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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.

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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,* that I have univerſally [4]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.

[5]

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; [6]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.

[7]

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 [8]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 [9]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, [10]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 [11]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 [12]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 [13]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 [14]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 [15]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 [16]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 [17]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.

[18]

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, [19]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 [20]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 [21]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 [22]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, [23]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; [24]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 [25]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 [26]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 [27]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 [28]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 [29]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.)
[30]
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 [31]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.

FINIS.
Notes
*
See my tract upon the gout.
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Citation Suggestion for this Object
TextGrid Repository (2020). TEI. 5610 A tract upon indigestion and the hypochondriac disease with the method of cure and a new remedy or medicine recommended By James Rymer. University of Oxford Text Archive. . https://hdl.handle.net/21.T11991/0000-001A-5D84-7