TREA TMENT 



1793 



based upon Metchnikoff's researches, which showed that if the Bacillus acidi 

 lactici is taken with milk, it generates large quantities of lactic acid in the 

 intestines, particularly in the large bowel, and that this acid interferes with 

 intestinal toxins. Various preparations of the germ have been placed on 

 the market, including ' Sauerin ' made by Messrs. Allen and Hanbury, and 

 said to be a pure culture of the germ. Brown gives the following directions 

 for its use: 2 pints of milk are heated to 160° F., to kill off any bacteria which 

 might happen to be present, and then are allowed to cool in a jug which has 

 been boiled. When 100° F. is reached, 6 tablets of Sauerin are added, and 

 2 tablespoonfuls of sugar, when the milk is curdled in about three hours. 

 This curdled milk is taken four times a day, between the meals of a modified 

 meat diet, and is said to be efficacious. 



It may be mentioned that curdled buffalo-milk is commonly used by the 

 natives of Ceylon as a part of their food, and curdled milk is also used in 

 India, and, indeed, in many other places by natives. 



Under the heading of Meat Diets must be placed Cantlie's treatment, which 

 consists of putting the patient to bed, applying a hot wet pack from the nipples 

 to the groin for two hours, morning and evening, and giving three meals of 

 5 ounces of meat per diem, and, in addition, either beef-tea, beef-jelly, 

 calves'-foot jelly, or a plain jelly every two hours. Castor oil is administered 

 in i|-drachm doses every morning for the first three days, and santonin in 

 3-grain doses morning and evening for three days. Strawberries, to the 

 quantity of 3 to 4 pounds per diem, are also allowed between meals. When 

 the stools become solid, and show brown colouring matter, a poached egg and 

 pounded chicken are added, and, later, minced chicken, and, still later, the 

 undercut of meat, with stewed celery, seakale, vegetable-marrow, pulled bread, 

 and thin slices of bread, baked in an oven for twenty minutes. 



{e) Meat and Milk Diet. — Cantlie now advocates that when a patient is 

 on a meat diet, this should be stopped every third or fourth day for twenty- 

 four hours, and that milk only be given during this period. 



6. Medical Treatment.— It may be said at once that astrin- 

 gents as a rule are dangerous, and that antiseptics are not useful. 



Santonin, which must be yellow, has been strongly recommended by Begg, 

 who gives 5 grains night and morning in salad oil ; but we have seen no benefit 

 by ttus treatment. Mixtures containing bicarbonate of soda are often useful. 



People complain that yellow santonin cannot be obtained, but it can be 

 easily prepared from white santonin by exposure to the sun for a few days. 

 The crystals are turned from time to time until yellow throughout, as demon- 

 strated by crushing. The chromosantonin of Monte-Martini is not santonin, 

 which, according to Lestini, is changed into formic acid and photosantonin 

 acid and a red resinous substance. Peter Sys's remedy, which is much used 

 in China, is simply powdered cuttle-fish bone, 



Cantlie has had good results by the administration of 20 grains of ipeca- 

 cuanha daily for two or three days in advanced cases, and emetin has been 

 administered by several authors. Schmidt has used oxygen introduced per 

 rectvim, J to i litre weekly. 



Castellani has obtained in some cases a remarkable improvement by giving 

 massive doses of bicarbonate of soda. 



The mouth may be treated with any appropriate mouth-wash — 

 glyco-thymoline, glycerine and borax, diluted liquor aluminis, 

 etc. The teeth require attention, and, if there is any pyorrhoea, 

 this should at once be treated by syringing or spraying between 

 the teeth with peroxide of hydrogen solution. Pain may be re- 

 lieved by painting the raw surfaces with i to 5 per cent, solution of 

 cocaine, novocain, alypin, or stovain. The pain along the oesopha- 

 gus requires morphia. Janowski recommends 5 to 10 drops of a solu- 

 tion of I in ijOOO adrenalin, which, he says, gives prompt and 



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