Now, have those who say this, considered that, in order to obey, you must know how to obey, and that these soldiers certainly do not know how to obey in nursing.  I have seen these “kind” fellows (and how kind they are no one knows so well as myself) move a comrade so that, in one case at least, the man died in the act.  I have seen the comrades’ “kindness” produce abundance of spirits, to be drunk in secret.  Let no one understand by this that female nurses ought to, or could be introduced in regimental hospitals.  It would be most undesirable, even were it not impossible.  But the head nurseship of a hospital serjeant is the more essential, the more important, the more inexperienced the nurses.  Undoubtedly, a London hospital “sister” does sometimes set relays of patients to watch a critical case; but, undoubtedly also, always under her own superintendence; and she is called to whenever there is something to be done, and she knows how to do it.  The patients are not left to do it of their own unassisted genius, however “kind” and willing they may be.

IV.  NOISE.

[Sidenote:  Unnecessary noise.]

Unnecessary noise, or noise that creates an expectation in the mind, is that which hurts a patient.  It is rarely the loudness of the noise, the effect upon the organ of the ear itself, which appears to affect the sick.  How well a patient will generally bear, e. g., the putting up of a scaffolding close to the house, when he cannot bear the talking, still less the whispering, especially if it be of a familiar voice, outside his door.

There are certain patients, no doubt, especially where there is slight concussion or other disturbance of the brain, who are affected by mere noise.  But intermittent noise, or sudden and sharp noise, in these as in all other cases, affects far more than continuous noise—­noise with jar far more than noise without.  Of one thing you may be certain, that anything which wakes a patient suddenly out of his sleep will invariably put him into a state of greater excitement, do him more serious, aye, and lasting mischief, than any continuous noise, however loud.

[Sidenote:  Never let a patient be waked out of his first sleep.]

Never to allow a patient to be waked, intentionally or accidentally, is a sine qua non of all good nursing.  If he is roused out of his first sleep, he is almost certain to have no more sleep.  It is a curious but quite intelligible fact that, if a patient is waked after a few hours’ instead of a few minutes’ sleep, he is much more likely to sleep again.  Because pain, like irritability of brain, perpetuates and intensifies itself.  If you have gained a respite of either in sleep you have gained more than the mere respite.  Both the probability of recurrence and of the same intensity will be diminished; whereas both will be terribly increased by want of sleep.  This is the reason why sleep is so all-important.  This is the reason why a patient waked in the early part of his sleep loses not only his sleep, but his power to sleep.  A healthy person who allows himself to sleep during the day will lose his sleep at night.  But it is exactly the reverse with the sick generally; the more they sleep, the better will they be able to sleep.