(navigation image)
Home American Libraries | Canadian Libraries | Universal Library | Community Texts | Project Gutenberg | Children's Library | Biodiversity Heritage Library | Additional Collections
Search: Advanced Search
Anonymous User (login or join us)
Upload
See other formats

Full text of "The stomach: its disorders, and how to cure them"

Google 



This is a digital copy of a book that was preserved for generations on library shelves before it was carefully scanned by Google as part of a project 

to make the world's books discoverable online. 

It has survived long enough for the copyright to expire and the book to enter the public domain. A public domain book is one that was never subject 

to copyright or whose legal copyright term has expired. Whether a book is in the public domain may vary country to country. Public domain books 

are our gateways to the past, representing a wealth of history, culture and knowledge that's often difficult to discover. 

Marks, notations and other maiginalia present in the original volume will appear in this file - a reminder of this book's long journey from the 

publisher to a library and finally to you. 

Usage guidelines 

Google is proud to partner with libraries to digitize public domain materials and make them widely accessible. Public domain books belong to the 
public and we are merely their custodians. Nevertheless, this work is expensive, so in order to keep providing tliis resource, we liave taken steps to 
prevent abuse by commercial parties, including placing technical restrictions on automated querying. 
We also ask that you: 

+ Make non-commercial use of the files We designed Google Book Search for use by individuals, and we request that you use these files for 
personal, non-commercial purposes. 

+ Refrain fivm automated querying Do not send automated queries of any sort to Google's system: If you are conducting research on machine 
translation, optical character recognition or other areas where access to a large amount of text is helpful, please contact us. We encourage the 
use of public domain materials for these purposes and may be able to help. 

+ Maintain attributionTht GoogXt "watermark" you see on each file is essential for in forming people about this project and helping them find 
additional materials through Google Book Search. Please do not remove it. 

+ Keep it legal Whatever your use, remember that you are responsible for ensuring that what you are doing is legal. Do not assume that just 
because we believe a book is in the public domain for users in the United States, that the work is also in the public domain for users in other 
countries. Whether a book is still in copyright varies from country to country, and we can't offer guidance on whether any specific use of 
any specific book is allowed. Please do not assume that a book's appearance in Google Book Search means it can be used in any manner 
anywhere in the world. Copyright infringement liabili^ can be quite severe. 

About Google Book Search 

Google's mission is to organize the world's information and to make it universally accessible and useful. Google Book Search helps readers 
discover the world's books while helping authors and publishers reach new audiences. You can search through the full text of this book on the web 

at |http: //books .google .com/I 



IL^i^^Bl 




I11Y4I ^i^igiMijiMMiJl 



. '^^^^ f 




In Ihe ttlxivB dittgrdio llie posiLiun of Ihe stomuch will be 
Flenrly stten. together with its relation to other iaternul iirgana. 
I, HUlmacli, partially covr^red by lh(^ liver mill lungs; III. Small 
intestines: IV. Colon; V. I.«wer or sigmoid portion of the 

PLATK \.~ IS'TERNAL ORGANS. 





n^ 


i 


P 


1 


mL 


J 



THE STOMACH 



rrs DISORDERS, ind 



mow TO Cure Them. 



r 


By 


J. H. KELLOGG. M. D., 




f/tnUnI „/ ,ht 


Mrduial 


Miuianary ColUtrt. Oiuago. HI. 


; Mtmbtr of llu SHI 


m Gynct^ogi 


CBl Sociri, 




rr», of CyntMi,iy 


amd ObUttti. 








tf Scunu, 


• lAt Soti- 


•U ^ Hyg&nt af Praia : FanAw 




«f Rtligi 




MtCTBimpiiU : 


Amtric 


m Eltclrc 


•-Thrraftutu AHOCiatioH; Amtri 


can aimalo- 


tt^alSxitlf^ 


Amtncan Mediial Aimialian; . 






lley Mrdti, 


il Auocialum; nf-SlaU Mldical 


Saculy; 




MaKigan 


Stale Mtdical Sontlj; Superatlndtrnt 


\ 


of lltt 


BatUi Crttk (Afnh.i Santlarim 





ILLUSTRATED. 



MODERN MEDICINE PUB. CO., 

BATTLE CREEK, MICH. 

CarcAGO: New Yofk: Lohejon 



To 



MV l^ATIENTS 



This Book 



Is 



Affectionately Dedicated 




As eminent coroparative anatomist deflnea an animal as "a 

[omacb with various organs appi'ndiKl, " — a definition vliich 

presents in a very clear li^ht tlie relative Importance of ilie 

CUomach In thi> association of ihc organs and structures wliicli 

1 eoDBlltute the human as well as tlie animal bodj. Th« stomacli 

[ must certainly bo regarded as Ihu center at tlio nutritiro proc- 

a of tlie body, and any derail gi' me it t of its Tunctiona must 

[ therefore result in disorder ot the entire organism. 

The close relation between the condition of the Btoronch and 

F that of tbe miiid lias bei'o observed even by the most primitive 

} nations, and has led some of tht^m to regard the Htomach aa the 

veritable seat of thp soul. There is sound truth in the ancient 

[■German adapp, "As a man eateth, so is he." 

It may truly be said that disorders of digestion are the most 
rprevaleot ot all human ills, and investigators within the last 
J twenty years have been msldng more and more clear the tact 
L that the great majority ot diseases are primarily due to derange- 
J taentot tbe digestive processes. The remarkable researches ot 
l Pmfessor Bouchard, of Paris, and others, have shown that such 
I diseases as consumption, typhoid fever, and cholera, as well as 
I Bright's disease and analogous maladies, are indirectly, If not 
C dirtvily, due to a disordered condition ot the stomach, as the 
Liesull of which the defenses of the body arc broken down, and 
f infection rendered possible. 

Notwithstanding the great prevalence ot stomach disorders, 

I «od (he large amount of knowledge and eiperienoe which have 

I lieen accumulated by the profession in regard to them withip 

b the last few years, it is nevertheless true that no other class of 

P curable disorders has more frequently baffled the best directed 

(efforts ot medical practitioners. This is doubtless owing to 

the imperfect knowledge of the processes of digestion and of 

the nature of the disorders to which the digestive organs are 

subject which has prevailed from the earliest times to within n 

comparatively brief period. Within tbe last score of years. 

[31 



G4!273 



I 

i 



THE 



however, marvelous progress has been made Id Ibe stud; of the 
BtomActa and its work, through the use of the stomooh-tube. and 
by the aid ot experimental researches undertaken by numerous 
European and a few American investigators. 

Ab the result of these inquirJea. a great many most interesting 
and important facts have been discovered, which have almost 
■wholly tevoIutionUed our ideas respecting the nature of di- 
gestive ailments and successful methods of treatment. 

One of the leading purposes of this book is to cull atl«nti«n 
lo these newer facta in relntion to the digestive processes, and 
especially lo point out their relation lo the pn-vention and suc- 
cessful treatment of dyspepsia and allied ailments. As will be 
seen by reference to the tiible of contents, the work embodies, 
first, a brief sketch of the proc<>i»cs of digestion : then a consider- 
ation of the causes of indigestion, and their bearing upon die- 
tetic and other habits, to which is added a description of the 
various symptoms presi-nt in functional diseases of the stomach. 
together with the means by which they may be relieved, fol- 
lowed by a consideration of each of the several classes of di- 
gestive disorders, and the proper dietetic and other measures 
necessary for their cure. 

In the study of the practical part of the work, it will be 
noticed that the measures of treatment recommended are of n 
remarkably simple characicr. This may lead to the impression 
that they are lucking ill elHcicncy ; hence it may be proper In 
say in their defense, that many years of experience in the treat- 
ment of a large number of patients of this class, in connection 
with the Battle Creek (Mich.) Sanitarium, have fully established 
the author in the belief that in the proper regulation of the diet, 
In the varied uses of water as described in Bcientiflo hydrother- 
apy, in the employment o( electricity. Swedish movements. 
Swedish gymnastics, massage, and exercise, logelhcr with gen- 
eral control of the habits of life, we have means of far greater 
value than all others for combating those causes which give 
rise to indigestion, and of aiding nature in her efforts for re- 
covery from the varied morbid conditions resulting from the 
numerous disorders commonly iocluded under the general term, 
"dyspepsia." 

The man who is suffering from indigestion Is sick, not in his 
stomach alone, but in every cell and fiber of his body; there is 
no souiidnnss in him. The patient, is well as his sfomsch. must 




receive atteotion. Our aim must 
tient'a Eympioms, but lo cure ti- 
ls done, the symptoms disappear. 

Cace has beeo taken to gii'e iia Eicuuratc and precise descrip- 
tion ot the vatioufi measures oF treulmcut suggested, and to pre- 
sent them ia such n manner that they may be readily available 
to every reader; but to save the consumption ot space which 
would be necessitated by a constant repetition or the descrip- 
tion, the treatments are referred to by number. The numbered 
paragraphs will be found in the chapter between pa^es 287 and 
344, Ld which are described all the various measures ot treatment 
suggested in this work. 

The description of the newer methods of investigating dis- 
orderi of the stomach, whereby it is now possible 10 apply to 
their study the exact methoils of chemistry and biicioriologj-, 
will, it is hoped, be of special interest to the reader. It is In- 
deed Dot saying too much to assert that the nature of disorders ot 
digestion may now be determined with as much accuracy as 
thai of any other class of maladies, and that the old method of 
ascertaining by experiment tht^ diet best adapted to an indi- 
vidual case. Is no longer necessary, — at least where there are at 
command the resources aSorded by recent progress In this branch 
iif medical science. 

The iudividuul who wishes to make use of this worli as u 
means to his own recovery, must, first of all, carefully read the 
entire work. He should then Bv«k. either with or without the 
aid of B physician, to arrive at a correct diagnosis ot his case. It 
possiblu, the services of a skilled physician should be employed . 
a, toat moul taken, and the metliods of rxaminatioii described on 
pages 134, 320, and 332, utilised. More light is thrown upon the 
nature ot digestive dl.sturbances by the methods of examination 
here referred to. than from all other sources combined. The 
nature of the disorder being determined, it will be easy, by the 
aid of the table of coDtent.i or the imieit. to liirn to the section 
which deals with this purticular form of digestive disturbance ; 
and tben, having become familiar with the causes of the trouble, 
and the means ot preventing its aggravation, such rational 
methods of treatment as will be efUcienl. and. it is believed, 
successful in a majority of cases, may be carried out at home. 

In conclusion, the author desires to remark thai it is not the 
purpose of this book to undertake to displace the wise family 



TBS BTOMACH. 



pbysichm, but rather to aid and abet him Id the management of 
a class ot maladies which ruquirog, pt^rhaps more iliaii all ethers, 
I the thorough co-uperation o( the patient. That this may be 
!UFed. it is necessary that the patient should be educated in 
ation to [hi; nature ol liis m&lady aod the various methods b.v 
whioh he may rcniler assistance in his own restoration to health. 
The need of such a work has been made apparent to the writer 
I many times in his own practise. For years past, bis patients 
have been constantly demanding a manual which should consti- 
tute, to some degree at least, a guide to them in their efforts to 
recover a healthy digestion ; and it is hoped that this little work 
will be found to give the information which every sufferer from 
indigestion ought to have, and which every busy general practi- 
tioner cannot but be e\itil to have his patients suffering from this 
I class of disorders, possess. 

number of cuts, some of which are original, and several 
i. have been added to the text, which it is hoped will aid 
n giving the reader a clear Idea of the subject presented. 



TABLE OF CONTENTS. 



ITS DISORDERS AND HOW TO 



Moclt'rn researches — Germs and Iniligesiion — Pepsin 
un<l putent metltcincs — Rekiioa ot dyspepsia to Insan- 
ity and other disorders. 

^ THE ORGANS OF DIGESTION 

The healthy stomach — The alimentary canal ~ The 
mouth — The saliva — Ptyalin — The teeth — Tempo- 
rary teeth — Permanent teeth — The esophagus — Tht 
stomach — The pepiio glnnds — The gastric juice — Pep- 
Bio — RenniD — The pylorus — The small intestine — 
The iotestinal Juice— The absorbents — The colon — 
The liver — The bile — The pancreas — The pancreatic 
juice — Amylopsin — Trypsin — Steapsin — Millc-eur- 
dliDg ferment. 

' FOODS 

Animal and vegetable foods — Plants the only food-pro- 
duoers— Food elementa-Classiflcalionot food elements 
— Btarch — Sugar — Glucose — Millc sugar — Albumen — 
Cuein — Fats — Sails- Indigestible elements — Condi- 
menla — Food substaacea — Foods of animal origin — 
Milk — Cheese— Eggs — Flesh — Fish and Fowl — SbeU- 
fish — Oysters — Frogs — Lobsters — Salted and smoked 
meats — Vegetable foods — Fruits, grains, and vegetables 
— Legumes — Peptogens — Gluten — Dextrin — The nat- 
ural diet of man — Vegetarianism — Uses of the several 
food elements — Digestibility of various foods — Nutri- 



tive values of 



food substances. 



THE DIQESTIVE FLUIDS 

Alexis St. Martin — What the saliva digests- What the 
gastric juice digests — What the bile digests — What the 
pancreatic juice digests — What the intestinal juice di- 
gests. 

GENERAL VIEW OP THE DIGESTIVE PROCESS . 
Maslicailon — Salivary digeatioo — Deglutition, or swal- 



lowing — Stomach digeatloc 



-Action of the pylorui- 

m 



THE 6T0HACS. 



IntestiDHl digestion ~ Olher uses o( the digestive fluids- 
Gastric juice BDd bile, &atiseptica — PeriBtaltto nctioo 

— Absorption — How the diaphragm aids absorption — 
The tacteals — The portal vein — Liver digestion — Gly- 
cogen — Liver starch — The two doora, the liver and the 
kidneys — Breathing and liver action — Vagaries of di- 
gestion—Poison found in oysters. 

THE MALADIES OP THE MODERN STOMACH . i 

The causes ot dyspepsia — Conditions of healthy diges- 
tioD — Causes of fermentation in the stomach — Disin- 
fecting action of the gastric juice — Errors in diet — 
Hasty eating — Experiments in relation to salivary diges- 
tion ^Indigestion of starch — Relaiion of maltose to 
digestion — Diseased teeth — Relation of detective teeth 
to indigestion — Microbes ot the moutb — Disinfection 
of the mouth — Giles Corey's dream — Tartar of the teeth 

— Drinking at meals — Effects of tce-waler — Dr. Beau- 
mont's experiments upon Akils St. Martin — Eating too 
frequently — All-gone feeling in the stomach — Eating 
between meals — Irregularity of meats — Rhythmical 
action ot the intestines — Pro|>er number of meals — 
Habits of ancient nations in relation to the number ot 
meals- Habits of modern nations in relation to the num- 
ber of meals — Opinion of Dujardin-Bcaumetz — Late 
suppers and six-o'clock dinners — Eating when exhausted 
-Effects of violent exercise upon the digestion -Rest 
before and after meals — Sleeping after meals — Too 
many varieties of food at one meal — Good and bud com- 
binations of food — Hot and cold bathing after meats — 
Errors in quantity of food — Overeating — An extraordi- 
nary case — A case of dilatation of the stomach — Eating 
too little — How much should a person eat ? — Regula- 
tion of diet — Muscle -workers and brain-workers — Die- 
tetic habits of Dickens and Newton — The quantity of 
food required at different ages — Desserts — Cornaro^ 
Experiments ot Letheby and Parkea — Diet of pugilists 
in training — Economy in diet — Dcflcicncy in necessary 
food elements — Effects of an impoverished diet — "Pat- 
ent flour " and " family flour "— Unwholesome graham 
flour — Bogus gluten flours — Table relating to indiges- 
tion ot food elements — Table showing proportion of 
nitrogenous lo carbonaceous elements — Proper propor- 
tion of nitrogenous and carbonaceous elements —Amount 



COSTESTfl. 



of food required for a day's rations — Quality of food — 
Bad cookery — Fried food — "Uncooked food-— Cooking, a 
sort of artJQciaJ ripcnlog of food elements — Why green 
fruit and f aw vegetables are indigestible — Imperfectly 
cooked food — Decayed foods — Shell-fish — Rapid decay 
of animal tissuus after death — The true nature of beef 
lea — Cheese and cholera morbus — Microbes of milk — 
Soft food — Influence of soft fiiod upon the teeth of cows 
and human beings — Too abundant use of fats — Decom- 
position of fats in the stomach — Why butter is Indigest- 
ible — Why tuts cause biliousness — Why fnls are ren- 
dered indigestible by cooking — Why fnls Interfere with 
Ihe digestion of other foods — The superior dietetic 
value of nuts — Nut butter — The excessive use of sugar 

— Relation of sugar to fermentation — Influence of sugar 
upon the stomach and liver — Why the excessive use of 
su^r causes diabetes and obesity — Excessive use of flesh 
food — Relation of meat diet to rheumatism, g-out, and 
Brighfs disease — Dnnger in the use of raw meal — Con- 
diments — Beaumont's observations of the clTectB of con- 
diments upon St. Martin — The excessive use of mustard 
and pepper in Mexico, and the results — Effects of salt 
H[xin digestion — Pickles — Vinegar — Vinegar eels — 
Vinegar eels as parasites— Tea and coffee — Injurious 
effects of tea and coffee upon digestion — Alcohol— Sir 
William Roberts's experiments — Beaumont's experiments 

— Tobacco — Influence of tobacco upon digestion — 
Hard water — Alkalies^ Baking-powders — Perverted 
iippeiites — Adulterations of food — Unseasonable diet — 
Pressure upon the stomach — Bruin work — Lack of ex- 
ercise — Mental impressions — Drugs— Laxatives — Pur- 
gatives — Mineral waters— Sexual abuses — Diseases of 
other organs — Inherited dyspepsia — Nursing bottles — 
Infant foods — Paregoric — Mrs. Winslow's Soothing 
Sirup — Worm teas — Dilatation of the stomach in chil- 
dren—Undetermined causes — Impure water- Germs 



1 

4 



IMPORTANT NEW DISCOVERIES RELATING TO 

DIGESTION 1 

The stomach'lube — Measuring the size at the stomach 
— Clapotement — The author's method — Prolapsa of 
stomach, kidneys, and other organs — Examinatioo of 
stomach contents — Test meal — Facts determined by 



J 



I 



k. 



10 THE fiTOMACB. 

test meal — Bacteriological examination of the Btomach 
contenLa — Gcrma of Ibe stom&ch — CoefflcicDts — Ct&ssi- 
flcation of stomach disorders — Hyperpepsia — Hj-po- 
pepsia — Apt^psiu — Simple dj'Bpepsin, 

8YMPTOM3 OF DYSPEPSIA ..... 1 

ClBSHification ut iiidigeBlions — Prini'ipal Bymploms of 
indlgfsiion — Symptoms periaiuing lo the moulh — 
Symptoms porlaining to the throat — Symptoms pertain- 
ing 10 the esophagus — Symptoms pertaining to the 
stomach — Disturbances of the motor functions — The 
discharges — Symptoms pertaining to the rectum — 
General nervous symptoms — Pliysical signs. 

THE SYMPTOMATIC TREATMENT OF INDIGES- 
TION I 

Uneasiness at the stomueh— Flatulence — Fermentation 
— Acidity — Acidity from hyperpepsia ^Hi-arlbura — 
Water-brash, or pjTosls — Niiusca — Vomiting — Rogur- 
gitalion, ruminuliou, or mcrycism — Gripes, or colic — 
Weight, constriction, tightness, etc.— Piiin — Biliousness 

— Appe&rance of the tongue — Aphthie — "Throat-all" 

— Sour taste in the mouth — Constipation — Diarrhea — 
Backache — The stools — The urine- Dryness of the 
skin — Skin eruptions — Cold feet, etc. — Headache — 
Migraine, or nervous headache — Nervous apoplexy — 
Disturbance of the circulation — Nocturnal asthma of 
indigestion — "Stomach cough" — Nervous symptoms 

— Nervousness — Disturbances of sight, hearing, etc. ~ 
N'.-rvouB diseases — Unusual drowsiness — Sleeplessness — 
Heiital disorders — Dilatation of theBlomaah — Prolapse 
iif the stoniafh, 

TREATMENT OF DYSPEPSIA 2 

Diet and regimen — Dietetic rules — Diet tables- Diet 
List No. 1, aseptic dietary- Diet List No. 2, dry dietary 

— Diet List No. 3, nitrogenous dietary — Diet List No. 4, 
farinaceous preparatious^Diet List No. 5, milk — Diet 
List No. 6, eggs and milk — Diet List No. 7, easily disin- 
tegrated foods — Diet List No. 8, anti-fat dietary —Diet 
List No. 9, fat and blood dietary — Diet LislNo, 10, fruits 
and nuts— Diet List No, 1 1, Hquiddietary — Diet List No. 
12. fever diet— Diet List No. 13, unfermented breads- 
Diet List No. 14, for a hottle-(ed infant under six 
moDtfaa of age— Diet List No. 15, for a teething infant 




I 



CONTBNTB. 1 

— Diet List No. 16, (or a ciiild from one to five years of 
age — Diet List Ko. 17, ctttiDg (or strength— Diet List 
No. IS, diet for udulla — Diet List No. 10, for rheumatism 
and gout — Diet Dat No. 20, tvt gustritis — Diet List No. 
21, Tor constipation — Diet List No. 22, srticies diflicult 
ot digestion — Foods not easy of digestion — Diet List 
No. 23, foods wlitcti promote fennentation aud decom- 
position in the stomach — Di*t List No, W. nutritive 
encmata — Diel List No. 25, health foods — Zwiebaclt — 
Granose — Granola — Gluten biscuit — Caramel-cereal — 
Bromoae — Nut meiil and nut butler — Goflo — Kumy 
zoon — Flesh food — Antisepsis of the minith — Sln'pli- 
dyspepsia — Acid dyspepsia — Bilious or foul dys pepsin, 
or aeptio indigestion — Paiatul dyspepsia — GasiHu 
neurasthenia, or nervous dyspepsia — Hypopepsia and 
apepsia — What about pepsin ? — Hyperpcpsia — Catarrh 
of the Btomach — Starch indigestion — Intestinul Indi- 
gestion — Torpid liver — Infaiuile dyspepsia — An im- 
portant caution — Chronic catarrh of tlie atomaeh — 
Ulcer of the stomach — Cancer of the stomach — Con- 
stipation, 
REMEDIES FOR THE HOME TREATMENT OF DYS- 

PEPSIA 2 

The sponge or hand bath — The full biith— The salt 
glow^ — The shower bath ^ The tubbing wet-sheci — 
The wet-sheet paclt — Tho trunk pacl; — The hoi and 
cold trunii pacli — The wet girdlo — Fomentation — 
Mustard or turpentine fomentation — Dry heat — Tho 
toot bath — The sitz or hip bath— The aun balh — The 
vapor bath — The hoi-air bath — Hot and cold to the 
spine — The hot and cold pour, or pail douche — The 
hot and cold full balh — The enema- The colociys 
ter — The cold and tlie graduated enema — The laxa- 
tive enema — The oil enema — Oil rubbing — Massage, 
kneading — Abdominal massage — Massngo ot the 
bowels — Massage of the stomiich —Replacement of 
the viscera — Inspiratory lifting of the abdominal con- 
tents — Hacking — Beating — Qflneral massage — Exer- 
cise — Exercises to develop the abdominal muscles — 
Breathing exercises —Chest lifting — Manual Swedish 
movements — For general debility and anemia — For 
dilatation of the stomach — For prolapse of the stomach, 
bowels, colon, kidneys, and other abdominal organs — 



TRE 8TOHA.0H. 



I 

t 

I 



For dyspepsia with dilatation of the atomach — For 
constipation — The dry abdominal bandage — The ab- 
■JDinlii.il supporter — Lavage — Hot and cold lavage ot 
the stomach — CharcoMl — Cliarcoal taJjleta — AntiBeptio 
charcoal tablets — Lactic acid — Hydrochlorio acid — 
Laxatives — Caacara sagrada — Aqua sallna — Seltzer — 
Sulphur — Antiseptic dentifrice — Cinnamon solution 

— The Perfection VapotiKer — Benzoin solution — 
Guaiac solution — Subcarbonate of bismuth — Bubgal- 
tat« at bismuth — Bicarbonate of soda — Local applica- 
tions of laradio electricity — General app.ications of 
taradic eleclrieily — The high tension sinusoidal current 

— Thi: low tension sinusoidal current — Oalvani nation of 
the spine and abdomen — Oalvanizalion of the sympa- 
thetic nerve — ^The rest-cure — General nutritive treat- 
ment — Geiii-rul tonic treatment — Mechanical Swedish 
movements — The vibrating chair- Mechanical knead- 
ing — Trunk rolling — Pelvis tiltinir — Mechanical res- 
piration— Cannon-ball massage — Water-drinking— The 
hunger-cure — Healthful dress — Sleeping — Traveling 

— Mental and moral trealmi'iit. 

QUACKS AND NOSTRUJrfS 3 

Sloughloii Bitters — Brown's Iron Bitters — Hop Bitters 

— Hostetter's Bitters — German Bitters — tilomauh Bit- 
ters — French Absinthe — Vinegar Bitters— Lee's Anti- 
bilious Pills— Tropic Fruit Laxativi-- Carter's Little 
Liver Pills — Simon's Liver Regulator — Radway's Regu- 
lating Pills- Eno's Fruit Salt-- Hamburg Ten — Qar- 
Beld Tea — Holloway's Pills — Hamburg Drops — R.V. 
Pierce's Pleasant Purgative Pullets— Dr. Hall's Ho-ealled 

GRAPHIC METHOD 3 

Explanation of the Author's Graphic Mode of Repre- 
senting the Results of Stomach Work, obtained from the 
Examination of the Stomach Fluid by the System of In- 
vestigation Employed In the Hyjrienic and Physiological 
Research Laboratories of the Sanitarium at Battle Creek, 
Mich., U. S. A. — The coplfi<-ipnls of digestive work. 



LIST OF ILLUSTRATIONS. 



Fig. 


1. 


Fig. 


2. 


Fig. 


3. 


Fig. 


4. 


Fig. 


5. 


Fig. 


6. 


Fig. 


7. 


Fig. 


8. 


Fig. 


9. 


Fig. 


10. 


Fio. 


11. 


Fig. 


12. 


Fig. 


13. 


Fig. 


11. 


Fig. 


15. 


Fio. 


16. 


Fio. 


17. 


Fio. 


18. 


Fig. 


19. 


Fig. 


20. 


Fio. 


21. 


Fig. 


22. 


Fig. 


23. 


Fig. 


24. 


Fig. 


25. 


Fio. 


20. 


Fig. 


27. 



PAOR. 

•The Salivary Glanbs 22 

■ToB Temporary Teeth 23 

•Thb Permanent Teeth 2-1 

■The Stomach 25 

Peptic Gland 2(5 

•The Alimentary C\\nai 27 

The Absorbents 2d 

•A. Pancreas; B. Diodkntm: C. Spleen 30 

Starch Granules 32 

The Mesenteric Glands and Lacteals . 50 

Diagram of the Circulatory Systems 51 

Human Teeth Covered with Tartar 04 

Human Teeth Injured by Tartar 04 

Teeth of Healthy Cow 101 

Teeth of Cow Fed on Distillery Slops 102 

Vinegar Eels 113 

Yeast 159 

Uric Acid Crystals 189 

Shower Bath 291 

Simple Shower Bath ... . 292 

Rubbing Wet-Sheet 293 

■Wet-Sheet Pack 294 

Fomentation 295 

Hot Water- Bag 296 

Spine Bag 296 

Foot B.\th ........ 297 

The Sitz Bath Tub 298 

[18^ 



u 



THK STOMACH. 



Fio. 28. — Vapob Bath 299 

Fio. 29. — Stphon BYRHiaE 301 

FiQ. 30.— Fountain Sviunob 302 

Fio. 31.— Water Bottle and Syrisoe Combined 303 

Flo. 32.— Ann Flexion 308 

Fio. 3." — Ana Exteksios 309 

Fig. 34.— Exercibe to Strenothen Trunk Mubcleb 312 

Fig, 35. — Lyino, Knee Bekdtso 314 

Fio. 3(1,— Chest Lrenso . 315 

Fio, 37,— S.\CRUM Beatibo 31C 

Fio. S8. — Esercibe for Abdominal Musclkb 318 

Fig, 39.— Stasdinq, Stoewath Bbndiso .... 310 
Pi(i. 40,— NATtTKAL AuDOMtNAi. Supporter . .320 

Fib. 41,— STOMAcn-TuBK .331 

12,— PBRpEn-roK VAroRizEH . , , . ^2:< 
Fio, 43.— V, 



LIST OF PLATES. 



Pi^TB I. — The ISTEIiHAL OBOANa< colored) Frontitpiete. 
Platk II.— Miciio-OBOANisMa 128 

F!g. 1.— Micrococci amingod in cbftlnB («Mptococo( ). 

Fig. ).— MIcrococcrl In pulr. {diplixotet). 

Fig. B.— Micrococci In a mass ur Birarm (nmtrlfrn). 

Fig. 1.— Micrococci arranged la groups of tuur. toand !□ tlie 
spulB of coasumptlve patlouta. 

Fig. B.— Micrococci of pneumonia. 

Fig. t.~BacXtria Urmo, found In decoinpoalnit matter. 

Fig. T.— BacTerliteCerino. magnlfii!d40(»<l[ami'tcr». 

Fig. B.^BticlIlusfuIi((!fa. bay bacillus foand uu manure or lu a 
decoction ot bay. 

Fig. 0.— Boelcrla [fncolo, germs from stagnitnt water: some- 
times seen Id slimy masses on rottcD potatoes ; also 
found In irell-iTBter. 

Fig. 10.- Bacillus ot typhoid fever. 

Pig. 11.— BacUluti of malaria, found In tbe blood In cases of 
mala rill I fever. 

Fig IS,— Bacillus of tnbercalosls. 

Fig. 13.— Bacillus of leprosy. 

Fig, U.— SplrRIa tlndubt. launil actively moving In decom- 
posing tnfu»lou9. 



Plg.lS.- 


-Cholera germs. 


Pig. 18.- 


-SjXr((J»ffl iNiliKomi. a. germ with Baeftla. found In 




marsh water. 


Flg. 17,- 




FlB.18.- 






containing decomposing animal or venetablc matte 


Fig. IB.- 


- Wiabdi,m„nws r<mr,a. germs which form the rod-colored 






Flg.».- 


-A germ similar to the preceding, of a pate-red color, 




found In stagnant water. 


Fig.n. 




Fig.aa.- 




Fig.sa- 


-Germs of cholera. 


Flg, 24.- 


- A germ which causes fermentation. 


FlB.SS.- 


-Germs of anthrax In blood from spleen of mouse. 


Pig. 28.- 


- Gorma of anthrax grown on a potato. 


Flg, 37.- 


-Germs of anthrax at a different stage of growth. 


FKf,a8. 


- Foul water germ In dlllereDt stages of growth. 


Plate III. 


— AmUALCULES AKD ISFCBORIA IN IVatER 


Plath IV,- 


- DispLACEiCENTB or THE Stomach . 


Flg. 1.- 


-visceral dlsplacomeot. 


Fls. 2. 


-Displaced viscera. 


Fig. 3.- 


- Results of corset constriction (woman of thirty ). 


Flg *. 


-Dlsplacemenfsof spleen and other vlscera- 


Fig, S, 


- Woman who had worn a " health corset." 



Fig. B.— Bad standing corrected (J 





^^^^ 16 THE BTOMAoa. 


i 


^^^K Fig. 7.— BudstandliiKCorrralAdfwcimaD). 








^^m Fig. 9.- Kcaulta of corset constriction. 








^^^m Vig. 11.— WtjmaD chd had worn a. " boultli comet." 




^^B Plate V-— Germs {colored} .... 


. m 


^^^^1 FIK'I-~ Month germs toUDCl upon the surface of u 


coaled 


^^^L tongue, grc&tly mBpniatd. 




^^^K Ftg. S.- Germs trhlch cause deouy of Itie teeth. 




^^^P FlB.a-Oonns found In Iho stomaeh Quid uttar n tes 




^^^1 greatl; moBuiacd. 




^^^H Pl^TE VI.— MOVEMEHTB OF MAEaAQB 


. 301 


^^^B Fig. l.-Suportlclittkueadlng. 




^^K Fig. S.-DeevkaeatllDe. 




^^^B Fig. 3.— MasHitga of tbo abdomen. 




^^^K Fig. 4.— HuMageotthelfoircla. 




^^^B Fig. B.— MiuBagoof tbOHtomikCh. 




^^^B Fig. Il.— ltep1aclng of the viscera. 




^^K Pig. T.-IuBplratorrllftluK of the viscera. 




^^K Fig. B.- Hacking. 




^^B Fig. «.- Beating. 












^^^B Fig. 12.- Full breathing. 


■^^^^^1 


^^V Plate VII. — Massaoe 


M^^^^l 


^^H Fig. 1. -Trunk nilllna. 


' ^^^^1 


^^H ng. -i.- Vlbruilnf: chiilr. 




^^B Pig. 3.- Pctvli tilting. 


. 


^K Plate Vin.-MAa>^A.;E 


. S35 


^^B Fig. 1.- Mechanical knradlnz. 




^^H Fig. Z- t-annoo-bull oias^uEi-. 




^^^^b KIg. 3.— Mechanical reaplrHlloii. 




^^B Platk tX.— Hbalthitl and Ahti.'TU- Orb^^ 


. ai2 


^^H Fig. 1.- Varl«t« Costume. 


■ 


^^B Flg.3.'Freedom Waist wllh >ktri. 




^^^1 Flg.a.— NortolkJaCketwltb skirt of Bunlnoas full. 




^^H Fif. 4.- Womab-s Practical Bu»nie.5 Costume. 




^^^H Plate X.— Healthful Drbss 


. 343 


^^^K Figs. Sand B.-DlTtded Skin wub circular yoke. K 


loker- 


^^^K boekers. 




^^^H Fig. 7.— Woman's Practical Buslucss CostuDi<>. win 


Kklrl 


^^^1 opened Id back to ihnw divide. 




^^r Pigs. » and e.-Shlrt »alsi. 




^^m Fig- IU.-E<kirt «ltb circular yoke. 




^^^ Figs. 11 and 1!-— Colon suit. 




^^^ft Plate XI.— Gbapbic Uethoo < colored ) 


, -m 




. 


^^ ^^^^ 


^ 



THE STOMACH: 



Its Disorders and How to Cure Them. 



Some years ugo, while calling upon u professional 
friend in London, a Itjading English practitioner, he 
remarked, "I sappose that in America you have chiefly 
to deal with dyepeptiCB." In reply, I could not bat 
acknowledge that Americans enjoyed the unenviable, 
bat nevertheless deserved, reputation of being a nation 
of dyspeptics ; but added that the treatment of inva- 
lids in America was by no means so monotonous as 
might Bcem to be the case, for the reason that the 
general physical deterioration and vital dorangementa 
occaBioncd by dyspepsia give rise to a vast number of 
varied and complicated ailments which tax to the nt- 
moBt the skill and ingenuity of the practitioner. 

Indigestion, however, is by no means confined to 
America. The special manifestations of impaired 
digestion which are oxperientjod in the stomach itself, 
and which most readily attract attention, are perhaps 
I more comnion in tho United States than elsewhere, 
being a natural result of the hasty and disorderly hab- 
its of eating so usual among us. In England, Aus- 
( tralia, New Zealand, and other English colonies, while 
f there ia less complaint of indigestion, there is, never- 
[ liieless, evidence of the same prevalence of derange- 
a [171 



18 



TBB BTOUaCH. 



meiits in the digestive and nutritive processes, as is 
shown by the frequency witli which rhenmatism, gout, 
kidney und bladder diseases, and varioaB nervooa 
affections lire encountered. 

Modern researches into the relations of various 
maladies have shown that not only Bright's disease and 
the other complaints mentioned, but also pulmonary 
consumption, jaundice, many affections of the liver, 
typhoid fever, tapeworm, malarial disease, organic 
diseases of the spine and brain, and even insanity, are, 
in a targe proportion of cases, due either directly or 
indirectly to the vital disturbances arietiig from a 
morbid condition of the stomach. 

Dyspepsia is unquestionably the foundation of the 
greater share of all chronic maladies. When in a 
liealthy state, the body is able to defend itself, not 
only against germs, but against all other ordinary 
causes of disease ; but the general vital deterioration 
re-sulting from indigestion weakens the defenses of the 
body and its vital resistance, and renders it a prey 
to every malady. 

The function of a tissne or an organ depends upon 
its structure ; and the structure of every cell and fiber 
of the body is dependent upon the quality and quan- 
tity of the material absorbed fi-om the alimentary canal. 
A deficient supply of food weakens the structure and 
lessens the energy of the organ. An excess of food 
overwhelms the tissues with imperfectly oxidized and 
toxic substances, whereby their structure is deteriorated, 
and their functions perverted or retarded. Food con- 
taining toxic substances produces in the body general 
or specific toxic effects. The same thing results from 




THK STOMACH. 



HI 



dt'Vflopmtiiit of toxic substances in the alimentary 
(.■jiiiul from tlie fermentation or putrefaction of food in 
tlie stomach and iutestinee. 

Pasteur, David, and others liave shown that the 
mouth, the stomach, and tlio intestines are continually 
inhabited by a vast nuinbor of microbes capable of pro- 
ducing various acids, poisonous ptomains and toxins, 
varying in their physical and physiological properties, 
some of rhom being capable of producing powerfully 
poisonous effects. Tliese poisons exist in greater or less 

' quantity; but, owing to the poison-destroying power of 
the liver and tlie eliniinative function of the kidneys, 
the amount at any time circulating in the tissues of a 
healthy person is not sufficient to produce any more 
deleterious effect tlian that gradual deterioration of the 
organism by which the tiesue-modificatinus character- 
istic of old age are brought about. When, however, 
diseased conditions of the stomach or intestines exist, 
these poisons may be increased to an enormous degree ; 
for example, Bouchard has tiliown that if food is re- 
tained in the stomach more than five hours, the changes 
which take place are fermentative and putrefactive, 
rather than digestive. This explains the relation dem- 
onstrated by Bouchard and others between dilatation of 
the stomach and chronic rheumatism, and the lowered 
vital resistance which, hy dyspepsia, prepares the way 

I for tubercular disease of the lungs. 

That something is wrong with the modern stomach 

I is evident from the great number of remedies advertised 

[ in the newspapers, and displayed upon every druggist's 
ves, as capable of aiding a weakened stomach, 

I Pepsins, peptones peptonoids, and various < 



20 



ferments are manofaotured by the ton. Notwithstand- 
ing all these helps, however, the average etomach in 
civilized lands grows weaker year by year, and disorders 
growing out of indigestion multiply with alarming ra- 
pidity. Many persona suffer fnim disorders of digestion 
without being aware of the fact. Headache, backache, 
bladder and kidney disorders, sleeplessness, depression 
of spirits, wcaknesB, lack of energy, coldness of the 
extremities, nervous sensations of various sorts, even 
hysteria, epilepsy, and insanity, may exist as the i-esult 
of indigestion witliout any Buffering in the stomach, 
or anything to euggest to the patient bimst-lf or to 
the untrained observer, any disnrdi;r of digestion. In 
every case of chronic diaease, the stomach should be 
carefully investigated. A coated tunguo ia always 
indicative of a disordered stomach. The same is true 
of numerous other s_>Tuptcinis from which many people 
liuffer, such as a b:id ta^to in tlie mouth, duiness or 
headache after eating, nervous bcadiiclie, etc. 

Indeed, dyspepsia is a malady which demands the 
most serious attention. This is especially apparent 
wlien we recognize tho fact that, of all chronic ailments, 
it is preeminent as being preventable by the employ- 
ment of proper means. No disease is more dependent 
upon conditions which the individual himself can con- 
li'ol than is this ; neither is there any malady which 
more readily yields to the application of appropriate 
remedies when the necessary conditions are supplied. 
I have no hesitancy in asserting that every case of 
purely functional disease of the stomach may be cured, 
provided the requisite conditions can be obtained. 



THE ORGANS OF DIGESTION. 



The Healthy Stomach. — Tlie coiKlitions of a 
diseased fltomach cannot be underatoiid witliout a clear 
knowledge of the healthy etomach and its functione. 
Digestion is the process by wliich tlie food is dissolved 
and rendered capable of absorption into the body. 
All animals digest, and even plants digest by means 
of their leaves. The following brief description of the 
digestive pi'tifesH is largely taken from a text-book of 

L physiology and hygiene by the author : '— 

The Alimentary Canal. — -The process of di- 

• gcstion is chiefly performed in a long tortuous tnbe 
called the alimentary canal, which is from twenty-five to 
thirty feet in length, and reaches from the mouth to 

i the lower part of the trunk. 

The digestive organs consist of this canal and other 

I organs closely connected with it, including various 
glands. The latter produce peculiar fluids, by which 
the food is changed in several very remarkable ways, as 
we shall presently learn. The several organs which 
take part in the process of digestion may be named as 
follows : — 

The mouth, tongue, teeth, salivary glands, esoph- 
^is, stomach, small intestines, colon, liver, and 
pancreas. (The relative position of the liver, stomach, 
and intestines is well shown in Plate I.) 

1 "Second Bunk In Pliyslulogy siid HyKionv," by J. H. Eiillug^. M, D., 
published by the Amerlcuu Booh (^impany, TUe work may be obtnlned 
from the Modem McdlclDu FaliUsLInK Oumiiany, Battls Cruuk. MIr'h, 



93 



THE STOMACH. 



The Mouth. — The cavity of the mouth is the 
expanded upper portion of the alimentary canal. It 

contains tlie teetli and the tongue, and receives small 
dnctB, or canals, from the three pairs of salivary glands 
closely connected with it. These glands produce a 
fluid known as saliva. At the back part of the mouth 
are found, one on each side of the tonsils, glands which 



Fiu. 1.— The SALiVAttr Glands. 

help to form the saliva. The saliva contains an active 
principle known as ptyaliii. (Fig. 1.) 

The Teeth.— A tooth presents three parts for 
examination : the portion which is seen above the 
gum, called the crown ; the portion which is embed- 
ded in the jaw, called the root; and the narrowed por- 
tion which joins these two parts, called the neck. The 
interior of the tooth is filled with a tieshy substance, 




OSGAKS OF blOESTlON. 



a.'i 



the pulp, containing the blood-vessels and the nervea 
which nonrish the tooth and give it sensibility. The 
body of the tooth ia made up of a tissue resembling 
bone. The portion which projects from the gum is 
covered by a very hard, emooth substance, called 
enamel, which is eo brittle as to be easily broken 
by violent contact with hard substances. 




Temporary Teeth.— The teeth which appear in 
infancy and early childhood are called temporary, 
or milk, teeth. These teeth usually make theii" appear- 
ance between the ages of seven months and two years. 
Thoy are twenty in nnmber, and consist, in each jaw, 
of four front teeth, or incisors, two cnspids, one on 
each side of the incisors, and four molars, or double 
teeth, two on each side. (Fig. 2.) 




THE BTOMACH. 



Permanent Teeth. — At the age of six or sev- 
en years the temporary teeth begin to give place to the 
permanent set, which, when complete, at the age of 
seventeen to twenty, nuinbers thirty-two, each jaw con- 




Fia. S.— Tbb Pobuakes't Teeth. 



taining, in addition to those of the temporary set, 
fotir email double teeth, or bicuspids, and two addi- 
tional molars, the so-called wisdom teeth. The laat 
of the temporary tooth should give place to the perma- 
nent ones not later than the twelfth year. (Fig. 3.) 



I OF DIOESTION. 



The Esophagus.^ In the act of swallowing, 
the food passes from the moutii downward through 
a narrow passage about nine inches in length, com- 
monly called the esophagus, or meat-pipe. The walls I 
of this canal are made up in part of muecles, by the ' 
aid of which the food is carried through it. When 
empty, its sides lie in contact with each other. At 
its lower end a circular muscle guards the opening 
into the stomach. 



The Stomach. — This is a dilated portion of the 1 
alimentary canal, somewhat pear-sliaped in form, and , 
capable of holding from one to two quarts. The walls ' 
of the stomach, like those of the entii'c digestive canal, 
are made up largely of thin layers of muscle, by means 
of which it is able to change its size and shape, and 
BO to act upon the food as to produce a sort of churn- 
ing action. (Fig. 4.) 

The Peptic Glands. — The lining membrane 
of the stomach, when examined with a microscope, 
is found to present multittides of minute openings. 




I 



26 



TBK 8TOMACH. 



each of which is found, on farther examination, to com- 
mnnicate with a narrow tube which ia embedded in the 
walls of the Btomach, This little pocket ia lined with 
minnte living cells, which, during the digestion of a 
meal, are engaged in making a most important digest^ 
ive fluid, the gastric jaiee, (Fig- 5-) 

The Gastric Juice.- — Thia fluid ia intenaely acid. 
The acid of the gastric juice ia hydrochloric acid, 
probably not a purely chemical acid, bnt aii organic 
hydrochloric acid. There ia also preaent 
'11 small amount of lactic acid. 

The gastric juice contains two digeativi 
princijilcs, pepsin and rennin. 

The Pylorus. — Eiich end of thi 
wtnmach is guarded by a circular muscle.J 
That at the lower, or right, end ia kuow 
as the pylorus. By means of these mna*] 
clea, the openings of the stomach are kepl3 
tiglitly closed while the proceas of digest- 
ion is going on. 
The Small Intestine. — This portion of the ali- 
mentary canal is about twcTity fcot in length, reaching, 
from the stomach to the large intestine, which it join»> 
at the lower right portion of the cavity of the abdo- 1 
men. The walla of the inteatiiie are nniscnlar, likej 
those of the atomach. Its mucoua liuiug contains'l 
many glands, which produce an alkaline digestive flaida 
known aa inteatiual juice ; and it is also covered wi&ff 
giant cells, which defend the body againat germa. Dor-J 
ing digestion, tlio muscular walla of tlie intestinea are | 
in constant motion, (Fig. 6.) 



oROAMs OF noBenoN. ST ' 




Fto, 6.— The 




28 



THE STOMACH. 



The Intestinal Juice. — This, the most compli- 
cated of all tlie digestivo juices, ia produced by the ac- 
tioa of all the iinmerous and varied* glands fouud in the 
tnacoiiB membrane of the intestines. Being composed 
thus of the secretions of a ttnmber of different gUnda, 
it is of a componnd character, which especially fits it 
for its varied fuiictione. 

The Absorbents. — The mucous membnme rf 1 




the smitll intestine contains numerous folds, and alatfl 
peculiar structures for aiding absorption, known at 
villi. The villi are hair-like projections of mucous raemTl 
brane, which hang out iuto the cavity of the intestine.-.! 
Each villus contauis blood-vessels and lymph-channels. 
(Fig. 7.) 

The Large Intestine, or Colon. — Tins portion J 
of the nlimentJiry canul is about five feet in longth,J 
and is much larger in diameter tlian the small intea*J 



OBOAN8 OP DioEsnow. 29 

tine. It begins at the lower right aide of the abdom- 
inal cavity, wliere it is joined by the siuall intestine. 
From this point tho colon passes upward to the lower 
border of the ribs, crosses over to the left side, then 
passes down to tho lower left portion of tho abdomen, 
and thence backward, finally terminating in the rectum. 

The Liver. — I-yiiig chieliy at the right side, jnst 
above the lower border of tho ribs, and partly covering 
the atomacb, ia the largest gland in the body, the liver. 
At the under wide of the liver is a sac, or pouch; known 
08 the gall-bladder, in which is stored up the digestive 
fluid formed by the liver, called the bile. A short 
canal, or duct, connects both the gall-bladder and the 
liver with the small intestine at a point a few inches 
below tho stomafh. 

The Bile. — Human bile is alkalme, somewhat 
viscid, and of a golden-brown color when fresh. When 
vomited, bile ia often green or yellow, an the result of 
changes produced in the atomacli by contact with 
acid gastric juice. The bile of the ox is naturally of 
greenish color. 

A remarkable fact in relation to the strnctnre of 
liver ia that it is supplied with two sets of blood-vei 
sels. Tho extra Hj'Htem of vessels brings to the livi 
the blood from the stomach, iutestinea, and other dig( 
tive organs, and eonatitutes the portal circulation, 

The Pancreas. — Just behind tlie stomach is' 
a long, curiously shaped ghind, known as the pancreas^ 
which secretes tho pancreatic juice. 

The Pancreatic Juice. — This is a fluid much' 
like Baliva. It is pnidnccd during the digestion of 
meal, and is poured into the small intestine through 



4 



30 



THE STOMACH. 



duct which joins that from the liver, and with it opens 
into the intestinal canal four or five inches below the 
stomach. (Fig. 8.) 




The pancreatic jmco contains four active principles : 
amylopEin, trypsin, steapein, and a milk-curdling fur- 
raenl. 

In order readily to understand the relation of the 
digestive organs and their several digestive fluid.s to 
foods, it is necBBsary to briefly consider the qncstion, 
What are foods ! 



FOODS. 



Tee body is constaDtly eustaioing loBses in conse- 
quence of the vital work performed by its various organs, j 
Foods are substiinces which, when introduced into the 1 
body, make good its natural wastes and losses, and4 
furnish proper material for the repair of its tissues, or j 
for carrying on ita vital processes. These require- 
ments are met by organizi^d matter, water, and oxygen, 
or what may be termed solid, liquid, and gaseous 
foods. Of tliGse, the first only is commonly known 
as food. Liquid foods are called drinks, all of them | 
having water for theii- essential element. Our atteJi- 
tion will here be confined to the consideration of organ- 
ized foods. 

A poison is the opposite of a fotxl. It not only 
does not repair wastes ami losses, but interferes with 
the vital processes, distm'bing them in such a way as 
to occasion sickness and death. 

Animal and Vegetable Foods. — Man employs 
both animal and vegetable substances as foods. Somo J 
nations, particularly the English and the American, 
use a large proportion of flesh, and some barbarous 
tribes live almost wholly upon it ; but the larger portion 
of the human race live chiefly upon vegetable foods. 
Many millions of human beings in India and other 
parts of Asia never taste flesh food, considering it a sin 

to do BO. 

Plants the only Food. Producers.^ Plants 
alone possess the power to construct living substances 

[31] 



out of the elements of tbo oarth and the air. Animal 
are able to subsiat upon organized Bubatancea only. 
ao that a lion, in dining npon an antelope, ia only eat- 
ing at aecoud hand the grass and herba which the latter 
has eaten ; and a man, in eating roaat beef, ia taking 
at aecond hand tlie corn upon which tlie ox was fed. 
Food' Elements. — When a chemist examuiea a 
loaf of bread or a piece of meat, he finds it to be made 
np of various aubstances quite unlike in nature. Theae 
food elements each pos- 
sess peculiar proper tie a, 
and ai'e destined for 
(liiTtircut naus in the 
body when taken as 
fooiil. 

Classification of 
Food Elements.— 

Tlie variona substancea 
found in foods may be 
included in six claaaes : 
1. Starch ; 2. Sugar ; 
3, Albumen (all albuminous eubstaucea) ; 4. Fats ; 
5. Salts ; G, Indigestible elements. 

Starch. — -Tliis element is fnand only in vegetable 
foods. In a raw state, atarch is found in small par- 
ticles, or granules, each enclosed in a woody envelope. 
Starch ia the most abundant of all the food elements. 
(Fig. 9.) 

Sugar. — Sugar is very unlike stiu-ch in its general 
properties, although closely related to it. In the 
mysterious chemistry of plant life, the inaoluble, taste- 
less starch is converted into this sweet and extremely 



n 





soluble snhstanco. Several different kiuils of sugar 
occur in nature, tlie most important of which are cane- 
sugar, grape-Bugar, and milk-sugar. 

Cane-sugar is tbo sweetest of all the sugars, and 
is that commonly used as food. It is obtained from 
the Bugar-cauc, the sorglium plant, tbo beet root, and 
the maple-tree. Grape-sugar is found in most fruits 
and in honey. Milk-sugar gives to milk its sweet- 
ness. A sugar resembliug grape-sugar, called glucose, 
is very extensively maniifaetured chomically, by boil- 
ing the starch of corn or potatoes with sulphuric acid. 
Glucose ciuinfit be considered a perfect substitute for 
natural sugar. 

Ali>uni<rii. — The white of an egg is almost pure 

albumen. All true fnods contain eiemonls which in 

many respects resemble albumen, and serve the same 

pnrposes in the body, and bo aje termed albummons 

[ elements. For convenience, vro shall apply the term 

albumen to any or al! of them. The lean portion of 

li ami the casein of milk are forma of animal al- 

I bumen. Ail vegetable ftn.ids aUo eontam albumen. 

1 Casein, for exampU', is found in peas and beans, as 

I well as in milk. One of the most important of all the 

I albumens is gluten, which is found in wheat, rye, and 

barley. 

J'iit't. — Oil, or fat, is found in both animal and 

' vegetable foods. Tlio principal animal fats used as 

' food are butter, lai-d, suet, and tallow. Vegetable oils 

are chiefly derived from oily fruits, as the olive, from 

nuts, and from various seeds. A large quantity of 

I fat ie found in corn and oats. 

Sails. — When a portion of animal or vegetable 



34 



TBE BTOMACH. 



food ia burned, ihere is left a residue of ashes, made 
up of inorganic, oi mineral, elements. These are the 
so-called salts of the food. They do not exist in the 
food in the form in which they are found in its ashes, 
but in an organized form. Grains constitute the most 
important source of salts. Wheat, oats, barley, corn, 
and rye contain an abundant supply of this element, 
as do the potato and most other vegetables. The salt-s 
also exist in milk in good propiirtion. 

ImlifiettlbU Jilemenis. — All vegetable foods contain 
more or less of a woody substance, called cellulose. 
Tlie bran of wheat belongs to this class of elements. 
Cellulose is not to any extent digestible, but it servei 
an im^Kirtant purpose in givmg bulk to the food. The 
connective-tissue elements of flesh foods — the ligj- 
ineiit^, tendons, etc.^ — are hard to digest, and afford 
little or no nourishment. 

In addition to the several elements mentioned, all 
food substances contain eortain flavoring matters. 

Condiments. — A condiment is an article which 
possesses little or no food value, but is added to food 
for the purpose of inipaiting to it a characteristic flavor. 
The condiments most commonly used in this country 
are mustard, pepper, ginger, spices, pepper-sauce, 
Worcestershire and other hot sauces, and vinegar. All 
condiments possess irritating or stimulating qualities. 
They stimulate the appetite, and act as whips to the 
stomach and other digestive organs, and are for this 
reason injurious. 

Food Substances.^ None of the several food 
elements which wu have been considei'tng are, iu anv 



n 



35 



proper sense, t'» be regarded aa food. An animal fed 
esclusivelj- upon any one of tbem soon acquires such 
a disgust for its food that it will refuse to taste it, 
even though starving, and sooner or later dies. Glu- 
ten is the only exception to this rule. A true food 
contains various elements, which are combined in vary- 
ing proportions in different foods. Let us now briefly 
notice some of the leading food substances. 

Foods of Animal Origin. — Chief among 
animal U-Kxis is iniil; the natural diet of most young 
animals. Milk contains the different elements of na- 
trition in pi'oper pi-oportion, ftud will sustain life for an 
indefinite period. The chief albuminous element of 
milk ia casein. Tho white color of milk is due to 
the fact that it contains a considerable amount of fat, 
or oil, in a state of emulsion, or division into minute 
drops. By churning, tho little drops are made to 
unite, producing butter, Tho ease with which it is 
digested renders milk a most suitable food for the 
young. It is, indeed, with rare exceptions, a most 
wholesome food for persons of all ages. 

Chefii^f made from milk by adduig rennet, which 
separates the casein and fut from the whey, undergoes 
partial decomposition in the process of "curing," and 
18 on this account much loss wholesome than fresh 
milk. It is difficult to digest, and likely to interfere 
with the digestion of other foods. Sometimes a peculiar 
fermentation taket^ place in cheese, which produces 
a very poisonous substance, known as ty rot ox icon. 
Very serious and sometimes fatal illness often results 
from tho use of such cheese. This poison is destroyed 



3(; 



THE STOMACH 



by liL^iit. Oil this account cheese ie rendered less 
daogerouH hy toasting, whi1» at the same, tirao it ia 
made luoi'e digestible. 

/iy'j". — All egg contains wiltiiu itself every cle- 
ment needed for the euppoit of tlio body, and has 
tlie advant;igc, when projiurly cookcKl, of being one of 
the most easily digested of foods, and one of very high 
. nutritive vuhie. When stale, however, eggs are ex- 
ceedingly deleterious, and wholly unfit for food. An 
egg usually keeps perfectly fresh not more ihsin three 
or four days, when exposed to the oi-dinary summer 
temperature. Eggs laid by fowls fed ujmu decaying 
meat and other nuwholesomc food, are nufit to eat. 

Flesh. ^ — ^The flesh ot the ox, sheep, and hog 
ia mitre largely usetl as fmid in this and most other 
civilized countries than any other kinds of flesh food. 
Mutton is not so well relished aa beef by some, bi 
it is nearly as nourishing, and equally as easy to digest,^ 
Pork contains much fat, and ia difficult to digest^ 
besides being likely to be diseased, and must be 
regarded as an iiifeiior ftiod. The Jews in ancient 
times were forbidden to eat the flesh of the hog, and 
they still abstain from the use of j)oi-k. The flesh of 
deer and other wild game, while uaunlly less tender 
than that of stall -fattened animiils, is mom wholesome, 
if eaten wlioii fresh, on account of the healthier con- 
ditions of life which wild animals usually enjoy. Game. 
ia often allowed to become almost putrid before it ii 
eaten; such flesh is exceedingly nnwholesome. Yeal, 
like the flesh f>f all very young animals, ia difficult 
to digest, and cannot be recommended us food. 

Fish and Fowl. — The nutritive value of fish 



and fowl ie not quite equal to that of beef or mutton; . 
but when projwrly cooked, tliey are relislied by most J 
pePsoUB, and pussosa eonaiderablo value as foods. 

Shell-fish contain very little nutrimeut, although j 
6o^e of tliein, oystera in jmrtit-ular, are in vei-y great i 
favor aa talile delicafii'S. All aliell-fisli are scavengers, . 
however, and are Boniotimea poisonous. Frogs, k)l»- ] 
sters, shrimps, sea-crabs, etc., are by many coiieidtTi'd 
delicate eating, but cannot bo regarded as really first- 
clasa foods. The oyster is easily digested, tlKtugh it 
does not possess the power to digest itself, nor to aid 
digestion wlicu eaten raw, as many persons suppose. 
The oyster is a Beavengcr in its habits ; and when the 
beds in which oysters grow are located so as to be reached 
by the impure matters carried into the sea by the sew- 
ers of a large city, the oysters sometimes become 
diseased, and produce scrions illness when eaten. Ty- 
phoid foviT has been traced to the use of oysters. 

Salted and Smoked Meats. — Most kinds of 
flesh foods are preserved by salting. The process of 
salting hardens the tissnes, thus rendering them diffi- 
cult to digest. Smoked meats and fish are also hard to 
digest. 

Vegetable Foods. — Vegetable foods are the 
original source of tho nutritive elements contained in 
flesh foods ; hence we should expect them to fm-nish all 
the elements of nutrition, aud in proper proportions. 
This is the case with tlio best vegetitble foods. Veg- 
etable foods are usually divided into three classes: — 

Fniita, O'rni/Di, iind y'eiittahhu. — Fruits comprise 
fleshy seeds and seed bearing portions of plants, sucli 
as the apple, strawberry, and pium, each of which 



38 



THS BTOKACH. 



represents a liifferent class of fruits. Melons and 
aats are also fruits. Graiite comprise those seeds used 
as foods which ure produced by grass-Iiko plants, as 
wheat, oats, rye, barley, corn, and rice. Allied to this 
class are the edible seeds of pod-boaring plants, the 
chief of which are peas, beans, and lentils. Grains 
nro the most nourishing of all foods, and contain the 
elements of food in tho best proportion. Fruits, grains, 
and milk constitute a perfect dietary, and one partic- 
ularly suitable for young persons, and for students and 
filhor brain-workers. 

Those parts of plants used as food, other than seeds 
or fruits, such as leaves, stems, roots, buds, and flowers, 
are calletl vegetables. The nutritive value of vegetables 
19 much less than that of grains. The potato, one of 
the most valuable of all vegetables, is three fourths 
water, and contains oTily about two per cent, of alba- 
miniiua elements. Tlio starch of vegetables is more 
difficult to digest than that of grains and fniits, and the 
large amount of woody matter enntaincd in moat vege- 
tables adds to their indigestibility ; bo that they rntutl 
be regarded, in general, as much inferior to fruits s 
grains as foods. 

Peptogens.— Certain properties and elements of 
the food serve to stimuiato tho action- of tlie glands by 
"wliich the digestive fluids are produced. For example, 
tlio quality of dryness in. the food powerfully excites 
the action of the saliva. In experiments condocted 
by the author ui the Laboratory of Hygiene of the 
Battle Creek Sanitarium (Michigan, V. S. A.) it has ■' 
been proved that dry food stimulates tho secretion of ' 
saliva more than four times as much as moist food. 



SOODfi. 



Gluten, aibumeii, and other proteid eubatances stimu- 
late tho glands of the stomach to jirodnce gastric juice. 
The. same is true of dextrin. This fact is of consid- 1 
erable interest, as it emphasizes the iuiportance of i 
tliorough niaetication of the food. In this way the food ] 
has mixed with it an abundant quantity of saliva, hy J 
whoso aclinn upon tho starch, tlie dextrin is produced. 

The natural flavors of foods stiimilate tlie activity 
of all tJie digestive glands ; but condiments, auch as 
mustaril, pepper, pepper-sauce, and other substances i 
which bui-n and sting as they go down the tliroat, f 
do not stimulate tlie secretion of normal digestive I 
fluid. They simply provoke resistance and defense, 4 
causing an abundant flow of mucus wherewith to pro- 1 
tect the mucous membrane from theu- harmful action. 

The Natural Diet of Man.— It is pn.bablo 
that the diet of tho human family at first consisted 
almost wholly of fruits, grains, milk, and a few vegeta- 
bles. History informs us that the dietary of the ancient 
Egyptians, Assyrians, and the early Greeks and Ro- 
mans was of this simple character ; and tho sama 
diet is still practically adhei-ctl to by fully t\vo thirds . 
of the inhabitants of the ghibe. In dcusely populated 
countries, such aa Japan and China, tho diet U nccos- 
aarily almost exclusively vegetarian. The peasant class J 
of France, Italy, and Spain, and other coutinental 
European countries, use fleah so sparingly that it i 
be Baid to be a luxury rather than a food with them. 
Haman life and healtli can he well maintained upon 
vegetable fofnl. 

Uses of the Several Food Elements. — The 
varioos food elements bci'^'q diHerent purposes in tho 



^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^M 


^ ^^^^^^^H 


^^^^^^^V^^^^^^^H^^^^^^^^^^^I 


40 TUB STOMACH. 

body. Sugar, etai-ch, and fat make adipose tiBsuo, aud 
^v io the form of fat enter into the composition of nearly 
^h all the tissnes of the boflj. Tliey are of important 
^H service to tlio body in the proilnction of heat and force. 
^^V The different forms of albumen nourish especially the 1 
^H brain, nerves, muscles, glands, and other highly active 
^H tissues of tlie body. TIio salts are largely asod in J 
^H nourishing the bones. They are also required by 
^^P tlio brain aud the nerves, as vroll as by other tisBQea. 
^H The indigestible elements give necessai-y bulk to the 


^H DIGESTIBILITY OF 

H 

^H Rice 1 00 

^H Sago 1 45 

^^H Tapiocn 3 00 

^^r Barley 2 00 


VARIOUS FOODS. 

Hr.Ki. 

Mutton,- broiled 3 00 

Veal, broiled 4 00 

Veal, fried 4 30 

Fowl, boiled 400 

Duck, roasted 4 30 

Butter, melted !l 30 

Cheese S 30 

Soup, marrov-lKine 4 15 




Venison, bnilled 1 35 

Turkey, ribsuhI 3 30 

Turkey, domestic, Ix.il.-d 3 25 

Goose, roasted 2 30 

Lamb, broiled 3 30 

Efffs. hard boiled 3 30 




Corn and beana, green . , . 3 4!i 
Chicken soup, boiled .... 3 00 

Beans, pod, boiled 2 30 

Bread, wheaten 3 30 


Eggs, fried 3 30 


Egps. whipped 1 30 

Trout, boiled 1 30 

Salmon, salted, bc.iled... 4 00 


Apples, Bour and mellow. 


Apples, aweet aud mct- 


Oysters, stewed 3 30 

Beef, lean, rare roasted... 3 00 

Beefaleuk, broiled 3 00 

Beef, lean, fried 4 00 

Beet, salted, boiled 4 15 


Parsnipa, biiii^" 3 30 


Turnips, flat, boiled 3 30 

Potatoes, Irish, bi.iled... 3 30 
Potatoes, Irish, baked... 3 30 


Pork, salted, fried 4 13 









TnansHllKni lummi muE or 


^■m rWO SUBSTIHCEI. 


„..„„„c.. 


1 


li 


1 


5 
1 


1 




1 


1 


'1 


J 


j 


1 


! ■ 


W^^oUnJ 


f 


■,:'. 
i' 

li 

t! 

i' 

;i 
:1 


1 
SI 

II 

S! 

li 


. 


H 
.1 


!5 


i-i 


:■; 


i 

:l 




u 
", 

;': 
[; 

'i:, 

li 

i 

k' 
f 

I:; 

i:! 
a. 

■). 

1' 

t! 
1: 

si 


i 

p. 


MeIe;::;^:;:;:;: 








ir 

.?; 

iij 

it.', 
1 










H 










?' 




"— ■ 


1 




ij.j 




: ' 

V. 
i;! 








1 


l;Slii?wJ»^: ::::::: 




?M»r»um. 






TI 






"1 


fcEi^E:::::::. 


s 






f[^^ 




p':"^"''""!^;:::::: 




g^:::::::::::::::::::::: 




^:' 



1 rooD SL-uaTiKCXa.'-CoDiiauH]. 



FOon SITBSTANCl 



I 




THE DIGESTIVE FLUIDS. 



Ih studying the organs of cligestMni, wa buve learned 
that there are five digestive fluids ; viz., tho aaliva, the 
gastric juice, the bile, the pancreatic Juice, and the 
intestinal juice. In the jtreceding chapter it has been 
shown that there are five digcstiblo food elements ; 
viz., starch, albumen,' fats, sugars, and salts. Lot as ' 
now consider the use of each digestive fluid in relation ' 
to the various food elements. 

M,uch of the information which has been gained 
respecting the action of tho stomach upon the food is 
due to the persevering and accurate observations of 
Dr. Beaumont, a surgeon in the American army, who, 
iu 1823, while stationed in wbtt was then known as 
Michigan Territory, was called upon to take charge 
of the case of a young Canadian by the name of Alexis 
St. Martin, who had been accidently wounded in tlie 
side by the discharge of a mnsket loaded with shot, at a 
distance of one yard from hia body A portion of flesh 
as large as a man's hand was torn away from his side, 
leaving large openings into both the stomach and the 
chest. The opening communicating with the chest cavity 
finally closed up entirely, but the opening into the 
stomach remained, Lumediately after hia recovery it 
was about two and one half inches in diameter. What- 
ever was swallowed passed out tlirongh this opening, 
making it necessary for him to wear a pad to close 




44 



THE STOMACH. 



the opening. In time, nature remedied the difficulty 
by growing over the opening, upon the inside, a looae 
fold of ntembrune which effectually closed it, yet coald 
be easily pushed aside, thiia allowing a full view of the 
intcnor of the Btomach. 

Oroat and important additions to onr knowledge 
of digestion have been mado recently by the use of tli3 
atomach-tube, a flexible rubber pipe, by means of 
■which digesting food may be removed from the stomach 
for chemical examination. The facta tlius learned give 
us more positive and definite information respecting 
the work of the stomach and the digestive proper- 
ties of food tlinn has been previously possessed, and 
throw great light npon the hygiene of digestion. 

What the Saliva Digests.— A dry crust of 
bread, chewed for some minutes, becomes sweet. This 
is due to the fact that the saliva contains a peculiar 
principle wliich, when brought into contact with boiled 
starch, converts it into malt-sugar, or maltose. In act- 
ing upon the starch, the saliva produces first soluble 
starch, then dextrin, and finally the perfected product, 
malt-sugar, or maltose. This ciinversion into sugar 
constitutes the digestion of starch. It is essential, 
however, that the starch should be cooked, as the 
saliva cannot digest raw starch. 

What the Gastric Juice Digests. — Pepsin, 
one of the active principles of the gastric juice, acts 
upon the albuminous elements of the food, such as egg- 
albumen, the fibrin of mciit, gluten of grains, casein 
of milk, etc. By its action all of these various sub- 
stances are converted into one simple substance, known 
aa peptone, which is readily absorbed into the blood, 



; DIGKSTITE FIX 



i5 



' while QDdigested alboraen cannot be absorbed to any 

great extent, aiid, if absorbed, wonld bo of no nae in 

the eystem. The gastria juice preparea the food for 

furtJier digestiou by diseolving the substanceB by which 

the various elements of the food are hold logothor. 

Tho rennet ferment, or roniiiu, of the gastric Juice 

coagulates the caeein of milk, forming curds, whieh 

I are afterward dissolved in tho gastric juice. The curds 

i formed of cow's milk arc much larger und tongher than 

l those fonnod of iiiutlifi-'a milk; hence tho difficulty 

' experienced Ly many pcrwina in eating cow'a milk, 

especially in caises in which the stomach is dilated, and 

L consequently weakened to such an extent that it is not 

f able to break up the hard curds thus formed. Whon 

milk is mixed with oatniual or barley gruel, or other 

I farinaceous substances, the curds formed are more brit- 

'■ tie in character ; hence the advantage of a<hling oatmeal 

or barley water as a diuiinuent for milk in many cases. 

I Lime-water has a similar effect, but its long-continued 

use is objectiomible. 

Carbolic acid, common salt, and numerous other 
i- substances are calk-d antiseptics, because they prevent 
I fermentation or decay. Tho gastric juice and tlio bile 
f also possess this remarkable property. A dog was fed 
with putrid meat. On being killed, an hour after, the 
L meat, which had been extremely offensive, was appar- 
ently perfectly fresli. This property of tho gastric 
. juice is exceedingly imporlaut, as it prevents decay 
armentation in the stomach before digestion can 
take place. 

What the Bile Digests. — Like the saliva and 
\ tho gastric juice, the bile digests but a single one of 



: 



46 THE STOMACP. 

the digestible food elements. Its action is wholly upon 
the faltjportiona of the food. If oil and water are 
shaken together in a bottle, they quickly separate 
when the shaking ceaaes, Gnm-water and oil, when 
shaken together, form a milky raixtnre in which the oil 
and the water do not eepai-ate, and which may bo dilnted 
with water the same as milk. The bile acts upon fats 
in the samo manner. Such a mixture is called an 
emulsion. Under a micmscope, the oil of an emulsion 
is seen to be dinded up into very fine drops, or 
globules. 

What the Pancreatic Juice Digests. — The 
pancreatic juice digeats each of the three principal food 
elements, — Btarcli, albumen, and fats. Amylopsin 
converts starch into sugar, trypsin changes albumen 
into peptone, and steapsin makes an emulsion of the 
fata. The pancreatic juice thus does the work of all 
three of the preceding digestive fluids, — the saliva, 
the gastric juice, and the bile. 

What the Intestinal Juice Digests. — This 
fluid possesses but one characteristic digestive prop- 
erty, cane-sugar being ordinarily digestcMl only in the 
small intestine, and by the action of the intestinal juice. 
Tho intestinal juice also digests starch, albumen, and 
fats, and, together with each of the other digestive 
fluids, acts upon the Baits of the food. 

In herbivorous animals, and to a small extent in . 
man, cellulose is digested in the largo intestine. 



GENERAL VIEW OF THE DIGESTIVE 
PROCESS. 



The digestive process begins tLc moment a morBol 
of food enters the mouth, and continues throughout 1 
the entire lungth of tlio alimentary canal, or until the ^ 
digestible portions of the food have been completely i 
digested. 

Mastication. — The fii-st act in the digestive proc- 
eee is mastication, or chewing, the purpose of which ' 
is to crush the food and divide it into small parti- 
cleSr BO that the various digestive fl.utds may easily and 
promptly come into contact with every part of it. 

Salivary Digestion. — The saliva softens the I 
food, and thus prepares it f"r the action of the other ' 
digestive fluids. It also arts upon the starch, convert- 
ing a portion of it into sugar. 

Deglutition, or Swallowing. — In the act of ^ 
swallowing, the food does iiot drop down through an I 
open tube, but is seized by the mnscles at the back of 
the mouth, and is carried dawn into the stomach by 
the action of the esophagus muscles. 

Stomach Digestion. — Upon receiving the food, 
the stomach very soon begins to pour out t!ie gastric 
juice, which first makes its appearance in little di-ops, 
like beads of sweat upon the face when the perspi- 
ration starts. As the quantity increases, the drops ' 
run together, trickle down the aides of the stomach, 
and mingle with the food, The muscular walls of lh% j 



TBB BTOUAOH, 



stomach contvact npon the food, moving it about with a 
sort of churning action, thoroughly mixing the gastric 
juice with the food. During thia process both the 
openings of the stomach are tightly closed. The gas- 
tric jiiic-e softens tlie food, digests albumen, and coagu- 
lates milk. The saliva continues its action upon starch 
for half an hour aft^r the food reaches tha stomach. 
This action of the saliva is highly important to the proc- 
ess of digestion. It depends, of course, upon the 
thoroughness M'ith which the food is masticated. If 
the food is swallowed hastily, it will contain but Httle 
saliva, and consequently very little starch will be con- 
verted into dextrin and maltose, or sugar ; and the 
person will suffer from starch indigestion. 

Action of the Pylorus. — After the food has 
.remained in the stomach from one to three hours, or 
even longer, if the digestion is s!ow or indigestible 
foods have been eaten, the contractions of the stomach 
become so vigorous that the more fluid portions of the 
food are squecKcd out through the pylorus, thus escap- 
ing into the intestine. The pylorus docs not exorcise 
a species of intelligence in the selection of the food, 
as waa once supposed. The increasing acidity of the 
contents of the stomach causes its muscular walla to 
contract with increasing vigor, until finally those por- 
tions of the food which may be less perfectly broken 
up, and which the stomach has been unable to digest, 
are forced ihriiugh the pylorus. 

Intestinal Digestion. — As it leaves the stom- 
ach, the mass of partially digested food ia intensely 
acid, from the large quantity of gastric juice which it 
contains. Intestinal digestion cannot begin 



which It I 

until the J 



DIQES-nVB PHOOESS. 



49 



mast» becoming atkalme. The alkaline bile neutralizes 
thti gaatric juice, aud renders the digosling mass slightly 
alkaline. Tho bilo altio acts npon the fats of the food, 
converting them into an emulsion. The pancreatic 
juice converts the starch into sugar, digesting both raw * 
and cooked starch. It also digests fats and albumen. 
The intestinal juice continues the work begun by the i 
other digestive fluids, and digeata cane-sugar. 

