In this country, generally, catarrh and coughs and pectoral complaints of all kinds, are most apt to prevail in the winter and spring months, while bowel complaints are more numerous and distressing in the summer. The mucous membranes of the air passages sympathize with the skin under the agency of external cold; those of the stomach and intestines under that of heat.
The thoracic disorders which commence or grow worse in the winter are often fatal, and there are various other maladies that are aggravated by cold, so that the mortality of winter is greater than that of summer. Bowel complaints are more prevalent at the latter part of summer or early fall, when moderately cold days succeed a long period of hot weather, the high diurnal temperature being the predisposing cause, and the cold exciting or bringing on the disease.
I shall not refer to other causes of disease except to say that if two persons marry each other who have a hereditary predisposition to disease, their children, if they have any, will probably not be healthy.
CHAPTER II.
SYMPTOMS OF DISEASE, WITH INSTRUCTION TO NURSES.
Symptoms are the signs by which we know that disease is present. Every circumstance happening in the body of the sick person capable of being perceived by himself or others, which can be made to assist our judgment concerning the seat or nature of the disease, its probable course and termination or its proper treatment, is a sign or symptom.
These phenomena are the evidence upon which the whole art of the physician proceeds. It is important that the nurse should know how to note the symptoms, not only that she may know how and report to the doctor changes that occur in his absence, but that she may be able also to minister to those who are suddenly attacked with sickness, and to judge whether in cases of slight indisposition it is necessary to send for a physician.
By arranging and comparing symptoms, and by noting the circumstances under which they occur, the physician can distinguish the disease, and learn what are the indications of treatment—this belongs especially to him. But it is very important that a nurse should know how to note all changes as they occur, and sometimes it is best she should keep a written record of them. An important point in a trained or skillful nurse is that of her ability to observe accurately and describe intelligently what comes under notice in the absence of the physician. She should cultivate the habit of strict observation, and simple and truthful statement—neither deficient, exaggerated, or perverted, stating facts and not opinions.
Symptoms or phenomena which accompany disease may be subjective, those which are evident only to the patient, or objective which are observable by others. Both sorts of symptoms shed mutual light on each other, and as the statements of the patient are not always trustworthy, the nurse should be careful not to let anything pass unseen that can by vigilance be noted.
The following directions will help the nurse to cultivate the habit of observing symptoms:
Try to learn all you can of the previous history of the case; you will sometimes get information which the patient would not be likely to communicate to the doctor in person.