326 PRACTICE OF PHYSIC. 



gatives, it commonly does much mischief ; I believe it indeed to 

 be only the neglect of purging that renders the use of opiates 

 very necessary. 



" The propriety and use of opium is much disputed. I think 

 it is a proper remedy, upon the principle which we have ex- 

 plained, of the disease consisting in a spasmodic constriction ; 

 and we can see its use in moderating and taking oif that spasm. I 

 can believe Sydenham, when he affirms, that several slighter cases 

 of dysentery were cured by it alone. Whether, however, opium can 

 here prove a cure or not, we are obliged to employ it upon another 

 account : we are urged to it by the violence of the pain, which 

 gives all the urgent symptoms of the disease. It has been my 

 practice, when I gave the laxative two or three times in the day, 

 to give an opiate with the evening dose, and I am willing even 

 to interrupt the operation of the purgative in order to obtain a 

 little sleep. . Much has been said of the mischiefs and dangers 

 arising from the astringency of opium ; but it is not properly 

 an astringent : it induces no contracted state of the muscular 

 fibres, but merely interrupts their action, which was preterna- 

 turally increased ; and therefore this interruption of their action, 

 which is only temporary, cannot have much effect in confining 

 the morbific matter. And there is this particular, which has 

 not been much attended to : the interruption of the usual stools 

 of dysentery does not stop the course of the morbific matter ; 

 for the latter is not evacuated in these, it being chiefly generat- 

 ed in the small guts, from which hardly any thing passes : what 

 is evacuated from the rectum, is no morbid matter, but comes 

 rather from its substance, and to interrupt such an evacuation 

 will rather be useful and desirable, and not hurtful. So far I 

 would speak in favour of opium in dysentery. 



" But to go on to the other side of the question. It may be 

 improperly used, and extremely hurtful : it may, for the time, 

 in some measure take off the constriction of the colon, but it 

 occasions a sort of interruption in the action of the small guts, 

 which action, properly supported, urges on the proper motion of 

 the colon. Opium contributes little to the cure of the disease : 

 it only prevents its growing worse, and relieves symptoms which 

 would otherwise prove injurious ; it relieves the violent pains, 

 but it would be very improper to trust too much to it alone. If 



