The treatment of gastro-hepatic dyspepsia at Vichy, Carlsbad, and Cheltenham / by Gustave Monod.

  • Monod, Gustave.
Date:
1912
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Licence: In copyright

Credit: The treatment of gastro-hepatic dyspepsia at Vichy, Carlsbad, and Cheltenham / by Gustave Monod. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    it may well give the impression of poverty. I laid stress just now on clinical aspects, to which my remarks will be restricted, and in doing so I desire to disclaim all attempt at originality. The foundations of Vichy practice were well and truly laid fifty years ago. They are immovable. Additions may be suggested, fresh explanations offered, but the main structure, consolidated by clinical observation, must ever remain unshaken. It is not too much to say that upon the work of the great Vichy masters—Claude Fouet (1686), J. F. Chomel (1734), Charles Petit (1842), and Max Durand-Fardel (1851)—all subsequent writers have based their observations ; though in their pamphlets there is evidence of undue haste in the omission of tables of references. In this connexion even the authors of that excellent and original work “ Clinique hydrologique ” cannot escape from reproach. But they, at any rate, understand clearly that the reactions taking place in the living stomach differ radically from those of the test-tube, and that neither the classifi- cation nor the treatment of dyspepsia can be placed upon a purely chemical basis. Following the classification of Mathieu, they divide primary dyspepsias into three principal types. For each of these types Vichy offers resources, which while meriting the attention of the pro- fession as a whole, should be studied with the closest care by physicians whose opinions are sought when thermal and other methods are to be weighed against each other in the balance. For the physician should be able to reply to these two questions : What will be the nature of the treatment adopted; what the ultimate result to the patient ? Let ns then take three patients affected by gastric disorders of common type :— (1) The first one states that ingestion of food is always followed by painful sensations. After a few mouthfuls his stomach is distended, his face flushes, and he becomes sleepy, but in an hour or two all is well again. If you examine him at the height of the attack you may be surprised to find how scanty are the physical signs. Analysis of the gastric juice discloses hypochlorhydria—less commonly hyperchlorhydria. Such is the clinical picture described by Mathieu as sensory motor. Patients of this category are suffering from overwork of the stomach, from excessive feeding, or, often, from abuse of digestive drugs. One of our Vichy springs, Hopital, taken in small doses, meets both these indications of the case—stimulation of the motor power of the organ, and sedation for the over-sensitive mucosa. Add to that a few baths of indifferent temperature, and you have a sufficient idea of the treatment to which your patient will be subjected. He will return to your care if