324 PRACTICE OF PHYSIC. 



of the hardened excretions found in the colon is a matter to be 

 seriously attended to. But neither of these views come up to 

 my idea of the matter : I say, the indication is to obviate the 

 constriction which affects the colon, and which gives occasion to 

 the formation of hardened faeces, and to the retention of the 

 morbific matter which produces the other symptoms of the dis- 

 ease. This view will serve to modify our practice. When the 

 constriction of the colon has been allowed to subsist for some 

 time, somewhat of a smart and acrid purgative may be ne- 

 cessary, and has been found useful ; and then the use of senna, 

 recommended by Sydenham, and of rhubarb and calomel em- 

 ployed in latter times, may be proper. But such remedies can- 

 not be repeated but at intervals ; and, by allowing these intervals, 

 we allow the disease to return ; and the effect of acrid purgatives 

 is always to leave the intestines in a more constricted state : 

 hence, though they relieve the symptoms for the time, they 

 allow the disease to return with violence. It is therefore the 

 highest improvement in the present practice, not to employ in 

 the commencement of the disease the more acrid purgatives, but 

 rather the laxative medicines, and, by the frequency of their ex- 

 hibition, to keep the passage of the intestines clear, till the pre- 

 ternatural constriction of the colon is taken off, and the whole 

 morbific matter evacuated. So a dose of Glauber's salts, ss. 

 twice a day, or Cremor tartari employed in the same manner, has 

 met with the most desirable succe'ss. Some employ the Decoctio 

 Tamarindorum alone, or with Cremor tartari ; some merely the 

 fresh fruits. We have several instances in Tissot and some other 

 writers, of an epidemic dysentery merely cured by letting soldiers 

 into a vineyard, in consequence of which evacuations by stool 

 without pain and griping, were brought on, and an entire cure 

 of the disease effected." 



Whatever laxatives produce an evacuation of natural faeces, 

 and a consequent remission of the symptoms, will be sufficient to 

 effectuate the cure. But, if gentle laxatives shall not produce the 

 evacuation now mentioned, some more powerful medicines must 

 be employed : and I have found nothing more proper or con- 

 venient than tartar emetic, given in small doses and at such in- 

 tervals as may determine their operation to be chiefly by stool. 

 Rhubarb, so frequently employed, is in several respects amongst 





