenty-four. Respiration is the act of taking in (inspiration), and giving out (expiration) air by the lungs.

THE TONGUE.—This is coated in dyspepsia and fevers,—some healthy persons always have a coated tongue.

[NURSING DEPARTMENT 643]

In Ulcers of the stomach there is no coating.

In high fevers, the tongue may also be red and cracked as well as coated in some parts.

A dark brown or blackish coating indicates a serious condition in acute diseases.

Strawberry tongue is seen in Scarlet Fever.

Cankered tongue and month may be due to local conditions, or to stomach, liver and bowel disorders.

In Peritonitis the tongue is generally dry and red (beefy).

Cholera Infantum.—At first coated, then dry and reddish.

Constipation.—Tongue is generally coated.

Biliousness.—Yellowish dirty coating.

DIET FOODS AND DRINKS FOR THE SICK ROOM.

DIET.—The importance of diet and its relation to the needs of the system in disease can hardly be overrated. One should not only know what kind of food to give, but how much and how often it should be given to get the best result. Food should be given in small quantities in acute diseases and at regular intervals. It will digest better. The food should never be left in the sick room after a patient has finished with it. This applies to all kinds of food, but especially to milk, for it absorbs impurities from the air more readily than any other kind of food. How often do we see milk standing in a sick room and uncovered; how often is it placed in an ice box uncovered. I have often wondered how such people could eat some foods I have seen prepared for them in such a careless way and with no attempt to make it appear tempting to their poor appetite. Foods should be given just as regularly as medicines, when so ordered, especially in long wasting diseases like typhoid fever.

The kind of food.—Under each disease directions for the kind of food, time, and quantity have been given. In diseases like typhoid fever, special care must be given. It is better in that disease to give too little than too much food and the proper kind of food must be given. I shall never forget the death of a minister in my childhood days. I was about four years old. This minister was loved by everyone and when he died of typhoid fever, everyone was grieved and shocked and they could not understand why God should take such a useful man away. It made a great impression upon me. I found out more about the "why" afterwards. This minister was in the convalescent stage and very hungry. He wanted a genuine boiled dinner. That is bad enough for a well man. The doctor forbade it, but the family gave him the dinner and the result, of course, was fatal. It could not be otherwise. We often blame God for our own sins. Many people are killed by kind friends. I have seen it more than once. Peanuts, popcorn, and candy have caused many convulsions in children and some deaths.

It is generally allowable to give a little liquid food every two hours in acute diseases. It should be given at regular intervals in the conscious or unconscious patients, especially in long continued diseases.

[644 MOTHERS' REMEDIES ] LIQUID DIET.

1. Cream soups; tomato, pea, corn, celery, rice, spinach, asparagus, potato.

2. Gruels; oatmeal, cornmeal, cream of wheat, flour gluten (for diabetes).

How to Albuminize Fruit Juices.—Into a cup of lemonade, orangeade, grape juice, etc., put white of an egg slightly beaten, mix thoroughly, strain and serve.

The following may or may not be albuminized.

3. Fruit juices; lemonade, orangeade, unfermented grape juice, currant, berry juice.

4. Milk; peptonized milk, albuminized, buttermilk, malted milk, and milk porridge.

5. Stimulating drinks; tea, coffee, cocoa.

6. Broths; beef broth, mutton broth, chicken broth, bouillon, consomme, oyster broth, clam broth, oyster soup, clam soup, beef tea, and beef juice.

7. Eggs; raw eggs and egg-nog.

8. Cooling and nourishing drinks; oatmeal water, rice water, barley water and toast water. Ices and ice cream may be included in the liquid diet list.

SOFT DIET.—This diet includes everything in the liquid diet list, and the following additional foods:

1. Bread: soft bread; dry toast; milk, water or cream toast, brown bread (after the first day on soft diet).

2. Eggs: poached, soft-boiled and shirred.

3. Cereals: all cooked for some hours; cornmeal, oatmeal rice, sago, wheaten grits and cream of wheat.

4. Desserts: junket, custards, milk puddings, rice, thoroughly cooked, tapioca, jellies, baked and stewed apples, prunes whipped and stewed, ices and ice cream.

[NURSING DEPARTMENT 645]

CONVALESCENT DIET.—This includes everything in the liquid and soft diet lists and the following in addition:—

1. Breads: wheat, rye, Boston brown and graham bread and biscuits.

2. Meats: broiled steak, mutton, fish, game and fowl, or stewed fowl. Also calf's head, calf 's brains, shell fish and oysters.

