nd the meals reduced in number from six to four.

~Relapse.~--The patient must be warned against overeating or eating
any of the articles which are known to cause an acute attack in his
individual case, since one attack predisposes to another, and chronic
gastritis may develop as the result of the continual gastric
disturbance.

CHRONIC GASTRITIS

The treatment in chronic gastritis is very like that in the more acute
form; that is, it must be combated by removing the cause. Lack of
fresh air and exercise have much to do with the development of chronic
gastritis, but even they combined with a judicious amount of rest
would be wasted without a proper adjustment of the diet to cover the
main points of the disturbance. As has already been mentioned, the
cause may be a lack of gastric juice or it may be an excess of it; it
may be intensified by an ~atonic~ condition of the organ or from the
food passing too quickly into the duodenum.

~Test Meals.~--As a rule it is not safe to make a snap diagnosis as to
the cause of this disorder. Since in many instances the more serious
disorders may be traced to a disregard for nature's danger signals,
the physician as a rule advises a test meal, this meal consisting of a
glass and a half of water or a cup or two of tea without cream or
sugar and from one to two slices of toast or water rolls. In from
three-fourths to one hour or longer this is removed from the stomach
by means of a stomach pump and analyzed, the result of the chemical
and bacterial analyses forming the basis for diagnosis. This meal is
generally given in the morning before any other food has been
eaten.[92]

~Dietetic Treatment.~--The foods constituting the diet in chronic
gastritis must be of the simplest character and prepared in the
simplest manner. No fried foods are permissible. Pastries, griddle
cakes, rich puddings and sauces, candies, and alcoholic beverages must
be omitted from the diet as well as the following articles of food:
pork, veal, shellfish except oysters, sardines, canned meats and
canned fish, highly seasoned and spiced dishes, twice-cooked meats,
vinegar, pickles, olives, cold slaw, pickled beets, catsup, mustard,
coarse fibered vegetables such as cabbage, old onions, old turnips,
and cucumbers, strong tea, coffee, or chocolate, rich cream or dishes
made entirely of cream. In cases of excessive acidity due to a
hypersecretion of HCl the extractives of meat are contraindicated,
hence all gra