r suddenly," as it is called,
from some trifling ailment of a few days, which just makes up the sum of
exhaustion necessary to produce death. And everybody cries, Who would
have thought it? except the observing nurse, if there is one, who had
always expected the exhaustion to come, from which there would be no
rally, because she knew the patient had no capital in strength on which
to draw, if he failed for a few days to make his barely daily income in
sleep and nutrition.

I have often seen really good nurses distressed, because they could not
impress the doctor with the real danger of their patient; and quite
provoked because the patient "would look" either "so much better" or "so
much worse" than he really is "when the doctor was there." The distress
is very legitimate, but it generally arises from the nurse not having
the power of laying clearly and shortly before the doctor the facts from
which she derives her opinion, or from the doctor being hasty and
inexperienced, and not capable of eliciting them. A man who really cares
for his patients, will soon learn to ask for and appreciate the
information of a nurse, who is at once a careful observer and a clear
reporter.

CONCLUSION.

[Sidenote: Sanitary nursing as essential in surgical as in medical
cases, but not to supersede surgical nursing.]

The whole of the preceding remarks apply even more to children and to
puerperal woman than to patients in general. They also apply to the
nursing of surgical, quite as much as to that of medical cases. Indeed,
if it be possible, cases of external injury require such care even more
than sick. In surgical wards, one duty of every nurse certainly is
_prevention_. Fever, or hospital gangrene, or pyaemia, or purulent
discharge of some kind may else supervene. Has she a case of compound
fracture, of amputation, or of erysipelas, it may depend very much on
how she looks upon the things enumerated in these notes, whether one or
other of these hospital diseases attacks her patient or not. If she
allows her ward to become filled with the peculiar close foetid smell,
so apt to be produced among surgical cases, especially where there is
great suppuration and discharge, she may see a vigorous patient in the
prime of life gradually sink and die where, according to all human
probability, he ought to have recovered. The surgical nurse must be ever
on the watch, ever on her guard, against want of cleanliness, foul air,
want of ligh