There have always been two types of dyspeptics. One is the patient with acid indigestion, sour stomachwhose indigestion is really caused by peptic ulcer. He has almost always a ravenous appetite and the indigestion consists of discomfort of more or less severity after a meal has been eaten. But he really digests his food all right, and on account of the appetite keeps in good weight.
The only good name for the other kind is “asthenic dyspepsia.” The patients present the typical picture of the dyspeptic. They are thin and bent over and the brow is furrowed with a general dissatisfaction with life. They can’t eat. They have no appetite. They belch. They are constipated. They have a list of things as long as your arm which disagree with them.
They take dyspepsia tablets, sometimes one kind and sometimes another, changing aroundcharcoal one month, pepsin the next, soda the next, etc., etc. They get their stomachs washed out, they go from stomach specialist to stomach specialist, they know all the gossip, they delight in their friends’ misfortunes, they complain, and in spite of how sick they say they are, they live and live and live. When they have been sick about 60 years they begin to get better and the last 20 or 30 years of their livesthat is from the age of 70 to 100they have a right good time.
What is the matter with these people? When one looks at the stomach that has been causing all this trouble there is very little to see that is wrong. The trouble is the whole body has been put together the wrong way.
The stomach in this asthenic or visceroptotic dyspeptic is too large and it hangs down too low. It has too little muscular power. The intestines sag. They have no tone. The kidneys float. Naturally all the muscles are weak. Food stays in the stomach a long time and efficient digestion and absorption is not carried out. They are always fatigued and unhappy and always trying to do something they haven’t got strength for.
The treatment must take into consideration the whole body of the patient. An important element is plenty of rest. The diet should be light and very nourishing. The patient should lie down for an hour after each meal so as to help the stomach in its digestion and emptying. A corset to support the abdominal walls is often a great comfort. Exercises to strengthen the abdominal walls also help. Surgical operations on this type of patient, such as to anchor a floating kidney, have been found of little value, as all conservative surgeons agree. Often mental therapy in the way of assurance that their ills are not of bad prognosis is the most valuable portion of the treatment.