As to the regular flushing of drains which has been recommended, the late Sir Edwin Chadwick wrote- Those who talk of drains or sewers being good which require to be regularly flushed do not know what good drainage is. Good tubular sewers or drains should be so considered in size, form, and inclination as to run off water, and thus to be self-cleansing, and to be always clear of deposit.
42. Relapsing Fever.
This disease sometimes called famine-fever, and in Germany, hunger-pest is not common in England, but has been epidemic in Dublin, Edinburgh, Glasgow, and Liverpool. Some years ago it was very prevalent and fatal in Liverpool, Glasgow, and other places where overcrowding prevailed. It does not occur in tropical climates, or on the Continent, except in some of the German territories, and the Crimea, where it attacked our army during the Russian war. It has occurred in North America. To-day (1922) it is quite a rare disease.
CAUSE.-It is due to the action of a definite germ (a spirillum), but its victims are almost universally in the lowest social rank ill fed, occupy crowded, filthy, ill-ventilated houses, and enjoy but few comforts. In the latter part of 1871 relapsing fever made its appearance in Liverpool, and spread rapidly in the crowded and dirty parts of the town. Indeed, it was almost limited to the class in which a single room serves as the abode of a family. It ranks next to Small-pox in contagiousness; it is, however, seldom fatal, except in enfeebled and complicated cases. Typhus fever frequently accompanies or follows it.
SYMPTOMS. The seizure is sudden there are rigors and headache even more severe than that of the invasive stage of Typhus, but the prostration is much slighter. There are, also, pains in the muscles and joints resembling those of Rheumatism. After a short time violent reaction sets in, with a great heat of skin, headache, throbbing in the temples, intolerance of light and sound, and sleeplessness; anxious expression of the countenance; rapid pulse 110 to 140; white-furred tongue, thirst, and, perhaps, vomiting, or even Jaundice. The temperature is from 102 degree to 107 degree; and at the height of the fever Delirium may occur. Sweating may come on without relief. About the seventh day from the commencement the symptoms suddenly abate, the crisis being indicated by profuse perspiration. Sometimes a miliary eruption occurs; or Bleeding from the nose, Diarrhoea, menstrual discharge or Haemorrhage from the bowel; after a few hours there is an abrupt cessation of all bad symptoms; the patient feels much better, and appears to improve rapidly for four or five days; when about the seventh day from the last attack, or the fourteenth from the commencement, a sudden.
Relapse occurs-a repetition of the first attack. Perspiration again comes on in from two to five days in favourable cases. The sweat has a very sour and peculiar odour. In other instances, however, uncontrollable vomiting, great thirst, very rapid pulse, Jaundice, Delirium, and death may terminate the case (Aitken).
Sequelae.-The most common are Pneumonia, Bronchitis, Haemorrhages, excessive rheumatic pains in the limbs; sometimes the kidneys are involved; the dangers are similar, in some respects, to those attending Scarlatina. A species of Ophthalmia is a frequent consequence. Abortion often ensues.
TREATMENT.-Aconitum.-Rigors, followed by feverishness, especially in the first stage.
Bryonia.-Nausea, vomiting, and sensitiveness of the abdomen; sallow, anxious countenance; throbbing and heat of the head; rheumatoid pains from movement; perspiration. It may follow Aconite Dr. Kidd, who had great success in an epidemic of the disease in Ireland, relied chiefly on Bryonia
Arsenicum.-In Liverpool, during the epidemic of 1870-71, Arsenicum was found of special value during the seizure in a large number of cases. Nux V. was given between the attacks. When the rheumatoid pains were excessive, Eup.-Per. was very useful.
Baptisia.-Typhoid symptoms. Dr. Dyce Brown has found it to hasten the critical sweat, when Aconite was useless.
Gelsemium, China, Rhus. T. and Podoph. are sometimes required, or Phosphorus, or Ac.-Phosphorus during convalescence.
Prophylactics.-Camphor and Nux Vom.
Accessory Treatment.- See pp. 106-110, 169-176.
