Good springs which do not sag in the middle are very important. The mattress should be of hair and very heavy. To be comfortable while lying in bed out of doors, it is necessary to remember that cold can come through the mattress. To prevent this, stiff building paper which will not rustle can be placed between the mattress and the springs, or between two mattresses, if two are used. One or more blankets can be placed under the patient, who, if coldblooded, should sleep between flannel or outing flannel sheets. The number of blankets sufficient to keep some patients warm weigh so much that they should be replaced by comfortables of eiderdown or lamb's wool. "Feather beds" as coverings are used extensively in some Swiss health resorts. Four double blankets (eight folds) are usually sufficient to keep the patient warm when sleeping out in zero weather. Over all can be thrown a large horse blanket, to protect the bed from rain or snow. The head of the bed should have over it a blanket or shawl to ward off the wind. Do not forget that too heavy coverings prevent sleep and produce a tired feeling the next morning. If possible the sleeper-out should go to bed in a warm room and have someone roll him out. If this cannot be arranged for, he should have a warm dressing room and put on the eiderdown bootlets, mentioned previously, when going out to bed. If the bed must remain out of doors all day, a

heated brick, soapstone, hot "pig," hot-water bottle, or electric pad should be used to warm the bed before retiring.

KLONDIKE BED

The warmest bed is that known as the "Klondike" bed. Place on top of the mattress a horse blanket large enough to hang well over the sides and foot. On this lay the ordinary blankets, and finally upon these a single sheet. Then fold back the portion of the bedding hanging over the foot of the bed until the fold is even with the mattress. The two sides are folded over until just enough space is left for the body to slip in from the open top. This insures a large overlap of the bedding. Large safety pins may be used to fasten the laps. Over the whole throw the counterpane and tuck it well under the mattress at the foot and sides. The pillows are placed in the form of an inverted V.

THE PILLOWS

When sleeping in an ordinary bed in a cold room or out of doors, much cold air finds its way under the covers through the space which unfortunately is always ready to open up between one's head, the pillow, and the mattress. To provide against this the pillow may be arranged in the form of an inverted V and the head placed

in the apex. The shoulders should not rest upon any part of the pillows. This method is employed in the Klondike bed. Later a second method occurred to the author. One pillow is placed in the ordinary way at the head of the bed and two others, at right angles to the first, but under the covers. It is extraordinary what an amount of heat seems to be generated or retained in the pillow at one's back.

DANGER OF DAMPNESS

Few hesitate to affirm that a damp bed is dangerous, but not many have reasoned out why it should be so. Some indeed have stated that when a hot-water bottle has leaked in their beds they had no bad effects from ignoring it. What physical difference is there between a dry and a damp bed? Why is moist or damp air colder than dry air at the same temperature? The explanation is found in the fact that damp air or damp cloth dissipates much more readily the heat of the body. For a damp bed to do this it is necessary for it to be wet through and through. A damp sheet or a damp gown may have little effect when surrounded by many dry covers, for the dry covers prevent the loss of heat. This fact is made use of in treatment, and the patient may be wrapped in a cold, wet sheet, not only without harm but often with great benefit. From what has been said it can be

readily seen that damp clothes or a damp bed that leads to loss of the body heat is very dangerous and should be carefully avoided. Some patients who sleep out prefer to keep their beds indoors and roll them out only when going to bed. The large number of patients living in climates far from dry, who are not able to do this and still suffer no harm proves that such a step is rarely necessary.

X

ON THE PATIENT'S ROOM

"What room suffices him who knows a porch?"

FOR many reasons already mentioned the sick room is of secondary importance to the porch. In some instances, however, when a man suddenly becomes ill of pulmonary tuberculosis at his home and cannot be moved, and must occupy some room indoors, it is very important to have some knowledge of the requirements of a good room. In the first place the room should be well ventilated. This requires two openings to the outside air, for no air flows out of a room unless it can be replaced by air from without the room. It is much like the flow

of water or oil from a barrel. A vent is necessary for the continuous flow of the fluid. A match or a candle held in front of a window quickly tells the direction of the flow of the air. All communications with the rest of the house. should be closed in cold weather, for the heated air from the lower floors quickly rises through the halls to pass out of the open windows, and if only one opening exists, the invalid breathes the air from the house and not the live air outside. Every room, therefore, should have two windows