The special indications to be met by treatment in dyspepsia are:

1. To increase the quantity and quality of the gastric juice, and of the other digestive fluids.

2. To increase the muscular activity of the stomach and bowels.

3. To palliate the various other symptoms which grow out of derangements of these two important functions.

To Increase the Secretion of Gastric Juice

Any measure which will improve the tone of the stomach will accomplish this result. We may mention, as useful for this purpose:

1. Taking a few sips of cold or hot water just before or just after eating. A larger quantity may be taken half an hour before a meal with good effect. A few sips of hot drink taken an hour after eating is a very useful measure in slow digestion.

2. The application of hot fomentations to the pit of the stomach stimulates the activity of the gastric glands. Alternate hot and cold applications made to the portion of the spine just back of the stomach has a similar effect, and often in a remarkable degree. In some of the worst cases a fomentation applied a half-hour after each meal will have a most decidedly beneficial effect. The alternate hot and cold spray or douche may be employed instead of fomentations and compresses, and with greater benefit in some cases. The application should be at quite extreme temperatures, and alternated every few seconds. It should not be continued more than two or three minutes. Care must be taken to avoid chilling the patient. If the douche cannot be employed, an alternate hot and cold rubbing may be substituted, applying the heat and cold with cloths wrung out of hot and cold water alternately. A piece of ice wrapped in a thin cloth is a very good means of applying cold by rubbing.

3. The application of fomentations night and morning, and wearing a warm abdominal compress through the night, or for a few hours after each meal, are measures of very great utility. Moist warmth applied to the surface is a powerful stimulant of secretion in the stomach, as well as in the liver and other secreting organs.

Measures to Increase Muscular Action in the Treatment of Dyspepsia

The measures just described are equally useful in exciting muscular activity. In addition may be mentioned gentle manipulation of the bowels, or kneading of the abdomen, especially its upper portion. By this means the local circulation is stimulated, and the natural muscular action of the bowels is both imitated and encouraged. This is an excellent remedy, and can be employed to advantage each night and morning, and for half an hour or more after each meal.

If the patient is able, he should himself make a practice of kneading and percussing the abdomen for fifteen or twenty minutes night and morning. This is a powerful stimulus of muscular activity. Many years ago a quack doctor in New York City made a fortune by curing dyspeptics with this mode alone. He put every patient under an oath of secrecy, and required certain wholesome restrictions of diet, which of course aided in the cure.