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gestion, the natural alkalinity of the saliva is lessened, and patients often complain of a sour or bitter taste in the mouth. But beside these, there are other changes more directly affecting the gustatory nerve; substances are said to taste differently, and this sense is sometimes almost benumbed.
The sense of touch and ordinary feeling is often strangely implicated in functional disease of the stomach. Thus in many cases a general extreme "irritability of the cutaneous nerves is induced, or 'especially the nerves supplying the palm of the hand and the sole of the foot; but beside these there are local affections arising from gastric disturbance of a sympathetic kind, but probably due to direct nervous connection; the little and ring fingers become painful and hyperæsthetic in indigestion. This affection is probably due to the closer connection of the sympathetic nerve with the ulnar, which supplies those fingers, rather than with the median; a local pain, about one inch in superficial extent, is often complained of below the left mamma, and this is to be attributed to the splanchnic nerves—which are the large nerves of the semilunar ganglion, and thus connected with the stomach—having their origin from the lower dorsal nerves, commencing with the 5th or 6th, which same dorsal nerves send sensitive branches below the breast. Again, the sense of oppression and weight across the chest in indigestion is of a sympathetic kind, and is
explained in a similar manner. But not only do we find hyperæsthesia induced thus sympathetically in gastric disease, but actual anæsthesia, so that the fingers may become transiently benumbed.
Other parts of the nervous system are intimately connected with the stomach. We have already referred to hyperästhesia, local or general, and to conditions which might be mistaken for commencing paralysis ; but still more grave sympathies are found, especially in young subjects, or those in whom the nervous system is easily disordered. Crude semi-digested food in the stomach has often been the exciting cause of violent convulsions in children: it would seem, as if the connection was so intimate, that the peripheral irritation in the stomach sufficed to produce the most severe convulsive movements of a general kind, even epileptiform in their character.
Of a distinctive kind, but differing from the sympathetic affections already noticed, are the pains in the head, in the course of the branches of the 5th nerve, at the forehead or vertix, or in the lines of distribution of the branches of the 2nd and 3rd cervical nerves at the sides of the head and at the occiput. It is common fenough to have severe frontal headache, as the effect of excess and consequent indigestion ; but in numerous other instances pain in the head is induced, sometimes at the forehead, on one or other side, or centrally; in many cases of exhaustion, with feebleness of digestive
power, the pain is at the vertex; and in others, especially of a rheumatic and gouty character, the pain is at the occiput: when lateral it has been designated hemicrania ; with some a sense of coldness of the head is induced.
It is a common symptom of dyspepsia to find abnormal sensibility in the branches of the 5th nerve, supplying the face, and the branches of the 1st division are more frequently affected than the others; thus itching of the nose, pain in the eye, &c., are familiar illustrations of the fact. As to the converse of these symptoms, numerous cerebral diseases induce gastric irritation and change. After concussion of the brain a very common symptom is violent vomiting, and some of the most irritable conditions of the stomach we have ever witnessed, have arisen from abscess in the brain.
In threatening hydrocephalus of children the stomach is often disturbed, and the dangerous, nay even fatal, mistake is made of considering a terrible disease as a trifling “ bilious attack;" and when this inflammatory disease has become severe, it is often noticed that the least attempt to raise from the recumbent position is followed by violent vomiting. The same symptom is observed in strumous disease of the brain. Again, during the premonitory symptoms of apoplexy, especially in some of the more severe forms, vomiting comes on.
Another instance of this sympathetic connection between the brain and the stomach is shewn in mental disturbance and anxieties. Bad news will entirely destroy the appetite, and great mental distress places the digestive process almost in complete abeyance. In mania the appetite is changed, digestion altered, the bowels confined, and sometimes the strangest substances swallowed.
The connection of the stomach with the lungs and heart may be regarded in a threefold aspect :
1st. As it regards the entrance of nutriment into the system : if, from irritability or inability to receive the supply required for the maintenance of health and strength, the blood becomes 'impoverished, then a low organised product is more likely to form in the lungs or glands, as strumous tubercle, thus leading secondarily
to phthisis. · 2nd. In reference to the nerve supply to these
several parts: the pneumogastric, one of the most important nerves in the body, from the character of the organs to which it is directed, is largely distributed, both to the stomach, the lungs, and the heart; and in addition to this, the connection of the large semilunar ganglia, which sends branches to the stomach and abdominal viscera, is a very intimate one with the pulmonary and cardiac ganglia of the vaso-motor nerve.
3rd. The action of these important structures, the lungs and heart, in the circulation of the blood, has a
direct effect on the function of digestion; for, if the course of the blood be impeded by disease of the lungs or heart, the portal system of vessels becomes necessarily congested, the secretion from the mucous membrane is changed, and digestion is embarrassed.
From one or other of these reasons we find that there is a very close sympathy of the stomach with the lungs and heart; thus indigestion frequently produces hurried breathing and dyspnoea, with dry cough; and as to the heart, the symptoms are often so distinctive, that it is difficult to convince patients that they are not suffering from organic disease ; palpitation of the heart is thus induced, and irregularity, which greatly alarms the patient, and even faintness or actual syncope, if the heart be feeble. The converse symptoms are equally important, and early disease of the lungs, especially from peripheral irritation of the branches of the pneumogastric by miliary tubercles at the apex of the lung, is often accompanied by excessive irritability of the stomach, so that the practitioner may suppose that the stomach is at fault; the diminished nourishment increases the constitutional weakness, and thus leads to a rapid increase in the original disease ; too often the mistake is made, “ that it is all stomach,” and many of the so-called cases of gastric phthisis are of this kind. In whooping-cough a similar connection between the stomach and the lungs is noticed, and the former becomes almost as irritable as the latter;