Other Uses of the Digestive Fluids. — In 
addition to the usus which have already been men- 
tioned, Bt'veral of tho digestive fluids possess other ^ 
intei-esting properties. The saliva aids the stomach j 
by stimulating its gknde to make gastric juice. The J 
gastric juice and the bile are excellent antiseptics, by 
which the food is preserved from fermentation while- 
undergoing digestion. The bile also etimnlates the 
movements of the intestines, by which the food is moved 
along, and aids absorption. It is a remarkable and 
interesting fact tlm a fluid so useful as the bile should 
be at the same tiiiB largely composed of waste matters 
which are being removed from the body. This is 
illustration of the wonderful economy shown by nature ' 
in her operations. 

Peristaltic Action. — The food ie moved along ] 
the alimentary canal, from tho stomach downward, 
by successive contractions of the muscular walls of the J 
intestines, known as periatallie movements, which occur ' 
with great regularity during digestion. 

Absorption.-- The absorption of the food begins 
as soon as any portion has been digested. Even in the 
mouth and the esophagus a small amount is absorbed. 
The entire mucous membrane lining tho digestive canal 
ie furnished with a rich supply of blood-vessels, by 



50 



TEE STOMACH. 



which the greater part of the digested food is absorbed. 
Absorption ia greatly aided by a rhythmical coutrac- 
tiou of the villi, wliieh is in effect a sort of pumping 
action, alternately filling and emptying the lacteui and 
venoos absorltenta. The action of tlie diaphragm in 
normal breathing also aids absorption by emplving the 
blood-vessels of the slfunach and intestines. During 
absorption, tlie digested forjd is changed into blood. 




The Lacteals.— The walls of the intestines con- 
tain certain small vessels, called lacteals, on account 
of their white appearaueo after a meal. This appear- 
ance is due to the digested fat which they contain, and 
which it is their special duty to absorb. The small 
lacteal vessels unite to form larger ones, all joining at 
last in one large duet about the size of a crow's quill, 
called the thoracic duct, which passes upward, and con- 
nocte with the large vein which returns the blood from 
the left arm. (Fig. 10.) 




:VE PKOCESS. 



The Portal Vein. — The veins of the Btomat-h, , 
intestiueB, pancreas, and spleen all unite to form c 
large vein, called the portal vein. Instead of empty- i 
ing, aa do the other veins, into the large vein which goes 1 
to the heart, the portal vein conveys its blood to the J 
liver, through which it is distributed by a special i 
of vessels. Afterward it is gathered up by another 
large vein, and carried to the heart. Thus it appears 
that all of the food absorbed by the blood-vessels of 
the stomach and intes- 
tines, constituting the 
greater part of what is 
digested, is carried to 
the liver before entering 
the general circulation. 
(Fig. 11.) 

Liver Digestion. — 
The liver not only secretes 
a digestive fluid, the bile, 
but it acts upon the food 
brbught to it by the portal 
vein, and regulates the tio, u. 

supply of digested food to the general system. It 
converts a large share of the grape-sugar and par- 
tially digested starch brought to it into livcr-atarch, 
commonly termed glycogen, which it stores up in its 
tissues. During the interval between the meals, the 
liver gradually redigesta the glycogen, reconverting it 
into sugar, and thus supplying it to the blood in small 
[|uantitics, instead of allowing the entire ann unit formed 
in digestion to enter the circulation at onci>. If too 
'ge an amount of sugar entered the blood at once, i" 




Tim STOMACH, 



Hvsttiiii WDuli] b'^ Hiiablo to use it all, and wouli] be 
('(iiDpclktl U< gut rid of a coitaidorablo portion throngh 
ibe kidne; s. 

Tbe remarkable function by which the liver stores 
up starch witliiii its tissues is usefully employed as a 
means of protecting tho body from various poisons. 
When arsenic, mercury, lead, or any other metallic 
poison is taken into the etoTnach, any portiou absorbed 
is carried to tho liver, which absorbs and retains as 
much ns pussiblo of tho poison, aud thus protects the 
rest of tho binly. Tho liver treats alcohol and other 
narcotics in tho samo inaiUKT ; and it is doubtless for 
this reason that tho liver suffers so great damage from 
the use of alcoholic driuk», tobacco, and other narcotic 
substances. 

The Two Doors — The Liver and the Kid- 
neys, — One of the im>8t important functions of the 
liver is its poiaon-destroying action. Animal aud veg- 
etable poisons, whether origiuatiiig outside the body or 
within the stomach and iuteatinoa, from the fermenta- 
tion aud decomposition of tho food under tho action of 
germs, are in large part destroyed by tho liver, or bo 
modified as to greatly diminish their injurious proper- 
ties. Such portions of these poisons as escape through 
the liver must be carried out of the body through tho 
kiduoya ; hcitce the work of tho liver has a very im- 
portant relation to that of tho kidneys. 

If the liver fails to do its work properly, the kidneys 
are ov(>rwhelmed with work, and are liable to become 
disabled. The liver and the kidneys may be aptly com- 
pared to two doors. One of the most essential con- 
ditions in health, aud even in life, is that one of these 




niQKSTIVK PROCESS. 

doore should be constantly slnit, and the other coUBtantly 
open. The liver door is, in hL-alth, closed against 
the entrance of poisonoiia substancea, while the kidney 
door is held vido open, to allow these substances to , 
escape from the body as rapidly as passible. If the i 
liver 19 overwhelmed with poisonous subHtancea in * 
consequence of errors in diet, it fails to exclude them 
all, aiiH they enter the circulation, and so crowd iiiw>n 
the kidneys that these organs bocomo obstructed and 
disabled ; and the Hvor door thus being open, and the 
kidney door partially closed, poisons rapidly accumulate 
widiin the body, and the most disastrous effects follow. 
It tlius clearly appears why habits tif eating have so 
important a relation to every function of the body. 

Breathing and Liver Action. — The circu- 
lation of the blood through the liver, and hence all the 
functions of the liver, are greatly aided by the action 
of the chest and diaphragm in breathing. When the 
chest wall is lifted outward in the act of inspiration, air 
is not only drawn into the chest, but blood is also drawn 
toward the heart. Deep breathing is thus a very impor- 
tant means of aidmg both the stomach and the liver in ' 
their work. 

Yagaries of Digestion. — The stomachs of cer- 
tain persons sceiu to be possessed of marked peculiari- 
ties, as the result of which particular articles of food 
which agree perfectly well with most people, give rise 
in them to very unpleasant symptoms, such as oppres- 
sion or bm'uing, headache, aod occasionally slight fever. 
These symptoms sometimes occur as the result of eat- 
ing strawberries or honey. They are, however, much 
more likely to arise from eating lobsters, oysters, 



THE MALADIES OF THE MODERN 
STOMACH. 



OuK forefatliei-a knew comparatively little of the J 
panga of iDdigeatioD, or of the coDstitutional maladiea 1 
which grow out oE the tissue etarvation and syHtoinic J 
poisoning developed from derangement of the digestive j 
functions. 

. The Causes of Dyspepsia. — An old German ' 
proverb reads, "Aa a man eatfth, eo is he," This 
is perhaps a parody upon a more ancient proverb, "As 
a man thinketh, so is he." Putting both sayings to- 
gether, we may formulate another etjiially true, "As a 
maneateth, so he thinketh," Our bodies are composed 
of what we eat; nevertheless, the simple eating of gcMKl 
food does not guarantee gofid tissues, a healthy body, 
a sound mind, and normal functions. Food must not 
only be of proper quality, but it must bo well digesi 
Kormal digestion is pei-formed unconsciously. 
individual who is conscious of the working of hts j 
stomach is suffering with a disordered state of that \ 
organ. The disorder may be of any degree, from 
that indicated by a slight feeling of weight or unoasi- 
nees occasioned by taking a small exeesa of food, to I 
the most chronic case of indigestion, exhibiting all the 
most annoying eymptoma of this formidable diaei 
We say forintdahlc disease, not because it is often a 1 
fatal malady, but because of its obstinacy, which too 
oftCD baffles for years the best efforts of those Buffer- 

[55 1 



56 



THK STOMACH. 



ing from its debilitating effects. In ranst instances, 
onfortunatelj, the efforts of the patient and of liis 
advisers, though earnest and persevering, are niiuvaii- 
ing, becaase not well directed. "With this, as with alt 
other diseases, the first step toward recovery lies in 
the discovery and removal of the canses of the disease. 
Having considered the process of digestion as it occurs 
in health, and the conditions required for healthy di- 
gestion, we shall now be better able to appreciate the 
influence which vai'ious violations of the laws of health 
relating to this function may exort upon it. 

Healthy digestion depends upon a maintenance of 
the following conditions in relation to the stoniaoh : — 

1. The secretion of gastric juice in proper quantity 
and of good quality. 

2. The prompt absorption of the digested food 
substances. 

3. Normal muscular activity of the stomach, by 
which the organ ia emptied of its contents in due sea- 
son, or by the end of two or three houi;8 after a meal. 

4. The maintenance of an aseptic condition of the 
stomach; or, in other words, a condition in wbicii the 
stomach is free from microbes, or gi'rms. 

Dyspepsia may result from a dtiparture from the 
normal standard in relation to one or all of the above 
conditions. The gastric juice may be either deficient 
or too abundant. Absorption is never too rapid, but 
it may be greatly diminished, as in gastric catarrh. 

Muscular activity may be either deficient or exces- 
sive. If deficient, the food is retained for too long a 
time in the stomach, resulting in irritation of the 
mucous membrane from too prolonged contact with the 



1 



MAIADIXa OF TBI BTOHAOB. 



acid gastric juice, and in some cases oven giving rise j 
to ulceration. This delay in tho digestive processes | 
ulso allows opportunity for the action of germs upon J 
the food, tliiiB causing fermentation and pntref action. 
Professor Boucbiird, of Pai'is, has shown that if food 
is retained in the stomaeh for more than five hours, 
putrefactive changes take place. Fermuntation may 
begin much sooner tlian tliis. Muscular action may j 
be excessive, in which case the food will bo hurried % 
oot of the stomach into the intestines before the proc- 
ess of gastric digestion is completed, thus giviug rise 
to irrittifion in the intestinal canal from contiict with 
food which has nf>t beoii properly preparnd fiir the' 
processes which occur in this part of tlie digestive 
apparatus. 

Healthy gastric juice ia capable of keeping the i 
stomach in a perfectly aseptic condition ; that : 
desti-oying all classes of germs which are likely to J 
find entrance to the stomach. If the gastric juice is J 
. deficient in quantity or quality, it may fail to do its 1 
work as a disinfecting agent, so that germs may ' 
develop in tlie stomach, and becoming embedded in 
the mucus which covers its lining, permanently estab- 
lish tht'mselves tliore. Different classes of germs may i 
tlms become active in the stomach, either singly or in I 
combiiiiition. Such symptoms as acidity, or sour stom-". 
acli, lieartburn, coated tongue, a bad taste in th&4 
montli, distentioil of tlie stomach, eructations of gaa, f 
etc., are due to the presence of germs in the stomach, J 
and their action npon tiie food elements. Germs do I 
not find lodgment in the stomach when the food isl 
digested tlioroughly, and promptly absorbed or passed I 



58 



THS STOMACH. 



I 



onward into the intestine. Tlie special causes now to 
bu meutiouL'd are more or lesa active as agents pro- 
ductive of dyspepsia, in proportion as they disturb 
the essential conditions of good digestion above 
enumerated. 

Errors in Diet.^ — There is no room to donbt that 
errors in diet, in tlie manner of eating, or in quantity 
and (jnality of fotid, are by far the most active causes 
of indigestion. By asking a dyspeptic how he eats, 
what he eats, and when he eats, it is nsually easy to 
discover the cause of liis suffering ; and by inducing 
him to fnnu correct habits in tliese three particulars, a 
cure will bo effected in nine cases out of ten. In many 
and perhaps most cases, however, other adverse influ- 
ences of various sorts serve to some extent to compli- 
cate the digestive disorder, and to intensify the effects 
arisuig directly from tlie causes named ; hence we shall 
not confine our investigation of the causes of indiges- 
tion to the class of causes mentioned, exclusively, but 
sliail also notice those which more remotely operate 
in this direction, first, however, calJmg attention to 
dietetic errors as the most common and moat powerful 
causes of the disease under consideration. 

Hasty Hating. — The evils resulting from hasty 
eating may be enumerated as follows : — - 

1. From deficient mastication, tlie food is not prop- 
erly divided, so that the digestive juices cannot gain 
access to its various elements. 

'2. By being retained in the mouth too short a 
time, an insufBeient amount of saliva is mingled with it, 
so that salivary digestion cannot be properly performed. 
Aa the saliva is also a stimulus to the secretion of 



HAUDIE8 OF THR BTOU&CH. 

gastric juice, Btomnch digeation must necessarily be 
imperfect. 

3. Again, if the food enters tlie Btomach in a coarBSt, 
onmasticated state, it umj act aa a meclianical irritant tO' 
the delicate lining i>f tlie stamacli, and thus occasii 
congestion and giistric catarrh, one of the most con 
disorders of the stomach, and one which is often 
obstinate in its natui'i'. 

The heat remedy for tl^u habit of liaaty mastication 
ia the use of dry food. The impoitance of tJiia is well 
ehowD by a series of experiments conducted by the 
author for the purpoao of determining the amount of 
saliva produced in masticating dry food as compared 
with moist and h'quid foodw. The remdts wore as 
follows : — - 

A piece iif paraffin chewed for five minutes pro- 
duced two thirdp of an ounce of flaliva. 

One ounce of graunec, n dry fiK>d prepared from 
wheat, increased in woight ti» two oonces. The addi- 
tion of pepper and salt to tlie graungo slightly decreased 
the amount of saliva produced. The addition of vine- 
gar still further diminished the secretion. 

One ounce of moist bread chewed for five minutes 
caused the production of one ounce of saliva. 

One ounce of raw apple produced one and one- 
foorth ounces. 

An ouuce of water produced but one tenth of aa 
ounce of saliva, or about one sixth as much as a pieoe 
of paraffin, and one tliirtietli as much as an ounce (tf 
granose. 

One ounce of milk was slightly more active in pro- 
ducing saliva than the same amoonc of water. 




60 



THE STOMACH. 



An ounce of pea soap chewed for five nminteB pro- 
duced twico us much saliva as did water, bnt only one 
third as mnch as i>araffiii, and one tentli as mach as 
grauose. 

The nse of "slops," so common in the United 
States, and to a great extent also in other eonntries, 
is one of the ino-it serioua of dietetic errors. The 
American eata in a hurry, rinses down his food with 
copious draughts of tea, coffee, iced water, iced milk, 
or iced tea ; and in cimsequence the salivary glands are 
not stimulated to proper activity, so that the amount 
of saliva produced is altogetlier inadequate to digest 
the starchy elements of fiiud in the acid medium of 
the etomacb coutents, and the small amount produced is 
so diluted that its efficiency is greatly impaired. What 
wonder that starch indigestion is coming to be an 
almost universal complaint, as shown by acidity, 
eructations of gas, flatulence, and a great variety of 
stomach disturbances, to escape from which multi- 
tudes are continually swallowing quantities of magnesia, 
soda, neutralizing cordials, and alkaline mineral wa- 
ters of various sorts, together with malt extracts and 
other digestantsl 

The inability to digest starch is doubtless one of 
tlie great causes of the inordinate consumption of beef 
and other animal products to which the English-speak- 
iitg race has come to bo addicted, as a method of 
escaping the pangs of starch indigestion. 

The abundant provision made iii the human body 
for the digestion of starch, — first, the saliva ; second, 
the bile and pancreatic juice ; third, the intestinal 
juice ; and finally, the liver,^ is evidence that nature 



MALADIES OF THE STOMACn. 



61 



intended man to subsist largely upou fariiiacenue footle. 
The arguments of the "natnral food" advo<MteB, 
who insist that man should lire upon fruits and nuts, 
are based, not upon phyeioJogical facts, but upon the 
morbid experiences of the disciples of tliis doctrine, 
Tlie writer had an opportunity, a year or two ago, to 
examine tlic stomach fluid of one of the most earnest 
and stalwart adTocatea of the fruit-and-nut diet, and 
the stomach was found greatly dilated, and almost com- 
pletely inert. 

1 havt; cured many bcoi-os of chronic and very 
obstinate cases of dyspepsia by simply requiring the 
patient to subsist upon a dry diet, whereby he was 
compelled to tlioroughly masticate his food. A fa- 
vorite prescription with the writer, which is applicable 
in most cases of indigestion, is one or two ouncoa of 
dry granose eaten at the beginning of each meal. 
This introdnces into the stomach an abundant quantity 
of saliva, — probably from four to six ounces in most 
caacs, — and insures efficient starch digestion, 

Tlio dextrin and maltose produced by the action 
of the saliva upon the starch are exactly what the 
stomach needs to Htimulato it to healthful activity, 
whereby a proper quantity' and quality of gastric juice 
will be produce«l. 

Diseased Teeth. — Ulceration of the teeth is 
a very common ailment. Decay of a tooth is exactly 
analogous to ulceration in other parts of the body. 
This destructive action upon the toelh is due to the 
presence of germs in the mouth, which produce chem- 
ical substances of such a nature as to dissolve the 




enainel, aiid thns expose tlie inner portion of the teeth 
to the action of destructive microbes. 

Defective teeth, by interfering with the complete 
and thorough mastication of food, seriously impair 
the digestion. On the other hand, impairment of di- 
gestion, with its consequent perversion of the secre- 
tions, is a very common cause of decay in the teeth. 
Many persons suffering from disorders of digestion can- 
not hope to recover without giving attention to the 
teeth, that being necessary as the first step toward 
reforming the condition of the stomach. If ptissible, 
the natural teeth should bo preserved by tilling when 
decayed, and by such olLer measurfH as any good 
dentist will recommend. 

The microbes hai"bored by decaying teeth are swept 
into the stomach in drinking or eating, and there set 
up fermentative and putrefactive processes, whereby 
the food elements arc eonvei-ted into poisonous sub- 
stances. Some of these poisons are possessed of such 
strong odors as to taint the breath. Decaying teeth 
may also be the means of introducing into the body 
such destructive microbes as the germs of consump- 
tion, and others giving rise to serious and even fatal 
disease. 

Decay of the teeth is generally the result of lack of 
use and of cleanliness. By the use of dry food as pre- 
viously stated, the teeth are polished and tept free 
from the colonics of germs which settle upon them 
when they are not scoured by attrition of hard sub- 
stances. Meat eating is especially favorable to tlie 
destruction of the teeth. The small particles of meat 




MAI^DIBS OF TBB FTOtUCB. 

which collect between the teeth eocaorage the derelup- 
meDt of germs of the moet detftmctiTe t^iancter. Pret-, 
ervation of the teeth requires babiloal tad 
cleaDliaess. They shonld be thoroagblT 
and after each meal, — before the meal tor tbe 
pose of protecting the Btomach from the germs 
occumnlate in the mouth from the air. utd lodge 
the teeth ; and after tbe meal for tbe purpose oi mmor- 
ing every particle of food, bo that tbe grfnrth and devel- 
opment of germs which snbsist npon remnants of food 
left behind in the month, sball not be encooraged. 

It it! wi'11 to employ Bome mailable antiseptic a» well 
us a cleansing agent for tbe teeth, but many harmful 
substances are recommended for this use. Tbe writer 
lias had an antiseptic dentifrice prepared, tbe basis of 
which is an extract of tlie famons soap-tree of South 
America, and cinnamon oil. The firxt of tbeflo ingredi- 
ents is as cleansing aa soap, and avoids the impurities 
and chemical substances found in it. Oil of cinnamon 
is one of tbe best antiseptics, preventing the growth of 
germs even when not used in sufficient fjoanlity actually 
to destroy them. 

Tbe rapid decay of the teeth in civilized countries, 
which is principally due to the excessive am of meats 
and of soft foods, as mu!<he!«, soups, bouillons, etc., 
has in our time led to a full realization of the dream of 
Giles Corey, who was put to death for witchcraft at 
Balem nearly two hundred years ago, and who wrote : — 



"I B«w u man pull all his teeth, 
It look him but u miiiuii; : 
He op'd his Bioulh and put Ihem butk; 
I thought 'u deuce whb in It." 



64 



THK l^TOMAOH. 



The tartar which sometimes accumulates upon 
the teeth is due to the action of germs. Tartar should 
never be allowed to remain, — indeed, the teeth should 
be so often and so carefully cleansed as to prevent the 
slightest accumulation of tailar. When allowed to grow 
and remain, tartar separates the gum from the teeth, 
and produces an unhealthy state which often causes the 
loss of the teeth. Fig, 13 shows human teeth on which 
are formations of tartar. In Fig. 13 arc shown the some 
teeth with the taitai- removed. The teeth of Orientals, 
, and in fact of nearly all primitive people, are 




generally remarkably eoiuid, because of their simpler 
diet and small use of meat. 

If the natural teeth cannot be saved and made 
serviceable, they should bo replaced by artificial ones. 
No one can hope to preserve good digestion while 
munching food with toothless gums, or subsistuig on a 
dietary that does not require the use of teeth. 

Drinking at Meals. — In addition to the evils 
which it occasions directly, hasty eating induces the 
drinking of large quantities of hot or cold liquids to 
wash t!ie food into the stomach. Thus two evils are 
associated. Too much liquid of any kind is prejudicial 
to digestion, because it delays the action of the gastric 



MAI.ADIB9 OF THE BTOHACH. 



«^ 1 



I 
I 



juice, w<iBkons its digestive qualities, and overtasliB the 
absorbeuta. In case the fluid is hot, it relaxes and 
weakenB the stomach. If it is cold, it checks digestion 
by cooling the contents of the stomach to a degree at , 
which digestion cannot proceed. Few people are aware 1 
how serious a disturbance even a small quantity of cold i 
water, iced cream, or other i^old substance, will create i 
when taken into a stomach where food is undergoing 1 
digestion. This procoss cannot be carried on at a tem- 
perature less than that of the body, or about 100* F. 
Dr. Beaumont observed that when Alexia St. Martin 
drank a glassful of water at the usual temperature of 
freshly drawn well-water, tiie temperature of the food i 
undergoing digestion fell iuimediatcly to 70°, and did 
not regain the proper temperature until after the lapse 
of more than half &u hour. 

Of coarse the eating of very cold food must have a 
similar effect, making digestion very tardy and alow. 
If any drink at all is taken, it should be a few minutes 
before eating, so as to allow time for absorption before 
digestion begins. If the meal is mostly composed of 
dry foods, a few sips of warm or moderately hot water . 
will be beneficial rather than otiiorwise, taken either at ' 
the beginning of the meal or at its close. The habit 
of drinking during tho meal should be discontinued 
wholly, and especially by those whose digestive powers 
are weak. If the diet is of proper quality, and the 
food is well masticated, there will be little inclination 
to eat too much. When tho food is rendered fiery with 
spices and stimulating condiments, it is no wonder that 
there is an imperious demand for water or liquid of 
some kind to allay the irritation. 




Eating too Frequently. — One of the moat per- 
nicicns customs of inoclern life is tliat of frequent meals. 
Tliis habit is seen in its extreme development in Eng- 
land, five meals a day, including lunches, being there 
considered none ti^io many. The idea seems to prevail 
that the stomacU must never be allowed to become 
empty under any circam stances. In this country, three 
meals a day is the general custom, though more are 
sometimes taken. 

Healthy digestion requiics at least five or six honrs, 
and one or two hours for rest before another meal is 
taken. This makes six hours necessary for the dis- 
posal of each meal. If ordinary food is taken at 
shorter inter\'alB than this, the stomach must suffer dis- 
turbanco sooner or later, since it will be allowed no 
time for rest. Again, if a meal is taken before the 
preceding meal lias been digested and passed from the 
stomach, the portion remauiing, from its long exposure 
to the influence of warmth and moisture, is likely to un- 
dergo fermentation, in spite of the preserving influence 
of the gastric juice. Thus the whole mass of food is 
rendered less fit for the nutrition of the body, and what 
is still more serious, the etomach is liable to suffer 
permanent injury from the acids developed. 

Too frequent eating occasions too long contact of 
the acid contents of the stomach with the gastric juice, 
which produces catarrh and ultimately ulceration of that 
organ, Fi'ef|nent eatiug is often resorted to as a relief 
from what is commonly termed faintness, or an "all 
gone" feeling in the stomach. The fact that eatiug 
gives a respite from this sensation is taken as good 
evidence that it is the proper remedy ; but. at the best. 




M4LADIE8 OK THE BTOMACH. 




mlj temporary relief is obtained, and tbut at the ex- 
pense of aggravating the difficulty. Food aEEorda relief 
Binipty by separating the irritated mucous surfaces of 
the stomach, and diluting its acid fluid. The proper 
remedies for these unpleasant symptoms are given elsu- 
where in this work. 

Eating betvreen Meals. — This ia a gross breach 
of the requirements of good digestion. The habit many 
have of eating fruit, confeetionery, nuts, sweetmeats, 
etc., between meals, is a certain cause of dyspepsia. 
No stomach can long endure such usage. Those who 
indulge in this manner usually complain of a poor appe- 
tite, and wonder why they have no relish for their food, 
strangely overlooking the real cause, and utterly disre- 
garding one of the plainest laws of nature. 

This harmful practice is often begun in early child- 
hood. Indeed, it is too often cultivated by mothers and 
the would-be friends of little ones, who seek to please 
aud gratify thorn by presents of confectionery and other 
tidbits of various sorts. Under such indulgence, it is 
not singular that so many thousands of children annu- 
ally fall victims to stomach and intestinal diseases of 
various forms. In great numbers of cases, early indis-. 
cretions of this kind are the real cause of fully developed 
dyspepsia in later years. What a sad thought that 
the lives of such persons have been modified in their 
usefulness, and their whole characters more or less 
depraved, by the morbid influence of disordered di- 
gestion. 

Irregularity of Meals. — Another cause of dys- 
pepsia, which is cloHely related to the ones just men- 
tioned, is irregularity respecting the time of meals. 




Tht human system seems to form habits, and to be iti a 
great tipgree dependent upon the performance of its 
functions in accordance with the habits formod. In 
respect to digestion this is especially observable. If a 
meal is taken at a regular hour, the stomach becomes 
accustomod to receiving food at that hour, and is pre- 
pared for it. If meals are eaten irregularly, the stom- 
ach is taken by surprise, so to speak, and is never in 
a proper state of readiness for the prompt and perfect 
performaiice of its work. The habit which many pro- 
fessional and business men have of allowing their 
biieiness to intrude npoTi their meal hours, frequently 
either wholly depriving thom of a meal or obliging them 
to take it an hour or two later than tlie usual time, 
ultimately iindormines the best digestion. The hour for 
meals should be considered a saered one, not to be 
intruded upon except under some unusual circumstance. 
Eating is a matter of too momentous importance to be 
interrupted or delayed by matters of ordinary business 
or convenience. 

The Lahit of reguhirity in eating should be culti- 
vated early in life. Chihlrcn should bo taught to be 
regular at ihcir meals, and to take nothing between 
meals. This rule applies to infants as well as to older 
children. The practice of feeding tlie little one every 
time it cries, results in most serious injury to its weak 
digestive organs. An infant's stomach, though it needs 
food at more frequent intervals than an adult's, — every 
two to four hours, according to its age, — requires the 
sanie regularity which is essential to the maintenance 
of healthy digestifwi in older persons. The irregularity 
usually practiced is undoubtedly one of the greatest 



MALADIES OF THE StOMACn. 



causes of the large number of deaths among 

from disorders of the digestive organs shown bj oaira 

mortuary recoi-ds. 

Tlio action of the digestive organs, like that of alt 
other organs of the body, is rhythmical. The discharge 
of the alimentary residue, whicU constitutes the fecal 
matters, normally occurs after the first meal of the day. 
It is the result of tlie peristaltic movemenls set up by 
the introduction of food into the stomach. By this 
increased activity of the alimentary canal the fecal 
ters resting in the upper portion of the colon are movi 
downward into the rectum, thereby provoking a de, 
for evacuation of the bowt-le. By this moans, the 
tivities set up by each meal move the contents of 
intestine to their appropriate station, resulting, in healthy 
persons, in the disciiargo of the alimentary residue from 
the body at a stated hour each day. If a meal is 
omitted, or if meals are taken at irregular hours, this 
rhythmical a(rtion is broken np, and constipation is the 
natural result. 

It thus appears that eating at too frequent intervals 
is not the only evil in the way of irregularity in eat- 
ing. It is far better, however, to omit a meal than to 
introduce into the stomach a new supply of food before 
tliat already contained in it has been properly digested, 
and the organ given an opportunity for rest. 

The Proper Number of Meals. — The number 
of meals which should be taken by a person in health 
depends somewhat upon the habits of the individual, 
bis occupation, the number of tours he labors, etc. 
There is good reason to believe that for a large pro- 
portion of those wlio now take three to five meals a 



(0 THB STUMAC-H. 

day, two would be mnch better. According to Hippoc- 
rates, tlie ancient Greeks ale but two meals a day. 
The same was true of iho ancient Hebrews and Per- 
sians. This is also the cnstora of the natives of India, 
of South America, and of many semi-civilized nations. 
Among savage tribes, one meal a day is the prevailing 
custom. The Eskimo walrns banter sets ont in his kijaJc 
un a day's hunt at the break of day, but eats nothing 
until after he returns with his prey, jest before sunset. 

The modern frequency of meals is the outgrowth 
of a gi-adual losing sight of the true pur[)08e of tlio 
eating of fond, and of regarding the gratification of 
the palate, instead of the nourishment of the body, tlie 
chief object to be attained. That the system can be 
well uouriBhed upon two meals a day is beyond contro- 
versy, seeing that not only did our vigorous fore- 
fatliers require no more, but that hundreds of persons 
in modern times have adopted the same custom without 
injury, and with most decided benefit to themselves. 
Students, teachers, clergj'men, lawyers, ajid other lit- 
erary and professional men are especially benefited by 
this plan. The author has followed the plan for more 
than thirty years, aud with great satisfaction The 
special advantages gained by it are : 1. The stomach 
is allowed a proper interval for rest. 2. Bleep is much 
more recuperative when tlie stomach is allowed to i-est 
with the balance of the body. 3. Uigestiou cannot 
be well performed during sleep, 

DujardLn-Beaumetz, an eminent French physician, 
Bouchard, and other well-known European authorities, 
insist that seven hours is the proper length of time to 
be allowed for the digestion of each meal. If this 



i 




plan is followed, aeveu hours being allotted to llie di- 
gestion of each meal, and the proper length of time 
allowed to elapse before going to sleep after the last 
meal, it will be found impossible to make any arrange- 
ment by which oppoitimity can be secured for the nec- 
essary eight hoHTs' sleep at night. Not more than two 
meale can be taken when a person complies with all the 
laws of health. 

If more than two nieala are suited to auy class, it 
ta those who are engaged for twelve or more hours per 
day in severe mental and physical labor. Such persons 
are better prepared to digest a third meal than those 
whose occupation is mental or aedenfaiy, and they may 
at least take it with less detriment, though a third meal 
is not needed, even for such, provided the two meals 
are taken at suitable hours. For many years, the prac- 
tice at the Battle Creek Sauitarium has been to furnish 
its guests with two regular meals daily, the fii-st at S 
A. M,, the second at 3 p. w. ITie employees, num- 
bering at the present writing something more than six 
hundred, are also furnished with but two meals, at G 
A. u. and 1 :30 p. w. The universal testimony of all 
who have become acenstonied to tlicae hours for eating 
is that more work and better work can he accomplished 
than when three meals are taken. In cases requiring 
more than two meals, as when liquid food or only 
small quantities of food, can bo taken at a time, we 
find it wise to supply two minor meals, at V2 h. 
and 7 p. u. 

Late Suppers and Si.\. o'clock Dinners. — 
Eating late at night, when the muscular and nervous 
systema ai-e exhausted by the labor of the day, and 



I'l THE STOMACH. 

retiring to rest soon after, is one of the most positive 
dyspepsia-producing habits of modem times. A sleep- 
ing stomach ia a slow one. Secretion must of necessity 
be deficient in both quantity and quality, owing to the 
exhausted condition of the system ; and with the further 
obstacle afforded to prompt digestion by the slowing of 
the vital operations during sleep, it is almost impossible 
that there should be other than disturbed digestion, and 
restless sleep in consequence. It is under these cir- 
cumstances tliat people often suffer with obstinate in- 
somnia, bad dreams, nightmare, and similar troubles, 
from which they arise in the morning unrofreshed anil 
unrecuperated by nature's sweet restorer, the work of 
assimilation, by which repair takes place, having been 
prevented by the disturbed condition of the nerves. 

No food ought to be taken within four hours of retir- 
ing. This will allow the stomach time to get the work of 
digestion foi-warded sufficiently to enable it to be carried 
on to completion wilhout disturbance of the rest of the 
economy. If a third meal is taken, it should be very 
light, preferably consisting of ri]>o fruit and simple 
preparations of grains. The costum which prevails in 
many of the larger cities, of making dinner the last 
meal of the day, eating of foods the most hearty and 
difficult of digestion as late as six or even eight o'clock, 
is one that ought to bo discountenanced by physicians. 
It should be tolerated only by those who convert night 
into day by late hours of work or recreation, not retir- 
ing until near midnight. But in such cases a double 
reform ia needed, and so there can be no apology 
offered for this reprehensible practice, on any physio- 
logical grounds. 



MAL&DISB OF THB STOMACH. 



It shouhi be romembered tliat the process of dig 
tion is not complete when the food leaves the 8tomach.J 
Recent observations made upon a man having a fists- 1 
louB opening at the jnnctiou of the small intestine with 
the colon, have shown that fourteen hours elapse from 
the time food is eaten nutil it enters the colon, 
when the process of digestion is completed, the colon 
being chieilj a reservoir where the digested food is 
retained for absorption. 

Eating when Exhausted. — This is a mostj 
certain cause of deraugenient of digestion, and i 
which a very large number of cases of dyspepsia may^ 
be traced. The third meal of the day is almost alwayfH 
taJcen when the system is exhausted with the day'd 
labor. The whole body is tired, the stomach as well as ' 
other parts of the orgauism. The idea that by the tak- 
ing of food the stomach or any otlier part of the system 
will be strengthened, is a mistake. An eminent writer 
on indigestion says very truthfully, "A tired stomach 
is a weak stomach." When the stomach feels "weak 
and faint," rest is what is demanded, and is the only j 
thing that will do it good ; yet many people insist onj 
potting more fofid into it, thus compelling it to workl 
when it ought to bo allowed to remain inactive nntS,'l 
rested. The arm wearies hy constant exercise, and e 
docs the stomach, which, like the arm, is active throug] 
its muscular structure. Both secretion and muscularl 
activity are greatly lessened in a tired stomach, aodl 
the habitual disregard of this fact eannot but be disaa-i 
trous to the best digestion. 

Violent exercise eilhcr just before or just after eat' J 
ing is a hindrance to godd digestion. When the exBr--r 




<-isu Ih taken just before the meal, thu Btomach is left 
too tii-ed to do its work properly ; and when taken im- 
mediately after eating, the vital energies are diverted to 
other parte, and the stomach is tlius robbed of its nee- 
eeeary share. An English physiologist performed an 
experiment which well illustrates the truth of this posi- 
tion. Having fed a dag his usual allowance of meat 
one morning, he took him out upon a fox hunt, and 
kept him racing over the country until night, wheu, 
having killed the animal, he examined his stomach at 
once, and found tho meat in the same condition in 
which it had entered the stomach, no digestion having 
taken place. In another dog, fed with the same kind 
of food, but left quiet at home, digestion was found to 
be complete. 

The hurry and press of business among Americans 
is allowed to override every consideration of health. 
It seems never to enter the mind of the average busi- 
uesB mau that any time is required for digestion. 
Rushing to his dinner from the plow, the workshop, or 
the couuting-rooni, he swallows his food with all pos- 
sible dispatch, and hurries back to his work again, 
begrudging every moment spent in meeting the re- 
quirements of nature. Many years ago it was custom- 
ary in Edinburgh to suspend all business for two hours 
in the middle of the day, so as to allow ample time for 
meals. A similar custom once prevailed in Switzer- 
land ; but probably such a sensible custom is now con- 
sidered too old-fashioned to be tolerated. 

It should be remarked that severe mental labor im- 
mediately before or after and especially during meals, 
is even more injurious than physical employment. The 




MALADIES OF THE BTOMACH, 



T5fl 



habit many busineaa men have of anxiously Bcanning^ 
the nevfapapers during their nioals, and wliile going to 
and from their places of bnsint'aa, ia a ba<l one. At 

t a full hour should be taken for the midday meal ; 
and if an hour's rest can be aecured before eating, im-| 
proved digestion will well repay t!io time spent infl 
reinforcing the vital energies. Foi- persona of weakfl 
digestion, the rest before eating is ahrmBt indispon-T 
sable. 

Recent experiments have shown that the maacnlw 
strength is increased very soon after eating. Tliia muatf 
be dne to the digestion anJ absorptinn of the atarch,] 
whereby the muscles are furnished a fivsb supply of] 
glycogen, wbicli is their source of energy. It is, lliere-fl 
fore, admissable that a very snmll amount of fooda 
be taken by an exhausted person, but it should be of i 
kind which ie easily digested, and tho quantity should I 
be very small. Nitrogenous fi»od, such as meat andJ 
egga, ia eapocially detrimental to a person ia this coa^l 
dition. Tbin, well-boiled gruel or rice watijr, a littleJ 
rice, a crust of bread well chewed, a cup of vegetableJ 
broth, a bunch of grapes, an orange, or a bit of ripel 
fruit of some other kind, are most auitable for ttiis'j 
purpose. 

Sleeping after Meals. — While rest from i 
customed exerciae after eating is important, it ehoulct 
be noted that sleep at this time is oqually as bad as vigor-fl 
OUB exerciae of either mind or body. Good dig 
cannot take place daring sleep. While it is true thatl 
digestion is an involuntary act, it should bo recollected j 
that it is dependent upon the activity of the nervoos J 
system for its proper performance. The same nerve 



7ti 



THE STOMAi 



which secures activity of the respiratory organs, — the 
pnenmogastric,— controls the muscular activity of the 
fitomach and the iutestiueB. During sleep, from the 
lessening of nervous activity, both the respiration and 
the circulation are greatly lessened in vigor. It is but 
reasonable to auppuse that the activity of the digestive 
organs is docreast^d at the same time, being controlled 
by the same nerves. Actual experiment shows this to 
be true. Most people who lie down and sleep an hour 
or two Boon after taking food, awake feeling anj-tluiig but 
refreshed. The stiBpeoBion of the process to a consid- 
erable degree during sleep causes ini[>erfect digCHtion, 
with its numenius nnpieaeant symptoms. In the case 
of old people, it may soinetiines be beneficial, or at 
least not harmful, to secnro a few minutes' sleep after 
eating, before digestion is well begun ; but it must not 
bo long continued. 

In order to secure the beat conditions for digestion 
after eating, an iudividua,! should take gentle exercise 
of some kind, as walking, or carriage or horseback rid- 
ing. While violent exertion seriously interrupts the 
digestive process, a moderate degree of physical exer- 
cise facilitati!S it by increasing the activity of the glands 
by which the gastric juice is formed. It is probable 
that gentle exercise also encourages digestion by stim- 
ulating the movements of the stomach. 

Too Many Varieties of Food. — Many dys- 
pepsias aj-ise from the eating of too many kinds of food 
at the same meal, another growing custom of modern 
times which deserves to bo severely condemned. At 
great dinners in honor of distinguished personages, 
when friends are to be entertained, and in the majority 




I 



MALADIES OF THK STOMACH. 

of well-to-do families aa a guiieral cnistoin, the eai 
are tempted to gluttony by having presented to their ^ 
palates a great variety of complicated dishes. On thef 
occasion of the giving of a great dinner, more than a 
hundred dishes are souietimea served in successive 
courses. Such gormandizing soon breaks down the 
most vigorous digestive organs, since it adds to the 
labor of digesting food whidi is improperly cooked, a 
larger variety than the digestive juices are capable of 
bringing into a fit state for absorption. 

Food Combinations. — Carefnl experiments have'J 
shown very clearly that different cInBBes of food require J 
a particular qnality of digestive juices fur tlii'ir diges- 1 
tion. For instance, a gastric juice that will digest ani- 
mal food the best, is inferior for the digestion of vege- 
table food, and vice versa. The obvions conclusion to 
be drawn from this fact is that the simjiler the dietary, 
the mora perfectly will the digeutivo process be per- 
formed. For persona whoso digestion is naturally 
weak this is a matter of especial importance. The fol- 
lowing table represents the best and worst f<^od combi- 
natioDB : — 

OOOD COMBINATIONS. 

Grulns untl Fruits. Grains und Milk. 

OrNlDS and Meat, or Eggs. Oruiiis unit Vi'tn^tablc^. 

FAIR COMBISATIONB, 



Fruils and Vsgetables 



Those foods 



agree 



Milk aQd Meul. 
best whoBO chief constituent ele- 



meuta are digested by the same fluid, in the 



78 



TUK STOMACH. 



of the alimentary canal, and in about the same length 
of time, TegetablcB contain a great amount of coarse, 
woody Btmctures, which are retained in the stomach a 
long time before they are sufficiently broken «p to be 
easily digested in the intestines. Frnits, on the other 
hand, remain but a short time in the stomach. The 
large amunnt of Baccharine matter wliich fruits contain, 
makea them likely to sot up fermentation in the stom- 
ach, if retained too long. Acid fruits are also likely 
to delay starch digestion. This ia another reason for 
their interference with vegetables, the starch of which 
ia rather more difficult of digestion than that of grains. 

Milk and vegetables are likely to disagree, for the 
reason that milk, when taken by itself, ia retained in 
the stomach bnt a short time, its digestion being carried 
on chieHy in the small intestine. Milk and meat are a 
bad combination for the same reason. Meat requires 
long digestion in the stomach, whereas milk, when 
taken by itself, is quickly passed on, to be digested by 
the pancreatic juice. When taken with meat or vege- 
tables, milk, being long retained in the atomach, under- 
goes fermentation, resulting in aour stomach, bilious- 
ness, and various other unpleasant symptoma. 

If the hill of fare taken at a single meal were eon- 
fined to three or four articles of food, there would be 
fewer dyspeptics scanning the newspapers for aome 
patent nostrum to "aid digestion." 

Hot or Cold Bathing after Meals.— Especial 
mention should be made of the injury to the digestive 
organs quite certain to result from taking either a hot 
or a cold bath Bi>on after eating. Few people nro aware 
of the danger of laying the foundation for years of die- 



MALADIES OF THS 9T0UACH. 



T9l 



comfort in this way. If the bath be a hot one, the stom- 
ach will be deprived of the blood necessary to sup 
the rapid secretion of gastric juice for the digestion of J 
the food, by its being drawn to the surface of the body < 
by the sudden relaxation of the capillaries and small •! 
vessels of the skin. A cold bath, on the other hand, 
or any sudden exposure to cold, may, by causing con- 
traction of the blood-vessels of the surface of the body, 
cause sudden congestion of tho stomach, which is 
equally fata! to good digestion. Very nearly the same I 
danger exists from bathing just before a meal. 

The practice very common among boys and young 
men, of going into the water in the eummer-time, re- 
gardless of the state of the digestion or other conditions 
of the body, is a bad one. With many it ia a very 
usual practice two or three times a week, if not oftener, 
to go into the water immediately after the evening 
meal, not even allowing time for the work of digestion 
to become established. No bath involving any con- 
siderable portion of the body should be taken within 
two hours after a meal, except by the advice of a ' 
physician. 

Errors in Quantity of Food. — If errors in thftl 
manner of taking food are active causes of indigestion^ / 
mistakes in quantify are still more potent in this diroc- j 
tion. It should bo noted, however, that eirors of this j 
class are very closely connected with others in the n 
ner of eating, and in the quality of foixl taken. It is] 
generally true with physical as well as moral transgres-^ 
sion, that one bad liabit invites another ; and especially 1 
is this the case iu reference to diHetic errors. A per- 1 
son who eats too fast is likely to eat more than is neo--a 



80 



THE STOMACH, 



essary ; and the same Is true if too large a variety of 
food i» partaken of, or food rendered excitiug and 
Btimulating by seasoning with irritating condiments. 

Overmt ill r/.^ Intemperance in eating is, in the 
opinion of the writer, responsible for a greater anionnt 
of evil in tho world than ia intemperance in drink. In- 
deed, it can be clearly shown that intemperate eating 
is, in the first place, one of the most potent causes of 
intemperance in drink, and alao that it is one of the 
obetaeles in the way- of the reformation of those who 
have become the victims of alcoholic intemperance. 

The extent to which overeating is sometiraes carried 
is almost incredible. Travelers in the Arctic regions 
report that it is not an uncommon thing for a Laplander 
or an Eskimo to devour a large portion of a small sheep 
at a single mual. A German authority reports the case 
of a hysterical girl eighteen years of age, who ate regu- 
larly twelve times a day, consuming from twenty-four 
to twenty-six pounds of food. Id another case a woman 
who was seized with a peculiar form of morbid appe- 
tite, known as bulimia, in forty-five minntes ate twenty- 
three eggs, and drank three pints of milk and two pints 
of wine. 

But if we may believe the statements of historians, 
gluttony is by no means a modern vice. Indaed, there 
is quite gO(jd ground for concluding that overeating, 
while a very general fault, is rarely, if ever, at IcMt 
among civilized nations, carried to the enormous excess 
in which some of the luxurious Koman emperors in- 
dulged. 

The evil consequences of excess in eating are at first 
simply imperfect digestion, the overtaxed organs being 



MALADIKS OF TUB STOMACH. 



nimble to accoraplisli tho complete digestion of the 
alimentary mass. In conseiinence of the delay wbicli 
occurs, changes take place by which acids are deveh.i]>ed 
that, irritate the mucous niembrauo, togetlicr witli 
gases by which the stomach is distended, and its mus- 
calar walls weakened and partially paralyzed. In 
course of time, inflammation of the gastric membrane 
is developed, and permanent dilatation of the stomach 



This condition is one which cannot nsually be en- 
th-ely cured, and which gives rise to a groat variety of 
ailments in addition to tlio discomforts connoGted di- 
rectly with the stomach itself. These are inoi-e fnlly 
ptiinted out elsewhere. Dilatation of the stomach often 
originates very early in life. Tho writer lias found the 
organ dilated to more than its normal size in children 
scarcely a dozen years of age, and in many cases has 
been able to trace tliie condition found in adults back 
to early childhood. 

An individual who overeats will at firwt be likely 
to accumulate flesh tjuito rapidly ; but very soon the 
digestion becomes so much disturbed that no gain takes 
place, and, indeed, tho patient not infrequently becomes 
considerably emaciated even while daily taking large 
qnantiCies of food. Wlien tho opposite is the case, the 
blood is filled with crude, imperfectly elaborated mate- 
rial, which, when absorbed, fills the system with poi- 
sonous substances. At first the liver is able to exclude 
these to a considerable extent, but after a time the en- 
ergy of this patient organ is entirely exhausted, and 
the whole system suffers in consequence. Biliousness 
and the various conditions usually attributed to torpid- 



TRH BTOXAGIT. 



ity of tho livLT ai'o generally diie to pnisonirig of tlis.- 
Bjetera by toxic eubstaiieea absorbed from llio alimen- 
tary canal, wliich may bo e-ilber the result of tlie piitro- 
faction of food in a dilated atoniacli or colon, or the 
prodncta of uuperfect digestion. 

Excessive eating also occasions injnry to the health 
by producing an excessive fulneaa of the blood-vessels, 
tbna incurring the risk of ruptnre within the brain, and 
rpaulting paraiysia. Other equally aorioua mischiefs 
may arise from the accnmnlation in the system of a 
greater quantity of nutritive material than can bo ntil- 
ized, which occasions general clogging and obstruction 
of all the bodily functions, and imposes an enormous 
burden upon tlie kidneys in tho elimination of the nn- 
nsable nmterial. 

Jljithiif tiK> Little. — -A far less common fault 
than tlie one last mentioned, ia eating too little. The 
instances tliat occur are usually In the cases of those who 
have attempted to subject themselves to a rigid dietetic 
regimen for the prevention or cure of disease, and who, 
from having only a pailial view of ttio aubject, enter- 
tain extreino notions. By the weakening of tho system 
which neecBsarily occura when an insufficient amount of 
nutriment is received, the etomach also becomes weak 
and debilitated, its secretions and muscular efforts being 
gi'eatjy impaired in both (juantity and quality. 

How Much Should a Person Eat?— Thou- 
sands of times lias tlie writer been asked, this question, 
The only reply that can bo made to this inquiry is, 
Just so nmch as tho systura needs and tiie digestive 
organs can digest. In general, an individual may take 
as much food as he can digfst ; but often there are con- 




HALADISB OF THE BTOMAOB. 



83 ■ 



ditions in which he cannot digest as mnch as he really 
needs. For instance, when aa individual ia called 
upon to exert all his energies of brain aiid muscle, to 
straiu every nerve to its iitiuost, to compass a certain 
-object of great importance, to cope with an emergency, 
he may bo, for the time beiug, quite nnablo tfi digest 
Buflicient food to make good the waste that must uec- 
eeearily occur. Ho will lose flesh an<l strength under 
Buch circuinstancee ; and often a failure of the ajipetita 
at BUf^h a crisis indicates the inability of the stomach to 
digest, on iicconnt of the defieiont secretion of gastric 
juice. It is in this way that persons who are for a time 
called npou to make great exertions often break down 
their digestion. Thinking that they need abundance of 
nutriment, which is true, they eat as heartily as when 
required to i>ert'onn only their ordinary work, not con- 
sidering their diminislied power to digest and appropri- 
ate food, and in a short time find their digestive orgaus 
unable to digest well even a small amount of food. 
There is little doubt tliat this is what causes many law- 
yers, phypicians, and other professii^nal men to break 
down. If, when called npon to do a largo amount of 
extra work, tlie person would lessen the quantity of 
food eaten, instead of increasing it, he would conserve 
his vital forces much more than by pursuing the oppo- 
site course. When required by a press of business to 
do extra work, often working for sevci-al days in suc- 
cession with very little sleep, the writer has been in the 
liabit for many years of limiting the amoimt of food 
taken to not more tlian half the Dsnal allowance, and 
sometimes to even a less quantity. The result has in- 
variably been all that could be desired ; since, although 



^+ TUB STOMACH. 

several ponnds of flesli are often lost during an ordeal 
of titis kind, wh«n it is passed, and the usual routine of 
wnrk is resumed, tite digestive powers are intact,, and 
abki to digest the anioant of iood necessary for retru- 
jH.'1'tilioa, so that a few days suffice to restore the iiBual' 
weight, and without loss of either strength or time. 

It is evident that the diet of each individual mnet 
be regutati'd in quantity according to his occu]>ation. 
It must also be adapted to liis age. A man engaged 
in severe physical labor, while he really requires 
less food, may be able to dispose of more foi>d 
than one who labors with equal intensity in some men- 
tal pursuit. The body is wasted much more ra]>idly by 
vigorous brain labor than by physical ejiercise only. 
Indeed, it is asserted by our best authorities in physi- 
ology, that three hours of severe bnUn labor arc equal 
in exhausting effects upon Uio system to ten hours of 
physical labor or muscular effort. It is evident, then, 
that a man who works his brain constantly for ten oi- 
twelve h'lurs a day really needs more f<x>d to sustain 
his strength than a man who employs his muscles for 
the same k-nj^h of tune. 

But, as before remarked, the muscle laborer may be 
able to dispf)se of more food than the brain laborer, 
tliongh he needs less, since his vital forces are not so 
completely exhausted by his work. In other words, 
the occupation of the muscle worker being less exhaust- 
ive than that of the brain worker, he can overeat with 
greater impunity than can the latter. Each should 
e»t only the quantity actually reqniri'd, if he wonld en- 
joy the maximum of health and vigor ; but for the man 
whose vital enetgios are daily exhausted bj mental ef- 



ALADIES OF THE STOMACH. 



S5 ■ 



fort, any excess in CRting ib certain to be most disastrons. 
We have examples of great literary men who have been 
large eaters ; but it is a noticeable fact that these per- 
sons, in many instances, while celebrated for their pro- 
ductions, often worked very leisurely, their fame being 
really more largely attribiitable to brilliant genius than 
to great application. In several cases, too, as iu that 
of Charles Dickens, the hoiirg spent in brain labor were 
chosen frani the best of tlie day, much time being 
spent in physical exercise, by wliich means the integrity 
of the digestive organs was maintained to a degree 
that would otherwise have been impossible. In not a 
few instances, too, tliose great literary men wlio wore 
noted eaters died early, their physical stamina being 
exhausted by the double drafts made upon it. Newton, 
when engaged in the most severe portiun of his won- 
derful lalH^irs in demonstrating tlie law of gravitation by 
computations respecting the orbit of t!ie moon, confined 
himself to a spare diet of bread and water. The great- 
est amount of food is required by the person who is 
actively engaged in both physical and mental labor. 

The amount of food required by an individual, as 
already inthnated, varies at different periods of life, 
according to the degree of vital activity. In infancy 
and childhood, when the vital activities are at their 
highest degree of intensity, — when growth and develop- 
meut are to be maintained in addition to supporting the 
wastesof the system. — the demand for food Is greater in 
proportion to tlie size of tlie individual than at any sub- 
sequent time. In adult life, when waste and repair are 
about equally balanced, a sufficient amount is needed 
to make good the daily loss from the vai-ious mental. 



physical, and other vita! activities wliicli can only be 
eapporled at thu expense of tissue. Any larger quan- 
tity than this is cxouss. 

In old age, when the assinillativQ powers are weak- 
ened by declining years, the amount of food which can 
be assimilated by the individual is even somewhat less 
than what is really needed ; hence, as age advances, 
the quantity of food should be gradually diminished. 
Very maTiy old people break down much sooner than 
they would otherwise do, were they more careful in 
this regard. When they lay aside their vigorous, ac- 
tive life, they should also curtail the quantity of their 
food. By tliia act of temperance, tliey might preserve 
intact to a much later period the integrity of their di- 
gestive organs, and so add years to their lives. 

In not a few instances, the fotmdation of dyspepsia 
is laid by some mechanical injury, as a sprained ankle, 
a broken limb, or a severe bruise or cut, which requires 
rest from active exercise for a few weeks. Not con- 
sidering the fact that much less food is demanded when 
a person is nut engaged in active labor of any kind than 
at other times, the individual continues to eat heartily, 
and soon finds his digestive organs rofnaing to do 
their work from sheer e-thaustion. On this account, it 
should be made a uniform cnstom to eat lightly on the 
weekly reat-day. The hearty Sabbath dinners in which 
many people indulge, making the day an occasion of 
feasting rather than a rest-day, cannot bo too much 
condemned. The custom is without doubt responsible 
for many other forms of Sabbath -breaking, as no one 
can have clear perceptions of right and a quick sense 
of wrong when laburing under the ineubue of an over- 



' THK STOHACII. 



STi 



loadtid stonuiL-ii. For the liearty meal usually token, it i 
would be well to snbstitute a light one, consisting mostiy-fl 
of fruits and grains. 

This plan, if pursued, would do away with much o£S 
the drowsiness iu chnrcli of whieli many people andj 
not a few pastors have abundant reason to complain. 
The intellect would bo clearer, and hence better able to I 
appreciate the privileges and comforts of religion. The j 
sooner people recognize the fact that stomachs havel 
much to do with religion, and that true religion includes I 
the government of the appetite, and frowns upon abuse-3 
of the stomach aa well as abuse of a fellow-mai'i thfl'.J 
better it will be for both Btomachs and religion. 

Each individual must, to a considerable extent, bol 
his own guide respecting the exact amount of food tol 
be token at a given meal. If tho ap])etite lins been sol 
long abused that it is no longer a safe guide, then roa-I 
son must rule. The individual should, at the be-^ 
ginning of tho meal, determine just how much he will J 
eat ; and when the specified quantity is taken, he must J 
resolutely stop eating, leaving tho table, if necessary, to "I 
escape temptation. The practice of serving fruit, pad-, 
dings, nuts, confectionery, and tidbits of various kinds J 
as a dessert, is a pernicious one. In the first place, it | 
is an inducement to overeating, since it is quite proba-l 
ble that enough has been eaten before the dessert is J 
served. If the articles offered are whtjiesome, they J 
should be served and eaten with the meal, as a part of I 
it, and not at its close, in addition to the meal. Fnr-| 
thermoro, it is generally the case that most of thearticlea J 
served at dessert are wholly unfit to be eaten at any time, ,1 
and BO should bo discarded. Dessert is really an in- 1 



S8 



THE STOMACH, 



genious device to leiui ]>en|)l(j to make dyspeptics of 
tliemselvea by eating more tLuu tlioy nt'ed. 

A man wlio 'desires to be at peat-e with his stom- 
ach should learn to stop ■when lie has enough, no 
matter how strongly he may be tempted to do other- 
wise. There is mutli more truth than poetry in the old 
Scandinavian proverb, " Oxen know when to go home 
from grazing ;. but a fool never knows liis sttimach's 
measure." But experience, a dear school, onght after 
a time to teach the most unobservant person the amount 
of food his stomach will bear without discomfort and 
without injury. If a person in fair health finds tliat 
after eating of wholesome food he is troubled with ful- 
ness of the stomach, dulness over the eyes sonr 
stomach, eructations, or flatulence, he may bo very sure 
that he is eating too much, and ho should continue to 
diminish the amount taken at each meal until the symp- 
toms mentioned disappear. 

It is well to bear in m.ind that the danger is prettj 
much all on the side of overeating, the liability of 
ing too little being very small indeed, Tlie tondeuoy 
to overeat will be greatly lessened by eating very slowly, 
masticating the food thoroughly, and eating only the 
aimplest articles. One who has never made tlie experi- 
ment will be astonished to see how little food is really 
required to support life. The writer has lived for 
months at a time on an average of seventeen ounces of 
solid food per day, gaining flesh the whole time. Cor- 
naro, an Italian nobleman, lived for many years on 
twelve ounces of solid food per day (by solid food is 
meant the weight ), 

Numerous experiments by Letheby, Farkes, and 




T TBS STOH&CB. 



89 



many ociier scientists, together with a careful study of 
ttie dietaries of various classes of artisatiH, laborers, 
professional men, etc., show that life can be well sup- 
jiorted upon twenty ounces of carbonaceous and two 
and one-lialf ounces of nitrogeuous food per day. 
Pugilists in training usually take but twenty ounces of 
solid food, and numerous classes of individuals subsist 
upon a considerably less quantity. 

By refereTico to the table of nutritive values given 
on pages 41, 42, it will bo easily possible to ascertain 
the amount of nutriment consumed in any given quan- 
tity of different varieties of food. It is perhaps wortliy 
of remark that the grains, as shown in the above table, 
are by far-the most nutritiouB of all tlie various classes 
of food. It will be observed, for instance, that oat- 
meal, Indian meal, and peas contain three times as 
much real nutriment as lean beef. 'When economy 
must bo considered in the selection of food, this is a 
very important consideration ; and it becoiuea doubly 
evident when we consider tliat it takes eleven pounds 
of vegetable food, including Indian meal, dry hay, etc., 
to make one of beef. It thns appears that a pound of 
beefsteak, or second-hand grain, costs thirty times as 
much as a pound of grain taken at first hand, besides 
being vastly inferior in quality. 

Deficiency in Necessary Food Elements.— 
The food may bo abundant in quantity, and yet defi- 
cient in one or more of the various elements which 
go to make up true food. If the food is deficient in 
farinaceous and fatty elements, tlje individual will 
soon show signs of emaciation in consequence. A lack 
of the nitrogenous elements will occasion still more 



THE STOUACS. 



markeil effects, eansing tho Btomai'-h to lose its tone 
and vigor, tlju8 giving rise to acidity, flatulence, and 
variouB associated distiirbanceB. The deficiency of the 
coareer, innutritions elements of tlio food is also very 
Boon felt by diminislied activity of the stomach and 
Ixjwels, both in seeretion and in mnscnlar action. 
Hence tlie great impOrtan<« of clioosing carefully and 
judiciously the articles of food to be taken, especially 
when a regular dietary is to be followed, 8uch a selec- 
tion should be made as will supply to the system all 
the elements of nutrition in proper quantity. To em- 
ploy a dietary in wliidi any one of the nutritive ele- 
ments is dtificient, although the quantity of the food 
may be all that the digestive organs can digest, is as 
really stiirvation, and will as certainly occasion the 
same' results ultimately, as total deprivation of food. 
To attempt to live on white bread and strong tea or 
coffee, is as certain to impoverish the blood as to refrain 
from eating alttigethcr, the only difference being in 
the length of time required to bring about the result. 
Thousands of pale-faced, anemic, thin-blooded, nerve- 
less, dyspeptic women owe all their troubles to an im- 
poverished diet. Tea drunkenness is not an uncommon 
thing ; and in consequence of its pernicious influence, 
the sagacious physician not infrequently finds as well- 
marked cases of scurvy among ladies of the higher 
classes of society as among the poorly fed sailors of 
the whaling vessel after a long voyage, with prolonged 
confinement to a monotonous saline diet. Young ladles 
who attempt to exist with little other food than tea, 
pastry, and confectionery, need not wonder that they 
grow to bo lank, sallow, liollow-cyed dyspt^ptics. Tin- 




' THE STOMACH. 



91 



I 



der Bucli a regiiufii tlio mcist liardj quadnipetl would 
saccnmb. 

Many parents weaktm the digestive organs of their 
little ones for life by fL-oding tliem whfii very yonng 
up<in such InsafRcient diet as corn-starch or arrow-root 
gruel, and Hiniilar preparations, and when they become ' 
olJtT, u]ion fine-llnnr bread. Kepeated experimentB have 
shown tliat a dog will die of starvation in a month when 
fed upon wliite or fine-ilonr broad alone. Fed upon 
bread made of the wliole grain, or graham bread, dogs, 
as well as other aniiuals, Buffer no deterioration in 
weight Of in strength. Tiie difference between fine 
flour and graham flour is largely in the proportion of ' 
gluten which they contain. Fine flour ia made from 
the innermost portitm of the grain, which ie almost 
pare starch, thus excluding the brain-, ticrve-, and mus- 
cle-nonrishing elements which are fonnd chiefly in the 
portions of tho kernel which lie next to the outer hnsk. 
Whole-wheat flour also contains portions of innutritions 
matter which, under most conditions, are advantageous, 
enconraging both secretion and muscular attivity of the 
bowels, and thus preventing constipation, which is often 
a forerunner of more serious disease of the digestive 
organs. There are cases in which the coarser portions-' 
of the bran do liarm by cansing irritation ; but these 
do not often occur. 

It should be added that the more recently perfected 
processes employed in the manufacture of patent flonr, 
afford a product which is botli fine and nutritions, both 
the innermost portion of the ternel and the bran being 
discarded. But in connection with this, there is also b 
gra^Jo of flonr made, kiiown aa '-family flour,"' which 



i 

I 



92 



THB STOMACH. 



coiieistB only of tlie centra! portion of tlie grain. Tlie re- 
inai'ka re8|3ucting fine flour apply especially to this prod- 
act, and not to the best brands of patent flour. The 
ao-called "pliitcn flours" whicli are extenBively adver- 
tised, are for the most part inferior to first-class wholf- 
wheat flour, and are ncvtT in any way superior to it. 
Mufli (hat is B'lld nnder the name of grahum flour 
eiiiisists of inferior fiiniily flour mixed wilh coarse 
bran. Such grahmn flour is not to be recouimended. 
The best gi-ahaui flnnr is that made by the old milling 
process, in which etones, instead of steel rollers, were 
used for grinding. 

While it IB necessary to havu all the elements of 
the food in proper proportion, it is of first importance 
lliat tho nitrogenous elements be suflicieut in quantity, 
even if it slujuld be necessary to make use of an ex- 
cess of farinaceous foods to sfc-uro the proper amount, 
since it ia of these elemonta tliat tlie vital portions of 
the body are fonned. Tlie following table shows the 
respective amounts of different articles of food rctiuired 
to fnrninh flie requisite quantity of nitrogenous matter 
for one day : — 



Iiean Meiit 15.8 

Eggs..,. 21.2 

Peas 11.3 

Oatroeat 23.8 

Baker's Bread 3(1.7 

Wheal Flour (flat-) 27.5 

OrBliam Fluur Sri. 5 

[Ddlan Meal aa.8 

RyeMeul ^7,1 



rnunda. 

Rice 3.0 

Potatoes 8.8 

Carrots 1 1.3 

Turnips !o.4 

Cabbage 15.4 

Parsnips 16.9 

Ptnta. 

Boer 1S5 

Milk 4,5 



By reference to the above table, any one will be able 
80 to combine various articles of food as to secure the 



lUt^DlKS OF THB BTOUAOH. 



propur ainiiiuit of nitrogenous matter witliout overload- 
ing the digestive organs, and yet give to tlie food the 
bulk necessary for good digestion. Evidently, it would 
overtax the stomach to digest turnips in sufficient quan- 
tities to supply the wants of the body, while lean meat 
would afford an insufficient amount of bulk, as well 
as a deficiency of carbonaceous matter. By a combi- 
nation of such nitrogenous seeds as lentils, peas, and 
beans, or of oatmeal or wheat mea), witli potatoes or 
(ilher vegetables, the difficulty may bo overcome, as 
also by combining eggs wilh the carbonaceous grains . 
and vegetables. 

The projKn-tion of carbonaceous and nitrogenous 
fi>od elements retjuired for the niaintenunc^e of health U 
about one part of the latter to seven or eight of the 
former. The following table, including a few of the 
more important articles of food, will give a clear idea 
of the relative projxirtiou of the two elements in the 
articles mentioned : — - 



Lean Beet 


1 .5 
1 l-fl 
1 3.7 

1 a.« 

I 5.0 

1 G.i 

I 7.7 


Wheal Menl or 


Pens 


Rye Mta] 






Ofttmoiil 

IndiaDMeal 


Barli'V Menl 

Ilice 



According to M. Germain S^e, of Paris, one of 

the most eminent French phyaiciana, observations upon 
different races and physiological experiments show that 
the amount of albumen heretofore supposed necessary 
for tljo maintenance of health is greater than is actually 
required, and that tlie proportion of this element need 
not exceed one ninth to one tenth. About the sa 



94 



TBK STOMACH. 



smount of fst is required, the balance to be sUirch 
or 8agar. According to this authority, twenty to 
tweuty-oiie ounces of water-free food is required for a 
daily ration, of which two to two and one- third 
ounces should bo albumen or its equivalent, two ounces 
of fat, and the rcmaiudor starch and sugar. As we 
have elsewhere shown, starch is much to be preferred 
to sugar as a form of carbonaceous food. This re- 
mark, of course, applies especially to cane-sugar, 
since the sugar of fruits is already advanced in the 
digestive procoas, whercuB cane-sugar Luiders diges- 
tion, and produces gastric catarrh. 

The Quality of Food.— Man, like other animals, 
is made of what lie eats, and we may well credit the 
assertion of an enilnunt autlior, that the general ten- 
dency of tliought in any nation may bo determined by 
the character of the national diet. True as this princi- 
ple is when applied to the body in general, it is espe- 
cially true In referenc'e to the stumach. No oi^an is 
so directly and so in-ofirandly affected by the quality of 
the food as is the stomach. Hence we may well con- 
sider with care the various ways in which the digestive 
organs may become impaired through defects in the 
quality of the food. 

Bad Cookery. — As a ptitent cause of dyspepsia, 
bad cookery deserves lirst mention in tliia connection. 
The real object of cooking is to render the elements of 
food more digestible. It is intended, indeed, to be a 
sort of partial preliminary digestion of the food; but 
the numerous devices of cooks and caterers, with tlieir 
complex and indigestible mixtures, have so far sub- 
verted the original design of the pi-ocess as to render 



MALADIES OF THE 8TOUACQ. 



cooking a moans of making food indigestible as often 
aa otherwise. Altngetlifi- tmj littlo attention is paid to 
"the Hubject of cookery as a scienee. In the majority 
of cases the task of prepiiring food for the palate (the 
stomach is seldom thouglit of) is intrusted to ignorant 
servant -girls or colored cooks, who compound their mix- 
tures by "the rnlo of thumb," and without any ref- 
erence whatever to the physiological wants of the body. 
Some alight indications of reform in thia direction are 
shown in the eslablishment of edioola of cookery in 
the larger cities, and lectureships on the Bubjeet in some 
of our female seminaries. To become a good cook re- 
quires as much native ability and far more practical 
ex]>erionco than to become a musician or a school- 
teacher, or even to entiT some of the learned profes- 
sions. The position of cook ought to be made so re- 
s|)ectable and lucrative that it will attract persons of 
sufficient mental capacity and culture to make the art 
subservient to the purposes for which it waa first em- 
ployed and designed. A bad cook in a family is a 
worse enemy to tlie health, tlie eiimfort, and even the 
murals of the household, than would be a swamp gen- 
erating malaria a half-mile away, a cesspool fever-uast 
at the back door, smallpox across the street, or a Chi- 
nese josa-house in the next block. Give tis good 
cooks, — intelligent cooks, cooks who are thoronghly 
edncated, — and the cure of nine tenths of all the 
dyspeptics may be guaranteed, without money and with- 
out medical advice. 

Fried Food. — Of all dietetic abominations for 
which bad cookery is i-esiKmsible, fried dishes are the 
most pernicious. Meats, fried, fricaaseed, or other- 




wise cooked in fat, fried bread, fried vegetables, dongh- 
ntits, griddle -cakes, and all other similar oonibi nations 
of melted fat with other clemente of food, are must 
difficult articles of digestion. None but the most 
stalwart stomach can master such indigestiblcs. The 
gastric jaice has litile more action apon fats than has 
water. Hence a pfirtion of meat or other food satur- 
ated with fat is as com]itetc'ly protected from llie action 
of the gastric juice as is a ftxit within a well-niled boot 
from the snuw and water outside. It is marvelous in- 
deed titat any stuinach, under any circumstances, can 
digest such food, and it is far fn>m remarkable that 
many stomaelis after a time rebel. 

It is principally for this same reason tliat rich 
cake, shorlened pie-crust, and pastry in general, as 
well ae warm bread and butter, so uotoriuusly disagree 
witli weak stomachs, and are the efficient cause in pro- 
dncing disease of the digestive organs. The digestion 
of tlie fuud being interfered with by its covering of fat, 
fermentation takes place. The changes occasioned in 
the fat develop in the sttimach extremely irritating and 
injurious acids, which irritate the mucous membrane of 
the stomach, causing congestion, and sometimes chronic 
inflammation. 

VDCooked Food.^ — Raw foi>ds and food which 
has been insufficiently cooked, are a frequent cause of 
indigestion. This is especially true of uncooked vege- 
tables. Man is naturally a frugivorous animal, and is 
able to make use of vegetables and many grains as food 
only by the aid of cookery. 

As will be recalled, the digestion of starch is effected 
by both the saliva and th« pancreatic juice. Salivary 



HALAonca or tbb stomach. 



97 



d'gestioii takes place in tlie raotith imd the stomach, — 
chiufl^ in the stoiiuich, of cmirsf, as tlio food is not 
retained in the mouth for a 6u9icit.'iit length of time to 
allow the dig«stive process to proceed beyond the pre- 
liminary stage. In the digestion of starch, the starch 
ie &'Bt rendered Boliihle, and is then converted into 
dextrin, and finally into malt-sngar, or maltose. The 
digestive principle of the saliva is iucipabie of acting 
upon raw starch, but the pancreatic juice digests raw 
starch, although with k-aa facility than cooked starch. 

By the action of heat the starch granules, which 
consist of the starch proper enclosed in little capsules, 
are ruptured, and thus the digestive juices can readily 
come in contat^t with and digest the starch. 

By the prolonged action of moderate heat, or by 
exposure to a high temperature for a sliorter time, 
starch is converted into dextrin, Similar changes 
take place in ripening fruit. Green fruit contains a 
large amount of starch ; in the process of ripening, this 
starch is converted into dextrin and sugar, aa in the 
process of digestion, so that in the ose of fruit the starch 
is taken in a partially or completely digested state, 
which accounts for the easy digestibility of this kind 
of food. 

When starchy substances are eaten raw, tlie saliva 
being anable to act npon the uncooked starch, the 
gastric juice cannot gain access to the albnmlnous sub- 
stances present, and hence these particles are not 
brt>ken np, and being retauied in the stoinach for too 
long a time, fennentation and irritation are the resnlt. 
It is for this reason that green fruit and raw vegetables 
occasion so much disturbance of the stomach and 



THB fflDV ACH. 



bowel*, tBe«e iuunatnre foods contaiaing lar^ qttanti- 
lun of March in a rery indigestible state. Bv cooking, 
unripe fmit and regetablcs maj be in a gi^at d^r^e 
deprived of tbeir iojonotu properties. Cooking 19 tfaos 
a aort of preliminarr digestion. 

In Scoiland, the enring of osnucal imperfectly 
cooked is a vrry ct.mmfin pracliw. iU« result of which 
ia olmofit niiiversal Biifferiog frum a peculiar tuna 
at indigeetion dae to it, known as water-brash. The 
Scotch fanner prefers his oatmeal taw becaase of its 
indigeRtibiliry, as the resnlt of which it "Btavs by the 
stomach" longer than when well cooked. Nearly all 
kinds of food are uinch more easy of digestion after 
cooking than before, providing the crK)king is per- 
formed in the proper nianner. For vegetables and 
grainn, cooking is especially necessary. 

Decayed Food. — Much harm eoraes from eating 
food which has made appreciable advancement in the 
direction of decay. Tliis ia true both of vegetable and 
animal food. By the process of decomposition, poison- 
ouB elements are developed in animal and vegetable 
HnbHtanceH, especially the former, which do not nat- 
urally exist there. If decomposition is far advanced, 
tlieeo poisons may exist iu snch quantity as to produce 
imraodiato ill effects, sometimes occasioning death in a 
few hours. iTialancos of this kind have often occurred 
from catiDg canned meats which had spoiled, or which 
had boon kept for a slifjrt time after opening. The 
practice in vogue in some other countries, and to a cer- 
tain extent in this of keeping meat for some days 
before eating, so as to give it tenderness and a "high 
llnvor, is a most pernicious one. Better far, for health. 



J 



UALADIXS or TBB BTOMACH. 



I the barbarous Abyssinian custom of eating the flesh 
raw and whilo still warm and quivering. 

For dyspeptics such food is especially bad, siuco 
digestion is so slow that decomposition is not corrected, 
as it is to some extent in a healthy stomach, by the 
gastric juice, bnt is allowed to continue, with all its 
serious consequences E\cn if no immediate effects 
follow the UBO of such food, the poisons generated 
may be absorbed, and appear later in some form of 
blood-poisoning. The stomach of a hyena may be able 
to digest the putrid flesh of a decaying carcass ; but 
raan^s stomach was not intended for scavenger use, and 
requires fiesh, untainted food. 

