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CON STI PATION,
ZY A/27-
§is ſtºry & Curt;
EMBRACING
THE PEIYSIOLOGY OF DIGESTION,
THE INJURIES IN FLICTED
T H E E M P L O Y M E N T OF P U R G A T I W E S :
BY
JOHN EPPS, M. D.
£milmil :
PIPER, STEPHENSON & SPENCE, 23, PATERNOSTER ROW;
AND THIROUGH ANY BOOKSELLER,
Price 12s. 6d.
LONDON: PRINTED BY JOHN TRAPP, BUDGE Row, CITY.
DEDICATION.
To My WIFE,
To whom worthier than yourself can
I dedicate this work. You have been my comfort
through years past: you have made my labours
light by your unwearied kindnesses, by your gentle
forbearances: you have, by your tender care, pre-
served the life and husbanded the energies of him,
who will be glad, if he can, in realizing to himself
the immortality, arising from the presentation of
truth in a form of utility, at the same time convey
the fact, indelibly impressed on his mind, that,
without your aid, this realization could not have
been gained.
JOHN EPPS.
October 1, 1854.
PREFA CE,
IN an age like the present, when the printing press
is perpetually in action in order to communicate to
the public the results of the mental labour of those
who imagine they have something to communicate,
which may be beneficial either to others or to them-
selves, it becomes a matter of conscience to him, who
knows how difficult it is to read the various works
appealing to the attention, to abstain from adding to
the sum total of printed matter.
To this motive, originating in conscience, is super-
added an additional motive, derived from the fact,
that the more an individual extends his experience,
the less promulgative value does he attach to the
observations constituting the basis of that experience.
Matters observed once, twice or thrice, and, as such,
rarities, cease, when frequently observed, to be rarities.
This frequency of occurrence, resulting from the
abundance of observations, takes away the interest of
the observer in the matters observed : his very riches
make him feel poor. Hence the very source whence
his observations derive their highest valuc, as the
vi PRE FA C E.
products of an extended experience, not unfrequently
becomes a cause why the public are shut out from the
benefits which that experience must supply, the want
of rarity in them to the observer taking away one
motive for publication, namely, the supposed rarity.
Things uncommon to others of less experience become
to him things common; and a state is induced, men-
tally expressed thus, Why intrude common things
on the public
Inaction from this cause becomes a source of injury.
Its influence should be resisted by every well wisher
to the cause of human progress. .*
Another obstacle to the publication of the result
of an extended experience grows out of the conditions
essentially connected with the obtainment of this
abundance of experience. He, who gains this ex-
tended experience, has his whole time occupied in the
practical pursuits of the profession or art in which he
gains his experience. If in the medical profession,
his services are in continual demand. He is sought
for both at home and abroad; and the application of
his experience to those who seek the benefits of that
experience, and, in seeking it, augment it, occupies
his whole time. Engaged at home all the early part
of the day in successive consultations, in the middle
and the after part of the day travelling from place to
place, it may be in the widely extended metropolis,
he is fatigued when he reaches home, and the effort
to embody the results of his experience is one requiring
a powerful exercise of the will.
Add to these motives for abstinence from publishing
the results of his experience the additional motive,
PREFACE. vii
derived from the fact, that, most likely, those who
derive most from the results of his observations, will
be the first to depreciate his labours, to ignore, although
they appropriate, his experience, and it will be seen,
that a mass of reasons present themselves why he,
who has done much, will be backward in adding to
the already accumulated mass of excogitated and
printed matter.
All these motives may have exercised an influence
on the author's mind, notwithstanding he has decided
to appear in print. The difficulties connected with
such appearance are exhibited in the facts, that though
he has been engaged for years in this work, the
printer has been occupied (praise be to his patience),
in putting the work in form for the public eye,
upwards of a year. -
Some idea may be formed of the amount of expe-
rience embodied in this work from the Index.
In the first part, the subject of DIGESTION has been
investigated, as a knowledge of the matters which
this word represents seems essential in relation to the
appreciation of the matters contained in the second
and chief part of the work, namely, CoNSTIPATION, its
cause and treatment. - -
In regard to the Physiology of Digestion, the public
mind has been much enlightened by the work of that
candid and careful thinker, Dr Andrew Combe, and
also by works written by others. A deficiency, how-
ever, exists in all these works; a deficiency originating
in this, that the STOMACH has, by its importance, con-
centrated, so to speak, all the thoughts of the writers
on Digestion. The INTESTINEs have not received their
viii PREFA C E.
due amount of attention. It is expected that this
work will supply this deficiency.
One important feature of this work is, that in it the
science of DIETETICs is presented. The author, having
earnestly sought for facts on the subject of Diet, has
attempted at the same time to deduce from these
facts their scientific bearings. The chief facts herein
brought forward and reasoned on are those contained
in Dr Beaumont's* work, a book of which few know,
and still fewer appreciate. The greater part of Dr
Beaumont's work is embodied in this volume, and the
facts and the views which, in such embodiment, will
present themselves to the reader, will, it is believed,
serve to dispel an immense amount of delusion, exist-
ing not only in the public, but also in the professional
mind, respecting Diet; and in such dispelling the
work will, it is believed, be a most effective ally in
opening up to the general view the road by which
DYSPEPSIA walks in gaining its destructive ends, and
thus incidentally this work may be regarded as a work
on Dyspepsia.
The primary object of this work has relation to
CoNSTIPATION.
It is attempted to prove that Constipation is de-
pendent on constitutional conditions; that purgatives,
as purgatives, will not remove these constitutional
conditions; that, therefore, purgatives are only pallia-
tives; that homoeopathic remedies do cure these consti-
tutional conditions, and, by consequence, remove per-
* Experiments and Observations on the Gastric Juice and the Physi-
ology of Digestion, by William Beaumont, M. D. Surgeon to the United
States army.
PRE FA CE. ix
manently the constipation. It is proved, that diseases
of every kind can be cured without the bowels being
forced to act by the employment of purgatives; that
directly the diseases are in a certain stage of the pro-
cess of cure, the bowels invariably act of themselves
—facts setting aside the necessity of purgatives to
effect a cure of diseases.
It is demonstrated in this work, that the most
destructive results have originated from the employ-
ment of purgatives.
The fact has been recognised, that the employment
of purgatives has gained a mighty hold on public
opinion, and the causes of the tenaciousness of this
tenure have been sought and detected.
The proofs of the correctness of the views published
in this work, in relation to constipation and its homoe-
opathic treatment, are to be found in nearly two
hundred cases of cure, a number which might readily
have been augmented to a thousand, had the author
presented in full the results of his experience; he
having cured, in an homoeopathic experience of nearly
sixteen years, in which he has never employed a dose
of purgative medicine, not even a dose of castor oil,
cases of constipation more in number than that repre-
sented by the number just quoted.
In conclusion, it will be found when technical
terms are introduced, the derivation of the terms is
given, such derivation being useful as unfolding the
force of the terms, and thus strengthening the impres-
sion in connexion with the matters treated of. Such
benefit, as likely to accrue, is a sufficient answer to
any charge of pedantry.
X. PREFACE.
Many phrases occur embraced thus “ ”; these
expressions are either quoted phrases, or are the
expressions of the parties referred to. It was deemed
best to present their views in their own phraseology,
although not in perfect accordance with either scien-
tific or polished diction.
The way in which the work is gotten up, will, it
is hoped, accord with the value of the facts and the
views contained. It would be a great neglect of duty
were not the skill of Mr Henry Linton, whose wood
cuts adorn the work, referred to. These wood cuts,
printed by Werthiemer, will proclaim their own
praises.
JOHN EPPS, M.D.
89, Great Russell Street, London.
Ü O N T E N T S.
INTRODUCTORY CHAPTER.
A general view of the means and of the processes
by which Nourishment is realized to the Human
Being. -
tº-mºmºsºme
*
PART I.
CHAPTER 1.—On the Digestion of Food and the
various processes constituting it, together with the
various parts of the intestinal tube associated with
these various processes.
CHAPTER 2–On Mastication or Chewing: the in-
struments concerned in the process: their physiological
action: with practical remarks.
CHAPTER 3.—On Swallowing or Deglutition, with
practical remarks and deductions. -
CHAPTER 4.—On the Stomach and Chymification,
with practical deductions in connexion therewith.
CHAPTER 5.-On the Gastric Juice, with axioms
and practical deductions. This Chapter embodies the
greater part of Dr Beaumont's valuable work.
CHAPTER 6.—On the remaining agencies in con-
nexion with the Digestion of the Food in the
Stomach. -
CHAPTER 7–On Chylification and the organs con-
cerned in the process, with practical deductions.
Ü 2
xii CONTENTS,
CHAPTER 8.—On Defaecation and its course in
connexion with the small and the large intestines.
CHAPTER 9.-On Absorption, the Lymphatics and
the Lacteals, and the process by which the nutriment
is prepared for and carried into the blood.
CHAPTER 10–Concluding general remarks on the
similarities of the various parts of the Intestinal Tube,
, in reference to structure, fluids, movements, and the
powers affecting the movements.
PART II.
CHAPTER 11.—Constipation and its varieties. Cos-
tiveness. Confined bowels. Irregular action of the
bowels. Delayed and imperfect action of the bowels.
Constipation as to its cause. Constitutional diseased
state. Evidences of this. Conditions inducing this
diseased state. -
CHAPTER 12.—On the unscientific character of the
method of attempting to relieve constipation by pur-
gatives.
CHAPTER 13.−On the injuries resulting from the
employment of purgatives. Epilepsy, Blindness,
Dyspepsia, Chronic Inflammation of the Bowels,
Hernia, Descent of the Gut, Stricture of the Rectum,
Diseased Bladder, Descent of the Womb, Excessive
Monthly Discharge, Excessive White Discharge,
Abortion and Death, caused by purgatives.
CHAPTER 14.—The history of the employment of
purgatives for the cure of diseases. The views of
Dr Hamilton; their fallaciousness. The explanation
of the apparent success of his treatment.
CONTENTS. - xiii
CHAPTER 15.-The arguments used in defence of
and justificatory of the employment of purgatives.
The non-necessity of purgatives in the cure of either
chronic or acute diseases. Absurdities connected
with the employment of purgatives.
CHAPTER 16.—On the use of auxiliary means to
promote the removal of constipation. Obeying the
call to relieve the bowels. Soliciting the bowels after
breakfast. Moderation in the use of food. Sponging
the body with cold water. Drinking a tumbler of
cold water. Friction to the spine. The exercise of
walking. Reading aloud.
CHAPTER 17.—Cases of cure.—Group 1st. Cases of
constipation generally,–Group 2nd. Cases of descent
of gut.—Group 3rd. Cases of piles.—Group 4th. Cases
of stricture, fistula, hernia.
APPENDIX.
CHAPTER 18-Cases of cure of almost every form
of disease without any action of the bowels, and
cases of cure, where the bowels, having been active,
have become confined as the cure was effected.
CHAPTER 19–Cases illustrating the serious injuries
produced by purgatives. Cases from allopathic works
of obstruction of the bowels.
CHAPTER 20–Cases illustrative of the special
action of special medicines in constipation.
CHAPTER 21—Various matters connected with the
bowels. On the moulding of the feces: on liability
of the caecum to disease from the action of purga-
tives.
EXPLAN ATION OF THE PLATES.
PLATE I.
1. The tongue. 2. The lower jaw, sawn asunder. 3 & 4. The salivary glands.
5. The pharynx. 6. The gullet, or obsophagus. AAA. The ribs. 7. The spine.
8 & 9. The stomach. 10. The duodenum, a small portion seen. 11, 11, 11, 11.
. The jejunum. 12, 12, 12, 12. The ileum. 13. The caecum, or blind gut.
14. The worm-like appendage of the blind gut. 15. The ascending colon.
16. The transverse arch of the colon. 17. The descending colon. 18. The
sigmoid bend, or flexure. 19. The rectum. 20. The cavity of the pelvis. 21. The
right lung. 22. The left lung. 23. The heart. 24. The diaphragm.
This Plate represents the digestive apparatus. The inferior jaw (2) has been
cut away in front, and the larynx removed in order to render visible the cavity of
the pharynx (5), and its continuity with the oesophagus (6). The left extremity of
the liver has been removed in order to render apparent the point where the oeso-
phagus pierces the diaphragm (24) on its leaving the chest, and its continuation
into the stomach.
The arrangement of the small intestines 11, 11, 11, 11, 12, 12, 12, 12, is
artificial in order to show their continuity. In their natural position they are
gathered into a mass; but a continuity similar to that exhibited in the drawing exists.
This wood-cut exhibits further (20) the cavity of the pelvis, which contains the
bladder and other parts. It exhibits also the cavity of the chest, the ribs A A. A. A
being sawn through, and these parts of the ribs and the breast bone being removed
render visible (21) the right lung, (22) the left lung, (23) the heart. The liver is
seen lying on the right side under the diaphragm, (24)
PLATE II.
1. Orbicular muscle of the lips. 2. The upper jaw. 3. The lower jaw. 4. The
condyle of the lower jaw, fitting the shallow cavity (a) of the upper jaw. 5 The
temporal muscle. 6. The bony arch. 7. A projection of the lower jaw to which
the temporal muscle is attached, called the crown-like (coronoid) process, because
round like a crown. 8. The masseter muscles fixed (9) in the angle of the lower
jaw. 10 & 11. The two-bellied muscle (digastric). This is a depressor of the
jaw. At this spot a tendinous portion of this muscle passes through the centre of
another muscle. 12. The buccinator, or cheek muscle. 13. The hyoid bone and
its projections (14, 14), called its cornwa, or horns. 15. The larnya. 16. The
trachea, or lower part of windpipe.
PLATE III.
1. The parotid gland. 2. The submaxillary gland, emptying itself in the mouth
at each side of the bend (fronum) of the tongue: the duct is called Wharton's.
3. The sublingual gland. 4. The duct Steno, which is the duct from the parotid,
pierces the buccinator muscle (plate 2, fig. 12,) and empties its contents in the
mouth at the second grinder. 5. The cheek muscle (buccinator). 6. A powerful
muscle proceeding from the backbone of the head to the collar bone and breast bone.
7. The collar bone, 8. The pectoral muscle covering the chest. 9. The external
jugular vein.
PLATE IV.
This Plate is intended to show the relationship of the parts concerned in the act
of Swallowing.
1. The skin of the lips cut through. 2. The orbicular muscles of the lips cut
EXPLANATION OF THE PLATES. XV
through. 3. The tongue cut through. 4. The upper jaw cut through. 5. The
gavity of the larynx. 6. The fauces. 7. The cavity of the pharynx. 8. The
front boundary of the pharynx, formed by the larynx. 9. The epiglottis, or valve
at the top of the windpipe. 10. The gullet, or osophagus. II. The bones of
the spine, called vertebræ, cut asunder. 12. The spinal cord. 13. The spinal
processes of the vertebrae cut asunder. * -
PLATE W.
No. 1: The diaphragm or midrib, the muscular portion. No. 2. The diaphragm
or midrib, the tendinous portion. 3. The opening through which the gullet passes.
A. The spinal column. B. B. The bags above the kidneys, called the renal
gapsules. C. C. The kidneys, DD. The tubes, called ureters, carrying the urine
from the kidneys to the bladder (F). III. The external boundaries of the chest
and belly. No. 4. The great artery of the body, the aorta. -
PLATE WI,
This Plate represents the form, the site and the parts of the stomach. I. The
gullet. 2. The cardiac opening into the stomach. 3. The bulging or great extremity
of the stomach. 4. Small extremity. 5. Greater curve, (6) less curve of the
stomach. 7. The pyloric orifice of stomach. 8. The ascent of the duodenum.
9. A portion of the liver. 10. The commencement of the jejunum. 11. The
pancreas. 12. The spine. 13. The ureters carrying the urine from kidneys into
the bladder (14). 15. The inferior cava vein. 16. The abdominal aorta. 17. The
aOrta.
PLATE WII.
This Plate shows the internal rugae or folds of the stomach. 1. The oesophagus.
2. The cardiac opening into the stomach. 3. The puckerings of the mucous
membrane of the cardiac orifice. 4. Folds or rugae of the stomach, 5. The
bulging extremity of the stomach. 6. The smaller curve of the stomach. 7. The
larger curve. 8. The ascent of the duodenum. 9. The pylorus and its valve.
10. The duodenum. 11. The duodenum. 13. The folds in the duodenum.
14. The duodenum at its end. 15. The jejunum. 16. Opening of the bile and
pancreatic ducts into the duodenum. 17. Common bile duct. 18. Pancreatic duct
opening into the duodenum.
PLATE VIII.
This Plate shows the abundant supply of blood-vessels and nerves to the small
intestines. To show these the liver A B and the stomach FG H, have been turned
backwards and upwards. The bundle of Small intestines J J J, turned backwards
and thrown outwards, and to the right exhibits the innumerable branches of the
superior mesenteric artery and vein, and of the nervous mesenteric plexus.
A. The right lobe of the liver. B. The left lobe of the liver. C. The spleen.
D. The sweet-bread or pancreas. E. The left kidney. F. The stomach, viewed
on its posterior surface. G. The large curvature of the stomach. H. The small
curvature. I. The duodenum. J. J. The bundle of Small intestines. K. The
caecum. L. The worm-like appendage to the caecum. M. The ascending colon.
N. The transverse colon. O. The descending colon. P. The sigmoid flexure.
Q. The rectum. R. The bladder and the ureter (S) running into it from the
kidney. 2. The spinal column. 3. The aorta. 4. The first iliac arteries. 5. The
first iliac veins. 6. The inferior vena cava. 8. The Superior mesenteric plexus of
nerves following the course of the mesenteric arteries which are represented by the
vessels with circular lines, the mesenteric veins being represented by the vessels
not with circular lines.
PLATE IX.
This Plate represents the caecum and the commencement of the colon, 1. Ileum.
xvi EXPLAN ATION OF THE PLATEs.
2. Commencement of colon. 3. The vermiform appendage. 4. The valve of colon.
5. The ascending colon. 6. A longitudinal band of the colon. 7, 7, 7, 7. Bag-
like folds of the colon.
k PLATE X.
1. Section of the skin. 2. Section of the subjacent cellular tissue. 3. The
ischium bones. 4. The coccyx bone. 5. Large muscles. 6. Elevators of the
anus. 7. External closing muscle or sphincter. 8. The internal sphincter having
a portion of skin on it where it joins the mucous membrane of the gut. 8. The
transverse muscle of the perinoeum. 10. The muscles going to the cavernous
bodies, 11. Other muscles. 12. The canal of the ureter.
PLATE XI.
In this Plate the anterior abdominal boundary has been removed to show the
surface of the mesentery and a portion of the small intestines. A. Represents the
spinal column, to which the mesentery is fastened. B. B. Represents the lungs.
C. The great artery of the body, the aorta, cut away, D. A section of the
diaphragm. E E E E. A bundle of the small intestines. F. the mesentery.
1 11 1. The mesenteric glands. 222. The lymphatic vessels proceeding from the
small intestines to the mesenteric glands. 3. Mesenteric glands round the aorta,
4. The thoracic duct.
PLATE XII.
In this Plate many vessels are exhibited : A. The liver thrown back. B. The gall
bladder. C. The spleen. D. A portion of the mesentery. E. E. The kidneys. F. The
cºecum. G. The descending colon. H. The sigmoid flexure. I. The rectum. J. The
womb. K. The vagina. 1. The inguinal glands. 2. The lymphatic vessels proceed-
ing thence. 3. The external iliac glands. 4. The lymphatic vessels between these
glands. 5. Glands on the iliac vein and the inferior vena cava. 6. Glands round the
crural artery and the aorta. 7. Lymphatic Wessels proceeding from the womb. 8, 9.
Lymphatics from the ovary. 10, ll, 12. Lymphatics. 10. From the liver, 11. From
the left kidney. 12. From the spleen. 13. Glands at the origin of the rectum and
conveying vessels from the sigmoid flexure. 14, 15. Glands of the mesocolon, 16.
glands and lymphatic vessels of the descending colon. 17. Glands and lymphatic
vessels of the right extremity of the transverse colon. 18. The glands at the com-
mencement of the mesentery. 19. Glands and lymphatics of the ascending colon.
PLATE XIII.
In this Plate are exhibited : A. The collar bone cut away. B. The vertebral
column or spine. C. The rump or Sacrum bone. D. The bony crest of the ileum.
E. The artery of the armpit, called the axillary artery. F. The sub-clavian artery
cut asunder. G. The external jugular vein cut across. 1. The lymphatic vessels
proceeding from the glands of the cavity of the pelvis. 2. Lymphatic glands. 3.
Lymphatic glands. 4 and 5. Glands behind the aorta and vena cava. 6 and 7. The
thoracic duct. 8. The receptacle of the chyle. 9. The thoracic duct. 10. The
dilatation and the inclination of the thoracic duct 11. Lymphatic vessels and
glands in the spaces between the ribs.
The other Wood-cuts are explained at the parts where they occur.
t
\
INTRODUCTORY CHAP T E R.
A general view of the means and of the processes
by which Nourishment is realized to the human being.
1. Man lives and moves. Man lives
tº tº and moves.
2. To live and to move man must be nourished. Man must be
2 a. As in living and moving he is continually under- nourished.
going change and loss of substance, he, in order to
meet the changes and supply the substance lost, must
as continually be providing himself with nourishment,
thereby gaining the materials for new substance.
3. To cause him to fulfil this necessity, the ap-Hunger and
o e thirst the
petites of hunger and of thirst have been bestowed. motives to
4. To enable him to realize nourishment from the “”
bodies which surround him or which are obtainable
by his exertions, he is endowed with a long diges-Digestive
tive tube, into which the matters for nourishment º
being introduced are made to undergo various changes,
and are at length so modified as to approach to a
condition, nearly resembling that of the animal body
to be repaired, and, on this account, these matters,
thus changed, are said to be animalized.
5. The result of these changes, namely, the fluid
E --
2 Nou RISHMENT REALIZED
* animalized substance into which the external sub-
perfected stances taken into the stomach are changed, is taken
into blood. up by peculiar vessels, opening on the inner surface
of the Digestive tube, which, by their open mouths,
imbibe or suck up the nutritive fluid formed in the
tube; this fluid, after an additional animalization,
being carried into the lungs, where it, in the innu-
merable ducts of which the lungs are, in fact, formed,
is freed from all unnecessary matters, and acquires
its highest point of animalization, being converted
into blood.
º 6. Thus changed, thus perfected, this rich animal
#." * material is carried to the heart, and thence, changed
into arterial blood, is, by other vessels, termed
arteries, (these arteries themselves being distributed
to every tissue of the body, indeed forming a princi-
pal part of their very substance,) carried to all parts
of the body.
.*.* 7. Each tissue, each organ selects or works from
ºn this pure blood materials identical with itself, which
materials deposited, when thus identically formed in
the part itself, become part of the body, and thus
the body is built up and preserved.
8. Of the particles not consumed in this formation
of the new materials in all parts of the body, the
Lymphatics, chief are collected together by vessels, called lym-
phatics; of these particles so collected, some being
purified, enter the system; others, impure and not
fit for use, are rejected by the various excretory
Excretions. Organs in the form of excretions.
Digestion. 9. Digestion is therefore a process or a collection
of processes, by which exterior bodies are transformed
into a nutritive fluid, a fluid capable of being con-
Absorption, verted into blood. By the process of Absorption
TO THE HUMAN BIEING. 3
this fluid is taken up, and the fluid, thus taken up, is
carried to the lungs: the act of Breathing impresses Assimilation.
on this fluid a new modification, and thus modified,
the circulation introduces it to all parts of the bodily
frame. *
10. Legitimate inferences from these statements Healthy ac-
are, first, that the regular, i.e. healthy action of theº: *
various parts of this digestive tube, is essential to theº.º.º.
tive tube es-
agreeable performance of the duties connected with . .
happy exist-
existence; and, second, that deviations from this once.
regular, this healthy condition, must be dependent on
and be productive of, disease.
11. One condition, peculiarly associated with the
existence of many diseased states, is the inaction of
the expulsive power of this intestinal tube; in
other words, constipATION. Constipation.
12. Concerning this state much misunderstanding Much mis.
prevails. Resulting from the misunderstanding of º
this state the most unscientific and injurious means”
are made use of for its removal. Dr. Edward John-
son, a writer of the old-school, remarks:—“There is
perhaps no disease so extremely common in this
country as constipation of the bowels—no single
disease which, in the aggregate, inflicts so large an
amount of suffering on its inhabitants—and I trust
I shall be pardoned for adding, that there is certainly
no disease more completely misunderstood and mal-
treated by its medical men. All sorts of machines
have been contrived in vain—in vain every con-
ceivable combination of drugs has been exhibited.
All sorts of dietary plans have been laid down to mo
purpose—and the sufferers have been sent to every
corner of the habitable globe in search of a remedy
for this disease—equally to no purpose—until now
B 2 -
4 |USE OF DRUGS PERNICIOUS,
medical men no longer pretend that they can cure it,
and their patients have ceased to hope for more than
the most temporary and insignificant relief—to obtain
which, slight though it be, the daily use of perni-
cious drugs has become to thousands, as necessary as
their daily food.” --
ãº. 13. To cause the disuse of these means it is neces-
ject of Diges-sary that the subject of Digestion should be tho-
tion clear. roughly, i.e. scientifically understood.
14. In the first part of this work the attempt is
made to present the requisite information; in the
second, the theories connected with and the errors
embodied in the usual views on Constipation are de-
tailed and exposed: a new and it is deemed a true
theory of Constipation is put forward, and cases,
illustrative of the power of homoeopathic remedies
in the removal of this diseased state, are given.
It is hoped that the reader will endeavour in the
perusal of this part of the work, to become thoroughly
acquainted with the facts and the cases as they suc-
ceed each other, as such acquaintance will be not
only interesting, but also full of practical import-
ance, and will bring about the state of mind necessary
to the understanding and the adoption of the views
put forth.
ON THE DIGESTION OF FOOD. 5
PART I. CHAPTER I.
On the Digestion of Food and the various processes
constituting it, together with the various parts of the
intestinal tube associated with these various processes.
15. The intestinal tube, commencing at the mouth, CHAP. 1.
and ending at the anus, is the machine in which the ..."
food undergoes the changes necessary to render it
supportive to the system.
16. These changes are numerous, very peculiar, Digestion, ag-
and a knowledge of them becomes highly interesting #. of
and instructive. The sum total, the aggregate of
these changes, is presented by the term,
DIG E S T I O N.
17. The changes of this totality, digestion, taking Groups of
place in succession, may be arranged in groups, each”
group being associated with a distinct part or distinct
parts of the intestinal tube.
18. The intestinal tube is the essential organ of
6 ON THE DIGESTION OF FOOD
CHAP. I.
Length of in-
testinal tube.
digestion, though other organs are accessory to its
action. This tube is very long, being seven times
the length of the body; is very flexible, dilatable,
is continuous, but not uniform in all its length.
19. It commences at the mouth. With this part,
having associated with it the tongue, the teeth of the
upper and of the lower jaw, the palate, and the
Mastication.
Chewing.
Pharynx and
gullet.
Deglutition.
Diaphragm
or midrib.
Stomach.
salivary glands (plate 1, figs, 3 and 4) are conjoined
the changes, necessary to the breaking down of the
food and its preparation for the next process: this
group of changes being called MASTICATION or
CHEWING.
20. The cavity of the mouth contracts itself little
by little, and constitutes the pharynx, (plate 1, fig. 5,)
this part being represented cut open in order to show
the back part, to render which visible a portion of
the lower jaw (plate 1, fig. 2) has been removed.
The pharynx still further contracts itself into the
gullet or osophagus, (plate 1, fig. 6): the former,
the pharynx, being situated in the neck between the
spine (plate 1, fig. 7) behind and the windpipe in the
front: the latter, the gullet, passes through the chest
behind the heart (plate 1, fig. 23). Through these
parts of the intestimal tube the food passes into the
stomach, and the passage and the changes of the
food undergone in its passage, are designated by the
term DEGLUTITION, Or SWALLOWING.
21. This gullet part of the intestinal tube pierces
the muscular partition, separating the cavity of the
chest from the cavity of the belly, called the dia-
phragm or midrib (plate 1, fig. 24); and, undergoing
immediately afterwards a great enlargement, forms
a reservoir, called the stomach, (plate 1, figs. 8
and 9).
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AND ITS WARIOUS PROCESSES. 7
22. With the stomach is associated a group, con- CHAP. I.
sisting of the changes by which the various articles
of food swallowed are deprived of their individuality,
and are converted into a mass, called chyme: this Ghyme and
- * chymifica-
group of changes being called CHYMIFICATION. tion.
23. The digestive tube, hitherto vertical in posi-
tion, begins to change its course, to twist and to bend
itself back. The stomach (plate 1, figs. 8 and 9)
presents itself as placed transversely; the digestive
tube thence proceeds downwards, and forwards, and
is called the duodenum, (plate 1, fig. 10, the com-Duodenum.
mencement of the intestine is there indicated.) This
part of the intestinal canal is identified with another
group of changes in the food, consisting of those, by
which the chyme is converted into chyle: this group
of changes being represented by the term CHYLIFICA-Chylification.
TION.
24. The intestinal tube then proceeds to make
the most varied foldings, being heaped up into masses
occupying the middle and inferior part of the cavity
of the belly. These twisted portions are called
jejunum, (plate 1, fig. 11, 11, 11,) and ileum, ºn and
(plate 1, fig. 12, 12). g
25. In these portions of the intestimal tube, the
process, by which the chyle is absorbed, is specially
carried on: this group of changes being called AB-Absorption.
SORPTION. ~ -
26. The intestinal tube in the part, extending Small intes-
from the stomach to the point where the ileum ceases, tines.
becomes much smaller, and hence the duodenum, the
jejunum and the ileum, are called the small intes-
times. . -
27. Where the ileum ends, the intestinal tube
begins to dilate itself, and its convolutions and twist-
8 ON THE DIGESTION OF FOOD
CHAP. I. ings become much fewer. The first portion of the
º,”, enlarged tube is called the coecum or blind gut,
appendage." (plate 1, fig. 13), which has attached to it a peculiar
appendage (plate 1, fig. 14), something like an earth
worm, (vermis, a worm), hence called the worm-like
appendage, (appendix Caci vermiformis).
28. The continuation of this part of the intestinal
tube lies at the right side of the cavity of the belly.
Colon. It is called the colon: the first portion, that lying at
- the right side of the belly (plate 1, fig. 15) being
*...* called the ascending colon. The further continua-
tion of the intestinal tube proceeds transversely across
the belly, (plate 1, fig. 16), and is hence called the
Transverse transverse arch of the colon : the further con-
rch of the
jº. tinuation of this part of the intestinal tube descends
on the left side of the belly, (plate 1, fig. 17,) and
is called the descending colon.
29. The intestinal tube at the lower part of the
descending Colon makes a bend or flexure, (plate 1,
fig. 18) which being somewhat like to the Greek
jº" “letter s sigma, is called the sigmoid flexure or
bend.
30. This last noticed portion of the intestinal tube
ends in the concluding portion of the tube, (plate 1,
Rectum. fig. 19) the rectum. -
31. The coecum, the colon, the sigmoid flexure
and the rectum, being larger than the other intestines,
* * are called large intestines, and with these large in-
testines is identified another group of changes, by
which all the remaining chyle is absorbed and the
non-nutritive portions of the food are shaped and pre-
pared previous to expulsion.
32. In addition to these parts, another group of
changes is associated with certain glands situated in
AND ITS WARIOUS PROCESSES. 9
the folds of a membrane, which holds the various CHAP. i.
parts of the intestinal tube in their places, called the
mesentery, (usgoc mesos, middle, and evrepov enteron, Mesentery.
intestine). These glands are called the mesenteric, *
and in them the chyle is further changed, and made
into a more perfect animal fluid: the process being
called ANIMALIZATION. - *
33. Another group of changes, the concluding
result of all the other changes, is associated with a
tube, which ascends along the spine, through the
chest, called the thoracic duct, which carries the º
perfected chyle into the circulation, when it becomes
mixed with the blood, and is assimilated to the
vital fluid: this group of changes is called Assimi-Assimilation.
LATION.
33 a. The concluding group consists of those
changes by which the non-nutritive portions of the
digested food are collected together, and, being
moulded into form, are expelled from the body. This
process, which takes place in the rectum, is perfected
when these moulded non-nutritive portions pass
through the closing muscle of the rectum at the anus,
the process being called DEFA. CATION. Defecation.
The arrangement of the intestines (11,12) in plate 1,
is not to be considered as exhibiting the appearance
of them as presented in the human body: the arrange-
ment therein given is to exhibit the course of the
Small intestines.
The wood cut on the next page exhibits the real
though apparently complicated arrangement of these
C
CHAP. I.
10 ARRANGEMENT OF THE INTESTINES.
intestines. A. The oesophagus or gullet; B. The sto-
mach; C. The pylorus, continuing itself into the duode-
num; D D. The small intestines, continuing into the
coecum, E.; F. The appendix of the coecum ; G. The
ascending colon; H. H. The transverse arch of the
colon; I. The descending colon; J. The rectum ;
K. The anus or the extremity of the rectum; L.
The liver; M. The gall bladder with its two ducts;
N. The pancreas or sweet-bread, situated behind the
stomach; O. The spleen.

ON MASTICATION, OR CHEWING. 11
C HAPT E R II.
On Mastication, or Chewing ; the instruments con-
cerned in the process ; their physiological action:
with practical remarks.
34. The first group of changes, connected with
the process of Digestion, is designated Mastication
or Chewing, and is connected with the mouth and its
appendages. k
35. The mouth is guarded and bounded by the
CHAP. II.
lips, which are composed of fleshy threads, endowed Lips.
with the power of alternate contraction and relax-
ation; threads, so endowed, being called muscular *
l'OS.
fibres.
36. These fleshy threads are invested with a soft
skin, and imbedded in a peculiar tissue, very dila-
table, and erectile. The trunk of the elephant in
its sensitiveness and the variety of uses to which it
is applicable, gives a striking exhibition of the struc-
ture and of the action of this tissue, similar powers,
though in a less degree, belonging to the tissue of
the lips. -
C 2
12 THE INSTRUMENTS CONCERNED IN
CHAP. II.
Papillae.
Fourteen
muscles,
Orbicular
muscle.
The sphincter
muscle.
Labial
glands.
Teeth,
36 a. Distributed among these muscular fibres is
an immense number of sensitive, i. e. nervous points,
which are received into little pouches, producing an
appearance, to designate which the name papillae
is applied. These nervous papillae impart that in-
tense sensibility to the lips, by which they are enabled
among other uses to guard against the admission into
the mouth of things which might be injurious.
37. The muscular fibres of the lips (and, according
to Heister, the muscles, i. e. the distinct bundles of
muscular fibres of the lips are fourteen in number,)
are, when viewed in reference to mastication, for the
purpose of taking the food, and transferring it into
the interior, i. e. into the mouth. -
38. The largest muscle of those fourteen has its
fibres arranged in a circular, orb-like form, round
the mouth, and is hence called the orbicularis or
Orbicular muscle, (plate 2, fig. 1).
39. This circularly fibred muscle has the power
not only of grasping the objects applied to the lips,
but also of closing the mouth ; and, as acting thus,
is called a sphincter or closing muscle. So that
there is a closing muscle at the commencement of
the intestinal tube ; a gate-keeper to guard the
entrance.
40. Internal to these muscular fibres, i. e. nearer
to the teeth, are numerous glands, called labial,
which secrete a mucus, which is discharged through
small openings upon the posterior surface of the lips,
and serves the purpose of moistening the gums and
the lips. - -
41. Within the range of the lips are two ridges
of bones, the hardest in the body, called the teeth.
These are fixed in the jaws, the upper jaw, (plate 2,
PLATE II.
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THE PROCESS OF . MASTICATING, 13
fig. 2.) and the lower jaw (plate 2, fig. 3,) in sockets, cHAP. II.
being wedged therein like mails. -
42. Of these, in a perfect state of the mouth,
there are thirty-two. ºvo
43. Each tooth has three parts: the part un-
covered, called the crown; the part concealed in the Crown and
gº ge * root of tootli.
jaw, called the root; and a small portion, a circular
border, lying between the root and the crown, called
the neck of the tooth. Nº ºf the
44. The teeth are arranged into three divisions:
eight teeth in the front, four in the upper and four
in the lower jaw, with sharp edges for the purpose
of cutting the food, hence called incisors (incido, to Incisors.
cut): on each side of these is a tooth, ridged for
tearing food, a form of tooth possessed by dogs, and
hence this tooth is called a canine tooth (canis, a Canine.
dog): two of these are in the upper and two in the
lower jaw; on each side of these but lying more
backward are two teeth, the points of which being
two, (bis, two) and sharp, like spears, (cuspides,) are
called bicuspids, and are eight in number: and Bicuspids.
finally, on each side of these, lying still more back-
ward, are broad flat teeth for grinding the food,
hence called grinders, also molars, (mola, a grind-
stone): the term molar is sometimes applied to the
bicuspids as well as to the grinders strictly so called,
all these acting in grinding the food.
45. This arrangement of the teeth demonstrates
that the food, after being transferred to the teeth by
the lips, should be subjected to three processes, cut-
ting, tearing, and grinding; in other words, as in-
struments devised by the Creator, are always for Deduction
e practical from
use, the truth, revealed to man in such arrangementii.
of the teeth is that he, if wishing to fulfil the con-..." "
14 CUTTING, TEARING, AND
CHAP. II.
Motions re-
quired for
cutting, tear-
ing and
grinding.
Upper jaw
fixed.
Six pairs of
muscles, four
to raise the
jaw, two to
depress the
jaw.
ditions necessary to the preservation of his health,
must cut, tear, and grind his food.
46. However adapted the teeth may be to perform
the duties of cutting, tearing, and grinding the food,
it is certain, that, without some contrivance, by
which they can be moved one against the other, no
cutting, tearing, or grinding can be effected. The
motions required are realized by the agency of the
two jaws in which the teeth are fixed. -
47. In the cutting, tearing, and grinding the food,
not only is a capability of being effectively moved
necessary, but the power of moving must be bestowed
so as to enable the teeth to act on the food. To
afford the required power and motion of the jaws,
one jaw, the upper, is fixed immoveably to the bones
of the skull, whilst the other jaw is moveable. The
upper jaw thus becomes the anvil, firmly fixed, on
which the lower jaw, (plate 2, fig. 3,) the hammer,
acts and works. The mode of the attachment of the
lower jaw to the upper jaw wherein the lower jaw
moves or articulates, and the shallowness of the
articulating surface, necessary in order to allow of
the varied movements in chewing, are striking
exhibitions of adaptation of means to end, (plate 2,
fig. 4). º
48. To enable the lower jaw to move with effici-
ency, it is supplied with six pairs of muscles, i. e.
bundles of flesh, endowed with the power of con-
traction and relaxation. Of these six pairs, four
pairs raise the jaw, and two pairs depress the jaw,
the balance of power being so much on the side of
those which raise the jaw, because the depressed or
depending condition of the jaw is one, which the
lower jaw would take of itself. The muscles, which
GRINDING THE FOOD. 15
elevate the jaw, are immensely strong.” Plate 2, char. Ii.
fig. 5, represents the powerful temporal muscle,
passing under the bony arch (plate 2, fig. 6,) and
fixed into a projection (plate 2, fig. 7,) of the lower
jaw: plate 2, fig. 8, represents the powerful muscle,
called the masseter, which is fixed into fig. 9, the
angle of the lower jaw: plate 2, fig. 10 and 11,
represent the two-bellied muscle, the digastric
(óic, dis, two and Yaarowoc, gastrikos, belonging to the
belly,) a muscle which depresses the jaw.
49. The jaw joint, made by the contact of the
lower jaw with a cavity in the temporal bone,
(plate 2, fig. 4.) has between the two surfaces, i. e.
the surface of the lower jaw and the surface of the
temporal bone, on which the lower jaw moves, a piece
of gristle: hence it happens in the action of the jaws,
the action is made perfectly easy, by a contrivance, Moveable
which, as the mechanician well knows, peculiarly i.
facilitates the motion of a joint. -
50. It is further worthy of remark, that the
arrangement of the jaw joint and of the muscular Arrangement
fibres moving the lower jaw upon the upper, is such º
as to realize up, down, and sideways actions to the tºº
jaw, actions necessary to enable the teeth to cut, to *
tear, and to grind the food. -
51. In order that the food may be effectually Moisture no-
chewed it is necessary that it should be MOISTENED. . iºn.
52. Behind and above the jaw and before the ear
is situated a large gland (plate 3, fig, 1,) called the ºl.
maxillary and
parotid, (Tapa, para, near, wroc, otos, of the ear): sublingual
gland.
* Van Swieten relates that he saw a man, who held a stick between his
teeth with a resistance so powerful, that all the combined efforts of five
men could not pull it away.
16 THE SALIVARY GLANDS.
chap. II. under the lower jaw is situated a gland (plate 3,
fig. 2.) called the submaxillary (sub, under, and
maxilla, the jaw); and on each side under the tongue,
plate 3, fig. 3, exhibits (a portion of the jaw having
been removed in order to show the part,) a third
gland, the sublingual (sub, under, and lingua,
the tongue). - -
53. These six glands, three on each side, Secrete
the fluid called the saliva or spittle, and are hence
iº called salivary glands. These pour out a large
quantity of saliva. This is the case with the parotid
especially, which, by its pipe or duct, called, from
Steno's duet its discoverer, Steno's duct, (plate 3, fig. 4.) empties
its supply into the mouth. The duct in its course
perforates a muscle of the cheek (bucca, a cheek)
* called the buccinator, (plate 3, fig. 5,) and thus
enters the cavity of the mouth. The secretory
power of these glands is evidenced by the immense
quantity of fluid poured from the mouth in saliva-
tion from mercury. Helvetius affirms that the
quantity of saliva secreted by the parotid gland is
so great, that a soldier, having received a wound in
his cheek, which severed the salivary duct, wetted
several cloths every meal with the fluid which flowed
while he was eating. Four ounces and more of
saliva have passed in twenty-four hours from a
fistulous opening of the salivary duct.
54, Not only do these glands supply the required
moisture, but from their situation, it happens, that
sº the very motion of the jaws, necessary in chewing,
the glands, excites the glands to pour out the saliva essential
for mixing with the food in chewing.
55. Indeed the mere presence of food to a person
hungry causes a flow of saliva into the mouth from
PLATE III.

IMPORTANCE OF THE TONGUE. 17
these glands, giving a physiological reality to the old chap. ii.
phrase “Water in the mouth.”
55 a. The bony surface, extending from the teeth
on one side of the upper jaw to the other side, is of
an arched form and is called the palate. This part º
of the mouth cavity has to do its part in the process glands.
of chewing, and the mucous membrane, forming
the lining of the arch, is abundantly endowed with
glands, which pour out a viscid mucus, auxiliary to
the saliva. - -
56. The tongue is a part of great importance Tho tongue.
in connexion with the process of chewing.
57. The tongue is somewhat pyramidal in shape.
The more moveable and sharp portion, the point, is
called the apex; the thicker part behind is called º:
the base or root. -
58. The tongue is connected with all the surround-
ing organs, more especially with the hyoid bone, Hyoid bone.
(plate 2, fig. 13, 14.) This hyoid bone may be re-
garded as the bony apparatus of the tongue. It
supports the base of the tongue.
59. The tongue, though in appearance single, is
divided equally into two parts by a longitudinal line
running down its middle, and hence called the
median line. t Median line
tº of the tongue.
60. The tongue itself is a mass of flesh, that is,
it is an aggregate of eight collections of muscular Varied distri-
fibres or threads, arranged in different directions, º
thus giving to the tongue, by the alternate con- i. the
traction and relaxation of those fibres, that immense
variety of motions, which the tongue needs in order
to enable it to perform the varied duties allotted to
it. Besides these four pairs of muscles there are,
in the substance of the tongue itself, distinct mus-
I}
18 IMPORTANCE OF THE TONGUE
CHAP. II. cular threads, which run longitudinally, transversely .
and vertically, that is, in all directions, and which
by consequence, on account of the peculiar power
of muscular fibres, are capable of moving the tongue
in all directions, thus imparting almost every variety
of motion to the tongue. •.
61. These muscular masses composing the whole
ºf tongue are invested with three coverings or coats.
* The outermost is thick and composed of a large
number of globular pouches or sheaths; the cen-
tral is like a beautiful net-work, hence called reticu-
lar (rete, a net); and the third, the innermost, is
called the nervous papillary membrane, because
through it certain elevations called papillae, (which
contain the nervous points, the primary organ of
taste), arise and are spread out.
62. Over and throughout the surface of the tongue
are distributed three classes of papillary elevations.
The first class of papillae, situated chiefly at the
base of the tongue, and the largest, resemble, when
magnified, little mushrooms with short stalks. :
º: These are called headed. The second class of
lous papillae, papillae are small round eminences, a little convex,
the borders of which lie contiguous to the surface
of the tongue, and are called lenticular. Examined
with a microscope, the convex sides of these lenti-
cular papillae are seen to be full of small holes or
pores like the head or spout of a watering pot.
These occupy the middle and the front portions of
the tongue. The third class of papillae, the smallest
and the most numerous, occupy the whole of the
upper surface of the tongue and even the interstices
between the other papillae: these having a tufted
character like velvet, are called villous (villosae).
Papillary
membrane.
IN THE PROCESS OF CHEWING. 19
63. All these papillae are for the reception of the CHAP. II.
nervous substance derived from four large nerves, --
à. e. instruments conveying the motion and the sen-
sation power, of which two are from the fifth pair
of nerves, which fifth pair proceed from the brain or Nerves from
the cerebrum, and two from the eighth pair of nerves, º
which eighth pair proceed from the little brain or"
cerebellum. These papillae may be regarded as
arising from the papillary membrane and the nerves
of the tongue, and passing through the central reti-
cular membrane, terminate in the sheaths or pouches •
of the outer membrane, constituting, in fact, the
organ of taste. -
64. These papillae, the villous more particularly,
possessing contractibility and elasticity, are capable
of changing their state and form so as to adapt
themselves to the various substances, brought in con-
tact with them, and project (as Boerrhave remarks Papillo pro-
in his Institutiones Medicae, p. 485–490) from the"
surface of the tongue when a person is hungry.
65. The tongue, endowed with so extraordinary a
power of motion, moves about the particles of food
taken into the mouth, presses them against the palate,
mixes them with the mucus and the saliva of the
mouth, and, finally, collects the cut, torn, ground,
and salivated portions into a ball, in order to prepare
for the commencement of the second series of changes
under the second group of the phenomena of digestion,
designated by the term Deglutition.
PRACTICAL DEDUCTIONs,
in connection with the preceding facts.
a. As the chief use of the teeth is to cut, tear, and
grind the food, it is certain, that if any one neglect
D 2
20 PRACTICAL DED UCTIONS.
CHAP. II, to use the teeth for the purposes for which they were
bestowed, he disregards an essential to healthy di-
tº: gestion, and must pay the penalty, sooner or later, in
jºins the bad digestion, and in the host of evils, known under
e the name of “dyspepsia.” -
b. As the teeth are necessary to effect the proper
º º change in the food, it is evident that infants, who
should eat have no teeth, or few teeth, should have food not
soft food. requiring the exercise of teeth; and that aged
people, who have lost their teeth, should eat food
that is soft, or at least obtain properly constructed
artificial teeth.* *
c. In the situation of the salivary glands (plate 3,
šituatiºn of fig. 1, 2, 3), a situation by which every motion of
the salivary e e & e
glands shows the jaw stimulates these glands to discharge their con-
* º: “tents into the mouth, is found an additional evidence
* to the necessity of well using the jaws, and thus fully
exciting the glands, so as to cause a full supply of
saliva to be applied to the food, which supply will
take place only when the food is cut, torn, and
ground. *
d. In the facts, that the papillae have the power of
elevating themselves on the application to the tongue
Reason why of their stimulus, food, and that the lenticular papillae
food, before tº §
it can be di- (62) have their convex sides full of small holes or
Wested, all tº e -
É.” pores, is found the explanation of the well known
* The advertising cheap dentists should be avoided by every one.
The majority of them are knaves. Some have gilded copper plates for
the reception of the teeth; the gilding soon comes off, and the wearers
of such teeth are poisoned by the copper. Others have silver plates
for the reception of the teeth; these they get stamped as genuine at
Goldsmith's Hall; after the stamping they gild these plates, and people
are shown by these knaves the goldsmiths' mark, and think that they
are quite safe, as purchasing genuine gold, whereas it is only silver
golded.
PRACTICAL DEDUCTIONs. 21
fact, that a person, exhausted from the want of food, CHAP. II.
is relieved almost as soon as he takes food into the
mouth, the finer portions being taken up through
the small pores, and thus producing an impress on
the brain, relieving the cerebral condition causing
the sensation of hunger.
e. The fact, that the lenticular papillae have these
small holes around their margins, presents an addi-
tional evidence to the necessity of chewing the food,
in order that, by an abundant supply of saliva, the
finer particles of the food may be dissolved, and thus
passing through the pores, may afford to the sense of Means for the
taste all the delights which food is capable of afford. ºn ºf
ing: in other words, may give the delights connected
with flavour. -
f. The fact, that, in disease, especially fever, the
tongue is coated over with a thick crust, demonstrates
the absurdity connected with the giving of food inº,
such a condition, since the papillae are in a state unfitin ºver
for the reception of the impressions, which, in health, `
are made by the food on the tongue.
g. Viewing the tongue as an absorbing organ, how
appropriate appear the remarks of the Swedish
philosopher:-Thus, “the tongue, the feeder and
keeper of the entrance into the stomach and the
viscera of the body, not merely prepares the table
but also takes the first taste of the viands and begins
the feast.”
22 on swa LLOWING OR DEGLUTITION.
CHAP. III.
Hanging veil
of the palate.
Uvula.
Tonsil.
Fauces.
CIHAPTER III.
On Swallowing or Deglutition, with practical remarks
and deductions. *
66. On looking into the mouth, a fleshy curtain is
seen hanging at the back part of the palate: it is
called the hanging veil of the palate, (velum
pendulum palati). 2
67. At the centre of this curtain, the curtain itself
presenting the form of two festoons, hangs a little
fleshy tassel-like body, called, from its resemblance
to a small grape, uvula.
68. At the sides of the palate, the margins of this
hanging veil seem to separate, presenting at each side
in the part formed by the separation, a glandular
body, called the tonsil: this body is, in reality, a col-
lection of mucus-secreting glands, united together into
a little body, which, being like an almond, (amygdala)
is sometimes named the amygdala.
69. On looking into the mouth is seen behind this
curtain a chamber, designated the fauces, (plate 4,
fig. 6.) This fauces is a chamber or cavity into which
IV.
PLATE

ON SWALLOWING OR DIEGLUTITION. 23
terminate two passages from the nostrils, two from the CHAP. III.
internal ears, one from the mouth, one from the
windpipe, and one from the passage leading from the
mouth to the stomach. This last passage, this food
pipe, has two names, the term pharynx being ap-pharynx.
plied to the part nearest the mouth, namely, the part
situated above the figure No. 10, plate 4; the term
Oesophagus, (owoc, Oisos, food, and bayo, phago, to CEsophagus.
eat,) or the gullet, to the part represented below the
figure No. 10, plate 4, continuous from the upper
part into the stomach. .
70. The pharynx and the gullet are the parts con-
cerned in connection with the group of changes,
forming that part of the process of Digestion, to
which the term DEGLUTITION or swallowing is applied. Deglutition.
71. At the front of the neck is seen the windpipe,
and at its upper part can be felt a bony-like rim,
(plate 2, figs. 13, 14,) called the os hyoides. This Os hyoides.
bony rim is connected with the base of the tongue.
Below this bony rim are the chief gristles or cartil-
ages, forming the commencement of the windpipe,
called the larynx, (plate 2, fig. 15, plate 4, fig. 5,) Larynx.
the more narrowed portion of this tube being called -
the trachea, (plate 2, fig. 16). The trachea itself is Trachea or
composed of rings, three fourths of each ring, namely windpipe.
the front and the sides, consisting of gristle, the re-
maining fourth, i.e., the hind portion, of fleshy sub-
stance. The trachea or windpipe, strictly so called,
divides into two chief tubes, called bronchi, these Bronchi.
dividing into still smaller tubes, and these into still
smaller, and so until at last the windpipe has, as its
terminations in the lungs, air cells. Through this Air cells.
windpipe and its branchings the air is distributed
throughout the lungs (plate 1, figs. 21, 22.) during
24 ON SWALLOWING OR DEGLUTITION.
CIIAP. III.
Membranous
coat of the
gullet.
Muscular
Coat.
Cellular,
nervous, aud
villous coats
of the gullet.
Mucous fluid.
the act of inspiration, and is expelled from the lungs
in the act of expiration.
72. The oesophagus or gullet is a membranous canal,
reaching from the fauces to the stomach, (plate 1,
fig. 5). It is funnel shaped. The broadest part,
called the pharynx, or the bearer, from Øspo, phero, to
bear, being, as it were, the receiving or bearing vessel
of the palate, (plate 1, fig. 5,) lies behind the wind-
pipe, (71); indeed, the windpipe forms its anterior
boundary, (plate 4, fig. 8). The posterior boundary
is represented by the spine, (plate 4, fig. 11).
73. The pharynx and the gullet are a membranous
canal, composed of five layers or coats. The outer-
most is membranous, and is continuous with the
membrane lining the cavity of the chest interiorly;
this membrane being called the PLEURA. The second
layer or coat is muscular, consisting of fibres ar-
ranged in two directions, lengthwise (longitudinal)
and circular. The third coat is cellular, and a simi-
lar layer is found in other parts of the intestinal tube.
The fourth coat is nervous, and is supplied abun-
dantly with vessels and glands, and is continuous with
the interior membrane, both of the mouth and of the
stomach. The fifth coat has a surface similar to that
presented by velvet, hence called a villous coat, and
is covered with a viscid humour.
74. The third and the fourth coats of the gullet
have various longitudinal plaits or folds, being much
wider and larger than the muscular coat, so that the
gullet, where cut across, represents, from the inter-
mingling of these plaits, the appearance of one tube
embracing another tube.
75. The whole internal surface of the pharynx is
covered with glands, which secrete a mucous fluid,
PLATE. V.

ON SWALI, OWING OR DEGLUTITION. 25
for the purpose of rendering easy the passage of the CHAP. III.
bodies swallowed. -
76. In order to effect the act of swallowing, the
pharynx and the oesophagus require to be dilated. To
effect this dilatation, these parts are supplied with six i. º of
pairs of muscles.
77. To constrict or to contract the pharynx and
the oesophagus one muscle is provided, which arises
on both sides of the hyoid bone (71) and from the
cartilages of the larynx, parts essentially connected
with breathing. This muscle surrounds the exterior
part of the gullet or osophagus, and is hence called
the Oesophageus.
78. The origin, the attachments and the situation
of this last muscle, and the additional fact, that the
tongue and the larynx are both attached to the hyoid
bone, show how intimately the actions of the gullet
and of the windpipe, in other words, the actions of
swallowing and of breathing, are connected together. Connection
To this may be added, as evidencing the connection º
between the action of the gullet in swallowing and º'"
the action of the lungs in breathing, the additional **
fact, that the ocsophagus or gullet passes through the
fleshy partition called the diaphragm (plate 1,
fig. 24), at the part represented, (plate 5, fig. 3); this
diaphragm Separating the cavity of the chest from
the cavity of the bowels. The diaphragm acts at the
same time (synchronously) with the alternate action
of the lungs in breathing, and imparts of necessity
a corresponding action to the gullet.
79. The oesophagus decreases in diameter all the
way from the pharynx to the orifice of the stomach,
(plate 1, fig. 8.) .
80. The food has to be swallowed.
I.
26 ON SWALLOWING OR DEGLUTITION.
CHAP. III.
Passage of
the food into
the pharynx.
Epiglottis.
81. The tongue, after the food has been properly
masticated, collects it from all parts of the mouth.
The food has then to be passed into the pharynx.
To effect this passage, the tongue elevates its root;
the lower jaw becomes fixed; the hyoid bone is
drawn forward by the muscles which extend from
the lower jaw to the hyoid bone; the windpipe is
thus drawn forwards, and the morsel being passed
under the hanging veil of the palate, is carried into
the pharynx, the hanging veil of the palate prevent-
ing its return into the mouth, the pharynx being
passive while the tongue is acting; but directly the
tongue has acted, it raises and enlarges itself to meet
the coming body: the food, in passing into the
pharynx, has to pass over the windpipe, the windpipe,
as already described, being in front of the gullet.
If the food entered the windpipe, suffocation might
be caused. To prevent this, a valve, called the
epiglottis, (ºr, epi, upon, and yxorra, glötta, the tongue,)
fastened to the root of the tongue, closes down in
the action of Swallowing, and shuts the passage into
the windpipe, forming, in so closing the passage, an
arch over which the food passes safely into the
pharynx. When the food arrives in the pharynx, it
is carried thence down the gullet into the stomach by
the action of the muscular coat (73) already de-
scribed. -
82. Of the muscular action as the cause of the
food being carried down the gullet into the stomach,
a striking proof is found in the fact that animals,
which crop their food, their heads being bent down-
wards to the earth, carry the food upwards into
their stomachs; a muscular action, as being the opera-
tive cause of Swallowing, recognized in the old adage,
DEDUCTIONS. 27
“One man can lead a horse to drink, but nine men CHAP. III.
cannot make him drink.”
83. So much indeed is the act of swallowing a Swallowing
muscular effort, that it has been found that a single *
action of the pharynx involves the concurrence of
more than a hundred different muscles.
84. The oesophagus, having carried the food the
whole length of itself, passes it by its muscular action
through the orifice by which it ends in the stomach.
This orifice is called the cardiac orifice, (plate 1, º ori-
fig. 8, plate 6, fig. 2.) and is sometimes designated,
from the peculiar puckered form of the folds,
of which it is entirely composed, the ring of the Ring of the
Oesophagus. Oesophagus.
85. The food is passed slowly by the action of the
Oesophagus, that action consisting of a kind of spiral
movement, into the stomach. Of this demonstrative
evidence was afforded in the case of Alexis, see chap-
ter V., paragraph 112, into whose stomach Dr. Beau-
mont saw the food working its way slowly from the
Oesophagus, in a kind of spiral gyre.
D E D U CTION S.
h. The fact, that numerous glands pour out upon the Necessary
surface of the pharynx and of the oesophagus a con- ºil.
siderable quantity of mucous and other fluids (75) º
for the purpose of mixing with the food, demonstrates:...º.
that any hurrying in the act of swallowing the food lºyed
prevents the proper admixture with the food of this Y.
mucous, and the other fluids. Thus deprived of these
fluids, evidently for the purpose of effecting some
beneficial change in the food swallowed, the food is
E 2
28 ; T) EDUCTIONS.
CHAP. III.
Evils of
swallowing
unchewed
food
introduced into the stomach in a state unfit for the
next series of changes connected with the process of
Digestion, and thus becomes instead of a healthful
stimulus to the stomach, a matter productive of injury,
an injury manifesting itself in indigestion.
i. The fact, of the intertwining plaited arrangement
of the lining membranes of the gullet by which they
become closely applied and folded to each other,
demonstrates that any hard, unchewed portions of
food, carried down into and through the gullet, must
tend, by inducing an unnatural condition of the
gullet itself, to injure these plaited membranes, and
thus become, by frequent repetition, the foundation
of many of those pains in the centre of the back, and
of the chest, which torment many dyspeptics: and
further may give origin, in persons of an unhealthy
(cachectic) habit of body, to that thickening of the
lining membrane of the gullet, which ends not un-
frequently, in permanent difficulty of swallowing,
(dysphagia, 8ve dus, bad, gayo, phago, to eat.) which,
when proceeding to its ultimate, produces death by
imanition, the passage of the gullet becoming closed.
j. This fact, the folded structure of the liming mem-
brane of the gullet, demonstrates the quackery and
the injuriousness of the common surgical practice of
Absurdity of attempting to force down the gullet bodies, fish bones
forcing ob-
jects sticking
in the throat
down the
throat.
for instance, which have been incautiously swallowed.
This practice exhibits a lamentable ignorance both of
physiology and of the anatomical structure of the
gullet. Physiological pathology ought to have taught
surgeons that a foreign body retained induces a
perpetually recurring spasmodic contraction of the
gullet, which contraction they, in attempting to force
the body down the gullet, must overcome by the force
T) BDUCTIONS. 29
with which they use their instrument; add to this CHAP. III.
the increased spasmodic contraction, induced by the
instrument used in forcing the foreign body down,
and the necessity of the enlightenment of the public
on these points, in order to counteract the effects
which must result from the ignorance of such sur-
gical practitioners, becomes strikingly and painfully
apparent. -
Indeed, such practice is oftentimes the cause of the
closure of the oesophagus, a condition ending in star-
Vation.*
Å. The first fact, that the food does not pass into
the stomach directly it is swallowed, but is gradu-Cause of
ally and slowly worked into the latter organ by a” oplexy.
kind of spiral gyre-like action of the gullet itself;
the second fact, that the diameter of the oesophagus
gradually lessens as it nears the stomach; and the
third fact, that the aorta, the great arterial trunk of
the body, (plate 5, fig. 4, plate 6, fig. 17,) lies close
to the gullet, will explain why apoplexy so often
attends the taking rapidly an immense quantity of
food at public dinners. Persons, not habituated to
the luxuries presented at these dinners, having such
tempting varieties of food, swallow in haste what is
* Of this an instance has lately come under my notice. An interest-
ing and intelligent married lady consulted me for an impossibility to
swallow food. Intelligent was the countenance, but the eye had an
anxious brightness, indicative of the dreadful changes going on in the
system, caused by the deficient supply of food. She died, and the con-
dition of the gullet causing this state, which ended in death, was brought
about by the persevering efforts of a surgeon to force a fish-bone which
she felt in her gullet down into her stomach. In such cases of swallow-
ing hard pointed bodies the suggestion is “Let alone,” subdue anxiety;
the oesophagus will, it is not unlikely, digest the body, and, if not di-
gesting, it will so far act upon it as to dislodge or enable it to be dis- s
lodged, especially when aided by the passage of soft food.
30 DIED UCTIONS.
CHAP, III.
Advantages
of sucking.
before them. The gullet, not immediately emptying
itself into the stomach, becomes distended; a pressure
on the parts surrounding and in the neighbourhood
of the gullet takes place; the flow of the blood
through the aorta is impeded; arising from this
impediment the vessels in some overworked and weak-
ened part of the brain become ruptured, effusion of
blood takes place, and, after some hours of stertorous
breathing, the patient dies: apoplexy is the verdict
of the coroner's jury, whereas the true verdict is
“Died of excessively distending the oesophagus.” The
individual, thus self-sacrificed, might have eaten with
safety, though not with benefit, quite as much as that
which killed him, had he diffused the eating over a
double space of time.
l. The interesting connexion already detailed (78)
existing between the action of the gullet and the
action of the lungs, explains why the infant should
obtain its food by sucking, the action of sucking
being one, in which the child creates a cavity in its
mouth and fauces, when drawing the milk into its
mouth in the act of inspiration. In sucking the child
gives regular exercise to its lungs, and thus developes
the powers of the general system, so intimately con-
nected with the action of the lungs. From the ab-
sence of this exercise of the lungs, as well as, it is
likely, in part from the nature of the food taken,
children brought up by hand are not so healthy as
those brought up by the natural method. From this
view a deduction presents itself, namely, the advan-
tageousness of trying, as far as possible, in bringing
up by hand, to make the process similar to the
matural method. The letting a child suck from a
bottle is advantageous, it gives exercise to the lungs.
DEDUCTIONS. 31
m. The connexion between the action of breathing CHAP. III.
and the swallowing apparatus will explain the essen-
tial benefit in aiding digestion, derivable from reading Benefit to
aloud and from public speaking. These not only give *
freedom of action to the circulation of blood through”
the lungs, but promote those actions of the digestive
tube, subsidiary to healthy digestion.
m. It was noticed (77) that the muscle, called the
Oesophageus, which embraces and constricts the
pharynx and the gullet, is tied to the hyoid bone,
and the upper part of the windpipe; that the outside
covering of the gullet is derived from the same mem-Harmony be.
brane that lines the chest and covers the lungs, (the º,
pleura); that the pharynx and the larynx are con-..."
tinuous; and that the gullet passes through the
diaphragm, that partition already described, as that
which bounds the chest at its lower part, and that
which is called into action in every act of inspiration.
These connexioms between the breathing and the swal-
lowing apparatuses cause the following results: the
gullet transfers uninterruptedly through the stomach,
the next part to the gullet in the intestinal tube, and
thence through all the subsequent viscera, forming
part of and connected with the intestinal tube, the
alternate respiratory or breathing motions of the
lungs. In fact, it has been well said, that “the
osophagus with its appliances and powers is like a .
running axis, provided with thongs and cylinders,
whereby it excites, turns and whirls the abdominal
wheel to the same reciprocal motions as the lungs.”
32 ON THE STOMACH AND CHYMIFICATION.
CHAPTER IV.
gº-º-º-º-º-º:
On the Stomach and Chymification, with practical
deductions in connevion therewith.
tººmsºmº
CHAP. iv. 86. The third group of changes connected with
Digestion is associated with the stomACH, the organ
in which the oesophagus or gullet ends.
87. The stomach, (plate 1, fig. 8 and 9, and
situation of plate 6, A) is situated at the left side of the body,
the stomach. . we f e e
immediately under the diaphragm, in the part called
the left hypochondrium,” and there lies obliquely
between the spleen and the liver, extending trans-
versely and obliquely forwards and to the pit of the
stomach, this triangular portion embracing the pit of
Epigastrium, the stomach, being called the epigastrium.
Shape of 88. The stomach has a figure like that of a bag-
stomach.
* It may be useful in order to make this term and other terms refer-
ring to position intelligible, to study the adjoined figure, which indicates
the various divisions into which the surface of the body, more particu-
larly in relation to the contents of the abdominal cavity, is divided.
A line A A extends from one side to the other at the bottom of the
chest; a second line B extends from the crest of the ileum bone, i.e., one
of the hip bones, to the crest of the other; passing through both these
lines is the line C.
The figure E represents the epigastric region; that is, the region of
the pit of the stomach; D F represent the two upper side regions, called
VI.
-
-
PLATE

ON THE STOMACH AND CHYMIFICATION. 33
pipe, (plate 6, letter A,) being a membranous bag, CHAP. iv.
oblong, curved, large and capacious at the end,
namely, the end adjoining the diaphragm, this part
being called its bulging or great extremity (plate 6,
fig. 3,) and small and contracted at the other end
(plate 6, fig. 4).
the hypochondria; G represents the umbilical region, or the region of
the navel; H I represent the flanks, H the right flank, I the left flank,
J the hypogastric region, the lower part of this region at M being called
the pubic region; the letter N represents the groin.
The figures 1, 1, 1, 2, 2, show the situation of the stomach, occupying a
portion of the left hypocondriac region, and a greater part of the
epigastric region; 3, indicates the situation of the spleen; 4, represents
the situation of the intestine, called the coecum ; 5, that of the ascending
colon; 6, that of the transverse arch of the colon; 7, that of the descend-
ing colon; 8, that of the sigmoid bend of the colon ; 9, that of the com-
mencement of the rectum; 10, the portion of the abdominal cavity occu-
pied by the small intestines.

34 ON THE STOMACH AND CHYMIFICATION.
CHAP. IV.
Its openings,
Relative po-
sition of the
two orifices.
Pyloric
valve.
The coats of
the stomach.
The muscu-
lar coat.
Its peculiar
Sil'll Ctilll'e,
89. The stomach has two curves, a greater (plate 6,
fig. 5,) and a smaller (plate 6, fig. 6).
90. It has two openings, called its orifices; the
left being a continuation of the oesophagus, (plate 6,
fig. 1, plate 7, fig. 1.) called the cardia (plate 6,
fig. 2, plate 7, fig. 2.) and the right opening, si-
tuated lower and more towards the pit of the stomach
and connected with the next intestine. This open-
ing is called the pylorus, and corresponds in site to
the pit of the stomach, (plate 6, fig. 7, plate 7, fig. 8).
91. From this position of the stomach, it happens.
that if the stomach is divided along the curvatures
the cardiac orifice (plate 6, fig. 2.) would be found
in the upper half, and the pyloric or intestinal orifice
in the lower half (plate 6, fig. 7). &
92. At the pyloric orifice is a VALVE (plate 7, fig. 3,)
called the pyloric, which serves to close the sto-
mach. *
93. The stomach is composed of five layers or
coats: the first, the external or membranous, being
continuous with the common coat or lining of the
abdominal cavity called the peritoneum, is called the
peritoneal, and its fibres are transverse: the second
coat is called the cellular: the third coat is the
muscular: the fourth, the nervous: and the fifth,
the villous.
94. The muscular coat is made of several layers
of fibres, which may be grouped into two divisions,
the outer plane or layer being composed of longi-
tudinal, the inner plane of transversely circular
fibres. Many of the muscular fibres are spiral,
particularly about the pylorus. The fibres of the
outer layer are often intersected by small oblique
whitish, tendinous lines. The fibres of the inner
PLATE VII.

