pon a diet directed to overcome the chief symptom; for
example, if the ulcer developed as a result of hyperacidity, the diet
would be directed toward the relieving of that symptom. Boas[93]
divides the treatment into three stages: (1) hemorrhage; (2) the
intermediate stage; (3) the convalescent stage.

~Starvation Treatment.~--The majority of physicians institute a total
abstinence period for the first stage, allowing no food or water to be
taken by mouth. If the patient is very weak and anemic from the
extended course of the disease, nutrient enemas are given from four to
six times a day, alternating with saline enemas. This total abstinence
continues from three to six days. Some cases have been known to be fed
in this way for a month or six weeks with obvious success. However,
this is not the rule but the exception. The diet must be adjusted to
the needs of each individual, but a few general rules may be found
helpful.

~Dietetic Treatment.~--Milk is the food generally utilized in the
beginning. This may require peptonizing to be digested, or it may
have to be modified with limewater. Protein foods require HCl for
their digestion. If these foods are fed they will absorb some of the
excess acid, and in this way save the already irritated wall of the
organ from additional irritation. When protein foods are given they
must be in the form of soft-cooked eggs, scraped raw beef or beef
juice, milk soups, and like protein foods.

When there is a dilatation of the organ there is more or less danger
of fermentation taking place, with the formation of organic acids.
These acids are exceedingly irritating, and every care must be
observed to prevent their production. The following dietetic regime
may be used as a guide in many cases of gastric ulceration:

~Milk Diet.~--1/2 glass (4 ounces) of milk peptonized at 115 deg. F. for
20 minutes, every hour for three or four days. After this the interval
between feedings is lengthened to two hours and the amount of milk
increased to 3/4 of a glass (6 ounces). This is continued from a week
to ten days. The patient may be given a cup of well-strained meat
broth, reenforced with an egg, once or twice a day, to vary the
monotony of the diet. During the third week the milk may be given in
the form of milk soups. These may be slightly thickened with barley,
rice, or farina flour. The soups may be flavored with beef extract,
but only a small quantity must be used, owing to the stimulating