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Similar treatment should be pursued in dysentery. In Europeans passing much blood with pain and fever, some leeches may be applied in the early stages over the most painful part. Fine leeches can be got in the paddy fields. Natives do not stand bleeding. It has, indeed, happened not unfrequently in the case of Europeans, that the disease has been subdued, but death has followed from exhaustion. Bleeding should therefore be resorted to very cautiously, and the strength should be kept up as much as possible by nourishing food. A hot hip bath twice a day is often very useful. The patient should sit in a small tub of moderately warm water, and boiling water should be gradually poured in, till it becomes as hot as can be borne. Some hot sand in a pillow case may be spread over the belly. A flannel band may be used with much advantage. Diminish the medicines gradually from four to three times, to twice, and to once a day. If given up suddenly, the disease will probably return. When convalescent, the bael fruit (Ægale Marmelos) may be used with excellent effect.
The utmost attention to diet is necessary after an attack of dysentery. No disease is so apt to relapse. Fever.-
There are two principal varieties—Intermittent and Remittent. The former, also called Ague, has three stages, the cold, hot, and sweating stages. The cold stage sets in with shivering, and pain is felt in the back and large joints. After a little time the skin. becomes hot, the pulse quick, and the patient complains of headache, and thirst. This stage generally lasts some hours. At length perspiration pours forth freely, and the patient feels well, with the exception of a degree of weakness. The fever may return the next or following day. In Remittent Fever there are no distinct stages, though an abatement of symptoms takes place at certain times. It is a much more severe disease. Causes.--Malaria exercises most influence.
“ It is the product of heat, moisture, and vegetable decomposi
tion. It appears to be absorbed largely and retained by the soil, and is given off the first fall of rain or on turning up the soil, in sufficent intensity to produce disease in susceptible persons exposed to it. "In districts where it exists already, anything which retards free circulation of air, such as jungle, forests, high walls, or other similar impediments, add to its force. And on the other hand everything which tends to lower the standard of health of persons exposed to it increases their susceptibility to its influence. This malaria is universally believed by the natives of India to be conveyed in the drinking water.
“ Retentive soils, having imperfect natural drainage; expanses of shallow partially dried-up water; neglected tanks ; hollows filled with water; marshy ground, and damp or wet ravines, are all well-known sources of malaria in India.” Porous soils, especially decomposed granites, with water near the surface, also give off malaria.
Sleeping in damp clothes, exposure to extremes of heat and cold, heavy dews and fogs, night air, changes of season, and great fatigue, are other causes.
Treatment of Ague.-Twenty drops of sal volatile and twenty drops of laudanum in half a wine glass of water, will often cut short the cold fit. In the hot stage a dose of castor oil should be given. During the intermission, and after the bowels have been well acted upon by a purgative, three grains of quinine should be given every fourth hour. If the taste of the quinine be very unpleasant, make it into pills with a little bread crumb or with boiled rice.
If there be much shivering and headache at the commencement of the attack, an emetic of half a tea spoonful of ipecacuanha, or one tea spoonful of mustard, in water will afford relief. Promote the vomiting by large draughts of warm water. The stomach should be allowed to settle well before the purgative is taken.
Arsenic is sometimes employed instead of quinine ; but it requires the utmost caution.
As quinine is very expensive, chiretta, which may be bought cheaply every where, may be used as an inferior substitute. Dr. Lowe, Medical Missionary, Travancore, says, “A convenient tincture is made by digesting for a few days about five ounces of chiretta in a pint of arrack (20 oz.). A tea spoonful given four or five times a day will generally prove successful.”
Treatment of Remittent Fever.--As this is a much more dangerous disease than ague, and assumes different types requiring different treatment, medical advice should be obtained if procurable. Where that is impossible, the following course may be adopted. Four or five grains of calomel
, with as many of the extract of . colocynth, made into two pills, should be given at once; followed by a drachm of the compound powder of jalap in a couple of hours. After the bowels have been well acted on, and febrile symptoms somewhat decline, the following powders may be given every third or fourth hour : sulphate of quinine three grains, James's powder three grains, powdered nitre four grains. The bowels should be kept open by compound rhubarb pills.
