AUTHORITIES 
, ■ ON 
. £ I a t _ i: 
B. BBAKBBETE, M .. THE 
Doctrine of purgation. 
Curiosities from Ancient antr globcra literature. 
A COLLECTION OF QUOTATIONS ON THE USE OF PURGATIVES, 
PROM 
HIPPOCRATES, 
AND OTHER MEDICAL WRITERS, 
COVERING A PERIOD OF OVER TWO THOUSAND YEARS, 
PROVING 
Jporgation is tlje Corner-stone of all Cnratioeo, 
COMPILED BY B. BRANDRETH, M. D., SING SING, N. Y. 
BAKER & GODWIN, PRINTERS, 
PRINTING-HOUSE SQUARE. 
1867. Entered, according to Act of Congress, in the year 1867, by 
BENJAMIN BRANDRETH, M. D., 
In the Clerk’s Office of the District Court of. the United States for the Southern 
District of New York. INTRODUCTION TO AUTHORITIES 
FOR 
DOCTRINE OF PURGATION. 
Life may be considered the union- of Soul and Body ; 
it is tbe mature work of tlie Beneficent Creator, and the 
strongest evidence of creative power. 
While our knowledge of this principle must for a time con- 
tinue to be narrow, yet we may comprehend its opposite, or 
death principle, and thus we may control diseased action. This 
is illustrated and examined in the following pages. 
Two hundred medical writers, running through a period of 
over two thousand years, without any knowledge of what the 
other had written, agree as to the means of reducing this death 
principle; agree as to a general indication; agree as to the 
perfect innocence of purgation. We hold that this evidence is 
important in our intelligent age, and hope it may lead to a 
more uniform and a more humane method of treating patients. 
Perhaps a wise regard for the improvement of the human race 
will make purgation the principal curative reliance; other 
means should be only secondary. Physicians may soon be 
governed by this rule ; because purgation may be set down as 
the magnet, the guide, the star of safetv. 
Purgation corrects errors in the digestive organs; and Dr. 
Abernethy observes (in “Surgical Observations,” p. 22) : “ By 
correcting the obvious errors in the state of the digestive 
organs, local diseases which had baffled all attempts at cure by 
local means, have speedily been removed.” When local appli- 
cations are applied, they should be in harmony with purgation, 
and incapable of doing injury. 4 
THE DOCTRINE OF PURGATION. 
We can remove disease in two ways : by the upper and by 
the lower passages; by vomiting and by purging. Purging 
when the patient is weak; vomiting only when he is strong. 
We will define Purgation as “cleansing,” and apply to both 
the upper or lower ways. 
For forty years I have directed my attention to the cure of 
disease on this plan; and facts derived from experience have 
long since confirmed me in the belief that this is calm Nature’s 
own method of cure, because it assists her in removing impuri- 
ties by the means and outlets she has so wisely provided for 
herself. 
Believing that all mineral and chemical agents which can 
act on foreign or impure matters in the blood, invariably injure 
the organization of the blood itself—destroying its corpuscles? 
besides injuring the coats of the stomach, and producing serious 
effects upon the bones—I have, therefore, discarded minerals 
and chemicals entirely, and trust to vegetable remedies alone. 
That which I have principally employed to enforce this 
theory has been Brandreth’s Pills ; whose permanent and wide- 
spread success is the strongest evidence of their distinguished 
merit. 
The question has been asked, If the value of this medicine 
is so great, is it not a duty to make known its true components, 
so that physicians and others could prepare it ? To this it may 
be answered, that if Brandreth’s Pills certainly would be made 
the same as they are now, and all their healing, cleansing and 
innocent qualities retained, one of the reasons for their remain- 
ing a secret medicine would be removed. 
But every man knows, wko knows anything of the drug 
and medicine business, that not one box in a hundred would be 
prepared of such medicines as are incorporated in the Brand- 
reth Pills prepared by me. It is true the pills might be com- 
posed of ingredients called by the same name, but the name 
would be all the resemblance they would possess to the pure 
extracts and medicinal preparations which comprise the compo- 
sition of Beandeeth’s Pills. INTRODUCTION. 
5 
Therefore, for the sake of the lives and health of men—for 
the sake of the 
GREAT SANATORY THEORY OF PURGATION 
the manner of preparing Brandreth’s Pills will never be di- 
vulged, until the time arrives when all the drugs of the stores 
shall be true and uniform preparations. 
I am not without examples for this decision: 
Dr. James, the celebrated author of James’ Powder, left his 
prescription to Messrs. Newbery & Sons, of London, more than 
a hundred years ago, by whom they are yet made. The Great 
Stahl and Hotfman, of Germany, Professors of Physic at Halle, 
without scruple confined many medicines to their own private 
practice. And even in our own time there are few medical men 
of extensive practice who have not remedies which they care- 
fully retain in their own families, who are more likely to pre- 
pare them with reference to securing their curative effects, 
without regard to profit, than they would be in the hands of 
strangers. 
The quotations from the writings of medical men em- 
bodied in this pamphlet, prove the Talent that has been at 
work upon this Theory of Purgation for over a period of two 
thousand years—and in vain. Then what has prevented its 
complete success ? Simply this, in my opinion: Not a single 
writer has given a medicine which, out of their own hands, 
would successfully and safely enforce the purgative theory. 
The public in Brandreth’s Pills have a medicine which 
it is intended shall ever be within its reach, always certain to 
purge only impurities from the blood, and when the upper ways 
require cleansing, occasion vomiting; and that is safe for both 
sexes and all ages. Composed of vegetable preparations en- 
tirely—indeed the Pills are guaranteed to contain no mineral in 
any form—they may, if the requirement of the constitution 
need them, be taken daily for any length of time, without a 
possibility of producing any bad effects on the body, and 
must reduce the sum of disease. 6 
THE DOCTRINE OF PURGATION. 
So the difficulty in enforcing the Theory of Purgation for 
want of a safe agent, is measurably removed, because 
BRANDRETH’S PILLS 
will, for many hundred years to come, be made by me or my 
descendants. The public may rely upon this: that no accident 
to the writer would stop for a moment the current of the faith- 
ful preparation of Brandreth’s Pills. I am happy in having 
six sons, some of them already known to the world as able, 
intelligent men; I have also sons-in-law, who are distinguished 
as men of high probity and honor. All are firm believers in 
the Theory of Purgation, and use Brandreth’s Pills when sick. 
WARRANTEE. 
It is perfectly safe, therefore, for the world to accept this 
warrantee: 
That Brandreth’s Pills in all future time are war- 
ranted to possess and contain those purgative, those 
cleansing and innocent qualities, which they have 
always heretofore possessed in so high and in so 
eminent a degree. 
Tlie principle of curing disease by the use of purgatives is 
beginning to be extensively recognized as indispensably neces- 
sary for the recovery of health by many intelligent families and 
individuals. To prove to them and to the world at large, as 
well as to physicians of all schools, the broad and deep founda- 
tions and authority this principle of cure possesses, I have 
printed the following extracts which, as in a mirror, is exhibited 
the views and experience and sentiments of medical men, dur- 
ing a period of over two thousand years. 
They possess a peculiar significance for those who desire to 
investigate this subject, so important to the lives and health of 
men, because they throw a flood of light on the application of 
purgatives as a means of removing disease from the system. INTEODUCTION. 
The great aim by many of these writers is this: that in the 
administration of medicine we should do good possibly, but 
certainly never do harm. 
Now, Bleeding, Mercury, Tartar Emetic, Antimony, Vera- 
tria, Strychnine, and a host of similar remedial agents, may, 
nay generally do a great deal of harm, and often are the occa- 
sion of fatal mistakes; while the great advantage of using 
Brandreth’s Pills in sickness is, that they never make any 
mistakes. K 
In pleurisy, in inflammation, in fevers, and where pain is 
present, their prompt and energetic administration is often life- 
saving ; even in Bright’s Disease they have effected cures when 
physicians and friends had given up all hope. Then what risk 
does any man or woman take in using a medicine like Brand- 
reth’s Pills, which are the adopted remedy of millions of fam- 
ilies living in every part of the civilized world ? Clearly none. 
The facts given in the following pages prove that all fevers, 
inflammations, and severe pain are only, in reality, so many 
evidences of healthful constitutional power, and that if purga- 
tion is enforced according to the necessities of the case, the 
fever, severe pain, or inflammation will be removed. 
B. BRANDRETH. 
Sing Sing, June 1, 1867. Hippocrates. 
Purgation the Corner-stone of Curatives. 
Hippoceates.—Aphorisms, written about 400 b. c. Edited by Elias 
Marks, M. D., New York, 1818. 
1. Life is short, art long, occasion brief, experience fallacious, 
judgment difficult. It is requisite that the physician exhibit what is 
essential, and that the patient, attendants, mid all which surrounds him, 
concur therein (1, sect. I). 
The golden 
ru e' 
2. In diarrhea and spontaneous vomiting, if the matter voided be of 
a nature that ought to be expelled, let the patient be purged, for in this 
case the evacuations are beneficial and are easily supported (2. sect. I). 
Diarrhea. 
Purgation in- 
dicated by 
nature. 
3. The greater the evil the more vigorous the remedy (6, sect. I). 
The power 
the reme- 
4. In acute diseases the most violent symptoms supervene; the 
severest regimen is, therefore, to be observed. But if these symptoms 
be wanting, a more generous diet is to be permitted, only we are to 
have recourse to it in proportion to the subsidence of the malady (Y, 
sect. I). In the choice of regimen, more evil results from abstraction 
than from a small excess. A thin, frugal, and over-exact regimen 
accords not even with the man in health, who grievously supports the 
privation. Hence, in general, the superiority of a due refection over 
that which is deficient (5, sect. I). 
on Diet, 
The nutrf- 
cure.plan of 
5. In those diseases which quickly arrive at their climax, a thin 
regimen should immediately be adopted. In those which attain it at a 
somewhat later period, we should at or before that period, subtract from 
their diet; but, until then, sufficient nourishment should be allowed, 
that the strength of the patient may be supported (10, sect. I). 
Diet to be 
regulated ac- 
cording to 
the charac- 
ter of the 
disease. 
G. That which is excrementitious should he drawn off at the point 
to which it most tends, by the most convenient outlets (21, sect. I). 
Purgatives, 
Diuretics, 
Sudorifics. THE DOCTRINE OE PURGATION. 
When to 
give purga- 
tives. 
7. Purgatives should be administered after the food on the stomach 
is concocted, not while it is yet crude (22, sect. I). 
Note by the Editor.—There is no danger in administering a purgative before or after a 
meal, provided there be pain or dizziness, which symptoms are relieved by purgation. 
8. Depletion is not to be estimated by its copiousness but by its 
being judiciously used and easily supported. When it is necessary to 
extend it “ ad deliquium animi,” let it be done, but previously consult 
the resources of the patient (23, sect. I). 
How to di- 
rect the pur- 
ling. 
Note by Editor.—Where there is danger of congestion, purgation may be enforced to 
fainting with Brandreth’s Pills (see paragraph 65). 
9. If the convalescent acquire not strength from the food he takes, 
it shows that the body needs a more plentiful supply. But if the same 
effect arise from an inability to partake of food, it sufficiently evinces 
the necessity of purgatives (8, sect. II). 
10. When it becomes necessary to purge, the evacuations ought to 
be loose and free (9, sect. II). 
Quality of 
evacuation. 
11. Impure constitutions, when most nourished, are most injured 
(10, sect. II). 
How to di- 
rect the nou- 
rishment. 
Relapses 
from insuffi- 
cient purga- 
tion. 
12. The (morbid) matter remaining in the body after the crisis is 
past often produces, a relapse (12, sect. II). 
Change of 
dejections. 
13. In alvine fluxes, a change in the dejections, unless they assume 
a vicious appearance, is beneficial (14, sect. II). 
Tubercles. 
Examination 
of stools. 
14. When the fauces are affected, and tubercles arise therein, we 
ought to examine the excretions; when they are of a bilious nature, the 
entire body is affected; but if they be as in health, we may safely 
impart nourishment (15, sect. II). 
Disease 
pfanee6‘ii 
drink - rur- 
gution the 
15. Excess of food produces disease, and at the same time points out 
the remedy (17, sect. II). The sickness which arises from repletion is 
Clire<l by evacuation; and that which arises from evacuation, by reple- 
tion. Thus, opposites are counteractives of each other (22, sect. II). 
sudden ac- 
nafure.garro- 
mustding3be 
gradual 
uf.conUn' 
16. Evacuation, repletion, frigeration, and calefaction—these, or 
any other correspondent modifications of body, when excessive, or too 
suddenly accommplished, are dangerous—nature being ever opposed to 
exlremes. That which is gradually done is safely done, whether we 
pass from one extreme to another, or otherwise (51, sect. II). Every- 
tiling which is judicious being done, without success, we are not, there- 
fore, to recede from our plan, while we still entertain the same views as 
we did at first (52, ibid). THE DOCTRINE OF PURGATION. 
17. Some diseases accord better with some constitutions than others / 
and this also obtains with certain ages, as connected with season, climate 
and aliment (3, sect. III). In the various seasons, if cold and heat fre- 
quentlv alternate with each other, we must look forward to autumnal 
a r ’ 
dtseases (4, ibid). 
constitution, 
climate,aan"d 
fo/ld.: chan«e 
of tempera- 
ture. 
18. Those suffering from phthisis should avoid vomits (8, sect. IY). 
emet^'inju- 
rious. 
19. The melancholic should be copiously evacuated downwards ; and, 
from the same principle of reasoning:, those of a contrary temperament 
should be differently treated (9 sect. I V). 
Purgatives 
and emetics, 
where to be 
used. 
20. Sound Doctrine.—In very acute affection, attended with turg- 
escence, purgatives are immediately to be used; to procrastinate here 
is dangerous (10, sect. IV). 
Acute dis- 
eases, purge 
without de- 
lay. 
21. Those who are tormented with severe gripings, pains about 
the umbilicus, and in the region of the loins, and who are neither 
relieved by purgatives, or any other means, usually fall into tympanites 
(11, sect. IV). 
purgatives 
useful 
22. If there be pain immediately above or below the diaphragm, 
the former demands vomiting, the latter purging (18, sect. IAr). 
o" lroo\7 / 
and 
purging. 
23. Those who, during the operation of purgatives, have no thirst, 
ought to be purged until thirst be induced (19, sect. IV). 
Degree of 
purging. 
24. Pain in the lower region of the abdomen, with griping and ach- 
ing of the knees, unattended with fever, indicate the necessity of pur- 
gatives (20, sect. IY). 
pain in 
necessary. 
25. Dark-colored dejections, resembling black blood, coming on 
spontaneously, either with or without fever, are very unfavorable; and 
the more so if the color of these dejections become, with their continu- 
ance, still more depraved; but if the evacuations assume a more healthy 
complexion, or, if their dark color be the effect of purgatives, less evil is 
to be apprehended (21, sect. IY). 
svacua- 
eriti' 
26. The expectoration of blood, how small soever in quantity, is 
injurious; but the evacuation of black blood downwards is (frequently) 
advantageous (25, sect. IV). 
Evacuation 
of blood diff- 
erent in cha- 
racter. 
27. "With those who are deaf, a coming on of bilious evacuations 
generally removes it (28, sect. IY). 
Deafness, 
goodUation* 
28. If, in those recovering from indisposition, there occur any local 
pain, it foreshows the formation of an abscess (32, sect. IV). 
Pain, symp- 
tom of ab- 
scesses. 
29. From whatsoever part of the body sweat breaks forth, it fore- 
shows a determination of the disease to that part (38, sect. IV). 
SlBeat8 and 
heat> symP- THE DOCTRINE OF PURGATION. 
In whatever part of the body heat or cold arises there the disease 
seats itself (39, ibid). 
Where there occur alternate changes of cold and heat, and the com- 
plexion undergoes various changes of color, we may predict extended 
illness (40, ibid). 
Profuse sweats, during sleep, without any manifest local affection, 
may arise from a too plentiful diet; but if they take place notwith- 
standing the observance of a frugal regimen, it. shows the necessity of 
evacuation (41, ibid). 
tomatic of 
catTthe’nei 
Purgation, 
Fwe™*musl 
be purged' 
8way‘ 
30. In fever, where abscesses have not been dispersed during the 
primary stages of the disease, they foreshow extended illness (51 
sect. IV). 
Fever, in- 
the urine. 
31. When, with existing fever, a thick, gummy, scant urine is fol- 
lowed by a thin and copious discharge, it is beneficial; but it is the 
more so, when, at the commencement of disease, or a little time after, 
the urine deposits a sediment (69, sect. IV). 
pregnfncym 
causes ahor- 
32. With pregnant women, venesection produces abortion, especially 
•£ gestation be far advanced (31, sect. V). 
Irregular 
menstrua- 
tion requires 
purgation. 
Brandreth's Pills are safe at every period of gestation with the generality of females. 
33. Discolored and irregular menses indicate the necessity of purga* 
fives (36, sect. V). 
Tumor*, 
malignant.°r 
34. Tumors which have a soft feel are beneficial; those which are 
hard and callous are unfavorable (67, sec. V). 
Dropsy, 
the cure. 
35. In dropsy, if the water pass off into the intestines, by means of 
the veins, the disease ceases (14 sec. V1). 
jDisease* of 
the Eyes 
cured by 
Purgation. 
30. Diarrhea supervening in ophthalmia is beneficial (17, sect. YI). 
Pains of the eyes are relieved by pure urine, bathing, fomentation, 
venesection, and purging (31, sect. VI). 
Purgation brings itr to the intestines and so causes the water to be evacuated. 
Fever the 
natural cure. 
37. Pains in the liypochondrium, unattended with inflammation, are 
repeve(j py fever (40, sect. VI). 
Effects of 
purgation 
38. Long-continued dysentery, supervening in affections of the spleen, 
induces either dropsy or lientery, and consequent death (43, sect. VI). 
39. Those with whom purgatives agree should have recourse to 
them in the spring (47, sect. VI). 
Purging in 
Spring. 
wheiTinflam- 
purgMaway. 
40. Those attacked with the gout are entirely freed of it in forty 
days after the subsidence of the inflammation (49, sect. VI). 
More effects 
purgation!' 
41. In atrabilious affections the translation of the humors to various 
parts has a tendency to produce the following diseases: apoplexy, 
mania, convulsion and blindness (56, sect. VI). TIIE DOCTRINE OF PURGATION. 
42. When a serous collection, attended with pain, takes place be- 
tween the abdomen and diaphragm, without its having an issue in either 
cavity, if the fluid be drawn out of the body by means of the veins, the 
disorder ceases (54, sect. VII; vide Aph. 14, sect. VI). 
Aceumuin- 
intestines re- 
fTfpur,ja~ 
43. Excessive perspiration, cold or hot, continually going on, is in- 
dicative of redundant moisture within ; we ought, therefore, to evacuate 
it from the system either by vomiting, if the patient be strong, or by 
purgation if lie be weak (61, sect. VII). w " 
Sweat,—in- 
fluid accu- 
aauies. 
44. He should attend to the urinary discharge in order to ascertain 
whether it be conformable to what takes place in health ; in proportion 
as it departs from the healthy state is the severity of the disease, and 
“ vice versa” (66, sect. VII). 
If, on suffering the urine to remain, without disturbing it, we ob- 
serve a deposit resembling sawdust, the greater or less quantity of this 
deposit is indicative of the severity or mildness of the disease ; in either 
case, it is necessary to have recourse to purgatives j in proportion as we 
neglect these, for a nutritive regimen, will be the augmentation of the 
disease (67, sect. VII). 
The urine 
health or dis- 
'purgation* 
45. In continued fever, the expectoration of a livid, bloody, bilious, 
or foetid matter, is alike unfavorable ; but, if the expectoration be good, 
and in due season, it is favorable. The same may be said of the alvine 
and urinary discharges: furthermore, won excrementitious matter re- 
maining in the system, and not coming away with the evacuations, 
proves injurious (69, sect. VII; vide Aph. 12, sect. II). 
Continued 
oneTnd urt 
aulrJlaHy 
and thor-' 
quired. 
Hippocrates, the genuine works of. Transl. by Francis Adams, LL.D., 
and printed for the Sydenham Society. 2 rots. London, 1849. 
46. Medicine is, of all arts, the most noble; but, owing to the igno- 
rance of those who practice it, and of those who inconsiderately form a 
judgment of them, it is at present far behind all the other arts (The 
Law, p. 784, vol. I). 
Medical 
ignorance. 
47. When nature opposes, everything else is in vain. Nature is the 
physician of diseases (p. 102, vol. I). 
Nature. 
48. The physician must have his special object in view with regard 
to diseases, namely : to do good or to do no harm. The art consists in 
three things: the disease, the patient, and the physician. 
The physician is the servant of nature, and the patient must combat 
the disease along with the physician (Epidemics, Book 1, § 5, p. 360, 
vol. II). 
The phy- 
f" 
The, ser- 
iff. °fna' 
49. Gentle purging of the bowels agrees with most ulcers, and in 
wounds of the head, belly, or joints, where there is danger of gangrene, 
in such as require sutures, in phagediac, spreading, and in otherwise 
inveterate ulcers (On Ulcers, pp. 796—7, vol. II). 
ulcers. 
uyr"° gen THE DOCTRINE OF PURGATION. 
Purge in 
diseases. 
50. Disorders arising from repletion are removed by evacuation (On 
the Nature of Man, p. 262, vol. 1; Aplior, 22, sect. TT). 
Fevers pass 
moved isre 
51. When the discharges become thicker, more concocted, and arc 
freed from all acrimony, then the fevers pass away, and the other symp- 
l°ms which annoyed the patient (Ancient Medicine, p. 174, vol. I). 
52. When there is an overflow of the bitter principle, which we call 
yellow bile, what anxiety, burning heat, and loss of strength prevail! 
But if relieved from it, either by being purged spontaneously, or by 
raeans °f medicine seasonably administered, the patient is decidedly re- 
lieved of the pain and heat, But while these things float on the stomach 
unconcocted and undigested, no contrivance could make the pains and 
fever cease; and where there are acidities of an acrid and eruginous 
character, what varieties of frenzy, gnawing pains in the bowels and 
chest, and inquietude prevail! And these do not cease until the acid- 
ities be purged away (p. 174, vol. I, ibid.) 
Man • 
m™ed by 
artificial or 
purgation, 
cure°nlytme 
humors hn'of 
various 
kinds. 
53. The coction, change, attenuation, and thickening into the form 
of humors, take place through many and various forms (p. 174, ibid.) 
_ , , 
What to 
purge. 
54. We must purge and move such humors as are unconcocted (p. 
i TT, v fe \f 
703, Vol. II). 
purge until 
evacuations 
even to faint- 
55. The evacuations are not to be judged of by their quantity, but 
whether they be such as they should be, and how they are borne. And 
when proper to carry the evacuation to “ liquidium animi ” (faintness), 
this, also, should be done, provided the patient can support it (p. 704, 
vol. I; Aph. 23, sect, I). 
Note by Editor.—To give the patient an opportunity of doing so, have gruel or light 
broth ready for him to sip a little at a time. Intelligent nursing must go alongside of the 
purgative method, then success is moderately certain. 
Purgative 
axiom. 
56. If the matters which are purged be such as should be purged, 
the evacuation is beneficial (p. 704, vol. II; Aph. 2, sect, I). 
Effects of 
tsfsts 
57. Bodies not properly cleansed, the more you nourish, the more 
y°u inJure (p- w>>voL 11 ; APh-10>sect-n)-. 
What remains in diseases, after the crises is past, is apt to produce 
relapses (p. 707, vol. II; Aph. 12, sect. II). 
Purgative 
axwm■ 
58. In purging we should bring away such matters from the body 
as it would be advantageous had they come away spontaneously (p. 723, 
vol. II). 
59. Our Doctrine.—In very acute disease, pursue on the first day, for 
it is a very bad thing; to procrastinate m such cases (p. 724, vol. H ; 
Aph. 10, sect, IY). ’ 
. , 
eases. Purge THE DOCTRINE OF PURGATION. 
60. In convalescents from diseases, if any parts be pained, there are 
deposits being formed. But if any part be in a painful state previous 
to the illness, there the disease fixes (p. 728, vol. II; Aph. 32, sect. IV). 
Deposits 
from imper- 
fect purga- 
tion. 
61. X. B.—The translator says: “ Hippocrates was strictly the phy- 
sician of experience and common sense.” 
Experience 
and common 
sense. 
62. Nature finds out ways for herself without consultation ; nature, Nature's 
untaught and without learning, does what is needful (Epidem., lib. VI, Z™8 t0 
S. 5, Edinb. ed.) 
63. Asclepiades, about 100 years B. CL, the earliest hydropathist, con- 
trived easy methods, and such ones as any one might use without the 
help (and cost) of a physician. This made them very acceptable, and 
Plinius (Lib. XXVI, Cap. Ill, p. 444) writes about him the follow- 
ing : “ Five things of most common benefit he held to: Occasional ab- 
stinence from meat, at other times from wine, the use of the flesh-brush, 
the exercise of walking and of riding ; which, as every one believed he 
could prescribe for himself such remedies as these, and as it is natural 
to wish those things true that are most easy, made all people flock unto 
him as to one sent from heaven.” He disapproved of the then popular 
practice of frequently using violent emetics and purgatives, for which he 
substituted the clyster as the safest way to obtain—what appeared to 
him the first measure to be taken in most of diseases—evacuation of the 
bowels. His method of employing simple remedies, for the sake of their 
safety and innocence, but producing the effect wished for, and his extra- 
ordinary skill in a quick diagnostic, gained him a fame that almost 
overthrew the old heroic method of the then practitioners of Rome, as 
we read of him in Plinius, XXVI, 8 ; Celsus, III, 4, II, 6, Carlius 
Aurelianus, Morb. acert., I, 15; Aquilejus, Florid., IV, 362 ; Plinius, 
Hist. Xat., VII, 37; and Saleh Beu Balah, Chap. 12. 
lie recommended clysters of cold water for the aged, and for persons 
troubled with stone or gravel, for females having falling or other affec- 
tions of the womb, and in all kidney affections when the bowels require 
moving. 
Simple and. 
safe purga- 
tive reme- 
dies, THE 
MEDICINE OP 
THE PEOPLE, 
combined 
with whole- 
some food, 
personal 
cleanliness, 
temperance, 
and exercise 
of the body 
preserve 
health and 
cure dis- 
ease. 
Water clys- 
ters for the 
aged. 
64. R mazes or Rasis, on Pestilence, written about 890 at Corduba• 
This book of Rliazes’ is a curious and valuable record of the Arabian 
practice in small-pox and measles. The best edition in Arabic and Latin 
is that by I. Channing, London, 1766. The doctor’s theory is that of 
fermentation, and his practice is of the cooling kind, together with free 
evacuation of the bowels. 
There is also another translation of this book in English from the 
Arabic text by Dr. Greenhill (8vo., London, 1817). 
-powerful 
65. Avicenna, or Abu Ali Al Ilosain Ebn Abdallah Ebn Sina, who 
was born in the year of the liegira 370 or 987 A. D., tha first writer who 
formed a complete system of medicine, was of opinion that evacuation of 
the bowels, actively and perseveringly employed, was the main principle 
in the cure of disease. He was, however, more in favor of clysters than 
Intestinal 
disorders — 
powerful 
evacuation 
the cure. THE DOCTRINE OF PURGATION. 
of internal purgative remedies, not considering that that method of pur- 
gation, often repeated in a proportionately short space of time, by its 
mechanical action, must prove injurious, causing ulcerations in the in- 
testinal canal. Thus, when subject to a severe attack of colic, he took 
eight clysters in one day, which producing ulcers in the intestines, toge- 
ther with an epilepsy, a consequence of intemperance and sensuality, 
that had weakened his vital forces, thus causing his early death. Of 
his numerous books, said to be more than one hundred, liis “ CanorJ 
and some tracts were printed in 1593 in Rome. 
Coiic. 
Parey, Ambrose, M. 1)., Physician to Ilenry III., King of France 
and Poland. Paris, 1579. Transl. Thos. Johnson, M. D. Lon- 
don, 1634. 
Experience, 
thTscience. 
66. Although indeed we cannot deny but that experience has much 
profited this art, as it has and does many others. For, as men per- 
ceived that some things were profitable, some unprofitable for this or 
that disease, they set it down, and so by diligent observation and mark- 
ing of singularities, they established universal and certain precepts, and 
so brought it into an art, (Pref.) 
Disease 
itfotThf' 
blood. 
PurgaUves 
removemor- 
Nood. 
67. There is no disease which arises not from some one, or the mix- 
ture of more, humors. Which thing Hippocrates understanding, 
wrote every creature to be either sick or well according to the condition 
of the humors. And certainly all putrid fevers proceed from the 
putrefaction of humors. Nor do any acknowledge any other original 
and distinctive of the differences of abscesses or tumors ‘ neither do 
ulcerated, broken, or otherwise wounded members hope for the restora- 
tion of continuity, from other than from the sweet falling down of 
humors to the wounded part, which is the cause that often in the cure 
°f these affects. The physicians are necessarily busied in tempering the 
blood ; that is, bringing to a mediocrity the humors composing the mass 
of the blood, if they at any time offend in quantity or quality. For if 
anything abound or digress from the wonted temper, none of the accus- 
tomed functions will be well performed. . . . Purging corrects and 
draws away the vicious quality of the blood (pp. 11, 12; cf. Hippoc. 29, 
30). 
To preserve 
health, keep 
the blood in 
its normal 
state. 
68. But with the blood at one and the same time, all the humors 
are made, whether alimentary or excrementitious. Therefore the blood, 
that it may perform its office, that is, the faculty of nutrition, must 
necessarily be purged and cleansed from the excrementitious humors. 
. . . The parts of which the blood is composed ought to be tempered 
and mixed among themselves in a certain proportion, which remaining, 
health remains, but violated, disease follows (p. 12). 
Diarrhea 
and vomit- 
ing. The nat- 
ural ejection 
of morbid 
matter must 
69. Evacuation is no other thing than the expulsion or effusion of 
humors which are troublesome, either in quantity or quality. Of evac- 
uations some are universal, which expel superfluous humors from the 
whole body; such are purging, vomiting, perspiration, sweats ; some THE DOCTRINE OF PURGATION. 
particular, which are performed only to evacuate one part, as the 
stomach by vomiting and stools, the guts by stools, the liver and spleen 
by urine and ordure. These evacuations are sometimes performed by 
nature, freeing itself of that which is troublesome to it; otherwhiles by 
the art of the physician in imitation of nature (p. 37). 
be assisted 
by art. 
70. TJw causes of congestion are two principally, as the weakness of 
the concoctive faculty, which resides in the part, by which the assimila- 
tion into the substance of the part of the nourishment flowing to it 
is frustrated, and the weakness of the expulsive faculty ; for while the 
part cannot expel superfluities, their quantity continually increases (p. 
250). Those humors which are rebellious rather offend in quality than 
in quantity, and undergo the divers forms of things dissenting from 
nature, which are joined by no similitude or affinity with things natural 
(p. 252). A convenient diet and purging must be used ; ill humors are 
amended by diet and purging (p. 253). 
Tumor ft 
from morbid 
accumula- 
tions. Cure 
by Purga- 
tion. 
71. Cancer.—The antecedent cause depends upon the default of 
irregular diet, generating and heaping up gross and feculent blood; by 
the morbific affection of the liver disposed to the generation of that 
blood ; by the infirmity or weakness of the spleen in attracting and 
purging the blood ; by the suppression of the courses or liemorrhoides, 
or any such accustomed evacuation. The conjunct cause is that gross 
and melancholic humor sticking and shut up in the affected part, as in 
a strait (pp. 279-80). 
Cancer 
from impur- 
ity of the 
blood. 
72. The glands at the root of the tongue are very subject to inflam- 
mations and swelling from crude, viscous humors. Swallowing is pain- 
ful to the patient, and commonly he has a fever. Often the neighboring 
muscles of the throat and neck are so swollen together with these glan- 
dules that the passage of air and breath is stopped and the patient 
strangled. We resist this imminent danger by purging, by applying 
cupping-glasses to the neck and shoulders, by frictions and ligatures of 
the extreme parts, and by washing and gargling the mouth and throat 
with astringent gargarisms (pp. 293, 94). 
Sore-throat. 
Cure by pur- 
gation and 
external ap- 
plications. 
73. The dropsy is a tumor against nature by the abundance of 
waterish humors, of flatulences, or of phlegm, gathered one while in 
all the habit of the body, otherwhiles in some part, and that especially 
in the capacity of the belly, between the peritoneum and the entrails. 
From this distinction of places and matters there arise divers kinds of 
dropsies. . . . Yet they all arise from the same cause / that is, the weak- 
ness or defect of the altering or concocting faculties, especially of the 
liver, which has been caused by a scyrrhus, or any great distemper 
(pp. 299, 300). 
Dropsy— 
Its causes. 
74. The beginning of the cure must be with gentle and mild medi- 
cines ; neither must we come to a paracentesis, unless we have for- 
merly used and tried these; therefore, it shall be the part of the 
physician to prescribe a drying diet, and such medicines as carry away 
water, both by stool and urine (p. 301). 
Cure by 
purgatives 
and diuret- 
ics. THE DOCTRINE OE PURGATION. 
Tetanus, 
from excre- 
mentitious 
matters. 
75. Tetanus — Causes.—Abundance of humors causes repletion; 
dulling the body by immoderate eating and drinking, and omission of 
exercise or any accustomed evacuation, as suppression of the hemor- 
rhoides and courses, for hence are such like excrementitious humors 
drawn into the nerves with which they, being replete and filled, are 
dilated more than is fit, whence, necessarily becoming more short, they 
suffer convulsion. ... It is cured by discussing and evacuating remedies, 
as purging, digestive local medicines, exercise, frictions, and other things 
which may consume the superfluous excrementitious humors that possess 
the substance of the nerves and habit of the body (pp. 329, 30). 
Cure by 
purgatives 
and local 
medicines, 
&c. 
Note.—Allcock’s Porous Plasters applied along the spine from neck to os sacrum, and 
Brandreth’s Pills two every two hours, is good treatment for lockjaw. 
Palsy 
from obstruc- 
tion by mor- 
bid matter. 
76. Palsy.—The cause are humors obstructing one of the ventricles 
of the brain, or one side of the spinal marrow, so that the animal 
faculty—the worker of sense and motion—cannot, by the nerves, come 
to the part to perform its action (p. 332). 
In the cure of the palsy we must not attempt anything, unless we 
have first used general remedies, diet and purging, all which care lies 
upon the learned and prudent physician (p. 333). 
Purgation 
cures. 
77. Erysipelas.—The cure of such an effect must be performed by 
two means; that is, evacuation and cooling with humectation. If bile 
alone cause this tumor, we must easily be induced to let blood, but we 
must purge him with medicine evacuating bile (p. 353). 
Erysipelas. 
Purge, but 
do not bleed. 
Note.—Bleeding must never be resorted to in Erysipelas; it is dangerous, never does 
any good, and is certain to retard the cure. * 
Gangrene. 
Thesuperflu- 
ous humors 
must be eva- 
cuated. 
78. The cure of gangrene, caused by the too plentiful and violent 
defluxion of humors suffocating the native heat, by reason of great 
phlegmons, is performed by evacuating and drying up the humors, 
which putrify by delay and collection in the part (p. 456). ... If the 
body be plethoric, or full of ill humors, you must purge (p. 455). 
79. An ulcer has one, and that a simple indication, that is, exsicca- 
tion. . . . Before you do anything about the ulcer, you must first use 
general means; for in Galen’s opinion, if the whole body require prepa- 
ration, that must be done first, for in some ulcers 'purgation alone will be 
sufficient (p. 470). . . . Dry nlcers you shall correct by humeating 
medicines, as fomenting it with warm water, &c., but always you must 
first purge. . . . Then you must have recourse to refrigerent things 
-(p. 471). 
Ulcers re- 
quire always 
purgation, 
then exter- 
nal applica- 
tions. 
Note.—The Gum Elimi Universal Cerate should be procured. We can recommend it. 
It contains no grease or oil, but is a vegetable production, and very useful in all affections 
of the skin; as an application to a felon or otherwise it is superior to bread or linseed meal 
as a poultice. 
tion orthe°" 
eyes. Purge 
before all. 
80. Ophthalmia can proceed from different causes, external and 
internal, producing tlie settling of humors to the eye. The evacuations 
& " THE DOCTRINE OF PURGATION. 
of the matter flowing into the eye, shall be performed by purging medi- 
cines., cupping the neck and shoulders with scarification or withcnd; 
and lastly by frictions, as the physician shall think it fit (p. 645). 
Allcock’s Porous Plasters are superior, applied to back and shoulders, to cupping, scar- 
ifications or frictions. 
81. The Diabetes is a disease wherein presently, after one has drunk, 
the urine is made in great plenty, by the dissolution of the retentive fac- 
ulty of the veins, and the deprivation or immoderation of th6 attractive 
faculty. The causes are the inflammation of the liver, lungs, spleen, 
but especially of the kidneys and bladder. . . . For the cure of so 
great a disease, the matter must be jpurged which causes or feeds the 
inflammation (p. 688). 
Diabetes. 
morbid mat- 
causes’in- 
flammaticn. 
82. Whenever the guts, being obstructed or otherwise affected, the 
excrements are hindered from passing forth, if the fault be in the small 
guts, the effect is termed “ Yoloutus, Iteos, or miserere meibut if it 
be in the greater guts, it is called the “ colic,” from the part affected, 
which is the colon. Therefore Avicen rightly defines the colic as “ a 
pain in the guts, wherein the excrements are difficultly evacuated by 
the fundament.” Taul/us Eleginata reduces all the causes of colic to 
four heads, to wit: to the grossness or toughness of the humors impact 
in the coats of the guts; flatulencies hindered from passage forth ; 
inflammation of the guts; and, lastly, the collection of acrid and bit- 
ing humors. . . . Over-eating and taking in of nourishments that do 
not agree with each other, or with the constitution of the body, produce 
crudity and obstruction, and at length the collection of flatulencies, 
whereon a tensive pain ensues. . . I>y the use of crude fruits and too 
cold drinks the stomach and guts are refrigerated, and the humors and 
excrements therein contained are congealed, and, as it were, burned 
up (p. 689). . . . 
Colic. 
The causes 
and physiol- 
ogy- 
83. There is also another cause of the colic which is not so common, 
to wit, the twining of the guts, that is, when they are so twined, folded 
and doubled, that the excrements, as it were, bound in their knots, can- 
not be expelled.* . . . The colic is cured, the humors being first atten- 
uated anal diffused, and at length evacuated by medicines taken by the 
mouth and otherwise (pp. 690, 91). 
Enlerocele. 
Cure by pur- 
gation. 
* Some sweet oil, followed by a dose of Brandreth’s Pills, is the simple remedy by which 
to relieve such painful state of the bowels. Also, clysters of water, about summer heat, 
should be given. 
84 Arthritis, or Gout, is a disease occupying and harming the sub- 
stance of the joints by the falling down and collection of a virulent 
matter and humors. When there is a great abundance of humors in a 
body, and the patient leads a sedentary life, not some one, but all the 
joints of the body are at once troubled with the gout (p. 697). 
a out, 
pbnsldloa 
|*“gr^adniis; 
fesUngHseif 
locations. THE DOCTRINE OF PURGATION. 
85. The causes of gout are unprofitable humors which are generated 
and heaped up in the body, and in the process of time acquire a virulent 
malignity. Such humors arise from an inordinate diet; they offend in 
feeding who eat much meat, drink strong wine, sleep presently after 
their meals, and use little exercise. For hence a fullness and obstruc- 
tion of the vessels, crudities, and the increase of excrements, especially 
serous, and, if they flow down into the joints, without doubt they 
cause this disease. Besides, also, the suppression of excretions accus- 
tomed to be voided at certain times. 
. . . Those who recover of great and long diseases, unless they be 
fully and perfectly purged, these humors falling into the joints, which 
are the relics of the disease, make them become gouty. The humor 
impact and shut up in the capacities and cavities of the joints, it cannot 
be easily digested and resolved. The humor then causes pain by reason 
of distention or solution of continuity, distemper, and besides the viru- 
lency and malignity which it acquires. The concourse of flatulencies 
and hinderance of transpiration increase the morbific painful distention 
in the membranes, tendons, ligaments and other bodies of which the 
joints consist (p. 700). 
Laemper-8' 
timely sleep 
want of ex- 
duce accum- 
morbkTmat- 
ter- 
imperfect 
ducesaout 
• 
purgaUon, 
hadtrfspring 
and autumn! 
86. To cure the gout there are two indications: the first is the evacu- 
ation and alteration of the peccant humors, the other the strengthening 
of the weak joints, accompanied by a fit diet. ... A fit time for purg- 
jUg js the spring and autumn, because gouts reign chiefly in these 
seasons (p. 704 ; cf. Hipp. Aph. 55, S. VI). 
GOLDEN WORDS. 
87. Now, it is convenient that the purge be stronger than ordinary, 
for if it should be too weak it will stir up the humors, but not carry 
them away, and they thus agitated will tall into the pained and weak 
joints, and cause the gout to increase. . . . The fever accompanying 
1C gout easily becomes continual, unless the belly being first gently 
purged, nature be freed by stronger purges of the troublesome burden 
of the humors. . . . Seeing that physic is the addition of that which 
nature wants, and the taking away of those things that are superfluous, 
the gout is a disease that has its essence from the abounding 
humor, certainly, without the evacuation of them, we cannot hope to 
cure either it or the pain which accompanies it. Metrius, in his treatise 
of the gout, writes, that it must be cured by purging, used not only in 
the declination but also in the height of the disease, which we have 
found true by enperience (p. 710; cf. Hipp. Apli. 23, sect. I, and 
Aph. 8, sect, II.) 
n 
must be 
'gradually 
TtcuresaUo 
ike treat- 
Hif through- 
course°of the 
disease. 
sciatica. 
purges and 
romits. 
88. Sciatica.—Strong purgatives are here also useful, such as used in 
phlegmatic causes. Often vomitings do not only evacuate the humors, 
but also make a revulsion (p. 720). 
89. The heat or scalding of the water arises from repletion, inanition 
or contagion. That from repletion proceeds from too great abundance THE DOCTRINE OF PURGATION. 
of blood, causing tension and heat in the urinary parts, whence proceeds 
the inflammation of them and the genital parts. . . . Purgings are 
convenient, and a diet abstaining from heating articles, together with 
cooling external applications (pp. 738, 740). 
cfehy'ff 
oation. 
90. Buboes, or Swellings in the Groins.—The matter of these for the 
most part is abundance of cold, tough and viscous humors, as you may 
gather from the hardness and whiteness of the tumor, the poverty of the 
pain and contumacy of cure; which also is a reason why the virulency 
of this disease may be thought to fasten itself in a phlegmatic humor. 
The cure shall be performed by detergent medicines, and the humor evac- 
uated by a purging medicine (p. 746). 
Buboes 
Evacuate the 
fPjation. 
91. Tetters, Ring-worms or Chops.,—For general remedies, the distem- 
per of the liver and habit of the body must be corrected. This may be 
done by diet conveniently appointed, by purging and alterative medi- 
cines, as they acquire their matter from salt phlegm or adust bile 
(p. 754). 
Bing worm 
&c. Purge.' 
92. Now, the Small-Pox is pustules, and the Measles spots, which 
arise in the top of the skin, by reason of the imparity of the corrupt blood 
sent there by the force of nature (p. 757). You must neither purge nor 
draw blood, the disease increasing or being at its height, unless perad- 
venture there be a great plentitude, or else the disease complicate with 
others, as with a pleurisy, inflammation of the eyes, or a sejui nancy* which 
require it, lest the motion of nature should be disturbed, but you shall 
think it sufficient to loose the belly with a gentle clyster; but when the 
height of the disease is over, you may with cassia, or some stronger 
medicine, evacuate part of the humors and the relics of the disease 
(p. 759). 
Small-Pox 
and Measles 
from impu- 
rity of the 
blood. 
The use of 
purgatives. 
* Quinsy. 
Parey was plainly unacquainted with the good effect of purgation in the early stage of 
Small-Pox, when the purgative employed was efficient yet innocent. 
In many thousand cases the Brandreth Pills have been administered, more or less dur- 
ing the course of,Small-Pox, and with evident advantage in every case. 
These Pills are very useful where patients cannot obtain a doctor, and there are 
thousands of towns in the United States where there is not a medical man within one hund- 
red miles. i 
The following letter from Daniel Bissell, of Newcomb, Essex County, New York, who 
was supervisor of the town for twenty years, may be important. I consider it my duty to 
publish it here: 
MR. BISSELL’S LETTER. 
Four persons cured of Small-Pox by purging with Dr andr elk’s Pills. 
Newcomb, Essex Co., N. Y., Sept. 13th, 18G1. 
Doctor Benjamin Brandretii, New York, 
Dear Sir: In our family we have used your excellent Pills for several years, and have 
found them to be a never-failing remedy in mild and severe cases of sickness, but their full 
value we did not fully appreciate until last winter, when the Small-Pox visited so many fam- 
ilies in this and the surrounding towns. I was first attacked, and supposed 1 had a cold ; 
took four Pills and some warm drinks; next day no better, took four more; still no better, 
and my wife said I should take eight—did so, and then the Small-Pox began to show itself. 
On the fifth day took to my bed, and in less than four days was covered from head to foot 
with pustules. I continued to use the Pills daily, and took no other medicine whatever 22 
THE DOCTRINE OF PURGATION. 
except your Vegetable Universal Pills. The Pox was less than four days in coming to a 
head, and in about the same time they dried up. I began to attend some to my stock in 
about two weeks, but in three weeks I was attending to my regular farming business, having 
quite recovered my usual health. I took eighty Pills during my sickness, in doses of four 
to eight Pills, according to effect, being careful to procure two or three evacuations a day; 
and though covered from head to foot with the disease, yet it has not left a mark upon me, 
which is one of the benefits said certainly to be secured by the use of Brandreth’s Pills. I 
and my family found this to be so in our experience of their effects in this fell disease. 
My wife, well known as Aunt Polly for one hundred miles around us, was attacked with 
the disease about the time 1 was getting well of it. From the first she understood it was 
the Small-Pox, and prepared herself to combat its virulence by a free use of the Pills. In 
six days, and while confined to her bed, and scarcely able to move from excessive weakness, 
she used twenty-six Pills, or a little over an average of four Pills per day. And what was 
the consequence of this continued purging with Brandreth’s Pills ? On Tuesday she was 
obliged to take to her bed; by Friday the pustules were all filled; and by the following 
Tuesday she had dressed herself! and in one week after was attending to her regular house- 
hold duties, to the astonishment of all her neighbors. One fact deserves notice: although 
she was covered with the disease, yet it has left no mark whatever on her skin, which bears 
no evidence of the awful ordeal it has passed under. 
Mrs. Wetherbee, my daughter, her husband, and their only child, were all stricken down 
by the Small-Pox. Mrs. W. had it light, and only some seven pustules came out. She used 
thirty Pills in fourteen days. Alonzo, her husband, had a severe attack, and took the Pills 
all through it, the number not noted. They both recovered in fourteen days from its com- 
mencement. Their little boy, Daniel, about fifteen months old, had the disease badly; we 
had little hope to save him. He was covered from head to feet; he was like a huge scab; 
and for days he lay insensible. We all supposed he would die—that nothing could save 
him. His bowels had been confined for several days, and my wife said this must be reme- 
died—that perhaps if the boy could be purged he might revive. She read over yours and 
Dr. Lull’s experience, and gave him one Pill, crushed, in some warm water. The Pill pro- 
duced no effect, but she was impressed with your remarks upon the necessity and import- 
ance of having the bowels purged in Small-Pox, and in all serious sickness whatever; so she 
gave him another Pill. Still no effect. She then pounded three Pills, and added warm 
water, and gave them to the boy at once. Still no effect. There the little sufferer lay with- 
out motion, except the rapid breathing and peculiar signs of speedy dissolution evident to 
all. If he died, it would be said he might have got well had his bowels only been opened, 
and we then commenced to give him three Pills in two hours, or at the rate of one and one- 
half per hour. When this child of fifteen months had taken thirteen Pills, they operated, 
and most fully. The stools were black as pitch, and most offensive. Every one was satisfied 
that it was death and mortified matter which the Pills had brought away, and that the Pills 
had saved another life, through the Providence of God. 
