Advice to Diseased Persons.—In all cases where a person observes in himself, or in those for whom he is responsible, the symptoms already detailed, it is his duty to at once consult an intelligent physician, and if it be found that tuberculosis is present, every precaution should be taken by the diseased individual to prevent the further spread of the malady. IN SUCH A CASE THE SPUTUM THAT IS CONSTANTLY BEING COUGHED UP CONTAINS MYRIADS OF THE GERMS, and it is of the utmost importance in order to prevent other persons in the neighborhood from being infected that this SPUTUM BE DESTROYED. The patient should at all times carry about with him either a small receptacle into which the sputum can be expectorated, or a large cloth which would answer the same purpose, and in either case the sputum should be burned; if this be impracticable, it should be placed in some good antiseptic, such as a saturated solution of carbolic acid or a 1-to-1,000 solution of corrosive sublimate in water. The patient's handkerchiefs should be thoroughly boiled, and his clothing should receive like treatment. Every precaution should at all times be observed in order to prevent the sputum getting onto the furniture or floors, as, under such circumstances, it quickly dries and being broken up into small particles is carried by means of the air to other parts of the house.
The patient should always remember that the quicker he is placed under proper treatment the more the chances of ultimate recovery; in the early stages almost all of the cases of this kind are curable, but later this is not often accomplished.
TYPHOID FEVER.
Of all of the infectious diseases prevalent in the United States, typhoid fever is one of the most common and fatal. As a result of its ravages a vast amount of invalidism, suffering and financial loss is brought about each year, and a frightful mortality results. It has for some time been recognized that typhoid fever is among the most preventable of all diseases, and if our people would bestir themselves and carry out the comparatively simple rules that are necessary for its prevention, the scourge would, in a short time, practically cease to exist among us.
Character and Course of the Disease.—Typhoid fever, enteric fever, or abdominal typhus, is an infectious disease believed to be caused by a specific bacterial germ known as the Bacillus typhosus. It develops, as a rule, quite slowly, the first symptoms being loss of appetite, headache, and a marked fatigue on slight exertion. These symptoms gradually grow worse, fever develops, and the patient oftentimes suffers with chilly sensations; the temperature gradually rises, and in the course of from a few days to a week reaches a height of 102 degrees, 103 degrees, 104 degrees, or 105 degrees F. In many cases no symptoms exist that indicate trouble with the bowels, but in the severe forms of the disease diarrhœa generally comes on during the first week and continues throughout the course of the disease.
During the second week the symptoms above detailed continue, becoming often more severe, and there develops great nervousness and delirium. About this time there are frequently observed over the chest, abdomen and thighs, minute reddish spots resembling flea-bites; these spots last for a few days and then pass away and are followed by a fresh crop in other situations. During this period of the disease inflammation of the bronchial tubes frequently comes on, and now and then pneumonia develops. Bleeding from the bowels is an occasional highly characteristic symptom of the second week. When the disease follows a normal course, the symptoms during the third week begin gradually to abate; the fever lessens, and the patient, though much emaciated, gradually returns to a normal condition.
Unfortunately, however, the disease does not always pursue this favorable course, for, in quite a proportion of instances, the symptoms increase in severity during the second or third week, the patient becomes profoundly prostrated, the delirium deepens, and death occurs. The hemorrhage from the bowels, in some instances, is so severe that death is produced even in comparatively early stages of the affection.
In many instances, through indiscretion, usually as a result of eating solid food, patients who are apparently on the road to rapid recovery, relapse, and the disease repeats the course already detailed.
It is of importance to remember that now and then so-called walking cases of typhoid fever occur, the disease in these instances being characterized by the fact that the symptoms are so slight that the sufferer does not feel it necessary to go to bed. However, in these mild cases, fatal hemorrhage from the bowels is as frequent as in the severer types, and as a consequence the patient should receive careful attention. Moreover, it is of importance to remember that from this mild form of the affection the most malignant varieties of the disease may be contracted.
The mortality in typhoid fever varies from five to twenty per cent., depending upon the character of the disease and the nature of the nursing and treatment that the patient receives.