§221. Gastritis, inflammation of the stomach.

Acute gastritis, as is occasioned by corrosive poisons, is characterized by the following symptoms: Excessively burning, gnawing, constrictive, tearing, sticking pain in the epigastrium, increasing rapidly and without intermission, extending over the chest, and occasioning dyspnoea; the pain is aggravated by breathing, contact, the least pressure. There is a constant and intense desire for cold drinks, although every drop is vomited up again. The region of the stomach is hot to the touch, the patient wants cooling things to be applied to that region constantly; the epigastrium is distended, and the patient can neither swallow solid nor liquid things. The pulse, in such violent cases, is suppressed, small, wiry, frequently intermitting; face and extremities are covered with a cold sweat; the face is pale, spasmodically distorted, expressive of much pain; the patient is uneasy, anxious; stool and urine suppressed, or the secretion of urine is at any rate very scanty; death takes place very rapidly, from paralysis, preceded by singultus, dysphagia, aphonia, delirium, subsultus tendinum, and other nervous symptoms.

There are milder forms of gastritis, characterized by a feeling of pressure, heaviness, gnawing, tension in the umbilical region, which is not so sensitive to pressure. The patient is able to eat and drink, but afterwards he experiences pain, frequent eructations, attended with red face, accelerated pulse, hot hands, disposition to vomit, etc. The region of the stomach is distended by gas, tight, percussion yields a tympanitic sound over a large surface. The fever is not always present; when present, it is either synochal or erethic. The skin is dry, and its temperature raised. Sympathetic symptoms are: headache, pain in the limbs, paroxysms of cough, palpitation of the heart, nervousness, etc.

A mild form of acute gastritis may lead to a chronic one, which is frequently so deceitful that death takes place suddenly, in consequence of perforation; or innervation and marasmus develop themselves. The physician is frequently misled by the difficult digestion, eructations, flatulence, pyrosis, pain in the stomach, and is induced to treat the patient for dyspepsia, cardialgia, etc.

§ 222. An acute gastritis runs a rapid course; its phenomena are of short duration, but intense in their nature. The disease frequently terminates in death in a few hours, by exhaustion and paralysis of the nervous system. This likewise takes place when a chronic gastritis becomes acute, or else a slowly-progressing ulceration leads to perforation of the stomach. An acute gastritis lasts from 10 to 25 days; a chronic for months and even years. Gastritis is frequently confounded with cardialgia, colic, cholera, etc.

Gastritis may be occasioned by the following causes: the use of cold drinks or of ice when the stomach is heated; cold bathing when the body is very hot;* introduction into the stomach of mineral acids, arsenic, mercury, corrosive sublimate, saltpetre; inflammation of adjoining organs, mechanical injuries of the stomach, metastasis of inflammations of other organs to the stomach, suppression of herpetic eruptions, localization of dyscratic action, etc.

The prognosis depends upon the course and origin of the disease. When occasioned by cold drinks, poisons, metastasis, or dyscrasia, it is very dangerous. Children and old people are exposed to great danger.

§ 223. The treatment of gastritis differs according to the cause of the disease. A gastritis from gastric impurities or acrid bile is not very difficult to cure. Among these kinds of gastritis belongs the one arising from the use of too heavy food in the case of infants. The milk of the nurse ought to be changed for more adequate nourishment, after which, Ipec, Nux v., Bry-on., Antim., Pulsat., or Veratr., should be exhibited.

Traumatic gastritis is, properly speaking, a surgical disease, which requires to be treated, among other remedies, with Arnica, externally and internally.

* These causes may likewise cause a sort of cholera, which at first bears a great resemblance to gastritis.

In gastritis toxica, the poison has first to be removed; the vomiting should be promoted by warm drinks, except when it is excessive, in which case it has to be moderated. This result can most easily be obtained by means of mild oleaginous and mucilaginous substances, which are likewise the most suitable to neutralize the poison. Such substances are: linseed oil, milk, warm water, sugar-water, slimy drinks, etc.; milk and sugar-water may be continued together with the specific medicine.

Gastritis potatorum is to be treated with one of the remedies which we shall point out hereafter.

After the removal of the local causes of the disease, a few doses of Aconite require to be given, in rapid succession, to moderate the synocha, if there should be any.

The best remedy for the above-described most acute form of gastritis, is Arsenic.

Next to this comes Phosphorus, if the patient complain of a cutting burning, with pressure, burning heat in the stomach, as if hot gas were rushing out of the mouth, etc., accompanied with violent thirst, burning in the pit of the stomach, anguish, convulsions of the face, violent shuddering, cold extremities, clear eyes, with lachrymation, pale lips, hurried, small, feeble pulse, and prostration of strength.

Camphora corresponds to burning with pressure in the stomach, with coolness in the pit of the stomach, great painfulness of the pit of the stomach to contact, violent vomiting of bile and blood, gulping up of the ingesta, cold sweat in the face, general coldness of the body, hurried breathing, bruised feeling in the back, and feeble, scarcely perceptible, pulse.

Cantharides correspond particularly to stinging, burning, and cutting, particularly inthe region of the orifice of the stomach, feeling of fulness, sensation of screwing together, extending to the dorsal vertebrae, vomiting of the ingesta, vomiting of blood, with constant retching, agonizing uneasiness, small and intermittent pulse, with burning thirst. This kind of gastritis is always accompanied with pains in the abdomen, kidneys, and bladder, the pains of the latter organ descending from the ureters, and being attended with ischuria.

Bryonia is one of the remedies for the less violent forms of gastritis. It corresponds to an aching, stinging, burning pain in the stomach and pit of the stomach, to a sensation as if the pit of the stomach were distended, to gulping up of the ingesta, vomiting, even vomiting of blood, sore pain in the pit of the stomach, when touching it or coughing, anxiety and oppression. It corresponds particularly to a phlegmonous inflammation of the stomach, with violent synochal fever, great nervous and vascular excitement, burning and dry heat, with thirst.

Nitrum is indicated by a violent aching pain in the stomach, with cooling burning in that organ. Among the accompanying symptoms we distinguish: canine hunger, slight thirst, hiccough, gulping up of bitter fluid with some relief, vomiting of blood, as the disease increases; the pulse is very quick, full, and hard.

Nux vomica may prove useful in some cases of gastritis; it is indicated by burning in the region of the orifice of the stomach, violent vomiting, etc.

Veratrum is likewise an important remedy in gastritis. We would likewise name: Puls., Euphorb., Sec, Ipec, Antim. cr., Mezer., Helleb., Calc, Ranuncul. scel., lod., etc. If hydrophobic symptoms should supervene, Hyoscyam., Stram., Canthar., and Bellad., should be employed.