Climate and Health in Hot Countries and the Outlines of Tropical Climatology: A Popular Treatise on Personal Hygiene in the Hotter Parts of the World, and on the Climates That Will Be Met Within Them.Giles, George Michael James
Science
Climate and Health in Hot Countries and the Outlines of Tropical Climatology: A Popular Treatise on Personal Hygiene in the Hotter Parts of the World, and on the Climates That Will Be Met Within Them.
Giles, George Michael James
Hygiene -- Popular works; Medical climatology; Tropical medicine
From what has been said, it is clearly important to do our best to put
the digestive organs, if possible, in a position to perform their
functions, and as in the majority of cases the sluggish bowels are
loaded with half-digested or undigested food, it is a good general rule,
as a preliminary to the administration of quinine, to administer some
unirritating laxative, for which purpose nothing can be better than our
old friend and bugbear of childhood, castor oil; and the dose should be
repeated whenever constipation becomes a symptom in the course of the
case. Once the laxative has acted, the sooner quinine is administered
the better, and, unless the patient be one of those unfortunately
constituted persons who are unable to take it--and there are some few to
whom quinine seems as poisonous as it is to the malarial parasite--it
should be given in full doses to the extent of 20 or even 30 grains (1
to 2 grammes of metric system) in the twenty-four hours. A dose of 10
grains, followed by others of 5 grains each, will usually be found a
convenient plan of administration; but there are cases which do better
with smaller doses more frequently administered. The best way to give it
is, I think, to stir up the powder in a little milk; and it may be well
here to offer a word of caution as to the employment of the drug in the
form of tabuloids. For some reason, the drug appears difficult of
digestion in this form, for I have repeatedly found fever yield at once
to the ordinary powdered form of the drug, after days of fruitless
treatment with quinine tabuloids obtained from firms of so high a
reputation that the suggestion of the substitution of some less
expensive material for quinine is quite untenable. The indiscriminate
use, too, of antipyrin, phenacetin, &c., is also to be deprecated. They
are all powerful depressants; and though they afford great relief to the
aches and weariness of an attack of fever, undoubtedly have no effect
whatever in curing the disease, even if they do not, as I have often
been inclined to suspect, tend to prolong it. Where the suffering is
very acute, an occasional dose may be of use for securing rest, but
anything like continuous dosing with medicines of this sort should be
carefully avoided. On the other hand, the old-fashioned “fever mixture,”
composed of ten or fifteen drops of nitrous ether with a drachm of
Minderus’ spirits (_liquor ammoniæ acetatis_), every four hours, in a
wineglass of water, is often of great use in favouring perspiration,
besides acting as a useful diuretic; and may be recommended as not only
affording much relief to the patient’s subjective symptoms, but also of
being absolutely safe even in inexperienced hands.
Except in the weakness of very prolonged attacks, stimulants should be
but sparingly given, but they should not be withheld when the patient is
flagging, and obviously falling into what is known as a “typhoid state.”
Public-domain text, read in full here on John Shaqi.
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