I have, of course, made use of every grade of rest for my patients, from repose on a lounge for some hours a day up to entire rest in bed. In milder forms of neurasthenic disease, in cases of slight general depression not properly to be called melancholias, in the lesser grades of pure brain-tire, or where this is combined with some physical debility, I often order a “modified” or “partial rest.” A detailed schedule of the day is ordered for such patients, with as much minuteness of care as for those undergoing “full rest” in bed. Here the patient’s or the household’s usual hours may be consulted, a definite amount of time allotted to duties, business, and exercise, and certain hours left blank, to be filled, within limits, at the patient’s discretion or that of the nurse.
So many nervous people are worried with indecision, with inability to make up their minds to the simplest actions, that to have the responsibility of choice taken away greatly lessens their burdens. It lessens, too, the burdens which may be placed upon them by outside action if they can refuse this or that because they are under orders as to hours.
The following is a skeleton form of such a schedule. The hours, the food, the occupations suggested in each one will vary according to the sex, age, position, desires, intelligence, and opportunities of the patient.
7.30 A.M. Cocoa, coffee, hot milk, beef-extract, or hot water. Bath (temperature stated). Rough rub with towel or flesh-brush: bathing and rubbing may be done by attendant. Lie down a few minutes after finishing.
8.30 A.M. Breakfast in bed. (Detail as to diet. Tonic, aperient, malt extract as ordered.) May read letters, paper, etc., if eyes are good.
10-11 A.M. Massage, if required, is usually ordered one hour after breakfast; or Swedish movements are given at that time. An hour’s rest follows massage. Less rest is needed after the movements. (Milk or broth after massage.)
12 M. Rise and dress slowly. If gymnastics or massage are not ordered, may rise earlier. May see visitors, attend to household affairs, or walk out.
1.30 P.M. Luncheon. (Malt, tonic, etc., ordered.) In invalids this should be the chief meal of the day. Rest, lying down, not in bed, for an hour after.
3 P.M. Drive (use street-cars or walk) one to two and a half hours. (Milk or soup on return.)
7 P.M. Supper. (Malt, tonic, etc., ordered; detail of diet.)
Bed at 10 P.M. Hot milk or other food at bedtime.
This schedule is modified for convalescent patients after rest-treatment by orders as to use of the eyes: letter-writing is usually forbidden, walking distinctly directed or forbidden, as the case may require. It may be changed by putting the exercise, massage, or gymnastics in the afternoon, for example, and leaving the morning, as soon as the rest after breakfast is finished, for business. Men needing partial rest may thus find time to attend to their affairs.