The hiccup is a spasmodic or convulsive affection of the stomach and midriff, arising from any cause that irritates their nervous fibres.
It may proceed from excess in eating or drinking; from a hurt of the stomach; poisons; inflammations or scirrhous tumours of the stomach, intestines, bladder, midriff, or the rest of the viscera. In gangrenes, acute and malignant fevers, a hiccup is often the forerunner of death.
When the hiccup proceeds from the use of aliment that is flatulent, or hard of digestion, a draught of generous wine, or a dram of any spirituous liquor, will generally remove it. If poison be the cause, plenty of milk and oil must be drank, as has been formerly recommended. When it proceeds from an inflammation of the stomach, &c. it is very dangerous. In this case the cooling regimen ought to be strictly observed. The patient must be bled, and take frequently a few drops of the sweet spirits of nitre in a cup of wine-whey. His stomach should likewise be fomented with cloths dipped in warm water, or have bladders filled with warm milk and water applied to it.
When the hiccup proceeds from a gangrene or mortification, the Peruvian bark, with other antiseptics, are the only medicines which have a chance to succeed. When it is a primary disease, and proceeds from a foul stomach, loaded either with a pituitous or a bilious humour, a gentle vomit and purge, if the patient be able to bear them, will be of service. If it arises from flatulencies, the carminative medicines directed for the heart-burn must be used.
When the hiccup proves very obstinate, recourse must be had to the most powerful aromatic and antispasmodic medicines. The principal of these is musk; fifteen or twenty grains of which may be made into a bolus, and repeated occasionally. Opiates are likewise of service; but they must be used with caution. A bit of sugar dipped in compound spirits of lavender, or the volatile aromatic tincture, may be taken frequently. External applications are sometimes also beneficial; as the stomach plaster, or a cataplasm of the Venice treacle of the Edinburgh or London dispensatory, applied to the region of the stomach.
I lately attended a patient who had almost a constant hiccup for above nine weeks. It was frequently stopped by the use of musk, opium, wine, and other cordial and antispasmodic medicines, but always returned. Nothing however gave the patient so much ease as brisk small-beer. By drinking freely of this, the hiccup was often kept off for several days, which was more than could be done by the most powerful medicines. The patient was at length seized with a vomiting of blood, which soon put an end to his life. Upon opening the body, a large scirrhous tumour was found near the pylorus or right orifice of the stomach.
The hiccup may be removed by taking vinegar, or a few drops of the oil of vitriol taken in water.
CRAMP OF THE STOMACH.
This disease often seizes people suddenly, is very dangerous, and requires immediate assistance. It is most incident to persons in the decline of life, especially the nervous, gouty, hysteric, and hypochondriac.
If the patient has any inclination to vomit, he ought to take some draughts of warm water, or weak camomile-tea, to cleanse his stomach. After this, if he has been costive, a laxative clyster may be given. He ought then to take laudanum. The best way of administering it is in a clyster. Sixty or seventy drops of liquid laudanum may be given in a clyster of warm water. This is much more certain than laudanum given by the mouth, which is often vomited, and in some cases increases the pain and spasms in the stomach.