I. From Indigestible Food.
WHEN a small boy strays into an orchard before the fruit is quite ripe, and indulges his appetite without staying to reflect, he is apt to experience an attack of indigestion of the simplest kind. The food he has eaten is not digested, but remains in his stomach like an irritating foreign body. If he is discovered in time, the simplest process is to give him an emetic of salt-and- water or mustard-and-water, and so get rid of it in this way. But if it has already had time to pass into the bowels, other measures will be needed. The symptoms he experiences are sharp pains in the upper part of the body or about the navel, and even cramp and spasms which may go on to general convulsions. Stone fruit before it is ripe will cause the same symptoms.
Those who have reached mature years are generally more discriminating in their diet, but every little while they may forget themselves. Perhaps it is some favourite dish which they know does not agree with them, but which they cannot resist, and then they know what to expect. The symptoms very according to the food that has caused the indigestion. Nuts cause pains in the stomach 1 and chest. Fat food, especially fat pork, causes nausea and vomiting, with moist white tongue. This is frequently accompanied by pains in the body and diarrhoea.
Food may be indigestible under some conditions, and digestible under others. If a person in a state of exhaustion sits down to a hearty meal, even though the food is nothing but what he is used to, he will not be able to digest it. In all such states the very lightest food should be taken until the bodily powers are restored, which usually happens after a sleep. Some people can eat hot meat very well, but not cold meat, and to them cold meat is an indigestible food. The explanation of this is that in cold meat the albuminous and gelatinous parts are set, whereas in hot meat they are fluid, and these are more easily acted on by the digestive juices; moreover, cold meat must become warm in the stomach before it can be digested, and Pains in the chest and intestines, flatulence, and great distress, are the penalty of want of due care of these points.
1 *Throughout this treatise I use the word “stomach” in the anatomical sense, meaning the organ which receives the food as soon as it is swallowed. The stomach lies in the upper part of the abdominal cavity, more on the left side than on the right, which is occupied by the liver. The stomach is protected by the lowest ribs on the left side, and many of the pains arising in the stomach are felt in the chest. In common speech, the “stomach” means the whole of the abdomen, but I do not use it in this sense.* 1
Under the same heading of indigestion from indigestible food must come those cases due to defective teeth. When the teeth are faulty and cannot masticate the food properly before it is swallowed, it reaches the stomach ill-prepared, and sets up indigestion which is apt to become chronic. The remedy in this case is to consult a dentist, and if he cannot put matters right, the food–that is, the solid part of it–will have to be passed through a mincing-machine and so be chewed artificially.
2. From Excessive Indulgence in good Food.
It is just as possible to injure the digestion with good food as with bad, if too much of it is taken. By a process of training, the stomach can become developed out of proportion to the rest of the body, and then large quantities of food can be taken without any active symptoms of indigestion. The stomach becomes to the gourmand what the athlete’s limbs are to him- capable of an amount of exertion beyond the powers of other men. But over-development is not good in any part of the body, be it muscle or be it stomach; and the gourmand pays the penalty before long. His powerful digestion lays up more pabulum than he requires; he grows in bulk without growing in strength, and is one day seized with a fit of gout–he is fortunate if it attacks his toe and not some vital organ, or the stomach itself. Gouty dyspepsia is one of the most troublesome kinds to treat. Gout may be inherited as well as acquired, so it is not always the sufferer’s own fault. There is in cases of gouty dyspepsia much acidity, flatulence, pain, and constipation. 3. From Alcohol.
The man who drinks excessively of beer loses consciousness, and has an acute attack of indigestion and vomiting. The vomiting relieves his stomach, a few hours’ sleep restoring his senses, and after a day’s indisposition he is well. But one who habitually indulges in beer and not necessarily to such excess, will have chronic dyspepsia of a different kind. Alcohol acts on both the primary and the secondary digestion, and the action of beer is to relax all the tissues of the body. The beer-drinker gradually becomes of the “flabby” or “sodden” type, probably pale and rather fat, and his digestion also becomes flabby and slow, and the tongue is large and yellow-coated, and there is much flatulence. Those who live active lives in the open air in the country do not show the effects as soon as those who live in towns and get little exercise.
