STOMACH, DISEASES OF. In the discussion of the diseases of any organ, it is custom Iffy to begin with the consideration of its inflammation. In the stomach, however, acute gastritis, or inflammation of the mucous membrane of teat organ, is so rare a disease, except as -a result of the administration of an irritant poison, that it might almost pass unnoticed. Thus Louis states that during six years' experience at La Charite (one of the leading Parisian hospitals), in lie made notes of 6,000 cases of disease, and 500 dissections, he did not meet with a single case of fatal idiopathic (or spontaneous)gastri tis. The simple fact, however, that this disease is almost always the result of poison, gives it a special interest, and renders it especially necessary that the physician should be so thoroughly acquainted with its symptoms, as to be able with certainty to detect it, and thus to be led to investigate its cause.
The symptoms which indicate that an irritant poison has been received into the stomach, are a gradually increasing sensation of uneasiness or heat, which shortly assumes an acute burning character in the epigastric region. This pain is accompanied with vomiting, which becomes increasingly frequent as the pain augments, and often with hiccup. There is usually extreme tenderness on pressure, and the patient bends his body forward to relax the muscular tension. During the accession of these symp toms, there is a marked degree of excitement, as indicated by the acceleration of the pulse and breathing, and the heat of the skin. This condition is, however, soon exchanged for one of prostration. The skin becomes cold and clammy, the pulse thready and feeble, and the breathing catching and intermittent; until finally, after a variable period of exhaustion, the patient sinks, usually retaining his mental faculties to the last. Although the above-described symptoms are always more or less present, each irritant poison occasions some special symptom, and some characteristic lesion; and the period at which death ensues varies for different poisons. Hence, quite apart from the results of analysis, a fair conjecture can usually be made as to the individual poison which has been administered.
Sub-acute gastritis is by no means a rare affection, and its occurs in two distinct forms—" one in which the malady is caused by a constitutional state, the effects of which are shown in a variety of other organs, as well as in the stomach; another in which it is due to causes connected chiefly or exclusively with this organ, which is sub mitted to an irritative process somewhat analogous to that typified by the gastritis of irritant poisoning."—Brinton, Pn Diseases of the Stomach, 1859, p. 101. The first of
these forms is well illustrated in certain cases of scarlatina, in which, if death takes place between the third and seventh day of the disease, distinct: marks of inflammation are seen in the stomach. The other variety, which is often of a chronic form, is best seen in cases of delirium tremens; the affection being sub-acute or chronic, according as it has been produced by a single prolonged debauch, or by a protracted habit of drinking spirits; the patient's final malady being induced by a deficiency of food, or the want of the ordinary stimulant. Purely chronic inflamation may be induced by various causes, of which the most common are the abuse of alcoholic drinks, habitual excess in eating, the eating of indigestible food, and the excessive use of irritating medicines.
The treatment of gastritis varies so much with each individual case, that we shall only lay down a few general principles. The first point is the removal of the cause; to Ile attempted in cases of irritant poisoning, either by the removal of the poison (by the stomach-pump or emetics, as. for example, sulphate of zinc), or by its neutralization by means of an antidote. In very severe cases, leeches may be applied to the epigastrium; but counter-irritants, such as turpentine on a hot moist flannel, or mustard-poultices, are generally of more service. Continuous fomentation with water, as hot as can he borne, often gives great relief; while at the same time iced water, or small lumps of ice swab lowed whole, usually relieve the thirst and mitigate the pain. Enemata of purgative materials, if the bowels are constipated, or of a soothing diameter (as thirty drops of laudanum in a little starch or gruel), if the bowels are irritable, may be prescribed with advantage. When the stomach begins to be able to retain food. it must be given in the form of a bland liquid, in small doses, at distant intervals. Chronic gastritis must be treated in much the same manner as indigestion (q.v.) The most essential point of treatment is the due regulation of the diet.