Licence: Public Domain Mark
Credit: Lectures on the theory and practice of physic (Volume 1). Source: Wellcome Collection.
Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)
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![relief is given by eructations, either tasteless or acid and burning. The salivary glands are excited to the secretion of a viscous liquid, which is continually discharged by spitting. The tongue is large, moist, and trembling. The patient complains of headache, and ex- hibits an anxious expression, with tumid features and leaden com- plexion. He is easily fatigued, and is subject to vertigo on making the least intellectual effort. The appetite is usually diminished; at any rate irregular during acute cardialgia. Constipation is a com- mon and troublesome symptom. Treatment. — Obviously must our treatment vary with the vary- ing condition of the stomach in these cases. Simple nervous car- dialgia— some pain and acid eructation and vomiting, without increased heat of skin or activity of pulse, will require opiates and other narcotics, or preferably quinia and iron and bitter tonics, in alternation with carbonate of ammonia and other antacids. If, on the other hand, the fluid be acrid, and evidences of morbid irritation be present,so far from discountenancing the use of herbaceous vege- tables and an acidulous diet, which were prohibited in the first variety, these may be even recommended with good effect. In morbid capillary excitement of the gastric mucous membrane, mani- fested by a red tongue, tenderness of the epigastrium, dry skin, and an ever-craving thirst, leeches below the ensiform cartilage ought to precede other treatment. Inability to procure these, or prejudices against them, will authorise the substitution of a succession of small blisters in their place. After this, if the disease is not cured, we have recourse to other general means adapted to the presumed state of the organ and its mucous secretors. Mercury is generally prohibited in dyspepsia, but on a very im- perfect pathology of this disease. No doubt that, in strumous habits and in nervous temperaments and subjects, in whom the skin is cold, and there is little or no vascular excitement, — the tongue moist and clean or simply loaded, and the urine secreted in its cus- tomary abundance,— mercurial preparations are seldom called for, indeed ought to be withheld. But in more mixed cases of excite- ment with morbid secretion, dry, and occasionally hot skin, and im- perfect renal discharges, small doses of the blue mass, or of this with ipecacuanha, or mercury with chalk, will exert a very bene- ficial effect. In making this remark, let me add, however, a cau- tion against continuing this medicine, or giving it in such doses as will affect the constitution. Ipecacuanha, made; popular by Daubenton, has, since his time, been much used by practitioners in the treatment of dyspepsia, when characterized by morbid sensibility and depraved gastric secretions. The French practitioner just mentioned, gave the medicine in small doses, or from a quarter of a grain to two grains early in the morn- ing fasting. Dr. Thomson was accustomed to divide a full dose of ipecacuanha into several equal parts, which he directed to be taken in the course of twenty-four hours. This article is sometimes con- veniently combined with an aperient, sometimes with an alkali. Both these indications may be fulfilled by its union with rhubarb and soa]>, as in the following prescription: —](https://iiif.wellcomecollection.org/image/b21156955_0163.jp2/full/800%2C/0/default.jpg)
