MORE ABOUT STOMACH TROUBLES.

New Zealand Mail, Issue 1775, 14 March 1906, Page 53

MORE ABOUT STOMACH TROUBLES.

In a former article we discussed the nature of that ailment known ae? of the stomach.” The causes of the disease were also duly described; cause's which result in distention and expansion of the stomach far beyond its natural limits. The typical case of stomach dilatation presente us with what we call chronic enlargement—a long-standing complaint in fact, which is fraught with much" disturbance, not only of the digestive functions, but of the health of the body at large. To-day it is our duty to make ourselves acquainted with the symptoms of the ailment, ami more especially those which are likely to impress the mind of the patient himself. Thereafter the question of treatment will fall to he discussed, and this last in itself forms an all-important topic, because much can be done in early stages of the ailment to arrest the disorder. . In my former article I said that a certain degree of stomach enlargement was apt to he represented in cases of indigestion and dyspepsia. There is a stomach trouble known as gastritis, which, in plain language, may be termed “stomach-inflammation,” and in cases of the nature of the longstanding variety, the stomach may be expanded beyond its natural dimensions, In short, while “dilatation” of the stomach is a distinct and typical condition resulting, as we have seen, from some obstruction to the passage of food into the bowel and from other cause's (described last week), it is also apt to he found in a minor degree in severe cases of indigestion and stomach troubles of that nature. We need not feel surprised at such a result, for even indigestion of severe type may so alter the stomach's work and so disturb it as to cause it to become enlarged. I think physicians recognise very fully today that many cases of stomach trouble which are apt by the public to be lumped together under the common head of, “indigestion” A’eally resolve themselves into examples of the ailment we are considering.

The symptoms of' dilatation of the stomach, as a rule, are plainly marked. To begin with, there is the useful history of stomach-disturbance. Indigestion is complained of, and there is also a story told of acidity, often of very severe kind. But while ordinary indigestion may be said to reach this length in the way of symptom* dilatation of the stomach takes us much further along the high road of diseasesigns. A man may suffer from in digestion, but be does not neernsearily vomit and expel the contents of his stomach. This is what does occur in dilatation of the stomach. It is a symptom which is bound to attract attention, and probably it is the sign which first awakens the patient to the idea that his case is .not one of simple indigestion. Now"vomiting is always a valuable symptom, because if we read it aright it throws light on the. nature of the disease of which it is a sign and import. In the case we are considering its value is great, because it indicates and points t-o the probable source of the trouble.

It is the special character of the vomiting here, as elsewhere, which is of importance to note. Suppose a person vomits very soon after taking food. He suffers pain, often of an intensely sharp character, just after he ha,s swallowed a meal. The vomiting relieves the pain, and the vomited matters may contain blood. Such a case, we may be fairly safe in assuming, is one of ulcer of the stomach, and not dilatation. The symptoms are such as you would find in a person a common subject of the disease—say, a pale anaemic servant girl. Now’ in dilatation of the stomach the vomiting does not come on soon after the taking of food. It takes place long after food has been swallowed, and it may occur at intervals of long extent and duration. The vomited matters may contain blood, hut as a rule their chief characteristics are to be found in their dark brown colour, and in tbeir acid charstomach is accomplished easily, and actor. Again, the emptying of the there is little or no straining or retching. If the vomited substances are left to settle wm get a brown sediment falling to the bottom of the vessel, and a scum forming on the top. Under the microscope the sediment is seen to contain sundry lower forms of plant life, of which the chief are minute fungi, to which the name of “Sarcinae” has been given. These microscopic plants) ‘form cubical bundles of eight or more little cells. They are responsible, no doubt, for the production of the acids which give rise to the acidity represented in the cases under consideration. . . _ Naturally, in dilatation of the stomach, w r e find not merely the nourishment of the body interfered with, ana great exhaustion in time produced, but there is also represented disturbance of the whole system, which,, if not cured, can only lead onwards to exhaustion and death. How important it i» that this (and, indeed, all other, troubles) should be early, recognised, that treatment may be commenced at a period when there exists great hope of recovery, is a matter that needs no comment.

"We now come to consider the allimportant matter of treatment. Seeing that common causes of the ailment are the taking of improper food and interference in consequence with the stomach’s work, it is clear our first duty is to supervise the nutriment. Doctors tell us that people who are heavy eaters, and who, in addition take large quantities of beer or other fluids with meals, are most apt to suffer. This is a very reasonable supposition. If we go on distending the stomach week in and week out beyond its normal capacity, we are certain in time to find it give up its struggle, and to remain distended. Therefore it is that the rule here is to give light foods, of small bulk to avoid taking fluids* with meals as far as possible. Give up all starchy and sugary foods. Potatoes for example, should be omitted altogether from' the bill of fare; new bread is equally bad for the patient, and, indeed, bread of any kind should he partaken of sparingly in any case. If there is pain try liquid foods for a time, such as milk, beef tea and the like. In leas severe cases you may give easily digested foods, such as tripe, sweetbread, white boiled fish, soft-boil-ed eggs, and chicken. Perseverance in the selection of such appropriate foods, and care exercised in’avoiding any undue distension of the stomach, with accordance of. any excess of liquids, will cure, an ordinary case. If there is great acidity give ten to fifteen grains of salicylate of bismuth after food twice daily. Between meals instead may be tried a draught composed of five grains of sulpho-car-bolate of soda, twenty minims of spirits of chloroform, and half an ounce of infusion of gentian. Lastly, remember that lavage or washing out the stomach by means of the stomach pump or syphen, is an admirable aid to treatment. The stomach can be flushed out once or twice daily in a severe case with tepid water, to which is added bicarbonate of soda cr boric acid. The doctor alone can'teach, the patient this simple operation, so that he can treat hi mo elf in this way.