The Columbian. [volume] (Bloomsburg, Pa.) 1866-1910, 1890-01-24

ieriologically and chemically. We
accept the microbic nature of its ori.
gin, but it has not been proven.
"The prognosis is favorable, but the
general mortality is increased by the
epidemic. This is because persons pre-
viously diseased are carried off. For
instance, in these two cases with feeble
heart, if any unusual exertions were
made the patients would probably die,
If an elderly person with fatty heart
contracts this disease, for il is no re.
spector of age, he would be in immi-
nent danger. We call this heart fail
ure, but these hearts are diseased aud
enfeebled still more by the malady.
81 haye mentioned relapse. l have
seen few distinct examples of this.
One was that of lady who bad her
first attack in the country and came to
town to break it up. She was we'll for
two weeks when she was attacked the
second time. Another case was that
of gentleman who was suddenly
seized with relapse while in church,
two weeks after the first attack. In a
third case pneumonia occurred in the
relapse. The longest interval have
known was two weeks; the shortest
five days. To prevent relapse, great
care is necessary iu not gcing back TO
work too soon, and not exposing ones
self TO wet and cold, and with this
there should be judioious use of tonics,
and even stimulants.
TREATMENT.
"Now few words in conclusion
with reference to the treatment. The
treatment must, of course, be the ordi-
nary treatment of catarral affections.
For the relaxed and irritated throat l
have found nothing 80 servicable as
gargle of salicylaie of sodium, glvcerin
aud water. For the nasal catarrb,
which at times is very unpleasant, !
have found that a two per cent. solu-
ton of cocaine does the most good.
The bronchial catarrh should be
treated as any other bronchial catarrh,
according to the exact seat and num-
ber of rales. A good deal of the
paroxysmal cough is laryngeal, and
you will find that small doses of opium
at night, or bromide and opium, or
what l have employed in a number of
cases, broken doses of Dover's powder,
will give good results. One fourth of
grain of codeine, repeated according
to the circumstances of the case, is
often useful it allays the cough, in
duces sleep, and does not cause much
sweating. Let me say here, that
while perhaps the routine practic of
using diaphoretics in these cases is
useful, yet such drugs must be used
with judgment. In some cases there
Is great tendency TO sweating, and
you do not want to increase 1t, as it
rather adds to the debility. The dia-
phoretic must be adapted to the indi-
vidual case, not employed too actively,
and not at all where sweating is a
prominent symptom.
The debility must be borne in
mind, aud it is good practice to give
sulphate of cinchonidine or quinine,
ten or twelve grains daily Nourish-
ment should be kept up, and the action
of the bowels looked after. The pa
tient should not be overpurged, for, in
some instances, diarrhoea is asso-
ciated with the malady.
"For the headache and the pain in
the bones have found two remedies
of especial advantage. One is anti.
pyrin in five grain doses, with a grain
or two of qulniue to prevent depres-
sion, repeated every two or three hours
until the headache is relieved; the
other is phenacetin in five grain doses.
In one instance where these two drugs
failed to relieve the headache l found
gelsemium to answer.
"The general strength and the circu-
lation must be looked after, and espec-
tally during convalescence the patient
must receive nutritious food, alcohol,
small doses of strychnine, aud, later,
iron.
81 shall not speak of the treatment
of the complication pneumonia, but let
me point out, in concluding these re
marks, that you should keep your pa
tients for long time on tonics which
may prevent relapse, and, indeed, it
may be question whether it would
not be advisable when the disease
makes its appearance in household to
place the whole family on the use OF
tonics, such as cinchonidine or quinine
as preventive. My experience is
that, while his will not ward off the
disease, it renders the attack less
severe.