Licence: Public Domain Mark
Credit: Lectures on the theory and practice of physic (Volume 1). Source: Wellcome Collection.
Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)
143/776
![cerous disease, and that no good can be done. But the thing is to be able to know, when you are called to a case, whether it is a case of mere nervous dyspepsia, or chronic inflammation of the stomach. Some of the best pathologists think that most of the cancerous affec- tions of the stomach are, in the beginning, only chronic inflamma- tions of that organ. I believe we have not yet in this country adopted the plan of moderate application of leeches to the epigastrium in cases of chronic gastritis. I have seen, in many cases, great benefit result from the repeated application of a smalj number of leeches to the epigas- trium, at intervals of two or three days. Here is a point which you will find very useful in practice. You will meet with cases which have lasted for a long time ; cases where there is strong evidence of organic disease, and which have resisted the ordinary dyspeptic treatment. You will be called frequently to treat these three dif- ferent cases : — wher^'the disease has been of long duration ; where there is distinct evidence of organic disease ; and where the disease has resisted the ordinary dyspeptic treatment. Here is a case of a patient labouring under what is called indigestion, and which has resisted the stimulant, and tonic, and purgative treatment. Here is one fact. In the next place, the disease is chronic, and the proba- bility is that there is inflammation, and consequently that there is chronic gastritis. Now if, in such a case, you omit all medicine by the mouth, apply leeches to the epigastrium, keep the bowels open by injections, and regulate the diet, you will often do a vast deal of good. 1 have seen, under this treatment, the tongue clean, the pain and tenderness of the epigastrium subside, the acidity, thirst, nausea, and flatulence, removed, the power of digestion restored, and all Hie symptoms for which alkalies, and acids, and tonics, and purgatives, were prescribed, vanish under treatment calculated to remove chronic inflammation of the stomach. What is next in importance to regulated regimen and local bleed- ing ? A careful attention to the bowels, which in chronic gastritis are generally constipated, and this has a tendency to keep up disease in the upper part of the digestive tube. Is this to be obviated by introducing purgative medicine into the stomach ? No. If you in- troduce strong purgative medicine by the mouth, you will do a great deal of mischief. You must open the bowels by enemata,or, if you give medicine by the mouth, by the mildest laxatives in a state of great dilution. A little castor-oil, given every third or fourth day, or a little rhubarb, with some of the neutral salts, will answer in most cases.* The diet, too, can be managed, so as to have a gently laxative eflect.t The use of injections is, however, what I princi- * [Salts are often singularly unfriendly to the stomachof a dyspep- tic. Rhubarb and soap pill, or rhubarb and carbonated magnesia, well mixed, with a little cinnamon or ginger, are preferable. — B.] t ( And for this purpose bran or rye bread, rye mush and milk for breakfast and spinach for dinner, are among the best articles. But- ter-milk in season, and melasses and water for occasional drink, will tend to the same end. — B.] vol. i.— lxJ](https://iiif.wellcomecollection.org/image/b21156955_0143.jp2/full/800%2C/0/default.jpg)
