552 DISEASES OF THE STOMACH. 



1. Lake other nervous diseases, this affection is often observed in 

 anaemic persons. If in chlorotic females, who have more or less se- 

 vere attacks of spasm of the stomach as a constant symptom, the blood 

 be enriched by preparations of iron, the cardialgia disappears, even in 

 those cases where the amenorrhcoa continues, and the quick recurrence 

 of the chlorosis proves that the original disease has not been removed. 

 It follows, from these observations, that the cardialgia of chlorotic pa- 

 tients depends solely on the poverty of the blood ; not, as in hysterical 

 women, on affections of the sexual organs. The cardialgia not unfre- 

 quently observed in tuberculous persons, convalescents, and onanists, 

 probably, also, depends on poverty of the blood. 



2. Diseases of the uterus, such as dislocations, flexions, or chronic 

 inflammation, and follicular ulcers of the os uteri, as well as affections 

 of the ovaries, induce cardialgia. It is among the most frequent symp- 

 toms of hysteria. The dependence of spasm of the stomach on affec- 

 tions of the female sexual organs is most evident when the attacks 

 occur exclusively, or are most severe, at the menstrual periods. I 

 treated one woman for amenorrhoea with retroflexion of the uterus and 

 catarrhal erosions of the os uteri, whose cardialgic attacks recurred 

 regularly every four weeks and lasted three days ; but during the in- 

 tervals they only appeared when leeches were applied to the cervix 

 uteri, and they only lasted during the time of the application. 



3. In other cases, nervous cardialgia depends on diseases of the spinal 

 marrow or brain; and from analogy with other neuroses, it is probable, 

 although it has not been proved by observations, that it may be caused 

 by organic changes in the pneumogastric, or sympathetic nerves, 

 swelling of their neurilemma, or tumors pressing on them, 



4. Cardialgia may depend on dyscrasia. Infection of the blood, with 

 malarial poison, occasionally seems to excite spasm of the stomach in- 

 stead of the paroxysm of intermittent fever. Momberg attaches par- 

 ticular importance to arthritis as a cause, and in his own first attack 

 of gout he suffered severely from spasm of the stomach. 



5. Finally, we frequently cannot find, either during life, or on au- 

 topsy, any cause for cardialgia that has existed for years. 



From the description above given, the attacks of pain caused by 

 certain contents of the stomach, without any structural change, must 

 be considered as nervous cardialgia. Among these are the cases of 

 spasm of the stomach induced by excessive acidity, by the presence of 

 worms in the stomach, by the exhibition of certain medicines, and oc- 

 casionally after a cold drink and similar causes. 



SYMPTOMS AND COURSE. Like most neuroses, nervous cardialgia 

 is distinguished from other diseases by its typical course, i. e., after in- 

 tervals of freedom, follow paroxysms of the severest pain. Occasion- 



