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Clymer Diary Vol. 1

[Cover] Volume 1

[inside front cover] Volume 1

[page 1r V.1] Mary V. Clymer

[page 1v V.1] blank

[page 2r V.1] Principles of Antiseptic The methods directed against purte or spoil of the dis. in wounds ferments applied to sugar will s... — [page 2r V.1] Principles of Antiseptic The methods directed against purte or spoil of the dis. in wounds ferments applied to sugar will set up alcoholic & carbonic acid animal fluid like blood protected from the entrance of these bodies it will keep sweet & pure if we put beef tea blood [illegible] urine out to the air it will Decomp. & be offensive by the entrance of bacteria If preserves are not covered at once little bodies

[page 2v V.1] will enter, urine if exposed will smell but boil it & put a cork of Bach. cotton & it will keep. Beef tea will do t... — [page 2v V.1] will enter, urine if exposed will smell but boil it & put a cork of Bach. cotton & it will keep. Beef tea will do the same the cotton filters it & keeps the microbes out. There is something floating that we can’t see which if introduced will cause putrefaction. always act as if one knew. 90,000 of them to the cubic yard of hospital air. 15,000 in the st. only places not found is in mid [symbol]. or on mountain heights. Various things are used to kill them they increase very rapidly

[page 3r V.1] If brought in contact with something to kill it remains the same then shrivels [illegible] Br. lear. Iodoform these lear. i... — [page 3r V.1] If brought in contact with something to kill it remains the same then shrivels [illegible] Br. lear. Iodoform these lear. is volatile & in a weeks time it will all be evaporated. Bi. causes irritation Iodo. not as active as others but when wet is very good. These kill. Prevent to them from entering or kill them as soon as they enter the wound. Pyemia Sep. Ery. Haspi. San. these may enter through care. & enter the blood & cause poisoning

[page 3v V.1] Lister lost 30-40 before Antisepticise. 64 as soon as he had a glimmering of these bodies. then went to 15 in a few years h... — [page 3v V.1] Lister lost 30-40 before Antisepticise. 64 as soon as he had a glimmering of these bodies. then went to 15 in a few years he lost ½ of 1 per-cent. Same kind as we have here. 1-500 Boracic is valuable but not so active as the other. Often carried by the surg. fingers. Instruments not clean surgically clean washed first then dipped in solution not wiped on a dry towel. & instruments must not be laid on anything dry. The skin of a beast case contains Hundreds of them

[page 4r V.1] First use soap & water then alcohol because soap & water don't pen- far enough (or either) then use 1-20 or Bi. 1-5... — [page 4r V.1] First use soap & water then alcohol because soap & water don’t pen- far enough (or either) then use 1-20 or Bi. 1-500. Or 1-1000. 1-20. in 1-500. Car more penetrating B. kills instantly Car will go farther. Always do this some hours before then cover with or towel wet with this . If Bi. was not so imperious it would be best to put instruments, Car does not have this effect Dripping in Car is not enough must be in them 10-15-20 Surgeon sees to instrument then washes his

[page 4v V.1] hands as we have prepared. (Put on an Anti) then wring out the towels & cover all around where he may lay his instrum. ... — [page 4v V.1] hands as we have prepared. (Put on an Anti) then wring out the towels & cover all around where he may lay his instrum. Be sure no tape is hanging & help the surgeon to remember. Sponges ought never to be used twice as they can be pre- carefully by the nurse. Do not have them sitting around the ward dry as dressing must be kept moist in glass or in tin cans. Do not drain ligatures over any dry surface. but see that they are kept moist. Wet your hands ever time you touch anything dry.

[page 5r V.1] Dressings must not be laid down on anything dry. But kept moist. If much oozing rein as the blood comes in quantity it will... — [page 5r V.1] Dressings must not be laid down on anything dry. But kept moist. If much oozing rein as the blood comes in quantity it will be dissolve all the Bi. & it will spoil. If not done at once instead of healing by first in. we have suppera & fever- use gause or Bi. cotton & lay over the spot of blood and you may save the case. When the time comes for the Sur. to come see that everything is as clean as at the oper. As the danger is the same until the wound is healed near the surface. To clean first use Iodo. to fill all the china

[page 5v V.1] their protective or wax paper- wet in the Bi. The Bi. will soon be gone & it protects from the gauze which is full of B... — [page 5v V.1] their protective or wax paper- wet in the Bi. The Bi. will soon be gone & it protects from the gauze which is full of Bi. Pro. ought not go over the tube wiring the deep out this ought to cover 3 or 4 inches over the wound have a moist Superficial then cotton & last of all the bandage. The ends of the tube should be carefully covered with lots of gauze & cotton so that all of the discharge will be purified. In all cases of excision

[page 6r V.1] Oct 30th Dr. Harti On the Care of Burns Burns & sclads where it is solid it is burn. Vapor scald usually by artificial ... — [page 6r V.1] Oct 30th Dr. Harti On the Care of Burns Burns & sclads where it is solid it is burn. Vapor scald usually by artificial means, sometimes solar, the extent or burn from water extends over more than oil clean worse, Liquid metals are called scalds but wrongly, it is the same as solid. Burn, the hair is burned. In scald the super hair is intact. Classed according to the extent of the depth in the tissues. French E. Reddening of the skin Cuticle is involved skin is roused

[page 6v V.1] Epidermis 5 Tissue Muscles All the way to the bone Simple & Complicate by Gross Agnew 4. 1 Simple Red 2 Vessication is ... — [page 6v V.1] Epidermis 5 Tissue Muscles All the way to the bone Simple & Complicate by Gross Agnew 4. 1 Simple Red 2 Vessication is a blister filled with serum 3 Skin destroyed & tact comes off in a slough. 4 all the way to the bone. Redness the small vessels become parlay. 3 completely paral & serum & red carpers 3 it forms a slough

[page 7r V.1] by deficient blood supplies 4 all Pain is caused by burning the roots of the nerves in slight ones worse often than bad one... — [page 7r V.1] by deficient blood supplies 4 all Pain is caused by burning the roots of the nerves in slight ones worse often than bad ones as in bad the nerves are destroyed. Ways in which burns occur. Carelessness with coal oil & matches Vats exposed Signus constitutional of burns. The extent is if more than one third of the body is covered every dangerous. A small portion burned badly not as bad as if burned over a large surface. Children & old people

[page 7v V.1] bear burns badly. Trunk worse than extremities as the viscera are near the skin. Shock is as bad in burns- pulse is rapid — [page 7v V.1] bear burns badly. Trunk worse than extremities as the viscera are near the skin. Shock is as bad in burns- pulse is rapid & feeble. Breath rapid & feeble. Body cold & complain of cold. Stomach is irritable & rejects food. Suffer very little on account of In this condition die. Shock reaction & state of inflame temp rises, like after operations. Die in this stage as result of Pneumonia Duodenum ulcer not known why

[page 8r V.1] but one out of five have this. It may perforate & cause peritonitis, Bloody stools vomiting of blood. This occurs from ... — [page 8r V.1] but one out of five have this. It may perforate & cause peritonitis, Bloody stools vomiting of blood. This occurs from 10-15 day after. Inflammatory fever has set in. Many die from shock- 111 shock- suppr- stage- 33- From sloughing [illegible] Treatment first shock dry heat- Temp- as low as 92- Hot cloths or stipe on abdomen if not burned- Internal. There is tendency to congestion as liver & other organs suck blood up like a sponge.

[page 8v V.1] Ammonia is the most rapid_ Whisky_ Digitalis very slowly. Ammonia on a towel first to one nostril Carbonate of Mucillage of... — [page 8v V.1] Ammonia is the most rapid_ Whisky_ Digitalis very slowly. Ammonia on a towel first to one nostril Carbonate of Mucillage of cassia 5-10 gram every 15- Whiskey in small quantities & warm both may be given hypo- when the stomach will not return- Return egg turpentine & [blank] Opium for [illegible] a gr Morphia Suppository may be given. Local help air from the part ointments & oil of all kinds. Oxide of zinc is good. Sweet oil on Lint or cotton. Carron “ [oil] Lime water

[page 9r V.1] & sweet oil beaten up together so called in Scotland iron works. Cold water is good for a slight burn. their take from ... — [page 9r V.1] & sweet oil beaten up together so called in Scotland iron works. Cold water is good for a slight burn. their take from water & put on oint. Put on a bandage with pressure as it supports blood vessels. Oiled silk or wax paper. Linseed oil is better but objectionable on account of smell better because it forms a film over the burn skin in 24 hrs. Time to dress as along as it smell sweet leave it alone. Only expose a little at a time. Then use Car. or Bichlor. Permanganate is safest- Trickle the solution over it as it

[page 9v V.1] is cut the blebs with scissors let out the serum & let the skin drop back in its place sometimes it adheres. envelope i... — [page 9v V.1] is cut the blebs with scissors let out the serum & let the skin drop back in its place sometimes it adheres. envelope in cotton. If it makes an ulcer where the bleb was ulcerative process must come before enactive healing begins at the sides- sometimes granulations grow too fast & bleed. Put sticking plaster over the ulcer. Always use surgeons lead plaster not rubber as it irritates. Under the knee or joints may contract from the extension contraction, watch the position & keep the limb straight & apply on

