fficient inlet for the pure air from without to
come in. You must have open chimneys, open windows, or ventilators; no
close curtains round your beds; no shutters or curtains to your windows,
none of the contrivances by which you undermine your own health or
destroy the chances of recovery of your sick.[4]

[Sidenote: When warmth must be most carefully looked to.]

A careful nurse will keep a constant watch over her sick, especially
weak, protracted, and collapsed cases, to guard against the effects of
the loss of vital heat by the patient himself. In certain diseased
states much less heat is produced than in health; and there is a
constant tendency to the decline and ultimate extinction of the vital
powers by the call made upon them to sustain the heat of the body. Cases
where this occurs should be watched with the greatest care from hour to
hour, I had almost said from minute to minute. The feet and legs should
be examined by the hand from time to time, and whenever a tendency to
chilling is discovered, hot bottles, hot bricks, or warm flannels, with
some warm drink, should be made use of until the temperature is
restored. The fire should be, if necessary, replenished. Patients are
frequently lost in the latter stages of disease from want of attention
to such simple precautions. The nurse may be trusting to the patient's
diet, or to his medicine, or to the occasional dose of stimulant which
she is directed to give him, while the patient is all the while sinking
from want of a little external warmth. Such cases happen at all times,
even during the height of summer. This fatal chill is most apt to occur
towards early morning at the period of the lowest temperature of the
twenty-four hours, and at the time when the effect of the preceding
day's diets is exhausted.

Generally speaking, you may expect that weak patients will suffer cold
much more in the morning than in the evening. The vital powers are much
lower. If they are feverish at night, with burning hands and feet, they
are almost sure to be chilly and shivering in the morning. But nurses
are very fond of heating the foot-warmer at night, and of neglecting it
in the morning, when they are busy. I should reverse the matter.

All these things require common sense and care. Yet perhaps in no one
single thing is so little common sense shewn, in all ranks, as in
nursing.[5]

[Sidenote: Cold air not ventilation, nor fresh air a method of chill.]

The extraordinary