344 ENDOCRINE GLANDS 



the feces and the determination of fat will help to make 

 the diagnosis. 



3. In certain cases all clinical investigation is negative. 

 In an intermittent painful abdominal syndrome in which 

 the diagnosis of tabes, or organic gastric lesions or of 

 lesion of the pancreas cannot be made, the cause of the 

 syndrome cannot be found. These cases correspond to 

 the coeliac neuralgia of Friedrich and the mesenteric 

 neuralgias of Nothnagel. 



V. TREATMENT. 



In the organic lesions of the stomach and the pancreas 

 these solar crises lead in general, to an intense and rapid 

 cachexia which is not only due to the carcinomatous condi- 

 tion, but also to the fact that the patients do not eat, and 

 sleep very little. In this type of syndrome, there is very 

 little to be done. Even morphine, in ever-increasing 

 doses, is of little avail and surgical interference is the 

 only help. 



In the case of inflammatory gastric lesions, the libera- 

 tion of adhesions is often followed by improvement. Even 

 in cancer of the body of the pancreas, certain surgeons do 

 not hesitate to remove the solar plexus and the semi lunar 

 ganglia. Chauffard has reported several observations in 

 which the patients ceased to suffer for a certain length of 

 time, when nothing was done, in presence of the neoplasm, 

 except an exploratory laparotomy. The question comes 

 up if the cessation of pain was not the result of suggestion 

 (Mathieu). The important thing, however, is the fact 

 that the patient feels relieved. 



REFLEX SOLAR SYNDROMES. 



Sudden death may be caused by violent traumatism, 

 such as, a blow in the epigastric region. It has been also 



