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inflammation appears in the fauces, yet if some degree of pain be felt in the stomach, if there be a want of appetite, an anxiety, frequent vomiting, an unusual sensibility with respect to acrids, some thirst, and frequency of pulse, there will then be room to suspect an erythematic inflammation of the stomach; and we have known such symptoms, after some time, discover their cause more clearly by the appearance of the inflammation in the fauces or mouth.
. Erythematic inflammation is often disposed to spread from one place to another on the samé surface; and, in doing so, to leave the place it had first occupied. Thus, such an inflammation has been known to spread successively along the whole course of the alimentary canal, occasioning in the intestines diarrhea, and in the stomach vomitings; the diarrhæa ceasing when the vomitings come on, or the vomitings upon the coming on of the diarrhea.
401. When an erythematic inflammation of the stomach shall be discovered, it is to be treated differently, according to the difference of its causes and symptoms.
When it is owing to acrid matters taken in by the mouth, and when these may be supposed still present in the stomach, they are to be washed out by throwing in a large quantity of warm and mild liquids, and by exciting vomiting. At the same
time, if the nature of the acrimony and its proper corrector be known, this should be thrown in; or if a specific corrector be not known, some general demulcents should be employed.
402. These measures, however, are more suited to prevent the inflammation, than to cure it after it has taken place. When this last may be supposed to be the case, if it be attended with a sense of heat, with pain and pyrexia, according to the degree of these symptoms, the measures proposed in 393, are to be more or less employed.
403. When an erythematic inflammation of the stomach has arisen from internal causes, if pain and pyrexia accompany the disease, some bleeding, in persons not otherwise weakened, may be employed : but, as the affection often arises in putrid diseases, and in convalescents from fever, so, in these cases, bleeding is inadmissible; all that can be done being to avoid irritation, and to throw into the stomach what quantity of acids, and of acescent aliments, it shall be found to bear. .
In some conditions of the body, in which this disease arises, the Peruvian bark and bitters may seem to be indicated; but an erythematic state of the stomach does not commonly allow of them.
OF THE ENTERITIS, OR INFLAMMATION OF THE
404. The inflammation of the intestines, like that of the stomach, may be either phlegmonic, or erythematic: but, on the subject of the latter, I have nothing to add to what has been said in the last chapter ; and shall here therefore treat of the phlegmonic inflammation only.
406.* This inflammation may be known to be present, by a fixed pain of the abdomen, attended with pyrexia, costiveness, and vomiting. Practical writers mention the pain in this case as felt in different parts of the abdomen, according to the different seat of the inflammation; and so, indeed, it sometimes happens; but very often the pain spreads over the whole belly, and is felt more especially about the navel.
407. The Enteritis and Gastritis arise from like causes; but the former, more readily than the latter, proceeds from cold applied to the lower extremities, or to the belly itself. The enteritis has likewise its own peculiar causes, as supervening upon the spasmodic colic, incarcerated hernia, and volvulus.
* The articles were thus numbered in the last two editions of this work, published before the author's death. The errer is of no consequence; and is not corrected, for fear of making Worse errors or confusion in the subsequent references.
408. Inflammations of the intestines have the same terminations as those of the stomach; and, in both cases, the several tendencies are to be dis. covered by the same symptoms (389_391).
409. The cure of the enteritis is, in general, the same with that of the gastritis (393, et seqq.); but, in the enteritis, there is commonly more ac, cess to the introduction of liquids, of acid, accescent, and other cooling remedies, and even of laxatives. As, however, a vomiting so frequent. ly attends this disease, care must be taken not to excite that vomiting by either the quantity or the quality of any thing thrown into the stomach.
The same observation, with respect to the use of opiates, is to be made here as in the case of
410. Under the title of Enteritis, it has been usual with practical writers to treat of the reme, dies proper for the colic,* and its higher degree named lleus : but, although it be true that the en.
teritis and colic do frequently accompany each other, I still hold them to be distinct uiseases, to be often occurring separately, and accordingly to require and admit of different remedies. I shall therefore delay speaking of the remedies proper for the colic, till I shall come to treat of this disease in its proper place.
411. What might be mentioned with respect to the suppuration or gangrene occurring in the enteritis, may be sufficiently understood from what has been said on the same subject with respect to the gastritis.
OF THE HEPATITIS, OR INFLAMATION OF THE Liver.