It is important to avoid aggravating an ex isting trouble by illogical and promiscuous medication, faulty diet and the use of alcoholic stimulants. Between 80 and 90 per cent of the so-called stomach tonics, liver regulators and stomach bitters are composed of alcohol. But even the prescriptions of physicians are not al ways adapted to the existing conditions. One of the most frequent abuses among practition ers of medicine is the indiscriminate dosing with mixtures containing pepsin. In a similar manner the ferments which convert the starches, the carbohydrates, into sugar, have been much abused. These substances are called diastases. Now diastase is a ferment with which the digestive tract is abundantly supplied. It exists in the saliva in the shape of a ferment called ptyalin, and in many hundreds of tests with human saliva it has been discovered in only 2 per cent of the cases that this substance was not secreted in sufficient quantity. It is conceivable, however, that in a mouth which has been made offensive by carious teeth, by a badly coated tongue, enlarged tonsils and catarrh of the mouth, throat and nose, this ptyalin can be destroyed and rendered ineffect ive; it can also be inhibited by the loss of alki linity of the saliva in acidosis and gout. The proper thing to do then is not to give ptyalin or diastase in form of a medicine, but to cure the abnormal condition of the mouth and general system. A frequent form of gastric disturbance is called by general practitioners "amylaceous dyspepsia,') which is an objec tionable name given to the symptoms of hyperacidity and hypersecretion. This disease is frequently treated by cutting off the car bohydrates or starchy foods, which is irra tional, because they cannot be dispensed with, not on account of the starch only, but on ac count of the proteid which amylaceous foods contain. It will be found from the army rations of men under service of various nations that the carbohydrate portion of the foods is in creased with harder work much more than the proteid or fat portion. Therefore these foods should not be taken away because they may not be perfectly digested; but the cause of the indigestion should, if possible, be removed. If possible, a large amount of natural saliva should be swallowed after meals. Often it has been ob served that with the simple supply of additional saliva caused by chewing a piece of rubber, etc., starch indigestion could not be demon strated in the test-meal, although it had existed before. To Fothergill is attributed the saying that oferments are crutches No doubt many an invalid would prefer walking on crutches rather than not at all. But there are many crutch-walkers, who by modern surgery have been enabled to throw away the crutches and walk unaided. So with the digestive ferments; they may be used with success temporarily, hut the best thing to do is to discover how the patient may digest without them. And in case of amylaceous dyspepsia this is accom plished by cure of the excess of hydrochloric acid formation, or restoring the lost motor function of the stomach. For when the starchy foods are retained in the stomach overtime, they are very apt to cause an excessive secre tion, or to produce an excessive amount of organic acid by fermenting in the stomach un der the influence of bacteria.
In this connection it becomes a duty to warn against the use of saccharin as a substitute for sugar. As our nation is now engaged in the gigantic struggle to preserve its civilization, our government has found it necessary to restrict the sugar consumption. So far, fortunately, not under the caloric requirements for a human being. But to sweeten food and drink by sac charm is a mistake because this substance im pairs the digestive power of the gastric juice— in fact, of all digestive ferments.
Instruction m Cooking Needed in Amer ican Schools.— One of the chief features in the treatment and also in the prevention of diseases of the stomach is the avoidance of improper medication and, what is even more important, of unsuitable diet. Much improve
ment is needed in American cooking and public kitchens and cooking schools might be of great 'benefit. Serious injury is being caused by in sufficient or improper food. Instruction in cooking and diet should be given in all public schools where young girls attend. For nine out of 10 girls that attend these schools it will be a greater blessing, and they personally will Prove a greater blessing to the community, if they know how to prepare a roast, boil potatoes and make an omelet or good bread, than if, ignorant in these things, they can give the most scholarly translation of Virgil. In Europe it is not considered below the dig nity of daughters of the highest families, even those directly connected with royalty, to attend cooking schools. Nor is such an education incompatible with the best scien tific and classical training. So the prevention of diseases of the stomach demands a wider and more thorough knowledge of the art of cooking. In addition to this, it necessitates a simpler life, closer adherence to the laws of nature, more freedom from business strain and nervous tension, and above all things the avoid ance of excess in the use of alcoholic beverages and tobacco. Patients should be impressed with the fact that neither drugs nor any methods of treatment can improve them if they persist in their bad habits and faulty diet. Partic ularly must American business men, who, with admirable energy, but with little regard for their own health, persist in work too severe for their mental and physical constitutions, be taught that the prime factor in their successful treat ment is rest. To such cases mental and physical rest is more essential to recovery than medicine or treatment directed to the stomach. Another factor which frequently leads up to stomach dis eases is inactivity of the intestines, or consti pation. This should in all cases of dyspepsia receive proper attention. When a person begins to feel distress after eating, or eructates, vomits, or has feelings of oppression, fulness or pain in the abdomen and headaches, one of the first treatments that is usually given by sympathizing friends is a drink of some alcoholic beverage. usually whiskey; then comes the abuse of pep sin; very frequently the abuse of some com bination containing soda and mint, or some widely advertised panacea for the diseases of digestion. All this is generally being done in the entire absence of a correct recognition of the real disease. The safest thing for the patient to do in the absence of a logical diag nosis is to rest the stomach absolutely for 24 to 48 hours, and not take any food or medicine whatsoever; and thereafter, beginning with the very simplest kind of food — a small plate of farina, of strained oatmeal, a piece of toast, and a cup of hot milk and lime-water — pro ceed gradually to a cup of bouillon, and a small slice of lean boiled beef. Alcohol, sugars, rich and fatty substances should be avoided for a long time.
Organic Diseases of the are the various forms of gastritis (catarrh of stomach, ulcer, carcinoma, etc.) and the dis placements and enlargements, dilatation. Dis placements — gastroptosis may be congenital or acquired. When the stomach is displaced from its normal position, the condition is in the great majority of cases accompanied with an infirmity of the Keneral nervous system known as neurasthenia (q.v.). Stiller has pointed out that this condition in over 80 per cent of these cases is attended by the loose or floating 10th rib. Normally the 10th rib is attached to the costal cartilages, and these to the breast-bone. But whenever the stomach is displaced out of its normal position and a very diffused splashing sound is audible over the abdomen on shaking the stomach, there is, as a rule, a very movable or floating 10th rib.