491 DISEASES OF THE STOMACH. 



cause ol the disease. On this diminution of the gastric juice depends 

 the great inclination to gastric catarrh observed : 



1. In all fever patients. It is going too far to say that every fever 

 is accompanied by catarrh of the stomach ; neither the coated tongue 

 nor the loss of appetite of fever patients justifies this view. But, as in 

 every fever, in consequence of the increased temperature, the amount 

 of water lost through the skin and lungs is excessively increased, it 

 may be concluded a priori that less gastric juice will be secreted ; 

 this supposition is confirmed not only by the analogous condition of 

 other secretions, but by actual observations (Beaumont). (It is possi- 

 ble that in fever the composition of the gastric juice is also changed ; 

 but this hypothesis is not necessary to explain the results of slight 

 errors of diet on the part of the fever patients.) If the patients do 

 not bear this in mind, and adapt their diet to the diminished secretion 

 of the stomach, very distressing gastric catarrh will result. A large 

 portion of the gastric complications in pneumonia and other inflam- 

 matory affections result from neglect of this simple dietetic rule. 



2. The increased predisposition to acute gastric catarrh, which we 

 see in debilitated and badly-nourished persons, appears also to depend 

 on diminished quantity or inferior quality of gastric juice, which favors 

 the decomposition of the ingesta. If the amount of blood be decreased, 

 it is probable that the quantity of gastric juice as well as of the other 

 secretions is diminished. As, in hydraemia, there is a diminution of the 

 albuminates of the blood, which we must regard as the material of 

 which pepsin, the organic constituent of the gastric juice, is formed, 

 the supposition is warranted that a juice, deficient in pepsin, is formed 

 in such cases. From the diminished action of the gastric juice, part 

 of the ingesta remain undissolved and decomposed ; hence many con- 

 valescents have gastric catarrh from eating what would not have 

 harmed them at another time. In the same way puny children have 

 this disease when they take the same amount of mother's milk, or the 

 same quantity of cow's milk diluted to the same extent, as healthy 

 children of the same age can take without harm. 



3. Although we have many analogous facts in other organs, it is 

 not easy to explain the increased predisposition to gastric catarrh in 

 persons who are very careful about their stomach, and carefully protect 

 it from irritation. Catarrh of the stomach is more readily induced by 

 a slight excess in drinking, in persons unaccustomed to the use of 

 liquor, than in those who take a moderate amount daily ; and by a 

 slight error of diet in children whose diet is usually carefully watched, 

 than in those accustomed to complicated and indigestible food. 



4. Lastly, we find an increased predisposition to gastric catarrh in 

 persons who have suffered from it repeatedly. 



