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The trained nurse, however, like all skilled help,
costs money, so much money, indeed, that to em-
ploy one is beyond the hopes of the poor. Here it
is that charity intervenes. Since the earliest times
one of the great works of mercy has been to visit
the sick. We must, however, visit the sick after
the manner of our times. To-day the visitation of
the sick not only implies the friendly call, the
consoling word, the religious influence, but it
especially implies the use of those natural means
of healing or alleviating sickness which science
has put in our hands. Hence the charities that
operate in large cities have almost universally now
added a district nurse or several district nurses to
their staff.
The District Nurse is then a trained nurse at the
free service of the poor. She goes from house to
house to perform for them the same services that
any trained nurse performs in the sick rooms of
the well-to-do. In some places her work is simply
to carry out the doctor's orders in regard to treat-
ment — important orders which in the case of her
clients are so often disregarded as of small weight.
The poor usually lack the appliances necessary
for proper nursing. The nurse therefore carries
with her everything necessary. At her head-
quarters she keeps a "Loan Closet" whence she
must often furnish fresh linen and clothing; and
at times she must procure proper food and deli-
cacies as well as medicine.
In many cases, especially in those which are
chronic, the patient suffers chiefly from the igno-
rance, indolence of alcoholic habits of the family.
Here the chief duty of the nurse is to keep the

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patient clean and comfortable, as well as to pre-
vent bed sores.
Not the least among the benefits conferred by
the District Nurse is the instruction of the family
in the elements of hygiene as well as in the
elements of nursing. There is hardly a family in
which some of the younger members is not quite
capable of undertaking this work, while the num-
ber of families in which there is a profound igno-
rance of even the most elementary principles of
hygiene and nursing is much larger than one
would suppose. How to keep the house clean;
how to ventiliate it effectively, and how to prepare
proper food in the proper manner — these things are
taught as soon as possible by the District Nurse in
the families she visits.
The District Nurse has opportunities for doing
missionary work in the way of inducing people to
keep clean and to live regularly. She explores the
premises and removes unsanitary conditons, call-
ing on the Health Officers if necessary. She learns
the habits and the history of the family and is some-
times able to help them to better ways of living by
bringing them to the attention of a Society or
Church or of the "Friendly Visitor." Indeed,
she is herself their best friendly visitor.
But all cases are not in need of moral or hygienic
regeneration, as all the poor are not careless or
slovenly. The most pitiful cases the District
Nurse meets are where the high mind and the in-
dustrious fingers have even in the most galling
poverty kept that cleanliness, self-respect and
refinement usually associated with economic
comfort. In such cases there are times when
special treatment is demanded that can be given