596 PRACTICE OF PHYSIC. 



purging is the evacuation which has been most frequently, and 

 perhaps with most success, employed in dropsy. It has been 

 generally found necessary to employ purgatives of the more 

 drastic kind; which are commonly known, and need not be 

 enumerated here. I believe, indeed, that the more drastic pur- 

 gatives are the most effectual for exciting absorption, as their 

 stimulus is most readily communicated to the other parts of the 

 system ; but of late an opinion has prevailed, that some milder 

 purgatives may be employed with advantage. This opinion has 

 prevailed particularly with regard to the crystals vulgarly call- 

 ed the Cream of Tartar, which in large doses, frequently re- 

 peated, have sometimes answered the purpose of exciting large 

 evacuations both by stool and urine, and have thereby cured 

 dropsies. This medicine, however, has frequently failed, both 

 in its operation and effects, when the drastic purgatives have 

 been more successful. 



Practitioners have long ago observed, that, in the employ- 

 ment of purgatives, it is requisite they be repeated after as short 

 intervals as the patient can bear ; probably for this reason, that 

 when the purging is not carried to the degree of soon exciting 

 an absorption, the evacuation weakens the system, and thereby 

 increases the afflux of fluids to the hydropic parts. 



" Gamboge is a powerful purgative, and has accordingly been 

 long considered as a chief hydragogue. Observing that it was 

 a purgative which passed though the intestines more quickly 

 than almost any other, I have judged that moderate doses of it 

 might be repeated soon after one another, with more safety, and 

 with more effect, than by giving large doses at once. Accord- 

 ingly, I have given doses of three or four grains, rubbed with a 

 little sugar; and repeating these every three hours, I have 

 found it operate without vomiting or griping : and at the same 

 time, after three or four such exhibitions, a good deal of water 

 was evacuated both by stool and urine. Although I have not 

 yet had much experience of this management, I have no doubt 

 of its being adapted to the cure of dropsy, with more ease to the 

 patient than in any other manner of exhibiting it. M. M. 



MDCLXXXIV. The kidneys afford a natural outlet for a 

 great part of the watery fluids contained in the blood-vessels ; 

 and the increasing the excretion by the kidneys to a consider- 



