tures of their size. With cold, sweetened orangeade alone, the physicians of the Spanish-American hospitals often support their comatose patients for days together.
These remedies should be applied in the very beginning of the disease. As soon as the yawning and stretching languor of a bilious remittent announces the approach of an ague-fit, the patient should prepare for refrigeration by sponge-baths, air-baths, and rest, in a shady, well-ventilated room. The thirst that announces the needs of the internal organism should be freely indulged with fresh spring water (or the next best thing, filtered and ice-cooled cistern-water). I would not prevent a fever-stricken child from drinking five quarts of water in as many half-hours, if its system craves it, for, besides its refrigerating influence, fresh water fulfills an important expurgative purpose, and helps to eliminate the catalytic germs of the tainted blood. During the shivering stage of a fever there would not seem to be much need of artificial refrigeration; but I have noticed that a fit of "chills" is far more supportable if the craving for a warm cover is justified by an external cause. In a sultry room a woolen blanket is apt to turn a shaking fit into the ugliest symptoms of the hot and headachy stage, while in a cold room the shivering patient (covered up, but with his head exposed to a cooling draught) soon finds relief in a quiet slumber. The ancient Romans cured their fever-patients in subterranean grottoes, and where the means of refrigeration are as cheap as in the New Orleans ice-factory I would keep the yellow-fever ward of a hospital at a maximum temperature of 55°, and at night, if possible, below 50. Wet-packs and a frequent change of posture greatly alleviate the throbbing pains in the loins, where the pyrexial process of a yellow-fever paroxysm seems to center its activity. These pains are often accompanied by a stupor-like oppression of the brain and are grievously aggravated by a stagnant atmosphere.
In the tent-camp of Medellin, to where the French authorities had removed the fever-stricken paupers of Vera Cruz, I noticed that comatose symptoms occurred only in a small minority of cases, while their worst forms were frequently observed in all the city hospitals, except the excellently ventilated infirmary of the Catholic orphan asylum. In common ague, fresh air alone, and without the aid of fruit and ice (which can not be readily procured in some inland districts of our Southern States) will modify the paroxysms sufficiently to reduce them to debilitating rather than distressing—symptoms tremors, followed by perspiration, and a cerebral excitation somewhat resembling the first effects of certain intoxicants.
During the hot stage of an intermittent, delirium can be obviated
- "It is curious that the maximum of the heat observed after death should have been in the thigh, and the minimum in the brain. Dr. Bennett Dowler, of New Orleans, ascertained it to be (ten minutes after death) 102 in the brain, 109 in the axilla, and 113 in the thigh" (Carpenter's "Physiology," p. 619).