INDIGESTION. 



in a morbid degree is known, not only by its riling occa- 

 Conally into the mouth and throat by eruftation, and by the 

 heart-burn which accompanies it (fee Cardialgia) ; but 

 alfo by the occurrence of gnawing pains in the ftomach, 

 flatulency, irregular cravings for food, griping and loofenefs 

 of the bowels, See. The acidity already prefcnt in the 

 ftomach may be correftcd, by neutralizing it by means of a 

 chemical combination with fome alkali or abforbent earth. 

 The three alkahs, foda, potafs, and ammonia, may be taken 

 for this purpofe refpeftively, either in the pure (or cauftic) 

 ftate, or mild, ;. e. in the form of carbonates : on the whole, 

 they feem to be more efficacious in the pure ftate. The 

 foda-water, now manufaftured in the ftiops, is an agreeable 

 form of antacid ; but the alkali may be taken with advantage 

 in larger quantities than that beverage contains. Magnefia, 

 chalk, and the teftaceous powders prepared from crabs-claws 

 and oyfter-ftiells, which are carbonates of lime, likewife 

 combine with the gaftric acid, and neutralize it: the mag- 

 nelia (which is much more effeftual in its pure ftate, or cal- 

 cined, than in the form of carbonate) is often ufeful, inafmucli 

 as it forms a neutral fait, which is in fome degree laxative, 

 with the acid of the ftomach. It is not, however, fuf- 

 ficient to neutralize the prefent acidity, the difpofition to 

 generate it muft be alfo obviated. This is to be effecled 

 partly by avoiding acefcent aliments of the vegetable clafs, 

 and uling animal food, fueh as is little capable of acefcency. 

 But as vegetable food cannot be entirely difcardcd, the e.scefs 

 of its acefcency may be in fome meafure avoided, by chuiing 

 fuch vegetable matters as are the leaftdifpofed to the vinous fer- 

 mentation, fuch as leavened bread, and well fermented liquors; 

 and inftead of ufing the frefti native acids, employing vine- 

 gar. But the difpofition to acidity may be farther pres'ented 

 by other means ; namely, by thofe which invigorate the muf- 

 cular fibres of the ftomach, to be mentioned prefently. It 

 appears that the acidity occurs in a morbid quantity, either 

 from a change in the digeftive fluids, becoming lefs fit to 

 moderate the natural progrefs to fermentation, or from their 

 not being fupplied in iufficient quantity ; both of which 

 probably arife from a weakened aftion of the ftomach. For 

 it is obferved, in fome inllances, that fedative or depreffing 

 paflions immediately occafion the appearance of acidity in 

 the ftomach, which did not appear before ; and alfo that the 

 ufe of ftimulants, applied to the ftomach, often corrects or 

 obviates an acidity, that would otherwife have appeared. 



Of that fymptora of the dyfpeptic ftate of the ftomach, 

 which is a common concomitant of indigeftion, pain, or 

 Jlomach-colk, gajlrodynia, we have already treated at length. 

 (See the lad term.) Having there ftated the various circum- 

 rtances under which it occurs, and efpecially in the two oppo- 

 fite ftates of repletion and inanition, as well as the method of 

 cure, which fucceed in thefe two conditions refpeftively, 

 we deem it unnecelTary to repeat the obfervations here. 



In fulfilUng the fecond indication, another fymptom which 

 requires particularly to be obviated is cojlivmefs. There is 

 fo much connexion between the feveral portions of the ali- 

 mentary canal with refpeft to the periftaltic motion, that if 

 accelerated or retarded in any one part, the other parts of it 

 are commonly affefted in the fame manner. Thus as the 

 brilker aftion of the ftomach muft accelerate the aftion of 

 the inteftines, fo the flower adion of the inteftines muft in 

 fome meafure retard that of the ftomach. It is therefore of 

 confequence to the proper action of the ftomach, that the pe- 

 riftaltic motion of the inteftines, determining their contents 

 downwards, be regularly continued, and that all coftiveuefs, or 

 interruption of that determination, be avoided. But an indif- 

 criminate ufe of cathartic medicines is much to be deprecated. 

