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67 and irritation of the nerve plexuses in the abdominal cavity. Nausea can also be of Central origin, i. e. with CNS lesions. There is nausea in diseases of the liver, kidneys, helminthic invasion, during pregnancy. Vomiting (voimitus). This is an involuntary jerky ejection of stomach contents through the mouth. In the diagnostic assessment of vomiting, it is necessary to take into account the time of its onset, the amount of vomit, and their reaction. You should also pay attention to the nature of impurities to the gastric contents. Vomiting in the morning on an empty stomach occurs with alcoholic gastritis and hypersecretion due to the accumulation of a large amount of gastric juice in the stomach. Vomiting 5–10 minutes after eating is observed in ulcers and cancer of the cardiac part of the stomach or in neurosis. Vomiting 2–3 hours after eating, in the midst of digestion is characteristic of gastritis, ulcers, stomach cancer. Vomit- ing in 4–6 hours after eating is observed with an ulcer of the pylorus or duodenum, with atony of the stomach. Vomiting 6–12 hours or more after eating, i. e. vomiting on the eve of eating food is observed in pyloric stenosis. Esophageal vomiting is associated with food stagnation in the esophagus. Its peculiarity is that it occurs without previous nausea, as well as without the par- ticipation of the muscles of the stomach and abdominal press. The contents of the esophagus are pushed out when its walls contract, and sometimes passively flow out when the patient bends or when he lies down. Vomit consists of undigested food, they do not contain any hydrochloric acid or pepsin. Belching (eructatio-belching air, regurgitatio-belching food). Belching is usual- ly understood as two phenomena: the sudden and sometimes sonorous release of air accumulated in the stomach or esophagus through the mouth, this is a belch of air; the release of a small part of the gastric contents into the mouth is a belch of food. Sometimes belching air has the smell of» rotten eggs « (hydrogen sulfide). This indicates a far-reaching breakdown of protein substances. Rotten belching in the morning, on an empty stomach, is characteristic of pyloric stenosis, with omis- sion and expansion of the stomach, with stomach cancer. Regurgitation of food often occurs simultaneously with the gas burp. Belching in hypersecretion may be acidic. Especially sour regurgitation observed in patients with exacerbation of peptic ulcer disease of the stomach. Bitter taste belching occurs when bile is thrown into the stomach from the duodenum. Unpleasant belching of rancid oil in- dicates low acidity or complete absence of hydrochloric acid. It occurs when the stomach contents contain butyric, lactic and other organic acids that appear in the stomach during fermentation processes. Heartburn (pirosis). This is a peculiar feeling of heat and burning in the low- er part of the esophagus. It is associated with regurgitation of the stomach con- tents into the esophagus. The mechanism of heartburn is the same as belching, but