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Discomfort and Nausea

     The term discomfort as related to disease covers several aspects and none of the symptoms are fixed, but to note, the important ones include nausea, cramps, chills, sea- and car-sickness, haziness of consciousness, impatience. Probably most common is nausea. The causes of nausea include such conditions as gastric reflex from cerebral anemia, high fever, food and drug poisoning, gastric disturbance, and pyloric senosis.
     Of the causes of nausea, gastric reflex from cerebral anemia, high fever, and food poisoning should need no explanation, so I shall discuss drug poisoning, gastric disturbance, and pyloric senosis. Nausea caused by drug poisoning occurs when the liquefied forms of the ingested drug have permeated through the membrane of the stomach wall which they fill and where they remain. As time passes, they turn into toxins and return to the stomach where they solidify. When purification action starts, the toxins dissolve, producing the feeling of nausea that leads to vomiting. The secretion that is eliminated in vomiting smells like the ingested drugs that caused it.
     Next, gastric disturbance is the elimination of bile. Bile, which has the role of helping digestion, is continually flowing through the inside of the stomach and when its flow, whether through the suspension of eating or damage from drugs, is impeded, bile’s role in aiding digestion is impaired, and elimination of toxins is caused through vomiting.
     Finally, the nausea from pyloric stenosis occurs when that which has been digested by the stomach seeks to descend to the intestines, finds it difficult to pass because of stricture. Instead of continuing to descend, the digested matter returns backwards to the stomach, which produces the sensation of nausea. It is clear that with these symptoms, digestion of solid foods is impossible and that only fluids and soft foods which do not cause nausea can be ingested by patients. In this case even when the gate in the stomach has narrowed due to pyloric stenosis, foods will pass if they are in fluid form.

Medicine for Tomorrow, Volume 2, third edition, page 36, October 5, 1943
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