On the treatment, diet, and nursing of yellow fever : for popular use / by Wm. H. Holcombe. / Title Contents

Title Contents


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ON THE TREATMENT, DIET, AND NURSING OF YELLOW FEVER. (FOR POPULAR USE.) BY WM. H. HOLCOMBE, M.D., Of New Orleans. BOERICKE & TAFEL: NEW YORKI, PIHILADEEIIPHIA, SAN FRANCISCO, CIIICAA-GO, etc. NEWv OItLEANS, IA., 130 Callal St.

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TREATIENT OF YELLOW FEVER. A PATIENT feeling badly should not "fight off" yellow fever and keep up as long as possible, but should go to bed at once, and begin the proper treatment. Give him a warm foot-bath with a little mustard in it, and cover him with a sheet and two blankets. In very warm weather one blanket will be sufficient. Let the room be well ventilated, without any draught directly upon the patient. Hot orangeleaf tea is decidedly the best drink for a yellow fever patient, not to be

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4 as a means of quenching thirst, and at the same time keeping up a gentle perspiration. If that is distasteful or rejected, cold water (not ice cold) may be allowed, half a goblet about every half hour. Purgatives are not necessary unless the bowels are very constipated, and then only the mildest should be employed. An enema of warm soapsuds is useful, and it should be repeated every day during the sickness, unless diarrhoea is present, when it will not be necessary. There should never be more

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5 much by trying to keep the cover close around him. There is no danger of his taking cold, and you may greatly injure his nervous system. Keep the room shaded but not darkened, and let no " neighbors " in any nearer than the front door. Never wake him from sleep for anything. For the first two or three days, in the febrile stage, he needs very little, and yet a little nourishment. Offer him a little teacup of good black tea with a cracker or a small slice of toasted bread crumbed into it, abou

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6 3d. Put 10 drops into half a glass of water, stir it very thoroughly, and give two teaspoonfuls every half hour, until the patient is in a good perspiration, after which it need be given only every hour. In mild cases the fever will go gradually down, and no other remedy will be needed for the febrile stage. If, however, after 12 hours, the fever is still high and the pains severe, prepare Belladonna, 3d, and Bryonia, 3d, 10 drops of each in separate half glasses of water, and alternate every

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7 symptom. Give 5 drops of Ipecac, 3d, in a tablespoonful of water after every vomiting, and it will soon cease. A weak mustard plaster kept on a little while over the whole abdomen, will be very serviceable. Sleeplessness and restlessness at night is sometimes a troublesome symptom. Put 10 drops of Coffea, 30th, into one-third of a glass of water, and give two teaspoonfuls every 5 or 10 minutes. If delirium is present, Ilyosciamus, 3d, is better; use in the same way. A warm footbath and gentl

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8 perature keeps up, and brain symptoms occur, and meningitis is threatened. Then give Gelseminum, 3d, 10 drops to half a glass of water, and two teaspoonfuls every half hour; sponge the body occasionally with tepid water and cologne or bay rum, and keep the bowels open by enemas. If convulsions occur, or are threatened, prepare Cuprum Aceticum, 3d, in the same way, and alternate with the Gelseminum, 3d, every 15 minutes. Do not risk the motion of a general hot bath, but give a footbath and wra

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9 Nine times in ten, however, the fever goes nearly or entirely off, and the patient thinks himself well, which, however, is far from being the case. You must now give him Arsenicumrn, 3d, and Lachesis, 6th, alternately every hour, prepared like the other remedies, and 2 teaspoonfuls at a dose. You must drop the tea and toast, and give him milk and Lime Water, half and half, one tablespoonful every hour, between the medicines, or if that does not suit the stomach, as much good beef tea. If the

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10 spoonfuls of brandy may be added to each injection. The symptoms likely to give trouble in the second stage are vomiting, 6xhaustion, haemorrhages, and suppression of urine. Each is so important, it must be mentioned, separately. The Arsenicum, 3d, and Lachesis, 6th, have a tendency to prevent these occurrences, and the Arsenicum particularly should be kept up all along. Vomiting.- Milk and lime water sometimes checks it in the beginning, particularly in small children, but it cannot be rel

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11 Ipecac, as before, may be still useful. But Argentum Nitricum, 3x, is the best remedy for the vomiting of Yellow Fever, especially when signs of black vomit appear. Give 10 drops in a tablespoonful of water every time the patient vomits. If that fails after a fair trial, give Sulpho-Carbolate of Soda, 5 grs., in a little water, after every vomiting. Iced champagne, mint and brandy julep, by teaspoonfuls, are sometimes very useful. An enema, carrying off the wind in the bowels, sometimes re