Sholl-fish, and, in fact, fish of all kinds, are par- 
ticularly prone to decompositinn, undergoing this change 
much more quickly than do other forma of animal 
food. It ifl partly for tliis reason that poisoning from 
the nse of oysters and fish occurs so frequently, and 
sometimes with fatal results. Experiments recently con- 
ducted by Trombetta, an eminent French physiolo- 
gist, show that decomposition of flesh begins within 
twenty-four to forty-eight bours after the death of the 
animal, even when the flesh is kept within a refrigera- 
tor. Germs rapidly increase after tlie death of the ani- 
mal, and even after so short a period are found in 
abundance. It thus appears that all flesh food must con- 
tain more or less of poisonous matters, the products of 
decomposition. Bouchard has shown that meat juice 
is very deadly in its effects when injected into the veins 
of an animal, in consequence of the poisons which it 
contains. Beef tea is, for the most part, made up of 
soluble substances contained iu tlio flesh of the animal at 



100 



THE E^TDMACH. 



deatlt, or derelcyped h\ tbe actKMi of germs after death. 
An eminent French phTfttdan, epealdng c^ beef tea, 
letnarked that "it u a tme eolation of ptomains '''' 

(poieone). 

Cheese is anoiher article which onntains poisonnus 
Bnbatanccs known us yiiomain^ in great quantities, and 
not only poiwms, bnt g»njis capable of producing poi- 
Bons in abnndauce id tbe etomacb. Cases of cheese 
poisoning are a frequent and eonietimes fatal result of 
the nsc of cheese. Cbnleni nh^rhns, a disease due to 
germs, is frwjiientlv induced by eating cheese. Tliat 
poisoning does nt>t alwajs occur from the use of cheese 
is due to the fact tliat the gastric jnice of a healthy 
stomach is capable of destroying a considerable quantity 
of germs, and that the liver is capable of destroying 
the poisons intnxlnced with the cIkkjsb in considerable 
amount. Milk sometimes gives rise to indigestion and 
serious illness in consequence of the disease-producing 
microbes which it contains. 

Soft Food.— The structnre of man's teeth indi- 
cates that he was intended to employ a diet consisting 
of food of such consistency as to require vigorous 
mastication. His jaws are armed with thirty-two 
strong teeth, compactly arranged in the mouth in such 
a manner as to make thorn moat available for use. 
Obeying the general law governing all organized struc- 
tures, by which organs develop or degenerate according 
as they are used or allowed to remain inactive, the 
teeth retain their health if vigorously employed in the 
mastication of solid food, but raj^idly undergo decay 
when not thus nsed. We have an illustration of this 
in cows fed on distillery slops. The teeth of such 



J 



MALADIES <iF TRK STOMACH. 



101 



9 decay and drop out for want of use, wliilu tliosa 
of tattle wliith keep their teeth actively employed iu 
chewing tbe cud are preserv ed intact 

The effect of Boft food npon the teeth of an animal 
ia well bIjowii in the accompanvmg ilInHti'ationis. 




Fig, 14 reprcHunta the teeth of a cow fed upon proper 
food. Fig. 15 showa the teeth of a cow fed upon dis- 
tillery alopa. 

The same is true of human heings. Eating aonps, 
gruela, and other soft foods, to the exclusion of articlus 
requiring mastication, ruins the teeth at the same time 
that it diaorders the stomach through the taking of too 
much fluid, tiius causing deficient iuaalivation. 

Too Abundant Use of Fats. — Unfortunately 
for the poor stomach, the opinion prevails almost 
everywhere that food niade rich with fat ia the most 
nourishing. Undoubtedly fat is an element of nutri- 
tion, and can be digested and aaaimilatcd when taken 
in proper quantities and in a proper manner ; but the 
cessive nee of fata of varioua kinda, aa lard, auot, 
butter, and other animal and vegetable fats or oils, ia a 



103 



THE STOMACH. 



]>iYjlifif cause of certain forms of iiKligcstion, especially 
that kuuwii as bilious dyspepsia. The famous [ihysiol- 
ogist Bernard many years ago dettrmiued by can-ful 
experiment tlie fact that the free nse of fats greatly 
reduces the biliary secretion, the quantity of bile be- 
ing diminished in some instances to a very sraall fraction 
of the amonut secreted when only pure water or food 
containing little fat was taken. When it is remembered 
that the bile Is an essential element for the digestion of 
fat, it will bo seen that a dimination of this digestive 
ilnid in connection with the taking of an extra quantity 
of oleaginous matter is a most unfortunate circum- 
stance, since it is thus absent when most needed. This 
fact sufficiently well accounts for the distressing symp- 
toms which acojnipany the excessive use of fats by 
those whose digestion has been already weakened by 




abuse of this kind. The diminished quantity of bUe 
produced by the liver is also sufficient cause for the 
condition established by the over-uso of fats, vulgarly 
known by the expressive term "bilious." The ele- 
ments which ought to bo eliminated from the system 



MALIDIES OF THE BTOMACH. 



103 



are retaiuud, clogging tho vital macliinory, and giving 
rise to many HymptomB of systemic poiBoning. 

When it is remembered that the bile is the antisep- 
tic ogeut by which the contents of the aniall intestines 
are preserved from decom|JOyition, it will readily be 
seen that a deficiency of bile must result in decompo- 
sition of food elements, and the formation of poisonous 
snbstancGs. The absorption of these substances still 
farther' disturbs the liver, contaminates the body, and 
produces the condition of general poisoning which 
is commonly termed biliousness or bilious dyspepsia, a 
state which is not to bo remedied by the use of liver 
medicines, purgatives, etc., but by correction of the 
diet. 

Fats readily oudergo docom|X)8ition in the stomach, 
especially in a stomach which is dilatfd so that the food 
is too long retained, or in one which is the seat of gas- 
tric catarrh. It is on this account that fats, even in 
the form of butter or mingled with the food, as in 
rich gravies or the shortening io pic-cruHt, are so often 
a source of irritation and distnrbanee in dyspeptic 
stomachs. 

The nse of rich foods is not infrequently a cause 
of bilious headache or a bilious attack. Aiiimal fats 
are more likely tti undergo this decomposition than are 
vegetable fats. Ordinary butter is particularly un- 
wholesome, for tiie reason that it always contains mul- 
titudes of microbes derived from the milk, which are 
rapidly developed in the stomach, producing decom- 
position of the fat, and tlius forming irritating fatty 
acids. Only sterilized butter is tit for human con- 
sumption. 




Cooked fata are also mucli more irritating and likalj 
to produce indigestion than uncooked fats. Tlie process 
of cooking develops acrid faltj acids which are ex- 
tremely irritating to the gastric mucous membrane. 
This is one of iJie reasons whj fried and fricasseed fooda, 
griddle -cakes, doughnuts, Saratoga chips, etc.. are so 
harmful to digestion. Fata taken in the form of creain 
are generally mora digestible than in any other way. 
In some cases, however, there is an inability to digest 
the casein of milk in the form of cream ; for such eases 
sterilized butter is to be preferred. Tlie least harmful 
mode of using a free fat is in the form of sterilized but- 
ter taken with cold bread. Melted fat taken with fari- 
naceons substances ia extremely hurtful, as the starchy 
particles are so completely surrounded and permeated 
by the fat that the saliva, which should act upon the 
sturcli iu thti^ stomach, is unable to do so, thus leading 
to indigestion. 

The use of natural foods containing a sufficient 
quantity of fat is much to bo preferred to the use of 
free fat. In cream the fat ia iu a finely divided state 
in which it can mingle readily with the fluids of the 
stomach ; hence it docs not smear over those food sub- 
fltancea which are acted upon by the gastric juice and 
the saliva, thus preventing their digestion. Neither 
the gastric Juice nor the saliva has any action upon fat, 
and for this reason free fats may constitute a very 
serious obstacle to the action of both the saliva and the 



gastnc juice. 

Nuts also afford a most excellent form of fat. 



The 



popular idea that nuta are difiicult of digestion is the 
natural outgrowth of the common habit of swallowmg 




MALADIES OF THE STOMACH. 



105 



them ■without masticarioii. Nuts have a firm, hard 
structure, requiring very thorough mastication. If 
pains is taken to chew tlicm very thorouglily, nnts are 
as digestible and wholesome as any other food, and 
they are highly imtrilious. Lack of sound teeth is, in 
some cases, an almost insuperable obstacle to the 
proper mastication of nuts, as well as of other hard foods. 
The writer has succeeded in meeting this difficulty — in 
the case of nuts, at least^by preparing from some of 
the best and most nutritious nuts a very fine and thor- 
oughly cooked meal, and also a nut cream or butter. - 
The latter, like eream, is nearly a perfect euiuljion, but 
is, at the same time, so rich in fat as to be an excellent 
substitute for butter. It is especially useful in season- 
ing foods, and serves a most excellent purpose as a 
dressing for vegetables and other foods which are 
deficient in fats. These nut preparations are manufact- 
ured and sold by the Sanitos Food Co., Battle Creek, 
Mich. ( See page '2-i\.) 

The Use of Sugar in Excess. — While sugar, 
like fat, is a true alimentary principle, capable of aid- 
ing in the maintenance of life when employed with 
tlie other elements of food, if used in excess, it becomes 
a serious source of disease. When used alone, it is 
utterly incapable of supporting the vital activities of 
the body, being, in this respect, analogous to starch, 
its food equivalent. The popular idea that sugar nour- 
ishes the nerves or the brain, makes the teeth sound, 
and is both harmless and wholesome, is quite a mistake, 
as many an innocent little one whose fond parents 
shared in the general error, has found oat to the regret 
and sorrow of his friends. 



Tfae diSeraai fonns <t c^ar, swlaaseB, sir^i, trea- 
de, hoMn, cSc. an mamrially tfae mmr in their effects, 
cxocfri dm mc^Meei and bonejr sc^MtiiBeB contain pecul- 
iar demema tfaat to aome pefsoas seem to be almost 
active potsoos. Tbia is eqiMiall j Ime ot faonej. 

Tlie injuiT fmm die use of ea^a or odi^ saodurine 
fiabstances is occSBioDed, firet. bj die readiness tnth 
wfaidi it Dndergoea fermentadon vWn f:Qbiooted to 
warmtii and moisMire. In the stomach it finds all the 
conditions neceseajy for inducing f^rmf^ntatiiiD ; and 
were it not that eacdiarine sabstances is solation are 
csnall; so qnicklj absorbed that it is diffiralt for the 
chemiet even to det<Kt their presence in the stomach, 
this chan^ would alwajs cKvar. When a larger qoan- 
tit,v is taken than can bo absorbed prumplly, or when 
taken in Bueh form as to make ready absorption impos- 
sible, as in the case of preserves and sweetmeats of 
varioQB sorts, acid fermentation docs occur, and with 
scrions results not only to the stomach, but to the whole 
system. Tlie fermentation set np not only develops 
acids and gases from the sugar, but, being communi- 
cated to the other elements of the food, as the starch 
and oBpocially the fatty elements, still worse forms of 
fermentation or decomposition occm"; and the fotxl is 
tliiiM rendoi-ed unfit to nourish the body, while the mu- 
cous ineuibraue of the stomach and intestines is irritated 
by the contact of unnatural corroding elements in the 
food, and thi-ough their absorption, the whole system 
beconiCB uffccted. 

Tlio cxccHHive usci of sugar also greatly overtaxes 
the liver, wliit-li has an inijiortant part to act in its 
digt^stion, intorforing with the proper performance of 




A 



MALADIES OF TBE BTOUACH. 



107 



ita other functions, eupecially tliose of bile-making and 
poisoD-destroyiDg, and thus leaving tlio elemonta which 
it ought to ellmiQatf), to acciimulato in the syatein. 
Thus a person may become "biliouB" from the over- 
use of sugar as well as fiimi the excessive use of fats. 

When taken into the stomach in considerable quan- 
tities, sugar givos rise to a profuse flow of mucus, and 
may thus eventually develop chronic catarrli of the 
stomach, which, extending into the duodenum and 
the bile duets, produces catarrhal jaundice and the 
partial closure of the biliary passages. When sugar in 
used to excess for a considerable length of time, the 
liver finally loses its ability to retain the sugar in its 
tissues in the form of glycogen, — one of its most impor- 
tant functions, — -so that an excessive quantity of sugar 
is thrown into the blc»jil, and, being eliniiiiattd by the 
kidneys, appears in the urine. This is the most fre- 
quent and most common origin of diabetiv^ The writer 
has met cases in which nearly a pound nt sugar was 
thus eliminated through the kidneys in twenty-four 
hours, and quite a number of cases in which more than 
half a pound of sugar was thus thrown out of the body 
in the same length of tiinu. Sugar is never found in 
the oriue in a state of health. 

Excessive use of sugar is also a most common cause 
of obesity. The excess of carbonaceous nmierial in the 
form of sugar being deposited as fat, or adipose tissue, 
overwhelms the heart so that this excess of fat is some- 
times attended by fatal resuhw. 

Excessive Use of Flesh Food.— The flesh of 
animals, especially lean meat, is namilly considered the 
most easily digested and strengthening of all foods. 



108 



THE STOMACH. 



Tliis fact, together with tho Btimulaling character of 
lliiH class of foods, is, perhaps, the cause of its extensive 
tiBt- in English-speaking countries, especially in Eng- 
liind anil America. Tlio fact that itnmediate distress 
and unpleasant symptuiua relating to the stomach itself 
lcH» frefjuently follow the use of flesh food than the use 
of many olliiT foods, is perhaps one cause for this mis- 
apprchenaion. While it is trne that meat, especially 
l«an meat, is muro readily digested iu the stomach 
than coarHo vegetables, and is less likely to ferment^ 
foriiiiiig giiB and irritating acids in the stomach, than 
are siicchai-ine and starch foods, it is nevertheless true 
that inout>t ure, of all foods, most exciting and stimu- 
lating to the stomach ; aud when freely used, the 
ultimate result is to prodnce a condition of debility in 
rhe Htomach, and in some cases gastric catarrh and 
other wtomacli disorders may be attributed to the exces- 
Mive use of nii^at. The worst effects, however, from an 
excessive usu of meat aro to bo sought in the liver and 
In the body in general, resulting in rheumatism, gout, 
noiiraMtlienia, and a great variety of diseases which have 
tlioir origin in the introduction of an excessive quantity 
of t^ixic flubfttaiices into the body through the use of 
meat. 

Till? practice now much iu vogue, of administering 
largi^ cjuantiticB of raw or under-done meat, either in the 
form of an ordinary steak or chop, or spoeially prepared, 
tm by Hcraping or mincing, has been productive of a vast 
doal of injury. The writer has noted several instances 
of acHte Bright's disease in which general Hyniploiiis 
of poisoning and various nervous maladies could be di- 
rectly attrihiit«d to following, for a number of months, 



MALADIES OF THE STOMACH. 



nil) 



a prescription roqniriug raw meat as a principal article 
of ilift. 

Condiments. — ^B_y condiments are meant all sub- 
stances a<l*le(! to food for the more purjwse of render- 
ing it more palatable, but poBseesing no positive nutri- 
tive value in themselves. Mustard, vinegar, pepper, 
cinnamon, and various otb^r spices are included in 
tbia category, together witL salt, although the last- 
named article is by some h«ld to bo of the nature of a 
food, and sapposed to snpply Bimio want in the body. 

Mustard, pepper, pepper-eauco, cinnamon, cloves, 
cardamoms, and similar substances are of an irritating, 
Btimulatiiig character, and work a two-fold injury upon 
the Btoniach, By contact, they irritato the mucous 
membrane, causing congcsticm and diniiniBhed secretion 
of gastric juice, when taken in any but very small quan- 
tities. This fact was demonstrated by the observations 
of Dr. Beaumont upon St. Martin. After several years' 
careful study of the relations of various foods, drinks, 
etc., to tho stomach, Dr. Keaumont stated, in summing 
lip his experiments, that "stimulating condiments are 
injurious to the healthy stomach," He often saw con- 
gestion prtKluced in the nuicous membrane of St. Mar- 
tin's stomach by his eating food containing mustard, 
pepper, and similar condiments. 

When taken in quantities so small as to occasion no 
considerable irritation of the mucous membrane, condi- 
ments may still work injury by their stimulating effects, 
when long continued. The stomach being at first ex- 
cited to more than natural activity, afterwartl suffers 
from reaction, and is left in an inert, diseased state, 
incapable of secreting suificient gastric juice to supply 



110 



the needs of the Bystein in dlgeeting food. Thia final 
result is often averted for some time by increasing the 
quantity of the artificial stimulas ; but nature gives 
way at last, and chronic disease is the rosnlt. 

In experiments conducted in the Laboratory of 
Hygiene connected with the Battle Creek (Michigan, 
U. S. A.) Siinitariiim, we have found that the use of 
condiments does not increase the flow of oitlier saliva 
or gastric juice, but causes an outpmiring of a great 
quantity of protective mucus. When this becomes ha- 
bitual, the individual is the subject of gastric catarrh, 
a disorder which is by no means easily cured. The 
writer quite agrees wilh the conclusious of the small 
boy who, having tasted bnreeradish for the first time, 
spat it out, remarking to his mother, " Mamma, I think 
I won't eat that till it gets cold," Substances which 
are hot when they are cold are not fit to be eaten. The 
irritating and astringent properties of certain vegetable 
substances were doubtless put into them as warnings 
against their use by human beings. 

In Mexico, where pe]iper, mustard, and other con- 
diments are probably us'.'d more freely than in any 
other part of the world, gastric catarrh is an almost 
universal disease. 

In the case of salt, there are several objections to 
be urged, which are at least cogent against its excBssive 
use ; and by excessive use is meant a quantity which 
causes thirst either at or after meals, occasioned by the 
feverish state of the stomach induced by the caustic 
properties of the saline element. According to De- 
bove, physiological experiments have shown that salt, 
when taken in considerable quantities, int?rferes willi 
the digestion of albumen. Tliia statement agrees with 



MALADIES UF THE STOMACH. 



Ill 



I 



tlio writer's own laboratory experimenta, as well as with 
the experience of aailore, who, wlien making free use 
of Bait meat, suffer from scurvy and a long list of symp- 
toms indicating malnutrition and tissue starvation. Ex- 
perimental evidence shows tliat liuman beings, as well 
as animals of all classes, live and thrive as well without 
salt as with it, other conditions being equally favorable. 
Tins statement ie made with a full knowledge of conn- 
tf-'r argniiients and experiments, but not without abun- 
dant testimony to support the position taken. 

The author does not, except in rare instances, advise 
the I'ntire discontinuance of the use of salt; neverthe- 
less, he believes that it may be greatly reduced in 
quantity by all who use it, without detriment, and 
with real benefit. Lerieho and others have shown that 
salt, oven in so small a proportion as one per cent., 
diminishes both the amount and the efficiency of the 
hydrochloric acid of the gastric juice, and thus gives 
rise to fermentation, one of the most common symp- 
toms of indigestion, and a csnse of many other morbid 
conditions. 

Salted food is very hanl of digestion ; and when it 
is taken for a long time, the stomach often fails. A 
piece of fresh fish which will digest well in one hour 
and a half, requires four horn's after salting, according 
to Dr. Beaumont. 

Pickles.^ — Cucumbers, peaches, green tomatoes, 
and numerous other fruits and vegetables are sometimes 
preserved by saturation with strong vinegar. Some- 
times whisky or some other alcoholic liquor is added to 
increase the preservative property of the vinegar; but the 
same process which mak"^ it imposnililc for the fruit or 
vegetable to ferment or decay, makes its digestion 



112 



THE STOMACH. 



n 



eqnally difficult, if taken as food. Pickles are exceed- 
ingly nnwluilesome aa an article of diet, and are often 
the cause of acute dyspepsia. Those addicted to the 
free use of pickles may be assured that tbey must cer- 
tainly part with their favorite dainty or bid farewell to 
good digestion. Cucumbers preserved with salt or vin- 
egar are next to impossible of digestion. The pro- 
verbial uuhealthfulnesB of this vegetable is a popular 
notion based on exjicricnee with the article prcpai-ed 
with vinegar and salt. These chemical agents harden 
the delicate structiircB of the vegetable, and render it 
almost unapproachable by the digestive juices. The 
pure vegetable, unsophisticated by condiments, is no 
more harmful than other green vegetables. 

Vinegar.— As the use of vinegar is continually in- 
creasing, attention should bo called to the fact that it 
may be a cause of disease. Ordinary vinegar con- 
tains about five per cent, of acetic acid, its principal in- 
gredient. Like alcoliolic liquors, vinegar is a product 
of fermentation, being the result of carrying a little 
farther the same process by which alcohol is produced. 
Vinegar is much more irritating to the digestive organs 
than an alcoliolic liquor of the same strength. Its 
exciting nature makes it extremely debilitating to 
the stomach. Dr. William Roberts, of England, has 
shown that bo small a proportion of vinegar as one 
per cent., completely arrests the action of the saliva 
npon starch. The writer's own experiments have con- 
firmed the observations of .Dr, Huberts. 

The moderate use of a light wine or of ale or beer 
is mnch less destructive to the digestive organs than a 
free use of vinegar. This remaik is made, not to com- 




MALADns or niK stomach. 



113 



I 

I 



mend vine or beer, howerer, etnce tbe*e eabetsocta are 
pi>Bses84xl of no virtue, and are capable of doling a tmc 
deal of harm. Tbere is reallj no need of remaining to ao 
inferior s eoorce for a mild acid, as we have tite want 
met most perfectly in lemons, limes, citmns, mod otber 
acid fniits. As a dresiting f(»r some kinds of TCfcetaUc 
ffK)ds, lemon jnice is a perfect subetitnte for rinegar. 
Recent obeer^-ations hare ^hi^wn that the wiattf^ ccb 
which are nearly always to be fonnd in "f-ood dder 
vinegar,*' often take up their alfode id the slimemary 
canal, becoming intestinal par^ 
sites, and pro^lnmig macli Dii»- 
chief, (Fig. 16.) 

Vinegar is oft«n adnlterated, 
containing a very small projwir- 
tion, if any at all, of real afrple- 
juice, its acidity being dae to 
hydrochloric or sulphuric vri'l ; 
therefore each vinegar ia even 
more destructive to the faneti'ins of th« irtotnarh and 
also to the teeih titan ordinary ritK^ar, 

Tea and Coffee. — ClaMing theme fsv^/rita her- 
erages with caosee of dyspep«is will efirtainly call forth 
B loud protest from the namerona d*?vot<»-» of *• the fra- 
grant cup," as among the nnrntMrr of those who argue 
for their n>c are Dumerom leamol profeiwoni, an w<-t! 
aa nearly the whole sisterli')'^ <^ the maidens, wivw, 
mothers, and grandmoihem (*f the nation, along witli 
a good pro{>ortion 'it thu br</tben>, bEultands, fathers, 
and grandfathers atwo. Keverthelesa, It can be easily 
shown tliat whatever action may bu aMignod to these 

erages. It is unfiivurablo to digestion, rather than 




pml k— Tf >bm« Ecul. 



114 



THH BTOMAOH. 



Otherwise. Leaving out of consideration the objections 
wliich may be nrged against the use of tea and cotfee 
on other grounds, the following may be offered aa rea- 
sons why they are object inn able on account of exerting 
an injurious influence upou the digestive organs : — 

1. Both tea and coffee contain an element resem- 
bling tannin, which precipitates or neutralizes the pep- 
sin of the gastric Juice, nnd so weakens its digestive 
power. 

2. Thein and caffein, the active principles of tea 
and coffee, are toxic elements which diminish the ac'tiv- 
ity of the glands of the stomach by which the gastric 
juice is fonned, tJius intcrfei'ing with the digestion of 
albumen and other proteid substances. 

3. Both tea and coffoe are objectionable on the 
same ground as other beverages in connection with 
meals, on account of their disturbing the digestion by 
dilution and consequent weakening of the gastric juice, 
and by overtaxing the absorbents, tlius delaying the di- 
gestion of the food, and giving rise to fermentation. 

4. Experiments made by Dr. William Roberts, and 
repeated by the writer, show that tea, even in a com- 
paratively small amount, destroys the starch -digesting 
properties of the saliva, — another fact which accounts foi- 
the universal existence of indigestion in tea and cotfee 
drinkers. 

Alcohol. — Wc have not space in this connection 
to dwell at lengtli upon the damaging effects of alcohol 
upon the human system, nor the full details of its effects 
upon tlie stomach. Tho following facts, however, 
pre well worfh tho consideration of those who believe 




MALAOnn OF THB STOMACH. 



115 1 



in the nse of alcohol either moderately or with greater 
freedom ; — 

1. Alcohol itself ia an active poison, which when 
received into the stomach in a concentrated state, 
almost as ^quickly fatal to life as is prnssic acid < 
strychnia. It precipitates the pepsin of the gastric 
jnice, rendering it inert. 

'2. It irritates the gastric mucons membrane when j 
taken in any but extremely small quantities, even beer 
and the weaker liquors having this effect when long ' 
continued. 

■i. The ultimate effect of alcohol is to cause degen- 
eration of the Bccrettug glands of the stomach, by which 
its utility as a digesting organ is destroyed. 

Sir William Roberts, the eminent English physician 
whose authority wo have already quoted, has shown 
that alcohol diminishes the activity of gastric digestion, 
III experiments made by the writer in the Laboratory 
of Hygiene (Battle Creek, Mich., U, S. A.) it has been 
found that half a pint of light wine lessens the digest- 
ive activity more than one half ; aud that an ounce of 
alcohol, well diluted, almost completely arrests stom- 
ach digestion. 

Dr. Beaumont's observations on the affects of alco- 
hol are very positive and distinct in their indications. 
St. Martin being an intemperate man, occasionally in- 
dulging freely in drink. Dr. Beaumont had an oppor- 
tunity of observing the effects of its use, as by the aid 
of a strong light he could look directly into his patient's 
stomach through the window provided by the remark- 
able accident from which lie bad suffered. After he had 



11« 



THE BTOMAl-H. 



been drinking freoly for several days, Dr. Beaumont 
found the maeous mcmbraiio exliibiting inflamed and 
ulcerous patches, and tlie secretions very greatly viti- 
ated, the gastric juico being diminished in quantity, 
viscid, and unhealthy, although St. Martin did not 
complain of any unuif^ial feelings, and his appetite being 
apparently unimpaired. The condition continued to 
become still nmre aggravated for a day or two, when 
the doctor found, to use his own words, that "the 
inner membrane of the stomach was exceedingly mor- 
bid, the crythematic appeai-ance more extensive, and 
the spots still more livid. From the surface of some 
of them exuded email drops of grumons blood ; the 
aphthous patches were largo and very numerous, the 
raucous covering thicker tlian common, and the gastric 
secretions very greatly vitiated. The gastric fluids 
extracted were mixed with a large proportiim of thick, 
ropy mucus, and a considerable muco-purulent dis- 
charge slightly tinged with blood, resembling the dis- 
charge from the bowels iu some cases of dysentery." 

It will bo remarked that notwithstanding the very 
serious condition of his stomach, St. Martin was un- 
conscious of any great disturbance there. This was 
partly due, no doubt, to the paralyzing effect of alcohol 
upon the nerves of sensibility. It is owing to this fact 
that BO many suppose that alcoholic driuks have no 
specially bad influence upon the stomach, when really 
their stomachs are well-nigh useless from disease, but 
too insensitive to indicate their condition. 

The popular idea that beer, ale, and other similar 
liquors are very nourishing, has been shown to be an 
error. Alcohol is in no sc-nse a food. Professor 



.1 

t 1 



o be an I 

ior Lie- ^^^| 



UA^LADIES OF THS STOMACH. 



117- 



big, the eminent Gyriaan cliemist, haa shown by care- ■ 
fol analyais-that the amount ul nutriment contained in 
a whole hogshead of the best German beer is less than 
that contained in one ordinary loaf of bread. 

Tobacco. — Not infrequently, though leas often 
than is the case with alcoholic liquors, tliis narcotic drug 
is recommended as a reraodj for dyspepsia. Neverthe- 
less, in the case of tobacco, as in that of alcohol, the* 
remedy suggested is itself an active cause of stomach J 
disease. Only on the shnlVta simlllhits plan could 
either one be reasonably employed. Both smoking and 
chewing weaken and debilitate the digestive organs, 
though both of these practices are thought by those who 
indulge in tliem, to stimulate the process of digoaliou. [ 
This it probably doss for the time being, but only at 
the expense of subsequent injury. Snuff-taking, espe- 
cially, produces gastric irritability, probably by reflex 
sympathy of the mucous membrane of the stomach with 
that of the nasal cavity, which is irritated by the du-ect 
contact of tlia acrid drug. 

The idea that tobacco is beneficial because tif it 
supiHJsed antisoptic properties, in tljat it may aid diget 
tion by disinfecting the mouth, is without founda- ' 
tion, since the teeth of tobacco users are no less prone 
to decay than tlmse of other people, and cancer of the 
mouth, one of the most fatal and incurable of germ 
diseases, is almost exclusively confined to tobacco nsere. , 
Tobacco users are also no less subject to pneumonia, 
consumption, and other maladies, the germs of which I 
ent^r the body through the moutli and nose, than are I 
other people. 

The immense waste of saliva occasioned by chewing' ] 



UH 



THE STOMACH. 



I 



am) smoking may fairly be considered as one of the 
means bj wLiicli the system sustains Ins^ and injury 
tlirongli llie use of tobacco. An eminent physiologiat 
reported the loss of several pounds in a week, as the 
result of the stimulation of the flow of saliva by con- 
stant mastication for experimental purposes. This ex- 
plains the loss vf flesh in cases of tobacco using ; and 
there is an equivalent loss of strength. It is apparent 
that the loss of flesh is also in part attributable to the 
physical damage of the body by tlie poisonous nico- 
tine,— certainly a very doubtful sort of remedy. 

Those who chew or smoke to prevent excess of fat, 
should understand that any drug which will exert such 
an influence upon the system must be a powerfully de- 
structive agent. Those who succeed in keeping down 
fat by the use of tobacco may depend upon it that they 
are doing so only at the ruinous expense of their digest- 
ive organs, and may look forward with certainty to the 
breaking down of the nervous system. 

Hard Water. ^ — So little attention has been paid 
to this really common cause of indigestion by writers on 
this subject, that we cannot forbear mentioning it here. 
Experience has often proved that the use of hard water 
impairs the integrity of the stomach eoouer or later, 
when long continued ; and in numerous instances its 
eflfects are almost humediate upon persons who visit a 
hard-water district, having been accustomed to the use 
of soft water. The cause of these injurious effects is 
undoubtedly attributable to the lime and magnesia 
which are contained in water called hard. These alka- 
lies, as already seen in considering the physiology of 
digestion, neutralize the gastric juice, and thus work 





I 



HALADIEB OF THE STOMACH. IIS 

iiiifichief, Theru is little aeceBsity for the use of liard 
water in any part of this country. Where there are 
not Boft-water wella or springs, rain-water may be 
caught and preserved in cidterns, and by boiling and fil- 
tration through carbtm Ultere, made pure and palatable 
for drinking and cooking purpoaes. Boiling hard water 
greatly diminishes its hardness by precipitating the liine 
wLicli it contains. There is no foundation for the theory I 
that hard water is in any respect more excellent for nse J 
than pure soft water. Distillation is the most efficient 1 
of all means of securing pure water. A very convenient i 
and inexpensive apparatus for distillation is manafac- i 
tared by the Modern Medicine Co., Battle Creek, Mich. 
Alkalies,- — For the same reason, soda, satcratua, 
and the numerous compounds of these substances with 
ammonia, alum, cream of tartar, etc., are all objection- 
able on the same groui^ds as bard water. Being alka- 
line, they antagonize the action ui the acid gastric juice, 
and thus weaken digestion. There is no more active 
dyspepfiia-produeing agent than soda or saleratus bis- 
cuit, one of the miist common articles of food to be 
found on the tea-tables of rich and i>oor in this country. 
Doubtless well-prepared baking-powders are much pref- 
erable to soda and civam of tai'tar or salenitus and sour 
milk, mixed by the cook in accordance with the not re- 
markably accurate "rule of thumb," through which 
bungling chemistry the biscuit often present a golden 
hue, which may be quite attractive to the eye, but gives 
to the tongue quite too distinct a flavor of soda and pot- 
ash to be agreeable to a fastidious taste, tci say nothing 
of the probable effect npon a stomach not impregnable } 
to the attacks of chemical agents. In baking-powders, 



THX BTOlfAOB. 



the various ingredients are so mixed as to leave nearly 
neutral products, and yet these compounds are scarcely 
j less pernicious in their inilueuce npon digestiOD then 
the original chemicals from which they are formed. 

The constitttonts of the boat baking-powders, when 
mixed with water, are essentially tlie same as those of 
Rochelle salts. Many baking-powders contain alum, 
and nearly all contain more or less ammuuia. Both of 
these substances have been shown to be ostremely det- 
rimental to the digestive organs. Careful chemical 
I tests made by the writer and by others, have shown that 
ammonia, when used as a raising agent, is driven off 
, by the heat only to a small extent, a sufficient amount 
I remaining to occasion great damago to the digestive 
, functions. 

Alkalies of all kinds are injurious to digestion be- 
toaaseof their neutralizing the gastric juice. Hypo- 
I pep»ia and spepsia result from a long-continued use of 
i alkaline substances in the food or for the relief of 
Iflonr stomach, acidity, etc. 

Perverted Appetites. — Strangely perverted 
[, tastes, as shown in a fondness for earthy and other in- 
oi^anic or innutritioua substauccs, while sometimes the 
I resnlt of dyspepsia, are often the cause of stomach dis- 
I orders. They are either the result of nervous or men- 
I tal disease, or are adopted as a habit through example. 
I In South America there are whole tribes of human beings 
rvho habitually eat considerable quantities of a peculiar 
Lldnd of clay. Several North American tribes have the 
I same habit, being known as clay-eaters. A similar 
I propensity eometimos appeal's among more civilized 
I human beings, being almost exclusively confined, how- 



? THB STOMACH, 



21 



ever, to youug women, cliiefly schoolgii-ls, who acquire 
the habit of chewing up elate ptmcilB, and gradually be- 
come BO fond of such earthy BubstanceB that they have 
in BOme instances been known to eat very coneidorable 
qnantiticB of chalk, clay, and similar substaaces. 
While indicating a depraved state of the aystem, and 
often of the mind also, this practiee has a. very perni- 
ciouB effect upon tho stomach, wliicb is not intended, as 
is that of the fowl, to receive inorganic matter of that 
sort. 

Tho amount of abuse of tliia sort which the stomach 
will stand, however, is quite astonishing. Dr. Favy 
telle a story of an American sailor who saw a jnggler 
pretending to swallow pocket-knives With the char- 
acteristic recklessness of a sailor, and supposing that 
the knivea were really swallowed, he attempted to do 
the same thing himself, and succeeded in getting down 
four. Throe of these were passed off in a day or 
two, but he never saw the other. Six years after, he 
swallowed fourti-en knives in two days, aud was taken 
to a hospital, whero "ho got safely delivered of his 
cargo." lie was not bo fortunate on a subsequent 
occasion, when ho paid dearly for his folly, lingering in 
misery for some time until he died, when his stomach 
was found to contain a namber of rusty knife-handles, 
blades, springs, etc., the organ being greatly contracted 
and corrugated in consequence of the violence which 
had been done it. As a general rule, the innutritions 
parts of foods, as the skins of fruits and vegetables, the 
seeds and cores of apples and similar fraits, should he j 
carefully separated from the nutrient portions, and dis- > 
carded. 




Adulterations of Food. — Tbe numerous adal- 
teratioiiB of food which are now so extensively practiced 
must bo recognized as a not unimportant cause of func- 
tional disease of the stomach. Alum in bread and 
in baking-powders ; lead in drinking-water which has 
passed through lead water-pipes, or has been stored in 
lead ciateruH, or collected from a roof covered with 
sheet-tin containing lead ; lead occnrring in the tin cans 
used for preserving fruit, or in tin pans or other tinned 
ware, or in the glazing of kettle-s"; vinegar containing 
flulphuric and other strong mineral acids ; pickles boiled 
in copper or brass vessels, and thus poisoned with cop- 
per ; sugar ma<le from corn, refuse starch, etc., and con- 
taining irou, Bulphuric aeid, tin, etc.; flavoring extracts 
3 by purely chemical processes, and amtainiug not 
a drop of the extract of the fruit after which they are 
named, — these, with numerous other equally li arm fnl 
adulterations, may be reckoned among the active causes 
of indigestion. 

Unseasonable Diet. — Tlie failure to recognize 
the necessity of adapting tLe diet to the season and cli- 
mate is a prolific source of a certain class of dyspeptic 
dworders. This is especially noticeable when the use of 
large quantities of carbonaceous food, especially fats 
and sugar, which may bo nsed in the winter with com- 
parative impunity, is contiruied into the warm season of 
the year ; or when a diet of this sort is continued in a 
warm climate by persons who have been accustomed to 
it in a cold country. It is this sort of transgression of 
tlio laws of digestion that gives rise to " spring bilious- 
ness," "bilious dyspepsia," etc., in many persons. 
Large quantities of fat and sugar are not well tolerated 



*■ THE STOM4CH. 



by llie Btoruacli at any time ; and iu warm climates, and 
in the witrui scasou of t-oUt aiirl tfrnperate latitndes, 
they are exceedingly injurious. 

Pressure upon the Stomach. — The stumacli 
is remarkably sensitive to preBBure. It c\eu sometimes j 
bceomea temporarily paralyzed by oxcees in eating, t 
by the acenmnlation of gaa from fermentation, by the 
distention of its walls. It ia eqnally liable fn injury of i 
a aimilar sort fi-oni external eansee. A sudden blow . 
upon the stomach has been known to produce almost . 
instant death, through the impression made npon the 
sympathetic nervons system. 

The wearing of corsets, and tight-lacing with or 
without fho corset, are common causes of dyspepsiii, as 
well as of other Bcriima disoaacs. Wearing the panta- 
loons drawn tight and without suBpcndera has a simi- 
lar effed upon men. The soldiers of the Russian 
army once suflfored so mnch from this cause that it be- 
came necessary to correct the evil by a royal edict for 
tlio purpose. Very soon after the evil practice was 
discontinued, the effects disappeared. Bookkeepers 
and school-children, from sitting at a desk; seam- 
strcflses and tailors, from stooping over at their work ; 
slioemakers, weavers, and washerwomen, from direct 
pressure npon the stomach incidental to their work, ' 
are apt to sntfer from disturbance of that organ. 

Tlio disturbances produced by compression of the 
stomach, constriction ot the waist, or bad positions in 
sitting are chicHy due to di^^plucement of the stomach, 
resulting in too long retention of food, thus giving ex- 
cellent opportunity for the development of germs . 
taken in with the food, together with the irritating 



acids and poisonoiiB substances wliieh I'esult from tiicir 
growth. 

Brain Work.— Moiitiil labor, if agreeable and 
pleasant, is a mt)st healthful occupation. There is no 
evidence for believing tliat brain work o£ that sort ever 
disagreed with the stomach or Impaired its functions in 
any degree ; but mental worry, discontent, anxiety, and 
gloom are most unfavorable conditions for digestion, 
and under thuir inSuenco few Btomachs can long main- 
tain their integrity. 

Lack of Exercise.— Idleness is one of the most 
niihealthful of conditions. A lazy man 18 never well. 
Exereine aids digestion by increasing the activity of the 
diaphragm and the chest, as has been previously ex- 
plained. It is also useful by purifying the blood and 
aiding the vigor of the circulation. The detrimental 
influence of idleness or a Bedentary life upon digestion 
is very clearly shown by the results of such a life upon 
the appetite. In a normal state the appetite is a good 
index to the condition of the digestive organs, — in other 
words, a good appetite means good digestion ; loss of 
appetite means loss of tlio power to digest food. Out- 
door exercise is particularly helpful as an aid to diges- 
tion. Horselwck riding, bicycle riding, and rowing are 
to be higlily commended. 

Mental Impressions. — The digestive process is 
very greatly under tlio control of the mind. The con- 
nection between the mind and the stomiieh is so inti- 
mate that Van Helmont maintained for a long time that 
the stomach was the seat of tlie soul. By any strong 
emotion the whole digestive apparatus may suddenly 
cease to act. Fear, rage, and grief check the salivary 




MALADIES UV THE E 



secretioD, and without doubt the gastric nlso. Thnmgh 
the miiid, the appetite may be eitlier encouraged or 
quite destroyed. It seems very plausible that a strong 
nei-vous impresaion might so affect the system as to lay 
the foundation for chronic dyspepsia. 

A man who sits down to dinner with his mind 
depressed with business cares, the embarrassment of 
debts, or the anxiety of doubtful speculations, cannot 
hope to digest the most carefully selected meal. The 
woman who dines with her muid disturbed with discon- 
tent, fretfnlness, and worriment, is certain to suffer 
with indigestion. Domestic infelicity may well he 
counted as at luast an occasional cause of digestive 
derangements. Meals eaten in moody silence are much 
more apt ti.i disi^ree with the stomach than tliose which 
are accompanied by cheerful conversation. A hearty 
laugh is the very best sort of a condiment. Cheerful- 
ness during and after meals cannot be too highly rated 
as an antidote for indigestion. 

Drugs. — The continued use uf drugs of various 
kinds, and especially of patent niediciacs, "bitters," 
and purgatives, particularly the latter, has a very 
damaging effect upon the stomach and bowels. Too 
much eaniiot be said to discourage the use of laxatives, 
purgatives, "liver pills," etc. While sometimes bene- 
ficial, agents of this kind, if used for any leugtli of 
time, are quite certain to work mischief. Purgatives 
should never bo used except as temporary palliatives. 
If the bowels require artificial aid, the enema is far 
preferable ; and yet this jiljin also has its inconven- 
iences, and results badly if too long continued. In 
general, the less drugs are used, tho better. Patent 



THB ETOUACB. 



Dostruma should be Bliunned like tlie moat virnlent poi- 
eons, as in mauy iustauces tliey are. 

Alkaliiio laxatives and laxative mineral waters, 
when used for any considerable length of time, are 
exceedingly damaging ; they irritate the solar plexus 
and induce hypopepsia. 

Sexual Abuses. — Although thia is not the place 
for a dissertation on the subject heading this paragraph, 
sexual transgression in all its forms ninst be set down 
ae 8 not infrequent cause of the class of disorders un- 
der consideration. Secret vice in the yonng, thongh 
often unsuspected, is tlie ondermining inflnence which 
works irretrievable ruin in many constitutions, weaken- 
ing the stomach by extmusting the nervous energies 
upon which it depends for supptu-t. Marital excesses 
have the same effect, and in essentially the same way, 
the vital fiircTS being exhausted more ra|)iilly than they 
can be replenished. The researches of Erown-Sequard 
and his successors have shown that continence is not 
only consistent with perfect health, but that the secre- 
tion of the sexual glands is an ijnpoitant vital stimulus, 
which is of great benefit to the individual, and indispens- 
able as a cimtrolling element in the development of 
the body. 

Disease of Other Organs.— The nervona con- 
nections of tlie stomach and its associated organs are so 
extensive and numerous, involving, of course, equally 
extensive and varions sympathies, that it is not a matter 
of surprise that disease of other parts, through direct 
aympathy, or through a general influence upon the wliole 
system, often occasions disease of the stomach. This 
ia so generally tme that it may almost be said that 




MALADIES OF THB STOMACH. 



l'2T 



"■e-\cry disease liaa its accompanying dyspepsia." Tliis 
fact is particularly observable in the weakness of tlie 
digestive organs which usually follows prolonged fe- 
vers ; wliicli accompanies and follows malarial diseases; 
and which is closely connected with rheumatic and 
gottty affections, with most maladies requiring enforced 1 
rest for a great length of time, with moat forma of brain 
disorder, and with nearly every form of organic disease, 
as well as with structural diaeaae of the stomaeh, as 
simple dilatation, chronic ulcer, contraction, cancer, and 
other abnormal growth:*. 

Inherited Dyspepsia. — Many patients asnert | 
that tliey hnvo inherited dyspepsia from a dyspeptic i 
father or mother, having sutfored from their earliest ! 
recollection from disti-ess after eating, or other disturb- 
ance of the digestive functions. In many of these cases 
there is douhtlcHS an inherited weakness of the stomach, 
which may become genuine dyspepsia by a very slight 
deviation from the lawa of good digestion ; yet it can 
hardly be supposed that dynpopsia itself is inherited in 
the sense that some itthcr diseaMCS are. Tho tendency 
or predisposition may bo iidicritod in the form of a 
weak stomach ; hut in most, if not all, of these cases, 
carefnl inquiry will show tlnit the disease itself ia due to 
bad feeding or some other mismanagement in infancy. 
The use of nursing-bottles without proper attention to 
cleanliness, which is indeed impossible when a long tube 
ia oBcd ; tho employment of deceptive mixtures sold 
88 "infant food ; " and especially the use of pai-egoric, 
"Mi's. Winslow's Soothing Syrup," "worm teas,'' i 
vermifuges, and other pnw(?rful drugs, with an infinite 
variety of teas, sirups, and other patent and domestiQ 




THE BTOM, 



coinpomidH, — these are smne of the mtire powerful 
inflnences which occasion early dyaiiepsiii, and often 
entail lifelong misery and suffering. An individnal 
who has grown up to manhood or womanhood under 
the gloomy shadow of an ever-present, depressing, de- 
spair-producing dyepeptfia, can never fully see the sunny 
side of life, even if Lis stomach conld be made to do 
its duty. The mind falls into habits of thought and 
receives a certain cjist in eai-ly life that no inHiieuce of 
after-years can erase. Hence a reai^nsibility rests 
upon those who have t!ie eare of the diet of human 
beings at the beginning of life which is really fearful, 
in view of the immediate and remote consotjuences to 
the victims of improper management. 

A number of observations made by the writer have 
led him to the conclusion that dilatation of the stomach, 
a common condition in cases of chronic dyspepsia, often 
begins in infancy or early childliood. The overfeeding 
of children and the overd intention of the stomach with 
gas, — the natural result of the Hse of candy, sweet- 
meats, cake, and various other nnwbolesome and indi- 
gestible foods, — frequently result in permanent injury 
to the stomach, the consequence of which is lifelong 
Buffering from indigestion and all the various inconven- 
iences of constitutional maladies arising therefrom. 

Undetermined Causes. — No donbt there are 
many causes of disorders of the stomach which affect 
it indirectly, through the nervous system, and have not 
as yet been sutEciently studied to receive their due 
weight. Among these may probably be classed such 
influences as atmospheric or meteorological changes. 
I have often met with individuals who, though having 






fl 



r-j .' rj '( r.y « r.j „ 



-%Vr 






♦>l( © ^) /<) 




I 



MALADIES OF THE BTOMArH. 



129 



no difficulty with digestion ordinarily, whenever a f alHiig 
barometer indicated diminished atmospheric pressure, 
and clouds covered the skv, wtnitd suffer great disturb- 
ance of digestion. Similar results will, in some cases, 
almost invariably follow the electrical distiu'bancea 
which precedo and accompany a thunder shower. 

■ Impure Water. — Tlie discovery of the fact that 
most of the symptoms of indigestion are due to the de- 
velopment of genus in the stomach and the influence of 
the poisons which thoy pn>duce upon the stomach and 
remote organs, through their absorption into the blood- 
and their action npon the sympathetic nerves, has made 
very clear the relation of impnre water to iligestiou. 
Impure water always contains germs capiiblo of setting 
up fermentation and putrefaction in food substances 
within the stomach. Cold water taken into the stom- 
ach checks the secretion of the gastric juice and the 
process of digestion, thns giving the germs introduced 
with the water an opportunity to set up fermentative 
and putrefactive cliauges m the food, whereby are pro- 
duced acidity, flatulence, biliousness, and sometimes 
even nausea and vomiting. 

The accompanying plate [ Plate II ) presents some 
of the more common forms of germs with which the 
modern science of bacteriology has rendered us famil- 
iar, Plato III shows some of the numerous forms of 
small organisms, animal and vegetable, which are to be 
found in water obtained from nataral sources. 



IMPORTANT NEW DISCOVERIES RE- 
LATING TO DIGESTION. 



Within the last twenty-five years, but especially 
during the last decade, immeDse progress has been made 
in the study of the disorders of digestion, and especially 
in the methods of examining both tbo stomach as regards 
its physical condition, and also the products of digestion. 
This subject is somewhat too aliHtruee for the unprofes- 
sional reader ; but a brief resume of some of tlie more 
important facts relating to recent progress in methods 
of examination of the stiDmach and iuvt^stigation of its 
disorders can scarcely fail to be interesting even to non- 
medical readers. 

The most important discovery which has been made in 
modern times in relation to the examination of the stom- 
ach is the method sometimes termed "tubage," which 
consists in introducing into the stomach a soft or semi-soft 
and very smooth and flexible rubber tube. This tube is 
not forced into the stomach, as was the case with the tube 
of the old-fashioned stomach-pump, but is simply placed 
in the mouth so that the end of the tiibo touches the 
back part of the throat, whei-p, being grasjjed by the 
muBclea of the throat in the act of swallowing, it is 
quickly carried down into tlie stomach. By means of 
the stomach-tube it is possible, by an actual measure- 
ment of the quantity of fluid which the stomach will 
hold, to form a very accurate estimate of its size. It is 
also possible to dctermino whether the stomach empties 
[130] 



Hirw nrecovEBiBS kklatisg to diosstiow. 



131 



I 

I 



iteelf completely, and how long a time elapses after eat- 
ing before tlio Btomacli has disposed of its food con- 
tents by passing the digesting food along into the small 
intestines. Many other facts relating to tlie work of 
the stomach can be determined by tiiia means, but these 
will be spoken of later. 

Various methods have also been devised for deter, 
mining the size and location of the stomach without the 
use of the stomach -tube. One of the most ingenious of 
these is the distention of the stomach with gas by gen- 
erating carbonic acid gas in the stomach. For this pur- 
poee the patient is first given bicarbonate of soda 
dissolved in a little water, then tartaric acid, also dis- 
solved in water. The meeting of tliose two sabstances 
in tlie stomacli gives rise to the develiipment of a quan- 
tity of carbonic acid gas. The quantity of chemicals 
introduced must be varied eoniewhat, of course, accord- 
ing to tlie age and the size of the patient. This method 
is not very nmch used, however, on account of its incon- 
venience, and the possibility of injury, especially in 
cases of ulceration of the stomach, in which sorioas 
damage might be done by a rupture of the weakened 
stomach walls at the scat of the ulcer. 

Another method of detj^rmining the position of the 
stomach is that known as clapotement, which was 
devised by a French physician. This method depends 
upon the fact that agitation of the stomach when both 
fluid and air are present in it, gives rise to plashing 
sounds which can be easily heard by the unaided ear, 
and can be very accurately located by means of the 
Btethoscope. an instrument used also for examinatioo of 
tlie lungs and the heart. 



132 THE STOUACa. 

Another method, which the author had the good for- 
tune to discover a few years ago, is what might be 
termed "simple palpation." By this method careful 
examination of the stomiicU is made with reference to 
the presence or absence of tiiiid. If plashing sounds 
are not heard, then the patient ia made to drink water 
as before. After the water has beeu taken, the physi- 
ciaD, standing upon the I'iglit side of the patient, places 
his right hand upon the abdomen just below the ribs of 
the right side and to the right of the median line ; while 
the fingers of the other hand are placed upon the cor- 
responding point of the left side. Movements are then 
made by the right hand of a character calculated to agi- 
tate the contents of the stomach ; while with the left 
band carefid observation is made of tlie presence or ab- 
sence of the sign of "fluctuation." In case the patient 
is not too flesliy, the movement of the liquid from one 
side of the stomach to the other, resulting from the agi- 
tation with the right band, gives ri«e to impulses which 
ai'c readily recognized by the left hand, as the fluid set 
ill movement by the right hand impinges against the 
wall of the stomach, and communicates the impulse to 
the abdominal wall of the opposite side. After some 
practice the movements of fluid in the stomach can be 
readily detected, and, by directing the impulses in va- 
rious directions, the whole outline of the lower border 
of the stomach may be clearly defined. 

This method seldom fails except in very fleshy sub- 
jects. In order to locate the stomach in these coses, 
the author has constructed a special instrument, which 
consists of a stomach-tube, bearing at its inner ex- 
tremity a small electrical contrivance which is capable 



J " 


"- 


J_,^ Q 


: ■BEHIIp 



J 



SEW mSCOTERlES RELATrSU TO DIOKSTION. 



13»-| 



of emittiDg a elk-king or buzzing snunii wlien excited 1 
by an atteuuating electrical current. Passing the tube 
and listening with the stethoscope while the 
indicator is in poaitiou, it is very easy to determine the 
lowest lUiiit to which the tube can be passed ; and by 
making inuvements or readjustments of the instrument, 
the outline of the lower border of the stoiuadi can be 
very accurately marked out. 

Tliis is llie method commonly employed by the 
writer in making his examinations of the stomach. By 
this method it is possible for one suftincntly experi- 
enced to readily mark out the Incati-iu of the lower 
border of the stomath in a few 8ec<mds, and to dis- 

ir a prolapse of the stomach, dilatation of the etom- 
ach, or a pocket iu the stomach, — conditions one or ,1 
more of wliich are to be found in a great majority of I 
* the cases of chronic dyspepsia. 

The influence of tliese abnormalities in size and poaiK I 
lion upon digestion will be referred to later. The ac- 
companying cuts ( Plate IV ) are illustrations of a few 
of the abnormalities which the writer has noted in his 
examining office. In one of tlieeo cases, as will be 
noticed, the stomach was prf^lapsed nearly to the pulws. 
The colon, kidneys, and all the otiier viscera of. the 
abdomen were likewise in a prolapsed condition. The 
kidney^ in this particular ease, was prolapsed to such a 
degree that ita function had been interfered with, and tfiJ 
had become so badly diseased that it was foiin<l necessary i 
to remove it. Within the kidney was fount! a stone 
weighing four and one-third ounces. Tlie disease was 
evidently the outgrowth of the malposition of the kid- 
ney. Prolapse of the stomach and dilatation of the 




134 



THE erOUAOB. 



Btomacli and colon are conditions to which too little 
attention has been given. It is probable, also, that 
prolapse of the bowels and dilatation of the stomacli 
are Bometiines the result of indigestion ; but prolapse 
of the Btoniaeh must certainly be, in many cases, the 
cause of disturbance of the digestive function, being 
itself the result of such mechanical cansoB as waist 
constriction from corset- wearing, tight waistbands, or 
the wearing of belts. 

Examination of the Stomach Contents. — 
The examination of tlie contents of the stomach ob- 
tained after a test meal is of still greater importance 
than a physical examination, — at least in the treatment 
of functional or non-structural diseases of the stomach. 
The stomach contents are obtained by means of a stom- 
ach-tube, which has already been described. The pa- 
tient is given a test meal consLntiug of one and one-half • 
oancca of dry water-bread or two ooncea of oi'dinary 
baker's broad, with eight ounces of water. Exactly 
one hour from the beginning of the meal, the tube is 
passed into the stomach und the contents withdrawn. 
This is accomplished much more easily than might be 
imagijied ; indeed, few persons suffer much from the 
withdrawal of the test meal, although in occasional in- 
stances the attempt to introduce the tube provokes a 
spasm in the throat which renders the ])assage of the 
tube impossible. 

After obtaining the stomach fluid, it is subjected to 
a moat critical and elaborate examination. The method 
of exammation, which will bo more fully described, has 
been compiled, arranged, and })erfected by the author 



HEW DUOOTIKIBS BBI^TIItQ TO DIOK8TI0K. 



from the investigationa in this direction by many otharfl 
Bcientific workers. Some portions of the method i 
quite now, being the result of the author's person) 
work and experience. This is especially true in refer* 
ence to the methods of determining coefficients, wtiichtJ 
with the exception of one, have all been devised and^ 
determined by him. 

The metliods employed in testing the digestion oH 
starch, while not new to chemistry, have not been pre-9 
viously employed in studying the disorders of digestion.B 
The facta determined in this method of investigation^ I 
which is more elaborate and thoroughgoing tlian anyl 
other with which the writer is acquainted, will bo found 
in a colored chart near the close of thin book, together 
with the figures obtained in an actual case examined, 
in which tlie amount of work done by the stoniacli was 
greater than normal. This method of investigation has 
been developed as the result of years of patient reseai-eh 
and inquiry on the part of many different investigators 
in different parts of the world. The foundation for the 
method employed was laid by Dr. Golding Bird, of 
Guy's Hospital, London, more than fifty years ago, in 
the discovery that tlie acid of the gastric juice is hydro- 
chloric acid, and that the degree of activity of the stom- 
ach in the digestion of albtmien, is chiefly dependent 
upon the presence of this atnd. The hydrochloric acid 
of the gastric juice has been shown, however, to be notJ 
simply the ordinary chemical compound known 
hydrochloric acid, or muriatic acid, but an organic hy-J 
drochloric acid wliich is possessed of much greater ao- ' 
tivity as a digestive agent in combination with pepsin 
than is ordinary hydrochloric acid. 



136 



TBS STOMACH. 



Dr. Bird's researches were vttiim a few ^ears re- 
viewftl by Hayt-m and Winter, two French pliysiolo- 
gi»ts, who perfected methods for determiiiiug not only 
the amount of hydrochloric acid present in a given 
specimen of gastric juic*, but the amount and quality 
of the work done by the stomach in the digestion of al- 
bumen. Ewsld, Boas, and other G€!nuan physicians 
have contributed important methods for determining 
other facts. Professor Roberts, of England, has estab- 
lished a convenient method of studying starch diges- 
tion. The writer, though not pretending to any s 
eminence as a chemist or an originator of new methot 
of study, has undertaken to combine these various n 
ods, and by thu assistance of skilled chemists and the 
advantage of experience in the examination of more than 
five tliousand cases has perfected the method of study- 
ing disorders of digestion herewith presented. A brief 
explanation of the several facts determined by this 
method will be of interest : — 

1, The amount of stomach fluid is normally f 
cubic centimeters, or one and one-third ounces ; thai 
is, of the eiglit ounces of fluid and the one and one-hal 
to two onnc-cs of sttlid food, taken into the stomach, i 
with the oxcoptimi of one and one-third ounces, should^ 
be absorbed at the end of unc hour, or pass on i 
tho snnill intestine. K a larger amount is fonud, 
indication is slow absorption ; if a smaller one i 
found, the absorption is more rapid tlian normal. 

2. In tho examination of a large number of cas 
tho average residue loft after filtration, is found to l 
in healthy persons, twenty grams, or nbout one hi 
the total fimonnt obtained. A larger residue than thia 



SEW IliacOVBEIES RKLATINO TO DH5KSTIOS, 



or a larger proportion of residue, indicates deficient 
activity of the digestive fluids iu dissolving the food, 
or delayed solution. 

3. If the residue prusents masses of food of con- 
siderable size, it is evident that mastication has been 
insufficient. 

4. Tlio presence of a large Hmonut uf miicns indi- 
cates gawtric catitrrli, 

5. A greenish or yellow color usually indicates 
bile ; a red color, blood. 

C. The odop of putrescence indicates decay ; a sour 
odor indicates the presence of acetic acid. 

7. A red color, or the presence of any unusual i 
appearance, should lead to a careful microscopic ex- 
amination by which the presence of pn9 oi' germs may 1 
be readily determined. A thorough examination of J 
the germs or microbes present includes a eiiltivatioa i 
of the germs by mixing a few drope of stomach fluid i 
with a proper culture medium, and subsequent staining ^ 
or microscopic examination by oi-dinary bacteriological 
methods. 

8. Tlio digestive agents which have been found 
present in the stomach fluid are next investigated by i 
means of color an<I other reactions, Those of the most ' 
importance are hydrochloric acid, pepsin, and the r 
net or lab-ferment. Examination is also made for the | 
presence of bile. If any of these substances are i 
sent,. the effect is indicated by zero ; if present, by a ' 
simple + sign ; if in an unusual quantity, by -j- +. 

9. Recent discoveries in physiological chemistry 
have made it possible to investigate with almost per- 
fect accuracy the different products of the digestion of 



i;is 



THE STOMACH. 



albumen, or rather the products which are found in 
tho different atagt's of the cnnversion of albumen 
into peptone, the final product of the digestion of 
albumen. 

ll». By means of the reaction with a solution of a 
coiu|)ound of iodine, a verj good idea may ho obtained 
j-esjjeutiug the conversion of starch into dextrin or nialt- 
Hugar, the reaction slmwing in succession the colors, 
blue, violet, brown, and yellow while the change is 
taking place, until the solution becomes colorless. 

11. By methods which have been largely developed 
in the Sanitarium Laboratory of Hygiene, it has been 
found possible to obtain very definite data respecting 
ihe amount of fennentatiou which may hsivo occurred in 
iho case of any particular stomach fluid. Of the prod- 
ucts of fermontnlicm fonud in the stomach, the most 
common are lactic and acetic acids. Other acids and 
alcohol, are, however, sometimes found, 

12. Tlie above determinations are all of interest 
and importance, but still more so are the more exact 
determinations made by quantitative analyses of the 
stomach fluids, whereby the degree of acidity is ac- 
curately determined, together with the amount of chlo- 
rin found in the different conditions, free, combined, 
and fixed. The significance of this will be understood 
by the simple mention of the fact that the gastric juice 
depends, for its digestive activity, upon free hydro- 
chloric acid, and that when fermentation ia not present, 
the more strongly acid the gastric Juice, the greater its 
digestive vigor, other things being equal. 

13. Tlio det^irminations with reference to starch 
have been undertaken on an extensive scale. At the 




BIBCOVKKIKB BSLATINO TO DIGESTION. 



139 



I 



present writing, these determinations have been made in 
nearly one thousand cases in tlie Sanitariuui Laboratory 
of Pljgicne, under tlie aatbor's direction. The deter- 
minations made, are (1) with reference to tho saliva, 
whereby the quantity formed and its activity are de- ■ 
termined ; (2) the amount of malt-sugar or laaltose, or i' 
completely digestod starch, formed in the stomach ; (.^) 
the amount of dexti'iu und soluble starch, or the im- 
perfectly digested starch. 

14. By accurate chemical methdds the total quan- 
tity of acids resulting from fermentation, including i 
lactic and acetic acids, is dctormined. 

1."). A careful bacteriological study is made of the . 
etomac-h jluid for the purpose of determining tlio num- 
ber and kind of germs present, the number found vary- 
ing from none in a licultliy stomach to many niillions in 
an infected stomach. This I liave found to bo altogether 
the most exact method of determining tho condition of 
the stomach as regards infection and the resulting teu- 
dency to fermentation. 

Tlie experiments made show conclusively that fer- 
mentation is not a natural process in connection with 
digestion, and emphasizes the importance of suppress- 
ing germs in the food, so far as possible. 

The following facts are readily determined by this 
examination : — 

(1) The relative number of germs present. 

i_2) Tho character of the germs, and the nature of 
the disturbance which they produce in the stomach. 

16. Most interesting of all are the determinations 
relating to the coefficients of digestive work. These 
coefficients are worked out from the data furnished by 



140 



I analysis. The indication 8 uf thes-e coeffi- 



quantitative 

cientB are iis followH 

a. — -Tliia coeffick'nt indit-'ates tlie quality i>f the 
work dune by tlio etomach in tho digestion of albumen, 
The normal is l.Oi), as in the caae of each of the 
eoefficienli. In tho present cwpe tlio coefficient is 
found to be .S3, indicating that the work done by the 
stomach in tlio digestion of albiunen was mncb below 
jiar. Btill another fact, however, ia developed by this 
determination ; the difference between the coefficient 
and 1,00 indicates, in each case the proportion of 
the vicious products of the digestion of albnraen formed 
in the stomach and thrown into the circulation. With a 
coefficient of .5U tho indication would be that one half 
the albainen digeatod in the stomach was so imper- 
fectly digestod as to be of no value as food, bnt con- 
stituted, instead, a mass of poisonous substances which, 
after absorption into the blood, must be destroyed by tho 
liver and carried out of the body through tho kidneys. 

b. — This is the coefficient of starch digestion, and 
.indicates how nearly tho process of starch digestion in 
tlie stomach approaches completion. 

c— This coefficient indicates the degree of eEBeient 
activity of tho salivary glands. It expresses both the 
qnantity and the quality of, the saliva. 

X. — This is the coetEcient of fermentation. It indi- 
cates the relation of tho acidity due to abnormal acids 
to the total acidity. 

y. — This is the coefficient of solution, and indicates 
the degree to which a given case approaches the normal 
standard of twenty grama of residue to 40 e.c, or onq 
!ind one-thirtl ounces, of stomach fluid. 



^fii- 1 

the 1 

en. I 

the I 



TO DIOSSTION. 



Ul 



a,— TLia is the coefficient of absorptiou. It indicates 
the quantity of fluid fouod, or its approach to the normal 
amount. An excess of fluid indicates slow iibsorption. 

m. — This coefficient indicates tlio degree of activity 
of tho etoiuach in producing liydrochlorio acid, one of 
the mosf important constituents of the gastric juice. 

The abov§ data iu relation to the stomach fluid ob- 
tained after a test meal hitvQ been determined in tbeJ 
Laboratory of the Battle Creek Sanitarium, imder tho 1 
author's snpervision, in more than five thousand caaea^ J 
each one requiring more than fifty diflferent accnrately ■ 
executed chemical processea. 

It is impossible here to enter into an elaborate di&"1 
cussion of the bearing of all these important data upon 1 
the functional disorders of digestion and tlie treatment^ 
of those disorders. The reader will, however, be able 1 
to see at a glance that accurate d etc I'mi nations of this I 
kind niwit render poKsible b more exact adaptation oi\ 
remedies and diet to individual cases than is possible 1 
witliout such definite and precise information. 

Twenty years ago, when the writer was starting out 
in the medical profession, one of the greatest difficulties 
and embarrassments wliich ho encountered, was tho 
lack of definite information respecting the disorders of 
digestion and the adaptation of remedies to their relief. 
Prescriptions, diet, treatment, and regimen were almost 
altogether matters of guess-work or intnition ; and, in„ 
many cases, the only way «f finding out whether the I 
patient required one dietary or another, was to experi- 
ment upon bim. A recognition of this fact caused an 
eminent Kew York physician to declare that every doso 
of medicine was a blind experiment upon the vitality of 



k 



142 THE STOMACH. 

the patient. A new case of chronic dyspepsia waa 
always encountered witli dread, on account of the tedious 
experimental proceBs, painful alike to bntli physician 
and patient, whic^h must bo gone through in the dis- 
covery of just the dietary and the treatmiiiit best adapted 
to the case. By means of the present method, however, 
it is possible to obtain sui'h accurate information that 
treatment and a dietetic prescriptiim may bo made with 
full confidence that the patient will he afforded definite 
and prompt reliuf. 

One of the most important advantages gained by 
this precise nK^thcJ of analysis is the possibility of 
making an exact and definite classification of all the 
functional disorders of digestion. In relation to this 
new classification, it may bo said briefly that, considered 
in relation to the amount of work done, there are four 
general classes of indigestion, — h^pfrpepslii, in which 
there is excessive stomach work ; hypopepaw, in which 
there is deficiency of stomach work ; apejisiu, in 
which there is no digestive activity whatever ; and 
niiitple d;/Mj}tpst'a, in which the amount of work done 
by the stomach is normal, the change in tiie stomach 
work being qualitative rather tlian quantitative. By 
these studies I have been enabled to subdivide these 
several classes as follows : — 

ITyperpepaia, into three principal classes and twelve 
subclasses. 

Hypnpepmi^ into two principal classes and eight 
subclasses. 

Apepaia, into two subclasses. 

Simple dyspepna, into four eubi 



mW DtRROTBRIBfl aXhATUfa TO DiflssnoM. 



143 



TliiB mak(!B twenty-eix difierent varieties of mdigea- 
tion, eairii with its individual charaeleriaticH. 

In tbe results of the Btndy of over five tbonsaDd 
analyses made with painstaking accuracy by the methods 
which I have very briefly described, I have not foond a 
single case which did not fall in one of the classes 
named, and have found examples of every class. 

I give, in the following pages, an abbreviated out- 
line of the classification, together with a brief outline 
of the data determined by the thorough investigation 
of the work done by the stomach which the modern 
advances in chemistry and bacteriology render it possi- 
ble to make. 

It must not, of course, be supposed that the treat- 
tnent of disorders of digestion can be made, even by 
these exact methods, in any way mechanical or routine, 
since every individual case presents peculiarities which 
must be taken into consideration. The withdrawal of 
the contents of the stomach in the midst of the proc- 
ess of digestion, enables us to surprise the stomach at 
its work, and thas to detect special faults, such as ex- 
ecus or deficiency of activity, abnormal fermentations 
through the development of germs in the stomach, 
etc., and thus makes clear much which has heretofore 
been a mystery, or a matter of pure spc>culation in 
relation to the disorders of digestion. Nevertheless, 
the size, shape, and location of the stomach in relation 
to normal conditions, and many other details, must be 
taken into consideration in formulating a prescription. 



I 



CLASSIFICATION OF FUNCTIONAL DISORDERS OF THE STOMACH 

IN RELATION TO PROTEID DIGESTION, 
Bucd upon I QuantlUllvc Chemical Eiunliution of the Stomach Flald 



The symboU under each head indicali; the characlerislic 
each indiviiiual form of qimnliulive disturbance to which the 
slomach i« subject. 

HTFERFEFSU. A" +. 



. A' + H + C+TypicftW 



1 1. 



_ 1 1. Without ferm'n 
- (2. Wilh 

1 I. Withoui ferm'n 
~t2. With 
_J 1. Without (erm'n 
" i 2. With 

) I. Without ferm'n 
"ja, Wilh 
_i 1. Without ferm'n 
- ) 2. With 

) I. Without ferm'n 

J 2. With 



L-E(rO). 
,'n(«0).. 



HTPOPEPSU. A'- 



1 1. Without ferm'n 
\ 3. With 

i 1. Without ferm'n 
i 3. With 

1 1. Without ferm'n 
) 2. With 

j 1. Without ferm'n 
1 2. Wilh 



AJPEPSIA. A o 



SUKPLE DTSPEFSU. A -- 



I 1. Without term'n'f 

) 3. With 

i 1. Without ferm'n't'n (* I 

j 2. With ■• (»■ 



HEW DIBCOVBSIBH RKLATINO TO DIOB8TION. 145 

RESULTS OF 8U»UTJIIVE HO COJNTlTAmE DETERBINJ- 
HOBS RELATIKG TO SHIVAHY DICESTIOM A«D THE STOI- 
ACI FLUID OBIAMED AFTER A TEST lEAL. 



I 



Cue Tia...S2a4.. 

H/m B D»to. . . .Jag. S5 189.5. . 

Tert HmI.— Regular Test BfeakfBst 

Time of Digestion r h f3 m. 

PnrSlCAL AND MICROSCOPICAL CHAKACTERS. 

Phj'SiCAl. NarmBl. 

Aniimiit..95..c.c. (Wc.c); Disintegration. .+..; Color. ,b, . 

Residue. . 25. . gfins. <20grmB.): Mucus. . .0. . , ,: 0(ior..». , 
Mierotwnpical.— Blood ; Pub ; Misc ; Bacterini 

COLORESETEIC ANB OTHER qUALITATITE REACTIONS. 

DIOESTn-S AOBNTS. 

FreeHa Congo Red.. + .. RosorCLnc.. + .. Dried Ite.sidue. . + . . 
Pepsin Reimet Ferment. + .. Rennet Z}'inuKeii.+ ' ftile.ff.. 



, Pi-plcr 



Prot*Mg. — Syntonin., ..-}-.. Propeplor 

Albuminoids. .+. . 
Starch (Lugol'sSol.), Blue, Violet, Brown. Yellow, C.ilorless 

PEBMEKTATION- PBODircTS. 

l.iictlo Acid + 1 Acetic 

Aleohol Volatile Acids i Butyric . . 

Misc ■ ( Formic . . . 



I 




QCA-vnTATin: CHEancix determisatioss. 



.grms. (.ISO-.aOOgrms.) 'If 
■' A' 
, " {.300-.330 " ) 
. " (,025-.050 " )ff 
, '■ (.155-.180 " )C 

. ■< {.loo-.m '■ )^ 



ToUlafldilj, lA) 314.. 

C»letiiated«ddilj,U)" .382.. 

ToUl chloriu, (T) 390 . 

Free nCl,(Hl 04S.. 

Combined ehlorln, (C). . . .330. . 
fixed cUoridSftF) 032.. 




THE STOMACH. 



DlSSsnOI* OF BTABCB. 



Sollra, Btn't in 5 m. .H.-grmB. (1 c.c.) converted .1 grm. m..t3..m. 

SUItow, {M ) 1.424. . . .prma. 

Dextrin and Solable Slarch (D) S.9te. ... •■ 

Fattj Adds (from fermentation) (L) 005.... •• 

(Lactic acid.,.ffOff. .grins. Volatile acids grms) 

COEFFICEESTS OF DIGESTITE WOBK.ft 

Outrto J ProWds {<i) S3. . . . FermenUOon (r). i 

Dlgextlon Uurcli ('<) 24.... SuluUun (v) r.M.g 

SaUvarr AcUiltj (c) 42.... AbMrpUon i'). . . . 

(wniclpnt of Chlorin Liberation (m) r.5« ^J 

Froteld Dlsestlon and Add Fermentation (i and z) 



• The acidity (A and AT and the qnantltles at chlorln In the differ- 
ent torros Dt (T), (H), (01, aud (F>, are expressed as UCI. The valaea given 
relate to luo e.c. of sMmauh fluid. The amouat of tatty acld!i. chiefly 
lactic (L>, is eiprossed in graiuEi ul HCl. vblch should Iw multlplJL'd 



tcid pi 



. The 



ulpressad to 



tose (U), as well aa that of soluble starcli and dextrin (D). Is 
grams of equivalent dextrose. 

f By noting tlie sIkd tolIoKing the symbols Id this colamn and co- 
ef&ciouts (a) and U). and reterring to the claaalflcatlon. the diagnosis of 
any case In relation to proteld digestion and feraieatation luuj be easUy 
made. By transferring the figures to the blnnli tor ■' Graphic Bepresen- 
tatlon," the indicatlous will be seen at once, the analysis thus furolahiDg 
A basis for rational treatment and the proper dietary. 

** The calculated acidity (A*} Is determined by the foUowIng (armnla: 
C + H - L = A'. 

ttThe nomuil amount of irorlc Is. In the case of each coefficient, ret>- 
reMnted by 1.00. The flgares iiiTou usually represent the percentage of 
deviation from normal. The coefficient of fermentiitlon represents the 
number of mllilgramsof lactfc acid nr combined tatty acids toQDdtDoach 
100 c.c. of stomach fluid (expressed in equivalent HCD. 

The sign -]- indicates presence in normal rjuantily : ++ '*> 
excessive quanlily; — in dcflci>'nt quantity; (zero) wholly 



As regarde the relative frequency of tlie different 
classeB, Bimple dyspepsia ia the most common of all. 
Apepsia is quite rare. I have met less than fifty caBes 



irew mscovBHiis kklatmq to diobsttos. 



in more than five thousand, or a little less than one 
per cent. Hypopepsia and hyperpepsia are about 
equally frcqu«nt. 

