PATHOLOGY. 
144 
very agreeable, and it Teems moreover the raoli natural. 
There is no other accompanied with fuch a uniform and 
regular exercife of the mufcles and joints ; and, from the 
valvular ftru< 5 lure of the veins of the extremities, it is 
better fitted than any other to promote the circulation, 
and confequently all the functions of the fvftem. 
The effeil of riding on horfeback upon the abdominal 
vifcera is peculiar and faiutary ; and the jolting of a brifk 
trot Teems, without inducing fatigue, to give tone to and 
promote the adtion of the bowels and liver in an eminent 
degree. In the more advanced ftages of indigeftion, this 
delightful exercife becomes injurious 5 and little elfe can 
be borne, except the walking pace of the horfe. It is 
feldom, however, advifable to ride at ail at this period, 
fince at the pace juft mentioned the patient is fubjedled 
to the baneful effedl of diminifhed temperature. It is 
better therefore to indulge in the eafe of a carriage ; and, 
as this becomes too irkfome from its vibratory motion, 
failing is a gentler mode of exercife. It has the credit of 
being ferviceable in almoft all cafes of debility, and has 
been found particularly fo in debility of the ftomach and 
bowels. But even this exercife, except in warm weather, 
is unadvifeable on account of the expofure to cold air. 
Whenever thefe paflive exercifes cannot be borne, the 
dyfpeptic may find much relief from the ufe of fridiion, 
as he likewife might experience from the refrefhing prac¬ 
tice of champooing; wdiich, unfortunately however, is 
unknown in this country. 
Thereafter will find the fubjedl of paflive exercife well 
treated of in Dr. J. Johnfon’s work on the Atmofphere 
and Climate of Great Britain, p. 197, & feq. We extradl 
a portion, in which however it will be feen that the 
learned author differs in fome meafure from the view's we 
have taken in regard to exercife after meals. He fays, 
“ During geftation, for inftance on horfeback, the fto¬ 
mach, liver, inteftines, indeed the whole digellive appa¬ 
ratus, experience a fucceflion of (hocks, which develop 
the tonicity of thefe organs, and favour the exercife of 
their fundlions. If the ftomach be empty, geftation 
awakens the digeftive powers, whets the appetite, and 
induces hunger: if that organ be moderately filled with 
food, the whole chylopoietic fyftem, enlivened by gefta¬ 
tion, executes with greater facility, promptitude, and per¬ 
fection, the elaboration of nutritive matter; and the 
whole fabric receives, in confequence, an acceflion of 
ftrength. Hence people afflidted with anorexia, or diffi¬ 
culty of digeftion, experience the moft marked benefit 
from paflive exercife, efpecially if ufed before the hour of 
repaft. When ufed by them after meals, it muft be mo¬ 
derate in degree, and gentle in manner. Thus we every 
day fee invalids, to whom digeftion is a painful procefs, 
efcape the feelings of fatiety by a gentle ride on horfe¬ 
back or in a carriage after dinner. In this refpedt muf- 
cular or adtive exercife differs eflentiaily from geftation. 
To run, to dance, to play at cricket, immediately after 
eating, is to aflail the ftomach with violent fuccufiions 
which derange the natural order of its movements, and 
diffipate on the voluntary mufcles thofe vital forces and 
energies which ought to be concentrated on the organs 
of nutrition. 
“ But it is not on the procefs of digeftion alone that 
geftation exerts a beneficial influence. It enlivens the 
whole abdominal circulation of blood, but particularly 
that of the various branches of the vena portarum. It 
thus affedls the hepatic fyftem, facilitating both the fe- 
cretion of the bile, and its elimination from the dudts of 
the liver into the duodenum. It increafes the periftaltic 
motion of the inteftines; in confequence of which, the 
chyme is prefented with greater regularity and rapidity 
to the mouths of the ladleals, and the chyle is poured, 
in a freer current, into the blood-veflel fyftem.” 
