ΤΟ CORRESPONDENTS. NOTICE. All communications for the Editor must be addressed, pre-paid, to his house, No. 25, LLOYD-SQUARE. THE EDITOR is at home every day until One o'clock; and on the evenings of Monday, Wednesday, and Friday, from Seven till Nine. ERRATUM. By an error of the press, our answer to "A MARINER," last week, was rendered unintelligible by the omission of the word "or," before the word "vegetables," and by the want of the proper stop after that word. THE INFLUENCE OF THE PASSIONS ON THE HEALTH will be resumed in our next. C. K., who complains of "boils breaking out on different parts of the body," merely states the fact, and does not give us any other information. We are ignorant whether C. K. wears a hat or a bonnet. See answer to HENRY DOUGLAS in No. 39. A. B. (Wath).—You do not mention what kind of rupture you suffer from; some are curable-all are remediable. The best advice we can tender to you is, to avoid all quacks, and as you properly term it, "advertised stuff." D. D. (Anglesey).-Until the irritability of the stomach be removed, the tonics you are now taking are worse than useless, they are positively injurious. You do not describe the case with sufficient exactness for us to prescribe with satisfaction to ourselves, or with the prospect of benefit to you. You had better write privately. CAUTION TO PARENTS.-A boy aged twelve years of age died at Cheltenham last week from excessive smoking. The symptoms were those usually caused by narcotic poisons. A. B. (Leicester Square).-The creature is a quack doctor-he ought to have been a coachman; he is well able to drive the last stage of consumption to the end of life's journey. MARY (Huddersfield).-Collodion applied to the parts is the best means we know of to prevent bed-sores. If your poor mother could afford to purchase a water-bed, her life would be made much more supportable. Any assistance we can render her or you will be cheerfully offered. M. LOELLO. When you have perused the back Numbers of our Journal, which you say you have ordered, you will learn that we do not advise in cases having a like origin to yours, in this column. Communicate privately. A. B. (Brentford).-From your description of the case, we fear you are now suffering from an accumulation of ills that have distressed you at various times in former years: your critical age, your occupation, your liability to spit blood, the "painful deadness," and "creeping sensations," are all signs that indicate the necessity of careful management in 1850, to prevent still greater anxiety in 1851. We will not venture to advise without examining you. CIVIS (Dublin).-Yes. We wrote to you at your former address, two months ago, but have not received any answer. WILLIAM (Clerkenwell).—The symptoms resemble those of epidemic INFLUENZA, which is again becoming prevalent. Pursue the mode of treatment advised in No. 5, page 34, vol. i. O. P. Q. (Rotherhithe).-Care at this season may spare you months of pain, distress, and expense in the coming winter. We decline prescribing for you without having an opportunity of examining you by means of the stethoscope. DELTA (Cambridge).-Such cases are admitted into the metropolitan hospitals, the surgeons of which are always eager to receive patients requiring operation: if you will call upon us when you arrive in London, we will, if the case appears to merit it, give you a note of introduction. - EDGAR (Kilburn).-You are within the clutches of a Jew quack. Let the loss of your five-pound note for "the five-pound case, as usual, by which £1 is saved,' be your first and last loss. ALPHA (Belper).-Here's a list of evils !" pain in the wrist; muscular debility; irritability, and susceptibility; swelled cheeks; festered gums; burning pain in the head; pain in the muscles of the leg and shoulder-blades; griping, purging; fluttering at the heart; tape. worm; tremors through the whole frame;" and, last of all, a humble but independent spirit." We promise our good friend ALPHA of Belper our best assistance, and that without "charges," if he will send us his address. We should be barbarians did we not attempt to soothe so much misery: but we cannot tax the indulgence of our readers by devoting to ALPHA the seven pages of our journal which the moral, dietetical, and medical direction of his case demands. T. H. L. (York Place, St. Pancras).-When the residence of the applicant is so near to our own, as is yours, we never advise a patient without having the advantage of a personal examination. As well as this, yours is a case for which we do not publish advice in this column. OBITER DICTUM.-Accept our thanks. V. A. A. (Chelmsford).-Having already published several articles on COUGHS AND COLDS (see Nos. 1 to 11), it is not our intention to resume the subject in this volume. Read the Numbers referred to, or purchase Dr. Yeoman's small work on these winter maladies. AN ARTIST.