Pain

As a rule intense pains are absent. There is a mere sensation of discomfort and sensitiveness in the gastric region, which may increase after meals, more especially after ingestion of coarse food.

Pyrosis

The patient may experience a burning sensation at the pit of the stomach. In this instance a sour liquid, alone or mixed with food, often comes up through the oesophagus into the mouth (regurgitation).

Vomiting

Vomiting is not of very frequent occurreuce in gastric catarrh. It is met with most frequently after the morning meal or in the morning on arising. In the latter instance the quantity ejected is quite small, and consists of a watery fluid containing principally mucus. A feeling of nausea is more frequently observed.

Condition Of The Bowels

The bowels are frequently found abnormal: either they are very constipated, which is quite the rule, or there may exist diarrhoea, or again periods of diarrhoea may alternate with periods of constipation.

Urine

The urine is scanty, and frequently contains deposits of phosphates and urates.

General Symptoms

The patients feel languid and manifest less energy in the performance of their work. Their mental activity is frequently weakened. They often complain of headache, especially in the morning, and a heavy feeling in the limbs. A desire to yawn is often met with, and some patients assert that they cannot breathe as deeply as they desire. In some instances the flow of saliva is greatly increased. Sometimes patients experience a constant irritating feeling in the throat, which they seek to relieve by a kind of hacking cough.

Objective Signs

The general appearance of the patient is, as a rule, quite good. He looks well nourished, and usually possesses a good panniculus adiposus. Some patients, however, show black rings around their eyes, notwithstanding their being well nourished. Under these circumstances they frequently have cold hands and feet, and chill very easily. There are. however, exceptions to this rule, and patients are sometimes observed who have lost considerably in weight and appear quite emaciated and thin.

The tongue is, as a rule, covered with a fairly thick, grayish, and moist coating. The margins of the tongue show the indentations of the teeth. Either there is no offensive smell present in the mouth or, if it exists, it is due to some imperfection in the condition of the teeth, nose, or throat.

The gastric region often appears bloated. On palpation it is found to be sensitive to pressure, although there is no real pain. The splashing sound can be easily produced when the stomach contains some liquid. The size of the organ is, as a rule, not increased.

The gastric contents; One hour after Ewald's test breakfast the gastric contents show a lessened degree of acidity, and contain either no free hydrochloric acid at all or only small quantities. The pieces of roll are not as fine as normally. Pepsin and rennet are always present; erythrodextrin is present only in small quantities, while achroodextrin and sugar are abundant. The quantity of the gastric contents obtained after the test breakfast is either normal or somewhat larger (120-180 c.c). Mucus may be present in great quantities in the gastric contents of some persons, while it may be absent in others. In the former case the gastritis is designated by the name of "gastritis chronica mucosa." The mucus in the gastric contents can be easily recognized by its appearance. A glass rod dipped into the contents and lifted in an oblique direction will cause a part of the mucus to be drawn up in the form of strings. The contents pass very slowly through filter paper, and the addition of acetic acid to the filtrate will produce turbidity. In the fasting condition the stomach is either found empty, or it may contain only a few cubic centimetres of a turbid liquid, consisting of mucus, and presenting either an alkaline, neutral, or acid reaction.

In the latter instance free hydrochloric acid may be discovered in small quantities. Microscopically many round cells and some epithelial cells are found to be present. In washing out the stomach in the fasting condition, the wash-water, as a rule, contains more or less considerable quantities of mucus. Instead of examining the gastric contents, the vomited matter, if such is present, can be made use of for testing the chemical qualities of the gastric juice. As a rule, the same conditions will prevail here as stated above under the examination of the gastric contents.

The motor function of the stomach is either not impaired at all, or only slightly diminished.