GASEOUS ACCUMULATIONS. 129 



air in the stomach, and some have even regarded this symptom as 

 a special disease, and have termed it pneumatosis ventriculi. Even 

 in healthy persons, large quantities of gas may accumulate in the 

 stomach after the use of such kinds of food and drink as very 

 readily undergo fermentation, as, for instance, biscuits rich in 

 yeast, new bread, onions, garlic, radishes, raw fruit, or imperfectly 

 fermented wine and beer, especially when taken in very large 

 quantities. In such cases, a great excess of carbonic acid is always 

 found in the stomach, since all these substances undergo the vinous 

 and acetous fermentation, which is almost always preceded 

 by the development of carbonic acid. If, however, hydrogen gas be 

 found to occur in this air, its presence may be easily explained, 

 since, as we have already seen, the amylacea have a strong tendency 

 to undergo the butyric fermentation in the stomach, and this fer- 

 mentation is always accompanied, as has been shown by Pelouze, 

 Liebig, and others, by the development of hydrogen. 



Accumulations of air in the stomach are especially observed in 

 hysterical and hypochondriacal patients, who have an unnatural 

 tendency to gulp air, in persons in whom the food is retained 

 for too long a period in the stomach, and finally, in cases in which 

 the secretion of the gastric juice is altogether impeded. In 

 hysterical and hypochondriacal patients who have swallowed air, 

 the gases evolved by eructation are, for the most part, devoid of 

 odour, and hence it may be presumed that this air has undergone 

 very little change, except an augmentation of carbonic acid. 



In constrictions of the pylorus, as well as in chronic catarrhs, 

 the stomach becomes filled with air, not only after the moderate 

 use of the above mentioned articles of diet, but also after the 

 ingestion of other varieties of food which do not usually cause any 

 annoyance to healthy persons, or at the most only occasion accu- 

 mulations of gas in the large intestine, as, for instance, milk, 

 peas, cabbage, eggs, meat, and other animal food. In such cases 

 the air contains only little oxygen, much carbonic acid, probably 

 also hydrogen and carburetted hydrogen, and invariably sul- 

 phuretted hydrogen, which may be recognised by the smell of the 

 eructations, as well as by its reaction on paper moistened with a 

 solution of acetate of lead. 



In patients suffering from typhus fever, who for a considerable 

 time have taken neither food nor medicine, the stomach is not 

 unfrequently found to be distended with gas : here the meteorism 

 only comes on slowly, and its occurrence is very much favoured by 

 the paralytic condition of the muscular coat of the stomach, 



VOL. II. K 



