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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 vitiates 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.
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 fluid 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 viscera, 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 has, 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 classesand 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; and if so, how 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. Thus a man loses by speculation a certain sum of money, which makes a considerable impression on his mind and depresses his spirits. After a while, he finds that time instead of healing the wound which misfortune had 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 bis dreams. He finds, moreover, that some days he cau 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 his 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. Under 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 same in many others: namely, 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 be dwell on the pleasing emotions imparted by exhilerating 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 bis 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—he 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