ABOUT  THE   PROPER  TREATMENT  OF

                TYPHUS:

   A LETTER  TO AN  INQUIRING  FRIEND,

            JBy C. C. SCIIIEFERDVCKER,  M. D.   f
                         108 East 21th st., Jan. 16th, 1864.

Dear Sir :
    It seems impossible to let so many young and valuable lives
sink into the grave, while they might  be  certainly saved, with-
out protesting against tbe one-sided and heartless self-sufficiency
to which they fall victims.
  The typhus has become, within the last  four to five decennies,
not only more general, but also more dangerous and complicated.
I am not inclined to press my conviction, that  the most  infam-
ous crime of our age—" Vaccination"—is the cause of its spread-
ing  and  greater  danger, although  analysis   shows  identity
between  tbe  virus of pox matter and of the exudation  of tbe
inner eruption, while it is  an acknowledged fact that the single
forms of cutaneous eruptions  stand  in intimate relation  with
certain internal parts of  the  organism,  viz.:  Small-pox  with
the mucous membranes of the stomach and intestinal canal;
scarlet  with  the  membranes of the hae^ part of the mouth;
measles with the respiratory organs; erysipelas with the liver;
scarlet with the kidneys, <kc.
  The  object of  these lines is merely to show to you how un- 
2
warrantable the proceedings of physicians are, " who," as John-
son, Sir Chas. Sondamore, Mayo, Forbes, and a hundred other
eminent physicians say, " from the mere pride of prejudice, re-
fuse to adopt the safe, sensible, simple', intelligible, and successful
treatment with water  and proper diet.   They incur a fearful
responsibility, tbe amount of which, time will certainly reveal,
if not to themselves, at least to their successors.   For nothing
can prevent it from becoming  ultimately universal."
  Drs. Edwd. Johnson, with his sons Walter and Howard, of
whom the  eider, Walter, holds  the appointment of Medical
Tutor in the largest and wealthiest London hospital-—Guy's—
add,  referring to  Drs. Graves,  Gregory, Watson,  Copland,
Waitz  (Batavia), Mauthner, Schnitzlein,  Eicbter, Herschel,
Scouttetten, Champouillon, and others:
  " All that can be expected, and all that the sensible physician
ever does expect, in typhus  and similar cases, from any treat-
ment, is to pilot the ship through  the storm, and bring it safely
into harbor.  And it  (tbe water  treatment) will effect  this
object with a degree of certainty a hundred-fold greater than
any other, and the convalescence after  it will be Avonderfully
more rapid, while all those lasting and evil  consequences which
too often result, from the ordinary drug-practice,  to the consti-
tution, will be avoided."
  The very eminent, learned, and practical Dc. C.'urrie, of Liver-
pool, brings (long before tbe present development of the hydro-
pathic system as a perfect science), in his  u Medical Reports,"  a
mass of evidence,  in form of actual ea-es,  treated by himself  and
others, which one would have thought could not possibly have
failed to force the water-treatment into general acceptation ;  the
more especial1}* as Dr. Currie is a man universally acknowledged
to occupy a place in the very foremost  rank  of his profession.
Every honest medical man ought to read, among  the numerous
cases, detailed with great minuteness, in the Medical Reports,
at least  one, perhaps that communicated  by Mr. Dalrymplo, of
Norwich.   (Vide  Currie's Medical  Reports,  vol.  2, page  27,
second edition, 1805.)
  Thos. Bateman, M. D., F. L. S.. in. ,w A Practical Synopsis of
Cutaneous  Diseases," remarks: " After  the extensive evidence
which a period of more than twenty years has furnished in proof 
3
of the uniform efficacy and security of the external use of cold
water, in scarlatina, and in other febrile diseases, connected with
high morbid  heat of the  skin, it is  to be lamented that  some
practitioners still loolc upon the practice as an experiment; and
repeat the remnants of  exploded, hypotheses, about  repelling
morbid matter, stopping pores, etc.,  as reasons for resisting the
