55-4 THE TREATMENT OF DISEASES. 



fluids of all kinds should be avoided, as they distend the bowel with gas and increase 

 the danger of the rupture. The patient is often too apathetic to ask for something 

 to drink, even when suffering severely from thirst. You must never trust to his 

 helping himself, but as long as he is awake should frequently put the glass or feeder 

 to his lips. If he is not thirsty do not urge him to drink. 



Next, as to the food. There is no disease in which attention to diet is of more 

 importance than in typhoid fever. Articles of solid food should from the very 

 first be positively interdicted. From the time the nature of the illness is first 

 recognised, or even suspected, until convalescence is thoroughly established, not a 

 single particle of solid food, in any shape or form, must pass his lips. This is a- 

 matter of the utmost importance, in fact, a matter of life and death. Not very long 

 ago a sad case occurred in one of our hospitals. A young woman, aged nineteen, 

 was making a rapid recovery from typhoid fever, when her mother came to see her 

 and brought her an orange. Some of the pips were swallowed; one of them 

 perforated the bowel, and in a few hours the girl was dead. Mutton broth, beef- 

 tea, barley water, thin oatmeal gruel, and above all, milk or milk and water, must 

 be relied on for supporting the strength. The amount of stimulant, wine or brandy, 

 to be administered must depend upon the condition of the patient, and also, to some 

 extent, upon his previous habits. As a rule stimulants in any quantity are not 

 needed in the early period of the disease. The strength of the pulse is the best 

 guide, and should it fail, brandy must be resorted to. At first, four ounces of 

 brandy in the twenty-four hours will be enough, but subsequently twice or three 

 times this quantity may have to be administered. It should be given well diluted. 

 For patients who do not like brandy a somewhat larger quantity of port wine may 

 be substituted. 



Of course, the attendance of a doctor is indispensable, but so many emergencies 

 may arise in the course of the disease that we have no hesitation in indicating the 

 course of treatment to be adopted. 



We know of no specific antidote for this disorder, that is, of no drug which will 

 stop it at any stage of its progress, although, as it owes its existence to a specific 

 poison, it is not improbable that in time one may be found. 



Of late years the Baptisia tinctoria, or wild indigo, has obtained a great reputa- 

 tion for the power of aborting the disease. It must be given quite at the com- 

 mencement of the fever, and it is especially indicated when the following symptoms 

 are present : Hot and dry skin, quick full pulse, furred tongue, headache, great 

 thirst, wandering or delirium at night, high-coloured urine, and usually confined 

 bowels. The influence of baptisia in typhoid is said to be comparable to that of 

 aconite in simple fever. The tincture of baptisia is given hourly in drop doses in 

 about a tea-spoonful. of water. 



If we cannot cut short the disease we must try and tide the patient over his 

 difficulties. The great danger is lest he should die from the intensity of the fever 

 and the deleterious influence of the high temperature on the tissues. By far the 

 largest number of those who succumb to typhoid fever die from the effect directly or 

 indirectly of the fever heat. Out of 210 fatal cases that occurred in a large 

 hospital during a certain period eighty-six were due to the direct influence of the 



