[49] On the Treatment of the Dying. Medical Histories and Reflections. Vol. iii. p. 195. [50] Watson, p. 76. III. THE GENERAL AND MEDICAL TREATMENT OF THE DYING. Many of the sufferings of the death-bed are not naturally or necessarily incident to the act of the dying; but are due to surrounding circumstances that admit of alteration or removal. Thus, restlessness and jactitation are often due to the weight of the bed coverings, and are at once removed by lightening them;--difficulty of breathing and gasping, increased by the heat and closeness of the chamber, are removed by the admission of fresh and cooler air, by change of posture and by pillows carefully adapted to the efficient support of the trunk of the body. There is nothing of greater importance in the treatment of the dying than the right administration of nutriment. Errors in feeding are the cause of much of the disquietude and of many of the sufferings that attend the dying. The sinking and exhaustion that are in progress throughout the system, are assumed by the attendants to demand a free administration of food and stimulants, forgetting that the stomach shares in the exhaustion, and has lost its tone, and in great part, if not wholly, its power of digesting. Food is given too frequently, and in quantities too large. The dying person is induced by the wearisome importunity of his attendants to take food or stimulants, against which nature and his stomach revolt. The evident dislike and loathing with which he submits, the difficulty he has in swallowing it, and the urging and retching which that act sometimes induces, ought to save him from what is really under the circumstances an act of cruelty. “Here,” to use the words of Sir Henry Holland, “we are called upon to maintain the cause of the patient, for such it truly is, against the mistaken importunities which often surround him, and which it requires much firmness in the physician to put aside.”[51] The wishes of the patient himself, when he has reached the stage of existence here contemplated, may generally be taken as a correct indication in all that relates to the administration of food and stimulants. Food when unwisely given, accumulates in the stomach, distends and distresses it, and impedes the respiration. Under such circumstances the pit of the stomach will be found tumid and tense, dull upon percussion, and intolerant of pressure. At length some of the contents of the distended stomach regurgitate into the throat or mouth; or there may be actual vomiting, and this to the evident relief of the sufferer. Hiccup is often due solely to an overloaded and distended stomach.