654 ACUTE INFECTIOUS DISEASES. 



rules of surgery, with cataplasms, stimulating salves, red precipitate, 

 or nitrate of silver. 



Ifj in spite of all our care, the strength of the patient sink more 

 and more, if the pulse become small, the collapse and prostration 

 dangerous, we should boldly give strong wines, such as madeira, port, 

 etc., or strong beer (Pfeufer). No analeptic or roborant medicine in 

 the pharmacopoeia has an effect equal to that of a strong wine. The 

 fear of increasing the fever by administering alcoholic liquors is un- 

 grounded ; and it is best not to wait for great exhaustion before giv- 

 ing wine, but, in all cases where the patients begin to grow weak 

 toward the end of the second or commencement of the third week, tc 

 give them half a pint of light wine daily. 



Lastly, during convalescence, the diet of the patient should be 

 most carefully watched. The number who die during convalescence 

 from typhoid fever, from the fault of the physician, because he has 

 neglected to say exactly what and how much they may eat, or from 

 their own, because they have not followed the rules laid down for 

 them, is proportionately large. It is best to let the patient eat fre- 

 quently, but only a little food at a time, so that the slight amount of 

 gastric juice secreted by the convalescents may suffice for its com- 

 plete digestion. All indigestible food, which forms large amounts of 

 faeces, should be strictly forbidden. An apparently insignificant indi- 

 gestion, a moderate diarrhoea, or slight vomiting, should be regarded 

 as a very dangerous occurrence, because it may induce perforation of 

 an ulcer that has not yet cicatrized. 3 



CHAPTER IX. 



FEBBIS RECURRENT RELAPSING FEVER. 



ETIOLOGY. Relapsing fever is among the acute infections about 

 whose propagation by contagion there is no doubt ; but we hesitate to 

 proclaim this as a purely contagious disease, such as the acute exan- 

 themata, measles, scarlatina, and small-pox, which never occur in a 

 person who had not been infected by a measles, scarlatina, or small- 

 pox patient. There are certain points in favor of the view that the 

 infecting substance, which induces relapsing fever, is not only pro- 

 duced in the body of the patient, but that it may be produced outside 

 of the human body. The mere fact, that certain regions, whose telluric 

 conditions give rise to a pure miasm, malaria, are also subject to epi- 

 demics of relapsing fever, can hardly be made to agree with the ex- 