Wine and spirits act somewhat differently. They do not cause so much puffiness as beer, but they redden the skin more, causing dilatation of the small blood-vessels, especially of the nose. Often there is pallor of the rest of the face, leaving the nose only red. There is in general wasting of the tissues of the body.
One marked symptom of the alcoholic dyspepsia– and this applies to all kinds, whether from beer, wine, or spirits–is sickness in the morning. There is bad appetite at any time, but in the morning, before anything has been taken, there is vomiting, of mucus generally. The tongue is tremulous, and there is a tremor through the body; flatulence and constipation generally accompany this kind.
4. From Tobacco.
The first attempts to smoke are almost always attended with an acute attack of indigestion, deathly nausea, and vomiting. But habitual over-indulgence in tobacco causes dyspepsia of a different kind. In the most aggravated form it is characterised by perpetual sickness; no food can be retained, and at this time, smoking, and even the smell of tobacco, is intolerable. In the less severe cases it takes the form of acidity, heartburn, pain after taking food, sinking sensation at the pit of the stomach, and generally constipation.
5. From Tea.
It would be difficult to say which is the greater cause of indigestion-alcohol or tea. It is true people don’t often get drunk with the cup that “not inebriates” (though there has been one case reported, in which a woman who ate tea suffered from delirium tremens in consequence), but they do often get dyspepsia. In the tea dyspepsia the nervous symptoms predominate. There is more pain at the stomach than sickness or vomiting, the tongue is not so large and flabby as with beer- drinkers, and the subjects of it suffer more from what is called “nerves.” They are always on high tension, easily startled, sleep little, and have no appetite for anything but–tea. They want tea always; it is the only thing that relieves the “sinking” they complain of (itself a consequence of the tea). They suffer much from low spirits.
6. From Cold.
Few things stop digestion so soon as lowering the bodily temperature. A cold bath soon after a meal arrests the process completely, and is very apt to cause dangerous symptoms. A drive in cold air with insufficient wraps will cause symptoms of indigestion, chiefly pains in the stomach, and flatulence. The next meal gives great pain, and it takes some time for the stomach to recover from the injury.
7. From Bad Air.
When many hours of the twenty-four are passed in air that is spent, heated by gas, or polluted by the breath of human beings which cannot escape, it is impossible for the digestion to go on properly. The stomach, as well as the rest of the body, loses its proper vitality; the digestive fluids are not able to transform the food eaten; and, for want of proper oxygen in the blood, the secondary digestion is imperfectly performed. The results are wasting and pain.
8. From Vinegar
Some persons who have a tendency to grow fat take to drinking vinegar, in order to prevent such a dreadful, unbecoming calamity falling upon them. Many have succeeded by this means in bringing about “vinegar-consumption,” and dying of it. Others have gained their object at the price of no worse a disease than ruined digestion. Constant acidity, pain after food, flatulence, flushing of the face, great thinness, are the leading symptoms of vinegar dyspepsia.
9. From Tight-lacing.
Another vanity for which many women have paid dearly is a wasp waist. Wherein the beauty of this anatomical enormity consists it is difficult to discover, and it must be classed along with the foot-deforming custom of the Chinese, and the head flattening of some tribes of North American Indians. The organs of digestion resent it, and show their resentment by painting the nose red, and torturing the offender whenever she attempts to put food into the stomach without leaving it proper room. Constipation is usually one result of this.
10. From Nervous Debility.
Some of the most inveterate cases of indigestion arise from weakness of the nervous system. This may be brought on in many ways. It may be due to nervous strain or worry of business. It may arise from fright, mental shock, or anxiety. Much more frequently it arises from evil habits and abuse of the organs of generation. One vicious boy at school will often corrupt numbers of others, and so the disease will spread like an infection, bearing fruit before long in the loss of all manly qualities, and in sufferings of a most distressing kind connected with the process of digestion. These cases, like most of the others, are curable, but they need much care, and, of course, a sine qua non is the abandonment of the habits that have brought about the disorder.