testimony of some of the greatest ornaments of the medical pro-
fession.  For my OAvn part. I have been in the constant habit of
resorting  to  the practice,  at every opportunity, in  scarlatina,
(and in typhoid fevers, during my superintendence of the fever
institution for the last ten years), attending to the simple rules
laid down by Dr. Chime ;  and I  have never witnessed  any in-
convenience, much less any injury from  it; but an uniformity
in Us beneficial operation, of which no other physical expedient,
with which I'am acquainted, affords an example"
   Sundeliu,  Von Siebold, Balling, Most, and a host of  other
most eminent physicians, highly recommend water  in typhus.
   Dr. C. E. Bock (the celebrated Professor of Pathological Ana-
tomy in Leipzig), in his " Diagnostic," &c, declares all Specifica
and Medications in Typhus as " unphysiologiccdly " objectiona-
ble : and adds,  " that  all rational treatment of the typhus, as
of all other dyserasias,  must have in view, to support properly
the metamorphosis  of the blood, and to  remove  troublesome
nipmptoms.   Experience teaches,  that, with proper dietetics, far
more typhus patients are  restored, and  quicker  strengthened,
than with drug-medication and  stimulation.  But  a proper die-
tetic  treatment  consists in giving a  mild, mostly fluid food,
(alternating between milk,  butter-milk,  bread, egg-drink, meat
broth), in keeping the air day and night fresh and pure : in
most scrupulous cleanliness of clothes, bed and person (washing
and baths);  in preventing all excitement of body, senses and
mind; in proper attention to the excretions, particularly of the
cutaneous activity by baths, urine  by cathetre and stool by
enemara.   Against violent headache, apply cold wet compresses
to the head.   Excessive bleedings remove rather by cold appli-
cations, than by lead, alumn and acids ; the intestinal bleeding
by cold injections, and  cold compresses to the abdomen ;  great
sensitiveness and swelling  of abdomen removed by warm fomen-
tations ;  keep the body from getting sore by a good bed  and 
4
cold washings; the dryness and covering of lips and mouth can
easily be corrected by keeping these parts clean and moist Avith
water."
  Dr. H. E. Richter (Professor, &c, in Dresden), after giving
his views on prophylactics (here so much neglected, as if, to say
the least:, unknown), remarks: " We have in vain hunted for a
specificum  in typhus.   We are bound to a dietetic treatment.
Fluids only can be given ; wine and eggs in cases of extreme
exhaustion.   Room well aired and cool;  windows ojjen day and
night, and some fire.  Cleanliness in every respect.  Wash body
often, or bath, or pour pure water over it.  By dry skin pack
in wet sheet.   Wash forehead,  face, arms and  legs with vina-
ger, or such packs  are beneficial, derivative, quieting and  sudori-
fic.   All excitement to be avoided.'1  " The internal and ex-
ternal use of  cold  water is not only cooling,  refreshing, anti-
febrile and energetically contracting, but is also a most import-
ant skin-irritant,  derivative and  crisis-promoting means, and
gives us in  typhus  now, since the development of the water cure
as a scientific system, a far more extensive applicability than be-
fore.  We have now systematically circumscribed :  Cold immer-
sions, cold affusions (particularly on the bead in stupor); pack-
ing of naked body  in wet sheets (particularly in dry heat of the
body); local  baths  of many kinds;  half baths  of different tem-
perature ; cooling  or warming  cold water-compresses (particul-
arly ice-cold ones on the abdomen in meteorismus); tepid  or cold
local or general washings, <fcc."
  The  "Encyclopaedic Dictionary  of the  Medical Sciences,"
edited by the Professors of the Medical Faculty in Berlin (viz.:
C. F. v. Graefe, Hafeland,  Link, Rudolphi,  Von Siebold, Bush,
Horn, Ossan, Hecker, Miiller, Jungken, and other authoritative
giants of the Medical Profession), says, in vol. 34, under tbe bead
of Typhus : " According to our insufficient knowledge of  the na-
ture of the typhus, the following is left for us to do:

