American National Red Cross

“ Drugs are given far less than they were a generation ago; yet medicines are still the most familiar of all remedies, and the most abused by those who persist in treating themselves. Misuse of medicine even by intelligent people is astonishingly common.
Problems of sickness and health would be enormously clarified if the uses and limitations of drugs were more generally understood. Many people still believe that every disease can be cured by a drug if only the doctor is clever or lucky enough to think of the right one to give. ”

“ Every woman who cares for the sick should remember that she is the patient's chief if not his only link with the normal world, and that his plight is pitiful indeed if she is complaining or irritable or unwilling. ”

“ At the same time that she is caring for a patient with a communicable disease, the attendant ought not to care for children or other members of the family, she ought not to prepare food, and she ought not to handle dishes or utensils used by other persons. Every day, however, many women are doing just these things, and it is true that in many instances no bad results are observed. Yet if any arrangement to insure safety can possibly be made, it is inexcusable to run the risk of spreading diseases which kill thousands of persons every year and injure many more for life. ”

“ The whole field of caring for the sick offers nowhere greater opportunity for fine and finished work than it offers in the case of chronic invalids. It is an achievement of which an artist might be proud to make a chronic patient comfortable in body, happy in mind, and agreeable to others. Moreover, since success can never be attained by one who wearies in well doing, the care given to a chronic invalid tests not only the attendant's skill but also her moral and spiritual quality. ”

“ Health and sickness, at all times momentous factors in the welfare of our nation, now as never before are matters of vital importance. To win its victories both in peace and in war, the nation needs all its citizens with all their powers, and it is a matter of more than passing interest that, as conservative estimates show, at least three persons out of every hundred living in the United States are constantly incapacitated by serious sickness. ”

“ The problem of sickness is by no means peculiar to our own day and generation. It has been a medical, a religious, and a social problem in every age. From the time of Job its meaning has baffled philosophers; from his day to ours thoughtful men have devoted their lives to searching for causes and cures. Yet before the middle of the last century little progress was made, either in scientific treatment or in prevention of disease. ”

“ Clearly much must and should be sacrificed by members of a family to the needs of an invalid; but in general it may be said that a sacrifice is injudicious if it relieves the patient of activity or responsibility that he can support without injury, if it makes him more dependent in mind or body, if it results in restricting his attention to himself and his affairs, or if it increases his tendency to make demands on others. ”

“ Care of a chronic patient has for its aims maintaining the patient's health, rendering him as happy and comfortable in mind and body as it is possible for him to be, and providing whatever special treatment and attention his case requires. ”

“ If a person is not expelling pathogenic germs, it is clear that he cannot pass diseases on to others. But both pathogenic and harmless germs follow the same routes from person to person, so that safety as well as decency lies in preventing so far as possible all exchanges of bodily discharges.
There are five routes by which the bodily discharges most frequently travel from one person to another. Four of these routes of infection are called public, because in most cases efforts of individuals alone are not sufficient to control them. The public routes are water, milk, food, and insects. ”

“ Cure of sickness and alleviation of suffering must never be neglected; not in cure, however, but in prevention lies the hope of modern sanitary science, of modern medicine, and of modern nursing.
Nearly every woman at some time in her life is called upon to assist in caring for the sick. Indeed, approximately 90% of all sick persons in the United States are cared for at home, even in cities where hospital facilities are good. Moreover, every woman is largely responsible for maintaining her own health, and few escape [xiv] responsibility at some time for maintaining the health of others. ”

“ In order to maintain his health constant attention must be given to diet, to hygiene of the sick room, and indeed to all his surroundings. In many chronic illnesses, such as rheumatism and kidney disease, the diet is prescribed by the doctor; in every case care should be taken that the patient is not overfed or underfed, that the food is suited to his digestive powers, that foods causing flatulence are eliminated, particularly if the patient's trouble is heart disease, and not the least important requirement, that he derive as much pleasure from his food as possible. ”

“ Important as it is to build up the patient's physical strength, it is hardly less important to direct his thoughts away from himself and his sickness, and to help him renew his interest in normal living. During his illness he has of necessity relied upon the judgment and support of other persons, and his pain and discomfort have forced him to think constantly of himself and his many needs. The habit of sickness is readily broken by some persons, particularly by those whose nervous exhaustion has not been great and whose interests outside themselves are naturally keen. ”

“ To announce baldly in the sick-room that the patient is tired and the visitor must go, will only elicit aggrieved protests from both. In illness lasting only a day or two all visitors should be discouraged; during colds, because they are communicable; during general fatigue, headaches, digestive upsets, and painful menstruation, because rest and quiet are highly desirable. Visitors at such times too frequently give injudicious sympathy, and may actually delay the recovery of patients who enjoy playing the rôle of interesting invalid. ”

“ The design is no less important than the color; a design that on casual inspection appears quite harmless may become an instrument of torture to a person unable to escape from it for a single hour. Weak or nervous patients sometimes become quite exhausted from attempting to follow an intricate pattern, or from counting over and over a design that is frequently repeated on the wall. If the patient sees grotesque faces and figures in the design the paper is more objectionable still. ”

“ The common saying that the best bed for an invalid is his own bed contains an element of truth. Taking from a patient his own accustomed bed, even when a better is substituted, sometimes disturbs him greatly and makes him feel that he is indeed very ill. Nevertheless, a suitable bed is essential to the proper care of a helpless person, and no patient should continue to use an unsuitable one, unless his illness is slight and also likely to be of very short duration. ”

“ And over-anxious health seekers might well remember that health is not so much an end in itself, as a means to a happy and productive life; even in concern over health, it is possible for him that saveth his life to lose it. ”

