WE do not here mean to treat of those astrictions of the bowels which are the symptoms of diseases, as of the cholic, the iliac passion, &c. but only to take notice of that infrequency of stools which sometimes happens, and in which in some particular constitutions may occasion diseases.
COSTIVENESS may proceed from drinking rough red wines, or other astringent liquors; too much exercise, especially on horseback: It may likewise proceed from a long use of cold insipid food, which does not sufficiently stimulate the intestines. Sometimes it is owing to the bile not descending to the intestines, as in the jaundice; and at other times it proceeds from diseases of the intestines themselves, as a palsy, spasms, torpor, tumours, a cold dry state of the intestines, &c.
EXCESSIVE costiveness is apt to occasion pains of the head, vomiting, colics, and other complaints of the bowels. It is peculiarly hurtful to hypochondriac and hysteric persons, as it generates wind and other grievous symptoms. Some people however can bear costiveness to a great degree. I know persons who enjoy pretty good health, yet do not go to stool above once a-week, and others not above once a fortnight.
PERSONS who are generally costive should live upon a moistening and laxative diet, as roasted or boiled apples, pears, stewed prunes, raisins, gruels with currants, butter, honey, sugar, and such like. Broths with spinage, leeks, and other soft pot-herbs, are likewise proper. Rye-bread, or that which is made of a mixture of wheat and rye together, ought to be eat. No person troubled with costiveness should eat white bread alone, especially that which is made of fine flour. The best bread for keeping the body soluble is what in some parts of England they call meslin. It is made of a mixture of wheat and rye, and is very agreeable to those who are accustomed to it.
COSTIVENESS is increased by keeping the body too warm, and by every thing that promotes the perspiration; as wearing flannel, lying too long a-bed, &c. Intense thought, and a sedentary life, are likewise hurtful. All the secretions and excretions are promoted by moderate exercise without doors, and by a gay, cheerful, sprightly temper of mind.
THE drink should be of an opening quality. All ardent spirits, austre and astringent wines, as port, claret, &c. ought to be avoided. Malt-liquor that is fine, and of a moderate strength, is very proper. Butter-milk, whey, and other watery liquors, are likewise proper, and may be drank in turns, as the patient's inclination directs.
THOSE who are troubled with costiveness, ought, if possible, to remedy it by diet, as the constant use of medicines for that purpose is attended with many inconveniencies, and often with bad consequences. I never knew any one get into a habit of taking medicine for keeping the body open, who could leave it off. In time the custom becomes necessary, and generally ends in a total relaxation of the bowels, indigestion, loss of appetite, wasting of the strength, and death. The learned Dr. Arbuthnot advises those who are troubled with costiveness to use animal oils, as fresh butter, cream, marrow, fat broths, especially those made of the internal parts of animals, as the liver, heart, midriff, &c. He likewise recommends the expressed oils of mild vegetables, as olives, almonds, pastaches, and the fruits themselves; all oily and mild fruits, as figs; decoctions of mealy vegetables; these lubricate the intestines; some saponaceous substances which stimulate gently, as honey, hydromel, or boiled honey and water, unrefined sugar, &c.
THE Doctor observes that such lenitive substances are proper for persons of dry atrabilarian constitutions, who are subject to astriction of the belly, and the piles, and will operate when stronger medicinal substances are sometimes ineffectual; but that such lenitive diet hurts those whose bowels are weak and lax. He likewise observes, that all watery substances are lenitive, and that even common water, whey, sour milk, and butter milk have that effect; - That new milk, especially asses milk, stimulates still more when it sours on the stomach; and that whey turned sour will purge strongly; - That most garden fruits are likewise laxative; and that some of them, as grapes, will throw such as take them immoderately, into a cholera morbus, or incurable diarrhoea.
WHEN the body cannot be kept open without medicine, we would recommend gentle doses of rhubarb to be taken twice or thrice a-week. This is not near so injurious to the stomach as aloes, jalap, or the other drastic purgatives so much in use. Infusions of senna and manna may likewise be taken, or half an ounce of soluble tartar dissolved in water-gruel. About the size of a nutmeg of lenitive electuary taken twice or thrice a-day, generally answers the purpose very well.
THIS may proceed from a foul stomach; indigestion; the want of free air and exercise; grief; fear; anxiety, or any of the depressing passions; excessive heat; the use of strong broths, fat meats, or any thing that palls the appetite, or is hard of digestion; the immoderate use of strong liquors, tea, tobacco, opium, &c.