43. Simple Continued Fever (Febricula).
The term Fever included various forms of disease in which there are shivering or chilliness succeeded by preternatural heat, quickened pulse, muscular debility, and general functional disturbance. This morbid condition accompanied many diseases as one of their phenomena, and is then called Symptomatic fever, as in Phthisis, Abscesses, etc.; but under certain circumstances we meet with Idiopathic or Essential fevers, which are independent of any local inflammation, as Enteric and Typhus, which are the result of specific germs. Again, fever may be of an ephemeral character, dependent on some cause, which is merely sufficient to produce febrile disturbance without further mischief, as Simple Continued fever and Febricula. It must be held to be due to some definite infection against which however the body resistance is sufficiently good to prevent the development of other symptoms.
SYMPTOMS.-Simple Continued fever is usually ushered in by chills, or alternate chills and flushes, followed by burning heat and dryness of the skin; full quickened pulse; dryness of the mouth, lips, and tongue the tongue being red or coated white; thirst; and high-coloured, scanty urine. These may be accompanied by pains in the loins, Headache, loss of appetite, hurried breathing. Delirium, etc. Most of the symptoms are usually more severe at night. Profuse perspiration, bleeding of the nose, Diarrhoea or herpetic eruptions, are generally associated with the decline of the fever, and the patient is left weak, but otherwise well.
DURATION.-This fever lasts from one to three days, or longer. When the symptoms disappear in twelve or twenty-four hours, it is said to be Ephemeral. But severe forms of the disease may be the precursors of Typhus, Pneumonia, Acute Rheumatism, etc. During epidemics, cases of simple fever occur which are to be regarded as abortive cases of the epidemic prevailing.
CAUSES.-Great, sudden changes of temperature; damp linen or houses; poor or insufficient diet, or, on the other hand, overfeeding; inebrity; injuries; exposure to foul odours or sewer gas; the action of small or uncertain quantities of specific poisons, as of Enteric or Typhus poisons; mental or bodily fatigue or excitement; or any circumstances which shock the nervous system. It may also be associated with various local or functional disturbances, as Bronchial or Gastric Catarrhs, Milk fever, etc. All these are to be regarded mainly as concomitant and determining factors. The actual process which results in the fever is often obscure and no doubt varies in different cases.
TREATMENT.-Camphor.-Sudden seizure of chilliness; shivering, with lassitude, and general indisposition which has come on rapidly. Two drops of the strong tincture of Camphor on a small piece of loaf sugar, or two or three pilules, repeated every fifteen minutes, three or four times.
Aconitum.-Alternate chills and flushes, hot and dry skin, sneezing etc. A dose every two hours, or in urgent cases, every thirty or forty minutes, until the skin becomes moist and the pulse less frequent. Should the attack be one of Simple fever merely, this remedy will be rapidly effectual; if it be the precursor of a more severe disease, it is still the best remedy at this stage.
Belladonna.-Violent Headache; redness of the face; confusion of ideas; a wild, fiery appearance of the eyes; throbbing of the blood-vessels in the temples; wakefulness, nocturnal Delirium, or other cerebral symptoms. It may follow or be alternated with Aconite
Bryonia.- Heavy stupefying Headache, aggravated by movement, with a sensation as if the head would burst; Cough and oppressed breathing; oppression at the pit of the stomach, yellow-coated tongue; nausea, Constipation, brown or yellow urine; shooting pains in the limbs; irascibility.
Arsenicum.- Severe or prolonged cases of Febricula, with much prostration, especially when the symptoms have a periodic character, or occur in feeble patients.
If the symptoms do not yield to the remedies prescribed, but increase in severity when they are expected to be declining, the case will probably prove to be one of Enteric fever.
ACCESSORY TREATMENT.- The patient should be protected from too much light, heat, noise, company, too many or thick bed- coverings, and everything likely to cause excitement or prevent sleep. In the early stage of the fever, the adoption of the hot foot-bath, described p.92, or the wet pack, pp. 92-93, often restores the equilibrium of the system, or, at least, hastens the cure. Water should be the principal beverage, given in small, frequently repeated draughts; it encourages perspiration, and promotes the favourable action of the baths just described.
44. Asiatic Cholera-Malignant Cholera.
LICENTIATE OF THE ROYAL COLLEGE OF PHYSICIANS; MEMBER OF THE ROYAL COLLEGE OF SURGEONS; LICENTIATE IN MIDWIFERY, LONDON AND EDINBURGH, ETC. PHYSICIAN TO THE READING AND BERKSHIRE HOMOEOPATHIC DISPENSARY.
Author of "The Stepping Stone to Homeopathy and Health,"
"Manual of Homoeopathic Treatment". Editor of "The Homoeopathic World."