You have noticed, too, the large size and prominence of
the liver. M. Bianchon has, besides, constantly watched the patient,
and he tells us that digestion is troublesome and difficult. Strictly
speaking, there is no stomach left, and so the man has disappeared.
The brain is atrophied because the man digests no longer. The
progressive deterioration wrought in the epigastric region, the seat
of vitality, has vitiated the whole system. Thence, by continuous
fevered vibrations, the disorder has reached the brain by means of the
nervous plexus, hence the excessive irritation in that organ. There is
monomania. The patient is burdened with a fixed idea. That piece of
skin really contracts, to his way of thinking; very likely it always
has been as we have seen it; but whether it contracts or no, that
thing is for him just like the fly that some Grand Vizier or other had
on his nose. If you put leeches at once on the epigastrium, and reduce
the irritation in that part, which is the very seat of man's life, and
if you diet the patient, the monomania will leave him. I will say no
more to Dr. Bianchon; he should be able to grasp the whole treatment
as well as the details. There may be, perhaps, some complication of
the disease--the bronchial tubes, possibly, may be also inflamed; but
I believe that treatment for the intestinal organs is very much more
important and necessary, and more urgently required than for the
lungs.
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