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Chronic Indigestion.Symptoms. - A description of the symptoms of dyspepsia may seem superfluous to many, since the disease is so prevalent throughout the country; yet the fact is, that this term is so loosely employed that it is made to cover almost any difficulty of the stomach. The symptoms vary largely with the cause of the disease, and with the general health of the sufferer. They may be de scribed in general as, first, those which proceed directly from the stomach difficulty; and second, those which result from the impaired nutrition of the body. In most cases of dyspepsia both sets of symptoms are com bined ; the patient suffers perceptibly during process of digestion, and his general health suffers evidently from the imperfection of his digestion. While this combination of symptoms is the rule, in stances occur in which only the local symptoms are present. That is, the patient suffers distress after taking food, but his general health remains unimpaired. Of all dyspeptics it may be said that they feel the stomach. The healthy individual has only a vague idea as to the existence or location of the stomach; the dyspeptic is always conscious of the existence and of the exact location of this organ. He does not, it is true, always experience pain in the stomach; but he has always a dull, heavy sensation, especially upon rising in the morning. The patient is apt to awaken with a bitter taste in the mouth ; he has a dull, heavy pain in the head, and but little inclination for food. Often there is a discharge of considerable phlegm from the throat upon rising. There is a general lack of vigor and energy, an indisposition for exertion, physical or mental ; the face gradually becomes pale and sallow, the eyes sunken, the body somewhat emaciated ; yet the abdomen is usually quite full, being distended with gas in the stomach and intestines. The derange ment of digestion is soon followed, naturally, by derangement in the action of the bowels; the general tendency is to constipation, though this is often interrupted by transient attacks of diarrhea. After the continuance of dyspepsia for some time, there often occur symptoms which indicate difficulty in other organs than the stom ach ; thus, there is often an obstinate troublesome dry cough, and perhaps even palpitation of the heart, which may mislead the patient into the belief that he has heart disease. There are certain symptoms which appear quite prominently during most cases of dyspepsia, and which are of importance as enabling us to distinguish dyspepsia from other diseases of the stomach. Among these symptoms is the habit of bringing up liquids from the stomach into the mouth. This act - technically termed re gurgitation - may occur at any time, but is especially frequent immediately after eating, and after long fasting. The materials thus brought up into the mouth vary somewhat, but are usually quite sour, and even scalding to the throat. At other times large quantities of gas will be belched up - an almost characteristic symptom of dyspepsia. This gas may be merely sour to the taste, or if it be expelled during digestion, may have various unpleasant odors, even that of bad eggs. These gases indicate that the food is undergoing putrefaction and not digestion. Sometimes these expulsions of gas are accompanied by the ejection of a sour or salty liquid into the mouth. This occurs especially when the stomach is empty, and therefore in the morning, and is known as water brash. Another symptom of dyspepsia is what is popularly termed heartburn. This consists of pain over the stomach, of a gnawing or burning character, gradually spreading into the breast, and seeming to the patient to involve the heart. This symptom seems to depend upon the presence of an acid liquid in the stomach, for it can be at once relieved by taking an alkali, such as baking soda. Another symptom, which is often quite distressing, is a dis- tention of the stomach with gas. This gas is produced by the decay of food in the stomach. The result is a decided fullness of the abdomen, which may become so great as to interfere with breathing, and to embarrass somewhat the action of the heart, causing palpitation. This is especially apt to occur in females, and in them may be accompanied by painful contractions of the intes tines. The habitual distention of the stomach with gas occasions in some individuals a peculiar splashing sound whenever liquids are taken upon an empty stomach, a sound which is often heard in horses. This feature of the case, while occasioning no physical distress, is the source of much mortification, especially to women. It may usually be avoided by swallowing only small quantities of liquid at a time. Dyspepsia is not usually accompanied by vomiting - a point whereby it may be distinguished from certain other disorders of the stomach, such as chronic inflammation and ulcer. There are times, it is true, when the condition of the stomach becomes aggravated by some error in diet or neglect of personal care ; at such times the individual may suffer from repeated nausea and vomiting. As a rule, however, while there may be large quantities of gas and liquid expelled from the stomach by the act of belching, yet there rarely occurs any genuine vomiting, or even nausea. Exception must be made to this, however, in a certain form of dyspepsia confined almost exclusively to young females. In these cases the vomiting is obstinate and constant, so that the patient seems to be in danger of death from starvation. In consequence of the violence of the vomiting, there may be at times a few streaks of blood in the ejected matter. Indeed, the symptoms may simulate very closely those of ulcer of the stomach, for which the disease has been mistaken. This variety of dyspepsia must be distinguished from the usual forms ; it seems to be largely dependent upon a hysterical element in the patient-a point of importance with regard to treatment. Among the second class of symptoms-those associated with other organs than the stomach-the most prominent are perhaps the mental disturbances, for dyspeptic patients seem unusually lan guid and dull, not only during the somewhat painful process of digestion, but also at other times. " There is great languor and incapacity for exertion, coming on generally about an hour after food, and