CHRONIC GASTRIC CATARRH. 



If the chronic catarrh extends from the stomach to the mouth, we 

 Lave, at the same time, the symptoms of chronic oral catarrh: the 

 tongue is coated, shows the impression of the teeth along its sides ; 

 there is a stale, slimy taste, and a more or less fetid smell from the 

 mouth. But a clean tongue and absence of the other symptoms of oral 

 catarrh do not at all prove that the stomach is healthy. 



Not unfrequently the chronic gastric catarrh extends to the intes- 

 tines, and, besides the symptoms above described, we have those of 

 chronic intestinal catarrh. We must, however, bear in mind that every 

 intestinal catarrh does not cause diarrhoea, because it is not alwa} r s 

 accompanied by fluid secretions, or large quantities of mucus. There 

 is more apt to be somewhat obstinate constipation, because the move- 

 ments of the intestines, like those of the stomach in chronic gastric 

 catarrh, are greatly impeded. Decomposition of the contents, which 

 thus remain a long time in the intestines, continues ; there is flatu- 

 lence, which renders the belly tense, and the patients, who feel relieved 

 oy the escape of flatus, usually ascribe their difficulty to the " move 

 ments of the flatus." 



Occasionally, also, the catarrh extends from the duodenum to the 

 ductus choledochus, and there are retention and absorption of bile. We 

 shall find that the jaundice caused by gastro-duodenal catarrh is the 

 most frequent form of icterus. 



Tn regard to the general state of the patient, the severe headache, 

 pain and weakness of the limbs, and other general symptoms which 

 iccompany acute gastric catarrh, are usually absent in the chronic form ; 

 but, on the other hand, there is usually some mental depression. If 

 this state be designated as hypochondria, because the abnormal excite- 

 ment of the brain depends on abnormal conditions of the abdominal 

 viscera, there can be no objection to it ; but the mental disturbance 

 accompanying gastro-intestinal catarrh should not be distinguished 

 from other forms of melancholia by the fact that the bodily state is 

 the sole object of the gloomy thoughts. I have seen a general dis- 

 couragement, an under-valuation of mental power, despair as to busi- 

 ness, etc., induced by chronic gastric catarrh, and have seen these 

 symptoms disappear on the cure of the disease. Only a few years 

 since I treated a very wealthy man for chronic gastric and intestinal 

 catarrh, who, during the disease, thought he was near bankruptcy, and 

 left unfinished a building that he had begun, because he thought he 

 had not sufficient money to continue it. After spending four weeks at 

 Carlsbad, his old strength and feelings returned, he finished his house 

 with great splendor, and has been well ever since. 



When the disease lasts a long while, the nutrition of the patient 

 suffers from the disturbance of chymification, as well as from the in- 