  " 1.  Restriction  of the typhus-process, by cold, pure air, clean-
sing of the skin.  The typhus of 1813 has shown this to  the ut-
most extent.   Cold rooms, light covering, cold drink, cold wash-
ings and baths are the principal means for the extraction of the
heat so much  roused by this disease.  Cold drinks, cold wash- 
5
ings,  cold douches  and  affusions had the best effect.  Those
whose heads had become  freer, desired  to remain in the cold
room, asked for cold drink and cold head-compresses.  Coldness
helps to cure, and to diminish  the contagion.—This proceeding
is proper as long as dry heat, stupor, delirium, etc., exist.  When
the heat is diminished, and the skin becomes soft, we have to
moderate  the first treatment, and pass to a more moderate tem-
perature, but with the greatest caution.

   "■ 2d. Limitation of the congestion of the blood to the head, client,
and abdomen.    Prevention of 'inflammation.—Warm  rooms,
w-arm covering, warm drinks, and stimulating means, cause these
congestions, and are injurious.  External  cold  applications,
washing, and cold compresses,  are here  also the best remedies.
To prevent congestions to bead and brain,  the means are ice-cold
fomentations, cold washings, affusions with cold water and cold
douch-baths, partly in dry bathing-tubs,  partly  in tepid half-
baths.   Of all  agents  these  are the best,  most powerful and
indispensable.   It  is proper to continue  energetically these ex-
tractions  of warmth and  diminutions of blood-congestions, till
the sopor,  delirium, dry-heat, etc.,  are  removed.   The  head
compresses must be renewed when ceasing to be cold.  Another
cold compress is to be applied to the back and neck, but they
must not  be too heavy.   The washings with ice-cold water are
to be made with a sponge, and continued as long as the skin  is
hot and dry.  The addition of viuager, chloride of lime, or wine,
is not essential, for very cold water is sufficient.  The cold affu-
sions of the patient, while in a tepid half-bath, daily two or three
times repeated for four to five  days,  are  invalnable.  The  ma-
jority of those  Avho snffered from severe typhus, have been  suc-
cessfully  treated with these  cold agents, and few  only were
restored without them."   The writer then mentions : " That in
certain cases  more  moderate temperatures of the water were
used ; but in most cases  of typhus with severe affections  of the
head, tepid water is too feeble an agent.   Baths are needed for
the after-cure  to support  the convalescence,  and to strengthen
the organism.  This continuation of the \\>a of baths is particu-
larly necessary in hospitals, to exterminate the contagion.   It is
to  be recommended as  prophylactic  and as a. sanitary duty. 
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There  are only  fewr cases where bleeding  is not  injurious.
Cathartics and  cooling drugs  are only relatively useful, but
mostly injurious.  We must care for a daily evacuation.  Vomit-
ives are of no value, and do often harm.   Cedomel  has been
recommended and  condemned.   Acids are  pleasant,  but do
not influence a cure.  As to Chlor (acidum muriaticum oxygen-
atum) its effect is overrated ; and cleanliness,  water,  fresh air,
are much more important and necessary,  than the  mass  of
fumigations so apt to cause cough, oppression,  and pain.

  3. Limitation of such symptoms, which by their continuation
become  dangerous, and  prevent the crisis,  viz.:  Bleedings,
diarrhoea, cramps, pains,  gangrene, &c.   Bleeding,  (if not a
critical symptom) treated with  ice-cold compresses and injec-
tions, cold affusions, and douches.   Metrorrhagia, cold foment-
ations,  injections, affusions on abdomen and sexual organs with
cold water, cfcc.

  4. Promotion of  the crisis, prevention of after  diseases and
new infections.   Baths,  baths, baths !  Fresh air  and proper
diet.

