See also:

• DYSPEPSIA (from the Gr. prefix Sur-, hard, ill, and 'irirreiv, to digest)

DYSPEPSIA (from the Gr. prefix Sur-, hard, See also:

• ILL

ill, and 'irirreiv, to See also:

• DIGEST

digest)  , or indigestion, a See also:

• TERM

term vaguely given to a See also:

• GROUP

group of pathological symptoms . There are comparatively few diseases of any moment where some of the phenomena of See also:

• DYSPEPSIA (from the Gr. prefix Sur-, hard, ill, and 'irirreiv, to digest)

dyspepsia are not See also:

• PRESENT

present as associated symptoms, and not infrequently these exist to such a degree as to See also:

• MASK (Fr. masque, apparently from med. Lat. mascus, masca, spectre, through Ital. maschera, Span. mascara)

mask the real disease, of which they are only complications . This is especially the See also:

• CASE
• CASE, JOHN (d. 1600)

case in many organic diseases of the alimentary See also:

• CANAL
• CANAL (from Lat. canalis, " channel " and " kennel " being doublets of the word)

canal, in which the symptoms of dyspepsia are often the most prominent . In its restricted meaning, however (and it is to this that the present See also:

• ARTICLE (from Lat. articulus, a joint)

article applies), the term is used to describe a functional derangement of the natural See also:

• PROCESS

process of digestion, apart from any structural See also:

• CHANGE (derived through the Fr. from the Late Lat. cambium, cambiare, to barter; the ultimate derivation is probably from the root which appears in the Gr. «a urmu', to bend)

change in the See also:

• ORGANS

organs concerned in the See also:

• ACT (Lat. actus, actum)

act . The causes of this trouble may be divided into (a) those which concern the See also:

• FOOD
• FOOD (like the verb " to feed," from a Teutonic root, whence O. Eng. foda; cf. " fodder "; connected with Gr. lrareicOae, to feed)

food, and (b) those which concern the organism . Among the causes connected with the food are not only the See also:

• INDULGENCE (Lat. indulgentia, indulgere, to grant, concede)

indulgence in indigestible articles of See also:

• DIET

diet, but the too commonpractice of eating too much of what may be otherwise quite wholesome and digestible; and irregular, too frequent or too infrequent meals . The quantity of food required by different individuals varies between wide limits, but also the quantity required by the same individual varies considerably according to circumstances, more food being needed in See also:

• COLD (in O. Eng. cald and ceald, a word coming ultimately from a root cognate with the Lat. gelu, gelidus, and common in the Teutonic languages, which usually have two distinct forms for the substantive and the adjective, cf. Ger. Kolte, kalt, Dutch koude

cold than in warm See also:

• WEATHER (O. Eng. weder; the word is common to Teutonic languages; cf. Du. weder, Dan. veir, Icel. ve8r, and Ger. Wetter and Gewitter, storm; the root is wa- to blow, from which is derived " wind ")

weather, and more in an active open-See also:

• AIR (from an Indo-European root meaning " breathe," " blow ")
• AIR, or ASBEN

air occupation than in a sedentary one . The thorough mastication of the food is a very important precursor of digestion,' and this only too often fails, either owing to haste over meals or because of painful or deficient See also:

• TEETH (O.E. Eel); plural of tooth, O.E. top)

teeth . Again, the quality of the food is of importance, some kinds of flesh being harder and more difficult of mastication than others . This is especially the case with See also:

• MEAT

meat that has been smoked or salted, and with that cooked too soon after the See also:

• DEATH

death of the See also:

• ANIMAL
• ANIMAL (Lat. animalis, from anima, breath, soul)

animal . Drinks are a See also:

• COMMON

common source of dyspepsia . See also:

• BEER

Beer when new and its See also:

• FERMENTATION

fermentation not completed is especially See also:

• BAD, BCD

bad .

See also:

• VINEGAR

Vinegar and See also:

• ACID (from the Lat. root ac-, sharp; acere, to be sour)

acid wines, if taken in large quantities, tend to produce gastric See also:

• CATARRH (from the Gr. Karappeiv, to flow down)

catarrh, and See also:

• TEA (Chinese cha, Amoy dialect t€)

tea is a very fruitful source of this trouble . Even too much See also:

• WATER

water at See also:

• MEAL

meal-times may cause indigestion, since the food in the mouth is See also:

• APT

apt to be softened by the water instead of saliva, and also the gastric juice becomes unduly diluted, rendering the digestion in the See also:

• STOMACH (Gr. vrbsaxos from arbga, a mouth)

stomach too slow and prolonged . Carious teeth and oral See also:

