a sense of constriction supervened, amounting rapidly to pain; it seemed as if the chest was strictly bandaged, then as if the ribs were pinched together by red-hot screws; the agony being now intense, he suffered, in addition, pain at the wrists, and his hands were numb and powerless. The whole of the attack would occupy three or four minutes; the pain appears to have been frightful; and the patient was left for some time exhausted to the last degree. He recovered his health upon a total change of diet, taking no wine or fermented liquor of any kind, or animal food; but eating for dinner, pudding hot with cinnamon, and for breakfast, and in the evening, taking tea only, with bread and butter and ginger. This patient consulted me when he had pursued this system, which had cured him of the attacks above described, so long a time that it had reduced him to a state of debility, and threatened to originate a new form of dyspepsia. Upon resuming ordinary and wholesome diet, by my advice, he completely recovered his health.

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CHAPTER II.

MANAGEMENT OF THE BOWELS.

WHEN the food has been converted into chyme by the action of the gastric juice, it passes from the stomach into the small intestines. There the chyme becomes penetrated by the bile and other fluids; after which mixture it gradually separates into two parts; one of which, the chyle, is immediately absorbed by the lacteal vessels, and carried into the blood; while the remainder is propelled onwards into the great intestines, to be thence, after some additional changes of less importance, and some further absorption of its elements, finally eliminated. Such is, in brief, the ordinary theory of the functions of the bowels. It assumes, the reader will observe, that our food consists of two parts, recrementitious matter, and refuse. But a doubt may be raised whether this distinction is invariable and essential; or, rather it is most probable that it is not so. Under some circumstances, there is every reason to believe that all the food taken becomes nutriment. When, for example, one is in habits of strong exercise, and eating, at the same time, sparingly, and of whole

some and digestible food alone, it is presumable that the whole of many meals is assimilated.

When we inquire for rules as to the management of the function of the bowels, it becomes evident that in what concerns recrement and nutrition, there is room for none. When the stomach has digested, and the chyme has reached the bowels, the nutriment which it contains is, without our control or knowledge, absorbed and conveyed into the circulation. Rules of management only apply to the getting rid of the refuse part. The importance of this point, however, merges in one of greater consequence. The same channel which provides an escape for the accidental quantity of refuse in the food (whether less or greater, from the food having been sparing or in excess, digestible or indigestible,) gives vent simultaneously to new secretions. It is to be understood that the alimentary canal forms a sort of inward skin, or has a membranous lining continuous with the outer skin, which pours out its own secretions, as the outer skin pours out perspiration. And as there are special occasions when the flow of perspiration from the external surface relieves and lightens the body, so are there others, when secretion from the mucous lining of the intestine tends to a parallel purpose. Or we are no doubt to suppose that one use of the intestinal secretions is to dilute the refuse matter passing down, and to cause to separate from it addi

tional nutriment; but it is additionally certain that another object is obtained by these secretions, the cleansing, namely, or purifying the blood of the matter so discharged. And it is probable that unless our food is indigestible or immoderate, the elimination of that part of the fæces which is new secretion is of much more importance to the œconomy than the expulsion of the refuse of the ingesta.

It is moreover probable that the larger part of the fæces is new secretion, not refuse food. Whence it is that, in different individuals, the quantity of fæces does not bear an uniform proportion to the quantity of ingesta. Another circumstance determines this proportion ;-which is the disposition in the individual to pour out intestinal secretion, which varies in different persons, just as the same function of the skin varies; there are some who perspire readily and profusely, and others who never display sensible perspiration; so are there some to whom large alvine discharges are natural, others to whom they are not so. The blood has, through one vent or another, to get rid of the noxious elements which accumulate in it in the changing flow of the circulation; that vent may be the skin, the kidneys, the bowels, almost vicariously.

In proportion as the fæces consist of intestinal secretion, is their increased quantity capable on the one hand of relieving the system, on the other of

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lowering it. Suppressed perspiration leads to various kinds of illness, so likewise the suppression of this function. Excessive perspiration debilitates, much greater debility is produced by excessive action of the bowels. And both upon the same principle; the blood in the one case is not cleared and strained of impurities, on the other, too much material is abstracted from it.

Consistently with, or following out these views, it will be found to be generally true, that persons with natural looseness of the bowels are of less stamina than those who are habitually costive. And the management of the bowels becomes of the greatest moment; as in it are the readiest and least exceptionable, and most scientific means of altering the quantity and chemical nature of the blood, and of reducing the bodily strength. Both of these objects have continually to be aimed at in medicine and surgery.

There is a collateral ground upon which the management of the intestinal secretions is of a value hardly less than the preceding. All the organs of the body are wonderfully linked together by sympathetic influences. So that one cannot be disturbed without the others being in some degree affected; and often, when several are deranged, a wholesome action excited in one will draw the others into health; so Dr. Currie found in the general disorder of many functions ushering in continued