. Medical diagnosis for the student and practitioner. auses are given usually, but probably are, for the most part, of slightimportance. The more one studies the manifestation of congenital asthenia and its viscer-optoses in both the complete and the still more interesting imperfect forms, thebetter he realizes the dominant part played by it in simple atony. The Symptoms.—Subjectively the gastric symptoms are those described Inefficientmusculature. 8oo MEDICAL DIAGNOSIS Effect of rest. under nervous dyspepsia. In the early stages at least, appetite is oftenwell maintained, though in others and
. Medical diagnosis for the student and practitioner. auses are given usually, but probably are, for the most part, of slightimportance. The more one studies the manifestation of congenital asthenia and its viscer-optoses in both the complete and the still more interesting imperfect forms, thebetter he realizes the dominant part played by it in simple atony. The Symptoms.—Subjectively the gastric symptoms are those described Inefficientmusculature. 8oo MEDICAL DIAGNOSIS Effect of rest. under nervous dyspepsia. In the early stages at least, appetite is oftenwell maintained, though in others and especially in cases of long standing,the slightest quantities of food may give the sensation of repletion and dis-tention. Vomiting is relatively infrequent, irregular or wholly absent inmarked contrast to stenotic atony and ectasia and there is usually more orless obstinate constipation. It is commonly stated that these patients are intolerant of food and thatits ingestion immediately excites distress, pyrosis, eructation, heartburn andthe Fig. 451.—Atony of the demonstrable type. Note failure to grasp the bismuth mealin a normal manner. The great elongation of the stomach represents usually the con-genital deficiency of tonus which is largely symptomless so long as a certain nutritionallevel is maintained. Ectasia is manifest in this case. This is certainly not to be taken as wholly expressive of the behavior ofcases or applying to food in all forms and quantities. Liquid food is often badly borne, whereas light solids and semisolids, es-pecially if taken six rather than three times a day in less quantities may givegreat relief and bring about the desired improvement in nutrition. The prompt effect of rest and isolation is often demonstrated in cases ofthis type, and large daily quantities of food given at even shorter intervalstogether with rest for the heart are well borne and rapidly overcome the basicsubnutrition. Objectively, one notes usually only the fillin
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectdiagnos, bookyear1922
