ULCER OF THE STOMACH. 573 



a thick pulp. This is given as an enema, care lui\ inic been taken to wash out the 

 l>ov>rl \vith water about an hour before. In explanation of the name it should be 

 stutrd that the sweetbread is known technically as the pancreas. By the use of 

 this injection a person can be nourished for a long time without experiencing any 

 sensation of hunger. This somewhat disagreeable mode of treatment has for- 

 tunately to be resorted to only in severe cases, although the results are highly 

 satisfactory. 



Besides resting the stomach it is very desirable to prevent by every means in 

 our power the long-continued collection of acids in the stomach. This object is 

 usually effected by the administration of Carlsbad salt, which consists chiefly of 

 common salt, carbonate of soda, and sulphate of soda or Glauber's salts. Common 

 salt promotes digestion, carbonate of soda diminishes the excess of acidity of the 

 contents of the stomach, and sulphate of soda aids in their expulsion from the 

 stomach into the intestines. The natural or artificial Carlsbad salt is obtainable 

 from any chemist, and in these cases is best used every morning as follows : One 

 table-spoonful of the salt is dissolved in a pint of lukewarm water, and of this- 

 the patient drinks, fasting, about a fourth part, and repeats this quantity every ten 

 minutes, so as to be about three-quarters of an hour in taking the whole amount. 

 Then he is to wait half an hour longer before he takes his breakfast, which is usually 

 followed by one or two watery discharges. If he have more than two, or none at all, 

 the quantity of salts taken the next day must be regulated accordingly, but the 

 amount of water in which the salt is dissolved is to remain the same one pint. 



For how long should this restricted diet be resorted to 1 One cannot lay down 

 any absolute rule as regards time, and one has to be guided entirely by the condition 

 of the patient. After a few days the pain and vomiting usually cease, and the 

 healing of the ulcer advances so rapidly that after two or three weeks the patient 

 may gradually return to a more solid diet. At first the greatest care should be taken 

 that the convalescent's stomach is not taxed with the digestion of any food which is 

 not easily assimilable. The following mode of treatment is largely adopted in 

 Germany, and is in strict conformity with the rules already laid down. The patient 

 is confined to bed during the whole course of treatment, and active movements of 

 the body are avoided as much as possible. Hot poultices are applied to the abdomen, 

 or if there is any tendency to haemorrhage, a bag o* ice. During the first few days 

 the Carlsbad salts (a table-spoonful in a pint of luKewarm water) are given every 

 morning. The diet consists entirely of milk and extract of beef, with the exception 

 of a few pieces of rusk, which must not be swallowed until they have become 

 thoroughly softened and masticated. All the food should have a lukewarm 

 temperature unless there are signs of bleeding, when everything must be cold. 

 After from two to three weeks the patient is placed on a light diet, consisting of 

 pigeon, chicken, puree of potatoes, soups, wheat bread, <fcc., and after eight days 

 longer anything may be taken which is not absolutely indigestible or injurious. 



Perhaps it may be thought that we ought to say something with regard to medi- 

 cinal treatment of this complaint, but if the foregoing directions are carried out in 

 their integrity no medicine will be required. In some cases benefit is derived from 

 the administration of arsenic according to Pr. 40. We would advise our readers 



