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PROPHYLAXIS
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cheese, bread, coarse fruit or coarse vegetables, nuts, pickles, and such-like are, as a rule, not well borne. Fruit and fine well-cooked vegetables in moderation are necessary and often beneficial. In obstinate chronic dysentery it is often a good thing to change the diet from slops to solids, from a meagre to a more liberal one. The quantity of food is as important as the quality. Chronic dysenteries should eat no more than suffices to maintain their weight. Large meals must be avoided, and food should not be taken unless there is appetite. Monotony of food should be guarded against. Wonderful results are sometimes got from a sea- voyage.

Hepatitis.—During the whole course of an attack of dysentery, and for months thereafter, the condition of the liver must receive the most careful attention. We may not be able to prevent abscess of this organ; but if pain and swelling seem to suggest it as threatening we can try by means of full and repeated doses of ipecacuanha, emetine, saline aperients, rest, low diet, fomentations, dry cupping, and similar measures to avert what, to say the least, is a very grave complication.

Prophylaxis.—The prophylaxis of dysentery consists principally in securing a pure water supply; in avoiding unwholesome or contaminated food; in searching out and eliminating and sterilizing dysentery carriers, especially those in whose stools encysted amoebae occur; in temperance; in clothing warmly and avoiding chill; in correcting constipation and stopping diarrhœa; and, in public institutions such as gaols and asylums, in regarding dysentery as an infectious and readily communicable disease, in strictly isolating patients suffering from symptoms of colitis, or even looseness of the bowels, and in careful sanitation, directed towards the disposition of fæcal matter and the suppression of house-flies.