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Related post: ■ch cases, we have known one grain taken at bed-time to meficial in carrying off redundant phlegm. Ipecacuan, by g the internal lining of the stomach and gullet, occasions it f oflT the phlegm or slime that may be adhering to it, so that mm off with the chyme. It may also afford relief by pro- i less adhesive secretion, and by diminishing the quantity inning a determination of blood to the surface of the body, reasing the secretions of the skin. In elderly people of ebnstitutions, or of leucophlegmatic habits, or disposed to il swellings of the legs, this medicine, by nauseating the p bas, in a few days, induced such a degree of general de* hat even the most powerful stimulants have failed to pro- \j salutary effect, the patients generally complaining of m rallying power. meniof Costiveness in Scrofulous Subjects. — By all medical scrofula is termed a disease of debility* Cullen, in Buy Indapamide Online his f, thus describes it, ^^ tumefaction of the conglobate glands, fthe neck, swelling of the upper lip and soft parts Buy Cheap Indapamide of the rid cheeks, soft skin, and enlarged abdomen." Dr. Good t' to be '^ a disease of debility, operating by a specific influence rculaiiftgj and particularly on the lyfnphatic system ;*' but this influence is, as is supposed, '^ the result of a specific I^HYsic] 100 [Costheness in Scrofula. matter,** the doctor admits is not clear to him. The prevalent idea that the specific matter is from the first a peculiar irritant or an aeri* monj, he positively asserts to be a mistake; for, sajs he, ^^ the dis- iaase is accompanied throughout with diminished instead of inci'eased irritability," and hence, in his opinion, the power producing it mast be more of a sedative nature than of an exciting or actuating qusliiy ; and it is in this diminution of irritability, proceeds the doctor, that scrofula differs from a// other diseases of weakness, since the debility and irritahiliti/ generally augment in like proportion, and maintatn an equal march. '* In refutation of this opinion, we need only notice a fact, well known to the surgeons of provincial hospitals, that scrofulous affec- tion more frequently occurs in robust than in debilitated subjecta, whose muscular system shews no deficiency of irritability, and whose sanguiferous system is in a plethoric state and evinces increased strength.* Every surgeon of observation knows that the progress of scrofulous tumefaction of glands is increased by a stimulaiimg cataplasm ; and, if it arose from debility, surely a local stimiHant would have a contrary effect. In cases of white swelling, scrofuloas affections of the periosteum and of organs, stimulants evidently prove injurious. The idea which generally obtains among routine prac- titioners, that scrofula is a disease of debility, has assuredly led to a maltreatment of the disease ; and, from long observation, we have no hesitation in saying, that, by the use of stimulating or tonic medi* cines, and a stimulating generous diet, many thousands have been hastened to their graves in this country, and to it we ascribe the prevalence of pulmonary consumption. Dr. Lambe, a physician of great experience and observation, who has paid particular attention to scrofula, states that he has found nothing more eflScacioos in arresting the progress of scrofula, and in preserving the scrofnlous habit in a healthy state, or free from local mischief, than a. vegetable diet ; and he condemns the use of any kind of stimulants. Dr.Good observes, that ^^ this disease of the lymphatic system often extends itself to the eyes, the mucous glands of the nose, the tonsils, and even the joints and bones; as gout that ordinarily shews itself at first in the \9i7iii// joints, and rheumatism in the large jolniSy apread \ ■ ■ ■ ." * With respect to the assertion so frequently made by routine physicians, thsitdebiiitjf and irritability generally augment in like proportion, andmaip- tain an equal march, i. e. that irritability increases with debility, we really discover nothing in it but jargon, to which the ignorant most have reoouive in order to cover their ignorance, or to prevent in^jfauitive enquiries. Irri- tability is a power residiug in muscles ; and if it be diminished in a muscle its power will of course be diminished ; is it not then ridiculous to saj that the irritability augments in proportion as the debility of the body increases? When a muscle exhibits an increase of power, as in cases of acute and chronic spasms, it is attributed to increased irritability, and this increase routine practitioners ascribe to debility !! The fact is, without such jar|oa or obscurity of technicalities, the fee^rade could not be supported^ It is common for the mind and nervous system to become too suscep.Ubls of impressions, or excitable as the strength of the body declines ; but the irritability, a property inherent in muscles, decreases in proportion as the body becomes weak. FHT81G . 1 10 1 [Cosiiveness in Scrofula. lot ttofirequently to the membranes and the muscles.'