93 
tomatic conditions present. On the theory that tlie infection enters through the 
alimentary canal, I employ intestinal antiseptics and evacuauts and a supportive 
treatment.” — Bowers, 1896, p. 64. “No medication will relieve the pain and fever; 
but quinine, dissolved in aromatic sulphuric acid, in comparatively large doses, gives 
the best results to those who can withstand the treatment.” — Dubois, 1896, p. 64. 
“ It is a self-limited disease, and drugs have little or no effect upon the attack. I 
treat on expectant plan principally. When pain is severe I control it with morphia, 
and to lessen the hyperasmia of the cord, etc., I usually give a mixture of bromide 
and ergot. AVhen temperature goes above 103° F., I bathe with tepid water, and, if 
indicated, give small doses of acetanilid or phenacetin. Quinine has given no results 
in my hands. I keep patients in a recumbent position constantly, overcome con- 
stipation with salines, and confine them to a milk diet.” — Fairchild, 1896. “ I never 
employ any other than such as is used in ordinary malarial fevers, and that of symp- 
tomatic nature.” — Figgins, 1896, j). 64. “Expectant. Morphine for pain; salines 
for constipation; sponge baths and antipyretics for high temperature. Diet, milk.” — 
Springer, 1896, p. 62. “3Iilk diet; a cholagogue followed by frequent alcohol hot 
baths, with usually very little positive medication. As routine, I usually relieve the 
dengue ache with salol, quinia salts, and some coal-tar products in very small doses 
until free diaphoresis is obtained. I give little but a placebo in mild cases.” — Sweet, 
1896. “Treatment is entirely symptomatic. The hygienic and sanitary surround- 
ings should be the best possible to obtain. Frequent baths and changes of bedding 
add materially to the patient’s comfort. For the fever I usualh' use cold sponging, 
with occasional doses of acetanilid or phenacetin and codeine, or Dover’s powders 
may be required to relieve the pain and restlessness. During convalescence stimu- 
lants, iron and bitter tonics are in order.” — Maxey, 1899, p. 438. 
Montana. — “I have tried many remedies, but found most of them to do but little 
or no good, and often harm if they should be pushed in amount or number. The 
treatment which has served me best is what might be termed eliminative and sup- 
portive treatment. The old rule of keeping the head cool and feet warm should be 
closely observed. The patient should be frequently turned in bed after the disease 
is well established, in order to prevent hypostatic pneumonia, and to cool the under- 
side of the body, which may be superheated while the upper side is cool.”— Gwinn, 
1902. “The best results are obtained by systematic and eliminative treatment” 
(McCullough, 1902, p. 227). “Until the past season [1903] the treatment of this 
disease has been purely symptomatic, but after the discovery of the parasite. Doctor 
Wilson and the writer suggested the use of quinine in large doses, preferably hypo- 
dermatically ” (see below, p. 94). — Anderson, 1903c, p. 40. “Many drugs have been 
used in the treatment of ‘spotted fever,’ but while some of them are important as 
stimulants, sedatives, etc. , none of them — except perhaps quinine — seem to have any 
specific action on the disease through destruction of the parasites.” — Wilson and 
Chowning, 1904a, p. 57. 
SUKEOUXDIXGS. 
“The room should be kept dark and as free from noise as possible.” — Anderson, 
1903c, p. 41. “Darkening of the room and hot sponge baths add much to the com- 
fort of the patieiit.” — Wilson and Chowning, 1904a, p. 57. 
^ DIET. 
Idaho. — “The diet and bowels should be properly regulated, particularly after the 
eruifiion is well out, for I have found in the majorit}’ of my cases that at this time 
the appetite is apt to return to the patient, and the physician’s judgment will be 
taxed to decide just Avhat and how much food may be allowed.” — 3Iaxey, 1899, 
p. 438. 
Montana. — “Milk, butternnlk, broths, soft eggs, and soft toast may all be allowed. 
The whisky may be administered in an eggnog.” — Anderson, 1903c, p. 41. 
