Vomiting

“ II. Vomiting consists in the inverted order of the motions of the stomach, and œsophagus; and is also attended with the inverted motions of a part of the duodenum, when bile is ejected; and of the lymphatics of the stomach and fauces, when nausea attends, and when much lymph is evacuated. Permanent vomiting is for a time relieved by the incitantia, as opium or alcohol; but is liable to return, when their action ceases. ”

“ In this form the temperature rises rapidly and the symptoms develop quickly and become very severe in a remarkably short time. The vomiting is very severe and usually appears simultaneously with the diarrhea. After the stomach has been emptied of food the vomitus becomes serum and mucous. The contents of the small intestines may regurgitate into the stomach and be vomited up. Vomiting may be induced by taking water into the stomach. The stools are frequent, are of a pale green, yellow or brownish color at the beginning, but later become almost entirely serous. ”

“ It sets in with great pain in the bowels, sickness at the stomach, and vomiting of large quantities of dark greenish bitter tasting substance. At first, the vomiting will seem to afford relief, but sooner or later the stomach and bowels cramp, and the cramping may extend to other parts of the body, the feet, hands, calves of the legs, and the arms, cold sweats come on, and death terminates his sufferings. ”

“ Presently vomiting, also profuse, at first perhaps of food, but very soon of the same rice-water description, supervenes. Cramps of an agonizing character attack the extremities and abdomen; the implicated muscles stand out like rigid bars, or are thrown into lumps from the violence of the contractions. The patient may rapidly pass into a state of collapse. In consequence principally of the loss of fluid by the diarrhœa and vomiting, the soft parts shrink, the cheeks fall in, the nose becomes pinched and thin, the eyes sunken, and the skin of the fingers shrivelled like a washerwoman's. ”

“ The treatment for reflex vomiting, quite obviously, consists of correcting the disturbing condition, whatever it may be, after which the nausea usually subsides in a short time. The nurse should take care that her patient resumes a regular diet very gradually, even after the cause of the nausea has been removed, for the stomach has become irritable and the vomiting habit, both mental and physical, though easily established, is usually broken up with considerable difficulty. ”

“ Nausea and vomiting are late but moderately constant features. Their relation to the ingestion of food is not fixed. The vomited matter may consist of food, of glairy mucus more or less tinged with bile, of colorless liquid, or of a fluid resembling a mixture of bran and water. If there is marked pyloric obstruction with dilatation of the stomach, large quantities of frothy and fermenting material containing sarcina ventriculi are rejected at intervals. ”

“ Too frequent feeding at night is another cause of vomiting. When the stomach is full, the failure to lay the baby down quietly, as is so often seen in those homes where bouncing and jolting are practiced, may also result in vomiting.
Vomiting may be the first sign of many acute illnesses such as scarlet fever, measles, pneumonia, whooping cough, etc.
The treatment for acute vomiting is simple. All foods should be withheld—nothing but plain, sweetened water should be administered, while it is often advisable to give a dose of castor oil. ”

“ If patients expect that there is to be vomiting, if they are of the neurotic temperament that not only {759} vomits easily but has a tendency to secure sympathy by fostering this symptom unconsciously perhaps, then the vomiting may become even a dangerous complication. If there is no expectancy in the matter, however, but if, on the contrary, it is made clear to these patients before the anesthetic is administered that, while there may be some nausea, there need be no vomiting unless they yield too readily to their feelings, much can be done to lessen the vomiting. ”

“ A physician should be called at once if the vomiting continues, and not until the vomiting has entirely ceased for a number of hours and water is easily retained, should food be given, and even then it should be begun on very weak mixtures. ”

“ Nothing but a prodigious Quantity of such weak Liquids can avail such a miserable Patient. If the Cause of the Disorder is immediately known, after having very speedily taken down a large Quantity of warm Water, Vomiting may be excited with Oil, or with melted Butter, and by tickling the Inside of the Throat with a Feather. But when the Poison has already inflamed the Stomach and the Guts, we must not expect to discharge it by vomiting. Whatever is healing or emollient, Decoctions of mealy Pulse, of Barley, of Oatmeal, of Marsh-mallows, and Butter and Oil are the most suitable. ”

