of purgative and stomachic medicines, and attention to diet, will be of short duration, unless the visceral obstruction be removed. In order, therefore, to render the cure permanent, three or four grains of the blue pill should be given every night, for about a week. This medicine will not only remove the visceral congestion, but render the stomach, &c. more susceptible of the action of a strengthening medicine, and being diffused throughout the abdominal viscera, will establish a healthy harmony between them.--(See DIURETICS, p. 25, Toxics, p. 49, and SroMACHICS, p. 45.)

In this variety of indigestion, the simple decoction of sarsaparilla, which generally proves beneficial (probably as a diluent) in the variety from increased nervous excitement, oppresses the stomach, and increases its debility.

The conversion of food into good chyme, greatly depending on its being properly masticated, and mixed with healthy saliva, the mouth may be considered as forming a part of the digestive organs. The process of digestion is, no doubt, often disturbed or rendered imperfect by morbid secretions of the mouth, especially of the salivary glands, unhealthy mucus of the tongue, and the collection about the teeth termed tartar. Attention, therefore, should be paid to the condition of the mouth, as well as to the stomach and intestines. The teeth should not only be cleaned every morning by a powder, that will remove the collection, without abrading the enamel, before breakfast, but also the gums and the tongue, with an astringent lotion, not only to remove unhealthy matter, but to strengthen the gums, and the salivary and other glands, so as to produce healthy secretions. That there is a kind of continuous sympathy or feeling between the mouth and stomach (from continuation of surface and nervous connection), must appear evident to every person who has paid any attention to them. The sense of hunger and disease in the stomach, will bring on a copious secretion of saliva, and mechanical irritation of the fauces will excite vomiting. The strengthening effects of an astringent lotion on the tongue, gums, &c. are communicated to the stomach; and I have known many invalids from indigestion, receive more benefit from such lotion than from the use of a tonic medicine taken into the stomach. · (See PREPARED ARECA CHARCOAL, p. 155.)

Indigestion being, in fact, only a symptom of some disorder or disease of the stomach, which again may be primary or sympathetic, a treatment applied to it only, must, of course, in a majority of cases, prove only palliative, and in order permanently to remove it, the treatment must be directed to the primary alfection, as well as the mitigation of troublesome symptoms.

With respect to diet, there is so much peculiarity of stomach and constitution in dyspeptic subjects, that it is impossible to give instructions applicable to every case. In general, broths, with celery or green vegetables, gravy soups, and thick soups, onions, stuffing, the outside of roasted meat (particularly of pork), green vegetables, either boiled or raw, as cabbage, spinach, celery, water-cress, &c. pastry, raw fruit, cows' milk, eggs, and tea, are improper.- (See Remarks on DIET, page 200.) - In my Treatise on the Regulation of the Stomach and Intestines, I have enlarged on the treatment of indigestion of elderly people, bordering on that condition of the system, termed by Sir Henry Halford the climacteric disease, or breaking up of the constitution.

Dr. Wilson Philip has noticed, in his publication on indigestion and its consequences, a variety of consumption from indigestion, to which he has given the name of dyspeptic indigestion; but the disease in the lungs is in such cases always of a constitutional nature, and is brought into action by the cause of the indigestion; and when the disease of the lungs has advanced to its second stage, the disorder of the stomach generally ceases, and although the digestion becomes perfect, the affection of the lungs advances.

PREVENTION.It must appear evident, from the foregoing observations on the causes of this disease, that the most effectual prevention consists in, 1st, properly exercising the body; 2dly, proportioning the quantity of food to the degree of exercise *; and, 3dly, relinquishing the use of spirituous or vinous liquors, tea, and coffee. If sufficient bodily exertions cannot be taken, in consequence of debility or age, and an artificial appetite must be produced by stimulating the digestive organs, such stimulants should be employed as will not injure the coats of the stomach, nor disturb the brain. Of this class, ginger, Cayenne pepper, and well-seasoned pickles, are the most innocent and effectual. Of wines, sound Madeira and Port are the best.

