portant changes of structure, and other disorders incident to these parts, have their origin in this cause. The full consideration of such a subject would involve many points, which would be as unprofitable as they would be unintelligible to the un-medical reader. Nevertheless, diseases of the rectum, or lower portion of the bowels, so frequently form a sequel, in cases where the symptoms of the disease which I am now considering, have been long protracted, that I cannot here pass them over altogether in silence.

The distress arising from change of structure in the lower portion of the bowels, at all periods of life, but particularly in middle and in old age, can hardly be conceived, except by such as have themselves suffered from them, or attended much upon those who have

done so.

Many suffer greatly from piles, others from fistula; some from fleshy excrescences growing from the extremity of the gut,-others from hard compact tumours growing from the inner surface of the bowel, a little within its termination; some from excrescences which arise from its interior walls, which resemble the gills of fish in appearance, more nearly than any thing else with which I can compare them; others from a cancerous state of the substance of the rectum; some from contraction, or stricture of the gut; and this form of disease is perhaps more teasing, painful, and exhausting, than any of the others I have mentioned.

In the early stages of stricture, or rather tendency to stricture, the feces are often expelled in a compressed, tape-like form, showing clearly that the aperture through which they had passed was small and irregular; when on examination, no contraction in the bowel could be felt. Of this, however, it is very difficult to persude the patient, as he declares that when straining at stool he can distinctly feel the feces pass through the stricture a little before they escape from the body; and this, from my own feelings, as well as from the testimony of many other sufferers, I know to be true. How then is this seeming contradiction to be explained?

The spasmodic and painful feeling termed cramp, has been experienced by, and is familiar to, almost every body. Something of this kind, it appears to me, takes place in the part of the gut which is most liable to stricture, long before any permanent contraction exists. Spasms frequently occur in these parts, which are aggravated by hardened feces coming in contact with them, more especially when efforts are made to evacuate the bowels. When the constitutional irritation is great, this spasmodic affection is sometimes so much increased, as to require the utmost efforts of the patient to pass even a small portion of semi-liquid feces through the contracted bowel. This contraction is not permanent, however, even when all the above difficulty is experienced; for it is known to all the unfortunate sufferers from this disease, that although the obstruction to the

passage of the feculent matter at one time be such as I have described it, yet at another, and probably, the very next attempt which is made, the feces pass freely, or with very little difficulty. But if nothing be done to remove the cause, these attacks return with various degrees of severity, and at various intervals of time, according to circumstances, until actual permanent stricture takes place.

It is a remarkable fact, in this, as well as in many other diseases incident to the human frame, and one for which, so far as I know, no satisfactory reason has yet been assigned; that occasional remissions in the severity of the symptoms occur, in many cases, with great regularity. This is particularly the case in the complaints which I have been considering; the patient feeling lightened and relieved the one day, flatters himself that all will soon be well, but the languor, the lassitude, and the return of all his harassing symptoms on the morrow, soon dispels the illusion.

Although other causes are well known to be a fertile source of stricture in the urinary passage, yet I am fully persuaded that it arises often solely from a defect in the general health; and that in all such cases, bougees armed, or unarmed, will never remove the disease, until the general health be improved. Whereas, I have frequently found improvement of the general health alone, without any local application, even in cases where the disease had been of long standing, relieve the patient,

whose sufferings from the stricture, although great, had been trifling compared with the agonies he had endured from the introduction of bougees, to which he had been taught vainly to look for relief.

SECTION V.-Watery Swellings, or Dropsy.

In explaining, or rather giving a cursory view of the healthy secretions of the human body, which I attempted to do in the outset of these remarks, I mentioned that during health, a serous or watery fluid was constantly poured out, or exhaled in vapour from vessels terminating in the skin, and also into every cavity and interstice of the body, capable of receiving it; and that this fluid, without remaining long, or being accumulated in these spaces, was constantly absorbed from thence by another set of vessels adapted to that office. From this view of the animal economy, it will be obvious, that if the quantity of fluid poured out be greater than the absorbents can take up, an accumulation in such parts will be the consequence. Or though the quantity poured out be not more than usual, yet if the action of the absorbing vessels be in anywise interrupted or diminished, from this cause also an unusual collection of fluid may be oc casioned.

It is evident that many causes may contribute to destroy the balance between these vessels, which I have

mentioned as necessary to health. But if the reader will recall to mind some of the symptoms of indigestion formerly mentioned, such as urgent and insatiable thirst, generally in the afternoon, languor and torpor of body, and disinclination, and often inability, to take exercise, he will have little difficulty in conceiving how this complaint becomes a frequent cause of simple dropsy; and this will also explain the reason why the ordinary remedies have so little effect in removing such watery swellings, unless the debility of the digestive organs be first removed; and, moreover, satisfactorily explains the reason why dropsy so often disappears soonest and most effectually, under the means best calculated to invigorate the digestive organs.