ON THERAPEUTICS. 
5 
the mucous track is predisposed to inflammation; so that 
when used at all, great caution is necessary both in selecting 
the drug and apportioning its dose. If it be understood that 
the object is to diminish fever, and not merely to overcome 
constipation, these agents will be more considerately em¬ 
ployed than they have been. 
Fourthly, we find constipation to result from defective 
nervous and muscular action; in paralysis, and general 
debility, and the disease “ dropping after calving;” the 
“ puerperal apoplexy” of Professor Simonds. 
In the case of constipation occurring from debility, we 
presume no discussion is necessary, as no reflecting person 
would think of giving purgatives in such a state of the 
system, excepting it may be in the form of dietetics. In the 
other cases, constipation is the consequence of diminished 
nervous action, and the argument is, “if you can excite the 
membrane of the intestines, you help to restore nervous func¬ 
tion,” a sentence we would modify by saying, “if you can 
excite nervous function you restore at once the action of the 
intestinal canal.” The question then occurs, are purgatives 
the best medicines for this object ? And the answer is,—No! 
as they can hardly be expected to effect any alterations in a 
part where the nerves are incapable of receiving or conveying 
an impression. Thus we find purgatives in these diseases 
scarcely to act at all, or not until a certain amount of nervous 
action is restored by a more direct course of stimulation. 
Even at the commencement of the disease, puerperal apo¬ 
plexy, during the preliminary excitement, when their action 
would be sufficiently decided, we have not found them to be 
necessary, as a more satisfactory effect is produced by 
aconite, which by diminishing the nervous action prevents 
that congestion of the brain and spinal cord which otherwise 
might occur. In paralysis, the same reasoning will hold good. 
Constipation is the simple result of defective action, and will 
cease shortly after such defective action is removed; and as 
purgatives expend their influence upon the nerves of the 
intestines, without influencing the nervous system generally, 
we cannot understand the benefits expected from their 
action. 
Fifthly, constipation is present frequently in ordinary 
spasm, and in tetanus. In both cases, probably from an 
interference with the movements of the intestines, combined 
with the fever that is also commonly present, which dimi¬ 
nishes secretion ; the perversion of the muscular action we 
assume to be the prominent cause. Here again purgative 
action seems to us to be altogether ineffective. The indi- 
