HEALTH NOTES.

New Zealand Mail, Issue 1717, 25 January 1905, Page 17

HEALTH NOTES.

ULCIBRATIOX OF THE STOMACH. (By Dr. Andrew Wilson, F.R.S.E.) More than one reader of this column has asked for information regarding the disease known as ulceration of the stomach. As it is a serious complaint, and as certain o-f its effects may be attended with danger to life, it may be well to respond to the inquiries m question by giving some account oi this trouble if only by way of enabling the patient the more perfectly to second the efforts of the doctor in treating it. By the word "uloeiation” we indicate one of the results of inflammation itself. Inflammation may end eitffei by a natural p. ooess oi’ cure, or it may pass onwards towards the development of matter oi “pus” keen in the case of an abscess, whilst later on, ulceration may take place as a further stage in the process. This ulceration consists in the leaving in the inflamed part of a raw and unhealed surface. Having regard, therefore, to the nature of ulceration, we may readily understand how, in the case of an organ like the stomach, the inner coating of which is affected, its duties must be seriously interfered with. 'When food enters the stomach that organ begins to contract or move upon itself bo as to circulate the food within it, and to procure the thorough mixing of the food wuh the gastric juice. In order that the stomach may perfectly discharge this duty, it is necessary firstthat it should be in a healthy condition. When the lining membrane of the stomach is, therefore, inflamed or ulcerated, we expect that a very considerable amount of pain will result from the natural operation of digestion. If this ailment is not attended to digestion of food will be imperfectly accomplished, if, indeed, it can bo carried out at all. Hence the seriousness of this disorder entitles it to the full consideration of those who may be unfortunate enough to be afflicted therewith. THE CHRONIC FORM. In the first instance we may note that what is often termned ulceration of the stomach of a chronic or lasting character, practically may be regarded as a case of indigestion due to the fact that the structure of the stomach lias been affected by the process of inflammation. Tiio causes of tins affection are very varied. Most commonly there is a history of ill-health, and very frequently of under-nourishment of the patient"? It is frequently found in women who partake unduly of tea, and who otherwise do not receive a sufficiency of wholesome food. In men it is only too frequently set up by excess in alcoholic liquors. Here, in what may he called this chronic form of ulceration, pain is not a marked feature of the affment. Vomiting, on the other hand, is not uncommon, and brings up as a rule partially digested food. to start with, whilst afterwards the expelled material is of a thin character. As a ,ul© constipation is present, and the general health call round suffers, severe headaches being characteristic of this affection. With regard to this longcentmued affection of the stomach, the great principle on which treatment is carried out is that of affording rest to the affec.ed organ. The physician will p. obabiy recommend that no food should be taken for a period of, say, twentyfour hours. ■To relieve thirst a little ioe may be sucked, whilst to clear the bow r els tore© to five grains of calomel may be placed on the tongue and swallowed with a little water, this being followed in from six to eight hours by a salient aperient. If much pain exists over the region of the stomach warm poultices may be applied. The return to the food should be marked by the giving of nourishment at first in the liquid form in the shape of invalid Bovril, meat soups, chicken broth, and the like, whilst milk may be taken in small quantities mixed with soda water. GASTRIC ULCER,

Where, on the other hand, ulceration of the stomach tends to run an acute and rapid course we meet with a very different and, to say the least of it, more dangerous trouble than that represented by the chronic form. This gastric ulcer is much more frequently seen in women than in men. The typical sub.]ect again is an underfed, anaemic, or bloodless, girl. Her symptoms, as a rule, admit of no mistake w ith regard to the character of the disease, fc>he will complain of pains in the stomach, generally in the same spot, and beginning within, say, a quarter of an hour or less after a meal lias been taken. Note this point particularly, because so long as the stomach is empty the pain w’ill not be present, but when the stomach begins to contract we readily see that the tveak spot represented by the ulcer becomes materially affected. What happens in this case is that a certain limited portion of the stomach has become infl lined. The result is that a raw surface or ulcer is produced not extending as a rule ever the whole stom-vch. The average size of an ulcer of the stomach may be described as that

of a fairly large pea. This dimension is, however, often exceeded. Ulcers are most frequent on the hinder walls of the stomach. They are apt to be more dangerous if they affect the front wall. The danger here represented is that of the ulcer in consequence of inattention and want of proper treatment breaking through the wall of the stomach, in which case the contents of the stomach may escape into the abdomen at la.ge, and may set up fatal inflammation of a general kind. Even in such cases however, there is still hope, because nowadays surgeons can perform operations whereby the ulcerated surface can be removed, and the patient’s life saved. TREATMENT. Her© again no system of treatment can be of any use without first- of all securing rest of the stomach. The patient must go to bed, securing thereby rest of body at large. No food is to be given by the mouth, and for a certain period, in order to secure complete repose of the stomach and to favour the healing of the ulcer, the patient will be fed by enemata or injections of nourishing materials into th© bowel. These injections consists of various substances such as the physician will order. In addition to the pain coming on after food, it ought also to be remarked that another sign of gastric ulcer is that seen in the fact that after a meal has been rejected traces of blood may follow. Indeed, the presence of blood in vomited matters, along with the symptom of pain already described, may make us almost certain that we have to deal with a case of the kind under discussion. After the stomach has in this way been allowed to rest, and so to favour the healing of the ulcer, feeding by the mouth may be started, care being taken to only employ light foods, such as milk, arrowroot in fine powder, bovril, soft boiled eggs, and the like. A very important rule is that of rather erring on the side of delay in returning to ordinary diet than in hastening any adoption of natural food. If bleeding occurs it may be stopped by giving small pieces of ioe, which should be allowed to dissolve in the mouth, whilst a teaspoonful dose of hazeline given occasionally will also be found useful. For vomiting, it persistent, a capsule containing one minium of creosote may be tried. Bismuth is also given, the dose being a dessertspoonful of liquor of bismuth thrice daily.