In an hour after the Pills commenced to operate he began to revive, and took some re- 
freshment. He continued to improve until he got well. He is not marked with the disease. 
It seems proper to state that, though it took thirteen Pills to open his bowels, yet two days 
after he had a full natural evacuation without medicine, and his bowels have been regular 
up to this day, which is nearly nine months from the time of his sickness, nor has he used a 
Pill since. He is as lively, intelligent, and healthy a boy as can be seen. His parents will 
ever be grateful to you, and they and myself and wife desire you to publish this letter, 
which, if need be, can be certified to by all the residents of. this and the adjoining towns. 
I am, respectfully, yours, 
DANIEL BISSELL, 
For many years Supervisor of the Town. 
We certify to the truth of the above. (Signed)—Polly Bissell; Alonzo Wetherbee; 
Mary Wethi.rbee; Russell Root, Postmaster, Schroon River; Erastus P. Root; Thomas 
R. Carey, Justice of the Peace, Town of Long Lake ; Cyrus IT. Kellogg, Supervisor of Town 
of Long Lake, 1860; William Wood, Commissioner of Roads, Town of Long Lake; Josiah 
Wood, Raquette Lake; Wm. Helms, Forked Lake; W. H. Plumbley, Forked Lake; Amos 
Hough, Forked Lake; Ezekiel Palmer, Long Lake Hotel. 
ANOTHER CURE OF SMALL-POX. 
I may also in this connection introduce the following statement of Joseph Daily, of No. 4 
Union Square, New York : 
Joseph Malone and Henry Downs, acquaintances, on the same day were taken sick. 
Malone took ten Pills of Brandreth’s; next day, feeling no better, he took six more: still 
feeling no better, he took four more the third day; fourth day better, got up and dressed 
himself, when, to his great astonishment, he observed large pimples on his face; it was in 
HOW TWO MEN WERE TREATED. THE DOCTRINE OF PURGATION. 
fact covered with Pox. Upon a further examination he found that they were coming out all 
over him; even the soles of his feet were full. Malone used the Pills more or less every day 
until he was perfectly recovered, which was within three weeks from the first day of sick- 
ness, when he was again at his business. Though covered from head to foot with the Pox 
they did not leave a mark behind. 
Henry Downs when taken sick called in a doctor, who discovered on the third day the 
true nature of the disease, and sent his patient to the Small-Pox Hospital on Blackwell’s 
Island. There he remained two months, and then was discharged cured. He lost an eye 
while in the Hospital, and was so marked that his nearest friends hardly knew him. These 
facts will bear the strictest investigation. 
WORMS. 
93. A gross, viscid and crude humor is the material cause of worms, 
which having got the beginning of corruption in the stomach, is quickly 
carried into the guts, and there it putrefies, having not acquired the 
form of laudable chyle in the first concoction. This, for that it is viscid, 
tenaciously adheres to the guts, neither is it easily evacuated with the 
other excrements; therefore, by delay it further putrefies, and by the 
efficacy of heat, it turns into the matter and nourishment of worms 
(p. 765). In this disease there is but one indication, that is the casting- 
out of the worms forth of the body, as being such that in their whole 
kind are against nature. ... Now as such things breed of a putrid 
matter, the patient shall he purged, and the putrefaction repressed. . . „ 
Oil of olives kills worms, and so do all bitter things (p. 767). 
or ms 
from viscid 
/minors ac- 
cumulated 
in the intes- 
tines ; eject- 
ed by pur- 
gatives. 
Brandreth’s Pills are infallible as a cure for worms, with or without olive oil. 
94. Leprosy proceeds from impurity of blood.—You must understand 
that the cause of the leprosy by the retention of the superfluities, happens 
because the corrupt blood is not evacuated, but regurgitates over the 
whole body, and corrupts the blood that should nourish all the members, 
wherefore the assimilative faculty cannot well assimilate by reason of 
the corruption and default of the juice, and thus, in conclusion, the 
leprosy is caused. The antecedent causes are the humors disposed to 
adustion and corruption into melancholy by torrid heat. . . . Galen (ad 
Glauconem, lib. 1, cap. II.) defines it: “ An effusion of troubled or gross 
blood into the veins and habit of the whole body” (pp. 769, 70). A 
cooling diet and purging shall be prescribed to evacuate the impurity of 
the blood and mitigate the heat of the liver (ibid.; cf. 68 ; cf. 71, 82, 93 ; 
Hippoc. 42, 60). 
tfafa'of 
Leprosy— 
Jfty oT'the 
eynt a?t‘ 
regeneration 
95. Hydrophobia.—Such as have not their animal faculty as yet 
overcome by the malignity of the raging venom must have strong jour- 
natives given them. For it is a part of extreme and dangerous madness 
to hope to overcome the cruel malignity of this poison already admitted 
into the bowels by gentle purging. . . Neither shall they let blood, lest 
so the poison should he drawn further into the veins. But it is good 
that the patient’s body be soluble from the very first (p. 789). 
nydropho- 
™%.gative/ 
fr?m 
Bleeding 
dangerous. 
Note.—Brandreth’s Pills, four every two hours, until twenty pills be taken, is the best 
means, and will hardly fail if resorted to in season. THE DOCTRINE OF PURGATION. 
from cor- 
and tepredil 
the body °f 
96. The general and natural causes of the plague are absolutely two, 
that is the infection of corrupt air, and a preparation and fitness of 
corrupt humors to take that infection (p. 819). 
Humors putrify either from fullness which breeds obstruction, or by 
distemperate excess, or by admixture of corrupt matter (p. 820). 
97. I say that the pestilence does depend on the default of the air; 
this default, being drawn through the passages of the body, does at 
length pierce into the entrails, as we may understand by the abscesses 
that break out, by reason that nature using the strength of the expul- 
sive faculty, drives forth whatever is noisome and hurtful (p. 8457 
nature.6 °J 
98. The physician must not let blood, for when nature is debilitated 
by this evacuation and the spirits, together with the blood, exhausted, the 
venomous air will soon pierce and be received into the empty body, 
where it exercises its tyranny to its utter destruction. . . . If there be 
great fullness in the body, especially in the beginning, . . then it is 
lawful to purge strongly. . . . If you call to mind the proper indica- 
tioiis, purging shall seem necessary, and that must be prescribed as the 
case requires, rightly considering that the disease is sudden, and requires 
medicines that may with all speed drive out of the body the hurtful 
humor wherein the noisome quality does lurk and is hidden (pp. 846, 
47). 
ktfi8.e<iing 
strong 
chute 1purg- 
ing saves, 
90. Concussion of the Brain.—By a heavy blow or the like occasion, 
the veins and arteries of the head may be broken. From hence pro- 
Ceeds the afflux of blood running between the skull and membranes, or 
else between the membranes and brain. The blood congealing there, 
causes vehement pain, and the eyes become blind, vomiting is caused, 
the mouth of the stomach suffering together with the brain, by reason 
of the nerves of the sixth con jugation, which run from the brain thither, 
and from thence are spread all over the ventricle ; whence, becoming a 
partaker of the offense, it contracts itself, and is presently, as if it were, 
overturned; whence first these things that are therein contained are 
expelled, and then such as may flow thither from the neighboring parts, 
as the liver and gall, from all which bile is first expelled (p. 351). 
Concussion 
Purgation 
indicated. 
Brandreth’s Pills in these cases purge in from thirty to sixty minutes. 
turn /moCi 
bones and all 
operations 
nfy'uic bio'ud 
100. To cure a broken and dislocated bone is to restore it to its 
f°rmer figure and site; that is, first to restore the bone to its place; 
second, to bring it to stay, being so restored; third, to hinder the 
increase of malign symptoms and accidents, or else if they happen to 
temper and correct their malignity. . . . For this purpose we. drive 
away the defluxion ready to fall down upon the part by medicines, repel- 
ling the humor and strengthening the part, or by appointing a good 
diet, hinder the begetting of excrements in the body, and divert them 
by purging (pp. 565, 66). 
Note.—The importance of purging and the reasons therefor are strongly presented by 
Ambrose Parey, and will have weight with sensible men, in or outside of die profession THE DOCTRINE OF PURGATION. 
Sanctorius, M. D., Prof of Physic at Venice ; Ars. de Station medi- 
cina, Venice, 1614. Aphorisms, translated by John Quincy, M. 1). 
London, 1720 
101. If there daily be an addition of ivhat is wanting, and a subtrac- 
tion of what abounds, in due quantity and quality, lost health may be 
restored, and the present preserved. (Apli. 1, sect. 1.) 
lie only who knows how much and when the body does more or 
less insensibly perspire, will be able to discern when and what is to be 
added or taken away, either for the recovery or preservation of health 
(Aph. 3). 
The great 
principle oj 
health: a 
systematic 
disorgani- 
zation and 
reorganiza- 
tion. 
Note.—Nature herself does all these things, provided we relieve the body by purgation ; 
for innocent purgatives take out no humors but those which are depraved. 
102. Insensible perspiration is either made by the pores of the body, 
which is all over perspirable, and covered with a skin like a net, or it is 
performed by respiration through the mouth, which usually in the space 
of one day amounts to about half a pound (Aph. 5). 
Insensible 
perspira- 
tion, liow it 
is performed. 
Note.—Should either of these processes of the skin or the lungs be partially suspended, 
we have only to increase by purgation the activity of the bowels, this organ measurably 
taking upon itself their work, they partially resting the while; then both lungs and skin 
will soon regain their healthy functions. 
103. If the body increases beyond its usual weight without eating or 
drinking more than customary, there must either be a retention of the 
sensible excrements, or an abstraction of the perspirable matter (Aph. 9). 
The body continues in the same state of health as long as it returns 
to its wonted weight, without any increase of the sensible evacuations; 
but if it comes to its standard by larger discharges, either by stool or 
urine, than ordinary, it then begins to decline from its former health. 
(Aph. 10; cf. Parey, 71, 82, 93, 94; cf. Hippoc., 44, 45.) 
Static me- 
dicine : its 
fundamental 
principles. 
104. From too great fullness arise bad qualities, but none vice versa 
(Aph. 18). Too great a weight and fullness may be lessened by sensible 
or insensible evacuations, either of digested or undigested matter, and 
it is good so to do (Aph. 19). 
Plethora 
requires 
evacuation. 
105. That perspiration which is beneficial, and most clears the body 
of superfluous matter, is not what goes off with sweat, but that insensi- 
ble steam or vapor (Apli. 21). . . . which becomes sensible when there 
is too great a supply, or upon faintings, or upon violent motions (Aph. 
22). Insensible perspiration accompanied with sweat is bad, because 
sweat diminishes the strength of the libers. (Aph. 23 ; cf., Hipp. 29, 43.) 
Sweat (or 
visible per- 
unhealthy, 
When persons faint from severe purging, I have always observed that when they 
came to, the countenance appeared relieved from great anxiety ; perhaps a congestion was 
broken up, or some troublesome humor removed. 
106. The body is not presently thrown into a disease by an external 
injury, unless some of the viscera be first disposed to receive its impres- 
Predispo THE DOCTRINE OF PURGATION. 
sions, which predisposition may be known by a greater or less weight 
than is customary, and that not without some considerable uneasiness 
(Aph. 39). The first impressions of a disease are much more easily 
discernible from the changes of an unusual perspiration, than from the 
disorders of any of the other functions (Aph. 42). If, upon weighing, 
the perspirable matter appears to have been obstructed, and there is 
neither increase of sweat nor urine for some days after, there is a great 
deal of danger of a putrefaction of the detained crudities (Aph. 43). If 
the obstructed matter can neither be removed by nature nor a feverish 
heat, there is immediate danger of a malignant fever. (Aph. 46 ; cf. 
Hipp. 17; cf. Hipp., 37.) 
nit ion for, 
and symp- 
toms of ad- 
vancing dis- 
ease. Re- 
move crudi- 
ties and pre- 
vent disease 
by purga- 
tion. 
107. The excrements of the guts which are well digested, are large 
in bulk, but light in weight; they swim because of the included air, 
and what is ejected at once seldom exceeds the third of a pound (Aph. 
72). 
Evacua- 
tions, when 
healthy. 
108. Importance of Ventilation to Imperceptible Pores.—Nothing 
more tends to prevent a corruption of the humors than plentiful ventila- 
tion ; not only by that which is drawn in by the lungs, but what is 
drawn in through the imperceptible pores. (Aph. 120; cf. Hipp., 10, 
55 and 13, 26.) 
Double ac- 
tion of the 
lungs and 
pores (active 
and nega- 
tive). 
109. The plague is communicated not by any immediate contact, but 
either by drawing in infectious air or the steams of tainted furniture; 
and it is thus: the vital spirits are infected by the air, and from the 
infected spirits the blood is coagulated, which produces black spots, car- 
buncles and buboes, and if not sufficiently discharged, occasion death; but 
if it be all thrown out, they escape. (Aph. 127; cf. Parey, 94). 
Pestilen- 
tial infec- 
tion, how 
propagated, 
prevented 
and cured 
by purga- 
tion. 
The above shows the absolute necessity of Brandreth’s Pills in Plague, because they 
purge safely. 
110. The external air which passes through the arteries into the 
body may render the body heavier or lighter; lighter if it be subtle 
and warm, and heavier when thick and moist (Aph. 3, sect. II). In a 
foggy air perspiration is lessened, the pores are obstructed, and the fibers 
weakened and not rendered, more firm; and the weight of the retained 
matter is both perceivable and injurious. (Aph. 8 ; cf. 103, 106, 109.) 
Air—its 
influence 
upon the 
body. 
Summer- 
complaint : 
how it en- 
sues. Its cure 
by gentle 
purging to 
remove ob- 
structed 
matter. 
1 11. Temperate persons weigh in summer time about three pounds less 
than in the winter (Apli. 23). That lassitude or weariness which is per- 
ceivable in summer time is not because the body is then heavier, but 
because it is then rendered weaker (Aph. 24). In summer time the 
body is not uneasy from the heat of the air immediately, for every part 
of the body is even then hotter than the external air, but because at 
such times there is not a sufficient coldness to concentrate the natural 
heat. By which means it becomes so scattered that it cannot drive out 
the perspirable matter, in its own nature hot, by insensible steams ; which 
matter, by being retained, acquires a sharpness, and is really the cause 
of that uneasiness we are under from a sense of the summer heat (Aph. 
27, sect. 1) THE DOCTRINE OF PURGATION. 
112. When to Purge.—The autumn is unhealthful, both because per 
spiration lessens upon the supervening cold, and because that which is oh- 
structed acquires an acrimony and a corrosive quality (Aph. 42V Tliev 
1 * , , , r . . . G ' /, -/7 J 
who are accustomed to a distemper m winter, that arises from a fullness 
of humors, ought to purge in autumn (Aph. 48). ' 
Autumnal 
h-y efcuat: 
tngtheacn- 
mowious ac- 
tionflvla~ 
Note.—Our experience is, purge only when the body calls for it—when we have 
pain or oppression, or the bowels are costive. 
113. But for such diseases as arise from noxious qualities, purging 
ought rather to be used in the spring than autumn, because in the hot 
weather such qualities grow worse more than in the winter (Aph. 49; 
cf. Parey, 86). 
Spring the 
season for 
purging for 
constituti'n- 
al diseases. 
114. If the obstructed perspirable matter acquires an acrimony, it pro- 
duces fevers and inflammations; but when it offends only in quantity, 
it causes ajoostumations, distillations, and cachexies (Aph. 51). 
Acrimony 
is corrected 
and super- 
abundance 
carried off 
by purga- 
tion. 
115. When a full meal is not perfectly digested, it is to be known by an 
increase of weight, for the body will not then perspire well ; but an 
empty stomach is filled with vapors (Aph. 12, sect. 3 ; cf. Apo. 5, sect. 1.) 
Robust persons discharge their food for the most part by perspiration; 
those not so strong by urine; and the weak chiefly by an indigested 
chyle (Aph. 14). A full or an empty stomach lessens perspiration ; for 
a full one diverts it by corruption of the aliment, and an empty one 
draws it back, that it may be filled (Aph. 11), arid the obstructed mat- 
ter will acquire a sharpness, whence the body will be subject to distem- 
pered heat (Aph. 15). 
Insensible 
and visible 
excretion— 
their equi- 
librium de- 
pending on 
constitution- 
al strength. 
116. When a person seems to himself lighter than he really is, it is a 
very good sign, because it arises from a perfect digestion of all the juices 
(Aph. 19). 
sensation 
of health. 
117. That sort of food best perspires, and affords the most suitable 
nourishment, whose weight is not perceived in the belly (Aph. 28). 
What is 
suitable 
food. 
118. Nothing more frequently interrupts sleep than a putrefaction of 
the food, such is the sympathy between the stomach and the brain (Aph. 
40, sect. 4). From eating comes sleep; from sleep digestion, and from 1 
digestion a good 'perspiration (Aph. 59 ; cf. Parey, 99). 
Watchful- 
ness from 
morbid mat- 
ter—purge. 
Sympa'hy 
of brain and 
stomach. 
119. By exercise bodies are rendered lighter ; for all the parts, espe- 
cially ligaments and muscles, are cleared of their excrements by motion ; 
the perspirable matter is fitted for exhalation, and the spirits rendered 
firmer (Aph. 9, sect. 5). Exercise promotes both the sensible and in- 
sensible evacuations; but rest only the insensible (Aph. 10). 
Digestion 
requires ex- 
ercise of the 
body. 
120. The heavy part of the perspirable matter being more than usually 
retained in the body, it will dispose a person to fear and sorrow ; but 
the lighter part being obstructed, to anger or joy (Aph. 5, sect. 7). 
“ Nervous- 
ness” from 
obstructed 
exertion— 
therefore 
purge. THE DOCTRINE OF PURGATION. 
Harvey, William, Dr.—The works of, written 1628-51/ transl. by 
Robt. Willis, M. I)., and published by the Sydenham Society. London, 
1846-47. 
ITarvey on 
the blood. 
121. The blood acts with forces superior to the forces of the elements. 
As the instrument of the Great Workman, no one can eyer sufficiently 
extol its admirable, its divine faculties. . . It penetrates everywhere, and 
is ubiquitous; abstracted, the sold or the life, too, is gone, so that the 
blood does not seem to differ in any respect from the soul, or the life 
(anima) itself. At all events it is to be regarded as the substance whose 
act is the soul or the life. . . In one way the blood is part of the body, 
but in another way is the beginning and cause of all that is contained in 
the animal body. . . That which is abundantly nourished by it, in- 
creases; what is not sufficiently supplied, shrinks ; what is perfectly 
nourished, preserves health; what is not perfectly nourished, falls into 
diseases (pp. 510, 11). 
vitiated 
Mood. 
122. Yitiated states and plethora of the blood are causes of a whole 
host 0f diseases (p. 391; cf. Hippocr. Works, p. 262, Yol. I., Aphor. 22, 
sect. 2; cf. Parey, 68-99). 
Nature the 
medidne °f 
123. The physiological consideration of the things which are accord- 
1° nature is to be first undertaken by medical men, since that which 
is in conformity with nature is right, and serves as a rule both to itself 
and to that which is amiss (p. 90; Hippocr. Works, p. 102, Yol. I., p. 
360, Yol. I). 
The timid 
the?newdoc- 
trine. 
124. Not yielding implicitly to the truth, he fears to speak out 
plainly, “ lest he offend the ancient physic” (p. 91). 
The old fo- 
aie* of iiar- 
vey’s time. 
authority, 
125. Who will not see that the precepts he has received from his 
teachers are false; or who thinks it unseemly to give up accredited 
0p[Tqolls. or wlio regards it as in some sort criminal to call in question 
doctrines that have descended through a long succession of ages, and 
carry the authority of the ancients; to all these I reply: that the facts 
cognizable by the senses wait upon no opinions, and that the works of 
nature bow to no antiquity / for, indeed, there is nothing either more 
ancient or of higher authority than nature (p. 123 ; cf. Hippocr. 47). 
The mood 
again- 
126. The blood-is the generative part, the fountain of life, the first to 
live, the last to die3 and the primary seat of the soul (p. 377). 
The blood is both the author and preserver of the body/ it is the 
principal element, moreover, and that in which the vital principle (ani- 
ma) has its dwelling place. . . The blood, moreover, is that alone which 
lives and is possessed of heat while life continues (p. 379; cf. pp. 
510, 11). THE DOCTRINE OF PURGATION. 
Collins, Samuel, M. D., System of Anatomy. London, 1685. 
127. Cathartics do not only affect the blood at a distance, but also the 
villous coat and nervous filaments, which do immediately disturb them 
with troublesome stroaks proceding from the pungent particles of pur- 
gatives, vellicating the inward coat of the stomach as a tender compage 
beset with nervous fibrils, which, irritated by sharp medicines, spew out 
serous liquor out of the excretore ducts, derived from the glands of the 
intestines. 
The purgation extract of medicines first produced by the ferments 
of the stomach, and afterwards imparted to the intestines, does highly 
excite the nervous and carnous fibers, and gives a most troublesome 
sensation to the inward coat of the guts finely dressed with fibrils; and 
afterwards affects the excretory vessels of the pancreas and hepatic ducts 
with a kind of convulsive motion, making them disgorge their pancreatic 
and bilious recrements, into the larger receptacle of the intestines. 
And not only the feces of the blood, secreted from it in the glands of 
the liver and pancreas, are thrown into the guts by the excitement of the 
nervous and carnous fibers, but also the extremities of the arteries and 
excretory vessels belonging to the glands, are opened by the sharp and 
aperient qualities of the purgatives, unlocking the secret pores of the 
inward coat of the intestines lined with a mucous matter, which is 
scraped off by the cleansing qualities of purgatives, leaving the intestines 
exposed to the active power of raking medicines, which force open the 
extremities of the arteries (p. 369, vol. I). 
How pur- 
gative medi- 
cines act on 
the stomach 
and intes- 
tines, by irri- 
tation of the 
intestinal 
nerves, stim- 
ulating the 
peristaltic 
motion and 
cleansing off 
the mucous 
matter. 
128. The concoctive faculty of the intestines is disaffected; first, as it 
is wholly abolished, when no chyle, or very little, is extracted in the 
stomach or intestines. This evil proceeds from the want of natural heat 
deficient primarily in the blood, and from a defect of good succus pan- 
creaticus, and bilious liquor, and a laudable serous and nervous juice, 
not being imparted by the extremities of the arteries and nerves to the 
crude aliment lodged in the guts. This disorder is commonly called 
lienteria, an unnatural excretion of the aliment, little or no ways altered, 
wherein its compage is not well opened by due ferments, and a secretion 
made of the alimentary liquor from the grosser feces (p. 370). This 
obstruction of the hepatic and pancreatic ducts is cured by aperient medi- 
cines (p. 371). 
Pathology 
OF THE INTES- 
TINES. 
Lienteria 
from ob- 
struction of 
the hepatic 
andpancre- 
atic ducts. 
Cure by pur- 
gatives. 
129. Another disorder of the intestines near akin to the former, as 
differing from it in degree, is the lessened concoction, commonly styled 
caeliac affection, wherein the food is in some sort digested, and remains 
confused, as not secreted from the gross parts, because the chyle is not 
well attenuated by the pancreatic and bilious liquor, and serous and 
nervous juice, which are destitute of volatile salt, oily and spirituous 
particles, so as to render the chyle fluid in the intestines; whereupon the 
clammy chyle embodying with the crude aliment, is excreted by the ex- 
pulsion faculty (p. 370). This distemper is cured by the same means as 
a lienteria (p. 371). 
Cartiao 
affection is 
imperfect 
digestion 
from defec- 
tive compo- 
sition of the 
circulating 
fluid. Cure 
by purgat- 
ive medi- 
cine. 
130. The third indisposition of the coneoctive faculty of the intestines 
impsr/ect 
digestion THE DOCTRINE OF PURGATION. 
from acrid 
humors. 
Purge. 
is its depraved action, produced by ill ferments of sharp bilious, and acrid 
pancreatic liquor, vitiating tlie extracted aliment in the guts, and after- 
wards spoiling the mass of blood, when it is received into association with 
it in the blood-vessels (p. 370). It denotes gentle aperient medicines (p. 
371; cf. Parey, 94). 
131. Another disaffection of the intestines, and that none of the least 
because it concerns the nutrition of the whole body, is when the 
distributive faculty of the chyle is either wholly taken away or much 
lessened, which may proceed either from the clamminess of the chyle, 
or from the grossness of pituitous humors, more or less obstructing the 
orifices of the lacteal vessels seated in the intestines. The cure of this 
disease may be assisted with a light diet and medicines promoting the 
digestion (p. 371). 
Indiges- 
tion from 
disorders of 
the distrib- 
utive facul- 
ty of the 
chyle, by 
viscosity of 
humors. 
Slowness 
of excretion 
from fnact- 
iveness of 
the intesti- 
nal nerves. 
Purgatives 
stimulate 
them to acti- 
vity. 
132. The intestines are also incident to divers diseases in reference to 
their 'expulsive faculty, when the peristaltic motion is too slow, or too 
quick, or aggrieved with the discomposure of pain. 
The slowness of the motion of the guts proceeds either from the 
torpid indisposition of the nervous coat, not resenting the irritation by 
gross excrements, when the nervous fibrils inserted into the inward coat 
of the intestines have their acute sense lessened, proceeding from the want 
of animal spirits intercepted first in the fibrous parts of the brain, and 
by consequence in the nerves of the guts, produced by cephalic diseases, 
compressing or obstructing the fibrils seated in the brain. This dis- 
affection is cured by proper methods and medicines relating to the dis- 
eases of the head (p. 371). In all the diseases of the brain, Collins 
recommends purgatives to a greater or less extent (pp. 1133, 1134, 
1138, 1145, 1153, 1163, 1169, 1181, 1194, 1199 ; vol. II ; cf. Sanctorius, 
118). 
Torpor of 
the intes- 
tines from 
narcotics 
)opium) re- 
moved by 
strong pur- 
gation. 
133. The slowness of the peristaltic motion, incident to the guts, may 
be also derived from narcotic medicines, dulling the acute sense of the 
nerves which terminate into the inward tunicle of the intestines, where- 
upon they are not sensible of their burden, when they are oppressed with 
excrements. This disease may admit a cure by strong purgatives and 
sharp clysters (p. 372). 
Hardened 
feces are re- 
moved by 
purgatives. 
134. The remissness of the expulsive power of the guts may also 
arise from the viscid and indurated contents, produced by ill concoction; 
the other from the heat of the guts, exhausting the liquid parts of the 
excrements ; the guts being overcharged with excrements, purgatives may 
be advised (p. 372; cf. Hippocr. 13, 25, 26). 
135. The over-hasty motion of the guts is made in a lientery and 
caeliac disease, proceeding from the quantity of crude and indigested 
aliment provoking the nervous and carnous fibrils to excretion. This 
disaffection of the guts is visible also in diarrhea proceeding from salt 
phlegm and from bilious and serous excrements discomposing the tender 
compage of the guts, and irritating them to expulsion. The cure of 
Lientery, 
Caeliac dis- 
ease and di- 
arrhea from 
exalted peri- 
staltic mo- 
tion. Cure 
by purga- 
tives. THE DOCTRINE OE PURGATION. 
this disease is performed by lenient and astringent purgatives (p. 372; 
cf. Sanctorius, 103; Ilippocr. 44, 45). 
136. Inflammations of the guts producing dysenteries are most com- 
monly seated in the great gut, which, proceeding from a quantity of 
blood impelled by the mesenteric arteries into the intestines, some part of 
which is stagnant in the substance of the bowels, and other parts are 
transmitted sometimes into the small guts, where it seldom makes any 
long stay, as, being throwm from there into the colon, wherein the blood 
is long retained; whereupon the tender frame of the coats is corroded 
by the sharp blood confined in the deep cavities of the colon (p. 372). 
The vitiated expulsive faculty of the guts coming from inflammations, 
and from an ill mass of blood, is cured by clysters made of healing 
medicines and by purgatives (p. 373; cf. Sanctorius,103, 106, 109, 110). 
Dysentery 
from inflam- 
mation pro- 
duced by 
stagnation 
of impure 
blood in the 
bowels. 
137. The iliac passion proceeds from divers causes, sometimes from the 
small guts twisted, other times entangled and tied in knots, and also 
when they shoot downwards and upwards into one another. It may be 
derived from astringents unduly used, and from a stoppage of the intes- 
tines by viscious matter from hardened excrements, and from flatulent 
matter contained in the guts intercepting the passage of the gross 
feces. . . Now and then the upper shoots into the lower, and sometimes 
the lower into the upper part of the small intestines, which are much 
distended in several places, and in other parts contracted for some space 
both above and below ; whereupon the free play of wind being checked, 
the patient is highly tortured with pain, and, to ease himself, puts his 
body in divers postures by various agitations and flexures of it. A re- 
laxation is made of some part of the guts adjoining the contracted parts, 
which, being moved forward by the pressure of wind toward the relaxed 
intestines, force them into the next expanded parts of the guts, which 
are afterwards closed up by the duplicature of them, entirely intercept- 
ing the passage of excrements. And when in this miserable distemper 
the lower part of the guts is thrust into the cavity of the upper, the 
pressing down of the excrements, made by art in purgative medicines, 
discharges the insinuation of the lower gut into the upper (pp. 375, 76). . 
The iliac passion may arise out of a gross alimentary liquor or phlegm 
concreted in the intestines, wholly shutting up the passage of them ; 
whence ensues a recoiling of the excrements upward, produced by the 
irregular contraction of the fleshy fibers (p. 377). This disease often 
happens upon a long suppression of natural evacuations by stool, gener- 
ated by a load of hard excrements, long residing in the guts, productive 
of intolerable pains (p. 378; cf. Ilippocr. 38, 41, 44). 
Iliac pas- 
sion, or 
pains in the 
small guts 
from accu- 
mulation of 
fecal matte)' 
generally ac- 
companied 
with costive- 
ness of the 
bowels ; 
which is re- 
moved by 
purgative 
medicines. 
138. The colic is near akin to the iliac passion in the situation of the 
subject and in the cause of the disease, both proceeding from sharp 
humors productive of vexatious pains, and from the great obstruction 
and tension of the guts, caused by a quantity of gross excrements, and 
more thin and flatulent matter (p. 379). This disease takes up its man- 
sion, if not solely, yet chiefly, in the colon. Colic pains are generally 
felt in the lower apartment of the abdomen, accompanied with nausea, 
vomiting, suppression of stools, pains in the back, &c. . . Colic, accom- 
panied with heat and beating pains, arises from blood impelled out of 
(Cf. Parey. 
83.) 
Colic: Ac- 
cumulation 
of stagnat- 
ing blood, 
excrementi- 
tious matter 
and flatulen- 
cy,the cause. 
Its symp- 
toms. THE DOCTRINE OE PURGATION. 
the terminations of the capillary mesenteric arteries into the substance 
of the coats of the colon; piercing and fixed pains come from sharp 
pancreatic liquor blended with viscid phlegm, or bilious humors lodged 
within the coats of the guts, which produce pungent and wandering 
pains (pp. 380, 81). . This disease denotes purging and alterative medi- 
cines (p. 382). 
139. I conceive the carnous and nervous fibers are much weakened 
by the inflation of the coats of the intestines, whereupon the irritation 
of the medicines is not easily felt, and the carnous fibers do not con- 
tract ; upon this account strong purgatives must be given, or rather gen- 
tle, often repeated, assisted with purgative clysters, which excite the 
peristaltic motion of the guts to discharge the indigested aliment or 
gross vitreous phlegm, or indurated excrements (p. 384; cf. Hippocr. 
55; Coll. 134). 
Active, re- 
action pthe 
cure. 
Abscesses 
and Ulcers 
of the me- 
sentery. 
140. Abscesses and ulcers of the mesentery are cured by gentle purga- 
tives and proper drying diet-drinks (p. 393). 
141. Great pains in the back are not the disaffection of the colon 
only, but of the mesentery, too. . . Mesenteric affections are often de- 
rived from the serous feculencies of the blood, impelled out of the capil- 
biry arteries into the substance of the mesentery, and from flatulent 
matter distending the fibers of the mesentery. A cure may be attempted 
by emollient and discutient clysters and by purgatives, gradually increas- 
ing their strength, and by fomentations (p. 395). 
. 
the amlacl 
?useases°thof 
tke mesente- 
causes and 
yation.pl" 
Diarrhea 
ijiuon.pu> ' 
142. When patients labor under a great diarrhea, I conceive it very 
dangerous to advise powerful astringents until nature lias fully discharged 
herself, or art emptied the guts of gross and more thin excrements (p. 
376 ; cf. Parey, 92, and Hippocr. 2). 
0pium 
the cause of 
apoplexy. 
143. The immoderate use of opiates produces apoplexy, the drug 
stupifying and relaxing the nerves, and causing the stagnation of the 
Uood jn the COJ,tex (pp U28; U29^ 
Apoplexy, 
yation. 
14A. The sleepy diseases (apoplexy, earns, coma, lethargy), being 
a.kin 'm tlieir causes? are much alike in their cures, too. . Strong purga- 
fives may be given, and after a purgative has been celebrated, vomito- 
ries may be administered (pp. 1131, 1132, 1133). 
Vertigo- 
tionofinm- 
tirudnerves. 
145. Vertiginous symptoms arise from irritation of the nervous 
fibrils of the stomach, intestines, liver, pancreas, spleen and kidneys, 
proceeding from sharp recrements, which, offending the fibrils of the 
viscera, taking their origin from the brain, give a lightness to it (p. 
1136)and as to the preservatory indication in an ill habit of the body, 
purgatives may be applied (p. 1138 ; cf. 132). 
Delirium, 
emcuation 
°f lhe bow- 
146. In phrenitis and paraphrenitis, produced by an undue effer- 
vescence of tile blood caused by heterogeneous particles, or by the blood 
being poisoned with malignant qualities (p. 1140), which is induced by 
serous recrements vitiating the nervous liquor (p. 1143), clysters are THE DOCTRINE OF PURGATION. 
very successful to empty the bowels of excrements and winds (p. 1145 ; 
cf. Parey, 94; Sanctorius, 109). 
147. Melancholy being produced by vitiated blood and corr upt humors 
in the viscera (pp. 1150, 1151), is cured by vomitories and purgatives, 
removing the gross phlegm from the stomach and discharging gross, 
acid, and saline recrements from the blood (p. 1153). 
Melancho- 
ly. Remove 
morbid 
matter from 
the blood. 
148. Mania borrows its flrst rise from an ill mass of blood, caused 
by the distemper of the hepatic glands not secreting the bilious from 
the more laudable parts of the blood (p. 1159). Strong purgatives are 
used with advantage in this stubborn malady, as they purify the blood 
and nervous liquor (p. 1163). 
Mania. 
Purify the 
Hood by 
strong pur- 
gatives. 
149. Frequent and large doses of opiates incrassate the mass of the 
blood (p. 1167) and nervous liquor, rendering them effete and vapid, so 
that the brain cannot accomplish the acts of sense and reason, making 
men mopes and sots. To refine the blood, purging medicines, prepared 
with eephalics, may be very proper in those diseases (p. 1169). 
Opiates 
produce mo- 
pishness & 
stupidity. 
150. The indication to take away the cause of epilepsy is principally 
founded in rectifying an ill mass of blood and nervous liquor, which 
depends much upon a laudable state of the viscera, so that the ill diathe- 
sis of the blood and viscera is taken away by vomiting, purging, and 
bleeding (p. 1181). 
Epilepsy 
from a viti- 
ated state of 
viscera. 
151. Palsy.—The motive faculty is impeded or abolished, because 
the origins of the nerves are obstructed by the grossness of the nervous 
liquor, which may arise from a thick, feculent, albuminous part in the 
blood (p. 1193). A palsy sometimes succeeds severe pains of the stomach 
and intestines (p. 1194), which are produced by an accumulation of bilious 
and excrementitious matter and hardened feces and dilatation by flatu- 
lency, compressing the beginning of the vertebral nerves and intercept- 
ing the current of the circulating fluid (p. 1195). The antecedent cause 
of palsy is an ill mass of blood generated by a bad diet, hard of digestion 
(p. 1196). Vomitories may be advised in a foul stomach, but purgatives 
and alteratives for a habitual palsy (p. 1199). In a palsy derived from an 
evident cause—a fall, stroke, or wound—-the apertion of a vein may be 
proper, after an emollient and discutierit clyster has been administered 
and rejected (p. 1198; cf. 139; Parey, 83; cf. 136, 137, 138). 
Palsy from 
feculent mat- 
ters in the 
blood, pro- 
duced by 
imperfect 
digestion. 
The/frsf step 
toward cure: 
purgation. 
Sydenham, Thomas, M. D. The whole Works of that excellent practical 
Physician, written about 1686. Transl. Dr. Pechey. London, 1701. 
Sydenham. 
152. Though a purge does for the present raise a greater tumult in 
the blood and other humors, on the day it is taken, and in the operation, 
than was before, yet this injury will he sufficiently made up by the ad- 
vantage that presently follows; for it is found by experience that purg- 
ing quells a fever sooner and better than any other remedy whatever, 
both as it expels those filthy humors from the body, by which, as the 
antecedent cause, the fever was occasioned ; and if they were not peccant 
before, yet, at length being heated, concocted and thickened by the fever, 
Purgatives 
quell fevers 
soonest and 
best. THE DOCTRINE OF PURGATION. 
Filthy hu- do much to render it more lasting (p. 432 ; cf. Hipp. Works, I., 174 ; 
Tcedenr W. Harvey, 391; Sanctorius, 103, 106, 109, 110; Collins, 136-138, 
cause. j j-- 
and60*™? 
ing com- 
though mi- 
fwer8Cwr by 
sweating, 
curebypur- 
gahves. 
sons given 
most excel- 
153. Purging preferable to Sweating.— . . . On the contrary, as 
that method which is busied in eliminating the febrile matters through 
Hie pores of the skin is less certain, so it is more troublesome and 
t.edious; for by it the disease is very often protracted many weeks, and 
the life of the patient thereby endangered. . . .For this reason I insist, 
upon good grounds, that purging is more powerful than any other 
method for the subduing fevers of most kinds, for though sweating is 
nature’s own method by which she casts out febrile matters, and is more 
genuine and commodious than the rest, when nature is left to itself 
-j. prs£ digestg the aforesaid matter, and then, when it is well concocted, 
gently expels it through the- habit of the body. 
Yet art, how much soever it may seem to imitate nature, cannot 
arrogate to itself the privilege that it is able to cure fever certainly by 
sweating. For, first, art knows not by what means the peccant matter 
should be fitly prepared to undergo expulsion ; and if it should know 
this, yet it has no certain signs by which it should be admonished of the 
due preparation of it; so that also it is unavoidably ignorant of the fit 
time for provoking sweat, which it is very dangerous to provoke rashly; 
while if the physician should, by purging, miss his aim in curing the 
patient, yet he will not hurt him (pp. 432-34; cf. Gid. Harvey, p. 
286; cf. Ilipp. 29, 43 ; Sanctorius, 105 ; Parey, 69 ; Hipp. 9.) 
The above a highly important article. 
Pafhoio ral 
Diseases0™- 
portion" prto 
quautyy an0df 
morbid mat- 
154. If the humors are retained longer in the body than they ought, 
either because nature cannot concoct them and afterwards expel them, 
or because they have contracted a morbific disposition, they become 
exalted into a substantial form or species, which discovers itself by this 
or that disorder, that is agreeable with its own essence. 
ducts uk °~ 
The symptoms of disease, though to the less wary they may seem to 
arise from the nature of the part which the humor possesses, are really 
disorders arising from this or that specific exaltation or specification of 
some juice in the body. For nature is as methodical in producing and 
ripening these as of plants and animals, unless the order of it be dis- 
turbed by some extrinsic thing (as purgation'). The species of diseases 
depend on those humors from whence they were generated. (Preface.) 
in Chronic 
tMnaZre! 
155. Chronic Diseases.—Nature has not an effectual method in these 
diseases, to eject the morbific matter, as in acute, whereby, we assisting 
and aiming at the right mark, the disease may be cured. (Preface.) 
Note.—Purgation usually changes the chronic into an acute disease by assisting nature 
to expel impurities ; thus the blood becomes endowed with greater vitality. 
Disease— 
aeffortat 
curt- 
156. A disease is nothing but nature’s endeavor to thrust forth, with 
all her might, the morbific matter for the health of the patient, though 
the cause of it be contrary to nature (p. 1; cf. Ilipp. Aph. 2, sect. I; 
Sanctorius, 106.) THE DOCTRINE OF PURGATION. 
157. Impurities mixed with the blood affect the whole with a mor- 
bific contagion, partly from the various ferments or putrefaction of 
humors which are detained in the body beyond their due time, because 
it was not able to digest or evacuate them, either upon the account of 
their bulk being too great, or the incongruity of their quality (pp. 1, 2). 
Why na- 
ture cannot 
expel impu- 
rities. 
158. What is the Gout but Nature’s contrivance to purify the blood 
of old men (p. 2) ? 
Gout 
159. Purification.—Nature performs this office, sometimes quicker, 
sometimes slower, for when she requires the help of a(fever, whereby she 
may be able to separate the vitiated particles from the blood, and after- 
wards expel them, the whole business is done in the mass of the blood, 
and that by violent motion of the parts. . . . When this kind of matter 
is fixed to any part which is unable to exclude it, either upon the ac- 
count of its conformation, as it is in the morbific matter of a palsy that 
the nerves are stuffed with, or upon the account of a continued flux of 
new matter, wherewith the blood is vitiated, which is only disposed to 
carry it off, does oppress and overwhelm the part. I say in these cases 
the matter is very slowly or not at all concocted, and so diseases that 
proceed from such unconcocted matters are, and are called, chronic 
(pp. 2, 3 ; Cf. p. 432; 19. ; W. Harv. 90, 391 ; Sanctorius, 112). 
Fevers— 
fr 
any cause 
these ";hpv- 
low. severe 
cZ*aryfe 
160. He will not be mistaken much who should affirm that more 
diseases arise hence, viz., from the omission of 'purging after autumnal 
diseases, than from any other cause whatever (p. 21; Cf. Hipp. Aph. 
12, II. ; 43, 56, VI.; Works, 707, II.; 728, II. ; Aph. 32, IV). 
Diseases 
■ffm 
tunf 
161. All means to avoid disease or infection are nseless, if the body is 
furnished with humors disposed to receive the infection (p. 59 ; cf. 
Hippoc. W. 102, I). 
To escape 
disease, the 
blood must 
be pure. 
162. Cholera.—Should I restrain the first effort with narcotic medi- 
cines and other astringents, whilst I hindered natural evacuation, and de- 
tained the humors against nature, the sick would undoubtedly be 
destroyed by the intestine war, his enemy being kept in his bowels (p. 
115; cf. Hipp. Aph. 2, I. ; 21, I; Collins, 142). 
cholera— 
ingent8 
163. Sydenham on Hippocrates, Nature and. Disease.—The excellent 
Hippocrates who arrived at the top of physic, laid this solid foundation 
for building the art of physic upon, viz., nature cures disease, and he 
delivered plainly the phenomena of every disease, without pressing any 
hypothesis into his service. He also delivered some rules gathered from 
the observation of that method that nature uses in promoting and 
removing diseases, and of these things consisted the theory of the divine 
old man . . . This theory was nothing else but an exquisite description 
of nature; it was reasonable that in practice his only aim should be to 
relieve her, when she was oppressed, by the best means he could ; and 
therefore he allowed no other province for art than the succouring of 
nature when she was weak, the restraining her when she was outrageous, 
Hippocrates’ 
piyadescrip- 
ture. Art of 
™e,<^ine;j,°. 
ture ?.n,y by 
and simple. THE DOCTRINE OF PURGATION. 
and the reducing her to order, and to do all this in that way and manner, 
whereby nature endeavours to expel diseases; for the sagacious man per- 
ceived that nature judges diseases, and does in all, being helped by a few 
simple forms of remedies, and sometimes without any (preface; cf. pp. 
432, 2-3; W. Harvey 123). 
164. Scarlet Fever.—I reckon this disease is nothing else than a 
moderate effervescence of the blood, occasioned by the heat of the fore- 
going summer, or some other way, and therefore I do nothing to hinder 
the depuration of the blood and the ejecting of the peccant matter 
through the pores of the skin, which is easily done by the blood itself. 
FeverUt 
purgatives 
cure, other 
reme ies e- 
165. But when the scales are gone off and the symptoms ceased, I think 
it proper to purge the sick with some gentle medicine that is agreeable to 
Rge an(j strength ; and by this simple and plain natural method, this 
name of a disease, for it is scarce anything more, may be easily and 
safely removed. Whereas, on the contrary, if we disturb nature by 
cordials and other needless remedies too learnedly thrust in secundum 
artem, the disease is hightened and the sick dies by the over-officiousness 
of the physician (pp. 189-90). 
a naturai'Tt- 
tempt to cure 
ing morbid 
thebtood°m 
166. I think pleurisy is a fever originating in a proper and peculiar 
inflammation of the blood, an inflammation by the means of which 
nature deposits the peccant matter in the pleurae. Sometimes she lavs 
it on the lung itself, and then there comes a peripneumonia. This differs 
from the pleurisy only in degree. It exhibits the results of the same 
cause with greater intensity. (Society’s Ed., vol. I., p. 247.) 
Harvey Gideon, M. I). The Vanities of Philosophy and Physick. 
3d edit. London, 1702. 
167. 1st. Tilings in philosophy and medicine which we do not know, 
are beyond all manner of comparison more than those things we do 
kllOW. 
2d. The greatest part of these things in medicine, which we pretend 
to know, is conjectural and uncertain. 
3d, Many if not most of these things which we do peremptorily 
affirm to be this or that, to be caused by this or that, or to cause and 
effect this or that, are or may be proved to be false (pp. 7, 8; cf. 
Parey, 66 ; cf. W. Harvey, 124-126). 
uncertain- 
ty in medi- 
The hiood 
disease8 °f 
Theory of 
disease. 
168. The antecedent causes of most diseases are the fluid parts of the 
blood, the fluid animal lympha, the glandulous lympha, and the blood 
being vitiated (p. 139; cf. F. Harvey, p. 391). 
169. How True.—The -weakness of the stomach and its faintly per- 
forming its office, is only occasioned by the debility of the stcmaeh- 
nerves, and their various branches, by being plastered up by too much 
fleam, gross anal acid dregs, indigestible meals, or offensive drinks, or 
other matter admitted into the stomach, which, by lodging there too 
long, assume a corroding quality. . . . (cf. Sydenh., Prof.). THE DOCTRINE OF PURGATION. 
170. This supposed, I do believe, and have experimentally observed, 
tliat all those corroborations of the stomach, whose virtue is commonly 
asserted to consist in a gentle restrictive and warming quality—whereby 
these slimy humors are more firmly cemented—so far from contributing 
the least strength to the stomach, being long continued, do carry danger 
with them (p. 227). 
“ Strength- 
eners ” do 
not strength- 
en. 
171. The only means I have hitherto found to strengthen the stom- 
ach are proper abstersive medicines, gently wiping off those clammy sub- 
stances from the tunic of the stomach, and the terminations of the nervous 
branches. . . . Do only keep your stomach clean, you unit certainly pre- 
serve its strength, and prevent most diseases (p. 228; cf. Hipp. Aph. 8, 
sect. II. ; Parey, 87). 
Purgatives 
the only 
strength- 
ened. 
