Chronic gastric catarrh may be primary, when it results from long-continued excesses in eating and drinking, aggravated usually by hurried and irregular meals, and by septic state of the teeth; it may be secondary, as in advanced heart disease, chronic renal disease, cirrhosis of the liver, and hypcrchlorhydia. In the latter group the treatment has to be more particularly directed to the primary disease.

Complete rest in bed for some days is advisable, and a diet of the blandest form is indicated. This should be an exclusive milk diet; about 2 pints of milk, diluted one-third with barley-water, may form the sole food for the first forty-eight hours. In view of the enfeebled state of the gastric secretions, often associated with vomiting, it is sometimes advisable to give the milk peptonised. In cases where the plain milk is for any reason impossible, koumiss, Kephir, or whey may be substituted. Buttermilk is a useful addition to this diet, and should be given in 10-ounce doses twice daily. The diet should be kept fluid until the patient is able to take about 2 pints of milk, or its equivalent, without discomfort. The diet is then added to very cautiously. The digestion is enfeebled, so that the addition of carbohydrates is very apt to cause flatulence. They are best given in the form of a predigested foodstuff, e.g., Benger's or Allenbury. Only easily digested proteins should be given, e.g., white of egg, meat juice, Plasmon, and Somatose. These may be arranged in the following way: -

8.30 A.M. - Milk, 8 ounces, with Plasmon. 11 a.m. - Milk bovril (p. 36), or Allenbury. 1.30 P.M. - Veal jelly and dry toast; or Curds and cream.

4 p.m. - Milk, 8 ounces, with Plasmon.

7 p.m. - Benger's food.

9 P.M. Milk, with white of egg.

Later, more egg, fish, chicken, underdone meat, butter and toast, and peptonized cocoa may be added. The diet must be kept exceedingly simple, and it is necessary to forbid sugar, spiced condiments, alcohol. Tea and coffee can only be permitted if used as flavouring agents.

8 A.M. - Peptonised cocoa and milk.

Toast and butter, or stale crisp roll.

11 a.m. - Cup of clear consomme or a meat tea, and 1/2 ounce of prepared Plasmon (p. 159). 1.30 p.m. - Small cup of chicken or fish soup.

Fish, chicken, tripe, sweetbread, with one well-cooked vegetable.

Stewed apples.

4 P.M. - Cup of milk tea.

Dry sponge cake or biscuit.

7 P.M. - Steamed fish, or scrambled egg, or chicken souffle. Toast and butter. Small cup of hot milk. 9.30 p.m. - Consomme or beef-tea.

The diet should be maintained for some weeks along the lines laid down. Thereafter a gradual return to ordinary diet may be effected. Alcohol in all its forms must be avoided, and the patient must realise the necessity of keeping to a simple ordinary diet, avoiding rich dishes, condiments, excess of tea or coffee, and other stimulating foods.