The belly is usually distended and slightly tender, and there may or may
not be the characteristic typhoid rash, consisting of rose-pink circular,
slightly raised spots, about the size of a large pin’s head. They occur
chiefly on the chest and abdomen, and come out on successive days, often
only three or four at a time. These spots are frequently absent, and then
one must be guided by the presence of other symptoms. They are difficult
to be seen upon a dark skin.
_The possibility of enteric fever should always be remembered in cases
where there is constant fever, unaccompanied by any definite symptoms,
such as the recurrent shiverings of malaria, or the spitting of blood in
pneumonia._
_Prophylaxis._—As for dysentery (_see_ p. 186). Preventive inoculation
is very important and confers immunity for a considerable period (_see_
“Inoculation,” p. 168).
_Treatment._—Absolute quiet in bed. If constipated, bowels should be kept
open by soap and water enema only.
Milk only (three to four pints daily) should be given during the whole
course of the illness and till ten days after the temperature has
descended to, and remained, normal. Stimulants, if pulse is feeble and
rapid; opium only if there is much pain. If bleeding occurs from the
bowel, an ice poultice or cold-water cloths should be applied to the
belly; ice may be given to suck; opium and an astringent, such as tannin,
administered by the mouth, or an opium enema be given. Milk should be
given in small quantities only, and to each half-pint five grains of
bicarbonate of soda should be added.
The motions must be burned, or carefully disinfected.
_Epilepsy._
_Symptoms._—This is the most common form of fits. There are three stages.
_1st stage_—The patient falls down completely unconscious and without
warning, the face is pale, the limbs become stiff and rigid, and the
breathing ceases. _2nd stage_—Convulsive movements take place, the
tongue being often bitten, the breathing becomes heavy and laboured, and
the motions may be passed unconsciously. _3rd stage_—A confused mental
condition, sometimes acute mania, usually sleepy for some time. In some
cases the fit may only last a few minutes. They almost always recur.
_Treatment._—During the attack nothing can be done beyond loosening all
tight clothing, and gently preventing the sufferer from injuring himself
in his struggles. It is especially important to keep the teeth apart with
a piece of cork or rubber to prevent the tongue from being bitten.
Bromide of potassium (ten to twenty grains) may be given three times a
day as a preventive.
_Faintness._
Public-domain text, read in full here on John Shaqi.
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