172. Herodotus (in Euterpe) who was contemporary with Hippoc- 
rates, tells us that the Egyptians, to whom the first invention of physic 
is ascribed, used to take purging-pliysic, for three days together every 
month, for no other purpose than to cleanse their stomachs, knowing they 
could be subject to no diseases but what the foulness of their stomachs 
might occasion, in regard their bodies were strong, and their air the most 
clear and temperate in the world, (p. 232). 
Regular 
purgation 
among the 
•ancient 
Egyptians. 
173. It is not to be understood, where a heap and weight of crudities 
is accumulated, that, gently absterging remedies can have power to disen- 
gage the stomach, any more than a wet mop can be supposed to rid a room 
ot a heap of rubbish,—in which case something more stimulating is re- 
quired, that may be used in all seasons ofthe year, be it sultry or freezing, 
without the inconvenience of confinement to diet or warmth of air, or 
without offence to the stomach, or putting the body into any disorder; 
to which purposes the pill I here now describe, I have experimentally 
found to be effectively answering in most respects, (p. 228). 
Full pur- 
gation. 
Brandreth’s Pills are superior to the following in all the elements of cleansing physic. 
174. Take one ounce of tlie clearest shining aloes; powder it in a 
mortar, covered over with a brown paper having a hole in the middle 
for a passage to the pestle. Observe to anoint thinly the bottom of the 
mortar and pestle with a little Florence oil, to keep it from sticking to 
the bottom. When it is reduced to a gross powder, by grinding it with 
the pestle you must bring it to a smooth fineness. Put the powder into 
a small glazed flat-bottomed earthen pan, that will contain about half a 
pint, pouring upon it about a quarter of a pint of water, wherein has been 
dissolved 2 drams of Spanish juice of Liquorish, which is done by slicing 
it very small and setting the water in a porringer over a gentle heat; 
place this same earthen pan into one somewhat bigger, having sand in the 
bottom to the height of an inch, and afterwards filling it up to the 
brim. Set them over two piles of bricks of three or four bricks laid flat. 
The piles must stand at such a distance, that they may reach the edges 
ofthe bigger pan to support it. Then make a moderate fire of charcoal un- 
der it, to heat the same, to cause the superfluous moisture to be evaporated, 
The Har- 
vey Pill. THE DOCTRINE OF PURGATION. 
until the aloes is brought to the thickness of honey. Or you may, by drop- 
ping two or three drops on the back-side of a plate, to cool, make a trial 
whether it be reduced to the consistence of dough; for if it be over- 
done, the mass being rendered brittle, will not only lose most of its 
virtue, but also its aptness of being framed into pills; and if it be not 
evaporated enough, it will be sticky, and not apt to be brought into a 
mass. The lesser pan being taken off, when the evaporation is sufficient, 
before it is quite cold, you must with a spatula or slice take out the mass, 
and between your fingers, being a little anointed with Florence oil to pre- 
vent the sticking, roll it into a round ball, which you may keep in a 
sheep’s-bladder, being likewise thoroughly wetted over on the inside with 
the same oil, for many months, if necessary. A small piece of this mass 
being formed into 6, 7, 8, or 9 little pills of the bigness of a pepper-corn, 
is a dose sufficient to give two or three motions. 
The safeness of this medicine adds much to its character, since the 
taking of one pill, or two, more or less, imparts as little hazard, as the 
taking it very often, or in any kind of season, be it hot or cold, &c. . . . 
By the addition of the use of Liquorish, the aloe is designed to be obtused 
in its too purgative qualities, whereby it is apt to raise the piles, and 
become somewhat less precipitating, Ac. 
The same correction may be obtained by taking a large handful of Bug- 
loss or Borrage-leaves, and stirring half a pint of warm water with them 
in the bruising, and clarified by subsidence in letting it stand in a cellar 
for a day or two, and pouring it off the feces or dregs in the bottom. 
This evaporated in the same manner, will produce a mass almost equal 
in goodness to the former, (pp. 223—5). 
The whole of what follows in Paragraph 1*75 is equally applicable to Erandreth’s Pills, 
whose virtues far exceed all other cleansing medicines the world has yet seen. 
175. I cannot but heretofore observe, that the use of these pills, though 
frequently taken, accordihg to the time the stomach, by reason of its 
degree of weakness in the digestive faculty, may require, does in anywise 
debilitate those that may properly use them; but on the contrary, rath- 
er corroborate their stomach by assisting it, to throw off that heap of rub- 
bish and crude humors, which those that eat and drink plentifully, and 
either live sedentary lives, as many that are educated to professions, or 
others that are not used to exercise or labor, are subject to engender, 
especially if naturally of a weak constitution or of an advanced age. 
(p. 235). (cf. Hipp. Aph. 8. Sect. I). . . For three or four days succeed- 
ing the use of these pills, a good Elixerproprietatis taken morning and 
evening, in a proportionate dose, has, by my observation, ever had the 
good effect of preserving health and preventing disease, (p. 235.) 
(cf. Sydenh. 153). 
Purgatives 
do not weak- 
en. 
176. As lesser purgatives do ratlier contribute strength by their con- 
sequence, so the greater, being properly used, do not carry that danger 
them people commonly imagine, since I have known many that, 
for three months successively, have taken strong churlish purging pills, ev- 
ery morning, some few days only omitted. I may say some have swallowed 
a bottle of strong purgative pills in a few years, and lived in full health 
PuraativM 
andn<3do Zot 
weaken. THE DOCTRINE OF PURGATION. 
to a remarkable old age, and not without a libertine mode of eating and 
drinking. Whence it is apparent, that the toughness of the nerves, upon 
which the strength and action of the bowels only depend, does suffer as 
little by the strongest purgatives, as an Indian cane by a thousand times 
bending, which notwithstanding will recover its former figure and full 
strength, (p. 236), (ef. p. 223). 
Our experience and the experience of all who have used Brandreth’s Pills confirm these 
remarks on bleeding. 
177. Et were to be wished that bleeding could be admitted with the same 
safety, of which it may be justly said, that the lancet has, and does in 
proportion kill more men, than the sword ; and it is as commonly observed, 
that those physicians who do so generally practice it, know little else 
what to do. (p. 236.) ... It is a consequence an idiot infers, because 
a person having been bled eight or ten times in a great distemper, does 
recover his health, he owes the benefit of it to the bleedings, whereas it 
ought rather to be said, neither the distemper nor the bleeding could 
kiil him. (p. 237). 
Bleeding. 
178. I stand amazed at the folly of mankind that is so easily allured, 
by vain boasting and mendacious encomiums upon Laudanum liquidum, 
plainly prepared or disguised; to the frequent and constant use whereof 
a man being once debauched, under the pretence of ease, and quieting 
himself of a few gripes, fumes or vapors, lie can no more leave it off for 
a fortnight, a week, or a day, than a laborer his bread and cheese, or a 
man throw off his coat and waistcoat in a hard winter, or a brandy- 
drinker forsake his spirits and return to small-beer. Using onesself to 
such plain or disguised opiates, after some months or a few years, is like 
making a contract with the devil to live easy and well for a few years, 
upon condition he shall have his soul to torment afterwards. For certain 
it is, that the familiar use of opiates, after some months or-very few 
years, does wholly desist from being friendly, by suffering your trouble 
or distemper to return in a more horrible manner, or create a new one 
incomparably worse than the former, or strangles you with an apoplexy, 
or some other soporous distemper, which is most amply proved by those 
that make opium their sacred refuge in every fit of the gout, colic or 
stone, who seldom or never fail of a speedy exit, by some incurable dis- 
ease of the brain in very few years. And those that do advise such a 
lethiferous remedy for a common use to their patients, have a greater 
title to a halter labelled ivith an inscription of “ Mathews’ Pills,” or 
“ Pacific Drops,” than those that murder a man on the highway, (pp. 
237-38.) ... In short all strong narcotic medicines occasion weakness 
of the stomach-nerves, numbness, palsies, lethargies, loss of memory and 
dullness of understanding, diminish and deprave all the offices, actions 
or operations of the bowels, suppress the appetite, occasion a wildish 
countenence and paleness, and at last, upon long usage, usher in death 
(pp. 238-39.) (cf. Collins, 133). 
ON LAUDANUM. 
Laudanum 
~its evils- TIIE DOCTRINE OF PURGATION. 
Purgation 
preserves 
and pre- 
vents. 
1T9. To preserve health and prevent disease in valetudinary consti- 
tutions—for strong, vigorous bodies stand in no need of other preserva- 
tions or preventives, than moderation in their nonnaturals, the know- 
ledge and sense whereof nature has implanted in all other animals, as 
well as in man-—no better Avays and means can be used, than applying 
at certain intervals to those cleansers and abstersers before mentioned, 
(p. 239). 
180. For those subject to Ilemorrhoides, the following Liniment 
Electuary is recommended. Four ounces best Cassia Fistularis, newly 
drawn and evaporated to a consistency—the manner of doing it you may 
read in a treatise called the “ Family Physician and House Apothecary ” 
—Rhubarb, powdered, while Mechoacan, grated and powdered, and 
clean Rhenish (not cream of) Tartar powdered, of each a quarter of an 
ounce, Sweet Fennelseeds, powdered, a dram and a half, Syrup of Mash- 
Mallows, as much as will suffice to make them into an electuary, (pp. 
239-40). Take half an ounce or an ounce, dissolved in a quarter of a 
pint of thin gruel, barley-water, posset, or thin chicken-broth, according 
to directions given concerning the aloeties. (p. 240). 
Ilemorr- 
hoides. 
Harvey's 
Liniment. 
181. In Headaches f rom over-eating or drinking, in Apoplexies, 
Palsies, Fevers, <&c., when purging medicines are too tedious in their 
transportation through so long a space, as the roundabout of the guts, a 
vomit that will throw up immediately through the gullet, by a short 
passage, the whole burden at once and operate kindly, without disturb- 
ing any of the other bowels, or raise a mud in the humors—antimonial 
vomits are excluded, as being too long before they operate, too churlish in 
disturbing all the bowels, and exciting a violent commotion in the 
humors. Ipecacuanha, that new fangle, brought by the French from the 
West Indies, is the root dried of a mere common juncas whereof, in the 
places where it grows, you may buy a cartload for a two-penny looking- 
glass, or a penny-worth of bugles, though at Paris they have the confi- 
dence of selling it at thirty or forty livres a pound,—which, notwith- 
standing, our asarum-root does far exceed in the operation—than which 
there can not be a more unacceptable drug to the taste in the world, 
&c. . . Take the purest White "Vitriol, one and a half ounce, being pow- 
dered and ground very fine, put it into a glass bottle-bolt-head, pour 
upon one and a half pint of springwater, and half a pint of clean English 
Spirits, once rectified, which they call Double Spirits. Close your bolt- 
head with a cork and a wet bladder over it, tied with packthread. 
Place the bolt-head standing upright in a sandbath and let it digest, with 
a moderate warmth, twenty-four hours. But remember to shake the 
bolt-head very well, before you place it in the sand. After this digestion 
decant the liquor gently into a glass funnel, wherein is placed a coffin of 
cap-paper folded according to art, and so let it filtrate into a glass bottle. 
When it is almost quite passed through to the quantity of a spoonful, 
take out the funnel and throw away what is left. If you filtrate it a 
second time over, it will be the clearer and more depurated. This is a 
very easy, gentle and safe vomit, operates nimbly, and for cheapness ex- 
ceeds all others. It may be kept always ready upon every occasion, 
without making any bustle, and so lasting, that its virtue continues for 
Harvey's 
Emetic. THE DOCTRINE OF PURGATION. 
many years ; and for the most part it will move a stool or two, whereby 
it carries off those crudities that are remaining in the stomach, or that 
are escaped into the guts. When you find occasion for using the vomit, 
you must pour out three, four or five spoonfuls, according to your easi- 
ness or difficulty to vomit; but commonly three spoonfuls is enough. 
This must be mixed with double the proportion of warm small-beer or 
warm water, wherein a little Carduus has been boiled, or thin gruel; 
then drink it off. If this do not operate in a quarter of an hour, take a 
spoonful or two more, or you may load yourself with carduus boiled in 
water until you vomit. This may be taken safely in the beginning of 
most distempers without any further consultation, (pp. 244-45). 
Gideon makes a grave mistake in respect to Ipecacuanha. It is one of the best and most 
safe roots ever applied to the use of man, as a vomit or purgative. It is one of the ingredi- 
ents of Brandreth’s Bills. When a vomit is needed take four Pills, and drink hot boneset 
tea, and your stomach will surely discharge its contents. 
182. About throwing off the febrile mutters by sweat. 
. . . Whether diaphoretics ought to be used before the declination 
of a fever, at which time only they appear to be healthful in assisting 
nature to throw off, for it must be owned by all experienced practition- 
ers that the causa febrilis, be it vicious humors, heterogenous particles, 
or what other offensive they are pleased to allow, must be first sub- 
dued, or digested and separated, before it can be expelled by sweat; and 
therefore, should you exhibit the largest doses of diaphoretics that nature 
can possibly bear, and second them by loading the patient with a num- 
ber of bedclothes, he will scarcely be brought to sweating; and if, per- 
adventure, he should happen to be forced into a sweat at the augment or 
state of the fever, it must be a very great detriment. . . Supposing, 
fictitiously, that diaphoretics were proper, the uncertainty of their oper- 
ation would often occasion a failure of the effect that is expected from 
them. Purgatives and vomitories seldom or never fail in their operation, 
if justly dosed, but sudorifics and diuretics very often, though adminis- 
tered in great quantities (p. 286 : cf. Sydenli., pp. 432-434). 
s :)eats__ 
their use and 
The advantage of Brandreth’s Pills is that they require no care, and whether taken in 
large or small doses are sure to be of service. In full doses the beneficial effects in all se- 
vere diseases are at once evident. And when the system requires a vomit they usually act 
on the upper passages of the stomach. But the additional use of hot boneset tea, after a 
dose of four or six pills, is sure to act as an emetic and without any danger. Some gruel 
should be ready for the patient to take after the vomiting is over; this is needed, when sleep 
will follow. 
Harvey, James, M. D. Prmagium Medieum. London, 1120. 
183. In delirious distempers great hopes of recovery are had from 
all sorts of evacuations, chiefly because they check the velocity of the 
blood, diminishing its quantity, take off' its obstruction, and relax the 
nerves (p. 10). 
ffuHurrff 
184. Pains, especially if they be fixed a long time in any of the THE DOCTRINE OF PURGATION. 
impurUies.nd 
noble viscera, impair the strength of the patient, and obstruct the circu- 
lation of the blood, concoction, and secretion of the humors. . . But in 
acute disease it is accounted a sign of recovery when pains invade the 
legs and feet, and happen upon a crisis or signs of it. 
The Crisis. 
185. But though such pains speak an impetus of the blood and force 
0f natUre to throw off the matter of the disease upon those more igno- 
ble parts, yet, when they go off without any apparent cause, as the ad- 
ministration of medicine, or natural evacuations, the humors may be 
justly suspected to have returned into the mass of bloodf by which the 
case is rendered more dangerous than it was, and a happy event of a 
crisis in acute distempers, depending upon mere chance, or a favorable 
turn of nature, is always uncertain and never to be relied on (p. 30 ; cf. 
Sydenli. 132: M. Ilarv. 391; G. Harv. 139; Collins, 1301. 
How na- 
ture removes 
impurities, 
or otherwise 
disposes of 
them. 
186. In the ordinary and natural motion of fluids that serve either 
for nutrition or excretion there are necessary passages or channels 
through which they run easily, but in extraordinary cases, as all diseases 
are, nature finds out extraordinary ways by which it throws out the 
noxious matter, or at least puts it in a less dangerous place (p. 13 ; cf. 
Hippoc., Edinb. ed. Epidem., lib. ii., sect. 5; Parey, 69). 
187. The. animal life depends upon many and different causes, and 
an integrity of all the parts of the body, especially those that are prin- 
cipal, as the head, heart, arteries, and veins, and the liquors that run in 
them, namely, the blood, chyle, cfec. But because our bodies cannot 
always continue in the same state, its parts, both solid and fluid, being 
worn, consumed, and dissipated by continued motion, there must be a 
continual supply of food for its reparation, as well as proper instruments 
and vessels, in which it may be prepared and made fit for that purpose. 
Life, Health 
and 
Disease. 
188. Nature, therefore, has contrived the stomach, intestines, and 
glands, in which, by a wonderful mechanism, our food is pounded and 
concocted, and its grosser parts separated from those that are more tine 
and subtle, the one for the preservation of life, and the other as the 
useless, to be thrown out by emunctories ordained for that end. But 
when those instruments are defective—which often happens—and the 
muscular force of the stomach is insufficient to grind the food and make 
a chyle of fine parts, that which we receive for nourishment and repara- 
tion of our bodies not being duly prepared, is so far from being usef ul 
that it is rather hurtful to us. For this unconcocted food or crudity 
entering into the mass of blood, renders it viscious, tough, and of a clary 
substance, unfit for motion and circulation, and the cause of most dis- 
eases (cf. Collins, 137; Sanctorius, 109, 101*). . . 
The Stom- 
ach, 
189. Whatever, therefore, is useless to the body, or inconsistent with 
the blood, must be separated from it, that it may he preserved in a per- 
* At these times an extra dose of Brandreth’s Pills should be administered. THE DOCTRINE OF PURGATION. 
feet state. Hence the endeavors of nature, and the contrivance of the 
intestines, cuticular glands, and other emunctories appropriated indeed 
to their peculiar excrements, but sometimes common to all or most of them 
(p. 92; G. Harvey, 163). 
The Intes- 
tines, and 
their \)lca- 
rious office. 
190. Evacuations by sweat are to be attempted with the greatest 
caution, not indiscriminately by all persons nor at all times. For if 
medicines to procure it be given when the blood is of a texture not open 
enough—which it cannot be near the beginning of most feverish dis- 
turbances—or when too heterogeneous substances abound in it, feyrced 
sweats oftener dispose the blood to stagnate in the tender vessels of the 
brain and nerves than to separate its noxious particles at the designed 
secretory parts (p. 129 ; cf. Sydenli., pp. 432-434; Gid. Harv., p. 286) 
Forced 
f^f“^ger 
191. Nature—by which I mean the effects of matter and motion, 
according to the laws and constitution of animal economy—is indeed 
the great physician and cure of disease; so that now-a-days several dis- 
turbances are happily taken off by the slightest remedies, or by a mere 
abstinence from them. But, in acute diseases, the die is cast for life or 
death, and in this case nature is not to be altogether relied on ; neither 
must we, as the advocates for the doctrine of crisis, patiently wait for 
the issue of the conflict between nature and the disease, the peccant 
humors of some fevers being sometimes so stubborn, that art must in- 
terpose to promote their evacuation some other way. (pp. 207-8.) (Cf. p. 
92 Sydenham, 163, 166.) 
Assist na_ 
ZaUontvac 
Willan, J., M. I)., An Essay on the King's Evil. 1735. 
192. The diminution of the morbific matter, both in the primae vice 
and whole body, is to be effected by cleansing that canal, and evacuating 
the morbific matter out of it; and by this means we cannot fail of 
lessening its quantity in every other part of the body. (p. 21.) (Cf. J. 
Hamilton, 218.) 
Diminish 
the morbid 
matter, and 
you lessen 
the cause of 
disease. 
Purging with Brandreth’s Pills infallibly lessens the quantity of impurities; and as they 
are harmless to the most tender age, or the weakest or most feeble, they can be used every 
or every other day, reducing the sum of unhealthy matters contained in the body, and thus 
taking an extinguisher or weight from the blood, whose vitality becomes thereby increased, 
and all the parts of the body be duly nourished into a renewed life and vigor. 
Pringle, Sir John, M. D., on the Diseases of the Armies. London, 
1753. 3d Ed., 1761. 
193. Early Sweats.—It has been usual to give the theriaca, or some 
other hot medicine for this purpose ; but all such increase the fever, if 
they fail in bringing out the sweat (p. 131). 
Mout 
sweats. 
194. The bilious or remitting fever of the camp begins with chilli- 
ness, lassitude, pains of the head and bones, and a disorder at the stom- 
ach. At night the fever runs high, the heat and thirst are great, the 
Bilious 
and remit- 
tent 
symptoms, THE DOCTRINE OF PURGATION. 
tongue is parched, the head aches violently, the patient gets no better 
and" often becomes delirious, but generally in the morning a perfect 
sweat brings on a remission of all the symptoms; in the evening the 
paroxysm returns. These periods go on daily, till the fever changes 
insensibly either into a continued, or into an intermitting form. Some- 
times loose stools carry of the fit and supply the sweats. Although the 
fever most frequently appears in the form of a quotidian, yet sometimes 
it is to be seen in a tertian shape I remember of no natural evacua- 
lions making a complete cure, unless when a violent discharge super- 
vened of the corrupted bile, or other humors which seemed to be the cause 
of the disease (pp. 165-67). (Cf. J. Harvey, 190.) 
Nature’s 
efTcompuctere 
when evacu- 
jfower/ui!'6 
Sweat. 
195. When the sweat is abundant, the putrid parts of the blood are, 
either wholly or in some degree, expelled, after which the fever is either 
entirely cured, abated, or brought to intermit, (p. 183,) (cf. 194.) 
196. On bilious fevers in Britain.—Instead of evacuating or correct- 
jno- what is amiss, we often nenlect it, till it ends in obstructions of the 
viscera, feo that hence may proceed nervous com,plaints without lever, 
or fevers of a nervous hind, instead of fluxes, intermitting or remitting 
fevers, the common consequences of a more sudden and thorough cor- 
ruption of the humors, (p. 200.) (Cf. Collins, 132, 135.) 
Evacua- 
u°m pre- 
forms of 
why the 
the Attestis 
season to 
197. We may observe that the fibres are more relaxed in the spring 
than in the winter; hence that the body becoming more plethoric, the 
humors will then be apter to corrupt, upon any suppression of perspira- 
tion. And this may perhaps be forwarded by the eflbtma arising from 
all putrid substances which, being locked up during the cold of winter, 
are then set at liberty by the greater heat of the sun. (p. 201.) 
Excellent ot>l 
servations 
m une of 
imrgatives. 
«r!dPaftfi- 
motfdanger- 
ous pallia- 
198. Dysentery.—We must at all times attend less to the dose than to 
effects, which are never to be judged of by the frequency but by the 
larqeness of the stools, and the relief the patient finds from the (trims 
and tenesmus ajter the operation. The motions are generally more fre- 
qnent from the disease alone than from the purgation. As on the one 
hand, the physician must avoid all the rough and stimulating purges, so 
on the other hand, he is not to spare those of a lenient kind. (p. 240.) 
The necessity of continuing the physic is to be determined more by the 
obstinacy of the gripes and tenesmus, than by blood in the stools, 
Without such frequent evacuations, it is in vain to attempt a cure ; as all 
opiates and astringents by themselves only palliate and render the disease 
fatal in the end. (p. 241.) (Cf. Sydenham, 162 ; Hippocr. 8. Gf. 
Harvey, 175, 176.) 
0 .afes 
“jtffthf 
the dise’asf 
199. As to opiates, it were better they were never used at all, than 
given before the first passages were thoroughly cleansed ; for though they 
afford some ease, yet by penning up the wind and corrupted h umors, 
they fix the cause. This I presume to affirm from repeated experience. 
1 am well assured, that the fluxes I have seen in the army, are never to 
be cured without evacuations, (p. 241-42.) (Cf. .T. Harvey, 191.) THE DOCTRINE OF PURGATION. 
200. In some cases the patient would seem likely to recover, but 
would relapse upon voiding hard scybala which, coming away in small 
parcels for several days together, made a constant irritation. These, 
therefore, were to be speedily removed by a full dose of rhubarb with 
manna, or by some other lenient physic, (pp. 245-46.) (Cf. Collins, 
134, 139, 151.) 
Hardened 
faces the 
cause of dis- 
ease, to be 
removed be- 
fore conva- 
lescence en- 
sues. 
201. Palsy.—Of purgatives the most active should be selected, and 
such as influence most energetically the principal secreting viscera ; as 
calomel, colocyntli, jalap, scammony, &c. In paraplegia, and even in 
hemiplegia, the bowels are very torpid, and require repeated and full 
doses of those, and even of still more energetic cathartics, as croton-oil, 
or elaterium, in some obstinate cases. In many cases recourse should 
also be had to purgative enemata. It is not merely necessary regularly 
to evacuate fecal matters by means of these, but to employ them so, as to 
derive from the cerebro-spinal axis any increased flow of blood to it, 
which may have occasioned, or prolonged the attack. Indeed, with 
these conjoined objects, they are advised by Halle, DaTberg, Brodie, and 
others, who have insisted on their use. (p. 242.) (Cf. J. Harvey, 183 ; 
J. Harvey, 171, 175, 179.) 
Palsy— 
ACTIVE PUR- 
GATIONS. 
Paraplegia 
—Hemiple- 
gia. 
I have advertised the above sentiments for forty years, at an outlay of more than a mil- 
lion of dollars, and long before I saw the above able remarks. 
I now insert the following testimony, which applies well to Sir John’s remarks. 
The following was published in 1863. It tells its own story: 
SANITARY COMMISSION. 
“ What is it doing to economize the Life and Health of our Soldiers ?” 
“ Is it using all the means Providence has placed within its reach, or is it stiff-necked, 
and determined that so great a remedy as BRANDRETIFS PILLS shall not be used to econ- 
omize the life and health of our Soldiers ?” 
Sagacious men believe that the administration of BRANDRETIFS PILLS, in its 
“ Homes” and as “ Special Relief ” would more than quadruple the present value to the 
“ Life and Health of our Soldiers.” 
Let the following testimony from sixty returned volunteers be studied by members of the 
United States Sanitary Commission. If the statements be true, can they be doing their 
duty as Christian Men in not using the means Providence has placed within their reach ? 
FRIENDS OF SOLDIERS—READ ! 
Rrandreth’s Pills protect from the arrows of disease, usually as fatal to soldiers as the bul- 
lets of the foe. 
Sing Sing, October 26, 1863. 
We, the undersigned, surviving members of Company F, Seventeenth N. Y. Volunteers, 
hereby certify that we have used Brandreth’s Pills during our two years’ service, and to 
them we attribute the fact that our constitutions are uninjured by the necessary hardships 
and privations of a soldier’s life in the field. In costiveness, colds, chills, diarrhoea, dysen- 
tery, and typhoid fever, their prompt use cured us in a few days. Our health was often 
restored without having been entered on the sick list; in fact, a single dose of four or five 
pills usually cured what, under the regular treatment, would have been a serious sickness. 
Others, who appeared to be sick in no way different to us, hut who used the remedies pre- 
scribed by the regimental surgeon, either died or were sick for weeks in the hospital. 
When we left Sing Sing, in June, 1861, you gave us a supply of these Pills, and we feel 
sure, from our experience, that if every soldier was supplied with this medicine, the gen- 
eral health of the army would be greatly improved. For ourselves, it is our sole remedy, 
answering all our wants in the way of physic, and we have known and tested it from our 
childhood, and our parents before us. THE DOCTRINE OF PURGATION. 
John Yickars, Captain; J. J. Smith, 1st Lieutenant; William See, Is? Sergeant; G. H. 
Dearing, 2c? Sergeant; Dennis Shay, 3c? Sergeant; Patrick Cullen, 4th Sergeant; Benj. F. 
Brown, Is? Corporal; Wm. Mathers, 2c? Corporal; Noah W. Miller, 3c? Corporal; Theodore 
Crofut, Drummer ; Geo. B. Coe, Drummer. 
Francis J. Jenning, William W. Campbell, William J. Charlton, Albert Wesley, John W. 
Griffin, William Holmes, William W. Rider, Martin See, George Ackerly, Hiram Seagle, 
Alfred Wilkins, William Griffin, George Ayles, William J. P. Hewett, John L. Branden- 
burgh, Thomas A. Barlow, Henry Hannah, William Waldron, John Conover, Jacob Baker, 
Lewis B. Coy, Albert Lane, Ellis Jones, Wm. Yan Wert, James B. Crofut, Roscoe K. Wat- 
son, Frederick Hunt, William Tuttle, Jotham Carpenter, Charles Wright, Sanford Olmstead, 
Fuller Carpenter, James Bentley, Robert W. Westcott, Jacob II. Dyckman, John M. Bodine, 
James N. Hines, Edward Waldron, Warren Wright, David Baker. 
T. B. Lane, Is? Lieut, 38th N. Y. Vols.; M. C. Larle, Is? Sergt. Co. D, 17th N. Y. Yols.; 
Wm. Knight, Co. I, 6th N. Y. Artillery ; Millard F. Lanning, Musician, 1st N. Y. Vols.; 
Wm. Kenney, Co. R. Berdan’s Sharpshooters; Cassius Bishop, Co. E, 38th N. Y. Vols.; 
Elliot See, Co. B, 38tli N. Y. Yols.; Daniel Gillis, Sergt. Co. B, 3d N. Y. Vols.; Caleb S. 
Frisbie, Co. B, 6th N. Y. Yols. 
State of New York, Westchester Co., ss.: 
I, William M. Skinner, a Notary Public, duly commissioned and sworn, residing in the 
village of Sing Sing, County and State aforesaid, do hereby certify that the names of the 
sixty persons subscribed to the Certificate hereto annexed, dated October 26, 1863, concern- 
the value and efficacy of Brandreth’s Pills, beginning with Capt. John Yickars and ending 
' with Caleb S. Frisbie, were signed in my presence, and that I, at their request, witnessed 
their signatures to said Certificate. 
I further certify that I am well acquainted with all who signed said Certificate, and 
know them, individually, to be meii of truth and veracity. 
In witness whereof, I have hereunto subscribed my name and affixed my official seal, 
this eleventh day of January, one thousand eight hundred and sixty-four. 
WM. M. SKINNER, Notary Public. 
State of New York, County of Westchester, ss. : 
I, Hiram P. Rowell, Clerk of the County aforesaid, and also Clerk of the Courts in and 
for said County, do hereby certify that Wm. M. Skinner, Esq., whose name is subscribed to 
the Certificate of the Proof or acknowledgment of the annexed Instrument, and indorsed 
thereon, was, on the day of the date of the said Certificate, a Notary Public, in and for 
said County, residing in the said County, appointed and sworn, and duly authorized to take 
the same according to the laws of the said State. And further, that I am well acquainted 
with the handwriting of the said Notary Public, and verily believe that the signature to the 
said Certificate is genuine. 
In testimony whereof, I have hereunto set my hand, and affixed the seal of the said 
Courts and County, the 12th day of January, 1864. 
HIRAM P. ROWELL, Clerk. 
Cullen, William, M. D., First principles of medicine, London, 
1777. 
Fevers. 
often di-n- 
gerous. 
202. Fevers.—Sweating employed to prevent intermittent fevers, lias 
often changed them into continued fever, which is always dangerous. 
104.) 
Urging the sweat, may produce hurtful determination to some of the 
internal parts, and may he attended with very great danger, (p. 166. f.) 
Robertson, Robert, M. D., An essay on fevers, dec* &c. Robinson, 
1790. 
203. Idiopathic fever.—Whenever men complain of being seized 
with chilliness, or alternate chills and heats, headaches, sickness at stom- THE DOCTRINE OE PURGATION. 
ach, universal pains, or as the sick express themselves “ pains all over 
them ; or pains in all their bones, or joints, especially in their loins and 
back, with less or more debilityand if their countenance is at the same 
time obviously diseased, whatever the other symptoms accompanying 
these are, I can, from experience, assure the reader, that a most virulent 
infection is present (p. 59). 
Fever. 
Its general 
character. 
204. Whatever has a tendency to debilitate the system, may either 
be a remote or a proximate cause offerer, according to the constitution of 
the patients. A sufficient reason may be assigned for many people being 
seized with fever at the same time; which is, their being exposed to the 
same debilitating powers of heat, cold, draught, or wet, or sudden 
changes of these (p. 88V 
Cause of 
fever is all 
that debili- 
tates the sys- 
tem. 
Miller, Edward, M. D., Inquiry concerning cutaneous perspiration 
and the operation and uses of sudorific remedies. New York, 1798. 
Medical Repository, 1798, Yol. II.q See Med. dc Phys. Journ. 1799, 
Yol. I 
205. That sudorifics can not be usefully employed as a general remedy 
in fevers, is apparent from the fatal course pursued by many of these 
diseases, notwithstanding the most copious, universal, and continued 
sweats, spontaneously taking place. The memorable sweating sickness, 
which first appeared in England, towards the close of the fifteenth cen- 
tury, and was one of the most fatal epidemics on medical record, affords 
ample proof of this position (Journ. p. 288). 
Fevers are 
not cured by 
sweats. 
206. On the whole it may be concluded, that much of the use of 
sudorifics has arisen from mistaken doctrines, concerning the nature of 
perspiration and of fever, particularly from the erroneous opinions, that 
the matter of perspiration is excrementitious; that its occasional obstruc- 
tion is noxious ; that it ought as much as possible to be eliminated from 
the system ; and that it is only carried oft', in considerable quantity, when 
discoverable by sight or touch (ibid). 
Errors 
about sweat- 
ing. 
207. It may be also concluded, that sudorific remedies, especially 
those of the more powerful kind, are, in general, highly unsafe, and cal- 
culated to augment the violence of inflammatory and malignant fevers / 
and, that though they may succeed in some cases of less violence, or by 
a favorable concurrence of circumstances, yet they are so constantly 
liable to produce mischief, and exasperate the disease, that the abuse, on 
the whole, must be pronounced greatly to overbalance the use (ibid). 
Sudorifics 
unsafe and 
injurious. 
Selle, II., M. D., Professor in the University of Berlin • new con- 
tributions to physical and medical knowledge, Berlin, 1798. See Med. 
& Phys. Journ. 1799, Yol. I. 
208. Puerperal fever.—This disease originates in an accumulation of 
corrupted humors in the abdomen, which humors have either been al- 
ready separated in the form of milk, or intended by nature to be so. 
Puerperal 
fever, from 
accumula- 
tion of mor- 
bid matter 
in the abdo- 
men. THE DOCTRINE OE PURGATION. 
The causes of this accumulation may be various, but are principally an 
epidemic miasma, passions, sudden cold, and inflammation (Part III. 
p. 92). 
In corroboration of Professor Selle’s theory, Dr. ITermbsteadt has 
proved by chemical experiments, that the fluid matter found in the cavi- 
ties of the abdomen was virtually milk. It deserves, however, to be 
remarked, that the fat of the omentum and the mesentery, being dissol- 
ved by the febrile heat, may combine with the extravasated lymph, so as 
to produce a fluid of a more or less viscid consistence, and resembling 
milk in its external characters (Journ. p. 387). 
Bache, William, M. I).. On a successf ul case of Birming- 
ham, 1799. See Med. & Piiys. Joubn. 1799, Vol. II. 
Asthma. 
the cause, 
209. I became convinced that an acid pervaded the whole of the 
circulating system, and I presumed that it existed in a morbid degree, 
either as to quantity or strength, and was the exciting cause of the 
spasmodic affections observable in the lungs, and other membranous parts, 
to which it might occasionally be applied, probably sometimes in a gase- 
ous state, and at others in a more dense and concentrated one, and per- 
haps variously combined. The indications of cure suggested to my 
mind were to restrain its influence, and my attention was principally 
directed to the state of the stomach, the bowels, the expectorations, the kid- 
neys and the skin (p. 141). 
Coxaadi, D. G. C., M. D., Resident Physician at Northern, Ger- 
many. Practical remarks on the most prevailing species of cramp in the 
stomach. See Med. & Phys. Jouen. 1799, Vol. 1. 
210. The affection is not violent in the beginning, but a pressure, and 
sti'icturc, and griping, rather than an acute pain, is felt in the region of 
the stomach. The patient has an oppressive sensation, as if something, 
n°t unhke a nail, were fixed behind the stomach : if the attack increases 
in violence, he complains of stitches in the breast and towards the back, 
and endeavors to procure relief by shifting his posture. The principal 
paroxysms are observed to take place generally in the afternoon, in con- 
sequence of bodily exercise immediately after dinner, the use of acid food 
and drink—and particularly after giving way to gusts of passion, such 
as terror, anger, grief, and anxiety. 
This affection is often contracted by persons subject to passionate emo- 
tions, on their neglecting to take an emetic occasionally • it is not, in 
general, attended with acidity, but rather and most frequently is pro- 
duced by a bilious acrimony; and it at length almost invariably degene- 
rates into a nervous habit (Jour. p. 49). 
Cramp in 
neglectuo 
the cure hull- 
causeby the THE DOCTRINE OP PURGATION. 
Denman, Thomas, M. I)., On a case of dropsy in the ovarium. See 
Med. & Phys. Joukn. 1199, Vol. II. 
211. After giving the history of h female patient, who had suffered 
from violent pains in her bowels, tension of the abdomen, and much 
soreness on pressure, accompanied with vomiting, constipation, and fre- 
quent fainting, symptoms which were chiefly relieved by clysters and 
gentle purgatives, hemorrhages from the uterus, violent pain in the low- 
est part of the back, and, on pressure upon the sacrum or hip, in the 
neighboring parts, Dr. Denman says : There was great tension and pain 
above the “ ossa pubis,” and the whole hypogastric region was full and 
hard. She discovered a large hard tumor, extending to the right side of 
the navel, the increase of which was so rapid that in the course of a few 
days it occupied the whole abdomen. She was then freed from pain in 
all the parts contained in the pelvis, could lie on either side, and walk 
much better. She frequently after this had slight shivering flts, and a 
sense of coldness down her back, followed by restlessness and feverish 
heat, especially in her hands and feet in the evening, which went off 
with a free perspiration toward morning. Iler pulse was at all times 
very quick. Though one or more stools had been regularly procured 
every day, an immense quantity of hardened faeces, of a large volume, 
were now discharged for three or four successive days, by which her size 
was much lessened. She had been treated for sciatica. When I first 
visited her, the whole abdomen was distended by a circumscribed tumor 
springing from the right side, near the groin, thence extending across, 
and high up in the abdomen, and I thought I could feel an obscure flue- 
tuation in it. I could also feel an angle of the tumor in the posterior 
part of the pelvis, by which the “ os uteri ” was projected so high and 
so far forwards as to be almost beyond my reach, as is the case in the 
retroversion of the uterus. She was not pregnant. I did not therefore 
hesitate in the opinion that it was a dropsy of the ovarium ; and by sup- 
posing this, early in the disease, to have dropped low down in the pelvis, 
and afterwards to have risen according to its increase, all the symptoms 
which had occurred could be satisfactorily explained. I directed only a 
strong purging draught. On the following day, she informed me that 
after suffering considerable pain in the bowels, she had four or five 
copious motions, and that after every motion she was sensible of her 
size decreasing. The motions were unusually offensive, and, before they 
came away, the desire to expel them was unnaturally urgent and pain- 
ful. On examining them, I found that they almost wholly consisted of 
a gelatinous fluid, with many streaks of blood, and with little or no mix- 
ture of faeces. Instead of feeling weakened by the evacuation, the 
patient felt herself very much relieved. The medicine was continued for 
two days more, producing the same number of motions; the swelling of 
the abdomen had gone, the os uteri had descended into its proper posi- 
tion, and no tumor whatever remained in the cavity of the pelvis. I 
concluded that, in consequence of }>receding inflammation, an adhesion 
had taken place between the cyst of the tumor and some part of the in- 
testine, probably the rectum, the adhering portion of the bowels had 
given way, and, by that opening, the contents of the tumor had been 
evacuated. She was perfectly restored to health (pp. 20, 22). 
Dropsy of 
(« ««“ 
i)atwn- 
Regular 
evacuation 
mulation- 
Powerful 
and contin- 
ued pxirqa- 
tion the cure. 
Let the reader examine the Van Wart case at the end of these quotations. THE DOCTRINE OF PURGATION. 
Henderson, Stewart, Surg. Practical remarks on the diseases 
which occurred on board of II. M. Ship Astrea, on the Jamaica station, 
&c. See Med. & Phys. Journ. 1199, Vol. I. 
Remittent 
fever from 
marsh efflu- 
via. 
“There is 
BUT ONE FE- 
VER,” but un- 
der different 
modifica- 
tions. 
212. Remittent or Marsh-fever.—This fever, the legitimate offspring 
of all hot climates, especially where marshes abound, is the autumnal 
disease of most parts of Europe, only appearing in a milder degree. It 
has been described under various names—bilious, yellow, Jamaica, xSene- 
gal, and in Bengal, pucka—but multiplying distinctions which do not 
exist only serves to perplex and mislead, for it will be found to be the 
same individual disease, under different modifications, depending on 
constitution, season of the year, and local situation. The cause of this 
fever, in all its varieties, is marsh effluvia. We find that in some places 
at the Cape of Good Hope, where no such cause exists, this fever is un- 
known. We likewise find that strangers are more liable to be affected 
by this noxious effluvia, and have the disease in a more formidable de- 
gree, than the natives of the country, whose constitutions acquire a cer- 
tain power of resisting it from habitual exposure : at the same time, its 
effects on them are obvious, by shortening the duration of life. I do 
not think that the original disease produced by this miasma is infectious, 
but that it may alter its type and become highly contagious from con- 
current causes; as from too many diseased bodies being crowded to- 
gether, without paying sufficient attention to ventilation and cleanliness, 
(p. 141.) This noxious exhalation enters the system either by the lungs, 
the skin, or stomach ; but the manner in which it produces those symp- 
toms of disease which characterize the fever does not appear to be well 
understood. We can only perceive its general effects on the system; 
and that it may lurk for a certain time in the habit before morbid move- 
ments take place (ibid). 
Miasmata 
increase the 
bilious secre- 
tion ; pur- 
gatives car- 
ry it away. 
213. In men not below nor above the common standard of health, 
although there were marks of irritation and inflammatory diathesis, it 
seemed not sufficient to justify blood-letting; which I considered would 
have diminished the vital power. Antimonial emetics were not used, 
having always observed that they increased the irritability of the stom- 
ach, which is the most troublesome symptom attending this form of the 
fever. I, therefore, thought it more advisable to employ -mercurial pur- 
gatives, which had a very good effect in carrying off the bilious sordes 
collected in the first passages / emetics were sometimes given ; James’ 
powder with camphor, to promote perspiration, and effect a complete re- 
mission (p. 143). 
Dysentery 
—from cold 
and wet ob- 
structing the 
perspiration 
and increas- 
ing the flow 
of fluids to 
the intes- 
tines. 
214. Dysentery. This disease is not limited or peculiar to any cli- 
mate, nor is there any natural cause known to produce it: if it were oc- 
casioned by any particular quality in the air, the natives, as well as sea- 
men and soldiers, would be attacked with it, but we find this is not the 
case. For, when the dysentery was raging among the British troops at 
the Cape of Good Hope, not one of the inhabitants were seized with it, 
nor is it a disease known among them. Whenever it becomes epidemic 
among the inhabitants of any country, it may always be traced to infec- 
tion introduced; it being the constant attendant on camps, and the 
scourge of an army more destructive than any other enemy. I, there- 
fore, consider it an artificial disease. Cold and dampness, when the 
body is not sufficiently covered, by obstructing perspiration, and increas- 
The cure 
by evacua- 
tion by the 
mouth and 
anus. THE DOCTRINE OF PURGATION. 
ing the determination of the fluids to the intestines, sometimes combined 
with febrile miasma, produce the whole phenomena of dysentery. In 
the treatment of this disease, I generally began with an emetic of ipecac- 
uanha ; bleeding was never employed, unless the patient was of a strong 
plethoric habit; purges of salts or rhubarb with calomel were frequently 
repeated ; emollient injections and fomentations were of use, when the 
pains were wandering, and large blisters in every instance removed the 
pain where it was fixed (p. 237). 
215. Diarrhoea generally arose from relaxation brought on by eating 
unripe fruits, and committing other irregularities. It was easily re- 
moved by lenient purgatives (ibid). 
Diarrhoea 
—purgation 
cures. 
216. Hepatic complaints were brought on by violent exercise in the 
sun, joined to the abuse of spirits. Symptoms: pain in the side, some 
difficulty in respiration, pulse full and frequent, sometimes pain in the 
shoulder, and about the region of the liver, which, when pressed, was at- 
tended with a catching and troublesome cough. Bleeding, calomel 
purges, a blister to the side, sometimes mercury in small doses, were 
alternately resorted to, until health was perfectly restored (ibid). 
Liver Com- 
plaint. 
Cure by 
evacuation. 
217. Spasmodic affections were mostly confined to the abdominal 
viscera, and brought on by lying on the deck in the night. The patients 
complained of excruciating pain and stricture, commonly about the um- 
bilical region, nausea, and sometimes vomiting. If fomentations did not 
cure the pain, a large blister was applied ; calomel with jalap taken in- 
ternally and clysters given, until stools were procured, which removed 
the complaint (p. 238). 
Cramp of 
the stomach. 
Strong 
purges the 
remedy. 
IIuGGAN, A., M. I)., On the Croup, Plymouth, 1799. See Med. & 
Phys. Jottrn. 1800 Vol. III. 
218. In a manuscript copy of the late Dr. Gregory’s Lectures, I found 
a caution respecting bleeding in children, even with leeches, as apt to 
bring on fits. Now, if the learned professor’s admonition was the re- 
sult of experience—and a case which I myself once saw, leaves me little 
room to doubt it—what have we not to dread from taking blood away 
in a large stream from infants ? (p. 57.) . . . With regard to blood-let- 
ting in general, as a means of cure in inflammation, synocha, dec., let me 
ask, whence the necessity of diminishing the quantity of blood in such 
diseases f or what proof have we that the quantity of blood being increas- 
ed,—allowing, however, that it actually is so,—is the increase of it the 
cause of evil f By taking blood away we undoubtedly lessen the quan- 
tity of it, but do we really diminish the bulk of the circidating fluids, 
and contract the size of the bloodvessels f This is but doubtful; for, it is 
more than probable that from the loss of blood the secretions are dimin- 
ished, and absorption of moisture from the atmosphere increased, (p. 
58.) . . From the prevalence of bleeding in inflammatory diseases, some 
have, either from prejudice in its favor, or from want of proper discrim- 
ination, used it copiously in genuine typhus, accompanied, as it some- 
times is, with thoracic pains, dec. The result of such practice will be 
obvious (p. 59). 
Croup. 
Blood-let- 
ting dan- 
gerous in 
children, i3 
altogether an 
injudicious 
arid useless 
practice, in 
inflamma- 
tion as well 
as in typhus. 
Bleeding 
is NEVER NEC- 
ESSARY, SEL- 
DOM SAFE, 
OFTEN HURT- 
FUL, SOME- 
TIMES FATAL. THE DOCTRINE OF PURGATION. 
Upon the whole I think that I am sufficiently warranted, from experi- 
ence, to draw the following conclusions respecting the use of venesection 
in the practice of medicine, viz.: Thai it is never necessary, seldom 
SAFE, OFTEN HURTFUL, AND SOMETIMES FATAL (p. 60). 
Miller, E., M. D., On the effects of Abstinence on the approach of 
Acute Diseases. See Medical & Physical Journ. London, 1799, Vol. I. 
hSiitfoP 
dise^ee*and 
1 'prelrve 
health' 
219. If the art of preserving health and prolonging life chiefly con- 
in & fru9al and sparing use of stimuli, and adapting them with cau- 
tion and skill to the fluctuating circumstances of the vital principle, we 
shall surely find still stronger motives to apply this doctrine at the ap- 
proach and in the treatment of diseases, when noxious powers of such 
preternatural violence invade the body, baffle every remedy, and stimu- 
late it to death. The regulations of this vital principle, here denomina- 
ted excitability, the preservation of it when present, and its restoration 
when deficient, the restraint of the excitement within the bounds of 
moderation, the prohibition of all wasteful and undermining excesses, 
will probably hereafter, at some more enlightened era of medicine, form 
a system of rules for the management of health and the prevention of 
disease, for the enjoyment of sense and the refinement of intellect, which, 
instead of the present feverish dream of human life, will present a con- 
summation of improvement and happiness which we now ascribe to su- 
perior beings (Journ. p. 45). 
