These diseases are closely related and usually represent the first, second and third stages, although it is claimed that hypersecretion may commence suddenly. Causes of Excessive Secretion.

Excessive use of alcohol, mustard, pepper and other condiments. The use of ices. Too rapid eating for a number of years. Indigestible food, grief, worry and pressure on the stomach. The disease may commence suddenly or gradually.

Symptoms

The principal symptoms in excessive secretion is pain. It may begin with mere uneasiness, one or two hours after meals, or with sharp, stinging pain. The excessive amount of acid irritates the stomach, and as soon as digestion in the stomach is completed (usually from two to three hours) the pain begins. In severe cases there may be an attack after every meal, the one after breakfast will be the lightest, and the one after dinner the most severe. Often a little hot acid liquid will be belched. The pain is often sharp and severe, and is usually called cramps. It may be relieved by taking a drink of water, which dilutes the irritating acid, or by eating a soft egg.

Appetite is usually good and the tongue clean. There is no flatulence; no feeling of fullness. If meat or eggs be given every three hours, and it is well tolerated, it is suggestive of excessive secretion, because meats are slowly digested, when the secretion is deficient. If nothing but starch be taken when there is excessive secretion, it may remain in the stomach a day or two. The symptoms of excessive secretion are different from other diseases in this: In nervous dyspepsia, there is no time relation to meals. In gastritis there is more nausea and flatulence, a furred tongue, and the pain less sharp, and not relieved by food.

This is, ordinarily, only an advanced state of excessive secretion, although some specialists say that it may begin suddenly, but, in such cases, it is more than probable that it is a sudden manifestation of what has long existed. The symptoms are similar to excessive secretion, only more pronounced. Hunger is more acute. Patient may wake up in the night with an "all gone" sensation, and if nothing be eaten, there will be severe pair. Thirst is constant, especially at night. The attacks are generally worse in the middle of the night, and last two or three hours, and terminate by vomiting, which relieves the pain. Another characteristic symptom is diarrhoea in the night, due to the excessive acid condition of the food discharged into the intestines, and to the large quantities of fluid drank. This may be followed by constipation. Notwithstanding the voracious appetite, and large amount of food eaten, the patient usually gets thinner. The tongue is seldom furred, and likely to be very red. Probably the easiest way to distinguish hypersecretion from other diseases, is by the matter vomited. If the vomit shows that the lean meat is practically all dissolved, and the bread-stuff unchanged, it points strongly to hypersecretion.

Where the excessive secretion has long been continued, the stomach is almost certain to be dilated.

Diet

A meat diet is usually prescribed in excessive secretion, on the theory that meats are easily digested in an acid stomach, and starches difficult. This is true. And it is also true that meat furnishes the system more hydrochloric acid than any other food. Now, in excessive secretion, the objeet is to reduce it, and what more rational method can be proposed than to withhold foods that make most hydrochloric acid? Diet in this disease must be as bland as possible, and as milk is well tolerated, if diluted as heretofore described, it is the best of all foods. Of meats, fresh fish is the easiest digested, and of most service in excessive secretion.

In catarrh of the stomach it is necessary to have the food finely divided, so that it can be dissolved. In excessive secretion, it is necessary to have it as fine as can be powdered, so that it will not irritate the stomach, and excite the secretion of more acid.

The chief difficulty is in the digestion of starches, and it is not easy to prevent loss of weight without them. Continued loss of weight, means loss of strength, and great care must be taken to maintain it. Bromose (malted nuts), cream, nut oils, and the fat of boiled ham, will be useful in furnishing fuel for the body. If the stomach can be washed out once a day, considerable dry toast may be eaten soon after, if taken without any liquid, and thoroughly mixed with saliva. Malt will also be serviceable, and malted gluten should be used in preference to meat or meat powder. Sour fruits are not suitable, but such fruits as bananas, sweet grapes and pears can be eaten, unless there be dilatation of the stomach. In such cases foods that ferment quickly must be avoided. The cereals must be extra well cooked, and then roasted brown and powdered, and then eaten dry. If the stomach is not washed, a half pint or pint of cold water or moderately cold alkaline mineral water may be drank a half hour before meals and before retiring at night.

Mucilaginous drinks, made by steeping "slippery elm" (ulmus fulva) in cold water, may be drank before or after meals.

If there is no dilatation of the stomach, the patient should eat as often as every four hours. The bowels should be kept active by massage. All irritating substances such as pepper, mustard, raw vegetables, vinegar, sage and cheese, must be shunned as enemies. A few grains of salt may be used in the food, but the less the better. Very hot drinks are absolutely prohibited, especially where there is a possibility of ulcer.