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of sufferance. Now this is undoubtedly true, and his disorders seem to us to arise from excess of nourishment. No abstinent man ever complained of this species of dyspepsia-it is the gormandizer, as Abernethy calls him, who suffers from it. Nature has given him too good a stomach; it is an overmatch for the other viscera. His mill grinds more than it can bolt. All the food he takes is speedily and regularly digested, that is made chyme of, but there is a great deal too much of it. The surplus runs into fat if the body be disposed to obesity; if not, it deluges the vessels, and, is poured out through the pores of the skin in fætid sweats, or floods the alimentary canal with a subacid Auid only partially prepared for assimilation, and which the lacteals cannot take up, as they have already as much as they can do, and which, therefore, finds an exit with the alvine discharges. If the stomach pours into the duodenum one gallon of chyme, when not more than two quarts can be properly chylified by admixture with the bile, the whole mass must be imperfectly prepared to answer the purposes of assimilation, the whole canal will be distended with it, and it will either form obstructions in the viscèra, or the peristaltic motion will drive it out. This latter effort tends either to impair the sensibility of the lacteals, (which are little tubes running from all the viscera by which the chyle is carried into the circulation) or to produce in the bowels the bad habit of parting with nourishment without extracting its virtues, and thus the enormous eater becomes emaciated. The greatest gluttons we ever beheld (except one) were meagre men, whose tempers became so crabbed, that even their children have wished them dead. That these are real dyspeptics, is proved by their cure being practicable, if they are subjected to the same regimen which dyspeptics require.
We have thus considered a sufficient number of the physical causes of dyspepsia for the present, though others remain to be mentioned in the sequel. Let us now give a momentary attention to those which are moral. That the mind acts directly on the body, all know from experience, and all may rest assured that every such act bas, on the body, a beneficial or injurious tendency. Fear, grief, anxiety, or mental distress, from whatever cause, disorder' more or less the functions of the digestive apparatus through the medium of the nerves.
These become, by such means, irritated, and react on the mind, and thus between action and reaction, the sufferings are aggravated. But at such periods it not uncommonly happens that the mental distress alone is felt, and the disordered state of the alimentary canal is unsuspected. Happy is it for the sufferer when this is not the case, for then by timely advice he may be rescued from
alarming disease ; for when the stomach gives him no notice, he goes blindly onward and imagines that no physician “can minister to the mind diseased, or rase out the written troubles of the brain." As soon, however, as the digestive process is recommenced and proceeds to a successful termination, the mind becomes composed; nor is its philosophy put to flight till intestinal irritation is again created by a load of food. This state is termed hypochondriacism, which, when aggravated, mounts into insanity, and sometimes leads to suicide. The prevalence of this wretched disease in England, is thus asserted by Dr. James Johnson :
“In civilized life, indeed, what with ennui and dissipation in the higher ranks—anxiety of mind, arising from business, in the middling classes--and poverty, bad food, bad air, bad drink, and bad occupations among the lower classes, there is scarcely an individual in this land of liberty and prosperity-in this kingdom of ships, colonies and commerce,' who does not experience more or less of the 'English malady'that is to say, a preternaturally irritable state of the nervous system, connected with or dependent on, morbid sensibility of the stomach and bowels.” p. 103.
Some remarks of the same judicious writer on the subject, are so excellent, that we cannot refrain from laying them before our readers.
" Whenever, therefore, a man finds any alteration in his temper or moral feelings, there being no adequate or moral cause, he should suspect some physical cause. Let him then narrowly watch the state of these deviations from natural temper or feelings, after free living and after abstinence; after complicated dishes and after plain food; after wine and after water. If he does not find an increase or diminution of his mental or corporeal ailments, according as he leans to the one side or to the other of those points of regimen, then I am no observer. But I am confident that he will readily recognize the correspondence between cause and effect; aud if so, bow can we have a better test for the nature of the complaint, or a firmer basis for the treatment? Even if the original causes be purely of a moral nature, as for instance, severe losses in business, still the mental despondency is aggravated by the morbid sensibility of the stomach; and this morbid sensibility is mitigated or exasperated by the quality and quantity of our food and drink. The physician cannot remove the moral cause that preys upon the mind and ihrough that medium injures the body; but he can, in a great measure, prevent the reaction of the body on the mind, by which reaction, the moral affliction is rendered infinitely more difficult to bear. man loses by speculation a certain sum of money, which makes a considerable impression on bis mind and depresses his spirits. After a while, he finds that time instead of healing the wound which misfortune bad inflicted, has increased it; and that what he could look upon with some
degree of fortitude in the beginning, is now become such a source of despondency that it haunts him by day and by night, and is forever uppermost in his thoughts and even his dreams. He finds, moreover, that some days he can view the misfortune with courage, and spurn the idea of giving way under it; while on other days, it presents itself in the most frightful colours, and he seems completely deprived of all fortitude to resist its overwhelming influence. This is a true copy, of which I have seen many originals, during the late commercial distresses and ruinous speculations. What does it teach us? Why, that the moral affliction was borne with comparative ease till the digestive organs were impaired through the agency of the mind, when reaction took place, and impaired in turn the mental energies. But how are we to account for the fact, that one day the individual will evince fortitude, and the next despair; all ihe attendant circumstances of the moral evil remaining precisely as they were? It can be clearly accounted for by the occasional irritation of food or drink exasperating the morbid sensibility of the stomach, and thereby reacting on the mind. This temporary irritation over, the mind again recovers a degree of its former serenity, till the cause is reapplied. I was led to this solution of the enigma, some years ago, by observing that a very aged hypochondriac was every second day affected with such an exasperation of his melancholy forebodings, that he did nothing but walk about his room wringing bis hands, and assuring his servants that the hand of death was upon him, and that he could not possibly survive more than a few hours. Uuder these gloomy impressions, he would refuse food and drink, and in fact, give himself up for lost. The succeeding sun, however, would find him quite an altered man. The cloud had broken away ; hope was rekindled ; and the appetite for food and drink was indulged ad libitum. Next morning all would again be despair, and nothing but death could be thought of. So he went on, as regular' as light and darkness. But if on the good day, he could be kept on a very small portion of food, and the bottle unopened, the next would be good also. This, however, could seldom be done; for as soon as he felt a respite from his miseries, procured by one day's abstinence, he returned to his usual indulgencies, and again irritated his stomach and bowels, and through them reproduced the blue devils in his mind. Another curious phenomenon was observed in this case, and, indeed, I have seen the many others: nanfely, that any purgative medicine which operated at all briskly, brought on an exasperation of the mental depression. He was always better when the bowels were constipated; clearly showing, that whatever irritated the nerves of the alimentary canal, whether as food or as physic, increased the mental malady. Indeed, the abuse of irritating purgatives is one of the common physical causes of this morbid sensibility, and should be carefully avoided in the treatment of the disease."
