412 MATER i A MEDIC A AND THERAPEUTICS. 



or more elegantly with Spiritus Ammonias Aromaticus, to act as 

 a carminative. The result is that the acidity of the contents 

 is reduced and it is remarkable how small may be the quantity 

 of alkali required for this purpose so that the mass passes with 

 comparative safety into the duodenum. Instead of Soda, Mag- 

 nesia or its Carbonate is occasionally used as an antacid, which, 

 being also a purgative, hastens the expulsion of the offending 

 contents. Gas may be partly absorbed by charcoal, given in 

 powder or in the form of lozenges or biscuits, and partly 

 removed by eructation induced by the carminative, which will 

 further help to arrest decomposition, relieve pain, and rouse the 

 heart and nervous system from the state of depression caused 

 by the attack. 



3. Treatment of the effects. When the process of indiges- 

 tion is at an end, and prostration requires to be relieved, the 

 therapeutist will avail himself of some of the many gastric 

 sedatives at his disposal, of which Diluted Hydrocyanic Acid, 

 Bismuth, and Morphia (whether given subcutaneously, applied 

 to the epigastrium endermically, or combined in an effervescing 

 mixture) will be found the most useful. Champagne or effer- 

 vescing Soda- Water and Brandy will serve at once as a gastric 

 sedative and a general stimulant, or Milk with Lime- Water or 

 Soda- Water may be given as a sedative and nutritive. Ice is the 

 best means of relieving thirst ; in other cases water as hot as can 

 be drunk often acts as a valuable sedative. Linseed poultices, 

 hot fomentations, or warm compresses may be ordered to the 

 epigastrium, and in severe and persistent cases Mustard or 

 Cantharides blisters. The chief problem will be to support the 

 strength without increasing the pain and sickness, and in very 

 urgent cases the patient must be fed by the rectum. 



The greatest caution must be exercised in resuming gastric 

 digestion. The best treatment, unless the patient be very weak, 

 is to rest the stomach absolutely for many hours. Fortunately, 

 anorexia conduces to secure this end. The first food given 

 should be in the smallest possible bulk, and of the blandest and 

 most digestible kind, such as broths, essences, meat juices, and 

 milk ; and j ust before each meal a small dose of a mixed 

 stomachic, such as Bicarbonate of Soda, with Diluted Hydro- 

 cyanic Acid or Bismuth, and a mild aromatic bitter, such as 

 Gentian, should be prescribed, which will restore the secretion 

 of gastric juice and arrest the flow of alkaline mucus set up 

 by the dyspepsia. 



4. Chronic Dyspepsia is rationally treated on the same princi- 

 ples as the acute form of the disorder, with certain modifications, 

 which a careful consideration of the pathological associations of 

 the particular case and general experience will suggest. The 



