BILIOUSNESS. 133 



constipation or not Aperients bring away not only bile, but waste material from 

 the blood. Saline aperients, from the promptness of their action and the large 

 watery motions they induce, are among the best for the purpose. Recourse is 

 usually had to Epsom salts (sulphate of magnesia), Glauber's salts (sulphate of soda), 

 Rochelle salts (tartrate of potash and soda), or the phosphate of soda, or to varioun 

 combinations of these salts with common salt (chloride of sodium), carbonate of 

 soda, and other alkaline salts, such as are found in the waters of Carlsbad, Freidrich- 

 shall, Piillna, Harrogate, or Cheltenham, or in the recently-discovered Hungarian 

 spring, Hunjadi Jnos. The salts derived from most of these springs can be 

 obtained from any chemist, and they are best taken with warm water, and in the 

 morning fasting. 



One of the most valuable remedies in cases in which the liver is out of order is 

 Bim-pitt. Of late years an attempt has been made by physiologists to show that 

 mercury has no action at all on the liver in increasing the flow of bile. We do not 

 know how that may be ; but we do know that if you are bilious you cannot do better 

 than take a dose or two of blue-pill. Everybody who suffers from biliousness knows 

 what a great deal of good blue-pill will do him. He knows that there is nothing else 

 like it. If anybody does not believe in medicine let him get right-down bilious, and 

 then take a blue-pill We believe that even the most sceptical would admit that 

 there was something in it. Even supposing we agree to talieve the physiologist, and 

 admit that mercury is incapable of increasing the flow of bile in health, it by no 

 means follows that it is inoperative when the liver is out of order. It is quite con- 

 ceivable that mercury may remove certain unhealthy conditions of the liver which 

 prevented the secretion of the bile. Surely it is far better to endeavour to restore the 

 liver to its natural condition than to give an unhealthy liver a drug to make it work. 

 Putting theory on one side, we all of us know practically that blue-pill removes what 

 we call biliousness, and nobody in the world can deny that. The pill, taken at bed- 

 time, may be followed by a saline aperient (Pr. 25), or black draught, ia the morning. 

 In many instances one of the sugar and grey powders (Pr. 71) given frequently will do 

 almost as well as a large dose of blue-pill. These powders are especially indicated 

 when there is a dull oppressive pain over the liver, preventing the patient from lying 

 long on the right side ; when the whites of the eyes are tinged with yellow ; when 

 the skin is sallow, when there is shivering followed by profuse clammy perspiration ; 

 when there is loss of appetite, a nasty taste in the mouth, and constipation, with pale- 

 coloured motions. 



PodophyUin is a very good substitute for mercury in some cases, when the latter 

 cannot be used. It is, on the whole, less certain in its action than mercury, and more 

 likely to cause griping. A dose that will purge one person violently often proves in- 

 operative in another. Individual differences occur, it is true, with other purgatives, but 

 podophyllin is unusually uncertain in its action. The time it takes to act also varies 

 very much. It purges some people in an hour or two, whilst others have to wait 

 about all day. Sometimes, instead of doing its work straight off and have done with 

 it, it makes a number of ineffectual attempts, and is a long time before it succeeds. 

 The following is a good formula for its administration, the henbane being supposed 

 to reduce its tendency to cause griping : 



