This is a dangerous, and with the ordinary allopathic treatment, a very fatal disease. It generally comes on insidiously, the patient feeling a dull head ache, more or less pain in his joints, back and shoulders, with loss of appetite, restless and disturbed sleep, slight chilly sensations, with a little fever, dry skin, and a general languid feeling. These symptoms continue from four or five days in some cases, to two or three weeks in others, gradually getting worse until the patient is prostrated, or if he takes no drugs, and keeps still, avoiding food as far as practicable, he may escape prostration, and after lingering for eight or ten days, and sometimes longer, just on the point of prostration, he begins slowly to get better, and recovers about as slowly and imperceptibly as he grew sick. This is in accordance with observation of cases under my own eye, and I have no doubt those cases of spontaneous recovery, had they taken a single dose of active cathartic medicine or any of the active drugs, they would have been immediately laid upon a bed of sickness from which a recovery would have been extremely doubtful. I believe that two-thirds of the deaths from typhoid fever are the direct results of medication, and that those who recover, do so in spite of the cathartics and the active drugs when such are used. Some cases, however, will not thus spontaneously recover, and require proper treatment; and it is safest to treat all cases, at as early a day as possible. Some cases come on more rapidly and run into the prostrating or critical stage, in a very few days. Delirium is a symptom that comes on early in these cases. When the disease is fully established, and even sometimes in the early stage, diarrhœa sets in and runs the patient down rapidly.
TREATMENT.
In the early stage, that which might be called premonitory, while the patient is yet able to be about his business, but is complaining of the symptoms above named, he should, as far as possible, abstain from exercise and food, and take of Baptisia and Phosphorus alternately, a dose once in three hours. These will almost invariably produce amendment in a few days, and as soon as he improves any, leave off the medicines. Should there be diarrhœa present, use Phos. acid instead of Phosphorus. If the patient is delirious or has fullness and redness of the face, the eyes red, and headache, give Belladonna in rotation with the other two. For the foul breath that comes on, use Mercurius cor., especially if the diarrhœa assumes a reddish tinge, like beef brine. Should the fever at any time rise high, the pulse being full and hard, give Aconite, but it rarely happens that Aconite is useful in the later stage. If the patient complains of pains in the back, and fullness of the head, give Macrotin. This is particularly useful for persons who have rheumatic pains in the limbs or back, during the fever. If the evacuations from the bowels are dark, or yellow and consistent, or there is bilious vomiting, Podophyllin is the remedy. From some cause or other, to me wholly unaccountable, the writers generally have laid down Rhus and Bryonia as the remedies in typhoid fever. I must confess I have no confidence in them for this fever as it prevails, and has for several years past, in this country. They have proved a failure, and I discard them altogether, as I am confident, from thorough trial, we have much more reliable remedies as a substitute for Rhus in the Podophyllin, and for Bryonia in the Macrotin. In the early stage, or at any time to arrest febrile and inflammatory symptoms, the Baptisia is much more potent than Aconite, its symptoms corresponding peculiarly with typhoid fever. If the discharges become slimy or bloody, give Leptandrin and Nit. acid. It is important to bathe in this disease.
Scarlet Fever.—Scarlatina.
This fever assumes two principal forms: Simple or mild, and Malignant. In the Simple form, there is great heat of the surface, extremely quick and frequent pulse, headache, and some sense of pain and soreness in the throat. After a day or two, there appears upon the surface, bright scarlet patches, in some cases extending over the whole limbs, the skin smooth and shining, and somewhat bloated or swollen; upon pressure with the finger, a white spot is seen, which soon disappears on removal of the pressure. As the disease subsides, the cuticle comes off (desquamates) in patches. In the simple form of this disease, the throat, though often more or less sore, does not ulcerate. In some cases, notwithstanding the fever is high, the pulse frequent, and the throat sore, there may be no external redness, but the mouth and tongue will have a scarlet hue, indicating the existence of disease more dangerous than when it appears externally. In the malignant form, the same symptoms are present, the patient suffers more pain in the head; the back and throat, root of the tongue, tonsils and soft palate become ulcerated, turn black, and sometimes gangrenous, proving fatal in a few days, or slough out in large portions, the ulcers destroying the parts extensively. The breath becomes foul and fetid, and the effluvia from the ulcerated surface, is very sickening to the patient and all around him. This disease rarely attacks adults, but occasionally, and for the last six or eight months, in one region where I am acquainted, where Scarlatina of a malignant type has prevailed among children, adults have been affected with an epidemic soreness of the mouth and throat, strongly resembling the worst form of the angina in malignant Scarlatina, together with a low typhoid form of fever.
TREATMENT.
In simple scarlatina, all that is necessary is to keep the child quiet, in a room of uniform temperature, as far as practicable; let it drink cold water only, and give Aconite, Belladonna and Pulsatilla in rotation, a dose every hour until the fever subsides. If any soreness of the throat remains, give a few doses of Mercurius. If the fever subsides, and the soreness remain, Hydrastin or Eupatorium arom. will soon complete the cure. In the malignant form, with ulcerated, dark colored, or red and purulent throat, and typhoid form of fever, give Aconite and Belladonna in alternation, every hour, and, at the same time, gargle the throat freely with Hydrastin. Some of the tincture may be put in water, about in the proportion of ten drops to a teaspoonful, or a warm infusion of the crude medicine may be used. This can be applied with a camel's hair pencil, or a swab, to the parts affected, once in two hours, and will soon bring about such a state as will result in speedy recovery. After the active fever has subsided, the Aconite and Bell. may be discontinued, and Eupatorium arom. used instead, once in three hours until convalescence is complete.
I would remark that, with these remedies applied as here recommended, my brother, Dr. G. S. Hill, of Erie County, Ohio, has, during the last four months, treated a large number of those malignant sore-throats, (the "Black tongue Erysipelas,") and been universally successful, relieving them in a few hours, when the symptoms were of the most alarming character, and the disease in some cases, so far advanced that the patients were considered by their friends and attendants, "at the point of death."
The Hydrastin is a most potent remedy in putrid ulcerations of the mucous surfaces, and much the same may be said of Eupatorium aromaticum.