wind. In general, too light air disagrees with patients under this disease: hence elevated situations are found hurtful. But such is the variable nature of the malady, that some cannot breathe in a light air, while others feel equal inconvenience in a condensed atmosphere. An uniform pure air is required by some, while the air mixed with the carbonic acid from a gas lime-kiln, or from burning coke, is more grateful to others. Some again are greatly relieved by being placed near a fire of coal or wood, and experience a sensation of suffocation when coke is used in lieu of coal or wood. The sea air is often prejudicial, even independent of its temperature.

In this disease, walking and sailing have been much recommended as exercise; riding on horseback is, perhaps, most salutary, as the viscera are exercised by it, and the nervous system quieted by the pleasant occupation of the mind, in managing or guiding the horse, &c.

In regard to clothing, flannel next the skin is proper during winter: but in summer it tends to relax the body, and render the nervous system more irritable; it should, therefore, in this season, be changed for cotton. The chamois leather has been much recommended as a substitute for flannel, to be worn next the skin, in cases of asthma; but in consequence of its absorbing the sensible perspiration, and becoming cold on taking rest after a little exertion, it does not act so beneficially as fine flannel.

In asthmatic cases, the state of the mind is one great and leading consideration. Mental perturbation I have already observed is, in itself, often an exciting cause of the disease, and never fails to aggravate, or prolong, the paroxysm; the patient, therefore, should be indulged in his particular fancy, or prepossession. The mind is here extremely irritable, and the least opposition or restraint often produces very depressing effects.

PREVENTION. - Flannel next the skin, the occasional use of an emetic of ipecacuan powder, the oxymel or lozenge of squill, and an issue between the shoulders, or in the arm, will often succeed in preventing, and never fail to abate the violence of a paroxysm of asthma, or to relieve the breathing during its absence in young or plethoric subjects. The diet should consist of broth, light puddings, fowl, veal, and other articles of tender fibres; and a little ginger used in the beverage, to obviate the flatulent effects of vegetables. Good old perry or cider, when it agrees with the stomach, is a proper beverage.

Asthmatic people, in consequence of peculiarity of the nervous system, being differently affected by the atmosphere, they must consult their own feelings as to the place in which they should reside. A spacious room should always be preferred. When the breathing is very difficult, oxygen, or the vapour of tar, gra

dually diffused throughout the air of the room, generally affords great relief, and will often prevent a paroxysm. The odour or gas which escape from flowers or plants during night, being very apt to aggravate the difficulty of breathing, they should be kept in the bed-room only during the day-time.

DISTINCTION. Asthma may be distinguished from inflammation of the lungs and pleurisy, by being chronic, unattended with acute pain or stitches in the chest, and being free from fever. The returning of the paroxysms at intervals, the sense of constriction about the chest, occasioning the patient to get into an erect posture, and to fly for relief to the cold air, will distinguish asthma from other diseases of the lungs.

Practical Remarks. By the foregoing article on asthma, it appears that the disease is dependant on morbid irritation of the nerves of the lungs; that whatever disturbs the general health is capable of bringing it into action; that the treatment must be varied according to the state of the constitution; i. e. when plethora prevails, bleeding, and such remedies as are calculated to reduce the strength of the system, are proper; but when the system is in a debilitated state, strengthening means are to be employed. The sufferings of all asthmatics being increased by distention of the bowels, the state of the stomach and intestines should be particularly attended to. That the most efficacious remedy for allaying morbid irritation of the nerves of the lungs is the anti-asthmatic draught, page 106. That opium, by checking expectoration, constipating the bowels, and disturbing the general health, is generally hurtful. That when extreme debility prevails, the system must be supported by a generous diet, and the use of cordials.

OF BARRENNESS. There are several causes of barrenness, which, from their peculiar delicacy, cannot be noticed in a work of this kind.* Disease of the ova, injury sustained by frequent miscarriages, general debility of the system, irregularity in the menstrual secretion, and morbid irritability of the womb, are its most frequent causes.

Whatever be the cause, all that art can do is to improve the state of the general health, and to remove local obstruction or morbid irritability. With the former view, the patient may take ALTERATIVE PILLS, p. 116, and the NERVOUS MIXTURE (D), p. 113. If acidity prevail in the stomach, two drachms of prepared soda may be added to the mixture. In case the bowels should not be sufficiently relieved every day, one or two of the APERIENT PILLS, p. 117, may be taken every or every other

Those who wish to be acquainted with the different causes, &c. of barrenness, the author refers to the Supplement to the 35d Number of the Monthly Gazette of Health, and a Practical Treatise on the Buchu Leaves, by the author of this work.

night, according to their aperient effects. After the alterative pills have been discontinued a week, cold bathing will prove beneficial. In case the patient be affected with fluor albus, the same topical management will be necessary as directed for that disease.

The same rules as are given in cases of indigestion with respect to diet and exercise should be strictly attended to by the barren lady.

If the cause be either general debility, irregularity of the menstrual evacuation, or an unhealthy state of the womb or ova, this treatment may succeed. When a mechanical cause exists, such

as tumours or contractions, surgical aid will be necessary. Anxiety and fretfulness, by increasing the general irritation of the nervous system, are very inimical to breeding.

In sanguiferous habits, an overloaded state of the sanguiferous system is a very common cause of barrenness. In such a case, the system should be reduced by occasional abstraction of blood by leeches (applied to the part to which there may be a determination), an aperient diet, low diet, and exercise. It is worthy of notice, that when a female, between the ages of 25 to 35, is improving in health after a fever, salivation, continued diarrhoea, or hæmorrhage, she is very apt to become pregnant.

