Nursing. 
If trained nurses are available, give the instructions about urine, 
temperature, pulse, medicines, etc., in writing. See that suitable 
temperature charts are provided. Failing trained nurses, willing 
volunteers must be instructed, but in severe cases the lack of skilled 
nursing cannot but militate against the ultimate outcome. A yellow 
fever case requires to be nursed even more intelligently than a 
typhoid case. The disease is rapid ; it is a question of hours, not of 
days, and when the critical moment arrives, unless you are on the 
spot, much valuable time will be irretrievably lost. I speak from 
experience, as my colleagues and myself are heavily handicapped by 
lack of trained lay nurses in treating patients in private houses. Many 
a time have I had to acknowledge that the public hospital yellow fever 
patient was better provided for than the richer private patient. The 
volunteers are willing, but the facilities for nursing are absent and 
• impossible to obtaia 
Until well on the road to recovery the patient should never be 
left alone. Visitors must be prohibited, and only those actually m 
attendance on the case should enter the room. 
The room should be large and airy, and the bed should be so 
arranged that day and artificial light will not cause annoyance. 
Photophobia is frequently a most distressing symptom. Ventilation 
is necessary, but care should be taken that the patient is expose to 
no draught. The bed should be narrow and have good springs ; the 
mattress should be covered with a rubber sheet. The bedclot nn to 
should be light. A sheet is usually sufficient. 
The necessary bed-pans and urine-bottles should be procure . 
generous supply of bowls should be ready for catching the \omitus, 
and when black vomit appears these should be changed as quick y - 
possible. Ice and ice-bags are necessary, as is also a hypo ermic 
syringe, previously sterilised and ready for any emergency, an < 
collection of ampoules of caffeine, spartein, strychnine and ctrer, 
some tubes of ethyl chloride ; cotton wool for the gums and n 
cleansing solution for the mouth. . 
The patient should be made to understand that absolui e r 
bed is necessary. If possible the faeces and urine shou P i 
in the bed-pan and bottle. No excitement should be allow e , a 
sleep can be obtained the outlook is all the better. 