• SEPSIS (Gr. Qi7,/iss, putrefaction), or SEPTIC INFECTION

sepsis, from whatsoever cause, See also:

• LEAD
• LEAD (pronounced iced)

lead to the same trouble . Of the causes which concern the organism, See also:

• NERVOUS

nervous influences come first . Bad See also:

• NEWS

news may take away all See also:

• POWER [WILLIAM GRATTAN] TYRONE (1797-1841)

power of digestion and even provoke vomiting, and any worry or See also:

• MENTAL

mental trouble tends to bring on this See also:

• CONDITION (Lat. condicio, from condicere, to agree upon, arrange; not connected with conditio, from condere, conditum, to put together)

condition . See also:

• GENERAL
• GENERAL (Lat. generalis, of or relating to a genus, kind or class)

General weakness and atony of the See also:

• BODY

body affects the stomach in like degree, and, if the muscles of the abdominal See also:

• WALL (O. Eng. weal, weall, Mid. Eng. wal, wane, adapted from Lat. vallum, rampart; the original O. Eng. word for a wall was wag or tenth)
• WALL, RICHARD (1694-1778)

wall be much wasted, they become too weak to support the abdominal viscera in See also:

• PLACE (through Fr. from Lat. platea, street; Gr. IrAar6s, wide)

place . Hence results a general tendency for these organs to fall, giving rise to a condition of visceroptosis, of which an obstinate dyspepsia is a very marked feature . Adhesions of the intestines from old inflammatory troubles, floating See also:

• KIDNEY

kidney and bad circulation may each be a cause of painful digestion . Again, a dyspepsia that will not yield to treatment is often one of the symptoms of renal disease, or, in See also:

• YOUNG
• YOUNG, A
• YOUNG, ARTHUR (1741-1820)
• YOUNG, BRIGHAM (1801-1877)
• YOUNG, CHARLES MAYNE (1777–1856)
• YOUNG, EDWARD (1683–1765)
• YOUNG, JAMES (1811-1883)
• YOUNG, THOMAS (1773-1829)

young See also:

• PEOPLE

people of fifteen to twenty years of See also:

• AGE (Fr. age, through late Lat. aetaticum, from aetas)

age, it may be the earliest sign of a gouty diathesis, or even of a more serious condition still—incipient See also:

• PHTHISIS (Gr. 49Lnns " wasting ")

phthisis . Chronic dyspepsia, by weakening the organism, renders it more liable to fall a See also:

• PREY (0. Fr. preie, mod. proie, Lat. praeda, booty, from prae and the root hed—seen in prehendere, prendere, to grasp)

prey to the attacks of the tubercle bacillus, but, on the other See also:

• HAND
• HAND (a word common to Teutonic languages; cf. Ger. Hand, Goth. handus)
• HAND, FERDINAND GOTTHELF (1786-185r)

hand, the tuberculous See also:

• LESION (through Fr. from Lat. laesio, injury, laedere, to hurt)

lesion in the See also:

• LUNG

lung is often accompanied by a most intractable See also:

• FORM (Lat. forma)

form of dyspepsia . From this it is clear that any condition which lessens the general well-being of the organism as a whole, apart from its producing any permanent morbid condition in the stomach, may yet interfere with the normal See also:

• DIGESTIVE

digestive processes and so give rise to dyspepsia . The symptoms of dyspepsia, even when due to a like cause, are so numerous and diversified in different individuals that probably no description could exactly represent them as they occur in any given case .

All that can be here attempted is to mention some of the more prominent morbid phenomena usually present in greater or less degree . Very briefly, a furred See also:

• TONGUE (O. Eng. lunge)

tongue, foul breath, disturbance of appetite, See also:

• NAUSEA (from Gr. vain, a ship)

nausea and vomiting, oppression in the See also:

• CHEST (Gr. Kiarl, Lat. cista, O. Eng. cist, test, &c.)

chest, See also:

• PAIN (from Lat. poena, Gr. robin, penalty, that which must be paid: O. Fr. peine)
• PAIN, BARRY (1867– )

pain, flatulence and distension, acidity, pyrosis and See also:

• CONSTIPATION (from Lat. constipare, to press closely together, whence also the adjective " costive ")

constipation or See also:

• DIARRHOEA (from Gr. &Q, through, pfw, flow)

diarrhoea are a few of the commonest symptoms . When the attack is dependent on some See also:

• ERROR (Lat. error, from errare, to wander, to err)

error in diet, and the dyspepsia consequently more of an acute See also:

• CHARACTER (Gr. xapareri7p, from xap&crew, to scratch)

character, there is often pain followed with sickness and vomiting of the offensive matters, after which the patient soon regains his former healthy See also:

• STATE
• STATE, GREAT OFFICERS OF

state . What are commonly known as " bilious attacks " are frequently of this character . In the more chronic cases of dyspepsia the symptoms are somewhat different . A sensation of discomfort comes on shortly after a meal, and is more of the nature of See also:

• WEIGHT

weight and distension in the stomach than of actual pain, although this too may be present . These feelings may come ' This aspect of the See also:

• MATTER

matter—" buccal digestion "—has been specially emphasized in See also:

• RECENT

recent years by See also:

• HORACE [QuINTus HORATIUS FLACCUS] (65-8 B.C.)

