On disordered digestion and dyspepsia / by Frank Woodbury.

Date:
1889
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    PREFACE. The past few years have witnessed a marked advance in our knowledge of the chemistry of the digestive process, and of the role of micro-organisms in the alimentary canal under different conditions. There are indications that disorders of digestion which, in token of ignorance, were classed as func- tional a short time ago, are now in a fair way of being better understood, and better treated, in the light afforded of the con- ditions which produce them. Fermentation of food in the stomach has long been a well-known characteristic of certain forms of dyspepsia, but it was left for Milne Edwards (1862), fresh from the study of Pasteur’s work on lactic and butyric acid fermentation, to apply his results to the explanation of cases of acid dyspepsia, and to declare, that “we are led to the conclusion that the phenomena of lactic and butyric fermen- tation which is manifested in the digestive tube, may well depend upon the action of infusoria (or microbes ?) which live and multiply in the interior of this canal ; a hypothesis which explains the production of two gases found here : viz., hydro- gen and carbonic acid.” Leared had also shown (i860) in “Experiments as to the Cause of Heartburn,” that this symptom is due to the presence in the stomach of butyric acid, a pro- duct of lactic fermentation. Among papers that have recently appeared, may be noticed, prominently, Vaughan’s valuable contributions on Tyrotoxicon as a cause of digestive distur- bance in young children, T. Lauder Brunton on “Poisons formed from Food and their Relation to Biliousness and Diarrhoea,” and Sir Andrew Clarke’s “ Chlorosis, or Faecal Intoxication as a Cause of Anaemia.” Frequent communications of this character in current medical literature, show the interest which has been excited in disorders of digestion by the work of
    VIII. Pasteur, Koch, Duclaux, Vignal, Abelous and many other indefatigable investigators in the field of bacteriology and biology, and indicate the direction of further progress in the study of disorders of the stomach. The possession of more light than ever before may even enable us to approach the subject “ so vast and so obscure,” as Trousseau styled it, of dyspepsia, with the hope that the days of empirical treatment of the disorders of such an important function as digestion, are almost if not quite at an end, and that we may now con- sider them intelligently and treat them rationally in accord- ance with the old dictum of the schools, obsta principiis. Frank Woodbury. 218 So. i6th Street, Philadelphia. /
    DISORDERED DIGESTION Comparative anatomy shows that man’s digestive apparatus in its type repeats characters found both among the carnivora and the ruminants. His simple stomach with lengthy digestive tract, his cutting and grinding teeth, confirm what long experience has conclusively and abundantly shown, that for him a mixed diet is most suitable. While man is, thQrefore, properly styled an omnivorous eater—and, indeed, while observation of all sorts and conditions of men, under different circumstances and in all parts of the world, goes far towards proving this to be correct in fact—yet it is observed that in civilized communities he is inclined to become rather fastidious, limiting his food to a comparatively few articles, and almost invariably requiring these to be prepared by cooking INTRODUCTION. 2 HH
    and associated with condiments so as to make them palatable, appetizing and more readily digestible. The need for constantly renewing the supply of nourishment, arises from certain well established physiological principles, which may well be borne in mind in the treatment of every case of dyspepsia. The exercise of any function of the body is made possible only through the principle of the transforma- tion of energy. The normal expenditure by the human organism of force, in the form of heat, elec- tricity, cell-activity and mechanical motion, amounts each day to many thousand units of work. For ex- ample, the absolute amount of heat-units daily pro- duced by an adult of average weight, has been variously estimated from 2200 to 2700, which, if con- verted into mechanical force, amount to more than would be required to raise his body to a vertical height of over eight miles. In addition to this the work of circulation and respiration, and the expendi- ture of muscular power in locomotion or other body labor, requires the production of over five hundred foot-tons more. Of this large amount of force daily produced by the body, therefore, about nine-tenths or five-sixths, according to circumstances, are required simply to maintain the bodily temperature at the normal stand- ard, the remainder being utilized in internal and ex- ternal dynamical work. It is an axiom that the source of all this energy is the food, and chiefly through the