Under the name gastric pneumatosis are classified a group of cases in which the stomach is distended with gas (air), giving rise to a sensation of marked tension and frequently also to shortness of breath (asthma dyspepticum, Henoch). It is generally believed that a spasmodic contraction of both the cardiaand pylorus is partly the cause of this condition. This affection may appear periodically or exist constantly. It is often found associated with other symptoms of neurasthenia or hysteria; occasionally, however, it is met with alone. In typical cases of pneumatosis the epigastric and gastric regions are found greatly protuberant, sometimes the upper part of the abdomen looks like a balloon. On percussion this area gives a highly tympanitic sound. The patients experience a sensation of distention and marked want of air; sometimes a feeling of utmost anxiety is also present.

Belching, as a rule, cannot be produced by these patients.

In making the diagnosis of this condition, it will be necessary to exclude organic affections of the stomach which may give rise to similar symptoms. In the latter, however, the gas accumulated in the stomach will have a foul odor.

The treatment consists in a general tonic regimen of the nervous system and in the administration of the bromide salts. An acute attack of pneumatosis can be checked in the quickest and easiest way by the introduction of a tube into the stomach, so that the imprisoned air can find an exit. The symptoms of tension then disappear at once. This procedure must be repeated whenever a considerable quantity of gas has accumulated in the stomach and given rise to the characteristic symptoms. If a tube is not at hand, or its introduction be inadvisable, the attack may be relieved by a subcutaneous injection of morphine (Ewald). The extract of Calabar bean may also be found very useful.