220. If I do not mistake, it has been proved, that abstinence will be 
0pen a complete, generally a useful, and almost always a safe means 
°f obviating the approach of acute diseases. And, in a word, if it were 
possible to offer to mankind a maxim of universal application to the 
treatment of incipient fevers, in all their variations and circumstances, I 
should be inclined to hazard the following aphorism : When symptoms 
denoting the approach of acute diseases are discovered, abstain, for a 
proper length of time, from all aliment (ibid). 
ofAbstmence 
rupts the*ad- 
vance of dis- 
In the place of abstinence from all aliment, purgation is the method which experience 
has proved safe and effectual, both as a preventive and cure for acute or chronic or incipient 
affections. Brandreth’s Pills and weak oat-meal gruel for a few days wTill do more good than 
abstaining from food, or half starving for weeks. And purging with these pills never weak- 
ens the vital forces, which cannot be said of the other plan. I think that the starving method 
is next in evil effects to bleeding. One takes the life out, the other prevents its renewal. 
It is effete matters, impure humors, floating in the blood or settling upon some organ, that 
cause all general or local disease. Purging takes these out, and, being done, the health is 
often restored at once. If you have poisonous matters about you, get rid of them as soon as 
possible. This is the sensible way. Starving does not get rid of them, it only reduces your 
life, your power to feel, that is all; places you nearer the grave. While every dose of 
Brandreth’s Pills takes the death principle away, and places a greater distance between the 
sick and the grave. 
Nooth, J., M. D., Superintendent-General of the hospitals in British 
America. Letter on the treatment of dysenteries and other autumnal dis- 
eases, to Dr. Mitchell, Quebec y Jan. 24,1799. See Medical Repository, 
Vol. II. p. 437, quoted in Med. & Phys. Journ. 1799, Vol. II 
221. Having seen, in the course of my practice, a great number of THE DOCTRINE OF PURGATION. 
dysenteric cases, and having experienced the inefficacy, in general, of the 
usual mode of practice, I was induced to try the effects of the several 
'purgatives now in use, with the view of ascertaining how far any one 
was preferable to the others, in the treatment of dysenteric patients. 
Experience soon taught me that the neutralized tartarit of potass was 
the most salutary in its effects; and of course I have always, since that 
discovery, had recourse to it in dysenteries and other autumnal diseases, 
with the greatest success, both in children and adults (Journ. p. 181). 
Dysentery 
and other 
autumnal 
diseases— 
purgation 
the cure. 
Skrimshire, J., M. I)., Cases of Fractured Shull, Wish each, 1799. 
See Med. & Piiys. Journ. 1800, Vol. III. 
222. A boy four years of age had fallen from a height of ten feet 
upon a brick pavement. He vomited soon after he was taken up, and 
complained of a bruise on his head, but seemed otherwise quite well. 
There was a very evident depression of the right temporal bone, and 
fracture of the right parietal bone. Merely a spirituous embrocation 
and a gentle laxative was given. On the next day the depression was 
considerably less. No one bad symptom had come on, but as the physic 
had not operated, I ordered an enema, took six ounces of blood froimthe 
arm, and ordered a strictly antiphlogistic regimen for three weeks; in 
a few days the depressed bone had risen to its natural situation, and in 
a few weeks every trace of it had disappeared (Journ. p. 28). 
Fractured 
skull. 
Purgatives, 
as soon as 
they ope- 
rate on the 
bowels, re- 
move the 
bad symp- 
toms attend- 
ing fractures 
and bruises. 
Another boy, nine years of age, fell from a cart-horse upon a stone 
pavement and the wheel of the cart passed over his head. 1 found the 
whole left side of his head very much flattened, the temporal and great 
part of the parietal bone being very much depressed ; besides, there was 
a fracture of both bones, which crossed the squamose suture. The boy 
was comatose, but roused for a moment when spoken to. His breath- 
ing was laborious, pupils dilated, pulse of natural velocity, but intermit- 
ting. He had vomited several times, had bled much from the nose, and 
likewise from the right ear. Trepanning was proposed, but the parents 
objecting, the antiphlogistic plan was all that was left us. He, accord- 
ingly, was bled and an enema administered. The clyster had not oper- 
ated, neither a purgative given on the second day; the depression kept 
on lessening, but the boy remained comatose; another aperient was 
given, and on the third day a purgative enema produced a copious stool; 
the symptoms abated, and disappeared after a repetition of the enema, 
the bowels now being opened (Journ. pp. 28-29). 
Sutton, T., M. D., Considerations Regarding Pulmonary Consumption. 
London,' 1799. See Med. and Piiys. Journ., 1801, ml. VI. 
2237 The first symptoms of disease were in the bowels, and by degrees 
the disorder became a confirmed phthisis pnlmonalis. Hence I was led 
to suspect the emaciation and debility to be induced by some disease of 
the abdominal viscera, which, however, I could not account for in any 
other way except by supposing the mesenteric glands to be obstructed, 
as the symptoms led to no suspicions of any other cause or causes that 
could be considered as adequate to produce such effects. I have seen 
several cases where affections of the bowels preceded the pulmonic symp- 
Gonmmp. 
tion pro- 
sympathy 
pedisease 
fe^me5en' THE DOCTRINE OF PURGATION. 
toms. It is a very common thing for patients, in protracted dysenteries, 
to have pulmonic affections before death • and it frequently happens that 
diseases of the abdominal viscera are, in their latter stages, accompanied 
by pulmonary consumption. By writers on this disease the “tabes me- 
senterica” is mentioned as sometimes accompanying it. . . Hence, it ap- 
pears to me that phthisis pulmonalis is caused by a disease in the mesen- 
teric glands, and that the tubercles in the lungs, and some other of its 
sJmptorasi are excited by sympathy (Journ., pp. 89, 90). 
224. For, an increased action may be produced by exciting an in- 
creased motion in the contiguous parts, which may be effected by the use 
of empties and purgatives, which promote a greater motion in the intes- 
tinal canal, and, from their contiguity, in all probability, communicate 
some of it to the mesenteric glands (Journ., p. 90). 
Purgatives 
cure.emetlC!' 
White, W., Surg., Remarks on Hydrocephalus Internus. Bath, 1799. 
See Med. and Phys. Journ., 1800, vol. III. 
225. Case of hydrocephalus given. He took small doses of calomel 
combined with digitalis. As purgatives produced no effect in stimula- 
ting the intestines, clysters were resorted to lor that purpose. Alter a 
fortnight, evident symptoms of amendment took place, and he soon re- 
covered (Journ., p. 113). Dr. Whytt, to whom we are greatly indebted 
for a very minute description of the symptoms usually attendant on the 
disease, observes: “ The immediate cause of every hind of dropsy is the 
same, viz., such a state of the parts as makes the exhalent arteries throw 
out a greater quantity of fluids than the absorbents can take upT Which 
state, from wliat he afterwards mentions, he evidently considered as con- 
sisting in debility (p. Ilf). Purging is necessaip, not only on account 
of lessening the determination to the head, but particularly as the symp- 
toms, which proceed merely from fullness in the stomach and bowels, 
have been frequently soon removed by evacuating the bowels (p. 119). 
Hydroce- 
phaius, like 
caused by 
dance°hurof 
cannotbeab- 
sorbed. 
Purgatives 
T* 0)he 
disease. 
Carson, William, M. D., Letter on the Applicability of Mercurial Prep- 
arations in Children'1 s Diseases. Birmingham, 1800. See Med, 
and Phys. Journ., 1800, vol. IV. 
226. For several years I have been dissatisfied with the general and 
indiscriminate nse of calomel in the diseases of children ; I am not more 
certain of any one fact that pertains to medicine than that I have seen 
many children who have fallen a sacrifice to the improper application of 
this raechcine. Calomel, when mixed with sugar, forms a medicine 
agreeable to the palate of the child ; its exhibition is easy to the mother 
or mirse, and it may with safety he given as a purge, when a purge is 
indicated. When given as a purge, its action is confined to the first pas- 
sages ; but when the dose is frequently repeated, either for the purpose of 
obviating habitual costiveness, or with any other intention, it is absorbed 
by the lymphatics, and enters the system, by the action of which it is de- 
composed, . . . and that state of the system produced which is called 
mercurial fever. Although mercury does not appear to have so power- 
ful an action on the salivary glands of children as it has on adults, yet 
I apprehend its general effects upon the system are greater. The mer- 
curial fever in adults soon runs into indirect debility. 
diseases!16 
in minute 
a°poison.ays THE DOCTRINE OF PURGATION. 
227. The injurious consequences likely to flow to children from the 
high degree of excitation and extreme succeeding debility produced by 
a mercurial course I wish to impress upon your readers. Mercury has 
been erroneously held forth as a specific in hydrocephalus, and is often 
given as a preventive of that fatal malady. Hydrocephalus appears to 
be the result of debility succeeding too high an action of the vessels of 
the brain. If so, can any medicine more powerfully produce hydro- 
cephalus than mercurial calces? (Journ., p. 411.) 
Hydro- 
cephalus is 
rather in- 
duced than 
cured or pre- 
vented by 
mercury. 
Chapman, John, Sur., Cases of Injuries of the Head, with Observations. 
Ampthill, 1800. See Med. and Phys. Jouen., 1800, vol. III. 
228. The fondness for trepanning, so much inculcated by Mr. Pott, 
and so very anxiously supported by Mr. Benjamin Bell, has justly met 
with two very able antagonists in Mr. John Bell and Mr. Abernethy (p. 
31, Journ). Every man, previous to applying the trepan, ought to ask 
himself for what he is going to trepan ? “ To think that a fractured 
skull is a chief cause, or even an absolute sign of danger, is a very erro- 
neous notion; it is not the damage done to the skull, but the injury to 
the brain, that is the cause of danger; and the fracture of the skull is 
but a faint, uncertain mark of the harm done to the brain ” (J. BelVs 
Discourses on Wounds of the Head, p. 131). Again : “ There is still 
but one motive for applying the trephine, viz., to relieve the brain from 
compression ” (ibid., p. 144). 
Now, I am speaking of affections of the brain, I cannot forbear ob- 
serving that I have long been dissatisfied with the Edinburgh treatment 
of concussions of the brain, viz., with cordials, wine, and stimulants. 
My ideas on this subject are so exactly consonant to what has been said 
by Mr. Abernethy (Surgical Essays, vol. Ill, pp. 59, 60), that I shall 
therefore refer my readers to his Essays (Journ., pp. 33, 34). Ah. B. 
Abernethy employs purgatives, bleeding, and antiphlogistic regimen. 
In injuries 
of the head, 
chirurgical 
operation 
must he post- 
poned, the 
safer way 
being to 
purge, and 
thereby de- 
termine the 
blood from 
the head. 
Fowle, William, M. D., A Practical Treatise on the Different Fevers 
of the West Indies, and their Diagnostic Symptoms. London, 1800. 
See Med. and Piiys. Journ., 1800, vol. IV. 
229. Very early after my arrival in the country I observed that per- 
sons attacked with fevers, in almost any situation, very generally became 
yellow. This soon led me to conceive it merely a concomitant symptom, 
and by no means such as could be sufficiently characteristic of any one 
fever to give it a particular denomination; it also led me to discover the 
cause of the variety of symptoms attributed by different authors to the 
yellow fever, and to account for successful methods of cure which were 
often diametrically opposite to each other. The longer I remained in 
the country the more I was convinced of the danger attendant on giving 
a name to one disease from a symptom common to so many (Journ p 
355). 
Yellow fe- 
ver a denom- 
ination 
without par- 
ticular mean- 
ing—the dis- 
ease a com- 
mon fever. 
Dr. Fowle divides the fevers of the West Indies according to their 
appearances into intermittents, remittents, ardent fever, and the malig- 
nant or jail fever. THE DOCTRINE OF PURGATION. 
Gkoghegan, Edward, Surg., On Strangulated Hernia. Dublin, 1800. 
See Med. and Piiys. Jouen., 1800, vol. IV. 
230. Let us for a moment consider the state of the parts: A portion 
of the intestine lies without an aperture, through which it is too large to 
pass ; the question then arises, what occasions its bulk ? Surely, the 
nature of the part, the touch, and all the circumstances of the case, 
clearly evince it to be flatus, and sometimes together with excrement and 
an inflamed intestine, whose functions are so far deranged that it cannot 
act upon its natural contents, so as to move them in their ordinary 
course. . . Nothing can be more obvious than that every effort should 
be made to lessen the bulk of the hernia, and none to push it through 
the ring ; it will pass in of itself after the air has been extracted (Journ., 
p. 318). 
Strangula- 
ted hernia. 
A plain 
view of the 
case indicat- 
ing evacua- 
tion. 
Purging with Brandreth’s Pills is what is needed. 
Magennis, J., M. D., On Epilepsy. Birmingham, 1800. See Med. 
and Piiys. Jouen., 1800, vol. IV. 
231. I observed in these patients, and in most others who have long 
labored under this untoward disease, a dullness of apprehension, a par- 
ticular stare and vacuum of countenance, a dilated pupil, and an inabil- 
;r[s to contract on the admission of light, accompanied with 
stUp0r an(] a general irritability of the muscular fiber. This torpor ex- 
tends to the stomach and intestinal canal, as those people subject to the 
disorder usually require the most active cathartics and emetics to excite 
the primae vise into action (Journ., p. 419). 
Epilepsy. 
The torpor 
of the stom- 
ach and in- 
testines re- 
quires pow- 
erful 
purges. 
Peeve, Ii., Surg., On a Successful Case of Hydrocephalus. See Med. 
and Piiys. Jouen., 1800, vol. III. 
232. Hydrocephalus internus.—The author’s own child, at the age of 
eight months, in December, 1798, could stand alone, and had every ap- 
pearance of a healthy, forward child. Ilis temper was unusually placid, 
and his spirits invariably good. Towards the end of the month he be- 
came extremely costive, and though medicine for a time relieved him, 
he was frequently and violently seized with pain in the abdomen, which 
was generally mitigated by a clyster. . . ITe ceased to grow, except the 
head, which, towards the end of January, 1799, was perceptibly increased 
in size, and his costiveness was become so obstinate as scarcely to yield 
to the most active purgatives. It was this singular state of the alimen- 
tary canal, which had existed upwards of six weeks, that first led me to 
suspect some material derangement in the state of the brain. On the 
12th of February he was convulsed in the night, took antimon tartaris 
in small doses, with little or no effect, and on the following day castor 
oil, Avliich was repeated a second time, before any motion was produced; 
the abdomen was very hard, and of an extraordinary size; the stools of 
a clay color, and of such an adhesive nature that they could not easily 
be separated from his napkins; his urine high-colored, secreted in large 
quantities, and gave a yellow tinge to his linen. James’ powders were 
given, but fever and delirium set in, with a voracious appetite, and all 
the symptoms of hydrocephalus. Calomel given as purgative in the be- 
Case of 
hydro- 
cephalus 
proving the 
necessity of 
.full, contin- 
ued, power- 
ful purga- 
tion of the 
intestinal 
canal. THE DOCTRINE OF PURGATION. 
ginning of March was charged with mercurial friction, but all hope of 
his recovery was lost; he cried much, had much pain in his bowels, 
which were distended by flatus to an alarming degree, and the only relief 
that could be obtained was by clysters. A blister that was applied to 
the anterior fontanelle was kept open and discharged copiously, and in 
April he commenced slowly to recover. . . Now his bowels are quite 
restored, and he has left off all medicine (Journ., pp. 61-64). 
Brandreth’s Pills could have saved all this pain and suffering. 
llxwixs, David, Surg., On Febrifuge Medicines. See Med. and Phys. 
Journ., 1800, vol. IV. 
233. A derangement of the nervous system, occasioning general de- 
bility, is an invariable attendant on fevers of every denomination, and to 
this single cause, debility, are all the symptoms which occur under differ- 
ent circumstances of constitution, situation, habit, &c., of the patients 
to be referred; for, notwithstanding the minute division and extensive 
classification which have been adopted by nosological and systematic 
writers on febrile affections, there -appears to be no specific or abstract 
difference in the diseases themselves, the variety of appearance wThich they 
assume being totally dependent upon the state of the constitution receiv- 
ing the affection. Thus, the same causes operating upon a person of a 
sanguine temperament and plethoric habit will occasion the disease 
which has obtained the appellation of inflammatory fever, with symptoms 
of vascular excitement, which, on a patient of a contrary description, 
will be productive of a typhus or nervous fever (p. 54). 
Fever, 
fe-3 
VER ” one 
different 
uonfiJesta~ 
234. When the quickness, smallness, and irregularity of arterial pul- 
sation, distressing pains in the head, extreme oppression of the mind, 
and other symptoms are present, denoting the highest state of nervous 
debility, a dose of powdered antimony, in such quantity as to create a 
slight nausea of the stomach, will often reduce the pulse to its proper 
standard, and, by inducing a regularity and due proportion between the 
action and reaction of the system, will effectually arrest the further pro- 
gress of the disease. 
theconstant- 
attending 
moved, 
sympathy,gh 
stomach. 
Woodward, W., Surg., On Infantile Diseases. See Med. & Phys. 
Journ. 1800, Vol. IV. 
235. There is a liquor in the bowels of infants and many other ani- 
mals, when they are born, which is necessary to be carried off; the medi- 
cine which nature has provided for that purpose is the mother's first 
milk; this, indeed, answers every purpose, and effectually; hut we 
think some drugs forced down the child’s throat will do much better— 
the composition of which varies, according to the fancy of the good 
woman who presides at the birth. ... We see that notwithstanding the 
many moving calls of natural instinct in the child to suck the mother’s 
breast, yet the usual practice is to deny that indulgence till the third day 
after the birth ; by that time, the suppression of the natural evacuations 
infantile 
Tmoth- 
er^he 
medicine. THE DOCTRINE OF PURGATION. 
The natu- 
ral evacua- 
tion prevents 
and cures 
milk-fever. 
of the milk usually brings on a fever, the consequence of which is often 
fatal to the mother, or puts it out of her power to suckle the child at 
that time. The sudden swelling of the breasts, which commonly hap- 
pens about the third day, is another bad consequence of this delay. 
When the breasts become thus suddenly and greatly distended, a child 
is not only utterly unable to suck, but, by its cries and struggling, fa- 
tigues and heats both itself and the mother ; this is another cause which 
prevents nursing. . . . The gentlemen of the Lying-in-IIospital in Lon- 
don ordered the children to be put to the mothers breast as soon as 
they showed a desire for it, which was generally within ten or twelve 
hours after birth ; this rendered the usual dose of physic unnecessary; 
the milk-fever was prevented; the milk flowed gradually and easily 
into the breasts, which before were apparently empty, and things went 
on in the natural way. If a mother is determined not to nurse her own 
infant, she should, for her own sake, suckle it at least three or four 
weeks, and then wean it by degrees from her own breast. In this way 
the more immediate danger arising from repelling the milk is prevented 
(pp. 43-44). 
i 236. There is, in truth, a greater luxuriancy of life and health in 
infancy than in any other period of life. Infants, we acknowledge, are 
1 more delicately sensible to injury than those in advanced life; but to 
compensate this, their iibres and vessels are more capable of distension, 
| their whole system is more flexible, their fluids are less acrid, and less 
disposed to putrescence; they bear all evacuations more easily, except 
that of blood / and, which is an important circumstance in their favor, 
they never suffer from the terrors of a distracted imagination. . . . 
Children recover from diseases under such circumstances as are never 
survived by adults ; if they waste more quickly under sickness, their re- 
covery is quick in proportion and more complete than in older people ; 
in short, a physician ought never to despair of a child’s life while it con- 
tinues to breathe (p. 43). 
The vita l 
energy in 
children 
higher than 
in adults. 
Bleeding 
alone inju- 
rious to it, 
purgation 
never. 
Moobe, James, Surg., A case of Synocha, London, 1801. See Med. 
& Phys. Joubn., 1801, Vol. V. 
Synocha 
ifsacommon 
of high 0 dJ. 
tatton°f and 
tioner dura 
Purgation 
mi . _ . , , 
237. Synocha, or pure 'inflammatory jever, is a disease so rare m this 
country that many experienced practitioners have doubted its existence. 
Here follows a case:—The treatment employed during the live days he 
was unc^er my cliarge consisted simply of two purgatives, and a draught 
of one-fourth of a grain of tartar emetic, and two drachms of the acetate 
ammonia water, which was exhibited regularly every six hours. (Journ. 
p. 233.) 
Synocha certainly very much resembles the symptomatic fever at- 
tendant upon phlegmon ; the common ephemera is undoubtedly of the 
same species, and the synocha seems to be precisely the same malady, in 
a more violent degree, and running on for a longer period, (ibid. p. 234.) THE DOCTRINE OF PURGATION. 
Pricards, J., Surg,,' On Hydrocephalus, Brentford, 1801. See Med. 
& Phys. Journ., 1801, Vol. V. 
238. Case of a boy, 8 years of age, strong purgatives given: This 
produced very brisk evacuations at each time of repeating it (every other 
morning); after each repetition, however, he appeared better and more 
lively. The plan was continued for several weeks, during which every 
symptom of the disease gradually subsided, until his pristine state of 
health was completely renewed. (Journ. p. 344.) 
Therefore it appears to me, that drastic purgatives, f requently ad- 
ministered, have a much fairer chance of success by increasing very pow- 
erfully the acticrn of the absorbents, while they do not produce that debility 
of the system which is the consequence of mercury (ibid. p. 345). 
Hydro- 
cephalus. 
Brisk, con- 
tinued pur- 
gation re- 
stores health 
and vigor. 
Mercury 
weakens the 
system. 
Savaresi, Antonio, M. D., Physician to the French Army in Egypt, on 
the Cure and Prevention of the Endemic Ophthalmia of that Coun- 
try. Transl. by G. Plane, M. D., London, 1801. See Med. and 
Phys. Journ., 1801, vol. VI. 
239. Dr. Savaresi first divides this complaint into the sthenic and 
asthenic; the one depending on an excess, the other on a defect, of tone. 
The former effects the bulb of the eye ; the latter sometimes the “ sar- 
sus,” sometimes the “tunica conjunctiva.” 
In the beginning I purge in all the three species, without distinction, 
with an ounce of magnesia vitrolata, otherwise called Epsom salts. The 
sthenic ophthalmia requires very close and strict attention, inasmuch as 
the cure depends on the efficiency of the first remedies. After this, top- 
ical remedies, as emollient eollyria, are employed, and low diet. 
As preventive, he recommends avoiding exposure to the sun with the 
head uncovered, and to the night dew, abstaining from salted food, avoid- 
ing cold after being heated, and attention to the intestinal evacuations 
(Journ., pp. 357-359). 
Ophthalmia 
of three va- 
rieties, 
purging the 
first remedy 
upon which 
the cur.e de- 
pends. / 
Tainsh, W., Surg., Account of Scone Cases of the Plague, which occur- 
red cm board of a British ship-of-war on the coast of Syria. See 
Med. and Phys. Journ, 1801, vol. V. 
240. Plague.—Mr. Tainsh employed, after removing all clothes 
from the patients, and washing them with soap over the whole body, 
powerful repeated evacuations of the bowels by emetics and laxative clys- 
ters. The sick used to discharge “an enormous quantity of bile, viscid 
sordes, and tough phlegm,” and the stools gave the sick evidently much 
relief; when a bitter taste and nausea continued, emetics were repeated, 
which cleared the stomach of a large quantity of disagreeable matter, 
which gave great ease. After thus removing the cause of the disease, a 
strengthening treatment was pursued, and the buboes treated by poul- 
tices (Journ., pp. 539-541). 
Plague. 
Powerful 
and repeat- 
ed evacua- 
tion removes 
the cause. THE DOCTRINE OF PURGATION. 
Vage, T., M. D., Criticisms on the Treatment of Venereal Diseases. 
London, 1801. See Med. and Pnvs. Journ., 1802, vol. VIII. 
241. Opiates are usually and properly given, in the intention of 
mitigating severe pains in the venereal disease; but, notwithstanding 
their utility, a free and frequent use of them always induces a relaxation 
of the system, and debilitates the chylific organs, which are primary things 
guard against in mercurial courses. Although both these effects of 
opium appear to spring from one common source, by producing a ner- 
vous, sedative stupefaction, yet some obseiwation in practice inclined me 
to suppose that ease may be procured without any concomitant debility 
(Journ., p. 8). 
opium re- 
nervous sys- 
finishes'1'' 
chymca- 
242. Mercury, however, with all its anti-venereal properties, is natu- 
rally inimical to the nervous system, and exerts its injurious effects, in 
some degree or other, in the most judicious use of it. When it is ex- 
hibited too copiously, and suddenly, it is apt to produce violent effects, 
as great swelling of the head and tongue, apoplexy, Ac., because it breaks 
down the blood before any outlet is prepared for its evacuation. When 
its use is gradual, these effects will be moderate, but they will accumu- 
late in time to considerable injuries of the same nature. The most vio- 
lent and mildest effects of remedies are produced upon the same princi- 
ple, and the former are frequently the only index to explain the latter, 
which would otherwise be too minute for observation (Journ., p. 9). 
Mercnry 
downfhe* 
uood. e 
Axiom. 
The two 
causes of 
mercurial 
disease. 
Parallel 
between 
lead and 
mercury. 
243. The infirmities which arise from the use of mercury appear to 
originate from two 'principal sources: one is its dissolution of the Hood, 
by which a redundance of serum is forced into the interstices of the cel- 
lular substance of the muscular, vascular, and nervous systems; in con- 
sequence of which the gluten, which gives strength and stability to the 
solids, becomes relaxed, and the different functions of the animal economy 
so debilitated as to be incapable to be properly actuated by the nervous 
influence, while the nervous system itself may remain in a tolerable 
condition. The oilier source of infirmity, on the contrary, is when the 
nervous system has been left impaired and cannot invigorate these func- 
tions, which may not have suffered any considerable detriment. For, it 
is experimentally ascertained, that if the nerves of any part are injured, 
either at their origin or in their course, that part will become propor- 
tionally inert in its office (Journ., p. 9). 
The effects of mercury are somewhat similar to those of lead; both 
have power to produce paralytic affections; both, in a weaker degree, 
abate inflammations and mitigate pain; and the imbecility of both re- 
main after they have been quite expelled from the habit (Journ., p. 10). 
244. In considering tlie dyspeptic symptoms of this or any other dis- 
ease, it appears to be generally conceived that the cause of them is the 
weakness of the stomach alone. This opinion has probably led to some 
imPortant mistakes in practice; for this organ is not less subject to be 
affected by causes, and the condition of parts remote from itself, than it 
ig capajqe 0f affecting the whole system. Tims an indolence of the in- 
Dyspeptic 
fromsympa- 
thtkehintet-Q 
Unesand the 
whole ays- THE DOCTRINE OF PURGATION. 
testines, or a dimin ution of their action in any part, from the pylorus to 
the rectum, will produce nausea and indigestion, even when the stomach 
itself may be in a good condition; and hence it is that often a cathartic 
will remove these symptoms by giving an additional irritation to the 
obstructed and enervated parts. In general, however, here the stomach 
participates of the mercurial debility, and corroborating aperients be- 
come requisite. In regard to the inertness of the intestinal action, it 
may be further noted that it frequently proceeds from a deficiency of the 
bile, which a cathartic stimulus is likely to prevent, for undoubtedly this 
secretion depends much upon the proper action of the duodenum. But 
the chief utility of the bile results from its chylific property, which ap- 
pears to consist, in a great measure, of mixing the oily and aqueous 
parts of the aliment, and assimilating them into a uniform liquid. 
This great importance of the hepatic secretion, whenever it appears de- 
fective, demands immediate assistance by active purgative medicine (p. 
172). 
intesti- 
promoting 
bffymcathe 
non: 
Auld, Isaac, M. D., of Edisto, S. C., Case of Acute Bilious Fever read 
before the Medical Society of South Carolina, 1802. See Med. and 
Fiiys. Journ., 1808, Vol. XIX. 
245. Case.—A young man who had spent a month in the country, 
on the morning after his return complained of slight chilliness and a 
dull pain at the pit of his stomach, which soon after terminated in exces- 
sive vomiting, violent fever, and intense pain in his head. These symp- 
toms continued without abatement until about three o’clock in the 
afternoon, when they suffered considerable remission. At this time I 
saw him. I found that so general a suffusion of bile through the System 
had taken place as to resemble a person laboring under jaundice, with 
the exception of the eyes, which were slightly inflamed. His bowels 
were obstinately bound, having been in a state of constipation for the 
two or three previous days. His tongue was moist, the edges inflamed, 
the top white, excepting the middle, down which ran a yellow streak 
(Journ., p. 106). 
Acute bil- 
ious fever 
(vulgo yel- 
low fever), 
; symptoms: 
costiveness 
preceding 
and attend- 
ing, fever 
and chills, 
pains in the 
head and 
Stomach, 
vomiting, 
yellowness. 
246. Treatment.—As his pulse, which was slow and irregular, seemed 
now to forbid the lancet, though there was still some pain in the head, 
and costiveness and debility appeared to be the principal inconveniences 
under which he labored, I contented myself with leaving for him two - 
smart purges of calomel and jalap, with directions to take one immedi- 
ately, and the other in four hours, if the first did not procure eight or - 
ten copious stools. On visiting him again, about nine o’clock, I found ; 
that he had taken both his purges with the happiest effect; they were then j 
operating briskly,- and had already produced several large evacuations of 
hard, dark, and very foetid fceces. The pain had entirely left his head, 
his pulse had become regular and more full, a gentle moisture had over- 
spread his skin ; his stomach had recovered much of its usual tone, and ( 
this was accompanied with desire for food. On the next morning he had j 
left his bed with an assurance that he felt himself quite free from indis- 
position. The discharges from his bowels were still kept up, but had \ 
entirely lost their foetor, and appeared to consist chiefly of healthy-look- J 
Cure : 
Powerful 
purgation, 
removing 
the cause, 
i. e. accu- 
mulation of 
hard, dark 
and foetid 
faeces. 
Natural 
stools suc- 
ceeding mor- 
bid evacua- 
tions do not 
absolutely 
indicate ces- 
saion of the 
purgative 
treatment. THE DOCTRINE OF PURGATION. 
ing bile. IBs skin had become much clearer, as had his urine, which 
before was of a deep bilious hue. 
I suggested the propriety of his taking gentle purgatives for a day or 
two longer : but this advice, from the comfortable state of his feelings, 
he declined, and I, of course, left him. On the third morning after this 
I was sent for to attend in all possible haste, as the patient was supposed 
to be dying. I found him speechless, his jaws were fixed, as also were 
his eyes, which were nearly closed; he had no pulse at the wrists, his 
feet, legs, and knees were perfectly cold, and his stools, which were black 
and very offensive, came from him involuntarily; liis breathing had 
been very laborious, but now it appeared to be free from anxiety. I was 
informed that the day I left him the pain in liis head and the fever had 
returned with its former violence, and had continued without any dimi- 
nution until this morning, when it terminated in the comatose state de- 
scribed. The cure was hereafter effected by nitric acid and blisters, 
which restored the vitality of the patient, and by a continued applica- 
tion of that acid and strong purgatives, which carried off large masses 
of very foetid, hardened fseces (Journ., pp. 106-109). 
Awful con- 
sequences of 
imperfect 
pur gap on. 
Badger, John, Surg., On a singular hind of Eruptive Disease. See 
Med. and Piiys. Journ., 1802, Vol. VIII. 
247. The first opportunity of witnessing this disease was at Putney, 
in the month of July, 1801; it seemed to be confined to children only 
of a certain age, having never seen a child affected with it before seven 
nor after fifteen years, though equally exposed, as it was evidently infec- 
tious to them. It commences with a slight fever, which continues three 
or four days; it then increases; nausea, and sometimes vomiting, attend 
(in one or two instances I have observed the patients to complain of vio- 
lent sickness after they were put to bed), with pain in the head and 
loins; it is then succeeded by an eruption containing a well-matured 
pus; the pustules are large and very thick about the head, resembling 
those of small-pox; and in every case I have seen they have been con- 
fined to the head, particularly to the scalp. The bowels during the pro- 
gress of the disease were unusually constipated, and, in one or two in- 
stances, not only the body but the face likewise was much swelled. The 
first two or three cases I had not an opportunity of seeing till after the 
eruption had taken place to a great extent, covering almost the whole of 
the scalp. 
Eruptive 
disease of 
the head. 
Physiology. 
248. The hair was shaved off as close as possible, tar ointment and 
a mild purgative applied ; but this treatment produced no amendments, 
the ointment rather increasing the number of pustules. I ordered, there- 
fore, the head to be kept clean with warm soap and water, the patient 
to use a spare diet, and the bowels kept open with an active purgative 
once or twice a week, or “ pro re nata,” and a few drops of antimonial 
wine given once in four or six hours, till the feverish symptoms had sub- 
sided. This plan was pursued for several days without having at all 
mitigated the complaint, though it seemed, under every circumstance, to 
be the best mode of treatment that could be adopted. Accordingly it 
was continued for a few days longer, at which period the pulse became 
regular, the paiu in the head and loins was removed, the pustules began 
Treatment 
by cleanli- 
ness, with 
spare diet 
and purga- 
tion. THE DOCTRINE OF PURGATION. 
to dry off*, and in about a week the complaint entirely ceased (Journ., 
pp. 106, 107). 
Cukkie, William, M. D., Observations on the Treatment of the Malig- 
nant Yellow Fever which prevailed partially in the City and Liber- 
ties of Philadelphia in the summer and autumn of 1802. Phila- 
delphia, 1802. See Med. and Phys. Joukn., 1803, Vol. IX. 
249. Mercury was generally employed both internally and externally 
for the purpose of exciting salivation as speedily as possible, both at the 
hospital and in private practice; but, if I can trust my observations, 
seldom with success, excepting where employed at the very commence- 
ment of the disease, and so conducted as to affect the mouth before -the 
dangerous symptoms of the second stage had time to make their appear- 
ance. 
When employed in the second stage of the disease, at which time the 
predominant symptoms are generally disordered stomach, restlessness, op- 
pression, and deep sighing, and a countenance that denotes great misery, 
it constantly aggravated the disease, and hurried on the fatal symptoms 
of black vomiting. 
In this stage of the disease, when the recited symptoms predomina- 
ted, the frequent exhibition of mild laxatives in small doses, particularly 
Rochelle salts, soda phosphorata, soluble tartar, castor oil, senna, and 
cream of tartar, and when these could not be obtained, laxatives and 
clysters, were the most successf ul remedies, especially when aided by 
blisters to the stomach, wrists and ankles, at the same time. 
A solution of carbonate of soda in water, which is much more pal- 
atable than the vegetable alkali, followed immediately by a tablespoon- 
ful of diluted lemon juice, or cream of tartar in water, had also some- 
times the effect of allaying the distressing propensity to puke. But 
these, as well as every other means that I have seen tried, too frequently 
failed of affording relief (pp. 98, 99 Journ.) 
Yellow fe- 
ver. 
■ >. 
Mercury 
seldom use- 
ful in the 
first stage, 
absolutely 
injurious in 
the second 
stage. 
Purgatives 
and laxative 
drinks re- 
move the 
worst symp- 
toms. 
[If mild laxatives wTere frequently apt to allay the wrnrst symptoms, 
it is reasonable to expect complete success from active purges.] 
250. In this state of the stomach the internal' use of mercury, either 
alone or when combined with opium, always increased the distressing 
propensity to puke ; and, when it failed to operate by stool, it aggravated 
every symptom of the disease (Journ., p. 100). 
fuftplum 
toms. 
251. In cases where the disease began with strong action of the arte- 
ries, severe pain in the head, back and limbs, with little or no sickness at 
stomach, bleeding, purging with active medicines, and the strict observ- 
ance of every part of the antiphlogistic regimen, generally occasioned 
a partial solution of the fever on the third, and a complete solution on 
the fifth, day from the attack (Journ., p. 101). 
Active 
pvmgation 
combined 
with deple- 
tion cures. THE DOCTRINE OF PURGATION. 
Hebeeden, William, M. D., Commentaries on the History and Cure 
of Diseases. London, 1802. 
252. A diarrhoea arises from a variety of causes, most of which are 
void of all danger, and are easily removed. It is often brought on by that 
Iower which is exerted in every part of the body of freeing itself from 
anything painful and oppressive. Not only the mischief from the nox- 
ious qualities and improper quantities of what has been taken, and im- 
mediately offends the stomach, are carried of by means of a diarrhoea, 
but likewise many disorders of remote parts or of the whole body are, 
by the self-correcting powers of an animal body, determined to the bowels, 
and thence discharged by diarrhoea. It is frequently useful to cooperate 
with nature in promoting this evacuation. (Chap. XXYII.) (Cf. Coll. 
136, 143 ; Pringle, 200.) 
Diarrhoea 
Nature's way 
mith nature 
curelLoniJ 
by remov- 
ufifmat- 
ters- 
253. Dysentery.—The usual methods of treating this malady, with 
which I was acquainted, oftenfailed of procuring ease, and of preventing 
its ending fatally. It appeared that in a dysentery some hurtful humors 
had been deposited in the intestines, which threw them into such disor- 
derly agitation as to hinder the expulsion of what had offended them.... 
Purgatives were administered with the double good effect, both of afford- 
ing present ease, and afterwards of entirely removing, by effectual evac- 
uations, the cause of the disorder. (Chap. XXXI.) 
254. Icterus {Jaundice).—Good effects may with reason be expected 
from purging medicines, by their increasing the natural motions of the 
intestines and soliciting a greater flow of bile as well as of all the other 
humors which are poured into them. Mercurial purges have been pre- 
ferved by some practitioners, but there appears nothing in the known 
IowerB °f mercury peculiarly useful in dislodging a biliary concretion, 
and the preference should be given to those purges wich act with the most 
ease, and may be continued with the greatest safety. (Chap. L.) (Cf. 254.) 
jaundice, 
Avoid mer- 
use o?ther and 
ttvespur°a' 
255. Ileus {Colic).—The peculiar and distinguishing symptom 
which characterizes the inflammatory colic in the very beginning is cos- 
tiveness, which it is always extremely difficult, and too often impossible, 
to conquer. As soon as a discharge downwards can be procured in a 
copious manner, the patient perceives a quick abatement of all his mis- 
ery, and is often restored to health. But it is not from one or two small 
evacuations that we can entertain much hope of the distemper beginning 
to give way. This has happened on the first or second day, from the 
excrement which was lodged in or near the rectum, far below the seat 
of mischief. And later in the distemper, a very small portion of that 
liquid matter with which the bowels are deluged has seemed to have 
been forced downwards, while the disease was every hour growing 
worse. Such inefficacious evacutions have been observed more than 
once or twice in the course of this illness, without saving the patient’s 
life Warm baths, fomentations, &c., are serviceable helps in dis- 
posing the bowels to yield to the power of cathartic medicines, by the fail- 
ure or success of which the life or death of the patient must at last be 
determined. (Chap. LI.) (Cf. Ilipp. 12, 38, 41, 45, 57. Parep, 85, 87.) 
Colic. 
Purgatives 
cure. 
Evacua- 
tions must 
be contin- 
ued and co- 
pious to in- 
sure recov- 
ery. THE DOCTRINE OF PURGATION. 
* Tyro.—On Apoplexy. See Med. & Phys. Journ., 1802. Vol. 
VIII. {Controversy between Mr. Crowfoot and Dr. Lang slow on the 
question whether emetics or Weeding be applicable in apoplexy f 
256. In addition to the testimonies adduced by Pyrrho (one of the 
writers participating in the controversy), I shall only add, that Baglivi, 
who divides apoplexy into sanguineous and pituitous, observes: 
“ Arcanum in sanguineis est phlebotomia. In pituitosis contra emeti- 
cum, aut purgans vehimens. Sunt qui apoplexia (pituistosa scilicet) lib- 
erati sunt, hausto singulis mensibus vomitivo ex infuso prsedicto (infus. 
croc, metal cum vino).” a. . . .Aretaeus does not recommend emetics, but 
observes : “ if the sacred purge should excite vomiting, it is not to be 
restrained, because it evacuates pituita, the cause of the disease, and 
rouses the patient by imparting a degree of vigor.” Beerhaave, among 
the general evacuants to be used in this disease, mentions vomits and 
strong purges; though he adds, there is something uncertain in their 
action. Vanswieten, also, in his Commentaries upon this Aphorism 
(1026), observes, that emetics ought not to be condemned in this dis- 
ease, and are often useful, because they evacuate pituita ; though he 
afterwards thinks purgatives less objectionable. (Journ., pp. 68-69.) 
Apoplexy. 
eis by pur- 
vomiting is 
Bardsley, Samuel Argent, M. D., Physician to the Manchester In- 
firmary, Dispensary and Lunatic Hospital. An Account of the 
Epidemic Catarrhal Fever or Influenza in Manchester, dec. See 
Med. and Phys. Journ., 1803, Vol. IX. 
257. Emetics were found highly beneficial on the first attack; in- 
deed, the frequent occurrence of spontaneous nausea and sickness pointed 
out their use. They scarcely ever failed to relieve the urgent symptoms 
of pain in the head and stricture of the breast. To obviate costiveness, 
and at the same time to cleanse the primae vise, moderate doses of calo- 
mel, with rhubarb and antimoni al powders combined, were exhibited with 
excellent effects. . . Opiates were seldom employed during the first stage 
of the disorder, as they had a tendency to exasperate the complaints of 
the head and chest, and increase restlessness and feverish heat (Journ., 
pp. 525, 526). 
Influenza. 
Evacuation 
of stomach 
and bowels 
relive the 
symptoms; 
Opium in- 
creases 
them. 
Kinglake, Robert, M. D., On Influenza. See Med. and Puts. Journ., 
1803, Vol. IX. 
258. My experience authorizes me to say that the benefit of abstract- 
ing heat, by atmospheric exposure, light bed-clothes, copious dilution 
with cold water, and avoiding stimulants of every description, wTill 
almost certainly rescue the patient from danger, and leave nothing more 
for medicine to do than gently to move the bowels in case of costiveness, 
and, at most, to aid the refrigerant plan by the milder sudorifi.es (Journ., 
p. 520). 
Influenza. 
Purgatives 
the only 
medicine re- 
quired. 
a In the sanguineous, phlebotomy is the arcanum. In the pituitous, on the contrary, 
emetics or strong purgatives. Some people remain free from apoplexy by taking every month 
a draught of aforesaid vomitive infusions. (Inf. croc, metal, c. vino.) THE DOCTRINE OF PURGATION. 
The refrig- 
erativeplan 
contended 
for. 
259. It is an erroneous notion that occasional refrigeration and ab- 
stinence in disease weaken more than a heating and stimulating treat- 
ment. The native energy of healthy power is certainly reduced both 
by the abstraction and increase of excitement, but by its due diminution 
vital force may be said to be nursed, while undue stimulant agency tends 
to dissipate it even to extinction ; lienee a moderate negation of excite- 
ment debilitates much less directly than its excessive employ does indi- 
rectly (Journ., pp. 519, 520; Remark). 
Our method for the cure of Influenza is to purge very freely with Brandreth’s Pills, six 
pills every twelve hours the first day. Keeping in bed as much as possible; oatmeal gruel 
or light broth; if the head is very painful, feet in hot water with mustard or wood ashes; 
if throat is sore, gargle with weak alum-water; outward applications are the Allcock Plas- 
ter, mustard poultice, red pepper, or any stimulating liniment. When the skin of the 
throat becomes a little red, the outward applications dispensed with. Should a choking 
sensation be felt, or the breathing be difficult, four Brandreth’s Pills must be taken every 
four hours, or even oftener, until relief is experienced. 
O’Beene, P., Sum., Observations on the Fevers in Hot Climates. Lon- 
don, 1803. See Med. and Phys. Joukn., 1803, Vol. X. 
260. The more severe in symptoms, and dangerous in effect, any dis- 
ease is, the more necessary the investigation of, and researches after, 
methods of cure must be fully impressive on every mind ; it is scarcely 
necessary to add that perhaps none comes more strongly under this de- 
scription than that generally termed yellow fever / none, therefore, more 
interesting claims our attention. 
In the commencement, generally nausea, pain in the head, loins and 
hams, succeed ; dry surface, increased pulse, but not to be depended on, 
varying from 80 to 140, chills, anxiety, sighing, prostration of strength; 
vomiting soon takes place, and not unfrequently is the first indication of 
the disease. The vessels of the tunica conjunctiva become turgid, and 
.a yellow tinge of that membrane takes place, frequently extending over 
the body, riot withstanding this circumstance gives rise to the name 
usually given this complaint, it is by no means a constant attendant, and 
in many totally wanting. Watchfulness and desire to sleep, without 
being able to effect it; whilst in others constant dozing, pain and sensa- 
tion of heat in the stomach, great thirst; vomited matter gradually 
changes from yellow to dark green, and at length perfect black. Clammy 
skin, sometimes petechke, but unfrequent; stupor or violent delirium 
succeed ; paroxysms of vomiting become more rapid, and many expire in 
one of those paroxysms too shocking to describe, whilst others placidly 
resign exhausted nature (Journ., pp. 36, 37). 
261. No disease perhaps exhibits a greater variety of symptoms, and 
often less to be depended on, than this; sometimes it goes on with every 
favorable appearance, suddenly changes to the worst, and patients, ap- 
parently almost in a state of convalescence, expire in an hour or two. 
This is a melancholy fact (Journ., p. 37). 
262. The symptoms that we may call favorable are, settled state of 
the stomach, lessened headache, eyes lively, formation of pustules over 
the surface, or that eruption known in tropical climes by the name of 
joricldy heat, I have ever remarked as almost a certain indication of re- 
covery ; bilious flux, copious and high-colored urine, free perspiration, 
and sound sleep (ibid.) 
Yellow fe- 
ver. 
Its com- 
mencement, 
symptoms 
and general 
course. 
Anomalies 
and sudden 
changes. 
Th efavor- 
able symp- 
toms. THE DOCTRINE OF PURGATION. 
263. The dangerous, and, I am sorry to add, most common, symp- 
toms, are severe headache, frequent vomiting, heat increasing to a burn- 
ing sensation, extending down the trachea and alimentary canal; matter 
vomited and faeces becoming dark, frequent sighing, dull or glassy eye, 
pale and little urine, dark fur on the tongue, muscular and nervous de- 
bility, intermittent pulse, clammy feet, cold sweats, stupor or violent 
delirium, singultus, coma (ibid.) 
ffeJous dan 
symptoms. 
264. That dark matter vomited, termed Hack vomit, it may be neces- 
sary to remark, although laid down by most authorities as a certain fatal 
sign, is by no means so, as I have seen many recover after it; it is also 
said “ that a diarrhoea almost precludes any hopes of recovery.” If by 
diarrhoea is understood a simple {or bilious) flux, I have ever observed it 
a decided fortunate event; certainly a flux of putrid dark faeces is ex- “ 
tremelybad, and yet even thatl have many times seen prove salutary 
(ibid.) 
The black 
vomit and 
diarrhoea 
NOT AT ALL 
fatal symp- 
toms. 
265. Our first and principal attention should be directed to clearing 
the first passages, and to keep them firee during the disease being of the 
greatest importance. \ 
Emetics are by many laid entirely aside, on the principle of increas- 
ing the already irritable state of the stomach. That a great deal of 
caution and discrimination in their use is extremely necessary must be 
allowed; but I am decidedly of opinion much benefit is to be obtained 
by them. AY here nausea or slight vomiting occurs, ipecacuanha is the ; 
best; but if the vomiting be more severe, an infusion of chamomile will < 
answer every intention. 
Cathartics.—Calomel, combined with powder of jalap, is perhaps one 
of the best; the irritating quality of the neutral salts seldom makes 
them advisable. 
The TREAT- 
MENT. 
In the 
first stage: 
Purgation 
at ALL 
EVENTS ; 
emetics ad- 
missible with 
caution. 
