CHINA is one of our most neglected digestive medicines. Formerly, it was used extensively but, for some reason, it has fallen into disuse in this country. One hardly ever sees it prescribed, which is a great pity. It would seem that this is because we have all come to look on China as a medicine which is prescribed merely for the result of loss of fluid of prolonged illness; we look on it as a general pick-me-up instead of considering it on its merits and prescribing it for the conditions which it fits. And there are some very definite indication for China in digestive disturbances.The condition in which you will require it is the atonic dyspepsia, associated with a good deal of intestinal disturbance, probably amounting to a definite colitis. It is also indicated in chronic dyspepsias associated with definite hepatic disturbances, which may go on to the formation of actual gallstones. No matter what the type of lesion from which they are suffering, these patients always have the most intense flatulence.
They seem to manufacture gas, and the outstanding characteristic is that they seem to be able to bring it up in any amount. Watching these cases, it is clear that many of them are air swallowers, and it is not really a fermentation. They are so constantly uncomfortable that they are swallowing air all the time and blowing themselves out. They bring up a great deal, start swallowing again, and again blow themselves out.
Mentally, China patients are interesting. They are always depressed, very discouraged and they have a horrible sense of frustration. Very often you get the history of a severe illness as the onset of the trouble, as the result of which they become irritable and develop a general hyperaesthesia. They are sensitive to everything-noise, touch, odours of any kind, and very often develop a peculiar hyperaesthesia to taste. This is rather interesting because, in spite of their extremely acute sense of taste, quite a number of China patients develop a craving for all sorts of highly tasting food-pungent, spicy things-in order to tickle their appetites.
All China patients are intensely chilly, very sensitive to cold draughts and want to be warmly covered up all the time. To this symptom of general chilliness you can add a China peculiarity : the patients complain of intense coldness in the stomach.
The tongue in the typical China case tends to be flabby, toneless and rather pale in colour; and they complain of an intensely bitter or salty taste. Not infrequently you meet a patient who complains of a horrible, slimy feeling in the mouth and, when that is present, they usually develop an intense antipathy to butter or greasy food of any kind.
There are various disturbances of the appetite. Some China patients have a horrible, gnawing, empty feeling and yet no real appetite for their food at all. They are quite indifferent about starting a meal, but their appetite seems to return once they begin. And they always get an increase of their flatulence and distension immediately after food. With that distension they begin to eructate, and this eructation may go on to definite vomiting, the vomit being of sour mucus which may be bile-stained or contain traces of blood.
Many of these patients eat quite well, taking reasonable quantity of food, yet nearly all of them are emaciated. Not infrequently you come across a case in which the patient suffers from flatulent dyspepsia which is accompanied by the passage of undigested food in mucous stools. These cases give a definite history of night sweats and, in spite of a good appetite which is, in fact, frequently abnormally large, the patients are noticeably emaciated.
Associated with the digestive upsets in China patients, you will almost always get a complaint of intense weariness and a general aching pain all over. They say they feel just as if they had done a great deal of hard physical labour and were completely tired out.
In the attacks of acute abdominal pain, the abdomen becomes hyperaesthesic on the surface to light touch, and yet the pain is relieved by firm pressure. These chronic dyspeptics are very liable to suffer from attacks of facial or definite dental neuralgia; it seems to pick up the trigeminal nerve. These neuralgias, again, are very sensitive to any draught of cold air, very sensitive to light touch, definitely helped by firm, steady pressure, and relieved by warmth.
All China patients give a history of absolute intolerance to any acid – sour food or sour drink. These immediately produce a feeling of acute, abdominal discomfort, increased abdominal distension, general gurgling in the abdomen and an attack of diarrhoea. In dealing with a China colitis, you will find that the patients complain that they are liable to get an attack of diarrhoea immediately after food. In addition, they get very troublesome nocturnal diarrhoea. The motion usually consists of a mucous stool with a quantity of undigested material, and is passed to the accompaniment of large quantities of flatus.