Perchloride and Biniodide of Mercury have been vaunted as anti 03 septics, but they cannot, owing to their solubility, be expected to act upon the diseased intestine until after their absorption and dilution by the great volume of the circulating fluid. Crispolti advocated the intravenous injection of :; gr. of the perchloride. N1 edgwood's mercurial treatment is advocated by Ewart: it consists in the administration of gr. Perchloride with 15 mins. 'Fr. Ferri Perchlor. every 6 hours, and is said no. to cause salivation.
Urotropine has been demonstrated to he a reliable disinfectant of the urinary tract, and though its administration reduces the number of bacilli in the urine, its routine employment in the treatment of the acute stages of the disease is futile.
Oil of Cinnamon is the least objectionable of the antiseptics tried. 2 to 5 mins. given in capsule or emulsion as recommended by C. Ross may be given every 2 hours for long periods or throughout the entire attack till the temperature falls. Whether the drug acts through increasing the natural resistance by promoting phagocytosis, as some believe, or by neutralising the toxins. it often seems to minimise the severity of the symptoms. The great barrier to its use is the irritation of the stomach which usually supervenes when the drug is pushed for any length of time; its mild hypnotic action is very beneficial in some cases where insomnia is prominent.
plan of treatment by antipyretic drugs, like antipyrine, has been univ ersally abandoned, owing to the depressing action of the drugs upon the heart w hen administered for any length of Lime, and also from the fact that the pyrexia returns in greater force almost immediately aft T their suspension.
Quinine is upon a somewhat different footing; though it often fails signally in reducing fever heat, it nevertheless exerts its specific tonic action and usually does no harm. To be of use, however, as an antipyretic agent it must be given in large doses (2o grs.) a few hours before the expected maximum, and cinchonism is very liable to add to the patient's discomfort. In the case of children the antipyretic action of the drug is much better marked; grs. administered in cachet 2 hours before the evening rise will usually prevent this, and it may safely be continued in one daily dose at this hour for long periods. It is, however, a doubtful mestion \\ holier such depression of temperature will cause any permanent benefit beyond preventing the undue wasting by the prolonged and con tinuous rexia. The tonic action of the drug in smaller doses will often be clearly indicated, and these may he obtained by resorting to Yeo's Chlorine mixture, though the taste and odour of this compound are strongly resented by children, and indeed by most adults.
Hyperpyrexia must never be met by the administration of any anti pyretic drug. A dose capable of influencing these temperatures would probably prove fatal. Even in heroic doses antipyrine is useless.
the judicious use of cold or tepid water, the fever temperature may be regulated with certainty and safety, and it does not appear that anything but good results have been obtained by keeping the pyrexia even for long periods or throughout the entire attack moder ately depressed by the application of water. This is very different from antipyretic treatment carried out by drugs, in which cases several objec tionable depressing factors are introduced which are avoidable in hydro therapy when properly applied.
There is considerable difference of opinion amongst authorities regarding the limit of temperature which should be accepted as an indication for the use of hydropathic measures. Brand, whose name is associated with the external application of cold or tepid water, advocated the bath as a routine in all cases as soon as the thermometer registered F.; Liebermeister's limit was lo3°, whilst Goodall advises that the physician should not wait till the temperature rises beyond 'or' or if restless ness, insomnia, or delirium be present.
The methods of applying hydrotherapeutic measures are numerous, and the physician will be wise in not adhering blindly to any particular plan as a routine, hut to select the method suitable to each case. Thus in the mild continuous type, especially in the case of children, a sufficient antipyretic effect may be produced and maintained by cold or tepid sponging of the body, the limbs and trunk being successively uncovered and well moistened by a sponge saturated with cold or tepid water. By placing a mackintosh sheet under the limb operated on, a small stream of water may be squeezed from the sponge and allowed to trickle over the surface and flow into a receptacle by the side of the bed. Sometimes the sponging may be supplemented by rubbing over the skin with a large smooth piece of ice. This plan does not necessitate any considerable moving of the patient's body, and may be kept up almost continually as lie lies still in the horizontal position, provided a couple of nurses are available to carry it out day and night in severe cases. As soon as the temperature falls to near the normal the skin may be allowed to dry by evaporation if the patient be lying between blankets.