PATHOLOGY. 
Edwards’s Hiftory of the Weft India Iflands.) It has 
been fuppofed that the prevalence of an acid in the fto- 
iriach occaftoned the demand for earthy and abforbent 
fubftances in pica : but many of the fubftances, taken in 
different inftances, are not poffeffed of any antacid quali¬ 
ties. The diforder is very frequently beyond the power 
of medicine to relieve in a direct way. In the cafe of 
pregnancy, it commonly ceafes altogether about the fourth 
month, and has been relieved by blood-letting in ftrong 
and plethoric women : but in chlorotic girls it is only 
removed by the courfe of medicine which removes the 
morbid ftate of the habit in general, and reftores the na¬ 
tural difcharge where that was fufpended. In inftances 
where it attacks men, or women in whom the uterine 
functions are healthy, it ftiould be treated on the common 
principles of Dyfpepfia. 
It is aftoniftiing to note the various difgufting and in- 
digeftible articles fwallowed by the patients of this dif- 
eaie: chalk, allies, coals, foot, pitch, cinders, &c. have 
each been taken in fome cafes. But among the moft un¬ 
natural talles evinced under this affeCtion, though we 
do not agree with Dr. Good in calling it “ one of the 
moft common,” is that for fwallowing knives. In our 
own country it has occafionally occurred; (fee Knife- 
eater, vol. xi. p. 784.) but Plouquet, Init. Bibl. art. 
Pantophagus, has collected examples from almoft all the 
different ftates of Germany and the neighbouring prin¬ 
cipalities, Balle, Pruftia, Prague, and different parts of 
Ruffia. Another curious propeniity is that of fwallow¬ 
ing glafs, of which alfo the inftances are numerous. 
But thefe, as well as eating hair (Brefl. Sammlung, 1719.) 
and ordure (Borell. Obf. cent, iv.) mu-ft rather be confi- 
dered as inftances of folly and bravado, than of tafte. 
Not fo, however, the 
y. L. pica nali, a name given by Cohaufen to the im¬ 
moderate and habitual taking of fnuff, a filthy depravity 
common to both fexes ; and which, after being confined 
for fifty years, in this country, to the old women of the 
old French fchool, has been revived by the dandies of the 
prefent day. It has not yet reached the ladies; and fo 
we hope it may end where it has begun, with the moft 
contemptible part of the creation. Pica nafi feems a 
whimfical term; but Cohaufen has chofen to treat this 
habit as adifeafe, and has written an exprefs treatife con¬ 
cerning it. The word pica, in general, denotes an abfurd 
and unnatural appetite; and the define of taking the 
powder of tobacco in this manner is called a diftempered 
appetite of the part into which it is taken, that is, the 
nofe. The confequences of the taking fnuff immode¬ 
rately, are, that the fenfe of fmelling is either entirely 
deftroyed, or at lead greatly impaired : for the nervous 
tubercles of the noftrils, being continually' vellicated by 
this powder, are by degrees clogged up, or wholly defi- 
troyed ; and the fenfible membrane, which lines the nof- 
trils, is rendered callous, and wholly unfit for the dif¬ 
charge of its office in fmelling. The voice is next af- 
f'eCted by this powder; for it caufes a fort of aftriCiion 
at the bottom of the nofe, which affeCts the palate, and 
confequently the fpeech; this gives the perfon who takes 
it a continual defire of taking more and more, to rid him- 
felf of that ftoppage. 
As we are treating of morbid longing, it may not be 
improper to mention, that many perlons recovering from 
febrile affeCtions experience a particular defire for articles 
of food which we ftiould, a priori, be inclined to think 
highly prejudicial, and confequently to deny them the 
enjoyment of. But experience has fliovvn, that in this 
cafe the inftinCt may be often fafely indulged : a rule to 
be admitted, however, with much caution and reftriOion. 
4. Limofis cardialgia. This and the two following 
fpecies we find it impoffible to confider in any other light 
than as fymptoms of indigeftion. We (hall therefore 
give but a brief account of them. Cardialgia has three 
varieties : a, mordens ; £, fyncopalis; y, fputatoria. 
a. L. mordens is that painful fenfation of heat and 
Vol. XIX. No. ii 9 a. 
