Etiology

Nervous derangements of the stomach may be divided into three classes: (1) Motor, (2) Secretory, and (3) Sensory Neurosis. These are the distinctions given by some of our best authorities, but certainly are distinctions without very much difference, because one type runs into another, and there is always a reason for an organ developing a condition of neurosis.

A nervous dyspepsia may be found in all types, from those who are quite stout--those who carry more than a normal amount of flesh--to those who are emaciated; indeed, some cases become skeleton-like and at the same time have more desire for food than those who carry more flesh. Many very healthy-looking people will have a neurosis of the stomach. An hour before meal-time there will be a feeling of discomfort, which food relieves. The layman usually jumps to the conclusion that it is a hunger pain, which should be relieved by taking food. The more it is relieved, however, the more it must be relieved and the oftener the symptoms will present themselves. The cause of this primary condition is rapid eating, overeating, using alcoholics, tobacco, and drugs of various kinds. This condition is also brought about by overworked emotions--jealousy, envy, spite, and anger.

Again, this condition may be brought on by exhausting the nerve energy in seeking pleasure--wearing out the nervous system enjoying, so to speak. Instead of taking a moderate amount of pleasure in going to the theater or picture shows, dancing, etc., the nerve energy is worn out taking these pleasures in excess. These symptoms are often covered by the blanket term "neurasthenia," but there is no more reason for labeling these patients neurasthenics than there formerly was for calling them hysterical or hypochondriacal. This nervous state cannot exist without a cause, and the causes are as enumerated above, Patients of a very imaginative turn of mind, and others who are idealistic, take their little ailments too seriously, and build upon them, making them larger than they are. The idealist thinks that people should have perfect health; because he happens to feel uncomfortable, he becomes introspective, and soon he is making mountains out of mole-hills.

Nearly all uterine diseases have a certain reflex influence on the stomach. Many cases of stomach neurosis can be traced to painful menstruation, catarrhal inflammation of the neck and body of the womb, misplacements of the womb, or acute and chronic inflammations of the ovaries.

Symptoms

Many of these patients will complain of acid eructations--belching of acid fluids-and gases. These attacks of acid eructation follow each other day after day, and, as the disease becomes better established, the inconvenience from these symptoms lasts longer. Patients who at first have experienced simply a little eructation of sour fluids in the throat an hour or two or three after eating, will in time develop such a nervous state that sleep will be disturbed, and perhaps vomiting will be produced.

Many cases of this disorder will manifest as periodic headache. Migraine rests upon this kind of basis; for it is purely a nervous disease, and is one symptom of nervous dyspepsia. Quite a large percentage of patients with this disease are troubled with gas soon after eating, which they expel from the stomach frequently. As the disease grows more chronic, intestinal indigestion joins with the stomach indigestion, and the bowels fill with gas. Enlargement of the stomach results after months and years of indiscreet eating; rapid eating--neglect of thorough mastication. When the stomach and intestine are very greatly distended, the diaphragm is pressed upon and the heart action is interfered with. This can be pushed to such an extent that even kidney trouble will develop. An overworked heart from this cause will soon be accompanied by albuminous urine.

Nervous vomiting of spitting-out of food is common. An hour or two after a meal the patient will eructate a mouthful of partially digested food, which he will spit out. This condition may develop to such an extent that a certain percentage of these patients spit out everything they eat before the next meal-time, and they become more and more emaciated. Others find it difficult to go through the digestive act without vomiting once or twice, getting rid of the previous meal. It such patients could understand the "modus operandi" of their condition, they could save themselves great discomfort by eating one-half or one-third the amount to which they are accustomed, and soon evolve into first-class health. But too often they attribute their disagreeable symptoms to a disease of the stomach--a real entity, so to speak; when in reality overeating and eating wrong combinations are the source. Often physicians will treat patients according to this idea, and it is no wonder that such cases never recover. Nearly all the symptoms named for every other disease of the stomach may be found in this disease. The truth of the matter is that nomenclature is rather superfluous; and that is not the worst part of it; unfortunately it is confusing. It has a tendency to make laymen and young physicians really believe that, when a name is given to a disease, the cause is understood. Nothing, however, could be more erroneous than this conclusion; for ordinary diagnosing throws no light on the real cause.

Treatment

It should be obvious to anyone who has studied the symptoms that this disease cannot be treated in a cut-and-dried fashion. The real cause must be discovered and corrected. If the disease is produced by reflex irritations--irritation from the uterus, or reflex irritation from fibroid or ovarian tumor; or it is the result of over-worked emotions, or any of the causes set forth under the head of etiology and symptomatology, such condition must be sought out and corrected. But the disease will return if the patient returns to former habits. In cases of disagreeable acid eructations, temporary relief may be had by taking a little bicarbonate of soda. The most reliable relief, however, is to find one's limitations in regard to the amount of food that can be taken and digested, and then confine the eating within those limitations. This will give full relief until the disease on which the reflex irritation depends can be corrected. Indeed, the majority of people suffering from stomach derangement cause themselves a great deal of unnecessary suffering from imprudent eating. The neurotic state is brought on from whatever exhausts the nerve energy and produces reflex irritation of the stomach; but no particular suffering will be experienced until more work is put upon the stomach than it can take care of. When this is persisted in, patients will suffer very greatly from discomfort as well as from perverted nutrition.