drink freely with him."* It is, doubtless, more rational to adopt this emptying habit than to die from an overloaded stomach; and, as we scruple not to take an emetic to remove indisposition, we see not why it should not be taken to prevent it. They, however, who think otherwise, must be content to submit their appetites to a rigid rule. We lay it down then as a general rule, liable to very rare exceptions, that three light meals at the utmost, with meat at one only, are as much as any one, much more a dsypeptic, should venture on; and if he make them two, it will, perhaps, be so much the better. Between these meals no luncheon or any thing whatsoever should he eaten ; and any repast in the nature of supper, after eight o'clock, should be eschewed. Some physicians have recommended that we should eat little and often. And Drs. Potter and Calhoun, in their edition of Gregory's Elements, say, "it will be proper, when the person is disposed to inordinate indulgence, to take some food half an hour before the regular meal, &c. to prevent oppression of the organ." To this Dr. Paris objects, because the several processes of chymification, chylification, &c. follow each other in a certain order, as he says, and "cannot be simultaneously performed without such an increased expenditure of vital energy as weak persons cannot, without inconvenience, sustain: thus chylification would appear to require the quiescence of the stomach, and sanguinification to be still more incompatible with the act of chymification. If, therefore, the stomach be set to work during the latter stages of digestion, the processes will, in weak persons, be much disturbed, if not entirely suspended." He adds, "the specious aphorism of Dr. Temple, that the stomach of an invalid is like a schoolboy, always at mischief unless it be employed, has occasioned more dyspeptic disease than that respectable physician could ever have cured, had his practice been as successful as that of Esculapius, and his life as long as that of an antediluvian." The reasons given by Dr. Paris are not satisfactory. He assumes the fact that chymification and chylification cannot be carried on at the same time without too great an expenditure of vital power; yet if Dr. Philip's account of digestion be correct, the chyme is gradually formed and poured into the duodenum as it is formed, whereby a fresh surface of food is exposed to the gastric juice-consequently, these two processes are simultaneous after the first layer of food has been chymified. But we have no doubt of the injurious nature of the practice for other reasons. It interrupts the healthy habits of the stomach by putting it to work at irregular periods 2 * Middleton's Life of Cicero, vol. ii. p. 419. it keeps it almost constantly employed-"all work and no play"—and it destroys the appetite which nature has implanted to excite the flow of saliva and gastric juice. An exception, however, must be made when the stomach is unable to bear food enough at one time, but such cases are very rare, and when such patients become a little stronger, the practice of a little and often should be abandoned. An afflicted dyspeptic, who is not too far gone, usually, as we have said, eats too much. If he doubts this, let him first convince himself of the fact. He may place the milk-pan by his side during every meal for one day, and put into it as much of every thing as he helps himself to and eats, liquids as well as solids. The amount, at the conclusion of the last meal, will astonish and convince him. As soon as he is satisfied on this point, let him reduce the quantity consumed at that particular meal which precedes his customary attacks, to one-half, and mark the effect. If the attacks come on after breakfast, that meal is, perhaps, the cause; if at any other period of the day, the fault is, probably, in the dinner. If the reduced meal produce no sensation in the stomach, pleasant or the reverse, his standard is discovered; but if, after several trials, his painful symptoms recur, let him by degrees go on and decrease the amount of each meal, till he ceases to experience any inconvenience from his food. Thereafter, he must judge solely by his eye, and be careful how he trusts to his appetite for the measurement. "When the gustatory nerves," observes the facetious Dr. Kitchener, "are in good humour, hunger and savoury viands will sometimes silence the tongue of a grand gourmand to betray the interests of his stomach in spite of his brains." To prevent this, he must put on his plate at first all he intends to eat, and on no account add to it afterwards. The hunger he may possibly feel, will endure but a few minutes, when it will be succeeded by a philosophical calm as gratifying to his self-love as to his bodily feelings. He will thenceforth rise from his repasts with a serenity to which he had long been a stranger. Dr. Philip recommends another method, which, if duly observed, will lead to the same felicitous result. He says, "the dyspeptic should carefully attend to the first feeling of satiety. There is a moment when the relish given by the appetite ceases: a single mouthful taken after this, oppresses a weak stomach. If he eats slowly, and carefully attends to this feeling, he will never overload the stomach." Dr. Paris coincides fully with him in this opinion, and we have no doubt of its correctness : but there are so few who can trust to this warning from satiety, that we doubt its general usefulness. The only safe method of judging is, as we have said, by the eye. But they who love to eat will use ingenious arguments to convince themselves that they require more food than is thus allowed them. They will declaim against starvation, and their friends will join them; they will complain that it produces faintness and weakness, and renders them unfit for the active duties of life. This is all delusion, all wilful self-deception. More nourishment and strength are imparted by six ounces of welldigested food than by sixteen imperfectly concocted. It is truly astonishing what a small quantity of food will nourish a man. The quantum contained in two eggs, some say one, administered each day, will keep him alive and pretty well for six months. The weakness which is, perhaps, justly complained of, at first, upon a reduction of food, proceeds more from the change of habit than the wants of nature. Bodily strength is maintained, as well as disorders repelled, by moderate diet. Those old persons who eat the least quantity, and the coarsest victuals are universally the strongest. Of this, several instances are given by dietetical writers. "Old Parr, says one of these, who lived to see his hundred and fifty-third year, was always exceedingly temperate, and there is every reason to believe that he would have lived many years longer had he not been taken into the family of the Earl of Arundel, for in examining his body the physicians found every inward part sound