aggravation of local symptoms, however much it may alarm their physician, and make his prognosis graver, prevents the general feeling of relief. Or watch a case of consumption: the deposit of tubercle may be insignificant, and is at all events in its first stage; yet the patient is despairing of recovery. Why? Because the skin is sluggish, the bowels costive, the urine of low specific gravity; because, in short, there is retention of effete matter in the system. But let this patient's tubercles soften, let there be night sweats, copious expectoration, diarrhœa -everything that prophesies ill-and who so full of hope as the sufferer himself? Morbid states where destruction is in excess are the most fatal, but those where retention preponderates are invariably the most distressing.

Costiveness must be regarded as a disorder of the whole system, and not of the intestinal canal alone. The only effectual remedies are those that are advised under that conviction.

The objects of treatment must be: first, to relieve the body of the immediate presence of effete matter; and, secondly, to prevent artificially its reaccumulation till such time as a complete renewal of the tissues has taken place. Then the body ought to be able to take care of itself, and a cure may be said to have been performed. The attention to local disorders, arising from the successful study of morbid anatomy, has too much made us forget this main object of all medical advice— the replacement of morbid tissue by healthy. "Renew my age," was the chief earthly blessing prayed for by the inspired prophet; and physiology teaches us it should be the motto of the rational physician; for if he omits to rebuild the healthy, his care for the destruction of the unhealthy is all thrown away.

Purgatives, then, may very fairly begin the treatment; for the immediate relief they give to the feelings of discomfort is great. But let not that relief be set down to the mere "clearing out of the bowels;" it is the cleansing of the blood which is the real object of the remedy, and the real cause of the relief. An inspection of what comes away shows it has been newly formed; it is fresh bile and other natural constituents of recent fæces, not of those which have rested long in the canal.

Nothing is easier than thus with a vigorous blue-pill and black draught to drive away, as with a charm, the patient's dis

comforts; and he is ready enough to cry out that no more medicine is wanted. But what is the consequence of leaving off treatment? The renewal of the blood and tissues not having had time to regain its original activity-there not being enough new-made blood to carry on vigorous life-the effete materials again collect, and the disease takes a fresh starting-point. Again and again the coarse expedient is called for, and at last fails to effect its object of giving relief.

To avoid this evil consequence it is best to give no quicklyacting complete purgatives which directly deplete the abdominal plethora by serous exudation; but rather such as cause a gradual increase in the solid matter of the stools. Aloes and rhubarb are the best of these; and I find it also beneficial to combine with them resins which act as a tonic to the surface of the mucous membrane, and prevent the exudation of serum and mucus. Four grains of aloes-and-myrrh pill, every night, will in a week produce all the good effect of strong purgation; and it will produce the good permanently instead of merely for a time.

All accessory food that has the property of arresting destruction must be left off. Wine, beer, tea, and coffee, must, on this account, be excluded from the dietary; and milk, cocoa, whey, soda-water, Seltzer-water, &c., substituted for them.

Perhaps it is on account of their temporary arrest of destructive assimilation, that general tonics, such as cinchona and quinine, rarely agree well in those cases. I find it better to give pure bitters, such as oak-bark, quassia, and gentian, which seem to act chiefly on the mucous membrane. Their use is to increase the appetite; and, when that object is attained, I leave them off; or, if it is attained without them, I do not begin.

Water is a very accessible remedy, and certainly a very rational one, when the destructive assimilation is deficient. The conclusive experiments of Dr. Böcker and of Dr. Falck,* show the increase of all interstitial metamorphosis by this agent to be in close proportion to the quantity taken, within certain

* See 'Digestion and its Derangements,' p. 217; and Zeitschrift der K. K. Gesellschaft der Aertze zu Wien,' April, 1854; and Vierordt's 'Archiv,' i. p. 150, 1853.

bounds; and all who have heard or read of the agreeable sensations experienced by patients during the water cure, cannot doubt its power of removing morbid accumulations of effete matter in the tissues. In this lies its strength; for, as Dr. Böcker observed, "the demand for new tissue, as expressed in the sensation of hunger, keeps pace exactly with the extent of the metamorphosis." And if this demand is rightly supplied, the result must be a complete renewal of the body.

