143 
PATHOLOGY. 
the appetite. The truth of this is evident to every one 
who has obferved that, if his meal is interrupted for ten 
or fifteen minutes, although he has not eaten half his ufual 
quantity, he finds that he is fatisfied. The gaftric fluid 
which had accumulated has had time to combine with, 
and be neutralized by, the food he had taken. On the 
fame account a few mouthfuls taken a little before dinner 
will often wholly deftroy the appetite, efpecially in deli- 
cate people, in whom the galtric fluid is fecreted in fin all 
quantity, or of a lefs aftive quality. Moreover, when we 
eat too faft, the food is not only received into the ftomach 
in too great quantity, but is fwallowed without being 
duly mafticated and mixed with thefaliva, and therefore 
without properly undergoing what may be confidered the 
fir ft procefs of digeftion. It is thus prefented to the fto¬ 
mach in a ftate in which the gaftric fluid pervades it, and 
confequently a fits upon it, with more difficulty. In this 
way eating too faft is injurious, even when the patient eats 
but little. For thefe reafons, “ to eat moderately and 
(lowly,” is often found of greater confequence than any 
other rule of diet. The dyfpeptic, in eating, (hould care¬ 
fully attend to the firft feeling of latiety. There is a 
moment when the reliffi given by the appetite ceafes § a 
Angle mouthful, taken after this,oppreffes a weak ftomach. 
If he eats (lowly, and attends carefully to this feeling, he 
will never overload the ftomach. 
Another frequent caufe of over-diftention of the fto¬ 
mach is high-feafoning and great variety of food, or fuch 
as particularly pleafes the palate, by which we are induced 
to eat after the appetite is fatisfied ; or, by the ftimulus of 
the high-feafoning, a greater fupply of gaftric fluid than 
the food call's for is excited, and thus the appetite pro¬ 
longed. This feems in particular to be an effeft of wine 
drank duringdinner; and this praftice, although it occa- 
fions lefs immediate inconvenience than eating too faft, 
often, if carried very far, by the preternatural excitement 
of the ftomach, at length impairs its vigour. It is not 
uncommon, in the diffeftion of fubjefts who have greatly 
indulged in the pleafures of the table, to find the ftomach 
enlarged, and its fibres fenfibly relaxed. 
The degree of diftention which the ftomach undergoes 
alfo depends much on the kind of aliment. All food ap¬ 
pears to fwell more or lefs after it is received into the fto¬ 
mach 5 fome kinds more than others, and of courfe that 
which is moft difficult of digeftion, cct. par. fwells molt; 
both becaufe it is digefted and removed from the ftomach 
moft (lowly, and becaufe that which moft refills the aftion 
of the gaftric fluid is moft apt to run into fermentation. 
It would take up too much time to mention all the 
kinds of food which are prone, by their gazeous condi¬ 
ments, to produce gaftric diftention. Generally fpeaking, 
vegetables have this effeft in a much greater degree than 
animal food, and in a crude ftate efpecially. Bread often 
produces it 5 and it is probably on the fame account that 
malt-liquors, taken during meals, exert a pernicious in¬ 
fluence over digeftion. Diftention of the ftomach is alfo 
produced by too much drink, or, as with refpeft to food, 
by fwallowing it with too great rapidity. 
Now, with regard to the third origin of dyfpepfia, dis¬ 
ordered fecretion, it arifes in moft cafes out of the two 
former dates; and, the errors or accidents producing 
them being removed, the effeft generally ceafes. When, 
however, it becomes eftablilhed, its removal implies a 
much wider indication. In the firft periods of difeafed 
fecretion, this fluid is perhaps not much impaired in its 
digeftive properties, though diminiflied in quantity, and 
pollefled of fome additional condiments. Emulations of 
various kinds, pain, &c. now occur, but with little gene¬ 
ral difturbance, which, as wefaid before, a little attention 
todietfoon fets to rights. In this llage we agree with 
Dr. Philip in thinking, that a diet compofed of a mode¬ 
rate portion of animal food and bread is the bell; but of 
courfe this rule will be daily excepted againft on account 
ot conftitutional peculiarities. 
Though the coB/fidoration of diet is again before us, af. 