 For it muft be obferved, that, as every confiderable evacuation 



of the inteftines weakens their aftion, and tends therefore to in- 

 duce coftivenefs when thtevacuationisover; fo thofe purgative* 

 which produce a large evacuation are unfit for correfting the 

 hiibit of coftivenefs. The milder cathartics, therefore, are 

 the moll fuitablc for this 'purpofe, which do no more than 

 folicit the intci\ines to a more ready difcharge of their prefent 

 contents, without either hurrying their aftion, or increafing the 

 excretions into their cavity ; either of which might produce a 

 purging. Dr. CuUen was of opinion, that medicines w Inch 

 particularly ftimulate the large inteftines, and aft little on the 

 higher parts of the intcftinal canal, were pecuharly proper 

 for this purpofe, fuch as the aloetic, and other refinous 

 purgatives. Thefe medicines certainly produce a very bene- 

 ficial operation in numerous inftances, probably by fupplying 

 the place, as it were, of the bile, which appears to be the 

 natural tonic and laxative to the inteftines, and which is 

 often both deficient in quantity, and depraved in quality, in 

 dyfpeptic habits. The augmentation and correction of this 

 fluid is often an important objeft in the treatment of indi- 

 geftion, and the changes in the appearance, odour, and con- 

 fiftence of the ftools, as well as the prefence or abfence of 

 griping, teuefmus, heat and irritation in the feat, &c., are 

 among the principal diagnoftic fymptoms in regard to the 

 condition of the bile, which feems to be the chief caufe of the 

 variations of the alvine difcharge. (See Abernethy's Obfer- 

 vations on the Dif. of the Health, &c. ) For the purpofes of 

 augmenting and correfting the biliary fecretion, the milder 

 preparations of mercury, which require to be varied accord- 

 ing to circumftances, which have not yet been accurately 

 defcribed, appear to be the moft effectual agents. It is pro- 

 bable that the long expected treatife of Dr. James Ci'rry will 

 contribute materially to elucidate this important fubject ; 

 and we truft that we (hall be able to avail ourlelves of the 

 affiftance of that work, before we compofe our article on the 

 chrome dijeafes of the \^WS.K. 



The peculiar modification of dyfpepfia, called by the 

 Scotch liiatcr-hraJJi, the Cardialgia fputatoria of Linnaeus, 

 (Gen.Morborura,Ciafsiv. Ord. i.) and the P^rro/ij of CuL 

 len, (for which we have no appropriate Englifh nan'e,) is a 

 fufficiently diftincl difeafe to be difcufled in a feparate article. 

 See Pyrosis. See alfo Flatulence, Nausea, and Vo- 

 miting. 



The third indication, which is properly the curative one, 

 is to reftore the tone and vigour of the ftomach, the lofs of 

 which is deemed the principal fource of the difeafe. The 

 means of accomplifliing this indication may be refeiTed to two 

 heads ; one of which includes thofe means which operate 

 direftly and chiefly on the ftomach itfelf ; and the other, 

 thofe which, operating upon the whole fyftem, communicate 

 their tonic powers fecondarily to the ftomach. 



The medicines which operate diredtly on the ftomach, com- 

 prife all thofe articles which are denominated tonics, and 

 many of thofe cailedjlimu/ants, and ajlringents. — The bitter 

 vegetable fubftances, or Utters, as they are emphatically 

 called, and efpecially thofe which combine fome aromatic 

 quality with their bitternefs, are moft frequently prefcribed 

 for this purpofe, and poflefs very confiderable efficacy. Such 

 are the roots of gentian, colomba, and riuibarb ; the bark 

 of cinchona, cafcarilla, S:c. ; the quaflia wooj ; the flow.TS 

 of chamomile ; and many other vegetable produdions. Ex- 

 perience, however, feems to have decided, that thtle bitters 

 cannot be taken for a great length of time with impunity. 

 Some have imagined that there is a certain quantity oi a nar- 

 cotic power refidentin tliem, which, though infinlible in its 

 effefts for a confiderable time, ultimately occafions a dele- 

 terious influence on the conltitutiou. This ivas particularly 

 learned from the confequenccs of a long continued nl ■ .'f the 

 I 2 celebrated 



