(From α, neg. and Apepsia 936 to digest; also dyspepsia). Indigestion. That genus of disease which Dr. Cullen names dyspepsia, he arranges in the class neuroses,and order adynamics. The symptoms are, a want of appetite, a sickness, sometimes vomiting, sudden and transient distentions of the stomach, eructations, heartburn, pain in the region of the stomach. These symptoms, or the greater number of them, are attended most commonly with costiveness, without any other disorder either in the stomach itself, or any other part of the body. In this case, when what ought to be digested and form materials for good chyle becomes acid, or putrid, a variety of other symptoms occurs, according to the nature of the materials thus morbidly changed. But indigestion is very frequently a secondary and sympathetic affection, though the just mentioned symptoms are essential to this disease, as idiopathic. All these may arise from one cause, viz. weakness, or loss of tone in the muscular fibres of the stomach: and this weakness is the proximate cause of the disorder, when an original one. The remote causes are various, as tumour, in the stomach itself; or some disorder of other parts communicated to the stomach, as in the gout; in these cases the indigestion is symptomatic.

In most instances of indigestion, as an original disease, the weaker action of the muscular fibres of the stomach is the chief cause; a depravity or defect of the gastric juice has been supposed to occasion it; but even here, perhaps, weakness is the only cause to which we can attend usefully in practice. To succeed in the cure, we must avoid the occasional causes, remove such symptoms as tend to aggravate or to continue the disease, and invigorate the tone of the stomach. For this purpose the patient must be informed of the necessary changes in his conduct; for though he has often pursued such a practice without sensibly suffering, except he conforms to a contrary one, the present complaints will not be removed. Crudities, acidity, and costiveness, must be obviated at least in their excess, as they tend both to aggravate and continue indigestion. When these ends are accomplished, the restoration of the tone of the stomach alone remains for perfecting relief.

Abstemiousness and excess, but chiefly the latter, are causes of indigestion. An over-distention of the stomach may in some measure injure its proper tone; and frequent long fasting, render it feeble. Hard drinking, and any of the causes of an anorexy, also injure digestion. Fasting, however, must be long continued, and frequently repeated, to have any bad effect. When it produces dyspepsia, improper food has been occasionally taken.

Anxiety and uneasiness of mind are often remote causes of dyspepsia, and when these are removed, the effects often continue. Intense study, not properly alternated with cheerful conversation or exercise, has the same effect; but no remote cause is more frequent or powerful than late hours, and indulgence in spirituous liquors. In these cases the management of diet is of considerable importance; and they form one of the very few exceptions to the general rule of suffering the stomach to be occasionally empty. When it is so in dyspepsia, all the symptoms are aggravated; and persons labouring under this complaint should frequently swallow some food. A bit of ship biscuit, as bread not subject to fermentation, is one of the best substances to be frequently taken, and a little beef tea may be also occasionally added. The food should in general be of the light animal kind, and the more flatulent vegetables and fruits avoided. The drink should be porter, or strong, not sweet, cyder; and the wine, Madeira or sherry. If these cannot be obtained, a slight addition of good brandy to cold water, without sugar, may be allowed. Tea should be at once abandoned; and an infusion of our own warmer herbs, as pennyroyal, peppermint, or rosemary, substituted.

In some weak stomachs a singular aggravation of the symptoms comes on, in about an hour or two after a tolerably full meal, attended with a sense of sinking or weakness. This seems to be owing to a digestion unusually rapid, and consequently imperfect. In such cases, aliment of more difficult digestion, as eggs boiled hard, or the addition of condiments which retard digestion, may be allowed; but, in general, a bit of biscuit and a glass of wine will remove the sense of weakness, which is owing to the sudden emptying of the stomach before too much distended.

Little need be added in order to the cure; for the treatment is the same as is required in Anorexia, q. v.

The columbo root, not mentioned in the article Anorexia, is particularly useful when the stomach is languid, the appetite defective, digestion with difficulty carried on,or when a nausea with flatulence attends. It may be given in substance with any grateful aromatic, or infused in Madeira wine, now and then interposing gentle doses of the tincture of rhubarb.

A mixture of mustard seed with the columbo root is of considerable utility in complaints of this kind; particularly where acidity and flatulence prevail much in the primae viae; and the aqua kali purae always assists its action: a warm plaster, with the addition of some opium, worn at the pit of the stomach, is occasionally of great service.

The Bath waters, assisted with warm nervous medicines and corroborants, are not to be omitted when circumstances admit of their use.

See Percival's Essays in the Reflections on Exper. 4, 5, and 6. Cullen's First Lines, v. iii. p. 217. edit. iv.