Horace See also:

• FLETCHER, ALICE CUNNINGHAM (1845– )
• FLETCHER, ANDREW
• FLETCHER, GILES (c. 1548-1611)
• FLETCHER, GILES (c. 1584-1623)
• FLETCHER, JOHN WILLIAM (1729-1785)
• FLETCHER, PHINEAS (1582-1650)

Fletcher of the See also:

• UNITED

United States, whose experience of the results of systematic " chewing," confirmed by See also:

• SIR

Sir M . See also:

• FOSTER, GEORGE EULAS (1847– )
• FOSTER, JOHN (177o-1843)
• FOSTER, MYLES BIRKET (1825-1899)
• FOSTER, SIR CLEMENT LE NEVE (1841-1904)
• FOSTER, SIR MICHAEL (1836-r9o7)
• FOSTER, STEPHEN COLLINS (1826-1864)

Foster, Prof . Chittenden and others, has almost revolutionized the See also:

• SCIENCE (Lat. scientia, from scire; to learn, know)

science of See also:

• DIETETICS

dietetics . on after each meal, or only after certain meals, and they may arise irrespective of the See also:

• KIND (O. E. ge-cynde, from the same root as is seen in " kin," supra)

kind of food taken, or only after certain articles of diet . As in most of such cases the food is See also:

• LONG, GEORGE (1800-1879)
• LONG, JOHN DAVIS (1838– )

long retained in the stomach, it is apt to undergo fermentive changes, one of the results of which is the See also:

• ACCUMULATION (from Lat. accumulare, to heap up)

accumulation of gases which cause flatulence and eructations of an acid or foul character . Occasionally quantities of hot, sour, tasteless or See also:

• BITTER, KARL THEODORE FRANCIS (1867– )

bitter fluidpyrosis—or mouthfuls of See also:

• HALF

half-digested food, regurgitate from the stomach .

Temporary See also:

• RELIEF

relief may be obtained when another meal is taken, but soon the uncomfortable sensations return as before . The appetite may be craving or deficient, or desirous of abnormal kinds of food . The tongue registers the gastric condition with See also:

• GREAT

great delicacy: —a pasty See also:

• WHITE
• WHITE, ANDREW DICKSON (1832– )
• WHITE, GILBERT (1720–1793)
• WHITE, HENRY KIRKE (1785-1806)
• WHITE, HUGH LAWSON (1773-1840)
• WHITE, JOSEPH BLANCO (1775-1841)
• WHITE, RICHARD GRANT (1822-1885)
• WHITE, ROBERT (1645-1704)
• WHITE, SIR GEORGE STUART (1835– )
• WHITE, SIR THOMAS (1492-1567)
• WHITE, SIR WILLIAM ARTHUR (1824--1891)
• WHITE, SIR WILLIAM HENRY (1845– )
• WHITE, THOMAS (1628-1698)
• WHITE, THOMAS (c. 1550-1624)

white See also:

• FUR (connected with O. Fr. forre, a sheath or case; so " an outer covering ")

fur on the tongue is considered a sign of weakness or atony of the digestive See also:

• TRACT (from Lat. tractare, to treat of a matter, through Provencal tractat and Ital. trattato)

tract; a clean pointed tongue with large papillae, and rather red at the edges and tip, is a sign of gastric irritation; and a See also:

• PALE (through Fr. pal, from Lat. palms, a stake, for paglus, from the stem pag- of pangere, to fix; " pole " is from the same original source)

pale flabby tongue suggests the need of stimulating treatment . Constipation is more common in the chronic forms of dyspepsia, diarrhoea in the acute . Numerous disagreeable and painful sensations in other parts are experienced, and are indeed often more distressing than the merely gastric symptoms . Pains in the chest, shortness of breathing, palpitation, headache, giddiness, affections of See also:

• VISION (from Lat. videre, to see), or SIGHT

vision, coldness of the extremities, and general languor are common accompaniments of dyspepsia; while the nervous phenomena are specially troublesome in the form of sleeplessness, irritability, despondency and See also:

