The case is very interesting, first, as it proves how such animals may become affected, then how they may spread the disease, and lastly, that some kind of a disposition must exist in the person infected; for here, of many who had eaten of the diseased flesh, only a few contracted the malady. The whole report teaches us how careful we have to be, and how necessary is the appointment of skillful experts by the State to inspect all food offered for sale.—Med. and Surg. Reporter.
NEW METHOD OF REDUCING FEVER.
For many years eminent medical savants have sought earnestly through the vegetable and mineral worlds for some substance by means of which the high temperature often prevailing in typhoid, malarial, and other fevers might be reduced with rapidity and safety to the patient. A few substances have been found which produce a decline in temperature when administered in enormous and frequently repeated doses; but such administration has often been found to be decidedly detrimental to the patient, producing not infrequently serious injury to the stomach, kidneys, and sometimes the nervous system. So great is the danger of such injurious results, few careful practitioners have cared to adopt the heroic "antipyretic" medication recommended by experimenters, preferring to allow their patients to burn with fever, mitigated only by such simple means as are commonly employed by nurses, than to require them to combat the poisonous influences of a drug in addition to the morbid element of the disease.
Happily, however, it is not necessary to leave the patient to the unaided efforts of nature. By cool sponging of the surface, persistently and thoroughly applied; by large, cool compresses placed over the abdomen and chest, or even the whole front of the body, and changed as often as warm, or every three to five minutes; by frequently repeated cool packs; by cold water drinking; by ice-packs to the spine; by constant application of ice or frozen compresses to the head; by forcing perspiration by copious hot drinks and a warm blanket pack—by any or all of these means the temperature may be reduced with promptness in nearly every case. However, cases will now and then occur in which the temperature remains dangerously high, notwithstanding the thorough application of the above means. What shall be done?
Several years ago our attention was called to a series of experiments made by Dr. Winternitz, Professor of Hydropathy in the Medical University of Vienna, for the purpose of determining the influence upon temperature of enemas of water of different temperature in cases of fever. The results claimed by Prof. Winternitz were so striking that we improved the first opportunity to repeat his experiments, and with such results as have justified the continued use of this means of lowering temperatures in fever, in cases in which the ordinary measures were not efficient. The only objection we have found to the method has been the inconvenience to the patient occasioned by the frequent use of the bed-pan. In a recent case in which we found it necessary to resort to this method, the nurse observed that if the tin can of the fountain syringe used in administering the enema happened to be lowered below the level of the bed on which the patient lay, water which had previously been introduced into the rectum returned readily through the tube into the can. On learning this fact, the attendants were instructed to employ the enema in this way. From one to two pints of water, of 70° or 75° F. temperature, were allowed to pass into the bowels; and after being retained for five or ten minutes, or until the patient experienced uncomfortable sensations, it was made to pass out through the tube by simply lowering the reservoir to the level of the floor. A new supply of water of a proper temperature being introduced into the reservoir, it was again raised to the proper height, and the operation so continued until six quarts of water had been used. Then the patient was allowed to rest half an hour or an hour, according to the height of the fever, and the same process was repeated. Careful record was made of the temperature of the patient just before the treatment and immediately after. It was found to be invariably reduced from one to one and a half degrees by each treatment. The temperature, which had been exceedingly obstinate previous to the employment of this method, ranging from 104° to 105°, during the intervals between the treatments would, of course, rise somewhat; but each time it stopped short of the point reached during the previous interval, so that in the course of a few hours the fever was brought down to very nearly a normal temperature. The temperature of the water, when taken after passing through the bowels, was found to have risen each time from 10° to 13°.
The great capacity of water for absorbing heat renders it one of the most useful of all substances for lowering the temperature; and it is readily apparent that, by the means described, heat may be abstracted from the body almost ad libitum, and the temperature may thus be controlled with a rapidity and a degree of certainty which cannot be approached by any other method. In a still more recent case, in which the same treatment was employed, the temperature of the patient had reached 106° F., in spite of the vigorous application of ordinary measures of treatment, such as cold compresses, etc.; but it was, in four or five hours, brought down to nearly 100° by the use of the cold enemas.
The advantages of this method are: 1. It may be employed without wetting or moving the patient; very frequently a patient will sleep continuously during the administration of the treatment. 2. It seldom causes chilliness, which is frequently a disturbing symptom, especially in fevers of a low type, and even, when the temperature is alarmingly high, causing the patient to dread the employment of sponging with cool or tepid water. 3. It is not necessary to employ cold water, a temperature of 80° or even 85° being thoroughly efficient. In the majority of cases, however, water of 70° or even 60° may be employed without danger. The water comes in such immediate contact with surfaces filled with large blood-vessels that a temperature but a few degrees below that of the body is more effective than very much colder water applied to the surface.
In cases in which the use of the cool enema is attended by chilliness, this uncomfortable symptom may usually be relieved by the application of a hot bag or fomentations to the spine or to the pit of the stomach.