[page 10r V.1] extension for the leg arm on splint- keep head up- Skin drafts may be made to a healthy ulcer. this will usually unite in ... — [page 10r V.1] extension for the leg arm on splint- keep head up- Skin drafts may be made to a healthy ulcer. this will usually unite in 24 hrs. these cells may be scarped not always successful but drafting is. Not so liable to break & form new ulcers as the skin is strengthened. There sometimes form cancers. To remove clothing try & not tear or carry away the skin- better to cut the clothes off & life him out of them

[page 10v V.1] Nov. 6th Dr. Seiler On the care of the nose & throat in sickness & in health (upper air passage) child cold in the... — [page 10v V.1] Nov. 6th Dr. Seiler On the care of the nose & throat in sickness & in health (upper air passage) child cold in the head can make them comfortable our part. Drs. to assist nature in recovering. Have to know they act (chouza is a cold) & what they have to do- immerse importance the work they do. The gullet or upper part of the throat leading to the nasal cavity. The septum is the cartilage the lower part is called the respiratory portion above is olfactory because the nerves of smell cover the mucous mem_ over the turbinated bones covered

[page 11r V.1] with sponge a hole over the eye brows called the frontal sinus back is the sphenoid covered cavities between the bones upp... — [page 11r V.1] with sponge a hole over the eye brows called the frontal sinus back is the sphenoid covered cavities between the bones upper lower & middle leading into the air passages- All the nasal cavity lived with mucous mem- nostrils is lined with skin. This sponge has arterial blood with out capillaries all animals breathe through the nose- a baby does not know how to breathe through the mouth. The nose is the organ to breathe through because it prepares the air to be received filters the air of the dust by the

[page 11v V.1] hair which keep it from the lungs finer is caught by the mucous secreted by the mem- second the curled bones form a large ... — [page 11v V.1] hair which keep it from the lungs finer is caught by the mucous secreted by the mem- second the curled bones form a large surface for the air to pass over. This spongy tissue has the faculty of the watery portion of the blood & pass down the throat & passes down into the stomach. This maintains the air. & warms it by going over this warms it it is a sentinel by smell purifies moisture & warms. Throat what we can see. Uvula- Palate, pillows, back of this is a smooth wall when tonsils come forward so you can see it they are

[page 12r V.1] diseased a cheesey substance dig it out if it will come off easily without bleeding there is danger in this as theses smal... — [page 12r V.1] diseased a cheesey substance dig it out if it will come off easily without bleeding there is danger in this as theses small particles form bacteria by the million more & throat should be kept aseptic. Larynx is below the epiglottis is over the windpipe to keep foreign bodies out there is two pair of bands under the epiglottis & keep the food out in incubation a tube is put between the epiglottis & these bands below the ventric is more bands which are acted on by the air & so we have voice if these chords are

[page 12v V.1] swelled we get hoarse. Larynx regulates the breath in speaking & in singing, voice regulation & the breath in voca... — [page 12v V.1] swelled we get hoarse. Larynx regulates the breath in speaking & in singing, voice regulation & the breath in vocalization prevent food from going in. Fever patients breathe through mouth because it is swelled & the air foes not absorb the secretions. Temper. is raised by breathing through mouth as the lungs do not take up the air spray out the throat even if delirious make a solution that will resemble the fluid. Spoonful of soda one of salt tables poured glycerine thymol or any anti- mild add to a quart of water &

[page 13r V.1] cleanse easiest way to let sniff it up the nose & gargle & it will relieve children or delirious must do it oursel... — [page 13r V.1] cleanse easiest way to let sniff it up the nose & gargle & it will relieve children or delirious must do it ourselves with an atomizer until the solution runs out behind do not scratch & start bleeding as this may course perforation of the septum. Syphilis said but not so as this comes will attack bones before cartilage only but inside the nose & throat the same never put powder in the nose as it may stimulate but reaction will come & cause catarrh- the turbine tissue & even the bones decay only way to get out is to gradually

[page 13v V.1] Stimulated by cleanliness so they may be restored. Powder may be used for the tonsils- to apply wrap paper around a pencil... — [page 13v V.1] Stimulated by cleanliness so they may be restored. Powder may be used for the tonsils- to apply wrap paper around a pencil & stick if you can put powder in the paper & squirt with the atomizer- prefer a paper tube to any kind in Laryngitis how shall we apply cold to a child simpler may get a piece of rubber tubing put around the throat put bucket of ice water up & one under the bed- suck the air like a vinegar tube sew it around inside of a cap bring soak in paraffine

[page 14r V.2] paper or grill or glass tube Take care of ourselves fresh air carbonic acid gas is injurious. Diph. or croup have steam — [page 14r V.2] paper or grill or glass tube Take care of ourselves fresh air carbonic acid gas is injurious. Diph. or croup have steam & keep temp above what the room ought to be make a tent of netting & pin two sheets- put your thermometer inside & pump out the carbonic acid & be comfortable wash with cold water. The neck is where we take cold- have a big sponge squeeze it out over the nape of the neck.

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[page 15v V.1] Dr. Edwards Nursing of sick children The feeding of the sick This is fully ½ of our duty the enormous importance of it nu... — [page 15v V.1] Dr. Edwards Nursing of sick children The feeding of the sick This is fully ½ of our duty the enormous importance of it nurse must be observant & note the effects of prescribed diet. expect us to know when not to give it if we have tact we may give more in 24 hrs. 2 groups- 1 starches sugars & fats 2 of albumen white of egg & meats 3 water acts the part of food 70 per cent of body in fever require more than usual. aids digest & helps carry food to body & nourishes. 2-3 week stupor & want of atten- extends to fevd & drink we must supply this need & give it, the

[page 16r V.1] value has been overlooked in most cases of fever Dr. prefers food be restr- in amount & kind. In begin prefer milk. — [page 16r V.1] value has been overlooked in most cases of fever Dr. prefers food be restr- in amount & kind. In begin prefer milk. “ [In] Ty- this diet from beginning to end or until fever is done. In Med- Sur- & Obst- 86 per cent water With 5 “ [per cent] Albumen 10 “ [percent] sugar & butter 2 classes of food well represented & water in addition, Ability of success depends on the way we can give them milk. If patient hates it say we will not give it give skim or buttermilk. In certain con- of digest- whole milk cannot be borne lime water 2 table- & the tumbl

[page 16v V.1] see at once the nourishment is dependent on this article see that it is pure & fresh 2 daily fresh vessel with cover p... — [page 16v V.1] see at once the nourishment is dependent on this article see that it is pure & fresh 2 daily fresh vessel with cover put in the refrigerator supervise this ourselves. In the last five years food may be digested before giving (Pepton- or predigested food). Pancreatine 5 grs- good extract 15 grs of ba-soda 2 tables- of water- add to 1 pt of milk put it in a clean bottle keep it at lukewarm temp 100- 20 minutes usually requires becomes bitter as soon as it is digested different preparations require different time

[page 17r V.1] as soon as it is comple lid put it on ice & stop further digestion. If object to bitter remove a few minutes sooner. D... — [page 17r V.1] as soon as it is comple lid put it on ice & stop further digestion. If object to bitter remove a few minutes sooner. Do not always tell them what you do. Along with these starchy foods mixed with milk Arrowroot boiled flour put it in a bag & boil for 10 hrs. bake for 10 more grate & put 2 or 3 table- in milk Kourmiss is valuable this is milk ferments 1 pt milk A little sugar tablespoonful small piece of Fleisch- yeast cork the bottle & put it in lukewarm water for 10 or 12 hrs, or a bin Champagne. Put it in a cold place if it is very acid apt to disagree

[page 17v V.2] Oat meal may be used with digested milk little points if small quantity to be given use small cup- very cold or very hot m... — [page 17v V.2] Oat meal may be used with digested milk little points if small quantity to be given use small cup- very cold or very hot milk make the very cold & they think it is not hot the name- Glass tube while lying- cups with nozzle very useful sensibility is very much heightened. Handle on cup will often take more. In fever like typhoid how much to sustain life- quantity kind & time note Temperature of room is watched can live on a pt a day for a short time, 3 will retain strength & flesh- above this adds

[page 18r V.2] Convalescence appetites are so strong requires all our skill to keep from overeating- add to milk & arrow- bread toast... — [page 18r V.2] Convalescence appetites are so strong requires all our skill to keep from overeating- add to milk & arrow- bread toasted cut them & soaked in milk. Oysters remove the hard part. This period administer cautiously & exper- examined seem to be very nutritious but disagree with many. White is more delicate yolk contains not less than 1/3 buttery substance give while in milk or poached in hot water. Food substance when taken into body maintains life & produces flesh- Taking proper amount of milk

[page 18v V.1] add alcohol & it will assist. In Ty- can take very much from 2-4 others requires 16-20 oz. cannot say how much first p... — [page 18v V.1] add alcohol & it will assist. In Ty- can take very much from 2-4 others requires 16-20 oz. cannot say how much first place the expirations of breath if notice it 2 or 3 hrs. after giving 2 if restless 3 secretions by mouth become dry One of the most acceptable is wine whey Where vomiting is constant can often give teaspoon fill of this 1 part sherry wine to 4 of milk make

