DIETETIC AND GENERAL MANAGEMENT.
IN adults the dietary suitable for an attack of English cholera is the same as that for the Asiatic kind. That is to say, during the first hours nothing but plain water need be given. If there is much collapse it should be given hot, but if there is not it must be taken cold. Only small quantities should be given at a time. When the acuteness of the attack is over, milk and soda-water, Whey Koumiss No. 3. or infants’ foods may be given until the powers of digestion renew themselves.
All soups and beef-teas should be avoided, as they have a relaxing tendency. The addition of isinglass, however, helps to correct their relaxing properties, and in cases of great exhaustion they may be given with this added. They are better given cold, in the jelly form, one or two teaspoonfuls at a time. All hot drinks excite the action of the bowels. During convalesence mutton broth or chicken-tea may be given, and beef- tea when the looseness has entirely passed away. Plain water arrowroot with a teaspoonful of brandy in it has binding proper- ties; and white of egg beaten up into a froth, and slightly flavoured with lemon and sweetened with a little loaf sugar, is a most excellent form of nourishment in cases of diarrhoea.
In the case of children no definite line of treatment can be laid down. If one kind of food does not suit a particular child, another must be tried. Carnrick’s, Mellin’s, Allen & Hanbury’s’, Nestle’s, are all good, and may be tried when breast milk or cow’s milk is not tolerated. A very useful substitute for breast milk is the Aylesbury Dairy Co.’s Artificial Human Milk, which I have known to agree when all other kinds have failed. But it must not be forgotten that a child will take no harm if it goes without all food for 12 hours or more, and is given only water.
In many cases of infant cholera the frequent administration of teaspoonfuls of water is the very best “food” the patient can have, until the signs of irritation have subsided.
Of no less importance than the question of diet is that of air. Plenty of fresh air is an essential requisite. An airy room that is exposed to sunlight during some part of the day is one of the best aids to recovery, either of the infant or the adult. If there is great coldness, warmth must be supplied by means of hot bottles and hot flannels. The clothing must be warm but not heavy, and woollen materials are the best. Absolute rest in the recumbent position is necessary in all cases.