ON THE STOMACH AND CHIYMIFICATION. 35
layer, when examined minutely, appear rather as CHAP. Iv.
segments of than complete circles, being intersected
by great numbers of small white, very oblique lines,
tendinous in appearance. These circles of fibres, as
approaching the greater extremity of the stomach,
gradually lessen in size, forming a kind of muscular
whirlpool, the centre of which is in the middle of
the great extremity of the stomach. All this pecu-
liarity of structure has an important practical bear-
ing in reference to Digestion. - *
95. The fourth coat, the nervous, has on its con-Nervous coat.
vex side, a large number of small vessels, which,
having the minuteness of hairs, (capillae,) are called
capillaries. Besides the nerves in this coat are nu-
merous vessels. The concave, i. e., the interior side
of this nervous coat, presents a spongy texture like
fine cotton or wool, which contains a large quantity
of glandular bodies, like little grains, hence called
glandular granules, which appear to be the secre-Glandular
ting organs of the peculiar fluid, called the gastric"
juice.
96. The fifth coat has a velvety appearance, hence
called the villous coat, called formerly the fungous villous, fun-
coat. It is thin, porous, the pores corresponding to “
the glandular granules (95).
97. The two coats, just described, the nervous and Rows of ruge
the villous, like the corresponding coats of the gullet, ..".
are of a greater extent than the coats external to".
them, and form large folds or wrinklings (rugae,)
(plate 7, fig. 4.) on the internal concave surface of
the stomach. At the cardiac orifice (plate 7, fig. 2,)
the rugae are radiated, forming a kind of crown.
Those over the greater part of the stomach are
transverse, irregular and wavy, (plate 7,) becoming
F 2
36 ON THE STOMACH AND CHYMIFICATION.
cuAP. Iv. longitudinal at the pylorus where they terminate.
Some longitudinal rugae intersect the others.
98. At the pyloric extremity of the stomach the
pylorus itself presents the figure of a ring trans- . . "
versely flattened, the inner edge running naturally
into plaits or gathers like the mouth of a purse
The fºrma when closed. This arrangement of fibres enables
º: ºw the pylorus to act as a closing or sphincter muscle,
and this part is hence very appropriately named the
pyloric valve, (92).
99. In health and when free from food the sto-
mach is usually entirely empty and contracts upon
itself. -
100. The inner coat of the stomach in its natural,
i.e. healthy and unstimulated state, is of a light, pale
pink colour, and is constantly covered with a very
thin, transparent, viscid mucus, lining the whole
interior of the organ. The coat, so covered with
Mucous coat, mucus, is hence sometimes called the mucous coat.
Blood-vessels 101. The stomach is abundantly supplied with
of the e tº ºf ſº
stomach, blood vessels, the chief vessels dividing and sub-
dividing, and these sending cross branches one to
the other, thus forming quite a met-work over the
stomach, the nervous coat being that coat which,
according to Ruysch, is most abundantly supplied
with blood-vessels.
Nerves of the 102. The nerves supplying the stomach are very
" numerous, dividing and spreading in different direc-
tions, forming bundles of nervous net-work, from
which are sent off fine nervous threads or filaments
to the immer coats of the stomach.
103. The chief nerves of the stomach are derived
Par vagum. from the eighth pair of nerves, called the PAR WAGUM,
which nerve passes down the oesophagus from within
ON THE STOMACH AND CHYMIFICATION. 37
the skull, in the form of two great cords, which CHAP. Iv.
unite round the upper orifice of the stomach, forming
there a net-work or, as it is technically named, a
plexus of nervous fibres. A plexus.
104. Besides these nerves thus derived from the
eighth pair, there are numerous branches of nerves
from the great intercostal nerve, or, as it is called,
the great sympathetic nerve, being so named be- ..
cause its branches being distributed to all the interior
organs of the body, it combines all the Organs, uniting
them into one great sympathy. These by branches,
which unite with the branches from the par vagum,
establish a communication with that nerve, and thus
bring the brain into connexion with the general
digestive system.
105. When food passes into the stomach through Food stimulus
- te gº & to stomach.
the cardiac opening, the action of the vessels of the
stomach is increased, the pale pink colour of the
internal coat of the stomach becomes deepened, and
little transparent drops are seen upon the surface of
the stomach, this fluid being the gastric juice. Gastric juice.
106. Pure gastric juice is a clear, transparent fluid, ºº,
without smell, slightly saltish, and very perceptiblyjuice. "
acid. Its taste when applied to the tongue, is similar
to thin mucilaginous water, slightly acidulated with
muriatic acid. It coagulates white of egg in a re-
markable degree, is powerful in resisting the putre-
faction of meat.
107. Pure gastric juice will keep for many months
without becoming foetid.
108. The changes upon the food, which take place
in the stomach, manifest themselves in the converting Formation of
the various articles taken as food, into a soft poultice.”
like mass, in which all the individual articles lose
38 ON THE STOMACH AND CHYMIFICATION.
CHAP. IV, their identity, and become changed into a substance
of a like nature, called chyme.
jºine- 109. This group of changes is called Chymifi-
g cation.
110. Several agents are engaged in effecting this
change.
111. The principal agent is the gastric juice. So
numerous and so important are the facts connected
with the gastric juice and its action, as to require for
its consideration a distinct chapter.
ON THE GASTRIC JUICE. 39
CHAPTE R. V.
On the Gastric Juice, with avioms and practical
deductions.
112. Alexis St Martin, a Canadian of French chap. v.
descent, of good constitution, robust and healthy, in .º.
his eighteenth year, was, while engaged in the ser-
vice of the American Fur Company as a voyageur,
accidentally wounded by the discharge of a musket.
The accident occurred on the 6th of June, 1822.
The injuries inflicted were very severe: the sixth rib
was fractured and the anterior half was carried away:
the fifth rib was fractured: the lower portion of the
left lobe of the lungs was torn, as was the diaphragm,
and the stomach itself was perforated. A portion of
lung, lacerated and burnt, as large as a turkey's egg,
protruded from the wound; and immediately below
this was another protrusion, which proved to be a
portion of the stomach. The food he had taken for
his breakfast, poured out through an Orifice large
enough to admit the fore-finger.
By skilful surgery acting in accordance with a
strong constitution, Dr Beaumont, under whose care
its results.
accident and
40 ON THE G ASTRIC JUICE.
CHAP. W.
No action of
the bowels for
Seventeen
days.
Action of
bowels after
food retained
in his
stomach.
Alexis came, succeeded in completing the closure of
the wound into the chest. -
113. During this period, as Dr Beaumont relates,
for seventeen days all that entered his stomach by the
Oesophagus soon poured out through the wound, and
nutritious injections per anum were the only means
of support.
114. During this period of seventeen days, no
action of the bowels could be obtained, al-
though cathartic injections were given, and various
other means were adopted to promote the intestinal
action.
115. In a few days, after firm dressings were
applied, and the contents of the stomach were
retained, the bowels became gradually excited,
and, with the aid of cathartic injections, a very hard
black, fetid stool was procured, followed by several
smaller ones, after which the bowels became quite
Process of
healing.
regular, and continued so. --
116. The fourth week after the accident, the sides
of the protruded portions of the stomach had ad-
hered to the membrane (pleura) lining the rib (the
costal pleura) and to the external wound. Cicatri-
zation and contraction of the external wound com-
menced on the fifth week, the stomach becoming
more firmly attached to the pleura and to the adjacent
muscles situated between the ribs, (the intercostals).
The orifice into the stomach exhibited no sign of
closing. Fortunately for science, Dr Beaumont's at-
tempts to close the aperture were ineffectual. By
June 6th, 1823, one year after the accident, all the
injured parts had become sound, except the aperture
in the stomach and side: the perforation at this time
being about two inches and a half in circumference,
ON THE GASTRIC JUICE. 41
food and drinks being kept in the stomach only CHAP. v.
by the application of a tent, a compress and a
bandage. -
117. The wound still improved, and in the winter
of 1823-4, a small fold or doubling of the coats of the
stomach appeared to be forming at the upper margin
of the orifice, slightly protruding, and increasing
till it filled the aperture, so as to supersede theº. #S
necessity for the compress and bandage, which to close aper-
º e ture into the
had hitherto retained the contents of the stomach. Stomach.
This valvular formation adapted itself to the
accidental orifice so completely as to prevent
the escape outwards of the contents of the stomach,
when the stomach was full. At the same time this
valvular formation was easily depressed with the
finger, so as to enable the observer to SEE INTO THE
INTERIOR OF THE STOMACHI.
118. The valve thus formed is strictly a slightly
inverted portion of the inner coats of the stomach,
fitted so exactly as to fill the aperture. Its free por- Its action.
tion hangs pendulous, and fills the aperture whenº."
to the respi-
the stomach is full, and plays up and down simul-.”
ments.
taneously with the RESPIRATORY muscles when
the stomach is empty.
119. In the spring of 1824, Alexis had completely
recovered his natural health and strength.
In May 1825, Dr Beaumont commenced his first
series of experiments in connexion with the stomach
of Alexis, and continued them till the autumn, at
which time Alexis left him to return to Canada, his Return to
native place. Canada,
Alexis remained in Canada four years, married
and had two children, working hard to support his
family. In 1825 he engaged with the Hudson's Bay
G
42 ON THE GASTRIC JUICE.
CHAP. V. Fur Company as a voyageur to the Indian country,
went out in 1827, and returned in 1828.
Having learned his place of residence, Dr Beau-
mont, at great expense, had him conveyed, in August
1829, with his wife and children, from Lower Canada
to himself, at Fort Crawford, Upper Mississippi, a
distance of nearly two thousand miles.
The aperture into his stomach still remained, and
his health was good. -
120. Alexis again entered Dr Beaumont's service,
º and submitted to a second series of experiments,
which were carried on uninterruptedly till March
1831: he performed the duties of a common servant,
chopping wood, carrying burdens, &c., with little or
no suffering or inconvenience to his wound.
** 121. In 1831, he returned again to Lower Canada
with his family. They started in an open canoe, via
Mississippi, passing by St Louis, Mo: ascended the
Ohio river, crossed the state of Ohio to the lakes:
descended the Erie, Ontario and the river St Law-
rence to Montreal, where they arrived in June, and
remained in Canada till October 1832, having been,
in the midst of the cholera epidemic, safe from the
ravages to which hundreds around them fell sacri-
fices. *. -
122. In November 1832, Alexis again engaged
himself to Dr Beaumont, joining him at Plattsburgh,
New York, travelling with him to Washington,
where he was subjected to experiments from Novem-
ber 1832 to March 1833. te
123. Alexis had all this time enjoyed average good
health, and had been engaged in athletic exercises,
and living as other healthy people.
124. This history has been given with two objects:
ON THE G ASTRIC J U ICE. 43
first, to record the facts of the case; and second, to CHAP. V.
show that the experiments performed on Alexis, are
to be considered as experiments on a healthy
person.
125. These experiments have an intensity of in-
terest associated with them, from the fact that never
did an opportunity occur before of seeing what
goes on in a healthy stomach,” and, it is likely,
never will such opportunity occur again.t
126. From the experiments made by Dr Beaumont,
numerous most important facts in relation to the
digestion of food have been developed, and the fol-
lowing history, deductions, axioms and conclusions,
have been drawn from the invaluable work containing
these experiments.
It may be useful again to record the fact, that the
great agent in the digestion of food in the stomach is
THE G ASTRIC J UICE.
127. Dr Beaumont obtained the gastric juice from ºasiº juice,
its character,
how obtained,
* Dr Combe, in his preface to the English edition of Dr Beaumont's
work, remarks: “Two or three other cases have, indeed, occurred, in
which the cavity of the stomach was laid open by external wounds; but
in none except that of Alexis St Martin, observed by Dr Beaumont,
did perfect recovery take place while the opening remained unclosed. In
all of them, death occurred in a longer or shorter time without affording
any opportunity of observing the phenomena of really healthy digestion,”
p. 11, edit. 1838. The facts recorded 119, 121, sufficiently demonstrate
that Alexis was healthy and strong.
f It is lamentable that the British Association has not taken steps to
obtain Alexis for the purpose of submitting him to some further scientific
experimenting. Physiological science and dietetics might obtain there-
from an almost incalculable mass of facts, pregnant with utility. This
neglect on the part of the Association is one of the greatest blots on its
history; and as the matter was brought before them, there exists no
excuse for the neglect.
*
a 2
44 ON THE GASTRIC JUICE.
CHAP. v.
Quantity
poured out.
Alexis's stomach by the following method: Alexis
was placed on his right side, the valve was depressed
within the aperture ; a gum elastic tube, of the size
of a large quill, was introduced five or six inches
into the stomach; Alexis was then turned on the
left side, until the orifice became dependent. The
fluid, immediately on the introduction of the tube,
began to flow, first by drops, then in an interrupted
and sometimes in a continuous stream. Moving the
tube up and down, or backwards and forwards,
increased the discharge. à
128. Four drachms to one and a half or two
ounces, varying according to the circumstances and
the condition of the stomach, were ordinarily ob- - *
tained.
Sinking sen-
sation caused
by the ex-
traction of
the gastric
juice.
129. The time chosen for extracting the juice was
early in the morning, when the stomach is empty and
clean. . f
130. This extraction of the gastric juice was ge-
nerally attended with a sinking sensation,” and
some degree of faintness at the pit of the stomach,
a sensation sometimes so strong as to render it neces-
sary to stop the operation.
131. Dr Beaumont found that, when one ounce
and a half or two ounces of gastric juice had been
* Sinking at the pit of the stomach explained.—Will not this explain
the sinking felt by some dyspeptics, which requires the immediate sup-
ply of some article of food to prevent faintness? That is, may not the
diseased state of the stomach cause the pouring out a portion of gastric
juice, which becomes a source of unpleasant sensation P
This effect, produced on the feelings of Alexis by the production and
the extraction of the gastric juice, demonstrates the absurdity of attempt-
ing to remove a sinking sensation by stimuli.
te
ON - THE G ASTRIC J U ICE. . 45
suffered to run out from Alexis's stomach, besides crisp. v.
the sinking, he was affected by dimness of vision ºne ºf
- vision and
and giddiness on rising.” giddiness
132. Besides the gastric juice, chymous fluids tiºn
were extracted from Alexis's stomach. These were º gastric
obtained by depressing the valve within the aperture, other fluids
laying the hand over the lower part of the stomach discharged.
and pressing upwards. In this manner any quantity
was obtainable.
133. The gastric juice appears to be secreted from º
numberless vessels, distinct and separate from the papiliary ves.
mucous follicles of the stomach. These vessels,”
when examined with a microscope, appear in the
shape of small lucid points, or very fine papillae,
situated in the interstices of the follicles. They
discharge their fluid only when solicited so to do by
the presence of aliment, or by mechanical irritation.
134. Pure gastric juice, when taken directly out
of the stomach of a healthy adult, unmixed with
any other fluid, save a portion of the mucus of the
stomach, with which it is most commonly, and per-
haps always combined, is a transparent fluid, imodor-Its appear.
ous, a little saltish, and very perceptibly acid. Its .."
taste, when applied to the tongue, is similar to thin
mucilaginous water, slightly acidulated with muria-
tic acid. It is readily diffusible in water, wine, or
* Dimness of vision in dyspepsia eacplained.—Will not these effects
produced explain the dimness of vision and giddiness connected with
dyspepsia? And will not the fact that this faintness was produced by the
application of an indigestible agent, namely, the tube, to the coats of
the stomach, and that the gastric juice was poured out when no food
was in the stomach to be acted upon, show the absurdity of attempting to
relieve the symptoms felt by dyspeptics, by stimuli, since the discharge
of the gastric juice is dependent upon a diseased action? Veratrum is
very valuable in these cases. -
46 - ON THE G ASTRIC JUICE.
CHAP. V.
Gastric juice
poured out
on the appli-
cation of
food.
spirits; slightly effervesces with alkalies, and is an
effectual solvent of all articles of food. It possesses
the property of coagulating albumen in an eminent
degree; is powerfully antiseptic, checking the putre-
faction of meat; and is effectually restorative of
healthy action, when applied to old fetid sores and
foul ulcerating surfaces.
135. Saliva and mucus are sometimes abundantly
mixed with the gastric juice. The mucus may be
separated by filtering the mixture through fine linen
or muslin cambric. The gastric juice and part of
the saliva will pass through, while the mucus and
spumous or frothy parts of the saliva remain on the
filter. When not separated by the filter, the mucus
gives a ropiness to the fluid, that does not belong to
the gastric juice. The mucus soon falls to the bot-
tom in loose white flocculi. Saliva imparts to the
gastric juice an azure tinge, and frothy appearance,
and, when in large proportion, renders it fetid in a
few days; whereas the pure gastric juice will keep
for many months, without becoming fetid.
136. The gastric juice does not begin to accumu-
late in the cavity of the stomach, until alimentary
matter is received, which excites the vessels of the
stomach to discharge their contents, for the immediate
purpose of digestion. -
Under such an application of food, the gastric
juice is seen to exude from its proper vessels, and its
exudation increases in proportion to the quantity of
aliment naturally required and received. A definite
proportion of aliment, only, can be perfectly digested
in a given quantity of the fluid. From experiments
On artificial digestion, it appears that the proportion
of juice to the ingesta is greater than is generally
ON THE G ASTRIC J U ICE. 47
supposed. Its action on food is indicative of its
chemical character. Like other chemical agents it
decomposes or dissolves, and after combining with
a fixed and definite quantity of matter, its action
ceases. When the juice becomes saturated, it
refuses to dissolve more; and if an excess of
food have been taken, the residue remains in
the stomach, or passes into the bowels in a
crude state, and frequently becomes a source
of nervous irritation, pain, and disease, for a
long time; or until the vis medicatrix naturae
restores the vessels of this viscus to their
natural and healthy actions—either with or
without the aid of medicine.
137. Dr Beaumont used the greatest diligence to
discover the truths which the peculiar condition of
Alexis' stomach rendered discoverable. The expe-
riments he has recorded, as performed by him, amount
CHAP. V.
Gastric juice
combines
only with a
given quan-
tity of ali-
ment.
to one hundred and eighty ; and these experiments one hundred
were performed with a freedom.from bias extremely
favourable to the discovery of truth. Indeed, Dr
Beaumont seemed to have formed no theories before
he began his experiments, but to have recorded
simply what he saw. -
138. From these experiments numerous are the
results. -
To aid in their enumeration, and in their impression
on the mind, it may be useful to cmbody the geno-
ralities connected with them under the following
axioms.
&-
A XI O M S.
and eighty
experiments.
Axiom 1. The gastric juice exercises its solvent Axiom 1.
bower similarly on all alimentary Substances,
I tº
48 ON THE G ASTRIC J U ICE.
CHAP. v.
Axiom 2.
Axiom 3.
Axiom 4.
Axiom 5.
Axiom 6.
Axiom 7.
Axiom 8.
Axiom 9.
Axiom 10.
Axiom 11.
Axiom 12.
Axiom 2. Chyme being a compound of gastric
juice and of aliment, the stomach can by digestion
dispose of a definite quantity only of aliment.
Axiom 3. Minutemess of division and tenderness
of fibre are the two grand essentials for speedy and
easy digestion.
Axiom 4. Generally speaking, vegetables are di-
gested more slowly than meat and farinaceous sub-
stances, and require greater powers of the gastric
Organs.
Axiom 5. Food that is solid is sooner disposed of
by the stomach, than food that is liquid, and the
nutritive principles of the solid food are sooner car-
ried into the circulation.
Axiom 6. The fat of meat is always resolved into
oil before it is digested,
Axiom 7. When solid and liquid substances are
mixed at the same time in the stomach, the liquid is
absorbed before any action takes place on the solid.
Axiom 8. Bulk is nearly as necessary to the articles
of diet as is the nutritive principle.
Axiom 9. A considerable variety of diet seems
necessary to man in a state of civilization.
Axiom 10. A healthy stomach digests its contents
in from one to three or four hours.
Axiom 11. The sense of satiety is produced when
the appetite has been gratified beyond the point of
healthful indulgence. The pleasurable sensation of
perfect satisfaction, ease, and quiescence of body,
and of mind, are the indications that enough has
been taken.
Axiom 12. Condiments, particularly those of the
spicy kind, are, for the purpose of digestion, non-
essential to the inhabitants of these climates.
ON THE GASTRIC JUICE. 49
Axiom 13. Coffee and tea, the common beverages CIAP. v.
of all classes of people, have a tendency to debilitate “”
the digestive organs.
Axiom 14. Persons who do not exercise much, Axiom 14.
require less nutritious diet than those who are in the
habit of constant labour.
Axiom 15. The motion of the stomach increases Axiom 15.
the flow of the gastric juice.
Axiom 16. Hunger being dependent on the state Axiom 16.
of the brain, it may be developed in disease, and, as
so developed, such hunger is a false hunger, and is
not an indication of a need of food, any more than
the hearing, in diseased states of the brain, of imagi-
Inary sounds, is an indication that such sounds should
be obeyed.
Axiom 17. In the febrile state very little or no Axiom 17.
gastric juice is secreted.
Axiom 18. Undigested portions of food cause all Axiom 18.
the phenomena of fever. -
Axiom 19. Anger and other mental emotions cause Axiom 19.
bile to pass into the stomach.
Axiom 20. Bile is never found in the stomach, in Axiom 20.
a state of health, except when oily food or fat food
are taken, which causes the presence of bile in the
gastric fluids. -
Several important facts and deductions will develop
themselves in the consideration of these axioms
individually.
139. Axiom 1. THE GASTRIC JUICE EXERCISEs ITs
SOLVENT POWER, SIMILARLY ON ALL ALIMENTARY SU B-
STANCES. - -
140. However various the articles taken as food Gastric juice
wº tº e e destroys the
into the stomach, the gastric juice completely des-identity of
troys the identity of each article, acting by its solvent.”
PI
50 ON THE G ASTRIC J U ICE.
CHAP. V.
Chyme, a
compound of
gastric juice
and aliment.
Experiment.
power: So that, viewed in this aspect, the ultimate
principles of nutriment are probably always the same,
whether obtained from animal or vegetable diet,
realizing as true the assertion of Hippocrates, “There
are many kinds of aliments, but there is at the same
time but one aliment.” -
141. The greyish, poultice-like mass, obtained by
the action of the gastric juice on the food, designated
chyme, is a compound of gastric juice and aliment,
and, using the chemical language of the day, may be
described as a gastrite of whatever the gastric juice
is combined with.
142. The most innutritious vegetable and the most
animalized substance require the same action of the
gastric solvent to effect the conversion into chyme.
143. Axiom 2. CHYME BEING A COMPOUND of
GASTRIC JUICE AND ALIMENT, THE STOMACH CAN
DISPOSE ONLY OF A DEFINITE QUANTITY OF ALIMENT.
144. This axiom is illustrated by the following
experimentation:— -
Dec. 14, 1829. At one o'clock P.M. I took one and
a half ounces of gastric juice, fresh from the stomach,
after eighteen hours fasting, into an open-mouthed
vial, put into it twelve drachms of recently salted
beef (boiled) and placed it in a basin of water, on
a sand bath, and kept it at about a hundred degrees
(Fahrenheit) with frequent gentle agitation. Di-
gestion commenced in a short time on the surface
of the meat, and progressed in that manner uniformly .
for about six hours, when its solvent action
seemed to cease. The meat was at this time nearly
half dissolved; the texture of the central portion
considerably loosened and tender, resembling the
same kind of aliment, when ejected, partly digested,
ON THE G ASTRIC J U ICE. 51
from the stomach, some hours after being Swallowed, °". Y.
as is frequently seen in cases of indigestion.
The vial, continuing in the same situation, its con-
tents varied considerably in their sensible qualities.
In twenty-four hours, the digested portions separated
into a reddish brown precipitate, and a whey-coloured
fluid. -
I now separated the undigested from the chymous
portion, by filtration, through thin muslim. When
squeezed dry, it weighed five drachms, two scruples
and eight grains, which, deducted from the twelve
drachms of meat put in at first, leaves six drachms
and twelve grains, digested in twelve fluid drachms
of gastric juice.
145. From Dr Beaumont's experiments it appears
that a given quantity of gastric juice acts on a defi-
nite proportion of aliment. In this experiment
twelve drachms of gastric juice were required to di-
gest six drachms twelve grains of aliment. The
gastric juice then becomes saturated, and, when So
Saturated, the gastric juice is inadequate to produce
any further effect.*
146. If chyme is a compound of gastric juice and ºf
aliment, i. e., if gastric juice is a solvent and dis-indigestion.
Solves only a given quantity of food, it is evident
that any quantity taken more than that which is
—-º
* The stomach itself, if the phrase can be used, seems to be aware of
the necessity of not overloading itself. Dr Beaumont made the follow-
ing interesting observations on Alexis's stomach :—
“The stomach will not admit of the introduction of food, even of a
liquid kind, through the aperture of the cardia at a rapid rate. If a few
spoonfuls of soup, or other liquid diet, be put in with a spoon or funnel,
the rugae gently close upon it, and gradually diffuse it through the gas-
tric cavity, entirely excluding more during this action. When a relax-
ation takes place, another quantity will be received in the same manner.
H 2
52. ON THE GASTRIC JUICE.
CHAP. W.
Digestion re-
commenced
by the addi-
tion of fresh
gastric juice.
Experiment
on well
chewed food.
Experiment
on underdone
equivalent to the solvent power of the gastric juice,
must remain unacted upon and indigestion must be
the result.
As an additional evidence that gastric juice acts
in a fixed relationship to quantity is the fact, that,
in several experiments where chymification had
ceased on the food taken out of Alexis's stomach,
it recommenced on the addition of fresh gastric juice.
147. Axiom 3. MINUTENEss of DIVISION AND
TENDERNIESS OF FIBRE ARE THE TWO GRAND ESSEN-
TIALS FOR SPEEDY AND EASY DIGESTION. The proofs
of this axiom are to be found in the following
experiments:– * -
148. Experiment 33. March 13, at one o'clock
P.M. Alexis dined on roast beef, bread and pota-
toes. In half an hour the food taken was reduced
to a mass resembling thick porridge. At two o'clock
nearly the whole was changed into chyme, and at
half-past four the chymification was complete. The
food in this experiment had been broken down and
divided by the act of chewing.
149. Dr Beaumont tried, on another occasion, an
andunchewed experiment, the converse of this: at a quarter-past
food.
eight A.M. he suspended by a string two pieces of
“If the valvular portion of the stomach be depressed, and solid food
be introduced, either in entire pieces or finely divided quantities, the
same gentle contraction, or grasping motion, takes place, and continues
for fifty or eighty seconds; and will not allow of the introduction of
another quantity until the above time has elapsed; when the valve may
again be depressed, and more food be put in. Food and drinks will be
received through the aperture no faster, even when the stomach is
entirely empty, than they are ordinarily received through the oesophagus.
“When Alexis was placed so that the cardia could be seen, and he was
allowed to swallow a mouthful of food, the same contraction of the
stomach, and closing upon the bolus, was invariably observed to take
place at the Cesophageal ring.” -
&
ON THE GASTRIC JUICE. 53
rare roasted beef in the stomach and examined it CHAP. v.
each hour till twelve A.M., the beef showed an uni-
form but very slow process of digestion, the digestion
being confined entirely to the surface of the meat.
150. These experiments demonstrate the essential.”
necessity for masticating the food as a means of
realizing minute division of the fibres or texture of
the food, and also as imparting a sort of tenderness
to the food.
151. Those foods, which possess minute fibres,
will be best for digestion. Such are game and wild º
animals. Dr Beaumont found that venison was of
all foods the most readily converted into chyme in
Alexis's stomach. In one experiment, a breakfast
was made of Venison, pastry, cranberry jam and
bread, and the whole was digested in an hour and
thirty-five minutes. Birds and wild animals wan-
der where they will. They give due exercise to the
muscular fibres, and thus the flesh gains a peculiarity
of structure, favourable to digestion.*
152. South-down mutton is famous for its digesti-South-down
bility, and its tenderness of fibre is dependent partlyº”
on the peculiarity of the breed, partly on the herbage,
and partly on the range of feeding allowed to the
animal, permitting and inducing much muscular
exertion in order to obtain its food.
153. The axiom leads to the conclusion, that the
flesh of young animals (chicken, for example,) is a Chicken in-
e - e. & digestible.
food very indigestible. The fibres of all young Tº
\
* Beattie remarks on the freedom of birds:—
“Oh let them ne'er with artificial note,
To please a tyrant strain their little bill,
But sing what Heaven inspires, and
Wander where they will.”
54 ON THE G ASTRIC JUICE.
CIH. A. P. V.
Relapse
caused by
eating
Chicken.
Veal to be
avoided by
the sick.
Incipient pu-
trefaction ne-
cessary to
tenderness.
Ilung meat.
animals are long and stringy; they have not attained
their proper texture, and hence, if the adage is true,
“tender as a chicken,” the usual mental if not verbal
adjunct to the adage is not true, “ digestible as a
chicken.” -
154. It is a practice too common for a “friend” to
bring a chicken to some sick person. If the chicken
be used to make broth and the broth only be taken,
as the water dissolves only the gelatine or jelly of the
chicken, injury does not result; but if the patient
eats the chicken, it is not unlikely that a relapse of
the disease, under which the patient has been labour-
ing, will be produced. - 3.
155. How continually are illustrations presented in
connexion with the dietetic treatment of the sick, of
the necessity of attending to the exhortation, “Let
your love be with wisdom.”
156. On the grounds already brought forward
(there are other grounds,) all young meats, such as
veal, are to be avoided by the sick, by those labour-
ing under chronic complaints, and hence the special
directions, given by homoeopathists in reference to
diet, are founded on scientific data.
157. It is on the account, that incipient putre-
faction, bringing about a disintegration of the par-
ticles of the meats, renders these particles more easily
separable, that meat requires to be kept a short time
after the animal has been killed in order to become
easy of digestion. Hence it is that “hung” meat is
so tender and easy of digestion.
158. A concluding evidence of the effect of minute-
ness of division and tenderness of fibre as intimately
associated with and favourable to digestion, is to be
found in the facts, that albumen, such as the white
ON THE G ASTRIC J U ICE. 55
of egg, if taken into the stomach, either very slightly chap. v.
or not at all coagulated, is perhaps as rapidly chymi-...}}
fied as any article of diet; whereas, if formed into º
hard portions or coagula, by heat or otherwise, and digestible."
Swallowed in large solid pieces, the digestion is pro-
tracted. .
In the first state, the albumen is firmly coagulated
and divided in the stomach; in the second, it is less
susceptible of subdivision from its hardness.
159. The principle, embodied in this axiom, has
relation to vegetable substances, as well as to animal;
that is, they are more capable of digestion the more
minute the state of division. Dr Paris, in his work Nº.
on Diet, p. 78, states “ that potatoes are better when ible. "
boiled only so as to be rendered tender, and have
their form preserved, than when boiled to a dry in-
sipid powder.” ---
This statement of Dr Paris may lead to mistake.
It is certain that mealy potatoes, though not pre-
serving their form, are more digestible than potatoes
not mealy which do preserve their form. Dr Beau-
mont's experiments demonstrate that vegetables, like
animal substances, are more capable of digestion in
proportion to the minuteness Of their division. He º
found, that, when boiled or otherwise cooked to dry-more easy of
ness so as to be readily mashed, potatoes are readily"
converted into chyme; when differently prepared,
and boiled only so as to be rendered barely soft,
moist and tenacious, with the shape preserved, entire
pieces remain long undissolved in the stomach, and
very slowly yield to the action of the gastric juice.
Pieces of raw potato, when submitted to the operation ..".
of the gastric fluid in vessels kept warm by means of thºsie
a bath, in the same manner, almost entirely resist its”
56 ON THE G ASTRIC J U ICE.
action.* Many hours elapse before the slightest ap-
pearance of digestion is observable, and this only on
the surface, where the external portions become a
little softened, mucilaginous, and slightly farinaceous.
160. These facts in regard to vegetable substances,
will explain why colics and other derangements of
digestion are produced by eating uncooked or imper-
fectly cooked vegetables. Indeed, violent spasms,
affecting different and remote parts of the system,
often supervene on the introduction of crude or indi- .
gestible food into the stomach. -
161. Axiom 4. GENERALLY SPEAKING VEGETABLES
ARE DIGESTED MORE SLOWLY THAN MEATS AND FAR1-
NACEOUS SUBSTANCES AND REQUIRE GREATER POWERS
OF THE G ASTRIC ORGANS. -
162. It is a curious fact that raw vegetables are
sometimes allowed, even when the stomach is in a
healthy state, to pass the pyloric orifice, while other
food is retained there to receive the solvent action
CHAP. V.
Colic from
uncooked
vegetables.
Raw vege-
tables pass
undigested.
* These views are strikingly demonstrated in the following experiment.
Experiment 95.
“February 3.—At twelve o'clock M., I put two equal and entire pieces
of parsnip, ten grains each, one boiled and the other raw ; the same
kinds and quantities of carrot; and the same of potato, into four drachms
of gastric juice, and placed them on the bath. At twelve o'clock M. on
the fourth, the vegetables, taken out and wiped, or filtered as dry as
when put in, showed the following result:-
“The piece of raw parsnip weighed three grains, the boiled one grain;
raw carrot three and one-fourth grains, boiled half a grain; raw potato
eight and a half grains; boiled no entire particle could be distinguished; .
a fibrous and farinaceous residuum of six grains remained on the filter.
At twelve o'clock A.M. on the fifth, the pieces of parsnip and carrot were
almost entirely dissolved, a grain or two of the raw carrot and fibrous
centre of the parsnip only remaining. About a grain of the roughish-
white farina of the boiled potato remained. The raw potato was a little
softened and wasted on the surface, but weighed the same as at last
examination, eight and a half grains.
ON THE GASTRIC JUICE. 57
of the gastric juice. Such bodies that leave the CHAP. v.
stomach in this state pass rapidly through the intes-
tinal tube.
These bodies not undergoing digestion may, in
delicate individuals, cause colics and bowel com-
plaints.
163. Axiom 5. SOLID FOOD Is MORE EASILY DIS-
POSED OF BY THE STOMACH THAN FLUID, AND ITs
N UTRITIVE PRINCIPLES ARE SOONER, CARRIED INTO
THE CIRCULATION.
164. This axiom affords an explanation of the
benefit that some dyspeptics derive from living almost
wholly on solid food. The stomach has less to do.
Indeed it is quite clear that much injury is inflicted
in the stomach by the too common practice of drink-
ing much water at meals. It is far better to wait an
hour or two hours after a solid meal before drinking
liquids. A few years since a medical practitioner Dyspepsia
obtained some reputation in the treatment of dyspep- * not
sia, he allowing his patients no liquid at all: of his *
success in certain cases an explanation might be
derived from the truths embodied in this axiom.
164a. When to this axiom is added the fact, esta-
blished by Dr Beaumont's experiments, that, when
solids and liquids are mixed at the same time in the
stomach, the liquid is taken up first, (axiom 7, 170,) Liquids a
e e tº tº * * * burden to the
the importance of dyspeptics living on solid food” stomachs of
with little drink, becomes further apparent, since the"
stomach is saved from the additional labour of taking
up the liquid.
* I have a patient who suffers from cancer, and she found-she has
always more pain in her breast when she takes liquids: she has very
little pain when she makes a meal of solid food only.
I
58 ON THE GASTRIC JUICE.
CHAP. W.
165. Axiom 6. THE FAT OF MEAT IS ALWAYS RE-
solved INTo oil. BEFoRE IT is DIGESTED.
166. The fat of meat being converted into oil
before it is digested it may be inferred, that the oil
would float on the surface of the contents of the
stomach. This is the case. Dr Beaumont observed
in Alexis's stomach, when Alexis fed on fat meat
or butter, that the whole superior portion of the con-
Children not
to eat fat. .
tents of the stomach, if examined a short time after
eating, was covered with an oily pellicle.* This
will explain how, when flatulence troubles a dyspep-
tic, it happens, that the wind brings up with it
some rancidity. It will explain how fat disagrees
with many weak stomachs, that is, the fat is separated
in an oily form, but the stomach has not the power
to digest it in this state.
167. Fat, too, is concentrated nutriment. Chil-
dren, it is well known, very rarely like fat meat.
Children want food in large quantities, not in con-
centrated forms. -
168. This dislike to fat may therefore be viewed
* “March 15.—At eight o'clock thirty minutes, A. M., breakfasted on
fresh sawsage, light pancakes, and a pint of coffee.
“At nine o'clock thirty minutes, examined, and found the stomach
full of fluids, mixed with the aliment, and a large portion of clear oil
floated on the top, and presented itself at the perforation of the stomach.
At ten o’clock thirty minutes, I 'took out a portion,-found the cakes
and particles of meat about half digested, with some oil, pure, bland,
and limpid, rising upon the top, untouched by digestion. Placed it
on the bath. * p
“At twelve o'clock M., examined stomach,-found no vestige of his
breakfast, not a particle of oil was to be seen, nothing but pure gastric
juice could be extracted, of which I took out twelve drachms.
“That portion of his breakfast taken out at ten o'clock and thirty
minutes, was at this time almost completely chymified, a few small par-
ticles of oil only remaining. The chymous mass of a milky colour, and
thick gruel-like consistence.”
ON THE GASTRIC JUICE. 59
as a result of natural instinct, and should teach CIIAP. v.
parents not to force children to eat fat: not, as the
dogmatic phrase is, to make them eat “fair,” i. e.
fat and lean together. -
169. Axiom 7. WHEN solid AND LIQUID sub-
STANCES ARE MIXED AT THE SAME TIME IN THE STO-
MACH, THE LIQUID is ABSORBED BEFORE ANY ACTION
TAKES PLACE ON THE SOLID. -
170. This axiom is founded upon several experi-
ments. In an experiment, in which, at half-past two Experiment.
P.M., Alexis dined on fresh beef, vegetable soup,
and four ounces of bread: at half-past three,
the soup appeared to have had its more fluid parts
absorbed, for at this time it was much more consist-
ent than when eaten. As Dr Beaumont states, the
soup could not be digested until it was formed into
a harder mass by the absorption of the watery part:
and Dr Beaumont adds, if water were permitted to
remain in the stomach, it would render the Soup too
liquid to be acted on by the gastric juice.
171. From this axiom and these views, the un-
scientific nature of the practice of drinking much
liquid at solid meals is apparent; people think that
water cannot do any harm. This is a mistake.
172. Axiom 8. BULK Is NEARLY AS NECESSARY
TO ARTICLES OF DIET AS IS THE NUTRIBNT PRIN-
CIIPLE.
173. Dr Andrew Combe relates that, in a conversa-
tion held with the spokesman of a party of Veddahs,
or wild hunters of Ceylon, by Dr Combes's friend,
Mr Marshall, the conversation originating in an en-
quiry, why the Veddahs always mixed the pounded $ºf
fibres of soft or decayed wood with the honey, on sary.
which they fed when meat was not to be had, the
I 2
60 ON THE GASTRIC JUICE.
practical Veddah remarked, I cannot tell, but I
know that the belly must be filled.
174. Highly nutritive diet, i. e., nutriment in a
Small compass, is not at all adapted to the human
system; dogs fed on oil and sugar, convertible almost
wholly into chyle by the digestive organs, become
diseased, and die in a few weeks. Concentrated food,
as Dr Combe properly remarks, is out of harmony
with the Organic structure of animals.
The Creator has constituted every animal with
relation to its natural or proper food and no other,
and if that be denied, it must of necessity suffer.
The cow, for example, has four stomachs,” especially
adapted for digesting herbage, out of which it ex-
tracts its nutriment: but supposing that, as Dr Combe
CHAP. V.
Too nutritive
diet injurious.
* The arrangement of the stomach in the cow is the following:—A is
the paunch; this, which is very large, is distributed internally into
many partitions. At the right of the gullet E, and the front part of the
paunch, is the second stomach, called the bonnet; this is the smallest of
the stomachs. Next is the stomach C, called the omasus or the maniplus,
which is at the right side of a small duct F, that conducts from the
gullet into this stomach. The fourth, called the obomasus, is repre-
sented by D; this communicates with the third stomach by a small
orifice, and opens into the duodenum G by a small orifice H, analogous
to the pylorus.

ON THE G ASTRIC J UICE. 61
inquires, by a chemical process, we were able to CHAP. v.
extract the nutritive essence from the grass or hay,
and were to give it in a concentrated state to the
cow, can any reasonable being even fancy that the
cow would thrive as well as when it had the pleasureº.
of cropping the grass for itself, and occupying its with the es:
own stomachs to effect the preparation. sence of hay.
The thing is absurd, and we may be equally cer-
tain, that, if the stomach and intestines of any ani-
mal are constructed by the Creator for the reception
of a mixed bulky diet, that animal cannot thrive on
pure and concentrated food. Magendie evidently
overshoots the mark when he seeks for the explana-
tion of the injuries, resulting from the use of concen-
trated food, in the supposed absence of a single
chemical principle.
175. If highly nutritive diet is unsuitable to the
system in health, it is far more unsuitable in disease.
The stomach cannot digest the food when the person
is labouring under disease, and the very concentration Concentrated
on which the excess of nutritiveness depends, is likely º º
to induce a more injurious effect by excitement, which *
even if digested, the concentrated food will be sure
to produce in the system; hence the absurdity of
jellies, blancmanges, strong beef teas and other articles
with which the tables of sick rooms are loaded by kind Foods not to
but unwisely kind friends. Indeed, little doubt ex-º..."
the rooms of
ists that these preparations often become poison:**
they are penetrated by the odours of the sick room,
and then, being taken, they carry into the stomach
the impurity which previously was received only by
the lungs. To an enlightened medical practitioner,
there is hardly any prospect more painful than to see
on a chair, on a level with the sick man's breath,
62 ON THE GA STRIC J U ICE.
CHAP. v. Oranges, and arrow root, and jellies and jams. No
foods, not even water in large quantities, should be
kept in the sick person's room. They absorb the
poisonous effluvia. They should be taken into the
room when wanted, and what is not needful for im-
mediate use should be taken away.
Fallacy in the 176. In regard to nutriment in sickness, persons
#"ºu. often declare, that, when the doctor had forbidden
Fº the patient to eat, he would eat, and became well.
* . This has happened under the old system practice, but
has done good 2
º * then the benefit in such cases arose, because the €X-
ment, there haustion of the patient was caused, not by disease,
.*.*.*.*but by the depletory and exhausting medicines used
...” by the practitioner; and the food given was like
giving nourishment to an exhausted man. So that
the benefit sometimes resulting from food given to the
patients under the old system treatment, is not an
argument proving that food is good in relation to
disease, but its benefit, under the circumstances
stated, shows the exhausting effect of that treatment.
177. Axiom 9. A CONSIDERABLE VARIETY OF DIET
SEEMS NECESSARY TO MAN IN A STATE OF CIVILIZATION.
178. The advocates of vegetable diet have a strong
case. They enlist our sympathies and even the poetry
of our nature. The fact of killing animals is a prac-
tice against which most people recoil, and from this
necessity the vegetarians would free society. The
philosopher, however, does not coincide with these
advocates. He is obliged, looking at the facts of
human existence, viewing the human intestinal struc-
ture, viewing man living in various latitudes and
vegetable exposed to varying contingencies, to allow, that all
º kinds of food are suitable to the human being, and
further to acknowledge while the natives of the vast
ON THE G ASTRIC J U ICE. 63
plains of India live on rice, and live well, the Esqui- cIIAP. v.
maux influenced by the necessities, imposed by
climate as well as by their circumstances, rejoice in
fish, whale and sea blubber, animal oil and flesh.
179. To these general facts may be added those
derived from the masticatory apparatus. -
“ Man is born polyphagous.” All the organic
and functional circumstances of his digestive appa-
ratus demonstrate satisfactorily that he may appro-
priate indiscriminately materials from both kingdoms
for his mourishment. Thus, although, Originally, he
may, without doubt, have derived nourishment exclu-
sively from vegetable substances, and although there Man omnivo-
still exist wild tribes, who live upon plants and fruits,”
the notion of some physiologists, and of the philo-
sopher of Geneva, that the human being was created
herbivorous, and the notion of some others, that
it was originally carnivorous, a motion still less
founded upon fact, are not believed at the present
day. •
The facts stated declare the truth; and comparative
amatomy dissipates all doubts. In the first place, the
medium structure of the masticating apparatus of
man is a positive proof of his two-fold nature. What Man omnivo.
determines and proportions the mode and the extent"
of the movements of the lower jaw, the only one,
in mammiferae, which is moveable, is the arrange-
ment of the surfaces which serve to unite this bone
with the cranium. Now, the condyles of the jaw, and
the glenoid cavities which receive these, have, in man,
a transverse direction, whence results the possibility
of the vertical motion of the jaw. Moreover, the
depth of the glenoid cavity being not great, and the
condyles of the jaw which this cavity receives being
lº
64 ON THE G ASTRIC JUICE.
CHAP. V.
covered with a cartilage, this two-fold circumstance
permits of and facilitates the lateral movements.
In fact, if it is remembered, that, in lowering the
jaw, the condyle is carried a little forward, so as to
slide upon the Small tubercle, which in this sense
forms the boundary of the glenoid cavity, to pass over
it even, thus producing luxation, if the lowering is
too considerable, it will be seen that motion back-
wards and forwards takes place in man, as well as in
ruminating animals. *
Thus while carnivorous animals have the power
of vertical motion alone, the only one necessary in
Man's jaws
have a verti-
cal and hori-
zontal motion
Muscles of
carnivorous
animals pe-
culiar.
Muscles of
ruminants
special.
order to the cutting and tearing of their prey; while
ruminating animals, on the contrary, have the mas-
ticating apparatus disposed merely for lateral and
horizontal motion; man can, according to his pleasure,
or his necessities, give to his jaw every kind of move-
ment, and profit from the advantages of variety of
foods.
The arrangement, and the degree of energy of the
various motive powers of the jaw, moreover, favour
this prerogative of man.
In animals which feed upon flesh, the elevating
muscles of the jaw, (temporal and masseter,) are
very strong and large. The temporal cavity, con-,
siderably extended, rounded, covered with roughness,
adds vigour to the temporal muscle by the multipli-
city of points of insertion which it offers, and the
zygomatic arch, being very convex above, augments,
by this arrangement, the energy of the masseter
muscle, to which it serves as a Support.
In ruminating animals, on the contrary, the tem-
poral surface, nearly smooth, is but of small extent;
the muscles adapted to the lateral motions (external
ON THE GASTRIC JUICE. 65
pterygoid) are much developed, and the zygomatic arch
is flattened, even a little depressed. It may be added,
that, in animals not furnished with teeth this arch
presents an arrangement the reverse of that in herb-
ivorous animals; that there are some even, who,
not masticating, have no vestige of the zygomatic
arch.
effect of Original organization, the various mater
characters which we have just enumerated. In him
the temporal hollow is neither much rounded, nor
perfectly flat; the ridgy appearances exist in him, but
not very prominent, and without roughnesses; their
extent moderately circumscribed supports a muscle
not very large either in its mass, or in its configura-
tion. - -
The zygomatic arch is almost straight, and the
three kinds of muscles which terminate in the jaw,
communicate to this, with equal energy, that variety
of movements which, in man, denotes his omnivorous
Inature.
180. Axiom 10. A HEALTHY STOMACH DIGESTs ITs
CONTENTS IN FROM ONE TO THREE OR FOUR HOURS.
The following tables present the relative digesti-
bilities of different kinds of food, as demonstrated by
experiments on food taken by Alexis. It may be
granted that some of the experiments admit of dis-
pute; yet, taken as a whole, the results approximate
to accuracy, and will serve most practical purposes.
The influence of the state of the mind on the di-
gestion, is most strikingly illustrated in one of the
experiments.
CHAP. W.
Man alone unites within exact limits, and by the Man com-
ial bines all.
IK
TABLE.
Articles of Diet.
With Bread or Vegetables, or both.
Tripe, soused, º &
Pig's feet, do. -
Venison steak, fresh,
Codfish, dry, .
Bread and milk,
Turkey,
Goose, wild
Pig, young . e º
Hash, meat and vegetables,
Oysters, º e
Do. . º . . .
Do. º
Do.
Do. . e © Q
Beef, fresh, fat and lean .
Do. do.
I)o. do.
Do. do,
Do. do.
Do. do.
Do. do.
l)o. do.
Mode of Meal Exercise.
Cooking- - A. S| Rest
Moderate. Increased. -
H. M. H. M. H. M.
Fried Breakfast | 1
Boiled - 1
Broiled -* 1 35
Boiled Dinner 2 ,
Cold - 2
Boasted --- 2 30
* - 2 30
*=º -- 2 30
Warm Breakfast || 2 30
Raw Dinner 2 45
Stewed *-* 3 30
Raw Breakfast || 3
— Dinner 3
Stewed -*. 3 30
Roasted Dinner : 30
- Breakfast || 2 45
Broiled -* 3
-e * * • tº tº 3 45
*s -- e 3 30
Boiled -- 4. e G
* Dinner 3 30
Remarks.
|
Oyster suspended in stomach
during experiment. . .
Nothing but a little dry bread or
cracker taken at these meals.
Exercised till fatigued.
Morbid appearance of stomach.
*s
.

%
g;
É
Beef, fresh, fat and lean, .
Do. do. . tº
Do. do.
Do. do.
Do. do.
Do. do.
Do. do.
Do. do.
Do. Salted, .
Do. do. . e
Pork, recently salted,
Do. do. .
Do. do.
Do. do.
Do. do.
Do. do
Do. do.
Do. do.
Do. do.
Do. do.
l)o. fresh, .
Do. steak, .
-Do. O, -
Mutton, fat and lean
Do. do. .
Do. do. .
Do. do. .
Do. do. .
Do. do.
Eggs,
Do.
Do.
Boiled
Hard boiled
Soft boiled
Hard boiled
Breakfast -
Supper
Breakfast
Dinner
Breakfast
*
Dinner
Breakfast
s
Dinner
Breakfast
Dinner
*se
Breakfast
Dinner
Breakfast
*g
smº
Dinner
Breakfast
Dinner
:
3
30
30
30
30
15
30
15
30
30
30
30
30
15
30
15
30
30
30
30
30
3
.
30
15
15
Large proportion of fat.
Do.
Do., and in recumbent position.
Became angry during experiment.
Unusullay fail meal.
Unusually full meal.
Morbid appearance of stomach,
Pull meal, coarsely masticated.
Bread, or bread and coffee, nove-
getables used with the eggs.
Morbid appearance of stomach.
:
:
With Bread or Vegetables, or both.
Articles of Diet, .:. Meal. f Exercise. N | Rest Remarks.
Moderate. Increased.
EI. M. H. M. | H. M.
Eggs, Hard boiled | Breakfast || 3 30 Morbid appearance of stomach.
Do. Soft boiled | Dinner 3
Sausage, Broiled Breakfast || 3 30 With soft boiled eggs.
Do. * Dinner 3
- Muslin bag containing same kind
Do. . Fried IBreakfast 4 of diet, suspended during these
Do. . gºms * 5 experiments.-Morbid appear-
ance of stomach also.
Do. Broiled *g 3 30 -
Do. . . e *s sms tº º 4 15 Full meal—Severe exercise.
Fowls (hens), Boiled *º 4 With bread and coffee.
Do. . & *==== Dinner 4. With bread and water.
Do. . *gº * 4. Do. do.
Weal, fresh, Broiled Breakfast | 4 Muslin bag suspended in stomach.
Do. . tºº-ºº: Dinner 4. -
T}o. *se Breakfast | 4
Do. * Dinner 4 45 tº º Morbid appearance of stomach.
Do. * Breakfast to º 3 45
Do. . * Dinner 4 30
Do. * Preakfast || 5 30 Morbid appearance of stomach.
| 4.
- H. M. * H. M.
Soup, made of fresh muscular fibre of beef, and vegetables, 4 Bread buttered, for breakfast, with coffee, 3 45
TABLE–Continued.
Do., made of the hock, with vegetables,
Bread, buttered, for breakfast, with coffee, [morb
ance of stomach,)
id appear.
4 15 Do.
Do.
4 15
dry, for breakfast, with coffee, . & e 4.
dry, for dinner, with dry mashed potatoes,
3 45
3.

ON THE GASTRIC J U ICE. 69
From these tables it appears that tripe and venison CHAP. V.
are the most digestible of meat; that oysters are very ...”
digestible more especially raw, stewed oysters* being digestible.
less digestible than raw, though digestible neverthe-
less. Mutton is more digestible than beef: though
beef is very digestible. Veal is not digestible: pork
is still less digestible: pork fresh, roasted, took six
hours and a half to be digested. -
Many interesting facts are represented by these
tables: and from them abundant evidences are de-
rivable, demonstrative of this, that the directions, sº
issued by homoeopathists in reference to diet, are *
based upon a solid basis, namely, the basis of the dietetics.
established relative digestibilities of different kinds
of food.
It will be seen from these tables that fowls are iº.
not readily digestible, their digestibility being nearly"
in the same ratio as that which pertains to veal.
Of vegetable bodies perhaps no foods are so digesti-
ble as sago and bread and milk: The following ex-ºilº
periments illustrate the high degree of digestibility bread and
in reference to sago. Experiment 34:— milk.
October 20.—At nine o'clock, forty-five minutes,
A.M., he breakfasted on one pint of Sago, boiled, thick
* It is remarkable what disparity of opinion exists in connexion with
the digestibility of oysters. Some maintain the total indigestibility of
oysters, others, the converse. The experiments on Alexis settle the
question. How then is the discrepancy to be explained? Simply thus.
Some one has eaten oysters when his stomach has been in a diseased
state and he has found them indigestible. Henceforth he has a vengeance
against oysters and gives them a bad name.
It is a common practise with consumptives to get up early, and to go
to an oyster shop in the morning and take half a dozen oysters. Many
maintain that much benefit has resulted. It is not unlikely: the early
rising, the fresh air, the easy digestibility of oysters, tend to improve
the general constitutional state. *.
70 ON THE GASTRIC JUICE.
CII AP. W.
Digestibility
of sago.
and rich, sweetened with sugar. Eleven o'clock thirty
minutes, stomach empty and clean.
Remarks.-There was no acrimony of the gastric
contents, or smarting of the edges of the aperture,
during the chymification of this meal, as is usual in
most vegetable and farinaceous aliments; it seemed
peculiarly grateful to the surface of the stomach;
rendering the membrane soft, uniform and healthy.
Experiment 37 adds its exemplification:-
October 21,–At nine o'clock, A. M., St. Martin
breakfasted on one pint of sago, boiled, and sweetened
with sugar. Ten o'clock, forty-five minutes, stomach
empty and clean; no vestige of the sago remaining;
no acrimony of the gastric contents, or Smarting of
the edges of the aperture, during the chymification
of this meal.
In regard to milk and bread, Experiment 6 is
highly instructive:–
September 30.—At seven o’clock, thirty minutes,
Digestibility, A. M., he breakfasted on bread and milk, and con-
of bread and
milk.
tinued his usual exercise. Eight o'clock, thirty mi-
nutes, stomach nearly full of milky fluid, pulp of
bread and coagulae. Nine o'clock, contents of sto-
mach considerably diminished since last examination
—took out a portion, nearly chymified; very little
fine coagulae perceptible; bread in small particles,
reduced to a greyish soft pulp; the menstruum of a
whitish whey-colour and consistence. Nine o'clock,
thirty minutes, chymification complete: stomach
empty and clean. -
The facts in regard to sago, demonstrate how suited
is this food to patients in a state of convalescence.
181. Axiom 11. THE SENSE OF SATIETY IS PRO-
DUCED WHEN THE APPETITE HAS BEEN GRATIFIED
ON THE G ASTRIC J U ICE. 71
BEYONID THE POINT OF HEALTHFUL INDULGENCE. CHAP. V.
THE PLEASURABLE SENSATION OF PERFECT SATIS-
FACTION, EASE, AND QUIESCENCE OF BODY AND
MIND IS THE INDICATION THAT ENOUGH HAS BEEN
TAIKEN. -
182. “There appears to be a sense of perfect intelli-
gence conveyed from the stomach to the brain centre,
which, in health, invariably dictates what quantity
of aliment (responding to the sense of hunger, and
its due satisfaction) is naturally required for the pur-
poses of life; and which, if noticed and properly
attended to, would prove the most salutary monitor
of health, and effectual preventive of, and restora-
tive from disease. It is not the sense of satiety, for
this is beyond the point of healthful indulgence,
and is nature's earliest indication of an abuse and
over burden of her powers to replenish the system.
It occurs immediately previous to this, and may be
known by the pleasurable sensation of perfect satis-
faction, ease and quiescence of body and
mind. It is when the stomach says enough, and
is distinguished from Satiety by the difference of the
sensations—the former feeling enough—the latter Enough and
too much. The first is produced by the timely”
reception into the stomach of proper aliment, in
exact proportion to the requirements of nature, for
the perfect digestion of which, a definite quantity
of gastric juice is furnished by the proper gastric
apparatus. But to effect this most agreeable of all
sensations and conditions—the real Elysian satisfac-
tion of the reasonable epicure, timely attention
must be paid to the preliminary processes, such as
thorough mastication, and moderate or slow deglu-
tition. These are indispensable to the due and S
72 ON THE GASTRIC J U ICE.
CHAP. V.
Condiments
not needful.
Vinegar and
Salt useful.
natural supply of the stomach, at the stated periods
of taking food; for if food be swallowed too fast,
and pass into the stomach imperfectly masticated,
too much is received in a short time, and in too im-
perfect a state of preparation, to be disposed of by
the gastric juice.” -
There is further no doubt, that an individual could
eat more before feeling this enough sensation if he
would well masticate his food, because the sense of
satiety is produced before the reception of the pro-
per amount, by the irritation which the unchewed
particles of food produce on the stomach.
183. Axiom 12. ConDIMENTS, PARTICULARLY
THOSE OF A SPICY KIND, ARE NON-ESSENTIAL FOR
THE PURPOSE OF DIGESTION TO THE INHABITANTS
OF THESE CLIMATES.
184. Dr Beaumont maintains, that condiments
afford no nourishment; that they do not aid diges-
tion; that, though they may excite a debilitated
stomach to action, they produce in the end an in-
creased debility of the organ. Present relief is
afforded at the expense of future suffering, in the
5 3
organic, what so often happens in the “moral” sys-
tem: “Peace, peace, when there is no peace.”
185. Vinegar and salt are to be regarded as excep-
tions. Both assist digestion; vinegar by rendering
muscular fibre more tender, and both together by
producing a fluid having some resemblance to the
gastric juice.
186. From these views and statements the reason
becomes apparent, why homoeopathic practitioners
forbid the use of condiments; they prove that such
forbidding is a result of scientific precision and not
of empirical positiveness.
on THE GASTRIC JUICE. 73
187. It is interesting to notice that the majority CHAP. V.
of condiments are the products of warm climates, of
tropical countries. Curry powder is a condiment of
India, and the condiments in these tropical countries
are useful to the inhabitants. The Hindoo lives prin-
cipally on rice: such unstimulating food requires a
stimulus, which the peppers of India afford.
188. Axiom 13. CofFEE AND TEA, THE COMMON
BEVERAGES OF ALL CLASSES OF PEOPLE, HAVE A TEN-
DENCY TO DEBILITATE THE DIGESTIVE ORGANS.
189. Dr Beaumont infers from his experiments,
that phenomena are produced in the stomach after
taking strong tea and coffee, very similar to those
exhibited after taking intoxicating liquors.
190. Dr Andrew Combe tries to obviate the power-
ful antagonistic bearing this has on the tea-total
scheme, by adding, in a note to the observations of
Dr Beaumont, “It is an assertion proving merely
that too much is bad, weak tea may be good enough, Tea and coffee
although ‘very strong’ tea is pernicious.” Injurious.
191. Without discussing this question further,
the facts of Dr Beaumont afford the complete justi-
fication of the directions of the homoeopathic prac-
titioners,” who forbid the use of tea and coffee to
their patients, and recommend the use of cocoa, milk,
and milk and water.
* “Some professedly homoeopathic chemists advertise and sell “Ho-
MCEOPATHIC COFFEE’ and ‘HoMCEOPATHIC TEA.’ These traders, not
content with the position and the profits which homoeopathy, through
its legitimate channels, affords them, pander to a popular desire, and
taking advantage of the opportunity of coming in contact with numerous
individuals, a contact gained only by means of homoeopathy, use that
opportunity to invalidate the truthfulness of the very practitioners
through whose recommendations they live and pecuniarily prosper: for
how can the public reconcile the two facts, that homoeopathic chemists
L
74 - ON THE GASTRIC JUICE.
CHAP. W. 192. Axiom 14. PERSONs who Do NOT ExFRCISE
MUCH, REQUIRE LESS NUTRITIOUS DIET THAN THOSE
WHO ARE IN THE HABIT OF CONSTANT LABOUR.
193. This axiom has many practical bearings.
It teaches the necessity on the part of persons lead-
Pººr ing sedentary lives, to live on a sparer diet than those
º: § who are actively engaged in open air duties. It
teaches the absurdity of the man, who has little or
no out door exercise, and is satisfied with a small
quantity of food, denouncing his neighbour, who has
hard labour and much out door exercise, for eating a
* ... larger quantity. Where there is little exhaustion,
why persons
of different the supply need be small. It teaches that young
ages and of e te e e
different oc- people, who are growing, and in continual exercise,
cupations re- ſº e lº.
. † require an abundant supply of simple food.” It
.*.* teaches that old people, who have little or no exer-
cise, and who have no increase of bodily frame,
should take but little food, and that of the most
digestible character. It teaches, that, in sickness,
where but little exercise is taken and no labour is
sell coffee and tea, while the practitioners who recommend the patients
to these chemists, forbid the use of coffee and tea P As to any coffee
or tea being “homoeopathic,’ except to diseased states, (such is not the
application of the term by these chemists,) the idea is as false as it is
erroneous.”—Domestic Homoeopathy, by John Epps, M. D.
* Dr Southwood Smith weighed eight of the men employed in feeding
the fires of the Phoenix Gas Company in London, before they began and
after finishing their work, which latter lasted one hour. The temperature
of the atmosphere at the time was sixty degrees, and the barometer stood
at 29.25. The loss sustained-during that short time amounting to
2 lb. 8 oz. in the lowest of the eight, and to no less than 4 lb. 3 oz. in
the highest. The general result was, that the men employed in that
work lost from 2 lb. to 5 lb. weight twice a day by perspiration
alone. In extreme cases like this, the necessity of a proportionately
large supply is self evident; without it the men would perish in a week.
—Philosophy of Health, p. 393, vol. 2.
ON THE GASTRIC JUICE. 75
gone through, food should be taken in very small chap. v.
quantities, and of the lightest quality.
194. Axiom 15. THE MOTION OF THE STOMACH
INCREASES THE FLOW OF THE GASTRIC JUICE.
Of this axiom some facts demonstrative will be
presented in the chapter on the movements of the
digestive tube.
195. Axiom 16. HUNGER BEING DEPENDENT UPON
A STATE OF THE BRAIN, IT MAY BE DEVELOPED IN DIS-
EASE, AND, AS SUCH, IS A FALSE HUNGER.
196. Brachet has proved by experiments, that,
when the nervous communication between the sto- Hunger de-
mach and the brain is cut off, the feeling of hunger F. tº
instantly ceases even when a moment before it was
ravenously strong.
197. The first proposition in this axiom has been
demonstrated by the observations of phrenologists,
and has an important practical bearing, because,
if hunger so depends, then the desire for food, or As hunger.
more strictly the appetite of hunger is, when theº º,
brain is in a diseased state, to be regarded as not at..."."
all indicative of a want of food, but as indicative of...
a state of disease; and the enlightened physician
exercises his judgment and decides whether the
demand of the patient is or is not to be listened to ;
and, though medically ignorant and partizan coro-
ners” may try to obtain verdicts of died by starvation,
* The following verdict was given in the case of Mr Cordwell, who
was a patient that had been under the care of Dr Curie, but who, by some
busy-body, was transferred to the care of an apothecary, in whose hands
he died. A coroner's inquest was held, and the verdict given, without
hearing what Dr Curie would have said upon the subject, was the fol-
lowing:— -
“The jury are of opinion that Henry Cordwell died from exhaustion, -
caused by loss of blood from the intestinal canal, produced by natural
L 2
}*/
j6 ON THE GASTRIC. JUICE,
CHAP. v. against physicians, who do exercise their judgment,
such physicians will still persist in using their judg-
ment on the point in question, being satisfied, that,
in so exercising their judgment, they are using the
highest and noblest power of the mind in meeting a
question, pregnant with life or death, according as it
is wisely or unwisely answered, to the patient.
198. The feeling of hunger being developed in
disease, is no more indicative of a need of supply
than is the hearing of imaginary sounds, produced in
Skill neces, diseased states of the brain, any reason why the
sary to decide
whether the sounds should be obeyed. The physician understands
hunger be the , 1 . © ſº tº º • ~ •
㺠ºf " this: his skill consists in the judging whether or not
returning - gº
jof the hunger depends upon the disease or on the resto-
disease. ration of the healthy condition of the system, calling
for a supply. It is most difficult sometimes to decide;
granted—but what is skill! what but working the
way through difficulties?
199. In typhoid cases, in particular, hunger is
sometimes felt, and, in typhoid cases, under the old
system, food, and especially wine, is oftentimes given,
The non- and it is said with success. The homoeopathist, who
necessity of e wº e
jºy" can use his weapons rightly, never needs to give food
hoid cases. e e { } ©
" * or wine or brandy in typhoid fevers, while the tongue
–-º
*.
disease; and in complying with what the jury believe to be their bounden
duty, in returning their verdict in strict accordance with the sworn
evidence of the medical gentlemen who have been called as witnesses,
the jury cannot refrain from expressing the strongest feelings of disgust
and indignation, at hearing it proved by the testimony of the nurses,
that the afflicted gentleman had been cruelly exposed to a system of
starvation, while in a state of the most extreme debility, during at least
ten days previous to his death; he having, during that long time, been
allowed nothing but cold water, by the advice of his medical attendant.”
Of this Mr. Wakley, the coroner for Middlesex, expressed his appro-
bation, he having refused to hear Dr Curie.
ON THE GASTRIC J U ICE. 77
is coated. It is true he is met with the statements CIIAP. V.
of the benefits which resulted in some given case...
from the use of wine and other stimuli. But these apparent
e is © utility in
cases, are cases in which the life power has been some cases.
exhausted under the old system treatment by the
depletory measures, whether by purging, leeching,
bleeding, or other means, and then the stimuli do
good, not because a scientific treatment of the disease
needed such aids, but because the life power ex-
hausted by the injurious treatment, required an aux-
iliary: so that the deduction of the advocates of
wine in these cases is a testimony not to the scientific
character of this part of their treatment, but to the
miserable and destructive empiricism of that treat-
ment.
200. It is true, that, in certain forms of typhus Food useful
fever, where semi-starvation has preceded the attack, ...
2 cases of
some kind of food in very small quantities and of aº.
liquid form may be useful. The utility of food in *
these cases does not depend upon the food being
necessary for the cure of typhus fever, but because
the constitutional state, in which the febrile has
gained its position, is one, which was produced by
a previous deprivation of food.
201. It may be added as a fact, further confirm-
atory of the evil of giving food to patients labouring
under fever, that the very worst typhoid fevers are voracious
often preceded by and attended with a voraciousness sº
of appetite. of fever.
202. Dr Beaumont asserts, “When the stomach is Food not di.
unusually debilitated, food is frequently retained twen-iº
ty-four hours or more, and is sometimes the cause of.”
most distressing symptoms, producing, particularly in
children, convulsions and death.”—P. 61, liber cit.
78 ON THIE GASTRIC JUICE.
CHAP. v. 202a. Indeed experience has given abundant evi-
dence of this. I have known cases of inflammation
of the brain, the treatment of which was proceeding
most favourably, the patients after having been insen-
sible had recovered their senses, and their power to
notice, and which have been made to terminate fatally
by some unwise mother, aunt, uncle or grandmother,
giving the patients some (so called but miscalled)
mourishment.
203. Axiom 17. IN THE FEBRILE STATE LITTLE OR
NO GASTRIC J U ICE IS SECRETED.
Experiment 204. The experiment on which this axiom is
º founded was performed March 16th. The villous
.." membrane of Alexis's stomach was red and dry.
He complained of headache, pain and distress at the
pit of the stomach, lassitude and loss of appetite.
On introducing the tube into the stomach, no clear
gastric juice could be obtained. A little acrid fluid
and frothy mucus only could be extracted.
205. This axiom and this experiment completely
Unscientific establish the absurdity, the unscientificness of giving
.." food in fever. The agent, the gastric juice, which
jº is the efficient cause in digestion, is absent; how can
- the action of digestion be completed? The worker is
not there, how then can the work be done? It is
hence evident that it is absolutely necessary to with-
hold food from the stomach in febrile complaints.
It can, being undigested, afford no nourishment, but
is actually a source of irritation to the organ, and,
through it, to the whole system, increasing the fever
and perilling the life. “No solvent,” says Dr Beau-
mont, “Can be secreted under these circumstances, and
food is as insoluble in the stomach as lead would be
in ordinary circumstances.”
ON THE GASTRIC JUICE. 79
206. It should ever be remembered, that before CHAP. v.
food can be nutritive, two conditions must exist; first,
that the food is by its nature, suited to the stomach;
and, second, that the stomach is in a state, suited to
act on the food. In fever, it is certain, from this Why food
experiment of Dr. Beaumont, that the stomach is not ñº,
in a state suited to act on the materials, taken into”
that organ, and consequently this condition, necessary
to the realization of nutriment out of the food being
absent, food, instead of being nutritive, is poison to
the recipient.
207. Axiom 18. UNDIGESTED PORTIONs of FooD
PRODUCE ALL THE PHIENOMEN A OF FEVER.
208. Dr Beaumont observed that there is always
disturbance of the stomach when more food has been
received than there is gastric juice to act upon it:
i.e., a condition induced similar to that which is pre-
sent in fever, namely, that the gastric juice not Food undi-
being able to act on the undigested food, the stomach gº tº
is irritated, just as if food had been introduced into
the stomach when the system was in the febrile state.
If to these facts is added the fact, already refer-
red to, that the gastric juice combines with only a
given quantity of aliment, it becomes apparent that
in weak stomachs and in persons labouring under
disease, the supply of gastric juice being diminished
by the state of disease, the evils of taking a large
quantity of food must be indeed great.
209. Axiom 19. ANGER AND OTHER MENTAL EMO-
TIONS CAUSE BILE TO PASS INTO THE STOMACH.
210. The experiment, on which this axiom is
founded, is the following. On March 12, at nine A.M.
Alexis breakfasted on fat pork, bread and pota-
toes. At one P.M. the contents of the stomach were
80 ON THE GASTRIC JUICE.
cHAP. v. of a thin gruel-like consistence, and considerably
*...*tinged with yellow bile. This tint Dr Beaumont
the stomach. ascribes to a fit of violent anger, which occurred in
Alexis at the time of taking out the parcel, and
Dr Beaumont considers that when bile is found in
the stomach, it is an indication of either mental or
corporeal disease. - -
211. It is a common opinion that bilious people
are ill-tempered: in connexion with this axiom origi-
mates a query, whether the ill temper does not make
them bilious rather than the biliousness making them
ill-tempered; in other words, may not the ill temper
cause the bile to enter the stomach, and thus changing
the properties of the chyme, altering its homogeneous
quality, retard and otherwise disturb the due egress
of the chyme into its destined receptacle, the next
gut, the duodenum, thus causing the common pheno-
mena, known under the name of biliousness.
212. From these facts and views may be under-
Adage, “A stood how true is the old adage, “A merry heart .
. * doeth good like a medicine.” How necessary it is,
.*.* as a means of health, to cultivate good temper.
213. Axiom 20. BILE IS NEVER FOUND IN THE
STOMACH IN A STATE OF HEALTH; OILY FOOD AND FAT
FooD CAUSE THE PRESENCE OF BILE IN THE GASTRIC
JUICE.
214. Dr Beaumont states, “I have observed that
º, when the use of fat or oily food has been persevered
is is present in for some time, there is, generally the presence of
ºl. bile in the gastric fluids. Whether this be a patho-
logical phenomenon, induced by the peculiarly indi-
gestible nature of oily food, or whether it be a pro-
vision of nature to assist the chymification of this
particular kind of diet, I have not as yet satisfied
ON THE GASTRIC JTUI CE. 81
myself. Oil is affected by the gastric juice with con- chAP. v.
siderable difficulty. The alkaline properties of the
bile may render it more susceptible of solution in
this fluid, by altering its chemical character. Irri-Irritation of
tation of the pyloric extremity of the stomach with theºl
end of the elastic tube, or the bulb of the thermometer,...,
generally occasions a flow of bile into this organ. stomach
b cause a flow
External agitation, by kneading with the hand on the bile into the
right side, over the regions of the liver and pylorus, stomach.
produces the same effect. It may be laid down as a
general rule, however, subject to the exceptions above
mentioned, that bile is not necessary to the chymifi-
cation of food in the stomach.”
215. Dr Combe says, “There is one form of im-
paired digestion in which the fat of bacon is digested...,
with perfect ease, where many other apparently more indigestion
appropriate articles of food oppress the stomach for suitable.
hours. It would be interesting and useful to ascer-
tain, whether, in these cases, bile is present in the
stomach, and also to discover indications by which we
could predicate whether bacon will or will not be
suitable. As yet, although I have often seen the
fat of bacon being easily digested by a weak sto-
mach, I have not been able to distinguish by the
symptoms, prior to experience, the cases in which it
ought to be allowed. In many cases it proves ex-
tremely indigestible. Possibly this may have some
relation to the presence or absence of bile.”
*.
MI
82 THE MOTION OF THE STOMACH.
CHAP. VI.
Motion of
thé stomach.
Great variety
of motions.
CHA PTE R V I.
On the remaining agencies in conneanion with the
Digestion of the Food in the Stomach.
216. An agent, next in importance to the gastric
juice in effecting the digestion of the food, is the
MOTION OF THE STOMACH.
217. The structure of the muscular coat (95) shows
that it must have a variety of actions. The motions
of the stomach seem to commence at the cardiac
orifice, the folds of the inner coats of the stomach
being there radiated, (plate 7, fig. 2): from this point
to the pylorus, where the fibres become longitudinal,
the fibres of the stomach are continually acting, during
the change of the food into chyme, in a never-ceasing
gyre; thus causing the stomach continually to act on
the food, carrying it, when acted upon, to the pylorus,
producing in this action a spiral movement, or, as it
is called, a worm-like, vermicular or peristaltic
motion.
218. The wonderfully varied muscular structure of
the stomach enables it to perform an almost innumer-
able variety of movements. In fact, the stomach,
THE MOTION OF THE STOMACH. 83
regarded as a whole, may be looked upon as made up
of innumerable little stomachs, represented by the
peculiar fibrous and tendinous lines already described,
(94). Dr Beaumont, who saw the actions of Alexis's
stomach, relates that the mixture of articles of food is
perfectly heterogeneous at first, and is kept in constant
agitation by the churning motions of the stomach.
He adds, as already recorded, the first effect of the
introduction of food is to irritate the gastric papillae,
thus exciting the discharge of the gastric juice, and
stimulating the muscular fibres of the stomach.
CHAP. V. I.
The vermicular motions, being excited by mechani-Cºmebº.
cal irritation, not only carry the things taken to all:
parts of the stomach, but mix the aliment uniformly
with the gastric juice, which is constantly being Se-
creted in proportion to the quantity of food taken
into the stomach. Some stimulus seems to be neces-
sary to continue the motions of the stomach after
chymification is accomplished, in order to effect the
complete discharge of the chyme into the lower
bowels. And it appears highly probable that the
compound fluid of gastric juice and aliment, or chyme,
by its acquired acid properties, affords this stimulus,
and thus rendered a stimulus propagates the con-
tractile motions of this organ, even after the mechani-
cal irritation of the crude food ceases. This fluid
acquires new chemical properties, becomes more acid
and stimulating, as chymification advances, until the
process is complete. “When the chyme is all transfer-
red to the duodenum, the motions of the stomach cease.”
219. By this action in part, it happens, that food,
when taken into the stomach, is diffused over the
whole villous surface, and excites the gastric vessels
generally to excrete their fluids copiously.
OneS D101°C
timulating
as digestion
proceeds.
MI 2
84 THE MOTION OF THE STOMACH.
CHAP. vi. 220. The subjoined important observations by Dr
Beaumont on the muscular actions of the stomach,
although in part embodied in the previous statements,
are so full of practical bearings as to deserve record.
221. “The human stomach is furnished with mus-
cular fasciculi, bundles or bands so arranged as to
Description shorten its diameter in every direction. By the alter-
...º. nate contraction and relaxation of these bands, a
* great variety of motion is induced in this organ, some-
times transversely and at other times longitudinally.
These alternate contractions and relaxations, when
affecting the transverse diameter, produce what are
called vermicular or peristaltic motions. The
effect of the contraction of the longitudinal fibres is
to approximate the splenic or cardiac and the pyloric
extremities of the stomach. When they all act
together, the effect is to lessen the cavity of the sto-
mach, and to press upon the contained aliment, if
there be any in the stomach. These motions not
only produce a constant disturbance, or churning
of the contents of this organ, but they compel them,
at the same time, to revolve around the interior from
point to point, and from one extremity to another.”
In addition to these motions, there is a constant agi-
tation of the stomach, produced by the respiratory
muscles.
222. These contractions and relaxations of the
muscular fasciculi do not observe any very exact
mode. Their motions are modified by various cir-
* Swammerdam relates that the stomach of the louse is in continual
agitation, being hardly a moment at rest.— Bib. Nat., p. 71.
+ The motions in the stomach of the Silurus fish are very extraordi-
nary, and illustrate the view, that the stomach in its actions is to be
regarded as an infinity of little stomachs. Hartmann, who observed
THE MOTION OF THE STOMACH. 85
cumstances, such as the stimulant or non-stimulant CHAP. VI.
property of the foods taken, the healthy or unhealthy
state of the internal coat of the stomach, by exercise
and by repose, &c. &c.
223. The ordinary course and direction of the 9.
revolutions of the food are; first, after passing the the food.
Oesophagus ring the revolutions proceed from right to
left, along the small arch; thence, through the large
curvature, from left to right. The bolus, as it enters
the cardia, turns to the left, passes the aperture, de-
scends into the splenic extremity, and follows the great
curvature towards the pyloric end. It then returns,
in the course of the smaller curvature, makes its ap-
pearance again at the aperture in its descent into the
great curvature, to perform similar revolutions.
224. Such I have ascertained to be the revolutions
of the contents of the stomach, from being able to
identify particular portions of food, and from the fact,
that the bulb of the thermometer, which, in the
experiments on Alexis has been frequently introduced
during chymification, invariably indicates the same
movements. These revolutions are completed in from
one to three minutes. They are probably induced in
a great measure by the circular or transverse muscles
these motions, states, that the motions begin in particular spots, not far
from the pylorus, contracting vortically to three different points, and after-
wards extended back from the same points through the same vortexes
with a kind of regular contraction and dilatation. These motions of these
reciprocating vortexes set in motion the rest of the upper part of the
stomach as well as the intestine adjoining the pylorus. On pressing the
spots mentioned they seemed to rise into the same kind of rhythmical
motions, which continued at short regular intervals, and this took place
even when the stomach was cut into pieces. The spots described were
occupied by innumerable nerves, lying like twisted cords, without any
membranous covering on the external surface of the stomach.
86 THE MOTION OF THE STOMACH.
of the stomach, as indicated by the spiral motion of
the stem of the thermometer, both in descending to
the pyloric portion, and ascending to the splenic.”
These motions are slower at first than after chymifi-
cation has considerably advanced.
225. While these revolutions of the contents of the
stomach are progressing, the trituration or agitation
of the food is also going on. There is a perfect ad-
mixture of the whole injestae, during the period of
alimentation and chymification. There is nothing of
the distinct lines of separation between old and new
food, or of the peculiar central or peripheral situation
of crude, as distinguished from chymified aliment,
CHAP. VI.
Old and new
food all
mixed.
* The accuracy of these views is demonstrated by the following ex-
periment on Alexis:—
January 30,—At six o'clock, thirty minutes, A. M., weather cloudy and
damp; wind N.E. and light; thermometer thirty-nine degrees; stomach
empty, clean, and healthy; temperature immediately before rising, ninety-
nine and a half and ninety-eight and three quarter degrees; rose slowly.
At nine o'clock, temperature of stomach a hundred and one and a half
and a hundred and three quarter degrees, rose quick; extracted three
drachms of gastric juice; it came slowly, the last mixed with yellow bile.
He breakfasted on beef-steak, bread, and coffee. At eleven o'clock, sto-
mach almost empty; temperature a hundred and one and a quarter and
a hundred and a half degrees. When the bulb of the glass tube descended
towards the pyloric extremity, the stomach evidently contracted upon it,
and drew it forcibly down. If left free to its own motions, the tube
would sink to the pylorus, the whole length of the stem, ten or eleven
inches, and then rise again of its own accord. When drawn above this
point of apparent contraction, into the splenic end of the stomach, towards
the perforation, the motion of the bulb was reversed, in a direction
towards the fundus of the stomach, not inclining, however, to make its
exit at the perforation, but took a sort of irregular motion, revolving the
tube from right to left, so as to turn it completely round in the space of
ten or fifteen seconds. This motion was not always present, nor con-
stantly continuous when present, but interrupted, and alternate with the
appearance of contraction at the pyloric end, and distinctly evident only
from about one and a half to three hours, or more, after eating, and at a
time when the chyme was most rapidly leaving the gastric cavity.
THE MOTION OF THE STOMACH. S7
(said to have been observed by Philip, Magendie and
others, in the experiments on dogs and rabbits,) to
be seen in the human stomach, at least in that of the
subject of these experiments. The whole contents of
the stomach, until chymification be nearly complete,
exhibit a heterogeneous mass of solids and fluids;
hard and soft; coarse and fine; crude and chymified;
all intimately mixed, and circulating promiscuously
through the gastric cavity, like the mixed contents of
a closed vessel gently agitated or turned in the hand.
226. If a mouthful of some tenacious food be swal-
lowed, after digestion is considerably advanced, it
will be seen passing the opening, to the great curva-
ture; and, in the course of about one and a half or
two minutes, it will re-appear, with the general cir-
culating contents, more or less broken to pieces, or
divided into smaller pieces, and very soon loses its
identity.
This agitating motion has the effect, and is un-
doubtedly designed, to break up the bolus, as well
as to separate the external and chymified portion of
the particles of food, and allow the undigested por-
tions to come in contact with the gastric juice, their
proper solvent. If the motions were simply revo-
lutionary, the central portions would retain their si-
tuation, until the outer, or chymified part, had passed
into the duodenum, in successive parcels, which, it
is evident, would very much retard the process of
digestion.
227. As the food becomes more and more changed
from its crude to its chymified state, the acidity of
the gastric fluids is considerably increased—more so
in vegetable than animal diet—and the goneral con-
tractile force of the muscles of the stomach is aug-
CIIAP. VI.
88 THE MOTION OF THE STOMACH.
CHAP. VI.
Chyme con-
tinually
during di-
gestion
passes into
duodenum.
mented in every direction, giving the contained fluids
an impulse towards the pylorus. -
228. It is probable, that, from the very commence-
ment of chymification—from the time that food is
received into the stomach—until that organ becomes
empty, portions of chyme are constantly passing into
the duodenum, through the pyloric orifice, as the
mass is presented at each successive revolution. I
infer this from the fact that the volume is constantly
decreasing.
his decrease of volume, however, is slow at first;
but is rapidly accelerated towards the conclusion of
digestion, when the whole mass becomes more or less
chymified. This accelerated expulsion appears to be
Action of the effected by a peculiar action of the transverse mus-
transverse
band at the
pylorus.
Motion of
the thermo-
meter put
into the
stomach,
cles, or rather of the transverse band, as described
by Spallanzani, Haller, Cooper, Sir E. Home, and
others, in their experiments on animals. This band
is situated near the commencement of the more coni-
cally shaped part of the pyloric extremity, three or
four inches from the smaller end. In attempting to
pass a long glass thermometer tube, through the
aperture, into the pyloric portion of the stomach,
during the latter stages of digestion, a forcible con-
traction is first perceived at this point, and the bulb
is stopped. In a short time there is a gentle relaxa-
tion, when the bulb passes without difficulty, and
appears to be drawn quite forcibly, for three or four
inches, towards the pyloric end. It is then released,
and forced back, or suffered to rise again, at the same
time giving to the tube a circular, or rather spiral
motion, and frequently revolving it completely over.
These motions are distinctly indicated and strongly
felt, in holding the end of the tube between the thumb
THE MOTIONS OF THE STOMACH. 89
and the finger: and it requires a pretty forcible grasp CBAP. VI.
to prevent it from slipping from the hand, and being -
drawn suddenly down to the pyloric extremity.
When the tube is left to its own direction, at these
periods of contraction, it is drawn in, nearly its whole
length, to the depth of ten inches: and when drawn Motion of the
back, requires considerable force, and gives to the *:
fingers the sensation of a strong suction-power, like”
drawing the piston from an exhausted tube.
This ceases as soon as the relaxation occurs, and
the tube rises again, of its own accord, three or four
inches, when the bulb seems to be obstructed from
rising further; but if pulled up an inch or two,
through the stricture, it moves freely in all directions,
in the cardiac portions, and mostly inclines to the
splenic extremity, though mot disposed to make its
exit at the aperture. -
229. Above the contracting band, and towards the
splenic portion of the stomach, the suction or grasp-
ing motion is not perceptible; but when the bulb is
pushed down to this point, it is distinctly felt to be
grasped, and confined in its movements.
230. These peculiar motions and contractions con- All motions
tinue until the stomach is perfectly empty, and not aiº,
particle of food or chyme remains; when all becomes" “”
quiescent again.
231. If the bulb of the thermometer be suffered to
be drawn down to the pyloric extremity, and detained
there for a short time, or if the experiment be re-
peated too frequently, it causes severe distress, and a Pain pro-
º l- * > e duced if the
sensation like Cramp or spasm, which ceases on with-join.
drawing the tube, but leaves a sense of soreness and ...”
tenderness at the pit of the stomach. the pylorus.
232. The peculiar contractions and relaxations,
N
90 THE MOTIONS OF THE STOMACHI,
CHAP. VI. mentioned above, succeed each other, at irregular
intervals of from two to four or five minutes. Simul-
taneously with the contractions, there is a general
shortening of the fibres of the stomach. This organ
contracts upon itself in every direction; and its con-
IIow the sto-tents are compressed with much force. The valvular
º portion of the stomach is firmly thrust into the aper-
tents, ture, closing the orifice, preventing the egress of
aliment, and obstructing the view of the interior.
During the intervals of relaxation, the rugae perform
their vermicular actions, the undulatory motions of
the fluids continue, and the alimentary and chymous
masses appear, revolving as before, promiscuously
mixed, through the splenic and cardiac portions.
233. All these facts, taken together, will rationally
admit of the following explanation. -
The longitudinal muscles of the whole stomach,
with the assistance of the transverse ones of the
splenic and central portions, carry the contents into
the pyloric extremity. The circular or transverse
muscles contract progressively, from left to right.
When the impulse arrives at the transverse band,
this is excited to a more forcible contraction, and
closing upon the alimentary matter and fluids, con-
tained in the pyloric end, prevents their regurgita-
tion. The muscles of the pyloric end, now contract-
ing upon the contents detained there, separate and
Course of the expel some portion of the chyme. It appears that
:"... the crude food excites the contractile power of the
*.*.* pylorus, so as to prevent its passage into the duode-
num, while the thinner chymified portion is pressed,
through the pyloric valve, into this intestine. After
the contractile impulse is carried to the pyloric
extremity, the circular band, and all the transverse
THE MOTIONS OF THE STOMACH. 91
muscles become relaxed, and a contraction commences char. vi.
in a reversed direction, from right to left, and car-
ries the contents again to the splenic extremity, to
undergo similar revolutions.
234. In addition to these actions of the stomach
another class of actions remain to be noticed.
235. The synchronous action of the oesophagus,
with the respiratory motion of the lungs, has been
noticed (78). -
236. It appears that a correspondent synchronism of ººººº.
action of the
action takes place between the stomach and the respi-stomach and
ratory motions of the lungs. The connexion of the of the lungs.
diaphragm with the oesophagus or more strictly with the
stomach, this being a continuation of the Oesophagus,
would induce the synchronism of action referred to ;
but when to this is added, that the stomach is con-
nected with the underside of the diaphragm and con-
sequently must be moved at each inspiration and
each expiration, the undoubted existence of the sym-
chronism becomes more apparent. If to these re-
lationships is added the additional fact, that this
external coat of the stomach is continuous with the
common coat lining the abdominal cavity, i. e. the
cavity containing the stomach, the correspondence
of action between the respiratory motion of the lungs
and the actions of the stomach, becomes still more
satisfactorily established. Add to this the fact, that
the valve in Alexis's stomach was seen by Dr Beau-
mont to pass up and down simultaneously with the
action of the respiratory muscles, (118).
237. This synchronism of action is not a matter
of mere deduction. It has been demonstrated as a
matter of fact. Dr. Beaumont states as a result of
personal observation of the action of Alexis's sto-
N 2
92 IPRACTICAL IDED UCTIONS.
CHAP.VI.
The heat of
the stomach.
Three agen-
cies in chy-
mification.
mach : “In addition to these motions, there is a con-
stant agitation of the stomach produced by the respi-
ratory muscles.” Paragraph 101.
238. A third agent, auxiliary in the chymification
of food, is the heat of the stomach.
239. The average temperature of the human sto-
mach is 100°, as indicated by Fahrenheit's thermo-
meter.
240. The essential necessity of temperature, as
connected with the conversion of the food into chyme,
is evidenced by the fact, established by numerous ex-
periments, that when the gastric juice was used so as
to act on the food out of the body, the action was
extremely slow, unless the vessels, containing the gas-
tric juice and the food, were kept at a temperature
nearly the same as that of the human body. Then
the action of the chymification of the body took place
almost as quickly as when the action took place in
the stomach itself.
241. The digestion of the food does not, according
to Dr. Beaumont, cause any increase of the tempera-
ture of the stomach: though, according to some ex-
periments, an increase of temperature takes place at
the pyloric orifice. -
242. So that it appears from all these views and
statements, that three agencies are concerned in ef-
fecting the chymification of the food: first, the sol-
vent power of the gastric juice; second, the motions
of the stomach ; and third, the warmth of the
stomach.
gººmsºmºsºsºsºs
Jºrº,
PRACTICAL D E D U CT I O N S.
o. If the stomach has actions to perform on the
PRACTICAL DEDUCTIONS. 93
food, which ought to have been performed in the CHAP. vi.
mouth or the gullet, it is certain that injury must Injury if the
result: as injury always occurs when any part isº."
called to perform a duty, which does not properly..." .
belong to it. Unmasticated food, as demonstrated in º
the experiments already recorded, is food in a state
unsuited to the stomach. Those, therefore, who, to
use a common but expressive phrase, bolt their food,
who eat ravenously, must impose labours on the
stomach, which though the stomach may perform
them, must injure that organ over-laboured in the
performance. It is true that the effect is not felt
immediately; hence many gluttons boast that these
excesses do them no harm. But mark these violators
of their constitution in connexion with the stomach,
when attaining their forty-fifth year: then all the
over-loadings of the stomach with unchewed food rise
up against them, and record, in the bitter language
of dyspeptic sufferings, the injuries done.
p. If the stomach is habitually over-distended, a
condition of it must at length be induced contrary to
the natural state, which, being unnatural, will be
indicated by distressing sensations. Heister remarks,
that, in persons addicted to gluttony, the stomach is Over-disten-
unusually large. It appears likely, that the pains i.
and the sensations of sinking, which such persons”
experience, depend on the unnatural enlargement
thus induced, causing a condition of the nervous
tissue, contrary to the natural condition, and conse-
quently sensationally unpleasant.
q. As digestion is carried on in the stomach viewed
not as one organ, but as composed of numerous little
stomachs, (218,) it is evident, that, if the stomach is
continually unduly expanded, the little stomachs can-
94. PRACTICAL DEDUCTIONS.
cHAP. vi. not perform what they have to do, and consequently
indigestion must result. *
+. The peculiar increased vascularity of the internal
Pain after lining of the stomach, produced directly food is in-
º troduced into the stomach, (105,) will explain why,
* in cases of indigestion, pain is produced by the taking
of food.
The nerves of the stomach are in a morbidly sus-
ceptible state, and the impressions, associated with
the increased flow of blood to the mucous coat, pro-
duce an unpleasant state, not because there is a too
great flow of blood to the stomach, but because the
nerves are diseasedly modified.
s. As all the actions of the stomach, and all the
changes consequent upon and connected with these
actions, are necessary to the proper change of food,
and as, in completing these actions, the food must be
nº delayed, or rather detained, a certain time in the
mach essen- stomach, until all the changes necessary are effected,
tial. any means by which the food is hurried out of the
stomach into the next intestine must be injurious.
Viewed in this respect, how unscientific and how in-
jurious must be the practice (common with many) of
º taking “ dinner pills,” as they are called, immediately
ious by after dinner, with the view of helping digestion.”
*:::::::The chyme, under such conditions, is not perfected:
* imperfectly formed chyme is carried into the duode-
num, and thus a long series of injurious agencies are
created, since the chyme not perfectly formed must
cause every action, that subsequently takes place in
the successive portions of the intestimal canal, to be
more or less out of Order or abnormal.
t. From the correspondence between the respiratory
motions of the lungs and the vermicular action of the
PRACTICAL DEDUCTIONS. 95
stomach, it becomes clear, that any practice, which CHAP. VI.
& & ſº A. * ti
impedes the free action of the lungs, must impede the ...".
proper action of the stomach, and must tend to in-jº.""
2 the lungs
duce the derangement of this important organ. *
w. Tight lacing must, in this point of view, beſign aging.
highly prejudicial to digestion.
v. From the immense supply of nerves to the sto-
mach from the Par Vagum, and also from the Sym-
pathetic system of nerves, the powerful influence Influence of
which the mind must exert on the stomach and the *
stomach on the mind must be apparent.
w. The effect of strong mental emotions on the i.
stomach all appreciate: very good news, or bad news take away
received in the midst of a meal, will extinguish ap-” etite.
petite. The death of an object beloved will take
away all desire for food. What boarder at a school
cats his breakfast heartily on the morning of the day
when he is to return home for the holidays?
a. Hence it must be highly unwise to devote the No abstruse
mind immediately after meals to any abstruse study. º
3y. Hence the fact, that much mental emotion, or
the intense pursuit of any object, will suspend hunger,
is easily explained. The intense action of the brain Intense men-
suspends the nervous energy of the stomach. How *
often does it happen that a man in the intense pursuit”
of riches, when told that his meals are ready, puts
them off, saying he is too busy: Nature submits to
the violation for a time, but, at length the digestive
system suffers, and a gastric fever seizes the man of
greed, and, in a few weeks, the fruits of his excessive
labour are eaten up in the necessities of a sick room,
and in the consequent neglect and disarrangement of
his concerns.
2. IIow wise is the remark viewed in reference to
96 PRACTICAL DEDUCTIONS.
CHAP. vi. the action of digestion, “Let your moderation be
j." known unto all men.”
a a. Equally unwise is it, soon after a hearty meal,
when the stomach is engaged in the performance of
a duty, to use any violent muscular efforts.
Yºr. The experiment of John Hunter with the two dogs
meal inju is quite conclusive on this point. He fed two hunt-
tºº ing dogs with the same food, and with the same
.** quantity. One he took out to hunt. The other was
allowed to lie down before the fire. On returning
from the coursing he killed both dogs: the one, that
had been in the pursuit of game, had the food in the
stomach quite undigested: whereas the dog, who had
had rest, had no food at all in his stomach; it had
digested and passed away into the duodenum. How
many a person has suffered and died from hurrying
directly after a meal to reach a steam boat or railway
carriage.
** bb. Moderate exercise does good. Dr Beaumont has
meals aids established by his experiments that moderate exercise
* after meals conduces considerably to healthy and rapid
digestion. Dr Beaumont considers that gentle exercise
increases the circulation of the system and the tempe-
rature of the stomach. The increase is about one
and a half degrees. This increase, Dr Beaumont
thinks, aids the solvent power of the gastric juice.
Dr Beaumont found that “exercise sufficient to
produce moderate perspiration, increases the secre-
tions from the gastric cavity, and produces an accu-
mulation of a limpid fluid within the stomach,
slightly acid, and possessing the solvent properties
of the gastric juice in an inferior degree.” This is
probably a mixed fluid, a small proportion of which
is gastric juice.
PRACTICAL DEDUCTIONS, 97
c c. The situation of the heart in relation to the CHAP. VI.
stomach (plate 6, fig. 17,) will explain why derange-
ments of the stomach are so frequently attended
with palpitation of the heart. If the stomach be
over distended with food or be distended with wind,
the action of the heart must be more or less interfered
with. And here it may be added that palpitation Palpitation
and other affections of the heart when complicated with *.
affections of the stomach are often curable, because the ..."
affections of the stomach constitute the chief existing
cause of the diseased manifestations in connexion
with the heart; whereas, when uncomplicated, they
are often more difficult of cure.
98 ON CHIYLIFICATION.
C HAPT E R VII.
On Chylification, and the organs concerned in the
process, with Practical Deductions.
cIIAP. VII. 243. The next series of changes, connected with
and forming part of the digestion of the food, is
associated with the first of the Small intestines, the
DUODENUIM.
Duodenum. 244. The duodenum is the first portion of that
part of the intestinal canal, strictly called the intes-
times.
245. Heister remarks, “The intestines are large
and long membranous canals, reaching from the sto-
Length of in-mach to the anus. Their length is usually six times”
* the height of the individual they belong to.”
246 They are connected and continuous, and are
fastened to the spinal column by means of -a spread
out fan-like process of the tissue investing the cavity
º of the belly, called the peritoneum (ript, peri, around,
3.1101 (0.6SCIl-
tery.
* In children the intestines are ten to twelve times the length, in adults
five to six times the length, of the individual. In the animals that chew
the cud, the ruminants, the intestines are twenty-seven times the length
of the body.
ON CHYI,IFICATION. 99
and rewo, to stretch). This fan-like extension of the CHAP. VII.
peritoneum is called the mesentery.
247. Though strictly one continuous tube, the
intestines are generally considered to be six. Six intestines.
248. Three of these are named small intestines, small intos-
namely the duodenum, the jejunum, and the ileum;"
and the other three, namely, the coccum, the colon
and the rectum, are designated large. tº intº
249. Of the small intestines, the first is called the ""
DUODENUM, (duo two, and denum ten,) because it
is about twelve inches in length.
250. This intestine begins at the pylorus, (plate 6, ºne
fig. 7, plate 7, fig. 9,) and at first ascends a little,
(plate 6, fig. 8, plate 7, fig. 8,) then descends (plate 7.)
then ascends (plate 7.) and then runs transversely to
the left kidney.
251. The course is very remarkable, and the coats
and the cavity of this intestine are larger than the
coats and the cavities of the other small intestines.
252. The innermost coat or lining membrane of
this intestine is puckered up into folds, (rugae) form- Wrinkles or
ing little valves or valvules, lying transversely across"
the intestine and parallel to each other, hence called
commivent valves (valvulae conniventes), (plate 8, fig. Connivent
14, 15). These are few in number at the commence- valves
ment of the duodenum, but become very numerous
in the portion of the duodenum nearing the next
Small intestine, the jejunum.
253. Numerous glands are found in this intestine,
they are called BRUNNERIAN, and secrete a thin fluid. Brunnerian
254. Into the duodenum open at a point about glands.
three or four fingers distance from the pylorus, two Tubes cnding
tubes, one from the gall bladder and the liver, called.” "
Illiºl.
the common bile duct, (plate 7, fig. 17,) (ductus
O 2 J J f -3 ; , , !,
_j ...} J
J 3. 2 J. J
2
100 ON CHYLIFICATION.
CHAP. VII, choledochus), and one from the sweet-bread gland
... (pancreas), the pancreatic duct, (plate 7, fig. 18).
The bile duct carries the bile; the pancreatic duct,
the pancreatic juice, into the duodenum, (plate 7,
fig. 16). -
255. These two fluids are highly active in effecting
the changes destined to be effected in the chyme,
which passes into this intestine from the stomach.
Bile. 256. The bile is a fluid, secreted by the liver; the
pancreatic juice is a fluid, secreted by the pancreas.
º 257. The LIVER (plate 1,) is a large organ of a red-
ion. dish colour, situated in the abdominal cavity at the
right side and extending to the pit of the stomach.
The upper surface of the liver is convex and smooth;
it lies in close contact with the diaphragm (plate 1,
fig. 24, plate 5, fig. 1, 2,) and, by its shape and
smoothness, the actions between it and the diaphragm
take place with ease.
258. The liver is connected firmly with the diaph-
The ligaments ragm by strong bands, called ligaments; it is con-
*" nected with the navel also by a strong ligament,
which, being round, is called the round ligament.
259. The liver is composed of several kinds of
vessels, the branchings of which are multiplied in a
- most extraordinary manner, and by the interlacings
Granules that of the fine hair-like, called capillary, extremities of
secrete the º e - - e
bile. their branchings, form an innumerable multitude of
fine and pulpy granules, which are the parts of the
liver that secrete the bile, and which appear, when
seen through a microscope in clear water, to be thick
villous little bags or follicles.
* 260. The bile is secreted from the blood, brought
carries to the to the liver by a large vein, called the vena portac.
liver the blood tº º o
#."..." This large venous trunk is made up of innumerable
bile is made,
© º
© © e gº
0 & o
e
© Q e
:
:
e
º
;
:
ON CHYLIFICATION. - 101
veins, which arise in the intestines, the spleen, the CHAP. VII.
rectum, and the principal abdominal Organs.
261. The blood, which these vessels bring to the
liver, is loaded with impurities; and it is from this
blood, thus loaded with impurities, that the glan-
dular bodies of the liver make bile; i. e., they purify
the blood, and from the very impurities make the
valuable fluid, the bile.
262. This bile, formed by the glandular bodies, is,
immediately after its formation, collected in another
set of vessels, called the biliary pores, (pori biliarii), Biliary pores.
which unite their branchings so as to form one com-
mon trunk, called the hepatic duct.
263. This hepatic duct, soon after the commence-
ment of its course, joins a pipe or duct, which comes
from the gall bladder. This duct is called the cystic cystic duct.
duct.
264. This cystic duct contains some beautiful spiral
valves: they have been described as resembling the
turns of a snail's shell, and their presence in the
duct, it is likely, prevents the return of the bile
when once, after being perfected, it has passed from
the gallbladder. --- .
265. These two ducts, namely, the hepatic and the
cystic, unite to form a common trunk, called the
choledic, (XoAm. Chole, bile,) or common bile duct. Choledic or
(Plate 7, fig. 17). - ºn is
266. This common bile duct proceeds to the curva-
ture of the duodenum, (plate 7.) and opens into the
cavity of the intestine by a longish orifice, rounded
above and contracted below, (plate 7, fig. 16).
267. The gall bladder, resembling a pear in shape, Gall bladder
lies in a depression on the concave side of the liver, i. º
This gall bladder is a depository of the bile until it is
102 ON CHYLIFICATION.
CH AP. VI I.
Gall bladder
perfects the
bile.
Uses of the
bile.
Liver, a pu-
rificatory
Organ.
wanted for use. This bile lies in the gall bladder
until the chyme enters the duodenum; at its entrance
the gall bladder contracts and forces its contents into
the duodenum. -
268. The bile that passes direct from the liver
enters continuously the duodenum : the bile of the
gall bladder, called cystic bile, enters the duodenum
only when the gall bladder is full, or when the sti-
mulus of the chyme excites the gall bladder to dis-
charge its contents. -
269. The delay of the bile in the gall bladder
seems to be connected with some process, which takes
place in the gall bladder, by which the bile is per-
fected. Heister maintains that the bitterest portion
of the bile is secreted by the gallbladder.
270. The use of the bile, according to this exact
anatomist, is to attenuate the chyle, to mix the ole-
aginous with the aqueous parts, to stimulate the
intestines, and, in part, to alter the acid of the chyle.
Boeerhave remarks—“The cystic bile resists acescent
matters, and, by its admixture with other things,
gives them a similar power of resistance; it is sapo-
naceous and detergent; it makes oils miscible with
water; it dissolves and thins resins, gums, and viscid
substances, and renders them uniform, if it be rubbed
with them.”
271. The liver, regarded as a great purificatory
organ, has an immense interest associated with it.
“I do not think,” writes the profound Swedish philoso-
pher, “there is in the whole body another such sewer
and turbid gulph of humours as the vena portac. The
impure stream passes through this sewer, is carried
successively through finer and finer strainers into
myriads of glands, which secrete the bile.” -
ON CHYLIFICATION. 103
272. The other fluid, poured into the duodenum, CHAP. VII.
in connexion with the conversion of chyme into chyle,
is the pancreatic or sweet-bread juice. -
273. The pancreas is a large flat gland (plate 8, D) Pancreas, its
of a fleshy colour, situated behind the stomach and Situation.
extending from the duodenum to the spleen. Its
length is eight to nine inches; its shape is that of a
dog's tongue; it is made up of numerous soft glam-
dular molecules, so combined as to present the appear-
ance exteriorly of one mass.
274. Running along the middle of the breadth of
the pancreas is a particular duct, in which several º
smaller ducts end laterally, almost as the veins of a course.
leaf may be seen to terminate in the chief central
vein. , - . -
275. This duct is very thin, white and almost trans-
parent. It pierces the coats of the duodenum at the
same spot with the common bile duct, (plate 7, fig. 18).
276. The fluid secreted by the pancreas is slightly Pancreatic
saltish, limpid, abundant, continually secreted, and!.""
resembles very much the saliva—it is neither acid mor
alkaline. It is, in fact, a saliva.
277. By the mixture of the pancreatic juice and the
two kinds of bile, the universal salivary menstruum or Hºn.
dissolving agent is formed, which is tempered and
adapted, with infinite variety, to every necessity and
demand of the intestines digesting, and of the food
to be digested.
278. “The pancreatic juice is the first cause, the
hepatic bile is the second, and the cystic bile is the
third.” * ->
An analogy subsists between the fluids acting on
the food in the stomach so as to make chyme, and
the fluids engaged in acting on the chyme in the
104 ON CHYLIFICATION.
CHAP. VII. duodenum to make chyle; the saliva and the gastric
jº. ºf juice are engaged in the one, and the salivary juice
juices. of the pancreas and the bile are engaged in the other,
elaborating the chyme in the duodenum.
279. The effect of the admixture of the bile and
of the Sweet-bread juice with the chyme is to cause a
change in it, by which it is separated into two por-
tions; a nutritive and a feculent.
280. The nutritive portion presents itself in the
Chyle. form of a milky-like fluid called chyle.
P R A CT I C A L D E D U CT I O N S.
d d. The close connexion between the liver and the
diaphragm demonstrates, that the liver is subjected
to the motions which the lungs undergo in the chest;
that is, its actions must accord with the respiratory
The reason actions. Such being the case it becomes evident, that
why tight tº a º Q e º
lacing inju-any conditions, which interfere with such accordance,
I'l OllS. must be injurious to the health. Such an interference
is presented in the wearing of tight-fitting trowsers,
of tight belts. Such an interference is induced, when
the practice is adopted of tying round a person's
waist preparatory to running, a tight handkerchief.
ee. The fact that irritants, passing through the duode-
num, cause the bile to flow into the duodenum, which
bile, when there is nothing in the duodenum to be
ºf pur-mixed with it, itself becomes an irritant, demonstrates
how injurious purgative medicines, which cause a
flow of bile, must be to the lining membrane of the
intestine.
ff. And this fact, that purgative medicines cause a
flow of bile, demonstrates how absurd is the common
PRACTICAL DEDUCTIONS. 105
belief, expressed in the argument, that, because the
... bile irritates as it passed through the bowels, how
bilious the individual was and how bad was the state
of the bile; whereas the truth is, that the bile irri-
tates because it passes as bile and not as a part of the
natural evacuations formed by it, when mixed pro-
perly with the nutritive and non-nutritive portions of
the food.
CHAP. VII.
106 SMALL AND LARGE INTESTINES.
CHAP TER VIII.
Défacation and its course in connea ion with the
Small and the Large Intestines.
CHAP. VIII. 281. The remaining series of changes, connected
with and forming part of the digestion of the food,
are associated with the remaining intestines, namely
the jejunum and the ileum, (small intestimes;)
the coecum, the colon and the rectum, (large
intestines).
282. The jejunum and the ileum form the princi-
pal part, so far as length is concerned, of the intesti-
mal canal. Considering the jejunum as commencing
at the last curve of the duodenum, and the ileum as
terminating at the beginning of the large intestine,
Length ºf the length of the two is equal to four to five times
the small in-
tostinos, the length of the human body.
Their site. 283. Being of this length they occupy, as repre-
sented in the wood cut at page 33, a considerable por-
tion of the abdominal cavity, namely, the region of
the navel, a portion of the lower belly, a portion of
the loins, and a portion of the cavity of the pelvis.
SMALL AND LARGE INTESTINES. 107
284. They present the most numerous foldings and chap. viii.
exhibit great variety of position in their course (DD, ..."
wood cut page 10).
285. These intestines have the same coats as those
constituting the stomach and the duodenum. The
mucous coat of these intestines supplies a considerable
secretion of a mucous fluid, this fluid being poured Yº..."
out from innumerable points so fine as to create afrom the
- - points in the
velvety or villous appearance, technically known under villous mem.
the name of “villosities.” These villosities, as viewed brane.
through a microscope, are represented in the sub-
joined wood cut.*
No. 1, represents the mucous coat of the intes-
tine cut through; No. 2, represents the villosities
or projecting points; No. 3, represents the little
opening, presented at the extremity of each villosity
or prolongation of the mucous membrane. The
mucous fluid poured out from these points has an
* This wood cut represents a portion of the villous coat of the small
intestines as viewed through a microscope. 1, the mucous coat of the
intestine: 2, 2, the villous projections: 3, 3, the orifice presented at the
end of each prolongation or projection.
P 2

