THE typical Sepia digestive disturbance is a chronic, not an acute one, and the impression produced by the study of Sepia digestive disturbances is that the whole digestive mechanism is slowed down.
The patients suffer from a typical atonic dyspepsia. And they are liable to have a marked gastroptosis, even a marked visceroptosis, with a severe feeling of dragging and emptiness in the abdomen, which is not at all alleviated by eating.
Most Sepia patients one sees have had a long history of digestive difficulty. They give the story that they are always having sour, bitter eructations, their food does not seem to digest and, some hours after eating, the food is returned practically unchanged-except that it is sour and bitter.
They vomit all the food they have eaten and then, following the clearing of the stomach of the actual food material, they bring up a quantity of milky-looking fluid. This vomiting of milky fluid goes on indefinitely for hours after a meal.
With this atonic state of the digestion, the patients develop all sorts of desires for food with a definite taste- bitter, acid, vinegary, pungent-anything that has a bit of a kick about it. When the attack are more acute, they develop an aversion to all food. In spite of the hungry, empty sensation, they do not want anything at all : the sight or, particularly, the smell, of food nauseates them.
In addition to their general drag and acidity, they get attacks of acute gastric pain. The peculiarity about the Sepia pain is that vomiting does not relieve it all : it persists, or may even be aggravated, after they have vomited.
In addition to the gastric difficulty, there is the same atonic condition throughout the whole digestive tract. The patients suffer from that is popularly described as a sluggish liver. They are always conscious of a feeling of weight and drag in the region of the liver.
This dragging sensation is usually associated with a troublesome occipital headache. They are apt to suffer from very acute heartburn and burning, acid eructations which feel as if they scald the throat. There may be a degree of jaundice, and there is always very marked constipation.
In addition to the general liver disturbances, there is the same kind of torpid condition in the bowel. They suffer from intense flatulence, a feeling as if the whole abdominal contents were dragging down-and they appear to be just the type of patients that you would expect to get this disturbance.
They are typical visceroptotic, pot-bellied, flatulent, constipated people. Very often with these disturbance-either liver or flatulent constipation-you will find, on examination, large pigmented patches on the abdominal wall.
Associated with the bowel disturbances, there is commonly the most obstinate constipation. The pointer to the Sepia constipation is that after the bowels have acted, there is a feeling as of a great lump still left in the rectum which will not come away. The stools are always accompanied by the passage of a quantity of jelly-like mucus.
There will occasionally be a history of attacks of acute diarrhoea in Sepia cases, and again in the diarrhoea, the stool is always accompanied by a quantity of this jelly-like, whitish mucus, and after the bowels have acted there is a feeling as if there is a quantity of stool still to come away.
In addition to the general loathing of food, and nausea at the sight or smell of food, these Sepia patients very often have a marked aversion to milk and not infrequently are upset by it.
The impression I keep of the Sepia patient is one that might be expected as the result of the kind of food, these Sepia patients very often have a marked aversion to milk and not infrequently are upset by it.
The impression I keep of the Sepia patient is one that might be expected as the result of the kind of physical make-up I have described : the tired-out, anaemic, depressed, miserable type of person, usually with a rather sallow complexion, very often with definite pigmented spots on the skin, very easily tired-mentally or physically-on any exertion, not wanting to do anything at all, wanting to be let alone and hating to be disturbed.
These patients always have a grievance; they have too much to do, or people are not kind to them, or no one realises how much suffering they have or with what difficulties they have to contend.
As one might expect in these tired-out patient with a grievance, they tend to be definitely bad-tempered, they resent criticism of any kind, are very liable to be spiteful and when things are too much for them, they are liable to burst into tears. Self-pity is one of the most outstanding characteristics of the Sepia make-up.
Sepia patients are always chilly, and sensitive to changes of temperature and electrical storms. They are very much better after a good long sleep; if they are wakened after a short sleep, they feel awful. Yet many of them say that they always wake in the mornings with an occipital headache, and feel more tired than when they went to bed and they very often feel sickish.
They are rather better after they get up and move about. Passive movement, however, such as riding in a car or train, is liable to make them feel worse, and may make them sick.
In women, all complaints-indigestion, constipation, liverishness, headaches, etc.-tend to be very much worse before and during the menstrual periods.
A peculiar thing about Sepia patients; in spite of their general tired, sluggish sort of state, they are peculiarly sensitive to noise. This usually produces the characteristic reaction of irritation and annoyance.
With vomiting of pregnancy, which is confined to the mornings and in which the patient has constipation, they may have slight headache on waking and vomit a quantity of whitish, milky- looking fluid, which will often be controlled entirely by Sepia.
This is particularly true if the patients have that strange Sepia empty hungriness most of the time and are very sensitive to the smell of cooking food.