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ON

A NEW METHOD OF TREATING DYSPEPSIA.

BY J. SPURGIN, M.D., F.R.C.P., &c.

ABOUT seven years ago I prescribed for my own case; whichwas troublesome indigestion, with excessive acidity andejection of a large portion of my food three or four hoursafter my meals. I had tried various remedies that are com-monly resorted to upon the usually received principles of ourart; but in vain. It next occurred to me to prepare a salinesolution to add to my liquid ingesta, on the same principlethat salt is taken with all our solid food. For this purpose Idissolved chloride of sodium in liquor potassae to saturation,and took a few drops of the solution in my tea and beer, andsometimes in water. I found my digestion much improved inconsequence, with relief of backache and other ailments, de-pending, it would seem, on acidity of the contents of thestomach and bowels. Succeeding so far, I thought I mightimprove the solution by the addition of some phosphate ofsoda, and, in fact, produce a useful condiment for the table,which might eventually be recommended by the professionupon a scientific basis, not only to neutralize the consequencesOf a weak digestion, but to prevent their occurrence, and sorender the chyle more suitable for absorption into the system,and for its further change into the condition and function ofblood. In this way the solution might also prove an instru-ment in our hands for the expulsion of quackery from someOf the domains of our art.This latter consideration weighed strongly with me to in-

duce me to give the article a proper trial; and I encouraged thelate Mr. South, of Hunter-street, who was a general practi-tioner, to prepare and sell it, after having satisfied myself inmy own person, and with several of my dyspeptic patients, ofits efficacy and undeniable utility. The widow of this gentle-man has continued to prepare and to vend it, under the title ofthe " Liquid Condiment," for her own benefit, according to thisformula :-Liquor potassse, chloride of sodium, of each oneounce; phosphate of soda, a drachm and a half; water, threeounces. As much of this solution may be taken at a time aswill not affect the taste of the beverage disagreeably.In a great number of instances this article has proved most

useful. Many families have it on their table for daily con-sumption, and even make their tea by first putting two orthree spoonfuls into the teapot with the tea. It is not in-tended to be resorted to as an occasional remedy for variousforms of indigestion, but as a constant practice in like manneras with common salt.

I could write a treatise to record the successful results ofits employment; but its utility needs no corroboration from i

myself. I leave it to its own merits in this respect, and have Ialways objected to the advertising system to recommend it tothe community.When I consider the manifold causes that are in operation

for the production of indigestion in the great mass of society,and which are resolvable into two primary classes, namely,care and self-indulgence-care that dreads want, and self-indul-gence that seeks excess,-I am not surprised at indigestionbaffling our art; but notwithstanding these great disturbingcauses, the liquid condiment has both removed the conse-quences of indigestion and re-established the process ofdigestion in its integrity. Had the idea or the theory of theagent emanated from the ranks of quackery, I should haveblushed for my profession as a science; but even then, at thebest, it would have been only a lucky hit, and not the resultof a course of legitimate reasoning. For myself, I reasonedout the matter; and whilst, on the one hand, it will be provingmore and more useful to society-for nothing can prevent itsextensive adoption,-on the other hand, it will be instrumentalin driving away quackery from many families, and thus greatlybenefit our noble profession, which was never so damaged byparasitic growths upon its majestic stem and branches as it isat this day. These growths I have long endeavoured to tearaway in the circle in which I have been moving; too fre-quently my efforts have been viewed as partaking of the likenature; but this is only a passing liability. My duty to myprofession is my first consideration; and I can congratulate itnow that I perceive a disposition upon the part of the publicto examine the grounds of every pretension; in other words, tojudge for themselves, instead of idly contenting themselveswith the representations of others.

