DIETETICS. 



fl?tulency and sense of languor increase, 

 ana the spasm becomes severe ; and 

 after eating, all the symptoms of dyspep- 

 sia occur, and the pain very often is ag- 

 gravated. 



Those who, during their residence in a 

 hot climate, have been attacked by acute 

 inflammation of the liver, not terminat- 

 ing in suppuration, are frequently found, 

 on their return to Europe, as we have 

 already observed, to have the liver en- 

 larged from the deposition of coagulable 

 lymph in the progress of the inflamma- 

 tion, and in its termination by resolu- 

 tion : in the same manner as the testi- 

 cle, and particularly of the epididymis, 

 which remains for a long time enlarged 

 after the inflammation called hernia hu- 

 moralis : it is seldom, however, that 

 these symptoms will not yield to a judi- 

 cious and persevering mode of medical 

 practice. 



In affections of the stomach and other 

 cbylopoietic organs from hard drinking, 

 the chief of the same symptoms will be 

 found to occur : but those peculiarly at- 

 tendant upon this last disease, perpetual 

 loss of appetite, nausea, and vomiting, 

 when the stomach is empty ; an almost 

 constant pain at the pit of the stomach ; 

 a general tremulation of the muscles, 

 and especially those of the hands and 

 arms, so that nothing can be held steady; 

 vertigo, and frequent fainting- fits. 



In the case of enlarged liver, from the 

 deposit or accumulation of coagulable 

 lymph, mercury should be administered 

 so freely and reiteratedly, as to produce 

 immediate and permanent action on the 

 liver, and rather by inunction on the ab- 

 domen than by the mouth ; or perhaps 

 by both at the same time. Yet the exhi- 

 bition of mercury in large quantities, and 

 so as to excite ptyalism, has of late years 

 become too indiscriminate; and excepting 

 in the individual case now alluded to, its 

 admission in this unrestrained manner 

 will be generally doubtful, and often un- 

 questionably injurious. In all other ca- 

 ses, when its use is at all indicated (and 

 it is seldom that it is not indicated) it 

 should be administered in small doses, 

 seldom exceeding the quantity of half a 

 grain of calomel once or twice a day : and 

 the plan thus begun should be persever- 

 ed in for wt eks or months in effect, 

 till a radical cure be obtained, if it be 

 obtainable at all Into the rationale of 

 this progressive system, we cannot fully 

 enter at present: it may not, however, be 

 amiss to observe, that in everv case the 



VOL. IV. 



chylopoietie organs have a much better 

 chance of being restored to a sound an4 

 healthy state by progressive gentleness 

 than by sudden violence ; that the per- 

 manent solicitation of a comparatively 

 mild stimulus will eventually accomplish 

 what a more forcible system can never 

 produce; and that hence the latter should 

 be reserved for mere cases of decided 

 extremity. 



Aperient medicines are almost always 

 necessary, from the great irregularity of 

 the bowels, and generally an habitual 

 propensity to costiveness. Dr. Stone has 

 lately opposed the use of castor oil, 

 which has hitherto been in great vogue, 

 as well from the inaccuracy with which 

 it is generally expressed, as from its act- 

 ing chiefly on the large, and but little or 

 not at all on the small, intestines. But 

 after all, the patient must determine for 

 himself; for though it may disagree with 

 many constitutions, it will often occur in 

 others, that there is no aperitive that 

 completes its purpose so pleasantly. 

 When castor oil does not agree, a little 

 rhubarb, in combination with neutral 

 salt, in the proportion of a scrupla or 

 half a dram of the former, and a dram of 

 the latter, dissolved in mint water, may 

 be resorted to, or the neutral salt alone 

 in double the quantity now prescribed. 



Where we have reason to suspect 

 schirrosity of the liver, purgatives are of 

 more consequence than in any other 

 case : and here the more drastic kinds 

 are to be preferred ; as jalap, colocynth, 

 and scammony. 



Peruvian bark seldom agrees with the 

 stomach in anj stage of this disease ; but 

 bitter tonics will usually sit easy, and of- 

 ten afibrd considerable relief. If the 

 pain be violent, opium must necessarily 

 be had recourse to, but never otherwise. 



When the sense of sinking in the sto- 

 mach is distressing, and particularly when 

 this symptom occurs with cardialgia, the 

 best stimulus is the compound spirit of 

 ammonia, in camphor mixture, or in some 

 other light vehicle : this is much less in- 

 jurious to- the digestive organs than 

 aether, or any other strong spirituous pre- 

 paration, or than aromatic confection, or 

 any other spice in large quantity ; and it 

 is frequently useful in conquering the pa- 

 tient's habit of taking high-seasoned 

 dishes ; it is sometimes not only useful, 

 but necessary, to be gradual in breaking- 

 this habit, and it is commonly best to 

 allow a few glasses of generous wine, re- 

 questing the patient at the same time to 



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