(a) Small meals, slowly and deliberately eaten, is the first essential. The meals should be small, and very moderate in quantity. A diet should be selected that gives the necessary nourishment with the least labour to the stomach. It is important to remember that the digestive function begins in the mouth. Thorough mastication is, therefore, of paramount importance. Particular attention should also be directed to the state of the teeth.

(b) A sufficient amount of time should be allowed between meals to permit of complete digestion of one meal before the next is taken. When on a fluid diet, and only very small quantities being taken at a time, the meals must be taken more frequently, two and a half to three-hourly; but when solid food is taken, four to five hours should at least elapse before the next meal. This is especially important in dyspepsia in elderly subjects.

(c) Avoid sitting down to food immediately after hard physical or mental work, and do not return to work immediately after a meal, rest for half an hour.

(d) A few notes on the most suitable type of food may be added: -

It is exceedingly important that the food of the dyspeptic should be carefully and skilfully cooked. Of the meats, the shorter-fibred and more easily digested meats and fish should be selected. Chicken, turkey, pheasant, partridge, sweetbread, tripe, mutton, are better than beef, goose, duck, wild fowl, veal, or pork. Lamb and rabbit are not so digestible as is often assumed. Of the fish, the white varieties, as sole, whiting, plaice, flounder, are the best, and fish is best grilled, or plainly boiled or steamed. For cooking, if the meat is tender, grilling is the best method; underdone roast is also good.

As to sauces, it is best for dyspeptics to avoid rich sauces entirely; and when butter is required, as with fish, to use plain fresh butter.

Fat in some forms is difficult to digest. Grilled fat bacon eaten with dry toast is easily digested, tasty, and a good form of fatty food. When taken with bread and yolk of egg it makes a nutritive and compact meal. Breadstuffs saturated with butter, such as buttered toast, hot scones, muffins, pastry, are not easily digested, the saturation with fat preventing the gastric juice getting at it, with the result that these foods undergo abnormal fermentative changes.

Some varieties of bread are indigestible, but often when complained about it will be found that the patient is taking too much. A digestible bread is one that is not new, which breaks short, is open and crumbs easily (pan loaf); scones and wholemeal bread are often very troublesome for people with feeble digestive power (see Bread, p. 93).

Sweet dishes are apt to undergo acid fermentation, and unripe acid fruits, nuts, and the hard coverings of vegetables containing much cellulose are difficult of digestion and must be avoided. Vegetables should be smoothly mashed, or reduced to the form of purees, especially all green vegetables.

Tea or coffee do not always cause indigestion, but are apt to do so in some persons. If they do cause indigestion they should never be taken with or soon after food, but a cup of freshly made tea or coffee three or four hours after a meal will not unfrequently be found to promote the final stage of stomach digestion. No food, however, should be eaten at the same time. Light China teas are much less likely to cause dyspepsia than the stronger Indian kinds. There are other varieties of so-called digestive teas on the market, which are reputed to contain little tannin, e.g. Typho-Tips.