and is caused by the presence of Bacillus pneumoniae. It is generally ushered in with a rigor (a sudden coldness attended with shivering), which is often very severe; in children convulsions may take the place of the rigor. The temperature rises, and may reach 104° or 105° F. There is pain and loss of appetite; the face is flushed, breathing is rapid, and there is a short hacking cough; the matter expectorated is tenacious and rusty-coloured.
Treatment.—Keep the temperature of the room at about 65° F., or rather higher, but not lower if it can possibly be avoided. Support the shoulders well with pillows; this will assist breathing. Give milk, beef-tea, white of egg, custards, Brand's jelly, strong chicken tea, etc. Cold water may be given to allay thirst. Medical aid should be sought at once.
Quinsy. This is a severe inflammation of the throat, chiefly involving the tonsils and frequently going on to suppuration. It is usually ushered in by chilly feelings, which are succeeded by fever. The speech becomes nasal in character, and there is pain and difficulty in swallowing.
Treatment.—In the early stage this disease may be cut short by the administration of an emetic of 20 grains of powdered ipecacuanha, or by small doses of tincture of aconite frequently repeated, say, a quarter or half a drop every 15 minutes or half-hour till the patient is in a good perspiration, when the medicine may be given less frequently. A mixture containing the following ingredients may be given with advantage: Steel drops, 3 drachms; sulphate of quinine, half a drachm; chlorate of potassium, 2 drachms; glycerine, half an oz.; water added to make 8 ozs. A tablespoonful in water every 4 hours. The food should consist of milk, eggs, beef-tea, cocoa, etc.; pieces of ice may be given to suck. A medicated spray will afford much relief and is preferable to gargling. Sprays can now be bought very cheaply.
Rheumatic Fever.—This disease begins with restlessness and fever; there is a white or creamy condition of tongue, and the bowels are deranged. Presently the joints begin to ache, the pain increases till there is great swelling and tenderness over one or more of the large joints of the body; the temperature rises, and, in some cases, becomes excessively high; the urine deposits a thick brickdust sediment on cooling. As there is a great risk of the heart becoming affected in this disease, it must always be regarded with apprehension, and medical advice procured at once.
Treatment.—Absolute rest in bed must be enjoined, and careful nursing and light, nutritious diet provided. Milk and potass water, alone or together should be given. Beef-tea and beaten-up eggs are important items in the diet. The following medicine may be usefully given: Salicylate of sodium, 3 drachms; iodide of potassium, half a drachm; water added to make up to 8 ozs. A tablespoonful of this