Render out mutton tallow on the back part of the stove; do not brown it. Strain through a piece of muslin; add the olive oil and carbolic acid; set dish into cold water and beat its contents until set. This will make an ointment the consistence of vaseline, and it will keep indefinitely. If the skin needs a great deal of stimulation, camphorated oil or, better still, castor oil may be substituted for the olive oil in the above recipe.

When the skin becomes excoriated the part should be cleansed as mentioned before, not with soap and water, but with boric-acid solution, normal salt solution, or sterile water; then gently painted with oxide of zinc ointment made into liquid form by the addition of olive oil, castor oil, and balsam of Peru in equal parts, or castor oil alone, and covered with a clean cloth fastened on with a binder. Gentle massage may be used around the excoriated surface with excellent results.

The treatment of bed-sores is usually directed by the physician; but if it is left to the nurse, she will find the following method helpful. If there is necrotic tissue or suppuration present, she may irrigate the cavity once daily with peroxid of hydrogen, one glass syringeful, followed by normal salt solution, boric-acid solution, or sterile water. Then apply a hot boric-acid dressing, one inch thick, every four hours until wound is clean. If the stimulation of the tissues is needed, fill the cavity with a sterile dressing saturated with balsam of Peru and castor oil, equal parts bovinine, castor oil, or camphorated oil alone. When the depression is filled with granulation tissue, it can be treated as an excoriation.

THE MOUTH.

The subject of the care of the mouth in fever nursing is equally as important as that of prevention of bed-sores. An unclean mouth is not only very unpleasant and often painful to the patient, but is a source of infection. The accumulation of food and mucus is a fertile field for the lodgement of bacteria. If this infected material is allowed to remain, it can easily spread to the middle ear and the mastoid cells, and cause abscesses or be carried by the food to the already overburdened alimentary tract to add to its infection. When the accumulation of sordes is profuse and persistent the patient’s mouth ought to be cleansed after every feeding. This may be done by wrapping a two-inch square piece of linen or gauze, saturated with the mouth-wash, around the little finger and wiping every portion of the cavity—not far enough on back of the tongue to provoke nausea. If it is necessary to clean the throat, a small swab may be employed. For thorough cleaning of the mouth several sponges are necessary. These may be received in a piece of paper and at once burned. While cleaning the mouth of a delirious patient the nurse for her own protection must place some hard substance between the patient’s teeth. A rubber cork is the best, but if that is not available, a fork-handle may be used. Its prongs must be carefully wrapped to avoid an accident. If the cork is used, the nurse must hold it in place to prevent its falling down the patient’s throat. There are numerous preparations used for cleaning the mouth, as:

1. Listerin,f℥j;
Water,f℥ij.
Dobell’s Solution.
2. Borax,ʒss;
Sodium bicarbonate,ʒiv;
Listerin,fʒj;
Carbolic acid, 95 per cent.,♏ viij;
Warm water,f℥x.
3. Boric-acid solution,f℥j;
Alcohol,fʒss;
Glycerin,fʒj;
Tincture of myrrh,f♏ j.
4. Glycerin,
Water, of each,f℥ss.

The following three formulæ have been found excellent for special cases:

For Mucus-coated Mouth.
1. Sodium bicarbonate,gr. x;
Glycerin,fʒij;
Water, enough to make,  f℥ij.

If the coating be of long standing, thick and dry, this solution may be applied with an applicator every five or ten minutes for one hour, and then the cleansing may be done with sponges. In these cases it is necessary to use a toothpick to gently loosen the sordes between the teeth.

For dry or fissured lips and tongue, and for anointing the baby’s nose, the following will be found useful: