PATHOLOGY. 
feds. This deficiency in the fecretion of bile, the con- 
Sequence of mental exertion and corporeal inadivity, is 
evidently the morbus eruditorum, * which ficklies o’er, with 
the pale caft of thought,’ 'the countenances of the ftu- 
dious, who wafle their hours and their health by the 
midnight lamp ! To them I need not defcribe the ma¬ 
lady ; they are too familiar with its various, fymptoms. 
But few of them are aware how far material caufes can 
influence intelledual ideas. If I wi(h to exert, on any 
particular occafion, the whole force of my memory, ima¬ 
gination, perception, and judgment, I know, from re¬ 
peated experience, that by previoufly emulging the liver 
and its duds, and carrying off all bilious colluvies from 
the alimentary canal, by mercurial purgatives, which 
alfo excite a brifker fecretion in the chylo-poi'etic vifcera, 
I am thereby enabled to avail myfelf of thofe faculties 
above mentioned, to an infinitely greater extent than I 
otherwife could. This is no theoretical fpeculation -5 it 
is a p radical fad. It may help to explain the great ine¬ 
quality which we often obferve in the brighteft effufions 
of fancy 5 and fhew us why even the immortal -Homer 
fometimes nods.” 
The ftomach is influenced by fympathy with other 
parts to a very great degree: iftly, by the (late of the 
Ikin ; sdly, and mod materially, by the ftate of the lungs; 
and, laftly, by the ftate of all the coliatitious vifcera. 
Among thefe the moft ftriking is the liver. It is fcarcely 
fair to infer, however, that affedions of the alimentary 
canal are produced by the coliatitious vifcera through 
the medium of the nervous fyftem; fince the unnatural 
fecretions poured into it by them may produce all the 
difturbances we have occafion to witnels. From the na¬ 
ture of this ftrudure it is verjt evident, that each of its 
fecondary procefles is dependant on the due performance 
of the primary ones. Thus the faliva cannot mix with 
the food in a proper manner until the teeth have 
performed their office; the ftomach cannot ad if any 
impediment exifts in the pharynx ; nutrition cannot 
take place if the adion of the ftomach fufpended or 
materially depraved ; and fo on. Hence, then, the belt 
mode of considering thefe difeafes is according to their 
anatomical relation to each other; fo that difeafes of the 
teeth, faliva, pharynx, and fo on, will form the order of 
our arrangement. 
Before enteringon them, however,we have a few remarks 
to make on fome grand divifions in regard to the patho¬ 
logy of the mucous membrane of the ftomach and bowels. 
To thefe derangements the fweeping term indigeftion 
has by moft writers been applied, with a view of compre¬ 
hending the whole of this varying and numerous clafs. 
We are indebted to the continental writers for fome very 
material elucidations of the nature of gaftric affedions. 
We find, in the work of Brouffais efpecially, a moft able 
expofition of the chronic inflammation of the ftomach ; 
a difeafe which had been greatly overlooked, and perhaps 
confounded with thofe inexplicable modes of adion 
which have been accounted for on the unfatisfadory af* 
fumptions of want of tone, laxity , weuknejs, or delicacy, 
of ftomach, &c. It is to be doubted if the ufe of thefe 
vague expreffions has not induced many to adopt thefti- 
mulating, the purgative, or the ftomachic, plan, to the 
manifeft injury of their patients, when cooling and un¬ 
irritating meafures were more appropriate. Gaftritis, in 
the common fignification, is certainly a difeafe of rare 
occurrence, and is as dangerous as rare; but this applies 
only to its moft acute and. violent form. Brouffais has 
eftablifhed the fad, by repeated diffedion and obferva- 
tion, that this inflammation exifts in various forms ; that 
it is capable of going on to produce diforganization of 
the mucous expanlion of the alimentary canal; that, on 
the other hand, it may produce iymptoms and effeds re- 
fembling acute fevers. He has traced the gradual (hades 
and gradations, from the violent and acute form of inflam-: 
mation to which old nofologifts have applied the word 
gu frit is, down to thole troublefome though flight a»- 
Vol. XIX. No. 1291. 
