The treatment of sthenic conditions of the stomach : namely, hyperesthesia, hyperchlorhydria, and hypermotility / by Anthony Bassler.

  • Bassler, Anthony, 1874-
Date:
[between 1910 and 1919]
Catalogue details

Licence: In copyright

Credit: The treatment of sthenic conditions of the stomach : namely, hyperesthesia, hyperchlorhydria, and hypermotility / by Anthony Bassler. 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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    constipation exists: Tinctura rhei Tinctura valerian* a.a. 10.0 3iiss Fiat et Sig.: Take twenty drops after meals in water. As supplements to the treatment, hy- gienic and hydropathic measures, cold compresses to the abdomen to relieve the distress, galvanism, occasionally the use of nux vomica in moderate-sized doses, and those for hyperchlorhydria and hy- permotility are indicated. Hyperchlorhydria: The most impor- tant part of this treatment is the dietetic. The all-important plan of the diet is that the foods, in character, form or quantity, should produce as little irritation to the glandularis of the stomach as possible. The main reasons for this are, that the hyperesthesia of the stomach must be controlled as much as possible, and foods sufficient to maintain equilibrium, and if necessary cause an addition in nutrition be employed. The factor of combining the free acidity is really of secondary im- portance, only of value in the way of causing relief for the time being, and is an unwise plan of treatment to put in practice for all cases. The reason for the latter is that the stomach of hyperacidity is most sensitive in response to all stimu- lation, and the dietetic one of persistently maintained high proteid foods is liable to perpetuate the condition (adaptation juice of Pawlow) unless the condition is sec- ondary to some devitalized state of the general body or functional disturbance in the general neurological system. Still, on the other hand, these foods in the fluid form and simple character are the best to use for a time in the beginning of treatment, because in that way the ele- ment of hyperesthesia is minimized, the subjective symptoms are controlled, most of them are naturally in fluid or semi- fluid forms (thus handy), and are of high caloric values in small bulks. But, at the point at which subjective symptoms are controlled, the proteid elements should gradually be withdrawn, the ultimate ob- ject being that the diet after that should be mainly carbohydrate in nature. This latter type of diet must be continued for a length of time and test-meal analyses are called for to note that the acidity does not run down too far, or to arrive at the point at which the lowest continuous level that may be possible is achieved. Should it be found that the acidity becomes too low, such foods as the animal proteids can be gradually added until normal se- cretion is stimulated. But if it is noted that the acidity is normal or still rather high, the vegetable and fish-food diet must be continued indefinitely. The die- tetic treatment in cases of persistent hy- peracidity should continue for from three months to a year, the length of time in the average case being three months. In continuous hypersecretion the treatment should be continued longer and the num- ber of cases that eventually are given the meat proteids much fewer. The plan of diet that I ordinarily persist with up to a month in the beginning of treatment is the following: “This diet is a temporary one, and is to be continued until a change is made. The plan of the diet is not to partake of any solid foods whatsoever, and to take the foods that are suggested at regular inter- vals of three or four hours during the day, attention being paid that a strict regularity is preserved, and that the foods are divided up in character and amounts rather evenly for each time. A glass of plain fresh milk and perhaps a few crack- ers should be taken before retiring, and if there is distress in the stomach an extra glass of milk during the night. The diet consists essentially of only four foods, namely, eggs, fresh milk and cream, well- cooked cereals and bread or crackers, and nothing else in the food or fluid line (ex- cepting plain water) should be taken. The eggs may be eaten raw or cooked in any form, or may be taken in the milk. The milk may be warmed if desirable, but should not be taken too hot or too cold. The ‘ten minute’ modern break- fast foods should not be employed, and the old-fashioned forms of well-cooked oatmeal, ground corn, farina, rice, tapioca or sago are the, best. To these a little sugar, but as little salt as possible may be added. The bread should not be too fresh (one day old), any of the sweetened