The testimony of experience to the use of water as a remedial agent, is shown in the patronage bestowed from the earliest times upon numerous springs whose saline constituents are even less abundant than those of ordinary drinking water. Pfeffers, historically famous for freeing Martin Luther of his demonhaunted hypochondriasis, is still the resort of the invalid. It is situated in a most gloomy hole; and the copious hot stream that boils out of the rock is almost chemically pure. So that really the pure nymph of the fountain, innocent of salt, should have the whole credit. The same may be said of the well-known Gastein and Wildbad, the crowded Baden, imperial Plombières, of the French Aix, and our own long-frequented Buxton; for, practically speaking, the influence of the saline particles they contain must be reckoned for nothing. It is certainly nothing as compared with the effects of moderate doses of water in Dr. Böcker's experiments.

As physiologists we cannot be surprised at the benefit derived from the simple expedient of drinking water beyond the demands of thirst, in all diseases of arrested metamorphosis. Taken several times a day between meals it is a most efficient remedy. Warm hip-baths are also of great use, and can be borne even from the first by those reduced to extreme anæmia and lifelessness. Afterwards, the cold sponge-bath, preceded and followed by friction to the skin, is a most active promoter of life in the skin and capillaries. The raising the specific gravity of the water by the addition of salt prevents the chill which fresh water is apt to impart. So that even persons with cold hands and feet, and very sluggish circulation indicated by weak heart and pulses, can bear to be sponged with sea-water or brine.

Alkalies and neutral salts have the same action on the moulting of effete tissues that water has. Hence the repute of many

really strong mineral wells. But care is needed lest the same result should follow their use which is threatened by the unguarded use of purgatives. In cases where there is arrest of metamorphosis without organic change in any of the viscera, I find that the weaker the spring the better for the patient.

While pulling down an old house, we must remember to be building up the new. Let full supplies of albuminous material be continuously kept up in such form as the absorbents love. Let milk, mutton, and bread be the staple diet, with the smallest quantity of anything else that human weakness will submit to. If the patient be one of strong mind, the best and bravest thing is for him to carry out advice himself. He will then have gained a victory, not only over the flesh, but over the spirit. But if he is no Stoic, and cannot attain to the dignity of being his own gaoler, we need not be afraid of sending him to a hydropathic hotel. A little pressure will induce the owners of these houses to carry out rational directions, and the situations of most of them are well chosen for the advantages of air and amusement.

Medical men sometimes fear that in sending patients to watercure establishments they may be abetting quackery. In my opinion scientific hydropathy, the renewal of the body by water and food, the increase of growth secondary to the increase of moulting, is very far from quackery. It is not an underhand mode of doing nothing, but a bona fide use of a powerful tool. And therefore a contrary effect than what has been feared would follow; for the very fact of medical men using the treatment as remedial, would show that science ranked it as a genuine physical power; and that, consequently, it is capable of doing as much harm as it does good; in fact, that, like all medical treatment, it needs as much prudence to prescribe it rightly as the most powerful agent in the pharmacopoeia. Its being thus adopted by regular practitioners would soon remove it out of the hands of advertisers, who discredit their really valuable wares by attributing to them impossible powers.

CHAPTER IX.

NERVOUS DISEASES CONNECTED WITH INDIGESTION.

Sick-headache-Hemicrania-Cutaneous eruptions and derangements-Loss of control over the thoughts-Vertigo-Epilepsy -Stomach cough-Anesthesia and Paralysis-Atrophy of muscles.

THE most common morbid affection of the nervous system arising from imperfect digestion is sick-headache. By a kind of physical law of retaliation, it usually is found accompanying those cases where the chronic condition of the stomach has itself been promoted by misuse or overuse of the nervous energy. The landlord seldom disturbs the tenant, till the latter has shown himself to be a ruinous one.

CASE CCVIII.-Rev. T. S― has been an occasional patient of mine since 1860, when he was 45 years old, a confirmed bachelor contented with his lot and quite disposed to a rational enjoyment of life. He had had gout in early manhood, and lived temperately by rule to avoid a recurrence. But he had an anxious, easily worried mind, and the occasion of his coming to consult me was the occurrence as often as twice a month of intense headaches, lasting several days. They occupied the whole head, obscured the sight, and rendered him unfit for his clerical duties during the paroxysms. I found that each attack was preceded by gastric symptoms, nausea, vomiting, and complete anorexia. A holiday trip to the seaside, when the cares of the parish were forgotten in boating, sketching, riding, and society, entirely relieved them and kept them off for many weeks afterwards. After each attack he was used to have pain in the anus and urethra, and pain on passing urine, which was acid, and deposited copious clouds of lithates on standing.

A long-continued course of non-purgative doses of taraxacum, the