Every part of the foot should be free from pressure, so far as to allow a free circulation of the blood in the small est vessels. Some years 1 Fig. 24 represents an English dandy or exquisite of 1646. His hat with a sugar-loaf crown, a bunch of ribbon on one side, and a feather on the other. His collar edged with lace, a moustache about his mouth, cheeks dotted with patches; two love-locks, one on each side of the head, hanging down in front of the bosom, tied with bows of ribbon at the end. A tight vest partly opened, and between it and his breeches large folds of his shirt hang out. His breeches ornamented with many points at the knees, and above them great bunches of ribbon of various colors. His boot-tops so large as to require a straddling walk. СНАРТER II. VENTILATION LIGHT SLEEP EXERCISE BATHING. § I. VENTILATION. THE necessity of pure air to the preservation of health is admitted by all, and appreciated only by few. In the construction of dwelling-houses, the same want of regard to this subject, with here and there an exception, is manifest that existed forty years ago. In the northern parts of our country great pains is taken, by tight rooms and double windows, when they can be afforded, for shutting the air out, but no provision made in way of regular supply for letting it in. Very extensively in our farming districts the open fire-place, sometimes broad enough for a rousing fire of wood four feet long, besides a row of children inside the jamb, has given place to the close iron stove. The large open fire, when in brisk action, secured an adequate ventilation, while the close stove requires only air enough for the combustion of the fuel within. One stove often answers for the whole family, during the cold season. The warming, cooking, and washing are all done in one room. The exhalations from the cookingvessels, and from the lungs and persons of the whole family, are all mixed together, and breathed over and over, to sustain the movements of life. Is it to be wondered at that consumption is, as I am assured by some of my friends, far more common among the Green Mountains of Vermont than it was twenty-five or thirty years ago, before the close stove was generally used, as now, instead of the open fire? In our cities and large villages many a lady, who has the windows of her sleeping rooms opened for a short airing once a day, supposes that nothing more is necessary for the twenty-four hours. Speak to her on the importance of ventilation, she agrees with you, remarking that her chambers are always ventilated every day. How surprised she would be, on being assured that seven to ten cubic feet of air per minute to each individual in an apartment should be admitted, in order to maintain its atmosphere in a state fit for healthy respiration. In sickness, no sanitary influence is of more value than pure air. This is especially the case in fevers. In typhus, typhoid, and eruptive fevers, the exhalations from the bodies of the sick are sometimes so intense as to cause nausea and vomiting among the attendants. Soon after I commenced the practice of medicine, I had a patient, sick with typhoid fever, who was ill cared for, in a badly ventilated room. At one of my visits I inhaled effluvia so offensive as to create a nausea that lasted two hours. Within five days I was attacked with a similar form of fever, which confined me to my chamber for six weeks. Some years since, at Baltimore, I received a horrid impression, which I can never forget, from looking into a room, apparently wholly unventilated, containing ten colored men with small-pox. In one of our large. cities I was requested to look in upon my friend, the Rev. Dr. who, I was told, was sick with scarlet fever. I found him in his bed, which lay up snug in one corner of the chamber, although it was a large one. He was surrounded by bed-curtains, with an opening sufficient to allow his friends to peep through and see him. I left the chamber with the impression that he would die of that sickness, as he did. In unpromising cases, the favorable change in the symptoms, when the patient, sunk and apparently near to death, is transferred to a cleanly and well-ventilated apartment, is sometimes very striking. In the winter of 1837-8, while occupied at the Fairfield Medical School, Herkimer County, New York, I was requested to visit two patients, sick of typhoid fever, which for several weeks had prevailed in that neighborhood. One was a girl of sixteen, whose life was despaired of by her physician. She lay in a small bedroom without a window, the door of which opened into a larger room warmed by a close stove, the smoke-pipe of which communicated with the chimney through a fire-board that shut from the room a large fire-place. The poor girl lay unconscious, the mouth open and dry, the eyes half open, turned upward, motionless and glassy. I made a remark that the prospect for life of the patient, in that small place, with little else to breathe but the steam of her own body, was to my mind very much like that of the persons whose bodies had recently been laid in the burial-ground hard by. This remark, if it seemed harsh, had the effect to promote a ready observance of the suggestions which followed. She was to be removed to a clean bed in the large room, the stove and fire-board to be taken away, and a brisk fire made upon the hearth, as the weather was then cold, the patient to be fed, in the small way, with diluent and farinaceous drinks, and to be covered with sufficient bed-clothing. In two or three hours consciousness returned. This was in the afternoon. She slept sev eral hours that night, was comfortable the next day, and had a rapid recovery, almost without medicine. The other patient, in the same house, a student of the Academy, had been sick several days, — his case not very unpromising, except that he had been daily getting rather worse. He was in a small chamber, warmed by a close stove. This and the fire-board were removed, and the room kept well ventilated. He, too, recovered under good nursing. How impotent is medicine in such cases, compared with pure air. Dr. Thayer, in his Report on Practical Medicine, read at the annual meeting of the New Hampshire Medical Society, in 1858, remarking on the importance of ventilation in the treatment of disease, refers to the case of a large number of "emigrants, who arrived at Perth Amboy, from Liverpool, with ship fever, and who, for want of sufficient accommodation, were placed in shanties where they were exposed to the pure air, the buildings being so loosely constructed that they admitted the rain. Of the whole number of eighty-two patients not one died; of four others, who were removed to an ordinary dwellinghouse, and who were subjected to precisely the same medical treatment, two died." 1 "The deaths of new-born infants, between the ages of one and fifteen days, which, in the Dublin Lying-in Hospital, amounted in the course of four years to 2944 out of 7650 births, were suddenly reduced to only 269 deaths during the same period, after a new system of ventilation had been adopted."2 1 Dr. Watson refers to an epidemic fever in Ireland, where "the mortality among the patients, who were placed in sheds upon straw, and left with very little medical attention, and even without any great personal attention from others, was very small indeed." — Lecture 86. 2 Blackwood's Magazine, Sept. 1828. |