Relation Of Intestinal Antisepsis To Diet

It is said that bacilli fed on beef juice produce ptomaines which act more strongly upon the nervous system than if they are fed upon milk (Rachford). The starches do not make ptomaines.

The typhoid germs certainly thrive in nitrogenous media, but not upon carbohydrates. Their development in the former is accompanied by the production of toxic material in the intestine, which, on being absorbed into the system, produces the symptomatic phenomena of the disease. This theory, which is of comparatively recent adoption, has emphasised the possible value of antiseptic treatment of the alimentary canal. While there are as yet no remedies known to therapeutics which can be used in sufficient strength in the intestine to be completely antiseptic or germicidal to the typhoid bacilli, there is another aspect of antisepsis, or rather asepsis, of the alimentary canal, which should not be overlooked - that is, the prevention of those fermentative changes which accompany indigestion in any fever. In typhoid fever the importance of maintaining as nearly as possible the normal digestion and absorption of the food is of special urgency on account of the length of the disease. Moreover, it would appedr that the overdistention of the intestine by flatus must have a very injurious effect upon the ulcerating surfaces by stretching them.

At autopsies upon typhoid patients ulcers are often seen which might have been easily torn by slight distention, and the prognosis of typhoid fever is more grave when extreme and obstinate intestinal flatulency appears early in the disease, before there has been time for either perforation or peritonitis. One can do much to prevent this condition by bestowing special care upon the whole alimentary canal.

Care Of The Mouth

The mouth should be washed very frequently at regular intervals, and always after taking a glass of milk, for nothing causes coating of the tongue more than a milk diet, or forms a better field for the development of bacteria, which are constantly being carried down to the stomach to excite indigestion and flatulency there. Listerine and hydrogen peroxid make most satisfactory and cleansing mouth washes. A whalebone bent in a loop forms a good "tongue scraper," and cleans its surface quite thoroughly. If patients are too feeble to rinse the mouth, the nurse should swab it out for them with a bit of cotton. Nurses should be made to understand the importance of this simple detail, for, if properly attended to, it adds greatly to the patient's comfort and appetite. When this is faithfully done, one seldom sees even in fatal cases a typical "typhoid tongue " - brown, dry, hard, fissured, and so stiff that it is useless to the patient. Patients can often learn to use a tongue bath to advantage - that is, to hold the mouth full of fluid for several minutes at a time, when much moisture is absorbed by the mucous membrane.

The proper care of the mouth will greatly lessen the liability to parotitis and catarrh of the middle ear.