As regards recognition of these various classes by 
Byraptome alone, I am sorry to be obliged to say that 
it- is impossible. A test breakfast and a careful ex- 
amination such as I have described is absolutely 
essentiul to a precise diagnosis of the functional dis- 
orders of digestion. One who has studied a large num- 
ber of cases by the methotl described, may, by a careful 
study of the symptoms, sometimes form an approximately 
corret^t judgment in respect to the nature of the case 
in hand without making a chemical examination ; but 
positive information can be obtained by no other 
method than by exact chemical analysis. A few p(nnts 
relating to symptams are worthy of mention, as fol- 
lows : — 

In hyperpejma there is an excessive secretion of 
gastric juice, in connection with which there is usually 
a good appetite, but an escegsive irritability of the 
stomacli, as is ehown by the tenderness elicited by 
pressure at the pit of the stomach or just at the lower 
end of the sternum. Other symptoms due to excessive 
irritation of the gastric mucous membrane are also 
more common than in simple dyspepsia, hypopepsia, 
or apepsia. Acidity not due to fermentation is co 
monly present in extreme cases of hyperpcpsia. This ■ 
form of acidity develops soon after the taking of a 1 
meal, gradually increasing until the food is expelled 
from the stomach into the intestines three or four 
hours after eating, or until the acid contents of the 
stomach are washed out with a stomach-tube, diluted 



148 THB BTOHACH. 

by the drinkiDg of water or some other fluid, or some- 
what modified by the taking of moVe food, or neiitnilized 
by soda, carbonate of magneeia, or some other alkali. 
PatientB suffering from hyperpopsia are often fleshy 
and florid, altbougli not infrequently they are quite 
thin in floeh. 

In hyjMipepnia there is often a lose of appetite, 
general feebleness, pallor, and more or less pronounced 
symptoms of indigestion, with anemia, or an impover- 
ished condition of the blood. 

In ajwpsia the symptoms of hypopepaia are very 
much more pronounced. 

In 8imj>h dyspejintti the principal symptoms may 
be simply weight at the stomacli, and evidences of 
fermentation. 

In caso of fermentation, whatever other symptoms 
may be present, the bacteriological examination shows 
germs of some sort present in great numbers. In 
one case investigated in the Laboratory of Hygiene 
connected with the Battle Creek Sanitarium (Mich., 
U. S. A.), the stomach fluid was found to contain for 
each ounce, more than 16,437,300 yeast cells. Other 
germs were entirely absent. By the aid of this investi- 
gation it has often been possible to make an immediate 
and successful application of appropriate remedies, 
which, without this method of learning the exact con- 
ditions present, could only have been reached by a 
long and perhaps disappoiuting experimental effort. 



SYMPTOMS OF DYSPEPSIA. 



As Dearly every disease may includo amoug its I 
symptoms some disorder of digestion, so dyspepsia maji 
include in it8 symptoma some of those of nearly everyfl 
disease t)i:tt could be named. TLia is readily uuder-'f 
Btood when we consider the fact that impairment oiM 
digestion interferes with the nutrition of every organs 
of the body. Every part suffers, and of course the 
suffering organs express themselves in the various 
symptoms by which they manifest diseased or dis- 
ordt-'rud functions. The particular features manifested 
in any given case will differ with individual peculiari- 
ties of constitution or temperament, which give promi- 
nence to some particular set of Bymptoma which may 
or may not refei* to the stomach. As a usual thing, 
however, there are certain symptoms which refer di- 
rectly to the stomach, and which are generally nndor- 
stood as indicating disordered digestion. The intensity 
of the symptoms manifested varies from the slight un- 
easiness and sense of weight or fulness occasioned by 
a small excess of eating, to the most distressing and 
painful condition of the more aggravated forma of the 
diBorder. 

When possible to do so, the treatment of every 

case of disordered digestion should bo preceded by a 

careful examination of the stomach fluid, which gtves 

information ubtainable in no .nher way, and which can 

[1491 



150 



bt Fcfied mpi» aft oacL b is i 
dat Ae paCieat iteaU visl a labonoorjr in order 
. be made. ICoct modem phj- 
tnbaa, and 
tha test braakfmt and remore tiie 
I flaid at As proper tune, place it in a clean 
bottle, car^nllj leal and padi the same, and send it 
hf e»p t c e B to a labocatDrr in vbich each examinatiODs 
are made. &COraacli fluids usnall/ keep witboat ma- 
terial dtto^ for some little time. (For diractioofl for 
teat meal, see page 131.) 

As tbia vork is especially inteDd«d, Itoverer, for 
persoDs vbo are bo situated tbat tbcy canuot arail 
themselves of skilled mMlicid advice, and siDOe 
home treatment of this disease must be largely sym] 
tnatic, wc pre^icni a siiuplu cla^itication based 
symptoms, and a detailed account of the principal 
symptoms of dyspepsia, together with the best mediods 
obtainable at home for tlie core of tbe disease. 

Classification of Indigestions. — Djgpepaia 
may be classified, first, as acute and chronic One of 
the most important differences between an acute and a 
chronic ca&e of indigestion is that in acute dyspepsia 
recovery will occur in time, usually in a very short 
period, by the unaided efforts of nature ; while a chroni^' 
case of tbe disease continues from bad to worse, 
without material improvement, indefinitely. 

Most cases of acute dyspepsia are the result 
excess in eating, taking food at an unseasonable hoar, 
the partaking of unwholesome and indigestible sul 
stances, or the accidental swallowing of some hig] 
irritating substance, as poisoned or decayed food, 



irail I 



SYMPTOMS OP- DYSPEPSIA. 



151 



soma similar iiritant. Tho majority of these eases 
recover spontaneously, and so qaickly tliat they scarcely 
need further uttentiim in this cunnection. 

Chronic dyspepwiji is generally much less active i 
its symptoms than is the acute form of the disease, Itt^ 
usnally begins slowly, making its advances insidiously,.! 
and thus for a long time eluding observation, in many 
instances until well established. This is one reason 
why the diagnosis of the disease is often obscure. 
Very frequently it is overiookud for years, being mis- 
taken for some other disease through the special promi- 
nence of symptoms elsewhere than in tho stomach. 

Basing the classification of chronic dyspepsia upon 
the most prominent symptoms observed in different 
cases of the disease, by far the greater proportion may 
be included in the following five classes ; viz., simple, 
acid, septic or bilious, painful, and nervous dyspepsia. 

Each of the classes named has its characteristic 
symptoms, though any given case may combine the 
symptoms of one or of all the different classes. After 
a brief consideration of the most important symptoms 
relating to the etomach which appear in different phases 
of the disease, we will consider the special symptoms, 
or groups of symptoms, which characterize the differ- 
ent classes of dyspepsia mentioned. 

Principal Symptoms of Indigestion. — Tlie 
different symptoms observed in the disorders of diges- 
tion arise from — 

1. Disturbance or irritation of the nerves of the 
stomach. 

2. Disturbance of tlie muscular apparatas, or motor 
functions, of the stomach. 



IBfi TllB STOMACH. 

3. Diatnrbanco ff tho secreting, or glandnlKr, 
fanctions of the Btomacli. 

4. Change in the size ami location of tho stomBck, 
as in dilatation and prolapse. 

In addition to these, there are also physical eymp- 
toma relating to the tongue ; Bymptoms pertaining to 
the evacuation of the stomach and bowels, vomited 
mattera, and stools ; symptoms which pertain to the 
rectum ; and various general and remote symptoma 
which are the outgrowth of tlie diaordora of digestion. 
A brief enumeration of the most important of these 
symptt»mB may bo found of practical interest. They 
are presented here in the order in which the writer 
commonly notea them in the examination of a patient. 

Symptoina Pertaining to the Moath. — 1. Morbid 
sensations — stinging, burning, loss of taste and mor- 
bid tastes, such as metallic, acid, eweet, or peppery sen- 
sations ; 2. Secretion — viscid, scanty, or in excess ; 
3. Mucous membrane — small ulcers, red points ; 4. 
Breath — sour, fetid, fecal ; 5. Coated tongue. 

Symptoms 1'erfai.tiing to tite Thnmt. — Excessive 
tliirst, dryness, irritation, cough, choking. 

Symptoms Pertaining to ths Rnyphagust. — Symptoms 
of burning, constriction, or a feeling of a ball or lump 
in the throat. 

Symptoms Pertaining to the Stomach. — Symptoms 
arising from disturbance of sensation — distention, con- 
striction, heaviness, burning', coldness, senaation of ful- 
ness, beating ; abnormal hunger, — constant, sudden, 
and nn controllable, frequently requiring food between 
meals ; appetite excessive, diminished, variable, de- 
praved, absent, but returning after taking a little food. 



i 



BVUPTOUa OF UV8PWBIA. 153 

increaeinK 'with meal, insatiable, craving for special 
foods, diBgast for certain foods ; naaeea ; pain. 

Dutwhancea of the Motor ^u/iciio;;^. — Kegnrgita- 
tion of food, rnmination or merycism, eructations of 
gas, vomiting of fluid, food, blood, pus, bile, or mucus 
(either with or without nausea)', burning, dull, or sharp 
pain ; faintness ; pain on eating. 

77ie Discharges. — -Vomit, — blood, pus, bile, curd, 
bitter, sour, odor of decay; stools, — hard, soft, or 
balls, ragged, acid, very foul, black, clay-colored, 
watery, oily, mixed with mucus, bloody ; parasitic 
worms; constipation, diairhea. 

Syviptoma Pertaifung to the- ^f<'<i»w,^ Painful 
stools, burning pain after Btool, loss of desire to evac- 
uate the bowels, anal itching. 

Gcnernl Ncri'oaa Symptomn. — Nervoneness, morbid 
fears, depression, loss of memory, lack of energy, 
inability to concentrate the mind, mental confu- 
sion, dulnesa ; disturbance of apeecli, aa stammering ; 
fidgets, iiTitability, insomnia, loss of self-control ; 
drowsiness constantly, or after meals ; headache at the 
back, front, top, or side of the head, affecting one or 
both eyes, constant, periodical, or occasional ; sensation 
of heaviness, constriction, or discomfort in the head, legs, 
arms, or other parts of the body ; sensation of abnormal 
size in arms, head, or logs ; strange sensations in the 
eyes, as strained feeling, a feeling as if bursting from 
the sockets or sunken in tlie sockets ; desire to support 
the back of the head ; pain in the scalp or in different 
portions of the spine after drinking or meals ; pain 
between the whonlders ; pain in the lower part of the 
back j pain between the ribs or under the ribs ; giddi- 



154 



THB erOMAOH. 



ness, vortifro ; partial or oiiiplete liiss of conBcionsneas 
duo to suddou fi'ight or hoiuq strong impression ; seiiaa- 
tioti of ligbtuess in tbe head ; disturbing dreams ; sudden 
awakeuiug at night with constriction of chest, with 
difficult breathing or heavy beating of the heart ; ''ex- 
ploBtone ' ' in the head ; coldness between the shonlders ; 
coldness in hands and feet or knees ; sensation of shiv- 
ering or burning after eating ; ringing in the ears ; 
disturbances of vision, unnatural colors ; disturbance of 
smell or taste ; abnormal sensations, such as nnmbness, 
tingling, burning, etc. ; sndden loss of strength ; trem- 
bling and twitching of muscles ; constant weariness ; 
palpitation of tiie heart ; irregular sensations of the 
heart ; sensation of constriction or heaviness about 
the heart ; shortness of breatli ; nervous asthma ; 
stomach cough ; hiccough ; inviiluntarj sighing ; cxces- i 
sive quantities of nrine of liglit color ; seamy urine ; too | 
frequent urination ; whitish or reddish sediment in the 
nrine. 

Phijuicol Slgna. — Physical examination shows in a 
large proportion of cases of chronic dyspepsia, dilata- 
tion or prolapse of the stomach (see page 317 and Plate 
rV). This condition is often indicated by an nn- 
natural plashing sound heard by the patient in walking 
or other movements, especially after drinking water, 
and by unnatural prominence of the lower abdomen. 

All the above symptoms and many others of less 
importance are observed aa the rusnlt of disordered di- 
gestion, although of course all the symptoms named 
are not present in any singlo case. 





THE SYMPTOMATIC TREATMENT OF 
INDIGESTION. 



Uneasiness at the Stomach.— Oue of the 

most cummoQ symptoms, aTid one which is frecjiieiitly 
the &rst noticed by patients, is an uneasy sensation in 
the stomach, which ia variouaiy dcacribed as fulness, 
weight, tightness, oppression, heaviness, heat, cold, 
pulling, "a load on the stomach," ditiwing, "work- 
ing," etc. There may or may not bo tenderness on 
pressure at this stage. Tlio uneasiness complained of 
is greatly increased by any excess in food, and may be 
occasioned by even an ordinary amount, by eating too 
rapidly, by drinking at or soon aftur meals, or by eating 
articles of food which are dithcult of digestion, as warm 
broad or biscuit and butter, pastry, fried food, pickles, 
etc. The essential diiference between this condition 
and that resulting from eating to excess in health, is 
that the symptomB described are produced by an or- 
dinary and proper amount of food, being only increased 
in severity by excess in quantity. 

These symptoms are all due to an increase of the 
irritability of the gastric nerves. They may be caused 
by the use of alcoholic liquors, tea and coffee, ice-cream, 
iced drinks, too frequent eating, and the use of condi- 
ments, as mustard, pepper, pepper-sauce, liorseradish, 
Worcestershire sauce, and in some cases by the use 
of raw onions, radishes, and fats. 

[155] 




156 



THK STOMACH, 




Tnntiiiriit. — Tlicae symptoms are generally relieved 
by an aseptic dietary {Diet List No. 1). In extreme 
caseB the dietary should be confined to well-disintegrated 
foods (Diet List No. 7). In very obstinate cases, a 
liquid diet (Diet List No. 11 ) or a milk diet is indicated. 
All foods difficult of digestion (Diet List No. 22) should 
be avoided when there is fulness, eructations of gas, or 
acidity. All foods which proiaote fermentation (Diet 
List No. 23) should be carefully avoided. A fomenta- 
tion (10) should be applied over the stomach and abdo- 
men at night, followed by a wet girdle (9) to be woro 
during the night, and the dry abdominal bandage (44) 
during the day, witti nutritive treatment (page 331), eleo- i 
tricily (65, t>7, 69), Swedish movements (39), and sub- , 
carbonate or subnitrat© of bismuth (62). In casea of 
prolapsed kidney, or in extreme cases in which acidity 
occurs within an hour or two after eating, especially 
when there is a suspicion of ulcer of the stomach, bicar- 
bonate of soda (64) may bo used in ten- to fifteen-grain 
doses before each meal. The Natural Abdominal Sup- 
porter (45) is requu-ed in cases in which relief is ob- 
tained by upward pressure with the hands applied to the J 
lower part of the abdomen. 

Flatulence.— This symptom indicates the presence ^ 

of gas in the stomach or bowels, the character of which l 

varies greatly, sometimes consisting of air which baa | 

been swallowed with the food in hasty eating. Some> 

times, also, persona acquire the habit of swallowing i 

air, OS do horses, in which the habit is known as ' 

"cribbing." The act requires quite a strong effort, 

yet it is sometimes practiced constantly by hysterical 

patients, and sometimes also by dyspeptics to relieve 



SVHFTOUATIO TBBATMZNT OF IKDIOSSTION. 157 

unpleasant sensationB at tbe etomacb. A Bmall qnan- 
tity of air is EWallowed in the act of golping, which 
usually occniB just before vomiting, and can be accom- 
plished at will by most persons. 

The usual cause of gaseous distention of the bowels, 
however, is the formation of gas within the bowels 
themselves, by the formontation of starch or sugar. 
Sometimes tliia occurs to an enormous extent, giving 
rise to belching and eructations, well compared to 
roaring in extreme cases. In some cases, accom- 
panied by hysterical manifestations, the accumulation, i 
of gas will be almost instantaneous. In these cases ] 
the air may be swallowed, or regurgitated from the 
small intestine. 

It is probable that flatulence, or distention of the 
stomach with gas, is sometimes due to the secretion 
of gaa from the blood. It seems to be rapidly thrown 
out in great quantities in certain cases, particularly 
in nervous disease of the stomach. 

When caused by fermentation, the gas usually con- 
sists eliiefly of cai-bouic acid, from the destruction of 
starch and eugai', and is both tasteless and odorless. 
At other times it contains sulphureted hydrogen and 
other foul gases, from the decomposition of the albu- 
minous and fatty elements of the food throngh the ao- j 
tion of germs. 

Intestinal flatulence, giving rise to rumbling in the 
bowels, or borborygmus, has the same causes as flatulence 
of the stomach. Tlie form of flatulence which affects 
chiefly the small intestine seems to he in a gi-eat degi-ee 
duo to deficient secretion of bile. It affects chiefly 
weakly persons, those greatly debilitated by chronic 



158 THE PTOMAOH. 

rhemnattBin, «-iipecially, and more often women than 
mPu. It is frequently a cause of aleeplesaness, and of 
uiipl^anaut and erotic dreams, ginng rise to nocturnal 
lossoH iu persons whose sexual organs are in a weakened 
condition. 

Flatulency of the colon, or large inteatine, occa- 
sioning offensive gaseous discbai^eB, arises from the 
det-<itnix)sitioQ of the retained contents of the bowol. 
It occurs most frequently as an accompaniment of coii- 
stipHTiou, and of a deficiency of bile. This condition ia 
0B]ieciully noticeable in cases in which a mixed or a 
iiKiat diet has been used, in consequence of the decompo- 
siliun of portions of undigested meat, which takes place 
in the colon. In cases uf this kind there is constant 
poisoning of the system through the absorption of boI- 
ublo poiaoiiB which are formed in connection with the 
offensive gases. 

Tfratment. — Temporary relief from flatulence may 
generally be obtiuued by sipping a little very hot water, 
either with or without a few drops of some volatile sub- 
stance, as camphor, peppermint, or ciimamon. The 
hot water-bag over tbo stomach usually gives relief if 
there ia much distention with the flatulence. Perma- 
nent relief from this condition can be obtained only by 
employing an aseptic dietary (Diet List No. 1). It is 
generally necessary to discard all articles difficult of 
digestion { Diet List No. 32 ), and those which are apt 
to promote fermentation ( Diet List No. 23 ). In cases 
in which starch is digested only with difficulty, farina- 
ceous foods (Diet List No. 4) must be avoided, and 
a nitrogenous dietary should be strictly adhered to for 
some time, with tonic water treatment ( page 333), 



TREATMENT OF INDIGESTION. 



159 



electricity (65, 66, 68), maesage (30, 31), Swediab 
raovemeiita (42), and daily exercise in the open air. 
Charcoal tablets (47, 48, 49) shonld be taken after 
each meal. 

Fermentation. — Septic and even pntrefactive 
changfs may take place within the body as well as 
outeide of it. According to the conclueionB arrived 




at by careful scientific iuvcstigation, the process of fer- 
mentation consists of chaagos in organized substances 
induced by germs roccivud fiom the air. There are va- 
rious kinda of germs, which induce different forms of 
fermentation. A variety of oiganisms known as yeast, 
excites the fermentation by means of which bread is 
raised, beer and wine fermented, etc. Through the 
11 



18 



THB BTOMAOH. 



action of yeast, sugar and starch are first converted into 
carbonic atid, aliioliol, and water. 

It is this kind cf fernn;ntatiou which produces that 
form of flatulence in whicli the stomach is distended 
with a tasteleBfl and odorless gas. In tho stomach, 
ihe pritcesa ia precisely the same as in tlio baker's 
dough trough or tlic beer vats of the brewer. Wlion 
digestion is promptly jwrformpd, the food is digested 
and absorbed before it has time to ferment; but when 
it is slow, either un account of deficient muscular 
action on the part of the stomach, or because of ile- 
ticieiit or defective secretion of gastric juice, fermenta- 
tion takea place before digestion ia completed. The 
eonditiouB of the stomach are then peculiarly favorable 
for the occm-rencG of fermentation. 

This change would always occur iu the stomach 
were it not foi- the preservative influence of the gastric 
juice, which, when hydrochloric acid ia present in suffi- 
cient quantity, effectually prevents fermentation by de- 
Btroying the germs which enter through the mouth, or 
which are ordinarily taken in the food. As befoi-o re- 
marked, however, if digestion is delayed for any reason, 
the germs taken in from tlio air or with the food quickly 
excite fermentative changes, and gases and various 
poisons are developed. 

Bacteriological experiments conducted in the Lab- 
oratory of Hygiene of the Battle Creek Sanitarium 
(Michigan, V. S. A. ) for the purpose of studying the 
nature and action of germs found in the Btomach, have 
shown that the healthy Bti>mach is capable of destroying 
the germB which enter it iu the art of eating, providing 
the food itself is sterilized ; Ihat is, before being eaten 



it is heated to a temperature snfficiently higli lo de- 
stroy any germs which it may contaia. This is found 
to be true, at least in the case of granose, a thoroughly 
sterilized fotxl. In nine stomach fluids obtained after 
eating granose, germs were found in only two cases, 
and then very few in number. 

Raised bread and ordinary biscuit always contain 
quantities of yeast germs in their interior which hav6_^ 
not been exposed to a sufficiently high teniperaturo to j 
destroy tlieir vitality. When taken into the stomach, 5 
these germs grow and develop, producing fermentation. 
Various yeasts, the spores of which are always to bo < 
found in flour, and which give rise to fermentation in the 
presence of warmth and moisture, occasion in tlie stom- 
ach the alcoholic fermentation by which carbonic acid 
gas is produced in abundance, and even sraall quanti- 
ties of alcohol. Other germs give rise to acetic acid, or 
vinegar fermentation, in which the alcohol produced by 
the action of yeast germs is converted into acetic acid. 
Other germs produce the lactic acid, or sour- milk fermen- 
tation, and still others give rise to a butyric-acid fermen- 
tation, the fermentative change which occasions the 
rancid flavor of strong butter or decomposing fats. 

All of these fermentations may take place at tha 
same time. While the healthy stomach is able to de- 
stroy a few germs, the quantity of germs introduced ' 
with the food may be so great that even a healthy 
stomach cannot destroy them all. This is likely to be 
the case in the use of cheese, m;.-at which has acquired 
a "high" flavor, sauerkraut, and such unnatural foods 
as oysters, either raw or impcrfcftly cooked, the liquor 
of which swamts with germs, infusoria, and other small 




aaot vsten «loi^ tbe seadiore. 

Trmttt'^rU. — The tmtmeot is tmaiSa^ tbe 
«• ihttt reccmiDeoded for flrtalence (sm page 150|. 
ffpeciml care mart be taken lo aroid all foods likel; to 
proaote femusitatiion (DietLutSo. 23i: charcoal tab- 
lata (48, 49) aboaid be taken after each meal. In ob- 
atuiat« cases it ia neces^ar; to confine the diet lo tbe 
vary simplest arti^^es. Zwieback or granoee eaten dry 
will often be digested when fluid foods give great di»- 
tKM. A diet of granose and bromose (Diet List No. 
25) will be ftfuod most effit-tent in relieving thia condi- 
tion in a great majority of cases. 

In caae« which do not yield to the above measores, 
lavage, or utoniacli washing (46), must be njsoried to. 
At firxt it may be neoesBary to administer lavage tivo 
or three tiiweii a week, or even daily for a few days ; 
but if the diet has been carefully regulated, the stomach 
wanlilng may be made more aud more infrequent, until, 
at the end of three or four weeks, its nsc uiay be dis- 
[wiined witli altfigether, TfW luug-coutinued use of the 
Htomach'tiilw in injurious. 

Acidity.— Tliis eyiuptom may be due to the for- 
mali'ju of either acetic or luetic acid in the stomach by 
[iieiiUH of gcniiH, an has already been explained. The 
H4ihfltancet( moBt liktily to give rise to acidity are bakers' 
broad, milk, swocta, confectionery of all sortH, ice- 
croiim, rich flmiceH, beer, wine, fluid foods, such as 
Nou]>8, aud furinuceoua foods when taken with large 
qUHrititiea of liquids, particularly cold fluids. In }ia- 
tiuntH Kiiffi^ring from dilatation of the stomach, all 




BTltFTOMATtO THEATMENT OF INDIGESTION. 



103 



I 
I 



Btarchy or saccharine foods are likely to give rise to acid- 
ity by reason of fermentation. 

This condition requires the same treatment as has 
been recommended for flatulence and fenuentation. 
Tlie habit of relieving acidity by means of soda, mag- 
nesia, alkaline mineral waters, etc., is an exceedingly 
injurious one, and servos to aggravate the difficulty by 
lessening the activity of tho gastric juieo. The only 
remedy wliith can be properly used for relieving acidity 
is water. A copious draft of warm water may give re- 
lief, either by producing vomiting or by diluting the ir- 
ritating acids to which tlie mucous membrane of the 
stomach is exposed. 

Acidity from Hyperpepsia. — A form of acid- 
ity not due to fermentation is occasionally encountered. 
It is not due to the action of germs in the stomach, but 
to the formation of an excess of gastric juice or of gas- 
tric juice containing too nmeli hydrochloric acid. This 
form uf acidity is likely U' be accompanied by in- 
tense burning at the pit of the stomach. Gastric crises, 
or attacks of severe pain in the stomach soon after eat- 
ing, frequently occur in those casos. Hot liquids, acid 
foods, especially fruits, and in many cases sweet foods, 
increase the acidity, and are likely to give rise to pain. 
Eructations of a sour or bitter liquid are frequent iu 
this form of acidity. There is not usually distention of 
the fitumach with gas, or flatulence ; but in some cases 
gas is formed, not by fermentation, but by secretion 
from the blood. In this form of acidity the pain 
usually begins half an hour or an hour after eating, and 
increases as long as the food remains iu tho stomach. 



K3fl4 



TIIR ETOMACH. 



■ in »omo extreme caBL-s of this class the secretioo i 
Idrochlorio iieid continues all the time, even when 1 
r|t4)iiinfh coululns DO food. In th^ee instances, an ex- 
I trKrouly »onr, acrid liquid is often rogargitated from the 
I Btomach before eating in tlie morning. 

Trout im-i't. — TliiB condition is sometimea anexcced- 
I Ingly obstimite one, resisting the lueosures of treatmeul 
I emiitoyed iinril botli patient and plirsiciau are thoronglilv 
[ diticonriigt^d. Tlio dietary and general measnres of treat- 
ment NiiggiiBted for the relief of uneasiness at the stora- 
arh are apiilieitble to cases in which acidity from 
euccMMive Heeretion of gastric juice is a prominent 

f»yinptoiri. When these measares do not fully relievo 
the condition, Hiib(?arbonate or siibnitrate of bismoth 
(62) may bo taken before meals in twent>--grain doses, 
and birarbonato of soda (64) either just before or soon 
ftfU^r eating, or aTi hour or two later, an may be required. 
Hcurtblirn. — A burning or smarting sensation, 
ofttm apoken of ait " Iioartburn, " is frequently felt at 
the pit of the atoniaeh or the lower end of the esophs- 
gUB, BomeliineM extending upward, and often accom- 
-paiiied by the rifing into the moutli of a small qnantity 
very acrid, irritating, pungent, foul-smelling 
\ liquid. 'Hie latest investigations on the subject seem 
I to nhow tliut tliis symptom is due to the formation in 
I the Btoinach of butyric or lactic acid, from the fcrmeo- 
C tation of sfinio of the elements of food. The formation 
mgl butyric acid is particularly favored by the presence 
1 the fltoinoch of fatty substances. It is this acid 
pwhich gives to old choose and ^Gvy rancid butter their 
^jteculiar pungency. It is also to its presence that the 
taiueating odor of vomited matters is due. 



fOJtATIO TEBATMBNT ( 



' IND1QEBTI0N. 



165 



The use of cheese, an article entirely unwholesome 
and utterly unfit to enter a human stomach, is very 
likely to produce the sensatiou of "heartburn." 

Treatm^m.t.—'When heartburn ia habitual or a con- 
stant symptom after eating, lavage (4-6) ia required. Ae 
a rule, however, Mimple regulation of the dietary ia suf- 
ficient to effect a cure. The dii;t should be aseptic ( Diet 
List No. 1), All foods difiieult of digestion (Diet List 
No. 2i) and likely to give riso to fermentation (Diet 
List No. 23) should be avoided. A dry dietary (Diet List 
No. 2), particularly the use of such fooda aa graiiose 
and zwieback (Diet List No. 25), and nut meal or nut 
butter in the place of butter, should be used. Tea and 
coffee and other drinks at meals shrtuld be avoided. 
Employ the genera! measures recommended for ' ' Simple 
Dyspepaia," for which see page 245, 

Water-Brash, or Pyrosis. — This is a symp- 
tom which commonly occurs whon the stomacli is 
empty of food, or nearly so ; often before breakfast. 
A quantity of clear fluid, either slightly acid, alkaline, 
or neutral in taste, is thrown into the mouth from the 
etoraach, varying in amount from less than a mouthful 
to half & pint or more. It is usually supposed to be 
caused by the accumulation of saliva in the stomach, 
which faUs to absorb its fluid contents on account of 
inactivity. The expulsion of fluid may be accompanied 
by pain, or may be quite free from unpleasant sensa- 
tions of any kind. It is a eymptora said to bo almost 
universal among the Lapps and New Zealandcrs, and 
18 also exceedingly prevalent in Scotland, where it 
seems to be due to the use of insufficiently cooked 
oatmeal. 



■ toAsv Am AeSsidfl 
I is MX iBied bvta Ae j 
■ Ab ^MMk aaSv. kanp d«e to ■ s 





II MS* be fvodoced bv 

L, « *■—*■;; kidaer, pressirc (^ 

■- iBMBi, as wefl ae br emm 

I DC ^mn to DM) tcmoTu 

I to die eoneclion of tike 

t ivq m iv i it tke ninir as that 

I for '-rBcavaas tt de Ste mach ," (see 

NmB 

reCenvd to the ^■— — ^, wUch is boC easlj c 
■■ it ja anlike aavthi^ dscL It asaallT prLcaJe s dw* 
act of TcmiliD^ thoo^ nut alwrnn. ami freqneiitly ex- 
Mto vithoat -voBotiag. It is derind fnaa the Greek 
wovd Mil. meaning '''a ehipi,"beu^aIwaTa a protniiwmt 
tympbom m a c a u Aneas. Kaiuea indkatea an irriiatloB 
of the nerres of the «t«BacIi, iritic^ may be doe to an 
exoeesiTe initabilitj of the nenneSf vherebj tb«?T ate 
imoBiuUy excited hj the toere contact of food viih the 
mnooDB membrane of the stomach ; or it mar be the 
reenlt of the irritation of the nerres of the etomacb hj 
acrid acids or poisonoos snbstancea prodaced by gexms 
in the stomach or bj the too long retention of food ; or 
it maj arise from the infection of the stomach by lat^ 
qnaotitiefl of microbee which the gastric juice, through 
some defect in qoantitr or qaality, is Dot able to de- 
stroy. There are also eome so-called nervous cases in 
which naaaea ia the revolt of tlie irritation of the vomit- 




BTKPTOIJATIO TKKATMENT OF INDIQESTION. 



107 



I 



ing centers in the brain by poisonous subBtances circu- 
lating in the blood. 

Treatment. — Swallowing a few bits of ice, a few ' 
sips of bot water, ice over tbo stomach, ice about the 
throat, fi imentationa (10, 11) over the stomach, fomen- 
tatiniia to the spine, hot and cold applications to the 
Bpiiie (18), faradization (65) of the spine and stnraacii, 
gentle kneading of the stomach (31), suhnitrate of bis- 
muth (62) in ten- to twenty-grain doses, — these are 
simple measures wliicb are sometimes successful in re- 
lieving vomiting. In cases of nausea iu which there is 
reason to suspect offensive material in the stomach, lav- 
age (46) should be employed, as the most efficient means 
of relieving this condition. In cases iu which the nausea 
is habitual, except in cases of pregnancy, it is often ad- 
vantageous to withhold all food from the stomach for a 
day or two, or even longer, nutrition being maintained 
by the nutritive enema (Diet List No. 2+). Fasting is an 
excellent remedy for all conditions of the stomach in 
which there is excessive irritability. The general treat- I 
ment should be the same as that recommended for " Un- 
easiness at the Stomach" (page 155). 

Vomiting. — The nature of the act having been al- 
ready described, only its indications need be noted. 
As a symptom of acute dyspepsia, it ia very com- 
mon, but ia much less so in chronic disorders of 
the digestive organs. When present, it usually indi- 
cates something in the stomach wliich should be ejected, 
being an effort of natm'e to defend the system from in- 
jory. Sometimes the preseoee of simple mucus in ex- 
cessive quantity, as in gastric catarrh, will give rise to | 
vomiting. Vomiting also occurs very frequently in 



168 




THB (TOIUca. 



coonectioa with -wfaoopiog-cotigb, chrome bronclutia, 
and coneumption, being due to violetit cooj 
is aliM) eomctimcB indaced, S5 is cooglung, hj tbe tick- 
Hog Bcnaation prodnced in Uie throat hy a relaxed 
elongated palat«. Tickling the tliroat viib the finger 
or B feather will in many persons excite vomiting, espe- 
cially if there is the slightest degree of nausea. Some 
persons can prodnoe the act of vomiting at will. 

When violent vomiting continues fur a considerable 
length of time, the vomited matter consists wholly of 
bile and mncns. The presence of bile leads many pep- 
sone to Bitppoee that bile is the cause of the vomiting, 
being an evidence of "biliousness," and having pro- 
duced nausciu by its presence in the stomach. This is 
UNUrtlly an errur. The bile is usually present in the 
Htoniach only as the result of revevse action, indicated by 
retching or long-continued vomiting. 

The writer has, however, met several cases in which 
dilatation or prolapse of the stomach had dragged the 
pyloric orifice down to so low a point that the bil^- 
wliich enters the small intestine a few inches below 
the lower orifice of the stomach, was led by gravity to 
flow uito the stomach, instoad of flowing in the oppo- 
Hito direction, as in health. In sucii cases bile is often 
found in the stomach whca the organ is othorwise 
empty, rtnd if not oxpcHod by vomiting, gives rise to 
constant nausea ; by nutraliziug the gastric juice, it 
riously interferes with stomach digestion. Such cases, 
require replacement of tlie stoniach and support of the' 
orgau in position by means of the abdominal supporter 



^ ■ 



UMATic Treatment of indiqestion. 



169 



The violent efforts made in vomiting sometimes ex- 
. tend to the dnodemun, where the bile exists naturally, 
causing it to bo thrown upward into tlie etomacli, whence 
it is expelled by vomiting. The first portions of bile 
vomited usually liavo a yellowish color, duo to the fact 
L that the alkaline bile is nentralized by the acid contents 
of the stomach. Afterward, when tlie bile becomes more 
than Bufflcicnt to neutralize the acid contents and secre- 
tions of the stomach, its natural greenish color appears. 
Severe, protracted, and painful vomiting is a com- 
on symptom o( organic disease of the stomach, us in 
t cancer, nicer, dilatation, contraction, or some other 
strnctnral change. 

Tfeatirt{'iii. — The measures soggested for the relief 
of nausea are also sometimes successful in the treatment 
of vomiting. However, it is not infrequently the case 
that vomiting continues in spite of tho means men- 
tioned. In such cases, larnge (46), or washing of the 
stomach, ia the most important measure which can bo 
employed, and it almost invariably succeeds, ahlmugb 
not infrequently the passage of the tube must be re- 
peated several times before the stomach becomes quiet. 
Surprisingly large quantities of fluid are sometimes ra- 
red in cnsea of tliis sort, especially in those com- 
I monly called "green vomiting." In these cases there 
is regtirgitation oF bile and other fluids from the intes- 
tine into tlie stomach. 

Cases am occasionally encountered in which vomit- 
ing seems to be purely nervous in character. These 
are sometimes best relieved by the introduction of a 
atnall quantity of fowl into the stomach. 



no 



Thk stomach. 



I 



There are still other caeea in which vomiting eeemB 
to be purely lijsterieul in character, and which can be 
controlletl by commanding the patient in a very positive 
manner to cease vomiting. Tlie writer has cured a 
number of cases in this way. One young woman who 
had not retiiuied a single meal for more than three 
years, ceased vomiting when convinced that she must 
do Bo or abstain from eating. I said to this young 
woman tliat I could not allow so much good food to be 
wasted, and that if she insisted npon vomiting every- 
thing she ate, she must cease eating. Thia she did for 
a short time, but was finally glad to come to terms, and 
agreed to vomit no more, which promise she kept in a 
very satisfactory manner, 

Trentni'-nt. — Fa.-iting, and the dietetic and other 
measures recommended for "Nausea" (page 166) and 
" Uneasiness at the Stomach " (page 155) should be em- 
ployed in addition to the measures above snggested. 
The patient should rest in a horizontal position one oeJ 
two hours after eating. 

Regurgitation — Rumination, or Merycism. 
— Kuminatiou ia an act by which the food is returned 
to the mouth from the stomach by a reversal of the act 
by which food is swallowed, and without the violent 
efforts attending vomiting. In some animals, as the 
ox, sheep, goat, and others of the same species, all the 
food is returned to the mouth in this way, being re- 
chewed, lu man, regurgitation does not occur in 
health, being caused by an irritable state of the mncous 
membrane of the stomach, which excites contraction in 
the organ, and forces the food upward. Sometimes 
the act becomes more or less voluntary *, but more 



r 



SYMTTOMATIt; TEEA.TMENT OF ISDIOE8TION. 



171 



often it ia occasioned by a morbid condition of the 
stomach, and cannot be readily controlled bj any effort 
of the will. 

The ease with which some persona voluntarily re- 
gurgitate substances which have been swallowed is very 
curi<itis. A woman who ruminated regularJy, amused 
hcT friends and the public by swallowing two live gold 
fish, each abnnt two and one-half inclies long, regurgi- 
tating them alive twenty minutes afterward. 

Regnrgitation and rumination are perlmps only dif- 
ferent degrees of a morbid coniUtion. In regurgita- 
tion there is usually simply a return of a small quantity 
of liquid to the mouth. The patient complains of spit- 
ting up or tasting Lis food for some time after eating. 
In rumination proper, only the more suVul portions of 
tlio fiHid are returned to the month. In most cases of 
this kind the food is re-chewed and swallowed. Some 
patients who ruminate profess to experience a peculiar 
pleasm'e in re-chewing and regurgitating food. The 
old idea that rumination ijidicates some relation to i 
ruminating animals, Buch as the sheep or cow, ia of 
course without any foundation. It ia a morbid condi- 
tion, the exact nature of which is not well understood. 

Tiraf/nent.—Tho food should consist of such sub- 
stances as will bo quickly diaaolved in the stomach (Diet 
List No. 7). In severe eases, a liquid diet (Diet List 
No. 11) should be employed. Granose, bromose, and 
kamyss (Diet List No. 25) have been found especially 
helpful in extreme cases. The diet recommended for 
" Simple Dyspepsia " (page 245) should be employed. 

Gripes, or Colic. — This symptom, sometimea 
called "belly-ache," is caused by irregular muiscular ; 



172 



TBK STOMICB. 



contraction, or epasm, of tlie small intestine. The ex- 
citing canso may be distention with gas, or the presence 
of irritating matters in the TkjwcIs. It is very common 
in patients subject to constipation. 

Colic pains are sometimes caused by the introduc- 
tion of air into the colon in the administration of the 
water enema. In nsing the bulb syringe, this is quite 
likely to uccnr, but it cannot take place to any ext«nt in 
the use of tli« fountain ByrUigc. 

Tre<if»n=nf. — Fimientation (10, 11 1, hot enema (22), 
drinking one or two glasiies of hot wattT either with or 
without the addition <if a few drops of peppermint es- 
sence or camphor, with a dry or aseptic dietary (Diet 
Lists Ni>8. 1, 'Jj constitute the treatment for this disor- 
der. In cases In which starch cannot In: digi'sted, a 
nitrogeuona diet (Diet List Ho. 3) should be adopted, 
and all f<x»Is avoided wliieh are difficult of dige8ti<^Q and 
liable to promote fennentation (Diet Lists Nos. 23, 23). 
The general treatment recommended elsewhere for simple 
dyspepsia or Bh)w digestion bIiouM bo employed. 

Weight — Constriction ^Tightness, etc. — 
A symptom very often complained of by patients 
who may or may not have acidity, heartburn, water- 
brash, and other local symptoms, is sometimes referred 
to as "a constriction."' "a tightness," or "oppres- 
sion," and is generally roferred to a point a little to 
the left of the median line, just beneath the lower 
border of the ribs. It indicutea a catjurhal condition 
of the membrane of the atomacli. The sense of fulness 
whicli it often occasions after eating is deceptive, 
being quite as great in many caaos when the stomach 
is empty, or when only a small quantity of solid food 



BYMPTOMATIO TKEATMBST OF INDIOESTION. 



173 



or liquid haa been taken. Persons suffering thus lire 
QBnally very despondent, and it may be this fact that 
has given rise to tlio term fiypochyndria, which literally 
has reference to tlio region in which the sensation de- 
scribed is felt. It often iiccompanies spermatorrhea and ■ 
other forms of sexual weakness. 

The "sinking sensation " at the stomach, of which' 
many patients complain, though not identical with, is 
allied to, the sensation of weight described. 

The eensations of weight, constriction, tightness, 
palling, and others similar, when nut the result of an 
excessive meal, are due to an abnormal sensibility of 
the nerves of the stomach. These sensations are most 
likely to bo present in cases iu which the stomach is J 
prolapsed or dilated, and are due to a strain upon thel 
branches of the sympathetic nerve which enters thB, 
stomach from tlie solar plexns. 

Treatment. ~-T\\e same general treatment should] 
be employed as is recommended for " Fneaeiness at thet 
Stomach" (page 155.) The abdominal supporter is iis<J 
nally required fiS). 

Pain. ^ Ah a symptom of dyspepsia, pain majrl 
appear in the region of the stomach, or it may be 1 
referred to the spine, the chest, beneath the shoulder-l 
blade or between the shoulders, or, in fact, to any parti 
of tho body. The most qshuI pain is a dull aching! 
after meals at the pit of the stomach, which is in- J 
creased on pressure either with the palm of the hand J 
or with tho tip of tho fijiger. In some cases pain, J 
though not severe, is constant, being no greater after a 
meal than when tho stomach is empty, and often being 
apparently relieved by bland food, bat coming on agua 



17* 



THE ffTOUACH. 



as Boon as tbe stomach is empty. This sort of pain ie 
nsnally accompanied hj a pain beneatli the sboalder. 
It indicates congestion of the mDCooe membrane of the 
stomach, and being asaalW preceded by the sense of 
weight already described, is donbtless indicatiye of 
gastric catarrh, in many instances at least. 

Sometimes pain felt in the stomach comes wholly 
from increased sensibility of the mucous membrane. 
This condition is accompanied by abnormal sensibility 
elsewhere, in most cases, and conunonly occurs lo per- 
sons of hysterical teniieiicies, chiefly in young ladies. 
It not infrequently accompanies the condition rather 
vflgnely known us "spinal irritation." I have nearly 
always found tenderness at the epigastrium present in 
cases in which there was marked tenderness of the 
dorsal sptnc, and 1 have also noted tliat in these cases 
pain is always jtresent at two important diagnostic points, 
known iis Bm-kart's tender points, eitaated about two 
inches on each side of the umbilicus. The tenderness 
at these points is elicited by deep pressore, with the 
patient lying on his back and the knees drawn up. 

A constant, wearing pain, though not severe, often 
becomes unbearable from its long continuance. It 
gives to a person a haggard, despairing look, which is 
alHo in part due to deprivation of sleep, anotlier ill con- 
sequence of this variety of pain. The local pain is 
often aggi'iivated by shooting pains emanating from the 
pit of the stomach, and running into the limbs and 
other parts of the body. Patients frequently complain 
of ft pain fait "clear through the body," starting from 
iho ])it of the stomach, and terminating in a tender 
spot in the spine nearly opposite. 



STHFTOUATIO 



' ISDIiiBSTIOB. 



Fain aecompanied hj vomiting of blood is iodicatiTe 
of gastric nicer or of some otber serexe : 
trouble. Flatolenee produces a pain pemliar to itatU. I 
Neuralgia of tbe stomadi is one of the ntoM fleren' 
pains an indiridaal can erperience, often coming on 
sodden];;, and in many cases soon after eating, and by 
its intensity not infreqaently causing fainting. 

Soreness on pressnre, with nenralgic and other 1 
pains, also exists in the small intestines in some cases of \ 
dyspepsia, the conditions being essentially the s 
those present in stomach pain. 

It should be remarked in this connection that the I 
various pains referred to are often mistaken for other 
diseases. The pain in the chest leads the patient and 
his friends to believe that he has consumption ; and the 
emaciation occasioned by the defective nutrition seems ' 
to confirm this opinion. If the patient has a slif^t < 
coagh, this diagnosis is considered certain, and he ia 
hurried off to Florida, California, Colorado, or some 
other locality supposed to be favorable for consump- 
tives. By change of air, scenery, diet, increase of ex- 
ercise, etc., the patient recovers, and the locality visited 
gets the credit of having cured a case of consumption, 
when the lungs have been snund from the first. If the 
patient stays at home, some qnack or a worthless nos- 
trum is quite likely to get the credit, and every real con- 
sumptive who hears of the wonderfnl care forthwith tries 
the same remedy, but of course without benefit. 

Such cases occur constantly, yet it must not bo sup- 
posed that all pains in the cheat come from the stomach. 
The same mistake is made in respect to other pains. : 
In the region of the heart, it is supposed to be heart j 





176 



THB BTOUAOB. 



disease, eapeeiall}' if there is sympathetic palpitation of 
that organ 1 Pain between the shonldurs ia spinal dis- 
ease. Occurring lower in the spine, it is thought to be 
kidney tronble, especially if there happens to be a sedi- 
ment in tht! ui'ine. Pain m the dnodenum, occurring 
just beneath the lower b(*rc]or of the ribs on the right 
Bide, is "liver complaint," and is accordingly treated 
by a plastor or a "livor pad " 1 

It is often difficult to undeceive the patient, and to 
relieve him of the idea tliat he is suffering from some 
terrible organic malady, — an ulcerated lung, an abscess 
of the livor, incurable disease of the heart or some other 
organ. 

The supci-fleial character of these pains, and the 
readiness with which pain is developed by pressure of 
the finger upon certain tender points, which for the 
most part He bt-tweeu the ribs, aloug on either side of 
the sternum and the spine, and half-way between the 
sternum and the spine, is sufficient evidence that they 
do not arise from disease of the deep stiuctures, or the 
organs which lie within the trunk. It should be re- 
membered, however, that disease of the lungs, liver, or 
other interna! organs may exist in connection with tliese 
Buperficial pains. Pains of die character described are 
generally due to irritation of the sympathetic nerve 
either from the presence of acrid substances in the 
stomach or from a strain upon the sympathetic nerves 
produced by prolapse of the bowels or stomach, or the 
constant pull upon these uen'es by a floating or wan- 
dering kidney, a condition frequently associated with 
prolapse of the stomach, and the dTS]>eptic symptoms 



arising 



from this condition. 



8TMPT0MATI0 TRBATMKNT OF IHTWOEffnOM. 



177 



Migraine, or nervous headache, is, in tlio writer's 
experience, always associated with dilatation of the 
stomach, and the formation within tlie stomach of poi- 
sons or poisonous suhstancea, or the strain upon tiio 
sympathetic nerves caused by prolapse or dilatation of 
the stomach and associated organs. 

Pain may exist in the stomach, liver, bowels, or 
other organs concerned iu digestion, as the result of dis- 
ease of the pnemnogastric nerve — the nerve of seusation 
for these as well as the other organs of the abdomen. 

Tj'eatmeiti.^The treatment consists of the hot-water 
or mustard fomentation (10, ID, hot trunk pack (7), 
wet girdle (9), abdominal supporter (4'5), and aseptic 
dietary (Diet List .No. 1) or a dietary of well-disinte- 
grated foods (Diet List No. 7). In extreme cases, 
a liqnid diet (Diet List No. 11), the use of granose, 
bromose, and kumyzoou (Diet List No. 25), electricity 
to the spine, stomach, and abdomen (65, 67, 69), and 
the general trealmt'iit recommended elsewhere for ' ' Un- 
easiness at the Stomach" (page 155) should be employed. 

Biliousness. — What is termed " biliousness, " or 
f'a bilious attack," is really aeutu gastric catarrh. From 
the long retention of undigested food, the stomach be- 
comes irritjitcd to snch a degree that nausea and vomit- 
ing arc produced. At firnt the matters vomited" consist 
of undigested food in an advanced stage of decomposi- 
tion, as indicated by the foul odor and nauseous taste. 
After vomiting has continued for some time, bile and 
mucus are the principal matters expelled. Tlie patient 
Boon feels bettor, and in a few days ia as well as ever. 
In these cases the difficulty is really in the stomach, 
and not in the liver, as many suppose, tliough snch 




178 



THE STOMACH. 



I 



attacks may be accompanied by dietarbaiice of the 
functions of the livor. The irritation extends down 
to the duodenum, its mucous membrano becoming eo 
flwollen that the opening of the duet from the liver 
is obstructed. This occasions retention of the bile, 
and absoqjtion takes place, when the individual notices 
a jaundiced color of the skin, a dingy appearance of 
the white of the eye, etc. This is what gives to this 
symptom, or group of symptoms, the term bi'ltomt/n^ss, 
when it ie really gastric catarrh. 

One of the most common causes of acute gastric 
catarrh is "taking cold" after overeating or eating 
food difficult of digestion. 

Biliousness is due to the abnormal development of 
poisons in tlie stomach or intestines, and the failure of 
the liver to destroy these poisons or remove tfaein from 
the blood. A healthy liver is able to protect the body 
from an ordinary amount of poisonous substances ; but 
wlien a person indulges in such gross articles of diet as 
cheese, raw oysters, rich gravies, fat moats, or liabitu- 
ally makes free use of meats of any sort, or paralyzes 
his stomach by the nse of alcohol, tobacco, tea, or 
coffee, and in cases in which the stomach retains its 
food for too long a time as the result of dilatation or 
prolapse from corset wearing, tlie poor liver is over- 
whelmed with such a quantity of poisons that it is 
unable to completely disinfect the blood brought to it 
from the stomach and intestine ; consequently the whole 
system is invaded by them, and a condition of general 
systemic poisoning, or what Professor Bouchard terms 
*' autointoxication," or self-poisoning, is produced. 
It will readily be seen that biliousness is not due to 



STVPTOltATIC TBS1.TMBIIT OT IMDiaBSTION. 



179 



torpidity of the liver, but to abuse of the liver. The 
liver does its work as well as it can under the circmn- 
stances. The thick brown coat upon the tongue and 
the bad tiiate in the mouth experienced by bilious 
peraoDB are indicative of an unclean state of the whole 
alimentary canal and the genera! poisoning of the entire 
body. It is not simply the patient's tongue which 
tastes bad, but it is Le himself. The relief obtained 
by the use of mercury and other so-called cholagogues 
is not duo to the stimulation of the liver, as is generally 
aup])08ed, but rather to the disinfection of the alimen- 
tary canal through the carrying off of a quantity of germs 
and decaying substances. 

The treatment of this condition should be the Kante 
as is elsewhere recommended for "Bilious Dyspepsia" 
(see page 251). 

Appearance of the Tongue. — Wliile the im- 
portance of tile condition of the tongue as a symptom 
of dyspepsia is such as to make its mention necessary, 
it should bo borne in mind that its indications have 
more distinct reference to the system in general than 
to the stomach in particular. A clean tongue, of 
natural color, appearance, and moisture, ia a pretty 
sure indication of health. Unnatural redness of the 
tongue, most commonly at the tip and edges, some- 
limes with a strawberry appearance, indicates an irrita- 
ble state of the stomach. It is usually accompanied 
by soreness at the pit of the stomach, little appetite, 
and great thirst. 

A yellowish or creamy coating on the tonguo in- 
dicates an inactive state of the stomach and intestines, 
giving rise to a foul condition of the organs. If 



180 THE STOHACH. 

small portion of the sluny jellow or brownish material 
covering the tongne is planted upon the cut Biirtace of 
a boiled potato, and exposed in a moist room for a few 
days, the potato will be found covered with a thick 
growth of germs closely resembling that upon the 
tongne, demoustrating that the coat upon the tongue is 
really a growth of fungi eirailar to a patch of mold 
upon the wall. or mildew upon a garment. When this 
condition exists, not only the tongne, but the stomach, 
is also infested with these miachief-raaldng microbes. 
The bad taste experienced in connection with a foul 
tongue is due to the production of poisons by the 
germs. The headache, uHusea, loss of appetite, and 
other symptoms which often accompany a coated 
tongue, and the bad. taste in the mouth, are due to the 
absorption of these poisons from the stomach, where 
they are often produced in enormous quantities. Plate 
V shows the appearance of germs from the tongue and 
the stomach as seen growing upon the cut surface of 
a sterili/ed potato, and also the appearance of these 
germs as seen under the microscope. 

A white coat on the tongue indicates a feverish con- 
dition. This often appears in connection with unnatu- 
ral redness at the edges and tip, indicating kritation. 

A broad, pale, flabby tongue indicates a weakened, 
debilitated condition of the digestion and of tlie whole 
system. A tongue of this sort usually exhibits inden- 
tations on its margin, formed by the teeth, owing to its 
flabby state, usually present in hypopepsia. 

A brown coat upon tbo tongoe is very common in 
acute dyspepsia. It is often accompanied by a bad 
taste in the mouth, with unnatural dryness. Sometimes 



J 



TREATMENT OF INDIGESTION. 



181 



this iB doe to slooping with the month open, by which 
the secretions and epitlielinm becomo dried to an un- 
natural extent. 

Sometimes the tongue ia coated in the middle, the 
edges being smooth and clean. Tltis is dae to the fact 
that the epithelium Jias become softened on the smooth 
portions, and has been rubbed off by the friction of the 
teeth. Clean spots are also due to lost epithelium, in 
many cases. 

Transverse fissures of the tongue indicate a diseased 
state of the mucous membrane of the stomach, usq- 
ally due to acid dyspepsia, 

Treatmenl. — A yellow or brown coat upon the tongae 
indicates an infected condition of the stomaeli, which 
requires the treatment recommended for '* Bilious Dys- 
pepsia" (page 251). A broad or pale, flabby tongue 
indicates hypopepsia, and requires the treatment recom- 
mended for this condition (see page 260). In cases 
accompanied by rise of tempL-rature, the patient's diet 
should be carefully restricted to such foods as are 
suitable in fever (Diet List No. 12). Fine charcoal 
(4^7, 48) should ho freely used in cases in which the 
tongue is unusually foul, and the patient shnnid be 
made to drink water freely. The amount taken in 
twenty-four hours should usually be from three to six 
pints More is often advantageous. 

Aphthae. — In cases of acidity of the stomach, oc- 
casioning uritability of tlie organ, little pimples often 
appear on the sides and under part of the tongue, and 
just within the corners of the mouth. After a short 
time, small white patches of lymph may be seen, which 
frequently leave very troahlesome little ulcers when 



182 



TELE STCIUACB 



they disappear. These very annoying ulcers are poai- 
tive evidence of stomach disorder, though the patient 
will often assert that he has no difficulty with his food, 
and never experiences any pain or inconvenience con- 
nected with the stomach. 

Aphtbffi are probably most often present in cases of 
hyperpepsia, or excessive secretion of the gastric juice ; 
but the writer has also found them present in hypo- 
pepaia. 

Treatment.^- The mouth should be thoroughly 
cleansed after each meal ; it should be rinsed every 
hour witli a saturated solution of boric acid or chlorate 
of potash. The ulcers may be touched with a solution 
— forty grains totlie ounce — of nitrate of silver, after 
being carefully dried. Treatment for either hyperpep- 
sia or hypopepsia should be employed, according to the 
indications of other symptoms. 

"Throat-Ail." — Congestion of the pharynx, with 
a granular condition of the mucous membrane, relaxation 
and elongation of the uvula, accompanied by a sense of 
constriction, tightness, dryness, tickling, and other 
symptoms, are not infrequent indications of stomach 
disorder. The patient is often much troubled with a 
tenacious mucus which he finds difficulty in dislodging. 
Sometimes the throat trouble amounts to real difficulty 
in swallowing. 

What is known aa "clergyman's sore throat" is 
usually associated with disorders of digestion. 

Treatment — Fomentations (10, 11) applied to the 
throat at night, and followed by a cold compress, well 
covered, to be worn dnring the night, and a cold sponge 
bath (1) with vigorous rubbing in the morning, are ex- 



flTBIPTOMATIO TRBATMEST OF IHDIOE9TI05. 



cellent remedies for LoarsenesB. Gargling hot water 
in tbo throat three or four tiines a day is also useful. 
The vaporizer (59, 60) sliould be used five or six times 
a day, five to ten mimitea each time. It may be used 
to advantage even more frequently, if convenient. The 
course of tonic treatment and the general measuree 
indicated for slow digestion should be employed. 

Sour Taste in the Muuth. — This symptora, 
not a very infrequent one, is due to an acid condition 
of the saliva, which not only renders it of little use as a 
digestive fluid, but also rnins the teeth, by destroying 
the enamel. 

In anomalous cases the saliva has a swci^isli taste. 

In inactive conditions of the liver, it is likely to be 
bitter, so that the jtatient complains constantly of a bit- 
ter taste m the month. Viscidity of the saliva, accom- 
panied by an unpleasant sense of heat in the mouth in 
the morning, is a common indication of derangement 
of digestion. 

In the careful examination of the saliva in a large 
number of cases, I have found acidity present much 
more often than I had formerly suspected. A careful 
examination of the condition of the digestive organs 
must hence include an investigation of the condition of 
the saliva as regards its chemical reaction and its digest- 
ive activity. 

Ti'eatment, — Rinse tho mouth with a solution of car- 
bonate of soda (©i') three or four times daily ; cleanse 
the mouth tlioroughly before and after each meal with an 
antiseptic dentifrice (57), or rinse the mouth with cin- 
namon water (58), cleansing by ordinary means. The 
diet and other treatment should be such as is recom- 



THE STOMACH. 



nionded for "Simple Dyspepsia '" with fermentation (see 
page 245). 

Constipation, — Though often an accompaniment 
of dyspepsia, this condition is not a constant one in 
that disease. There seems to be a quite general error 
on this point, since many patients confound the use of 
tiie term htdigestnm- with constipation. I Iiave often 
been told by patients, in answer to an iuquii-y respect- 
ing the state of the bowels, that their "digestion " was ' 
very regular, or very irregular, as the state of the 
bowels happened to be. A person may have very poor 
stomach digestion without any marked disturbance of 
the bowels; yet constipation, or costivenoss, — -some 
make a distinction between the two, — is very rarely 
present without disorder of some sort in the digestive 
appai'titus. 

As a rule, it may be expected that any disturbance- 
in the function of those digestive organs which lie 
below the stomach ai'e secondary to disease of the 
stomach. Intestinal catarrh follows gastric catarrh ; 
cirrhosis of the liver, jaundice, gall-stones, and otlier 
hepatic affections are also consequences o£ chronic 
gastric or gastro-inte^tinal catarrh. Biliousness also 
begins in the stomach, as has been shown. Cancer 
of the liver is nearly always secondary to disease of 
the stomach. 

In constipation there may be either excessive hard- 
ness of the fecal matters through too long retention, 
and consequently too great absorption of the fluid por- 
tion, or there may be lose of nerve sensibility at the 
lower, or an^, orifice of the intestinal canal. 



BYHPTOUATIO TBEATHENT OF INDIGESTION, 



1S5 



I 



Tj'eatinent. — For the treatment nf lliiB condition, 
see page 279. 

Diarrhea. — This also is as marked a Bjmptom of 
dyspeptic conditions as the preceding, tliongh less 
frequent. Whether constipation or looseness is pres- 
ent depends on the particular form of indigestion. 
When the most prominent difficulty is slow digestion, 
constipation ia usually present. In hilions dyspepsia, the 
decomposition of the food gives rise to such a degree 
of irritation that diarrhea is induced. Diarrhea iu 
these cases is doubtless the result of the effect of 
poisonous substances generated by the germs develop- 
ing in the alimentary canal, and which the digestive 
fluids have failed to destroy. 

Diarrhea is also present in cases in which there is 
so great irritability of the mucous membrane that the 
food is hastened along without complete digestion. 
Not infrequently tlio two conditions constipation and 
diarrhea, alternate, each being occasioned by the other, 
the vital forces being too weak to maintain a healthy 
medimn of activity. Hardened fecal matters are 
retained until they become a soui-ce of irritation, then 
diarrhea ensues until tlie bowels have been emptied, in 
part at least, this excessive activity being followed by a 
return of the constipation. 

Treatment. — The treatment of this symptom will 
vary according to the conditions which gave rise to it. 
If other symptoms indicate foul or bilious dyspepsia, 
then the treatment elsewhere recommended for this con- 
dition should be employed, together with a large hot 
enema administered daily. Charcoal (4-7, 4'8) or 



THB BTOHACa. 



antiseptic charcoal tablets (4-9) should be habitnally 
used. 

When diarrhea is due to excessive irritability of the 
mucous membrane of the stomach, indicated by a red, 
sensitive tougue and other eymptoms of irritation of tlie 
alimentary canal, liquid food (Diet List No. 1 1) or food 
which will readily dissolve in the stomach (Diet List No. 
7) should be used. A diet of kumyzoon (Diet List No. 
2.>}, kumyss, or buttermilk is sometimes required. An 
enema taken after each movement to cleanse the bowels, 
fomentations (10), a wet girdle (9), and in cases of 
prolapse of the bowels, with dragging sensation across 
the abdomen, the abdominal supporter, are very help- 
ful measures used in connection with ttiose means 
which are indicated by other symptoms of indigestion. 
In old and very feeble patients, " Nutritive Treatment " 
(page 331), and in stronger subjects, "Tonic Treat- 
ment " (page 333) should be employed. 

Long, patient, and persevering treatment ia re- 
quired in these cases. Sometimes in chronic diarrhea, 
the "Rest-Cure" (see page 359) for two or three 
weeks, and a diet consisting chiefly of kumyss, kumy- 
zoon, or buttermilk, and eggs is necessary to give the 
patient a good start in the direction of health. The 
daily hot enema (22) and " General Tonic Treatment " 
(page 333) are required in these cases. 

Backache. — This symptom is so common in dys- 
pepsia that it requires separate consideration. A 
chronic ache in the lower part of the back is due to an 
irritation of the lumbar ganglia of the sympathetic nerve 
(page 193). Fain or soreness between the shoulders is 
dae to irritation of the solar plexus. The sjonptoms 



STMFTOMATIO TEEATMEHT OF IND1GB8TI0N. 



1S7 



I 



arise most frequently from prolapse and dragging of the 
stomach and bowels. Prolapse of one or both kidneys 
or of the liver or spleen ia also frequently present in 
these coses. Examination of the abdomen shows a 
Bagging or abnormal protrusion of the abdomen at its 
lower portion. In these cases tenderness is found 
; deep pressure at points two inches on 
either side of the ombilicns. Constipation ia usually 

Treatment. — The following measures will be found 
the most eSective : "General Tonic Treatment " (page 
333), fomentations (10, 11) to the spine, hot and cold to 
the spine (18), hot and cold trunk park (8), applications 
of electricity to the spine (65, 67, 69), Swedish move- 
ments (41). Proper measures for the relief of consti- 
pation should be employed (see page 379). 

The Stools. — Quite too little attention is paid to 
the character of the bowel discharges by physicians as 
well as by patients. In all cases of dyspepsia, they 
should be carefully and frequently examined. The 
stools should be well-formed and of moderate consist- 
ency. Kagged, unformed stools indicate some degree 
of irritability of the digestive tract. " Watery stools 
show deficient absorption, or too profuse secretion from 
the mucous membrane. Slimy discharges indicate a 
catarrhal condition. Small, pellet-like masses are 
indicative of constipation due to deranged function 
of the colon. If the discharges are unnaturally light 
in color, too little bile is present. An unnaturally dark 
color, with very offensive odor, often accompanies foul 
dyspepsia. The appearance of portions of undigested 
food indicates great inactivity of the digestive organs. 



188 



THE BTOMAOH. 



I 



A microscopic examination is often extremely useful, 
as by tliis means it can ho ascertained, in majiy cases, 
what particular element of tfie food may not be well 
digested. For example, if fat globoles are found in 
great abwidance, the indigestion of fat or oleaginous 
substances is indicated ; if portions of undigested meat 
are discovered, difficulty in digesting animal food will 
be ■ understood. 

Examination of the fecal (liscbargea also affords the 
only reliable evidence of worms, as by this means eggs, 
if not the worms themselves, may certainly be found if 
they are present. Examination for the eggs of piiror 
sites requires tlie nse of the microscope in the hands of 
an expert. 

Tread/iffuf.—The treatment required for abnormal 
conditions of the fecal matters varies according to the 
indicatiouH, Dark, offensive fecal matters indicate a 
foul condition of the alimentary canal, requiring an 
aseptic dietary (Diet List No. 1), charcoal or antiseptic 
charcoal tablets (47, 48, 49), and the general measures 
recommended for bilious dyspepsia. Bilious or septic 
indigestion (page 251), with alight discharges, indicates 
a catarrhal condition of the bowels. Tlie presence of 
mucus in excessive quantity indicates a catarrhal condi- 
tion of the intestines. If the mucus is discharged first, 
a catarrhal condition of the lower portion of the rectum 
exists. If the mucus follows the feca! discharge, the 
catarrhal condition is located higher up in the bowel. 
If the mucus is mixed throughout the fecal mass, it is 
probable that a considerable portion of the colon is af- 
fected. This condition requires an aseptic dietary (Diet 
List No. 1), especially the disuse of all forms of flesh 




SYHFTOHATIO TREATUENT ( 



1S9 



I 



food, the use of charcoal (47, 4% 49), a large hot 
enema daily, to thoroughly cleanse the bowels, to be j 
followed by an astringent enema consisting of a draiQ'l 
of tannin to a quart of water, the last to be retained 1 
for half an hour, if possible. Masses of undigested | 
food indicate the need of a dietary consisting of well- ' 
disintegrated food substances (Diet List No. 7). 

For a liquid dietary (Diet List No. 11), in extrems'l 
cases, a diet of kumyzoon (Diet List No, 35), kumysBj ■ 
or buttermilk is rec|uired. 

The Urine.— Examination of the urine is im- 
portant, though littlo need be said on thia point, as a 
reliable examination can be made only by a competent 
physician. A white, piuk, reddish, or brick-dust sedi- 
ment ia very common in dyspepsia, together with other 
deposits. These are most often found after an unusu- 
ally severe attack of indigestion. Tho fact that deposits 
ui the urine are frequent in this disease, is nietitionvd 
more particularly hocauso those 
who are ignorant on tho subject 
are often lud, by tho advice of 
quacks or otherwise, to take this 
as evidence of disease of the kid- ^'IXW^ j-<)L S 
ueys, of which it is not a posi- LP\\^^i^^ 

live indication. These deposits 




the liver to oxidize, or reduce to urea, the great quantity "j 
of imperfectly prepared matter tlu-own into tho blood, . 
Tliey are particularly liable to be present in persons I 
who use considerable meat. ( See Fig. 18. ) 

Tr&itiiumt. — A white, pinkish, reddish, or brick-' 
dust sediment indicates the necessity for an aseptic diet | 



THX STOMACH. 



(Diet List No, 1), and eapeciallj the avoidiinco of all 
_ articlea hard to digest and likely to undergo fermenta- 
tion (Diet Lists Nob. 22, 23), and the disuse of meat. 

Tliis condition often precedes Bright's disease, and 
sboold receive careful attention. The patient should 
drink from three to six pints of water daily, and should 
exercise out of doors two or three hours daily, the exer- 
cise being as vigorous as is consistent with the strength 
of the patient. A hot bath of some kind once or twice 
a week, and ' ' General Tonic Treatment ' ' (see page -333) 
ehould be employed. Fomentations (II) over the liver 
daily, and the wet girdle (9) are also measures of value. 

Dryness of the Skin. — A peculiar dry, rough 
condition of the skin is very common in dyspepsia, 
though not jwculiar to the disease. In those cases, the 
natural secretion of tlie skin is greatly diminished. The 
patient will frequently complain that he never sweats. 

In some forms of dysjiiepsia, the opposite condi- 
tion is present, the skin being tawny, and having a 
greasy feeling. Occiiaionally it is unusually clear, 
pliable, and sensitive, sometimes being almost trans- 
parent. These cases usually occur among nervoue 
dyspeptics. 

Treatment. — "General Tonic Treatment" and ft 
daily oil rub (27) are indicated for the relief of this 
condition. 

Skin Eruptions.— The use of particular articles 
of ftKid will in certain individuals give rise to various 
skin eruptions snon after eatiug, the eruption being 
accompanied by marked evidences of indigestion- 
Eczema, ncnc, and other skin diseases are chiefly 
dependent upon disordered digestion. All the glandu- 



STKFTOIIATIO TKKATHBIfT OF niDIQESTION. 



181 



I 



lar strnctureB of the bod^ are controlled by the Bympa- 
thetic nervona ayfitem. la diseases of the stomach, 
this nerve ia certain to be more or loss affected, and 
hence disturbance arises in the glmida aa well as in tiie 
other BtriictnrcB under the control of the sympathetic 
nerves. Indigestion in in this way the principal cause 
of acne, or pimples of the face. 

Trmtmeiit. — Relief of the digestive disorder by 
'•General Tonic Treatment" (see page 333), ahonld 
first be sought. Zinc ointment, obtainable from any 
drng-etore, may be applied to the ernptions. For chronic 
coses of eczema, with a thickening of the skin, the daily 
application of hot water by moist cloths (10) or a htit pour 
(19) is a proper measure to be employed. Acne some- 
times requires the use of a hot solution of corrosive 
sublimate, one part of tlie sublimate to two hundred of 
water, after a thorough cleansing of the parts with soap 
and water. Care should be taken not to get the solution 
into the eyes or mouth, as it is very poisouous. Use 
daily ffir five minutes. 

Colli Feet, etc. — To cure cold feet, do not heat 
them at the fire nor parboil them In hot water ; this 
only relaxes and weakens the circulation. A better 
plan is this : Just before going to bed, place the feet in 
a cold bath, with the water about one fourth of an inch 
deep. In a few minutes, dry and rub warm ivith a 
coarse cloth or with the hand. The alternate hot and 
cold foot bath may bo used with still greater effective- 
ness. At night, if the feet cannot otherwise be kept 
warm, hot jugs or foot-stones may be employed ; but it 
is far better to bo independent of such artificial sub- 
stitutes for vital heat by wearing warm bed socks. 




193 THK BTOMACH, 

'VTheii the feet or hands are too liot, they may be 
oooled by employiug cold instead of heat. Ice-water 
may be employed when necessary, and will be found a 
most excellent means of relieving the unpleasant burn- 
ing of the feet from which many people, especially 
older persons, often softer much. 

Coldness of the extreraities in dyspeptics is dne to 
an irritated condition of the abdominal sympathetic 
nerve, whereby the blood-vessels are caused to con- 
tract, 80 that an insufficient amount of blood is circu- 
lated through the extremities. Patients suffering in 
this way often complain of a dragging sensation aci-osa 
the lower abdomen, or an aching in the back, espe- 
cially when obliged to be much upon the feet. There 
is also a disposition to elevate the feet in sitting, and 
a symptom commonly known as "fidgets" is often 
present. These symptoms indit:ate the necessity for 
relief of the irritation of the abdominal sympathetic, 
and also for the support of the abdominal organs, the 
downward displacement of which is a cause of the 
UTitation. The principal measures required are fomen- 
tations to the abdomen daily, the wet girdle (9), and 
"General Tonic Treatment" (see page 333). The ab- 
dominal sujiporter (45 1 should be worn constantly when 
the patient is exercising in an upright position. The 
application of electricity (65, 66, 67) and Swedish 
movements (40) are also very useful measures in these 
cases. 

Headache. ^ — Various forms of headache are 
among the most common symptoms of dyspepsia. In 
different cases, different parts of the head are affected, 
and in the same person at different times. The whole 





8TMPT0MATIC TREATMEKT OF INDIGESTION. 

head may be affected, feeling, aa the patient sometimes 
says, "as though it would burst." Again, the pain 
may be confined to the temples, or to the biick or front 
of the head, to the top of the head, to the region of the 
ears, to the eyeballs, to tbo upper part of the neck, or 
it may extend down between the shoulders. In many 
there is also tenderness of the part affected. 

When headache occurs during digestion, or soon 
after eating, it is usually of a dull, heavy character, 
often located in the front part of the head, and is 
accompanied by more or less confusion of thought, cold 
feet, and sometimes dunness of vision. This form of 
headache is often accompanied by a sense of weight at 
the pit of the stomach. 

The beadatihe which comes on the next day or sev- 
eral hours after taking an indigestible meal, is of a 
more severe character. It is commonly accompanied 
by pain and tenderness just below the ribs on the right 
side, in tbe region of the duodenum, which is probably 
the part chiefly affected. 

Migraine, or Nervous Headache. — This af- 
fection, long treated as a nervous disease, has been 
clearly proved to be a purely symptomatic malady, re- 
sulting from irritation of the sympathetic nerve as the 
result of tho action of poisons formed in the stomach, 
A careful stady of a large number of these cases has 
convinced the writer that nervous headache occurs only 
in persons suffering from dilatation or prolapse of the 
stomach. After having made a careful examination of 
a large number of cases of this disease, numbering 
more than one hundred in all, I am able to say that I 
have failed to find a single case in which there was not 



1(*4 



THB STOMACH. 



evidence of great irritation of the abdominal eyrapa- 
thetic nerve, aa shown by extreme sensitiveness at the 
tender points first pointed out by Burkart, in 1882, 
Tliese points lie about two inclies on each side of the 
umbilicus, at the posterior surface of the abdominal 
cavity. An indication of chronic poisoning which is al- 
most invariably to be found in these cases is the fool 
tongue and malodorous breath presented by the patient, 
and which afford the most indubitable evidence of a 
septic condition of the alimentary canal. A peculiar 
bitter, or what is frequently described by the patient as 
a "nasty," taste in the mouth nearly always accompa- 
nies this disease. The disagreeable, and often fetid, 
odor of the breath is evidently derived from the forma- 
tion of Bulphuretic compounds, the extremely toxic 
character of which is well known. Pepper mentions 
coses in which jewelry worn by the patient was always 
tarnished during an attack of this disease. 

Intellectual overwork or worry is an exciting cause 
of the disease only through the fact that by reflex 
action downward it increases the sensitiro condition of 
the abdominal sympathetic, and at the same time re- 
tards the digestion, and eo favors both the production 
of toxins, which are the direct cause of the disease, and 
the susceptibility of the sympathetic nerve to the action 
of these poisonous substances. 

The frequent occurrence of attacks of migraine at 
the menstrual period in women is occasioned simply by 
the increased sensitiveness of the nervous system at. 
that time. It is a well-established fact that both mental 
and nervous disturbances are much more likely to occur 
in women at the menstrual period than at other times. 



4 



BTMPTOMATIO TREATMENT OF mDIOXSTIOIT. 



