SPASM OF THE STOMACH NERVOUS CARDIALGIA. 551 



catients to faint, is very dangerous. Cold must be regarded as the 

 most efficacious remedy in haemorrhage from the stomach ; we may 

 let the patients swallow small quantities of ice-water or small pieces 

 of ice, from time to time, and we may cover the epigastrium with cold 

 water or ice-compresses, and renew them frequently. Styptic medi- 

 cines are not always well borne, but are often vomited up ; the best 

 of these are mistura sulphurica acida or alum, particularly in the form 

 of serum lactis aluminatum. We should always give these remedies 

 in small quantities and keep them on ice. Acetate of lead, sulphate 

 of iron, and ergotin, may be dispensed with. 



The indications from the symptoms, first of all, require attention 

 to the syncope. The patient must lie flat in bed ; must not rise to 

 stool, but use a bed-pan. If syncope occur, we may hold eau de cologne 

 or hartshorn to the nose, and sprinkle the face with water, but be 

 very careful about the internal administration of restoratives. Among 

 these cold champagne is best, as it is less apt to cause vomiting than 

 the analeptic medicines. The unceasing inclination to vomit, which is 

 partly due to the attacks of syncope, partly to the blood in the stom- 

 ach, is the most annoying symptom that the patient has. In trying 

 to arrest it, we should be careful about the use of narcotics, and should 

 preferably apply a sinapism to the pit of the stomach occasionally, 

 and give a pinch of effervescing powder. Since P. Frank has an- 

 nounced that it is necessary to purge patients with haemorrhage from 

 the stomach, to prevent the blood from exciting low and putrid fever, 

 clysters and slight cooling laxatives are almost universally prescribed. 

 My observations correspond with those of JBamberger, according to 

 whom even enemata are injurious for the first few days after a haamor- 

 rhage. 



CHAPTER IX. 



SPASM OF THE STOMACH NEEVOTJS CARDIALGIA. 



ETIOLOGY. By nervous cardialgia, we mean painful affections of 

 the stomach, not dependent on perceptible changes of structure. JRonir 

 berg distinguishes two forms of this disease, one of which, he says, de- 

 pends on a hyperaesthesia of the pneumogastric, the other on hyperaes- 

 thesia of the solar plexus. The former he calls gastrodynia neuralgica, 

 the latter neuralgia cceliaca. But it can probably never be determined 

 in any given case whether the pains be located in the filaments of the 

 pneumogastric or in those of the sympathetic ; and JSenoch says, with 

 truth, that this distinction is practically worthless, though it may be 

 theoreticallv correct. 



