A TRACT UPON INDIGESTION AND THE HYPOCHONDRIAC DISEASE, WITH THE METHOD OF CURE, AND A NEW REMEDY OR MEDICINE RECOMMENDED.
BY JAMES RYMER, SURGEON.
— VIDES, UT PALLIDUS OMSIS CAENA DESURGAT DUBIA.—
—VICTUS TENUIS QUAEQUANTAQUESECUM ADFERAT.—
HORACE.
LONDON: Printed for T. EVANS, Paternoster Row MDCCLXXXV.
A TRACT UPON INDIGESTION, AND THE HYPOCHONDRIAC DISEASE.
THE
dyspepsia
of nosologists, namely, indigestion; and the hypochondriac disease, the vapours or low spirits, are distempers generally so blended with each other, and with the
atonic,
irregular, or flying gout,
See my tract upon the gout.
that I have universally found the medicine here recommended to mitigate the various symptoms, and invigorate the whole habit, where it was used for a due length of time in proper doses, and when the patients strictly pursued the rules of regimen and exercise which I prescribed: but when the gout has absolutely seized the stomach, then the other more powerful tincture must be used.
It must be remembered and understood when I say that
dyspepsia
and
hypochondriasis
are generally blended with the
atonic
gout, that I confine myself chiefly to persons who never, or very rarely and imperfectly, have had the inflammatory affection of the joints, viz. the regular gout in the extremities.
To prove what I have advanced it is only necessary to enumerate the symptoms of
dyspepsia
or indigestion, and of
hypochondriasis,
and then compare them with the symptoms of the
atonic
or flying gout.
The chief symptoms of indigestion are a diminution of the appetite of hunger, loathing of food, nausea, frequent inclination to reach, or sickness at stomach, commonly in the morning, and frequently at the sight, or smell, or even bare mention of particular dishes, which, when the stomach was in proper order, and digestion and chylification were duly performed, not only had no such effect, but used to be gratifying; cructation, four belchings and heartburn; fullness of the stomach, with a grumbling noise in the bowels caused by the motion of wind or air in the intestines; gnawing pains about the region of the stomach, generally attended with costiveness; confused head-achs; anxiety and oppressions at the heart, with frequent hiccups and palpitations; a sense of weariness, faintness, and aversion to motion, or active undertakings; sometimes pains in the back and loins, with a general fulness of the lower belly; irregular appetites and strange cravings; also diarrhoea, or looseness, accompanied with colic pains and gripings, wasting of the whole body, universal debility, relaxation, loss of tone, and flabbiness of all the muscular or fleshy parts.
In consequence of these sufferings of the body, the temper and mind are often wonderfully affected. The patient becomes peevish and touchy at mere trifles; dejected, timid, distrustful; bereft of hope as to his cure, and all future events; with aversion to society.
In
hypochondriasis,
besides the foregoing symptoms of indigestion, the patient is sometimes attacked with a copious spitting, like unto a salivation; with various spasms, cramps, and pains about the chest, shoulders, and back. Moreover the mind and temper are generally more affected by whim, fear, despondency, and apprehension of a thousand horrors and evils; disturbed sleep, dreadful dreams, tossing and watchfulness during the night. The patient shall be cross-grained, and snappish at times without cause; and at other times he shall manifest all the goodness and kind heartedness of human nature. Very generally no persuasion can have any effect in removing his very dismal and fixed expectation of a variety of evils which will never come to pass.
If we compare some of the principal symptoms of each of these diseases, we shall discover a near and striking resemblance between them. For in the
atonic
gout there are pretty constantly very marked symptoms of hypochondriasis, as dejection of spirits, seriousness, timidity, distrustfulness, fickleness, caution and care about absolute trifles; waspishness, and sometimes apparent rudeness to inferiors, a want of kind and civil attention and good breeding to equals, with indifference and great shyness to strangers; all the great powers and generous passions of the mind being subdued by the depressing influence of melancholy, and the conception of a variety of evils, santastical, and groundless—shadows and nonentities being represented to the mind as serious realities, and magnified into the most important concerns.
