CHRONIC GASTRIC CATARRH. 



if the prescribed diet be considered as a regular treatment, it is usually 

 observed by the patient with painful conscientiousness. Since the use 

 of meat, and other animal food, particularly requires activity of the 

 stomach, one might suppose that the indication was to allow only vege- 

 table diet to a patient with chronic catarrh of the stomach, the diges- 

 tive power of whose gastric juice has become weakened, but experi- 

 ence teaches the contrary. The power of the gastric juice to convert 

 the protein substances into peptone (Lehman), or albuminose (Mialhe), 

 is diminished in chronic catarrh, it is true, but it is not entirely lost. 

 If they be given judiciously and in proper form, the patients improve 

 more than if fed only on amylacea, from which quantities of lactic and 

 butyric acids are formed in the stomach. From what has been said 

 above, it follows, of course, that fat meat and sauces are to be for- 

 bidden ; that the food is to be carefully chewed, and only small por- 

 tions of it swallowed at a time. Some patients get along very well 

 when they only eat concentrated, unskimmed meat broth ; others do 

 so when they only eat cold meat, and but little white bread. The 

 latter prescription is especially useful in patients who suffer from ex- 

 cessive acidity, and, in very obstinate cases of this kind, instead of the 

 " cold-meat treatment," we may recommend the use of salt or smoked 

 meat. If it be considered curious that some patients bear meat better 

 when in this indigestible form than otherwise, it is because the fact is 

 overlooked that smoked and salt meat, even if indigestible, has this 

 advantage over fresh meat, that it is not so readily decomposed as 

 fresh meat. In one case that I treated, the patient, who had chronic 

 gastric catarrh, with great inclination to acidity, knew exactly when 

 he must abandon all other food (because it increased the gastric juice), 

 and limit himself to the use of lean smoked ham, sea-biscuit, and a 

 little Hungarian wine. The exclusive use of milk, the so-called milk- 

 cure, agrees wonderfully with some patients, while others cannot stand 

 it at all, and we cannot certainly tell beforehand which will be the 

 case. Butter-milk suits many patients better than fresh milk. In 

 Kruken 'burg's clinic I have seen very brilliant results from the pre- 

 scription, " when the patient is hungry, let him eat butter-milk ; when 

 ne is thirsty, let him drink butter-milk." Perhaps fresh milk is not so 

 well borne, because it readily curdles in the stomach, and forms large, 

 firm lumps, while in the butter-milk the casein is already curdled, but 

 finely divided. 



Dietetic treatment does not succeed so often in chronic as in acute 

 gastric catarrh, but we have some very efficjent remedies for the former 

 disease. The chief among these are the alkaline carbonates. We 

 have already recommended bicarbonate of soda, in divided doses, and 

 tmctura rhei aquosa, in prolonged attacks of acute gastric catarrh 



