It seems strange that this state of affairs should have so long been allowed to exist, for such coadjutors must have effected quite as much hindrance as help, and what useful purpose they could have served in hospitals, except as scrub-women, is incomprehensible to the trained nurse of to-day, who realizes the responsibility which her position involves, and the daily exercise of gentleness, firmness, and, above all, tact, which the successful management of a single ward necessitates. But a prejudice against the instruction of nurses was entertained at the outset by some of the medical profession, who feared that educated nurses would trench upon their own province, and, if they were taught to know one drug from another, would immediately proceed to the practice of therapeutics on their own account.

This feeling is fast dying out, as they come to see that in just this particular is the essential point of difference between the trained and the untrained nurse. It is only those who have had no formal instruction as to their duty, its extent and its limits, who are guilty of thus overstepping the bounds of propriety; not those who are taught, but those who are untaught, and who have picked up, in a hap-hazard way, certain isolated facts regarding medical treatment, which they generalize and act upon. The trouble with such nurses is not that they know too much, but that they know too little. It is impossible that, with sickness and its treatment always under their eyes, they should not assimilate some information; the only question is whether they shall be taught it systematically, and in its proper relations, or whether they shall be left to appropriate and use it empirically. The question has been sufficiently answered by the success of the training-schools, and the ever-increasing demand for nurses trained to a knowledge

befitting their position. The existence of the schools has been amply justified; it remains for each individual nurse to prove the thoroughness of her training, by showing how completely and exclusively she can mind her own business.

Says the great English physiologist, "If knowledge is real and genuine, I do not believe it is other than a very valuable possession, however infinitesimal its quantity be. Indeed, if a little knowledge be dangerous, where is the man who has enough to be out of danger!" Learn, then, all that you can-only take care that your knowledge is real and genuine, and not a mere smattering of technical terms-and you may be assured that the more you know, and the more thoroughly you know it, the more will you realize the depth of your own ignorance, and the less will you dare to make any other than the legitimate use of your knowledge.

Health has been comprehensively defined as the "perfect circulation of pure blood in a sound organism." Any departure from either of these three conditions constitutes disease. There is recognized in nature a certain tendency to reparation, a predisposition to return to the conditions of health, whenever there has been any deviation from them. To assist this is the object of treatment. To keep the patient in the state most favorable for the action of this reparative tendency, is especially the vocation of the nurse, and it is beyond a doubt that those who best understand this, and have the fullest acquaintance with nature's processes, will be the most successful nurses.

The importance of the art of nursing can scarcely be overestimated; in many cases the recovery of the patient will depend more upon the care he receives than

upon medical skill. Nursing properly includes, as well as the execution of the physician's orders, the administration of food and medicine, and the more personal care of the patient, attention to the condition of the sick-room, its warmth, cleanliness, and ventilation, the careful observation and reporting of symptoms, and the prevention of contagion. It is a work which falls largely, though not exclusively, to the share of women, and it has sometimes been claimed that all women make good nurses simply by virtue of their womanhood. But this is far from true. To fitly fill such a position requires certain physical and mental attributes, which all women-even all good women-do not possess, as well as some special training. A natural aptitude for nursing is a valuable basis for instruction, but will not take the place of it, nor will good intentions ever compensate for a lack of executive ability.

Unimpaired health and power of endurance, intelligence, and common-sense, are primary essentials for a nurse. She should be a person of even, cheerful temperament, not easily irritated or confused-for to lose temper or presence of mind in the sick-room is fatal to usefulness. She must have acute perceptions, habits of correct observation and accurate statement, and some manual dexterity. She needs to be quiet, neat, and systematic, and capable of eternal vigilance.

There is still too prevalent the impression that it is a waste of ability for an educated woman to become a nurse; that it is a fit resource rather for those worn out, discouraged, or incapable of anything else. Those who have tried it know that, on the contrary, there is in this work room for the exercise of talents of the highest, and virtues of the rarest order, and surely in this day, when there are so many women in need of occupation—

women of some degree of culture and refinement, who look in vain for some suitable outlet for their energies— it ought not to be true, as it is, that the majority of the applications for admission into our training-schools are from those utterly unfit for the work; either surviving relics of the by-gone times when a nurse ranked on or below the par of house-maid, or sentimentalists with their heads full of romantic visions of themselves flitting about like angels of mercy, bathing the brows of suffering heroes, and distributing among them flowers and smiles. The latter class are sure to be disappointed, generally disgusted, for they find the reality practical, prosaic, and often even revolting. But it is a field of usefulness such as is nowhere else afforded, and a woman with the requisite qualifications, who desires to be really of service to her fellow-creatures, and to adopt an employment of absorbing interest, at once honorable and remunerative, can not do better than to train herself for a nurse. It is to such as have entered upon this course with an earnest aim to well qualify themselves, and to elevate the professional standard, that the following instructions are addressed.

When you have once undertaken the care of a sick person, his welfare is of course understood to become your first consideration. With this object always in view, your duties may be classified as threefold: those which you owe to yourself, those due to the physician under whose direction you work, and such as relate immediately to the patient. Something is perhaps owing also to the school with which you are or have been connected. You are at least afforded an additional motive for guarded conduct by the remembrance that you are its representative to the public, the exponent of its methods, and that, according as you behave yourself well or

ill, credit or discredit is reflected upon the entire school. It may at first glance seem somewhat strange to assert that your own personal duties should take precedence, but a little reflection will show that whatever theories of self-devotion you may entertain, and however willing you may be to sacrifice your own comfort to the welfare of your patient, disregard of the duties to yourself will sooner or later incapacitate you for the fulfilment of all others. You may give up your convenience, your pleasure-indeed will be perpetually called upon to do so as the inevitable claim of the work you have chosen-but your health you have no right to risk. Remember that self-sacrifice is not always unselfishness, and that the nurse who takes the best care of her own health will be best able to care for her patient. Ill-regulated zeal only defeats its own object; if you wish to be really and permanently efficient, you will take pains not to lower the standard of your own physical condition. Even a nurse is but human; you can not retain your vigor and consequent usefulness without a due allowance of rest, food, and exercise. It is your duty, as well as your right, to insist upon securing these, and to take proper time for the care of your own person, and for your meals. You owe it to yourself also, and to the whole nursing sisterhood, to enforce a suitable regard for your reputation, and for the dignity of your position. The maintenance of strict propriety and decorum on your own part will rarely fail to command respect.

To the doctor, the first duty is that of obedienceabsolute fidelity to his orders, even if the necessity of the prescribed measures is not apparent to you. You have no responsibility beyond that of faithfully carrying out the directions received. It is true that nearly all orders are conditional, and that circumstances may