TINE.) Sanitary scientists predict confidently that the world will soon be rid of this scourge. Preventive inoculations of specially prepared seninis have been tried• but not found generally effective. Serums also have been used for treat ment, bat with indefinite results.
Yellow fever is a st•lf-limited disease, but is likely to be attended by serious lesions of im portant organs. Absolute rest in bed, from the first appearance of symptoms until convalescence is well established, is imperative. In no other disease is rest so important, and disregard of this precaution fraught with such serious dan ger. Sudden death has occurred from too early exertion when the patient was apparently on the highroad to recovery. Careful nursing, fresh air, proper ventilation, and scrupulous cleanli ness of bedding and clothing are all necessary. At the outset of the attack a mild emetic such as ipecac or warm water and mustard may he given to empty the stomach, and the bowels should he evacuated quickly by menus of castor oil, or an effervescent saline cathartic, as citrate of magnesia or a Seidlitz powder. During the following days one or two bowel movements should he obtained, preferably by enemas of sul phate of magnesia in warm water. Fever is best controlled by means of cold sponging. laths, while effective in lowering the temperature, are dangerous on account of the movement they en tail. Antipyretic drugs have to be given with caution because of their tendency to depress an already weakened heart. Internally alkaline carbonated waters, vichy and apollinaris, are useful in allaying nausea and vomiting, and to cleanse the stomach and promote the action of the skin and kidneys. Warm drinks will serve
the same purpose. To overcome severe vomiting, blisters to the epigastrium, small doses of co caine, or larger ones of subnitrate of bismuth may be necessary. Threatened suppression of the urine is a grave complication and is combated by wet or dry cups over the region of the kidneys, intravenous or intracellular injections of nor mal saline solution, or high rectal injections. Restlessness and sleeplessness are relieved by suitable doses of morphine or chloral. No reme dy will certainly check the hemorrhage, but ergot, acetate of lead, and adrenalin may do so. Free stimulation with whisky and strychnine is neces sary at times to counteract the tendency to col lapse and heart failure. The conduct of attend ants and nurses should he such as to allay fear and quiet excitement. Many yellow-fever pa tients (lie of fright. If possible, attendants should he immune. Contrary to the practice in other fevers, no food should be allowed yellow-fever patients for the first three or four days, or longer in severe cases, and then only the blandest and most easily digestible liquids may be taken. Milk and lime water, o• vichy. barley water, or buttermilk, may he continued well on into conva lescenee. Solid food cannot be absorbed by the patient and it may work serious harm.