• HYPOCHONDRIASIS (synonyms— " the spleen," " the vapours ")

hypochondriasis . As regards treatment only a few general observations can he made . The careful arrangement of the diet is a matter of first importance . Quantity must be regulated by the digestive capabilities of the individual, his age, and the demands made upon his strength by See also:

• WORK

work . There is little doubt that the danger is in most instances on the See also:

• SIDE
• SIDE (mod. Eski Adalia)

side of excess, and the See also:

• RULE

rule which enjoins the cessation from eating before the appetite is satisfied is a safe one for dyspeptics . Due See also:

• TIME (0. Eng. Lima, cf. Icel. timi, Swed. timme, hour, Dan. time; from the root also seen in " tide," properly the time of between the flow and ebb of the sea, cf. O. Eng. getidan, to happen, " even-tide," &c.; it is not directly related to Lat. tempus)
• TIME, MEASUREMENT OF
• TIME, STANDARD

time, too, must be given for the digestion of a meal, and from four to six See also:

• HOURS, CANONICAL

hours are in general required for this purpose . Long fasts, however, are nearly as hurtful as too frequent meals .

Of no less importance is the kind of food taken, and on this point those who suffer from indigestion must ever exercise the greatest care . It must be See also:

• BORNE, KARL LUDWIG (1786–1837)

borne in mind that See also:

• IDIOSYNCRASY (Gr. Ibwavyspavia, peculiar habit of body or temperament; 'lbws, one's own, and viryKpao , blending, tempering, from o-vyiepavvvoOat, to put together, compound, mix)

idiosyncrasy often plays an important See also:

• PART

part in digestion, some persons being unable to partake without injury of sub-stances which are generally regarded as wholesome and digestible . In most cases it is found very helpful to See also:

• SEPARATE

separate the protein from the farinaceous food, and the more severe the dyspepsia the more thoroughly should this be done, only relaxing as the dyspepsia yields . No fluid should be drunk at meal-times, but from one to two tumblers of hot water should be drunk from an See also:

• HOUR

hour to an hour and a half before food . This washes any remnant of the last meal from the stomach, and also supplies material for the See also:

• FREE

free secretion of saliva and gastric juice, thus promoting and accelerating digestion . The only exception to this is in the case of a dilated stomach, when it is wholly contra-indicated . With regard to mastication, Sir See also:

• ANDREW (Gr. 'AvBp4as, manly)
• ANDREW, JOHN ALBION (1818-1867)

Andrew See also:

• CLARK, FRANCIS EDWARD (1851- )
• CLARK, GEORGE ROGERS (1752—1818)
• CLARK, JOHN BATES (1847— )
• CLARK, JOSIAH LATIMER (1822—1898)
• CLARK, SIR ANDREW
• CLARK, SIR JAMES (1788—1870)
• CLARK, THOMAS (1801—1867)
• CLARK, WILLIAM (1770-1838)
• CLARK, WILLIAM GEORGE (1821—1878)

Clark's rule is a very See also:

• GOOD, JOHN MASON (1764-1827)

good one, and is more easily followed than the ideal theory laid down by Horace Fletcher, according to whom any food is digestible if properly treated while still in the mouth . Clark's rule is that as the mouth normally contains See also:

• THIRTY

thirty-two teeth, thirty-two bites should be given before the food is swallowed . This, of course, is a See also:

• PRACTICAL

practical See also:

• DOCTOR (Lat. for " teacher ")

doctor's concession to human weakness . Mr Fletcher would See also:

• TRAIN (M. Eng. trayn or trayne, derived through Fr. from Late Lat. trahinare, to drag, draw, Lat. trahere, cf. trail, trace, ultimately from the same source)

train every one to " chew " till the contents of the mouth were swallowed by reflex See also:

• ACTION

action without deliberate act; and he applies this theory of mastication and salivation also to drinks (except water) . Again, a lack of warmth being a source of dyspepsia, this should be attended to, the back of the See also:

• NECK (O. Eng. hnecca; the word appears in many Teutonic languages; cf. Dutch ride, Ger. Nacken; in O. E. the common word was heals; cf. Ger. Hals)

neck, the front of the See also:

• ABDOMEN (a Latin word, either from abdere, to hide, or from a form adipomen, from adeps, fat)

abdomen and the feet being the parts that require See also:

• SPECIAL

special See also:

• ATTENTION (from Lat. ad-tendo, await, expect; the condition of being " stretched " or " tense ")

attention . The feet should be raised on a See also:

• STOOL

stool, the ankles protected with warm stockings and a woollen " See also:

• CUMMERBUND

cummerbund " See also:

• WOUND (O. Eng. wund,connected with a Teutonic verb, meaning to strive, fight, suffer, seen in O. Eng. winnan, whence Eng. " win ")

wound two or three times See also:

• ROUND (O. Fr. rond, Lat. rotundus, the Fr. is the source also of Du. rond; Ger., Swed., Dan. and Nor. rond)

round the body .

