ACUTE INFECTIOUS DISEASES. 



previous height or even higher ( Obermejer). I have repeatedly said 

 that I consider energetic abstraction of heat by cold baths quite a he- 

 roic remedy. If the high temperature in recurrens were accompanied 

 by great danger to life, of course we should have no hesitation in com- 

 bating the exhaustion of the body, from the increased production of 

 heat, by the energetic and continued use of cold baths ; but, since, in 

 spite of the high temperature, relapsing fever has a low mortality, 

 scacely three per cent, of the patients dying, I do not consider cold 

 baths indicated in this disease. It will be well to limit ourselves to 

 sponging the body with cold lotions, and, if the cerebral symptoms be 

 severe, to the application of ice to the head. At the same time we 

 should attend most carefully to the patient's cleanliness and supply of 

 fresh air, and internally give dilute mineral acids. Obermejer recom- 

 mends the administration of lemon-juice when the kidneys are much 

 affected. We should carefully give the patients nourishment early, 

 and, if there be much debility, prescribe some wine. From the ten- 

 dency to diarrhoea, they should not drink much water. During con- 

 valescence, iron and quinine may be given. 



Ghriesinger recommends large doses of quinine (gr. x-xxx daily) 

 in bilious typhoid. He says it is just as useful here as in intermittent 

 fever ; but it is well not to begin the quinine treatment till after the 

 administration of a mild purgative of salts, oil, or cream of tartar, at 

 the commencement of the disease. 



CHAPTER X. 

 



EPIDEMIC DIPHTHERITIS MALIGNANT PHARYNGITIS ANGINA 

 MALIGNA DIPHTHERIA. 



ETIOLOGY. Epidemic diphtheritis belongs among the infectious 

 .Useases, and even among those that are most typically contagious. 

 The miasmatic origin of the disease is doubtful, at least in our coun- 

 try, where it has only occurred during the past ten years, and has ap- 

 peared almost exclusively as more or less extensive epidemics which 

 occasionally spread around from one place to another. The contagion 

 is contained in the false membrane and shreds of tissue detached from 

 the fauces, and in the air breathed out by the patient. Physicians are 

 in great danger of being infected by the morbid products coughed out 

 by the patient when they are painting or cauterizing his throat, or per- 

 forming a tracheotomy. Science has to mourn the loss of a series of 

 excellent physicians and observers who fell victims to diphtheria while 