108 SMALL AND LARGE INTESTINES.
CHAP. VIII.
Flatulence.
Jejunum, why
so named :
its site.
Commence-
ment of the
ileum.
Nerves and
blood vessels.
Connivent
valvules.
important use in perfecting the nutritive and other
matters passing through the intestinal canal.
286. When the mucous membrane becomes dis-
eased, the nature of the fluid - secreted from these
points becomes altered, and according to the diseased
modification will be the nature of the secretion: in
many cases flatulence seems to be generated.
287. The jejunum, the second of the small intes-
times, is so named, because, in examinations of bodies
after death, it is generally found empty (jejunus,
empty). Its situation is chiefly above the navel, and
its length varies from fifteen to sixteen spans.
288. The jejunum is particularized by the valvules,
already described as commivent valvules (252), being
very abundant, also by its colour being redder than
is the colour of the next intestine. The diminution
in the number of these valvules indicates the com-
mencement of the next intestine, the ileum.
289. The small intestimes are characterized by the
great number of arterial and venous vessels and of
nervous fibres branching over their substance. This
supply is great especially in relation to the jejunum.
In plate 8, I represents the duodenum; J J, a bundle
of the small intestines: 8, represents the branches of
nerves, named the superior mesenteric plexus;
these branchings distributing themselves among the
mesenteric arteries and the mesenteric veins supplying
these intestines; the arteries being represented in
plate 8, by the vessels with circular lines; the veins,
by the vessels with longitudinal lines.
290. The commivent valvules by their forms and
position causing them to be hanging down as folds on
the internal surface of these intestines present an ex-
tended surface, over which the portions of the food,
PLATE VIII.
|

SMALL AND LARGE INTESTINES. 109
both nutritive and feculent, have to pass in traversing chap. viii.
the intestinal canal, and consequently afford a greater
number of points, at which the contents of the intes-
tinal canal are subject to the actions, dependent upon
the peculiar powers connected with these parts of
the canal.
291. The third small intestine, the ileum, so called º
because, situated below the navel, it lies near the
bones of the ileum.
292. Its length is greater than that of the jejunum, Its length.
being from fifteen to twenty spans in length. Its
commencement is indicated by the relative absence of
the commivent valvules, and its termination is in the
first large intestine, the coecum. -
293. The termination of the ileum in the coecum
is in a very peculiar manner, it ending at the left
side of the colon, forming thereat a peculiar valvular Valve of the
formation, called the valve of the colon, (valvula.”
coli,) exhibited 44, plate 9. -
294. This valve has the appearance of a thick
membranous muscular band, elliptic and floating,
being constituted of a fold of mucous membrane, of
cellular tissue, and of muscular fibres. It is fre-
quently named the ileo-coecal valve. º
295. It seems to have a function in relation to the Analogy be.
large intestines and their position to the small intes-..."
times, similar to that which the pyloric valve (92)* Pylºr".
exercises in relation to the stomach and its position to
the small intestimes. º,
296. The large intestines are three.
297. The first is the blind gut or coecum, being so The cooum.
called because it appears to have no opening: to be
in reality a bag, surrounding the termination of the
ileum and the commencement of the colon.
110 SMALL AND LARGE HINTESTINES.
CII A P. VIII.
The coecum,
its site and
length.
298. Its length is about three or four fingers
breadth. It is situated under the right kidney. In-
deed it, as stated, can scarcely be considered as a
distinct intestine, but rather the extremity of an in-
testine, being similar to a round, short, broad bag,
with its base beneath and its mouth above, having a
worm-like appendage, (plate 1, 14, plate 8, L); this
vermiform appendage, being about three lines in
diameter.
299. In this appendage are some glands, showing
Fluid formed that some fluid is secreted there which passes thence
in the ap-
pendage.
into the coecum. Seeds and other bodies have been
found after death in this appendage, these bodies
having caused ulceration and death.
300. This bag-like intestine is represented, in
plate 9, as surrounding and embracing the termi-
Formation of nation of the ileum (1) and the commencement of
the ileo-
coecal valve.
Ileo-coocal
valve, its
form and
llSGS,
the colon (2). Indeed, at the place where the coecum
joins the colon, a portion of the circumference of both
is depressed, forming on the inside a large fold (4,4),
which advances into the cavity of the intestine. It is
open in the middle. The extremity of the ileum is,
as it were, grafted into the opening of this fold, and
is strongly united at both sides by the mutual adhe-
sion of the transverse fibres of the two intestines,
making by the two folds or lips, which form an open-
ing like a button hole. The upper border of these
folds or lips adheres to the intestine, the other is free
and floating in the cavity of the coecum. The ring
thus formed is in truth a valve. As Dr Mason Good
observes, (Study of Medicine, voli., page 9,) “ In
the more perfect classes of animals, the division be-
tween the large and the small intestines is distinctly
indicated by a muscular valve, formed jointly of the
P.I., ATIE IN .
PLATE. N.
-


SMALL AND LARGE INTESTINES. 111
coats of the colon and of the ileum by a short na- chAP. VIII.
tural passing within (introsusception) of the termi-
nating portion of the latter into the commencing
portion of the former ; the important use of which is
to moderate the flow of the contents of the smaller
intestines into the latter, and to prevent a regurgita-
tion of faeces into the former.”” .
301. The second large intestine is the colon. Colon.
302. Its length varies from five to seven spans, and,
in its course, it forms as it were a circumference Its site.
round the small intestines, (plate 1, fig. 13, 15, 16, 17,
plate 8, NO P). * .
303. It is the largest of the intestines. * Its size,
304. It has three bands or ligaments, running on Bands.
its convex surface and ending in the vermiform pro-
cess or appendage. One of the three is seen in
plate 8. These bands compress the colon into bag-
like folds (sacculated) (7, 7, 7, 7, plate 9,) and
elevations. -
305. Besides these bag-like folds and bands, the
colon has, hanging from its surface, fatty append-Appendages.
ageS. f -
306. The interior membrane of this intestine pre-
sents very large connivent valvules, which correspond Conniyent
to the folds externally, being formed internally in"
correspondence with and equal to the elevations ex-
ternally.
307. This intestine has more numerous and larger
glands than those present in the coecum. It ends in
the sigmoid flexure, (plate 1, fig. 18, plate 8, P),
* This lengthened detail of this valve has been given, because this
valve has much importance in relation to the injuries inflicted by pur-
gatives.
112 SMALL AND LARGE INTESTINES.
CHAP. VIII.
Iliac fossa.
Rectum.
Its course.
which corresponds in situation to the left inguinal
region, and lies in a cavity, formed by one of the
bones of the bony basin (pelvis,) which supports the
bowels. -
308. This cavity, being formed chiefly by th
ileum bone, is called the iliac fossa. &
309. The last intestine is the rectum.
310. This intestine is so named because it lies
straight (rectus, straight,) upon the sacrum, the rump
bone, the bone lying wedged in between the hips at
the bottom of the back bone. The intestine itself is
not straight but curved. -
311. This intestine begins opposite to the last bone
of the vertebrae of the back. It is about twelve
inches in length. It descends towards the right side
of the cavity of the pelvis: it then passes horizon-
tally, bending obliquely downwards and forwards
from three to four inches: it then bends so as to form
an angle, turning on itself backwards and down-
wards. It is capable of great distension, even to the
size of a large bladder. Its extremity is called the
anus. w
312. The coats of the rectum are the most thick
and fleshy of all the intestines. These characters
apply specially to the muscular coat, represented
(1, 1, 1,) in the subjoined wood cut.* This muscular
coat presents two layers of fibres, the external being
longitudinal and the internal circular.
313. The wood cut represents the rectum deprived
* This wood cut (p. 113) shows the intestine rectum, deprived of its outer,
the peritoneal, coat. 1, 1, 1, represent the muscular bands of the gut,
meeting together: 2, the swelling of the rectum near its termination:
3, the folds of the clevator muscles of the anus: 4, the opening at the
0.]]llS, -
SMALL AND LARGE INTESTINES. 113
of its peritoneal covering, thus rendering visible the char, viii.
longitudinal muscular fibres. No. 2 represents the
enlargement of the rectum near its termination in
the anal opening, (4).
314. On account of the thickness and the large-
mess of the coats of the rectum, it happens, when the
rectum is empty, that its interior surface, i. e. its mu-
cous coat, falls into folds or rugae, which are called
the columns of the rectum. This structure has a Columns of
practical importance, since surgeons, ignorant of this
structure, fancy, because they may experience some
difficulty in passing bougies into the rectum, stric-
tures to exist in the rectum : whereas, not unfre-
quently, these impediments arise from modifications
of the lining membrane of the gut. To this it may
be added, that, in many cases, these ignorant men
produce by the use of their bougies and other me-
Q


114 SMALL AND LARGE INTESTINES.
CHAP. VIII.
IHoemorr-
hoidal ves-
sels.
Rectum
veins numer-
OllS.
chanical means, adopted by them to get rid of these
imaginary strictures, the very strictures, non-existent
till they used their means.
315. The mucous coat of the rectum is thicker and
more vascular than in any other part of the large in-
testines, containing many distinct mucous follicles,
which secrete a mucus, that preserves the internal
surface of the gut in a state of healthy moisture.
316. The absorbents of the rectum are numer-
ous, and there are a few vessels that take up chyle,
called lacteals.
317. The arteries, carrying the nutritive blood to
the rectum, are remarkable, being derived from three
distinct sources. These vessels, called the haemorr-
hoidal, are three: the upper, derived from the inferior
mesenteric artery, which supplies the lower intestines
generally; the middle haemorrhoidal, which come
from one of the divisions of the great artery in the
pelvis; and the lower haemorrhoidal, from an artery
that has its course on the pelvis, a bone, forming part
of the bony basin, supporting the contents of the
belly and the pelvis.
318. The veins of the rectum are very tortuous
and numerous, and form between the mucous and the
muscular coats of the gut quite a network of vessels.
The haemorrhoidal veins help to form the inferior
mesenteric vein, which, with the Superior mesenteric
vein, the vein from the spleen (the splenic) and the
gastric vein, compose by their union the great portal
system vein (260) already described as supplying the
liver with that blood, from which the bile is formed.
319. As the blood is supplied to the rectum from
such various sources and in such abundance, the reason
why, in diseased states, blood is discharged from these
SMALL AND LARGE INTESTINES. 115
vessels, is apparent, and also why, in cases of severe CHAP. VIII.
ſº gº & Blood often
constipation, blood often passes at the time of the .
evacuation of the bowels. º
320. The external surface of the rectum has a great
resemblance to the external surface of the gullet. It
is smooth and polished without any elevations and
without the longitudinal depressions, so evident in
the colon; the only marks it presents being parallel,
dependent on the powerful muscular fibres described,
as, in part, forming the gut.
321. To facilitate the action of the rectum in the
reception and the expulsion of the faeces, it is imbed-Rectum im-
ded in fat, a condition specially favourable to the “
objects to be realized, as such a padding, so to de-
scribe it, allows of the distension of the gut and of
its restoration to its original shape and position when
it has expelled its contents.
322. In the rectum the facces accumulate and lose
their thinner parts by absorption. Little doubt can
exist that the faeces are moulded in the colon and in
the rectum, more especially the upper part of the
rectum. This is rendered probable by the form of
the faeces varying in different animals, and these forms
correspond to the intestinal cavities: thus the horse
has very large cavities in the colon, and has corres-
pondingly formed faeces. Add to this the additional
fact, that properly formed faeces were realized in
persons, who, not having the power to have food
passed through the gullet, were fed by nutritive in-
jections into the bowels. When the faeces have
accumulated in sufficient quantity they excite the
rectum to action and a sensation is experienced,
causing a desire for their expulsion. The escape of
the contents is prevented by two muscles which close
Q 2
1}6 PRACTICAL REMAIRIKS.
CHAP. VIII,
Retention
and expul-
sion of con-
tents of the
bowels.
the anus: the eaternal closing muscle or sphincter”
(represented 7, plate 10): the internal closing mus-
cle, or sphincter (plate 10). When the will sub-
mits to the desire to expel the contents of the gut,
several agencies operate in effecting the expulsion.
The muscular fibres of the rectum act: the dia-
phragm acts, the contraction of which is followed by
the inflation of the lungs: the muscles of the wind-
pipe close the epiglottis, (the valve at the top of the
windpipe) and prevent expiration: the abdominal
muscles, which act in opposition to the forcing down
of the diaphragm and compress the bowels and force
them backward and downward: and, last of all, the
two muscles, lifting up the amus (elevators of the
anus) (represented 6, plate 10), press the rectum for-
wards and upwards, and, diminishing the curve of
the rectum, aid in the expulsion. The force, thus
produced, is greater than the resistance of the sphinc-
ters, which close the anus: the anus is dilated and
the contents of the rectum are expelled, in other
words DEFA CATION takes place. -
P R A CT I CA. L. R. E M A. R. I. S.,
g g. The fact, that the small intestine, the jejunum,
is so called because it is generally found jejune or
empty, implies that the other intestines ought to be
found containing their contents, i. e. not empty—
* It is interesting to notice that the intestinal tube commences by a
sphincter muscle, the orbicular muscle of the lips, and it ends with a
Sphincter muscle.
PRACTICAL REMAIRISIS. 117
indeed the intestines ought to have therein matters—
intestines wholly empty would indicate disease rather
than health. In patients dying of Asiatic cholera
the bladder is found empty. This is regarded as a
sign of disease; and so with an empty intestinal tube;
indeed many reasons exist for the belief that the
presence of contents in the bowels is essential to the
intestimal actions connected with life.
h h. As wind is generated in the intestines (286),
and as such generation is dependent upon a diseased
state of the lining membrane of the bowels, the absur-
dity of the opinion, so generally prevalent, of using
medicines to expel mechanically the wind, is apparent.
Since supposing that these medicines do expel the
wind, which is very questionable, if they do not alter
the diseased state, causing the generation of the wind,
they do mischief. The great object should be to
discover a medicine, which will remove the diseased
state itself. Homoeopathy supplies such means. Some
of the fatal cases of diseased stomach, that have come
under my medical treatment, are those of patients,
who have taken during former years large quantities
of ginger and other similar agents to get rid of wind
and pain in the stomach.
i i. As the act of defaecation is one in which the
diaphragm is particularly active, it is certain that
tight lacing must interfere with this act, because im-
peding the free action of the diaphragm, and this
tight lacing must act injuriously by weakening the
abdominal muscles.
CEIAP. VIII.
118 - ON A BSORPTION.
C H A P T E R IX.
On Absorption.—The Peritoneum. The Mesentery.
The Lymphatics. The Lacteals. The Mesenteric
Glands. The Receptacle of Chyle. The Thoracic
Luct. -
CHAP. IX. 323. The organs, contained in the cavity of the
* * abdomen, many of which have been already described,
rated frºm do not lie in direct contact with the fleshy walls of
i. i. “ the belly, which enclose them. They are separated
from these walls by a fine serous membrane of great
extent, and, in appearance, transparent.
324. This membrane being stretched (rerova tetona)
.* about (zip: peri) these organs, is called the perito-
neum. It forms a large bag, of which the internal
surface lies in contact with itself or with the serous
fluid it secretes. The external surface adheres to the
abdominal walls and the whole superficial extent of
the organs contained in the abdominal cavity.
325. Of this peritoneal investment a portion fastens
itself to the spinal column, proceeds forwards and
embraces at its opposite border, by means of a large
outspreading of itself, the whole of the small intes-
PLATE N I.

ON ABSORPTION. 119
times, and thus, being situated in the midst of the CHAP. IX.
abdominal cavity and in the midst of the intestines,
is called mesentery (uegoc mesos middle, and swrepov
enteron, intestine).
326. The mesentery, (plate 11, FFF) being thus Mesentery.
strictly nothing but a portion of the peritoneum,
nothing but a large fold of that membrane, fixed by
a very narrow border to the spinal column, is com- º
posed of two layers, which are united only to a short with an in:
distance from the intestine enclosed. This union * Căl-
ceasing and the layers becoming separated, a space is
formed between these layers, a sort of triangular
channel, which allows the mesentery to dilate itself
freely. -
327. Of this mesentery, the part holding the great
bundle of small intestines (plate 11, EEE,) (this part
being at one end connected with the spine,(plate 11, A)
at the point formed by the lumbar vertebrae and bound
down thereto,) is very broad and much plaited, and,
when viewed as a whole, forms, as Winslow has re-
marked, a kind of spiral roll: this part is more strictly
the mesentery.
328. The peritoneum, which holds the coecum in
its place, is called the meso-coecum; that retaining Meso-coecum.
the colon in its place, is called the meso-Colon; and Meso-colon.
that, retaining the rectum, is called the meso-rectum. Meso-rectum.
329. Between the folds of the mesentery are found
certain glandular bodies of the form of lentils, called
mesenteric glands; also blood vessels, both venous ſº
and arterial. -
330. The nature of these glands and of these ves-
sels is peculiar.
331. The body is sustained by the absorption of
fine fluids. -
120 ON ABSORPTION.
CHAP. IX.
Absorbents
diffused
throughout
all the body.
Lymphatics
and glands.
Lacteals,
chyliferous
vessels.
332. The organs, which take tip these fluids, are
called absorbents.
333. These organs have not any distinct cavity of
the bodily system appropriated to them, but occupy.
all parts of the system.
334. The absorbent system consists of an immense
number of vascular tubes, called lymphatics, and of
little glandular egg-shaped bodies, known under the
name of glands, (plate 11,” 1 1 1, plate 13, 1 2 3).
335. Of these lymphatic vessels, those that arise
from the internal surface of the intestines are called
lacteals or chyle bearing (chyliferous), being charged
with the absorption of chyle as the contents of the
bowels pass along their cavity. As the colour and the
Lacteals.
The lacteals
seem to ela-
borate the
chyle.
consistence of chyle approach to the colour and the
consistence of milk, these receive the name of lacteals.
355 a. It seems further, that, in the act of receiving
the chyle, the chyliferous vessels seem to impress on
the chyle a kind of elaborating or perfecting process,
of which the proof is, that, if the chyliferous fluid is
examined in any part of its course, the qualities pos-
sessed by it in the first ramifications through the mes-
* In this plate (11), the anterior abdominal boun-
dary has been removed to show the surface of the
mesentery and a portion of the Small intestines. A,
represents the spinal column to which the mesentery
is fastened; B B, represent the lungs; C, the great
artery of the body, the aorta, cut away; D, a section
of the diaphragm; E E E E, a bundle of the small
intestines; F, the mesentery. 1 1 1 1, the mesenteric
glands; 22 2, the lymphatic vessels proceeding from
the small intestines to the mesenteric glands; 3, mes-
enteric glands round the aorta; 4, the thoracic duct.
PI, ATE
N II.

ON AIBSORPTION, - 121
entery, are not found in the other parts of the chylifer-
Ous system of vessels. This circumstance presents an
analogy to the action of the roots of plants, which,
in choosing the materials in the earth suited to their
nature, communicate thereto a special elaboration,
which makes of these materials a nutritious matter.
The mesenteric glands seem to have a similar rela-
tion to the chyle in perfecting it: they seem, as it
were, to add the finishing change to the chyle,
so as to make it fit to form part of the animal being:
they complete it.
336. The lymphatic vessels,” which originate from
# In this plate (12) these vessels are exhibited.
A, the liver thrown back; B, the gallbladder; C, the
spleen; D, a part of the mesentery; E E, the kid-
neys; F, the coecum ; G, the descending colon; H, the
sigmoid flexure; I, the rectum ; J, the womb ; K, the
vagina. 1, the inguinal glands; 2, the lymphatic ves-
sels proceeding thence; 3, the external iliac glands;
4, the lymphatic vessels between these glands; 5,
glands on the iliac vein and the inferior vena cava;
6, glands around the crural artery and the aorta;
7, lymphatic vessels proceeding from the womb ;
8 9, lymphatics from the ovary; 10, 11, 12, lymph-
atics; 10, from the liver; 11, from the left kidney;
12, from the spleen; 13, glands at the origin of the
rectum and conveying vessels from the sigmoid flexure;
14, 15, glands of the mesocolon; 16, glands and
lymphatic vessels of the descending colon; 17, glands
and lymphatic vessels of the right extremity of the
transverse colon; 18, the glands at the commence-
ment of the mesentery; 19, glands and lymphatics
of the ascending colon. -
R.
CHAP. IX.
122 - ON ABSORIPTION.
CHAP. IX, other parts of the body, are those to which the name
... • of lymphatics is more strictly appropriated, as they
carry transparent lymph, (plates 12 and 13).
Lymphatics 337. The vessels, having the names of lacteals and
and lacteals tº
are similar lymphatics, are both absorbents, and the two sets of
vessels are exactly correspondent in texture and in
arrangement.
338. Besides the glands and the chyliferous ves-
sels contained between the folds of the mesentery,
there are found between these folds the vessels which
supply the intestines with arterial blood from the
... heart, called mesenteric arteries, and the vessels
veins. which carry the venous blood back to the heart, called
mesenteric veins, (plate 8).
} 339. Besides these vessels and glands the mesentery
Mesenterie is abundantly supplied with nerves-derived from the
In Cl’WCS. intercostal nerves and the par vagum (plate 8).
340. The lacteals or chyliferous vessels have their
place in the coats of the intestines and in the mesen-
tery, being most abundant in the small intestines.
Heister observed a few proceeding from the duode-
num. A few are to be met with in connexion with
the colon and the rectum. *
Lacteals of 341. The chyliferous or lacteal vessels are of two
*** kinds: those, which run from the intestimes to the
mesenteric glands, and those which run from the
- glands to a receiver or receptacle, in which they end,
called the receptacle of the chyle (receptaculum
chyli). This is more visible in some of the lower
animals.
Laeteals very 342. The number of these vessels in man at the
.”" point of their connexion with the intestine is very
great. They form a beautiful network. As they
leave the intestine, they increase in size and become
ON A BSORPTION. 123
fewer in number. They unite together, and, follow- cIIAP. IX.
ing the course of the mesenteric arteries, ramify
themselves throughout and in the mesenteric glands.
343. The mesenteric glands are about a hundred.
Their form is, as already stated, of an irregular len-
ticular shape, and vary in size, the largest being found
near the spinal column, where the mesentery is fixed
to that column.
344. The lacteals have semilunar valves, these *
valves being double and placed opposite to each other.
They prevent the flowing backwards of the chyle.
345. The lacteals themselves may be divided into
three classes. Those of the first class arise from the
villous surface of the intestines, and particularly of
the small intestines, by a great number of roots ex-
tremely fine, like a fine hair, (capilla, a hair,) hence
called capillary. Boerrhave put forth the idea, that
animals have roots within them, which are these cap-
illary vessels, or the villi, which villi, Beclard has
described equally appropriately as the radicles of
animal life. These roots form a beautiful network
between the coats of the intestimes, which network
surrounds almost the whole circumference of the
intestinal canal between the muscular and the ex-
ternal coats. This network of lacteals forms two
planes of ramifications, lying separate between the
folds of the mesentery until they approach the mesen-
teric glands, where they unite.
346. After this union, the lacteals of the second;..."
class present themselves, adopting a different arrange-class,
ment, distributing themselves throughout the whole
extent of the mesentery, having most extraordinary
branchings and unions (anastamoses).
347. The lacteals of the third class are the lacteals. Lacteals of
* the third
F. 2 class.
Mesenteric
glands.
124 ON ABSORPTION.
CHAP. IX.
Thoracic
duct.
Its situation.
which, as they proceed towards the spinal column,
decrease in number but increase in size, and, after
running along the descending aorta to between the
extremities of the small muscle of the diaphragm,
terminate in a kind of cistern, already referred to
under the title of the receptacle of the chyle (plate 13,
fig. 8). .
348. The thoracic duct, (plate 11, fig. 4, plate
13,” fig. 9,) of which the receptacle of the chyle is
the commencement, begins at the front surface of the
second and third lumbar vertebrae, just at the opening
where the aorta penetrates the diaphragm. It passes
into the cavity of the chest between the aorta, which
is at its left side, and the vein, which passes up the
spine, called the vena cava, (plate 8, fig. 6) which vein
is at its right. The course of the duct is vertical and
it is at times twisted. It sometimes divides itself into
many branches, which again re-unite. Its whole
length is seen in plate 13, figs. 889 10.
* In this plate (13) are exhibited: A, the collar
bone cut away; B, the vertebral column or spine;
C, the rump or sacrum bone; D, the bony crest of
the ileum ; E, the artery of the armpit, called the
axillary artery; F, the sub-clavian artery cut asun-
der; G, the external jugular vein cut across. 1, the
lymphatic vessels proceeding from the glands of the
cavity of the pelvis; 2, lymphatic glands; 3, lymph-
atic glands; 4 and 5, glands behind the aorta and
the vena cava; 6 and 7, the thoracic duct; 8, the
receptacle of the chyle; 9, the thoracic duct; 10, the
dilatation and the inclination of the thoracic duct;
11, lymphatic vessels and glands in the spaces be-
tween the ribs.
PLATE
XIII.