266. Blood-letting has been advised by some of the most respectable 
authorities; I shall therefore only observe that I never saw it used with 
advantage ; on the contrary, I always thought it of disservice (Journ., 
p. 38). 
Bleeding 
aiwaysTurt- 
fu1, 
267. Our next intentions must be directed towards lessening the 
irritable state of the stomach, supporting the strength, and resisting that 
tendency to putrescency that exists in this disorder. 
Notwithstanding the great variety of opinions that have been, and 
still are, on this subject, calomel ydll still perhaps be found the most 
successful medicine hitherto employed, and, in general, I have but little 
doubt its want of success in many instances may be attributed to the 
manner of giving it, or want of attention to the state of the bowels. Cal- 
omel if not given in large quantities quickly repeated had better not be 
given at all. I have used from five to eight grains every two hours, and 
sometimes every hour, combined with three grains of the antimonial 
powder, until a diaphoresis wras induced, when the latter was omitted, 
and the calomel continued until the effect was evident, as metallic taste, 
foetid breath, or sore mouth. When a gentle salivation is raised, desist 
Inthesgc. 
ond stage, 
peculiarthe 
thlreaj“£°k 
must be kept 
f°eftantly THE DOCTRINE OF PURGATION. 
in frequency, yet continue so as to keep up the effect of the mercury; 
the criterion of its success may be determined by its action or non-action. 
When a speedy and copious salivation comes on, the most happy effects 
may be looked for; while the contrary prove the reverse. And here 
again let me observe that the most minute attention must be paid to keep 
the bowels free, for which purpose enemas are the best (Journ., pp. 
38, 39). 
External 
remedies. 
268. Blisters, although uncertain, are of great utility both in pre- 
venting delirium and lessening vomiting, applied to the region of the 
stomach. General warm bath is of the utmost service, or, where that 
cannot be conveniently had, washing all over with warm water (Journ., 
p. 39). 
Enemas. 
269. Of all remedies in use for this disease, excepting calomel, per- 
haps none are of more real service than enemas, and the more simple the 
better—such as warm water, oil and vinegar; but on the increased vas- 
cular action and heat subsiding, enemas composed of orchis, sago, or 
portable broth; this last I have found of such uncommon service as 
makes me wish most strongly to impress the use of it; in many cases, 
where animation seemed nearly exhausted, recovery was the unexpected 
and welcome effect of this salutary practice (ibid.) 
Opium 
and bark 
useless. 
270. Opium I have found of little, if any, service, in any stage. 
Cinchona appears to me evidently of disservice until the patient is 
in a convalescent state (ibid.) 
Brandretli’s Pills are in every respect superior to calomel as a purge, and they leave no 
evil after effects. 
Potter, Nathaniel, M. I). Letter on the Epidemic Distempers of the 
year 1802. Baltimore, 1803. Bee Med. and Piiys. Journ., 1804, 
vol. XI. 
271. The cure of measles this year may be almost reduced to two 
simple remedies, blood-letting and purging. For, when these were used 
in time, and carried to a sufficient extent, little or nothing remained to 
be done. These remedies were no less efficacious in removing the im- 
mediate symptoms than in removing the consequences of the disease. 
This will be sufficiently apparent when we enumerate the deplorable 
train of consequences that followed their neglect (Journ., 7, 312). 
Measles. 
Purging 
actively em- 
ployed cures 
and pre- 
vents bad 
conse- 
quences. 
272. Purging was a very useful remedy, and required to be repeated 
every second day, or oftener, as there was a constant reaccumulation of 
that green and acrid matter that was sometimes ejected from the stom- 
ach on the first attack; and this disposition commonly lasted four or 
five days. Where purging was neglected in the commencement, the 
evacuations from the intestines were often of a darh green, brown or 
black complexion, just as it happens in other malignant fevers (Journ,, 
p. 3181. 
Purgatives 
cure by car- 
rying off 
the morbid 
matter. 
273. Antimonials were certainly improper remedies in this disease ; 
they depressed the pulse, and seemed to act too much like the causes of 
the disease. Are not antimonials equally unfit remedies in all malignant THE DOCTRINE OF PURGATION. 
fevers,, where the tendency to indirect debility is great, and more espe- 
cially in those called contagious, where the “ vis nocens ” is so prone to 
induce the same state of the system ? 
Blisters were equally inapplicable in the first state of the disease, 
but co-operate powerfully with emetics in arresting the progress of indi- 
rect debility in the advanced state of measles, and sometimes called 
forth dormant excitement to great advantage. 
Antimo- 
nials alto- 
gether inju- 
rious ; blis- 
ters and opi- 
ates applica- 
ble on ly con- 
ditionally. 
Opium was also inadmissible in all its forms, unless toward the latter 
state, when fever did not contraindicate its prescription for the cough, 
which was often the last troublesome symptom, and seemingly occa- 
sioned by the action of a small portion of the pulmonary vessels (Journ. 
p. 314.) 
Power, George, Surg., Assistant Surgeon to the Twenty-third Pegiment 
of Foot, Poyal Welsh Eusileers. Attempt to investigate the cause of 
the Egyptian Ophthalmia, dec. See Med. and Phys. Journ., 1803, 
vol. ix. 
274. The next local cause of Ophthalmia in Egypt is the custom of 
sleeping at night in the open air, imbibing with every inspiration, and 
absorbing at every pore, the putrid virus contained in the descending 
dews. . . . Thus in a system peculiarly debilitated, and unable to resist 
all its powers combined, it produces that highly putrid fever called 
plague. In a patient less relaxed, as the habit of the body determines 
the disease either to the surface of the skin or to the intestines, an erup- 
tive fever or dysentery is produced; and when the putrid virus is but 
partially applied, to the eyes for instance, or to the month, or even on 
the surface of the body, ophthalmia, ulcerated fauces, or ichorous blotches 
on the skin ensue (Journ., p. 78). 
Ophthal- 
mia. 
Influence of 
night-dew 
in hot cli- 
mates pro- 
ducing differ- 
ent diseases, 
according to 
predisposi- 
tion. 
275. As the author freqently refers to a treatise of the French Sur- 
geon Bruant, it will be of interest to know what this writer says on the 
cure : “ This disease is frequently cured by the simple operation of na- 
ture, and without any assistance from art; and indeed we may affirm 
with truth that nothing so much opposes the cure as too great a prof usion 
of remedies, especially topical. Some patients have been relieved by an 
eruption coming on at the temples; others, and the greater number, by 
a slight diarrhoea; and hence, to act conformably to the views of nature, 
I have encouraged a discharge from the bowels during the whole dura- 
tion of the disease, by employing tamarinds or other laxative titans 
(Desgenettes Histoire Medicate de l’armee de l’Orient.—Journ. p. 580). 
Mature in- 
evacuation, 
AVadley, T. AV\, Surg., on the Prevailing Epidemic Influenza. Stow on 
the Wold 1803. See Med. and Puts. Journ., 1803, vol. IX. 
276. First, the exhibition of an emetic was always promised, which 
seldom failed of evacuating the stomach of a dark colored, greenish, and 
most offensive fluid. Aperients were always rejected when given before THE DOCTRINE OF PURGATION. 
from bilious 
accumuia- 
rCk-fiol'- 
mentT*'6' 
Cure by 
the cause. 
an emetic, and an enema was found of no service. The pain in the 
head was constantly lessened and frequently removed by the vomit, and 
a freer expectoration sometimes relieved the cough. When costiveness 
was a very urgent symptom an active purgative was givhn, which never 
failed of being followed by stools of a peculiar foetor and black color, 
and this state of the alvine discharge often accompanied the disease 
throughout (Journ. p. 516). 
Medicus, Practical Observations on the Treatment of the Scarlet Fever 
and Sore Throat. See Med. and Phys. Journ., 1804, vol. XII. 
Scarletfe- 
ver, when 
mild, re- 
quires but 
little medical 
assistance. 
The cause 
—morbid 
matter in 
the bowels— 
must be re- 
moved by 
purgatives. 
Brisk pur- 
gation does 
not hurt, but 
strengthens 
the vital 
power. 
277. It is well known that many pass very safely through the scarlet 
fever, in its mild state, with little or no medical assistance. But when 
in that state medicines are administered, I fear the cure is, by the inge- 
1 nious theoretical practitioner, ascribed too often to their effects and not 
to the mildness of the disease, especially if some fashionable medicine 
has been prescribed. Hence remedies undeservedly creep into prac- 
tice, and, I fear, in serious cases frequently supersede the use of those 
which have long stood the test of sound practical experience. 
I pretend not to account for the source or origin of the scarlet fever 
and sore throat, but am well satisfied that the “ fomes morbi ” of the 
disease, however generated, lurk in the bowels. Under this conviction 
I enjoin them to be well cleared, in whatever stage or however violent the 
disease may be, when I first see the patient, if I suspect that such necessary 
treatment lias not been before observed. The very foetid smell of the 
evacuation, and the relief such evacuation immediately procures, strongly 
prove to me the necessity of purgatives, and I may add, from reiterated 
observations, that the longer they are delayed the more severe proves 
the disease. Many practitioners, alarmed at apparent debility, are de- 
terred from exhibiting brisk cathartics lest their operation should irre- 
coverably sink the patient. Such apprehensions would be justly 
founded if purgatives were administered without due discriminating 
attention to age, constitution, and immediate state of the patient. But 
where such attention is paid, I have never seen any mischief arise; on 
the contrary, the most salutary effects have taken place merely from 
the bowels being • relieved from the contained accumulated foetid faeces, 
and hence every febrile symptom becomes milder, and the vital powers 
invigorated, not debilitated (Journ., pp. 25, 26). 
Patterson, W., M. D., Case of Brainular Affection from an Internal 
Cause. Londonderry, 1804. See Med. and Phys. Joijrn., 1804, 
Vol. XII. 
278. A gentleman, aged above sixty years, was suddenly attacked 
with a severe pain in liis forehead, accompanied with so much megrim 
an(l stomach sickness as would have caused him to fall had he not re- 
ceived support; to these symptoms was added coldness. lie was put to 
bed; blood-letting pretty largely in the arm; purging, and blistering 
the back, legs and head, in succession, were employed. Four days after 
the seizure, when I was called, I found him in bed complaining grievously 
Apoplexy, 
eryltpefa- 
touscharac- THE “DOCTRINE OF PURGATION. 
of a violent pain in the forehead, together with an irksome stricture in the 
eyeballs and surrounding teguments. The functions of the brain were 
impaired by a degree of stupor, attended frequently with incoherent 
mutterings. His pulse was unequal, laboring, and accelerated with a 
tenseness in the vessel; the temporal arteries throbbed considerably, but 
were uniform in their action. The countenance was sometimes pale, 
sometimes reddish, and at other times suffused with a bluish tinge ; the 
eyes were languid, and the sense of vision much diminished, at periods 
almost lost. The temperature of the skin was sometimes pretty high, 
more frequently below the medium warmth, and generally felt languid 
and flaccid. There was sometimes an urgent thirst, but for solids little 
or no appetite. His stomach, indeed, continued to have a loathing, and 
so retrograde a disposition as to approach vomiting, which he himself 
considered to proceed from vitiated bile. His bowels were sluggish, and 
had not emptied themselves since the operation of the laxative medicine, 
which was a space of thirty-six hours before I saw him. He was rest- 
less, and when he seemed to sleep it was a morbid comatose state rather 
than a salutary repose. The organs of respiration did not appear par- 
ticularly engaged, and the urinary organs were equally unaffected. 
From the preceding phenomena I concluded that there existed a de- 
termination of blood to the head, with increased tension of the arteries 
of the part. Under this impression, I ordered local evacuations, by 
means of numerous leeches to the temples, and a brisk cathartic to excite 
and empty the bowels, as well as to promote an equilibrium in the gen- 
eral circulation. The first application of leeches procured a sensible 
relief, and therefore it was repeated. The cathartic was not active enough 
in its operation, and accordingly a stronger one, composed of calomel and 
aloes, was given, and with manifest advantage. The stupor in a short 
time decreased, and was succeeded by a loud talkative raving, accom- 
panied with unconsciousness of persons and things around him, of which 
inattentive state a remnant continued for several days. The delirious 
condition lasted for some hours, and was followed by a profound sleep, 
attended with a stertor resembling that of apoplexy, but distinguishable 
from it by softness and equable movement in the pulse. This change 
was the harbinger of convalescence, which gradually but slowly took 
place. 
Considering the phenomena of this case, I am led to conceive that 
we would be justifiable in setting it down as a decided instance of apo- 
plexy ; but certainly it was rather of an anomalous description, as it 
assumed many of the features of a species of erysipelas which takes 
place in the membranes and vessels of the brain in the evening of life 
(Journ., pp. 109-111). 
Cure by 
purgation 
driving the 
blood from 
the head and 
restoring 
the equilib- 
rium of 
circulation. 
Pearson, A., Snrg., in the service of the East India Company. Some 
Observations on the Pathology and Prevailing Diseases of Warm 
Climates. London. 1804. See Med. and Piiys. Journ., 1804, Vol. 
XI. 
279. On Acclimation.—In the first change from a cold to a hot cli- 
mate it was formerly the practice to bleed indiscriminately ; it is now per THE DOCTRINE OF PURGxVTlON. 
mifest inA 
vie tp>'even- 
tive of cu- 
eases.0 ls 
Debility 
larity 
cretion. 
haps too generally omitted, as it might be often employed to obviate or 
remove disease arising from inflammatory congestion. Purging has also 
i,een recommended for universal adoption / and when we reflect that the 
constitution both admits and requires this evacuation more frequently in 
warm than in cold climates, and bears it better, its utility will be found 
as probable as experience proves it to be. The neutral salts have been 
generally prescribed, and these are certainly of the most universal appli- 
cation and use; but vegetable purgatives will be best for frequent use. 
(Inf. sennse et temarind, p. rhei. et kali tartar, separately or combined; 
of the former 3j. to i., and § j.to 5 h- of the latter.) Occasionally four 
or five grains of calomel may be taken with much advantage, from its 
effect in stimulating the mucous or biliary excretories, when some of the 
laxatives above specified ought to be given next morning. The day on 
which any of these remedies are given ought to be one of peculiar mod- 
eration, and dilution with barley-water or rice gruel attended to. 
With regard to the use of tonics, or antiseptics, the indications for 
employing them, and their utility, are much less than is generally sup- 
posed. The feeling of debility is often fallacious, and produced by the 
organs being overloaded, or a biliary absorption (Journ., pp. 161, 162). 
280. In the warm climates the attacks of febrile disease are gener- 
ally accompanied with symptoms of bilious absorption, and torpor of the 
intestinal canal, and with a greater or less tendency to remission. The 
treatment recommended by authors is very contradictory ; some advising 
a continued and severe evacuant plan, while others administer bark on 
every appearance of remission, and even without waiting for it. If 
purging with calomel and neutral salts is assiduously practiced in the 
first days, giving intermediately mild diaphoretic and antimonial medi- 
cine, the use of bark will be found unnecessary (Journ., p. 201). 
Fevers. 
The symp- 
toms indi- 
cate purga- 
tion from be- 
ginning. 
281. I am doubtful if the genuine remittent fever appears without a 
previous exposure to the exhalation of marshes, or that from rank vege- 
ia^on 5 and the distinct remissions and exacerbations described in books 
are not frequently to be met with. . . It is frequently some time after 
the application of the remote causes before the disease comes on. . . The 
debilitating effect of the marsh-miasmata is generally recognized, and it 
is probable that the nervous energy and muscular irritability are much 
and suddenly impaired by their impression upon the sensorium; the 
powers of circulating the mass of blood are for a time diminished; from 
that, irregular actions of the vessels of different viscera, a relative degree 
of plethora and inflammation takes place, while, from the excretories 
being similarly affected, the power which the economy possesses to rid 
itself of an excess of heat is abated. In such a state it is not surprising 
that congestions should take place in the brain and glandular viscera 
(Journ., pp. 201, 202). 
Miasmata 
andhowttVy 
act upon the 
pressing the’ 
"muscular* 
activity. 
Bennion, Thomas, Sim/., on the Gibraltar Fever. Gibraltar, 1805. See 
Med. and Phys. Jouen., 1805, vol. XIV. 
rlmSwer 
fever artakf 
ingr of the 
pngue,terye°f 
typhulerand 
282. In the first the patient is seized, without any previous notice, 
giddiness, pain of the head, slight sickness at stomach, darting 
pains from the head to the back, and spasmodic affections of the calves 
of the legs. The breathing was very hot, incessant sighing, the greatest 
dejection of spirits. The tongue wTas in the beginning white; a bad THE DOCTRINE OF PURGATION. 
taste wTas complained of; the sense of smelling was imperfect or de- 
praved ; the visage extremely distressed, and unwillingness to speak. 
The countenance on the first attack became suddenly sallow; in a very 
short time, however, it became red, full and bloated, with the exact ap- 
pearances of intoxication. Drowsiness and sleep followed in a fewr hours, 
when a little moisture came out on the skin. This appearance, however, 
at this stage was delusive; it suddenly left the patient, and was succeeded 
by the most intense heat, that gave a smarting sensation to the fingers 
when applied to the skin. There was at this time a most uncommon and 
offensive smell from the whole body. The eyes were now much inflamed; 
there was violent pain in the temples and over the arches of the eye- 
brows, darting to the orbits. The pulse from first to last was greatly 
increased, but never so strong and firm as in inflammatory diseases; the 
thirst less than generally in acute diseases. There was strong pulsation 
in the carotid arteries, and an evident enlargement of the jugular vein. 
The color of the skin approximated that of the lilac, cocklicoque, violet 
or poppy, and changed as the disease advanced to a deep yellow. By 
the early administration of strong emetics and purgatives on the first 
attack, the yellowness seldom appeared, and every other bad symptom was 
averted (Journ., pp. 137-138). 
Symptoms 
of the first 
stage avert- 
ed by emet- 
ics and 
strong 
purges. 
283. When these had not been exhibited, and in cases where the dis- 
ease from first appeared in a more aggravated form, the second set of 
symptoms soon appeared ; the patient w as very comatose, much tremor 
of the limbs, frequently an incessant vomiting of black matter, with 
convulsive hiccough; the eyes were drawn in a direction alternately from 
the nose to the temples in a frightful manner, with nearly total blind- 
ness. The skin was now parched with burning heat, or covered with a 
clammy offensive sweat. The body was covered with pe tech he and 
vibices, swellings appeared in the armpits and groins, often degenerating 
into abscesses; foul gangrenous sores on the back, and carbuncles on 
different parts of the body. There were hemorrhages from the nose, 
ears, mouth, and pores of the body, with every appearance of a total 
dissolution of the blood-vessels. Then the faeces and urine wTere passed 
involuntarily, and the other usual symptoms indicated speedy dissolu- 
tion (Journ., p. 138). 
The symp- 
toms of the 
second stage 
and the 
close. 
284. My first step was invariably to put tlie patient into a warm 
bath, then to rub the body well with soaped flannel, and put him to bed. 
If the powers of life were strong a solution of tartar emetic and glauber 
salts was given, which generally operated smartly both on stomach and 
bowels, so that I frequently had little more to do but remove the debil- 
ity, the patients being often well on the third day. If the solution, per- 
severed in, did not operate, the stomach and bowels being very insensible, 
I gave calomel either alone or combined with jalap and the compound 
extract of colocynth. I endeavored by all means to keep vp the alvine 
discharge; when obtained, the patient was perfectly relieved and free 
from fever ; if not, the fourth or fifth day put an end to all enquiry. 
After procuring evacuation, I prescribed saline medicines, when 
little fever remained; but when the disease continued after the third 
day, it turned out to be the severest typhus. Opium or bark did not 
succeed; when liberally given, I perceived them evidently doing mischief 
(Journ., p. 139). 
The treat- 
ment by full 
evacu tion 
of sti.much 
and bowels. THE DOCTRINE OF PURGATION. 
Clark, Thomas, Surg., Observations on the Nature and Cure of Fevers 
and Diseases of the West and East Indies, and of America, Ac. 
Edinburgh, 1805. See Med. and Piiys. Journ., 1806, Vol. XV. 
Dysentery. 
Enemas of 
emetic sub- 
stances. 
Also in 
piles and in- 
flammation 
of the rec- 
tum, &c. 
The man- 
ner how they 
operate. 
They in- 
crease the 
secretion of 
mucous and 
carry it off 
per anum, 
without pro- 
ducing* vom- 
iting, and re- 
move the in- 
flammation 
from the in- 
testinal ca- 
nal and rec- 
tum. 
Their ap- 
plication. 
285. Dysentery.—Having, in violent cases, often found the remedies 
now described, or any others that I had tried, ineffectual, I at last had 
recourse to the use of emetic substances in the way of injections. I did 
not adopt these, however, till I had reflected very seriously and reasoned 
very fully on the subject. The other remedies already mentioned, except 
injections, were administered at the same time. From much experience 
I do not hesitate to assert that they have been, and, I believe I may 
venture to say, will be, found extremely beneficial in dysentery. It ap- 
pears to me more than probable that they will also prove useful in cases 
of piles, and, in short, in all kinds of inflammation affecting the rectum 
and parts adjoining. When given early in the disease they generally 
afford immediate relief, and sometimes one or two injections effect a cure. 
When they have not been used until the advanced stages the patients 
experience more uneasiness from them, particularly on their first being 
thrown up; but if they can be prevailed upon to keep them for a min- 
ute or two, the uneasiness in a great measure ceases, and they are often 
able to retain them for a considerable length of time. The manner in 
which these injections operate is for the most part as follows: 
In the incipient stages of the disease, even when attended with vio- 
lent pain and tenesmus, and all the more violent symptoms of this dis- 
ease, immediate relief is almost constantly experienced from them ; and 
they are commonly retained for a considerable length of time with little 
or no uneasiness. At length an effort to go to stool comes on, and several 
copious natural evacuations, mixed with mucous, are procured; and in 
the more violent cases several evacuations of slime, or mucous alone, or 
intermixed with blood, succeed to the natui'al stools, accompanied with 
little or no straining. After this, the patient commonly remains for a 
number of hours without any symptoms of disease, and in some in- 
stances it does not return. 
Those injections do not appear to occasion vomiting, or even to in- 
crease the irritability of stomach that may have previously existed. 
They probably assist in increasing perspiration, however. I do not 
believe that they operate very powerfully in that way; at least, in some', 
cases, I have found it impossible to produce a copious perspiration by 
ipecacuanha, both in the form of injection, and also at the same time 
given by the mouth, in considerable quantities. 
The salutary effects of these injections appear to me to depend chiefly 
upon their exciting a copious secretion of mucous from the internal coat 
of the great guts, and thereby removing the inflammation affecting 
them. 
I have known a few ounces of this injection give immediate and 
permanent relief in several instances of very painful inflammatory affec- 
tions about the extremity of the rectum; a copious secretion of mucous, 
resembling the white of eggs, being produced. 
I generally have given two, and sometimes three, in the course of 
twenty-four hours. The best general rule, I believe, is to administer 
injections whenever the more violent symptoms of dysentery return, or 
threaten to do so. THE DOCTRINE OF PURGATION. 
Strangury, which frequently accompanies violent cases of dysentery, 
will be found very seldom troublesome when these injections are used ; 
the reason why it is not so must appear obvious to every one. 
The form of injection which I have found to answer best has been 
about three drachms of ipecacuanha root, bruised, and boiled down in a 
quart of water to one pint, and given at once as- a clyster. From ten to 
twenty grains of tartar emetic, dissolved in a pint of warm water, will 
produce nearly similar- effects (Journ., pp. 85-87). 
Strangury 
removed by 
this injec- 
tion. 
paration of 
the enema. 
Dysentery and Diarrhoea.—These affections of the bowels are Nature’s efforts-to expel 
diseased matters from the blood, and must never be suppressed; but nature must be assisted 
by a free use of Brandreth’s Pills, which are absolutely certain to cure if used before the 
powers of life are exhausted. 
Dr. Clark’s method is vastly superior to opium or any of the astringent remedies so 
readily prescribed by the generality of medical men. But Brandreth’s Pills are certain and 
commit no mistakes. If convenient, an ejection of pure water, about summer heat, will be 
found to comfort the bowels, but the cure depends upon purging the humors from the blood. 
Hamilton, James, M. D., Physician to the lioyal Infirmary and various 
Hospitals in Edinburgh. Observations on the Utility and Admin- 
istration of Purgative Medicines in Various Diseases. Edinburgh, 
1805, 8th edit., 1833. 
236. The history of medicine clearly shows that theory or reasoning- 
lias contributed in no small degree to impede its progress. 
Let it be our endeavor, by circumspect induction from facts, to estab- 
lish sound principles which may lead to the discovery of other facts, and 
these again to the introduction of more general doctrines, or a compre 
hensive and connected theory of medicine (p. 21). 
Theory 
RETARDS, 
facts AD- 
VANCE trite 
medicine. 
237. The nutritious part of our food is prepared and separated by 
the changes which it undergoes in the mouth, oesophagus, stomach, and, 
with the assistance of fluids secreted from the liver, pancreas, and spleen, 
is perfected in the smaller intestines; while the lacteal vessels, opening 
on their internal surface, absorb and convey the nutrimental fluid into 
the circulating system. The residue of the food, which is not adapted 
to afford nourishment, constitutes part of the fecal evacuation which is 
made directly from the intestinal canal (p. 21). 
The mode 
of digestion. 
Functions 
of the stom- 
ach and in- 
testines. 
288. This fecal residue is discharged into the more capacious colon, 
where the ilium enters it by a lateral opening, so contrived that the 
contents of the colon cannot be returned. This circumstance makes a 
distinction between the functions of the smaller and larger intestines, 
which is not commonly noticed. The former complete the preparation 
of the nourishment, and afford opportunity of its being absorbed; while 
the latter receive and detain the fecal part till after it has accumulated, 
and, perhaps, undergone certain changes, when it is voided in a given 
quantity and at stated intervals (p. 22). 
The colon. 
The big and 
small intes- 
tines. 
289. Besides, the intestines exhale and throw off fluids which have 
became noxious in consequence of changes which they undergo in the 
body. The intestinal canal, therefore, serves the double purpose of 
repairing waste and of preventing decay. In this latter function, which 
I am solely to consider, the intestines co-operate with the other secretory 
Double 
function of 
the intes- 
tines. THE DOCTRINE OF PURGATION. 
Vicarious 
.function of 
organs. 
Pretention 
of fecal 
matter 
causes dis- 
ease ; regu- 
lar diges- 
tion neces- 
sary for 
health. 
organs, the skin, the lungs and kidney. All these organs have, in re- 
spect of this their common relation to the system, a dependence upon one 
another, and any of them will compensate, to a certain extent and for a 
limited time, the interrupted action of the others. Nevertheless, their full 
activity is necessary to the enjoyment of perfect health, and the contin- 
uance of life; and the regularity of the intestinal evacuation is connected 
in a particular manner with the well-being and healthy state of the 
stomach and intestines themselves. The urine and perspirable matter 
pass off immediately after being secreted, and do* not load the organs 
which separate them. The unnatural detention of these excretions has 
indeed a more or less remote, and often fatal, effect upon the general 
system, but the skin and the kidney remain uninjured. It is otherwise 
with the intestines : secluded from that communication with the atmos- 
phere by which the perspirable matter is carried off, and unprovided 
with an appendage resembling the urinary bladder connected with the 
kidneys, they are the reservoirs of fecal matter as it is poured out, which 
they retain till the accustomed period of evacuation comes round. Dif- 
ferent circumstances are apt to induce irregularity in this evacuation; 
these, together with the facility with which the larger intestines admit 
of distension without uneasiness being excited, give frequent oppor- 
tunity for a progressive accumulation of feces, whence arise interrupted 
action of the stomach and smaller intestines, and consequent dangerous 
and fatal ailments (p. 22). 
Evacua- 
tions.— 
Their ap- 
pearance 
indicative 
of either 
health or de- 
rangement of 
the bowels. 
290. In infancy, the alvine evacuation is frequent, and the faeces are 
abundant and fluid. In mature years the body is generally moved once 
in twenty-four hours, and the faeces, although soft, preserve a form too 
well known to require description; they are of a yellow color, and they 
emit a peculiar odor. When, therefore, the faeces are evacuated less 
frequently than the age of a person demands ; when they are indurated; 
when they change their natural color and odor, derangement of the 
stomach and bowels is indicated, and the approach of disease, if dis- 
ease be not already formed, is to be apprehended. For it is not to be 
imagined that organs of so great importance in the animal economy as 
the stomach and bowels are, can be long in a state of inaction, and the 
general health remain unimpaired (p. 23). 
Peristal- 
tic motion 
of the bow- 
els, if inter- 
rupted by 
constipa- 
tion, causes 
excrementi- 
tious accu- 
mulations 
producing 
disease. 
Its cure by 
purgation. 
291. The propulsion of the contents of the intestines is effected by 
means of a vermicular, or, as it has been called, a peristaltic motion of 
the bowels from above downwards ; hence torpor, or loss of tone in the 
muscular coat of the intestines, by which this motion is thought to be 
interrupted, is understood to be the cause of much distress, and tonic or 
stimulant medicines are employed to remedy this torpid state. I use 
this language, and speak of torpor of the bowels, although my ideas 
respecting it do not correspond with those of others. I am inclined to 
think that the symptoms referred to loss of tone proceed, in many 
occasions, more directly from the impeded peristaltic motion, the conse- 
quence of constipation. In this situation we may easily understand 
that the distended colon cannot, for want of space, receive the contents 
of the smaller intestines, which will of course stagnate throughout the 
whole canal; the action of which being thus interrupted, will soon alto- 
gether cease, and be at last inverted. The various ailments which THE DOCTRINE OF PURGATION. 
thence ensue, are daily before our eyes; and the relief which, under 
these circumstances, we observe to follow soon after the exhibition of a 
purgative, and the cessation of complaint which takes place upon its 
operating freely by stool, are in proof that this opinion is wrell founded. 
If \ again, we farther consider that the greater part of the exhalations 
made into the cavity of the intestines is excrementitious, and will, if re- 
tained beyond the usual period, undergo changes and acquire injurious 
acrimony : and if, moreover, we advert to the sympathy which many of 
the organs of the complicated animal frame have with the stomach and 
intestines, we cannot but recognize the great influence which these must 
possess over the comfort, the health, and the life of the individual 
(p. 24). 
292. These are weighty considerations, and ought to excite our 
attention to any irregularity of the divine evacuation. The necessity of 
this will farther appear when we reflect that many circumstances, unavoid- 
able in social life, expose mankind in a peculiar manner to constipation ; 
such as improper food, intemperance, sedentary occupations in confined 
or otherwise tainted air. Besides, in a therapeutic view, we are encour- 
aged to exercise this attention. It is admitted that diaphoretic and 
diuretic medicines employed to remedy interrupted secretion by the 
skin and kidney, operate circuitously, often possess deleterious qualities, 
or are uncertain and irregular in their effects ; while the means of re- 
moving constipation act directly on the seat of disease, are safe, and 
seldom disappoint us in the attainment of our object (p. 25). 
Constipa- 
tion—its 
causes 
Constant 
attention to 
the state of 
the diges- 
tion recom- 
mendable. 
293. In the dawm of physic, purgatives were employed. But, 
although they have been recommended by the earlier as well as by later 
tvriters, and although the indications they are meant to fulfill have been 
an object of attention to the practitioners in all ages, yet I do not think 
that the extent of their utility has been always clearly perceived, or that 
their administration has been always properly directed (p. 27). 
gfjje £ 
sufficiently 
atef.r6Cl 
294:. Another objection to the use of purgatives is urged with a force 
that seems to carry conviction along with it. It is observed that the 
constant application of stimulating articles creates a habit not only of 
using them, but entails also the necessity of occasionally increasing their 
stimulating power. Habit or custom will indeed reconcile us to the im- 
pression produced by unusual stimuli, and will counteract their effect in 
such a manner, that if the stimulus be suddenly withdrawn, or, which 
is the same thing, be not gradually increased, the functions of the organ 
to which it had been applied will become languid and irregular. Ibis 
law of the economy no doubt extends to the promiscuous use of purga- 
tives given unnecessarily during the enjoyment of perfect health. In 
many instances, however, of disease, constipation and accumulation of 
faeces demand this stimulus to restore the healthy state of the intestines, 
and to promote the expulsion of their indurated contents. In propor- 
tion as these objects are accomplished, the stimulus from the same pur- 
gative becomes more and more powerful ; and so little is the necessity 
for continuing it, or for increasing its dose, that, on the contrary, were 
regulate the 
0fPpu?galive 
medicines, THE DOCTRINE OF PURGATION. 
not the activity of the purgative diminished, or were it not withdrawn 
altogether, as convalescence advances, we should be in danger of in- 
ducing weakness by an excess of purging (p. 29). (Cf. Hipp. 16.) 
295. Purgative medicines, properly administered, will not induce 
debility / on the contrary, the bowels being excited to propel their con- 
tents, their functions are restored, appetite and digestion improved, and 
the patient, so far from being weakened, is nourished, supported, and 
strengthened. (29.) 
remove»hat 
unty. 
296. Purgative medicines have also been thought unnecessary on 
this account, that in many diseases little food is taken ; and, therefore, 
regular alvine evacuations are neither requisite nor to be expected. The 
residue oj food unfitJOT the purpose of nutrition contributes, no doubt, its 
share of feculent matter ; yet the abundant secretion from different or- 
garis, and the exhalation of excrementitious fluids made into the cavity 
°f ie constitute the bulk of the faeces collected within them, 
So long, therefore, as fluid is supplied, and so long as the circulation is 
supported, it is equally easy to understand how fteces are produced, 
independently of much solid food, as to perceive the necessity of their 
daily evacuation during the course of fever, and of other diseases of 
long continuance (p. 30). 
„ 
mentitious 
Tfafare 
vffthhut 
uTa' 
turn justi- 
fied' 
297. I refer the superior utility of purgative medicines in typhus 
fever to the circumstance of their operating throughout the whole extent 
of the intestinal canal, the healthy functions of which are essential to 
tjie recovery, in a manner that is consonant to the course of nature, by 
propelling its contents from above downwards, and to their moving and 
completely evacuating the feculent matter, which in this case becomes 
offensive and irritating (p. 85). 
feverphws 
Purgation 
why eonso- 
ture. ° "' 
ningtoend. 
298. More extended experience confirmed these conjectures; and I 
was gradually encouraged to give purgative medicines during the course 
0f typhus from the commencement to the termination of the disease 
(ibid.) 
299. I have directed a strict attention to this practice for a long 
time, and I am now thoroughly persuaded that the full and regular 
evacuation of the bowels relieves the oppression of the stomach, cleans the 
loaded and parched tongue, and mitigates thirst, restlessness, and heat of 
surface, and that thus the later and more formidable impression on the 
nervous system is prevented, recovery more certainly and speedily pro- 
moted, and the danger of relapsing into fever much diminished (ibid.) 
gation fits 
hffjfial 
Purgation 
moving de- 
300. For many years past I have found wine to be less necessary (in 
typhus fever) than I formerly thought. . . This chiefly attributed to the 
purgative medicines which I employed with freedom, obviating and re- 
moving symptoms of debility. This doctrine is at variance with that THE DOCTRINE OF PURGATION. 
which is commonly entertained, but I am confident it is'consonant to the 
fact (p. 36). 
301. The complete and regular evacuation of the bowels, in the course 
of fever, is the object to be obtained (ibid.) 
PurgaVon 
the thing 
needful in 
fever. 
302. The early exhibition of purgatives relieves the first symptoms, 
prevents the accession of more formidable ones, and thus cuts short the 
disease (p. 37). 
Early pur- 
gation an 
axiom. 
303. I had learned that the symptoms of debility which take place in 
typhus fever, so far from being increased, were obviously relieved by the 
evacuation of the bowels. I have never in scarlatina, in a long course of 
experience, witnessed sickness and fainting, which some authors have so 
much dreaded; neither have I observed revulsion from the surface of 
the body and premature fading, or, in common language, “ striking in ” 
of the efflorescence, to follow the exhibition of purgatives (p. 45). 
Accordingly no variety of the disease has hitherto prevented me 
from following out this practice to the extent which I have found neces- 
sary (p. 46). 
purgation 
fmfdn f 
i)hus; cures 
ver, and 
striking °in. 
304. Purgative medicines are useful in removing dropsical swellings 
the consequence of scarlatina, when the weakness of the patient is often 
very great. Purgatives also afford a means of preventing this swelling, 
and other derangements of health (ibid.) 
Dropsical 
swelling 
prevented 
and removed 
by purga- 
tion. 
305. When I consider the languor and lassitude which precede mar- 
asmus, instead of adopting the common opinion of its being occasioned 
by worms, I am more disposed to think that a torpid state, or weakened 
action of the alimentary canal, is the immediate cause of the disease, 
From this proceed costiveness, distention of the bowels, and a peculiar 
irritation, the consequence of remora of the faeces ; and I have accord- 
ingly been long in the habit of employing purgative medicines for the 
cure of marasmus / the object is to remove indurated and foetid faeces, 
the accumulation perhaps of months, and as this object is accomplishing, 
the gradual return of appetite and vigor mark the progress of recov- 
ery (p. 59). 
fffrptd 
bowels, con- 
eases and 
purgatives. 
306. Epilepsy, than which no disease is so afflicting to the patient, is 
frequently the effect of particular irritation of the mind or body. Prac- 
titioners enumerate worms in the intestines, or marasmus, among the 
causes of epilepsy. Surely this will induce us, on the first attack of' epi- 
lepsy in children, arising from an uncertain cause, to set on foot the most 
decided and active course of purgative medicines, lest wre peradventure 
allow the disease to strike root, while we are idly employed in the exhi- 
bition of inert and useless vermifuge medicines, or are groping in the 
dark in quest of other causes of the disease, or of uncertain remedies 
for their removal (pp. 63, 64). 
Epilepsy. 
to be taken. THE DOCTRINE OE PURGATION. 
Chlorosis. 
Fearful re- 
sults of cos- 
tiveness. 
307. Chlorosis.—The slightest attention to the history of the disease 
evinces that costiveness precedes and accompanies the other symptoms. 
Costiveness induces the feculent odor of the breath, disordered stomach, 
loss of appetite, and impaired digestion. These preclude a sufficient 
supply of nourishment at a period of growth when it is most wanted ; 
hence paleness, laxity, flaccidity, the nervous symptoms, wasting of the 
muscular flesh, languor, debility, the retention of the menses, the suspen- 
sion of other secretions, serous effusions, dropsy, and death (p. 71). 
308. The greater capacity of the female pelvis gives more room for 
that part of the intestinal canal which is contained within it to dilate, 
and, of course, to admit of greater accumulation of feculent matter, which, 
in proportion to its remora, becomes more and more abundant, and more 
impacted. Hence costiveness is more obstinate, and chlorosis and other 
dise ises originating in costiveness, are more severe and are of more diffi- 
cult cure in the female than the male (p. 72). 
w n 
requiff/uii 
more0 than 
men- 
to escape 
failure 
and fear- 
les&iy. 
iNSP'tr 
the stools, 
309. Great attention and assiduity is requisite in the exhibition of 
purgative medicines in chlorosis, and the frequency of its repetition must 
be varied according to circumstances, which can only be ascertained by 
the inspection of the “ divine egesta.” The practitioner who is not aware 
this, and who, yielding to the importunity of his patients, or the 
caprice of their relations, does not steadily pursue his plan of cure, will 
be disappointed, his abilities will be called in question, and his practice 
vilified and neglected (p. 73). 
its 
movPednby' 
purgation, 
gativeUrri- 
subside*001* 
su su.es. 
310. The symptoms (of hysteria) undoubtedly denote a preternatural 
affection of the stomach and alimentary canal. In my opinion they 
aff°rd conclusive evidence that this affection is primary, and that the 
other multifarious symptoms of hysteria depend upon it (p. 87). The 
first purgatives that we use may seem on some occasions to aggravate 
the symptoms, but the practice must not be deserted on that account. 
ie additional irritation which purgatives may give in the first instance 
8oon passes away, and perseverance in the use of them removes that irrita-. 
tion which gave rise to the disease, which, of course, disappears in pro- 
portion as the bowels are relieved of the oppressive mass of accumulated 
faeces (p. 88). 
311. St. Vitus’ Dance.—Powerful purgatives must be given in suc- 
cessive doses, in such manner that the latter doses may support the effect 
°f the former, till the movement and expulsion of the accumulated mat- 
ter are effected, when symptoms of returning health appear. Whoever 
undertakes the cure of chorea by purgative medicines must be decided 
rm to his purpose. The confidence which he assumes is necessary 
to carry home to the friends of the patient conviction of ultimate suc- 
cess. Their prejudices will otherwise throw insurmountable obstacles in 
his way. Half measures in instances of this kind will prove unsuccess- 
ful, and were it not for pei'severance in unloading the alimentary canal, 
the disease would be prolonged, would place the patient in danger, and 
thus bring into discredit a practice which promises certain safety (p. 97). 
dance™**' 
Let the 
Yfontimud 
Small*'doses 
dangerous, 
antfperseve- 
ffjufo' THE DOCTRINE OE PURGATION. 
312. The agonizing spasms, the prominent symptoms of tetanus, have 
arrested the notice of every one. To resolve the spasm and to cure the 
disease have been conceived to be one and the same thing. Accordingly, 
opium, musk, warm bathing, cold bathing, and mercury, have been em- 
ployed in tetanus. But have they mitigated the severity of tetanus or 
obviated its fatal tendency ? “ The records of physic bear a sad testi- 
mony in the negative.” However just these observations may be, I 
should yet have been sorry to have advanced anything to shake the tot- 
tering fabric of medical practice in tetanus unless I thought it had been 
in my power to substitute one more efficacious, originating in other 
views of the disease. These views, I apprehend, will warrant the expec- 
tation of considerable benefit from the full and free exhibition of purga- 
tive medicines (pp. 107, 108). 
Tetanus 
cannot be 
cured by 
“ antispa s- 
modics 
but by free 
and full 
purgation. 
“ The tot- 
tering fabric 
of medical 
practice.” 
313. Under the impression which I entertain of the utility of pur- 
gative medicines, and of the inefficiency of the tonic plan of treatment 
in tetanus, no doubt remains with me respecting the mode of attempt- 
ing the cure of hydrophobia, which has hardly in any instance yielded 
to the most powerf ul antispasmodics. Purgatives are proposed to remove 
a cause which frequently induces, and which may always aggravate 
spasmodic affections (p. 123). 
nydro- 
314. Palpitation of the heart merits particular notice in this place. 
I have witnessed the efficacy of purgative medicines in the most forbid- 
ding and apparently desperate instances of the ailment, in so much, 
that I am not now disposed to despair of any case, till I am satisfied 
that purgative medicines have been fully employed, and employed in 
vain (p. 122). 
Paipita- 
heah°f The 
cases 
315. I am persuaded that the preservation of regularity in the alvine 
evacuation, will at all times prevent the accession of those diseases (pre- 
viously enumerated). If these expectations be not too sanguine, it is 
likely that the marasmus and chlorosis, the vomiting of blood, chorea, 
and hysteria, of which I have spoken, wTill rarely, if ever, appear. It 
is fitting, therefore, that this observation should be widely spread, that 
it should be conveyed to mothers and nurses, to superintendents of nur- 
series, of manufactories, and of boarding-schools, and to all instructors 
and protectors of children and young people, and strongly impressed on 
their minds, by such of their medical advisers as think with me, and 
who will acknowledge that to prevent disease is the paramount duty 
(p. 125). (Cf. Sanctorius, Apli. 1., Sect. I.) 
AN APPEAL 
TO ALL 
CLASSES: 
“ Keep the 
bowels regu- 
lar and thus 
prevent all 
forms of dis- 
ease. 
316. The practice which leads to this conclusion (the free use of pur- 
gatives in the case of diseases), is presented in a simple form. It is nei- , 
ther disguised by hypothesis, nor obscured by the simultaneous employ- \ 
ment of various remedies. At the same time it is supported by proofs 
of unquestionable authenticity, which are not surpassed by any in the 
records of medicine. On these accounts, the truth or fallacy of my 
opinions may be easily investigated, and an adequate judgment of them 
6 
The pur- 
gative plan 
justified— 
the proofs 
irrefraga- 
ble. THE DOCTRINE OF PURGATION. 
readily formed (p. 114). Here follow upwards of fifty cases of cure in 
various diseases, extracted from the records of the Royal Infirmary. 
Chronic 
diseases re- 
quire the 
fullest pur- 
gation. 
317. The steady exhibition of purgative medicines is absolutely nec- 
essary to the success of the practice in chronic diseases. The puny state 
of the sufferer may on some occasions excite alarm in the breast of the 
practitioner; and the caprice of his patient, and the whims of relatives, 
may oppose obstacles to his conducting the cure in the most advantage- 
ous manner. But these he must disregard ; for unless he can suppress 
his own improper feelings, and overcome the unreasonable objections of 
others, he had better not adopt measures which, to prove successful, must 
be conducted with firmness. A contrary conduct will necessarily term- 
inate in the vexation of the practitioners, in the disappointment of the 
patient and of his relatives, and in the discredit of that practice which 
it has been my wish and study to recommend (pp. 124, 125). 
Half meas- 
ures bring 
discredit on 
the cauBe. 
318. Diseased actions depend on the nature of the impressions, the 
parts on which they are made, and on the constitution of the patient. 
The same impression applied to different parts of the body may produce 
different actions; cold to the extremities producing chilblains, or gan- 
grene ; to thg head catarrh ; to the chest cough or pleurisy (p. 125). 
Location 
determines 
the nature of 
the disease. 
319. To conclude, the reader must have observed the beneficial 
effects of purgative medicines, in diseases apparently different, and inci- 
dent to people at various periods of life. The facts are undeniable, and 
serve to prove the extent and importance of the subject; but of these I 
do not feel it to be incumbent on me to give any explanation at present. 
Such an attempt might be premature. I am satisfied to have established 
certain leading facts, and to have opened views which, if properly pros- 
ecuted, must give an opportunity to extend our knowledge respecting 
the utility and administration of purgative medicines. It will then be 
time to generalize the facts, and to form a system of medical doctrines 
at once clear and comprehensive, and thence to deduce practical pre- 
cepts useful in proportion as they will be simple and precise. When 
THESE EXPECTATIONS ABE FULFILLED, OUB POSTERITY MAY SEE DECEPTIVE 
SEASONING, HOW INGENIOUS SOEVEB, BANISHED FBOM THE SCHOOLS OF 
MEDICINE, AND FBOM THE PBACTICE OF THE HEALING ABT A MULTIFAEIOUS 
PRESCBIPTION OF INERT AND NAUSEOUS MEDICINES (pp. 125, 126). 
Facts alone 
establish re- 
liable sci- 
ence. 
Practical 
experience 
must super- 
sede theoret- 
ical schemes, 
and simple 
remedies the 
rubbish of 
the materia 
medica. 
IMPORTANT SEKIES. 
McMullin, Joan, M. D., On the treatment of Chorea Sti. Viti, by 
purgatives. See Edinb. Med. and Surg. Joukn., 1805, Vol. 1. 
320. Many diseases of symptomatic debility, which have resisted the 
use of tonics, have either been considered as incurable, or our failure 
has been ascribed, not to our pursuing an erroneous method of treat- 
ment, but to our means having been too feeble, or employed too late; 
and obstinately persisting in the tonic plan, on each succeeding occasion, 
The ton 'c 
plan a fail- 
ure. THE DOCTRINE OF PURGATION. 
we push it with greater vigor and with the same want of success. There 
are, however, fortunately, practitioners who act more philosophically, and 
regarding with distrust theories which do not stand the test of experi- 
ence, endeavour to advance the science of medicine by the slow but sure 
method of observation and induction. It is in this way that we some- 
times find a disease yielding to a plan of treatment diametrically oppo- 
site to that which the established opinions concerning its nature would 
have suggested (p. 25). 
