OF ACIDITY, and its concomitants or effects.
It is difficult to determine whether aci dity of the stomach depends at all times on the introduction of acid by the mouth ; or whether the gastric fluid be sometimes secreted in a vitiated state. A great va riety of acids are occasionally introduced into the human stomach with food or me dicine ; and that acid, which is the pro duct of fermentation, is frequently form ed in the stomach from the spontaneous changes of vegetable matter in cases of imperfect digestion, and where food is taken in so large quantity that it is impos sible for any stomach to dissolve it : from the latter cause, principally, the acid so perpetually troublesome to the stomachs of children appears to arise ; and the cardialgia of adults may justly be suppos ed most frequently to have the same ori gin : it is constantly to be observed, how ever, that in obstructions of the liver or gall-ducts, symptoms of cardialgia occur, and that in cases of sick-head-ache and of hypochondriasis, where the strictest at tention has been paid to rules of diet, the patient is not relieved till acid be evacuated from the stomach, either miting or purging : hence it appears pro bable that the gastric fluid is in itself vi tiated in some diseases, having acquired the properties of an irritating acid, and being bereft of its solvent power ; and that a due secretion of the bile is al ways requisite to the correction of acid in the stomach, both as neutralizing the acid matter, and as stimulating the in testines to expel any uncombined acid, which may resist its effects, or prove more than it is adequate to neutralize.
The symptoms attending acidity in the stomach are, flatulency ; cardialgia ; nau sea ; vomiting; costiveness ; or purging with discoloured faces ; foul bowels ; head-ache ; paleness sometimes alternat ing with Hushing ; increased pulse ; a tongue coated with a white or brownish fur ; increased heat, particularly on the skin of the abdomen ; loss of appetite ; sense of weight, pain and oppression ; rigors ; langour, particularly about the eyes, with discoloration round ,the eye lids.; stupor, and convulsions, or a dilat ed pupil so as to resemble hydrocepha lus. These symptoms occur according
to the magnitude and duration of the at tack, in conjunction with the constitution of the patient.
In all common acidities in the stomach, evacuation from the bowels is always ne cessary, whether the attack be accompa nied with costiveness or purgation. For this purpose calomel is generally highly serviceable. From its nature and the " smallness of the quantity requisite to pro duce the requisite effect, it may be ta ken without being tasted, and it common ly produces no na,,sea or vomiting, when a fluid purgative would instantly have this effect, from its irritation on the al ready irritated stomach, and from the sympathy of that viscus with the organs of taste and smell, when offended by such medicine : the mode of operation of ca lomel, and its quickness of action, also highly contribute to render it eminently useful ; it instantly excites copious mu cous secretion from the glands of the stomach, which contributes to dilute and wash away the offending acid, and a con siderable portion of this medicine quick ly passing the pylorus augments the se cretion of bile, the natural corrector of acid ; and that of the pancreas produc ing further dilution. It may be given in doses from one grain to five, or even in larger quantity, according to the age and strength of the patient, and repeated as occasion may require. In an hour or two after its exhibition, the stomach will bear some directly purgative matter, which should be given, to insure the passage of the calomel through the bowels, and to increase the purgative effect. Rhubarb will hereafter be of great advantage, in termixed with some aromatic powder or pungent water, as mint or peppermint ; though the neutral salts will better agree with some constitutions. Absorbents we cannot recommend so largely as they have often been recommended, especial ly the calcareous earths, for it often hap pens that the insoluble compound form ed by the union of chalk and the acid in the stomach increases the load and irri tation in the bowels. In slight or recent cases, they are chiefly useful, and to be depended upon.