PATHOLOGY. 
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acid, C3n have only two fources ; viz. either from the 
chemical changes which the food undergoes in confe- 
quence of deficient fecretion, or from the altered ftate 
of the fecretions themfelves; for there is little doubt that 
air may be fecreted, as Mr. Hunter firft fuggefted. There 
are three varieties of this complaint: a, borborygmus; 
( 2 , eruftatio ; y, crepitus. 
a. The firft Variety of flatus is indicated by a fenfe 
of uneafinefs, with a rumbling or gurgling noife in the 
belly. It isfometimes very diftrefling, fince it draws the at¬ 
tention of by-ftanders; and is not uncommon in young 
women, about the age of puberty. “ I attended a young 
lady about fixteen,” fays Dr. Darwin, “ who was in other 
refpefts feeble, whofe bowels almoft incefiantly made a 
gurgling noife fo loud as to be heard at a conliderable dif- 
tance, and to at t raft the notice of all who were near her. 
As this noife never ceafed a minute together for many 
hours in a day, it could not be produced by the uniform 
defcent of water, and afcent of air through it; but there 
muft have been alternately a retrograde movement of a 
part of the bowel, which muft again have puthed up the 
water above the air ; or which might raife a part of the 
bowel, in which the fluid was lodged, alternately above 
and below another portion of it, as might happen in fome 
of the curvatures of the fmaller inteftines, the air in which 
might be moved backward and forward like the air-bubble 
in a glafs level.” Dr. Darwin recommends “ ten corns of 
black pepper fwallowed whole after dinner, that its 
effefts may be flower and more permanent,” in the 
borborygmi of young women. We have feen them fuf- 
pended by any fubftance, taken into the ftomach, as a 
piece of dry bifcuit, which, by the way, the late Dr. Buchan 
confidered “as one of the beft carminative medicines,” 
and recommends it in all complaints of the ftomach, ari- 
fing from flatulence and indigeftion. Thefe diforders 
are often particularly troublefome when the ftomach is 
nearly empty ; and perhaps the operation of a bifcuit 
taken at fuch times is merely that of relieving this tem¬ 
porary vacuity, which any other light aliment would 
equally efteft. 
0 . The fecond variety, eruftatio, is of courfe pro¬ 
duced by the aftion of the mufcular fibres of the ftomach 
on thecontained food. When this fymptom does not take 
place, and wind is pent up in the ftomach, it produces all 
the diftrefling confequences which are attendant on great 
diftention of that organ. In fome inftances great pain 
of the ftomach is excited, either by the Ample extenfion 
of the fibres, or by partial fpafmodic contraftions; 
great anxiety and oppreflion are felt in the cheft; the 
refpiration becomes laborious and difficult, with a fenfe 
of fuffocation ; and the heart intermits in its aftion, giving 
rife to intermiflion of the pulfe, or is excited to violent 
palpitations. Thefe fymptoms are generally alleviated 
by the difcharge of wind by eruftation : this alleviation, 
however, is only temporary; for the flatus again accumu¬ 
lates, and re-produces the fame effefts. The generation 
of air in the ftomach, in lefs degrees, is an ordinary con¬ 
comitant of indigeftion ; but it generally pafles off readily. 
Some people, indeed, acquire a habit of voluntary 
eruftation, which, Dr. Darwin fays, augments the malady. 
He obferves,“ that, when people voluntarily ejeft the fixed 
air from their ftomachs, the fermentation of the aliment 
goes on the fafter; for flopping the veflels which contain 
new wines retards their fermentation, and opening them 
again accelerates it; hence, where the digeftion is impaired, 
and the ftomach fomewhat diftended with air, it is better 
to reftrain than to encourage eruftations, except the 
quantity makes it neceflary.” (Zoonomia, Clafs i. 3. 1.) 
It has been fuggefted, but, we think, incorreftly, that, in 
the repeated voluntary attempts to difpel wind from the 
ftomach, which are often continued for fome length of 
time, the atmofpheric air is often aftually fwalloued, and 
the difagreeable fenfation of diftention thus augmented. 
For the relief of flatulence, (the radical cure, as we 
have already obferved, can only be effefted by curing the 
dyfpepfia,) a number of medicines have been devifed, 
from a very early period of time, efpecially fuch as are 
comprehended under the appellation of carminatives. 
