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But we must go rather minutely into this matter. trace the too ordinary progress of a youth from health to the grave. Perhaps it may open the eyes of some before it is too late, who are floating down the current of disorder in despair. He returns from college with a stomach, preserved in all its native vigour by a scanty and coarse diet, and limbs firmly set and strengthened by the usual exercises of youth. He finds, at home and abroad, temptations to excess, which his philosophy cannot withstand. He daily sits down to a table abounding in delicacies that court his appetite. For some time he feels no inconvenience from the indulgence, but, on the contrary, an increased vigour from the change. Nature kindly adapts herself, in some degree, to circumstances, and when unimpaired by habitual disorder, often exhibits a prodigious resistance to physical evil. This vis medicatrix succeeds in preserving his sound condition, and if he is not outrageously immoderate in his sensuality, he passes years, perhaps, with impunity. At length, as life advances, he finds his amusements and employments begin to encroach on the regularity of his hours of eating, sleep and exercise. If he becomes a student, his sedentary and intellectual habits assist in the generation of disorder. His frame gradually grows weaker; but it is remarkable that his appetite, under this course, seldom fails, but is rather increased , for he finds food often supplies the want of sleep. He, therefore, continues to keep irregular hours, to indulge in eating, till he feels a distention of the stomach, and in drinking to remove this uneasiness, and create agreeable emotions in his brain. He now, however, feels, occasionally, a sick headache-sometimes bis dreams are interrupted by a horrible night mare, and ever and anon comes a thundering cholic. At this state, dyspepsia come mences its reign, but these manifestations of the presence of the tyrant are doubted and disregarded, except at the moment of actual suffering. He flatters himself he is enduring the usual lot of humanity, “the ills that flesh is heir to," which are unavoidable, and he therefore continues his wonted habits. In a short time his headaches increase in frequency and duration - he feels a screwing pain in the breast, pit of the stomach, or abdomen, and is tormented with crude and acid eructations. Still his gustatory pleasures are pursued, as his appetite flags not. He adds to his food more Cayenne and brandy to quiet his now rebellious stomach. He experiences frequent constipation, which he attempts to remove by drastic purgatives, or tobacco smoking ; and failing in this, he suffers it to take its course. At length his nerves become sensibly affected. The troubles and perplexities of life begin to be felt more acutely-little
things disturb his tranquillity, and fret him-his headaches assume a new form, remaining fixed over one eye for days, in a spot which may be covered with the end of a finger, or it seizes the eye itself or takes up its abode in the bones of the head, behind the ear. His skin and eyes become stained like the fallen leaf, and heartburn, furred tongue, and tainted breath give undeniable proofs of a morbid system. Even occasional ease becomes now almost a stranger, and he, at length, reluctantly admits what he would not before acknowledge, that he is a dyspepuc. He now consults every body, takes every kind of advice and prescription, whose aim is to cure without interfering with his habits and appetites, swallows loads of patent physic, but finds cordials, tinctures, pills and decoctions all equally unavailing; and, for this simple reason, that they are all levelled at some symptom, and not at the cause of the disease, which, instead of removing, they invariably increase. He is now forbidden to touch some particular articles of food-he obeys, but makes up bis usual quantity in the rest. What he takes one day with impunity, disagrees with him the next-what disagrees to-day, sits lightly to-morrow. The rules of diet thus grow into disrepute with him, and though he is obliged to drink less wine, as he is sensible of its acidity in the stomach, he will not believe that a good dinner can injure any body, and he resumes his attacks on his plate with desperate courage. His corporeal pains and mental horrors are then aggravated-melancholy seizes him, and increases his malady. He begins to believe himself differently constituted from others-thinks his machine is an inscrutable secret, and that suffering must be his portion for life. Obstructions now gradually accumulate in his intestines-his brain, heart, or liver, from being so frequently sympathetically disordered now become the seat of organic disease. Spasms, nervous twitchings, palpitations, nunbness, or tic doloroux assail bim-he becomes an hypochondriac, and thus drags out a wretched and insane existence; or is constipated longer than usual, and is struck down by palsy; or the circulation is forced with too great rapidity on the brain, and the melancholy scene closes with apoplexy.
Thus linger or fall too many of the noblest of the sons of men-men most highly gifted with intellect, whose genius might have shed a lustre on mankind. Cut down for want of a little judicious advice, or from not turning their own attention on their own nature and constitution till too late, or from being wedded to their appetites and self-indulgence. They lived in the perpetual violation of the laws of their nature, and died the victims of her justice.
" I tell you honestly, [says Dr. Abernethy) what I think is the cause of the complicated maladies of the human race ; it is their gormandizing and stuffing, and stimulating their digestive organs to an excess, thereby producing nervous disorders and irritation. The state of their minds is another grand cause; the fidgetting and discontenting yourself about that which cannot be helped ; passions of all kinds—malignant passions, and worldly cares pressing upon the mind, disturb the cerebral action, and do a great deal of harm.'
