Page:Transactions of the Provincial Medical and Surgical Association, volume 1.djvu/78

 character. In all such, the intestinal secretions become first increased, then vitiated. This vitiated matter accumulates, inflicting a two-fold injury, both obstructing the secerning vessels in the exercise of their functions, and acting itself as an irritant in producing or aggravating manifold distant disturbances. If the stools, and especially those which detergent purgatives evacuate, be duly inspected, they will supply ample evidence of the vitiated secretions here referred to, and furnish much valuable guidance both in the choice of purgatives, and in limiting their salutary use. In no class of remedies is accurate administration more important than in that of aperients. Remedies of this class act in various ways; they carry forward the ordinary contents of the bowels; or they excite the exhalents producing watery evacuations; or they cause the mucous membrane to throw off its redundant secretions. According as either operation is needed, should the special aperient be adapted. So connected is a disordered state of the intestinal canal with most diseases, whether as cause or effect, that its precise condition, as evidenced by the stools, cannot be too accurately noted in reports of medical treatment. Much benefit has resulted from the greater attention directed to the state of the bowels, by Dr. Hamilton and Mr. Abernethy, both of whom have ably advocated the free evacuation of the alimentary canal. Both, however, fail to connect the disordered condition of bowels with the previous state of health, and so far leave the pathology of the diseases of which they treat, defective. Mr. Abernethy errs in tracing diseases to a disordered state