Etiology

Anything that will irritate the stomach may be a cause: overeating; eating improper food; improper combinations; swallowing chemicals of any kind, accidentally or with suicidal intent.

Symptoms

As a rule, an attack is brought on from imprudence in eating. Fermentation takes place, with so much irritation that the food is expelled by vomiting. The patient complains of pain and nausea; the tongue is coated, the breath is bad, and vomiting is severe. The thirst is great. If satisfied, the vomiting increases until a small amount of water will not stay on the stomach any length of time before it is rejected. When the vomiting is severe, the thirst is very great. There is a little fever-seldom above 102° F. Sometimes there are diarrhea and pain like colic. The duration of the attack will not be longer than twenty-four hours, if the patient is treated properly from the start.

Treatment

Stop drinking entirely, or taking anything into the stomach. Nothing is to go into the stomach until the nausea and vomiting are all gone. The bowels should be washed out by an enema. If the symptoms are very severe, enemas may be used three times the first day. If the nausea is gone within six to twelve hours, then all the water that the patient wants may be taken, beginning with a few sips at a time, and increasing as desired. If the nausea is severe and thirst is great, water should not be taken by mouth, but a cup of water may be put into the bowels with a fountain syringe and allowed to remain. This may be repeated frequently enough to satisfy the thirst, In cases which have been abused by feeding and water-drinking the vomiting may be so severe as to bring on congestion and a trace of blood in the ejected fluid.

Within twenty-four hours after the patient is able to take water without nausea, feeding may begin; but it should be buttermilk, or fruit if the fruit is thoroughly masticated. If the fruit and buttermilk are tolerated, the second day buttermilk may be given in the morning; lamb broth with grapefruit, or any fresh fruit or combination vegetable salad, at noon; and fresh fruit in the evening. The third day the same breakfast; meat at noon, with cooked, nonstarchy vegetables, and a salad; in the evening, toasted bread and butter, followed with an apple. After this the patient may be given his freedom.