THE GENERAL TREATMENT OF STOMACH DISORDERS.
If we exclude cancer, and certain cases where the outlet of the stomach has been narrow from birth, one might say that the great majority of stomach disorders are due to errors in diet, and, whatever else may be done, the dietetic errors must be corrected. It will not always follow that the correction of obvious errors is attended by a disappearance of the digestive discomforts. For the stomach is, in many people, a very long-suffering organ, and when at last, by the urgency or persistence of the symptoms, the patient is compelled to pay heed, mere correction of errors is too mild a measure to set back symptoms the final pro duct of the errors of years. When an arm has been strained by excessive work, the pain pro voked by movement is the call of the muscle to be let alone to have rest, and when discom fort, sickness, and so on attend the taking of food, these are the call of the stomach for rest. But complete rest can only be given for a short time, for the patient's strength must be main tained.
In acute cases, however, when a few days may be sufficient to get rid of the worst symptoms, if the patient is not emaciated or weak, the reduction of food to the smallest possible amount, of the simplest kind, may be unattended by any risk. But where the patient is already emaciated and weak by prolonged suffering and digestive difficulty, reduction in the food supply may be impossible. In such cases the lightening of the work of the stomach can only be achieved by saving the patient's energy in every way, which means absolute rest in bed. In acute cases this should always be the first step, since when the patient is at complete rest in bed a much-lessened supply of food is called for.
In all cases where symptoms cannot be re lieved by correction of obvious errors in diet, it is best to reduce the food to the minimum, or for a day or so even below, and then as im provement takes place gradually to build up a diet.
The minimum may be taken as 3 pints of milk in 24 hours, but it is best to administer it from early in the morning to late at night, hut to leave 6 hours or so during the night for complete stomach rest, when nothing is taken unless a little water.
Three pints mean 6 tumblers, or 12 tea-cup fuls, that is a tea-cupful every hour from 8 a.m. to 7 p.m., or, let us say, every hour from 6 &m. to 12 noon, that is 7 cups, and then every 2 hours up to 10 p.m., that is other 5 cups.
If all discomfort ceases, as it often does, in 24 or 48 hours, then the interval should be lengthened and the amount increased, say 1 tumbler every 2 hours from 7 a.m. to 9 p.m., that is equal to 8 tumblers or 4 pints. If im provement is maintained the interval may be further lengthened and the amount increased, not now by increasing the amount of milk, but by adding something else ; thus a tumbler every 3 hours with a rusk, or i-slice white bread, stale, broken down in the milk, or a cracker, or plain tea-biscuit. If this is successful, a little milk-pudding may be substituted for the bread, or a portion of au egg which has been dropped into half a pint of hot water and allowed to stay long enough just to set the white. One may substitute for 1 tumbler of milk a break fast cup of the thin only of chicken or mutton soup, with bread made into a " mush " in it, and the interval lengthened to four hours or varied according to the meal. Later, all symp toms remaining away, small supplies of solids may be introduced in substitution for one of the other meals, say lightly-steamed finely minced tender beef or chicken or the lean white fish, whiting, haddock, sole, or flounder, with a little stale bread. After such a meal 4 or 5 hours would be allowed to elapse before a fresh supply of food would be given. Thus gradually a return to fuller and more solid meals would be made. The principles that should guide such meals are these : 1. There should be no mixtures of solids and liquids, except such as easily mix and form a pulpy mass, such as bread or rusk and milk, well - boiled oats and milk, rice and milk, or milk-pudding and milk.