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an alarming kind, and which was likely to prove permanent.* In these remarks, we are aware that we are somewhat deviating from the main purpose of the present paper; we could not, however, well resist the opportunity which the occasion af. forded, of doing what in us lies, to correct that mistaken idea which seems prevalent, namely, that the feeble may be made strong by engaging in those exercises and exploits which are rather suited to preserve than to communicate robustness. In this, however, as in all other cases of cau. tion, we would guard against misconception. Although we would neither starve the stomach into good behaviour, as is proposed by some, nor lash enfeebled organs into unlimited exertion, we are very ready to allow, that occasional absti. nence, and constant moderation, are of the greatest consequence as regards healthy digestion, and that due or well adapted exertion is one of the most efficient means of calling forth latent, and improving weak energies.
One of the principles upon which exercise manifests its utility, is, that of preserving the secretions in good order, - more especially the secretions from the surface of the body; and how material this is towards the due maintenance of stomach health needs scarcely be noticed, after the intimations we have given of the connexion of the skin with the stomach. On this account, partly, it is, that friction of the whole surface of the body, more especially of the chest and abdomen, will be found an exceedingly good practice to have recourse to every morning immediately upon rising from bed. Merely rubbing the body with a dry towel will prove salutary to a certain extent, but the previous use of a large sponge well filled with water, so as to form a sort of shower-bath, is a most useful preliminary to friction of the surface with a coarse towel. We have known individuals have recourse to this kind of matin-bath, and with a great improvement in their digestion and general health,-to whom the shock of immersion in cold water had produced languor and heaviness during the day; and had excited to febrile and irregular reaction, rather than to that free and genial warmth which is characteristic of firm health; not to say any thing of the superior facility with which the mode now recommended of freeing the skin from impurities is practised, compared with that of plunging into the cold bath. · The practice of cold bathing is, however, in some cases, highly refreshing and salutary; but, like athletic exercise, it is
The father of one of the principal contributors to this Review, brought on himself, by hard running, an asthmatic affection, which continued to harass him through life.
for the most part calculated to preserve strength, rather than to create it. When used for the purpose of obviating dyspepsia by the enervated and feeble, it ought not, as Dr. Paris very justly remarks, to be employed immediately upon rising, but an hour or two after breakfast. This author likewise very properly opposes the vulgar error, that it is wrong for a heated person to plunge into cold water. It has often been directed, that if an individual walk briskly to the edge of the bath, so as to produce somewhat of excitation and heat, it is necessary to stay a short time on the brink, in order that the body be cooled before the plunge is made. Now, this happens to be precisely what ought not to be done ; in fact, it is good practice for the lan. guid and feeble thus to excite internal heat before they en, counter the cold medium; as it is to fill their bodies with caloric before venturing out into cold air. This transition from heat to cold is by no means dangerous, provided the heat be below that degree which causes perspiration : then, and not till then, is it unsafe with an excited frame to rush into cold air or plunge into cold water. This principle was well illustrated by the late Dr. Currie, and it is now fully proved, that even after a warm bath, the body is not, as was formerly imagined, more than ordinarily susceptible of cold; The idea,' says Count Rumford,- of going into bed after a warm bath, in • order to prevent taking cold, is erroneous; no alteration • should be made in the clothing; and the body, on exposure to 'the air, is not more susceptible of catching cold than it was • before going into the bath. It must, however, be recollected, that when the previous heat has been so high as to produce exhaustion and cause the surface to be in a perspirable state, the transition from heat to cold is likely to be followed by highly injurious consequences.
Warm bathing is often found beneficial to the dyspeptic. This will regulate the functions of the skin, promote the di. • gestive powers, and concur with other measures to re-establish • health. The temperature should be from 95° to 98°, and the most proper period for using it, we are told by Dr. Paris, is about an hour or two before dinner.
Sea bathing will occasionally prove salutary, when cold spring baths are inadmissible. It is advisable for those who are of a relaxed and feeble habit, to bathe, even in the sea, an hour or two after breakfast, rather than to rise from their beds and almost immediately take the plunge.
That the dyspeptic should cease from hard study,-that he should subject himself to those circumstances which foster a disposition to hilarity of mind and equanimity of temper,—that he should avoid the use of spirituous liquors in any other way,
than as occasional medicinals,-that he should forego the enployment of narcotics, as of opium and tobacco,—and cease to provoke his stomach into unnatural excitation by spices, or even bitters to any extent,-are facts and principles too certain and plain to require enlarging upon in this place; and we shall now bring the subject to a close by the mention of one or two particulars in reference to the more strictly medicinal part of dyspeptic regimen ; and, even on this topic, for reasons sufficiently obvious, we shall offer little more than very general intimations.
