hom (as a moment's consideration would show
us) it must be quite impossible to masticate such things at that hour.
Again, a nurse is ordered to give a patient a tea-cup full of some
article of food every three hours. The patient's stomach rejects it. If
so, try a table-spoon full every hour; if this will not do, a tea-spoon
full every quarter of an hour.
I am bound to say, that I think more patients are lost by want of care
and ingenuity in these momentous minutiae in private nursing than in
public hospitals. And I think there is more of the _entente cordiale_ to
assist one another's hands between the doctor and his head nurse in the
latter institutions, than between the doctor and the patient's friends
in the private house.
[Sidenote: Life often hangs upon minutes in taking food.]
If we did but know the consequences which may ensue, in very weak
patients, from ten minutes' fasting or repletion, (I call it repletion
when they are obliged to let too small an interval elapse between
taking food and some other exertion, owing to the nurse's
unpunctuality), we should be more careful never to let this occur. In
very weak patients there is often a nervous difficulty of swallowing,
which is so much increased by any other call upon their strength that,
unless they have their food punctually at the minute, which minute again
must be arranged so as to fall in with no other minute's occupation,
they can take nothing till the next respite occurs--so that an
unpunctuality or delay of ten minutes may very well turn out to be one
of two or three hours. And why is it not as easy to be punctual to a
minute? Life often literally hangs upon these minutes.
In acute cases, where life or death is to be determined in a few hours,
these matters are very generally attended to, especially in Hospitals;
and the number of cases is large where the patient is, as it were,
brought back to life by exceeding care on the part of the Doctor or
Nurse, or both, in ordering and giving nourishment with minute selection
and punctuality.
[Sidenote: Patients often starved to death in chronic cases.]
But, in chronic cases, lasting over months and years, where the fatal
issue is often determined at last by mere protracted starvation, I had
rather not enumerate the instances which I have known where a little
ingenuity, and a great deal of perseverance, might, in all probability,
have averted the result. The consulting the hours when the patient can
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