CAUSES.– The actual agent, probably a micro-organism, has not been identified, but there is no doubt now that it is conveyed by body lice. the accessory causes are overcrowding, with defective ventilation destitution, and want of personal and domestic cleanliness. Hence it is the scourge of the poor inhabitants of our large towns. Overcrowding includes too many occupants in rooms, and also building dwelling house upon too circumscribed an area, preventing the proper ventilation of streets and houses. A spacious dwelling with free ventilation, robs the disease of half its power, and the danger of its spread to others is reduced to a minimum. Since this was written the general spread of Sanitation has rendered Typhus in the United kingdom a disease, virtually of the past. Privation.– famine through failure of crops, commercial distress, strikes, hardships in war, etc.– predisposes tom Typhus by deteriorating the constitution. Before the days of Howard, Typhus was never absent from our prisons and hospitals; it was the scourge of the armies of the first Napoleon, and it decimated those of the Allies in the Crimea, the disease varying among the troops exactly in proportion to the degree of privation and overcrowding. In 1818, and again in 1847, the failure of the potato crop in Ireland gave rise to an epidemic of this fever, some that it is estimated that one-eighth of the entire population was attacked. Dirty dwellings, fifty clothes, and personal squalor constitute favouring attendants of the disease.
TREATMENT.– It is a question whether Typhus can ever be cut short, or the definite course of the disease altered by the administration of remedies; some contend that it may be broken up in the first stage especially by the combination of Homoeopathic remedies and hydropathic appliances; other believes that the disease must have its course. However, our experience amply proves that in the great majority of cases the violence of the symptoms can be held in check, the patient’s comfort promoted, and convalescence hastened, by judicious treatment.
EPITOME OF TREATMENT.–
1. Febrile symptoms.– Aconite, Baptisia, Bryonia, Gelsemium
2. Cerebral Symptoms.– hyos., Belladonna, Veratrum-vir. Stramonium Terebintha (from Uraemia).
3. Sleeplessness.– Coffea, Belladonna, Gelsemium
4. Stupor.–Opi., Rhus.
5. Extreme prostration.– Ac.-Mur., Arsenicum, Ac.-Phosphorus
6. Pulmonary complications.– Phosphorus, Bryonia, Aconite, (Congestion).
7. Septicaemic conditions.– Carbo V., Arsenicum, Rhus., bapt.
8. Convalescence.- A.-Phosphorus, Ac.-Nit., China, Sulphur Psorin.
SPECIAL INDICATIONS.– Aconitum.– Thickly-furred tongue, foul taste, thirst, heavy, aching pain in the head; soreness and heaviness in the bowels and other parts of the body; excerbations towards evening; the urine dark and foul; the patient is restless, depressed in spirits, wakeful of drowsy, and dreams heavily in sleep. Aconite is of great service in the first stage, before the brain is much involve, and when severe febrile disturbance is present; but not afterwards, probably except as a intercurrent remedy, and for inflammation or local congestion.
Gelsemium.– Is specifically indicated when, from some great excitement or over-exertion, a typhoid state suddenly supervenes, with prostration of all the vital forces, and the patient experiences strange sensations in the head, with morbid condition of the motor-nerves, manifested by local paralysis, or jactitation of certain muscles (Hale).
Baptisia.– Should typhoid symptoms appear, and there be difficulty in determining the exact nature of the disease, this remedy should be at once administered and repeated several times. if improvement does not follow in a reasonable time, another remedy should be chosen.
Hyoscyamus.– Severe pains in the hand; dull, distressed, or haggard expression of the face; dry and glazed brown tongue; sordes on the teeth, noises in the ears, deafness, and aberration of sight– the patient seeing double of treble; delirium, win which the patient frequently manifests a desire to escape from some imaginary enemy or evil. Hyos,. is probably one of the best remedies in this disease.
Belladonna.– Great cerebral congestion, bright red, even bloated face; throbbing of the temples and carotids; glistening and staring of the eyes; partial loss of the use of the tongue, so that the patient can scarcely articulate; much thirst; confusion of ideas; picking at the bed-clothes; furious delirium.
Opium.– Stertorious breathing; low muttering delirium; stupor; dark red face; hot and dry, or clammy skin; thick brownish coated tongue; complaint of thirst (if the patient can express his sensations).
