A large proportion of the disturbances of the stomach and intestines relates to digestion. In every attack of indigestion the processes involved in the changes which the food undergoes before absorption, are not only retarded, but also accompanied by numerous local and general difficulties. Indigestion, or as termed by some authors dyspepsia, was formerly supposed to be a purely functional affection, existing without any morbid changes in the gastric mucous membrane. This theory is not generally accepted et the present time.

The name indigestion as herein used does not apply to disorders incident to fevers, inflammatory affections, or structural diseases of the digestive organs.

Causation

The influences which induce this disease may act directly or indirectly. Food if irregularly given in excess or of an unwholesome quality, too long fasts, and weakness of the digestive organs following inflammations are among the direct causes.

The indirect agencies involved are far more numerous. Want of sufficient exercise, over exertion, poverty of the blood, and disarrangements of the system are among the more prominent causes.

Symptoms

Probably the most constant sign of indigestion is impairment of the appetite, which is at least capricious if not entirely absent.

The food taken into the stomach digests very slowly, and gases are generated, producing distension or bloating. Vomiting occurs; masses of mucus and food are rejected in a more or less altered condition.

The matters vomited are occasionally mixed with bile, which is an unfavorable complication, as its presence in the stomach additionally disturbs digestion. The appearance of streaks of blood at times has no significance whatever. In an attack of indigestion, changes occur in the digestive tract both above and below the stomach. The former are shown by thirst, a coated tongue, hot nose, increased salivary secretion, and a foul breath. Below the stomach, associated disorders are manifested by constipation or diarrhoea, abdominal distension, and colic.

The animal is often dull, listless, and depressed in his manner, and in severe cases fever in a certain degree, is present.

Treatment

In some attacks of indigestion a regulated diet suffices to control the disturbance. When the disease is of a more severe nature, the stomach must be favored as much as possible, and only the simplest and most easily digested articles of food given.

In commencing treatment it is desirable to remove any portions of food, retained in the stomach and fermented, the presence of which keeps up the irritation of the gastric mucous membrane. This can be done by emetics or laxatives. If persistent vomiting has existed, naturally emetics are contra-indicated; the same with laxatives if diarrhoea is present, unless the discharges are very offensive in character, in which instance a cathartic need not be withheld, but would rather be indicated to remove the exciting cause evidently still acting. The wine of ipecac is recommended as an emetic, two teaspoonfuls of which should be given as the first dose, followed by one teaspoonful every ten minutes until vomiting occurs.

From its peculiar action in neutralizing the abnormal quantity of acid in the stomach, calcined magnesia is the better laxative to employ, and one teaspoonful should be given in milk.

After the stomach has been emptied of its irritating contents, the greatest care should be exercised in feeding, and only the simplest and most easily digested articles of food chosen. In the severest cases, nourishment should be given every two or three hours. No better diet can be advised than scraped raw beef, raw eggs, and a little gelatine mixed together, and given in tablespoonful quantites. As the stomach grows stronger the diet may be varied by giving milk and lime water, bread and milk, beef tea, meat stews well cooked, flavored with a little onion and thickened with rice, corn, or oatmeal, the animal allowed to eat of the meat chopped fine. It must be remembered that the liability to vomit is increased in proportion to the amount of food taken into the stomach.

In the use of medicines in indigestion, the peculiarities of the animal must be understood, and experimental treatment as in feeding may be necessary.

The writer submits a variety of drugs and combinations applicable to the different indications and phases of the disease; if the use of one proves unsuccessful another should be substituted.

In cases of vomiting, from five to ten grains of the subnitrate of bismuth should be placed on the tongue, and washed down with a tablespoonful of milk before nourishment is taken.

With the food should be mingled either of the following agents - French pepsin three to five grains, the saccharated pepsin five grains, one peptonic pill, or five grains of lactopeptine. When pure pepsin can be secured it is undoubtedly the most admirable agent which can be used to assist digestion.

It must be remembered however, that during the past few years the quality has sadly degenerated, and rarely can a reliable preparation be obtained. The saccharated is many times inert, and even the French pepsin the most expensive form, will often be found inactive. The pill peptonic and lactopeptine are more recent preparations, and will probably for a time at least prove reliable.

As the disease is in a measure controlled, and the need of such frequent feeding and dosing is no longer manifested, the number of meals can be lessened to three, continued for a time, and then restricted to two. The tonics which may be advantageously used are many; among them the elixir bark pepsin and bismuth, the elixir calisaya iron and bismuth, of either a teaspoonful before eating. The chlorate potassa is sometimes efficaciously employed and combined as follows. -

℞ Elixir Calisaya Ferri et Bismuth. ij Potass. Chloratis ℥ ij.

Aquas ad. ℥ iv.

Ft. Mist. Sig. Dose one teaspoonful before eating.

Strychnine is a useful agent and may be given with pepsin and bismuth as follows. -

℞ Pepsini Sacch. ℥ iss.

Bismuth. Subnitratis ℥ iss Strychniae gr. ss.

Ft. Pil. No. xxx. Sig. Dose one, three times daily before eating.

Where constipation exists with gaseous distension, the following is a useful preparation. -

℞ Sodae Bicarb. Pulv. Rhei Sacch. Pepsini Pulv. Zingiberis Bismuth. Subnitratis Pulv. Cubebae aa ℥ iij.

Ft. Pulv. Sig. Dose from one third to one half a teaspoonful after eating, in milk.

At times in cases of indigestion, it will be observed that the discharges from the bowels are clay-colored, an evidence of liver derangements or closure of the passage from the gall-bladder to the intestines. No especial medication for this condition is demanded unless constipation co-exists, in which case it will be well to employ a tonic, with which a laxative having a direct action on the liver is combined, as in the following. -

℞ Quiniae Bisulph. ℥ ss.

Ferrl Sulph. Exsic. ℥ ss Acid Arseniosi gr.ss.

Ext. Taraxaci ℥ i.

Ft. Pil. No. xxx. Big. Dose one, two or three times daily before feeding.

The diarrhoea which sometimes accompanies indigestion calls for no especial treatment, unless evident pain attends the discharges, in which case a teaspoonful of paregoric given occasionally as demanded, will prove sufficient.

Recovery from severe cases of indigestion may be slow and tedious, but the result of patience and judicious treatment in the end, well repays the effort and waiting.