149 
PATHOLOGY. 
Pain in the courfe of the colon is often relieved by fric¬ 
tion with a liniment, by fuppofitories and clyfters. Be¬ 
fore leeching has been ufed, the inflammatory (late of the 
bowels is rather increafed than relieved by cathartics; and, 
after it, thofe only of the mildeft nature fliould be had 
recourfe to. 
The fubjeCfs of mtelena, diarrhoea, See. which would 
naturally follow here, mult be deferred till our nofologi- 
cal arrangement brings them before us. 
When inflammation of the mucous membrane of the 
lungs is connected with Dyfpepfia, we have a very power¬ 
ful agent in the hydrocyanic acid. This remedy has in¬ 
deed been preferibed with fuccefs by Dr. Elliotfon for 
the relief of all dyfpeptic fymptoms dependent on dif- 
turbed nervous power; but we have not introduced it 
into our lift, as we have not been able to colleCt, from 
mere general experience, the like favourable teftimony of 
its virtues; and it is fo potent a drug, that we would not 
hazard its occaftonal deleterious effeCts, fince the correc¬ 
tion of the firft ftage of dyfpepfia may generally be ac- 
compliflied by milder meafures. In the. removal, how¬ 
ever, of bronchitis, this acid muft be regarded as an im¬ 
portant agent, and one which at the fame time perhaps 
relieves the original fourceof difeafe. It is given in the 
dofe of half a minim at firft, and this is- gradually ex¬ 
tended in proportion to the efteCt obferved from it. Of 
courfe this complaint requires more ftriCt attention to the 
purity of air, the regulation of temperature, and the 
perfpiration of the Ikin, than other forms of the dyfpeptic 
Sympathies. It is generally accompanied with hepatic 
derangement; and on this account is ufefully treated by 
imall dofes of calomel, perfevered in until a healthy 
bilious difeharge is feen in the (tools. 
The cacbeCtic difeafes of indigeftion require in general 
a very remarkable change in the diet of the invalid ; nor 
does itfeem that we need in thefe cafes fo particularly re¬ 
gard the fpecies of change, fince an alteration of whatever 
kind is generally found ufeful: thus, a meat-diet will 
produce a cachectic date of blood in fonie, as a vegetable 
diet will in others; and a change is in either cafe clearly 
indicated, both by reafon and experience. We (hall take 
up this fubjeCt under the head Dyfthetica. 
The chlorotic indigeftion mentioned at p. 139, requires 
in general a more generous diet and more active exercife ; 
and as, in females, the uterus is often implicated in the 
difeafe, fteel, aloes, See. are appropriate remedies. 
The connection between urinary gravel and indigeftion 
does not lead to any difference in the ufual plan of cure ; 
fince, from whatever caufe gravel may arife, it will re¬ 
quire a peculiar treatment. It is worthy of remark, how¬ 
ever, that beer, efpecially if ftale, will caufe the depofition 
of fabulous matter; while fpirits, efpecially alcohol, di- 
minilhes this tendency in a remarkable degree. Thefe 
facts are of courfe of moment in relieving the fymptoms 
in queftion. 
In the ufe of all thefe meafures, and in their application 
to the various forms of dyfpeptic derangement, the prac¬ 
titioner (hould endeavour fo to conjoin them, and adopt 
their ufe to the idiofyncrafy of his patient’s conftitution, 
that he may not materially difturb the balance of power in 
the various parts of the iyftem ; but the ufe of remedies 
will feldom avail much, if the primary and fundamental 
fources of the difeafes in queftion, viz. bad air, improper 
orexceflive quantity of food, and lympathetic irritations, 
be not removed. 
Genus VI. Colica, [from tuoMv, the colon ; this part 
being the chief feat of the difeafe.] Griping of the guts. 
This genus contains fix fpecies. It is characterized 
by griping pain in the bowels, chiefly about the navel, 
with vomiting and coftivenefs. The-caufes of the com¬ 
plaint are local irritants, whether undigefted aliment, 
poifon, or crude fecretions of the upper parts of the ali¬ 
mentary canal. Or it may, and indeed moll commonly 
does, arife from fympathy with a remote part; perhaps 
more frequently with the (kin. Seven fpecies are enume¬ 
rated by Dr. Good, and Cullen mentions more; but the 
proximate caufe of all thefe appears to be the fame; viz. 
fpafmodic contractions of the mufcular fibres of the in- 
teftines. 