Such a miserable state of mind deserves and demands our most sincere commiseration; and our best offices and abilities should be exerted to palliate and remove it. It ought to be a great consolation, however, that although the sufferings of the patient be very distressing, yet the danger is in a great measure imaginary; and that his cure rests and depends as much upon his own conduct, as upon the attention and skill of his physician.
It is not unworthy of observation that hypochondriacs generally possess the best rudiments of health and longevity notwithstanding the apparent flimsiness and craziness of their constitutions; and that when in a company they like, if the captious humour be absent, many will not only shine and excel in vivacity and sprightliness of fancy, off-hand wit, and an aptness and rapidity in arranging their ideas; but often raise our admiration by their elaborate and abstruse thoughts, their depth of understanding, and the coherence and solidity of their arguments.
Dyspepsia,
or indigestion; the hypochondriasis, or low spirits; and the
atonic,
or flying gout, appear more generally among men of learning, genius, and property, whose minds are constantly upon the rack of thought, than among the illiterate, the stupid, and the indigent, who seldom experience the fatigue of study, the labour of reflection, or any cares but such as are necessary for the supply of the present moment.
And even among persons of the first description, those who are possessed of fine sensibility, and irritability, of great vivacity, spirits, and ready wit, are more liable to these diseases than those who appear on all occasions easy, careless and unconcerned; who have no humane and tender feelings, and upon whose hardened hearts the distresses and calamities of human nature make no impressions.
Intense thinking, or the labour of the brain, therefore, which exhausts the finest spirits, the nervous influence, the pabulum cogitationis the
internuncii
of the soul, (call it what you will) while the whole body remains inactive, and the muscular system relaxed, must be a powerful remote cause of hypochondriasis, &c.
The passions of hatred, envy, malice, love, fear, jealousy, anger, &c. immoderate care, grief, troubles, and disappointments, study, night-watching, close application to business requiring deep thought; excess in venery; excessive drinking of warm watery fluids; frequent intoxication, and immoderate and sumptuous meals; chewing and smoking of tobacco, which exhausts that saliva requisite for digestion; a sedentary, inactive and indolent life, contribute likewise to the production of these maladies, and ought carefully to be avoided.
It is to be observed that the temperature and gravity, or spring of the air, and its dryness and moisture have wonderful effects upon hypochondriacs. Those who are not conscious of this, and who pay no attention to the changes and feelings which take place in their bodies, by the rising and falling of the mercury in the barometer, and by particular winds, are apt to attribute their sufferings either to the nature of their own distemper, to their own conduct, or to the want of attention, management, and skill of their physician.
It is not unnecessary to mention, that in the above diseases,
dyspepsia
and
hypochondriasis
especially, the patients are apt to harbour many incoherent, whimsical, and groundless notions concerning the cause of their disorder. Some persons will fancy, and insist upon it, that the cause of all their complaints is a scorbutic humour in the blood which is thrown upon the offending parts, as the stomach, and bowels, &c. others imagine the cause to be some relics of insection, or the dregs of some violent and acute disease which they have had twenty or thirty years before. Some will have the cause to be seated in the internal surface of the oesophagus and stomach; others in the liver and gall-bladder; others in the pancreas and spleen; some again in the mesentery and small guts only, with schirrhosity of the lacteal and lymphatic glands; and others, in the great guts and rectum, with obstructions in these different organs; convulsions, cramps, spasms, pullings, pinchings of the navel; gripings and twisting of the guts; and (because strong purges abrade and discharge the natural mucus which lines, sheathes and defends the inner coats of the intestines from the stimulus of acrimonious matter, &c.) viscid phlegm glewing up the passages and filling the bowels with hardened excrement, balls, &c. with a variety of similar hypothetical absurdities, which frequently have no existence but in the minds of the patients.
As it is not to be expected that every person can have philosophy, fortitude and self-denial enough to avoid and abstain from all the remote causes of indigestion and hypochondriasis, so a complete and what is called a
radical cure
is an affair of a doubtful nature. But if the patient will follow some of the principal rules I shall here give, and continue to take the remedy according to the directions given with it, he may depend upon enjoying a far better state of mind, temper, and constitution than he at present possesses; and, probably, go through life to a good old age, with a share of comfort and happiness he might have but little expected. To soften and mitigate the various natural evils which in many instances render this life a load, while it yet lasteth, is surely well deserving of any pains and attention that can be bestowed by a rational being.
