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dreaded, large quantities of stimulants, alcoholic and medicinal, nervine
tonics such as strychnine, and such drugs as ammonium carbonate,
caffiene citrate, tincture of strophanthus, tincture of digitalis and nitrate
of pilocarpine. Fever is best treated by sponging and ice-cap, antifebrin
and phenacetin not being suitable and having a transient effect only.
Headache by bromide of ammonium, opiates, ice-cap or evaporating
lotions. Sleeplessness by bromides, opiates or camphorodyne. Vomiting
by bismuth and hydrocyanic acid in effervescing draughts. Pulmonary
congestion by diffusable and alcoholic stimulants, with digitalis, tur-
pentine stupes and blisters. Surgeon-Captain Thomson, I.M.S., who
was in charge of the Parel Hospital and from whose report the above
information is taken, notes that " As a special. mode of treatment, liq.
hydrargyri perchloridi was resorted to from a conviction of the value of
such a powerful disinfectant in specific disease * *. At first it was
given in drachm doses well diluted three times daily; later, in half-
ounce doses every two hours for four doses; and then in the same
quantities every eight hours. In no case of plague did these enormous
doses induce salivation, though this phenomenon was carefully sought
for." In one case which turned out to be another disease, salivation
was produced after the third dose, so he concludes that " this mode of
treatment is therefore both diagnostic and rational."
As regards the treatment of buboes, he strongly deprecates attempts
to induce suppuration, and holds that when they are left to themselves
the tendency is for them to subside, and that when irritants are avoided
and sedative applications used, only 7 per cent. end in suppuration. On
the other hand if irritants are applied, a very large number suppurate
and having to be opened lead to the formation of large granulating
surfaces slow to heal and retarding convalescence."
(G.O., No. 2448-M., dated 6th November 1897.)
4. The following simple rules for the treatment of plague
may be adopted when there is no professional medical
attendance:-
"The patient should be treated as much in the open air as possible.
A tent well protected from the sun and with the side kanats raised to
allow wind to blow through, makes an excellent sick ward. The floor
should be kept covered with lime-wash, renewed once in two days or so.
Everything leaving the sick-room should be disinfected. Glass, cutlery
and crockery should be scalded. Bedding and clothes should be boiled
for half an hour or soaked in disinfectant for some hours before washing.
The most convenient disinfect ant is 1/2 oz. mercuric chloride, 1 oz. hydro-
chloric acid in 3 gallons (a stable-bucket full) of water, coloured with
red-ink powder. No metallic vessels should be used for storing this
solution, and any clothes soaked in it should be steeped for an hour in
water before being sent to the dhobio. All discharges of the patient
should be sprinkled with lime and at once burned.
The patient should be kept constantly lying down, not being
allowed to sit up even to relieve bladder or bowels until at least four
days after fever has ceased. This is to avoid danger of sudden collapse
and death from failure of heart's action.
As the tongue is generally coated, calomel in a dose of 5 to 10
grains should be given, followed by a dose of salts some hours after, if
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