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The bubo to be fomented a little with hot water, and the paste to be applied thickly,
a piece of lint to be placed over it, and, over the whole, hot linseed-meal poultices to
promote rapid absorption. Generally within six to twelve hours the pain ceases
excepting on movement, and this is really a point achieved, since it lessens the
patient's discomfort. As soon as the pain ceases, the poultices are discontinued, and
the paste allowed to dry over the bubo. Suppuration commences without disturbing
the external skin, and even without the knowledge of the patient about the tenth
day. ID. those cases where the heart shows symptoms of failure from the very begin-
ning, the quantity of opium is lessened and sometimes omitted.
Fever.—For this symptom it is easy to say what drugs are harmful rather than
what are useful. All antipyretics are contra-indicated, excepting quinine in very
small doses, the most fatal being aconite, antipyrin, antifebrin, phoenacetin and
salicylic acid ; so also depressent diaphoretics, The only useful medicine for this
symptom is alcohol in moderate doses given at stated intervals. Good brandy, diluted
well, proves the best diaphoretic, the best expectorant, the best diuretic, and the best
soporific in. this disease. Of late I have given extensively a much neglected
Compound, viz., Tincture of Warburg. It proves a good stimulating diaphoretic, and
having seen lately a copy of the original receipt, the idea that it contained any harm-
ful drug, such as aconite or Iodine, is dispelled. This compound contains aloes which
relieves constipation, und eliminates poison. It requires to be given in moderate
doses, lest the aloes may set up diarrhoea. During the onset internal remedies are
not tolerated, and we have to depend on external ones—ice to the head, cold douche,
sponging the body with evaporating lotion, (and for this too brandy and water serves
best), wet packing of the abdomen and back.
Headache,—Nothing affords so much relief as the ice bag. Shampooing or
massage of the scalp also affords great comfort.
Insomnia.—All drugs having a depressing influence on the heart are contra-
indicated. If there be no delirium, tine, cannabis ind. answers best.
Delirium.—Excepting ice bag, everything else is harmful.
To support the heart, moderate doses of stimulants, in combination with strych-
nia, caffeine and strophanthus, are the best. All other heart tonics, such as digitalia,
convalaria majalis, iron, &c., are contra-indicated.
Nausea and vomiting are checked by a little vinegar and water sweetened with
honey. Gastric sedatives, such as hydrocanic acid and bismuth, are contra-indicated.
For pneumonia nothing is better than supporting treatment. Alcohol, in com-
bination with caffeine, nux-vomica, and carbonate of ammonia, suits well. External
irritants, such as different liniments, only serve to make the patient more uncomfort-
able. Dry fomentation answers best. For septicsemia, if there is no complication
of the lungs or the kidneys, mercury and iodine answer best.
For diarrhoea, vegetable astringents, such as tannic or gallic acid, are useful.
Opium and its preparations are contra-indicated. Bismuth and saiol are sometimes
good, but they produce flatus.
I have given full trial .to the Khoja Hospital decoction, containing several native
herbs, and find that it is as useful as any ordinary diaphoretic mixture in curing
the disease. Mild and ordinary cases which yield to any treatments are benefited
by this decoction also, but it is found to be worse than useless in severe and other cases
for it paralyses the heart, as much as Digitalis does, and the resins contained in it sets
up fatal diarrhoea. The reason why it succeeds so well in the Khoja Hospital is to be