[page 19r V.1] & put away like milk. Other cases of irritable stomach crushed ice with whey. Dry Champagne with crushed ice. Carbonic... — [page 19r V.1] & put away like milk. Other cases of irritable stomach crushed ice with whey. Dry Champagne with crushed ice. Carbonic acid mixed with milk is often used. Syphon of this 1/3 to milk Do not keep the basin where it can be seen. Food by mouth is impossible by mouth Inunction of oil into skin serve a good purpose 1 Olive oil 2 cocoamine butter melts readily at the temperature of the body. Be sure to have

[page 19v V.1] It fresh 1-2 ounces may be rubbed in so it will entirely disappear Nutritious Enemas Syringe 4 ozs- Hard rubber one is not... — [page 19v V.1] It fresh 1-2 ounces may be rubbed in so it will entirely disappear Nutritious Enemas Syringe 4 ozs- Hard rubber one is not desirable. One can be made of metal entirely under control of one hand. For injection milk is preeminent. 1 give 1 or 2 ounces increase as patient becomes habituated to its use increase the value by adding cream ½ ozs 2 or 3 teas of brandy may be given to stimulate Enormous importance to have rectum return enema- care in admin-

[page 20r V.1] care in [illegible] if irritability begins diminish the quantity & frequency brandy is a local irritant & will oft... — [page 20r V.1] care in [illegible] if irritability begins diminish the quantity & frequency brandy is a local irritant & will often cause the whole to be rejected 2 of pep milk ½ ________ cream 2-3 teas- brandy every 4 or 5 hrs. Blood is not much emphazed. Broths beef tea & mutton “ “ is strim- does not give flesh but stimulate for the time. Just bottle in cold water & bring it to boiling point never boil allow it to strand for 1 hr.

[page 20v V.1] Baked Potato- Brush or cloth to remove sand. Singe thoroughly. use spirit lamp- often at the back of the neck. Draw & ... — [page 20v V.1] Baked Potato- Brush or cloth to remove sand. Singe thoroughly. use spirit lamp- often at the back of the neck. Draw & cut it up as Mother taught one. Open birds as I known Potato 46 per cent water. in winter put them on in boiling water all green vegetables must be cooked in hard water. one teaspoonful of salt to quart will make it soft add Bicarb soda ½ teaspoonful to the gallon for all dry vegetables to pan a bird put the salt in bottom of pan & baste it while it is cooking. Never use butter unless you know it is allowed- add a little butter when it is done.

[page 21r V.1] 1 tableson of butter one of flour mix or rub together until you have smooth paste, add ½ Pt milk stir it continually unti... — [page 21r V.1] 1 tableson of butter one of flour mix or rub together until you have smooth paste, add ½ Pt milk stir it continually until it boils. We always want corbonac food in health- 4 times as Nitrogenous in disease as the heal tissues waste Broil 5 minutes for rare 8 well done Never boil flax seed tie 2 tablespoon in [illegible writing along the sides] thin piece of cloth & dip it in & out of the water until it becomes mucilaginous

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[page 22r V.1] Diet Recollect that every old woman & patient knowns more Rules that apply to the majority flex to suit the patient. W... — [page 22r V.1] Diet Recollect that every old woman & patient knowns more Rules that apply to the majority flex to suit the patient. What is harmless to one is injurious to other Principles of Digestion begins as soon as food enters the mouth- Salivary glands emphasis saliva in the mouth chewing makes them secrete. This is present when in health a normal condition. In fever the salvia is less. The stomach is an organ of various size. The gastric juice is secreted by the stomach & between digest it is empty. In febrile condition this is diminished. If the we should not

[22v V.1] take food when tried as it will not digest. This is acid in reaction & a sour stomach is caused by fermentation caused by t... — [22v V.1] take food when tried as it will not digest. This is acid in reaction & a sour stomach is caused by fermentation caused by the absence of this juice. If we give a very sweet drink & to Phthisis- if we don’t give sugar it will not fervent- like egg nog- condensed- milk the 1 fluid will is not present. The di. goes on in the intes. 18 ft of small 4-5 in large- this is largely done in the small in Pancratic- & the intestinal juices- Bile comes from the liver & empties high up in the small. All food that digestion does not begin

[page 23 r V.1] In the mouth is done in the small- Absorption is done by the large intestine. When feeding by rectum give food that has b... — [page 23 r V.1] In the mouth is done in the small- Absorption is done by the large intestine. When feeding by rectum give food that has been predigested as it is only by absorption. This can take place injuriously. How harmful constipation is. Add the foods that are digested Mouth digests starchy foods rice potatoes vegeta starch is not digested in the stomach. Pancreas acts on starch & creates it into grape sugar. Sugars are di. in the mouth cane sugar converted into grape sugar. Fats are di. in the small intestine by pancreases &

[page 23v V.1] bile. If in disease of pancreas stools are examined to see if bile is deficient by the presence of fat. Starch is not dige... — [page 23v V.1] bile. If in disease of pancreas stools are examined to see if bile is deficient by the presence of fat. Starch is not digested tell by fullness of stomach. Principal food of the body are di. in the stomach. The albuminoids meat milk, & eggs, fish. These are the constructive food of the body one may starve upon (starches supply largely the heat of the body & tend to make fat so are fats. The albuminoid are the foods for the sick. We require a mixed diet & so this animal is omnivorous. To increase

[page 24r V.1] digestibility. In fever we must remember these juices are deficient. In other disease medicines are given to evoke these s... — [page 24r V.1] digestibility. In fever we must remember these juices are deficient. In other disease medicines are given to evoke these secretions. Take food that will be of the best advantage. The reason milk is rejected is the caseine forms a clot & is rejected. It is the object to get rid of this substance. Goats milk has much less caseine- Peptonized milk expels this caseine this is pre- & is a favorable way to take it one other objection is it is not good to depend on as it makes the stomach useless use temporarily in diarrhea- fivers

[page 24v V.1] lime water may be given even one half may be given it is not good to use an alkali like lime for a long time. Skim off the... — [page 24v V.1] lime water may be given even one half may be given it is not good to use an alkali like lime for a long time. Skim off the cream & add it as we see they can digest it. Add a little salt if stomach resents fat salt forms a chemical change with bile- Buttermilk- Give malt sometimes before food- maltine mixed with is goof malted milk is an article that may be good but we must not rely on these artificial or prepared

[page 25r V.1] In diarrhea with children or adults this is good. Weigh out patients & we can tell. Boiled milk & skimmed is good.... — [page 25r V.1] In diarrhea with children or adults this is good. Weigh out patients & we can tell. Boiled milk & skimmed is good. Mix milk with starches this prevents coagulation & promotes the digestion. If fed up or concentrated food for a long time the bowl is not distended & so there is not enough contraction of the bowel. All milk as soon as it enters the stomach is enabled by each curd is as separate as flakes of snow Condensed cannot be given to adults for a long time as it is too sweet fit for

[page 25v V.1] children under 6 months. Adults for a short time. Cooking of albumen spoils it just in portion to the time we cook it. Bro... — [page 25v V.1] children under 6 months. Adults for a short time. Cooking of albumen spoils it just in portion to the time we cook it. Broths are only a pleasant change & only a very limited food. If mixed with rice or barley water we get a Mutton. Chicken or Beef tea- always use under done or rate meat. In diarrhea we can give meat in this way if not suffering with fever- Scrape with a knife Neurasthenic subjects can take this Starches should not be given to patients whose digestion is

[page 26r V.1] impaired Rheumatoid Arthritis Feeble- Cook it well as this breaks up the starch & helps digest it. Throw it aside enti... — [page 26r V.1] impaired Rheumatoid Arthritis Feeble- Cook it well as this breaks up the starch & helps digest it. Throw it aside entirely in fever so should sugar/yolking is more likely to create indigestion than sweet lemonade or punch Do not give fat in fever- C. L. O. in fever from Phthisis Water is never objectionable unless too cold. Ice water reduces digestion & water enables Wine is not good for nearly all the red wine turn sour & ferment. The only one champagne. It contains carbonic

[page 26v V.1] it excites the nervous & is a feasible stimulant Use dry- Alcohol is a food &stimulant only prevents our system fr... — [page 26v V.1] it excites the nervous & is a feasible stimulant Use dry- Alcohol is a food &stimulant only prevents our system from wearing out quite so fast & it quickens circulation. In chronic cases it no good as In acute disease we can use it but not in chronic It reduces the gastric juice in concentric well dilute it to present irritation. After Hem. from any cause or after ether- nausea- from want of blood in the brain- then give it concentrated- Put Brandy on cracked ice

[page 27r V.1] Dr. Deaver On the administration of Anesthetics, collapse- shock & anything else that happens

[page 27v V.1] Pulmonary diseases by Dr. Musser Lungs alone Bronchial tubes lung structure & Pleura all of them have separate disease... — [page 27v V.1] Pulmonary diseases by Dr. Musser Lungs alone Bronchial tubes lung structure & Pleura all of them have separate disease. Acute & chronic bronchitis & asthma, spasm, of these tubes. One disease of lungs is Pneumonia Plenary of the Pleura is the membrane that lines the chest, water in this- pus or empyemia - & air. In children cold causes bronchitis- quick breathing little cough & prostration stupor that cannot be cured. feet become cold, lips drowsy. It develops so gradually that one hardly notices it. This is also known as suffocated catarrh under three months this is very fatal. Old people Pne. dis. develops

