101 



to disorder, or to break oft'. Those who have practised in great hospi- 

 tals, know to how many patients indigestions are fatal. I have seen some 

 with large ulcers; suppuration was copious and healthy; the granula- 

 tions florid, and all promising a happy issue, when ignorant friends bring 

 them by stealth indigestible food, with which they cram themselves, in 

 spite of the utmost watchfulness. The stomach, used to mild and mode- 

 rate regimen, at once overloaded with food, is changed into a centre of 

 fluxion, towards which the blood all tends. An irritation is produced 

 beyond that on the ulcerated surface ; which, in a little time, ceases 

 to secrete pus, the fleshy granulation become flabby, extreme op- 

 pression is felt ; with a difficulty of breathing comeson a pungent pain in 

 the side, the pain sympathetically felt in the lungs, makes this organ the 

 seat of an inflammatory and purulent congestion, a rattle ensues, and the 

 patients die of suffocation, at the end of two or three days, sometimes 

 in twenty-four hours; and this fatal termination is especially accelerated, 

 when, as I have often witnessed, a blister is applied to the seat of the 

 pain, instead of the ulcerated surface. 



It will seem surprising, perhaps, that in the case of which I have just 

 been speaking, it should be in the lungs, and not the stomach itself, that 

 the congestion and the pain take place; but besides that the most per- 

 meable organ of the body, is the lungs, as well as the weakest, and the 

 most easily yielding to fluctionary motion* ', a host of instances prove, what 

 a close sympathy unites it to the stomach. Let us but call to mind pleuri- 

 sies and bilious peripneumonies, those acute pains of the side, which, 

 since Stahl, physicians have so successfully treated with vomits. The 

 rapidity with which their symptoms go off, on the evacuation of the 

 sordes which oppress the stomach, shows clearly that the sympathetic 

 diseases are not owing to the metastasis of bile upon the lungs, and that 

 they do not consist in the simultaneous existence of a gastric affection, 

 and of an inflammatory state of the pleura or of the lungs, but that they 

 are simple gastric affections, in which the lungs are, at the same time, 

 the seat of a sympathetic pain. 



The action of the parietes of the stomach ceases, only when this viscus 

 is completely cleared of the food it contained. The gastric juice, no 

 longer secreted, ceases to be poured so freely by its arteries, and the 

 parietes, which close upon each other, are chiefly lubricated by the 

 mucus so plentifully secreted by the inner coat. 



At times, the action of the muscuiarfibresof the stomach is altogether 

 inverted, they contract from the pyloris, towards the cardia, and this 

 anti-peristaltic motion, in which the contractions are effected with more 

 force, more rapidly, and in a manner really convulsive, produces vomit- 

 ing. Then, the action of the abdominal muscles is added to that of the 

 stomach ; the viscera are driven upwards and backwards, by the contrac- 

 tion of the larger muscles of the abdomen ; the diaphragm rises up to- 

 wards the chest. If it sunk as it contracted, the oesophagus, which 

 passes in the interval of its two crura, would be compressed, and the pas- 

 sage of the alimentary substances by the cardiac orifice, could not take 

 place. Accordingly it is observecJ, that it is only during expiration, that 

 any thing passes from the stomach into the oesophagus. Vomiting may 



* Of all the erg-ads it is that in which we most meet with organic injury; and those 

 who have opened many bodies, may have observed, how rare it is to find the lungs 

 completely sound in adults and in old men. Author's J\ *ote. 