When head-ache is very severe, cloths steeped in cold water may be kept constantly to the head. In the case of strong Europeans, a few leeches may be applied to each temple. The thirst may be quenched by lemonade, barley water, and the like.
Should the stomach become irritable, a mustard poultice will be found of advantage. If there is great exhaustion, give camphor.
Jungle Fever is accompanied by great prostration of strength, and followed by delirium. Seek medical ad
* An excellent preparation of chiretta by Dr. Lazarus, Benares, is sold by many medicine vendors at 4 Rupees each bottle,
vice at once. Stimulants should be given if the patient be very
low. Warburgh's Fever Tincture, is by some considered a specific in severe cases of fever. Care must be taken to procure the genuine preparation, for there are fraudulent imitations which are dangerous. Directions accompany the medicine.
A change to a healthy locality is generally indispensable in severe cases of fever. Precautions against Fever'
.—When fever is epideinic, be careful about food; use a generous diet, and do not go out in the morning fasting. Avoid exposure to dew. Do not sit outside in the evening. Keep the windows and doors of the house closed on the side from which the wind may blow the miasma. Sleep in an upper room. Malaria generally moves along the surface of the ground. Special care is necessary during the hours of sleep, as from the diminished vital energy the body is less able to withstand miasma. Take good drinking water with you when travelling through a feverish district. When you meet with a well which the natives say contains good water, take a supply with you. Three grains of quinine with a cup of hot coffee every morning, is an excellent prophylactic.
" Much is talked,” says Martin “ of the good effects of tobacco-smoking in damp localities, by persons who, in defiance of geographical differences, carry the habit wherever they go--from the marshes of Arracan to the arid plains of Delhi; but I think there is good reason to question the benefits of this habit of smoking even in the fatherland of fog and damp, or that tobacco ever acts as preventative to any disease, and least of all to tever."
Cholera.—This is emphatically the “pestilence that walketh in darkness." The attack frequently comes on about two in the morning. A pre
A premonitory diarrhæa often precedes cholera. The stools resemble rice water, and there is a suppression of urine. Vomiting is
generally an early symptom, followed by cramps in the limbs. As the disease progresses, the patient becomes cold and pulseless.
Causes.-Cholera is still a great mystery. The following are some predisposing causes : indulgence in fruit, especially when unripe, or in other articles of difficult digestion, exposure to night dews, fatigue, filth, and crowding.
Treatment.-In the early stage it is difficult to distinguish cholera from an attack of diarrhoea. Undue alarm should not be excited. Still, especially when cholera is epidemic, immediate steps should be taken. 30 drops of laudanum in hot brandy and water will be found very efficacious in checking the premonitory diarrhoea. 30 drops of chlorodyne in a little water is also an admirable remedy. Camphor dissolved in spirits of wine and dropped on a little sugar, is another useful medicine. The body should be kept warm. Vomiting may often be stopped by a tea spoonful of carbonate of soda, dissolved in hot water and drank as hot as possible. If thrown up, repeat the dose.
Natives generally prefer remedies in the form of pills. Often they are retained in the stomach when Huid medicines are rejected. When cholera is epidemic, the Madras Government furnishes supplies of Paterson's cholera pills. Each pill contains calomel ! grain, opium · grain, camphor grain, acetate of lead 1 grain, compound cinnamon powder 2 grains, acetic acid, sufficient to mix the whole. One or two pills should be broken up in a little conjee or any fluid, and taken immediately. One should be given every or
hour according to the urgency of the symptoms, until vomiting and purging are checked. The maximum number of pills to be given to an adult is 24 ; children under 7 years should not take more than 4 pills; from 7 to 15 years, 8 pills; youths from 15 to 21, 12 pills,
Acetate of morphia is a very powerful preparation of opium, one grain being as strong as four grains of