[page 28r V.1] Differently from adults not with quick breath fever & pain in the side. Passive congestion low form of weak heart Old ... — [page 28r V.1] Differently from adults not with quick breath fever & pain in the side. Passive congestion low form of weak heart Old or insane the symp. may be a little increase in breathing, cough little fever at night restlessness appetite off drowsy- Pulse does not increase necessarily so that we cannot always judge by that. If tongue becomes dry & brown we may be sure that a low form of pneumonia is progressing. We must always tell as soon as we see these symptoms. There are 4-5 common symp. to all three diseases (in addition we have hemorrhage)

[page 28v V.1] pain cough shortness of breath & hemorrhage. Consumption or tuberculosis Bronchitis is an inflammation of the bronchia... — [page 28v V.1] pain cough shortness of breath & hemorrhage. Consumption or tuberculosis Bronchitis is an inflammation of the bronchial tubes. We can do many things for cough this is a very trying symptom to infants old people & debilitated. For a hacking cough hot water or a little whisky in hot water. Flax seed tea irish moss- Sometimes inhalations of simple things, Gum Arabic water, Add lemon to flax seed & moss. Compound tinc of benzoin or Turlingtons balsam put a teaspoonful on top of hot water, creasole may be used. These two are the

[page 29r V.1] best that we can use. Applications to the chest mustard, flannel or hot plate put on the chest Poultices should only be us... — [page 29r V.1] best that we can use. Applications to the chest mustard, flannel or hot plate put on the chest Poultices should only be used under Drs. care. The dangers arises from the moisture. A hot water bag is one of the best ways to relieve cough or irritation. Medicines Anodynes are bad both for little ones & old people, this depresses the nerves of respiration & are they are using every effort to get oxygen as there is too much carbonic acid gas. We must not resort to opiates unless the Dr. says so. Shortness of breath is common

[page 29v V.1] cough is due to phlegm tube are filled with water matter or the inflammation causes the lessening of the caliber of the ai... — [page 29v V.1] cough is due to phlegm tube are filled with water matter or the inflammation causes the lessening of the caliber of the air tubes. For middle life we can throw off the phlegm mucous & so the tubes do not close so much. Asthma how to relieve shortness of breath. We must give stimulants that stimulate these organs. Hot brandy or Ammonia with “ [brandy] & hot water Hoffman’s anodyne or compound this cannot be given to infants, but good

[page 30r V.1] for old people ½ -1 teasponful- Ammonia 5-45- Heat applied externally stimulate the respiratory nerves. Turpentine lin or... — [page 30r V.1] for old people ½ -1 teasponful- Ammonia 5-45- Heat applied externally stimulate the respiratory nerves. Turpentine lin or Hartstorn or chloroform rub with, Turpentine stupe 1 cup vinegar ½ cup turpentine one egg shake it up in a beer bottle Pain is usually in connexion with pleurisy this is the rubbing together of two inflamed pleura (or parts of it) all of the things before shaken of may be used Hemor seldom occurs but in consumption

[page 30v V.1] although it may occur independent of consumption We may encourage sometimes occur in some diseases of heart & this oft... — [page 30v V.1] although it may occur independent of consumption We may encourage sometimes occur in some diseases of heart & this often relieves it. Comes from lungs red & frothy. If we can see it &examine the back of the throat we might see where it comes from Very much agitated cough must be quieted breathing the same & to do this give opium Paregoric in teaspoonful dose every ½ hour until it is eased. Dover’s powder 1 grs. is of great service. If you can have them lie down or as near that as possible Then

[page 31r V.1] instead of heat use cold. Ice pack or clothes wring out. Gallic acid t gram doses. Ergot may be good if it occurs in peopl... — [page 31r V.1] instead of heat use cold. Ice pack or clothes wring out. Gallic acid t gram doses. Ergot may be good if it occurs in people in health. Rarely die with while having hemorrhage. Give an enema or have bowels relieved at once. Astringents are not of service in cases of consumption, but they may be of great service where it occurs in healthy people

[page 31v V.1] Dr. Hare On the administration of drugs. & the application of external remedies The untoward action of drugs. Peculiar... — [page 31v V.1] Dr. Hare On the administration of drugs. & the application of external remedies The untoward action of drugs. Peculiar action. Antipyrine produces a habit 5 or 6 hrs. after rash appears which looks like Scarlet fever, sometimes measles- hard to tell what a rash is. Measles are said to come in a crescent. Scarlet in pointed. Anti. may resemble either remember this. If given in large doses changes in blood- lips may be blue ears so- finger tips so, febrin in small doses is the same- the base of the nail is where the darkening appears watch this sometimes face looks as if

[page 32r V.1] they were choking. Salycilic acid for Rhem produces some symptoms this will cause collapse or a great fall of temp. Urine ... — [page 32r V.1] they were choking. Salycilic acid for Rhem produces some symptoms this will cause collapse or a great fall of temp. Urine becomes of an Olive Green this comes sometimes before the temp falls. This also causes symp. like Quin. Iodo is are of it causes fatty degeneration of all the tissues & even the arteries are affected. This affects even after the dressing is removed this resembles Meningitis, or concussion of the brain- Contracted pupils high fever stertor breathing. Remember whether much has been sued on the edges of a wound examine urine before

[page 32v V.1] & after dark urine Iodine sometimes high & sometimes the reverse. Screaming delirium. Meningitis Muttering Delirio... — [page 32v V.1] & after dark urine Iodine sometimes high & sometimes the reverse. Screaming delirium. Meningitis Muttering Delirious Quinine will cause rash with some people. All people Idiosyncrasies toward some drugs, this will make some people blind & cause deafness. With child remember it has been given before saying it is Scarlet; Causes congestion of brain. Causes gastritis If malaria we might stop if congestion comes Ether causes. Keep up heat always external, in every case of poisoning, always put the first over the abdomen. In Typhoid of toward morning we can

[page 33r V.1] apply heat Carbolic is a poor thing for disinfecting drains next to Hydro. it is the most violent (Prussic Acid) Creosote ... — [page 33r V.1] apply heat Carbolic is a poor thing for disinfecting drains next to Hydro. it is the most violent (Prussic Acid) Creosote is identical with Car. made from beech wood Car. from coal tar. Odor lips while spots tongue they change to brown in the centre their around this white it is red or purple. Then the tongue roof of mouth is all puckered like the fingers, unconscious respiration begin to fail give Salts or any kind magnesia. No matter how long after the Antidote may be given & will find it soluble sulphate

[page 33v V.1] give the same for lead poisoning. Acute of lead Sub. A. is more so. After taking this mouth will taste sweet- vomit is whi... — [page 33v V.1] give the same for lead poisoning. Acute of lead Sub. A. is more so. After taking this mouth will taste sweet- vomit is white diarrhea is black. Then give Salts & in excess- Chloral produces cardiac suppression. Chloroform is the same. Keep up bodily heat always. Aconite is given more to children than adults but this paralyses the stomach so it does not (tartar) act. give Alcohol hot & concentrated & it will be absorbed if cold the stomach has to heat it.

[page 34r V.1] Arsenic will produce very severe acute poison. May die 3 or 4 weeks after. Causes vomiting & purging if larger dose is... — [page 34r V.1] Arsenic will produce very severe acute poison. May die 3 or 4 weeks after. Causes vomiting & purging if larger dose is taken. If takes an ounce of Fowler’s Sol. burning pain in Stom. Rice water purging a thin watery passage if put in glass bottom looks like rice in bottom peels off the mucous membrane. Iron Dialyzed iron. 3 or 4 ounces of trichur of iron give magnesia, fell the iron full of this if you can after 48 hrs. patient seems to be well comparatively Invariably becomes worse both in phosphorous &

[page 34v V.1] Arsenical, this sometimes causes structure as it stops up the intestinal canal. burns up the glands in the stomach. Nitrat... — [page 34v V.1] Arsenical, this sometimes causes structure as it stops up the intestinal canal. burns up the glands in the stomach. Nitrates of silver is sometimes [illegible]. (Chloride of sodium common salt) after the antidote it will vomit white spots like white of egg then brown, then black will vomit brown before the antidote is given All but silver either die from inflame or is obs in the blood & acts on the nerve center Sulphuric acid (Nitric Hydrocholor color tongue yellow)

[page 35r V.1] Sulphuric burns all the parts. four mineral acids give an alkali any kind of lime soda, then give oil then albuminous drin... — [page 35r V.1] Sulphuric burns all the parts. four mineral acids give an alkali any kind of lime soda, then give oil then albuminous drinks Sulphuric is black Monsells Solution is poison Antidote give soap, this

[page 35v V.1] Disinfection & Disinfecting Preventive medicine nothing to with Anti Acute dis. presence of a poison in a body living ... — [page 35v V.1] Disinfection & Disinfecting Preventive medicine nothing to with Anti Acute dis. presence of a poison in a body living Contagions Misaims Noxious emanations Not 1 Organic multiplied in the body. Small fox 2. Comes from without but does not multiply Intermittent, agne 3. Alkaloids, or gases- comes from sewers & such acts like strych or other

[page 36r V.1] poison, Remove the source Remedies Antiseptics & Germicides kills the in hundred germs of diseases. Salt is an Ant-. K... — [page 36r V.1] poison, Remove the source Remedies Antiseptics & Germicides kills the in hundred germs of diseases. Salt is an Ant-. Kills putrefaction. Germs are all Ant- Anti- not “ [all] Germin- (Alchol borax salt- lime- Anti.) Germicide Chlorine Care Corrosive Sublimate Nature dispenses or oxides Purify by opening wide the windows out of doors. Water will cause oxidation. Fight germs where they are produced. Miasmata after the conditions of production.

