The health question box

Regurgitation of Food Q. What causes the regurgitation of food? A. Regurgitation of food is in most cases probably due to permanent or temporary ob­struction of the outlet of the stomach. The pylorus may be permanently obstructed by can­cer or other growth, or it may be temporarily ob­structed by contraction. The last named con­dition is the most frequent cause of regurgita­tion. When the outlet of the stomach is obstructed by some organic change, such as ulcer, cancer or compression by bands due to inflammation, relief may be obtained by operation. Spasm of the pylorus is most frequently produced by hy­peracidity, which may generally be relieved by regulation of the diet. The foods should be soft, not in a liquid state; that is, in the form of pu­rees. The food should be swallowed after slight mastication only, and one or two tablespoonfuls of olive oil should be taken at each meal. Care should be taken to have the bowels move three or four times a day . The bile and panc...

Pain in the Stomach Q. What is the best method of securing relief from acute pain in the stomach? A. Apply hot fomentations over the seat of pain. A large drink of-hot water will frequently stop the pain at once. Cramp in the stomach may usually be relieved in the same way. Pain in the stomach may often be relieved by a general hot bath when other measures fail. The temper­ature of the water should be increased after the patient enters the bath, as hot as can be borne, say 110°or 112° F. In many cases it is well to drink a couple of glasses of hot water. The temperature of the water should be as hot as can be swallowed with­ out inconvenience.

Movements of the Stomach Q. What are the movements of the stom­ach? A. The cardiac portion of the stomach is not subject to regular movements during digestion. It remains quiescent, a fact which permits of the orderly stratification of the foodstuffs, the last portions eaten entering the center of the glob­ular mass which is formed in the cul-de-sac. Peptic digestion goes on at the surface of the mass, while the salivary digestion proceeds in the center and may continue for two or three hours from the beginning of the meal. As fast as the food is liquefied at the center of the alimentary mass it goes through the pylorus where it is mixed with the pyloric secretion containing pepsin, which begins its work in the stomach and continues in the intestine. The movements of the stomach are not confined to the pylorus. Infrequent rhythmical movements occur in the pre-pyloric portion, but the pyloric portion contracts regularly every ten seconds during digestion, making 2500 to 3000 ...

Diet in Hyperacidity Q. Please outline a diet that will remedy this condition. A. Both liquid foods and dry foods should be avoided. Everything should be taken in the form of a puree. The food should be chewed very little. Chewing stimulates the stomach and pro­duces an excessive amount of appetite juice which is highly acid. Wholesome fats, such as sterilized butter, cream and vegetable fats should be freely used. One or two teaspoonfuls of olive oil should be taken just before each meal. The administration of liberal quantities of pure gluten one or two hours after eating is an ex­cellent remedy. The gluten absorbs the acid as effectively as does soda, and has this advantage, that it does not in any way injure the stomach. The bowels should be made to act three or four times a day, but laxatives must be avoided, as these irritate the stomach and the small intestine.

Hyperacidity Q. What are the causes of excessive acidity of the stomach? A. The immediate cause of excessive acidity of the stomach is generally an excessive for­mation of hydrochloric acid. There may be sev­ eral causes for this. Probably the most common cause is an inactive state of the bowels, or chronic autointoxication. Poisons formed in the intestine and absorbed, being excreted into the stomach, over-excite the gastric glands. Another cause is hasty eating, in consequence of which food is re­ tained for too long a time in the stomach, giving rise to excessive irritation of the mucous mem­ brane. The free use of meat is perhaps the most im­ portant of all the cause which can be mentioned. The soluble substances of the meat, which give to it its peculiar flavor, are most powerful stim ulants of the gastnc glands . Pawlow showed that the gastric juice produ c ed by eating meat is much more acid than that produced by bread, milk and other food substances. Copious drink...

Gastric Examination Q. How can one determine whether he has an excess of hydrochloric acid or a deficiency? A. The presence of an excess or deficiency of hydrochloric acid in the gastric juice can be determined only by taking a test meal and hav­ing an analysis made by a competent chemist. In general, however, it may be said that acidity occurring within two or three hours after a meal is the result of an excess of acid in the gastric juice and not of fermentation.

Gastric Juice Q. How is the gastric juice produced? A. Gastric juice is a special fluid produced by certain glands of the stomach. Each food generates its own gastric juice. Pawlow has shown that each natural food con­tains subtle elements which act upon the nerves with which they come in contact in such a way as to cause the digestive glands to secrete fluids exactly adapted to the digestion of the particular food in question. This action is due in part to the flavoring substances of food, and in part to little-known substances that are known as pepto­gens. The gastric juice produced by different food substances varies greatly in both quality and quantity. Milk produces the least active digestive fluid. Meat produces a strongly acid digestive fluid. Bread produces during a long period a moderately acid but highly active gastric juic e. Represented numerically, the digestive value of the juice produced by the substances named, according to Paw low, stands as fol...

Peristalsis Q. What is peristalsis? A. By peristalsis is meant the movements of the intestines by which the food is moved along and reduced, and wastes discharged from the body.

The Pancreatic Juice Q. By what means may the pancreatic secretion be increased? A. An increase of acids in the food, increases the quantity of the pancreatic secretion. Fats are a very positive stimulant of the secretion. The quality of the pancreatic juice is also influenced by the food. On this account persons suffering from achylia should make free use of acid fruits.

