[4] [Sidenote:  Diseases are not individuals arranged in classes, like cats and dogs, but conditions growing out of one another.]

Is it not living in a continual mistake to look upon diseases, as we do now, as separate entities, which must exist, like cats and dogs? instead of looking upon them as conditions, like a dirty and a clean condition, and just as much under our own control; or rather as the reactions of kindly nature, against the conditions in which we have placed ourselves.

I was brought up, both by scientific men and ignorant women, distinctly to believe that small-pox, for instance, was a thing of which there was once a first specimen in the world, which went on propagating itself, in a perpetual chain of descent, just as much as that there was a first dog, (or a first pair of dogs,) and that small-pox would not begin itself any more than a new dog would begin without there having been a parent dog.

Since then I have seen with my eyes and smelt with my nose small-pox growing up in first specimens, either in close rooms, or in overcrowded wards, where it could not by any possibility have been “caught,” but must have begun.  Nay, more, I have seen diseases begin, grow up, and pass into one another.  Now, dogs do not pass into cats.

I have seen, for instance, with a little overcrowding, continued fever grow up; and with a little more, typhoid fever; and with a little more, typhus, and all in the same ward or hut.

Would it not be far better, truer, and more practical, if we looked upon disease in this light?

For diseases, as all experiences hows,[Transcriber’s note:  Possibly typo for “show”] are adjectives, not noun substantives.

III.  PETTY MANAGEMENT.

[Sidenote:  Petty management.]

All the results of good nursing, as detailed in these notes, may be spoiled or utterly negatived by one defect, viz.:  in petty management, or in other words, by not knowing how to manage that what you do when you are there, shall be done when you are not there.  The most devoted friend or nurse cannot be always there.  Nor is it desirable that she should.  And she may give up her health, all her other duties, and yet, for want of a little management, be not one-half so efficient as another who is not one-half so devoted, but who has this art of multiplying herself—­that is to say, the patient of the first will not really be so well cared for, as the patient of the second.

It is as impossible in a book to teach a person in charge of sick how to manage, as it is to teach her how to nurse.  Circumstances must vary with each different case.  But it is possible to press upon her to think for herself:  Now what does happen during my absence?  I am obliged to be away on Tuesday.  But fresh air, or punctuality is not less important to my patient on Tuesday than it was on Monday.  Or:  At 10 P.M.  I am never with my patient; but quiet is of no less consequence to him at 10 than it was at 5 minutes to 10.