ORDERS FOR THE SICK ROOM.

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DWARD C. REGISTER, in the Charlotte Medical Journal, gives some excellent advice upon the subject of the doctor's instructions as to the care of his patient. Leave absolutely nothing to chance and possible misunderstanding, he says. Know how to do yourself properly the things you order done for your patients and don't think it above you "to take off your coat" and deign to show your nurse how you want things done in case the one in charge of the nursing end of the case needs to be shown. The best explanation of how to do something is not one of many longdrawn-out words, but of actual demonstration. If there is a possibility of any crisis arising suddenly or unexpectedly in any given case don't say to your nurse "if such a thing occurs you know what to do," but give plain, definite and explicit instructions what you want done if the crisis arises, and see to it personally before you leave the house that the necessary things are at hand to combat the crises with should it become necessary to do so. If they should not happen to be there for use when they were wanted your able directions would not be of very much value to the patient.

In giving orders to either a trained nurse or the family member who is acting in a nurse's capacity it is better to write down everything in plain, simple language, concisely put, and not trust to the memory of anyone. Besides, it protects you against possible trouble. If you have written a thing down and it is not carried out the claim can not be made that you gave no such instructions. It might save you from having a malpractice suit on your hands some time. Insist that the nurse do the same so far as her reports to you are concerned. This

refers to the trained or amateur nurse. Insist upon her writing down everything she does or gives to the patient and the time at which it was done or given. The same rule also applies to anything noticed regarding the patient's actions or condition. It must be written down at once and in detail. Then when you come you will receive full information as to what has taken place in your absence instead of just what happens to be remembered on the spur of the moment at the time you came in. In this latter method many important things that you should know are usually forgotten while you are at the patient's bedside and remembered just after you left, and therefore you are left in total ignorance of them, when, had you known of them, your treatment might have been materially changed, and for the good of the patient. Don't be careless in the giving of orders yourself, and do not permit carelessness on the part of those charged with the carrying out of them.

ALCOHOL AS A CLEANSER. Professor Schumburg, a surgeon on the general staff of the German Army, asserts positively that by washing hands with as strong alcohol as possible, 99% or more of hand bacteria can be rendered innocuous. For a single disinfection about one-half is sufficient. The same effect can be obtained from the use of the ordinary denatured alcohol. According to Schumburg's investigations, the application of soap softens the skin as well as the capsules of the bacteria, rendering them more adherent, so that even prolonged brushing does not effect their removal, while alcohol, by hardening the skin, causes the bacteria to cling less firmly, so that they can be more easily detached. That this view has good foun

dation in fact is shown by the reports from the medical department of the Prussian Ministry of War, according to which bacteriological experiments have demonstrated that washing the hands with alcohol is a rapid and safe means of diminishing the number of germs, while soap is without any action in this respect. To secure absolute protection with alcohol, however, the preliminary use of soap and water must be excluded, since a certain amount of moisture is left after drying, and by diluting the alcohol makes it less effective. Furthermore, the softening of the skin by water causes it to contract more strongly when the alcohol is later applied, and by rendering it rough and scaly encourages the transferrence of bacteria from the surgeon's hands to the wound.

As in all methods of hand disinfection the chief aim is to secure as close an approximation to asepsis as possible, together with the greatest simplicity of technic. The procedure suggested above is worthy of more than ordinary consideration.

DIRT AND DIRT.

R. G. Eccles remarks that mud and soil, coal dust and ashes, paint and varnish, are almost as harmless as the clothes we wear. It can kill no one in any such doses as any single mortal is likely to take. The suckling infant is not at all likely to be harmed by it. The "great unwashed" revel in such dirt from age to age and, the moral effect being excluded, no harm comes to them from it. But this dirt of theirs, by being a telltale of careless habits, becomes a visible index of the invisible dirt that is deadly. People who are willing to tolerate the visible dirt are pretty sure to be none too careful concerning the dangerous dirt. The two kinds get blended. is, however, not only possible but actually probable that there are foul and filthy hands, of the kind to which reference is here made, that are by their owners kept

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perfumed, manicured till finger nails shine, and every vestige of visible blackness has disappeared. They wash as they eat and sleep, under the guidance of a clock. That there is a fitness in the time for washing in order to be clean has not dawned upon their understanding.

It is only within the past two decades that physicians themselves have learned the difference between the apparent and the real cleanness of their own hands. It is a subject of extreme importance to pharmacists, for they touch practically everything they dispense except liquids and we have even seen some of them strained through a soiled towel! However, this latter is quite a rare instance of careless filthiness. Remember that the worst dirt is invisible, and as every drug store is stocked with good soaps, efficient germicides, water and clean towels, there can be no excuse for anything less than absolute cleanliness.

THE DIETETIC CURE OF OBESITY.

