It takes from 10 days to two weeks for this disease to develop. The child-patient feels chilly, tired and weak. He suffers from headache, and loss of appetite, followed by backache and either diarrhoea or constipation. Many patients also have bronchitis, so that in the early stages of typhoid, the disease may appear as pneumonia. The temperature rises and remains high for about 10 days to two weeks. It has tendency to rise in the evening and fall in the morning. Skin eruptions tend to appear in the second week and if proper care is not taken, inflammation of the bones and ulceration of the bowels may occur. The loss of appetite is more apparent. The tongue becomes dry and is coated with white patches in the central region of its surface. The fever gradually comes down to normal by the end of the fourth week.
A complete bed rest and careful nursing is essential for the child-patient. He should be given liquid diet like milk, barley and fruit juices. Orange juice will be especially beneficial. In fact, the exclusive diet of orange juice diluted with warm water can be taken for first few days of the treatment with highly beneficial results. In typhoid fever, the digestive power of the body is seriously hampered, and the patient suffers from blood poisoning called toxaemia. The lack of saliva coats his tongue and often destroys his thirst for water as well as his desire for food. The agreeable flavor of orange juice helps greatly in overcoming these drawbacks. It also gives energy, increases urinary output and promotes body resistance against infections, thereby hastening recovery. If possible, warm-water enema should be given daily during this period to cleanse the bowels.
Cold compresses may be applied to the head in case the temperature rises above 1030F. If this method does not succeed, cold pack may be applied to the whole body. The procedure for this pack has been explained in the appendix.
After the temperature has come down to normal and the tongue has cleared, the child-patient may be given, for further two or three days, fresh fruits and other easily digestible foods. For drinks, unsweetened lemon water or plain water, either hot or cold, may be given. Thereafter, the child-patient may be allowed to gradually embark upon a well-balanced diet according to his age. The emphasis should be on fresh fruits and raw or lightly-cooked vegetables.
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