ten free from uneasiness, took an aperient draught, and by the afternoon was perfectly well.

To produce such an indigestion, it hardly seems necessary that anything positively unwholesome should be taken : fish, shell-fish, or raw vegetables, however, often seem to be the food at which the stomach takes offence. Yet the party may have been in the habit of eating the same kind of food without its having disagreed before; so the fault in such cases commonly is in the stomach, which is accidentally out of order, and then the least digestible part of an ordinary meal resists digestion, and becomes an irritant.

So, when, as in the case described, uneasiness at the stomach and nausea supervene shortly after a meal, it is desirable at once to bring on, or to encourage vomiting. For this purpose, half a teaspoonful of common salt in a tumbler of tepid water, followed by a second within a few minutes, if it be necessary, will generally answer. This remedy has the following advantage: if great part of the offending matter has been thrown up already, the salt and water after does not produce further vomiting, but at once calms the stomach, and subsequently acts as an aperient. If the matter thrown off the stomach is acid, the patient, as soon as the stomach is quiet, should take ten grains of carbonate of soda in a wine-glass of water, not at once, but by two or three mouthfuls. After a few

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hours' sleep, a breakfast-cup of arrowroot and milk is one of the best things that can be taken, being at once light, digestible, and nutritious.

It is, however, important to remark, that vomiting is not a remedy to be used indiscriminately with all persons. A vomit agrees with good stomachs, and with young people (so children are the better for emetics at the commencement of most of their disorders). But persons of weak stamina, or of a weak digestion, are shaken to pieces by vomiting, and suffer for some days afterwards. After the middle period of life, again, the effort of vomiting, generally violent, is extremely distressing. There are some, again, of powerful stomachs and constitutions, to whose idiosyncrasy this process is abhorrent; and who can bear the roughest discipline of medicine rather than the strain and effort of retching. Before administering an emetic, the patient should be asked if he knows how emetics agree with him.

The ordinary consequences of neglecting such an attack of indigestion as has formed the theme of these remarks, are, either a smart attack of purging brought on seemingly by undigested food reaching the bowels, or several days' indisposition, impaired appetite, heartburn, furred tongue, and general uneasiness, till the food remaining in the stomach has been either at length digested, or has slowly passed off, or has been helped to get away by purga

tive medicine. But sometimes the undigested food remains for days without altering its place, or the symptoms changing; and it becomes necessary, though late, to discharge it by vomiting, for fear of some serious illness.

Lieut. Gen., aged sixty-eight, consulted me for the following symptoms. Five days previously, after a repast, which he had eaten of not immoderately, but without caution, he had been taken in the night with uneasiness of the stomach, attended with nausea, but he had not vomited. The pain at the stomach continued through the following day, when he took some aperient medicine, which moved the bowels, but without benefit: the uneasiness at the stomach remained. He then determined to disregard it, expecting that it would wear off. But this not succeeding, on the fifth day he thought the disorder too serious to be neglected; day and night there had been a wearying uneasiness of the stomach: the tongue was furred, the appetite and relish of food gone; yet he took food at his regular meals, which he digested. The pain was distinctly seated in the stomach, which was uncomfortable if pressed: the seat of the pain had not varied from the first. I made no doubt that some part of the dinner of the preceding Sunday remained undigested in his stomach. Accordingly I prescribed an emetic of a grain of tartarized antimony, and a scruple of ipecacuanha; the vo

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miting which followed, was violent and distressing; but when the stomach had been emptied by it, the pain was gone.

A common form of temporary indigestion, or disorder of stomach, results from bile, and is closely allied to the preceding instances. It often goes with them, and the same causes which temporarily weaken digestion, will produce bile. Excess in diet, unwholesome food, exposure to cold and wet, with some the mere change of the wind to east or north-east, these physical causes, and any mental disturbance, are liable to cause bile to be poured into the intestines in large quantities, from whence it regurgitates into the stomach.

Bile in the stomach is characterized by headach, sometimes attended with impaired vision, ringing in the ears, and the like, by nausea, often with a bitter taste in the mouth, by vomiting of bile, either pure or mixed with ingesta, or diluted with mucus.

Persons of the bilious temperament are liable to slight attacks of this description from slight causes. Their skin, and the white of the eye, are tinged yellow; they experience languor, loss of appetite, and severe headach. Quiet, abstinence, and brisk laxative medicine, accelerate the departure of the attack, which is disposed to last from half a day to two or three days.

I have known the affection of vision in bilious

attacks take three forms. A gentleman, aged twenty-six, who was under my care for a protracted constitutional disease, told me that he was liable, when bilious, to vertigo, attended with a dark shade over the centre of the field of vision gradually diminishing towards the circumference; so that he could not see what he looked at, but only things around, and that dimly. Such an attack might last half an hour. On going off, pain in the head, and sometimes nausea, would supervene. Another gentleman told me that he had, when suffering bilious attacks, often experienced general failure of vision, so that he could only distinguish that part of a scene to which his eye was immediately turned, all around being obscured by a brown fog. The same gentleman told me that, at other times, he had semivision of objects, sometimes seeing the right half only of objects with both eyes; while in other attacks, he had seen the left half alone. These visual eclipses would last two or three hours, being at their worst about half an hour.

The most acute and severe attacks of bile on the stomach are characterized by bilious vomiting, with pain at the præcordia, coldness, and great depression of strength. At first, the stomach is so irritable, that any attempt to allay the vomiting by medicine only aggravates the complaint: the least excitement of the organ causes more bile to flow into it. Perfect quiet and warmth are the best