Diseases of the larynx / by Dr. J. Gottstein ... trans. and added to by P. M'Bride.

  • Jacob Gottstein
Date:
[1883]
Catalogue details

Licence: Public Domain Mark

Credit: Diseases of the larynx / by Dr. J. Gottstein ... trans. and added to by P. M'Bride. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    avoided. In this respect patients usually know what is best borne. Ices are usually pleasant, and there is no reason why they should not be from time to time taken, but hot drink and food are injurious. In ulceration of the upper part of the larynx, such food as can most easily be swallowed, and causes least pain, should be given; usually semi- solid or gelatinous food suits best (milk, thickened with flour or rice well boiled, and puddings). Among the most valuable means of nourishment may be reckoned milk, and milk cures have long been advocated in phthisis ; it is, how- ever, only of benefit when it is given in sufficient quantity (two litres or more a day)* and when it is not taken at the expense of other food. During, and shortly after each meal one or two glasses should be taken. Alcoholic beverages cannot be dispensed with in phthisis ; in laryngeal ulceration wine and beer often cause severe pain, and therefore the former should be diluted, and the latter slightly warmed. Nutrition is aided by the use of malt extract, and cod-liver oil in winter if it be well borne. Of not less importance than nutrition is pure air ; a roomy, well- ventilated bedroom, especially if the patient be confined to it, should be insisted upon. When at all possible, however, the patient should go out every day. Many persons afflicted with laryngeal phthisis are attacked by cough whenever they go into the open air; respirators must then be worn, but this is very much a matter of habit. When the patient lias been induced to take a daily walk, even in unfavourable weather, his sensitiveness to changes of temperature is diminished. In the early stages of phthisis, great attention should be paid to the skin. It is not sufficient to recommend cold sponging, but this should be carried out by an experienced person, and modified according to the condition and powers of the patient. In anaemic individuals Bponging with water at a temperature of 20' R. (77' F.) should be first used, and thf temperature gradually diminished. We must now consider the question whether consumptives should be treated at home, or whether they should be sent to another climate, and if the Latter be decided upon, whether treatment should be carried out in a special institution or not. It is somewhat difficult to give genera] directions on these points; phthisical patients in whom the i-' Is advanced, and who rarely leave their rooms, or have to remain in bed. should stay at home, for even in the best situated and regulated of establishments they feel ill and are not improved by change of air. Oil the other hand, it is often astonishing how much the general health, local disease, and nutrition are improved by change of air. I fit be not intended only to produce a very transient improvement, it is not suffici-nt to spend four or six weeks at a bath, and then return home to > A litre equali from BS t- SO cranoec (Tran.-l.u<>r).