Where the former causes are known not to exist, the presence of poison should always be suspected. As the cause sometimes becomes a matter of legal investigation, it is very important that the practitioner should be able to determine the real origin. If caused by poison, the disease is very suddenly developed, the patient complaining of a very intense burning sensation in the throat and the lining membrane of the mouth, which will generally show the action of the poison. A diarrhea is also more apt to accompany the disease. If inorganic or vegetable poisons are known or suspected irritants, the appropriate antidotes should be promptly administered. For a list of the principal poisons and their antidotes, with practical suggestions for treatment, the reader is referred to the article in this volume, on Accidents and Emergencies.
Treatment. The inflammation should be allayed, and a tea made of peach-tree leaves is very serviceable. Small pieces of ice, swallowed, will generally allay the thirst and vomiting, and a mucilage of slippery-elm is very soothing to the inflamed mucous membrane. This is an important disease, and its management should be entrusted to a skillful physician.
CHRONIC INFLAMMATION OF THE STOMACH.
Chronic Gastritis is sometimes mistaken for dyspepsia or gastralgia. It is very necessary to discriminate between these diseases, as the appropriate remedies of the latter will often only aggravate and augment the former.
A chronic inflammation of the stomach is a very common affection and has many phases, but the term chronic gastritis is applied only to that species of inflammation occasioned and accompanied by irritation. It is seldom a result of the acute form.
The Symptoms of chronic gastritis are various and sometimes vague. Among those which are prominent we may mention an irregular appetite. At times it is voracious and the patient will consume every available article of diet, while at others he will experience nausea and disgust at the sight of food. Even when very hungry, one mouthful of food will sometimes produce satiety and cause vomiting. The appearance of the tongue is variable, sometimes natural, at others thickly coated. The desire for drink is capricious, varying from intense thirst to indifference. Another prominent symptom is a sense of heaviness and heat in the epigastric region, after partaking of food. Often a small quantity, as a teaspoonful of milk, will produce a sensation of weight, as a heavy ball lying at the pit of the stomach. This symptom is frequently accompanied by a frontal headache, and a small and wiry pulse. Dull or shooting pains are experienced in the stomach and between the shoulders, and the patient becomes weary, melancholy, and emaciated.
Causes. The general cause of chronic gastritis is excess in eating or drinking, and the use of alcoholic liquors. We have known it to be produced by drinking hard cider. Great mental excitement predisposes the system to this affection. Occasionally it is a result of febrile diseases, as scarlatina, typhoid fever, etc. In some families there is a constitutional tendency to its development.
Treatment. All medicines which tend to irritate the stomach, should be studiously avoided. The bowels should be kept regular, and the skin clean by frequent bathing. Stimulants of all kinds must be avoided. As a principle article of diet, we would recommend milk and farinaceous articles. If these precautions be observed, nature will sometimes effect a cure. Lime water and the subnitrate of bismuth, in twenty-grain doses three or four times a day, are useful to allay irritation. Other suggestions applicable to its domestic management, maybe found under the hygienic and medicinal treatment of dyspepsia, to which we refer the reader.
NEURALGIA OF THE STOMACH. (GASTRALGIA.)
Gastralgia is a neuralgic affection of the stomach, unaccompanied by inflammation. It is sometimes mistaken for chronic gastritis, although there is a marked difference in the symptoms.