Practical Remarks. The cause of sterility is generally with the female. The common impediments to breeding are, diseased state of the ova or womb, morbid irritation of the vagina, and general nervousness and relaxation. All that art can do to prepare the female for breeding is to keep the system in a state of health, and, if she be of a languid or leucophlegmatic habit, occasionally to invigorate it, or raise it above the natural standard by mild cordials. (See IMPOTENCE, in my Treatise on the Buchu Leaves).

OF BILIOUS COMPLAINTS. Of late it has been a fashion to attribute a variety of disorders, particularly of the digestive organs, and of the head, to a redundancy of bile in the stomach; an idea evidently founded in error, and first broached by designing quacks, in order more successfully to impose their antibilious specifics on the credulous and ignorant. It is a common practice to have recourse to an emetic for the purpose of relieving the stomach of an accumulation of bile; and the liver and duodenum being compressed by the action of the abdominal muscles during its operation, a quantity of bile is forced into the stomach, which, on being brought up, induces the person to suppose that his idea was correct. The matter, however, first vomited being acid, is an indisputable proof that at the time of taking the emetic there was no bile in the stomach. The bile is also the last thing ejected. The advantage, therefore, arising

from an emetic in such cases, is not from bringing up bile from the stomach, but by producing a greater flow of it into the intestines, rousing the action of the liver, and cleansing the stomach of slime and acid matter. In cases of indigestion there is generally a deficiency of bile, through a sluggish state of the liver; yet it is very common for such patients to complain of an excessive collection of it in the stomach.

The liver being the largest viscus in the animal body, it is fair to conclude that its office in the animal economy is important. The body is constantly undergoing a mutation. The meals we daily take are by the powers of the stomach converted into chyme, from which chyle is formed in the duodenum, for the nourishment of the body. The old particles taken up by the absorbent vessels are also conveyed to the mass of blood; and hence it will appear obvious that a deterger of the blood, or some organ, is necessary to purify the blood. For this purpose the liver and the colon appear to be the principal organs, and as such the office of the liver is certainly an important one. Hence we may account for the salutary effects of medicines which increase the action of the liver in diseases of the skin; and many local, as well as constitutional disorders, which were very correctly attributed by the ancients to foulness of the blood, a doctrine ridiculed by the moderns, whose theories are founded on hypotheses instead of facts. Some late authors suppose that the bile promotes the digestion of the food; but if this were its use, it would be emptied into the stomach; instead of which, the duct, which conveys it from the liver, terminates in the upper part of the intestinal canal, termed duodenum. We also find, that when the bile is forced into the stomach by vomiting, or when it is excessive, as in cholera morbus, it disorders the stomach, and produces the most distressing nausea and vomiting.

Dr. Dick, who obtained great celebrity for the successful treatment of chronic affections of the liver, during a long residence in the East Indies, and latterly in this country, was in the habit of recommending and taking a pill, which appears to be chiefly composed of colocynth, scammony, and juniper, as the best remedy for those affections of the stomach and intestines attended with an indolent state of the liver, which in this country are termed bilious. This composition, he observes, not only removes superabundant slime and matter from the stomach and intestines, but rouses the action of the liver and kidneys. These pills, which I have certainly found very beneficial, are sold under the name of the Bengal purgative pills. - (See APERIENT PILLS, p. 89, and STOMACHIC MIXTURE (A), p. 114.)

In nervous subjects, whose constitutions had suffered from mercury, the alcaline tincture of Fumitory, in the dose of two tea

spoonsful twice a day in a glass of water, has proved very beneficial. (See STOMACHIC MIXTURE (C), p. 114., and INDIGESTION.)

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OF BLEEDING AT THE NOSE. A spontaneous discharge of blood from the nose, in young people, arises from a plethoric state of the arteries; and in people far advanced in life, from plenitude of the veins. The discharge of blood from the nose, which is generally confined to one nostril, occurs for the most part in warm weather, and is generally preceded by head-ache, redness of the face and eyes, noise in the ears, giddiness, frightful dreams, coldness of the extremities, &c.

TREATMENT. In a case of spontaneous bleeding of the nose, the first point to determine is, whether it be of a salutary nature, which, in cases of ambiguous fever, is often extremely difficult. I have known fevers, pronounced by physicians of eminence to be putrid, suddenly terminated by a discharge of blood from the nostrils, which at the time it happened was considered a most unfortunate occurrence. If it be preceded either by head-ache, giddiness, redness of the eyes, or disturbed sleep, or if occasioned by the violence of hooping-cough, or during labour, it may be considered of a salutary nature, and an indication for the adoption of medicines and diet which tend to unload and quiet the system. In young people, it is scarcely worth notice, unless the discharge be so profuse as to weaken the body. If it arise from plethora, and the system be not sufficiently unloaded by the evacuation from the nose, the loss of blood from the arm will be proper, as well as the occasional use of the Aperient Mixture, p. 111., or. the Epsom salt. After due evacuations from the bowels, the Diuretic Powder, p. 119., may be taken two or three times a day in cold water. Vinegar, diluted with water, should also be applied cold to the nostrils. If these means fail to check the bleeding, a dossil of lint, moistened with vinegar, a strong solution of alum, or tincture of kino, may be introduced up the nostril, which, by coagulating the blood, and compressing the ruptured vessel, generally succeeds, if properly managed. The person should be kept in an erect posture, and exposed to a cold air, and every thing carefully avoided that is likely to irritate the part, such as blowing the nose, speaking, &c. The diet should be low, and taken cold, and the extremities kept warm. If it arise from suppression of the menstrual evacuation, which in young women is frequently the case, aloetic purges should be employed, and the legs frequently immersed in warm water. When attendant on low fever, it happens from the weak state of the vessels, and should be stopped by the compressive means suggested above, unless the vessels of the brain be evidently overloaded. When it occurs in old age, and is preceded by head-ache,

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