321. With the view of alleviating the sufferings of those laboring 
under similar complaints, and of correcting the erroneous ideas enter- 
tained of the nature of the disease, I am induced to publish some 
observations which occurred to me in consequence of having witnessed 
the cure of some cases of Chorea Sancti Viti in the Royal Infirmary of 
this place (Edinburgh). In these cases, a mode of treatment was adopted 
which no opinion of the disease hitherto published seemed to authorize; 
although in every instance it was attended with the most marked advan- 
tages. This treatment consisted in the repeated frequent exhibition of 
drastic purgatives, which will appear on perusing the following cases 
not to have had the effect of debilitating still more an apparently debili- 
tated system ; but on the contrary, during their employment the patient 
recovered strength, the involuntary motions gradually abated, and by 
persisting in this treatment for a short time, a perfect cure was effected. 
What is particularly worthy of observation, is the appearance of the di- 
vine discharges, which in every instance was black and fetid (p. 26). 
Here follow five cases. 
St. Titus' 
dance. 
Cure by 
drasticpur- 
gatives;— 
they do not 
debilitate, 
l)ut 
strengthen. 
322. From these cases, the following facts seem to be established : 
1. From the exhibition of even two or three cathartics, the involun- 
tary motions and other symptoms were much abated. 
2. Although the cathartics were continued daily for a considerable 
length of time, the patient, instead of becoming more debilitated, became 
stronger and walked with a firmer pace. 
3. During the progress of the cure, if at any time the cathartics did 
not produce an evacuation, the involuntary motions recurred, and all 
the symptoms were aggravated. 
4. Tiie faeces before the exhibition of the cathartics, were small in 
quantity, required a large dose of the purgatives, and in every instance 
were black and fetid. And lastly, 
5. When the disease was cured, the appearance of the faeces became 
natural (p. 30). 
General 
advantages 
from purga- 
tion. 
323. Upon the whole, the connection of the disease with the state of 
the intestinal discharges seems evident; and as in all the five cases fetid, 
dark-colored evacuations preceded the cure, it would appear that, with \ 
them,, the cause of the disease was removed. We may, therefore, legiti- 5 
mately conclude that the involuntary motions, debility,. and other symp- 
toms,, were in these cases produced by local irritation in the bowels, 
which was afterwards communicated to the whole system, through the 
medium of the nerves (p. 31). 
Disease 
from intes- 
tinal impu- 
rities. THE DOCTRINE OF PURGATION. 
andhePurga- 
compared*19 
324. All systematic writers have considered chorea as a disease of 
debility, and the same opinion has been almost universally adopted by 
Pract'cal physicians, who, seeing their patients laboring under evident- 
debility, have ransacked the whole materia medica for tonics and anti- 
spasmodics. Under this treatment, chorea lias always been considered 
very difficult to cure. How, when we compare the frequent failures of 
the tonic plan of cure with the invariable success of the purgative, we 
must conclude, in direct opposition to the hypothetical dogma of Brown, 
that the symptoms of chorea do not depend primarily on debility, but 
that the debility is merely symptomatic <f the disease. But in whatever 
manner the phenomena of these cases may affect the theory of the dis- 
ease, they establish incontrovertibly a much more important conclusion 
—that it yields readily to the repeated and ccmtinued use of drastic 
purgatives (pp. 33, 34). 
Abernetiiy, John, M. I)., Surgical Observations on the Constitutional 
Origin and Ireatment of Local Diseases. London. 1806. Eighth 
Edit., 1826. 
Sympathy 
between the 
viscera and 
other parts 
of the body. 
325. That the stomach and bowels are disordered by injuries and dis- 
eases of the parts of the body has been remarked by various persons ; 
but the subject has never been extensively surveyed, nor viewed with 
that accuracy of observation which its high importance merits. It has 
been observed that sprains of tendinous or ligamentous parts produce 
sudden sickness; and Mr. Hunter has attributed that shivering which 
is consequent to accidents, and attendant on some diseases, to the state 
of the stomach. It is known that in some local injuries from accident or 
operations, the stomach has appeared to be the part principally affected. 
But remarks on the affections thus induced in the digestive organs have 
been made only in a cursory manner. ... It also appears to me, that 
the connection of local diseases with the state of the constitution in gen- 
eral is either not sufficiently understood, or not duly regarded by the gen- 
erality of practitioners (p. 5). 
326. The operation for hernia (in a certain case) was followed by 
general disorder of the system, manifested by a full and strong pulse, 
furred tongue, great anxiety, restlessness, and total want of sleep. The 
stomach was particularly affected, being distended, uneasy on compres- 
sion, and rejecting everything that was swallowed. He was bled largely 
in the evening, and took saline medicines, but could not be prevailed 
upon to swallow anything else except some toast and water. The sick- 
ness had in some degree abated on the next day, a solution of sulphate 
of magnesia in mint-water was prescribed, in small doses, given at regu- 
lar intervals, in order to relieve the disorder and distension of the stom- 
ach by procuring discharges from the bowels. In the course of the day 
the salts were administered which were not rejected by the stomach ; 
yet he could scarcely be prevailed upon to take anything else. The 
tongue was still covered with a thick yellow fur; the skin was hot and 
dry, and the pulse frequent. As there was no particular tenderness 
about the epigrastic region, he was not again bled. The second night 
was passed without sleep. As the salts had produced no effect, the same 
Hernia 
from accu- 
mulation of 
fetid matter 
—advantage 
of persever- 
ance in the 
purgative 
plan. THE DOCTRINE OF PURGATION.' 
medicine was ordered in an infusion of senna, with the addition of some 
of its tincture, which by being given in very small doses, was retained. 
When, however, it seemed likely that no effect would result from this 
medicine, a grain of calomel was given at night, and repeated on the 
following morning. Still the loathing of food continued. The third 
night passed like the former ones without sleep, and in great anxiety. 
On the next morning two pills, containing five grains of the pil. colo- 
cynth and the same quantity of the pil. aloes cum myrrha, were given 
every fourth hour. They procured no stool, nor produced any sensation 
which inclined the patient to believe they would operate. Again he 
passed a sleepless night, but toward the morning he felt his bowels 
apparently filling, to use his own expression, and a profuse discharge 
ensued. A dozen copious, fetid and black evacuations took place 
between five and ten o'clock, and he had several others in the course 
of the day ’ after which his appetite returned, his tongue became clean, 
and a sound and pleasant sleep succeeded, from which he awoke appa- 
rently well (pp. 7-10). 
327. It is most probably the disorder of the brain first affects the 
stomach / but the reaction of the latter affection is liable to increase and 
maintain the former, by which it had itself been produced. The effects 
that result from the sympathy of the whole constitution with local 
disorder vary greatly both in nature and degree (p. 8). I could relate 
numerous cases in support of the inference, that local irritation acting 
on the nervous system may affect the digestive organs in a very serious 
manner, and thereby create great disorder of the whole constitution, 
which is afterward alleviated in proportion to the amendment that en- 
sues in the state of those viscera. Such cases of great local irritation must 
frequently occur to every one; it is, therefore, unnecessary to adduce 
more instances to support the opinions here delivered (p. 12). 
The whole 
system sym- 
pathizes 
with its ev- 
ery part. 
328. With respect to the treatment of cases of this description, it 
may be right to add, that the primary object should be to produce secre- 
tion from the irritable organs. In the case which has been related, and 
in many others recorded in tins volume, the effect of secretions from the 
disordered organs in relieving their irritable state is very manifest. In 
many instances opium will not prevent the continual efforts to vomit, yet 
when by sulphate of magnesia, or purgatives administered in the farm 
of pills and clysters, stools are procured, the vomiting ceases, the stom- 
ach retains both food and medicine, and general tranquillity of consti- 
tution is as suddenly restored (p. 13). 
Spontane- 
ous vomit- 
ing not to be 
cured by 
opium l>ut 
by purga- 
tives. 
329. A slighter degree of disorder occurs in the advanced stages of 
lumbar abscesses, diseased joints, compound fractures, and all kinds 
of local disease, which impart considerable and continued irritation to 
the whole constitution. We also find a less important disease, as, for 
instance, a fretful ulcer, keep up a disorder of the system in general, 
and of the digestive organs in particular, which subsides as the irritable 
state of the ulcer diminishes (p. 17). 
Every ex- 
ternal dis- 
ease in con- 
nection with 
the digestive 
organs. 
330. If the brain and nervous system should be disordered, without 
any apparent local disease, similar derangements may be expected to 
take place in the functions of the digestive organs (p. 18). 
The nerv- 
ous system 
and the di- 
gestive or- 
gans. THE DOCTRINE OF PURGATION. 
331. Patients commonly declare that they are in good health, except 
that they feel disturbed by their local complaints; yet they are found, 
on inquiry, to have all the symptoms . which characterize a disordered 
state of the digestive organs. The mind is frequently irritable and des- 
pondent ; anxiety and languor are expressed in the countenance. The 
pulse is frequent or feeble, and slight exercise produces considerable 
fatigue and perspiration. The patients are sometimes restless at night, 
but when they sleep soundly they awaken unrefreshed, with lassitude, 
and sometimes a sensation as if they were incapable of moving. Slight 
noises generally cause them to start, and they are, to use their own ex- 
pression, “ very nervous.” These circumstances seem to indicate weak- 
ness and irritability of the nervous and muscular systems, which, in 
addition to the disorder of the digestive organs, are the chief circum- 
stances observable relative to the general health. By correcting the 
obvious errors in the state of the digestive organs, by the judicious 
administration of purgatives, local diseases, which had baffled all 
attempts at cure by local means, have speedily been removed, and the 
patient has acknowledged that such an alteration has taken place in his 
general health as greatly excited his surprise (pp. 21, 22). 
Thorough 
examination 
of the pa- 
tient neces- 
sary. 
“ Restless- 
nesx and 
nervous- 
ness” from 
disordered 
digestion. 
332. When digestion is imperfect, gaseous fluids are extricated from 
the alimentary matters. Vegetable food becomes acid, and oils become 
rancid. TJneasy sensations are also felt, and undigested aliment may be 
found in the faeces (p. 24). 
Imperfect digestion must influence the qualities of the blood, and all 
parts of the body may be affected from this source (p. 65). 
Disorders of the digestive organs may produce, in the nervous sys- 
tem, a diminution of the functions of the brain, even so as to produce 
apoplexy and hemiplegia (p. 70). It may produce, in the muscular sys- 
tem, weakness, tremors, and palsy, or the contrary affection of spasms 
and convulsions. It may excite fever, by disturbing the action of the 
sanguiferous system, and cause various local diseases, by the nervous ir- 
ritation which it produces, and by the weakness which is consequent on 
nervous disorders or imperfect chylification (pp. 71, 72). 
Imperfect 
digestion— 
various ef- 
fects : pro- 
duces gas ; 
impoverish- 
es the blood; 
disorders 
the brain, 
the muscu- 
lar system, 
&c.; i. e. 
causes local 
diseases. 
333. Being in a warm and moist place, the undigested food will un- 
dergo those chemical changes natural to dead vegetable and animal mat- 
ter ; the vegetable food will ferment and become acid, the animal will 
grow rancid and putrid. . . These effects must continually take place, 
unless, by the digestive power of the stomach, the food is converted into 
a new substance which is not liable to these chemical changes. Such 
irritating compounds cannot fail to be detrimental to the whole tract of 
the alimentary canal. Part of the food thus changed will be absorbed 
from the bowels and render the blood impure, from which there is no 
outlet for various kinds of matter but through the kidneys, and this may 
prove a cause of foul urine, as well as of the presence of many sub- 
stances in that fluid not natural to it (pp. 74, 75). 
Indigestion 
or constipa- 
tion—fur- 
ther effects 
of. 
All pur- 
gatives are 
not equally 
efficient. 
334. Persons may be purged without having their bowels cleared of 
the fecal matter which may be detained in them. We should therefore 
endeavor to ascertain what kind or combination of purgative medicine 
will excite a healthy action of the bowels (p. 89). THE DOCTRINE OF PURGATION. 
335. Thz principle that should govern our conduct in the adminis- 
tration of purgatives may be briefly stated ; the excitcLnent is to be re- 
peated till the requisite action is induced, yet no single excitement being 
such as may prove an irritant to the organs (ibid.) 
How to re- 
gulate the 
administra- 
tion of pur- 
gatives. 
336. I am aware that laxative medicines may relieve irritation merely 
by augmenting the natural secretions of the viscera, and thus unloading 
their vessels; and also by determining the fluids from the head, when 
the nervous symptoms are aggravated by a plenitude of the vessels of 
the brain. As I have found the lenient plan of treatment—that of ex- 
citing the peristaltic action of the bowels, so as to induce them to clear 
out the whole of their contents, without irritating them (so as to produce 
what is ordinarily called purging), particularly successful—I have rarely 
deviated from it. I am not, therefore, warranted from experience in 
speaking decisively respecting the more free use of purgative medicines 
(pp. 90, 91). 
Laxative 
medicines—- 
their effect. 
The lenient 
plan. 
337. The most judicious treatment will not remedy the disease if the 
exciting causes continue to operate—such as improprieties of diet, agita- 
tion of mind, sedentary habits, or impure air (p. 96). 
Disease 
cannot be 
cured while 
its cause 
continues. 
338. It is necessary to the cure of disorder, first, that the stomach 
should thoroughly digest all the food that is put into it; secondly, that 
the residue of the food should be daily discharged from the bowels 
(pp. 99, 100). 
What is 
necessary 
for cure ? 
339. The profuse discharges which sometimes follow the continued 
exhibition of purgatives consist of morbid secretions from the bowels 
themselves, and not of the residue of alimentary matter detained in 
those organs (p. 35). 
The stools, which resemble pitch, are principally composed of diseased 
secretions from the internal surface of the intestines (p. 36). 
Character 
of evacua- 
tions. 
340. All the experience which I have had relative to the treatment 
of tetanus (locked-jaw) has convinced me that more benefit is obtained by 
correcting the errors of the digestive organs than by any other means. It 
may be useful to mention one case as a striking proof of this fact: A 
man who had been wounded in the foot, was brought about ten days 
after the accident to the hospital, and so violent and general were the 
spasms that it was scarcely expected he could be taken to his bed alive. 
The jaw was fast clenched, and the muscles of his back and belly rigid; 
convulsive actions came on frequently, and then all his limbs were vio- 
lently affected. His bowels had not been relieved for many days. When, 
after twenty hours, his bowels were purged, the discharges were not like 
feces, and so extremely offensive that the patient could not stay in the 
ward. From this time, however, there was a complete subsidence of the 
spasm, and the patient recovered seemingly in proportion as the digestive 
organs regained their healthy functions (p. 130). 
Tetanus 
from consti- 
pation. 
Purgation 
necessary in 
all external 
lesions. 
341. A female patient, about twenty-seven years of age, was lately 
admitted into the hospital for paralysis of the arm, which had come on 
suddenly. She complained of much pain when pressure was made along 
Paralysis 
from neg- 
lected sta’e 
of the bow- 
els ; cure by THE DOCTRINE OF PURGATION. 
continued 
purgation. 
the outer margin of the scalene muscles,- where the nerves emerge that 
form the axillary plexus. Her digestive organs were greatly disordered, 
and, in one week, by means that could only operate directly on those 
organs, she regained the use of her arm (p. 132). 
A gentleman of the medical profession, whose digestive organs haa 
been long disordered, suddenly lost the use of his right arm, without any 
apparent disturbance of the cerebrum. A professional friend asserting 
that the paralysis was a consequence of the disorder of the digestive 
organs, the patient promised strictly to adhere to any course of medicine 
that his friend would prescribe. The only medicines ordered were pills, 
containing two grains of calomel, at night, and purges on the following 
morning, for one week. The bowels were cleared daily. On the sixth 
day, however, several copious, dark-colored and offensive discharges took 
place, and the patient immediately regained the use of his arm (p. 132). 
Blegborougii, Henry, Surg., On Chronic Croup. London, 1806. See 
Med. and Phys. Journ., 1806, Vol. XV. 
342. When the disease has subsisted some days there is generally 
thick and short breathing, with heat of skin and frequent pulse; but as 
these symptoms are always relieved by a calomel purge, I conclude they 
are produced by loaden bowels. Being removed, they always in a few 
days return, and are, by the same means, again and again relieved 
(Journ., p. 509). 
Chronic 
croup 
Purges re- 
move the 
cause. 
Bradley, James, Surg., On Hernia. Huddersfield, 1806. See Med. 
and Phys. Journ., 1806, Vol. XVI. 
Hernia. 
Purgatives 
useful as 
cooling sed- 
atives, re- 
moving the 
irritation in 
the prim® 
vi®, and pro- 
moting the 
reduction. 
343. Mr. Bradley gives seven cases of hernia in patients of different 
ages, sexes and constitutions, demonstrating his method of employing 
the taxis in inguinal or scrotal hernia. Generally costiveness precedes 
the hernia, and vomiting accompanies it. On the employment of pur- 
gative medicines he says: 
In case seventh, the cathartic solution was administered from evident 
symptoms of enteritis; and here, as well as in case first, where this 
medicine was administered, I could not perceive any of those unpleasant 
effects ascribed to purgatives in general. The small quantity taken into 
the stomach not proving sufficient to increase the disorder of that organ, 
and the position in which the patients were placed, might tend, perhaps, 
in some measure to obviate any increased distress arising in that quarter. 
I gave this medicine, not with a view of obtaining any laxative effects, 
but as a cooling sedative, calculated to abate irritation in the first pas- 
sages, under the circumstances of a quick pulse, considerable thirst, and 
great pain in the abdomen. I was led to adopt this remedy in prefer- 
ence, from observing its good effects in enteritis, and in obstinate con- 
stipations of the bowels attended with colic, which I have seen it fre- 
quently remove, before any laxative effects have been produced 
Journ., p. 48). 
Morgan, Charles, M. D., On the Use of Purgative Medicines. See 
Edinb. Med. and. Surg. Journ., Vol. II, 1806. 
Purgation 
removes de- 
bility. 
344. Debility is itself an effect of disease, and, when the disease is 
removed, the strength and vigor of the system will return. Have we THE DOCTRINE OF PURGATION. 
not often seen the debility which attends some of the complaints of in- 
fancy removed, as well as the disease of which it was a symptom, by 
evacuating the bowels ; and nausea, and anorexia, with all the depress- 
ing symptoms of dyspepsia, how often alleviated by a brisk purgative f 
(p. 100). 
345. If we would follow out this practice on general principles, we 
must calculate the whole effect of our remedies. Sometimes we empty the 
bowels simply ; at others we promote an increased secretion of fluids by 
purgative medicines. In some cases it appears sufficient to unload the 
bowels of their contents accumulated by long retention, and thereby 
relieve the system from the effects of this local irritation ; but in others, 
and especially in those in which a freer and more continued purging be- 
comes necessary before the symptoms yield, we bring off not only the 
contents of the bowels which are out of the course of circulation, we 
eliminate also the secretory organs which terminate in the intestinal 
canal—the obstruction, torporyor deranged actions of which may have 
been a chief cause of the morbid actions of other parts of the system 
(ibid.) 
Effecls of 
various de- 
grees of pur- 
gation. 
346. We are surely authorized to make this inference from cases in 
which the purging is continued for weeks, to the exhibition of three or 
four stools daily, with progressive relief of the morbid symptoms, with 
improved looks and strength, and at length followed by the perfect cure 
of a complicated disease. In other cases we find the cure advancing 
with the discharge of fetid stools of a bilious appearance, or black and 
greenish color (p. 101). 
In propor- 
tion as the 
morbid, 
matters are 
discharged, 
so health is 
restored. 
347. Having been an eye-witness of Dr. Hamilton's practice, I could 
not avoid being struck with its simplicity and success, and adopting it 
as my own. Much dissatisfaction may have arisen among practitioners, 
from the unwillingness of patients to submit to a repetition of purga- 
tives, who all esteem purging a debilitating operation, and think them- 
selves “ far too nervous ” to undergo it with impunity. Many too, I 
believe, are disappointed in their hopes of cure, by stopping short of the 
wished-for point (ibid 1807, vol. III. p. 144). 
The danger 
is in not 
purging 
sufficiently. 
348. Both these evils may arise from a neglect on the part of the 
medical adviser. I mean, not inspecting the stools. If the practitioner 
be too much an “ emunctae naris homo ” to submit to such a drudgery, 
let him go on trusting to remedies that have long failed, or rather let 
him lay aside the practice of medicine altogether. It is only by daily 
inspection of the stools that the purging can be regulated; for, as long as 
they exhibit morbid appearances, so long are purgatives necessary, 
and no longer. 
When the stools are not seen, the patient conceives that he is discharg- 
ing far more than you are aware of, and more than his constitution can 
bear. By an earnest inquiry after them and a strict injunction that the 
whole may be saved, together with an occasional appeal to the patient, 
whether such matters can remain in the body with impunity, I have 
never failed in inducing a cheerful submission to the plan, and the pa- 
Always ex- 
amine the 
stools. THE DOCTRINE OF PURGATION. 
tient at last looks for the repetition of the doses as a sure relief from the 
misery he is suffering. Having premised these remarks, which arise 
from the objections of several medical friends, I proceed to the relation 
of two cases, not picked out as proving more than others, but as exhib- 
iting the obstinacy of the disease, and the ultimate advantages derived 
from a steady perseverance in the purgative plan (p. 145). Here follow 
the cases: 
Walsh, E., M. D. An account of a malignant fever, which appeared 
in the Garrison of Quebec during the Autumn of 1805, with some 
preliminary observations on the diseases of the Canadas. London, 
1806. See Med. and Phys. Journ. 1806, vol. XV. 
349. Lake Fever.—The cure of this fever is not less easy and cer- 
tain at its commencement, than difficult in its advanced stages. An 
antimonial emetic, followed by a brisk purge, with attention to regimen 
for two or three days, seldom failed of curing it on the access. But if 
this was neglected, and the disease far advanced, such a torpor of the 
system was induced as frequently rendered ineffectual the most active 
medicines (Journ., p. 448). 
Dr. Walsh characterizes the malignant fever at Quebec exactly 
like Mr. Bennion describes the fever at Gibraltar, and has employed the 
same remedies against it; confer, therefore, Bennion on the Gibraltar 
Fever (Journ., pp. 451-453). 
Lake fever. 
Emetic and 
brisk purg- 
es. 
Cheyne, J., M. D. Observations on the Effect of Purgative Medi- 
cines. London, 1808. See Edinb. Med. and Surg. Journ., 1808, 
vol. IV. 
Fits and 
inability to 
walk cured 
by purga- 
tives. 
350. Case of a youth who, in consequence of a fall, was subject for 
a year to most distressing fits, intense pains, etc., and who, in conse- 
quence, had lost the power of walking. (Case given.) This boy in 
about two months -was restored to health. During this period he used 
a great quantity of strong cathartic medicine. A scruple of aloes and 
ten grains of gamboge were given daily for several weeks before his 
stools became natural; and as his stools became large, loose and natural, 
the tits left him and he recovered the use of his limbs. About the end 
of my attendance, when his bowels were acting more naturally, one pill 
of the same kind, of which it before required sometimes ten to produce 
the desired effect, was a sufficient dose (pp. 310, 311). 
In this case our practice is supported by analogies drawn from the 
successful treatment of other diseases where, along with convulsions or 
spasmodic affections, we have also been able to detect a great degree of 
foulness in the bowels. It is in compliance with a common idiom that 
I use the expression of foulness of the bowels. I am persuaded that 
such a state cannot, with any propriety, be said to exist. Take the 
slow infantile remittent of Dr. Batter, or the marasmus of Dr. Ham- 
ilton—we have a train of symptoms supposed to be induced by foulness 
of the bowels; and the appellation seems to be countenanced by what 
is observed during the cure, the effects of the purging medicines 
employed. By these medicines stools are procured, at first dark, slimy 
Spasmodic 
affections. 
Infantile 
remittent, 
marasmus. 
Fetid stools. THE DOCTRINE OF PURGATION. 
and fetid, which perhaps, for a considerable time, have nothing of the 
appearance of natural feces; the evacuations seem merely a collection 
of vitiated secretions, but at last, by pursuing the purgative plan, large 
natural stools are evacuated, and it is generally supposed that these 
stools have been all the while lodged in the intestines, and that our 
medicines were not powerful enough at once to expel them—that the dis- 
ease was solely from an accumulation of fecal matter (p. 312). 
Powerful 
purgation. 
351. But the fact is, that these critical stools are produced by the 
restoration of the viscera to a healthy condition. The purgative medi- 
cine employed is useful, not so much by removing the accumulations, 
hut that it stimulates the bowels. By the steady application of this 
stimulus the visceral functions are restored. The bilious and slimy 
stools are expelled, the light food is concocted, and from the fecal resi- 
duum, with the increased supply of gall, of gastric and pancreatic fluids, 
and the secretions from the large intestines, in consequence of the reno- 
vation of the organs supplying these fluids, the large natural stools are 
produced and the disease resolved. Were the bowels in a healthy con- 
dition, they would be acted upon by what at all other times is their 
natural stimulus, and, consequently, they would not admit of this sup- 
posed accumulation. If there be accumulation, the torpid state of the 
intestines is the cause of it; but the disease may exist without any accu- 
mulation whatever (p. 312). 
Critical 
evacuations 
by stool. 
Critical or 
fetid stools 
indicate re- 
moval of dis- 
ease and re- 
turn of 
healthy ac- 
tion. 
352. In dysentery, where hardened faeces are lodged in the bowTels, 
we see a constant succession of unsatisfactory stools, and of these stools 
the hard faeces or scybala would seem often to be the cause. For, it is 
observed by every practical writer, that when, by proper purgatives, the 
scybala are evacuated, there is immediately a remission of the most 
urgent symptoms, in particular of the tenesmus, and frequent mucous 
stools (p. 313). 
scybala. 
353. Hydrocephalus.—The cure. The exhibition of the largest dose 
which can be safely prescribed of some powerful cathartic medicine, 
two, three, or four times a day; and this continued for several days, or 
until natural stools are produced. The advantage of keeping the intes- 
tinal canal under the continual influence of a stimulus, I have, in 
various instances, found to be so great, that I am induced to repeat the 
declaration of my belief, that the happiest result may be expected from 
this measure. (Essay on Hydrocephalus Acutus, Edinb., 1808 ; ibid., 
p. 346.) 
cure by the 
ffun.pur' 
Gay, M., M. D., An Essay on the Nature and Treatment of Apoplexy. 
Paris, 1808. Translated by El. Copeman, Surg., with an Ap- 
pendix. London, 1843. See Beit, and Foe. Med. Rev., 1843, Vol. 
XVI. 
354. This treatise proves that bleeding is injurious in all eases of 
apoplexy, and that the primary cause is always to he found in the primge 
vise ; that purgatives are indicated in every case, except wrhen the attack 
follows a full meal, when emetics should be first administered ("Rev., 
272). 
but purge.' THE DOCTRINE OF PURGATION. 
Halliday, Andrew, M. D., On Epilepsy. Bland ford, 1808. See Med. 
and Phys. Journ., 1808, Vol. XIX. 
Epilepsy 
from worms. 
Continued 
purgation 
removes the 
cause by 
carrying off 
accumula- 
tion of 
morbid 
matter in 
the intes- 
tines. 
355. Case given of a girl of five years old who was subject to fits with 
violent contraction of the limbs, had an unnaturally voracious and de- 
praved appetite, and could articulate but very few words, however she 
understood what was said to her. 
Upon an attentive consideration of this case, it occurred to me that 
purgatives were likely to be of service, and from my 'intimate acquaint- 
ance with the practice of that justly-celebrated physician, Dr. Hamilton, 
of Edinburgh, I entered upon the treatment with great confidence, and 
did not hesitate to promise success to the parents of the girl if they 
would faithfully and implicitly follow my directions. I confess that I 
had my fears lest there should be some organic disease ; yet the pulse, 
though rather slow, was regular. The bowels, I was told, were very 
irregular, but generally costive; I felt the abdomen very tumid; and 
notwithstanding the feebleness and emaciated state of the patient, I felt 
convinced that no time was to be lost; I therefore ordered an active 
purgative. The fits recurring and no stool being procured, infusion of 
senna was given, one ounce every half hour, which produced several 
scanty, fluid motions, of a greenish color, and highly fetid. Both 
medicines were continued for four days, without alteration in the state 
of the patient or her bowels, several lumbrici were voided, the fits had 
rather increased in violence; on the fifth day she had two motions, the 
last 'very copious, consisting chiefly of hardened scybala, and containing 
two worms; fits returned only during the night. Three days more 
brought more large evacuations of the same kind, diminished voracious- 
ness, and less severity of fits which occurred during the nights. From 
this time (the 6th of January) to the 20th, I continued the exhibition of 
calomel and rhubarb, and the senna occasionally, never intermitting 
more than one day. The quantity of feculent matter which she passed 
during that period is beyond conception. Her appetite began to flag 
about the 14th, and on the 16th her mother informed me that she had 
not had a fit for twenty-four hours; on the 17th she had one very severe 
fit, but remained free from them again till the 20th, when she had one 
which did not continue above ten minutes. During this period she had 
voided three lumbrici. The fits gradually abated, the appetite became 
natural, while purging pills were continued so as to secure a regular 
alvine discharge (Journ., pp. 305-308). 
356. Thus far the purgatives have fully answered my expectations, 
The child appears to be cured of her fits, but I am afraid she will remain 
an idiot while she lives. The doses of medicine that were necessary to 
move ]ier bowels were very large, and also the length of time which 
elapsed before the bowels could be said to be properly moved, for I con- 
ceive that she bad no proper motion till the seventh day. The large 
doses of medicine which were necessary may be accounted for, perhaps, 
from the state of the sensorium; and the difficulty which there was in 
moving the bowels was, no doubt, owing to the great accumulation 
which had taken place (p. 308). 
Large doses 
andp«rse- 
cure 
success. THE DOCTRINE OF PURGATION. 
357. Though the fits are removed at present, I fear they will be apt 
to return, unless great care is taken to keep her boivels open for some 
considerable time, until the predisposition from habit is overcome, and 
the bowels are restored to their natural tone / but if this is attended to, 
I am certain the cure will be complete. This case, then, I would say, 
tends to corroborate the very valuable observations of Dr. James Ham- 
ilton, but indeed those observations stand in no need of any such testi- 
mony ; for Dr. Hamilton has proved every position which he has 
advanced by facts that never can be controverted. The novelty, the sim- 
plicity, and the efficacy of Dr. Hamilton'1s practice attracted much notice 
on the first appearance of his invaluable work ; and as the doctor did 
not venture to give his discoveries to the world till experience had most 
fully confirmed them, lie was able to speak with certainty; and I will 
venture to affirm that if purgatives ha/ve failed in any instance to pro- 
duce the effects which Dr. Hamilton’s observations have so incontestibly 
proved them capable of producing, that that failure is to be attributed 
more to the prescriber than to the medicine prescribed (Journ p. 309). 
It is neces- 
sary to estab- 
lish regu- 
larity of al- 
vine evacua- 
tions in or 
der to secure 
health. 
The purga- 
tive plan of 
treatment 
and Hamil- 
ton's doc- 
trine vindi- 
cated. 
358. I have often heard it argued, by those who were unwilling to 
give too much credit to Dr. Hamilton, as was generally allowed, that 
though no doubt the cases which he had related seemed to prove the 
good effects of purgatives, yet that many of those cases—for example, 
his cases of typhus fever—were so trilling that any other remedy would 
have done as well as purgatives. And, moreover, it has been often 
hinted that though this practice may do very well in the north, and in 
the Royal Infirmary of Edinburgh, yet that it is by no means calculated 
for the delicate constitutions of this country. I shall only say, that 
those who have witnessed Dr. Hamilton's practice have been fully con- 
vinced of the good effects of purgatives in severe as well as slight cases 
of fever; and, indeed, had the doctor felt any anxiety about this, he 
might have tilled the second number of his appendix with cases more 
severe than any he has given. With regard to the second hint, I can 
add my testimony to that of Dr. Morgan, of Dover. (See Edinb. M. 
and S. Journ., 1807, April 1.) 
I have prescribed purgatives in different diseases since my residence 
in England, and have found their effects uniformly the same as in the 
north. While I resided at Ilalesworth, in Suffolk, I attended Robert 
White, of Walpole, with Mr. Walker, surgeon, in one of the worst 
cases of typhus I ever saw. The disease was speedily subdued by pur- 
gatives. The bolus jalapse compositus had the same good effect in Suf- 
folk as in the Royal Infirmary of Edinburgh (Journ., pp. 309, 310). 
Typhus. 
Further vin 
dication of 
the purga- 
tive plan 
and Hamil- 
ton's prac- 
tice. 
Watt, Robert, M. D., Cases of Diabetes, Consumption, dee., with Ob- 
servations on the History and Treatment of Disease in general. 
Paisley, 1808. See Edinb. Med. & Surg. Jour., 1809, Vol. V. 
359. The functions of the lungs are twofold : to assimilate the new 
materials supplied by the digestive organs, and to preserve the blood in 
a healthy state. In health there must he a due balance between the di- 
gestive and assimilative organs. If this balance be disturbed, disease 
ensues (p. 93). 
Tli6 iungs ; 
0 THE DOCTRINE OF PURGATION. 
Chyle,. 
360. If more chyle be thrown upon the lungs than they can assimi- 
late, it must remain an incumbrance upon the system, or be discharged 
by one or other of the excretories (p. 94). 
The blood. 
361. The blood may be deteriorated, and yet support life, in an im- 
perfect manner. The vessels which increase and repair the solids may 
be in want of proper materials, though the system were overcharged 
with blood. The nervous system being deprived of its natural support 
from these vessels, acquires a depraved sensibility, and all the phenomena 
follow which we have described as attending a diseased habit. The 
greatest number of secreting organs are idle for the want of arterial 
blood, the only stimulus which can call them into action. The liver 
receiving its stimulus from venous blood, has more to do than in health ; 
hence arise “ bilious complaints ” which, with low spirits, prostration of 
strength, <fec., generally mark the first stage of disease (p. 94). 
The nerves. 
Secreting 
organs. 
The liver. 
" Bilious 
com- 
plaints'' 
debility. 
Reaction. 
362. If the system possesses sufficient reaction takes place, and 
goes on to a proper crisis. ... In place ot fever the balance is often 
restored by a critical evacuation. If the superfluous matter take to the 
intestines, it produces diarrhoea / if to the kidneys, diabetes ; if to the 
uterus, menorrhagia / if to the skin, profuse perspiration. If the re- 
action fail to produce a salutary crisis, the system falls back, collects 
new vigor and resumes the conflict, as in intermittent fever, and other 
periodical diseases. In other instances, such as hypochondriasis, it re- 
peats the same thing over again, or tries other means of relief, and is 
thus said to counterfeit every disease ; that is, it employs many efforts 
to throw off the incumbrance, but is generally unequal to the task. Af- 
ter a longer or shorter struggle, a confirmed phthisis, diabetes, diarrhoea, 
dropsy, or some other disease, terminates the patient’s sufferings (p. 95). 
Critical 
evacuation: 
Diarrhoea— 
intestines; 
Diabetes— 
kidneys; 
Menorrhagia 
—uterus; 
Perspiration 
—3kin. 
Hypochon- 
driasis— its 
causes, 
course, and 
end, if im- 
pnities are 
not remov- 
ed. 
Vagaries of 
medical 
practice. 
363. In every period of the history of medicine, there has not only 
been practice opposed to practice and theory to theory, but one fashion 
has succeeded another with astonishing rapidity. One practitioner 
treats burns and scalds by heating, another by cooling applications; one 
cures the gout by carefully wrapping the feet in flannel, another by 
plunging them in cold water ; one combats fevers with wine and opium, 
another by gruel and purgatives. These, though abundantly striking, 
are but a small sample of the oppositions in medicine. To notice the 
fashions would be to enumerate the various articles which, from time to 
time, have entered the materia medica, and almost every possible man- 
ner in which these can be prepared and compounded. (Journ, 1810, 
Yol. VI, p. 287.) 
364. From a belief that there is no disease without a corresponding 
remedy, medical men have been much in search of antidotes. The task 
of finding a specific for each disorder, reminds me of the labor of the 
Chinese in inventing a distinct character for every word in their lan- 
guage. However numerous and diversified the hair-splitting systems of 
nosology may represent diseases, the means of cure, like the simple 
sounds in language, are few and obvious. Galen remarked that bleed- 
ing and purging were the two legs of physic, and it is doubtful how 
far the art has been improved by the legs which have since been added 
(ibid.) 
About “ spe- 
cifics." 
Purgatives 
the “ legs of 
physic." THE DOCTRINE OF PURGATION. 
Briggs, II., M. D., Physician of the Royal Dispensary of Liverpool; 
History of a case of tetanus cured by purgatives. Liverpool, 1809. 
See Edinb. Med. & Surg. Jouen., 1809, Vol. V. 
365. Remarkable case of Luke Gaskell, given in detail.—The cure 
was perfect in four weeks. On the fourth day of the case, Dr. Briggs 
says:—“ I had all along been aware of the awful responsibility I in- 
currred by departing so widely from the usual practice in tetanus, and 
now my resolution failed me altogether. I was terrified with the ap- 
prehension that I had already delayed the free exhibition of opiates too 
long, while yet I was loth to relinquish the use of purgatives (p. 154). 
On a cool review, I asked myself whether, if the case should prove 
fatally, as I then feared it would, I could with justice affirm, thatpurga- 
tion had been fairly tried and failed, whether on the contrary the ex- 
acerbations that had occurred ought not to be ascribed to the interrup- 
tion of the plan, rather than to the plan itself? (p. 155). Finally, I con- 
cluded to adhere to the plan of purgation, and to discontinue the inter- 
nal use of opium (ibid). 
Locked-jaw 
—remark- 
able case; 
cure by po w- 
erful pur- 
gation. 
“ Nil despe- 
randum." 
366. After the cure, he says :—“ If there be any point in medicine, 
on which, after having been engaged in dispensatory practice for sixteen 
years, I have arrived at any certain conclusion, it is this, that in gastro- 
dynia, and many other spasmodic affections, brisk purgatives will be 
found incomparably better antispasmodics than any of that tribe to 
which this epithet is usually applied. I believe, too, that their operation 
is strictly antispasmodic—that their first effect is, to supersede the 
spasmodic action ; for I have often known complete relief to be obtained 
before a stool was procured, in so much, that I have more than once 
been asked by patients, ‘ if I had not given them laudanum V ” (p. 161). 
I am inclined to think, that the more drastic purges were laid aside 
for no sufficient reason. . . The more active purgatives appear literally 
to have possessed antispasmodic virtues (p. 162). 
The quantity of medicine taken from first to last for twenty-five 
days is certainly very large, as follows :—calomel 320 grains, scamrno- 
ny 340 grains, gamboge 126 grains, powdered jalap 6 ounces, infusion 
of senna with tincture 10f pounds, colocynth-pill nearly 2 ounces, of 
which the greater part was taken within the first week. 
During forty-eight hours (on the 5th and 6th days) was given scam- 
mony 210 grains, gamboge 89 grains, jalap ounce, infusion of senna 
2-J- pounds, calomel 80 grains; and all this without causing sickness or 
griping, but on the contrary with most decided benefit (ibid.) 
Spasms of 
the stomach. 
Purgatives 
the best 
“ antispas- 
modics." 
Drastic 
'purges. 
367. In short, if a remedy be indicated at all, surely the dose should be 
regulated, not only by' weight and measure, but by the effect. And when 
there is such a strong concatenation of morbid actions, as in tetanus, it 
might perhaps have been expected, a priori, as it has proved in fact, that 
nothing but the most active purges, in large doses, and frequently re- 
peated, would avail to break the train (p. 163). The whole quantity of 
opium taken was 100 drops in two days, and so far from answering any 
good end, it seems manifestly to haw prevented sleep, as well as to have 
impeded the operation of the purgatives (p. 161). 
This is the most important evidence, in respect to purgatives, we have yet published. 
Our directions for the use of Brandreth’s Pills need no modification. Dose, from 2 to 20, or 
any quantity required to purge. 
The, effect, 
not the quan 
tity of the 
dose to be 
considered. THE DOCTRINE OF PURGATION. 
Rush, Benjamin. M. D., Medical Inquiries, 4 vols. Philadelphia, 
1809. 
Disease a 
unit. 
368. There is but one fever. However different the predisposing, 
remote, or exciting causes of fever may be, still I repeat, there can be 
but one fever (vol. III., p. 16). 
A il forms 
of disease lo- 
cal, etc., 
from the 
sanguifer- 
ous system. 
369. I infer the unity of fever, further, from the sameness of the 
products or effects of all its different forms (ibid., p. 17). All ordinary 
fever being seated in the blood-vessels, it follows, of course, that all 
those local affections we call pleurisy, angina, internal dropsy of the 
brain, pulmonary consumption, and inflammation of the liver, stomach, 
bowels, and lungs, are symptoms only of an original and primary dis- 
ease in the sanguiferous system. The truth of this proposition is ob- 
vious, from the above local affections succeeding primary fever, and 
from their alternating so frequently with each other. There being but 
one fever, of course I do not admit of its artificial division into genera 
and species (ibid. p. 33). 
Nosological 
arrange- 
ments of dis- 
eases objec- 
tionable and 
useless. 
370. Pulmonary consumption is sometimes transferred into head- 
ache, rheumatism, diarrhoea and mania. The bilious fever often ap- 
pears in the same person in the form of colic, dysentery, inflammation 
of the liver, lungs and brain, in the course of five or six days. Phreni- 
tis, gastritis, enteritis, nephritis, and rheumatism—all appear at the 
same time in gout and yellow fever. . . . Much mischief has been done 
by nosological arrangement of diseases. They erect imaginary boun- 
daries between things which are of homogeneous nature (ibid., p. 34). 
Consequen- 
ces of artifi- 
cial nomen- 
clature. 
371. They gratify indolence in a physician by fixing his attention 
upon the name of a disease, and thereby leading him to neglect the 
ranging state of the system. They moreover lay a foundation for dis- 
putes among physicians by diverting their attention from the simple, 
predisposing and proximate to the numerous remote and exciting causes 
of disease, or to their more numerous and complicated effects (ibid., 
p. 35). 
The mater 
ria medica 
denounced. 
372. The whole materia medica is infected with the banef ul conse- 
quences of the nomenclature of diseases, for every article in it is pointed 
only, against their names, and hence the origin of the numerous contra- 
dictions among authors who describe the virtues and doses of the same 
medicine (ibid). 
A good time 
coming, 
when the 
unity of dis- 
ease will be 
acknowl- 
edged and 
acted upon. 
373.. By the rejection of the. artificial arrangement of diseases, a 
revolution must follow in medicine. Observation and judgment will 
take the place of reading and memory, and prescriptions will be con- 
fined to existing circumstances. The road to knowledge in medicine 
by this means will likewise be shortened, so that a young man will be 
able to qualify himself to practice physic at as much less expense than 
formerly, as a child would have to read and write by the help of the 
Roman alphabet, instead of Chinese characters (ibid, pp. 34, 35). THE DOCTRINE OF PURGATION. 
374. The efficacy of this remedy (purgation) in the cure of dropsies, 
has been acknowledged by physicians in all ages and countries (vol. II, 
p. 182). Both drastic and gentle purgatives act by diminishing the ac- 
tion of the arterial system, and thereby promote the absorption and 
discharge (ibid. p. 183). 
Dropsy;— 
action of 
purgatives. 
375. However varied morbid actions may be in their causes, seats 
and effects, they are all of the same nature, and the time will probably 
come when the whole nomenclature of morbid actions will be absorbed 
in the simple name of “Disease ” (ibid., p. 234). 
All diseases 
one cause. 
(Apothegm.) 
376. A mild remittent, and yellow fever are different grades of the 
same disease (ibid., p. 256). 
A mild re- 
mittent, but 
diluted yel- 
low fever. 
377. If we mean by gout a primary affection of the joints, we have 
gained nothing by assuming that name ; but if we mean by it a disease 
which consists simply of morbid excitement invited by debility, and dis- 
posed to invade every part of the body, we conform our ideas to facts, 
and thus simplify theory and practice in chronic diseases (ibid., p. 272). 
Gout; -—a 
local deposit 
from general 
derange- 
ment : this 
view simpli- 
fies theory 
and practice 
in chronic 
diseases. 
378. The gout affects most of the viscera. In the brain it produces 
headache, vertigo, coma, apoplexy and palsy; in the lungs, pneumonia, 
notha, asthma, hemoptysis, consumption; in the throat, inflammatory 
angina; in the uterus, hemorrhagia uterina; in the kidneys, strangury, 
diabetes, and'calculi; in the liver, inflammation, suppuration, melea, 
schirrhus, gall-stones and jaundice (ibid., pp. 258, 259). All these dis- 
eases have but one cause, and they are exactly the same, however differ- 
ent the stimulus may be from which they are derived (ibid., p. 261). 
Gout, con- 
sumption, 
asthma, etc., 
all diseases 
from but one 
cause. 
379. Thus rheumatism, the gout, the measles, smallpox, the different 
species of cynanche—all furnish examples of the connection of local 
affections with general diseases; but the apoplexy and the pneumony 
furnish the most striking analogy of local affections succeeding a general 
disease of the system (ibid., p. 86). 
Local affec- 
tions and 
general dis- 
ease. 
380. Pneumony is apoplexy of the lungs, allowing only for the dif- 
ference of situation and structure (ibid., p. 8t). 
Pneumony. 
381. After the production of predisposing debility1 of the system 
from the action of remote causes, the fluids are determined to the weak- 
est parts of the body. Hence the effusion of serum or blood takes place 
in the lungs. When serum is effused, a pituitous or purulent expectora- 
tion takes place; when blood is discharged a disease is produced which 
has been called hemoptysis. The pneumony is produced by remote 
exciting causes which act on the whole system (ibid.) . . The expectora- 
tion which terminates the disease in health, is always the effect of effu- 
sions produced by a general disease (ibid., pp. 87, 88). 
Unity of dis- 
ease further 
demonstrat- 
ed. 
382. Who has not seen the pulmonary symptoms alternately relieved 
and reproduced by the appearance or cessation of a diarrhoea or pains in 
the bowels ? (Ibid., p. 85.) 
Consump- 
tion—nature 
tries to cure 
by sponta- 
neous pur 
gaion, THE DOCTRINE OF PURGATION. 
The unity 
of disease. 
383. Science has much to deplore from the multiplicity of diseases. 
It is as repugnant to truth in medicine as polytheism is to truth in reli- 
gion. The physician who considers every different affection of the dif- 
ferent systems in the body, or every affection of different parts of the 
same system, as distinct diseases, wdien they arise from one cause, resem- 
bles the Indian or African savage who considers water, dew, ice, frost 
and snow, as distinct essences; while the physician who considers the 
morbid affections of every part of the body, however diversified they 
may be in their form or degrees, as derived from one cause, resembles 
the philosopher who considers dew, ice, frost and snow, as different 
modifications of water, and as derived simply from the absence of heat 
(vol. III., pp. 146,147). 
Humanity has likewise much to deplore from this paganism in medi- 
cine. The sword will probably be sheathed forever as an instrument of 
death before physicians will cease to add to the mortality of mankind 
by prescribing for the names of diseases (ibid., p. 147. Account of the 
bilious yellow fever of 1793). 
The recog- 
nition of this 
doctrine is of 
the highest 
importance 
to human- 
ity. 
Experience 
of Dr. Rush. 
384. IIow Dr. Rush came to believe in the efficacy of purgation.— 
Condensed from pp. 222-230, vol. III.: 
I gave gentle purges and vomits, bark in all its usual forms, applied 
blisters to the limbs, neck and head, attempted to rouse the system by 
wrapping the whole body in blankets dipped in warm vinegar (p. 223), 
rubbed the right side with mercurial ointment, with a view of exciting 
the system through the liver; none of these remedies were of any service. 
