Trying as are many, indeed we may truly say most of the duties of the sick-room, nothing renders them so much so as the fact that the disease under which the patient is suffering is of an infectious, or of a contagious nature.

There is a great deal to be said on the head of avoidance of infection or contagion, while nursing a sufferer through disease of either one nature or the other. In this as in all other matters connected with sick-nursing, heroic, would-be-martyr-like conduct is absurd and blamable, for prudence goes for a great deal, and indiscretion brings trouble and suffering on others as well as yourself. 'I don't mind what risk I run; I am too anxious to think about myself!' always seems to us a feeble and (to use a strong northern word) a very feckless sort of remark, only made, in nine cases out of ten, to exact the tribute of a surprised or admiring look. On the contrary, the aim and end of every sick-nurse should be to do as much good and be as much comfort as possible with the least possible risk. To achieve this, the smallest and most apparently trivial precautions are worth taking, in order to prevent the friends and relatives about you having the additional trouble and anxiety of nursing you as a second invalid, just when 'number one' is recovering.

'I am so anxious I can't eat! I haven't touched a morsel to-day!' are by no means uncommon remarks to hear from the lips of some one who is nursing, or assisting to nurse a case of infectious disease. Yet this abstinence is just the very worst thing you can possibly do under such circumstances, and the most calculated to render yourself an easy prey to that unseen influence pervading the air, and like the seeds of some poisonous plant, ready to take root if soil be found favourable to its growth. Feebleness, over-weariness, exhaustion, want of sufficient nourishment—all these things aid in preparing this suitable soil, and woo the disease germs that are floating about in the air to take root and bring forth bitter fruit. A vigorous cheerful person, capable of strong self-control, often seems able to defy the closest contact with disease; and even if some malaise (often closely allied to the disease of the patient) knocks over the willing nurse for a time, the elastic constitution of body and mind seems to throw off the poison, and no serious illness results. Nothing is more common than the occurrence of these spurious attacks of illness, allied to that from which the person nursed is suffering, and the following case is an example.

A lady nursing a friend in small-pox, after lengthened attendance in the sick-room, was attacked by faintness, shivering, a sensation of nausea, and violent headache. Both the nurse and her friends concluded that a seizure of the loathsome disease from which the patient was suffering was inevitable. However, the following day several large blotches appeared on various parts of the body; all unpleasant symptoms gradually disappeared; and in a day or two—without the original sufferer having had any idea that her nurse was kept away by anything more serious than need of rest—she was able to return to her duties, and never suffered any further deterioration of health. In the same way we have known those who were nursing cases of fever to be suddenly attacked by sore throat, headache, and vertigo, these symptoms passing off after twenty-four or forty-eight hours, and no further evil resulting. A vigorous constitution, care while nurse-tending as to diet and exercise, joined to a mind calm and equable, and ready to face all possibilities without flurry, feverish excitement, or fear, will in many cases enable the sick-nurse to throw off the seeds of disease. But a malignant influence which floats in the atmosphere of the sick-room, pervading the breath of the sick person, and hanging like a bad odour about the bed-clothes, carpets, and even the wall-paper of the room, is necessarily a difficult enemy to evade—and such is infection. And any one who has a timorous dread of it is far better away from the sick-room.

This is, we think, a matter that cannot be too strongly insisted upon. To watch for symptoms is often to develop them; and constant dwelling upon the condition of any one organ of the body, and apprehension as to disease in that organ, will often produce at all events functional derangement if no greater evil. By this we do not mean that neglect of one's self is ever justifiable, but only that fearful and timorous apprehension is deleterious.

So strongly has this fact impressed itself upon us with regard to infection, that we even think it would be well to strain a point, and encourage a person to absent herself from the sick-room, rather than run the risk of having a nurse of this temperament near a patient suffering from disease of a catching nature. In sickness the perceptions are often rendered painfully acute, and the mind naturally much concentrated on itself, is therefore ready to take offence or be troubled by trifles. We have seen a patient shrink from the ministrations of a person whom he felt to be in a state of fear.

Just in the same way, if the duties of the sick-room are (as they often must be) unpleasant, a look of aversion or disgust is enough to wound the sufferer beyond the power of caress or words to heal! A woman who turns sick, or is obliged to put a handkerchief to her nose at a foul smell—who shudders at the sight of blood, ought never to be in a sick-room. The same may be said of one who is always feeling her own pulse, or (as we once saw) looking at her own tongue in the glass (by no means a graceful proceeding), to see if symptoms are 'declaring themselves.' All or much of this sort of nervousness may be affectation; but at the same time we must not judge unkindly of those who from natural temperament dread infection, and are therefore likely to fall a prey to it.