-The best book for your purpose is " Anatomy for Artists" by Mr. Wheeler; the price is only 2s. 6d. ANTIDOTE FOR ARSENIC.-M. Lucas, of Beauvais, gave large doses of calcined magnesia to nine persons who were poisoned by bread containing arsenic; they had very severe symptoms, but all recovered. CHARLES BENNETT (Great Portland Street).-Take three grains of the extract of conium and four of camphor every night, for a week. then report progress. A S. J. N. TRADESMAN (Huddersfield). It cannot be colic: the disease would have terminated, fatally or favourably, ere this: it cannot be intus-susception-that is, one portion of intestine enclosed within another, for a like reason. We consider the case to be one of spasm of the muscular coat of the bowel, caused by the impaction of some hardened feces. It will be useless advising what to do for your wife, as before this can reach you she must have obtained relief. Why did you not send your address ? Let us know the result. A. SIMPSON (91 or 97 Bermondsey St.).—We have been favoured with a long letter from this gentleman, advocating Mesmerism, in which the writer says, in consequence of our derision and exposure of the quackery, that "Dr. Yeoman is either very ignorant or very prejudiced " but," adds the flatterer, "I am inclined to think the latter." S. A. S. has voluntered an opinion on the Editor: if S. A. S. will transpose his own initials, he will have the Editor's opinion of him. 66 B. (Hoxton).—We imagine that the defective vision may be traced to some derangement of the digestive organs. Will you refer to the answer to T. H. L. in this number? M. (Birmingham).—The reviews appended to the filthy advertisements of the advertising quacks are all fictitious. Do you suppose that the editor of the Dispatch, the editor of the Sun, or any other respectable newspaper, would soil their pages, and pollute the understanding of their readers, by a criticism, far less by a recommendation of works which emanate from men" who," as the editor of Lloyd's says, in his paper of the 20th instant, "not merely satisfy themselves with draining their victims of their money, but drive them eventually to the brink of the grave"? A letter appeared in No. 9 of our Journal, in which was detailed the manner by which these spurious "notices of the press" are obtained. HENRY WALSH (Coventry).-You can get all the back numbers of Mr. Marr, or Mr Tarn, in your town. HARRIET (Bradford).—See Dr. Yeoman's small work on HEADACHE. In intermittent headache this snuff has been strongly recommended by RADIUS, & Prussian physician: Take, of any common snuff one ounce, add to it fifteen grains of the disulphate of quinine-and snuff at your pleasure. This can do you no injury acquaint us with its effects. JOURNEYMAN BAKER.-We would willingly render you and your fellowworkmen any assistance in our power, especially as we so well know the evil effects of night work on the health: but we cannot "agitate" the question in our columns. We suppose Lord Robert Grosvenor, your former advocate, has forgotten you in his zeal for the Globulists. CLERK (Finsbury Circus).-It may be only varicocele, perhaps some extravasation of blood-it cannot be "bursting," as you term it, of the testicle. We must see you. A A MR. SMARTT's letter arrived too late for insertion in this Number. PETER WILKINS (Gateshead).-Take, fifteen drops of elixir of vitriol in a wine-glassful of water, three times a day live sparingly, take a mild saline purge, avoid all violent exertion. Send your address, and describe particulary the colour and quantity of the blood that you expectorate. T. INGLIS (Trongate, Glasgow).-The usual practice was to defer the operation of hare-lip until after dentition. But within the last year several surgeons in London have operated immediately after birth; and certainly, from the success that has attended the cases known to us, this early age appears to be the best. So long as the deformity is confined to the lip, the operation is a simple one; if the palate be implicated, it may become a formidable affair. We should advise you to submit your child to some competent surgeon with as little delay as possible. FRED. HARKNESS (Everton).-In good health, perfect quiet, with an open chest, few persons, perhaps, breathe more frequently than about twenty times in a minute; and the quantity inhaled and exhaled may be estimated at from twenty-six to thirty-two cubic inches each time. London: Printed by CHARLES ADAMS, at his Printing Office, 8 St. James's Walk, Clerken well, and published, for the Proprietor, by GEORGE VICKERS, Strand. PEOPLE'S MEDICAL JOURNAL, No. 44.