Part 20

Absolute rest in bed is necessary, and no solid food should be given to the patient until his temperature has been ten days at normal point. All food given in the illness should be liquid enough to pass through the meshes of a milk strainer. Care should be taken in this matter, as death has often followed the taking of solid food, when otherwise recovery would have come.

Milk should always form the largest portion of the diet, and may be given with arrowroot or oatflour. Beef tea is of little use, and is always to be avoided if there is a tendency to diarrhoea. Plenty of cold water may always be given.

In a community which is visited by gastric fever as an epidemic this fact is striking--only a portion of the people are affected by the visitation. Here is one man who drinks the water which gives gastric fever to another; that water goes into his stomach as it does into that of his neighbour, and passes through his system the same, yet death is the result in one case, and not even sickness or inconvenience in the other. In the latter case the system has the power of resistance, and our aim should be to increase this. Therefore we say by all means look to the healthful state of the lungs and bowels when you have the least reason to fear that bad water may bring gastric fever to you or yours. If there is any tendency to constipation get some liquorice, and boil it thoroughly with about half an ounce of senna leaves to a twopenny stick. Strain well, and let all in any danger have a teaspoonful of this thrice a day. It will do wonders in keeping matters in a good state within. If possible, give a good rubbing all over once a week with hot vinegar, and follow that up with warm olive oil. That will do a great deal to keep things right outside. Take and give more rest than usual to the toil-worn when such danger is near, and have as good food provided for all as is possible. There may be danger in the air, and still worse danger in the water to those whose vital force has got low, while there is none in either to those whose systems are in good tune.

You are, perhaps, ready to ask if we care nothing about bad water? Certainly; we care a great deal about it, as we do about bad air. By all means condemn wells and streams that are corrupted, and insist on the opening of better ones. Make it a first condition of having anything to do with a place for habitation that it has good air and good water. We are only pointing out the best safeguard when neither the one nor the other can be insured.

In all cases where water is suspected, it should be boiled before use.

There is, in great numbers of persons, both old and young, what may be called the natural aptitude of healing. They are kept back from trying to help because it is regarded as so dangerous a thing to go near fever, and also to interfere where only professional skill is legally allowed. To apply such a remedy as that which we have here sketched for gastric fever is perfectly safe in both senses. No medical man worthy of being regarded will find any fault with it, and there is no danger to either the patient or the person applying it.

The mode we have pointed out involves nothing that may not be easily had by the very poorest. What is wanted is only one or two who shall be Christian enough to care just a little for human bodies as well as human souls, and who shall study such simple and accessible remedies, and be ready to guide their fellow-creatures in a time of trouble.

Fever, Hay.--See Hay Fever.

Fever, Influenza.--This is a slow, smouldering kind of fever. For treatment, pack the feet and legs in hot fomentation over the knees, and apply cold cloths over the stomach and heart, taking care in applying the cold if the patient is weak. In such a case only moderately cool cloths should be used. Carry out these two processes effectively, and a cure should soon result. Give light food--milk and water, and milk diet generally. Give small quantities frequently rather than a good deal at once.

Fever, Intermitting.--For this the treatment may be given as in gastric fever, and, in addition, the stomach and bowels should be carefully lathered over with soap lather (see Lather). This has a wonderfully soothing effect. It may be spread with the hand over the skin, and fresh supplies gently rubbed on until much of the fever is removed. Some five minutes' lathering at a time is enough--this may be done several times a-day. Carefully dry after it, and let the patient rest.

It will be well to anticipate such attacks by softening the skin when it shows a tendency to be hard and dry. A gentle rubbing now and again with fine lather and good olive oil will secure this. We say lather and oil because, when there is no fever heat, lather by itself is too cooling, but when mixed with a little oil the mixture is comforting rather than chilling, and softens nicely.