We know very well that dyspepsia may arise from other causes, from a fit of illness, as a fever, brought on without our fault, that it may be symptomatic of other diseases, &c: such things sometimes happen, but then you can generally trace the disorder to its cause as plainly as the stream to the fountain. But this is not the exact disease of which we are treating, though its cure must be effected by the same means. We allude to that dyspepsia which generally comes on by degrees, and has the reputation of proceeding from indigestible articles of provision, intellectual and sedentary modes of life, intemperance, &c. Dr. Hall has fancifully divided this class of disorders into five forms, each of which, he says, consists of a more general morbid affection, usually combined with some topical symptoms. He denominates them Mimosis from the Greek (tos, imitator, in allusion to their multiform character. The modification to which we have reference is that which he terms the mimosis chronica, the dyspepsia or hypochondriasis of medical authors, and which in its most aggravated form, rises in dignity to his mimosis acuta. The causes of this class of disorders, he, like most others, finds in sedentariness, impure atmosphere, and indigestible diet, which affect injuriously the skin, mouth, stomach, alimentary canal and the contributory digestic organs, the liver and pancreas, either immediately or syinpathetically, together with the brain, heart, senses and muscular strength.
It may, we think, be safely assumed that dyspepsia, as its etymology indicates, is primarily seated in the stomach or bowels. We like Dr. Paris' definition of it best. He calls it “a primary disease, in which one or more of the several processes by which food is converted into blood, are imperfectly or improperly performed, in consequence either of functional aberration or organic lesion.” Now, we shall not stop to define the stomach, for it is rather a difficult subject of definition. “Some, says Dr. Hunter, will have it that the stomach is a mill; others, that it is a fermenting vat; others again, that it is a stew pan : but, in my view of the matter, it is neither a mill, a fermenting
vat, nor a stew-pan--but a stomach, gentlemen, is a stomach !" Old William Shakspeare was happier in his description of it :
"It is the storehouse, and the shop
Whereby they live.”-Cor. Now this store-house is a bag of great consequence to its owner, and must be treated kindly. When overstuffed, even with the greatest dainties, its temper is soured, and when left too long empty, its windy recreations are very annoying. Its great duties are almost hourly in performance, and it contains a secret magic that converts the flowers of the field into the bodies of men.
But let us penetrate this secret as far as we can. We know that the food it receives is converted into what we call nourishment, by the aid, principally, of the gastric juice ; a liquor which, in the healthy state of the organ, is copiously secreted, or poured forth from its inner surface by the assistance of the nerves, and which can digest food even out of the stomach, as experiment has shown. The food in contact with the sides and bottom of the bag, is first, according to Dr. Philip, submitted to the operation of this juice, and changed into a milk-like fluid, which has received the name of chyme ; this then rises by a mechanical pressure or motion of the organ, and pours over at the mouth of the stomach into the duodenum, a second stomach, prepared for its reception ; where, by intermixture with the bile, &c. it forms chyle : a fresh surface of food is then presented to a new secretion of the gastric juice, and is disposed of in the same way till the whole of the contents is consumed, and the bag is left empty. This secretion is carried on during the time the stomach is acted on by the stimulus of food, and if during this
process other food be taken, it does not mix with the rest, but arranges itself in the centre of the undigested mass, and does not interfere with the process of chymification ; though it does, as will be hereafter shown, with the subsequent process of chylification. Now, the desideratum is to preserve the stomach in so healthy a state that it will generate and pour forth this gastric fluid in sufficient quantity, strength and purity to digest the food; and this power necessarily differs in different stomachs. All, however, have their limits, nor can any pour out its treasures for ever-the organ, like the eye, must have its hours of repose, and when these are denied it, and larger drafts are made on it than it can honour, it must become bankrupt. If
it can produce juice enough to digest two pounds of food, and three are submitted to it, one pound will remain there, as it would in any other warm bag, till the heat induces a chemical fermentation ; changing that additional pound into a poisonous mass of acrid or acid matter. This mass is indigestible, and the longer it remains in the bag, the worse it becomes. Its first attack is on the nerves that regulate the functions of the stomach, which are of that class which govern the operations of the vital organs, and are technically called the ganglionic. These nerves make themselves felt only when ill-treated ; at other times, they perform their official duties, that is, assist in the process of chymification without our notice : but as soon as they feel the contact of the deleterious compound, they become irritated, and as the stomach is the great centre of sympathies, its nerves communicate their disturbance to the whole class. Thus the brain, heart and liver immediately suffer; low spirits, mental confusion, dizziness of the sight, singing in the ears and headache come on, with pulsation of the arteries; the skin becomes pale and cold, muscular energy abates, and nausea supervenes. If this latter sensation prove efficacious, the disgusting mass is thrown up, and the sufferer is relieved; but if this does not take place, as the load cannot remain always where it is, the mechanical motion of the stomach gradually empties it into the subjacent viscera, where it yitiates the secretions of the liver, pancreas, and other intestinal glands, poisoning whatever it touches, and producing diarrhæa, cholera, jaundice, spasm or other nervous affections. Let this process be repeated from day to day, and it requires no great sagacity to perceive that by the functions of the alimentary canal being thus continually disordered, not only will the chylepoietic viscera at length become morbidly affected, but even the brain and heart, and thus arise hypochondriasis and organic affections of the heart. As soon as the alimentary canal is diseased, the whole of the food becomes imperfectly digested; for a sick stomach can no more secrete sound juice than a sick cow give good milk; and, from imperfect digestion, the same ill effects, to a certain degree, will flow, and the patient become a confirmed dyspeptic.
But what appears more remarkable, these symptoms of disorder often occur without any previous notice from the stomach. As far as the sufferer can discover, that organ is very well. The appetite is good, the taste exquisite, and the digestion unaffected, yet is the man decidedly dyspeptic. He remarks that nothing he eats disagrees with him; nothing he drinks gives him pain, and, in other respects, he is as regular as the town clock; yet he is dyspeptic-both mind and body are in a state VOL. IV.NO. 7.