Vol. XIX. No, 1293. 
ter the ample notice we have bellowed on this fubjeft, 
(p. 102-106.) it would be fuperfluous to do more than 
briefly recapitulate the rules to be adopted. Thefe are 
only to be underltood, and will always be bed remembered, 
by a knowledge of the digeftive procefs. The patient of 
indigeftion will therefore in the firft place attend to the 
due maftication of his aliment; to its moderately (low 
tranfmiffion to the ftomach 5 to its degree of moifture, 
which regards the two points, that it be fufficiently moilt 
to allow the pervafion of the gaftric juice without weaken*- 
ing that fecretion by dilution, and without producing 
fermentation by its own excefs. He will take efpecial 
care, when he confiders the nature of the propulfive 
power of the ftomach, that he offers no impediment to 
that function by taking violent exercife during digeftion. 
He will carefully note and partake of thofe fubllances 
which on their reception into the ftomach produce lead 
pain or irritation. He will avoid thofe, on the contrary, 
which produce any ill feeling; namely, for the moft part 
the tough, oily, oracefcent, particles of food. Nor (hould 
various kinds of food be taken at once by the dyfpeptic. 
Few patients will digell well more than one fort of ali¬ 
ment at a meal. Moreover, the popular notion of 
taking little and often is to be regarded as a popular 
error: and when it is confidered, that the maftication and 
other precedes belong to digeftion, that economy in which 
nothing is vain, and which are in faft indifpenfably necef- 
fary, the dyfpeptic (hould not evade the neceflity of fuch 
precedes by taking aliment reduced to a pultaceous con¬ 
fidence. We dwell on this point, becaufe it is fo common 
to hear of nour'Jhing food, an expreffion which, in its 
common acceptation, is meant to imply the capability of 
certain fubllances to nourilh our frame rather by its own 
nature than by that of the digeftive aftion. Thus a va¬ 
riety of jellies, rich foups, &c. are laviflily bellowed on 
the emaciated fufferer, and thefe greafy llimulants fail 
not to deftroy the little remaining function which the 
ftomach may poffefs. Dr. Philip fays very wifely, when 
fpeaking on this point, that, “ however impofing the 
plans of concentrating much nutriment in a fmall com- 
pafs may at firft view appear, we may be well adured, that 
in fuch concentration fomething is taken away from what 
nature deligned for our food, which is ufeful to us.” 
Thus moft dyfpeptics find, that potatoes, for example, 
finely maflied, although without any admixture, are more 
difficult of digeftion than when properly mafticated. To 
mention a more ftriking faft: it has been fliown by the 
chemifts, that a very clofe analogy, an apparent identity 
indeed, exifts between fugar and the chyle which is de¬ 
rived from vegetables; yet a horfe fed on fugar will not 
live a month. 
The relation which exifts between all the ftruftures of 
the body, and the neceflity of preferving a proper corre- 
fpondence of energy between the nervous, the vafcular, 
and the mufcqlar, ones, fince they are all connefted in 
the alimentary canal, at once (hows the propriety of cor¬ 
poreal exercife in indigeftion : for the exercife of the vo¬ 
luntary mufcles affords energy, not only to them, but to 
the involuntary movements, and gives, as is well known, 
much a(fi(lance to the circulatory powers. But the bodily 
exercife of dyfpeptic patients is a matter of nice and dif¬ 
ficult diferimination; for it is well known, that, how¬ 
ever falutary exercife may be to a certain extent, yet that 
its excels tends to produce confequences direftly oppo- 
fite. Sleep, appetite, and digeftion, which are improved 
by gentle exercife, are often fufpended after violent fa¬ 
tigue or exertion. The weak ftate of the rnufcular fyf- 
tem in fome cafes is another ftrong argument in favour 
of medicating the degree of locomotion, and of caution¬ 
ing patients not to run into the common error of fa¬ 
tiguing themfeives, under the idea of ftrengthening their 
frame by ftrenuous exertions. 
In the firft ft age of indigeftion, and ere much debility 
arifes, walking during the interval of digeftion is un- 
queftionably the bell exercife. It is, in the firft place, 
P p very 
