An invalid's hair is, as a rule, a source of much anxiety to the home nurse. This is especially the case when the illness is a long one, or when the patient belongs to that unfortunate class designated "chronic." The condition of the health almost invariably affects the hair, and during a long and exhausting illness its growth is naturally arrested, while it frequently falls to a very alarming degree.
In some cases of acute fever, the doctor orders the hair to be closely cut. One of the reasons for this is that the head may be kept cool; another, that as the patient may be in a critical condition for some time, the daily combing and brushing of the hair necessary to keep it in good condition would be too disturbing to the patient. When the hair has been cut close it is, of course, very easy to manage. The difficulties are many, however, in eases where the hair is long and thick, exceptionally dry, or, on the contrary, of so greasy a nature that it becomes easily matted and tangled. The constant tossing of the head of a restless invalid makes the task of keeping the hair in order by no means an easy one.
When the patient is a child, and is fretful and restless, infinite patience is required; but firmness is also very necessary, as one day's neglect of the hair generally leads to greater trouble on the following day. The little sufferer must be made to understand that the morning toilet is as important as the taking of medicine, and the art of gentle, forbearing persuasiveness must be brought into play by the tactful nurse, who must never be weak enough to "give in" on this point; for, as children are influenced very much by precedents, the defeat of the nurse upon one occasion may be followed by many battles royal in the future.
A home nurse who has charge of an invalid's hair will, in the first instance, take care to provide herself with the right kind of brush and comb. Brushes with metal or whalebone bristles must be rigorously avoided. These unnecessarily tear the hair, and frequently scratch and injure the scalp. A hard brush should very seldom be used, as an invalid's scalp is always tender, and, in some cases, exceedingly sensitive. The most satisfactory brush that can be used is one with bristles of the best Siberian boar. These are rather expensive, but with care they will last for many years. The bristles should be of graduated lengths, as in this way they more easily penetrate the hair without causing any strain. If the hair is thick, a comb with rather coarse teeth should be used; a fine-toothed comb is of very little use in disintegrating tangled hairs.
The Best Position for the Patient
A patient is so often tired after the operation of washing the face, neck, arms, and hands is over, that it is sometimes better to leave the toilet of the hair until an hour or two later. If the patient is in a weak condition, and sitting up distresses her, she should be directed to lie upon the side. The nurse will now carefully unplait the braid on the side nearest to her, and with the comb will divide a small strand of the hair. Taking this in her hand, she will gently draw the comb through it, and if a knot or tangle is felt, she will proceed to hold the strand above the knot, close to the head, with the left hand, while she combs the hair with the other. This will prevent any "tugging" from the scalp.
How to Deal with Tangles
If the knot or tangle does not easily comb through, she must lay down the comb, and with the fingers of both hands carefully pull apart the hairs. Having freed one strand completely from tangle, she can now divide another, and continue in this way until the hair on the whole of that side of the head has been completely combed out. It must now be carefully brushed, and it is best to perform this operation also piece by piece. It will be found that the process of brushing the hair is often grateful and refreshing to the patient, provided the combing has been thoroughly and efficiently performed. The hair which has been combed and brushed can be loosely plaited and tied at the end with a smart ribbon bow. The patient now turns on the other side, and the process of combing, brushing, and plaiting is repeated. If the hair is carefully combed and brushed, parted in the middle at the back, and arranged in two neat plaits in this way every day, there will be little fear of its getting into a matted, tangled condition, and much pain and irritation will be spared the patient. The action of the brush upon the scalp also will help to keep it clean and free from dandruff.
An invalid who is confined to her bed can very seldom have the head washed. The scalp, however, may be occasionally sponged with a refreshing, invigorating, and cleansing lotion. The hair should be carefully parted with the comb, and the following lotion should then be well rubbed into the scalp with a small piece of sponge or flannel:
Sulphate of quinine .. . . 5 gr.
Vinegar of cantharides .. 6 dr.
Glycerine of borax .. .. 2 dr.
Lavender water......2 oz.
If the hair is of an exceedingly dry nature it may sometimes be necessary to apply a little oil. Nothing is better for this purpose than pure olive oil, rubbed gently into the scalp with the tips of the fingers.
An invalid's hair which has a tendency to become excessively greasy is more difficult to deal with, especially if the nature of the illness absolutely precludes washing the head. The following lotion will sometimes prove efficacious in remedying excessive greasiness, and will also arrest the advance of moist dandruff:
Hydrochlorate of quinine .. 20 gr.
Tinct. of nux vomica .. .. 1 dr.
Acetic acid........4 dr.
, Tinct. of cantharides .. .. 4 dr.
This should be well rubbed into the scalp with a piece of sponge, and the hair should then be gently brushed for a few minutes with a very clean brush.
Both the above lotions are also stimulative in their action, and will be remedial in case of falling of the hair.
As a remedy for dandruff, the nurse may rub well into the scalp every night this lotion:
Glycerine of borax .. .. 1 oz.
Spirit of camphor .. .. 2 dr.
Spirit of rosemary .. .. 1 oz.
Aromatic spirit of ammonia 3 dr.
Distilled water to . . . . 10 oz.
If an anti-dandruff pomade is preferred, the following formula will be found excellent:
Quinine hydrochlorate .. 10 gr.
Precipitated sulphur .. .. 1 dr.
Carbolic acid........8 drops
Lanoline ........ 1 oz.
During convalescence it is best to continue the use of a stimulative lotion, as in nearly all cases the tendency of the hair is to fall excessively for some time after an illness. This is especially so in surgical cases. The shock of an operation affects the whole nervous system, and not infrequently the hair not only falls out, but becomes prematurely grey. When this happens, the pilocarpine preparations advised in the chapter on greyness (page 327) should be applied.