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Treatment.
The patient is brought to the hospital in the special ambulance (rubber tyred)
on a stretcher, and removed carefully in the horizontal position. The greatest care
is taken that the patient does not sit up. The House Surgeon on duty attends to the
case previous to admission in the wards and takes notes of the condition on
admission. The patient is. removed to the ward on a stretcher, and under the
personal supervision of the nurse, is lifted on to his bed which has been kept
ready-prepared. On the cot is placed a mattress of cotton and over it a mackin-
tosh of the full length of the bed, and over it a white blanket and draw-sheet, and a
small piece of mackintosh over the draw-sheet. A pillow stuffed with cotton is placed
under the head, protected by a mackintosh and a towel over the latter The nurse
removes the home-clothes, which are handed over to the Manager (who burns them)
and sponges and thoroughly cleans the patient laid over a mackintosh of the full
length of the bed with soap and hot-water with some disinfectant, and clothes him
with a "sudra," a "lenga" and flannel shirt.
Professional Treatment..
A large enema of warm-water (or ice-cold water if Temperature be high) is
immediately administered (unless the- bowels have been thoroughly moved at home)
and an ice-bag is placed on the head, and vinegar lotion and ice-bag are placed on
the bubo. If there be Tympanitis, another large ice-bag is placed on the
stomach, and Tr., Assaftetida and Turpentine mixed in equal quantities are rubbed
on the abdomen, as well as the Tympanitis Enema (containing Tr., Lavand. Co.,
T., Assafœtida, Ol. Ricini, &c.) administered always with good results. The rectal
tube is also inserted and kept for 15 to 30 minutes in case of spasmodic contraction of
the lower end of the gut. Cold douche of iced water is poured on the head for 10
to 15 minutes, and if the temperature keeps up, it is repeated every two hours. This
is also done if the patient be restless or delirious or violent. If violent, the patient
is tied to the bed with a tape which runs across the chest and other measures are
taken to prevent the patient from sitting up. Bromide of Potash is only administered
in special cases and in small doses of 3 or 5 grains, if the patient is very noisy or
violent, provided the pulse is not weak. A special chart is kept for every individual
patient, where full particulars of his temperature, pulse, respiration, &c., &c., are daily
marked morning and evening, and in very bad cases even every two hours. No food
is given to acute cases except a cupful of arrowroot congee with 3 ii of Brandy
every three hours, and no milk unless they commence to improve, when fresh milk
(a cupful) is given morning and evening.
In all cases with a Temperature above 99°, the patient is kept in a half-pack
which is removed and wetted every two or three hours as it gets dry.
If the Temperature be above 103°, ice-cold pack is wrapped round the whole
body, with separate pieces for the arms and legs. The half-pack is kept constantly
on and removed only when the Temperature remains normal for several days and
the patient is quite convalescent.
Medicinal Treatment of Plague.
Stimulant mixture /ill i (consisting of Spt., Ammon. Aromat, Liq. Strychnia
and Brandy) is given every three hours and Strychnia-Brandy mixture is given in
dram doses every hour, or in very bad cases in half dram doses every half hour. If
there be any rigidity of the limbs, Strychnia is omitted entirely from both the mixtures
and Tr. Belladonna in minim doses is given every hour. In cases with a small pulse
special Strychnia and Brandy mixture (containing ether) is given every half-hour
in minim doses. In cases of high breathing, Belladonna Tincture is pushed on in
small hourly doses, and in bad cases of this type, Liq. Atropine m.i. is injected
occasionally, if the pulse-condition allows.