A twofold indication is presented to the practitioner, who may be called to the treatment of stomach ailment. He is tu endeavour at counteracting present conditions, and he is to aim at preventing the recurrence of these conditions. Every one who knows any thing of dyspepsia, either by feeling or observation, knows, that acidity and flatulence are two of its prominent characteristics. Now this acidity and this flatulence also may have two sources,—the fermentation of undigested food, or a vitiated state of the secretion from the gastric membrane. Dr. Paris tells us, that the former is the case when the disorder is that of imperfect chymification, and the latter where it depends upon the irritation of some distant organ. In this, perhaps, there is a little too much of refinement, although the general principle may not be altogether incorrect. At any rate, when we can clearly trace the flatus and the acid heat of the stomach to fermenting and acidified ingesta, the alkalies and magnesia are clearly indicated as remedies ; and the latter is, for the most part, preferable to the former, inasmuch as in the neutralization of the acid it meets with in the stomach, a salt is formed which proves purgative, and thus the double purpose is served of correction and evacuation. It is often found highly useful to anticipate, as it were, this acid formation in the stomach; and nothing can be found more efficacious in preventing the ill consequences likely to result from repletion or debauch, than taking a tea-spoonful or two of magnesia in a glass of cold water, previously to retiring to rest. When a more positive purgative is required, the combination of the sulphate of magnesia (Epsom salts) with the carbonate, in the proportion of about two large spoonsful of the former to one of the latter, will be found an exceedingly useful remedy: and in cold habits, the addition of two tea-spoonsful of tincture of rhubarb will much improve the combination. When acidities prevail, connected with gouty spasms, the carbonate of ammonia will meet the requirements of the case in an especial manner. This is one of the remedies pointed out by Dr. Philip as applicable to the more protracted cases of indigestion. We have no other means,' he says, ' which so powerfully excite the nerves • with so little disturbance to other parts.' He attributes a pora tion of its virtues to the excitation of the skin, and in this ascription, we think our author perfectly correct. Indeed, we regard ammonia as one of the most useful articles in the materia medica; and it is, as we have above intimated, more particularly applicable to gout in combination with dyspepsia, correcting the acidity of the disease, and stiinulating the nervous frame. Its dose is from eight to ten grains.
It would seem, at first sight, incongruous to meet the acidity of the stomach by acid medicinals; but these certainly do prove occasionally powerful antacids in their effects. We imagine they do so by communicating a tone to the stomach, and thus getting this organ into a course of better secretion. They may indeed directly, like the alkalies, check fermentation, and thus obviate acidity; but we believe their main operation is upon the fibres and membranes of the stomach itsell.
The combination of aperient with bitter medicinals, will be found occasionaily useful, such as tlie quassia or caloinba with tincture of rhubarb and Epsom salts. Than tincture of rhubarb, we scarcely know any thing more suitable to general derangements of the stomach ; and although we are aware of the danger connected with unprofessional tampering, we think it proper to say, that much preventive good in incipient irregularity of the digestive organs, may be effected by the timely taking of two or three spoonsful of this tincture in a glass of common water..
The blue pill has become a fashionable medicine for the purpose of preventing the establishment and confirmation of threatening derangement of the system ; but there does not seem to be any reason why this medicinal should be taken, unless, besides stomach affection, there exists a torpid or irregular condition of the liver, as indicated by sallowness of the complexion, lowness of the spirits, and general lassitude. When these symptoms are present, five grains of the blue pill upon going to rest, followed in the morning by a decoction of dandelion, may sometimes succeed in overcoming the present ailment, and even, occasionally, in preventing the occurrence of actual jaundice. In this state of things, also, quassia, and calomba, and rhubarb, are excellent medicines.
External applications are not seldom efficacious in counteracting internal disorder. A blister placed on the back, we have known to succeed in correcting obstinate dyspepsia ; and the application of tartar emetic to the pit of the stomach, either in the form of lotion, or plaster, or ointment, will frequently be followed with good results.
Galvanism might, upon the principles formerly adverted to, prove highly beneficial in some sorts of stomach as well as pulmonary disorder; and we have no doubt, from what we have ourselves seen, that this influence may be employed with much advantage under the discreet management of the careful and judicious practitioner. But it is an edged tool, and must not be played with. Stimulants of all kinds should be had recourse to in deranged states of the systen under the imprese sion, that, if not proper, they may be very improper; and physiology, moreover, has not yet so completely unfolded the electric connexions and susceptibilities of the living system, as to enable us to pronounce, with much certainty and precision, on the voltaic impulse as a remedial agent.
Although, as it has been seen, we object to the divisions and subdivisions, the distinctions and demarcations of some authors; and although we see no good reason for falling in with the general feeling of the times, and viewing all protracted dis• order as resulting from local inflammation; we are ready to admit that, occasionally, topical irritation mounts up to the positive degree of inflammatory state, and that then, leeches, and cupping, and nitrate of potash, and tartrate of antimony, may, separately or together, be demanded ; under restrictions and modifications, however, which it would be quite inconsistent with our plan and limits to detail or dwell upon. We find, indeed, that we have only space left for a remark or two upon the subject of a domestic medicinal, which has recently excited so much attention, that we should be considered as guilty of a serious omission, were we to pass it altogether unnoticed, in a paper devoted to the consideration of stomach affection.
The writer of one of the pamphlets before us, under the signature of B, has issued an angry and vehement protest against white mustard seed, as likely to be productive, in its indiscriminate use, of consequences the most alarming; while others are going about from town to town, and from country to country, proclaiming its virtues as a catholicon, and calling upon all, as they value their life and well being, to appreciate and apply this potent antidote to physical evils, which Providence has put into our hands. A Leiter from Naples, which has this moment reached us, contains the following statement." In a place " where people devote themselves so much to pleasure, there o must be a sufficient portion of disease ; and, as all are seekring some universal remedy, different medicines and different I systems will rise and fall as fashion dictates. When I first
came here, all the world was running after a course of vioolent purgatives, introduced by the pamphlet of Monsieur Le • Roi; such was the rage for this man's medicine, that it was