r of her "coming in upon" him or
speaking to him, just at the moment when he finds it quite as much as he
can do to crawl from his bed to his chair, or from one room to another,
or down stairs, or out of doors for a few minutes. Some extra call made
upon his attention at that moment will quite upset him. In these cases
you may be sure that a patient in the state we have described does not
make such exertions more than once or twice a-day, and probably much
about the same hour every day. And it is hard, indeed, if nurse and
friends cannot calculate so as to let him make them undisturbed.
Remember, that many patients can walk who cannot stand or even sit up.
Standing is, of all positions, the most trying to a weak patient.

Everything you do in a patient's room, after he is "put up" for the
night, increases tenfold the risk of his having a bad night. But, if you
rouse him up after he has fallen asleep, you do not risk, you secure him
a bad night.

One hint I would give to all who attend or visit the sick, to all who
have to pronounce an opinion upon sickness or its progress. Come back
and look at your patient _after_ he has had an hour's animated
conversation with you. It is the best test of his real state we know.
But never pronounce upon him from merely seeing what he does, or how he
looks, during such a conversation. Learn also carefully and exactly, if
you can, how he passed the night after it.

[Sidenote: Effects of over-exertion on sick.]

People rarely, if ever, faint while making an exertion. It is after it
is over. Indeed, almost every effect of over-exertion appears after, not
during such exertion. It is the highest folly to judge of the sick, as
is so often done, when you see them merely during a period of
excitement. People have very often died of that which, it has been
proclaimed at the time, has "done them no harm."[17]

Remember never to lean against, sit upon, or unnecessarily shake, or
even touch the bed in which a patient lies. This is invariably a painful
annoyance. If you shake the chair on which he sits, he has a point by
which to steady himself, in his feet. But on a bed or sofa, he is
entirely at your mercy, and he feels every jar you give him all through
him.

[Sidenote: Difference between real and fancy patients.]

In all that we have said, both here and elsewhere, let it be distinctly
understood that we are not speaking of hypochondriacs. To distinguish
between real and fancied disease f