Delirium. Delirium is a derangement of the mind. The higher centres or controlling power of the brain are in abeyance, and the imagination is left to run riot. There are two main types of delirium, acute or maniacal, and typhoid delirium or low, muttering delirium. There are many causes of the condition: disease of the brain, insanity, fevers, such as pneumonia, typhoid, and other exhausting fevers, Bright's disease, and certain drugs, including alcohol, may all cause a person to become delirious. In delirium due to alcoholic poisoning, sleeplessness is a prominent feature. Delirium is more evident by night and generally improves as morning comes on.
In treatment, the cause of the condition must be taken into consideration. A nurse is generally necessary. Sedative drugs may have to be administered by a doctor; cold cloths or an ice-bag to the head are useful in certain types of delirium.
Diabetes is a disease characterised by large quantities of urine. It occurs in two forms: diabetes mellitus, the more serious form, in which the urine contains sugar; and diabetes insipidus, when there is no sugar. Diabetes insipidus is said to be due to some nervous cause, and it often follows upon injuries to the head.
Two varieties of diabetes mellitus are met with. In the milder form it attacks rather stout, middle-aged people as a result of worry or strain, and is generally curable by attention to diet. The more severe form is found in children and young adults, arising suddenly after head injuries perhaps. The cause of the condition is still a little obscure. Formerly it was thought that the appearance of sugar in the urine depended upon disorder of the sugar-regulating function of the liver (see Home Nursing on Absorption, Part 4), but some forms of it are now considered to be the result of changes in the pancreatic gland. The sugar which is required for the nourishment of the tissues passes out of the body in excessive amount, and emaciation follows from impaired nutrition.
Treatment. Regulation of the diet is the most important thing. Sugar and farinaceous food - for example, bread, potatoes, rice, tapioca, sago, macaroni, carrots, turnips, beans, peas, and shellfish - must be given up. Sweet fruits, such as pears, plums, grapes, etc., and sweet dishes of all kinds, are to be avoided, and all sweet wines. Butchers' meat, fish, poultry, eggs and cheese, butter, fat and oily green vegetables provide suitable variety. Ordinary white bread must not be taken, but there are many diabetic Dreads which are quite palatable. Glutin bread, almond meal, rusks, and biscuits are some of these. Tea and coffee may be taken without sugar; soda-water, sherry, claret, and small quantities of brandy and whisky are permissible. Drugs must be ordered by the physician in charge of the case.
Diarrhoea. - The commonest causes of sudden, acute diarrhoea are irritating foods, poisoned water, intestinal parasites, and a poisoned blood state, such as occurs in typhoid and other fevers. Chill in some people will cause an attack of diarrhoea, whilst in the tropics dysentery and cholera are frequent causes of the condition. When there is much vomiting and prostration present, it points to decomposed food or other irritant poisoning. Over-ripe or bad fruit, tinned meats, shellfish, tinned fish, such as sardines or salmon, are all foods which would be likely to cause this condition. In such cases diarrhoea is Nature's effort to get rid of the poisoned food, and is in that sense a good thing. In certain districts in the warm weather of summer and autumn the drinking water supply causes diarrhoea, especially if it contains peat. Infantile diarrhoea will be considered under the children's section later on, as it is the cause of more deaths in infancy than any other disease.
Diarrhoea due to errors in diet is best treated by giving a tablespoonful of castor oil (adult dose) and five or six drops of tincture of opium. Only milk and gruel should be taken for the first twenty-four hours, and in very bad cases the patient may only be able to take raw white of egg or raw meat juice. The invalid must, of course, be kept warm and perfectly quiet.
Chronic diarrhoea may continue for weeks or months, and is sometimes caused by errors in diet; but it may be due to some ulceration of the intestines. In these cases a doctor should always be consulted. Simple diet and attention to the general health will help the condition. Milk and eggs should be allowed, and vegetables and fruit given up for a time.
Diphtheria is a contagious disease associated with membranous growths upon the throat due to the diphtheria bacillus. It very often begins as a simple sore throat, and there may be headache and a feeling of general ill-health associated with rise of temperature. If the throat were examined, patches of creamy white wash leather membrane would be seen on one or both tonsils. These patches are surrounded by redness, and if they are removed, the surface below bleeds, and the membrane forms again. The patches run together, and spread over the soft palate. The glands at the angle of the jaw are swollen, and the neck feels stiff. There is apt to be great prostration, but very often general symptoms are slight. The great risk is the spreading of the membrane to the larynx, whilst later death may take place from extreme debility, due to the poisoned state of the blood or to heart failure.
Great care, also, is necessary to guard against complications such as broncho-pneumonia, kidney disease, and paralysis. The disease is very serious, and medical skill is essential. Since the introduction of the modern serum treatment a large number of cases recover. As a rule, doctors give anti-toxin treatment in every case, and the earlier it is given the better. Medical skill is required for the treatment of the throat condition by syringing, spraying, or swabbing with strong disinfectant. Hot applications to the front of the neck give relief to the pain.