-VOL. II.] AND FAMILY PHYSICIAN. EDITED BY THOMAS HARRISON YEOMAN, M.D. SATURDAY, NOVEMBER 2, 1850. THE INFLUENCE OF THE PASSIONS ON (Continued from page 106) FEAR-TERROR. DIFFERENT individuals are by nature more or less susceptible to the action of fear. Thus some, even from their early childhood, are notable for their cowardice, whereas others are equally so for their intrepidity. Habit and recreation, however, may certainly do much in conquering a native timorousness of character. Good health, as a general rule, conduces to boldness, whereas infirmities of body are apt to beget cowardice. Thus, disorders of the stomach and liver commonly awaken false apprehensions, and diminish the natural fortitude. So, too, many other morbid states of the system depress the courage, and transform even the most daring into cowards. The effect, however, of different maladies in weakening our moral resolution, and engendering imaginary fears, is more or less strongly marked. The dyspeptic, for example, will generally be more timid and apprehensive than the consumptive subject. And, again, there are some diseases which, through the unnatural stimulation they promote in the brain and nervous system, tend to excite in us even a morbid excess of courage. Fear, like the other passions, exhibits numerous shades or degrees. It may be slight and transient, or so aggravated as completely to dethrone the judgment, and hazard not only the health, but even the existence of its subject. It is one of the most painful of the passions, and exerts very astonishing effects, both upon the mental and the bodily functions. Under its powerful influence the fiercest animals are rendered gentle, and subservient to our will and purposes. In acute fear the effects induced on the physical organisation and its functions are very remarkable, and oftentimes exceedingly distressing. The respiration becomes immediately and most strikingly affected. Thus, on its first impulse, owing to a spasmodic contraction of the diaphragm, a sudden inspiration takes place, directly succeeded by an incomplete expiration; the latter being, as it would seem, interrupted, or cut short, by a spasm of the throat, windpipe, or lungs. Hence arises the irregular and convulsive breathing and painful sense of suffocation, so characteristic of extreme fear. The voice becomes embarrassed and trembles, and, in consequence of the diminution and "ropyness" of the saliva and other secretions of the throat, is dry, husky, thick, and unnatural. Even temporary speechlessness may be induced under the first shock of this passion. The heart, likewise, suffers acutely. It becomes oppressed and contracted; it flutters, palpitates, and is agitated; the pulse is consequently small, feeble, rapid, and oftentimes irregular. T ONE PENNY The viscera of the abdomen, too, not unfrequently experience disagreeable sensations, unnatural or spasmodic contractions, and a morbid increase of their secretions. Sometimes vomiting, but oftener a diarrhoea-involuntary, perhaps -takes place; and jaundice has, in occasional instances, speedily followed its operation. The urine, also, is increased in quantity, is pale or limpid, and the desire to void it becomes frequent, urgent, and often irrisistible. The blood, as might be anticipated, abandons the surface, the face turns pallid, and the skin becomes universally cold, contracted, and rough, like goose flesh, and in consequence of this contraction, the hairs growing from it are elevated, or, in the common phrase, "stand on end" ("like quills upon the fretful porcupine"); or if this does not occur in fact, such is generally the sensation to the individual. Chills often spread themselves over the surface of the body, or portions of it, sometimes as it were in streams; and cold sweats, partial or general, frequently bedew the skin, and especially the forehead. Partial tremors, or a general shuddering, as shaking, and chattering of the teeth, as under the effects of extreme cold, or in the first stage of a paroxysm of ague, are of common occurrence. The eyes glare wildly, seeming almost as though they would start from their sockets, and the whole countenance is drawn into a most painful and unnatural expression; a convulsive sobbing, accompanied by a profuse secretion of tears, and in sensitive females severe paroxysms of hysterics, frequently occur. The muscular system may become timidly convulsed, or its energies may be temporarily suspended, and the individual consequently be rendered dumb and motionless. In extreme cases, the whole chest and the upper part of the abdomen are affected with an agonising sense of constriction, and in many instances fainting takes place. Extreme terror will, in certain cases, instead of depressing and paralysing the nervous power, arouse it into new and astonishing action. We read that it