1794 



SPRUE AND OTHER DIARRHCEAS 



permanent relief for oesophagitis. The muscular pains may be 

 relieved by massage, or by pilocarpine nitrate, given in — q to i grain 

 doses three times a day. Intestinal pain may be relieved by hot 

 packs, as recommended by Cantlie. Acute diarrhoea must be 

 - checked by a dose of liquor opii sedativus or lead and opium pills. 

 Dysenteric symptoms must be treated as described under Dysentery. 



7. Change of Climate. — It is obvious that, if possible, the patient 

 should be transferred from the tropics to the temperate zone, 

 but only if he is strong enough to travel. There is no advantage 

 in putting him on board a ship in such a condition that he will 

 probably die when changing from the warm to cooler weather. 

 Personally, we are not in favour of a patient being sent from the 

 low country to the hills. If he is able to travel, let him go to the 

 temperate zone. 



Vaccine Treatment. — Vaccines have been prepared with various 

 bacteria from the mouth, and Rogers and Nicholls report very 

 encouraging results by the use of streptococcal vaccines prepared 

 with streptococci isolated from the mouth lesions. MoniHa vaccines 

 have been used by Ashford, Michel, Taylor, and others, who claim 

 satisfactory results. 



Prophylaxis. — Nothing ot any practical value can be said under 

 this heading. 



PSEUDO-SPRUE. 



One of us has called attention to some cases presenting clinical symptoms 

 closely allied to sprue and due to bacilli of the Flexner group. Such cases 

 have no dysenteric symptoms, but present the white frothy motions, the sore 

 tongue, and the anaemia as found in typical sprue, but in contrast to this 

 disease they may recover without any change from the tropics, and a vaccine 

 treatment is very useful. 



Motility. 



Litmus 

 Milk. 



Lactose. 



Saccharose. 



Dulcite. 



Mannite. 



Glucose. 



Maltose. 

 Dextrin. 



Ra-ffinose. 

 Arabinose. 



Adonite. 



Inulin. 



i Sorbite. 



Galactose. 



j Levulose. 



0 



A 



0 



0 



0 



A 



A 



t 



A ' A 



! 



A A 



0 



0 



0 





A 





1 Inosite. 



Salicin. 



Amygdalin. 



Isodulcite. 



Erythrite. 



Glycerine. 



Indol. 



Voges- 

 Prosk. 



Redn. 

 Nitrates. 



Neutral 

 Red. 



Gram. 



Gelatine. 



Serum. 



Broth. 



Pept. 

 Water. 



0 



0 



0 



A 



0 



As* 



+ s 



0 



0 



0 



0 



0 



0 



G.T. 



G.T. 



Abbreviations. — A, acid; G.T., general turbidity; s, slight; o, negative 

 result— viz., neither acid nor gas in sugar media, non-motile, non-liquefaction 

 of gelatine or serum, as the case may be. 



* Certain strains are distinctly acid on ninth day. 