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12 from over-purging, over-sweating, and a starvation diet. Champagne is the sovereign remedy for a quick relief- a teaspoonful every few minutes. Give also injections of beef tea and brandy, until the stomach can bear the gradual introduction of food. Hemorrhage S.-Whenever any blood appears, from the stomach, or from the gums, or nose, or throat, or in the discharges, put 10 drops of Crotalus, 6, into half a glass of water, and alternate with the Arsenicurn, leaving off the Lachesis. Rinse th

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13 Acid, lx, Terebinthina, 2x, and Ergotine, 2x, are all good remedies for hemorrhages. Plumb., 2x, and Ergotine, 2x, from the stomach and bowels; Gallic Acid, from the gums and mouth; Gallic Acid and Terebinthina, from the kidneys; and Ergotine, from the uterus. One of these remedies may then be given intercurrently between the regular medicines-a little powder of one or two grains at a dose, dissolved in a little water. Suppression of Urine.This alarming symptom may last several days without

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14 of Nitre in some water between the regular medicines, until the secretion seems restored. Encourage the patient to drink water. Rub the lower half of the spine freely with hot alcohol, and put a hot flaxseed poultice over the lower half of the abdomen. If these measures fail, make strong watermelon-seed tea, and get the patient to drink as freely of it as possible. Be careful that it is really a suppression of urine, and not a retention, with inability to pass it. In retention, the bladder i

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off by the catheter, without difficulty or danger. Suppression of urine, with brain symptoms, such as stupor and smothering delirium, is very dangerous. Here Apis, 2x, and Opium, 3x, alternated every half hour, to the exclusion of all other remedies, and in conjunction with the external applications above advised, may still rescue the patient from the jaws of death. If the patient seems to get worse, and all the above means have failed, there is still hope in Carbo. veg., 12 -10' drops in half

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16 oil, heated as hot as can be borne, and repeat this inunction about every six hours. In the latter stages of Yellow Fever, intermissions and remissions sometimes occur from the admixture, no doubt, of malarial influences. Then Quinine is very valuable. If it cannot be tolerated by the stomach, give it by injection, 5 grs. to 2 ounces of milk every four or six hours, until 20 grs. have been given; or, in very young children, by rubbing it into the skin with sweet oil or lard. During convalesc

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17 from Yellow Fever. No solid food should be allowed, until'all danger is passed, and a while after. He should take food in small quantities and often. I give you a bill of fare: Beef tea and chicken tea, from which the fat has been carefully skimmed; rice gruel, milk, buttermilk, weak egg-nog, milk punch at night, oyster soup (carefully), oranges to suck, beef steak and mutton chops to chew and spit out; aleree, porteree, and finally soft-boiled eggs, etc. A Yellow Fever patient should not be

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18 sive. It is then better to change it than to run the risk of sickening his stomach by its odor. Sponging with warm water, with soda and alcohol, brandy or bay rum in it, removes the odor, and is very refreshing. Do not let your convalescent read, or listen to long conversations, or sit up7 too soon. After severe cases he is a perfect wreck, and needs the utmost care, perfect rest and quiet, gentle stimulation and nourishment cautiously introduced. In fine, do not overheat and oversweat your

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19 ances. Satisfy his natural cravings for water, air, and light. Do not worry him with over-nursing, which is sometimes a terrible mistake. Make him comfortable in every respect. Let every nurse remember that if anything makes a sick man feel uncomfortable, it will soon make him worse. There are many other remedies which might be required in different and intricate cases, but the above is a fair synopsis of the medication, diet, and nursing of yellow fever patients which, in the hands of the h

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LIST OF MEDICINES. Aconite, 3. Gallic acid, lx trit. Apis mel., 2x trit. Gelsemium, 3. Argent. nit., 3x. Hyosciamus, 3. Arsenic, 6. Ipecac, 3, Belladonna, 3. Lachesis, 6. Bryonia, 3. Opium, 3x trit. Carbo. veg., 12. Plumb. acet., 2x trit. China, 3x. Sulpho. Carbolate Soda, Coffea, 30. Pure. Crotalus, 6. Sweet Spirifs Nitre, (o. Cuprum acet., 3. Terebinthina, 2x trit. Ergotine, 2x trit. Tinct. Arnica,'. Extract of Witch Hazel. The above