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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    stage may be acquired, or its unpleasant physiological effects that are brought about may be such that its employment would have to be discontinued. The hy- podermic administration of atropine has been suggested by Riegel, but its use by mouth is sufficient for all practical pur- poses. The tablets or pills of extract of belladonna, 0.016 (% grain), or atropine sulphate, 0.00065 (1/100 grain), may be given after meals, or these may be added to any of the foregoing alkaline combina- tions, or given in the following: B Ext. belladonnas 0.32 gr.v Bismuthi subcarbonatis ....15.0 3iv Fiat tablets or powders no. xx. Sig.: Take one before meals. (And possibly one of the antacid mixtures mentioned above after.) The bismuth salts, calcined magnesia and cerium oxalate have a mechanical sedative effect on the mucosa. Bismuth subcarbonate, being a better antacid than the subnitrate, is the most serviceable, and combinations have been mentioned. The following of Stockton’s is helpful: B Cerii oxalis 1 part or 10.0 Bismuthi subcarbonatis 2 parts or 20.0 Magnesii carbonatis ..4 parts or 40.0 Fiat pulv. et Sig.: Take one-half a teaspoon- ful every four hours. Nux vomica in ascending doses has been strongly recommended by Musser in hyperchlorhydria due to a sensory neurosis. This author claimed uniformly good results from its use. Other bitter tonics are to be avoided. Nerve sedatives, like the bromides, valerianates and sumbul, are the most valuable of all drugs to control the symp- toms of hyperesthesia. It must be re- membered that gastric hyperesthesia is commonly present in these cases, and the symptoms of this are most pronounced when irritation from free hydrochloric acid takes place. A prescription to be recommended is the following: R Sodium bromidum Tinctura valeriana Ext. sumbul fl a.a. 15 0 3iv Syr simplex q.s. 90.0 3iij . *iat et Sig.: Take a teaspoonful after meals in water. Olive oil and other forms of hydrocar- bons have been highly recommended. Cohnheim has written much and always highly advises the use of olive-oil. The plan of this author is to administer 100 or 200 cubic centimeters of olive-oil (through a stomach-tube) each morning, or it may be given in smaller quantities before meals. The oil coats the interior of the stomach and inhibits the secretion of acid. As a general routine of prac- tice in hyperacidity, this treatment is not satisfactory. Many patients object to the use of the tube, and others again are nauseated by taking the olive-oil in such quantities before meals. Still, when it is easily taken it may be used, because it may be efficient in the desired way, is a good reconstructive to undernourished patients, and may keep the bowels regu- lar. However, no addition of salt to the olive-oil to make it more palatable should be allowed, and it should not be used in cases of fat intolerance or those who com- plain of headache and eye symptoms after its use. While not so much benefit in controlling acidity comes from the plan of taking fats with the meals, still the heavy indulgence of the more palatable forms (butter, cream, or milk) often serves to good purpose in these cases. A morning dose of Carlsbad salts in a glass of warm water is an excellent practice in cases of very high acidity or hypersecretion. This salt possesses the double value of neutralizing the acidity present and moving the bowels, and when given well diluted in water it acts as an internal lavage of the stomach. The Carlsbad salts can also be used in small doses at meal-time, the dose being about 1 gram (15 grains) in vichy after the meals. In all cases of hyperacidity or hypersecretion of a chronic nature, search for cause must be made and if after six months’ steady observation the condition persists, one of two decisions are in order, namely, the long persistency of medical treatment to afford subjective relief, or surgery. Among the surgical conditions that may be present can be mentioned gastric ulcer, gall, kidney or pancreatic stones, chronic appendicitis and peritoneal adhesions.