182 
HINTS TO TRAVELLERS. 
gets worse, give him from forty to sixty grains a day, support his strength 
and keep his skin acting. 
If the patient is very uncomfortable during the attack of fever, twenty 
drops of chlorodyne may be given with advantage. 
If there is much pain in the left side under the lower ribs, i.e., in the 
position of the spleen, hot fomentations or poultices may be applied. 
If the urine is irritating, give plenty of fluid, and administer five 
grains of bicarbonate of soda three times a day. 
If the quantity of urine passed is obviously getting smaller, the patient 
must be purged and the skin made to act by antipyrine, Warburg’s 
tincture, hot drinks and warm stimulants. Bicarbonate of soda helps 
to increase the flow of urine, and may be given freely, ten or fifteen grains 
three or four times a day. 
An ordinary fever is usually cured in three or four days; as it begins 
to abate, less quinine should be given, say fifteen grains a day for two 
days, then ten grains should be administered for three or four days, 
and subsequently five grains daily. Patients frequently on the second 
or third day leave off quinine altogether, and then have a relapse which 
they mistake for a fresh attack, and so they go on for weeks or months, 
constantly having “ slight goes ” of fever, till eventually, when anaemic 
and broken down, they suffer from a violent attack of malaria, perhaps 
associated with blackwater symptoms. 
As soon as the patient can stand it, that is, when the fever is nearly 
gone, tonics, such as iron and arsenic, will be required. 
Diet .—The patient must be fed between the attacks of fever, or when 
the sweating stage is on, with good soup, slightly thickened with sago 
or rice, or with eggs beaten up with milk. If necessary, a small amount 
of whisky mixed with milk may be given. 
If the patient cannot take food, then a nutrient enema must be given. 
Baths , etc .—In ordinary cases it is not necessary to take special 
measures to reduce a temperature of 102° or 103° F. unless it is kept 
up; but if the temperature reaches 104° or 105° F., and remains there, 
cold applications to the whole of the body will be required. (Seq 
Baths, p. 245.) 
In cases where there is acute malarial poisoning, with temperature 
rushing up to 105° or 106° F., or even higher, do not wait to undress 
the patient or get a bath, but empty gallons of water over him, one boy 
