128 
P ATHOLOGY. 
a fit ftate to combine with, or to be operated upon, by 
the gallric juices ; which, when effe&ed, is rapidly con¬ 
veyed to the other extremity of this organ, by the re- 
aftion of the mufcular coat, from the undue diftention 
and the ftimulus of folid contents. Thus a double eft'efil 
is produced by the healthy organic contractility of this 
organ, when in a weakened ftate, and yielding a dimi- 
n 5 filed quantity of the ufual fluids ; which ftate indeed 
may be confidered as conftituting this peculiar affection, 
namely, that part of the aliment which is diflolved by the 
gaftric juices is conveyed towards the pylorus, while, at 
the fame time, the tonic adtion tending to diminifh the 
capacity of the organ pufh'es the lefs comminuted and 
indigeftible portions of food into the unrefifting cardia ; 
which is returned, as I have attempted to describe, in 
order to undergo a fecond comminution and intermixture 
with the falivary juices; after which it is in a fit ftate to 
be conveyed to its deftination along the mucous furfaces, 
with the juices of which it combines, and thus permits a 
central portion of the rnafs to return and undergo a fimi- 
larprocefs. 
“In the curative plan purfued during the time this 
gentleman was under my care, the cutaneous eruption 
was viewed as originating in the long and progrefiive de¬ 
rangements of thedigeftive canal; and the ruminating 
affedlion, from the highly intelligent hiftory of its origin 
afforded me by the patient, as well as of the fenfations 
and connexions of the phenomena fo kindly accorded me 
during my attendance, was confidered as the moft ad¬ 
vanced and peculiarly modified ftate of dyfpepfia, or gaf¬ 
tric debility. 
“ Under the ufe of infufions made from a combination 
of vegetable tonics, aperients, and aromatics, with the 
addition of an alkaline carbonate ora carminative tinc¬ 
ture, and the frequent ufe of the warm bath, with fub- 
fequent friflion ; while, at the fame time, a deliberate 
maftication of the aliments, and a moderate indulgence 
in light and digeftible food, was enjoined ; amendment 
foon became apparent. After a fortnight’s continuance 
of this plan of treatment, the cutaneous difeafe had made 
conliderable progrefs towards removal, and the ruminat¬ 
ing affedlion, which till then had been prefent after every 
conliderable meal, was now very feluom experienced ; 
nor did any fymptoms of dyfpepfia take its place, unlefs 
when the injunctions regarding the mode of living and 
maftication of the food were not attended to, or when 
fubjedted to caufes operating a diminution of the digef- 
tive energy; then, dyfpeptic fymptoms, or even flight 
rumination, occafionally prefented themfelves. 
“ Within a few weeks, the eruption was entirely re¬ 
moved ; but the ruminating affedlion returned whenever 
the proper precautions were not obferved. Having im- 
prefled the mind of my patient with the neceflity of pur T 
filing corredtly the plan I had prefcribed to him, upon 
the grounds that fuch an affedlion, if indulged, would 
gradually undermine the energy of his fyftem, he became 
more attentive to the ftate of his digeftive organs, and to 
his mode of living; and now, (March 1821.) for feveral 
months, he has enjoyed perfedl health, and had no re¬ 
turn of the ruminating adt. Having transferred, as he 
fays, the gratification formerly enjoyed in the fecond 
maftication to the firft, this procefs is now performed more 
deliberately ; a more complete admixture of the aliments 
with the falivary fluids and with the air, takes place; 
while the ftomach is lefs fuddenly, and much more mo¬ 
derately, diftended.” 
Diflections have not been able to throw any light upon 
this affedlion ; nor can it be expedted, in the prefent ftate 
of our medical knowledge, that, even in the event of 
a violent death taking place in a ruminating fubjedl, 
any vifible alteration in ftrudlure could be detedled. Fa- 
bricus ab Aquapendente and Thos. Bartholinus were 
confident of finding two ftomachs, at leaft, in ruminating 
individuals, from the analogy of the cornuted tribes. 
