DISCOURSES ON HEALTH AND DISEASE.

New Zealand Herald, Volume XXIII, Issue 7644, 22 May 1886, Page 1 (Supplement)

DISCOURSES ON HEALTH AND DISEASE.

[BY DR. <». TOOSSAINT GIRDLER.) VII.—PREVENTABLE DISEASES

Of all fevers there is none more easily kept under control (with proper care and the intelligent use of disinfe~tant3) than typhoid fever. It has no special connection with overcrowding, poverty, or ill-health; it attacks without prejudice people living in town or country, rich or poor, healthy or weak. It has been proved beyond all doubt that it is the fever of fiecal decomposition, and that it occurs only amongst those exposed to the influences of defective drains, foul or overflowing cesspools which have be* n contaminated by typhoid poison, more especially when these are so situated as to poison, by their leaking and draining, wells used for drinking and cooking purposes.

Typhoid fever is not contagions—that is, it is not conveyed from one person to another by the touch or by the breath : this is proved by the fact that nurses attending typhoid cases seldom if ever take the disease from their patients.

It is well known to all medical men that the poison of fevers will and dons remain latent in the system for week;, without showing the slightest signs ; then suddenly, without any warning, the disease shows itself in all its worst forms. We see the same thing occurring daily in our gardens ; we plant seeds, and watch day after day for the appearance of the plant, until, disappointed and disgusted in our expectations, we decide the seed is a frau d; when long after the proper time th« /<lant make its appearance, and in due time reaches its full growth. So it is with the germs of fevers. Although, a3 a rule, they bave certain fairly well-known periods of incubation, it is very rarely we can be certain t,o a few days. With typhoid fever '.he usual period of incubation is from eight to twenty-four days, but may be much longer than this, as has frequently been proved in prisons, and on board ships which, have not seen land for over a month.

Nearly all the av'.thbrities 01 the subject are agreed on one pointnamely, that if the excreta of typhoid patients be at once properly disinfected, there is no risk to any one ; but if any jjarticle remains, no matter how small, in fcv/enty-four hours it becomes decomposed, find is highly virulent. It will at once impart 'its poisonous properties to the contents of a/ay cesspool or sewer; or if thrown on thfj ground, will contaminate any wells the surf.ace rain water may wash it into ; or, becoming dry, may be blown about by the wind, to poiaon anyone who inhales it, for the poison may enter the system by food, or d rink, or the dust we breathe. This is why >.n many cases it is so difficult to learn how the disease has been contracted.

D uving the last four months there have been 7)' cases registered as occurring in the city wards alone. This means that there are 72 centres of infection for the disease to start from next year. I have little doubt there hp.vf; been as many more cases in the various boroughs round. if a serious outbreak is to be avoided during the next typhoid season, the proper precautions and remedies must be used now. All fevers are ouly prevented by ftarly measures; when there is an epidemic it is too late.

What a storm of indignation would take place against the authorities if this number of animals had been attacked, and there had been a money loss to the various owners ! What takes place in an epidemic amongst cattle? Bills are posted all over the neighbourhood by the magistrate's orders, declaring that place an infected district. Isolation is at once strictly enforced, because the pockets of the inhabitants are affected.

Contrast the energy and skill shown in one case and the indifference, stupidity, and indecent neglect when humau life and happiness are at stake. As Christians we boast of our love of humanity, but spend our time and energy in taking good care of our animals, and trusting to chance to remedy our carelessness with regard to human life. In the early management of typhoid fever, the friends of the patient are content to trust their medical adviser; bat id is when the immediate danger has passed, and the stage of convalescence has commenced, that the greater peril has to be met, and it is at this time so many die from the injudicious folly of friends. The patient now begins to have a constant craving for food, one of the signs of the great nervous depression to which the illness has reduced him ; we see that he is so feeble that he cannot move without assistance ; but it is not realized that the internal organs are equally weakened, and that the stomach and bowels can no more do their proper work than the legs.

For nearly a fortnight after the fever has gone the diet should consist only of slops.

How often we see this rule ignored through false kindness and a want of firmness, and in defiance of medical orders ; solid food— may be only a cake or a piece of bread and butter —is given, with the romark, " Oh, the doctor won't know !" the result being only too often death or a relapse.

The poison of typhoid fever causes ulceration of the glands of the small bowels. The number of ulcers may vary very much ; there may be only one, or as many as twenty.

When solid food is given before the ulcers have healed, so much irritation is set up in the inflamed and thin bowels that it becomes perforated, and death ensues from bcetnorrha^e.

Nothing is more painful than to see death caused by the want; of a little firmness and patience on th« part of friends and relatives. No one should be allowed to attend a typhoid patient who does not understand that a fever patient requires fever diet, and that fluid foods contain, if properly prepared, more nourishment than solids, are more easily digested, and tho only ones suitable for an inflamed and enfeebled stomach.