“ With more moderate and yet large doses, nausea and vomiting are very prominent symptoms, and are seldom delayed more than half an hour. The regular course of symptoms may therefore be summed up thus:—A metallic taste in the mouth, repeated vomitings, which are sometimes bloody, great faintness and depression, pains in the abdomen and stomach, and diarrhœa, which may be involuntary. If the case is to terminate fatally, the urine is suppressed, the temperature falls, the face becomes cyanotic, delirium and convulsions supervene, and death occurs in from two to six days. ”

“ Vomiting also when the stomach is empty will answer well; to produce which first swallow some small radishes, cresses, rocket, mustard and purslain, and then by drinking warm water procure vomiting. Upon those who neglect these symptoms the following diseases are apt to supervene: pleurisy, peripneumony, melancholy, acute fevers, frenzy, lethargy, ardent fever attended with hiccough. ”

“ There is sometimes even a probability that some of the food ingested finds its way through the pylorus and is used for nutrition, though the vomiting may come on not long after ingestion. Practically always nature asserts herself and stops the vomiting when serious conditions seem about to develop. The solicitude of relatives may be calmed by this assurance, and just as soon, as a rule, as they show less anxiety about the patient, the first symptoms of improvement will be noted. ”

“ If a poisonous substance is received into the stomach, [8] the action of vomiting is frequently excited, or if it passes into the bowels, nature still endeavours to carry it off by an increase of the peculiar motion of the intestines, and of the secretion from their surface ”

“ The vomiting is persistent, especially at the onset, and occurs as soon as food enters the stomach. In older children it may be stercoraceous after the third or fourth day. It never occurs, however, in infancy. The vomiting is the result of the intestinal obstruction and is adaptative on the part of Innate Intelligence. It is quite obvious that it is better not to have food in the stomach than it is to have it and not be able to complete the process of intestinal digestion. ”

“ Coins rarely cause inconvenience.
[122 MOTHERS' REMEDIES] Symptoms of Acute Obstruction.—Constipation, pain in the bowels, and vomiting are the three most important symptoms. Pain sets in early, and may come on abruptly when walking or more commonly when working. It is at first colicky, but soon becomes continuous and very intense, vomiting soon follows and is constant and very distressing. First the stomach contents are vomited, and the greenish bile-stained material, and soon the material vomited is a brownish-black liquid, with a bowel odor. ”

“ The perpetual vomiting in ileus is caused in like manner by the defective excitement of the sensorial power of association by the bowel, which is torpid during the intervals of pain; and the stomach sympathizes with it. See Enteritis, Class II. 1. 2. 11. Does this symptom of vomiting indicate, whether the disease be above or below the valve of the colon? Does not the softer pulse in some kinds of enteritis depend on the sympathy of the heart and arteries with the sickness of the stomach? ”

“ It is attended with languor of the stomach, nausea, and loathing of food, bringing on vomiting of bile or phlegm, anxiety, and pains in the stomach. All these symptoms arise, they say, from a sanguineous plethora, brought on by a suppression of the menstrual discharge. They, therefore, recommend a restricted diet, and moderate exercise when the woman was accustomed to it. When the humour which infests the stomach is of an acid, acrid, or saltish nature, they direct draughts of tepid water, to encourage vomiting; they forbid all sweet things; and recommend an old sub-astringent wine. ”

“ Sometimes there are convulsions and cramps, but these latter symptoms are speedily followed by death. For treatment give warm water, lime water, linseed tea, or anything to cause vomiting. Some people are made sick very easily; others cannot vomit at all, save with great difficulty. It is best to ask the patient this before trying anything, as he may know something that will make him sick. I have seen leeches applied to the bowels, and all that part of the stomach fomented with hot flannels. ”

