DYSPEPSIA is that combination of symp toms that results from interference with the proper digestion of food in the stomach. Be cause of the taking of too much food or un suitable food, the mucous membrane of the stomach becomes irritated and there is set up an acute or subacute gastric catarrhal condition which prevents the proper digestion of the food. This food is apt to ferment and to decompose, and as a result the familiar picture of acute dyspepsia may arise. In mild cases there may be nothing more than an uncomfortable feeling in the stomach, with a certain amount of de pression, headache, loss of appetite and perhaps belching of wind and occasionally vomiting. There may also be accompanying intestinal symptoms, such as diarrhoea and colic, particu larly in children. There may be only the fa miliar heartburn, due to the over-dilatation of the stomach, from the excessive gases of fer mentation or putrefaction. In the more severe cases, those that last over a day or two, the symptoms enumerated may be much more in tense. The distress may be marked, and the general constitutional symptoms more evident. Vomiting, loss of appetite and mental depres sion are much more pronounced. This is par ticularly true of acute gastritis, due to the excessive use of alcohol.
Very frequently, from continued errors in diet, the acute or subacute condition may be come chronic, so that there is a continual indi gestion. Here the symptoms persist for an indefinite period, the appetite is very apt to be variable, although at times very good. Oppres sion after eating, which may amount to actual pain, is one of the most constant symptoms. Occasionally the pain may be pronounced when the stomach is empty. Heartburn is frequent, if not constant, the stomach is painful on pres sure, the tongue is coated, there is bad taste in the mouth, there are changes in the amount of salivary secretion. Frequent belching of gas is a very common accompaniment of chronic dys pepsia, particularly of the flatulent variety. Here also the intestines suffer from distention.
Nausea is more pronounced, particularly in the morning hours, and vomiting is common in the morning. Constipation is usually present, although diarrhoea may alternate with consti pation, and mental depression is almost char acteristic. The treatment of acute and chronic dyspepsias constitutes one of the most difficult problems in modern medicine, particularly as few patients are willing to undergo the ordeals of a rigid dietary regimen. Most cases of dyspepsia can be cured if the diet is looked after, although each case needs careful con sideration from the standpoint of causation. Proper eating and proper amounts of food are the two most important features in the treatment. Most people eat too fast and eat too much. If the food is taken slowly, observ ing the old-fashioned rules of counting between mouthfuls and small amounts are taken, many patients suffering from indigestion can treat themselves with success. More than one-half of the dyspepsias are really mental in origin. They are produced by worry and by impatience. and are best treated by proper psychotherapy. One group of recurring dyspepsias which come on in attacks lasting, a few weeks or a few months, with slight depression, are mild forms of a manic-depressive psychosis. These are amenable to psychotherapy also. They get well by themselves, but are apt to recur without proper therapy. As to the details of the dietary and as to the medicinal treatment of the condition, medical advice is absolutely necessary.
One of the most pernicious of all practices in the treatment of dyspepsia is the taking of many of the patent medicines which are so blatantly advertised in the religious and lay press. As most of these so-called tonics are hardly more than alcoholic beverages, it is evident that their use is not unattended with a great deal of dant: ger. The treatment of the constipation that is so frequent an accompaniment of chronic dys.. pepsia by means of the many patent pills, pow ders, teas and liquids is positively suicidal. See CONSTIPATION ; ; GASTRITIS.