286 PATHOLOGICAL VARIATIONS OF DIGESTION. 



nerves (inflammation, ulceration, trigeminal neuralgia), so that the saliva is secreted in great 

 quantity. Mercury and jaborandi cause secretion of saliva, the former causing stomatitis, which 

 excites the secretion of saliva reflexly. Even diseases of the stomach accompanied by vomiting 

 cause secretion of saliva. A very thick tenacious sympathetic saliva occurs when there is vio- 

 lent stimulation of the vascular system during sexual excitement, and also during certain 

 psychical conditions. The reaction of the saliva is acid in catarrh of the mouth, in fever in 

 cousequende of decomposition of the buccal epithelium, and in diabetes mellitus in consequence 

 of acid fermentation of the saliva which contains sugar. Hence, diabetic persons often suffer 

 from carious teeth. Unless the mouth of an infant be kept scrupulously clean, the saliva is apt 

 to become acid. 



C. Disturbances in the activity of the musculature of the stomach may be due to paralysis of 

 the muscular layers, whereby the stomach becomes distended, and the ingesta remain a long 

 time in it. A special form of paralysis of the stomach is due to non-closure of the pylorus 

 (Ebstein). This may be due to disturbances of innervation of a central or peripheral nature, 

 or there may be actual paralysis of the pyloric sphincter, or ansethesia of the pyloric mucous 

 membrane, which acts reflexly upon the sphincter muscle J and lastly, it may be due to the 

 reflex impulse not being transferred to the efferent fibre within the nerve-centre. Abnormal 

 activity of the gastric musculature hastens the passage of the ingesta into the intestine ; vomit- 

 ing often occurs. 



D. Gastric digestion is delayed by violent bodily or mental exercise, and sometimes it is arrested 

 altogether. Sudden mental excitement may have the same effect. These efforts 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). An excessive formation of acid may be due to nervous disturbance, and is called 

 11 nervous gastroxynsis," by Rossbach. 



[Action of Alcohol, Tea, &c., in Digestion. 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. Distilled Spirits brandy, whisky, gin have but a 

 trifling retarding effect on the digestive processes ; and when one considers their action on 

 the secretory glands, it follows that in moderate dietetic doses they promote digestion. Wines 

 are highly inimical to salivary digestion, but this is due to their acidity ; and this effect can 

 be removed by the addition of an alkali. Wines retard peptic digestion, the sparkling less 

 than the still wines. Tea has an intensely inhibitory action on salivary digestion, in fact a 

 small quantity paralyses the action of saliva, while coffee has only a slight effect. This 

 action of tea is due to the tannin. Tea, coffee, and cocoa all retard peptic digestion, when they 

 form 20 per cent, of the digestive mixture (W. Roberts).'] 



Inflammatory or catarrhal affections of the stomach, as well as ulceration and new forma- 

 tions, 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 sauce or alcohol. In the case of a dog 

 suffering from chronic gastric catarrh, Griitzner observed that the secretion took place con- 

 tinuously, 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 hydrochloric acid ought to be administered (0*4 per cent.). Small doses of common salt 

 seem to aid digestion. 



[Absence of HC1. HC1 is almost always absent in carcinoma of the stomach {van de Velde\ 

 amyloid degeneration of the gastric mucous membrane (Edinger), and sometimes in fever. In 

 all these cases the acid-reaction is due to lactic or butyric acid. The absence of HC1 in 

 cancer of the stomach is an important diagnostic and prognostic symptom. It is not absent in 

 simple dilatation of the stomach. Test the contents of the stomach for free HC1 with tropseolin 

 (red colour), methyl violet (blue), and with ferric chloride and carbolic acid {Uffelmann). -fa 

 per cent, of free HC1 causes the amethyst-blue of the last to become steel-grey, while somewhat 

 more discharges the colour altogether. [In testing for the presence of free lactic acid in the 

 gastric contents use Uffelmann's reaction ( 163). The lactic acid is easily extracted by ether 

 from the gastric contents, and the reaction can then be performed with the residue obtained 

 after evaporating the ether. A solution of 1 drop of the liquor perchloride in 50 c.c. of water is 

 made yellow by lactic acid.] 



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, together 

 with some hydrochloric acid, are useful. 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. 



E. Digestion during Fever and Anaemia. Beaumont found that in the case of Alexis St 



