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Rules For The Application Of Water In Typhoid Cases

Source: Hydriatic Treatment Of Scarlet Fever In Its Different Forms

As a general rule, in typhoid cases, bathing should form one of the
principal features of the treatment; i. e. the patient should have more
baths than packs in proportion to the treatment of other cases.

The temperature of the baths should be in proportion to the
reactive power of the body; i. e. the longer the patient has been sick,
and the weaker he is, the higher should be the temperature of the water,
but never so high as to have rather a weakening than a strengthening
effect upon the nervous system. The highest temperature which may be
used should not exceed 75 deg. F.

When the delirium is active, the patient restless, almost raging,
the water should be used colder; when the delirium is more passive, the
patient weak, muttering, the water should be warmer: in the former case,
the water may be between 50 and 60 deg., in the latter, between 60 and 70 deg..

When the skin is hot and dry, a wet-sheet pack will produce relief,
and assist in bringing out the rash. After the pack, a half-bath should
be given, the duration of which must be regulated by the condition of
the brain. If the delirium continues, the bath should be prolonged.

The patient should not leave the bath before his head is clearer.
It may be necessary for the patient to stay in the bath for more than
half an hour.

In a low condition, with passive delirium, the packs should not be
continued very long, as they will be apt to increase the bad condition
of the brain. In that case they should be used only to prepare the body
for the bath following it.

When the skin is cool and moist, neither a bath nor a pack is
indicated. When the skin is rather cool and dry, an affusion of cold
water and frictions with the bare hands should be used, and the patient
packed afterwards in a dry blanket, to assist in producing a reaction.
In such cases I have found very cold water to be of more service than
water of a warmer temperature. When the patient has not been too much
weakened already, a rash is likely to be produced by the proceeding, and
in consequence of repeated baths, the nervous system to be relieved and
a healthier reaction to be obtained.

Should putrid symptoms appear, I would advise the use of mineral
acids and chloride of lime, in addition to hydriatic treatment.

In no case would I advise a hydriatic practitioner to overdo,
either in regard to the temperature or to the quantity of the baths. The
state of the brain and of the skin should always guide him. The increase
of delirium will require a bath, and the dryness and heat of the skin a
pack. If both symptoms exist, the bath is to be preferred, as the
condition of the nervous system should always command the principal
attention of the physician. When the nervous system is supported, the
whole of the organism is, and the condition of the skin usually improves
with the former.

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