562 THE TREATMENT OF DISEASES. 



the attendance of a doctor is necessary. The general treatment is not essentially 

 different from that we have already adopted in other fevers. 



It is very necessary that the patient should be placed under the best possible 

 hygienic conditions. He should be placed in a large room, with an ample supply of 

 fresh air at a moderate temperature. Cleanliness is absolutely essential, and 

 frequent change of both personal and bed linen is most desirable. The services of 

 a couple of experienced nurses should be obtained. In the case of poor people, 

 living in close crowded rooms, removal to a hospital should be insisted on both for 

 the sake of the patient and his neighbours. Quiet and freedom from anxiety greatly 

 add not only to the patient's comfort but to his chances of recovery. It is a good 

 plan to carefully sponge over the whole body several times a day ; and, in many 

 cases, the employment of the wet pack proves beneficial. 



In a disease of this severity it is very essential that the patient's strength should 

 be supported by every means in our power. In the early stages of the fever, as 

 long as the appetite remains good the diet need not be restricted, and the patient 

 may have anything he chooses if it is not positively noxious. Soon, however, all 

 relish for food is lost, and the patient will take nothing but liquids and sick-room 

 delicacies. Sometimes the dislike for food is so great that it has to be administered 

 just as if it were so much medicine. The digestive functions are so greatly impaired 

 that only the most nutritious substances should be administered. Beef-tea, mutton- 

 broth, chicken or veal broth, milk, eggs, arrowroot, jellies, and other similar articles 

 will be found useful. A good nourishing soup is made as follows : Stew two 

 ounces of the best well-washed pearl sago in a pint of water till it is quite tender 

 and very thick, and then mix it with half a pint of good boiling cream and the 

 yolks of two fresh eggs. Blend the whole with a quart of beef essence made by 

 cutting up in small pieces four pounds of lean beef from the sirloin or rump, 

 placing it in a covered saucepan with a quart of cold water by the side of a fire for 

 four or five hours, and then allowing it to simmer gently for two nours. It 

 must be skimmed well, and the mixtures are to be mixed when both are 

 hot. So little is usually taken at a time, that it is necessary to administer some- 

 thing every two hours ; and the fact of the patient being drowsy or sleepy should 

 not prevent this from being done. The patient usually suffers greatly from thirst, 

 and he should have plenty of water, lemonade, soda water, cold weak tea, or any 

 other beverage he may fancy. Iced drinks often prove very grateful and 

 refreshing. 



The administration of the proper amount of alcohol is a point which requires 

 some judgment. Children rarely require stimulants of any kind, and many adults 

 do very well without them. Alcohol may be advantageously administered in 

 the case of old people, or when the patient has been long accustomed to the free 

 use of stimulants. Its employment is especially indicated when there is great pros- 

 tration with low delirium and drowsiness, and in cases in which the pulse is weak, 

 or the extremities are cold and blue. It is rarely required before the appearance of 

 the eruption, and proves most useful during the second and .third weeks of the 

 disease. In cases in which stimulants are required, a daily allowance of a bottle of 

 good claret, or half a bottle of sherry, would not be excessive for an adult. In 



