The "dry cure" is the name given to the treatment which consists in withholding fluid from the diet in increasing degree until the patient takes just as little as is necessary to sustain life. If carried to this extreme, however, thirst becomes intolerable, and patients usually rebel against the rigour of such treatment.

Practically it is found that the minimum of water aside from that contained in food which patients can tolerate is about fifteen ounces per diem, which should be taken between meals. For the relief of thirst in these cases various measures are employed, such as are described on p. 43.

In Germany the dry diet has been tried extensively in some cases, especially those of gastric dilatation and cases of chronic effusion into the joints and in the peritoneal cavity. There are many forms of disease in which it is well to temporarily restrict very much the quantity of fluid consumed, but it is hardly ever justifiable to do so to the degree recommended by enthusiastic advocates of the "dry cure," among whose patients fatal cases of scurvy have occurred as well as cases of fever with a temperature sometimes amounting to 1040 F. The conditions in which the quantity of fluid drunk should be especially restricted are gastric dilatation, chronic serous effusions, flatulent dyspepsia due to indulgence in sweets, coffee, tea, etc., some few cases of obesity, and aneurism of the aorta (compare Tufnell's treatment, p. 491).

Schroth's Method

The dry cure of the yeoman John Schroth has achieved some notoriety in Europe, where several "institutes" have been established for its practice. It is a rigorous method which many patients find difficult to endure. The diet is gradually reduced in quantity and variety at first for a few days, and then the actual "cure " is begun, which consists in giving no fluid at all, excepting a small glass of hot wine twice a day for as many days as the patient will endure it. Boiled vegetables are allowed for dinner, and otherwise nothing is given but dry bread. Thirst becomes so extreme that in three or four days the patient is allowed to drink hot wine freely to quench it, after which the quantity of fluid is again cut down to two small glasses a day until the patient is again obliged to receive more.

This treatment has in some cases been carried to the verge of starvation with extreme prostration and fever, and it has little or nothing to recommend it. Even fatal scurvy has followed its use at Kiel. It is based upon the theory that the blood becomes more dense, which favours osmosis between the serum and the surrounding lymph and tissues. As an adjunct to the treatment hot moist packing is employed.

Jürgensen modified the treatment by giving from one third to two thirds of a pound of lean beef with bread as desired, and light red wine. It has been found by this writer and by Bartels that proteid metabolism is undoubtedly increased by the dry diet, for the urine contains nitrogenous waste in as large a proportion as when the patient is upon a full diet - in some cases there is even more than the normal.

Upon slowly resuming the accustomed diet a considerable gain in weight compensates for previous loss, which is attributed in part to restoration of water to the tissues. Bartels noted an increase in urea which was greatest immediately after the treatment. The considerable rise of temperature (1040 F.) which accompanies this treatment is explained by the facts that but little water is evaporated from the lungs and skin, and that the body heat is retained by the hot packs.

The treatment has been applied with some success in obstinate cases of syphilis, gastric dilatation, chronic rheumatism, and chronic peritonitis.