Now what kind of a nurse is this?
[Sidenote: Difference of excitable and _accumulative_ temperaments.]
I would call attention to something else, in which nurses frequently
fail in observation. There is a well-marked distinction between the
excitable and what I will call the _accumulative_ temperament in
patients. One will blaze up at once, under any shock or anxiety, and
sleep very comfortably after it; another will seem quite calm and even
torpid, under the same shock, and people say, "He hardly felt it at
all," yet you will find him some time after slowly sinking. The same
remark applies to the action of narcotics, of aperients, which, in the
one, take effect directly, in the other not perhaps for twenty-four
hours. A journey, a visit, an unwonted exertion, will affect the one
immediately, but he recovers after it; the other bears it very well at
the time, apparently, and dies or is prostrated for life by it. People
often say how difficult the excitable temperament is to manage. I say
how difficult is the _accumulative_ temperament. With the first you have
an out-break which you could anticipate, and it is all over.
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