DIETETICS. 
ing sleep, should never be allowed. Much, 
in this respect, is to be accomplished by 
regularity in the hours of rising and going 
to bed, and especially by opposing all pro- 
pensity to sleep in the daytime. 
The mind in hypochondriasis cannot be 
properly regulated without the best efforts 
of the patient himself, but he will for the 
most part be induced to use them, on the 
representation of a medical man of intelli- 
gence and good humour, that it is impossi- 
ble for him to accomplish any plan he has 
in view, and that he must always be a bur- 
then to himself and his connections, till he 
makes the search after cheerfulness and 
health his primary pursuit ; he must make 
himself alive to the scene which passes be- 
fore him, and his family may commonly be 
insti'ucted in some methods of diverting his 
attention from dismal reflections on him- 
self, and from unremitting application to any 
favourite topic, and gently to remind him 
of the harm he is about to do himself, when 
he seems ready to give way to any excess 
of passion. His resort to public places will 
be beneficial when he can be brought to 
attend to what is going forward there, and 
by such attentions his pursuit of health will 
daily become less irksome and laborious ; 
and by the same means he must be brought 
to unbend his mind in the society of his 
equals, and to attend to the proper times of 
exercise, food, and rest. 
HEPATIC AFFECTION, Catenating with af- 
fection of the stomach, and produced by hot 
climates or hard drinking. 
We have already sufficiently commented 
upon the general nature of the bile, and the 
importance of its due and healthy flow to- 
wards the proper action of the stomach, 
and the whole of the intestinal canal. Now 
it is clear tliat if the organ which secretes 
this important fluid be perpetually irritated 
by a stimulus of every kind whatever, it 
will, first become inflamed, and suppurate 
if the inflammation be very great and pro- 
gressive ; and secondly, it will become 
wholly exhausted and torpid, if the stimu- 
lus be not sufficient to produce inflamma- 
tion. 
The stimuli of hot climates and of hard 
drinking, especially when the beverage con- 
sists largely of alcohol, have both a tendency 
to produce each of these effects, though not 
in an equal degree ; and consequently not 
merely to injure the liver itself but to de- 
range the entire process and economy of 
digestion. 
VOL. 11. 
In general those w'ho are affected by a 
diseased state of the liver in w'arm climates 
return to their native homes before inflam- 
mation sufficient to excite suppuration has 
taken place ; and hence in our own coun- 
try we seldom meet with cases of this 
kind : but if the same persons do not re- 
turn home in time, or if they be actually 
prevented from returning at all, suppura- 
tion will be a frequent consequence of the 
disease they are labouring under ; and it is 
therefore a result which is by no means un- 
common in the East and West Indies. 
Commonly, as the case appears to us, on 
the arrival of the patient in Europe, the 
morbid excitement of the liver has only 
produced an enlargement of its parenchyma 
by the effusion of coagulable lymph : which^ 
is often re-absorbed by a recovery of 
healthy ac^on in the lymphatics of the af- 
fected visctis, and especially by gently sti- 
mulating them through the medium of mer- 
cury. In the meanwhile, however, tiie 
stomach and the whole of the digestive 
economy suffers severely, and much atten- 
tion is necessary to tlie nature and regula- 
tion of the diet. 
The excitement produced by hard drink- 
ing, has a worse tendency, and is often suc- 
ceeded by a worse result to the stomach, 
liver, and indeed all the chylopoietic visce- 
ra, than tliat produced by hot climates. 
For, though in tlie former ease, we have 
seldom morbid action enough to produce 
suppuration, we have enough to excite 
schirrus, in conjunction with torpidity, and 
consequently to render the organs almost 
incapable of recal to a healthy and harmo- 
nious state by any kind of regimen, or plan 
of medicine whatever. While, at the same 
time, the villous membrane of the stomach 
from perpetual exposure to the acrimony of 
alcohol, becomes abraded of the mouths of 
its secerning vessels, and rendered often 
polished and glabrous throughout its whole, 
surface, like a sheet of glass ; whence 
the stomach is just as incapable of secret- 
ing gastric juice as the liver is of secreting 
bile. 
The symptoms chiefly indicatory of an 
affection of the liver from a long residence 
in hot climates, are, costiveness, often alter- 
nating with diarrhoja, or dysentery : strong 
spasmodic pains about the epigastrium, and 
hypochondria ; flatulence, and at times car- 
dialgia. There is also a general languor 
and depression altogether intolerable and 
insuperable to the patient. If he indulge 
in activity he sinks into a state of increas- 
L1 