123 
acrimony about the fuperior orifice of the ftomach, 
which, from the vicinity of its feat to the heart, is popu¬ 
larly called heart-burn. It is produced by the irritation 
of acid matter in the ftomach, which rifes to the upper 
orifice, fometimes by eruCtation into the cefophagus and 
throat, and is fometimes completely ejected by vomiting. 
That this irritating matter is of an acid nature, is evinced 
by the tafte ; and it has even been feen to produce an 
effervefcence on falling on a marble hearth, according to 
Dr. Darwin. When vomited, or raifed by eruCtation, it 
is fometimes fo intenfely four as to abrade the mouth 
and throat; and, in general, it produces a fenfation in 
thefe parts fimilar to that which exifts in the ftomach. 
The production of this acid may arife from two fources. 
If the gaftric powers are fo deficient that they cannot 
within a certain time digeft the food, and propel it from 
the ftomach, fermentation will take place, and acid will 
be generated. Abetter explanation feems to be, that the 
acid is lecreted, that it is gaftric juice changed from its 
natural ftate. That this is the cafe feems probable, be- 
caufe acid eruCtation is often felt fo foon after a meal, 
that it is impoffible acid could be generated by fermenta¬ 
tion ; and moreover we have known eruCtations poffeffing 
the higheft degrees of acidity to pafs from a patient whom 
we had confined for many cfays to an animal diet. The 
palliative remedies are alkalies. Dr. Darwin remarks, 
that, as the faliva fwallowed along with our food prevents 
its fermentation, according to the experiments of Pringle 
and Macbride, confiderable relief is fometimes found by 
chewing parched wheat or rnaftic, or a lock of wool, fre¬ 
quently in a day, when the pain occurs, and by fwallow¬ 
ing the faliva thuseffufed. 
£. L. fyncopalis. This appears to differ from the laft 
only in this, that the production of the acid is attended 
with fo peculiar an effeCl on the nerves of the ftomach, 
that feelings of extreme weaknefs and fyncope are expe¬ 
rienced. The pain, too, which in the firft variety is felt 
in the upper extremity of the ftomach chiefly, is extended 
in this to the lower part of the fame organ. 
7. L. fputatoria, or water-brafh ; the pyrofis of Cul¬ 
len. It is a burning pain extending over the epigaftrium, 
with an eruCtation of watery fluid, ufually infipid, fome¬ 
times acid. This difeafe comes on in paroxyfms, which 
ufually happen in the morning and forenoon when the 
ftomach is empty. The firft fymptom is a pain at the 
pit of the ftomach, with a fenfe of conftriCtion, as if 
the ftomach were drawn towards the back: the pain is 
increafed by railing the body into an ereCt pofture, and 
therefore the patient bends himfelf forward. This pain 
is often extremely fevere, with a fenfe of burning ; and, 
the fluid continues to be brought up for fome time, and 
does not immediately give relief to the pain which pre¬ 
ceded it; but at length it terminates the pain, and the 
fit ceafes. Thefe paroxyfms come on without any evident 
caufe, nor is the origin of the difeafe always to be im¬ 
puted to any particular fort of diet. It feldom, if ever, 
attacks thofe people who ufe frefti animal food daily ; but 
appears to be moft common among thofe who live almoft 
entirely upon tea, milk, potatoes, and farinaceous fub¬ 
ftances. It is much more common in women than in 
men; fometimes it attacks pregnant women, and often 
thofe who labour under leucorrhcea. It feldom occurs 
in any one before the age of puberty, or in thofe who 
are confiderably advanced in life : when it has once taken 
place, it is very prone to recur occafionally for a long 
time afterwards. It is more common in Scotland than 
in this country, and chiefly affects the lower claffes of 
the people. The paroxyfm is moft effectually relieved by 
anodynes, efpecially opium, hyofeiamus, and coniurn ; 
and with lefs certainty by other ftimulants and antifpaf- 
modics, as fulphuric ether, ammonia, and the tinCture of 
guaiacum, Thefe remedies, however, do not materially 
contribute to prevent the recurrence of the difeafe. 
5. Limofis flatus, or flatulence, is the generation of 
air in the inteftinal canal, which, like the production of 
K k acid, 