[page 36v V.1] Typhoid Breath Passages Urine Scarlet fever Keep disinfectant in all utensils for filth use something that destroys & ... — [page 36v V.1] Typhoid Breath Passages Urine Scarlet fever Keep disinfectant in all utensils for filth use something that destroys & make it innocuous not an anti. as this only to keep pure. Lime is the best for filth if there is no germs- lime & plastic paris will keep it dry & prevent poisonous gases rising- Heat first excessive is the surest germinated we have. (Cold keels miasma) 140 moist kills vaccine moist is better than dry 212- dry- will not be as 240 we ought to have if dry & use it for a long time

[page 37r V.1] good as moist. 212 will not kill the spoor. Add salt & it will How to manage disinfecting take all articles like sofa ... — [page 37r V.1] good as moist. 212 will not kill the spoor. Add salt & it will How to manage disinfecting take all articles like sofa & wardrobes out- scrub- scrub- scrub- Car. is the lest Corrosive Sub. & Chlorinated lime sulphate of iron 1-1000 – 1-500 use no soap. use water first then corrosive- then soap Tie up the bed clothes & souse them in boiling

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[page 47v V.1] Mary V. Clyme

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[page 55r V.1] been lying. better to be too cold than hot, as this will cause convulsions test water with the elbow as hands become callo... — [page 55r V.1] been lying. better to be too cold than hot, as this will cause convulsions test water with the elbow as hands become callous. Use as few pins as possible & don’t make it too tight. Busy Drs., fail to tell a nurse when it ought to be nursed. As soon as the baby is washed put it to the breast, although there is no milk as it draws out the milk nipple learns the baby to nurse & will help get uterine contraction. Baby ought to be put to the breast every 3 hrs during the first 48. after this, every 2 hrs during day and 2 at night. 11-5.

[page 55v V.1] ties the cord. We may tie it alright but as soon as baby is bathed the warm water causes it to relax. Tie a surgeons knot ... — [page 55v V.1] ties the cord. We may tie it alright but as soon as baby is bathed the warm water causes it to relax. Tie a surgeons knot first with a piece of tape then make a bow knot opposite the knot after bath untie the bow. Take the cord between the fingers and direct the scissors toward the palm of your own hand. Baby is dirty and covered with cheesy varnish. Grease it from head to foot with cosmoline or sweet oil, rub it all over especially its scalp. The temp should be 98° as this is what it has

[page 56r V.1] walls. We must cut it and press it. Hemorrhage symptoms are the same as in all secondary hemorrhage. Another accident come... — [page 56r V.1] walls. We must cut it and press it. Hemorrhage symptoms are the same as in all secondary hemorrhage. Another accident comes suddenly and that is convulsions. Like a child any serious difficulty is often ushered in by this. A sharp headache, failing vision, see double, pupils contract. These symptoms last for a little. Mouth twitches, arm drawn up. Eye drawn down & then a violent convulsion. Protect the tongue as this is convulsive. Also protect put something between the teeth-always send for Dr. at the first. A skilled nurse usually

[page 56v V.1] Have hands clean-& do not use sponges. use something that can be thrown away. Prefer burnt cotton put this in oven unt... — [page 56v V.1] Have hands clean-& do not use sponges. use something that can be thrown away. Prefer burnt cotton put this in oven until the outside is quite brown, put it in a little box. Dip it in Bichlor. Use it and throw away. Glass tubes ought to be used for all, wipe, cleanse the tube. Another subject danger of hemorrhage. We must be ready to recognize this veins are torn across as large as the jugular vein. If it were not for the contraction of the uterine muscle would bleed to death. Make pressure on the outside of the uterus, on the abdominal

[page 57r V.1] best soap so called soft potash soap. Almost as strong as Bichlor, as a disinfectant. Carbolic acid 2 per cent solution no... — [page 57r V.1] best soap so called soft potash soap. Almost as strong as Bichlor, as a disinfectant. Carbolic acid 2 per cent solution no use. Unite the soap with Bi- Clean instruments metallic ones in car. As soon as the placenta is expelled-give douche 1-2 qts-1-2000, bath of the same take away the pad & upper rubber. After this put a small piece of blanket rubber under napkin over Change them every four hours, during the first 24. Take them at once from the room. Keep skin clean from blood as it is full of microbes.

[page 57r V.1] blankets take with the convalescent to their ward. Then put them in washing soda or potash to remove the blood. Then in 1-... — [page 57r V.1] blankets take with the convalescent to their ward. Then put them in washing soda or potash to remove the blood. Then in 1-4000 Bi. do this fast. Sheet rubber blanket 3 feet square canton flannel napkin, which can be removed. Anti before during & after confinement as soon as labor give a bath, if a discharge from vagina douche of 1-2000 Bi. to kill the microorganisms. If this is not done it may injure the woman by causing sepsis or destroy the child’s eyes. Wash the hands, scrub them well. Then dip in 1-2000.

[page 58r V.1] the use of Anti. where one out of ten use to die. it is one hundred fold less. Ward if properly managed the best place to ... — [page 58r V.1] the use of Anti. where one out of ten use to die. it is one hundred fold less. Ward if properly managed the best place to be delivered. The measures to be taken in a hospital after child birth. Wards. Septic infection occurs by actual contact-may be by fingers, bed clothes. May be taken by the very atmosphere. 5 may be delivered, then they must be cleaned after each one shut doors open windows. Mattress must be covered with a rubber sheet tag to tell how many times it has been used. After using ten times tear it up. Sheets changed twice a week, oftener if necessary.

[page 58v V.1] Obstetrics Learn by practice rather than theory. Few points, tact if we have any. Careful about dress, tone of voice. Duri... — [page 58v V.1] Obstetrics Learn by practice rather than theory. Few points, tact if we have any. Careful about dress, tone of voice. During pregnancy, labor and after like a little child. First thing we must bear in mind nervous irritability. One thing so very important. Antisepsis is more important in this than in surgery. Blood has under gone a change less in iron & salts & nutritive qualities. In a state of physical exhaustion discharges is made up of blood. All along the genital tract it is open for the reception of all germs. More dangerous than later is now, use to be before

[page 59r V.1] in Catheter must be used some hours after or before bed time. Stimulating enema, turpentine & yolk of egg if too much ... — [page 59r V.1] in Catheter must be used some hours after or before bed time. Stimulating enema, turpentine & yolk of egg if too much alcohol it will be almost sure to be rejected do not scrub a delicate knife joints of ours

[page 59v V.1] have dressings large enough to cover all well Plaster another must can be provided, pitcher or pot. Fish plaster moistened... — [page 59v V.1] have dressings large enough to cover all well Plaster another must can be provided, pitcher or pot. Fish plaster moistened with solution We must have a hypodermic and ether sometimes we must give it Have it must go way down deep in the tissues or it may be very injurious have the bed warm before temperature & stimulus carbonate of ammonium-liquid food if won’t take milk give tea or coffee beef tea and broth.

[page 60r V.1] either over the artery as appropriate it Esmarch bandage & tube, so the Sur. can have it bloodless and able to see. Th... — [page 60r V.1] either over the artery as appropriate it Esmarch bandage & tube, so the Sur. can have it bloodless and able to see. This need not be too tightly as it may cause paralysis permanently. hold limb steadily and tilted a little forward. Have sponges clean as & dry. Cut ligatures catgut cut both ½- 1/3 inch long silk only cut one unless in abdominal then cut off and left in wound

[page 60v V.1] patient-hold up by feet sometimes for 30-45- minutes side to be operated upon must be next the edge of bed or table if wet... — [page 60v V.1] patient-hold up by feet sometimes for 30-45- minutes side to be operated upon must be next the edge of bed or table if wet towels are used they must be hot & be careful not to have them touch the patient hot cans may be needed during operation. Tourniquet may be used see that it is in good order strong & clean & dry so it will not slip make a pad of the end a roller bandage then 2-3 times around roller obliquely so if the artery slips it will control

[page 61r V.1] as long as face is red, if blue or ashy suspend at once Chloroform if pale too much. watch breathing if stop put thumb bac... — [page 61r V.1] as long as face is red, if blue or ashy suspend at once Chloroform if pale too much. watch breathing if stop put thumb back of the jaw and press forward. If that does not do pull the tongue forward. Stertor nasal is of no consequence- larynx stertor is dangerous [illegible]. in cases of excessive dip towel with in cold water & slap in face battery at hand. in chloroform invert

[page 61v V.1] lead suture is good & if the part swells will break if silk is used it is usually black because it can be seen if shar... — [page 61v V.1] lead suture is good & if the part swells will break if silk is used it is usually black because it can be seen if sharpened on both sides it is the best this is the needles & an ordinary needle may be used. tube must be provided. Either laudanum alcohol or oil. Alcohol 50 per cent Sponges we ought to see that they are clean and soft splints we must see about cover with padding and silk oil cloth we may have to give ether after once under

[page 62r V.1] hemistatic [hemostatic] & sutures and scissors, ligatures-retractor & if for thigh-below left tail. begin at the l... — [page 62r V.1] hemistatic [hemostatic] & sutures and scissors, ligatures-retractor & if for thigh-below left tail. begin at the left Carbolic is preferable because it does not corrode meat dish or water in 1-40-carbolic. Arrange them as he said-catgut chrom or in oil of juniper if not provided &we have to cut silk. do not waste it either catgut or silk hank or skein will make 12-if for hemorrhoids it must be twice as long-wax silk with bees wax so it will not be tangled.

