This ailment is not really a disease, only a local manifestation of some nerve derangement. It differs from all other diseases of the stomach in this: it has no anatomical change and is not directly due to any alteration in size or structure of the stomach, but to some shock, strain, nervous exhaustion, or nerve irritation in organs other than the stomach. Some eminent physicians are disposed to charge all but contagious or infectious diseases to some functional disturbance of the nervous system, but it seems that in most cases the theory of nervous origin is, '"Putting the cart before the horse" - the effect before the cause. Strictly speaking, the term nervous dyspepsia should only be applied to diseases or symptoms which result from mental disturbances, such as emotional excitement, mental worry, or mental activity, too long continued without rest; but for practical purposes it is better to class all derangements of the stomach directly due to the causes mentioned, or that are simply reflex from nerve irritation in other parts of the body, as neuroses of the stomach. Some writers have heretofore classed both insufficient and excessive secretion as of nervous origin, doubtless because they were attended by nervous symptoms.

All agree that it is extremely difficult to determine the dividing line between cause and effect. We have in the preceding pages shown how the system may poison itself, and if the blood contains crude or poisonous matter, it is very likely to affect the nervous system. If the food supply be of such a character that it cannot be digested, the whole system will be weakened, and fatigue follow very little exertion, and if lack of nourishment affect: the muscles and the sensibilities, why not the central nervous system? On the other hand, a debilitated nervous system, from extraordinary worry or loss of sleep, affects the stomach. As to whether the nervous system or the stomach is the primary cause of the nervous symptoms, would seem to depend on the causes in operation likely to produce them. If there were some cause of extraordinary worry and loss of sleep, the indigestion should be considered as of nervous origin, but if there were a disposition toward unusual worry about trifles in connection with nervous symptoms, it is most likely due to some form of mal-nutrition, or self-poisoning. But few people would be overworked or over-worried if they were properly nourished; and by this we do not mean that there has necessarily been a lack of nutritious foods.

It may be because of the inability of the system to assimilate the food as it is supplied. As people mistreat their stomachs much more than their nervous systems, it is safe to consider that, primarily, it is not overwork that causes most nervous attacks, but lack of good blood and excess of poisonous waste in the system. This is well illustrated by the general anaemic condition, common to most persons suffering from nervous dyspepsia. The disease is much more common to women than men, and more frequent under forty years of age than after the middle period of life.

Nervous dyspepsia has no uniform symptoms, as there may be lack of gastric secretion and muscular activity, an excess of secretion, or extreme irritability of the nerves of the stomach.

Symptoms

Where there is lack of secretion, or lack of muscular activity, the symptoms are much less marked than the other conditions. Vomiting only takes place when the food has long remained in the stomach and become decomposed. In the mild form there is not much pain, but a sinking sensation, or one of great fullness is felt after eating, which may be accompanied by slight nausea and dizziness. In severe cases the stomach will not tolerate any food at all, and vomiting occurs almost as soon as the food reaches the stomach. Some of the symptoms of nervous dyspepsia are found in other diseases of the stomach, but there is usually something about each that indicates to which class it belongs. In catarrh of the stomach the disagreeable sensations do not arise until some time after the meals, usually three or four hours, unless there is an acute attack and great irritation of the stomach. In some cases there is excessive sensitiveness of the mucous membrane of the stomach, and the pain severe and the stomach sensitive to pressure.

The pain is more general than in ulcer, and has but little relation to meals or kind of food, while the pain from ulcer is much more intense when coarse vegetables or acids are ingested, than when the stomach is empty or when soft-proteid foods like milk and eggs are eaten. In the form of nervous dyspepsia known as gastralgia, the pain in the region of the stomach seemingly radiates in all directions. It occurs quite independently of meals. In neurasthenia, the symptoms and pain are generally out of proportion to any discoverable disease, and often occur when there has been no previous history of dyspepsia. Another cimracteristic of nervous dyspepsia is belching of air or gas, without regard to whether the stomach is full or empty. In other diseases of the stomach the belching only appears when there is gaseous fermentation of food in the stomach. When more or less food is brought up instead of gas, it is called regurgitation, which often precedes nervous vomiting. Sometimes the openings of the stomacn are closed by a nervous spasm, or the pyloric end may, for a time, refuse to close and the food at once passes into the intestines, causing diarrhoea.

Vomiting In Pregnancy

This is usually called "morning sickness," and appears after rising in the morning, when the patient feels faint, "light-headed" and nauseated. When this occurs, slowly sip a cup of hot milk or meat broth, and eat a dry biscuit (cracker) and remain in bed for two or three hours. If the stomach be foul, drink a cup of hot water instead of milk, without food.

Aids To Treatment Of Nervous Dyspepsia

If the attack be due to overwork or worry, rest is the first requisite; but if from emotional excitement, change in surroundings and something to divert the mind is of great importance. When there is general neurasthenia or hysteria, the patient should be put to bed and kept free -from excitement and away from visitors.

Diet

The diet must be easily digested, nutritious, and non-irritating. If the stomach be inactive, so that it does not readily empty itself, the diet must be of such character as will not quickly ferment. The principal foods should be malted milk - pasteurized or sterilized - cream, soft-cooked or whipped eggs, eggnog, malted gluten, meat broths, in acute cases. Such additional foods as meat-powder, toast bread, nut oils, butter, malted nuts, may be given as the patient progresses. If hot milk should be vomited, try it cold, and vice versa. It may be of great advantage to dilute milk with gelatine. If not convenient to make it, a refined gelatine, like the Keystone, may be used. As the appetite is often capricious, it may be of great advantage to flavor the food with a little vanilla, lemon, nutmeg, or fruit flavors. In the acute or severe cases, a little food should be given at short periods. It may be necessary to begin with" a tablespoonful of milk. The patient must take as much nourishment as possible, but must not be crowded beyond what can be digested. When only milk is fed, it should ordinarily be given every two hours, in quantities of one or two ounces at a feeding for the first few feedings.

Most patients will tolerate a pint and a half of milk the first day, and twice as much the second, and should be able to take eggs and other food the third or fourth day. All made dishes, tea, coffee, and fried foods, must be avoided.