APPENDIX. STATISTICAL INQUIRY INTO THE CAUSES OF DYSPEPSIA. Ir is very desirable that we should know how far the different circumstances under which men are placed operate in the production of disease, and which are more particularly injurious. With the view of ascertaining this as regards indigestion, I carefully inquired into the habits of about five hundred persons who came under my care. Half of this number were dyspeptics; the other half had never suffered from any disorder of the digestive organs. All the subjects of this inquiry belonged to the "working classes," and care was taken to avoid " leading questions.” The dyspeptics were grouped according to the form of the disease from which they suffered. The cases included under the head of "painful digestion," were all affected with subacute gastritis. Those who complained of constant acidity were considered as labouring under chronic congestion or inflammation of the mucous membrane, and were consequently separated from those who applied for medical relief on account of the symptoms of "weak digestion." 1 1 See p. 135. win most be given in considerable doses Tee a serie daracter, small blisters elms f i beladins are useful. The i - is berest the skin is by far the endig reef in such cases. by repeated, and its employment Lyle da ested to the patient or his friends. eir such as conium, belladonna, and It ms are been greatly recommended, but wring my experience they are much inferior The reament of the vomiting depends entirely ova me pathingies endition from which it arises. In the mutes red be clear, watery, or acid, the ime we and other alkaline remedies is If they onsist of mucus, astringents, st is histure of silver, kino or tannic be given with or without opium, as the of case require. When signs of Le re present, creasote or charcoal will the symptoms indicate dilatation the treatment must be directed to the APPENDIX. STATISTICAL INQUIRY INTO THE CAUSES OF DYSPEPSIA. It is very desirable that we should know how far the dittot circumstances under which men are placed operate in the produs tion of disease, and which are more particularly in unos the view of ascertaining this as regards and geos. ↑ inquired into the habits of about five hundred person wit, tyabrek my care. Half of this number were peha, ka qen it sho never suffered from any disorder of the tugeva subjects of this ingusy beinager to the was taken to anding per The dyspeption wen g form which they 3 he first rs of age, aint when or the first ions, conse NOTE A. THE INFLUENCE OF AGE UPON THE PRODUCTION OF INDIGESTION. I have alluded to the changes which take place in the symptoms of indigestion, and shown that the same individual may suffer from different forms of the complaint at different periods of his life. The proportions per cent. of those who at each age presented themselves for medical relief were as follows: From this Table we might be led to conclude that the greatest liability to dyspepsia is in the middle period of life, and that the chances of suffering from it are about equal between ten and twenty years of age and above sixty. The great difference in the numbers alive during the above periods must, however, be taken into account; and, when this is done, we find the probability of any person becoming affected with indigestion varies greatly at different periods of life. I have assumed that 236 persons may be at one time suffering from indigestion out of every 1000 of the population; and I have calculated, in the next Table, the numbers per cent. who, on that supposition, would at each separate age be affected with it. It must be understood that 236 is an arbitrary number, and simply taken for convenience.1 1 The number 236 was adopted because I had ascertained the ages of so many dyspeptics, and 1000 as being a convenient number on which to calculate the proportion of persons living at different ages. The Table was formed as follows: Of the 236, there were fourteen between the ages of 10 and 20, and twelve above 60 years of age. But as the proportional numbers in 1000 persons living in Newcastle-upon-Tyne (to which town and its neighbourhood the patients belonged) in 1861 were 196 at the former, and 55 at the latter period of life, the percentages of dyspeptics at these periods were 7 and 21 respectively. Instead of being equally liable to indigestion, persons above sixty years of age are here seen to be three times more so than when they were below twenty. The greatest tendency to suffer from the complaint is manifested between thirty and forty years of age; it decreases between forty and sixty; and is still smaller between twenty and thirty. We might expect that age and its accompanying influences would produce a decided effect, not only in exciting indigestion in those otherwise liable to the disorder, but also in the development of the primary attacks of the disease. In the next Table, the numbers per cent. are grouped according to the form of the disorder with which the indigestion was ushered in. In nearly one quarter of the whole number of cases, the first symptoms of indigestion were experienced below twenty years of age, and one-tenth remembered to have suffered from the complaint when under ten. After fifty it is rare to have persons affected for the first 1 Decimals have been avoided; and the numbers in the sub-divisions, consequently, will not be found to agree with the totals. |