Albu, of Berlin, recommends his obese patients a strict vegetarian diet. He remarks that vegetable foods are very poor in fats, comparatively poor in albumen, and that their carbohydrates, enclosed within cellulose envelopes which are more or less insoluble, are are only assimilable in part.

It is a matter of common knowledge that the assimilation of vegetables rich in carbohydrates is greatly facilitated by giving them in the form of purées, for which reason this form should be rigorously excluded from the regimen under consideration. Should also be forbidden, vegetables, farinaceous articles and almonds, walnuts, filberts, etc., which are particularly rich in alimentary principles.

The dietary must consist in the main of bread, fresh vegetables, salads, stewed fruit and raw fruit. Potatoes need not be forbidden.

Beef tea, coffee, tea, mineral waters and lemonade are allowed. Patient should be advised not to drink much with meals, because free drinking with meals usually means taking plenty of food. Two or three eggs a day may be taken. This diet has the advantage of stimulating the intestinal functions. In persons who suffer from habitual constipation we may also authorize half a pint to a pint of soured milk daily.

In drawing up the dietary we must choose articles of food that contain as few calories as possible in as large a bulk as possible. Proceeding on these lines the author has drawn up a number of diet tables, of which we give a few below:

Lunch (1)-A bouillon, one egg, four ounces of spinach and some potato, some stewed apples or apricots; half a pound, or more, of grapes, a cup of coffee with saccharine.

Dinner-Radishes, 2 ounces; brown or rye bread with a third of an ounce of butter and some lemonade or tea with saccharine.

Lunch (2)-Cauliflower with four or five potatoes, cucumber salad, stewed prunes, raw apples or apricots.

Dinner-About one pound of potatoes, cabbage or cucumber salad, raw fruit.

Lunch (3)—A fruit soup and a dish of carrots or French beans and some potatoes (four or five), raspberries and pineapple.

Dinner-Fried potatoes with French beans, stewed fruit and half a pound cherries.

Lunch (4)-Spinach with poached eggs, potato salad, stewe rhubarb, half a pound of raw fruit.

Dinner-A pint of soured milk, a twoegg omelette and half a pound of cherries.

Lunch (5)-An omelette with herbs, stewed fruit, four potatoes, a salad of

raw fruit and a cup of coffee with saccharine.

Dinner-French beans and potatoes, a cabbage salad, melon or apples, eight ounces, and so on.

The author has never continued a strict vegetarian diet for more than from four to six weeks. After that he allows small quantities of meat; five to seven ounces of beef or lean veal, boiled, thrice a week. Thereupon the loss of weight comes to an end.

This diet may be continued for months without any drawbacks to health. It is contraindicated in cases of fatty heart and in presence of grave digestive disturbances.

IODINE IN TOOTH DECAY. Eugene S. Talbot, in the Dietetic and Hygienic Gazette, declares that no one drug will destroy lactic acid bacilli and their ferment and thus stop tooth decay like iodine. Frequent applications will destroy all germs in the mouth and reduce mouth and general disease to a minimum.

Before operations on the mouth and fauces, the gums, teeth and mucous membrane should be given an application of iodine; especially in the removal of tonsils. After this treatment, and after the iodine has become absorbed, the tonsil or part to be operated on should receive similar treatment. This application should be made from ten to fifteen minutes before operation.

To prevent contagious and infections among public school children, their teeth, gums and mucous membrane should be painted with iodoglycerole as often as once a week during the school term. This method will greatly reduce tooth decay.

The author has been able to reduce decay of the teeth in his practice thirty to forty per cent during the past thirty years by this method of procedure.

While mouth washes may, in a measure, produce certain results, there is nothing positive in relation to germ

destruction. The iodine compound enters into the deep tissues of the mouth and cavities of the teeth and destruction of bacteria is assured. The nasal cavities, eyes, ears, throat and body generally should receive as careful attention as the mouth.

Surely the school child and his possibilities are of as much importance to the parents and community as the animal and his possibilities to the stock breeder, which receive the most careful consideration. The later results are far more reaching. As this country develops, those in control of its welfare should possess healthy bodies and brains. The stability of this country depends upon the health of its citizens, so the coming generations should be reared in body and mind as near normal as possible.

INDUCING SLEEP.

W. T. Marrs, in the Medical Times, remarks that suggestion has from time immemorial been used in hundreds of ways to invite sleep. The influence of monotonous noises and vibrations to which the patient has long been familiar are well known, and these same have all been imitated or a psychic appeal of a similar character has been called into requisition. The ancient and honorable methods of trying to go to sleep by watching the sheep, reciting the multiplication table and Declaration of Independence, counting, going up the alphabet backwards, etc., are too often opposed to sleep and only weary the patient into more extreme wakefulness. It sets the mind off on new tangents when you are already letting too many vagrant and worthless thoughts go chasing through the brain. One of my patients, an educated gentleman, while indulging in the classic stunt of doing the alphabet backwards, got to thinking of that psychological freak perpetrated by some one to the effect that certain letters are possessed of color, weight, odor and even an aura suggestive of virtues or unregenerate

qualities. Thus the alphabet only further disturbed his peace of mind and so did the other rigmaroles which he employed. with a view to favoring somnolency.

