Part 5 (1/2)
Should the patient remain cold in his pack for longer than an hour,--a case, which will seldom occur,--a little wine and water may be given him to a.s.sist the organism in producing a reaction; and, in case of need, the dose may be repeated once or twice in intervals of half an hour. The quant.i.ty should be adapted to the age and const.i.tution of the patient, and by no means sufficient to affect the head. Instead of water, it may also be mixed with warm broth or tea, or hot water and sugar, to make it agreeable to the little patient.
86. ABLUTIONS AND RUBBING WITH ICED WATER OR SNOW.
In a few very obstinate cases, when no rash would appear after two or three long packs, I have succeeded by was.h.i.+ng the patient with ice-water or snow, rubbing him dry with my bare hands, and then packing him in a dry blanket. After staying there for several hours, more or less eruption always appeared.
87. WET COMPRESS.
The wet compress on the throat in torpid cases should not be changed often, but left till it becomes almost dry. Should the feet of the patient be cold, a bottle filled with hot water and wrapped in a piece of blanket or a sheet should be placed near them, either within the pack, or out of it, when the patient is lying in bed. The feet should always be kept warm.
88. VENTILATION ALL-IMPORTANT.
If the circulation of air is necessary in any other form of scarlet-fever, it is all-important in torpid reaction, especially when it inclines to a typhoid type. We should never forget that it is the oxygen of the air that nourishes the process of combustion going on in every living body, and that in the same manner as no fire can burn bright without a sufficient supply of air, the combustion within the patient will be slower in proportion as there is less pure air in the sick-room, and consequently his reaction will be weaker, and _vice versa_. A sick-room, filled with a number of people, and with a large fire in it, or fed with the corrupted air of a furnace, without the access of pure air, will always prove a dangerous place for a patient in torpid fever, the fire and every living soul in it absorbing the oxygen indispensable to his recovery. And if the case become typhoid, there is little hope of saving the patient's life without plenty of pure air.
89. CONTINUATION OF PACKS--CONVALESCENCE.
Whether the eruption appear or not, the packs should be continued during the whole course of the disorder, and as long as the throat continues troublesome; and one pack and bath a day should be given during some ten or twelve days, after every symptom has disappeared. The patient, during convalescence should not go out, except after his bath and in fine sunny weather, till he feels quite well. However, he should not be kept unnecessarily too long in-doors either, as exercise in the open air will a.s.sist him in regaining his strength. If the weather is clear and bright, the low temperature of the air need not be minded. I never saw any one take cold after a pack and bath that walked out warmly dressed in clear and cold weather.
90. MINERAL ACIDS, IN CASE OF SEVERE SORE-THROAT.
In case the throat be very troublesome, there cannot be any objection to using the mineral acid, as I have indicated above (35), except h.o.m.oeopathic remedies should be thought preferable and found to afford sufficient relief. Some good may, and no harm can be done by either.
91. PUTRID SYMPTOMS--GARGLE--SOLUTION OF CHLORIDE OF SODA--DRINK: CHLORATE OF POTa.s.s--LIQUOR CALCII-CHLORIDI.
Should _putrid symptoms_ make their appearance (21), I would strongly advise the acid in full and repeated doses, as well as the frequent repet.i.tion of the packs. In putrid cases, not only the syrup, but also the gargle will do good service. Gargling is so much the more advisable as the putrid matter should be frequently removed. If nothing else can be had, pure water or water and vinegar may be used. The temperature of the gargle should be about 70-75 Fahrenheit. For the same purpose, the _aqua chlorina_, and the _chloride of soda_ have been strongly recommended.[34] A few drops of the solution may be used, also, on the compress outside.
92. TREATMENT OF AFFECTIONS OF THE NERVOUS CENTRES.
In affections of the nervous centres, the _brain_, the _cerebellum_, and the _spine_ (see 17-19), the danger which threatens the patient's life is princ.i.p.ally averted by the sitz-bath. The nervous system needs support, and the circulation must be regulated. In every case where the packs do not relieve the symptoms in the head and spine, the sitz-bath is probably the only remedy to remove the danger. It should be about 70, and the patient should stay in it till relieved, which will probably be in half an hour or there about. After the sitz-bath, if the patient feel quite easy and inclined to sleep, he may be put to bed; if he continues restless and still complains of pain, he should be put in a wet pack of about 65. There he should stay till he complains of more pain, when he should take his bath and repeat the sitz-bath. Thus he should alternate till he becomes entirely relieved.
93. SITZ-BATH, ANCHOR OF SAFETY.
If there be much delirium, the sitz-bath may be required longer, and the pack shorter, as indicated above (81). In all such cases the packs and sitz-baths, alternately, ought to be continued, till the nervous symptoms disappear altogether, and should they make their appearance again, the treatment must be resumed without delay.
