566 THE TREATMENT OF DISEASES. 



attack a purgative pill (Pr. 60) should be given with the view of thoroughly clearing 

 out the bowels. During the cold stage no special treatment is required. If the hot 

 stage be mild, without much headache or heat of skin, no interference is necessary 

 beyond giving the patient iced water, or lemonade, or soda water to drink, or, better 

 still, a little ice to suck. 



If, however, the skin is very hot, the headache and pains in the limbs and loins 

 severe, or the patient very restless, cold towels may be applied to the head, and the sur- 

 face of the body sponged with tepid water. The vomiting is not only very distressing, 

 but rapidly induces exhaustion. Sometimes it may be combated by sucking little 

 lumps of ice, or by the application of a mustard poultice, or a pad of lint sprinkled 

 with chloroform, and covered with oil silk, to the pit of the stomach. A still better 

 plan is to give drop doses of ipecacuanha wine every ten minutes for the first hour, 

 and subsequently hourly, in a tea-spoonful of water. During its employment other 

 medicines and methods of treatment should be suspended. 



Directly the remission sets in that is to say, as soon as moisture appears on 

 the skin, and the pulse is reduced in frequency, a ten-grain dose of quinine (four 

 table-spoonfuls of Pr. 10) should be given. This should be repeated every second 

 hour until thirty grains have been given, or until its administration is interrupted 

 by the access of another fit. If the stomach refuses to retain the quinine, a twenty- 

 grain dose must be injected into the bowel in beef-tea or any bland fluid. It is a 

 golden rule that by some means or other thirty grains of quinine must be taken into 

 the system between the termination of one fit and the commencement of the next. 

 In some very bad cases, it may even be advisable to give quinine at once, and not to 

 wait for the remission ; but it is better not to do this unless it is absolutely neces- 

 sary. The patient's strength must be supported by nutritious food and a judicious 

 administration of stimulants. 



How TO AVOID FEVER IN HOT CLIMATES. 



The following simple rules will, we trust, be of use to emigrants and others living 

 in tropical climates. They are, with a few minor alterations, identical with those 

 drawn up for the guidance of the soldiers serving on the Gold Coast in 1873 : 



1. Avoid needless exposure to the sun, rain, night-dews, and fogs. 



2. After being exposed to the sun, bathe the head and face, and if possible the whole body. 

 If wet, change your clothes with the least practicable delay, and rub yourself with a rough toweL 

 If exposed to dews or fogs, take a cup of hot coffee or soup, or a little quinine wine. 



3. Avoid stagnant water or such as contains " bush" plants, whether they be dead or living. 

 When possible, use only water which has been filtered or otherwise purified. When at work, cold 

 tea is the best beverage. Einse out the mouth before swallowing the first draught, and take only 

 two or three mouthfuls at a time. This will relieve thirst as effectually as a longer draught. 



4. Avoid all spirits, or other drink offered by natives. All of them are more or less un- 

 wholesome to Europeans, and they may be absolutely poisonous. 



5. The moderate use of tobacco in smoking may be of use during the prevalence of damp, 

 malarious fogs. In excess, however, it does more harm than good. In no other form than 

 smoking has it any good effect whatever. 



6. In regard to food, the more you restrict yourself to a plain, substantial diet, the better it 

 will be for you. If in the bush, carry with you a small supply of pepper, mustard, salt, and an. 

 onion. These may often be the means of furnishing you with a savoury repast. 



