Tongue-tie. This condition occurs when the frenum of the tongue, the little piece of mucous membrane fastening it to the floor of the mouth, is too short, or is attached to the tongue too far forward. In such cases the tongue cannot protrude from the mouth, and the child has difficulty in speaking distinctly. When the condition is marked, the frenum will have to be clipped with a pair of sterilised scissors, and this should invariably be done by the doctor.
Tremors. Various muscular tremors of the hands, lips, or head are associated with different conditions of health. There is the tremor which comes in old age, affecting the head or hands, chiefly due to general weakness and loss of tone of the muscles. Then there is hysterical tremor, which often appears after some emotional shock, and is best treated by attention to the general health. Alcoholic tremor affects the hands, and is worse in the morning, whilst there are tremors due to poisoning (such as lead), and to various nervous conditions. In every case, the cause must be dealt with, and general healthful conditions aimed at so that the tone and vitality of the muscles may be improved.
Tumours. There are two main types of tumours - simple and malignant. A simple tumour does not endanger life,and it does not recur after removal by operation. Examples of simple tumours are common warts, naevus, or birth-mark, and the fatty tumours which are sometimes seen on the scalp and the neck.
Malignant tumours, on the other hand, affect the blood or lymphatic system. They grow quickly, destroy the healthy tissue around, and are apt to recur after removal. A common example is cancer (which see).
Typhoid Fever, or Enteric. Typhoid is an acute fever due to a specific microbe, the typhoid bacillus, which finds its way into the intestinal system and causes ulceration of the intestines. It may occur in epidemics due to the contamination of the water supply by sewage. It is very infectious, and nurses and friends may contract the disease by handling the sheets or receiving articles from the patient. The disease has been caused by eating oysters, ice-cream, and contaminated milk. It is most common in autumn and early winter, and chiefly occurs in people under thirty years of age.
After the incubation period of about ten days, the disease begins with severe headache, shivering, loss of appetite, and pains over the body. The temperature rises gradually, falling a little each day, but attaining about the end of the first week 103 or 104 degrees. The patient generally suffers from diarrhoea, but this is not necessarily a sign. About the seventh day crops of little rose-coloured spots appear on the body. Each spot lasts two or three days, and then disappears. The patient is generally very ill. The cough of bronchitis frequently appears, and the disease is often mistaken for bronchitis, and even for pneumonia.
During the second week the symptoms become more aggravated, delirium is often present, the fever and quick pulse continue, and abdominal symptoms are marked. In the third week the temperature falls gradually, but it is at this stage that complications may arise. The heart may become enfeebled, haemorrhage may occur from the bowel or perforation may set in. In the fourth week convalescence should begin, the temperature gradually falls, the pulse improves, and the patient shows a desire for solid food.
Typhoid fever is always a serious disease, and requires very careful nursing. Slight cases require as much care as severe ones, as they are just as liable to haemorrhage and perforation if the patient is not kept perfectly quiet and properly fed.
Treatment consists in supplying rest and suitable diet, keeping up the strength of the patient, and seeing that he takes the various medicines ordered by the doctor. The nurse has a great responsibility, and important details were noted in the home-nursing article on infectious diseases. The patient should not be allowed to sit up in bed, and must be carefully watched during early convalescence.
Diet is of the greatest importance, and should consist of milk diluted with barley-water or lime-water, whey, egg, albumen, buttermilk, clear soup, chicken broth, etc. No solids should be given at all. Predigested foods will probably be ordered by the doctor.
As typhoid is a disease likely to be prevalent when out of reach of medical assistance, a few hints as to the administration of diet may prove useful. About two or two and a half pints of milk should be taken in twenty-four hours, diluted with an equal quantity of barley-water, soda-water, or lime-water. Food should be taken, about four ounces at a time, every hour during the day, and every two hours during the night. This may be varied with beef-tea, milk jelly, albumen-water, egg whey, and lemon-sponge, which is made from white of eggs only. No solid food should ever be taken until the temperature has been normal for a week, and, as a rule, the patient is on fluid diet for five or six weeks. For distension or wind, apply hot turpentine stupes, and the doctor will give directions as to medicines and stimulants.
Typhus Fever (called also hospital, gaol, and ship fever). This fever is much less common than formerly, owing to improved hygienic conditions and preventive medicine. It occurs wherever overcrowding, defective ventilation, and destitution exist, and is still prevalent in back to back houses in which the poor are crowded together.
It is a very contagious disease and lasts about a fortnight, resembling typhoid in some of its characteristics, but differing in the appearance of the eruption, which shows mottling of the skin and reddish spots.