In no other disease is it more necessary to enforce the principles of physiological rest together with an adequate supply of digestible non-irritating food than in sprue. The patients, as a rule, are wasted and anaemic, the mucosa of the alimentary canal from mouth to anus is inflamed, eroded in places and exquisitively sensitive, the stomach and intestine are distended with gas, the glandular and absorbing tissues of the bowels are inflamed and perhaps partially destroyed, the muscular coats are wasted, the liver small, and the pancreatic and biliary ducts are catarrhal; whilst the stools are pale, phenomenally abundant, fermenting, loaded with fat globules and air bubbles, and usually loose and frequent, especially so in the morning and early forenoon.
The disease is very persistent and generally progressive and, unless arrested or cured, will terminate sooner or later in death by inanition, even if no secondary infection supervene.
Experience has shown that drugs play an insignificant part in the management of this disease, which as regards the European is one of the commonest and most fatal of tropical maladies. Its etiology is unknown. The specific germ, if there be one, has not been recognized, nor has any remedy which might be regarded as specific been discovered. Drugs, therefore, play a very secondary role in its management; nevertheless, if properly taken in hand and at a stage sufficiently early and before the digestive apparatus has been hopelessly destroyed, and if the patient is otherwise of sound constitution and under fifty years of age, much may be effected by proper treatment.
Various methods of dieting have been advocated and are used either singly or in combination. They may be classified as follows : -
I. The milk diet.
II. The meat diet.
III. The fruit diet.
IV. The mixed diet.