156 
PATHOLOGY, 
for evacuation, purgatives may be adminiftered. They 
areadmiffible only with much reftridtion. Calloroil feems 
the only purgative which can be prefcribed with fafety, 
lince moll: others in common ufe irritate the nervous ex- 
panfion of the bowels, and in even the morbid contrac¬ 
tions. This oil is faid indeed to fheathe the nerves, by 
its lubricity, from the irritating fecretions, while it pro¬ 
duces natural and general fecretion. Clyfters have been 
recommended ; but the ilimulus of detention is of all 
other ftimuli the moll irritating to the difeafed inteftine. 
Moreover they do not reach to thofe points where the 
eftabliftiment of fecretion would be a defirable matter; 
and confequently little good can be expected from them. 
It has been urged by Dr. J. Johnfon, that we fhould not 
be obedient to every call of nature, the ftraining which 
enfues being highly detrimental, and augmenting, in 
many cafes, the difcharge of blood. Every motion of the 
body indeed, increafes the defire to evacuate. As little 
or nothing, except mucus and blood, comes away in 
four efforts out of five, we fhould therefore endeavour 
to ftifle the inclination to ftool; and we (hall often fuc- 
ceed ; for the tormina go off in a few minutes, and by 
thofe means we elude not only the ftraining, but the pain¬ 
ful tenefmus which continues fo long after every fruit- 
lefs attempt at evacuation. This circumftance, though 
apparently of a trifling nature, Dr. J. thinks of confider- 
able importance, though it has feldom been attended to. 
It has the fandlion of antiquity, however, as may be feen 
in the following precept of Celfus : “ Et Cum in omni 
fiuore ventris, turn in hoc precipue neceffarium eft, non 
quoties libet defidere, fed quoties neceffe eft ; ut hac ipfa 
mora in confuetudinem ferendi oneris inteftina deducat.” 
Diaphoretics are of courfe to be ufed, and the fecre¬ 
tions of the fkin encouraged by the warm bath ; but this 
is by no means an eafy tafk, fince, independently of the 
uncertain operation of thefe remedies, the perforation is 
liable to frequent checks on account of the patient’s fre¬ 
quently rifing from bed to evacuate his bowels. The 
painful contra dlions of the bowels are beft allayed by 
opium. A fmall pill may be introduced into the redlum; 
or it may be given in the form of the pul v. ipecac, comp, 
in which combination its effedts are alfo beneficially ex¬ 
erted on the fkin. 
The adfion of the fecreting veflels is altered by mercu¬ 
rial medicines; calomel in large and frequently-repeated 
dofes being indeed our principal dependence in this com¬ 
plaint. The modus operand! of this medicine is by no 
means generally underftood. Thofe who have ufed it 
molt fuccefsfully affert indeed, that it corrects the condi¬ 
tion of the liver by emulging its dudls, unloading its 
congefted or over-gorged veflels, removing undue deter¬ 
minations of blood to its yielding texture, prompting the 
healthy fecretion of its peculiar fluid, and thereby re- 
folves pyrexia. But all this is of courfe gratuitous af- 
fumption. The medicine may certainly ftimulate the 
liver; but it is too much to affert that by fo doing it 
cures dyfentery, fince it is feldom fuccefsful till ptyalifm 
is produced ; and every one knows that the fecretions of 
the liver may be corrected by mercury in very fmall 
dofes. Mercury is faid to equalize the circulation ; but 
this appears an illogical propofition. If the affertors of 
this imply that it produces general fecretion, and thus 
brings into a <51 ion torpid fecernents ; it is a truifiu which 
cannot be queftioned ; but to fpeak of equalifing circu¬ 
lation in any other manner implies that calomel affedts 
morbid ftrudtures in one mode, and healthy ones in ano¬ 
ther ; a notion which does not feem to have the leaft pro¬ 
bability on its fide. However this may be, mercury is the 
only medicine to be trufted to in dyfentery: and it mufl 
be pufiled to fuch an extent as to induce falivation. It 
may be given from dofes of a few grains to that of one 
fcruple three times a-day ; and it is aflifted by other me¬ 
dicines in conjunction: thus opium, ipecacuanha, and 
calomel, anfwer the defired end with lefs uncertainty 
than the feparate exhibition of any fingle one. 
