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continued watchfulness. These symptoms, the burden of the dyspeptic, we have already spoken of, and need not further dwell upon them than to remark, that in functional disease the severity of the symptoms and the distress of the patient are often out of all proportion to the magnitude of the affection.
On The General Treatment Of Disease Of The Stomach.
In no class of diseases is it more important to regard the system in its entire character than in the maladies before us, and amongst these general considerations the state of the mind stands foremost, for as long as that is unsettled and disturbed, mere medicinal treatment will have very little effect in relieving the symptoms. Intense mental anxiety will cause such an irritability of the stomach that the meal is at once rejected, and the only effectual remedy is to calm the mind, and to remove the causes of anxiety. Mental repose has a wonderful effect in conducing to the healthy performance of digestion. Anxiety will destroy the appetite, so will pleasurable excitement or intense exercise of thought; but as soon as the stimulus ceases, it is followed by a sense of exhaustion. Amidst beautiful scenery there may be no sense of bodily fatigue, whilst the mind is entranced; hunger is not experienced, but when at length the excitement is lessened, the exhausted system may be unable to take the required refreshnent, or, if taken, there is the inability to digest it.
Sudden alarm, unexpected news, whether pleasurable or painful, take away the appetite, and may even induce rejection of food. In the treatment of these gastric Vnaladies, perhaps more than in any other, the confidence of the patient in the skill and diagnosis of the practitioner is an essential element of success. Without that confidence, every suggestion will probably result in an aggravation of the symptoms, and with it the simplest placebo will sometimes suffice to relieve functional disease.
The effect of climate is very perceptible in stomachic disease. A damp relaxing atmosphere, a locality upon clay, where moisture is retained and preternatural humidity induced, have a marked influence in perpetuating the symptoms of gastric affection, especially where atony exists, where the powers are enfeebled, and where a strumous diathesis renders the functions generally more easily disturbed. A dry bracing air tends to invigorate and to strengthen, and to the dyspeptic accustomed to a damp, confined situation, it will often suffice effectually to ameliorate his symptoms. It is scarcely necessary to refer to the injurious influence of impure and miasmatic conditions of the atmosphere, as affecting the gastric in common with other functions of the body. The ideas handed down to us from past centuries as to the influence of the season upon the health, have been confirmed by the scientific observations of Dr. E. Smith, that there is the greatest amount of general vigour in the spring, and the least at the autumnal season; and he infers, that the greater quantity of effete material during the summer months leads to the frequency of diarrhoea and intestinal diseases.
^ Amidst the multitudinous occupations of ordinary life there are some which tend in a greater degree than others to induce gastric complaints. Sedentary pursuits, especially when associated with late hours, and with pressure upon the stomach, greatly impair healthy digestion; and too often the necessities of the system are disregarded, and insufficient time allowed for meals, or they are taken at too long intervals. Again, several hours spent in a hot and oppressive atmosphere, containing an excess of carbonic acid, produces a sense of exhaustion and oppression, and the organic functions become less energetic. Some professional duties involve great irregularity as to the hours at which food is taken, and the strong and vigorous system can alone bear with these repeated disturbances without injury.
As to numerous mechanical occupations, some are injurious from pressure upon the- scrobiculus cordis, and from constrained position, as with the shoemaker, the tailor, the hand-loom weaver; in others the air is loaded with dust, but in these the respiratory organs suffer more severely than the digestive; and, lastly, the exhaled fumes may be of a poisonous character, as with lead, mercury, phosphorus, &c.
Many of those whose trade requires the tasting of cheese, butter, sugar, &c., become affected with troublesome dyspepsia. In general, an out-door occupation is better than one requiring confinement; and that which is connected with vigorous exercise is better than one which demands a constrained position.
Another valuable agent in affording relief to the symptoms of functional disease of the stomach is change of scene. The mental effect produced by travelling tends in a powerful degree to act upon the functions of organic life. The locality may be really less healthy than the home, but the change is beneficial; the diet may be less digestible, but it is more easily assimilated; and it often happens that, when the thoughts continually revert to an organ affected with apparent or with real disease, anything that will draw the attention into other channels promotes cure or relief. Still more marked is the beneficial effect of change, when the anxieties of professional and commercial life are left behind, and when the confined atmosphere of a large town is exchanged for the invigorating influence of sea or mountain air.
Lastly, we must refer to the ordinary circumstances of the dwelling as greatly affecting digestion. In some cases, we almost involuntarily ask ourselves, How can any one live in rooms so over-heated and ill-ventilated ?— with a deficient quantity of oxygen gas to renovate, and an excess of the excreted carbonic acid—it may be with the impurities of town gas, added to the defect of a