107 
pearances which we have been accuftoined to call indigef- 
tion. The notion of a flight modification of gaftritis had 
indeed been entertained by Cullen ; for he fpeaks of ery- 
thematic inflammation of the ftomach ; but it does not 
appear that this idea was ever followed up by him, or 
applied with any advantage to practice. With refped 
to the exiftence of this affedion, we fhould, a priori, 
conclude that inflammation of the. ftomach would be a 
difeafe of frequent occurrence, becaufe that organ is of¬ 
ten oppofed to fubftances of a highly-irritating nature, 
becaufe its vafcular fyftem is much developed, and be¬ 
caufe it poffeffes a high degree of fenfibility. Indeed we 
are inclined to think that many difturbances in the ali¬ 
mentary canal may be traced to inflammation in the firft 
in fiance, and that the ftate of atony of the digeftive appa¬ 
ratus is often the refult of that previous over-adion. 
To generalife thus would, however, in the prefent ftate 
of our knowledge, be premature; for we fhould know 
precifely in what proportions the abforbent, the vafcular, 
or the nervous, fyftem, of this digeftive tube, are im¬ 
plicated in difeafe, ere we could ftate the fweeping cou- 
clufion, that inflammation is the general forerunner of 
gaftric difturbance. Moreover many cafes will occuh' to 
the pradical phyfician in which no inflammatory adion 
was in the leaft degree apparent. 
Perhaps then the moft appropriate arrangement will 
be into, 1. Chronic inflammation of the alimentary canal; 
2. into difturbed fundion of that canal arifing from un¬ 
known modes of adion ; and, laftly, into fympathetic 
propagated difeafe arifing from, or communicated to* 
other parts. It is with the fecond only that we have now 
to do. The firft, as being conneded with general in¬ 
flammation will be treated of under gafritis; and the third 
will receive frequent iiluftration in almoft every difeafe 
in our catalogue. It is however of the utmoft import¬ 
ance that the two dates of atony and excitement fhould 
be well difcriminated ; and on that account we cannot 
avoid giving in this place a fhort diagnofis of the two 
kinds of difeafe. 
Chronic gaftritis differs from the Ample fundional 
difturbance of the ftomach, in that a fenfe of pain (of 
various kinds however) is almoft continually prefent, and. 
that the fenforial fundions and the pulmonary fyftem- 
are more powerfully affeded : the (kin exhibits more of 
heat; in the early flages, the circulation is fomewhat af¬ 
feded ; third and evening exacerbations are frequently 
prefent; and vomiting is feldom abfent. Moreover the 
fympatheticf irritations that arife from the irritation of 
the ftomach, prefent more of an inflammatory charader. 
It will eafily be feen, that every one of thefe fymptoms 
is equally prefent in various kinds of Ample indigeftion ; 
but the connexion of the whole mull be taken into con- 
fideration. The excellent effeds of cool drinks, &c. in 
allaying the difeafe, feems to prefent another difcrimina- 
ting point, fince that effed is feldom experienced in Am¬ 
ple indigeftion. 
The fame cautions are pradically neceffary in treating 
the mere fundional difturbances of the lower parts of 
the alimentary canal, and chronic enteritis, colonitis, 
&c. but, as this is not the place to enter into difcuffions 
on inflammation, we merely point out the fad that dif- 
crimination is neceffary in thofe difeafes. The fundional 
difturbances of the alimentary canal are fo numerous, 
and fo anomalous in their charader, that they almoft 
baffle defcription, and we (hall meet with no order of 
difeafes .in which our nofological arrangement is more 
itnperfe.d than in this; for not only do many of the in¬ 
dividual difeafes run into eacli other, but fome of the 
fpecies, we ace inclined to think, are merely fymptoma- 
tous. Cullen arranged thefe complaints in a very gene¬ 
ral way. Mr. Abernethy too, though he has written fome 
of the heft hiftories of them which we have, did not at¬ 
tempt to claffify or arrange the different kinds, though 
he expreffed a hope that fuch difcrimination might after¬ 
wards be made. More recently, in the interfiling work 
Ff of 
