32 PRACTICE OF MEDICI\E. 



from an early period ; and this need not hinder leeches from being 

 applied to combat any local congestion. 



The use of opium in fever is nearly the same as that of wine. 

 The general rule is to give opium^ when nervous excitement exceeds 

 vascular action, where there is much delirium, and sleeplessness, 

 with a feeble pulse. In some cases it is right to give a good dose at 

 once ; in others, to feel the way cautiously with small doses. In 

 some cases of excitement, in young subjects, opium may be given in 

 small doses, gr. |, with tartar emetic, gr. J, {Yide Graves' Clinical 

 Medicine.) 



Opium and wine may be known to do good in fever, if they make 

 the skin and tongue moist, the pulse fuller and slower, and if they 

 allay nervous excitement, and produce sleep. 



The state of the bladder should be inquired into every day ; and 

 the bed be kept dry and clean. Any spots that seem likely to 

 ulcerate, should be washed with brandy, and protected with soap- 

 plaster. 



To conclude : the chief indications in the treatment of typhus and 

 typhoid fever are, to nurse the patient carefully through it ; to allay 

 excitement ; to prevent local inflammation ; and to support the strength. 



RUBEOLA {Measles). 



This is a contagious fever, with eruptions and catarrh. 



Symptoms, — \st day. Alternate shivering and heat, anxiety, las- 

 situde, sense of pain and weight across the forehead and eyes, and 

 dullness, with a disposition to sleep. The pulse becomes accelerated, 

 the skin hot, the surface of the tongue white, and its points and edges 

 of a bright red. Epigastric tenderness, with nausea, is frequently 

 present, and sometimes there is vomiting. 



'Zd daij. All the symptoms are aggravated ; the eyes become red 

 and watery ; there is coryza, with frequent sneezing ; the throat is 

 a little painful ; and in very young children there is stupor, and 

 sometimes convulsions. 



3fZ day. A still further aggravation of all the symptoms is evi- 

 dent ; the eyes become more inflamed ; the eyelids appear tumid ; a 

 dry and frequent cough ; dyspnoea ; a feeling of tightness across 

 the chest, and pain in the head, precede the appearance of the erup- 

 tion. 



Aih day. Appearance of the eruption. — The eruption first begins 

 to appear in the form of small circular spots, on the forehead, chin, 

 nose, cheeks, and around the mouth, and extends itself successively, 

 within a day or two, to the neck, chest, and limbs. In general, the 

 small spots are succeeded by larger ones, and the final arrangement 

 of the patches is usually in a semicircular or a crescentic form. 

 The red tint of the eruption assumes its greatest intensity on the face 

 on the fifth day. 



