As all the text books teach, can be subdivided into the treatment of the intestine and the treatment of the general nervous affection. It will depend upon the individuality of the therapeutist whether the one or the other line of treatment is adopted. From an historic point of view we may say that formerly more attention seems to have been given to the treatment of the nervous system, whereas, now-a-days, attention is chiefly directed towards correcting the perversion of the digestive apparatus. We believe that both methods are of equal value; if it is found impossible to treat the patient in all directions the chief attention should be given to the intestine, for regulation of the bowels invariably leads to a rapid cure of any case of colica mucosa. Even if the bowels are again normal the patient is by no means a perfectly healthy individual, for in many of the cases signs of hysteria and of neurasthenia persist. The rapid removal, however, of the most important and the most distressing symptoms of the disease often acts so favorably on the general nervous system and on the general nutrition of the patient that the digestive disorders also improve in rapid order and all the nervous symptoms ultimately disappear.

Any treatment of diseases of the digestive tract must in the first place be dietetic; all other methods of treatment are of secondary and tertiary importance. Although this is an old rule, that we have learned by experience, the dietetic treatment of colica mucosa has nevertheless been carried out along many different lines. The one extreme is to protect and spare the intestine as much as possible - i. e., to give as simple and non-irritating a diet as possible, and a diet that leaves the smallest possible residue; here the treatment is essentially the same as in chronic enteritis or even in ulcer of the stomach. It appears to us that a remark of Fleiner's has contributed much - perhaps altogether unintentionally - toward creating new confidence in this old method of treatment and in inducing many clinicians to adopt this method in the treatment of colica mucosa. I refer to the following: Fleiner argues that the disease under discussion is apparently an affection in which the intestine is seriously involved but that it differs from simple colitis in the same way as croupous inflammation of the larynx differs from catarrh of the larynx (Berl. Klin. Wochenschr, 1893, pag. 98); this view essentially corresponds with the opinion expressed by v. Leyden. It is not quite clear from the description of the disease that Fleiner refers to, whether this author really means the form of colica mucosa that we have described. If he does mean the same disease we need hardly mention that - in common with the majority of other authors - we do not agree with him. At all events, this remark of Fleiner's has had the effect of inducing many physicians to treat colica mucosa along lines that are not rational; in addition it has unjustly conferred upon colica mucosa the reputation of a disease that is very difficult to treat and to cure; we have had occasion in numerous cases to hear patients and physicians refer to these remarks of Fleiner's. We do not deny by any means that it is possible to attain some good results in colica mucosa with a very carefully selected bland diet, particularly if this diet is combined with a systematic oil-cure (according to Kussmaul), and if, in addition, the general state of nutrition of the patient is at the same time raised. Under this treatment the motor power of the intestine will also gradually improve, and as long as this function remains intact the patient will be protected from new attacks of colica mucosa. We believe, however, that after this treatment, relapses are not infrequent; we have seen this in patients who were treated in this way by ourselves and by others. These patients even after the oil treatment has effectually brought about a thorough cleaning out of the bowels persist in eating a non-irritating diet and a diet that leaves only a very small residue; consequently there is a great tendency to irregular bowel action with the deposit of hard and dry stools; sooner or later then another attack of colica mucosa is apt to appear.