As regards diet do not give any milk at first, and indeed if the case is
recognized as being one of bacillary dysentery milk should not be given
at all as it tends to favour putrefaction. Albumin water, rice water,
chicken broth are required during the first twenty-four hours. Thereafter
in the amœbic form milk diluted with barley water or with citrate of
soda (three grains to the ounce) can be given. Soups are often useful,
and at a later period custard, arrowroot and jellies are indicated. In
the bacillary type arrowroot, meat and fruit jellies and beef-tea can be
given from the outset. In both types the food should be given in small
quantities frequently, and it should be neither too hot nor too cold.
Alcohol is deleterious.
Fortunately we now have a specific drug for treating amœbic dysentery
and that is emetine, which is the active principle of ipecacuanha. It is
best given in the form of emetine bismuthous iodide, which is supplied
in capsules and the dose of which is three grains per day for twelve
consecutive days. The dose is best given in the evening along with a cup
of hot tea on a full stomach when the patient is in bed. If it causes
much vomiting it is well to give ten or fifteen drops of tincture of
opium before administering the emetine. The latter can also be given
by subcutaneous injection, but this method of treatment should only be
carried out by a physician. Where emetine is not available ipecacuanha
itself may be used and is given as follows:—
_Treatment by Ipecacuanha._—When the bowels have been opened, give twenty
grains of ipecacuanha, either solid or mixed with a wineglass of water,
or less; arrowroot, starch, or gum-water, which will help to suspend the
drug. Of course, ipecacuanha will act more quickly if it can be taken
suspended in a liquid, instead of in the solid form. To prevent vomiting,
put a mustard leaf to the pit of the stomach. Absolute quiet must now
be observed; darken the room, and allow no moving in bed or talking.
Withhold food and liquid for at least two hours if possible, but if there
is much thirst, teaspoonful doses of water may be given.
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