NEURASTHENIA 209 



stand that the organs of digestion in the neurasthenic are 

 suffering from too much intermeddling. 



The central influence is so largely inhibitory that the 

 chief effect may be characterized as a general retardation 

 of the activities of the tract. This includes a loss of posi- 

 tiveness in movement and a withholding of secretions. 

 The stomach retains its contents longer than it should, and 

 instead of being acted upon by a strong and antiseptic 

 gastric juice, they are fermented by micro-organisms. 

 What happens in the stomach is continued with minor 

 variations in the intestine. The extensive decomposition 

 may well give rise to definitely poisonous bodies and so 

 to auto-intoxication, which is thus both a cause and an 

 effect of neurasthenia. Another annoying result of the 

 fermentation is the voluminous production of gas. This 

 feature of nervous prostration is so marked that some 

 physicians have thought that the quantity of the gas could 

 not all be due to bacterial action. They have considered 

 whether it might not come in part from an actual secre- 

 tion of carbon dioxid from the blood into the tract. At 

 any rate, it becomes a source of discomfort, even of sharp 

 pain, while the distention is likely to occasion reflex dis- 

 turbances of heart action. The picture is a familiar one, 

 particularly in the country, where there is less thought 

 for appearances the sallow, angular dyspeptic, with fre- 

 quent sighs and yawns and noisy belching of gas. 



With deficient tone and peristalsis, constipation is to be 

 anticipated. It may be extreme and is a matter much 

 brooded over by the sufferer. He may be much given to 

 experimenting with cathartics and enemata. On the 

 other hand, constipation rhay actually exist and yet be 

 unrecognized, for, if there are massive accumulations in 

 the colon which the relaxed muscles fail to displace, the 

 local irritation may set up a catarrhal condition' with 

 liquid discharges made urgent by the ever-present gas 

 and simulating diarrhea. There are two places in the 

 large intestine where fecal retention is likely and which 

 may become the seat of pain. One is near the spleen 



14 