195 



Those who have made a careful study of this dis- 
ease will at once recall manj circumstances which arc 
confirmatory of these views. Many have doubtless ob- 
served in certain cases a peculiarity of the disease men- 
tioned by Niemeyer, who remarks as follows : " In 
some cases, a severe attat^k, particularly if it ends with 
sick stomach, results in a certain immunity to relapses." 
Vomiting is, of course, in some degree equivalent to a 
lavage, and so affords the patient temporary exemption 
from suffering. The fact that great benefit may be de- 
rived from the use of saline laxatives in many cases, 
the disease being frequently aborted by the early nse of 
an active cathartic, ia another confirmatory evidence. 
It will also be remembered that food of any kind, no 
matter how simple or digestible, frequently aggravates 
the disease, although there are occasional cases, as 
mentioned by Brinton, in which the taking of a hearty 
meal seems to terminate an attack, probably by excit- 
ing stomachic and peristaltic activity. Niemeyer re- 
marks as follows with reference to the treatment of this 
disease : — 

"In most cases we can do nothing but attend to 
existing disturbances of the general health and of the 
digestion, and the chances of benefit from treatment 
are much greater when we can discover any such dis- 
turbances. During the attack we should spare the pa- 
tient from the use of any remedies, and let him take 
nothing but water." 

Viewed from this standpoint, migraine is no longer 
a complex or mysterious nervous malady, but simply a 
state of systemic poisoning, the origin of which 
is decomposition of food products in a dilated or 



THE STOUACB. 



prolapsed stouiach which, through muacnlar weakness, 
ia unable to rid itself of its contents with enfficient 
promptness to prevent eeptic and pntrefjing processes. 
Although tliese causes m&y be constantly in operation, 
they do not nsuallj produce pronounced symptoms of 
poisoning except at intervals, the kiJneys ordinarily elim- 
inating the poisonous substances with sufficient rapidity 
to prevent those "norve storms" to which the term 
migraine, or megrim, has been attached, except when 
the nervons system is by excessive nervous or mental 
activity, or by the functional disturbance of menstrua- 
tion, rendered unusually susceptible. 

The remedy for this malady is to bo sought, then, 
not in the discovery of some new drug which shall tern-, 
porarily paralyze the nervous sensibility, reduce the i 
blood pressure or raise it, as may be required in the 
individual case, but in the remo^■al of the real cause of 
the disease. The writer believes tliat every case of 
migraine is capable of being radically cured. 

Treatment. — The treatment required in these cs 
consists of two classes of measures : — 

1. Those that are palliative, or asefnl daring aa I 
attack. 

2. Those that are curative, to be used in the inter- 
vals. 

The most efficient of all paUiaiive means ia lavage, or 
washing out of the stomach. By employing lavage (46) 
at the very beginning of the attack, it may often be cut 
short, and by adopting this measure still earlier, aa on 
the appearance of the first premonitory symptoms, it is 
found possible in many cases to prevent tlie attack al- 
together. Many times the stomach-tube brings ap a 




MATTQ TREATMENT OF INDI0K8TI0N. 



197 



great quantity of ill-Bnielling, andigeeted, and decompos- 
uig food. In other cases, no food, bat a small quantity 
of clear but very bitter and acrid fluid, Ja obtained. 
When there is very marked dilatation, it is some- 
times necessary to repeat the lavage a number of times 
before the stomach ia completely cleared of its fetid 
contents. Not infrequently there is bi!o present. It 
should not be forgotten that the bowels as well as the 
stomach may contain a conaidorable amount of decom- 
posing matter ; hence a large hot enema (22) should be 
administered as a means of cleansing the lower portion of 
the alimentary canal. This should be done whether the 
bowels are known to bo constipated or not, Tlie enema 
serves a useful purpose, not only in washing out the bow- 
els, but in supplying fluid to the body, by which the kid- 
neys are aided in eliminating the irritating poisonous 
substances with which the blood ia charged. 

Hot and cold sponging of the spine (18), fomenta- 
tions to the heatl when the face shows pallor, and also to 
the stomach, heat to the extremities if cold, and appli- 
cations of galvanic and faradic electricity (65, 70), are 
needed. It must bo admitted, however, that no reme- 
dies are of very great value when an attack is once fairly 
started, although faithful Bse of the measures snggeated 
will certainly serve to cut short the attack. The use 
of antipyrin, migranin, antifebrin, and other allied 
drugs is to bo deprecated, for the reason that these 
drugs, though Bometimcs temporarily palliative, soon 
lose their effect, requiring an increase of dose at each 
successive attack, until the injurious results of the drug 
may become a more serious matter than the disease 
itself. 



IPS 



THE nOHACH. 



The patient should not est daring an attack, or at 
least not tmtil after the first twenty-four boore. There 
is, however, an occasional exception to this mle, 
which eating after the omission of a single meal seems ' 
to aid in bringing the attack to a termination by nn- 
loading the contents of the stomach into the intestine, 
and thus provoking movement of the bowels. The 
first food taken should consist of some simple cereal or 
fruit preparation. All forms of flesh foods and animal 
extracts, and also milk, should be avoided. Tea and 
coffee, which are popular remedies for sick-headache, 
are highly detrimental ; for although they may some- 
times mitigate the symptoms during an attack, they 
prepare the way for a speedy recurrence of another. 
Granola, granose, zwieback, gluten, and water breads I 
of various kinds ; grapes, peaches, in fact, frnita of all 
kinds ; and such green vegetables as peas, asparagus, 
and string beans, are wholesome and suitable, but for 
these cases should be cooked without milk or cream. 
Kuts, if well chewed, — preferably, however, taken in 
the form of nut meal ( Diet List No. 25 ) , — afford the 
most suitable form of fat. Milk is allowable only in 
the form of buttermilk, kumyss, knmyzoon ( Diet List 
No. 25), or cottage cheese. It should be carefully 
sterilized. 

The curative treatment of migraine consists of a care- j 
ful adhei'ence to an aseptic dietary ( Diet List No. 1 ), 
special preference being given to the articles mentioned. ■ 
Everything possible should bo done to baild up the 
patient's general health. For this purpose the cool 
morning sponge bath (1), followed by vigorous rub- 
bing with a towel or fleah-brush, and the wearing of 



8TMPTOMATI0 TKEATUENT t 



INDlaBSTION. 



199 



the moist al>doiimia1 bandage (9) during tlie night, are 
especially lielpfnl. Outdoor exercise should be taken 
daily to the extent of producing gentle perspiration. 
Bicycle riding is especially helpful, also boating and 
boreeback riding. Patients who soffer from dilatation 
and prolapse of the stomach, however, should take 
care to eapport the prolapsed viscera by a proper 
abdominal supporter. For this purpose the author has 
devieed an instrument called the Natural Abdominal 
Supporter (45) which elevates tlio viscera in a manner* 
exactly similar to that in which persons often support 
themselves with their hands when they have au un- 
pleasant dragging seusatiun in the lower abdomen. 
Tendei-ncBs of the abdominal sympathetic may be 
relieved bj the daily application of the hot water-bag 
for an hour or two, or a fomentation (10). Special 
pains should be taken to masticate the food very 
thoroughly ; and in cases of extreme dilatation of 
the stomach, the almost exclusive use of dry food 
(Diet List No. 2) and well-disintegrated foods (Diet 
List No, 7 ) is required, for a few weeks at least. 

Lastly may be mentioned tlie use of an intestinal 
antiseptic as a means of preventing the development of 
germs and the fiirmation of the poisons which are the 
real cause of this disease. One of the very best of 
these is vegetable charcoal, preferably charcoal made 
from cereals (^T, 48). The addition of a small pro- 
portion of sulphur increases the efficiency of the 
charcoaL The writer has for many years employed a 
mixture of this sort, which is manufactured by the 
Modem Medicine Company, Battle Creek, Mich. 
(tJ. S. A.), and put up in the convenient form of very 



I 



200 



TBK STOUACH. 



palatable tablets (49). Two or three of these taken 
after each meal aid the stomach in preventing the 
action of germs, and at the eaioe time so act upon the 
bowels as to prevent constipation. I know of no 
remedy so valuable in the treatment of this class of 
cases, and, in fact, all cases arising from septic or foul 
conditions of the stomach and bowels. 

Regularity of tlie bowels should be established by 
the use of coarse food like granose (Diet List No. 25) 
and other whole-grain preparations, and by the use of 
the gradoatod enema, and other mcasorea suggested 
elsewhere in this work ( ace page 279). Lavage should 
bo employed once or twice a week in cases of extreme 
dilatation of the stomach, or when fermentation or 
considerable quantities of mucus are found present by 
an examination of the etnmach fluid. The charcoal i 
tablets (49) and lavage should be employed until the-j 
tongue becomes clean. 

Swedish movements (40), massage of the stomach 
and abdomen (29, 31), daily replacement of the ab- 
dominal viscera (32, 33), with general massage (36), 
are measures of great value in cases of migraine. 

Nervous Apoplexy. — This is another condition 
dependent upon a disturbance of the abdominal sympa- 
thetic, the symptoms of which so closely resemble 
those of apoplexy that the person suffering from it 
sometimes lives in almost constant dread of death from 
paralysis as a result of cerebral apoplexy. The sub- 
jects of nervous apoplexy complain more or less 
habitually of giddiness, esjiecially after eating, double i 
vision, scintillations before the eyes, sudden loss ofl 
vision, sudden change of color in surrounding objectB, I 



8V1JPTOMATIO TREATMENT OF INDIOEBTION. 



I 



everything appearing green, blue, or red, as the 
case may be, and occasionally sndden I088 of con- 
HCiouaneBB. The writer has had several caaea under hi«^ 
care in which these symptoms were very pronounced, 
the patients often being brought in from the porches or 
corridors, where snddenly, in the midet of a conversa- 
tion, they had fallen to the floor insensible. Attacks 
of nervous ajxtplexy are frequently induced by fright 
or some sudden, strong emotion, or even by a lond 
sound. 

TrcatTneni. — In the treatment of these cases I 
have BOraetimea seen tlie most remarkable results fol- 
low the application of the abdominal supporter (Fig, 
40), whereby the strained and irritated aympathetic 
nerves, which are always extremely sensitive in these 
cases, were afforded relief by the support of the pro- 
lapiscd stomach, bowels, or other viscera. The moist 
abdominal bandage worn at night, fomentations (10) to 
the epino in the morning, followed by a cool sponge 
bath (1), massage (31, 36), Swedish movementa (41), 
and, if possible, the application of galvanic electricity 
to the spine and abdomen (69), are the most efficient 
measures of treatment. 

The diet should be strictly aseptic (Diet List No, 1), 
and should in all particulars be the same as that recom- 
mended for nervous headache. When the stomach 
is considerably dilated, lavage should be employed 
once or twice a week, until the tongue, which is 
always coaled, becomes clean. The bowels should 
be thoroughly and regularly evacuated. Constipation 
shonld be combated by the measures elsewhere recom- 
mended in this work. Antiseptic charcoal tablets (49), 



i 

201 I 

the I 

con- ^^gj 
n his^^^^l 
need, ^^^^1 




THB STOUAOH. 

as recomnicnded for migraine, should also be need in 
this disease, two or three to be takeu after each meal. 
In both raigraijie and nervous apoplexy, it is eometimea 
necessary to use some intestinal antiseptic habitually, 
on accoant of the inability of the gastric juice to 
thoroughly disinfect and preserve the contents of the 
stomach during digestion. 

For the immediate relief of an attack of nervous 
apoplexy, employ the following measures : Put the 
patient to bed in a quiet room, excluding the light and 
all Bonrces of excitement. Apply fomentations (10, llj 
over the stomach and abdomen ; administer an enema 
(22) if the bowels are constipated ; apply a wet girdle 
(9), and make hot or cold applications to tlio head 
when indicated. If the head is cold and the face pale, 
hot applications should be made ; if the head is hot, 
hut or alternate hot and cold sponging of the spine (18), 
with cold applications to the head. 

Disturbance of the Circulation. — Varions 
distm'bances of the circulation are common in dya- 
jx'paia. Coldness of the hands and feet, or the op- 
[Hieite condition, especially at night, accompanied by 
an aggravated burning sousation ; unnatural heat in 
the head, often accompanied by fulness of the veins 
of the forehead and neck, sh(fwing intense congestion ; 
palpitation of the heart, especially occasioned by excite- 
ment of any kind, and sometimes coming on suddenly 
without apparent cause; intermittent action of the heart, 
with sudden sensations as of stopping, causing the pa- 
tient to apprehend impending death ; tlirobhing of 
the arteries in various parts of the body, this being 
especially noticeable in irritable conditions of the Btom- 




ach, which are often accompsinied by strong pulsation 
of the aorta, felt at the pit of the stomach or lower 
in the abdomun: eudduu flushing of tlie face, with or 
without any slight mental e xci tome at, — these are the 
most common Bjmptoma of tliia condition, some of 
which often occasion no little uneasiness on tlie part 
of the patient by exciting fears of organic disoaso of 
the heart, aneurism, or some other serious malady, 
which ha thinks may end his life at any moment. 

Treatnumt. — " General Tonic Treatment "' (seepage 
333), beginning with very gentle measures and pro- 
gressing gradually, is one of the most effective means 
for relief of disturbances of the circulation. For tem- 
porary relief, hot or hot and cold applications may be 
made to the feet and legs, and prolonged cold appli- 
cations to the parts which are esoesaively hot. Cold 
should be applied over the heart in caat-a of palpita- 
tion, and such measures employed as have been else 
where recommended for relief of reflex symptoms due 
to an irritable condition of tlie abdominal sympathetic, 
as indicated by uneasiness at the stomach and pain in 
the region of the umbilicus ( see page 193 ). 

Nocturnal Asthma of Indigestion. — In rare 
cases the disturbance of the abdominal sympathetic is 
80 great, on account of the formation of poisons in the 
stomach and bowela, and the failure of the liver to 
destroy them or the kidneys to eliminate them, tliat tbc 
patient becomes the subject of dyspnea, or difficulty in 
breathing, of the most distreesing character. The 
attacks usually come on about midnight, — often be- 
fore, but rarely later. The patient wakes suddenly 
from sleep to find himself sitting uprigbt in bed. 



r 



204 



THE STOMACH. 



gasping for breath, and expecting every moment to 
breathe hi a last. Tliese paroxysma are often ex 
tremely distreesing, and not easy to relieve except by 
the nse of the etouiach-tube, which nsnally quickly cuts 
short the attack. A large bot enema is often of valao j 
in these cases. Tlie reason for tlio occurrence of thisl 
attack in the night is probably the lessened activity of I 
the kidneys during sleep. During the daytime thej 
poisons are eliminated with sufficient rapidity to ] 
vent serious injury ; but the action of the kidneys bt 
diminished during sleep, the poisons . accumulate infl 
such quantities as to produce the symptoma referred to^. f 
Those thus afflicted often experience relief after expel- 
ling a quantity of gas from the stomach. Eating sup- 
pers is also a cause of these attacks. The delay in the 
digestive process occasioned by sleep gives rise to fer- 
mentations and decompositions, to which the poisons 
above referred to are due. 

Treatment. — An iiscplic dietary ( Diet List No. 1 ), 
from which flesh food of every description, including 
fish, oysters, etc., is strictly excluded, is indispensable 
to recovery in these cases. Cheese must also be 
prohibited. The most prompt relief is occasioned by 
a diet of fcumyss, kumyzoon, or buttermilk ( Diet List 
No, 25). In many instances a milk diet is sufficient, 
but in cases of dilatation of the stomach, milk is not 
suitable, hence buttermilk or kumyzoon is to be^ 
preferred. From two to three quarts of buttermilltl 
should bo taken daily. No other food but buttermilk, 
or kumyzoon should be taken in severe cases, at least ^ 
for a few days after an attack. After three or four * 
days, granose (Diet List No. 25) and cereal foods, < 



BTUTOiuTia TSBATHXHT OF TSmammon. 



with fruits, may be naed, but vegetables maat still be 
avoided. A large hot enema should be taken daily, 
and tlie patient ahould take as much exercise out-of- 
doors as possible. A short sweating bath will aid in 
the elimination of the poisons, but the hot bath should 
be followed by a cool eliower, wet-sheot rubbing, or 
sponge bath, as a skin or heart tonic. A hot and cold 
full bath (21) is s most excellent measure for these 
cases. Antiseptic charcoal tablets (49) should bo habit- 
ually used in these cases, three or four being taken 
after each meal. It is probable that nervous or es- 
sential asthma is always due to poisoning of the nerve 
centers by substances generated by germs in the ali- 
mentary canal, and absorbed into the circulation, 

" Stomach Cough." — This popular term has 
really more significance tlian many pliysicians are sc- 
cnstomed to allow. It is a very common observation 
that the stomach and lungs sympathetically affect each 
other. Most cases of consumption and chronic bron- 
chitis are accompanied bj stomach disorder ; and, on 
the other hand, there are many eaaos in which dyspep- 
tic conditions are accompanied by a troublesome congh, 
usually of a dry, hacking character, without expectora- 
tion. In not a few instances of this kind the congh is 
due to an elongated palate, or to congestion of the 
pharynx. Most of the remarkable cures of consump- 
tion by drugs are cases of this nature. 

It must not be sujiposed, however, that every hack- 
ing cough is due to disease of the stomach. Many real 
consumptives make the mistake of thinking that their 
congh is wholly duo to the stomach, and by procrasti- 
nation lose their only chance for recovery. A cough 





THE STOMACH 



accoinpaiiied by copious expectoration, or by a rapid 
pulse and night eweats, is rarely a *'6tomacb cough." 
Serious dieiurbance of digestion is present, howeTCC».r 
in nearly all cases of consamption. In fact, as a rnley,| 
failure of digestion precedes consumption in nearly allS 
cases ', hence in most cases of cobgh, except those iitjj 
which the eyinploni ia duo to an acute cold, special at-:j[ 
teution must be given to the condition of the stomach.'? 

Difficulty of breathing and a sense of suffocatioaa 
are among tlio sjniptoma of dyspepsia in which thad 
lungs are involved. The difficulty may arise from 
pressure against the diaphragm by a distended stomacby'l 
or through nervous influence. 

Trmfment.^la these cases, the cough will he pei>a 
manently relieved only when the digestive disorder isg 
cured. Temporary relief may be obtained by the i 
of the Perfection Vaporizer (59, 60). "GeneralToni 
Trciitraeat" (see page 333 J and such other measures a 
are indicated by the symptoms of indigestion whicbj 
may be present, must be perseveringly employed. InA 
cases of chronic cough, the vaporizer should be i 
several times a day. Temporary relief may be ocoft- 1 
sioned by gargling hot water in the throat for five tOjl 
ten minutes two or three times a day. This is also j 
a good curative means. Another excellent measure is 4 
the throat pack, applied thus : First place on the throat:1 
a cotton bandage consisting of several thicknesses ofj 
cloth wrung dry from cold water, and of snfficier 
length to extend around the throat. Cover this with-jl 
several folds of flannel cloth of sufficient width toJ 
extend an inch or two over each side of the moist band- j 
age, wrapping as tightly as possible without interfeiva 



ing with breathing. Thie applicatiou should be made 
at bedtime. On rising in the mornijig, remove the 
bandage, bathe the throat and chest with cold water, 
and apply a dry flannel bandago to be worn during the 
day. The persistent nse of this measure is one of tho 
most effective means of relieving chronic irritation of] 
the throat. In many cases a diseased condition of tha I 
tonsils or of the posterior portion of the nasal cavity 1 
IB present, and requires proper treatment by a specialist. 

Nervous Symptoms. — Most of the symptoms 
thus fur mentioned have related directly to the digest- 
ive organs ; bat still other symptoms of importance 
remain to be noticed, which may be termed "nervons 
symptoms," us they are indirectly occasioned by ab- 
normal conditions of the stomach and bowels. These 
symptoms, akliougli they really arise wholly from dis- 
turbances of digestion, are often supposed to be in- 
dications of distinct and serious diseases of the nervons 
system. There la no douI)t that faulty digestion iB « 
one great cause of nervous disorders, owing to the I 
fact mentioned, symptom? ut first temporary becom 
chronic, and functional disturbances giving rise to3 
organic diseases. 

The nervous disorders which accompany dyspepsia 
are due to four causes : (1) To sympathetic disturbance 
■of function, through the nervous connections of the 
stomach ; (2) to impaired nutrition of the nervous sys- 
tem, defective digestion occasioning a poor quality of 
blood ; (3) to the presence En the blood of the products 
of indigestion, imperfectly elaborated food, acetic and 
butyric acids, and other poisons resulting from the 
action of germs ; (4) to retention of the excretions, ow- 



THB 8T01(A.0H. 




ing to the inactive condition of the liver, skin, and 
bowels, resulting from bnpairod nutrition. 

The injurioue elements mentioned, enming in con- 
tact with delicate nerves already weakened by impaired 
nntritioQ, increase their irritability, and occasion disor- 
dered actions of almost every conceivable variety, 
from the slightest degree of mental disturbance, as 
abowTi in the confusion of thought observed by the dys- 
peptic student or the forgetfulness of engagements by 
the bnainesa man, to complete loss of mental control, 
even actual insanity ; and from the alight nervousness 
familiarly known as "fidgets," to the most alarming 
convulsive action, as in epilepsy and hysteria. 

Tr&itment. — The symptoms referred to in the above 
paragraph should receive promjit and efficient attention, 
as they may be t!ie beginning of grave nervous or men- 
tal disorders. The treatment most generally required 
is that indicated for slow digestion (see page 245). 
The coloclyster (23) or a laxative enema f'25) not in- 
frequently dissipates a distressing headache almost in- 
stantly. 

Nervousness. — Many dyspeptics suffer more or 
less with an indescribable uneasiness, sometimes termed 
"fidgets." The limbs are chiefly affected. The pa- 
tient finds it impossible to sit still. The lower limbs, 
especially, are kept in almost constant motion. Such 
persons find the confinement of sitting in church almost 
unendurable. This difficulty is especially troublesome 
in the afternoon and at night. It is often accompanied 
by peculiar aonsations in the limbs, especially when sit- 
ting or lying, as "crawling," "prickling," "numb- 
ness," etc., which are sometimes thought to indicate a 



STVPioiiATio TBKATXBST OF iDDiexernotr. 



tendency to paralysis, but are merely signs of a weak- 
ened circulation and badly nourished nerves. 

An alliod and very singular sensation is that of 1 
motion. The patient, if very nervona, — and thia is 
especially the case with young women, — will often 
complain of feeling as though being carried involun- 
tarily to different parts of the room, as from one corner 
to another, to the coiling, to the window, or even into 
another room. Patients sometimes complain, also, of 
feeling as though some portion of the body were larger i 
than natural ; as, when lying down, the senaation will l 
be that a limb, or a band, or the head is immensely J 
lai^e. TliQ delusion vanishes, however, upon the pa- 1 
dent's attempting to move the particular part affected. 

Treatment. — Hot and cold B|ionging of the spine \ 
daily (18), fomentation (10) over the abdomen at night, 
followed by the moist abdominal bandage (9) to be 
worn diu-iug the night, the cool morning sponge bath 
(1), and the abdominal supporter (45) are the best 
means of palliation in these cases ; hat a thorough 
course of treatment and training at a well-equippod 
and scientifically conducted eanitarium is essential for 1 
a cure in most cases. General nutritive (page 331) c 
tonic treatment (page 333) should be employed. 

Disturbances of Sight, Hearing, etc. — Noth- 
ing is mure common in this disease than dieturbanceB | 
of vision and of the various other special senses. Dim- 
ness of vision, deafness, ringing in the ears, extreme' fl 
sensitiveness to noise and also to light, occur in many'l 
cases. Not infrequently the patient sees imaginary I 
forms of various sorts. Sometinios the intolerance of J 
light is BO groat that the patient wishes to remain in i 



310 



TBK ST^KACB. 



i 



dntr 



TUi isinon ccnunoa m vantni thaa 
mni. Oftes tfat* eztreioe degne of apparent »eDsin«'e- 
aeat ii mote imapnmrj tfasn reaL The appearance of 
biaek or brij^ qxMs f>( v-arioaa shapes and eizes, espe- 
eiallj noted when atoopai^ orer, is amttlKr roiumou 
•ymptom. CTDDStBral tfairat, perret Bi ona of taste, pe- 
mltar amshiTeiKss of varions porta of d»e bodr, are 
also srniiMoinfl worthr of notice^ 

Treatment. — lo extreme cases, the "Resl-Cnre" 
(page 32S). followed br prc^reaM^e application of 
□Dtrilive and tonic treatment ( pages 331 and :Mi:i }, ia 
required in addition to the application of each palliative 
measnree as nia,T be indicated b; the geoeral and local 
ftymptoms presented. 

Ner\'ous Diseases. — Fanctional neixoos disor- 
ders, as hysteria, epilepsy, and even temporary pa- 
ralysis, often originate in dyspepsia. Dr. Chambers, 
an eminent English physician, asserts that nine cases 
ont of ten of hysteria are due to Uidigestion. This 
statement I have found nbandantly confirmed by ray 
own observation. In the treatment of epilepsy, I 
have observed in many cases, tenderness at the 
pit of the stomach, and a foul tongue. In some in- 
stances, no doubt, the stomach disease is secondary ; 
but many times, at least, I believe that the latter 
difficulty is tlie primary affection. In many cases 
the remedy given to cure the disease is of a character 
to defeat the end desired, by deranging the stomach. 
The long- continued use of bromides is certain to derange 
the digestive organs, as this drug lessens the activity of 
Iho glands of the stomach. AVlien bromides are used, 
a good intestinal antiseptic should be constantly em- 



n 

1 




I 



BTMPTOMAtIc TBEATMKST ok IKDIOE8TION. 211 

ployed, as a means of preventing the fermentation of 
the food substances tlirough the action of microbes 
which are I(>ft to develop in consequence of a deficient 
supply of hydrochloric acid in the gastric juice. Anti- 
septic charcoal tablets are most suitable for this pur- 
pose t49). 

If the tongue is coated, the treatment recommended 
for septic indigestion (page 251 ) Bhoald be employed. 
Careful examination should be made in relation to the 
condition o£ the stomach aa regards dilatation (page 
2I.^(. If possible, a test meal should be given and the 
stomach fluid examined, as mnch light is by this means 
often thrown upon the nature of the disease presented 
( page 184). 

Unusual Drowsiness. — This symptom occurs 
most often after eating, though it is aometime8_ almost 
continuous. An hour or two after eating, the patient 
feela an almost irresistible desire to sleep. The sense 
of weariness and lassitude is sometimes so great that it 
is with difficulty that the person so affected can be in- 
duced to make an attempt to exercise. If he does so, 
however, he feels much better than if he yields to his 
desire to sleep. Exercise dispels the exhausted feel- 
ing, which is not fatigue ; while if the patient allows 
himself to sleep, he awakes unrefreshed, and feeling 
really worse than when ho lay down. In these cases, 
drowsiness is duo to the development of poisonous 
substances through tlie action of germs upon the food, 
and their absorption into the system. 

Trmtim-nt. — This symptom, often very trouble- 
some, ia frequently due to overeating, and is promptly 
relieved by eating a smaller quantity of food. Kjipid 



eMuig is another common cause. The hot and cold 
trunk pack is a raloable toeasare of treatment, also 
fomentations to the abdomen, the moist abdominal 
bandage at night, and plenty of ootdoor exercise. 
The meaaoTvs recommended for '* Simple Drspepeia,'" 
or slow digestion { page 245 ), should be emplojed. For 
temporary relief the patient shonld drink ono or two 
gtasBos of hot water, and practice decp-brestbiog ex- 
ercises (38). 

Sleeplessness. — This condition, quite the oppo- 
site of the preceding, is equally common, and often ex- 
ists in the same individoal, the person being very 
sleepy soon after eating, bnt wakcfal at night. The 
patient is not kept awdie by pain, but by simple 
norvoDBiicsB, by a sense of weight at the stomach, by 
morbid anxiety or fears, by burning of the feet and 
hands, or some similar cause. If sleep comes, it is 
not Bonnd. There are troubled dreams, and tho per- 
son awakes in the morning nnrested and nnrefreshed, 
Tlicse patients usually feel best in the afternoon and 
early evening. 

In most cases of chronic insomnia tlie patient will 
be found to present a very foul tongne. There ia 
often dilatation of the stomach, and generally many 
other symptoms pointing to disturbed digestion as the 
real cause of the sleeplesaness. 

Tiviiiintiit. — Lavage of the stomach, the employ- 
ment of a strictly aseptic dietary ( Diet List No. I ), — 
it may be necessary to discai-d even milk if tho stomach 
is dilated,— the use of antiseptic charcoal tablets (49), 
fomentations to the abdomen at night, the wet girdle (9) 
worn during the night, and " General Tonic Treatment " 




BTltFTOHATIO TEEATlfKNT OF ISDiaESTION, 



213 



I 



( page 333 ) are the meaBorea specially indicated. The 
sleeplessness is thti result of tLe circulation in the 
blood of substances of an irritating or exciting char- 
acter. An aseptic dietary prevents the development of 
these poisons, and their elimination may be aided by 
copiouB water- drinking, exerciae (37) in the open air i 
suHiciont to cause perspiration, breathing exercises (38), 
a light sweating bath onco or twice a week (16, 17), 
fomentations over the stomach and liver (10), snn or 1 
electric- light batlis (15), whereby the skin is stuuu- 
lated, etc. The Natural Abdominal Sapporter (45), ' 
in casea whicli require tt, affords greiit relief. 

TUia most annoying and exhausting symptom - 
sleeplessness ^- also requires attention to ttie following J 
suggestions : — 

1. Retire early, having taken, an hour or so before, 
safUcient muscular exercise to induce slight weariness. ' 

2. Eat nothing within four hours &f bedtime. Go- 
ing to bed without supper is perlmps the best of all 1 
remedies for sleepleHsuoss. If theru is a faint feeling m 
at tlio stomatrU, drink half a glass of hot water. If J 
this does not suffice, a mellow, sweet or subacid appla J 
may be taken an hour before retiring, unless fruit oe- i 
casions pain or acidity, in wliieh ease one or two tableta | 
of bromose may be substituted. ' 

3. If feverish, the skin being hot and dry, take a J 
light hand bath with tepid wator upon retiring. 

4. If the feet and hands are cold, employ the mi 
elsewhere suggested for this condition (page 191). 

5. Sleep in a cool room, taking care to see that the 
bedding is well aired and dry, and the room well 
ventilated. 



214 



THB STOMACH. 




6. When nervouaaess caases loss of sleep, there 
are various methods of inducing Bhimber, one of the 
most efficient being slow, deep, and steady breathing. 
By this means the lungs are filled with blood, and the 
brain is thus relieved of the congestion which causes 
wakefulness. 

7. When the head feels cold, the indication is that 
there is tiot enough blood iu the brain, and the head 
should be protected by flannel coverings. If the head 
is hot, a cl()th moistened in cool or cold water may be 
applied, the hair being first wet. 

8. In case the head is hot and full of blood, sleep 
may often be induced by raising the head of the bed six 
inches or more above the level of the foot. If tho face 
is pale and the head cold, xhe foot instead i>f the head 
of the bed may Ijo raised. 

9. For sound sleep, the sleep ing-room should not 
bo too warm, anJ tho patient should not be too warmly 
covered in bed. 

10. Avoid exciting conversation or reading shortly 
before retiring. 

Mental Disorders.— Until of late years it was 
not known that dyspepsia could be recognized by the 
mental and nervous symptoms alone ; and even yet the 
fact is not as well understood as it should be. It is 
tlioroughly established, however, at the present time, 
that this is the case, and also that when the mental and 
nervous syinptoins are most prominent, those whioli 
point directly to the digestive organs are the fewest 
and moat obscure. Hypochondria has long been 
associated with indigestion, though often attributed 
to the liver. Students, clergymen, and other mental 




STXFTOICATIC TSBATMSKT OF IMDIOSeTtDM. 



515 



workers whn Buffer from cerebral hyperemia, or chronic 
congeetioQ of the brain, are nearly alwaya victimB of 
iudigeetioa, which resultB in defective nutrition of the 
nervous Bvetem. Gloomy apprebenBiona, forebodinga, 
poeviahnesH, perveraity of disposition, religious despair, 
confusion of thought, loss of memory, abac nt- minded- 
neee, and many other forma of mental disturbance are 
justly attributable to this cause, and disappear upon ita 
removal. 

Tiie failure on the part of many physicians to 
recognize tliia c-laas of cases has consigned many men 
of ability and influence to insane asylums, with no 
hope of recovery, who might have been Bavcd to the 
world, their families, and themselvca by a judieioHsly 
directed course of treatment. Hnndreda of nervous 
women who have had their spines blistered and burned 
and cauterized for sonio supposed obscure nervous 
trouble, enduring years of torture, all without benefit, 
might have been made well by a few months of intelli- 
gent treatment for impaired digestion. A largo number 
of botli classea of invatida have come under my care, 
some of whom had been inmates of insane asylums 
for years without recovering, while others had baffled 
the skill of eminent neurologists ; and having seen a 
large number of these cases recover mental soundness 
under rational treatment and with regulation of the diet 
and regunen, I am convinced that much more attention 
should be paid to tliia class of dyspeptic cases. It is 
gratifying to see that particular attention is given to this 
matter in some of the best-regulated insane asylums. 

Dilatation of the Stomach. — This condition 
is one which has, until recently, been rarely recognized. 



, 210 



THE STOMACH. 



Ten or twelve years ago Glonard, an eminent French 
phyaician, called attention to the freqnencj with which 
both dilatation and prolapse of the stomach occur. By 
carefnl observation and logical deduction, Glenard 
showed that a large share of the must obstinate symp- 
toms encountered in dyspeptics is dependent U|>on a 
disturbance of the functions of the stomach arising from 
dilatation or prolapse of tlie organ. The principal 
canso of prolapse is constriction of the waist by corsets, 
tight skirt-bands in women, and the wearing of belts in 
men. In conjunction with dilatation and prolapse of 
the stomach, one or both kidnevg are frequently found 
prolapsed, tlie colon fallen below its normal position, 
and not uncommonly folded upon itself, and the liver 
and spleen also displaced in a downward direction. 
The consequences of these displacements are far more 
serious than any other visceral displacements which 
can occur in the body. Dislocation of the womb or 
ovaries in women, or the dislocation of a joint in either 
sex, is a matter of small consequence compared with 
displacement of the 8t()macli, the liver, or the colon. 
Space will not here permit a consideration of all the 
symptoms which may grow out of these displacements. 
Suffice it to say that most of the numerous symptoms 
previously described as observable in indigestion may 
be the direct outcome of displacement or dilatation of 
the stomach, or prolapse of the other organs of di- 



la prolapse of the stomach and other abdominal 
organs, the fact is in many cases quite apparent from 
the external form of the body. The waist is nsnally 
flat or depressed, and the lower abdomen exceBsively 




SYMPTOMATIC TKEATMENT OF 1NDIOE8TION. 217 

prominent. In addition, there is usually a forward 
carriage of tlie hips, round shouldei's, depressed chest, 
with undue prominence of the spine between the 
slioulders, and forward carriage of the head. This 
condition is a prevailing one in women who have worn 
the ordinary conventional drees. A very common 
symptom of dilatation of the stomach is a plaeliing 
sound hoard in walking or when rocking in a rocking- 
chair after swallowing a quantity of water or otiier 
fluid. Some illustrations of cases of dilatation and pro- 
lapse of tlie stomach and otiier organs associated with 
indigestion, are represented in Plate IV,- page 133. 

Treutmeiit. — In tlio treatment of this condition the 
most important measnrcs are : — 

1, Sufficient loosening of the clothing to permit 
proper expansion of tl»e body at the waist, thus allow- 
ing the prolapsed organs to return to their normal 
position. For suggestions respecting proper dress, 
which is very essential to the cure of indigestion in 
women, see page 123, 

2. The support of the lower abdomen by means of 
the Katurat Ahdominal Sapporler (^S), whereby the 
displaced viscera are lifted up into position. The 
action of the supporter is practically identical with 
that of the hands when used to lift up the abdomen, — 
a practice to which many such sufferers resort as a 
means of relieving uncomfortable, sinking, dragging, 
and other distressing sensations experienced in the 
lower abdomen. The employment of artificial sup- 
port, however, is not sufficient to accomplish all that 
needs to bo done in these cases. The viscera nmst be 
replaced by massage applied by u pkilled masseur or 



'218 



TBE STOMA OH. 



who lias been taught the normal poeilion of 
the viscera, ami how to distingnish each organ by 
palpation, and restore it to its normal position. By 
the employment of raaasage, the abdominal muscloB 
may also bo strengthened, a dilated stomach otDptied, 
and congestion relieved (31, 32, 33)- 

- 3. The ajiplicatiou of electricity, particularly by the 
einuBoidal current," to the abdominal rauselua, whereby 
they may bo exercised and Btrengtbened. I have 
foiind the application of tho sinusoidal electrical cur- 
rent to the interior of the stomach, an excellent means 
of treatment in cases of dilatation of that organ. The 
application is made by parsing a conducting wire 
through a stomach-tube introduced into the stomach. 
In one case in which every other metwure had failed, 
the patient was iu this way rapidly and permanently 

' benefited (67, BS). 

4. Carefully graduated exercise, particularly mannal 
(42) and mechanical Swedish movements (page 3''i4), 
which in an inipoilaut means of developing the musclea 
of the trunk in cases of this class. Bicycle riding and 
boating are also to be recommended, if employed Intel- 
ligently, and not indulged to excess (37). 

5. All aseptic dietary ( Diet List No. 1 ) is abeo* • 
lutely essential in these cases, and should be licrtipu- 
lously adhered to for an indefinite period. For three 

' or four weeks the patient should be confined strictly to 
R dry diet ( Diet List No. 2 ), no fluid whatever being 
allowed at meals nor until five or six honrs after eating. 

•For a dcscrii>t1on of Iho Slnusoldnl Carrent, discovered by the 
BOUior In 1883. Mw "Tbe Grapblc Study of ElKvlrlc&l Curronis In Bt>la- 
tlon to TbprKpeutlca. villi tipeclal Refer^iicp to tbe Sluiuoldal Current." 
Hodeni Medicine PubllsbluB Co., Buttle Creek. MlcL. 



BTIEFTOIUTIO TBEATHSHT Or IBDieBSTIOII. 219 

Indeed, little fluid sliould bo taken into the stomach at 
ally time in tiieao cases. If the patient is thirsty, the 
thirst may be relieved by introdocing water into the 
bowels by means of the enema. 

A person suffering from diSatiWion of the stomach 
should avoid swallowing plum stont^s anil cherry pits. 
Tlie stomach of an adult German was found, at the 
aiftopsy, to contain nine hundred and twenty cherry 
pita and seventeen pimn stones, which had been re- 
tained for at least eight or nine months. 

The writer has succeeded in curing two cafies of 
exceedingly bad prolapse of the stomach by a surgical 
operation. The abdomen was opened by an incision 
extending from the lower end of the sternum to the 
umbilicus. The stomach, the lower border of which 
lay several inches below the umbilicus on the right 
side, was pulled into position, the lower border lifted 
as high as possible, and sutured to the median line by 
means of four silkworm-gut sutures, wliich were left 
buried in the tissues. A floating kidney was also 
found in one case, and sutured in position. Both 
patients made good recovery. The tongue, which 
had for years been extremely foul, became clean in a 
short time, and other disturbing symptoms which had 
been present for years soon disappeared. 

Another method which has been employed is the 
enfolding of a portion of the dilated stomach. It is 
said that the enfolded portion disappears in the course 
of time, Stu'gical measures are seldom required, how- 
ever. I have succeeded in restoring the prolapsed stom- 
ach to position and greatly diminishing the size of a 
dilated stomach in a great number of cases, by purely 



TREATMENT OF DYSPEPSIA. 



As dyspepsia is not usuallj a fatal disoasG, thoa- I 
sands of people allow themsetvea to suffor from its 
pains and inconveniences for years without making 
serious efforts to recover. If anything is done, it ia 
most likely to be a trial of some qnack nostrum ad- 
vertised on the fence or heralded in the daily news- 
paper as a "sore cure" for indigCBtion, its merits 
certified to by a long list of fictitioas or purchased 
testimonials. Of course every effort of this sort makes 
the disease worse in the end, even though there may 
be apparent temporary relief. The sufferer finally 
settles down to the melancholy conclusion that liis 
malady is incurable, and thus lives along in a 
wretched way nntil consumption, tliut dread disease 
whicli often follows close on the heels of the hydra- 
headed malady we are considering, claims him as a 
victim, and ends his misery. 

The importance of giving serious attention to the 
treatment of this disease is further proved by the fact 
that many organic affections which, when once well 
established, it is impossible to cure, have their origin 
in indigestion. This is undoubtedly true of tuber- 
calar degeneration of tJio lungs and of other degen- 
erative changes in various parts of the body. The 
same may also be said of many nervous affections. 
This accounts, in part at least, for the almost constant 
[221] 



292 



THK 8TOHACH. 



association of impaired digestion with consumption 
and various organic affections of the liver, kidneys, 
and other orgiins. In most of these cases, the best, 
sometimes the only, hope of a cure lies ia the treat- 
ment and cure of the digestive disorder ; and, without 
donbt, if this euold be accomplished sufficiently early, 
many cases of hopeless organic disease of the lungs 
and other organs might be prevented altogether. 

The djBpeptic, of all invalids, needs to enter upon 
the work of getting well wilh a determination to suc- 
ceed, and with a resolution to do all in his power to 
accomplish that end. Though an intelligent physician 
can do much, the patient can do vastly more for him- 
self than any one can do for him- Indeed, he alone 
can control many of the conditions esaential for the 
happy termination of his Bufferings. If the dyspeptic 
would recover, he must seek carefully for each of the 
causes of his disease, and remove them. It is of no 
use to hope for recovery without doing this. If the 
cause is in the manner of eating, let him take care to 
eat properly. If he has erred in eating too much, or 
in eating improper articles of foixl, let him make a 
thorough reform in this regard. If the difficulty has 
been in overwork, too much anxiety, too little time for 
digestion, or too sedentary habits, he must get away 
from his care, his business, his writing-desk, and seek 
health in. outdoor exercise, with happy, cheerful asso- 
ciatioDB. The careworn, burdened mother must have 
relief from the tedium of her routine life. A journey, 
a visit to a friend, or eome other means of diversion 
must be adopted. Whatever the cause has been, it 
must be removed. No medicine known, no matter how 



TEEiTMENT OF 



223 



I 
I 



potent nor how skilful its administration, can antidote 
the effects of the transgression of physical laws. Na- 
ture is inexorable. She demands obedience, and will 
not 1)0 put ofE with any subterfuge. 

The dyspeptic must also remember that it is not 
only his stomach which is diseased, but that every cell 
and fiber of his body is more or less injured by the fail- 
ure of the stomach to supply proper nourishment for 
rebuilding the tissues, or by poisoning from the products 
of fermentation and decay which have been absorbed 
from the dilated or prolapsed and sluggish stomach. 

It must not be expected lliat recovery from the con- 
sequences of a disease of many years' standing can be 
effected in a few weeks. Getting well is a process of 
growth, as much as the raising of a crop of corn or 
the development of a tree. The diseased stomach must 
lie grown out of its vicious ways and into a healthy con- 
dition, under the influence of correct habits of eating 
and appropriate conditions nf regimen and treatment. 
Many symptoms which have been long establislied will 
persist for some time after proper treatment has been 
established ; but this fact must not discourage its con- 
tinuance. The patient should weigh himself at the 
beginning of treatment, and thereafter at least once a 
week. Loss of flesh for the first few weeks must not 
be a cause of discouragement, however, as it is a fre- 
quent occurrence. A gain in flesh may, however, be 
regarded as one of the most promising symptoms in 
cases in which any considerable degree of emaciation 
has existed. 

It must not be supposed that any one plan will ac- 
complish the result desired in all cases. There are 
IS 



:i24 



varione forms of dtBpepaia, each of which requires 
special mauagemeDt, though the general principles laid 
down apply to all clasaea of the disease. 

Diet and Regimen. — In the treatment of this dis- 
ease, proper diet and regimen are of first importance. 
It is necoasarr, however, that thoy should be moat care- 
fnlly adapted to the wanta of each individual case, as 
nothing is timer than tlie old au-laga that '*what is 
one man's meat is another's poison," when referring 
to cases of dyapepsia. The common plan of recom- 
mending some special dietary to all dyspeptics indis- 
criminately is a most pernicious one. We hear much 
of tho "grape cure," the "beef cure," the "fat cure," 
the "cod-livor-oil cure," the " miik cure," and sundry 
other special diet cures of dyapepsia, as well as the 
"vegetarian cure." Each of these diets may be of 
eerviee to some special case, but all aro totally unfitted 
for all cases alike. 

It is not an easy matter to induce individuals suffer- 
ing with dyspepsia to deny the demands of appetite. 
In many cases the ajipetito is perverted, and the will is 
80 weakened by long-continued disease that the patient 
loses aelf-control, and thus himself constitutes the most 
dilBcalt obstacle in the way of his recovery. If a cure 
is expected, the directions given must bo followed im- 
plicitly. In no other way can a confirmed dyspeptic 
hope for recovery. All bnt one or two requirements 
may be carried out, yet fuiluro in one particular be 
sufficient to make all other efforts useless. 

Dietetic Rules. — Although there is no such thing; 
as a universal diet for dyHpeptica, there aro certain arti- 
tlfjs which must be discarded by all j^reonii who havQ 



TRBATUENT OP DTSPIPStA. 



335 



I 



weak digestion, and certain dietetic mlea which must 
be conformed to bj all. To the most important of 
these attention is now called. 

1. Eat slowly, masticating the food very thor- 
oughly. The longer the food remains in the mouth, 
the less time it will spend in the stomach, 

2. In general, dyspeptic stomachs manage dry 
food better than that containing much fluid. 

3- Avoid drinking at meals ; at most, take a few 
sips of warm drink at the close of the meal, if the food 
ia very dry in character. 

4. Be careful to avoid excess in eating. Eat no 
more than the wants of the system require. Sometimes 
less than is really needed must Lo taken when digestion 
is very weak. Strength depends not on what ia eaten, 
but on what is digested. 

5. Never take violent exercise of any sort, either 
mental or physical, just before or just after a meal. 

6. It is not well to sleep immediately after eating, 
nor within four hoars of a meal. 

7. Never eat more than three times a day. and 
make the last meal very light. For most dyspeptics, as 
well as healthy adults, two meals are better than more. 
Tlie length of time between meals shonld not be lesa 
than seven hours, unless a special dietary is followed ; 
S : 00 A M. and 3 : UO p. m. are suitable times for 
raeala. 

8. Kever eat a morsel of food between meals. 

9. Never eat when very tired, whether exhausted 
from mental or physical labor. 

10, Never eat when the mind is worried or the tem- 
per ruffled, if possible to avoid doing so. 




11, Eat only food that ie easy of digestion, avoid- 
ing compliuBted and indigestible dishes, and partaking 
of few kinds at a meal. In severe cases it is often nec- 
essary to confine the diet for a time to one or two arti- 
cles of food which are the most easily digested and 
asaiinilated- 

12. Must persons will do well to discard the use of 
meats, and add to their bill of fare an increased pro- 
portion in quantity and variety of cereal foods. The 
foods manufactured by the Battle Creek Sanitarium 
Health Food Company, are to be highly recommended. 
They have been prepared especially for the use of in- 
valids with feeble digestion, and are just what they 
claim to be. Tlio writer baa prescribed tbeni in many 
thousands of cases, and finds them indispensable in 
the treatment of the hundreds of invalids witli disor- 
dered digestion who come uuder his care amiually. 

As an aid to the reader in the selection of a diet 
suitable to his c&so, the following diet lists are pre- 
sented, which it is hoped will be found helpful : — 

DIET TABLES. 

The following is a list of dietaries which are based 
upon observations made in connection with the exact 
methods of analysis of stomach fluids and the study of 
digestive disorders, to which reference has already 
been made. They have been tested in the treatment 
of many thousands of invalids at the Medical and 
Surgical Sanitarium at Battle Creek, Mich., and have 
proved highly satisfactory. The made dishes called for 
are cooked in accordance with recipes given in "Sci- 





I enco in the Kitchen," by Mrs. E. E. Kellogg, A. M., 
[ published by the Modem Medicine Pah. Co., Battle 
[ Creek, Mich. 

ASEPTIC DtETARI'. 

EupGcially adapted to caucs iii which fermentation is 

I present, alao in caseu of clirouic biliousness, sick-head- 

, jaimdicG, Bright's disease, gastric and intestinal 

I catarrh, simple dyspepsia, most cases of hyperpepsia, 

-End cases of hvpopepaia not of extreme degree. 

Sterilized FocmIs Prepsrad without HIili or Egfs. 



P»s purJP. 


Macaroni with uim 


to Bromoso. 


LeulU purif. 


saui.-t'. 


Nut porridge. 


Btana puric. 


Fruit toast. 


Nut butter. 


Nuts puH«. 


Vegetable broths. 






Corn son p. 


aterllUod butler. 


Oriinola. 


GRAINS. 




Gruham musb. 


Barley gruel. 


Boiled rye. 


Hlxcd niDBli. 


Oracliea wheat. 


Bice water. 


Olulon musb. 


Boiled wheat. 




Granolamnsh. 


Molded wheat. 


Browned rice. 


HoidId; flakes. 


Pearled wbeat. 


Hulled corn. 


Oatmeal blBDC-maDge. 


Boiled wboat. 


Gluten. 


Gluten wator gruul. 


Orabam gtltn.. 


Grains of gold. 


GrshBniKrlU Bfel. 


Bran Jelly. 


Hominy. 


Corn-meal btuuI. 


Grain Jellj. 


Popped Corn. 


Orabam gracl. 


Jellied oatmeal. 


Corn goflu. 


Oatmeal «ruel. 


Boiled oals. 


Wbeatgoflo. 


Split pea Kup, 


Baked potato. 


Pnlp succoiasb. 


Lentil Houp. 






Green peua. 




Kornlet. 


Lentil toast. 


Orjstal nbeat. 




OraiKme brown bread. 


Btltlts. 


prepared wltbout 


Zwieback. 


CrUp§. 

FRESH FRUITS. 


milk. 


OiapM. Bvrrles, 


feaubes. 


Pearg. Melons. 


Balslns. irbetrlrs 




Figs. Dates. 


Apples. Outrau. 


Plaeapples, 


.Bananas, 



THB erOVACB. 



Baked apple deawn 
Baked lomato. 
Prnne mann&lade. 



Slewed pro net. 
Slewed nlslns. 



Apple Jelly wltkont 
Cranbeniu and 



Apples (t««ed wtth 



FRUITS COOKED WITH SRUHS. 



Pculed wheat with 


Rice with ralsiD*. Balain grnel. 






Pearled taftey with 


Urtiham grll« with touoatoiaD 




ralslm or flgi. Banaiu (oast. 


Cracked wheat wlih 


Graham apple miuh. Tomato loasu 






FnHiia with Bg ^m-c. 


Farina with fresh fruit. Prune pie wlih 


Rl<;« with Us «m-e. 


Pcmclied egg». trmniiiji I'ru 



B> F4M>d§ which Eocoiinge Asepsis of the Stomarb and InUatiiies. 

All the articles named in the preceding list of ater- 
ilized foods prepared without milk or eggs, with the 
addition of the following : — 



Hedlnm boiled egip. 
Beateii whites of egg>' 



Soft bollMl ei 
Beaten wboli 
Cottage cheei 



C. Foods which do not Fermeiit in a Stomaeh oT 
Moderate DlgestlTC Ti|ror. 
All the preparations of grains, fruits, milk, eggs, 
and easily digested vegetables in Diet Lists Nos. 1 to 
10, only raw milk excepted. 

With tliis list it is necessary for many patients who 
have lung aiiffored from dilatation of the stomach, to 
employ some intestinal antiseptic, of which the best is 
charcoal, in the form of antiseptic charcoal tablets (49), 

DIET LIST NO. 2.— DRY DIETABT. 

A dry dietary is indicated in cases in which there is 
dilatation of the stomach, with slow absorption. In 



TRBATUBNT OF 



cases of this sort, Hqnid foods remaiti t(Hi long in the 
Btomacb. 

The chief pnrpoee of a dry dietaiy ie to secure thor- 
ough mastication of the food ; hence the articles in the 
following lists should be taken without water, milk, or 
other liquid. Granose is an ideal article of food for a 
dry diet, as it stimulates the ilow of saliva to a greater 
extent than any other food with which we are ao-1 
quainted. Granose, combined with nuts, nut meal, ' 
bromose, or the yolks of bard boiled eggs, may often 
be oaten with advantage almost exclusively fur a few 
days at the beginning of a course of dry dietary, 

A. Drj Met- 

This list includes all the unfermented brcadx I Diet 
List No. 13), and in addition, — 

Yolksot hurd boiled eggs. Bromose I dry }. NutbaU'T. 

Gmiiost. Popped corn. Nudneal. 

Stuniued ags. Sterilized butter. Roosted ;>ltuuuils. 



B. Modified Orr Diet. 

This list includes all the preceding list ( A ), and in i 
addition the following : — 

Boiiten whole BKgs. 



Poanhed eggs. 
Card led egg^ 
Floated vggs. 



Popped corn. 
Musbed pens. 
Masbcd beans. 
Stewed prune-i. 



DIET LIST NO. 8.- SITB0GEN0II8 DIETARY. 

The nitrogenous elements of food are also pepto- 
gens ; that is, they stimolate the secretion of gastric 
juice, and hence foods of this class are especially 
adapted to cases of hypopepsia and ajiepsia, in which 



230 



THE 8TOUA0H. 



the production of gastric juice is alwaja deficient. Al- 
bumeu and casein are the most important nitrogenous 
eletnenta. Egga consist chiefly of albumen ; milk con- 
tains casein in abundance ; nnts are rich in aibumcu 
and vegetable casein ; peas, beans, and lentils contain 
a very large proportion of vegetable casein. At the 
beginning of a course of treatment, in extreme cases of 
apepsia and bypopcpsia, it ia sometimes necessary to 
confine the diet to a single nitrogenous food, as kumyss 
or knmyzoon. Later, eggs may be added advanta- 
geously, then some farinaceous food, as gruuose, with 
nuts, and still later the various unfennented breads and 
soft grain preparations ; but dry foods are to be pre- 
ferred. 

Beans cur€c. 

PifHS purtc. 

Nats puHu. 

Milk (Diet List No. ». 



Almund meal. 
LbdHIb with iiu 



This list consists oxchisivcly of fai 
tious of a character easy of digestion. 



Crenm rice soup. 




TKBATMBNT OF DYBPBPaiA. 



Glaten mash. 



MacaroDl baked vlt h 



Burlvy gruvl. 
tii^bara grits grui-l. 

Oatrntal grael. 
UllkKTiiel. 
Gruham grnvl. 
Com-nnml grncl. 
Outmeal porridge. 

b1 blanc-muGge, 



JelllHd uutmeul. 
Barley milk. 
Milk panadu 
Bran Jelly. 

Rice molded. 

Bice water. 
Gralnjeilj. 
Cracked wbeai. 
Uoldcd wheul. 



Oranoli. 
Bullpd outB. 
Hollud rye. 
Puarled wliiuit. 
nulled Liirn. 
Popped curi). 

Hominy (iHkcs. 
Corn RuHo, 
Grains uF gold. 
Cryntal wbeat. 



DIET LIST NO. 5.— Mn,K. 



DIET LIST SO. n. 



TLis list is composed entii'ely of ]>reiiaratioiis of j 



Hedlutu bulled eggs. Soft boiled eggs. (.'urdlei 

lliird boiled yolks ot eggs. Poached pggs. BeHU'D 



The articles in this list contain milk or some cei 

preparation iu addition to eggs. 

Gluten custnrd. Oranow custurd. rnsum toast witl 

OlutsR meal custard. Rice castard. poncbed eggi 

Bread cnstard. Rim with egg. Poat-lied uggs on 

Parlns cnstard. Crucked wheat cuslurd. foii*t. 

DIET UST SO. 7. 

Foods which iiro easily disintegrated, and hence . 
to ca^es of dilatation of the stomach. 



UNFENMENTED BREIOS. 

(Ulct List No, 13.) 



THE BTOHACH. 



Broimed rice. 
Corn BoBo- 



FRESH FRUITS. 

GrupU!.. Uriniges. 

FRUITS WITHOUT BUOMR. 



Baked apples. Nli 


(wed pruues. ITune dessert. Prult iubM. j 




FRUITS COOKED WITH GRIINS 




Graham peach mush. 


MlicaroQl with tomato 


Orahum grIU with 


Grape mnsh. 




rablna, dales. Op 


Bran Ola gmpo mush. 


BIce with fig sauee. 


Act. 


Oatmi>a! truH mubh. 


Farina with fig suuce. 


Rife with raisin*. 


Granoln fruit mush. 


Pearled barley. 


Wheat with herrlM. 


Orunola pt^acJi muitb. 


Qrape toast. 


Farina with tro»h 


Graham apple mush. 






Blackberi? math. 


Banana t«ust. 


Bice and stewed 






apple dessert. 


miub. 


Apricot toaiit. 


Cracked wheat wtUl 


Oranola apple mush. 


Berry toast. 


»t«amod apple. ' 


Lemon barley gruel. 


Poath toust. 




Baspbcrrf grila gruel 


Farina fruit mold. 


swwed fruit puddl* 


Raisin gruel. 


Bed rlee molil. 


Wheat with peacluft 


OraiiUBruel. 


Pearled wheat with 


Riee with peachB*. 


Lemon gluten gruel. 




Prune pie with gra- 


Lemon oatmeiil gruel. 


Peurled barley with 


nolB erust, 


Boiled wheal. 


VEBETHBLES MD LECUHES. 


Grunoae sbortctke. 


Peas purie. 


Oreeo peas. 


Kornlct. 


Lentil pur^. 


Vegetable broth. 




8pllt |»H8. 


Corn pulp. 

EGGS. 


NulBwItbiontlla. 


UedlnmboUed eggs- 


Poachud ugRs- 


SoftboUedegga. 


Beaten nhites of oggB. 


Curdted eggs. 


Beaten whole c«gi. 


Bard boiled yolks of eggs. Flonted eggs. 






■IISCELUUIEDUS. 




Now Cru KumrKi. 


SUrlUied butter. 








Nut butter. 


Knmjiooii. 




Nut meal. 



DIET LIST KO. 8.— AHTI.FAT DIETARY. 

An anti-fat dietary need not neceBBarilv exclude all 
starchy foods. The moet important points to be ob- 
served are — 



THSATHBNT OF DTBrBPfllA. 



333 



1. Limitatioii of food to the smaUest amount with 
which the strength can be maiDtained. 

2. Restriction of the diet to one article, or at most 
to two or three. 

3. Avoidance of fats. 

4. Avoidance of liquid foods of all sorts. If ku- 
mysB or kamyzoon is used, it abuuid be made the chief 
dietary. 



GrHDOsL' (oatentlrj). 


Oluu-n, 


Celery <ooo 


Hard rolb. 


Gluten biHcult. 








Tomaloes. 


Medium bollod eggs. 


Gluten ouslard. 


String belli 


Booteii whites ot eggs. 


Sour apples. 




Poached eggs. 


Oranges. 


OrecDS. 


Curdled eggs. 


BtTBW berries. 


Sticks. 


FloBled eggs. 


. BunuaiLS. 


Zwieback. 


Son boUed eggs. 







DIET LIST NO. D.-FAT AXD BLOOD DIETARY. 

Those foods which abound in starch, sugar, dex- 
trin, aiid easily digested fata, are the moat conducive 
to fattening. At the head of the list stands bromoae, 
which contains one fourth its weight of emulsified, or 
partially digested, nnt fat, and nearly forty per cent, of 
digested storeli. The following articles are fattening 
in character : — 

Fruits and Nuts (Diet Diet List No. T. 
Lint No. m. Diet LlKt No. 13. 

Diet List No. C Bromose. 

DIET LIST NO. 10.— FEDITS AND NUTS. 



I 



Grapes. 


Oranges. 


PcBcbea. 




Pineapples. 


Bans nils 


RalslDS. 


Apples. 


Cherries 



is* 


THE STOMACH. 






B.-FRUITS COOKED WITHOUT SUGAR, 


Baked apples. 

Htvired raisins. 
Applesslpwi'dni 

Usked iKurs- 


Appli'ji-113' without 
tliralslns. sagni. 

ITimE d^aserl. 
Ptuw marmalade. 

C.-FHUITS WITH SUGAR, 


Crunburries and 

»*«etapplo* 
liakeil apple deisert. 

j-U'Wed prune*. 


l-TifiTmenlc-dwl: 
liluiwvd fruits. 
(.luiQwl fruits. 


BL-. 0«pcjeily. 
Fruit Jalces. 
B»k«l.iuluce. 

D.-NUT8. 


LcmoD apple. 
fltron appl«. 
Bunaiias tu fruit 
sirup. 


Mmoaas. 
n\ckary tints. 
FllborW. 


rhestnutBbullcil^jr 
Almond meal. 


Nut meftl. 
Nut porridge. 



DIET LKT NO. II.— LIQUID DIETART. 

A liquid dietary is especially indicated in fevers, j 
and iu some cases of painful dyspepsia, especially ca 
of hyperpapsia accompanied by much irritation, aa in- ' 
dicated by pain on pressure over the pit of tbc stomach | 
and pain after eating. The purposu of a liquid diet is t 
to present nutriment in a form wluch will tax the 8to 
ach as little as possible, and secure the early emptying'! 
of the stomach by the passage of its liquid contents ] 
into the small intestiui'. 



Olutcn KTUul. Fruit Juice*. 


KumysB. 


Malted Kluten eruel. Burle? WBl«r. 


Kumysanog. 


Fruit and unts gruul. Nut porrldgi;. 


Kamyuwu. 


Nols and gluuin gruel. Cruam. 


Cottasc cheese. 


VegoliibIesoup{p<.'a,lonl[I, Hot nillk. 


Curdlisd eggs. 


IWBU, lamatu. rlue.Mi" Boiled milk. 


Bcat'nwhlteBofe«Bl 


ley, and corn). Buttermilk. 


Beaten whole esgs. 


Vegetable hnHli. Custard. 


Bromose. 


DIET LIST NO. 12.- 


FETEE DIET. 



In fever the digestive powers are feeble. With the 1 
exception of boiled rice, only liquid food should be j 



^H taken. 

■ most t 

I 



TKKATMENT (. 



235 



taken. Graels and Bimilar farinaceous preparations are 
most suitable, and they should be boiled several lionrs. 
A. To be used during the active period of the fever, 
while the temperature is high : — 



Barlay waWr. 


Gmnolii RToal. 




Prunes pnrie. 


Barli^y gruel. 


GluWn BTUel, 




Bromose. 


Strained tmlmoal gfucl. 


Fruit aniJ nnttrruel. 


Kumys.1. 


Bollod rico. 


Un(»Diriit«d a™ lie 


KumywHin. 




Juice. 
Fruit jnlcBs- 




Biittpmiilk. 


B. During con 


valescence, ir 


1 addi 


ition to the above,- 


the following may 


bo used : — 






MlUi porrldRe. 


Whipped Bgg. 




Feai'bes. 


Cream tonsl. 


Kumysa nug. 








SlfWi-d froll. 




ZwIelHf'k. 




Ititked uppli-s. 




riifermrntpdbreadu 


PoBClu-d PKBS. 






'fuustt'd wliolu-wheat. 


Costard. 






wafrrs. 


DIET UST NO. IS.— CNFERHEIfTED BREADS. 


Whole-wboat puffs. 


Snow Btms. 




Buawii blspiilt. 


L\>TD puffs. 


Wfauie-nlieat aem*. 


Kig sandmlL-b. 


Unkbam puffs. 


Olulen watt^n. 




Apple sandwich. 


Rolls. 






Grabam Hakes. 1 


ToasWd rolls. 


ToMiwI wafers 




Gluten. ' 




Dyspeptic wufi 




Oraiiola. j 


BreBkfiKit roll*. 


Crisps. 




Crusts. 


GrahuiD gemN. 


Grnbam crlsim. 




Zwieback. 1 


Ryp Beroa. 


Graham <:™<;k* 


T9. 


StIrkB. 



Blueberry gems. TcKLSted beaten biscuit. Hne cukit. 

DIET LIST NO. 14.- FOR A BOTTLE-FED INFANT 
CNDER (ilX MONTHS OF AGB. 

Sterilized cow's milk properly diluted with boiled ] 
water, barley water, or oatmeal water. I'ndor throe ,1 
months of age, use one third milk ; three to six montfis, 
one half milk ; after six months, two thirds milk. 

Barlry Water. — Boil one tablespoontul of whole barlej'lo on 
enameled sauce-pan or a double boiler for live minutes, and lliri>w 
the wat«r awaj ; then add one and one-half pints of water, slowly 
almmer down to one idnt, then strain. To be used for dllutinic 



986 THB BTOUAOH. 

mtllc, orssasubMltute fur it when cow's milk dix'S not Hgree, tuid 
in cues of vomiling. 

Oatmeal Water, — One tablespoonful of fine o&tmeal, one pint 
or boiling water. Boii for one hour, keeping the quantity of in- 
ter good ; Bttain. To be used instead of plitin water for diluting ' 
milk. ! 

ffarteif WaUr and Cream.— Five parW of barley water mode ij 
as directed above, to one part of eterilixed cream, 
8ubtUt«ttfoT MothrrS MiUt.— 

Milk lox. 

CrcHin a OK. 

Blcarboimli' of nihIu I gt, 

Hilksugiir 3 dr. 

Water to m.iki- 8 m, 

Orudualty increusi! the quantity of ir.vum and milk as th< • 
child lidviinces lii a((i'. 

DIET LIST NO. l.l.-FOR \ TEETHISU INTAXT. 

As Buoii as a child begiiiH tu cut its tuetb, it flbould-J 
begin to u^o tliem. Iti addition to Diet Lint Ko. 14, ( 
the child may bo fed stewed fruits in Bmutl quantities, 
thoHo being avoidwd whit-h require much sugar fcr Hwoct- 
eoing. Such fresh fruits as etrawberries, grapes (ex- 
cluding the soods and Hkinsj^ ripe poaches, and very rip© 
Bweet or subacid apples may bo given, also baked 
Bwoet apples and peara. Grauose oaten dry, or granose 
and granola eaten with milk or fruit jtiice, are perhaps 
the best of all cereal foixls for an infant. Zwieback a 
softened with milk or cream, and gluten gruel (Saui-'a 
tarium Infant Food) are also excellenr. 

DIET UHT NO. ltt.-FnR A (HILO FROM ONK TO 
FIVE YEARS OF AUE. 

Tlio most suitable foods are those in Diet J 
KoB. 1 and 2, which a child from two to five yei 
of age may oat without injury, provided, of course, that 



TBEATJiIENT OF DYSPEFBIA. 



23T 



the food is properly masticated. Vegetables sbonld be 
avoided until the second teeth begin to make their ap- 
pearance, with the exception of the following : Aspam- 
gUB, green peas, and baked sweet potatoes. Children 
snbject to colic or other forms of indigestion should ' 
avoid potatoes. Purees of lentils, peas, and beans, 
and bean porridge may bo allowed. 

The articles included in Diet Lists Nos. 22 and 23 
should never enter into the dietai-y of children, being still j 
more unwholesome for them thun for adults, 

DIET LIST SO. 17.- EATING FOK STBEKOTH. 

Those articles are most useful in developing nerv- 
ous and muscular energy which are the most easily 
digestible, while at the same time possessed of the 
highest nutritive value. The nutritive value of the 
following articles is, on an average, with the ex- 
ception of eggs, about three times that of beefsteak, 
while they tax the digestive organs less : Peas, beans, 
lentils, whole-grain preparations, bromose, granose, 
granola, uufennented bread. The food preparations , 
mentioned in Diet List No. 1 are especially to be com- 
mended for producing strength. 

DIET LLST SO. IS.- DIET FOB DIABETES. 

An exclusive meat diet was formerly recommended 
for diabetes, but it is now known that such a dietary 
does not give the most satisfactory results, and in- 
volves the danger of sudden death from an excessive 
accumulation of tissue poisons which the kidneys are 
unable to eliminate. 



Qlaum biscuit. 


Asparsfii-. 


KumyFtfl. 


Nuts. 


LeUuce. 


Sntnuri.. 


Callage cbceii 


I- Nul. butter. 


Celery. 


OmoB. 


ButtermUh 


^utmeul. 



THB 8T01HOB. 

DIET LIST SO. in.-FOR RHECMATISM A5D GOCT. 

It is especially impoi'tant to avoid an excess of ui- I 
trogenous fouU ; hence meats of all kinds must be | 
avoided. In cases of dilatation of the stomacb, milk 1 
must also be avoided. lu most cases the articles in--] 
eluded ia the following diet lists are to be preferred : 



DIET LI8T KO. £0. 

For gastritis, gastric catarrh, and ulceration of the I 
stomach. 



LltiDld foods (DIft List 



DIET UST NO. 21, 

ITnfermentcd gniliuiii Apples 



pufHilgc. 

FOR (OSSTIPATION. 



Curdled ogt 

Rieg-nog. 

Kuxoyiunu, 



Urwked wheat. 


Must raw tru1t«. 


/.wiebuok. 


Grits. 




Goflo, 


Oatmeal musL. 


l-riBlnl wbL-Hl. 


rnjHori.. 


DIET LIST NO. 


S2.- ARTICLES DIFHCULT OF DKIENTION* i 




ANIMAL FOODS. 


V 


Pork. 


Scrambled eegs- 


Mac^kerclandullollrftidbi 


TmI. 




Salt bab. 


OOMB. 


llaslivd and atvwud 


lirliidaixd smoked flah. 


Urer. 




Surdliira auil otber Bsb ' 


KMncj. 


Snltnd BDd Kdokcd 




nwiM. 




l>HBit«r, crebB, etc. . 


SmiiSUBi.-, 


Melt«lhutterai.il all 




Hard Iwllisl pggs. 


VEGETABLE FOODS 


Fried mean of all aDrtel 


Warm brcnd. cspr- 


Oriddle-cBkPB. 


Mustard, pepper, splCM, 


i^lallr vbeti eutvi 


1 Pried bread uud vi-Ku- 




wltlihutliT. 


l»l>lf«. 




Mufflnis. 


OlllDBS, 


Kiiw gniM ur vegetablM. < 


Buttered tonsl. 




ItHworlmiHTfectlrcoolM*' 


Pies. cak«». mid III 






•ort« ot putn'- 


Tea. cofft-c. tocoa. 


"■'"""■ a 



TREATMENT OF DYSPEPSIA. 



239 



FOODS NOT EASY OF DIGESTION. 

The following articles are miicli more digcstiblu than 
tliose just named, but are aeverthelesa so difficult of 
digestioii that persons with dilated stomachs or weak 
digestive powers are compelled to wholly abstain from 
their use to avoid inconvenieuce from indigestion ; — 





AKIHAL FOODS. 




AoltDSilsoupsaf all loHs. 


Tripe. 


Oodflsb. 


Beel. 


Tnrkej. 


Oysters, raw. 


Lamb. 


Duck. 


Butter. 


Game. 


VefiETlBLE FOODS. 


Roust meata. 


Puutoes. 


PtUD.9. 


Salads of all 


Turulps. 






CabbngB. 


Plneupples. 




Tom»toes. 


BiKta. 


Uoosebprrles. 


Pens (wUolo and dried). 


Carrols. 




Bguus (wbolo and dried). 


Splnnch. 


Blackberries. 






liLulMtrb. 


fruits. 


Vegetable amp-.. 


Jellies. 



I 



DIET LIST SO. 28.— FOODS WHICH PROMOTE FEBMENTA- 
TIOX AND DECOMPOSITION IS THE STOMACH. 

These are of three classes : A. Foods which are fer- 
menting or decotDpusing when taken into the atomach', 
B. Foods which readily undergo fermentation in the 
conditions present in the stomach when the digestive 
vigor is somewhat impaired ; and C. Foods which fer- 
ment in a diluted btouiach. 

A. Fermenttns or DecompoBln; Fvods. 



B. Fowls which Reodil; I'liilprga FennenlJitlotii 




I 

LHIIglll 
hy til 
ming 
furtm 



e treat^ I 



l^nku, r. & Jl VkKfrnm^grttrnmBmotin die treat- 
XM^timt. — Ck-immw tBtmaa^d fareai csl into Uun 



tjf^mrnr. — A pnimaboa «f vtwat in vhicb the 
gnun ifl finH tl»<r(>o^T cooked, tben compresoed into 
ettrvimly thin flakes, wfaidi are afterward baked untU 
■lighll;. brown. T».i« f.joj can be eaten and digeatt 
inBiiy |M-rBMnii wlio can digest nothing else. 

•fft. — A |rreparati<iii of wheat, cx)rn, aod o 
Wlnglud in midi |.roiM.rtion« nii to rondt-r tlio mixtorsj 
piir/aul tuuii, uial trvatod Id mteh a uiauu«r aa to i 




TREATMENT OF DTBPKPBIA. 



241 



digest it. This food ia capable of snstaming life atij 
longtb of time. 

Gluten Biscuit. — A small biscnit made of wheat 
flonr from ■wliicli the starcb has been carefully sepa- 
rated by washing. From this biscuit, carefully dried 
and browned, gluten meal is produced. 

fiirflmt^CertW.— A substitute for coffee, having a 
pleasant, aromatic flavor, and freo from the anwhole- 
Bome properties of tea and coffee. 

Bromme. — -This is a preparation having for its basis 
carefully selected and prepared nutn. It contains about 
forty per cent, of digested starch, twenty-four per cent, 
of digested fats, and twenty j)er cent, uf finely divided 
albuminoids. It is one of the most valuable uf all the 
fat- and blood-making foods. 

Ifut Mi'ul and Nut Butter. — These are nut prod- 
ucts of a very palatable, wholesome, and highly digest- 
ible character, and valuable stibstitutes for animal fats. 

Gofio. — This is a preparation of parched grain much 
employed by the natives of the Canary Islands. After 
being parched, the grain is ground, and mixed with 
milk or water. 

Kvmysii'm. — This is a lactated preparation "f milk 
prepared by fii-st sterilizing the milk, and then subject- 
ing it to the action of a special lactic acid by which is 
produced a ferment whereby the BUgar of milk contained 
in it is converted into lactic acid. It is a very easily 
digestible and highly nourishing article of food, and is 
of great service in certain forms of indigestion, as well 
as in diabetes and general malnutrition. Ordinary ku- 
myss and buttermilk, though somewhat inferior, are 
useful subatitutea. 



THE BTOHAOE. 



^K eae< 



When kumyzoon is made the solo article of diet, it 
Bhoulil be taktiii in quantitioB of two to three quarM— 
daily and at intervals of four or five hours diirin^l 
the day. 

Flesh Food. — It will be noticed that meats of all 
kinds arc omitted from these liets. The reason for this 
is that fleeh foods require strong digestive powers to 
disinfect and digest them, since they are not naturally 
adapted to the human stomach ; hence, while they are 
apparently well tolerated by persons in health, a person 
whoso stomach is in a diseased condition will do better 
to adhere as closely as possible to the natural diet orig- 
inally intended by the Creator for tlie sustenance of hu- 
mau beings, as indicated by the command to Adam : " I 
have given you every herb bearing seed, whielt is npoa 
the face of all the earth, and every tree, in the which 
is the fruit of a tree yielding seed ; to yon it shall be 
for meat." According to tlie most eminent compara- , 
tive anatomists, the anatomical structure and digestivd j 
functions of man agree entirely with those of sucbJ 
purely frugivorous animals as the chimpanzee, tho| 
orang-ouiang. and the gorilla. 

