and they will always jeopard and protract recovery; whereas, if the disease be treated by a rigid abstinence from cordials, and, when necessary, by a well adapted use of the lancet or of leeches, along with the employment, say every four hours, of drachm, or sometimes of half-drachm, doses of sulphate of magnesia, largely diluted, till copious watery stools, free from blood or slime, are obtained, and the use of these be then followed by a large opiate, and, if required, by a blister,-it will in every early case of it, as it occurs in this country, be most probably subdued. The weak, watery solution of sulphate of magnesia seems to prove beneficial in dysentery, not simply by freeing the bowels of their contents, but chiefly by unloading the congested vessels of the intestinal coats. There appears to be a more advanced stage of the affection, in which the vitality of these vessels has become so impaired, that this effect is no longer obtainable by such means. In these cases the action of the nearly disorganized capillaries may yet be restored by an alterative course of calomel and opium. 5. Religion.

6. Education.

Other things being equal, individuals whose judgment, will, and affections are regulated by true religion have fewer diseases, live longer, recover with greater facility, and observe treatment more intelligently, than those do who are of an opposite character. Their testimony, also, on points which involve moral considerations, is more credible, and their non-exposure to many causes of disease which influence others, may often be safely assumed. The mental culture and discipline which a merely intellectual education even gives to some patients, infuse a distinctness into the narration of their ailments which greatly aids our diagnosis; and they permit also such appeals being made to their intelligence and good sense, as often, by enabling us to carry them along with us in the practical appliance of a distinct principle of treatment, to increase its efficiency.

The question of religion involves various other considerations of a therapeutic or remedial character, to some of which I may be permitted to advert.

The relations which our patients occupy, for example, as responsible and moral beings, entail on them often physical effects of the gravest description; and it is only in the light of the Divine government that such relations can be correctly appreciated, and their consequences averted. Of what moment is it, therefore, that the judicial, punitive, yet forbearing dispensation under which humanity is placed be clearly recognised by the medical practitioner, and that on befitting occasions he should counsel obedience to its sanctions as the essential prerequisite to the removal of disease! I would refer here to the illustrations of

this view which have been suppled by the recent prevalence of cholera; in regard to which, wille the agency of natural causes, whether in its infliction or removal, need not be disputed, the efficacy of public and national submission to the Divine administration and aid was, I think, most conspicuous and satisfactory.

Another consideration of a kindred nature, with which it is equally desirable that we as medical men should be acquainted, arises out of the position in which our patients are placed under a spiritual and moral, remedial or sanative dispensation. The full elucidation and proof of this agency in the production and removal of physical maladies, is to be had exclusively in the Scriptures; but there the announcement is often made, that not only is disease in its multiplied forms employed by the Saviour as a mean to awaken the fears and arrest the attention of the spiritually unconscious subjects of his regard, but that its removal is frequently made contingent on their reception of His righteousness and atonement. As counsellors of the sick it is often so that we, with much honesty and mistaken benevolence of purpose, give reiterated, earnest injunctions that our patients in their last days shall not be exposed to conversations on religion; and, whether from this cause or from the influence of like feelings on their relatives, it is a common thing that the bed-rooms of the dying are effectually closed against those who would deal faithfully with them on their spiritual interests. Many medical men think, and think sincerely and also strongly, that to infringe on this rule is to deprive their patient of his last slender hope of life; whereas the Scriptures unequivocally (vide Job xxxiii.) assert that to admit a free announcement to the dying of the Divine righteousness, in their reconciliation to God through the Mediator, is, when it is welcomed by them, the only way to secure at once their spiritual life and health, and also in many cases restoration to the full enjoyment of all their bodily powers.

I do not doubt that such conversation may sometimes be illconducted as to time and other circumstances, and the possibility should be provided against; but what I insist on is, that the declaration of the Gospel to the sick and dying, instead of proving to them a source of bodily injury, is often, when it is received, the Divine appointment for their restoration to bodily health, and that we as their medical guides cannot better consult their welfare, as to their disease and seeming approaching death, or more really fulfil, in the spirit of genuine medical science and wisdom, as well as of benevolence, the functions of our office, than when we recommend and duly regulate the adoption of this measure.

There is still another aspect of the psychological constitution of our patients, with which it is most desirable that we should be fa

miliar. I allude to the influence exerted on the intellectual and physical functions by purely spiritual causes.

The reconciliation of a human being to his Creator is in general preceded by such a disturbance of every element of his moral nature, and the resistance of his will in the process is often so protracted, that every bodily function becomes disordered, the general health is withered, and, according to existing predispositions, the brain, the heart, the digestive or other organs, are found to manifest more special sympathy with the existing spiritual struggle. Individuals so affected, although usually preserving entire silence on their state of mind and feeling, frequently, from the solicitude of their friends, come under our care for the removal of their impaired health, and the mistakes into which we may be betrayed in such circumstances, are sometimes as prejudicial to our reputation, as they do not fail to prove to the welfare of our patients. Here, again, an intellectual order of means, wielded by an omnipotent spiritual agency, are indispensable to the removal of the functional ailments of the body; but the physician who is duly aware of what is wrong may, nevertheless, secure a large measure of benefit to his patient by the distinctness of his diagnosis, coupled with the assurance of the absence of danger, and also by the proper regulation of both the moral and physical means of treatment.

