In a majority of the infectious diseases of which fever is a prominent symptom, the great danger to life is occasioned by the great increase of temperature. This is also the principal cause of the rapid loss of weight and strength by a patient suffering with fever. There is an unusually rapid destruction of the tissues of the body, while at the same time there is a loss of assimilative power, so that the wasted tissues are not readily replaced. The nervous system, and especially the heart also suffers directly from the depressing influence of a high temperature. In consequence of this fact, the treatment of fevers comprises the most essential measures to be employed in the treatment of the whole class of diseases included in this section; and the directions given should, with few exceptions be followed in all cases in which fever is a prominent symptom, other measures being employed as may be indicated by their special symptoms. As the high temperature is the greatest source of danger in fever, the greatest importance attaches to remedies which will have an influence to lower the temperature. Those which are most effective for this purpose may be briefly enumerated as follows: Sponging with cold cool or tepid water; the application of the cold compress to the abdomen chest or head or to all at the same time; ice to the spine; wet sheet pack; cool shower bath; affusion; cool or cold enemas; drinking ice water or swallowing bits of ice; the graduated full bath; the cool air bath.

Any or all of these measures may be employed, according to the particular indications of each individual case. When the fever is slight, tepid and cool sponging, and the application of tepid compresses over the abdomen, are usually sufficient. When fever rises very high as indicated by very full and rapid pulse, severe headache or delirium, throbbing temples, and a temperature of 102 to 105 or upward, ice to the head and spine, cold compresses over the bowels, frequent cool sponging, and the use of the cool or cold enema once in two or four hours, are the remedies upon which we chiefly depend. By the combined, use of these measures, the temperature can almost always be readily controlled. The cold enema is a very useful measure indeed, and is especially serviceable in cases in which the patient complains of chilliness upon being sponged with cold water.

We also value very highly as a means of reducing the temperature, the application of the ice compress to the spine and back. If the patient complains of chilliness, a bag of hot water may be placed at the pit of the stomach. The compress may be continued for from fifteen minutes to two or three hours, care being taken that the skin is not injured by the direct contact of the ice, or the patient annoyed by the cold water from the melting of the ice running down about the body. In extreme cases, the shower pack, or the graduated bath may be employed. We believe, however, that these measures can be dispensed with, even in the most severe cases, if the other measures mentioned, especially the cold enema, are thoroughly employed.

When the fever is high, the patient may be allowed to drink freely of cold water, as by this means an appreciable effect upon the temperature may often be obtained. If at any time, unpleasant sensations are produced in the stomach by taking too much cold or iced water, it may usually be quite promptly relieved by applying a hot fomentation over the stomach. When the patient complains of a bad taste in the mouth and a dislike for water, weak lemonade, slightly sweetened, may be used to very great advantage. Juices of various other fruits, as of apples, raspberries, currents, etc., may be used in the same way as lemon juice. In cases in which the stomach is very irritable and rejects drinks of all kinds, the thirst will often be relieved by giving the patient an enema, as a considerable quantity of fluid may be absorbed by the mucous membrane of the lower bowel. When given for this purpose, as when administered to reduce the temperature, quite a large quantity of water should be employed. It should be introduced very slowly and should be retained as long as possible, half an hour at least. When the disposition to expel the water cannot be readily controlled, a sponge or napkin should be held against the anus for some ten or fifteen minutes. The severe headache which most fever patients suffer, is best relieved by a continous application of cold to the head.

The diet of a fever patient should be very simple, consisting almost wholly of fluid food, as oatmeal gruel, graham gruel, milk, and, occasionally, chicken or mutton broth, or beef tea. We are not much in favor of animal broths, however, on account of their stimulating character. The same objection is valid against the use of beef tea, and especially against the various extracts of beef which are sold at the drug stores, which are almost entirely devoid of nutriment, being of a very stimulating character. No meat nor solid food of any kind, with the exception of toast, should be allowed. Baked sweet apples, ripe grapes, oranges and lemons are about the only fruits which may be safely employed under nearly all circumstances when the stomach does not reject food. When grapes are taken, the skins and seeds should be rejected. Vegetables should be discarded as deficient in nourishment, and hard of digestion. Jellies, rich sauces, preserves, pastries, and other delicacies, should be strictly prohibited. These articles are not only very difficult of digestion, but contain very little nourishment. Milk is an article of food more generally acceptable than any other. It has the advantage of being easy of digestion, and containing all the elements of nutrition. When it can not be taken alone, it may be combined with barley-water or oatmeal gruel, in varying proportions to suit the wish of the patient. When necessary, lime-water may be combined with the milk, in the proportion of one part lime-water to three or four parts milk.

