It is obvious that in this distressing and painful malady diet is of the greatest importance, the necessity and aim being to maintain the strength of the patient by such food as can be digested without provoking movements of the stomach, and without causing the dreaded pain and vomiting. The object must be to give the stomach as much rest as possible, so that cicatrisation of the ulcer can go on uninterruptedly. Food must therefore be given in very small quantities at a time, and at short intervals. In cases where there has been severe haemorrhage, and where it is likely to recur, the stomach must be kept absolutely at rest, and the patient fed by nutrient enemata for a few days at least.

An exclusive milk diet is the diet indicated, and this is, as a rule, well borne in ulcer of the stomach. The casein of milk is, however, thrown down as curds on coming in contact with the gastric juice of the stomach, and these curds are often difficult of digestion, especially the curds of cow's milk, which are large and flocculent. To prevent their formation the milk should be mixed with an equal quantity of lime water or an alkaline water. Dr. Burney Yeo recommends that to every four ounces of milk be added ten grains of bicarbonate of sodium, five grains of light magnesia, and ten grains of common salt dissolved in a tablespoonful or two of water. This may be taken every two or three hours. The yolk of an egg beaten up with two tablespoonfuls of hot water may, if required, be added to the cup of milk, and given twice a day, or an ounce of the crumb of a stale roll, well soaked previously in hot water, may be mixed with the milk two or three times a day (Yeo). Buttermilk is sometimes recommended, as curdling of the milk in the stomach is thus avoided, but the sour taste of the buttermilk is disliked greatly by some patients. Malt extract is recommended by some physicians, and a pur'ee of potatoes in cases where a vegetable food is well borne.

In Some Cases A Milk Diet Cannot Be Endured

There may be a distinct intolerance of milk - and recourse must be had to bouillons and purees of meat. The meat or chicken must be reduced to a fine pulp and mixed with a little broth or beef-tea. Leube's soluble meat (see page 120) is much used in Germany in these cases; it is so prepared that it is ready for immediate absorption without the action of the gastric juice, and hence it must be a valuable preparation for ulcer of the stomach, where it is necessary to obtain healing by rest.

Hot Tea And Coffee, Gruel, Porridge, And Alcoholic Drinks Are Strictly Forbidden

If the symptoms of pain and vomiting have disappeared, after two or three weeks of this restricted diet, there may be a gradual return to more solid food, but the greatest caution must be exercised not to take more food than is absolutely required for the support of the body.