When referring to some of the ways in which religious considerations demand the intelligent regard of the practical physician, I must not omit the mention of a class of cases, in many respects resembling those already noticed, but widely different from them in essential nature. Í allude to persons who are supposed by themselves and their friends to be undergoing a work of the Divine Spirit on their minds, in whom the spiritual distress or commotion which exists is dependent on natural causes, and is aggravated by religious reasonings and suasion, while it is removed or relieved by the judicious employment of moral and medical treatment.

Such persons, instead of being secretive, in reference to their feelings, like those formerly mentioned, cannot refrain conversation on their supposed religious state. This they always regard as utterly hopeless, a feature which is far from being strongly marked in the others. The pertinacity with which they cherish desponding views of the Divine administration in reference to themselves, and the eagerness with which they seek relief from their feelings by applications to others whom they deem more favoured, together with the melancholy fact, that they never escape from their difficulties by these means, and at length seek relief uniformly in meditated suicide, which is also but too frequently accomplished, are all so many distinguishing characteristics of this condition. On inquiry, also, a predisposition to insanity will in general be satisfactorily established in such cases, and the patient will be

found to labour under more or less derangement of the health, and to exhibit a morbid exaltation and acuteness of the intellectual functions.

The proper treatment here is absolute seclusion, due attention to the condition of the organic functions, and a total prohibition of religious reading or conversation.

7. Age. This element, possessed as it is of all the universality and unerring precision and uniformity of a natural law, is eminently fitted to throw much important light on the position and circumstances of the sick.

The possibility of dentition, of acute eruptive diseases, and of affections of the liver or of the brain, in infancy or childhood; of irritation of the genitals, of phthisis, and of hysteria, in adolescence; of disorder of function, particularly of the assimilative organs, and of commencing lesions of the solid tissue, in adult age; and the visceral and chronic cutaneous diseases of advanced years,-will thus require remembrance; while, the diagnosis once formed, the great susceptibility of all the organs in early life, the energy of the vital actions in the adult state, and the altered qualities of the blood and lowered vitality of the system after the fiftieth year, supply recollections of much value in the prognosis and treatment. An important consideration, also, on this subject, is the measure of correspondence which there is between the patient's apparent and his declared age. A marked discrepance here is most unfavourable to his attainment of the average expectation of life, even when in health. How inferior, also, the chances of an individual's recovery from fever, variola, or any acute disease, after his fortieth year! and how greatly enhanced is his danger, should to this be added the appearance of premature senility!

8. Married, Single, or Widowed.

9. Number of Children, and whether nursing or otherwise dependent on patient, or contributing to the support of patient, and also the number which may have died, and their diseases.

These are all of them points which nearly and variously affect the status of the party, yielding evidence, as they do, on the nature of any sexual disorder which may be present, and on the constitutional vigour and hereditary tendencies of the patient. The predisposing influence, for instance, of recent marriage in relation to contagion in general, and its exciting tendencies in the subjects of hereditary or of dormant chronic disease, are often as powerful as they are unsuspected; and the repeated mortality of infants in any family, soon after their birth, is sometimes significant of the syphilitic, as that occasioned in more advanced infancy or childhood by hydrocephalus, scarlatina, or measles, is of the scrofulous tendencies of the patient.

The insight which a reference to the particulars noted under

this head affords into the social or commercial condition of our patient, often enables us to anticipate with much precision the complexion which his case will assume under our hands. There are some individuals whose systems you observe to respond slugglishly and uncertainly to remedial appliances, and who are no sooner freed of one ailment than they relapse into another, and so on, till you are ashamed of the protraction of your attendance; and there are others in whom the very reverse of all this is gratefully observed. Now, it will often be found that the former persons are secretly eaten up of chagrin, or that they have long been maintaining an unequal fight with commercial or other difficulties; and that, in the other, the circumstances of the patient have been comfortable, and that his mind has been sustained and cheered by the influence of hope and agreeable expectation. Periods of mercantile distress, such as we have recently passed through in this country, or of political agitation and change, such as still disturb some of the other nations of Europe, teem with the most melancholy illustrations of the first of these kinds of cases.

10. Occupation.-I commend this prolific source of disease to your notice, as supplying a field of inquiry, in which, whatever the facilities of which otherwise deprived, you may all engage, and contribute to the general stock of medical knowledge, and the relief of humanity.

Its bearing on the expectation or value of life, and its utility as a key to the diagnosis of disease, are both important; and, in a population like ours,-so accumulated, diversified, and thoroughly engrossed in the acquirement of the means of subsistence or indulgence, its investigation is full of promise.

I have spoken of the influence of occupation on the value of life. I do so in reference to the professional responsibilities which you will soon have to encounter, in the examination of lives for assurance societies. On such occasions you will be guided no doubt by the general aspect of the individual, and will challenge in succession his natural, moral, and medical history; but how different, everything else being equal in these particulars, will be your estimate of the expectation of life in an unfortunate member of our own profession, who is called to labour amongst the midwifery, contagion, competition, and irremunerative but ceaseless hurry, of a country or even of a town practice, and that of a beneficed ecclesiastic, or of any other man of literary leisure! The disparity, to borrow the language of commerce, will be equal to something more than ten per centum, and in cases which are only a little doubtful, will prove sufficient to throw the poor medical practitioner out of the category of assurable lives.

The surgical wards of this hospital are ever teeming with unmistakeable illustration of the agency of occupation in giving rise to mechanical lesions; and although the power of the same in