GASTRIC TYMPANY 63 



In this particular instance the use of the carbonate 

 would be well-nigh fatal : and this is the reason. We 

 may safely assume with a tympanitic stomach that we 

 have an acid condition of its contents. That being so, the 

 administered carbonate would, by the action on it of the 

 acid, be caused to evolve carbonic acid, and add still 

 further to the volume of that gas already in the stomach. 



The form of ammonia indicated is the solution of 

 ammonium hydrate (the liquor ammonias fort, of the 

 pharmacopoeias), because by its exhibition the carbonic 

 acid gas present in the stomach will readily be absorbed 

 (to form ammonium carbonate) while, with a suitable 

 addition (as, for example, iron or bismuth) the sul- 

 phuretted hydrogen may also be combined, and caused 

 to leave its gaseous form, thus greatly lessening the 

 volume of gases in the stomach. Such an admixture is 

 easily prepared as follows : 



Ferri sulph. pulv. gi. 



Aqua (fervens) Oii. 



Liq. amnion, fort. 3iv.^ 



This mixture, with its resulting precipitate, should be 

 administered at once. The freshly precipitated hydrate 

 of iron combines with the sulphuretted hydrogen, while 

 the free ammonia, still exerting its stimulant and anti- 

 spasmodic actions, absorbs the carbonic acid. 



This is the treatment I would recommend as the most 

 suitable for disposing of the accumulated stomach gases. 

 This done, it is wise to follow on with the exhibition of 

 some form of mild antiseptic, one with stimulant pro- 



1 One word is necessary in order to explain the apparently 

 excessive dose of liq. ammon. fort. An estimated 3 drachms of 

 that goes to the formation of hydrate of iron, thus leaving really 

 only I drachm of free ammonia for stimulant and antispasmodic 

 purposes. — H. C. R. 