Antisepsis of tlie Mouth. — So long as the ^ 
mouth is swarming with microbes, which is always the 
case when the tongue is coated, and the teeth uncleanly 
and presenting unfilled cavities, thousands of germs are 
carried down into the stomach with every mouthful * 
footi or drink swaUowed. The first step toward i 
sis of the stomach, and a most essential thing in 1 
treatraent of indigestion, is mouth cleiinliness. 

Modern researches have shoKti that nearly all die- 1 
eases of the mouth, as well as a large share "f the dis- 




i 



TBIATltSMT Ot DfBPXPfilA. 



eases of the stomach, are due to the action of germs 
which iiDd lodgment there. The mouth is peculiarly 
exjwaed to the attacks of j^erms, ae it is located at the 
very entrance of the body, and a portion, at least, of the 
respired air passes tlirough it, and the germs readily 
find lodgment about the tongue, cheeks, between the 
teeth, and elsewhere. The nmcua secreted by the 
glands uf the mucous membrane lining tlie mouth, is, to 
scmie degree, antiseptic in character, and possesses 
gtirmicidal, or germ -destroying, properties to some ex- 
tent. When the mouth ia kept clean, this disinfecting 
mucus is capable of thoroughly protecting the struc- 
tures of this portion of the body against the attacks of 
microbes ; but when particles of food are left to lodge 
between the teeth, the germs, finding abundant soil in 
wliich to grow and multiply, Ijecomo so numerous that 
the poisonous substances which tbey produce neutral- 
ize the antiseptic mucus so that it becomes powerless 
for protection. 

Meat, more than all other foods, is injurious in this 
respect, for the reason that its fibers readily lodge be- 
tween the teeth, and are not easily removed, and for 
the further reason that it furnishes a kind of soil in 
which germs grow with, the greatest rapidity and de- 
velop the most virulent properties. 

It is thus apparent tliat thorough cleanliness of the 
teeth and mouth is one of the most important hygienic 
measures. Tliis fact becomes still more apparent when 
we remember that the act of eating or drinking and the 
frequently repeated act of swallowing to clear the throat 
from mucns, a practice which cannot be too much dep- 
recated, are the means of carrying down int<] the atom- 



S44 



THE STOMAOa. 



1 



ach any microbeB which ma.y be present in the month. 
There are certain microbes, alan, which seem to have 
their habitat in the mouth, particularly those of diph- 
theria, pneumonia, and conanmption. It is not know&J 
that these germs propagate outside the Immau bodyjl 
except under artiiicial conditions ; but they find readya 
lodgment in tho mouth, and are often present there ia3 
persons apparently enjoying perfect health, waiting t 
opportunity when a severe cold or some other depreae 
ing agent shall, by reducing the resistance of the body^J 
enable them to obtain a stronger foothold, and to maoir'J 
fest their presence by the characteristic symptoms < 
diphtheria, pneumonia, or some form of tubercuU 
disease. 

A very excellent means of cleansing the teeth is t 
Antiseptic Dentifrice prepared by the Modern Medicin 
Company, Battle Creek, Mich. Tho basis of this prep* 
aration is the extract of the bark of the famous eoap< 
tree of South America, one of the most rcmarkaU 
cleansing agents known. The antiseptic properties < 
the dentifrice are due to the pure cinnamon oil which ll 
added. These substances are combined with very t 
precipitated chalk, making a detergent paste which i 
most effective in its cleansing action. Directions for i 
the use of the dentifrice accompany each package. \ 
Simply rinsing the mouth with cinnamon water, pre- \ 
pared by a<lding half a teaspoonful of cinnamon € 
to half a glassful of water, is a useful means of disin- 
fecting the mouth, to be used after thorough cleansing 
with a tooth-brush. 

Artificial teeth must receive as scrupulous care aa 
tlie natural teeth. It is cunaidered best that they sbonlil 




TREATMENT OF DYSPEPSIA. 



245 



I 



be removed nt DJght. After tliorough eleanBing they 
sliould be pkcod in a propar receptacle containiug a 
quantity of pure water. This will prevent deposit from 
insects and the development of fungi, which often grow 
with great rapidity, especially in warm seasons of the 
year. 

The distinguishing features of the several forms of 
dyspepsia and the general lino of regimen and treat- 
ment necesBarj to effect a cure, are pointed out Willi 
greater definitenesB than heretofore in this work in the 
following classification, which is based upon symptoms 
rather than upon the examination of the stomach fluid, 
which is the more scientific method, and the one habitu- 
ally employed in the treatment of patients at the Battle 
Creek Sanitarium (see page 134). The suggestions 
made, if thoroughly understixid and efficiently applied, 
cannot fail to be of great service, although based only 1 
upon aymptiims. Those who can do so should by all I 
means avail themselves of the advantages of treatment 4 
at a sanitarium where treatment is ba«ed on the exami- 
nation of the stomach fluid. 

Simple Dyspepsia. — This, the eimplest audi 
most common form of the malady, is sometimes called 
slow digestion. It is common in both men and women, 
and especially affects sedentary people and those nerv- 
ous persons who eat rapidly and swallow their food 
without proper mastication. It is also common in 
persons whoso teeth 'are defective. Its immediate 
cause is delicient activity of tlie muscular walls of tljo , 
stomach and intCBtines. The symptoms are much the I 
same as tliose which follow the taking of an excess of 1 
food, but are felt even when ouly u moderate amount 



■nn 



TM PlVUACn. 




tiM Iwwii Iwludi. An lionr or two tdter c«tiii^ m sena*> 
I I'M) lit wulfflil MNd opprtiMion is felt. Tbe dicoomfun 
''ilillriutin for ffftoe bourit. ^nuluallj wi«riDg off before 
tlt» iit'Nl (itfiil. Tlid iip]MfUU- is uaoallf foirij good, 
liit( cfli'ii ia mil ruiuly for tin* rvcv]ttioa of f'xtd ai tnenl- 
lliijK, UN tlii> Work of ili^Htiu); the jireritMis mi-al has 
mil ,yi<t l>tit>ii ci(iiij|j|ct«il. Homutiiiic-H there is considvr- 
iililii lliihili'iini iif till' HtoriiHch, the cnictntious being 
Inoli'lt'Hii, (I lilt ii«vi>r iifri'imivo ; pain iK'twueti the 
ithiiiilihii'H iir liKtii-iilli iirin nhoiildcr-bhiiji!, and tiot iti- 
fr<i((llt'iill,V 111 ill" ifgUiw iif tho heart. Palpitation of 
lllii hititrl. iiri»ii iii'iiiii'K [n till' night, uuiHing great alarm 
oil llio |iiirl of lliK piilicMt nntl hix friends, who c-ntertain 
tvnvu ut itiidili'i) ih'Uth. Sk>f<ji is Uiatui-hed anil unre- 
ftiw)ilii|t, Till' toiiKiit' is friHjiu'iillv foni in tho morn- 
Inn, with tt Imd tftoU' in thi> inimth. All tlic symptoms 
iitimMithttl HIV HMVrtiiv *'Xtifqp>rHtwt by u late supper, or 
li,r Hii.v iinimHit) vmx^kh in ijuantity or ')iuli[y of ft>ocl. 
TIlP (mwi-lp HIV Mpl lo Ih« (xmBtiiHiti'^). When tlic diffi- 
(Hkll^V ttiia iwvu \\t Umft olAwUnit. ttH'n- is usually oh- 
m^rvwl H luMrktHl diii)NwlioH to tdwp after meaU, or 

Utilttthlltl) »W)kiltt>M> At t«<lKT til»0&, UhI « dvdtlMl lOM 

KvMttiHMttvM t^ tKt> stv^nHkdi tni in tbcs» emoeia 
t» )t^>tvr iH i^Mit^T. tVw^ M WW Hy ann or kes dc- 

Mwi4, fjtvv twr «w> iW jpNkMvl ijwmiiiiMi alnftlf *•- 
{WtlMWWt.. — 1W MRoMAmw Ik «&•» li^pwnJM C'E 



TBEATHRKT OV DTBPKPeiA. 



I 



especially of the organs cuncorned in tlio digestive 
process, and supprosBion, ao far as possible, of tli« 
action of germs in tlie stomach aud bowels. The ; 
following measures faithfully followed will be found 
serviceablo : • — 

1. Eut simple, dry food, taking pains to masticate 
it very thoroughly. Granoae, zwieback, rolls, and 
other nnfermented breads constitute the staple arti- 
cles of diet. To these may be added cooked fruits. 
The only raw fruits which may bo eaten, in most 
cases, are perfectly fresh and well-ripened peaches, 
grapes, and strawberries. Very ripe swoet apples are 
well tolerated by most patients, if eaten with dry food 
and carefully masticated. Nuts, well masticated, are 
not objectionable. Milk is tolerated in some cases, 
but is better avoided by most patients, unless taken 
in the form of kumyss, kumyzoon, buttermilk, or 
cottage cheese. Sweets of all kinds must be carefully 
avoided, also drinking at meals, iced foods, rich pit^s, 
jiastry, rich gravies, pickles, condiments, and all foods 
difficult of digestion. 

S. The cool morning sponge bath (1), a warm bath 
once or twice a week (2, 10, 17), followed by a cool 
shower (4) or sponge bath, general applications of 
electricity (66, 68), when possible, dry rubbing with a 
Uesh-brush or towel at night before i-etiring, a salt glow 
(3) two or three times a week, are tbe moat seiTiceable 
measures which can be employed at home. A bot bag 
may be applied over tbe stomach for lialf an hour after 
each meal, to hasten the digestive process. Gentle ex- 
ercise or kneading of tbe stomach (31) after eating 
also hastens the digestive process. The moist abdom- 



5+f? 



THfi ftTOMAOH. 



iiial baudage (9) at night encourages intestiaal activity, 
promotes seci'etion, and relieves congestion of the vie- 
cora. A dry flannel bandage worn about the abdomen 
during the daytime i» also helpful, eapecially in cold 
wosther. Regularity of the bowels must be secured, 
by the enema, if necessary, and by other moasm^s recom- 
mended for the relief of constipatiou. Electricity 
applied to the spine and over the stomach is also a 
Btimulaut to the digestive processes, and useful to re- 
lieve constipation. The hot and cold full bath (31}J 
is an excellent means of arousing activity of the secret^ 
ing organs connected with digestion. 

Swedish movements (39, 4-2)) both manual imd 
mechanical, are very helpful. 

Some ton years ago the writer devised a vibrating 
chair which has been found very helpful in this class , 
of cases, also a kneading apparatus by which the stoni- ^ 
ach and bowels may be kneaded in a most efficient man- J 
tier. This, together with numerous other machines loTM 
applying movements to the body which have been de- M 
vised by the author, are used in the Swedish movement 
department of Uio Battle Creek Sanitarium. The can- 
non-ball (Fig. 2, Plate VIIl) is also helpful in stimn- 
lating the activity of the intestines, particularly as s 
means of relieving constipation, 

3. Abundance of outdoor exercise is indispensable 
in the treatment of tliis aa well as all other forms of 
indigestion. It not only creates a demand for food, 
but increases tlie ability to digest it. Horseback rid- 
ing, bicycle riding, and boating are all excellent moans I 
of exercise, but are perhaps not preferable to useful a 
labor in the cultivatiou of the soil. 




TREATMENT OF DYSPEPSIA. 



2i9 



A course of ' ' General Touic Treatiucut '" (page 333) 
19 required. In very feeble patients a course of nutri- 
tive treatment (page 331) should be given at first as a 
preparation for the more vigorous tonic measures. 

In this, as well as in all other forms of indigestion 
in which germs play an active part, some intestiual an- 
tiseptic, one of the best of which ia antiseptic char- 
coal tablets (49), is found to be almost indispensable. 
Two or three tablets should be taken after each meal, 
and continued for several months. 

Acid Dyspepsia. — This form of indigestion is 
that in which the digestion is so slow that tho food 
undergoes fermentation, forming acids which ii'ritate 
the stomach, and givo rise to the same symptoms, much 
exaggerated, which are mentioned as pertaining to 
simple dyepepsia, with several additional ones, the 
principal of which are heartburn, regurgitation of in- 
tensely Bour liquid from the stomach, and acid eruc- 
tations ; a white tongue, frequently with transverse 
fisBures, often flabby and indented at the edges ; acid 
saliva, causing decay of the teetli ; irregular bowels, 
either constipated or unnaturally loose ; grinding of the 
teeth at night ; and a reddish sediment in the urine. 
There is quite likely also to be pain at the pit of the 
stomach, with soreness on pressure. The digestion be- 
ing very slow, portions of fermenting food remain in 
the stomach from one meal to anotlier, so tlmt acidity 
becomes habitual. No one case presents all of those 
symptoms, but several are often present. 

Patients suffering with this form of dyspepsia are 
usually very thin and bloodless. Occasionally, how- 
ever, a case of the opposite kind is met, in which 





fltar^T foods, tf^wctal]/ 
alio &«i^ aggrrnnOB the 
tendcnry to addit7. 

7nw/awW. — Id t^Mn caws, pstieiitd «e fretjuentlv 
foond mhMKing al«KHt vhoOy m a meat did, f«ir the* 
reacra thm ibr; Snd florii food Ims lUcdr to f<inii 
add* liiaii an- Offcal* and Tt^etaUe foods. Tlib prac- 
tice, bowerer, aggniTatm the disease in tlie t-nd. sirI 
n«vor effects a (-nrc. The meaenres suggested for tlic 
relief of «iii|ile dv^pepsiA are equally appntpriale for 
this condition. Id adflition, it is neecssarjr in suiii^ 
ciuctt — in nil ca«?«. in fart, in which Uie tendency ro 
acidity is very pronounct-d — to cleanse tlie stomiich at 
loiut two or llirce tiitiee a week, and Hcmietimea daily, 
by meann of tlie «toHmch-tnbe(46j. The best time for 
iva«hiiig thv etuinacli is at night. The- extremi! ulow- 
llBBH of the digestive work renders more than two meals 
a dfty impossible wilhoat injury. Tlie interval l>e- 
tweeii tlio two meals should bo at least seven hours, 
riiIdnh tlie quantity of food taken is very small, in 
which case it may be as short as fonr or five hours, 
and tliu number of uienls may be increased. The 
lungur interval, however, is (jrefemble. Milk, un- 
feniu-nted broad, sugar, uncooked fruits, very acid 
fruits, fruits and vt^getables Together, and coarse v^e- 
tabli'M should be cspi-ciiUly avoided, also all articles dif- 
Ueull •>{ digestion, and liki.>ly to cause fermentation (Diet 
l.ialn Noti. •2'i, :iS), Wheat charcoal in its ordinary 




TKEATMENT OF DT8PEP8IA. 



251 



form, or better in the form of autiseptic charcoal tablets 
(49), is almost Indispensable in the treatment of this 
condition. 

Acourseof " General Tonic Treatment " (page 333), 
preceded in feeble eases with nutritive treatment (page 
331), is indicated in these cases. 

Bilious or Foul Dyspepsia, or Septic Indi- 
gestion. — The term bUlmi-H is used to diatiiigiiish 
tliis form of indigestion, not because either the liver or 
the bile iu the immediate cause, but becauHe of tlie bil- 
ious vijuiiliug and sallow appearance of tliti akin whicli 
usually a«'campanie8 this condition. Tliis is what is 
generally known as " biliousiiesa. " Acute dyspepsia 
of the same natnre is termed "a hilioiia attack.** 
Women, tailors, shoemakers, and sedentai'y persons 
generally, are particnlarly subject to this fomi of the 
disease. 

As in acid dyspepsia, this form of indigestion ditfers 
from simple dyspepsia chiefly in the exaggeration of 
tlie morbid conditions present in that furni of the dis- 
ease. Digestion being still slower than in acid dys- 
pepsia, the characteristic symptoms occur more remotely 
from the time of eating. The usual time for the ap- 
pearance of the most marked s^Tiiptoms is in the morn- 
ing before breakfast. Headache, great flatulence, a 
very foul tongue, a bitter taste in the mouth, with 
nausea and finally vomiting of undigested and partially 
decayed food, indicate tlie inactivity of the digestive 
organs. When vomiting is continued, bile is generally 
expelled, the duodenum being affected, and taking part 
in the expulsive action. Diarrhea often accompanies 
ai]<l in some cases takes the place of the vomiting. 



252 



THE (rrOMACH. 



Owing to tiiis thorough clearing out of the rtotnach 
and bowels, these attacks nsaally occnr at intervals of 
at least several days. They are often periodical, how- 
ever, recnrriiig sometimes as often as once or twice a 
week, and again not oftencr than once in two to four 
weeks. 

In addition to the more important ajmptonis meo- 
tioned may l>c noted headache, often of a "splitting" 
or throbbing character, fetid eructations, and nsoally 
severe pain in the eyce. 

Farinaceous foods give mnch lesa trouble than meats, 
especially fat meats. Vegetables eaten with fat, pas- 
try, milk, meat which has been kept too long, and 
sometimes eggs, especially those not perfectly fresh, 
with albuminoiiB and fatty foods generally, increase the 
ByraptfJins peculiar to bilious dyspepsia, and bring on 
the attacks. In some cases the disease seems to be dne 
t« inability to digest starchy foods. This is especially 
true as regards the starch of vegetables. Sufferers from 
this difliculty often mako themselves worse by the use 
of purgative niodicines. 

Treiitiiumt. — Employ the same measures recom- 
mended for simple dyspepsia and acid dyspepsia, taking 
care to give even greater attention to intestinal asepsis. 
Uwe an aseptic diet (Diet List No. 1). It may bo nec- 
essary to resort to an exclusive kumyzoon or buttermilk 
diet (Diet List No. 25) for a short time. A diet con- 
sisting of granose (Diet List No. 25), with fruit-, with 
or without the addition of unt meal, is an admirable 
dietary to bo followed for a week or two in bilious dya- 
pepsiii. GranfjJa, and nmat oilier cfreil foods, if prop- 
erly cixikod, agree well wicii tliis class of cases. As 



TKKATMKST OK DVfiPKPBIA. 



L 



severe constipation UHiially exists, special uttentiou mnst 
be given to tUe ruUef nf this condition (see page 279J. 

Lavage (46) one to three times weekly is necessary 
in the majority of cases of bilious dyspepsia. Charcoal 
or antiseptic charcoal tablets (47, 48, 49) should be 
taken after each meal. A diet of granose or zwieback, 
bromoso (Diet List No. 25), and stewed fruit, will, in 
most cases, clfvc-t a radical change within a few days 
in cases of thi.s kind. 

Painful Dyspepsia. — The chief characteristic 
of this disciLse is tL'nderness at the pit of the stomach, 
QBualty jiist at the lower end of the sternum, but some- 
times affecting other portions of the stomach aiid also \ 
die duo<loiiuin, the pain in the latter region being oftea 
mistaken for some affection of the Uver. In occasional 
cases the sensibility extends to other parts of the small I 
intestine, 

The tenderness described is almost always accom 
panied by a very unpleasant sensation at the epigaa- 
triitm or extending along under the sternum, describe^l 
bytho patient as a "tearing,'' "burning," "rasping," 
''gnawing " pain, which comes on soim aftor taking 
food. This pain may bo due to a morbid sensibility of 
the mncouB membrane, or to a congested state usually 
called chronic inflammation of the stomach, or chronic I 
gastritis, accompanied by a catarrhal secretion resem- 
bling that from any other mucous membrane in a like 
condition. When the pain is due to morbid sensibility 
of tlic stomach, it usually ceases when digestion is com- 
pleted. Wlien due to congestion, it is continuous, and 
is sometimes relieved to a dogreo by taking a moderate 
amount of bland food whea tbs stomach becomes 



THB STOMACH. 



empty. Tlie pain is fiften accompanied by throbbing 
of tho aorta, felt at tlie pit of the stomach or below< • 
Soxiial excesses are a very conunou cause of irritabili^ ' J 
of tho stomach iu both sexes. 

Not infrequently the cougestiou to which this pain 
is sometimes duo is caused by compression of the ab- 
dominal organs, obstructing free circulation. Hence 
women who wear coraets aro very liable to be affected 
by it, though they will rarely admit the cause, and 
still nioro rarely can bo induced to remove it. As a 
pithy writer oneo wild, women have a strong "won't," 
whicli they Bometimcs ojipnsu to all arguments, no mat- 
ter how irresistible may be the logic. 

Trnitmeiit.- — In this condition it is often advan- 
tageous to place the patient upon a diet of kumyzoon 
for a few weeks, adding eggs and soniu simple farina- 
ceotis preparations, suchasgrauolaorglntenujush (Diet 
List No. 25). The general measures employed may be 
the same as those for simple and acid dyspepsia. A 
hot trunk jjack (7) usually gives relief from pain in tho 
region of tho stomach, abdomen, and spine. 

Frequent eating, which is so often resorted to as B 
means of relieving the discomfort experienced in this 
form of dyspepsia, is a most pernicious practise, and 
serves only to aggravate ttio disease in the end. If 
eating ia followed by pain, it may be necessary to con- 
tine the diet to the very blandest articles of food, snch 
as gluten mush or gruel, gninola mush, buttermilk, and 
pnnjes of fruit, peas, or other legumes. Diet List No. 
7 is especially euitahle. 

In some coses it is preferable for a lime to give tho 
patient a small quantity of frmd three or four tic 




TREATMENT OF DY8PE1>6IA. 



day, thtia a larger amotiiit twice a day, as the stomach 
is thus not ao severely taxed as by two bearty meals. 
When food is administered more than twice daily, 
care should be taken to give only the most easily di- 
gestible food. The two principal meals should be taken 
as far apart as possible, and the intermediate meals 
should consist only of liquid foods. We have found 
the hours of $ a, m. and 3 p. m. the most suitable for 
the principal meaU, and 13 m, and 7 v. u. for the 
minor meals, Not infrequently the appetite is unnat- 
ural, the exercise of much will-power being required to 
control it. In many cases the pain occasioned by tak- 
ing food maybe relieved by tlie administration of twenty 
to thirty grains of stihiiitratc of bismuth before each 
meal. The remedy is a harmless one, but colors the 
stoola hlatrk, front the action of the sulphide of hydro- 
gen of the feces irpon the bismnth. 

Such articles as cracked and crushed wheat, oatmeal, 
graliam bread, and othi-r foods containing the coarser 
parts of the grain, are likely to do harm in this form of 
dyspepsia, the woody outside parts of the grain acting as 
a mechanical irritant to the sensitive mucous membrane 
of the stomach. It is this fact which has given seeming 
occasion for an ignorant cliiss of writers to declaim so 
loudly against the use of whole-wheat floor. The fact 
that tlio coarser parts of the grain can with advantage 
be removed for certain cases, is no evidence against its 
wholesoraeness or ita utility in most otlier cases of in- 
digestion. Granose is a most suitable food. 

In severe cases, it is often necessary to put the 
patient on an extremely simple diet. As a usual thing, 
nothing answers the indications so well as milk. It 
17 



THK BTOHAOH. 



should be tukcn as fresh as possible, and about as 
warm as can be bornu with comfort, unices there is 
considerable fever, when it may be taken in small 
quautities iced. Id extreme cases, the irritability may 
be so great that the food will be rejected if received in 
any but small quantities. If necessary, so small &n 
amount as one or two spoonfuls may be given once an 
hour at first, both the quantity and the inten-als being 
gradually increased until the necessary amount is taken 
at the usual intervals of meals. Thou a little well- 
boiled and strained oatmeal or graham gruel may be 
added, the quantity being increased until the ]iatient 
can bear semi-solid food. Many lives have biseii saved 
by this plan when death soomed imminent because of the 
inability to digest Bufflcieiit nourishment. Sometimes 
even milk is found intolerable ; in such cases the most 
successful results are often obtained by the use of the 
white of egg beaten to a froth, and made palatable by 
the addition of a few drops of lemon or other-fruit juice. 

In this form of dyspepsia, the patient is apt to feel 
a terrible faintncss as soon as tho stomach becomes 
empty. This is in some degree relieved by taking 
food, which often leads the patient to resort to frequent 
eating when there is no requirement for so doing, and 
the result is only detrimental. The methods of reliev- 
ing many painful symptoms which occur in connection 
with this disease have already been described in this 
work (see page 155). 

In fet'ble patients, nutritive treatment, and in more 
vigorous cases nutritive treatment followed by tonie 
treatment (pages 3)11 and 3:13), should be employed. 
The application of galvanism (69) to the apii^e and :ibdQ> 



TRSATKKNT OV DTBPBMIA. 



257 



men ia an excellent raeane of relieving the irritation of 
the abdominal sympathetic nerve, to which ino8t of 
the Byraptoms are directly or indirectly traceable. The 
treatment indicated for hyperpepsia is necessary in 
many cases of painful dyspepsia. 

Gastric Neurasthenia, or Nervous Dys. 
pepsia. — The sympathy between the stomach and the 
brain is very marked. Disease of the stomach may be 
produced by mental disorders, and on the other hand, 
various mental and nervous affections may arise trom 
disease of the stomach. Indeed, c^es sometimes occur 
in which the most prominent ejTnptoma of dyspepsia. 
by which alone the disease may be recognized, mani- 
fest themselves through the nervous system. All the 
symptoms previously enumerated under the bead of 
mental and nerrone diatorbances are obserred in these 



The stomach symptoms of indigestion are sometimes 
BO slight as not to be easily distinguished ; yet there is 
undoubtedly a serious fault in the elaboration of the 
food. The process of digestion is left incomplete, and 
the blood becomes full of crude, uoassimilated material, 
which not only does not impart to the tissues new life 
and vigor, but is a direct source of irritation and poi- 
soning. The brain, being the most sensitive part of the 
nervous system, of course suffers most ; and hence there 
is abundant cause for the mental depression, unbalanced 
mental action, confusion of ideas, vacillation of judg- 
ment, perversity of disposition, and other kindred dis- 
turbances from which the nervous dyspeptic suffers. 

Many persons, finding themselves in this wretched 
state, and not realizing the influence of physical condi- 



Ifl58 



THB BTOUAOa. 



: tit'iis ii|i<)n tlie luiud, fall into hopeless despair, even 

' wlitn no intentionally wrong act has been committed. 

' At first thore ta observed simply an exaggeratiou of 
real diOiciilties or misfortnnoa ; but after a time the in- 
dividual nettles into n utate of gloom, despondency, and 
mental depression, in which ho suffers with troubles that 
are purely imaginary. 

Nervous dyspeptics often suffer much in mind from 
a morbid sensitiveness. They iumgine tliomselvea the 
subjects of criticism or ridicule, and therefore become 
morose, irritable, and exceedingly unhappy. Occasion- 
ally they tind theinsolves haunted with evil thonghta, 
and sometimes with almost irresistible impnlaes to com- 
mit improper or criminal acts, as blasphemy, aaioide. 

They are almost certain to imagine themselves - 
suffering from many different diseases, usually of an 

. incurable nature. 

It ia observed that mental disorders uf the chamctor 

[' described are often the result of intestinal dyspepaia, a 

I'form of the disease in which the local symptoms are 

I less prominent than those which relate to tlie stomach, 

I but equally grave. 

This class of patients are often greatly injured by 
the use of mineral waters, whicli, not being absorbed 

I readily, remain long in the stomach, and servo to iQ- 
ease the nervous irritability. 
In nervous dysg^^psia the symptoms characteristic of 

I the disease are due to an overexcited or irritated state 
of the sympathetic nerves. This is usually the result of 
dilatation or prolapse of the stomach, and is the direct 
consequence either of the strain upon the abdominal 
sympathetic nerves from the weight of the prolapsed 



TBKaTMENT of DTfil-EPSlA. 259 

stomach, or colon, oi- other abdominal organs, or of the 
abaorption of tbo irritating pnxlucts of tlie fernienta- 
tioD and decomposition taking place in tlie stomach, 
through its inability to unload its contents into the in- 
testine witli sufficient promptness. 

TriMtiiieiit. — In the treatment of gastric nourae- 
thenia, or nervous dyspepsia, the services of a skilled 
physician are usually rotjnired. Many patients suf- 
fering from this disorder need a change of scone and 
Burroundingg, and relief from the home cares and 
bnsiness worries which have beeu largely responsible 
for the production of the disease. Hence they cau 
be more successfully treated in a sanitarium tliau 
at home ; and even in a well-equipped institution, 
the iugcnuity and skill of the physician are often 
taxed to the utmost to bring about a successful re- 
covery. Not the least difficult task to be accom- 
plished is the deliverance of the patient from the 
morbid fancies which hauut him and make him in 
imagination a prey to almost every ill to which human 
flesh iw heu'. 

The general measures of treatment are the same 
as those recommended for simjile dyspepsia and acid 
digestion. A few special measures, however, will 
be found of service, particularly the hot and cold 
trunk pack (8), and the application of electricity to each 
remote parts as the arms, legs, hack, etc, (65, 67). 
Headaclie, a symptom of nervous dyspepsia, is often ' 
relieved by the application of heat to the back of the | 
head, a cold compress over the forehead, including 
also the eyes in cases in which the distress extends 
to these organs. lu some eases an ice-bag to the 



26(1 



C STOUAOH. 



back of the head, and a fomentation (10) to the 1 
the head or over the eyes, gives myro immediate 
relief. Hot and cold eponging of the spine (18) is a 
valuable means for exciting the vaaomntur centers 
of the spine. Galvanism of the spine and abdomen 
(69) promotes secretion, and relieves congestion of the 
viscera. As prolapse of the abdominal viscera ex- 
ists in many cases of this class, the Natural Abdom- 
inal Supporter plays an important part in treatment (45). 
The same mnst be suid of abdominal massage (20) 
and manual Swedish movements (40). 

Hypopepsia and Apepsia.— It is not easy 
to determine the presence or absence of hypopep- 
sia or apepsia without a careful examination of the 
stomach fluid ; hut when this condition is known 
to exist, — and it may bo suspected in all cases of 
great debility, especially in those in which there is 
dilatation of the stomach and prolapse of the viscera 
in persons past middle age, — ■ vigorous stimulating 
measures for the development of both muscular and 
secretory activity in the stomach niiist be employed. 
In these cases special attention must be given to the 
application of heat over the stomach, abdominal maa- 
sage (29), hot and cold trunk pack (8), and manual 
Swedish movements (39, 41). Moderate exercise 
directly after eating encourages the secretion of gastrie 
juice. Two other measures of treatment which have 
not been mentioned should be employed in these cases, 
especially when there ia any considerable degree of 
tenderness over the region of the stomach : — 

1. The hot and cold doncbe over the stomach (20). 

2, The hot and cold douche applied to the etomacll 




TkEatmkst of dybpepsta, 



261 



itself througli the stomacb-tubo, or hot aud cold la- 
vage (46). This may be emplojed whenever the etom- 
at'li ia washed out, if frequent lavage ia necessury, 
or the Btomach-tube may be introduced two or three 
timea a week for the purpose of applying this vig- 
orous Btimulatiiig measure, even if lavage la not 
necessary for the removal of fermenting food or 
mucus. 

The dietetic measures recoiumcuded for sinipli' dys- 
pepsia should he employed in hypopepsia wlthont 
acidity, and those for acid dyspepsia in hypopepsia 
accompanied by fermentation of the food. 

What about Pepsin? — The use of pepsin in 
cases of so-called atonic dyspepsia, or hypopepsia, is 
very general, and many tons of this digestive ferment 
borrowed from the stomach of the bog are annually 
swallowed by human beings. It is doubtful, however, 
whether any benefit whatever is derived from the use of 
this Bubetancre. Some years ago Mosao, by experiments 
upon a dog, determined that the stomach of a dog of 
ordinary size was able to fumisb pepsin enough to di- 
gest 70 kilograms, or 15i pounds, of albumin. This 
fact was ascertained by passing through the dog's stom- 
ach 2000 litres of water, acidulated with hydrochloric 
acid, to determine the degree of digestive activity. 

More recently, Georges, according to Dobove and 
Remond, has demonstrated that the use of pepsin, 
papain, and pancreatin, cither with or without hydro- 
chloric acid, are valueless to supply a deficiency of pep- 
sin formed by the glands in the stomach. My own 
observations f xactly agree, in this respect, with those of 
the authorities mentioned. 



fl 




THE STOUACR. 



After having eniployeil pepsin for man^ veare, on 
the HtrengUi of anthorit;, I long ago abandoned iu 
use, together with tliat of otln-r digestive fennent&, 
with tha exception of malt, having been utterly uuable I 
to see any good results from tlieir nse. What the stom- 
ach reqiiirc»«in cases of inactivity of the gastric glands, . 
is not a substitute for the normal product of these I 
glaudit, but an increase of the activity of the glands. 
pGptogons are needed rather than peptones, pcpttmoids, 
or pepsins. Proteid substances arc the best of all l>ep- ■ 

<as. The natural flavors uf foods and the dextrin | 
developed by the action of the wilivn ujjon -starch are I 
also peptogciis of the highest value. The fact last | 
mentioned furnishes anothiT reason fur the use of dry J 
food, thus securing thorough, mastication. 

One of the very best peptogens is gluten, ^gg^ \ 
and milk are also peptogenic substances of value, par- 
ticularly eggs. The peptogenic power of gluten veas 
well shown in a case exaininfd in the Sanitarium Lab- j 
oratory of Uygieiie, in which, by adding gluten to tho | 
test meal, tho amount of free IlC'l was increased from J 
.036 milligrams to . 1:}U milligrums, uud the total acidityj 
from .attO to ..'i54. 

The popular idea thai pepper, mustard, and similai 
Bubstances increase digestive vigor has been found by I 
experiment to be erroneous. These substances, like ] 
common salt in excest^, increase the flow of uincua j 
without increasing the production of pepsin or hydro- I 
chloric acid. The production of pepsin and hydrochloric j 
itcid can be increaeed only by natural stuuuli, especially ] 
by peptogenic food substances. These consist (1) of 1 
proteid substances, which ai-e intended to be digested j 




I 



B action of pepsin and hydrochloric acid ; ('2) of 
dextrin and maltose, the snbBtancea which naturally 
precede peptone in the order of production in the di- 
gestive process ; and f^i) of food-Havors, which by the 
reflex action jircKluced increase the activity of all the 
digestive glands as a preparation for the digestive act to 
follow. 

The only medicinal agents which I have fuund of 
any value whatever in the treatment of hy[M.>i>epsia and 
apeptiiu, have been antiseptics, such as cereal charcoal 
or charcoal in the form of antiseptic charcoal tablets 
(49) previonsly describe<l, lactic acid in twenty-drop 
doses, and hydrochloric acid in dosea of five to eight 
drfjps (51), well diluted, half an honr after eating. The 
use of antiseptics is a matter of great importiinco in 
these cases, in many of which the continued use of an 
antiseptic is necessary, owing to the failure of the stom- 
ach to secrete a proper amount i>f hydrochloric acid. 
The aDtiseptic charcoal tablets are a remedy which «in 
be used for a long time without detriment. Hydro- 
chloric acid may sometimes be used for a few weeks 
with advantage, but shonld not be depended upon for 
a great length of time. The stomach must be trained 
to make its own hydrochloric acid in proper quantity ; 
otherwise no permanent improvement will be secured. 
In liypopopsia and apepsia great care should be taken 
to avoid chilling the stomach by very cold foods. 

General tonic measures are required (page '6■i'■^). In 
very feeble patients, the rest-cure (page SiiEt), may be 
first needed for a time, and it is sometimes wise to em- 
ploy nutritive treatment (page 331) for a few weeks be- 
fore beginning more vigorous tonic measures. 



Hyperpcpsia.^TLe Bymptoms presented in this 
condition are in many cases i^linust identical with those 
of ordinary acid dyspepsia. The condition itself, how- 
ever, is very different, the acidity of the stomach flnid 
being due to an excessive secretion of hydrochloric acid J 
rather than to fermentation. Yet in eomo emua then 
is both au excessive formation of hydrochloric acid i 
fermentation. This combination produces the moat B^M 
gravated of all forms of acid dyspepsia. Tlio acidity o 
hyperpepsia differs from that of acid dyspepsia in th< 
fact that it usually makes its appearance soon after t 
ing, often witliin an hour, and iDcreaaes as long aa t 
food remains in the storaact. Not infrequently the p 
tient Buffers from headache and other reflex B_>Tnptom 
during the entire period occupied hy the digestive proo-B 
ess, almost instant relief being experienced as soo 
stomach becomes empty. An examination of the stoin 
ach fluid by the method explained elsewhere in tliuiS 
work (page 134) is necessary to distinguieh with cer^l 
tainty between hyperpepsia and ordinary acid dyspepsia-T 

Treatment. — The treatment of hyperpepsia is rad?^! 
ically different from that required for the relief of acid 
dyspepsia. It is necessary that the activity' of the stom- 
ach glands should be diminished. This is best accom- 
plished by the following means : Rest for one or two 
hours after eating ; an aseptic or dry dietary (Diet Lists 
Nob. 1 and 2} ; careful avoidance of the use of me^ts, 
condiments, and of all arlicles difficult of digestion 
(Diet List No. 22j. When fermentation ia present, 
which is frequently the case, especially when hyperpep- 
sia is accompanied by dilatation of the stomach, articlea 
likely to ferment (Diet List No. 23) and preparations 



TEEATMKNT of DTSPKFaiA. 



265 



of milk, with the exception of kumysa, kuiDjzoon, and 
buttermilk, must be carefully avoided. A hot or cold 
pack (8) before meals, a wet girdle (9) at night, gen- 
eral tonic treatment or, in case of feeble persons, tonic 
treatment preceded by nutritive treatment (pages 333 
and 331)aretbemea8tire3 indicated. The patient should 
take abundance of outdoor exercise daily. Swedish 
movementa (39, ^■O) may be employed with advantage, 
but movements should not be taken within two or three 
hours after eating. 

In very severe cases it is sometimes necessary to ad- 
minister Boda in ten- to twenty-grain doses soon after 
eating, to neutralize, in part, the excessively acid gas- 
tric juice. 

Catarrh of the Stomach.^ This condition is 
characterized by the production of an excessive quantity 
of mucus in the stomach. Tlie tongue is heavily 
coated ; there is loss of appetite, either partial or com- 
plete; usually tenderness at the pit of the stomach; con- 
stipation; in many cases dilatation '.t prolapse of the 
stomach ; and not infrequently occasional attacks of 
jaundice, accompanied by severe pain similac to that of 
gall-stone, but unlike it, in that it docs not terminate 
suddenly, as in the passage of gall-stones. Jaundice 
in these cases ie always much more persistent than that 
which appears in connection with gall-stones. 

Treafr/ii-vf. — In the treatment of catarrh of the 
stomach, tlio measures recommended for simple dys- 
pepsia and painful dyspepsia should be employed. 
An aseptic diet (Diet List No. 1) agrees beet with these 
cases. All articles difficult of digestion (Diet List No. 
23) and liable to ferment in the stomach (Diet List Ko. 




or evvrj otlier daj, tf &e toosae >* ^^cy foal, uid 
OHvfcMl wjmfOBta at TnifigFirinii ate ptMeot. " Gen- 
eral ToMiic Treatnoit'^ i page 333) afaiMU be giren io 
conacctim wid tfas ocW luf ■■■?>■ nggeated. In 
umaj caw* aeooMdaaUe ^B antt ^ of water will be re- 
^aind to wagfa oat dw moeaa whirfa has aoeamnlated. 

Tbe mnwt abdominal bandage (9) and the hot and , 
cold tmnk fnck ^8; aboald be aaBdnoasly i»ed, and fMC: j 
a lontf time. Aj^tringent* are of no Taloe. If (XMH- ■ 
iidersble irriistion exists, ami pain after eating, twenty 
or thirty graio-s of aubnitrale of bismath |62^ may be 
taken befi>re each meal. 

Starch lodigestiun. — Indigestion of starch may 
be tlie result of sereral causes ; — 

1, ItinnfGcieut ctmking of the food, 

2. Insufficient mastication, and consequent insnffi- , 
cioiit inHalivation. 

'^. An excCBBively acid gastric jnice, 

4. Improper food combinations, as the eating of 
vitieKur or »ome strong vegelahle acid, like lemon . 
juice, in connection with farinacooua foods. 

fi. Thii taking of a lurgo quantity of fluid with the 
fof«J, thus dihiling tlic digoative juices to an excesBive 
dcgi'<w. Tlio Btiirch of vogotables is much more difficult 
iif digt^itioii than that of most grains. Potatoes sscm 
to lio iiioro liatilo than otluT vegetables to give rise to 
Indigestion iu tlicso cH§es, perhaps frtirn the fact that 
thoy contain a larger quantity of potash than otlier vege- 



THBATMENT OF DT«l^I^tA, 



S67 



tables. The jtotash salts are very irritating tu a. aeusi- 
tive stoniach. 

The syraptnms of starch indigeBtion are flatulence, 
distentiDn of the atoimich, in some iiistancea acidity, 
- with enictatioiis of gas aitd sour liijuids — in other 
words, the symptoms of acid dyspepsia, 

Trfntiitfiit. — Tlie treatment consists of tho follow- 
ing inoasurea : — 

1. Tho removal of each of the causes mentioned, 
which have been sufficiently clearly indicated to render 
further directions unnecessary. 

2. The use of dry and thoroughly sterilized food. 
Germs are the active eanae of the indigestion of starch. 
Experiments made in the Laboratory of Ilygicno of 
tho Battle <_'roek Sanitarium have shown that a tc^t 
meal consisting of granose furnishes no germs what- 
ever, all tho microbes swallowed with the fimd being 
destroyed by the normal gastric juice produced when 
a dry and well-sterilized food sneli as grauose is eaten 
with thorough mastication. 

3. The use of sonte good antiseptic, as antiseptic 
charcoal tablets. 

4. The employment of f(x>d substances free from 
starch, as gluten, malted gluten, and in stmie cases 
malted milk, nuts, nut meal, eggs, kurayss or kumy- 
zoon, buttermilk, and cottage cheese. A nitrogenous 
dietary (Diet List No. 3) or a diet of fruits and nuts 
{Diet List No. 10) may be advantageously employed. 
Marked benefit is frequently experienced from the use 
of a strictly dry diet (Diet List No. 2). 

It is particularly important to avoid the use of pots- 




I of 
bSe 4wia. IiafriM] io- 
4t t» gmiaie imli- 
HaMj MtiiM'aa, wfanliT food eai 
liBBMs mponcuj' aewd^ ■■■ Mler > turn 
iMdf dnvB Mte Ab ilnatit, Ane tobecotDeaa 
at irriMawt, ii oam of At miMl eoannoa asses t 
teatinal indigMtian. Tk me el coedimentB, 
qnsndties of nneete, tntmt, conas regetables, 
dies, ieeft, etr., are alao ooaunoa caosea of intestinal 
d;iipep«ia. 

Trmtment, — Well-cooked oereals, cooked fmita of 
sll Hnrta, kouiTHS. kamrzoon, or bnttermilk, ^^s, and 
Dnt meal ehoald crtnatitnte tbc dietarr in cases of intes- 
tinal djHpcfMia. Drinking at m^als should be < 
fullj' avoided. Antiseptic charcoal tabtols (%^) or tbejr^ 
eiltiivalniit are of great service in aidiDg the etomachf 
in dcfltmylnK germB, to the action of which the disturb- . 
aiice in the lut^Btines is chiefly due. It has 
r«'C«iitlj' "li'iwn by careful bacteriological study, thatj 




I 



TRBATMENT OF DTBPEP8IA. 269 

the intestiites always contain fewer genus than the 
stomach ; so that if the contents of the stomach tire 
made perfectly sterile, it is reasonable to believe that 
the nnmber of germs iu the small intestine may thus be 
rapidly diminished. 

Fomentations to the abdomen at night (10), followed 
by the moist abdominal bandage worn over night (9), 
also a cool spongts bath (1) every morning, preceded, if 
necessary to avoid chilliness, by fomentations to the 
spine and vigorous rubbing with a coarse towel or a 
dry flesh-brush, are the most important measures of 
treatment wliicU can woU be employed at home. If 
there is prolapse of the bowels, the Natural Abdominal 
Supporter (45) should be worn. The bowels must be 
kept well evacuated, by moans of the enema (22) or 
coloclyster (23) administered daily, if necessary. It 
should be employed quite hot in cases of looseness of 
the bowels and diarrhea, and at a lower temperature 
in cases of constipation. If much mucus is present 
after the bowels have been thoroughly wushed out by 
the coloclyster, a quart of water containing one dram 
of tannin may be taken and retained for ten or fifteen 
minutes, the remainder then being passed o£F. See 
also measures recommended elsewhere for diarrhea. 

Torpid Liver. — Errors in diet may justly he 
said to be the most frequent of all the canses of torpid- 
ity of the liver. Fashionable dinners, late suppers, 
overeatiug, and especially the exeessivo nso of fats, 
sugar, pastry, condiments, alcoholic drinks, tea and cof- 
fee, are the most common causes of inactivity of this 
organ. The free use of mustard, ginger, pepper, curry 
powder, auU other irritating condiments, leads to tha 



270 



THE FTOMACH. 



r 

i 



almoBt amversal prevalence of this diseaaG id many 
tropical countriee. Id addition, sedentary habits, the 
use of tobacco and other narcoticB, restriction of the 
liver by wearing tight clothing, and also malarial dia- 
eases, may be mentioned as freqaent causes of torpidity 
of the liver. The prolonged nse of laxative medicines, 
"after-dinner pills,"' and the various drugs recom- 
mended for eiinstipation are most prolific sources of 
torpid liver. The same may bo said of mercnrv, al- 
though this drug is less frequently used than formerly. 
The liver possesses the curious property of being 
able to retain in its structure metallic poisons which 
may be brought to it in the circulation, so that the 
injury received from a mercurial course is apt to he 
more or less permanent. 

Treatiiitiit. — In severe chronic cases of this affection ■ 
the patient must carefully avoid the use of fats, sagBTii 
condiments, and alcoholic drinks. Hegulation of t 
diet is a positive necessity in the radical treatment ( 
tills disease. Tobacco, if used, must also be discoB^ 
tinned. If the patient's habits are sedentary, he mast b 
gin a course of regular, systematic exercise, and should 
strive in every way possible to build up his general health. 
Food should be taken in moderate quantities, and 
should consist diiefly of grains, nuts, and fruits. Some 
are obliged to av<)id the use of milk, while with others 
it does not seem to disagree. In addition to these , 
general measures, the patient, if not emaciated, i 
with advantage take two or three vapor baths (16) " 
{)aok8 (6) a week for two or tlireo weeks, Tlio wetl 
girdle (9) slmuld bo worn night and day. The use of tin 
hot and cold douche over the liver (20) is very effic^enC 



TBXATUBHT OV DT8PHPSIA. 



Central gaivanization may also bo applied with aiJva 
tagu. Tho O80 of the various liver medicines which a 
recommended for this very common affection will ( 
more harm than good. The best that any of thesail 
drugs can do is to whip np the flagging energiea of thej 
already overworked organ, without in any way lightening 
its burdone, or giving it increased atreugth to perfon 
tlie labor required of it. Tho repeated nse of remtf 
dies of this kind greatly aggravates the trouble, aa ] 
only increases the inactivity of the organ. Merot 
does not stimulate the liver, as is commonly 
posed, but, on tho contrary, lessens its activity. 

An aseptic dietary ( Diet List No, 1 ) should be 
adopted, Kumyzoon or buttermilk should be UJ^ed in 
place of milk, and in many cases nut meal (Diet List 
No. 25) should be substituted for milk and butter. ^ 
Fomentations may be applied over tho liver i 
with advantage, and a cold sponge bath taken evei 
morning. 

Vigorous outdoor exerdse is a matter of very grei 
importance. Breathing exercises (38) are especially 
helpful, as they aiti the circulation of the blood 
through the organ, thus diminialiing congestion. So- 
called torpidity of the liver is chiefly duo to the forma- 
tion of poisonous substances in the stomach. The 
liver must be relieved, as far as possible, of all nn- 
necessary burdens by tlio discarding of all substancea 
which are readily decomjKisablo (Diet List No. 23). 
Intestinal antiseptics are of great value. Charcoal or 
charcoal tablets (47, 48, 49 ) may be constantly used 
with a<lvantage by persona who habitually suffer from 
biliousness or torpidity of the liver. 
18 



27S 



TBB STOUAOH. 



Infantile Dyspepsia. — The most common symp- 
tom of infantile dyspepsia is vomiting. When tiie luat- 
tera vomited are very sour, tbe child ia suffering with 
acidity of the Btomadi, which may bo the result of over- 
eating or of the use of sugar or starchy food. Qreeo, 
offensive bowel discharges indicate decomposition of 
the contents of the intestines in consequence of imper- 
fect digestion. Tbe green discharges are generally pre- 
ceded by discharges in which lumps uf card are seen, 
indicating that digestion is imperfectly performed. 
After awhile, an irritation of the intestinal canal ariat 
from the coiituct of hard, undigested curds which shooldfl 
have been digested in the st<^>mach, and the discbargwl 
become more offensive in character, and are likely to.] 
contain considerable mucus from catarrh of the bowolB. J 
Clay-colored stools indicate an inactive condition of thfij 
liver, or an obstruction of the bile ducts, probably il 
consequence of the extension of the intestiuai catar^fl 
into the bile dacts. When the stools continue greenish, T 
sour, or fetid, the child sometimes shnws marked symjH I 
toms of wasting, becoming thin and wrinkled, — thaj 
countenance wearing an old look, — weak, peevish, 
restleBS. In many cases, the child has convulsions i 
consequence of its weakened state, and sometimee diosfl 
in one of them. In other cases, it dies from exhaustion, f 
When vomiting is the principal symptom, the difHcal^ 
frequently increases until the little sufferer is unable USM 
retain anything upon its stomach. 

The chief causes of infantile dyspepsia are, over* 
feeding, the nse of unclean bottk-s or of titale or unstei 
ilized milk for bottle-fed babies, improper food, 




TREATMENT OF 1 



278 



I 
I 



errors in diet or ill Iioallb on the part of thv mother 
during tbe nufBing period. 

Trt-iitmcn!. — The dietary should be adapted to the 
age of the child (Diet ListB Nos. U, 15, IC). Dnrilig 
thu attack a special dietary will be required. If the 
child is six mouths or more old, milk should be with- 
held for a few days, thin, well-boiled bark-y or oat- 
meal gruel being substituted. The beaten white of eggs 
dissolvud in water or a thin gruel is also an vxcollent 
diet iu euMOs of this soil. General tonic mcaRures nro 
required (pago 33ii), and the other measures rocom- 
nicnded for relief of slow digestion (page 245). 

An Important Caution.— It is of great im- 
portiiuce to reciiilot:t that the special directions for the 
diet in dlfforeTit forms of dyspepsiti here given are not 
intended as rules to be followed for any great length of 
time. In many cases it is necessary to adhere strictly 
to the s|>eciul dietary only for a few days, when it may 
by degrees be made to iucliido a larger variety of foods. 
This fact liiu^t, however, be impressed upon the mind of 
the dyspeptic, thut when he tinds himself well again, 
he must not make the error of supporting that the prin- 
ciple "once iu grace, always in grace " in any BOnBo or 
in the smallest degree applies to the improved slato of 
his digestion. Although the stomach may be restored 
to a sufficient degree of health and vigor to enable it to 
do its duty well under favorable circuiuBtauces, it will 
be certain to relapse into a discjiscd state again as mooq 
as those conditions are no longer supplied. The 
dyspeptic must make up his mind to etndy earefiilly the 
laws of good digestion, ami upply thoni to hist own case, 



THE BTOMAOH. 



Dot on]y as s means of recoTering his beuUb, bat as a 
taeeDtJR] for keeping well wben be has recovered. 
When ttic stomach has once I'jst its natnral, healtbjrl 
tone, it will never again bear the degree of abase which* 
it luajr have endured for a considerable time b^ore 
breaking down. 

In the treatment of tiyspepaia, attention to the 
principles of Iiygiene and the application vi hygienic 
remedies are of first importance. Indeed, it is by these 
agents that nature is sided in her restorative work more 
than by any others, and npon these the most skilful and 
snccessfnl of those who liavo given great attention to the 
treatment of the functional diseases of the stomach find J 
it safest to rely. Undoubtedly there are cases whicbj 
may be benefited, and the work of cure hastened, by J 
the employment of medicinal agents ; nevertheless, that I 
abuse of drugs is so very great, and has been tito direottl 
caase of so many cases of confirmed dyspepsia, that it J 
would seem far better to do without them altogetb^ 
than to use them as they are frequently employed. An J 
eminent writer on this subject, in referring to the treat- ■ 
ment of dyspepsia, says, "My main object in the 
treatment is to prevent the sufferers from resorting ■ 
to drugs, which in snch cases not only produce their j 
own morbid conditions, but also confirm those alreadjrj 
existing. ' ' * 

TIte extensive and often habitnal use of alkalies for 
acidity, of purgatives for constipation, nervines and 
opiates for sleeplessness, and "after-dinner pills" to 
goad into action the lagging stomach, has been a potent J 
factor in the production of a large class of most inveter-jj 
ata dyspepsias. This sort of treatment for dyapepsi&l 
* ChaiDb«r«. 



^ 



TREATMENT < 



375 



cannot be too mncli discouraged. Especially to be dis- 
countenanced is the wholesale employment of "liver 
pills," "stomach tonics," "anti-bilioua pills," "bit- 
ters," and the entire genns of qnack nostrnms and 
proprietary drugs. 

Chronic Catarrh of the Stomach. — The 
syniptoraa of chronic gastric catarrh are prc'ssure and 
fulness at tho stomach after eating, flatulence, heart- 
bum, little or no appetite, vomiting, water-brash, ten- 
derness at the pit of tho stomach, slimy tongue, bad 
taste in the mouth, obstinate constipation, occasional 
jaundice, mental depression, lassitude, pains in the face 
and limbs, and sleeplessness. 

The chief causes of gustric catarrh are chronic indi- 
gestion, tho UBO of flesh food, hasty eating, overeating, 
the use of condiments, alcoliolic lic|uors, tea, and cof- 
fee — in fact, whatever tends to excite, irritate, or in- 
terfere with tlio normal functions of the stomach may 
produce chronic gastric catarrh. In this disease there 
is an abnormal development of microbes, which, being 
imbedded in the mucus which covei-s the lining mem- 
brane of the stomach, are retained and attack the food, 
giving risQ to fermentation, and the consequent produc- 
tion of poisonous substances which increase the gastric 
irritation and catarrh, and when absorbed into the sys- 
tem, give rise to the great variety of nervous symp- 
toms present in this disease. 

Treatment. — Proper regulation of the diet is the 
most important measure. Coarse foods must be 
avoided when there is much local irritation, the diet 
beuig restricted to well -disintegrated foods. An asep- 
tic diet, and in severe cases a liquid diet — exclud- 



276 



THE STOMACH. 



ing, however, milk (unless in the form of kiimyzoon, 
kum^'ss, or buttermilk), beof tea, and meat broths of 
every description — must be employed fur a, consid- 
erable length of time. Condiments must be avoided, 
as well ns all exciting food sabstances, together with 
tea and coffee, and alcoholic liquors in every form. 
The treatment to be employed is tbo same as that 
recommended for "Bilious Dyspepsia" (page 251), a 
frequent precursor of this disease. The moist abdomi- 
nal bandage (9) worn at night ; the hot and cold 
trunk pack daily (8) ; the daily cool morning sponge 
balh (1) ; lavage of tllb stomach (46) two or three 
times a week, if necessary to remove accumulated mu- 
cus or to suppress fermentation ; the giadnated enema 
(2^) when constipation exists ; and all measures for 
the improvement of the general health whicli have been 
mentioned elsewhere in this work, are the most reliable 
means of combating this disease. 

"General Tonic Treatment" (page 333) should be 
employed, beginning with "Nutritive Treatment"' in 
the case of feeble patients. 

Ulcer of the Stomach. — The symptoms of 
nicer of the etoniach are pain in the stomach and in 
the Bpino opposite the sturauch, increased by taking 
food, especially hot drinks and sugar ; tenderness of 
the abdomen, pai-ticularly over the stomach ; violent 
beetmg at the pit of the stomach ; vomiting ; ulcerated 
and furred tongue ; often great thirst ; coustlpatioa. 

tjicer of the stomach is a much more common dis- 
ease than is generally supposed. Many coses thoDghl 
to be merely neuralgia of the stomach are really chrool 
ulcer, the two diseases being very easily confoondeifl 




TREATMENT OF DTaPEPSlA. 



277 



I 



The nicer may be very amfill in size, not more than one 
fourth of an inch in diameter, or it may extend until it 
becomes b.s large as tho palm of thci hand. Sometimes 
the ulcer eucirclea the stomach like a baud. 

The chief causes of ulceration of the stomach are 
the use of condiments and other exciting foods, the ex- 
cessive use of meat, the tiae of alcoholic liquors, oTer- 
eating, hasty eating, and hyperpepeia (i>age 204). It 
sometimes results from gastric catarrh. 

Treatment. — ^In scveiB cascH tho stomach should 
be given absolute rest, the patient being kept in bed, 
and nourished by nutritive enemata for some days. 
After a week or two a liquid diet may bo employed, 
tho patient being given only very small quantities of 
food at intervals of threo or four hours. The liquid 
diet should bo adhered to for aouie weeks, until all the 
symptoms have disappeared. Tho severe pain of ul- 
ceration may U) greatly relieved by fomentations. In 
some instances ten or fifteen grains of soda taken just 
before eating aSord relief by decreasing tho acidity of 
the gastric jnicc. In cases uf ulceration of tho stomach 
in which dilatation exists, the stomach-tube may some- 
times bo use<i to advantage (46) when fermentatioo 
is present, hut it must be employed with very great care. 
Salt sliould bo omitted from tlio Bolutiou used in wash- 
ing out the stomach. Tbo measures elsewhere recom- 
mended for liypopepsia (page 260) should be employed, 
in addition. 

Cancer of the Stomach. — The symptoms of 
cancer of the stomach are pain at the pit of the stomach 
of a burning or gnawing character, increased by food ; 
tenderness to pressure over the stomach ; nausea and 



278 THE erouAca. 

frequently vymtring. tLe vomited matters often resem- 
bling coffee grains ; bard, pulsating tnmor felt near the 
pit of tLe Btomacli ; great emadotion ; tawn/ yellow 
complexion ; symptoms of enlargement of the etomadi ; 
great eshaostion ; spelling of the ankles ; sometimes 
general dropsy. 

Cancer of the stomach is one of the most frequent 
forms of malignant disease. Recent researches seem 
to show tLat cancer is a parasitic disease. Like other 
parasitic maladies, cancer does not attack a healthy 
organ, but only one which has become weakened by 
abuse. The nse of alcoholic liqnors and chronic indi- 
gestion are doubtless predLqrasing canses of cancer. 
Tlie disease itself is not hereditary, but tlie predisposi- 
tion to it ie. Cancer of the stomach frequently occotb 
subeeqaemly to cancer in other organs of the body. 

Trenttin-nt. — This disease is practically Incurable^ 
By careful treatment, however, much can bo done to 
prolong the patient's life. The same measures should 
be employed as have been recommended for chronic 
catarrh of tlie stouiach, ulcer of the stomach, and dila- 
tation. Dilatation of tlie stomach occurs in cases of 
cancer in which the disease attacks the pyloric portion 
of the organ, thns causing obstruction at the outlet of 
the stomach. Tlio disease is greatly aggravated by tho 
use of meat. An aseptic dietary (L>iet List No. I) 
ia always indicated. When a state of ulceration is 
reached, the diet must be wholly liquid in character, 
and the treatment should bo such as has been elsewhere -4 
recommended for "Ulcer of the Stomach" (page 276).j] 
" General Nutritive Treatment"' (page 331) should \ 
employed. 








TEESTMEST < 



279 



Constipation. —The canseB of this exceediagly 
common condition aro very numerous. Some of the 
most frequeut maybe enumerated as follows; — 

1, Prolapse of the bowels, a condition in which 
the stomach is usually involved, is the cause of chi'onic 
inactivity of the bowels in a very large nnmber of cases, 
especially among elderly people. The usual causes of 
prolapsed bowels are two : — 

(1) Tight-lacing from corset-wearmg or the pressure 
of tight bands, in women ; or from wearing belts, a 
practise not oncommon among soldiers and cert^n 
classes of laborers, in men. 

(2) A relaxed condition of the abdominal masclea, 
common in both sexes, but most frequent in women, be- 
ing the resnlt of improper dress, a sedentary life, or in- 
attention to the proper attitudes in sitting, standing, and 
walking. When the large intestine becomes prolapsed, 
it is not infrequently folded upon itself, producing a 
sort of pseudo-stricture, so that the fecal matters, de- 
tained in their passage along the intestine, become 
hardened, and accumulate. 

2, Dilatation of the large intestine is nsually the 
result of overaccumulatiou of fecal matters, but la 
sometimes caused by abnormal fermentations. This 
condition may be the residt of tlio preceding, as the 
pressure of vigorous abdominal muscles is necessary to 
prevent overaccumulation of gas, and to support the 
thin walls of the intestines. It is quite likely, how- 
ever, to result from neglect to empty the bowels regu- 
larly. When overaccumulation has been allowed to 
exint habitually for some months or years, the walls 
of the intestines may become so stretched that their 



THE 8TOHi.0H. 



^^B tlirougl 



natural moscnlar activity i» gone, and can never be 
recovered, althoHglj aome improvement may be aecnred 
by proper treatment. This condition ia common in 
both sexes, but is more frequent in women, and is the 
direct result of improper dress and sedentary habits. 

3. Dilatation of the stomach, a condition exceed- 
ingly common in personB suffering from dyspepsia, and 
existing in fully one half of all cases of this kind, some- 
times becomes a cause of constipation by provoking 
intestinal catarrh through the irritating inflnence of 
fermented and improperly digested substances, which, 
after a long delay, escape from the stomach into the 
intestine. 

4. General weakness and relaxation of the mus- 
cular system of tlic body may induce a similar condi- 
tion of the intestinal muscles, resulting in constipation 
from deficient peristaltic activity ; hence exhausting 
labor or, in fact, anything which exhansts the nerve 
centers, may give rise to intestinal sluggishness. 

5. A torpid liver, by which is meant a liver^ which 
does not secrete a sufficient quantity of bile, may be the 
cause of constipation. Bile is a natural laxative, serving 
to stimulate the muscular contraction of the intestinal 
walls. When lacking in quantity, deficient intestinal 
activity is a natural result. Anything which clogs the 
liver, or renders it inactive, may be a cause of consti- 
pation. The use of animal food, condunents, tea and 
coffee, and an excessive amount of sweets and fats, 
must all be considered as productive of constipation, 
through their intluonco upon the liver. 

fi. Hemorrhoids may be a cause of intestinal inac- 
tiviQ', acting mechanically to prevent comploto evaoua- 




TBEATUENT OF DyBPKFSIA. 281 

tion of the bowels, aod to cause a i-etention and harden- 
ing of fecal matter. The n amber of peraonB who carry 
about with them constantly congiderable quantities of 
hardened fecal matters in the large intestine, mast be 
very great, judging from the results of treatment in 
dislodging old accmnulations of this sort in cases which 
have come under the writer's care. In some cases, 
great cjuantities of black and decomposing matter have 
been discharged after two or throe weeks, during which 
time the patient's bowuls had been daily washed out 
with two or three quarts of warm water applied in the 
most thorough manner possible. 

7. Rectal nicer, catarrh of the rectum, and an irri- 
table rectum resulting in spasmodic contractions of the 
muscles which close the lower end of the bowel, some- 
times induce constipation by presenting too great resist- 
ance to the expulsive effort by which the feca! matters 
are discharged from the body, so tliat the bowel is never 
completely emptied, and the accamulations thna began 
are gradually increased. 

8. A loss of natural sensibility in the mucoos mem- 
brane of the rectum is doabtleas a frequent cause of 
constipation. This semi-paralyzed condition is usually 
due to failure to evacuate the bowels at a regular time. 
After long neglect of this sort, the natural reflex 
activities by which the boweU are stimulated to ex- 
pulsive action are no longer awakened by the pres- 
ence of fecal matters in the rectum ; and constipation 
is the result. 

9. Another cauao of constipation is excessive dry- 
ness of the fecal matters, which prevents tlieir ready 
movement along the loi'ge iotestiue. This is usually 



I 



2S2 T 

the result of tuo long retention witbia the lower bowel, 
but may result from other causes, aa a feverish condi- 
tion, or from a deficient secretinn of tlie maens which 
acts na a lubricant. 

10. Many persons are finflering from chronic con- 
stipation as the result of "oriflcial surgery." The 
rectum not only contains pockets in which a qnftutity of 
mncus is formed for the purpose of lubricating the fecal 
mass as it is expelled from the boily, but a fringe of 
papilla is also found in the healthy rectum just within 
the anal orifice. These papillio arc connected with 
nerves, tlie function of which is to bring forcibly and 
involuntarily into action at just the riglit moment tbe 
fitrong muscles of the abdominal wallw, so as to accom- 
plish complete evacuation of the bowels, Tbese pock- 
ets and ])apill8B were discovered by Professor Horner, 
the eminent anatomist of Pliiladelphia, who described 
and pictured them in his "^^ Anatomical Atlas" nearly 
half a century ago. The " orificial " surgeon often iu- 
duBtriously trims off every papilla, and slits np every 
pocket, for no otber reaaon^ apparently, tban to line his 
own pockets, and certaijily to the great disadvantage of 
tlie patient, who, with his rectum tlius maimed, has lost 
two important links in the chain of automatic activities 
by which nature secures o daily evacuation of the 
bowels, 

Treaimtnd. — Any coarse of treatment, to be cura- 
tive of tliis condition, must take into consideration all 
the various possible causes which may have brought 
about the intestinal inactivity in any particular case. 
It is necessary also, not only to remove these causes, 
but to repair, so far as possible, by the application of 



id 




TKEATMEST OF 



efficient means, the damage which has been wrought by 
wrong habits and morbid influences. 

The matter of first importance in the treatment o£ 
constipation is the diet. Tlie abundant use of fruit is 
one of the most excellent meana of preventing nnd 
curing this disease. One or two oranges before break- 
fast ; a couple of applea at breakfast ; the free use of 
steamed figs, stewed prunes, and other fruits, are means 
to be recommended in nearly all cases of chronic con- 
stipation. There are, of course, some cases in which 
frnits must be avoided. In these cases coarse grains — 
cracked wheat, oatmeal, graham or bran breafl, bran 
cakes, etc. — serve a useful purpose. Peas, beans, 
lentils, asparagus, green peas, string beans, and similar 
vegetables which are easy of digestion, but which con- 
tain a considerable amount of woody or indigestible 
substance, may also be advantageously used. Coarse 
vegetables, however, most bo avoided in cases where 
there is marked dilatation of the stomach. Granose, 
goflo, and other esc-ellent heuUh foods manufactured by 
the Battle Creek Sanitarium Health Food Co., Battle 
Creek, Mich., have proved of very great value to 
thousands of persons suflfering from this condition. 
Granose (Diet List No. 25), a new health food recently 
perfected, is especially valuable as a food-cnre for con- 
stipation, if freely used. Most persons are very promptly 
relieved by its use. Bromoso {Diet List No. 25), an- 
other now health food, is also found to be a very ex- 
cellent remedy in these cases. 

A gla.ss of cold water before breakfast is a prescrip- 
tion which has cured many cases of constipation. Tlie 
free use of water, either hot or cold, taken one or two 



THE STOKACB. 



hours before each meal, is a valuable remedy. (See 
Diet List No. 21.) 

Exercises of rarious kinds, particularly such as 
bring into active play the mnsclcs of the lower part of 
the trunk, are essential in the treatment of matiy cases 
of intfHtinal inactivity. Walking throe to five miles 8 
day ia sufficient to secure regularity of the boweU in 
many persons. A short walk before breakfast is espe- 
cially helpful. 

The exercises of the Ling system, known as Swedisli 
gymnastics, have been found of special value iu the 
treatuiout of this class of cases at the Battle C^ek 
Sanitarium (^S). Horseback riding, rowiDg, and bi- 
cycle riding are also very helpfnl. 

Massage of the bowels (2!), 30), Swedish move- 
ments (48), tlio wet girdle (9), applications of elec- 
tricity to the alxlomen (6t>, 69), and, in special casea, 
to the abdomen and rectum, are measures of great ira- 
IKirtance. The livor dnncbo (20) and the hot and cold 
full bath (21) .may also bo ompluycd. General tonic 
measures (page 333) are essential as means of reinforc- 
ing the general nervtms energy. In cases t>f prolapse 
of the bowels, the abdominal supporter (45) should 
liQ worn. 

Introduction into the rectum of a small quantity of 
cold water, half a pint or a pint, before breakfast, to be 
retained until after breakfast, is u useful meusure. A 
small, cold enema taken at the regular time for the 
bowels to move, is better than a large, warm one, »» 
it is a more powerful stimulant to intestinal activity. A 
small amount of cold water ijitroduced iTito the rectum at 
night upon retiring, is a useful measure in casea where 



TREATMENT OF DYSPEPSIA. 



285 



I 



DO inteBtinal contents are dry and hard ; half a pint or 
a pint 18 a aiifficieiit amount. In some cases in which 
the stools are large and the rectum irritable, an ounce 
or two of olive or almond oil introduced at night or 
before breakfast is a useful measure. Camphor water, 
eoneistiiig of three or four ounces of water to half a 
teaspoonful of spirits of camphor, may be introduced 
into the rectum before breakfast with advantage in 
many cases. Some cases are relieved by the inti'oduc- 
tion of a small quantity of glycerin, — two or three 
tablespoonfuls with an equal quantity of water, — al- 
though Bometimes pure glycerin may be necessary. 
Two or three trials will determine. Sappositories made 
of glycerin or glycerin and camphor are also valuable 
for the same purpose ; tliey may be introduced either 
at night or before breakfast, or at both times. 

When the rectum is the scat of catarrh, a mixture 
consisting of equal parts of starch and boi'acic acid, 
introduced by meaus of a proper instrument, is a very 
helpful measure. The nso of equal parts of boracic 
acid and eubcarbonato of bismuth, or swbcarbonate of 
bismuth alone, is preferable when thi-io is an unusual 
degree of irritalion. The introduction of a dram or 
two of boracic acid into the rectum daily before break- 
fast, is a most valuable remedy, and one which is often 
found curative of this condition. 

It must not be forgotten that regularity in attending 
to the demands of nature is a matter of the utmost con- 
sequence in these cases, both as a preventive and a 
curative measure. Sometimes the inability to evacuate 
the bowels is due to weakness of the abdominal mus- 
cles ; in such cases it may bo necessary to aid the bowels 






286 T 

by preasnre of the hands. Several cases have come 
andcr tlie author's care in which there wua inabilitjr to 
evacnate tlio bowels when sitting in the usual position, 
but no difficulty when a crouching position was as- 
BUiuod. This was doubtless due to the increased pres- 
sure brought to boar upon the abdominal contents when 
sitting in a eronched position. 

Some cases of constipation tax the skill and ingenu- 
ity of the physician to the ntiuost, and cannot be re- 
lieved by the simple measnres which can bo uudertakeu 
at home. Tliere is now and then a case in which ex- 
treme dilatation of the colon exists, so that this organ 
entirely loses its power to contract upon itself, and 
becomes little more than a lifeless sac. In such coses 
constant use of tlie enema (22) or coloclystor is the 
only means by which the bowels can bo relieved, and 
this measure must be employed habitually. 

There is no one remedy for constipation so valuable 
in all cases as a diet consisting chiefly of granose, fruits, 
and nuts or bromose ( Diet List No. 25). 



REMEDIES FOR THE HOME TREAT- 
MENT OF DYSPEPSIA. 



In tho majority of cases of chronic dyspepsia the 
patient is more (»r less permanently disabled, and hence 
needs to be made familiar with measiii-es of treatment 
vhicb he cair himself employ at home, since he cannot 
have a physician or nurse always with him, and cannot 
live coutjmially at a sanitarium. There is no way m 
wliich tlie chronic sufferer from indigestion can so well 
accomphsh this object as by placing himself for a few 
months under treatment at a thoroughly equipped and 
rationally conducted sunitarium. In such cases health 
is to be obtained only by a lung aud persevering course 
of correct regimen aud careful health culture and train- 
ing, which, in order to secure the best results, requires 
the personal supcrvieion of a skilled physician and of 
trained assistants in carrying out the necessary treat- 
ment. As it is impossible, however, that all shonld 
enjoy these advantages, the writer has undertaken to 
describe sneh measures of treatment as extensive obser- 
vation and study in the hospitals of tliis country and 
Europe, and many years' experience in the treatment 
of various forms of digestive disorders, has led him to 
consider most efficient and best adapted for employ- 
ment at home. 

Before beginning a course of treatment, the patient 
shonld read carefully the chapter on " Symptoms, " and 
19 [287] 



E STOMAOB. 



make up hia mind as to the form of djapopaia from 
which he ia suffering. The diagnosis being determiued, 
he should give careful attention to the prescription for 
the treatmiiiit of the particular form of dyspepsia from 
which he ia suffering, and should arrange his diet, pro- 
gram of treatment, and whole course of life with refer- 
ence to the requirements of his malady, no matter how 
inconvenient it may be to do bo. Nothing less than 
thorough measures will accomplish anything in tlie 
treatment of this disease. 

It must be remembered, also, that a malady which 
has been acquired as the result of long years of traua- 
gresBiou of the laws of health, caunt)t be overcome by 
a few days or even a few weeks of treatment. Many 
months of persevering effort are usually required to 
secure penuiinent and favorable results, altliough it ia 
just and proper to expect some immediate amelioration 
of distressing symptoms wheu tiiey exist. 

Not infrequently there is a slight exaggeration o( 
symptoms at the beginning of treatment, and sometimes 
new symptoms make their appearance. There is often 
a slight or even a considerable loss of flesh -for a short 
time. Any aggravation of symptoms should be care- 
fully considered. The cause may be a miHtako in diag- 
jioais, incorrect application of the treatment, or somu 
liidiriduul idiosyncrasy which must bo taken into coni 
sideration. Aa a rule, any measure of treatment op 
regimen which aggravates symptoms should be at onca 
discontinued. 

A reasonable amount of good judgment and com- 
mon sense must be employed in eonnectiun wilh the 
treatment recomniende<l ia order ior i\ \o b^ fully eS«ctr 



HOME TEEATMKKT OF DYSPEPSIA. 



289 



ive. Moat of tlie meaanres described tii the following 
paragraphs arc designated by numbers, for convenience 
of reference : — - 

1. The Sponge-or Hand Bath. ^ Soft watetTfl 
a soft spoiigo or a linen or cotton cloth, and one or twoV 
soft towels or a sheet, are the requisites. The hand 
may be used in the absence of a cloth or a sponge for 
applying the water. For a saline sponge bath add a 
tablespoonfiil of salt to a quai't of water. One part of 
vinegar may bo added to three parts of water for a 
vinegar spongo bath. 

