are accountable for the heart failure and collapse so often
fatal during the second, third and fourth weeks of typhoid
fever. * * * * *

"The old idea that in peristaltic action lay the great danger of
increase of the hemorrhage and perforation of the bowels, is
giving way to the more rational view that gaseous distention and
septic absorption, are what bring about fatal results from these
complications, and that the moderate peristalsis of the
intestinal walls lessens these dangers by closing the gaping
ends of the injured vessels, and expelling the septic matter and
foul gases. To meet these indications I have found lavage of the
bowels, even during hemorrhage, with water of 105 deg. to 110 deg. F. or
even hotter, given in moderate quantity of from one pint to
three, to give great relief by freeing the large intestines of
blood clots, fecal matter and other morbid matter. It also
increases peristaltic action in the small intestines, thus
favoring the expulsion of gas. The heat stimulates the
circulation in the peripheral vessels of the intestines, and
overcomes the tendency to blood stasis.

"In the cases cited, ice-bags, alternated with fomentations,
were used over the abdomen externally, and heat, or hot and
cold, to spine. The extremities were kept warm. From ten to
thirty minims of turpentine, in an ounce of gum acacia or starch
water, increased the efficiency of the enemata, and aided in
expelling the gas and checking hemorrhage.

"The tendency to hypostatic congestion and bed-sores, was
prevented by frequent change of position, and the use of hot and
cold to the spine by fomentations and compresses, or better
still, hot fine spraying, or the alternate hot and cold spray.
In one grave case, spraying was kept up for about twelve hours,
with only short intermissions. The heart was stimulated by heat
applied over it, whenever depression and collapse threatened,
and by hot and cold sponging of the spine."

Dr. Noble said some time ago in the _London Times_:--

"Although it is true that alcohol is an antipyretic, yet its
exhibition neither shortens nor modifies (favorably) the
diseases of which the fever is but a symptom. The paralysis of
the brain which is so frequent a cause of death in typhoid
fever, is more often brought about by alcohol than any other
c