ACUTE INFECTIOUS DISEASES. 



posing the sloughing and ulceration, and whether, consequently, we 

 can only expect benefit from it in the first weeks of the disease, when 

 these changes have not yet taken place. Willebrand has lately rec- 

 ommended iodine as a specific in typhoid, and the results published 

 by him, Liebermeister, and others, urge us to make more trials with 

 the preparations of iodine in this disease, although the treatment is 

 not a new one. Wittebrand dissolves six grains of iodine and twelve 

 of iodide of potassium in one drachm of water, and gives three or four 

 drops of this solution in a wineglassful of water every two hours. It 

 is said that, even after one, two, or three days of this treatment, there 

 is a decided remission of the temperature ; sordes do not come on the 

 gums, or they disappear early ; the fever ceases in an unusually short 

 time. 



In most cases of typhus, the indications are to protect the patients 

 from all injurious influences, to combat dangerous symptoms, and to 

 maintain the strength of the patient by dietetic rules. In the first 

 place, wherever circumstances permit, we should see that the sick- 

 room be not too small, and be very careful to have it well ventilated. 

 Fresh, pure air is very necessary for all typhus patients, and they do 

 not catch cold nearly so readily as the laity imagine. The tempera- 

 ture of the room should be regulated by the thermometer, and should 

 be kept as nearly as possible at 60 to 65. In North Germany there 

 is a belief that a vessel of water under the bed prevents bed-sores. If 

 it do not fulfil the expected end, this practice is probably useful in 

 maintaining a certain degree of moisture in the room. We should also 

 attend carefully to the patient's bed. The coverings should not be too 

 heavy, and the sheet should have no creases in it. The bed and body 

 linen should be changed as often as soiled. We should not neglect to 

 see that the body of the patient is kept scrupulously clean through- 

 out the attack. Even among the neatest persons this is not super- 

 fluous, for they are often prejudiced, or else fear to injure the patient 

 by exposure, or do not carefully inspect the parts about the anus and 

 sexual organs, so as to cleanse them from any excretions. Neglect 

 of this precaution frequently cannot be subsequently made good. 

 The most insignificant erythema on the nates, which might have 

 been avoided, may prove very dangerous late in the disease, by 

 forming the commencement of an extensive bed-sore. If the pa- 

 tient be too weak to clean his own mouth, we should have it washed 

 out regularly with a linen rag wet with cold water, or, still better, 

 with cold soda-water. Particular care should be paid to washing 

 ff the sticky mucus clinging to the teeth and gums, before it dries 

 and decomposes. Even when the patient is in a state of stupor, he 

 usually shows some signs of pleasure and gratitude after this proceed 



