PYROSIS, OR WATERBRASH. 463 



Next as to the treatment. It need hardly l>e said that when the disorder has 

 arisen from the use of innutritions or unwholesome food, the adoption of a more 

 generous and varied dirt, ii it-hiding a suHirimt proportion of meat, is essential. 

 Mai iv of the rules we have laid down regarding the diet of dyspeptics are applicable 

 to thr treatment of this complaint. In obstinate cases the most brilliant results 

 have followed this prescription : " When the patient is hungry, let him eat butter- 

 milk, and whrn hr is thirsty, Irt him drink buttermilk." Fresh milk is not so well 

 borne, as it curdles in the stomach. 



There are sevrral medicinal preparations which are useful in the treatment of 

 waterbrash. The compound kino powder of the Pharmacopoeia is an admirable 

 remedy. It should be taken in twenty-grain doses three times a day. The only ob- 

 jection to its use is that it contains opium, which has a tendency to confine the 

 bowels. This difficulty may, however, be readily overcome by administering with it 

 some simple purgative, as the watery extract of aloes, confection of sulphur and senna 

 {Pr. 59), or the compound colocynth pill (Pr. 60). Bismuth (Pr. 18) usually succeeds 

 admirably. If the ordinary dose should fail, thirty grains of carbonate of bismuth 

 should be taken three times a day in a little water half an hour before meals. When 

 the fluid which regurgitates into the mouth is distinctly sour or acid, nothing 

 suceeds like dilute hydrochloric or nitric acid given before food. From twenty to 

 thirty drops of either taken in. a wine-glassful of water half an hour before each 

 meal will, in these cases, usually effect a cure. When the fluid of pyrosis has an 

 alkaline reaction, and is accompanied by much distress and nausea, and the vomiting 

 of the just-eaten food, the acid should be given in the same dose, but just after food. 

 In obstinate cases nux vomica (Pr. 44) or pulsatilla (Pr. 43) may be tiied. A 

 tea-spoonful of glycerine three times a day often proves useful. 



In connection with the subject of pyrosis we may mention that rumination occa- 

 sionally occurs in the human being. One of the most remarkable cases on record is 

 that of a carpenter's apprentice. Although a sharp and intelligent young man, he 

 was a " slow eater." In the struggle for existence, he found himself at a consider- 

 able disadvantage, for only a few minutes were allowed for meals by an exacting 

 and ubiquitous taskmaster. It was obvious that he must either go with insufficient 

 food, or swallow it whole and run the risk of suffocation. Having a natural dislike 

 to hunger, he selected the latter course, and in process of time acquired the art of 

 swallowing his food in wholesale pieces, and without any attempt at mastication. 

 Having finished his meal, he usually repaired to the workship, and no sooner com- 

 menced handling the implements of his craft than the regurgitation of the food com- 

 menced. As a rule, in ten or fifteen minutes after the meal was swallowed it was 

 returned in mouthfuls, at intervals of from five to ten minutes, to be masticated and 

 again swallowed until the whole contents of the stomach had been similarly served, 

 when the abnormal process ceased. This regurgitation was first noticed about the 

 age of fifteen, soon after this young carpenter entered on his apprenticeship. 

 For the succeeding fifteen years he invariably returned to his mouth all his food, or 

 nearly all, until at length, as time rolled on, and as fortune and circumstances im- 

 proved, he had more leisure for his meals, and more tune for what may be called 

 primary mastication, and then this striking, novel, and supplementary process of 



