TYPHOID FEVER. 



jig. The best article of drink is pure spring-water or soda-water ; if 

 there be severe diarrhoea, we may give oat or barley water. All addi- 

 tions of fruit-juices, vegetable acids, toasted bread, etc., to the drinks, 

 soon become objectionable to the patient. The patient must drink 

 freely, in order to replace the loss of water induced by the copious 

 perspiration. If, during the advanced stages of typhoid, they do not 

 ask for drink, because they do not perceive the want of it, it should be 

 offered to them. Badly-instructed or thoughtless nurses sin a great 

 deal against this rule. Shall we give the patient nourishment, or 

 place him on absolute diet ? Views vary greatly on this point. Most 

 German and French physicians consider the administration of meat- 

 broths, eggs, and other nutritious substances in fevers generally, as so 

 decidedly injurious, that they regard " fever-diet " and water-soup as 

 identical. From England, there is an accusation against the German 

 physicians particularly, that their dietetic rules cut off from the patients 

 the supply of material by which the consumed portions of the body 

 might be replaced, and that, consequently, the mortality is greater in 

 Germany than in England, because the patients are starved, as it 

 were. There is some truth in this assertion. I have no hesitation in 

 saying, that the aggravation of a fever by giving the patient milk, 

 eggs, and meat, has not been proved by actual observation, and I be- 

 lieve that much injury may be done by blind faith in the correctness 

 of this hypothesis. There is no doubt that in every fever the con- 

 sumption of the constituents of the body is greatly increased, and that 

 no sort of exercise will use up the body so rapidly as a fever does. 

 While continued bodily exertion is usually borne with impunity, be- 

 cause the increased consumption is hidden by increased supply, most 

 fatal cases of fever are due to insufficient material being furnished for 

 the replacement of that used up. Regarding typhoid fever, particu- 

 larly, we find that in this disease the bodily temperature is above the 

 normal for several weeks, and the consumption of tissue, by which this 

 calorification is induced, is greatly increased. We see that in the 

 most favorable cases, during convalescence, the greatly debilitated pa- 

 tients, who have often lost ten to twenty pounds in weight, recover 

 very slowly; and we must agree, that these facts urge us to give 

 meat, milk, eggs, etc., rather than water-soup, until it shall be proven 

 that such diet increases the fever. But, on the other hand, it cannot 

 apparently benefit the patient if we give him this nourishment, and he 

 is not able to assimilate it ; on the contrary, it would hurt him to fill 

 his stomach with food that will not be digested, but will decompose 

 and cause irritation of the gastric and intestinal mucous membrane. 

 We have before seen that dyspepsia is a constant accompaniment of 

 all fevers. If we do not attend to this fact in regulating the diet of 



