ADVERTISEMENTS.

JOHN BEATH'S PATENT IMPROVED

TRUSSES.

R. BEATH invites those who deMR sire an effectual remedy for the dangerous and distressing disease of Rupture, to call at his office, 672, Washington Street, where he is in constant attendance, to adapt his trusses to the particular case of the patient.

Among the variety of trusses made by Mr. Beath, are Patent Elastic Spring

Trusses, with Spring Pads Trusses without steel springs; these can be worn day and night. Improved Hinge and Pirot Trusses, Umbilical Spring Trusses, and Trusses with Ball and Socket Joints. Trusses for Prolapsus Ani, by wearing which, persons troubled with a descent of the rectum, can ride on horseback with perfect ease and safety. Mr. B. makes also Trusses for Prolapsus Uteri, which have answered in cases where pessaries have failed. Suspensary Trusses, Knee Caps, and Common Trusses, are kept always on hand, charged at the lowest

prices. Machines for femedying deformi

ties, Artificial Legs, &c.

Surgeons' Instruments and Trusses repaired at the Manufactory.

We have often witnessed Mr. Beath's success, and have been personally benefited by his ingenuity.-Ed. Med. Intel.

man Body. By V. L. BRERA, Professor of Clinical Medicine in the University of Pavia, &c.

BICHAT on the Membranes.

Discourses on Warm and Cold Bathing. A Dissertation on Medical Education, and on the Medical Profession.

Remarks on the Dangers and Duties of Sepulture.

The LANCET, a weekly London publication.

H

RETAIL DRUG STORE. ENRY WHITE would inform his friends and the public, that he has now established himself as a retail druggist, at No. 188, Washington Street, op. posite the Marlboro' Hotel, where Physicians and Families may depend on the most strict and personal attention to their orders.-No Medicines will be put up unless of the first quality.

N. B. Medicines delivered at any hour of the night.

JOSEPH KIDDER, 70, Court St.,

FFERS for sale a assortment of

Drugs and Medicines of the best

quality. Confining himself principally to the retail business, every attention will be given to meet the wishes of Physicians and others in the preparation and delivery of medicines. Prescriptions will receive constant personal attention.

Rochelle and Soda Powders carefully prepared as above.

Also, constantly for sale, Black Currant Wine, prepared by Mr. Pomeroy.

DR. HULL'S TRUSS.

Every great superiority of this in

strument over every other heretofore invented, as to convenience, ease, and comfort to the wearer, and its curative power, is shown by the testimony of respectable physicians, and the formal approbation of Medical Societies, but more than all by the actual cures it has performed. For a more particular description of this Truss, see the last Edition, 1826, of Thacher's Modern Practice.

EBENEZER WIGHT,Apothecary, Milk Street, opposite Federal Street, has just received an assortment of Umbilical and Inguinal Trusses. March 6th.

VOL. 5.

TREATMENT OF PROTRACTED

CASES OF INDIGESTION.

On the Treatment of the more Protracted Cases of Indigestion. By A. P.W. PHILIP, M.D., F.R.S. L. and E., being an Appendix to his Treatise on Indigestion. 8vo. London, T. and G. Un

derwood. 1827.

It is well known that Dr. Wilson Philip has published a very useful book on indigestion, in which, though little novelty is contained, there is a considerable improvement in the general view of the affection. Dr. Philip gives himself credit, indeed, for an improved plan of treatment; but as we were familiar with the principles he has laid down, and had frequently seen them acted on, long before his work was published, we apprehend that he labors in this respect under some mistake. We nevertheless have always regarded the volume on indigestion as very valuable, because it has made the proper method of treating this disorder more extensively known than it was before; and has particularly impressed the necessity of attention to the inflammatory stage. To this work, which has now gone through five editions, he has added an appendix, in the form of several distinct essays on the different points to which he conceives the attention of the practitioner ought to be directed.'

No. 7.

Previous to entering on the first essay he has made some observations on the misinterpretations of Dr. Paris and Dr. James Johnson, with regard to some part of his doctrines.

It is unnecessary,

however, to follow him here, though it certainly seems that these authors have perused his former treatise with very little attention.

The word indigestion,' as employed by Dry Philip, has a much more extensive import than what has commonly been assigned to it, and comprehends not only the first inconveniences experienced in the primæ viæ, and the temporary symptoms conjoined with them, but the whole constitutional disorder, from mere functional derangement to its termination in morbid change of structure. In thus extending the signification of indigestion, he has trodden in the same path with Mr. Abernethy, in his Essay on the Constitutional Origin of Local Diseases; and the observations of these two eminent men reciprocally confirm the opinions of each other.

Indigestion, thus explained, is divided by Dr. Philip into three stages: the first being that simple disorder which has always been acknowledged as originating in imperfect digestion, as flatulence, eructation, languor, emaciation, &c., without any organic disease; the second being characterized

by tenderness or other uneasiness on pressure in the part of the epigastric region, and a degree of hardness in the pulse, often accompanied by other febrile symptoms; and the third stage is when organic disease is already established.