With respect to a peculiar species of
hypochondriasis
and
hysteria,
nothing need be advanced in this tract. As they proceed from very different causes they require a different treatment. They must be relieved by a method altogether different from that which I have taken the liberty to recommend for the cure of the maladies I have been describing.
It is remarkable that eunuchs never, or very rarely, have the gout, or become hypochondriacs.
In
dyspepsia
and
hypochondriasis
it is very certain that the stomach and intestines have lost their natural tone and energy; that the peristaltic or propulsive motion of the alimentary canal is greatly diminished and weakened; that the office, or function of digesting the food, so as to produce that bland nutritious chyle, assimilated into the animal nature, is deranged and imperfect; and that, from this loss of tone and energy in the stomach and intestines, the liquor or ferment of digestion in the stomach is so changed, and become so peculiarly acid, that, instead of disposing the aliments to dissolve or digest into the animal nature, it very evidently throws them into a kind of vinous fermentation; in which process a great quantity of fixed and other air or wind is separated; and remaining still hard and undigested, nature, considering them as extraneous substances, brings on nausea, or sickness, to eject them by vomiting; or, if such
ingesta
pass from the stomach into the guts, from the loss of tone, want of a proper and natural stimulus, and from the diminished energy of the peristaltic motion of the intestines, they become a mere load; and it is often a long time before they can make their way to the natural outlet. During their passage from the
pylorus
to the
anus,
not being disposed to mix with the solvents of bile and pancreatic juice, they yield very little nourishing chyle; and, fermenting in their own way, the bowels are filled and distended with air continually evolving from them, till their expulsion. In such a case, to ease the patient of his sufferings, if no looseness occur, it becomes necessary to administer vomits, and purges or clysters; by the repetition of which the whole alimentary canal becomes insensible to every common stimulus; so that without strong emetics, drastic purges, and very stimulating clysters, the patient can have neither comfort nor stools; and thus the body being deprived of its due nourishment, and the brain and nerves of spirits, the patient becomes at length entirely emaciated, miserable in mind and body; and too frequently recurring to the last wretched resource, spirituous and intoxicating liquors, and inefficacious cordials, finally sinks under the pressure of his misfortunes and afflictions.
It is to be taken notice of, that all the symptoms I have enumerated, never take place at one time, in any one person.
The CURE.
If sickness at stomach, and reaching or vomiting, be the principal symptoms, with a want of appetite; and if these have been of long duration, or the consequences of repeated excess, it would be necessary to cleanse the stomach by drinking camomile tea, or by an emetic; after which, every morning, an hour at least before breakfast, let the patient ink either a small tumbler-ful of a cold infusion of camomile flowers, or about half a pint of pure cold water: then, if the weather and other circumstances admit of it, let him take a walk for the space of half an hour or so, and return to breakfast; which may consist of water gruel, with a spoonful of rum, some crumbs of toast, and, if the stomach can bear them, a little butter and sugar, or salt; or his breakfast may be tea and toast only; or it may be panada, or thin weak broth, with a glass of mountain, sherry, or madeira in it, and some toast or a crust of well-baked bread. After breakfast let him use that kind of exercise which not only employs the body, but also engages the attention, for an hour or more.
For which reason travelling in general, or through such a country as England, from town to town, as it affords a variety of new and curious objects, and draws off the attention of the mind from infirmities and bodily sufferings, is always highly useful.
Every day at noon, or an hour or two before dinner, I beg leave to advise the patient to take one table spoonful of my tincture, unmixed, and by itself.
At dinner let him eat of fish, or of any simple and tender meat, that quantity which shall be less than he can and desires to eat. Of his bread, which must be thoroughly baked, he ought to eat but little. He must either abstain altogether from vegetables and fruit, or eat a small quantity of such as he finds to be of easy digestion; of cheese very little; his drink during the meal should be fair water with a toast. Every thing he eats must be minutely and thoroughly masticated and chewed into a smooth pulp before deglutition.
