The Daily bulletin. [volume] (Honolulu [Hawaii]) 1882-1895, 1885-08-18
chr @ailn g lllEtim.
TUESDAY, AUG. IS, 1885.
HYGIENE AND TYPHOID FEVER.

7. in a recent paper on Typhoid
Fever, read before the County
Medical Society and published in
the Medical Record, objects to the
present method of relying so entirely
on powsssi autipyretic drugs in its
treatment, and recommends more
earnest attention to proper aliment-
alton and hygiene. Among other
things he says:
Antipyretics are not necessary in
II large number, perhaps we may
say in large mcjority of cases of
typhoid. We know that the disease
is self-limited, 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
confidently on the excellent hygienic
rules well-known to us, avoiding
drugs and sall strong agencies as
much rs 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 management of case Of
typhoid fever, is the selection of
large, airy, quiet room. If any
point in hygiene is important. it is
that of perfect quietude. No person
should be admitted except the at
tendant and physician. A few
strange faces in the room for only a
brief time will very likely insure a
restless night and higher tempera-
ture. Even friends and intimate
acquaintance should not be admit
ted, though they promise to remain
silent. If my patients have no
other luxury they can and shall have
this one. Grant it, and careful
attendant and the thermometer will
surely indicate lower scale. Next,
always prepare everything for dis
injecting Immediately, all excretions
and soiled clothing before they are
removed, to effectually prevent fur
ther spread of infection. In the
meantime carefully seek for the
source whence the patient was first
infected 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. Es-
pecially should the teeth be often
thoroughly cleansed from sordes and
foul secretions, which would other
wise be left to form continual foun-
tain of putrid, poisonous matter.
This is to be done by the attendant,
if the patient is unable to do it fol
himself.
The position of the patient should
be often changed, to aid in prevent
ing hypostatic congestion Of the
lungs and other organs. This little
manGuvre is unquestionably of great
utility-much more than the time il
takes to mention it.. Even the brain,
l believe, sometimes suffers from
this hypostatic force of the blood
l further believe the aOeight of the
various organs may discomfort and
injure them, when the patient is
allowed to maintain one position fol-
weeks. The heart certainly cannot
afford this.
In regard to alimentation, 1 nee6
scarcely say it is immeasurably i'm
portant. 1t is a radical principle Of
typhoid therapeutics, based upon ex
perience and the combined testimony
of the largest number of those mos
experienced. We would as soor
think of saving a mans life withou
tying or COMPRISING severed az
terry, as to think of treating typhoid
without diligent support. Rapie
waste is steadily and surely goins
on from beginning to end. Com
bustion is intense, involving the tbs
sues everywhere. AS Niemeye
well says, ''No sort of exercise will
use up the body so rapid as feve
, does, and most fatal cases of feve
are due to insufficient material bein!
furnished for the replacement o
that used up" ''Food and susten
ance," says Aitken, "are the pre-
ventives of delirium, and the bes
stimulants of the nervous system.
Invariably do we see patient VIII
r has been well fed, get up from
S typhoid fever but little emaciated
More than this, such ones convalesc
q more rapidly. There can be n
0 doubt in the propriety of even crowd
3 ing the patient to take nourishment
S especially ii he is listless or refuses
l am sure by so doing many lif
has been saved.
The kind of food has been a sub
iect for much discussion. but il