DIETETICS, 
iug debility, and if he attempt any mode- 
rate exertion he is overcome by fatigue, or 
sulFers from cold, or from some new symp- 
toms, the consequences of accidentally in- 
creased action ; and unless some effectual, 
but moderate and permanent means of re- 
lief, be afforded, he dies of some symptoma- 
tic disease which ensues, or sinks exhausted 
by the primai-y affection of the stomach 
and other viscera concenied in digestion. 
Such are the most striking features of disease 
originating from this state of the abdominal 
viscera, when it is severe and permanent. 
In the more common attacks a great num- 
ber of symptoms are very troublesome : 
nausea, cardialgia, eructation, faintness, 
sense of weight, and oppression in the epi- 
gastric region, which is tender to the touch, 
and pain between the shoulders. In almost 
every case, the appetite is exceedingly fas- 
tidious ; if food be not taken, ♦flatulency 
and sense of languor increase, and the spasm 
becomes severe ; and after eating, all the 
symptoms of dyspepsia occur, and the pain 
very often is aggravated. 
Those who, during their residence in a 
hot climate, have been attacked by acute 
inflammation of the liver, not terminating 
in suppuration, are frequently found on 
tlreir return to Europe, as we have already 
observed, to have the liver enlarged from 
the deposition of coagulable lymph in the 
progress of the inflammation, and in its ter- 
mination by resolution ; in the same man- 
ner as the testicle, and particularly of the 
epididymis which remains for a long time en- 
larged after the inflammation called hernia 
humoralis : it is seldom, however, that 
these symptoms will not yield to a judici- 
ous and persevering mode of medical prac- 
tice. 
In affections of the stomach and other 
chylopoietic organs from hard drinking, the 
chief of the same symptoms will be found to 
occur ; but those peculiarly attendant 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 accnmulatidn of coagulable lymph, 
mercury should be administered so freely 
and reiteratedly as to produce immediate 
and permanent action on the liver, and ra- 
ther by inunction on the abdomen than by 
the mouth j or perhaps by both at the 
same time. Yet the exhibition of mercury 
in lai’ge quantities, and .so as to excite 
ptyalism has of late years become too indis- 
criminate ; and excepting in tlie individual 
case now alluded to, its admission in tliis un- 
restrained manner will be generally doubt- 
ful, and often unquestionably injurious. In 
all other cases, when its use is at all indi- 
cated (and it is seldom that it is not indi- 
cated) it sliouid 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 
per.severed in for weeks or months — in ef- 
fect 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 every case the chylopoietic 
organs have a much better chance of being 
restored to a sound and healthy state by 
progressive gentleness than by sudden 
violence ; that the permanent solicitation 
of a comparatively mild stimidus will event- 
ually accomplish what a more forcible sys- 
tem can never produce ; and that hence 
the latter should be reserved for mere 
cases of decided extremity. 
Aperient medicines are almost always ne- 
cessary, from the great irregularity of the 
bowels, and generally an habitual propen- 
sity to costiveness. Dr. Stone has lately 
opposed the use of castor oil, which has hi- 
therto been in great vogue, as well from the 
inaccuracy witli which it is generally ex- 
pressed, as from its acting 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 witli many constitutions, it will 
often occur in others that there is no aperi- 
tive that completes its purpose so plea- 
santly. When castor oil does not agree, a 
little rhubarb in combination with neutral 
salt, in the proportion of a scruple 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 schir- 
rosity of the liver, purgatives are of more 
consequence than in any other case : and 
here the more drastic kinds are to be pre- 
ferred : as jalap, colocynth, and scam- 
niony. 
Peruvian bark seldom agrees with the 
stomach in any stage of this disease , but 
hitter tonics will usually sit easy, and often 
afford considerable relief. If tlie pain be 
