INDIGESTION. 



s^\-^ra of tlie food in its undigefted flats, and that of 



('.;:1. jtiuii by the cvohition of air, which is probably oc- 



<-a!i);ied by the fpontaneous decompofition or fermentation 



of llif alimentary matter, and is relieved by eriiftation and 



the I'.ifcharpje of flatus. The irritation of the acid or acrid 



cr:(!ities upon the coats of the ftomach, efpccially about 



;^;K'r orifice, excites the fenfation of heart-burn, and 



. Mial fpafmodic and inverted aflions of the llomach 



pallet, by which erudations are produced, as well as 



ij,.. 1.1 iodic contraftion of the mufcular parts of the Ito- 



( fnach, which is accompanied by pain or galtrodynia : over. 



I ditlentiou of tlie coats of the Itomach, by tlie flatus, is 



likewife productive of pain. 



But in addition to thefe morbid fenfations and phenomena 

 in the ftomach itfelf, an infinite variety of fyniptonis oc- 

 cur, in different inftances, indicating the fynipathetic af- 

 ■ fefrtion of the conilitution at large, or of particular organs. 

 Thefe have commonly been called tKriwits fymptonis, in- 

 afmuch as they have originated merely from a fympathy of 

 parts, independently of any dilordered Hate of the circu- 

 lation, or of any morbid change in the ftruclure of the 

 fufFering organs ; and they are often more dillrcffing than 

 the primary fymptoms belonging to the affeftion of the 

 ftomach. Among the fymptoms to which we allude, are 

 languor, fliiggilhn^ls, and indifpofition to exertion, either 

 mental or corporeal, but efpecially the latter ; drowfuiefs, 

 particularly after meals or (light cxercife ; giddiiiefs, noife 

 in the ears, occafional dimnefs of fight, or a fenfe of objeSs 

 floating before the eyes, with head-ache under various 

 forms, moft frequently affefting the forehead and temples, 

 fometimes the crown and the occiput ; fevere flying pains ; 

 palpitations of the heart, or intermiffions in its pulfation, 

 with confiderable variations in the ftate of the pulfe ; total 

 reftilelTncf?:, or unrefrefliing fleep during the night, with 

 frightful dreams, the incubus, or night-mare, &c. ; tem- 

 porary abfenre of mind, impaired memory, unufual timidity 

 and dcfpondency ; and, in fhort, all the train of complaints 

 which belong to hypochonJriafis and hyjferia in the conft^i- 

 tutions in whicb they are liable refpeftively to occur. See 

 thefe articles. 



■ The experiments of modern phyfiologifts have (hewn that 

 the procefs of digeftii n is principally effected by means of the 

 fluids of the ilomach, which poiL>fs a folvent power over the 

 fubllances u.*ed as aliment ; and that it is not a procefs of 

 concoclion, putrefaction, attrition, or fermentation, as was 

 anciently fnppofed. (See DlGEsriox.) It would feem, 

 therefore, that the elfential caufe of idiopathic dyfpepfia 

 ronfiihin a change in the quantity or quality of this gailrie 

 fluid, or folvent, originating from an impaired condition of 

 the ftcretery function of the ftomach. This, however, can 

 perhaps only be afciibed to the deficiency of its tone and 

 vigour as a mufcular organ. Dr. Cullen juftly remarks, 

 that, as the peculiar nature of the digeftive fluid, the changes 

 which it may undergo, and the caufes by which it may be 

 changed, are very little known to us, we cannot found a 

 practic.d doclrine upon any fiippofition refpecting it ; but as, 

 «t the fame time, the imbecility of the ftomach, either as the 

 caufe or the effedl of the change in the digellive fluid, feems 

 always to be prelent, and to have a great (hare in occa- 

 sioning the fymptoms of indigeftion, we may Hill coiifider 

 the imbecility of the ftomach as the proximate and almoil 

 fole caufe of thj'pef)fia. He obferves, too, that tiiis view 

 of the fubject is the more admilTible, as it appears to be 

 fully and clearly applicable to the explanation of the pra(f\ice 

 which experience has ellabliihed as the moll fuccefsful in this 

 difrafe. Firft Lines, ^ lup. 



