SYMPTOMATIC TREATMENT 



1197 



there is no ice, dissolve some salt and juice of fresh limes or lemons, 

 together with some vinegar or weak acetic acid and Florida water 

 or eau-de-Cologne, in a small basin of water, and, after soaking 

 handkerchiefs in this mixture, apply them one after the other, 

 changing as they get warmed, to the patient's forehead. 



A little stimulation of the auricular branch of the pneumogastric 

 by applying some of this cool lotion to the lobule and behind the 

 ear is most refreshing to the patient. 



Another method of relieving the headache and pains about the 

 body is to give phenacetin and caffein. Phenacetin or antipyrin 

 should only be given in small doses (gr. ii.-iii.), and not to debilitated 

 patients. 



When the sweating begins, the patient usually feels much better, 

 but care must be taken to change the damp clothing, and when this 

 stage is drawing to a close a sponge over with tepid water is most 

 refreshing, after which he will probably go to sleep and wake 

 feeling much better. 



Diet in Acute IiIalaria. — During the attack the strength must 

 be maintained by light food, such as Brand's essence or chicken- 

 broth, and stimulants, in the form of brandy or champagne, may be 

 required. Milk or whey may also be given, and in cases of stomach 

 irritation albumen water. 



During remissions broths and clear soups and milk-puddings 

 should be allowed. In the intermission of a quartan or tertian, 

 and during convalescence, regular meals of good plain food may 

 be given. 



Treatment of Symptoms and Special Conditions. — Vomiting 

 is often distressing, and can be relieved by sips of iced soda-water 

 or champagne. When there is no ice, cover the bottle with a thin 

 layer of flannel soaked in water, and hang in the breeze. If these 

 simple remedies fail, and the symptom is really urgent, apply a 

 mustard-leaf to the pit of the stomach, or give a mixture contain- 

 ing chloroform or a hypodermic of morphine. If, despite all this 

 treatment, the vomiting still continues, the stomach may be washed 

 out with slightly alkaline water. 



Hiccough is not often present, and would be a most unpleasant , 

 sign. It can be checked by the mustard-leaf, by codein, or by a 

 hypodermic of morphia (gr. J) . 



Cough not infrequently worries the patient. It may be sharp and 

 dry, and is best treated by codein or morphia in some form, e.g.: — 



Codeinae . . . . . . . . . . . . gx. ^. 



administered every four hours. 



Constipation must not be allowed, and should be promptly 

 relieved by a dose of calomel (i to 3 grains), if necessary, followed 

 by a saline. Ziemann strongly recommends washing out the rectum 

 with warm normal saline solution as a routine practice, but though 



Syrupi tolutanse 

 Aquae chlorof ormi 



