Hot salt solution may be given by enema or hypodermoclysis, perhaps with dextrose added to the salt solution, may be employed.

During convalescence, the diet should be carefully regulated and a middle course should be steered between a vegetable diet which yields irritating residue and one too closely confined to meat, eggs and milk, which favors intestinal saprophytosis and thus, indirectly, hepatic abscess. Even when amoebae are found in the bowel and in the hepatic abscess, they probably cause the latter only by carrying colon bacilli and other more or less dis-tinctly pyogenic bacteria. Eggs, custards, gelatin preparations, rice and other fine cereals, blanc mange, arrowroot, tapioca, and such meats as steak, roast beef, broiled lamb chop, fresh fish may be used. Moderate quantities of lemon, orange, lime and pineapple juice should be given, but not fruit itself nor any notable quantity of butter, cream, or any other fatty food.

Amoebic dysentery of the more chronic, wasting grade, is attended with marked anaemia, and requires iron in some form, hence, meat, blood if it is well borne, or bovinine, should be given. Otherwise, the diet should be easily digested and nourishing and should be about as for early convalescence from typhoid and other fevers in which the intestine is involved. Predigestion will be required in the majority of cases and the concomitant administration of the vegetable ferments, not only to digest the food but to aid in removal of stringy mucus and possibly, to exert an unfavorable influence on the parasites, is indicated. Inunction and hypodermatic nutrition may be employed.

Acute Colitis of temperate climates is ordinarily regarded as an infection with the colon bacillus or with various bacteria, not specific, more or less permanently denizens of the intestine. It is thus due, both directly and indirectly through irritation of the intestine, to putrefying food and indirectly to various causes of intestinal indigestion. According to one view, it differs from cholera nostras, only in the part of the bowel affected, and is due, like cholera nostras, to one strain of true dysentry bacillus.

The dietetic treatment is similar to that of tropical dysentery but, on account of the generally less severe grade of the disease, there is less urgency as to nutrition and greater indication for cathartic treatment at the beginning and abstinence from food for several days. The diet then instituted should be about as for convalescence from typhoid.

Chronic Colitis may develop on account of portal obstruction, or without these elements, it may occur as the result of repeated saprophytosis due to a diet rich in putrescible proteins, to the continued use of tainted meats etc., while constipation is both an effect and a cause. The colon may become dilated, and paralytic. In some way, coffee used to excess, seems to be a cause. Chronic colitis may also follow the acute forms, including the various forms of dysentery and may be distinctly of toxic origin, as from lead, arsenic etc. The constipation of chronic colitis is apt to be interrupted by periodic diarrhoea, when considerable mucus is discharged, either as slimy masses, as strings or as casts, which are rarely true exfoliations of epithelium. Some consider mucus colitis to be a neurosis but it should be remembered that nowhere else is the discharge of mucus regarded as analogous to a neurotic supersecretion, that the analogy drawn to true secreting glands is not well taken and that the general neurotic symptoms are readily explained as the result of the organic process, there being no good evidence that the so-called neurosis antedates the lesion.

It is usually taught that the dietetic management of such cases demands the avoidance of vegetables with indigestible cellulose and the use of foods as perfectly as possible, digestible in the stomach and small intestine. Such a diet has just been descril>ed for convalescence from dvsenteries and acute colitis.

Recently it has been advocated to administer foods rich in indigestible material, as coarse meals, cracked corn, etc., with the idea of mechanically removing mucus and stimulating local blood supply.

The proper course seems to be midway between these extremes. There seems to be no question that corn, apple scales, grape seeds etc., may increase the inflammation mechanically. On the other hand, the finer, chaffy residue of whole wheat, and the soft cellular net work of green vegetables can not produce mechanic injury but may serve a useful purpose in gently sweeping mucus from the bowel wall. Again, foods rich in protein and especially meat and eggs and even milk curds, are prone to putrefy and serve as a pabulum for the colon bacillus and allied germs. On the other hand, the fermentation of cellulose favors the development of antagonistic bacteria and, if not carried to an extreme may thus do good. Fats and oils are commonly described as healing to the bowel but it should be remembered that the substances produced from them both by digestion and by bacterial action, are irritating.

Thus, the most appropriate diet is nearly vegetarian, with moderate quantities of milk, eggs and small quantities of meat, which should he absolutely untainted. There seems to be no objection to the occasional use of tender boiled ham, dried salt cod fish and even other preserved meats. The vegetable foods should include the cereals and bread stuffs, with avoidance of hot biscuits, pie crust etc., and soft, well divided fresh vegetables, especially in the form of purees. Even cauliflower, lettuce, creamed asparagus, peas and green and lima beans may be allowed. If starch digestion by the pancreas is good, bananas may be used. Fresh and stewed fruits, excepting those containing seeds, as raspberries and blackberries, may be used. Grapes should be seeded before swallowing. Sugar should be allowed in small quantities only. Butter and cream should be allowed in reasonable quantities but an excess of fats - say over 50 grams - should not be given. If necessary, fats may be administered by inunction. The olive oil treatment should not be followed but it may be allowed to mention the advantage of purpetrol, which is not changed by digestive or bacterial processes and which maintains its oily, soothing character throughout the intestinal canal. Owing to their possible constipating action, tea and coffee should be allowed in very small quantities and alcoholics should be given only as indicated to stimulate gastric digestion.

The insurance of proper gastric digestion is important.