Ac.-Muriat.– In an advanced stage this acid is sometimes capable of effecting a most beneficial influence; especially when there are,– complete loss of muscular power; extreme dryness and parched appearance of the skin, which is cold; quick, feeble pulse; low delirium; slavering; foul exhalations from the ulcerated throat, etc.
Rhus Tox.– Blackish brown mucus on the tongue; thirst; bleeding from the nose; discharge of foetid urine; involuntary, bad-smelling alvine evacuations; small and rapid pulse; stupor.
Arsenicum.– Sunken countenance and eyes; dry, cracked tongue, burning thirst; involuntary diarrhoea.
Ac.- Nitric.–This remedy has often a very salutary effect, and may be given occasionally throughout the disease.
ACCESSORY MEASURES.– The points of greatest importance may be briefly summed up as follows; (1) The Patient should be placed in a large, or at least in a well-ventilated room, so as to secure a continuous and ample supply of fresh air. Cases occurring in close, crowded rooms, in which this prime hygienic condition cannot be secured, should be removed to a suitable place. (2) Frequent changes of personal and bed-linen, and changes of posture to avoid congestion and bed-sores; if bed -sores from notwithstanding the patient should be placed on a water-bed. Directly there is the least indication of a bed -sore, the part should be coated over with a layer of flexible collodion. (3) The wet-pack (see Secale 26) is a valuable measure, especially early in the disease, and when the skin is dry and hot. (4) Food or beverages should be given in small quantities at regular and frequent intervals, including water, milk-and-water, tea, broth, and beef-tea. It is extremely important that, from the first, nourishment should be given regularly and persistently. The tendency to death is by Asthenia, and, keeping that in mind, the patient should be frequently supplied with small quantities of very nutritious food. If prostration, feeble and irregular circulation, or complications indicate it, wine or brandy, but stimulants require to be used with caution. In some cases in which patients obstinately refuse all food, or are unable to swallow, life may be saved by nutritious or stimulating enemata. (5) Quiet; in noisy streets stuffing the ears with cotton wool; cleanliness; sponging the whole surface of the body and carefully drying at least once a day; and intelligent and unremittent watching. In no disease is careful nursing more necessary. See also the hints on nursing fever patients in the following Section, and the general measures described in Part II.
PREVENTIVES.– As disinfectants– fresh air, efficient ventilation, and cleanliness, are of paramount importance., As additional means for avoiding contagion, but by no means as substitutes- white- washing with quicklime, washing the wood- work with soap and water reappearing infected rooms, cleansing the linen kin water to which chloride of lime has been added and the use of Carbolic Acid or Sanitas in the water employed in sponging the patient,– five drops of pure acid, or a teaspoonful of Sanitas, to a quart of water. Without cleanliness and fresh air, vinegar, camphor, and other so-called preventives are useless, and only disguise noxious vapours. Nurses should not be over-worked, deprived of repose in bed, nor of daily out of -door exercise. If there is any ground to fear an attack of Typhus. Hyoscyamus and Baptisia are probably the best preventives, with plenty of fresh air and wholesome food.
41.– Enteric Fever– Typhoid Fever.
DEFINITION.– Enteric Fever (so-called from its chief pathological effects being evident in the bowels ) is a continued fever, whose infective agent is contained in the motions, and is generally conveyed through contamination of the water supply, lasting about twenty-one days, often longer, with an eruption of a few rose-coloured spots on the chest, abdomen, or back, and attended with a great feebleness, abdominal pains of tenderness, ulceration of the intestine, and usually diarrhoea, which increases with the disease, the discharges being copious, liquid, of a light-ochre colour, putrid, and often containing altered blood.
The word Typhoid signifies similarity to Typhus; but although the two fevers have many symptoms in common, Enteric is essentially a different disease, which render it important to be able early to identify the variety we may be called upon to treat. Thus the causes of these fevers are different, and suggest sanitary regulations of an opposite nature. Enteric is less directly contagious than Typhus; the tendency to a fatal issue varying, the treatment must be regulated accordingly; and, further, if not early recognized., patients may persist in their usual occupations at a time when rest in bed would conserve the strength and moderate the progress of the disease. For the easy recognition of these fevers, we have given in a tabular form the chief differences on page 150. In these days ( 1913). Typhus is so rare that the liability to error has almost vanished.
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."