has even caused the dumb to speak, and the paralytic to walk, and that the most obstinate and painful diseases have been known suddenly to yield under its potent influence. Von Swieten records the case of a man, who, under the action of sudden terror, recovered from palsy of one half of the body, that had afflicted him for years. Many instances have also happened where gout has been immediately expelled by the influence of unexpected fright. An old author relates of one of his patients suffering a paroxysm of this disease, that having his feet and legs wrapped in poultices of turnips, a hog entering his room and beginning to feed on the turnips so alarmed him that he began to run and jump, and all his gouty pains straightway vanished. Intermittent fevers or agues have also yielded to the same impulse. Dr. Fordyce tells of a man afflicted with a fever of this description, that his brother having led him to walk by which persons entrusted with their education ought to have the the edge of a mill dam, pushed him suddenly into the water; strictest regard to." Sporting with the timidity of children, as and which, as he was unable to swim, naturally put him in a very startling them with sudden and uncommon noises or sights, which great fright. He was speedily, however, taken out, and from appears to afford so much amusement to some inconsiderate peothat time he had no further paroxysm of his disease. The follow-ple, cannot be too severely censured. Equally censurable, too, is ing case is related in the 18th volume of the Medical and Physical the practice of playing on their natural fears as a method of Journal :—“ A lady in the prime of life, of robust habit, was for punishment, or with the view to enforce their obedience, as four years afflicted with epilepsy in a violent degree, the paroxsyms shutting them up in the dark, threatening them with some returning three or four times a week, continuing for some hours, of the many nursery spectres, which have been created to help and leaving the patient in a state of stupor. A variety of me- inefficient parents in subduing their misgoverned and consedicines had been tried in vain, and the case was considered hope- quently refractory offspring. How common is it to hear from the less, when, on receiving a dreadful mental shock, by the circum-lips of nurses and even mothers, while striving to put children stance of her daughter being accidentally burnt to death, the dis- asleep, invocations to "Bogy," "Black-man," "Shut your eyes! ease entirely and finally left her." Here's old bogy!" "Hush-hush! lie still! he'll have you!” Trifling, now, and unimportant as such expressions may seem, yet are they far from being so when we view them in their influence on the moral and physical well-being of the young. The impression which such thoughtless language is liable to induce on the tender and naturally timid mind of childhood is far deeper than most of us are prepared to believe. Even severe and settled insanity has been completely removed by immoderate fright. In the thirty-first volume of the Medico-Chirurgico Review, we find the following case, quoted from a Prussian Medical Journal :-"A man between thirty and forty years of age had been from the year 1827 to 1831 affected with an extreme degree of insanity, alternately with periodic fits of raving madness. His case was deemed quite hopeless; and for the two following years, he vegetated, so to speak, in the public lunatic house of the place. A fire having accidentally broken out near his cell, his mental powers, which had so long slumbered, were suddenly aroused; and Dr. Ollenroth, upon visiting him a few days afterwards, found him perfectly intelligent, and assiduously occupied with some domestic arrangements. He had no recollection of his former condition. All that he remembered was simply that, on the approach of the flames, he felt himself seized with an indescribable sense of terror, that he sprang up from his bed, and that he suddenly regained his intelligence.' Many minor affections are also known to be immediately removed, or suspended, under the strong impression of fear, as toothache and other nervous pains, hypochondriasis, sea sickness, &c. These cases illustrate what may be termed the curative effects of fear-how many cases are recorded of its fatal effects? Terror may prove instantly fatal, by at once destroying the nervous energy and suppressing the action of the heart; or it may bring on hæmorrhage, and convulsions, quickly terminating in death. Children and females, in consequence of the higher degree of nervous sensibility with which they are generally endowed, are the most liable to fall victims to fear. Broussais relates the case of a lady, who, on feeling a living frog fall into her bosom from the claws of