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Show INSTRUCTION CLASSES. MEDICAL AND SURGICAL NURSING. MEDICANL W~INGAN D THE CAREO F MEDICALO ASES. Mm. P. C. H. PAEL. The diseases liable to tocur are typhoid fever, malarial fever, pneumonia, and the eruptive fevem. Typhoid fever is an intestinal disease produced by a specific germ in the alimentary canal, roducing ulceration. It is an acute infectious disease, principally contagious througg the excretions. A typhoid patient feels n d in disposition for ten days or more; often has nose-bleed, loas of appetite, an%%rred tongue. The first week is the period of inwion. The second week is 'the period of tissue changes. The third week resolution begins if no complications arise. First week is eriod of glspdular enlargement; temperature rises to 10ID or 10ZO in the evening an% at 8 p. m. ~t is usually at its height, remaining that till midnight, when it subbides, and the following morning it is .nsually one dkgree in dxcess of the prevlons mornmg. The temperature rises till the second week, when it reaches its maximum. Second week there is pain and tenderness in the right groin, nausea, and sometimes delirium. The ulcers begln to slough, though sometunes not till the third and fourth week, at which time there is danger of perforation. During first and second weeks pulse and .temperature correspond; later the pulse gains. B end of secondpieek fever is at its height, and toward the middle of the third weeg there is a remission of temperat-. If no complica,tions arise, the usual duratlon of the fever is twenty-one days. The common complications are catarrhal pneumonia, h& failure, perforation of bowels hemorrhages, kidney difficulties, and acute meningitis. Derangement of mind &ill sometimes last after temperature and other symptons have subs~ded. Patients need little medicine, but much good nursing; they should have a hily tepid bath (soap and water), and if tempemture goes to 103°, should be bathed to reduce tern erature, as beyond 103O the tissuesare rapidlydestroyed; for this, bathe with two-tgirds water and one-third alcohol, very hot or very cold; take special pains with ankles, wrists, bend of the knees and arms, and about the neck, the places where large arteries come nem the surface; also up and down the spine. Place the patient on a blsnket and allow the moisture to evaporate. Another way is to a ply packs, very hot or verycold, as follows: Place the patient an rubber or oilcloth, txenimrnersea sheet in waterand, without wringing, fold cloeely about the body; repeat every twenty minutes until the temperature lowers. If the ~ti!n> is very sensitive to heat or cold, begin with tepid water and ,increase or lrnlnlsh the temperature. Allow the patient to drink freely; also flush the bowels with warm water to which boracic acid is added. Care must he taken not to overdistend the bowels, 98 one of the greatest dangen; is of the ulcers perforating the intestine, producing hemorrhage, md even allowing the oison to escape, producing death by peritonitis. Great care should be taken that t t e patient does not sit up, hut change the positiox several times a day. In ease of hemorrhage, elevate the foot of the bed, place ice on the abdomen, keep absolutely quiet, and give morphine, f grain, and ergot, 1 scruple. Hemorrhages occur most frequently about the end of the third week. If perforation occurs there is no remedy. Nourish well, as in no disease does tissue waste more quickly. The diet must be strictly liquid; milk is quitesu5cient; 4 to 6pints within the twenty-four horn. If the heart weakens stimulants may be administered. 464 |