508 DISEASES OF THE STOMACH. 



to act in this way, and their effect is only to be explained by their 

 power of arresting decomposition. If a child is suffering from a slight 

 gastric catarrh, which only shows itself by the characteristic vomiting 

 and the presence of undigested milk in the acid dejections, besides strict 

 diet (of which we will hereafter speak), we should use the mildest of 

 the above remedies, such as the carbonates of the alkalies, with small 

 doses of rhubarb ; a well-known and popular form of these is the pulv. 

 rhei comp. ; if the diarrhoea is more severe, we may give the tine, rhei 

 aquosa. An old and extensively used mode of giving the latter is in a 

 mixture of tinctura rhei aquosa 3 ij, with liq. potassii carbonici gtt. xij, 

 aqua fosniculi ij, and syrupus simplex 3 ij, of which a teaspoonful is 

 to be taken several times daily. If this treatment is inefficacious, if 

 the decomposition in the stomach continues, and the passages become 

 more frequent, we may give small doses of calomel, a plan that 

 has long been justly popular in the treatment of infantile diarrhoea. 

 I usually give -J to J- gr. two or three times daily. Bednar, who pre- 

 fers calomel to all other remedies in this disease, gives it combined 

 with jalap, in larger and more frequent doses. His prescription is : 

 " $ calomel, gr. iv; pulv. jalap, gr. ij; sacchar. alb. 3 ss; m. ft. pulv. 

 no. viij. S. Take one powder in water every two hours." Even this 

 treatment is not always successful. The evacuations often persist in 

 spite of the most rigid diet and the free employment of calomel, until 

 we fear to use any more mercury, although, from the continuance of 

 the vomiting and purging, but little of it seems to be absorbed, and 

 hence mercurial stomatitis rarely occurs. In such cases, every prac- 

 tising physician sometimes finds himself in a position where he is 

 obliged to give up the remedy from which he has seen the best effects 

 and which he usually trusts most, and try one in which he has less 

 confidence. He may even feel around from one remedy to another. 

 There are no definite and certain indications for the cases where nitrate 

 of silver, tannin, muriatic acid, tincture of nux vomica, etc., are re- 

 spectively advantageous. Usually the remedy that was efficacious hi 

 the last attack is given ; if it fails, others are tried. Without laying 

 particular stress on it, I would recommend very small doses of nitrate 

 of silver ($ argent, nitrat. gr. ; aquae distillat. f ij. HI. S. Take 

 a teaspoonful every half hour or hour), and frequent potions of ice- 

 water, in those cases where there are excessive vomiting, great thirst, 

 and copious -watery evacuations. If there be no vomiting, but great 

 purging, and calomel does not answer the purpose, I usually give tan- 

 nin ($ tannin, 3ss; aquae distillat. iij. ty. S. A teaspoonful 

 every two hours). In mild but prolonged cases I give muriatic acid 

 in mucilage. I have not much experience in the use of tincture of nux 

 voraica, creasote, or tincture of muriate of iron. 



