In some cases pain is experienced when the stomach is empty, and is relieved by food. Eating a small biscuit often puts away the pain at once. A little magnesia or a tea-spoonful of aromatic spirit of ammonia may be employed if needful.
Such, then, are the main types of indigestion. Again, however, it must be noted that the dis tinctions drawn are merely those of convenience, and that no real distinctions can with certainty be made. Even after proceeding in the most careful and rational manner, treatment of dys pepsia may fail till several remedies have been tried.
One or two additional remarks of a general character may be made.
It will perhaps be noticed that alcohol is ! nowhere advised in these paragraphs. This is not because it is valueless, but because of the risks involved in recommending it. Many people need only the hint that whisky or brandy would be useful, to seize upon it, and make it an excuse for tippling. Indeed one may say that the cases are so few where some substitute for alcohol cannot be found, that it is safer to leave its prescribing to the hands of a medical man who has immediate knowledge of the in dividual case.
While a certain amount of water is necessary for the digestion of food, dyspeptic symptoms are frequently due to the immoderate use of water during meals. When it is desired at a meal it should be taken chiefly at the end, and in small quantity. Iced drinks during meals frequently hinder digestion. (Details as to drinks are to be found in the section on HY GIENE—FOOD.) Dyspepsia may be due to no derangement of the digestive process, properly speaking, but to confirmed costiveness. The remedy in such a case is to correct the sluggish bowels—it is frequently the large bowel that is at fault. A drug highly recommended for this is belladonna, the method of using which is stated in the paragraphs on costiveness (p. 245).
In women various forms of indigestion are frequently connected with affections of the womb and derangements of its functions. Often as soon as these are rectified the dyspeptic symptoms disappear.
Hiccough OP Hiccup is a symptom of stomach derangement which has not been men tioned in preceding paragraphs. It consists of sudden, short, convulsive inspirations accom panied by a pecular sound, and followed by an expiration. It is due to convulsive movements of the diaphragm (p. 345), and is excited by irritations of the stomach due to errors in diet, &c. If it continue for any time it becomes ex tremely painful. It becomes very exhausting in cases where it is removed with difficulty. Drinking, it is well known, occasions it, and sometimes it persists for days, to the extreme distress and anxiety of the patient. It is also an occurrence in hysteria, and may attend serious diseases of lungs or liver, fevers, &c. Whenever there are any severe or long-con tinued stomach or bowel symptoms, persistent hiccough is a very serious symptom.
Treatment.—Simple cases are sometimes met by taking a few deep inspirations and then holding the breath as long as possible. A sud den slap on the back or a sudden start often drives it off. A drink of cold water may arrest it. These measures failing, various remedies may be used—a tea-spoonful of aromatic spirit of ammonia in water, a few drops of spirit of camphor in water, or 10 grains of bismuth in water. Obstinate cases have been immediately cured by the drinking of an infusion made with a tea-spoonful of mustard steeped in 4 ounces of boiling water for twenty minutes and then strained.
We must now consider some of the chief stomach diseases attended by marked struc tural changes in the stomach.