THE ALUMNI JOURNAL, 



29 



cated solution ; at least, I have been 

 unable to attribute any more beneficial 

 results to medicated solutions, of which 

 I have tried a vast number, than to the 

 pure water at a temperature something 

 more than lukewarm. After a pint and 

 a half of water (approximately) has been 

 allowed to pass into the stomach, the 

 funnel is lowered quickly, just as it is 

 about to empty, to a point about two feet 

 below the level of the stomach and the 

 water in the latter is syphoned into a 

 suitable '*l-eceptacle. The operation is 

 then repeated until the water flows clear. 

 The procedure is not difficult although 

 occasionally very sensitive, nervous sub- 

 jects find considerable trouble in swal- 

 lowing the tube for the first time. 



No harm can possibly be done by 

 the soft rubber tube. The best time 

 for stomach irrigation is three or four 

 hours after eating, although in some 

 cases this will be found earlier than is 

 possible when the stomach is diseased or 

 whea the patient has eaten a hearty meal 

 of solid food. The patient should be 

 directed to eat a light lunch in the mid- 

 dle of the day of liquid or semi-liquid 

 food, and should afterwards present him- 

 self to the doctor at four or five o'clock 

 for treatment. 



The rationale of this treatment is as 

 follows : 



First, the stomach is emptied and 

 thoroughly cleaned ; the irritating ma- 

 terial is taken from it ; the action of the 

 water repeatedly distending and contract- 

 ing the walls of the stomach is that of 

 passive exercise, tending to strengthen 

 the muscular coats ; the peptic glands 

 are freed from irritating substances. After 

 a time the stomach gains in strength. It 

 must not be forgotten that digestion is 

 to an enormous extent aided by muscular 

 contraction in the stomach. When the 

 muscles of the stomach are weak this 

 muscular action is of course less. 



In the dietetic treatment of these cases 

 it is quite as important as active and more 

 directly remedial methods. There are 

 three objects to be attained. First. The 



prevention of over distending the stomach. 

 Second. The prevention of fermatation. 

 Third. The prevention of irratation. The 

 foods selected should therefore be mostly 

 solid, small in volume, and not too 

 hot. 



In very advanced cases, the food should 

 be taken in small quantity at frequent 

 intervals; say everj^ two or three hours. 

 Nitrogenous foods are better than carbo- 

 hydrates, becau-e the former contain the 

 elements of nutrition in a smaller bulk, 

 and are not so easily fermentable as the 

 carbo-hydrates. Meats such as fresh beef, 

 mutton, eggs, oysters, and tender chicken 

 are indicated. Alcoholic beverages, spices, 

 condements, made dishes, potatoes and 

 the starches generally do harm. Beef 

 peptonoids are excellent in that they 

 supply nourishment in highly concen- 

 trated form. 



Anything that exhausts the nervous 

 system or in other words, that uses up 

 nerve force faster than the digestive 

 organs can digest the food which sup- 

 pies that force must sooner or later 

 resnlt in derangement and in disease 



of the stomach, and this disease is a 

 factor of the greatest importance in pre- 

 venting the recovery of the patient and 

 in increasing the effects of the nerve ex- 

 haustion. 



It would seem that when nature at- 

 tacks the health of an individual, she 

 calls innumerable factors to her aid, all 

 of which aid her in her destructive work. 



The lesson I have striven to teach this 

 evening is three-fold : 



First. Do not neglect a disordered 

 stomach, no matter how brilliant the intel- 

 ect is unless backed by a sound stomach 

 it is of little use. With a healthy 

 vigorous digestion there is no work too 

 difficult, no load too heavy. 



Second. Nervous exhaustion is in a 

 majority of cases due primarily to diges- 

 tive disease. 



Third. Washing the stomach by 

 means of the stomach tube, affords the 

 most efficient means of curing the condi- 

 tion I have described. 



