-and known too among those--and _chiefly_
among those--whom money and position put in possession of everything
which money and position could give--I have known, I say, more
accidents, (fatal, slowly or rapidly,) arising from this want of
observation among nurses than from almost anything else. Because a
patient could get out of a warm-bath alone a month ago--because a
patient could walk as far as his bell a week ago, the nurse concludes
that he can do so now. She has never observed the change; and the
patient is lost from being left in a helpless state of exhaustion, till
some one accidentally comes in. And this not from any unexpected
apoplectic, paralytic, or fainting fit (though even these could be
expected far more, at least, than they are now, if we did but
_observe_). No, from the expected, or to be expected, inevitable,
visible, calculable, uninterrupted increase of weakness, which none need
fail to observe.

[Sidenote: Accidents arising from the nurse's want of observation.]

Again, a patient not usually confined to bed, is compelled by an attack
of diarrhoea, vomiting, or other accident, to keep his bed for a few
days; he gets up for the first time, and the nurse lets him go into
another room, without coming in, a few minutes afterwards, to look after
him. It never occurs to her that he is quite certain to be faint, or
cold, or to want something. She says, as her excuse, Oh, he does not
like to be fidgetted after. Yes, he said so some weeks ago; but he never
said he did not like to be "fidgetted after," when he is in the state he
is in now; and if he did, you ought to make some excuse to go in to him.
More patients have been lost in this way than is at all generally known,
viz., from relapses brought on by being left for an hour or two faint,
or cold, or hungry, after getting up for the first time.

[Sidenote: Is the faculty of observing on the decline.]

Yet it appears that scarcely any improvement in the faculty of observing
is being made. Vast has been the increase of knowledge in
pathology--that science which teaches us the final change produced by
disease on the human frame--scarce any in the art of observing the signs
of the change while in progress. Or, rather, is it not to be feared that
observation, as an essential part of medicine, has been declining?

Which of us has not heard fifty times, from one or another, a nurse, or
a friend of the sick, aye, and a medical friend too, the following
remark