Pyer and Morgagni ridiculed the idea, and fupported a 
contrary opinion, upon the ground that there were ani¬ 
mals that ruminated without a double ftomach. The 
only inftance Dr. Copland had met with in which in- 
fpedtion after death took place, was in the inftance of 
this affedlion occurring in a monk. This defection is 
recorded both by Jo. Rhodius (Cent. ii. obf. 59.) and alfo 
by Bonetus, (Sepulchretum, 1 . iii.) It was made by 
FancifcusPlazzonus, and is thus related by Jo. Rhodius : 
“Monachus cum voluptate cibus ruminavir. Medici 
brutorum more gemino ventriculo praeditum putabant. 
Ipfo defundto, F. Plazzunos cefophagum reperit undi- 
quaque carnofum inftar mufculi, reliquis univerfi cor¬ 
poris partibus fe redte habentibus.” The phyficians of 
the feventeenth century were not much enlightened by 
the opening of this monk, but their dreams refpedting 
the exiftence of two ftomachs were henceforth diflipated. 
Enthufiaftsin their arduous profeflion (which all young 
medical men ought to be) are greatly indebted to fuch 
learned phyficians as Dr. Copland, Dr. Cooke, &c. for 
their indefatigable refearches into the early hiftories and 
records of the more ambiguous difeafes ; and the utility 
of fuch condenfed communications is greatly enhanced 
by the practical remarks accompanying them. Mr, G. 
Nefle Hill has added a cafe, and diffettion, of fimilar dif¬ 
eafe in a feverely-afflidted infane patient, who fell under 
his care in the year 1791 : he appeared to fall a victim to 
epileptic infanity, the refult of early indifcretion. That 
part of the hiftory of this young man which related to his 
rumination of his food, bore an exact refemblance to the 
onefo ably detailed by Dr. Copland. “ I examined the 
body, (fays Mr. Hill,) in the prefence of the venerable 
Haygarth, who, as well as myfelf, was much ftruck with 
the extreme tenuity and fmooth internal furface of the 
ftomach. In order the more corretly to obferve the ru¬ 
minating procefs, I invited my patient to dinner feveral 
times ; he ate with a ravenous appetite and wonderful 
quicknefs, but never finithed a meal withoutcommencing 
the ruminating procefs.” A further hiftory of this cafe 
will be found in the Appendix to Hill’s Effay on the 
Prevention and Cure of Infanity. 
7. Limofis dyfpepfia, or indigeftion. The funtion of 
digeftion in the ftomach being performed by means of 
fecreting agents, which are veflels and nerves, and by 
mufcular fibres which propel the food downwards, ail 
caufes of indigeftion mud operate, 1. by difturbing the 
tranfmiftion of nervous influence; 2. by difturbing the 
ation of fecreting veflels; or, 3. by paralyfing the play 
of the mufcular fibres. Now it would require little la¬ 
bour to fhow, that nothing can influence the one mate¬ 
rially without influencing the others, both on account 
of their reciprocal ation, and on account of the agency 
which foreign fubftances will produce on the other ftruc- 
tural elements in confequence of the deficient ation of 
one. Thus, if nervous influence be difturbed, fecretion 
will be wanting; confequently the food will undergo 
chemical decompofition, will fwell and evolve gales; 
thus it will diftend the circular fibres of the ftomach be¬ 
yond their ufual fphere of relaxation, and by that means 
prevent the further digeftion of food. In the fame way 
the mufcular coat will be liable to diftention in the cafe 
of diminilhed fecretion, when that diminution arifes 
from torpor of thefecernent veflels; and, if the circular 
fibres are diftended by mere quantity, that diftention will 
hurt the nervous power; for it is known that when muf- 
cles are ftretched beyond a certain natural compafs, their 
nerves communicate to the fenforium pain or irritation. 
In this way, therefore, reafoning from our knowledge of 
the quick communication of nervous power to and from 
the brain, we infer, that increafed tranfmiflion of ner¬ 
vous influence to the affeted organ will arife. Here 
fecretion will be increafed, though in early inftances 
probably unaltered. By this increafed fecretion, the 
food will be prevented from enlarging by chemical 
changes, and cannot therefore further diftend the cir¬ 
cular fibres ; while thofe forces will, in confequence of 