Suggestion and psychotherapy, when rightly used, are of the greatest value in the treatment of insomnia. After the sufferer has regulated his physical and mental habits he is in a good way to sleep normally, provided that pain or a pathologic condition of severity do not exist. It is an exceedingly easy matter for the users of narcotics to form the "pain habit” which, after all, is only another name for dopiness. The sleepless victim should practice auto-suggestion and endeavor to school his nerves into calmness and his brain into non-thinking. He should try to inhibit unnecessary movements and root out fixed ideas. Whenever one suppresses one of those little imbecilic obsessions that he must whistle, clear the throat, touch wood, cross the legs, giggle, count his steps, or hundreds of other things just as absurd that seem to enthrall so many people he (more often it is she) has done much toward mastering self. One of the objections to sheepcounting and its ilk is that it trains the mind toward obsessions and fixed ideas.

COOKING AND HEALTH.

Elmer Lee, in the Medical Times, points out that health of body and contentment of mind depends on full, natura! and acceptable rations. Scanty and imperfect foods produce shriveled cells and weak bodies.

The heat applied in cooking splits up the organic unity of food. Heat too intense or too long continued carbonizes, mineralizes, crystallizes and destroys food, bursts upon or burns up the capsules of the cells and liberates much of the inherent dynamic force. Foods gently, delicately prepared by heat retain the original dynamic power, form, appearance and bulk, and but a small part of the vital essence is driven off by mild heat and pressure of the cooking process.

Heat-prepared plants, vegetables, berries, and fruits, in the ripe and original condition, are vital and nourishing. Vital and organized foods obtained from the vegetable kingdom sustain the vigor and substance of animals in strength and health. Foods of poor and defective quality may be made palatable by spices, dressing and seasoning, but such preparations are unfavorable and harmful.

Prolonged daily use of weak, watery and stale table preparations, badly cooked and soggy vegetables, fried and much. roasted meats, gravies, fats and oils, clog, corrupt and debauch the human body, cause irritation, congestions, inflammations, suffering, debility and dis

ease.

Wrong kitchen cooking is the principal destroyer of mankind, and the dining table an altar of human sacrifice.

The waste of human life everywhere is gradual, progressive and appalling, costly and demoralizing.

Favorable foods in abundance, yet misunderstood, neglected, rejected or misused, shorten and afflict the life of the human race.

Sound health is the vital and precious asset of life.

Life is freely transmitted, but food to sustain and develop it can only be obtained by great, persistent and thoughtful labor. He who will not work and produce shall not eat, and even if he cats what is created by another it will not prosper him.

Selected plant-grown substance is man's true and fitting food, favorable and suitable, keeping him in clarity of blood, strength of muscle, purity of body, resourceful, patient and cheerful.

Food articles that are old, shriveled, stale, refrigerated, cured, generally contain decay, poisons and harmful ingredients. The habitual use of such food gradually and certainly brings derangement, weakness and disease. Better food and perfect nutrition is a question of greatest importance to such as aspire to

longevity and a retention with free use of the faculties..

WHAT IS A RATIONAL DIET?

Melloy Lyon, writing in the New York Medical Journal, contends that unless a physician has a practical knowledge of the physiology of digestion and has studied foods in their relation to nutrition in both normal and pathological conditions, he had better ignore the subject entirely. Better admit to the patient: "Eat what you want, what seems to agree; eat plenty, take good care of yourself, and we will worry along with the hope that Nature will step in and in some mysterious way bring you out of this and save my bacon by covering up my ignorance." Nature often does wonders in spite of our very best efforts to destroy her works.

From a layman, one Horace Fletcher, we are told that a square meal may be had on a cracker or a cherry or a bite of meat, by simply chewing the food for a portion of the day. And Upton Sinclair has spun several columns in one of the popular magazines in telling how stomach ills vanish by his system of fasting for many days at a time. Professor Chittenden has contributed to the dope sheet in declaring that we can live and move and have our being on about one-half the amount we eat. As these gentlemen seem to be in harmony with their ideas, think what a blow to the food trust would be dealt if we ate but half what we do now and then fasted eight or nine days in every month.

Ralstonism, raw food, no-breakfast theory, and a dozen other dietetic fads, all have a specific principle in view, and maybe they all have a serious deficiency. The most of them are exploited in the popular periodicals and the layman adopts the new idea as a Heaven-sent blessing a panacea for present ills. Let us not fall into the trap of allowing these enthusiasts to mislead us. Let us either know the subject thoroughly and