DIGESTION DURING FEVER AND ANEMIA. 381 



Gastric digestion is delayed by violent bodily or mental exercise, and some- 

 times it is arrested altogether. Sudden mental excitement may have the same 

 effect. These effects are very probably caused through the vaso-motor nerves of 

 the stomach. Feeble and imperfect digestion may be of a purely nervous nature 

 (Dyspepsia nervosa Leube ; Neurasthenia gastrica Burkart). [According to 

 J. W. Fraser, all infused beverages, tea, coffee, cocoa, retard the peptic digestion 

 of proteids, with few exceptions. The retarding action is less with coffee than 

 with tea. The tannic acid and volatile oil seem to be the retarding ingredients in 

 teas.] 



Inflammatory or catarrhal affections of the stomach, as well as ulceration 



and new formations, interfere with digestion, and the same result is caused by 

 eating too much food which is difficult of digestion, or taking too much highly 

 spiced sauces or alcohol. In the case of a dog suffering from chronic gastric catarrh, 

 Griitzner observed that the secretion took place continuously, and that the gastric 

 juice contained little pepsin, was turbid, sticky, feebly acid, and even alkaline. 

 The introduction of food did not alter the secretion, so that in this condition the 

 stomach really obtains no rest. The chief cells of the gastric glands were turbid. 

 Hence, in gastric catarrh, we ought to eat frequently, but take little at a time, 

 while at the same time dilute (0'4 p.c.) hydrochloric acid ought to be adminis- 

 tered. Small doses of common salt seem to aid digestion. [In cases of carcinoma 

 of the stomach, the acid reaction of the gastric juice is almost invariably absent.] 



Feeble digestion may be caused either by imperfect formation of acid or 

 pepsin, so that both substances may be administered in such a condition. [It 

 may also be due to deficient muscular power in the wall of the stomach.] In 

 other cases, lactic, butyric, and acetic acids are formed, owing to the presence of 

 lowly organisms. In such cases, small doses of salicylic acid are useful (Hoppe- 

 Seyler), together with some hydrochloric acid. Pepsin need not be given often, 

 as it is rarely absent, even from, the diseased gastric mucous membrane. Albumin 

 has been found in the gastric juice in cases of gastric catarrh and cholera. 



D. Digestion during Fever and Anaemia. Beaumont found that in the 



case of Alexis St. Martin, when fever occurred, a small amount of gastric juice 

 was secreted ; the mucous membrane was dry, red, and irritable. Dogs suffering 

 from septicsemic fever, or rendered anaemic by great loss of blood, secrete gastric juice 

 of feeble digestive power and containing little acid (Manassem). Hoppe-Seyler 

 investigated the gastric juice of a typhus patient, in which Von der Velden found 

 no free acid, and he found the same in gastric catarrh, fever, and in cancer of the 

 stomach. The gastric juice of the tj'phus patient did not digest artificially, even 

 after the addition of hydrochloric acid. The diminution of acid, under these cir- 

 cumstances, favours the occurrence of a neutral reaction, so that, on the one hand, 

 digestion cannot proceed, and, on the other, fermentative processes (lactic and 

 butyric acid fermentations with the evolution of gases) occur. These results are 

 associated with the presence of micro-organisms and Sarcina ventriculi (Goodsir). 

 He advises the administration of hydrochloric acid and pepsin, and when there 

 are symptoms of fermentation, small doses of salicylic acid. Uffelmann found the 

 secretion of a peptone-forming gastric juice ceased in fever, when the fever is 

 severe at the outset, when a feeble condition occurs, or when the temperature is 

 very high. The amount of juice secreted is certainly diminished during fever. 

 The excitability of the mucous membrane is increased, so that vomiting readily 

 occurs. The increased excitability of the vaso-motor nerves during fever (Heiden- 

 hain) is disadvantageous for the secretion of the digestive fluids. Beaumont 

 observed that fluids are rapidly absorbed from the stomach during fever, but the 

 absorption of peptones is diminished on account of the accompanying catarrhal 

 condition of the stomach, and the altered functional activity of the muscularis 

 mucosse (Leube). 



Many salts when given in large amount disturb gastric digestion e.g., the 



