hours.

[CONSTITUTIONAL DISEASES 321]

Nursing.--The nurse must have the patience of Job to attend a patient sick
with this disease; but you must remember the suffering is awful. The
patient may be very restless and the pillows may need rearranging every
few minutes. Also be careful how you handle the patient. It hurts terribly
to be even touched. A rough, hearty person has no business to care for
such a patient. I allow patients to say anything they wish, for this is a
painful disease. They may swear at me if they wish. I know how it is, for
I was there twice, the last time for six long weeks. Have patience and
courage and cheer your patient. Do not look cross or scold.

Diet.--Milk mainly, broths, gruels, albumen water, oyster or clam broth,
milk toast, buttermilk, kumiss. Do not give solid food. Water, lemonade,
vichy or carbonated water.

CHRONIC RHEUMATISM.--Causes.--Heredity may predispose to it. It is most
common in those who are exposed to hard labor in the cold and wet;
especially in women about middle age. It occasionally follows sub-acute,
but rarely acute rheumatism.

Symptoms.--Many large joints are usually affected; sometimes it may be
only one joint; at times, the small joints only are affected. It may be
only on the one side. It usually persists in the joints involved, but may
attack others. The chief symptoms are stiffness of the joints, especially
after a rest and this diminishes after some motion, also pain, which grows
worse in damp weather. The joints may be tender to the touch, slightly
swollen, rarely red. They may in time become entirely stiff and deformed.
The general health may be good or there may be anemia, dyspepsia and
valvular disease due to sclerosis,--hardening of the valves of the heart.

Prognosis.--This is good as to life, but the disease is often progressive.

Treatment. Preventive.--A warm, dry, unchangeable climate, good
surroundings, good food; keep the stomach and bowels and kidneys in good
condition, avoid taking cold. Do not sit down in a draft to "cool off." Do
not go into a cool room in summer when you are warm or sweated. Do not
sleep in a bed that has not been used for months and kept for "company."
Do not dry your clothes in the kitchen and in that way make the whole
house steamy and damp. Do not sleep under unaired damp covers or in a damp
night dress. Always air and dry your bedding and night dress before using.
Do not take a hot bath and go into a cool room to