506 DISEASES OF THE STOMACH. 



the beautiful experiments of Magendie and Budge have proved that 

 the emetic influence of ipecac, and tartrate of antimony do not result 

 from irritation of the gastric mucous membrane, but from absorption 

 into the blood. By injecting tartar emetic into the veins, Magendie 

 proved that vomiting could be excited even where a bladder had been 

 substituted for the stomach. 



If the prominence of the epigastrium, percussion over the stomach, 

 eructations of gases and fluids whose smell and taste are like those of 

 the food that has been eaten, render it certain that there are decom- 

 posing substances in the stomach, and if the sufferings of the patient 

 justify such active treatment, it will be best to give a sure emetic, 

 such as ipecacuanha 3j with tartrate of antimony gr. j. In the para- 

 graph on symptoms we have shown that, even in such cases, without 

 the use of an emetic, the undigested and decomposed ingesta may be 

 occasionally passed from the body quickly and uninjuriously ; but this 

 is not by any means an absolute rule. The injurious substances often 

 remain a long while in the stomach, and when they pass into the intes- 

 tines cause severe and lasting disturbance. If we can rid the stomach 

 of the substance causing a continued irritation and protect the bowels 

 from its action, we should not dread the temporary irritation of the 

 gastric mucous membrane by the emetic. If, in such a case, we do 

 nothing, or, instead of an emetic, prescribe the popular mixture of 

 magnesia usta, we may just as readily cause a prolongation of the at- 

 tack as if we gave an emetic at the wrong time, or without sufficient 

 cause. Moderate fever, accompanying the gastric catarrh, does not 

 contraindicate an emetic ; but if the fever is more severe, and we have 

 the faintest suspicion of a commencing typhus, it should not be used, 

 for typhus almost always runs a severe course, when emetics or laxa- 

 tives have been used at its commencement. 



The causal indications never require the use of laxatives in the 

 treatment of simple acute gastric catarrh. It is different when the 

 injurious ingesta have passed into the bowels and caused flatulence, 

 colicky pains, escape of flatus, and other symptoms which are called 

 the passage of the gastric turgescence downward. In such cases 

 mild laxatives, such as rhubarb or compound infusion of senna, may be 

 prescribed ; if there is excess of acid, we may use a mixture of mag- 

 nesia usta ( | ss to | viij water, a tablespoonful every hour or two), 

 which, in these cases, acts as a mild and efficient laxative ; the purga- 

 tive neutral salts are less suitable. 



If there be an excessive formation of acid in the stomach that 

 seems to keep up the catarrh, whether it be caused by the transforma- 

 tion of the amylacea into lactic or butyric acids, or if acetic fermenta- 

 tion has been induced by the use of beer or wine, and if the very 



