MEDICAL HINTS. 
181 
of chlorodyne. Five or ten grains of bismuth subnitrate may assist 
in allaying the vomiting. A large warm-water and soap enema will 
frequently check vomiting by increasing the action of the bowels, and 
a mustard leaf may be applied to the pit of the stomach. 
During the cold stage give hot drinks, such as thin broths, weak tea, 
or a little hot spirit and water. A hot-water bottle in bed is useful. 
Sponging with warm water often gives relief at the beginning of a fever, 
and tends to shorten the cold stage. 
During the hot stage from five to eight grains of antipyrine may be 
given with advantage; this will soothe the patient and promote perspira¬ 
tion. Too much reliance must not be placed on antipyrine or phenacetin, 
and the sweating and lowering , of temperature which they produce. 
They are depressant in their action, and the violent perspiration they 
produce is frequently very exhausting, and they have no real specific 
action on the malarial germs which cause the disease. If the skin is 
very dry four tabloids of Warburg’s tincture should be given, and the 
dose may be repeated in three or four hours. 
Drinks of diluted lime-juice and water will be found refreshing, but, if 
the lime-juice is given too strong, it may cause vomiting. 
Cloths kept wet with an evaporating lotion made of one ounce of spirit 
in half a pint of water, may be applied to the head, and cold sponging of 
the face, neck, arms and chest helps to lower the temperature, is very 
refreshing, and can do no harm if the patient is not allowed to get 
chilled; if he is very feverish, it may be necessary to give a cold bath. 
During the sweating stage care must be taken that the perspiration 
is not stopped by a chill. Hot drinks will help to make the skin act 
freely. 
Give five to ten grains of quinine towards the end of the sweating 
stage, and another ten grains a couple of hours before the fever is likely 
to return. In the tropics very often it is impossible to say when an 
attack will come on, and it is best to begin with ten grains and then to 
take regularly, for two or three days, five grains every four hours. 
The temperature is the best guide to the treatment, therefore it should 
be recorded and kept for comparison with subsequent temperatures. 
Usually the total amount of quinine given by the mouth during twenty- 
four hours should not exceed twenty to thirty grains, but if the patient 
