In this disease the dietetic indications are to maintain strength, avoid irritation of the kidneys, and promote elimination by the various emunctories. Special difficulty in feeding is encountered in many cases because of stupor or delirium. As in all diseases in which temperature ranges high, the ability of the digestive organs to do their work is lessened. Food should, therefore, be given in a form in which it is easily digested. Milk is the best food to depend upon. From one and one-half to two pints should be given daily. It is well to give also bouillon, or, better, meat-juice. These often prove more grateful when taken cold than hot. If they are slightly acidulated with lemon, they are better liked by the patient. An agreeable and nutritious drink can also be prepared by whipping up an egg in lemonade. This is best given in the milder cases and especially to those who do not have albuminuria. Gruels may be substituted for part of the milk, and may be given especially to those persons who do not tolerate milk. Milk, bouillon, gruels, and custards form the staples of diet. During the period of pyrexia all food should be given in small portions and often. In this way it is least likely to overtax the stomach.

Drinks are craved and should be given freely. They may consist, in addition to the liquid foods just mentioned, of water and acidulated or carbonated waters. Copious drafts of fluid promote a healthier metabolism and aid in the dilution and elimination of toxins. Liquid foods and bland drinks will avert, so far as one can avert such accidents, irritation of the kidneys or serious permanent lesions of these organs.

After crisis, semiliquid food may be given, and in one or two days, solid foods. In mild cases soft foods, meat jellies, soft-cooked eggs, corn-starch, and similar bland articles may be administered during the entire course of the disease. In some severe cases anorexia makes feeding extremely difficult. Stomach-feeding must sometimes be supplemented for a few days by rectal feeding. Great care should be taken in these cases that a sufficient amount of water is absorbed to keep the kidneys acting, and the toxins well diluted.

Alcohol is needed only in exceptional cases. What has already been said of its indications and counterindications must be borne in mind.

Too much emphasis cannot be placed on diet in dysentery. Dietetic treatment will effect a cure in mild cases and diminish the gravity and duration of severe ones. Errors in feeding are a frequent source of relapses and exacerbations. During the first day or two, when the stomach is extremely irritable, it is often well to give little or no food. At this time it is important to empty and cleanse the bowel, which cannot be accomplished well if food is given persistently. But it soon becomes necessary to administer food both in order to maintain the patient's strength and to lessen his feeling of hunger. So far as possible food should be such as will leave little residue in the lower bowel to putrefy and to irritate it. An exclusive diet of milk is generally recommended. If the stomach as well as the intestine is irritable, it must be given in small amounts frequently. An exclusive milk diet is as useful in chronic dysentery as in the acute form of the disease; but rarely need be enforced, however, except during acute exacerbations.

When a diet consisting exclusively of milk cannot be maintained, it may be varied by administering bouillons, meat-juices, clam broth, soft-cooked or raw eggs, and fish. Beef-tea, homemade beef-juice, or the meat-juices of the shops, such as Valentine's or Wyeths, may be given advantageously in alternation with milk. For those who cannot tolerate milk, beefjuice must be used as the main article of diet. About one quart should be given daily whenever it is possible. In severe cases this can best be accomplished by giving two or three teaspoonfuls every ten or twenty minutes. Both milk and beef-tea or meat-juices can be made more nutritious by sometimes adding an egg to them. In mild cases the patient will tolerate and be benefited by the use of shredded fish - as, for instance, salt codfish - or a boiled fresh fish. A soft-boiled or poached egg can often be given without harm, and it will be relished. During beginning convalescence, and in chronic cases during periods of remission, oysters, or a squab, or a little of the breast of young chicken, may be given, and, later, when recovery seems most certain, finely chopped or scraped beef entirely free from fat and, as far as possible, from fibrous tissue. When a more varied diet is craved, farinaceous foods must be allowed very sparingly. Gelatin jellies and custards will give some variety. Bread can safely be given in the mildest cases only; nor should it be given at first until after it has been thoroughly dried. Zwieback and pulled bread are the best kinds.

Demulcent drinks, such as barley-water, rice-water, weak tea, and albumin water, are often grateful to patients and slightly nutritious. In chronic cases, when emaciation is considerable, inunctions of olive oil and of cod-liver oil may be resorted to, as aids to the maintenance of strength and restoration of flesh.