Book 3
4
Thus those who are troubled with this symptom expect, with good reason, that they will also be unable to digest adequately; proper digestion cannot take place in a weak stomach. In such people also, the mass of food may be plainly seen to remain an abnormally long time in the stomach, as would be natural if their digestion were slow. Indeed, the chief way in which these people will surprise one is in the length of time that not food alone but even fluids will remain in their stomachs. Now, the actual cause of this is not, as one would imagine, that the lower outlet of the stomach,The pylorus. being fairly narrow, will allow nothing to pass before being reduced to a fine state of division. There are a great many people who frequently swallow large quantities of big fruit-stones; one person who was holding a gold ring in his mouth, inadvertently swallowed it; another swallowed a coin, and various people have swallowed various hard and indigestible objects; yet all these people easily passed by the bowel what they had swallowed, without there being any subsequent symptoms. Now surely if narrowness of the gastric outlet were the cause of untriturated food remaining for an abnormally long time, none of these articles I have mentioned would ever have escaped. Furthermore, the fact that it is liquids which remain longest in these people's stomachs is sufficient to put the idea of narrowness of the outlet out of court. For, supposing a rapid descent were dependent upon emulsification,Chylosis, chylification. cf. p. 240, note 1. then soups, milk, and barley-emulsionLit. barley-chyle, i.e.. barley-water. would at once pass along in every case. But as a matter of fact this is not so. For in people who are extremely asthenic it is just these fluids which remain undigested, which accumulate and produce gurglings, and which oppress and overload the stomach, whereas in strong persons not merely do none of these things happen, but even a large quantity of bread or meat passes rapidly down. And it is not only because the stomach is distended and loaded and because the fluid runs from one part of it to another accompanied by gurglings — it is not only for these reasons that one would judge that there was an unduly long continuance of the food in it, in those people who are so disposed, but also from the vomiting. Thus, there are some who vomit up every particle of what they have eaten, not after three or four hours, but actually in the middle of the night, a lengthy period having elapsed since their meal.
