GASTRIC INFLAMIATION—GASTRIC NEUROSES 3if meantime. Vomiting and pain should be met by small doses of Morphia combined with Bismuth and Hydrocyanic Acid (see recipe on p. 237). Where there is a thick coating of fur on the tongue with much nausea and retching a plain effervescing mixture every two hours gives better results. 4o grs. Bicarbonate of Potash should be administered in solution with each oz. fresh lemon-juice, and a large sinapism may be applied to the gastric region. As soon as vomiting ceases, a brisk saline purge should be given, and a spoonful of iced milk mixed with effervescing kali water or liquor calcis may he administered every few hours.
The catarrhal condition subsides upon the withdrawal of the cause, and as this is usually due to errors in the selection or cooking of the food, imperfect mastication or irregularity in meal-hours, &c., these points should be thoroughly investigated, and the general directions detailed in the article on Dyspepsia carried out.
The treatment of Acute Toxic Gastritis is that of the poisoning by the mineral irritant which is operating as the cause of the acute inflammation. This will he found under Arsenic. Phosphorus, Mercury, &c., in the article headed Poisoning.
Acute Phlegutonous or Suppurative Gastritis is a rare and almost in variably fatal disease for which little can be done, as the affection runs a course too rapid to admit of vaccine or serum therapy. Relief may he obtained by rectal and hypodermic injections of normal Saline solution and by Morphia given hypodermically.
Chronic Gastritis.—As acute catarrh of the stomach is usually accepted as a synonym of acute dyspepsia, so chronic gastric catarrh is by many regarded as identical with the tangled web of symptoms known as "chronic dyspepsia." That the primary error is not of inflammatory nature in the strict sense in which we use this term is at once obvious when we see how speedily the chronic dyspepsia disappears upon removal of the exciting cause.
The first step in the treatment should be a minute search for every possible factor which causes simple dyspepsia. These have been dealt with in the article on Dyspepsia, and need not be here recapitulated. The gastric symptoms may be counted upon with confidence to fade away as soon as the diet,imperfect mastication, belching habit, oral sepsis,improper cookery, &c., have been corrected. Rarely will drugs be required unless in those very chronic alcoholic cases where the disturbing factor has been long in operation and has established an atony leading to gastric dilata tion, in which case the dyspeptic condition has glided from that of a simple dyspepsia into an inveterate gastric neurosis, or ulcers may have formed. In addition to the remedies mentioned under Dyspepsia, lavage, massage, electricity and even gastro-enterostomy may be then demanded, as detailed in the articles on Gastric Dilatation and Gastric Neuroses.