406 MATERIA MEDICA AND THERAPEUTICS. 



1. We have complete power over all that enters the stomach 

 in the form of food and drink, and much influence, as we 

 have seen, over salivary digestion. Even if the food have left 

 the mouth and reached the stomach, we can evacuate its contents 

 by means of the pump, or by the use of emetics, which will be 

 considered in chapter iv. 



2. As regards the gastric juice, we can increase its flow in 

 many ways. We can irritate the tubules mechanically by the 

 character of the food, making it more or less solid as may be 

 required. We may provide, as the first part of the meal, sub- 

 stances, such as soup, which will be rapidly peptonised and 

 absorbed, and stimulate the follicles to abundant secretion. 

 We can subject the secretion to nervous influences which are at 

 our command, such as the agreeable sensations of taste, which 

 are aroused by artistic cookery, wholesome condiments, and 

 grateful wines, as well as by pleasing associations during meals. 

 The activity of the glands may be increased through the 

 medium of the local circulation by various means to be pre- 

 sently described. Further, we can provide for moderate 

 alkalinity of the contents of the stomach, by increasing the 

 salivary flow. The same end may be secured more certainly 

 by the administration of dilute alkaline solutions before meals, 

 such as Bicarbonate of Soda, Sal- volatile, or Liquor Potassae, 

 which are amongst the most useful and generally employed of 

 remedies, and constitute the alkaline stomachics. We can go 

 even farther than this, and modify the amount either of the 

 pepsin, or of the hydrochloric acid, or of both, by giving them 

 along with the food, and thus constituting them digestive 

 adjuvants. 



3. The activity of the nerves of the stomach is readily in- 

 fluenced in either direction. We may increase their sensibility 

 by administering the same series of hot substances which we 

 studied in the mouth, such as Alcohol, Aromatic Oils, Pepper, 

 and Mustard ; the effect being not confined to a sense of warmth 

 in the epigastrium, but extending to stimulation of the local, 

 and even the general circulation, and the associated nervous 

 structures, as we shall presently see. These substances, as well 

 as the aromatic bitters, such as Gentian or Orange, and the simple 

 bitters, such as Calumba, have the effect of stimulating the 

 nerves, dilating the vessels, and possibly increasing the activity 

 of the glands and muscles of the stomach, whilst they create 

 the sensation of hunger, probably by setting up these changes 

 in the gastric wall. They form, therefore, other groups of 

 stomachics, the aromatic, spirituous, bitter and pungent 

 stomachics. On the contrary, we may appease the sense of 

 hunger by such artificial means as tobacco smoking. 



