158 P A T H O 
continued ufe of alterative medicines., which maintain 
a deady but gentle aftion upon the alimentary canal, and 
the adjoining vifcera, feems to be the mod fuccefsful treat¬ 
ment. At the fame time we mudcorreft and modify their 
operation according to circumftances, and palliate urgent 
fymptoms. The occafional ufe of injections of thin 
darch and laudanum, in the proportion of eight or ten 
drops of the latter to two table-fpoonfuls of the former, 
may like wife be employed. 
A fevere and often fatal fpecies of diarrhoea is known 
in Scotland by the name of the “ weaning brafh.” It oc¬ 
curs after weaning a child too fuddenly, efpecially at an 
unfavourable feafon, as the autumn. It commences 
fometimes two or three days after weaning, but fre¬ 
quently not for three or four weeks, with a purging and 
griping, and green Pools. If this be negledted, the 
fymptoms increafe, retching and vomiting fupervene, fol¬ 
lowed by a loathing of every kind of food, emaciation 
and foftnefs of the flefh, reftleffnefs, third, and fever of a 
heCtic charafter. But the mod charaCteridic fymptom of 
this difeafe is a condant peevifhnefs, the efteCt of uncea- 
fing griping pain, exprefi'ed by the whine of the child, 
but efpecially by the fettled difcontent of its features. 
In the progrefs of the difeafe, the evacuations from the 
belly fhow very diderent aCtions of the intedines, and 
great changes in the biliary fecretion ; for they are fome¬ 
times of a natural colour, at other times flimy and afh- 
coloured, and fometimes lienteric. The difeafe feldom 
proves fatal before the fixth or feventh week ; but fome¬ 
times an earlier termination is fuddenly produced by in- 
cedant vomiting and purging, or by convulfions, from 
the extreme irritation in the bowels. 
On dideftion, the intedinal canal, from the domach 
downward, is found abounding with fingularcontraftions, 
and has in its courfe one or more intus-fufceptions; the 
liver is firm, larger than natural, and of a bright-red co¬ 
lour ; and the gall-bladder, which is enlarged, contains a 
dark-green bile. In fome cafes the mefenteric glands 
have been found fwelled and inflamed ; in others, how¬ 
ever, fcarcely enlarged, and having no appearance of in¬ 
flammation. It is probable, therefore, that this difeafe 
is owing to the morbid date of the liver, and that the ex¬ 
tremely irritable date of the whole abdominal vifcera, 
marked by the fpafmodic contractions and intus-fufcep¬ 
tions, See. is occafioned by fympathetic irritation. 
The diet fhould confid of eggs, the finer kind of light 
fhip-bifeuit, or arrow-root, cudard, the juice of lean meat, 
plain animal jellies, broths freed from their oily part, and 
milk. The bread-milk might perhaps be redored with 
advantage. Vegetables of all forts, particularly fruits, 
acids, and compofitions of which fugar or butter form a 
part, and fermented liquors of every kind, fliould be 
itriCtly prohibited. The feet diould be kept warm by 
woollen dockings, and flannel worn next the lkin; and 
the warm bath and fomentations may be frequently ufed 
to alleviate the continual fpafms. Small dofes of calomel 
are howeverthe mod effectual remedy againd the weaning 
brafli, as againd other chronic forms of bilious diarrhoea. 
We may generally give half a grain of calomel morning and 
evening, or a grain every night, for a week or ten days. 
After the third or fourth dole, there is generally a great 
change in the colour of the alvine difeharge; it becomes 
of a dark mahogany-colour, and is in general more offen- 
ftve. When this change takes place, it produces a favour¬ 
able change in the diforder. Soon afterwards, the chil¬ 
dren become free from fever, more placid ; and in a day 
or two more their appetite returns, with their former 
complexion, and every other demondration of health. 
ConneCied with diarrhoea, we have to notice a com¬ 
plaint of the bowels clearly deferibed of late by Dr. 
