The dietetic treatment of such cases requires to be carefully considered. So long as the motor-power of the stomach remains good the patient may be allowed such animal foods as will readily and quickly pass through the pylorus into the bowels. Thus it is proper to give milk, eggs, meat reduced to a pulp, chicken panada, light steamed fish, milk puddings, custard, junket, jelly, and stale bread. It should not be forgotten that butter and other fats check the secretion of gastric juice, and should be reduced to a minimum ;while soup, beef-tea, and meat extracts promote the secretion of gastric juice and are useful foods. The following dietary would be suitable for an average case :-

Breakfast

Two eggs lightly boiled or poached; or 5 ounces of fish (sole, plaice, whiting, fresh haddock, brook trout, brill, bream, etc.); stale bread, "pulled" bread, or dry toast; a breakfastcupful of milk, cocoa, or weak tea.

Lunch

A cupful of fairly strong soup or broth; chicken or mutton; potato, spinach, vegetable marrow, boiled lettuce, kidney beans; milk pudding, custard, junket, or jelly.

Dinner

Soup; fish; chicken, pheasant, breast of turkey, rabbit, lean mutton, undercut of beef; potato puree, spinach, or other vegetables as for lunch; and the same kind of puddings, baked apples, or apple sauce. A few grapes, a slice of pineapple, a tangerine orange, one plum or apricot or a few strawberries may be allowed. Alcohol. - A glass or two of claret or burgundy, or whisky and water.

"Pulled" bread is prepared by taking small pieces, about a dessert-spoonful each, from the inside of a new loaf and baking them in an oven until they are crisp and dry. Toast should be crisp, and eaten without butter. Apples are considered a tonic to a weak stomach; they do not suit everybody, even when baked or made into sauce they may irritate the mucous membrane; but they may be tried.

The food should be well salted, as salt is considered to increase the strength of the gastric juice. Spices and condiments have temporarily a good effect by promoting the motor activity of the stomach, causing the expulsion of gas and assisting the stomach to propel the food into the intestines. They are useful if taken in moderation by persons who have not previously abused them. The old rule, that we should treat the patient rather than the disease, here comes in again. Spices are well-known causes of indigestion; they have been enumerated among the substances which cause an excess of gastric juice and hydrochloric acid. But their continued use in large quantities causes congestion of the mucous membrane, hypertrophy, and ultimately atrophy of the gastric glands; so that primarily they cause a profuse and secondarily a scanty secretion. The deduction with regard to acid dyspepsia is this: if the patient has been accustomed to use a lot of pepper, mustard, horseradish, pickles, cayenne, and other heating substances, he must be forbidden to take them at all if he has not been accustomed to take them, except in very small quantities now and then, he should be encouraged to use them more freely, in the hope that the stomach will be improved by the stimulation derived from them.

Similar remarks apply to soup, etc. A free secretion of gastric juice soon follows the consumption of soup, beef-tea, extract of meat, and its various preparations. Therefore such patients should take a cupful of one of these fluids at the beginning of lunch and dinner. A cupful of Bovril or Oxo would have the same effect as soup, and as they are more quickly prepared and sometimes better relished by patients, they may be used to the same extent as soup.

The attendant should be warned against allowing patients of this class to take soup made from scraps of meat. If soup or broth is given at all it must be made from fresh meat or fowl. The danger of introducing the products of bacterial action on meat into the stomachs of such persons is obvious.

Vegetables have to be considered. Mashed potato, spinach, vegetable marrow, tender green peas, and other soft vegetables are permissible. But all coarse and fibrous vegetables, in their usual form, must be forbidden. Nevertheless, they are very useful for their salts and vegetable juices. But they should be taken in the form of French soup. This is made as follows : All kinds of vegetables are put into the pot along with some bones and scraps of fresh meat. Onions, turnips, carrots, celery, leeks, marjoram, a bit of thyme, mint, tarragon, or savory, some endive, chicory, and even cabbage may be added. These are boiled together for four or five hours, until the whole is reduced to a puree or consomme, and is then flavoured with salt, pepper, and other spices. It is now ready for use by ordinary persons; but for patients of the class we are considering it must be poured though a sieve to remove every particle of coarse fibre. It is not essential that any meat or bones be used in the preparation; but in that case the strained soup should be mixed with milk, one or two raw eggs, and put into a pan and stirred until it boils.

Sugar and sweets should be forbidden, on account of the fermentation and acidity which they cause. Therefore sweet puddings, cakes, jam, etc., are taboo. Acids are equally injurious; therefore sour fruit, pickles, and vinegar are forbidden. Salads are much too firm, and contain too much fibre to be digested by such a weak stomach.

These patients should take no fluid during the meal, except a cupful of soup or tea; they should not drink any more, lest they dilute the already weakened gastric juice; but they may drink freely two or three hours after the meal, when a cupful or two of hot tea, soup, or a glass of whisky and water would assist the final processes of gastric digestion.

But there are patients who will not improve with the most careful dieting; in spite of all care the hydrochloric acid becomes more deficient, and the stomach weaker, until it is unable to propel its contents into the intestines in a reasonable time. In such cases the patient should be put to bed and given a milk diet for two or three weeks. Milk is the least irritating of all foods, and causes the least expenditure of energy during digestion. The amount given must not be very large at first; indeed, the patient may not be able to take more than two to two and a half pints a day at the beginning of the treatment, and the dose should not be more than a tumblerful every two hours. But the amount must be gradually increased until five or six pints a day are taken; the dose may then be a tumblerful every hour, or one pint every three hours. It may be raw if it is fresh from the cows, or boiled if it has been stored for some time; and it may be pure or diluted with barley-water, or flavoured with salt, celery salt, or extract of meat. The chief drawbacks to the diet are pain, flatulence, and diarrhea or constipation. The pain is usually due to the formation of hard curds, which may be prevented by the judicious use of barley-water, or the addition of some extract of malt about ten minutes before it is consumed. Flatulence is due to fermentation, which may require the use of drugs. If ordinary milk is not tolerated after a few days' trial, we can resort to the sour-milk treatment, especially kefir or koumiss.

But ordinary milk or sour-milk diet is at the best only a temporary method of treatment. After two or three weeks some improvement of the diet must be begun. Thus: Breakfast, one pint of milk; lunch, one and a half pints of milk and two raw eggs; tea, one pint of milk; supper, one and a half pints of milk and two raw eggs. The duration of this diet must depend on the progress. Ultimately we must add soup, chicken panada, light fish, junket, jelly, custard, and thereby gradually build up a dietary similar to that given above.