Thefe are generally fubftances pofl'efling ftrong fenfible 
qualities, which render them inftantaneoufly ftimulant to 
the nervous fyftem ; and, by fuddenly exciting the muf¬ 
cular coat of the ftomach to aftion, enable it to overcome 
the diftenfion, and difpel the diftending gas. The aro¬ 
matic vegetables, containing much eflential oil, fuch 
as juniper-berries, the feeds of anife, carraway, and cori¬ 
ander, fhe roots of ginger and zedoary, and the waters 
diftilled from thefe, are among the mod efteemed car¬ 
minatives. To thefe may be added other ftimulant and 
antifpafmodic medicines; fuch as aflafcetida, and other 
ftrong-fmelling gums ; volatile alkali ; opium, ether, &c. 
Warm fomentation externally to the region of the ftomach 
has been recommended by Dr. Darwin, and other ex¬ 
ternal remedies were employed by Dr. Whytt; efpecially 
friftions on the region of the ftomach, with liniments 
compofed of the warm oils ; fuch as the exprefled oil of 
mace, oil of mint, See. and alfo the application of large 
plafters to the belly, made with the ftimulating gums and 
gum-refins. 
y. L. crepitus, is a term ufed to exprefs the expulfion of 
wund ab ano. We confefs ourfelves totally at a lofs to con¬ 
ceive why this expreffion was introduced into a fyftem of 
nofology. 
6. Limofis emefis, rejection of the contents of the 
ftomach, or tendency to rejeft. This afteftion feems the 
fimpleft form of gaftric difturbance. It is generally the 
immediate confequence of diminilhed nervous influence. 
Thus, blows on the head, injury of the nerves, or fym- 
pathy with difenfed vifeera, readily excite it. It has 
three varieties, which are only different degrees of the 
fame aftion ; and that aftion is, as we have faid before, 
only a fymptom of other difeafes. The firft variety, 
a. L. nauftea, or loathing, is the mere fenfation of 
ficknefs without vomiting. The caufes of naufea are 
numerous. We (hall mention the moft frequent one, 
viz. dilordered digeftion, under that head. 
The brain is feldom materially aftefted by any feriotis 
irritation or derangement, without deranging the ftomach 
by fympathy : thus, ficknefs at the ftomach is a common 
fymptom of every degree of local injury of the head, in 
which preflure or concuflion of the brain is occafioned; it 
accompanies inflammation of the brain and its mem¬ 
branes, the preflure of water in the ventricles, or ofother 
morbid effufion or growth within the cranium ; as well as 
the oppofite ftate or inanition of the veflels of the brain, as 
in fyncope, or after great Ioffes of blood. The other or¬ 
gans, with which the ftomach is often fympathetically de¬ 
ranged,and fickened, are chiefly the kidneys and the uterus. 
Thus naufea is a common concomitant of inflammation 
in the kidneys, or of the irritation of gravel or of a ftone 
lodged in thefe organs, and becomes one of the diagnoftic 
marks by which difeafe in the kidneys is diftinguifhed 
from other painful affeftions of the loins. Sympathetic 
naufea is alfo a frequent concomitant of uterine irritation 
or diforder ; thus it is one of the moft frequent fymptoms 
of the beginning diftention of the uterus in pregnancy, 
and accompanies inflammation and other painful con¬ 
ditions of that organ. The influence of the mind alone 
is likewife capable of exciting naufea, and even its ul¬ 
timate degree, vomiting. The fight, or even the de- 
feription or imagination, of loathfome and offenfive 
objefts and aftions, will produce this effeft on the ftomach 
of many individuals of refined habits, or who are unac- 
cuftomed to fuch objefts. 
It is not eafy to account for that variety of ficknefs, 
which is produced by certain kinds of motion of the body, 
fuch as fwinging, whirling, and the undulating motion 
of a fhip at fea. It feems, however, to be referrible prin¬ 
cipally to the fympatlietic connexion between the ftomach 
and brain ; i. e. to the vertigo ordizzinefs produced in the 
latter, through the medium of the organs of vifion, by thefe 
4. unufuai 