When thefe meafures fail, when exercife does not in¬ 
duce thofe trains of adlion which lead to health, and 
when the abftradtion of noxious particles of diet fails in 
the fame purpofe; it becomes neceflary to have recourfe 
to medicine. It feldom happens, however, but that dyf- 
pepfia alone will yield to the meafures above mentioned : 
when it does not, we fhould be always fufpicious of the 
extenfion of the difeafe. The bowels are, as we have be¬ 
fore fliown, the parts moft difpofed to participate in the 
difeafes of the ftomach; and therefore our treatment 
fliould not unfrequently be direfted to them. Indepen¬ 
dently however of the implication of the bowels in the 
common afteflion, the adlion of certain medicines on 
thefe vifcera is beneficially exerted on the fecretions of the 
ftomach and liver. Purgatives promote thofe fecretions 
in two ways : by the mechanical ftimulus derived from 
the periftaltic motions of the bowels, and through the 
medium of that fympathy fo remarkably obfervable in the 
continued mucous ftrudlures. The proper ufe of ape¬ 
rients is a fubjedl of great importance at all periods, and 
in all dates, of indigeftion. In the period under conii- 
deration, their objedl is merely to fupport a regular adlion 
of the bowels, which, as the fecretions of the whole canal 
are inclined to fail, and the ftomach and upper bowels do 
not difcharge their contents fo readily as they ought to 
do, fhould be rather freer than in health. Different ape¬ 
rients fuit different conftitutions.. For the purpofe of 
fupporting a regular adlion of the bowels, we recommend 
pills compofed of ipecacuanha, compound extradl of colo- 
cynth, and foap, with the addition of a little gamboge 
when they are not fufficiently adlive, to be taken occafion- 
ally at bed-time. But we abound fo much in forms of 
aperient medicines, that it were wafting time to mention 
many of them in this place. 
It is a common pradlice to give fome form of mercury 
to patients labouring under indigeftion ; and, in confe¬ 
quence of the ftimulus this mineral exerts on the liver, 
its ufe is generally beneficial ; but as a Ample aperient it 
fhould not be reforted to, and that for two reafons : the 
firft, that it exerts a prejudicial influence on the fecretion 
of the gaflric juice ; and fecondly, becaufe it has the effedl 
of often doing more than we require 5 as for inftance, 
when it falivates (which it will fometimesdo in very fmall 
quantities), or when it excites ftrudlures undifeafed, and 
thus deftroys the balance of adlion to the reftoration of 
which our endeavours are ofteneft diredted. 
The ufe of aperients alone is not however always fuf- 
ficient. The difordered fecretion of the ftomach conti¬ 
nuing, it becomes neceflary to excite the fecreting veffels 
by artificial ftimuli, for the purpofe of altering their adlion 
on the blood, and cauiing them to elicit more appropriate 
fluids; as well as of exciting the mufcular fibres and ttie 
nervous expanfions to carry off their load. Among thefe, 
bitters hold the firfl rank. Thofe in common ufe are— 
gentian, chamomile, bitter orange-peel, wormwood, co- 
lumba, and bark. We are not of opinion that much dif¬ 
ference exifts in the merits of thefe vaiious fubftances. 
Many pradlitioners ufe one or the other of them exclu- 
fiveiy, and perhaps with nearly equal fuccefs. It feems 
that the chamomile, orange-peel, gentian, and worm¬ 
wood, are lefs inclined to promote the general circulation ; 
and are therefore preferable when a plethoric ftate of fyf¬ 
tem is obfervable. On the other hand, the cafcarilla, 
columba, and the Peruvian bark, exert a more general 
influence on the fyftem; and are therefore proper when, 
from the irritation of the nerves of the ftomach, the cere¬ 
bral mafs communicates too languid an impreffion to the 
circulating fyftem. 
It is generally found advifeable to combine bitters and 
aperients. A formula confifting of fix drachms of com¬ 
pound infufion of gentian and of the fame quantity of in- 
fufion of fenna is of this kind: it is generally found to 
promote all the procefles of digeftion and abdominal excre¬ 
tion. The combination of falts with the fame bitter in¬ 
fufion is likewife a common and excellent formula. 
It is often requifite to adminifter ftimuli derived from 
the mineral kingdom. Of thefe the mineral acids, the 
preparations of iron, and the fulphate of zinc, are in 
common ufe. Of the mineral acids, the fulphuric is per¬ 
haps 
