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Show Vour Doctor Says . . . The following is one of a series of articles written by members of tie Utah State Medical A ssociation imd published in cooperation with your load newspaper. These articles are scheduled to appear etety other week throughout the year in an effort to better acquaint you with problems of health, and designed to improve the well-being well-being of tit ptopie of Utah. PAIN IN THE "PIT OF THE STOMACH" A pain is a most useful and natural warning that something is wrong. Pains vary widely from a mere discomfort to agony sufficient to bring on a state of shock. In any event, the logical procedure pro-cedure when one has a pain is to try and find the cause and remove it if possible. Sedatives for temporary relief come in as an important part of the picture. Some very common pains are misunderstood by the sufferer indeed there are pains that a good doctor may have trouble explaining without a careful care-ful investigation. One of these is the one generally referred to as pain in the pit of the stomach. Before going further, let us get our terminology straightened out. In most people the pit of the stomach is six to ten inches below where the person imagines im-agines it to be. The pain commonly complained of is high in the abdomen where the edges of the rib cage come together like an inverted V. The only explanation handy for this common misconception mis-conception is that when old Doctor Gray, the father of anatomy, wrote his books, he got his drawings from cadavers who's stomachs were shrunk up and out of shape. Be that as it may, a great many conditions, physical, mental and nervous ring a bell, so to speak, in the upper abdomen. So folks go about saying, say-ing, "I've got a pain in the pit of my stomach." A doctor seeing such cases from day to day might list as follows some of the conditions associated with this complaint. Gall bladder disease, ulcer or cancer of the stomach or duodenum, duo-denum, acute gastritis, hernia of the diaphragm, spinal arthritis, fatigue or anxiety, or just plain indigestion from careless eating. This is obviously a wide assortment of diseases and it follows that a large percentage of patients have pain in the upper abdomen along with their other symptoms. A search for a diagnosis usually proceeds as follows: The doctor takes a good look at the patient and decides whether or not he is acutely ill. If no immediate treatment is called for he makes a rough guess as to what category the complaint will come under. To himself he thinks: A hustling young executive is liable to have a peptic ulcer. An overweight woman in the forties is likely to have gall bladder disease. An older patient with a bad heart frequently has associated associ-ated indigestion. Broad muscular people often develop a hernia of the diaphragm. Arthritis in the dorsal spine may hurt right around into the abdomen. A person with that pinched look about the eyes may be worrying about something other than being in the doctor's office. AH of these possibilities are thought about, a classification is decided upon and investigation in-vestigation starts. This included a careful care-ful x-ray examination (there's nothing so convincing as demonstrating a lesion on black and white films). Heart and blood may be checked in the laboratory. Personal problems are carefully inquired into. Eventually definite information, either positive or negative is obtained, and treatment is commenced. There is a final interesting feature associated with the type of pain we have been discussing. It is frequently noted that as the examination progresses pain recedes independently of treatment. This seems to point out the nervous or anxiety features that accompany abdominal ab-dominal disease and the physical relief that comes with relief of tension. In other words, the upper abdomen seems to be a sort of alarm center for trouble and when the trouble is investigated the alarm ceases to ring |