TYPHOID FEVER. 653 



plication of wet and dry cups most frequently causes temporary allevia- 

 tion, and in most cases the cutaneous irritants are even injurious. If 

 we hear extensive moist rales in the chest, while the expectoration is 

 arrested, we may give a few doses of flores benzoes (gr. ij iv), and, 

 if they fail, give a certain emetic, which will be of service here, and, 

 avert the threatening danger, if any remedy can. To prevent the ex- 

 tension of hypostasis, we may attempt to preserve the patient from 

 constantly lying on the back, by changing him from one side to the 

 other ; but, unfortunately, this good advice cannot always be carried 

 out continuously. The treatment of collapse of the lung and of pneu- 

 monia is the same as that of the bronchitis. In profuse epistaxis, we 

 should not try mineral acids and cold applications too long, but apply 

 a tampon early. 



Among the intestinal symptoms, moderate diarrhoea requires no 

 especial treatment. If the evacuations become very profuse, we may 

 give astringents, especially solutions of alum ( 3 j to | vj), or of 

 tannin (3j 3 ss to vj), with an addition of tinctura opii (3j 

 3 ss). For the tenesmus, which is occasionally very annoying, starch 

 injections containing ten to twelve drops of laudanum are almost al- 

 ways beneficial. Where there is much meteorism, we may attempt to 

 evacuate the gas by passing a stomach-tube up the anus. Constipa- 

 tion is to be overcome by injections, or by castor-oil. In intestinal 

 haemorrhage, we should apply cold or ice compresses to the abdomen, 

 and renew them frequently, at the same time giving alum internally 

 in the form of serum lactis aluminatum. In perforation of the intes- 

 tines, we should also employ cold compresses to the abdomen, but 

 especially should give opium in quickly-repeated large doses (a grain 

 every hour or two). At the same time, the patient may take small 

 quantities of ice-water, or small portions of ice, to quench his thirst, 

 but should have no food at all for several days. If peritonitis occur, 

 independently of perforation of the bowel, cold compresses over the 

 abdomen still deserve the preference to leeches. If there be paralysis 

 of the detrusor vesicae, which, to the great injury of the patient, is 

 often overlooked by inexperienced and careless physicians, the bladder 

 should be evacuated at least twice daily by the catheter. 



It has already been stated that scrupulous cleanliness greatly aids 

 in preventing bed-sores. On the first appearance of erythema, we 

 should protect the reddened spot from further pressure by an air-cushion, 

 and wash it several times daily with lead- water, dilute brandy, or with 

 red wine. Eroded spots should be covered with lead or zinc salve, 

 or with ungt. tannicum (ungt. contra decubitum Autenreithii), and 

 aghtly touched with nitrate of silver. If there be a deep loss of sub- 

 stance, with unhealthy base, it should be treated, according to the 