“ If the Party is much oppress'd at his Stomach, and strains to vomit, or else with vomiting throws up bitter and stinking Matter; let him presently take a large draught of Carduus, or Camomile Posset-Drink, and in it either half a Dram of Salt of Vitriol, or two Ounces of Liquor of Squills, and with his finger or a Feather, fetch up what is contain'd in his Stomach; but take no Antimonial Medicine, that will work beyond the Stomach. ”

“ These cases are due to some serious disturbance of metabolism or to the absorption of some little understood poison. They are probably always fatal. The cases of neurotic vomiting are rather common. They are exaggerations, of the ordinary familiar vomiting of pregnancy which is exhibited by nearly all women at the recurrence of the menstrual times in the early portion of pregnancy. In some of these cases, however, the vomiting is so persistent and so prolonged that the patient's nutrition suffers severely, and there seems to be danger of a fatal termination. ”

“ Nausea and vomiting are limited, in the vast majority of cases, to the early morning, but some patients are annoyed only after meals, and a few at irregular intervals during the day. The fact that the attacks do not always appear at the same time, and that they differ in severity, indicates that different causes may be concerned in their production. And it is true that there are several kinds of vomiting that occur during pregnancy, although the classification interests only physicians. ”

“ Constipation, diarrhea, colic, and vomiting. Gastric or stomach trouble is indicated by vomiting or the belching of gas; intestinal trouble by colic, flatulence, diarrhea, and constipation.
The wise mother will learn to distinguish between the various forms of vomiting. Regurgitation, already described, is not a danger signal; [Pg 91] if the milk, unchanged in consistency and color, runs easily from the baby’s mouth almost immediately after the child is taken from the breast or bottle, and then, as if relieved, the infant rolls over in comfortable slumber, there is no cause for anxiety. ”

“ There are profuse sweats over the whole body, and particularly about the chest, the tongue is rough, expectoration saltish, bitter, or bilious, pains suddenly seizing the sides or shoulder-blades, frequent yawning, watchfulness, oppressed respiration, thirst after sleep, despondency of mind, coldness of the breast and arms, trembling of the hands. These symptoms may be relieved in the following manner: Procure vomiting after a moderate meal without medicine. Vomiting also when the stomach is empty will answer well ”

“ If some poisonous or very irritating food is swallowed, as soon as it begins to hurt the cells lining the stomach, these promptly telegraph to the vomiting centre in the brain, we begin to feel "sick at the stomach," the brain sends the necessary directions to the great muscles of the abdomen and the diaphragm, they squeeze down upon the stomach, and its contents are promptly pumped back up the gullet and out through the mouth, thus throwing up the poisons. ”

“ Young, physician to the army, that he found an infusion of chamæmile flowers one of the best medicines in this vomiting; and a surgeon of one of the line-of-battle ships informed me, that he also found advantage from it in alleviating this symptom. The French author above mentioned affirms, that milk, boiled with some flour or bread, given in the quantity of a spoonful at a time, and frequently repeated, had more effect than any thing he tried in stopping the vomiting in this fever. ”

“ The symptoms appear soon after the ingestion, and consist of a feeling of burning in the mouth, spreading downwards to the stomach, increased secretion of saliva, and difficulty of swallowing; then follow violent vomiting and diarrhœa, with great pain in the bowels, often tenesmus; there is also headache, giddiness, a feeling of anxiety, and the pupils are dilated. The consciousness is ordinarily intact; the pulse is weak and slow, and the breathing embarrassed ”

“ For the infant, calomel followed by a warm enema will carry off the poison in the intestines. For an older child the calomel must be followed by half a glass of citrate of magnesia, given early in the morning, to thoroughly cleanse the intestines.
Severe vomiting is treated exactly like intestinal indigestion, by the use of cathartics. If either diarrhea or vomiting does not yield to this treatment within twenty-four hours a physician [Pg 186] should be summoned. Severe vomiting may be a symptom of an acute and serious attack of illness. ”