A TRACT UPON INDIGESTION AND THE HYPOCHONDRIAC DISEASE, WITH THE METHOD OF CURE, AND A NEW REMEDY OR MEDICINE RECOMMENDED.
BY JAMES RYMER, SURGEON.
LONDON: Printed for T. EVANS, Paternoſter Row MDCCLXXXV.
THE dyſpepſia of noſologiſts, namely, indigeſtion; and the hypochondriac diſeaſe, the va⯑pours or low ſpirits, are diſtempers generally ſo blended with each other, and with the atonic, irregular, or flying gout,* that I have univer⯑ſally [4]found the medicine here re⯑commended 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 ſto⯑mach, then the other more power⯑ful tincture muſt be uſed.
It muſt be remembered and un⯑derſtood 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 im⯑perfectly, have had the inflammatory affection of the joints, viz. the re⯑gular gout in the extremities.
[5]To prove what I have advanced it is only neceſſary to enumerate the ſymptoms of dyſpepſia or in⯑digeſtion, and of hypochondriaſis, and then compare them with the ſymptoms of the atonic or flying gout.
The chief ſymptoms of indigeſ⯑tion are a diminution of the appe⯑tite of hunger, loathing of food, nauſea, frequent inclination to reach, or ſickneſs at ſtomach, com⯑monly in the morning, and fre⯑quently 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 per⯑formed, not only had no ſuch effect, but uſed to be gratifying; cructa⯑tion, four belchings and heart⯑burn; [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 fre⯑quent hiccups and palpitations; a ſenſe of wearineſs, faintneſs, and averſion to motion, or active un⯑dertakings; ſometimes pains in the back and loins, with a general ful⯑neſs of the lower belly; irregular appetites and ſtrange cravings; alſo diarrhoea, or looſeneſs, accompanied with colic pains and gripings, waſt⯑ing 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, deſponden⯑cy, and apprehenſion of a thouſand horrors and evils; diſturbed ſleep, dreadful dreams, toſſing and watch⯑fulneſs during the night. The pa⯑tient [8]ſhall be croſs-grained, and ſnappiſh at times without cauſe; and at other times he ſhall mani⯑feſt all the goodneſs and kind heart⯑edneſs of human nature. Very ge⯑nerally 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 prin⯑cipal 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, ti⯑midity, 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 non⯑entities being repreſented to the mind as ſerious realities, and mag⯑nified into the moſt important con⯑cerns.
Such a miſerable ſtate of mind deſerves and demands our moſt ſincere commiſeration; and our beſt offices and abilities ſhould be ex⯑erted to palliate and remove it. It ought to be a great conſolation, however, that although the ſuffer⯑ings of the patient be very diſtreſ⯑ſing, [10]yet the danger is in a great meaſure imaginary; and that his cure reſts and depends as much up⯑on his own conduct, as upon the attention and ſkill of his phyſician.
It is not unworthy of obſervation that hypochondriacs generally poſ⯑ſeſs 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 cap⯑tious 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 ela⯑borate and abſtruſe thoughts, their depth of underſtanding, and the [11]coherence and ſolidity of their ar⯑guments.
Dyſpepſia, or indigeſtion; the hypochondriaſis, or low ſpirits; and the atonic, or flying gout, appear more generally among men of learn⯑ing, genius, and property, whoſe minds are conſtantly upon the rack of thought, than among the illite⯑rate, the ſtupid, and the indigent, who ſeldom experience the fatigue of ſtudy, the labour of reflection, or any cares but ſuch as are neceſ⯑ſary for the ſupply of the preſent moment.
And even among perſons of the firſt deſcription, thoſe who are poſ⯑ſeſſed of fine ſenſibility, and irrita⯑bility, 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 hu⯑mane and tender feelings, and up⯑on whoſe hardened hearts the diſ⯑treſſes and calamities of human na⯑ture make no impreſſions.
Intenſe thinking, or the labour of the brain, therefore, which ex⯑hauſts 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 hypochon⯑driaſis, &c.