[page 62v V.1] Surgical nurse should be strong, able to hold a limb & lift a patient. One must be patient with Drs. as well as patien... — [page 62v V.1] Surgical nurse should be strong, able to hold a limb & lift a patient. One must be patient with Drs. as well as patients. remember it is the good of person & not our feelings in question. Have physical endurance & moral because we must endure – we must be self denying. Instruments we may have to get. should be clean & see that they are. have them sharp. arranged in a certain order for amputation Knife 1-2-3- saw, cutting forceps, tena. [tenaculum] –artery forceps,

[page 63r V.1] sponge or brush. Then car. Bichlor. sometimes remove what one can but if it distresses do not. give light breakfast if lat... — [page 63r V.1] sponge or brush. Then car. Bichlor. sometimes remove what one can but if it distresses do not. give light breakfast if late in afternoon if morning tea-coffee. Moral treatment- before we can cheer and encourage always remember we must are not responsible be careful and not allow it to be seen. Costume could not be better. have those that will not rustle and hinder us from being quick have clean hands always be dignified & grave & during operation avoid levity and grief.

[page 63v V.1] if a capital operation have old blanket or tin with sawdust have bottles hot or bricks wrap all in blankets have brandy or... — [page 63v V.1] if a capital operation have old blanket or tin with sawdust have bottles hot or bricks wrap all in blankets have brandy or whiskey if needed ask about dressing before so as not to have any delay some use a spray, car. or Bichlor if Dr want prepare by giving a laxative previous day and give enema in morning urine late by catheter if necessary shave if can Have clothing loose cut out sleeves. Breast case don’t put sleeve in. Wash with turpentine to dissolve natural secretion use soap & water stiff

[page 64r V.1] Surgical operations Preparing- assistance and care. What room-light from the north side without the sun better abundance o... — [page 64r V.1] Surgical operations Preparing- assistance and care. What room-light from the north side without the sun better abundance of light & where the windows overlook neighbors may make it to candles like we have them properly heated or may take cold and die with pneumonia. 70-75 for tracheotomy. Take away all superfluous objects for they may contain germs be careful and not distress the patient by taking everything. Have table or bed prepared but many can be operated upon the bed use machintosh to keep clean use large one first & small one over lots of blankets to use during operation and afterwards

[page 64v V.1] Add a little boiling beef tea mix thoroughly season then pour into the whole amount. Scraped beef meat cut across the fibe... — [page 64v V.1] Add a little boiling beef tea mix thoroughly season then pour into the whole amount. Scraped beef meat cut across the fibers scrape about II ounces to a piece of bread, use sharp [illegible] knife. spread smoothly then season toast bread side first, then turn and carefully brown.

[page 65r V.1] ice. Jellies must be placed immediately in the refrigerator or ice. Broth. Liquid beef tea in cases where meat cannot be t... — [page 65r V.1] ice. Jellies must be placed immediately in the refrigerator or ice. Broth. Liquid beef tea in cases where meat cannot be taken. beef tea without the fibers is the best nourishment. Water egg white and shell mix thoroughly - ½ cup water. To clarify, put directly on fire. Add the egg water shell strain and the drink is ready.

[page 66v V.1] [illegible] beef tea and barley water – a concentrated food 1 oz of beef tea, same of barley water, ½ oz of cream, ... — [page 66v V.1] [illegible] beef tea and barley water – a concentrated food 1 oz of beef tea, same of barley water, ½ oz of cream, heat the barley water and beef tea together Then when just to boiling point add to cream Soups and Broths Beef tea 1 lbs bone from the neck or round chop [fine?] add 1 pt cold water to each lb of meat. Never use metal of any kind to cook with; let it stand 2 hrs put in water at 180°. Put in 6 peppers corns, bay leaf. add salt of [lime], strain. it should taste like roast or broiled meat. Keep in a cool place.

[page 66v V.1] Milk punch – 2/3 pt milk add ½ oz of sugar. ½ oz brandy. Shake for ½ min, a little nutmeg. Egg nogg. [2/3?] pt mi... — [page 66v V.1] Milk punch – 2/3 pt milk add ½ oz of sugar. ½ oz brandy. Shake for ½ min, a little nutmeg. Egg nogg. [2/3?] pt milk, add ½ oz sugar, white of one egg. cook and shake mix thoroughly. Add ½ oz sherry. Egg nogg. Separate white and yolk beat until light add 1 gr salt. Stir both add ½ cup milk, then add sugar. Don’t have milk in the bottom of glass, and egg floating on top – ½ oz brandy Plum porridge. ½ pt milk to scald 6 good sized raisins, stir 5 minutes a level teaspoonful sugar, ½ oz cornstarch. 1 oz of milk turn in quickly stir [illegible] a pound add 1 oz of sugar

[page 67r V.1] Scald milk 202° if you [illegible] wish it to bust without [illegible] add salt - it will add to the density. Soon as the... — [page 67r V.1] Scald milk 202° if you [illegible] wish it to bust without [illegible] add salt - it will add to the density. Soon as the albumin coagulates the milk is scalded. [Illegible] to 1 pt of milk, take 2 pieces of toast, soak in water for 5 min; it is soft and white. Then lift out and place in milk. Cook for 5 min. add 1 g sugar; don’t add [illegible] unless ordered before straining cool the moulds. Use ordinary sieve, stir down, pour in mould and stand away. Wine whey. milk with the [cream?] taken out. ½ pt milk, put over fire – [illegible] sherry. Strain thro. cheese cloth. When the curd has separated from the whey strain it may be kept all day and served.

[page 67v V.1] point it is free from gaseous pull from the cold water. [******'s?]. Use mixed milk 1 qt of milk set in pan of boiling wat... — [page 67v V.1] point it is free from gaseous pull from the cold water. [******’s?]. Use mixed milk 1 qt of milk set in pan of boiling water stirring until it is lukewarm. 2 tablespoons of pressed yeast dissolve in warm water stir until thoroughly dissolved. 1 oz of granulated sugar in 1 oz of water stir over fire until dissolved then boil for 10 sec from a clear syrup if the sugar is not thoroughly dis it will burn. 1st yeast into milk, then syrup. Stir until mixed, then it is ready to put in bottles, Fill 2/3 full cork & [illegible]. Keep on temp of 70° for 12 hours then turn on its side in a temp 55 & in 24 hrs. it is sweet [illegible].

[page 68r V.1] Milk foods. The most [illegible] Milk is [illegible] to support the junctures of the body and is in itself perfect. Wine w... — [page 68r V.1] Milk foods. The most [illegible] Milk is [illegible] to support the junctures of the body and is in itself perfect. Wine whey. why what happens milk being a perfect food to [illegible] Starchy food in typhoid. 1 pt of milk. Pearl barley boiled in water. 1 oz barley 1 qt boiling water [illegible] boil rapidly 5 min then drain off the water and throw away the water; 1st being blue and distasteful to patient. Then add 1 qt of [briskly boiled?] water simmer gently for 2 hrs. then strain and it is ready for use. Water that is at boiling

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[page 69r V.1] Nov. 12TH Am not learning anything new but practicing the same all the time. M.V. Clymer Nov. 19TH Have very busy nights n... — [page 69r V.1] Nov. 12TH Am not learning anything new but practicing the same all the time. M.V. Clymer Nov. 19TH Have very busy nights nothing hard to do but much that is trying. Try every way to have my patients sleep from bathing head and arranging pillows to letting them sit up to have their beds freshly made (when a patient is allowed to sit up) & it often helps put them to sleep. Give medicines & carry out the Physicians’ orders as far as I possibly can. Mary V. Clymer [blanks]

[page 69v V.1] Friday In addition to my usual work helped get ready of an operation that came up from the ward. Practice bandaging some. ... — [page 69v V.1] Friday In addition to my usual work helped get ready of an operation that came up from the ward. Practice bandaging some. Mary V. Clymer Monday 24TH Came on duty at 9 P.M. Went around to all my patients made them as comfortable as possible. Gave medicines as ordered, nourishment also. was kept very busy all night as some of my patients were nervous and wakeful requiring a great deal of attention. Do not think I learned anything new. Every night is a repetition of the first excepting time of giving medicine and the different ones that may be ordered. Mary V. Clymer Nov. 4TH I do not think I learn anything new. am kept very busy waiting on my patients every night M.V.C.

