The Pacific commercial advertiser. [volume] (Honolulu, Hawaiian Islands) 1856-1888, 1879-11-22
Hygiene and Typhoid Fever.


so entirely on powerful antipyretic drugs In Its
treatment, and recommends more earnest atten-
ton to proper Authorization and hygiene. Among
other things he says:
Antipyretics are not necessary in a large num-
Der, perhaps we may say in a large majority of
cases of typhoid. We know that the disease is
s~elflimited, that it cannot be cut short, that heat
is an inevitable symptom, that we are To support
early the otherwise rapidly wasting body, that
digestion and assimilation are fortunately on the
side of the patient. We may therefore lean con-
fdently on the excellent hygienic rules well-known
to US, avoiding drugs and all strong agencies as
much as possible. L cannot help thinking these
are truisms; some of them very old, none of them
really new, yet well worthy Of our thought and
attention.
One point OF the first Importance in the man
agement of a case of typhoid fever, is the selec-
ton of a large, airy, quiet room. If any point
in hygiene is important, 1T is that of perfect quie-
tude. No person should be admitted except the
attendant and physician. A few strange faces in
the room for only a brief time will very likely in
sure a restless night and higher temperature.
Even friends and intimate acquaintance should
not be admitted, though they promise to remain
silent. If my patients have no other luxury they
can and shall have this one. Grant it., and a
careful attendant and the thermometer will sure
ly indicate a lower scale. Next, always prepare
everything for disinfecting Immediately, all ex-
cretions and soiled clothing before they are re-
moved, to effeciually prevent further spread OF in
lection. In the meantime carefully seek for the
source whence the patient was first infected; a
search which will be often rewarded with success.
Lastly, assure the patient of ultimate safety,
speak to him confidently, count the days for him
and encourage him.
Cleanliness is all important. Especially should
the teeth be often thoroughly cleansed from sordes
and foul secretions, which would otherwise be
left to form a continual fountain of putrid, pois-
onOus matter. This is to be done by the atten-
dant, if the patient is unable to do it for himself.
The position of the patient should be often
changed, to aid in preventing hypostatic conges-
ton of the lungs and other organs. This little
man9uvre is unquestionably of great utility
much more than the time 1t takes to mention it.
Even the brain, L believe, sometimes suffers from
this hypostatic force of the blood. l further be-
lieve the toeight of the various organs may dis
comfort and injure them, when the patient is al
lowed to maintain one position for weeks. The
heart certainly cannot afford this.
In regard to Authorization, [ need scarcely say
it is immeasurably important. 1t is a radical
principle of typhoid therapeutics, based upon ex-
perience and the combined testimony of the largest
number of those most experienced. We would as
soon think of saving a man s life without tying or
COMPRISING a severed artery, as to think of treat
ing typhoid without diligent support. Rapid
waste is steadily and surely going on from begin
ming to end. Combustion is intense, involving
the tissues everywhere. AS Niemeyer well says,
9 No sort of exercise will use up the body SO
rapidly as a fever does, and most fatal cases of
fever are due to insufficient material being fur
nished for the replacement of that used up"
90 Food and sustenance," says Aitken, " are the
preventives of delirium, and the best stimulants
of the nervous system" Invariably do we see a
patient who has been well fed, get up from a
typhoid fever but little emaciated. More than
this, such ones convalesce more rapidly. There
can be no doubt IN the prOpriety of even crowd
inc the patient to take nOurlshment. esDeclally if
he is listless or refuses. L am sure by so doing
many a life has been saved.
The kind of food has been a subject for much
discussion, but it is now pretty generally settled
that milk should form the basis. 1t is at once
abundant. cheap, always ready, no cooking pro-
cess needed, and it contains all the elements of
support and nutrition which the system requires;
natures own compound, and like herself perfect;
adapted to all ages, as well as every stage OF the
disease. 1t may given clear, or, perhaps, pre-
ferable with l~ime-water, and il it produce a full
ness at the stomach, failing to digest properly, 1t
may be aided with pepsiD, as recommended by
DIR. W. H.. Thomson, of New York. The guam
tity should be, il possible, from three to six plnts
in twenty-fOur hours. L once had a case, a lady
of large frame and plenty of adipose tissue, who
drank every day four quarts by measure of clear
milk. | was frequently inquired of as to the
probability OF her recovery. 4 answered that she
cOutd not die, because she was able TO appropriate
so much nOurishment. She recovered, of course
For the diarrb9a there is probably nothing
equal to "a milk diet, and as a support to the ner-
yOus system 1T can scarcely be surpassed. 1t
must not be forgotten, however, that it fails to
agree with all cases; that 1t required in some in
stances to be given in smaller quantities. the de-
fciencies to be made up in other food. Occasion
ally a case will be found wherein it must be dis
continued altogether. Very rarely indeed, how
ever, must this happen. Solid food, as before
said, is often agreeable, such as tender meats,
afala hraoH otn Gronoa and Daoohna houaa oil
ways found acceptable, Notwithstanding their in
terdiction by Liebermeister.
Beef-tea, so fashionable the world over, is at
best poor stuff. 1t easily ferments in the stom-
ach, and must then surely increase the dlarrhoea
as well as the tympanitis, by filing the i%ntestines
with gas (Ziepssen, johnson, Liebermeister) and
further, we know it contains little nourishment,
| have generally found eggs Objectionable also,
especially If taken raw in the form Of egg-nog.
Inunctions of the whole cutaneous surface, sew
eral times a day, with fresh cocoa or olive oil.
with or without lime-water, are highly useful.
Many are aware OF their beneficial influences over
the extreme heat of scarlet fever. They are equal
ly valuable in typhoid fever. They reduce the
heat quite perceptibly; keep the skin moist, open,
and active; sheath the sensltiveness of the cutane-
Gus nerves, and thus promote rest. | find they
are highly praised by DR.. Thomson, of the Uni
versity of New York, who has marked a fall in
temperatur of from one-half to a full degree.
AAS ~ ~ - NV NlAlO ~
storing the functions of the skin, which enables
it to add water to the system when needed, as
well as to abstract it when the circulation is too
full. He is quite sangulne In the belief OF Its
good effects also in cases of general anasarca
when the skin Is tense and thus rendered incapa-
BILE of performing its functions. Furthermore,
be thinks these inunctions prevent bed-sores. DR..
Edward Warren also indorses these views fully.
a physician may find some use for drugs to
subdue now and then an excessive diarrhoa, or
cough, or active delirium, but many believe with
myself that in fevers and most other self-limited
diseases the old maxim Is appropriate. 1" Throw
physic to the dogs"
A long list of names could be appended to the
above sentiments, but we will close with the ex-
cellent words of DIR. Aitken: at is, above all.
necessary to guard against the habit of trying al
ways 20 be doing something. Journal of
Health.
A beet sugar factory in Bangor has 100 en-
ployees and uses 200 tons of beets a day.