The principles of treatment and their applications in practical medicine / by J. Mitchell Bruce.

  • John Mitchell Bruce
Date:
1899
Catalogue details

Licence: Public Domain Mark

Credit: The principles of treatment and their applications in practical medicine / by J. Mitchell Bruce. 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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    personal hygiene in the fullest sense, which will be found to have been neglected by many of the subjects of this disease —wholesome bodily exercise and mental relaxation; regular, deliberate and sociable meals; and daily evacuation of the bowels. In this way the debility, heartlessness and digestive incapacity itself are also successfully removed. ]\Ianifestly improvement of digestion will react quickly on the nutritive and functional conditions of the gastric walls. The smallest improvement is therefore a decided and promising gain. In all cases of residual dilatation, as we saw in Part I., there is an indication to remove residues which have accumu- lated as arrears of work within the cavity. In connexion with all hollow organs subject to dilatation from muscular failure, such as the heart, bladder and bowel, this step is necessary; in the case of the stomach it is peculiarly essential, since retention of imperfectly digested food leads to decomposi- tion, and decomposition to further weakening of the walls and further dilatation by gaseous pressure, as we have just seen. The most obvious method of emptying the stomach is by vomiting. It is the automatic means of relief which usually secures a few days' comfort until arrears have re-accumulated. The sufferer from dilated stomach sometimes practises it for himself in the acme of his distress from distension and pain. Emetics might be employed therapeutically; but a more elegant and thorough and much less depressing means is found in lavage. The stomach-tube is passed, the abundant acid frothy fluid is evacuated, and the more solid particles and mucus are washed out: the indication is successfully fulfilled. In a case of dilatation under regular treatment the practitioner does not wait for residues to form, or at any rate to accumulate, but arranges for daily lavage. Some patients, however, do not require lavage and others will not submit to it. For them two indirect methods of dealing with decomposition of the residues may be employed, in addition to measures otherwise indicated. Torulas and sarcinaj may be destroyed in situ by means of disinfectants, of which sulphites, phenol and creosote are examples; and they are also starved by removing saccharine and amyloid substances from the diet. In this connexion the next indication will be readily