BACILLARY DYSENTERY 201 



cotton-woo! instead of sanitary paper should be used. Stools to be 

 saved for physician's inspection. Protection of stools from flies. 



Disinfection of stools with carbolic acid. 



Give castor oil 5ss with opium tincture, 10 minims; much opium 

 causes constipation and distension of gut and flatus. 



In a few hours give astringents : — 



^ Bismuth salicylate gi- v 



Salol gr. V 



In cachets two-hourly at first. 



High rectal enema, boric acid i in 500; normal saline gr. v to 51 

 are well borne in mild cases. 



In severer cases give a polyvalent or other serum (Shiga) as soon 

 as possible. 



(i) In mild cases 10 c.c. only. 



(2) In medium cases 10 c.c. twice, six hours between. 



(3) In severe cases 10 c.c. twice daily for three days, or 40-80 c.c. 

 intravenously first day, 60 c.c. second day, 60 c.c. third day. 



This hastens the cure, ameliorates the symptoms, and reduces the 

 mortality. 



In connection with the rapid preparation of serum. Professor 

 Flexner has hastened the process considerably. In summarizing his 

 work, he says : — 



Antidvsenteric serum can be safely prepared in the horse by the 

 method of three successive intravenous injections of living cultures 

 with intervening rest periods of seven days. 



When this method of immunization is employed, the specific anti- 

 bodies responsible for agglutination and protection appear early and 

 rise rapidly. 



By inoculating alternately living dysentery bacilli belonging to 

 the Shiq-a and Flexner groups a polyvalent serum of high titre may 

 be prepared. 



A polyvalent serum so produced should be suitable for the thera- 

 peutic treatment of acute bacillary dysentery, irrespective of the 

 particular strain or strains of the dysentery bacillus causing the 

 infection. 



An effective antidvsenteric serum suitable for therapeutic employ- 

 ment in man can be prepared in the horse in about ten weeks. 



Calcium chloride or lactate gr. 15 to gr. 30 is good. 



Salines are useful, especiallv when sera are not available or are 

 not very successful. Stop on the third da^- if no impriivement, other- 

 wise continue : — 



5; Mag. sulph oil 



Sod. sulph. ... ... ... 5ii 



Aqua. ad. ... ... ... ,5! 



5i two hourly until two days after motions are feculent. 



