Upon the proper arrangement and care of the bed will largely depend your patient's comfort. This should be low and narrow enough for you easily to reach him from either side. The bedstead should be of iron or brass, with springs of woven wire, permeable by the air in every part. This is the only kind which you can be sure of keeping thoroughly clean. On this should be a hair mattress, never a feather bed. Make the under sheet as tight and smooth as possible, and take especial pains to keep it thoroughly dry and free from wrinkles, crumbs, and other inequalities. Neglect in this particular will give rise always to much discomfort and sometimes to serious troubles in the form of pressure-sores—which are extremely difficult to cure, but nearly always preventable by care. Very heavy or very much emaciated patients, and those suffering from affections of the brain, are particularly liable to these. It is often advisable, especially where a bed is prepared for long occupancy, to put next to the under sheet one of rubber, covered with a second folded sheet, or draw-sheet. This can be easily and frequently changed with but very slight disturbance to the patient. The bed-coverings should be such as are warm without being heavy, as their weight is often found oppressive. In some cases even slight pressure is unendurable. The weight of the clothes may then be supported by a wooden frame-work underneath.
All bedding should be frequently renewed, and always well aired and warmed before being used. If you have a patient entirely confined to bed, it will add greatly to his comfort if you can give him two beds, each provided with its own complement of sheets, blankets, etc. Let him occupy one during the day, and be transferred to the other for the night. If they are of equal height, this can be easily done, and the smooth, fresh condition of the unused bed will do more than any narcotic toward securing for him a good night's rest.
To prop a patient up with pillows, begin by slipping one as far down as possible against the small of the back. Put the next and succeeding ones each behind the last; this will prevent them from slipping. Aim to raise the head, and support the shoulders without throwing them forward so as to interfere with the free play of the lungs. Two or three small pillows, which can be moved from place to place as occasion requires, will be found of great service.
About the person of your patient, no less than about his room, labor to secure the most scrupulous cleanliness. Neglect of this too often arises from a fear that the patient will take cold; but it entails a greater risk than this to leave him in clothing saturated with morbid effluvia, and with the pores of his skin clogged by the noxious products of disease. No patient is ever too ill to be kept clean. If proper precautions are used and unnecessary exposure avoided, no danger need be apprehended.
The proper administration of food is often the great problem of the sick-room. There must be due regard to the kind, quality, and
