Report of the Commissioners appointed to inquire into the regulations affecting the sanitary condition of the army, the organization of military hospitals, and the treatment of the sick and wounded ; with evidence and appendix. Presented to both Houses of Parliament by Command of Her Majesty.

Great Britain. Royal Commission Appointed to Inquire into the Sanitary Condition of the Army.

Date:: 1858

Credit: Report of the Commissioners appointed to inquire into the regulations affecting the sanitary condition of the army, the organization of military hospitals, and the treatment of the sick and wounded ; with evidence and appendix. Presented to both Houses of Parliament by Command of Her Majesty. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

696/978 page 570

$and dif- ferent ways in adnii- iiistei'ii]g them. Sudori- ferous to be given warm. Lemonades to be given cold. Time and quantity of drinkinsr. Assisting invalids in drinking. Use of 'drinking cups. Patients refusing to drink. Jugs to be labelled. Drafts or potions. Broth of vegetables after ape- ricatdrafts. Tepid •water after emetics. ptisan. Tf the ptisan is given to promote or main- tain the perspiration, such as of linden flowers or sarsapariUa, &c., it must be given warm, as well as when tlie cold temperature might produce some effect oil the course of the malady : on the other hand lemonades, and particularly the mineral lemonade, must be given cold. Besides this the lemonade must )iot be put into vases of varnished clay, but of glass or stone ; should not be taken or given oftener than at intervals of half-an-liour, shaking the bottle every time when the tartro-boracic lemonade is given to a patient. The frerpiency of the drink is to be regulated by the thirst of the patient in general ; but for grave invalids requiring the assistance of an infirmier, it will be well to ask of the medical officers special instructions to regulate the time and quantity of drink to be given, besides its quality. Infirmiers must be instructed how to help the invalids in drinking when they cannot help themselves. If the patient can do a little for himself he must be supported while he drinks, that he may do it more at ease ; if he is so weak that he cannot sit up without assistance, the infirmier will put the drinking mug- within easy reach, then with both hands take up the invalid liy the shoulders and pass gently one of his arms under his back and support him with it. With the other hand then free he takes up the mug and gives him to drink, after which he replaces him gently on liis bed with his head on the bolster. If the patient is in a state that he cannot be moved without danger or pain, a drinking cup must be used, with the pre- caution to pour out neither too much nor too little, both of which would cause him painful efforts or weariness. When it happens that either from delirium or other ]iliysical or moral cause a patient refuses to take the prescribed draughts, persuasive modes mustfirstbe tried with great patience. If these avail not advantage must be taken of the time when he opens his mouth :ni(l teeth to introduce a stojjple between his teeth, liil he shall be able to pour in a little of the draught ; but if all other means prove useless one can press gently the soft parts of the nose, and when he feels obliged to open his mouth to breathe, some drink is gently poured into it, in quantity not too great so as to cause him to cough. To avoid mistakes or confusion every jug of ptisan >:l!ould bear the number of the bed for which it is intended, and so with other drafts or potions. Drafts or potions are small liquid medicaments deli\ ered generally in glass vials ; they are of several descriptions, such as pectoral drafts, of gum, anodyne, of liark, &c. &c. Pctio'is are to be taken sometimes all at once, sometimes in small quantities, at fixed intervals, according to the prescription of the doctors as indi- cated by the dispenser. The infirmiers must ascertain wliat is the relative jirescription for each patient, and That ihey are taken accordingly, viz., at the time or limes and in the quantiti(>s jirescribed, that they are not thrown away, exchanged or sold, helping them to take them when they are not able to do so by ihemselves. In this last^case it is not necessary to lift up the patient as for the ptisans ; it suffices to raise his head a little, and without the necessity of using a drinking cup, the neck of the vial or a spoon will serve to introduce it into the patient's mouth. The drafts are generally given by the dispensers themselves. The duties of the infirmiers vary with the nature of the medicine to be taken by the patient. They must give them drinks to facilitate their effect. After the first ejection produced by the aperient draft, the infirmier will give to the patient some broth of vegetables, and continue to give him about liali' a pint of it every half hour for three hours afterwards. To those that have taken emetics the infirmier must give every quarter of an hour the eighth p.art of a pint of tepid water, beginning half an hour after the last dose. The next duty of the infirmier is to keep ready the close stools or basins as may be required, taking care that they are perfectly clean. The boluses or pills require also special attention. They must be taken at the intervals prescribed, for instead of producing the effect desired they would prove dangerous if taken too frequently or at an im- proper time. They must be swallowed quickly, and when the infirmier is to give them instead of the dis- penser, he will attend well to the directions that were given with regard to them. If the patients do not know how to take them, he must cause them first to drink a little ptisan to moist their throat, or procure a plum or a portion of it to wrap it into it to facilitate its being easily swallowed. Gargles are liquid medicaments used for sores in the mouth or in the throat ; they must be kept in the mouth as long as possible, but as there may be also some that are dangerous, they must not be swallowed but completely rejected. To render them useful they must be brought to remain on the affected part as long as possible, and that can be obtained by bending the head on that same side ; and if it is required to act on the throat, to prevent the liquid from going down it is agitated l)y a movement given to the tongue and the air and then rejected. The collutoires are medicines more or less liquid or thick, particularly destined for diseases of the mouth. They are used steeping in them a little lint pledget fixed upon a stick, and then passing it over the guins, aphthaj, or ulcerations, to deterge and wash them. Fomentations are external medicaments. There are two kinds of fomentations, viz., dry or wet. Dry fomentations .are those made with ^wwders, such as ashes, bran, powdered elder flowers, or camomile, &c., that are put into bags and applied warm on the part affected. Wet fomentations are composed of different liquids, such as water, wine, aromatic infusions, emol- lients, decoctions, &c.,&c. into which pieces of swanskin or flannel are steeped and then applied warm on the different parts of the body according to the prescrip- tion, taking care to renew them as they get cold. By covering them with a bit of oiled canvas or gummed silk their getting cold is retarded, but these should not be used without consulting the medical officer. Liniments are made of fat or oily substances ap- plied by frictions on the skin. They are poured out upon a piece of linen or woollen cloth, and rubbed with it lightly on the skin, upon M^hich it is left after that friction. In default of cloth, the hand is used instead. Lotions are liquid medicaments intended to wash certain parts of the body or wounds, to deterge them and bring on salutary changes. During the dressing the lotions are applied by the surgeons ; but when they are to be renewed at other times, they must be re- peated by the infirmiers, who will take care to make them exactly as the surgeon has made them. A cataplasm or poultice is a medicament made of a soft and pulpy substance aj^pHed warm or lukewarm on the different parts of the body to keep them moist. Poultices may be warmed in two waj s, viz., one by putting the material of the poultice into a vase on the fire, stirring it well to prevent its sticking or singeing, the other by putting the poultice on a bit of cloth, and then on a piece of tinned iron, which is ])laced on the fire and kept thel-e till it gets to the required degree of heat. Injections are liquid medicaments of different kinds introduced into the cavities of the body by the means of a syringe. Clysters are liquid medicaments intro- duced into the body through the lower end of the digestive canal, by the means of a large syringe. They are given either by the infirmiers attached to the dispensary, or the wards. Any repugnance to give them would be unjustifiable in the infirmiers, Avho must entertain to no other feeling but that of giving relief to the patients. We shall not describe here the syringe, which every infirmier of course knows. Bohtopr, pills Gar Colh Fomi tions, or we Linini Lotion Catapli or pool Injectio$