500 DISEASES OF THE STOMACH. 



the other hand, it is sometimes the cause. Bidder and Schmidt have 

 shown that when the gastric juice is rendered alkaline by admixture 

 of mucus, it loses its power of dissolving protein substances, which 

 then undergo spontaneous decomposition, and give out a putrid odor. 

 Daily experience in practice confirms this experiment. But those sub- 

 stances also, that are not digested by the gastric juice, undergo abnor- 

 mal decomposition in gastric catarrh. The amylaceous substances, 

 whose change had already begun in the mouth from the admixture of 

 saliva, under normal circumstances, are not converted into sugar until 

 they enter the stomach. But, in gastric catarrh, the mucus secreted 

 acts as a ferment, and induces a change of a large portion of the sugar 

 into lactic acid, and often also into butyric acid. If, during gastric 

 catarrh, fermented substances, such as beer or wine, be taken, or if ex- 

 cessive use of these has induced the affection, acetic fermentation takes 

 place ; if fatty substances be swallowed, fatty acids appear to be de- 

 veloped from them. In all of these decompositions of the contents of 

 the stomach, except the lactic acid fermentation, gases are set free. 

 In the breaking up of albuminous substances, stinking, sulphuretted, 

 Hydrogen gases are freed; hydrogen and carbonic acid are formed 

 in butyric-acid fermentation ; in acetic fermentation, carbonic acid is 

 freed. This explains why the epigastrium is slightly prominent in pa- 

 tients with acute catarrh, and why, from time to time, they belch up 

 gases which sometimes smell disagreeably, at others are odorless, ac- 

 cording to the quality of the food that has been taken. At the same 

 time, sour or rancid substances often rise into the mouth. 



Since gastric catarrh, as before mentioned, is usually complicated 

 with oral catarrh, the tongue is generally coated, the taste stale and 

 slimy, and there is a bad breath. 



If the patients fast, and do not expose themselves to any new 

 sources of injury until the stomach is able to fulfil its normal functions, 

 the above symptoms usually disappear quickly. The abnormally-de- 

 composed contents of the stomach pass through the pylorus into the 

 intestine ; there further decomposition seems to be arrested sometimes 

 by the admixture of bile, but more frequently, although moderated, it 

 still continues ; the secretion of the irritated intestinal mucous mem- 

 brane increases, the movements of the intestines are hastened, flatu- 

 lence, rumbling, etc., with griping pains in the belly, occur, and are 

 relieved by the passage of badly-smelling gas ; finally, one or more 

 pulpy stools occur, and the trouble ends. If the patient sleeps the 

 following night, his general health is usually improved, or fully restored. 

 We may also mention that, during the affection, the urine usually con- 

 tains quantities of pigment and urates, and that herpetic vesicles not 

 imfrequently come on the lips. 



