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THE ALUMNI JOURNAL. 



ance the young man was robust, and here 

 I would say, that many dyspeptics appear 

 to be in perfect health. They are often 

 well nourished, and the look of good 

 health which they have leads their 

 friends and relatives to consider their 

 discomforts as imaginary. They are 

 looked on as hypochondriacs. Their 

 digestion is slow, and attended with 

 pain and discomfort; four or five hours 

 after eating, sometimes a longer period 

 elapses before the stomach has suc- 

 ceeded in coping with the indigested food. 

 Besides the three conditions I have pre- 

 viously described, i. e. catarrh of the 

 stomach, the ptomaine poisoning and the 

 peripheral nerve irritation due to the 

 latter, and to the long continued presence 

 of the food, is a fourth. The stomach 

 walls become weakened, undergo atrophy 

 and are much thinner than normal. This 

 results in dilatation of the stomach; it 

 becomes a thin walled cavity, much larger 

 than normal. The fermentation or decom- 

 position of the food produces gas, which 

 distends both the stomach and bowels. 

 Gastric disturbances are invariably ac- 

 companied by constant diarrhea or ex- 

 treme constipation One or the other of 

 these conditions is almost always present; 

 the one condition is present perhaps quite 

 as often as the other. The distinctive 

 point between gastric and intestinal indi- 

 gestion is that in the latter the uncomfort- 

 able symptoms begin two or three hours 

 after the ingestion of food, and diarrhea is 

 a symptom. When the trouble is purely 

 gastric the pain and discomfort com- 

 mence immediately or soon after eating, 

 and constipation is apt to be the rule. It 

 is, however, common to see both condi- 

 tions united in the same individual. The 

 diarrhea and the constipation should be 

 treated as symptoms by appropriate 

 remedies, such as are usuall}'- in vogue for 

 this purpose. The latter may be effectu- 

 ally remedied by means of a pill of 



extract of cascara, aloin, and strychnine. 

 Mineral waters or other aperient saline 

 solutions also do good as laxatives. An 

 excellent plan is to give a teaspoonful of 

 phosphate of soda in a tumblerful of hot 

 water a half hour or so before each meal, 

 or twice a dav, before the two principal 

 meals, breakfast and dinner, regulating 

 this by its effects. As an anti-fermenta- 

 tive, salicin in ten grain doses before 

 meals often effects good results In a 

 very excellent paper entitled "Remarks 

 on Fermentative Dy.spepsia," Dr. Austin 

 Flint, in the New York Medical Journal 

 of October 14, 1893, advocated the sub- 

 gallate of bismuth, which he had used 

 since December, 1892, with excellent re- 

 sults. I have myself in two cases veri- 

 fied Dr. Flint's results, but a third case 

 in which I used the agent resulted nega- 

 tively. 



There is no form of treatment as effi- 

 cacious as the one which we find at our 

 hand for the treatment of such conditions 

 as I have described. It consists in irri- 

 gating the stomach through the sesopha- 

 geal tube. This instrument, which is a 

 modification of the old stomach pump, 

 does its work through the principle of 

 siphonage. It has been used for a long 

 time, although its use has been restricted 

 to comparatively few physicians. It is, 

 I believe, a French device and was first 

 used in Paris some years ago. It consists 

 of a soft rubber tube about two feet in 

 length, connected through a short glass 

 cylinder with another similar tube, ter- 

 minating in a funnel. 



The red portion ot this tube is intro- 

 duced through the mouth into the stom- 

 ach, which is filled through the funnel 

 with water. This water may be medicated 

 with bi-borate of sodium, bi-carbonate of 

 sodium or any other agent which may 

 seem best to the physician. Pure warm 

 water will, I think, be found to answer 

 the purpose quite as well as any medi- 