ON ABSORPTION. . 125
349. This receptacle of chyle is placed in the cem- CHAP. IX.
tre not only of the mesentery, “ of which the sphere of iº
action is circular, but is, in one sense, in the centre of aole of chyle.
the universal body.” - -
350. The receptacle of the chyle, (plate 14, fig. 8,)
is a kind of membranous bag, composed of very thin
coats, its cavity being divided by fine membranous
divisions. It is chiefly at the lower part of the recep-
tacle that the lacteals are inserted.
351. The thoracic duct is to be regarded as the con- i.".
tinuation of the receptaculum chyli, and is a canal duct.
which receives the chyle from the lacteals and the
lymph from the lymphatics, and conveys them through
the chest to the left subclavian vein.
352. The duct itself is composed of a fine thin
transparent membrane. Throughout its whole extent
are valves, which prevent the reflux of the chyle, and
at its termination in the subclavian vein there are two
semilunar valves, opposite to each other.
353. The relations which these parts bear to each
other in reference to the absorption of the chyle may
be summed up thus. The fungous or villous coat of Papillae, or
the intestines consists of an immense multitude of fineº.
papillae, full of pores. These pores may be regarded"
as little mouths, the papillae being endowed with a
special sensibility to detect the chyle. These mouths
are continually imbibing the nutritive fluid that passes
along the intestinal tube. The particles of chyle
being globular pass with ease into the little mouths
fitted to receive them. These uniting form the cellu-
lar coat of Albinus, which, as the Swedish philosopher
remarks, appears to resemble “ a conglobate gland
thrown into a plane.” -
354. “As soon as the nutritious particles approach,
126 ON A BSORPTION,
CIHAP. IX.
Nutritive
particles
taken up.
Lymph nu-
tritive.
Cod liver oil.
both the internal villous or fungous coat, and the
glandular vascular or nervous coat, receive them joy-
fully and throw open their manifold doors, avenues
and receiving rooms, and hailing them as welcome
guests, transmit them through innumerable channels
and passages into the chambers appointed for them,
that is, into the cellular coat.”
356. The lymph, which is gathered from all parts
of the body, seems to be in many respects nutritive.
The fact that persons who are badly fed, live upon
their own substance, being mourished by themselves,
demonstrates that the lymph is nutritive. These ves-
sels seem to take up all the fat of the body; and it
may happen that the cod liver oil owes its efficacy
to the two circumstances; first, that its oily particles
are easily appropriated by the lymphatics; and, second,
that the infinitesimal quantity of iodine contained in
the oil may, in certain cases of consumption to which
iodine is homoeopathic, act homoeopathically curative.*
357. The lymphatics are very numerous, they are
diffused all over the body and constitute a most
beautiful network.
357 a. Those connected more particularly with the
digestive system and organs in the belly are extremely
well marked, and their position, together with the
position of the thoracic duct, are exhibited in plate 12,
and plate 13.f
* The old-system practitioners, not knowing how to decide in what
sphere of cases of phthisis cod liver oil is curative, give it in all cases, and
cause the death of numerous patients by occupying the time, that, wisely
used, would have led to the restoration of the patient, in administering
the cod liver oil, and, in so administering, neglect the use of the right
IY) ea]] S. -
f The immense number of those and their wonderful arrangement are :
seen in plate 12, and plate 13.
PRACTICAL REMARKS. 127
358. The milky-like fluid, the chyle, a fluid hold- CHAP. IX.
ing the first rank among the fluids taken up by the
absorbent vessels, is the chief source whence the ma-
terials for the reparation of the various parts of the
bodily frame are obtained. It is carried into the blood Chyle carried
through the thoracic duct, this duct having its termi- º
nation at the junction of the internal jugular and
subclavian veins, a course seen in plate 13, where,
below the letter B, the thoracic duct is seen tending
towards the left to its termination. The chyle mixed
with the blood, circulating in these veins, is carried
forthwith to the right side of the heart, is passed
thence through the lungs: thence it, as perfected
blood, is passed through the left side of the heart,
and is carried through the arteries to all parts of the
body; and from it, as converted into blood, all the
different parts of the body are renewed, each class of
secreting vessels, distributed through the body, sepa-
rating and manufacturing from it its special pro-
ducts.
PRACTIC A. L. R. E.M.A. R. K. S.
jj. The facts, that the intestines are supplied with
so great a multitude of blood vessels, that the chyle
has to pass through the mesenteric glands, and that
a healthy state of these glands is essential to effect
the changes in the chyle necessary to its perfection,
show that means should be adopted to keep up a free Why cold
circulation through the vessels of the bowels, and to *ś.
prevent diseased conditions of the glands themselves.
As the application of cold tends to produce conges-
tions in the vessels of the body and congestions in the
128 PRACTICAL REMI.A.R.R.S.
glandular tissues, the injuriousness of letting little
children wear petticoats and clothing that scarcely
reach to the knees is apparent. Mesenteric diseases,
which end in atrophy and death, are thus produced:
and this happens particularly with scrofulous chil-
dren, who are specially liable to diseases of these
glands. Such children are almost certain to suffer
from such diseases, if they have happened to have
had the usual treatment for mesenteric and almost
every other affliction, namely, calomel exhibited: it
is impossible to number the thousands of children
that have been killed by calomel and unclothed
bellies.
Å k. To keep the blood vessels of the abdominal
organs in a healthy state exercise is essential: nothing
will supply the place of exercise, and there is no ex-
ercise equal to walking.
! !. As all the contrivances of the intestinal tube
tend to retain the chyle in the tube until an oppor-
tunity has been afforded to the absorbent vessels to
take it up, how injurious must be the administration
of purgatives, which, by their action, carry rapidly
through the intestimal tube the contents of the tube,
and thus remove the chyle from the action of the
CIIAP. IX.
Walking a
means of
health.
Purgatives
preventing
the absorp-
fion of chyle.
absorbents.
!
GENERAL REMARKS. 129
C HAPT E R X.
Concluding General Remarks on the similarities of the
various parts of the Intestinal Tube, in reference to
structure, fluids, movements, and the powers affecting
the movements. b
359. Such are the various parts of this interesting chap. x.
intestimal tube: the tube contrived for the digestion
of food, so as to provide nourishment for the in-
dividual. -
360. In comparing the various parts of this tube,
more particularly the stomach and the intestimes,
many points of similarity present themselves, showing similarity of
that, though the parts of the tube are distinct in”
functions, there is that unity about the whole, which
constitutes the entire intestinal apparatus as one tube.
361. The number of coats to the stomach and the Coats similar.
intestines is the same; namely, the common perito-
neal coat, the cellular coat, the muscular coat, the
nervous coat, and the internal or villous coat.
362. The arteries supplying the stomach and the **
intestines are the same or continuous.
S
130 GENERAL REMARKS.
CHAP. X. 363. The veins of the stomach and of the intes-
yºn, simi. times have the same direction, namely, towards the
g liver, (321). -
gºint 364. The glands in connexion with the stomach
and the intestines are similar in structure, and tend
to the same central point, the receptacle of the chyle.
ºn 365. Taking all these points of similarity into con-
stomach sideration, the intestines may be viewed, as has been
well stated by the Swedish philosopher so often
quoted, “ A continued, consecutive, or elongated
stomach.”
º; 366. A similarity between the different parts of
the intestinal tube is exhibited not only in the points
enumerated, but also in relation to the fluids sup-
plied to each part in carrying on the process of
digestion.
Fluids 367. All the fluids poured into the intestinal tube,
poured into e tº ę
the intestinal may be regarded as modified salivas. Thus in the
flºº. mouth, the first fluid is that specially called the
saliva, this being limpid and watery in the front part
of the mouth; the second fluid is the mucus of the
palate, that of the pharynx and of the oesophagus,
much thicker in consistence; the third fluid is the
gastric juice of the stomach, potent in its energies;
the fourth embraces two fluids, the more active juice,
the bile, tempered by the milder saliva, the pancre-
atic juice; the fifth fluid is that secreted by the brun-
nerian glands in the duodenum; the sixth fluid is
the mucus poured into the small intestines; the se-
venth fluid is the salivary fluid generated in the
vermiform appendage; the eighth is the fluid poured
into the colon; and the ninth fluid is the mucus,
poured out so abundantly into the rectum. While
each part of the intestinal tube has its special fluid,
GENERAL REMARKS. 131
destined to fill some part in the process of digestion, CHAP. x.
there is an unity of character about these fluids that
mark the oneness of the whole intestinal tube.
368. Another point of view in which the similarity Similarity in
between the various parts of the intestinal tube exhi-”
bits itself, is in relation to the movements con-
nected with the stomach and with the intestines.
369. The wonderful muscular actions of the sto-The move-
mach have been fully detailed 221, 222, 223, 224, ..."
225, 226, 227, 228, 229, 230, 231, 232, 233, 234, -
235, 236, 237. -
370. Not less wonderful are the muscular actions Muscular
connected with the intestines. The intestines have º of
many circular fibres, or segments of circular fibres,”
which contract the intestine, that is, diminish its Alternate
diameter, and longitudinal muscular fibres, which *iºn.
shorten the intestine, and are thus made by the action
of those two sets of fibres alternately to contract and
dilate. When they dilate, they at the same time ex-
tend or lengthen, and when they contract they at the
same time retract or shorten. The actions of the
intestines are always from above downwards.
371. These actions cause the intestines to have a
gyre-like motion, alternate and reciprocal. The mo-Gyrº-like
tion of the intestines being in this gyre, that is, in a“
constant flux and reflux from one surface to the other,
is designated, from its similarity to the motions of a
worm, (vermis,) vermicular.
372. The order of the actions is thus: the stomach Order of the
moves in its gyre from the cardiac to the pyloric"
orifice; the small intestines from the pyloric orifice to
the valve of the colon; and the large intestines from
the valve of the colon to the sphincter, or closing
muscle of the anus; To AND FRO.
s 2
Aºf
132 ~ GENERAL REMAIRRS.
CHAP. X. 373. Important is it to remember that the order of
... ." motion is not the same in the large and in the small
small and the intestines; for “while the duodenum, the jejunum
#." and the ileum are, in their onward career, wreathing
their volumes forwards to the valve of the colon,
the coecum and the colon wreath theirs backwards
to the same point. It thus happens that the small
and the large intestines both meet with their extremi-
ties in the ileo-coecal valve, that is, in the coecum as
a centre: they meet during the expansion (diastole)
of the intestines: they mutually recede from the
valve during the contraction (systole) of the intes-
times.”
Fffect in- 374. The intestines, “ in the exercise of this their
duced on the g ſº e
ºntºniº of gyre, induce on their contents a kind of endeavour or
i."gravitation from their centres to their circumferences,
tion. and next from these circumferences to the centre of
the circle, thus producing a perpetual mingling of
both alimentary and excrementitious materials, by
which actions these materials apply themselves closely
to the openings of the chyliferous canals and pass
through the pores, which there meet and open for
them, to their ultimate destination.
Actions of 375. Not only does the stomach present extraordi-
intestines * * tº º *
jous mary muscular actions, but its actions take place in
.*.*... accordance, i. e., synchronously with the action of
the lungs. The same exists in relation to the actions
of the intestines, which take place synchromously
with the respiratory movements. This is seen in
examining the lower orders of animals. In the snail,
the intestines wind circularly to the apex of the shell,
closely following the spiral windings of the shell,
and after a circumgyration they return to the border,
where they discharge the faeces,
GENERAL REMARICS, - 133
376. “The abdominal muscles expand and con- CHAP. x.
tract the abdomen synchronously with the expansion
and the contraction of the lungs, and communicate
their forces and reciprocations to the peritoneum, and
by it, as well as by means of the diaphragm, to the
stomach and the intestines.”
377. Another point of view in which the similarity similarities.
between the different parts of the intestinal tube be- -
comes apparent, is the existence of distinct demar- ºil.
cations at different parts of the canal. Thus, at the tinct parts of
tº the intestinal
commencement of the tube, namely the mouth, is a j
sphincter or closing muscle; at the mouth and be-
tween it and the pharynx is the valve, the hanging
veil of the palate; at the end of the oesophagus,
there is a valve-like formation at the cardiac orifice in
the stomach; at the ending of the stomach in the
duodenum is the well marked valve, the pyloric; at
the ending of the small intestines is the ileo-coecal
valve; and, at the termination of the intestinal tube,
there is the sphincter or closing muscle.
378. To sum up the whole of these actions in General sum
reference to the carrying on the contents of the intes- of actions.
timal canal through the whole of the tube.
379. The food is taken into the mouth, there to
be cut, torn and ground, to be mixed with the salivary Summary.
fluids, to be acted upon by the tongue: thence it is
passed under the hanging veil of the palate into the
pharynx, there to be mixed with the mucus of the
pharynx, and to be carried by the muscular actions
of the pharynx and of the oesophagus or gullet into
the stomach. In the stomach it is subjected to the
various actions already so fully described, being mixed
with the gastric juice, and being there aided by the
heat and the motions of the stomach, is converted into
134 GENERAL REMARKS.
CHAP. X.
Action of
CO2Cllin.
Action of
colon.
chyme: from the stomach the chyme is passed through
the pylorus into the duodenum, there to be mixed
with the bile and the sweet-bread juice and to be con-
verted into chyle, portions of which are taken up by
the lacteals of the duodenum. The two portions, the
nutritive and the non-nutritive, of the contents of
the duodenum, are expelled by the motions of the duo-
denum into the jejunum. This intestine receives the
materials, rolls them onward, selecting from them the
chyle, the intestine in its motions applying the materi-
als to the innumerable pores, the openings of the
chyliferous vessels. This intestine seems to carry on
its contents with great rapidity, hence, as already
explained, it is generally found empty (jejune). The
ileum receives the materials passed into it from the
jejunum and imbibes the chyloid drainings and juices.
The spiral forms, which this intestine makes in its
motions, are more frequent, and the gyre-like move-
ments are shorter; and from this it may be that the
convolutions of this intestine are specially liable to
become knotted together, constituting the disease
called ileus, also the iliac passion, in which the ver-
micular motion of the intestine is arrested.
380. “The coecum is connected with the ileum above
and with the colon beneath: it is the common hall, the
place of meeting of these two intestines: the goal of the
gyratory course of the small intestines and the starting
point of the outward career of the large intestines.”
381. Every time the ileum expands it forces its ex-
tremity and its contents into this cup-like intestine;
and the colon moving up to meet it, receives and swal-
lows its ejections. The valve of the colon opens and
shuts the door, and also guards against and forcibly
prevents the reflux of materials from the lower into
PRACTICAL REMARKS. 135
the higher intestines. The colon, which, as already chap. x.
noticed, has a greater size and a greater thickness of
coats and strong ligaments, channelling the intestine-
itself into great furrows, has these structures to enable
it to act powerfully on the materials that pass into it,
so as to extract every thing extractible from these
materials, and to be able to propel on the contents to
the rectum. The rectum was noticed as being Sup- Action of
plied with powerful muscles, which enable it to expel.”
the hardened faeces, deprived by this time of all mu-
tritive particles; and these being expelled the sphinc-
ter muscle closes the anal aperture.
PRACTICAL REMARKS.
m m. The history of the process of absorption of the
chyle, the history of the movements of the intestinal
tube, the history of the various valves in the various
parts of the intestinal tube sufficiently demonstrate,
that the contents of the intestinal tube should pass
slowly and regularly through the tube itself. Any
rapidity of transit of these contents must of necessity Injury from
prevent the absorption of the chyle, must produce”
irregularity in the movements of the tube itself,
must prevent a proper admixture with the various
juices that are poured into the tube, and must, as
inducing all these deviations, cause irritation of the
tube itself, and thus affect the general system, and,
by consequence, the health. As purgatives produce
this rapidity of transit, their injuriousness is apparent.
mn. The peculiar double gyre-like motions of the two
principal portions of the intestinal canal, that from
136 PRACTICAL REMARKS.
CHAP. X.
Purging a
cause of
death.
Tenderness
in intestinal
disease.
the stomach to the coecum being forwards and on-
wards from the stomach towards the coecum, and that
from the coecum to the rectum being backwards from
the rectum to the valve of the colon, gyres realizing
the forcing of the contents of the ileum (where this
intestine expands into the coecum,) on to the colon,
which by the action, connected with the gyre moving
in the opposite direction, moves up to meet the ileum
and receives and swallows the contents of the ileum,
(381) show how likely it is that purgatives must do
injury, as causing by their irritation this harmonizing
action to take place irregularly, and thus cause
diseased states. Cases are recorded where plum stones
and other bodies have been found in the cavity of the
vermiform appendage, and also in ulcerated portions
of the rectum. Little doubt exists that these bodies
have been prevented passing by the irregular action,
induced by the irritation produced by purgatives, and
not having been passed they have been forced into
the vermiform appendage, or being detained have pro-
duced ulceration in the coecum and have been lodged
in the ulcerated parts.
o o. These facts and these views, connected with the
motion of the intestines in carrying on their contents,
sufficiently explain the reason, why, in diseases of
the intestimes attended with inflammation, such pecu-
liar sensations and often such excessive pain and ten-
derness are present. How painful it is to press
against any body a sore finger, or any sore part; and
how severe must be the pain, produced in an inflamed
intestine continually in motion as the intestines are,
and grasping as they do the intestinal contents in
passing them forward. How painful must be the
condition induced at the coecum, supposing, as not
PRACTICAL REMARKS. 137
unfrequently happens, that the ileo-coecal valve is CHAP. x.
diseased, and when the peculiar action of the ileum
moving onwards to meet the colon, the colon moving
backwards, (thus allowing the colon to grasp the
contents,) what must be the pain as these contents are
passed through an inflamed aperture? And further, as
every diseased state produces a modification of the
nervous system, how easily appreciable is the fact of
the variety of sensations, connected with the various
diseased conditions of the intestinal tube.
p p. The dependence of the efficiency of the
changes which take place in the intestinal tube, upon
the circumstance of the free action of the intestinal
tube in reference to the vermicular movements already
described, clearly establishes the necessity of allowing
no mechanical interference with the movements of
the tube contained in the intestinal cavity. Hence
the injuriousness of bandaging the bowels, either by Tight trow-
trowsers or tight stays or abdominal belts. Hence"
the cruelty to the horse of making the belt under his
belly tight, as it is when the weight of his body in
part is made to counter-balance the badly arranged
weight in the vehicle the horse has to draw. Hence
the injuries that are likely to result from the tying
handkerchiefs tightly round the belly: a practice too
Common among boys at School.
NOTICE TO READER.
# ========º
[This history of the process of Digestion and of the
various circumstances connected with it, will, it is
hoped, be mastered in its details by the reader before
proceeding to the examination of the second part of
this work. The understanding thereof forms the
basis on which the views contained in the second part
are builded; and the basis being understood, the
superstructure, raised on that basis, will obtain a fixity
of tenure, which no sophistry will be able to loosen,
and will enable him, who has gained the knowledge
thus conveyed, to adhere to a course of treatment for
Constipation which will be sure to reward him with
its cure, and by consequence with a freedom from
disease.]
PART II.
CONSTIT’ATION AND IT'S VARIETIES. 141
O H. A. P. T. E. R. X. I.
Constipation and its varieties. Costiveness. Confined
bowels. Irregular action of the bowels. Delayed
and imperfect action of the bowels. Strangulated
hernia. Intussusception of the bowels. Constipa-
tion, as to its cause. Constitutional diseased state.
Evidences of this as the cause of Constipation. Con-
ditions inducing this diseased state.
382. It may be regarded as the rule, THAT THE CHAP. xi.
INTESTINAL DIGESTIVE MACHINE COMPLETES ITS RE-
voluTION once IN twenty-four Hours. Expressed in Twenty-four
other words, the food, taken into the digestive tube, **
is, in that period of time, carried on through the whole."
tube, undergoing, in its carriage onwards, the changes
necessary to render the food supportive of life. In
the course of the gyre-like motion, by which the food
is carried through the described extent, all the
changes, required to impart nutritiveness to those
portions of the food, destined for nutrition (those
portions being absorbed) are effected, while the non-
nutritive portions, destined for expulsion, are moulded
into a mass, which is rendered of such a consistence
142 CONSTIPATION AND ITS WARIETIES.
CHAP. XI.
Deviations
dependent
on a consti-
tutional dis-
eased state.
Costiveness.
Confined
bowels.
by the fluids, poured into the bowels, aided by the
various agencies in connexion with the intestines,
that its expulsion is attended with a sensation of
relief.
383. Any deviation from the rule stated, where such
deviation occurs primarily, (that is, unassociated with
acute disease,) being attended with inconveniences,
modifying the state of health, may be regarded as re-
sulting from a constitutional diseased state, affecting
the intestinal tube. The deviations from the normal
or regular state are various, and have distinctive
characteristics.
384. Deviation first. The most common deviation
is that, in which the action of the bowels takes place
once in twenty-four hours, but the results of the
action are hard and cause pain. This condition, called
COSTIVEN ESS,
presents two varieties; one, in which the actions are
hard, cause pain, and are large; another, in which
the actions are hard, cause pain, and are small.
385. Deviation second. The deviation, next in com-
monness, is that, in which the bowels do not act
more than once in forty-eight or seventy-two hours
or even more. This condition may be designated
CONFIN ED BOWELS.
386. T)eviation third. A deviation, not at all un-
frequent, is that, in which the bowels act, at first,
with difficulty, the actions being confined and cos-
tive, but subsequently, act relaxed, the confined and
costive state preponderating. This deviation may be
designated as -
IR. R. E. G. U L A R A CTION OF T H E B O WIELS,
CONSTIPATION AND ITS WARIETIES. 143
387. Deviation fourth. Another deviation is that, CHAP. XI.
in which the bowels act daily, but require a great
length of time to complete the action. This condition
of the action of the bowels, designated
DELAYED AND IMPERFECT ACTION of THE BowFLs, º
- action of
presents two forms: one, in which the patient con-bowels.
tinues to expel only small portions during a length-
ened period, extending sometimes to half an hour;
another, in which the action is soon completed, but a
want to relieve is felt for some time after.
388. Deviation fifth. Another deviation is that in
which the bowels present no action for a week or
nearly as long, and, in some cases, longer. This
condition, designable as
INACTION OF THE BOWELS, ºn ºf
embraces two varieties; one, in which there is a total
absence of want* to relieve the bowels; another, in
* This condition is, in many cases, not indicative of disease: many
persons, apparently in perfect health, have no action of the bowels for a
week. Dr Edward Johnson remarks:—“Every medical man of any con-
siderable practice knows that there are many persons whose habit it is to
have their bowels relieved once a week. A few years ago these cases
were very numerous indeed, and they are only less so now because the
public mind has been so impressed by medical men with the importance
of having the bowels emptied every day, that most persons, rather than
suffer their bowels to be confined, will take medicine every day. Still
these cases are even now sufficiently numerous to prove my point. Some
years ago I had a patient at Stepney Green, a lady, whose habit it was,
from childhood, to have the bowels relieved once a fortnight; and if they
were emptied oftener she felt weak and exhausted. Only last year, I had
at my house a clergyman, whose habit it was to have his bowels relieved,
and that very scantily, only once in three weeks. And I have met with
multitudes of persons, whose bowels were only relieved once in the week,
wntil they were told, on their first application to a medical man, that it
was very dangerous to suffer this to be the case. Or perhaps they were
told that this constipated condition of the bowels was the cause of the
144 CONSTIPATION AND ITS WARIETIES.
CHAP. XI. which there is a want to relieve, felt frequently, but
attended with no result.
389. All these states are manifestative, in a greater
or a less degree, of a want of eapulsive power in the
7'éCú/772.
390. It appears, that, in a majority of individuals,
affected with any of these deviations, the contents
of the bowels are carried forward efficiently until
reaching the sigmoid flexure of the colon. When
they have passed through this portion of the intesti-
º nal tube and have gradually entered the rectum, the
recium," rectum is, by the approach of its appropriate stimu-
lus, i. e., the intestinal content, stimulated to contract,
and, in its contraction, grasping the content, expels
it. In the case, however, where the bowels do not
act or act imperfectly, this inaction being connected
with and dependent on the diseased constitutional
state affecting specially the gut, the stimulus from
the intestinal content is not sufficient to cause the
expulsive effort to be effective, or if effective, great
difficulty attends thereupon.
391. Some cases of constipation, or more correctly
of non-expulsion of the contents of the bowels, are
dependent upon mechanical obstruction; i. e., the
intestine becomes entangled, and its bore becomes
obliterated by a stricture obliterating the bore of the
intestine. In some cases the stricture is formed of
the part through which the intestine has passed, such
* entanglement being designated strangulated hernia.
Other cases present the mechanical obstruction in the
condition, wherein one portion of the intestine passes
malady for which they consulted him; and that if they would get rid of
that malady and avoid it in future, they must keep their bowels daily
open.”—Results of IIydropathy, p. 118, by EDWARD JOHNSON, M.D.
CONSTIPATION AND ITS WARIETIES. 145
into another portion, the intestine being in this case char. xi.
said to be intussuscepted. Other cases present the .
mechanical obstruction in the condition, where the of the .
intestine becomes obliterated by the thickening of the *
intestinal coats, or by the formation of a transverse
band, causing a stricture. Other cases present the
mechanical obstruction in the condition wherein the
enlargement of surrounding organs, as, in some cases,
of enlarged and hardened womb, causes a pressure
on the gut.-See appendix.
392. In all these cases the bowels cannot act or
can act only imperfectly, because a mechanical ob-
struction impedes. Such constipation is not the con-
stipation here treated of. The constipation here con- **
sidered is one, not dependent on mechanical causes; treated of
it is a constipation, dependent upon a modification of
the vital powers, associated with the carrying forward
movements of the intestinal canal.
393. Constipation, taking the term as embracing
all the various deviations noticed, (the mechanically
caused constipations excepted,) is dependent on a
constitutional diseased state, affecting either the whole
or special parts of the intestinal tube.
394. For such constipation the only cure consists,
not, as is virtually held by the majority of practiti-
oners, in the mere removal of the accumulated con-
tents, such accumulation being only a consequence, Cure of con-
an effect; but in the removal of the constitutional sººn
diseased condition, the cause; the removal of which "..."
of the con-
will invariably effect a cure of the result of that con-..."
stitutional diseased state, the constipation. State.
395. In presenting these views and making these
statements it is not denied that constipation may be
relieved, i. e., its manifestation may be made tempo-
U
146 CONSTIPATION AND ITS CA USE.
CHAP. XI.
rarily to cease by purgatives so called; but it is pro-
mulgated, that cure can be effected only by the
removal of the diseased constitutional state.
396. This dependence of constipation on a diseased
constitutional state is demonstrable by many facts.
397. Fact first. In the Medico-Chirurgical Trans-
actions (vol.xxv.) is an essay by Mr Curling, in which
ºceration of twelve cases of ulceration of the duodenum, (249)
the duode-
Illl Ill.
Diseases
cured before
the constipa-
tion ceases.
subsequent to BURNs, are recorded. It is certain that
the burn could not have directly thus affected the
duodenum, i. e., could not by direct action have
locally produced the injury at the part. How then
did the ulceration take place : A constitutional dis-
eased state was excited by the burn; and a transfer
of this constitutional diseased state, induced in the
skin by the burn, must have taken place, and thus
the lining membrane of the intestimal tube became
affected.
398. What took place in these cases of burns may
take place under other agencies, and a constitutional
diseased state may be developed, having in its mani-
festation, not ulceration as in the cases of the persons
burned, but a condition of the intestinal tube, non-
exhibitive of the usual regularity of action in con-
nexion with that tube.
399. Evidences of the existence of this constitutional
diseased state as causing constipation are found in the
facts, recorded in a subsequent chapter, where the con-
stitutional diseased state, as causing the constipation,
is exhibited in process of cure before the constipation
has ceased, though when that constitutional diseased
state is cured, the constipation invariably ceases,
although no means, except those acting on the con-
stitutional diseased state, have been used.
CONSTIPATION AND ITS CAUSE. 147
400. As illustrative of the dependence of consti- CHAP. XI.
pation on constitutional diseased states, the following
established fact has an interest. Let a person, liable
to headache and who does not take homoeopathic
medicines, be constipated for three days, and a head-
ache is the invariable result. Let the same person
be placed under homoeopathic treatment, that treat- º:
revented by
ment, not having reference chiefly to the constipation taking home-
2 5 opathic medi-
but primarily to the constitutional diseased state, ofcines though
e g * g * ſº tº the bowels
which the constipation is simply a manifestation, and jor
it will happen, though his bowels remain inactive for **
a period longer than three days, he will have no head-
ache,” the reason being that the medicines, though
not to that time effective in removing the constipation,
have been effectively acting on the constitutional
diseased state, and thus prevent the occurrence of the
* This fact (for it is a fact,) ought to teach those
imperfect homoeopathic practitioners, who begin their
treatment with patients, who have been in the habit,
before coming under homoeopathic treatment, to take
purgative medicine, by the administration of, as they
say, merely a little castor oil, to pause ere they persist
in a practice, which does injury to the homoeopathic
cause, as implying, which is not a true implication,
that homoeopathy is by its means incapable of meeting
this difficulty. Such procedure by such practitioners
is the more painful, because the necessity of it results
from an ignorance of the appropriate homoeopathic
remedies, and in justifying themselves they attach to
homoeopathy a degree of impotence, which impotency
is not in homoeopathy but in their ignorance of
homoeopathy. - -
U 2
148 CONSTIPATION AND ITS CAUSE.
inconvenient result, namely, the headache, usually
attendant on the constipation. -
401. These views will meet a common question,
frequently put by persons coming for the first time
under homoeopathic treatment, “Suppose the bowels
do not act for three or four days, as I hitherto never
have had an action without purgatives, and not
having an action am sure to have headache, what
shall I do for the headache 7” The answer is to be
found in the fact, already referred to and established
now beyond doubt by a lengthened experience, that,
though the bowels do not act for a week, there is no
headache. This absence of headache, as stated, proves
that the medicine is curing the constitutional diseased
state, and consequently the headache, which, like the
constipation, was one of the manifestations of that state,
does not occur, although the constipation is present.
402. Most are aware of the fact, that constipation
is a symptom, present in the greater number of dis-
eased states: that is, the special diseased state affect-
ing the constitution shows, as one of the evidences of
its so affecting the constitution, an inactive state of
the bowels; and it is not a matter of wonder that the
routine practitioner, whose want of a well grounded
general education has allowed his mind to remain in
that illogical state, which causes him to mistake a
coincident for a causant condition, should devote his
chief attention* to the removal of the constipation.
CHAP. XI.
Constipation
present in
many dis-
eased states.
* It is not a matter of wonder that medical coroners, such as the
medical coroner for Middlesex, should, when holding inquests, got up by
partizans of allopathy, turn lecturer on purgatives, and declare that the
first thing in every diseased state is “to clear out the bowels.” Such ex-
hibitions of untrained thinking are to be lamented, especially by those
so fond of tauntingly charging homoeopathists with treating symptoms,
CONSTIPATION AND ITS CATUSE. 149
403. Another fact, illustrative of the dependence cIIAp. xi.
of the constipation on a constitutional diseased state,
is presented by Mr Haden in his valuable work on Mr Haden's
Colchicum. He relates what appeared to him as very fºot
extraordinary, that, all the curative* effects of Colchi-"
cum are gained without the bowels being acted upon ;
i. e., the constitutional diseased state was removed
without a previous activity of the bowels.
404. Constipation, it would appear, occurs princi- º
pally in the large intestines, more especially at the cipally the
coecum, at the sigmoid flexure, and in the rectum. hºnºr
The rectum seems to be less a receptacle of the faeces
than a conveyer of the faeces. In the majority of
cases, when the faeces enter the rectum from the last
portion of the sigmoid flexure, the rectum at once
contracts, carries forwards or draws forth from the last
portion of the sigmoid flexure the feculent portion,
and carries it on to expulsion. In numerous cases of
constipation, the rectum has lost its power and that
power is very great, of grasping the intestinal con-
tents, and the cure of constipation is not, as the old
system, practice would indicate, to irritate the whole
intestinal tube from the mouth to the anus by an
irritant poison, called a purgative, but to select the
of which treating of symptoms the practice of trying to remove consti-
pation by purgatives followed by the vituperators of homoeopathy is
an apposite illustration. In pointing out the mote, which they con-
ceitedly suppose they see in their brother's eye, they discover not the
beam in their own eye. -
* The amount of curative power connected with Colchicum Mr Haden
considers to be great. He considers Colchicum, in the form of powder,
“to be a remedy of great efficacy in controlling the action of the heart
and arteries, and therefore as a substitute for the lancet in the treatment
of inflammatory diseases and of those acute and chronic complaints,
which are designated diseases of excitement.”—Practical Observations on
the Colchicum Autumnale, by Charles Thomas Haden, 1820. Preface, p. 5.
150 CONSTIPATION AND ITS CAUSE.
CHAP. XI. remedy suited to the general constitutional diseased
condition, and thus restore to the rectum its grasping
power on the intestinal content. -
405. It is imagined by many that the hardness of
the faeces is the cause of the bowels being inactive.
This is not so. The faeces ought to acquire a certain
solidity before expulsion. Indeed the feces have or
ought to have lost nearly the whole of their fluid
portions before reaching the rectum. The proof of
ºrm this is found in the fact, that the forms in which the
shape in the faces in different animals are moulded before expul-
intestinal e e tº * ~ * tº -
cavity. sion are so various: thus exhibiting that they have
passed through certain moulding cavities in the intes-
tinal canal, their form representing the interior forms
not more of the rectum than of the other intestines.*
Even the partially relaxed actions of the cow show
the moulding into form, which the intestines exercise
on the intestinal contents.
406. Want of grasping expulsive power of the
Form of..., rectum is a chief condition associated with constipa-
faeces caused .. te tº e ©
by a stricture tion, and that want is dependent for its manifestation
not a proof e gº G
tº on a general constitutional diseased state.
t l tº tº e
j." 407. Many causes may act in producing this state,
* The fact is put forth in support of the view,
that the rectum is the chief agent in moulding the
intestinal contents, that, in cases of stricture of the
rectum, the shape of the expelled contents is modified
according to the form of the stricture. But this does
not prove that the rectum is the only intestine that
moulds the feces: it proves that if the moulded
faeces have to pass through a part, of which the
natural formation is altered, such alteration will
modify the shape of a soft body passing through it.
CONSTIPATION AND ITS CA USE. 151
which seems to depend on an exhaustion or suspension CHAP, XI.
of the nervous power of the rectum, a kind of palsy
of the muscular fibres of the gut itself.
408. That constipation is to be regarded as a
manifestation of general constitutional disease is evi-
denced, as has been already pointed out, in the
acknowledged fact, that constipation is a symptom Constipation
© g e & tº a symptom in
of a majority of diseased states, especially in the first a majority of
stage of their progress. But the evidence from this º
fact is strengthened by the additional evidence de-
rivable from another fact, that, if the diseased state
is not cured, then the state opposite to constipation,
diarrhoea, is exhibited: in other words, the diseased
state proceeding in its action, causes another develop-
ment of itself, the diarrhoea. This fact has a consi-
derable importance, inasmuch as it shows that the
constipation itself cannot be regarded as the diseased
state, or as the cause of the symptoms: for how could
the diarrhoea be produced, the other symptoms remain-
ing apparently the same, were the constipation itself
the diseased state
409. ConstLPATION IS NOT A PRIMARY DISEASE.
410. Constipation is the absence of action in a given tºº,
way; and that absence of action is caused by a special action.
constitutional diseased state, which suspends the har-
monizing actions of the various parts of the human
frame, of which suspension the constipation is one
manifestation. The homoeopathist recognizes this,
and treats the constipation not as, per se, a disease,
but as a part of a whole, and thus, in so treating the
constipation, refutes the taunt, made against homoeo-
pathic practitioners, that they treat symptoms only;
a taunt, coming with a bad grace from those, who,
in allopathically treating constipation by purgatives,
152 CONSTIPATION AND ITS CAUSE.
chap. xi. demonstrate (it is worthy of repetition,) that they
themselves are guilty of that with which they charge
others, namely, treating symptoms only; for what
else is the treatment of constipation by exhibiting a
purgative 7 --
411. An eyidence of the view, that constipation is
a result of a constitutionally diseased state and not a
primary disease, is found in the fact, that constipa-
tion is so frequently produced by medicines which
create a constitutional diseased state. Thus what is a
Frequent em- cause of constipation more frequent than the employ-
º ment of purgatives, i. e., medicinal means used for
cause of con- e g e ©
.." the purpose of curing constipation ? It is a fact, re-
cognized upon the least consideration, that all pur-
gatives act by unusually stimulating (to take the least
injurious view of their action,) the intestinal tube.
This unusual stimulation is, like all unusual stimula-
tion, followed by a deficiency of power of action,
and this deficiency of power of action being a state
induced by the purgatives, must be attended with the
induction of an alteration in the natural condition of
the intestinal tube; and this alteration, itself a dis-
eased condition, manifests itself in the very constipa-
tion for the removal of which the purgatives were
given. - -
412. Even in those cases where purgatives, allo-
pathically administered, have removed constipation,
such removal has not been effected by the action of
the purgatives as purgatives, but by the action of the
purgatives being in homoeopathic relationship to the
diseased states on which the constipation is depend-
ent; and all the cures could have been effected with-
out the injuries produced by the purgative actions of
the medicines given. -
CONSTIB ATION AND ITS CATUSE. 153
413. Another evidence, that constipation is merely CHAP. XI.
a manifestation of a general constitutional diseased
state, is found in the view put forth first by Mr Aber-
nethy, that the secretions of the bowels cause or create
the faces.
414. Mr Abernethy remarks, “Indeed I think it tºº.
probable that the profuse discharges which sometimes
follow the continued exhibition of purgatives, consist
of morbid secretions from the bowels themselves,
and not of the residue of alimentary matter detained
in those organs. Mr Abernethy further relates as
illustrative, a case of a child born fat and healthy,
but which having the oesophagus impervious no food
could pass into the stomach. The child lived for º º, is
thirteen days and died of starvation, its skin hanging of starvation.
like a loose garment which could be folded and lap-
ped over its limbs. Yet notwithstanding the child
took no food, it passed at first the usual evacuation
from the bowels, and, during eight days, one or two
alvine evacuations, in quantity, colour, and consistence
not distinguishable from the stools of children who
take food in the usual manner.” After the eighth day
the discharges, per anum, became more scanty and
less frequent, but they continued to the last.”—On the
Constitutional Origin and Treatment of Local Diseases,
p. 35 and 36. Ninth edition, 1827.
415. If this view of Mr Abernethy be correct, it
is not asserted that it is, the absence of secretions,
* I am attending at the present moment, Feb. 1854, a lady who has no
passage for food through her gullet. She is nourished by injections into
the rectum. I was not consulted till the gullet was impervious, at which
time she was rapidly sinking because the injections were rejected almost
as soon as injected. Homoeopathic treatment succeeded so far as to en-
able her to retain the food injected and perfect faeces are formed in the
rectum.
X.
154 CONSTIPATION AND ITS CATUSE.
CHAP. XI.
which secretions when present manifest themselves
in an alvine evacuation, must depend upon the exist-
ence of a general constitutional diseased state, pre-
venting the development of these secretions.
416. This view of the dependence of the faeces on
the secretions of the bowels has been presented lately
Dr Johnson's under another form by Dr Edward Johnson. He
view, that
feces are se- does not refer to the idea of Mr Abernethy, published
cretions from
i. i.e.” nearly thirty years since, though this idea would
afford the foundation for the amplified ideas, which
Dr Edward Johnson puts forth, namely, that mone of
the food taken is ejected from the body, but that all is
absorbed, all is consumed, and that the faeces are
really the intestinal secretions, moulded into a
mass and expelled.
417. Dr Edward Johnson further maintains, that,
when the bowels do not act, it is because no secretions
are manufactured in the bowels; that is, in reality,
there is, in constipation, a general constitutional
diseased state, which causes the constipation, i.e., the
non-secretion* of the secretions, which, secreted and
moulded, constitute the faeces. The views both of
Mr Abernethy and of Dr Johnson have an interest
as showing that both have recognized, unwittingly
perhaps, that constipation, i. e., the absence of faeces,
depends on a constitutional diseased state.
* This view of Dr Edward Johnson, if correct,
exhibits strikingly the absurdity of administering
purgative medicines, since all these purgatives can
do is to cause not the cure of the general constitutional
diseased state, causing the constipation, but simply
the development of unnatural secretions, produced by
the irritation of the lining membrane of the bowels.
CONSTIPATION AND ITS CAUSE. 155
418. A consideration of some of the causes that CIIAP. XI.
operate in producing a want of expulsive power of
the rectum, will still further illustrate the existence
of a general constitutional diseased state as the cause
of constipation.
419. A not unfrequent cause of constipation, cur- º
vature of the spine, shows the connexion of consti-cause ºf con-
pation with a constitutional diseased state, curvature”
of the spine being, in the majority of instances, a
manifestation of a general constitutional diseased state.
As a condition resulting from such a state, it itself acts
specially as second in succession, in causing a consti-
tutional diseased state which produces its results. It
is likely that the curvature produces pressure on the
spinal nerves, and modifies also the nervous communi-
cations with parts of the great sympathetic system of
nerves, and, thus causing an imperfect supply of ner-
vous power to the rectum, produces the constipation.
420. To Dr Edward Harrison* the world is in- Dr Harrison's
debted for the establishment of the immense amount of: º
disturbance of bodily functions, produced by curvature ºr.
of the spine. He thus writes, “A curvature in the"
dorsal or back vertebrae, whether protuberant or
lateral, generally displaces the liver and deranges its
* It is interesting as illustrating the law of progress, that Sir Benjamin
Brodie, who was the most violent opponent of the views of Dr Harrison,
and who, despising the mild but efficient, because scientific means, that
Dr Harrison employed for the cure of spinal curvatures, used the most
violent agents, namely, issues, setons, blisters, &c. &c., has now, at the
end of a practice of upwards of thirty years, been obliged to acknowledge
that such practice was unwise, unsuited, and injurious. This recognition
of his crºor is honourable; it would have been still more to the credit of
Sir Benjamin, if he had added to this recognition of his error the amende
honorable to Dr Harrison, whom he designated, for advocating what
Sir Benjamin Brodie has now acknowledged as true, a quack, &c.
x 2
156 CONSTIPATION AND ITS CAUSE.
CHAP. XI. Secretions. The biliary secretion is defective in
quantity and pale coloured, the countenance assumes
a sallow hue, the appetite fails and the food is not
properly digested. The abdomen is tumid and pain-
ful, the bowels are obstimately constipated, and hoemorr-
hoids often prevail to a great extent.”
i.º 421. As a proof of the dependence of constipation
between con- on curvature of the spine, the fact has been estab-
tº..."lished by the practice of Dr Harrison, that the bowels
** become quite regular as the curative treatment of the
spinal curve proceeds. It is found, that, as the
patient's spine begins to be curatively acted on, and
the pressure on the spinal nerves, caused by the curve,
is in process of removal, the actions of the body take
place with regularity; a fact, demonstrating the ab-
surdity of attempting to remove the constipational
state by purgatives.
§º. 422. In the Harrison Spinal Institution, the fact is
tution. presented, that patients, who, before they came under
the treatment there adopted, never could have an
action of the bowels except by the aid of the most
powerful purgatives, have their bowels act every day
after they have been a few weeks in the Institution,
in that time gaining in part the removal of the di-
seased state causing the constipation.
423. An evidence of the dependence of constipa-
tion on a general constitutional diseased state is
afforded in the fact of the occurrence of constipation
in the last two months or the last month of pregnancy.
Many imagine that the constipation, then and thus
* For a clear and an interesting description of the treatment, devised
by Dr Harrison, the reader is referred to a work, entitled Spinal Curvature,
its Theory and its Cure, by George N. Epps, Surgeon to Harrison's
Spinal Institution. Piper and Co., Paternoster Row.
CONSTIPATION AND ITS CAUSE. 157
developed, is dependent upon a mechanical cause, CHAP. XI.
namely, the pressure connected with the enlarged
state of the womb. This mechanical effect cannot be
considered as the primary cause of the constipation, Constipation
since all pregnant women are not constipated. The *...*
real cause seems to be that the action connected with
pregnancy suspends to a certain extent the power of
the rectum, i.e., in individuals not healthy. It pro-
sduces a development of a diseased constitutional state,
of which the inaction of the bowels is an indication.
It is not denied that the constitutional diseased state
being present, the mechanical pressure, exercised to
a certain extent on the parts within the pelvic basin
and on the rectum, as one part of the pelvic contents,
may add its effects to constitutional effects developed
under the pregnant state in persons unhealthy. The
production of constipation as a manifestation of con-
stitutional diseased state developed by pregnancy,
is no more to be disputed than is the existence of this
constitutional diseased state as exhibited in the pecu-
liar diseased appetites, prevalent in unhealthy women
during pregnancy.
424. The dependence of constipation in pregnancy
upon a general constitutional diseased state exhibits *
the cause of the injuriousness of the practice of ad- Injuriousness
ministering purgatives, Castor oil in particular, in preg- tºº.
nancy, since this exhibition of purgatives does nothing sº preg-
to remove the state on which the constipation depends,
but not unfrequently injures the mother or the child,
or both, and sometimes causes premature delivery,
and even in some cases death.-See a case in appendix.
425. A kind of paralysis of the muscular fibres of
the rectum as causing constipation, is induced by
many causes, these causes operating in exhausting
158 CONSTIPATION AND ITS CAUSE.
CHAP. XI.
Cause of in-
activity of
the muscular
fibres of the
rect unI.
or suspending the nervous power imparted to the
rectum.
426. One cause, not unfrequently productive of
this state of the rectum, and one not generally recog-
nized, is connected with the genital system. The
nerves, which supply the genital organs, are intimately
connected with the nerves which supply the rectum
and the sigmoid flexure of the colon: the blood ves-
sels, which supply the rectum with blood, have an
intimate relationship with the vessels which supply
the genital organs. The nerves, supplying the mus-
cles of the rectum and of the part, the perinaeum,
between the gut and the genital organs, have a con-
stant community of action. It is hence easy to com-
prehend how the over-excitement of the genital organs
by sexual or other excess, produces, by exhausting
the nervous energy,” a loss of expulsive power in the
muscles of the rectum, thus causing the rectum not
readily to respond to the stimulus of the faecal matter.
Accumulations are thus caused in the rectum and
constipation is manifested. -
427. In some cases the paralysed condition extended
so far as to affect the closing or sphincter muscle of
the gut. Then the faeces escape.
428. It is a fact well known, that, in old people,
constipation is a condition, very frequently present.
Old age is attended with a diminution of the vital
power, and among the parts, one, that manifests this
diminution, is the rectum.
Aged persons
subject to
constipation.
* It is not uncommon to find the bowels become inactive after mar-
riage. F. H., 1638, 1852. On the other hand, it is not at all uncommon
to find the bowels, which, in continent males about forty, have been in-
active before marriage become more active after marriage. Mr P., 457,
country book.
CONSTIEPATION AND ITS CATO SE. 159
429. In the case of constipation, resulting from the CHAP. xi.
exhausted contractile power of the gut, it is certain,
that the only means of cure must be the removal of
the diseased constitutional condition, and that the com-
mon method of rousing the gut to action by irritating
purges is as vulgar as it is barbarous, as futile as it is
cruel: a practice, however, almost universally followed
by allopathic practitioners, and defended by them as a
part of scientific, of rational medicine.
160 PURGATIVES UNSCIENTIFIC.
C HAPT E R XII.
On the unscientific character of the method of attempt.
ing to relieve constipation by purgatives.
chap. xii. 430. If constipation depends upon a constitutional
diseased state, and is, as such, merely a result, a mani-
Remºval of festation of such diseased state, the attempt to remove
constipation . ge g tº
by purgatives it by means which force an opposite state, this state,
* thus induced, having no recognized scientific relation-
ship to the diseased state, causative of the constipation,
is destitute of all scientific character, and, by conse-
quence, of all certainty of result.
ºrian 431. This want of certainty is exhibited in the well-
* known fact of the almost total inefficiency of purga-
& tives for the cure of constipation.
iſſion 432. The practice is not only inefficient but is pro-
ductive of much suffering, and, in many cases, of
irremediable injury.
Empirical, 433. It is a practice essentially empirical. It is a prac-
tice, in pursuing which, the medical practitioner takes
a stand no higher than that taken by the most illiterate
pill vendor: in fact, in so practising medicine, the
PljRGATIVES UNSCIENTIFIC. 161
medical man gives a basis on which the former can cIIAp. xii.
and does build his pretentious appeal to the public:
his plea being the necessity for the sake of health to
Żmake the bowels act.
434. The attempted removal of constipation by pur- º
gatives is empiricism. The practice wants the basis of founded on no
all science, a law. It treats an effect, and neglects the law.
cause. To meet a symptom by its opposite is a mode
of medical practice extremely easy, and being easy,
the fact, that this mode is adopted by the majority of
medical practitioners, admits of a ready explanation.
Scientific practice requires industry and skill: ad-
ministration of purgatives practice requires not much
of either. To cure constipation requires a knowledge;
first, of the special general diseased state, on and in
which the constipation in each given case rests;
Second, of the special medicine suited to the special
diseased state, constipation being one manifestation of
that special diseased state; and third, of the law
regulating the action of the medicine in relation to
the diseased state. To gain and to apply all this know-
ledge imply labour and skill. The mental labour, º,
necessary in order to gain an accurate knowledge of homoeopathic.
the pure effects of medicines, i. e., their pathogenetic ally.
effects, so as to realize the medical picture of symp-
toms each mcdicine is capable of producing, is by no
means little. Labour and accurate observation so as to
gather together all the phenomena of the diseased
state, presented in the picture of symptoms of the
disease, are necessary; and skill is required, the know-
ledge of the homoeopathic law, “Similia similibus
curantur,” having been obtained, to select the appro-
priate remedy, i. e., the one having a homoeopathic
relationship to the special diseased state.
Y
162 PURGATIVES UNSCIENTIFIC.
cHAP. XII. 435. The homoeopathist, having gained by his indus-
try the required information, finds the power is award-
Çure ºuts ed to him of selecting a remedy, which being suited
from homoe- © ºn tº gº 8-> 7 º tº
opathic treat- to the individual aggregate of symptoms, with which
ment. e e tº e . . e tº , º
the special constipation is allied, and of which it is
one symptom, he, in the administration of the selected
remedy, acts scientifically, and by its administration,
acts curatively, i. e., removes the whole of the diseased
state, and, in that whole, the constipation, a part.
435 a. The old system practice has its laxatives, its
purgatives, its drastic, i.e., in plain English, its violent
Ignorance of purgatives. Its advocates boast that its calomel and
old-system e te * e ©
practitioners blue pill act specially on the liver: its Saline purga-
of the effects , . } } chal + l f
. . . tives act, say they, more on the exhalent vessels o
cines they tº e • e
... the intestines: its aloes, say they, acts specially on the
rectum. But what do all these assertions amount to ?
To the recognition of only one point of action of the
medicines; whereas the calomel, the saline purgatives,
the aloes, have each a wider range of special actions,
of which the old system practitioners are, in a great
measure, ignorant. Had these actions been known
to them, (they are known to homoeopathists,) they
would have understood, that these medicines are
remedies only when used in diseased states, which
have the opposite of constipation, namely diarrhoea,
as a symptom, i. e., they are primarily curative of
diarrhoea and not of constipation.
436. It is hardly to be expected that the mere drug
vendors among medical men will shake off their preju-
dices respecting the treatment of disease by purgatives.
Some few old-It is pleasing to find that some enlightened physicians
system prac- e te e
iºnº and surgeons recognize the absurdity of attempting
cognize the
...; to remove disease by the removal of constipation by
P"g"g purgatives. Dr Edward Johnson observes, “If my
P U R GATIVES UN SCIENTIFIC. - 163
views be correct, it will be seen that, in constipation, CHAP. XII.
the reason why the bowels do not discharge their con-Dr Johnson's
tents is not because they are unable to do so, but be- W1G W.S.
cause they have no contents to discharge. The error
is not in the expulsive function of the bowels, but in
the manufacturing function of the secreting arteries.
No stool is formed, and therefore, and therefore alone,
no stool is expelled. I speak thus roundly and sweep-
ingly to illustrate my principle the more clearly. I
say no stool is formed—but this is not quite true—at
least, not in the majority of cases. For whenever a
mild dose of medicine is taken, a small stool will
generally be produced. This happens because the
alvine secretion is hardly ever wholly suspended. It
generally goes on, but goes on very slowly. There is,
therefore, almost always some small amount of secretion
within the bowels, which is not expelled, however,
because its amount, weight, or bulk is not yet sufficient
to cause the bowels to exert their expulsive power—
just as there is always some urine in the bladder,
which, however, is only expelled when its amount
has become sufficient to induce that viscus to contract
upon its contents. The effect, then, of a gentle dose
of medicine is merely to irritate the bowels to con-
tract prematurely upon their contents, which contents
however would have been equally expelled, without
the medicine, had time been allowed for them to accu-
mulate sufficiently to induce the bowels (by their bulk
or weight) to expel them.” The remarks that follow
are valuable. “Nothing is gained, therefore, by these
gentle doses of medicine, except a very unnecessary
and very hurtful degree of irritation inflicted upon the
bowels. I may illustrate what I mean by an allusion
to the pregnant condition of the uterus. Let it alone,
Y 2
164 PURGATIVES UNSCIENTIFIC.
CHAP. XII. and, at the end of nine months, that is, when its con-
Dr Johnson's tents have arrived at a certain amount of bulk and
views.
weight, it will contract and expel them. But you
may, by certain irritating drugs, cause it to contract,
and expel its contents prematurely. But this irritation
and premature contraction and expulsion can only be
obtained at the expense of great injury to the system
—so great, in most instances, as to involve the lives
of both mother and child. The injury, in both in-
stances, that is, of the uterus and bowels, is of the
same kind. It only differs in degree. Every prema-
ture expulsion of the foeculent contents of the bowels,
is a sort of miscarriage of the bowels effected by arti-
ficial means. These artificial means do a certain
amount of harm to the bowels, of the same kind as
that done to the uterus when artificial means are used
to effect an ordinary miscarriage. It only differs in
Q???0?!?!?. *
“Because, therefore, every gentle dose of medicine
is answered by a certain amount of secretion, it by no
means follows that the secretion was produced by the
medicine. The medicine does no more than expel it
—and that, too, prematurely and unnecessarily.
“But whenever a strong dose of medicine is given,
it is generally answered by a very copious but liquid
evacuation. Yet here again the object of the medi-
cine is not achieved. For, both in the case of the
gentle dose and the strong dose, the object is to pro-
duce, to make, to manufacture, stool; to excite the
secreting vessels to renew their suspended functions.
In neither case is this object effected. In the case of
the gentle dose, the object obtained is merely the pre-
mature and unnecessary expulsion of a certain amount
of foeculent matter, which, however, was already pro-
PURGATIVES UN SCIENTIFIC. 165
*
duced and deposited in the bowels. In the case of cIIAP. XII.
the strong dose, the object obtained is merely theºnwº
secretion, exfiltration, or outpouring of the serum of
the blood into the bowels. Their mucous membrane
is made, as it were, to sweAT. These watery motions
are not motions at all. They consist merely of the
watery parts of the blood, poured out by the capil-
laries, and tainted with the odour of stool by admixture
with the foeculent gases always present in the large
intestines, and with whatever small amount of true
stool the bowels may happen to contain.
“Great relief is sometimes experienced by a copious
discharge of this kind. But this merely arises from
the diminution thus effected in the volume of the
blood. The engorged capillaries are relieved of a
part of their load, and the whole system feels and is
lightened. A part of the oppression is removed.
The capillary system has been bled—but only bled of
its watery contents.
“Neither the strong nor the gentle dose of medi-
cine, therefore, contributes anything towards the cure
of constipation—because they contribute nothing to-
wards the removal of its cause. Both the strong and
the gentle dose do, what is called, open the bowels.
But the next day they are as constipated as ever, and
indeed more so. To attempt to restore the secreting
powers of the bowels or of the liver by thus arti-
ficially spurring them to unnatural actions, is like
attempting to recruit the exhausted powers of the
horse by spurring his sides till they bleed. You may
thus urge him on, from time to time, to a desperate
and brief acceleration of speed, but it is only at an
increased expense of energy, and only tends ultimately
to a more rapid exhaustion of his powers.
166 PURGATIVES UN SCIENTIFIC.
CIIAP. XII.
“In habitual constipation we have seen that the
P. Jºhnson's error lies in the too tardy manufacture of the foeculent
views.
matter. The quantity secreted from the blood is
deficient. A sufficient quantity of secretion is not
sent out of the bowels because it has never been sent
into them. The object of our remedial practice, there-
fore, should be to increase the quantity manufactured
—to cause the secreting vessels to secrete more, by
removing the cause which has arrested their secretion.
But instead of this, we have gone on teazing and
fretting and inflaming and whipping the bowels for a
fault which is not theirs. The doctor cries to the
bowels, ‘Expell expel !’ and the tortured and grum-
bling bowels reply (or would if they had a tongue),
“We can’t we can’t because we have nothing
to expell’ -
“In a word we have all along been labouring to
bleed a gate-post; and have been whipping the post
with great perseverance, because it would yield no
blood.
“He who would cure constipation must address his
remedies, not to the eagulsive powers of the bowels,
but to the secreting powers of the arteries. Deficiency
of stool is only an indication of a deficiency of secre-
ting power. This last is the cause of the disease
called constipation, and this cause must be removed
before the disease, which is the effect of this cause,
can cease. The secreting powers must be restored.
This done, there will be no difficulty whatever, on the
part of the bowels, in expelling the secretion, when-
ever this shall be deposited within them in sufficient
quantity. But to endeavour to restore the enfeebled
secreting powers by a process of forcing—by the
daily administration of irritating drugs—is just as
PURGATIVES UNSCIENTIFIC. 16"
}*/
sensible practice as it would be for a man to endeavour CHAP. XII.
to restore the exhausted powers of his jaded horse by."
the incessant application of whip and spur.
“The frequent exhibition of aperient medicines,
not only cannot cure constipation, but it will increase
the constipation of those who have it, and produce it
in those who have it not. How constantly does it
happen that those who begin by one dose every week,
end by a dose every night!
“Again, it frequently happens that delicate persons
always feel best when their bowels are rather confined
—better with four or five stools a-week than with
seven or eight. This is clearly intelligible. For, the
stools being a secretion from the blood, like the urine,
perspiration, &c., whenever the amount of this secre-
tion is disproportioned to the strength of the body, it
will produce the same languor and sense of exhaustion
which is always produced by excessive perspiration—
or an excess of any other secretion.
“One evacuation daily is proper for a person in
robust health, because he is well filled with blood, and
his strength will bear it. But in the thin, pale, deli-
cate, and weakly, especially if they be small eaters, I
am quite certain that seven dejections in the week is
more than enough. It is a greater demand than the
system can easily supply; and when medicine is given
to force this number of stools in the week, it only
produces exhaustion and all its consequent mischiefs.”
437. The hypotheses of Dr Edward Johnson,
namely, that the faeces are not the non-nutritive por-
tions of the food but the secretions from the arteries
of the intestines, and, that, in constipation, there is
no secretion, and, consequently, that there is no stool,
are not at the present moment subjects for confutation
168 PTRGATIVES UNSCIENTIFIC.
CHAP. XII.
Dr Johnson’s
hypothesis a
mistake.
Palliative
IOlea,SUll"eS CX-
hibit a low
state of me-
dical skill.
or confirmation. All that need be remarked in re-
lation to these views is, that Dr Johnson mistakes an
effect, the non-secretion by the arteries, for a cause.
He ought to have proceeded one step further in the
succession of phenomena, and them the diseased state,
causing this want of secretion, would have presented
itself as the cause of the constipation: i. e., he would
have been led to the general constitutional diseased
state. Still his remarks are valuable (hence their re-
cord), as showing that an old system practitioner has
recognized the unnecessariness and the injurious
character of the system of employing purgatives for
the removal of constipation: as showing that he re-
cognizes the employment of purgatives as purely anti-
pathic and palliative, and not curative.
438. Palliative measures exhibit a low state of
medical skill and a lamentable want of knowledge of
the power of remedial means.
439. Palliative remedial means are to the body or-
ganic what expediency but unjust measures are to the
body politic: temporarily alleviative but permanently
destructive: temporarily relieving an inconvenience
to make it hereafter more troublesome.* The employ-
ment of these mere palliative measures to the organic
body diseased exhibits an absence of the knowledge of
the mode of treatment proper for the bodily disease,
like as the employment of expediency measures to the
body politic shows the want of qualification on the
part of the professed statesman for his political duties
in the absence of the knowledge of true political
science.
* Borrowing is a refuge of weak minds, who wish to sacrifice the
future for the present.—Gilbart on Banking.
} URGATIVES UNSCIENTIFIC. 169
440. The scientific practitioner, (and the homoeopa- chap. xII.
thic is pre-eminently so, he practising according to a
law,) tries, in attempting to remove the constipation, to
remove the diseased state, which causes the intestinal ºf
inaction, and thus, in removing the antecedent condi-
tion, he removes the consequence, the constipation.
441. What would any one think of the man, who,
because his watch stopped from some imperfection in
the machinery, and having determined that it should
go, places a machine so as to make the hands on the º .
face of the watch go round, i. e., to perform their watch to go,
movement. It is granted that the hands do go round,
and that the watch to appearance does go ; but he,
who did as described in order to realize the end
sought, would be regarded as foolish, simply because
he neglected to put away the interior cause, which
originated the stopping of the watch.
442. Equally absurdly acts the man, who, because
the intestinal canal does not cause its actions to be
manifested regularly, determines to make the canal
show an action by means, which do not remove the
interior diseased state causing the inaction. He
may say the bowels are moved; the intestinal clock
goes round: so did the hands of the watch go round.
443. A man cannot get over a stile because his Illustration.
lower limbs are troubled with contraction. It is kind
to help him over the stile, but it is scientific to cure
the contraction, which hinders him performing the
action of getting over the stile. And it is a truth,
that, however numerous the occasions on which he is
lifted over the stile, such liftings do not add ought
to his power to get over the stile unaided.
444. It is true that the superficial observer, seeing
the watch go, might be satisfied because the hands
Z
1.70 PURGATIVES UNSCIISNTIFIC.
CHAP. XII.
Temporary
use of pur-
gatives not
justifiable.
Fungus.
Polypus.
of the watch moved; that the person, who saw the
man over the stile, might be satisfied, because, know-
ing that the man could not, at a time that is past, get
over the stile, and now seeing him over, he might
infer that he had gotten over; so those who look to
great curative effects from mere opening the bowels
may be satisfied, but not he who looks at the treat-
ment of constipation in a scientific point of view.
445. It is true it may be pleaded, that the man is
helped over the stile only till such time as he is enabled
to get over by himself: such a pleading would be
effective, were it not that the means used to help him
over the stile happened to be, as happens when con-
stipation is treated by purgatives, the very means,
preventive of the use of the means, which would be
effective in removing the contraction, which prevented
him getting over the stile.
446. If the purging removed the diseased state on
which the constipation depends, there would be some
ground for the exhibition of purgatives: though, even
then, it would be improper to employ these means as
purgatives, because as homoeopathic remedies they
would remove the constipation, without the injury
resulting from the purging.
447. A fungus grows on the tree. You knock off
the fungus and the fungus ceases to appear because
knocked off, but this does not cure the diseased state
of the tree, which afforded the condition necessary to
the development of the fungus.
448. A polypus grows on the nose. You remove
the polypus; the polypus is no longer apparent, but
this removal of the polypus does not remove the dis-
eased condition of the tissue lining the nose, the con-
dition necessary to the development of the polypus.
PURGATIVES UN SCIENTIFIC. 171
449. Worms exist alive in the stomach and the CHAP. XII.
bowels. The unscientific practitioner gives emetics
to expel the one and purgatives to get rid of the other.
Perhaps he succeeds: the worms no longer appear.
But he does not remove either the diseased condition Removal of
-- e worms does
of the stomach, which causes the stomach, as John not cure the
Hunter has explained, to secrete a gastric juice of alº"
kind that allows the worm to live in the stomach, or
the diseased condition of the mucous membrane of
the bowels, that causes the mucous membrane to se-
Crete a mucus, that allows the worm to exist in the
bowels.
450. The fungus again appears: the polypus again
grows: the worms again irritate: all, because the
means were palliative and not curative: were empiri-
cal, not scientific, and consequently not resultive.
451. Equally empirical and equally unscientific is
the employment of purgatives as purgatives for the
cure of constipation and for the cure of diseases.
452. The practice of giving purgatives for the cure
of diseases is founded upon an assumption, that the
constipation is the key-stone that binds all the other Constipation
symptoms of the disease together, whereas it is merely ..º.
one of the many stones that go to form the diseased.”
structure. No doubt its presence arrests the attention;
and vulgar minds are apt to notice that which is most
apparent: cultivated minds penetrate deeper, and dis-
cover that that which is less obtrusive is often the
more important.
172 FURGATIVES IN J U RIOU S.
CHAP. XIII.
Purgatives
injurious,
What purga-
tives are.
C H A P T E R XIII.
On the injuries resulting from the employment of pur-
gatives : Epilepsy, Blindness, Dyspepsia, Chronic
Inflammation of the Bowels, Hernia, Descent of the
Gut, Stricture of the Rectum, Diseased Bladder,
Descent of the Womb, eacessive Monthly Discharge,
eaccessive White Discharge, and Death caused by
purgatives.
453. Constipation of bowels being dependent upon
a general constitutional diseased state, and purgatives
not having, per se, that is, in their character as pur-
gatives, any essential relationship to that general con-
stitutional diseased state, it might be inferred, that
their employment, being, as it is, unscientific, must be
productive of injury. &
454. The injury, necessarily resulting from the
employment of purgatives, will be rendered more
apparent in the reply to the question, what is the
action of the medicines, called purgatives?
455. Purgatives are medicinal substances that irri-
tate the intestinal tube, and cause by their action a
destruction of the natural form of the fºcal evacuation:
PTURGATIVES IN J U RIO U.S. 173
a fact of itself demonstrative of the unnaturalness of CHAP. XIII.
their action.
456. Though in repetition of previous statements,
it may be again recorded, that the intestinal tube is
made up of membranes (muscular, cellular, nervous
and mucous), abundantly supplied with blood vessels,
nerves, and secreting and absorbing vessels. This
intestinal tube is excited to the actions, necessary to
carry onward through the whole of its extent the
substances passing through it, by the stimulus im-
parted by these very substances in their transit. The
natural contents of the tube constitute the appointed ºf
stimulus to excite the action of the tube containing, their natural
These contents are the nutritive and the non-nutritive"
portions of the food and the fluids which are poured
into the tube. They stimulate the intestinal tube to
the proper action, just as the heart is stimulated to
contract by the blood passing through it, just as the
bladder is stimulated to contract by the urine con-
tained in it. And when these contents are in a pro-
per state, and the intestinal tube itself is in its natural
condition, the tube is excited to a regular action, mani-
fested in the regular relief of the bowels at a given
period.
457. If from any cause, these contents of the in- Hººd
testinal tube deviate from their regular character, the unnatural,
effect of such deviation is manifested usually in the º
more rapid action of the bowels, and in the discharge
of the contents of the bowels in the form of actions,
or evacuations having a consistency less than is natural
to the intestimal contents. The individual is purged.
He has diarrhoea.
458. This relaxation or diarrhoea is oftentimes a Diarrhoea
te e tº º º from cold
result of taking cold, and the irritation induced, j.
174 PLJR GATIVES IN J U RIOUS.
CHAP. XIII.
Dysentery.
Diarrhoea.
from purga-
tives.
The natural
Contents
themselves
rendered
poisonous.
manifested by the diarrhoea, is indicated by the pain,
which almost invariably, to a greater or less extent,
attends the diarrhoea. Just as when a person takes
cold in the head, an increased discharge of fluid takes
place from the nostrils, and the discharge, being aug-
mented in quantity and, concomitant therewith, altered
in quality, has with such augmentation, so concomi-
tanted, acquired an irritating property.
459. Varying is the degree of the irritation of the
lining membrane of the bowels, and varying are the
amount of pain and the character of the discharge.
It may be the slight watery almost painless diarrhoea,
or it may be the dysenteric slime and blood, attended
with agonizing abdominal and rectal pains and cramps
of the thighs.
460. Such is natural purging.
461. Artificial purging is induced by the employ-
ment of purgatives. A purgative is strictly an irri-
tant to the bowels. It, a foreign and an indigestible
body, poisons the intestinal membrane. The stomach
and the bowels, to protect themselves from the poison,
hasten to expel the poison from their cavities and
pour out a large quantity of fluid, in part, the effect
of the irritation from the poison itself, in part, it may
be, the effect of an effort of nature to sheathe, by
pouring out an augmented mucous secretion, the intes-
tinal membrane itself from the action of the irritant.
462. Any natural contents of the bowels are, by
the increased action of the stomach and of the bowels,
thus induced, prevented (their expulsion being too
speedy.) undergoing the appropriate changes: so
these contents, in themselves natural, are rendered,
the requisite changes not being effected in them, irri-
tating to the bowels: add to the irritation thus in-
PlURGATIVES INJURIOUS. 175
duced, that induced by the excessive and unnatural CHAP. XIII.
secretions poured out, as already noticed, from the -
lining membrane, add to these the irritation from the
purgative poison itself, and a sufficient explanation
will be afforded of the injury that must result to the
lining membrane of the bowels, and to the system,
from the operation of a purgative in forcing an action
of the bowels.
463. Purgatives are purgatives because they cause Purgatives
disease, i.e., they irritate, because they are poisons ...”
to the intestinal tube. They excite unnaturally, and,"
like all bodies exciting unnaturally, they inflict in-
jury. By this excitation, they cause the bowels to
have an excessive action, or, to use the usual lan-
guage, deceptive indeed of the true conditions induced
by the purgatives, they cause the bowels to be opened,
A reaction subsequent to the excitement invariably
occurs; and the intestines pass, the excitement not
being kept up, into a state of inaction. Hence con-
stipation almost invariably follows purgation. Hence
the necessity, on account of the induced inaction, of
increasing the dose of the purgative in order to excite
the intestines to a fresh action.
464. Purgation is intestinal tube stimulation by
poison. The bowels gradually become habituated to
this stimulation, and, at last, the intestinal tube will
not act without the artificial stimulus: hence some
assert that they never obtain an action of the bowels
without medicine.
465. It is true some purgatives, because less irri-lººtion
tating, are less injurious than are others; but with"
regard to all, it is a truth, that they are purgatives,
because they irritate the intestinal tube.
466. All irritation is injurious.
* 176 Fly RGATIVES INJURIOUS.
CHAP. XIII. 467. Stimulation is useful. Even then, however,
.* the only appropriate stimulation in relation to the
intestinal tube, is that which results from the contact
of the natural contents of the intestimal tube.
sº *. 468. Purgatives Create unnatural secretions in the
from purga bowels. In creating these they irritate. When the
tives. great length of the intestinal tube is considered,
when the connexioms of the intestinal tube with the
other parts of the human system are taken into cal-
culation, when the fact is remembered, that the pur-
gative, in acting as a purgative, must pass throughout
the whole length of the intestinal tube, irritating the
whole of the intestinal mucous membrane, the inju-
ries that must result, sooner or later, from the em-
ployment of purgatives, will present themselves to
every unbiassed mind.
469. The mucous membrane becomes diseased.
The foundation of the direst forms of dyspepsia is
laid. Chronic inflammation of the intestines is caused.
Innumerable modifications of disease are developed;
and death is not unfrequently caused.
Pain pro- 470. One would think that the pain produced by
dušd by pur- e tº e s tº g
gatives purgatives would lead all to discover their injurious-
shows their t & * e
injuriousness, mess. Pain, all allow, is an evidence of the exist-
ence of disease; and yet, though when purgatives
are taken, they produce the most violent pains, few
recognize that the development of this pain proves
that the purgatives excite intestinal disease. Let the
same amount of pain and of diarrhoea be produced
by natural causes, as is produced after the taking of
purgatives, and how earnest would be the endeavour
on the part of most to remove the effects, which
they would be inclined to ascribe, from the severity,
to inflammation of the bowels.
PURCHATIVES INJURIOUS. 177
471. The deaths, produced by purgatives, are very CHAP. XIII.
Ill Iſſ) Cl’OllS.
472. The medical periodicals give not unfrequently
cases illustrative. The cases are given not as illus-
trative of deaths caused by purging, but as cases of
obstruction of the bowels which have terminated
fatally: whereas in the majority of these cases death
was caused, not wholly or principally by the obstruc- º
tion in the bowels, but by the irritation induced by of the bowels
the violent purgatives given to remove the obstruction, º
which irritants, being detained by the obstruction at
the part obstructed, induce inflammation and render
the obstruction permancnt, and cause death; and
because inflammation and ulceration are found after
death at the obstructed part, the unskilled observors
refer the deaths to the inflammation and the ulcera-
tion consequent on the obstruction, whereas the ob-
struction became fatal in consequence of the inflam-
mation induced by the purgatives.—See appendix.
473. Opinion in these matters is mighty. When a
person is poisoned by purging, if the poison has.
been administered by a legally qualified though often-
times really unqualified practitioner, no notice is
taken of the result. The death is referred to diseaso,
whereas it is the result of exhaustion, consequent on
the excessive irritation by the purgative of the intes-
timal lining membrane. In fact it is death by cholora,
medicine made: for as Asiatic cholera kills by the
cxhaustion from purging produced by natural causes,
so violent purging by medicine is a fatal process, the
agent being miscalled medicinal. *
474. It is impossible to calculate the injuries which Purgation is
have been inflicted by the employment of purgatives."
Purgation is poisoning: it is because purgatives pro-
A A
178 PU R G AT IV ES IN J U RIO U S.
CHAP. XIII.
Fpilepsy
caused by
purging.
duce disease that they form one chief resource of the
old system practitioners. These purgatives act allo-
pathically in relieving disease; the artificial disease
induced by the purgatives suspending, for a time, the
previously existing natural disease. Hence the allo-
pathists praise purgatives. They exalt, in so doing,
an injury. They praise their own destructive ope-
rations.
475. Their mistakes, and their laudation of these
mistakes, do not prevent the injuries continually re-
sulting from the employment of purgatives. Of these
injuries, the cases published in the appendix present
but a faint exhibition, though, it is hoped, that this
exhibition of the injuries from purgatives will create
an impression on the unbiassed intelligent mind, suf-
ficiently deep as to leave recorded thereon these
truths, PURGING IS POISONING, and, IF HEALTH Is
DESIRED, ABSTAIN FROM PURGING.
476. The cases recorded have, except when other-
wise noted, come under the author's care or know-
ledge.
477. EPILEPTIC attacks have been often induced by
the employment of purgatives. It is common to give
purgatives to prevent the attack, and this, on the
ground, that, before the approach of an attack the
bowels not unfrequently become confined. The illo-
gical practitioner foolishly imagines, that, by inducing
the opposite state of the bowels he will prevent the
attack. Experience proves that he does not succeed;
and this because constipation of the bowels is not the
cause of the attack; but is merely one of a series of
phenomena, preceding the attack. The series, it is
granted, may be interrupted while the irritation of
the bowels produced by the purgatives is kept up,
PURGATIVES INJURIOUS. 179
but directly the irritation ceases, the series again pro-
ceeds, and the attack is present. In some cases, it
recurs even while the bowels are being acted upon.
Indeed, in many cases, the purging brings on the
attack. The irritation produced by the purgatives
disturbs the equilibrium of the system. It weakens
the life power; and by thus weakening the life power
renders the diseased state, specially associated with
the epileptic seizure, more easily influenced by the
cause, excitative of and essential to the attack.-
See appendix.
CHAP. XIII.
478. BLINDNESs and other injuries of the eyes have Blindness
followed the employment of purgatives. The most;
striking case of the late Dr Davis, Professor of Mid-
wifery, is painfully exemplificatory of the effect of
purgatives.—See appendix.
aused by
urging.
479. Consumſ PTION has been not unfrequently de- Consumption
veloped from the effects of purgative medicines. It
is a well known fact, that a majority of persons have
tubercles in their lungs. These tubercles, if unex-
cited, lie dormant until old age, and are then dis-
covered after death; but if, by the action of medicinal
agents, the powers of the system have been weak-
ened, these tubercles often assume an activity, which
proceeding produces phthisis. Among the medicinal
agents, producing this debility, none are more effect-
ive than purgatives, and many a person has been
destroyed not simply by the purgatives acting as such,
but by the debility induced, allowing the diseased
tendency in the tubercles to be developed.
480. PALPITATION OF THE HEART, in the same
manner, has been not unfrequently a result from
purging.
481. It is, however, in regard to the digestive
caused by
purging.
A A 2
180 PURGATIVES INJURIOUS.
CHAP. XIII. System, that the injuries, in connexion with the em-
ployment of purgatives, develop themselves. The
stomach and the intestines are the receivers of those
poisons, and consequently on their tissues the inju-
rious actions are sure to be felt.
ºn: 482. Hence DYSPEPSIA, that name for an almost
purging, infinity of states of wretchedness and of misery, is a
most common effect of the employment of purga-
tives; (see cases of Robert Side and Mary Godwin,
, appendix).
Chronic in- 483. CHRONIC INFLAMMATION OF THE LINING mem-
flammation
of the bowels brane of the bowels is another diseased state, pro-
...” duced in a majority of cases by the habit of taking
purgatives. ... *
484. Cardialgia is caused by drastic purgatives,
Dr Mason Good asserts, p. 120, vol. i.
. 485. The well known fact of CONSTIPATION AFTER
” PURGING, one would have thought would have led
medical men to see the evils and the uselessness of
purging; as the very state, which the purgative was
given in order to remove, is induced. Cases illus-
trative are given in the appendix.
ºn 486. What ruin turpentine, as a purgative for the
urpentine *
5. *m. expulsion of worms, has caused.
487. This is illustrated in the case of Mary Gill,
(appendix,) who was so injured by purging with tur-
pentine, that she could scarcely stand; in the case of
William Ives, (appendix,) whose bladder was seri-
ously injured; in the case of Mary Jane Sheppard,
(appendix,) who, since purging with turpentine, has
felt as if her bladder was continually distended ; in
the case of George Hull, (appendix,) who, since he
was purged by turpentine for worms, has had a drip-
ping of water for ten minutes after he has passed his
BURGATIVES IN J U RIOUS, 181
water; in the case of George Bromley, (appendix,)
in whom epileptic fits were excited by the purgative
action of turpentine, given him under the idea that
he had the tape worm ; in the case of Tubal Cain
Hammond, who has had a pain and a difficulty in
passing water ever since he was purged by turpentine;
in the case of William Judd, where death after much
suffering and lingering disease connected with the
kidneys, was caused by turpentine given to expel
worms, &c. &c.
488. One of the most painful and dangerous of
CHAP. XIII.
Danger in
in the use of
intestinal diseases has been induced by the use of pur-purgatives.
gatives. This disease is exhibited by griping pain,
vomiting, costiveness, accompanied with retraction of
the navel and spasms of the muscles of the belly. It
is a disease attended with the most agonizing pain
and with very great danger.
489. It is called ileus; and, in relation to this
disease, Dr Mason Good notices among its causes,
“Drastic purgatives in an over dose, as scammony,
black hellebore, and colocynth,” p. 162, vol. i., edi-
tion 4th. Hundreds of children have been killed by
the intussusception of one intestine into the other,
by the irritating doses of scammony given for the
vulgar purpose of expelling worms.
490. It seems not illogical to conclude that the fatal
cases of inflammation of the bowels connected with
the presence of the stone of some plum, some pea,
some other seed, or glass bead, in the vermiform
appendage of the coecum, may have resulted from
the irritation and consequent irregular action in-
duced in the corresponding movements of the ileum
and of the colon towards each other at the mutual
place of meeting, the ileo-coccal valve; and thus
Ileus.
182 PURGATIVES INJURIOUS.
CHAP. XIII, the pea, seed, or bead, not passing, has been forced
Fatal dis- into the vermiform process, and there, irritation being
*"; the excited by the purgatives, ulceration has been caused,
action of " and, at length, the irritation being still persisted in,
purgatives. death.
Hernia. 491. HERNIA has been produced by the action of
purgative medicines.—See case of Sarah Weldon,
appendix; also case of Mr B., appendix. -
Bearing down 492. BEARING Down OF THE GUT has been pro-
of the gut. duced, in numerous cases, by purgatives. From taking
salts when young, in the case of Mary Nash.-See
appendix. -
Descent of 493. The DESCENT OF THE GUT has been caused
** by the taking of purgatives, such as Hooper's pills.
Case of Frances Hughesdon, appendix; as also in the
case of a patient at Derby, appendix.
Piles pro- 494. The PRODUCTION OF PILEs by purgatives is a
duced b ſº wº
º well known result; illustrated in the cases of John
Buckingham, appendix; of Frederick Barrett, ap-
pendix.
stricture of 495. STRICTURE OF THE RECTUM and Subsequent
** death have been produced by the exhibition of pur-
gatives. The case of Mrs B., (see appendix,) pre-
sents a real tragedy.
496. Intense pain in the back, and discharge of
blood from an eruption, have been caused by the
exhibition of purgatives: this is illustrated in the
case of Martha Rycroft, appendix.
women ºpe: 497. Women are special sufferers from the action
sº of purgatives. As a general rule, the twenty-four
tives hours regularity of action of the bowels is not so
operative in women as in men; and it seems, further,
that they do not suffer much inconvenience from the
non-existence of this regularity. The prevalence of
PURGATIVES IN J U RIO U.S. 183
the notion, that the bowels must be acted upon every CHAP. XIII.
day, has induced many women to have recourse to
purgatives, and they have suffered in consequence.
498. The organs connected with the GENERATIVE Organs con-
© e e e e º nected with
system are those in which the injury is manifested: iºn.
these organs, being in close neighbourhood to the in- i.
testinal tube, are specially liable to be acted upon ***
injuriously by purgatives.
499. Thus the womb is situated in the vicinity of
the large intestines, and from this propinquity a ge-
neral opinion prevails, that some connexion or sym-
pathy exists between the large intestines and this
organ. Hence aloetic purgatives, which are supposed
to act principally on the large intestines, are the means
to which principally the old system practitioners have
recourse in order to bring on and promote the monthly
discharge from the womb.
500. It may be inferred from this and other reasons
that this organ will suffer much from the employment
of purgative medicines. It does so: in fact there is
little doubt, that a common and one of the most
troublesome affections to which women are subject,
namely, the BEARING Down of THE WOMB, either actual .# the
descent of the organ, or a sensation as if such were womb.
the case, is produced, in nine cases out of ten, by the
employment of purgative medicine.
501. Single and married women have this affection,
but it is more frequent with married women who have
had children. The reason of which is not simply,
that the bearing of children tends to produce this
state; but it is because medical men have a most
absurd, but almost universally followed practice of
purging women after their confinement.
184 PURGATIVES INJURIOUs.
CIIAP. XIII.
Injury from
purging after
childbirth.
Injurious of
fect of spur-
red rye.
502. What is the effect of this injurious practice?
It must be remembered that the womb has been en-
larged to a great extent to contain the foetus. The
foetus being expelled, the womb has to contract, and
to restore itself to its natural form and size. To
effect this and to produce milk, Nature, as it were,
concentrates all the energies of the system to the
breasts to give the milk for the infant, and to the womb
to restore it to its proper state. The action of the
bowels is properly suspended; a suspension not at all
injurious, more particularly since, for the first few
days after confinement, the mother takes nothing but
very light food. The unthinking medical practitioner
interferes with this beneficial suspension of action,
and gives his purgative medicine to undo the ver
* 8->
thing, which Nature is beneficially doing. He purges;
à, e., he excites the intestines, draws the life power
away from the womb to the bowels: Nature's health-
ful operations at the womb are wholly or in part sus-
pended, and the womb never recovers its proper
healthful condition, which it would have done, had it
not been interfered with ; and the result is that the
individual bears about with her, oftentimes for the
remainder of her life, a sensation of bearing down of
the womb. This comes from treating a natural con-
dition as a diseased condition.—See appendix.
503. The following case is illustrative.—“October
1852. I was sent for to visit a lady at Hampstead
labouring under a low fever. She had been confined
about a fortnight. The surgeon who attended her,
having been informed that she was subject to profuse
bleeding after childbirth, gave her, when the “waters”
had escaped, a dose of spurred rye. In less than an
19 URGATIVES IN J U RIOUS, 185
hour the child instead of coming slowly into the World
came, as the lady expressed it, head body legs and
arms all at once. She felt, ever since she took the
spurred rye, pain at the side of the bowels, (the ovary
is enlarged).
“The surgeon, finding the bowels were confined,
gave her castor oil, which so purged her that she
was brought to the lowest state, and a diarrhoea was
established. - .
“He tried but failed to arrest the diarrhoea. When
I saw the patient first she had great tenderness in the
belly, intense fever, thirst, profuse sweats at night,
excessive diarrhoea, pain at her side, and she could
not by any possibility draw a full breath.
“The diarrhoea, the peritoneal inflammation, the
fever were cured, but the ovarian enlargement and
disease arising from the use of the spurred rye troubled
her for a considerable time.”
CHAP. . XIII.'
504. ExCESSIVE MENSTRUAL DISCHARGE has often Excessive
been caused by the employment of purgatives.—(See
appendix).
505. Not only is the womb affected injuriously by
the use of purgative medicines but the mucous mem-
brane, that lines the passage leading to the womb, is
injuriously affected.
506. To a majority of women what a trouble is
the white discharge (leucorrhoea). This is often the
result of purgative medicine, since the passage lead-
ing to the womb sympathizes with the intestinal
passage.
menstrual
discharge.
507. ExCESSIVE WHITE DISCHARGE, so weakening to Excessive
white dis-
the female constitution, has often resulted from the j
employment of purgatives.—(See appendix).
508. Many a strong person has been made a wreck
B B
186 PURGATIVES IN J U RIOUS.
CHAP. XIII.
of by the employment of purgatives. Case of Henry
M“Kowan, appendix; case of Ann Baker, appendix.
Death has been caused very frequently by the action
of purging, indeed patients have been purged to death;
case in appendix. How many can say as Frances
Goyder said, p.821, 1846, “I have been under Dr K.
of Westminster, and have been almost killed with
medicine.” k -
508 a. Indeed the injuries from purgatives are
innumerable.
EMPLOYMENT OF PURGATIVES. 187
CHAPTE R XIV.
The history of the employment of purgatives for the
cure of diseases. The fallacies of Dr Hamilton. An
eaplanation of the apparent success of his treatment.
ºn-me
509. It may be asked, How is it to be accounted CHAP. XIV.
for, if the employment of purgatives is so unscientific
and so injurious, that this employment of them has
become so general, and that, on such employment
in the treatment of disease, so much reliance is placed
by the old system practitioners?
The best answer to this question will be obtained
by a short history of the introduction of purgatives History of
e the introduc-
as means employed for the cure of diseases. tion of pur-
510. It is interesting to note, that the employment”
of these means, viewed as based on any well con-
ducted series of observations, has not half a century's
duration.
511. In the year 1805 was published by Dr James
Hamilton, a work entitled “Observations on the Utility
and Administration of Purgative Medicines in several
Liseases.” In the preface to the first edition of this
B B 2
188 THE HISTORY OF THE
CHAP. XIV.
Dr IIamil-
ton's doc-
trine.
work the author remarks—“As the doctrine which I
maintain, with respect to the exhibition of purgative
medicines, may have the appearance of novelty:” It
is thus apparent, that the use of purgatives as a means
generally to be used in the treatment of disease, was
deemed by Dr Hamilton a novelty, and as such to
require some defence.
512. In the preface to the work he refers “to the
practice which I have endeavoured to introduce, p. xvii.
eighth edition; and he refers to the fact that a num-
ber of intelligent young gentlemen, who attend the
hospital, have become converts to the free exhibition
of purgative medicine.” The idea at once suggests
itself, that conversion implies a previously existing
belief, and that the belief, adopted on conversion, is
a new belief. He adds further that his mode of treat-
ment has been subjected to what almost all new modes
of treatment are subjected, “to hasty and mistaken
criticism.”—See periodical, p. xxiii. preface. A re-
mark implying that the mode of treatment was new.
513. Dr Hamilton remarks—“In mature years, the
body is generally moved once in twenty-four hours;
and the faeces, although soft, preserve a form too well
known to require description; they are of a yellow
colour, and they emit a peculiar odour. When, there-
fore, the faeces are evacuated less frequently than the
age of a person demands; when they are indurated;
when their natural colour and odour are changed,
derangement of the stomach and bowels is indicated,
and the approach of disease, if disease has not already
ensued.”
514. He adds—“The propulsion of the contents
of the intestines is effected by means of a vermicular,
or, as it has been called, a peristaltic motion of the
EMPLOYMENT OF PURGATIVES, 189
bowels from above downwards; hence torpor, or loss CHAP. xiv.
of tone in the muscular coat of the intestines, by Dr Hamil-
which this motion is thought to be interrupted, is **
understood to be the cause of much distress; to remedy
which tonic or stimulant medicines are employed.
Be this as it may, I am inclined to think, that the
symptoms referred to loss of tone, proceed, on many
occasions, more directly from the impeded peristaltic
motion, the consequence of constipation.”
515. He further remarks—“There is certainly
nothing new in the position, that the loaded state of
the intestimal canal commonly induces general bad
health. But when I allege, that this state accom-
panies and aggravates other symptoms of fever, and
that it is the immediate cause of certain disorders in-
cident to children and young people, I know that I
advance opinions in which there is considerable novelty,
but in which, I trust the following sheets will satisfy
the medical reader, there is an equal degree of sound-
ness. For I have learned, that the due regulation of
the alvine discharge constitutes much of the prophy-
lactic part of medicine, and teaches the propriety of
advising those who wish to preserve good health, or
to recover it when it is impaired, to attend carefully
to this circumstance.” These latter views are cor-
rect, but the difference between Dr Hamilton's and
the homoeopathist's is in relation to the means, by which
this due regulation is to be obtained and preserved:
and also as to the constipation itself, whether it itself
is not rather a result than a cause of disease.
516. As to the use of purgatives, Dr Hamilton
remarks, pp. 20-21—“ Modern physicians have two
objects in view in administering purgative medicines;
the one to empty the bowels, the other to increase
190 THE HISTORY OF THE
CHAP. XIV.
Dr Hamil-
ton’s doc-
trine.
HIuxham's
remarks.
the secretion of fluids into the cavity of the intestines,
or, in other words, to induce purging.”
517. Dr Hamilton refers the benefits derivable from
purgatives not to the relaaring of the bowels, but to the
unloading of the bowels. .
518. He then refers to the treatment of scarlet
fever by purging. He remarks that the febrile state
in scarlatina is more apt to induce costiveness.
519. In cynanche maligna complicated with scarlet
fever, Dr Hamilton recommends the restricted use of
purgative medicines—
“The restricted use of purgative medicines, how-
ever, to the extent of unloading the bowels only,
does not increase this debility, while it relieves the
symptoms of the general fever; and may thus prevent
either its termination in Cynanche maligma, or alleviate
the attack.”
520. He quotes Huxham in justification of the use
of purgatives—“Huxham, in a dissertation on the
malignant ulcerous sore throat, London, 1757, re-
marks, p. 297 : ‘However improper purging might
be at the beginning of this distemper, gentle easy
cathartics, as rhubarb, manna, &c., were necessary at
the end to carry off the putrid colluvies of the intes-
times, which otherwise protracted the feverish heats,
and occasioned great weakness, want of appetite,
tumid bellies, and great obstruction of the glands.
But in general, p. 295, after a purge or two, the sick
soon recovered a keen appetite, strength and spirits;
many, however, required frequent purging.’”
521. This view of Huxham respecting the putrid
accumulations is one which influences most practi-
tioners at the present day. The putrid secretions are
nothing more or less than the secretions of the diseased
EMPLOYMENT OF PIJ R GATIVES. 191
lining membrane of the bowels, and just, in the same chAP. xiv.
manner, as the tongue cleans itself as the disease, Dr Hamil-
which caused it to be unclean, is in course of cure, tºº.
so will the bowels cease to discharge diseased se-
Cretions.
522. He then notices the use of purgatives in Purgatives in
marasmus. He thinks that the languor and lassitude.”
which precede marasmus, indicate that a torpid state
