376 PRACTICE OF PHYSIC. 



MCCII The propriety and necessity of the first indication is 

 sufficiently evident, as the continued application, or frequent 

 repetition of those causes, must continue the disease ; may de- 

 feat the use of remedies ; or, in spite of these, may occasion the 

 recurrence of the disease. It is commonly the neglect of this 

 indication which renders this disease so frequently obstinate. 

 How the indication is to be executed, will be sufficiently obvi- 

 ous from the consideration of the several causes. But it is 

 proper for the practitioner to attend to this, that the execution 

 is often exceedingly difficult, because it is not easy to engage 

 men to break in upon established habits, or to renounce the 

 pursuit of pleasure ; and particularly, to persuade men that those 

 practices are truly hurtful which they have often practised with 

 seeming impunity. 



MCCII I. The symptoms of this disease which especially con- 

 tribute to aggravate and continue it, and therefore require to be 

 more immediately corrected or removed, are, first, the crudities 

 of the stomach already produced by the disease, and discovered 

 by a loss of appetite, by a sense of weight and uneasiness in the 

 stomach, and particularly by the eructation of imperfectly di- 

 gested matters. 



" Vomiting and eructation are not actions entirely of the 

 same kind. In vomiting there is always a concurrence of the 

 diaphragm and abdominal muscles, and the whole contents of 

 the stomach are pressed and commonly ejected in considerable 

 quantity ; whereas in eructation, the diaphragm, and abdominal 

 muscles do not concur, and the quantity rejected at once is small. 



" Vomiting is always, eructation seldom preceded by nausea. 

 Nausea will always pass into vomiting, very seldom into eructa- 

 tion. 



" Further, nausea and vomiting may be excited by causes 

 acting in the fauces, by imagination, by causes irritating the 

 whole or particular parts of the stomach : Eructation seems to 

 depend upon an irritation of the cardia alone, at least it is es- 

 pecially excited by every matter which is apt to separate from 

 the other contents of the stomach, and at the same time to float 

 next to the cardia. 



" Thus the most frequent cause and most frequent matter of 

 eructation is air. 



