PATHOLOGY. 
phthifis, or in fatt that difeafe is formed. He£Hc fever 
becomes completely formed, and the patient is wafted 
with profufe perfpirations, anafarca and other dropfical 
fymptoms often fupervening. 
As the pulmonic difeafe becomes more clearly formed, 
the difeafe of the alimentary canal diminishes, as we 
have before Ihown it is apt to do when idiopathic difeafe 
(which operates as a derivative) is fet up ; and this occur¬ 
rence leads of courfe to a fearful prognofis. 
The intimate connexion between gaftric and cutaneous 
difeafes has been clearly pointed out by Mr. Abernethy, 
and the belt practical phyficians of the day. Indeed the 
natural fympathy which is perceived between the ftomach 
and the lkin would lead us to expeft fuch a connexion. 
It is not ftrikingly evinced, however, in moderate tempe¬ 
ratures, and while no extraordinary agent' is in aflion ; 
but, when in a high range of atmofpherical heat, when 
the veflels of the lkin are excited, and the procefs of per- 
fpiration is increafed, we clearly obferve this confent be¬ 
tween the lkin and ftomach, as evinced by want of appe¬ 
tite ; an effeft which is greatly increafed, if to the exter¬ 
nal ltimulus of high temperature we add fatiguing ex- 
ercife, whereby the perfpiration is morbidly excited, and 
the indireft debility of the fub-cutaneous veflels and 
ftomach (by fympathy) induced. Hence, after pedeftrian 
exercife in the forenoon during the heat of fummer, and 
after the perfpiratory veflels have become relaxed, we find 
a fenfe of fainting at the ftomach, and anorexia ; while, 
on the contrary, as the weather becomes cool, and the 
veflels of the lkin contrafted thereby, we perceive the fym¬ 
pathy in queftion exerted in the oppofite mode ; for a fti- 
mulus is quickly communicated to the ftomach and the 
appetite is keen s and again, when the degree of cold is 
fo great as to induce permanent debility of the veflels of 
the furface, and this is not immediately counteracted by 
exercife or clothing, the ftomach, as well as other organs, 
inevitably fympathifes, and the important procefs of di- 
geltion is interrupted. 
As further inftances of this fympathy, we may adduce 
the effeCts exhibited on the lkin by a glafs of water or 
wine taken into the ftomach j the breaking-out of fweat 
which enfues to fome as foon as acids are applied to the 
cefophagus; and, when we add to thefe faCts the nume¬ 
rous examples which daily occur of furfeits, and the de¬ 
rangements in the colour, fenfation, and function, of the 
furface immediately consequent on a debauch, we fhall 
have no doubt in deciding, that, in nine cafes out of ten, 
cutaneous foulnefs and gaftric irritation are related to 
each other as caufe and effeCh 
Among the numerous painful fenfations and impeded 
functions which we have had occafion to enumerate as 
confequences of dyfpepfia, we believe there is not one 
which, primarily occurring, will not produce, as well as 
follow, that difeafe. Thefe derangements in the circu¬ 
lating media, all nervous irritations, all agents fufficiently 
powerful to control the actions of the living powers, 
impediment in any part of the refpiratory or aflimilating 
apparatus or in the functions of the mind, all fortuitous 
lefions, will, unlefs counter-irritations or predifpofitions 
to difeafe exift in other parts, produce indigeftion. This 
eftablifhed, it ferves to fhow the imperious neceffity that 
there is to ftudy the caufes of dyfpepfia, and to direCf 
our therapeutical maxims accordingly ; and, in fo doing, 
what a large fund of observation this enquiry admits of, 
when we turn back to confider the formidable though in¬ 
complete lift which we have already detailed. 
In confidering, therefore, the treatment of dyfpepfia, 
we fhall revert to what we faid, at p, 128, of its firft caufes. 