or a weakened action of the alimentary canal is the
cause of this disease.
“From this proceed costiveness, distension of the
bowels, and a peculiar irritation, the consequence
of the delay of the faeces, and I have accordingly been
long in the habit of employing purgative medicines
for the cure of this marasmus; the object is, to
remove indurated and foetid faeces, the accumulation
perhaps of months; and, as this object is accomplish-
ing, the gradual return of appetite and vigour mark
the progress of recovery.”
523. This accumulation of months, put forth by
Dr Hamilton, is a delusion.
524. After giving a very accurate description of
the disease, Dr Hamilton remarks—“The slightest
attention to the history of the disease evinces, that
costiveness precedes and accompanies the other symp-
toms. Costiveness induces the feculent odour of the
breath, disordered stomach, depraved appetite, and
impaired digestion. These preclude a sufficient supply
of nourishment, at a period of growth when it is
most wanted: hence paleness, laxity, flaccidity, the
nervous symptoms, wasting of the muscular flesh,
languor, debility, the retention of the menses, the
suspension of other excretions, serous effusions, dropsy
and death.”
192 THE HISTORY OF THE
CHAP. XIV.
Dr IIamilton
mistaken.
525. Dr Hamilton might just as well have stated,
that the slightest attention to the history of the disease
evinces that depraved appetite precedes and accom-
panies the other symptoms; and so with any other
symptom attendant upon the course of the malady.
526. Costiveness, according to Dr Hamilton, causes
these states. But in this he is mistaken. He should
have asked, “What preceded the costiveness?” If cos-
tiveness be the cause, why should not costiveness cause
chlorosis in all women. There is a special consti-
tutional diseased state, which originates the chlorosis,
of which one symptom, but not at all a constant One,
is constipation. If Dr Hamilton had asked the ques-
tion just propounded, he being endowed with the
logical acumen, possessed by his educated country-
men, would have found in the research, that the
costiveness was indeed a consequent of a previously
existing state, and not the primary state itself. To
assert, as does Dr Hamilton, that the costiveness,
the mere manifestation of a diseased state, is the
cause of all the effects connected with that diseased
state, is not more absurd than would be the assertion,
that, because the hour hand of a clock does not move,
that this is the cause why the clock does not work
out the right time.
527. Dr Hamilton then notices the value of
purging in the treatment of vomiting of blood.
528. He considers that this vomiting of blood de-
pends upon constipation of the bowels.
529. He refers to a discharge of blood by the anus
when the patient is at stool: this discharge being
unaccompanied with hemorrhoidal or local affection
or with pain. In these cases he recommends the use
of purgatives: aloes in particular.
EMF LOYMENT OF PIU R GATIVES. 193
530. He them records his views as to the benefit of CHAP. XIV.
purgatives in hysteria. He details the symptoms; ºr
connected with hysteria:—“ Among the symptoms trine,
which mark the hysteria constitution, shifting pains
in the abdomen, flatulence, constipation at One time,
at another vomiting and purging, together with acid
and foetid eructations, are conspicuous.
“ The sensation of a ball wandering through the
abdomen, and ascending to the stomach, and from
thence through the oesophagus to the pharynx, is a
prominent symptom among those which immediately
precede, and give warning of the approach of the fit.
“ Convulsive motions of the muscles of the abdo-
men, which is thereby greatly contracted and drawn
inwards, accompanying the paroxysm; upon the ces-
sation of which, a murmuring noise throughout the
abdomen is frequently heard.” -
531. He further remarks—“These symptoms un-
doubtedly denote a preternatural affection of the
stomach and alimentary canal. In my opinion they
afford conclusive evidence that this affection is pri-
mary, and that the other multifarious symptoms of
hysteria depend upon it. *…, &
“ I may add, by way of caution, that, in hysteria,
as well as in chlorosis, and vomiting of blood, the
full exhibition of active purgatives is frequently ne-
cessary to procure even moderate evacuations from
the bowels; and that this exhibition must be con-
tinued from day to day, until such time as the faeces
are natural, or until the disease ceases.”
532. In reference to St Vitus's dance, Dr Hamilton
remarks—“ The approaches of chorea are slow. A
variable, and often a ravenous appetite, loss of usual
vivacity and playfulness, a swelling and hardness of
C C
194 THE HISTORY OF THE
CHAP. XIV.
Dr. IIamil-
ton’s doc-
trines.
the lower belly in most cases, in some a lank and soft
belly, and, in general, a constipated state of the
bowels, aggravated as the disease advances, and slight
irregular involuntary motions, of different muscles,
particularly of those of the face, which are thought
to be the effect of imitation, precede the more general
convulsive motions, which now attract the attention
of the friends of the patient.”
533. He adds—“ If my conjectures were well
founded, the first and principal object of practice
would be to remove the constipated state of the bowels.
In pursuance of this object, I began to try the effects
of purgative medicines, given regularly in moderate
doses.”
534. To Dr Hamilton such removal of the con-
stipated state of the bowels might be the first and the
prineipal object of practice: and to have such an
object was pardonable, he and the old system practi-
tioners having no means of acting direct on the
chorea state as a whole, and, of removing, as parts of
the whole, the constipation and other indications of
diseased condition of the lining membrane of the
bowels. The homoeopathist possesses such means,
and hence he cures the chorea, and, if constipation
has attended the disease, he cures the constipation as
a part of the whole, the chorea.
535. Dr Hamilton then refers to the efficacy of
purgatives in tetanus. He reasons thus in favour of
purgatives:— .
“In the first place, it appears from the history of
tetanus, that it often approaches in a gradual man-
ner; hence it is probable that the attack is generally
preceded by symptoms of bad health, although these
may not be always observed. We learn from the
EMPLOYMENT OF PURGATIVES. 195
history of tetanus, that an uneasy sensation or tense- CHAP. XIV.
ness about the pit of the stomach is among the first?.º
symptoms, and is at the same time a permanent One trine.
of tetanus; and that as this is aggravated, all the
other spasms are increased in the frequency and
severity of their attack. The history further shows
that the body is obstimately constipated throughout
the whole of the disease.
“These circumstances, which present themselves
with great uniformity, make it exceedingly probable,
that the functions of the stomach and intestines, are
materially deranged, previous to the attack, and
during the prevalence of tetanus, and point out the
propriety of using purgative medicines in the treatment
of it.
536. They prove rather that a constitutional diseased
state has been developed, in which the tetanic con-
dition becomes developable.
536a. Dr Hamilton's argument for the use of pur-
gatives in tetanus, that the bowels are always obsti-
mately constipated in the disease, amounts to nothing,
for there are other symptoms of the disease that are
more constantly so than is the constipation.
537. It is known to all that tetanus is associated
with a special condition of the nervous system, and it
is known further, that excess in drinking induces the
condition of the system, which being called into
special action by a wound, especially in tendinous
parts, causes an attack of tetanus. The constipation
is merely a symptom of this special condition of the
nervous system. To remove that without removing
the whole of the special condition of the nervous
system will not cure tetanus. The homoeopathist
cures tetanus, because he treats it as a whole: and,
C c 2
J.96 THE FAILLACIES OF DIR HAMILTON.
CHAP. XIV. in thus curing it without seeking at all to act spe-
.* cially on the bowels, he cures the constipation at-
trine, tendant upon the disease.
538. Dr Hamilton then refers to the use of cold
bathing in dyspepsia, and expresses his belief that
much of the benefit results from the purgative action
of the cold bathing.
538 a. He concludes by giving cases illustrative of
the use of purgatives in these various diseases.
539. This lengthened analysis of the work of Dr
Hamilton on purgatives has been given, because it
seemed proper to give a review of the best arguments
in favour of the use of purgatives in diseases, and
thereby to give an explanation of their present ex-
tended employment in the old system practice.
540. Since the time of Dr Hamilton, the employ-
ment of purgatives has extended widely. Little doubt
can exist that Dr Hamilton's work tended very much
Purgative to aid such extension. From the history given, it
medicines in- . º
troduced will appear that half a century has not passed since
Yº...the introduction of purgative medicines.
tury. 541. The above history of Dr Hamilton's obser-
vations demonstrates this, that he regards an accumu-
lation of faecal matter to be the cause of the diseased
states, which he describes, and that the cure consists
in the removal of this accumulation.
542. Even were these views adopted, it is quite
clear that, with the aids which homoeopathy presents,
no need for purgatives exists; since medicines, homoe-
opathic to the diseasd state, establish regularity in
the bowels, and remove the state on which intestinal
accumulations depend.
543. The very fact of Dr Hamilton placing so much
stress on the use of purgatives, until the STATE causing
Al’IPARENT SUCCESSFUL TREATMENT. 197
the accumulation is removed, proves that he unwit- CHAP. xiv.
tingly recognizes that the accumulation is not the
Cause, but the state of the intestinal canal which
causes the accumulation.
544. This state the homoeopathist recognizes, and Cºnstituti.
tº wº onal diseased
he maintains that that state, which is a constitutional state removed
diseased state, can be removed by the appropriate *:::...
homoeopathic medicines. dies. -
545. Accumulation of faecal matter is an effect: if
in the removal of the effect the cause is removed, then
cure results; but not by the mere removal of the
accumulation, but by the removal of the state causing
the accumulation. Hence, in the cases of cure pub-
lished by Dr Hamilton, the medicines used were
effective in removing the condition causing the accu-
Imulation, in other words were homoeopathic. But
how numerous have been the cases where the removal
of the accumulation by the purging, although most
diligently persevered in, did not effect a cure, and forº *.
this reason, that the medicine used, although anº"
established purgative, did not act homoeopathically in
curing the diseased state on which the faecal accumu-
lating tendency rested.
546. It is not denied that Dr Hamilton did service
by his labour in relation to purgatives; i.e., the means
he used were, in the absence of the knowledge of the
homoeopathic law and of the homoeopathic medicines,
far superior to the means previously employed in the
diseases which he treated.
547. All the benefits which Dr Hamilton points
out as worthy to be sought for by the use of purga-
tives, the homoeopathist realizes by the use of homoe-
opathic medicines. He can remove the inaction of
the bowels, by removing the diseased state on which
:
-
J
J
198 FALLA CIES OF DIR HAMILTON.
CHAP. xiv. the inaction depends, and this without the injuries
arising from the employment of purgatives.
*...* 548. The cases of cure recorded by Dr Hamilton,
can be explained by the fact that the medicines given
were in homoeopathic relationship to the maladies.
549. This is demonstrable even with the knowledge
at present possessed by homoeopathists of the patho-
genetic effects of the medicines Dr Hamilton used:
the success he obtained depended not upon the
employment of purgatives as purgatives, but, upon
this, (it is worthy of repetition), that the purgatives
he employed were medicines that had relationships
homoeopathic to the diseased states, and thus cured
these diseased states, not, because they acted as pur-
gatives, but simply as homoeopathic medicines: their
purgative action was merely the point of view in
which Dr Hamilton but not the diseases, using a per-
sonification, viewed them. In fact, he cured, but
added purging as a Superogatory work in the cure.
550. Cures having been effected by the means Dr
Hamilton employed, and medical men finding by ex-
perience the inefficacy of the means hitherto used for
the cure of many of the diseases, in which Dr Hamil-
ton successfully employed purgatives, were led to
adopt the purgative treatment,” which gradually ex-
cines given
were in ho-
moeopathic
relationship
to the ma-
lady.
* The author of this work in negativing the use of purgatives has had
to overcome the prejudices of early medical education. The medical
gentleman, Dr Durie, to whom he was articled, was a great admirer of
Dr Hamilton, and was a steady advocate of purging. He had the duty
of well purging everybody early impressed on his mind, and, this im-
pression was strengthened greatly by the fact, that his teacher practised
on himself what he recommended to others, and he took the bitter pur-
gative draughts, not an unfrequent occurrence, with a truly stoical com-
posure. The writer believes that this medical gentleman killed himself
by the employment of purgatives. He died suddenly, it is thought, of
ulceration of the stomach. Peace be to him
APPARENT SUCCESSFUL TREATMENT. 199
tended its range, until almost all medical men in their
practice have realized the adage of the celebrated and
original Dr Hamilton himself, who used to express
his belief by modifying, with perhaps not very good
taste, but expressing strongly his view, a scripture
quotation, “Fear God and keep your bowels open is
the whole duty of man.”
CHAP. XIV.
200 UN SOUND NESS OF THE ARG UMIENT FOR
C H A P T E R XV.
The arguments urged in defence of and justificatory of
the employment of purgatives. The non-necessity of
purgatives in the cure of either chronic or acute
diseases. Absurdities connected with the employment
of purgatives.
CHAP.XV. 551. Though evidences of the injuries resulting
º, from the employment of purgatives must have been
sanctioned perpetually presenting themselves during the last half
” “ century, a period during which such employment has
been so general, and though the unscientific character
of the method of treating diseases, which consists in
the employment of these medicinal agents, is demon-
strable, the practice of administering purgatives has
become so general as to have established itself as one
among the many matters, which are fixed in the
popular belief.
552. Matters, which have so fixed themselves, have,
in obtaining this firm tenure, surrounded themselves
: by with arguments and incidental circumstances, which,
generally known and appreciated, are deemed quite
justificatory of the fixedness of the tenure of the
belief itself.
THE EMPLOYMENT OF PURGATIVES. 201
553. In endeavouring therefore to set aside, as is chap. xv.
proposed, a popular belief in reference to the practice ſº
of administering purgatives, it is essential to consider the utility of
the various arguments and views, deemed by those, ..."
holding the belief, as justificatory of the practice.
And as the belief in the supposed utility of purgatives
is based upon arguments, deemed by most to be sound,
it will be necessary to consider these arguments; and
if these, as usually put forth and depended on in re-
lation to this practice, can be shown to be founded
upon unsatisfactory bases and in direct opposition to
the laws, regulating the functions and establishing the
actions of the digestive tube, on which tube the pur-
gatives are by their advocates supposed specially to
act, the existing belief will be shaken, and an open-
ing will be made, by which a more correct belief will
have an opportunity afforded it of gaining admission
into the public mind.
554. ARGUMENT first. An argument, deemed power- *
fully supportive of the practice of exhibiting purga.
tives, is presented in the subjoined extract from a
letter from a patient, who, in the year 1844, was
under the author's care for the cure of epilepsy:-
“Dr P., of E–, was here a few days ago, and I
told him that you had directed me to avoid laxative
medicine entirely. In answer he said, that more or
less laxative medicine was indispensable as there were
accumulations in the system, which a natural stool The accumu-
© lation theory.
would not carry away, and, until these were removed,
I would not feel well.”
555. The answer to this accumulation theory and
the practice thereupon founded was thus given: The
accumulation theory, viewed, per se, is a fallacy.
The stomach and the intestines were made for the
D D
202 UNSOUNDNESS OF THE ARGUMENT For
CHAP. xv. purpose of receiving food, to digest it when received,
to carry it forward, when digested, through the tube,
and nature has, in the arrangements for so digesting
the food and for carrying it forward, acted quite
efficiently to prevent accumulations. To suppose
otherwise would be to recognize the blasphemy, that
the intestinal tube was not properly made by its great
tº: Contriver. Such tube is not a dead machine. It is
a dead ma- a living instrument, adapted by an allwise hand to de
chine. a certain work. It is not a mere sewer, but a tube,
endowed with life, having in itself a power of moving
its contents continually onwards. If it does not per-
form its work, that is, carry on to expulsion the to be
expelled portions of the food, such non-performance
ºf depends on the existence of some diseased state, of
ºr of which this non-performance is a symptom: and this
ſº diseased state cured by the employment of the appro-
priate homoeopathic remedy, the non-performance, the
manifestation of the diseased state, will cease, and the
bowels will act, and that, without the administration
of a particle of medicine, designated purgative.
556. The accumulation fallacy has one of its main
supports in the fact, that, when a purgative medicine
has been taken, a great discharge not unfrequently
takes place from the bowels. The occurrence of this
discharge indicates to the superficial thinker an accu-
mulation, whereas the greatness of the discharge is
dependent upon the irritation of the intestines, caused
by the action of the purgative poison, this poison
exciting the secreting vessels, spread over the mucous
membrane of the intestinal tube, to increased action.
557. The accumulation theory has derived some
strength from the idea, that the faeces are something
unpleasant, and not only unpleasant, but injurious.
THE EMPLOYMENT OF PURGATIVES. 203
These ideas, which are erroneous, when viewed in CHAP. xv.
relation to the deduction derived from them, that.
therefore it is wise to empty the bowels, as unloading ***
unpleasant and injurious matters, are deemed by many
to have great potency. Hence, it happens, that, if a
patient dies of any disease, and facces are found in his
bowels, some, who deem themselves very sapient,
exclaim, “See the effect of not having given purga-
tives: see here are faeces in the bowels.” To such
hastily conceived and ejaculatory uttered thoughts,
another thought arises, What else than faces has any
one a right to eagect to find in the bowels 2 Is not
urine found in the bladder after death . Should not
these individuals, who thus ejaculate because faeces
are found in the bowels, be equally emergetic in ex-
claiming, “See, here is water in the bladder;” and,
in complaining in reference to the symptoms attend-
ant on the death of the patient, having urine in his
bladder, they should add, to keep up a parity with
their reasoning in reference to the faeces contained in
the bowels, “See, here is the effect of not emptying
the bladder.”
558. A proof perfectly demonstrative of the un-
soundness of the accumulation theory is found in the
fact, that purgatives, though removing the supposed.
accumulation, do not cure disease: if suspending for disease.
a time diseased actions, they do not remove these
actions. Does not every one, who has seen much of
the treatment of diseases, know, that diseased states
proceed in their injurious course, notwithstanding the
bowels are forced to act daily A fact, which could
not present itself, if the removal of supposed intes-
timal accumulations was so essential to the cure of
diseases; a fact, which continually manifests itself
D D 2
204 UNSOUNDNESS OF THE ARGUMIENT FOR
CIH. A.P. XV.
Argument
second.
Natural that
the bowels
should act
daily.
Eallacy of
this argu-
ment.
in the circumstance, that hardly a patient presents
himself or herself for homoeopathic treatment, who
has not been personally subjected to violent purging,
or if not to violent, at least to continuous purging,
and yet such has been the destitution of benefit, that
that very destitution drives him to seek homoeopathic
aid. - -
559. If there exists any accumulation of faecal con-
tents, such is dependent upon a constitutional diseased
state: cure it, (which purgatives in their character of
purgatives never can,) all accumulation will cease.
560. It is indeed a vulgar view, this of unloading
the organs of the body. It is the introduction of
mechanical agencies where vital agencies develope
the powers that are active. It is a negation of the
truth, that the human body is a vital machine.
561. ARGUMENT second. It has been urged in
favour of the use of purgatives, that it is natural
that the bowels should act daily. This proposition
may be regarded as a truism. But, when from
this truism, it is argued, as it often is, that, as, in
disease, the bowels do not act, and as purgatives
make them to act, I should be neglecting the use
of a means, suited to cure the disease, if I did not
give purgatives, the argument is unsound; and not
the less so though put forth by men, whose logical
attainments ought to enable them to detect the un-
soundness.
562. The fallacy of this argument becomes readily
apparent. One might just as correctly argue, that,
because it is natural to a man to use his legs daily, a
patient, afflicted with rheumatic gout, and, as such,
unable to move his legs, should be forced to rise up
THE EMPLOYMENT OF PURGATIVES. 205
and walk. Such a practice has been recommended; CHAP. xv.
tº sº tº As tº Unnatural to
but its cruelty is so apparent, that no medical man.
would, in these times, dare to practice it. ºth
563. Facts innumerable prove, that the excitement gout to rise
of the action of the bowels by purgatives, when, from up and walk.
the action of disease they have been inactive, does not
effect the cure of disease. The means supposed to
be necessary for relief are used, but the end sought is
not gained.
564. ARGUMENT third. Another argument, brought *
forward as justificatory of the use of purgatives, is "
embodied in the common expression—“I always feeliº
better when my bowels act regularly.” bowels act.
565. This embodies an axiom which none will dis-
pute, any more than they will the axiom, equally
logical in its parts, “I always feel better when I am
well.” Of the fact, that a person always feels better
when the bowels act regularly, there is no question.
But the deduction drawn from the fact, that, when
the bowels are not regular, purgatives are to be used
in order to realize the betterness, has a fallacy em-
bodied in it.
566. The legitimate deduction is—“Get the bowels
to act of themselves and then the betterness will
result.” When regularity of the action of the bowels Legitimate
is thus arrived at, the bowels act, because the diseasedº.
state, which prevented their action, has ceased to
operate, and, ceasing to operate, the action of the
bowels, the natural result, when the intestinal canal is
not affected with disease, takes place. Such action is
an indication of such deliverance, and as the indivi-
dual feels better because of this deliverance, he is led
to consider the improvement to depend on the action of
206 UNSOUNDNESS OF THE ARGUMENT FOR
CHAI’. XV.
Torcing the
bowels does
not remove
the diseased
State.
Not denied
that the ac-
tion of pur-
gatives pro-
duce tempo-
rary relief.
the bowels, that being the result which appeals most
prominently to his senses. It truly is the indication
and not the cause of the deliverance.
567. In forcing the bowels to discharge their con-
tents by purgatives, the old system practitioner does
not realize the condition, necessary to relief from the
disease: he removes by force a condition of the bowels
dependent on a diseased state, and mistakes such tem-
porary removal for a curative process.
568. The homoeopathist does not deny, that the
action of a purgative, manifested in inducing a forced
expulsion movement of the bowels, is sometimes at-
tended with apparent benefit. The person purged is
relieved; but the relief is dependent, not on the action
of the bowels, but on the irritation, induced by the
purgative, suspending for a time, by the irritation in-
duced, the diseased action proceeding in some other
part of the system. And this power of suspension is
great, since the wide extent of the lining membrane
of the intestine affords a surface on which a great
amount of counteraction can be induced.
569. This argument implies, that, as the person is
always better when the bowels act, and, that, there-
fore, if from any cause the bowels do not act, and they
being forced to act the individual becomes better, that,
therefore, it is essential to realize this betterness to
give purgatives. Still the fallacy in this argument
few seem to have the power of detecting. Few minds
are capable, or, if capable, will take the trouble of
distinguishing between benefit as connected with and
as resulting from the action of the bowels.
570. Coincidence most minds regard as causation.
They have never fully recognized what Dr Thomas
Brown, in his “Philosophy of the Human Mind,”
THE EMPLOYMENT OF PIJRGATIVES. 207
(lecture vi., p. 35, Tait's edition,) has thus expressed— CIH.A.P. XV.
“Power, in short, is significant, not of anything dif-
ferent from the invariable antecedent itself, but of
the mere invariableness of the order of its appearance
in reference to some invariable consequent; the invari-
able antecedent being denominated a cause, the in-
variable consequent an effect.”
571. Not having appreciated the exact relation
between cause and effect, not having worked out the
mental exactnesses necessary to distinguish between
coincidence and causation, these persons argue thus: Coincidence
my bowels act: I obtain relief: therefore my bowels *
acting are the cause of the relief; this is syllogism
first. The second follows, “I am not well: my
'bowels do not act: I will force them to act by purga-
tives and I shall be well.”
572. The syllogism does not prove its soundness by
the result, for though the bowels are forced to act, the
individual is not cured. -
573. Still it is allowed, that, when in the course of
a disease, the bowels have been inactive, and, at length
they act, great relief is obtained. But, in this case
the benefit was not the cause of the relief; it was
a circumstance coincident with the action of the
bowels.
574. The cause of such coincidence is easily worked The cause of
out. The patient was diseased: one phenomenon of º
that disease was inaction of the bowels: the patient
takes the appropriate homoeopathic remedy; and, as
that remedy effects the cure of the diseased state, the
constipation, one manifestation of the diseased state,
ceases, the bowels act, and the patient feels a great
relief. But the relief was felt before the bowels
acted; but the action of the bowels being the mani-
208 DNSOUNDINESS OF THE ARG UMENT FOR
CIIAP, XV.
The bowels
made right
only by the
appropriate
remedy.
festation most apparent to the individual, that he re-
cognizes as the cause of the relief, whereas it is merely
a coincident circumstance.
575. Another form, under which this third argu-
ment in defence of the employment of purgatives is
not unfrequently put forward, is “If my bowels were
right I should be right directly.”—See appendix.
576. The correct statement would be, “If my bowels
were right it would be because the disease having been
made to cease by the appropriate remedy, there re-
mains nothing to prevent the action of the bowels, and
as the diseased state which caused the inaction is
removed, relief is experienced.” The bowels being
open is not, as is generally supposed, the cause of the
relief, any more than the hour and the minute hand of
a clock moving round, and, in so doing, showing the
right time, are the cause of the watch showing right
time. Such manifestation of right time proves that
the machinery has had nothing to impede its free
action: and supposing that something wrong in the
machinery had prevented the hour and the minute
hand showing the right time, and that something
wrong being removed, the hour and the minute hand
being rendered correct became exhibitive of the right
time, then, though the observer might be justified in
asserting that the watch goes right, yet he would be
committing a mistake in reasoning if his argument
run thus, that the hands moving correctly constituted
the cause of the watch showing the right time. It is
true the correct movements of the hands of the watch
constitute a circumstance, coincident with the resto-
ration of the proper state of the watch, and might be
considered by the superficial observer, ignorant of the
interior machinery of the watch, as the cause of the
THE EMPI,OYMENT OF PURGATIVES. 209
correct time. So in reference to the action of the CHAP. XV.
bowels and the relief there with concomitant: the in-
testinal clock has now assumed its twenty-four hours
regularity of action: a regularity which it had lost;
the regularity is regained by the removal of the
diseased state: the superficial observer that did not
recognize the diseased state, does recognize the regu-
larity of the intestimal clock, and he refers to this
recovered regularity the cause of the relief.
577. In connexion with the view, embodied in the
observation just quoted, is another observation, “Will Yºº-
the medicine act on the bowels? This question is to be the bowels
answered thus: the medicine given will not act pri-
marily or specially on the bowels, but it will act cura-
tively in the relation to the disease, of which, as an
aggregate, the inaction of the bowels is a part, and
the disease being cured, or in process of cure, the
bowels will act of themselves.
578. Mr Haden, in his valuable work on Colchicum, Mr IIaden's
e & tº ge views on the
when referring to the use of this remedy in inflamma-...}.
tory affections of the chest, notices with astonishment.”
the fact, that all the good effects of the colchicum are
obtained without the action of the colchicum on the
bowels as a purgative. This, which was to Mr Haden
a fact presenting difficulty, is a testimony to the
Scientific accuracy of the views already stated, namely,
that a disease can be cured before any action of the
bowels is produced; and is an evidence that the bet-
terness, attendant oftentimes on the bowels acting, is
not a result of the bowels acting, but is a concomitant
circumstance therewith connected.
579. ARGUMENT fourth. It is argued in favour of *
e Oll I'till,
the employment of purgatives—“I have such a feel-
E E
210 TJN SOUND NESS OF THE AIRG UMENT FOR
CHAP. xv. ing of stoppage: I feel as if there was something in
the way: if I take a purgative, the obstruction will
be removed and I shall be well.” -
580. This argument, in reality another form of the
third argument, is put forth frequently by individuals,
who labour under chronic inflammation of the pyloric
portion of the stomach.
581. It is not denied that this feeling of stoppage
is frequently relieved by the exhibition of a purgative.
... But the relief does not prove the existence and the
not prove the
.* removal of any stoppage. The sensation is merely a
º symptom of the diseased state of the pylorus, and the
relief is gained by the production of one or other of
the following conditions. The purgative may, by the
irritation it excites, subdue temporarily the irritation
connected with the disease, and thus afford temporary
relief: or, the purgative, by causing the contents of
the stomach, (the stomach being irritated by the pur-
gative), to pass more rapidly from the stomach into
the duodenum may lessen the period of time, which,
without this hastening, the food would have taken to
pass through the pyloric opening, and thus relief is
afforded to the feeling of stoppage: a relief, it is
true, but attended with the injury of making the
food to pass out of the stomach before it is properly
digested. -
Sensation 582. That this sensation is unconnected with any
unconnected {e º
with want of want of action on the part of the bowels is proved by
º * the well established fact, that persons who have felt
this sensation to the day of their death, have presented,
when examined after death, a stomach perfectly empty
and an intestimal tube, free of feculent matter. The
cause of the sensation was the pylorus in a state of
disease.
THE EMPLOYMENT OF PURGATIVES. 211
583. Many persons declare that they often obtain CHAP. xv.
relief from a pain, occurring about two hours after
taking food, by the employment of a purgative pill.
584. It is granted that they are relieved, but how Action of
* e ge : . e pills ex-
is the relief obtained . The pill, as previously ex-plained.
plained, causes, by the irritation it excites, a more
powerful expulsive effort of the stomach, and thus
hastening the transit of the contents of that organ,
shortens the duration of the irritation, induced in the
stomach by the digestion of the food taken. It is also
true, that the pain is oftentimes increased while the
contents are passing: the pain is severe but it is soon
over: and the pain ceasing, the relief is agreeable to
the sufferer, and the purgative pill, to him the appa-
rently relieving agent, is regarded with approbative
complacency. Such temporary increase of pain may be
submitted to in the case of a surgical operation, which
Once done is not again necessary, but this action of the
stomach being a daily action, the use of purgatives in
order to obtain relief exhibits the vulgar, the empi-
rical necessities forced upon the allopathist, he, not
knowing any certain method of curing by direct action
the diseased state of the stomach causing the pain.
He obtains relief, but in reference to such relief con-
tinually repeated, the remark of Hannibal in reference
to his victory over the Romans is applicable, “another
such victory and we are undone.”
585. It is worthy of notice that a similar sensation Sensation of
of fullness is felt in the bowels in the case of chronic . i.
disease of the intestimal membranes. In this diseased.
state there is a sense of distension, and the sufferer brane.
imagines that this sensation would be relieved by the
emptying of the bowels.
586. The fact is, that, in most cases, there is nothing
E E 2
212 UN SOUND NESS OF THE AIRG UMIFNT FOR
CHAP. XV.
Argument
fifth.
Constipation
precursory of
a diseased
State.
Epilepsy pre-
ceded by con-
stipation.
in the bowels that is unsuited to the bowels, to empty.
The sensation depends on a diseased condition of the
intestine, and though purgatives sometimes tempo-
rarily relieve this condition, the relief is obtained, not
from the effect of the purgative in its character as a
purgative, but from the action of the purgative,
having a homoeopathic relationship to the diseased
state of the intestine, and thus having the power of
producing a state similar to that existing in the intes-
timal tube produces relief. Even in such case the
benefit gained is attended with an injury, namely,
that derived from the action of the purgative as a pur-
gative, an injury not to be permitted or justified, since
by homoeopathic remedies the whole amount of benefit
gained can be gained without the injury.
587. Sensations do not always indicate the means
of relief. It is a well known fact that persons, who
have had a limb removed, have had the sensation of
pain in the limb which no longer forms part of them.
588. ARGUMENT fifth. It is argued in favour of the
employment of purgative medicines, that a confined
state of the bowels often precedes the development of a
diseased state, and that such a precursor indicates that
purgatives should be employed to prevent the develop-
ment of the diseased state, precursored by the con-
fined bowels. t
589. Such is the argument. Its value is now to be
ascertained. -
590. It is a fact, that, in epilepsy, it often happens
that the sufferer a few days before the epileptic seizure,
has his bowels confined. The common practice is to
purge the individual, and this is adopted under the
THE EMPLOYMENT OF P URGATIVES. 213
idea, that, by removing the constipation by the exhi- CHAP. XV.
bition of purgatives, the seizure will be prevented.
591. Has success attended the practice? No. If
for a short time the attack has been suspended, it is
only for a short time, and it came notwithstanding all
the purging, however violent it may have been, and
comes with a greater severity, caused apparently from
the enforced delay.
592. The mistake in connexion with the argument
put forth originates in the undue importance attached
to the precursory constipation. The constipation, it º
is granted, is one precursor, but it is one of many many pre:
precursors. Besides it is not a precursor causant of, .."
but a precursor coincident with, the attack. k
593. If sufficient attention were paid to the course
of the development of the attacks of this distressing
disease, many deviations besides that of the state of
the bowels would be detected. The superficial prac-
titioner recognizes that which is recognized most easily,
and it is consequently to constipation of the bowels
that medical and popular attention is most powerfully
drawn. The deviations from the natural regularities
of the system would be found to be numerous, and the
special deviations in relation to the state of the bowels
would be found to be but one link in the chain of
phenomena preceding the attack, and, viewed rela-
tively, perhaps not an important link. Its want of
importance, or, rather its low scale of importance, is
proved by the fact, that the alteration of the state of
the bowels by purging does not stop the progress of
the malady or permanently arrest the attack. -
594. It is a fact, that a peculiar dryness of the hair Peculiar dry-
often precedes an epileptic seizure. So great is this: º
* 1 . - gº G les epi-
dryness that the writer has known patients, afflicted.
214 TJN SOUND NESS OF THE ARG UMIENT FOR,
CHAP. xv. with epilepsy, who noticed, that, before an attack,
they could not brush their hair down or make it
smooth. How absurd would it have been for such
patients to imagine that, by wetting the hair, they
would prevent the attack of epilepsy. Not more
absurd than is the practice because the bowels are con-
fined before an attack of epilepsy, that to force the
bowels to act is the best remedy to prevent the epilep-
tic seizure.
595. The same inaction of the bowels precedes, in
numerous cases, the development of that common
; º affection, known under the name of “sick headache.”
ceded by con-Here purgatives are with the mass, medical and non-
* medical, the means most frequently resorted to, and
the more violent the action the higher is the estimation
in which the purgative agent is held. But does not
daily experience prove the ultimate inefficiency of
purgatives in such a condition ? Does not every ho-
moeopathic practitioner have cases of such headache
coming under his care in which purgatives have been
employed and employed in vain? The mistake rests,
as in the case of epilepsy, in considering the One link
in the chain of causant phenomena, connected with
the headache, as the whole chain. The majority re-
cognize, as was stated, the inaction of the bowels, but
they ought to inquire for that which caused the in-
action itself; and that, successfully found and treated,
would cause both the inaction of the bowels and the
epilepsy itself to cease: but such inquiry requires
patience, time, skill, and what is more difficult, a
knowledge of the pathogenetic effect of medicines.
596. The fabulist declares, that, once a fly sat on a
chariot wheel while it revolved, and beholding the
amount of dust caused by the rotation of the wheel,
THE EMPLOYMENT OF PURGATIVES. 215
5
exclaimed “What a mighty dust I am raising.” There CHAP. xv.
was a coincidence between the fly sitting on the
chariot wheel and the dust being raised. The mistake
of the fly was in making a coincidence a cause.
*-* *
597. ARGUMENT sixth. A main argument in favour Argument
of the employment of purgatives is, that their employ- sixth.
ment is a means of purging the system, or, as the buc-
caneers in medicine put forth, of purging the blood.
598. How many take purgatives every month or
even oftener to cleanse the system, to clear out the
bowels, to purify the blood. They argue for the prac-Thºburging
© gº purifies the
tice, as tending to remove the grossness of the system ; blood.
and some actually maintain, that, if they did not
physick themselves when in health, diseases, when
attacking them, will find such a suited resting place
in their grossness, that it will be next to an impossi-
bility to dislodge the enemy.” Such balderdash is.
uttered by people, who consider themselves in the
possession of sense. How such people can utter such
absurdities is wonderful. Such utterances may serve
as a cloak for the cunning of some Morrison pill seller,
or may be used as a cover to hide the rascality of
some Ægis of life advertiser, but that such utterances
* A kind of superstition lurks in this reasoning;
a superstition somewhat similar to that expressed by
Philip, king of Macedon, who, having heard in one
day three items of good news, the birth of a son,
a great victory by one of his generals, and that he
himself had carried the prize at the Olympic games,
prayed—“Great Jupiter! in return for so many bless-
ings, send me as soon as possible some slight misfor-
tune.”
216 U NSO UN DIN ESS OF THE ARG UNITENT FOR
should be sanctioned by those who have no interest
but to preserve their health is indeed lamentable.
599. Such profiters upon human ignorance may and
do talk of purifying the blood by their purgings. In
so talking they (what care they !) beg the whole ques-
tion, mamely, that purgatives do take away impurities.
How do they know that purgatives do not take away
purities? With reckless audacity, they presume on
the ignorance of the public So far as to ascribe a
selective property to the purgative” that it shall know,
in the darkness of the intestinal tube, purity from im-
purity, and knowing shall select the one from the
other, leaving the purity untouched, and carrying
away the impurity alone. Can deception go further
Can credulity be further stretched 2+
CHAP. XV.
* They urge the name of purgative: to purge is to cleanse, say they :
and does not this prove the value of purgatives? Such is the force of
a name, that many believe that purgatives do cleanse. How many have
been ruined by this term injuriously influencing their minds. Like as
many have been destroyed by the cleverness of that man, who gave to
beer the name of “stout.” The sick believed they would stouten them-
selves by taking stout and have died of diseased liver, the consequence
of taking stout.
f A young Scotch gentleman consulted me some years since when the
Morrison pill mania was at its height. He had, in taking these pills, found
that one pill of No. 2 exercised a power on the bowels equivalent to three
pills of No. 1. Careful of his money, and priding himself on his shrewd-
ness, he thought he might save somewhat by having two boxes of pills
No. 2, instead of a box of No. 1 and a box of No. 2.
Calling on the pill vendor he asked for two boxes of No. 2. The man
asked why he wanted two boxes of No. 2. The young gentleman told
the reason. Oh, said the pill vendor, you do not understand: pill No. 1
goes into the blood, gathers all the impurities and pours them into the
stomach ; pill No. 2 goes into the stomach and carries all the impurities
away. -
This was too strong a draft on the Scotchman's credulity: too great
an insult to his common sense. Disgusted, he came to me for advice, and
related the circumstance as deciding him to leave the mode of treatment,
of which he had been the subject.
THE EMPLOYMENT OF PURGATIVES. 217
.*
600. They assert in defence of this purifying action on AP, xv.
of their purgatives, that the discharge from the bowels
is, when their purifying medicines are taken, so offen-
sive. But here again they beg the whole question,
for how do they prove that the offensiveness is not a offensiveness
result from the injury done to the intestinal tube by tºº
the diseased action induced therein by the action of" "é".
their purifier, which is in reality a poison or a col-
lection of poisons?
601. That such offensiveness depends upon such an
action admits of little doubt. The purgative alters
the natural state of the secreting vessels existing in
the mucous membrane of the bowels. This alteration
thereof causes an alteration in the secretion from the
vessels themselves, and as this alteration is connected
with the production of an unnatural state of these
vessels, the result is offensiveness of secretion; so that
that which these buccaneers in medicine put forth as
a proof of the efficacy of their means is, in reality, a
demonstration of the injuriousness of these very means.
602. That an alteration in the state of the lining
membrane of the intestinal tube is the cause of offen-
sive discharges from the bowels is evidenced daily in
diseases of the intestinal membrane. What can be Diseases of
* & e the intestinal
more offensive than the diarrhoeal discharges presentiºn.
in the last stages of phthisis? Also in those occur- º
ring in the last stage of diseases after the thrush has *.
appeared in the mouth, an appearance, in such states,
generally indicative of the ulcerative process having
established itself in the bowels.
603. If such offensiveness may result from a dis-
eased action of the lining membrane of the intestine,
why should it not happen that a diseased state, in-
duced in the intestimal canal, by the poisonous trash
F F
218 UN SOUNDN ESS OF THE ARGUMIENT FOR
CHAP. xv. given by these buccaneers, may cause the offensive
evacuations, subsequent to the exhibition of this
poison by these “blood purifiers.”
604. In connexion with this argument about purify-
ing is a statement, frequently put forth in favour of
Purgatives purgatives, that they produce “bilious stools,” and,
...; that, because they produce such stools, the purgatives
stools. must be highly valuable; that is, they are beneficial
because they cause the bile to pass. So far from this
discharge of bile as bile being an evidence of benefit,
it is, in reality, an evidence of injury done. Bile
ought never to flow except when the chyme enters
the duodenum. The entrance of the chyme into the
duodenum affords the stimulus, appointed by nature,
to cause the bile to flow from the gall bladder. If
the bile flows into the duodenum at any other time,
or under any other circumstances, such flow depends
upon an unnatural stimulation, and such unnatural
stimulation purgatives excite.
i. 605. Bile ought never to be seen, as bile, in any part
only in the of the intestinal canal except the duodenum; if, as bile
" present in any other part, it is, instead of being a
proper stimulant to the intestimal tube, an irritant. It
is an acrid body as thus presented. Yet, such is the
want of logical power in the majority, and even
amongst medical men, who ought to be able to reason
accurately, this very excessive irritation, induced by
the action of purgatives in causing the discharge of
bile as bile, is brought forward as an evidence of the
benefit resulting from the employment of purgatives.
tºº 606. “See what acridity is made to pass away,” is
an observation often put forward.
607. Every one knows that the spittle in the mouth
is one of the most harmless of fluids; but if the
TIIIE EMPLOYMENT OF PURGATIVES. 219
Spittle, from some ulceration or wound in the cheek, CHAP. xv.
passes through to the outside of the cheek, it is acrid
and irritating to the cheek. Just as rational would it
be to maintain that the excessive irritation caused by
the Spittle, when escaping to the outside of the cheek,
is a benefit, as to maintain that the irritation caused
by the bile appearing as bile in the parts where it
Ought not so to appear, is a benefit, is an evidence of
the value of the agent that causes it so to appear.
Such irritation is a demonstrative proof that the pur-
gative has caused the bile to be discharged without its
proper admixture with food, or chyme, and, that, in
travelling as bile along the intestinal canal, it causes
distress.
* *
608. ARGUMENT seventh. “I want some cooling Argument
e e g e * seventh.
7medicine” is a phrase, which embodies another argu-want of cool-
ment urged by many in favour of the employment” ".
of purgatives.
609. That such an utterance affords no argument
in justification of the employment of purgatives, a
Small amount of investigation will demonstrate.
610. The question presents itself, What causes theº
heat that renders the cooling necessary" and, con-
sequent on this question, follows another, If cooling
is required, is the use of irritants forcing the bowels
to act, the rational mode of effecting the end sought !
611. Purgatives act as such by producing irritation
in the lining membrane of the bowels. In inducing
this irritation the life power is directed in excess to
the intestines. The result of such excess directed to Injury pro-,
the intestines is a diminution of action in some other º this
parts of the body, and, as in the state connected with
the condition, which indicates the necessity of cool-
F P 2
A
220 UNSOUNDNESS OF THE ARG UMENT FOR
CHAP. xv. ing, the part affected had the life power modified in
connection with it, the excess of action, excited in
the intestines by the purgative, causes this modifica-
tion in some cases temporarily to be suspended, and
the state described as “cooling” is attained; and be-
cause the end sought is gained, and, because the
diseased state induced in the lining membrane of the
intestines by the purgatives is not visible or imme-
diately apparent, the injury inflicted by the purgative
is disregarded, the relief gained is looked upon with
complacency, and the purgative obtains a reputation
- for effecting what the individual wanted, a cooling.
Hºl. 612. The existence of an unnatural heat in any
cation of part or parts of the body indicates, as just hinted,
“ the existence of a diseased state, of a modification of
the life power, which modification can be properly
met only by the appropriate remedial agent, chosen
according to the homoeopathic law, and the modifica-
tion will be made to cease without any injury to the
constitution: the individual will have the diseased
condition, which caused the unnatural heat, to cease,
and thus he will be scientifically, and, consequently,
safely and permanently, cooled. Whereas, in the
cooling produced by purgatives, the diseased state
not being removed by the purgatives, the feverish
irritation will again be developed, and purgatives
must again be administered to induce a repetition of
what is vulgarly called the cooling.
*gººmsº
* 613. ARGUMENT eighth. As an argument for the
The smell of necessity of purgatives it is asserted, that, when the
the bod - * - e.
jºin bowels are confined for a length of time the smell of the
the bowels © e * * * > . e.
... ... body is focal. This smell, it is intimated, depends
fined. on the absorption of the fascal matter, which, it is
THE EMPLOYMENT () F. PU-R GATIVES. 221
argued, could not have occurred, if purgatives had CHAP. xv.
been used.
614. This argument embodies assertions, wanting
proof. It is a well known fact, that the bowels have
been confined for weeks without any such faecal smell
being caused.
615. Even if the smell of the body in such cases ãºn
of delayed action of the bowels was facal, such a caused by the
tº tº e * diseased state
coincidence would not prove that the inaction of the j
bowels was the cause of the smell, unless it could be
positively demonstrated, that no other deviation from
the natural state save the one, non-action of the
bowels, existed. The cause of the faecal smell is to
be found in the diseased state of the body, which
causes the bowels to be confined. The confined con-
dition of the bowels is only one among many condi-
tions, resulting from the diseased state, and those
ascribing to this condition the peculiar smell, refer to
one effect of the diseased state what truly results
from the whole of the diseased agency.
616. Besides, what proof exists that faecal matter Proof want.
is absorbed Even in cases where the calibre of the:
intestinal tube is obliterated, and where the feces are”
rejected from the mouth, there is no faecal smell, ex-
cept that resulting from the faeces rejected from the
mouth.
617. That the faecal smell, when present, and, it
is believed that its asserted presence is, in most cases,
an imaginative rather than a real presence, is not
dependent on the constipation of the bowels, is evi-
denced by facts which have come under the writer's
notice. In some cases of palsy, which have come
under homoeopathic treatment after the old-system
treatment (blistering, leeching, purging,) had been
222 UNSOUNDNESS OF THE ARGUMENT For
CHAP, XV.
tried in vain, the smell of the paralytic patients, al-
though the bowels were regularly active, has been so
offensive, that those, who most loved the patients,
have found it difficult to remain in the room where
the paralytics were. Add to this, how common is
this smell in atrophied children, who have diarrhoea
much more frequently than they have constipation.
618. Corroborative of the view that the faecal smell
does not depend upon the mere confined state of the
bowels, but upon the diseased state, of which the
confined state of the bowels is but one symptom, the
fact stands forth, that different diseased conditions
are indicated by special smells. Writers on insanity
maintain, that, the insane have a peculiar smell; so
marked, that such smell is an indication by which the
insanity of such person so smelling can be certainly
known. Under the erotic orgasm, it is held, that
the persons so affected, have a peculiar smell. These
smells depend on special bodily conditions. Why
then should the faecal smell be referred to the inaction
of the bowels, and not rather to a general bodily
diseased state, which causes, among other effects, the
inaction ? Indeed, the writer has found the smell de-
cidedly faecal in scrofulous caries of bone occurring
after amputation.
619. The deduction, that the fecal smell depends
upon the retention of the contents of the intestinal
canal, owes its origin to what cannot be admitted as
an established fact, namely, that the faeces in the in-
testinal canal are offensive. Much reason exists for
doubting that the faeces in the intestimal canal are
offensive.” It is allowed that the faeces are offensive,
Diseased
conditions
indicated by
special
Smells.
Questionable
deduction.
* The opinion that the facces have a fºcal smell in the body is held by
THE EMPIOYMENT OF PUTRG ATIVES. 223
when expelled into the air; but, when expelled, they CHAP. xv.
are placed in new conditions; i. e., they are exposed
to conditions, not present when the faeces are con-
tained in the intestimal canal: they are exposed to
the air; and, it is not unlikely, that such exposure
causes the development of effluvia, which without
actual contact with the air would not be given out.
Indeed it seems to be a somewhat similar condition,
when persons pass offensive flatus; for, in such case,
air has been generated in the intestines, and it is not
unlikely, that the offensiveness of the flatus depends
not on the faeces, per se, being offensive, but because
they have been subjected to the action of the air
generated in the intestimal tube.
620. If the facal smell of individuals, in whom
the contents of the bowels are retained in obstimate
constipation affords the idea, that the smell depends
son the retention and the consequent absorption of the
intestimal contents, is an argument for purging, it
certainly affords an argument much stronger against
purging. For, if injury results from the mere reten- *śa.
tion of the faeces, how much must the injury be aug-retention of
mented, if, in addition to the natural contents of the º IIl
bowels being retained, the violently active purgatives,
many. Mr John Hilton, a highly talented surgeon, attached to Guy's
Hospital, holds this opinion. In referring to the discharge from fistulous
ulcers he maintains, Medical Gazette, p. 225, 1851, vol. i.-“That, when an
abscess forms in any situation near the abdominal walls, and the abscess
opened, the discharge is offensive.”
This view, which has some interest, does not militate against the view
already given; for the fact, that the abscess referred to was fistulous,
indicates that it has an opening, and through that opening the air" can
gain entrance, and when not fistulous the secretion itself might be offen-
sive. -
* Why are water closets in such request? Because the water excludes the air and
thus prevents much offensiveness.
224 TJN SOUND NESS OF THE ARG UMENT FOR
CHAP. xv. administered by the old-system practitioners to force
the bowels to act, are retained as well. If the reten-
tion and the absorption of the natural contents of the
bowels be injurious, how tenfold more so must be the
retention and the absorption of both,” not only from
their own injuriousness, but from the effect, not at
all improbable, that they, by their irritation, may
excite the absorbents to take up more faecal matter,
that is, supposing the absorbents do take up faecal
matter, as is supposed in the argument put forth in
connexion with the faecal smell.
621. As a conclusion to this consideration of the
arguments usually put forth in favour of the employ-
ment of purgatives in diseased states, is the demon-
stration, that inaction of the bowels is to be regarded
tºº. as a natural result of diseased state, and that there-
fore the employment of purgatives is not necessary.
622. The fact is granted, because it is a fact, that the
bowels are often inactive during the course of disease.
This suspension of the action of the bowels in dis-
eased states is one circumstance, but it is only one of
many circumstances. Another circumstance, especi-
ally prominent in acute diseases, is that in these
º sus diseases the appetite is suspended. This suspension of
during dis- appetite is an utterance of Nature, “Feed not;”
©:US0. which utterance being attended to, little or no incon-
venience will result from the mere inaction, however
much may be the inconvenience resulting from the
disease.
* Every year's experience strengthens the belief, long entertained by
the writer, that the greater number of cases in which death occurs in
connexion with stoppage of the bowels, the individuals die, not from
the stoppage, as is supposed and complacently asserted, but from the
inflammation and consequent ulceration, and not unfrequently mortifica-
tion, produced by the purgatives, used to force a passage. (Appendix).
THE EMPLOYMENT OF PURGATIVES. 225
623. Experience demonstrates that the disturbed CHAP. XV,
states, called gastric derangement, occurring during Gastric de-
the progress of a disease, and which are generally ºf tº as
referred to inaction of the bowels, are not at all the º,
consequences of inaction, but are effects arising from ****
the ... of food into the stomach under cir- **
cumstances, in which Nature declares by the loathing
of food that the stomach cannot digest it. Hence
food, which, under different circumstances, would be
nutriment, becomes poison. Of the impossibility to
digest food in diseased states proof was afforded in the
experiments on Alexis. These experiments establish-
ing, first, that, in fever no gastric juice can be ex-
tracted, not even on the application of the alimentary
stimulus; and second, that food, in the febrile condi-
tion of the stomach, remains undigested for twenty-
four or forty-eight hours or more, increasing the de-
rangements of the whole alimentary canal, and aggra-
vating the general symptoms of the disease.
624. The axiom may be presented, “ WITHOUT No action of
FooD THERE IS No ACTION OF THE Bow ELs.” ºl.
625. Of this axiom the demonstrative proofs are
numerous. The infant in the womb receives nou-
rishment through its mother's circulation, and not
through the digestive process, and consequently there
is no action of the bowels while in the womb, no
food being received into the stomach. And, even,
though the intestines have formed in them a peculiar
matter, which may in some respects be regarded as
faecal, yet there is no action of the bowels, even after
the child is born, till the child takes its mother's
breast, that is, till it takes food into the stomach.
Then the gyre-like motion, which carries on the con-
tents of the bowels, is communicated to the intestinal
G. G.
226 UN SOUNDNESS OF THE ARG UMENTS FOR
CHAP. XV.
Cruelty of
physicking
infants.
tube in its whole extent, and the contents of the
bowels, called the meconium, are expelled: in other
words, digestion of food is followed by action of the
bowels. The recognition of these views has an im-
portant bearing, as at once forbidding the absurd, the
injurious custom of giving physic to the poor little
just born infants. These physic givers would seem to
think that the first business of life is to take physic,
and little doubt exists, that the pains which the little
sufferer manifests, produced, it is said, by the wind in
the bowels, is produced, in many cases, by the injury
resulting from the employment of the purgative,
, which itself produces the wind, charged as the pro-
ducer of all pain.
626. Another demonstrative proof of this axiom is
Alexis's case, to be found in Alexis's case. The injury from which
While the
food escaped
he suffered was such, that, for seventeen days, all
that entered the stomach by the gullet passed out
from stomach through the wound in the stomach, and the only way
no action of
bowels.
Food being
retained the
bowels be-
came gradu-
ally excited.
of sustaining him was by the aid of nutritive in-
jections by the amus, until compresses and adhesive
straps could be applied so as to effect the retention of
the food. It is interesting to notice the effect of this
non-retention of the food in the stomach. Dr Beaumont
states, “During this period no alvine evacuation could
be obtained, although cathartic injections were given,
and other means were adopted to promote them.”
627. What happened subsequently in this case is
still more demonstrative of the axiom under considera-
tion: Dr Beaumont adds, “In a few days after dress-
ings were applied and the contents of the stomach re-
tained, the bowels became gradually excited : that is,
directly food entered the intestinal canal, the intes-
timal gyre was put into motion and the action of the
THE EMIPLOYMENT OF PURGATIVES. 227
bowels took place, and took place, as it ought accord- CHAP. xv.
ing to the law of intestinal action, gradually.
628. The following fact gives an additional demon- Additional
stration to the truth of the axiom : A gentleman one *
day in the country looking over an estate, was pre-
vented dining till past nine o'clock in the evening,
Inot having eaten since ten in the forenoon. To his
astonishment he did not have an action of the bowels
the same night, or on the following morning, as was
his constant practice, namely, an action morning and
might, but the next action of his bowels took place
about the usual time the following night.
629. If therefore in acute diseased states, the voice
of nature is listened to, and, while the loathing of
food remains no food is taken, nothing but water or
gummed water, the inaction of the bowels would be ºf
an evil, only as exhibitive of a diseased state, of sometimes
which it is a symptom, and, which, together with *
the other symptoms of the diseased state, will disap-
pear when the remedy, homoeopathic to the diseased
state, is administered.
630. Indeed the grounds are not few which indi-
cate that the inaction of the bowels, while the dis-Inaction of
e tº º bowels in
eased state endures, is a benefit rather than an injury, disease a be-
When a part of the body is in a state of disease,”
there seems to be a partial suspension of the activity
of the life power in all other parts of the body except
the part diseased. Great efforts seem to be made in
the part diseased to free it of the state affecting it.
This, to a certain extent, suspends other actions, and
the bowels are the organs, which, in their inaction,
show not unfrequently the effect of the irregular
activity of the life power. To force the bowels to
act is therefore to interfere with the series of actions,
G G 2
228 UN SOUNDNESS OF THE ARGUMENTS FOR
CHAP. XV.
Food not to
be given in
acute dis-
€al SeS.
In some
diseases de-
sire for food.
Morbid ap-
petite indi-
cated by the
state of the
tongue.
necessary to be gone through in order to effect a cure,
and this interference with the life power, though
Sometimes affording temporary, that is, palliative re-
lief, often exhausts the life power itself, and prevents
it, even when afterwards guided in its action by the
appropriate medicine, so readily effecting a cure.
631. It is maintained that the inaction of the
bowels in acute diseases is not in itself a matter of
moment: that no danger results from or is caused by
it, if the rule be attended to of giving no food. It is
maintained further, that, directly the disease is sub-
dued, the bowels will act of themselves.
632. But it may be argued and is argued, that, in
some diseases there is not a loathing but a strong
desire for food, and that such being a fact the argu-
ments, that if in disease there is no appetite no food
should be given, and, that if no food is given no
injury will result from the inaction of the bowels,
are not perfect. It may be said, and truly said, that
in diseases which have been treated under the old
system where the patient has been forbidden food,
and where the patient has taken food notwithstanding
the directions to the contrary, he has got better, in-
deed has rapidly recovered.
633. These facts are recognized as true, and are
explicable. In reference to the first fact, the strong
desire for food is a morbid appetite, which is indi-
cated by the state of the tongue, and food taken
under such circumstances generally causes the disease
to be fatal. In reference to the second fact, the de-
sire for food depends not on the presence of disease,
but on the exhaustion of the physical, organic, and
vital power by the depleting measures, employed by
the old-system practitioner, in the treatment of dis-
THE EMPLOYMENT OF PURGATIVES. 229
ease; and hence the want is a natural want, and the CHAP. xv.
supply of that want saves the patient from death.
634. To conclude: If purging be so beneficial as is
asserted by the old-system practitioner, why do me-
dical men try to arrest natural purging or diarrhoea,
when present in the course of disease ? They seek to
produce artificial purging, but deprecate the pro-
duction of natural purging. When Nature gives Absurdity of
them their delight, immediately they interfere with ...:
Nature, and try to arrest that which, effected by tº.
their own agents, they rejoice in. In such cases they"
give medicines to bind, they give astringents,” as such
medicines are called. These exhibitors of purgatives
administer purgatives to get rid of some diseased
state: i. e., they give irritants which cause an in-
creased secretion from the mucous membrane of the
bowels, this increased secretion being the result of a
diseased action, induced in the mucous membrane.
They applaud their own proceedings, and condemn
others who do not adopt similar proceedings. Di-
rectly however Nature causes an increased secretion
from the bowels, they immediately interfere and use
their chalk mixture,t and other agents to arrest the
* The allopathists, it is worthy of repetition, are perpetually taunting
homoeopathists with treating symptoms only. What is this trying to
arrest diarrhoea by astringents, but the doing the very thing which they
charge against homoeopathists, namely, treating symptoms ? The homoe-
opathist treats, when diarrhoea is present, not the diarrhoea as a symp-
tom, but he collects from the aggregate symptoms the disease that is
present, of which the diarrhoea is a part of the whole, and meeting the
whole disease by a homoeopathic remedy acting on the whole aggregate,
removes the diarrhoea, a part of that aggregate.
+ The son of a tradesman was attacked with diarrhoea. The apothecary
did all he could to arrest the diarrhoea, but was unsuccessful. A phy-
sician was called in, and they mutually agreed that the recovery was
doubtful. The action of the bowels at length ceased : the end they
230 UNsoundNESS OF THE ARGUMENTS FOR
cHAP. xv. action of the bowels. But if the one kind of purging
is beneficial, Surely it is inconsistent to arrest the
other. Indeed it is dangerous, for very often when
success attends their efforts, the diseased state which
caused the diarrhoea is rendered permanent, and the
foundation of incurable chronic disease of the intes-
times is laid. -
} *. 635. It is true that enlightened old-system prac-
cessary in titioners declare that care must be taken in arresting
suddenly ar- te º -
jäiºr a natural purging, a diarrhoea, too suddenly. They
hoea. allow that injury may result from such sudden arrest;
but when constipation occurs, (in many diseases as
much a natural effort in one direction as the diarrhoea
is in the other,) they do not adopt the same argument
and say—Be not in a hurry to force the bowels, wait
a little and the constipation will cease: they purge.
Purgatives 636. But purgatives do not cure constipation: they
*::::::::::.. relieve ; but as soon as the effects of the purgatives
* have ceased, the bowels become more confined than
they were before: this is always the case unless the
purgative happens to be homoeopathic to the diseased
state, causing the constipation. In such a case, there
was no need of producing purging, because such
medicine would have cured the constipation without
inducing the amount of irritation manifested in
purging.
637. The allopathists put forward the theory, that
inflammation is the cause of constipation; and yet
purgatives, given for the cure of constipation, pro-
sought for was obtained. Not acting for eight hours, the apothecary,
who had attended the family twenty years, thinking eight hours was a
long time to be without an action of the bowels, gave a purgative;
diarrhoea again came on, and the youth, aged eighteen, died of the
consequent exhaustion.
THIE EMIIPLOYMENT OF PURGATIVES. 231
duce irritation and, in many cases, inflammation of CHAP. xv.
the lining membrane of the intestimal tube. To add
inflammation to inflammation indicates an inconsist-
ency in connexion with allopathic theorists: to the
homoeopathist the matter has less of inconsistency.
638. In the cases where the allopathist cures con-
stipation by medicines he deems purgative, but which
really are homoeopathic, and act by their homoeopathic
relationship, he, though curing, produces injury,
causing disease of the lining membrane of the intes-Disease
te d © tº d by th
timal tube. What a mass of intestinal misery and of..."
health destruction is connected with the employment ºf P*
of purgatives, as embodied in the too frequently
heard declaration, “He always requires very strong
medicine to act on him.”
639. The arguments, already brought forward in
justification of the employment of purgatives, have
relation to the action of these medicines as removing
the constipational state. Another view, in justifica-
tion of the employment of purgatives in disease is
put forward, has relation to another mode of action;
it is the general argument that purgatives act as de-Depletion
© a º argument.
pletory measures—or, as it is expressed by one of the
most violent and most rude of the vituperators of
homoeopathists— -
“One of the apparently strongest arguments, brought forward by un-
believers in the powers of medicine to prove their assertions, is the great
diversity in the practice of medical men. But this argument is merely
specious, and will not bear the slightest scrutiny. It is more especially in
the treatment of inflammatory and febrile diseases that this diversity
exists, and in these diseases, precisely, the indication is one which may
be attained by a variety of means. DEPLETION is the indication, and
depletion may be equally produced by the action of local bleeding, of
large blisters, of purgatives, of diuretics, or of diaphoretics: thus we
find, that the physicians who, in the treatment of pneumonia, in England,
rely partly on bleeding and partly on purgatives; in France, entirely on
bleeding, or on the application of large blisters; in Germany, partly on
232 EMPLOYMENT OF PURGATIVES DANGEROUS.
CHAP. XV.
bleeding and partly on critical evacuations, urinary or cutaneous;–all
arrive at the same end—the depletion of their patient, though by different
methods.”—Lancet, vol. i. 1844, p. 165.
640. This depletion argument is a melancholy evi-
dence to the unscientific and injurious nature of the
old-system treatment: inasmuch as the argument
virtually testifies to the fact, that the old-system prac-
titioners have no means of acting on diseased states
directly, and hence they act indirectly by depletion.
They do injury to the bowels to relieve an injury that
is being inflicted on some other organ of the body.
They excite a riot in Bristol in the hope that it may
suspend a riot in London—they think that a riot ex-
cited in the bowels is a satisfactory mode of quieting
a riot existing in the head, forgetting at the same
time that the human body is the field on which both
riots are carried on.
641. Indeed, “purge, purge,’
2
is the cry from the
very beginning of a human being's existence. First
of all, the mecomium of the just born infant has to be
purged out. This, it would appear, is the first wel-
come which the attendant thinks he must offer to the
little being he has helped into the world; forgetting
altogether that the Creator has provided in the first
portions of the mother's milk a proper means for the
expulsion. Purge, purge, is the constant Cry during
childhood, youth, and adult age; and purge, purge, is
the last cry; indeed too often it is the last act in life's
drama.
THE REMOVAL OF CONSTIPATION. 233
CHAPT E R XVI.
On the use of auxiliary means to promote the removal
of Constipation. Obeying the call to relieve the
bowels. Soliciting the bowels after breakfast. Mo-
deration in the use of food. Sponging the body with
cold water. Drinking a tumbler of cold water.
Friction to the spine. The eavercise of walking.
Reading aloud.
642. A truth, ever to be remembered in connexion CHAP. xvi.
with all efforts to realize a right end, to carry out a
proper aim, is this, that the tendency to the natural .
order is the greater tendency; Or, in other words, to here to the
adhere to the primal form is stronger than the tendency normal form.
to attain to other forms; or, to express the fact other-
wise, that to the normal rule nature tends more than
she does to the abnormal deviation.
643. If this had not been appointed as a verity in
nature, then monstrosities would continually occur.
Each tree would no longer adhere to its own shape.
It might happen that the nose would not cease to
grow and the fingers might continue extending.
644. This truth ought to encourage every indivi-Regularity of
ſº e s tº e . . . bowels the
dual in all legitimate efforts to be made in establishing natural ten-
|H H dency.
234 ATſ XII,IARY MEANS TO PROMOTE
CHAP, XVI. regularity of the bowels. He should remember there
is a greater natural tendency to regularity than to
irregularity of the bowels. ^.
645. The fact, however, meets the attention that
the circumstances, in which man is placed in large
cities, are oftentimes such as tend to interfere with
the regularity with which the functions of the body
should be performed.
... 646. Civilization is an immense blessing, but civi-
obedience to
the laws of lization is not as yet sufficiently influenced by a
lº. knowledge of and an obedience to the laws of man's
ganic being. physical and organic being. The consequence results,
that the customs of society exercise an injurious
influence on the bodily and even on the mental con-
stitution, and this injurious influence is exhibited in
deviations from the normal state, which would be
much more frequent and much more earlily induced,
were it not for the strong tendency in nature to keep
to the right, the normal line.
647. One form in which this injurious influence ex-
hibits itself has reference to the action of the bowels.
648. It may therefore be useful to point out the
Means to pre-means, by which civilization may be made to march
nºis more in harmony with the human constitution in
.*relation to the actions of the intestinal tube, so as to
tube. preserve regularity to the actions of that tube.
649. A means most efficient to prevent constipation
ºul and to aid in its cure when it is present, is the obeying
the bowels, the call to relieve the bowels.
650. If any bodily action is inclined more than any
other to regularity, such action is the action of the
bowels. The reason of such inclination is to be found
in the facts, that the intestinal tube has a fixed
LENGTH and a fixed ACTION, and consequently the
THE REMOVAI, OF CONSTIPATION. 235
intestinal food journey may be expected to occur in a CHAP. xvi.
fixed time. So that regularity of the bowels is a
condition, of necessity associated with the bowels.
651. As a fact illustrative of this regularity, is the Aº
tº the bowels of
circumstance that the bowels of most people act atmost persons
e act at a fixed
one fixed time every day; most commonly after time every
breakfast. X day.
652. In a public institution, with which the writer Illustration.
has an official connexion, the patients recline con-
tinually. They do not rise even for the purpose of
relieving the bowels. As several are in the same
ward, it becomes a matter of convenience and of com-
fort that all the patients should relieve the bowels at
the same time. It is a fact that they do do so, so that
at one hour all the patients effect relief from the
bowels. And to this fact may be added the additional
fact, as an evidence of the efficacy of the treatment
at that institution, that, though many of these patients
before they entered the institution, were subject to
such severe constipation, that the most powerful pur-
gatives were ineffectual to their relief, yet, in a short
time after their admission into and treatment at the
institution, the regularity referred to appeared.
653. A second means of great efficiency in pre-
venting constipation, is to solicit the bowels after Solicit the
breakfast. - º: º t
654. It is a fact, that, taking food into the stomach fast,
in the morning excites the action of the stomach, and
that causes the peristaltic action of the intestines to
be excited, and there is generally a want to relieve
within half an hour after breakfast. Indeed the action
induced in the stomach by the food is transferred, as
has been in previous chapters already explained,
H H 2
236 ATJXII,IARY MEANS TO PROMOTE
CHAP, XVI,
Sometimes
beneficial
that the ac-
tion of the
bowels take
place when
going to bed.
through the intestimal tube, and thus the rectum is
excited to act.
655. It does not seem difficult to understand why,
after breakfast, the desire to relieve the bowels is
generally felt. The stomach during the hours of night
has had rest, and, consequently when food is intro-
duced into the stomach in the morning, the action in-
duced is energetic, and this powerful vermicular action
induced in the stomach is transferred equally ener-
getically through the whole intestinal tube, thus
exciting the rectum to discharge its contents.
656. In some cases where there is a weakness of
the lining membrane of the rectum so that it descends
with the action of the bowels and without aid will
not return, it is often advantageous to regulate the
time of the action of the bowels so that defaecation
shall take place at night just before going to bed.
The individual assuming in bed the horizontal posture
any irritation from the state of the gut is prevented,
while an opportunity is afforded by the posture and
the rest to the gut to recover its natural tone. In
these cases it will be useful to take a hearty meal
about seven o’clock in the evening, fasting, if possible,
from a late and a light breakfast to the evening meal.
The peristaltic action of the bowels will, by the action
induced in the stomach by the food, be powerfully
awakened, and such action will be transferred through
the intestinal tube and will cause the bowels to act
in a few hours.
657. To revert to the action of the bowels after
breakfast. This solicitation of the bowels should be
persevered in, even though, at first, ineffectual:
perseverance will bring its reward, i. e., regularity
of action. .
THE REMOVAL OF CONSTIB ATION. - 237
658. A third means, actively efficient in ensuring
regularity in the action of the bowels, is moderation
in the use of food.
659. Moderation in the use of food applies both to
the quantity of food taken, and to the times at which
the taking of food is repeated.
CHAP. XVI.
Moderate use
of food.
660. As Dr Beaumont has demonstrated, a given Dr Beau-
mont’s de-
quantity of aliment requires a given quantity of gas-monstration.
tric juice for its change into chyme, and, if more
than the proportioned quantity of food is taken it
remains in the stomach undigested, producing irri-
tation and other inconveniences, it is certain, that any
irritation, thus induced, must interfere with the regu-
lar action of the intestinal tube: in some cases,
causing a too frequent action of the tube, manifested
in purging, which is sure to be followed by inaction,
and, in other cases, producing constipation directly.
661. Let the irritation produced by taking food in
too large quantities be frequently induced, permanent
irregularity of the action of the intestinal tube takes
place, and constipation results.
662. Constipation is often induced by the injury
done to the stomach by the too frequent taking of Too frequent
food.
663. It is a fact, as proved by the experiments of
Dr Beaumont on Alexis, that three to four hours are,
in the adult, the average time that simple food, that is
food easily digestible, takes to disappear from the
stomach. If therefore persons have their meals at
intervals too near, the stomach never has repose: it
is always engaged in digesting. It happens thence
that the intestinal tube is in a state of perpetual
action, its powers become exhausted and Constipation
results. -
taking of food
injurious.
238 A UYILIARY MEANS TO PROMOTE.
CHAP. xvi. 664. With adults five hours at least should inter-
vene between one solid meal and another: and many
persons, who take food oftener and are constipated,
will find an efficient auxiliary in removing the con-
stipation is the lengthening the intervals between the
meals.
665. The habit of taking little portions of food
between meals is a great cause of constipation. If
º the article taken be only an apple, or a few strawber-
isiºn ries, or a bun, or a biscuit, the process of digestion
*...* has to be gone through with each, and thus the sto-
mach has no rest, and what is worse the apple, or
whatever has been taken, is half digested when the
next meal is taken, and, thus, half digested and fresh
food, i. e., food not at all digested, are mixed together
in the stomach; people, so disturbing their stomachs,
are almost constantly troubled with wind. -
666. A fourth means, auxiliary in preventing and
* relieving constipation, is sponging the body, especially
j wºn the BELLY, with cold water. 3.
beneficial. 667. The sitz bath is a valuable auxiliary. No
doubt can exist that the water treatment has been
peculiarly successful in the cure of many severe cases
of constipation: and though some part of the efficacy
depends on the various excellent hygienic and dietetic
means combined in such treatment, a considerable
part of the efficacy is connected with the water part of
the treatment, and it is not unlikely that the views
developed in this work may lead to a correct estimate
of the exact amount which the water treatment occu-
pies in the cure.
668. Added to the sponging of the body in the
morning may be the soap-lathering the bowels, also
THE REMOVAL OF CONSTIPATION. 239
between the thighs to the gut behind, with warm soap chap. xvi.
lather on going to bed at night: after well lathering
by means of a soft flannel or worsted stocking, wash-
ing off the soap with warm water and rubbing dry
with a well dried towel.
669. Warm water is to be preferred at night, be-Warm water
cause there is not the same reactive power in the º at
evening, after the exhaustion from the fatigues of the
day, as there is in the morning, when cold water can
be used with safety. -
670. This soap-lathering with warm water is espe-
cially serviceable in the constipation after delivery, or
rather as preventing the constipation so likely to
occur after delivery.*
smºs--msm-ºsmºmºms
671. A fifth means, efficient in aiding the action of Drinking a
g tº ſº e g t bl we f
the bowels, is the drinking a tumbler of cold water in.
the morning while dressing. *
- 8-y
672. The water should not be taken at one draught, dressing.
It should be taken by sips.
* A very experienced monthly nurse remarked to a physician—I have
attended upon ladies in their confinements, when treated according to the
old system and according to the homoeopathic system, and I am quite
satisfied, that they get up better under the homoeopathic than under the
other. Still there is a difficulty in relation to the homoeopathic, and that
is the bowels. I have seen much inconvenience result from the inaction
of the bowels.
Dr Hering relates in regard to this inaction of the bowels after delivery,
“Nothing should be given for the constipation in childbed, even though
it last a fortnight, as it is at all times a very good sign, and promotes
the strength of the patient.”
Many will hesitate in adopting Dr Hering's view. With some modifi-
cations, however, it is substantially correct. It is no doubt desirable that
the bowels should act after confinement before the contents by detention
become so indurated as to be difficult and painful to expel. The soap-
lathering will be found, when used twice a-day, highly useful as an
auxiliary.
240 ATU XIII ARY MEANS TO PROMOTE
CHAP. xvi. 673. A sixth means by which the action of the
...tº bowels is favoured is friction to the spine.
e Spine. e
674. The friction should be down the spine from
the nape of the neck to the lowest part of the back-
bone. The friction ‘should be continued for five
minutes. -
675. The remarks on the causes of constipation
present the reason of the efficiency of friction in
these cases. (See Chapter XI.)
676. A seventh means by which the action of the
ºf bowels is favoured is the evercise of walking.
© 677. As the action of the diaphragm and of the
abdominal muscles constitute a chief agent in the pro-
cess of defecation, it is quite certain, that a free
exercise of the abdominal muscles and of the dia-
phragm, essential to the imparting to these parts a
fullness of power, must be highly effective in aiding
the establishment of regularity in the action of the
bowels.
678. Walking is one of the best means of
strengthening the abdominal muscles and thereby
ºf "aiding defecation. In walking the leg is raised,
first one leg then the other leg. To raise the leg it is
necessary previously to elevate the hip of the side on
which the motion of the leg takes place. This raising
of the hip is effected by the contraction of the muscles
of the belly, in which contraction, they press upon
the bowels and aid the peristaltic movement.
679. Exercise of the lungs, by expanding the chest
and calling the diaphragm into action, aids the action
iºns of the bowels: hence reading aloud is very valuable
as an agent aiding in the act of defecation.
680. Any impediment to the free action of the
THE REMOVAL OF CONSTIPATION. 241
abdominal muscles, of the muscles of the lungs or
of the muscles of the diaphragm must be injurious—
hence tight-lacing is decidedly injurious and impedi-
mental to the action of the bowels, as such a practice
impedes the action of all the parts named, and ulti-
mately weakens the abdominal muscles, and thus
lessens their expulsive power.
681. In connexion with the action of the abdomi-
mal muscles as aiding the relief from the bowels, it
has been found, that friction to the bowels has a most
beneficial influence in preventing constipation.
682. Of late years an important practical appli-
cation of muscular action, in connexion with the res-
toration to and the preservation of health, has been
developed by the Swedish philosopher and poet, Ling.
He has reduced the modes of application to a system,
which has received the name of LINGISM. This sys-
tem has of late received the name of KINESIPATHY.
683. Some of the movements, which the practisers
of this method of treating diseases have devised, have
a good effect in relieving constipation. The move-
ments most effective are connected with the placing
the body so as to put forward the abdomen by bend-
ing the chest backwards and then using a kind of
shampooing on the abdominal surface, following the
course of the colon and the sigmoid flexure.
684. An eighth means useful in preventing consti-
pation is the non-eating of suppers.
685. One efficient agent in helping to remove the
state of the bowels, which tends to the production of
constipation, is to give perfect rest and inaction for
some time to the stomach. When a person takes a
hearty Supper, i. e., makes a meal of that meal, the
CII.A.P. XVI.
Friction a
preventive of
constipation.
Kinesipathy.
Non-eating
of Suppers,
I I
24.2 A UYKILIARY MEANS TO PROMOTE
chap. xvi. process of digestion is going on the greater part of
the night. It thence happens, that, in the morning
by the time of the breakfast meal, the stomach has
not had its full repose. The stimulas to the action of
the bowels which would, under a different circum-
stance, have originated from the taking of the morning
meal, is much lessened: the action of the stomach is
languid, and languid is the stimulation conveyed from
the stomach to the intestimal tube. *.
686. The only supper, which persons, liable to con-
stipation should take, should be a roasted apple, a few
figs, or a cup of cocoa. ..
687. The essential point is to do nothing at night,
A substantial which may prevent the eating, or take off the full
breakfast tº e - .
ji, effect of eating a substantial breakfast.
Precautions 688. One of the most painful and the most trouble-
against bear- e e & * e e
ing down of some of diseases in connexion with the intestinal
the gut. tº
§ tube is the descent of the gut.
689. A ninth means of great benefit in connexion
with the cure of this disease is a regulation of the time,
at which the bowels can be made to act.
690. The following letter received from a very
intelligent patient puts the matter in a very clear
light: it shows also the futility of cutting away
piles:—
L t, Jan. 14th, 1854.
DEAR SIR.—Late in the year 1839 or early in 1840, I became subject
to ha-morrhoids, or rather to prolapsus ani, of which I suffered much for
more than a year. In the early stage of the complaint, almost any degree
of excitement would bring on copious bleeding. I used, under advice,
cold-water with an enema every morning, and a cold ablution of the
lower part of the body after the bowels had acted, and also an astringent
application; but without benefit. In the mean time the application of
a few leeches stopped the bleeding.
Early in 1841 I removed to London; and as I continued to suffer
severely, I consulted an eminent surgeon, who advised the use of Ward's
THE REMOVAL OF CONSTIPATION. 243
paste, but as this was equally without effect, I submitted in the spring of
that year, to the removal of the parts, consisting then of three clusters;
one of which was removed with a ligature, and the two others were shortly
afterwards removed with a knife. The benefit lasted for some months; but
I afterwards became nearly as bad as I had been at any time, and the com-
plaint continued more or less troublesome without anything more being
done till the close of 1847, when a portion of the hemorrhoids was
removed with a knife. The relief was very partial, and, in different
degrees, I still suffered from this cause till I came under your treatment
last year. -
The first advice you gave me on this subject was on the 1st of July—
“Take one globule sepia one day, phosphoric acid next day, so four
times: then wait a day after each, and so four times: then Wait two days
after sepia, and one day after phosphoric acid, and so three times.” You
added that if decided improvement did not result, you must see me. I
begun to take the medicine on the 5th July, and continued it till the
18th August. -
I did not record the symptoms regularly during the period of taking
these medicines; but I made several memoranda. Without noting the
times at which the bowels acted on the 6th, 7th, and 8th of July, I made
a memorandum applying to the 7th, 8th, and 9th–" Suffered of piles
early in the morning, but got better on rising.” And again, the follow-
ing note was made—“The piles were worse all the time I was taking the
second course of medicine, and at the end of that time became better.
Always they were better if the bowels acted only once in 36 or 48 hours.
On the 30th of August I consulted you personally, when you pre-
scribed medicines for the glandular state of the neck, but you ordered
none for the ailment now described. In regard to this, you advised me
to get the bowels to act in the evening, so that, after such action, the
body might rest in a recumbent position. To effect this, you advised me
to dine about seven or eight o'clock. The bowels did not act on the day
I saw you, but did so in the afternoon of the next day, (the 31st.) I did
not dine so late as you advised; for, on changing my dinner hour from
three to five o'clock, I soon brought the bowels into the habit you had
directed; and, after the habit was formed, I again dined at my usual
hour, my custom being to take only two meals a-day. On the 1st Sept.
the bowels acted just before going to bed, and I suffered much of piles
in the morning. On the 3rd the bowels acted about eight o'clock, and I
was free from piles all night. On the 4th the bowels acted about the
middle of the day, and I had freedom from piles in the night. On the
5th, 6th, and 7th, the bowels acted just before going to bed, and the
piles came on in the morning. On the 8th the bowels acted about the
same time, but the like effects did not follow. On the 9th, after an
action of the bowels just before bed-time, the piles came on again in the
morning. . The experience now obtained was sufficient to suggest that I
CHAP. XVI. .
II 2
244 Al J XII,IARY MEANS TO PROMOTE
CHAP. XVI.
must obtain an action earlier in the evening. On the 10th, therefore,
this action took place about three hours before going to bed, and with
the desired effect. A few days further experience showed I was in the
right track, and I found, as a general condition, that when the bowels
acted from two to three hours before retiring to bed, I was free from
inconvenience during the night and the following day. I did not always
find that deviations in time led to inconvenience, for occasionally the
action has taken place about ten o'clock, and I have not suffered. When
considerable improvement was experienced, and as a motion once in
twenty-four hours was usually costive, I tried the effect of going thirty-
six and occasionally forty-eight hours, and I have not found that the
action taking place in the early part of the day has led to inconvenience.
I wished, before submitting this statement to you, to ascertain the
effect, at the present time, of the bowels acting immediately before
retiring to bed. I tried the experiment last Monday, and the same
symptoms followed early in the morning which I had observed in the
early part of September, and it was about two days before I quite re-
covered from the relaxation of the parts thus induced. I should say that
the relaxed portion of the bowel always comes down when alvine action
takes place, and that I am not aware of any diminution in the quantity
of the descent. The remarkable and valuable benefit I have obtained
from your advice is, that, by attention to the times when the bowels act,
I avoid the frequent pain and almost constant weakness of having the
bowel descend at other times than when the evacuation of the bowels
takes place.—I remain, dear Sir, your's very sincerely,
C. B–.
John EPPs, Esq. M.D. -
This patient adds in another letter:—
The descent of the gut is so far improved as seldom to occur except .
when the bowels act, and this whether the action takes place in the
morning, middle of the day, or evening. The variations of time occur
from the occasion not happening w8wally under thirty or thirty-six hours,
as at a shorter interval the motion has been generally costive, and it has
seemed better to avoid this condition by so easy means. Thus, by a
simple observance of nature, you have enabled me to realize a condition
of ease and comfort which has been aimed at before by other means,
both medical and surgical, without effect, leaving me in a state which,
before consulting you, often rendered life a painful burden.
691. These auxiliary means have been useful in
- other cases. It will be well to add another fact of
considerable importance. In these cases the indivi-
dual after the contents of the bowels are expelled feels
a strong desire, (almost like the feeling of urging in
THE REMOVAL OF CONSTIPATION. 245
an opposite state of the bowels in dysentery), to urge chap. xvi.
again and again to expel more. To this feeling he
should not give way: if there is anything to pass,
let it pass, but without any effort: i.e., let the sphinc-
ter ani relax itself but let not the gut be urged down.
692. In connexion with these auxiliaries some ad-º.
ditional views may be noticed having reference to a of obstinate
g e º constipation.
tenth means. These views will be developed in con-
nexion with a question which has often been put,
What will you do in cases of obstinate constipation,
where no medicine or even enema seems effective in
relieving the bowels?
693. Such cases are, indeed, very rare. Indeed the
writer has not met with more than six cases in the
course of the sixteen years that he has practised
homoeopathy. •e
694. In such cases mechanical means must be made The use of
use of to remove the accumulation in the rectum, for, :
in these cases, the accumulation is in the rectum, and,”
the gut has lost its contractile power: a collection of
feculent matter takes place in the gut, which needs
removal by mechanical means: just in the same man-
ner as when, as happens in some diseased states when
the bladder becomes distended, and it is impossible
for the patient to expel the contents, the medical
practitioner uses the mechanical agency of the cathe-
ter to draw off the water.
695. The following case, as exhibiting the con- Case re-
ditions under which mechanical aid was used, isłºń.
deserving of record.
696. I was consulted at the latter end of April
1852, by Mrs , who appeared dying. She had
been treated by a surgeon and by a physician. Get-
246 AUXILIARY MEANS TO PROMOTE
CHAP. XVI.
Bowels not
relieved for a
week.
The rectum
llad recovered
its sensa-
tional but not
its expulsive
power.
ting worse and worse, her family sought, as a last
resource, the aid of homoeopathy. Her state was one
of great danger. Every portion of food swallowed
caused an agonizing pain in the gullet. She has a
pulsating tumour below the pit of the stomach. She
can lie only on the left side. I prescribed for her:
she derived benefit.
697. On May 5th, 1852, I was sent for in haste to
see her as her children feared she was dying. When
I reached her house, she was screaming. She stated
that she had suffered more pain in the anus from the
want of relief from her bowels than that of four child-
births. Her bowels had not been relieved for a week.
An enema had been used but the instrument was un-
suited. Although she suffered so much at the gut, she
acknowledged that the pain at the gullet was better
and the pulsating tumour was less troublesome, and
the patient herself was lying on her right side, which
she had not been able to do for a great length of time.
Though in this great agony her pulse was better, i.e.,
stronger. She would not recognize the improvement:
her cry was “the bowels.” All this pain (which
caused herself and her family so much alarm,) I tried
to make her understand to be an indication of im-
provement. The expulsive power of the rectum was
paralyzed, and, it is likely, that, previously to the
improvement of her state, the rectum was so deficient
in sensation as not to recognize the accumulation in
it. Now her state had improved, the rectum had re-
covered its sensational power but not as yet the earpul-
sive power. I tried to illustrate it to her by the fact,
that, when a paralysed limb is recovering its power,
sensations of pricking, “pins and needles,” are felt in
the limb. This patient had for years taken large
THE REMOVAIL OF CONSTIPATION. 247
quantities of ginger for spasms in the stomach : CHAP. xvi.
indeed she, by this ginger and other means, had ex-Injury from
• e the use of
hausted the contractile power in the muscular coats ginger.
of the intestines.
698. She was an uneducated woman and so were
her relatives: she wished not to wait. I therefore
passed my finger into the rectum and removed a large
quantity of feculent matter.”
* In maintaining the necessity of using the me-
chanical agency of the finger to relieve the rectum
when excessively distended with fæces, in the same
manner as the catheter is used of necessity in cases
where the bladder is distended by the urine, it is not
maintained that the necessity in the former case ever
attains the same amount of urgency as it does in the
latter.
The reason why this amount of urgency cannot be
attained is to be found in the facts, that the kidneys
are perpetually secreting a fluid, the urine, and as the
liquid tribute is continually forwarded to the bladder,
a rupture of the bladder or of the uterus must take
place if relief is not afforded; whereas, in the case of
the intestinal canal, there is satisfactory evidence to
establish, that, in case of disease, the Secretions from
the lining membrane of the intestines do not take
place, at least, in any quantity, and, consequently, if
food is not taken, the distention from accumulated
contents in the rectum is not likely to be injurious.
If it is argued, that the secretions, that may be
formed in the intestines when disease is present, are
unhealthy in their character and consequently ought
to be removed, the reply is, that this is not a reason
why the contents of the intestinal tube should be
248 THE REMOVAIL OF CONSTIPATION.
cHAP. XVI, 699. Such is an instance where mechanical means
may be used. Had the woman been a strong minded
woman, and had she not been so exhausted by the
long continuance of her disease, I should have
waited longer without having recourse to this me-
chanical aid. Delay would have been wise, and, it is
believed, effective.
700. In such a case the advocates of purgatives
say “why not give purgatives?” Simply because the
patient has already exhausted the contractile power
of the gut, and to excite the jaded gut to action would
*: º: require such a powerful irritant, that, fatal disease
powerful would, it is likely, have been developed in the intes-
* times by the purgative agent as it traversed the intes-
timal tube.
701. The urgency to relieve the bowels in cases of
severe disease is a sign of improvement, and experience
establishes that it is better, in relation to the future
action of the bowels, even when such urgency is press-
ing on the patient, to avoid, in a very great majority
of cases, the use even of an enema.
forced away. The crust, which covers an ulcerated
surface, is unhealthy, but who would be so foolish
because the scab and the crust are unhealthy, to
attempt to tear off the crust so as to expose the sores
and the ulcers they cover.
CASES OF CURE. 249
C H A P T E R XVII.
Cases of Cure.
*
702. Dr Jeanes, in his work on the “Practice of CHAP. XVII.
Medicine,” makes the following observations:—
“The medicine which is properly adapted to re-º.
move the morbid condition of the system, is the proper
remedy for the constipation or costiveness which is
connected with and forms part of such morbid condi-
tion. And it frequently happens, that there occurs,
within a few hours after the administration of a proper
homoeopathic remedy, a stool of more normal cha-
racter than has appeared for a great length of time:
and, afterwards, the bowels continue regularly and
properly to discharge the faeces. A list, therefore,
which should contain all the remedies that have
proved themselves useful in removing constipation or
correcting costiveness, would embrace a large propor-
tion of the materia medica. I am unable at present
to prepare a list so perfected as to be of utility, which
is the less to be regretted, because the collateral
symptoms will be found more positive guides to the
remedy peculiarly suited to the case, though this
remedy must also be adapted to remove the consti-
pation, a fact which can be readily ascertained by a
reference to our materia medica. But since consti-
pation and costiveness are frequently the original and
IQ K.
250 CASES OF CIJIRE.
CHAP. XVII. predominant symptoms, I shall mention a few of the
Important
truths.
articles which have most frequently or strongly sig-
nalised their power in the removal of these affections;
at the same time advising, that it should be borne
in remembrance, that however frequently these reme-
dies may succeed under the circumstances just men-
tioned, or where they are suited to correct the whole
disease, of which constipation and costiveness are a
part, yet that they must inevitably fail, where they
are not so adapted, as these affections, however trou-
blesome, are but subordinate to the general morbid
condition.”
703. These observations express important truths,
which will readily receive the sanction of readers of
the preceding pages, in which the dependance of con-
stipation on constitutional causes has been so fully
detailed.
704. At the same time, it is impossible to ignore
the fact, that there are diseases of the intestinal tube
on which constipation and its concomitants constitute
the most troublesome and the most notice-attracting
phenomena, and which are these for which medical
aid is sought. Add to this, there are many diseases
of the rectum, which are special to it, and which
originate in conditions, associated with the consti-
pational state.
705. It will therefore be advantageous to record,
in this chapter, individual cases of cure, and, in the
appendix, illustrations of the special constipations
belonging to special remedies will be given in full.
706. It is believed that this record of cases”
* The names of the patients are given, also the pages in the Writer's
case books in which the cases are to be found, as perhaps in future years
CASES OF CURE. 251
of cure, will be highly valuable to the public and CHAP. xvii.
to the medical practitioner. The former will find
the cases of constipation, adapted to each medicine,
