Gastric ulcer is becoming exceedingly common. In days gone by it is quite evident that any so-called dyspeptic cases were really cases of chronic ulcer, or ulcers which had healed and left behind large scars and crippled function.
The cause of gastric ulcer must very as to the individual, and it is very important to determine as nearly as possible. This cannot always be done, but a careful examination of the patients mode of living, inquiry into events preceding the illness, and a careful physical examination and possibly X-ray of the teeth will very frequently determine it.
Now, in nearly all cases of ulcer, there is present an over activity of the stomach glands with formation of a excess of hydrochloric acid. This acid is poured out in the stomach nearly all the time, instead of as in normal cases only when required for digestion. This excessive acid nearly always precedes the formation of an ulcer. Its presence gives rise to that burning sensation in the epigastrium so frequently complained of, to the heartburn, waterbrash, and irritations, etc. No one can state positively at what time the ulcer forms, but its presence renders all the above mentioned symptoms more distressing, and adds the extra, symptoms of pain.
The particular location of the ulcer in the stomach wall has much to do with the severity of the pain. The acid in the stomach passing over the ulcer causes irritation, this is followed by contraction or spasm of the stomach muscles, and this in turn causes the very severe pains met with in these cases. The slow gnawing pain is probably due to the acid in contact with the raw ulcer surface.
All remedial measures in these cases must be mechanically correct as well as functionally so. One must eat, but as coarse foods are mechanically more irritating they must be omitted. Functionally we recognize the presence of an excessive acid. This must be diluted so as to reduce the irritation and spasm, and the food used to do this must be a protein, as starches and sugars are not digested in the stomach. Milk is the best of all foods and eggs follow. They are functionally and mechanically right.
Just as an injury or ulcer in any other part of the body will not heal if constantly irritated, and must get rest, so must a person suffering from a gastric ulcer have rest. This rest must be in bed if the case is very acute, if not so acute the omission of coarse foods from the diet is a form of rest, and the patient should be instructed to lie down or sit down at every opportunity.
Rest of mind is nearly as important. You will find when searching for the cause of the ulcer, that a very great percentage of them are brought on by mental strain, worry and grief.
There are undoubtedly some cases which will defy al measures aimed at their relief. These cases are happily very scarce.
If an ulcer case is treated with rest, proper diet, and the correct homoeopathic remedy, they return to health very rapidly. It is indeed rare that any patient who is regularly a homoeopathic patient, ever develops and ulcer. They may and often do develop a hyperacidity, but consult their physician, and the condition quickly yields to the remedy.
The type of case that we most frequently meet with is therefore on who has passed through the stage of hyperacidity into that of ulcer formation, and who have frequently been to other doctors first, and now days in the large centers they have been through the hands of a stomach specialist, and radiologist. They are on diet more or less strict when they arrive in your office. The history in some cases is very long, and in one of my cases, there had been three operations at intervals of fro four to five years.
It is quite probable that in many cases an operation gives permanent relief. I believe that in these cases the ulcer was probably caused by an infection say from teeth. This condition is usually remedied early and an operation in such a case should give permanent relief. In a case due to worry and fear the mental relief to the patient from knowing that there is no cancer, and that he is now well will cause the operation to be a permanent success, or permanent so so long as there is no repetition of the worry.
In a tremendous number of cases however the functional disturbance is the cause, and as the operation removes the results only it cannot be a success, and is not. These patients need good homoeopathic prescribing, and will never get well without it.
A few words regarding haemorrhage in gastric ulcer may be of interest. You have had cases come who give a history of many years of hyperacidity, ulceration and perhaps operation, but no history of haemorrhage, while other cases give a history of one or more haemorrhages. The tendency to haemorrhage in any acute case can therefore be discounted if in previous attacks there was no history of bleeding. If however there is now or has been haemorrhage look out for more. That patient is to be given more rest, and that tendency to haemorrhage must be included in your study of his symptoms.
Just as ulcers on any other part of the body run a rapid or chronic course, so do gastric ulcers, but on the whole they are slower to heal because the stomach can never be put completely at rest. Rectal feeding does not give the complete rest to the stomach which it is supposed to give. Duodenal feeding is applicable only when the ulcer is not near the pylorus.
Now as to remedies, they are numerous. Where the ulcer is deep and getting near the peritoneum or where it is inflamed you will find the patient is worse from every jar, and at times complains of a throbbing. Belladonna speedily relieves. If he goes about holding his hand over the ulcer and is much better lying down Bryonia is likely to assist. Where there is burning, great weakness, and frequent vomiting, try Arsenicum. If vomiting, haemorrhage, and thirst occur, Phosphorus is very often indicated.
The greatest of all chronic ulcer remedies is, of course, Sulphur. It will cure nine out of ten chronic cases. Carbo veg. ranks next. Nux vomica is useful where the ulcer is caused by business and other worries and drugging. Anacardium where eating greatly relieves the pain, also Graphites. Where the haemorrhage is severe and the patient partially collapsed use Secale. For smaller haemorrhages try Kreosotum.
I mentioned a case in Montreal last year where the symptoms were simply not present. He has had three large haemorrhages. It developed that, about two weeks previously the patients mother had died suddenly. Ignatia promptly stopped the haemorrhage, and later Sulphur completed the cure.