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as others, have attempted to reduce the hernia, previous to the use of the knife, therefore their object in dividing the sac, could not be for the purpose of inspecting the hernial contents, but for removing stricture only; and as this may generally be effected without a division of the sac, it follows, that I was justified in performing the operation, as

above described.

From the preceding premises, as to the propriety for and against opening the sac, the following inferences may be deduced.

1st. That a great proportion of those cases, where the sac has been opened, and the hernial contents have been in a diseased state, have terminated unfavourably.

2dly. That a great proportion of those cases, where the stricture has been removed, without a division of the sac, have done well.

3dly. That in all those cases, where the taxis is performed, the surgeon is justified in returning the hernia by any other method, save that of opening the sac; because the taxis implies, that the parts are in a fit state for reduction.

4thly. It also follows, that if the method above described, of returning the hernia, without opening the sac, be unjus tifiable, the operation of the taxis immediately preceding it, is unwarrantable.

5thly. That if the state of the case require the hernial parts to be inspected, any attempts at reduction, immediately preceding the operation, will be inadmissible.

6thly. That in most instances, where the operation is performed, without dividing the sac, and symptoms of stricture still remain, the seat of the mischief is generally in the neck of the hernial sac, which is to be opened accordingly.

As to the theory of returning the sac unopened, I wish to be understood in a qualified sense; and in order to prevent misconception, I will be as brief and explicit as possible.

In all cases, where the surgeon on due deliberation, judges the hernial contents to be in a fit state for reduction, and performs the taxis accordingly; in such cases I would not hesitate to adopt the practice, under the precaution and rules before described; and it is on this ground only, I wish to advise or recommend it. Again, if the taxis be right, and it fail, this method cannot be wrong; or, in other words, if it be right to perform the taxis, can it be wrong to return the hernia, with the sac unopened, by an operation? Where is the difference? In

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the one instance, the stricture is overcome by the hand; in the other, it is removed by the knife. Are not the symptoms, peculiar to reduction, common to both methods? Are not these common symptoms as conclusive in one case as the other? What surgeon will hesitate to speak decidedly, when he succeeds by the taxis, as to the certainty of the hernia being reduced? What reasons, therefore, will he have to doubt the return of the hernia by the other method? Cannot he ascertain the reduction in one instance as well as the other.

(To be Continued.)

ON THE DANGER OF CURING CERTAIN DISEASES.

(From the French of Mons. Raymond, nouvelle edition par M Giraudy )

ONE of the most dangerous errors in medicine is the desire of curing all diseases. The methods which are employed for this purpose oftentimes are inimical to nature, interrupt her efforts, and occasion accidents more or less unfortunate. If we obtain a cure, it is frequently a very imperfect one, we only shift the disease or conceal it for a time; for daily experience shows that this pretended cure lays the foundation of some other disease often more grievous than the first, or at least weakens the constitution very much and renders the health more delicate, and thus shortens the duration of life. Forty-eight years practice, mostly in a large and populous city, have at least convinced me, that it is often better to abstain from all remedies, than to incur the evils which arise from the removal of an inconvenience at once salutary and easy to be borne, I mean to show the bad effects which are produced by the humours either from their noxious qualities, or from their quantity, when they are retained, or driven inwards; with what circumspection young physicians ought to conduct themselves towards those who consult them for their ailments; and how the public should be on their guard not to listen to the multitude of ignorant people, who, destitute of skill and experience, have the impudence and effrontery to prescribe medicines for all their complaints. What sagacity and knowledge of diseases ought he not to possess, who undertakes to determine whether any one disease or symptom is useful or prejudicial, and consequently, whether he ought to remove (No. 138.)

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it or suffer it to continue? And if the most able physician is often at a loss, as to what course to pursue; in doubt as to the time, the means, and the choice of remedies; what can we think of a person who possesses neither science nor practical experience of diseases?

It was perhaps with the same impression, that an English physician published, about the end of the last century, his treatise, entitled Ars curandi morbos expectatione; that Celsus said, many diseases are cured by diet and by rest; that almost all celebrated physicians acknowledge, oftentimes the best remedy is doing nothing, and that polypharmacy or a multiplicity of remedies is the resource of ignorance, or a sign of little faith in the physician, or of the weakness of his judgment.

I should have thought myself wanting to the public, which the laws of religion no less than those of society command us to love, if I had withheld from them these reflections, which are founded upon my own observations, faithfully related, and upon those of some authors highly worthy of credit. I only beg of my readers to peruse them without prejudice, and to recollect what was said by Richard Morton, + that of all authors, none had enriched the science of medicine except those practitioners who had faithfully and accurately given their own observations, and had detailed from nature, the history and progress of each dis

ease.

Article 1.- ON HABITUAL SWEATS.