Cuufes of IiiifiytjVion. — Certain original conftitution of the 

 Vol.. XIX. 



body is obvioufjy conncAed with a predifpofition to tTiis 

 complaint : this is fometimes manifeft only in a defcaive 

 performance of the funffions of the ftomach itfelf; but in 

 other cafes it is evidently a part of the general want of 

 tone and vigour in the body, and occurs in pcrfons of 

 lax fibre, and fangnine or fanguinco-phlegmatic tempera- 

 ment. In perfons of dark and fallow complexion, the fto- 

 mach itfelf appears to be often originally weak, in a degree 

 difproportionate to the general condition of the habit. 



The exc'it'mg caufis of indigeftion, then, muft be looked 

 for among thofe circumftances which tend either to produce 

 a lofs of tone in the mufcular fibres of the Ilomach, or which, 

 in ihe debilitated ftate of that organ, tend to opprefs its 

 powerj and to impede its funaions. The caufes which 

 contribute to impair the vigour of the ftomach are of 

 two kinds ; namely, thofe which operate direftly upon tliat 

 organ, and thofe w hich affect it indirectly, or through die 

 medium of the general fyftem. 



The vigour of the ilomach is impaired by the excelTive 

 ufe of ftimulatir.g condiments, and of fpirituous liquors, ai 

 well as by the abufe of certain articles of the fedative or 

 narcotic kind, fuch as tobacce, tea, coffee, opium, bitters ; 

 and by the too frequent and copious ufe of acid and afcef- 

 cent articles of food, and of warm watery liquids. Frequent 

 vomiting, whether ariling fpontancouOy or excited by art, 

 tends alfo greatly to debilitate the ftomach ; and over-dif- 

 tention of the organ by an exceiTive quantity of food or 

 drink, or the ufe of food in itfelf difficult of digcition, or 

 diflicult from the idiofyncrafy of the individual, equally 

 contribute to the fame effeft. The want of due mafticatioit, 

 and of the proper commixture of the faliva with the food, 

 by which its tendency to putrefactive decompofition may 

 be diminillied, liJcewife materially enfeebles the digeftive 

 powers of the ftomach, and adds to the oppreffion where it 

 is already weakened. Whence the habit of frequent fpitting, 

 or rejection of the faliva, is juftly enumerated among the 

 caufes of indigeftion. ComprefTion of the itomach after a 

 full meal, as by particular poftures, &c., or violent exercife 

 or fiiecuffion of the body, under the fame circumftances, 

 have been found to have a material influence in preventing 

 the procefs of digeition, and oppreffing the powers of the 

 ftomach. Hence various occupations and trades, in which 

 comprclTion and fuccuffion of the diftended ftomach are daily 

 produced, occafion habitual dyfpepfia in thofe who are pre- 

 difpofed to the difeafe. 



Many of thefe occupations, however, debilitate the fto- 

 mach likewife through the medium of the general fyftem, 

 or by deranging other organs and funftions with which the 

 llomaeh particularly fympathifes. The fedentary and in- 

 active life, connedtcd with many of them, debilitates the body 

 in all its fimftions, and the ftomach moft particulr.ily ; in- 

 tenfe ftudy, or clofe application of mind to any buiinefs, 

 when long continued ; grief, anxiety, vexation of mind, and 

 diforderly paflions of any kind ; venus immodica ; cxpofure 

 to moift and cold air, when without exercife ; and frequent 

 intoxication, wliich belongs partly to this head, and partly 

 to the former, — are all common remote caufes of that im- 

 becility of itomach which is connected with indigeftion. 

 Dr. Cullen remarks, that, though the difeafe, as proceed- 

 ing from tlie laft fet of caufes, may be conlidcrcd as a 

 fymptomatic affedion only ; yet as the diforder of the fto- 

 mach is genei:;lly the liril, always the chief, and often the 

 only efi'eCt which thefe caufes produce or difcovcr ; fo the 

 affeftion of the ftomach may be confidered as the difeafe 

 chiefly to be attended to in practice ; and the more pro- 

 perly fo, as in many cafes the general debility is only to 



