GASTRIC NEUROSES.
The connection between functional affections of the stomach and the tangled web of symptoms recognised as dyspepsia has already been dealt with in the article on Dyspepsia, which should be studied in association with the following remarks. The gastric neuroses are usually divided into the Sensory, Secretory and Motor types.
The success of every step in the management of a gastric complaint obviously depends upon accuracy in diagnosis; organic affections being eliminated, the next procedure should be to investigate the well-recognised causes which produce simple acute or simple chronic dyspepsia. It is a very common error to assume that every symptom of disturbed diges tion occurring in a neurotic subject—hysterical, neurasthenic, neuralgic or migrainous—is due to a true neurosis of the stomach. It is an un questionable fact that many highly neurotic individuals digest their food normally, hence the mere discovery or recognition of a general neurosis should never be accepted as evidence that the gastric disturbance is part of this until the ordinary every-day local causes of dyspepsia can be eliminated. These, as laid down in the article on Dyspepsia, are errors in
cooking and dietary, imperfect mastication, belching or wind-sucking, caries of the teeth, irregularity in meals, &c.—causes which operate upon the digestive function of the typically healthy and neurotic alike. It is therefore futile to treat a case of dyspeptic trouble in an hysterical patient by Weir Mitchell or other method when the commoner causes are left uncorrected. These being in every instance eliminated, the treatment of a gastric neurosis may be then entered upon with confidence.