THE TREATMENT DURING THE ATTACK 1401 



and dissolving the chlorine gas so evolved in 12 ounces of water, which con- 

 stitutes the first bottle, and should be dispensed in a non-actinic bottle with 

 a glass stopper. The second bottle contains quinine bihydrochloride 36 grains, 

 syrup of lemons i ounce, also dissolved into 12 ounces of water. One table- 

 spoonful from each bottle is mixed and taken three times a day. A thin slice 

 of orange is sucked after each dose to remove the unpleasant taste. Some 

 authorities prefer giving tincture of iodine 2 to 3 minims in an ounce of water 

 every three to four hours ; others prefer ^S-naphthol 2 to 3 grains mixed with 

 bicarbonate of soda 2 to 3 grains, or eucalyptus oil or cinnamon oil 2 to 3 

 minims in a suspension. 



Constipation must be counteracted by a simple enema or an 

 enema with a little turpentine if there is some tympanites every 

 other day. 



After the second week urotropine may be given in lo-grain doses 

 three times daily in order to disinfect the urine and gall-bladder. 



Serums and Vaccines. — Serums have not been successful; some- 

 what better results have been recorded by a number of authorities 

 by the use of vaccines. We do not use the vaccine treatment 

 except in some protracted cases with low fever and fairly good 

 general condition. 



Tchikana, Fagiuoli, Micheli, Quarelli, and others, give the enteric vaccines 

 by intravenous injection. Kraus, De Castello, and Lucksh, claim to have had 

 good results in enteric by the intravenous injection of heterologous vaccines, 

 as, for example, a B. coli vaccine. Intravenous injections of a peptone solu- 

 tion have also been used. 



II. The Treatment of Special Symptoms.— The special sjnnp- 

 toms which require treatment may be considered under the follow- 

 ing headings : — 



1. Tympanites. — Tympanites is to be treated by fomentations, 

 turpentine stupes, by the administration of 15 minims of turpentine 

 every three hours, or 3 to 5 minims of cinnamon oil at the same 

 intervals, or by a hypodermic injection of -/q grain of eserine. 



2. Intestinal Hcsmorrhage. — The nurse should be prepared on the 

 onset of this complication to stop all food and drink except a few 

 sips of cold water, to apply an ice-bag to the abdomen, and to raise 

 the bedclothes on a cradle and to administer either the enema 

 mentioned above or to give a capsule of 3 minims of turpentine, or 

 both. This is of the utmost importance, as then time is not wasted 

 in getting the treatment under way. When the physician is certain 

 that a perforation has not occurred, a hypodermic injection of 

 morphia is very useful, but this should not be given so as to hide 

 the signs of a perforation. The turpentine capsules may be con- 

 tinued three or more times a day, and calcium lactate in lo-grain 

 doses may also be given. 



1. Tympanites. 



2. Haemorrhages. 



3. Perforation. 



4. Diarrhoea. 



g. Phlebitis. 



10. Bedsores. 



11. Abscesses. 



7. Delirium. 



8. Cardiac failure. 



5. Cholecystitis. 



6. Hyperpyrexia, 



12. Bone lesions. 



