574 THE TREATMENT OP DISEASES. 



to study carefully the case of vomiting quoted from William Hunter. (See 

 VOMITING.) Directions for treating medicinally many of the most troublesome 

 symptoms of gastric ulcer, such as vomiting (see VOMITING) and hsematemesis (see 

 BLEEDING FROM THE STOMACH), have already been given. 



When perforation occurs that most disastrous event in the course of gastric 

 ulcer the measures consist in the administration of large doses of opium (fifteen 

 drops of laudanum in a little beef tea as an enema every three hours) or hypodermic 

 injections of morphia, so as to keep the patient constantly drowsy, absolute rest, ab- 

 stinence from all food, and hot fomentations, or ice-cold compresses to the abdomen. 

 Under these distressing circumstances the highest possible medical skill should be 

 obtained. Give nothing whatever by the mouth not even a drop of water and 

 remember that these cases are not absolutely hopeless, and that whilst there is life 

 there is hope. Should the patient rally, the strength will have to be supported by 

 enemata. The following is a good formula for an injection : Mix four ounces of 

 extra strong beef-tea, one ounce of cream, and half an ounce of brandy or an ounce 

 of port wine. 



Even when the ulcer has entirely healed the patient may require treatment for 

 various sequelae dependent for their production on the contraction of the scar, or 

 other damage the stomach may have sustained. They will usually be found to 

 assume the form of indigestion, and are best treated by the remedies indicated whilst 

 speaking of that complaint. The patient should be kept upon a -light, easily 

 digestible diet for some time afte? the beginning of the convalescence, the main 

 object being to avoid taxing the powers of the stomach more than is absolutely 

 necessary. It must not be forgotten that relapses in this disease are not infrequent, 

 and caution in the use of food is imperative, even after complete recovery. 



People who are supposed to be liable to the formation of ulcer in the stomach 

 would do well to be very careful with regard to what they eat and drink. Pale, 

 sickly young women, who are supposed to have a tendency this way, must avoid 

 taking acids and irritating food, especially when the stomach is empty. They 

 should always restrain powerful and prolonged acts of vomiting, and must by every 

 means in their power endeavour to improve the general condition of the health. 



VOMITING. 



Vomiting, as we have already seen, is often one of the most distressing symptoms 

 of dyspepsia. It is not unfrequently a concomitant of some of the most serious 

 disorders of the stomach, such as ulcer and cancer. It occurs moreover as a 

 symptom of many other disorders besides those of the stomach. Thus it not 

 uncommonly marks the onset of some of the fevers, such as measles or scarlet fever, 

 and is not unfrequently the first indication of the approaching illness. It is a 

 constant and important feature in inflammation of the brain. It is important to be 

 able to distinguish vomiting arising from disease of the brain from the sickness 

 which accompanies stomach disorder, or we may be in danger of confounding a very 

 grave disease with a mere temporary indisposition. To facilitate the diagnosis we 



