136 
PATHOLOGY. 
former tend to keep up and increafe the original difeafe, 
thefe (the latter) aft on that which excites it in the 
fame manner as a counter-irritant is known to do, though 
tinqueftionably in a much more effeftual manner. Thus, 
it is not uncommon in indigeltion for the liver to fuller 
in fuch a manner, that it (hall become enlarged and ten- 
deron preffure; and, when ahe difeafe' is deftroying the 
texture of the lungs, having fpread from the liver to 
them, for the former to recover, or nearly recover, its 
healthy ftate. And thus an extenfive external difeafe, 
occurring in fuch cafes, will often fave the vital organ, 
even after the difeafe has made confiderable progrefs in it. 
It is obvious, then, from the foregoing remarks, that 
the treatment of all difeafes remotely traceable to indi¬ 
geftion are not to be difcuffed in this place ; nor are the 
diforganizations of the ftomach to be treated of here; as 
each of thefe form diftinft fpecies, and require feparate 
confideration. It only remains therefore to trace the dif- 
ordered Hates of the fanguineous and fecretory funftions 
arifing in the fecond ftage of Dyfpepfia; and to notice 
the general indications for the relief of the local, and the 
particular indications for the cure of the general, difeafe. 
For the reafons Hated in p. 108, we lhall forbear to 
mention all the complaints traceable to the confirmed ftage 
of indigeftion. Indeed it would feem from what we have 
there remarked, that, as thefe propagated complaints are 
literally the complaints of the fanguineous and nervous 
ftrufture of the parts affefted, they are diftinft and idio¬ 
pathic; that ■they are inflammations, however induced, 
and therefore to be met with the ufual remedies for that 
aftion. But praftical conflderations (which fhould fuper- 
fede all other) induce us to notice certain cafes in which 
experience has ftiown that the moft marked and ferious 
forms of chronic inflammation, and of difeafed fecretion, 
have been cured by the medicinal treatment of dyfpepfia ; 
and we think that, when the laws of fympathy are better 
known, this divifion will appear no lefs philofophical than 
praftical. We have before adverted to the impoflibility 
of drawing an accurate diftinftion between inflammations 
which, though produced by nervous irritations, are ren¬ 
dered permanent by their own difeafed tendencies, and 
thofe which are merely fympathetic. And, in the cafes we 
are about to confider, probably a ftill greater difficulty of 
diagnofis exifts. The difficulty in thefe cafes is to efta- 
blifti how far, when the original caufe of dyfpeptic dif¬ 
eafe is removed, the parts will return to their natural 
.ftate. 
Reafoning a priori, we (hould conclude, that the ope¬ 
ration of this caufe could not extend beyond inflamma¬ 
tion and altered fecretion ; but experience has clearly 
fliown, that, nervous irritation being removed, difor- 
ganized parts undergo reparative proceffes, and in an 
aftoniiliing manner may refume their natural ftrufture. 
In the nervous fyftem we remark, that the head is in¬ 
fluenced in this difeafe in a manner decidedly inflamma¬ 
tory. This inflamed ftate of the cerebrum, in the fecond 
ftage of indigeftion, is well ffiown by head-ache, by in- 
creafed hardnefs and fulnefs of pulfe, and by the in- 
creafed pain which the recumbent pofture produces. As 
it advances, various forms of mental difturbance become 
rnanifeft. In this form of difeafe we mull be efpecially 
careful not to let our notions of the dyfpeptic origin of 
the difeafe weaken the vigour of our pradlice ; for local 
and (when the date of the circulating powers demand it) 
ievere general depletion are neceffary here, as in 
idiopathic difeafes; and indeed, as this is the part where 
the moft intimate connexion between the fanguineous 
and nervous fyftems takes place, we Ihculd naturally ex- 
peft to meet with this faft. 
It fometimes happens, in this fecond ftage, that the 
head-ache aflumes a chronic form, continuing for weeks, 
or even months, without being very fevere. Both local 
and general blood-letting then very frequently fail to 
give permanent relief. The bell means are thofe which 
iupport an habitually-free aftion of the bowels and Ikin, 
(and moft efFeftually correft the difeafe of the digeilive 
organs,) and permanent drains from ther neighbourhood 
of the head. 
