ACUTE INFECTIOUS DISEASES. 



typhoid cases, but expect that their stomachs will supply plenty of gas 

 trie juice to digest large quantities of protein substances, we shall not 

 increase their strength, but shall add a complication which will aug- 

 ment the danger. From this we have the rule, supported by ex- 

 perience, that at first we should give typhoid patients small quantities 

 of milk and strong broth several times daily, whenever they desire it. 

 The longer the disease continues, and the greater the exhaustion of the 

 patient, the more untiringly we must attempt to supply nourishing food, 

 but always in small quantities and in fluid form. In addition to these di- 

 etetic rules, we should have typhoid patients washed all over with pure 

 cold water, or with a mixture of three parts of water to one of vinegar. 

 This should be repeated several times daily, and should be done very 

 carefully, so that its beneficial and soothing effects may not be an- 

 nulled by the fatigue induced by the act itself. In a mild, regular 

 course of typhoid, we need give no medicine ; but probably the old 

 prescription of dilute chlorine- water (aqua oxymuriat. ij, aqua des- 

 till. vj, det. ad vitr. nig., tablespoonful every two hours), or of mu- 

 riatic acid in mucilage (acid, muriat. cone. 3 ss, mucil. salep | vj, syr 

 simp. | j, tablespoonful every two hours) is at least of palliative ser- 

 vice ; and, as there are few patients that can be treated entirely with- 

 out medicine, we should prescribe the above mixture, and it deserves 

 the preference over other more active prescriptions. We may also 

 follow the old custom of giving the muriatic acid in a weak infusion 

 uf ipecac, (gr. viij to vj), instead of in simple mucilage, during the 

 second week, if the diarrhoea and bronchitic symptoms increase, and 

 hi a weak decoction of Peruvian bark during the third week. 



The above treatment answers for most cases ; but there are many 

 others which require a different procedure, and in which threatening 

 danger can only be averted by energetic treatment. In abdominal 

 as in exanthematic typhus and other infectious diseases, the greatest 

 danger is from the severity of the fever. But against this we have a 

 most efficient remedy. The danger from the fever is a double one. 

 On the one hand, the increase of bodily warmth above a certain point 

 induces paralysis of the heart and renders life impossible ; on the other 

 hand, continued increase of the production of heat, or, what is the 

 same thing, protracted increased transformation of tissue, on which the 

 feverish over-heating depends, induces consumption of the body of the 

 patient. In fevers of proportionately short duration, as in the acute 

 exanthemata, exanthematic and abdominal typhus, the danger from 

 increase of the bodily temperature is, of course, more to be feared than 

 that accompanying the increased production of heat. But, in combat- 

 ting the former, we should not lose sight of the latter, or else we may 

 injure the patient instead of benefiting him. Without fear of being 



