The typhoid condition / by J Milner Fothergill.

  • Fothergill, J. Milner (John Milner), 1841-1888.
Date:
[1873]
Catalogue details

Licence: Public Domain Mark

Credit: The typhoid condition / by J Milner Fothergill. Source: Wellcome Collection.

    13/14 (page 237)
    gaining ground, and is, after all, but the logical outcome of the doc¬ trines of Sydenham. The effect of a cold bath on a fever-stricken patient is to restore his consciousness and relieve the sense of prostration,—in fact, to relieve him of the consequences of his high temperature, by aiding in the radiation of his superfluous heat. For, as we saw by Naunyn’s experiments, the effect of increased heat is waste of the nitrogenous tissues. Popular impressions will, it is to be feared, long obstruct the general adoption of this direct means of lowering temperature, but the dispelling of them will not be accomplished by passive reasoning, but rather by active measures, leading to convic¬ tion by demonstration. While writing this paper I came across a case of typhoid fever with a temperature of 106*8 °, successfully treated by cold baths in Addenbrooke’s Hospital, Cambridge. Dr Bradbury says, u The immediate change produced by the baths upon the patient was remarkable. Her intellect became much clearer whilst she was in the baths, and she fell asleep after them. The frequency of the pulse was much reduced.”1 While one branch of therapeutics is the attempting to check the excessive formation of these histolytic products, another is the trying to remove them. To attain this it is necessary to maintain the action of the kidneys, and consequently preparations of potash in combin¬ ation with vegetable acids are deservedly in repute in the treatment of pyretic conditions. The bitartrate'of potash in the form of potus imperialis forms an agreeable beverage as well as being no mean therapeutic agent. Position, too, can be utilized, as seen in the plan of rolling over the patient from his position on the back, first to one side and then the other. This relieves the congestion of the kidneys alternately, and is found to be practically useful. Another thera¬ peutic measure is to take advantage of the capacity of one emunctory to help another. Thus, free purgation will effect more or less what the kidneys cannot do unaided, and the catharsis so induced will relieve the general condition. Indeed, in ursemia spontaneous cath¬ arsis is very common. Under ordinary circumstances the action of the skin supplements the work done by the kidneys, but in pyretic conditions free perspiration is not so easily induced. When prac¬ ticable, diaphoresis may be found useful. Looked at from a rational point of view, the administration of food and stimulants must also affect this condition ; and it would not be discreet to administer anything which would increase the histolytic products already in excess. Consequently the use of the fashionable extracts of meat is not without its objections. These extracts consist of derivatives of flesh which are really in the commencement of histolysis. They are already too far advanced on their retrograde career to be regarded as food, being no longer in a condition where they may be utilized in construction. They are stimulants, and correspond rather to vege¬ table principles, as theine, than to food in its true sense. 1 British Medical Journal, 14th December 1872.