These are remedies designed to check nausea and vomiting In the treatment of nausea and vomiting the recumbent position should be maintained. The antemetics are:

1. Antacids, to check hyperacidity; especially sodium bicarbonate, 20 grains (1.3 gm.), and milk of magnesia, 2 drams (8 gm.); or to check acidosis, large amounts of sodium bicarbonate.

2. Carminatives

Champagne, brandy, chloroform water, essence of ginger, spirit of peppermint, menthol, etc. In alcoholic nausea and vomiting strong hot carminative mixtures are indicated. (See Alcohol.)

3. Protectives - which mechanically-prevent irritation of the mucous membrane, as: bismuth subnitrate, bismuth subcar-bonate, bismuth subgallate, and cerium oxalate, dose of each, 30 grains (2 gm.).

4. Local sedatives, those which depress the sensory nerve-endings: Tincture of belladonna, 15 minims (1 c.c.), atropine sulphate, 1/100 grain (0.0006 gm.), cocaine hydrochloride, 1/4 grain (0.015 gm), orthoform, 5 grains (0.3 gm.), anesthesin, 5 grains (0.3 gm.), phenol, 3 grains (0.2 gm.), and cracked ice.

5. Central Sedatives

Bromides, chloral hydrate, chloretone, codeine, morphine, sulphonal, veronal, and to some extent other narcotics.

. 6. Counterirritants to the epigastrium, as a hot-water bag, an ice-bag, a mustard plaster, or the actual cautery.

The nausea of pregnancy and that of seasickness are especially resistant to treatment. In pregnancy, alkalies given at the height of digestion or before going to bed, and sometimes a light breakfast before arising, may be effective. Atropine or bromides or cerium oxalate in large doses may also be tried. Frequently no measures are entirely satisfactory. Persistent vomiting in pregnancy is a serious toxic manifestation, usually requiring the termination of the pregnancy. The cause of the vomiting may be acidosis, and this is an indication for abundance of alkalies and carbohydrate food.

In seasickness the recumbent position on deck, with eyes protected so that the rolling of the vessel is not seen, is often effective. Another effective measure is thorough purgation with calomel or compound cathartic pills before sailing, and every two or three days during the voyage. The avoidance of much liquid, such as soup, and of tobacco, is also recommended. Bromides, chloral hydrate, veronal, chloretone, champagne, and iced brandy are employed with varying success. A much-vaunted, and at times an exceedingly satisfactory, prophylactic remedy is strychnine sulphate, 1/120 grain (0.0005 gm.)., and hyoscine hydro-bromide, 1/240 grain (0.00025 gm.), every hour for five doses before sailing, and, if necessary, repeated every day during the trip. A hypodermic of strychnine sulphate, 1/30 grain (0.002 gm.), and atrophine sulphate, 1/100 grain (0.0006 gm.), will sometimes bring about a striking improvement in the patient's comfort.