and strong. They, therefore, justly concluded, that the change to a plentiful diet so disordered his body as to prove a speedy cause of death. Henry Jenkins of Ellerton, in Yorkshire, who lived to the age of one hundred and sixty-nine, was a poor fisherman, and when he could no longer follow this occupation, he went begging about Bolton and other places, his diet being uniformly coarse and sour. The Cardinal de Salis, Archbishop of Seville, who died at the age of one hundred and ten, states his diet to have been universally sparing; and that Cornaro's, (who lived to above one hundred years) was so, is well known. The celebrated physician Galen, lived to see his hundred and fortieth year, and was from the age of twenty-eight, always sparing in the quantity of food he took. In addition to these instances, the fourteenth volume of the Philosophical Transactions contains an account of a number of very old persons in the north of England, and it is said their food, in all that mountainous country, is exceedingly coarse, as salted beef and sour-leavened oatbread." No stress has been laid on the quality of the articles of food, but it deserves some attention. According to Dr. Paris, it is mere folly to state that such or such an article is wholesome or otherwise, for it may be very beneficial to one and very injurious to another. "Its wholesomeness depends on its fitness to produce the particular effect which the case in question may require." Van Swieten has said, that "to assert a thing to be wholesome without a knowledge of the condition of the person for whom it is intended, is like a sailor pronouncing the wind to be fair without knowing to what port the vessel is bound." We so far agree with these gentlemen, that we would not recommend an absolute abandonment, without trial, of those things which are generally reputed to be difficult of digestion, if the patient craves them: for there is no universal rule on this subject. Because Titius has been injured by eating cabbage, it does not follow that Caius must entirely avoid it, but simply that he must be very cautious to test it before he feeds on it. Habits too must be attended to; for, as Dr. Calhoun justly observes, a dyspeptic Irishman can digest a potato which would kill a Scotchman. So bacon and long collards might lie easy in the bag of a Virginian, when they would raise a tempest in that of a NewEnglander, whose stomach would rejoice in a sop of molasses that would turn the Virginian's insides into a vinegar cask. But as many things have been determined by the majority of dyspeptics and others, to be of difficult digestion, it may be as well to give a short list of the most prominent. At their head stand all liquids, hot and cold, simple and compound. At meals they should be used only in small quantities, particularly at dinner : at the distance of three or four hours after a meal they may be taken more freely; but much should never be indulged in. We have heard of persons of weak stomach being restored to health by never drinking at all; but this absolute negation we do not recommend. The reason why liquids should be avoided is because they are indigestible themselves, and their presence, in too large quantities, puts a stop to the labours of the stomach upon the solid food. The gastric fluid, it will be recollected, becomes mixed with the food contiguous to the sides of the bag and dissolves that portion first into chyme: but it cannot mix with liquids, for they escape its contact. It is a ropy and viscid fluid, and cannot combine with liquids unless it change them into solids as it does inilk; then it digests the solid part, and the fluid is absorbed and finds its way into the blood without passing through the intestines. So with all fluid mixtures; their solids are first deposited or combined, with the food in the stomach, and their liquids pass off, but not by digestion; but their presence, in considerable quantities, stops the progress of chymification, till absorption takes place; but this absorption is not VOL. IV.-No. 7. 29 digestion. Even the most concentrated liquid, extracts of meat, jellies, &c. if unmixed with something solid are indigestible. "A person under my care, (says Dr. Philip) was attacked with a severe pain of the face whenever the smallest quantity of solid food was put in the stomach; a single mouthful of bread never failing to bring on the attack; and as he at length refused all solid food, he was confined, for some weeks, to a strong decoction of beef; but, however strong, and in whatever quantity it was taken, it never relieved the calls of hunger, and he rapidly emaciated." Sir John Sinclair, in his Code of Health states, that a dog was fed on the richest broths, yet could not be kept alive; whilst another that had only the meat boiled to a chip, and water, throve very well. But this is not all. Liquids, in quantities, impede the regular secretion of the gastric juice, which is only given out freely, and in a proper state to the gentle stimulus of that food which it can master. Solids are rendered sufficiently soft by mastication, and the saliva they then imbibe. The quantity of this fluid swallowed during a meal is much greater than is generally supposed. In the case of a felon who cut his throat in prison, and so completely divided both the larynx and the esophagus at the same point, that whatever was introduced into the mouth escaped by the external wound, it was found that during each meal there was a discharge of saliva from the mouth amounting to from six to eight ounces, or even more. Now we must say that the dyspeptic who freely drinks, particularly spirits, wine and fermented liquors, prefers them to health. Their stimuli not only irritate the gastric nerves, but increase the circulation of the blood, and tend to the production of morbid affections of the head, heart and liver. The difference, however, between these liquors is worthy of notice. Their common base is alcohol; but the effects resulting from brandy, either pure or mixed with water, and that quantity of wine which is combined with the same portion of brandy, are very dissimilar. According to Mr. Brande's table, Madeira, Sherry and Port contain one fourth of pure alcohol in a state of combination not mixture; Claret has about 15 per cent. of it; Champagne, Burgundy and Hermitage, about 12 per cent.; and brandy, rum, gin, &c. about 53 per cent. The wines commonly have an additional quantity of brandy mixed with them by the vintner before exportation; but without considering this addition, the above table shows that Madeira, Sherry and Port,* are * Mr. Brande's results were obtained by distillation, (see a detail of the process in the Philosophical Transactions for 1811, Part II.) and there is no doubt entertained of their accuracy. But it has been denied that he has thereby succeeded in confuting, as he thinks he has, the old notion that the alcohol, obtained by distilla |