sufficiently clearly adumbrated by the cases given:
the latter will discover the beautiful illustration which
these cases afford of the homoeopathic law, “Similia
similibus curantur,” and will thus be strengthened
in his faithful adherence to the law.
707. The first group of cases will embrace con-
stipation generally: a second group will present cases
of descent of gut: a third group will present cases
of the successful treatment of piles; and the fourth
group will embrace some cases of fistula and other
diseases of the rectum.
Group first.—CASES OF CONSTIPATION GENERALLY. Group first.
(1) Constipation attended with palpitation and night Sweats.
Patrick Kennedy, (p. 977, case book 1850,) aged 36,
married, consulted me Sept. 23, 1850.
He complaims of palpitation of the heart, of a sen-
sation of tightness at the chest, of confined bowels,
and of sweats at night. -
Kali carbonicum, 412 to be taken during the week. ... ºom-
Sept. 30, 1850.-The palpitation is slightly less-
ened: the bowels are less confined: he still sweats at
night.
Rali carbonicum, 4|12 in less doses. .
Oct. 14.—The palpitation is better: the bowels act
regular: the sweats have ceased.
it may be interesting to refer to these cases. The cases to which names
are appended are public patients, i. e., those who have received gratuitous
advice. The names of private patients have not been given.
K K 2
252 CASES OF CURE.
CHAP. XVI. (2) Constipation with pain at heart, palpitation dº nightsweats.
Margaret Marshall, (p. 1185, case book 1850,)
aged 44, married, the mother of two children.
She is troubled with a red scurfy rash on the leg,
which itches much at night: she has pain at her
heart and palpitation: the food lies heavy at the
chest, the uneasiness extending to between her shoul-
ders: one chief trouble is the constipation of the
bowels, which is constant, and the actions from their
largeness and hardness cause pain: the patient sweats
both by night and by day: her legs swell.
Kali carboni- Kali carbonicum was administered, 4/12 the first
" week, 4/30 the next week, and 3/12 the third week.
When she consulted me on Sept. 24, about a month
after the first consultation, the improvement of her
health was manifested in the following particulars;
the itching has not troubled her : the pain at, and the
palpitation of, the heart are lessened: the tongue is
cleaner: the food lies lighter: the bowels have acted
very much better, and do not pain her. She was de-
lighted at the improvement in the state of her bowels.
(3) Constipation with affection of the heart.
John Kent, (p. 959, case book 1850,) aged 40,
married. This patient was under treatment for a pain
at the pit of the stomach attended with a peculiar
sensation at the same place, which sensation when it
comes on, affects him with fright, followed by shiver-
ings: he has pain under the ribs at the right side.
While under treatment his bowels became very con-
Bryonia, fined, which bryonia did not relieve. On Sept. 14 the
pain was very severe, he having shooting pains in his
side: he sleeps badly: wakes up with fright: has pal-
pitation of the heart.
CASES OF CIU R.E. 253
Lachesis 4|12, to be taken in the course of the CHAP. xvii.
week. The palpitation became better: the shooting Lachesis.
pains lessened and the bowels acted regularly.
(4) Constipation attended with Sciatica.
Mary Phair, (p. 1316, case book 1850,) aged 52,
married, the mother of fourteen children.
She consulted me in September for sciatica: the
pain extends from the hip to the foot, and the pain is
always increased when the action of the bowels takes
place: the Smarting pain, present when the bowels
act, is like as if she was suddenly electrified.
The actions of the bowels are large and costive:
the water is pale and in large quantities: she has
pain across the loins. -.
Lycopodium 8/12, in the course of four days. Lycopodium,
Sept. 24.—The bowels now act pretty well: the
water is in less quantities and of a natural colour.
Lycopodium was continued, in less doses.
Oct. 2.-The bowels have recovered their proper
activity.
**-*.
(5) Constipation attended with a modification of the wrine.
John Lee, (p. 1085, case book 1847.) In this case
the bowels were confined, and the urine did not pass
with freedom. Lycopodium effected a cure. Lycopodium.
(6) Mary Pond, (p. 220, case book 1848.) In this
case the constipation of the bowels was attended with
thickness of the urine. Lycopodium ij.[12, one-sixth Lycopodium.
of a globule every six hours effected a cure. July 1.
(7) Ann Finch, (p. 697, case book .) In this
case the bowels were confined: the skin was dry:
254 CASES OF CURE.
‘CHAP. XVI.
the belly was swelled and half a gallon of water was
passed. Lycopodium 4|12, was prescribed on Jan. 16.
(8) Constipation with eactremely small faecal portions.
Sarah Sidnell, (p. 1674, case book 1850,) aged 60,
mother of twelve children, now a widow. -
Between two or three years since a fire occurred in
the house in which she lodged, and she had to stand
for nearly two hours in nothing but her night dress,
without shoes or stockings, on the stones: she caught
a severe cold and has never been well since: she has
been under the care of many doctors at the dispen-
saries: she has been an out-patient at the London
hospital (she lives at the east end of London); but,
as she says, “they will not hear me,” and have done
me no good.
She has been affected for years with a sensation as
of something across the belly: for the last few months
she has been unable to pass the stools: the actions,
when they do occur, are like little peas: she feels a
want to relieve but has no passage: her appetite is
good, but she dares not eat animal food: she has a
burning at the place where she feels the sensation in
her belly, this burning extending to the back: it is
agonizing like as if the flesh was being scorched with
iron bars. Sepia was prescribed.
Dec. 9.-The peculiar sensation in the belly is
lessened: the burning is almost gone: she had been in
bed for weeks before she consulted me last week.
Ordered sepia. -
Dec. 20.—The patient still feels the want to re-
Sepia.
* Query, does not this explain the immense number of patients these
hospital physicians profess to see in a day? They do not hear them.
CASES OF CIU R.E. 255
lieve the bowels but without effect: the water is CHAP. xvii.
scanty: after food she feels agonizing pain over the
belly: she has a severe pain at the right hip.
Ordered colocynth, one globule every four hours. Colocynth.
Dec. 27.-Her bowels have acted once a-day, the
excessive difficulty attendant on obtaining an action
has much lessened: the actions themselves are still in
the form of small lumps: the agonizing pain is still
felt after food: she has had headache through the
head. Ordered nua, vomica, 4|12. Nux vomica.
Jan. 4, 1851.-The bowels are now regular, acting
once a-day: “she has not been for years like this "
her food causes her less agony: she says “I am a
new creature:” the burning has occurred once but
has lasted much less long; she states that “for years
I could not lie on the left side, now I can lie for an
hour together. Ordered nua, vomica, 4|30. Nux vomica.
Nua in this case completed the cure, but sepia gave
the curative direction. At a period, subsequent to
this, she had constipation and sepia made the bowels
act daily; eight globules were taken in a fortnight
and relief was obtained.
(9) Constipation with descent of gut (prolapsus) in a child.
Mr Cumming stated, Jan. 26, 1853, that his child,
for whom I prescribed about a month since, who
had been troubled almost from birth with the gut
coming down after each action of the bowels, is now
nearly well. º º
I had ordered the child sepia ; and the gut which Sepia.
came down, as stated, now came down only once in
twelve days. *mºmsºmºre emº-me
(10) Constipation with ineffectual desire to relieve.
James Greave, (p. 704, case book 1846.) This
256 CA. SES OF CUR.E.
cIIAP. xvii. patient has, March 30, 1846, been troubled with
constipation for some time: he has a feeling of want-
ing to relieve the bowels, but the effort is attended
- with no effect, his bowels being confined.
Sepia. He was ordered half a globule of sepia every eight
hours till he had taken four globules. His bowels
were rendered regular in their action.
(11) Constipation with action once a week.
Elizabeth Harrison, (p. 1806, case book 1851.)
This patient came under treatment in December 1851.
She had previously been under the care of two phy-
sicians; one declared she was consumptive, the other
that she was asthmatic: her age is 26, she is married,
and has two children. She complains of a severe
cough, particularly troublesome, when she goes into
the cold: food lies heavy at her chest, and she vomits
her food invariably: she has pain between her shoul-
ders: she is low spirited and cries: her bowels are
always confined, and, when they act, pain is caused:
they would not act oftener than once a week or a fort-
night unless she took opening medicine: she never-
theless frequently has the want to relieve the bowels,
but without effect: her water escapes from her when
she coughs. Dolorem habet in coitu. The nails of
this patient decay.
ãº. Ordered sepia and causticum on alternate days.
Dec. 23.−The cough is better: the food lies easier:
she has not vomited since she took the medicine: the
pain between the shoulders has lessened, but having
desisted a few days at the conclusion of her medicine,
the pain has not been so well: her bowels act very
much better, indeed they act every day and no blood,
as was the case, is caused by the action: the water
CASES OF CIJ R.E. 257
escapes less. Dolor in coitu diminuitur. The nails CHAP. xvii.
have not shown any increase of the tendency to
decay.
(12) Constipation with newralgia of head and face.
Harriet Cole, (p. 286, case book 1847.) This
patient complained of severe face ache and head ache
attended with confined bowels, having a want to
relieve the bowels, the want not being attended with
any relief: this was on June 8, 1847.
Sepia 4|12, half a globule every eight hours, re-sepia.
moved the head ache, the face ache and the confine-
ment of bowels.
(13) Constipation with cracks (rhagades) of the lips,
David Ainsworth, (p. 62, case book 1843.) This
patient suffered from constipated bowels, attended
with cracked lips and foot sweat: he consulted me on
Sept. 12, 1843. Sepia produced the most beneficial sepia.
effects.
*-
(14) Constipation with darting pain in the gut.
Sarah Vigors, (p. 1711, case book 1847.) This
patient suffered from constipated bowels attended
with a darting pain in the gut, Sept. 2. Sepia 7|12, sepia.
taken in sixteen days, effected a cure.
(15) Constipation with forcing at front and back passages.
Sarah Abraham, (p. 67, case book ——.) This
patient has confined bowels, experiences a want to
relieve the bowels but attended with no effect: she
has in addition a forcing pain at the back and at the
front passages. Sepia effected a cure. Sepia.
* -º
L L
258 CASES OF CIU R.E.
CHAP. XVII.
Graphites.
Nux.
(16) Constipation with inflamed eyes and -blood with action
- of the bowels.
Mary Reast, (page 1117, case book 1844.) aged
25, married. She is suckling and has suckled for
eleven months: her eyelids have been weak since her
child was born, being inflamed with angry reddish
yellow margins, having pricking pains in them,
water comes into the eyes and prevents her seeing,
especially at the candle light: her eyelids feel to her
to draw down: she has been under homoeopathic
treatment for eight or nine months: she consulted me
on Feb. 20. Her bowels are confined, acting only
once in three or four days: the stools are large and
cause blood: her skin is dry. Ordered graphites.
Feb. 29.-She has now weaned the baby, and she
has had lumps and darting pains in the breast since
that time: her symptoms are better. Ordered gra-
phites. Her sight became better: the bowels became
regular, acting every day: the blood ceased.
tºmºmºmºmº ºmºmºº
(17) Constipation habitual with head affection, cured.
Wm Sanson, (p. 1556, case book 1843,) aged 22.
He had stoppage of his bowels seven years since:
he consulted me April 1, 1843: he is obliged to take
medicine twice a-week: he has taken English's pills:
he has an uneasy sensation at the top of his head:
he has also a sensation of heat at the bladebone.
IVua, was ordered. -
April 8.-His bowels have acted four days out of
the seven : the sensation on the head and in the
shoulder are lessened. He continued nua, but being
foolishly persuaded that “the medicine had been
searching him,” he fell back on his English's pills,
and he became worse. Ordered nual to be followed
CASES OF CUIR.E. 259
by sulphur, and if the bowels did not act in four or chAP. xvii.
five days to take three globules of opium. He took
opium twice, and under the influence of nua and sul- .
phur his bowels and his health much improved. He
found that sulphur seemed to confine his bowels.
He states that he has now attained, what he had so
long sought in vain, regularity of the bowels.
(18) Habitual constipation in a case of ovarian dropsy.
Rebecca Watts, (p. 2002, case book 1843,) aged 27,
married, the mother of three children. She consulted
me August 8, 1843. She has an ovarian tumour at the
left side: it came after confinement. Dr Roots dis-
covered the existence of the tumour. In April she
had the swelling tapped, and had eleven pints of fluid
drawn from it: she is getting large again: she has
constant pain down the left groin : she has pain in
her back down her left side: her bowels are confined:
her monthly period has not appeared for the last two
months: she has taken mercury, iodine and elixir of
vitriol under the old system. Ordered nua, vomica. Nux vomica.
She repeated the nual vomica and her bowels became
quite regular, which was to her great astonishment,
for she states she has never had the bowels to act
regularly without the aid of strong medicine.
(19) Constipation with the necessity to remain long at the closet.
James Moring, (p. 868, case book 1843,) aged 39,
married, consulted me when his state of health was
almost broken up. He had had an attack of pleurisy
three years since, with which, under old system treat-
ment, he was laid up for five months: he complains
of pain through the left side to the shoulder: food
causes a sense of weight and pain: his throat is
L L 2 ^,
260 CASES OF CURE.
CHAP. XVII.
Graphites.
Graphites.
Sepia,
affected with Soreness if he is exposed to the least
damp air: he has pain in his back: his skin is dry:
he has great difficulty in passing a stool: he has to
sit a long while when at stool. He was ordered gra-
phites on April 8, and on April 16, he was not obliged
to sit so long when at stool: his bowels are more
regular: he repeated the graphites with benefit.
**sº
. (20) Habitual constipation, not acting for nine days, cured.
John Twigg, (p. 1502, case book 1849,) aged 46,
married. He suffers from an eruption on the skin
which itches much at night: he has had this eruption
ever since he can remember: he is very thirsty: the
throat is parched: he has been a patient at several
hospitals and has been under the care of others: his
bowels are habitually confined, and he now, July 24,
has had no action for eight days: his skin is dry.
Ordered graphites.
March 1.—His bowels acted the day after he came,
and have remained again inactive eight days: there
is an inclination to relieve them but there is no effect:
he feels chilly on his shoulder. Ordered sepia.
March 6.—His bowels now act nicely.
(21) Constipation in a lady aged 71, of years duration,
wholly cured.
As the records of this case could not be found,
application was made to the son of the lady. In
reply he thus writes:—
“The prominent and impressive facts are simply.
In A. D. 1840, A. B., being then in her 71st year,
and having of long time had compulsory recourse to
various appliances for regulating the bowels, which
seldom or never acted naturally, was induced by some
CA SES OF CURE. 261
cracked brain of her family to give homoeopathy a
chance of killing her: that she put herself in the
hands of Dr E., and very shortly came out of the
ordeal sound and hearty, her ailments put to flight,
and, at least, ten years rubbed off the score of her pil-
grimages: that she is now in her 85th year and has
excellent health: appetite, digestion and consequent
functions all that can be desired: memory excellent,
indeed extraordinary, faculties bright, and, above all,
a well grounded hope for futurity, (we mustn't claim
this last feature for the globules, although their in-
fluence has doubtless greatly contributed to the enjoy-
ment of the blessing).
“Now I'm afraid you can’t find much practicable
matter in this scrawl, but you will, I know, rejoice
that the latter facts are as I have stated them.”
Such was the reply, and, its peculiarity is so inter-
esting that its record as given was deemed the most
satisfactory mode of presenting the cure of a person,
thus advanced in years.
-(22) Constipation of four years,
Mr T., aged 23, single. He has been troubled
with constipation since 1849: he consulted me in
December 1853: he is of an active temperament:
his bowels are confined: his appetite is good: he
passes his water with ease but the water is often thick
when it is cold: sometimes he has large quantities of
water and then it is pale: he feels a heaviness in
connexion with the confined bowels: his hands and
feet are cold. Ordered lycopodium.
This patient consulted me again in December, at
the latter end of the month; and he was, because he
had experienced a numbness of the hands in the
CIHAP. XVII.
Lycopodium.
962 CASES OF CURE.
CHAP. XVII.
Causticum.
Nux with
lycopodium
or sepia.
Sulphur.
and sepia
morning for the last two days, ordered to take causti-
cum. He improved under the homoeopathic treat-
ment, and on the 13th of May, 1854, the following
was received from him:- -
“My dear Dr Epps, It is with the greatest plea-
sure as well as the deepest thankfulness that I write
to tell you of the great improvement which has taken
place in my health. During the vacation from one
cause and another I was a little deranged in the
bowels, but always succeeded by alternating nua, with
lycopodium or sepia to keep them regular. Since I
have returned I am thankful to say medicine has be-
come no longer necessary, and at the present time I
am better than I have been for the last five years, in
short since the summer of 1849. For four years I
have taken castor oil, pills and electuary without
permanent relief, and now under your skilful treat-
ment, accompanied by the Divine blessing, I am quite
well. Believe me most sincerely yours, C. T.”
(23) Mr Thomas P. F., August 30, 1850. “Having
taken the first series of medicines and waited two
days, I may honestly state that I am better, the pains
in my head are less violent, my spirits have improved,
and I am better off than I have been for years as to
the state of my bowels.”—Extract from a letter.
(24) Mrs J. M., Oct. 25, 1850. This patient took
sulphur 412 one week, sepia 4|12 the next week, sul-
phur 4/30 the third week, sepia 430 the fourth week.
She states in a letter, “I am happy to state that my
bowels are more regular under your treatment than
they have been for some years, for which I am thank-
ful to you.”
CASES OF CURE. 263
(25) Sophia Copley, (p. 261, case book —) states CHAP. xvii.
that her bowels have been more regular since taking
homoeopathic medicine than ever they were in her
life before.
(26) Daniel Allen, (p. 31, case book 1845,) states,
July 12, that he now has a natural stool which he has
not had for three years.
(27) Peter Mitchell, (p. 1095, case book 1851,) who
is under treatment for an affection of the eyes states,
Sept. 6 1853, that his bowels act better than he could
remember they had ever acted before: he now can eat
white bread, formerly he could, on account of his
bowels, never eat any bread except brown.
(28) Constipation in mother and in child.
Martha Jolliffe, (p. 920, case book 1847.) aged 29,
married: her bowels are habitually confined: the
stools are large: great pain is caused in their passage,
causing pain the whole of the day succeeding the
action: blood attends the passing of the stool.
Ordered graphites. Graphites.
May 4.—The bowels act better: the pain in the
action of the bowels is very much better: she has
heats all over her attended with faintings.
Graphites was again prescribed and her bowels Graphites.
became regular.
Charles Jolliffe, (p. 920, case book 1847,) aged 8
months. This child has, since his fifth week, had a
whistling wheezing, with a burning heat in the skin
which is dry: his bowels are confined. Ordered hepar Hepar sul-
sulphuris. phuris.
April 14.—The whistling is better: the wheezing
264 CA SES OF CURE.
CHAP. XVII.
Hepar sul-
phuris.
Graphites.
Nux,
Calcarea.
is better: the burning heat is better: the bowels act
better. Ordered hepar sulphuris.
May 4.—The whistling is still very much less: the
wheezing is better: he has had a return of the heat
at night: his bowels have not acted for three days
till last night. Ordered graphites.
May 28.—His bowels acted well till the medicine
was finished: he has a fresh cold. Hepar sulphuris
cured him.
(29) Constipation with gastric affection. -
Charles Tonge, (p. 1643, case book 1844.) aged 24,
married, came under treatment July 13, 1844. He
has been under medical treatment for a great length
of time: he was under a medical practitioner for
two years for a pain in his loins: he has latterly
taken every day for eight weeks four pills a day
together with mixtures. July 13, 1844, he com-
plained of sickness of a morning with headache across
the forehead: the eyes ache: he has, when still, a
pain at the right side: he has a pain under the right
shoulder: he feels heavy and sleepy: his appetite is
good but his food lies heavy: he has a sinking at the
pit of the stomach: his bowels are confined but cause
no pain in the action: his water is thick and he has
had pain in his loins for two years: he has a cold
sweat on his chest: his spirits are low and the morn-
ing is the time of the day at which he is worst.
Nua was prescribed: his morning sickness is bet-
ter: the sinking at the stomach is better: the bowels
act better: his water is clear. Ordered nuan.
July 27.-He improved except in his spirits and
the sweat which affected all parts, particularly his
head. Calcarea was prescribed in alternation, day by
ÇAISES OF CU. R.E. 265
day, with nua, and, on August 10, he was better in his CHAP. xvii.
spirits as well as in all other respects, except that his
bowels were confined and his water was high-coloured,
for which lycopodium took the place of calcarea in Lycopodium.
alternation with nºta.
August 20.—He was better in every respect: the
eyes no longer ached: his water is clear. Ordered
mua and lycopodium, waiting a day after each medi-
cine. On Sept. 10 his bowels had become regular,
but a little irritability of bladder manifested itself in
a frequent want to pass water and passing only a
little at a time. Cantharis was prescribed, but, as on Cantharis,
Sept. 12, the mouth was disagreeable and twitching
pains were felt in his shoulder, pulsatilla was pre-Pulsatilla.
scribed, and on Oct. 12 the patient called to return
thanks, and mentioned to the servant “what a won-
derful cure had been made of him.”
(30) Constipation with rheumatic affection and discharge
- from the eye.
Samuel Skinner, (p. 1843, case book 1843,) aged 76,
consulted me December 19. He has had rheumatics
affecting the knees and the hips in the morning and
in the evening for the last two or three years: he
walks only by the aid of two sticks: the pains are
shooting: he has a swimming and a giddiness in the
head: he has a watery discharge from the left eye:
he formerly had a discharge from under the orbit:
his bowels are confined. Ordered muay 4/12. Dec. 26, Nux.
the rheumatic pains are lessened: the bowels act
every day. Ordered nua, 412 to be taken in ten days.
Jan. 19, 1844.—He is better: the giddiness, which
occurred at least every other day, recurs now only
every fourth day. To continue nuv.
- M. M.
266 CASES OF CURE,
CHAP. xvii. Jan. 26.—He is better in himself, but feels his
thighs so tender that he can hardly bear the clothes
to touch them : he uses but one stick, Ordered nua,
because his pains are worse on motion.
April 16.-He states that his bowels are regular
Nux. as a child's. Nua, repeated in smaller doses restored
him. -
* *
(31) Constipation connected with Scarlet fever.
The following case of scarlet fever is given, not
because it was one of any great severity, though
it had difficulties in the peculiar cachectic state of
Kali carboni. the child; but, as illustrating the action of kali car-
GUIIIl. bonicum in curing constipation.
Julia Baker, (p. 110, case book 1848,) aged 12,
was seized on Saturday night with
Symptom 1. Sickness. Symptom 2. Her head be-
came violently affected on Sunday. Symptom 3. The
fever became high. Symptom 4. The throat sore and
swollen, as if she had two lumps pressing together
and stopping up the throat. Symptom 4a. Though
in so high a fever she feels cold. Symptom 5. Vomits.
Symptom 6. Has thirst. Symptom 7. Her breath is
offensive. Symptom 8. Her bowels are relaaved. This
last symptom with Symptom 6, decided to choose ar-
senicum instead of aconite.
* Ordered arsenicum and belladonna, a globule, alter-
2.]] €1,3- e g
donna. mately, at six hours interval.
August 11.—No. 1, Sickness better. No. 2. The
eruption better, but now her skin has broken out
into little bladdery eruptions. No. 3. The
fever is lessened. No. 4. The throat is sore but less
swollen. No. 7. Breath feverish. No. 8. Her bowels
are now rather confined.
CASES OF CIU RIE. 267
The bladdery eruption indicated Thus, and Thus was CHAP. xvii.
given in alternation with belladonna. ºil.
August 15.-Her sickness, throat, and mouth are
better. Her tongue is furred and the breath is still
feverish, No. 8. The bowels act only once in three
days. •.
Symptom 9, She sweats very much at night.
Symptom 10. She has a severe pain extending
from the hip joint down the thighs.
It will be seen here, as in the previous case, that
the patient gets better although the bowels become
more confined.
The confined bowels, the sweats at night, the pain
down the thighs, indicated Kali carbonicum, which ºne
was given, four globules, to be taken in the course of
six days, and she became perfectly well.
(32) Constipation and deafness of both ears cured.
Eliza Sykes, (p. 1432, case book 1848,) consulted
me November 22, for
Symptom 1. Deafness in both ears. Symptom 2.
She has a buzzing noise. Symptom 3. Her bowels
are confined.
Ordered graphites, four globules. Graphites.
Nov. 29.-No. 1. Deafness a little better. No. 2.
The buzzing noise still. No. 3. The bowels act bet-
ter. Ordered graphites, four globules, to be taken in
the course of ten days.
Dec. 9.—No. 1. Deafness still better. No. 2. The
buzzing noise gone. No. 3. The bowels act better.
Ordered graphites, half a globule every other day.
Dec. 27.-No. 1. The deafness has ceased : the
buzzing noise also. The bowels are regular.
M. M. 2
268 - CASES OF CURE.
CHAP. XVII.
Cuprum,
Graphites,
(33) Constipation, amenorrhaea, and leucorrhaea cured.
Sarah White, (p. 1727, case book 1848,) aged 30,
married, but never pregnant, consulted me Dec. 12,
1848, has had, Symptom 1. The monthly period sus-
pended for three months. In addition hereto she
complained of Symptom 2. Bearing down at bottom
of belly. Symptom 3. Bearing down also in passage
to the womb. Symptom 4. Very severe pain in back.
Symptom 5. Profuse leucorrhoea, attended with Symp-
tom 6. Great irritation. Symptom 7. Attended with
hysterical excitation. Her bowels act regularly, her
food lies easy, and her water passes with freedom ; in
fact, her digestive system is healthy.
Ordered cuprum, four globules.
Dec. 19.—No. 1. The monthly period has come
on. No. 2. The bearing down is much better. No. 3.
The pressure in the passage is better. No. 4. The
back is much better. No. 5. The white discharge is
much lessened. No. 6. The irritation is much less-
ened; and No. 7. The hysterical excitation is much
lessened. The bowels have become confined; a fact,
in direct opposition to the common idea, which makes
it essential, in order to induce the monthly period, to
excite powerfully the bowels by purging. The skin
was dry. -
Graphites was ordered for the bowels, and with the
desired effect.
(34) Constipation and colic.
Thomas Love, a painter by trade, (page 1012,
case book 1848,) consulted me at the beginning of
October 1848, for the following symptoms:–
Symptom 1. His bowels are confined, not having
acted since the previous Saturday. Symptom 2. He
CASES OF CURE. 269
has severe pain at bottom of back. Symptom 3. He CHAP. XVII,
has headache all over the back of head. Symptom 4.
What he eats appears to lie heavy at the bottom of
belly. Symptom 5. He has profuse perspiration which
is very hot. Ordered opium, one globule, in alter- *...
nation with a globule of kali carbonicum. Cll LIl,
Oct. 6.-The symptoms are much the same; but
the pain, which is intolerable, extends across the
belly. No. 5. The perspirations are less. Ordered
cocculus, a globule every eight hours.
Oct. 9.—No. 1. His bowels are now quite free.
No. 2. The pain is much better. No. 4. His food
lies much easier: he says he has been laughed at for
taking his cold water, i. e. the medicine; but, as he
says, he can now laugh in turn, for the relief afforded
to his pain is so great. Ordered cocculus, in less Cocculus.
doses. -
Oct. 14.—No. 1. His bowels act every day. No 2.
The pain at back is felt only when he works very
hard. No. 3. His headache is much better. Symp-
tom 6. He has been restless and dreamed the last two
nights. Ordered belladonna, four globules. Belladonna.
He was cured.
(35) Constipation with colio.
Elizabeth Pound, (page 1299, case book 1847.)
aged 36, single. This patient (Nov. 22.) has a violent
pain in her back, which, like a stitch, goes round all
the bowels: the pain is so severe, that, while it is on,
she cannot move her hand to her head: she received
a fright from a cab, which run against her striking
her on the breast: her bowels are confined. Opium opium.
was prescribed. The pain ceased in the bowels and
the bowels became regular. Arnica, taken inter-Aconite.
270 CASES OF CURE.
CHAP. XVII.
Sepia.
nally and applied externally, removed the effects of
the injury to her breast.
(36) Constipation with bearing down of the womb.
Sarah Pidgeon, (page 1290, case book 1847.)
aged 48, married, the mother of eight children. She
has had two miscarriages. This patient suffers from
pain at the left side of her belly: she has palpitation
of heart on exertion: she has pain at chest extending
to between the shoulders: some kinds of food lie
heavy: her appetite is deficient: her bowels act only
once in two days: the actions are hard and cause
pain: she has a bearing down of the womb: her eyes
are weak, and she cannot open her eyes from a sense
of weight pressing upon them: one finger seems to
have no power in it. Ordered sepia.
The effect of the sepia was to create a daily action
of the bowels.
(37) Constipation with discharge of blood and matter from
the bowels with eruption on the skin.
E. Plant, (p. 1357, case book 1844.) aged 22,
single. This patient consulted me on Feb. 13. She
has had pain in the back across the loins for a month,
bad especially when sitting long and rising after sit-
ting, attended with a discharge of blood and of mat-
ter from the bowels: her bowels are much confined:
her skin is dry: she has an eruption on the skin, par-
ticularly about the shoulders, and also on the fore-
head: on the forehead the eruption presents the
appearance as if an egg had been Smeared on the
forehead and having become dirty, dried : the eruption
itches and Smarts after washing: the skin has a
general roughness: she has a pain at the chest: her
CASES OF CURE. 271
monthly period is regular: she has headache at the CHAP. xvii.
forehead. Ordered graphites 4|12. Graphites.
On Feb. 20, the patient was better. Ordered to
continue the graphites.
On Feb. 27, the patient was still better: the erup-
tion was better: sweating less and the skin was be-
coming moister; but as the blood continued to pass
from the bowels and the bowels are still confined,
graphites was ordered to be taken one day and sulphur
the next, until she had taken four globules of each.
Under the use of these remedies the blood and the
matter lessened: by a repetition of the graphites and
of the sulphur, waiting a day after each medicine, Sulphur.
the eruption became much better, and the bowels
acted less confined.
She had subsequently taken nua in alternation with
sulphur and became well.
(38) Constipation with incipient phthisis.
John R. W., (p. 1804, case book 1852,) aged 14,
has been delicate from childhood: he is pale: has an
anxious countenance, and that peculiar brightness of
eye so characteristic in phthisical patients: he has a
severe cough, which hurts him at the right side of
chest: he expectorates a black phlegm : he sweats at
might: his appetite is not good: his bowels are con-
fined: his water passes with ease. Ordered kali car-Kali carboni-
bonicum. Cllſſl.
Oct. 20.—The cough still hurts him at the top of
his lung: he sweats less at night: the phlegm is now
yellow : his appetite has improved: he is still very
confined. Ordered kali carbonicum.
Oct. 27.—The cough no longer causes pain: the
sweats have lessened: the phlegm is whitish : the
272 CASES OF CURE.
CHAP. XVII.
bowels act every other day. Ordered kali car-
Kali carboni- bonicum.
Cºll Iſl.
Kali carboni-
Cll Iſl.
Nov. 5.—The cough is gone: the bowels act more
confined: he sweats still at night. Ordered kali car-
bonicum in less doses. He became well.
(39) Constipation and phthisis threatening.
William Crick, aged 55, married, (page 363, case
book 1848,) has been asthmatic for eight years; he
began to show phthisical symptoms in December §
1848, and in July 1849, he was troubled with great
tightness at chest, with difficulty of breathing, parti-
cularly after breakfast: with pain at chest: with
cough attended with expectoration: he describes his
cough as a thick.cough: might sweats: he presents
the phthisical features: his bowels were confined.
Ordered kali carbonicum, iv/12. This was on July 12.
July 18.-His chest pain and tightness were better:
his breathing was better: his cough is bad, and the
expectoration is white: he sweats less: his bowels act
better. Ordered kali carbonicum, iv/12.
July 24.—His chest is better: his breathing is
better: the thick cough is better: his bowels are
better. Ordered kali carbonicum.
Aug. 9.—The pain and the tightness of the chest
are much better: the breathing still improves: the
cough is better: he expectorates sputa of a slate
colour, but it is of a better kind. Ordered kali car-
bonicum.
Aug. 19.-The chest pain and tightness are almost
well: he has no cough : his expectoration is now
phlegm ; his bowels have acted once a-day. Ordered
kali carbonicum, half a globule every third day.
This case shows one form of chest affection to which
CASES OF CURE. 273
kali carbonicum is suited, and shows how, at the same CHAP, XVII.
time, it renders the bowels regular.
(40) Constipation and phthisis threatening.
William Shinn, (p. 1682, case book 1845,) aged 41,
married. This patient is troubled with tightness
across his chest: it hurts him to take a full breath:
he has had for two months a dreadful pain at the
front part of the arm : rest makes this pain worse:
the pain affects him in his head on one side: he
sweats at night: his bowels are confined. This was
on July 12. Ordered kali carbonicum. ºwn.
July 14.—The tightness at the chest is much less-
ened: the pain at one side is still felt: his bowels are
still confined, and he sweats at night. Ordered kali
carbonicum.
July 19.-The appetite is better: the pain has
shifted from the arm to the shoulder: he still sweats
at night. Ordered kali carbonicum.
July 21.—His bowels are now regular.
Arnica restored him to health, subduing his sweats
and his other symptoms.
(41) Constipation with bleeding at nose, (epistaavis,) with
a cachectic habit of body.
Ann Painter, (p. 137, case book 1844,) single, aged
26, consulted me April 2, 1844.
She has in the spring, twice a-week, bleeding at the
nose, at the right nostril, of black blood. The loss
of blood has caused great weakness: bowels confined:
water thick and difficult to retain: white discharge
profuse: her flesh heals badly. Ordered graphites. Graphites.
April 10,—Nose bled twice on Wednesday, and
twice on Thursday, the blood this time was pale:
N N
274 CASES OF CURE.
CHAP. xvii, white discharge lessened: water is held better: bowels
are less confined: her nails are white. Ordered
tr. acris, a drop of the third dilution.
April 27.-Nose bled three times on Wednesday:
the blood is brown: the bowels are very confined: the
actions hurt to pass, and are large: water is held bet-
Graphites, ter. Ordered graphites, four globules.
March 4.—No blood: bowels regular: water clear:
white discharge less: appetite better: she is much
better altogether. Ordered graphites, in less doses.
March 13.−Not bled now for three weeks : bowels
Graphites and again rather confined : nails white. Ordered gra-
sulphur. phites and sulphur in alternation, more particularly
for the return of the confined bowels.
June 11.—Not bled for two months: bowels still
º rather confined: nails white. Ordered graphites and
& lycopodium in alternation.
The cure was effected.
(42) Constipation with wound, attended with a cachectic
Statüe.
Richard Lamborn, (p. 982, case book 1849,) aged
32. He has a wound on his head which was caused
three months since by a scald; the wound scabs over,
the scab comes off and forms again: his bowels are
Kali carboni-confined: he sweats all over at night. Ordered kali
C Ultile carbonicum.
March 20, 1849.-The wound still continues and
the bowels are still confined, but the sweats are bet-
Bryonia, ter: the tongue is much coated. Ordered bryonia
for the coated tongue, then kali carbonicum.
April 3.—The wound is a great deal better: the
bowels are less confined : the tongue is cleaner.
Ordered kali carbonicum,
CASES OF CU R.E. 275
April 20–The wound is almost well: the bowels onAP, XVII.
are regular. Ordered kali carbonicum in less doses. *
May 8.-The patient is well. *
The patient did not take more than twelve globules
in the whole time: the bowels, which were irregular,
became quite regular.
*mºnºmise sº-mºs
(43) Confined bowels with swelling (scrofulous) on thigh,
and night Sweats,
Augustus Clark, (p. 441, case book 1847.) aged 22.
He looks cachectic: he has a swelling on his left
thigh which came a month ago: it has gradually en-
larged: his tongue is furred: his bowels are confined,
and have been so a fortnight: his water is thick, it
deposits a reddish sediment: he perspires at night all
over, which he has done for some weeks. Ordered .
kali carbonicum. Kali carboni-
His health is much better: his bowels are regular ºn
the perspiration is gone : he has a violent itching all
over the boby.
The abscess subsequently broke.
This case is interesting as showing the power of
Kali carbonicum in the sweats connected with the for-
mation of abscesses, and also in confined bowels as
connected with this state. It may be said that the
abscess having nearly come to its maturity was the
cause why the night sweats ceased, and the bowels.
became regular. This does not seem to have been
the case, for the abscess did not discharge till some
time after, and when it did discharge, blood was the
principal matter. -
(44) Constipation with suicidal feeling cured.
Joseph Elliott, (p. 637, case book 1850,) aged 71,
N N 2
276 CASES OF CURE.
CHAP. XVII.
Weratrum.
Calcarea.
Sepia.
married, consulted me June 28, 1850. He has been
ill upwards of two months, and is troubled with
(Symptom 1,) great lowness of spirits in the morning
When he awakes, attended with a desire to destroy
himself. He has -
Symptom 2. A sour taste in the mouth. Symptom 3.
Clammy cold perspirations. Ordered veratrum, four
globules of the twelfth dilution to be taken in the
course of the week. f
July 5.-His mental state is a little better. No. 2.
The sour taste is better. No. 3. The perspirations
are better. Ordered veratrum, four globules of the
thirtieth dilution.
July 12.—His bowels are confined: he wakes with
the cold clammy perspirations, but principally on his
thighs. Ordered calcarea, four globules in the course
of a week.
July 19.—No. 1. The desire to destroy himself is
decidedly better, indeed almost gone. No. 2. The
sourness in mouth has ceased. The sweats on the
thighs are lessened: his bowels are confined: he feels
the want to relieve, but it is attended with no effect.
Ordered sepia, four globules of the twelfth dilution.
July 26.—The desire to destroy is still lessening:
the sweats on thighs still diminish: bowels are now
regular. Ordered sepia, four globules of the thirtieth
dilution. .
August 2.—The destroying feeling is much better:
the acid in mouth has ceased: the cold Sweats on the
thigh have lessened. Ordered sepia, three globules of
the twelfth dilution. The patient was cured.
(45) Constipation and peculiar cerebral symptoms.
Maria Cox, (p. 356, case book 1845,) aged 19. She
CASES OF CURE. 277
has swimming in her head: things appear to go round: CHAP. xvii.
her bowels are confined: she sweats over her chest:
she has when she lies down in bed a sensation come
over her as if she were too large for the bed: this
sensation she has been troubled with some time. She
had been under the care of the late Dr Callmann for
two years. Her countenance is very oppressed.
Ordered kali carbonicum. - ºlºne
This was on July 28, 1845. On August 7, 1845,
her countenance appeared much brighter: the Swim-
ming in the head is much better: the objects do not
appear to go round: the appetite, which was bad, is
much better : the feeling of largeness has ceased.
*** *gº
(46) Constipation with uterine symptoms and shaking of
the leg.
This patient had continual shaking of the leg and
thigh so that she could not keep them still: she had
great weakness in the back: her bowels are confined:
she had pain in the womb shooting into the passage:
she has pain in her back when she is excited: she has
pain in the left side. She was ordered crocus one Crocus and
e - © natrum mu-
globule one day, and matrum muriaticum the next raticum.
day.
A few weeks after she consulted me again, and the
back weakness was better, but is felt most in sitting:
her bowels are regular: the shooting pains in her
womb are much better: her feet are cold: the leg is
steady: the pain in the side is relieved by lying.
The young lady had taken many medicines for the
womb and leg shaking, but no permanent relief was
gained till she took these medicines.
278 CASES OF CURE.
CHAP. XVII.
Graphites.
Sepia and
graphites.
Sulphur and
sepia.
Group second.—CASES OF DESCENT OF GUT.
(47) Prolapsus after operation cured.
Amelia Perkins, (page 1379, case book 1849,)
aged 43, married, but never pregnant. She had, when
first affected, an abscess at the rectum ; this affected
her for twelve months: she was operated upon at the
infirmary, in Charterhouse Square, about two years
since: she consulted me Dec. 28, 1849: she states
that her state at the time of the operation was exactly
similar to her state at present: she cannot pass her
stools except with the greatest pain: there is a feel-
ing of great tightness: there is a large lump at her
anus: her bowels are confined: the actions large at
first but afterwards flattened: blood occasionally at-
tends the action of the bowels: her food lies heavy at
the chest and pains her between the shoulders: her
skin is dry: the monthly period is profuse: she has
had a largeness at the left side of the belly many
months, and she has pain, post coitum, at this side of
the belly. Ordered graphites, 4|12.
Jam. 2–She is better in every respect. Ordered
graphites, 3/12.
Jan. 11.—She is still better. Ordered graphites,
2|12. On Feb. 1, the feeling of tightness at gut has
returned: the gut comes down, and blood has been
caused by the action of the bowels twice in the last
week. Ordered sepia 4|12, then graphites 4/12.
Feb. 13.−The tightness is still felt, but no blood
has passed: the gut still comes down: she has pain
in the womb. {
Ordered sulphur 4|12, then sepia 4|12.
On Feb. 27, she experienced violent throbbing
in the fundament extending to the front of the body:
CASES OF CURE, 279
the pain indicating the formation of an abscess. CHAP. xvii.
Ordered hepar sulphuris. Hepar sul-
March 6.—The throbbing continues, but she is phuris.
better. Ordered hepar sulphuris.
March 15.—Pain is felt at the time of the action
of the bowels, they act daily. Ordered sepia 3/30. Sepia.
March 22.-Better: a little scalding in passing the
water was relieved by cantharis 4|12, followed by sepia.
April 15.—The lump comes down, but the pain is
less. Ordered sepia, ii. -
In a letter dated May 14, in a subsequent year, she
writes, “After the great benefit derived from my
attendance upon you for prolapsus, I feel ashamed at
the abrupt manner that I must appear to have left,
(the letter here narrates explanatory circumstances).
On my return I shall take the liberty of again wait-
ing upon you. With sentiments of gratitude, I remain
your's, &c.” ** *
(48) Descent of gut &nd constipation cured.
James Moring, (page 1323, case book 1848,)
consulted me Jan. 5, 1849. He was in great agony
from the gut coming down, attended with a want to
go to stool to relieve the bowels, the attempt being
unattended with effect: he cannot by any possibility
sit down. Ordered sepia 4|12, to be taken in the sepia.
course of four days. .
Jan. 8.—He looks better: the want to relieve the
bowels occurs less often, still he cannot sit down.
Ordered sepia in less doses.
Jan. 12-He now can sit down: he has the want
to relieve still less frequent: the gut comes down less.
Ordered sepia in Smaller doses.
Jan. 19.-He can now sit down for an hour or two
hours: the gut comes down now only when he goes
280 CASES OF CURE.
CHAP. XVII.
Graphites.
Sepia.
Graphites.
Sepia.
to the closet: his bowels act once in three days: he
has a great difficulty to pass the contents of the
bowels: the evacuations are like round nuts: he can
pass the gut up, whereas before he had the greatest
difficulty to effect this: his skin is dry. Ordered
graphites.
Jan. 31.- The gut comes down when he goes to
stool, but he can pass it up and now it keeps up : the
actions are still hard, but rather less so. Ordered
sepia 4|12, in the course of a week.
Feb. 12.—He is much better in every respect: the
bowels act better. Ordered sepia in less doses.
March 6.—The gut scarcely comes down at all:
there is still great difficulty in expelling the contents
of the bowels: the stools are now large and hard,
and the hands are dry. Ordered graphites.
He was cured.
fº-º-º-º-mºmºmºmº
2 (49) Descent of gut.
Susannah Turner, (page 1647, case book 1844,)
aged 45, married. She has been troubled with the
coming down of the womb for sixteen to seventeen
years: she feels as if she cannot walk. She was
seized April 29, 1845, with a dreadful bearing down
pain at the gut, giving her great pain when she sits
down: the part is swollen: the gut comes down when
she relieves the bowels: she has a discharge from the
womb : she has pricking pains in the front passage:
she has frequently a want to relieve the bowels, but
attended with no effect. Ordered sepia. -
May 6.—The bearing down is lessened : the swell-
ing is lessened: the pain on sitting is lessened: the
gut comes down less: the want to relieve the bowels
is better, but when she has the desire to go to stool
CASES OF CORE. 281
she has a shooting pain in the front passage. Clematis chap. xvii.
removed this shooting, and, on May 27, the bearing”
down was still better: she has had no pain in the
front passage for several days, which, subsequently
to taking the clematis, was felt when she made water:
water passes better, and indeed she became so much
better that she desisted from medicine.
(50) Descent of gut with blotches on face dº syphilitic taint.
Wm Holmes, (p. 1173, case book 1843,) aged 25,
single. He has been troubled with blotches on his
face for the last two years, which came first after
syphilitic disease: his nose has been affected for three
years with dry scabs: he has lost the power of smell:
he has, during the last six months, taken much Sarsa-
parilla: his gums are sinking away from his teeth:
his gut comes down and he has lumps round the anus:
the passage of his stools is attended at times with the
passage of blood. Ordered sulphur for one week, then Sulphur.
mitric. acid. for another week; and then, on Sept. 26, Nitric acid.
because his bowels were confined, his skin dry, and
blood attending the action of his bowels, I ordered
graphites. There is a want to relieve the bowels and Graphites.
no effect. -
Under the use of grºphites for a month, about four
globules a week, the bowels acted well: the desire to
relieve without effect had ceased: the hard lumps
round the gut had disappeared. As he became better
he felt shootings in the parts which had been affected
with syphilis.
(51) Descent of gut cured.
John Tyler, (p. 1394, case book 1851.) This
patient, under treatment for epilepsy, is troubled
O O
282 CASES OF CURE.
cHAP. xvii. with a descent of the gut, which he is obliged to re-
turn by pressure with the fingers: he has great heavi-
ness in the head: the bowels act regularly. Ordered
Sepia. sepia 3|12, on Jan. 24. Jan. 31, the gut now has re-
turned: his head is much better. Ordered to con-
tinue the sepia, and on Feb. 14, the gut has become
quite comfortable.
(52) Prolapsus of the gut from a strain cured.
Wm Palmer, (p. 1366, case book 1844.) aged 44,
married. He consulted me March 9, 1844. He
strained himself two months since by lifting a heavy
stone: his gut came down at the time and it does not
go up: he passed blood with the action of the bowels
at first but not now : his bowels are relaxed: one of
Arnica, his testicles is swollen and hard. Ordered arnica and
armica poultice.*
April 4.—The gut affection is much better; as is
the state of the testicle, which is swelled less and
softer: he has been attacked with the gout, which was
º cured by aconite and pulsatilla, the gout being at-
tended with great weakness and affecting the knee of
one leg and the foot of the other: the bowels having
become confined, and the legs having become set fast,
Lycopodium, lycopodium was prescribed and a cure was effected.
Arnica, acon- The subsequent year the gut came down. Arnica
ite and nux. e { }
followed by aconite and nual again restored the gut.
In this attack the bowels became towards the con-
clusion of the cure confined.
* For the preparation of this see p. 89, Treatise on the Virtues of
Arnica, Rhus Toxicodendron, and Calendula, in reference to Wounds,
Bruises, &c., by John Epps, M. D. Piper & Co.
CASES OF CURE. 283
(53) Descent of gut for three months cured. CHAP: XVII.
Frederick Caster, (p. 457, case book 1847.) aged 21.
His eyes are weak, watering much and attended with
a running at the nose: his appetite is not good: his
bowels are confined: his gut comes down and has so
done for three months: he is feverish and has sweated
the last two nights. Ordered aconite, which lessened Aconite.
the affection of the eyes and the running of the nose
and the feverish heat and the sweats, but did not
affect the bowels or the descent of the gut, which is
troublesome. Ordered sepia. Sepia.
Jan. 12.—The bowels now act twice a-week: the
appetite is bad: the tongue is furred: the water is
difficult to pass: the gut is better, it does not descend
since the action of the sepia ; he has a cold shivering.
Ordered nua, on account of the appetite and tongue Nux.
and shivers, and the symptoms became better, the
bowels acting twice a-week, the gut remaining well:
the water still remaining thick and rather difficult to
expel, lycopodium was prescribed, and the patient Lycopodium.
was cured.
(54) Descent of the gut with piles and discharge of blood.
Jane Palmer, (p. 1034, case book 1844). This
patient is troubled with piles attended with swelling
and discharge of blood, intense burning and darting
pain, the bowels being confined, the stools hard, and
pain many hours after the action of the bowels: the
gut comes down when she coughs. Ordered arseni-Arsenicum,
cum in the morning, graphites one globule at mid-day, ºie, and
and nua, one globule at night. This patient had been
troubled for several months with these piles. These
remedies were prescribed on Oct. 14, when her state
o o 2
284. CASES OF CUR.E.
CHAP. XVII.
was exceedingly distressing, and the agony endured
extremely great.
-Oct. 19th.-The burning pain has almost ceased:
the blood has ceased: her stools are matural: she had
no pain for the last two days after the action of the
bowels: her appearance has completely altered, she
looks so well. -
*mºmºsºmsº
(55) Descent of gut.
Wm P. Davies, (p. 467, case book 1844,) aged 35,
single. This patient consulted me Feb. 21, 1844.
He has had prolapsus recti (descent of gut,) for
eighteen months: he has had a burning pain in the
gut: he passes blood both with and without an action
of the bowels: he has been a patient at Bartholomew
Hospital: his bowels are costive: whenever he takes
food he feels it lie heavy at the gut and the gut
comes down:* the gut remains down in the day, i.e.,
when from any cause it has descended. Ordered muay.
Feb. 28.—The gut pain is much better: the dis-
charge of blood has lessened, it is of a dark brown :
the food lies less heavy: the gut yesterday was down
two hours less time than it had been before. As the
bowels still continue costive though the patient was
better, sulphur was ordered in alternation with nua,
day by day, waiting occasionally a day after the
sulphur. - - -
March 13.—The pain in the gut has ceased: the
blood has ceased : the bowels are less costive: the
food no longer lies heavy: the gut came down only
once in the last week, and the descent was very
Nux,
Sulphur and
I) ll MC.
* This fact is highly interesting. It illustrates the physiological ſact,
that food, taken into the stomach, produces an action at the extreme
end of the intestinal tube : a fact of high practical importance.
CASES OF C U R.E. 285
trifling. Ordered nua one day, wait a day, Sulphur CHAP. xvii.
the third day, wait two days. .
The symptoms continued to improve: the discharge
from the gut became at first of a light brown; sub-
sequently the discharge was mucus with a little blood;
and, on April 10, the gut had not been down for a
fortnight, and he states that he has been better for
the last fortnight than he has been for eighteen
months previous: he can sit down, which he could
not do before: he was obliged either to stand or
to lie.
(56) Constipation with descent of gut and windy spasms
with chronic gastric derangement, *
Elizabeth Brett, (p. 299, case book 1844,) aged 29,
married, the mother of two children. She is troubled
with windy spasms, attended with great pain at the
navel, which cause her to swell up very much, at-
tended with a rising in the throat: the food causes a
feeling of being hurt in the throat: her bowels act
every other day, and are costive: her body comes
down : for some months water has passed profusely
from the mouth: her monthly period is regular; she
had an epileptic or other fit two years since, which
has caused an eversion of the eyelid: she is worse in
the evening. Pulsatilla relieved some of the symp- Pulsatilla.
toms, especially the symptoms connected with the
stomach; but as the bowels continued confined and
the gut came down, and the water still rises into the
mouth, muay 4|12 was ordered, and in ten days her Nux.
bowels became regular, the water scarcely ever rose
into the mouth: the nua was repeated, and the body
did not come down. ‘. -
In a subsequent year, her skin became dry, her
286 CASES OF CURE.
CHAP. XVII.
Graphites.
Sepia.
Graphites.
bowels became confined, and the body came down :
graphites effected a cure.
(57) Constipation with descent of gut and head affection.
Harriet Cotton, (p. 873, case book 1844,) aged 39,
married, the mother of two children. She consulted
me Nov. 7, 1844. She complained of a severe pain
between the shoulders, going up the neck to the head,
this pain being always worse at the monthly period,
at which time she has pain at the lower part of the
belly: she has a pain and a burning heat at the front
of the head: she has a weakness of the eye, attended
with a dazzling and a dinginess before the eyes: her
tongue is furred: she has a feeling of sickness: she
cannot Smell her food: her bowels are confined: she
has a pressure on the bladder: she has itching in the
front passage: she has a descent of the gut. Under
the use of sepia 4|12, all her symptoms became better
on Nov. 14, and by a repetition of the sepia in less fre-
quent doses she became nearly well, with the excep-
tion of a feeling in the passage as of something
stopping it. Graphites 4|12 was ordered, and all the
symptoms improved, and by a repetition of the gra-
phites she became well.
(58) Descent of gut and fistulous abscess in groin with
- Sycotic growth therein.
E. L., (page 1040, case book 1850,) aged 27, mar-
ried five years, and the mother of two children. She
consulted me Sept. 16, 1850. She had a tumour in
her groin, which was lanced at St. Thomas's Hos-
pital. . She was told there that it was cured.
In three months time after the declared cure the
CASES OF CURE. 287
wound broke out afresh: she had it often probed. CHAP. xvii.
Finding no relief at the hospital, the wound not
healing and discharging very much at night, she
sought homoeopathic aid.
From the opening, which is of a fistulous cha-
racter, there is a little growth, apparently sycotic in
its character: the pain is aching. Her hands are
damp : her feet damp and cold: her gut comes down :
her appetite is very bad : her monthly period is regu-
lar. Ordered silicea 4/12. - Silicea.
Sept. 23.—Discharges still: her head is painful.
Ordered silicea 4/30. -
Sept. 30–Discharges still: the growth appears
smaller than at first: she has pain at her back: she
feels low and weak, but does not sweat. Ordered
baryta carbonica, to be followed by silicea. º
She states that this growth came after the wound silicea.
was probed; and little doubt can exist, that the probe
had been in contact with some person labouring under
sycotic disease. -
Oct. 14.—The discharge is now slightly increased:
the part feels stiff; the pain at the back extends to
the hip. Ordered thuya. Thuya.
Oct. 29.-The pain at the back has ceased, there
is now an aching pain near the wound. Ordered
thuya and a thuya poultice.
Nov. 4.—She stated to-day that her gut, which
used to descend, now remains up better: the wound
is improving, Ordered thuya and thuya poultice.
Nov. 19.—Gut descends less: the wound is gene-
rally worse a day or two days before the monthly
period: thread worms come from her. Ordered cina Gina then
for the worms, then thuya and thuya drops. thuya.
Dec. 9.—No more worms: gut descends less: the
288 CASES OF CURE;
CHAP. XVII.
Thuya.
wound is smaller: improved in appearance. Ordered
thuya 3|30.
Dec. 23.−She had a little relaxation ; for this and
Acidum phos because the bowel comes down more, I ordered aci-
phoricum and
thuya.
Thuya.
Hepar sul-
phuris and
thuya.
Sulphur.
dum phosphoricum, to be followed by thuya, 26.
Jan. 7, 1851–The discharge, which generally is
more at the monthly period, was not increased at the
last monthly period, and the discharge has now
ceased: the bowel comes down less. Ordered acidum
phosphoricum, to be followed by thuya.
Jan. 17.—The discharge has returned. Ordered
thuya 2/12.
Feb. 12-Discharge is now very little. Ordered
thuya 2/30.
Feb. 24.—Discharge still less. A weakness of the
ancle, which had been present since the discharge
came, and which she mentioned now for the first
time, is better: her bowels are less free. Ordered
hepar sulphuris and then thuya.
March.-No discharge. Ordered hepar sulphuris
and thuya 1/6. '
April 7.-Discharge very little : the ancle is
stronger. Ordered sulphur.
Dec. 5, 1851–The patient called to-day about her
child, and said she was quite well; the sycotic growth
had disappeared and also the discharge ; nothing
remains but the scar, and a little induration of the
tissue above the scar.
Additional cases present themselves. These will
serve to illustrate the painful condition, associated
with descent of gut, and the power of homoeopathic
treatment therein. -
CA SES OF CIJ RE. - 289
Group third.—SUCCESSFUL TREATMENT OF PILEs. CHAP. xvii.
(59) Piles for thirty years. -
Francis Layton, (p. 1162, case book 1844.) married,
aged 59. He has been troubled with piles for thirty
years: the piles come down and he has pain after
every motion for six to seven hours; and the pain
occurs whether the bowels are costive or not costive :
the pain “quite unnerves me:” his bowels are gene-
rally costive: blood attends the action of the bowels
sometimes, and the blood passes when the actions of
the bowels are most easy: he has no headache: he
has a good appetite and he has no signs of indigestion,
but has a red eruption on the face. Ordered gra-Graphites.
phites 4|12.
Jan. 18, 1844–The piles are much better: the
pain troubles him only for three hours: the bleeding
has been less: the eruption on the face is better.
Ordered graphites 412, in less doses.
The patient became much better and I did not see
him till the 18th of March, when his disease had re-
turned, he having been much harassed in business,
and one day having eaten too heartily at dinner, and
then having gone to sleep, he, on awaking, found his
eyes set and his teeth clenched. For the harass and
the spasmodic conditions, induced most likely by the
harass and the overloaded stomach, I ordered nual .
vomica alternating day by day with sulphur.
April 11.-The piles are better: he states when he
desists from his medicine he has pain, but when he
takes his medicine he has no pain.
(60) Piles attended with the passing of dark blood, cured.
George Bryne, (p. 84, case book 1849,) aged 26,
P P #
290 CASES OF CURE.
CHAP. XVII.
Nux.
Graphites.
Pulsatilla.
Graphites.
Nux vomica,
and sulphur.
married, consulted me Feb. 16, 1849. He has piles
Which cause him to pass dark blood after the stool,
and sometimes before the stool: he has pains in the
chest in the morning: his appetite is not so good as
it was: his food lies heavy: he has forehead head-
ache: his bowels are confined. Ordered nºta.
Feb. 23.—The chest pains are now worse before
going to bed after food: the piles still trouble: the
appetite and the headache are better: the bowels are
confined: the actions large. Ordered graphites.
March 2.—The piles are very much improved: the
appetite and the head still improve: the bowels act
every two days: he has pains in the shins which parts
seem swollen. Ordered pulsatilla because the food
still lies heavy and for the pain in the shins, to be
followed by graphites.
The patient was cured.
(61) Easternal and internal piles with a special head
affection.
M. A. Lee, (p. 976, case book 1848,) consulted me
in May 1848, for piles, with which she had been
troubled for a length of time. She has both external
and internal piles, attended with profuse bleeding at
times: her bowels act very irregularly. Ordered nua,
vomica.
May 27. Her piles still trouble her. Ordered nua,
and sulphur in alternation.
June 28.—The bleeding has in a great measure
ceased: her bowels are more regular in their action.
But she now complains of a pain, which affects one
half of the head one day, and the other half of the
head newt day. In the morning she feels “bad” all
round the loins, which state improves after she has
CASES OF CIJ RE. 291
had exertion. Ordered rhus towicodendron, four glo-CºAP, XVII.
Rhus toxico- .
bules. dendron.
July 1.—Her head is better: her loins are better.
August 1.—She called on hehalf of another patient
and returned thanks, stating she was quite cured,
(62) Piles and long time in relieving the bowels.
Mr K. This gentleman came up from Wales to
consult me in 1850. He has been troubled for a long
time with piles and their concomitant troubles. In a
letter from him July 10, he thus writes:—“The
bleeding from the piles has been very severe.” The
bleeding continues the whole time he is at the stool,
he is generally upwards of half an hour at stool: the
piles are hot while the bleeding continues, but the
heat almost entirely ceases when they are pressed in
after the action of the bowels. “In most other respects
I am better, and the piles do not fall down nearly so
much as they did, and I have seldom more than one
operation in twenty-four hours.” I ordered him to
take millefolium 6/12, repeated four times.
In a letter dated Sept. 16, 1850, he writes—“Since
our last correspondence I am happy to state my health
has somewhat improved, and the bowels have acted
better, as for some weeks past I have had only one
motion a-day, and, though still slow, say occupying
a half hour each time, I have but little else to com-
plain of in that respect.”
(63) Piles hereditary.
Mr J. H., aged 35, consulted me Oct. 16, 1846.
The piles protrude about the size of small birds eggs;
attended with a severe burning darting pain through
the swellings: he experiences a severe pain on the
P P 2
292 * CASES OF CTU R.E.
CHAP. xvii. contraction of the fundament in passing water, on
Sneezing, on coughing, or in stepping off a step: this
pain is often so severe as to cause him to cry out: he
has severe pain when the bowels act: all the symp-
toms are increased both by bodily as well as mental
exertion: he used in walking to chaſe between the
thighs: this occurred before the development of the
Acquite, nux piles. Ordered aconite and nºta: one day, and carbo
and carbo ve- * * * * © U.
jaji. vegetabilis the next day. His father was much trou-
bled with piles.
Nov. 18, 1846.-The tumour at the amus is gone:
a little soreness is felt at the part: the pain at the
contraction of the fundament is troublesome at times
but is very much better: the bowels are costive, though
regular: he had a violent itching in the feet and the
hands some months since : Scratching caused red pim-
ples to appear: this rash has ceased since his present
malady: he has now itching at the rectum, Ordered
Aºife, nº, aconite and nua one day, sulphur next day in alterna-
su! plur and , . e ºf g º
tº tion, then carbo vegetabilis for two following days, so
tabilis. repeat waiting between the medicines.
He became well.
(64) Piles attended with burning in the region of the
stomach and with bronchitis.
John Dovey, (p. 523, case book 1844,) aged 38,
single. He consulted me May 13, 1844: he com-
plained of a heavy cough in the morning expectorating
much white phlegm : he has nausea with a rising of
sour water: his food lies heavy: he has a burning
across his stomach : he has had piles for four months
with pain: he passes blood with red water when he
Nux. has a stool. Ordered nºta.
May 20,-liis cough is easier: he has expectorated
CASES OF CURE. " 293
very much phlegm for four days: the nausea and the chap. xvii.
burning ceased after this discharge of phlegm : the
burning at the stomach is very much better: the piles
are less painful and the discharge has lessened.
Ordered muay 4|12, in less doses. He still improved Nux.
and by repeating nua, in smaller doses and at longer
intervals he became well.
Group fourth-Fistula AND OTHER DISEASES OF
THE RECTUM.
(65) Case of fistula.
Mrs C. (p. b. 59,) aged 42, married, the mother
of thirteen children. She had a miscarriage five
years since and she had a still-born child in Sept.
1848. Her surgeon told her she must lie by and be
operated on. She has been laid up with fistula: the
feces pass through the fistulous opening: she suffers
great pain; she has a good appetite: her bowels are
confined: she can hold her water: she has a severe
cough, which has troubled her for the last week: she
has her monthly period: she has white discharge um-
attended with irritation: she perspires both by night
and by day. Ordered kali carbonicum. Kali carboni-
I was consulted on Sept. 28, 1849. On Oct. 5, the “”
fistula was better, so that the patient was enabled to
go about more: she has less discharge from the fistu-
lous opening, but has a sense of fullness in the part:
she feels bloated after food: her cough is better: she
perspires less. She received a globule of aconite and Aconite.
was ordered to take lycopodium. -
Oct. 26.-The fistula gathered last Wednesday and
discharged, but it is now better: it Scems to gather each
Lycopodium,
294 CASES OF CURE.
CHAP. XVII.
China and
hepar sul-
phuris.
Arnica and
hepar sul-
phuris.
Arsenicum
and hepar
sulphuris.
Wednesday: she feels better inwardly: the feeling of
fullness and a feeling of stiffness still continue: she
has a pain in the back and a pain round the lower
part of the belly: the bowels act better: her cough
has ceased: the white discharge is better: the perspi-
rations are better. Ordered china for the periodical
recurrence of the discharge, and hepar sulphuris for
the discharge itself. •
Nov. 20.—The fistula is a great deal better, she
has now no discharge through it: she has no pain:
there is a little stiffness still: the back pain is better:
pain at the lower part of the belly is better: the bowels
are regular, though rather costive: she does not per-
spire: the periodical gathering is better: her legs,
which have swelled before, swell most at night: the
least touch upon her flesh causes a bruise: walking
causes an aching. Ordered armica and hepar sulphuris.
Dec. 17.—The fistula is much better, there is no
discharge: there is a little hardness still to be felt, and
there is a sensation of stiffness although it is very
much better: the back pain is better: the pain at the
lower belly is almost gone: her bowels are regular:
the gathering becomes less and less: she swells to-
wards evening, and she has a sore at the angles of
the mouth. Ordered arsenicum and hepar sulphuris.
This patient became cured and without an opera-
tion. This case is highly interesting, since the patient
had been ordered to lie by in order to prepare herself
for the operation.
(66) Case of fistula.
L. S., (p. 185, case book 1851,) is troubled with a
fistula: she has been operated upon by Mr Salmon :
she is aged 29, is married, and the mother of six
CASES OF CURE. 295
children: she has had one miscarriage. She con- chap. xvii.
sulted me Nov. 14. She has piles, which bleed at
times, more especially before the monthly period; the
piles burn: she is thirsty at times: becomes lost at
times: she has a bearing down of the womb : she has
been prescribed for by an eminent physician accou-
cheur; a surgeon burns the neck of the womb once
a week. Ordered arsenicum to be followed by sepia. sº
Nov. 28,-There has been no bleeding: the burn- *
ing is less : the thirst has been absent: the fistula has
been less troublesome : she has shooting pains from
womb to thigh. Ordered clematis then sepia. Clematis and
Dec. 12.—The patient is better: the memory is Sepia.
better: the fistula does not now discharge : the womb
still bears down. Ordered acidum phosphoricum and ..".
hepar sulphuris in alternation. i. * *
Dec. 26.—The bearing down is rather worse: there phuris.
is a little discharge from the fistula: memory im-
proves. Ordered graphites and hepar sulphuris. Graphites
Jan. 5, 1852–The piles bled twice last week: she .
has pain after the action of the bowels: a white skin
covers the motion: tongue is coated: a great weight
is felt over the eyes: she has a shining light before
the eyes: she has a bearing down of the gut with a
want to go and no effect. Ordered sepia and aurum Sepia and
&\ll 1’ll lll.
in alternation, three quarters of a globule alternately
every eight hours. The patient became well.
(67) Hernia painful and coming down more, with fistula.
Thomas Smith, (p. 486, case book 1842,) aged 39,
married, consulted me Sept. 19, 1842. He has been
three years troubled with fistula which he has had
cut: he is now troubled with dryness of the hands,
and rash and itching: loss of power in the hand: he
296 CASES OF CURE.
CHAP. XVII. has a rupture: the numbness and the rash and the
itching lessened under homoeopathic treatment, and
the fistula improved; but, on Dec. 27, the rupture be-
came very troublesome, coming down more and at-
tended with pain when going to stool: he has to
strain, and the rupture, he thinks, was caused origi-
Nux. nally by straining. Ordered nua. -
Jan. 7, 1843.−The rupture is better: the bowels
act quite easy. He continued to improve, and under
º the action of causticum and ignatia his fistula ceased
*" to discharge.
(68) Case of fistula. -
Eliza Francis, (p. 658, case book 1844,) aged 22,
married, mother of two children. She has been
injured by her husband: she has a hard fistulous
discharging ulcer at the gut: she has had for three
months a dreadful burning heat in passing water and
has a yellow discharge from the vagina: she has a
dreadful forcing at the gut.
Under homoeopathic treatment she became much
better; and on Sept. 12, her water, which used to
scald her, passes free: a soreness and a stiffness which
she had about her hip were also better: her bowels
had become regular; and the principal suffering she
has was from the Soreness produced in the fistula by
the passage of the stool, blood passing after every
Causticum. action of the bowels. Causticum was ordered, and,
on Sept. 16, the pain connected with the fistula was
much lessened: she has pain at her thigh. Ordered,
* because the blood continued, armica one day and
causticum the next day. The pain was much lessened:
** the discharge of matter became offensive. Carbo vege-
tabilis, and then carbo vegetabilis in alternation with
CASES OF CURE. 297
mercurius, were prescribed, and, on Dec. 10, the fistula CHAP. xvii.
was almost healed.
(69) Case of Supposed fistula cured.
Mr T., (p. 100, book T.) consulted me Oct. 1849.
He had consulted a surgeon of St. Bartholomew's
Hospital for a swelling in the neighbourhood of the
anus. This surgeon considered that it was a fistula.
He subsequently consulted Mr Salmon, who, when
asked whether he thought it was a fistula, said, “I
do not think, but know that it is a fistula.” The
patient, anxious to avoid an operation, came under
homoeopathic treatment.
He stated that for several years he had had a little
swelling which comes and goes. He feels pain when
the swelling is developing itself, and he feels an un-
pleasant tightness at the part. Ordered hepar sulphur-IIepar sul-
is, four globules to be taken in the course of a week, phuris.
to be followed by Silicea, four globules to be taken in silicea.
the course of a succeeding week.
Nov. 5, 1849.-The pain has ceased: the tight-
ness has ceased: the bowels are rather costive: the
actions of the bowels do not hurt him. Ordered
hepar sulphuris, four globules the first week, three IIepar sul-
globules the second week, two globules the third"
week, one globule the fourth week.
Dec. 22.-He is much better, though his bowels
are more confined. Ordered graphites, six globules Graphites.
during a week; the second week to take hepar sul-Hepar sul-
phuris, and so in alternation. phuris,
Feb. 18, 1850.-There is no swelling. In fact he
is well, and came to express his thanks that he was
freed from what was declared to be fistula, or for
Q Q
298 CASES OF CUIRE.
cHAP. xvii. which he fully expected to have had to submit to -
an Operation.
(70) Stricture of rectum.
Emily Cook, (page 450, case book 1850,) aged 60,
single, consulted me August 5, 1850.
She has laboured under stricture in the gut for
three years. At least such has been asserted to be
her complaint by those under whose care she has
been. Her symptoms are,
Symptom 1. At times sharp pricking pains in the
gut. Symptom 2. She is hurt when she goes to stool.
Symptom 3. She generally passes blood when she has
an action of the bowels. Symptom 4. Her appetite
is not very good. Symptom 5. Her bowels are con-
fined. Symptom 6. She has a want to relieve in the
morning but often without effect. Symptom 7. She
has piles which bleed. Symptom 8. Suffers from a
Sepia. heavy headache. Ordered sepia, 4|12.
August 11.—No. 1. The gut is more easy. No. 3.
Her bowels act better: the actions are small. No. 8.
Her headache distresses her. Her skin is moist.
Ordered sepia 430, a smaller dose.
August 17.—No. 1. The gut is much better: the
pains are lessened and the pain on action of the bowels
is much diminished. No. 3. She still passes blood.
Her appetite is better. No. 5. The bowels are com-
fortable: a pain is felt some little time after. No. 8.
The head is better. Ordered sepia 3|12.
August 24.—The gut is a very great deal better,
“I have much to thank you and God for.” No. 2.
Blood lessened, indeed, she has passed none for two or
three days. No. 4. Her appetite has very much im-
proved. No. 8. The actions of the bowels improve:
CASES OF CORE. 299
the piles bleed less: the headache a little this morn- CHAP. xvii.
ing. Ordered sepia 3/30.
August 30.—Much better. Sepia, ij|12. Sepia.
Sepia continued. She considers herself as cured.
(71) Hernia painful.
Susannah Boch, (p. 493, case book 1842,) aged 60,
married, the mother of six children, consulted me
Nov. 1842. She complains of a lump in the groin
which she has had for eight months: a rupture: “it
comes in and goes out:” I adopt her language, it was
at first the size of a nut, now it is of the size of an
egg; she has a painful sense of bearing down and
weight, and when this painful condition presents itself
the rupture advances further: her bowels act regu-
lar: her water is free. Ordered nua, 4|12. Nux.
Nov. 17.—The rupture is much lessened: she has
had pain only once since she took the medicine.
Ordered muay in less doses. -
Dec. 19.—She took her medicine, but having been
without medicine for some days she had a severe pain
in the rupture. In this case the rupture kept up
under the influence of muay for six weeks.
---
(72) Case of cancer of the rectum.
This disease, so dreadful to the sufferer both from
the pain it causes and from the peculiar offensiveness
of condition which it induces, admits of much relief
by homoeopathic treatment. I have attended several
cases, and have experienced much satisfaction from
the relief afforded. Cure can hardly be expected.
The very nature of the results of the disease operates
against cure. The disease itself is almost irresistible;
but when it is known that, as a result from it, the
Q Q 2
300 CASES OF CURE.
CHAP. XVII.
Thuya and
arseniculu.
cancerous growth or ulceration destroys or eats away
the sphincter muscle, that closes the gut and allows
the faeces to escape, the continual irritation of the
parts which must thus be produced, must present a
great impediment to the action of all remedies.
Still, even, in this worst form, much may be done.
I had a patient in whom cancer of the rectum had
eaten away the sphincter, and the bowels were con-
tinually relaxed, and the relaxed contents were con-
tinually discharging. The patient was obliged to lie:
she was in this state when I was consulted, other
treatment having been tried in vain. Homoeopathic
treatment, combining the use of thuya, arsenicum,
and other means, afforded great relief, so much so
that she could sit up to work with her needle, and,
finally, was enabled to take a journey from London to
a village beyond Guildford, bearing it well. She re-
turned to town and still continued to improve, when
she was frightened : a terrible crash occurring in the
middle of the night, attended with the shrieks of her
husband: the roof of a little lean-to room, in which
he slept, fell in upon him. The shock was too much
for her constitution, her disease became worse and
she sank. Such, however, was the benefit gained,
that the conviction became established, that, in these
cases, it is a duty to use means to try and effect a cure.
(73) Disease of gut and of womb with chest affection.
A. W., (page 2822, case book 1853,) aged 28, the
mother of two children.
She is troubled with bearing down in the passage
of the womb, and a similar sensation in the gut
passage, attended with great uneasiness: she has
violent pains in the back and the thighs, like labour
CASES OF CIU R.E. 301
pains: there is no discharge from the womb, and she chap. xvii.
has no pain in coitu : her bowels are confined: her
eyes are painful: her breasts are painful: she has a
severe cough : her appetite is bad: she is extremely
weak and very ill: she is four months pregnant.
Ordered sepia and mercurius in alternation. ..
May 20.—She has bearing down in the womb
passage, and still has the backache; but the gut
passage affection is better: her bowels have acted
twice: the pain in the thighs is still very severe : the
pain in the eyes is a dull, deep-seated pain, more par-
ticularly in the evening: she has fits of shivering in
the middle of the day: she has pinching pain in the
stomach: she is very ill and weak. Ordered kali Kali carboni-
carbonicum and rhus in alternation. Cll Ill.
May 24,-She is better, but her cough still con-
tinues. To continue kali carbonicum and rhus. *ś.
May 30.—The bearing down in the womb passage
is better: the gut passage is better: the backache is
better: the pinching pain is better: the shivering fits
have ceased: the weakness is still great: the tongue
is covered with a brownish coat: the bowels act very
well: there is pain over the right eye and at the back
of the head at the right side: she does not sweat at
might: she has a feeling as if she shall go out of
her mind. Ordered stramonium and acidum muriaticum. Stramonium
June 6.—She is better in the womb, the gut, the tº.
back, and the pinching pain ; but she has a cold feel-
ing in the early part of the day: when lying down
she flushes, gets thirsty, and sweats at her head, legs
and feet: she still has the mad feeling: bowels have
acted: water is reddish: Cough is better, but it shakes
her in the belly: she has a pain round the loins to the
bottom of the belly. Ordered arsenicum and cantharis. Arsenicum
and call-
tharis.
302 : CASES OF CUIRE.
CHAP. XVII.
Arsenicum
and sepia.
Aurum, ni-
tric acid,
hepar sul-
phuris and
thuya.
June 13,-The skin is better: the cough has
ceased : she passes her water better, and it is of a
natural colour: she has lost the pain in the loins, in
the belly, and over her eye: she has a presenti-
ment as if she must commit some horrible
deed : her bowels are confined: she has severe pains
at the right side of the face extending all over her:
she trembles much when she gets up: she has a sour
taste in the mouth. Ordered arsenicum and sepia.
June 24.—She is better in every respect: the pain-
ful presentiment has ceased: the gut is well.
It is certain, from the description given, that some
serious disease in connexion with the gut was in pro-
cess of development. The remedial means effected an
arrest of such development, but the effects on the
mental condition showed how powerfully it had af.
fected that condition. - -
. (74) Fistula.
J. A., aged 24, single, (page 28, A book). This
patient was operated on in the East Indies, four years
since, for fistula. The fistula again troubled him in
May 1851. Aurum and nitric acid, followed by hepar
sulphuris and thuya, effected a cure.
** sººmºsºmsºmºsº
708. This enumeration of cases might be extended
almost indefinitely : other cases are given in the
appendix. Sufficient has been recorded to demon-
strate the power of homoeopathic treatment and the
possibility of curing constipation of every kind.
Sufficient evidence has been afforded to prove that
the action of purgation is not necessary for the cure
of inaction of the bowels.
CASES OF CUIR.E. 303
APPEND IX.
The matters treated in this part of the work,
although not essential to the frame-work of the work
itself, are of the highest importance. They will
afford illustrations of many points, that could not,
without extending the chapters in the previous parts
of the book to an excessive length, have been worked
out: and it is believed that these illustrations will
materially strengthen the convictions, which have
been created by the facts and the views already de-
tailed. -
Thus what can more usefully exhibit the non-ne-
cessity of the employment of the so-called purgative
medicines, than a series of cases demonstrating that
diseases of almost every kind have been cured without
the bowels being acted upon Such cases will be
presented. If to these cases can be added cases de-
monstrative of serious injuries, produced by the action
of purgative medicines in the treatment of disease,
the evidence of the non-necessity of purgatives will
be strengthened, because proof will thus be given,
that it is not merely a question of employment or
non-employment of purgatives, but a higher question
304 CASES OF CURE.
of injury or no injury, as connected with the employ-
ment of these agents.
If to these cases can be added cases of obstruction
of the bowels causing death; whether from the me-
chanical obstruction itself, or from the purgatives
used to remove the mechanical obstruction, the evi-
dence against the employment of purgatives will be
most efficiently augmented, as such cases will establish
the absurdity of attempting to remove mechanical
obstructions by purgative means.
All these and other matters may be beneficially
considered in this appendix.
ÇA SES OF CURE. 305
CHAPT E R XVIII.
Cases of cure of diseases without the bowels being
active , also cases of cure of diseases in which the
bowels having been active, becoming inactive: Fevers:
Affections of head: Opthalmia : Chest diseases :
Gastric diseases: Diseases of the abdominal organs:
Diseases of the urinary organs and of the womb:
Diseases of the skin: Non-eahibition of purgatives
after child-birth.
The non-necessity of the employment of pur- CHAP, XVIII.
gatives for the cure of disease, is evidenced not only
by the views put forth in previous chapters, but also
by the facts, that diseased states are cured though
the bowels remain inactive; and, what is still more
important, that diseased states are cured though the
bowels, which were active in one period of the disease,
become confined during the cure of the disease.
Cases illustrative of these two classes of facts
are numerous. Previous to their record, it may be
well to notice another fact, which even the old sys-
tem practitioners acknowledge, namely, that hardly a
case comes under medical treatment, but in which
purgatives have been most actively employed: a fact,
R. R.
306 CASES OF CIU R.E.,
CHAP. XVIII.
Peyer.
Aconite and
lachesis.
Belladonna
and cina.
Opium and
cina.
which, if viewed unbiassedly, demonstrates the ineffi-
cacy of purgatives in resisting the progress of disease,
it being on account of such inefficacy, that additional
medical aid is sought.
Division I.-FEVERs.
(75) Fever with atrophy cured though the bowels were not
open for three weeks.
John Cox, (p. 302, case book 1852,) aged six years.
He has been ill a week: his mother gave him some
jalap: he is in a violent fever: his body is hot: skin
dry and burns: he grinds his teeth: starts in his
sleep: no appetite: breath very offensive: bowels are
confined: he has wasted rapidly: his water passed
freely till yesterday, when it did not pass for twelve
hours. Ordered aconite and lachesis.
Jan. 3.−His skin is a little moist: he still grinds
his teeth: wanders in his talk, and startles still in his
sleep: his bowels are still confined: he wastes more
and more. Ordered belladonna and cina in alternation.
Feb. 2.-His skin is more moist: he eats a little:
he was dressed yesterday and ran about the room :
he looks better in himself: he picks his nose: breath
offensive: his bowels ARE NOT OPEN, though he has
had an injection. Ordered opium and cina in alter-
nation. -
Feb. 7.-He has had an injection every day but
without effect: he has a little pain at his side, but has
no pain at his belly, and his belly does not swell: he
eats: he sits up and plays about the room ; he grinds
his teeth in his sleep, and perspires a great deal:
Kali carboni-breath offensive. Ordered kali carbonicum and opium.
Cll Ill.,
CASES OF CURE. . 307
Feb. 11.—The bowels acted on Monday: breath is chAP. xviii.
sweet now : grinds his teeth less.
The child became well. It is to be remarked (many
would say it is remarkable, but to the homoeopathist
it is not so,) that the child's bowels did not act for
three weeks, and yet he became steadily better. This
child was cured without being seen : his mother
brought an account of his state.
*mºs º-º-º-º-º:
(76) Melancholia cured though the bowels became more
- confined.
Miss , (p. 55, p. b.,) aged 21, single, consulted Melancholia.
me Jan., 1852. She enjoyed good health till eighteen
months since, when she passed into a very low way,
having a dread of every thing, and a fear of some-
thing dreadful happening to her, especially felt
towards evening: she has gloomy views of the Deity.
She has pain in the lower part of the back: she
has great debility, dreading to get up : for the last
two months she has been unable to bear the fatigue
of dressing.
Her appetite is indifferent: her bowels are not free:
her water is thick, and, at times, passes with pain,
and when it passes, she has pain at the left side of
the belly: her monthly period is regular: it is clot-
ted, though of a proper colour, and is attended with
pain at the back: her feet are very cold: her sight is
not good: in reading the letters seem to run into one
another, and a mist appears before both eyes: her
spine is curved. Ordered lycopodium, a globule of the Lycopodium.
twelfth dilution every other day for eight days, then
three-fourths of a globule of the thirtieth dilution
every other day for eight days, then three-fourths of a
globule every other day for eight days.
R. R. 2
308 CASES OF CURE.
CHAP. XVIII.
Typhus,
Carbo vege-
tabilis and
arsenicum,
Rhus and
arsenicum.
Feb. 10.-The patient consulted me again. Her
spirits are much better: her dreads are much better:
her views of the Deity are changed: her debility is
much lessened: she does not dread to get up, and she
can go through the process of dressing much better:
her appetite is now good: her water is not so thick,
and it passes without pain: the pain in the belly has
troubled her only once: the monthly period was less
clotted, though still the pain at the back was present:
the sight still bad, but the letters do not run so much
into one another, and the mist before the eyes is not
so frequent.
The patient was better in every respect, and yet she
states that her bowels are more confined than they
were when she paid her first visit.
(77) Typhoid fever cured and the bowels not active.
Fanny Hopton, (page 649, case book 1853,) aged
twelve years, is laid up with typhoid fever: she is
prostrate: the skin is dry and burning: her face is
pale: her lips dry and crack: tongue furred with a
brown fur: her breath smells offensive: she is much
purged: she has bled at the nose: she was attacked
with headache, sickness, and pain below the breast:
she notices nothing. Ordered carbo vegetabilis and
arsenicum in alternation.
On May 29, the purging had ceased: the heat of
the skin was lessened but dry: she is more inclined
to talk and she notices a little. Ordered rhus and
arsenicum in alternation.
May 31-Before taking the rhus she became more
confined and sleepy and half unconscious: she is now
better of the semi-comatose condition, though the skin
is still dry, the lips are cracked, the tongue furred,
CASES OF CURE, 309
the breath foul, and the face pale and sunken and CHAP. xviii.
altogether excessively weak, and she is still thirsty.
Ordered acidum muriaticum, Thus, acidum muriaticum *
and arsenicum in alternation. rhus, acidum
June 2.—The patient is better: her appetite is re- º
turning: she is more lively: inclined to talk: wishes"
for food: a little moisture is on the hands. Ordered
bryonia and rhus. ºn and
June 7.—Better. June 12.—She is still better :
will eat any thing: she came down stairs yesterday:
her bowels have not acted since Tuesday week.
It is interesting to add that this patient was cured
without having been seen, her sister used to bring
an account. -
sºmºsºm-ºsmºmºsº
(78) A case of fever cured without any action of the
bowels.
I was sent for on Monday, July 3rd, to Castle-street, Fever.
Holborn, to see Mr C., who had been confined to his
bed since the previous Tuesday.
I found him in bed, suffering from fever: his skin
burning: his countenance anxious: loathes all food:
great prostration : head-ache: inability to think:
bowels inactive: lips crusted with dark crusts. I
prescribed for him aconite, one globule, wait six hours; Aconite, nux
nua, vomica, one globule, wait six hours; aconite, one **
globule, wait six hours; one globule of sulphur, and"
so in alternation; waiting eight hours as he improves.
I visited my patient on Wednesday, July 5, 1848, and
found him perfectly free from fever, sitting up, having
had a boiled sole for dinner: tongue much cleaner,
but his bowels had not acted since Friday.
The wife of this patient was much astonished that
the patient should have become so well without any
310 CASES OF CURE.
CHAP. XVIII.
Bead affec-
tion.
action of the bnwels. In two days the bowels acted
and the patient was soon enabled to attend to his
public duties.
*-* ****
Division II.-HEAD AFFECTIONs.
(79) Severe pains in the head cured, but the bowels still
confined.
Isaac Messeder, (p. 1162, case book 1846,) married,
aged 33, consulted me at the beginning of June.
When he was 17 years of age he had a fall, which
affected the head. For the last six months, he has
had violent pain at the top of his head, which pain is
worse when the bowels are confined: his appetite is not
Nux vomica.
Cocculus.
Nux and
sulphur.
good: his food lies heavy at the pit of the stomach:
his bowels are naturally costive, but the medical prac-
titioner, under whose care he has been, has purged
him, but without benefit to his head: he has a cough
in the morning. Ordered nua, vomica.
June 10, 1846.-His pain is very much better, his
bowels HAVE BECOME CONFINED : his appetite now is
good: his food lies lighter: his cough is better, but
he has a bearing down at the gut, and pain in his
belly. Ordered cocculus.
June 17.—His head pain still improves, but bowels
continue to be confined: appetite good : food lies
light: cough still improving: the bearing down of the
gut is better, though still the bowels are confined.
Cocculus, in smaller doses.
June 22.—Still improving in head though bowels
are confined, and the bearing down of the gut is bet-
ter, though blood passes after the stools. Ordered
nua, vomica and sulphur in alternation.
July 1.—The head is quite well, though the bowels
CASES OF CURE. 3.11
are still much confined: the blood after action of bowels CHAP. xviii.
has ceased. Ordered to continue nua, vomica and sul-Nux vomica
tº and Sulphur.
phur in smaller doses.
His bowels recovered their regular action. This
case exhibits four facts: first, that the patient was
(till under homoeopathic treatment) always worse
when his bowels were confined: second, that the for-
cing his bowels to act did not relieve his head: third,
that his head became better though his bowels con-
tinued confined: and fourth, that his bowels at length
regained the natural regularity, i. e., not by giving
purgatives, but by giving medicines homoeopathic to
the cure of the whole of the diseased state.
(80) Bowels confined, yet cerebral and gastric symptoms
better.
Happy Wing, a miniature painter, (p. 1731, case Cerebral and
book 1844.) aged 20, single, consulted me March 9, ºw dis-
1844. She had suffered at intervals for twelve years
from a head affection: she has complained of severe
pain at the top and the back of the head for several
months: she feels this pain much increased after lift-
ing any weight or going up stairs: she often feels sick,
has a pain at the chest, which passes through to
between the shoulders: her bowels are confined :
appetite is good: water thick: the monthly period is
not at all regular, is little and pale: she perspires in
bed. Ordered aconite and pulsatilla in alternation. º
March 16.—The head pain at the front is decidedly
better: she can lift weights, and can go up stairs
without being so much affected: her sickness is bet-
ter: appetite is very much better : her water is
clearer. Indeed she is better altogether, but her
bowels are still confined. -
312 CASES OF CIJ R.E.
CHAP. XVIII.
Cerebral
affection.
Sulphur.
Cerebral
affection.
(81) Bowels not acting for a week, and yet all the symp-
toms better.
Ann Rogers, (p. 1468, case book 1844,) aged 33,
married, mother of two children, consulted me August
7, 1844. She complained of pain at the back of the
head, from which she had suffered two or three years,
and for which she had been in vain leeched and blis-
tered: this pain is much worse before the monthly
period, but she is continually in pain : her tongue is
furred: appetite bad : bowels costive: water thick:
monthly period very little, and sometimes very dark:
spirits are depressed: her teeth are loose from some
medicine given her at some dispensary. Ordered
sulphur, six globules to be taken during a period con-
sisting of several days.
August 14,-Her headache has been away, and,
though it returned, its severity has much lessened:
her tongue is cleaner: her appetite better : the water
clearer : her spirits less depressed : her eyes are
brighter. Indeed, she says she is better altogether,
but her bowels have not acted for a week.
* *m-mºs
(82) Bowels remaining confined and yet a cerebral affection
decidedly better.
Hy Robjohns, (p. 1436, case book 1844,) aged 28,
single, consulted me April 20, 1847. He complained
of coldness of the feet, to which he has been subject
for two years: he feels a flow of blood to the head
attended with a sensation of heat: he feels giddy after
sitting, and when sitting has frequent perspirations:
a little exertion affects his head: his digestion is good,
but his bowels are confined and his tongue is furred:
he has had an eruption on his face for twelve months.
CASES OF CURE. 313
Ordered nua, vomica, four globules to be taken during cIIAP. xviii.
the subsequent week. Nux vomica.
May 8.-His feet are warmer: his head is better:
he is less giddy: his perspiration is less: he can bear
exertion better: the eruption is better, but his bowels
are confined, and his tongue furred : he feels pains
flying about from one arm to the other. He took
pulsatilla, and then lycopodium. Continued improving
in his health, though still the bowels remained
confined.
(83) Buzzing in head like the noise of the Sed, and feeling
as if she show.ld fall removed, and yet bowels confined.
Ann Jackson, (p. 962, case book 1848,) aged 30, ..."? "
married, consulted me Feb. 13, 1846, for a yellow
discharge from the womb, with pain in the loins, and
Scalding in passing the water. Of these symptoms
she was relieved to a great extent by three powders,
each containing a grain of the third trituration of
mercurius. On March 18, she experienced but very
little pain in the loins: she passes her water freely,
but it scalds: the discharge still continues a little:
she had taken a bad cold: her head is now much
affected: she feels as when she has taken laudanum,
of which she has taken much, and also brandy and
pills by the direction of the medical gentleman, who
had previously attended her: she has a buzzing like
the roaring of the sea in her head: she feels as if she
should fall down : her bowels are rather confined.
Ordered nua, vomica, four globules. Nux vomica. ,
March 26.—The pain in the loins has ceased: the
buzzing has ceased, and the feeling of falling down
is better; but the bowels are still confined.
rt
S S
314 CASES OF CIU R.E.
CHAP, XVIII.
Affection of
head.
Pulsatilla.
Affection of
head.
(84) Affection of head better, though bowels inactive for
a week.
Charles Whitchett, (page 1800, case book 1852.)
This patient suffered from a chronic affection of the
head. His symptoms were much relieved by homoe-
opathic medicines, although his bowels had not acted
for a week.
(85) Affection of head with noise removed, though bowels
inactive for four days. !
Mary Crawley, (page 307, case book 1847.) This
patient had been troubled for some time with a ham-
mering thumping noise in the head, also a squeaking
like the noise of a mouse in the head. Pulsatilla
was ordered for these and the concomitant symptoms,
and the pulsatilla removed these noises although the
bowels remained inactive for four days.
(86) Affection of head cured, though the bowels, which pre-
viously to taking the medicine were regular, became confined,
and she feels better in every respect. - -
Mary A. Brookes, (page 118, case book 1849,)
March 24.
(87) Head affection relieved, though bowels confined.
William Procter, (p. 1367, case book 1851.)
(88) Giddiness and gastric symptoms better without any
action of the bowels.
Exhibited in the case of James Worth, (p. 1792,
case book 1849.) July 14, 1849,
Giddiness.
** * *s
CASES OF CIJIRE. 315
(89) Giddiness, pain in head and Smarting across the belly CHAP. xviii.
cured, the bowels not acting for Sia, days.
Exhibited in the case of Edwin Sharp, (page 1551, Giddiness.
case book 1849).
(90) Head affection with gastric symptoms better though
- bowels more confined.
Mary Femcott, (p. 668, case book 1851,) aged 29, ºn affec-
consulted me April 29, 1851. e
This patient had sickness: a bitter taste in her
mouth : tongue coated: severe headache, with the
hair coming off. Ordered graphites, 4|12 one week, Graphites.
to be followed by graphites 4|30, the next week.
Her headache, her sickness, and the bitter taste
became better: the tongue became cleaner : the hair
came off less, and yet the bowels had become more
confined.
tºmsºmºsºs ºsmºs
(91) Nervous disease better yet bowels, which were free,
became confined.
James Bishop, (p. 629, case book 1848,) consulted Nervous
me May 13, 1850, for a trembling when he rises in disease.
the morning : his appetite is not good : his food lies
heavy: his bowels are regular: he has a slight cough :
he feels ill. Ordered calcarea. Calcarea.
May 20.—The trembling is much better: his appe-
tite is better : in fact he feels a great deal better, but
his bowels have become confined: he wheezes.
Ordered veratrum. Weratrum.
He gets worse at night: he could not sleep : he
sweated last night: he has a hacking cough, which
hurts him at his back. Ordered phosphorus. Phosphorus.
He was cured.
316 CASES OF CURE.
CHAP. XVIII.
Bleeding
from nose.
Arnica.
Nux vomica.
ICpileptic
attacks,
(92) Bleeding from the nose (epistaais.) and head affection
cured, though the bowels became confined.
David M-Lachlin, (p. 1204, case book 1845,) single,
consulted me in June, 1845: his symptoms follow.
Symptom 1. Has a considerable “fermentation” at
the stomach. Symptom 2. The chest seems filled
with wind, which rises up. Symptom 3. This con-
dition affects the brain, preventing all thought. Symp-
tom 4. The face swells much and is hot. Symptom 5.
Blood flows from the nose. Symptom 6. The appe-
tite is bad. Symptom 7. The tongue is brownish
white. Symptom 8. Water is thick at times. Symp-
tom 9. Sweats on the head. Ordered armica.
June 16.—No. 1. No fermentation. No. 2. The
flatulence is very much better. No. 3. Feels still an
inertness. No. 4. Better. No. 5. No bleeding.
No. 6. Better. No. 7. Tongue cleaner. No. 8.
Water still thick. No. 9. Still sweats on head.
Ordered armica in smaller doses.
August 13.−The symptoms are all better, though
the bowels, which were free, have become ConFINED.
Ordered ºua, vomica.
On August 26, 1845, I received the following letter:
“SIR,--I have derived much benefit from your
advice and prescriptions. The improved state of my
health makes it unnecessary for me to trespass on
your valuable time; but I avail myself of this oppor-
tunity to express the sincere gratitude I feel and owe
to your kindness and generosity.—DAVID M-LACHLIN.”
Constipation. Fits better when bowels are confined.
Maria Albino came to me to-day, March 5. She
has epileptic seizures, and approaches to imbecility:
CASES OF CURE. 317
her attendant states that she is always better of her chap. xviii.
fits when her bowels are confined: they act generally
but once a week: whenever her bowels purge she has
the fits much more frequently.
Division III.-DISEASEs of EYEs.
(94) Ophthalmia better though bowels very confined.
Henry Wiles, (p. 2606, case book 1853,) aged two ophthalmia.
years, was brought to me on the first of April. He
has severe inflammation of the eyes: he cannot open
his eyes, and has not been able to open them for five
months: he holds his head fixed downwards, not being
able to bear any light: his mother cannot persuade
him to eat: he is very thirsty: he cries much: he lies
on his face with the view apparently of shutting out
the light: the perspiration is profuse, it runs off him :
his lips feel dry, they could not be seen, he held his
head so bent down. He was ordered to take arseni-Arsenicum
º g and kali car-
cum and kali carbonicum, three-quarters of a globulebonicum.
every three hours in alternation.
April 5, 1854, four days after, he was brought to
me: he could look up a little: he opens the eyelids a
little: the sweats are much lessened : the thirst is
lessened; and yet his bowels have become very much
confined.
- -
(95) Dimness of sight of one eye, eacăsling for years, relieved,
though bowels confined more than a week.
Fanny Royston, (p. 1416, case book 1847.) This * of
© e º - , Siglit.
patient has been suffering for years from a dimness of "º
sight in one eye: she is affected also by partial palsy.
December 21, 1847. -
318 CASES OF CURE.
CHAP. XVIII.
Opium.
I’ain in the
chest.
Opium 8/12, were ordered to be taken in the course
of a week, and although her bowels did not act from
Saturday week, the day of commencing the medicine,
the dimness of sight was very much relieved.
Division IV.-CHEST DISEASEs.
(96) Bowels confined, and yet violent pains in the chest,
and other symptoms better.
Elizabeth Rice, (p. 1271, case book 1843,) con-
sulted me in September, 1843. She complained of
intolerable pain at the breast bone: she is excessively
Bryonia.
Heart affec-
tion.
Gastric
affection.
chilly and has a most unpleasant sensation of coldness
at the nape of the neck: her bowels are rather con-
fined: the attack appeared as incipient pneumonia.
Ordered bryonia, a globule every six hours in the form
of a powder.
Oct. 2–I was again consulted, her pain at the
breast bone is much better: the chilliness is gone:
her bowels have NOT BEEN RELIEVED since taking her
powder, which she says did her a great deal of good.
The patient herself in this case testified to the
benefit derived from the bryonia, a benefit gained
although, as stated, unattended with action of the
bowels. - ſº-º-º-mºº smº-E,
(97) Heart affection relieved though bowels confined.
Emma Button, who consulted me for an affection
of the heart, took by my direction aconite. Her
heart affection was relieved, and yet the bowels con-
tinued confined.
(98) Gastric affection cured and yet bowels confined.
Amelia Henry, (p. 951a, case book 1846,) aged 34,
CASES OF CURE. 319
married, mother of one child, consulted me Oct. 26, CHAP. XVIII.
1846. Her symptoms follow—
Symptom 1. She has pain at the chest extending
up to the throat. Symptom 2. Her food lies heavy
at the chest, and, symptom 3, produces pain between
the shoulders. Symptom 4. Her bowels are confined.
Symptom 5. She has headache in the forehead.
Ordered nua, vomica, four globules. Nux Yomica.
Nov. 2.-No. 1 and 2. Pain at chest and food
lying heavy, very much better. No. 3. The pain
between shoulders has ceased. No. 4. The bowels
still confined. No. 5. Headache better. Ordered nua,
vomica in smaller doses,
Nov. 9.—No. 1. Chest is easy, but the throat feels
full, No. 2. The food lies very much easier. No. 3.
Still well. No. 4. Bowels confined five days. No. 5.
Headache in forehead, Ordered graphites, four glo-Graphites.
bules.
Nov. 16.-No. 1. Fullness in throat still. No. 2.
Food lies quite easy. No. 3. Pain still absent be-
tween the shoulders. No. 4. Bowels not quite so
confined. No. 5. Headache. Ordered graphites in
smaller doses.
Dec. 1.—No pain, and fullness nearly gone. No. 2
and 3. Absent. No. 4. Bowels much better. No. 5.
Forehead ache very much better, Ordered graphites
in smaller doses.
