If there is a choice of rooms, the patient's welfare demands that he should be placed in the one affording to a greater degree light, pure air, warmth, etc.  The patient should not be put into the room which is dark and gloomy, but let it be one that is light and cheerful, and with a fire-place in it, if possible.

    If the illness be fever, an ophthalmic affection, brain disease, or other disease requiring quiet, a back room away from the family should be selected, as quiet is absolutely necessary, and the patient will not care to look at anything or to speak much.  If, however, he be suffering from an accident, he will be more contented and cheerful if he is placed near to the rest of the family, where he can assist in the conversation, watch your movements, and see you at your labors.  It will greatly tend to make him forget to a greater extent his misfortune, and it will also save time in waiting upon him.

    The room should be free from all unpleasant odors, and should not be exposed to disagreeable effluvia from water-closets, sinks, etc.  The furniture of the room should be but very simple and plain, and, in infectious diseases, but very little should be placed in the room.  If you have ever been in a hospital, you may have noticed the bare floors, the iron bedsteads, the absence of woollen bed-clothing, and the plain tables, and most probably pitied the inmates for their lack of comforts, and involuntarily the thought may have arisen in your mind that fortune is more propitious to you when sick, for your sick-room would have at least a good carpet, upholstered furniture, and your bed an easy one to repose upon, and plentifully supplied with woollen blankets, etc.  But you and many more are also deluded in this respect.  If you will bear in mind that woollen fabrics retain smells much longer than cotton and linen, and are therefore less sanitary, you would probably not consider them so advantageous.  The room should have no upholstered chairs or sofas, cane-bottomed or plain wood are preferable, and it would be better if no carpet was on the floor, except perhaps a narrow strip for you to walk upon to prevent noise, but a clean boarded floor, kept clean and sweet by scrubbing and "elbow-grease" is infinitely better.  It is better to have no curtains; but if the room looks too cheerless without them, use light muslin or something which will easily wash.

    The position of the bed is also very important.  In case of accident the bed should be placed where the patient feels most comfortable, only it should be placed where there is a good light to see and dress the wound; but in fever and small-pox the bed should occupy the position between the door and fire place.  The reason for this is that as fire cannot burn without air, there must be a draft to feed it; as this becomes heated and escapes up the chimney, it is replaced by a fresh supply drawn in through the door and window.  This prevents a spread of the disease, as the chimney acts as a ventilating shaft, carrying away the impurities of the room.  A stove will also do this, but to a much less extent.  It is very apparent, therefore, that if a person stands between the bed and the fire-place, he must breathe air laden with the effluvia from the patient, whereas, on the other side, that is, between the bed and door, he inhales air that has not yet come in contact with the patient.  If, from the form of the room, the bed cannot be placed in this position, the space between the window and the bed should always be sufficient to stand in.

    The room should always be fully prepared before the patient is placed in it, as the setting it to rights is not only annoying, but may do positive harm to the patient.  The fire, if any is wanted, should particularly be previously built, for very often the chimney refuses to draw well, and the poor patient is choked with the smoke.  He may suffer from a chest complaint, and his difficulty of breathing be so aggravated as to put him in a miserable plight.  The windows should not be so fastened that you cannot open them, especially from the top.  An equable temperature should be kept up, neither too hot nor too cold, and extremes avoided.

    The bed itself is very worthy of consideration.  Unqualifiedly, the best is a hair mattress, but, as this is so expensive, it cannot be expected to be found in every house, but, unless obliged, use no feather bed.  It is too soft, and the patient sinks into holes, so that, in case of wounds or burns, you cannot get at them properly, and besides, if the feathers get wet, you cananot easily put them right again.  Good clean straw or chaff, evenly packed, is far superior.  It costs but little, to begin with, is more comfortable, far superior in a sanitary point of view, and has this advantage: that in case of being spoiled, it can be emptied, the cover washed, and refilled without loss of time, and at a very trifling expense.

    The bed should not be too wide, for if the patient needs help, the attendant is obliged to move him kneeling on the bed, or at arms' length, should be be lying in the middle.

    It is often a matter of much concern how to change the bed-clothing in case of fracture or low states of disease, where the patient cannot be moved from the bed.  The following method should be pursued: --roll up the clothes to be changed tightly to the middle, lengthwise, not across the bed; put on the clean things with half the width rolled up close to the other roll, lift the patient on the newly made part, slip off the soiled clothes, unroll the clean ones, and the bed is made.

    Before the patient is put to bed scour the floor right well, and wash it with hot water with a few pennies' worth of chloride of lime, or, if you cannot get this, use a little quicklime, and rub it well into cracks and corners.  The whole of the lime need not be removed, as the little particles left sticking in the cracks and pores of the wood will prevent insects, give a clean, sweet smell to the place, and tend to keep away infection.  After the room is thoroughly dried, it is ready for the sick occupant.

