Cloths for washing the teeth and mouth are made in small squares of gauze or old linen.  They are best to use since they can be burned immediately after being used.  Wrap one of the squares around the first finger, dip it into the mouth-wash and insert in the mouth.  Go over the whole cavity, the cloth being passed along the gums and behind the wisdom teeth, thence over the roof of the mouth, inside the teeth and under the tongue.  Use more than one piece for all this.  This is very necessary in typhoid fever.  If the tongue is badly coated, it can be soaked and gently scraped.  A good mouth-wash for general use is the following: 

Glycerin                    1 dram
Soda                       10 grains
5% solution of Boric Acid   1 ounce

Bed sores.  Prevention and care of.—­Very fat flabby people or thin emaciated patients are liable to suffer from bed sores.  They result from constant friction or pressure on a certain spot or spots and when the body is poorly nourished.  Moisture, creases in the under sheets, night gown, crumbs in the bed and want of proper care and cleanliness also are causes.

Bed-sores due to pressure occur most frequently upon the hips and lower back, the shoulders and heels; those from friction, in the ankles, inner parts of the knees, or the elbows and back of the head.  In patients suffering from dropsy, paralysis or spinal injuries, or when there is a continuous discharge from any part of the body, the utmost care must be taken to prevent bed sores.

Treatment.  Preventive.—­Cleanliness and relief from pressure.  Bathe the back and shoulders with warm water and soap night and morning and afterwards rub with alcohol and water equal parts.  Dust the parts with oxide of zinc or stearate of zinc powder, or bismuth mixed with borax; all are good.  If there is much moisture due to sweating or involuntary stools or urine, castor oil should be well rubbed in addition.  The sheets must be kept smooth and dry under the patient.

[ Nursing department 629]

Redness of the skin may be the first symptom of this trouble.  This may be followed by a dark color under the skin, and when the cuticle finally comes off the underlying tissues are found broken down and sloughing.  Any skin scraped or worn off—­abrasion—­should be carefully washed and a small pad of cotton smeared with olive oil and stearate of zinc placed over it and kept there with collodion painted over it; or white of egg painted over the sore is sometimes very beneficial; also equal parts of castor oil and bismuth make an excellent dressing.  Rubber rings or cotton rings over the part relieve the pressure.  Changing the position is often beneficial.

Treatment of the Sore Proper.—­Sponge with clean soft cloths, with a solution of boric acid or one per cent solution of carbolic acid and the cavity packed with iodoform gauze, or iodoform, or aristol ointment, over which apply a layer of borated cotton.  Dress the sore daily.  If it sloughs apply hot boric acid dressings every four hours and follow with an application of castor oil and balsam of Peru.  When it is better treat as any other sore.