522 DISEASES OF THE STOMACH. 



The treatment of dilatation of the stomach has latterly made 

 great progress. In some instances happy results have been obtained 

 by a modification of " SchrotHs cure," in which the patient's supply 

 of water and of liquid food is reduced to the smallest endurable 

 limit. 



In other and more numerous cases great improvement, and often 

 complete cure has been brought about by repeatedly pumping out the 

 stomach by means of Woman's stomach-pump, and by rinsing out 

 the organ with soda-water or the alkaline-muriatic mineral waters. 

 Kussmaul has done great service by introducing this mode of treat- 

 ment. 



After a somewhat extensive experience of my own, I can fully sub- 

 stantiate the striking results which Kussmaul has obtained. Even 

 the first application of the pump generally gives the patients such 

 relief, that, so far from dreading a repetition of this, in' itself, by no 

 means pleasant operation, they clamorously beg for it ; and the first 

 timidity once over, the introduction of the stomach-tube which at 

 the outset inspires almost all patients with fear no longer is dis- 

 tressing ; moreover, they soon learn to introduce the tube for them- 

 selves, and I have met with several instances when the patient would 

 scarcely wait for my visit, but earnestly besought my assistant to 

 pump his stomach out or " acidulate '* it forthwith. In one instance, 

 where all previous treatment had been fruitless, the patient gained 

 thirty pounds in weight, and was fully restored to his strength; 

 although, when received at my clinique, he was reduced to the extreme 

 of emaciation, and was quite incapable of any labor. 



In this patient the sarcinse, which were very numerous in the 

 matter vomited, under treatment, disappeared entirely from the con- 

 tents of the stomach evacuated by the pump. 



It is remarkable that even after a very few sittings the stomach re- 

 acquires the power of propelling the greater part of its contents into 

 the duodenum. It is easy to verify this, firstly, from yielding of the 

 previously-obstinate constipation, and from a more regular occurrence 

 of the stools ; secondly, because the patient's urine, which before was 

 scanty, now so augments in quantity as to impress the attention of 

 the patient himself. The latter observation proves conclusively 

 that very little indeed of the fluid contents of a dilated stomach ia 

 absorbed. 



This complete restoration of apparently desperate cases of gastric 

 dilatation might give rise to the impression that this affection occurs 

 as an independent malady, more often than has been supposed. But, 

 both in my cases and in those of Kussmaul, the evidences of a pre- 



