ACIDITY, Gastric.
This is but a sign or symptom of various pathological or functional conditions, and much confusion exists regarding its treatmenta con fusion which has become intensified by the temptation of conveniently labelling every form of functional stomach ailment as a gastric neurosis. In many instances the regurgitation of the acid liquid, which comes on at the middle or late stage of the digestive process in the stomach, causing much pain and distress, has no connection with the condition known as hyperchlorhydria or excess of HCI in the stomach, but on the contrary is too often a result of deficient acid secretion, which permits of fermentation, ending in a large production of lactic, acetic, and butyric acids.
Preventive measures consist (I) in a diminution in the amount of farinaceous and fatty foods, especially of fat meats baked in the oven, of beer, acid wines. badly made pastry, etc., and the administration of under-cooked red neat; (2) the establishment of oral asepsis by the removal of decayed teeth, and the use of such dental appliances as will insure thorough and slow mastication of the food, which should be given at regular intervals of 4 to 6 hours in order to insure the complete emptying of the stomach before the next meal is eaten. One large dose of I3icar bonate of Sodium (5i.), freely diluted, generally gives immediate relief, and in chronic cases the combination of 3 grs. Papain with the alkali will cause neutralisation of the organic acids without hindering the diges tive process, which is hastened by the papain. In severe acute cases following the ingestion of baked pork and bad pastry, it may be necessary to cause emesis, but a large dose of alkali is a wise preliminary, since the stomach contents may he so highly acid as to cause irritation about the epiglottis during the act of vomiting, or lavage may be employed. This latter measure be indicated in all cases where there is impaired motility or obstruction at the pylorus, when the fluid employed may advantageously he charged with antiseptics like Creosote or Perman ganate Solution to insure neutralisation or destru( Lion of abnormal ferments before fresh food is introduced.
Creosote in 2 or 3 min. capsules, an equivalent amount of Carbolic Acid in pill, 5i. doses of Sulphurous Acid freely diluted, teaspoonful doses of freshly dried Charcoal. given in wafer paper, or 3 min. doses of the Oil of Peppermint may be administered about i hour after each meal. Occa sionally a large dose (io grs.) of Pepsin gives relief, but it is inferior in most respects to the following combination: The mistake is too commonly made of prescribing a cut-and-dried regimen, which is liable to depress the gastric function by its routine sameness. Farinaceous foods and fats should be restricted, and fish, poultry, tripe, and carefully made soups may be freely partaken of, the patient being left to his own judgment to abstain from all articles of diet which he knows, by previous experience, increase his acid discom fort. He can, however, be assured that by taking his alkaline powder he may often eat without risk such articles of diet as lean chops and roast meat, fresh vegetables, milk, etc., when these were before inadmissible. Beer, wines, pastry, pork, and fresh fruits are, however, better left alone, as are also all hashes, stews, goose, duck, and re-cooked dishes of every description. Some patients do well for a time upon large quantities of raw meat, as in the Salisbury treatment. Where the acidity is due to a true gastric neurosis—gastrosuceorrhcea (Reichmann's disease), or gastroxynsis (Rossbach's disease)— the underlying neurotic condition will require primary attention. The hyperchlorhydria of ulcer, both gastric and duodenal, as described under its own heading, must be treated by rest and the free administration of alkalies and suitable diet. Asnis has recently shown that Olive Oil has the power of very markedly diminish ing the formation of gastric acidity due to the excessive formation of HO.