MEDICINE. 
sternEra and scrobiculns cordis ; gentle 
laxatives should be ordered ; the patient 
should take copious draughts of some muci- 
laginous acidulated liquids j a gentle dia- 
phoresis should be promoted by nauseating 
doses of tartar emetic, with spirit of min- 
dererus, or by exhibiting the volatile alkali 
in wine whey ; the vapour of warm water, 
impregnated with vinegar, should be fre- 
quently inhaled ; mucilaginous oily demul- 
cents should be given, and expectoration 
should be promoted by the means pointed 
out when treating of pneumonic inflamma- 
tion. If the cough remain troublesome, 
after we have subdued the inflammatory 
diathesis, opiates, combined with the tar- 
tar emetic, or with ipecacuanha, may be 
employed with safety and advantage ; rub- 
bing the nose externally with oil, some 
ointment, or, with what is most commonly 
employed, warm tallow, is very often of 
great service, when the mucous membrane 
of the nose is much aiFected, which practice 
has very frequently come under my obser- 
vation. In the treatment of the epidemic 
catarrh (influenza), as being frequently at- 
tended with a considerable degree of debi- 
lity, the antiphlogistic regimen must not be 
pushed too far, even though there may be 
some appearance of excitement : it will, 
in general, if blood-letting should be deem- 
ed necessary, be more advisable rather to 
trust to local than to general blood-letting, 
blisters, mild diaphoretics, and diluents; 
sometimes, however, a more liberal diet, 
and the moderate use of wine, will answer 
better. Might not the affusion of tepid, 
or even cold water, be employed with 
safety, if the heat of the surface be greater 
than natural, and there be at the same 
time no tendency to asthma or phthisis pul- 
monalis ? 
Dysentery is most commonly preceded 
by cosliveness, unusual flatulence, acid 
eructations, and wandering pains in the 
bowels ; in most cases, however, from the 
commencement, griping pains are felt in 
the lower part of the abdomen, which often 
arise to a considerable degree of severity; 
the bowels are irritated to frequent eva- 
cuation, in indulging which, but little is 
voided, and the rectum often becomes 
exquisitely painful and tender ; the matter 
evacuated is often very foetid, and the 
stools are frequently composed of mucus, 
pus, blood, membranous films, and white 
lumps of a sebaceous nature, tlie mucus is 
generally mixed with a vvatery fluid, and i? 
often frothy : tenesmus, in a greater or 
less degree, generally accoirrpanies the 
evacuation of the bowels, and it very rarely 
happens that the natural fasces appear dur- 
ing the whole course of the disease, and 
when they do, they are in the form of 
scybalae, that is, small separate balls, which 
appear to have lain long in the cells of the 
colon ; when these are voided, either by 
the efforts of nature, or as solicited by me- 
dicine, they procure a remission of all the 
symptoms, more especially of the frequent 
stools, griping, and tenesmus ; with these 
symptoms there is loss of appetite, great 
anxiety about the prmcordia, frequent sick- 
ness, nausea, vomiting, and the matter re- 
jected is frequently bilious, watchfulness, 
and prostration of strength ; there is always 
some degree of symptomatic fever, which 
is sometimes of the remittent or intermit- 
tent type; sometimes it assumes the syno- 
chous, and very frequently the typhous 
type ; the tongue is white, and covered 
with tough mucus, or rough, dry, and some- 
times black ; the patient complains of a 
bitter taste in the mouth, and in the ad- 
vanced stage of the disease there is hiccup, 
and aphtha:. If the small intestines only 
be affected, the pain is described to be 
most acute and excruciating about the um- 
bilicus, the bowels are not evacuated im- 
mediately after the griping pains, the blood 
is mixed intimately with the feces, and 
the sickness, vomiting, and pain at the sto- 
mach, are more urgent. If the large intes- 
tines be the seat of the disease, the pain 
is more obtuse, not so constant, is more dis- 
tant from the umbilicus, and is more imme- 
diately followed by stools, and the purulent 
matter of blood, if there be any, is less 
mixed with the rest of the excrements, or 
only floats upon them, and there is more 
sickness than griping ; but it frequently 
happens, that both the large and small 
intestines are affected, which renders it 
very difficult to determine, with any cer- 
tainty, the seat of the disease. The remote 
causes are, cold alternating with heat, de- 
rangement of the prim® vi®, and contagion. 
The proximate cause is supposed to be a 
preternatural constriction of the intestines, 
more particularly of the colon. This dis- 
ease will be readily distinguished from diar- 
rh®a, by the absence, or less degree of 
fever in the latter ; the less degree of grip- 
ing and tenesmus, the appearance of the 
stools, and the other symptoms in diar- 
rhma will further assist us. 
Treatment, When the patient is of a 
robust and plethoric habit, and the disease 