After dinner, he may, if he choose, drink three or four glasses of some generous wine, or rum, brandy, or true geneva mixed with water, a few bits of sugar and preserved bitter orange peel being added; the proportion should be one glass of spirits to four glasses of water.
At six or seven o'clock in the evening he may drink two or three dishes of tea, or some coffee; the black tea, as congou or souchong, will be best.
His supper should be very trifling indeed; he may eat, if so disposed, a very little of any thing there may be at table, which he knows to be of a light nature. He should prefer toast and water for his drink, but if he be fond of malt liquor, let him never exceed a pint of the best and clearest old porter, which should by no means be stale and hard.
After supper, if he wish for something, let him drink a few glasses of warm rum and water, mixed as above.
When he goes to bed if he should be uneasy at stomach in consequence of wind or pains, let him take one table spoonful of the tincture, and then go to rest.
The day following he must proceed as before, and persevere in such a plan of temperance, moderation, exercise, and amusements, till he shall have acquired a better state of health, when he must never, or as seldom as may be, commit any excess. His exercise should never be carried to such a degree as to induce fatigue or a sense of weariness; and his amusements must be of that nature which shall promote cheerfulness and rational mirth, taking care never to be altogether idle, and in a state of
ennui;
that is never to be so thoroughly vacant and lost as to have the
fidgets,
and not to know what to do with himself or how to spend and kill his time.
Every time he shifts himself let him have his body well chafed and rubbed by a stiff flesh-brush till he feel an universal glow.
If costiveness be the principal symptom, let the patient take a sinall dose of physic before he begins with the tincture, and then proceed as above.
That kind of food which yields much nourishment, and is easy of digestion, is always to be preferred, because of such aliment a less quantity will suffice, and the stomach will not be loaded, nor the bowels distended with air.
The patient should always finish his meal before the appetite of hunger shall be satisfied; that is, he should be able to say, I could eat more, but I will not.
He must never add another meal to one yet undigested: of all absurdities and evils in relation to the above diseases, none are greater than eating when one is not hungry, and drinking when one is not dry. There must be no drinking between meals; no relishes nor gills of wine before dinner; such a habit is
felo de se.
Stock fish is a nourishing food of easy digestion, and it will agree with, and be proper for many patients, once or twice a week.
Cold bathing, as it strengthens and braces the whole body, will be very beneficial.
Electricity quickens the circulation, and increases perspiration and all the excretions; and sparks taken from the belly, or the application of electric friction over the whole abdomen, will strengthen the alimentary canal remove obstructions of the abdominal viscera; and by promoting the secretion of mucus from the inner surface of the intestines, and by increasing their peristaltic motion, will powerfully tend to remove costiveness.
Patients who suffer much from costiveness, sour belchings and heartburn, and who are liable to spasms and cramps, will reap much benefit by taking one, two, three, or four occasionally, at bed time, of the following pills. In order that these pills may be made of the best ingredients and properly mixed, it will be necessary to have them from the family Apothecary.
℞ Aloes Socotor. ʒ i.
Extract. Flor. Chamoemel. ʒ ss.
Camphorae ℈j (in spt. vin. rectificat. solut.)
Magness. alb. ℈ ij.
Syr. croc. q. s.
F. massa dividenda in pilulas xxiv.
Some patients will find it requisite to take two or more of the above pills every night at bed time; and immediately after having swallowed them, the patient should take one table-spoon full of the tincture.
The public is respectfully informed that the Tincture for the Gout in the Stomach; and the Tincture for Indigestion and Low Spirits, are prepared and sold by myself at my house in
Reigate;
and carefully delivered into the hands of Messrs. Armitage and Roper, Stationers, No. 63, Bishopsgate Within, where only they may be bought at the following prices.
The Tincture for the Gout in the Stomach, at half a guinea the half pint bottle.
The Tincture for Indigestion and Low Spirits at five shillings and three pence the bottle.
Every bottle has a label upon it which is signed by James Rymer.
If persons afflicted as above shall be desirous of corresponding with Mr. Rymer, they may depend upon receiving every information and advice in his power to grant.
Reigate,
22d Nov.
1784.
FINIS.