The temperature of the bath should not be above 
92° F., and 86° is generally better. Most people can 
habitnally employ a temperature of 75° or 80° F. with- 
out injury, and some receive most benefit from a still 
lower temperature. The use of a much lower tempera- 
ture is not commonly advisable, however, and is often 
productive of great injury. 

Begin the bath by wetting the bead. Bathe the 
face, then the neck, chest, shoulders, arms, trunk, and 
back. Rub vigorously until the skin is rud, to prevent 
chilling ; for even when the temperature of the room is 
nearly equal to that of the body, the rapid evapora- 
tion of water from the surface will lower tlie exter- 
nal temperature very rapidly, unless a vigorous circula- 
tion is maintained. 

After thoroughly bathing the upper part of the 
body, turn the attention to the lower portion, continu- 
ing the rubbing of the upper part at brief intervals to 
prevent chilliness. As soon as the bathing is con- 
cluded, envelop the body in a sheet and rub dry, or 
dry llio skin with a towel. When the surface is nearly 



290 



THB STOMACH. 



or quite dry, rub the whole body vigorously with the 
bare hand. 

Tlio bath should uot be prolonged more than tea or 
fifteoD minutes. Five miuutes is a sufficient time to 
secure all the benefits of the bath, and even three 
minutes wUl suffice. 

Persons who chill easily will find it better to bathe 
only a small portion of the body before drying it. 
Some persons will even find it necessary to rotalri 
Bome of the clothing upon the lower part of the body 
while bathing and drying the upper part. 

This bath may be given to a feeble patient with very 
little disturbance, even in bed. Only a small portion 
of the body should be uncovered at one time, that being 
bathed, dried, and rubl>cd, and then covered while 
another part is treated in a similar maimer. 

2. The Full Bath. —This bath is taken in an 
ordinary bath-tub, which (shcmld contain water enough 
to cover the body. For a hot bath a temperature of 
100° to luS" F, should be employed ; for a warm bath, 
90° to 95" F. When employed for eliminative pur- 
poses, the bath should bo continued until the patient 
perspires gently. A fnll bath, accompanied by the use 
of soap and the flesh-brush, is especially useful oa a 
cleansing bath. Care should be taken to lower the 
temperature of the bath fifteen or twenty degrees just 
at its conclusion, to prevent the patient from taking 
cdld. Tlio body should be thoroughly dried after the 
bath in this as in all other baths. In cold woatlier, 
oil should be applied after the use of soap, to lessen 
the danger of taking cold. 




BOMB TRGATUENT C 



291 



3. The Salt Glow. — This is a moat eseellent J 
tonic batb. It couHistH essentially in rubbing the whole I 
body witb moiat aalt, applied froely to the surface..! 
Tlie bath should not occupy more than three to five J 
minutes. The salt should be rinsed off bj pouring i 




PiU. IS.— SaowKH Uatb. 



pail of water over the patient, by a shower bath, or hjA 
sponging. 

4-. The Shower Bath. — An apparatus such as 

in indicated in Fig. ly is the most convenient for this 
batii, but water poured through an ordinary colander, j 
or the simple device ehown in Fig. 20 may be employed, f 



THE STOUACB. 



This consists of a. vessel with u perforated bottom, fur- 
nished with a hollow tube for a handle. The vessel is 
tilled by immersing it in water, and the thumb placed 
over the end of the handle, which prevents the water 
from running out. When the tliumb is removed, the 
water falls through the perforated bottom in a shtiwer. 
The shower b^th is usuiillv administered cold or at a 
tuinperature of GO" to fSO° F. It should last bat a fow 
set'oniU. This is a. most powerful tonic bath, Tlie 
shower may be applied to 
the whole bi>dy, nt a single 
])oint, as over the region of 
the stomach and liver, or to 
any portion of the truok or 
limbs. 

The temperature should 
be GO" to 811° F. for tonic 
effects. In taking a general 
shower bath, the patient, 
properly prepared, begins 
'''■''i''i''V-ii ■.! ;■'■■■''■''"" the bath by ])lacing one hand 

Fui. a),-sijiPLK Shower Bath, or one foot under the shower, 
and then quickly passing ime arm midor to the shoulder, 
tlieu the other ana, allowing the water to fall upon the 
chest, then upon the back, and so on until the whole 
surface has been exposed to the direct force of the 
stream. 

5. The Rubbing Wet-Sheet.— This is a very 
valuable means of stimulating the skin, and, through 
it, the central nervous system ; indeed, it is one of the 
best of all tonics. The patient, standing, is quickly 
wrapped with a sheet wrung out of water at a tempera* 




OF DTfiPEPSIA. 



tore of 80° to 90** F. for feeble patientH, and a lower ] 
temperatnre for stronger ones. He is tlien briskly ,' 
mbbed outside the sheet. The sheet may be renewed ■J 
from one to tliree times, according to the strength of 
the patient or tlie intensity of the effect desired 
(Fig. 21). 

6. The Wet-Sheet Pack. — Two or three com- 
fortables or thick blankets, one woolen blanket, and a 1 
large linen or cotton sheet, are the articles necessary. 
It is important that the sheet 
be sufficiently large to ex- 
tend twice aronnd the pa- 
tient's body. Two or raoi-e 
blankets are required in cool 
weather or by weak patients. 
Spread the comfortables, one 
by one, npon a bed or 
straight lounge, making them 
evun at the tup, Ovfr them 
Bprend tlie woolen blanket, 
allowing its upper edge to 
fall an inch or two below 
that of the last comfortable. 
Wet tlie sheet in water of the proper teniperatm-e, hav- 
ing gathered the end in one hand bo tiiat it can be 
quickly spread out. Wring bo that it will not drip i 
much, place its upper end even with the woolen blanket, ■ 
and spread it out on each side of the middle sufficiently 1 
to allow the patient to lie down upon his back, which 
he should do quickly, letting bis ears come just above J 
the upper border of the sheet, and extending his limbs 
near together. Carefnlly wrap the patient, first with 




294 



TnE STOMACH. 



i th<: blaukt>t, taking paina 




tlie sliuot and afterwui'd wi 
to exclnde the air (Fig. 22). 

7. The Trunk Pack. — Tbis is adiuinistered in 
tLe sarao way aa th« WBt-alieet pack, with the oxeep- 
tion that tlie applicatiou is eoufined to the trunk of the 
body. 

8. The Hot and Cold Trunk Pack. — Thia 
valujiblo measure is administered in the sann" wanner 

a» the trunk pack, 
fxccpt thiit a rubber 
bug two tbii'ds full 
nf hot water is placed 
■ over the at'Tiiach be- 
fore tlie cold elieet is 
applied. A flannel d<ir]i should be placed nest the 
skin to prevent injury from the hot bag. 

9. The Wet Girdle. —This woh « favorite 
remedy with the early German hydropatliists, and tt 
ie a wry nsofnl appliance when pmperly employed, 
though it has been much abuaed by excessive use. To 
apply it well, a coarse towel about three yards long is 
the most convenient. "Wet one half of this iu cold 
water, wring until it will not drip, and apply it to the 
abdomen, placing one end at the side and bringing it 
across the front tirst, so that two thicknesses of the wet 
portion will cover the abdomen. After winding tiie 
whole tightly around the body, fasten the end secnrely 
with piiia or with tapes attached for the pnrpose. 
Cover all with several folds of flannel. 

In cold weather, the moistened towqj should be 
covered with oiled mnsliii before the application of the 
flannel, and care should be taken to ha\'o tlio dry wrap- 



tins 1 




Home tekatment of dyspepsia. 



pings extend at least two iuches beyond the edges of 
the moist towel, to prevent evaporation and chilling. 
The colder the water in wliich the towel is wrung, the 
more vigorons will be the eifoct produced. For feeble 
patients the towel should bo wrung as dry as possible. 




10. Futnentation. — ^Fold a soft flannel twice, 
so as to make four tliiclcnesses. Dip in vory hot water, 
lifting out by the corner and placing in the raidille of 
a towel. Roll up quickly in tbo towel lengthwise, and 
wring nearly as dry as possible by twisting llie ends of 
the towel. In this way the fomentation can bo wrung 



TBB ■TOUACH. 



out luucli hotter than with the hands. Of course it will 
bo too hot to apply to tlie bare fleeh ; but the ekiii 
should be protected by one or 
more thicknesBes of llaunel, and 
the fomentation applied at once, 
and covered with another dry 
flannel. Renew the iometita- 
tion when the lieat begitu to 
moderate very perceptibly, and 
continne ae long as necoasary 
I Fig. 23). 

11. Mustard or Turpen- 
tine Fomentation.— The ef- 
fect of the fomentation may be 
increased by adding a tablespoon- 
ful o£ mustard to the water from 

nO.i'l.— IICIT " iTCH-llAU. ..... . ■ 

winch the fomentation is wrung, 
or by sprinkling over the fomentation cloth when ready * 
to apply, an ounce of alcohol in which a leaepoonfid of 
tui'pentine lias born dissolved. 

12. Dry Heat. — Dry applications of heat may 
bo made by means of a rubber bag filled with hot 
water fFign, 'H. ■J.'>), healed bricks wrappoi! with flaunt 




t 



cloths, flannel bags containing hot stdt. bottles filled j 
with hot water, and similar means. 




HOME TKEATMKrr OK DYSPEPSIA. 



13. The Foot Bath. — Adj vessei sufflcientl;:^ 
large to receive the feet and enough water to eovopJ 
them to the ankles, is suitable for this bath. Tbo tent^^ 
perature should usually be 100° to 105° F, If theJ 
water is cold, it should uot be more than one fourth ot^ 
an inch deep. 

The alternate hot And cold foot bath is a verj vala' 
able remedy for cold feet. It is given thus : Place the i 
feet in hot water — ^ 100° to IhCF. — for two or three 
niinntes. Then withdraw them, and plunge thorn 
quickly into a bath of cold water, (>0° F. or leas- 
After two or three minutes, realore tlicm to the hot 
bath. Thus alternate three or four 
times, and conclude by dipping the ' 
feet quickly into the cold water and wi])- 
i»g dry. This bath produces a must 
powerful reflex action (Fig. 20). Fio.ai.-riWT iutr. 

14. The Sitz or Hip Bath. — For this bath a 
common tub may be used, by placing a support under 
one edge to elevate it two or three inches ; but it ia 
better to use a tub made for the pui-pose, which should 
have the back raised eight or ten inches higher than 
the front, to support the back of the patient, and the 
sides sloping gi'adually so as to support the arms of the 
bather. The bottom should 1m3 elevated two or three 
inches. The depth in front should bo about the aame | 
as that of a common wash-tub. 

Enough water is required to cover the hips and ex- 1 
tend a little way np on the body. Four to six galloni 1 
is about the pro]>er quantity. 

A very good plan for administering t 
one which will be applicable to most c 



THB 8T0M&OB. 




Begin the bath at 92° or !13° F. If a thermometer is 
not at hand, pour into the bath-tub tliree galloDs of 
freBh well- or Bpring-water, and then add one gallon of 
boiling water. Tliia 
will give the desired 
temperature. After 
the patient has been 
in the bath ten min- 
utes, cool it down t«» 
85" F, , which may bu 
done by adding a 
gallon of cold water. 
Continue the bath 
five mmutes lunger ; 
then administer a 
F:o. ST.-Ttw sitz BATS TcB. pail douche or spra.v 

at about 85" F., and wipe dry, as directed after a baud 
bath (Fig. aT). 

15. The Sun Bath. — The whole body, unpro- 
tected by clothing, should be exposed to the sun, the 
head only being covered. The exposure should be 
from three to fifteen iiiiiiutee, when a tepid eponge 
bath should be administered, 

16. The Vapor Bath. —This excellent elimi- 
native bath may be easily iuiproviBed by placing the 
patient in a chair surrounded by thick coverings, and 
heating the water in a pail or small tub placed beneath 
the chair by gradually lowering into it hot stones or 
bricks. For permanent use, a wooden box may be con- 
structed after the plan shown in Fig. 2S. 

The skin of most dyspeptics is very inactive, and 
with many tlio perspiration has an oScnsive odor. On 



HOME TREATMENT OF DYBPBPBIA. 



299 



this account, a short hot -water or vapor bath may be 
taken once a week with advantage. The bath sboold 
be continued just to the point of inducing perspiration, 
but not longer, as warm bathe are relaxing and debili- 
tating. A daeh of cold water over the body, poured 
from a pail or by means of the shower, eliould irame- 
dintely follow the hot bath. The patient should then 
be quickly dried and rubbed, ijo as to secure a good 
reaction. Wrapping in a dry woolen blanket promotes 
reaction, and is necessary in the cases of some tliiii- 
blooded dyspeptics. A full hot 
bath, an improvised vapor or hot- 
nii' bath, or a hot-blanket pack 
may be used as a means of induc- 
ing geiitlo poi-a pi ration. The best 
of all Buelt nieasurea, however, is 
the sun hath or the eloctric-liglit 
bath. 

17. The Hot.air Bath.— 
This is administered in a manner siraihir to tlie vapor 
bath, except that the heat is produced by burning alco- 
hol in a small dish placed for safety in a vessel con- 
taining a little water. The purpose of the hot-air bath 
is to induce perspiration, A cold shower or sponge 
bath should be applied at the conclusion of the bath. 

18. Heat and Cold to Spine. —Alternate 
fomentations and cold compresses may be applied, 
or alternate hot and cold sponging, if it is preferred, 
the alternations being made every half minute, or 
mice in one t'> thi'eo minutes Wuler aa hot and 
as cold an can be borne should bo used. In some 
cases it is necessary to employ ice in order to obtain 




IBM fiTOKAOB. 



tbt; dosiied effect. When ice is applied to the Rkin, 
the enld application eliould occupy only five to teu 
seconds. 

19. The Hot and Cold Pour, or Pail 
Douche. — Two pails of water, one at a teinpenilare 
of iao° to 130° F., the other aa cold as can be ob- 
tained,- — ice water when a very atrong effect is de- 
su-ed,— and a dipper, are the essential requirenietiu. 
If the application is to tlio spine, the patient elioold ait 
on the edge of the tub wliilo tlio water is poured ujkjd 
the ppine from a dipper. The force of the application 
may be varied somewhat by the height at which the 
dipper ia held. The application ehoiild be alternated 
every eight or ten seconds. 

20. The Hot and Cold Liver Douche.— 
The patient lies in a full-bath Inb while a hot and cold 
pour is administered to the right aide, aa directed 
above. The application ehuuld continue five to fifteen 
minutes. If the patient chills eaaity, the tub may 
contain a sufficient amount of warm water to partiaJly 
immerse the body. 

In casee of hypopepsia and apepaia not accompanied 
by tenderness in the region of the stinnach, this douche 
may bo emjiloyed with advantage as a means of etinm- 
lating the activity of the atomacli glands. The patient 
should lie in auch a position that the water will fall 
upon a point just below the end of the brejist bone. 
The best time for the liver or stomach douclie ia juat 
before retiring at night, or an hour or two before din- 
ner. A heating compress, or wet girdle (9), should be 
applied afterward, and worn over night or during tho 
i^geetiou of the meal, in obstinate cases, 




HOME TBBATMBNT OF DTSPBPBIAy 



301 



21. The Hot and Cold Full Bath.— Tho 

fill] bath IB prepared in tlic usual maimer, with a tem- 
perature of ItiO" F. After lying immersed in water 
for about one minute, the patient rises to a sitting 
poBtare, A quantity of cold water at a temperature of 
tiO" to 70° F. is dashed about the neck and shonldera. 
The patient then lies down in the bath for a minute or 
two, the water being warmed again. He then sits erect 
while the cold application js made as before. The bath 
may bo continued from 
one to five minutes, con- 
cluding with a cold appli- 
cation and vigorous rub- 
bing. 

Another method is to 
administer a h&t bath at 
a temperature of 100° to 
105° F. for five or six 
minutes, or until tho Bkin 
is reddened. The patient 
is then taken fi-om tho 
bath, and tho surface 
rubbed with a towel 
wrnug out of ice- water, or Fm, a»,— STrnosBTBtKOK. 
with a piece of ice. The cold rubbing bIiouM be 
executed very rapidly. Lastly the patient should be 
rubbed dry with a coarse towel, 

22. The Enema. — This exceedingly useful ap- 
plication of water is best administered by a syphon or J 
fountain syringe (Figs. 2^, 80). A bulb syringe may b 
employed, but there is always danger of pumping e 
into the intestines, and thua giving rise to severe pain, I 




302 



THB STOHACH. 



The patient should lie upon the back. The temporaturo 
of the water ehould be 95" to 100° F. When the pur* 
pose is evacuation of the bowels, a small cold enema 
is nsefnl as a means of stimnlatiog the h>wer bowel. 
A large Ijut enema is employed in casea of catarrh or 
for the relief of pain. 

23. The Coloclyster, — This is simplv a modi- 
fied form of the enenia. The patient should lie upon 
the right side while the water is being introduced, or 
should assume tlie knee-chest position. In the knee- 
chest position, the patient first kneels, then bends for- 
ward until the head and chest are 
on a level with the knees. The 
thighs should be- upright, so tliftt 
the thighs, trunk, and the surface 
upon which the patient ia kneel- 
ing shall form a right-angled tri- 
angle. The purpoBu of this ap- 
phcation is to render possible the 
introduction of a larger quaiitit/ 
of water iuto the colon. Three 
or oven four quarts can be thiu 

.-YKi.voE. introduced in eomo cases. 

24. The Cold and the Graduated Enema. 
— The cold enema ia a powerful means of stimulating 
intestinal activity. Tlie quantitj' of water used should 
not be greater than half & pint in ordinary cases. 

The tjraduated enema consists of an ordinary 
enema gradually cooled from day to day by the addi- 
tion of half a pint of cold water, tho total amount of 
water employed being at the same time diminished. 
The amount of water need each day should be loesened 




-^L 



r 



HOME TREATMENT OF DYePEPaiA. 



303 



sufficiently ao that by the em] of ten days or two weeks ^ 
the total quantity used will not be more than _a pint, ] 
and the temperature 60" to 70" F. In a few days 
more, if proper diet and other measures are employed, 
the enema mav t>o discontinued. 




FiQ. Jl.-Wiiefi Bottle and s^mrNoe 

25. The Laxative Enema. ^ In cases < 
treme constipation it is sometimes necessary to employ i 
a laxative enema. Strong soapsuds is excellent fori 
this purpose, and is effective in most cases. It U | 
sometimes necessary to odd conunon salt to the -9 



804 



THB BTOIUCB. 



in the proportion of a tablespoonfiil to the quart. The 
following mixture may also be advantageously em- 
ployed in very obstinate caecs : Snlpbatc of magnesia, 
one tablespoonful ; glycerin, one tablespoonful ; boil- 
ing water, two tablespoonfule. The mixture should 
be introduced as high up in the bowel as possible, a 
catheter being uf^ed for the purpose if necessary. 

26. The Oil Enema. —Two or three ounces of 
oKve oil introduced into the rectum at night serves as 
a sufficient remedy for constipation in certain cases. 
The oil enema may also be advantageously used in 
cases in which hardened masses of fecal matter have 
accumulated in the intestine, and cannot be removed 
by tlie ordinary warm-water enema. 

27. Oil Rubbing. — Applications of oil are 
always made after certain kinds of baths. Ordinarily, 
a tepid sponge bath is first given, after which tlio oil 
is systematically applied to the entire body witli vtjf- 
orous rubbing. Any excess of oil remaining should 
be wiped away. ' Olive oil, cocoanut oil, or even 
vaseline may be employed. 

28. Massage — Kneading. — Superficial aod 
deep kneading, as illustrated in Figs. 1 and 3, Plate 
VI, are among the most useful procedures employed 
in massage. The movement is that of firmly grasping 
and then releasing the tissues. The purpose ia to 
knead and manipulate the skin and the muscles so as 
to stinmlate the circulation and other vital activities iq 
these structures. 

29. Abdominal Massage.— (Fig. 3, Plate yi,> 
The operator endeavors to seize the abdominal content^ 
yt\1.l\ both hands, manipulating thera precisely ft^ ^ 



- ! 




HOME TREATMBST OF DYSPEPSIA. 



baker does a mass of dough, the fingers of one hand 
being naed in 0])po8ition to the heel of the other hand, 
and the abdominal contents kneaded and manipulated 
between the two hands. In this procedure the heel of 
one band of the manipulator operates npon the side of 
the patient nearest him, while the fingers of tlie other 
hand operate upon the tissues of the opposite side. 
This method is only applicable to cases in which the 
abdominal walls are considerably relaxed. This, as 
well as most other forms of abdominal massage, requires 
the Bcrvices of an assistant, the patient lying upon a 
bed or couch, 

30. Massage of the Bowels. — (Fig. 4, Plate 
VX,) With the closed fists used in alternation, the 
operator works along the whole course of the colon, 
beginning at the lower end of the cecum, directing tliu 
movements upward to the lower border of the ribs on 
the right side, following the oblique border of the 
ribs to a point midway between the umbilicus and the 
sternum, at which the median line is crossed ; then 
down on the opposite side, ending at a point close 
to the pubic bone, and just to tlie left of the median 
line. 

If the patient is able, he should make a practise 
of kneading and percussiiig the abdomen himself for 
fifteen or twenty minutes night and morning. This is 
a powerful stimulant to muscular activity. Many 
years ago a quack doctor in Kew York City made n 
fortune by treating dyspeptics by this method alone. 
He put every patient under an oath of secrecy, anil 
required certain wholesome restrictions of diet, whitli 
of course {tided in the cure. 



306 



TBB BTOUAOB. 



31. Massage of the Stomach. — (Fig. 5, Plato 
VI.) With the patient lying upon the back, the assist- 
ant BtandB upon the right eide, with his buck to the 
patient, and execntea the following movementB : Placing 
the right hand upon the left side of the abthfiQcn oppo- 
site the umbilicus, with the fingers extended and close 
together, he presses the ulnar border of the hand back- 
ward, at the same time carrying it upward with a vibra- 
tory movement. Following along under the riba of 
the left side, he continues the movement upward to the 
epigastrium. At this point, before releasing the tia- j 
sues, ho places the tips of the fingers of tlie left hand 
so as to support the tissues at the point to whicli they 
have been lifted by the niovenient of the right hand, 
making firm pressure ; then withdrawing the right 
hand, he repeats tiie movement. Tliis is onitiTincd for 
three or four minutes. If it is desired to empty the 
stomach, the strokes should be miTied across the epi- 
gastrium, and along under the lower border of the ribs i 
of the right side. Tlio following movements are espo- 1 
cially useful in aiding digestion : — - 

Execute the movements just described, and at the 
same time have the patient breathe deeply. With 
every alternate breath the patient should execute what 
the writer terms insplrntory cfimprt'tminn, tlms ; Fill- 
iug the lungs completely, hold the breath for a few 
seconds, and at the same time raise the head forward , 
as far as possible, strongly contracting the abdominsll 
muscles. 

Gentle kneading of tho abdomen, especially itsi 
upper portion, is an excellent means of sliinulatii^ J 
muscular activity on tho part ot the stomach, and tlim^ 



- b 



f 



HOME TBEATMENT t 



307 



preventing too long delay of the food in this part of 
the digestive apparatus. By this means the local cir- 
culation is stimulated, and t!ie natural muscular action 
of the bowels is both imitated and encouraged. This 
is an excellent remedy, and may be employed to advan- 
tage each uiglit and morning, and for half an hour or 
more after each meal. 

32. Replacement of the Viscera. — (Fig, (t, 
Plate VI.) The patient lying upon the back, with the 
head — not tho shoulders — elevated, knees well drawn 
up, the operator places his hands at the lower portion 
of the abdomeii and presses inward, lifting upward at 
the same time. The patient should relax tho abdominal 
muscles as perfectly as posaiblo, and should take full, 
deep respirations. With each expiration the operator 
endeavors to lift the contents of the abdomen a little 
higher, holding the hands firmly during tlie inspira- 
tion, 80 as not to lose the ground gained. The patient 
should take full, deep inspirations, expanding tho waist, 
and lifting the chest well. 

33. Inspiratory Lifting of the Abdominal 
Contents. — A number of years ago the author dis- 
covered a method by which tlie abdominal organs may 
be forcibly lifted into position by a simple modification 
of the breathing movements. The mt-lhod is as fol- 
lows : The patient, lying upon the back, after fully 
emptying the lungs, executes the same movements as 
in ordinary inspiration, but, by closing the throat, pre- 
vents the admission of air to tho lungs. Care is taken 
to raise tho chest as high as possible, and at the same 
time to draw in the abdominal muscles with as much 
force as possible. Tlie result is, that, no air b«.vt^ 



308 ' TBE STOUACH. 

admitted to the lungs, the stomach, bowels, anj^^ 
viscera are sucked up into the chest in a very forcible 
manner. Bj grasping the lower abdomen with the 
hands, and lifting upward at the same time this move- 
ment is executed, the effect upon prolapsed organs may 
be greatly increased. Fig. 7, Plate VI. shows very 
clearly how this movement is effected. 

34-. Hacking. — This consistB in stroking the 
part with the &ige of the hand, the fingers being 
separated, as shown in Fig. 8, Plate VI. 

35. Beating. — This pro- 
cedure of massage consists in 
striking the body with the half- I 
closed fist, as shown in Fig. 
Plate VI. 

36. General Massage. — \ 
Qenerjil massage consista in the 
rubbing and manipulation of the 
whole body. The movements 
are chiefly those doscribed as fric- 

FiQ.as.-AiiMFLiLiioN. tion and kneading (28). Thosa i 
movements are applied to the limbs and back. A\>- 1 
dominal massage (29) and massage of the stomach and I 
bowels {30, 31) are employed for the abdominal r&. 1 
gion ; hacking and beating (34', 35) for the sptneJ 
(Figs, s and 9, Plate VI), especially iho lower part oC'l 
it, the fleshy portion of the thighs, over the liver, \ 
and the large nerve tranks. 

Joint movements, or flexion of the arms and 1 
with resistance, are employed iu general masst 
The patient is made to draw the limb up while 1 
assistant offers slight resistance to bis doing s 




;T of DYaPKPElA. 



patient then extends the limb wLile the assistant makes 
resiBtance in like manner. The movement is repeated 
several times, the number of times and the aniouut 
of reeistance offered being regulated according to the 
strength of the patient. Figs. 32 and 33 illustmte arm 
flexion and extension. > 

An expert is required for the administration of 
massage in a thoroughly skilled manner. In another 
work* the author has given a full description of the 
various procedures and manipulations i 

37. Exercise. — This is 
of first importance as a general 
renovator of the tissues. The 
secretion of gastric jnice is, un- 
der ordinary circumstances, pro- 
portionate to the amount of ( 
nourishment which the system 
is prepared to assimilate. Ex- 
ercise creates a d e m a n d fur 
■ food, and so stimulates both as- 
similation and secretion. Tho^ 
best forms of exercise are those 
which will secure the moat uni- 
form activity of the several parts of 
system. Riding, walking, rowing, and es 
back riding are to be recommended as excellent. 
nastic exercises and the jndicioue use of the "health 
lift " are also good ; and for persons who, for lack of 
time or for any other cause, cannot adopt the other 
methods, those may be considered as almost indis- 

■ ■■ TbB Art of Mttssafje." Modern MedlflUB Publishing Co.. Battle 




THK BTOHAOH. 



peuBaijle. Such txerci»eH &s running, jumping, base- 
ball plajing, walking matchoe, and other violeut exer- 
cises cannot be rocommendt'd. Trapeze exerrise must 
also be discouraged on tlie mnmc grounds. Agricultural 
labor, especially the raising of small fruits and tlif cul- 
tivation of flo\vt>r8, eanaot Iw too highly recotiuncuded 
as forms of exercise for dyspeptic patients. For that 
large class of sal low- fated, weak-backed young ladies 
who have been made dyspeptics by idleness and too 
much coddling by fond mothers, the varied excrciseB 
of domestic labor are a most admirable panacea. And 
for the gauut, hollow-cheeked, sunken-eyed young man. 
whose principal occupation is cultivating a moustache, 
smoking cigarettes, and swinging a slender cann, a lit- 
tle wbolesome experience iu earning a eubsietoncc by 
the sweat of his brow, instead of depending upon 
wealthy relatives, will i)rove a specific for the "soft- 
ening" which begins in the brain, and estcnds to 
every part of the systeiu. 

Exercise before breakfast, while excellent for some, 
may be very harnifnl for others. Persona who com- 
plain of a feeling of "gonenesB," "faintness," "eink- 
iiig," and allied pains when the stomach is empty, 
and especially in the morning, must avoid exercise to 
any considerable extent before eating. Disregard of 
this rule often occasions loss of appetite and weakening 
of the digestion. Persons who are very weak most 
also avoid exercise before eating in the morning. 

As before remarked, only gentle exercise can be 
taken soon after eating, or immediately before, without 
uijnry. Persons who feel a constant "sinkJug" or 
weakness in the stomach and bowels, will derive benefit 



-^ L 



DYSPEPSIA. 311 

from wearing about t!ie body a broad band of flannel. 
In many oE tlii-sB cases the Natural AbdurainaJ Sup- 
porter will be found of great advantage. It is in these 
cases especially that complaint is made that walking 
prodnces coldness in the extremities, instead of serving 
to worm them. 

One of the most marked effects of exercise u}>on 
digestion is to increase the activity of the gastrio 
glands, and thus promote the secretion of the gastric 
juice. This has been clearly shown by recent exi^ri- 
ments. It is hence apparent that iu hyperpepsin little 
or no exercise should be taken immediately after oatrJ 
ing, whereas in hypopepsta moderate exercise after ) 
eating may pro\'e beneficial by increasing the activit 
of the gastric glands. 

Enrcises to Develop the Abdomitial Muscles.-^ De- 
velopment of the abdominal muscles is one of the moat) 
important of all curative measures in chronic indigc'tt* 
tion, since its most obstinate forms are due to prolupaa 
of the stomach, and those forms of conjttipation least 
benefited by a regulation of the diet or other curative 
means arc usually the result of prolapse or dilatation 
of the colon. Development of the abdominal muscles^ 
benefits cases of this kind by holding the prolapsed \ 
organs in place, and also by increasing the pressurQ'J 
within the abdominal cavity, aa well as the cxpuliii 
power. The following are among the mosl cxeellenti 
exercises for developing the abdominal muscles : 

(1) Lying upon tlie back, raise the head forward asl 
far ns pnsaible without the use of the arms. Repeat^ 
every five seconds, breathing in as the head goes back, 
and breathing out as the head is raised forward. 



THB STOHACH. 



(2) Baiee the right leg as liigh as posaible, and 
return to position. Repeat with the left leg, then with 
both tegB. Empty the luuge as the leg is raised, filling 
the lungs as the leg is lowered to position. Repeat 
each exercise three to twenty times. 

(3) Combine exercises 1 and 2, following the eame 
instructions in regard to breathing (Fig. 10, Plate VI}. 

(4) Lying upon the back, with the togs extended, 
rise to the sitting position without using the arms. 
Slowly return to the horizontal position ; repeat three 
to twenty times. Exhale while rising to the Bitting 




Trdnk tlDsct-es. 



position ; take one full breatli after each movement. 

(5) Repeat exercise 4, with the hands placed at the 
top of the head, and the elbows extended sideways and 
in line with the body. 

(i>) Lying npon the face, place the trunk, elbows, . 
and toes in such a position that the whole body will be 
BQspended upon the elbows and toes. Lower the center 
of the body until it rests npon the supporting surface ; 
then raise to a horizontal position, repeating three to 
twenty times (Fig, 34), 

(7) Lying upon the back with the knees drawn up, 
separate the knees as widely as possible, then bring 
them together again. The assistant should meanwhile 
make resistjince to each nioventent by pressing first 



■'L 



HOME TEEATMENT OF DYSPEPSIA. 



313 



I 



on the oater, then the inner surface of the knees (Fig. 
11, Plate VI.) 

(8) An excellent exercise for strengthening the 
abdominal muscles is the following : Standing with 
the feet separated as in Fig. 39 (page 319), and the 
hands placed :ipon the hips, the patient bends gently 
forward until a strain is felt upon the abdominal mus- 
cles, then rises to position, repeating the exercise a 
number of times. 

38. Breathing Exercises. — The following ex- 
ercises in breathing will be found verj helpful to diges- 
tion. Before engaging in them it is well to take a 
little vigorous general exercise, as jumping up and 
down or a short run, which will create a thirst for air. 

(1) Breathe in the ordinary maimer for one minute, 
taking care that the greatest expansion is at tlie sides 
of the waist. 

(2) Fill the lungs as full as possible, breathing 
slowly in and out, forcing the sides of the chest out as 
far as possible. Be careful not to confine the breath- 
ing to the upper part of the chest. Occupy equal time 
in breathing in and out, — about five seconds each for 
inspiration and expiration (Fig. 12, Plate VI}. 

(3) Take a deep breath occupying about two sec- 
onds, and breathe out in pufis, occupying about five 
or six seconds in expiration, 

(4) Take a quick, deep insjtiration, expanding the 
lungs as fully as possible, and follow with a prolonged 
expiration, sounding the syllable "ah. " 

(5) Standing or sitting, repeat each of the above 
exercises, at the same time raising the arms from the 
sides to a horizontal position while inhaling, and allow- 



814 



thb eroHAOH. 




F10.8S.— Lvnca. KneBsKotKii. 



ing tlicm to return to positiou by the sides wLilv 
exhaling. , 

(0) Repeat exercises 1 to i, raising the arms from 
the sides to a Tertical positioTi, reaching overhead as 
high as possible at tbe 
end of iuspirnrion. and 
allowing the arms to re- 
turn to the sidos during 
expiration. 

(7) C/i€>it L(ff!nff.— 
In Fig. 30 is shown « 
most excellent exercise, 
which, however, r p- 
quires the aid of an 
assistant. The patient 
sits in a chair while 
the assistant stands 
behind him. The assistant benils forwaid, grasps the 
arms a few inches below tlie shonMcrs, and lifts them 
npward and backward, the patient drawing in his 
breath at flie same time. Tlie arras ehonld be drawn 
npward far enough to produce b decided strain upon 
the chest walls. After being held in position a few 
seconds, the arms are retnmed to the sides. TTie 
movements are repeated ten to twelve times a 
minute, the patient taking a deep breath after each 
movement. The clothing should bo loose enough to 
allow the orgjios of respiratitm free play. 

Manual Swedish Movements. — Among the 
most important of all forms of exercise nseful in indi- 
gestion, must be mentioned Swedish medical gyrnnos- 
tics, or what are ordinarily termed "manual Swedisb 
movements. " Fnll directions for tbe employment of 



nOME TREATMENT OF DYSPEPSIA. 



315 



tnannal Swedish movenients in disease will be found 
in a moat excellent work no "Swedish Movements, 
or Medical Gjmnastics," Ii^ Professor T. J. Kartelitm, 
M. D., director o£ the Central Gymnastic Institute of 
Stockholm, Sweden, recently translated by Dr. A. B. 
Olsen, and edited by the writer ; published by the 
Modern Medicine Publishing Co., Battle Creek, Mich. 

The following groups of movements have been 
found especially valuable in the treatment of eases of 
chronic indigestion: — 

39. For General Debility and Anemia. — 



Re|>eat each of the following movements fonr to 
eight timea : — 

I. Lying, full breath- 
ing (38) (Fig. 12, Plate 
VI 1. 

1'. L y i n g, knees 
drawn np, knees separa- 
ting and closing ivith re- 
sistance (Fig, 11, Plate 
- VI) (37 p]). 

3. Replacement o f 
the abdominal organs 
(Fig. 0, Plate TI). 

4. Alternate head 
raising and leg raising for- 
ward (Fig. llJ, Plate VI). 

5. Sitting, arm, 
fiexion, extension and rol- 
ling (Fig*. 82, :)?.) (m). 

6. Lying, iDspirator^ lifting (Fifg. X,, VWaNV^_ 




Bepeat each of the following movements four to | 

eight times : — 

1. Inspiratory lifting (Fig. 7, Plate TI). 

2. Lying, knee bending and stretching (Fig. 35). j 




3. Hacking over liver, stomach, and spleen (Fig. 8, 
Plate VI). 

4, Sitting, armn extended sideways, arms rolling. 

5, Lying, raise trunk to sitting position ^37 [i]). 

6. Lying, knee bending and stretching. 

7, Replacement of abdominal organs (Fig. 6, 
Plate VT). 

8. Sitting, cheat lifting (Fig.. 36) (38 [7]), 



HOME TREATMENT OF DTBPEP8IA. 



317 



40. For Dilatation of the Stomach.— The 

following movements may aleo be employed for dilata- 
tion of the stomach and prolapse of the stomach and 
bowels, which are usually present in cases of nervoua 
headache : — 

Repeat each of the following movemeiits four to 
eight times : — 

1. Chest lifting (Fig. 36). 

2. Lying, knees bent, knees separating and cloeing 
(Fig. 11, Plate VI) (37 [7]). 

3. Sitting, arm raising, full breathing (38 [5]). 

4. Standing, hands upon the hips, backward 
bending. 

5. Lying, knee bending and stretching (Fig, 35). 

6. Lying, leg and head raising in alternation (Fijf- 
10, Plate VI) (37 [1, 2, 3]). 

7. Sitting, neck twisting and bending. 

K. Inspiratory lifting (Fig. 7, Plate VI). 

9. Reach-eupport-standing, sacrum beating (Fig. 9, 
Plate VI ; Fig. 37). 

10. Sitting, gentle backing ot head (Fig. 8, Plate 
VI), stroking head and neck downward. 

41. For Prolapse of Stomach, Bowels, 
Colon, Kidneys, and Other Abdominal Or- 
gans.— 

Repeat each of the following movements four to 
eight times : — 

1. Chest lifting (Fig. 36). 

•2. Replacement of abdominal organs (Fig. 6, 
Plate VI). 

3. Lying on back, leg and head rt^ising (Fig. 10, 
Plate VI) (37 [1, 2, 3]), 



318 



THE ETOUACa. 



4. Inapiratory lifting i^Fig. 7, Plate VI). 

5. Lying, knees bent, kneatiing of abdoialnal 
muscle B, 

G. Sitting, knees separated, tnmk twisting right 
and left. 

7. Lying, raise to Bitting position (Fig. 3 ■) 
(37 t*)). 

8. Sitting, lient forward, raise backward witlj pres- 
sure npon the loins. 

9. Rejjeat exercise 2 with inspiratory lifting, 
10, llcpeat exerciao 3. 

42. For Dyspepsia with Dilatation of the 
Stomach. — 

Kepeat each of the fol- 
lowing niovemontB four to 
light times : — 

1. Chest lifting (Fig. 




'J. Keaclhs n p p o r t- 
standing, spine hacking 
and sacrum heating (Figs. 
S, !", Plate VI; Fig. 37). 
3. Lying, knees bunt, 
kneading the stomach 
(Fig. 5, Plate VI; Fig. 3»}. 

+. Lying, leg and head raising (Fig. 10. Plate 
VIJ (37 [1, 2, 3]). 

5. Arm raising, fall breathing (38 [5]). 
(', Lying, knees bent, pressing under right and left 
ribs witli vibratory movements. 

7, Sitting, trunk twisting to right and left, 

8. Repeat exercise 3. 



r 



1 TREATMENT OF DYSPEPSIA. 



9. LyiDg, knees beot, kaees separating and closing 
with resistance (Fig. 11, Plate VT) (37 [7]). 

in. Repeat exercise 6. 

11. Standing, forward bent, sacrum beating (Fig. 
37). 

43. For Constipation. — 

Rejieat each of the 
following iDdvements four 
to oight timi?8 : — 

1. BtAnding, leut 
separated, sideways Ix-nd- 
ing to right and loft | Fig. 
39). 

2. Chest lifting (Fig. 
36) (38 [7]). 

3. Sitting, twisting 
to right and left. ' 

4. Inspiratory lifting '"'^.-vf^^r^""'" 
(Fig. 7. Plate VI). 

5. Lying, kaeea bent, kneading of the colon (Fig. 
4, Plate VI). 

6. Head and leg forward raising (Fig, Ki, Plate 
VI) (37 [1, 2, li]). 

7. Sitting, feet separated, describo a large circle 
with tlie head and shonlders, holiliiig the trunk straight 
and the hips stationary. 

8. Repeat exercise 4. 

9. Reach -support- standing, sacrum beating (Fig, 
37). 

10, Sitting, arms stretched above liead. hend arms 
with resiatance, back supporttnl by the knee of the 
attendant. 




THE BTOMACH, 



44. The Dry Abdominal Bandage.— A dry 

tiaimol bandage worn about the abdomen is often ofl 
great value m oases of indigestion. The whole abdo- 
men, from the lower end of the steninni to the pubes, 
should bo covered by the bandage, which sliould fit th< 
skin eniigly. It should always be worn during tlie daj- 
time by persons who wear the wet girdle at night. 

45. The Abdominal Supporter. —The aV 
dominal supporter (Fig. 4li) consists, first, of two hard 
rubber piods connected by an elastic wt,bbing, nbioh' 

lest againit tlio lower abdo- 
men being caiefully shaped 
so as to make a unifortq 
prmsufL, and second, ii 91 
of steel springs attached to 
back piece, and so adjusted 
as to make piessure upon 
the hard rubber plates simul- 
taneously backward and up- 
ward Tlie action of thi 
supporter is almost a perfect 
imitation of the hands 
lifting the prolapsed ab- 
dominal contents. After trying every form of sup* 
porter offered in the market, I have fonnd the Natoral 
Abdominal Supporter naoro satisfactory than any other, 
and have employed it in a very large number of 
It is manufactured and sold by the Modern Medlctiu 
Company, Battle Creek, Mich. 

46. Lavage. — The accompanying cut (Fig. 4l) 
shows an approved form of stomach-tube, which U 
used in obtaining a test meal for the examination of tk« 




- I 



HOME TREATMENT OF DYSPEPSIA. Ii21 

stomach flaid, and for waBhiug out the stomach when 



The most snitahle time for washing the stomach is ' 
juat. before retiring :it uigbt, or five or six hours after 
the last meal. The operation is by no means so diffi- 
cult or distressing as it might appear. The tube em- 
ployed is of very soft, flexible rubber. It is not forced 
down into the stomach after the fashion of the old 
stomach-pump, but is simply swallowed as one would 
swallow a portion of food or a capsule. One end of 
the tube being introduced 
iuto the mouth and passed 
well back into the throat, the 
patient makes movements 
of swallowing whereby the 
tube is readily carried into 
the stomach. Water of 
about the temperature of the 
body is then poured in, 
either with or without the ad- 
dition of common salt and soda iu the proportion of a 
teaspoouful of each to a quart of water. A powder 
consisting of three paite of bicarbonate of soda, one 
part of sodium sulphid, and one part of chtorid of 
sodium, may be advantageously used in cleausiug the 
stomach, one teaspoonful of this powder being added 
to each pint of water used in cleansing the stomach. 
After a pint or so of water has been poured into the 
stomach, tlie outer end of the tube is lowered, and by 
coughing or similar movements tlie contents of the 
stomach are forced through the tube into some proper 
receptacle. Repeat imtil the water is clear. 




THE STOMACH. 



Hot and Cold La^vage of tlie Stotnacli, — The pnr- 
poae of hot and cold lavage of the stomach is to stimii- 
]ate the secretion of pepsin and hydrochloric acid iu 
cases of hypopepsia and apopsia. The geucral mtsihod 
is the same as that for lavage. The temperature of the 
fluid nsed may vary from 70° to 120" F., and tlie 
quantity from half a pint to a pint. Ordinarily, at tho 
beginning, the extremea of temperature should not be 
more than 20° F., or S5° to li)5° F. Alternate hot 
and cold applications are a powerful means of stimnlat- 
ing vital activity, and the method is as serviceable 
when applied to muctius membranes as to the skin. 

^T. Charcoal.— Charcoal is valuable by reason of 
its remarkable absorbent qualities, whereby it takes up 
the poisonous substances produced in the stomach, thus 
preventing their absorption. It also exercises a vt>ry 
remarkable influence in preventing certain forms of 
fermentation in the stomach. It should be impalpably 
fine, so that it will not produce irritation of tho mucous 
membrane, and should be freshly prepared, Tho author 
has succeeded in preparing, and has for many years 
employed, a special form of charcoal made from cere- 
als, which he has found to bo very much superior 
to the willow charcoal obtainable at tho drug-stores. 
Charcoal must be taken in large doses (a heaping tea- 
spoonful at leaat) to bo of any service. It is best taken 
by mixing with a little water. At first use just enough 
water to moisten, then add more. 

48. Charcoal Tablets.— The Modem Medicine 
Company, Battle Creek, Mich,, U. S. A., have suc- 
ceeded in preparing charcoal in tho foi-m of tablets, 
which are more convenient for nse than the pulverized 




I 



HOME TREATMENT OF DYSPEPSIA. 



323 



charcoal, as tbey can be handled readily, and taken witb 
out water and without inconvenience, besides retaining 
their active properties indefinitely. 

49. Antiseptic Charcoal Tablets.— These 
tablets are also prepared by the Modern Medicine 
Company, and are found to bo the most effective 
means of preventing fermentation and decomposition 
in the stomach. They are especially valuable in acid 
and bilious dyspepsia, and in cases in which the tongue 
is heavily coated, 

50. Lactic Acid. — Lactic acid, in the proportion 
of one ounce of the acid to three of water, is a useful 
remedy in cases of hypopepsia without fermentation. 
The dose should be one tcaepoonful in water immedi- 
ately after each meal. 

51. Hydrochloric Acid. — Hydrochloric acid, in 
the proportion of one dram of the acid to three ounces 
of water, is useful in cases of hypopepsia and npcpsia, 
but should not bo used habitually. Two teaspoonfuls 
in water, half an honr after each meal, constitutes a 
dose ! a second dose may her taken half an hour later. 

52. Laxatives. — Such fruits as tamarinds, figs, 
manna, and prunes, with a tablcspoonful of bran mixed 
with boiling wattir, aro all food laxatives of value in 
many cases. Antiseptic charcoal tablets (49), three or 
four after each meal, also have an excellent laxa- 
tive effect. The advantage of these tablets is that their 
continued use does not destroy their efficiency, aa is the 
ease with most laxatives. 

53. Cascara Sagrada. — The fluid extract of 
cascara sagrada is one of the most valuable of all 
drags for temporary use as a laxative in cases of iaacr 



THE STOMACH. 



tivity of the bowels. The dose ia fifteen lo thirty 
drops of the fluid extract taken at night in a little 
water and before breakfast, for a few days. It should, 
however, be uscd only for a sliort time, as it usually 
loses its effect when long continued. 

54. Aqua Salina. — This is composed of anl- 
phate of soda, one and one half ounces ; sulphate of 
magnesia, one half dram ; sodium chlorid, one foartb 
dram ; water, one pint. One fourth lo one half a glass- 
ful, diluted with cold water, should be taken before 
breakfast. This is an excellent substitute for the beet 
of the laxative mineral watern, but should be used only 
in case of emergency, when the enema cannot be em- 
ployed, and should not be long continued. 

55. Seltzer. — This is composed of sulphate of 
magnesia, one ounce ; tartaric acid, three and one half 
ounces ; bicarbonate of soda, four ounces. The dose 
is two to four heaping teaspoonfule, in water, before 
breakfast. Use same as 54. 

56. Sulphur. — Sulphur is an old-fashioned but 
useful remedy as a laxative and intestinal antiseptic. 
It should bo taken in ten-grain dosos three times a day, 
or in doses of one half a dram at bedtime. It may bo 
mixed with a little molasses or brown sugar. 

57. Antiseptic Dentifrice. — This excellent 
preparation for cleansing the teeth is based upou the 
extract of the bark of the famous soap-tre« of South 
America and aromatic antiseptics. It may be obtained 
of the Modern Medicine Company, Battle Creek, Mich, 

58. Cinnamon Solution. — Add two teaspoon- 
fids of oil of cinnamon to a pint of water ; shake thor- 
oughly. Tliis is to bo used as a lotion for rinsing and 
washing the mouth. 





BOUS TBZATMKNT OP DYBPEPBIA. '^SS 

59. The Perfection Vaporizer. —This is au 
excellent instrument for the vaporization and nebu- 
lization of medifated 
eolations for nse in 
the treatment of af- 
fections of tlie throat 
and nose (Fig. 42). 
It is for sale by the 
Modern Medicine 
Company. 

60. Benzuin A\ "^l 

Solution. — Gum 

benzoin and all other 

balsams and essential „ , , „ ^ 

Flo- 43, — PERFErTios Vaporizer. 
Otis are antiseptics, 

and, used by means of tlie Perfection Vaporizer, are of 
great value in the treattuent of dises^sea of the nose 
and throat. The folhiwing solntiou, in which benzoin 
is one of the principal ingredients, has been found 
especially valuable : — 

Q CompounO Tr. BcDzoin. . . ilrniB. (i 
Oil Cinnamon, Oil Wln- 
lergreen, Oil Eucalyptus, 

~",|lli Mi-niliol Crystals aa. •Mm. 1 

-■•' Alcolifil drtna. 15 

61. Guaiac Solution.— 

B Menthol Crystals. 
Oil Eucalyptus, Tr. 
(:uaiac,...au.drm. 1 
Akohol drms, 

02. Subcarbun- 

"i-llin ' i|t)(|-«|P''«iii'!iiii||||'"''"-»ia*e of Bismuth.— 

I Subcarbonuto and sub- 
Fio. 43.— Vapobizkr in Use. t\\ttM» q1 \iYKO.\jSa. «.i<* 




Wi^^^ 



326 THE 8T0MA0B. 

two very usefnl drugs, which may be frpqnenlly used 
to advantage in casoa of indigestion acconijianied by 
great irritation of the mucous membrane, and aro in- 
valuable in ulcer of tlic stomach and in hyperpepBia, 
The doBB ie fifteen to thirty grains before each meal. 
When lavage of the stomach gives pain, it should be 
followed by a dose of twenty to thirty grains of snbni- 
trate or Bubcarbonate of bismuth. 

63. Subgallate of Bismuth. — Snhgallate of 
bismuth is an excellent intestinal antiseptic, five to ten 
grains to be taken before each meal. It is especially 
valuable in eases in which there is a tendency to looee- 
nesB of the bowels, as it is somewhat atttriiigent in 
its nature. It has a tendency to produce constipation 
when its use is loug continued. It is, on this account, 
inferior to antiseptic charcoal tabli?ls (^9) as an intes- 
tinal antiseptic, but is especially valuable in cases in 
which an intestinal antiseptic is required in connection 
with an irritable condition of the stomach and in cases 
of intestinal catarrh. 

64. Bicarbonate of Soda,— This much-abused 
drug may be usefully employed in hyperpepsia and 
ulcer of the stomach, in which it should bo taken in 
twenty- to thirty-grain doses, just before eating, in very 
severe cases, or two or three hours after eating in caaefl 
of less severity. 

65. Local Applications of Faradic Elec. 
tricity, — Care should betaken that the sponges arc 
moist, the conducting cord in good repair, and the 
battery in good order. Strong currents are generally 
best for relieving pain. When it is desired to exercise 
the muscles, the sponges should be applied near the 



HOUG TREATMENT HV nVSrEPSlA. 



327 



edges of the muscle, and tlie current should be rapidly 
interrupted by' removing the B])onge and replacing it, 
BO as to produce repeated muscular conti-actions. The 
application of electricity to the poctum is a most excel- 
lent means of relieving constipation. A special elec- 1 
trode is required for the rectum, a large, flat sponge i 
being placed over the abdomen. In the absence of a J 
special electrode, a small spimgo may be applied to ] 
the amis. 

66. General Applications of Faradic Elec. 
tricity.^As a general tonic, the current is applied 
in the following manner : A large, flat sponge is placed 
at the feet or connected with the feet by means of a 
foot bath, one sponge being dropped into the bath 
while the other sponge is passed over the whole surface 
of the body, — first the spine, then the arma and legs, 
then the tmnk, — the strength of the current being 
sufficient to create a slight tingling sensation as tlie 
sponge is brushed over tlie eurface, without producing 
muscular contraction. 

For muscular effects, the following mode of appli- 
cation is employed ; Two sponges, held a few inches 
apart, are applied to the muscles of the arms, legs, and 
trunk in such a way as to cause strong contraction of 
the muscles. By frequent interruption of the cm-rent 
by the removal and replacement of one of the sponges, 
repeated contractions are produced. Thus all the mus- 
cles of the body may be exercised. 

67. The High Tension Sinusoidal Cur. 
rent. — This current is obtained from a specially 
constructed electrical apparatus fsee Fig. -14), and i 
particularly efficacious in relieving pain, often sacceed*. 



THE STOUACU. 



ing when other means fail. The current ia applied the 
same as the faradic currcut (65, 66). 

68. The Low Tension Sinusoidal Cur- 
rent. — This current is obtained from the same appa- 
ratus as the preceding, but by a different atljustraent of 
the machine. It ia especially useful f*ir exerciae of the 
mnscles, especially those of the trunk and abdomen. 
It is very valuable as a moans of relieving chronic con- 




stipation. When nsod for this purpose, a metal elec- 
trode is placed in the rectum, and a large sponge over 
the abdomen. The current should bo of sufGcient 
strengtli to cause \-lgoroiiB contraction of the abdominal 
muscles. The abduntinal niu»ck-e are thus strengtltcned 
and the nerves of the rectum stimuhited, 

69. Galvanization of the Spine and Ah. 
domen. — A galvanic battery of thirty to fifty cells ia 
required. A sponge about the widtli of the hand and ten 
or twelve inches in length is placed upon the central por* 




HOME treatue: 



329 



tion of the spine. Aootlier sponge of the same length, 
and twice as wide, ia applied over the abdomen opposite. 
As strong a current is passed as can be endured by tlie 
patient without severe pain or injury to the skin. The ' 
sponges should be well moistened, and should be 
closely adapted to the skin. Clay electrodes secure 
better contact than sponges. 

70. Galvanization of the Sympathetic i 
Nerve. — A galvanic battery is required as indicated J 
in 69- A sponge the size of the hand is placed at the 1 
back of the neck, and another twice as large is placed \ 
over the umbilicus or the epigastrium. A cnrrent as 'i 
strong as the patient can bear witliout injury to the 'i 
skin is applied from ten to twenty minutes. 

The Rest-Cure. — A course of rest-cure treat- 
ment is indicated in cases in which there ia excessive J 
nervous irritability, combined with nervous exhaus-] 
tion, and especially in cases in which emaciation i 
prominent symptom. Rest -euro sliouM be followed! 
by "General Nutritive Treatment," and afterward bya 
"General Tonic Treatment," fur which it ia a prepa-l 
ration. 

FoBM A. 

1. Absolnte rest in bed, with exclusion, of friends, 1 
is demanded. The patient should bo kept quiet, and.] 
encouraged to exorcise tlio ntind as little as possible, to 1 
sleep all ho can, and to rest both physically and mentally. 

2. The patient should take four meals a day, — twa I 
major and two minor, — the major meals preferably at ' 
S A. M. and 3 r. m. ; the minor meala at V^ h, and 

7 p. M., and should eat as much aa can be digested. | 
The major meals may conaist of any of the artidegj 



TRB STOUAOB. 



included in Diet Lists Nus. ;i, 3, and 10. The minor 
menls should be confined to the articlee found in Diet 
LiBtB 5 and 6, or euch funds as are very quickly digested, 

la cases in which the digestion is very ranch im- 
paired, it is better to confine the diet chiefly to kumy-J 
zoou or buttermilk, and eggs. Bromose and granof 
(Diet List No. 1^5) are also especially nseful in thesft | 
cases. Bromose may be taken as a substitnte for milk 
in cases in which milk does not agree well with the 
stomach. It is a most excellent food for the minor 
meals. When obtainable, granose should be used at 
the major meals as a means of regulating the bowels. 

The patient should, on awakening each morning, 
have di-y friction applied to the whole surface of tho 
body by the band, or, better, with a rough towel or 
a soft flesh-brusb. At 10 a. u., hot and cold applica- 
tions should be made to the spine (18), to be followed 
by a tepid sponge bath {I). Massage (3ti), at first 
very light, should be applied with increasing vigor 
from day to day. After tho first week, the muscles 
may bo exercised by flexion and extension of the arms 
and legs, the patient making resistance (see Figs. 32 
and 33). Tho bowels should ho moved daily by means 
of the enema (22), if necessary. Tlio action of the 
stomach and bowels Bboiild bo encouraged by massage 
of the stomach (31) and kneading of the bowels (30). 
Symptoms of indigestion should receive attention as 
elsewhere reeoraraendod. 

Form B. — Modified Rkst-Cuek, 

The same measures recommended in Form A should 
be employed, but tbe patient should be given a litt le 



HOME TREATMENT OF DYSPEFSiI 



3.11 



exercise out of doors for an hoar or two daily in a 
wheel-chair, or at first lying upon a cot. After a few 
daya the patient may be allowed to walk a little, bat 
should spend at least half the time each day in bed. 

Form C. 

Tho measures recommended for " General Nutri- 
tive Treatment," eombiued with rest in bed the greater 
part of the tmie, should be employed. 

General Nutritive Treatment. — The por- 
poae of nutritive treatment is to improve the patient's 
nutrition by increasing the demand for food, hence the 
appetite, and tims enlarging the store of food and blood 
in the body without overtaxing tlie nervous system. 
Xutritive treatment is required in the case of very 
young and very old persons. 

The following series of [jrescripLions are progress- 
ive. Feeble patients slifiuld begin with A ; while 
strong patients may begin with B, or even C. The 
patient should be promoted at the end of one, two, or 
three weeks, to the next prescription, and after com- 
pleting this uutritivD series, should begin the tonic 
series, page 333. 



Fomentation over the stomach and liver every 
morning before rising, to bo followed three times a 
week by a tepid sponge bath (90" F.). rubbing with 
oil, and on other days by dry friction with a soft flesh- 
brush or a coarse towel. 

General massage and massage of the stomach, 
bowels, and liver, about li) a. m. daily. 



333 



THE 8TOM4CB. 



A short, warm full bath, with soap shampoo, fol- 
lowed by an oil rob, taken just before retiring at siglit, 
oDCe a week. 

Carriage riding, walking, bicycle riding, or otheE 
exercise iu the open air euited to the patient's strength, 
from one to three hoars daily. 

Sun bath five to fifteen minntes daily, or whenever 
possible. 

Swedish movements (39, A), daily. 

Breathing exercises before and after each nteal. 

One or two hours' rest in a horizontal position be- 
fore dinner. 



Warm full bath {'.<o° F. ), with a cold pour over th<i 
spine and the liver twice a week. The bath ehouM b» 
cooled to 80" F. for ten or fifteen seconds at the close, 
and followed with an oil rub. This bath is best taken, 
at night just before retiring. 

Hot and cold sponging of the spine for ten 
fifteen minutes every morning, followed by a tepid 
sponge bath (85" F.) and an oil rub, with hackin|; 
over spine and liver. 

Soap shampoo once a week. 

Sun bath, out-of-door exercise, and massage as iu A. 

Swedish movements (39, B). 

C. 

Short vapor, Turkish, or hot-air bath, or a wet- 
sheet pack continuing twenty to thirty minutes, twicq 
a week, followed by an oil rub at about 10 a. m. or 
uight just before retiring. 




I 



HUME TSKATaENT OF DYSPEPSIA. '-VA'S 

Fomentations to the spine for fifteen minutes, fol- 
lowed by a cool (75° F.) sponge bath and an oil nib 
every morning. 

Swedish movements {39, B). 

Exercise, sun baths, and massage as in A, with in- 
creased vigor. 

General Tonic Treatment.— One of the es- 
sential features of tonic treatment is the application of 
cold water. Water is one of the best of all tonics. 
This treatment is indicated in cases of general debility, 
anemia, and most forms of chronic disease. It is only 
contra-indicated in tJie cases of feeble, very yonng, 
and aged persons, and in those in whom there is a 
high degree of irritability or excitability, Tlie treat- 
ment should bo made progressive. The feeble patient 
should begin with A, being promoted at the end of two 
or three weeks to B, and later to C. After completing 
the entire series, the patient may advantageously con- 
tinue some of the measures recommended, as a regular 
habit, particularly the cool morning sponge or shower 
bath, followed by vigorous rubbing, and the regular 
daily exercise out of doors. 



Hot sponging of the spine, a cool (80° F.) towel or 
sponge bath every morning before rising, followed by 
hacking of the spine, spatting of the general surface, 
and oil rubbing. 

At 10 A, M. general massage or Swedish move- 
ments. 

General applications of electricity — faradic (66) or 
Binasoidal (67) — daily. 




THE STOMACH. 



Swedisli movements (39, A). 

Exercise out of doors, csirriage riding, horseback 
riding, bicycle riding, according to tbe patient's 
strengtli, daily from two to four honre. 



In addition to A, the patient should three times 
a week take fomentations ovt^r the stomach and liver, 
followed by a nibbing wet-sheet. This treiitraent may 
be given at bedtime, unless the patient is apt to bo 
greatly fatigued at night. In each cases it should be 
taken earlier in the day, but not within two boors of 
a nieal. 

Swedish movements (39, B). 



Tht! patient should talte, each morning, a fomenta- 
tion o\'i'r tiie abdomen, hot and cold sponging of tlie 
apine, a cold (75° F.) sponge bath, followed by an 
oil rub, hacking over the spine and liver, and general 
massage. 

At 10 A. u. or at bedtime, three times a week, a 
cold wet-sheet pack for twenty to thirty minutes, fol* 
lowed by a rubbing wet-sheet and an oil rob. 

Swedish movements, general applieationa of elec- 
tricity, massage, and out-of-door exercise as in A 
and B. 

Mechanical Swedish Movements. — For 
many years I have made use of uiechanical means 
iu the treatment of indigestion and constipation. Pa^ 
tionts under my care have derived special benefit from 
the use of the vibrating chair, the kneading apparatns. 




ROME TKESTMEST UP DYSPEPSIA, 



335 



and tlie trunk-sliakitig apparatus, wMch are illustrated 
in Plates VII and VIII. Tlie following dosciiption 
of these miiehiues is copied fi'om the author's work, 
"The Art of Massage," previously mentioned : — 

"?:(<> Mbrating CAam— Fig. 2, Plate VII, rep- 
rusents a vibrating chair de^-ised by the author in lH'^'Ay 
and in constant use since tliat time at the Battle Creek 
Sanitarium. The usual rate of vibration employed is 
twenty per second. A person needs to experience but 
a single application to become convinced of the power- 
ful physiological effects which may be produced by 
mechanical vibration. When seated in the chair, 
strong vibratiiiry movementa are experienced, in which 
tlie whole body takes part. The greatest amount of 
force ia applied to the lower portitm of the trunk. 
The vibratory irapnisoa communicated are felt power- 
fully in the lower bowel, and have a dei-ided stimulat- 
ing effect upon the rectum. 

"jV(Wki«kw^ Knmdlng, — Mechanical kneading of 
the alxlomcn is one of the most useful of the several 
forms of kneading ; indeed, it may perhaps with justice 
be said to be the moat useful of all. It is best admin- 
istered by means of the apparatus shown in Fig. 1, 
Plate Vni. This apparatus, which the writer had 
constructed for the purpose several years ago (18S3), 
and has had in constant uae since, consists of a table 
with a large aj>ertaro near the center of the top. In 
tills opening plays a aeries of eix vertically placed bars, 
each surmounted by a suitable pad. Each bar ia sepa- 
rately actuated by a cam, or eccentric, so that it has its 
own independent motion. These six eccentrics are so 
arranged as to give a wave-like form to the combined 



TBS STOMACH. 



Itaneouan 



inovcmcriU of t!ic six kneading pads. Simnltaneoi 
with the vertical movement of this kneading devic^ 
the table-top, witli the patient which it bears, is uia<Ie 
to move back and forth, thus changing the relation ol 
the pads to the abdominal surface, and caosing tliei 
to knead the entire abdomen. The two eeta of mow 
tnentH are bo tiniod that the wave-like kneading mon 
ment is made to follow very closely the conrae of tt 
colon, thus bringing this part of the intestine especial] 
under control. 

" 7Vm«A Rdling. — The apparatus represented i 
use in Fig. 1, Plate VII. consists of a pair of pnli^ 
moving in alternation and in opposite directions, , 
fraction of a revolution in each direction. To ead 
pulley is attached one end of a broad strap, which 
passed around the trunk in such a manner that, Ba d 
strap is pulled first in one direction and then in tl 
opposite, the tissues are acted upon very mncb as i 
certain forms of palmar kneading. When appli« 
about the waist, it is a very excellent means of admil 
istering a rolling movement to the muscles of tli 
trunk, and a shaking movement to the viscera ; when 
applied to the shoulders, the effect is that of deep 
kneading. This apparatus, devised by the aatbor 
about ten years ago, is a favorite with patients who 
are under treatment by mechanical massage. Its ap- 



ingO^ 



plication is so vigorous that it is not continued longi 
than from two to four minutes, 

' ' Peloiif Tlltiity. — The parpose of this device ( Fi^ 
3, Plate Vn ) is to aid in restoring the prolapsed organe 
to a normal position. Tlio apparatus consists of a tilt- 
ing table which moves rhythmically from a horizoo] 




HOMK TREATMENT OF DYSPEPSIA 



positioD to that shown in the cut, in which the position 
of the patient ia such as to cause the abdominal organs 
to be dragged upward by gravity. It ia very useful 
in relieving pelvic congestion and other symptoms 
commonly present in eases in which the pelvic and 
abdominal -organs are prolapsed. 

''Mechnnical Rmjnratkm. — ln Fig. 3, Plate VIII,. 
is shown an apparatus by means of which artificial res- 
piration may bo mechanically administered. In its use 
the patient is seated upon a stool, the arms being placed 
over movable rests, which fall in the axilla;. The back 
is supported by a padded rest placed between the shoul- 
ders. When the machine is set in motion, the shoul- 
ders arc lifted upward and backward in such a way as 
to expand the chest in an efficient manner, producing 
a strong inspiratory movement quite independent of 
any effort on the part of the patient. The effect is to 
correct the condition known as flat or hollow chest, 
and to give flexibility to the chest walls when they 
have become rigid in ciinsequenco of iusutticient uso. 
This apparatus Is in part modeled after a similar ar- 
rangement by Zander, but several improvements have 
been atlded ; among others being a device by means 
of which the arms, as well as the shoulders, are raised, 
tlins increasing the vigor of the inspiratory movement. 

'■^ Cannon- Ball Maesage. — A cannon-ball covered 
with leather is a valuable mechanical accessory in the 
application of abdominal massage. A ball weighing 
from four to six pounds is usually employed. The ball 
is simply rolled upon the abdomen, following the 
course of the colon from right to left. I have found 
the canuon-ball very useful when employed in connec- 



I 



338 Thb stomacb. 

tioii with utLcr Measures of treatment. It has tliiA' 
iidvantagt', tliat it may bo employed by tbe patient 
himself. It ehoulJ be uaed for fiftpen minutes morn- 
ing and evening. In the morning it may be employed 
jost before rising, or half an hour after breakfast." 

Water-Drinking. - — In cases of obstinate con- 
stipation, due to inactivity of tlie liver, water-drinking 
is of advantage, if the stomach will bear it. The qnao- 
tity of water which can be taken will vary from a single 
glassful before breakfast to six glassfuls a day in the 
intervals between meals. Kepeated experiments by 
the most eminent physiologists have shown that the: 
liberal nse of water as a beverage is a great promoter 
of vital activity, not only of the liver, but of other vital 
organs. This measnre must not be cari'ied to excess, 
however ; it should be discontinued if it distnrba di-i 
gestion. 

Water- drinking has been very much abnsed withiii 
the last twelve or fifteen years, since it was broaght; 
prominently before tlie public by I>r. Salisbury and 
Dr. Cutter, of New 1 ork. In cast-a of dilatation rf 
the stomach, which is very common among dyspeptics, 
constituting nearly one half the entire number, copiood 
water- drinking is often productive of groat mischief. 
The dilated stomach being unable to absorb fluida 
rapidly, and retaining for a long time the large quaa*i 
tity of water introduced, becomes abnormally distended 
and overweighted, and the patient's condition is thai 
aggravated rather than benefited. The use of Uu 
stomach-tube in washing out the stoniaeh largely obvi 
ates the necessity for copious water-drinking. In case) 
in which water-drinking must be interdicted o 




HOUE TREATMENT OF DV8PKFS1A. 



of dilatation of the stomach, a sufficient amount of 
moisture may be supplied by alowly introducing a 
quart or two of water into the colon daily, preferably 
at night, allowing iib much of the liquid to be absorbed 
as pottsiblc. 

The Hunger-Cure. — Fifty years ago the hunger- 
cnre was much practised by the followers of Dr. Joel 
Shew, aud at the primitive water-cures which were at 
that time to be found in various parts of the Middle 
and Eastern States. The advocates of the hunger-cure 
extolled it so highly, however, and used it so indis- 
criminately, that it fell into disrepute, and faating is 
now seldom mentioned aa a mode of treatment. How- 
ever, the wiiter is of the opinion that abstinence from 
food is one of ttie most important and valuable of eui-a^ 
tive measures in a groat variety of morbid conditions, 'j 
and especially in certain forms of indigestion. , 

The fasting exploits of Drs, Tanner and Griscom, I 
who abstained from food for forty and forty-two days * 
respectively, and of the Italian faster who, in London, - 
under conditions of strict surveillance, abstained wholly 
from food for the full period of sixty days, have dissi- 
pated the erroneous notions formerly held respecting 
the immediate necessity of food as a condition of life. 
The body contains within itself a considerable store of 
nutrient material, upon which it is able to draw in case 
of need. 

In all conditions in which the system is laboring 
under the iutluonco of poisons absorbed from the ali- 
mentary canal, abstinence from food is the surest and 
sometimes an indispensable means of prompt relief. 
These intestinal poisons are due to the action of germs, 



340 



THE STOMACH. 



lubstftDOeq 

of mi- 
■wjnire 
iig rid 

OQt M 

, Bcntf 



and result from the decomposition of food sul 
consequent upon the growth and development of mi- 
crobes. Germs, like other living organisms, rwjni 
food for growth. Tlie quickest method of getting rid 
of them and their evil effects, is to starve them oot 
abstinence. 

The advantage of withholding food in fever, 
rheumatism, and inflammation of the stomach andj 
bowels, has long been recognized. Fasting is equally 
useful in many eases of biliousness, bilious dyspepsf" 
and dilatMion of the stomach. Nothing will so quick^ 
relieve an attack of sick-headacbc as abstinence trot 
food. Fasts of two or three weeks' duration, as prai 
tised in water-cures half a centnry ago, are not, faow 
ever, to be recommended ; but the omission of a tm 
when one feels slightly indisposed, with loss of app< 
tite, and perhaps slight headache, will often prevent 
more sorions illness, and quickly restore the vital eqm 
libriom. A nimiber of years ago the writer succeeds 
in effecting a cure in a case of very pronounced dilatl 
tion of the stomach, by requiring tlie patient to abstv 
from taking food by the mouth for two weeks. Nm 
tion was maintained by means of the nntritive enen 
At the end of the two-weeks' fast the stomach a 
found to be reduced to nearly its normal dimenaioi 

I had under my eare at one time a lady who man 
years before had submitted to the hunger-cure. Th 
patient was sutfering from obstinate constipation, 
result of prolapse of the stomach and colon, and dili 
tion of the colon. She claimed that the two-wee^ 
fast which she had undergone some twenty years bj 
fore, had resulted in a complete cure of the eoi 





HOUE THEATMENT OF DYSPEPSIA. 



tioD for more than twelve yeai's. So severe a. measure 
is not necessary, however, in cases of this kind. A 
proper regulation of the diet, the support of the pro- 
lapsed viacera by a suitable abdominal 8upport«r (Fig. 
40, page 32lJ), and the employment of euch curative 
measures as electricity, manual Swedish movements, 
gymnastics, and hydrotherapy, will suffice to effect a 
cure, if employed intelligently and perseveringly. 

Fasting methods can very easily be abused. Fro- 
longed fasting should never be undertaken without the 
advice and cai-eful aupervision of a physician. I have, 
in my experience, met with very few instances in 
which I have thought it proper to advise a prolonged 
fast, but have in a great number of cases observed de- 
cided benefit as the result of omitting a few meals, or 
fasting for a day or two. 

Great benefit may be received from what might be 
termed a partial fast, in which the patient subsists 
wholly npon some one simple article of food luken in 
moderate quantity. Fruit, as ripe apples, grapes, or 
peaches, is best suited for this purpose. The effect of 
such a regimen, which may be followed for a week 
without injury, providing the patient is resting, is to 
purify the general system in a wonderful manner, first, 
by preventing, through the destruction of microbes, the 
production of poisons in the alimentary canal, which 
overtax the liver in their destruction, and the kidneys 
in their elimination ; and, second, by encouraging the 
activity of the kidneys in removing impurities from the 
blood. Fruit is a natural diuretic. 

Healthful Dress. — As has already been men- 
tioned, dress is a matter of no small consequence in 




the twatineiit of ehroiiiu dyspepsia. Any press OT 
iipoD \im stomach ia liiglily injurious. Men, as wc 
as women, frequentlj' suffer injury from constrict, 
the waist, iii supporting their clothing by means of 
belt. The writer has met with two cases of floatit 
kidney in men, in which the condition was evidentl; 
due to c<intr&(;tiou of the waist. In one case a btat^ 
smith had usually supported his clothing by mean 
of his leather apron-strings tied tightly aboat 
waist. In the other case an army officer had b 
injured in the same manner by the constrictioD of 
Bword-belt. 

The clotliing should fit the body so loosely 1 
there will be ample room for fall expansion of 
chest at the waist ; otherwise, with each inhalatioi 
the stomach is crowded down out of position. Th 
clothing should be wholly suspended from the shotitq 
ders, not merely by straps, but by waists ; or it is atjltj 
better to wear what are known as " union garments^ " ' 
which tho upper and lower garments are nnited in oih 
Plates IX and X show some excellent designs £l 
bealtliful dress for women which have been designl 
in the Dress Dcj>artmeut of the Battle Creek San 
tarium, from which patterns may be obtained. 

In addition to wearing the clothing loose daoi 
to give every organ perfect freedom of action, it is 
the greatest impoitauce tliat the extremities be k4 
thoroughly warm. Cold hands and feet are very ci 
mon with dyspeptics. It will generally be found I 
to wear flannel uiidergarmenta throngliont the y< 
graduating the thickness to tho temperature. In i 
(reme cases oi disturbed circulation, it may be 




^ 



TREATMENT OF DYSFSFSEA 



BSry to change the clothing once or twice a da}- to 
accomplish this. 

Sleeping. — It ia of great importance that suffi- 
cient sleep be obtained hy those suffering from indi- 
gestiott, though sometimes tin's seems impossible on 
account of the nervouaueas occasioned by this disease. 
It is generally best to retire early, but there is no virtue 
in getting up in the morning at an early hour unless 
the body is recuperated by rest. Sleep must be ob- 
tained, and on many accounts it is better to take it in 
the forepurt of the night ; but if not secured then, it 
should be taken at other times. Sleeplessness induced 
by anxiety is often a cau^e of dyspepsia. It is a gi'cat 
obstacle in the way of successful ti"eatmeut. 

