In almost all febrile affections the liberal use of water, or some beverage composed chiefly of water, is to be recommended both for the relief of thirst and on account of its diluent effect and of its increasing the facility with which the waste matter resulting from the rapid metabolism of the fever is eliminated through the kidneys. A dry mouth destroys the appetite. It is believed by many that the toxins produced by the action of typhoid-fever germs or other micro-organisms are rendered less powerful and are in some degree "washed out" of the system by the imbibition of large draughts of water. Patients who are extremely feeble, or who are not wholly rational, may not ask for drink although their mouths are dry and parched, and it should always be the duty of the nurse to give water in proper amount at regular intervals. In long-continued fevers there is a tendency for an increased loss of water from the surface of the lungs, and sometimes from the skin, although the kidneys may be less active than normal, and if care is not taken to replace the fluid in the body the effects of this loss become much more pronounced.

If there are profuse watery evacuations from the bowels the drain of fluid from the blood, and eventually from other body tissues, is considerable.

Sour lemonade constitutes one of the most useful and refreshing of beverages. It is not particularly apt to disorder the stomach, especially if taken in the intervals between the ingestion of food, and to many persons it is exceedingly grateful. It may be made effervescing by the addition to a strong lemonade of Vichy, carbonic-acid water, soda water, or ten grains of sodium bicarbonate.

Barley and rice water with a little lemon juice and sugar, or with cinnamon, wine, and sugar, afford refreshing drinks to many persons, especially children, but they contain very little nourishment. Either tea or coffee may be allowed once a day in many cases of-fever, although this fact is often overlooked. Tea should be avoided if there is marked indigestion in the stomach, and coffee as well as tea should be avoided in cases where there is insomnia or excessive nervousness. If there is flatulency they should be given without sugar, and not with other food. Persons who object to the taste of milk may take it if a tablespoonful of good coffee be added to the tumblerful. Strong black coffee, moreover, is useful in controlling vomiting, and is mildly stimulating in cases of heart failure. Its diuretic action is also valuable in fever, but it should be remembered that those who are not ordinarily disagreeably affected by the daily use of strong coffee may be made very nervous by even small quantities given when the system is reduced by the wasting processes of fever. Both tea and coffee should be used, therefore, with discretion, although they may at times prove valuable in relieving the monotony of a fluid diet.

Other useful beverages are whey, or whey and beef tea, either hot or iced, and unfermented grape juice.

For the immediate relief of thirst cracked ice may be given, but it sometimes parches the lips. Some patients prefer a glycerin mixture. A drachm or two of glycerin and half a drachm of borax or boric acid may be added to a tumbler of water and used to rinse the mouth.

By sipping fluids, thirst is more relieved than if they are quickly drunk. There is more satisfaction in draining a small glass than in merely taking a few mouthfuls from a large tumblerful.

The question of the temperature at which milk or any form of beverage should be given in fevers may safely be left, in most cases, to the liking of the patient. I have elsewhere shown (p. 338) that the body temperature can be but little if any affected by that of ingested fluids, and it is a matter of far more importance to give them in so agreeable a form that they will not be refused. An excess of cold drinks may embarrass digestion or cause stomach cramps, and should be avoided, but any cold fluid slowly sipped will do no harm.