1. Colica ileus, (Colica fpafmodica, Cullen .) Characte¬ 
rized by retraCtion of the navel, and fpafms of the muf- 
cles of the belly. It begins with a fenfe of weight or 
pain, at the pit of the (tomach, attended with lofs of ap¬ 
petite, yellownefs in the countenance, a (light ficknels, 
and coftivenefs; the pain gradually increafes, becomes 
fixed about the navel, from whence painful dartings pro¬ 
ceed in various directions ; wherever pain is felt, forenefs 
and tendernefs remain fome time afterwards. The fick- 
nefs increafes with the pain ; and, at length, a vomiting 
of bilious matter comes on, the function being of courle 
deranged by the difeafe of the inteftines. The urine is 
diminiflied in its ufual quantity, and a tenefmus fome- 
timesadds to the diftrefs. While the pain is fpafmodic, 
the pulfe remains unaffected, except concurring circum- 
ftances produce a change in it. The urine is various. If 
the fmaller inteftines are the feat of the pain, it is felt 
more acutely; if the larger inteftines are the parts ag¬ 
grieved, the fenfe of pain are more dull and heavy ; fome- 
times there is a bitter tafte in the mouth, and a yellow¬ 
nefs in the countenance. Sometimes the diforder limn- 
lates a fit of the gravel ; (tones pafling through the ure¬ 
ters; rheumatic pains in the mufcles of the belly; the 
blind piles ; (tones pafling through the gall-duCf. Gra¬ 
vel in the kidney produces often colic-pains, not eafily 
diftinguifhable; but, when (tones pafs through the ureters, 
the tefticle on that fide is often retraCted, the leg is be¬ 
numbed, and a pain (hoots down the inlide of the thigh. 
Rheumatic pains in the mufcles of the belly rarely affect 
fo accurately the umbilical region, but dart, in various 
directions, to the cheft or to the pelvis, and are attended 
with forenefs, not confined to the abdomen. The pain 
from the blind piles is confined to the reCtuin; and that 
from a (tone in the gall-duCt is felt in the pit of the fto- 
mach, occafionally (hooting through the body to the 
back. 
When the diforder is purely fpafmodic, the mere alle¬ 
viation of the fpafm is fufticiently obvious. Ether, vale¬ 
rian, ammonia, opium, &c. being premifed, means are to 
be put in force for procuring (tools. Therefore, either 
foon after or in conjunction with an opiate, fome cathar¬ 
tic medicine (hould be adminiftered, either by the mouth 
or in a clyiter. If the conftipation has been but of ftiort 
duration, the neutral falts will generally be adequate to 
the purpofe of procuring evacuations ; fuch as the mag- 
nefite fulphas, for ir.ftance, or the fodae ftilphas : both 
have the advantage of being conveniently repeated at 
ftiort intervals, in fmall quantities, until the defired ef¬ 
fect is produced ; and their aCiion is increafed by their 
union. Caftor-oil, a mild and tolerably-certniu purgative, 
is the belt medicine we know of. Indeed molt painters 
who are aware of the utility of caftor-oil efcape the attack 
of this malady, to which (as well as to the next fpecies) they 
are very (ubjeCt, by taking a large dofe as foon as they 
perceive the flighted: fymptoms of the difeafe. Where 
ficknefs is prefent, if more aCtive means are required, calo¬ 
mel, combined with jalap and rhubarb, may be employed. 
Moreover, remedies may be applied immediately to the 
part affefted, by means of clyfters. Large quantities of 
warm water (to the extent of fome pounds), injefted by 
a proper fyringe, have frequently had the effeCf of remo¬ 
ving the pain and fpafmodic ftriClure of the colon, partly 
by the foothing effeCts of the warmth, and partly by me¬ 
chanical dilatation. Opium may alfo be adminiftered in 
the fame menftruum, combined with neutral falts, with 
confiderable advantage. Thefe emollient clyfters act alfo 
powerfully in aid of laxative medicines taken by the 
mouth, particularly where the latter are impeded in then- 
operation by a collection of indurated feces ; for, while 
the periftaltic motion of the bowels is roufed by the 
laxatives 
3 
