University of Virginia Library

CHAPTER III.

When Menenius Agrippa quelled the turbulent
passions of the Roman populace by
repeating to them the beautiful fable of the
stomach and members of the human body,
he set forth, in bold relief, the advantages
derived through the agency of that great reservoir,
from which proceeds the elements of
that vital current that swells the muscular
arm of the patriot, and tinges with a modest
blush the maiden's cheek; but if it had
equally suited his purpose, he might have
depicted, with no less truthfulness, the wan
cheek, the tottering step, the sunken eye, the
palsied tongue, produced by pampering it to
repletion. The functions of this organ are
so important that we are tempted for the benefit
of our unprofessional readers, to give a
brief account of its normal and pathological
condition:

"The stomach [Paris] is immediately situated
below the diaphragm, the cardia being

nearly opposite to the middle of the vertebræ;
from thence it bulges out to the left side, the
great curvature coming forward and downward;
it then passes on to the right side,
rising upwards so that the pylorus is not
much farther from the diaphragm than the
cardia; when therefore a man is in an erect
posture, substances must ascend to pass
through the pylorus. In its flaccid state, it
occupies the epigastrium and part of the
left hypochondrium; whilst, when distended,
it exchanges its flattened for a rounded form,
and fills almost completely the hypochondrium;
the greater curvature descending
towards the umbilicus, particularly on
the left side; on account of the resistance
opposed by the vertebral column, the posterior
surface of the stomach cannot distend
itself in that direction; this viscus is
therefore wholly carried forward. The dilatation
of the stomach produces very important
changes in the abdomen; the total
volume of the cavity augments; the belly
juts out; the abdominal viscera are compressed
with greater force. At the same time the
diaphragm is pressed towards the breast, and
it descends with some difficulty; whence the
respiratory motions are impeded.

The villous, or mucous membrane has a
whitish-red appearance, and presents a singular
velvet-like appearance, from which it
has derived its name; not being elastic, it
has numerous folds, or rugæ, which supply
this deficiency, and serve to accommodate
the capacity of the stomach to the bulk of its
contents, and, at the same time, to retain the
aliment until it is duly elaborated.

The stomach is abundantly vascular; indeed,
it may be observed, that few structures
receive so much blood as this organ; four
arteries, three of which are considerable, are
exclusively devoted to its service, and their
several branches communicate most freely
with each other, in all directions, by innumerable
anastomoses; and being tortuous,
they can then accommodate themselves to the
full and empty states of the cavity. Nor are
its nerves less numerous; they are composed
of the eighth pair and a great many filaments
proceeding from the solar plexus of the great
sympathetic.

The different secretions concerned in digestion
are thus enumerated by Dr. Paris:

1st. Saliva, which is formed by glands
whose excretory ducts open into the mouth.
2. Mucous matter, which results from the
action of numerous follicles situated in the
interior of the cheeks and palate, upon the
back of the tongue, on the anterior aspect of
velum, and on the uvula. 3. Gastric juice,
formed by the glands in the stomach, and the
mucus secreted by its membrane. 4. Mucus
intestinalis, or proper juice of the duodenum
and small intestines. 5. Bile, which being secreted
in the liver and rendered more stimulating
in the gall bladder, is afterwards carried
into the duodenum. 6. Pancreatic juice,
which is secreted in the pancreas, and carried
into the duodenum along with the bile; to
which perhaps may be added the watery
fluids thrown into the intestines by the exhalants.

If we may be allowed to conceive a condition
of the system in which all the organs
of digestion accurately perform their respective
functions, and harmonize beautifully
with each other, like the well-oiled mechanism

of the steam engine, we may well believe
it a state of perfect health; and indeed,
it were difficult to connect with such a condition
the idea of disease in any organ of the
human body. But as in the engine, besides
the wear and tear incident to matter, an unskilful
and careless engineer, who piles on
fuel, raises the steam above the point of security,
and neglects the safety valve, hazards
a concussion awful to contemplate, or by delaying
some repair which at first sight may
seem of minor importance, deranges first one
portion of the machinery, then another, until
all the parts become finally implicated and
obstructed. So it is with the human frame;
if from any cause it receives a shock which
overpowers its vital energies, it succumbs to
the blow. If any of its organs become so
impaired as to produce diseased function,
a continuance of that condition will in the
end react upon the organ, involve other organs
and their functions in the derangement,
and finally undermine the constitution.

It would be foreign from our purpose to
treat of the various diseases that may affect
the digestive apparatus; we shall, therefore,

confine ourselves to the consideration of
Dyspepsia, which, as being the most general,
is also the most important.