Experience has shown that in this complaint no particular kind of food or avoidance of food is absolutely to be relied on, but that in general the best diet is one of a mixed animal and vege-table kind, simply but well cooked . The partaking of many dishes, of highly-seasoned or salted meats, raw vegetables, newly-baked See also:

• BREAD

bread, pastry and See also:

• CONFECTIONERY (from Lat. confectio, conficere, compound)

confectionery are all well-known common causes of dyspepsia, and should be avoided . When even the See also:

• SIMPLE

simple diet usually taken is found to disagree, it may be necessary to change it temporarily for a still lighter form, such as a See also:

• MILK (0. Eng. meoluc; from a common Indo-European root, cf. Lat. mulgere, Gr. ?t dXyetv)

milk diet, and that even in very moderate quantity . The employment of alcoholic stimulants to assist digestion is largely resorted to, both with and without medical See also:

• ADVICE (Fr. avis, from Lat. ad, to, and visum, viewed)

advice . While it seems probable that in certain cases of atonic dyspepsia, particularly in the feeble and aged, the moderate See also:

• ADMINISTRATION (Lat. administrare, to serve)

administration of See also:

• ALCOHOL

alcohol has the effect of stimulating the secretion of gastric juice, and is an important adjuvant to other remedies, the advantages of its habitual use as an aid to digestion by the young and otherwise healthy, is more than questionable, and it will generally be found that among them, those are least troubled with indigestion who abstain from it . See also:

• REST (O. Eng. rest, reste, bed, cognate with other Teutonic forms, e.g. Ger. Rast, Riiste, rest, and probably Gothic Rasta, league, i.e. resting or stopping place)

Rest should be taken both before and after food, and general hygienic See also:

• MEASURES

measures are highly important, since whatever improves the state of the See also:

• HEALTH

health will have a favourable See also:

• INFLUENCE (Late Lat. influentia, from influere, to flow in)

influence on digestion . Hence See also:

• REGULAR

regular exercise in the open air, See also:

• EARLY
• EARLY, JUBAL ANDERSON (1816-1894)

early rising and the cold See also:

• BATH
• BATH, THOMAS THYNNE
• BATH, WILLIAM

bath are to be strongly recommended . The medicinal treatment of dyspepsia can only be undertaken by a physician, but the following is a very brief resume of the drugs he depends on to-See also:

• DAY (O. Eng. dreg, Ger. Tag; according to the New English Dictionary, " in no way related to the Lat. dies")
• DAY, JOHN (1574-1640?)
• DAY, THOMAS (1748-1789)

day . Bicarbonate of soda with some bitter, as See also:

• QUASSIA

quassia, See also:

• GENTIAN

gentian or See also:

• COLUMBA, SAINT (Irish, Colum)

columba, is much in See also:

• VOGUE, EUGENE MELCHIOR, COMTE DE (1848- )

vogue as a See also:

• DIRECT

direct gastric stimulant . In irritable dyspepsia some form of See also:

• BISMUTH

bismuth in See also:

• SOLUTION (from Lat. solvere, to loosen, dissolve)

solution or See also:

• POWDER (through O. Fr. puldre, modern poudre, from Lat. pulvis, pulveris, dust)

powder; and, to assist digestion through the nervous See also:

• SYSTEM

system, nux vomica and See also:

• STRYCHNINE

strychnine can be relied on . To give directly digestive material, hydrochloric acid, See also:

• PEPSIN

pepsin and rennet are prescribed in many forms, but where there is much vomiting ingluvin is more efficacious than pepsin . When farinaceous food is badly borne, diastase is helpful, given either before or with the meal .

To prevent fermentation, phenol, creasote and sulpho-carbolate of soda are all extremely useful in skilled hands; and for intestinal decomposition and flatulent distension, bismuth salicylate with salol or 0-naphthol is much used . Cyllin, and See also:

• CHARCOAL

charcoal in many forms, may be taken both for gastric and intestinal flatulence . But all these drugs, of proved value though they are, must be modified and combined to suit the special idiosyncrasy of the patient, and are therefore often worse than useless in inexperienced hands . The condition of the bowels must always have due attention . See also DIGESTIVE ORGANS; See also:

• NUTRITION

NUTRITION and DIETETICS .