For a detail of the symptoms in each of the two first stages, we must refer to the work itself; and in the present review we shall confine ourselves to the consideration of some of those points which are noticed in the appendix. "We shall only premise, that regimen and diet are of more efficacy in the first stage of the disease than medicine; and that a strict attention to them will frequently suffice alone for the restoration of health. The observations on diet in the Treatise on Digestion, we believe to be tolerably accurate; and our own experience abundantly confirms the doctrine of Dr. Philip respecting broth 'all kinds of broth are apt to become sour on a weak stomach.' Some fluid is of course necessary, but dyspeptic patients very ill bear even a small quantity; anything beyond what is sufficient to moisten the food, has often appeared to us injurious. We are disposed to impress this point the more, because we have known it a common practice among medical men to withdraw solid food entirely in cases of indigestion; and this has been continued so long, that a return to solid food is of very difficult accomplishment, the smallest portion exciting much uneasiness, and sometimes even pain.

The first essay in the Appendix is entitled, On the Examination by Pressure on the Regions of the Stomach and first Intestine.'

There appears to be some misapprehension in some of those authors who have remarked on the phenomenon; and they seem to imagine that the tenderness is the consequence of severe pressure, originating in fact from the mode of examination, and forming no part of the real disease. We speak of course under some limitation. What may be the degree of pressure employed by Dr. Philip, we have had no opportunity of ascertaining; but we can scarcely think it possible that any practitioner can confound the inconvenience arising from pressure with the tenderness dependent on local disorder. That many patients may shrink on even slight pressure, is true, but the countenance exhibits very different appearances, according both to the nature and the degree of tenderness. Moreover, if but a little patience be employed, we shall find that should the inconvenience proceed only from pressure, it will disappear by continuing it; whereas, should there be a morbid sensibility, the pain rather increases, never diminishes. To this, it may be added, that unless the tender spot be very deeply seated, slight pressure only will be necessary, such as could by no means, under a healthy state of the parts, produce the slightest inconvenience: and another observation also to be made is this, namely, that the tenderness is confined for the most part to a particular spot, while the pressure may be employed over other points of the abdomen, without causing any uneasiness, which could scarcely be, were the pain attributable to the pressure merely. Dr. Philip has observed, that the expe

in its direction; and sometimes where there is much borborygmus, the pain is observed to change its situation as the different parts of the bowel undergo contraction. In this last case, however, it may be said that the pain is entirely spasmodic, and different therefore from the inflammatory irritation mentioned by Dr. Philip. To a certain extent, this is undoubtedly true; but at the same time, some one point will be always more readily affected than another, and be referred to as the principal seat of disease, from which the general tenderness is derived. With this state of tenderness, whether confined to the stomach, the duodenum, or the colon, the author of the present treatise appears disposed to maintain, that a certain tightness of the pulse is conjoined, indicating the presence of an inflammatory action. To this doctrine we are inclined only partially to assent; for we feel convinced that there are many cases of local pains in the abdomen attending on indigestion, which are neither accompanied by a sharp nor tight pulse, nor curable by common antiphlogistic measures. It is true, that in the very great majority of cases, the fact is as it has been stated by Dr. Philip; and local bleeding will suffice to subdue or to relieve it. There is, however, a state of irritation of the colon which exhibits nothing inflammatory in its nature, and which has often appeared to us rather aggravated than relieved by leeches and counterirritants. The individuals most subject to this peculiar uneasiness are young women, from sixteen years of age to thirty; and the seat most generally affected is

either the caput coli and its immediate neighborhood, or the sigmoid flexure of the same intestine. We have most commonly met with it in dressmakers, some of whom have been compelled to leave their occupations on account of it. When the pain is confined to the right side, they often experience a sense of dragging, and complain of inconvenience, occasionally arising even to pain, on moving the arm. Frequently, also, there is pain at the base of the scapula. The countenance is seldom much affected; nor have we ever noticed a jaundiced state of the skin, or any other symptom that would lead to the suspicion of hepatic disease. In many cases, there is not the slightest fulness of the abdomen in any one point; and in one of the most obstinate cases that has fallen under our notice, the bowels were so empty that by a very little pressure the vertebræ could be perceived.

The duration of this painful state is very uncertain; but several instances have occurred to us in which it had been more or less experienced for three years.

Hitherto we can only confess our ignorance of a successful method of treating it. Leeches and blisters have frequently increased the constitutional derangement, without affording the slightest relief to the local affection; and purgatives invariably aggravate tenderness of the intestine.

The second essay is entitled, Of the Organs of Waste in Indigestion;' and Dr. P. commences it with remarking, that it very frequently happens in the second stage of indigestion, that when the disease begins to yield, the patient gets thinner, whether he