3. Treatment Of The Effects

Treatment Of The Effects. When the process of indigestion is at an end, and prostration requires to be relieved, the therapeutist will avail himself of some of the many gastric sedatives at his disposal, of which Diluted Hydrocyanic Acid, Bismuth, and Morphia (whether given subcutaneously, applied to the epigastrium endermically, or combined in an effervescing mixture) will be found the most useful. Champagne or effervescing Soda-Water and Brandy will serve at once as a gastric sedative and a general stimulant, or Milk with Lime-Water or Soda-Water may be given as a sedative and nutritive. Ice is the best means of relieving thirst; in other cases water as hot as can be drunk often acts as a valuable sedative. Linseed poultices, hot fomentations, or warm compresses may be ordered to the epigastrium, and in severe and persistent cases Mustard or Cantharides blisters. The chief problem will be to support the strength without increasing the pain and sickness, and in very urgent cases the patient must be fed by the rectum.

The greatest caution must be exercised in resuming gastric digestion. The best treatment, unless the patient be very weak, is to rest the stomach absolutely for many hours. Fortunately, anorexia conduces to secure this end. The first food given should be in the smallest possible bulk, and of the blandest and most digestible kind, such as broths, essences, meat juices, and milk; and just before each meal a small dose of a mixed stomachic, such as Bicarbonate of Soda, with Diluted Hydrocyanic Acid or Bismuth, and a mild aromatic bitter, such as Gentian, should be prescribed, which will restore the secretion of gastric juice and arrest the flow of alkaline mucus set up by the dyspepsia.

4. Chronic Dyspepsia is rationally treated on the same principles as the acute form of the disorder, with certain modifications, which a careful consideration of the pathological associations of the particular case and general experience will suggest. The patient's diet will require constant supervision. The possible causes of indigestion, beyond food, must be searched for, such as disorder of the liver or bowels, of the heart or kidneys, gout or tuberculosis, and the treatment must be arranged accordThe flow of juice may still require stimulating by Alkalies, but these remedies must not be overdone, as they tend to depress the muscular and cardiac energy. The digestive adjuvants, Pepsin or Diluted Hydrochloric Acid or both, may now more rationally be brought to the relief of the failing secretion, being given during or at the end of meals. In still more chronic cases, e.g. in aged persons, where chronic indigestion depends on wasting of the glandular structures, peptonised foods will be of great service. In most cases of chronic dyspepsia, the nervo-muscular structures of the stomach require to be strengthened, and distension or overfulness of the organ avoided. Flatulent substances must be excluded from the diet, such as green vegetables, sweets, sloppy food, and large draughts of strong, hot tea. Powerful bitters, such as Strychnia and Quinia, the former being peculiarly valuable as a specific nervo-muscular stimulant, and Diluted Nitric and Phosphoric acids-in short, stomachic tonics-are given to increase the functional and nutritive vigour of the muscular coat. In some of these cases gastric disinfectants, such as Creasote and the Sulphites or Hyposulphites, may be required to cleanse the contents and surface of the organ, and destroy the organisms of putrefactive and fermentive processes.

Chronic dyspeptics always suffer from starvation to a degree, and the food selected for them must be nutritious as well as digestible. Alcohol in proper form and amount may be required, and bland preparations of Iron, such as the Ammonio-citrate, ordered at intervals, if they can be taken without increasing the dyspepsia. If the dyspepsia depend on a chronic catarrh of the stomach with excessive secretion of mucus, gastric astringents will manifestly be indicated, such as Oxide of Silver or Zinc, or Kino, Cinnamon, and other substances containing Tannin.

The treatment of organic disease of the stomach cannot be discussed here, but it is hoped that the student will understand from what he has learned, the principles which he must follow to fulfil the most urgent indications in this class of cases also: to relieve pain and sickness, and to insure functional rest of the stomach, remembering that many of the symptoms are referable to dyspepsia.

The therapeutics of vomiting, and incidentally of certain other associated disorders of the stomach, will be discussed in the next chapter.

Synopsis of Drugs which act upon the Stomach.

Alkaline Stomachics.

Liquor Potassse Potassse Bicarb. Sodee Bicarb. Ammonise Carb. Spiritus Amnion.

Aromaticus Magnesia Magnesia Levis Magnesia? Carbonas Magnesiro Carbonas Levis

Bitter Stomachics.

As in the Mouth

Aromatic Stomachics.

As in the Mouth

Aromatic - Bitter Stomachics.

As in the Mouth

Spirituous Stomachics.

Alcobol (in all forms) Ether Chloroform

Acid Stomachics.

Acidum Sulphu-ricum Dilutum

Acidum Hydro-chloricum Dilutum

Acidum Nitricum Dilutum

AcidumNitro-Hydrochloricum Dilutum

Acidum Phospho-ricum Dilutum

Acidum Aceticum

Pungent Stomachics.

Piper

Cubeba

Capsicum

Sinapis

Armoracea

Nervo-Muscular

Slimulants, Or

StomachicTonics

Mineral Acids

Nux Vomica

Strychnia

Bitter Stomachics

Aromatic Stomachics

Bitter Aromatic Stomachics

Spirituous Stomachics

Pungent Stomachics

Stimulants, becoming

Irritants and

Emetics.

Iodum

Tabacum (in excess) Scilla Digitalis Veratria Colchicum Senega Copaiba Cambogia Guaiacum F'errum Hydrargyrum Arsenicum

Digestive Adjuvants

Pepsina

Acid Hydro-chloricum Dilutum

Nervo-Muscular Depressants.

Hot Water Belladonna Hyoscyamus Stramonium Acidum Hydrocyanicum Opium

Carbonic Acid Ice Tabacum (at first)

Gastric Astringents.

Acid. Tannic. Argenti Oxidum Plumbi Acetas Zinci Oxidum

Antacids.

Potassa

Soda

Lithia

Ammonia

Calcium

Magnesia

Mechanical Sedatives.

Bismuthi Carbonas Bismuthi Subnitras

Sedatives of Obscure Action.

Cerii Oxalas Ipecacuanha

Gastric Disinfectants.

Carbo Tannicum Creasota Acidum Sulphurosum Sulphite of Soda Hypo-Sulphite of

Soda

Carminatives.

Camphora

Serpentaria

Assafoetida

Ammoniacum

Valeriana

All Aromatics Aromatic Bitters Spirituous Stomachics Pungent Stomachics