accompanied in some cases by an almost irresistible drowsiness, which lasts for several hours. This symptom is par ticularly marked in the afternoon, if the patients dine in the middle of the day, and endeavor to continue their employment afterward. Yielding to the drowsiness and taking a siesta seem to make mat ters worse, for there is usually felt after such an indulgence an intense headache or giddiness, which continues longer than the symptoms would have done had the inclination to sleep been resisted. The depression of spirits is not so remarkable as the feeling of utter helplessness, both of mind and body, accompanied, in persons naturally active, with a sense of shame at their unwonted apathy. ''-Chambers. This dullness and languor are apt to be fol lowed by some general impairment of the mental faculties, which is often indicated by the patient's nervous anxiety about his health, and his disposition to magnify the importance of every unfavorable feature, however slight. As the disease progresses, other symp toms are added to these of mental disorder. The action of the bowels becomes very irregular ; the skin becomes rough and dry; the sleep is unsatisfactory and disturbed by dreams ; the patient often rises in the morning quite wretched and miserable ; and not infrequently a dry cough is added to the other annoyances of the patient. Cause.-The popular idea that dyspepsia is always and neces sarily the result of errors in diet, is not warranted by the facts. Doubtless in many cases the disease can be traced directly and positively to excesses in eating and drinking ; but to induce the dis ease the food need not be excessive in quantity, if the quality be improper. Not the least frequent cause of dyspepsia is the abuse of spirits, resulting first in inflammation of the stomach and then in dyspepsia. This variety of dyspepsia has been described as the 11 remorse of a guilty stomach." There are various departures from health which indirectly induce dyspepsia. Among these are mental causes - long con tinued anxiety and depression ; the excessive and continuous mental effort of professional or commercial pursuits. So, too, a combination of mental worry and physical fatigue, of bad air and insufficient food, sedentary habits - these are merely instances of the cases which may ultimately develop dyspepsia. Other causes, which may be easily overlooked, may be found in the absence of teeth - more than one obstinate cause of dyspepsia which has resisted all manner of treatment, has promptly recovered upon the substitution of artificial teeth for decayed stumps ; doubtless the peculiarly American habit of bolting the food half masticated ia also responsible for much of the dyspepsia so prevalent in our country. That simple excessive quantity of proper food can in duce dyspepsia is not denied ; but it is equally true that very many high-livers and professional epicures escape the disease entirely. Treatment.-In the treatment of dyspepsia the first consid eration is to determine, as accurately as possible, the cause of the difficulty. It is quite irrational and impossible to prescribe any treatment " for dyspepsia " which will be valuable in all cases. For in some instances we have to do with the results of improper modes of eating and the use of improper food ; in other cases we have, in a case of dyspepsia, merely the case of mental worry and exhaustion. In some instances, therefore, the dyspepsia is merely an incident to the depressed condition of the body generally, and in such cases the treatment should be directed to the restoration of the health without especial attention to the stomach itself. In other instances the disease is evidently the result of inflammation of the stomach, and the treatment must consist of measures in tended to improve the condition of this organ. Generally speak- ing, we may say that measures of treatment in all cases may be divided into three classes : First, those relating to the regulation of food ; second, those addressed to the general condition of the patient; and third, medicines. If the dyspepsia be apparently the result of errors or excesses in diet, the stomach should be rested by restricting the food to reasonably small quantities of easily digested food. Yet it is important that the patient should not go to the other extreme, as he is so often inclined to do. Many individuals doubtless derive a certain moral benefit by thus doing penance for their previous excesses; but the effect upon the body is rather disastrous, if the quantity of food be suddenly reduced from excess to a starvation or slop diet. Indeed many cases of dyspepsia occur in persons who have acquired the idea that they should live upon coarse food in small quantities. Not a few of those who follow out some hobby of this sort become victims to dyspepsia, which they fondly believe attacks only epicures. " As regards the diet for dyspeptics, there are no rules suited to all cases. Individual experience in each case is to be a guide. But there is a liability to error in regard to this experience. Unusual difficulty or disturbance of digestion after a meal is often imputed by the patient to certain articles of food, when it was due to some other incidental circumstance. Peculiarities in relation to particu lar articles of food are far less common than the statements of patients would lead one to suppose. In general, articles which are wholesome to most persons, are not unwholesome to any. It is rarely true that what is one man's meat is another's poison. As a a rule, when a patient says that he cannot take such and such articles, which general experience shows to be digestible and nutritious, it is fair to presume that he is deceived, and of this the patient may generally be convinced, if he be persuaded to persist in their use. At first the expectation that an article will prove hurtful, contrib utes to render it so; but after a time the idea is overcome; it is often an object in the treatment of dyspepsia, to do away with these fallacious ideas respecting various kinds of food. Some persons seem to be fond of encouraging the notion that their digestive organs are endowed with peculiar susceptibilities which prevent them from conforming to general rules of diet. In most cases of dyspepsia animal food is best digested, especially old and tender meats plainly but well cooked; but in some cases a