Authority is, indeed, the aim of many to attain, but few arethe prizes in this lottery of life. It is high time that this gameof chance in the great business of life should be abolished;

rather let the certainty of truth and the sway of right reasonbecome the foundations of human progress.To our profession itself I do not hesitate to ascribe much of

the inroad which quackery has made into it, for, like thepublic, it has shown a proneness to run after some two orthree authorities, or some few public men, as they are called;and this to the immense injury of the profession. It is utterlyimpossible for any finite mind to give a due consideration tothe cases which are pouring in upon its attention; its mostpractised skill cannot be adequate to the discharge of thebusiness it is thus called upon to execute. The consequenceof this is, that an applicant for relief is not unfrequently disap.pointed; he conceives he has consulted the most eminent ofour faculty: he has no alternative but to commit himself tosome form of quackery, where he sooner or later obtains therelief desired. His gratitude then knows no bounds; everyword of his praise, however, is a reflection and a scandal uponour art. But who can justly impute blame to him for it!The blame rests with ourselves. If our profession is foundedupon true principles, these should be our chief authority; forthey will manifest their authority in their power to relieve,whether exercised by this individual or that; but if personalauthority-the authority of a name-is what our professionwould rely upon, the sooner our schools and colleges are closedthe better, for their pupils and members will have quickly tomake for the " diggings." No! the study and the practice ofour profession must be based upon truth, and upon the cer-tainty of the result to which it leads. There have been falselights and bad leaders in the great field of professional action:let us be more wary, therefore, for the future; and, doubtless,under the guidance of careful observation and cautious expe-rience, which are our best authority, the profession will secureits hold upon society with a firmer grasp, and be independentof the rotten props of personal authority or capricious fashion.With our means and appliances there ought not to be a quackin the land. So far from their assuming the bold front whichthey are now manifesting, they should be suffering inanition,instead of reaping a golden harvest. So far from their boldadvertisements maintaining the cost of many a journal, theyshould cease for want of the profit to which the advertiserlooks. So far from their puffs tickling and winning the publiccredulity, they should be regarded as the noisy nonsense ofthe mountebank. We have treasures of knowledge in ourprofession, notwithstanding what the world may think to thecontrary. From these treasures have the quacks stolen adlibitum; nor is there a plan, nor a nostrum, nor a pill, potion,ointment, bath, nor globule, but they have stolen the valuablereason and ingredient from our coffers, and impudentlyvaunted them forth as so many infallible remedies for everyailment, curable or incurable. I repeat, we have vast treasuresof most useful knowledge; and if we will but make good use ofthem as instruments of curo and relief, rather than as ’sup-porters of some new theory, we shall be less divided as a body,more united in action, and too successful for the empiric artto triumph, even in a single instance, over our godlike voca-tion.And now with regard to my connexion with the healing

art: I beg to observe that I am neither an " allopath" nor a"homaeopath," but a physician at full liberty to prescribemedicines in all doses, according to my judgment, and anxious,also, to cure my patient with a readiness and a tact that are

creditable to my profession. I therefore avail myself of allthe observation and experience that I can gather from every

’ quarter. Moreover, as I have been in the study and practice’ of my profession for upwards of forty years, I feel entitled to, speak, and even to teach, as one gifted with the authorityI which a large experience and an independent course of obser-; vation impart.; Let me be excused, therefore, if I append a case to the aboveL observations, which is but one of numberless of the like naturer which are occurring every day within the sphere of honourableand legitimate practice, but which, so occurring, are only re-3garded as "a matter of course;" whereas, if but one is suppliedr from the ranks of quackery, it is at once lauded to the skies,- and blazoned forth everywhere as a prodigious example of the

charlatan’s power.r It was only a few evenings ago that I was called to at patient in my neighbourhood, who was taken to his residence3boy two policemen, in a state of great mental excitement. Heo was mad drunk from a very slight cause. His madness was sos violent that his friends were anxious to have him removed toan asylum; but my experience led me to prescribe for him,

6 even under a slender knowledge of the peculiar circumstancese I of his case, four grains of the compound antimonial powder; two grains of calomel, and one of opium, to be administered

