Page:Tropical Diseases.djvu/607

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XXXII]
TREATMENT
561

at most are allowed in the twenty-four hours, small quantities being given every hour or every two hours. When the patient is very weak the feeding must be continued during the night. The milk should not be drunk, but sipped with a teaspoon, or taken through a straw or fine glass tube, or from a child's feeding-bottle. As a rule, on this regimen, in the course of two or three days, the patient's condition is very much improved. The stools have increased in consistency— are solid perhaps, the distension of the abdomen has subsided, dyspeptic symptoms have vanished, and the mouth is much less tender and less inflamed. The quantity of milk should now be increased at the rate of half a pint a day or every second day, until 100 oz., or thereabouts, are taken in the twenty-four hours. It is well to keep at this quantity for ten days at least, when, everything going well, a gradual increase to 6 or 7 pints may be sanctioned. Up to this point the patient should keep in bed; but when he has reached this quantity he may get up and, if he feels strong enough and the weather is mild, go out of doors. For six weeks, dating from the time the stools become solid and the mouth free from irritation, no other food or drink whatever should be permitted. A raw egg, if it is found to agree, may now be added to the milk; later, some artificial malted food; next, small quantities of well-boiled arrowroot, rusks, pulled bread, thin bread (stale) and butter, or other digestible form of starchy food; later still, chicken broth, a little fruit; and, by and by, fish and chicken may be gradually introduced.

Importance of prompt treatment of threatened relapses.— Should, however, the slightest sign of dyspepsia or flatulence, especially of diarrhœa, or of sore mouth show itself, then the extra food must be discontinued immediately, a dose of compound rhubarb powder or castor oil administered, and the patient be sent back to bed and placed once more at absolute rest and on a pure milk diet. In convalescents, no matter how long the acute symptoms have been in abeyance, this prompt recognition and treatment of