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Gastric Ulcer

HM Shelton

Orthopathy VII

Definition:

A circumscribed loss of tissue in the stomach, usually involving both the mucous

membrane and the deeper structures. An ulcer differs from a wound in the

following ways: A wound arises from some external source; an ulcer has its cause

within the body. A wound is always idiopathic; an ulcer is always symptomatic.

The tendency of the wound is to heal because its cause is removed: the cause

acted but momentarily. An ulcer persists and often enlarges, because its cause

persists and often increases. The healing of an ulcer therefore depends

primarily upon the removal and correction of the internal condition of which it

is but a symptom. This done, the ulcer quickly heals.

Symptoms:

Pain, usually paroxysmal, severe and localized, though it may radiate to the

back or sides, is usually present. In many cases taking food induces or

aggravates the pain and this lasts until the stomach is emptied, either by

vomiting or by emptying into the intestine. Localized tenderness is often felt.

Vomiting, usually of undigested food and acid fluid, which is quite frequent,

usually comes on from one-half hour to two hours after eating. Hemorrhage into

the stomach with vomiting of blood occurs in more than half the cases and is

said to cause death in about twenty per cent of all fatal cases of ulcer. There

is an excessive secretion of hydrochloric acid (hyperacidity). Symptoms of

indigestion (dyspepsia) precede most cases, though in some cases there are few

symptoms until sudden perforation into the peritoneum, pleura, pericardium, or

intestine, with hemorrhage, occurs.

Complications:

Perforation occurs in from 8 to 10 per cent of cases. General or circumscribed

peritonitis results from perforation. The peritonitis is a conservative process

resulting in adhesions and walling up of the perforation. Sub-phrenic abscess

sometimes follows the formation of adhesions. Stenosis, either of the cardiac or

pyloric orifices, or hour-glass constriction of the stomach may result from

contraction of the cicatrices — scars. About 20 per cent of ulcers become

malignant — cancerous.

Etiology:

As gastric catarrh evolves, the catarrh passes to inflammation, from

inflammation to induration (hardening), and from induration to ulceration.

Stomach ulcer is the end of a chain of stomach disorders beginning with

irritation — indigestion from imprudent eating or drinking — which, when very

severe, or oft repeated causes' inflammation (catarrh); and when the abuse of

the stomach is continued, ulceration follows, or induration (hardening), then

cancer.

Decidedly nervous individuals who consume much starch — bread, cake and pastry —

are more inclined to develop ulcer. Where there is a decided acidity of the

secretion, inflammation and ulceration are almost sure to develop. Discomfort

and often great pain accompany this condition.

It is not uncommon to see a patient whose stomach is so sour that, on drinking

water and vomiting, the returned water and diluted acid are strong enough to

sear the throat and paralyze the epiglottis so it can not close, and an attempt

to drink water will cause the water to run into the nose. Even gases eructated

from such a stomach burn the membranes of the nose and throat.

Prognosis:

This is very favorable in all early; cases. Many persist for years, then

recover. Relapses, so common under regular care, are due to failure to remove

causes. Advanced cases, in the profoundly enervated may end fatally in spite of

the best of care.

Care of the Patient: The palliative treatments in vogue are so unsatisfactory

that a noted American surgeon recommends that ulcers be removed after they have

been cured nine times. As in all other troubles, the first necessity is the

removal of the causes — immediate and remote — of the trouble. All enervating

habits must be discontinued and sufficient rest in bed secured to permit of

restoration of full nerve energy. A fast, both to hasten elimination of toxemia

and to give the stomach an opportunity to heal, is essential. Chronic

provocation by food, indigestion and drugs prevent healing. Food also keeps up

the excessive gastric secretion. Fasting soon stops gastric secretion so that,

while it often increases the pain during the first two or three days, it

speedily establishes a state of comfort so that satisfactory healing may

proceed. The fast should last until the body is free of toxemia.

Feeding after the fast should be, in most particulars, exactly opposite to the

feeding commonly employed in cases of ulcer. Instead of the highly acid-forming

diet in vogue, an alkaline diet should be employed. Fruits and vegetables, and

these raw, should make up the bulk of the diet. If, at first, there is

sensitiveness to the roughage in these foods, raw juices of the fruits and

vegetables and purees and strained vegetable soups may be used. Cooked fruits

are never to be used.

Every health building agent — sunshine, exercise, etc. — should be employed as

early as possible.

Operations are notoriously unsatisfactory in ulcers. First, the operation does

not remove the cause of the ulcer. Second, the ulcer is in a field of

inflammation in the mucous membrane, which inflammatory field may be quite

limited or may involve much of the gastric mucosa, and an operation will remove

the ulcer, but there is always quite an area of inflamed mucous membrane left

after the ulcer is removed and this inflamed membrane tends to ulcerate. Two,

three, four, five and even more operations are performed for the removal of

ulcers, as these persist in developing. There is nothing to restore an inflamed

mucous membrane to health when the causes of the inflammation are left

operative.

--

Peace be with you,

Don " Quai " Eitner

" Spirit sleeps in the mineral, breathes in the vegetable, dreams in the animal

and wakes in man. "

Nearly all men die of their remedies, and not of their illnesses. ~Jean

Baptiste Molière, Le Malade Imaginaire

The obstacle is the path. ~Zen Proverb

--

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