MEDICINE. 



Practice, crease, we must introduce a class of specifics. Of tlie 

 s "Y""*' existence of a class of remedies, which have the power 

 of stimulating the skin wlu-n applied to its surface, we 

 have sufficient evidence ; but there is considerably more 

 difficulty in clearly distinguishing the action of seda- 

 tives; and when we wish to produce this effect, it is 

 generally accomplished in an indirect manner, or sim- 

 ply by the removal of some stimulating cause. The 

 cirumstances which direct our judgment in the choice 

 of remedies, are derived partly from inquiring whether 

 the symptoms indicate an excess or a defect of action in 

 the part, and partly by tracing an analogy between the 

 disease under consideration, and others, with the treat- 

 ment of which we are better acquainted, a kind of 

 practice, it must be confessed, which is often verj em- 

 pirical, and t!ie result of which is very uncertain. Of 

 this uncertainty we have the most convincing evidence 

 in the writings of those, whose judgment and informa- 

 tion on the.<e topics is held in tne highest estimation ; 

 for we find that they proceed principally upon the ex- 

 perience that is derived from insulated facts, and that 

 they frequently recommend, for the cure of the same dis- 

 ease, remedies that appear to be of the most opposite na- 

 ture, in the selection of which we have very little explicit 

 direction, but are recommended to try them in succes- 

 sion, and to adhere to th-U which appears to be the most 

 beneficial. Upon the whole, we may conclude that 

 whatever promotes the general health, must be always 

 favourable to the relief of these diseases, and in many 

 cases will effect a cure; that, for this purpose, it is of the 

 highest importance to obtain a healthy state of the di- 

 gestive functions, and that temperance, fresh air, exer- 

 cise, and purgatives, are to be regarded as the basis on 

 which we are to proceed, and which will materially as- 

 sist us in the future progress of the cure. Upon this 

 principle, we shall be at no loss to account for the be- 

 nefit that is obtained from purgative saline waters, and 

 when they contain sulphur, which has a decided claim 

 to be considered as a specific in certain cutaneous dis- 

 eases, they present us with the most effectual remedy 

 for some of these affections. Calomel has been very 

 generally employed in these cases, and there can be no 

 doubt of its frequently proving highly useful ; but we 

 should be disposed to refer its good effects to its action 

 as a purgative, or at least to the power which it exer- 

 cises over the organs that are concerned in the process- 

 es of digestion and assimilation. We have but little 

 confidence in most of the boasted specifics for cutaneous 

 diseases, they are generally given after the exhibition 

 of more active remedies, if not in conjunction with 

 them. Their operation, even as admitted by their ad- 

 vocates, is slow, and unattended with any sensible ef- 

 fects, and they are commonly prescribed in connexion 

 with some system of regimen, or with some change in 

 the occupation or mode of life, to which we may, with 

 more probability, refer any advantage that is gained. 

 We must, however, make an exception in favour of 

 sulphur, of the efficacy of which no one can doubt, and 

 the same remark may be also extended to arsenic, and 

 probably to iron, but of the nature of their operation 

 we do not presume to offer any opinion. As to the 

 whole tribe of stimulants, both the various chemical 

 preparations, acids, alkalies, metallic oxides, and salts, 

 as well as the acid vegetable substances, we have little 

 to observe in the way of general principles, how far any 

 of them ought to be regarded as possessing specific vir- 

 tues, or whether they differ from each other solely in 

 the degree of their stimulating power, or in their me- 

 chanical properties, we do not feel competent to decide. 



Practice 



CHAP. V. 



Pareccrists. 

 SECT. I. Diarrhoea. 



WE have placed the diseases of the secretory organs in 

 a separate class, under the title of Pareccrises, and have 

 divided them into the two orders of Apoceno^es and Apoceo- 

 Epischeses, according as they produce an excess or a Bes - 

 defect in the quantity of the secreted fluid. In the first 

 order, we have the following genera depending upon the 

 organs which they immediately affect, Diarrhoea, Cho- 

 lera, Hyperuresis, Blennorrhoea vesicae, Lithiasis, Me- 

 i:orrhagia, Leucorrhcea, 1'tyalismus, Ephidrosis. These 

 diseases may be considered as, in a great measure, local 

 in their origin, and during their progress are not essen- 

 tially productive of any constitutional disturbance ; they 

 are not necessarily attended with fever, they have no 

 effect upon the nervous system, except upon those 

 parts of it with which they are in immediate contact, 

 and they may frequently be removed by remedies that 

 seem to act locally, or without the intervention of any 

 organ besides that to which they are directly applied. 



The first genus of this order is Diarrhoea, a very com- Diarrhtca. 

 mon disease, which consists in an increased discharge 

 from the alimentary canal, the evacuations being but 

 little affected except in their assuming a more liquid 

 consistence; they are generally preceded or accompa- 

 nied by flatulence and a griping pain in the bowels, 

 and frequently by sickness ; but this should perhaps 

 rather be attributed to the same cause wh'ch produces 

 the Diarrhoea, than be considered as a part of the dis- 

 ease itself. The symptoms of this complaint are so 

 obvious as seldom to leave any doubt respecting its 

 existence ; but there are two diseases that resemble it, 

 and from which it is important to distinguish it, Dy- 

 sentery and Cholera. For the most part an attention 

 to the nature of the evacuations is sufficient to point, 

 out the distinction, or if, as occasionally happen, the 

 diseases appear to run into each other, our remedies 

 must be administered accordingly, always adapting 

 them rather to the symptoms than to a technical no- 

 menclature. I he exciting causes of Diarrhoea are va- 

 rious ; perhaps the most frequent is repletion of the 

 stomach, or the reception into it of some kind of in- 

 digestible food ; cold applied to the surface of the body, 

 and especially to the legs and feet, is also an exciting 

 cause of Diarrhoea; and it is occasionnlly produced by 

 impressions upon the nervous system, or even by mere 

 mental emotions. In children the peculiar irritation 

 produced by teething seems to be a frequent exciting 

 cause of Diarrhoea, as well as that which arises from the 

 presence of worms in the alimentary canal. Although 

 the evacuations in Diarrhoea essentially consist of facu- 

 lent matter, they vary considerably in their appearance; 

 and from observing these variations, we have it in our 

 power, in some cases, to judge of the state of the parts 

 which immediately give rise to it. Diarrhoea is often 

 symptomatic of some other disease, many instances of 

 which have been stated above ; of these one of the most 

 violent is the colliquative discharge from the bowels 

 which occurs in the latter stages of hectic fever. It is 

 also a frequent attendant or sequel of the affections of 

 the liver that come on after a residence in hot climates, 

 and is then found to be one of the most unmanageable 

 symptoms of these diseases.. 



