rer 
the bad syntitoms; nay, I think that chil- 
dren decay ¢ven faster than when the purging 
“is most violent. 
*2 «The disease seldom proves fatal before 
tthe sixth or seventh week; and in this short 
time I have seen the finest children miserably 
wasted. I have seen, though rarely, a child 
recovered after the disease had continued 
three or four ih and again, I have seen 
the disease cut short by death in the second, 
‘third, or fourth week, before it had reached 
the acme;'the sudden termination having 
been occasioned by an incessant vomiting 
and purging, or by convulsions from the 
immense irritation in the bowels. 
<< The disease is more frequent in children 
who have been weaned before the eighth or 
ninth month, and in particular in those who, 
‘in consequence of some accident happening 
to the nurse, have been weaned abruptly.” 
~ It is a disease of the autumnal months, 
and is most likely to oceur in delicate 
constitutions, such as might be supposed 
to be, in future, Hable to scrophula. 
.. The peculiar nature of this disease the 
author thinks he has*detected by dis- 
section, which, instead of confirming his 
first opinion, has given, him season to 
conclude, that it originates in an in- 
creased secretion of acrid bile, or rather 
in the morbid state of the liver, which 
Occasions it. He observed, 
**—in every instance, that the intestinal 
canal, from the stomach downward, abound- 
ed with singular contractions, and had in its 
course one or more inius-susceptions ; that 
the liver was exceedingly firm, larger than 
natural, and ofa bright red colour, and that 
the enlarged gall bladder contained a dark 
green bile. Jn some dissections the mesen- 
teric glands were swelled and inflamed; ia 
others, however, they were scarcely enlarged, 
and had no appearance of inflammation. 
“«'Yhese contractions and intus-suseep- 
tions were entirely of a spasmodic nature, 
as in the latter the contained part of the gut 
was casily disengaged from that which formed 
its sac; and in no part of the entanglement 
was there adhesion, or even the mark of in- 
flammation ; and ithe contracted portions of 
the intestine were again permaneatly dilated 
by pushing the finger into’ therm.” 
The connexion which the author pre- 
sumes to exist between these appearances, 
and an increased secretion of acrid bile, 
he infers from some positions which n:ay 
be regarded as rather hypothetical. 
When a child is weaned abruptly, and at 
an improper period, the food on which 
it is put becomes too violent a stimulus 
tothe intestines. ‘lhe liver is connected. 
with the intestines by a very close sym- 
pathy, and is*hence excited to unusual 
action, Which preduces a large and vi- 
MEDICINE, SURGERY, ANATOMY, &e. 
tiated secretion of bile, to whiclr the 
long-continued purging, and the various 
phznomena observed by dissection, are 
supposed to be owing. The green stools, 
which are observed at an early period of 
this complaint, discover an increased ’se- 
cretion from the liver; and though, at 
some stages of it, the feces are clay-co- 
loured, and therefore seem to indicaté 
defect of bile, yet this circumstance seems 
to the author accountable, upon the sup- 
position that when the gall bladder is 
distended with bile, it presses so much 
upon the cystic duct, and so much in- 
creases its natural curvature, as to pres 
vent it from flowing out freely; hence it 
becomes concentrated and more acrid} 
and when by some action of the stomach’ 
and duodenum the enlarged gall blad- 
der is compressed, the intestines are in 
undated with bile. This supposition,’ 
however, requires the necessity of .an.in= 
terruption to the passage of the secreted 
bile, which could be poured into,the, ins, 
testine by the hepatic and common ducts, 
notwithstanding any obstacle to its flow 
from the gall bladder... .,,,- 1F 
With regard to the cure of this com 
plaint, the author, after trying without 
success various means of relief, was ati 
last induced to employ calomel, and from{ 
the use of this medicine has-had many; 
very satisfactory results. He gives it, 
generally in doses of half a grain every 
morning and evening, and until its ope-,; 
ration on the liver has taken place, mo-, 
derates the griping, purging, or vomit-; 
ing, by opiate glysters. The same plan, 
has been found efficacious in the: diar-. 
rheeasof children.. Whatever opinion may , 
be formed of the author’s theory of this; 
disease, the practice which he recom-, 
mends, of giving calomel for its reanoval, 
is certainly a yery proper one, but at the, 
same time it is too general to admit of its, 
being received asa new idea. ‘The aus 
thor annexes several cases to exemplify. 
the effects of hts practice, and to illus- 
trate the appearance observable on dis. 
section, ‘Two well executed and  ¢o-: 
loured plates exhibit the morbid appear-, 
ances in two cases which terminated fa-., 
tally. ; Af st 
A few pages at the conclusion of this, 
essay, which are intended to be placed. 
ith that part of his work to which they. 
refer, are. devoted to the defence of some. 
of the author’s ideas on croup. He’ 
entertains an extreme aversion, to. the. 
operation of bronchotomy, which he is, 
of opinion no circumstances, can ever 
justify, and now gives some observations 