    If all this is done, you will have the healthiest sick-chamber possible, and rob the disease of its exciting causes.  He must then be well nursed, and as this is so important, the author will next consider
 

NURSES AND NURSING

    Next to the physician, the nurse has responsibilities that must be faithfully discharged, as the life of the patient is not alone dependent upon the skill of the physician, but in a great measure also upon careful nursing.   Every physician will tell you that he recollects cases in his practice where all his skill would have been unavailing had it not been for the excellent nursing that the patient received.

    It is a common opinion that women only can nurse.  This is erroneous, as men are frequently met with, especially husbands and brothers, who are quite as gentle in their touch, quite as considerate about little wants, and far more tender and thoughtful than almost any woman.  A male nurse has, moreover, one great advantage--his strength.  Ask that wife who requires lifting from the bed, and she will tell how safe she feels in her husband's strong arms, and what a comfort it is to be lifted by him.  It is a dreadful feeling for a patient not to have full confidence in the power of the person assisting, and the nervous shock induced by the fear of being let fall, may take days to recover from.  It is therefore, not to be thought that nursing is peculiarly woman's work, but that men are just as capable.

    A nurse should have five qualifications--sobriety, cleanliness, firmness, gentleness, and patience.

    Sobriety. -- The drunken nurse should not be allowed to cross the door-sill of the sick-room.  It is no place for her,--she cannot be trusted.  Human life is too precious to be entrusted to the care of one who cannot resist the temptation to indulge in intoxicating drinks.

    Cleanliness. -- The nurse should not only keep the room clean, but always be clean herself.  A very little thing will spoil the appetite of a sick person, and nothing offensive, as dressings from wounds or burns should be allowed to remain in the room.  All necessary vessels should be emptied as soon as done with, well washed out, and left in the open air.  It should be remembered that bad air is just as poisonous to a person as bad food, and hence it should be frequently changed by opening the window.  The dreaded draft will do no harm, but bears upon its wings the elements conducive to the health of both patient and attendants.  The fever-poison is weakened by admixture with pure air just in the same proportion as spirits are weakened by the addition of water.  The food that the patient cnanot eat should not be left in the room--it will breed distaste for it if always in the sight of the patient.  The drinking-water should be frequently changed, as it absorbs all the gases in the room, so that if the patient is allowed to drink it, it actually puts back into his stomach what his body exhaled.  Always give him fresh water, then, when he wants to drink.

    Firmness. -- The lesson that firmness is not rudeness should be learned first.  It is not to be expected that a suffering person knows as well what is best for him as those whose brains are clear.  If, therefore, a certain thing is best to be done, do it, do it kindly, but do it, and the patient will thank you afterwards.

    Gentleness. -- It should never be forgotten that gentleness is an absolute requirement of a nurse.  If the poor patient suffers from rheumatism or a broken limb, and the bed-clothes must be changed, it should be done gently, and all needless suffering avoided.  If his position in bed requires change, do not torture him, but gently move him, and avoid all jerks and knocks with great care.

    Patience. -- Need a word be said to the effect that of all beings nurses should especially be patient?  It should never be forgotten that the difference is a great one between the nurse and the person under his or her care, and it should be remembered that in their own experiences they have been cross and irritable even when they were well, that they were easily put out, and so peevish and fretful from the slightest causes.  They should then consider how it must be with the person taken suddenly from active life and compelled to lie still in one position, or with one whose whole body is racked with pain.  The one, therefore, who loses patience, however sorely tried, and who cannot bear with these trials for a while, should stay away from the sick-room in the capacity of nurse.

    Nursing, in a great measure, is a natural gift either in man or woman, just as much as music, painting, and other things are.  It is not every one, therefore, who is fit for a nurse, not because they wilfully do wrong, but they are not adapted for it.  There are many good-hearted yet thoughtless people who would never make good, handy nurses with all the training in the world.

