From whence is it possible, that this great quantity of fluid for many successive days can be supplied, after the cells of the body have given up their fluids, but from the atmosphere? When the cutaneous branch of absorbents acts with unnatural strength, it is probable the intestinal branch has its motions inverted, and thus a fluid is supplied without entering the arterial system. Could oiling or painting the skin give a check to this disease?

So when the stomach has its motions inverted, the lymphatics of the stomach, which are most strictly associated with it, invert their motions at the same time. But the more distant branches of lymphatics, which are less strictly associated with it, act with increased energy; as the cutaneous lymphatics in the cholera, or iliac passion, above described. And other irritative motions become decreased, as the pulsations of the arteries, from the extra-derivation or exhaustion of the sensorial power.

Sometimes when stronger vomiting takes place the more distant branches of the lymphatic system invert their motions with those of the stomach, and loose stools are produced, and cold sweats.

So when the lacteals have their motions inverted, as during the operation of strong purges, the urinary and cutaneous absorbents have their motions increased to supply the want of fluid in the blood, as in great thirst; but after a meal with sufficient potation the urine is pale, that is, the urinary absorbents act weakly, no supply of water being wanted for the blood. And when the intestinal absorbents act too violently, as when too great quantities of fluid have been drank, the urinary absorbents invert their motions to carry off the superfluity, which is a new circumstance of association, and a temporary diabetes supervenes.

[16]. I have had the opportunity of seeing four patients in the iliac passion, where the ejected material smelled and looked like excrement. Two of these were so exhausted at the time I saw them, that more blood could not be taken from them, and as their pain had ceased, and they continued to vomit up every thing which they drank, I suspected that a mortification of the bowel had already taken place, and as they were both women advanced in life, and a mortification is produced with less preceding pain in old and weak people, these both died. The other two, who were both young men, had still pain and strength sufficient for further venesection, and they neither of them had any appearance of hernia, both recovered by repeated bleeding, and a scruple of calomel given to one, and half a dram to the other, in very small pills: the usual means of clysters, and purges joined with opiates, had been in vain attempted. I have thought an ounce or two of crude mercury in less violent diseases of this kind has been of use, by contributing to restore its natural motion to some part of the intestinal canal, either by its weight or stimulus; and that hence the whole tube recovered its usual associations of progressive peristaltic motion. I have in three cases seen crude mercury given in small doses, as one or two ounces twice a day, have great effect in stopping pertinacious vomitings.

[17]. Besides the affections above described, the stomach is liable, like many other membranes of the body, to torpor without consequent inflammation: as happens to the membranes about the head in some cases of hemicrania, or in general head-ach. This torpor of the stomach is attended with indigestion, and consequent flatulency, and with pain, which is usually called the cramp of the stomach, and is relievable by aromatics, essential oils, alcohol, or opium.

The intrusion of a gall-stone into the common bile-duct from the gall-bladder is sometimes mistaken for a pain of the stomach, as neither of them are attended with fever; but in the passage of a gall-stone, the pain is confined to a less space, which is exactly where the common bile-duct enters the duodenum, as explained in Section [XXX. 1. 3]. Whereas in this gastrodynia the pain is diffused over the whole stomach; and, like other diseases from torpor, the pulse is weaker, and the extremities colder, and the general debility greater, than in the passage of a gall-stone; for in the former the debility is the consequence of the pain, in the latter it is the cause of it.

Though the first fits of the gout, I believe, commence with a torpor of the liver; and the ball of the toe becomes inflamed instead of the membranes of the liver in consequence of this torpor, as a coryza or catarrh frequently succeeds a long exposure of the feet to cold, as in snow, or on a moist brick-floor; yet in old or exhausted constitutions, which have been long habituated to its attacks, it sometimes commences with a torpor of the stomach, and is transferable to every membrane of the body. When the gout begins with torpor of the stomach, a painful sensation of cold occurs, which the patient compares to ice, with weak pulse, cold extremities, and sickness; this in its slighter degree is relievable by spice, wine, or opium; in its greater degree it is succeeded by sudden death, which is owing to the sympathy of the stomach with the heart, as explained below.

If the stomach becomes inflamed in consequence of this gouty torpor of it, or in consequence of its sympathy with some other part, the danger is less. A sickness and vomiting continues many days, or even weeks, the stomach rejecting every thing stimulant, even opium or alcohol, together with much viscid mucus; till the inflammation at length ceases, as happens when other membranes, as those of the joints, are the seat of gouty inflammation; as observed in Sect. [XXIV. 2. 8].

The sympathy, or association of motions, between those of the stomach and those of the heart, are evinced in many diseases. First, many people are occasionally affected with an intermission of their pulse for a few days, which then ceases again. In this case there is a stop of the motion of the heart, and at the same time a tendency to eructation from the stomach. As soon as the patient feels a tendency to the intermission of the motion of his heart, if he voluntarily brings up wind from his stomach, the stop of the heart does not occur. From hence I conclude that the stop of digestion is the primary disease; and that air is instantly generated from the aliment, which begins to ferment, if the digestive process is impeded for a moment, (see Sect. [XXIII. 4].); and that the stop of the heart is in consequence of the association of the motions of these viscera, as explained in Sect. [XXXV. 1. 4].; but if the little air, which is instantly generated during the temporary torpor of the stomach, be evacuated, the digestion recommences, and the temporary torpor of the heart does not follow. One patient, whom I lately saw, and who had been five or six days much troubled with this intermission of a pulsation of his heart, and who had hemicrania with some fever, was immediately relieved from them all by losing ten ounces of blood, which had what is termed an inflammatory crust on it.