3. Eggs, as in soft diet.

4. Drinks as in soft diet.

5. Vegetables: tomatoes, green peas, string beans, potatoes (Irish and sweet), lettuce, cresses, asparagus, onions, celery, spinach and mushrooms.

6. Desserts: custards, creams, jellies, ripe fruits and stewed fruits. No pastry or rich puddings.

FOODS FOR DIFFERENT MEALS FOR THOSE WHO CAN EAT, BUT WHO DO NOT HAVE MUCH APPETITE.

Breakfast; drinks: tea, coffee, cocoa, milk or albuminized fruit juices; cereal with cream; eggs; omelet, scrambled or poached on a piece of round toast, or soft boiled in a hot cup; muffins or gems.

Dinner; broiled porterhouse or tenderloin steak; baked potatoes; bread or rolls; pretty salad, as apple salad in apple case; custard baked in souffle dish; tea, cocoa or milk.

Supper; broiled squab, raw oysters or meat balls, asparagus tips on toast, fresh or stewed fruit, bread cut in fancy shapes.

Foods that may be taken together.—Meat; eggs: soft boiled, poached, shirred or baked; potatoes, baked, boiled or mashed; fruit sauce and ices may go with the following: stewed tomatoes, salad, spinach, or cucumbers, acid drinks, etc., any foods prepared with vinegar.

Meats, vegetables cooked in milk, or served with cream sauce, cream soups and eggs prepared with milk may be given with fruits, vegetables, drinks, etc., containing no acids.

Foods that should not be taken together.—Any food prepared with milk should not be given with lemonade, tomatoes, salads containing much vinegar or any foods served with vinegar or lemon juice.

Diets in Fevers.—Furnished us by a Trained Nurse in a Hospital.

May Take—

Foods.—Soups, clear or thickened with some well-cooked farinaceous substance, mutton, clam or chicken broth, beef tea, peptonized milk, panopepton with crushed ice.

Drinks.—Pure cold water, toast water, lemon or orange juice in cold water, jelly water, cold whey; all in small quantities sipped slowly.

Must Not Take—

Any solid or vegetable food or fruit until so directed by the physician in charge,

[646 MOTHERS' REMEDIES]

Diet in Debility sent us from one of our Leading Hospitals.

May Take—

Soups.—Any broth thickened with farinaceous material, chicken or beef soup containing chopped meat, rich vegetable soups, whole beef tea.

Fish.—All fresh fish, boiled or broiled, raw oysters.

Meats.—Beef, mutton, chicken, game, boiled ham, lamb chops or cutlet, broiled bacon, tender juicy steak, hamburger steak.

Eggs.—Soft boiled, poached, scrambled, raw with sherry wine.

Farinaceous.—Cracked wheat, rolled oats, mush, sago, tapioca, hominy, barley, macaroni, vermicelli, rolls, biscuits, cakes, whole wheat bread, corn bread, milk toast, dry toast, brown bread.

Vegetables.—Nearly all perfectly fresh and well cooked.

Desserts.—Custards, egg and milk, rice or apple pudding, baked apples, fruit jams, jellies, cocoa junket, marmalade, sweet fruits, calf 's foot jelly.

Drinks.—Cocoa, chocolate, milk hot, cold or peptonized, pure water, plain or aerated, wineglassful of panopepton.

Must Not Take-

Hashes, stews, cooked oysters or clams, pork, veal, thin soups, turkey, salt meats, except ham and bacon, cabbage, cucumbers, turnips, carrots, squash, spices, pickles, vinegar, pies, pastry, bananas, pineapples.

DISHES FOR THE SICK ROOM.

Oatmeal Gruel.—Boil one part oatmeal and two parts water in double boiler two hours; strain through gravy strainer, add one quart sweet cream, a little sugar, pinch of salt. Do not make it too sweet.

Raspberry Shrub.—Place red raspberries in a stone jar and cover them with good cider vinegar, let stand over night, next morning strain and to one pint of juice add one pint of sugar, boil ten minutes, bottle hot. When desiring to use place two tablespoonfuls full of the liquid in a glass of ice water; very nice.

Root Beer.—Take blackberry root, black cherry bark, spruce boughs, wintergreens, sarsaparilla roots; steep in a large vessel till all the goodness is out; strain, and when lukewarm put in a cup of yeast, let work, bottle up, sugar to sweeten.

Cream Toast.—Toast a piece of light bread and moisten it with hot water; butter and then put on a layer of sweet cream on top and place in oven a moment. This is easily digested.

Lemon Jelly.—On one box gelatine pour 1 pint cold water and let stand one or two hours. Then put on 4 cups of granulated sugar, squeeze juice of 4 lemons with the grated rind of

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