It is an excellent practise to retire for rest for an 
hour or two before the mid-day meal. Many dyspep- 
tics ai-e able by this means to recruit sufficient energy 
to digest the second meal, while otherwise they suffer 
from indigestion after dinner, although capable of di- 
gesting breakfast without difficulty. 

Traveling. — Many physicians are in llie Imbit 
of recommending patients upon whom t\wy liave <j\- 
hansted their akill, to seek hoaJlh by traveling. Thou- 
sands annually leave their homes, and at great expense 
visit various watering- J daces, mineral springs, etc.. in 
this country and in Europe, iti accordance with such 
advice. Some return much benefited ; but the ma- 
jority are no better except for the rest. This ia due 
to the fact that traveling does not remove the real 
cause of the difficulty, and may often increase it. In 
general, it is next to impossible to secure, while fr-ivfl- 
ing, either regularity of meals or other habits, vr :i 



3W 



proper quality of food. This, of course, to a great 
degruc counteracts the benefit which might otherwiiw 
be derived. 

The advantage of special climates is unUonbtedlr 
very greatly overrated, thuugh a cool climate may gen- 
erally be coDBidered as best, especially for those suffer- 
ing with bilions dyspepsia. With nervous dyspeptics, 
however, a warm climate Heems to agree better, aa it 
occasions lesa disturbance of the circulation. 

Mental and Moral Treatment. — This is u>o 
important a part of a successful plan of treatment to be 
neglected. The gloomy despondency which so com- 
monly goes with this disease, must be steadily combated 
by a determination to be cheerful. The disposition to 
fret and worry, and to dwell upon tlio unpleasant or 
painful features of one' a ctmdition, must be fought 
against with firmness and resolution. The dyspeptic 
who allows his mind constantly to dwell upon faia 
stomach, and who speculates npcm the prohabilitit-s 
respecting the digestion of each uiorael ()f f(HMl as be 
swallows it, will be certain to remain a dyspeptic. 
This unfortunate tendent-y on the part of sufferers 
from this disease is a great impediment to recovery. 
The mind should bo diverted from self as much as 
possible at all times, and especially while eating. The 
habit many dyspeptics have of talking constantly about 
themselves, which sometimes araonnis almost to » 
monomania, cannot ho too strongly condemned. Too 
great solicitude about the stomach, the diet, etc., {a_ 
worse than none at all. 




QUACKS AND NOSTRLMS. 



There is no class of inalaiiiea tbo victims of which 
have been bo constantly aud extensively u prvy to the 
quack and t!io patent-medicine vender, as disoi'dcrs of 
the stomach. The chronic dyspeptic, daily tormented 
by the discomforts of his malady, eagerly seeks relief ■ 
from any Bource, and is readily beguiled by the decep- 
tive and alluring deseriptiona of newspaper advertiaerB, 
patent medicine almanacs, and manufactured testimoni- 
als, to try first one and tlioa another of the thousand 
and one nostrnms which are displayed upon the drug- 
gist's ahelvcs and catalogued upon c<inntry barns and 
fences. Quite a large proportion of dyspeptics thos 
become addicted to the use of patent medicines. The 
writer has met many persons who might very jnstly 
be termed "nostrum maniacs." They eagerly scan 
every newspaper that comes into tlieir hands for the 
announcement of some new medicine of this kind, and 
as soon as possible obtain it for trial. 

The great charm of the patent medicine is the se- 
crecy thrown about it, and the idea often positively 
maintained — always encouraged — by the manufac- 
turer, that his particular nostrum cimtains some newly 
discovered remedy, the virtues of which have been en- 
tirely nnknown to seientifio medicine. One of the beat 
means of dissipating this fallacy is to cxjxise the faot 
(.3*4 1 



346 



THE STOMAOB. 



well known to the snientific physician, that all patent 
medicines an<l nostrums arc either inert and wortblees, 
because of theu- inefficiency or their injitrions obaracuir, 
or else are simply cheap and well-known drugs with 
which every physician is familiar, and which may bo 
obtainod from any druggist for a very small fraction of 
the pi'ice charged for the nostrum. As a rule, the first 
cost of the patent medicine is scarcely one twentietli 
the price charged for it. The manufacturer puts his 
ill-gotten gams into newspaper advertisements an<] 
huge signs painted upon board fences, burns, rocks, 
and conspicuous places along highways and railroadx, 
iustea^l of iuto the mediciue bottle. For an cx()06e it 
is only necessary to publish the composition of Uicim> 
nostrums. Here are a few of them : — 

Stviujhton Bitters. — Orange peel, li oz. ; gentian 
root, 8 oz. ; Virginia snake root, I^ oz. ; American saf- 
fron, i oz. ; red saonderH, i oz. ; alcohol, 4 pts. ; water, 
4 pts. 

£r/>i/'fi'n Iron Btfters, — Trim, 1 gr.; caUsaya bark, 
2 gr.; phusphoruB, 1-200 gr, ; coca, 1 gr,; viburnum 
prnnifolium, I gr. 

IIiij) Bittern. — Hops, 4 oz.; orange peel, 2 ot.\. 
cardamom, d dr.; cinnamon, 1 dr.; cloves, J dr.; aloo~ 
hoi, 8 oz. ; sherry wine, Spts. ; simple sirup, 1 pt. ; 
water, sufficicut. 

Himtettei-'' K Bitters. — These bitters contjiiu, accord- 
Jn^ to the Mcilical BvlUtin, the following ingredients :■ 
.Sugar, 2 lbs.; calanms root, '2 lbs.; orange peel, 2 lbs.; 
Peruvian bark, 2 lbs.; gentian root, 2 lbs.; colnmbo 
rooti 2 lbs. ; rhubarb, 8 oz. ; cinnamon, 4 oz. ; cloves, 
2 oz.: diluted alcohol, 4 gals. 




347 



Oei-nuin Bitters. — German camomile, 2oz,; sweet 
flag, 2 oz. ; orris root, 4 oz, ; coriandtT seed, 1^ oz. ; 
centaury, 1 oz. ; orange peel, 3 oz, ; alcohol, 4 pts. ; 
water, 4 pts. ; sugar, 4 oz. 

StiiiiKich Blttcra. — Gentian root, l^oz. ; cinchona 
bark, ^ oz. ; orange peel, 2^oz. ; cinnamon cort., \ oz. ; 
aniso seed, ^ oz. ; coriander seed, ^ oz. ; cardamom scwl, 
i oz. ; gum kino, \ oz. ; alcohol, 1 pt, ; water, 4 tjts. ; 
sugar, 1 lb. 

French Absinthe. — Oil wormwood, 1 dr. ; oil melisa, 
15 drops; oil anise, "2^ dr.: oil star anise, "2^ dr.; oil 
fennel, 4 dr. ; oil coriander, 3 drops ; alcohol, 14 pta, ; 
water, 6 pts. 

Vintfgar Bitta's. — The following is Dr. Gibbon's 
account of the origin of Walker's Vinegar Bitters, 
a specimen of which the writer analyzed several 
years ago, and found to cnutjiin five per cent, of 
alcohol : — 

"This 'bitters' is one of the nastiest nostrums, 
and is introduced and largely sold by the most cxtcu- 
sive and brazen advertising under the false pretense of 
being free from alcohol. It originated witli the cook 
of a party which traveled overland as a mining com- 
pany to California in 1849 ; he settled in Calaveras 
county, and having no success as a miner, turned his 
attention to the bitter qualities of the herbs growing 
about him, and came to San Franciseo with the idea of 
making and vending a nostrum to bo called ' Indian 
Vegetable Bitters.' Ho felt in with an enterprising 
druggist, who saw money in the project, and joined 
him. At the suggestion of the latter, the ' Indian ' 
was struck out, aud as the concoction got sour by fer- 



348 THE BTOUACH. 

inentution, it was concluded to call it ' Vinegar Bitter^ 
and to identify it with tbe temperance movement. Th 
native lierbs, which became rather troublesome to col 
lect, were discarded ; and aloes, being a cheap bitt« 
was substituted. ' Nine sick people out of ten,' sai 
the druggist, 'will bo cured bv purging,' therefore tb 
aloes and Glauber's salt. Si> the cook turned doctoi 
the decoction became sour, and of Ciilifornian iasteaq 
of Indian paternity, and ' Dr. "Walker's Vinegar Bittem*| 
began its career in the newspapers and on the shelve 
of the drug-stores." 

The statement has recently been made that ' ' Vii 
gar Bitters" is now manufactured of sour Iwer a 
aloes. 

L-y's A/'t;-B>/''(MM /'///«.— Calomel, 3(J gr.; jali 
fin gr. ; gamboge, li! gr, ; tartar emetic, 3 gr. 

Trojilv Fruit Lax(ttu-e. — Jalap, ]>owdered. 6 paitfla 
senna, powdered, b parts ; sugar, 5 ^&n» ; tamarioj^ 
pulp (E. I. ), 30 parts. 

C'irte.)' H LitiU LIi't PiU«. — Podophyllin, IJ gr.; 
aloes (Socotrine), 3^ gi-. ; mucilage of acacia, sufficient. 

Shiton'9 Livtr ^^yu/rt^cA— Hepatica, 1 oz. ; h 
tandra, I oz. ; eerpentaria, 1 oz. ; senna, 1\ oz. 

Radical/ » liegulath-g PHU. — Each box cc 
from twenty-nine to thirty-one sugar-coated pilli 
unequal size. They consist of 30 grains of aloes, 
grains of jalap, 8 grains of gamboge, and some 
substance. 

Eiui'if Fruit Salt. — Soda bicarbonate, 168 
tartaric acid, 150 parts ; Rochelle salt, HO parts, 

Hamhurg Tea. — This is composed of senna 1 
and stems, coriander fruits, manna, and tartaric 



QUACKS AND SOSTRUMS. 349 

Garfield Tea. — This consista chiefly of senna leaves 
snd couch grass. 

Holl<nvay'« P'llU. — Aloes, 2 dr.; rhubarb, 1 dr.; 
cflpsicnm, 20 gr. ; saffron, a gr. ; sulphate of soda, 5 gr, 

ffamlnifg Drops. — Powdered Socotrine (aloes), IJ 
oz. ; American saffron, \ oz.; tincture of myrrh, 16 oz. 

R. V. Purree's Ph'a«ant Purgative Pellets. — Each 
little bottle contains from twenty-eight to thirty-sii 
small Bugar-coated pills of unequal size, and weighing, 
in all, from eighteen to twenty-two grains. Their ca- 
thartic effect ie due solely to podophyllin, the resin of 
the root of the May-apple. 

Dr. JTalVa So-called " Secret.'''' — For several 
years, a man styling himself Dr. A. Wilford Hall, 
of New York City, has been advertising and vending 
about the country a pamphlet purporting to disclose a 
discovery made by himself something more than forty 
years ago. The so-called discovery of Dr. Hall's is 
this: — 

Having had dyspepsia for a number of years, and 
being greatly troubled with constipation, he resorted to 
the enema as a means of emptying his bowels, and 
discovered, aa he asserts, that it waa possible to inject 
a gallon of water into hie colon by means of a bnlb 
syringe. 

This is the whole of Dr. Hall's so-called diflcovery. 
He recommends the enema as a substitute for nature's 
method of relieving the bowels, to be employed by all 
persons, sick or well, and claims that persons who will 
adopt this method of relieving the bowels, will be proof 
against most of the diseases to which human flesh ie 
I heir, mentioning particularly such disorders ae Bright's 



TBK STOMACH. 



disease of the kidneys, emallpos, and other grave and 
contagious maladies. This so-called discovery ia em- 
bodied by Dr. Hail in a cheaply printed pamphlet cost- 
big about two cents, for which he charges the modest 
sum of four dollars. 

Some three or four years ago, the writer, in the 
magazine of which he ie editor, Good Ht^tli^ exposed 
in a most thorough manner the fraud perpetrated by 
Dr. Hall in professing to be the discoverer of the 
enema as a mode of emptying the bowels. Whoever 
was the discoverer of this method of mechanically mov- 
ing the bowels, it certainly was not Dr. Hall. Dr. 
Shew, a water-cure physician, advocated the method 
in this country some years before Dr. Hall professed 
to have made the discovery, and PreiBsnitz had em- 
ployed it long before. The enema may be properly 
used as a means of emptying the bowels when they are 
not emptied by the unaided efforts of nature, and is 
preferable to the habitual use of laxatives or cathartics 
of any sort ; but the practise of daily introducing a 
large quantity of water into the alimentary canal, has 
the effect to destroy the normal sensibility of the 
bowels, and to establish an abnormal condition, bo 
that this lai-ge amount of water becomes necessary as 
a stimulus to provoke an evacuation of the intestinea. 

It was long ago discovered by physicians that the 
habitual use of the enema as a means of stimulating 
the movement of the bowels, is by no means free from 
evil consequences. Chronic constipation cannot be 
cured by this method any more than by the use of 
cathartics. It is only a mechanical means of emptying 
the bowels, which ia undoubtedly preferable to the re- 



QDAOKS AND NOSTRUMS. 



351 



tention of fecal matter ; but at the eoiue time it is not 
a cure of the morbid condition, and a person who habit- 
ually uses the enema becomes as much dependent upon 
it as is the habitual nser of mineral water or pills, opon 
these agents. 

A person who has become dependent upon the 
enema as a means of moving the bowels in consequence 
of following the erroneous teachings of Dr. Hall, may 
find relief by the employment of the graduated' enema 
(24), massage of the bowels (30), and the Swedish 
movements recommended for constipation (43), to- 
gether with the adoption of other measures which are 
elsewhere recommended for the relief of constipation 
(see page 273), 

It may be added that the author's exposure of Dr. 
Mair^ fraudulent claims resulted in destroying his ne- 
farious business, in this country at least, but he suc- 
ceeded in pocketing a hundred thnnsand dollars or 
more before bis business was interrupted by the pub- 
lication of his en-called "cecrct." 




Explanation of the Author's Qraphic Hode of Ren 
resenting the Results of Stomach Work 01^ 
tained from the Examination of the Stomach 
Fluid by the System of Investij^atiun Employed 
in the Hygienic and Physiological Keseard 
Laboratories of the Sanitarium at Battle Cre«fl 
Hich.. U. S. A. 1 




In tLia Bcheme for the graphic represeutation of tM 
results of the analysis of stomach fluids (Plate X^ 
the firBt fivo columns relate to the work done hj tig 
Btomacli in as many different phases of its dlgeflti«4 
and chemical activity. The remaining colmnnH arc 
devoted to the coefficients of digestive work, by refer 
ence to which one may see at a glance the relation ol 
the work done, in quantity or quality, to tlie normal 
standard. The figures in the several columns repro- 
sent, at the bottom, the lowest figures, and at the t 
the highest figures, which have been observed in t 
examioatiOD of more than five thousand stomach flu: 
The figures included in the dark-colored band wh] 
passes acrosB the center of the chart, represent the i 
mal limit. The significance of the figures shown in i 
several columns is as follows : — 

The letter A' indicates the total work ilono bjr i 
stomach in setting free the hydrochloric acid net 
13521 















B 


1 










^■i 


, 


1 


1 










GRAPHIC REPRESENTATION 


















Cau 


a/ - - 






A' 


H 


c 


A 


s 


cocrriCKNTS or oiqcstive work. 








MWT 










FnRi. 


MM 


TiU 


tUNl 




















Clftmi. 


IcKti, 


ttintU. 


m 


a 1 


b 


c 


y 


_4_ 




.130 


.!10 


-iio 


.4S0 


1.00 


!.00 


S.00 1 


» e.ofl 


10.00 


^ 


^ 




.<J0 


.Hi 


.500 


.440 


6.iO 


l.flO 


4.00 


iO 1.00 


9.00 


>«^ 


ol 






.8ftJ> 


.!I0 


.»:o 


.410 


a.is 


I.SO 


1.S0 


l« 1.80 


8.00 


1.?^ 


ET 


1 




.s:« 


.103 


.»iO 


.SS3 


e.00 




1.00 


10 l.jO 
HI* 


-.00 


i::J. 


r <* 




.3i*. 


.ISO 


.H30 


.300 


t.IS 


1.05 


a.30 


0.00 




r 




.»a3 


.105 


•lis 


.3J0 


G.iO 


J.il) 


3.00 


:;:3, 


t.:w 


E 




.JSO 


■,.150 


.w» 


'-.tto 


t.S5 


1.^ 


tlJ 


3.00 




t H 




.90.1 


•AX, 


,«^s 


.aop 


fi.Oft 


i:ii» 


a.-w 




4.30 


Xiol 


iia 






.tM 


Mtt 


'.s:o 


.200 


«.!S 


C4t 


r.si 


*, 1.41 




(Ai 


ii.3^ 






.lis 


.11* 


.iai 


.a;! 


4.S0 


f.llt 


£.00 


a ,1.40 


\*-'y 




?-l 






.SM 


.100 


•SIO 


.STO, 


«.» 


j.3i-. 


i.;s 




v» 


ijAj 






.9IS 


.ow 


.t» 


.tli- 


4.00 


3.80' 


■ .so 


/:3o 


i..«! 


IJoS 






.no 


.«u 


.tio 


.330 


■.» 




I.IO 


1 


I.!i' 


tss 






.tse 


.070 
,0M 


.too 


.sto 
_.«o 


a^o 
,a.ti 


n.so 


l:S| 


\Z 


\;? 






■■^^^^^^^^^^■1 1.IO 


i 




^ 


1.10 


£ 








f? 


1 


T 


.ftl 






^^^^^^^H «.K> ^^^H 






.80 


.M 






^^^H^^l"'' H^H 


1 ''S,. 


"I'l! 












EMl.iMJ4» .m 




■i' 

.Vi 

.(0 
,M 
.W 


4 


i|i 


1 

.SO 

"■.» 






tekS^fS-SS' 




■^ 


-:a 


_: '" 


.10 
.00 


.10 
.00 




1 m 


a 1 b 1 c 


y 


z 


PLA-SV. XV. 


J 



1 




OH&PHIC its 



353 



I 



for digestion. If the figures found by analysis fall 
below the normal limits, that is, below .180, the case 
ie one of hypopepsia ; in other words, the stomach 
does lees than the normal amount of work. If the 
zero point is reached, the case is one of apepsia, and 
the stomach is doing no digestive work whatever. If 
the figures fall above the normal limit, that is, above 
.200, the case is one of Lyperpepsia ; in other words, 
the' stomach does more than the normal amount of 
work. 

In the treatment of apepsia and hypopepsia, all 
proper means are used to increase tlio activity of the 
gastric glands, thereby supplying the deficiency of 
hydrochloric acid. The principal means to be adopted 
are, licat over the stomach, massage, electricity, the 
moist abdominal bandage, exercise after eating, a hot 
and cold douche over the stomach. 

In cases of hyperpcpsia, or excessive formation of 
hydrochloric acid, the aim of the treatment adminis- 
tered is to lessen the glandular activity of the stomach. 
It should consist of hot sponging of tiie spine ; an ice 
bag over the stomach in extreme cases ; galvanism to 
the spine, the stomach, and the pneumogastric nerve ; 
and tlie avoidance of all stimulating foods and con- 
diments. 

The figures of the second column, H, relate to the 
amount of free hydrochloric acid present in the stomach 
fluid. When it is remembered tliat free IICl is neces- 
sary, not only as an aid to digestion, but as a means of 
preventing the growth of germs and the production of 
poisonous substances through the decomposition of the 
food, the importance of this determination will be ap- 



35+ 



THB STOHACB. 



predated. Free hydrochloric acid may be abaent, defi- 
cient, or present in either normal quantity or in exccBs, 
in both hypopepsia and hyperpepsia, as well as in case* 
in which the total amount of work done by the stomaoli 
is normal, the chief departure from the normal standard 
being eorae form of acid fermentation. 

Column A, which has relation to the total acidity 
of the stomach conteiits, has the eame normal limit ae 
A'. Outside of the normal limits, however, there is 
often a wide contrast between the figures shown in 
these two columns. The total acidity may be either 
greater or less than the Bum of the free hydrochloric 
acid (HCl) and the combined chlorin (0). Wlieu 
greater, the indication is that acids are present in the 
stomach which have been formed by fermentation. 
When less than tlie normal amoimt, the indication is 
that the products of digestion are of an inferior 
quality. 

A deficiency of free HCl requires stimulation of the 
gastric glands, and in some extreme cases benefit is 
derived from the adminietration of small qnautities of 
HCl with a little diluted water. When the HCl ia in 
excess, patients often suffer pain or sympathetic norvoas 
disturbances. The total acidity, A, compared with A', 
is a good means of determining the quali^ of the di- 
gestive work done. 

Column S represents the quality of maltose, or di- 
gested sugar, found in the stomach for each 100 cc, 
or three and one half ounces, of stomach fluid. A defi- 
ciency indicates either an excessively acid gastric juice 
or insufficient mastication of the food. When the fig- 
ures found are above normal, the indication is that the 




r.RAPHIC MKTHfJI). 



S5.T 



activity of eaJivary digestion has been unuBually groat. 
This is a condition from which no harm can arise. 

The facts wliich the author's researches have elic- 
ited respecting starch digestion are, for the most part, 
new. They are, nevertheless, important, and have 
ezcited considerable interest. 

The Coefficients of Digestive Work. — Of 
the several coefiScients of digestive work, coctEcient a 
is one of the most valuable and important. When be- 
low 1.00, this coefficient indicates an inferior qnalitj in 
the digestive product. . When above 1.00, the indication 
is that there are present other acids than HCl and com- 
bined ehlorin. 

Coefficient b relates to starch digestion. If the, i 
figures found by analysis fall bt>low the norma! limit, 
1.00, the indication is that a smaller amount of angar is 
formed by the action of saliva upon the starch than in 
the normal state. This difficulty may commonly be 
remedied by the use of dry food, which naturally se- 
cures thorough and prolonged mastication. 

The figures falling below 1.00 in column c indicate 
a deficient eecretion or a deficient quality of saliva. 
Those found above the normal line indicate an nnusnal 
activity or abmidanco of salivary secretion. 

Coefficient y has relation to the disintegration or di- 
vision of food into fine particles. When disintegration 
is deficient, as shown by figures below 1,00, the indica- 
tion is for the use of dry food and thorough mastica- 
tion. Oranose is admirably adapted to those cases. 

Low figures under coefficient z represent very slow 
absorption. Figures which fall above 1.00 indicate 
an UDuenally rapid absorptioo. 



356 



TBS BTOMAGH. 



The two last-mentioned coefficients, — those relating 
to disintegration and absorption, — especially the last- 
named, or coefficient z, are leas exact than are the 
other coefficients, jet are of considerable value, if pains 
is taken to obtain the whole quantity of tluid containet 
in the stomach at the end of an hoar after the I 
meal is taken. 

Coefficient m has relation to the work of tl: 
acb in producing free hydrochloric acid to lake pai 
with pepsin in the digestion of food. In bypopepsil 
too little chlorin is set free ; in hyperpepsia, too mndifl 
in apepsia, none at all. Improvement in hyperpepi 
will be indicated by a lowering of the tigures repreaenl 
ing this coefficient ; in hypopepsia and apepaia, I 
reverse. 

The indications derived from these coofficientfl t 
as follows : — 

Coefficient a indicates the necessity for tmpror^ 
ment in the quality of digestive work done. Electri 
ity, massage, maiiual and mechanical Swedish movi 
meats, and a suitable dietary, especially foods conta 
ing lactic acid, as knmyss or kmnyzoon, buttermiU 
etc., are necessary. Malted gluten and granose hart 
also proved very serviceable in improving the quality < 
the digested products. 

A high coefficient x, or a and x, indicates fel 
mentation. A diy diet, consisting chiefly of gran<u 
and fruits, with the nse of antiseptic tablets, is f 
erally required in these cases. Stomach waaluBg hm 
means of lavage is also required. 

A low coefficient b indicates the necessity of moi 
thorough mastication or the withdrawal of starchy tot 



357 



from the dietary. In these cases a friiit-and-nut diet or 
tho tiBe of malted gliiteu is found to be of very great 
service. In some ca^cs a diet consisting chiefly of 
kumjzoon, kumjss, butUirmilk, eggs, and similar foods 
must be resorted to for a timo. A high coefficient b 
requires no attention. 

A low coefficient c may result from gum-chewing 
or tobacco-using, the constant spitting having the result 
of weakening tho salivary glnnds. The application of 
electricity to the back of tho neck and at the pit of the 
stomach is often useful in these cases, 

A low coetlicient y indicates a demand for more 
thorough mastication, and per]ia)is tho use of some 
thoroughly disintegrated food, as granoae, for a short 
time. 

Coefficient z, if low, indicates the necessity of ab- 
staining from the eating of lirjuid foods and drinking 
at meale. ■ Special massage or manual Swedish move- 
ments most be adopted as u means of increasing tho 
motor activity of tho stomiich. Electricity is often 
useful iu this class of cases. 



^^^^^^^■^^H 


^^^^^^^^^^^^^^^^^^^^^^^^^^1 ^^^^^^^^1 


^ 


^ 


^P INDEX. 1 


j^^ Abdomen. KBlvaiiiiatlon ot. XX. 


Aiinit sallaa, 33i, ^^J 


^^ AbdomlDBl baDdugt. the dry. iSO. 


Aseptic dietary. S7. ^^^^^H 




AspamRus. nutritive vulue of, O. ^^^^H 


^H llttlngot.SOT. 


Assyrians, diet of. 3a. ^^^H 








Asthma of IndlgCHtion, nocturnal, .^^^^^H 


develop. aU. 


^^^H 


Abdominal supporter. 39). 




AbBlDtbc. French. 3tT, 


Backache. SO. IM. ^^^^H 


Ab8orbeMB.28. 


bread. SS. ^^^H 


Add. hydrochloric 38, Iftt. .m 


Baking-powders, tlfl. ^^^^^^t 


Aflrt. lacllc, a 323. 


BaDano. antritlve value of. (L ^^^^H 


Addlty, H7. 193. 


Barley meal. 93, ^^^^H 


Aeldily. calPulttled. UX 


Barley, nutritive value 41. ^^^^1 


Algidity from hyptrpt-uaiu. KCl.. 


Barley. South Busshin. nutritive ^^^^H 


Apldliy.ioUi.il-''. 


value ^^^H 


Acne, IM. 


nurley, tlmeofdlgestloAotM. ^^^^H 




Batblng after meals, TH. ^^^H 


^^ Alcobol, U4. 


BeaDS,aeId. antritlve valoe of. 41, ^^^H 




Beans. French or kidney, nutrltlva ^^^^H 


^^1 Alkiil1es.l1S. 


value oris. ^^^H 


^^H Almond, sweet. natr[tivi> value 


BeuDS,Llma.iintrltlv'valueof.41. ^^^H 


^r of. 13. 


Beans, pod. boiled, tlmu ot dlgw- ^^^H 


i; Alum. 120. 


lion of. 40. ■ 


Ammonia. ISO. 


BeHns.strlag.nutrlI1veva]uvot.(£. M 


Amylopsln. 30. 


Beans, white, nutritive valne ot.iH ■ 


Anul Itching. 158. 


Beating, maw. ■ 




Beuumont. Dr., 10ft. ■ 


^L 3IS. 




^^P Anlnitl foods. SI. »r>. 


Bet't. leau, m fl 


^^^V Aotl-fBt dietary. Zd. 


Beef, lean, tried, tlmi? of dlgesTlou ^M 


^^H Aiitirebrln. IST. 


of. 40. ^^_™ 


^B Antlpyrln. IW. 


Beef, tcun, nutritive value of. 4S. ^^^^H 


^H Ap»P!>iB,14I.2<W. 


Beet, lean, rare roasted, time oC^^^^^H 


^H Aphtha 181. 




^V Apoplexy, nervoui^ a». 


Be<-f, sailed, boiled, tlmn ot dl«tM- -^^^H 


^^^ Appetite, excessive, LIS. 




Appetites parverlfld, 120. 




Apple, dried, nutritive tbIho ot, *J 


llOD ^^^M 


Apple, nntrltlve value ot. 41. 


Beet l«a. Bit ^^^^1 


Apples, lloie ot digestion of, M. 


«. ^^^H 


^^l Apricot, nntrltlve value ot. 41. 


Beet, nutritive value of. O. ^^^^1 


■ 


[U501 ^^M 


^^^^^^ 


gBHy^^l 







^ft THE ^^^^^^H 


^H Beet, sugar, nutritive value of. i2. 


Cabbage, raw. time of dtsesUoi^^^H 


^M Belcblng, 1C7, 




^V Beiiu>liifioluclon,X». 


Cubiiage. red. autrlUre TolttA^^^^H 






^1 Bicycle riding, 124, IW, 


CahbAge. white. nntriUve rtUne^^^^H 


^P Bllc. SS. 








' BlllouHOess, fil, 177. 


^^^H 


Bl5Ciilt.lBI. 


^^^^1 


Bismuth. subtraiboDiii^ of. 32fi. 


CuDcer of liver. 1S4. ^^^H 




Cancer of stomach. SIT. ^^^H 


^ Blackberry, nutrlilve value ol. O. 


Cano-sngar, 3;*. ^^^^^| 






^V Bowels, nmssage of, 30.1. 


Cardamonia. lOO. ^^^H 


^m BowBlB, ppolapBcd, Swedish more- 


Carrot, nutritive value »t. <t ^^^H 


^H nenta tor. 317. 


Carrots, 9Z, 83. ^^^H 


^H Brain work. ISl. 


Carter's Little Uver l>ills, 3W. ^^^^H 


^H BrvBd, barley, untrltlvo value 


Caaeara aagrada. 533. ^^H 


^H 


Casein, S. ^^^H 




Catarrh, gastric, IN. ^^^^1 


^H BruNd, Oue-flour. BL 


Catarrh, gai>trle. diet ror.SM. ^^^^M 


^H Bread, ralacil. IGl. 


Catarrh, Intestinal. ISk ^^^^M 


^V Bread, ryu. Qulrltlvc value or. 41. 


Catarrh ot stoniaeh. a&. ^^^^H 


^m Bread, 8>r.^<ll«l> sptLie tirwl. nutrl- 


CaUrrh of stomach, cbronle. S^^^H 


^H . tlve value Dt.tl. 


Cauliflower, nutritive valiw j^^^H 






^H ur.w. 


Celery, nutritive value uf. IS. ^^^M 


^H Bread, white, nutrlUvo value of. a. 


Cellulose. U. ^^^1 


^^K Bread, whole -wheat, ulitrltlve 




^H or, 


^^^H 


^H BreadM. unlerment^d, 33S. 


Charcoal, ms. ^^^^M 


^H Breath, sbortness ot. lol. 


Charcoal tablet*, m ^^^H 


^V BrlKht'a disease la. ]»«, IW. 


Charcoal t«l>lets.antlsepUt>. an. ^^^H 


^B Biluian. Dr., IBS. 


Cheese. S5. IDIK ISl. ^^^^H 


^H Bromoae. »[. 




^H Brown's Inin Bitters. 1411. 




^M Btickwheat, uutrltlvu viDue of. ^1. 


Chee».tltnrofdlgeBltaacitA l^^^| 


^H BorkBTI. IW. 


Cherry, dried, nutrlilva v»li*»i^^^^| 




^^^1 


^m Butler. W. IDE. 103. ItS. 


Cherry, nutritive value of. IL ^^^^H 


^H Butter. Freuch, nulrltlvu value 


Chestnut, nutritive value <H,tf^^^^ 


^M Ot.1£. 


Chicken souih bulled, tlmu at ^^^H 


^H BulU-r. melted, time of dlgcsiloD 


gcstlOD ot. 40, ^^^H 


^m of. to. 


Child, food for a. »!. ^^^H 




LMn<.-^: diet of. % ^^^H 


^H Butter. Swedish, nutritive vuluo 


Cblorlds. (lied. 145. ^^^H 


^H 




^^B Butyric acid, 104. 


14&. ^^^H 


^B cabbage. K!. 


CIiinainoii'soKition, 324. ^^^H 


^B Oabbattc. boiled, time or <ll|{cstloii 


Clrrulallun, dli<[urbanc« ot. SKt^^^H 


^H otM. 


Cirrhosis ot liver. IM. ^^^^H 





^^^*^^^ 


— d 


^ INDEX. 361 ^^^1 


^H Clapotcmcnt. m. 


Dlarrbea. 153, 185, ^^^^H 




DIukena. Cbaries, 85. ^^^H 


^H Clay-eaters, 130. 


nin and reglmon. SI. ^^^H 


^M Cloves. IW. 


Dlrti'tlc roles, £24. ^^^^H 




Diet, natural. 39- ^^^H 


^r Oocfflclents. 139. 313. 


nk't tables. £M. ^^^H 


Coldness. ISL 




Oollc. 171. 


DigL'sllon. ^^^^H 


Coloclyster. 301 


mention, allottlne time tor, 74. ^^^H 


Colon, tbe. S6. 




Colon, the. a reserrolr. 13. 


Dlg<!stIbIlltyotvarloutitouds.tablB ^^^^H 


dolors, unnatural. 151. ' 


^^^H 






Condiment*. 34. IDO. 


Dinnen. sU o'clock, TL ^^^H 


OoDtectlODury. W. 


Disvbsrses, the. U3. ^^^H 


Cookery, lMid,M. 


Dl^^onUint, 1=4, ^^^^H 


Oooklnn, 98. 


nisletitlon.ins, ^^^^H 


constipation. B8. 153, 184, STB, 


Doncbe, llver.WO. ^^^H 




Doaohc, poll. 300. ^^^^H 


Oonntlpatlon, Siredlsh movcmcals 


Dress, benltlitul, 311. ^^^^H 


ri>r,aiB. 








Oonsomptlon, 18. 


Drags, l£h "^^^^H 




Dry dietary, £SS. ^^^H 


Corn snii beans, gcccn, tlmu i>[ di- 




gestion ot. 40. 




Oornaro. 88. 


DuJurdln-BeauRicti^ TO. ^^^^H 


Corn, (lent. nutrUlve value ot, 11. 


Dyspepsia, uGld. SHL ^^^H 


Oorn, flint, nntritive value of. 41. 


Dyspepsia, bilious or foul, Sil. ^^^H 


CoTD-starcb or arrow-rout itroel. 


Dyspep!<la. home treatment of, 397. .^^^^H 


^1- 


Dyapepsia in Amerloi, IT. ^^^H 


Oora, sweet, nutritive vslac ot, 41. 




Oorseti, 1S3. 


Dyspepsia. Inherited, 127. ^^^H 


^B Cow-trco, milk of, nntritlvo valuv 


Dyspepsia, nervous. ST. ^^^^H 


^m 4B. 




^H Ontnberrj, nntrlllve value of. «. 


Dyspepsia, simple, 315. ^^^H 


^V Cnsam, 104. 


Dyspepsia, symptoms of, 149 ^^^^^1 


^^ Oream. nutritive voloc of, 4a. 




Oroain l«rt«r, IIS. 




Oucumber, nutritive value ol. 12. 


Dyspepsia, troatmcDt at. iSl. ^^^^H 






CniTftnt, untrttlrt value ol. tt. 


Ears, rinsing In, IS*. ^^^^H 




Eallug bctweoD meals. ST. ^^^^H 


Date, dried. nUtrlUve value ot, 41, 


Eatlns laco at ulgbt, 71. ^^^^H 


David. 19. 


Gullng too freqnently, W, ^^^H 


Debove, 381, 


Gntlns too little. F8. ^^^^H 


^^ DcDtltrlce. aBtlieptIc 334. 


Eating wbeo exhausted, 73. -^^^^^^| 




E(.^olIon]y of vegetable food, «S. ^^^^H 


^H Dessert*. 97. 


Eczema, 190. ^^^H 


^H Dextrin. 97. 


Eel<>. vlnegitr. ^^^^H 


^H Diabetes, loT. 


F.KB. entire. iintrlUve value of,«. ^^^H 


^^f Diabetica, diet tor, in7. 


Eggs, 30. K^ 93, 2Q. ^^^H 



^HD^BJ^B^ 


363 THE STOMACH, ^^^^^^H 




Flour, bauans. xutriMve value <i|;,^^H 


Ebbb. hBrd boiled. Uroo of digaatlon 


.^^^1 


^H 


Flour, barley, Dutrltlre tkIm flfl^^^H 






^^1 EggB. 8oft'boll»d. lime of aigtsllou 


Flour, bean, ontntlve value of, I^^^H 


^m 


Flour, buckwheat, nutritive vala^^^^H 


^^H Ekss, Hlilppcd, tlmo at dlgosdun 


<^^^H 




Flour, corn. DUtrltive value uf< (^^^^^^| 


^^H EBi,ii>hlleot.Tiiitrlll7pvnluei>t.43. 


Flour, family. ^^^^1 


^^M Egg. jrolk or. nutritive valuu of. i=. 


Flour, grohDm. iinirltlvc mind Of^^^^M 


^B Egyptians dlc(, or. at. 




^^H EDeni&.»BI. 


Flour, oat, nntritlvo value of, tt ^^^H 


^^H EtiGma, cold. 303. 


Flour, patent, ^^^^H 


^^^H EnemK, gradualc'd. va. 


Flour. pcA. nutritive value of. tt. ^^^^H 


^^m- Giiembla>Htlvi!.3IO- 


Flour, rye. uutrltlve value ul. 41. ^^^H 


1^^ Enemn. oil. aw. 


Flours, glnten. ttL ^^^H 


li Eneroata. nutrlllvp, 240. 


Flour, wheat, nutrltlr* tbIiu) al^^^H 


Enu's fruit Hnll.^UK. 




Epilepsy. 3nB. 


Flour, wliole-ohCBU 91. ^^^H 


1 Eructnllons. 1S3. 






FomunUtloD, laustnrd or turpvd^^^^H 


^^B EsopbBgns. symptoms pi'ruikiln^ 


tiD^ sua. ^^^H 


^H UMSS. 




^^H Exercise. 3m. 


Tuod L-onibluatlons. 7T. ^^^^H 


^^H Exercise, lock or. iL-j. 


l-uod. decayed, sa ^^^H 






^^H mu«:les.21H. 




^^^H Extracts. Savoring. US. 


Food elements, deflcl^ncy In. M. j^^^H 


^^B Extremities, uuld, 30. 


Food, rermcnlatlon of, ID. ^^^^H 




Food for brain laborer, at. ^^^^H 


^^H Fitlulaess. ae. isa. 


Food for muscle laborer, (U. , ^^^^| 


^^H Faivdlc elect riclly, gcQcrul uppll- 


Food, fried, ts. ^^^M 


^^H cation* of. xn. 


Food, quaotlty of. 79. ^^^H 


^^H FastlDg. 'SM. 


Foodpn>dacers,31. ^^^H 


^H FBt,W. 


Food, proper quontity of, ffi. ^^^H 


^^H Put uid blood dlciiiry.^. 


Food, quality or. W. ^^^^1 


^^1 Fata, 33. 


Food. sa1t«d. lU. ^^^M 


^^B F>t8, ikbundiint useof. ini. 


FcMMl, soft. 100. . ^^^M 


^^m F«el. cold. Itil. 


Food, too many varieties of. n. ^^^^^H 




Food, uncooked. M ^^^H 


^^H F<>Terdlct,£3l. 


Foods. 31. ». ^^^H 


^^1 FIdgcla. m 




^H Fig. dried. DUlrlUv.. value of, 41. 


i^^^M 


^^H Fl>h,ai. 


Foods, raw. DO. ^^^H 


^^H Flsb, vblt«. Dutrlttvc value or. K. 


Foods, sierlllwd. m. ^^^H 


^^H FlStnleuue, ISA, ll«. 


Foods, vegelnhle. Ha. 37. ^^^H 


^^H Flatulence, IntestlDal, 137. 


Foot batb. an. ^^^H 


^H Flesh, sa. 


^^^H 


^^H Fleah food, 242. 




^^^L Flesh food, excessive use of. 107. 


l^^^^l 


^^^ Flonr. arro«-ruol. nulrltlvu vtlue 


Frogs. Zt. ^^^H 


^^^K 


Fmlk green. K. ^^^H 





^■^^H 


^^^^^^^^^^^1 ^^^^H" ■ 


^^^^^^^^ ISD 


■^^^■^ 


se^^^H 


^P Frolta.3T.B38. 


Headache, nervous, ISO. ^^^| 


^ Fullliiit!i.2W). 


Health foods, UO. ^^^^1 


Full balh, boc and cold, 301. 


Bearing, disturbances of, SO*. ^^^H 




Heurtburu. 1«4. ^^^H 


Gall-bladder, the. IS. 


Heat. dr7. SK. ^^H 




Heaviness. I5S. 153. ^^^M 


Galvanlmtlon of spine and ab- 


Hiccough. 151. ^^H 


domen, aas. 


Ulpbatb.SOT. i^^^M 


Oulvanliaclon ot symputlictlc 


Holioiray's Pills. 319. ^^^^H 


nerve. 3=8. 


Home treatment of dyspepsia. 197. ^^^M 


^^ Game. 36. 


Iloner, nutritive value of. 4S. ^^^H 


^L Garfield Tea. »g. 


Hop Bitters. 348. ^^^^M 


^m Oaiitrlujuk'e.3e. 


Horseback riding, 121. ^^^^H 


^K Gastric juke, excess of, IKI. 


Host«tter's Bitters, 3M, ^^^^H 


^H Gaatrltia, diet lur, SSa. 


Hut-air buth, m. ^^^H 


^m OeorgeB. 301. 




^H German Bitters. 317. 


Hauger.cure,-m ^^H 


^m GenoB In nator. LS. 


Hydrochloric acid. SB. KO. XS. ^^^H 


^P Ginger. 3i. 


Hyperpepsla. 113. mi. ^ ^^^^M 


^ Girdle, wet, I«. 


tlrpcrpcpslB, acidity (roui, ISi. SSI. ^^^H 


Glands, pepllu. 19. 


llypochoQdrla, 173. ^^^^H 


Gleoiird. Dr., SIO. 


Rypopepsia, 142, £00. ^^^M 




ny!.teila,S08. ^^^H 


Glateo.3n. 




Gmt«Qblaciilt.Ml. 


IceIftndmosB,initrlHvBvalucof,41. 1 


OtuttODj, 80. 


Indian meat, IK, W. J 


Gofio, SU. 




Gooseben'jr. nutrKlve value of, 4J. 






Indigestion, septic, SSI. ^^^J 


^L ot. 40. 






ludlgestloua. Bymptoma ot, 151. '^^^^H 




Infant, tood for a bottle-ted, Sj. ^^^H 


■^ Orubamaour.ie. 


Infant, tood tor a teething, £38. ^^^^H 


aranolo.Z40. 


Infantile dyspepsia, STi. ^^^^H 


Granose, 3W. 


Insanity. ^^^^H 


Onpe. nutritive value ot, U. 




Grape-susar. 33. 


Intestinal ludlgestlon, m ^^^H 


Graphic method, 333. 


Intestinal Juice. £8. ^^^H 


Gravies, loa 


Intestine, the large. 28. ^^^^H 


Greeks, diet of. 38. 


Irritability, 153- ^^^H 


Griddlc-cakefi. 101. 




Gripes. 171, 




GnalB«iolutli»l.SZS. 


Japanese. dlelof,39. ^^^H 




Jaundice. 18.181. ^^^H 


HKUDg.3a8. 


Jaundice, catarrhal. IDT. ^^^H 


H&ll->M>-ealled " BocreV 310. 


Joint movements, 3W. ^^^^H 


^_ SBEQburg Tea, 34B. 




^L Hamburg DropH, 319. 


Kidneys. prolapsed.8wcdlshmov«- ^^^H 


^M Baud bath. £SB. 


ment^ for, 317. ^^H 




Kaeudlng. 301. ^^^H 


^K HCl. free, 14S. 


Kneudtng. mechanical. S3S. ^^^M 




Kamytooa.Stl. ^^^M 





^^H 384 TBB StOMACa. ^^^H 


^^H Lactic acJ(l.fli. 


Mlc^rolws of ibe moatli. U, 


^^^H Lamb, brolli^. tituo <>t HlgcMluii 


Migraine, 177. 103. 


^^B otW. 




^^■^ Lappa. ISS. 


Milk. 3S, 9S, W, SI. 


^^B Lard, 101. 


Milk and meat. 78. 


^^V LHvti^. :»>, 




^^^B LHVKge. hot ■nd cold. ;i^. 


Milk. bollMl. time of dlgcsLlan of. 


^^^1 LBxaMve:.. ISH, ȣ3. 




^^^H Lean meat^ IS. 


Mllk.eo»-s. nntrltlve value of, «. 


^^H LM'a An>l-B1lloui Pills. U8. 


Mllk-furriling termont, 30. 


^^^V LentlK Ouriunii. iimclclvis vuluo 


Milk. motUor's. nutritive valno of. 


^^^V 




^^B Ll>1]lll^. iitilnllvo v»liu' or. 10. 


Milk of cow-treis natrlUre valne 


^^m 


of, -IS. 






^^M LIqulil -Ik'tury, ^- 


Milk, sklinniud. nutritive value ol. 


^^B Llvor. m 


<S. 


^^^B Liver, CHiicer of, IM. 


Mllk-sngar. 33. 


^^H LIrrr, cirrhosis of. isi. 


Mlllel, nutritive vnluo of, 41. 


^^H Liver pills. Un. 


Mineral waters. UH. 


^^H Liver. h>rpld. 309. 


Moral treatment. 314. ^^_ 


^^H LulHt«rG,3T. 


MosMi, Dr.. sai. ^^^^^H 




Motor tUDctlons. dlsturtMnoMif^^^H 




■^^^H 


^^H Malarial disease. IK 


Moulb. Zl ^^^^M 


^^H Mutt sugar, or mulloso. 07. 


Moull.. antisepsis of. 341. ^^^^1 


^H Man a fruglVDroas .>.1m»1.-M. 


Moutb. sonr Uiile In. I6R. ^^^^M 


^^^1 Manila, uutrltlvv value uf, 11. 




^^B UasiaEe. M4. 






Mustard. W. 109. ^^^M 


^^B Uassage, cannon-ball, xn. 


Mutton, brollwl, time of <tlgestloii V 


^^^^M Huaagc general. 308. 


of, «a B 


^^B Uassage of bovels, m. 


Mutton, lean, nutritive vulno of. B 


^^B M<uisaReotBtoinacb,ilO(l. 




^^B ^'^^^ bathing urter. Ttl. 


Malton. roast^fd, time of dlgesllou B 


^^^H Heals, eating bctvcen, AT. 


of. 40. B 


^^M Meals. Irregularity of, S7. 




^^^1 McalH. proper number Of, CD. 




^^B '^^'^ sleeping after. ?n. 


W. ■ 


^^H Meals, too fr*>qurut. ce. 


Nausea. US, UK. . ■ 


^^M Meat, "hlgb."l«i. 


Nervous diseases, SIO. ■ 


^H Meat, raw. I«8. 


Nervausneiia,S0.153.e(e. ■ 


^^H Meats, canned, es. 


Nervous syroplonia, JOT. ^^^^^H 


^^^1 Mecbanlcal kneading. 33S. 




^^M Melon. DulrltlTe value of. iS. 


N'eurastbenia. gastric, B7. ^^^^B 


^^^1 Memory, losi of. 1/3. 


Keinon, 85. ^^^^B 


^^^V MonUI Impressions, 124. 


New ZeaUnders. US. ^^^H 


^^B Mental confusion. 1st. 


Nlemyer. Dr., lie. ^^^B 


^^V Mental disorders. S11. 


Nitrogenous dieury. Hi. ^^1 


^H Mental labor, m. 


Xostmms. 34l>. ■ 




Numbness. IM. H 


^^B 





^^^^^^^w__^r~^^^^i 


^^^^^^^^^^^^■^^^H ^^^^^H 


^^^^m^^iB^^^^^^i 


^^^K 


^V IKDU. S6ff 


^ KntbatMr.Ul. 


Pirkles. III. 


Kateremm.1l». 


Plti-crust. loa. 


Hot>iiMLMI. 


Plaiitn. 31. 


NuU,UW.Bl.SM. 


Plants, pod-bearing. 38. i 




Pluasant PiirKatlve Pellets, 34^ 




Plum, nutritive value oL 41. 


OstmnLRgO. 


Pork, U. 


Okta, nntrlUve VBl ue ot, 41. 


Path. Dutrltlre value ot. 4S. 


ObBsltj, »T. 




Oil rubbing, aot. 




Olli. v^eMble, » 


Pork, salted, tried, lime of dlges- 


OnloQ. DQtntlvc valud ut, O. 


Uon ot, to. 

PoPtnlclreulBtlon.Sl. 


Ore reft ting, W. 


Ojiw™. 37, IM. 


Pw>[l1oaa. bad. IS. 


Oysters raw, tlms of digestion of. 


Potaloes, 9E. 93. 


to. 


Putatovs. Irish, baked, time of di- 


Ojriten. •Mmd, time of digestion 


gestion of, 10. 


ot,«0. 


Potatoes, Irish, boiled, tune of di- 




gestion ot, to. 


PHa. lO. IT*. 


Potato, nutritive value of, 41. 


PklpltatlaD of the heart, m. 


Potato, sweet, nutritive value of. 


P>rk«a,«g. 


42. 


ParsDlp, aatrltlve nine of. 4£. 


Poultry, nutritive value ot.tS 


Parenip* M. 


Pour.hot and cold. aoo. 


Ponnliw. tjoUed. time ut dlgestloD 


Prolapsed colon. Swedish move- 


at. 40. 


mEula tor. 817. 


pMt«ur. 19. 


Prolapsed stomach. Swedish move- 


Paslrjr. DO. 


nn:nt5tor,317. 


Peacb, nutrlUTS value of, tl. 


Prune, dried, uutrltlve value of. 


Peach pickles. 111. 




Peanut, nutritive vnlus of. «2. 




Pear, dried, natrltlvc value of. 41. 


Itomalnik 19. 


Pear, natrltln value of, 41. 


Ptyallu. a. 


Pea9,«l.n. 


PuBlllsts, B9. 


Peu, African, nutritive value of. 




41 


Pylorus. SB. 


PeBMDta.(lletof.3B. 


Pyrosis, ins. 


P«u.Ci«eii,eardeD,notnitTeVBlDe 




ot.4S. 


Quacks. 34!i. 




QuButlty of food. Tft 1 


value of. 41. 


^■a 




^^H 


Peivudiung.aae. 


Radway's Begulallng Pills. SI8. ^^^H 


Pepper, 34. W. 


Ralslu, nutritive value of, tl. ^^^H 


Pepper. Dr., IM. 


Raspberry, nutritive value of, tl. ^^^H 


PepperHBUCe, M, lOB. 


Eectum, symptonis pertaining to. ■ 


Pepsin. 19. 


KB. T 


Pepsin, what about T ttl. 




Peptic Kland>,n. 


R^mond, SBL J 


Peptogen*. 38. 




Peptonea, 19. 


Rest-cure. 329. 1 


Perfection Vaporlier. m. 


RheumatUm. IM. 1 


^^^A 



^^H^^^^^^H 


^^^^^^^^^pi^li^^^^^^^^l^^^^^^^^^l 


^W 366 THE 8T0MA0H. 1 


^r HheuiaaUHm i.rid goul. rtl.^t tor 


lilci'plxsatMr mnla.73. 










Klce, M. sa. 


Smokod meats. 37. 


nice, nutritive value of. <1. 


Soda, bicarbonate ol, 83S. 




SootblDg gyrap Mrs. Wlnsloit'a. 


Bobcrts. Dr. William, UX. 




Romans, diet of, M. 


Boreueu. ITS. 


Rowing, 13*. 




Rabbi Dg wet-abeet, SgL 


*0. 






Rje meal. I& 03. 


tlou of, to. 




Soup, multou, lime of dlge.UoB of. 


41. 


40. 


Rye. wlnier. noHiClre suluo of, 


Spinach. Duuitlve valuo ot. 4a. 




Spine. ^Ivunliatlou of, SEN. 




Splue. beat and cold to. SW. 


Sago, llmo of tlieestloii ul. «>. 


Sponge bath, 2)0. 


DBleretns, iia. 


Squash, nutritive value of, 48. 


Saliva. B. 


StammeTlQS, IS3. ^^^H 




Starch, ffi, to. ,^^^^H 


B«llv»ry glaniis. 2i, 




Balcdon, uulrlilve value of. «. 


Starch granules. »7. ^^^H 


Salnion, salteil. boiled, cimv of dt- 




gesllon of, 10. 


Starch, ra*, 91. ^^^^H 


Salt, m 110, 


Sieaptln. 30. ^^^H 


Kattglow, 201. 


Martin, 10». ^^^^H 


Salts. 3S. 33. 


Stomach, £1. S. ^^^^M 


Salted meats, 37. 


Stomach Bitters, 847. ^^^^H 


Sarologa i?h1p«. 101. 


Stomacb. earner otSTT. ^^^^H 


Sauerkraut. Ifll. 


Slomachi cutatrh of. SS5. j^^^^^^t 


Sourvy.flO. 


Stomach, cliranlc caUrrb ot.tf^^^^H 


ate, M. GeroiBUic. S3. 


.stomach contents e».nU>S^^H 


BeHier, 324. 


^^H 




stomach coagb, IH, SOG. ^^^^M 


Sexuul abuses. HA. 


stomach. dllataUon ot IS. aL ^fl^^^^M 


6bell-fisb. 37, W. 


Stomach masuige. XS. ^^^^H 


aiRhlng. 154. 


Stomach, pressure ol. 121 


Shower balli.a81. 


aiomach. prolnpK of, Sid. 


Slgbt. dl&lnrbaoces ot. 2m. 


Stumach, prolapse of. fiKMltali 


Simon's LUcr KeKulator, ;h& 


movements for. n7. 






SlnkliiB seusallon. 178. 




Wnusoldal eurrent. hlKb l^u-slon. 


Stomacb-tabe, MO. UI. 




Stomach, ulceraUon of. dtv) ftt». 








StoDi<>-h.iilcernf.am. 


SItup, Dtitrltlve value of, f! 


Slomai'li. uueusluew al. l.V. 


SIU bntb, m. 


StodK IBT, 


skill, dryness of. mo. 


KUKils. lutlnful. ISJ. 


Kkln erupt Ion », ISO. 


sionghlon BlTlers,aie. 


1' Hlocplng. HO. 


Mrawbsrrj. nutritive vuhio ot,4L 



^^^^^^^V^^H 


H^^^^IH^HH^^^BI ^^^^^^1 


^M' ihbbz. 367 1 


StraiiKtli, mllng For. S?r. 


Turnips, flat, boiled, time of diges- 


!<UL'l. 101. 


tion of, <0. 


Bngar, 38; 40. 


Typhoid fever. IS. 


aiig«r, use ot Id excess. U». 


TyrotoilcoQ, ai. 


Sulphur. 3S4. 




8unbulh.Sge. 


Ulcer of EiomHcb. SiS. 


Suppera. InlA. TI. 


tirlcacid crystalh. ISt. 


Swedlab movKmeol* mechanical. 


Drlue. ISO. 
Urine, scanty. HU. 


Swoetmeiits, 87. 






Van HelmoBi. IM. 


ot.Wk 


Vapor bath. m. 


Byniptoois, sonenl nurvous, IB3, 


Veal, tried, time of digesUon of. ^^^M 


Tapeworm. 18. 




^^M 


Tea drnnkonness. ». 


Veal, nutritive value of, «£. ^^^^M 


Teeth. £1. 


Vegetable fats. 101. .^^^M 


Teeth, permanent, 3t. 


Vegetable foods, 37. ^^^^M 


Teeth, BlructQre of. lOD. 


Vegetables, 33. ^^^H 


Teeth, temporary, a 




Test meal, 1S4, 


Vegetables, raw, 87. ^^ 


Theln. m. 


Venison, broUed, lime otdlgeitloh 


Throat-all. 18S. 


of, M. 




Vibrating chair. 38S. 


W. 


Villi. 38. 


Tight lacing, m 


Vinegar, 34, 10», IB. 


Tightness. 172. 


Vinegar Bitters. 317. 


Tingling, IM. 




Tobacco, 117. 


Vomiting, isa, IflT. 


Tomato, DUtrltlTO value of, <£. 




Tomatoes. lU. 




Tonic treatment, general, 333. 


Walnut, nntrltlre value of, a. 




Wat«r-bnub,HUS. 


ToLguB, coaled, at. 




Tonsils, a. 


Water, bard, 118. 


Toxins, 19. 


Water, Impure, 12B. 


Tra»ellDg.3i3. 


Weight, 178. 


Tropic Fruit Laxative, 3tlL 


Wet-sheet pack. M3. 




Wheat. Japanese, nutritive value 


TruDlE pack. XM. 


of, 41. 


TruDic pack, bat and cold. KM. 


Wbest, Michigan, Dleble, nutritive 


Trunk ml Hog, SX. 




Trypsin. 30. 


Wheat, Ulchlgan, white, nutritive 




value or. 11. 




Wheat. Poland, nutrlllve value of. 


Turkey. roUt«d, time of digestion 








Turnip, while, nutritive value of. 


Wheat meal or bread. B3. 


42. 


Whortleberry, nutHtlve raluo at. 




^^^M 



• ■*% 



. 4 



THE ART OF MASSAGE. 



By J. H. KELLOGG. M. D. 




Th« most complete and thorough work upon the subject of n 
ever publisbed. Illustrated by 139 cuts and 10 finely colored anatom- 
leal plates. Concise directiaus are given Tor all the different procedures of 
sctentitic massage. It ought to be in the hands of every nurse. 

The Perfection Vaporizer. 



Is especially adapted to the 
treatment of diseases of the 
nose, throat, ear, brondiial 
tubes, and lungs, both acute and 
chronic. Many severe spells of 
sickness can be avoided by its 
early tise. Is especialy recom- 
mended in "La Grippe," when 
afTecting the air passages, hay 
fever, and asthma. 

Full directions and formnlEe 
with each instrument. 




MODERN MEDICINE CO.,BkT\\.t C'ssxx-,'"*^^^!^ 



Ml nis OF 1 11 Fiei 



The accompanying cut represents these outline Charts mounted 
D a convenient Exhibitor, which is SO arranged that both the Charts 
md the Exhibitor can be snugly packed in a compact case. 



C/0 



o 



THE following expression regarding the value of Dr, Kellogg'i 
"Outline Studies of the Human Body," is from Jay W. Sea\-er, 
A. M., M. D., President of the Chautauqua School of Physical Edu- 
cation, and Medical Director of the Yale University Gymnasium ;— 
"Dr. Kellogg's 'Outline Studies' I am sure will prove to be 
very helpful to any person who is studying the human body, or who 
is teaching personal hygiene. These outlines should be widely in- 
troduced into public schools, where their mere presence on the wall* 
would be a constant object lesson." 




MODERN MEBIGINE PaBLlSHING GO., 
BATTLE CREEK, MIEH. 



SomethiDgGoodrZC 

A nrw cereal preparation made from the choicest wheal, by a process 
which retains all the elements of the grain. By combining the proc- 
esses of digestion, cooking, and roosting, by the use of special macliin- 
ery, the wheat is brought into the form of delicate HakcE, in which the 
bran is thoroughly dUlntegrated. and the starch largely converted into 
dextrine, and thus made ready for solution by the digestive juice and 1 
for prompt assimilation. 

L -^GRANOSE*-' 

■b crisp, delicious, appetlzlntCf and digests quiclcer than any 
lather cereal preparation. It clears oH the tongue, rids the 
stomach of germs, and cures constipation. 

It is unique; an Incomparable food. Babies thrive upon it. 



BATTLE CREEK SflNITftRmW HEftLTH fOOD CO., 

Battle Creek, Mich. 



Antiseptic- Charcoal, 



Tablets. 



•••• These Tablets consist of a newly pro 
duecd form o( vegetable charcoal, 
which has been shown by eiperience to be possessed of superior 
qualities, with which are combined vegetable digestive agents 
and Intestinal anti^ptlcs and antlferm^nts. In these Tablets ] 
charcoal Is for the first time presented in agreeable farm. 



. When to be Used. 



I 



The use of these Tablets is indicated in all cbbh of Stomacb 
and intestinal Indigestion, and especially in cases in which 
the following symploms are present : SoUf StOntach, Of Acid 

Fermentation, Bloating of the Stomach or Bowels, 
Flatulence, Eructations of Gas, Foui Tongue, Bad 
Breath, Unpleasant Taste In the nouth, Biliousness. 
Sick Headache, Nervous Headache, and Constipation. 



Dose: Ont 



o four Tablets alter each meal. 



MODERN MEDICINE CO.. Battle Creet fttod. 




Nut Meal. 



■ 
I 



Ibe food product 



Th!« prtp«™Uon li mide troat e^refnllr »■ 
Itdcd and prepstcd onti. II nprMtnt* «■* 
of tb« mMt DOurUIilns and dIsertlUc ef all 
f the TCEcUblc kiagdam. 11 ii ripcciilly sdapicd for pa- 
ifficully in diB«liog atanh, and lor tbOM wko 1t*4 W 
InNuh. It agreu well with the moit del 
gelled when the (tomach Kill tolerate notbing tiac. 
Meal a»} be eaten dry, or conblncd with otbcr loodf, or ml 
1lh the addllloo ofa lillle ult. ilioak 



a UtUi 



deliclou 



Nut Butter. 

vlei, uuce*. etc. TborouKhlri 
In water; has a rich nulty fiavc 
keep* well. Is Iharouihly (tcrl 

can be urged agalnit animal fai 

Almond Meal 

■igaed Tor dlabetlci and Invallda wh 
nutrilloui, ciccedlnxly dellcals and 

Malted Gluten 



A caplUI (ubatltHU tor anlaul Ma ■< 
■II lorti In the acatOBlag or aborMi* 
log of lood«, la the preparatloa ■! gr^ 
vlei, uuce*, etc. TborouKhly cooked and emulnlGcd. lo it diuotTe* teadUr 
In water; has a rich nulty Savor; la tieecdiDgly palatable aad dlgestlM*. 
keep* well. Is Ihanmihly Mcrltlzed. and fret fiom all otijeellaa* oblcb 
can be urged agalnit animal fal*. II girei a mealy flavor to aou^ 

Tbia I* •Imply • fine meal p(» 

pared from the chaloil 

MaBcbed almaadt. eopccUlly dc- 

■igaed for dlabetlci and Invallda who cwmot dlgeit *t<rcb. Ii la k%My 

nutrilloui, ciccedlnxly dellcals and palatable, and an adnliabte food Ifar 



MBDIA' 



! ABSORPTION. TtaeK>ut< 



and Is 1 
.e digMI 



' of fine dlvldOQ 
Clulen 



1 the larlnaeeou* hot 
( In a ilalc of compteic 
1. REAOV FOR IM- 

aiaa has been lubjerted 
, « tfa.I It U promplly 



Indefinitely. II 

that MALTED QLUTEN IS A PERFECT BLOOD AND PLESM-MAKINa 
FOOD. II is free from the impleaHnt Bivor of the variou* loeal peptoaea, 
and is especially sdapled lo thoie caaei requiring perfect lateatloal aHpsia. 
In which meat peploaea and meal preparatlona of e*ery description arc cod- 
tTa-lndlcaled. It has proved a floverejgn rciDedy la caaea €rf BcrviMW b e ad 
■cbc, sick headache, obstliute naDsca. and vonttlng. and Bunenms caaea 
lo which all olher food aubslanccs weie lejected by the itomach. 



Bromose. -'.rJ":i 



Kavi 






ance? WOULD VOtl UKE TO BB FAT r Wa 
: EAT BROnOSE i 

. exceedingly palatable food preparation, cooalata of cereati 
■h the lUrch is coDplclely dtgeited, the oula perftcUy 
fal emulsified. It I* thus ready far iramedlile assimila- 
tion. II is the most easily digested and moil faltealng of all foodi, and at 
the lame lime rich in proteldi. and henoe UNEQUALED AA A TISSUB 
BUILDER. 

BROMOSe makes fat and blood more rapidly than any other food. II 
is the food par eicelleoce for blood, bnln. and nenei. Innlldi wba« 
troubles are due la ihe fad Ihal they caouot digest Ibe atiieh of cereals aad 
vegetables, flnd In BROMOSE A PANACEA. Bromose Is rich la salt*, H 
well U protelds sod food elementa. It Is uceileDl for wMk, fd«ll< l»- 
vallds. and feeble children. 



SANITAS roOD COMPANY, Bottle Creek, Mich. 



Sanitarium Medical Battery. 

THE ADVANTA6ES CLAIMED FOR THIS BAHERy ARE 

I Efficiency, Durability, 



of Construction, 




THE CELLS HAVE THE FOL- 
LOWING ADVANTAGES. 

The elements are zinc and carbon. 

The excitant is a solution of muriate of ammonia (sal ammoniac) 

and water. 
There are no fumes nor strong acids to corrode battery parts. 
They will run for medical purposes many months without the 

slightest attention. 
There is no consumption of the zinc element when battery is at rest. 
They are perfectly sealed, so that evaporation is impossible. 
High electro- motive force. Small internal resistance. Great power 

of recuperation. 



pmicm, WITH MLMCTifOoms, cOMPLeTM, 910.00, 



MOBERH UBDICmE CO., *».VV\s. Cv«.<>8.,"«J>!3' 



^ 



COMBINATION 



Watsr MIe and Fountain S fringe. 




This combination was first arranged by us a number of yean | 
ago, and we have had hundreds manufactured for us. We have re- J 
cently arranged for the maiuifacture, for our special trade, of thiftl 
convenient combination in an improved form. It consists of a saV I 
stautial water bottle with funnel neck, a safe and durable cap, andl 
E six feet of fine improved tubing, with suitable attachments for o 
necting with the bag. An outfit of the usual syringe tubes is c 
plied with the syringe, and the whole is packed in a neat i 
substantia] tin box. 

PRICE, complete, , . , - $2,001 

Postage, 25 cents. 

MODERN lAEDiaUE CQ.,Bwt:l£ Crbek, 




EAR DOGCHE. 



^^HE continuous application of hot water 
j!p' to the ear is a raost valuable means of 

preventing the destructive inflamniation and 
loss nf hearing in cases of earache, and in the ear 
troubles which accompany diphtheria, measles, and 
scarlet fever. The objection to the employment 
Mi' this remedy is its inconvenience. This device 
]K*rmits of the application of a continuous stream 
of hot water with the patient in any position 
without danger of wetting the clothing. Its timely 

will often save life-long inconvenience. It ought 
to be in e\'ery family. 



SPIME: BA<SiS. 



P 



RUBBER 
SPINE 
BAGS. 

Verj- strong and (UuMbif , i,-.--i.nnal m iht- ireatiiicnl ol" some forms 
of Dyspepsia, Spinal Irritation, and many nervous diseases. 
PRICE, 20 Inch, postpaid, - • - S1.40 
26 inch, post<paid, - - 1.66 



= HOT -WATER BAG. 




As a foot-warmer, or for applications of 
either moist or dry heat, this bag is invaluable. 
For moist heat, wring a flannel cloth from hot 
water and lay on the bag. It is a durable 
article, and one not wilUngly dispensed with 
after once using. 

Price, post-paid, »1.S0. 



MODERN U^XSVOCS^ "C^- 



tDiilcanized IRiibbep ITce Bags. 



Hhese bags are designed for making applications of ice to the ■ 
} head, throat, or spine. Where ice cannot be obtained, very coldj 
water may be used. It avoids the necessity for wet cloths, wbidlj 
wet the patient's clothing, soil the bedding, and require cotistantl 
renewal. The mode of fastening renders the bags water-tight. 

PRICES. 

No. 1 50 cents. 

No. 2 (narrower than No. i ), speci- 
ally adapted to the bead. 50 cents. 

No, 3. Specially adapted to the 
throat. Made of pure gum, 
and furnished at the follow- 
ing prices: — 

7 inches long, 50 cents, 

8 inches long 60 cents. 

9 inches long 65 cents. 

I inches long 80 cents. 

Postage, each, 4 cents. 




HEAD BAGS. 



Beneficial results may often be obtained by the use 
of one of these bags in cases of headache. They an 
very light, and can be filled with either hot or cold 
water. They are easily carried and readily applied. 

Price, 32.00. Postage, 5 cents. 



iDstrtiraenf for the flppIi^atiOD of Heat to the Uagina. 




It above shown has been devised for the purpose of appljrjn 
dry heat to Che vaginal walls. It may also be used for cold applications, i 
alternate hot and cold applications ia this region. It is used in conDftcde 
with a fountain sjringe, a current being passed through it either hot, col 
or alternalel/ hot and cold. 

PRICES : No. 1, $1.25 ; No. 2. Si.oo ; No. 3, 75 ceaU. 



MODERN MED\CWt CO.,■e.^•K^v■^. <:>,«» 



THE NATURAL ABDOMINAL SUPPORTER. 



Ought to be worn by every 

woman who has the 
shape of Fig. i. 

Cures backache, headache, drag- 
ging sensatkiii, and many 
other discomforts. 





P^ISICE, FOST'F.a.iD, ^S.OO. 



Clubs and Dumb-Bells. 




By the use of these the muscles can be 
exercised aud developed, giving vigor, appetite, 
and cheerfulness to the user. 

SIZES: 1-3, 8-1, I, 1 t-2, 2, 3 1-2, 8, and 4 lbs. 

The '/^ lb. is adapted to the use of children 

from 2 to 4. years of age. The ^, from 4 to 8 

years of age. Prices given on application. 

We fiimish outfits for home gymnasiums at various prices 

from $10.00 upwards. One of these outfits ought to be in every 

home. 

SEND FOR CIRCULAR AND PRICES. 



MUSCLE BEATERS. 



Simple, cheap, and efficient instruments for 
securing some of the effects of massage. By 
their habitual use one can obtain most beneficial 
results without the aid of an expert. 

Price of Ball Be&t«r, postpaid, - $1.40 
Price or I'lliiger Bealer, postpaid, 2.15 




MODERN MEDICINE C0.,ftKV\V5. Cvsst.,-«v\'=xv. 



^ 



Umbilical Belts. 

Made to order of any size desired. 
PRICE, $1.50. Postage, 4 oeou. 

Air Pillows. 



Air Pillows are always cool and restful. They can be a 
at will. Just the thing for camping out or traveling. Can 1 
packed in small space by letting the 



PRICE, 

. I, Sateen cover, gx 




$1,60 
2.50 



Invalid Air Cushic 

These cushions are unsui 
comfort they afford to very thin j 
sitting, and are also essential as a d 
preventing the formation of bed-si 

PRICE, 



diameter (postage, 10 cents), 



$t.i 



Exhalation Tube for Lung Developmen 



I The EzbaUtioD Tube is one of the most effective means for luag de«clop> 
t. It can be earned in the pocket, and can be osed at any time wilbon 
interfering with other occupationa, and caii thus be made to act contlnootvl} 
in developing the lungB, expanding the »ir-cells, and deepening the rctpitBtofy 
jnovemeDts, It is worth many tkacs \Va "uti^W 
Htaur oCber person whosa Inngs kic ve%^. 
^^L MOOBR.N (AtWCWE. «>-.^-^i 



PERFECTION 



Douche Apparatu 



,n 




T 



-i- 

"HIS apparatus consists of a pail 
for water, with a long rubber 
tube, and a convenient bed-pan. 
It is made of tin, and is light, dura- 
ble, and easily cleaned and disin- 
fected. 

It is especially useful for giving 
douches in cases of confinement, and 
to feeble patients who cannot be removed from the 
bed. 

It can be adjusted under the hips without moving 
the patient, on any form of bed or mattress. 

Any amount of water can be 
used, the water running out as ' 
fast as it runs in. To start the 
water running, close the rubber 
tube by folding it below the bulb, 
and then squeeze the bulb, which 
will at once fill with water when 
released. Then open the tube, and the stream will 
continue to flow till the pan is empty. 




^■Complete $2.25. 

^■Douche Pan, without fountain or tubes, 1.35. 

^B Sent by e:K^t^%%. 

^■ODERN MEDICINE CO..^^T\v.t C-vs.^'*^,'^^'^^- 



RECTAL IRRIGATOR. 



fllE great prevslence of diseases of Ihe leclum, and the lecof^niied xl*a>U(«i 
uf hot water in the ircBtnicDl of 'diseases af mucous raembriuies. led, mtoiI 
years ago, lo the iovenlion of the hard rubber reclal irrigator, of wlucli the »■ 
ventor speaks as follovi : — 

"The virtue of hot water as an agent in removing the thickeningm and indi 
which rciult from chronic congestions and inflaminalions of mucous surfaces and 

(iguous parls, has long been recognized. In the irealment of pel*lc is- 
duiations resulting from cellulitis, no agent ii to polent as the hot 
vaginal douche. Dr. Emuielt states that be regards Ihit one •{ml ■ 
more valuable than all other local measures combined. The raise «l 
hot water in the treatment of rectal diseases seems lo have been 
appreciated by Ihe profession, Ih'iugh leeentlj' it has been used bf 
rioui specialists, and with excellent results. 

"For some years I have used hot water by means of the conlinu 
enema, and with most excellent results; but feeling the need of (one be 
mode of applying hot water lo this pari of the body, I have cup 
menled with various forms of inslrumenls for ihe purpose All the ift- 
slrumenU 1 found in use were loo large lo be used without discomlocl,, 
in most cases, and all were made of metal, which is wholly unRi fat tht^ 
purpose on account of its great conductivity of heal. The mncoui men* 
brane is much mote tolerant of heat than ii Ihe skin. When a melallic' 
instrument is used, the heal transmitted to the very sensitive surface at 
the jUDclioii of ihe skin and mucous membrane become* anbeaiable be- 
fore the Icmpcralure is high enough lo make the applicalion of muck 
value. I have bad made an instrument, which I believe embodies tli* . 
excellencies of instruments previously made, and several additional ad- 
vantGges, chieHy Ihe following: — 

"I. Il is made of hard rubber, a poor conductor of heal, which ^ 
lows the use of waler as hoi as the mucous membrane will tolerate. 

"I. The instrument is of tuch size that it can be easily used even in 

tbosecases in which there is unnatural coniraclioa of the sphincter miuelea 

from the irrilalion of a rectal ulcer or Essure, the class of cases in whick 

an instrument of this sort a of grenlesi service, and in which olhei !*• 

I slrumenls can seldom be used, never with water of proper temperilnre. 

"3. The sleeve of the inslrutnent is notched at its outer eitremilj 

to as to prevent obstruction to the return Bow when the inner tube is pushed in a* far 

as is allowed by the stop. 

*'l have used this instrument in the treatment of hundred* of cases of rectal di*- 
eaies of various sons, and have found it a most sailifaciory and eSective aid in the 
management of ihis class of diseases." 

CAN BE USED WITH A IVY SYRINGE. 

DlrectlDni lor ok iGCOiDpariy each inatniBCDl. 

niU, pHUgt ttii, ilM. WiU liiTttul Sjilu ijtiMgt. nJi; (Mtifi It I 



L 



MODERN lAEDlCWt CO-.feKvw-t C»sH(-,'»*<i-A. 



f 

I 



: n 




■•'• •'» i 

!,i:ffi 



LANE MEDICAL LIBRARY 



reo 9 1 9 77