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Art. VIII.-1. An Essay on Disorders of the Digestive Organs,
and General Health, and on their complications. By MAR
SHAL HALL, M.D. F. R. S. Ed. &c. London. 2. A Treatise on Indigestion and its consequences, called nervous
and bilious complaints ; with observations on the organic diseases in which they sometimes terminate. By A. P.W. PHILIP,
M.D. F. R. S. Ed. &c. London. 3. A Treatise on Diet, with a view to establish on practicable
grounds, a system of rules for the prevention and cure of the diseases incident to a disordered state of the digestive functions. By J. A. PARIS, M.D. F.R.S. Fellow of the Royal College
of Physicians, &c. Re-printed in Philadelphia. 4. An Essay on morbid sensibility of the Stomach and Bowels,
as the proximate cause or characteristic condition of Indigestion, Nervous Irritability, Mental Despondency, Hypochondriasis, &c. &c.: to 'which are prefixed, Observations on the Diseases and Regimen of Invalids on their return from hot and unhealthy Climates. By JAMES JOHNSON, M.D. Fellow of the Royal College of Physicians, &c. Re-printed in
Philadelphia. 5. Sure Methods of Improving Health and Prolonging Life; or
a Treatise on the art of living long and comfortably, by regulating the diet and regimen, embracing all the most approved principles of health and longevity, and exhibiting the remarkable power of proper food, wine, air, exercise, sleep, &c. in the cure of chronic diseases, as well as the preservation of health and prolongation of life. To which is added, the Art of Training for Health, Rules for reducing Corpulency, and Maxims of Health for the bilious and nervous, the consumptive, men of letters, and people of fashion. Illustrated by cases. By a Physician. First American edition, with additions.
Philadelphia. Cary, Lea & Cary. 1828. If the universality of a disease can render an investigation into its nature and cure proper in a journal of this kind, we know of none which is entitled to precedence over Dyspepsia. It is not the malady of the rich or the poor ; the ignorant or the learned; the young or the aged; the virtuous or the vicious; of one sex or one condition, but the disease of all. In the language of Dr. James Johnson, “it knocks at the door of every gradation of
society, from the cabinet minister planning the rise and fall of empires, to the squalid inhabitant of St. Giles or Saffron Hill, whose exterior exhales the effluvia of filth, and interior those of inebriating potations. Against which wide-spreading evil, no moral attributes, no extent of power, no amount of wealth, are proof. The philosopher, the divine, the general, the judge, the merchant, the miser and the spendthrift, are all, and in no very unequal degree, a prey to the Protean enemy."
Our ancestors were so little troubled with it, that, although it doubtless existed, its name has become familiar only within twenty or thirty years past. That it always could be found when men fed high and lived indolently, cannot be doubted ; but it is only of late that luxury has affected, directly and indirectly, the whole mass of society, and scattered the seeds of this pestilence over the face of the land. We mean not that the "operatives," as they are affectedly called, contract dyspepsia from too much food and ease, but from the close pursuit of such sedentary occupations as subserve the ends of the luxurious. Want of healthy exercise in the open air, let it arise from what cause it may, will produce the same effects. The pursuits of commerce, of the majority of mechanical trades, of professional advancement, of literature and science, and even of pleasure, are sedentary. Our modes of life are entirely changed from wbat they formerly were in this country, as well as in Europe. We are less exposed to the open air, take less exercise, are more intellectual in our pursuits, and fare more sumptuously every day than formerly, when there were few carriages, few books, plain food and little wine. Our new fashions have sapped our strength, made us effeminate, indolent, and luxurious in all things. Our improvements in gastronomy bave made us excessive eaters, and our love of excitement deep drinkers. Is it any wonder that we have lost our health? “If,” says Cobbett very justly, “people will not restrain themselves from those indulgences which cause sickness, sick they will be, and sick they ought to be."
Now, we cannot doubt but a knowledge of the true nature of this complaint and of its cure, involving an explanation of the process of digestion, will be generally regarded as a subject of interest, as well as of rational curiosity. It may enable the valetudinarian not merely to shun the dangers to which he is hourly exposed, but to remove his ills ;-it may confirm the young and inexperienced in their resolution to avoid the calamities which have overwhelmed so many thousands : and by turning the public attention more intently on the subject, it may VOL IV.No. 7.
tend to throw discredit on the disorder, as one usually arising from criminal excess, and thereby lessen its frequency.
We have looked into a great number of books on this subject, and having had no little sad, personal experience in the inflictions of this cruel disorder, brought on by light excess and aggravated by ignorance, we shall proceed to place it in, what we regard, its true light. We shall adopt as much of the respective theories and statements of these writers as we think conformable to fact, and discard the rest. And as we are all curious to discover the true reason upon which every recommendation is made, we shall endeavour to furnish it. Novelty in a subject of this kind, whose basis is human nature, is not to be expected or desired. Truth alone is our object.
