It is just as easy to give too little food to dyspeptics as too much. When a stomach has once become whimsical, its whims will have to be disregarded in the process of breaking it into more wholesome habits. Of course, this will mean a certain amount of suffering at first, but the good results of it will soon be apparent.
When there is ulceration of the stomach present, it will be necessary to give only liquid food, and of all liquid foods in these states, Koumiss is the best.
In acute attacks of indigestion the best of all remedies is to go without any food at all until the stomach has had time too recover itself.
In the chronic cases where the vitality is low, and the general tone of health not robust, great care will be required in bringing the patient back to ordinary diet. Cold foods must be particularly avoided. Bread only sparingly used. Bread is not nearly so digestible an article as most people imagine, and dyspeptics should never eat bread and butter or hot buttered toast. Dry toast is all they should indulge in. When toast is not tolerated, rusks or biscuits may take its place. Plain water- biscuits are the best; such as Huntley & Palmer’s “Breakfast biscuits,” and “Captain’s biscuits”; Cracknells; and for breakfast there is one cold article of diet dyspeptics may take, and that is the fat of very good cold boiled bacon. They may have this with toast.
Tea is bad for the digestion, and for most people the habit of drinking tea in the afternoon is an exceedingly objectionable one. It breaks up the proper interval between lunch and dinner, and gives the tea its best possible chance of working its evil effects on the stomach. Coffee is not so injurious to the digestion as tea. It rather assists the digestion of fats which tea hinders.
Though coffee has more tendency to cause headache, and with some persons flatulence and constipation, with others it assists the action of the bowels. Tea should never be taken without milk or cream, and it should never be strong, or taken after it has been made more than a few minutes.
The teas of China are less injurious than those of India and Ceylon. Green teas are especially poisonous, and should never be taken under any circumstances.
Cocoa possesses more of the nutrient and sustaining properties and is less of a pure stimulant than either tea or coffee. Some object to it on that account, as they say they want a drink rather than a food. This difficulty may be avoided by using an infusion of the nibs; or the shells, or husks which contain the nibs, may be used for making the beverage.
When meat cannot be taken, beef-tea must be substituted. Mutton is more digestible than beef, because in beef the fat is more intermixed with the fibre of the meat, and the fat is more difficult to digest, and the fibre is harder.
In cases where there is manifest ulceration of the stomach, Koumiss is the best food. It may be given alone every hour or every two hours, until the pain and vomiting have ceased and other food can be taken. Or one of the forms of soured milk such as Hindley’s “Bulgolac” (119, Coniston Road, Bromley, Kent) may be substituted. This is an excellent preparation, and is valuable in many forms of dyspepsia.
When dyspepsia is constitutional, the particular constitution must be studied.
Gouty patients should avoid all rich or highly spiced foods, and eat little butter and milk except with tea or coffee. These should be taken not strong, and the tea only when freshly made. Meat should be taken once a day, never cold, and never cooked a second time. The less flatulent kinds of vegetables are good, as French beans, spinach, young peas, also stewed celery. Potatoes should be avoided, and cabbage. Malt liquors, wines and spirits should be avoided. Water is the best drink at meals; Salutaris water or toast-water may be substituted, or Caley’s Aerated Distilled water, or “Poland water.” Hard water should be carefully avoided. Gouty patients should drink freely of liquids. A tumbler of water taken half an hour before meals and at bedtime will supply all that is needed. Vittel and Contrexeville waters are useful as eliminators.
Those who have a tendency to rheumatism should observe most of the rules indicated for the gouty. Excess of meat and milk are not good. Oatmeal porridge should be taken at breakfast; at lunch or dinner, soup, meat from the joint, with vegetables, plain rice or other farinaceous pudding without eggs, and no fruit. Toast-water should be the drink with meals. Freshwater fish, and watery fruits and vegetables, must be avoided.
For the psoric no special rules can be laid down. They must be dieted according to their symptoms. The chilly “sycotic” patients must avoid all cold foods and watery foods, as the rheumatic. They may drink hot water, but never cold water. It will often be found beneficial to the circulation to sponge them every morning all over with spirit of wine before dressing. Fruit, milk, melons, mushrooms, hard-boiled eggs must be avoided.
Oysters can sometimes be taken when nothing else can and they contain a considerable amount of nourishment. They may be taken raw or cooked as desired.
Pepsine and all the artificial digestives I do not like, except for short periods. The stomach is ready enough to accommodate itself to inaction; and when it finds the food put into it already peptonised, it will not trouble itself to secrete any pepsine itself. Hence it falls into bad habits, and finally the artificial pepsine ceases to suit the patient, whose stomach is then really weaker than before the pepsine was given.
An exception must be made in favour of a preparation I have found very useful, namely, Bullock’s Acid Glycerine of Pepsine, a teaspoonful being mixed in half a tumbler of hot water, and drunk at meals as a beverage. This is very pleasant to take, as well as efficient. It must not, however, be used continuously. A still more convenient preparation is Reed & Carnrick’s “Peptenzyme” in tablets, one or two of which may be taken after meals.
Vitalia and Vinsip contain nourishment in the most concentrated form. It is valuable as a restorative and stimulant as well as a nutrient.
Bovinine is another preparation of beef of great value. It is in a form to be absorbed almost immediately without digestive effort.
Brand’s beef jelly is the next best thing to good home-made beef-tea.
Liebig’s beef-tea, “Lemco,” is more of a stimulant than a nutrient. But if taken with biscuit it is nourishing.
Among Milk preparations Horlick’s Malted Milk is one of the most valuable. It is in dry powdered form, and can be mixed with either hot or cold water, requiring no cooking.
The various invalid foods are almost all good. Neave’s, Ridge’s, Sanvia, Allenbury’s and Savory & Moore’s foods have obtained well deserved reputations.
This is the most convenient place in which to mention the treatment of states of intestinal digestion by lactic bacilli, usually known as the sour-milk treatment of Metchnikoff. The object of the treatment is to introduce into the intestinal canal cultures of the bacillus which multiply there and take the place of less desirable organisms. The methods adopted are the use of milk or cheese soured with the bacilli or the taking of tablets, such as those of Metchnikoff himself, “Lactobacillin,” or Lacteol. These may be taken plain, after meals, or crushed and mixed (they do not dissolve) in a little sweetened milk.
I have already (p. 117) referred to milk preparations soured with the lactic ferments.
The use of these preparations is often of service as an adjunct to homoeopathic treatment in a large number of cases of indigestion, and especially in those associated with neurasthenia. It is safe for any one to try these preparations, but they do not suit everyone and sometimes cause a little inconvenience, in which case they should not be persevered with.
In dieting dyspeptics the most important thing is the times of eating; next in importance is the quantity they take, most dyspeptics taking either too much or too little; and last, and perhaps less important than either of these two, is the regulation of the quality.