44 



Scientific Proceedings (iio). 



hourly administration keeps the secretory glands of the stomach 

 in a state of constant activity. Recognizing this some authors 

 advise the neutralization of the gastric contents with magnesia or 

 soda midway between the feedings. Since the majority of the 

 symptoms of gastric ulcer, at least in the earlier stages, and 

 possibly considerable injury, are referrable to hyperacidity, such 

 a diet lacks physiological support. In addition to excessive secre- 

 tion, the motor activity of the stomach is abnormally increased. 



In the diet which I propose the objections referred to have been 

 eliminated. Moreover, I believe that the maximum protection 

 of the ulcer obtainable when food is given by mouth has been 

 achieved. As in some other diets, complete rest is given the 

 stomach for 3 to 5 days through the use of glucose enemata — 300 

 c.c. of a 7 per cent, to 12 per cent, solution by the Murphy-drip 

 method, three or four times a day. The quantity of water is 

 sufficient to prevent thirst. Protein and fat are not added to the 

 enemata because of the doubt of their absorption. 



Since a satisfactory state of nutrition cannot be maintained 

 by nutrient enemata alone, foods for administration by mouth 

 must be selected. Theoretically, egg-albumin to furnish the 

 necessary nitrogen and olive oil to furnish the greater part of the 

 energy most nearly meet the requirements. According to Pawlow 

 egg-albumin, alone, does not call forth gastric secretion and oils 

 inhibit it. In addition, olive oil affords mechanical protection to 

 the ulcer. The olive oil is given at first in moderate but gradually 

 increasing quantities, up to a total of 150 c.c. a day — 1,395 

 calories. The whites of two or three eggs a day are added shortly 

 after the oil is begun and increased to five or six — 7-8 gm.N and 

 450 calories. The 100 gm. of glucose, given by rectum throughout 

 the treatment, brings the energy intake to some 2,200 calories a 

 day. The procedure is continued for three or four weeks. This 

 diet has been employed for about eight years and the results 

 have been satisfactory. 