The patient became quite well. The history of
this case shows that the patient progressed towards
case notwithstanding that the bowels were confined.
It shows also the efficacy of graphites in constipation :
it being in this kind of constipation the most effica-
cous remedy.
320 CASES OF CURE.
*
CII Al’. XVIII.
Millar's
asthma.
JIepar sul-
pluris and
Sambucus.
Wheezing at
(99) Asthma. Millar (Milſar's asthma) better, though the
bowels became confined,
Walter Greaves, (page 745, case book 1853,) con-
Sulted me September 10, 1853. He has had short
breath for the last seven to eight years: he cannot lie
down, the difficulty of breathing is so increased by
lying down: and at night the difficulty is so increased
that he is obliged to jump up, even from the semi-
recumbent position in which he places himself, other-
wise he feels he must be choked: the dust of his
business (he is a miller) and all dust makes his
breathing worse: his hands are damp; his feet are
dry: he can, it is worthy of notice, lie on either side;
i. e., in the semi-recumbent position he is obliged to
assume, it matters not on which side he lies: he passes
his water with ease, it is pale like water: he sweats
at times: he wheezes, and the wheezing sounds like
the noise of a whistle. I ordered hepar sulphuris and
sambucus in alternation, about three-quarters o a
globule every six hours. By the time he had taken
sixteen globules of each medicine, his breathing be-
came much better: he could lie down: he scarcely
ever wakes with fright: the dust of his business
affects him much less: his hands are not so unplea-
santly moist; but his bowels have become rather
confined.
(100) Bowels becoming confined, attended with difficulty of
breathing, yet affection of chest better.
George Sutton, (p. 1504, case book 1844.) aged 49,
married, consulted me Jan. 7, 1844. He suffered
from a wheezing at the chest: he has had this wheez-
ing twenty years; often he cannot go up stairs: he
coughs and cxpectorates in the morning : his bowels
CASES OF CURE. 321
are regular and his health is otherwise well, except chap. xviii.
that the food lies a little heavy at the pit of the sto-
mach. --
Ordered hepar sulphuris four globules, to be taken Hepar sul-
in the course of a week. phuris.
Jan. 14.—His wheezing is better: his cough is bet-
ter: he has much expectoration, but it is white. To
continue hepar sulphuris.
Jan. 29.-His wheezing is very bad : his cough
still continues: his breath is very bad in ascending
stairs. Ordered arsenicum for his breath. - Arsenicum.
Feb. 8-His cough is very bad at night: he coughs
most when lying on his left side: his wheezing is bet-
ter: he can go up stairs with comparative ease: his
food lies easy: but now, though his symptoms are
much better, his bowels have become confined.
-->
(101) Asthmatic affection better though bowels remain
confined.
Lydia Gibbon, (p. 727, case book 1846) aged 21, sº
single, consulted me March 12, 1846. She has for
the last week complained of such a stoppage in her
breathing that she can hardly get her breath: her
tongue is furred. Ordered aconite one globule, every Aconite.
eight hours. r
March 18.—Her breathing is improved: her tongue
is cleaner, her appetite improved, but bowels are con-
fined: she feels giddy, and has pain at the right side
of the belly when stooping. -
May 28.—Her breathing still improves: her bowels
are still confined, and the pain at the right side of
the belly is better.
T T
322 CASES OF CURE.
CHAP. XVIII.
Cough.
Pulsatilla,
Calcarea.
Opium and
sepia,
(102) Case of cough with phthisical conditions better, though
- bowels, which were regular, became confined.
Jane Threlfall, (p. 1845, case book 1846,) married,
aged 34, consulted me November 9, 1846. She has
the following symptoms:—
Symptom 1. A cough. Symptom 2. She expecto-
rates a hard yellow phlegm. She has the general
characters of a consumptive tendency. Ordered pul-
satilla, a globule every eight hours. we
Nov. 11.—No. 1. Cough is better. No. 2. Sputa
yellow. Her water is clear. Symptom 3. She per-
spires at her chest. Symptom 4. She experiences a
weight at her bowels as if her inside was dropping
through: her bowels are regular. Ordered calcarea,
half a globule every eight hours.
Nov. 23.—No. 1. Cough better. No. 2. The sputa
are darker. No. 3. The sweats on the chest are less-
ened. No. 4. The weight at the bowels is better,
her husband states that she is better altogether.
Ordered calcarea in smaller doses.
Nov. 30.—No. 1. Cough still improves: better in
every respect, but now her bowels are eartremely con-
fined: she feels a want to relieve the bowels, but
obtains no relief when attempting it. Ordered opium
and sepia, a globule alternately every eight hours.
This patient became ultimately cured, and what is
interesting in the progress of the case is, that her
bowels became extremely confined, and yet she im-
proved.
Chest affec-
tion.
*-*-
(103) Chest affection cured, though the bowels, which were
regular, became confined.
Catherine Aldridge, (page 21, case book 1843,)
aged 27, single. This patient came under treatment
CASES OF CURE. 323
on August 29, 1843, for a bronchitis, which had trou- cIIAP. xviii.
bled her for two years, but which now, in spite of
allopathic treatment, had become much worse: she
coughs after any exertion, after speaking or laughing:
she has soreness at the left side of chest, and lying on
the left side causes an uneasy sensation: she expecto-
rates a little in the morning: her face flushes after
eating: her bowels act daily: the water is clear: the
monthly period is pale: she sweats at night, and has
Cramps in both legs and soles of feet. Phosphorus phosphorus.
in diminishing doses had, by Sept. 19, very much im-
proved her symptoms, so much so, that she could lie
on either side: the cough was much better: the sweats
had ceased, yet with this improved state her bowels
had become confined, and her water had become thick.
Ordered lycopodium. - Lycopodium.
On the week following she was much better in
every respect. The bowels were still confined though
improved under the action of lycopodium.
(104) Bowels confined a week, but heart affection better.
Exhibited in the case of Eleanor Elliott, (p. 620, º affec-
case book 1850,) May 6.
(104a) Bowels, which were not costive, became cos-
tive; but the patient became better in regard to her
chest affection. Hepar was the medicine used. IIepar.
Division V.-GASTRIC DISEASE.
(105) Violent gastritis, (inflammation of the stomach,) cured
without any action of the bowels for three weeks.
In the month of November, 1852, I was sent for Gastritis.
in haste out of town to see a gentleman dangerously
TT 2 ,, . .
324 CASES OF Cluſ R.E.
CHAP. XVIII.
Ipecacuanha.
Weratrum,
bryonia and
belladonna.
ill. I found that he had been seized at two in the
morning with the most violent vomiting and retching.
When I reached his residence about seven miles from
London, he was so exhausted as to be almost unable
to speak. He could just manage to answer “Yes” and
“ No.” To do more seemed to be a great effort.
This patient had suffered for some time from a chro-
nic affection of the kidneys and bladder, and, it
seems that the action had transferred itself to the
stomach, and this, in my opinion, saved him from
apoplexy, which would have happened had the trans-
fer been to his brain. He, though exhausted, could
not take the least particle of fluid : even his medi-
cine, which was ipecacuanha, a drop of the third di-
lution in half a tumbler of water, and only a tea-
spoonful of this, he could not retain: it brought on
violent retching. The matters ejected from his sto-
mach were brown and glairy, and at last like coffee
grounds: in fact, had not relief been obtained, he
must have sunk. Here, in passing, it may be re-
marked, how valuable is homoeopathy in its infini-
tesimal relationship. He was enabled to have medi-
cine dry on his tongue and in small globules; veratrum,
bryonia, and belladonna, in succession, cured his dis-
ease: he had one very copious action of the bowels
while he was vomiting.
He was not allowed to have any thing for three
days, except a little bread soaked in water and sweet-
ened. On the fourth day he was very hungry; but
as his tongue was not clean he was forbidden to take
any thing more; and yet, a fact inexplicable to those
who talk about mourishing sick people by giving them
food, he gained strength every day on his bread,
sugar and water.
CASES OF CURE, 325
He became so hungry at last that he said he would chAP. xviii.
have some meat. His wife, a most intelligent lady,
but who is in very bad health herself, had nursed
him with the greatest care, declared that he must not
deviate from the physician's rules: that if he brought
on vomiting again, she could not attend him ; and
that if he would run the risk for the sake of a tem-
porary gratification, she would not be a party to it.
This appeal, he being a man of sense, was effective ;
and the food, which was brought up to his chamber,
he allowed to remain untouched.
He gradually increased his food, taking mutton
broth; and he had no return of his vomiting, no
headache, no pains, but daily increased in strength.
His bowels did not act for three weeks. This caused
him some anxiety; but the fact that he experienced no
inconvenience, but grew daily in strength, in appe-
tite, and in mental power, and the fact that there
was no distention of his belly although he has a
slight umbilical hernia, made me feel convinced that
the inaction of the bowels was merely a state, conse-
quent on the previous violent retroverted action of
the stomach exhibited in the vomiting, and that time
was required for the gradual restoration of the regular
action of the bowels.
Let it be that some old system practitioner had
been called in and had given his purgatives, little or
no doubt could exist that he would have induced
vomiting and the patient would have died.
Indeed, there is considerable ground for the opinion,
that, in inflammation of the stomach, benefit results
from the inaction of the bowels. The violent retro-
version of the action of the stomach requires time for
the stomach to recover itself, and to enable the
326 CASES OF CURE.
CHAP. XVIII,
Gastric and
heart affec-
tion.
Stomach
affection.
Pulsatilla.
Gastric af.
fection.
stomach so to recover itself the action of the bowels
seems to be suspended: and may not the deadly fata-
lity of inflammation of the intestines, where purging
and vomiting take place, depend upon the violence
of the two actions, retroversion of action of the
stomach and violent onward action of the bowels.
(106) Swelling at the region of the navel with gastric and
heart affections relieved, though the bowels have become
confined.
Sarah White, (p. 1806, case book 1852,) aged 26,
single. She has suffered two years from pain at the
pit of the stomach and heart symptoms. •
(107) Stomach affection better though the bowels became
* confined.
W. Cavan, (p. 502, case book 1850,) single, con-
sulted me October 21. He has pain all over his chest
after taking food : the pain extends between the shoul-
ders: his breathing is short: his bowels act daily :
the pain depresses his spirits. Ordered pulsatilla,
four globules to be taken in the course of a week.
Oct. 28.-The pain over the chest is much better:
the pain between the shoulders is better: the breath-
ing is better: the spirits are better, and yet his bowels
have become bound.
*mºms smº
(108) Gastric affection better though the bowels became
confined.
Wm Reed, (p. 1237, case book 1843,) consulted
me Dec. 28, 1842. He suffers from a gastric affec-
tion, and from weakness and oppression of the chest
occasionally for three years, which have become much
worse the last three weeks. The affection is attended
with pain, the pain and the weight being increased
CASES OF CTJ RE. \ 327
by food: his spirits are depressed: he feels extremely cIIAP. xviii.
weak: his bowels are regular, Ordered pulsatilla. Pulsatilla.
Jan. 4, 1844.—He perhaps would have been bet-
ter, but he has been obliged to do extra work, which
made him almost faint. Ordered aconite in alterna- *
tion, at eight hours intervals, with pulsatilla. -
Jan 11–All his symptoms are better : he feels he
is gaining strength. Ordered aconite one day and
pulsatilla the next day. - •.
Jan. 18.—All the gastric symptoms are decidedly
better, but the bowels, which were regular, have be-
come confined. Ordered nua, vomica. Nux vomica.
Jan. 25.—The symptoms are still better; in fact,
the pain and the weight are almost absent: he is
much stronger: the bowels are still rather confined.
Ordered sulphur 4|12, because of the bowels. Sulphur.
Feb. 1.-He is better altogether: the bowels are
regular. Ordered sulphur, half a globule every other
day for three times, then every third day for three
times. He became well. -
It will be seen that the patient became decidedly
better, although his bowels became confined; and it
will be further seen, that, under the action of muay
followed by sulphur, the bowels became regular.
(109) Gastric affection better, though the bowels having been
open became confined. -
Wm Warren, (p. 1690, case book 1851,) has been gastric af.
ill three years: he is troubled with sinking pain at fection.
the pit of the stomach, made worse by food: he has
great lowness of spirits: his appetite is bad: his
bowels act once a-day. Under the use of nua, vomica,
baryta carbonica and lycopodium, he steadily progressed.
On Sept. 12 he called. The sinking and the other
328 CASES OF CIJ R.E.
CHAP. XVIII.
Gastric pain.
Pulsatilla.
Gastric
symptom8.
Stomach
affection.
Pulsatilla.
symptoms were much better, but the bowels have
become of late much confined, so much so as to cause
blood in the action.
(110) Gastric pain cured though the bowels became confined.
Martha N., (p. 1209, case book 1850,) aged 33,
married, never pregnant. She complains of pain at
chest after taking food: the pain extends to between
the shoulders: she has pain also at the right side :
her bowels are pretty regular : she has pain in the
head at time of the monthly period, which occurs
about three days before its proper time. Ordered
pulsatilla four globules.
Oct. 16.—Her pain at the chest and the shoulders
continue, but the pain at the right side is better:
dolorem habet in coitu : sensus est cujusdam duri in
vagina. Ordered cocculus six globules.
Oct. 23.−All her pains are better: her tongue,
which was furred, has become cleaner. Her bowels
are now confined, so that in this case the pains became
much better and yet the bowels became confined,
having been tolerably regular when coming first
under treatment.
(111) Gastric symptoms better though bowels confined.
Sarah Hobbs, (page 863, case book 1846.) April 6,
1846.
(112) Elizabeth Baker, (p. 213,) states that pulsatilla
cured her stomach affection, but rendered her bowels
confined, which became regular, when she desisted
from the pulsatilla. October 30.
*
(113) Mary Coxton, (p. 449, case book 1847.) Pul-
satilla was used Nov. 10. -
CASES OF CURE. 329
Division VI.-DISEASEs OF THE ABDOMINAL ORGANs. CHAP. xviii.
(114) Abdominal disease with tendency to miscarriage sub-
dued, although the bowels became confined.
Eliza Ward, (p. 1807, case book 1850,) aged 26, Abdominal
married. This patient has miscarried nine times. disease.
She is now pregnant and complains of dragging pains
at the side of the belly, which she always experiences
when the miscarriage is approaching: she generally
has a dark discharge two days before the miscarriage
takes place : she has generally very little monthly
discharge : her bowels act regularly : her water scalds
and she has a bearing down pain. Ordered sepia, sepia.
half of a globule every twelve hours.
Sept. 25.—She is now two months pregnant, the
time at which she has always miscarried : she has
pain at the right side of the belly when she walks.
Ordered secale cornutum, four globules. Secale cornu-
Oct. 2.-She experiences agonizing pains at the ""
side, and pains at the top of the head : she has a
discharge of a yellow colour from the womb.
Ordered sabima.
Oct. 9.—The side pains are somewhat better: the
discharge has lessened: she has much wind in the
bowels: her head is better at times. Ordered
cocculus. -- Cocculus.
Oct. 16.-The pain is severe at her right side: the
yellow discharge has ceased: her bowels are confined.
Ordered sepia, three quarters of a globule every six sepia.
hours. .
Oct. 18.—The pains are better: the bowels have
acted once: the womb discharge is a little. Ordered
sepia, three quarters of a globule every eight hours.
Oct. 23.−The pains have ceased: her bowels act
U U
330 CASES OF CURE.
*
CHAP. XVIII.
Graphites.
Sepia.
Aldominal
affection.
very confined: the evacuations are hard and large and
hurt her: there is no discharge from the womb. Or-
dered graphites, which restored regularity to the
bowels. -
It will be seen, that, in this case the patient, under
the use of sepia, gets rid of the pains and of the dis-
charge from the womb, and yet the bowels became
very confined.
This patient went her full time : that is, after nine
miscarriages she is enabled to go her full time; a
result very frequently occurring under homoeopathic
treatment. --
(115) Abdominal, gastric, aud bladder affections in process
of cure, and yet the bowels confined.
Bridgett Mindenhall, aged 47, (p. 1103, case book
1846,) consulted me January 7th, 1846. She had
been a patient at St Thomas's Hospital, but had de-
rived no benefit. She is married, has had six chil-
dren and one miscarriage. -
Symptom 1. Feels pain at the left side of her belly,
which she has had seven or eight months. Symp-
tom 2. The part feels so sore as to prevent her sleep-
ing. Symptom 3. The feeling as if something falls
down. Symptom 4. She cannot lie on the back from
pain in her side. Symptom 5. Her appetite is bad.
Symptom 6. Her food lies heavy at the stomach.
Symptom 7. Her habit is costive. Symptom 8. She
feels a desire to relieve the bowels, but obtains no
relief when she attempts an action. Symptom 9. The
actions, when relief is obtained, are small. Symp-
tom 10. She has a difficulty at times of passing her
water. Symptom 11. The monthly period is at too
long intervals. Symptom 12. She has much white
CASES OF CIJ R.E. 331
discharge, which weakens her. Symptom 13. Has CIAP, XVIII.
frequent flushes of heat. Ordered sepia four globules Sepia.
to be taken in the course of a week.
Jan. 13, 1846.-No. 1. The pain is a great deal
better. No. 2. Slept better since Saturday than she
had slept for two months. No. 3. The feeling of some-
thing falling down is better. No. 4. She can lie
much better on her back, in fact she can lie both on
her back and on either side. Nos. 5 and 6. Appetite
still bad, and food lies heavy. No. 7. Bowels still cos-
tive. No. 8. Feeling of want to relieve and with no
effect, is better. No. 10. She can pass the water with
greater freedom. No. 12. The discharge still con-
tinues. No. 13. The flushes are better. Ordered
sepia, four globules in the course of ten days.
The patient continued to improve, the bowels were
still costive, the actions becoming large, and causing
blood, the flushes were quite removed; and four glo-
bules of graphites completed the cure.
From this case will be seen, first, the power of
sepia in removing diseased states of several months
standing, and second, that while the bowels remained
confined, the greater part of the symptoms were re-
moved, and third, that the conditions of feeling of
wanting to relieve the bowels and no effect conse-
quent, were removed by the medicine without the
bowels acting
Graphites.
(116) Piles better, though bowels confined. -
Wm. Wells, (p. 1644, case book 1846,) aged 30, Piles.
married, consulted me April 7, 1846. He complained
of Symptom 1. Pain between shoulders and pain at
chest. Symptom 2. It hurts him at the chest to take
a full breath. Symptom 3. He has a cough. Symp-
U U 2
332 CASES OF CIU R.E.
CHAP. XVIII.
Aconite.
Bryonia.
Nux womica.
Pains in the
bowels.
Pains in the
bowels.
tom 4. He cannot lie well on the left side. Symptom 5.
His bowels are confined, and Symptom 6. He is
troubled with piles. Ordered aconite, a globule every
eight hours. -- ge
April 9, 1846.-No. 1. Pain between shoulders is
better. No. 2. Cannot take a full breath. No. 3.
He had a violent fit of coughing this morning. No. 4.
Still unable to lie easy on left side. No. 5. His bowels
acted this morning. No. 6. He is chilly and thirsty,
Ordered bryonia.
April 13.—No. 1. Pain between shoulders almost
gone. No. 2. The pain at chest is only occasional.
No. 3. It does not pain him to cough : the cough
affects his head. No. 4. He can lie better. No. 5.
Bowels rather confined. No. 6. Piles still.
Ordered mºla, vomica.
April 30.—No. 1. Pain between shoulders is gone:
the pain at chest is very much better. No. 3. No
pain to cough. The cough hurts him at the back.
No. 4. Can lie very well on the side. No. 5. The
bowels still confined, but the piles are decidedly
better.
(117) Severe pains in the bowels removed by cocculus,
though no action of the bowels took place for three days.
Exhibited in the case of Richard Griggs, (p. 762,)
October 23. This is one of the cases in which the
necessity of opening the bowels is proclaimed as
specially necessary by the advocates of purgatives.
(118) Bowels not acted since last Saturday, (this was on
a Thursday) and yet the pain in the bowels, for which
advice had been sought, was better.
Exhibited in the case of John Hill, (page 918,)
CASES OF CURE. 333
Nov. 15, 1847. He took 3/12 of cocculus, half a glo- chAP. xviii.
bule every eight hours.
&ºm=s* sº-ºº-mº
(119) Bowels not acting for a week and yet piles not worse.
Miss H., (p. 65, p. b.,) aged 32, single. This lady Piles.
had been troubled with a portion of blood passing
away with the action of the bowels and sometimes
without the action. With this she has been troubled
for two or three years. Sepia and causticum were sepia and
Causticum.
the medicines prescribed. She consulted me in May,
and she again consulted me June 1852, and she stated
that she had felt better in herself the last fortnight
than she had for years, and further that the blood
from the bowels is much lessened,
She stated, that, when she first took the medicine,
she had no action of the bowels for a week, and when
they did act they did not give her so much uneasiness
as that she used to feel when they were made to act
by taking opening medicine.
sº-mºm-º:
(120) Bowels confined, the patient better.
Maria Elwin, (p. 613, case book 1851,) suffered º,
many years since with inflammation of the bowels,
which has left a liability to purging with violent pain
and the passing of mucus. She became much better
under treatment, and states that she finds herself
always better in health when her bowels are rather
confined.
*sº
(121) Intolerable cramp better, though bowels still confined.
The idea is very common that in cramp and pain Cramp.
in the belly, if the sufferer can get anything to pass
through him, all will be right. This common mis-
334 CASES OF CTURE.
CFIAP. XVIII.
take is not justified by facts, besides the great injury
done by the forcing medicine. -
John Davis, (page 567, case book 1853,) aged 27,
single, June 19, 1854, has had for a few days very
severe cramp in the belly: his food lies heavy: his
Cocculus and bowels are confined. Ordered cocculus and opium.
opium,
On June 20, the cramps have all ceased, but
the bowels are very confined.
Division VII.-DISEASEs of THE URINARY ORGANs
AND OF THE WOMB.
(122) Chronic inflammation of wrinary organs better,
though bowels confined.
Inflammation Wm. Pope, (page 1240, case book 1851,) aged 56,
of urinary
organs.
Cantharis.
Affection of
the womb.
married, consulted me April 1. He suffered from
pain in his loins extending to the bottom of the belly,
attended with great looseness: the water scalds: he
cannot rest at night: at one o'clock he wakes from a
sense of heat and Smarting pain, which keeps him
awake and obliges him to get up. Ordered can-
tharis, 4|12.
April 8.-All his symptoms are decidedly better,
but his bowels have not acted the whole week till
this morning, when they acted.
*= y ==º
(123) Bowels confined, and yet affection of the womb and
other states decidedly benefitted.
Elizabeth Moore, (page 1495, case book 1844,)
aged 36, married, mother of three children, and
having had one miscarriage, consulted me May 28,
1844. She had a child born dead four years since:
she looks seriously ill; in fact, she presents a most
miserable spectacle. She complains of being ex-
CASES OF CURE. 335
tremely ill: she feels obliged to pick her nose much, chap. xviii.
which causes much bleeding: she has severe pains in
the loins, and at the left side of the belly, just above
the hip: she has bearing down of the womb: pro-
fuse white discharge: monthly period regular, but
rather profuse: her appetite is bad, food lies heavy:
she feels sick: her bowels are much confined, and
spirits very low. Ordered nua, vomica. Nux vomica,
June 4, 1844.— She consulted me again. She ex-
presses herself full of gratitude at the wonderful
improvement in her state: she looks cheerful, the
picking and the bleeding of the nose are better: her
pain in the loins and in the belly is better: the bear-
ing down feeling is better: the white discharge is
lessened: the appetite is better: the food lies less
heavy: the sickness is better: the tongue is cleaner:
to her astonishment she remarked, that, though she
is so much better, her bowels are still greatly confined.
Ordered nua, vomica, the doses to be taken only every
other day.
July 1.—By repeating the nua, the bowels became
regular. -
Division VIII.-DISEASEs of THE SIDE, BACK, &c.
(124) Bowels becoming confined, and yet affection of side
and feeling of melancholy improved.
James Hutchens, (p. 884, case book 1844.) aged 21, Aºtion of
single, consulted me Nov. 28, 1849. He had been
troubled with a pain and a palpitation at the side,
which ceasing, a swelling came at the same side:
this swelling had continued for several months: the
swelling gives pain occasionally and food causes an
increase of the SWelling, but otherwise the food lies
336 CASES OF CURE.
CHAP. XVIII.
Pulsatilla.
Rheumatic
pains.
Rhus and
lycopodium.
Rheumatic
pains.
Pain in the
back, &c.
easy: bowels are regular, but his spirits are very much
depressed. Ordered pulsatilla.
Dec. 5.-The swelling still continues, but the pain,
the increase of swelling produced by the food, and the
depressed spirits have become better, though the
bowels, which were regular, have become confined.
The improvement continued several weeks, though
the bowels were still more confined than when the
treatment commenced.
cº-ºmrº vºmºsº-º-º-º-º-
(125) Pains rheumatic in the neck and the shoulders
better, though the bowels were confined.
Jasper Dubding, (p. 506, case book 1853,) con-
sulted me, June 1853, for pain in his shoulders and
his neck, which pain troubled him most in bed: he
had had this pain for three weeks, having been for
three months in a state of great weakness: he has
taken much medicine to force the bowels, (which
have been inactive three or four years,) into activity:
his water is thick: he sleeps uneasily.
I ordered rhus and lycopodium in alternation, and,
in a fortnight, his shoulder pain and neck pain were
much relieved: his water was much clearer, and yet
notwithstanding his bowels are more confined than
they were before this improvement took place.
(126) Rheumatic pains cured and yet bowels confined.
Exhibited in the case of Maria Payne, (p. 1241,
case book 1844),
(127) Bowels becoming confined and yet symptoms (pain in the
back, &c.) present, when the bowels acted every day, are better.
Sarah Rhodes, (p. 1451, case book 1844,) single,
CASES OF CIJ R.E. 337
aged 21, consulted me June 12, 1844. She com- chap. xviii.
plained of pain at the lower part of her back, when
sitting at work: the pain is aching, and is felt still
worse when walking: her appetite is bad: her tongue
is furred: the food lies heavy and rises: her bowels
act every day freely: she feels worse in the evening:
her spirits are depressed. Ordered pulsatilla. Pulsatija.
June 24, 1844.—She consulted me again, her back
pain is very much better: she can walk very much
better: appetite is better: food lies lighter, and does
not rise: she feels better in the evening, the time
when she felt worse, and yet her bowels have become
confined.
(128) Bowels during cure becoming confined, and yet the
symptoms present when bowels were regular, become better.
Esther Cox, (page 419, case book 1844,) aged 33, .
belonging to a family of which three have died, con-
sulted me August 29, 1844. She complained of ex-
treme weakness: of swollen face: pain in the side of
the throat: appetite bad, food causing pain at the
stomach : her water is clear : monthly period regular,
though liable to be brought on by a little excitement:
she has profuse white discharge, attended with irri-
tation: she sweats by day: her spirits are very low.
Ordered pulsatilla. Pulsatilla,
Sept. 4.—Her weakness is better: the swelling
comes and goes: the throat is easier: appetite is now
good: food produces less pain. Ordered pulsatilla,
the doses on alternate days. -
Sept. 13.—She feels much better in herself: all
the symptoms are better; yet, now, the bowels have
become confined.
338 CASES OF CU R.E.
‘CHAP. XVIII.
Enlarged
glands.
Mercurius,
hepar sul-
phuris and
silicea.
Belladonna.
Severe burn.
Silicea.
(129) Glandular affection much better and yet bowels
confined.
Sarah Burup, (p. 278, case book 1852.) This girl,
aged 15, has had upwards of two months the glands
under the jaw at one side of the neck enlarged: the
glands are very painful: her complexion is sallow :
her countenance is anxious: her bowels are confined.
She took mercurius, hepar sulphuris, then silicea,
then hepar sulphuris, and improved much : her counte-
nance became less anxious: her complexion became
clearer: the glands lessened in size: proceeded to
healthy suppuration, but the bowels were very con-
fined. - .
(130) Bowels not acting for six days, and yet a quins.y
which burst, become quite healed.
Exhibited in the case of Thomas Taylor, Sept. 18.
He took mercurius and belladonna in alternation.
s-s-s-e ‘ms-s-s-s
(131) Ulceration with severe constitutional symptoms, but
bowels confined.
James Greaves, (p. 704, case book 1846,) consulted
me April 1, 1847. A red hot spark from the metal
which he was working in the forge, fell between his
fingers: it burned him severely: he treated it as well
as he could, but his sufferings had now become so
intense that he determined to have my advice: the
part is now ulcerated: the ulcerated surface looks
very unfavourable. -
April 5.--His finger is much swollen: proud flesh
is present at the ulceration: it burns much : head-
ache is very bad: his bowels are very much confined.
Ordered silicea, a globule every eight hours.
gº- CASES OF CIU R.E. 339.
April 7.-His finger is almost of its natural size: cIIAP, xviii.
the colour of the flesh is natural: the proud flesh
has disappeared; but he has had no action of the
bowels for a week. Ordered to repeat silicea in less Silicea.
doses. He became quite well.
Here ulceration of the most severe character is
cured without any action of the bowels; and yet how
continually is the doctrine promulgated by the old-
system practitioner, that, in the treatment of un-
healthy ulcers, purging is one of the most effectual
}]].628.]].S.
*
(132) Abscess in the breast decidedly better, but bowels
not active for a week.
These phenomena were exhibited in the case of º º
C. Ol'C:\Sū.
Mary A. Scowen, (p. 1438, case book 1852).
*-*º
(133) Bowels, which were regular became confined, and yet
the patient was much better.
These phenomena were exhibited in the case of
..James Bishop, (p. 629, case book 1848.) He was
taking calcarea 4/12, May 12. Calcarea.
(134) Bowels not acting for sixteen days, and yet the patient
relieved of a most serious malady.
Hester King, (p. 969,) Sept. 17, 1847.
*====
(135) Bowels not active for a week, and yet all the symptoms
better. -
Mr. Carroll, (p. 472, case book 1847.) Jam. 14,
1847. Graphites was the medicine used. Graphites.
*-****
N. N. 2
340 CASES OF CIU RTE.
CHAP. XVIII.
lycopodium.
Tulsatilla.
(136) Bowels confined but pains, which were troublesome af.
ternoon, evening and might, became much better.
Lycopodium was the medicine used, (p. 1250, case
book 1847,) June 25, 1847.
(137) Though bowels are or became confined, the symptoms
better.
Exhibited in the cases of -
. Mary Otley, (p. 1204, case book 1849.)
. Isabella Tomlinson, (p. 1560.) Sept. 9, 1487.
. Eliza Smart, (p. 1737,) Oct. 14, 1846.
. Mary Hodder, (p. 839, case book 1846,) May 16,
1846.
5. James Paul, (p. 1323,) August 28, 1844. This
patient's bowels had not acted for four days and yet
he was better.
6. Sarah Scott, (p. 1458, case book 1847.) June 29,
1847.
7. Elizabeth Hull, (p. 1003, case book 1849.) In
this case the bowels had not acted for a fortnight,
and yet the patient was better.
8. Mary Noakes, (p. 1187, case book 1850.)
June 18. In this case the bowels became confined
and yet the patient was better.
In the cases 3, 4, 5, 6, 7, 8, pulsatilla was the
medicine used.
Mrs Allwork, (p. 6, case book 1847.) states, that
she does not feel that inconvenience from the bowels
being confined which she expected to experience.
Dec. 6, 1847.
:
CASES OF CURE. 341
Division TX.--SKIN DISEASEs. CHAP. XVIII.
(138) Case of prurigo pudendi much relieved, and yet the
bowels confined.
Ann Finch, (p. 676, case book 1846) aged 50, º Pº
married, mother of two children, consulted me
Aug. 22, 1848. She complains of the following:
Symptom 1. Pain in the passage to the womb with
burning heat; to these conditions she has been sub-
ject at times for the last seven years. Symptom 2.
She is much swollen. Symptom 3. She has severe
itching, particularly at the gut, and all the hind
parts, and for four years she has used all manner of
things to get relief, but without benefit. Symptom 4.
She has very much white discharge. Symptom 5.
Her monthly period lasts only three days and is very
offensive.
Ordered petroleum four globules, to be taken inter-Petroleum.
nally in the course of a week, and to use a lotion of
ten drops of the tincture of petroleum, of the first
dilution, mixed with a table spoonful of water.
August 29.-No. 1. The pain in the passage is
much better: has experienced great relief from the
use of the lotion: her bowels are confined, and she
feels headache and sickness. Ordered bryonia, a glo-Bryonia then
bule every eight hours, four times, then petroleum petroleum.
again.
Sept. 5.-No. 1. Pain in the passage is a great deal
better: itching has not been felt for the last week:
headache is better. Bowels confined, not acted at all
for the last two days.
This case is remarkable as showing the power of
the petroleum in this troublesome disease, when pre-
senting the phenomena as recorded, and also as esta-
342 CASES OF CUPE.
chap. xviii. blishing the fact that the patient improved in health,
though the bowels have not acted for two days.
(139) Vesicular erysipelas cured, though no action of the
bowels for five days.
Vesicular Robert Gardner, (p. 795, case book 1852.) This
erysipelas. patient, who was confined to bed with vermicular
Lachesis and erysipelas and other symptoms, took lachesis and
.." acidum nitricum, and though his bowels did not act
for five days, the erysipelas was cured.
It is a fact that some patients are better when
their bowels do not act freely.
Patients bet- Jane Jarrett, who has long been troubled with an
iº, affection of heart, for which she has been treated for
** a great length of time allopathically without benefit,
has derived very great benefit under homoeopathic
treatment. She states that she is always better when
her bowels are rather confined, and she is never so
well when they act every day.—November 28, 1851.
A. patient under the writer's care for epilepsy, has
the attacks much more frequent when the bowels are
free than when they are confined: so that the nurse,
who attended upon her, always dreads an attack
when the bowels act daily.
Miss Chipperfield consulted me March 1854, on
behalf of her sister. She states that whenever her
sister's bowels act freely, she is always worse.
CASES OF CURE. 343
Division X. —NoN-EXHIBITION OF PURGATIVES AFTER CHAP. xviii.
CHILD-BIRTH.
The non-necessity of forcing the bowels in order Non-necessity
to recover regularity of action is strikingly exhibited º
in the benefits resulting from the homoeopathic treat-"
ment of child-birth, a part of that treatment consist-
ing in the non-exhibition of purgatives,
It may be useful to record a few cases, showing the
non-necessity of the exhibition of these agents.
“Since the birth of my child last Friday week, I
have adopted your plan of not taking opening medi-
cine—much, I can assure you, against the wishes of
my medical adviser, and indeed of all those around
me—but I am happy to say that, at present, I have
had no cause to regret having done so, on the con-
trary, I may say I have never felt so strong and so
well at any of my former confinements, this being the
seventh, as I have done this time. On the sixth day
the bowels were relieved and have been each day
since. - S. S.
“ Leicester, Oct. 7, 1844.”
This lady is of a confined habit of body as well;
but she had, previous to her confinement, taken nua,
with benefit. She took bryonia four times before the Bryonia.
first action of her bowels, and has taken nua, several
times since.
Mr Green called Sept. 14, 1844, (p. 741, case book
1843,) said he had a Domestic Homoeopathy, and
when his wife was confined with her (the first) child,
he would not let her have any medicine but some
coffaea, for her severe pains, which relieved her much, Coffea.
344 CASES OF CIU R.E.
CHAP. XVIII.
Bryonia.
Arnica.
Pulsatilla.
and she was delivered in three hours: he allowed her
to have no purgative medicine, and he would not let
them give his child any. They both were and are
exceedingly well.
Constipation after delivery for six days; no action,
and yet very well and feels no inconvenience. Janu-
ary 29, 1844. Mrs Deere took bryonia and was re-
lieved. -
Mr Samuel Kidner called, said his wife had been
delivered. The surgeon had sent some medicine,
although he told him his wife would not take it; the
bowels did not act for four days; the doctor said she
would fall between the two stools and that she must
take her medicine. She said No, I shall take no
medicine. She had a good time.
“Ardwick, July 6, 1843.
“Dear Sir, I have great pleasure in informing
you that my dear wife was safely delivered of a fine
boy on the evening of the 4th instant, she had a very
severe labour, but now both she and the infant are
going on very well. Mr T– attended her and has
treated her homoeopathically. The babe is to be named
John William. Your's truly, J. T.”
Mrs Harvey was confined May 30, 1843, with a
dead child. It was almost in a state of decomposition.
She used armica and nothing else: she has had no pain
since but has been well, excepting that her breast
was a little painful, for which she used some pulsatilla.
She had very little discharge since: she did not think
that she was in the family way and had made no
CASES () F. Cl] R.E. 345
provision. I had told her that she was, but she said CHAP. XVIII.
she had not had the quickening.
Mr A–– called June 10, 1844, and stated that
Mrs A. had presented him with a son : that she did
as directed in my book: that she took no medicine
from her medical attendant, and she never was so well
as she was this time after her confinement.
She told her surgeon that she was a homoeopathist,
and that he need not send any medicine as she would
take none, but would go by Dr Epps's book.
Mrs Hanks, April, 1843, was confined a week
since: used armica, but took no physic and has done Arnica.
very well. g
April, 1845, saw Mrs A–, of Frederick Street,
Gray's Inn Road: she had been confined a fortnight:
she looked excellently: she said she had taken no ,
medicines but homoeopathic medicines and she was
very nicely. The surgeon's medicine was in the
drawer. Her sister stated that so it was with her in
her confinement. .
Mrs Davis, Jan. 9, 1845, went through her con-
finement “very nicely indeed:” was confined last
Saturday: took armica globules and applied arnica Arnica.
tincture.
Mrs Dawson confined of a boy, she took some physic
her surgeon sent her: she was worse: she then took
some homoeopathic medicine and was well. Harriet
Thomas stated this, Jan. 29, 1845.
Y. Y.
346 CASES OF CIUF.E.
CHAP. XVIII.
Arnica.
Jane Bennett, confined a week, doing very well,
took nothing but the armica, (p. 88, case book 1844.)
Elizabeth Harvey was confined eight days ago:
she took no medicine, but the nurse pressed her to
take some : her husband insisted she should not: she
did not, her bowels acted of themselves and she has
done very well, (p. 886, 1844).
Thomas Edwards called, (p. 484,) much improved
in health, Feb. 18, 1848. He had not been able to
come before because his wife had been confined: she
had an excellent time: she had no medicine but ho-
moeopathic: she has been married four years and
never had a child before.
Mrs T., (April 10, 1852,) stated that she managed
very well with her daughter in law's children with
the medicine chest and the Domestic Homoeopathy:
her daughter in law had been confined lately, and she
would not take her surgeon's medicine, but was treated
according to the Domestic Homoeopathy, not taking
any purgative medicine at all, and she was up and
about in a fortnight, whereas, never before when fol-
lowing her surgeon's rules, had she been up till a
month had passed; proving, as Mrs T. remarked, the
injury done by the physic the doctors give. Mrs T.
expresses her wonder at the obstinate incredulity of
the profession.
* *-m-mºs
Injuriousness of purgative medicine after child-birth, and
their non-necessity.
Mrs H., of —, in Kent, consulted me: she had
had eight children: directly she was pregnant the
CASES OF CURE. 347
©
surgeon was in continual attendance prescribing for CHAP.XVIII.
her (because her bowels are confined,) purgatives and
other medicine, and she is always on the sofa or lying
down. When in child-birth her times were most
severe, and she then and afterwards was deluged with
medicine. -
I Ordered some medicines for her symptoms, and
When she had taken those medicines, she was ordered
to take no more medicines.
This time she was able to keep up till the day of
her confinement: she had a very good time, and felt
extremely well, regaining her strength speedily: her
bowels were confined, (she is habitually confined,)
but sepia and opium, in alternation, established regu- º
larity.
C O N CL U S I O N.
Similar facts to those recorded in the various sec-
tions of this chapter, might have been added to a
very large amount; but it is deemed that those,
already recorded, will be quite sufficient to demon-
strate the non-necessity of purgative medicines for
the purpose of curing diseases, or for removing states
which are deemed as productive of disease.
xx 2
348 CASE S OF CURE.
C HAPTE R. XIX.
Introductory remarks. Injuries to the brain and eyes
º produced by purgatives. Injuries to the stomach and
digestive organs from purgatives. Injuries to the
intestines from purgatives. Injury to the womb and
the uterine organs from purging. Injuries special
from purgatives. Injuries from the employment of
turpentine as a purgative.
CHAP. XIX. Section I.-INTRODUCTORY REMARKs.
Introductory The reason of the injuriousness of purgatives was
remarks. tº g
fully worked out in chapter XIII., and various
illustrative statements have been presented in con-
nexion with the physiological conditions of each part
of the intestinal tube, these conditions being morbidly
affected by the action of purgatives.
Before noticing individual cases, illustrative of the
injuries inflicted by purgatives, it may not be unad-
vantageous to present a condensed statement of the
views already put forward.
The facts, already stated in the physiological part
of the work, in relation to the structure and the
functions of the various parts of the intestinal tube,
CASES () F. C.U. R.E. 349
develop the law, that “each portion of the alimentary CHAP. xix.
tube in effecting and producing something particular
for itself, also effects and produces something general
for what comes after it.”—Regnum Animale, p. 163,
vol. i.
Indeed “the intestines may be regarded as a new,
continued, consecutive stomach.”—Regnum Animale,
p. 62, vol. i.
As therefore each part of the intestinal tube has º,
for its end the preparation of the food so as to con- has a duty to
vert it into nutriment, and as each part performs its hº in-
own special duty in the geaeral whole of digestion, ...
it is certain, that any interference with the action of”.
each or any of those parts must tend to impede the
proper formation of that nutritive fluid, to perfect
and to abstract which the intestinal tube and its con-
nected parts were formed.
Why is the intestinal tube of the great length it is,
namely, six times the length of the body ? Why are
the parts of which it is formed, endued each with its
distinct duties? Why except to ensure that the con-
tents of the tube should have extracted from them all
the matter that can be appropriated to the support of
the body. Indeed, in order that all the chyle should
be taken up in its passage along the intestines, it is
necessary that their contents should be delayed, so
that these contents may be applied to all the parts
of the intestinal tube through which absorption of
the chyle can take place. If a purgative is taken, it
irritates the intestinal tube and causes the food to be
carried through the tube much quicker than it should
be; the consequence is that the chyle is not absorbed,
it is expelled. - -
The fact that lacteal vessels, which are so abun-
350 - CASES OF CURE.
CHAP. XIX.
Lacteals in
all parts of
the intesti-
nal tube.
Purgatives
injure the
coats of the
rectum.
Epilepsy
produced by
purging.
dantly distributed through the intestines, are found
even in the rectum, demonstrates, that, even, in this
intestine, delay should take place, so that any chyle
that has not been absorbed in the food's journey
through the other parts of the bowels, should not be
lost but taken up. But purgatives will carry the
bowel contents away before the absorption can take
place; and thus inflict injury on the general system,
by depriving it of the materials necessary to nourish it.
But purgatives act destructively on the coats of the
tube themselves, especially on those of the rectum.
In the description of the rectum it was stated that
mucous follicles abound in the rectum. These mu-
cous follicles secrete an abundant supply of mucus
to prepare the intestine for the passage of the faces.
Purgatives by continually irritating these mucous
follicles cause an excessive discharge, and thus at
length deprive these follicles of the power of secreting
the mucus necessary to the lubrication of the faeces.
The consequence is that the faeces become excessively
hard, rendering them difficult of expulsion, and often
productive of pain when they are expelled; and thus
induce a state which causes permanent constipation,
and, in some cases, stricture of the gut itself.
The close neighbourhood of the womb to the larger
intestines explains why such serious uterine affections
are induced by the irritation of purgatives.
Section II.-INJURIES TO THE BRAIN AND EYES PRO-
DUCED BY PURGATIVES.
(140) Epilepsy produced by purging.
Thomas Smith, (p. 763, public case book,) who had
been under my care for epilepsy, of which he had not
CASES OF CIJIRE, 351
had any attack for months, was seized with a fit. **
He stated that he had been persuaded to take some
castor oil, and it was after the action of the castor oil
that the fit occurred.
(141) Injury to sight from old system medicines.
Alfred Smith, (p. 1566, case book 1849) aged 33, hºw
came to me, August 18, 1849, with a dreadful attack.”
of tic. He has been affected since Christmas, 1847.
This patient has been made a medical martyr. He
has been under the care of Dr Thomson and of Dr
Latham at the Middlesex Hospital. He has been
salivated twice; electrified for four months; blistered
four times; besides multitudes of other means, but
with no benefit, but getting worse.
His sight is affected. This affection came on while
he was taking the medicine He then lost his sight,
so that he could not see earcept by looking SIDEWAYs;
THIS IS BETTER, SINCE HE LEFT OFF TAIKING MEDICINE.
The patient is gradually getting better under homoe-
Opathic treatment. *
(142) Blindness produced by pººrging.
“In the spring prior to his (Professor Davis's) de-Blindness.
cease, an attack of TOTAL BLINDNESS, which lasted
about five minutes, supervened during a violent vomit-
àng, induced unintentionally by a purgative. This left
behind double vision, in certain positions of objects
only, which continued for about six weeks. He
showed symptoms of rapid failure of health during
the ensuing summer; he nevertheless, until the last
month of his summer course, continued to throw the
same interest into his lectures, and to address his
352 CASES OF CURE.
CHAP. XIX.
Dyspepsia.
Throat, af.
fection,
Stomach
affection.
class apparently with the same spirit as heretofore.
He recovered in some degree his strength and
energies by a brief residence at the sea-side, suffi-
ciently to induce him, on the October following, to
re-commence his duties, which it was now destined
he should enter upon for the last time.”
Section III.-CASEs of INJURIES TO THE STOMACH
AND DIGESTIVE ORGANS FROM PURGATIVES.
(143) Dyspepsia, caused by purgative medicine.
Robert Side has been troubled for years with pains
at the stomach with risings. These came on first
after taking purgative medicines.
(144) Injury to throat by strong medicine.
Mary Leighton, (page 970, case book 1852,) has
had an affection of throat six years. She went to
Guy’s Hospital because her monthly period was not
regular: they gave her such violent medicine that
she has suffered in her throat ever since, and a dozen
of her teeth became rotten and they fell off: the
stumps still remain in the jaw. -
(145) Stomach affection (chronic gastritis) induced by
purging.
Mary Rogers, (p. 1562, case book 1845,) had, at her
35th year, her monthly period arrested by a sudden
fright at the death of her mother. The physician,
who attended her, gave her violent medicine, to bring
on the discharge, and from that time to the present
(many years) she had never been well, having been
a sufferer from a variety of gastric symptoms.
CASES OF CIU R.E. 353
(146) Gastric irritation induced by purgative medicine. CHAP. xix.
A. B., who has the common symptoms of gastric Gastric irri-
disease, viz., pain at the pit of stomach after taking”
food and confined bowels, remarks, that, whenever he
takes purgatives to open the bowels, he has an in-
crease of the pain at the pit of the stomach; showing
that the action of the purgative, though perhaps
effective in opening, as the phrase is, the bowels, in-
creases the gastric irritation.
(147) Weakness of inside (chronic gastritis and enteritis,)
ânduced by forcing medicines.
Mary Godwin, (page 720, case book 1846,) who wºn of
was under my care for swelled joints, mentioned that."
her monthly period had stopped. I replied that it
might be restored. She, with anxious look, said im-
ploringly, “ Doctor, do not give me anything to force
it, for I am so weak in my inside.”
This entreaty exhibits the injuriousness of the
method, almost the only method which the old system
practitioners have to bring on the monthly period,
namely, to purge briskly, i. e., to irritate the bowels.
The poor sufferer had already experienced the
effects of the aid afforded by allopathy in such cases;
and, thinking there was no other method to bring on
the monthly period, deprecated the means.
(148) Gastric and intestinal disease brought on by pur-
gatives.
Martha Carson, (p. 350, case book 1852,) aged 22, Gastric and
married, the mother of one child, having had four *inal dis-
miscarriages, is a great sufferer. She ascribes her
sufferings to the employment of purgatives.
Z Z.
354 CASES OF CURE.
[CHAP. XIX..
Graphites and
cocculus.
Descent of
gut.
She has a bad appetite: a sickly feeling at the
stomach: much wind: a sensation of lightness in the
head when she rises from her seat : her bowels are
confined: she has piles, which bleed; her water
passes thick: she has a feeling, extremely distressing,
of pressure at the heart: she feels, when in bed, as if
something snapped in her back: she has a sense of
choking in the throat: she screams at night in her
sleep. -
All these distressing symptoms are identified in
her mind, as concomitant with and dependent on the
taking of purgatives. \
She has derived great benefit from the alternate
use of graphites and cocculus.
Section IV.—TNJURIES To THE INTESTINES FROM
PURGATIVES.
(149) Descent of gut after childbirth from taking purgative
medicine.
Mrs. S.—I was called out late to see this patient:
it was feared she could not live out the might. I
found her in a state of intense excitement, high
fever, thirst, tongue coated brown, great prostration,
rapid pulse, with marked cerebral symptoms.
I found that she had been a patient of mine about
a year since. I then told her, so her friend stated,
that, when cured, it was likely she would become
pregnant: she had had no child for six years: the
prediction was verified.
She had been confined a week and she was going
on very well, pursuing the rules laid down in the
CASES OF CORE. 355
Domestic Homoeopathy,” when the surgeon, who at-
tended, told her she must take some castor oil : she
refused, but he frightened and forced her to take it.
It purged her violently and brought down the gut, and
produced great suffering: the surgeon then gave her
some opiate medicine, to soothe her and to take off
the effect of the castor oil; but she became much
worse, and on the morning of the day on the evening
of which I saw her, he came and gave her some
medicine to take, and she would not. He told her
she must. She would not. He sent for her husband,
whom he required to stand over her and see that she
took the medicine.
She would not : the struggle, which this incon-
siderate surgeon ought to have known would have
done more injury than all his medicine could do good,
even if it were suited to the case, (yet the person is
an accoucheur in large practice,) brought on a sup-
pression of the lochial discharge, and when I saw her
the symptoms threatened, as was stated, cerebral
affection.
Belladonna and bryonia were given in alternation.
On the following day she was better, but the day
after, being visited by some relation, she became
worse, and in the night was delirious: she had ex-
cessive thirst, great prostration, and profuse perspira-
CHAP. XIX,
Belladonna,
and bryonia.
tion: she was ordered arsenicum and phosphorus in Arsenicum
and phos-
alternation, and in the course of a few days she was phorus.
restored to health. -
What mischief do these meddling surgeons by their
* Domestic Homoeopathy; or Rules for the Domestic Treatment of
the Maladies of Infants, Children, and Adults, and for the Conduct and
the Treatment during Pregnancy, Confinement, and Suckling; by
JoFIN EPPs, M. D. Piper & Co. 23, Paternoster-row, 4th edition.
Z Z 2
356 CASES OF CURE.
CHAP. XIX.
Descent of
gut.
Bearing
down of gut.
medicines, treating, as they do, pregnancy and child-
birth as a disease.*
tº-mº ºmºmºmº-e
(150) Descent of gut from taking Hooper's pills. r
Frances Hughesdon, (page 74, case book 1847.)
aged 26, has had a bearing down of gut since 14
years of age, when her aunt gave her some of
Hooper's pills.
(151) Bearing down of gut for many years, produced by
taking Salts when very young.
Mary Nash relates (Sept. 1853,) that she has been
afflicted with this malady from the cause stated.
(152) Descent of the gut with pain when taking purgative
medicine.
Mrs T., of W., writing to me, Oct. 10, 1850, of a
patient, Mrs W., remarks, “I have learned from
Mrs W., that, at every action of the bowels some
part descends, not causing any pain, except when
taking purgatives.
(153) Descent of gut from purgative medicine.
In July, 1847, I was sent for by express to Derby,
to see a gentleman dangerously ill. I found his con-
stitution destroyed by physic: his age was 54. His
rectum had descended after every stool for some
months, and it was necessary to have it pressed up
each time of relieving the bowels. This affection
came on after violent purgative medicine, given to
him by a surgeon at Derby.
Descent of
gut.
* In fact so universal is this treatment of child-birth as a disease,
that surgeons agree to a fee which is to comprise the attendance and the
medicine.
CASES OF CURE. 357.
(154) Eacessive debility induced by purging. CEHAP. XIX.
Wm. Beckett, (page 142, public case book,) had º de-
been affected with erysipelas. To cure this he had
been briskly purged; and after this brisk purging, he
had become debilitated to an extent quite distressing.
**
(155) Piles brought on by purgative medicine.
The surgeon gave me (John Buckingham, a patient Piles.
who had been under my care, but who was taken ill
in Wales,) a purging draught, and brought on an
attack of piles. Nov. 1846, p. 195, case book 1846.
(156) Piles brought on by purgative medicine.
Frederick Barrett, (page 218, public case book,) Piles.
came under my care. He has had piles with intense
suffering, which came on under allopathic treatment,
strong purgative medicine forming part of that treat-
ment.
(157) Discharge of blood from the bowels caused by salts,
Francis Joseph Leaver, (page 986, case book 1851,) * of
aged 35, married. He passes blood whenever he
goes to the closet, sometimes dark, sometimes light:
he has at times a pricking pain in the part: he was
once troubled with itching and rash on the hands: he
took salts for the rash and itching, and ever since he
has had this discharge.
(158) Hermia caused by violent purgative medicine.
Mrs B., of D., called Dec. 22, 1846. She stated Hernia.
that she had consulted me Nov. 26, 1846, for stomach
and intestinal pains and affections, with which she
358. CASES OF CTJ RE,
CHAP. XIX.
Hernia.
had been troubled for twelve months, and now she
is well.
She stated that she is six months gone in preg-
nancy, and that she dreaded her confinement, be-
cause her surgeon, Mr M., “deluged her with physic”
at those times.
She asked me, further, whether homoeopathic treat-
ment had reference to rupture, because, if so, her
husband would consult me. He (her husband,) had
had rupture for some years, ever since having had
what was called inflammation of the bowels, when
he was violently purged. The rupture came from the
pººrging.
(159) Hernia (vaginal) caused by purging, communicated
by Dr Kelsall. -.
Sarah Weldon, aged 44, a poor, pale, emaciated
woman, presented herself to me Jan. 12, 1852, suf-
fering with ascites and oedema of the lower extremi-
ties. She says she enjoyed tolerable health until
about six months ago, when she put herself under the
treatment of an allopathic practitioner, who told her
she had “deranged liver,” and gave her pills (four
times a-day,) which salivated her severely; after
which she took much iodine, till it produced many
distressing dyspeptic symptoms, flatulence, cardialgia,
sour risings, loss of appetite, &c. obliging her to
discontinue the use of it. Shortly afterwards, (i.e.,
about three months after commencing medical treat-
ment,) her abdomen began to enlarge rapidly, for
which her medical attendant prescribed elaterium :
she took this drug for two months in the form of
pills, and says it completely “poisoned her.” On
the first day she took elaterium, it occasioned twenty-
CASES OF CTURE. 359
four hours incessant vomiting, (her husband says
faecal vomiting,) and watery purging, followed by
great debility and faintness, the size of the abdomen
was temporarily reduced, but her limbs permanently
emaciated, and on ceasing to take elaterium the fluid
soon collected again in the abdomen, which with her
legs and feet are much distended: she has constant
pain in the right hypochondrium, right shoulder, and
under the right scapula : can lay only on her back:
her motions are clay-coloured, which, for the last
month, she has been obliged to obtain by a dose of
castor oil once or twice a week.
During two months that she took elaterium the
straining occasioned by the purging, has caused a
tumour to protrude from the vulva, which has been
gradually increasing in size, and which she supposes
to be a prolapsus uteri; but, on examination, it proves
to be a species of hernia, caused by the peritoneal
cul de sac, between the rectum and the vagina, which
(filled with serum from the cavity of the abdomen,)
has forced down the posterior wall of the vagina
through the vulva, where there is a bag, filled with
water, nearly as large as a goose egg, hard and tense
but compressible; the tumour filling the vagina, and
pressing the uterus against the fundus of the bladder.
CHAP. XIX.
Pulsatilla and hepar were prescribed, to be taken Pulsatilla
alternately every four hours.
January 19.—She came to tell me her appetite had
improved, and that this morning she had been sur-
prised to have had a perfectly natural evacuation from
and hepar.
the bowels, without the use of castor oil. Nua, vomica, Nux vomica.
Quarter of a drop of the third dilution was prescribed,
to be taken every night at bed time. *
Jan. 26.—Her husband came to tell me she had had
360 CASES OF CURE.
CHAP. XIX.
Case of
stricture.
a natural evacuation every day since the last report;
but that she has increased an inch in circumference
round the abdomen, and the tumour from the vulva.
is increased in size: as he had no means of obtaining
proper attendance at home he was about getting her
admitted into Guy's Hospital.
Feb. 9.—The husband reported that she had un-
dergone the operation of tapping in the hospital, and
that with the evacuation of the water from the abdo-
men, the tumour protruding from the genitals had
quite disappeared.
(160) Case of stricture of the rectum from purging by
JEpsom Salts and Swbsequent death.
Mrs B., aged 38, married, the mother of five chil-
dren, has had besides four miscarriages, two of these
having been within eight months. The last miscar-
riage was on Feb. 20, 1845, and she was so reduced
as to be unable to have her bed made till the 9th of
March. On the 19th of April, 1845, (Saturday)
when I visited her for the first time, she was obliged
to keep to the sofa in her bed room.
I found that she had suffered for twelve years from
a difficulty of passing the contents of her bowels:
during the whole of that time she had passed occa-
sionally substances like flesh. The surgeon who had
examined and treated her, declared that her disease
was stricture of the rectum.
Her state, when seen by me, may be thus de-
scribed; and attention to her history in this point of
view will amply reward the reader, and will painfully
demonstrate the evils of purgatives, and the mischief
inflicted by many of the rectum surgeons,
She has constantly confined bowels, and never gets
CASES OF IN J U R.Y. 361
an action of them without medicine or an injection. CHAP. xix.
She feels nevertheless a constant desire to relieve Constant de-
them, and the gut every few minutes discharges the **
liquid faeces, so that every few minutes she soils her
linen, and hence it happens, as she herself relates,
that her whole mind is concentrated in her rectum,
and she being a person of the greatest sensitiveness
in reference to cleanliness almost loathes herself.
The continual excitement thus produced and the
medical means used to relieve her have brought her
nervous system, she states, to the verge of madness.
When her bowels have not been relieved for a few
days, she experiences great fulness, pain, and un-
easiness in the region of the left groin.
When, to relieve the bowels, she uses the injection,
she has, directly she introduces the instrument, the
most agonising spasms; in fact, she can introduce Agony from
only the smallest possible quantity of water at a "
time, and sometimes when the instrument has passed
through the Small aperture left in the gut, the spasms
are so severe that no means could cause the tube to
go any further: so severe indeed are the spasms, that
at times she fears the womb, or the bowels, or both
will be forced away.
In the attacks of pain she is obliged to seize hold
of the head of the bed or of any thing near her, just
like as in the forcing of labour: indeed she asserts
that the pains of straining after the injection are as
violent as at child-birth : these, she adds, she knows
will have an end, but those will not.
The stools are constantly relaxed. In fact she stools con-
believes she could not pass any evacuation unless it tº re-
were relaxed. The feeling she has is as if the gut
that ends in the rectum was contracted and worked
3 A
362 CASES OF IN J U RY
CHAP. XIX.
down towards the rectum, and, then, if perchance
the opening in the contracted part of the rectum
meet it, the stool passes: if not then strain follows
strain. She feels as if a large ball of fire were
stuffed up the bowels. Great stiffness and Soreness
are felt in the lower belly.
Besides all these miseries she has considerable mu-
cous discharge from the vagina, and she has had at
times, besides the miscarriage, profuse homorrhage
from the womb. Her sight is affected by the loss
of blood.
The only relief she gets to the spasm after the in-
Temporary jection is by the use of a suppository of morphia, of
relief by the
use of sup-
pository of
morphia.
a strength equal to a drachm of opium. She passes
this through the stricture, and, after some time, relief
is obtained; but when the effect of the morphia sub-
sides, the straining comes on again.
Besides the suppository, she is obliged to take
morphia to make her sleep.
As may be supposed, she has had medical and
Surgical treatment. -
Seven years since the passage was nearly closed.
The surgeon used very large bougies. She states
that he passed a wooden instrument like the tuning
fork of a pianoforte. The Soreness thus caused was
such that she could not walk or move. She begged
him not to pass the instrument any more. He said
the stricture was cured, and a bougie passed daily
with an injection would soon restore her. She has
used an injection every two days for the last six years.
About a year after this operation she became worse,
and went to a surgeon who is famous for seeing rec-
tum disease in every diseased person. He asserted
that her bowel had been injured by the violent means
FROM PTVIRGATIVES. 363
used. He prepared for her a metallic instrument, CHAP. xix.
the smallest, he stated, he had ever had made. She
still however became worse until she attained the
state already described, her womb suffering also. For
this latter she obtained the advice of Dr Blundell.
During the last pregnancy she had hoemorrhage on
the least movement, but yet, contrary to the statement
of the rectum surgeon, she went her whole time.
To what then is all this misery to be attributed?
Primarily, as she acknowledged to me, to the practice
of having from the age of 13 years, been in the habit
of taking quantities of Epsom salts, for constipated º
bowels. Her mother died early, and, having no one nued use of
to guide her, she frequently took salts, and took two “
ounces as a dose. The bowels became so weak, that
she could not leave her bed till the salts had worked
Off.
She observed, as the first indication of a diseased
state, after these purgings, that portions like skin
used to escape from her bowels when she had an
action of them.
This lady came under homoeopathic treatment, but
in an agony of suffering (before she could come under
the curative influence of homoeopathic remedies) she
took, as was supposed, some morphia powder which
she kept by her and died.
This indeed is a sad instance of the injury from
salts taking and bougie forcing, for the lady was a
beautiful being, of good constitution, naturally gene-
rous, full of sympathy, blessed with all the comforts
and the elegancies of life, and in the prime of her
days. - +
She was strong minded, had great power of en-
durance, had strong religious feelings which sustained
3 A 2
364 CASES OF IN J U R.Y
CHAP. XIX.
Descent of
womb.
Bearing
down of
womb.
her, and yet, notwithstanding, her agony was so great
as to induce her to take, as it is believed, morphia,
to her destruction. She had been in the habit of
taking it to allay pain.
Section IV.-INJURY TO THE WOMB AND THE UTER-
INE ORGANS FROM PURGING.
(161) Descent of womb induced by purgatives.
Mrs B., after her confinement, had purgative medi-
cine administered to her, by her surgeon, (a practice
almost universal) and descent of the womb was thus
brought on.
Hºmºmºmº-º-º-º-º:
(162) Bearing down of womb and descent of gut caused by
purging after confinement.
Ann Kingston consulted me Sept. 1850. She had,
after child-birth a few weeks ago, purgative medi-
cine administered to her by her medical attendant,
and she has been troubled ever since by a bearing
down of the womb and a descent of the gut when
she goes to stool. The gut she is obliged to pass up,
as it will not return itself. She was not subject to
these affections until she took the purgatives.
(163) Bearing down of womb from purgative medicine.
Mrs S. stated, in consulting me, that she has been
troubled with a bearing down of womb ever since a
confinement, in which she was not attended by her
regular medical man. The surgeon called in purged
her, and the womb affection followed.
FROM PURGATIVES. 365
(164) Descent of the womb induced by purgative medicine. CHAP. XIX.
Eliza Whitaker, (p. 1752, case book 1847.) when .*.
$ º . Cent Of Wom
consulting me, deprecated the use of purgative medi- from purga-
e º gº tive medicine.
cine, remarking, that the womb comes down if she
takes forcing medicine.
* *mmºns
(165) Descent of the womb from the use of purgative
medicine.
Cornelia Baker, (p. 166,) was attended during her
labour, which was a very favourable one, by a surgeon
who gave her some castor oil. The action of the
castor oil was followed by a descent of the womb and
by a discharge.
(166) Bearing down of the womb induced by purging.
Mrs M., from a town in Buckinghamshire, con-
sulted me Nov. 16, 1846. She stated that she had
been troubled with bearing down of the womb for
many years, which she ascribed to the circumstance,
that the surgeon who attended her in her last con-
finement, because her bowels were confined, ordered
her purgative medicine; which, being taken, acted
twenty-six times in forty-eight hours. Her womb has
been affected ever since.
(167) Descent of the womb from purging after confinement.
Mrs Margaret Smith consulted me Nov. 22, 1844.
Among her other symptoms she was troubled with
bearing down of womb, from which she had suffered
ever since her confinement. It came on after purging.
gºmºmº Pºmº
(168) Bearing down of the womb from purgative medicine.
Elizabeth Boughton, (page 152, case book 1849,)
366 ...” CASES OF INJURY
CHAP. XIX, consulted me for weak eyes, the eyelids are inflamed
at the margins: they feel very weak on using them
in the morning: she cannot see by candle-light. She
complained beside of bearing down in the passage of
the womb : the womb comes down: she has heat in
the belly. These latter symptoms, relating to the
womb, she has suffered from for years, ever since
some strong medicines were administered to her by
her medical attendant.
Sepia, three globules, removed the womb affection.
sº- vº-
(169) Pressure in the region of the womb induced by pur-
- - gatives. .
flººr Ann Dawson, (page 553, case book 1853,) the
the womb, mother of thirteen children, suffers from great weight
and pain at the region of the womb, as if a great
stone was thrusting itself from her. She has had
this sensation since the last labour, when she had not
her usual medical attendant but another, and this
latter gave her strong medicines to force the labour.
She has had since such intense pain in coitu that she
has been obliged to avoid it.
--
(170) Eaccessive menstrual discharge caused by purgative
-- medicine.
º Miss — consulted me May 1844. Some time
discharge. before she had felt a little poorly, and had gone to a
chemist in her neighbourhood, who gave her a powder
to take at night and a draught to be taken the follow-
ing morning.
She was violently purged by these means. In ad-
dition, she was seized with violent pain at the lower
part of her belly, which was followed by a profuse
clotted discharge from the womb, (metrorrhagia).
FROM PT) RGATIVES. 367
Her monthly period had always been regular and chap. xix.
proper before this.
She consulted me, and her countenance was SO
haggard and altered that, although knowing her well,
I scarcely recognized her when she came.
She was cured; but it was a month or six weeks
before she was quite free from this metrorrhagic
disease, which recurred after any exertion.
(171) Leucorrhaea of four years duration brought on by
purgative medicine.
Elizabeth Comb, (page 3401,) took some hicra Leucorrhea.
picra. Some years since. It acted upon her power-
fully, and she has never been free from white dis-
charge since.
(172) Contraction of the vagina subsequent to violent purga-
tive medicine.
Sophia Hopkins, (p. 759, case book 1846,) stated º
of the vagina.
that the passage to the womb had been gradually
contracted since she took medicine at St George's
Hospital, where she had been a patient.
(173) Too frequent menstrual discharge brought on by
- purging.
Jane Collard, (p. 305, case book 1846,) had some Too frequent
e & g meustrual
purgative pills prescribed for her by a surgeon of j
Islington, and she has suffered since from a recur-
rence of the monthly period at intervals of a fort-
night.
(174) Feeling of descent of the womb from purging with
castor oil seven days after delivery,
I was consulted Nov. 1851, by a young married Feeling of
descent of
lady, who had been confined with her first child. She womb.
36S CASES OF IN J U RY
CFI AP. XIX.
Diseased
ovary.
Leucorrhoea.
had been perfectly well; but her bowels having been
inactive for six days, she was persuaded to take a dose
of castor oil. When the castor oil seemed to be
about to act she sat on the night chair, and felt at
the moment a forcing down of the womb, so that she
could hardly recover herself. Whenever she stood
she felt the dragging down, and so unpleasant was it
that she sought aid. When I saw her she seemed
perfectly well in health : nothing troubled her but
this distressing feeling.
(175) Diseased ovary and enlarged neck of womb caused by
forcing medicines.
I was sent for to see a young person aged 22, who
had been brought up to town on a bed in an omnibus
from the neighbourhood of St Alban's. She was suf-
fering extremely from burning shooting pains at the
left side of her belly. On examining her, I found
the neck of the womb much enlarged and tender, an
ovarian tumour on the left side, and the left breast
much larger than the right. She has had pain there
since she took some forcing medicine which the medi-
cal man in the country had given her, as he said, to
force the monthly period, though she told him that
her monthly period was regular, and had been so
from thirteen years of age.
(176) Leucorrhoea brought on by forcing medicine.
Susan Gibbs, (page 654,) has had a white dis-
charge ever since her last confinement. Her medical
man gave her some medicine to force labour, and she
has suffered ever since.
FROM PLJ R GATIVES. 369
(177) The ea’ercise of the matrimonial connevion rendered CHAP. XIX.
painful by the employment of purgative medicine,
Consequences
Ann Missen, (p. 1515, public case book,) states that..:”.
she has suffered pain post coitum ever since she had". Pº"
been violently purged.
(178) Inflammation of the ovarium and peritonitis and
diarrhoea induced by spurred rye and by castor oil.
Nov., 1851. I was requested to visit a lady at º:
Hampstead. She had been confined by a surgeon
of that village. She stated that she was liable to
hoemorrhage in her confinement: he, anxious to obvi-
ate this, and there being delay in the birth of the
child, gave a dose of spurred rye, and the effect, as
the lady observed, was that the child was jerked into
the world. She felt at the moment that some in-
jury was done to her side: the pain was an intense
dragging: she could not bear pressure: the belly was
very much distended: the surgeon had given her
castor oil contrary to her wishes: it purged her vio-
lently: and when I was consulted she had great ten-
derness all over her belly : continual diarrhoea :
intense thirst: dry tongue: no appetite: great ex-
haustion: incessant restlessness: night sweats, pre-
ceded by burning fever. All these states were
developed in their fulness after she had taken the
castor oil: she had cough and severe pain in her
side affecting her breathing.
Her state was highly dangerous. Homoeopathic
treatment subdued the peretonitis, and she now
(August 1854) is in good health.
3 B
37 () CASES OF INJURY
CIHAP. XIX.
Excessive
debility.
Severe pain
in back.
Injurious
action of
purgatives.
Excessive
injury from
purging.
Section VI.-INJURIEs SPECIAL FROM PURGATIVES.
(179) Eaccessive debility induced by purging after con-
finement.
Sophia Love consulted me March 29, 1844. She
was suffering from extreme debility, and from con-
stipation: she had been confined three weeks pre-
viously: after the confinement the surgeon said she
must take medicine: he purged her violently, and
she is now suffering the consequence of his ignorance.
(180) Severe pain in the back and bleeding from a leprous
eruption after the w8e of purgative medicine.
Martha R., (p. 1226, case book 1843,) took, by the
advice of a friend(1) a mixture of sulphur, saltpetre
and syrup of ginger: she was dreadfully purged:
she consulted me a week after : she looked extremely
ill: she has had, ever since the purging, pain in the
back, and bleeding from the leprous eruption, which
she has had some time over her body.
* *
(181) Injurious action of purgatives on the seminal recep-
tacles.
IV[r G. states, that, when he takes purgative medi-
cines he always has the emissions worse.
(182) Eaccessive injury from purging, inflammation of the
testicle.
Henry Mc Kowan, (page 1067, case book 1850,)
aged 27, single, consulted me for inflamed testicle:
he has had pain across his loins: the testicle was
much swollen : the pains were aching and shooting:
the patient looked a wreck, pale, cadaverous, exhausted,
could scarcely stand: he had been treated by a sur-
FROM PURGATIVES. 371
geon with violent purgative medicines; in fact, the CHAP. xix.
man was almost killed. Had he died I should have
had no hesitation in stating that he had been killed
by purging: he had been obliged to have this surgeon
by his master. When he came to me he had had no
action of the bowels for several days; that is, the
violent purging now presented the counterpart, obsti-
nate constipation: his tongue is furred: his lip is
breaking out. Ordered cantharis and clematis. Clematis.
March 14.—Re-action set in : he has now much
fever: the left testicle is smaller, but now the right
is affected: bowels still confined: cerebral symptoms
have appeared: delirium was present. Ordered aco-ººººº..."
belladonna.
nite and belladonna.
March 18,-The pain is better: the swelling is
less: the inflammation is less: the bowels are now
regular; i.e., without any purgative medicine: great
irritation at testicle. Continue aconite and belladonna.
March 25.—He is better altogether except some
yellow discharge from the urethra. Ordered sulphur Sulphur.
one grain of the third trituration. -
April 6.—All symptoms better. Continue the
sulphur.
April 18.—Discharge lessening. Continue the sul-
phur. He was cured.
(183) Injury from purging.
Ann Baker, (p. 170, case book 1849,) consulted Injury from
me Oct. 9, 1850. Her face was swollen all over:"
all round her lower jaw the swelling and the pain
were so severe as to prevent motion: she was exceed-
ingly prostrate, sweating by day on the least motion:
she was so ill that she thought she should die: all
these symptoms came on after taking what was called
3 B 2
372 CASES OF INJURY
cHAP. xix, an antibilous pill. Three-quarters of a globule of
phosphorus every eight hours till she took eight glo-
bules, took off some of the bad effects.
(184) Death from the administration of purgative medicine
after child-birth.
Of the many difficulties with which the homoe-
opathist has to contend, not any one is more potent
and more frequently occurring, than that connected
with the commonly existing motion of the necessity
of the mother taking purgative medicine after de-
Absurdity of livery. The absurdity of giving purgative medicines
É..” at such a period has been demonstrated by a writer,
*** who remarks—
“Do not be troubled about the bowels not acting.
Nature is busy restoring the natural condition of the
womb and the genital organs: all her powers are
occupied in that direction, and therefore she leaves
the intestines. When she has effected her purposes,
the intestines will act of themselves.
“Remember this—that ACUTE diseases, inflammation
of the bowels, puerperal fever, and the CHRONIC diseases,
the bearing down of the womb, the inability of retaining
water, which so much trouble women who have borne
children, are, in most cases, the consequences of the
purging system.” .
Notwithstanding the correctness of this view, and
notwithstanding that Dr Hering, of America, directs—
“For constipation in child-bed nothing should be
done,” and if it continue fourteen days, as it is al-
ways a very good symptom, the woman will, in Con-
* The non-necessity of purgative medicines after child-birth, is ex-
hibited in cases recorded in the previous chapter, Vol. iv., No. 12,
p. 374.
FROM PLJR GATIVES. 373
sequence, be healthier and stronger:” still many feel chap. xix.
prone to give purgatives. The following case will be
useful to show the dangers of such practice.
Observations wyon a case of death caused by the administra-Death caused
finement. Eatracted from the Journal de Medecine et
Chirurgie, art. 2432.
In the Annals of Hygiene, a fact is to be met with,
which appears to us of considerable importance to
practitioners.
“A young woman was delivered without any danger
the 4th of October. She was in the most satisfactory
state, when on the 11th of the same month her phy-
sician thought he must prescribe a purgative for her : .
he prescribed forty grammes (an ounce and a quarter,)
of sulphate of potash, (sel de duobus,) to be taken in
six packets. Immediately after having taken the first
dose of this medicament, the woman complained of
excruciating pains in the stomach, in the bowels,
Cramps in the arms and legs; nausea and vomitings
succeeded ; all these phenomena augmented in in-
tensity; nevertheless the medicine was continued,
and, at the fifth dose, an hour and a quarter after
the first, the unfortunate patient sank.
“The existence of a poison was necessarily inferred.
The physician had prescribed forty grammes of sul-
phate of potash : this salt, in such a dose, is not a
poison ; but forthwith it was concluded that the apo-
thecary had committed an error, and a judiciary
enquiry was commenced accordingly. Messrs Bo-
nassies and Bayard were appointed to open the body.
These gentlemen discovered no other injury than an
emphysema of the gastric and intestinal mucous
membrane. This mucous membrane was pale, and
º & tº dº tº y purga-
tion of a purgative Inedicine to a woman in her con-tive
medicine.
374 CASES OF INJURY
CHAP, XIX.
Reflections.
seemed in its normal state: but it was raised by
swollen bubbles, developed between it and the mus-
cular membrane. -
“Messrs Bayard and Chevalier performed the che-
mical analysis of the intestines, and of the liquids
contained in them, with the greatest care. That
examination demonstrated that no mistake had been
made on the part of the apothecary, and that the
salt used had really been the sulphate of potash.
“Reflections.—M. Bayard drew attention to the fact,
that the dose prescribed by the physician was a little
too large, and indeed the sulphate of potash is seldom
administered except in doses of from sixteen to thirty-
two grammes (half an ounce and an ounce). Even
in this quantity, however, it has sometimes produced
accidents, as stated by Messrs Merat and Delens.
(Dict. Univ. de Mat. Méd.) ‘It is, moreover,’ say
they, “one of the most common purgatives after de-
livery, in doses of one, two, and three drachms, for
women who do not suckle their children. It is more
active, more irritating, than the greater number of
the neutral salts, with which we must be careful
not to confound it, as has been done in the article
Sulphates, Dict, des Sc. Méd., p. 389. In 1821 we
saw an ounce of this salt taken by mistake in a glass
of barley water, instead of Seidlitz salt, cause a kind
of poisoning, (a feeling of burning, epigastric pain,
vomitings, &c.) J. G. Greisel relates, even from the
action of half a drachm of this sulphate, the super-
purgation and the death of a fever patient; but, in
this case, it is undoubtedly less the peculiar action
of the salt, than the inappropriate use of the same
to which the result must be attributed.’
“The dose of an ounce and a quarter was, then,
FROM PURGATIVES. 375
evidently too strong; but this is not sufficient to CHAP. xix.
explain the catastrophe which befel. A two-fold
instruction, however, seems deducible from this ob-
servation. First, that practitioners, as guided by the
usual formulary, generally administer the sulphate of
potash in a dose too large ; and, in the second place,
that an active medicine should never be administered
to an individual who is not ILL. In fact, this woman,
seven days after her delivery, was perfectly well, and
nevertheless her physician prescribed for her a violent
purgative, with the intention, no doubt, of warding
off those latent maladies with which she might, on
a future day, be visited, thus transforming a very un-
certain danger into a real peril, which art could not
overpower. This conduct is not rational, and ought
in no case to be imitated.
“Wise practitioners advise that not the slightest, Unwise to
most insignificant operation, should be performed º
without a most precise indication; bleeding, a blister,”
the removal of a pimple, are certainly very simple
operations, but in certain cases, however, even these
have been followed by serious evils and even by
death. It is the same with every active remedy
taken into the interior: although such unexpected
catastrophes are very frequently related in the jour-
mals, it is most probable that a still greater number
are allowed to pass by in silence, for few practitioners
are desirous of publishing their misadventures, especi-
ally when by a more prudent course such misadven-
tures might have been avoided. We cannot, therefore,
too much insist upon the necessity of using every
energetic medicine with the greatest circumspection,
in order to avoid those accidents the recital of which
from time to time afflict us.”
376 CASES OF IN J U RY
CHAP. XIX.
Gastric af.
fection pro-
duced by
turpentine.
Epilepsy
caused by
turpentine.
Section VII.-INJURIES FROM THE EMPLOYMENT OF
TURPENTINE As A PURGATIVE.
It is most likely that numerous injuries will result
from the employment of turpentine, it being employed
as a purgative for the expulsion of worms. The
excessive irritation which it induces affords a reason
quite sufficient to explain its injuriousness; and, yet,
such is the dearth of means in the old system practice
for the cure of worms, that the old system practi-
tioners have scarcely any means left, but such as are
violently irritating, for the purpose of expelling
WOTIOS.
The following cases will present some illustration
of the injuries caused by turpentine, as unwisely
used for the expulsion of worms.
(185) Injury from purging with twrpentine.
Mary A. M. Gill, (p. 1107, case book 1850). She
is suffering from gastric affection, influencing the left
side chiefly. This came on after having been treated
for tape-worm by turpentine. She states that she
was brought so low under the medical treatment
for the tape-worm by turpentine, that she could
scarcely stand. And what marks the flagrancy of
the ignorance of the medical man, who treated her,
she had no tape-worm.
(186) Injuries from turpentine taken for the eaſpulsion of the
tape-worm. -
George Bromley, (p. 349, case book 1847,) con-
sulted me Oct. 3, 1848, for epilepsy, with which he is
afflicted. -
CASES OF IN J U R.Y. 377
He states that, before coming under homoeopathic crlap. xix.
treatment, he had had turpentine prescribed for him,
under the idea that he had tape-worm, and that this
caused the fits. He felt much injured by the tur-
pentine. Among the effects, one in particular he
mentioned, viz., that he felt dizzy as if drunk.
(187) Injury to the womb from the use of twrpentine.
Mary A. Burrows, (p. 244, public case book,) wellº.""
formed, complexion pale and whitish, consulted me womb,
for violent palpitation of the heart, attended with
pain extending to the back so severe that she cannot
lie down.
She is troubled also with descent of the womb.
All these severe afflictions (and to a young person
more particularly must they be severe,) were brought
on by the use of turpentime, advised by a physician
for the cure of worms.
(188) Injury from purging by twrpentine.
Wm Richardson, (p. 1336, case book 1848,) stated, Rheumatism.
on consulting me Sept. 15, 1848, that he had taken
turpentine by Dr R.'s advice to get rid of tape-worm,
until the blood came from the bladder, and he has
been ill of rheumatism ever since.
(189). Injury done to the bladder from purging by turpentine.
William Ives, (page 1066, public case book,) has Bladder af.
e fection.
suffered many years from an affection of the bladder.
This affection supervened after the use of turpentine,
administered to him for the purpose of expelling
WOTIOS.
*
3 C
378
5 | CASES OF INJURY
CHAP. XIX.
Affection of
the bladder.
Affection of
the bladder.
Injury from
purgatives.
Injury from
turpentine.
(190) Injury done to the bladder from purging by turpentine.
Mary Jane Sheppard, (p. 1558, case book 1847.)
age 24, consulted me Nov. 10. She is troubled .
with tape-worm, for which she took the usual remedy,
turpentime, five times. She had no affection of her
bladder before taking the turpentine, but ever since
she has suffered from a feeling in her bladder as if it
were overcharged, a sensation produced no doubt by
the turpentine.
Elizabeth Woodliffe (p. 2019); a similar case.
(191) Injury from turpentine taken for worms.
George Hull, aged 18, (p. 807, case book 1847.)
consulted me for an affection of the bladder, namely,
a dripping of water for ten minutes after he has
passed water. This was brought on by turpentine
taken for worms.
(192) Injury from turpentine taken for worms.
Wm Sievier, (March 1, 1850,) stated that he had
told Mr Salmon his child had worms. Mr Salmon
ordered a medicine, which acted so violently on the
child’s bowels, that the child has not been well since.
(193) Injury from turpentine taken for worms.
Eliza Jewett, (Jan. 18, 1851,) states that she and
her husband were once nearly killed by turpentine,
which they at the dispensary gave her and him for
tape-worm.
(194) Injury from turpentine,
Charles Westall, (p. 1691, case book 1851.) This
patient has been under two medical men and deriving
\
FROM PT) RGATIVES. 379
no benefit sought homoeopathic aid. He has had CHAP. XIX.
shortness of breath for three months: he has a slight
cough, it is dry: he has tenderness at the chest: he
cannot lie on the left side, he feels as if something
was dropping over from the other side. Ordered
ledum. Ledum.
June 10.—His shortness of breath is a little better:
the cough is still dry : the tenderness still remains:
he wakes up frightened.
Ordered aconite, to be followed by ledum. Aconite and
June 28.—The breathing is still bad, but the cough ledum.
and the tenderness are better: he can lie better : he
wakes frightened.
He states that he feels a great weakness all of a
sudden, a trembling in his inside, and a weakness in
his knees, and he is troubled with worms, and has an
itching at the gut: he has felt this weakness ever since
he was treated for worms by turpentine, by Mr A.,
surgeon at a dispensary in the New Road.
Ordered verätrum, to be followed by ledum. Voratrum
July 9.-The breathing is a little better: the cough and ledum.
is well: he can lie better: the sinking is better: the
itching is better. -
Ordered cina for the worms, then ledum. Cina and
August 2.—The breathing is still far from natural: ledum.
his other symptoms are better, namely, the cough, the
lying on the side, the itching, the sinking.
Ordered a comite. Aconite.
August 16.—He is well, except his breath, which
is short. -
Ordered ledum. Ledum.
Sept. 14.—He has a dry wheezing cough, otherwise
he is much better.
Ordered hepar sulphuris and then ledum. º
3 C 2
380 CASES OF IN J U R.Y
CHAP. XIX.
Spigelia.
Injury from
turpentine.
Moulding of
the fºcces.
Oct. 14.—His, cough is better: he has pain at
heart.
Ordered spigelia.
Ełe became well.
sº-º-º- ºmºsºsºs
(195) Injuries from twrpentine taken for the eaſpulsion
of worms.
Tubal Cain Hammond, (p. 1009, Oct. 28, 1848,)
states that he has pain and difficulty in passing water,
together with a slight discharge from the urethra,
which he has had ever since he had taken, con-
tinuing for several weeks by direction of his surgeon,
Some turpentine for worms.
Another point of view exhibiting the injuriousness
of purging is found in the fact, that such purging
prevents the moulding the faces : purgatives causing
a fluid or semi-fluid state of the faecal evacuations:
a state of faeces unnatural.
The natural state of the faecal evacuations, that is,
the moulded form, and the conditions precursory to
and connected with the production of that faecal form,
performs, the writer believes, an important part in
connexion with the motions of life in the living or-
ganism. .
When the varying state of the faecal evacuations
at the different periods of the individual's life is con-
sidered, the idea seems justified, that the form of the
faecal evacuations has to do something of importance
in connexion with the full perfection of the interior
movements of the human machine. Thus, the infant
presents special pappy stools: who can deny that
the transit of these pappy stools through the intesti-
mal tube may not, in this very pappiness of state, be
FROM PLJ R GATIVES. 381
a condition essential to the development of those
modifications of the vital power, necessary to the
carrying on of the life : In the adult, on the other
hand, is the solid, the moulded faecal evacuation ;
and who can, authoritively, say, this solid form is not
a circumstance essential to the development of the
conditions necessary to the carrying on the life in
its full completeness? Who can doubt, that, as the
flow of blood through the heart is essential to the
induction of that action in the heart, necessary to the
proper carrying on of life, the application of the faecal
matter to the intestimal tube in a natural form and
state, (i.e., a state associated with the development of
the proper moulded faecal form,) is not as essential in
reference to the proper activity of life power in con-
nexion with its dependence on the action of the in-
testinal tube on its content, as is the action of the
heart on its pabulum, blood.
This idea of the proper moulded form of the faeces
being essential to life is favoured by the fact, that
nature seems to strive to give form to the faeces.
This has been referred to chapter VIII., paragraph
322, and in chapter IX., paragraph 446. Other facts
prove that the effort of nature to give this moulded
form to the faeces is constantly operative.*
* The strength of the tendency of the intestines to give the moulded
form to the facces, is exhibited in the following interesting facts, recorded
by Dr Currie:-
“In August 1795, a gentleman of —shire, aged 66, applied for my
assistance in a dysphagia, (obstructed deglutition) with which he had
been for ten or twelve months afflicted. At first the complaint was slight,
and occurred only when he attempted to swallow dry and hard sub-
stances; it afterwards extended to solids of every kind; and at the time
I first saw him, though still able to pass down liquids, the quantity he
could swallow was not sufficient for his nutrition, and he was considerably
CHAP. XIX.
382 CASE S OF IN J U RY
CHAP. XIX.
If the intestines are so contrived as to give a special
form to their contents previous to their expulsion,
such construction must be for the realisation of some
purpose, for the development of some conditions:
reduced. On the introduction of a bougee into the gullet, it passed about
two inches easily, but then met with an obstruction, which by a moderate
pressure was overcome. It then passed easily seven or eight inches more,
but experienced a firm fesistance in the lower part of the tube, towards
its termination in the cardia, which the skill and patience of Mr Park
could not surmount, and which finally baffled every resource of his art.
The obstruction doubtless proceeded from a schirrous tumour, gradually
increasing, which at first diminished the passage, and in the end obstructed
it wholly. Mr M. never had any considerable pain from the pressure of
the bougee on the tumour, and though he expectorated (if the expression
may be used) much mucus, there never was any purulence discharged, or
any reason to believe that the tumour had ulcerated.
“The last time Mr M. Swallowed in any quantity, was on the 17th of
October. On the evening of that day a sudden increase of the obstruc-
tion came on, and from this time forth he was able to swallow only a
table spoonful of liquid at a time, and with long intervals. It was with
difficulty that he got down seven or eight spoonfuls of strong soup in the
day, and this quantity gradually diminished. On the 1st of November,
the passage seemed wholly obstructed. As he wasted rapidly, we were
obliged, from the 18th of October, to employ the subsidiary modes of
nutrition, and he went into the tepid milk and water bath, and had a
nutritive clyster administered once a day.
“As Mr M. himself was far from despairing of his recovery to the last,
the affectionate friends around him did not wish him to be informed
of his real situation. Jºſe continued, therefore, to swallow two or three
table spoonfuls of milk daily, till about the 15th of Nov., on the suppo-
sition that some might pass; but though it rested in the Cesophagus some
time, it was constantly ejected at last; and being fatigued by this expecto-
ration, which disturbed his rest, and by which he perceived that the whole
of the milk was thrown up, for the last twenty days of his life he made no
attempt to swallow, but contented himself with washing his mouth and
fauces with wine and water.
“Mr M.'s friends, though they could not but foresee the issue of his case
after all attempts to remove the obstruction had failed, yet desired that
his life might be prolonged to the uttermost. The following plan was
therefore adopted with this view, on the last days of October, and it was
persevered in with the variations afterwards to be mentioned, till the
commencement of the delirium that preceded his death. &
“Every morning at eight o'clock, he had a clyster, consisting of eight
FROM PTIRGATIVES. 383
purgatives by interfering with the state of the in-
testinal tube, necessary for the production of this
special form, must, in producing a state opposed to
the natural condition, produce an interference with
ounces of strong broth, made chiefly of membramous parts of beef (being
the most nutritious, according to Dr Fordyce) into which were rubbed
two yolks of an egg, and to which were added forty drops of laudanum.
This was repeated at three in the afternoon, and again at nine in the
evening; but in the evening, instead of forty, one hundred and twenty
drops of laudanum were added, to compensate the want of an anodyne
draught, to which he had been accustomed at the hour of rest. Pre-
viously to this, however, he was placed up to the neck in a tepid bath, of
which one fourth was milk, and the rest water; the whole quantity
amounting to twenty-four gallons. The temperature was fixed at ninety-
six degrees to accomodate his sensations, and the time of immersion was
gradually prolonged from forty-five minutes to an hour. ‘.
“The size and repetition of the clysters were determined by our experi-
ence of what the rectum would retain; the laudanum being added to
increase its retention, as well as to allay irritation, and to stimulate the
living energy. In a few days the retention of the rectum improved, and
enabled us to enlarge the clysters to ten ounces of broth and three yolks
of eggs each ; to which, from the 12th of November, eight ounces of
white wine were added; the laudanum being increased to sixty drops for
each of the clysters in the day, and to one hundred and fifty, one hundred
and eighty, two hundred, and two hundred and fifty drops for the evening
clyster. Thus the whole of his nutriment for twenty-four hours consisted
of thirty ounces of broth, twenty-four ounces of wine, nine yolks of eggs,
and from two hundred and fifty to three hundred and eighty drops of
laudanum, by clyster; with what liquid might be supposed to be taken up
by the absorbents of the surface in the bath. Mr M. was very tall, and
naturally corpulent. In health he had weighed two hundred and forty
pounds. But imperfect nutrition had gradually reduced him, and at the
time of commencing this process, he only weighed one hundred and
seventy-nine pounds. On the 20th of November he was reduced to one
hundred and fifty-four pounds; on the 24th to one hundred and forty-
nine pounds. This was the last time we had an opportunity of weighing
him. He seems to have wasted about five pounds in four days, and on
the 2nd of December, when his delirium commenced, he probably weighed
one hundred and thirty-eight or one hundred and thirty-nine pounds,
having lost upwards of one hundred pounds of his original weight. He
lived till the 6th of December, but from the 2nd, the rectum no longer
retaining the clysters, they were of course omitted, as well as the bath.
“About the 25th and 26th of October, there was reason to suppose that
CHAP. XIX.
384 CASES OF INJURY
CHAP. XIX.
the realization of the purpose, with the development
of the conditions; and hence purgatives must be
injurious.
May not the regular movements of the intestinal
clock be as essential to the life time, as the regular
movements of the chronometer to the correct ex-
pression of the diurnal time !
Whatever may be the answer to this question, no
doubt can exist that the alteration, by purgatives, of
the natural faecal form must be injurious.
Mr M. would have had a shorter date. He had swallowed a very small
portion of nutriment for the preceding eight days, and the plan of nu-
trition just mentioned, though adopted in part, was not fully established.
His tongue and lips were at this time become dry; a blister applied to
the sternum, discharged a thick coagulated lymph only; and his urine,
reduced to a few ounces in the twenty-four hours, was become extremely
high coloured, and almost intolerably pungent. In a few days however
this state of the tongue went off; the skin became perfectly soft, and was
often covered with a very gentle perspiration; the urine flowed without
pain, and of the natural appearance, the quantity being from twenty-
four ounces to thirty-six ounces in the twenty-four hours—more than the
whole of his loss of weight in the same space of time.
“Mr M. had in general à stool after every fifth or sixth clyster, that is,
three or four times a-week. The substance of these stools was solid, and
nearly of the natural foetor, and the mass perfectly homogeneous. The
colour was lighter than natural, as in the case in obstructions of the bile
duct; their whole appearance resembling what we find in cases of dissec-
tion in the termination of the ileum or beginning of the colon, with the
exception of being much less liquid. The concoction of the faeces, if I
may so speak, was much more perfect towards the end, than at the
beginning of the period; at first they looked curdy, but at last they
approached to the natural appearance.”
The faeces, being more perfect as the use of the clysters became extended,
shows that the intestine was more and more developing its power of giving
a facal form to the contents, injected into the bowel P.
ACTIONS OF INDIVIDUAI, MEDICINES. 385
C HAPT E R XX.
On the special actions of individual medicines in regard
to Constipation.
In the seventeenth chapter, cases of cure of con- cBAP. xx.
stipation, &c., by various medicines were presented,
and therein a reference was made to the Appendix for
further illustrations as to the special action of special
medicines in reference to the cure of constipation; in
other words, the intention in the author's mind was
to present, if the phrase may be used, the special iº
constipation of each medicine : i. e., the constipation ºned.
that each medicine is capable of producing in a
healthy person; and, by consequence of the agency
of the homoeopathic law, the constipation that it will
cure in a person diseased.
On collecting together the illustrative cases, in
realizing the author's intention, it was found, that a
volume, as large as the one, of which this statement
forms part, would be required. The collection, there-
fore, is not given.
With the view, however, of showing the immensity
of evidence possessed by homoepathists, of the power
- 3 D
386 ON THE SPECIAL ACTIONS OF
CIIAP. XX.
Graphites.
of homoeopathic medicines in curing constipation, and
with the additional view of guiding investigators as
to the mode of presenting the facts they may accu-
mulate in their investigations in relation to this
subject; the facts in connexion with one medicine—
namely, graphites, are subjoined.
Similar evidences have been collected by the author
in relation to a great majority of homoeopathic me-
dicines, and should opportunity be afforded, it will
be deemed a duty” of the author to present these
evidences.
(196) FIRST SERIES, consisting merely of statements of cure
without particulars.
Confined bowels cured by graphites, Frederick
Whitehorn, p. 1786, 1843.
Confined bowels cured by graphites, Mr H., p. 36,
private case book H.
Constipation cured by graphites, Ann Sacker, page
1706.
Made bowels better than they had been for two
years by graphites, in the case of Mary Ingram,
p. 914, 1843. -
Bowels confined from childhood made, by graphites,
to act every day comfortably, in Jane Boyce, p. 118,
1848, August 22, 4|12 globules were taken.
First Series.
* It is said a duty, because the presentation of these facts affords no
pecuniary reward. Of this present work a thousand copies are published.
If they all are sold, the author will not obtain £100 for the labour and all
the time bestowed in preparing and writing this work. The bookseller
out of every hundred shillings, obtained by the sale of the work, takes.
thirty-five shillings: leaving sixty-five shillings to pay the stationer, the
printer, the bookbinder, and the engraver.
IN DIVIDUAL MEDICINES. 387
Constipation and many attendant symptoms cured CHAP. xx.
by graphites, in the case of Eliza Vicars, p. 1716, Graphites.
1848, Sept. 8. --
Constipation cured in the case of James Drewry,
May 30, 1848. Four globules of graphites each week
for two weeks: then four globules in ten days: then
four globules in twelve days.
Confined bowels in the case of Emma Igo, p. 999,
1843, cured by graphites.
Confined bowels cured in the case of Thomas
Harris, 4|12, p. 852, 1850, March 7.
Confined bowels cured in the case of James Waters,
1794, 1845, August 26.
Confined bowels relieved in the case of Maria
Alleyn, p. 22, 1845, June 20.
Constipation cured in the case of Ann Langdor,
p. 1106, August 1845. &
Constipation cured in the case of Harriet Ellson,
p. 661, 1850. Globules 8/12, taken in sixteen days,
effected the cure, Dec. 10.
Constipation cured in the case of William Joy,
p. 1029, 1848, June 20.
Constipation much benefitted in the case of Eliza
Harrold, p. 934, 1848, Oct. 19.
Constipation greatly relieved in the case of Martha
