vies and outside parts of roasted meat must be omitted or
limited in the diet.

GASTRIC ULCERATION

Gastric ulcer may develop without an apparent cause. As a rule,
however, it manifests itself in individuals between the years of
fifteen and forty, particularly after prolonged digestional
disturbances, especially those accompanied by a hypersecretion of
acid. As the disease progresses, anemia is more or loss severe, adding
difficulty to the feeding problem. Many of the symptoms are like those
of chronic gastritis, such as pain. However, the character of this
pain may be different, beginning soon after eating and radiating
toward the back. This point may be affected by position. As a rule
there is a tenderness over the seat of the ulcer. This is detected by
palpation. Vomiting is one of the most general symptoms in gastric
ulceration. This may begin from one to two hours after eating when the
pain is at its height, or it may start as soon as food enters the
stomach. As a rule the latter condition is found more often in very
nervous women whose mental attitude affects the stomach to such an
extent as to make it difficult to give them sufficient food to nourish
them.

~Hemorrhage.~--Hemorrhage occurs in about half of the cases. The
bleeding may be profuse and the blood bright red, or it may be less
severe and the color of the blood changed by contact with the gastric
juices to a dark brown like coffee grounds.

~Excess Acid.~--Hyperacidity is present in the majority of the cases,
the percentage of HCl rising at times fifty per cent. or more. Other
cases occur in which all of the just mentioned symptoms except
dyspepsia are missing, the first intimation of the ulcer being
hemorrhage or perforation.

The patient with gastric ulcer may recover entirely and never have a
return of the trouble, but care and close attention are necessary,
since the ulcers are apt to recur, at times a series of ulcers
developing one after another. Death may occur from exhaustion or from
perforation and peritonitis. Surgical intervention is as a rule
necessary when the ulcers persist, as they generally develop at or
near the pyloric opening; and the constant development of cicatricial
tissue brings about an obstruction of the pylorus, which if not
relieved would allow the patient to starve.

~Diet Treatment.~--There are a number of treatments used in overcoming
this condition. After the test meal and the diagnosis, the patient is
placed u