Meat and warm water diet.— Not infrequently, after the stools have become solid under a carefully regulated pure milk diet, it is found that any attempt to return to ordinary food, or to take anything beyond the most simple farinaceous dishes, is quickly followed by a recurrence of diarrhœa and the familiar flatulent dyspepsia. Such cases are sometimes successfully treated by a complete abandonment of milk, fruit, and farinaceous stuffs for a time, and placing the patient on what is known as the " Salisbury cure." This is a diet consisting only of meat and warm water. Commencing with smaller quantities, in time the allowance of meat is gradually raised to about 3 lb. per diem, taken at equidistant intervals in three or four meals. The meat must be of good quality, free from fat, coarse fibre, and gristle; it may be prepared as mince, or in the form of steak or chop, not too much cooked. Warm water, amounting in all to 4 pints in the twenty-four hours, is drunk before going to bed and on rising in the morning, and also about two hours before meals —never at meals. This course must be persisted in for six weeks, when ordinary food will be gradually attempted again. I have sometimes found it useful in cases of relapsing sprue to make the patient fast systematically one day a week, feeding him on that day with milk only. Sometimes, in cases of active sprue, I have found benefit by intermitting the pure milk diet for a day or two every week, and on these days feeding the patient on minced meat and hot water only.
Nutrient enemata or suppositories.— In all grave cases of sprue nutrient enemata or suppositories should be steadily administered every four or six hours. If tolerated they are most valuable aids to nutrition. It is well, when using them, to wash out the rectum once a day with cold water.
These methods of treatment— followed by a carefully selected and increasing mixed diet, combined with warmth and rest— are in my experience the most successful methods of treating sprue; should they fail, the chances of recovery are poor indeed. Never-
