Howland,1 in 1921. established a new era in the treatment of celiac disease when he said:
Halfway measures are quite unavailing and cause only loss of time, which is a serious matter.... The dietary treatment may be divided into three stages. First, that with protein milk alone.... That more than any other food is likely to bring satisfactory results. The diet of the second stage consists of protein milk as a basis reinforced by almost pure protein foods. The duration of this stage is many months, it may be years.... The third stage, that in which carbohydrates are added, is the really difficult one. The addition must be made very gradually with the most careful observation of the digestive capacity.... The treatment is time consuming but these patients well repay the effort expended on them. They do not remain semi-invalids. Many become vigorous and strong.
This three-phased, high protein
SAUER LW. CELIAC DISEASE (CHRONIC INTESTINAL INDIGESTION): ETIOLOGY, PROGNOSIS AND STANDARDIZATION OF TREATMENT. Am J Dis Child. 1927;34(6):934–949. doi:10.1001/archpedi.1927.04130240013002
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