_Treatment._—The three great principles of treatment are: (1) To open
the bowels; (2) to produce perspiration; (3) to give quinine. The
routine to be adopted is as follows. Put the patient to bed in flannel
pyjamas, and covered up well with blankets; in all cases, save where
there is diarrhœa, give an aperient, such as four grains of calomel, or
two tabloids of Cathartic Co, or two Livingstone’s Rousers, and if this
does not act, repeat the dose in about four hours. If free evacuation
is not produced, a warm-water enema should be given. A hot-water bottle
in bed is useful. Sponging with warm water often gives relief at the
beginning of a fever, and tends to shorten the cold stage. At the same
time hot drinks should be given, such as weak tea, in order to promote
perspiration and cut short the hot stage, and at this stage, _i.e._,
at the outset of the fever, 10 grains of Antipyrin, or 10 grains of
Phenacetin, may be found useful for inducing perspiration, or four
tablets of Warburg’s Tincture, which contains some quinine, may be
substituted for them. Antipyrin and Phenacetin should not be given except
in the earliest stages of the fever.
During the hot stage cold applications, such as cloths wrung out of cold
or iced water and sprinkled with eau de cologne, vinegar or spirit may
be applied to the forehead and behind the ears. The bed-clothes should
be lightened and drink freely supplied, unless it seems to promote
vomiting. If the temperature shows signs of getting above 105° F.
sponge the patient with warm water or cradle the bed-clothes, as it is
called—that is, remove them from contact with the body by some simple
means. In the sweating stage strip off the soaked pyjamas and sheets and
get the patient into warm, well-aired night-clothes and bed-clothes. If
there is any tendency to collapse a little stimulant may be given—say, a
dessertspoonful of brandy. In most cases alcohol is better avoided. If
vomiting is bad withhold all food, and give bits of ice to suck if it can
be obtained.
Whilst the above methods of treatment are important, it should be clearly
recognised that the one drug which can alone counteract the malarial
affection is quinine, and it is upon the proper administration of quinine
that successful treatment largely depends.
Public-domain text, read in full here on John Shaqi.
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