If we are to preserve the air within as pure as the air without, it is needless to say that the chimney must not smoke.  Almost all smoky chimneys can be cured—­from the bottom, not from the top.  Often it is only necessary to have an inlet for air to supply the fire, which is feeding itself, for want of this, from its own chimney.  On the other hand, almost all chimneys can be made to smoke by a careless nurse, who lets the fire get low and then overwhelms it with coal; not, as we verily believe, in order to spare herself trouble, (for very rare is unkindness to the sick), but from not thinking what she is about.

[Sidenote:  Airing damp things in a patient’s room.]

In laying down the principle that this first object of the nurse must be to keep the air breathed by her patient as pure as the air without, it must not be forgotten that everything in the room which can give off effluvia, besides the patient, evaporates itself into his air.  And it follows that there ought to be nothing in the room, excepting him, which can give off effluvia or moisture.  Out of all damp towels, &c., which become dry in the room, the damp, of course, goes into the patient’s air.  Yet this “of course” seems as little thought of, as if it were an obsolete fiction.  How very seldom you see a nurse who acknowledges by her practice that nothing at all ought to be aired in the patient’s room, that nothing at all ought to be cooked at the patient’s fire!  Indeed the arrangements often make this rule impossible to observe.

If the nurse be a very careful one, she will, when the patient leaves his bed, but not his room, open the sheets wide, and throw the bed-clothes back, in order to air his bed.  And she will spread the wet towels or flannels carefully out upon a horse, in order to dry them.  Now either these bed-clothes and towels are not dried and aired, or they dry and air themselves into the patient’s air.  And whether the damp and effluvia do him most harm in his air or in his bed, I leave to you to determine, for I cannot.

[Sidenote:  Effluvia from excreta.]

Even in health people cannot repeatedly breathe air in which they live with impunity, on account of its becoming charged with unwholesome matter from the lungs and skin.  In disease where everything given off from the body is highly noxious and dangerous, not only must there be plenty of ventilation to carry off the effluvia, but everything which the patient passes must be instantly removed away, as being more noxious than even the emanations from the sick.

Of the fatal effects of the effluvia from the excreta it would seem unnecessary to speak, were they not so constantly neglected.  Concealing the utensils behind the vallance to the bed seems all the precaution which is thought necessary for safety in private nursing.  Did you but think for one moment of the atmosphere under that bed, the saturation of the under side of the mattress with the warm evaporations, you would be startled and frightened too!