Fat and Blood: An Essay on the Treatment of Certain Forms of Neurasthenia and HysteriaMitchell, S. Weir (Silas Weir)
Science
Fat and Blood: An Essay on the Treatment of Certain Forms of Neurasthenia and Hysteria
Mitchell, S. Weir (Silas Weir)
Hysteria; Neurasthenia; Rest
12 M. Rise and dress slowly. If gymnastics or massage are not ordered,
may rise earlier. May see visitors, attend to household affairs, or walk
out.
1.30 P.M. Luncheon. (Malt, tonic, etc., ordered.) In invalids this
should be the chief meal of the day. Rest, lying down, not in bed, for
an hour after.
3 P.M. Drive (use street-cars or walk) one to two and a half hours.
(Milk or soup on return.)
7 P.M. Supper. (Malt, tonic, etc., ordered; detail of diet.)
Bed at 10 P.M. Hot milk or other food at bedtime.
This schedule is modified for convalescent patients after rest-treatment
by orders as to use of the eyes: letter-writing is usually forbidden,
walking distinctly directed or forbidden, as the case may require. It
may be changed by putting the exercise, massage, or gymnastics in the
afternoon, for example, and leaving the morning, as soon as the rest
after breakfast is finished, for business. Men needing partial rest may
thus find time to attend to their affairs.
If massage is not ordered, there is nothing in this routine which costs
money, and I have found it apply usefully in the case of hospital and
dispensary patients.
In carrying out my general plan of treatment in extreme cases it is my
habit to ask the patient to remain in bed from six weeks to two months.
At first, and in some cases for four or five weeks, I do not permit the
patient to sit up, or to sew or write or read, or to use the hands in
any active way except to clean the teeth. Where at first the most
absolute rest is desirable, as in cases of heart-disease, or where there
is a floating kidney, I arrange to have the bowels and water passed
while lying down, and the patient is lifted on to a lounge for an hour
in the morning and again at bedtime, and then lifted back again into the
newly-made bed. In most cases of weakness, treated by rest, I insist on
the patient being fed by the nurse, and, when well enough to sit up in
bed, I order that the meats shall be cut up, so as to make it easier
for the patient to feed herself.
In many cases I allow the patient to sit up in order to obey the calls
of nature, but I am always careful to have the bowels kept reasonably
free from costiveness, knowing well how such a state and the efforts it
gives rise to enfeeble a sick person.
The daily sponging bath is to be given by the nurse, and should be
rapidly and skilfully done. It may follow the first food of the day, the
early milk, or cocoa, or coffee, or, if preferred, may be used before
noon, or at bedtime, which is found in some cases to be best and to
promote sleep.
For some reason, the act of bathing, or even the being bathed, is
mysteriously fatiguing to certain invalids, and if so I have the general
sponging done for a time but thrice a week.
Public-domain text, read in full here on John Shaqi.
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