I returned to bark, wine, and the use of cold water (p. 224). . . Ilad the 
authority of Dr. Cleghorn for the former, who says: “ The bark, by 
bracing the solids, enables them to throw off the excrementitious fluids 
by the proper emunctories,” &c. Ho better success, however, attended 
my efforts (p. 225). . . I ransacked my library, and pored over every 
book that treated of yellow fever (p. 226). . . I recollected that 1 had 
among some old papers a manuscript account of the yellow fever as it 
prevailed in Virginia in 1741, wdiich had been put into my hands by 
Dr. Franklin, a short time before his death. I now read it a second 
time, and paused upon every sentence. I was struck with the following 
passages (p. 227): 
Franklin 
on yellow- ' 
FEVER. 
Purgation in- 
dispensable. 
The abdom- 
inal viscera 
chiefly af- 
fected. 
385. (Dr. Franklin, loquitur): “It must be remarked that this 
evacuation (meaning the purges) is more necessary in this than in most 
other fevers. The abdominal viscera are the parts principally affected 
in this disease, but by this timely evacuation their feculent corruptible 
contents are discharged before they corrupt and produce any ill effects; 
and their various emunctories and secerning vessels are set open, so as to 
allow a free discharge of their contents, and consequently a security to 
the parts themselves during the course of the disease. By this evacua- 
tion the very minea of the disease, proceeding from the putrid miasmata 
fermenting with the bilious and other humors of the body, is sometimes 
eradicated by the timely emptying the abdominal viscera, in which it first 
fixes, after which a gentle sweat does, as it were, nip it in the bud” 
(ibid.) 
Purgation 
promotes 
sweat by re- 
386. “ When the primce vice, but especially the stomach, is loaded 
with an offensive matter, or contracted and convulsed with the irritation THE DOCTRINE OF PURGATION. 
of its stimulus, there is no procuring a laudable sweat till that is 1*0- 
moved ; after which a necessary quantity of sweat breaks out of its own 
accord, these parts promoting it, when, by an absterging medicine, they 
are eased of the burden or stimulus which oppresses them” (p. 228). 
moving im- 
v-Mch'""pre- 
Jef exu'"- 
387. “ All these acute putrid fevers require some evacuation to bring 
them to a perfect crisis and solution, and that even by stools, which must 
be promoted by art, when nature does not do the business herself” 
(ibid.) 
Allfvef_ 
gatton. 
388. “ On this account, an ill-timed scrupulousness about the weak- 
ness of the body is of bad consequence in these circumstances ; for it is 
that wrhich seems chiefly to make evacuations necessary, which nature is 
ever attempting, after the humors are fit to be expelled, but is not 
able to accomplish for the most part in this disease. And I can affirm 
that I have given a purge in this case when the pulse has been so low 
that it could hardly be felt, and the debility extreme, yet both one and 
the other have been restored by it ” (pp. 228, 229). 
The weaker 
the greater 
fun pur- 
oation. 
389. Here I paused. A newr train of ideas suddenly broke in upon 
my mind. I supposed that my want of success, in several of the cases 
in which I attempted the cure by purging, was owing to the feebleness of 
my purges (ib., p. 230). 
weak 
fJss use* 
390. By full and continued purgation I cured perfectly four out of 
the first five patients, notwithstanding some of them were advanced sev- 
eral days in the disease. One gentleman had passed twelve hours with- 
out a pulse, and with a cold sweat on his limbs. His relations had given 
him over. Dr. Mitchell’s account of the effect of purging in raising the 
pulse excited a hope that he might be saved, provided his bowels could 
be opened. Purges were given to him three or four times a day; at 
length they operated and produced two copious fetid stools. His pulse 
rose immediately. A universal moisture on his skin succeeded. In a 
few days he was out of danger, and soon afterwards appeared in the 
streets in good health (p. 232). . . In three days he had taken eighty 
grains of calomel, and rather more than that quantity of rhubarb and 
jalap (ibid.) 
Astonishing 
purgation— 
stored to life, 
391. This practice could be said to be almost uniformly effectual in 
all those cases which I was able to attend. . . Many used calomel in 
connection with bark, wine, and laudanum, without any good effects. . . 
I can never forget the transport with which Dr. Pennington ran across 
Third Street to inform me “ that after he began to give strong purgatives 
the disease yielded in every ease” (ibid., p. 235). 
caiomeiwith 
opium use- 
less- 
Dr 
ningtonlnA 
purge! 
392. Never did I experience such sublime joy as I now felt in con- 
templating the success of my remedies. It repaid me for all the toils 
and studies of my life. The reader will not wonder at this joyful state 
of my mind when I add a short extract from my note-book of the 10th 
September: “ Thank God! out of one hundred patients, whom I have 
visited or prescribed for, this day, I have lost none !' (Ibid., p. 234.) 
Dr. Rush re- THE DOCTRINE OF PURGATION. 
393. My practice was, to give a purge every day while the fever con- 
tinned. I used castor-oil, salts, cream of tartar, rhubarb. Calomel and 
jalap were often ineffectual, then I added gamboge. The purges seldom 
answered the intention for which they were given unless they produced 
four or five stools a day (ibid., p. 240). . . When purges were rejected or 
slow in their operation, I always directed opening clysters every two 
hours (ibid., p. 241). 
mi kinds of 
thegreat ob- 
dav- 
purgation 
sefentepropo- 
sitions. 
394. The effects of purging were as follows: 
1. It raised the pulse when low, and reduced it when it was preter 
naturally tense or full. 
2. It revived and strengthened the patient. This was evident m 
many cases in the facility with which patients who had staggered to a 
close-stool walked back to their bed after a copious evacuation. 
3. It abated the painful symptoms of the fever. 
4. It frequently produced sweating, when given on the first or second 
day of the fever, after the most powerful sudorifics had been given to no 
purpose. 
5. It sometimes checked the vomiting which occurred in the begin- 
ning of the disease, and it always assisted in preventing the more alarm- 
ing occurrence of that symptom about the fourth and fifth day. 
6. Removed obstruction from the lymphatic system. 
7. Discharged the bile through the bowels as soon and fast as it was 
secreted, and prevented, in most cases, yellowness of the skin (ibid., p. 
243). 
Sympathy. 
partTuffers.1 
395. One of the laws of sensation is, that certain impressions which 
excite neither sensation nor motion in the part of the body to which they 
are applied, excite both in another part. Thus worms, which are not 
felt hi the stomach or bowels, often produce a troublesome sensation 
in the throat. . . In like manner the irritants which produce fever, in 
ordinary cases pass through the bloodvessels, and convey their usual 
morbid effects into a remote part of the body, which has been prepared 
to receive them by previous debility (ibid., pp. 60, 61). 
No amount 
tioffinjuri- 
cures*'ob 
tained by 
doses'arge 
396. It is not an easy thing to affect life, or even subsequent health, 
by copious or frequent purging. Dr. Kirkland (Treatise on Inflamma 
t°ry Rheumatism, vol. I., p. 407) mentions a remarkable case of a gen- 
tleman who was cured of a rheumatism by a purge which gave him 
between forty and fifty stools. This patient “ had been previously affected 
by his disease sixteen or eighteen weeks.” Dr. Mosely not only proves 
the safety, but establishes the efficacy of numerous and copious stools in 
the yellow fever. Dr. Say probably owes his life to three-and-twenty 
stools, procured by a dose of calomel and gamboge, taken by my advice. 
JDr. Redman was purged until he fainted by a dose of the same medi- 
cine (ibid., pp. 243, 244). 
newThms 
ease which'ia 
the cause of 
“r' 
397. But who can suppose that a dozen or twenty stools in a day 
endanger life that has seen a diarrhoea continue several months, 
attended with fifteen or twenty stools a day, without making even a mate- 
rial breach in the constitution f Hence Dr. Hillary (Diseases of Bar- THE DOCTRINE OF PURGATION. 
bacloes, p. 212) has justly remarked, that “ it rarely or never happens that 
the purging in this disease, though violent, takes the patient off, but the 
fever and inflammation of the bowels.” Dr. Clark (Diseases in Voyages 
to the Hot Climates, vol. II., p. 322) in like manner remarks that evacu- 
ations do not destroy life in the dysentery, but the fever,with the emacia- 
tion and mortification which attend and follow the disease (ibid., p, 245). 
398. I have remarked in the history of this fever that it was often 
cured on the first or second day by a copious sweat. It would be absurd 
to suppose that the miasmata which produced the disease were discharged 
in this manner from the body. The sweat seemed to cxire the fever only 
by lessening the quantity of the fluids, and thus gradually removing the 
depression of the system. . . The reason why a few strong purgatives 
cured the disease at its first appearance was, because they abstracted in 
a gradual manner some of the immense portion of stimulus under which 
the arterial system labored, and thus gradually relieved it from its low 
and weakening degrees of depression. . . Bleeding was fatal in these 
cases, probably because it removed this depression in too sudden a man- 
ner (ibid., pp. 277-279). 
Sweats 
(crises) 
and purges. 
Bleeding 
fatal. 
399. Baron Humboldt informed me that Dr. Caristo had assured him 
that bark hastened death in every case in which it was given in the yel- 
low fever of Vera Cruz. If, in any instance, it was inoffensive or did 
service in our fever, I suspect it must have acted upon the bowels as a 
purgative. Dr. Sydenham says that bark cured intermittents by this 
evacuation, and Wm. Bruce says it operated in the same way when it 
cured the bilious fevers at Massuat (ibid., p. 293). 
Bark 
destructive 
except when 
it acts as 
purgative. 
400. The result: 
Whilst Dr. Rush was working from eighteen to t wenty hours a day, 
healing and saving by hundreds, the old-school physicians, who derided 
his innovations, persisted in the use of bark, wine, and laudanum, and 
thus succeeded in killing their patients “ sec undum artemd 
Bark, wine, 
and lauda- 
num. 
401. The Rev. Mr. Fleming, one of the ministers of the Catholic 
church, carried the purging powders in his pocket, and gave them to his 
poor parishioners with great success. He informed me that he had ad- 
vised four of our physicians, whom he had met a day or two before, “ to 
renounce the pride of science, and to adopt the new mode of practice, 
for that he had witnessed its good effects in many cases ” (ibid., p. 314). 
Clerical evi- 
dence in fa- 
vor of purga- 
tion. 
402. Reason and humanity awake from their long repose in medi- 
cine, and unite in proclaiming that it is time to take the cure of pestilen- 
tial epidemics out of the hands of physicians, and to place it into the 
hands of the people. . . The safety of consigning to the people the cure 
of pestilential fevers, especially the yellow fever and the plague, is 
established by the simplicity and uniformity of their causes and of their 
remedies. 
Reason and 
Immunity 
are opposed 
to medionl 
monopoly. 
403. Dr. Lind lias remarked that a greater proportion of sailors who 
had no physician recovered from the fever than of those who had the 
Popular com 
pared with 
medical 
treatment. THE DOCTRINE OF PURGATION. 
The worst 
diseases are 
the simplest 
to cure. 
best medical attendance. The fresh air of the deck of a ship, a purge 
of salt water, and the use of cold water, probably triumphed over the 
cordial juleps of the physician (ibid., p. 319). 
Other medi- 
cal monopo- 
lies consid- 
ered and 
their hum 
hug de- 
nounced. 
404. For a long while air, water, and even the light of the sun, were 
dealt out by physicians to their patients w ith a sparing hand. They 
possessed for several centuries the same monopoly of many artificial 
remedies. But a new order of things is rising in medicine (ibid., p. 
320). It is not more necessary that a patient should be ignorant of the 
medicine he takes, to be cured by it, than the business of government 
should be conducted with secrecy in order to secure obedience to just 
laws. Much less is it necessary that the means of life should be pre- 
scribed in a dead language, or dictated with the solemn pomp of a ne- 
cromancer. The effects of imposture in anything are like the artificial 
health produced by the use of ardent spirits. Its vigor is temporary, 
and is always followed by misery and death (ibid., p. 321). 
405. I would as soon believe that ratafia was intended by the author 
of nature to be the only drink of man, instead of water, as believe that 
the knowledge of what relates to the health and lives of a whole city or 
nation should be confined to one, and that a small and privileged order 
of men. But what have physicians, and what have universities and 
medical societies done, after the labor and studies of so many centuries, 
towards lessening the mortality of pestilential fevers ? They have either 
copied or contradicted each other in all their publications. Plagues and 
malignant fevers are still leagued with war and famine in their ravages 
upon human life (ibid., p. 323; cf. Asclepiades, 63). 
Medical mo- 
nopoly fur- 
ther consid- 
ered. 
Medical ig- 
norance and 
contradic- 
tions. 
Why Dr. 
Rush would 
never “ con- 
sult” with 
the bark- 
wi&e and lau- 
danum men. 
406. A Mohammedan and a Jew might as well attempt to worship 
the Supreme Being in the same temple, and through the medium of the 
same ceremonies, as physicians of opposite principles and practice at- 
tempt to confer about the life of the same patient. What is done in 
consequence of such negotiations (for they are not consultations) is the 
ineffectual result of neutralized opinions; and, wherever they take place, 
should be considered as the effect of a criminal compact between physi- 
cians to assess the property of the patients, by a shameful prostitution 
of the dictates of their consciences. . . 
The extremity of wrong in medicine, as in morals and governments, 
is often a less mischief than that mixture of right and wrong which 
serves, by palliating, to perpetuate the evil (ibid., p. 349). 
Purge until 
BLACK (fetid) 
fasces—cri- 
sis—come 
away, and 
fear not. 
407. In one very malignant case the most drastic purgatives brought 
away, by fifty evacuations, nothing but natural stools. The purges were 
continued, and finally black faeces were discharged, which produced im- 
mediate relief (ibid., p. 375). 
This plan 
always re- 
moves debil- 
ity; 
408. I observed tlie same relief from large evacuations of fetid bile in 
the epidemic of 1797 that I have remarked in the fever of 1793. Mr. 
Bryce has taken notice of the same salutary effects from similar evacua- 
tions in yellow fever on board the Busbridge Indiaman in 1793. “ It 
was observable that the more dark colored and fetid such discharges were 
the more early and certainly did the symptoms disappear. Their good THE DOCTRINE OF PURGATION. 
effects were so instantaneous that I have often seen a man carried upon 
deck, perfectly delirious with subsultus tendinum, and in a state of the 
greatest apparent debility, who, after one or two copious evacuations of 
this hind, has returned of himself, astonished at his newly-acquired 
strength ” (Annals of Medicine, p. 123). 
409. Very different are the ffects of tonic remedies when given to re- 
move this apparent debility. The clown who supposes the crooked ap- 
pearance of a stick, when thrust into a pail of water, to be real, does not 
err more against the laws of light than that physician errs against 
a law of the animal economy who mistakes the debility which arises 
from oppression for an exhausted state of the system, and attempts to 
remove it by stimulating medicines (vol. IV., p. 38). 
whilst tonic 
Ifroy. 'e 
INTERESTING ARTICLE. 
Barlow, Edward, M. D., Pathological and Practical Observations. 
Bath, 1810. See Edinb. Med. and Surg. Journ., 1814, Vol. X. 
410. Purgatives are of three sorts: some evacuating the fecal con- 
tents of the intestines ; others acting on their exhalent arteries, and pro- 
ducing copious watery stools—and a third class stimulating the mucous 
follicles which so abundantly line the intestines and causing them ta 
expel the mucous matters they so copiously secrete. VY hen the bowels 
are merely inactive, their secretions healthy, and no constitutional disease 
present, the simple aperients of the first class suffice to obviate costive- 
ness and prevent feculent accumulations. The second are requisite 
when, in addition to unloading the intestines, it is desirable to abate 
internal action or allay fever, by reducing the quantity of the circulating 
fluid ; and the third are required either when the mucous secretions are 
so morbid as to give rise to diseases, or when they are too copiously gen- 
. -| • ° r> • i ,• r»ii i x i V 
erated m consequence ot increased action ot the vascular system (pp. 
431, 432). ' 
cal master, 
teryUCstooit 
exPel “y 
first, in inac- 
the bowels, 
costwenesf; 
h 
Honor fever, 
rcfrculiatinge 
fnuimirbiduy 
or super- 
abundance 
0f mucoua 
secretions. 
Brandreth’s Pills in one medicine accomplish the three indications required. In doses of 
from one to four Pills, they evacuate the fecal contents of the intestines; from four to six 
they operate upon the exhalent arteries and produce copious watery stools; in doses of from 
six to ten pills they stimulate the mucous follicles which so abundantly line the intestines, 
causing stools of pure mucous. In headaches, dyspepsia, apoplectic and paralytic symp- 
toms, and in gout and rheumatism, no cure can be obtained without the expulsion of large 
quantities of this mucous, which Brandreth’s Pills effect with entire safety. 
411. When it is considered that the diseases of repletion are by far 
the most numerous that the human body is liable to; that the alimenta- 
ry canal affords one of the most important outlets for discharging the 
redundancy of the system; that it is also a principal one for getting rid 
of the excrementitious impurities, with which in such diseases the blood 
is speedily adulterated, and that the diseased secretions which accumu- 
late within it are oftentimes a means of continuing, of complicating, 
and even of creating various diseases in different parts of the body, the 
value of purgatives cannot fail to be duly appreciated. 
It remains for me to show that such morbid secretions do exist within 
the stomach and intestines, and that they do produce therein the effects 
now attributed to them, being the direct cause of some local complaints, 
while they beget also, by remote sympathies3 diseases in distant parts (p. 
432). 
Diseases of 
repletion;— 
purgatives 
cannot be 
dispensed 
with to re- 
move the ex- 
crementi- 
tious matter 
from the 
blood. 
Morbid se- 
cretions in 
stomach and 
intestines. 
Sympathy. TIIE DOCTRINE OF PURGATION. 
Examine 
the 
discharges 
of intestines 
and stomach. 
412. Of the existence of superabundant mucous in the stomach and 
intestines during inflammatory complaints, sufficient proof will be 
afforded merely by inspecting the discharges brought off by particular 
evacuants, or occasionally by the natural efforts. With respect to the 
stomach this examination may mislead, if only superficial; for the 
mucous being clear and colorless, is not readily distinguishable from the 
watery fluid surrounding it; if, however, a rod or wire is passed through 
the liquor, and elevated, it will raise the mucous existing therein, and 
sufficiently manifest its dense and viscid nature (p. 433). 
Superabun- 
dant mucous 
creates dis- 
purgatives 
assist the ac- 
tion of the 
seexpe°uingln 
mucous. 
443. ]q tliis mucous that is produced by increased arterial action, 
no • -t i i i* 
anectmg the mucous glands ot the stomach m common with all the 
other parts. To it, and to the action which produces it, superseding the 
healthy action of these parts, do I attribute the incipient nausea of fever 
and of constitutional inflammation ; and its expulsion I deem important, 
, . . ... 7 ■ i 7 , . i 7 
both as removing an injurious accumulation, and as enabling the secret- 
Ag vessels, thus disencumbered, to continue those efforts, whose direct 
tendency is to relieve the general circulation, however inadequate they 
may be, when unassisted, to accomplish this purpose. Similar secretions 
are going forward also at such times throughout the whole course of the 
intestinal canal, and are evidenced by the quantity of mucous which a 
dose of calomel or antimony, administered under such circumstances, 
uniformly expels (ibid). 
How to se- 
fitivefi—' 
when the mu- 
is°Uof recent 
d°autcl°mf- 
when it is of 
tion, •power- 
{icefur°a 
Saits ineffec- 
tual 
414. The want of sufficient attention being given to the peculiar 
e^'ect produced by different purgatives, may perhaps suffice to account 
for the uncertainty and indecision which still prevail in their employ- 
ment. If this mucous matter is recently formed, and in no great abund- 
ance> a common purgative of the drastic hind will suffice to remove it, 
together with all such fecal lodgments as may have taken place in the 
intestines. A source of injurious irritation is thus removed ■ the narious 
secreting and excreting vessels are left free to perform their natural func- 
tions ; and the progress of nature, in her force to restore health, goes for- 
ward uninterruptedly. If the mucous secretions are of older formation 
and consequently more viscid, more tenacious and more difficultly expelled, 
the common purgatives fail to give relief, and a doubt is cast on the pro- 
priety of employing them, and on the veracity of previous reports of 
successful cures. The error here, however, is in employing a purgative 
inadequate to producing the effect required. . . . Vi saline purgatives 
are given with the expectation of cleansing the intestines when loaded 
with mucous secretions, they will very imperfectly effect this purpose 
(pp. 433, 434). 
Large quan- 
cous from 
easesei,inder 
efhnTnyapur- 
gatives. 
415. The quantity of t-liis mucous secreted in acute diseases is very 
considerable. It lines both tne stomach and intestines, and causes many 
powerful medicines to pass through them without producing tlieir ordi- 
naiT effects; for, in consequence of the interposed mucous, the medicines 
come only imperfectly or not at all in contact with the lining fibre, which 
alone they are capable of stimulating. It passes through, therefore, as 
if either the lining fibre were torpid, or the medicine inert, when neither 
supposition is correct/ and to mistake and accident we are occasionally THE DOCTRINE OF PURGATION. 
indebted for illustration of this subject, which perhaps regular prac- 
tice would more slowly and imperfectly afford us. For the errors of 
dispensers and the stupidity of patients have not unfrequently afforded 
me instances of inordinate doses of purgative medicines being given, 
with cndy moderate and salutary operation (p. 434). 
Large, doses 
often have 
but moder- 
ate opera- 
tion. 
416. Case of scarlatina given.—Purgatives were, in consequence, 
thenceforward more freely employed, and the effect regarded more than 
the dose necessary for producing it; and although the inflammatory 
fever ran high, and was not allayed for many days, there did not occur 
a speck of ulceration on either tonsil. Neither did any of the ordinary 
sequelae attend the disease, but the recovery was progressive and com- 
plete. 
We may hence infer the difficulty of establishing the precise doses 
of medicines to be admitted, and must be conscious of the superior ad- 
vantage of attending solely to the sensible operation, when this is capable 
of being ascertained, disregarding altogether the quantity of medicine 
necessary for effecting it. This is always possible with respect to purga- 
tive medicines, and to be accomplished by regular inspection of the almne 
evacuations, without which the practitioner must remain in much doubt 
concerning some of the most important operations going forwrard within 
the body, and must labor under great disadvantages in accurately apply- 
ing the remedies it is necessary to employ (p. 435). 
and not the 
Considered 
inspection 
fJunTi’f- 
ommended. 
417. Morbid secretions are very frequently formed in the stom- 
ach, which occasion a large proportion of gastric diseases. To par- 
ticularize only one. Conceiving the pain in gastrodynia to proceed 
from a contractile effort of the stomach to throw off from its surface the 
mucous which offends it, I have for many years laid aside the use of 
opium and stimulants, which merely repress the effect, without at all re- 
moving the cause, and which even tend to add to this by stimulating the 
glands to increased secretion of the offending mucous, and have trusted 
solely to such medicines as act by expelling that matter, to whose presence 
I attribute the complaint. . ._ 
I own I am averse to relieving the pain by opium, or by any means 
but a removal of the offending matter—as the relief to pain consequent 
upon such evacuation may be relied on as anncmncing the radical cure of 
the complaint. In some hundred cases that I have now treated on these 
principles I have in no instance given a grain of opium, or failed in 
giving decided relief. Almost the only medicine I employ as a purga- 
tive compound consists of extract of colocyntli, calomel, and antimonial 
powder (p. 436). 
Morbid mat- 
stomach o©. 
fftf 
c/yma. 
cause—pur- 
gatfi\hff 
418. The disease of colic I believe to be precisely analogous with gas- 
trodynia, both in its pathology and treatment, and to differ only in being 
more prone to pass into inflammation. The remote sympathies which 
different parts of the body evince under disordered condition of the 
stomach and digestive organs have often engaged the attention of prac- 
titioners (p. 437). 
colic-its 
treatment- 
419. I have mentioned tliat in all complaints attended with fever, or 
constitutional inflammation, the gastric and intestine secretions are 
constitution- 
mation. THE DOCTRINE OF PURGATION. 
quickly increased. Accumulations of morbid secretions oftentimes take 
place m the alimentary canal, of slow and gradual formation, and not 
referable by any well-marked connection to a state of generally increased 
a;r.j.er^aj ac^on> The former state may even be superinduced upon the 
latter, and thus an additional complication, both of diseased action and 
of diseased condition, ensue. A disease, in which this morbid state of 
the secretions exerts considerable influence, is rheumatism (ibid.) Cases 
{, ln 
follow : 
increased ar- 
ena ac ion. 
Bheuma- 
tism. 
Gout. 
V'cufl°by' 
purgatives. 
Coichicum. 
420. Admitting, then, the pathology to be correct which attributes 
gout to the existence of a state of plethora and inflammation in the blood- 
vesseis, anq the influence of vitiated secretions within the alimentary 
canal—which latter may be regarded in a great degree as the natural 
product of the former—does it not seem to be fully within our power to 
bring this hitherto intractable disease under the control of rational prac- 
tice \ And may we not hope to treat it as effectually, and much more 
safely, by the well-ascertained powers of such a remedy as a combina- 
tion of colocynth, calomel, and antimony presents us with, as by the less 
manageable means of white hellebore, or the precarious and uncertain 
« eau medicinale,” i. e.. •“ colchicumrf” (P.441.) 
Applicable to 
Brandreth's 
Pills. 
421. The means I would recommend are advocated not for their 
possessing any secret or unexplained power disease, hut from their 
being pointed out by a rational pathology, and fully established, both with 
respect to their safety and efficacy, by extensive experience (ibid.) 
B. G. B., Observations on the Treatment of the Sick returned from 
Corunna. See Edinb. Med. and Sukg. Joukn., 1810, Vol. VI. 
422. There appears too great a desire of discovering something like 
a sPec'*fiG f(yr f^er to the very great neglect of obtaining evacuations, 
Calomel seems to be regarded in this way, and is abundantly employed 
with a view of producing some particular irritation of the system that 
will arrest the progress of or remove the complaint. 
Whatever this medicine may do, after evacuations have been prom- 
ised, I feel certain of one thing, that it will never supersede the neces- 
sity of evacuations in fever; and I question very much if its good effects 
in fever, and in all inflammatory complaints, do not depend upon its 
evacuating qualities (p. 170). 
FeVtr&. 
canneversu- 
persede pur- 
cure;—some- 
XMapurga- 
tive. 
423. Those, however, who attempt to cure inflammatory fever, or in- 
flammation. by any other means than by evacuation of some sort or other. 
will lose many an opportunity jor doing good; and, m confirmation ot 
this opinion, 1 will quote the authority of the very learned Dr. Freind: 
a jjoc unum libi spondeo te experiundo comprobaturum, quod silicet ex 
febribus multae evacuantibus solis, etiam si haud alio fueris remedio 
usus, cedere consuescant; vix ullse antem, quae paulo vehementius in- 
valuerint, medicina qualicunque, si ab hoc evacuandi instituto decesseris, 
restingui possint.” (Commentaries on 1st and 3d books Hippocrates.) 
Dr. Freind here observes that many fevers will yield to evacuations 
alone, when no other remedy is used • but scarcely any will be removed, 
Dr. Freind 
on fevers— 
afone can 
Cout'thTm— 
death. THE DOCTRINE OF PURGATION. 
when the fever is great, by any remedy whatever, if evacuations are not 
employed. I have no hesitation in saying, when this plan is speedily 
adopted, that the most beneficial effects will generally result, and that 
a great many cases of inflammatory fever which would otherwise have 
ended fatally, or become putrid, and have been protracted for a fort- 
night or three weeks, or even longer, will by this system terminate favor- 
ably in a week (pp. 170, 171). 
Tuomey, Martin, M. D., A Treatise on the Principal Diseases of Dub- 
lin. Dublin, 1810. 
424. Bilious fever.—Purgatives must be steadily persevered in 
throughout the complaint, for it is upon them we must chiefly rely for 
success; and as the accumulation of foul matters in the alimentary canal 
is constantly and copiously produced, so there is no disease in which the 
free and regular use of purgatives causes less distress or gives more uni- 
form relief. It frequently happens that from the operation of a purga- 
tive a large quantity of foul excrements come away; and yet in ten or 
twelve hours after there is another large evacuation, so as often to cause 
iust surprise how so much could be generated m so short a time: and 
these copious and ioul evacuations continue tor several successive days 
without inducing proportionate weakness, but, on the contrary, they 
procure great mitigation of the symptoms. Even delicate and young 
females are relieved, without being exhausted, by these evacuations (p. 8). 
BiUouSfe. 
ver. 
copious 
evacuations 
rrimTfT'l, 
induce no 
425. So far from producing weakness, we have often observed with 
pleasure the renewal of strength, which these evacuations occasion, when 
a languor or depression of the animabpowers, even to faintness, had pre- 
viously existed. But we have likewise remarked that, as soon as the 
alvine excretions have assumed a natural appearance, a much smaller 
evacuation has actually produced a considerable reduction of strength 
(p. 9). 
Evacua- 
tions give 
strength— 
remove de- 
bility. 
426. It is remarkable that we are disappointed of any substantial 
improvement in the state of our patient whilst the dark faeces remain 
behind, notwithstanding the quantity of the evacuations procured (ibid). 
Dark fa,cks 
are critical, 
Buchan, A. P., M. D., Bisnomia. London, 1811. 
427. Is it credible tliat a human infant should be so imperfectly or- 
ganized that it cannot pass over the years of childhood, naturally the 
most healthy period of life, except the biliary system be ever and anon 
expurgated by calomel ? or that the early and habitual use of this min- 
eral poison can be unattended with injurious consequences % Perhaps 
the time may come, when the most judicious plan of curing internal as 
well as external complaints,will be acknowledged to consist in removing 
all impediments to the natural exertions made by the vital energy to re- 
store health (p. 71). 
childhood 
calomel. 
time to come, THE DOCTRINE OF PURGATION. 
Clark, Joseph, M. D., On the Bilious Colic and Convulsions of Early 
Lnfancy. Dublin, 1811. See Transactions of the Royal Irish 
Academy, 1811, Vol. XI. 
Childhood— 
i onnulsions 
—the old 
practice fatal 
—PURGATION 
the cure. 
428. In the beginning of my practice, as long as I pursued the beaten 
track of employing mixtures of rhubarb and magnesia, solution of man- 
na in fennel-water, chalk, musk, opium, and blisters, recovery from con- 
vulsions in early infancy was a rare occurrence. After six years’ close 
attention to the subject I am convinced that in colic and convulsions 
nothing but a brisk expulsion of the contents of the bowels is likely to 
afford permanent relief. A dose or two of castor-oil, or a common pur- 
gative enema, may remove slight attacks of this nature. It is in general 
after the failure of such measures that a physician’s advice is required 
<P- 121)- 
Evacua- 
tions—as the 
quantity so 
is the relief. 
429. The purgation must be very active and continuous to be efficient. 
In the course of recovery#the quantity of evacuation seldom fails to as- 
tonish the attendants, who cannot well comprehend whence it all can be 
derived. The relief obtained is uniformly proportioned to the quantity 
discharged (ibid.) 
Armstrong, John, M. D. Observations on the Origin, Nature and 
Treatment of Tyvhus Fever—in Medical Intelligencer, 1812. 
Typhus.— 
Many of its 
symptoms 
from wanting 
lecarboni- 
sation of the 
blood. 
430. The want of due decarbonization of the blood is the cause of 
many of the most remarkable symptoms attendant on typhus. Blood 
not duly decarbonized, operates more or less as a narcotic on the brain, 
and tends materially to influence the animal heat and the heart’s action ; 
and hence partly arise the state of the brain, the smothered heat 
of the surface, and the soft, compressible pulse, &c. Why typhus-fever 
assumes in one person an intermittent, and in another the remittent or 
continued form, is most probably owing to the dose of the poison, or the 
condition of the recipient, or both conjoined (Med. lilt., No. 30, May, 
1812).* 
Intermittent 
or remittent 
form— 
causes of. 
The Morbid Anatomy of the Bowels. Liver and Stomach. London, 1828. 
Small-pox, 
measles, 
scarlatina 
— Wood-dis- 
eases. 
Nature com- 
pared to a 
tidal flowing 
riper. 
431. The contagions of small-pox, measles and scarlatina first ope- 
rate on the blood, and that fluid being thereby changed, the solids are 
specifically affected, especially the skin and mucous membranes of the 
air-passages; and these affections, too, if left to themselves, and even 
often in despite of medical applications, ham a determinate course, the 
blood apparently, like the water of the Thames, requiring a certain time 
for its purification, which it effects, perhaps, by throwing off the effete and 
superfluous matters, through the secretions and excretions (Art. I, p. 10). 
Letter to Dr. Boot, contained in Dr. Boot’s edition of Armstrong’s Works. 
Much leam- 432. I have never yet met with a learned physician who was a good 
foilyhfprac3 Trpetitioner. At the bedside such men are lost in the conflict of au- 
tical matters, thority. THE DOCTRINE OF PURGATION. 
Hartz, William, M. D. On the use of Purgatives in Purpura. 
Dublin, 1813. See Edinb. Surg. and Med. Journ., Vol. IX. 
433. Purpura.—Convinced by my previous ill success of tne ineffi- 
cacy of mere tonics in bad cases, and favorably impressed by the occur- 
rence of cholera previous to the appearance of the petechise, I determined 
in this case to direct my whole attention to the state of the abdominal 
viscera, and accordingly prescribed brisk purgatives. From the good 
effects of the first, I directed its repetition for a few successive nights. 
To my surprise the hemorrhage soon ceased, the spots rapidly disap- 
peared, and in less than ten days the patient recovered, under every 
possible disadvantage of constitution, of air, and of diet. Encouraged 
by the Unexpected result of this unpromising case, I no longer hesitated 
in employing purgatives, and trusting to them only in both species of the 
complaint. It was often necessary, however, to purge to a great extent 
(p- 186). 
Purpura— 
the regular 
practice un- 
successful— 
purgation 
cures. 
Important 
case. 
Full and free 
purgation re- 
quired. 
434. It appears from the observations of Pur serins, that Strack sup- 
poses petechice to originate/rom vitiated bile in the primes vice, and from 
a tenacious mucus adhering to the intestines, and that he accordingly 
proposed strong cathartics as the proper remedy for the disease. I have 
carried this theory farther, and have, not without advantage, allowed it 
to influence my practice in typhus, when petechise are present, and many 
very desperate cases have appeared to me to owe their recovery, almost 
from the jaws of deatli, to the powerful and repeated interposition of 
purgatives (p. 187). 
Typhus. 
Petechias 
from vitiated 
bile. 
Medicus. On Pathology.—See Edinb. Med. A Surg. Jour. 1815. 
Vol. XI. 
435. Disordered actions of the human body are, generally speaking, 
the means which nature employs for the expulsion or removal of offend- 
ing agents; thus if the stomach be excited to vomit, the cause producing 
that disturbance is removed by that action; thus also diarrhoeas carry 
off noxious matters ; and the emunctories of the body are generally 
cleared out for the same purpose (p. 335). As a machine, the human 
body may be said to “ go,” at the same time that it includes powers 
for repairing all injuries that otherwise would prevent its going, and 
these reparatory processes include almost all the symptoms of disease 
(p. 336). 
Natural 
cure byvom- 
InSS, etc'3' 
436. We will suppose, for example, that the stomach, unable to per- 
form healthy digestion, presents to the liver, as it passes to the duodenum, 
an ill-concocted chyme or chyle. Does it not become necessary that the 
liver should pour forth a bile suited to the purpose it has to answer ? 
a purpose far different from what would be required if a healthful 
digestion had taken place in the stomach. Such a bile cannot be deemed 
improper, since it answers the purpose for which it was intended, name- 
ly, of carrying through the bowels what was noxious, and of effectually 
Thestoniach 
—vicarious THE DOCTRINE OF PURGATION. 
assisting in assimilating such parts as are healthy and proper. To attack 
the liver, therefore, because it has done its duty, would be adding to the 
ev^s which already excited its powers, and would be exhausting those 
means of resistance and reaction which were appointed for the most 
beneficent of purposes. To oblige, by medicine, the stomach to retain 
substances as, in a state undisturbed by medicine, it would reject, 
is the readiest conceivable method of calling forth the symptoms of “ liver 
affection,” and a general disturbance of the alimentary functions. And 
thus it happens that the more extended reactions of the constitution follow 
these circumstances, and thus, by a very easy process of reasoning, shall 
we arrive at those causes which produce gout, asthma, cutaneous diseases, 
and in short a long train of grievous maladies (p. 336.) 
Mpmctice— 
checking the 
functfonpro- 
compiadit 
res‘torIes 
hegeshtiondl" 
43T. During healthful digestion, feelings are excited far different 
from those which arise when the meal has not been regulated by mode- 
ration and sobriety; and howr often are means applied to appease the 
tumult occasioned at such times, and thus so many noxious agents are 
introduced, which become all the causes of great and extended future 
mischief (p. 337). 
Foulness of 
the bowels— 
curative. 
438. It has been said that foulness of the bowels is a common cause 
of disease. It appears to me that when the bowels produce the foulness, 
so often observed, such foulness proves curative. It is a reaction of the 
liver (?) against a constitutional disturbance, which in the end proves 
curative. Immediately on discovering this foulness, we feel satisfied that 
on its removal the various symptoms of disease will disappear (p. 339). 
439. There is a balance in the constitution consistent with every nat- 
ural effort; it may be called the diathesis, such as gout, and a variety of 
other inflammatory affections, and these states of balance involve their 
own series of phenomena. Thus the head may be oppressed with a super- 
abundance of blood, and may be liable to affections under one form or 
series ; another may involve rheumatism ; another, gout, &c.; and all of 
them, extended reactions of the system, tending towards a reparation of 
the constitution. 
It may be observed that foulness of the bowels cannot exist to the 
full extent at which it appears at any one period ; for the quantity that 
on some occasions is discharged would be more than the canal was capa- 
ble of containing. It must, therefore, be the result of successive deposi- 
tions from some great secreting organs. For instance, during the exist- 
ence of disease, wherein there are great determinations of blood, ape- 
rient medicines bring away evacuations of no particular character; but 
after a little time the circumstances of the case alter; heavy, lumpy, and 
discolored evacuations begin to appear, and continue to be parted with. 
As soon as these appearances arise, the symptoms of the original disorder 
begin to diminish, and, in the course of a short time, disappear altogether. 
It must have occurred to every practitioner who has strictly examined 
these circumstances, that he has found a difficulty in accounting for the 
quality and extent of this collection of foulness (p. 339). 
Reaction 
tending to 
reparation of 
the constitu- 
tion. THE DOCTRINE OE PURGATION. 
4-40. It mast also have been frequently observed that affections of 
the head, epilepsy, chorea, local diseases of various kinds, and great and 
extended affections of the skin, have all given icay as soon as the bowels 
have expelled a quantity of foul and fetid evacuation. During the 
progress, however, of these maladies, the bowels have not shown the same 
character until the disorders have attained a particular stage, and then 
the progress towards health is decided. Coukl we succeed in bringing 
about this stage, many very grievous maladies might be cured; that is, 
we might induce thereby the various organs of the alimentary canal to 
render the more extended reaction of the system unnecessary. I do not 
mean to deny that there is occasionally a very great accumulation in the 
bowels, so foul a state of them that worms occur, which appear there to 
have found a proper nidus ; and that other great sympathetic affections 
take place arising from these accumulations (ibid). 
Dark, and 
fetid evac- 
uations 
break tbe 
power of dis- 
ease and pro- 
duce reac- 
tions. 
Worms. 
441. If we trace these affections, we shall find many natural efforts 
made to remove such accumulations and foulness ; and even that many 
very distant reactions occur tending to relieve the body of the griev- 
ance. Thus the blood returning through the “ vena portcef is delayed, 
and as the heart acts uniformly, more blood flows to the head than usu- 
ally, in consequence of this remora in the return of blood from the 
lower circulation. This fullness of blood in the head occasions many 
reactions, amongst which we may rank epilepsy, which shakes the whole 
body in convulsions, and is the means of removing worms and other foul- 
ness from the bowels, as under the influence of that disorder the alvine 
and urinary excretions are violently expelled (pp. 338, 339). 
xhe naturaI 
cure—dis- 
tion. 
Epilepsy. 
442. Why disease and cure are units, physiologically accounted for. 
j jl «/ t/ «/ ts 
—The tendency of disease is either to spontaneous cure or to the extinc- 
tion of life (p. 340). 
disease and 
cure units 
443. The human stomach is an organ endowed by nature with the 
most complex properties of any in the body, and forming a centre of 
sympathy between our corporal and mental parts of more exquisite 
qualifications than even the brain itself. Yet the knife and eye of the 
anatomist do not discover the whole importance of the station it holds 
m the economy. W e must look to the living system lor those nice con- 
neetions of cause and effect, and that source of association which gives 
it a relation to so many organs, both in the healthy and disordered state. 
.... We find all those viscera which assist in preparing the chyle and the 
assimilation of food, joined in a circle of nervous communication of 
which the stomach is the centre. One portion of nerves is distributed 
over the whole, so that, while they are employed in one purpose, disor- 
der cannot take place in any one of them without the whole being 
thrown into confusion. These associated organs are regulated in their 
apparently disturbed state by laws tending to the relief of that pertur- 
bation. By these associated powers the causes of perturbation are 
removed, and the effects of such reaction are eventually rendered harm- 
less. (Condensed from pp. 345 to ult.) 
matereiatk® 
whole body, 
Sympathy 
through 
organsasuffer 
l0ne0rmaythbe 
saved, 
444. The nerves of the stomach are connected, throne’ll the great sym- 
pathetic nerve, almost every other nerve in the body. The lungs, 
Lungs, heart, 
nervous re« THE DOCTRINE OP PURGATION. 
lation with 
the stomach, 
and act with 
it in the “c*t- 
rative pro- 
cess.which 
is removal of 
noxious and 
offending 
agents. 
heart, and diaphragm, are also furnished with nerves which communi- 
cate with the great sympathetic. This nerve is the grand link or chain 
which connects the vital, animal, and natural functions with each other. 
It is no very difficult matter to trace the curative actions that take place 
in consequence of this nervous connection—how the heart may vary its 
pulsations agreeably to the impulse it receives through this nerve; how 
the liver and intestines are apprised of the necessity of varied exertions, 
agreeably to the kind of digestion that is to pass the sphere of their du- 
ties, &c.; all, I say, for the beneficent purpose of ultimately removing 
from the system the noxious influence of offending agents, such influ- 
ence as, were it not for those wise provisions of nature, would prove 
destructive to the human frame (ibid). 
More of this 
“ curative 
process.” 
If the stom- 
ach is unfit 
to effect this 
cure, exaite 
with purga- 
tives. 
445. These several reactions of the body seem all calculated to 
become effectual, when the system is in a state agreeable to the laws 
of nature. A really curative process may be so far altered in its ulti- 
mate results by improper habits of life, that it may not be enabled to 
answer the purpose intended, or it may run into an excess, and even 
occasion detriment to the subject (ibid). 
446. We now see why the operations of the stomach, liver, and 
bowels are so effectual in removing very great and extended disorders 
of the system; and why, when required, such medicines as call forth 
these reactions of the stomach and primce vice, are the true means of cure. 
So that, whether a disorder originates in the stomach, proceeds to distant 
organs through the stomach, or is a disease arising primarily in a distant 
part of the frame—still such reactions are capable of affording relief 
(ibid., p. 345, sq., cf.). 
The “ cura- 
tive process” 
—conclu- 
sion. 
Pritchard, J. C., M. D. Remarks on the Treatment of Epilepsy and 
some other Nervous Diseases. See Med. and Phys. Journ., 1815, 
Vol. XI. 
Nervous 
diseases— 
cure by pur- 
gatives. 
447. I consider the introduction of the free use of evacuating reme- 
dies into the treatment of nervous diseases as one of the greatest im- 
provements of the medical art which has taken place of late years. 
Imperfect as our knowledge confessedly is with respect to the pathology 
of nervous diseases, and inadequate as our remedies frequently prove 
themselves to be, we have yet the satisfaction of perceiving that we are 
evidently in the right path; and that, when we have not the means of 
cure in our power, we can at least often palliate, without incurring the 
risk of making matters worse than we found them (p. 459).—Cases of 
cures of epilepsy given. 
Epilepsy. 
Neurosis. 
448. I have tried the use of evacuant remedies in several other dis- 
orders of the class neurosis with success y but in none with more singu- 
lar advantage than in mania, in which distemper I have had extensive 
opportunities of witnessing their effects, having been for some years one 
of the physicians to a hospital where a great number of lunatics were 
admitted. I am firmly persuaded that if medical practitioners would 
depend more on physical and less on moral remedies, they would succeed 
Mania. THE DOCTRINE OF PURGATION. 
in a greater proportion of cases, especially recent ones, than generally 
happens (p. 456). 
449. Indications to be obtained by the use of purgatives are: 
1. By removing sordes from the intestinal canal. 
I am every day surprised at the prodigious accumulation of 
fecal matters which I find to take place in the intestinal canals 
of patients of all years. 
2. As depleting the system. 
3. As determining the fluids from the head. 
4. As setting up a new action in the system. 
5. Purging is a powerful means of stimulating the absorbent sys- 
tem, as we witness its effects on dropsical patients. 
6. A course of moderate purgation is one of the most efficient 
methods of invigorating the digestive organs, improving appe- 
tite, and removing visceral obstructions (p. 466). 
Indications 
of purga- 
tives. 
Dickson, D. J. H., M. D., Superintending Physician to the Russian 
Fleet. On the ZUlity of Repletion in a Fever among the Russian 
Sailors. See Edinb. Med. and. Surg. Journ., 1816, Vol. XII. 
450. It is now well understood that the value of purgatives is not 
limited to the mere removal of the fecal contents of the bowels, but that 
they may be so managed as to obviate or relieve a tendency to topical 
congestions elsewhere, and also to produce a considerable effect \upon the 
general system, by the increased quantity of fluids they cause the various 
glands and exhalent arteries to pour into the intestines. Thus they be- 
come more universally usef ul in diseases in general, in proportion as 
they are more uniformly applicable. . . . They were here considered 
not only indispensably requisite in the first instance, and assisted by 
enemas, when necessary ; but they were liberally exhibited throughout 
the disease; and very often the bowels could not be kept sufficiently 
active unless they were repeated day after day (p. 175). 
Purgatives 
—their value 
unlimited. 
Action on 
glands and 
exha lent ar- 
teries. 
451. Though not a new, it is a very important observation, that all 
uncertainty as to their full operation can only be removed by inspection, 
without which the practitioner is very apt to be led to imagine by the 
patient from his own report, or that of the nurse, that he has been suffi- 
ciently purged, when, at most, he may have had only two or three par- 
tial scanty dejections. . . While we are producing foul, dark, fetid 
evacuations, we may naturally expect that we are benefiting and relieving 
the patient. By those that have not had much acquaintance with fevers 
it is hardly possible to calculate the (juantity of medicine sometimes re- 
quired to overcome the torpor of the 'intestinal canal, the morbid accumu- 
lations that have been discharged after repeated purgations, and in some 
cases the speediness of their reproduction (p. 175). 
Inspect the 
evacuation 
in order to 
exact suffi- 
cient pur- 
gation. 
452. In tropical fevers especially, I have seen very striking exam- 
ples of the abatement of fever and delirium after the operation of pur- 
gatives, and it is therefore of great consequence to he aware that the 
febrile symptoms are often maintained or renewed by the retention of 
Tropical 
fevers. THE DOCTRINE OF PURGATION. 
vitiated secretions, or other morbid contents of the intestines, as also of 
the quantity of dark-colored offensive matter that is often discharged 
after the patient has been thought sufficiently purged, and its speedy ac- 
cumulation in some cases, in order to estimate the extent to which it may 
be necessary to versist in the use of evacuations (p. 176). 
Purges 
must be con- 
tinued until 
natural 
stools ensue. 
Naval Surgeon. Medical Topography of New Orleans-, with an 
account of the principal diseases that affected our Fleet and Army 
on the last Expedition against that City. Bee Edinb. Med. & Surg. 
