allowed to flow into the colon and out again, under low pressure,
without disturbing the patient, by means of a glass tube connection
(See Fig. 15). The temperature is quickly brought down to 100, then to
98, then to 90, usually finishing up at 80 or 85 F. The water is
allowed to enter the rectum slowly through a soft rubber catheter (not
a hard rectal point), and as it comes out it will be noted that the
water is very warm, sometimes registering 105, and it is needless to
add that if the water goes in at 80 and comes out at 105 F., much heat
has been taken from the body; and so, of all the treatments we have to
suggest for typhoid fever, the one just mentioned is possibly the most
important. When it is necessary to keep up this enema for an hour or
two, the cool water may cramp the bowels, but this may be entirely
obviated by applying hot compresses to the abdomen.

Another treatment of great importance in this second week is the cold
abdominal compress. Much fever is occasioned in the abdomen because it
is the seat of disease, and the much dreaded hemorrhages which often
cause the death of the patient are usually avoided by the use of
abdominal compresses--wrung out of water at 55 F.--the temperature of
ordinary well water--and changed every twenty minutes.

[Illustration: Fig. 15. The Cooling Enema]

I recall one mother in my dispensary practice who was so poor she
could not afford a nurse, her only helper being a son twelve years
old. A nurse went to the house twice each day and taught this lad of
twelve years to give his mother the cooling colonic irrigation; he was
also taught to warm up the abdomen by a hot application and afterwards
to apply the cold compresses. The mother made a good recovery.

During this second week the diet should be sustaining. It should
consist of boiled milk, eggs, fresh fruit and fresh fruit juices,
dextrinized grains (hard toast, toasted corn flakes, shredded wheat
biscuits, etc.). The mouth should be kept scrupulously clean, for in
all the infectious and contagious diseases there is always the
possibility of gangrene in the mouth if it is neglected.

_Third Week Treatment._ This is the week we look for hemorrhage from
the bowel unless the abdomen has been well treated during the second
week; and even so, the cool compresses to the abdomen will be
continued well into the third week--also the daily or semi-daily
enema. The skin is kept in good condition with soap washing and
frict