Both the appetite and the powers of digestion vary so much in different cases that it is usually best to favour, as far as possible, the patient's natural inclinations, and to abstain from hard and fast rules concerning the diet.
The existence of severe pain after meals is frequently the sign of ulceration of the growth, and should be treated upon the same lines as in simple chronic ulcer. If raw milk agrees, from five to eight ounces may be given every two hours, but when it gives rise to nausea or discomfort it should be peptonised, sterilised, or mixed with an equal quantity of limewater. Clear soups, the Leube-Bosenthal beef solution, or the various meat essences, jellies, or extracts may be tried, and the diet may be varied with eggs beaten up with milk, poached eggs, soft bread and butter, bread and milk, or milk puddings. In less severe cases scraped raw meat, boiled chicken, and fish that has been passed through a sieve, sweetbreads, and calf's feet or brains may be allowed. Green vegetables are to be avoided, and in most cases raw and stewed fruits occasion pain or acidity.
Stenosis of the pylorus accompanied by excessive vomiting must be treated with a dry form of diet, as free as possible from farinaceous substances. Only the strongest and most concentrated forms of meat essences or solutions should be allowed, and lightly cooked and finely minced meats, fish, and eggs should constitute the staple food. Tea and coffee rarely agree, but cocoa made from the nibs is often useful. Wines and malt liquors are apt to produce acidity and vomiting, but a small quantity of good brandy or whisky with the meals often aids digestion and prevents the fulness and distension of which complaint is so frequently made. When thirst is a prominent symptom the patient should be directed to sip hot water, or an enema of hot water may be administered from time to time. In all cases nutrition should be aided by the administration of a large enema of peptonised milk each night.
At a late period of the complaint it is usually necessary to peptonise the greater part of the food, and to administer it in small quantities at short intervals.