A discovery of the cause often gives a clear indication of the method which should be adopted in the treatment. When it is known that the ailment arises from the consumption of some article of food, the sooner the irritating cause is removed the better it will be for the patient and the more rapidly the disease will abate. Sometimes the only treatment required for an attack of diarrhea is a dose of castor oil, tincture of rhubarb, or other homely remedy to clear out the offending material. The patient may raise an objection to such treatment on the ground that she has already suffered from more than enough pain and purging. It may be sufficient to assure the patient of the correctness of this treatment when we say that, unless this method be adopted, some remnants of the irritating substance will probably remain in her interior and cause trouble for days or a week; whereas the administration of a proper aperient will bring speedy relief. A "proper" aperient for such a case is one which has a twofold action - a primary aperient effect, and a secondary astringent effect, such as rhubarb, castor oil, and a few other drugs. The same remedies are sometimes administered to infants and young children; but it has become the custom during late years to wash out the alimentary canal of infants daily, during an attack of diarrhea, with warm boracic lotion; thus removing decomposing foods and bacteria, and at the same time soothing the irritable mucous membrane.

If the patient is prostrated by pain and purging, she should be put to bed, and have some warm applications applied to the abdomen and feet. A dose of brandy or sloe gin, one ounce in some hot water, may now be given; a single dose will often stop diarrhea. There is no doubt about the efficacy of these remedies. Gin contains several aromatic carminatives, and brandy various ethers, besides the alcohol, which check abdominal pain, moderate the irregular and violent movements of the bowels, prevent cramp, and incidentally improve the general condition by removing lowness and depression.

The kind of food and its administration has to be carefully considered. In many cases it is advisable to withhold all food for a day or two. It is better to give the stomach and bowels a rest, so that the acute inflammatory or catarrhal condition may subside; this will take place speedily, providing the irritation is not kept up by the presence of food. There are, however, very few people who have the moral courage to go without food, if they can take it and keep it down. Moreover, there are some foods which are obviously useful in checking the diarrhea. These are preparations of starch - such as arrowroot or cornflour (cornstarch) - and albumen, of which the best and handiest example is the white of eggs. A cupful of milk, thickened with arrowroot or cornflour, flavoured with nutmeg or cinnamon, a little sugar, and the white of a raw egg stirred into it when it is about to be eaten, makes an admirable food for most cases of diarrhea.

In more severe cases it would obviously be impossible for the patient to consume so much as a cupful of milk and arrowroot at one time. We must treat such patients in much the same way as that described for acute gastritis. Begin by giving only a few spoonfuls of milk and barley-water, milk and lime-water, milk and arrowroot, isinglass jelly,' white of egg and lemon-water, ordinary whey, alum whey, tamarind whey, albulactin or glaxo dissolved in water or whey, etc. Barley-water being added to the milk prevents the formation of curds and assists in allaying the irritation. Lime-water has a similar effect; moreover, it checks muscular action in a manner similar to chalk mixtures, it neutralizes the organic acids which irritate the mucous membrane, and produces an insoluble soap which it is hoped may form a thin pellicle over the mucous membrane and protect it from irritation. Citrate of soda prevents the formation of curds in milk. Albulactin and glaxo are protein foods which do not form curds. Alum whey is astringent, and therefore tends to bind the bowels while affording the patient nutriment. It should, of course, be understood that the smaller the amount of food taken the more often it must be taken. A teaspoonful of milk every five minutes would only amount to 36 ounces in twenty-four hours. But under such treatment the vomiting will cease, and as the symptoms abate a larger amount of the same kinds of food may be given. But we must proceed cautiously. If an acute catarrhal or inflammatory condition of the bowels exists, as frequently happens in diarrhea, we must avoid giving much carbohydrate food for a time, owing to the tendency of such materials to undergo fermentation. When carbohydrates are given in such cases they should be peptonized or semi-digested - e.g., Benger's food. It is, perhaps, better to keep such patients entirely on protein foods for a time, and milk is by far the best; the formation of curd being prevented as before by adding citrate of soda, lime-water, or barley-water. Junket may be given freely because the milk is already coagulated, and it is improbable that such milk will form hard curds in the stomach. Custard may also be given if eggs do not disagree with the patient, and later on poached egg and toast. Jellies are useful. By and by we may allow some light broth made of veal, mutton, or chicken, but we must prohibit the use of beef-tea, meat extracts, and the proprietary essences of meat for some time, because they irritate the bowels and often cause diarrhea.

