GASTRIC ADJUVANTS AND TONICS. 413 



patient's diet will require constant supervision. The possible 

 causes of indigestion, beyond food, must be searched for, such as 

 disorder of the liver or bowels, of the heart or kidneys, gout or 

 tuberculosis, and the treatment must be arranged accord- 

 ingly. 



The flow of juice may still require stimulating by Alkalies, 

 but these remedies must not be overdone, as they tend tc 

 depress the muscular and cardiac energy. The digestive adju- 

 vants, Pepsin or Diluted Hydrochloric Acid or both, may now 

 more rationally be brought to the relief of the failing secretion, 

 being given during or at the end of meals. In still more 

 chronic cases, e.g. in aged persons, where chronic indigestion 

 depends on wasting of the glandular structures, peptonised foods 

 will be of great service. In most cases of chronic dyspepsia, 

 the nervo-muscular structures of the stomach require to be 

 strengthened, and distension or overfulness of the organ 

 avoided. Flatulent substances must be excluded from the 

 diet, such as green vegetables, sweets, sloppy food, and large 

 draughts of strong, hot tea. Powerful bitters, such as Strychnia 

 and Quinia, the former being peculiarly valuable as a specific 

 nervo-muscular stimulant, and Diluted Nitric and Phosphoric 

 acids in short, stomachic tonics are given to increase the 

 functional and nutritive vigour of the muscular coat. In some 

 of these cases gastric disinfectants, such as Creasote and the 

 Sulphites or Hyposulphites, may be required to cleanse the 

 contents and surface of the organ, and destroy the organisms of 

 putrefactive and f ermentive processes. 



Chronic dyspeptics always suffer from starvation to a degree, 

 and the food selected for them must be nutritious as well as 

 digestible. Alcohol in proper form and amount may be 

 required, and bland preparations of Iron, such as the Ammonio- 

 citrate, ordered at intervals, if they can be taken without increas- 

 ing the dyspepsia. If the dyspepsia depend on a chronic catarrh of 

 the stomach with excessive secretion of mucus, gastric astringents 

 will manifestly be indicated, such as Oxide of Silver or Zinc, or 

 Kino, Cinnamon, and other substances containing Tannin. 



The treatment of organic disease of the stomach cannot be 

 discussed here, but it is hoped that the student will understand 

 from what he has learned, the principles which he must follow 

 to fulfil the most urgent indications in this class of cases also : 

 to relieve pain and sickness, and to insure functional rest of the 

 stomach, remembering that many of the symptoms are referable 

 to dyspepsia. 



The therapeutics of vomiting, and incidentally of certain 

 other associated disorders of the stomach, will be discussed in 

 ihe next chapter. 



