As a proper, well-balanced dietary is an important curative measure it is therefore prophylactic.
Treatment.—In a disease which characteristically shows a marked amelioration in the winter or a disappearance of symptoms for one or more years we should be very conservative in attributing improvement to any drug.
At the New York Post Graduate hospital, 17 cases were apparently cured on rest in bed and full nutritious diet. Hospital treatment, thereby removing the patients from the environment in which the disease developed, is generally conceded of the greatest benefit.
It is always recommended by the advocates of some special drug treatment that the patient be kept on a nutritious diet. Roussel in 1866 stated: “Without dietetic measures all remedies fail.”
Many authorities speak highly of arsenic in various forms as Fowler’s solution, atoxyl, salvarsan, etc. Others are equally pessimistic as to the value of arsenic in any form.
Niles is a strong advocate of hydrotherapeutic measures. He recommends the drinking of two to six glasses of tepid water daily as well as colon irrigations, cold abdominal compresses, hot packs and saline baths.
Deeks prefers to eliminate sugar and starchy food from the dietary of pellagrins for a few days at a time and to give fresh fruit juices, with broths and milk. He highly recommends dilute nitric acid, well diluted, before meals. As there is almost constantly anacidity and pepsin deficiency in the gastric juice it would seem that this condition should be treated.
It is advisable to keep the patient out of the sun and require him to take his exercise after sunset.
Dyer recommends ½ to 1 ounce gelatin daily together with the juice of two or more oranges or lemons. He prefers a diet of eggs, milk and well-cooked vegetables. He also gives quinine hydrobromate in 3 grain doses 3 times daily.
Psychotherapy seems to be of importance in the treatment of pellagra.