DYSPEPSIA. 561 



met resembled most closely those I have just described, although I 

 will not consider them as exactly identical ; they had the same etiol 

 ogy, the same varied complaints (not exactly corresponding to any of 

 the usually-described forms of disease), the same sleepiness, paleness, 

 and emaciation, only the urine, which is usually acid, contained no 

 sediment of urates, but had crystals of oxalate of lime. Hence I deem 

 it most proper to regard the dyspepsia, which occurs as one of the 

 many symptoms of oxaluria, as the result of a constitutional derange- 

 ment, and that this derangement is developed in persons predisposed 

 to it, by the manner of living above described. At present we have 

 no idea which link in the long chain of processes between assimilation 

 of nourishment and the excretion of the used-up constituents of the 

 body, is first changed by this injurious influence, which induces the 

 formation of quantitatively or qualitatively abnormal products. 



In this affection we should employ the treatment which I above 

 recommended for the diseases allied to, if not identical with, the oxalic 

 diathesis. (The occurrence of oxalate of lime, as a final product of the 

 change of tissue in the oxalic diathesis alone, is opposed to their com- 

 plete identity.) The administration of nitric acid (twenty drops of the 

 dilute acid two or three times daily), recommended by English physi- 

 cians for the oxalic diathesis, and the forbidding of all saccharine arti- 

 cles of food, appear to depend more on theory than on the results of 

 practical experience. 



Before closing the consideration of dyspepsia, I wish to speak of a 

 peculiar form of dizziness which is a very frequent but inexplicable 

 symptom. Trousseau^ who considered that it arose from the dyspepsia, 

 called it vertige stomacale. Almost any practitioner can refer to some 

 case among his patients that will correspond with the true and life-like 

 description given by Trousseau of the vertige stomacale, the vertigo a 

 stomacho laeso, or, as our people call it, abdominal dizziness (bauch- 

 schwindels). The disease, which subsequently becomes very obstinate 

 and tedious, usually begins acutely without any premonition. The 

 patient, who just previously felt perfectly well, complains of great diz- 

 ziness ; it seems to him as if every thing around him, or as if he him- 

 self, were whirling or rolling about. Besides this hallucination, there 

 are usually abnormal sensations in the head, which, the patient says, 

 he cannot call pain, but which he in vain attempts to describe. Some- 

 tunes patients say their heads feel " empty," or " light ; " others speak 

 of a " numbness," of a " sensation of undefined pressure," of a " cloud 

 arising in the head ; " besides this, there are usually sparks before the 

 eyes, noises in the ears ; the patients are afraid of falling, seek sup- 

 port, want to sit down or lie down. These attacks, during which the 

 color is either unchanged or becomes pale, usually pass off after a few 

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