Although surgeons are coming to recognize the fact that individuals who have either by accident or by direct intention swallowed an acid or an alkali, and others with a probable or definite diagnosis of a malignant condition, are markedly benefited by gastrostomy, careful research has failed to reveal in any of the modern textbooks a diet that would be suitable for these cases. Water starvation is also a very strong indication for gastrostomy, as are spasmodic stenosis and esophageal paralysis.
It should be the earnest endeavor of all surgeons to have these patients in as good a constitutional state as is consistent with their physical make-up. This can be augmented by liquids subcutaneously, by rectum or intravenously, the most commonly used being physiologic solution of sodium chloride, dextrose or dextrose-sodium bicarbonate combinations.
I have had under my care and direct supervision a number of such patients. I have found that