RUMINATION is a gastric neurosis characterized by habitual regurgitation of small quanties of food into the mouth for several hours after its ingestion, which regurgitated food is not expectorated, but rechewed and re swallowed, all after the manner of the ruminant. The affection occurs in neu rotic individuals, and is often preceded by a more or less long period in which nervous disturbances of digestion have occurred and simple regurgitation of food has been common. This disease, as with insufficiency of the cardia and with sim ple regurgitation, is presumed to be due to an increased irritability of the vagus nerve. The onward passage of food into the bowel may be normal or atony may exist; the secretory function may be in a state of exaltation or depression; no relation seems to exist between the motor and secretory functions and rumination.
Treatment must be directed to the un derlying neurosis. Moral suasion, in which insistence upon constant autosup pression of the regurgitation is urged, is most important. Hypnotic suggestion is always worthy of trial. Thorough pre liminary mastication of food must be urged. The use of a pronounced bitter drug after meals, such as quinine, as sug gested by Hemmeter, is worth a trial.
10Ellvous ERUCTATIONS. — This affec tion is common in neurasthenic and ncu ropathic individuals or in the otherwise robust after mental strain or worry. It exists either as an ephemeral or a chronic condition. Eye-strain may be a factor. The gas is paroxysmally expelled. It is tasteless and odorless, and may arise from the stomach or merely from the cesopha gus, consisting of air that has just been swallowed.