In the use of serum Shiga recommends a dose of 10 cc. for a mild case or two injections of 10 cc. at intervals of ten hours for cases of medium severity, while in very toxic cases he uses 60 cc. in 3 daily doses of 20 cc. each. It is important to use serum early as it has little or no effect if used after the 7th day (Klein).
The best known sera are those of Shiga, Dopter and that prepared by the Lister Institute.
Animal charcoal and bolus alba are considered of value by some physicians. Opium should be avoided. Intravenous saline injections are of value in cases showing collapse signs. Again, such cases, from the standpoint of possible adrenal insufficiency, may be helped by adrenalin. Where there is a very small rapid pulse with marked cardiac weakness injections of camphor in oil may be of value.
Subcutaneous injections of ordinary or hypertonic saline containing about 10 drops of 1 to 1000 adrenalin solution is of value in collapse.
Ross considers opium as of value in dysentery and states that he regards ipecac as of value not only in amoebic but in bacillary dysentery as well. I have often given salol-coated pills containing 1 grain of ipecac and ⅙ grain of calomel every two hours to cases of bacillary dysentery with apparent benefit.
For the diet of cases of acute bacillary dysentery albumin water or barley water sweetened with lactose is to be preferred to milk, which is usually not well borne by such patients. Kendall has noted the value of sugar of milk in lessening the toxicity of various organisms. Tea sweetened with lactose is usually well borne. Meat juice expressed from a piece of lightly broiled steak is good. Various jellies or sago pudding are of value. Willmore and Savage praise yoghurt.
Unless given in small amounts liquid diet is apt to increase evacuations and some cases seem to do better on ordinary diet.
In the tropics there are many brands of sterilized natural milk and these can be inoculated with a culture of B. bulgaricus.
In chronic bacillary dysentery Rogers recommends 1 to 1½ pint enemata of albargin in strength of 1 to 500. Protargol seems to be equally efficient in the same strength. Owing to the effect of organic material on silver nitrate this salt does not seem so reliable as the organic silver compounds. It has also been recommended to flush the colon with warm boric acid solution. Another recommendation is to use milk for this purpose. Vaccine treatment has been employed, in cases of chronic bacillary dysentery. Either eusol-treated organisms or those sterilized by 0.25% trikresol are to be preferred.