milk and starchy diet is found to agree best. An obvious reason why so many persons imagine they do not digest milk well, is that it is generally taken as a beverage after or with solid food, the fact that it is in effect a solid article of food not being appreciated. Bread to be readily digestible should not be new, nor is it desirable when stale. Well boiled rice and corn meal mush are easy of digestion. Crude vegetables are apt to be digested with difficulty in cases of dyspepsia, but not invariably ; some dyspeptics find the much abused cucumber grateful to the stomach as well as to the palate. Pastries, rich puddings and sweetmeats, are generally to be eaten sparingly or discarded. Ripe fruits in moderation are useful. It is generally not advisable for the patient to limit himself to a restricted range, or to adopt any particular system of diet; on the contrary, he should persevere in attempting to digest all the varied forms of wholesome food, not confining himself to meat or a vegetable diet, but aiming to eat like persons in health, without the need of particular care in the selection of food. "-Flint. It is also advisable that the meals should be taken at regular intervals, and in most cases it will be found more agreeable for the patient to take food at least four or five times a day, including a light supper shortly before retiring. It follows, of course, that if food be so frequently taken, the quantity should be proportionately less at each meal. It is a general principle, that in dyspepsia the appetite is not a reliable guide as to the quantity of food required ; for, in many instances, there is a craving for more food than can be digested. The most readily digested articles are, among meats, beef, mutton, chicken, turkey ; roast, stewed or steamed oysters - not raw nor fried. Young vegetables generally are desirable. As to the use of spirits, certain care must be exercised, though it will generally be found beneficial to take an ounce or two of claret, or other light wine, with the meals. Tea and coffee, especially the latter, are best avoided, unless the patient has become inseparably attached to their use ; even in this case the quantity may usually be diminished. Yet it may never be forgotten that the object in diet ing a dyspeptic patient is not to have him live upon just as little food as will support life, but simply to give him such food and at such times that he can readily digest it. Hence underfeeding is to be avoided as carefully as overfeeding. Another important object in the treatment of dyspepsia is to provide for proper exercise in the open air. On this point, too, the general impression and the usual practice of dyspeptics is incorrect and injurious. An individual who finds himself dyspeptic usually ascribes the affection to overeating, and endeavors to counteract the effect by indulging in unusual and violent exercise. He begins to take long walks, to exercise with the health-lift, or per haps indulge in still more laborious exercise. This is carrying matters to an extreme, which is doubtless more injurious than even a complete abstinence from exercise. 'This is especially so if, as so often happens, the patient, while performing this increased amount of work, diminishes at the same time the amount of food taken. Certainly, exercise in the open air is desirable for a dyspeptic patient as well as for other individuals. It tends to recruit the system and to improve the general health ; but such exercise should never be carried to exhaustion. One of the most valuable restorative means in dyspepsia, as in other chronic complaints, is a change of scenery and of employ ment. It may not be necessary to take a formal vacation and a long journey, since the same benefits may accrue from relaxation and amusement. Much good may accrue, also, from the moral treatment of patients by securing the sympathy and confidence of the sufferer. It is doubtless true that many dyspeptics, especially those who have suffered long, indulge in many imaginary complaints and conjure up many symptoms and fears which have no foundation in fact or experience. The tendency among the friends, and even on the part of the physician, is, therefore, to ignore or even to ridicule the complaints of the patient, and to make light even of those symptoms which are genuine evidences of the disease. The patient need not be humored in all his vagaries, but can be instructed that his mental state is largely due to the disordered condition of his body. By securing his confidence, we may not only divert his attention from many needless fears, but may also secure a hearty co-operation in the measures recommended for his relief. It has been observed that when dyspeptic individuals dine alone, they are very prone to employ themselves in watching minutely all the sen sations connected with the process of digestion, and to interpret as unfavorable as possible the slightest indication of unhealthy action. By keeping the mind pleasantly occupied during digestion, as well as other times, the patient is rendered less morose, and positive good is accomplished in the treatment of the disease. The use of drugs, although perhaps the least important part in the treatment of dyspepsia, is nevertheless a matter of some con sequence. For much may be done to relieve some of the most distressing symptoms of this affection. The distension of the stomach with gas can often be at once relieved by the administra tion of charcoal, either in powder or in the shape of wafers pre pared for that purpose. This effect may also be induced or assisted by the oil of cajeput, two or three drops of which may be dropped upon a small lump of sugar and swallowed. This is especially useful if the distension of the stomach be accompanied with pain, as is so often the case. Instead of the cajeput, the following mixture may be given : Bicarbonate of sodium, - One drachm. Compound spirits of lavender, - - One ounce. Spirits of camphor, - Two drachms. Aromatic syrup of rhubarb - - Half ounce. Peppermint water, - Enough to make four ounces. Take a teaspoonful every half hour until relieved. A domestic remedy much used for the same purpose is the familiar Jamaica ginger. But first, if you want to come back to this web site again, just add it to your bookmarks or favorites now! Then you'll find it easy! 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