In the acute stage of the fever we have seen that the patient is restricted to a fluid diet. But it was emphasized that the milk is to be regarded as the solid part of the patient's food and must be given in regular meals. It cannot, then, be used to quench the patient's thirst. For the latter purpose there is nothing more suitable than cold water, which must always be kept standing at the bedside so that the invalid can help himself. The greatest attention must be paid by the nurse to unconscious and delirious patients, and water should be offered them frequently and forced upon them when necessary. Much good, in fact, can be done by forcing large quantities of water upon patients. All will probably agree that 3 or 4 pints a day should be a minimum allowance.1 As regards greater amounts than this the reader is referred to the discussion on a subsequent page of the subject of systematic treatment by the ingestion of large quantities of cold water.
We are accustomed to see large quantities of aerated waters given in the various fevers, usually in conjunction with milk. In enteric fever I cannot but think that they are a most undesirable addition to the liquids allowed. They are most liable to cause more or less distension, and there are few conditions likely to do so much harm in the course of enteric fever. Meteorism, indeed, is one of the complications which, when it occurs, calls for some modification of the diet, and it seems reasonable to prevent its occurrence, as far as possible, by avoiding anything which may cause accumulation of gas in the intestines. It may be admitted that the average British patient, unlike his American cousin, seems to have the most rooted objection to drinking plain cold water, unless, of course, he suffers from intense thirst. To induce him to drink more a lemon acid drink may be prescribed, composed of a few drops of dilute hydrochloric acid and syrup of lemons very freely diluted, but retaining a sufficient taste of acid to be refreshing to the patient. It is always easier to induce a patient to drink something which has a definite flavour, and moreover hydrochloric acid has a certain classical reputation in the therapeutics of fever, and has been recommended as a mild febrifuge both by Murchison and Fagge.
1 The 3 or 4 pints of water recommended are in addition to the fluid diet already prescribed.
Under ordinary circumstances it is only reasonable to allow tea to those patients who appreciate it. A cup of tea given to a female patient at about 4 o'clock in the afternoon is usually rather good for her than otherwise. It is an event in the dreary monotony of the day and has, as a rule, a good effect mentally. It is needless to say it should be freshly infused, not too strong, and given with plenty of milk. The only contra-indication is marked insomnia, although it is very doubtful if tea exercises much effect in keeping awake those who are thoroughly accustomed to it.