following symptoms in the summer of 1818. She was affected with violent pain in the stomach, which seized her immediately after dinner, continued with great violence during the whole evening, and gradually subsided after midnight: it sometimes occurred after breakfast, but more rarely. The complaint was of two years' standing, during which time a great variety of practice, and every variety of diet, had been tried, but with slight and transient benefit. The paroxysms occurred with perfect regularity; she was considerably reduced in flesh and strength, and had a sallow unhealthy look, and her whole appearance gave strong grounds for suspecting organic disease. In the epigastric region no hardness could be discovered, but there was considerable tenderness on pressure at a particular spot. Various remedies are employed during the summer with little advantage: at last, however, she appeared to derive some benefit from lime-water, and returned home in the autumn rather better. But the affection soon recurred, and she returned to Edinburgh as bad as ever. After another trial of various remedies, this severe and intractable affection subsided, under the use of the following simple remedy:—She took two grains of the sulphate of iron three times a day, combined with four grains of the aromatic powder, and one grain of aloes, which was found enough to regulate the bowels.

Under the use of this remedy, she was soon free from complaints, and has continued to enjoy good health.

The special features of indigestion which, each when most prominent, gives a character of its own to the disease, and requires some particular modification of treatment, (setting aside, for the present, the attendant symptomatic disorders,) are referable to three heads. Or the stomach may be disordered in three ways, in its secretion, in its mode of sensibility, in its action. In health, the stomach secretes gastric juice proper in quality, and just enough in quantity; it feels nothing when proper food is put into it, and undergoes digestion; and that food when changed into chyme, or digested, it moves on by the action of its muscular fibres into the intestines. But in indigestion, the stomach is liable to form a liquor, indigestive, irritating, or inert and profuse in quantity; it may be the seat of pain and tenderness; its action may be inverted. Each of these form principal features in different cases of indigestion, which may be studied under the three heads of heartburn or waterbrash, heightened sensibility of the stomach, nausea and vomiting.

Heartburn. The cause of heartburn is superfluous acid in the secretions of the stomach; or it is probable that there is something more than excess of acid, and that the acid formed is different

from the wholesome solvent acid of the gastric juice. However this may be, heartburn depends upon the presence of a superfluous quantity of acid in the stomach, which manifests itself by its effects on the sentient surface of the oesophagus. From time to time the acid escapes from the opening of the stomach, regurgitating along the tube of deglutition. But the sensibility of that tube is different from that of the stomach; it is much higher, and the sour liquid, which was not felt by the stomach, immediately excites in the oesophagus a painful sense of acridness.

The proof that it is the acid quality of the secretion which produces the sensation of heartburn, lies in the fact, that an alkaline draught immediately relieves it; 'ten grains of the carbonate of soda or potass, or magnesia, in a wine-glass of water, directly allay or lessen the unpleasant feeling, which if it recurs, again gives way to the same remedy.

Most persons have experienced heartburn; it is the commonest form of indigestion. In general, it occurs under the following law. The stomach has been set wrong by some imprudence in diet; and in the evening, or at night, heartburn is felt. The heartburn is for the time removed by an alkali. But for several evenings, the digestion having once been set wrong, it returns. The disposition to form acid then gradually wears off; re

covery is promoted by abstemiousness in diet, and the use of one or two doses of aperient medicine. Heartburn is of common occurrence in delicate women; they are slightly out of health, languid, of capricious appetite; the heartburn is felt more frequently after breakfast than after dinner, in the latter being prevented or corrected by the stimulus of wine. In such cases the following common formula, combining a tonic with an alkali, is often beneficial,-six drachms of infusion of orange-peel, joined to the same quantity of infusion of cloves, with from seven to fifteen drops of liquor potassa, and ten to fifteen drops of the aromatic spirit of ammonia, to be taken twice a day; that is, two hours after breakfast, and an hour before dinner. This remedy pursued for a fortnight, with occasional use of aperient medicine when necessary, will often completely restore the tone of the stomach in this trivial disorder. In

place of the infusion of orange-peel, twenty drops of the compound tincture of gentian, in three table-spoonfuls of spring water, may be used, which is the more convenient from its portableness. In general, I know no better or wholesomer tonic of a light description than the above combination, ammonia, namely, with gentian, soda being added or not, according to the quantity of acid formed.

There are some with whom it is beneficial to

take a small quantity of alkali with their meals; they should take, for instance, five grains of carbonate of soda, and five of magnesia, in a wineglass of hot water, or milk and water, at breakfast, and the same or a larger quantity in half a tumbler of Seltzer water, at the close of dinner. The formation of acid is thus prevented. The connexion between acid in the stomach and gout is well known. I am acquainted with a gentleman strongly disposed to gout, whose constitution affords a perfect test of the efficacy of alkalies taken thus at meals. If he omits to take his dose of alkali at dinner, within an hour after the repast, one knuckle of his hand is sure to burn and shoot: this he invariably experiences if he neglects adding to his temperate meal the antidote to the acid which it

causes.

Waterbrash.-There are patients into whose stomachs, when empty, there is poured out a vast quantity of transparent liquid, sometimes tasteless, sometimes sweet, sometimes acid, or of an acrid taste. The complaint is known by the name of waterbrash; it is more common in women than in men, and exists in every degree of severity or mildness. When the quantity of liquid formed is considerable, great extenuation often follows. It is commonly unproductive of pain, and is thrown up without nausea, the mouth filling spontaneously with the liquid, which rises without an effort, or

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