132 P A T H O 
exhibiting any traces of what we have called its firft. 
And, belides this,if morbid predifpofitions are exiftent in 
the remote ftruStures, idiopathic difeafes will occur in 
them, as foon as the nervous excitements we have juft 
fpoken of are applied to them ; and thus (how the fallacy 
that will attach to the unreftriSled notion, that the fym- 
pathetic diforders of the firft ftage of indigeftion are fo 
purely nervous as not to produce real topical inflamma¬ 
tion in fome cafes. We are convinced however, that, as 
the divifion we have made will be found good in the ge¬ 
nerality of cafes, it is better to adopt it than run the 
various remote and local fymptoms of indigeftion into 
one another without order. The anomalies we (hall 
notice will eafily be remembered ; and, though their 
confufion (if we may ufe the expreflion) muft undoubt¬ 
edly take from the uniformity of arrangement, we 
confider that far better than that we (hould fail to repre- 
fent with fidelity, and to the beft of our knowledge, the 
true phenomena of nature. 
To return, however, to the mimofes. The common and 
diftinguiftiing fymptoms of thefe affections are, that, 
while in idiopathic difeafe a peculiar and perpetual ftate 
of diforder is found, or at lead a ftate which exhibits re¬ 
gular intermiflions and paroxyfms, thefe complaints ex¬ 
hibit no regularity whatever; that, while in idiopathics 
one great and predominant fymptom arrefts the atten¬ 
tion of the patient, and often of the practitioner, in this 
the difeafe is complicated, afteCts for a time one ftruCture, 
then another; and indeed manifefts all thofe appearances 
which we (hould expeCt in merely excited dates of the 
nerves, without inflammatory aftion. As it is impoflible, 
on account of the multiplied groups of fymptoms which 
may occur in thefe affections, to detail all their forms, we 
(hall confine ourfelves to a general review of their nature 
as they occupy the nerves of the grand fyftems, or parts. 
The firft we (hall confider is the brain. Here we find 
many dates arifing from this caufe, very clofely refem- 
bling difeafe of the vafcular fyftem ; and it muft be re¬ 
marked indeed, that the latter ftate is more frequently 
induced by nervous excitement in the brain than in 
any other part. The moft common fymptom is faintnefs. 
This is the moft ordinary nervous excitement, fince it 
occurs in the (impleft derangements of the nervous 
power. The circle of fympathies in this cafe, fudden 
and fimultaneous as it undoubtedly is, is complex. The 
ftomach afteCts the head, the head the function of refpi- 
ration, the latter the heart; and, this laft failing duly to 
impel the blood into the cerebral ftru&ure,/amring takes 
place. A further confequence of this ftate is languor of 
themufcular fyftem from torpid circulation in the brain ; 
and the fame torpidity will likewife influence thefecret- 
ing powers. The irritant of the ftomach being however 
removed, all thefe effeCts ceafe. But, where acontinued 
dyfpeptic ftate exifts, thefe effeCts become more perma¬ 
nent, which readily explains the fainting, languor, tre¬ 
mor, &c. which are attendants on the firft ftage of indi¬ 
geftion, and which are eafily removed with that com¬ 
plaint. With regard to the languor, it is to be remarked 
that between languor arifing (imply from the caufe we 
are fpeaking of, and between that which fupervenes in 
the more advanced ftate of indigeftion, a great difference 
exifts : for, while the firft merely depends on the inter¬ 
ruption of nervous influence, the latter probably owes 
its prefence to fome alteration in the contractile power 
of the mufcular fibre. However this may be, the diffe¬ 
rence between real and apparent debility is allowed by 
the beft practical writers. 
