INDIGESTION AND NERVOUS DEPRESSION. 381 



As a saline we may use sulphate of magnesia, or Fi'iedrichsliall, Pullna, 

 Hunyadi Janos, or Carlsbad water ; but, whichever saline we may 

 choose, the use of one or other of them should on no account be 

 omitted. One of the best salines is half a drachm of crystallized Carls- 

 bad salts dissolved in a tumbler of hot water and drunk immediately 

 after rising in the morning, and this may be used not merely in the 

 morning after the mercurial, but it may also be employed every morn- 

 ing in cases where the bowels are constipated. The quantity of water 

 is of considerable importance. Half a teaspoonful dissolved in a 

 full tumbler is more efficacious than double the quantity of salt in 

 half the quantity of water. Nor is this to be wondered at, for not 

 only has the larger quantity of liquid greater power to wash out the 

 intestine, but the increased amount of the water tends to increase the 

 quantity of bile secreted, and this increase in bile is especially marked 

 when the water is taken frequently in small quantities, as it is by per- 

 sons undergoing the cure at Carlsbad, or who take the solution of 

 Carlsbad salts at home by sipping it at intervals while dressing, in- 

 stead of drinking it all off at once. 



Zawilski found that when liquids were taken in this way not only 

 was the bile secreted in greater quantity, but under a greater pressure, 

 so much so that secretion still occurred when such an obstruction was 

 opposed to its exit as would usually have caused the bile which had 

 already been excreted to be reabsorbed.* 



When the Carlsbad salts are employed after the mercurial, it is, I 

 think, best to take them in single large draughts immediately on rising, 

 but when used by themselves the solution should be sipped at intervals 

 during dressing. When used alone, the Carlsbad water, warmed by 

 standing the tumbler in a basin of hot water or in an iBtna, is perhaps 

 even better than the salts, which represent only a part of the normal 

 constituents of the water. After the liver has been thoroughly cleared 

 out in this manner by a mercurial purgative followed by a saline, 

 vegetable cholagogues, such as iridin and euonymin, may be employed 

 to assist the action of the Carlsbad salts, when these are found to be 

 insufficient, even although they ai*e taken with regularity. These 

 cholagogues, the introduction of which into medicine, in this country 

 at least, we owe to Professor Rutherford, are sometimes as useful, 

 perhaps even more so than mercury, but, as a rule, I think the mer- 

 curial purgative is the best to begin with. Euonymin is the chola- 

 gogue most usually employed, but iridin is really the most powerful 

 one, and is specially recommended by Dr. Rutherford. 



Instead of tiying to keep up the strength, as it is termed, by load- 

 ing the stomach with food, the exhausted brain-worker should rather 

 lean toward abstinence from food, and especially tOAvard abstinence 

 from alcoholic liquors. The feeling of muscular weakness and lassi- 

 tude, which I have already had occasion to mention as frequently com- 



* " Sitzungsber. der wiener Acad.," 1877 ; mat. nat. Abth., Bd. iv, p. 73. 