Fever, Rheumatic.--This results from severe damp chills, usually following exhaustion from some cause. Its best treatment at an early stage is by heat applied to the spinal nerves. If the trouble be chiefly in the legs, treat the lower back; if in the arms, treat the upper back. The heat is best applied by a large BRAN POULTICE (see). A teaspoonful of tincture of Guaiacum may be given before each poulticing, which may be done twice a day for an hour. We have known an illness that threatened to last six weeks cured in one week by this means. Give also teaspoonfuls of hot water from time to time.

Where the trouble has advanced to severe fever, and swelling of the joints, an entirely different treatment is best. Let a lather of soap be made (see Lather), and spread over the chest first, and afterwards gradually over the whole body. After four or five coats of lather have been put on, wipe off with a dry cloth, and proceed to lather again. We have seen half-an-hour of this treatment, well done, greatly relieve the fever; it was continued twice a day, and in three days the trouble was conquered. Care must be taken not to chill the patient. The soaping can be accomplished with only a small part of the body uncovered at once, and, with proper precautions, the bed can be kept perfectly dry. If a proper liniment is procured and lints sprinkled with it wrapped round the joints, the pain will be wonderfully relieved. But such liniments are only to be had on the prescription of a really good medical man, who will not, if he really seeks to heal, and knows his business, object to our treatment being applied.

Sometimes, after rheumatic fever, one or more of the joints become stiff. This stiffness varies in different cases from an apparently complete solidifying of the joint to only a slight inconvenience in its use. We have seen many such joints, even very bad cases, completely cured by a proper use of heat and massage. It is, however, no trifling matter to undertake the necessary work, and perseverance is an absolute requisite. Even very obstinate stiffening will in time be overcome by frequent and strong fomentation, followed by rubbing with olive oil in such a way as to squeeze gently all the muscles and sinews of the limb, and move them under the skin. This should be followed by gentle bending of the joint, back and forward as far as it will go without pain. It may need to be done twice a day for many weeks, yet the result is worth even more trouble, when you literally make the "lame to walk" (see Rheumatism).

Fever, Scarlet, or Scarlatina.--As a first precaution, when an epidemic of this exists, children should be sponged twice a week all over with hot vinegar before being put to bed. This is a powerful preventive. If anything like sore throat appears, bathe the child's feet in hot water until a free perspiration is produced. Dry well, under a blanket, and rub all over with hot vinegar, then put the patient to bed. If in the morning there is no evident fever, repeat the sponging with hot vinegar, dry well, rub with hot olive oil, and dry again. If the fever definitely develops, place the child in a light airy room, from which all unnecessary carpets, curtains and furniture have been removed. No one should enter this room except those on duty in nursing, nor should any from the house ride in public conveyances or attend meetings. These precautions are just as necessary in slight as in severe cases, as infection from a mild case may cause a fatally severe attack in another person.

Where the rash of the fever seems reluctant to appear, the SOAPY BLANKET (see) will bring it out very speedily. But the above simple treatment is usually sufficient. When vomiting is almost the first symptom, six teaspoonfuls of hot water are to be taken every ten minutes for an hour; then treat as above with foot-bath, hot vinegar, and oil.

In a severe case have medical aid if at all possible. Where there is great fever spread a large dry towel or sheet on the bed. Lay one wrung out of lukewarm water on it; let the patient lie down on this. Carefully wrap him up in the damp cloth, then over that wrap the dry one, with a blanket outside over all, and the bedclothes above. This will certainly soothe for a time. It may be repeated every two hours, for twenty minutes or half-an-hour at a time, night and day, till the fever is subdued.

For nourishment in succeeding weakness, give milk and boiling water, mixed in equal parts, every two hours. If stimulants are required, give CAYENNE "TEA" (see), reduced in strength until it just slightly burns the mouth, half a teacupful every half-hour. Cool the head also if necessary, as directed for typhoid fever.

Fever, Typhoid.--Treat as under Fever, Gastric, and Fever. In addition, great care should be taken to disinfect and destroy any stools, and especially to prevent these getting into any drinking water.

Keep the patient at rest in bed.