a bird of prey, while she was sitting on the grass, was instantly seized with such a profuse bleeding from the lungs that she survived but a few minutes. Many examples might be adduced where epilepsy has been the consequence of sudden fright, and even where a tendency to it has been thus rendered permanent in the system. A celebrated German physician asserts, that in six out of fourteen epileptic patients under his care at the hospital of St. Mark, at Vienna, the disease had been caused by terror. A man travelling alone by night, encountered a large dog in a narrow path, and fancying himself seized by the animal, he reached home in extreme terror, and on the following morning was attacked with a violent fit of epilepsy, of which he had many returns. (Dr. Clarke.) In young children, convulsions and epilepsy are brought on with great facility under the operation of strongly and suddenly awakened fear. Tissot in his Avis au Peuple, referring to the foolish and dangerous practice of frightening children in sport, observes: "One half of those epilepsies, which do not depend on such causes as might exist before the child's birth, are owing to this detestable custom; and it cannot be too much inculcated into children never to frighten one another; a point (To be continued.) ON VARIOUS CIRCUMSTANCES IMPORTANT TO BE ATTENDED TO IN PRESCRIBING MEDICINES. (Continued from page 130.) DISEASE exerts an influence on the action of medicine in the animal economy very important; the susceptibility to external impression and to action being much varied in morbid affections, and the operation of medicines of course being modified by such variations. The state of susceptibility being in general different when it varies much from that healthy standard, the doses of the medicine administered are regulated accordingly, and thus it is obvious does not admit of much general observation, as being entirely dependent on the nature and state of disease. We may mention, however, two striking extremes. In the diseases arranged under the class febres and exanthemeta of Dr. Cullen's arrangement, all characterised by febrile action, the animal economy is remarkably irritable, and susceptible to stimuli; the mildest medicines, and in the smallest dose, produce powerful effects. In the diseases arranged under the class neuroses, of the same arrangement,―mania, melancholia, hypochondriasis,—all characterised by stupor and insensibility to stimulants, the most powerful medicines, and in the largest doses, are required to produce even moderate effects. Besides these guides now mentioned in the administration of medicines, the choice of the practitioner must occasionally depend upon the circumstance of the patient being more or less immediately under the practitioner. Then, if the patient can be seen every day, or frequently, by the practitioner, the most active medicines which the nature of the case requires should be chosen. But if he cannot be seen, or is not resident in the same place, the practitioner should choose a remedy of the same class, but less likely to have a violent effect. Thus in prescribing for intermittent fever, where a patient cannot be visited every day or oftener, the Peruvian bark should always be preferred to the arsenical solution. In dropsical complaints, the supertartrate of potash to the digitalis or elaterium. In apportioning the dose of any very active medicine, it is of the greatest moment to determine the relative degrees of power between the system and the remedy; and to know to what extent the latter is likely to be carried consonantly with the power of life to resist it. Thus, after a patient has been exhausted by protracted or severe suffering, a dose different, or milder than one at the commencement of the disease, becomes necessary. THE VARIABLE ACTIVITY of a medicine should also be appreciated, and the practitioner would act judiciously, if he were to reduce the dose, should it be a very considerable one, whenever a fresh parcel of a medicine is commenced, especially of the powders of active medicines liable to deterioration from being long kept; those of cicuta, digitalis, &c. THE TIME OF DAY at which remedies should be administered, likewise deserves attention. Evacuating medicines ought to be administered late at night or early in the morning. It would seem that during sleep the bowels are not so irritable, and consequently not so easily acted upon, which allows time for the ready solution of the substance. The same observation applies to alteratives and other medicines, which are liable to suffer from vexatious irritability of the bowels. It is on this account eligible to exhibit guaiacum, pil. hydrargyri, &c., when they are not intended to purge, at bed-time. On the other hand, when the effects of a