The paſſions of hatred, envy, malice, love, fear, jealouſy, anger, &c. immoderate care, grief, trou⯑bles, and diſappointments, ſtudy, night-watching, cloſe application [13]to buſineſs requiring deep thought; exceſs in venery; exceſſive drink⯑ing of warm watery fluids; fre⯑quent intoxication, and immode⯑rate and ſumptuous meals; chewing and ſmoking of tobacco, which ex⯑hauſts that ſaliva requiſite for digeſ⯑tion; a ſedentary, inactive and in⯑dolent life, contribute likewiſe to the production of theſe maladies, and ought carefully to be avoided.
It is to be obſerved that the tem⯑perature and gravity, or ſpring of the air, and its dryneſs and moiſture have wonderful effects upon hypo⯑chondriacs. Thoſe who are not conſcious of this, and who pay no attention to the changes and feel⯑ings which take place in their bo⯑dies, 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 diſtem⯑per, 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 ground⯑leſs 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 pan⯑creas 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 or⯑gans; 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 mat⯑ter, &c.) viſcid phlegm glewing up [16]the paſſages and filling the bowels with hardened excrement, balls, &c. with a variety of ſimilar hypotheti⯑cal 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 philoſo⯑phy, fortitude and ſelf-denial enough to avoid and abſtain from all the remote cauſes of indi⯑geſtion and hypochondriaſis, ſo a complete and what is called a radi⯑cal 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 conſtitu⯑tion [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 mi⯑tigate 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, no⯑thing need be advanced in this tract. As they proceed from very different cauſes they require a different treat⯑ment. 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 ne⯑ver, 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 func⯑tion 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 be⯑come 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 ſepa⯑rated; 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 pro⯑per and natural ſtimulus, and from the diminiſhed energy of the peri⯑ſtaltic 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 lit⯑tle [20]nouriſhing chyle; and, ferment⯑ing in their own way, the bowels are filled and diſtended with air con⯑tinually evolving from them, till their expulſion. In ſuch a caſe, to eaſe the patient of his ſufferings, if no looſeneſs occur, it becomes neceſ⯑ſary 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 e⯑metics, 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 be⯑comes 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 preſ⯑ſure of his misfortunes and afflic⯑tions.
It is to be taken notice of, that all the ſymptoms I have enumerated, never take place at one time, in any one perſon.
If ſickneſs at ſtomach, and reach⯑ing or vomiting, be the principal ſymptoms, with a want of appetite; and if theſe have been of long dura⯑tion, or the conſequences of repeated exceſs, it would be neceſſary to cleanſe the ſtomach by drinking ca⯑momile 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 ge⯑neral, [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 bo⯑dily 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 ve⯑getables 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 pre⯑ſerved 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 pre⯑fer 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 ſome⯑thing, 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 pro⯑ceed as before, and perſevere in [26]ſuch a plan of temperance, mode⯑ration, exerciſe, and amuſements, till he ſhall have acquired a better ſtate of health, when he muſt ne⯑ver, or as ſeldom as may be, com⯑mit 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 pro⯑mote cheerfulneſs and rational mirth, taking care never to be al⯑together idle, and in a ſtate of ennui; that is never to be ſo thoroughly va⯑cant 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 be⯑gins 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 hun⯑ger 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 abſur⯑dities [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 pa⯑tients, once or twice a week.
Cold bathing, as it ſtrengthens and braces the whole body, will be very beneficial.
Electricity quickens the circula⯑tion, and increaſes perſpiration and all the excretions; and ſparks taken from the belly, or the application of elec⯑tric friction over the whole abdomen, will ſtrengthen the alimentary canal remove obſtructions of the ab⯑dominal [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 coſ⯑tiveneſs.
Patients who ſuffer much from coſtiveneſs, ſour belchings and heart⯑burn, and who are liable to ſpaſms and cramps, will reap much benefit by taking one, two, three, or four oc⯑caſionally, at bed time, of the follow⯑ing 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 Apo⯑thecary.
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 Indi⯑geſtion 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, Biſhopſ⯑gate 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.
Reigate, 22d Nov. 1784.