696 
CONSTIPATION 1 . 
sharp pain, though his countenance would not lead one to think 
he is free from pain altogether. There appears still dull pain 
or annoying feelings in his bowels. His belly, which has never 
been very large or tense before, seems getting so now. 
Nov. 1st, 9 o'clock, a.m. — He has commenced “blowing” 
again ; and his pulse has got up again to 90, and is small, indi- 
cating irritation more than inflammatory action. The tobacco- 
enema was administered with no effect. Let him continue his 
calomel and opium : I see no other chance of saving him. 
7 o'clock, p.m. — He has very slightly purged in the course of 
the afternoon. 
Nov . 2d. — Purging freely. He has taken nine drachms of ca- 
lomel. His breathing is tranquil again, and his pulse has got 
down; and he appears, now that his bowels are being plentifully 
relieved, to be in the road to recovery. He has also, for the first 
time since he was taken, shewn an inclination for food. Discon- 
tinue his balls, and make him some gruel, and get him a handful 
or two of very nice hay. 
Nov. 3d. — Still purging. Has commenced feeding with an 
appetite. Refuses now to drink gruel ; therefore let him have 
chilled water. 
4th. — Diarrhoea ceasing ; dung now being in a soft mass. 
Pulse 44. 
5th. — Going on well. Bowels regular, dung in balls of the 
ordinary character. 
After leaving the infirmary he became affected with tainted 
breath and tender mouth, from the mercury. 
Observations. — Two circumstances distinguish this case 
from one of cholic : the symptoms, although they intermitted, 
were not of that acutely painful character ; and, moreover, they 
proved protracted beyond any thing cholic would have done. 
There was evidently intestinal disease ; but there was no more 
reason for believing it was enteritis than cholic; for, as I said 
before, the symptoms were not urgent enough for either one or 
the other. And, again, had the disorder consisted in inflamma- 
tion, there would have been no such intermissions, during which 
the patient appeared free from pain, as there were. 
The case being neither cholic nor enteritis, and yet evidently 
one of bowel irritation, the scantiness of the alvine discharges, 
and the irregularity of them, together with their nature, led me to 
call it constipation ; and I think the result has borne me out in 
my diagnosis. One thing is certain, — that it was at once re- 
lieved, I may say cured, by catharsis. But how was this de- 
sirable object effected ? Although the two ounces of Barbadoes 
aloes may have contributed towards it, they did not appear, from 
