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the name climacteric, but commencing at a somewhat later period, 53 to 60 or from 56 to 63—a time of unsettled health—at the close of which a sort of equilibrium is again attained, unless organic disease have already sapped the remaining strength.

CHAPTER II.

ON THE GENERAL SYMPATHY OF THE STOMACH IN DISEASE.

It is the tendency of the clinical study of any isolated class of diseases, or of the affections of any particular organ, to exclude the consideration of other portions of the body, as if one part could be separated from the other. The nervous system is so connected with every individual structure that it sympathizes with changes in them, and may be thrown into a state of general disturbance by a comparatively trifling injury. The important function of respiration becomes affected when there is general febrile excitement; and in some functional diseases of the nervous system the respiration becomes as rapid as the pulse. Again, the central organ of the circulation, the heart, is equally susceptible of changes induced by sympathy with other structures; but it is not the mere fact of organic and functional sympathy to which we would draw attention, but to the equally important fact that the sympathy of one part with another is not equally intimate. This truth will be more apparent if we consider what is meant by this term of sympathy, and what are some of those means by which in the human frame it is brought about. By the word sympathy we mean! that an organ of the body may become functionally disturbed by irritation of a structure external to itself: in this way severe pain and abnormal sensation may be induced in parts far removed from the original seat of disturbance. This sympathy will be generally found to be regulated by one of three things,-1st, it is in proportion to the direct nervous connection of one part with another; 2nd, it is in proportion to the connection of function ; 3rd, it is in proportion to the mutual dependence of one organ on another for its vascular supply.

Amongst these sympathetic affections arising from disease of the stomach, we will first notice disturbances in the cerebro-spinal system, and these sympathetic symptoms may be arranged as follows:

Affections of the cerebrum, by which the mind, the memory, and the perceptions are changed.

Of the senses, so that the sight is perverted, the hearing disturbed, the smell changed, taste rendered unnatural, and ordinary feeling altered from its normal condition.

Of the spinal system, so that irregular muscular movements are produced by gastric irritation.

Affections of the cranial and spinal nerves, inducing pain or numbness in the head itself.

The mind is dependent for the fulfilment of its ordinary phenomena upon the functional integrity of other parts. The organism by which the mind operates is easily disturbed, and it has long been acknowledged that the stomach easily affects thought and judgment, reason and memory. Whilst digestion is going on the mind is less active, whether the effect be due to a larger quantity of blood being sent to the stomach, or to the blood being altered by the influx of new material ; and in states of exhaustion, the slight additional disturbance to the vaso-motor and cerebro-spinal system of nerves, is sufficient to induce a sense of faintness or of actual syncope. If the contents of the stomach be difficult of solution, or of a too stimulating character, these cerebral modifications are still more manifest; and if such be the case in ordinary health, during dyspepsia the faculties of the mind become more evidently disturbed. Mental oppression, and an inability to exert thought with the ordinary energy, is a common symptom, and the powers of reason and judgment often become perverted. The hypochondriac sees everything under an erroneous aspect, and forms his judgment accordingly. The manner in which the Senses are disordered by gastric disturbance is very remarkable. The functional alterations of the sight are not always identical. There may be a general haziness, but more frequently sight is perverted by irregular vision or partial obscurity, so that only part of an object is discerned, or irregular zigzag lines are noticed, or spots of an object become quite indistinct, or half a word is discerned; again, sparks of light may be perceived, or even the colour modified. To some patients one or other form of disturbed vision is the certain effect of disordered digestion, and the kind of attack is recognised by the character of perverted visual phenomenon.

Some care is however required, lest the symptoms of commencing organic disease of the eye—such as the various forms of amamosis—be ascribed simply to mal-assimilation. We have known instances where most valuable time was in this way lost, and measures which might have greatly retarded the organic changes in the retina needlessly postponed, till irreparable mischief was done.

The sense of hearing is not less easily disturbed, and the perception is either generally diminished and partial deafness induced, or there is noise in the ears of various kinds and degrees,-singing or whistling, humming or droning, the noise of bells, of steam, of falling water, &c. These symptoms sometimes become extremely distressing, but are frequently of a purely functional character, and, although not the only cause, the stomach is often greatly at fault in these cases. States of ancemia, and exhaustion, and organic disease of the ear itself, must be regarded in an altogether distinct category.

The sense of smell is less easily recognised as undergoing change from stomach disturbance; and the sense of taste is perverted oftentimes in a direct manner by change in the buccal secretions; thus, during indi

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