Dyspepsia is most generally produced by
a series of errors in diet; in which, of course,
we include improper potations. Every man
has a certain degree of vital energy allotted
to his organism, which constitutes health,
and an addition, or diminution therefrom,
elevates or depresses that power so as to constitute
an abnormal condition. Let us apply
this principle to the stomach, and we can
very readily understand how it becomes diseased.
Let us suppose the vital energy
possessed by the stomach of A., who labours
on the canal, to be 20, and that of B., a merchant,
who is all day hanging over his desk,
to be 15; now A. rises at dawn, works until
8 A. M., in all probability has roused into
action all the organs of secretion and excretion,
and has a relish and appetite for his breakfast.
He needs no buckwheat cakes floating
in butter, to excite his salivary glands,
and he is contented with a plain but plentiful
meal. B., on the contrary, sleeps, or rather
lies in bed, until 7 A. M., and dresses in

time to meet his family at the breakfast-table
at 8: his bowels are constipated, his liver is
torpid, his kidneys are sluggish, his skin is
dry, he has a morbid appetite, he eats hot
rolls and butter, beefsteak, or mutton-chops,
or likely enough, both. A dish of stewed
oysters now makes its appearance, and he
cannot resist the temptation; some three or
four varieties of hot cakes are served, and it
is necessary to decide which is the best; so
he must have a nibble at all. Two large
cups of coffee accompany his meal, and he is
literally crammed to repletion. A. returns to
his work, whistles or sings all the while, or
cracks a joke with his fellow-labourer; at
noon he eats his allowance of bread and fat
bacon, at night he again takes his homely
meal, and at a proper hour retires to his hard
couch and enjoys a depth of slumber that
kings may envy. B. after the meal through
which we have already accompanied him,
walks to his counting-room, pores over his
books, has a note to pay in bank for which he
is not prepared, is fretted or perhaps alarmed,
leaves his business at 3 P. M., takes a glass
of toddy to stimulate his appetite, eats turtle
soup, corned beef, roast mutton, baked oysters,
boiled fish, wild ducks, bread, potatoes,
hominey, celery, variety pudding, crackers
and cheese, apples and raisins; he drinks ale,
champagne, sherry, and perhaps port. He
lounges away his time until supper, takes
tea or coffee, writes until late, and then retires
to repose! Now observe that the conduct of
these two persons is in the inverse ratio of
their vital powers. While A. invigorates his
digestive organs by just that degree of stimulation
which Nature informs him is necessary
to repair the waste by the different
excretions, B. over-stimulates his already
feeble stomach, gives it a task to perform
which would oppress even the vigorous powers
of A. and by a succession of such abuses
lays the foundation of maladies as grievous
as they are unmanageable. Will it be said
that we have caricatured the habits of B.?
Alas! there are too many fac-similes, and
we are very certain that we might, with truth,
have given a deeper colouring to the picture,
in many cases.

If B., whose digestive powers may perhaps
be adequate to a slice of cold bread and half

a pound of roast beef or mutton, takes the
varied dinner we have already described, or
something like it; he applies an over-stimulus
to the nervous expansion; the nerves notify
the brain that an additional supply of blood
is necessary; the brain sends its orders to the
heart, the heart gathers its fluid from the capillary
system, and, guided by anxiety of the
nerves, directs the vital current to the mucous
coat; next follows plethora, or engorgement;
then succeeds irritation of the gastric nerves;
then follows an excessive secretion of acid
and of air; next comes pain, flatulence,
heart-burn, and innumerable ills.

A succession of irritations will produce inflammation,
and then follows a defective or
highly vitiated secretion; the pyloric glands
no longer discriminate between the portions
of chyme presented to them—it enters the
duodenum in a vitiated condition—the nerves
of this organ demand the sympathies of the
liver and pancreas—these are overstimulated,
irritated, engorged; they send through their
ducts highly concentrated and acrid secretions,
the mucous coat of the intestines is irritated,
and the result is mucous diarrhœa or

dysentery. In another portion of this work,
we have to consider the effects produced by
disease of the stomach on the lungs and
bronchi; we will, therefore, for the present
only remark, that they are both extensive and
important. The heart, the kidneys, the skin,
and the brain, are all most seriously affected
by derangement of the digestive apparatus.

We recognise, nevertheless, a condition of
the stomach the reverse of plethora, which is
usually produced by excessive hemorrhages.
In this condition, a certain amount of nourishment
and stimulation is not only proper but
necessary. We should err greatly, however,
were we, in cases of anemia, to push nutrition
beyond the vital powers of the organ.