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 anemia, 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

gestion, the natural alkalinity of the saliva is lessened, and patients often complain of a sour or bitter taste in the mouth. But beside these, there are other changes more directly affecting the gustatory nerve; substances are said to taste differently, and this sense is sometimes almost benumbed.

The sense of touch and ordinary feeling is often 1 strangely implicated in functional disease of the stomach. Thus in many cases a general extreme irritability of the cutaneous nerves is induced, or especially the nerves supplying the palm of the hand and the sole of the foot; but beside these there are local affections arising from gastric disturbance of a sympathetic kind, but probably due to direct nervous connection; the little and ring fingers become painful and hyperæsthetic in indigestion. This affection is probably due to the closer connection of the sympathetic nerve with the ulnar, which supplies those fingers, rather than with the median; a local pain, about one inch in superficial extent, is often complained of below the left mamma, and this is to be attributed to the splanchnic nerves-which are the large nerves of the semilunar ganglion, and thus connected with the stomach-having their origin from the lower dorsal nerves, commencing with the 5th or 6th, which same dorsal nerves send sensitive branches below the breast. Again, the sense of oppression and weight across the chest in indigestion is of a sympathetic kind, and is

explained in a similar manner. But not only do we find hyperæsthesia induced thus sympathetically in gastric disease, but actual anaesthesia, so that the fingers may become transiently benumbed.

Other parts of the nervous system are intimately connected with the stomach. We have already referred to hyperesthesia, local or general, and to conditions which might be mistaken for commencing paralysis; but still more grave sympathies are found, especially in young subjects, or those in whom the nervous system is easily disordered. Crude semi-digested food in the stomach has often been the exciting cause of violent convulsions in children: it would seem, as if the connection was so intimate, that the peripheral irritation in the stomach sufficed to produce the most severe convulsive movements of a general kind, even epileptiform in their character.

Of a distinctive kind, but differing from the sympathetic affections already noticed, are the pains in the head, in the course of the branches of the 5th nerve, at the forehead or vertix, or in the lines of distribution of the branches of the 2nd and 3rd cervical nerves at the sides of the head and at the occiput. It is common jenough to have severe frontal headache, as the effect of excess and consequent indigestion; but in numerous other instances pain in the head is induced, sometimes at the forehead, on one or other side, or centrally; in many cases of exhaustion, with feebleness of digestive

power, the pain is at the vertex; and in others, especially of a rheumatic and gouty character, the pain is at the occiput: when lateral it has been designated hemicrania; with some a sense of coldness of the head is induced.

It is a common symptom of dyspepsia to find abnormal sensibility in the branches of the 5th nerve, supplying the face, and the branches of the 1st division are more frequently affected than the others; thus itching of the nose, pain in the eye, &c., are familiar illustrations of the fact. As to the converse of these symptoms, numerous cerebral diseases induce gastric irritation and change. After concussion of the brain a very common symptom is violent vomiting, and some of the most irritable conditions of the stomach we have ever witnessed, have arisen from abscess in the brain.

In threatening hydrocephalus of children the stomach is often disturbed, and the dangerous, nay even fatal, mistake is made of considering a terrible disease as a trifling "bilious attack;" and when this inflammatory disease has become severe, it is often noticed that the least attempt to raise from the recumbent position is followed by violent vomiting. The same symptom is observed in strumous disease of the brain. Again, during the premonitory symptoms of apoplexy, especially in some of the more severe forms, vomiting

comes on.