In the Gazette of Health, a composition of the buds of red roses, rosemary, sage, &c. is much recommended as a substitute for tea or coffee, in cases of indigestion; and in many incipient complaints it has proved very beneficial. It is certainly a power

It is not an easy matter to ascertain the exact quantity of food proper for every age, sex, and constitution; the best rule is to avoid extremes. Three meals in a day are as many as nature requires, and certainly as much as the stomach can properly digest: dinner ought to form the chief of these. Hearty suppers, particularly of meat, in which some people indulge themselves, previously to their retiring to rest, are highly prejudicial to health; hence, the old adage:

"Great suppers a very great evil we call:

That sleep may be sound, let your supper be small."

ful auxiliary to medicine, and, as a preventive of indigestion, after the cause has been removed, is very efficacious.

Those who are in the habit of drinking a quantity of spirit, or spirituous wines, will receive great relief by taking water at meals †, instead of wine or malt liquors. I have known cases of indigestion from the use of spirits, attended with symptoms indicative of organic disease of the stomach, cured by drinking at meal-times nothing but distilled water, and gradually diminishing the quantity of wine, till it was reduced from eight glasses to one in a day. (See DIET, DRINK, and EXERCISE.)

Practical Remarks. From the preceding observations, it will appear, that indigestion arises from a variety of causes; that it is equally a disease of plenitude or excess of health, as of debility or depletion; that the principal cause, in this country, is inflammatory or nervous excitement of the stomach, in consequence of being over-stimulated by wine and high-seasoned dishes; that, when fulness of system prevails, bleeding and aperient medicines are the best remedies; that, when general debility of the system is an attendant, tonic medicines are necessary (see HEARTBURN); that, if the disease proves obstinate, some organic mischief may be suspected, either of the coats of the stomach, pancreas, liver, or intestines; in which case mercury is necessary, and the application of the Euphorbium plaster; that, in all cases, particular attention must be paid to diet and exercise; that water, during meals, is the best beverage; and that meat under-cooked is the most easy of digestion, as well as being more nutritious.

OF INFLAMMATORY FEVER.- SYMPTOMS. This fever is distinguished by an increased heat of body, without any material remission, attended with a throbbing, generally pungent, but sometimes dull and heavy, pain in the head; the face, and particularly the eyes, are red; the pulse strong, full, and quick; great thirst; sense of general lassitude; the urine high coloured; the tongue is generally covered with a white fur; the brain much disordered, and rest disturbed.

CAUSES. Whatever disturbs the brain, or checks the secretion of the skin, will, in plethoric habits, or irritable subjects, produce inflammatory fever.

* This composition, which is much cheaper than tea or coffee, is sold at 170, Piccadilly.

During a meal, water is certainly the best beverage. The custom of drinking fermented liquors, and particularly wine, during dinner, is a very pernicious one. The idea that they assist digestion is false; for those who are acquainted with chemistry, know that food is hardened, and rendered less digestible by them; and the stimulus which wine gives to the stomach is not necessary, excepting to the aged or those who have exhausted the excitability of that organ by excessive use of strong liquors. If food want diluting, water is the best dilucnt, and will prevent the rising, as it is called, of strong food, more effectually than wine or spirits.

TREATMENT. In the treatment of this fever our object is to allay the increased excitement of the brain, and to diminish the quantity of blood: the former is best effected by the application of cold water to the head, and the latter by abstraction of blood by cupping or leeches, if the subject be young, but if advanced in life, by opening a vein. The intestines should be unloaded by the Purgative Mixture (A), p. 113. If the stomach be much disordered, and the head not much affected, the Emetic Draught, p. 106, should be exhibited. If, after the operation of these remedies, the skin should continue dry, perspiration should be excited by the Antimonial Wine as directed, p. 66; and if this should fail, the body should be placed in a warm vapour bath of about 110 degrees Fahr.; the Saline Mixture (A or B), p. 114, with the wine of the colchicum seeds, or the tincture of foxglove, may be taken, and the perspiration kept up by small doses of ten or twenty drops of tartarised Antimony Wine, with warm diluent liquids, as barley-water, common whey, &c., and the body kept open by means of the aperient mixture.

