﻿IX, B, 3 Musgrave and Sison: Bacillary Dysentery 251 



though there is a small percentage of patients who recover 

 under this treatment, we should remember that there are cases 

 that get well even without any medical treatment, and we con- 

 sider it problematical whether or not the usual astringents and 

 gastrointestinal antiseptics are really beneficial in the treatment 

 of this disease. We must keep in mind the fact that most of the 

 astringents and so-called intestinal antiseptics, such as, bismuth, 

 tannic acid preparations, salol, beta-naphthol, benzo-naphthol, 

 benzoic acid, and others, have an irritating action upon the 

 stomach and intestines especially if they are given in large 

 amounts and over a considerable period of time. 



The use of the ice bag over the abdomen is a great help in 

 diminishing the abdominal pain, and hot turpentine stupes fre- 

 quently are useful for the same purpose. 



The essential part of the treatment, however, is dietetic. 

 During the first twenty-four hours of the acute stage of the 

 disease food must be withdrawn. Pieces of cracked ice may 

 be given to allay thirst. At the end of twenty-four hours, we 

 allow the patient albumen water or rice or barley water and 

 later skimmed or peptonized milk. When improvement has be- 

 gun, milk, broth, beef juice, and orange juice may be given. 

 The mouth must be frequently cleansed with an antiseptic mouth 

 wash to prevent the frequent complications of parotitis and 

 gastritis. 



The serum treatment, first recommended by Shiga in 1898, has 

 both advantages and disadvantages. If the variety identification 

 of the bacillus which is the cause of the infection can be carried 

 out with readiness, as well as with accuracy, this scientific treat- 

 ment ought to yield a greater percentage of cures than usually 

 is obtained. For practical purposes, however, especially in those 

 cases that have to be treated in places where the means of 

 identifying the infecting microorganism are not available, it is a 

 failure in most instances. The sera of patients suffering from 

 one form of bacillary dysentery usually will not agglutinate 

 other varieties of Bacillus dysenterise. 



It is possible that Flexner's polyvalent serum might be used 

 for any acute bacillary dysentery. However, what we have 

 already mentioned in the discussion of the etiology of dysentery, 

 in regard to the etiologic importance of other microorganisms, 

 such as streptococci, staphylococci, colon bacillus, and others con- 

 cerned in the production of colitis under certain circumstances, 

 will make the use of even a polyvalent serum unsatisfactory in 

 many instances. 



