Dietetic Treatment

In all cases of enteroptosis it is best to diminish the amount of fluids taken, i.e., care must be taken that the patient does not drink water, tea, coffee, or other beverages (beer, wine) in too large quantities (more than eight ounces at a time). Thorough mastication, the avoidance of strongly spiced foods, short rest (one-quarter of an hour) after meals are of benefit. In every case of enteroptosis we must individualize to a large extent in selecting the proper kind of diet. If, as is usually the case, we have to deal with emaciated anaemic persons, we must resort to forced feeding, i.e., we must try to introduce into the body large amounts of nutritive material, so that overnutrition and subsequent increase of tissues result. In these cases it is advisable to have the patients take five to six meals daily. The three principal meals (breakfast, dinner, supper) should be composed of the usual foods. The two or three intermediate meals should consist of milk (eight ounces) and buttered bread (one or two slices). Instead of pure milk, milk with chocolate or coffee, or milk punch, or kumyss, or thick sour milk, etc., may be given.

In regard to the amount of food, I usually tell the patients to eat as much as their neighbors at table, add ing only that the quantity of butter to be consumed daily should be at least one-quarter of a pound. If we have to do with people in a condition of good nutrition, we certainly would not make any change in the quantity of food to which they are accustomed.

If there are marked dyspeptic disturbances, and the state of the stomach in regard to its secretion is known, the diet may be adjusted accordingly. If hyperchlorhydria is present, large amounts of albuminous foods and less of starchy substances ought to be given; whereas in cases of diminished secretion or achylia only a little meat and abundance of the carbohydrates are permissible. The exclusion of a whole group of foodstuffs, either albuminous or starchy substances, is never a wise measure, because we are dealing with conditions lasting a long time, and a diet deficient even in but one of the three chief groups will certainly be deleterious. In cases of enteroptosis with obstinate constipation the so-called laxative foods (fruits, vegetables, salads) play a more important role, while in the presence of a tendency to diarrhoea all fruits and cold drinks must be excluded.

Electricity

Besides static electricity (franklinization) and general faradization, which serve to increase muscular tone, I attach much importance to intragastric electrical treatment. The latter is especially indicated in marked functional disturbances of the gastro-intestinal apparatus. Marked atony of the stomach, as usually present in enteroptosis, is favorably influenced by this treatment. Faradization is most frequently used intragastrically; only in cases of obstinate pains or nausea galvanism seems to be of greater value. This electrical treatment of the stomach contributes materially to the removal of the disturbances of this organ, thus affording a possibility for better nutrition and strengthening of the whole body. It serves, therefore, not only for the relief o' the gastric disturbances, but also indirectly aids in the removal of the enteroptosis.