THE REMEDIES OF NATURE. 483 



tares of their size. With cold, sweetened orangeade alone, the physi- 

 cians of the Spanish-American hospitals often support their comatose 

 patients for days together. 



These remedies should be applied in the very beginning of the 

 disease. As soon as the yawning and stretching languor of a bilious 

 remittent announces the approach of an ague-fit, the patient should 

 prepare for refrigeration by sponge-baths, air-baths, and rest, in a 

 shady, well-ventilated room. The thirst that announces the needs of 

 the internal organism should be freely indulged with fresh spring- 

 water (or the next best thing, filtered and ice-cooled cistern-water). I 

 would not prevent a fever-stricken child from drinking five quarts of 

 water in as many half-hours, if its system craves it, for, besides its re- 

 frigerating influence, fresh water fulfills an important expurgative pur- 

 pose, and helps to eliminate the catalytic germs of the tainted blood. 

 During the shivering stage of a fever there would not seem to be much 

 need of artificial refrigeration ; but I have noticed that a fit of " chills " 

 is far more supportable if the craving for a warm cover is justified by 

 an external cause. In a sultry room a woolen blanket is apt to turn a 

 shaking fit into the ugliest symptoms of the hot and headachy stage, 

 while in a cold room the shivering patient (covered up, but with his 

 head exposed to a cooling draught) soon finds relief in a quiet slum- 

 ber. The ancient Romans cured their fever-patients in subterranean 

 grottoes, and where the means of refrigeration are as cheap as in the 

 New Orleans ice-factory I would keep the yellow-fever ward of a hos- 

 pital at a maximum temperature of 55, and at night, if possible, be- 

 low 50. Wet-packs and a frequent change of posture greatly allevi- 

 ate the throbbing pains in the loins, where the pyrexial process of a 

 yellow-fever paroxysm seems to center its activity. * These pains are 

 often accompanied by a stupor-like oppression of the brain and are 

 grievously aggravated by a stagnant atmosphere. 



In the tent-camp of Medellin, to where the French authorities 

 had removed the fever-stricken paupers of Vera Cruz, I noticed that 

 comatose symptoms occurred only in a small minority of cases, while 

 their worst forms were frequently observed in all the city hospitals, 

 except the excellently ventilated infirmary of the Catholic orphan asy- 

 lum. In common ague, fresh air alone, and without the aid of fruit 

 and ice (which can not be readily procured in some inland districts of 

 our Southern States) will modify the paroxysms sufficiently to reduce 

 them to debilitating rather than distressing symptoms tremors, fol- 

 lowed by perspiration, and a cerebral excitation somewhat resembling 

 the first effects of certain intoxicants. 



During the hot stage of an intermittent, delirium can be obviated 



* " It is curious that the maximum of the heat observed after death should have been 

 in the thigh, and the minimum in the brain. Dr. Bennett Dowler, of New Orleans, 

 ascertained it to be (ten minutes after death) 102 in the brain, 109 in the axilla, and 

 113 in the thigh" (Carpenter's " Physiology," p. 619). 