II. From Bloodlessness.
Young girls between 12 and 20 are very frequently affected with a disease commonly called “green-sickness.” This is chiefly a fault of digestion, primary or secondary, or both, but it is also a fruitful cause of digestive troubles. There is almost complete loss of appetite, constant nausea, frequent vomiting. Usually, also, there is great weakness and constipation. When the condition is attended by violent pains at the stomach after all food, it is not easy to distinguish between simple indigestion and ulceration of the stomach. This is usually declared by vomiting of blood in the quantity, which never takes place in ordinary indigestion, and is rarely, if ever, absent at some period of ulceration.
Many a sufferer from indigestion traces his troubles to the prescriptions of his doctor. It is one of the commonest experiences of medical life, to find digestion ruined by strong drugs given for other complaints. Others owe it not to their doctors, but to their own efforts to cure themselves with drugs. Probably, in the first instance, it has been a slight attack of indigestion from indiscretion in diet, for which the offender has purchased a drug according to his own fancy. Then the drug has set up symptoms of its own, for which he has taken more drugs. More symptoms have followed, and the drugging has become a habit which he has not been able to break off. Palliatives, like Bicarbonate of Soda and Bismuth, are responsible for many cases of confirmed dyspepsia, and Iron, Mercury, and acids for many more. The symptoms in these cases vary according to the drugs which have caused them.
A depraved or disordered constitutional state is often answerable for chronic indigestion. Persons who inherit a tendency to skin disease frequently find that when their skin is affected their digestion is good, and vice versa. This is what Hahnemann called psora. In such cases, the only treatment that is of any permanent service is one which is directed to the constitution as a whole. The indigestion is only one symptom of many.
Indigestion is frequently a manifestation of the consumptive tendency which is one of the branches of Psora, and in such cases Tuberculinum or Bacillinum often greatly assists the cure. Occasional doses may be given inter-currently with the symptomatically indicated remedy.
The hydrogenoid constitution of Grauvogl is answerable for many disorders of digestion. *1 This subject is dealt with at large in the author’s Constitutional Medicine, with especial reference to the Three Constitutions of von Grauvogl.* The symptoms of this are an extraordinary sensitiveness to cold, damp, and barometrical changes. The persons are always chilly. Residence by water, in valleys, or forests, passing storms, and changes of weather bring on attacks of illness, which takes various forms. Sometimes it is general malaise, with no definite symptoms, only the patient feels wretched only the patient feels wretched, good for nothing. At other times it is an attack of asthma or ague. Certain kinds of food disagree with them, such as melons, cucumbers, mushrooms, hard-boiled eggs, watery fruits, fish, and sometimes milk. They are generally pale and have cold feet. They are better in summer than in winter, and are relieved when they perspire. This constitution may be inherited or acquired. It often follows malarial poisoning. The particular form of indigestion attending this constitution is marked by pains in the stomach, water-brash, eructations of odourless gas, often brought on by eating watery fruits or vegetables and vegetable acids. There is distaste for animal food, though the appetite is often good. With such patients drinking plain water produces aggravation, and in their case the addition of wine to the water they drink is necessary.
Vaccination often leaves behind it a depraved state of the constitution with many hydrogenoid symptoms, and the development of abdominal flatulence. Thuja meets most of these cases.
14. From Gout.
Chronic gout is answerable for much indigestion. It takes a great variety of forms and is often attended with pains in the joints or affections of the skin. There is loss of appetite, acidity, tendency to flatulence, generally constipation. Gouty persons are inclined to the formation of fat in spite of small appetite. This is in consequence of insufficient oxidation of the tissues. They have nearly always a great desire for the open air.
Some persons who are constitutionally dyspeptic always suffer from an attack when the wind is in the east.
Before closing this chapter I must say a word on a very inveterate form of indigestion which is associated with the modern malady Neurasthenia. It is beyond the limits of this treatise to deal with this subject, but I may mention that the nerve-weakness of the condition is very markedly manifested in the digestive tract. The stomach is dilated and the entire digestive system is in a state of devitalisation.
In addition to the above-named, there are cases of dyspepsia arising from causes which cannot easily be classed, and some which seem to arise from no discoverable cause, and which are hence termed self-causing, or, in the medical phrase, “idiopathic.”
In the following chapter I shall describe the treatment of the different kinds of indigestion, and shall relate a number of typical cases.