If the diarrhea has been due to the consumption of animal foods which were unfit for use, tinned meat, fish, pastes, meat-pies, etc., as in ptomaine poisoning, the best diet is a combination of milk and carbohydrates. The milk may have some rice boiled in it (rice-milk), or it may be thickened with arrowroot, cornflour, Benger's, Savory and Moore's, Neave's, or other farinaceous foods. The white of one egg can be given two or three times a day mixed in such foods, and the addition of nutmeg or cinnamon powder will not only give flavour, but carminative properties to the diet. Sometimes milk really disagrees with such patients. It may then be replaced partly by Sanatogen or Plasmon, Albulactin or Glaxo, and some rice or sago may be cooked in water until it is a jelly and eaten with cream. Such patients may also be allowed some of the least irritating meat preparations, as chicken or mutton broth, thickened with baked flour or arrowroot, Plasmon beef jelly, Brand's essence of beef, and Mosquera's beef jelly.

When the diarrhea is passing off the return to ordinary diet should be gradual. A little clear soup or broth with a slice of toast may form an early meal; this may be followed by some jelly, custard, rice pudding, or blancmange. On the following day sole, plaice, and a mashed potato may be taken; and the next day some boiled mutton or fowl. But the patient must beware of hurry; the old rule of festina lente should not be broken. For some time the appetite should be restrained, especially for uncooked fruit and vegetables, brown bread, pastry, pickles, and other articles which are likely to irritate the tender mucous membrane. An unsuitable diet might transform a simple diarrhea into a chronic enteric catarrh.

The above is an outline of the treatment of diarrhea in general. It is not necessary to say much about special forms of the disease. When diarrhea affects the residents of hot countries they should retire to bed and have only a milk diet, for a diarrhea which appears to be simple may be of a specific character. If it is of the nature of cholera the treatment required is that for diarrhea of bacterial origin. The vomiting may be checked by ice, ice-water, effervescing draughts, champagne, or brandy and soda. At first the diet should consist of whey (alum whey, tamarind whey), buttermilk, kephir, cocoanut milk. If these things are not at hand ordinary milk and citrate of soda or lime-water may be given. White of egg and lemon-water will assist in checking the sickness and at the same time introduce some food. The use of beef-tea and meat extracts is forbidden, but the stimulating effects of creatin (one of the substances in extract of meat) may be advantageous when the patient is collapsed; in such cases some Brand's essence, Valentine's meat juice, or Bovinine may be given. The condition of collapse may also be met by brandy and other stimulants, drugs, and saline injections into the armpits or other subcutaneous tissues. Various other aids to recovery may be employed, such as a mustard plaster over the heart or epigastrium, a warm application to the abdomen, and the entire body may be wrapped in blankets. As soon as the sickness is overcome the diet should be the same as for ordinary diarrhea, especially diluted milk, junket, arrowroot, barley water, and the white of eggs.

In the acute stage of dysentery the treatment should be similar to that for diarrhea. If there is much vomiting all foods should be avoided, except white of egg and lemon-water, barley-water, buttermilk or whey. When vomiting is overcome or absent, the food may consist of milk, junket, custard, thin arrowroot, Benger's food, blancmange, jelly, isinglass and milk, raw eggs, decoction of iceland moss, and other foods having a soothing or non-irritant character. All soups, broths, and meat extracts should be prohibited. Stimulants are usually required in the early stages of the disease, and brandy is probably the best form; later on some red wine, especially whortleberry wine, may be beneficial. Asylum dysentery requires similar treatment.

If diarrhea occurs during the course of some other disease, such as peritonitis, it is better not to give any food by the mouth for about twenty-four hours. If, however, it seems desirable to give anything at all it should consist of ice and a quarter of a teaspoonful of Valentine's meat juice, or half a spoonful of Brand's essence or Beef Plasmon, in alternation with albumin-water. When the vomiting ceases, or is absent, we may give in addition a few spoonfuls of junket, custard, jelly, or even milk and citrate of soda every few minutes, and as improvement occurs build up the dietary in the same way as for other forms of diarrhea.