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immediately; and if he were not calmed in half an hour, a tea-spoonful of antimonial wine was to be given every five minutestill he was quiet. I saw him again about two hours after-wards, by which time he had taken the pills and four tea-spoonfuls of the wine, and had had one copious dischargefrom his stomach, by vomiting, which removed the offendingcause: this was nothing more than a small quantity of rum,that had been poured down his throat whilst he was in a stateof suspended consciousness, to which he was subject, and onaccount of which he had been taken from an omnibus into thenearest public-house. Naturally he was most obnoxious to allfermented liquors, studiously avoiding the smallest quantity,by reason of their producing most exaggerated effects upon him.In this case, neither the reasoning, nor the practice, nor theglobule of the homoeopath, could have been of the slightestefficacy; and this, because a very long process of nature, unas-sisted, must have been gone through before a healthy state ofthings could have been brought about. Nor could the exhi-bition of large quantities of drugs be laid to my charge. Myprofession, however, as legitimately practised, is here vindi-cated from the impudent assaults of its enemies.

Guildford-street, Russell-square, July 5, 1852.

A CASE OF

RUPTURE OF THE JEJUNUM, CAUSED BY AKICK FROM A HORSE.

PERITONITIS; DEATH IN THIRTY-SIX HOURS; AUTOPSY; REMARKS.

BY M. J. M’CORMACK, A.B., M.B., M.R.C.S.L.,Shirley.

APRIL 17.-I was summoned hastily to see J. L-, who,it was stated, had been severely hurt by a kick from ahorse. The accident occurred about one o’clock P.M. ; but nothaving been at home when the summons came, I did not seehim till about half-past four P.M. I found him in bed, lyingon his back, complaining of acute pain in the lower portion ofthe abdomen, on the right side, a little below the umbilicus.He informed me he had received a kick from a horse, whilst

Istanding at no great distance. On turning down the bed- Iclothes, and examining the seat of the injury, no abrasion ofthe cuticle was perceptible, nor, indeed, any mark of a blowhaving been inflicted; pressure did not cause as much pain asmight have been expected; percussion gave a clear tympaniticsound over the whole of the abdomen; the knees were drawnup; respiration hurried; countenance pale and anxious; sur-face cold and clammy; pulse low and wavering; had passedurine freely immediately after the accident, free from anyappearance of blood; had not vomited, but felt sick; com-plained of great thirst; had not dined. The diagnosis Iarrived at was, that there was injury to some of the viscera,but that neither the bladder nor stomach was implicated;prognosis unfavourable. Directed warm fomentations tothe abdomen, and, should the pain become more intense,spirits of turpentine to be sprinkled on the flannel cloths;prescribed internally small doses of opium, with mercury-with-chalk ; and left word, should symptoms become moreurgent, to be sent for.

April 18th.-Ten A.M.: Visited the patient this morning,not having been sent for again during the night; was muchsurprised to find a very great improvement in all thesymptoms; indeed, had a stranger come into the room andcasually examined him, he would not have considered therewas anything the matter; his countenance was cheerful andnatural; pulse rather full, soft, 70; skin moist, and tempera-ture natural; had slept several hours; threw up only the firstpowder; pain very much diminished in the abdomen; pressurecaused but slight inconvenience; had passed water, bnt hadno motion from the bowels; had eaten his breakfast with

relish; could turn on either side with less pain; tongue cleanand moist, less thirst. The only symptom which made mehesitate in giving a favourable opinion, was, that the tympanitishad increased very considerably. I desired the fomentationsto be continued, and the mercury-with-chalk and opium everyfour hours. On my return from church, about one o’clockP.M., I found a message requiring my immediate presence, inconsequence of his having become worse, which I found wasthe case. It appears that about half-past twelve o’clock P.M.he had been seized with vomiting, and immediately aftercomplained of an intense burning pain extending over thewhole abdomen. I hardly recognised in him the sameperson I had seen in the morning, so great had been thechange in the short interval. His countenance was anxious

