MEDICAL HINTS. * 167 
affected the voice will become hoarse or absent, and there will be greater 
difficulty in breathing, accompanied by a loud crowing noise. 
Diphtheria may be accompanied by cough and pneumonia. 
Treatment .—Isolation. Bed. If diphtheria antitoxin is obtainable, it 
should be administered at the earliest opportunity, 1500 “ units ” being 
injected under the skin as the first dose. 
Nourishing foods and stimulants should be given frequently in small 
quantities. The throat should be thoroughly and frequently washed 
out with chinosol (1 in 1000) or other antiseptic lotion, or powdered 
sulphur may be blown on to the affected parts. If the difficulty in 
breathing is marked, warm baths should be given at intervals of about 
four hours. A steam kettle should be placed near the bed. The ex¬ 
pulsion of the membrane may often be aided and great relief afforded by 
the administration of emetics, such as ipecacuanha. 
Complications— Diphtheria may be followed by paralysis of the wind¬ 
pipe with loss of voice, or paralysis of other parts of the body, therefore 
great care should be taken not to allow convalescents to get up too soon, 
no matter how well they may appear. 
Typhoid Fever . 
It is impossible to give a full account of typhoid fever here, and more¬ 
over the presence of a medical man is absolutely necessary for its proper 
treatment. The chief early symptoms, however, will be given, and a few 
hints as to their treatment. 
The disease is characterised by ulceration of the small bowel, with 
continued high fever, and is usually accompanied by diarrhoea. 
Causes .—It is generally caused by the drinking of impure water, but 
may also be contracted from bad drains, infected clothing or milk. 
The incubation period is from ten to fifteen days. 
Symptoms .^-'The early symptoms of the disease are often so slight that 
the patient will not believe he is really ill; he may just feel out of sorts, 
or complain of headache, but still go about his work. There may be 
diarrhoea, or occasionally constipation (see note to Constipation). After 
five or six days the patient is generally compelled to give up and go to 
bed, headache or diarrhoea, or both, being the chief complaint. The 
temperature goes up in a characteristic manner, rising a little more 
