432 MATER i A MEDIC A AND THERAPEUTICS. 



to impairment of the general health by sedentary occupations, 

 foul air, etc. ; to a variety of obscure causes, commonly referred 

 to as locality, and change of habits; and to certain organic 

 diseases of the bowel. The most severe and obstinate cases of 

 constipation are caused by paralysis of the bowel in disease of 

 the spinal cord and lead-poisoning. Although constipation, 

 like diarrhoea, is but a symptom, and must be treated as such, 

 its unfavourable effects on digestion, sanguification, and the 

 functions generally, are almost endless. 



Along with constipation must be considered a class of cases 

 where disease of the digestive organs, liver, heart, lungs, general 

 circulation, brain, blood, or kidneys, demands free evacuation of 

 the bowels, and, it may be, even a hydragogue or cathartic 

 action, chiefly as a means of unloading the circulation or of 

 evacuating excrementitious substances. Frequent reference 

 will be made to this application of purgation under the several 

 organs in the following chapters. 



IV. NATURAL RECOVERY. 



Diarrhoea is a striking instance of the first method of 

 natural recovery by removal of the cause. By this means not 

 only is the bowel purged of irritant matters, but constipation 

 may be naturally relieved by a spontaneous diarrhoea produced 

 by the irritant effect of the retained faeces. Both diarrhoea 

 and constipation, if left entirely to themselves, may spon- 

 taneously cease, and the normal action of the bowels return. 

 Therapeutical assistance is, however, constantly valuable, and 

 frequently essential. Thus the diarrhoea of infants may quickly 

 end in fatal exhaustion, and atony of the gut may be the result 

 of neglected constipation. 



V. THERAPEUTICS. 



1. Excessive Intestinal Activity; Treatment of Diarrhoea. 

 The treatment of diarrhoea should begin, if possible, with the 

 removal of its cause. If this is being accomplished by the 

 bowel itself, we must encourage intestinal activity for a time 

 by such purgatives as Castor Oil, Rhubarb, Calomel, Magnesia, 

 and Senna. The first two drugs are specially valuable, as they 

 also possess an astringent action, which comes into force after 

 the purgation. On the same principle, diarrhoea from hepatic 

 or renal disorder or disease, is rationally treated by non- 

 interference or even by a judicious increase of elimination by 

 the bowel, hepatic and renal stimulants being also combined ; 

 that is, by the use of a purgative which is partly cholagogue, 

 followed by a diuretic a mercurial pill supplemented by a 



