ces in the service of nature. It must
be remembered that digestion, however well commenced in the stomach, is
not perfected there; that, in the words of Dr. Mason Good, "it ranges
through a wide spread of organs closely sympathizing with each other,
and each, when disordered, giving rise to dyspepsia." After the
formation of chyme, and the food has passed the pyloric orifice of the
stomach, it undergoes a new process in the duodenum, when it is
converted into chyle, probably by the action of the bile, although this
is a point not absolutely determined by physiological experiment; even
now, digestion is only half finished, the lacteals (a class of absorbing
vessels particularly numerous in the duodenum, and also existing in the
larger intestines) take up this fluid, for the purpose of conveying it
into the thoracic duct, which terminates in the left subclavian vein,
nor is the total process of digestion completed, until, in the language
of the author above quoted, "it has been exposed to the action of the
atmosphere, travelling, for this purpose, through the lungs, when it
becomes completely assimilated with the vital fluids." Hence, although
the meaning of dyspepsia must be restricted, as its derivations demand;
the term, digestion, bears a much more extensive signification than it
generally receives, and any error in its process may be properly
denominated indigestion; however, Mr. Halsted regards the term dyspepsia
as equivalent to indigestion, and we may, for once, adopt the same
phraseology. Now, as digestion is of so complicated a nature, how will
Mr. H. explain his reference to the muscular coat of the stomach as a
chief cause of its derangement? Is he so admirable a pathologist as to
discriminate, when called to a case of dyspepsia, whether, to use his
own words, "it consists in a diminished quantity or vitiated state of
the gastric fluid, in a morbid secretion from the inner coats of the
stomach, or from a peculiar acid generated there; whether chronic
inflammation of the mucous membrane of that organ, or a torpid state of
the liver and a deficient secretion of the bile occasion it: it would
appear that such conditions _may_ exist, and then produce their
different symptoms, requiring a _modified_ treatment;" but it frequently
happens that these cases, slight in themselves, determine principally to
the stomach, and are not apparent to the keenest eye in any other organ
upon the first attack. Besides, it is the prac