some ground to suspect, that the long-continued use of this bark may, like bitters, destroy both the tone of the stomach and of the whole system. 1216. Chalybeates may be employed as tonics in various forms, and in considerable quantities with safety. They have been often employed in the form of mineral waters, and seemingly with Success: but whether this is owing to the chalybeate in the composition of these waters, or to some other circumstances attending their use, I dare not positively determine; but the latter opinion seems to me the more probable. 1217. The remedies which strengthen the stomach, by being applied to the whole body, are exercise, and the application of cold. As exercise strengthens the whole body, it must also strengthen the stomach; but it does this also in a particular manner, by promoting perspiration, and exciting the action of the vessels on the surface of the body, which have a particular consent with the muscular fibres of the stomach. This particularly explains why the exercises of gestation, though not the most powerful in strengthening the whole system, are, however, very powerful in strengthening the stomach; of which we have a remarkable proof in the effects of sailing. In strengthening the general system, as fatigue must be avoided, so bodily exercise is of ambiguous use; and perhaps it is thereby, that riding on horseback has been so often found to be one of the most powerful means of strengthening the stomach, and thereby of curing dyspepsia. 1218. The other general remedy of dyspepsia is the application of cold; which may be in two ways; that is, either by the application of cold air, or of cold water. It is probable, that, in the atmosphere constantly surrounding our bodies, a certain degree of cold, considerably less than the temperature of our bodies themselves, is necessary to the health of the human body. Such a degree of cold seems to strengthen the vessels on the surface of the body, and therefore the muscular fibres of the stomach. But, further, it is well known, that, if the body is in exercise sufficient to support such a determination to the surface as to prevent the cold from producing an entire constriction of the pores, a certain degree of cold in the atmosphere, with such exercise, will render the perspiration more considerable. From the sharp appetite that, in such circumstances, is commonly produced, we can have no doubt, that, by the application of such cold, the tone of the stomach is considerably strengthened. Cold air, therefore, applied with exercise, is a most powerful tonic with respect to the stomach and this explains why, for that pur pose, no exercises within doors, or in close carriages, are so useful as those in the open air. : 1219. From the same reasoning, we can per ceive, that the application of cold water, or cold bathing, while it is a tonic with respect to the system in general, and especially as exciting the action of the extreme vessels, must in both respects be a powerful means of strengthening the tone of the stomach. 1220. These are the remedies to be employed towards a radical cure of idiopathic dyspepsia; and it might be, perhaps, expected here, that I should treat also of the various cases of the sympathic disease. But it will be obvious, that this cannot be properly done without treating of all the diseases of which the dyspepsia is a symptom, which cannot be proper in this place. It has been partly done already, and will be further treated of in the course of this work. In the meantime, it may be proper to observe, that there is not so much occasion for distinguishing between the idiopathic and sympathic dyspepsia, as there is in many other cases of idiopatic and sympathic diseases. For, as the sympathic cases of dyspepsia are owing to a loss of tone in some other part of the system, which is from thence communicated to the stomach; so the tone of the stomach restored may be communicated to the part primarily affected; and therefore the remedies of the idiopathic may be often usefully employed, and are often the remedies chiefly employed in sympathic dyspesia. 1221. Another part of our business here might be to say, how some other of the urgent symptoms, besides those above mentioned, are to be palliated? On this subject, I think it is enough. to say, that the symptoms chiefly requiring to be immediately relieved, are flatulency, heartburn, other kinds of pain in the region of the stomach, and vomiting. The dyspeptic are ready to suppose, that the whole of their disease consists in a flatulency. In this it will be obvious that they are mistaken; but, although the flatulency is not to be entirely cured, but by mending the imbecility of the stomach by the means above mentioned; yet the flatulent distension of the stomach may be relieved by carminatives, as they are called, or medicines that produce a discharge of wind from the stomach; such are the various antispasmodics, of which the most effectual is the vitriolic æther. The heartburn may be relieved by absorbents, antispasmodics, or demulcents. The other pains of the stomach may be sometimes relieved by carminatives, but most certainly by opiates. Vomiting is to be cured most effectually by opiates thrown by injection into the anus, CHAP. III. OF HYPOCHONDRIASIS, OR THE HYPOCHONDRIAC AFFECTION, COMMONLY CALLED VAPOURS OR LOW SPIRITS. 1222. In certain persons there is a state of mind distinguished by a concurrence of the following circumstances: a languor, listlessness, or want of resolution and activity with respect to all undertakings; a disposition to seriousness, sadness, and timidity; as to all future events, an apprehension of the worst or most unhappy state of them; and therefore, often upon slight grounds, an apprehension of great evil. Such persons are parti cularly attentive to the state of their own health, to every the smallest change of feeling in their bodies; and from any unusual feeling, perhaps of the slightest kind, they apprehend great danger, and even death itself. In respect to all these feelings and apprehensions, there is commonly the most obstinate belief and persuasion. 1223. This state of mind is the Hypochondriasis of medical writers. See Linnæi Genera Morborum, Gen. 76. et Sagari Systema Symptomaticum, Class xiii, Gen. 5. The same state of mind is what has been commonly called Vapours |