The diagnostics and treatment of tropical diseasesStitt, E. R. (Edward Rhodes)
Science
The diagnostics and treatment of tropical diseases
Stitt, E. R. (Edward Rhodes)
Tropical medicine
=Treatment.=—At the onset one should give calomel in small doses,
repeated every twenty minutes, until about 2 grains are taken, as
8 doses of ¼ grain calomel with soda. Magnesium citrate or sodium
phosphate should follow the calomel. Some prefer castor oil in large
doses (2 ounces). This treatment should not be repeated, it is only
indicated at the onset of the disease, so that if the case is not
seen until after the second day the laxative or purgative measures
should be withheld.
During the first three days of the disease no nourishment whatever
should be given. The patient should be allowed an abundance of
fluid, of which the best is Vichy, of which may be given a couple
of ounces every twenty minutes or so, iced or just cool, as the
patient prefers. Water, to which 30 grains of bicarbonate of soda
to the pint has been added, makes a good substitute. It is of vital
importance to put the patient to bed and keep him quiet. When
vomiting is severe cracked ice or iced champagne may be of value.
Alkaline enemata are indicated when the patient cannot retain the
Vichy. There would seem to be an acidosis in yellow fever.
A mustard foot bath is best given in bed, the feet and legs of the
prone patient being immersed in a foot tub half full of warm water
into which a pound of freshly ground mustard has been stirred.
Every few minutes there should be added a quart of very hot water
so that the bath may be very hot—just short of burning the feet.
The blankets are kept over the patient and the foot tub, so that we
also give a vapor bath which causes free sweating. This treatment
relieves the headache and backache. This foot bath can be repeated
2 or 3 times in the first twenty-four hours. After the bath, the
sweating patient must be thoroughly dried. Cold spongings are
important means of keeping down fever. For anuria use dry cups
to the loins or hot fomentations. Strychnine may be indicated in
the asthenic stage and camphor in oil hypodermically for extreme
cardiac weakness. The Sternberg treatment is 150 grains of sodium
bicarbonate and ⅓ grain of bichloride of mercury in a quart of
water. The dose is 1½ ounces every hour.
Any exertion causing a rise in blood pressure may be fatal. It
is possible that the stimulation of the circulation incident to
the taking of food may explain the dangers of allowing food to a
patient. As before stated no food should be given for the first two
or three days. Then commence with albumin water and thin barley
gruel. Later on wine jelly and easily digestible broths. Even when
convalescence sets in we should be very careful as to diet.
Public-domain text, read in full here on John Shaqi.
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