CHRONIC GASTRITIS. 



113 



at once administered, or vomiting excited ; circumstances alone .can 

 determine an election. Blood must be freely drawn from the arm in 

 severe cases, and the venesection repeated according to circum- 

 stances ; leeches, also, may be applied over the epigastric region. 

 The pulse will often be found to rise in force and fulness after bleed- 

 ing. Warm fomentations, containing an anodyne, will be found 

 useful in allaying the pain, but some prefer the immediate application 

 of a large blister over the region of the stomach, and of sinapisms 

 to the feet. The thirst may be allayed by the frequent administra- 

 tion of cold water in small quantities, but it will be advisable to 

 abstain from giving medicines by the mouth as long as acute 

 inflammation exists. If any be given they should be of the least 

 irritating nature. It is more prudent to administer laxatives by the 

 rectum, to trust to general bleeding and strict regimen, with revul- 

 sives or counter-irritants ; small doses of calomel and opium might 

 in some instances be advisable. 



CHRONIC GASTRITIS. 



This is an occasional cause of the severer forms of dyspepsia, and 

 is often attended with one or more ulcers in the stomach. 



The symptoms of chronic gastritis are extremely various, both in 

 number and intensity. The following, however, are usually present 

 in well-marked cases: — Pain and uneasiness about the region of the 

 stomach, particularly increased after meals ; sense of constriction in 

 the oesophagus, near the lower part of the neck ; imperfect digestion, 

 accompanied by eructation, nausea, and occasional vomiting of food, 

 or of mucus streaked with blood ; skin dry, but not warm ; pulse 

 nearly natural, but sometimes accelerated; tongue covered with a 

 whitish fur, or red at the tip and edges, or dotted with red spots from 

 development and injection of the papillae. The patient often exhibits 

 symptoms of hypochondriasis, and the spirits become low as the 

 disease advances. 



Treatment. — The principal indications are fulfilled by the appli- 

 cation of leeches to the region of the stomach, followed up by exter- 

 nal irritation and a careful regulation of the bowels. Strict attention 

 should also be paid to the diet. The patient should eat nothing 

 but very light food, at regular intervals, and the general health 

 should be improved by gentle exercise in the open air. In some 

 cases, the stomach is so irritable that no food of any kind can be 

 borne. Asses' milk, given by spoonfuls at a time, may be tried, and 

 very small doses of prussic acid; but if all these measures fail, it 

 will be advisable to abstain from administering food by the mouth, 

 and to support the patient by nutritious' enemata. After the subsi- 

 dence of all symptoms, the tone of the digestive organs may be 

 improved by mild tonics, but the best strengtheners will be found to 

 consist in moderate exercise and a strict attention to diet. 



10* 