  In regard to the use of wine and similar stimulants, it is said :
" Far better is thie entire exclusion of wine than its abuse.''''
  These rather heroic recommendations  are not made by  any
follower of tbe scientifically established water-cure system ; they
come from the heads of the Allopathic  drug-profession, which
scowls  at hydropathy in this country ; the American Allopathist
rather  than do honor to  his own  masters, kills,  by drug and
dietetic abuse, his victims, or lets them die without applying the
means  proved and recommenned as successful by bis teachers.
" But what would I do in case of Typhus T   I ansAver by de-
scribing the treatment of Dr. C. A. W. Richter, Berlin,  whose
work on Typhus has been honored by receiving the prize from
the Medical Faculty in 1848.  He says:
  " A timely and proper exhibition of cold water will frequently
prevent the breaking out of the disease, particularly when it is
spreading by contagion.   If an individual, exposed to the danger
of infection,  shows,  by the fact of being easily  fatigued, and by 
7
head-aches, vertigo, &c, the signs of being infected, we must
proceed thus:
   " The patient is entirely undressed and put into a dry bathing-
tub or on the bare floor ; five to six pails of cold water are then,
with  moderate  pressure,  from a height of  tAvo  to  three feet,
poured over head, neck and shoulders.    This  procedure is re-
peated after five to six hours—and four to fiVe such affusions are
generally sufficient to remove all impending danger."
   But when the disease is broken out, we cannot  stay its pro-
gress by this treatment; it runs its course.

   Treatment of the disease itself:—The patient is, at the time of
exacerbation, towards evening, packed in a cold Avet sheet,  in
which he  remains till he is slightly warm ; he then enters a half
bath of 68° F.,  and stays while moderately rubbed, four to six
minutes.   When dried he receives a wet bandage on the abdo-
men, his  legs are bandaged, and the head is surrounded by a
cooling wet compress,  to be reneAved Avhen getting warm.  In
the first days, when the boAvels are generally constipated, Ave
procure every 24 hours a passage by a large injection. Besides
this, we give daily tAvo small cold injections,  which  influence
advantageously the afterwards following diarrhoea. The patient
is again packed  in the morning, bathed and bandaged  as above ;
the proceeding is repeated in the evening. If on the  sixth and
7th day diarrhoea supervenes. Ave give in  the day, between the
two packs, a sitz-bath of 05° F. for ten to fifteen minutes, and en-
velope the patient after  it up to under the arms with a thick
Avoolen blanket.    About  the  ninth  or tenth day, or  earlier, if
before this indications of spontaneous perspirations  should ap-
pear, we let the  patient, by degrees,  remain longer in the wet
pack, till bis face gets slightly red and the temporal  pulsation
quicker; we then bring him quickly into  a bath  of 68° F., and
have him, for three to five  minutes from a moderate  height, af-
filed from the mouth of a large and repeatedly filled  watering-
pot, or from a shower-bath.   He sleeps, when  brought to bed,
generally  very  soon  after  this bath, and begins to perspire.
This perspiration should bo supported for three to four hours by
drinking from time to time a small swalloAV of fresh  water ; if
the sweat  spontaneously ceases to flow, we quickly moisten the 
8.
 body with a wet cloth on head, chest, extremities, and  cover it"
 again quickly and carefully with the bed covering; the perspir-
 ation then generally begins again to flow.   Finally, when he
 ceases to perspire, Ave bring him into a bath of 75° F., and then
 into the bed, when be will again sleep and perspire.
   When the patient awakes from this sleep, he feels like another
 being, and makes tbe impression of bis change upon  those avLlo
 surround him; his bead  is free, be can control bis  members,,
 and all  apathy has passed.   His friends perceive  the  clear,
 lively expression  of his eyes and of his features.  Patient is now
 only packed and  bathed in the morning, in the  evening he is"
 merely  washed  off,  but he continues to  wear  the abdominal
 bandage, which is reneAved several times during the day."
   With  this  method of treating the Typhus, which, since  the
 publication of bis " croinnecr  work on this disease, has been
 introduced into tbe hospital and private practice of physicians,
 Dr. Richter had restored some  (J0 typhus patients, among whom
 were some nearly "in agone," and given  up by  other physi-
 cians. '■
  I myself have bad some cases which I cured in  a  similar
 manner.   But what shall we think of physicians of some repu-
tation, who either know the above indicated facts and stubbornly
stick  to  their murderous  nonsense, or are really ignorant of
those  facts!  Are the}- worthy of their sacred position,  and of
any confidence of the public whatever?
                            Yours truly.
Dr. C. C. £ouiefer]>kcker,