Vol. 60, 1909 - University of North Carolina at Chapel Hill

-"•0 THF CHARLOTTE MEDIOAL JOUKNAL
financially or the givin.a; up of life-long chlorate, three grains to the ounce of water
habits. In order that he be willing to make The local anesthesia is not so great as tha
this sacrifice, he must fully realize the grav- from cocaine, but it is sufficient to last sev
ity of his condition. Of course, tact must eral hours.
be used in bringing this knowledge to him Because of the fact that people who ai
so as to, as much as possible, reduce the over-fed usually have sluggish bowel movt
mental shock. I have not seen any patient ments, it is well to have occasional doses o:
who was made worse on being told he had castor oil or senna to empty the colon It
tuberculosis. those who are habitually constipated, th«
Given an obedient patient, in moderate proper remedies must be used. In case ol
or good circumstances, who has gotten over low stomach motility, it may be necessarj
the first fright of the knowledge of his con- to use lavage or massage once a day in'
dition, I think it is probable that he can be order to remove material left over from the •
treated to better advantage in his own com- day before. In case there is diarrhea it;
fortable home than almost anywhere else, must, of course, be controlled. This cau*\
believing, as I do, that climate is almost a usually be accomplished by the regulationii
negligible factor in the case of the patient of diet and the occasional use of hio-h^i'
who will do as he is told. enemata.
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He should have a room, preferably a large Fczr/- and C/u7/s.—As the high tempera- "J
one, with several windows through which ture in consumption is due to the absorp--i
the sun may shine at least several hours a tion of toxic materials from the local lesion
day; or better, he should sleep on the porch and as exercise increases the amount of this i
or veranda, or in a shack in the grounds of absorption, it is, of course, plain that in \
his home. His waking hours should be fevering cases the exercise should be liiuspent
in the open air, indulging in moder- iled, and, if necessary, the patient put to I
ate exercises; or when this is not advisable, bed and kept there until the fe\ er lessens '
because of high temperature or rapid pulse. Also, as it is a daily observation that hi-h '
he should be on the veranda or in the yard temperature in consumptives is preceded by !
on a reclining chair or cot. If he spends chills, it is necessary to eliminate or reduce
his nights m his room, the windows, of these chills. This chill or chilly sensation I
course, must be kept wide open. appears in the maiority of patients at a j
While, as I said before, the majority of fairly definite time of day. This time should
consumptives are as well, or better off, in be noted when found; the patient should be i
their own homes than elsewhere, there are put to bed and covered up to the neck, with '
a few individuals who either will not or can one or more hot-water bags at his feet I
not follow directions at home. These it is, This should be done about an hour before i
ot course, best to send to a resort for con- the expected arrival of the chill and the .
sumptive:? where they will have example as patient kept so until about an hour after ,
well as precept, and will be away from the the chill should have passed. In case the i
influences which at home prevented them fever is not lessened by the rest in bed and I
from following out the treatment as it should the relief of the chilly sensation, recourse i
have been amst be had to cold or tepid baths and aiiti- i
jMei As to diet I, personally, believe pyretics. The least harmful of this latter
that It should be mixed"; that is, of such is probably pvramidon. This may be oiven
food as comes on the table of the ordinarily just before or about the time that the "fever
well-to-do, rather than a preponderance of usually rises, in doses of two or three grain i
any one variety of food, such as milk and capsules, repeated once or twice if neces- <
eggs. At the same time, I think the pati- sary.
ent should use milk to wash down his food Mg-/a Sz.rah—As in the vast majority '
instead of water or coffee, because the milk, of cases that have night sweats they are preot
course, has a large caloric value, while ceded by fever, it is evident that in order to I
water and coffee have practically none, cure them the fever must be relieved This
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Kaw eggs should, I think, be kept as a re- can usually be done by the measures out- |
serve. I'or instance, if by reason of lack lined above. As a temporary remedy cam- i
ot appetite the patient has not been able to phoric acid is probably the best because the j
chew and swallow what he knows to be a least harmful—40 to 50 grains to be oiven |
sulhcientmeal, he may take two or three in 5 or 10 grain capsules between six" and i
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eggs to finish out because they readily slip nine in the evening. This usually relieves
down without being chewed. n,„ ^.. „ * j u -j •
Tn il,oce ^,=»c 1- ^"- the
, ,. ^ sweats and,. besides, is a ,
In those good
cases
general
which are complicated by .^„- , . a , ,'.
' '^ ^^^"^^ lasting in most cases
tuberculous laryngitis of such degree that
deglutition is painful, the pain^may ^s
be
long as 24 hours.
greatly relieved by spraying the throat be- If the sweat has been severe, the patient
fore meals with a solution of heroin hydro- should change his wet for dry night clothes,
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