HYGIENE OF THE SICK ROOM

Far too little attention is generally accorded to the proper care of the
sick,--the prevailing opinion being that the royal road to recovery under
the circumstances is opened up only through the taking of drugs, and that
provided the appropriate ones be given in sufficient quantities recovery
will result. No greater mistake is possible. As a matter of fact, there
are very few diseases for which we have medicines that act in a specific
manner, and far more is usually to be hoped for from good nursing.
Fortunately the general public is beginning to recognize the truth of the
statements just made. It has only been a short time since the trained
nurse was unknown except in the larger medical centres, but now her
presence and beneficent influence is being felt from one end of the land
to the other, and her importance is destined to increase with the onward
march of time; she is undoubtedly the greatest advance that we have made
in medicine during the last decade.

Where persons are ill they should always be attended by a trained nurse
if possible, but if this is out of the question a few suggestions as to
the sick room and its hygiene should certainly not be omitted from any
book dealing with rural sanitation.

_Ventilation and Warmth._--The sick room if possible should be located on
the sunny side of the house, and should have fire in a fireplace if the
weather be cold. It is of the utmost consequence that the room have
windows and doors by means of which it can be at all times thoroughly
ventilated. At all seasons of the year a room on the lowest floor of the
house is more satisfactory, since it is warmer in the winter and cooler
in the summer. The room should not be uncomfortably cold, though it is
much better to have the temperature too low than to have the air stuffy.
In most diseases ventilation is of supreme importance, and should be
secured at any cost. Where, however, it is compatible with thorough
ventilation, a temperature of about 70°F. is generally considered most
desirable.

Before a patient is moved into a room all superfluous furniture should be
taken out, particularly carpets and hangings of all kinds. It is likewise
of the utmost importance that all insects, particularly flies, be
excluded by proper screening.

The patient's bed should be narrow, and a mattress is much to be
preferred to a feather bed. The mattress should be protected by a rubber
sheet or newspaper pads; oil-cloth cracks and wrinkles too badly to be of
service for this purpose. The rubber sheet should of course be kept under
the sheet nearest the mattress. The cover should consist of a sheet which
is long enough to fold back at the head over the other covering for some
distance, and blankets should be used for warmth in preference to quilts.
The bed should be kept scrupulously clean, and the linen and covering
should be removed when soiled. The nurse should see to it that
bread-crumbs do not remain in the bed.

In removing soiled bed-clothes the following plan is the one usually
adopted. The patient is moved to one side of the bed as near the edge as
possible, and the sheet beneath him loosened at the head and the foot and
on the opposite side; it is then rolled up toward the patient and pushed
well up under him, leaving the side of the bed opposite to that upon
which he is lying bare; upon this the new sheet is placed, which is then
tucked under the edges of the mattress, and the patient rolls or is
pulled back over on it. The soiled sheet is then removed and the edges of
the fresh one pulled over the portions of the bed still uncovered, and
secured in the usual way.

_General Precautions._--The room should also be kept scrupulously clean;
all sweepings should be burned. Soiled linen and all excretions from the
patient should be promptly removed, and if the latter need not be
preserved for the inspection of the physician, should be at once
disinfected and properly disposed of. Milk and other food should not be
left in the sick room; and soiled glasses and dishes should be removed
and washed at once in boiling water.

Persons who are ill should not be allowed to have company. There is
nothing more important in connection with the looking after patients with
infectious diseases than this precaution. The writer has often seen in
the country districts patients with typhoid fever and other infectious
diseases surrounded by the neighbors from miles around,--the entire
company often eating and drinking in the room occupied by the afflicted
person. The strain that results on the patient from a practice of this
kind might well in many cases have fatal consequences, and there is no
question whatever that many diseases, particularly typhoid fever, are
scattered in this way from house to house and from one community to
another.

The diet should be given regularly and should consist strictly of only
such things as are allowed by the physician.

All medicines should be given absolutely according to directions, as
otherwise having a doctor is worse than useless.

All patients should have a daily bath, special attention being given to
their hair, teeth, mouth and nails. In many cases it is necessary to
wash the patient's mouth frequently with some antiseptic wash. This
should only be done on the expressed instructions of the doctor.