to a degree; respiration hurried; body bathed in cold perspi-ration ; pulse 120, hard and small, at times intermitting; abdo-men much swollen and tympanitic, and so painful that thepressure of the bed-clothes was more than he could endure.I need hardly say my prognosis was most unfavourable. I atonce ordered the application of a dozen leeches to the abdo-men, to be followed by constant hot fomentations; and in-creased the dose of opium to one grain every hour, with halfa grain of calomel. Six P.M.—Again visited him, and foundmatters progressing rapidly to a fatal termination. Theleeches had slightly relieved the pain in the lower portion ofthe abdomen, but it was increasing more towards thediaphragm; pulse 140, almost imperceptible; thirst intense.His employer being anxious for further advice, I obtainedthe valuable assistance of Dr. Oke, Southampton, who sawhim at nine o’clock P.M. Suffice it to say, his opinion fullycoincided with mine, both as regarded the probable lesion,and the treatment which had been pursued. The onlyalteration suggested was the application of a large blisterover the abdomen. In about two hours and a half, deathterminated the poor fellow’s sufferings, which were everymoment becoming more intense. He retained his faculties tothe last, and died without a struggle, at twenty minutes totwelve o’clock P.M.An inquest was held the following day, but the coroner did

not consider a post-mortem examination requisite. As it was,however, a very interesting and important case, I obtainedpermission from the relatives to open the cavity of the abdomenonly. This was done by Mr. Norcott and Mr. Brock, the lattera student on a visit here. To this gentleman I am also in-debted for the following detailsAutopsy.-The body was that of a middle-aged, healthy

person; a patch of coagulated blood to the right of, and abouttwo inches below, the umbilicus, marked the spot where thefatal kick had taken effect; the abdomen was hard andtympanitic, and slightly discoloured in the neighbourhood ofthe injured part, the discoloration extending considerablydown the groin, in front, and backwards over the externaloblique. On opening the cavity of the abdomen, there was aconsiderable emission of very noxious gas, so powerful as tocompel the parties to leave the room for some minutes. Onresuming the investigation, the whole of the viscera werefound swimming in liquid faecal matter of an unusuallyoffensive description, mixed with large quantities of a thickpurulent substance, peritonitis having gone on to a con-siderable extent. The stomach was first opened; it was per-fectly healthy, and contained no trace of the black sanguineousmatter which had been so plentifully vomited before death.Beginning from the duodenum, and proceeding downwards,it was evident, that whatever the injury might be, nature hadmade vigorous efforts to repair it. False membranes wereplentifully thrown out in every direction; the intestines,which were in a highly inflamed and vascular condition, wereglued together into an almost inseparable mass, and theomentum was so adherent that it tore in endeavouring toraise it. No injury was discernible till, on arriving at aboutthe junction of the middle with the lower third of thejejunum, a rupture was discerned, which had probably beenrather larger than a shilling, but was now scarcely the sizeof a fourpenny-piece, owing to the quantity of coagulablelymph which the edges of the wound had thrown out; theopening seemed at first to have been a transverse slit, whichthe pressure of the faeces from within had converted into acircular aperture. This was the only injury received; fromthat part of the jejunum to the rectum, all was found healthy.The bladder was collapsed and natural; the cavity of theperitonaeum contained a quantity of pus; the liver was healthy.but rather darker than usual, and indicated that its owner hadbeen no teetotaller; the spleen was uninjured; the gall-bladdernatural. There was great discoloration of the left side of thethorax, extending from the sternum to the axilla, and fromthe clavicles to about the fifth rib, from what cause (as nofurther examination was permitted) we are unable to surmise;the wound on the abdomen was perfectly superficial, scarcelypenetrating the adipose tissue; and the rupture could onlyhave been caused by the sudden shock.Remarks.-The chief points of interest in this case are,-

1st, the infrequency of this lesion, more especially the result tof direct force, as we generally find such an accident producedmore by a heavy body passing over the abdomen than by ablow; 2nd, the absence on the following morning of any serioussymptoms, such as would have led me to anticipate the rapidly-fatal termination; and 3rd, the efforts which nature made inso short a time to repair the injury done. And it is worthy ofobservation, the extraordinary tendency exhibited by ruptures