* One would sappose Djf this remark, that the doctor was not aware that the miphatic system pervades the whole body« The doctor, regardin|f Ae disease as one of debility, directs his readers to adopt a tonic sad siimulaiing treatment. He admits that the alcaline remedies tmwe proved beneficial ; but not as some chemical theorists have hngined, by neulralizing acidity in the stomachy or acrimony that his generated in the system, although he does not deny the existence sfthe latter, but from its glimulating effects! '^ They are,'' says he, ^ geaile stimulants^ admirably adapted to the debilitaiea and mhlent condition of Generic Indapamide the vascular system ; and hence, observes the ioelor, in whatever form they are given, they have a cAancf of doing good.'* The late Dr. Baillie stated that he uniformly found alcaline ■edicioe to decrease the action of the vascular system j and con- aventlj to reduce the vittd powers. When ^uch preat authorities er, who dare to presume to decide which is right ? except, in- jfitdy the great doctors Shearman, Copland, Eady, and Solomon,who mnever at a loss to explainevery phenomenon. VVe confess we have Mrrer witnessed any beneficial effects from alcaline medicines in mofula, iHien an acid did not prevail in the stomach, or when uric icid did, not predominate in the urine, or when the sensible [NBrBpiration did not redden litmus paper. '^ It is to this principle [alcslioe),'* says Dr. Good, ^^ that we are perhaps to resolve all the idvaotage that has been stated by different writers, and in the liferent ages of the world, to have resulted from the use of burnt ipoBge, burnt cuttli^ fish^ burnt shells of all kinds, burnt hartshorn, tad bornt secundines." The doctor seems to be as great in chemistry It be Is in anatomy. It is the first time we have beard of burnt hKtahorD, burnt cuttle fish, and burnt secnndines being alcalines* Iheiruebumt hartshorn and calcined cuttle-fish bone is phosphate if liae^'and, if not adulterated with chalk, will not effervesce on the idditioB of an acid. ^In our days," says Dr. Good, *^ dU these remediiss l|m deservedly yielded, to Purchase Indapamide Online the carbonate of soda, or sabcarbonate of fllBOiiia, which," adds the doctor, " in a more elegant and con- pijilrii/frf form, offer oAo/eDfr virtues maybe contained in the old Mdidi^ea*' ! Now if the same effects are produced bv the carbonate ehoda, how can he attribute its eiScacy to the stimulating influence •f the alcali on the vascular system ? The carbonate of soda is not •ralcali, the soda being neutralized by carbonic acid gas. The 4wtor may say, as some legitimise routine physicians have said, how can this be the case when the carbonate is capable of neutralizing •ridity in the stomach, and' of curing' heartburn ? When the Sivbbnaie of soda or potash meets with an acid in the stomach, for pUehthe alcaline base has a greater attraction than for the carbonic mM, it of course unites with the former, and the latter is disengaged k* gaseous form. In good carbonate of soda, the alcali is as much itvtralized by the carbonic acid, as. by the sulphuric acid in glauber*8 iriLcir the muriatic acid in common salt ; and no petson acquainted Buy Indapamide iith chemistry would term the carbonate of soda, or the carboaatft of ftUuih^ mn alcali. •Lime wMer and the muriate of barites, the latter of which 'Or« TOL. X. p PHirsic.} 102 [Costkeness in Scrofula. Adam Crawford, about fortj years since, introduced as a specipic remedy for scrofula. Dr. Good observes, can only prove beneficial from the general principle of their bein^ stimulants^ and especially of the lymphatic system ; and the same, says he, may be observed d parsley, sarsapatilla^ meserion, balsam of sulphur, calamus aronuH ticus, and horse raddish, all of which have had their votaries ta their days." The balsam of sulphur unquestionably diminisbei irritability ; and, as to the decoction of sarsaparilla, if it ever did produce an^ salutary effect, we should attribute it more to its quieting or tranquillizing effects as a diluent than Order Indapamide any stimulating quality n possesses. Dr. Cullen found the coltsfoot more beneficial in cor rccting the scrofulous habit than any other medicine, and it impart! to boiling water nothing but a mucilage, similar to that of sarsaparilla We. have given the marshmallow root a preference to sarsaparilla because it affords a greater quantity of mucilage ; and we have verj frequently witnessed its beneficial effects in scrofulous Order Indapamide Online affections, do by stimulating the vascular or lymphatic system, but by allayiiq irritation. It appears to us that scrofula is not produced by any specifii poison or acrimony, but that it is dependant only on the origina delicate structure and excitability of the whole lymphsitic system and if this idea be correct, the object of practice is not to stimulati the body^ or any particular system of Purchase Indapamide it, but to keep down irrita- tion in the lymphatic system, and to strengthen it by gentle tonics and this treatment we have uniformly found beneficial. Scrofula, like almost every other disease, has its stages. In th first stage it is decidedly a disease of increased action. The loca affections are inflatnmatory, and they have a peculiar character probably in consequence of being confined to the lymphatic gland and vessels. After suppuration has taken place, or the diseaa has arrived to its last stage, the circulation generally heconic
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