The principle of rest here occupies the first place. In acute gastric catarrh one gives, during the first two or three days, in which, usually, there is a total loss of appetite, only very little nourishment in liquid form, containing principally amylacea, barley or oatmeal soup, bouillon, weak tea, water. As a rule, one must not force a patient to take food during the first or even during the second day of sickness. The anorexia in these conditions is a wise arrangement made by nature in order to give the stomach rest. If there is thirst, beverages may be taken in small quantities, and must be neither very cold nor very warm. As soon as the appetite reappears one may give some toasted bread or zwieback, milk, soft-boiled eggs, or oysters, permitting, after a while, small quantities of bread and meat, and then passing slowly to the ordinary diet.

Ulcer Of The Stomach

During the rest cure of von Ziemssen-Leube give liquid diet, consisting principally of milk, for two or three weeks. As is well known, Cruveilhier1 first recommended milk for this purpose, and even now there are some physicians who limit themselves to milk alone. As a rule, however, it is appropriate to allow, besides milk, milk in combination with barley, oatmeal, or rice-water. In addition to this, the different peptone preparations are here in place. I administer Rudisch's sarcopeptone, manufactured in this country, on account of its being palatable and highly nourishing. (The Rudisch's sarcopeptone contains forty per cent of nitrogenous substances, including twenty per cent of peptones.)

1 "Anatomic Pathol.," 1829-35.

One may give most appropriately every three hours one to two cupfuls of milk with or without the addition of the above-named decoctions (four times daily) and sarcopeptone (twice daily). The patient must not drink these fluids, but eat them with a spoon. In case of hemorrhage from the stomach, during the first three or four days it is not permitted to give any food whatever by the mouth; instead, the patient must be fed by the rectum. Ewald has proven that the large intestine has the ability of digesting and absorbing albuminates even with out special previous preparation; therefore the following may be given as a nutritive enema:

1. Three to five eggs are mixed with 150 c.c. of sugar-water (30 gm. of grape-sugar dissolved in 150 c.c. of water), a small quantity of common table-salt is added, and the whole mixture well beaten; one may add also a small quantity of starch solution or mucilage.

2. One-half pint of milk + 2 eggs + 50 gm. of grape-sugar.

3. One-half tablespoonful of Budisch's sarcopeptone or plasmon dissolved in a cupful of water.

The food enemata have to be given three or four times daily. It is necessary that the fluid should be at the temperature of the blood, and that it should be injected by means of a fountain syringe and a soft-rubber rectal tube. Every morning a cleansing enema of one quart of saline should be given, in order thoroughly to cleanse the large intestine and make it more fit for absorption. In case of thirst the patient is allowed to take small pieces of ice into the mouth from time to time. Three days after the disappearance of blood one slowly and cautiously begins the liquid diet.