When the writer entered the practice of medicine, more than twenty years ago, the treatment of diarrheal affections comprised practically the use of opium, tannic acid, chalk, and bismuth subnitrate« In other words, the chief aim of treatment was to check the profuse diarrheal discharges as soon as possible.With the development of the doctrine of the bacterial origin of many diseases, the treatment of intestinal disorders underwent a corresponding change, and thus arose what might be termed the antiseptic method of treatment. A large number of antiseptics have been proposed with a view of destroying the pathogenic organisms in the intestinal canal, and thus preventing fermentative processes. Among those which have chiefly claimed our attention are salicylic and carbolic acids, creosote, guaiacol-carbonale, resorcin and the various naphtol preparations. I have always been skeptical, however, as to whether the small doses of these drugs that can be administered with safety are really able to exert a sufficiently powerful antiseptic effect to arrest the growth of bacteria in the gastrointestinal tract. That, they effect some good I am firmly convinced, but I do not, think that we should depend upon them completely to the exclusion of other remedial agents.If we accept the modern theory, thai many bowel troubles are due to toxic products generated by bacteria, it seems more logical to me to initiale the treatment of intestinal catarrhs with the use of some évacuant which will promote the elimination oí toxins per viam naturalem. The drug most useful in my hands for this purpose is calomel, although castor oil may also be employed with good affect». The beneficial iullllence of calomel is shown by tlle change ill ihe cha racier of the stools. Castor oil also ads well, especially in the case of children, but is so objectionable lo many persons that in most cases I prefer (he use of calomel. Having freed the intestinal tract of all toxic irritating material, .the diarrhea will sometimes cease under the administration of simple stomachics with bismuth. Often it is necessary to resort to further treatment before the profuse and exhausting discharges can be checked. Here is the proper Meld l'or intestinal astringents.The list of intestinal astringents from which formerly we were compelled to make our choice was not a large one, comprising chiefly tannic acid and various preparations containing it, such as tinctures of kino and catechu and the mineral astringents, especially acetate of lead, sulphate of zinc, and sulphate of copper. The mineral astringents have the disadvantage of acting as irritants when given in doses sufficient to obtain their physiological effect, or of entering into inert combinations in the upper part of the intestinal canal. On the other hand, tannic acid and the various preparations containing it have the serious objection of irritating the mucous membrane of the stomach by acting upon the albuminous elements, and thus giving rise to more or less gastric disturbance. Much of the tannic acid administ...