In all fevers, but particularly the inflammatory, it is of great consequence to keep the skin moist; for by the evaporation of perspirable matter superabundant heat is conducted from the system. A dry skin, on the contrary, by favouring the accumulation of heat, never fails to aggravate all the symptoms. If there be considerable determination of blood to the head, the application of leeches to the temples, a blister to the nape of the neck, and the immersion of the feet in warm water, should not be neglected; and if the patient complain of stitches in the chest and difficulty of breathing, abstraction of blood should be repeated, and a blister applied over the breast-bone. In the treatment of inflammatory fever, the practitioner should always attend to local pains and affections; for in persons who have an internal part very irritable or predisposed to disease, the fever is very likely to occasion serious mischief in it. In such cases, local bleeding by leeches and blistering are of great importance. If, when the fever has subsided, morbid irritation of the brain exist, preventing sleep, ten or twelve drops of the solution of acetate of morphine may be given in a dose of the Saline Mixture. The diet should be principally arrow-root jelly, barley-water, gruel or tapioca, without spices or wine, till the inflammatory symptoms have considerably abated.

Washing the body with cold water, by means of a sponge, was much recommended by the late Dr. Currie, of Liverpool, and has certainly been attended with very beneficial effects, by diminishing nervous excitement, and conducting heat from the body; but the constant application of it to the head with a napkin will, after the first sponging, act equally beneficially.

When the fever has entirely subsided, the stomach should be invigorated, in order to lessen the period of convalescence by a mild strengthening medicine, as the Stomachic Mixture (D),

p. 114.

OF INFLAMMATION OF THE BRAIN.— People in the vigour of life, the passionate, the studious, and such as are predisposed to apoplexy, are most subject to inflammation of the brain.

SYMPTOMS. Inflammation of the brain, like other internal local inflammation, commences with rigours, tremor of the extremities, a sense of lassitude and stupor. The veins of the head soon become distended, and the arteries beat with increased force: the eyes are often steadfastly fixed, fierce, and sometimes sparkle; the voice shrill, and language incoherent; a proneness to anger, and at times a determined resolution to walk about the room: the pulse is generally languid, and the extremities cold; on dozing, he generally talks or mutters a great deal, with a chattering of the teeth, trembling of the hands, and almost constant motion of the fingers, which seem employed to pick or gather something, and often to gather the nap of the bed-clothes. After the fourth day, the delirium is more continual and furious, with watching, convulsions, and hiccup; the faces pale, and at length, with the urine, are discharged involuntarily; the pupils of the eyes are dilated, and other symptoms of approaching dissolution ensue; or critical sweats and looseness come on, or bleeding at the nose, or piles, which are of a more propitious import.

CAUSES. Excessive drinking, violent passions of the mind, exposure of the head to the sun, long watching, close application of the mind, suppression of natural evacuations, concussions of the brain, and whatever may increase the afflux of blood into the head.

TREATMENT. The most powerful remedies should be employed, on the first attack of this disease, to unload the vessels of the head; for this purpose as much blood should be extracted as the system will bear, either by opening one or both the temporal arteries, or from the nape of the neck, by the operation termed cupping; or from the jugular vein, or the arm, by a large orifice, twelve or sixteen ounces of blood, or till the patient faints, which will prove of much greater advantage than double the quantity extracted from a small vessel, or by leeches. Cold water, or vinegar and water, should be kept constantly applied to the head, by means of napkins or folded linen, and removed when they become dry or warm. The bowels should be well emptied by the Purgative Mixture (A), p. 113, and the Purgative Clyster, p. 103. With the view of producing a diversion in the