medicine are likely to be lost by perspiration, as is the case with diuretics, many of which are by external heat changed into diaphoretics-it becomes a question with the judicious practitioner whether he cannot select some more favourable period for their exhibition. Medicines which are in the form of a pill, as they are liable to be long kept in apothecaries' shops, and of course to become remarkably hard, should generally be administered at bed-time, to give time for the gastric juice and other secretions of the intestinal canal to complete their solution. Under these circumstances they will pass through the whole tract of the bowels as inert bodies, disappointing the intentions of the practitioner and patient. Aloes administered in powder operates in from two to three hours; given in pill it requires from eight to twelve hours to produce its full operation. The old custom of giving medicines in the morning, fasting, is not quite so absurd as some modern practitioners have been led to suppose. A weak or mild medicine, taken two hours before breakfast, upon an empty stomach, will operate equally powerfully as a much stronger one will if taken at a later period, or upon a full stomach. Every practitioner must be struck by the truth of this remark, when administering mineral waters, as those of Cheltenham or Harrowgate. THE INTERVALS between doses of medicine must be regulated by the nature of the remedy, and that of the object which it is intended to fulfil, and whether it be desirable or not that the last dose should support the effects of the preceding; or whether there be any fear of a reaction, or collapse, taking place after the effect of one dose has subsided, unless immediately repeated, Thus the effects of diffusible stimulants, ammonia, or of ether, are very evanescent; they should therefore be repeated at short intervals. The same may be said of diaphoretics. We ought not to allow the periods between the doses to be so remote as to occasion any striking abatement in the impression. So opium, when stimulant operation is required, as in diseases of debility, fevers of the typhoid kind, &c., should be given in small doses at short intervals, so that it may produce a uniform and regular state of excitement. But when the object is to mitigate pain, allay irritation, and produce sleep, it ought to be exhibited in full doses at distant intervals. There is a caution also which it is very necessary to impress upon the practitioner, respecting the power which some medicines possess of accumulating upon the system. This is notorious with regard to lead and mercury. Dr. Withering has observed that the repetition of small doses of digitalis at short intervals, till it produces a sensible effect, is an unsafe practice, since a dangerous accumulation will frequently take place before any signals for forbearance present themselves. From a COMBINATION of medicines beneficial and mild effects result, which would not be produced by any of them given separately. From two distinct emetics, combined together, or from two distinct purgatives, an effect results, which is far more certain and mild, than from either of the two administered separately; and the same holds good with other medicines. Besides the causes now detailed, affecting in a very material point of view the action of medicine upon the animal economy, and which ought to be minutely attended to by every medical practitioner, it is necessary to take notice of a few others not less important, affecting the vegetable and animal world. These are SOIL, CULTIVATION, CLIMATE, SEASON, and ADULTERATION. There can be little doubt but the soil, cultivation, climate, and season, may very materially influence the active properties of a medicinal plant; while the two latter of these causes (climate and season) may as essentially change the type and character of a disease, and modify the vital susceptibity of the patient. This must be admitted to its full extent, or it will be extremely difficult to explain the contradictory and even opposite opinions, and to reconcile the conflicting testimonies of the physicians of different countries, with respect to the efficacy of the same remedies in similar diseases. CLIMATE produces a powerful impression upon vegetable and animal life. It is probable that in some southern countries, some vegetables enjoy more energetic properties than in northern climates. Senna, by transportation from Arabia into the South of France, assumes a morbid change in its physiognomy and virtues. The leaves are more obtuse, and its taste is less bitter and nauseous, than the pointed leaved variety, whilst its effects will be found to be less purgative. Can a more striking proof of this fact be adduced, than the well-known effect of perfumes at Rome? The