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DIARRHOEA IN CHILDRENA survey was therefore made of 317 cases of diarrhoea in African children, each succeeding case being treated with phthalylsulphathiazole, sulphadimidine, and sulphaguanidine respectively, with the aim of establishing the relative merits of the " absorbable " and " nonabsorbable " sulphonamides in the treatment of bacillary dysentery and non-dysenteric diarrhoea.The average age group of the children in the series was 1 year and 8 months and the causes of the diarrhoea fell roughly into five groups: (1) proved bacillary dysentery; (2) enteric infections where salmonellae, B. proteus, or B. paracolon were isolated on stool culture; (3) enteric infections with no pathogenic organisms on stool culture and no obvious parenteral infections; (4) parenteral infections; (5) mixed enteral and parenteral infections.It was found that all three drugs were equally effective in cases where Shigella organisms were isolated from, the stools and gave similar results in the enteric infections of non-dysenteric origin.If diarrhoea was found to be secondary to a parenteral infection or if mixed infections were present, sulphadimidine had a definite advantage in that, in many cases, it controlled both infections without additional chemotherapy.Toxic reactions such as oliguria or anuria were not encountered with any of these drugs under trial, and no other undesirable side-effects were noticed.The trial period for each drug was limited to seven days, by which time 68.2% of the cases on phthalylsulphathiazole, 69.1 % on sulphadimidine, and 61.1 % on sulphaguanidine were fit for discharge.A point of considerable importance was the relatively high incidence of dual infections, showing that it was not enough to attribute the diarrhoea to an obvious parenteral infection or yet to conclude that the majority of cases would be dysenteric in origin, since the two might well coincide, with the symptoms of one sometimes overshadowing those of the other.Therefore, in reviewing all aspects of the problem of diarrhoea in African children, and bearing in mind that not all cases are admitted to hospital or seen and treated by fully qualified medical personnel, it is essential to provide a regime of treatment which combines efficiency with ease of administration, simplicity, safety, and cheapness.Since the " wide spectrum" antibiotics are not always available for routine use and the "non-absorbable" sulphonamides require the addition of penicillin or other antibiotics in the case of mixed infections, it is suggested that sulphadimidine could be used as a valuable general-purpose sulphonamide in the diarrhoeal diseases of African childhood.

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