Page:Tropical Diseases.djvu/609

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XXXII]
TREATMENT
563

of great service, especially when an alcoholic stimulant is indicated.

Fruit treatment.— The value of fruit in the treatment of sprue and other forms of intestinal disease has long been recognized by a limited number of practitioners, particularly abroad. It is only lately that it has obtained any hold on medical opinion in England. I have long been in the habit of prescribing bananas and apples, tentatively of course, in these cases, and often with marked success. Of late repeated trials of the strawberry in sprue have confirmed me in my belief in the value of the fruit treatment, and in the strawberry treatment in particular. The plan I follow is to give one or two strawberries with each feed of milk, and, if found to agree, to increase the number gradually until 2 to 3 lb. are taken daily. Preserved fruits, particularly peaches and pears, make suitable substitutes if strawberries or bananas are not obtainable. The bael fruit or Bengal quince (Ægle marmelos), introduced by Fayrer in the treatment of this disease, seems to exert a very beneficial effect in the countries (Ceylon and India) where it can be procured in a fresh state. Extracts, such as those sold in this country, appear to be inert. The ripe fruit should be scraped out of the hard exterior shell, and eaten raw with sugar and cream. Two or three fruits, depending on their size, may be given every day.

Treatment with meat juice and underdone meat.— Occasionally symptoms persist or become aggravated under this system of treatment, and one is forced to conclude that milk does not suit the patient. In such cases raw-meat juice will often prove an efficient substitute. The juice of 4 or 5 lb. of fresh lean meat, and a little water to allay thirst, may be taken in small quantities at short intervals daily. After a time, when the stools are reduced in number and quantity, although perhaps not quite solid, scraped meat, or very much underdone meat, and by and by a little charred toast, a plain rusk or biscuit, and so forth, may be gradually added to the diet.