Slow Eating

A simple explanation of the normal physiology of digestion will often interest an intelligent patient and secure his hearty co-operation in methods suggested for his cure, which otherwise he would find extremely irksome. He should understand that digestion commences at once in the mouth by the proper preparation there of all food and the digestion of starch in particular, and that the practice of slow eating gives time not only for more thorough mastication, but also for more abundant secretion of the necessary digestive fluids, saliva, and gastric juice. Very slow eaters are far less often dyspeptic than those who "eat and run." The sign "Quick Lunch," so commonly displayed in restaurants in business quarters of active American cities, has contributed much toward earning for Americans the title of a "Nation of Dyspeptics," for a meal quickly served is too quickly eaten as well. A dyspeptic child should be taught to count between his mouthfuls.

Solid food insufficiently masticated passes into the stomach too dry and in too large masses for the gastric juice to act upon it promptly, and stomach digestion is greatly retarded. In persons with feeble digestive power who eat hastily, pieces of meat and tough vegetable fibres often appear in the stools wholly unaltered. The sense of taste may be utilised in order to prolong mastication by savoury cooking. It also stimulates the secretion of saliva and gastric juice. In such cases, as well as in those in which the teeth are absent or defective, it is well to prohibit all food which is not completely subdivided or tender, as, for example, tough meats and stringy or fibrous vegetables.

Pain

In nervous dyspepsia pain exists as a prominent symptom, and is often independent of the quality of the food - even a mouthful of water may cause it, but, as a rule, fatty and acid foods excite it, and must therefore be avoided. The appetite, too, varies greatly - it may completely fail at one time, and return in an exaggerated form at another. Decker reported the case of a patient who was uniformly awakened from sleep by such excessive hunger that he was obliged to take a hearty luncheon in the middle of the night.

Examination Of The Stomach Contents

In all cases of protracted dyspepsia which do not yield readily to dietetic treatment and proper medication it becomes important to ascertain the exact condition of the stomach and gastric juice, and for this purpose several ingenious clinical tests have been devised. These tests are applied to ascertain - 1. The degree of acidity of the gastric juice. 2. The vigour of peristaltic action of the stomach wall. 3. The rate of absorption from the mucous membrane.

To determine the acidity of the gastric juice, a fresh specimen must be obtained for analysis, and by far the best method is by siphonage. The stomach tube is inserted in the manner described for gastric lavage (p. 547), and the contents of the stomach are withdrawn in sufficient quantity to yield a satisfactory analysis.

Some hysterical dyspeptics vomit so readily that the gastric juice may be obtained from the ejecta at any time.