1792 



SPRUE AND OTHER DlARRHCEAS 



to advance views as to its action, but in a certain class of cases it 

 is of benefit. Secondly, gall-pills or inspissated bile, as suggested 

 by C. J. Martin, and pancreatic preparations have been advocated 

 by some; but of these we have no experience. 



(b) Milk and Fruit Diet. — A milk and fruit diet has been found 

 to be even better than a pure milk diet in many cases. The milk 

 is administered as already described, but, in addition, fruit is given. 

 Strawberries are most highly recommended, beginning with | pound 

 and gradually increasing to 2 J pounds per diem. They should be 

 crushed, and eaten with sugar and cream. In lieu of strawberries, 

 bananas (not plantains, though people often call bananas plantains, 

 the difference being that a banana shows three cells on transverse 

 section and a plantain five), pears, grapes, in the same weight as 

 the strawberries or apples, from J pound to ii pounds per diem. 

 If these cannot be obtained, the juice of oranges, papaya (i J pounds 

 per diem), avocado pears, mangosteens, and sapodilla, may be used. 



Fresh Bael fruit is excellent, but must be carefully prepared. It 

 may be boiled in water and then cut open and shredded by means 

 of a fork into warm milk, in which it is pounded with castor-sugar, 

 and finally strained through a fine strainer to remove all debris. 

 This should be used three times a day. Preserved fruit is said 

 to be useful, if fresh fruit cannot be obtained. Acid fruits, such as 

 pineapples and sour-sops, should be avoided, and, personally, we 

 do not advise the use of mangoes. 



[c) Fruit Diet. — This was first advocated by Van der Burg, and usually 

 consists of grapes and pears ; but it appears as though almost any fruit which 

 is not acid might be used. 



{d) Meat Diet. — If the milk or fruit diets fail, it is advisable to try a meat 

 diet, or this may be made the basis of treatment from the beginning. Cantlie 

 is the great supporter of this dietary. 



If the patient is very ill, it may be necessary to begin with raw-meat juice 

 prepared by pounding sufficient good raw flesh in a mortar, so that, with the 

 addition of 2 ounces of water and 20 minims of dilute hydrochloric acid, 

 6 ounces of meat-juice is obtained on straining. The quantity of meat re- 

 quired to obtain these 6 ounces will sometimes be quite considerable, and, as 

 it varies in different regions, must be obtained by preliminary experiment. A 

 little salt should be added to this juice, and i teaspoonful should be given 

 every quarter of an hour in very bad cases, and rapidly increased in amount 

 if successful. 



As soon as the very serious symptoms subside, the meat diet should be 

 started. Brown gives the following directions for preparing a meat diet: 

 Take 2 pounds of good raw meat, free from fibrous matter, fat, and gristle, 

 and 2 ounces of fresh suet, and mince and pound them up thoroughly. 

 Sprinkle the pounded mass with a little salt, and divide into six portions. One 

 portion, cooked in a small, well-buttered saucepan until the red colour has 

 just disappeared, is given six times a day, as convenient. This portion. When 

 cooked, is estimated as weighing 4 ounces. In addition, ^ pint of plain warm 

 water, rice or toast water, is sipped half an hour before a meat meal, and a 

 little tea, with lemon-juice instead of milk, taken twice daily. It may, perhaps, 

 be as well to remind the reader that rice-water is an infusion of roasted rice. 



In about a week this meat diet should be changed to a modified meat diet, 

 which is first produced by the addition of fruit, followed in a little time by 

 chicken, then and gradually by eggs, biscuits, and fish, until the dietary 

 already mentioned under Milk is reached. 



With a modified meat diet some people combine curdled milk. This is 



