SURGEOM  GEMLRAL'S OFFICE

        JUL  2 7 1909
            IMMUNISM  IN  TYPHO{p.

                  fly £. 7>acy Bishop, M.D.

  I\ seeking to put into a condition of immunity any system in
which the typhoid bacteria have segJTPed lodgment, it is necessary
to supply a  material which is hostile fo- the existence  of the bac-
teria as it occurs in  its familiar habitat, the intestinal canal, but to
supply it in overwhelming quantitj^and kind  such  that it may
freely and abundantly permeate the tissues of  every  part of the
system.
  It is equally necessary at the same time to prohibit the introduc-
tion into  that system of any substance upon which the bacteria can
thrive.  Anything,  whatever  it may be, that microscopists  have
found advantageous as a culture medium should be excluded, as
also all related  food  substances.   This method of treatment of
Typhoid  Fever is not theoretical, but is entirely  in accord with the
universal, natural law.              *
  When  we want things to  grow  we put them into conditions
favoring  growth; when we want to prevent growth it is reasonable
and in harmony with  nature to establish surrounding  soil (if you
please) in which their existence is impossible.  The only objection
that I can think of to such a procedure is that heretofore it has been
unheard of.
  The human  intellect has been so bred to the  idea of promoting
reproduction and growth that it cannot entertain or  appreciate a
contrary  tk'-iu^ht.  The present method of treating Typhoid is not
at all in harmony with what we knrf.w of its nature and surround-
ings. It.is high time  the pro  re nata or the expectant methods be
abandoned for positive scientific methods.  We ought at least to
have as much method as there is  in material conditions.  Treat-
ment in accord with this principle has been employed by the writer
for many years and with phenomenally favorable results, the  diag-
nosis in various cases being confirmed by blood  tests.   v\
  After  having diagnosed  the  case, give a hot  soap and  water
sponge bath, then put the patient in clean clothes, and if he is foo
sick to be about, put him in a clean bed  (a straw  or cotton mattress
is best, with one or two clean sheets over it and a like covering).
Cotton is the  best  material, because it is more comfortable and
more easily  and thoroughly cleaned, and less liable to  retain moist
secretions.  The cleaning and changing of the  clothing should be
done morning and evening; if it cannot be washed, it  will do quite
as  well to iron  it  thoroughly with a  very hot iron.   The  room
should be cleared of everything not necessary to the patient.   It is

 
best to have plenty of windows and to have them as wide open as
possible.
  The medicinal treatment is begun with a capsule  containing six
drops of creosote dissolved in a dram or more of codliver oil (creo-
sote so compounded is not an irritant) even six hours during the
day.   This remedy rapidly permeates the entire system, but should
not,be discontinued entirely until a few days after convalescence is
established, which usually occurs in from five to ten  days from the
beginning of the treatment.   To secure the necessary sewerage of
the system, give a powder at bedtime composed  of one grain of
calomel and six grains of salicylate of soda, to be followed in the
morning by a tablespoonful of equal parts of codliver oil and castor
oil. A comfortable way of giving this  is by first wetting the mouth
with whiskey and then quickly swallowing the oils.  This treatment
should be employed  without regard to diarrheal conditions  that
may be present, as it is both nutrient and disinfectant.
  Nutrition as a remedy is equally, if not more important  than
medicinal  remedies in  uncomplicated  conditions.  It should  con-
sist of such substances as will be destructive to the  bacilli and nour-
ishing to the patient.  Such things are butter and  cream; no milk.
Butter can be used freely on thoroughly browned toast; it can also
be made into a very palatable soup, the toast to be broken into hot
water and the butter added.  Pure cream  similarly  used makes a
very acceptable soup.  Ice cream made of  pure cream is another
refreshing and nourishing dish; cream on the  pulp  of roast apple
is another; tomato soup made of pure, fresh  cream and strained
tomato is very grateful; good coffee, with an abundance of cream;
ripe peaches and cream (don't eat  the peach),  cream punch;  lem-
onade, with a little sugar and a little whiskey, cold or hot, is a bet-
ter drink  than water, and makes a good meal with well-buttered
toast; a salad of olive oil and lemon juice on lettuce is^ood, chew-
ing, but usually ejecting, the lettuce.  This keeps the mouth whole-
some  and  the secretory apparatus of the mouth in working condi-
tion, though not always relished.
  Patients should not be fed too often, but  if  possible at their
accustomed meal times, care  being taken to wash the mouth  with
the following preparation: Two grains of  corrosive sublimate in
an ounce of alcohol; one-half teaspoonful of this diluted with two
or three tablespoonfuls of water.  The food will  taste  better and
patients will not swallow any filth.  Of course, you will not have
the characteristic tongue and sordes which  go with the  "regular
treatment" and which are used to verify  the diagnosis, but the
patient won't care.
  It remains to say that the treatment of the patient's skin is  very
important. No matter what the temperature may  be, he should be
given an alcohol sponge bath when putting on his clean clothes at
bedtime and whenever the temperature is high.  When very  high
use freely, and if obstinate add 10 or 15 per cent, of ether to the
alcohol to promote rapid evaporation, using over the  patient a light
cover at the time; if necessary, use the spray.
  This treatment will be more effectual, less barbarous, and not so
dangerous as the cold-water bath as at present employed.  I know 
of a patient who was killed by the cold-water bath, a case of menin-
gitis having been mistaken for typhoid fever.
   Alcohol  disinfects the clothing and the skin.   When it irritates
the skin, follow it with a tepid or cold water sponge.
   It is not necessary to keep the patients in bed; they can be put
on a porch or under a tree if the weather is  favorable.  Patients
so treated,  and without complications or some  intestinal injuries or
periostitis,  will be entirely convalescent in from four to ten days
and with absolutely no chance of a relapse.
   For greater protection for attendants, the  discharges ought to be
treated at once.  Sulphate of iron in solution is effectual and cheap.
   In conclusion, I would ask that anyone employing this treatment
will do me  the favor of using it in its entirety,  as I wish to prove to
the profession beyond a doubt the truth of my contention.
   Appended are the records of the temperature of two sisters,
aged  19 and 21, and both, curiously enough,  attacked by the dis-
ease at the  same time.
   The records were kept by their mother during the first four days
of their illness and subsequently by the patients themselves.   The
diagnoses were confirmed by the Widal test.
   After six or seven days  and  reduced temperature, the  oil and
creosote capsules were limited to two a day:
	Temperature.		. Daisy	s.	Temperature.	
	A. IVI.	P. M.			A. M.	P. M.
■3--	. 104	IOI	September 3. .		104	103
4..	. 100^2	102^2	"	4..	100	101^
5--	■ 99	103	'•	5--	100^	ioil/2
6..	• 99	IOI	a	6..	98^	100^2
7--	• 99	loo1/*	a	7--	98	100
8..	. 98	IOI	"	8..	99	98/2
9..	■ 97V2	99	a	9..	98	98/2
10. .	■ 99TA	99	a	10..	97	99
n. .	• 97lA	98	a	11..	98	98/2