It has recently become customary in medical practice to administer large quantities of bismuth-powder before meals, in order to form a protective covering for the ulcer. This procedure is very appropriate. If the patient be not in a position to take a rest, being obliged to attend to his daily work, it becomes very difficult—often impossible—to effect a cure. Since a strict diet cannot very well be observed under such conditions, the only treatment that remains at the physician's disposal is internal medication, which is not certain as to success. In case a hemorrhage from the stomach occurs, immediate rest in bed is imperative. An ice-bag should he placed upon the abdomen, and cracked ice administered. Fluid nourishment only should be given, and in small quantities. Other efforts to stop the bleeding must be left to the physician.
Attempts have been made to treat gastric ulcer by operative m ans, either by removing the ulcerated part of the membrane, or by performing the operation of gastro-enterostomy, whereby an artificial canal is established through which the food may pass into the intestine. In this way the ulcer ated surface is, to some extent, spared the constant irritation caused by the passage of food. The results so far accomplished by surgical treatment are, however, too uncertain to justify its recommendation. The great majority of gastric ulcers may he cured by careful dietary and medicinal treatment.
STOMATITIS.—An acute inflammation of the mucous membrane of the mouth, characterised by a sensation of soreness and burning in the mouth (especially when eating), and by redness, swelling, and loosening of the gums, which bleed at the slightest touch. In the course of one or two days
a smeary coating develops. covering serrated ulcers, which rest upon a grey and greasy base. A large portion of the gums may thus be transformed into a sticky mass, usually accompanied with a loathsome odour. The saliva, which is secreted in profusion, becomes discoloured, malodorous, and often bloody. If the saliva flows backward into the larynx while the patient is asleep, coughing, or even attacks of suffocation, results. The teeth are loosened, and small parts of the lower jaw-bone may even become necrotic. The tongue is heavily coated, and its edges show impressions of the teeth. In rare cases gangrenous disintegration may occur, occasionally endangering life.
Stomatitis is observed either in isolated cases or in epidemics, the latter occurring principally in poorly ventilated prisons, barracks, asylums, etc. It may be due to a number of causes. Great heat, continued dampness, amemia, diseases of the lungs, diabetes mellitus, scurvy, and scrofula favour its appearance. The affection almost invariably terminates in recovery, gross negligence being probably always the cause of unfavourable cases. Treatment consists in the use of mouth-washes, to be prescribed by the physician. Internal remedies are frequently employed also.
STRABISMUS.—See SQUINTING.
STRAMONIUM.—The leaves of the Datum Stramoninm, called also Jamestown-weed, or jimson-weed. It contains atropine, hyoscyamine, and scopolamine. For the action of these alkaloids, see the articles under their respective headings. The tincture of stramonium is given in doses of one to three drops.