nd
upon relieving pressure by special devices and by turning the patient
frequently. The parts where pressure comes should be washed at least
twice daily with warm water and soap, rubbed frequently with alcohol to
improve the circulation and to keep up the tone of the skin, and
powdered with a little good toilet powder. Much powder is likely to do
harm by collecting in hard, irritating particles. The bed should be kept
constantly dry and smooth, and free from crumbs, lumps, wrinkles, or
other inequalities. Prolonged pressure should be relieved by turning the
patient often,--once every waking hour is not too often if the body is
emaciated,--and by pillows, pads, and rings.

Small pillows or thick pads of cotton should be placed under the
patient's back and shoulders, between the knees and ankles when he lies
on his side, and in other places where sores are likely to develop.
Rubber rings are useful, but few patients like them for a long time.
They should not be inflated more than necessary to raise the affected
part from the bed; if much inflated, they are uncomfortable and may do
harm. The ring may be covered with a muslin pillow case, or it may be
wound smoothly with long strips of bandage or old muslin. Ordinary
cotton batting wound with strips of muslin may be made into rings and
used to remove pressure from heels, elbows, or other parts. These cotton
rings are less heating than pads, and give better support.

The first sign of a bed sore is either redness of the skin or a dark
discoloration like a bruise. Every point where a bed sore may form
should be inspected daily. If the slightest symptom of a sore appears,
the patient must not lie on the affected part, and every effort should
be made to keep the skin from breaking; vigorous rubbing at this stage
is dangerous, and will by no means make up for previous neglect. The
condition should be reported to the doctor at once. If in spite of all
efforts the skin does break, a peculiarly difficult kind of open wound
results which must be treated and dressed according to the doctor's
directions.

DEVICES TO GIVE SUPPORT.--The variety and number of pillows one patient
can use is almost unlimited. A weak patient when lying on his side
should have his back supported by a pillow. When he lies on his back a
pillow should be placed under his knees to lessen muscular tension, and
if he may be raised in bed, several pillows are needed to support him
comfortably. A back rest is us