It is not surprising then, that under a great number of circumstances, the most heroic agents are absolutely ineffective.
Iron.—It is not necessary to give iron in too large doses. The two best ferruginous preparations are iron reduced by hydrogen, and the muriatic tincture of perchloride of iron. Small doses, often repeated, are much more easily absorbed than large doses. A quarter of a grain of powder of iron every hour, or a drop of perchloride of iron in three ounces of water, taken by the spoonful, every hour, is all that the stomach can bear; more is rejected by the stool or by vomiting. The reconstructive action of this remedy will be assisted by cold lemonades, and by ice in small quantities. Cold vinegar lotions over the whole body, frictions, enveloping the patient in sheets wet with cool vinegared water, compresses of cold vinegared water on the abdomen, changed as soon as they become warm, are adjuncts, which should not be neglected, and which will always be found good.
Ice.—Ice is one of the agents greatly abused, especially in the first and second period. It is an excellent tonic; but I am not well assured of its employment in the third period.
Drinks.—During the first period, the diet drinks ought to be warm or hot, to facilitate the diaphoresis so necessary at this time. But in the second and third period, there is used only cool water, slightly acidulated, and sweetened ad gratam saporem. In the great majority of cases the patient prefers simple water.
Regimen.—Absolute diet is demanded, rigorously, while the fever lasts. But when the febrile symptoms have disappeared entirely, and at the same time local congestions dissipated, a little thin broth may be allowed.
A certain sensation of hunger is felt, especially towards the end of the first period; but the desire of the patient must be resisted, although the pulse maybe less frequent and less full. Often at the first touch, the pulse seems regular, but the attentive physician will find something abnormal, and he will soon be assured, that the improvement is more apparent than real.
Convalescence.—The greatest care should be given to convalescents, because relapse is often fatal. The nourishment ought to be select and the patient should not be exposed to the sun or to the influence of the moon. When the disease does not go beyond the first period, convalescence is much shorter, if there is no leading organ assailed; but if it reaches the second and third period, especially that of hemorrhages and profound alterations of the blood, convalescence is long and painful, and often leaves its traces during the whole life.
When restoration is complete, wine of cinchona, wine of iron, cold baths, and sea baths are prescribed. In cases of swollen parotids, convalescence is prolonged during many months.
Is it possible to prevent a disease, which makes such ravages? Its entire destruction seems to me an unrealizable utopia, because we have seen, that one of the causes of its existence is in the atmosphere: but it is certainly possible to diminish its effects, and to avoid it, when it exists. A well observed hygiene would give the best results, and the government, which would attach its name to this undertaking, would deserve well of mankind.
Besides the causes of the disease, described in the commencement of this memoir, there is one important cause, in the collection of persons living together under the same roof, especially in barracks. These establishments are designed to shelter, day and night, strangers, who expose themselves without precaution to sun and to damp, and who drink, and eat, as if they had nothing to fear. These barracks ought to be built on elevated places, far from the city, and from the seashore, and especially, be well ventilated. The surgeon of the regiment, should have a roll-call three times a day, and, on his responsibility, put in the infirmary, and on diet, any one, who complains of the least headache.