652 ACUTE INFECriOUS DISEASES. 



ture rises above 104, the patient is placed in a bath, whose tempera- 

 ture is about 10 below that of his body, or about 94. While the 

 body and limbs are gently rubbed, we add cold water gradually till the 

 temperature of the bath is reduced to about 68. The patient is to 

 remain about twenty or thirty minutes in the bath, till he is slightly 

 chilled, and then to be placed quickly in a warm bed. At first, four or 

 five baths daily are necessary, subsequently two or three. The method 

 of Ziemssen has one great advantage, that in private practice there is 

 no great objection made to it. The laity consider it much less objec- 

 tionable to place a patient in a lukewarm bath than to wrap him up in 

 wet sheets, or to pour cold water over him, etc. For moderating the 

 fever in exanthematic as well as in abdominal typhus, next to the ab- 

 straction of heat, the administration of quinine deserves most confidence. 

 This remedy has been repeatedly recommended in abdominal typhus, 

 and almost as often it has been given up, because it did not equal the 

 expectations of the employers. The only effect of quinine on the 

 disease is to moderate the fever. If the temperature of a typhoid pa- 

 tient rise above 102, I give quinine, but of late do not give such large 

 doses as formerly, when I prescribed ten-grain doses and during the 

 day gave as much as thirty grains. Now I usually prescribe one or 

 two grains at a dose, in solution with dilute sulphuric acid. If we use 

 quinine at the same time with the abstraction of heat, we are not 

 obliged to repeat the latter so often, which is a decided advantage. 

 Wunderlich has recommended digitalis as an antipyretic in abdominal 

 typhus, and the results claimed by this trustworthy observer, in cases 

 with frequent pulse and continued high temperature, urge us to 

 further trials of this remedy, of whose antipyretic action, in the treat- 

 ment of pneumonia and other inflammatory diseases, we have already 

 spoken. 



Next to the fever, the most dangerous symptoms, when extensive, 

 are the disturbances of the respiratory organs, the bronchial catarrh, 

 hypostasis, and collapse of the lung ; but, unfortunately, we are far 

 more powerless in regard to these dangers than in regard to that in- 

 duced by the fever. The advice of most authors to give lukewarm, 

 instead of cool drinks, when there is severe bronchitis, is based rather 

 on theory than practice ; when feeling the burning skin of a typhoid 

 patient, no one would think seriously of combating the bronchitis b} 

 warm infusions. In severe typhous bronchitis, the most customary 

 prescriptions are wet or dry cups, warm compresses, sinapisms, and 

 blisters to the chest, and the internal administration of an infusion 

 of ipecac, (gr. vij to f vj), or of an infusion of senega ( 3 ss to vj), to 

 which may subsequently be added liquor ammoniae anisat. ( 3 ss 3 j). 

 None of these prescriptions do much good, though the occasional ap- 