    The awkward nurse is a queer creature, and she is everlastingly getting into some trouble.  If she is going up stairs with her hands full, she is sure to step on the bottom of her dress, and either drops what she is carrying or falls herself.  If the fire wants coal, she throws on a whole scuttleful, a good part of which falls upon the fender, and the poor patient is so terrified that he cannot rest for hours.  If she has a hole in her dress, or a bit of braid is loose, it will be sure to catch a chair or the fire-irons, bringing them down with a rattle.  If of matronly age and wears caps, she will have strings so long that when she stoops over to catch the patient's whisper, the ends will tickle his nose or other parts of his face.  At least one of her fingers is sure to be enveloped in a rag tied on with black cotton.  If the patient wants a little bread and butter, the knife that has been used for cutting cheese or peeling onions is unerringly used.  If she is cooking cabbage or frying bacon in the next room, she always forgets to close the door leading to the patient's room, fills it with a strong smell which sickens him, and then says that it is too bad that the patient cannot eat a morsel of food.  If the patient thirsts, she will fill the glass full to the brim, put her hand under his head, bend his neck till his chin touches his breast then puts the glass to his lips, spills a good part of it on his clothes, and thinks he is very awkward to choke over a mouthful of water.  If a candle is to be lighted, she sticks it in between the bars of the grate, which soon fills the room with the rank smell of burning tallow, and when she finally succeeds in lighting it, she finds she has a wick several inches long, gained at the expense of the melted tallow; or if it be gas, she takes a short bit of paper, turns the gas full on, makes a sudden blaze like a flash of lightning, forgets the bit of paper in her hand while she is regulating the blaze, burns her fingers, throws the lighted paper on the floor, and puts her foot on it.  All this does not escape the patient's notice, and he gets so nervous and frightened that he loses his night's rest.  If the patient is so far convalescent as to be able to sit up in bed to take his food, she will, of course, put the tray on his knees, then assist him into the sitting posture, and ten chances to one the things are upset all over the counterpane.

    Then there is the fussy nurse, and there are many of this sort.  Her zeal to benefit the patient is so great, that she sadly overdoes it: she bustles in and out of the room every few minutes, wearies the patient by persistently asking him if he cannot eat something, which she would willingly walk miles to get if wanted, raising him up, tucking in the bed clothes, drawing up and lowering the blinds; one, in fact, who is perfectly miserable if she is not constantly on the move.  The fussy nurse is generally a kind-hearted, loving creature, and it is her very goodness which makes her weary the patient, who congratulates himself on the relief gained whenever she vacates the room.

    Then we have the careless, slovenly nurse.  Doctors are always suspicious of this person; they can never feel sure that their patients really had the right quantity of medicine; if she happened to remember it they would get it, but if not, she would make up for it by giving a double dose next time.  There is no clean glass or cup when wanted.  Food is taken to the patient, and if he cannot eat it, it is left there for hours.  There are so many crumbs of bread in the bed that it feels to the patient like lying on a gravel walk.  Cinders cover the hearth all over, and the fire is black.  The slops, which should have been removed in the evening, are hid under the bed, filling the room with bad smells.  Those bits of meat, crumbs of bread, and other matters which have fallen on the floor are left there; the consequence is that being winter, the mice and perhaps rats finding a warm room and something to eat, think it a comfortable place, and use it accordingly.  No one can imagine the degree of comfort these scampering animals afford to the helpless creature in bed.

    Next we have the cruel nurse, who does her duty, but not from love; she carries out the doctor's orders exactly.  In matter of duty she is inflexible; if the medicine has to be taken at a certain time, she brings it to the minute, and worries the patient into taking it on the instant.  Her law in all things is like that of the Medes and Persians, which altereth not.  She may be perfectly  honest in her dealings, but the utter absence of tenderness and compassion makes her an undesirable nurse.

    And lastly, we have what I trust is a very rare character, the dishonest nurse.  She drinks all the wine, and partakes pretty freely of the food intended for the patient, and tells the doctor that the patient ought to get better according to the quantity of nourishment he gets through.  She is also dishonest in another way: she finds it a great deal of trouble to make the patient take his medicine, so she just empties it away, a regular dose at a time, so that when the doctor calls he may see that the bottle is gradually emptying.

    All these characters are to be met with, and doctors find one or more of them in various sick-rooms every day.  Now, it is not well to be too exacting in such matters, but as a good nurse is, next to a good physician, necessary to properly combat disease, it is will to object to what are positive faults.

    A good nurse should be tender and compassionate, and ought to have all her five senses in a healthy, active condition.  Sight, that she may be able to read directions, or read aloud to the patient, and watch the change of countenance.  A quick-sighted nurse will not need to wait for the sufferer to make his demands; she will see in a moment what is wanted from the motion of the eye, or the lips, or a finger.  Hearing, that she may be able to catch the faintest whisper, and not oblige a weak patient to exert the voice or repeat his requests.  Feeling, that she may readily detect the temperature of the skin of the patient, and not use any application which will either scald with heat or chill with cold.  Smell, that all impurities in the atmosphere of the room may be readily detected.  Taste, that she may not offer food unfit to be used, or improperly cooked if good in itself.

    She need not be highly educated, but she should be able to read writing, so that she can fully understand the directions on the labels.  She ought to have a knowledge of common and every-day affairs, and possess the qualification of "common sense."  But she must not place too high a valuation on her own opinion or skill, as that may cause her to use either in opposition to the wishes of the doctor.  She must do everything for the patient that she can, and deal with the doctor fairly.