Mother, Nurse and Infant / A Manual Especially Adapted for the Guidance of Mothers and Monthly Nurses, Comprising Full Instruction in Regard To Pregnancy, Preparation for Child-birth, and the Care of Mother and Child, and Designed to Impart so Much Knowledge of Anatomy, Physiology, Midwifery, and the Proper Use of Medicines as Will Serve Intelligently to Direct the Wife, Mother and Nurse in All Emergencies.

by S. P. Sackett

Another important quality of the pulse is its hardness or compressibility. The hard pulse ordinarily, though not always, indicates inflammation. This hard pulse may be known by pressing pretty hard with one finger, while we observe with the others whether we arrest or abolish the pulse.

A pulse is said to be full or large if it is felt to strike a large portion of the finger; other departures from the normal standard are spoken of as soft, quick, or sharp, throbbing, bounding, thready, wiry, flickering, &c.

OF THE TEMPERATURE.

The normal standard of the temperature of a healthy person is 98.4°. There is some variation, and indeed a daily cycle of variations, so that in the morning it is 99 or at least 98½ and in the evening 97½, but the range is small, and if the variation is more than that, it is indicative of disease. There is only a deviation of about 15° within which life can be sustained; a temperature of more than 107° or less than 93° will almost certainly prove fatal.

Every mother who can, as well as every nurse, ought to own a clinical thermometer, as thereby she may detect the beginning of a disorder before there are other marked signs of indisposition. She should use it upon the first suspicion of a departure from health and frequently afterwards, until she knows that the temperature is normal. An increase, especially if beginning each day a little earlier, is a bad indication; a decrease from a high temperature each day is a sign of improvement. In pneumonia and generally in such disorders as are initiated with a chill, the rise is sudden and rapid.

In typhoid and some other fevers, the elevation is slight at first and gradually rises. The exacerbations and remissions or other deviations can only be recognized by taking the temperature frequently, and it should be taken at the same hour each day to exhibit the cycle of changes.

An irregularity of temperature in the course of a disease that has a regular type may indicate a complication, or it may depend upon local causes, such as constipation, bad air, &c. The decline of fever and of temperature may be gradual, or it may drop to a steady normal within a few hours.

Before using the thermometer the index must be thrown down to a point below the normal. Hold it with the bulb down and shake till it falls sufficiently.

The part (the axilla) should not have been exposed for washing for at least half an hour before taking the temperature, and it is a good precaution to keep the axilla (or mouth) closed for ten minutes before putting the bulb of the thermometer into it, and a little time may be saved by slightly warming the bulb in the hand before its introduction. If we are careful and see that the axilla is first dried from perspiration, and that the clothing is not in the way, and that the thermometer is held firmly in position a sufficient time, we may get a correct axillary temperature, unless in a very emaciated person. If taken in the mouth the lips must be closed during the process.

The rectum gives the most reliable temperature, and this method is employed for infants. The thermometer should be oiled and introduced for about two inches. Unless the presence of feces prevent, the thermometer will be half a degree higher than if taken in the axilla. It will sometimes take ten minutes or more to obtain the temperature, but some thermometers will do the work in less than five minutes.