Electro-physiology and electro-therapeutics : showing the best methods for the medical uses of electricity / By Alfred C. Garratt.

(6.) Second, the depressing moral emotions. These, when at all intense, produce painful constriction of the epigastrium. To sum up, this muscular hypersesthesia is due to the two orders of physiological causes, namely, the direct influence of the ner- vous centres on the muscles, and the reaction of the disordered stomach on the same muscles. Epigastralgia extends peculiarly towards the left side, rising as high as the sternum middle, and rarely descending below the umbilicus. The pain is severe and continuous, and easily exas- perated by emotion, progression, compression, or the hysterical fit. The attitude is constrained, and sometimes the respiration is influenced ; but here the process of digestion docs not appear to aggravate the suffering. The ignorance that prevails as to the seat and nature of epigastralgia has led to most serious errors in medical practice — these muscular pains being some- times vaguely thought to be localized in the solar plexus, and, at others, in the stomach itself; and then, according to the doc- trine of the day, have been treated as neurosis, gastralgia, or gastritis. Now, if we bear in mind that, in somewhat less than half of the persons suffering from pains in the epigastrium, (stomach region,) the pain is only muscular, it is evident that that num- ber, at least, have been treated for a gastralgia that had no ex- istence. Moreover, in patients suffering simultaneously from epigastralgia and derangement of the digestive functions, the former may exist independently of the latter, and be easily re- lieved by means addressed specially to it; and yet, in these cases, the stomach has been needlessly tormented by treatment that, rather, should have been directed to the muscles. It is not meant to be said that the stomach itself may not be the seat of severe suffering, such as pyrosis, tearing pain, or distention, from indigestion; but such pains are intermittent and temporary, and should not be confounded with the continuous pains of the epi- gastric muscles. The writers on gastralgia never allude to these " muscular pains;" and, since amid three hundred and fifty-eight cases of hysterical patients the author found not above ten in which gastralgia existed without epigastralgia also, it is easy to