The Pancreas Q . What is the function of the pancreas? A. The pancreas is a gland, the most com­plicated gland in the body; in fact it is a sort of double gland. It has two separate and distinct structures which are closely interwoven. One of these produces an internal secretion which aids the muscles in burning up sugar which furnishes energy for work and to maintain the body tem­perature. This is the so-called internal secretion of the pancreas. The pancreas also has an ex­ternal secretion, pancreatic juice, which contains six ferments, various important activators, and alkali in the form of bicarbonates. The alkaline secretion of the pancreas is re­ ciprocal to the acid secretion of the stomach.

Sour Stomach Q. Is soda a good thing to take for sour stomach? A. It is better to take the soda than to have the sour stomach, but the continuous use of soda is damaging. The cause of the sour stomach should be found and removed. Constipation and intestinal toxemia are practically always present in cases of this sort and are probably the leading causes.

Hypopepsia Q. What is the cause of hypopepsia? A. Failure of the stomach to make gastric juice may result from an impoverished state of the blood and depreciation of the general bodily forces; or it may be the result of inflammation, or of cancer or some other form of degeneration. Hyperacidity in w hich there is an excessive secretion of gastric juice, is generally followed in time by hypopepsia, or apepsia through ex­ haustion of the gastric glands. An overworked organ is almost certain to undergo degeneration sooner or later.

Use of Stomach Tube Q. How frequently can the stomach tube be used without injury? A. In some cases the stomach tube may be used daily or even oftener, but in general the frequent use of the stomach tube should be avoided, if possible. If necessary to use the tube daily for a short time, say a week or two, the intervals should be greatly increased, until finally discontinued.

Abnormal Appetite Q . What is the meaning of a craving to eat abnormally at meal time and between meals? A. An abnormal condition of the sympa­thetic nervous system controlling the stomach. If care is taken to thoroughly masticate the food, this difficulty will probably disappear.

Heaviness of the Stomach Q. What is the best means of relieving heaviness in the stomach? A. Persons who suffer from heaviness after eating should lie down and r e st for three ­ quarters of an hour or an hour after eating. It is a good plan to place a hot water bag over the stomach and to practice deep breathing.

The Functions of Hydrochloric Acid Q. Of what use is hydrochloric acid in the stomach? A. Hydrochloric acid serves a great variety of useful purposes in the process of digestion. Laboratory experiments have shown that the acid of the stomach,- 1. Converts the protein into peptone. 2. Stimulates the secretion of the gastric fer ments. 3. Activates the gastric ferments. 4. Opens the pylorus. 5. Closes the pylorus, after entering the duodenum. 6. Disinfects the stomach. 7. Aids the development of secretin which stimulates the activity of the pancreas and the liver. 8. Stimulates the flow of bile. In the absence of hydrochloric acid, pepsinogen is formed and may be activated by the organic acids produced by bacteria or by the acid salts of the food. 9. Activates the pancreatic juice. The various organic acids activate pepsin, but hydrochloric acid is superior to all the others as a zymo-excitor. The reason for this is not un­ derstood .

Remedy for Achylia Q. What remedy would you suggest for the condition known as achylia? A. This is an exceedingly important question. The munber of persons suffering from achylia, a condition in which the stomach makes no gastric acid and often no pepsin, is becoming increasingly common. This condition often precedes cancer of the stomach, the occurrence of which is rapidly growing in frequency. A person suffering from achylia is much more likely to suffer from typhoid fever, cholera, and other infectious disorders of the alimentary canal than a person whose stom­ ach provides the normal supply of acid gastric juice, for the reason that the acid of the gastric juice owes its acidity to hydrochloric acid, a substance possessed of very active disinfectant or germicidal properties. There are three important things which persons suffering from achylia may do to obviate the several dangers that are mentioned above. These are, first, to adopt a strict anti-toxic diet, which means...

Achylia Q. What is achylia? A. Achylia denotes a condition in which the stomach glands have ceased to produce gastric juice. The gastric acid is necessary for the digestion of connective tissue and gluten. Gastric acid also regulates the closing and opening of the pylorus. When absent, the pylorus remains open and the food passes out of the stomach quickly. This is the explanation of those cases of diarrhoea in which food is passed undigested soon after it is eaten, often within an hour or two. Achylia is usually the result of long continued over-stimulation of the stomach. It is most com mon in persons who have made free use of tea or coffee, condiments, or alcoholic beverages, or who have been large meat eaters. Achylia fol­ lows chronic gastritis. There are two forms of achylia : (a) Achylia of nervous origin in which the ad­ministration of hydrochloric acid in large quant­ ities is followed by a secretion of pepsin. (b) Achylia accompanying organic disease o...

Gastro-enterostomy Q. What is the operation known as gastro­enterostomy? A. In this operation a loop of the intestine is attached to the stomach and an opening made be tween the stomach and the intestine so that food can pass from the stomach into the small intes­ tine without passing through the pylorus or duodenum. This operation is rarely indicated except in cases in which the plyorus has become obstructed by an ulcer, cancerous growth, or some other cause. The operation is sometimes performed for relief in cases of ulcer of the duodenum.

Ulcers of the Stomach Q. Are ulcers of the stomach and duodenum curable? A. That ulcers of the stomach and duodenum are curable is clearly shown by the fact that scars left by healed ulcers are often found in the stomach and duodenum after death . Numer­ ous cases are on record also in which patients who have suffered from severe gastric ulcer have recovered permanently. Without doubt the ma­ jority of cases are curable by the application of proper means. In general the measures which are of essential service are the following: 1. The patient must rest in bed or in a horizontal position from one to three weeks. 2. All food should be withdrawn for two or three days, sometimes even longer when severe hemorrhages have occurred. 3. If the secretion of acid continues although food is not given as shown by pain or other symptoms indicative of the presence of acid, car­bonate of soda should be given in sufficient quantity to neutralize the acid. When the acid is completely neut...