It not infrequently happens that cases of dyspepsia exhibit the symptoms which belong to two or more classes of the disease. In cases of this sort it is of course necessary to conform to the special indications so far as can be done. The most frequent combination is acid and painful dyspepsia. These cases are often very troublesome to manage. None buta careful discerning physician is competent to successfully pilot safely out of his doubly perplexing difficulties such a sufferer as this; but sufficient care, patience, perseverance, and well-directed effort will secure certain success.