Diseases of the digestive system / an authorized translation from "Die Deutsch Klinik" under the general editorial supervision of Julius L. Salinger.

  • Frank Billings
Date:
1906
Catalogue details

Licence: In copyright

Credit: Diseases of the digestive system / an authorized translation from "Die Deutsch Klinik" under the general editorial supervision of Julius L. Salinger. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    vent regurgitation by lying down immediately after their meals, but if, after some time, they rise, the regurgitation at once appears. The cir- cumstance that psychical alterations, fatigue, menstruation, etc., cause an increased and more freqiient appearance of the affection is in favor of its nervous character. The treatment, in the main, must be directed toward increasing the energy of the will and suppressing the pathologic process. Gastric lavage should be tried as well as preparations of bromin. Unfortunately, we rarely succeed in bringing about a cure. So-called nervous vomiting may also be included in this class of affec- tions. Vomiting is caused by increased muscular activity, but a paroxysmal contraction of the diaphragm and of the abdominal muscles only causes immediately a compression of the stomach, that is, an expulsion of its contents, and it is unquestionably true that the forcing of the stomach contents upward occurs all the more readily the less resistance there is on the part of the cardia. Nervous vomiting is characteristic because of the particular ease with which it appears (prodromes, especially nausea, are frequently absent), and it is obvious that flaccidity of the cardia plays an important role. This affection is prone to occur in hysterical persons, also in chlorotics, more rarely in neurasthenics. The idiopathic form of nervous vomiting described by v. Leyden, which is characterized by its periodic appearance (periodical vomiting), must be here included. Nerv- ous vomiting may exist for years without the nutritive condition of the patient suffering. [Eegurgitation of food due to stenosis of the esophagus, especially at the cardia, may be mistaken for vomiting. This is especially true of cardio- spasm. General nervous conditions may be the cause of the cardiospasm, and at the same time a nervous dyspepsia or a gastric ulcer may exist. A close attention to the character of the symptoms, especiall}'^ of the act of so-called vomiting and an examination of the expelled food, will make the case plain.—Ed.] In the diagnosis, an unusually large number of general affections and diseases of the most varied organs, intoxications and autointoxications, as well as organic gastric affections in which vomiting is a symptom, must be excluded, and furthermore, particular stress must be laid upon the etiologic factor of hysteria. Besides combating hysteria, local treatment of the stomach by lavage or irrigation and electricity are in place. Hypermotility.—Hypermotility is a condition in which the motor ac- tivity of the stomach, by means of Mdiich its contents are propelled into the intestine, is increased. In consequence the stomach is empty during a time in which, normally, ingesta should still be present. Whether in- sufficiency of the pylorus also plays a causative role cannot be determined. Hypermotility is by no means rare. It occurs particularly in neuras- thenics, and shows itself by the appearance of bulimia (see above). In