It is not my intention to enter into a consideration of all the different kinds of sweat, I shall confine myself solely to that which is habitual and advantageous, although perhaps inconvenient, and endeavour to show, that we ought not to check it or interrupt it, especially by external applications; but at most, if it becomes insupportable, to treat it by proper regimen and simple remedies; for upon its being suddenly stopped, either spontaneously or by art, it is frequently followed by colics, diarrhoea, or violent dysentery; sometimes by fevers, cough, epilepsy, hæmorrhage, &c. These habitual sweats are not commonly universal we find some individuals who sweat only in their feet, others who have moist hands, others in whom it is profuse on the head or in the arm pits. In some this fluid has neither smell nor colour, in others it is strong and warm; in some it is viscid, greasy, and often cold; every one however is eager for remedies to rid him of the inconvenience, which

* Gideon Harvey.

In Prefation. Physiolog.

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which being in fact an effort of nature to remove something noxious or superfluous from the system, often resist all the means we can employ for its removal; or if by chance any one attains the object of his wishes, he dearly pays for his weakness and imprudence.

It would be tedious to relate every thing that has been observed and written by our celebrated practitioners, on the alarming consequences of suppressing these sweats, and upon the care we should even take to encourage them; I shall only give what I myself have observed upon this

matter.

A religieuse, who had in her infancy and youth been subject to a humour in her eyes and eye-lids, attended with a flow of tears, with redness and sometimes with inflammation, was relieved of these complaints at the age of puberty; and at the usual time of the appearance of the menses, her feet and legs became subject to profuse sweating of a disagreeable odour, and which was increased in spring and summer. As long as she bore this inconvenience with patience she enjoyed good health, but being at length de sirous to get rid of it, and no longer to incommode thereby her companions in the church and in the refectory, she by the advice of some old woman washed her feet and legs with a very astringent aluminous lotion, which effectually prevented the sweats: but a short time after she was seized with epileptic fits, which continued frequently to recur during three years, and which at length gave way to no other remedy than change of scene; the glands of her neck and in the axilla then became large and swelled, the body was covered with pimples and pustules; at last a scrophulous pulmonary phthisis succeeded, accompanied with a cough and purulent expectoration of a yellowish and greenish colour and a slow hectic fever, thus terminating her days at the age of forty years, the whole of which, notwithstanding the regularity of her menses, she had passed in ill health, except the time the sweating continued.

I must not pass over what I experienced in myself during the plague which raged in Marseilles in 1720. As soon as that cruel malady appeared, I perceived my arm-pits, contrary to custom, very hot and moist, and sometimes Í experienced heats and smarting scarcely supportable; this, which was new to me, continued during the whole time the plague prevailed, and left me when that had entirely ceased, that is to say, in the spring of 1721.

The plague re-appeared in the spring of the following year, and I also experienced a return of the heats and swearing

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sweating in the axillæ, but they disappeared with the entire extinction of the plague, of which no trace was left by the autumn of the same year.

Although during this state, and at the two different times mentioned, I was employed in the care of those affected with the plague, of whom I daily saw a great number, I can say I never enjoyed better health, I even became more jolly than before. I think, however, I should infallibly have sunk under the hardships, the vexation, and the risques to which I was exposed, if Divine Providence, to whom I owe eternal gratitude, had not subjected me to these salutary sweats during this dreadful period.

Notwithstanding I have just now said, that these habitual sweats being seldom universal, but generally partial, do not derange any function of the body, and are salutary; that the health and even life are endangered whenever they are suppressed either by nature or art; it may not be amiss to point out the remedies that should be used by those who are much annoyed by the smell of this discharge, which is sometimes almost insupportable to themselves as well as to others, and obliges them to seclude themselves from company, and even to abandon their trade or profession, and who are willing to attempt without risk, the removal of such an unwelcome malady.

As to those whose sweats are neither very excessive nor fætid, and who are not weakened thereby, I can give them no other advice, than to bear them with patience, to keep themselves clean and neat, to wash their skin often, and especially the parts affected, with warm water, and a little orange flower water, or with a weak decoction of some aromatic herbs, and to avoid all excess of eating, to refrain from salted meats and spirituous liquors; to preserve themselves from violent passions and immoderate fatigue; in a word, to do nothing which will increase the elasticity of the fibre or the circulation of the fluids.

For those whose sweats are cold, clammy, and of a bad odour, I know nothing more suitable, or that has suceeeded better with me than a generous diet, roasted meats rather than boiled, or ragouts, or if the latter are preferred, to season them well with spices, shalots, saffron, onions, and even a small quantity of garlic, and to allow them old wine of a good vintage.

In addition to this regimen, we must employ purgatives and bitter decoctions; a drink prepared from China root or sarsaparilla, and viper broth, and also give the filings of iron or steel, which should be continued a length of time

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