medicines, that are merely purgative, as a panacea for every complaint. The success of the imposition has turned upon this principle; when the system is out of order, and there is no failure of stamina, in three cases out of four it is only necessary to purge, that is to say, to excite great increase of action in this one secretory organ, and the disorders of the rest subside.

I cannot better describe the treatment of constipation than by enumerating the different means which are available in it, and to explain what case each is appropriate to.

It should, however, be observed, to begin with, that, independently of the cases already mentioned, where costiveness is directly salutary, and in persons of average health, constipation of the bowels occasionally supervening without sensibly impairing the health had often better not be interfered with at all. In trifling ailments, Time is the great physician. Health is never stationary, but has its natural ebbs and flows; and in the wholesomest state of the economy, there are intervals of a lower condition of the bodily functions, from which it is best to wait their spontaneous recovery.

Where costiveness proceeds from known causes, the means of removing it are of course evident. If this ailment has supervened on neglect of bodily exercise, bodily exercise should be resumed

to cure it. For the strong, an hour's walking or riding before breakfast is not only most salutary, but is likewise compatible with most occupations and professions. For persons of less strength,for women generally,-exercise in the afternoon is preferable; the same is requisite in addition to morning exercise for the strong. So a late hour of dining, in summer, seven o'clock, for instance, is a wholesome arrangement, allowing from ten to five for business, and leisure for exercise after it.

Where costiveness is joined with inattention to regular times of relieving the bowels, it will often cease upon observing regular habits in this respect.

The disposition to costive bowels may often be obviated by using articles of food which are laxative. Fruit generally has this effect; but all fruit is not equally good for the purpose. The best are grapes, currants, strawberries, raspberries, gooseberries, eaten at breakfast. Next, peaches, nectarines, pears, apples, which may be conveniently eaten at luncheon. Fruit is less wholesome after dinner; but fruit tarts at dinner are free from objection. Cherries and plums can be eaten with least safety; they are liable to purge. Currants again, which are otherwise excellent, with some produce heat of the lower intestine, and hemorrhoids by their seeds lodging there. All fruit likewise, as nature intended, is best used for a season only; the wholesomest when pursued too long,

will disagree either with the stomach or bowels. A gentleman, eighty years of age, whom I have frequently attended, of a very hale constitution, has costive bowels, which in the early part of the summer he finds easily manageable by eating fruit, principally currants. One day in the middle of August in the present year, he had eaten currants with his breakfast; the bowels had acted properly, when in the forenoon, with no previous warning, he dropped down in a state of insensibility; he continued insensible for half an hour; then vomited a quantity of half-digested currants, and soon completely recovered, no indisposition beyond languor and some weakness being left.

Vegetables are generally laxative; many find brown bread answer the same purpose. When they agree, these are unobjectionable means. But both are liable to produce heartburn and flatulence.

The next means we may consider are such as are purely mechanical. Those in whom fæces are formed in adequate quantity, but are not voided through sluggishness of the muscular structure of the bowel, or because there is not liquid enough, often obtain perfect relief by the use of injections of water. The water should be used cold, to be more stimulating; to render it still more so, half a teaspoonful of salt may be added. The quantity ordinarily requisite is a pint. It is sometimes of course proper to use warm water. Many persons

who are temperate livers, and of sedentary habits, find the daily use of such an injection half an hour before the customary time of relieving the bowels, sufficient to obviate troublesome costiveness, and to cure the local complaints it has produced. But this remedy does not answer with all. In some, it produces uneasiness and a sense of weight and dragging from the loins, with general lassitude. In others, the bowel becomes relaxed, and a disposition to protrusion is formed through it. Nor is the practice of injections wholly free from more serious accidents. I have known the intestine torn, and the gravest consequences ensue, through inexpertness in the use of the instrument. The tube of the apparatus is generally made so long and sharp, that it is easily capable of tearing and lacerating; properly it should not exceed an inch and a half in length, and should end in a smooth sphere, half an inch in diameter, tapering to a neck a third of an inch thick.

It is possible that galvanic electricity will in time be made use of to promote the relief of the bowels.

A gentleman had been under the care of the most eminent physicians in England and Ireland for an obstinate state of the bowels, which was originally ascribed to having slept in a newlypainted room. From being of a full habit, he became greatly emaciated, and the complaint went

on in this manner for two years. Dr. Cheyne ther recommended galvanism, which in about three weeks restored the natural action of the bowels, and he soon recovered perfect health.

An American has a patent for a short bougie, which forms a voltaic pile. I cannot say that where it has been tried by my advice, it has been successful.

Cold-bathing, either the plunge or shower-bath, is an important indirect means of obviating costiveness, where it forms part of hysteria. The hot-bath is of great use in cases which present an acuter character, threatening obstruction.

These serve occasionally. But the means of obviating costiveness most commonly to be resorted to, consist in the use of purgative medicines. The classes of cases to which they particularly apply are those in which the intestinal secretions are not formed in wholesome quantity. But they are sometimes in addition the only resource in cases of the other class. These remedies may be enumerated under the heads of laxatives, drastic purgatives, mercurials.

As laxatives, any of the following medicines. may be safely tried, but generally one form is found to suit each case better than another.

It is to be observed that aperient medicine may be taken either in the afternoon or at night, or in the morning early, and that there are circumstances which render in different cases either plan prefer