Powell. Like the foregoing, it confids in a difeafed fe¬ 
cretion from the mucous lining of the alimentary canal ; 
the matter evacuated being of a fubdantial form, and 
confiding of layers of cosgulabJe lymph moulded into 
the form of the ioteftina) cavities, The fame matter 
LOGY. 
often formed towards the termination of dyfentery, and 
Villerme (Did. des Sciences Medicates) fays, “I have 
had occafion to fee great quantities of thefe adventitious 
membranes paffed by dool, in the colic of Madrid. They 
were generally of a gelatinous confidence, and enveloped 
in mucus. One of thefe exhibited an exaCl mould of the 
intedine, being tubular,and fome inches in length.” In 
this cafe it is eafily referred to throwing out of lymph, a 
confequence of inflammation. In the complaint in quef- 
tion, it does however follow inflammatory aCtion. In¬ 
deed we meet with the fame membraneous fubdances in 
fedentary perfons, efpecially females, who have languid 
and imperfeft digedion, with a torpid date of the biliary 
and intedinal fecretions. Here gelatinous concretions 
would appear to take place on the internal furface of the 
intedines, and even the hepatic dufts themfelves, from 
mere remora of the fluids and want of energy in the fe- 
cretory glands and organs. Sometimes thefe flakes are 
confiderable; and, when developed in water, reprefent 
entire tubes broken off irregularly at the ends j which 
has led to the erroneous opinion that they were portions 
of the mucous membrane of the intedines. 
The fymptoms of this difeafe referable very clofely 
thofe which attend the pading of gall-dones ; fo much fo, 
indeed, that Dr. Powell fays, “ Whenever violent pain 
takes place in the epigadric region of the abdomen, exa¬ 
cerbating in paroxyfms accompanied by ficknefs, yellow- 
nels of the eyes and fkin, and urine, by clay-coloured 
fasces, and without any proportionate increafe of aftion 
in the circulation, biliary concretions are fuppofed to 
be forcing through the duffs ; and, when thefe fymptoms 
abate, it is inferred that their paflfage into the duodenum 
has been effefted.” In the cafe of biliary concretions, 
however, we naturally expeft a repetition of attacks, and 
no very fpeedy termination of the patient’s fufferings: 
on the contrary, the fort of attack here deferibed is more 
initiated, and, when once it has paded, its recurrence is 
by no means equally to be dreaded as is that of the 
former. 
In edablidiing his diagnofis more particularly, however. 
Dr. Powell direffs the ufual large pan to be filled with 
water, and the faeces to be dirred in it, after which the 
water has been left to red long enough to afeertain whe¬ 
ther the concretions, as they often do, have rifen to the 
furface. This water he pours off; and repeated fimilar 
affufions are made, time being allow-ed for fubfidence be¬ 
tween each. The refidueis then to be examined. This 
refidue, in the cafes to which the author refers, “ has 
exhibited a large quantity of dakes, modly turned into 
irregular diapes, and appearing to have formed parts of an 
extenfive adventitious membrane of no great tenacity or 
firmnefs.” In the fird cafe that came under Dr. Powell’s 
notice, this membrane was paffed in perteft tubes, “fome 
of them full half a yard in length, and certainly fufficient 
in quantity to have lined the whole intedinal canal.” In 
the others alfo, the aggregate quantity has been very 
large, and continued to come away for many days, in ir¬ 
regular thin flakes, of but one or two inches in extent, 
and not perfedlly tubular. Dr. P. has definitely exa¬ 
mined four fuch cafes, in all of which the leading fymp¬ 
toms led him to fufpedl the paflage of biliary concretions 
at the time. They were all adult females. In but one 
of thefe our author had been confulted for previous ill 
health. “ She had frequently fuft'ered from occafional 
pain in the inteftines, and derangement of her powers of 
digeflion, with flatulence and a lenfe of fuffocation. She 
was always relieved, at the time, by mild opening medi¬ 
cine, and believed herfelf able to prevent the attacks of 
pain from increafing to any ferrous degree of violence, 
by repeating it according to circumftances. A fimilar 
hiflory of liability to frequent recurrence of pain, ac-t 
companied by indigedion, was related to me in the other 
indances. The more violent feizures. under which I faw 
all the patients, confided in a Bidden an.d exceffive pain 
in the epigadric region, increafing in paroxyfms very fre¬ 
quently. 
