Fever
By far the vast majority of instances of fever result from infection. There are, however, cases in which fever occurs and in which the exact cause cannot be easily determined. Certain principles have been established by years of experience for the handling of fever.
Rest in bed is the number one step for any person with fever. Under such conditions the work of the heart, kidneys, and liver is reduced. The sense of fatigue is lessened. The blood flow to the kidneys and liver tends to be better in the lying-down than in the standing position. The disadvantages of bed rest include: less stimulation to breathing, a sluggish blood flow in the legs, and a noticeable diminution in muscular strength. Bed rest should always be used in association with a certain amount of activity suited to the condition of the person concerned. This may involve simply encouraging him to move, turn and sit up in bed, but might include controlled exercise or even moving of the patient's limbs by the attendant nurse or member of the family. In the nursing of those with fevers, special attention must be paid to giving plenty of fluids.
The fever patient usually loses appetite and needs to be encouraged to eat, and if necessary, must be fed by the nurse. Dryness of the mouth can be helped by the use of suitable mouth washes, or the nurse can cleanse the mouth by a piece of gauze wrapped around the finger.
Profuse sweating may make necessary frequent changes of bedding and night clothes. The patient's skin must be protected against the formation of ulcers. If the sheets are kept dry and free from wrinkles, if alcohol rubs are used and if a suitable powder is applied, the skin is helped greatly. For dry skin baby oil is preferable to any other system of softening. Movement of the joints by the nurse is helpful against stiffening.
People whose temperature gets above 102 degrees need at least three quarts of water a day. If there is vomiting and diarrhea, the amount must be increased by the amount of fluid lost in this way. If patients resist the taking of plain water, they can have fruit juice or vegetable juice, carbonated sweet beverages, milk, soups and similar fluid drinks.
The bowels become less active when there is fever and a person remains long in bed. The choice of a proper technique for getting rid of the waste material from the body is up to the doctor who understands the condition and the nature of the disturbance. He will have to prescribe the cathartic that is to be taken, whether something as strong as the salts or something like mineral oil or other lubricants or perhaps even a soapsuds or water-and-glycerine enema.
The doctor can always prescribe drugs which are known to be valuable in bringing down serious fevers. He can also prescribe sponges with alcohol or tepid water, which do a great deal towards controlling temperature through aiding irradiation of heat from the surface of the body. Cold compresses and ice bags are other types of cooling.
The Attack On Infection
Only a few decades have passed since physicians confronted with cases of many serious infections could only apply a sort of general treatment. This involved putting the patient to bed, stimulating the action of the bowel and kidneys, aiding the action of the heart and controlling the fever with drugs that have a tendency to reduce fevers. Medicine has had for only a few years powerful remedies called "chemotherapeutic" remedies or antibiotic drugs which definitely control the growth of germs or viruses or other organisms in the human body.
The use of drugs to suppress the growth of organisms that damage the human body is one of the greatest accomplishments of modern medicine. Naturally, the drugs must be able to stop the growth of the foreign invader without injuring the sick person. The new drugs attack germs in various ways. Quinine is a fine example of the way in which a drug can attack a single organism since it is practically a pure specific against the plasmodia which cause malaria. Some of the new antibiotic drugs can attack a great number of different germs of many different species. Some chemical substances damage certain cells of the human body and may interfere with their growth. Out of this fact may come, eventually, some new and effective treatment for cancer.
The sulfonamide drugs and the antibiotics act by interfering with the ways in which the germs themselves live. In deciding which drug to use the doctor must know its effects on the patient. For instance, some patients do not react well to penicillin. In other instances the patient's germs have become accustomed to penicillin. Fortunately we now have streptomycin, chloromycetin, aureomycin, terramycin and other antibiotics, for each of which there is a long list of germs which it is capable of attacking successfully. Sometimes the medicine attaches itself to the tissues of the body and the germs cannot attack while the medicine is there. Sometimes the medicine relates itself to the way in which the germ feeds and grows.
The doctor chooses the remedy according to the dose he wants to give, the frequency with which the dose is to be given, whether or not the remedy can be taken by mouth or must be given by injection, whether it needs to be given by injection into the blood, into the muscles or under the skin, or for a number of other reasons.
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