TYPHUS FEVER. 557 



than three or four motions daily, the acetate of lead mixture (Pr. 30), to each dose 

 of which ten drops of solution of acetate of morphia may be added, will be found of 

 use, or a starch and opium injection twenty drops of laudanum to four ounces 

 of starch, water may be employed. Sulphate of copper and nitrate of silver some- 

 times prove of service in obstinate cases. 



When there is frequent copious diarrhoea, with the passage, at times involuntary, 

 of drab or ochre-coloured evacuations, associated with enlargement and tenderness 

 of the abdomen, excessive prostration and thirst, and a nearly imperceptible pulse, 

 arsenic, in the form of the arsenic mixture (Pr. 40), may be employed with advantage. 

 When there is a bitter taste in the mouth, a brown-coated, rough tongue, a 

 stupefying headache and cough, tincture of bryony will usually do good (Pr. 49). 



Bleeding from the bowel is a symptom which sometimes requires treatment. 

 When the quantity is very small it will do no harm, but should as much as a table- 

 spoonful appear in the motions at one time it is well to endeavour to check it. A 

 bladder or india-rubber bag containing ice should be placed on the abdomen. 

 Twenty drops of the tincture of perchloride of iron may be given every alternate 

 hour in a glass of water, or a tea-spoonful of the ipecacuanha mixture (Pr. 50) may 

 be given every ten minutes for the first hour, and subsequently hourly. When the 

 bleeding from the bowel is accompanied by suppression of the urine, drop doses of 

 turpentine may be employed. 



When there is much pain in the abdomen poultices or hot fomentations are 

 admissible. 



When perforation of the intestine takes place the only hope of a favourable 

 issue lies in securing complete rest of the intestines for a considerable time. Opium 

 should be administered in doses of a grain every hour, until the patient falls 

 asleep. A grain of opium is contained in fourteen minims of laudanum, but it is 

 better to use solid opium made up into little pills. The patient should be kept as 

 constantly as possible under the influence of the drug. At first no nourishment of 

 any kind must be given, nothing but a little ice to suck to allay the thirst, and for 

 a long time only the most easily digestible food should be given, and that in the 

 fluid form. The object is to get the opening in the bowel to heal, and this 

 will never take place if food is constantly passing out through it. Under no 

 circumstances must purgatives be given. 



To allay the excessive hunger from which many patients suffer during con- 

 valescence, and before it is safe to give any solid food, drop doses of tincture of 

 cinchona given hourly may be used with advantage. It does not matter how 

 earnestly the patient may pray for something to eat, he must have no solid food 

 until the evening temperature has been normal, i.e., as low as 984 Fahr., for 

 several consecutive days. This rule must be strictly and literally observed. Its 

 infringement would, almost to a certainty, be attended with the most disastrous 

 consequences. 



Typhus Fever is a contagious disease lasting from two to three weeks, and 

 characterised by a rash which appears between the third and sixth days. It has 

 received a multitude of names, almost every epidemic resulting in some addition to 