The diet of the dyfenteric patient fhould be very fpa- 
ring, and fhould confift of the leaft Irritating fubftanees, 
the various preparations of the farinacea, as fago, arrow- 
root, rice, See. are alone admiflible; but the lefs food of 
any kind that is taken in the beginning of the difeafe, 
the better. In chronic dyfentery, where our principal 
effort muff be directed to keeping the biliary fecretion by 
gentle dofes of calomel, and inducing regular adtion of the 
fkin by diaphoretics, by flannels next the fkin, and as 
much as poffible by regulated temperature; the diet fhould 
confift of the fame kind of fubftanees as in the acute 
ftage ; and it is fometimes advifable to ufe aftringents, 
as the kino, See. A difh is recommended by Dr. J. John¬ 
fon, which he fays the patients relifh much: it confifts 
of flour and milk boiled together, and rendered palatable 
with fugar and fpice. 
When the diforder is pretty well removed, gentle fti- 
mulation by the bitters and the mineral acids, particu¬ 
larly the nitric, muft be had recourfe to. At the fame 
time we mult guard again ft fuffering the patient to in¬ 
dulge in too much food; for after this complaint the ap¬ 
petite is often greater than the powers of digeftion, and 
its indulgence is fometimes followed by a relapfe into the 
original difeafe, or other difeafes, equally diltrefling and 
dangerous, are brought on. 
The queftion concerning the contagion of dyfentery 
will be difeuffed when we fpeak of the fubjedt at full 
under the order Pyrectica of this arrangement. 
Genus IX. Diarrhoea, [from pea, to flow.] Flux, or 
Loofenefs. Generic charafters—Alvine evacuations 
crude, loofe, and too frequent: with little or no griping 
or tenefmus. There are fix fpecies. 
1. Diarrhoea fufa. Faeces of common quality, but im¬ 
moderately loofe and copious. 
2. Diarrhoea biliofa. Fxces loofe, copious, and pecu¬ 
liarly yellow. 
3. Diarrhoea mucofa. Dejedlions confiding of, or con¬ 
taining, a copious difcharge of mucus. This is aferibed 
by Cullen to acrid ingefta, or taking cold, particularly in 
the feet. When produced by cold, it forms the Ca- 
tarrhus inteftinorum of various authors: the motions 
are acrid, often with but little bilious tinge, and the 
lower part of the redtum is excoriated, like the noftrils 
in a coryza. 
4- Diarrhoea chylofa. The dejeftions milky or chyli- 
form. 
5. Diarrhoea lienteria. The dejedlions confifting of 
the aliment palled rapidly and with little change. 
6. Diarrhoea ferofa, the watery loofenefs, in which the 
dejedlions are almoft entirely liquid. It is frequently 
metaftatic, and ftill oftener produced by elaterium, or 
other draftic purgatives. Sometimes urinous, occafionally 
tinged with blood. 
Diarrhoea is a leading and cbaradleriftic fymptom in 
many diforders, both acute and chronic, general and lo¬ 
cal. This genus is to be diftinguilhed from the foregoing 
by being generally without fever, and by the alvine eva¬ 
cuations confifting of the natural fxculent matter, though 
in a more liquid flate ; and by the abfence of tenefmus, or 
violent bearing down, which attends Dyfentery. There 
is alfo in the latter diforder more fevere griping than in 
Diarrhoea : but this occafionally occurs in the Diarrhoea, 
and therefore is not a decifive diftindlion. There is, how-, 
ever, as we faid before, a mutual alliance between the 
two difeafes, which occafionally pafs into each other; a 
diarrhoea, if negledled or improperly treated, fometimes 
being converted into dyfentery ; and a dyfentery, when 
its worft fymptoins have been fubdued, fometimes leav¬ 
ing a diarrhoea behind. 
The effential part of this difeafe, in all the fpecies we 
have enumerated, confifts in a preternatural increafe of 
the periftaltic motion, and of the fecretions, in the whole 
or a great part of the inteftinal canal; and the predifpo- 
fing caufe of the difeafe is a peculiar irritability of the 
inteftines, and of the fecreting veflels which open upon 
their internal furface. 
The 