This general view of the origin of that species of dyspepsia, of which we are treating, is sufficient for our purposes. WE now understand pretty well its prominent causes, remote and proximate, and are aware that a removal of the cause and not a mere alleviation of the symptoms, is the only rational mode of removing the disease. Now, as overfeeding is the grand temptation to be resisted, the first step towards a cure must be the absolute abandonment of the pleasures of the palate. No halfway measures can be adopted -no compromise between suffering and enjoyment can be allowed. The afflicted gourmand must bid a long adieu to his gastronomic pastimes farewell to callepash and callepee-to dull port and sprightly champaigneno more can he dwell on the pleasing emotions imparted by exhiserating ragouts, or forget himself in the titilations of incipient intoxication. He must now bow his proud head to the dusthe can no longer live to eat, but must abstain to live. He must regard his insides as a complex machine that cannot go without winding, and yet injured if wound too much-as a steam-engine that will burst with too much fuel. He must now find by experiment the exact quantity and quality that will suit him. If he should fall short in quantity, no great harm will ensue-be may become a little weak and faint, but that is a trifle and soon remedied; if he exceed his measure, however, by a few ounces, he will surely pay for it. But he will inquire.“ how shall I regulate it? If the celebrated Dr. Johnson (as he confessed to Boswell) always knew when he had too little, and when he had too much; but never when he had just enough, how can I expect to acquire more sagacity ?” We will tell him,--the discovery is easy to any one who is really in earnest about it: but a rigid adhesion to the rule after discovery, hic labor, hoc opus est! But he should remember, no rule, no ease.
We may safely take it for granted after long observation, that almost every man, woman and child in this country, habitually eats and drinks twice as much every day, on a moderate estimate, as is necessary. Now this procedure must be corrected both by those who would preserve and those who would regain their health ; unless they adopt the Roman custom of taking a vomit immediately after their feasts. “ The Romans, says Seneca, “vomit that they may eat, and eat that they may vomit:" it was used, says Dr. Middleton, “as an instrument both of their luxury and of their health. Thus Vitellius, who was a famous glutton, is said to have preserved his life by constant vomits, while he destroyed all his companions who did not use the same caution. And the practice was thought so effectual, that it was the constant regimen of all the athletæ or professed wrestlers, trained for the public shews, in order to make them more robust. When Cæsar dined with Cicero, and took a vomit before dinner, it was a compliment to the host, as it intimated a resolution to pass the day cheerfully, and to eat and drink freely with him."** It is, doubtless, more rational to adopt this emptying habit than to die from an overloaded stomach ; and, as we scruple not to take an emetic to remove indisposition, we see not why it should not be taken to prevent it. They, however, who think otherwise, must be content to submit their appetites to a rigid rule. We lay it down then as a general rule, liable to very rare exceptions, that three light meals at the utmost, with meat at one only, are as much as any one, much more a dsy peptic, should venture on; and if he make them two, it will, perhaps, be so much the better. Between these meals no luncheon or any thing whatsoever should he eaten; and any
; repast in the nature of supper, after eight o'clock, should be eschewed. Some physicians have recommended that we should eat little and often. And Drs. Potter and Calhoun, in their edition of Gregory's Elements, say, '“it will be proper, when the person is disposed to inordinate indulgence, to take some food half an hour before the regular meal, &c. to prevent oppression of the organ.” To this Dr. Paris objects, because the several processes of chymification, chylification, &c. follow each other in a certain order, as he says, and “cannot be simultaneously performed without such an increased expenditure of vital energy as weak persons cannot, without inconvenience, sustain: thus chylification would appear to require the quiescence of the stomach, and sanguinification to be still more incompatible with the act of chymification. If, therefore, the stomach be set to work during the latter stages of digestion, the processes will, in weak persons, be much disturbed, if not entirely suspended." He adds, “the specious apborism of Dr. Temple, that the stomach of an invalid is like a schoolboy, always at mischief unless it be employed, has occasioned more dyspeptic disease than that respectable physician could ever have cured, had his practice been as successful as that of Æsculapius, and his life as long as that of an antediluvian.” The reasons given by Dr. Paris are not satisfactory. He assumes the fact that chymification and chylification cannot be carried on at the same time without too great an expenditure of vital power ; yet if Dr. Philip's account of digestion be correct, the chyme is gradually formed and poured into the duodenum as it is formed, whereby a fresh surface of food is exposed to the gastric juice-consequently, these two processes are simultaneous after the first layer of food has been chymified. But we have no doubt of the injurious nature of the practice for other reasons. It interrupts the healthy
. habits of the stomach by putting it to work at irregular periods
* Middleton's Life of Cicero, vol. ii. p. 419.