DIETETICS. 



winds are severely felt, and should be 

 avoided : at the same time the propriety 

 of hypochondriacs accustoming them- 

 selves to bear the open air as much as cir- 

 cumstances will allow, must ever be im- 

 1 upon them : and proper warmth of 

 i-lothing-, particularly about the feet, must 

 be worn. 



FAvrcisc, short of fatigue, is essential ; 

 and even a little fatigue must be endured 

 by those, who, from long sedentary occu- 

 pation, have lost the habit of exertion ; 

 riding on horseback, or in a carriage, 

 sailing, rowing, are all useful ; also mode- 

 rate walking, bowling, or working with 

 a spade in the garden, and other exercise 

 out of doors intruded with some labour. 

 It is to be observed, howe\er, of sick- 

 h-ad-ache, that its attacks are frequently 

 induced by the motion of a carriage, boat, 

 or ship, and that exercise on foot or 

 horseback is best for such invalids : fric- 

 tion about the hypochondria with a flannel 

 or flesh- brush is often serviceable, and 

 to be recommended, when the debility of 

 the patient prevents other kinds of muscu- 

 lar action. The military exercise, as prac- 

 tised by our volunteers for a short time 

 t-\< -r\ day. is also, where it can be adopt- 

 ed, of very high advantage. 



The plan of diet in this disease is a 

 point of much delicacy and management : 

 the same mode will seldom answer for 

 any two distinct cases. In general, the 

 patient is to be nourished with whatever 

 aliment he can digest, and an equal and 

 uniform reservation as to spices is by no 

 means necessary, provided that they 

 seem to improve rather than to injure 

 digestion ; his appetite for a moderate 

 quantity of almost any variety of food is 

 to be indulged, provided no derangement 

 of the stomach ensue from it, and the 

 jmantia and Ixilentia are to be made out 

 from observation in each case ; vinegar 

 and native vegetable acid commonly are 

 prejudicial, yet very frequently ripe fruit 

 is beneficial. In general, every thing that 

 is oily or empyreumatic must be avoided ; 

 mustard, horse -raddish, and the like, arc 

 often useful in the prevention of flatulen- 

 cy; sometimes, in long cases of hypochon- 

 driasis, where vomiting has been a tire- 

 some symptom, the yolks of eggs boiled 

 hard have been digested, and the vomit- 

 ing in a short space of time has ceased ; in 

 these cases it is probable tlxat the stomach 

 is in an habitual state of contraction, as 

 it has been sometimes actually found on 

 dissection, and mustard or horse-raddish, 

 by increasing its muscular action, would 

 feave been injurious, whilst aiiv easily di- 



VOL. IV 



gestible substance nearly solid, from not 

 occupvingmuch space, would be retained, 

 and gradually distend the stomach, or, 

 from causing the muscular effort produ- 

 ced in vomiting to cease, give opportunity 

 to the stomach to recover its natural di- 

 mensions ; eggs, however, prepared iu 

 any way that has been contrived, will not 

 always agree, even when this state of 

 stomach is to be suspected; but will at 

 times be almost immediately rejected, 

 or produce much disturbance, when a 

 small quantity of gelatinous or mucilagi- 

 nous food, or even of light meat, will be 

 digested. 



It is by no means justifiable to prohibit 

 light suppers peremptorily ; since, in 

 point of theory, we know that digestion 

 and the absorption of chyle proceed more 

 regularly during sleep than at any other 

 time ; and, in point of fact, we know 

 equally that hypochondriacs are often 

 benefitted by light suppers. Thus much 

 is certain, that the meals should always 

 be light and sparing, and consequently 

 frequent; and that, if suppers be indulged 

 at all, the hour of dinner should be much 

 earlier than is customary in the present 

 day. 



With respect to drinks, malt-liquor 

 ought but seldom to be allowed. Soda- 

 water, with wine, commonly forms a most 

 excellent beverage. It is rarely proper 

 to require any large quantity of diluting 

 drink to be taken. Coffee generally agrees 

 better than tea ; and sometimes cocoa, 

 or even chocolate-, if its oily quality do 

 not offend the stomach, is very proper 

 for breakfast,.or in the forenoon. 



Opium, for the mere purpose of pro- 

 curing sleep, should never be allowed. 

 Much, in this respect, is to be accom- 

 plished by regularity in the hours of ris- 

 ing and going to bed, and especially by 

 opposing all propensity to sleep in the 

 day time. 



The mind in hypochondriasis cannot be 

 properly regulated without the best ef- 

 forts of the patient himself, but he will 

 for the most part be induced to use them, 

 on the representation of a medical man 

 of intelligence and good humour, that it 

 is impossible for him to accomplish any 

 plan he has in view, and that he must al- 

 ways be a burthen to himself and his con- 

 nexions, till he makes the search after 

 cheerfulness and health his primary pur- 

 suit ; he must make himself alive to the 

 scene which passes before him, and his 

 family may commonly be instructed in 

 some methods of diverting his attention 

 from dismal reflections on himself, and 



Aa 



