DIETETICS. 



comprehensive, as to be a general direc- 

 tory to the rest. 



The principal diseases then, whether 

 local or constitutional, in which the hu- 

 man stomach becomes so affected as to 

 render it a proper subject of medicinal 

 diet, are, acidity, flatulency, heart-burn ; 

 impletion? chronical sick-head-ache and 

 hypochondriasis ; hepatic affection from 

 hot climates ; hepatic affection from 

 hard drinking. 



OF ACIDITY, and its concomitants or effects. 



It is difficult to determine whether aci- 

 dity of the stomach depends at all times 

 on the introduction of acid by the mouth ; 

 or whether the gastric fluid be sometimes 

 secreted in a vitiated state. A great va- 

 riety of acids are occasionally introduced 

 into the human stomach with food or me- 

 dicine ; and that acid, which is the pro- 

 duct of fermentation, is frequently form- 

 ed in the stomach from the spontaneous 

 changes of vegetable matter in cases of 

 imperfect digestion, and where food is 

 taken in so large quantity that it is impos- 

 sible for any stomach to dissolve it : from 

 the latter cause, principally, the acid so 

 perpetually troublesome to the stomachs 

 of children appears to arise ; and the 

 cardialgia of adults may justly be suppos- 

 ed most frequently to have the same ori- 

 gin : it is constantly to be observed, how- 

 ever, that in obstructions of the liver or 

 gall-ducts, symptoms of cardialgia occur, 

 and that in cases of sick-head-ache and of 

 hypochondriasis, where the strictest at- 

 tention has been paid to rules of diet, 

 the patient is not relieved till acid be 

 evacuated from the stomach, either by vo- 

 miting or purging : hence it appears pro- 

 bable that the gastric fluid is in itself vi- 

 tiated in some diseases, having acquired 

 the properties of an irritating acid, and 

 being bereft of its solvent power ; and 

 that a due secretion of the bile is al- 

 ways requisite to the correction of acid 

 in the stomach, both as neutralizing the 

 acid matter, and as stimulating the in- 

 testines to expel any uncombined acid, 

 which may resist its effects, or prove 

 more than it is adequate to neutralize. 



The symptoms attending acidity in the 

 stomach are, flatulency ; cardialgia ; nau- 

 sea ; vomiting; costiveness ; or purging 

 with discoloured faeces ; foul bowels ; 

 head-ache ; pa!eness sometimes alternat- 

 ing with flushing ; increased pulse ; a 

 tongue coated with a white or brownish 

 fur ; increased heat, particularly on the 

 6kin of the abdomen ; loss of appetite j 



sense of weight, pain and oppression ; 

 rigors ; langour, particularly about the 

 eyes, with discoloration round the eye- 

 lids ; stupor, and convulsions, or a dilat- 

 ed pupil so as to resemble hydrocepha- 

 lus. These symptoms occur according 

 to the magnitude and duration of the at- 

 tack, in conjunction with the constitution 

 of the patient. 



In all common acidities in the stomach, 

 evacuation from the bowels is always ne- 

 cessary, whether the attack be accompa- 

 nied with costiveness or purgation. For 

 this purpose calomel is generally highly 

 serviceable. From its nature and the 

 smallness of the quantity requisite to pro- 

 duce the requisite effect, it may be ta- 

 ken without being tasted, and it common- 

 ly produces no nausea or vomiting, when 

 a fluid purgative would instantly have 

 this effect, from its irritation on the al- 

 ready irritated stomach, and from the 

 sympathy of that viscus with the organs 

 of taste and smell, when offended by such 

 medicine : the mode of operation of ca- 

 lomel, and its quickness of action, also 

 highly contribute to render it eminently 

 useful ; it instantly excites copious mu- 

 cous secretion from the glands of the 

 stomach, which contributes to dilute and 

 wash away the offending acid, and a con- 

 siderable portion of this medicine quick- 

 ly passing the. pylorus augments the se- 

 cretion of bile, the natural corrector of 

 acid ; and that of the pancreas produc- 

 ing further dilution. It may be given in 

 doses from one grain to five, or even in 

 larger quantity, according to the age and 

 strength of the patient, and repeated as 

 occasion may require. In an hour or two 

 after its exhibition, the stomach will bear 

 some directly purgative matter, which 

 should be given, to insure the passage of 

 the calomel through the bowels, and to 

 increase the purgative effect. Rhubarb 

 will hereafter be of great advantage, in- 

 termixed with some aromatic powder or 

 pungent water, as mint or peppermint; 

 though the neutral salts will better agree 

 with some constitutions. Absorbents we 

 cannot recommend so largely as they 

 have often been recommended, especial- 

 ly the calcareous earths, for it often hap- 

 pens that the insoluble compound form- 

 ed by the union of chalk and the acid in 

 the stomach increases the load and irri- 

 tation in the bowels. In slight or recent 

 cases, they are chiefly useful, and to be 

 depended upon. 



The morbid matter being removed or 

 destroyed, strict attention to diet is next 

 of very considerable consequence. What- 



