GASTRITIS, a general term that includes all strictly inflammatory diseases of the stomach. Acute gastritis or acute gas tric catarrh is an acute inflammation of the lin ing mucous membrane. The membrane be comes swollen, is covered by a coating of tena dons mucus and tends to bleed at minute points. Errors in diet, either by over-indul gence or the ingestion of improper food, is the most frequent cause of the malady. Certain chemicals and drugs, very hot food or liquid, foreign bodies and unripe fruits may cause the irritation. The symptoms depend on the sever ity of the inflammation, the milder forms being spoken of as subacute. Frequently premoni tory symptoms, such as a feeling of fullness or tenderness, or the eructation of gases, may be noticed, and may be soon followed, in the more severe cases, by nausea, vomiting and a rise of temperature, accompanied by painful thirst. If the retching or vomiting of mucus continues, there is apt to be great weakness and prostra tion. The duration of the disease under proper treatment is seldom over three or four days. The stomach should be given absolute rest for 24 hours, or even longer if nausea or retching continue. The intense thirst may be relieved by small pieces of ice, but not even the drinking of water is permitted. Rest in bed may be indicated in the more severe cases and, if so, hot poultices applied to the stomach re gion relieve some of the distressing symptoms. Drugs are of little value except to quiet exces sive vomiting. Toxic gastritis is that form caused by the ingestion of corrosive and irri tating drugs and chemicals. It is a severe form of acute catarrh, with the added effect of the particular poison taken. Strong acids and corrosives cause destruction of the deeper tissues, with ulceration and even perforation of the wall. The treatment depends upon the poi son taken, but dilution by the imbibing of de mulcent drinks is usually of value if taken sufficiently early. Chronic gastritis or chronic gastric catarrh is a chronic inflammatory change in the mucous membrane of the stom ach. It is a most wide-spread malady, affect ing all classes and ages. Not uncommonly successive attacks of acute gastritis, even in early life, start those progressive changes that sooner or later make themselves known as chronic catarrh. The most common cause is the repetition of irritants taken into the stomach in food, both as to quantity and qual ity, and in drink irritating from high tempera ture or presence of alcohol. Other causes may operate, such as venous congestion from dis ease of the heart, liver and spleen, changes in the blood-elements and the constant poisoning of infectious diseases. A most important cause
for chronic gastritis is a continuous mental irritability, which accompanies intense anxiety, impatience, bad temper and inability to push one's work ahead with ease and song froid. Liberal doses of good humor and increase of human sympathy will cure this.
For an understanding of the symptoms of this affection it must be appreciated that three mechanisms make up gastric digestion — the nervous, the muscular, and the secretory. De viation from the normal in anv one of these is almost certain to act on the others, and when, in addition to these mechanisms, the close relation of the stomach and other diges tive organs is considered, a marvelous complex is apparent. The symptoms of a chronic catarrh may be unnoticed, may be denced by changes due to poor gastric diges tion, or interwoven with resulting derangement of all the digestive apparatus. In the early stages the mucous membrane is swelled, the gas tric juice still has its normal ingredients and in addition the membrane secrets a mucus owing to degeneration of the cells. From this stage to a complete absence of acid, and then of ferments the change is gradual, the final stage being known as atrophic gastritis. No symptom or group of characteris tic of the disease, the diagnosis being made with accuracy only by examination of the gas tric contents. At one time or another one or more of the following symptoms are noticed: Absence of appetite, bad taste in the mouth, coated tongue, nausea and, occasionally, vomit ing, eructation of gases and some liquid, heart burn, and a feeling of fullness or bloating after meals. The presence of inflammation, and the stage, are determined by chemical and micro scopical analysis of the contents of the stomach after a test-meal has been eaten. In all except the atrophic stage there is always more or less mucus found mixed with the food. This is the distinguishing feature.
Of itself the disease is not fatal, but severe disorders of nutrition may result that render the sufferer more liable to other diseases.
The treatment consists in correction of the causes as much as possible, particularly in a dietetic regimen free of irritation and of ready digestibility. Lavage or washing of the stomach is of supreme importance where it can be borne. Drugs are of little use except for the relief of distressing symptoms. Where great diminution or absence of acid is found, it may be supplied, but the large amount neces sary usually makes the procedure imprac ticable. Electricity, massage and hydrotherapy may be beneficial.