There are two occurrences which ought ever to be pre- 
fent to the mind of the praftitioner : the firft is the ten¬ 
dency to the tranfition of nervous into idiopathic inflam¬ 
mation, which is particularly obferved with regard to 
the head; the fecond, the poffibility of the co-exiftence 
of the two ftates. 
The tranfition of the affeftion of the head in Dyfpepfia 
into an idiopathic inflammation, or the co-exiftence of 
the latter affeftion with the former, is to be apprehended 
on the occurrence of any of the following lymptoms in a 
ferious degree and continued form : A fenfe of flu'hing 
or fulnefs about the head ; acute pain of the head ; un- 
ufual heavinefs, dull head-ach, or vertigo ; drowfinefs, 
ftupor, difturbed fleep, delirium, incubus, ftertor; for- 
getfulnefs, timidity, confufion of mind; change of affec¬ 
tions ; tendency to laughter, and tears ; affeftion of the 
fenfes, as temporary lofs of fight, flalhes of light, double 
vifion, finging or loud noifes in the ears, intolerance of 
light, or found ; tendern^fs of the fealp. Many of thefe 
fymptoms, however, occur in the firft ftage. It is only 
when they exift in an eminent degree that they denote 
danger. But it is bell to take an early alarm. The 
danger of compreffion of the brain is unequivocal on the 
occurrence of an untifual diftortion, or an unmeaning 
expreffion, of the countenance ; of a deleft in articula¬ 
tion ; of a temporary numbnefs or torpor, or of tranfient 
and partial weaknefs of any of the limbs; efpecially if 
one fide of the body alone be affefted. The occurrence of 
ftupor, convulfion, paralyfis, or relaxation of thefphinc- 
ters, leaves little to doubt refpefting the exiltence of this 
fatal occurrence. 
In fome cafes, the erethifinal ftate of the brain before 
noticed puts on a more marked and formidable appear¬ 
ance ; and it is not very unufual, when this difeafe has 
continued fome time, to fee the patient, after more fe¬ 
vere attacks than ufual, and fometimes without this 
warning, fuddenly fall down, and in a few hours, and 
in fome cafes almoft immediately, expire. In fuch cafes 
the aids of medicine are vain. The powers of the con- 
ftitution are not oppreffed by difeafe, but worn out by 
its continuance. This is what, in contradiftinftion to 
apoplexy arifing chiefly from the ftate of the veflels, is 
properly termed nervous apoplexy, the moft fatal of all its 
forms ; and.it has been remarked, that in fome cafes no 
morbid appearance prefents itfelf on diffeftion : the fatal 
derangement is in the nervous fyftem alone, whole ftruc- 
ture is too minute for our obfervation. If the ufual plan 
of bleeding in cafes of fudden infenlibiiity be here re- 
forted to, the difeafe is only the more fuddenly fatal. 
The ftate of the brain in fuch cafes refembles that which 
furgeons call eoncvjjion. Its mechanifm is deranged. 
The difference is, that in the one this mechanifm is de¬ 
ranged by a fudden and violent caufe, applied while the 
powers of the fyftem are entire ; and which, confequent- 
ly, if the little ftrength that remains be carefully huf- 
banded, may often repair the injury : the other is the 
effeft of a fucceffion of flight caufes gradually changing 
the mechanifm of the brain, and at the fame time ex- 
haufting the powers of every other part, fo that the con- 
ftitution poffeffes no means of repairing the injury. The 
pure nervous apoplexy, however, as here deferibed, is an 
extremely rare difeafe ; becaufe it very feldom happens 
that the caufes continue long enough fo to derange the 
finer mechanifm of the brain as to produce lofs of func¬ 
tion, without influencing the ftate of the circulation in 
it in fuch a manneras to produce a fatal effeft in this way. 
It more often happens, that difeafe of veflels caufing 
apoplexy is produced ; and it is worthy of remark, that 
in this ftate a pallid countenance is ufually met with. 
This circumftance occurs occafionally in all the forms of 
apoplexy ; but we think it is more particularly noticed in 
this than in any other. Dr. Philip fays, “ I have repeat- 
