766 



DYSPEPSIA. 



It succeeds to previous irritation, aiul is often occa- 

 Moned by irritation in other organs. 



The preceding form a first class of dyspeptic dis- 

 eases, which, depending entirely on the stomach, may 

 be termed gastric dyipepsia. They present diame- 

 ters totally different, and require a very opposite 

 treatment. This class embraces three species. 



A second class of dyspeptic diseases is connected 

 with the duodenum and its functions. This viscus, 

 similarly constituted to the stomach, is subject to the 

 same morbid alterations. Its mucous membrane is 

 tin- seat of irritation, in its various grades, and pro- 

 tlnriive of its usual consequences augmented irrita- 

 bility, sensibility, perversion of secretions, vitiation 

 i >f structure, and disorder of function. Duodenic 

 irritation most commonly accompanies gastric irrita- 

 tion, and the symptoms of the two are blended toge- 

 ilu-r. It exists, however, in many instances, inde- 

 pendently, and then manifests particular symptoms, 

 which are often termed dyspepsia. It is, more espe- 

 cially, the chronic, irritation of the duodenum, Uiat 

 passes for dyspepsia. It is not probable, that con- 

 gestion, or asthenia, ever affect the duodenum exclu- 

 sively to the detriment of its function. When these 

 states prevail, it is in conjunction with similar con- 

 ditions of the whole digestive apparatus. At least 

 we have no knowledge of these states limited to the 

 duodenum. 



A third class of dyspeptic diseases depend on the 

 nervous organs, which furnish nerves to the digestive 

 viscera. The ganglionic system of nerves, distributed 

 on each side ot the spine, from the head to the pelvis, 

 transmits nerves to all the organs connected with the 

 nutritive function. The stomach, especially, is largely 

 supplied from the solar plexus, and it receives, like- 

 wise, numerous nervous filaments from the pneuino- 

 gastric, placing it in connexion with the functions of 

 relation. The offices of the ganglionic system are 

 not ascertained with precision. It is, however, well 

 determined, that diseases of the ganglions disorder 

 the functions of the viscera to which they transmit 

 nerves. Hence arises an order of dyspeptic symp- 

 toms, independent of any immediate afl'ection of the 

 stomach, but occasioned by disease in the great 

 solar, or other neighbouring plexus. The disorders 

 of the digestive functions, from this cause, are various. 

 The sensibility of the stomach is sometimes greatly 

 increased, constituting gastralgia. At other times, 

 the secreted fluids of the stomach are morbidly acid. 

 The stomach appears, in other cases, to be partially 

 paralyzed, and the peristaltic movements necessary 

 for the admixture of the food, and the gastric fluids, 

 anil the continuous passage of the chyme into the 

 duodenum, are suspended. At the same time, con- 

 siderable quantities of flatus collect in and distend 

 the stomach, preventing its action on the food. Me- 

 chanical manipulation of the abdomen, and particu- 

 larly of the epigastrium, after a meal, becomes a 



sutetitute for the natural motion of the stomach, 

 expels the wind, and facilitates digestion, that wouiu 

 otherwise be laborious and painful. 



Dyspepsia, or indigestion, from this analysis of its 

 modes of production, is seen not to be a disease of 

 uniform cliaracter, and depending on an identical 

 state of the digestive organs. It is attached, as a 

 symptom, rather, to a variety of conditions, e;icii 

 of which requires to be managed in its appropriate 

 mode. It is not possible that it can be remedied l>\ 

 any one general mode of treatment, or by any set of 

 specific remedies. The most common causes of dys- 

 pepsia are excesses of various kinds, especially in 

 the quantity of food eaten. Most individuals, in this 

 country, err in this respect. Meat at three meals. 

 daily, can be borne only by the most robust frames, 

 and by hard labourers. Persons of a sedentary life 

 require less nutriment ; the economy makes less de- 

 mand on the stomach for supplies ; and if it be com- 

 pelled then to labour, it is at its own loss. Exercise, 

 or the expenditure of the nutritive elements by the 

 economy, and the quantity of food to be digested, 

 must be proportioned to each other, for the preserva- 

 tion of health and the due vigour of digestion. This 

 fundamental principle is kid down in an axiom by 

 Hippocrates Homo edens sanus esse non potest, nisi 

 etiam laborat. DE DI^ETA, Lib. I. Good cookery, 

 by rendering food more digestible, is one preservative 

 against dyspepsia. The food, by being rendered 

 tender and pulpy, is reduced to chyme in a shorter 

 period, with a smaller expenditure of the secreted 

 fluids, and less excitement of the stomach, than when 

 it is not properly concocted. The art of long and 

 healthful living will depend on a perfect system of 

 cooking, and a rational mode of eating. The powers 

 of the stomach differ, in individuals, as much as the 

 force of their muscles ; and each one must adopt a 

 mode of nutrition, both as to quantity and quality of 

 food, suitable to the wants of his economy and the 

 digestive capacity of his stomach. The quality of 

 food is a frequent cause of dyspepsia. Tough and 

 badly dressed meats, and crude vegetables, are among 

 the prominent causes of this affliction, as are also 

 hot bread and cakes, heavy and fresh bread, and the 

 daily use of hot coffee for breakfast. In enumerating 

 the more common causes of dyspeptic symptoms, we 

 ought not to omit the frequent exacerbations .of the 

 malevolent passions, as anger, hatred, envy, jealousy, 

 and, what is not often suspected, excessive indul- 

 gence and abuses of the venereal propensity. An- 

 other fruitful source of the digestive disorders is 

 found in the employment of emetics, and in a fre- 

 quent resort to saline or drastic catliartic medicines. 

 When a constipated habit prevails, it should always 

 be overcome, if possible, by a laxative regimen, and 

 the aids of purgatives be cautiously and rarely in- 

 voked. 