Turner, p. 1721, 1845, Dec. 2.
Constipation cured in the case of John Gardner,
p. 794, 1845, 4|12, Nov. 22.
Constipation cured in the case of William Batty,
p. 1378, 1848.
Constipation cured in the case of a patient, p. 1380,
1848, Jan. 3.
Constipation cured in the case of George Tucker,
p. 1509, 1849, March 22.
3 D 2
388 ON THE SPECIAL ACTIONS OF
CHAP. XX.
Graphites.
Constipation cured in the case of Ann Gosling,
p. 715, 1849, April 1. -
Constipation cured in the case of Elizabeth Manning,
p. 1105, 1849, July 24.
Constipation cured in the case of Sarah Lambert,
page 981, 1849, April. 8/12 in the course of three
weeks.
Constipation cured in the case of Alice Roscoe,
p. 1572, 1845, Feb. 17, 1846.
Confined bowels cured in the case of Margaret
Church, p. 876, Sept. -
Constipation cured in the case of Mary Lewis,
p. 1068, 1847, July 7.
Confined bowels cured in the case of Grace Smith,
p. 1444, Sept. 7.
Confined bowels cured in the case of Sarah Belcher,
p. 51, Feb. 17.
“Made bowels beautiful,” George Day, page 549,
March 10. 4|12.
Constipation with a desire to go and no effect, cured
in the case of Thomas Coleman, p. 433.
“Worth its weight in gold,” Isaac Messeder, (page
1162,) called July 1854. He presented an old pre-
scription which he had: it was pasted on a piece of
stiff card board for to preserve it. It was graphites
that was prescribed on the prescription.
Elizabeth Audsley, (case book 1851,) states that
her bowels are quite regular while taking the medi-
cine, (graphites,) but have become confined since
ceasing to take it. **
INDIVIDUAL MEDICINES. 389
(197) SECOND SERIES, containing some concomitant symptoms CHAP. XX.
attending the constipation.
Confined bowels with crusts on face, produced by iºnise
the application of oil to an erysipelatous surface of the
face, cured by graphites, in the case of Anne Guenni-Graphites.
gault, Feb. 26, 4/12, p. 710, 1843.
Constipation with a scaly, brownish eruption, cured
by graphites, in Sarah Glover, p. 768, 1845. .
Confined bowels in combination with erysipelas,
cured by graphites, in John Langley, 4|12, p. 1221,
1844.
Confined bowels in combination with erysipelas,
cured by graphites, in the case of Lydia Wiggins,
4|12, p. 1980, 1843, Oct. 24.
Confined bowels attended with an ulcer at the toe,
cured in Margaret Catterns, p. 391, 1848.
Constipation with dry skin and an eruption on the
skin, cured by graphites, in Sarah Farmfield, p. 727,
1845, Oct. 29. This case was complicated with a
discharge from the uterus, and all the symptoms were
decidedly benefitted.
Constipation with a crustaceous eruption on the
head: the stools solid: cured by graphites, in the case
of Emma Bockett, p. 175, 1848.
Confined bowels attended with eruption, cured by
graphites, in the case of Mary Heast, page 1035,
1846.
Confined bowels attended with ulcerated leg, pains
in the ulcer, shooting like pins and needles, cured in
the case of Ann Wellby, p. 1617, 1846. The gra-
phites relieved the pains in the ulcers, Oct. 30.
Constipation attended with diseased knee, cured by
graphites, in the case of Emma Ashby, Jan. 1,
390 ON THE SPECIAL ACTIONS OF
CHAP. XX.
Graphites.
Constipation attended with large stools, headache,
with eruption on the hands, and dry skin, cured in
the case of a patient, p. 713, 1848, March 9. 4|12
effected the cure.
Confined bowels, with pain produced in the action,
with eruption on the skin, cured in the case of Eliza
Seele, p. 1446, case book 1846, May 25.
Confined bowels, with large stools, the stools caus-
ing blood, in the case of Mrs Turner, p. 1559, case
book 1847. In this case graphites and sulphur were
used alternate days.
Constipation attended with dry skin, cured by gra-
phites, in the case of Amelia Storey, p. 1599, 1845.
Confined bowels with dry skin and giddiness, so
severe as to cause the patient almost to fall, cured
by graphites, in the case of Sarah Powell, p. 1633,
Feb. 28.
Constipation attended with dry skin, cured by
graphites, in the case of John Parker, page 1360,
June 2, 1843.
Confined bowels attended with dry skin, cured by
graphites 4|12, in the case of Emma Smith, p. 1578,
case book 1845. •
Confined bowels attended with dry skin, cured by
graphites, in the case of Sarah Colebourn, page 428,
Dec. 27, 1845.
Confined bowels attended with dry skin, cured by
graphites, in the case of Louisa Howard, page 1149,
Jan. 13, 1845.
Confined bowels attended with a hot dry skin and
a desire to relieve the bowels without effect cured, in
the case of Mary Wiltsher, p. 1803, July 20, 1847.
Confined bowels with dry skin and great depression
of spirits, were cured, in the case of Hannah Clark,
INDIVIDUAL MEDICINES. 391
p. 378, July 28. The graphites had a remarkably chap. xx.
beneficial effect on the depressed spirits.
Confined bowels and great mental distress were Graphites.
cured by graphites in the case of Wm Knight, page
952, Aug. 14, 1847. 8/12 globules were taken in
sixteen days. .
Confined bowels with great depression of spirits
cured, in the case of John Day, p. 547, July 28, 1846.
(198) THIRD SERIES, containing cases having symptoms in Third Series.
connealion with the character of the constipation.
Bowels confined habitually, stools large, dreadful Graphites.
pain in passing the stool, causing blood to be dis-
charged, the pain continuing the whole day after.
Martha Jolliffe, p. 920, 1847, graphites cured.
Bowels which acted once in two days and caused
pain in the action, graphites taken caused them to
act every day, and without hurting. Henry Wells,
page 1594, Oct. 12, 1849.
Constipation attended with dry skin, and with the
skin of the face as if varnish had been put on it and
dried on it, attended with an inability to hold water,
was cured by graphites, in the case of Mary A. Gale,
3|12 repeated twice, p. 507, Aug. 2, 1846.
Constipation attended with hard and large stools,
the actions taking place every third day: after taking
graphites for a week, the actions became less large,
less hard, and act every day, in the case of John
Dobson, p. 521, Nov. 20, 1844.
Confined bowels with large stools cured, in the case
of Ann Burlisen, p. 53, Feb. 6.
Constipation attended with blood on the passing
of stool, in the case of a patient, p. 1311, May 9, 3/12.
392 ON THE SPECIAL ACTIONS OF
CHAP. XX.
Graphites.
Stools confined, attended with pain, cured, in the
case of Ann Sofe, p. 1615, April 7.
Confined bowels with large stools, causing pain in
the action, relieved, in the case of James Robertson,
p. 1340, June 9, 1847, 4|12.
Constipation with pain at gut cured, in the case of
George Adamson, p. 56, Oct. 24, 1843.
Constipation with large stools, attended with pain
in the passing, dry skin, the bowels were made
regular and free of pain by graphites, in a patient,
p. 1709, Sept. 2, 1845.
Confined bowels, the stools large, cured, in the case
of Richard Bastem, p. 301, case book 1847, 8/12
taken in a fortnight effected the cure. Nov. 12.
Confined bowels with stools of great size, p. 1615,
1846. Cecilia Wagg, March 11, 1846, 8|12 taken
in the course of sixteen days, realized the benefit,
Confined bowels with large stools cured, in the case
of Mary Evans, p. 601, Feb. 26, 1846, 8|12 globules
effected the cure in sixteen days.
Confined bowels with large stools and pain at the
bottom of the belly at the monthly period, graphites
afforded great relief. Mary Booth, p. 919, Oct. 19,
1846. -
Confined bowels with actions which hurt cured, in
the case of M. A. Fox.
tºmsºmºsº
(199) Cases illustrative of each series.
Ann West, (page 1787, case book 1850,) single,
aged 28. She consulted me Oct. 18, 1850, for a rash
at the bends of the arms, a rash on the ears and
behind the ears. The surface, affected with the
eruption, burns and discharges a watery-like fluid :
INDIVIDUAL MEDICINES. 393
she has sinking at the pit of the stomach, and great
heaviness. Her bowels are confined, and she is
obliged continually to take medicine on account of
the inaction of the bowels. Her skin is dry : her
feet are like ice. She has some leucorrhoea.
Ordered graphites 4|12, to be taken in the course of
the week.
Oct. 25.—Her rash is better. The bowels are quite
regular.
(200) Mrs M., consulted me in the month of June,
the 12th.
Seventeen years since she had a blow which has
developed a diseased breast, for which, during the few
last weeks, she has been applying plasters of different
kinds. - +
She has, in addition to the breast symptoms, the
following: headache at the temples, which headache
is most intense at the monthly period: her food lies
heavy at the pit of the stomach: her bowels are
costive, acting every third or fourth day: her skin
is dry.
Ordered graphites 4|12.
June 19.—The pain of the temple has been felt
just on going to sleep, but has ceased the last two
days: the food still lies heavy: the bowels are regular,
having acted every day, which has not occurred before
for years: skin still dry.
Ordered graphites. -
June 26.-The headache is still better: the food
lies lighter: the bowels are still regular : the skin
has improved. -
Ordered graphites, and she was cured.
*stºmsºmºsº
CHAP. XX,
Graphites.
3 E
394 ON THE SPECIAL ACTIONS OF
CHAP. XX.
Graphites.
(201) Ann Tritton, (page 1553, 1845, Feb. 1848,)
aged 21, single. She has suffered much from headache
with giddiness: great weight over the eyes: she has
dryness of her hands. She has confined bowels with
which she has been troubled for a long time.
Ordered graphites, April 25, 1845.
May 16.—Her head is much better: the dryness of
skin is lessened: her bowels act quite well. -
(202) W. Currie, aged 3, (p. 349, 1847,) consulted me
June 1847. He has had an eruption on his chin for
a fortnight, attended with much discharge : he rubs
his chin: he sweats in his head: his bowels are con-
fined. Sulphur was given for the first three weeks
with great benefit to the skin disease; but as his
bowels became more and more confined, acting once
in three days, his skin dry, and the stools large, gra-
phites 3|12, was ordered on July 6. On July 13, his
bowels acted every other day: his skin is still dry.
Ordered graphites.
July 20–His bowels act better. Ordered graphites
in less dose. He was cured.
**-*
(203) Elizabeth Coxe, aged 29, married, (p. 120,
1843,) consulted me 14th August, 1847.
She has much water fluid which comes off the
stomach by retching. The fluid is sour. She has
pain in her back. The bowels are bound: the stools
are large: the skin is dry. Ordered graphites 4|12.
August 21.—No more fluid has risen : the bowels
act very well. Ordered graphites in less doses.
Sept. 4.—No water rises: the back is well: the
bowels act well.
INDIVIDUAL MEDICINES. 395
(204.) Ann White, (p. 1787, 1849,) aged 40, married, cHAP. xx.
never pregnant. This patient had violent shooting, Graphites.
darting pains in the face and the teeth, extending to
the right ear. The head is affected by the pain. The
pain comes on when she gets warm, and is relieved by
the cold. She has taken blue pill for it. I ordered
aurum which, after an aggravation, cured the pains,
but left her with bowels confined: the actions large,
and skin dry.
Ordered graphites.
Her bowels became quite regular.
(205) Mary Read, aged 23, single, (p. 1321, 1846,)
suffers from palpitation, brought on by having been
frightened: food taken produces very uncomfortable
sensations at the left side. She has much beating in
the head. Her bowels are confined: her feet are very
cold. This was March 21. Ordered graphites.
March 20.-Her chest is better: her feet are less
cold: bowels less confined. Ordered graphites.
April 6.—Her chest is much better : her appetite
is better : feet less cold. Her bowels act regular.
(206) M. A. Williams, (p. 1715, 1849,) aged 54. She
has (March 14) an eruption on the head, which came
after using bear's grease. She has a dreadful oppres-
sion at the nose as if she should suffocate: she can
scarcely breathe through the nose: she spits lumps
of offensive phlegm from the nose. Her bowels are
confined: her skin is dry. Ordered graphites.
March 31.-She can now breathe through the nose:
the offensiveness of the sputa is lessened. Her bowels
act comfortable.
396 ON THE SPECIAL ACTIONS OF
CHAP. XX,
Graphites.
((207) Frederick Coster, (p. 1315, case book 1851,)
married. He consulted me Feb. 3, 1851. He has
a boil at his jaw, which is much swollen: the pain is
drawing and very severe. His appetite is very bad:
his bowels act once a day, but are confined.
Ordered hepar sulphurs internally with hepar sul-
phurs drops externally. -
Feb. 8,--The boil broke and discharged on Tuesday.
He has a bitter taste in his mouth. His skin is dry.
His bowels act now once in two days.
Ordered graphites.
He became well and regularity of action was
established in connexion with the bowels.
(208) Mr G. states that one globule of graphites
always cures constipation of his bowels. It produces a
feeling as if the bowels would be relaxed: it does not
relax, but produces a comfortable stool.
(209) Ann Thomas, (p. 1523, case book 1849).
This patient has the bowels very confined: she has
pain across the belly and across the back: her legs,
feet, and hands swell: she feels pain when standing
upright: her feet are dry at night and burn in the
morning, at which latter time she feels lowness of
spirits: her hair comes out: her breasts swell.
Graphites 4|12, to be taken in the course of a
week, was prescribed, and her bowels became regular.
(210) Mary Lee, (p. 1012, case book 1850).
This patient was labouring under bronchitic disease
and under enlargement of the belly. She had been
a patient at the Dispensary for Diseases of the Lungs,
but getting daily worse, she sought homoeopathic aid.
INDIVIDUAL MEDICINES. 397
In the course of the treatment (Sept. 11,) her CHAP. xx.
bowels became confined, and she felt as if she had Graphites.
sores inside her belly.
Ordered graphites 8/12, to be taken in four days.
Sept. 18.-The feeling of the internal sores is much
diminished, the belly enlargement has diminished,
and the bowels act regularly.
(211) Jane Peters, (page 1364, case book 1850,)
aged 36, married.
She came to be treated for lepra annularis, (ring
lepra,) with which she had been affected from child-
hood: she has confined bowels, an action taking
place about once in five days: she has had no monthly
discharge since her confinement, three months since:
the eruption itches and burns.
Graphites 4|12, to be taken during the week.
This was ordered on December 14. On Decem-
ber 21, 1850, the bowels became quite regular and
the monthly period came on profuse and black.
(212) Mary Frances, aged 45, married, the mother
of three children. -
She consulted me for suffering from diseased womb,
having a purulent discharge, which disease is lessen-
ing under homoeopathic treatment. In the course of
the treatment, (December 25, 1850,) she complained
of feeling a sickness in the morning : her bowels act
once in two or three days; the actions are large, and
blood is caused by their passage.
Graphites was ordered; and, on January 13, 1851,
the purulent discharge lessened: the sickness is less-
ened: the bowels act very well: indeed, “Since the
last medicine they have not hurt me.”
398 ON THE SPECIAL ACTIONS OF
CHAP. XX,
Graphites.
(213) Wm Clark, (p. 381, case book 1850,) aged 29,
married.
This patient consulted me May 13. He complains
of headache at the back and at the top of the head;
of pain at the right side; of bad appetite; of furred
tongue; of the food lying heavy; of confined bowels,
acting once in three days, the actions are large: the
skin is dry: the water is free but thick.
Graphites was ordered.
May 20. The headache is better: the right side
pain is very much better: the appetite is much im-
proved: the tongue is cleaner: the food lies light:
the bowels are very confined, acting three times in
the week: the skin is still dry.
Graphites was ordered to be repeated.
The bowels became regular, and the patient has
since enjoyed excellent health.
(214) John James, (page 1015, case book 1850,)
aged 35, married.
This patient was under treatment for an eruptive
disease.
During the treatment his bowels became very con-
fined, the actions being very large, and causing pain
in their expulsion from their largeness and hardness:
the skin is dry.
Graphites 8|12, taken in the course of four days,
cured the constipation.
(215) George Collings, (page 487, case book 1850,)
aged 23, married.
The patient is suffering from the effects of rheu-
matic gout, with which he had been laid up five
years: he has intense pains, shooting up the shoulder
INDIVIDUAL MEDICINES. 399
to the neck: he has heat flushes, great thirst: his CHAP. xx.
feet are painful and hot: he sweats profusely when Graphites.
in bed. -
Arsenicum relieved his symptoms greatly, but his
bowels became troublesome, the actions taking place
every two days, the actions themselves large and
causing pain in their expulsion.
Graphites 4|12, taken in the course of a week,
made the bowels act comfortably.
(216) Eliza Sykes, p. 1432, case book 1848,) con-
Sulted me Nov. 22, for deafness in both ears, she
has a buzzing noise: her bowels are confined.
Ordered graphites, four globules.
Nov. 29.—Deafness a little better, the buzzing
noise still: the bowels act better.
Ordered graphites, four globules, to be taken in
the course of ten days.
Dec. 9.-Deafness still better, the buzzing noise
gone: the bowels act better.
Ordered graphites, half a globule every other day.
Dec. 27.—The deafness has ceased, the buzzing
noise also: the bowels are regular.
(217) Emma Morrison, (p. 1060, case book 1851,)
married, aged 46, mother of four children, has had one
miscarriage: she has pains in the head at the crown;
the pains affect her sight: she is violently sick: her
food lies heavy: her bowels are confined: she has
taken much purgative medicine: her monthly period
has stopped two years: she has pain at chest and at
heart, attended with fluttering and a sense of cold-
1162 SS.
Ordered graphites on January 28, 1851.
400 ON THE SPECIAL ACTIONS OF
CHAP. xx. February 11.—The pain in the head is greatly
Graphites, better: her appetite is good: her food lies light: her
bowels, she says, “act nicely once a-day.” The pain
at the chest and the heart and the fluttering sensa-
tion are better: the chilliness and sight continue.
To meet these calcarea was ordered, and she was
cured.
(218) Eliz. Day, (p. 503, case book 1851,) aged 18,
single. She consulted me January 14, 1851. She has
had pain at chest for two months: she sits much : her
breath is offensive : she has a nasty taste in the
mouth: her appetite is bad: her bowels are confined:
she has a headache at the temples: her water is free:
her monthly period is right: she has some white dis-
charge.
Ordered pulsatilla 4/12.
- January 28, 1851.-The chest pain is better: her
breath is less offensive; but she has still the nasty
taste in the mouth: her appearance is better: her
temple headache is better: her bowels are still con-
fined, acting once in two days: her skin is dry: her
lips are dry.
Ordered graphites.
February 4.—The pain at her chest has recurred,
attended with dry lips and shortness of breathing :
her bowels are less confined. *
Ordered arsenicum for the breath and the lips, to
be followed by graphites. -
February 11.—The bowels have now become re-
gular.
(219) Jane Shirtcliff, (p. 1403, case book 1851,)
aged 48, married, never pregnant, consulted me Jan 6,
IN DIVIDUAL MEDICINES. 401
1851. She has had pain at the centre of the chest CHAP. xx.
on rising ever since she had rheumatic fever four Graphites.
years since; the pain is always increased by food: her
bowels are confined, and the stools hurt in passing
being large: the skin is dry: the water scalds much
in passing: she has much white discharge: the water
has scalded her since she had the fever.
Ordered graphites.
January 13.—The bowels now act well.
Cantharis and causticum were subsequently used to
remove the scalding and other symptoms.
(220) Jane Sheen, (1141, 1851,) aged 48, a widow,
the mother of eight children. She has had two miscar-
riages. She has been treated for asthma. She con-
sulted me January 12, 1851. She complains of short
breath, of a sense of pressure on chest. When she
attempts to eat she feels as if she could not eat, because
“something seems to tie me:” cannot go up stairs.
She makes but little water: she cannot sleep at night,
she has such a sinking at her side, which is attended
with a feeling just when she is going to sleep as if
she must be suffocated. Her bowels are confined.
Ordered sambucus. Sambucus.
January 17.—Her symptoms continue: her bowels
have troubled her, acting only once in two days: her
skin is dry.
Ordered graphites.
January 23,-Her breathing is better: she has less
pressure on chest: her bowels are now regular.
Graphites,
(221) Harriet Hunt, (p. 1285, case book 1850,)
aged 42, single, consulted me Dec. 27, 1850. This pa-
tient is a martyr to toothache; when a tooth is drawn
Ö
ej IF
402 INDIVIDUAL MEDICINES.
CIHAP. XX.
Graphites.
Pulsatilla.
she is laid up for two or three or more days: her
monthly period is irregular, sometimes not occurring
under three or four months: her appetite is bad: her
tongue is furred: the food lies heavy at the chest
through to the back.
She took pulsatilla, which brought on a clotted
monthly discharge.
The bowels remaining confined, the actions being
large, hurting when they pass, the skin dry, graphites
was ordered.
On February 18, the patient consulted me, and
she was quite well, regularity in the bowels was
established.
(222) Wm Nasmyth, (p. 1175, case book 1850,)
aged 42, married. He is troubled with a stoppage in
his breath for five weeks, attended with tightness and
cough : he has severe numby pains in head and ears,
dryness in throat and pit of stomach: his tongue is
covered with a brownish white fur; he has an ob-
struction in his nostrils. He has been under the
treatment of Mr. W., who has bled him and given
him much medicine, and who told him that he had
“nervous derangement of the liver.” He became
better in the course of his homoeopathic treatment, but
in the course of the cure the bowels became confined:
the actions of the bowels were attended with the pass-
ing of blood: the skin is dry.
Ordered graphites, and the bowels became regular,
acting without pain.
*==
These are facts illustrative of graphites and its
action,
OBSTRUCTION IN THE BOWELS. 403
CHAPTER XXI.
Mechanical obstruction in the Bowels. Bodies found
in the Caecum. Case of Fistula.
It may be useful in this concluding chapter to add CHAP. xxi.
Some facts and views, which are of importance, al-
though no place could be found for them in the pre-
ceding chapters.
The vulgar phrase “open the bowels,” is one, Open the
which is so imbedded in public opinion, as to make”
it almost a necessity to realize such result by any
means and under all circumstances. The proper
means have been already detailed; but the multitude
still adhere to the belief, that some irritant to the
bowels is necessary to effect this opening.
This belief will gradually give way to more scien-.
tific views and practices dependent on such scientific
views. Still there is a class of facts, which on the
minds most biassed in reference to the forcing the
bowels to act, will exercise an influence. Such facts Bowels inact-
are those where the bowels have been confined, whereº."
efforts have been made to open the bowels, and where.”
it has been found, that mechanical impediments, and,
3 F 2
404 MIECHANICAL OBSTRUCTION
CHAP. XXI.
in many cases, obstruction from a growth extending
across the intestine, caused the non-expulsion of the
faeces.
In such cases, the most violent bigot in favour of
purging will acknowledge the injury of forcing the
bowels; and, if, in such cases, the practice is absurd,
why should not some hesitancy be felt in forcing the
bowels to act in other cases, since, in obstinate con-
stipation, such obstruction may perchance exist: and
more particularly, since, in every case where the most
obstimate constipation exists, independent of mecha-
nical obstruction, a cure can be effected without the
use of purgatives.
The subjoined cases will illustrate constipation from
mechanical obstruction; will show the injury the pur-
gatives administered, produced; and will demonstrate
Case by
Dr Hocken.
their inefficiency.
“Case of immense accumulation of indurated faces in the rectum, and
complete suppression of the alvine evacuations for a month, by
EDWARD HOCKEN, M. D.—Lancel, p. 326, vol. 2, 1844.
“The patient was first seen on the 10th of June, 1844. She was much
emaciated and exhausted; the pulse 136 in the minute, and very feeble.
Complaints were made of severe agony in the rectum and lower part of
the belly, which latter was distended, firm, and highly intolerant of
pressure, no faces had been passed for a month; and injections which had
been frequently used, came away only slightly coloured. Food was re-
jected, by vomiting, a few minutes after it was swallowed, and even
liquids rarely remained on the stomach. The vomited matters had been
dark and offensive some few weeks previously, and during the course of
the complaint there had been an offensive discharge from the vagina.”
Dr Hocken did what most medical men of the old
school would have done, namely, gave purgatives.
What was the result
“There were frequent efforts to go to stool, from the exhibition of pur-
gatives, which occasioned the most frightful agony, and eversion of the
mucous membrane through the sphincter. On examination, the rectum
was found to be completely blocked up, and enormously distended by
IN THE BOWELS. 405
indurated faces to within an inch of the anus, bulging into and nearly CHAP. xxi.
obliterating the vagina.”
The most frightful agony was caused, Dr Hocken
acknowledges, by the purgatives.
“History.—Three months before, the patient fell over a tray whilst
nursing an infant, by which her thighs were widely and violently sepa-
rated. The accident occasioned much pain, followed by memorrhagia,
constipation, and the formation of indurated lumps, which were passed
with much pain and difficulty. This increased till about a month ago,
(from June 10th,) since which there has not been the slightest alvine
evacuation per rectum. During her illness she has been attended by
several medical men, some of whom attributed the symptoms to ‘cancer,’
and others to a tumour pressing upon and obliterating the rectum. Pre-
parations of opium had been used generally and locally; frequent ene-
mata, and occasional purgatives.
“June 11th.--The patient, who was almost incapable of standing from
weakness, was placed at the foot of the bed, her feet on the ground,
and the trunk of the body at right angles with the thighs, lying on the
bed. By means of a lithotomy scoop and the finger, the indurated mass
was broken down and removed portion after portion; some of these lumps
of about three inches in diameter, which had been placed transversely
in the rectum—until the gut was emptied, as far as could be felt. It was
then washed out by a powerful stream of water from a syringe. The
portions brought away were very considerable in quantity, of a most
firm and unyielding description, and of a dark brown colour. It required
very considerable force to remove some of these masses, so that the
sphincter was slightly ruptured at its posterior part, and the patient suf-
fered much pain from the operation. Half-ounce doses of castor oil,
with five minims of liquor opii sedativ., were ordered every three hours,
and simple enemata, with olive oil, every four hours. In the evening,
the patient appeared much improved, and brought off a considerable
quantity of dark liquid faeces, with numerous indurated lumps, appa-
rently moulded in the cells of the colon; abdomen very intolerant of
pressure. A flannel wrung out in hot water, and then saturated with
purified oil of turpentine, to be applied, and to continue as before.
About forty masses of indurated faeces were passed with the motions, the
following day.”
This case shows the absurdity of the use of purga-
tives. The obstruction was mechanical, and required
mechanical means for the removal. When the me-
chanical obstruction was removed, the patient was
treated, as recorded, with castor oil, &c. and she
406 MECHANICAL OBSTRUCTION
CHAP. XXI.
Case by Dr
James John-
SOIl.
was not cured till the beginning of September: in
fact, she was not cured then. Had she used the ap-
propriate homoeopathic remedial agent or agents, her
bowels would have been regular in the course of a
fortnight.
Dr James Johnson related, at a meeting of the
Westminster Medical Society, Nov. 5, 1842, the fol-
lowing case, where the bowels did not act for forty-
nine days:—
“Dr James Johnson related the following case, which had terminated
fatally that day. The patient, a medical man, about forty-five years of
age, had resided in London about eighteen months, with the intention of
practising there instead of in the country. Until forty-five days ago he
suffered only from occasional spasms of the bowels, the spasms have
nothing peculiar in them. His bowels were regular. During the last
forty-five days of his life there was no evacuation whatever from the
bowels, although every means had been resorted to by Mr Lane and
Dr Sims to produce such action. About a fortnight before death he
(Dr Johnson) joined in consultation. The patient had then severe
spasmodic pains in the abdomen, with almost constant vomiting. His
stomach seldom retained anything, the ingesta being either brought up
immediately, or two or three hours after being swallowed. None of the
matter, however, vomited up, exhibited the slightest stercoraceous cha-
racter. To afford relief croton-oil, bleeding, and croton-oil injections
were used, among other means, and Dr O’Beirne's tube, which, however,
could not be passed up any distance, and seldom more than half a
pint of fluid, and never more than a pint, could be injected. During
the whole of this time the distension of the bowels increased, and
his extreme sufferings were only occasionally relieved by the internal
use of opium and by opiate frictions over the abdomen. Five days before
death, at his own urgent request, half a pound of fluid mercury was
administered to him. This produced no perceptible effect at the time, but
the next day he was seized with spasms in the abdomen. The constipation
remained. On one occasion his agony from the distended abdomen was
so great that he begged it might be punctured to give him relief. He
died on that morning at eight o'clock, and at four in the afternoon of the
same day the body was examined. The tympanitis was enormous. On
opening the abdomen there were scarcely any signs of inflammation having
existed; there was no effusion, and the convolutions of the intestines were
not adherent to each other. The dilatation of the intestines was very
great; the colon was as large as the colon of a horse, and the other intes-
tines were of proportionate magnitude. The diaphragm was thurst up to
IN THE BOWELS. 407
a remarkable height, and the stomach was so contracted that it was dis-
covered with difficulty. The gall-bladder contained a few fluid drachms
of bile. On following the intestines nothing was discoverable but wind.
Not the slightest trace of the quicksilver which had been swallowed five
days before could be seen, but in the sigmoid flexure of the colon was a
dark, tarry-like substance, having a very peculiar odour, but neither in
appearance nor in smell like a facal collection. No globules of mercury
could be detected in it. The cause of the obstruction was found at the
junction of the sigmoid flexure with the rectum, in which situation was a
dense white scirrhus, surrounding the intestines for the space of three-
quarters of an inch, and so completely closing the passage, that although
the colon above was enormously distended with flatus, not the smallest
quantity of air could be made to pass the stricture. The case was re-
markable from the cause of the forty-five days constipation being disease.
When constipation was a habit the bowels might be inactive for a longer
period, but he (Dr J.) had never before known such protracted constipa-
tion dependent on disease. The longest period under such circumstances,
that he had witnessed, was eighteen or twenty days at most. It was
curious that no sign of the quicksilver beside that mentioned could be
discovered. He suspected that during the five days that the mercury was
in the intestines it had been converted by their convulsive action into the
ointment-like substance referred to. It was also singular that the mer-
cury produced no effect on the mouth or breath. Another remarkable
circumstance was the absence of difficulty in passing the motions wntil the
setting in of the constipation. The scirrhus must have been going on for
years. How could we explain the sudden and permanent closure of the
intestine?”—Lancet, p. 327, vol. 1, 1842-3.
Dr Johnson remarks as a noticeable circumstance,
that there was no difficulty in passing the motions
until the setting in of the constipation. It is notice-
able, and seems to prove that the very means resorted
to by Mr Lane and Dr Sims, caused an inflammation
which ended in the closure of the gut. But even
supposing that this were not the case ; the absurdity
of giving purgatives to force the bowels, when there
was a mechanical obstruction to prevent the passage
of the contents, is apparent: irritation, excessive irri-
tation, was added to the primary difficulty.
The absurdity of giving purgatives in cases of ob-
stimate constipation, is further evidenced by a case
related by Dr Reid, at the same Society:—
CHAP. XXI.
408 MECHANI CAI, OBSTRUCTION
CFIAP. XXI.
Case by
l)r Reid.
Case by
Mr Wallis.
“Dr Reid recollected a curious case which was in St. Giles's Infirmary
Some time since. The patient, when brought in, was almost pulseless, and
his skin cold, and he suffered much from dyspnoea. He complained of
pain over the lower part of the abdomen, which was not tympanitic.
Constipation had continued for three or four days. There was no sign of
a hernia. All the remedies employed were of no effect. Up to the
nineteenth day he rejected all he took, when the sickness gave way after
a three-drop dose of croton-oil. On the twenty-first day there was a very
copious fæcal evacuation, the discharge at first consisting of hardened
scybalae, but becoming, subsequently, of the natural consistence.”
Another case, published by Mr Wallis, of Castle
Cary, where the patient's bowels did not act for forty-
three days, has interest, as showing the absurdity of
administering purgatives:—
“On the evening of the 23rd of April, my attendance was requested on
a married lady, forty-seven years of age, who stated that for five previous
days no evacuation had taken place from the bowels, and as she had taken
salts and Senna without effect, she thought it right to seek medical aid,
although not suffering any further derangement of her health. Her
appetite was unimpaired, and she had neither pain nor sickness. Calomel,
castor and croton-oil, elaterium, turpentine, and, in fact, purgatives of
every kind, were administered, and (which is remarkable) uniformly re-
tained by the stomach. Injections of warm-water and the tobacco clyster, the
warm-bath, and friction to the abdomen, were used, and a bougie was also
tried, but could not be carried beyond the rectum. Although these re-
medies proved unavailing, the pain suffered by the patient was incon-
siderable, and she was able to take carriage-exercise until within two days
of her death, which took place on the thirty-eighth day of my attendance,
making (the five days previous to my seeing her included) a constipation
of forty-three days duration. -
“A post-mortem examination discovered a stricture at the junction of the
sigmoid flewure with the rectum, the large intestines being enormously
distended, and filled with faeces of a soft consistence; the colon was
gangrenous, particularly at about the transverse arch. The contraction,
which was of a circular form, and rather more than an inch in length, had
no doubt existed to a certain extent for a long time, as the bowel was
much thickened, and converted into a kind of gristly substance, its passage
being narrowed to the size of a crow-quill. All the other viscera were
normal.”—Lancet, p. 438. vol. 1, 1842-3.
It may further help to overcome the common
dogma of “open the bowels,” to bring forward some
cases, recorded in the allopathic journals, illustrative
IN THE BOWELS. 4.09
of the practice of purging in cases where the bowels
have been mechanically obstructed. The first two
occurred at Bartholomew Hospital, the third under
the care of Mr. Solly. The two first cases were read
before the Abermethian Society, Feb. 14, 1850, by
Mr R. Thompson, under the head of “Two cases of
fatal obstruction of the intestinal canal by peritoneal
bands,” and the third case was read before the Royal
Medical and Chirurgical Society on June 28, 1850.
CASE I.
CHAP. XXI.
Mary G., aged 20, single, was admitted into Faith ward, Nov. 13, 1848. ºse by Mr
A fortnight previous she was in good health, but then got wet feet, which Thompson.
checked the monthly discharge. She became very sick, vomiting every
thing she took, and complained of a very severe griping pain in the region
of the navel : she had shivers followed by great heat of skin. The second
day of the seizure she sought the advice of a chemist, who had audacity
enough to give it. She vomited his medicine, and all the food she took.
She then obtained the advice of a medical man. She was relieved, went
out walking, and the same night the belly pain and the vomiting came on
with increased severity. She was bled, had leeches and fomentations to
the belly, with some relief. She has taken frequently aperient medicines,
and injections have been administered, seven or eight times, without the
desired effect.
When she was admitted into the hospital—
“Face dusky : eyes sunken, with livid areolae around them; skin warm
and dry; pulse 120, Small, and rather sharp; lips dry; gums rather
vascular; slight sordes about the teeth; tongue moist, coated on its back
part with very thick brown fur; clean at the edges. Bowels have not
been open for seven days. Urine is said to be scanty, high-coloured, and
depositing a thick sediment. Catamenia regular.
“Complains of slight vertigo, and of nausea when she lies on the back.
The abdomen is distended; generally dull on percussion; intolerant of
pressure, especially in the umbilical region.”
She was again bled to 12 oz. ; twelve leeches were applied to the belly,
and then a poultice; a soap injection was given; calomel, ten grains at
once; and effervescing draughts, with one drachm of sulphate of magnesia
every sixth hour.
Nov. 14.—The patient was worse: she vomits faecal matter; pulse 120;
belly very swollen and very sensitive to pressure.
She continued the draughts, and calomel three grains every sixth hour:
she repeated the injections, and formentations were applied to the belly.
Nov. 16.-All nourishment given by the mouth is quickly returned;
3 G
410 MECHANICAL OBSTRUCTION
CHAP, XXI.
Mechanical
obstruction.
Case by Mr
Thompson.
the faecal vomiting continues; complains “as if something alive were
moving” in her belly; belly more distended and prominent, particularly
at left side of navel.
Ordered draughts with ten drops of laudanum added to each ; pills;
also brandy, 2 oz. ; beef tea for injection, two pints.
She rapidly became worse, the vomiting of faecal matter continuing ;
became delirious, and died on the 18th.
On examining her after death—
“The transverse portion of the colon was drawn down within the right
ăliac region, by a short narrow band proceeding from its lower border,
and attached to the spine by means of the portion of mesentery corres-
ponding to the last part of the small intestine. This band passed in front
of the small intestine about an inch before its termination in the calcum,
compressing it against the spine, and constricting it so as to render it
IMPERVIOUS. The mesentery immediately surrounding the constricted
part was inflamed, thickened, and matted around the intestine.
“The entire length of the small intestine, as far as the constriction,
was filled with liquid bilious matter, such as had been vomited during
life. The mucows membrane was reddened and Swollem in the neighbour-
hood of most of Peyer's patches, the individual glandules of which had
burst, leaving spaces surrounded by a thickened border of mucous mem-
brane. Each Peyer's patch thus presented a broad oval surface, the
mucous membrane of which appeared worm-eaten, and as if irregularly
removed by ulceration.
“Here and there a swollen red solitary gland was seen. As the Small
intestine approached the seat of constriction, it became very vascular, and
presented discoloured streaks and spots, as if from commencing slowghs.
The piece of small intestine between the constriction and the caecum was
pale and contracted, and its mucous membrane irregularly w!cerated.”
CASE II.
Hannah R., aged 23, married, mother of four children; the last con-
finement being premature at the seventh month; since then she has never
been well, suffering from troublesome constipation, for which she has had
medical advice. The last three months the constipation has been worse,
and the evacuations of unusually small calibre; the bowels were open last
after three days constipation, four days before entering the hospital; on
the day following the action she complained of great pain in the belly,
and ſaecal vomiting took place.
“Since that day she has taken various aperient medicines; but the
constipation, stercoraceous vomiting, and abdominal pain, continue un-
abated. Several enemata have been administered, and returned un-
changed.”
When admitted to the hospital, on Feb. 7, 1850—
“Face very dusky and flushed; eyes dull, sunken, and surrounded by
dark livid areolae; skin cold, moist, and clammy; pulse 140-50, very
IN THE BOWELS. - 411
small and thready, at times barely perceptible; lips dry and fissured; CHAP. XXI.
tongue dry, coated with thick dirty white fur; bowels last open four days
ago, but scantily; respiration natural, about 25.
“She complains of pain from the most gentle pressure on any part of
the abdomen, but especially in the hypogastric and iliac regions; the
abdomen does not appear distended, and is generally soft, except about
the umbilical region, where it is rather tense; there exists tympanitic
resonance on percussion over the course of the colon, and in the epigas-Mechanical
trium, but marked dullness in the umbilical and hypogastric regions, obstruction.
The patient is very restless; appears to lie indifferently on the back or
either side, keeping the knees slightly drawn up. Complains of pain about
the hypogastrium, and of constant nausea; vomits occasionally a light-
coloured frothy fluid, having an appearance like working yeast, and of a
decidedly feculent odour.
“An elastic tube was introduced for some eight or ten inches by the
rectum, and copious enemata administered. It was determined in con-
Sultation that no operative proceeding was justifiable; and the patient
was ordered wine, brandy, and beef-tea ad libitum, and to have large
enemata
“Feb. 8, 1 P.M.–She appears almost comatose, and fast dying; since
11 P.M. last night, she has taken four half-drachm doses of laudanum, to
quiet the pain and restlessness, and has swallowed brandy and wine pretty
freely; has vomited occasionally ; abdomen more full, but soft; enemata
came away unchanged: died at 4 P.M.
“The greater part of the small intestine was of a deep red colour, very
much distended in the upper part, and contracted below; about two feet
of its length appeared more distended, and of a darker colour, than the
rest of the intestine, almost black, or dark claret-coloured : in the middle
of this dark part was an ash-coloured slough, about three inches long,
with well defined margin; the extremities of this congested fold of intes-
tine were tightly girt by a firm band passing from the surface of another
portion of intestine of the mesentery at the point of constriction; this
band was very strong, and firmly attached at both its extremities.
“The contents of the strangulated portion of intestine gave to the
finger the Sensation of hardened facal matter, which was found to be
caused, however, by the congestion and enlargement of the valvulae con-
7vivenţes.
“In the two cases which I have related, there was no evidence of former
peritoneal mischief; indeed, from patients of this class it is always diffi-
cult to get a clear account of their ailments; it is curious that in both
instances it was carefully observed that the abnormal band forming the
constriction was the only one discovered of any strength or consistence,
which seems to disprove the inflammatory origin of the bands, and raise
a suspicion of their being congenital. Rokitansky mentions the frequent
congenital occurrence of unusual length of the duplicatures of the peri-
toneum, or of supernumerary folds and pouches of that membrane; these
3 G 2
412 MECHANICAI, OBSTRUCTION
CHAP. XXI.
Case by
Mr Solly.
pouches are chiefly found, he says, in the hypogastric, and more especially
in the iliac and inguinal regions, and about the fundus vesicae; and com-
municate with the peritoneal cavity by a well-defined fissure or ring, which
is frequently surrounded by a tendinous band, lying in the duplicature.”
CASE III.
Is that of a young man aged 21. Ten days previously to Mr. Solly
seeing him he had obSTINATE constipATION, for which he took STRONG
aperient medicine: this acting, caused much pain, and left considerable
irritation of the bowels, which lasted for some days, the evacuations being
tinged with blood. Three days before Mr. Solly saw him he walked
fifteen miles: this was on the Sunday. On Tuesday evening he made a
full supper of stewed beef: on Wednesday morning he ate to excess of
the same; at half past 8, when ascending the steps of his house, he was
seized with a violent pain in his belly, having at that time a swelling in
his groin. The pain was so severe as to oblige him to ride to the city.
When arriving there he was deadly pale and his lips blue with pain: he
then passed some faeces and noticed the swelling in the groin : this was a
hernia, which could not be returned though ice was applied and a warm
bath was used. -
Mr. Solly operated. The external abdominal ring, through which the
bag (sac) containing the intestine passed, was very tight and was divided;
but as the intestine was not thus released from its strangulated State the
sac was opened, and a portion of intestine in the sac was of a rather dark
colour and another portion almost healthy, the internal ring was then
divided, and the intestine was returned without difficulty in the belly.
The patient died : after death, “about a foot and a half of small intestine,
enormously distended, and nearly black, lying in the pelvis, was found;
on raising this, it was found girt by a band about an inch and a half long,
which was connected with the caecum on the one side, and with the peri-
tonaeum covering the iliacus internus muscle, close to the internal abdo-
minal ring, on the other; this band was round and firm, and seemed to
be either one of those bands of old adhesive inflammation which are
occasionally met with in the abdomen, or the remains of the omphalo-
mesenteric duct.”
Mr. Solly added, “it must have existed a long time. It was not so
tight as to have strangulated the intestine in its undisturbed condition.”
Little doubt can exist that the death of this young
man was caused by the irritation from the strong
aperient medicine, causing inflammation of the gut ;
and then the overloading of the gut by the excessive
eating, caused the development of the dormant inflam-
mation, which ended in death; for Mr. Solly states,
IN THE BOWELS. 413
the band found in the abdominal cavity was not so
tight as to have strangulated the intestine in its
undisturbed condition.
These cases are full of interest and of instruction.
Thus in two of these cases, though the patients
vomited all they took, the hospital surgeons gave food
continually, and poured down their calomel and effer-
Vescing draughts. The stomach rejecting every thing
one would have thought ought to have told them to
have given nothing ; but they listen not to such
speaking to them by nature: they say the patient
must have nourishment, forgetting that for food to be
nourishment the stomach must digest it.
Again, supposing the patient retained the medicine,
the result must have been to have carried the poison
through the intestinal tube to the part where the
stoppage existed, where the medicines taken, pro-
ducing perpetual irritation, must cause inflammation.
The unwiseness of the practice of giving purgatives
to remove constipation, as connected with mechanical
obstruction, is exhibited in cases of intestimal obstruc-
tion, by Benjamin Phillips, Esq., F.R.S., Surgeon to
the Westminster Hospital, in the Medical Gazette,
page 233, vol. 47. As the writer well observes,
“The following cases of intestinal obstruction are
recorded for the purpose of illustrating the difficulties
of the diagnosis of the causes of the mischief.”
The cases are very instructive: they will reward
a careful perusal to the professional and to the non-
professional reader : to the professional, demonstrating
how fatal complaints are often not indicated by any
great severity of symptoms; and to the non-profes-
sional, that to expect the relief of symptoms, by using
S-- ~~~----------------,
CHAP. XXI.
414 MECHANICAL OBSTRUCTION
means merely to remove conditional and solitary”
symptoms, is absurd. Before recording the cases, the
remark may be made, that it is refreshing to read the
productions of men of experience such as is the writer
of the cases; there is a beautiful simplicity prevalent
throughout, and this is always found in ment who
occupy the position that Mr. Phillips does in the
profession.
CHAP. XXI.
Case by Ben-
jamin Phil-
lips, Esq.
• ºmºmº-º-º-º-º-º-mº
A case of Pure Ileus—Operation—Death—Post-mortem eacamination.
A. W., a cabinet maker, aged 50, applied to me under the following
circumstances: he stated that he had had a sense of pain and tightness
around the lower part of the chest, with some nausea, for several days.
The tongue was pretty clean, the pulse quiet, the bowels somewhat irre-
gular in their action. He was rather a gross feeder, but a perfectly sober
man. I ordered for him calomel and compound extract of colocynth.
Two days afterwards I saw him again, when he was somewhat relieved.
The medicine had produced three small stools on the morning after it was
taken ; nausea, and some sense of oppression about the chest were still
present. I directed him to repeat the dose, and to take a castor oil
draught in the morning.
Two days after he expressed himself as somewhat relieved, but his
discomfort was not got rid of. He had had two scanty stools from the
medicine. The tongue was clean, and the pulse was quiet. On this
occasion, upon carefully exploring the epigastrium, the hand came in
contact with a small umbilical tumour, which he said had existed long,
and was unheeded. There was no tenderness upon pressure of this
tumour, neither was there impulse communicated by coughing; the
abdomen in other respects was natural. In this state the patient con-
tinued for ten days, the bowels acting scantily when medicines were
administered by the mouth; and during that time there was no abdominal
tension or tenderness : the tongue was clean, the pulse was quiet, but the
nausea persisted.
On the afternoon of the twelfth day from my first seeing him I was
sent for in haste. I found that he had had a violent “convulsive attack,”
from which he continued to suffer for more than an hour, and that a large
stool had been passed involuntarily during this time. He was quite
* In all scientific homoeopathic treatment the whole case is treated.
# It is an interesting fact that one never finds men such as Mr. Phillips
denouncing homoeopathy. Men such as he, do not herd with the vulgar
traders in medicine.—ED. •
IN THE BOWELS. 415
recovered from the attack when I saw him. He still complained of sick-
ness, and the tongue was slightly coated, but the abdomen was perfectly
free from tympanitis or tenderness.
I now felt it my duty to ascertain whether there was any mischief at
the umbilicus. I cut down upon it, and found that the tumour which had
been observed there was formed by a small pellet of omentum, tightly
bound and adherent, but exhibiting no sign of damage from constriction.
With some difficulty I enlarged the umbilical opening, and passed my
finger into the abdomen to satisfy myself that all was free; but I could
not without more dissection than I thought prudent, return the omentum
into the abdomen. I saw him again in the evening, the sickness still
persisted, the abdomen was still flat and free from tenderness. I ordered
that he should have a castor oil enema early next morning.
When I saw him again I found that the injection had brought nothing
away with it, that the sickness still persisted, that there was a good deal
of borborygmus, that the abdomen was still flat and painless, that the
pulse was eighty, and that a great deal of water had been passed. I
ordered calomel and opium immediately, castor oil and spirits of turpentine
for an enema four hours after.
The next morning I found he had had some sleep; but the sickness
and borborygmus persisted: the abdomen was still soft and flat, and not
tender, but there had been no stool. I ordered that the calome! and
opium should be repeated. *
Ordered to have calomel every three hours, omitting the opium.
He died the next day.
The body was examined twelve hours after death. -
The abdomen was by no means tumid; the parietes were very fat.
When the flaps were laid aside, the contents of the cavity were found
well covered by omentum, in which there was much fat.
The mesentery was edged, as it were, by something which bore a con-
siderable resemblance in colour and size to a large earthworm : we found
this to be the small intestine shrunk up to the size of narrow tape, and it
had a pink colour. It was carefully followed until we arrived in the left
hypochondrium, when the shrunken character ceased, and was succeeded
by a brown dilated portion of the same tube. The point where this
sudden change took place was three feet nine inches from the duodenum.
The appearance there was not unlike that of the appendix vermiformis
and the caºcum.
A portion of intestine, including some inches above and some inches
below the shrunken portion, was removed from the cavity, examined
carefully externally, and no pathological structural change was apparent;
some water was poured into it, and the whole shrunken portion at once
resumed its ordinary diameter. The other portions of the canal, as well
as the other abdominal organs, were in a healthy state.
ºmº-º-º-º-º:
CHAP. XXI.
416 MECHANICAL OBSTRUCTION
CHAP. xxi. Obstruction dependant mainly on an abnormal direction of the intestinal
canal.
Case by Ben- E. N., aged 22, was in his usual health on Thursday. About twelve
#.".hik o'clock, as was his custom, he took some bread and cheese, of which,
pS, tuSq. particularly of the latter, he ate heartily. Not long afterwards he began
to complain of a griping pain in his stomach and bowels. He attributed
it to the cheese he had eaten : and though it recurred at short intervals,
he did not suffer it to interfere with his duties. At five o'clock, his
dinner time, he did not appear at table; he remained in his bed-room
lying down, and complaining of a great deal of pain, which he referred to
the stomach. He still said it must be the cheese which distressed him.
The medical man who saw him prescribed an emetic, but before it could
be procured he made himself sick by irritating the fauces with his finger.
He took the emetic, however, and brought up from the stomach a very
large quantity of what seemed, in great part, to be undigested cheese; he
was relieved, and it was hoped that the cause of his trouble was removed.
In half an hour, however, he complained that the pain had become much
more violent at the same spot, and it was accompanied by violent though
ineffectual efforts to vomit. The pain occurred in paroxysms, which were
succeeded by periods of perfect ease.
There was no tenderness on pressure anywhere. He could not be
made to swallow anything, because of the great irritability of his stomach.
A few grains of calomel were laid upon his tongue, but it excited new
efforts at vomiting, and the stomach could not be quieted: meanwhile the
intensity of the abdominal pains increased. He was continually turning
from side to side, occasionally writhing with agony, much in the way of a
man having violent colic. Warm formentations, and subsequently a warm
bath, were tried, but without benefit.
In an hour or two the pain became more extended; it seemed to take
the course of the descending colon, and to lessen at the point it first
occupied, as if it was occasioned by an irritant which was passing along
the large intestine. At length the pain became more fixed and con-
tinuous in the left iliac fossa, and it continued there through the remain-
ing course of the affection. A dozen leeches were applied to that point,
and an injection of forty drops of sedative liquor of opium was thrown into
the rectum. Shortly afterwards he obtained ease : the vomiting ceased,
the paroxysms of pain abated, and he fell into a quiet sleep.
On the following morning (Friday) he looked and thought himself
better. The whole abdomen was not altogether free from pain, and there
was a very slight amount of tenderness. The patient was very anxious
that the bowels should be evacuated, as he thought that then all would be
right. (How common is this idea.—J. E.) The stomach was still some-
what irritable, but he thought he could keep down some medicine. A
saline purgative draught was given, and was immediately rejected. Soon
after, upon the patient expressing his belief that he could retain pills, ten
IN THE BOWELS. 417
grains of compound extract of colocynth and a drop of croton oil were
given him, but were not long retained. By two o'clock he had become
much worse, and it was at this time I saw him. He had been vomiting
very recently, and there was increased abdominal pain. I found, dis-
tinctly marked, upon the surface of the abdomen, below the umbilicus,
the course of a coil of intestine across the abdomen, together with general
and considerable tension. The tongue was covered with a buff slimy
coat: the pulse was frequent, but compressible. -
It was determined to let the stomach be quiet, exhibiting merely a
little hydrocyanic acid: emollient injections were thrown into the intes-
time. In the evening the pain was more severe; the skin was hot, the
pulse was 112 and wiry; the tenderness in the left iliac fossa was more
acute. Blood was taken from the arm to the extent of eighteen ounces
with some relief; it had a tolerably thick buffy coat. Calomel, two
grains, opium half a grain, to be taken every three hours.
Saturday morning early, the pain became more severe, and it was more
aggravated by pressure. There was also more general distress. Thirty
leeches were applied to the abdomen, and with much, though not lasting
relief. In addition to the pills, it was now determined that mercurial
ointment thickly spread on lint should be laid over the abdomen. The
distension and pain increased: no sleep was obtained, and there was no
evacuation of the bowels.
The right side and upper region of the abdomen were now most dis-
tended; the left iliac fossa was the seat of most pain. There being no
appearance of mercurial action in the system, the calomel was increased
to three grains every three hours.
Towards evening he suddenly complained of more violent pain than he
had yet felt. The breathing was irregular, the heart's action flagged, the
pulse was extremely feeble, the temperature of the surface fell, he was
covered with cold sweat, and the patient thought himself dying: stimu-
lants were given, and he gradually rallied, but the restlessness increased.
An injection was administered, and brought away only some small pellets
of facal matter.
The night was passed with more restlessness and urgent distress. In
the morning there was a slight remission in the distress for a while, but
there was more abdominal tension; the pulse was very feeble, and often
very rapid; the tongue was dry, and slightly brown, and there was no
mercurial action set up. The day was passed much in the same state,
and the night was unpromising.
On the morning of Monday there was not much change. The day
passed much as the last, but in the evening he was much excited. There
was some delirious dreamy excitement, and the opium was suppressed
under the idea that it might be probably producing this effect.
Tuesday morning, at five o'clock, a considerable quantity of fºcal
matter was evacuated. It contained two or three hard pellets, which
resembled plum stones, and a lump or two of excessive hardness. Soon
CHAP. XXI.
3 H
418. MECHANICAL OBSTRUCTION
CHAP. XXI.
afterwards there was another small evacuation. The prostration, however,
was very great, though there was a temporary mitigation of the symptoms.
The abdomen for a while was less tumid, there was less tenderness, but
there was a failing irregular pulse. Instead of sleep there was soon more
agitation; there was more abdominal distension. The breathing was
occasionally laboured; any portion of the surface when exposed became
quickly cold. Towards night the exhaustion increased; a blackish fluid
was vomited. He died at half-past two o'clock on Wednesday morning.
Post-mortem eacamination.—The abdominal cavity alone was examined.
On exposing the contained viscera, the small intestines were observed to
be distended to nearly twice their natural diameter throughout their
entire length, with the exception of the last inch or two of the ileum.
They were universally inflamed and glued together by recent lymph.
The omentum was spread out as usual over the small intestines, but at its
lower part it was drawn into a band of about two inches in width. This
band of omentum passed down in front, then under and behind the ileum,
close to its termination in the large intestine. The band then became
adherent to the posterior layer of the mesentery, and to the posterior
abdominal wall. Thus a partial stricture was formed on the ileum within
an inch of its termination. On one side of the constricting band the
intestine was distended, on the other it was not of its natural size. The
constricted portion of the intestine was neither thickened nor sloughy. It
was inflamed, and adherent to the band of omentum by recent lymph, and
would readily have admitted of the passage of the finger. The appendix
caci vermiformis was longer than natural, about five inches in length, and
one-third of an inch in diameter. When laid open and spread out it
measured an inch in width. -
The first three inches of this large appendix formed several doublings
or convolutions, which were connected to each other and the coats of the
cacum by five old adhesions, the last two inches of the appendix being
alone free. This free portion was situated just below the constricted
ileum; it was sphacelated, and contained two little oval bodies, resem-
bling in form and colour small cherry stones, but which on being broken
proved to be calcareous concretions. Below the constricted ileum and
loose sphacelated appendix was situated another fold of intestine adherent
to the cascum. This was found to be the sigmoid flexure of the colon,
which was traced from the left side across the upper part of the sacrum,
to the right iliac fossa. Here attaching itself to the caecum, it was
reflected upon itself to the centre of the sacrum, the two folds being
adherent. From thence it passed downwards to form the rectum.
* *
Partial Obstruction dependent probably upon Adhesion.
Augusta Barrett, aged 50, was admitted into Sanctuary Ward, suffering
from abdominal pain. She stated, that five days before, while reaching
for something from a clothes line, she felt something give way in the
IN THE BOWELS. 419
groin, and she found a swelling there. A year before a tumour some-
what similar was observed there, but after a time, and the use of fric-
tions, it subsided. At that time the bowels were for two or three days
obstinately confined, and since that time they have been occasionally
troublesome. At the latter end of December they were confined, but
they were made to act on the twenty-ninth : they were not again opened
until the first of January, the day on which she “over-reached” herself.
From that time until the time of her admission the bowels-had not been
relieved.
She was admitted at eleven o’clock, A.M. Her countenance was
anxious, pale, and dejected: her tongue was dry and brown : her skin
hot and parched : respiration hurried: pulse ninety. There was a pros-
trating pain in the abdomen, increased by pressure, and there was frequent
vomiting of a green bilious matter. *
There was an oblong irregular tumour in the right groin, which felt
like an omental hernia. It could not be reduced upon pressure, nor was
any impulse communicated to it by coughing. The taxis was carefully
applied to it, but it was not reduced. Her condition did not admit of
delay. A consultation was held, and although there was some difference
about the seat of protrusion, there was none as to the necessity of imme-
diate operation. -
I commenced the operation by making a longitudinal incision over the
tumour; but the thin integument could not be conveniently pinched up
for the purpose; it was somewhat thickened, and adherent to subjacent
parts. The operation was cautiously proceeded with, because there was
a peculiarity in the condition of the part. Under the integument I
quickly penetrated into a hardened gland-like mass. In the centre of this
mass was a purulent collection of a very foetid dark brown colour: pro-
bably over an ounce of this fluid escaped. I passed my finger into the
cavity, and found that it had a smooth lining membrane. The tumour
had by this time much lessened in bulk. After a careful search I could
find no indication of any abdominal protrusion; the operation was there-
fore not carried further. She was a good deal relieved by the operation.
She was ordered calomel, gr. v.; opium, gr. ss. : to be followed, after four
hours, by Epsom salts and peppermint, every two hours. Between nine
and ten o'clock, P.M., she had two good stools, and another during the
night, and in the morning was in every way much more comfortable.
Her countenance was more cheerful: there was no sickness: little
abdominal tenderness: tongue improved. The improvement proceeded
steadily from this time. The bowels required very little assistance: the
abdomen felt natural: her wound was granulating healthily: her appetite
was good; her countenance was cheerful. On the fourteenth day (Jan. 20)
a feeling of sickness returned, with shivering; the bowels did not act as
usual, and the countenance assumed an anxious appearance: the pulse
was only seventy-six, but the tongue had a yellowish slimy coat upon it:
the abdomen was not swollen or tender. - .
CHAP. XXI.
3 II 2
420 MECHANICAL OBSTRUCTION.
CHAP. XXI.
Ordered calomel, turpentine, and cream of tartar. There was so much
prostration that it was necessary to give her a little brandy occasionally.
There was frequent vomiting. -
The next morning there was a feeling of heat at the wound, and upon
examining it a bright yellow fluid in small quantity was found escaping
from it. It was quite liquid, and evidently bilious, and there had been
two stools. The face was flushed. the skin hot: the eyes sunken : the
pulse a hundred and ten : but little abdominal pain or tension, though
there was stercoraceous vomiting.
24th.—Her state was more hopeless, and on the 25th she died.
Post-mortem eacamination.—The body was examined about twelve hours
after death. Rigor mortis was fairly established, but was very moderate.
The body was not at all emaciated: the skin was very sallow : the
abdomen was moderately full, but not tense: the sides of the chest were
much flattened, and the lower ribs were pressed downwards as if by stays.
A wound with inverted edges, and discharging a bilious-looking matter,
appeared in the right groin. Upon a careful examination of the surface,
no tumour, nodule, or irregularity could be felt by the fingers. The body
was opened by the usual straight incision from the top of the sternum to
the pubis. A cross incision was made from the umbilicus to the right
crest of the ilium, and the flap turned back so as fairly to expose the parts
in situ.
Upon examining the contents of the cavity, the intestines appeared to
lie in their natural position; but the edge of the right lobe of the liver
was thin, though otherwise of natural appearance, but it extended down-
wards nearly to the crest of the ileum. The stomach and transverse
colon were covered and concealed by the depressed ribs of the left side.
A long process or appendix was observed stretching from the free margin
of the great omentum to the right groin, where it adhered to the
abdominal parietes at the inner ring of the inguinal canal. It was not
very tightly stretched, and could hardly be said to constrict the coils of
intestine over which it passed, but was quite capable of doing so if the
intestines were distended. Immediately underneath this band a coil of
Small intestine was perceived bent upon itself at a somewhat acute angle,
very partially engaged in the internal ring, that is to say, a portion of
its circumference slightly projected within the opening; but there was no
obstruction to the passage of fºcal matter along it. It was, however,
firmly adherent to the sides of the ring. A probe could be easily passed
from the wound in the groin, into this portion of bowel, which was ileum.
17, Wimpole Street, July 23, 1851.
These cases proclaim loudly the inefficiency of
purgatives; and not only their inefficiency, but their
injuriousness. It is a query, suggested by the perusal
THE CAECUM AND ITS WALWE. 421
of these cases, whether the fatal result would have CHAP, XXI.
occurred in these cases had purgatives not been
administered How much more probable would have
been a cure had only homoeopathic remedies been
applied.
The Cacum and its Valve.
It is considered by many that the caecum is pecu- The cºcum
liarly liable to disease. Its structure, and the special “"“”
form of the ileocaecal valve, have been considered as
causing this liability. But to allow that any speciality
of form of a part, contrived by the Creator for a given
purpose, could be in itself favourable to the produc-
tion of disease, would be to give sanction to the idea,
that the Creator had not made the part aright. This
no believer in the omnipotence and the omniscience
of the great Contriver will sanction. This view is
therefore repudiated. Willingly however it is granted
that the caecum is peculiarly liable to have diseased
action induced in it by the action of purging, such
action causing an irregularity, in the movement of
the intestines, which may cause bodies to pass into
the vermiform appendage (110, plate 1, 14), and there,
the irritation being kept up by purging, cause inflam-
mation and ulceration. These views are illustrated
by the following case.
Ulceration of the Caecum. By Dr. STORER.
Early in December last, Dr. S. was called to visit Miss L., aged about Case by
twenty-five years. She complained of great pain in the right iliac fossa, Dr Storer.
and was suffering from considerable constitutional excitement. Upon
examining the part affected, he found it tumefied from about two inches
anterior to the crest of the ilium, to some distance backward upon its
spine ; this tumefaction was exceedingly sensitive, and pressure upon a
portion of it detected fluctuation. Dr. S. ascertained that she had taken
a long walk a week or two previously, when the ground was damp, with
thin shoes, and that, at that time, she felt chilled: immediately after this
exposure, she began to complain of uneasiness in the affected part, and
422 THE CECUM AND ITS VALVE.
CHAP. XXI,
her suffering had since constantly increased. The abscess was punctured,
and egress given to several ounces of exceedingly offensive, ill-conditioned
pus, together with a small portion of air : great relief was immediately
experienced. The purulent matter continued to flow, unmixed with any
foreign substance, until the third day after the opening was made. At
this time, Dr. Storer noticed three or four small black masses about the
size of an ordinary pea, looking like little Scybala, and the patient told
him, that during the previous night she had been disturbed by the passage
of air from the orifice. On the fourth day, liquid fecal matter flowed
freely from the wound; this continued four or five days, requiring that
dressings should be applied repeatedly during the day. From this period,
nearly five weeks elapsed without the passage of any fecal matter, the
discharge being entirely purulent, accompanied occasionally by air. At
the termination of a month, the patient, having complained for a day or
two of local heat and fulness, together with general febrile excitement,
observed in the purulent discharge from the wound, “ quite a number” of
fig-seeds, which had been swallowed a fortnight previously. Succeeding
the passage of these seeds, a long, somewhat compressed substance was
observed in the aperture of the skin, which proved to be a portion of
apple-peel, several folds of which had become rolled upon themselves,
forming a fine, pointed body. Fecal matter followed these foreign sub-
stances, and continued to flow for four days, when the discharge gradually
subsided.— Records of the Boston Society for Medical Inprovement, in
American Journal of the Medical Sciences, July, 1851.
The author was consulted in the case of a youth for
intestinal disease. The youth soon after died; and a
pea was found germinating in the vermiform appen-
dage. There can be but little doubt that the pea was
forced there by the irregularity of the action of the
caecum and ileum, induced by the irritation of purging,
to which he had been subjected before he was brought
to the author.” And, in most cases, where bodies
are found in the vermiform appendage, the irritation
of purging is, it is likely, the cause of such bodies
being there.
* The inutility of any purgatives to force bodies through the bowels is
exhibited in a case published in “Rejected Cases.”—A case, in which a
farthing was Swallowed, and discharged a month and a day after the date
on which it was swallowed. -
A CASE OF FISTULA CURED. 423
Fistula cured. CHAP. XXI.
This case ought to have been inserted in the pre-Fistula cured.
vious chapter, but, at the time could not be found. -
Francis Holmes (p. 1646, case book, 1852,) aged 61,
a widower, came to me in May : he suffers under
fistula. His state is very bad, and he afterwards
expressed his own conviction of his state, by remark-
ing, “I thought I should have died before I came to
you, Sir.”
He saw Mr Salmon, subsequent to the opinion of a
medical gentleman that he had fistula: Mr Salmon
recommended him to go to Bartholomew Hospital.
Eſe went there, but they did not keep him. He then
returned to Mr Salmon, who stated that the fistula
was very bad, very deep, and declined operating. He
left the Fistula Infirmary five weeks since, having had
the fistula thirteen months. The fistula discharges:
it has two openings, and it takes half an hour to get
the faeces that pass through it through. When he con-
sulted me he was much swollen in his body, which he
referred to some medicine that had been given him
by the medical man whom he last saw. He consulted
me on April 26, 1853: he looked very ill. He was,
however, not thirsty: his tongue was furred: he seems
breaking up. - * -
Ordered hepar sulphuris and causticum in alternation. Hepar sul.
May 6th–The discharge from the fistula was.
lessened ; his legs are now swelled. There is that
peculiar unhealthiness about his appearance so charac-
teristic of, and so usually present in, fistulous diseases.
Ordered lachesis and hepar sulphuris in alternation,
and then lachesis and causticum in alternation.
May 16.-The fistula discharges very little: he
424 A CASE OF FISTULA CURED.
CHAP. XXI.
Bryonia and
calcarea.
Rali car-
bonicum.
Bryonia and
belladonna.
Lachesis and
causticum.
Thuya.
Lachesis and
causticum.
Arsenicum
and hepar
sulphuris.
swells all over the body: his water passes without
difficulty: his bowels are not confined: he perspires
when he lies down: his tongue is furred.
Ordered bryonia and calcarea in alternation.
Subsequently to this, the action of his bowels
became entirely stopped, and his sweats were profuse.
He has extreme trembling.
Ordered kali carbonicum.
May 28.—He has a very bad sore throat. His
cough is dreadful: he sweats less: his trembling is
less.
Ordered bryonia gtt. i. tertiae dilutionis, 12th part
as a dose, in alternation, with belladonna.
May 30.—His throat is better: he feels sick: his
cough is better.
Ordered lachesis in alternation with causticum.
June 29.—The swelling has almost gone : the dis-
charge from the fistula has much lessened: he says
his appetite, when he takes the medicine, is not so
good: the medicine makes him feel full: he can eat
but very little: his sickness is better: the cough is
better: his health has much improved: he thinks the
medicine is too strong for him, “it makes him sweat
so much :” he can now sit down, which hitherto the
fistula has prevented him doing : he has a spongy
sycotic-like growth at the part.
Ordered thuya One day, and lachesis and causticum
the next day, and so on.
August 19.—He can now sit pretty well: he does
not feel quite so well: the discharge from the fistula
is a little increased: some inflammatory redness is
perceptible about the part.
Ordered arsenicum and hepar sulphuris in alterna-
tion to subdue the inflammation, and then thuya one
A CASE OF FISTULA CURED. 425
day and lachesis and causticum the next day, as before. CHAP. xxi.
He has a chafing between the thighs. º
Sept. 5, 1853.−The fistula is better: the discharge
has lessened: he has some trouble from piles.
Ordered lachesis and causticum.
Jan. 11, 1854.—The fistula has been painful the
last day or two : he has digged hard: the part is
inflamed. --
Ordered arsenicum eight globules, and hepar sul- *
phuris eight globules, three-quarters of a globule, at sulphuris.
first every two hours, then every six hours.
Jan. 28, 1854.—He is a great deal better; the
discharge has stopped: he has a heat at the lump,
but there is now no smarting. He expressed his
gratitude, comparing his state now with his state last
year.
March 11, 1854.—He states he has never been so
well as he is now ; but on Tuesday the place became
painful, and yesterday the place broke, and discharged
a yellow matter. .
Ordered arsenicum and hepar sulphuris.
April 4, 1854.—The fistula is almost well: the
inflammation is very slight: there is a little yellow
discharge, but now no faces pass through the wound:
there is still a little heat.
Ordered arsenicum and hepar sulphuris.
June 10, 1854.—He has had a little discharge
again, attended with shooting, darting pains: his
stools pass naturally: he used to be half an hour in
passing the stools: he walked seven miles this
morning. *
August 29, 1854.—He has been well: he feels as
well as ever he felt in his life: he said he should like
Mr Salmon to know of his cure, as he told him he
3 I -
426 A CASE OF FISTULA CURED.
CHAP. XXI.
was a dead man. I suggested to him to call on Mr
Salmon: he said he would be offended.
The patient has been engaged this summer in
mowing, and is upwards of sixty years old, and yet
he mowed and beat a younger man.
N. B.-It is not unlikely that this patient, on ac-
count of his age, may have a fresh development of his
disease: still, the benefit, derived from homoeopathic
treatment, has been as described: a benefit sufficiently
palpable, and one establishing the power of this treat-
ment in a disease, generally not at all tractable.
§-N DEX. 4.
2
f
I N I) E X.
IPAQ ſº
Abdominal disease subdued, though bowels confined º 329
• * * e s a s & © e and gastric affection cured, though bowels confined 330
Abernethy, Mr., remarks by . e e o 153
Abscess better, though bowels still confined º o 339
Absorption - e •º & º e 3
Absorbent system . e c g º 120
Absurdities with respect to the purging system . e 215
Acidum Muriaticum, Rhus and Arsenicum, used with success 301–309
e - tº e tº tº Nitricum, Aurum, Hepar and Thuya, used with success 302
Aconite, disease treated by . e 269, 283, 293, 332, 321, 379
Aconite, Nux, Sulphur and Carbo e º º 292
e s e e s e tº Nux and Carbo tº º º e 292
• * > * * * * Nux and Sulphur . e º º 309
Aconite and Belladonna g º * • 3.71
e e s e s a tº and Pulsatilla . e e º * 282
tº e a e is a º and Lachesis e º e e 306
• * * * * * * and Ledum *- * º * 379
Accumulation in bowels, theory of e e º 201—2
Action of transverse band at the pylorus & º SS
tº e º ºs e º of intestines, how taking place . º º 131
Age, old, attended with diminution of power e e 15S
Agony from spasms tº e e e 361
Agony caused by purgatives e ſº e 405
Alexis . • e o e - 70
e e º s e e St. Martin, account of g e . 39, 40, 41
Allopathic journals, cases recorded in . & º 40S
Anecdote connected with action of bowels º e 227
Animal material, how carried to all parts e e 2
Animals, the action of swallowing in . o e 26
• e s e e º e tº young, not good for food º e e 53
Anger affects the bile e o e © 80
Aphorism of Dr Hamilton . & e © 199
Apoplexy, occasional cause of º º º 29
Arnica . e / & º e e 282, 316
º e s • * * and Hepar 294, and Causticum . Q © 296
tº e º e e e and Nux . e te • Te 282
Arnica . . e e e s 344, 345, 346
3 I 2
428 INDEX.
PAGE
Arsenicum, Acidum Muriaticum and Rhus g ſº 309
Arsenicum te g © © tº 321
e e s e e g c & e & and Kali Carbonicum wº . 316, 317
. . . . . . . . . . and Belladonna tº © “ § 266 -
'• • - - - - - - - - and Sepia ſº & . . 302, 295
Arsenicum, Graphites and Nux iº tº 283
e e º e s e º e º 'º Hepar and Sulphur tº te e 249
Arsenicum and Thuya tº ſº § © 300
tº e º e & G º e º º and Cantharis & te * e 301
Asthma, Millar's, better, though bowels confined ſº 320
Aurum and Sepia . º © ſº tº 295
. . . . . . Nitric Acid, Hepar and Thuya © e 3()2
Axioms with regard to digestion tº o . 47, 48, 49
Back, pain in, relieved, though bowels confined . “s 336
Bacon, when digestible • © d © 81
Baryta Carbonica . e º o • 287
Beaumont, Dr g tº º Q & 27
tº dº e º º ºs e º 'º º º º experiments by, on the stomach . . 40, 41, 42
Beaumont's observations with respect to food § e 79
gº © e º º º . . . . statement about oily food gº e 80
tº tº e º 'º e º ºs º º important observations on muscular action tº 84
Beverages, coffee and tea debilitating’. is g 73
Belladonna tº e g 266, 269, 306, 338, 355
tº e ſº e e º e e º º and Bryonia * © © 355
* > * g º e g º e º e and Aconite g º * ſº 3.71
Bile, use of & te & 80
- . cause of presence in gastric juice tº Q 80
Bilious people, supposed to be ill tempered • g 80
Blindness caused by purgatives & & . 179, 351
Blood, purifying of, by purgatives, absurdity & . 215, 216
Blundel, Dr gº e ſº & 363
Boerrhave’s idea respecting the villi of the intestines & 123
Bowels, inaction of e e • 145
gº º ſº e º º truism with respect to * (e . 204
... , , becoming confined during cure e * > 337
tº e º 'º º º inflammation of, important conclusion . © 181
s e s e o 4 errors with respect to action of . e . 208, 403
e g º e º confined, pain in chest better . e & 318
• . . . . . confined, patient better tº • . 311, 312
, º 'º £ tº e ſº constant desire to relieve º * 361
• * * * * , feeling of fulness in, deceptive ſº . 211, 212
tº dº tº e º 'º inaction of, preceding sick headache dº tº 214
tº g tº e º tº inaction of, during disease, is but one circumstance - 224
& e º 'º e º no action of, without food & tº ſº 225
© tº º e º . inaction of, sometimes a benefit e 227 .
INDEX, 429
Coincidence and causation with respect to the action of the bowels 207
PAGE
Bowels, action of, when most commonly occurring ſº 235
tº e º e º º action of, influenced by quantity of food e 237
* * * * * * * we ... . . . . . . . . . . . . . by taking food too frequently 237
s • * * * * case of constipation ending fatally gº 406
© tº º e º º respecting the action of after delivery 239
Brodie, Sir Benjamin, and Dr Harrison 155
Bryonia, treatment by 332, 352
© º e º e e º e and Belladonna g gº 324
Burns, constitutional disease cKcited by 146
Buzzing in head, like noise of sea e 313
Calcarea tº . . © º 264, 276, 315, 339
Carbo Vegetabilis, Aconite and Nux 292
tº e º e º e º e º 'º e º g º º ºs Aconite, Nux and Sulphur 292
. . . . . . . . . . . . . . . . and Arsenicum 303
Cases, instructive . ſº - 406—413
Caecum, or blind gut, description of 109
tº e º e º 'º bodies found in 421
Cancer, anecdote of patient 57
Cantharis e , e 334—265
Cantharis and Causticum used 401
Castor Oil ought not to be used 147
Castor Oil, use of, disease caused by . 367
Causticum ſº e 262, 296
* * * * * * * * and Arsenicum o 301
• * * * * * * * and Sepia º 333
Changes which food undergoes 5.
Chemists, homoeopathic, error of g 73
Chest affection better, though bowels confined 2
Children should not be forced to eat fat 58
Chymification 7–38
Chylification tº e 7
• e º e s e e º s e e series of changes connected with 98
Chronic inflammation improved though bowels confined 334
Cina * e º e + 287
... and Thuya 287
. and Carbo Vegetabilis 296
Civilization, the customs of, sometimes injurious e 234
Clematis and Sepia * º tº 281, 295, 371
Coats of stomach . . Q * * 34, 35, 36
Cocculus & e 269, 310, 329
* * * * * * * * and Opium s 334
tº e º 'º e º 'º & and Graphites tº e 354
Cod Liver Oil, when efficacious 126
Coffea . . t 343
430 INDEX.
*
TAG E
Colocynthis 255
Colon, description of & 111
Combe, Dr Andrew, anecdote -
s e e s e e º e º a s e e s e º is remarks by & 43
a s e e s a e e º is e e º e s s & respecting the fat of bacon . S1
- Constipation of pregnant women - 157
º e º gº tº . . . . . . . after purging .. 181
a e s e e º e º 'º º ... prevented by friction 241
* * * * * * * * * * * *, attends many diseased conditions 148
a e e º e º 'º s e s = * occurs in large intestines 149
. . . . . . . . . . . . not a primary disease 151
* * * * * * * * * * * * in a mother and child 263
e g º e º º s > * * * , connected with scarlet fever 266
e e s e < * * * * * * * in case of ovarian dropsy 259
• * * * * * * * * * * * for nine days, and with difficulty 259, 260
e s e g a s is a tº e º a of four years standing . . . 261
e e s s s e < * * * * * with palpitation and night sweats 251
& e º 'º º ... with affection of heart . 252.
e tº e g º ºs e º & 6 º' ... with sciatica e 253
* * * * * * * * . ... with modification of urine 253
. . . . . . . . . . . . with very small fºcal portions 254
s e e s e e º e º 'º e e with descent of gut (in a child) 255
e q e º e º e tº $ tº $ tº with ineffectual desire to relieve bowels 255
g e e s a tº s s e º a º with action once a week 256
s tº g º e s e º 'º e s a with neuralgia of head and face 257
e e º e º is e º e º 'º e with cracks of lips e º 257
g e º e º 'º e º & tº ... with darting pain in gut and with forcing 257
e e s s a is e º s e & with inflamed eyes, and blood evacuated 258
e e s is e e º 'º º e º & with gastric affection 264
sº e º g º e º & tº º e º with rheumatic affection, &c. 265
• * * * * * * , ... with deafness of both ears 267
& g g g º is tº $ tº e º 'º with amenorrhoea and colic 268
s e e s e s e s e a 6 ſº with bearing down of womb 270
e e º e º e s e º 8 s tº with discharge of blood 270
s e s e e s is a º & © º with incipient phthisis 271
e e e s tº e s tº e e s e with bleeding at nose 273
gº e º e e s sº e º 'º s a with wound . e * 274
g tº e g . * * is G .... with swelling on thigh, night sweats and suicidal feeling 275
a c e s • e * * * * * , with peculiar cerebral symptoms 276
e e g a s e e s e e s e with uterine symptoms and shaking of leg 277
Constipation, habitual, with head affection, cured 258
............ cure of is not the removal of obstruction 145
gº º g e º & e º ſº tº e . attempted removal of, by purgatives, unscientific 160
... . . . . . . . . . an inefficient means of preventing 234.
. . . . . . . . . . . . cases of, cured • th 262, 263
INDEX. - 431
PAGE
Constipation, special action of individual medicines in regard to 385
sº e º º e s tº e º 'º e e obstinate case of, by Mr Solly tº g 412
Cooling medicine, injury from tº e • 219
Coroners, medical . e & • tº 148
Costiveness, various conditions of ſº . * 114
Cough improved, bowels becoming confined tº g 322
Coverings or coats of tongue º e tº - 18
Cramp improved, though bowels confine • tº 333
Cow, four stomachs of the . tº e º 60
Crocus and Natrum Muriaticum { } e • 277
Curie, Dr, facts communicated by * . . 381, 382, 383, 384
Curling, Mr, essay by tº . gº gº e 146
Danger of too quick eating . e © e 30
Death caused by purging e g & g 177
Death apparently caused by aperient medicine . o 412
Deglutition considered :* º * 6—23
Delicate persons, how affected by confined bowels g 167
Dentists, observation with regard to . & • T 20
Depletion, argument e * & * 232
Descent of gut, cured e e e 279, 280, 281
e a c e s g º e º ºs º & º º for three months, cured e º 282
e e s e s e º 'º e º º e º is with piles and discharge of blood g 283
• - - - - - - - - - - - - - with constipation and windy spasms e 285
s e º s e º 'º e º e º e º e with constipation and head affection & 2S6
s e º ſº e s - tº e º ºs e º 'º with fistulous abscesses in groin © 286
Diarrhoea, error with respect to ſº te g 230
Diarrhoea e g ſº • © 173
Diet, highly nutritive, not suited to the sick tº e 61
Digestive powers in case of Alexis * & • * 70
e e º 'º e tº a º tube e • dº g gº 1
Digestion defined . º ſº & º 2
. . . . . . . . considered © & g te 5
g & º e º º º & changes connected with e e 11
Diseases, various, caused by purgatives 106, 179, 180, 181, 182
Doctors, errors of, with respect to bowels te 166
Drugs, vendors of, must be prejudiced & tº 162
Duct, cystic, spiral valves of . & wº & 102
Ducts, bile and hepatic dº tº . $ e 101
Duct, thoracic, description of • t & 124
Durie, Dr, his practice with regard to purgatives * 198
Dyspepsia caused by purging • e g 352
Empirical, purgatives, taking of ſº ſº * 161
Epilepsy not removed by purging º ſº , º 212
. . . . . . . . preceded by various irregularities g º 213
Epileptic attacks induced by purging . g e 178
4.32 INDEX.
Bpps, G. N., Mr, work on Spinal Curvature wº
IError of treating a natural as a diseased condition
Errors with respect to appearances after death
Brror with respect to feeling of stoppage
Evacuation, one enough daily G &
Examination, post-mortem, published by Mr Wallis
e is s e º ºs e s ∈ tº e post-mortem, case by B. Phillips, Esq.
Exercise, importance of, to animals used for food
tº º ſº tº ſº tº º ſº importance of
tº e º º is tº e tº essential for health .
Experiments on artificial digestion
tº gº tº e is e s is is & on gastric juice .
tº º is tº e º e º tº tº by Dr Beaumont e
e e º 'º e º e º is tº important practical bearings of
e e º ºs e e º e is on Alexis
Expulsion of food, time required for
Faeces, indurate, in rectum º
Faecal smell not caused by constipation .
• * e º & matter, important distinction respecting
Taeces, moulding of, prevented by purgatives
tº º º ſº º º proper moulding of essential
e - © tº e º form of, how caused .
e e s e e s e e s e s tº º when healthful
Fallacies with respect to purgatives
Fallacy, a, explained
Fat not suited to certain stomachs
Fever, case of & © e
e e º ſº º tº cured without action of bowels .
tº G & º º tº peculiarities in
Fistulas, cases of
tº a º ºs e e supposed case of
Fistula . tº . tº
Fits better, though bowels confined . e
Fluids, various, connected with the intestinal tube
Eood the cause of distressing symptoms is
. undigested produces all the symptoms of fever
.... requires heat to convert it into chyme
.... should not be hastily swallowed . ſº
. fittest for digestion &
.... under certain conditions becomes poison
. . . . should not be kept in a sick room
Tood, in fever, the use of, not scientific
... why pain produced on taking c
. quiet after taking, desirable
. observations respecting bad
g
IPAGE
g 156
184
203
210
167
40S
414
53
128
240
46
50
52
. 74
86
141
404
221
197
380
381
115
151
204-5
62
58
306 .
309
77
296,493
297
293,294—302
316
130
77
79
e 94.
© 27
* 53
o 225
61
78
94.
95
126
isors. 433
PAGE
Eood, error with respect to it in disease º º 228
... effect of, passing into the stomach º e 37
. changes of, in the stomach o tº • 37
... too much, why injurious e te • 47
... solid, advantages of . º g © 57
. concentrated, not good . e e & 60
. variety of, necessary to man & ſº º 62
. . . . time in which digested in a state of health . ſº 65
... experiments on o & tº º 66–67
.... effect of, on stomach . º O o 82
Gastritis caused by forcing medicines . e º 353
e e s = e º & violent, cured, though no action of bowels © 323
Gastric affection better, though no action of bowels . 318–326
tº e º e º e pain cured though bowels confined e º 328
e e º 'º - symptoms better though bowels confined . º 328
© e º 'º a e juice, characteristics of . T a 37–45
tº e s w w tº e º t e º 'º mixture of, with saliva and mucus . © 46
Gilbert, remark of . º o e º 168
Gill, Mary, case of, (Appendix) º o © 180
Glands of the jaw . e e º º 16
e - e. e. e. e. in intestines e º • e 99
e º 'º & © tº in folds of mesentery . e º º 119
Good, Dr Mason, observation of & º • 181
Gluttony, bad effects of º tº 93
Graphites 258, 260, 263, 264, 267, 268, 271, 273, 274, 275, 878,
280, 283, 286, 289, 290, 310, 331, 339, 386, 387, 389, 390, 391—401
e e e º e º 'º º and Hepar Sulphuris e © º 295
Gullet, anecdote connected with º e . - 29
* c e e a e case of no passage through e e e 153
Gut, disease of e º e * e 300
... descent of from purgatives e e ... 354, 356
.... descent of produced by salts e 2 © 356
. ... descent of . . & º • . 243
Gyre-like motion of intestines e © e 131
e a e º 0 < * * * c e º 'º º e effect of . tº º * . 132
Haden, Mr, on Colchicum . º * . 149, 209
Hair, dryness of precedes epilepsy & º & 213
Hamilton, Dr James, on purgatives . º . 187 to 190
e e e º 'º e o 'º - © e . . . . . . . on treatment of scarlet fever º 190
• - - - - - • * * * * * * * * * ... refuted e ... • o 192
• * * * * * * * * * * tº e e e ... medicines, given by, homoeopathic . 198
Hannah R., case of e e © Q 410
Haemorrhoids, letter concerning e º . 242
Harrison, Dr Edward, spinal curvature e - 155, 156
Head, severe pain in, cured, though bowels confined e 310
3 K
434 INDEX.
PAGE
Head, affection of, cured, though bowels confined 314, 315
Heart, action of, affected by stomach . º 97
º º e º sº e affection of, relieved, though bowels confined 318
Heat, unnatural, mark of disease e º 220
Hepar Sulphuris O tº 263, 264, 288, 297, 321, 323
Hepar and Pulsatilla o º e 359
...... and Sambucus - 320
. . . . . . and Thuya © 288
Hepar, China and Arsenicum º 294, 297, 322
... ... Acidum Phosphoricum and Graphites 295
© a e g g tº Aurum and Nitric Acid 302
tº a c e º e Mercurius and Silicea . 338
Hepar . te 379
Hernia, painful, with fistula 295
© G = e º ſº caused by violent purgatives 357
* c e º s e case of, communicated by Dr Kelsall 357
Hilton, Mr John, opinion on discharge from ulcer 223
Hocken, Dr, case communicated by 404
Homoeopathic practice, advantages of e 77
e - e. e. e. e. e. g. s e e - medicine, while taking, no headache with constipation 147
Hooper's pills e e 356
Hunger, why allayed by food 21
e & © tº e º e a depending on a state of brain 75
Hunt, Harriet, case of 401
Huxham on purgatives 190
Ignatia and Causticum o © 296
Ignorance of the talkers about blood purifying 218
Ileus, disease called o º 181
Ileus, pure, case of, operation, death 414
Ileum, description of 109
Illustration drawn from a fungus e º 170, 171
º º ºs e º sº e º a s drawn from a clock & 209
e - © e º ºs e º e e drawn from a man with contracted limbs 169
Infants, physic should not be given to 226
Intestinal canal, foldings of 78
. . . . . . . . tube made to act without purgatives 203
• * * * * * * * tube, contents of, should pass slowly 135
Intestines, arrangement of 9
e ‘p e º e s e e & description of 98
e tº e º e s e º & Small, characteristics of 108
Introductory chapter 1
Ipecacuanha º e 324
Irritation inflicted upon bowels 163
© e º e e c e s injurious 173
Irritants cause disease º 248
INDEX. 435
FAGE
Jaws, some peculiarities of . g iº º 64
Jeanes, Dr, observation of . © * g 249
Jejunum, description of ſº te tº te 108
Johnson, Dr Edward, remarks on constipation . ge 3
tº tº e º ºs e º e g º º ſº e º tº º ſº º on secretions of the bowels tº 154
tº e º ºs e º & e º e & © e e s e º e on constipation . e º 163
* * * * * * c e s ∈ e º a º e º e a hypothesis of . e ſº 167
Johnson, Dr James, case related by * * tº gº 406
Juices, bile and pancreatic . * cº ſº 100
Relsall, Dr, remark by e ſº 186
Kali Carbonicum 251, 252, 266, 267, 271, 272, 273, 274, 275,
277, 293, 301, 306
Kali Carbonicum and Opium tº , © & 269
Kinesipathy º tº & º tº 241
Lachesis * i. e e * 553
& e s tº e s ∈ and Nitric Acid ge © e ſº 342
e s e º e o e and Aconite tº * tº e 306
Lacing, tight e º & tº tº 95, 104
Lacteal vessels, description of & & & 122
Ledum . . tº * tº º tº te 379
tº gº e º e º and Aconite tº g tº º 379
tº º ºs e e & and Veratrum & tº e tº 379
tº a c e s tº and Cina . e & e g 379
Leucorrhaea caused by purgatives * ſº wº 367, 368
Ling with regard to muscular action . • ſº 241
Lymph . e ‘ tº se g ę 126
Lips, muscles of . º & e e 12
Liquid, much, with meats, not good tº e g 59
Liver, situation and description of * tº jº 100
tº & © tº º impure blood brought to * e • 101
Lycopodium - à 265, 282, 283, 293, 307
Lycopodium, treatment with * & 253, 261, 336
Lycopodium and Nux sº e tº * 262
Lymphatics © & te te e 120, 126
Marasmus, remarks on tº tº e tº 191
Meals, number of hours between e º † 237–8
Mechanical interference with intestinal tube {º wº 137
• a e º e < * * * * obstruction, cases of * e g 103,418
e º 'º e º 'º e º 'º e means, cases requiring & a * ge * 246
. . . . . . . . . . . . . . . . . when to be used . e • 245, 247
Medical men, absurd practice of ſe tº ë 183
e e º 'º e º e º 'º e º e great diversity in practice of © tº 231
Medical Gazette, communications in . * tº 413
Medical man, fatal case of constipation of tº ſº 406
Medicines produce a constipated state © * 152
3 K 2
436 - INDEX.
PAGE
Medicines, purgative, expel the secretions prematurely tº 164
Melancholia cured, though bowels more confined & 307
Melancholy feelings relieved . . & & tº 334
Membrane lining the abdominal cavity tº ſº 119
Menstrual discharge, excessive, from purgatives * 366
Menstrual, too frequent, from purgatives e we 367
Mercurius, Hepar and Silicea • * e 338
Mercurius and Sepia . © ſº ę & 301
Mesenteric glands . . & & = 9, 119, 120, 121, 123
Mesentery tº * tº tº . © & 119
Motion of stomach in digestion © • e 80
Motion of stomach and state of food therein e g 82
Mouth, description of tº r © º * 22
Mucous fluid useful for swallowing tº a • • 25
Mucous fluid, how supplied - e tº te 107
Muscles used in swallowing . . gº º * e 25
Muscles, abdominal, strengthened by walking e tº 240
Muscular layers or coats connected with mouth . . tº 24
Natrum Muriaticum and Crocus . © ge • 277
Navel, swelling at region of . gº tº tº , 326
Naysmyth, Wm, case of ſº • te wº 402
Nerves of stomach e º . & g 36
Nitric Acid . . tº 4 tº * 28
Nitric Acid, Aurum, Hepar and Thuya & ſº 302
Note, sinking at pit of stomach explained te tº 44
... dimness of vision in dyspepsia explained . . & e 45
... observation by Dr Beaumont . tº - © 51
Q & e º & experiment on stomach of Alexis q e 58
. ... error of chemists (homoeopathic) g § 73
... experiment of Dr Southwood Smith g * 74
. verdict of jury on Mr Cordwell . . tº gº 75
tº g º e º experiment on stomach & e a 86
... ... various lengths of intestines ſº gº * 98
tº e º ſº tº Dr Edward Johnson's remarks on bowels . * 143
Nux Vomica . tº © . gº ſº 255, 258
.... and Sulphur º º . 259
. and Lycopodium 262, 264, 265, 266, 283, 284, 332, 335
CEsophagus, description of . g & . 30
Omnivorous, characteristic of man © dº . . ; 63
Opium . . g tº & tº 269
o tº e º e º e and Kali Carbonicum g ſº ... g. 269
. . . . . . . and Cina . ** & e g 306
& © tº gº dº º º and Sepia tº de • ſº tº 322, 347
Order, tendency of nature towards © tº e 233
Ovary, diseased, caused by Secale Cornutum s * 368
Pains in bowels removed by Cocculus . te . 332, 333
INDEX. 437
. . . - PAGE
Pancreas, description of tº g © . 103
Pancreatic fluid . . tº e e # e e * 103
Palliative, remedial means . . g * . . 168
Palpitation caused by purging . * • tº e 179
Papillae described . . te & g ... a . 125
Papillary elevations of tongue . . . . . o - 18
Petroleum e * ſe tº 4 • . . e 341
Peritoneum, description of . . ſº is * 118
Petticoats, short, in children dangerous ſº Ö 128
Pharynx, description of * * • e ſe 6
Philip, king of Macedon, saying of . p e 215
Phillips, Benjamin, Esq., observation by . tº e 413
. . . . . . . . . . . . . . . . . . . . ... case communicated by . e 416
Phosphorus tº ſº © & f e 315, 323
Phosphorus and Arsenicum . e ſº 335
Phrenologists, respecting the desire for food te § '75
Pills, Morrison's, anecdote concerning ſº ...ſº 216
... ... dinner, shown to be injurious º & o 94
e sº e º ſº danger of . , e tº * . . . 211
Piles for thirty years tº e !e tº 289
tº º ſº tº º with passing of dark blood . . . tº * 289
Piles, external and internal, with special head affection . . . 290, 291
ge e º gº tº hereditary . . . ğ & 291
..... attended with burning in region of stomach sº . 292
Piles better, though bowels confined . . • © . . 231
Prolapsus ani, case of . • * • tº e 242
Prolapsus after operation, cured Q tº g 278
Prolapsus from a strain, cured • e e . 232
Prurigo pudendi, relieved, though bowels confined e 341
Purgatives causing increased gastric irritation . ſº 353
ge s is e º ſº e º 'º causing intestinal disease . . * e . .353
. . . . . . . . causing excessive discharge of blood . tº .357
Purgatives, why injury from tº * gº e 104
Purgatives relieve but for the present . e © 671
* e e º º & ... described tº e - e * * 172
Purgatives, why such tº , g ' e e 175
Purgatives create unnatural secretions & & 176
Purgatives, the cause of various diseases . . 182, 183, 184, 185
. . . . . . . . . . extended use of, since the time of Dr Hamilton 196
g e is e a 6 s e º & their employment a matter of general belief . 200
e e < e e º e s e & cause of relief from . tº . tº tº 206
Purgatives causing piles o se e - • 357
Purgatives, review of arguments concerning ſº º 201
Purgatives do not cure disease , ſº º & 209
Purgatives not to be used after child-birth gº • , s 343, 344
Purgative medicine, injuriousness of . tº . e 346
4.38 INDEX.
Purgatives, observation with regard to
e s e º e º e s e e injurious º
a s e e a e o e . cause of epilepsy e
e e e º e º 'º e º & cause of death and why
tº e º e º e s e ... disease caused by
Purgative, what it is © º
Purging artificial . •
Purging, cause of gastric affection e
Purging after confinement injurious .
Purging, violent, consequence of
c e o e º e º º injurious effects of ©
e e e s e e º 'º death caused by .
tº e o e e s º º reflections upon . . º º
Pulsatilla º . 265, 285, 290, 311, 322,
Pulsatilla used with Graphites e •
IPulsatilla and Aconite
Pylorus, diseased, cause of peculiar sensation
Pyloric portion of stomach, contraction and relaxation of
Pyloric valve © º º
Quinsey cured, though bowels confined
Reading aloud, its benefits
Record of cases of constipation e
Rectum, reason why blood expelled from
e - e. e. tº e s & stricture of o e
....... description of º º
. . . . . . . . cancer in º &
tº e o e º a t ... mucous coat of, arteries and viens of
.... cause of inactivity of the muscular fibres of
Reid, Dr, case related by ©
Rhus and Belladonna
... ... and Arsenicum ©
... ... and Bryonia º
... ... and Lycopodium º e
Rheumatic pains cured, though bowels confined
Relaxation of the bowels o
Salts, Epsom, danger of
* c e º e º . . . . . . stricture. produced by
Sambucus º
Sambucus used . e e
Satiety, sense of, when produced
tº e º 'o e e not healthful
Secale Cornutum . e o
Secretions unnatural, caused by purgatives
Series of statements of cure of constipation
Sepia, treatment with e •
Sepia
PAGE
128
135
350
136
231
175
174
352
370
369
370, 371, 372
373
374—5
326, 328, 344
254, 255, 256
402
282, 327
211
89
36
338
240
250
115
298
112
299
125
158
407
267, 291
308
309
336
336
361
363
360
220
401
70
71
329
176
386–391
330
INDEX. 439
PA.G. E.
Sepia and Opium . e wº * 322, 347, 367
... and Causticum dº º e 256, 257, 260, 333
..... and Sulphur 262, 270, 271, 276, 279, 280, 282,283, 286, 288, 312
tº e º sº º and Graphites tº g t 27S
... and Aurum . . • tº 295
..... and Arsenicum de e gº tº 302
tº $ tº e tº and Nux * e ſº 284, 289, 290, 310, 311
Sepia, Aconite, Nux and Rali Carbonicum 292
. . . . . Aconite and Nux * 309
Scotch gentleman, anecdote of 216
Sheen, Jane, case of & tº e 401
Sight, dimness of, relieved, though bowels confined 317
Sigmoid flexure . wº ſº 287
Silicea . e wº e 338, 339
Silicea and Baryta Carbonica & 287
Sims, Dr, and Mr Lane, treatment used by 407
Similarities of various parts of intestinal tube 130
Simultaneous action of the stomach and respiratory muscles 91
Sinking at pit of stomach explained . 44
Smells indicative of diseased conditions 222
Southwood Smith, Dr, experiment by 74
Spices, not beneficial in this climate . 72
Spigelia . e g 380
Spurred Rye, causing injury . & 369
e is e e s s º ºs e s e & bad effects of . © 184
Starvation, case of, in a child 153
Stomach, motion of, important 82
Stomach of a louse © © g 84
º e º e C & © tº of Silurus fish e © & 84
Stomach, situation and form of º 32
tº º e º 'º E tº e anecdote of Alexis St. Martin 40, 41
* c e º e º e e group of changes connected with e 7
tº G & º e º & © explanation respecting chyme 90
tº e is a e º e g affection of, better, though bowels confined 326
Stoppage, respecting the feeling of 210
tº gº tº tº tº gº tº tº death not often caused from . e o 224
Stricture, connected with the rectum . 360
Sucking, why good for an infant & dº cº 30
Sulphur te * 3.71
Surgeons, ignorance of some § º 113
Swallowing, act of, how effected º & 25
Swedish philosopher e & wº 21, 125, 130
Synchronous action of gullet and lungs g g 25
Table, showing the relative digestibility of foods tº 66
Teeth . tº gº e e * 12
Teeth, arrangement of * e dº e 13
440 INDEX.
LONDON : PRINTED BY JOHN TRAPP, BUDGE ROW, CITY.
- PAGE
Teeth, observation with regard to e 20
Temper, ill, common opinion respecting 80
Temperature of stomach e © . 92
Tetanus, Dr Hamilton on ſº © 194, 195
Thermometer, experiment on stomach with. 88, 89
Thompson, Mr, case recorded by 409
Throat affection produced by purging 352
Thuya º º 287, 288
tº e º e º 'º and Cina 287
tº º tº e º 'º and Arsenicum. te 300
Thuya, China and Hepar º © º 294
Tongue, importance of, in chewing, &c. 17
........ its peculiar structure º 17, 18, 19
Trunk of elephant 11
Tube, length of e 6
Turpentine, injury from tº . 376, 377
Turpentine for the expulsion of tape-worm e e 376
e e e º e º e s a e causing descent of womb . 377
Turpentine, injury to bladder from & & 377
e e o 'o e e º a e e injury to bladder from, and tape-worm o 378
tº e º e o e º 'º º º injury from 380
Vagina, construction of tº . © 367
Valve, ileo-coecal, its peculiar structure 109, 113
Veal, not wholesome º tº . tº e 54
Weratrum º • . o º 276, 315, 324
Weratrum and Ledum º º 379
Verdict of jury in Mr Cordwell's case 75
Vermiform appendage tº 110
Vesicular erysipelas cured 342
Villous papillae º tº . 19
Vision, dimness of, in dyspepsia 48
Vitus's dance, Dr Hamilton's remarks on 193
Walking, benefits of - 240
Wallis, Mr, case related by 408
Warm water, when most useful 239
Water, application of cold, useful º 238
Water, cold taken while dressing - 239
Water in mouth explained . e 17
Watch, comparison of º © º 169
Wind, error concerning expulsion of e." 117
Windpipe, description of e º g 23
Womb, affection of, benefitted, though bowels confined 334
º e º e º 'o descent of - º º º . & 364
• * ~ * - tº descent of, from purgatives 365
Women, especial sufferers from purgatives 182
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