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stomachic bitters and aperients, as the decoction of cinchona, or compound infusion of gentian, with infusion of senna; dilute sulphuric acid and sulphate of magnesia in one of the bitter infusions, or the infusion of roses; seidlitz powders, with tincture of calumba and compound tincture of cardamoms. teaspoonful of an electuary, composed of confection of senna, bitartrate of potash, carbonate of iron, and syrup of ginger, taken at bedtime, will, in many cases, have the effect of procuring a copious evacuation in the morning.

Nitric acid, with infusion of bark, without the addition of any aperient, will often give tone to the intestines, and produce a regular action. The compound extract of colocynth with quinine, to which, if necessary, one or two grains of blue pill may be added; or equal parts of the compound galbanum pill with the compound rhubarb pill will be found useful; to the foregoing I have, in some cases, added with advantage the oxide of silver. The extract of nux vomica, in combination with an aperient pill, has a powerful influence in relaxation of the rectum; or the alkaloid strychnia, in the proportion from a thirtieth to a fiftieth of a grain for a dose, may be prescribed with either of the foregoing mixtures. But lavements are the most important of all remedies in relaxation of the rectum: these should be

the least irritating, so that the bowel may not be habituated to this means of stimulation, and they should not exceed in quantity half a pint. I have seen important benefit result from the injection of six or eight ounces of cold water after each dejection, and its retention for a few minutes: when the relaxation has existed for some time, it may be necessary to add some vegetable or mineral astringent.

In concluding, I may recapitulate in a few words the principles on which habitual constipation is to be treated. In the first place it is highly essential that all who are able should take daily exercise, short of fatigue; if, from bodily debility or other cause, the patient is unable to leave the house, frictions of the abdomen at the closet, or whilst he is in bed, should be had recourse to; a regular period should be observed for evacuating the bowels, and if the nisus does not occur, the mind should be made to dwell on the subject a short time previously, that the desire may be provoked: a glass of cold water taken early in the morning will often influence the action of the bowels. Enemata of cold water, with or without the addition of astringents, used after dejection, are important adjuncts in the treatment of habitual costiveness. When it becomes necessary to prescribe medicines to be taken by the mouth, they must be so combined that, whilst they unload the bowels, they

may strengthen and impart tone to them, and drastic purgatives which produce debility of the intestinal canal should be avoided. The diet of the patient must be regulated: breakfast should consist of weak cocoa, which is preferable in most cases to tea or coffee, with dry toast and fresh butter with some people, brown bread is very useful in promoting the action of the bowels, yet in others it will induce pain at the epigastrium, flatulence, and heartburn. If the patient dine late, he may take a plate of thin soup, or a sandwich and a glass of water, for luncheon; at dinner he may partake of a moderate quantity of wellcooked vegetables, with brown meats well done; white meats are to be avoided, being less digestible: a very general opinion prevails that chicken is more easy of digestion than beef and mutton, but the converse is in fact the case; pastry must not be allowed, but there is no objection to light farinaceous puddings, or the Italian pastes, as macaroni, vermicelli, &c., which are highly nutritious and easy of assimilation. According to circumstances, wine may or may not be taken though a different opinion formerly prevailed, the French and Rhenish wines are more wholesome than port and sherry. Spain and Spain and Portugal grow many excellent light wines; but, from the little encouragement given to commerce by the governments of these countries, and the heavy import duties, they

seldom find their way to England. If any reason exist that wine cannot be taken, weak cold brandy and water may be substituted. In the evening, a cup of coffee, tea, or cocoa, and a biscuit, may be permitted; but the habit of taking wine or spirits before going to bed is to be entirely discountenanced. By the adoption of the plan suggested, and implicit obedience on the part of the patient to the rules laid down, we shall not often be defeated in our attempts to restore him to health and comfort.