224 OF THE STOMACH SECT. XXV. 17, 



from torpor, the pulfe is weaker, and the extremities colder, and 

 the general debility greater, than in the paflage of a gall- ftone j 

 for in the former the debility is the confequence of the pain, in 

 the latter it is the caufe of it, 



. Though the firft fits of the gout, I believe, commence with 

 a torpor of the liver , and the ball of the toe becomes inflamed 

 inftead of the membranes of the liver in confequence of this tor- 

 por, as a coryza or catarrh frequently fucce^:ds a long expofure 

 of the feet to cold, as in fnow, or on a moift brick-floor ; yet in 

 old or exhaufted conftitutions, which have been long habituated 

 to its attacks, itfometimes commences with a torpor of the ftom- 

 ach, and is transferable to every membrane of the body. When 

 the gout begins with torpor of the ftomach, a painful fenfation 

 of cold occurs, which the patient compares to ice, with weak 

 puife, cold extremities, and ficknefs ; this in its flighter degree is 

 relievable by fpice, wine, or opium 5 in its greater degree it is 

 fucceeded by fudden death, which is owing to the fympathy of 

 the ftomach with the heart, as explained below. 



If the ftomach becomes inflamed in confequence of this gouty 

 torpor of it, or in confequence of its fympathy with fome oth- 

 er part, the danger is lefs. A (icknefs and vomiting continues 

 many days, or even weeks, the ftomach rejecting every thing 

 ftimulant, even opium or alcohol, together with much vifcid 

 mucus ; till the inflammation at length ceafes, as happens when 

 other membranes, as thofe of the joinrs, are the ieat of gouty 

 inflammation ; as obferved in Sect. XXIV. 2. 8, 



The fympathy, or afibciation of motions, between thofe of 

 the ftomach and thofe of the heart, is evinced in many difeaies. 

 Firft, many people are occafionally affected with an inter rniffionof 

 their pulfe for a few days, which then ceafes again. In this cafe 

 there is a ftop of the motion of the heart, and at the fame time a 

 tendency to eructation from the ftomach. As foon as the patient 

 feels a tendency to the intermiflion of the motion of his heart, if 

 he voluntarily brings up wind from his ftomach, the ftop of the 

 heart does not occur. From hence I conclude that the ftop of di- 

 geftion is the primary difeaie ; and that air is inftantly generated 

 from the aliment, which begins to ferment, if the digeftive pro- 

 cefs is impeded fora moment, (feeSeft. XXIII. 4 ), and that the 

 ftop of the heart is in confequence of the aflbdatien of the motions 

 of thefe vifcera, as explained in Seft. XXXV. i. 4. i but if the 

 little air, which is inftantly generated (during the temporary tor- 

 por of the ftomach, be evacuated, the digeftion recommences, and 

 the temporary torpor of the heart does not follow- One patient, 

 whom I lately faw, and who had been five or fix days much 

 troubled with this intermiflion of a puliation of his heart, and 



who 