But a word of this host of dietetical writers. They are, to our utter dismay, frequently at points : somctimes on the mode by which digestion is performed, and often on the means of cure. Now, to understand scientifically what will cure a disorder, it is necessary first to understand its seat, and then its cause.Without knowing these, advice and prescription are mere quackery ; but when they are discovered, reason dictates that the cause must be removed, and such applications made to the seat of the disorder, as will enable nature to recover her lost pow
Both these processes require accurate knowledge of the parts and their operations. Dyspepsia is a disordered state of the whole or some part of the alimentary apparatus; and an accurate knowledge of every part of this apparatus is essential to the practitioner. The difficulty of attaining this knowledge will appear from the statements of one or two distinguished writers on the subject. The last we have seen, is the second American from the third London edition, with additions, &c. of Elements of the Theory, and Practice of Physic, by G. Gregorie, M.D. with notes, &c. by Drs. Potter and Colhoun of Maryland, published in 1829. Dr. Gregorie, speaking of the process of digestion, says,
" that food remains in the stomach on an average of from three to four hours. At the end of this period, the pyloric orifice, which had previously been closed, gradually dilates, so as to allow the mass of food to pass into the duodenum; the stomach remaining perfectly empty until the next meal."'* Dr. Wilson Philip, who is often quoted by these and other writers as authority, and whose experiments on digestion have thrown great light on the subject, says, over and over again, that the food next to the inner surface of the stomach is first digested, and rising, passes through the pylorus, whereby
* Vol. ii. p. 266.
another portion of food takes its place, and being in turn digested, passes on, till the whole be consumed. This fact is very important, and we are surprised it should be unknown to Dr. Gregorie and his annotators. Again-Dr. Paris observes that the food is churned in the stomach, and that if it be not sufficiently churned, it cannot become perfect chyle. (p. 151.) Dr. Philip on the contrary, has shewn from actual experiment and dissection, that the food first taken, arranges itself round the stomach and the successive supplies within that, so that the last taken goes into the centre; and that if it becomes churned or mixed, as it sometimes is by violent exercise, digestion is impeded. So in the method of cure, all agree in the importance of a strict regimen, but differ toto cælo when they descend to particulars. One respectable class who are not deficient in sagacity, recommend a course of life agreeable to nature. They y, “your disease springs from your disregard of the simple banquet prepared by the all-bounteous Creator-you have made yourself a sophisticated being-civilization and her excesses have destroyed you. You must, forsooth, ransack the ends of the earth for that which lies in a better state at your door, and you must heighten its flavour by stimulating spices and spirits! Change your plan or you die! the golden rule of health is live naturally?”
Dr. Paris, backed by the authority of Dr. Fordyce, exclaims, on hearing this—“Live naturally! live on fiddlesticks! no man can live naturally, for he has no natural food. He must discover his food by his acuteness and industry, and cultivate and alter it from its natural state. He can scarcely find any thing from the potatoe to the cabbage, growing naturally-cultivation has changed all, and what he gets he must convert into food by the spit, pan or pot! Besides, adds he, the gratification which attends a favourite meal, is in itself a specific stimulus to the organs of digestion.” Now we shall not attempt to reconcile these and other differences which might be designated, but leave the task to them. The obscurity in which the theory of digestion has been for so many ages involved, which is one cause of these discrepancies, begins to clear away. Dissection and experiment have spread much light on it, and professional opinions will, it is to be hoped, ere long coalesce. But it is a fearful dilemma in which the poor patient finds himself between the disease and the disputant doctors. It may well remind him of the appalling inscription said to be prepared by Hadrian for his own tomb. "It was the multitude of physicians that killed the Emperor."
Few words are necessary to explain the general causes of dyspepsia, and to indicate its cure. We cannot shut our eyes
to the fact that the modes of life of an advanced state of civilization, are in many respects, inimical to those which nature has prescribed. Man was placed naked on that earth whose productions were to furnish him with food and raiment. The love of life soon taught him that he could acquire the things necessary for the preservation of his existence only by labour. He found the soil producing weeds as well as fruits, and the latter he saw required aid to escape the deadly embraces of the former. This he alone could give, and thus the first among the laws of nature was that pronounced in the awful voice of God, “cursed is the ground for thy sake-in the sweat of thy face shall thou eat bread."
To labour merely for the sake of subsistence, whether that was to be derived from the cultivation of the earth, or the capture and preparation of wild animals, was, however, but a mode of taking daily exercise in the open air, which agreeably occupied the mind whilst it strengthened the body. Subsistence thus personally obtained, would necessarily be of the most simple nature. The productions of the earth, including the esculent animals, would be consumed with an appetite requiring not, and which, indeed, would have revolted at, the pungent condiments that now too often poison our food. Excessive labour, which is equally productive of disease with excessive indolence, was unknown, because uncalled for, and the first step which rendered it necessary, was a step towards the grave. He who, from whatever cause was obliged, as society advanced, to produce clothing and food for more than his own wants and his childrens', was compelled to commit an excess, for which if he did not expect it, he certainly received punishinent; for nature cannot be violated with impunity. It may, therefore, be safely averred, that a life conducted with a regular conformity to the rules thus prescribed by our earliest necessities, would produce a sound mind in a sound body-that the further we deviate from these rules, in consequence of the refinement of civilization or any other cause, the more liable we shall be to disarrangements of our system; and that the road to health will be to retrace our steps and come back to the true condition of our nature.
We mean not to imply that we must till the ground to obtain health, though we do certainly think it would be found no bad plan. All we intend to enforce, is the necessity of moderate exercise in the open air, combined with simple food, and absence from moral and physical excesses; a mode of life in the power of most persons in this country, but one requiring rather more philosophical restraint than is generally supposed.