to be taken, a nice hot poultice should be applied. Sometimes leech bites bleed very freely; usually pressure with the fingers or a small compress will stop the hemorrhage. You may want to use leeches a second time, and, if so, the best way to preserve them is to sprinkle some salt over them, which proceeding soon makes them empty themselves of the blood, and after having washed them in cold water a few times, you had best put them in a vessel half full of water and covered with a piece of perforated card-board. Vapor Baths. There are many apparatuses for giving patients hotair baths, and I shall not attempt to describe these; but it sometimes happens that it is absolutely necessary to get the skin to perspire very quickly and thoroughly, and if no such apparatus is at hand, what is to be done? If it be a child, a warm bath and wrapping up in flannel blankets will often suffice; but in the case of adults, if they be helpless or in the houses of the poor, where no baths are to be found, what can be substituted? For this Sir James Simpson devised a most excellent bath, always easy to construct and capital in its action. For it you only want a few sodawater bottles filled with hot water and tightly corked down, and these are wrapped round with pieces of flannel or worsted stockings, wrung out in hot water. These, then, are placed round the patient, in bed, and he is well covered up. In about half an hour you will find a thoroughly free perspiration. The bottles can now be taken away and the patient wrapped up in a flannel blanket for another half hour. If the bed during this process has got at all wet you must remove him to another bed, which has, of course, been thoroughly well aired and warmed. In case no soda-water bottles are at hand hot bricks answer very well. In cases of croup, as also in certain cases of bronchitis, the physician often wishes the patient to be kept, for at least some time, in an atmosphere of steam, and it is often difficult to know how to do this in the quickest and easiest way, unless you have a regular steam bed and appliances. In the case of children a very good way is to put them in a cradle, under a fairly sized table, then covering this over on all sides with sheets, to place under it, at the foot of the cradle, a vessel with boiling water, which is, of course, to be continually replenished. By this means you can always readily carry out what often appears a difficulty. How to Lift Helpless Patients. You may often want to lift some poor, helpless patient, who has been rendered utterly unable to help him or herself, through paralysis, accident or prostration, and it is a useful thing to know the different methods by which you can easily and readily accomplish this. One person can quite comfortably carry a child, but when the patient is an adult it is different. Two persons can manage this in the following way: They take their stand at each side of the patient, about opposite the nates, and stooping down they join their hands under the back and middle part of thighs, and in this way the patient can be easily lifted, carried and put down again. Of course, if a limb be injured, there ought to be a third person to take charge of it. Four persons can lift a patient with great ease and comfort in the following way: Two poles are placed, one on each side of the patient, and the under sheet and blanket are firmly rolled round them. The four persons now stand two at each side, facing the patient, and each one catches hold with one hand the end of the poles surrounded by the sheet, and with the other the pole near its centre. The patient in this way can be easily carried on to another bed or couch, whilst his bed is being made. How to Change Bed Linen for the Sick. By this I mean, of course, only the under sheets, and they can be changed in two or three ways. One is to roll up lengthways the dirty sheet one side of the patient and push it as far as possible under his side; now roll up half the clean sheet and place the roll next to the other, and by gently turning the patient over these two rolls and taking away the dirty sheet and unfolding the clean one, you have only to turn your patient gently back, and the otherwise tedious business is accomplished. Another way is as follows: You raise your patient into a sitting posture and roll the dirty sheet from the head of the bed downward as far as possible. You now roll up your clean sheet crosswise, and placing it near to the roll of dirty sheet you lay your patient down again and raise the lower extremities, and then you can easily pull down the dirty sheet as also your clean one, and spreading the latter out and tucking it neatly under the mattress your patient is soon again comfortable. It is a good rule for the nurse to put down on paper or on a slate all the directions of the medical man with regard to medicines, nourishments, and other things, as also to make notes of all that has happened since his last visit, such as how long and how often the patient has slept, whether on awakening he has appeared refreshed, what time he has taken his nourishment and in what quantities, and numerous other details, which will not only save cross-questioning, but also the physician much time, and give him a clearer account of his patient's condition since his last visit; in fact, he can see it all at a glance. HOW TO REMOVE THE INJURED OR SICK BY BEARERS OR ON STRETCHERS.' Carriage by Bearers. If no stretcher or other conveyance can be procured or improvised, you can, by means of bearers or carriers, transport an injured person for a short distance, and the methods of so doing, which I shall now describe, are those drawn up by Professor Longmore, of England. If only one person be available, and if the patient can stand up, great help may be afforded him by letting him place one of his arms round the neck of the bearer, bringing his hand on and in front of the opposite shoulder of the bearer. The bearer then places his arm behind the back of the patient and grasps his opposite hip, at the same time catching firmly hold of the hand of the patient placed on his shoulder with his other hand. Then by putting his hip behind the near hip of the patient, much support is given, and, if necessary, the bearer can in this way lift him off the ground, and, as it were, carry him along. If, however, the patient cannot stand, the only way in which one person can remove him is by getting him on his back; but this method is, of course, not practicable in a case where the thigh is broken. If two bearers are, however, available, the patient may be carried by them in three or four different ways: 1. He may be carried in a sitting position by the two bearers joining two of their hands underneath his thighs, close to the nates, while their other two hands are passed round his loins and clasped together. The patient, if he is able, can help to support himself by clasping the bearers round their necks. 1 From "Ambulance Lectures," by L. A. Weatherly, M.D., London, England. 2. A patient can be carried by two bearers, two of their hands forming a seat and the other two arms a back support. 3. Three of their hands may form the seat, while a back support is made by the remaining arm. 4. A seat may be made with all four hands, and this form of seat is well known among schoolboys as the "sedan chair." If the patient is able to sit up and help to support himself by placing his arm over the shoulders of the bearers, it is surprising how long a distance he may be carried by this method. Carriage on Stretchers. If we have no regular stretchers at hand, we must extemporize one, and among the many substitutes, I may mention a door or gate taken from its hinges, a window shutter, a hurdle, or even a short ladder. If two poles of sufficient length and strength can be obtained, a stretcher can be readily made with them, together with two coats. The sleeves of the coats are turned inside out, and the poles being put through them, and the coats having then been buttoned up, a very suitable stretcher is at your service. The rules to be adopted with regard to the proper carriage of patients on stretchers hold good, whatever stretcher is used and however many bearers are required. There are special words of command which are used in the British Army for the stretcher drill; by acting together at the word of command additional comfort and safety will be secured to the patient. 1. As regards the Bearers. It is best to have three persons to carry an ordinary stretcher (though, of course, if you are using a door or shutter, you would probably want five). Of these three, two carry the stretcher and the other one attends solely to the patient, changing when necessary with either of the other two, by way of relief. For convenience |