These conditions in children should be treated by very careful regulation of the diet. Parents are apt to be ignorant in regard to this matter, and strict written rules should be furnished to them. Children should be fed at regular intervals at least four times a day, in order that the quantity of food given each time may not be too much. They must not be given acid food, such as pickles, or indigestible substances of any kind, or fruit. Many cases do best when put upon a plain milk diet for several weeks, or, if this is not expedient, peptonised solutions or pancreatinised food may be substituted in part. Other good temporary substitutes for plain milk are buttermilk, whey, and koumiss. Beef broth should not be given exclusively, on account of its occasional tendency to increase diarrhoea. If the stools contain much fat it is an indication that the pancreatic and biliary secretions are deficient, and the use of pan-creatin is then of special service.

These children cannot digest sugars, starches, or fats very thoroughly, although cod-liver oil may be assimilated, and when it is it constitutes a valuable food. It does not necessarily increase diarrhoea, and it may even check it indirectly by improving nutrition.

Among foods which may be allowed to older children as improvement begins are raw oysters, boiled or broiled fresh fish, minced beef and chicken, soft-cooked eggs, soda crackers, bread and milk, toast, thin bread and butter, blancmange, custard, junket, and wine jelly. Sometimes the child continues to emaciate upon a diet of animal broths and meats, and fails to digest either eggs or milk. In such cases pancreatinised mush or some simple cereal, such as barley or rice, may be given with malt extract, and among vegetables which may sometimes be allowed, if diarrhoea has ceased, are asparagus, spinach, stewed celery, cauliflower, and thoroughly baked potatoes with a little salt and butter well mixed.

Hot water should be recommended before meals if the child will take it. It may be given a faint flavour of some spice, such as cinnamon or clove, and whey is an excellent beverage. Some children become very fond of koumiss, but it is expensive unless homemade (p. 82).

Many of these children become strikingly emaciated, and, in spite of all dietetic regimen, the skin is dry and wrinkled, and care should be taken to improve its nutrition. This may be done by tepid baths before bedtime and gentle friction, and by inunctions of three or four drachms of warm melted cacao butter or warm olive oil or cod-liver oil, to be rubbed in over the extremities and parts of the trunk other than the abdomen. In this way little if any nourishment can be rubbed into the circulation, and the main benefit of the inunction consists in improving the condition of the skin by local action, and in preventing excessive heat loss, to which poorly nourished children are prone.

Massage should be given for a quarter of an hour every morning. It may be applied over the entire body, unless there is much diarrhoea, when the abdominal wall should be omitted.