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."[3]

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 forms an important branch of the
education of a nurse. To manage fancy patients forms an important branch
of her duties. But the nursing which real and that which fancied
patients require is of different, or rather of opposite, character. And
the latter will not be spoken of here. Indeed, many of the symptoms
which are here mentioned are those which distinguish real from fancied
disease.

It is true that hypochondriacs very often do that behind a nurse's back
which they would not do before her face. Many such I have had as
patients who scarcely ate anything at their regular meals; but if you
concealed food for them in a drawer, they would take it at night or in
secret. But this is from quite a different motive. They do it from the
wish to conceal. Whereas the real patient will often boast to his nurse
or doctor, if these do not shake their heads at him, of how much he has
done, or eaten or walked. To return to real disease.

[Sidenote: Conciseness necessary with sick.]

Conciseness and decision are, above all things, necessary with the sick.
Let your thought expressed to them be concisely and decidedly expressed.
What doubt and hesitation there may be in your own mind must never be
communicated to theirs, not even (I would rather say especially not) in
little things. Let your doubt be to yourself, your decision to them.
People who think outside their heads, the whole process of whose thought
appears, like Homer's, in the act of secretion, who tell everything