135 
Care of the gums. 
The gums and mouth should be most carefully attended to. The 
gums are especially prone to become spongy and to bleed. Inflamma¬ 
tion of the parotids with abscess formation is a frequent complication. 
The use of the tooth-brush should be interdicted and the teeth 
cleansed with tooth-powder and pledglets of cotton wool. An anti¬ 
septic mouth-wash should be used four or six times a day to harden 
the gums and relieve the filthy taste in the mouth. 
Many cases will require very little more treatment, and drugs 
should not be given unless absolutely necessary. Your main care 
should be to supervise the nursing, absolute rest of the patient, 
starvation, the early purging and sweating, the reduction of the fev ci 
by cold spongings or baths, the use of alkaline drinks, enemata, ice- 
bags to the head and cleansing of the mouth and gums. It will 
require all your vigilance to direct the nursing and management of 
the case and to check the condition of the patient by his temperature, 
pulse rate and the action of the kidneys. 
Yellow fever is a disease which cannot be cured by drugs, and 
while employing symptomatic treatment you should endeavour to 
avoid causing any irritation to the stomach. 
In addition to Vichy many doctors prescribe fluid magnesia wit 
benzoate of soda, bicarbonate of soda either in cachets o i o o 
grammes every three to four hours, or in solution of I 5 t° 2 0 ST 
to ioo c.c. of water, giving 30 cc. every hour. I pitfei tie : 
as they are not so disagreeable to take. If abundant alkaline 
water is drunk, and sodium carbonate or magnesia is & 
addition, the acid reaction of the urine will gradually give p a 
neutral or alkaline reaction. 1 his is a fa\ ourable in ica 1 
Kidneys. 
Should the urine, despite the drinking of abundant alkaline waters, 
rapidly decrease in amount and failure of the renal sys e 
imminent, no time must be lost. Caffeine citrate is a car ^ 
and acts beneficially on the kidneys. It is easy to a rain G ther 
form of hypodermics, and should be given in P re er ® n ive 
stimulants.' If the kidneys fail to respond, it .. in 
theobromine, 2-0 to 3-0 grammes in the course o emulsion of 
cachets of 0‘3 to o’5 gramme, or in the form c 