No solid food should be given during the whole course of the illness. Milk mixed with an equal quantity of boiling water is best. Give only a wineglassful at a time, as often as the patient can take it. If the patient craves solid food, it must on no account be given. It is almost certain to cause a relapse.

Fits.--See Convulsions; Nervous Attack.

Flannel Bands.--See Band, Flannel.

Flatulence.--This is the accumulation of gases in the body, usually caused by fermentation of the food at some part of the digestive process. A failure of the vital energy in the stomach and related organs is generally the cause. Over-exertion, worry, grief, any prolonged strain, will cause this failure. As first treatment, then, the cause should be removed, if this be at all possible. Do less work, cultivate simple faith in God instead of worry. Do not sorrow over-much. The best material remedy is to take tablespoonfuls of hot water every few minutes for several hours. If cold, the feet should be bathed (see Bathing Feet), or fomented, for about an hour at a time. These two simple remedies will generally prove sufficient, if persevered in.

Flushings, Hot.--These are often a really serious trouble, especially to women, at certain stages of life. Most often they come about the age of fifty, but in weakly persons may occur at any time. A disturbance in the nervous system, due to lack of energy, is the cause of such feelings. They are often accompanied by DEPRESSION (see). Any treatment ought to be directed to strengthening the nervous system. A good plain diet, easy to digest, is a most important matter. Soaping with soap lather over all the body (see LATHER) will greatly restore the tone of the nerves of the skin. This may be done every night, and the CAYENNE LOTION (see) rubbed all over every morning for a week or two. This treatment will usually prove successful in curing.

Fomentation.--Some general remarks on this important treatment we give here. First, no fomenting should be done for at least an hour after a meal. And it should usually be followed by a period of complete rest. A very good way to foment any part of the back or front of the body is by an india-rubber bag of hot water of the proper size and shape, with two or three ply of moist flannel between the bag and the skin. These bags can now be had of very various sizes and shapes, and one or more should be in every house. In fomenting a knee, foot, or ankle, a good sized half or even whole blanket is necessary. Fold this one way until it is twenty inches broad. Lay it out on a clean floor or table, and sprinkle sparingly boiling water across one end. Roll this end over and sprinkle the roll, turn over again and sprinkle again, and so on until the whole is rolled up. Thoroughly knead and twist it, so that all is penetrated by the moist heat (see illustration, page 32). Or it may be prepared by soaking the blanket in boiling water, and wringing it out with a wringing machine. It may then be unrolled and unfolded so as to permit proper wrapping round the limb to be fomented. Care must be taken not to burn the patient, or give any shock by applying the fomentation too hot. It must be comfortable. See Heat And Weakness.

Sometimes fomentation may seem to increase the pain, say in a swelled limb, and yet we should persevere in the treatment. This may seem to contradict our dictum that we should be guided by the feelings of the patient. The reason is that if some dead matter has lodged deep down in the limb, it will have to be brought up to the surface ere the diseased state can be remedied. If strong fomentation is used in such a case, it is not unlikely to increase the painfulness of the limb, and a swelling may appear. It will at once be said that the disease is "getting worse." This is quite a mistake--the increased pain is arising from such stirring of life as will bring about a complete cure. If the treatment is continued, the swelling will by-and-by come to a head and burst, and can be treated as in Abcess.

Fomentation, Armchair.--This is applied as follows. Over a large armchair spread a folded sheet. Provide a good large blanket prepared as above in Fomentation. Then rub the haunches, thighs, lower back and abdomen of the patient with a little olive oil. Wrap these parts in a warm dry towel. Open up the hot blanket and spread it (still some three-ply thick) on the sheet on the armchair. Let the patient sit down upon it as soon as it is cool enough not to hurt. Fold the blanket all round the patient's lower body and thighs. Draw the sheet over all, and cover up well to retain the heat. At the end of an hour, or such less time as the patient can endure, a smart washing with hot vinegar, and a gentle rub with warm olive oil, will complete the treatment. This is best done at bedtime, as the patient must go to bed immediately after it.