And now, taking it for granted that we have a tolerably sensible woman to deal with, and that she is called upon to nurse a case of fever, small-pox, diphtheria, or any such-like unpleasant ailment, what precautions are best calculated to reduce the risk of infection to a minimum?—a risk which we cannot do away with, but are certainly called upon to guard against to the utmost in our power. Attention to diet, so as to ward off great exhaustion at any time, and taking at least half an hour's exercise in the open air, are excellent rules to observe. Never go into the sick-room fasting. And here we must strongly urge upon every sick-nurse the value of coffee as a restorative. In times of cholera epidemics among our soldiers, the first precaution the authorities invariably take is to order a cup of strong coffee to be served out to each man the first thing in the morning. The effects of this plan are known to be admirable.

Take a brisk walk shortly after your breakfast; order a cup of hot strong coffee to be ready when you come in, and take it before going into the patient's room. Nothing helps to throw off the weariness of a night's watching like this turn in the fresh air (even if taken of necessity under an umbrella), and the coffee braces the nerves and invigorates the system.

To speak of the avoidance of alcoholic stimulants is to enter upon delicate ground; though we are of opinion that in serious cases the nurse should seldom touch anything stronger than coffee throughout the whole time. This abstaining gives a power of recovering with great promptitude from the effects of long-continued watching and heavy duties in the sick-room. Depend upon it that the recurring glass of sherry, the oft-repeated 'nip' of brandy-and-water, do a world of harm both in the sick-room and out of it.

That wine and brandy are valuable restoratives in weakness, cannot be denied; and it is certain that there are many constitutions which need a moderate amount of stimulant; but that stimulants are taken to a perfectly needless and most pernicious extent, even by those who by no means come under the term 'drunkard,' and that among these are numbered women as well as men, is a stubborn and unhappy fact. One of the many evils resulting from this over-use of stimulants is this: when severe illness and prostration call for wine or brandy, the system is so used to their action that but little benefit accrues; at all events, little when compared to that prompt answer the constitution gives to even small doses, when that constitution has either made very sparing use, or no use at all, of such whips and spurs to the energies of life.

The proper ventilation of a sick-room is a most important means of lessening the danger of infection; and this more particularly in such diseases as fever, small-pox, or diphtheria—that is, diseases coming distinctly under the head infectious. In those which are contagious, ventilation is of course also important, but not equally so. And this leads us on to speak of the difference between infection and contagion. Infection is subtly diffused through the atmosphere, the patient's breath, the clothes, hangings, walls, &c. Contagion consists in the disease being propagated by the emanations of the sick person. It is therefore obvious that the latter (contagion) is more easily guarded against by a prudent person than the former (infection). The plentiful use of disinfectants seems to be one of the best preventives against contagion; but of course all such details are generally regulated by the medical man in attendance, and no better advice can be given to the amateur sick-nurse than to follow his directions implicitly.

We will, before leaving this subject, quote one passage from Dr Aitken's excellent work, The Science and Practice of Medicine. In volume one, page 222, he says: 'Ill-health of any kind therefore favours the action of epidemic influences.' Thus then, we see how one of our highest medical authorities bears out the truth of what we have said—namely that for the sick-nurse to neglect her own health—to go without sufficient and regular food—in a word, to lower by any means whatever the standard of her own physical condition, is to intensify the risk of infection or contagion for herself, and trouble and anxiety for those belonging to her.

We have no belief in the disinfecting of clothes that have been worn during attendance on cases of an infectious nature. It is far better to wear an old dress, wrapper, shawl, &c., and when the illness is over have them burned. The same thing applies to clothing worn by the patient.

We remember one most lamentable case where (as was supposed) everything was disinfected, washed, and exposed to the air; yet the gift of a night-dress to a poor woman resulted in virulent small-pox, and the sufferer, a young married woman, was cruelly disfigured in spite of the best care and nursing an hospital could give.

It comes then to this: infection cannot be evaded; but risk may be reduced to a minimum by an observance of the precautions we have noted, by the exercise of plain common-sense, and by the reality—not romance—of devotion to the work undertaken by the sick-nurse.