At night, if
the patient has had a day of excitement, it is almost imperceptible.
But, if the patient has had a good day, it is stronger and steadier and
not quicker than at mid-day. This is a common history of a common pulse;
and others, equally varying during the day, might be given. Now, in
inflammation, which may almost always be detected by the pulse, in
typhoid fever, which is accompanied by the low pulse that nothing will
raise, there is no such great variation. And doctors and nurses become
accustomed not to look for it. The doctor indeed cannot. But the
variation is in itself an important feature.
Cases like the above often "go off rather suddenly," as it is called,
from some trifling ailment of a few days, which just makes up the sum of
exhaustion necessary to produce death. And everybody cries, who would
have thought it? except the observing nurse, if there is one, who had
always expected the exhaustion to come, from which there would be no
rally, because she knew the patient had no capital in strength on which
to draw, if he failed for a few days to make his barely daily income in
sleep and nutrition.
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