PROFJLUVIA. 327 



opium supersedes the use of purgatives, or interrupts their pro- 

 per operation, it certainly proves hurtful. 



" I shall conclude with saying that which deserves our par- 

 ticular notice : if the purgatives, operating as I have former- 

 ly explained, have their usual effect in relieving griping and 

 tenesmus, I shall allow that they may entirely supersede the 

 use of opium ; and, very possibly, the more carefully and the 

 more powerfully we employ the laxatives, the less occasion there 

 will be for opium." 



MLXXXIV. When the gripes are both frequent and se- 

 vere, they may sometimes be relieved by the employment of a 

 semicupium, or by a fomentation of the abdomen, continued for 

 some time. In the same case, the pains may be relieved, and, 

 as I think, the constriction of the colon may be taken off by 

 blisters applied to the lower belly. 



MLXXXV. At the beginning of this disease, when the 

 fever is any way considerable, blood-letting, in patients of toler- 

 able vigour, may be proper and necessary ; and when the pulse 

 is full and hard, with other symptoms of an inflammatory dis- 

 position, blood-letting ought to be repeated. " In that case, 

 the use of opiates may be deceitful and even hurtful." But, 

 as the fever attending dysentery is often of a putrid kind, or does, 

 in the course of the disease, become soon of that nature, 

 blood-letting must be employed with great caution. 



MLXXXVI. From the account now given of the nature of 

 this disease, it will be sufficiently obvious that the use of astrin- 

 gents in the beginning of it must be absolutely pernicious. 



" It is extremely necessary here to take notice of an error 

 very generally prevailing in writers on the Materia Medica, in 

 their relating the virtues and powers of astringents. They very 

 generally mention the virtues of astringents as equally adapted 

 to diarrhrea and dysentery ; but I maintain that these two dis- 

 eases are very different from one another ; so that, while diarr- 

 hoea consists in an increased evacuation from the exhalents 

 and excretories on the internal surface of the intestines, which 

 may be restrained by astringents applied, dysentery consists or 

 depends upon an increased constriction in a considerable portion 

 of the intestinal canal, which must be increased by the applica- 

 tion of such astringents. This is now well understood, and 



