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gratifications and disappointments, its corroding cares and its seasons of buoyant happiness, its thirst for sensual enjoyment, as well as its highly intellectual pursuits. Were we to depict all the varieties of dyspepsia, we must comprehend every form from the trifling malady, which may scarcely be regarded, to those which are so severe as to rob life of its enjoyment; and even the same symptoms may in the one case be a mere temporary disturbance, and in the other they may indicate the commencement of serious organic disease; and, still further, the measures available in the treatment of these multifarious complaints are even more comprehensive than the symptoms; and were we to enter upon a minute detail of the whole subject, we must include the rules of hygiene, as well as those of therapeutical practice; for the diet and the clothing, the exercise and rest, the air we breathe and the water we drink are most important; and not less essential are mental rest and discipline in their effects on the physical organism. A full description of these remedial measures would lead us beyond our intended space, and we must content ourselves with general indications concerning them, still bearing in mind the fact, that they should never be placed in a position subordinate to the mere administration of medicinal substances.

As dysphagia indicates impaired action of the œsophagus, so dyspepsia is a term applied to corresponding defect in the stomach; and as the varieties of

dysphagia comprise the diseases of the oesophagus, so the forms of dyspepsia include the maladies of the stomach. The want of gastric power cannot however always be designated dyspepsia, for during the paroxysms of fever, as well as in the exhaustion of chronic disease, the stomach fails in common with every other part, and the local sign is almost disregarded in the general affection. We are fully aware of the danger attached to the special study of one class of disease; and we must ever be on our guard, lest in directing attention to the local symptoms we overlook the constitutional character of the malady.

In my former work on 'Diseases of the Abdomen' I arranged these affections of the stomach according to the physiological divisions, by referring to the various parts implicated, and then considered them in the following order :-1st. The dyspepsia arising from disorder of the mucous membrane of the stomach and its secretion; 2nd. That arising from the muscular movements of the stomach being impeded; 3rd. From an abnormal state of the vascular supply; 4th. From changes in the condition of the nervous system; and lastly from improper diet, or, from chemical decomposition taking place during the digestive process. My present intention is to enter into a more minute consideration of the varieties of the disease as observed in daily practice.

The first that we shall notice is dyspepsia from

weakness, whether from general imperfect nutrition and diseased vessels, or from exhaustion of the cerebrospinal nervous system, or from failure of the nerve of organic life; atonic dyspepsia, as it might aptly be termed.

2nd. Dyspepsia from congestion, as observed in chronic disease of the lungs, heart, and bronchi, and also in chronic disease of the liver.

3rd. Inflammatory dyspepsia, whether arising from irritants, excesses, or improper diet.

4th. Hepatic dyspepsia, or "bilious indigestion." 5th. Rheumatic and gouty dyspepsia.

6th. The dyspepsia connected with disease of the kidney.

In the varieties of dyspepsia thus alluded to, the mucous membrane and its secretions are especially affected, there being either deficiency or excess in the gastric juice, or its character being changed by defective secondary assimilation or continued congestion. We shall then describe,

7th. Dyspepsia from mechanical interference with the muscular movements of the stomach.

8th. Nervous or sympathetic dyspepsia.

9th. Dyspepsia from fermentation of, or chemical change in, the contents of the stomach, and,

10th. Duodenal dyspepsia.

Still further we shall refer to it as a symptom of more serious organic diseases, as ulceration and cancer.

In the earlier stages of these diseases the only indications of abnormal action are of a functional character, and a correct prognosis then requires the closest investigation, and a full knowledge of disease in all its relations.

CHAPTER I.

ON THE CHANGES OF DIGESTION AT DIFFERENT PERIODS AND CONDITIONS OF LIFE.

THE phenomenon of life does not present an unvarying series of actions, nor the constant repetition of the same living functions performed in an identical manner; but we find in vegetable, as in animal life, that there are stages of existence and phases of development ever changing and progressive in their action.

In the first germ of the seed plant there is living growth of a peculiar kind, namely, the gradual formation of the germ leaf, the cotyledon, and of the rudimentary root; and, at the same time, a supply of nutriment is stored up for the period of independent and separate existence; there is a vitality in the seed which may exist for an almost indefinite period, till, by the application of the needed stimulus, fresh changes take place of an entirely different character in connection with the sprouting of the seed; then, for a time, another stage of vegetable life follows, that of growth and development. But, with the growth of the plant there are cyclical changes daily and hourly evolved, and in those plants of an exogenous kind each

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