At first it is only the annoyance that is complained of but later on the appetite is lost and the patient becomes weak.
There is an absence of the sprue mouth. The laboratory diagnosis, other than the finding of excess of fatty acids, soaps, undigested food remnants and yeasts is unimportant.
Prognosis
While the disease responds to treatment in those who are not too far advanced yet it always should be considered a serious affection. The chances of a complete restoration to health are better for those who can leave the tropics and reside permanently elsewhere.
Treatment
It is essential that the patient possess the will power to carry out the course of treatment; the clothing should be of wool to prevent chilling and the patient should remain in bed until his condition has decidedly improved.
The Milk Treatment.—A preliminary dose of castor oil is given and when this acts the patient should begin taking milk as the sole food. At first about 4 pints of skimmed milk are given daily. The milk should be given in two-hour feedings, well warmed and taken through a glass tube or with a teaspoon—it should not be drunk. As the stools become less frothy the amount of milk is increased so that the patient takes from 6 to 7 pints daily. Milk should be the sole food for six weeks from the time the stools become solid and the mouth symptoms disappear. Rele prefers buttermilk to skimmed milk. Eggs are usually well borne after the milk course. Stale bread or toast is cautiously added and then some fish or chicken.
At times the patient seems benefited by giving a meat treatment day once or twice a week during the course of the milk treatment.
Meat Treatment.—If the patient is very ill it may be advisable, after the preliminary dose of castor oil, to give meat juice obtained by expressing the juice from slightly broiled meat, about 2 teaspoonfuls every half hour. If possible however one starts in with the meat cure, which is about 4 ounces of a lightly broiled chopped-up beefsteak, every four hours. Raw meat is usually given in this treatment but there is danger of T. saginata infection.
At least 4 pints of warm water should be taken daily but not at the same time the patient eats the meat. Rest in bed and the avoidance of chilling are important measures. In all food treatments we should avoid forcing the patient to eat—it is better to give food only when the patient desires it.