A text-book of medicine for students and practitioners / by Adolf Strümpell ; With editorial notes by Frederick C. Shattuck.
- Adolph Strümpell
- Date:
- 1901
Licence: Public Domain Mark
Credit: A text-book of medicine for students and practitioners / by Adolf Strümpell ; With editorial notes by Frederick C. Shattuck. Source: Wellcome Collection.
Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.
56/1284 page 28
![If there is considerable diarrhoea, we can give mistura gummosa [P. G., gunt arabic and sugar, each 15 parts; water, 170 parts], or small doses of opiiun, th& latter sometimes combined with tannin, tannigen, etc. In general it is certainly proper not to check the ordinary moderate diarrhoea of typhoid. Persistent con- stipation is always to be avoided. Constipation at the beginning of the disease is overcome by calomel {vide supra). In later stages we always try enemata first, to produce an operation. If this does not succeed, then we must employ rhubarb or castor-oil. Great tympanites may be diminished by laying cold wet cloths or ice-bags upon the belly. Considerable amounts of gas may often be removed by introducing a long rectal tube. As to puncturing the greatly inflated intestines, a method practiced by some physicians, we have no personal experience. If there are severe pulmonary symptoms, baths or wet packs are, as we have said, the best remedies. Internally we may try liquor anamonii anisatus [P. G., olei anisi, 1 part; aquae destillatee, 24 parts; aquse ammoniae, 5 parts] and benzoic acid (grains ij to iij, gramme 0.1 to 0.2, in powder). If the pulse be very rapid,^ we may put an ice-bag over the heart. If at the same time the pulse is small and weak, we give stimulants. Of late we have most frequently given tincture of strophanthus (ten to fifteen drops several times) with the best results. We only rarely use digitalis in typhoid. If symptoms of severe cardiac weakness—so-called collapse—suddenly occur a rapid and energetic interference is urgently demanded. Subcutaneous stimulation, injections of ether or camphorated oil,* should be given, with wine, stropanthus, etc., internally. If the respiration stops it can sometimes be started up again by douches of cold water on the back of the neck, or we may often restore it by artificial respiration. Digitalis (one-half grain of the leaves, gramme 0.03, two or three times daily) may also be employed if the pulse be rapid; but it should be used with great caution. For nervous symptoms the baths and douching are the most effective rerae- dies. The head is meanwhile covered by an ice-bag. Antipyrine sometimes acts favorably on the nervous symptoms. If there be great excitement, as shown by excessive restlessness or delirium, small doses of morphine internally, or, better, subcutaneously, are often very useful. The numerous other complications and sequelse which may occur, but which can not all be mentioned here, should be treated on general principles. The prophylactic measures to avoid the spreading of the disease can be only briefly referred to. Of chief importance is careful disinfection of the excreta. The best means for this purpose is a two-per-cent. solution of corrosive sublimate or a five-per-cent. solution of carbolic acid. We may also pour on milk of lime until the reaction becomes alkaline, or use concentrated mineral acids. We should take care that bed-pans, bed-clothes, linen, the rectal thermometer, etc., should be handled by other persons as little as possible, and should be care- fully disinfected. If there seems reason to suspect that the disease was due to bad water, of course the source of siich suspected water must be cut oif. [Eecent experiments tend to show that the above solution of carbolic acid does not kill spores except after prolonged contact. The following are the measures of disinfection recommended by the American Public Health Association. It will be observed that they apply to all infectious diseases, and it seems well to give them here nearly in extenso, as the directions for disinfection in most text-books are far too vague. Disinfection of Excreta, etc.—The infectious character of the dejections of patients suflering from cholera and from typhoid fever is well established; and this is true of mild cases and of the earlier stages of these diseases as well as of * One part of camphor to four of olive-oil in doses of seven to fifteen minims (gramme 0.5 to 1) every hour or two.](https://iiif.wellcomecollection.org/image/b21206296_0056.jp2/full/800%2C/0/default.jpg)
