5. Mr. C., aged sixty-six years; hyperacid dyspepsia.

Has been a sufferer for many years from gastric disturbances. Has traveled much since his twentieth year. Irregularity in eating. Formerly smoked very much. For three years has complained of gastric pain, particularly during the night, improved somewhat after eating. Emaciation. Acid belching, and within the last few weeks frequent vomiting.

Examination revealed that the stomach got rid of its contents within a normal time. Hyperacidity; no dilatation of the stomach (June 17, 1895).

The treatment consisted in the administration of 300 c. c. of Rakoczy; the frequent administration of large quantities of food ; carbonated mud baths.

The analyses of the stomach contents after a test breakfast showed:

June 17,

1895.

Total acidity,

0.34

per cent.

Strong hydrochloric acid reactions; no lactic acid.

" 24,

"

" "

0.28

"

" 29,

"

" "

0.24

"

July 4.

"

" "

0.22

"

" 14,

"

" "

0.20

"

The patient writes that he is free from all distress.

6. Mr. J. M., aged forty-nine years; hyperacid dyspepsia.

Has been suffering from a "weak stomach" since his youth. Frequently constipated. Belching, heartburn, especially if patient works hard. For two months has been complaining of frequent pain in the stomach, and has lost weight during this period. A very nervous, mentally overworked man.

July 23. Aspiration of the stomach contents after a test breakfast. Total acidity, 0.34 per cent. ; strong hydrochloric acid reaction.

Treatment: Regulation of the diet; large quantities of butter, 100 to 120 grams pro die. Homburg Elizabeth water, 300 c. c.

August 8. Total acidity, 0.20 per cent. ; subjective symptoms considerably improved; continuation of the cure at home.

August 27. The symptoms have disappeared.

7. Miss Veronica Kr., aged twenty-four years; chronic nephritis with hyperacidity of the stomach.

Patient comes under observation suffering from uraemic convulsions. Urine contains much albumin; the general health improves in the course of a few days. The patient, however, continues to complain of pain in the stomach. Patient is awakened frequently during the night by gastric pain. The stomach is not enlarged. Analysis of the gastric contents after an Ewald test breakfast shows the following :

On December 12. Total acidity, 0.03 per cent. Strong hydrochloric acid reaction.

On December 13. Total acidity, 0.25 per cent. Strong hydrochloric acid reaction.

The patient is ordered to take 600 c. c. of Rakoczy every day on an empty stomach.

December 26. Total acidity, 0.35 per cent. Of this free hydrochloric acid, according to Mintz, 0.21 per cent.

January 4, 1896. Total acidity, 0.35 per cent. Of this free hydrochloric acid, according to Mintz, 0.21 per cent.; 400 c. c. of Rakoczy water are taken for three days more, and then the administration of the water is stopped.

January 10, 1896. Total acidity, 0.22 per cent. Of this free hydrochloric acid, according to Mintz, 0.11 per cent.

January 14, 1896. Total acidity, 0.20 per cent. Of this free hydrochloric acid, according to Mintz, 0.08 per cent.

The gastric disturbances improved from the 4th of January, and disappeared completely after the 10th of

January. It is probable that this patient was suffering from a gastric ulcer.

In this case large quantities of Rakoczy water (600 to 800 c. c.) exercised no distinct influence on the excessive hydrochloric acid secretion in the beginning. As soon as the daily quantities of the mineral water were reduced, the excessive hydrochloric acid production was also reduced and remained approximately normal.