We sometimes meet with persons who manifest an idiosyncrasy toward certain substances, the ingestion of which gives rise to symptoms emanating from the alimentary tract alone or combined with other disorders, especially of the skin. The articles most apt to cause these disturbances are certain kinds of fruit, especially strawberries, lobsters, soft-shell crabs, oysters, fish; but besides these substances there are several other articles of food which may produce disagreeable symptoms in certain individuals. Thus I know of several members of one family who betray very unpleasant symptoms (feelings of pressure, pain, belching) if a trace of onion is added in the preparation of the food. In all these instances this is not an imaginary trouble, for even if the substances mentioned are given in a disguised form, so that the person is unconscious of taking them, he will nevertheless suffer from the same symptoms. Generally only gastric symptoms are produced: pressure, pain, belching, rarely nausea and vomiting; sometimes in addition to these there appear eruptions on the skin, either erythema or urticaria.

It is remarkable that in these instances the same individual always manifests the same symptoms upon taking the respective article against which he has an idiosyncrasy.

Talmal described several cases in which there was an idiosyncrasy against hydrochloric acid. The slightest quantities of a highly diluted solution of hydrochloric acid (1:750) produced pains within the stomach. I also have observed a case in which severe pains in the gastric region usually appeared one to two hours after meals for a period of over seven years. The analysis of the gastric contents one hour after the test breakfast revealed the presence of free hydrochloric acid and a degree of acidity of 40. As the symptoms corresponded to those found in hyperchlorhydria, I administered alkalies, notwithstanding the fact that the acidity in this case was rather diminished. The symptoms disappeared at once, and the patient, who was quite emaciated, began to gain in weight rapidly. The treatment was continued for over six months, and the improvement persisted. Here the pains were probably due to a kind of idiosyncrasy of the stomach against its own hydrochloric acid.

In all these cases nothing can be done to rid the stomach of tins peculiarity, and the persons affected must abstain from the offending articles, or else suffer for their indulgence.

Abnormal Sensations

Sensations of heat or more seldom of cold, of heaviness or of a foreign body within the stomach are present in some cases; and these may manifest themselves no matter whether the stomach be empty or not. They are not due to changes in the chemical condition of the gastric juice, but are merely symptoms originating from the nerves of the stomach. With these sensations we may also class the feeling of constriction or of cramp within the organ and the "epigastric beating." The latter is sometimes due to an increased pulsation of the abdominal aorta. While in the normal state people never notice these pulsations, in those affected the beating sensation is very tormenting and is sometimes the cause of many sleepless nights. All these abnormal sensations are usually found in nervous people, neurasthenics or hysterics.

1 Talma: Zeitschr. f. klin. Medicin, 1884, Bd. viii., p. 407.

Nausea also belongs to the abnormal sensations. Besides its occurrence in organic affections of the stomach it is also found alone, and it is then called "nervous nausea." It is met with in diseases of the central nervous system and in both neurasthenics and hysterics. Sometimes it is also caused by affections in distant organs, as for instance the uterus or the ovaries, and must then be considered as a reflex symptom. Nausea appears most frequently in the fasting state, sometimes, however, the patient also experiences the nauseous feeling shortly after meals, from half an hour to an hour. The treatment should therefore be directed principally against the general condition. Sometimes the intragastric application of the galvanic current will greatly facilitate the cure.