ACUTE GASTRIC CATARRH. 505 



with its results, is a very dangerous disease, which may end fatally 

 even under the most careful treatment. 



TREATMENT. To speak with only moderate exactness of acute 

 gastric catarrh, would lead too far, as we should have to mention all the 

 rules for diet. From the remarks on etiology, we may see that, in 

 order to avoid gastric catarrh, the diet of some persons, as of fever 

 patients and convalescents, but particularly of infants, must be carefully 

 watched. In the latter case, where it is impossible to give the child 

 the breast of the mother, or a healthy nurse, certain precautions must be 

 exercised in the choice of cow's milk ; these were mentioned under etiolo- 

 gy : 1. The milk must be fresh ; even in the city it should be brought, 

 twice daily. If it shows the least indication of acidity, it should be 

 boiled immediately, to prevent further transformation of the sugar into 

 lactic acid; carbonates of the alkalies may also be advantageously 

 added to such milk, till it becomes neutral or slightly alkaline [small 

 quantities of sulphite of soda are very good for this purpose]. 2. Milk 

 from cows fed on oil-cake or distillery swill should not be used. In 

 large cities, the best milk is that from brewery cows which are fed 

 on grains. 3. The milk should be sufficiently diluted, the first three 

 months, with about two parts of water, the second quarter with one 

 part. 4. It should be given at regular, and not too short, intervals. 

 During the first weeks, the bottle may be given every two hours, later 

 every three or four hours. The shorter the intervals, the less milk 

 should be given at each time. 5. The vessels from which the child 

 drinks, as well as its mouth, should be carefully cleansed. Neglect of 

 any of these rules may lead to gastric catarrh, while their observance 

 may prove, at least, some protection for the child, against the disease. 



The causal indications may require the administration of an emetic, 

 where injurious or decomposing food in the stomach keeps up the ca- 

 tarrh. Some carry the use of emetics in gastric catarrh too far, while 

 others neglect them too much. If we accede to the request of the 

 patient, or, from the feeling of pressure and fulness in the epigastrium, 

 the coated tongue and the odor from the mouth, conclude that the stom- 

 ach is coated also, and, in all such cases, give an emetic of ipecacu- 

 anha or tartrate of antimony, we shall often protract the disease by 

 letting a new injury act unnecessarily on the already diseased mucous 

 membrane of the stomach. But just as much harm is done by the ex- 

 cessive fear of the injurious effects of emetics, induced by then* acting 

 also as purgatives, and by the pustular inflammation of the stomach, 

 occasionally caused by the continued use of tartrate of antimony, but 

 particularly by a false theory of their action. It is forgotten that 

 the irritation of the gastric mucous membrane by the emetic, as is 

 proved by daily experience, is not very malignant or injurious, and that 



