In inoperable cases of cancer of the stomach the treatment is purely palliative. There is usually associated some degree of gastric catarrh, or dilatation of the stomach, which increases the difficulties in the dietetic treatment. In cases accompanied with haemorrhage, the dietetic treatment must be conducted along the lines laid down for gastric ulcer. In other cases, we aim at giving the most nourishing diet that is tolerated by the patient's enfeebled digestive capacity. The diet must be simple and nutritious, and should be given in small quantities at short intervals. Milk, chicken tea, meat broths, may be largely used; tea, coffee, and buttermilk are useful as accessory articles of diet. The more easily digested forms of meat foods, such as sweetbread, tripe, chicken, and the lighter forms of fish, are all suitable in the earlier stages. Of the vegetables, spinach, flower of cauliflower, and Portuguese onions are the most to be commended. Among bread foods, preference should be given to toast, rusks, and stale dry bread; and puddings made from the invalid foods, and custards and jellies (p. 185), are the most suitable. The pulp of good grapes and various fruit juices are a pleasant change. Any liking which the patient expresses for an article of food should be acceded to, unless there are the strongest reasons for withholding it. It is often surprising what these patients are able to take without any apparent gastric or other disturbance. In the later stages the diet has to be chiefly fluid, consisting of milk, beef-tea, and the like, which may be fortified by the addition of white of egg, Plasmon, Protene, or other concentrated foodstuff. A little whisky or brandy is of great value as an aid to digestion in these cases.

Diet In Gastroptosis And Enteroptosis

The treatment of the downward displacement of the stomach and bowels characteristic of gastroptosis and enteroptosis is mainly mechanical, consisting of bandages, massage, and in some cases surgical procedure. These conditions are frequently accompanied by a degree of dilatation of the stomach and intestines, and by a condition of general neurasthenia, and when these are present the treatment must be mainly directed to them (q.v.). The symptoms produced by the displacement of these hollow viscera are mainly those of indigestion, notably a sense of weight, fullness and oppression, eructations, with nausea and vomiting. The principles of dietetic treatment are similar to those in dilatation of the stomach. Rest in bed, with general tonic treatment and massage, are important factors in the preliminary treatment. Thorough mastication and slow eating should be insisted upon. The meals should be of moderate bulk, taken at regular intervals, and nothing should be taken between meals. The diet should be largely a dry one, little fluid being taken with the meals. Light and easily digested foodstuffs only should be taken, special care being taken with regard to the amount and nature of the carbohydrate foods. Buttermilk may be recommended as an accessory article of diet, for its favourable influence on fermentative processes in the bowel. Measures must be taken to correct the constipation usually present, e.g., massage and the use of suitable aperients (see also Dilatation of Stomach, and Neurasthenia).

The Dietetic After-Treatment Of Operations

Diet is one of the most important points in the after-treatment of abdominal and other major operations. For the first twenty-four hours little or nothing should be given except small quantities of hot water, to which a little bicarbonate of soda may be added, and a rectal injection of saline, 10 to 15 ounces. These allay thirst and relieve sickness. On the second day, and until the bowels have been freely opened, usually on the third day, liquid food only should be given, and it should be of a nature little likely to cause flatulence. Milk, diluted, is ordinarily given, but it frequently disagrees.

One of the safest and most reliable diets is albumin water (p. 47). Two pints of albumin water in twenty-four hours represents a fair amount of nutritive material, and are easily digested and non-irritating. Prepared Plasmon (p. 159) is another very useful preparation, and may be given in 2-ounce feeds every three hours. Grape sugar is strongly recommended by Gilford in the form of raisin tea, prepared as follows: - Take 1/4 lb. of raisins, chop them up finely, cover well with boiling water, stew for about two hours, and filter off the fluid. This tea may be mixed with water, and taken either hot or cold; it may also be combined with albumin water or prepared Plasmon, making a nutritive, easily digested, and non-fermentative food. After the bowels have been freely opened, the diet may include an invalid food (p. 183), gruel, bread and butter, a clear soup, e.g., chicken, beef-tea, or consomme, and cup of tea. The diet can then be increased along the lines suggested in the section on Convalescence, p. 294.