94. I repeat that in such cases, the sitz-bath is the only anchor of safety I know of. I have tried to remove these dangerous symptoms by packs, affusions, baths, but almost always in vain; whilst the sitz-bath has never failed to insure success. As I am the only writer on hydriatic treatment of scarlatina (as far as I know), who mentions the virtue of the sitz-bath in those cases, and as I am probably the first who ventured to use it, with one of my own children, in 1836, when all seemed to fail, I shall corroborate my advice by a couple of cases.
95. CASES.
During an epidemic of scarlatina in 1836 two of my children were attacked by the disease, a boy of about eight, and another of five years, the younger one two days after the older one. I ordered them to be packed, and all seemed to go well, when, during my absence from the city (of Freiberg) a medical friend, who called, persuaded my wife to desist from continuing the hydriatic treatment, and use some remedies of his instead. On my return, I found the elder boy (the other began only to show some slight symptoms) in a very bad state: the cerebellum and spine were distinctly affected by the contagious poison; the patient complained of insupportable pain in the back of his head, the spine and all over his body, so that no one dared to touch him. The fact of the packs having been discontinued during twenty-four hours being concealed from me, and the boy being subject to herpes and inclined to scrofula, I began to fear that the treatment would not be applicable in such cases, and became really alarmed about my child. I was then almost a novice in Priessnitz's practice, at least in the treatment of acute diseases, which seldom occurred at Graefenberg, and, had I had more confidence in blood-letting and drugs, I would probably have resorted to them. For a while I was doubtful about the course I should pursue, when Dr. B., my medical friend, made his appearance and I learned what had happened during my absence. Instead, however, of giving way to his earnest solicitations to rely on the old practice, I at once became encouraged by his confession, and declared I would persevere in my own practice, which was quite new to him, and in which no physician of the place as yet believed. He a.s.sured me, from the symptoms, that the boy could not live twenty-four hours, unless he be bled, and that even then he would not answer for his life. Having lost six children before under allopathic treatment, and having never had much confidence in drugs during the time I had been connected myself with the practice, I firmly refused to allow either bleeding or drugging, and expressed my resolution to see what water could do, resigning myself to the possibility of a bad issue of the case. I need scarcely a.s.sure my readers, that my feelings were far from agreeable, and that my resolution required all the reminiscence of the bad success of allopathic treatment of former cases in my family, and the confidence I had in Priessnitz and his system, to support it. I tried the pack again, which did little or no good. Judging from the effects of the sitz-bath in cases of affection of the brain during continued fevers, that it might be of service also in the present case (Priessnitz's directions did not go so far, nor had I treated a similar case since my return from Graefenberg), I put my boy with great care into a sitz-bath of 70 F. and left him there for a little over half an hour, when he felt greatly relieved. He was taken to his bed and allowed to become warm, when he began to complain again. I then packed him, seemingly without much effect; therefore the sitz-bath was repeated and proved quite successful. I then packed the patient immediately after the sitz-bath and left him two hours in the pack, where he slept almost all the time.
When he awoke, he complained again of pain in his head, which partly yielded to the half-bath. About three hours after the bath, he complained more of the pain in his head and spine, and I repeated the sitz-bath and the pack. He slept in the pack for about three hours, and when I took him out, he was covered with red spots. Feeling pretty well, he was dressed and permitted to stay up. In the forenoon, my friend called to see whether our patient were still living, and could hardly believe his own eyes when, on cautiously putting his head in at the door, he saw the boy walking up and down the room to warm his feet. In the afternoon, the pain returned and the rash faded. I repeated the pack, and the pain not yielding entirely, I gave him one more sitz-bath in the evening and a pack after it, in which he stayed asleep almost all the time, nearly four hours, upon which the rash stood out finely and never disappeared until desquamation set in. I managed to keep him in bed after the relapse mentioned, till desquamation was over. I need scarcely say that I continued to pack him (twice a day) till after desquamation, when the packs were given once a day for about a week longer. On the seventeenth day (which was the fifteenth with the younger boy, who had the fever in a very mild form, and was treated accordingly) the two scarlet-convalescents were seen playing in the street, throwing s...o...b..a.l.l.s at each other; a fact, which increased not a little the sensation caused by this miraculous cure. Although my friend was not converted to the new method, this case had a very decided encouraging influence upon myself, and, I am convinced, became the means of salvation for many hundred lives afterwards, treated partly by myself directly, partly by other physicians, or the parents of the patients, after my prescriptions. I felt the importance of my success in this difficult case of scarlatina, and warmly thanked Providence for having a.s.sisted me in saving my child for the benefit of many others.[35]