In cases in which the patient is too feeble to take nourishment, or is unconscious and refuses to swallow food when it is placed in the mouth, nutritive enemata should be employed. It is a mistake to suppose that a patient suffering from fever requires no nourishment at all until the appetite returns. The opposite extreme of excessive feeding should also be avoided. If the patient takes no nourishment at all, the depression and weakness resulting from the disease will be very much increased, and death may result from the great weakness occasioned by want of nourishment. Excessive feeding will increase the fever. We have observed cases in which the violence of fever was very greatly increased by the use of large quantities of stimulating food, as beef tea, egg-nog, brandy and milk, etc. The directions sometimes given to feed a patient every few minutes, or every half hour, is pernicious advice, unless the patient is so weak that only one or two teaspoonfuls of food can be taken at a time. Two or three hours is as short an interval as is admissible. As a general rule, it is better that the patient should take food not more frequently than three or four times a day, the quantity being made large enough to afford the required amount of nourishment.

The supply of an abundance of fresh air by proper ventilation is by no means the least important measure necessary in the successful treatment of fevers, as, in many cases the morbid action is a result of inflammation excited by poisonous germs. Thorough ventilation is necessary to remove the infectious particles with which the air of the patient's room may become impregnated, so that the infection will not become intensified by breathing over and over the poisoned atmosphere.

Ventilation is also necessary for the safety of nurses and attendants. Practical experience has shown a very great difference in fatality between cases treated in close and unventilated hospitals, and those in which an abundant supply of fresh air was furnished. At a Sanitary Convention held in Detroit in January, 1880, under the auspices of the Michigan State Board of Health, an old army surgeon related a very interesting experience illustrating the importance of securing to the sick, and especially persons suffering with fever, an abundance of pure air. He stated that during the war he had charge of a large hospital in which at one time in the winter season he had under treatment three hundred and twenty cases of measles. Just at this time the hospital took fire and burned to the ground. The patients were placed in tents and all but one or two recovered. He had no doubt that the number of deaths would have been thirty or forty at least, had the patients remained in the hospital. He afterward sent one hundred men who were only slightly ill, to the general hospital at Nashville and seventy five of them died. Upon visiting the hospital, he found it so poorly ventilated that the air was exceedingly foul, producing a sickening sensation when he had been in it only a few minutes. The Doctor concluded by remarking that he regarded pure air and water as most important agents and believed them to be capable of controlling the ravages of raging disease.

Dr John H Griscom read a paper before the New York Academy of Medicine many years ago, in which he gave an account of eighty two cases of typhoid fever which occurred on an American ship at Perth, Amboy New Jersey. The ship had brought over about four hundred passengers, of whom a number had died on the passage. On its arrival, eighty-two fever patients, twelve of whom were insensible were removed to the shore and for want of other accommodations were placed in two open shanties, the roofs of which were composed of old sails. The first night after the removal, a violent thunder-storm occurred, which was accompanied by torrents of rain. The next morning it was found that the clothing of all the patients was saturated with water. The principal measures of treatment employed, were enemas of lemon juice and cold water. The food was chiefly buttermilk. Four sailors, sick of the same disease, were cared for in a dwelling-house. Two of them died. Every one of the eighty-two emigrants recovered.

The danger of fever patients taking cold by exposure to cool air is much less than is generally supposed. An eminent German physician advocates the use of the cold-air bath, when the cold-water bath cannot be conveniently employed. His plan is to open the doors and windows of the sick-room, and after removing the patient's clothing, place him in such a position that he will be fully exposed to the draft of cold air. We have frequently employed a modification of this plan by stripping the patient, and after moistening the surface with a wet sponge, or the hand dipped in water, allowing evaporation to take place. A marked cooling effect can be produced in this way. If proper care is taken to keep the feet and hands warm, little fear need be felt that the patient will take cold when suffering from a general fever. The temperature of the room should be kept as low as possible without inconveniencing the patient. As a general rule, sixty to sixty-five degrees is a proper temperature. Seventy degrees should rarely be exceeded.

In many cases the discharges of the patient are the most efficient means for communicating the disease. They should be promptly and thoroughly destroyed by the use of disinfectants. The night-vessel should constantly contain a solution of copperas, or a strong solution of chloride of zinc or permanganate of potash. This will secure disinfection of the discharges as soon as passed. Immediately after it has been used, the vessel should be removed from the room, and its contents buried in the earth, at a safe distance from any well or cistern. The discharges of a patient suffering with any contagious or communicable disease, should not be placed in a common privy or water-closet. A neglect to observe this precaution has often resulted in the wide dissemination of infectious maladies. For the majority of fever-patients, careful nursing is more indispensable than the most skillful medical treatment. With careful nursing alone, the majority of patients will recover.