We have no knowledge why ftomachic irritation ap¬ 
plied to the brain caufes fometimes one, fometimes ano¬ 
ther, kind of diforder of that organ ; why one man feels 
temporary blindnefs, another debility, anotherdelirium, 
and fo on. We have certainly no means of knowing 
whether this takes place becaufe the applied irritants aCl 
only on particular parts of the cranial ftruCture, or whe- 
L O G Y. 
ther the nature of the irritants alters the nature of the 
fympathetic difeafe. We have good reafon to infer both 
of thefe circumftances. The firft, however, is a fpecula- 
tion of no ufe in practice: the latter may be fo in a (light 
degree, becaufe we (hall find that, in the inflamed ftate 
of the ftomach, the inflammation will more readily arife 
in the brain ; while, in the cafe of mere nervous irrita¬ 
tion, that ftate will be lefs frequently found. The moft 
formidable appearances which are complicated with irri¬ 
tation of the gaftric nerves are thofe of epilepfy and apo¬ 
plexy. Slight degrees of hypochondriafis, too, likewife 
occur ; but thefe are unfrequent in the firft ftage of dif- 
pepfia. A threatened attack of apoplexy of this kind is 
often obviated by the exhibition of a ftrong purge. 
Where it once takes place, or where the pulfe is the 
fame as we commonly find aflociated with that ftate, 
bleeding, &c. will of courle be had recourfe to likewife.' 
We mention this here, to remind the reader of the great 
neceflity of procuring evacuations by emetics and purga¬ 
tives when this form of apoplexy exifts. It is this kind 
of apoplexy which fo often and fo fatally attacks perfons 
retiring to bed after a hearty /upper ; an occurrence la¬ 
mentably frequent in the daily records of our times. A 
fudden attack of epilepfy has often been induced by the 
fame caufes. The purgative treatment is extremely be¬ 
neficial, as well as in dates of infenfibility and delirium, 
lofs of memory, blindnefs, &c. fuddenly fupervening to 
thefe digeftive derangements. 
A peculiar ftate of the brain is often induced by irri¬ 
tation in the alimentary canal, which has been called by 
Dr. Nicholl, the firft author who has given a clear view 
of it, “ Erethifm of the brain.” According to the ex¬ 
perience of that author, it feems that it chiefly occurs in 
children. Such a (lute, however, is often met with in 
patients afflicted with indigeftion at more advanced ages. 
Dr. Nicholl thus deferibes it: “ There is a ftate or condi¬ 
tion of the cranial brain in infants, which may be called 
a ftate of irritation, an irritated ftate, or, in one word, 
erethifm. What this peculiar condition of the cerebral 
ftructure is, I cannot explain. It is a ftate diftinCt from 
that which is called inflammation of that ftruCture, for it 
may exift without any perceptible increafe of the quan¬ 
tity of blood that flows through the cerebral blood-vel- 
fels ; it is a ftate under which inordinate effeCts arife from 
ordinary impreflions upon different parts of the nervous 
fyftem. In its perfect form, and under a high degree of 
it, it is a highly fenfitive condition of the cranial brain, 
a condition the very reverfe of that under which fleep 
occurs. Under fuch a condition of the cranial brain, the 
child is wakeful, fcarcely ever (leeping ; it is attentive to 
every found, and to every object of fight; its temper is 
irritable; the retina is highly fenfible to light, fo that the 
child winks if its face be turned towards the window, or 
towards a candle ; the pupil is, in many inftances, more 
or lefs contra£led ; but this is not always the cafe. The 
limbs are much in aCtion ; the head is often moved about, 
or is (haken from fide to fide; the child cries without any 
apparent caufe, and it is foothed only by tofling it, by 
carrying it about, by putting it to the breaft, or by letting 
it fuck the cheek of the nurfe, or its own fingers ; the 
fecretion of tears is, in many inftances, increafed, caufing 
fuffufion of the eyes, and rednefs of the edges of the 
tarfi; the fecretion of the fchneiderian membrane may 
be increafed, caufing a fluffed ftate of the nafal paffages, 
producing fneezing, and exhibiting the appearance of 
that ftate which is popularly called a cold. The bowels 
are, in many cafes, relaxed; yet no difordered ftate of 
the ftools may appear. During fuch a ftate as I have de- 
feribed, there may be a degree of animation, and a quick- 
nefs of obfervation, much beyond what are commonly 
met with in children of the fame age : fo that, although 
a morbid condition of the cranial brain be prefent, the 
child may be confidered as particularly healthy, on ac¬ 
count of its being wakeful and lively, and fenfible to the 
moft; 
