PURGATIVES. 363 



and it is, at any rate, certain that morbid materials 

 which may have been for some time accumulating in 

 the blood may be in this way directly removed ; and 

 at least, in this respect, the body will be in a more 

 favourable condition to bear an attack of acute disease 

 than would have been the case had such noxious 

 materials still remained in the circulation. Moreover, 

 many of us, after having been exposed to the influ- 

 ence of noxious gases and other deleterious agents, 

 have been seized with symptoms similar to those 

 which often precede a specific feverish malady, but 

 have been completely relieved by a sharp and sudden 

 attack of diarrhoea. These and many other circum- 

 stances which I will not stop to recount have been 

 considered by many to justify the old-fashioned prac- 

 tice of giving purgatives at the commencement of an 

 attack of acute illness, or on the occurrence of symp- 

 toms which seem to portend an attack. Like other 

 routine practice, this has been rightly condemned ; 

 but nevertheless, I believe it to be thoroughly sound 

 practice in many instances, and I think that of late 

 years patients have been allowed to suffer from great 

 inconvenience and discomfort for many days, when a 

 simple purge might have produced immediate relief. 

 To purge freely just as an attack of enteric fever is 

 coming on would unquestionably be very wrong ; but, 

 on the other hand, what relief is sometimes afforded 

 by the administration of a sharp purge in many a 

 case in which we have reason to think pneumonia, of 



