If the system of man resembled a machine, which, once in motion, continued an unvaried power, and retained an equality of force, merely requiring, when deranged, the tightening of a screw, the readjustment of a strap, or the addition of a quantity of oil, little knowledge would be required in the regulation of its functions; but when we find the constitutions of men as varied as their countenances, the affections of the body, numerous and diversified, never preserving identically the same characters in two cases, or requiring the same exact treatment in diseases, apparently of the same nature, we discover that something more than the artifice of the quack is necessary in their government and repair.
It would indeed be a Herculean task to administer the rod of correction to all the advertizing medical gentry of the day: it could be done, and with justice to the community; but it would be wearisome. A champion, however, has recently entered the medical arena, with whom we would fain contend, not only in the hope of conquest, but in the expectation that others may take warning by his defeat. With him we will now alone engage, and thus throw down our gauntlet.
A work has very lately appeared, professing to be a "New Method of Curing Dyspepsia, discovered and practised by O. Halsted of New-York." This publication sails in the wake of a tolerably successful practice amongst the dyspeptics of the day, who have resorted to the temple of our author "with faith sufficient to promote a cure." So long as this continued, all interference was of course out of the question, as every individual possesses an undoubted right to tamper either with his judgment or his money; but when this aspirer after dyspeptic fame leaves his concealment, and issues his discoveries and practices to the world, he invites the battery of opinion, and renders himself at once amenable to remark and investigation. A few words, however, on the subject of dyspepsia, may not be amiss, before we take leave to reply to Mr. Halsted.
This much abused term, is a compound of two Greek words, signifying "bad concoction," or bad digestion, alias indigestion, and sufficiently expressive of a condition in which the aliments supplied to the stomach are not met by a vigorous and sufficient action for the purposes of health; but this definition, however just, is not comprehensive enough for the genius of mankind. That genius, which, in former times, has sanctioned the appellations of nervous disorders, and bilious complaints, as comprising nearly all others, has now selected the term of dyspepsia, as the covering for a multitude of real and imaginary woes; so that when an invalid approaches with a variety of symptoms, and a host of pains or whimsies, he is at once pronounced to be a Dyspeptic.
The book before us, commences with a short account of the organs engaged in the process of digestion, copied from a periodical work of the day, very good as far as it goes, and leaving nothing to be desired on the score of brevity: our author then pursues his task, by a detail of the symptoms of what he calls dyspepsia; from what work he procured these, or from what unhappy wretch he could gain such a list of grievances, as he describes arising from indigestion, does not appear; if they be in existence now, the sooner the one is burnt and the other buried, the better. It is evident that Mr. Halsted is unaware that dyspepsia occurs, in one of two ways; either as a primary affection, or as a symptom of other diseases; that he is unacquainted with the share the liver, with its biliary apparatus, the pancreas, the spleen, the mesentery, the omentum, &c. take in digestion, and of the symptoms occasioned by an affection of these organs; it may therefore be adviseable to devote a few lines to the consideration of these points, as well for the satisfaction of the public, as for his instruction and the improvement of his second edition. Dyspepsia, or indigestion in its simple form, occurs either as a disease of debility, or as a consequence of excess: the first arises from numerous causes, and seldom exists alone: the secretion of the gastric juice is not only impaired, for the office of no organ continues in a state of activity, all alike feeling the result of that general depression affecting the system at large: the second may be referred to the stomach itself, as a natural effect from over-feeding, or indulgence in spirituous liquors. Dyspepsia, occurring as a symptom in other diseases, appears under numerous characters, either from the effects of sympathy, or from an extension of the malady to the stomach itself. It may be readily granted that all the symptoms described by Mr. Halsted, take place, in consequence of an affection of the stomach, either primarily or secondarily; but to assert that they are the results of a bad concoction of the viands we eat and drink, and to act accordingly, is to misunderstand the meaning of a term, as well as the treatment of a disorder.
