But in chronic cases, lasting over months and years, where the fatal issue is often determined at last by mere protracted starvation, I had rather not enumerate the instances which I have known where a little ingenuity, and a great deal of perseverance, might, in all probability, have averted the result.  The consulting the hours when the patient can take food, the observation of the times, often varying, when he is most faint, the altering seasons of taking food, in order to anticipate and prevent such times—­all this, which requires observation, ingenuity, and perseverance (and these really constitute the good Nurse), might save more lives than we wot of.

[Sidenote:  Food never to be left by the patient’s side.]

To leave the patient’s untasted food by his side, from meal to meal, in hopes that he will eat it in the interval is simply to prevent him from taking any food at all.  I have known patients literally incapacitated from taking one article of food after another, by this piece of ignorance.  Let the food come at the right time, and be taken away, eaten or uneaten, at the right time; but never let a patient have “something always standing” by him, if you don’t wish to disgust him of everything.

On the other hand, I have known a patient’s life saved (he was sinking for want of food) by the simple question, put to him by the doctor, “But is there no hour when you feel you could eat?” “Oh, yes,” he said, “I could always take something at ——­ o’clock and ——­ o’clock.”  The thing was tried and succeeded.  Patients very seldom, however, can tell this; it is for you to watch and find it out.

[Sidenote:  Patient had better not see more food than his own.]

A patient should, if possible, not see or smell either the food of others, or a greater amount of food than he himself can consume at one time, or even hear food talked about or see it in the raw state.  I know of no exception to the above rule.  The breaking of it always induces a greater or less incapacity of taking food.

In hospital wards it is of course impossible to observe all this; and in single wards, where a patient must be continuously and closely watched, it is frequently impossible to relieve the attendant, so that his or her own meals can be taken out of the ward.  But it is not the less true that, in such cases, even where the patient is not himself aware of it, his possibility of taking food is limited by seeing the attendant eating meals under his observation.  In some cases the sick are aware of it, and complain.  A case where the patient was supposed to be insensible, but complained as soon as able to speak, is now present to my recollection.

Remember, however, that the extreme punctuality in well-ordered hospitals, the rule that nothing shall be done in the ward while the patients are having their meals, go far to counterbalance what unavoidable evil there is in having patients together.  I have often seen the private nurse go on dusting or fidgeting about in a sick room all the while the patient is eating, or trying to eat.