The contemplation of thofe which aCt by influencing the 
nervous fyftem of the ftomach, is of courfe the molt ex- 
tenfive. It is by this medium that local injuries and to¬ 
pical inflammations, intenfe ftudy, See. produce gaftric 
diforder ; and, when the complaint in queftion is thus 
traced as a confequence, the treatment is obvious. There 
are fome nervous imprefiions, however, which, though 
141 
not themfelves continued, induce a train of morbid ac¬ 
tions which foon exhibit the form of dyfpepfia. 
Of thefe imprefiions, the moll frequent is the ftate of 
the atmofphere. The influence of falubrious air in pro¬ 
moting healthy digeftion cannot indeed efcape the moft 
fuperficial obferver. This fluid feems to operate bene¬ 
ficially in various ways. Thus it may promote digeftion 
by the excitement to mufcular aftion which its ftimulus 
produces, by the elevating and pleafurable mental emo¬ 
tions its purity excites, or its healthful impreffion on 
the mucous membrane of the lungs may be tranfmitted 
more direftly to the ftomach. Hence it follows, that, on 
the other hand, the want of due materials for refpiration 
muft be feverely felt in the digeftive function. The at¬ 
mofphere afts on the lkin only by its temperature; but 
the frequent variations in this refpeft which our own 
country is fubjedt to, has been long confidered a fruitful 
fource of bodily ailments. It does not feem that either 
the cold or heat of our own climate is particularly inju¬ 
rious, lince the compenfating powers of the conftitution 
foon render us equal to either extreme ; but that it is the 
fuddennefs of the change which is fo obnoxious to our 
health 5 for, while heat augments the cutaneous capilla¬ 
ries, both in fize and in frequency of aftion, (an eft’eft 
which extends to fome extent along the arterious trunks,) 
its abfence induces a diminution of their parietes, and 
a more-permanent and lefs-frequent contraction ; and, 
of courfe, a fudden change from one to the other of 
their ftates tends to diforder the contradlibility of the 
atonic velfels, by fympathy of thofe of the lungs and ali¬ 
mentary canal, and by another modus operandi of the 
general circulating forces. 
From thefe premifes the management of the dyfpeptic 
patient, in regard to air, follows in the moft obvious 
manner. The viciffitudes of the climate he cannot of 
courfe control; but he may avoid the more frequent 
and feverer changes of temperature to which his own im¬ 
prudence expofes him. We of courfe allude to the 
falhionable modes of dreffing, and the habit of being out 
in the night-air. See. Thefe errors, however, have been 
feverely inveighed againft by a multitude of writers, and, 
as might have been expedited, with little good to the 
community, few members of which have the refolution 
or the inclination to conquer habitual indulgences. It 
remains our duty, therefore, to point out the heft prevent- 
atives of danger during the expofure of invalids to the 
influence of nocturnal temperature. Thefe methods we 
have extracted principally from the writings of Dr. James 
Johnfon. 
After adverting to the deleterious combination of cold 
and moifture found in the night-air, this gentleman re¬ 
marks, that there are five circumftances to be attended to 
when we are fubjedted to its influence; viz. 1. The con¬ 
dition of the body before going out of doors. 2. The de¬ 
fence of the body’s furface while expofed. 3. The de¬ 
fence of the lungs. 4. The exercife on the way. 5. The 
condudV to be obferved on getting home. 
1. The condition of the body ought to be as warm as 
poflible, (hort of perfpiration. Many lives are annually 
loft by the ill-judged caution of lingering about the 
halls and doors of the heated apartments till the body is 
cool, before venturing into the air. In this ftate it is 
highly fufceptible of the baneful influence of the night. 
It would be better to iffue forth, even with fome per¬ 
fpiration on the furface, than wait till the fyftem is 
chilled. 
2. Upon the fecond point we need not enlarge. The 
frequent fight of thick coats, cloaks, See. clearly evince 
that our countrymen do not offend much againft this re¬ 
gulation. 
3. The defence of the lungs cannot be too ftrongly en¬ 
forced. They fliouid be guarded from the direft influ¬ 
ence of the night-air by fuch mufflings about the face 
as may detain a portion of the air expired from the lungs 
each time, and thereby communicate a degree of warmth 
to 
