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compared with the importance which must attach to the question of the after-condition of his health.

As regards the amount of exercise which a patient can take during the early stages of convalescence, of course there will be great variations, according to what has been the nature of the disease, the severity of it, and the natural constitutional strength of the patient. In some cases the patient has a tendency to greatly overrate his powers in this particular, and is not fully aware of the severity of the struggle through which he has recently passed. Such an one should follow his doctor's advice when told to begin with but very little exercise at first and increase it gradually.

We have already alluded to the subject of diet during convalescence. The patient should be careful, whilst taking as much light nourishment as he can digest, not to overstep the line and give himself an attack of indigestion. The appetite after acute disease is often voracious, and the temptation to overload the stomach is consequently great. On the other hand, a convalescent patient should not be too timid in the matter of diet. is of course essential that the diet should be light and easy of digestion, but, this being secured, the patient should take a fair quantity, or he will be very slow in recovering his lost strength.

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We have spoken of the avoidance of chill by remaining in bed: it need hardly be said that after leaving the bed it is of the utmost importance that patients avoid catching cold. This is not only the

case in diseases of the respiratory organs, but applies to the convalescent from any acute disease. The reader may be referred to the passages in 'The Patient's Bedroom' for suggestions as to how to obtain free ventilation without draughts. Chills must be avoided, but this must not be done by blocking out the fresh air, which is one of the most powerful agents in the restoration of health. If unhappily a chill should be taken, the patient should never fail to follow his doctor's advice when told to turn into a well-heated bed at once, and remain there for perhaps a couple of days, combining this measure with the drinking of hot fluids to produce free perspiration. A convalescence once interrupted is stated to very rarely or never go on with the same rapidity as one in which there has been no break; hence the importance of care in exercise, diet, and the avoidance of chills.

When the patient is able not only to leave his bed but his room also, very often his medical attendant will recommend that he should be removed to some health resort, in order that his convalescence may go on the more satisfactorily, and that the restoration to health may ultimately be complete. Now of course there are various reasons why a patient may feel unwilling to leave home. First of all, there may be a condition of nervous depression which causes him to shrink from a journey which in sound health he would have undertaken readily at a moment's notice. Then, again, his circumstances may be such that, after

the unavoidable expenses of a severe illness, he may most naturally be unwilling to add to the cost by a stay at the sea-side. With regard to the second of these objections, it may of course be impossible that the patient should follow his doctor's advice; but it should be remembered by those with whom it is only a matter of difficulty, that a stay at a health resort will frequently fit them for work far more speedily than would have been the case had they remained at home.

APPENDIX.

I-POULTICES.

A LINSEED-MEAL poultice is the one which is most commonly ordered by the doctor. It is very desirable that it should be applied to the patient as hot as he can comfortably bear it, and that the heat should be retained as long as possible. To this end the water must be boiling hot, the basin in which the meal is mixed. scalded out, and the spatula or knife used dipped in hot water. A piece of oil-silk or mackintosh rather larger than the poultice should be laid over it after it is applied. To make the poultice, a piece of linen about two inches larger each way than the requisite size of the poultice should be spread out on a board. Then the meal should be thrown into a basin and boiling water poured upon it, a little at a time, and the mixture stirred together till it is brought to a thick consistence. The meal must now be spread upon the piece of linen with the knife or spatula to the thickness of a quarter to three-quarters of an inch, according to the character of the case. The margin of the linen should be turned over the poultice, and it should be applied as quickly as possible. It is a bad custom to put a layer of muslin between the skin and the meal, as it spoils to some extent the effect of the poultice. A little olive oil can be spread upon the surface of the poultice to prevent the meal adhering to the part to which it is applied.

Bread poultices do not retain heat and moisture so long as linseed-meal, but they are sometimes ordered

when a milder effect is required. The bread should be stale, and cut up into little squares and placed in a basin. Boiling water should then be poured on the bread, and the basin covered with a plate and set by the side of the fire for a few minutes. After the water has been poured off, the bread must be lightly beaten up with a fork and spread on a piece of linen. The same care should be taken to scald out the basin before beginning as was observed in making the linseed-poultice.

Mustard-poultices are used as counter-irritants. The water should be cold or tepid, for if hot the active principle of the mustard is set free, and much of the strength lost. If vinegar is added, it only weakens the mustard. The mustard, being made into a paste, should be spread upon a piece of linen and covered over with a layer of muslin or tissue paper. This poultice should be kept on from fifteen to twenty-five minutes, as the patient can bear it. When the poultice has been removed, the skin should be gently sponged with lukewarm water and a layer of cotton-wool applied. Sometimes combined linseed meal and mustard poultices can be made; the ingredients being either in equal quantities, or the mustard merely sprinkled on the surface of the meal.

II.-FOMENTATIONS.

These applications are directed to be used for the purpose of allaying inflammations, pain, and spasm. A piece of coarse flannel should be folded eight times or so to the size required. Boiling water should then be poured upon it, and it should be wrung as dry as possible in a towel. The flannel should then be shaken gently, so as to let a little air get between its folds, after which it should be applied, a piece of mackintosh large enough to overlap it on all sides by at least an inch being placed over it. It should generally be changed once every hour or so, the skin being wiped dry each time, and the surface not left exposed.

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