I am inclined to think that this condition is often overlooked. Persistent tenderness in the epigastrium, with eructation of sour gas or sour fluids, with a sensation of heat and distress, are very suspicious symptoms. The conspicuous symptoms are severe pain from taking food, extreme acidity, loss of appetite, and hematemesis. The milder symptoms may prevail for a long time, and, as stated, may be entirely overlooked.
The treatment of this condition is by no means as difficult as many suppose. In the first place, the excessive acidity should be neutralized. The patient should be deprived of food for shorter or longer periods, as the severity of the symptoms would indicate. There are cases in which no nutrition should be given for a period of twenty-four or thirty-six hours.
Following this, I have found geranium to be an excellent remedy; 15 drops every two or three hours should be persisted in. Other auxiliary remedies are hamamelis, collinsonia or hydrastis. The latter remedy is capable of procuring cures alone. When food is resumed in the stomach it should be given sparingly and in conjunction with some mild digestive agent.
The washing out of the stomach, is advantageous in the severer cases, but is by no means as important as many would have us believe. The external application of heat is sometimes valuable and the administration of olive oil will not only exercise a soothing influence but it will act as a food.
When all the factors are fully understood, and are fully considered, the successful treatment of chronic gastric catarrh, or gastric ulcer is not complex nor difficult.
Ellingwood's Therapeutist, Vol. 2, 1908, was edited by Finley Ellingwood M.D.