5C2 DISEASES OF THE STOMACH. 



minutes ; but, while they last, they greatly terrify the patients and 

 those around them. They often, but not always, teiminate with gap- 

 ing and eructations. 



Sometimes there is only one such attack, but more frequently 

 there is a recurrence, sooner or later. It is, at the same time, very re- 

 markable that the new attacks are excited by apparently insignificant 

 causes, such as walking on a polished floor, or a smooth sidewalk, or 

 by passing a grating ; also, that on such occasions the patient does not 

 become dizzy if he holds the hand of even a small child, or rests on a 

 slender cane ; lastly, that there is no dizziness if he is engaged in 

 something that occupies his whole attention, or if he be mentally ex- 

 cited. I knew one patient who could on no consideration walk alone 

 through a hall, or across an open square, while he could dance without 

 trouble in the same hall, and unconcernedly rode a spirited horse across 

 the same square. The longer the affection lasts, the more, the thoughts 

 of the patient are directed to his enigmatical and curious state. 

 He becomes greatly depressed by the idea that he has disease of the 

 brain, and particularly when he hears that dizziness was one symptom 

 in some other patient who actually had cerebral disease, who perhaps 

 died of softening of the brain, that most terrible bugbear of the laity. 

 Physicians also are often mistaken, and order bleeding, derivatives, 

 preparations of iodine, saline springs, and forbid wine and beer, and 

 restrict the diet as much as possible. If this treatment be ineffec- 

 tual, and under it the patient becomes pale and thin, the physician 

 often changes his opinion : he suspects that the dizziness is caused 

 by anaemia of the brain ; then he prescribes iron, advises the use of 

 wine and beer, and places the patient on a nutritious animal diet. 

 However, this treatment also proves unavailing, and the patient re- 

 turns unimproved from the Alps, from the cold-water cures, and from 

 the sea-shore. As above mentioned, Trousseau believes that these 

 attacks of dizziness depend on dyspepsia ; at the same time he ac- 

 knowledges that in many cases the signs of dyspepsia are so slight as 

 to be readily overlooked. He relates cases of the successful treatment 

 of "vertige stomacale" by the alternate administration of infusion of 

 quassia and a composition of carbonates of the alkalies. Even from 

 this prescription I have never seen any benefit; and while I must ac- 

 knowledge that the first attacks of dizziness, affecting the patients ths t 

 I have seen, usually occurred after an indigestion, and were accompa- 

 nied by dyspeptic symptoms, still, in none of them were there evident 

 signs of indigestion during the subsequent attacks, which often con 

 tinued for years. I believe the repetition of the attacks of dizziness to 

 be due to psychical causes. As there are persons who become dizzy 

 when they stand on the edge of a precipice, or on a high tower ; and 