inhabitants are unable to encounter the strong scent of flowers in that climate, without experiencing a sensation highly oppressive, and which, in some cases, is even succeeded by syncope. Dr. Harrison, who resided some time in Italy, states, that he has no difficulty in asserting that narcotics act with greater force even in small doses, at Naples, than in England. The extract of hyosciamus, when given to the extent of three grains thrice a day, produced in two patients temporary amaurosis, which disappeared, and again recurred on the ultimate suspension and administration of the medicine. And it deserves particular notice, that these very patients had been in the habit of taking similar doses of the same remedy in England, without any unpleasant effect. Now that this depended rather on an increased susceptibility of the patient in the warm climate than on any increased power in the remedy, is unquestionable, since the extract which was administered in Italy had been procured from London. At the baths of the island of Ischia, the most prevalent diseases were effects arising from the abuse of mercury. Hence we may fairly conclude, that the metal is more active in its effects there than in our country. "The doses of medicines," says Dr. Harrison, as seen in the prescriptions and works of English physicians, excite universal astonishment amongst the faculty of Italy." Medicines act differently on the same individuals in summer, in winter, and in different climates. ADULTERATION deserves to be ranked amongst the most powerful causes which have operated in affecting the reputation of many medicinal substances. The Peruvian bark fell into total disrepute in the year 1779, from its inability to cure the ague, and it was afterwards discovered to have been adulterated with bark of an inferior species. Sydenham speaks of the adulteration of this substance before the year 1678. He tells us he had never used to exceed two-drachm doses of cinchona in the cure of any intermittent, but that of late the drug was so inert, rotten, and adulterated, it became necessary to increase the dose to one, two, or three ounces. "Very few practitioners have any idea (says Dr. Paris, who has paid particular attention to this subject) of the alarming extent to which the nefarious practice of adulterating medicines is carried on. There can be no doubt that it has been carried on in all ages, but the refinements in chemistry have enabled the manufacturer of the present day not only to execute this fraud with greater address, but, unfortunately, to vend them with less chance of detection. It will scarcely be accredited, when I affirm that many hundred persons are supported in London by the art of adulterating drugs; besides a number of women and children who find employment and excellent profit, in counterfeiting cochineal with coloured dough, isinglass with pieces of bladder and the dried skin of soles; and by filling up with powdered sassafras the holes which are bored in spice and nutmegs, for the purpose of plundering the essential oils." In prescribing medicines, the principal object to be kept in view is simplicity, and this was greatly neglected in the presciptions of former days, and is even so still in those surrounding countries. Dr. Paris informs us that he was told by a medical practitioner in the country, that the quantity, or rather complexity, of the medicine which he gave his patients-for there never was any deficiency in the former-was always increased in a ratio with the obscurity of their cases. "If," said he, "I fire a great profusion of shot, it is very odd if some of them do not hit the mark !" Sir Gilbert Blane, in his Medical Logic, has given us a similar anecdote. A practitioner being asked by his patient why he put so many ingredients into his prescription, is said to have answered, more facetiously than philosophically, "In order that the disease may take which it likes best." With regard to the directions in a prescription how medicines are to be taken, they ought always to be written distinctly in the vernacular (English) language. In prescriptions, perspicuity is our first object; it is not here that a medical man is called upon to display his learning, and by clearness,-by writing the directions distinctly-he puts it out of the power of any individual to injure his reputation, or to endanger the safety of the patient. THE DISEASES OF ARTISANS. THE DISEASES OF TAILORS. (Continued from page 131.) FISTULA IN ANO. FISTULA is literally a pipe to carry water; hence it denotes a pipe-like sore,, with a narrow orifice, and without disposition to heal. Fistula in ano is a sinuous ulcer in the neighbourhood of the anus and rectum, having a small outlet from a larger cavity, which discharges a thin, serous, foetid matter. In