“ Medicines to stop pain or to induce sleep are probably the most pernicious of all self-prescribed remedies, for they add to other dangers the possibility of forming drug habits. These habits are so insidious and so powerful that it is not safe to take habit-forming drugs even once except by a doctor's direction. In short periods of time strong people, apparently firm in will and character, [205] have acquired habits from supposedly moderate use of drugs like morphine, cocaine, and alcohol. No one, no matter how sure of his own self-control, can afford to run so grave a risk. ”

“ Occupations for invalids are more than a means to pass away the time; they are also of distinct curative value. The patient's interest is not always easy to arouse, and some ingenuity may be needed in the beginning; sometimes interest is best aroused by working at some handicraft in his presence, and finally offering, as a favor, to teach him to do it also. His interest in any occupation is invariably increased if a well person not only directs but shares in the work. ”

“ At the end of life, as at its beginning, every individual especially needs the interest and protection of his own family. In ordinary circumstances neither a baby nor an aged person can be cared for so fittingly or so successfully in any other place as he can be in his own home.
With advancing years is to be expected a general slowing down of all the powers. In old age both body and mind show characteristic changes, and particularly changes causing lowered resistance and diminished vigor. ”

“ In practice the problem is not so easy. Public sanitation has performed miracles in the past, and will do much in the future; behaviour, however, will continue to be influenced by many factors, social and economic as well as personal. Ignorance of the laws of health is an obstacle to progress, but in modern conditions even the instructed may be unable to control their ways of living and working. Indeed, such control is at present limited to the privileged few. On the ignorant and the poor, those least able to bear it, society loads the heaviest burden of sickness. ”

“ Accordingly it is important for every woman who has charge of others, sick or well, to form the habit of noticing unusual appearances of any kind. This habit is one that most people must take pains to acquire, because people generally see only the things that their own experience in life has taught them to see. An added difficulty is the fact that when illness begins it is not a trained observer, but the untrained sufferer or untrained member of his family who decides whether to send for the doctor and thus to set in motion the machinery for treatment and cure. ”

“ Patients who are confined to bed even for a few days often suffer acutely from muscular tension, from pressure, and from fatigue due to lack of exercise. Indeed, many a sick person is surprised to find that the bed which had seemed so infinitely desirable can change into a place of torment after a few short days of illness. "Bed-weariness" is hard to bear in any case of illness, but it is doubly hard for persons who are really helpless.
Unless the patient is an experienced sufferer he often has no idea what should be done to make him comfortable ”

“ A judicious visitor may do an immense amount of good, especially to a chronic patient; indeed, she may be the only ray of light in a dark day. Subjects of conversation should be pleasant, but not too stimulating or exciting. The visitor should be prepared to carry the burden of the conversation, to drop topics skillfully that seem to involve fatigue or excitement, and either to go or to stop talking if the patient seems tired. Visitors should remember to talk naturally and cheerfully on ordinary topics, and to avoid excessive sympathy and labored attempts to cheer the patient. ”

“ On the other hand, a person who is responsible for the care of a patient must be made to realize that she and she only is ultimately responsible during the entire 24 hours of every day. Being responsible for a patient does not mean that she should be with him every minute, or do everything herself: it does mean that she should plan so effectively [129] that everything necessary is done, either by herself or by another competent person. When she goes away for even half an hour, she should appoint someone else to be responsible in her place and to her when she comes back. ”

“ Disease germs are present in the bodies of persons suffering from communicable disease, but they may also exist in the bodies of persons in good health; if present in the body, they may leave it in any bodily discharge. While every kind of germ does not leave the body by all the different routes, it is nevertheless true that most germs expelled from the body are carried in discharges from the nose, throat, bladder or bowels. ”

“ Disordered bodily processes give rise to symptoms of disease; and it is the symptoms of disease, not the disease itself, that trouble the patient. A patient with typhoid, for example, is not conscious of the toxins in his blood, but of headache, weakness, and fever; the man with eyestrain is not aware of an imperfectly shaped lens, but of headache and indigestion. What the patient wants is to have his symptoms relieved; in some cases they can be controlled by drugs, and the sufferer then considers himself cured. ”

“ Cleanliness in every detail is absolutely essential to the patient's welfare; no one is more unpleasant either to himself or to others than a chronic patient who is neglected. Patients who are constantly in bed, it should be remembered, and paralyzed patients in particular, are peculiarly susceptible to pressure sores. If a patient is able, it is extremely important for him to sit up in a chair part of the day. Sitting up should never be omitted because it involves the expenditure of time and trouble for the attendant. ”

“ During weakness and pain, irritability and unreasonableness are as characteristic as other symptoms, and it is as foolish to demand a normal mental state from a sick person as it would be to demand a normal temperature. For a cheerful, reasonable, and unselfish patient—and there are surprisingly many—one should be devoutly thankful, but patience and pity should be given no less to those whose tortured nerves cause suffering to others as well as to themselves. ”

“ Many elements enter into health; in no single one is found hygienic salvation. Temptation always exists to emphasize one element at the expense of others. For instance, people who insist upon overventilating rooms regardless of others' comfort may themselves be utterly careless in regard to necessary sleep, and more than one fastidiously [57] clean person has disregarded the highly unclean condition of constipation. To maintain sound health only a rational program will suffice: properly balanced work and play, sleep and food and all other elements must be included in due proportion. ”

“ Physical care to whatever extent it is needed should be given to all old people as soon as they [309] are unable to care for themselves, and thought should be given to adapting their surroundings and ways of living to their strength and needs, just as they should be adapted to the strength and needs of chronic patients. But a warning should be given against managing old people too much. It is hard for people who have managed their own lives successfully for many years to be managed, even for their own good. ”