the enlarged transverse colon; and it often happens that an inactive condition of the sigmoid flexure and rectum distress the patients for a lengthened period.

By entirely leaving off medicinal irritants, and using measures calculated to invigorate and strengthen the system, especially walking and horse exercise, the healthy tone of the alimentary tract is gradually regained. The diet must be regulated; enemata are often of great service, and in some cases an electrogalvanic current will act as an effectual stimulant to the enfeebled muscles.

Mercurials. With all the vaunted improvements of modern science in therapeutics, mercurial medicines are given in a very indiscriminate manner, and most injurious results often follow their use. Because relief is produced in some cases, a furred tongue with paler evacuations than natural, or constipation, is pretty sure to have the benefit of blue-pill or calomel. In children this injudicious proceeding is the cause of hyperæmia of the mesenteric glands, and often, I believe, of strumous deposit; and in adults a form of chronic muco-enterite is induced. If the action be excessive, great prostration is soon evident; and if the mercury be continued so as to affect the system, the vaso-motor nerve is enfeebled in its action, nutrition is impaired, pallor is produced by diminished red corpuscles in the blood, general cachexia follows, and many months may be required to regain strength.

Alcohol.—Great responsibility attaches to medical practitioners in their recommendation of ardent spirits in the treatment of disease; and the public are too prone to resort to them for the immediate relief of gastric symptoms, and of weakness.

There can be very little doubt that the relief of flatulent distension of the stomach is often promoted by these means; but we especially see the beneficial result in the direct stimulant action to the vaso-motor nerve. Many lives have been saved by the right use of alcoholic liquors, but unfortunately that which the physician may prescribe as the requirement for shortening disease becomes the habit; and, however diluted they may be, ardent spirits as a constant beverage are productive of injury. And although many of the direct experiments that have been made in reference to ardent spirits checking digestion are comparatively valueless, because the alcohol was used in a strength very rarely, if ever, voluntarily taken; there is no doubt that alcohol irritates the mucous membrane, especially if given in a concentrated form, so that the mucous membrane becomes reddened, and the secretion of the normal gastric juice is checked.

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From the free use even of wine and malt liquors we often find a state of sub-acute inflammation of the stomach produced; congestion of the liver and enlargement follow. This state gives place to chronic dyspepsia, very frequently to the vomiting of blood, and to a

disordered state of the whole abdominal viscera. Organic degeneration of the liver and kidneys often succeeds, or chronic ulcer of the stomach, with its attendant miseries; an atheromatous condition of the arteries and capillary vessels is another sequence of alcoholic imbibition; and this again becomes the cause of valvular disease of the heart, and it may endanger life from apoplectic effusions into the brain.

Alcohol may be a most valuable medicine, but the abuse of it entails innumerable miseries, and that which may be of temporary benefit becomes direct injury when unnecessarily continued; the temporary requirements of disease and of a failing circulation are never meant to be the guide of normal health; and if large doses of stimulant be continued, organic disease will almost invariably follow.

CHAPTER VI.

DYSPEPSIA FROM WEAKNESS.-1. FROM IMPERFECT NUTRITION AND FROM DISEASED VESSELS. 2. FROM EXHAUSTION OF THE CEREBRO-SPINAL NERVOUS SYSTEM. 3. FROM EXHAUSTION OF THE NERVE OF ORGANIC LIFE.-ATONIC DYSPEPSIA.

As an expression in the science of medicine, weakness is both indefinite and of various import, and we should be unwilling to make use of it in describing imperfect functional energy of the stomach did we not recognise a class of cases to which the term may be justly applied. Want of strength may be real or imaginary, real, when due to general exhaustion, imaginary, when any impediment to the performance of healthy function or the separation of excreta embarasses the system; and when in exhaustion and general weakness the stomach cannot perform its digestive function, the feebleness is increased, because the supply of fresh formative material is cut off.

The varieties of exhaustion may be traced to three sources. 1st. The exhaustion connected with diseased vessels, as exemplified in advanced life. During the earlier stages of life general functional activity is

maintained at a high standard, the wear and tear of the system is considerable, and fresh increment is required for the general growth of the body; but during its later stages a contrary state exists, the organism works at a slower pace, the wear and tear is less, and it is not necessary that the same energy of the digestive organs should persist. It is well known that in old age the vessels become rigid and atheromatous, the blood is less freely distributed, and there is less ability in the economy to restore preternatural disturbance, and less elasticity of the system; as in the autumnal leaf of the tree, the nutrition changes are more sluggishly performed, the vessels gradually become obstructed, and at length almost obliterated, so that in course of time the connection with the parent stem is easily severed; thus also in advanced life functional activity lessens, till at length it fails altogether.

The same diminished power is observed in the enfeebled digestion of aged persons, as we have previously remarked; they are conscious that the function is not so energetic as it formerly was, and, indeed, they are aware that the necessity for supply is also lessened, the bodily activity is less, and the appetite for food is proportionately small. The fact of this decreased functional power is testified by the structural changes in the several organs themselves, the muscles are less vascular, they contract with less power, and