It is stated, in this work, that dyspepsia is Protean in its symptoms, but single and uniform in its nature; the very reverse is the fact; its symptoms are of a single character, and of an uniform attack, while its nature is variable and inconstant. A dyspeptic will complain of a want of appetite, a degree of squeamishness and irritability, eructations, heart-burn, pain in the head, stomach, and bowels, with costiveness; his tongue will be furred, and his pulse a little increased in strength and quickness. To use the language of Dr. Armstrong, "the most constant symptoms of dyspepsia, are a furred tongue, flatulence of the stomach, and fretfulness, or depression of spirits;" he goes on to say, "these may arise primarily from disorder or disease in the stomach itself, or they may depend upon an affection of the brain, liver, bowels, or some other remote or adjacent part." The nature of dyspepsia depends totally upon its cause, and where so many circumstances may occasion it, it is difficult to imagine one more variable. The important organs before alluded to, so necessary to the economy of life, are all liable to the most severe visitations of disease. Not to be too prolix, take, for the sake of example, the first on the list, the liver: both in the acute and chronic forms of inflammation of this viscus, how important a change is wrought in the digestive functions, how enfeebled does the system become during its continuance, and how futile would be the attempt to relieve the malady by merely attacking one of its symptoms! And so, of the other viscera, all marked when in a morbid state by peculiar characteristics, not only affecting their own action, but all the parts in their neighbourhood, the stomach as one of the great centres of the system in particular; and yet, with all these facts in review, are we presented with a list of ailments as dependant upon an impropriety in digestion, which may in all probability (at least the greater part of them) be traced to a source totally different. A careful discrimination of the origin of disease is as necessary as any after treatment, which can never, indeed, be applied with a reasonable chance of success without it.
Mr. Halsted recommends a change to a more temperate climate, travelling, regular exercise, particularly on horseback, and above all, moderation in eating and drinking; asserting, that if these means of recovery be neglected, things will inevitably go on from bad to worse. Astonishing! These new precepts, from the pen of such a distinguished practitioner, cannot be too highly extolled, and should be classed with the recommendation of old Parr; "keep your head cool by temperance, your feet warm by exercise; never eat but when you are hungry, nor drink but when nature requires it." Had the author stopped here, there would have been no occasion for a rejoinder to his work; for directions so admirable could only have obtained a ready compliance. In addition, however, to these usual modes of recovering health and appetite, we are put in possession of a few others, as purely original as can be imagined—but of these anon.
Mr. Halsted arranges dyspepsia in three stages; he has the incipient, the confirmed, and the complicated; in other words, dyspepsia in its commencement, in its continuance, and in its union with other affections. The two first may undoubtedly belong to dyspepsia, but the last, or complicated stage, is the one to which we must object; it is said, that this occurs when other organs are deranged, and a double set of symptoms produced; "when the patient will be said to die of liver complaint, an affection of the lungs, marasmus, dysentery, diarrhœa, or some anomalous complication of all these affections, conveniently classed by the Doctor when he renders his account to the sexton, under the sweeping term, consumption." The medical profession will doubtless appreciate the value of the connexion which Mr. Halsted is anxious to establish between the physician and the respectable officer who acts as the last gentleman-usher to mankind, and duly estimate the candid and gentlemanly mode of introduction of both parties to the public.
Dyspepsia, Mr. H. continues, is the original fountain from whence all this mischief, described in his third stage, proceeds; thus, according to him, a catarrh, pneumonia, and the numerous diseases attacking the respiratory organs, as "affections of the lungs," are occasioned by dyspepsia; the liver cannot be affected but by dyspepsia; marasmus proceeds from dyspepsia; dysentery depends on dyspepsia; and even diarrhœa must own dyspepsia as its parent. The effects of cold and damp, of obstructed perspiration, of scrofulous tendencies, and a thousand other causes, pass for nought; dyspepsia rears its head as the sole parent of ill, and little doubt can be entertained, that in the event of a man, a little weakened by sickness, falling and breaking his leg, this dyspeptic monitor would call the case dyspeptic fracture. Well may the poor patient who peruses the pages of his work be called "an unhappy dyspeptic;" and if he be not so already, he cannot read long, if his attention and conviction go hand in hand, before the discovery of such an accumulation of horrors, and all referred to his own person, will render him a fit subject for the author's experiments. Some of these symptoms are of too extraordinary a character to be passed over without notice: coldness in the head, ears, and eyes, difficulty of speech, and a jarring through the chest, numbness and coldness at the stomach, and sometimes a weight as if a lump of lead were there: if this be the case—
"Who breathes, must suffer; and who thinks, must mourn,
And he alone is bless'd, who ne'er was born."