consequence of the laxity of the cellular membrane in the vicinity of the rectum, abscesses, or common tumours, even boils, which form here, are easily diffused, and thus the matter, instead of " pointing," or "coming to a head," and escaping externally, burrows by the side of the gut, often to a very formidable extent, and frequently so far as to make a direct communication with it. Hence the necessity of very early attention and great care in the treatment of abscesses so situated. The causes of fistula are various; in some cases continued constipation is a well-detected cause, and in others relaxation of the bowels lays the foundation of the disease but it occurs far more frequently in persons whose occupation is sedentary than in those of active life; disease of the liver, consumption of the lungs, neglected piles, are also causes. It sometimes arises from an abscess formed externally near the anus, especially during hot weather, in persons who are not sufficiently attentive to cleanliness, and who neglect to wash away the peculiar secretions which collect in the neighbourhood, and produce much tenderness between the nates (buttocks). Fistula, however, more frequently arises from the formation of an abscess in the interior of an internal pile, which finally bursts into the cavity of the rectum. The constant action of the sphincter muscle, contracting and dilating as it does, prevents that repose which is necessary for the healing of the original abscess, which increases, suppurates, burrows, and completes the forma tion of fistula in ano. Those fistulæ in which the matter has made its escape by one or more openings through the skin only, are called blind external fistula: those in which the matter has been discharged through an opening into the rectum, without any aperture in the skin, are called biind internal piles: and those which open both into the gut, and also externally through the skin, are called complete fistula. Fistula generally commences with some degree of general fever; there is a burning heat, and acute shooting or throbbing pains experienced at the extremity of the rectum, with a swelling or small tumour at the lower part of the buttock, which now be comes so exquisitely tender, that the patient is unable to sit; the pain increases, matter is formed; the desire to go to stool is frequent and urgent, and the pain is then excruciating; sometimes there is great desire to pass the water frequently, and no ability to do so,-in fact, retention of urine takes place. The local irritation increases, the tumour enlarges, an abscess is formed, which either bursts externally, or, in consequence of its contiguity, internally into the rectum. The swelling, which is the forerunner, nay, the origin of the complaint, should at the commencement of the malady be opened by the point of a lancet at the most eligible situation, as soon as it is "ripe," otherwise it will "burst" of its " own accord," or else burrow and form one, two, or more sinuses or fistulæ. When a throbbing tumour has once formed, all consideration of preventing suppuration is generally out of the question; and our endeavours, if called at the beginning, must be directed to moderate the symptoms; to forward the suppuration; when the matter is " formed," to let it out; and to treat the sore in such manner as shall be most likely to produce a speedy and lasting cure. When there are no symptoms which demand especial attention, that is when the degree of pain is trifling, with little irritation about the bladder, and the pain is not violently urgent, all that we have to do is to promote the suppuration of the tu mour, and a soft poultice of bread or linseed meal is the best application. In some habits an obstinate constipation attends this stage of the complaint, accompanied, not unfrequently, with painful distension and enlargement of the veins of the rectum, both internally and externally. Whilst a quantity of hardened feces are detained within the large intestines, the whole habit must be disordered, and the symptomatic fever, which necessarily accompanies the formation of matter, must be considerably heightened. And while the vessels surrounding the rectum (which are large and numerous) are distended, all the ills proceeding from pressure, inflammation, and irritation must be increased. The warm bath, gentle laxatives, (see Nos. 22 & 23,) and a low cool diet must then be the remedies; whilst a soft poultice or piece of spongio piline will serve to relax and mollify the swollen parts and hasten the suppuration. We are not advocates of the knife; but by the proper and timely use of a bistoury or lancet, an immense amount of pain and misery may be obviated in the treatment of fistula. We beg our readers to observe that we only advocate the |