[page 70r V.1] covered it with wax paper and bandaged it. Thursday still taking care of the same patients. have not done anything new. Pr... — [page 70r V.1] covered it with wax paper and bandaged it. Thursday still taking care of the same patients. have not done anything new. Prepared and assisted with the dressings. Friday Duties the same during morning. saw a wound made by removing a tumor assisted with the dressing of it. During the afternoon assisted Miss B. in removing the articles used during an Ovarian operation Busy during entire day. Mary Clymer Monday Oct. 17TH. Helped prepare and serve breakfast. Took and charted temperatures. Made beds, swept and dusted rooms. Dressed a blister with iodoform powder and ointment dressed and bandaged a foot twice. gave medicines. Prepared an Antiseptic dressing usual cooking, afternoon and evening work same as it always is. Tuesday Nothing new. Wednesday Still the same work Thursday No change.

[page 70v V.1] Monday Tuesday Attended to the occupants of four rooms. Cleanliness and ventilation of the rooms. Medicines. Temp. Food, B... — [page 70v V.1] Monday Tuesday Attended to the occupants of four rooms. Cleanliness and ventilation of the rooms. Medicines. Temp. Food, Bathing, Dressing of wounds, and every attention required. Wednesday. On duty all day in order to have four hours tomorrow. Cut and got dressings ready for three antiseptic cases. still taking care of four patients. trying to have my eyes in thirteen while my hands make a bed in eleven the patient in thirteen has to be watched, the one in eleven is so afraid of a draught that I have to keep the door closed. Learned something about fractures. Simple, Compound, Comminuted, and Greenstick are the most common. They may be transverse, oblique or impacted. Dressed a foot twice with lead water and laudanum on lint

[page 71r V.1] what remedies are used for the different stages of healing of wounds. off duty from 5-6 P.M. very busy until 9 P.M. M.V.C.... — [page 71r V.1] what remedies are used for the different stages of healing of wounds. off duty from 5-6 P.M. very busy until 9 P.M. M.V.C. Saturday Sunday Still doing the same work, learned nothing new. Monday Duties still the same saw and helped prepare some of the necessary articles for an ovarian operation. Tuesday Special duty took care of four rooms gave medicine took temp, and attended to the various wants of patients in those rooms. Wednesday Thursday On general duty. Assisted with and made preparations for the antiseptic dressings did the same cooking, and all the little things that I have written before. Friday Special duty, same Tuesday. M.V.C.

[page 71v V.1] gave medicine before food. after breakfast took temp. gave medicines made beds. Got ready for dressing wounds. assisted Dr... — [page 71v V.1] gave medicine before food. after breakfast took temp. gave medicines made beds. Got ready for dressing wounds. assisted Dr. and Miss Bellamy with the dressings. Helped Miss B. get everything ready for operation. Taught how to pass catheter, also to give vaginal douche. Wednesday Worked very hard all day at the ordinary work kept very busy until 9 P.M. Thursday Same as yesterday, excepting I assisted at an operation. Friday Did the usual cooking for breakfast. Temp. Medicines, beds until 10:30 A.M. Waited on the Dr. again with dressing an ear case. Made all preparations for dressing a case of necrosis of knee. Cut all the dressings ready for tomorrow, am learning [page 71r V.1] what remedies are used for the different stages of healing of wounds. off duty from 5-6 P.M. very busy until 9 P.M. M.V.C.

[page 72r V.1] Took temperatures. made beds and attended to patients wants until 10-30 A.M. Assisted Miss Bellamy in making preparations ... — [page 72r V.1] Took temperatures. made beds and attended to patients wants until 10-30 A.M. Assisted Miss Bellamy in making preparations for operations again. Learned names of some of the bones in the human body. Friday 23RD Work same as yesterday morning. Prepared all the dressing for patients wounds. assisted with the dressing of the wounds after which I put all the things away in the dressing closet. This kept me busy until 11-30 A.M. went to dinner. Employed with the usual work until 2 P.M. off duty from 2-6 P.M did the necessary cooking. helped serve the supper took temps. bathed backs with alcohol and made patients generally comfortable for the night. M.V.C. Saturday Sunday Monday The same as Friday. Tuesday Made Tea, Coffee, Cocoa, Toast, and cooked eggs for breakfast. helped serve breakfast

[page 72v V.1] Friday The morning work still the same, busy until twelve. Had a lesson in anatomy while assisting Miss Bellamy with Uteri... — [page 72v V.1] Friday The morning work still the same, busy until twelve. Had a lesson in anatomy while assisting Miss Bellamy with Uterine case. Off from twelve until six. Saturday. Work still the same. Monday. Tuesday. Same. Wednesday. Allowed to prepare table for operation saw and assisted with two operations. Saw an Esmarch bandage applied and diseased bone removed without much loss of blood. cut and prepared Antiseptic dressing for the wound. The wound was an incised one. saw a uterine operation. Prepared beds for reception of patients after operations, with bottles of hot water and blankets to prevent chills (So Miss Bellamy told me) Thursday 22ND. Served breakfast and did some cooking for patients from 7 A.M. until 8 A.M

[page 73r V.1] of the amputation case. Wednesday. In addition to my usual work Learned how to prepare and administer an enema containing ... — [page 73r V.1] of the amputation case. Wednesday. In addition to my usual work Learned how to prepare and administer an enema containing four fluid ounces. Thursday. Allowed to cut the dressing and prepare for the Dr. to dress the amputation case. Monday. In addition to my every day duties, shown how to put on a knee bandage. Tuesday. Allowed to dress the knee and put on the knee bandage. Dressed it with lead water and Laudanum. Had lesson on Antiseptics. Wednesday. Helped Miss Bellamy prepare for an operation and prepared the bed to receive the patient after operation. Saw the operation and know well what an incised wound is. Thursday Did not learn anything new but was kept very busy doing ordinary work while some went out

[page 73v V.1] of linen quicker and better each time that I have it to do. Medicines still the same. Friday 2ND. Have been trying to use ... — [page 73v V.1] of linen quicker and better each time that I have it to do. Medicines still the same. Friday 2ND. Have been trying to use my eyes today to find were things are kept on the private floor. Assisted with meals, took temperatures and charted them. Tidied rooms, Bathed backs, with alcohol. Learned something about Antiseptic dressings and why they are used. Learned what putrefaction is. M.V.C. Saturday 3RD. On duty at 7 A.M. Assisted with the morning work. Took temperatures, charted them, Shown how to prepare an Antiseptic dressing. Saw the first wound that I ever saw assisted with the dressing. Sunday. Did not learn anything new. Monday the same Tuesday. Performed the duties assigned me. Helped prepare and assisted with the dressing

[page 74r V.1] with alcohol. Bathed back and combed hair for all who were unable to do so themselves. Washed Grandfather's back with alco... — [page 74r V.1] with alcohol. Bathed back and combed hair for all who were unable to do so themselves. Washed Grandfather’s back with alcohol and water. dusted it with zinc powder combed his hair and gave him a clean sheet. changed and made bed for a little boy. Cooked tomatoes and made all preparations for dinner. Have not learned anything new, but was kept very busy waiting on patients until 9 P.M. M.V.C. Friday 26TH. Have been very busy during the entire week. Do not think I have learned anything new a s all of our bad cases have typhoid fever and require the same bathing, changing of beds. patients linen. Cleanliness of everything in use in ward that I have written so often. M.V.C. Thursday, Sept. 1ST. Still working with our Typhoid cases. Learned very little new but can sponge and make all the necessary changes

[page 74v V.1] Thursday. On duty 7 A.M. served breakfast. The rest of the work as before until 9 A.M. Sponged three patients. 11 A.M assi... — [page 74v V.1] Thursday. On duty 7 A.M. served breakfast. The rest of the work as before until 9 A.M. Sponged three patients. 11 A.M assisted Miss Z. with patient in front ward. dinner 11:30 A.M. 12 P.M. dinner for patients from that until two busy tidying the ward, giving medicines. preparing lemonade and attending to patients in bed. Off from 2-4 P.M. the usual routine of preparing toast cooking tomatoes and various other preparations for tea. served tea. evening work same as yesterday. Four months today in the medical ward. M.V.C. Friday. On duty a few minutes before seven. gave medicine before food, served food, gave after food medicines. did the usual work of the ward. Bandaged limbs for two dropsy cases. washed patient and bathed him

[page 75r V.1] Wednesday. On duty at 7 A.M. prepared and cooked breakfast for some washed tables, helped sweep ward. took and charted the... — [page 75r V.1] Wednesday. On duty at 7 A.M. prepared and cooked breakfast for some washed tables, helped sweep ward. took and charted the morning temp gave after food and all the morning medicines. helped with all of the morning baths. With Miss Morand’s assistance, washed and changed clothing and bed clothing of paralyzed patient. Temp of one typhoid taken and recorded every two hours, milk the same, cooked special food for fever cases. Went to dinner 11.40 A.M. 12 P.M. served dinner assisted with clearing it away sweeping and making ward tidy and patients comfortable for visiting hours. Off duty from 2-4 P.M. Gave medicines cut bread and buttered it. made toast for two. prepared beef tea for three, made lemonade and strained it for four. served tea. after food medicines. rubbed patients with alcohol. [*****] Instructed how to give cold sponge bath. Washed a new patient changed bed and clothing twice. 9 P.M.