THE patient ought, if possible, to make choice of an open dry air; to take exercise daily on horseback or in a carriage; to rise betimes; and to avoid all intense thought. He should use a diet of easy digestion; and should avoid excessive heat and great fatigue.
IF want of appetite proceeds from errors in diet, or any other part of the patient's regimen, it ought to be changed. If nausea and reachings shew that the stomach is loaded with crudities, a vomit will be of service. After this a gentle purge or two of rhubarb, or of any of the bitter purging salts, may be taken. The patient ought next to use some of the stomachic bitters infused in wine. Though gentle evacuations be necessary, yet strong purges and vormits are to be avoided, as they weaken the stomach, and hurt digestion.
ELIXIR of vitriol is an excellent medicine in most cases of indigestion, weakness of the stomach, or want of appetite. Twenty or thirty drops of it may be taken twice or thrice a-day in a glass of wine or water. It may likewise be mixed with the tincture of the bark, one drachm of the former to an ounce of the latter, and two tea-spoonfuls of it taken in wine or water, as above.
THE chalybeate waters, if drank in moderation, are generally of considerable service in this case. The salt water has likewise good effects; but it must not be used too freely. The waters of Harrowgate, Scarborough, Moffat, and most other Spas in Britain, may be used with advantage. We would advise all who are afflicted with indigestion and want of appetite, to repair to these places and public rendezvous. The very change of air, and the cheerful company, will be of service; not to mention the exercise, dissipation, amusements, &c.
WHAT is commonly called the heart-burn, is not a disease of that organ, but an uneasy sensation of heat or acrimony about the pit of the stomach, which is sometimes attended with anxiety, nausea, and vomiting.
IT may proceed from debility of the stomach, indigestion, bile, the abounding of an acid in the stomach, &c. Persons who are Iiable to this complaint ought to avoid stale liquors, acids, windy or greasy aliments, and should never use violent exercise soon after a plentiful meal. I know many persons who never fail to have the heart-burn, if they ride soon after dinner, provided they have drank ale, wine, or any fermented liquor; but are never troubled with it when they have drank rum or brandy and water without any sugar or acid.
WHEN the heart-burn proceeds from debility of the stomach or indigestion, the patient ought to take a dose or two of rhubarb; afterwards he must use infusions of the Peruvian bark, or any other of the stomachic bitters, in wine or brandy. Exercise in the open air will likewise be of use, and every thing that promotes digestion.
WHEN bilious humours occasion the heart-burn, a tea-spoonful of the sweet spirit of nitre in a glass of water, or a cup of tea, will generally give ease. If it proceeds from the use of greasy aliments, a dram of brandy or rum may be taken.
IF acidity or sourness of the stomach occasions the heart-burn, absorbents are the proper medicines. In this case an ounce of powdered chalk, half an ounce of fine sugar, and a quarter of an ounce of gum arabic, may be mixed in an English quart of water, and a tea-cupful of it taken as often as is necessary. Such as do not chuse chalk may take a tea-spoonful of prepared oyster-shells, or of the powder called crabs-eyes, in a glass of cinnamon or peppermint-water. But the safest and best absorbent is magnesia alba. This not only acts as an absorbent, but likewise as a purgative; whereas chalk, and other absorbents of that kind, are apt to lie in the intestines, and occasion obstructions. This powder is not disagreeable, and may be taken in a cup of tea, or a glass of mint-water. A large tea-spoonful is the usual dose, but it may be taken in a much greater quantity when there is occasion. These things are now generally made up into lozenges for the conveniency of being carried in the pocket, and taken at pleasure.
lF wind be the cause of this complaint, the most proper medicines are those called carminatives; as aniseeds, juniper-berries, ginger, canella alba, cardamom seeds, &c. These may either be chewed, or infused in wine, brandy, or other spirits. One of the safest medicines of this kind is the tincture, made by infusing an ounce of rhubarb; and a quarter of an ounce of the lesser cardamom seeds, in an English pint of brandy. After this has digested for two or three days, it ought to be strained, and four ounces of white sugar-candy added to it. It must stand to digest a second time till the sugar be dissolved. A table-spoonful of it may be taken occasionally for a dose.
I HAVE frequently known the heart-burn cured, particularly in pregnant women, by chewing green tea.