Treatment

In the outset of the disease, and while its nature may as yet be uncertain, if the bowels have not been already purged by nature or by art, it will be well to give a mild purgative. After which he may take one of the mixtures recommended in Typhus fever, three or four times a day.

As the disorder proceeds, if the rose-coloured spots show it to be Typhoid, and if diarrhoea should arise, the state of the abdomen should be carefully investigated; and if, on gentle pressure with the hand, tenderness is found to exist, a few leeches should be applied, which may be followed by a poultice or by hot fomentations. Should the diarrhoea continue, a little of the Chalk Mixture, No. 7, may be taken, but it is not considered good practice in the present day to stop diarrhoea, and lock up the poison in the bowels.

As there is ulceration of the bowels in most cases of Typhoid fever, anything, either of medicine or food, of a stimulating or irritating nature should be avoided.

Dr. G.. Wilks, of Ashford in Kent, strongly recommends the use of Sulphurous Acid in Typhoid fever. He says: In the summer of 1869 a great number of cases of Typhoid fever occurred in Ashford, at first sporadically, and after a time in greater numbers. The diarrhoea was profuse, and exhausted the patient so much that it was absolutely necessary to control it. The first patient upon whom I tried it (the Sulphurous Acid) was very ill before I saw her, alarmingly prostrate both in body and mind, vomiting and purging, with the abdomen tympanitic and painful to the touch. The pulse was 120, and very feeble; the temperature 103. With some fear as to the issue of the case, I began to administer the Sulphurous Acid freely. After twelve hours, I saw her again. The vomiting had ceased, the purging was fast abating; the tympany was much reduced; the feeble pulse had not grown feebler; but the parched tongue was moister, and the thirst lee She said that the medicine, each time that she took it, relieved her within a few minutes of the indescribably miserable feeling in her bowels, and of the nausea which had before oppressed her. She could now take the nourishment ordered without fear or retching; and the whole aspect of the case, from the first a severe one, was more hopeful. To cut a long story short, she recovered, though she had entirely resigned all hopes.

"Plentiful opportunities for using the Acid came to hand; and the more we tried it, the better we liked it, and the more firmly we became convinced of its efficacy. This summer we have used the Acid in more than a hundred and seventy cases with signal results; of them all, one only died, and he was an habitual drunkard, and would not take his medicine. In one case only did we withhold the Acid; the patient, a female, died. But the circumstances were exceptional, and probably more to blame for the death than the want of Sulphurous Acid was."

Dr. Wilks publishes several cases in illustration of his treatment, and adds:

"The Acid should be given in doses of from two and a half to twenty minims, according to age, repeated every four hours, and continued for a week, ten days, or even more, until the patient complains of tasting, smelling, or feeling like sulphur or lucifer matches; or in the case of infants, until they actually emit an odour of the gas from their skin and breath. I have never pressed its use beyond this, under the belief that the system must be by that time supersaturated; nor have I ever seen reason to regret stopping it at that point.

"Where I have seen the case early, before the diarrhoea has become severe, I have given simply the Sulphurous Acid, flavoured with Syrup of Orange Peel, in water. Where the diarrhoea was troublesome, I have added Sulphuric Acid and Laudanum, according to the age of the patient. Thus my usual formulae for adults have been:

Sulphurous Acid..............................Two Drams

Syrup of Orange Peel........................Six Drams.

Water sufficient to make....................Six Ounces

Or

Sulphurous Acid.............................Two Drams.

Diluted Sulphuric Acid.....................Two Drams.

Syrup of Orange Peel........................One Ounce.

Laudanum......................................Twenty Minims.

Water sufficient to make, Six Ounces.

For Infants:

Sulphurous Acid...........................Fifteen Minims.

Syrup of Orange Peel.....................Three Drams.

Water sufficient to make, One Ounce.

Or

Sulphurous Acid...........................Fifteen Minims.

Diluted Sulphuric Acid..................Fifteen Minims.

Laudanum...................................Two Minims.

Syrup of Orange Peel..,...................Half an Ounce.

Water sufficient to make, One Ounce.

A sixth part of either of these mixtures to be taken for a dose.

For ages between Infants and Adults, the dose must be regulated according to the age.

"Lest I should be misunderstood, I will state distinctly what I claim for the Sulphurous Acid in Typhoid fever; that it arrests the further development of the fever poison, and by continuing this arrest long enough, exterminates the fever.

"In some of my early cases, I left off the Acid after a few days use, because the patients seemed better. In almost all such cases they had a relapse, which was again immediately arrested by the resumption of the Acid."

Dr. Murchison says Aconite is a remedy of great value for reducing the pulse and temperature in fever. It may be given in doses of from one to two grains of extract, (English) three times a day (for an Adult.)

If the patient is sleepless and restless, fifteen or twenty grains of Bromide of Potash, or the same quantity of Hydrate of Chloral may be given at bedtime.

If the patient is inclined to sink into a state of stupor, a blister may be applied to the shaven crown of the head.