[page 75v V.19] linen room. Washed Boland's eyes. Put ice in. Filter. Keep cold applications on typhoid's head. Learned that there w... — [page 75v V.19] linen room. Washed Boland’s eyes. Put ice in. Filter. Keep cold applications on typhoid’s head. Learned that there were two kinds of Dropsy. Dropsy of the stomach called Acites [sic, Ascites], of the legs, Edema. Saturday. Nothing new. M.V.C. Same work that I’ve told before. Sunday. Learned why turpentine Spts. were given in enemas, also what Dover powders were used for. Monday. Had a case pronounced pneumonia. Learned how to make a jacket poultice. One fever case improving rapidly. The other two improving, but very slowly. Tuesday. Learned nothing new, and everything seemed to go wrong. M.V.C.

[page 76r V.1] seems worse. Keep iced cloths on his head which makes him more comfortable. Sweeping, dusting, temperatures, food and medi... — [page 76r V.1] seems worse. Keep iced cloths on his head which makes him more comfortable. Sweeping, dusting, temperatures, food and medicines, the same with few changes. Thursday. On duty at seven. from seven until nine A.M. served food gave after food medicines. Temperature, sweeping and cleaning gone through and finished. The typhoid still worse. Put away the clean linen. 930 A.M. sponged the three fever cases and bathed them with alcohol. 11 A.M. cut bread and made preparations for dinner. 11.40 A.M. off to dinner back at 12 P.M. busy until 2 p.m. off until four. Changed a paralyzed patient have learned how to change one without assistance. Friday. Morning duties still the same. Typhoid still worse sponging occupies one hour and a half every day. Put clean linen away swept and dusted

[page 76v V.1] off duty 2 P.M. till 5 P.M. helped prepare the supper and served it. was kept busy doing the evening work till 9 P.M. M.V.... — [page 76v V.1] off duty 2 P.M. till 5 P.M. helped prepare the supper and served it. was kept busy doing the evening work till 9 P.M. M.V.C. Monday. Worked the same as usual, nothing new came in, fever cases still receiving same treatments. Learned that the bandage used in tapping a man for dropsy was called a Leister belt. M.V.C. Tuesday. Work still the same. two of the fever cases are improving the other one not a very great deal of change yet. still sponge the fever cases. Cannot say I have learned anything new, but am learning more about medicines all the time by constant use. M.V.C. Wednesday. Have been very busy today because of Miss Adams absence and one case of typhoid

[page 77r Vol. 1] handled. Assisted Miss Adams in removing some of it and putting him to bed. Took temp. gave antipyrine. Temperature had... — [page 77r Vol. 1] handled. Assisted Miss Adams in removing some of it and putting him to bed. Took temp. gave antipyrine. Temperature had to be taken every hour until it came down administered medicines to him every hour. During afternoon temp became very low. Applied hot water bottles and gave brandy in milk according to Drs directions. The usual work still the same. always wash tables after breakfast and dinner and as often as I can possibly find time after tea. M.V.C. Sunday. Morning work as usual. Bored till after 11 A.M. went round with Drs. (Miss A. absent) several fresh orders to carry out. change of two or three medicines. A man had a chill at 1 P.M. took temp and applied blanket. gave hot milk to drink.

[page 77v V.1] able to bathe himself the other a very sick and almost helpless old man who required a great deal of attention. At 8 P.M. ... — [page 77v V.1] able to bathe himself the other a very sick and almost helpless old man who required a great deal of attention. At 8 P.M. a little boy had a fit. Kept him from biting his tongue by inserting a bandage between his teeth. August 6th – The usual work again in the morning. Still sponge the fever cases and bathe them with alcohol. Poultice still have to be applied to abscess. Assisted Miss Adams with the dressing of the helpless old man. Learned that his disease was called sloughing abscesses. Dressed them with cosmoline, just finished this when we received a case of heat exhaustion. He had been working among coal and was as black as the coal he

[page 78r V.1] Aug 5th A reflection of yesterday as far as medicines, temperatures, bathed fever cases with alcohol also all the backs of... — [page 78r V.1] Aug 5th A reflection of yesterday as far as medicines, temperatures, bathed fever cases with alcohol also all the backs of patients in bed. dressed one with zinc ointment. made poultice for abscess washed patient with lotion for skin infection 8 P.M. took four temps. gave milk to fever cases. Assisted with the evening medicines. Gave ice water to all who were allowed to have it. every intervening moment during the day I was busy washing and carbolizing various utensils in use in the ward. M.V.C. Aug 5th A repetition of yesterday as far as serving food, taking care of ward, giving medicines and taking temperatures. Two new cases came in one was

[page 78v V.1] Zimmerman with dressings one could not do alone. Kept there until 11.40 a.m. went to dinner. Came back 12.10 served dinner... — [page 78v V.1] Zimmerman with dressings one could not do alone. Kept there until 11.40 a.m. went to dinner. Came back 12.10 served dinner to patients. gave after food medicines. helped sweep ward. washed bed stands. Straightened beds and made ward generally tidy for visiting hours. 140 P.M. gave two o’clock medicines. gave fever cases milk and took temperatures at 2 P.M. Off duty from 2 until 4 P.M. came back, gave drinks and various other attentions to patients until 5 P.M. commenced to get bread ready for tea. gave 5 o’clock medicines tea came at six. gave six o’clock medicines. took one temp. served tea. gave after food medicines removed tea things. 645 P.M. commenced taking evening temp.

[page 79r V.1] Aug 4th I am on duty at 7 A.M. With the assistance of one patient – served the breakfast- gave after food medicines.... — [page 79r V.1] Aug 4th I am on duty at 7 A.M. With the assistance of one patient – served the breakfast- gave after food medicines. washed the bed stands with warm water and ammonia. Took temperatures of all patients in the rear ward. 830 gave all of the morning medicines. 9 A.M. made poultice for an abscess on an arm. Bathed the same patient with lotion for skin infection. Gave three fever cases a sponge bath, bathed them thoroughly with alcohol. At 10 A.M. took temperature of typhoid, gave medicine gave milk to three fever cases. Washed a back with warm water and alcohol attended to boiling milk and giving it to a patient who is kept on boiled milk alone because his stomach will not retain any solid food. 11 A.M. gave medicines. 11.20 A.M. went to front ward to assist Mizz

[page 79v V.1] blank

[Inside Back Cover] Volume 1

[Back Cover] Volume 1

Spine

[Loose note, 1r V.1] middle. take 10-15 min- in eye & put it on pellet in few minutes dissolved & you can get it all, then eject... — [Loose note, 1r V.1]

middle. take 10-15 min- in eye & put it on pellet in few minutes dissolved & you can get it all, then eject the oil by holding in vertical position.

2 methods 1 English pinch up fold of skin quickly put in between the skin & under lying tissue give slowly the stretching of the skin gives pain & then abscess likely to put the needle all the way through if at all nervous

2 free from large veins biceps- fore arm thigh or calf. Draw from the back & insert straight down in muscle-

[Loose note, 1v V.1] it in order always wash out the barrel after using (first water also through the needle wipe off & put the wire... — [Loose note, 1v V.1]

it in order always wash out the barrel after using (first water also through the needle wipe off & put the wire in the needle or it rusts or clogs with dirt.

Whiskey will shrink the piston, put cap back

If dry unscrew the cap at the head flatten out the leather & soak in tepid water, Metal better as it will not break when putting it back) Fill with water & face it out next medicine pellets in spoon or bottom of saucer bott of goblet best as it is hollow in

[Loose note, 2r V.1] drop on goblet pellets are not soluble. Labor case uterine Hem occurs- pressure over uterus ergot & cold give a... — [Loose note, 2r V.1]

drop on goblet pellets are not soluble. Labor case uterine Hem occurs- pressure over uterus ergot & cold give a syringe full & inject it into the Abdom- wall-

Brights dis convulsions. Pilocarpine 1/8 Consider justifiable although some may censure. Do not buy a complicated one. Mustard plasters are too severe & expensive at druggists. 2 mus- 3 flour- mix together then use warm water if cold it will not call forth liberate the active principle, Hot destroys

[Loose note, 2v V.1] if solution unfit may make abscess- time to give when Dr. says Emergency may arise first get Dr. if possible & ... — [Loose note, 2v V.1]
if solution unfit may make abscess- time to give when Dr. says Emergency may arise first get Dr. if possible & use mild means if these fail use Hypo- Abdom- mus. poul. stupe. typhoid if he does not come give 1/8 or ¼ of morphia if hemorrhage give it at once, apply cold & ergot Dr. would advise Phthisis. pul. Hem. give ¼ of mor- Heart failure without a cause- rapid pulse livid lips Dysp- 1 per cent solution Nitro. Gly.