tea and beer should be avoided. The offending article of food, if known, should of course be relinquished. Spirituous liquors should be avoided. Flatulence may often be only the symptom of dyspepsia, It may be relieved temporarily by a slight stimulant, such as aromatic spirits of ammonia, or by 15 drops of sal-volatile in water every hour or two. The following may be used with benefit: 3 drachms of bicarbonate of potash, or the same of bicarbonate of soda, 1 oz. of the concentrated infusion of calumba, and sufficient peppermint water added to make 8 ozs. A tablespoonful of this mixture to be taken 3 times a day in water. From 1 to 2 drachms of tincture of mix vomica, with 1 oz. of the concentrated infusion of calumba, and water as before added to make 8 ozs., is another useful combination. This mixture should be taken in tablespoonful doses as the other. From 2 to 5 drops of pure terebene, taken on a lump of sugar, and repeated 2 or 3 times a day, is also a most useful remedy. The best beverages for flatulent subjects are weak cocoa essences, and hot water with a little lemon juice.
Gastric Ulcer.—This is a disease most frequently met with in young servants, and is nearly always preceded by anaemia.
Symptoms.—Pain, vomiting of coffee-ground matter, the colour being due to the presence of blood.
Treatment—has to be long and careful, as if the ulceration continues it may end in perforation of the walls of the stomach. Peritonitis will result from perforation, and will probably prove fatal, unless an immediate and dangerous operation should prove successful.
When there is bleeding ice should be sucked; this is also most useful in checking vomiting. Opium in one or other of its forms (laudanum, morphia) will relieve the pain. Small doses of morphia with bismuth may be given thus: 5 or 10 minims of the solution of the muriate of morphia with 10 or 15 grains of sub-nitrate of bismuth 2 or 3 times a day. Milk is the best food. If the patient is very sick and pained, it may be necessary at first to withhold food from being given by the mouth, in which case it ought to be administered in the form of enemata, but only under definite medical direction. (The writer has found a teaspoonful of Carlsbad salts given in water 3 times a day useful in this disease.)
Gout is a complaint depending upon the presence in the system of an excess of uric acid. It may be acute (or regular) gout, showing itself in the joints and more especially in the large joint of the great toe; or irregular gout, having other and manifold manifestations. The disease is either hereditary, in which case it often misses a generation, or acquired. Excessive eating, undue indulgence in alcohol, and indolent habits will tend to produce it. Meat, especially beef, the more potent wines and malt liquors are the articles of diet most prone to originate gout.
Symptoms.—Inflammation and pain in the great toe or other joints,