Journ., 1816, Vol. XII. 
Dysentery— 
its origin 
from the 
liver. 
Morbid mat- 
ters the 
cause which 
must be re- 
moved. They 
injure the 
fabric of the 
passages— 
cause flux, 
ulcerations, 
etc. 
453. Dysentery.—In short, to give a condensed view of the whole 
matter, the phenomena of the cases that recovered, as well as the mor- 
bid appearances of those that died, impressed upon my mind a convic- 
tion that the diseased condition of the liver was the soil from which 
dysentery drew its malignant growth, strength, and nurture. This was 
the “ fons et origo mali,” by it the dysentery was excited, and only by 
its removal could the disease be removed. 1 can readily conceive that 
from the disease of any gland, the fluid it secretes may acquire acrimo- 
nious properties sufficient to injure the fabric of the passages through 
which it is destined to pass. 
We generally observe in dyspeptic complaints, or after a period of 
constipation, when the bile, from remora in the bowels, becomes morbid 
in quantity or quality, either that spontaneous diarrhoea comes on, or, 
after a brisk cathartic has been exhibited, that the dislodged bile excites 
a sensation in the rectum, as if boiling lead were voided. When the 
state of the liver is still more morbid, may not the bile acquire the 
property of exciting flux, and of excoriating and ulcerating the villous 
coat of the colon and rectum f (Pp. 142, 143.) 
Typhus and 
the bugbear 
“ debit ty." 
Calomel and 
James’ pow- 
der. 
454. The imaginations of professional men in tropical climates were 
formerly held in subjection by that bugbear, debility, and its train of 
needless horrors. Systems of nosology had been pleased to style the dis- 
order “ typhus icterodes / ” consequently active depletion was carefully 
shunned. The practitioner stood fidgeting with his calomel and his 
James’ powder. The disease took its hue from the species of treatment 
employed at first. The neglect of evacuation allowed the excitement 
to riot and revel unchecked; hence camepetechice, hemorrhages, &c. . . 
Then indeed the disease was pronounced “ malignant, pestilent, and 
highly putrescent” and the golden opportunity occurred for throwing 
in—as the phase is—his bark, his wine, and his opium against that de- 
bility, about which at a wrong time he was over-solicitous. That caba- 
lbtical word “ typhus,” I verily believe, has slain its thousands and its 
tens of thousands (pp. 147, 148). 
Neglect of 
evacuation 
—its conse- 
quence in ty- 
phus. 
Bark, wine, 
opium. 
Dropes, Richard L., Snrg., Remarks on some Remedies which are Used 
in Fevers. London, 1817. See Edinb. Med. and Surg. Journ., 
1817, Vol. XIII. 
Fevers.— 
Emetics, 
diaphoret- 
ics, and pur- 
455. Fevers.—Emetics, I am convinced from experience, have most 
f requently proved injurious, and have seldom failed to aggravate the 
symptoms in a very obvious manner. The great concussion they give THE DOCTRINE OF PURGATION. 
the whole system, particularly the brain, almost invariably increased the 
violent pain so often felt in the head, and especially over the eyeballs; 
and this, it is to be presumed, by increasing the morbid action of the 
vessels of the encephalon. The only cases in which emetics are admissi- 
ble are those in which an obstinate vomiting takes place, owing to some 
crudities in the stomach, which require to be evacuated (p. 59). 
g dives com- 
pared. 
The suprem- 
acy OF THE 
latter main- 
tained and 
proved. 
456. Diaphoretics.—I believe that it is on the principle of the heat 
of the body being morbidly increased, owing to obstructed perspiration, 
that sudorifles are prescribed for the purpose of removing this obstruc- 
tion, and lowering the temperature. However, I conceive this practice 
is not well founded. Diaphoretics, before they can have the desired 
effect, almost always increase the morbid action, and most obviously have 
an injurious tendency. Besides, we have other means of lessening vas- 
cular action and reducing morbid heat without being attended with the 
same inconvenience as sudorifles. Every day we see patients attacked 
with fever completely recover without there being the smallest tendency 
to a diaphoresis through its whole course. When these medicines have 
been chiefly relied on, I have always observed the disease to be much pro- 
tracted, and the cure extremely tedious (p. 60). 
sudorifles 
a cure, 
457. Purgatives.—The generality of physicians place too little de- 
pendence on these, and trust too much to other remedies. I know of no 
general means attended with so much success as the liberal employment 
of cathartics. They should be given in large doses, and often repeated, 
till the patient becomes convalescent, which is generally in a few days 
from their first employment (ibid.) 
Purgatives 
the only reli- 
able remedy, 
when given 
in large 
doses, often 
repeated. 
458. When given merely as aperients their effects are only trifling; 
but when administered with sufficient freedom, with a determination of 
reducing inflammation, their curative powers are often astonishing 
(p. 61). 
Aperient and 
full purga- 
tive action 
contrasted. 
Wilson, Andrew, M. D., Practical Observations on the Action of Mor- 
bid Sympathies. Edinburgh, 1818. 
459. Nerves possess muscular fibers and blood-vessels, and are subject 
to foreign influences ; and the condition of the blood must influence their 
actions by influencing their secretion (text condensed from pp. 20, 21, 
and 82). 
Nervous 
diseases 
from impure 
blood. 
460. There is no department of the nervous system by which, if cer- 
tain or peculiar irritating causes are applied, some other department of 
the same system may not be influenced, so as to draw the organ to which 
they belong into morbid action by sympathetic affinity (pp. 165, 166). 
Sympathy 
of the nerves. 
461. Certain acrimonious matters applied to the extremities of the 
gastric and alvine nerves give a variety of de?’anged actions of the brain, 
although otherwise in a sound state, and the accelerated pulse of the 
whole arterial system, from inflammation found in a small portion of its 
capillary branches, is at once perceptible both to the eye and touch. . . 
Morbid 
matters in 
the stomach 
and disor 
ders of the 
brain, strict- 
ures, etc. THE DOCTRINE OF PURGATION. 
Gastric irritation gives spasmodic affections of the bladder and kid- 
neys. . . Irritation of the lower extremities will excite nausea and vom- 
iting (pp. 166, 167). 
The body a 
unit—mor- 
bid matters 
derange any 
and every 
part of the 
body. 
462. Of all the organs of the human body the gastric and alvine de- 
partment is that which is most extensively and constantly exposed to the 
action of these causes; a surface which extends from the cardia to the 
rectum, every part of which is provided with nerves of the greatest sen- 
sibility (pp. 167, 168). 
Fever—its 
causes. 
463. Fever is excited by acrimonious irritation in the alimentary 
canal, or by the increased secretions which take place in the liver and 
other abdominal glands (p. 19). 
JTeart-dis- 
easesi from 
the digestive 
organs. 
464. The natural and healthy action of the heart and the whole vas- 
cular system is impaired and reduced below its natural standard, as 
exhibited \\\ palpitations, languid pulse, torpor of the limbs, syncope, and 
even death itself, in consequence of the mere application of a peculiar 
offensive substance to the digestive organs (p. 19). 
This paragraph applies to and explains the action of poisons. 
Typhus and 
yellow-fever 
caused by 
infection act- 
ing on 
impurities. 
465. The approach of typhus and yellow fever is at all times attended 
by decided symptoms of an existing diseased state of the stomach and 
bowels, i. e., with those signs which are known to point out their con- 
tents to be of a morbid, irritating nature; but whenever the alimentary 
canal happens to be loaded with irritating matter, some derangement of 
the healthy operation, either of the general system or of some particular 
organ of the body, is the certain result; and when this state happens to 
be united with any other cause of fever (as infections), its effects are 
always thereby much aggravated. It is therefore reasonable to use 
every exertion in such cases to expel it as quickly as possible (pp. 107, 
108). 
Purge with• 
out delay. 
Malignant 
fevers. 
Experience 
teaches pur- 
gation. 
Copious de- 
jections indi- 
cate a cure 
by removing 
a superven- 
ing cause of 
disease. 
466. The method which the most eminent practitioners have adopted 
from experience as the most advantageous is by discharging from the 
primce vice, as expeditiously as possible, their irritating and offensive 
contents, and in reducing the febrile heat by cold applications (p. 128). 
It is also worthy of remark, as it further demonstrates the agency of 
the contents of the stomach and intestines, in producing organic inflam- 
mation, that in these cases which terminate most favorably the stools are 
all along abundant and bilious, with some occasional bilious vomiting; 
and that by these free discharges, the intestinal contents being carried 
out of the body as they are collected, their agency as a supervening 
cause of the febrile state is greatly removed, and they are not left to ac- 
quire that degree of acrimony which is necessary to the establishment of 
inflammation (pp. 129, 130). 
Acute rhm- 
result of irri1 
Morgans*” 
467. A powerful morbid sympathy is called into action (in acute 
rlieumatism), and becomes established betwixt the irritated digestive 
organs and the ligaments of the joints; the adjoining tendonons expan- THE DOCTRINE OF PURGATION. 
sions, the membrane of the muscles, and occasionally the muscles them- 
selves, often forming organic obstructions, and exhibiting all the severe 
phenomena of acute rheumatism (p. 210). . . The primary cause in the 
digestive organs is entirely overlooked, and so is left to continue its 
action with full vigor; consequently the daily repetition of the spas- 
modic paroxysm depending upon it, keeps up the local inflammation on 
the sympathizing membranes, and often extends it (p. 220). 
Pains con- 
tinue until 
the primary 
cause is re- 
moved. 
468. These shiftings of the pains, and change of place from one part 
of the body to another, depend on the occasional change of place of the 
irritating matter contained in the intestines, to one with which some 
other distinct part of the body has a more direct sympathetic affinity 
than that which the pain has left (p. 249). 
Atonicrheu- 
£jdthI£a{"?l!'; 
change their 
location. 
469. The character of atonic rheumatism consists in a painful affec- 
tion of some muscular parts, or of their membranes. The pains are not 
so severe as in acute rheumatism ; they very frequently wander from 
one part of the body to another, although it often happens that they re- 
main fixed in one part for a long time. . . A particular muscle, or a 
portion of its fibers, become frequently so affected by the sympathetic 
spasm as to be impeded in its free action; the pain being constantly 
aggravated by the slightest movement of the part, although quite easy 
when the muscle is at rest (p. 247). 
—its charac- 
470. The remote cause of these phenomena is decidedly seated in the 
digestive organs in atonic as well as in acute rheumatism. They are in 
their nature spasmodic, only the seat of the morbid sympathy most com- 
monly appears to be one less susceptible of that inflammation which 
forms the secondary disease of acute rheumatism (p. 248). 
The cause of 
all rheu- 
matic com- 
plaints is in 
the digest- 
ive organs. 
471. In the treatment of acute rheumatism much attention is due to 
the state and circumstances attending the primary gastric fever. Expe- 
nence has supported the opinion that,m proportion as the primary 
. cause of disease is removed, the sympathetic effect on the membranes of 
the joints begins also to subside (p. 221). In order to accomplish this 
object the most free evacuations from the stomach and intestines are re- 
quired, and the patient generally bears them well (p. 222). 
thg cause the 
mostfrf 5 
** required. 
472. But of a much more painful nature than the atonic rheumatism 
are the cases of lumbago, sciatica, tic douloureux, andperiodical or inter- 
mitting rheumatism. They are with great certainty to be traced from 
the same remote cause, and, like the former, are only sometimes attended 
with gastric fever, but are uniformly associated with decided signs of a 
diseased state of the alimentary canal (p. 249). 
and uc-dou- 
from disease 
fffaf/ca- 
nal 
473. All local applications, independent of clearing the alimentary 
canal from its contained acrimony, can go no further than merely to pal- 
liate the effect of this cause, but without curing the disease, which will 
not happen while the power of the other remains in action (p. 257). 
on>y Pall!- 
cause must 
to c«”°ved THE DOCTRINE OF PURGATION. 
removing 
t,,eea™°e.bld 
474. Erysipelas is intimately connected with the state of the diges- 
tive organs, which is clearly demonstrated by the well-known fact of its 
appearing in various degrees on the skin, in consequence of certain kinds 
of food having been taken into the stomach, and this not only in too 
short a space of time after to admit of the chyle impregnated by them 
to be taken into the circulation, but while they as yet remained in the 
stomach, and the inflammation disappearing as soon as those contents 
were thrown off (p. 371). 
Sore-throat 
TevertroL 
stomach- 
475. From the great similarity of the general symptoms exhibited in 
scarlet fever to those exhibited in typhus fever, it will be obvious that 
the treatment here ought to be very similar to that adopted to those 
under typhus; which is, in the first place, pointed to the mitigation of 
the two great supervening causes of fever—irritation in the primce vice 
and excess of caloric—especially to that which is seated within the diges- 
tive organs; the very exhalations from which, ascending to the fauces, 
do, beyond a doubt, tend to keep up the inflammation, and, consequently, 
the ulcerated state (pp. 142, 143). 
476. That free evacuations increase debility is in reality an un- 
founded apprehension. . , Whatever will act upon the morbid cause, so 
as to evacuate it from the body, so far from weakening, will assuredly 
tend to restoration of the strength ; and this is a fact which unvarying 
experience has proved in every instance where nature lias not been 
already exhausted by other means (pp. 60, 61). 
Purgation 
removes de- 
bility, and ,j 
gives 
strength. 
477. The intention is not merely to preserve the bowels soft, but to 
discharge from the intestines a lurking cause of disease / to accomplish 
which purpose very full evacuations are always necessary, procured by 
the help of the most active purgatives administered in appropriate doses; 
remarking the nature of what comes off till it puts on a healthy ap- 
pearance (p. 62). 
The advan- 
tage of full 
purgation. 
Examina- 
tion of de- 
jections. 
478. To restore health, purgatives must be perseveringly applied (in 
typhus fever), as it is certain that the retention of any sort of noxious 
m°tter 'in tf,e primes vice, the tendency of which is in general to lessen 
the energy of the nervous system, is infinitely more debilitating to the 
human frame than the temporary fatigue attendant on the moderate 
operation either of an emetic or purgative medicine, besides the harm 
which may ensue from the noxious matters being partially reabsorbed 
(pp. 110, ill). 
impurities 
weakening 
fullest thur 
' geationpur 
Measles. 
Sympathy 
between 
stomach and 
lungs;— 
purge the 
acrid mat- 
ters away. 
479. That a state of morbid sympathy betwixt the stomach and 
lungs does actually exist in many cases of measles I believe to be cer- 
tain. My belief is founded on the very great relief from pneumonic 
symptoms received by a free discharge of acrid matter from the stomach 
and intestines—a relief which can be accounted for from no other law 
of the animal economy. Repeated bleedings will, no doubt, tend to 
lessen the vascular action, but probably in no high degree, while the 
secondary cause of fever continues to give its irritation to the nerves of 
the stomach and bowels ; and it is obvious that venesection cannot act as 
a means of removing this cause, neither, indeed, are the more lenient 
mm pur g a- 
useiess!"and 
why' THE DOCTRINE OF PURGATION. 
cathartics to be depended on for this purpose; for although they will to 
a certainty open the bowels, yet they very frequently pass along and leave 
the offending cause behind. It is the more active powers of drastic pur- 
gatives alone which are here to be confided in (pp, 136, 137). 
Hamilton, Jr., John. On the Use and Abuse of Mercurial Pemedies. 
Edinburgh, 1819. 
480. In pleurisy, from the time that the influence of mercury be- 
comes evident, the general strength rapidly declines (p. 7). 
481. If there be ulcerations in any part of the body, they must as 
certainly degenerate into malignant sores, under the influence of mer- 
cury, as blistered surfaces or scarifications mortify in cases where the 
living powers are much exhausted (p. 9). 
Pleurisy— 
baneful 
effects of 
mercury. 
Ulcers— 
become ma- 
lignant by 
mercury. 
Johnson, James, M. D. Critical and Explanatory Pemarhs in his 
Periodical, Medico-Ciiirukgical Review, established in 1819. 
482. Purgatives in intestinal inflammation have been objected to 
on the ground that they are quickly rejected by vomiting ; but this ob- 
jection is not valid. . . If the first purgative be rejected, it is repeated 
by Dr. Pring in an hour or two, and so on, with various forms of pur- 
gatives, until the bowels are opened, when in general we find the ball 
at our own feet (vol. IV., 1823, p. 259). 
Intestinal 
inflamma- 
tion. 
Give purga- 
tives until 
the stomach 
retains them, 
and the cure 
is effected. 
483. Dr. Pring says, “ typhus has two origins, one from external 
affection, and the other from a spontaneous generation of disease in the 
subject affected by it ” (ibid., p. 250). 
Typhus — 
its origin. 
484. Ilis favorite practice is purgation of a very active kind (Pr., p. 
102); has seen his patients stimulated into fatal apoplexy (ibid., p. 
lants. s 
485. In the treatment of any form of chronic disease, whether in 
the digestive organs or elsewhere, purgatives frequently increase the 
symptoms at first, an effect which is rather desirable than otherwise, 
and it proves that the remedy has a relation with the disease, and is 
capable of subverting this state, if continued for a sufficient length of 
time (ibid., p. 275). " 
Chronic die- 
Effft'of 
hrae“ef7e,° 
aon with the 
disease. 
By the use of Brandreth’s Pills the vital forces change chronic affections into acute. Then 
further purgation with them soon effects a cure. 
486. Dr. Abercrombie is of opinion that the only remedies of real 
efficacy in epilepsy are purgatives and a strict vegetable diet, with total 
abstinence from strong liquors (ibid., pp. 127, 128). 
purgatives. 
487. Constipation in Pregnancy.—De Lemazurien was sent for on 
the 8th of July, 1823, to see a woman in the seventh month of her 
pregnancy. Abdomen much distended, transverse arch of the colon 
Constipa- 
tion. TIIE DOCTRINE OF PURGATION. 
Fatal conse- 
quences of 
the neglect 
of purga- 
tion in preg- 
nancy. 
greatly distended, pulse and appetite feeble, dyspnoea, sleeplessness, 
faintness, pains in the loins. Lavements were ordered, but it was deter- 
mined to wait till the accoucliment was over before the evacuation of 
the bowels should be attempted. 
After child-birth, clysters being, employed, the fecal accumulation 
appeared to break up, and there was an evacuation of two or three 
pounds of hard brown fetid matter, but there remained a collection too 
large for expulsion. The patient was worn down by nausea, fever, col- 
icky and other pains, and died 21st September. 
The colon from the csecum to the rectum was found to be intensely 
inflamed. It was a foot in circumference throughout its whole length, 
Avas filled with gas and with 13£ pounds (French) of solid fteces (1824, 
A'ol. I., pp. 233, 234). 
This case was simple. Two or three doses of Brandreth’s Pills would have certainly re- 
lieved, by thoroughly removing all the fecal contents of the bowels. And no danger incur- 
red at any period of gestation to either mother or child by the use of this safe but certain 
medicine. 
Epilepsy. 
The cause, 
seated in the 
bowels, to be 
removed by 
continued 
purgation. 
488. Epilepsy.—The views of Dr. Chapman coincide with those of 
Dr. Pritchard, in placing the cause of apoplexy very frequently in the 
bowels. lie was led to the use of purgatives by the total failure of the 
ordinary plans of treating the disease: “ it will not do, however,” he says, 
li merely to evacuate the bowels ; cathartics must be repeated day after 
day without interruption, unless absolutely forbid by circumstances ” 
(vol. IV., 1823, p. 73). 
Nervous 
diseases 
from 
retained ex- 
cretions. 
489. The retention of biliary, urinary, intestinal and cutaneous 
excretions is often the remote cause of diseases of the nervous system, 
as well of the neuralgic as of the spasmodic and maniacal groups (New 
Series, 1852, vol. X., p. 97). 
Neuralgia 
from morbid 
matter in the 
blood, which 
acts on the 
part predis- 
posed, to in- 
duce local 
disease. 
490. Whenever there exists “ induced local susceptibility ” morbid 
elements in the blood act most obviously in inducing neuralgia. Mala- 
ria may be present therein, yet remain latent and harmless until this 
state occurs. So also the materies morbi of rheumatism or gout may 
fly about until it is specially manifested in some locality rendered 
more susceptible by predisposing causes. It may be observed that 
poisons in general have a specific elective affinity for certain portions of 
the nervous system (New Ser., 1852, vol. X. p. 103). 
All our 
knowledge of 
medicine is 
from expe- 
rience. 
491. We find that under certain circumstances a drug does good, and 
we employ it when those conditions present themselves. The modus 
operandi is often totally unknown, and though it would be very satisfac- 
tory to know it, yet we can dispense with it, and from experience alone 
prescribe our remedies with very considerable success (New Ser., 1851, 
vol. VIII., p. 204). 
Erysipelas 
from retain- 
ed and pu- 
trid faeces. 
492. The condition of the alimentary canal should be carefully 
watched in erysipelas, for we have long suspected that it arises more 
frequently from its derangement than the generality of the profession 
are aware. Excrementitious matter allowed to putrify in the fecal tube 
will not only operate as an irritant upon the whole system, but from the 
close and constant sympathy which holds between the cutaneous and THE DOCTRINE OF PURGATION. 
mucous surfaces, may be expected to exert a deleterious influence more 
immediately upon the skin. Hence the erysipelas bilcosum and gastri- 
cum of many writers (p. 371, Ser. I., 1828, vol. IX). 
493. In the concluding stages of the putrid fevers, when the bowels 
had been long neglected before assistance was procured, we have seen 
the most tedious and inveterate forms of the disease (ibid). 
Putrid 
erate from 
Toweil °J 
Boyle, James, Surg., A Treatise on Epidemic Cholera in India. Lon* 
don, 1821. 
494. It sometimes happens, after patients are despaired of, they have 
a critical evacuation of viscid bile. When this circumstance takes place 
the patient invariably recovers. I have known it to occur in cases when 
the pulse had been almost imperceptible for twenty-four hours. I looked 
on the obstruction of the biliary ducts as a source of irritation to the 
nervous system generally, and the nausea and sickness of the stomach as 
an effort of nature to free herself from an unaccustomed evil. These 
views and a general want of success in practice induced me to embrace 
ideas perfectly new on the subject. Emetics and purgatives were adopted 
as the most likely means to answer the various purposes of clearing the 
stomach, removing obstructions of the biliary ducts, and exciting a new 
action in the vascular system (pp. 51-61, condeus.). Many successful 
cases given. 
Cholera—its 
cause, and 
purgation 
its cure. 
The very course I pursued iu London in 1831, and again adopted in New York in 1849, 
1853, and 1866. 
Chapman, N., M. D., President of Academy of Medicine in Philadel- 
phia. The Elements of Therapeutics and Materia Medica, 2 Vols. 
Philadelphia, 1821. 
495. Gout.—My impression, very concisely stated, is, that this dis- 
ease, if not originating in, has a most intimate connection with, certain 
state of the alimentary canal. It generally commences with those symp- 
toms which denote a depraved condition of the stomach and bowels 
(p. 190). 
Gout—its 
origin. 
496. I have now for many years habitually employed purgatives in 
the paroxysms of gout, and with unequivocal advantage. Not content 
with simply opening the bowels, I completely evacuate by active purging 
the whole alimentary canal. This being accomplished, all the distress- 
ing sensations of the stomach which I have mentioned are removed, the 
pain and inflammation of the limb gradually subside, arid the paroxysm, 
thus broken, speedily passes away. To effect these purposes, however, it 
is often necessary to recur to the'remedy frequently (ibid.) 
Cure: by 
powerful 
purgation. 
497. Palsy.—Dissatisfied with this course (the usual routine of bleed- 
ing, blistering, and stimulating embrocations to which he formerly had 
recourse) I have for many years abandoned it, and rely navi almost ex- 
clusively on evacuating the bowels by the drastic purgatives. Of the 
propriety of the change I can entertain no doubt, the success having 
Palsy. 
Bleeding re- 
jected. 
Purgation 
highly suc- 
cessful. THE DOCTRINE OE PURGATION. 
exceeded my most sanguine expectations. To do justice to the practice, 
it should be steadily persevered in, and aided by such remedies as the 
case may from time to time demand (p. 193). 
Lloyd, Eusebius, A., M. I)., Treatise on Scrof ula. London, 1821. 
498. The very great influence which evacuations from the bowels 
have over the rest of the body cannot be denied by any impartial ob- 
server ; it is therefore certain that by increasing or diminishing them we 
are able to produce a decided effect cm the whole, or, as 1 have proved 
before, on a particular part of the body. Thus, if there is much general 
irritation, or local irritation and inflammation, by increasing the intesti- 
nal evacuation—taking care, however, not to irritate the bowels—we 
may very much relieve both the one and the other (p. 162). 
Scrofula. 
Purgation 
—its action 
explained. 
When Brandretli’s Pills are the purgative there is no danger of irritating the bowels. 
Nickoll, William, M. D., General Elements of Pathology. London, 
1822. 
TJnity of 
the human 
body. 
499. We speak of the body as being composed of distinct sets of 
structures—the vascular, the nervous, the muscular; or else we treat of 
it after the manner of geographers, as consisting of the head, the thorax, 
the abdomen, &c. Whichever mode we adopt, we acquire a habit of 
considering each portion which we enumerate as a distinct and isolated 
fact. The consequence is, that when any deviation from health occurs, 
our attention is fixed upon the diseased condition of this particular part 
of the body, while every other portion is supposed to preserve its former 
healthy state. It is evident that each part cannot be considered as a dis- 
tinct insulated republic, but as a constituent portion of the general com- 
monwealth, whose health is dependent upon a certain condition of every 
portion of the body- (X.) 
Disease not 
local but 
general. 
Shaw, John, M. D., On Partial Paralysis • a Paper read before the 
Medico-Chirurgical Society of London, in April, 1822 ; a Narra- 
tive of the Discoveries of Sir Charles Bell in the Nervous Sys- 
tem, by Alexander Shaw, Surg. London, 1839. 
Nerves. 
Those with 
one root have 
only one 
function; 
those with 
two roots a 
double func- 
tion, namely 
motion and 
sensation. 
This is true 
of nerves 
both that 
originate 
from the 
brain and 
from the 
spinal mar- 
row. 
500. By experiments upon the portio dura he (Sir Oh. Bell) demon- 
strated that it was a motor nerve exclusively, and had no power of be- 
stowing sensation. When cut across, in the living animal, the motions 
of a certain set of muscles were immediately arrested, but the sensibility 
of the surface supplied by the nerve remained undiminished. Upon sub- 
mitting the fifth pair to experiment, a totally different set of phenomena 
presented themselves. This nerve, although it arises from the brain by 
two roots, has one of its origins nearly four times larger than the other. 
. . It was found that when those branches which proceed simply from 
the larger root were cut across, only one endowment—sensation—was 
destroyed; whereas upon cutting across those branches in which the 
fibrils of the two roots were united together in the same sheath, not 
only sensation, but the power of motion, were destroyed (pp. 9, 10). An 
attempt was made to apply the new observations, in a similar manner, THE DOCTRINE OF PURGATION. 
to the pathology of the spinal marrow. Certain affections of the upper 
or lower extremities, supplied by these spinal nerves, sometimes occur, 
in which the sensation of the limb is destroyed, while the motion remains 
entire, and vice versa (p. 11). 
501. Now, as it has been established experimentally that motor 
power belonged to the anterior roots, and sensation to the posterior, it 
was concluded that when motion, in these cases, was lost, it depended 
on a morbid condition of the anterior or motor column of the spinal 
marrow; while, if sensation was lost, it depended on disease of the pos- 
terior or sensitive column (pp. 11, 12). 
The causa of 
of impaired 
'ensa wn' 
These butcheries lead to little good in a practical way. 
502. I shall make a few remarks upon a question which has particu- 
larly excited the attention of physicians of all ages, since the time of 
Galen, “ Why sensation should remain entire in a limb when all volun- 
tary power over the action of its muscles is lost; or why muscular power 
should remain when feeling is gone? ” . . In answer, Galen said : that 
two sets of nerves went to every part; one to endow the skin with sensi- 
bility, the other to give the m uscles the power of voluntary action. This 
opinion was probably founded on a mere theory; but the facts lately 
discovered, and the observations which have been noted in attending to 
the phenomena of disease, though they do not afford absolute proofs of 
Galen’s supposition, still go far to establish the fact, uthat every part of 
the body which is endowed with two or more powers, is provided with 
a distinct nerve for each function'''’ (p. 13). 
Further ex- 
planation of 
the above. 
Galen's 
opinion. 
503. The form of the nerves, which at the same time endow the 
skin with sensibility and the muscles with the power of voluntary mo- 
tion, is such that they appear to be single cords; but if we examine the 
origin of any of these nerves, we shall find that it is composed of two 
packets of fibres, which arise from distinct parts of the spinal marrow. 
These origins are soon enveloped in tlie same sheath, so as to appear to 
form a single nerve (p. 13). 
nerffora- 
root, 
504. It is not too much to suppose that either of these origins may 
he affected, while the other remains entire. To prove this by ocular 
demonstration will perhaps be impossible. But we have already seen 
examples of the consequences of injury to a nerve that has a single root, 
viz., the “ portio dura; ” for, if we cut it, there will be only one set of 
actions paralyzed ; while by dividing a nerve which has a double origin, 
viz., the fifth, we shall destroy two powers, namely, voluntary motion 
and sensibility. We know, also, that when we cut through the trunk of 
a nerve going to the hand, we destroy both sensibility and the power of 
motion. . . if the view here taken be correct, it may lead to this rule of 
practice: If only one set of functions of a spinal nerve be deficient, we 
should apply our remedies to that part of the system from which the 
nerve arises; but if both functions are impaired, we must direct our 
inquiries to the state of the nerve in the whole course, from its origin to 
Local appli- 
cations and 
general 
treatment. 
Nervous af 
fections as 
proceeding 
from impuf e 
blood, or 
fetid mat- 
ters in the 
bowels, al- 
ways indi- 
cate pu ga- 
bion assisi- 
ing the local 
application 
and perfect- 
ing the 'gen- 
eral treat- 
ment. TIIE DOCTRINE OF PURGATION. 
its distribution, as tlie loss of power is probably owing to some affection 
of a part of the nerve after the two sets of filaments, by which it arises, 
are united together (pp. 13, 14, 15). 
—• It may here be observed that Mr. Shaw was a pupil of Sir 
Charles Bell’s, and that his treatise was based upon the latter’s 
opinion, given in a short “Essay on the Anatomy of the Brain,” 
printed and distributed among his friends in 1809 or 1811. (See 
A. Shaw, p. 14.) 
Pring, Daniel, M. D., An Exposition of the Principles of the Path- 
ology and of the Treatment of Diseases. London, 1823. 
Inflamma- 
tion, perito- 
neal and in- 
testinal— 
purge 
without fear 
of increasing 
the inflam- 
mation, and 
why not. 
505. In enteritis and peritonitis I have trusted more to purgatives 
than to bleeding, and I have no reason to regret this confidence. The 
use of purgatives, it has been objected, must increase inflammation ; the 
effect, however, is otherwise / and the testimony of experience must on 
this as on other occasions, supersede all a priori reasonings. But as a 
matter of reasoning, the conclusion against purgatives on tliis ground is 
not legitimate (p. 219). 
Argument 
original and 
logically 
stated. 
506. It does not follow, that an agent which is related with a secret- 
ing function so as to increase it, should also be so related with inflam- 
mation, which frequently suspends secretion, as to augment its intensity. 
On the contrary, in the way of reasoning, it would appear that if secre- 
tion is suspended by inflammation, that which restores secretion must 
diminish inflammation. 
Setting reasoning for the present aside, I suspect that in cases in 
which purgatives have been supposed to increase intestinal ihflam'tnation, 
it is because those means were inadequately employed (ibid.). 
The danger 
is in not 
purging 
with suffi- 
cient en- 
ergy. 
Dyspepsia. 
507. Dyspepsia, whether simple or accompanied by disordered func- 
tion of the liver, chronic pains in the side, &c. When the inconvenience 
attending purgation has passed away, then an improved state of the di- 
gestive organs succeeds (pp. 307-309, condensed). 
Chorea. 
Purge until 
healthy 
stools ap- 
pear. 
508. Chorea.—In the few cases which have occurred to me of this 
disease, some of which were severe ones, it has yielded to purgatives in 
about three weeks. The stools have commonly in about this period 
assumed a healthy appearance, and the spasmodic action of the muscles 
has quickly ceased (p. 245). 
Chronic 
rheumatism 
—cured by 
free, purga- 
tion. 
509. A gentleman had chronic rheumatism, chiefly affecting his 
knees and shoulders. He went out on a cold damp day ; in the evening 
he had rigors; the rheumatic pains left the extremities, and he was 
taken with something like syncope, sense of constriction at the bottom 
of the throat, of weight in the chest, with a fluttering irregular pulse of 
1G0 a minute. I gave him a full dose of calomel, salts, senna and jalap, 
which produced eight or ten stools in as many hours. 
The next day he was able to lie flat in his bed. The purgings were 
continued. In four days his pulse came down to 60, and in a few days 
he began to recover rapidly (p. 217). THE DOCTRINE OF PURGATION 
510. Humoral Patholoeiu may be said to have been perfected by 
Boerhaave (Preface, p. 1). ‘ 
unmoral 
511. So unsettled is the state of pathology that those who read are 
skeptics in all its doctrines; and those who do not read are left to the 
guidance of a sort of intuition, which is not always productive of happy 
results, hut very frequently suggests, through the course of a long life, 
only reiteration of the same error (p. 1). 
Medical ig- 
norance. 
512. It appears to me, then, in the case of the “ peccant humors,” 
that their phenomena are not produced by a mechanical agency. It is 
more agreeable with the results of analytical inquiry to conclude that 
the animal poisons contain latent properties of a vital hind, which are 
related with those of the same hind in living bodies / that the phenomena 
of disease or death, which ensue from the operation of the animal poi- 
sons in living bodies, are according to the nature of the properties which 
are engaged in this relation (p. ii.). 
Th}ffffrit 
_ Original 
' “action.eir 
513. In my own experience it has been invariably the case, that 
those who have sustained great loSses of blood suffer more or less from 
what is called determination to the head. The symptoms most common- 
ly are intense pain and throbbing in the forehead or back of the head, 
with a pulse seldom under 90 (p. 23). 
weeding m- 
wood, 
514. It is common in severe and threatening forms of cerebral dis- 
orders, notwithstanding previous loss of blood, to resort to the lancet, and 
to repeat copiously and frequently, if the symptoms continue. I have 
observed that this practice has generally had a fatal termination 
(p. 86). 
rowing in 
orders/«<at 
515. I have been in the habit of confiding in purgatives to the almost 
total neglect of the lancet; but these purgatives have not been of a 
milk-and-water kind. I have given 6 grains of calomel, 6 grains of 
James’ powder, followed by a 2-ounce draught of senna and salts with 
half a drachm of jalap in it. If this has been rejected, it has been re- 
peated in less than an hour, and repeated as often as it was rejected, until 
it has produced copious evacuations f rom the bowels (ibid). 
aiimiel 
Pur0jaffs 
strongest 
exhibited, 
516. One, and perhaps an important effect of such purgatives, is to 
make a great revulsion to the whole intestinal canal, which is commonly 
followed by almost perfect relief to the head, and perhaps an immediate 
subsidence of the pulse to 100 or 110. The tendency to disorder of the 
head is afterwards easily kept within safe bounds by small repeated doses 
of purgatives (ibid). 
exPlained- THE DOCTRINE OF PURGATION. 
Crampton, John, M. D., On Tinea. See Transactions of the King’s 
and Queen’s Colleges of Physicians in Ireland. Vol. IV., 
1824. 
Ringworm. 
gatimf™ 
517. Tinea, or Ringworm.—Having exhausted my patience with 
trials of all enumerated topical remedies, the treatment which I finally 
adopted was, first to use simple poultices, aided by a constant use of 
purgatives, and the tepid bath (p. 60). 
In scald head and ringworm the patient should use Vinegar of Bloodroot as an external 
application twice or thrice a day, and Brandreth’s Pills so as to purge freely. Read directions. 
ITosack, David, M. D., Medical Essa/ys. Few York, 1824. 
Hosack’s def- 
inition—its 
effects if pur- 
gation is neg- 
lected. 
If nature 
floes not re- 
move impu- 
rities, art 
must, or 
death fol- 
lows. 
Fever. 
518. “ Fever is a disease of the whole system ; the absorbing, the circu- 
lating, and the excreting systems of vessels are all affected by it. . . 
Fever cannot long continue without inducing debility in the heart and 
arteries. It not only wastes the power of the solids, but by the derange- 
ment of the functions and excretions, and especially by the retention of 
those materials which should have been thrown out of the system as 
noxious, which in health are constantly ejected, the circulating fluids 
become changed and vitiated, and thereby become additional sources of 
irritation to the heart and arteries” (vol. II., p. 93). 
From this view we infer that, unless by some salutary power inhe- 
rent in the system itself, or by some means suggested by art, the greater 
irritability of the whole system be diminished, or the morbid changes 
induced in the fluids they circulate be counteracted, these causes of 
fever mutually operating upon each other must increase and fever be 
continued, until the vital principle be totally expended (pp. 93, 94). 
Effects of 
retained 
feeces. 
519. Attention, should be daily given to the bowels far the purpose 
of evacuating their offensive contents, especially of the lower tract of 
the alimentary canal • for, these malcontents being retained, not only 
in some instances become the source of irritation to the intestines them- 
selves, producing diarrhoea, but by their absorption into the mass of 
circulating fluids, which are thereby rendered still more malignant, they 
necessarily constitute fresh sources of febrile excitement (p. 98). 
520. I believe that the typhus fever of our country owes much of its 
malignity to the indiscriminate use of mercury (p. 101—Report to the 
Governors of New York Hospital, Sept,., 1819). 
Typhus 
fever. 
Mercury in- 
creases its 
malignity. 
Malignant 
pleurisy. 
521. The prudent physician will of course carefully abstain from the 
use of blood-letting and other depleting remedies (in malignant pleu- 
risy). But he will not certainly guard against debility by the excessive 
use of brandy and ardent spirits. So far from promoting the excre- 
tions of the system they actually restrain those very evacuations 
which it should be an object to promote, and by which alone we are 
enabled to counteract the typhoid state of the body in this or any other 
febrile disease (p. 197—Letter of Dr. Hosack’s to Dr. T. R. Beck, Feb. 
3d, 1813, on the fatal epidemic prevailing at Albany). 
Bleeding 
destroys. 
Monies use- 
less, even in- 
jurious. 
Purgation 
saves. 
Brandy and all alcoholic stimulants retard the decarbonization of the blood, because the 
oxygen of the atmosphere has greater affinity for alcohol than it has for carbonic acid. THE DOCTRINE OF PURGATION. 
522. Gout is exclusively an inflammatory disease of the whole sys- 
tem as well as of the part affected. Apoplexy, palsy, angina pectoris, 
asthma, habitual catarrh, eruptions on the skin, obstructed viscera, and 
dropsy, arise from the same habit of body and from the same causes 
—the effects of an overloaded state of the blood-vessels (pp. 234, 235). 
Various dis- 
eases from 
retention of 
impurities. 
Good, John Mason, M. D., The Study of Medicine. 5 Vols. London, 
1825. 
523. Toothache is often produced by a remote cause, as sordes, in the 
stomach (vol. I., p. 41), or whatever tends to render the fluids acrimo- 
nious, as long use of mercury. 
Chronic rheumatism, or acrimony in the stomach, produces nervous 
toothache (ibid., p. 57). 
Toothache, 
from morbid 
matter in the 
stomach;— 
also nervous 
toothache. 
524. The grand proximate cause of cardialgia, gravel, and gout, is 
debility of the stomach, whence, among other evils, a morbid secretion 
•f gastric juice. The debility is not confined to the stomach, but ex- 
tends to the intestinal canal and the other viscera. 
The debility is evident from the habitual costiveness which so pecu- 
liarly characterizes this affection. The imbecility of the liver is equally 
obvious from the small quantity of bile that seems to be secreted, or its 
altered and morbid hue, as evinced by the color of the fasces (ibid., p. 
(59). 
Cardialgia. 
gravel, and 
gout, from 
disorder of 
the stomach. 
Costive')i ess 
the habitual 
symptom. 
525. The lungs are also in many instances apt to associate in the 
morbid action of the digestive organs, when it has become chronic, and 
i o produce a peculiar variety of consumption—dyspeptic phthisis (ibid., 
p. 160). 
It must be obvious that, if the chyle which originates in the stomach 
should be conveyed to the lungs in an unhealthy condition, its peculiar 
stimulus must be changed in its mode or degree of action, and the lungs, 
in consequence, suffer (ibid., p. 163). 
The medical treatment: We must restore the debilitated organs 
riO THEIR PROPER TONE (ibid., p. 164). 
The lungs 
are impli- 
cated ; bad 
blood is 
made, and 
consump- 
tion fol- 
lows. 
526. Colica—colic.—Among the chief causes, acrid, cold, or indi- 
gestible esculents, worms, calculous or other balls congested in the in- 
testines and obstructing their passage, as scybala and indurated faeces 
(ibid., p. 195). 
Cure.—Warm fomentations—clysters. Purgatives should be at- 
tempted by the mouth, though the vomiting is sometimes so incessant 
that we can get little or nothing to stay on the stomach. But the at- 
tempt must be made, and steadily persevered in (ibid., p. 196). 
Colic from 
acrid mat- 
ters. 
Persevere in 
purgatives. 
527. Constipation.—As the faeces are forced forward by the peristal- 
tic action of the intestines, it is obvious, whenever this action is weakened, 
there must necessarily be a retardation, and, consequently, an accumu- 
lation of faeces. In some instances this accumulation is prodigious. . . 
In one case which ended in death, the cause being mistaken for preg- 
nancy, the colon measured in circumference twenty inches, and on dis- 
section was found to contain three gallons of faeces (ibid., pp. 232, 233). 
Constipa- 
tion — mor- 
bid matters 
in the intes- 
tines. 
Interesting 
case of dis- 
tended colon. THE DOCTRINE OF PURGATION. 
variety of 
.nanifesu- 
constipation 
528. Effects of constipation, when long continued: pains in the head, 
nausea, febrile irritation, general uneasiness in the abdominal region, 
congestion in the abdominal organs, and hence an impeded circulation 
of the blood, piles, varices of the lower limbs, colic (ibid., p. 234). 
powerful 
purgatives. 
529. If laxatives fail, the more powerful purgatives must be had re- 
course tm the patient can habituate himself to evacuate the bo wels at 
a certain hour every day (ibid., p. 235). 
Diarrhoea 
ingesta1;- 
purge. 
530. Diarrhoea.—Chief causes: “acrid ingesta” and obstructed bile. 
Often antecedently to the looseness there is a sense of sickness, and per- 
Laps a few slight torminal pains. But if the disorder do not prove its 
own remedy, it is easily removed by any common purgative medicine 
(ibid., p. 240). 
531. It requires to be restrained with caution; for a sudden cure, 
and especially a sudden transfer to a state of costiveness, has often pro- 
duced some severe complaints, and, in one or two instances, epilepsy and 
phthisis (ibid.) 
Astringents 
worms. 
ancTwh7 
532. Worms.—Dr. Ileberden says: “ Till some more certain remedy 
shall be discovered, nothing will be more serviceable than to keep the 
bowels loose. By their irritation they augment the secretion of mucous, 
in which also they involve themselves.” 
By heaping the bowels loose we prevent the accumulation of this slimy 
material in which the worm burrows, and, if we have reason to believe 
that such accumulation has taken place, the best plan is to give active 
purgatives (ibid., p. 329). 
p<ies— 
physiology. 
533. Piles derive their existence perhaps in every instance from a 
iurgiy on(i varicose state of the anal veins, covered with a slight thick- 
ening of the inner membrane of the rectum (ibid., p. 363). 
fJcettke 
cause. 
534. Causes:—Local irritation produced by indurated and retained 
faeces, congested state of the liver and adjoining viscera, &c. If left 
to themselves, they swell into tumors, and become so painful as to pre- 
vent walking or sitting (ibid). 
permanent. 
s.vmptotnsin- 
1 "ture. e 
535. Jaundice is easily reproduced in those who are subject to it, 
\>y flatulence, acrimonious or indigestible food. The bowels are for the 
most part costive and moved with difficulty (ibid., p. 390). 
Yeiiow-gum 
-purge. 
530. Yellow-gum—-jaundice of infants.—A dose of any active pur- 
(jai[ve win generally be sufficient to remove the obstruction (ibid., 
p. 404). 
Fever—. 
'('kfluition.0 
537. Fever.—It was the opinion of Hippocrates that fever is an 
effort of nature to expel something hurtful from the body, either ingen- 
erated or introduced from without (vol. II., p. 44). THE DOCTRINE OF PURGATION. 
538. There is no writer of the present day, perhaps, who has carried 
this view of the subject farther, or even so far, as Professor Frank, 
who regards typhus, plague, petecliise, and all pestilential fevers, and 
indeed nervous fevers of ami kind, whether continued or remittent, not 
only as proceeding f rom specijic contagions in the same manner as ex- 
antliemas, but from contagions producing a like leaven in the system, 
and matured and thrown off through the various outlets of the body, 
by the same process of depuration (ibid., pp. 45, 46). 
“ All fevers 
puritie“rom 
me'J)‘rli1“at.tll 
impurities 
in.” 
Dr0ffufs 
539. Typhus.—The term is derived from Hippocrates, and means to 
smoulder, or burn and smoke without vent. When a typhus has once 
arisen, the effluvium from the living body during its action is loaded 
with miasms of the same kind, completely elaborated as it passes off 
(ibid., p. 224). 
Typhus. 
The body 
exhales 
miasms. 
540. Dr. Hay garth and Dr. Bancroft show from numerous cases, 
that the miasmatic poison of typhus, when received into the body, con- 
tinues in a latent state at least for seven days from the time of exposure 
to the contagion, before the fever commences. . . . 
A peculiar state of the body gives a peculiar tendency both to gene 
rate and receive typhus, whilst some seem to be favored almost with a 
natural immunity (ibid., pp. 227, 228). 
The typhus 
poison latent 
for seven 
days; —free 
purgation 
will therefore 
remove the 
poison before 
it is elabora- 
ted. 
541. Dysentery :—primary a disorder of the colon, so considered by 
Sydenham and Dr. Olieyne;—first gripings, then dejections, and the 
fever follows. Sydenham’s chief remedy was active purgation twice 
every other day, with warm diaphoretics on the days when the aperient 
was not employed (ibid., pp. 552-556, cond.). 
ion; —cure 
Ration fu>~ 
542. Eruptive fevers.—Whenever any diseased action is taking place 
internally, there is a constant effort exhibited in the part, oi in the sys- 
tem generally, to lead it to the surface, where it can do but little mis- 
chief. . . It is by means of the fever that the disease works its own 
cure, for it is hereby that a general determination is made to the sur- 
face, and the morbid poison is thrown oft* from the system ; but the 
fever may be too violent, and from accidental causes of the wrong kind 
(vol. III., p. 5). 
Eruptive- fe- 
vers—a, nat- 
ural effort to 
rid the sys- 
tem of mor- 
bid matter. 
The benefit 
of purga- 
tion pal- 
pable. 
543. The grand principle in the treatment of smallpox, as of all 
the other exanthemas, is to moderate and keep under the fever / and how- 
ever the plans that may have been most celebrated for their success 
may have varied in particular joints, they have uniformly made this 
principle their polar star, and have consisted in different modifications 
of cold water, acid liquors, and purgative medicines—heat, cordials, and 
other stimulants having been abundantly proved to be the most effectual 
means of exasperating the disease and endangering life (ibid., p. 109). 
Dr. Mead seems to have been almost indifferent as to the hind of 
purgatives employed\ and certainly gave no preference to mercurial pre- 
parations. Ilis idea was, that all were equally beneficial that would 
tend to lower the system ; and in this manner he accounts for the mild- 
ness of the disease after any great evacuation, natural or artificial (ibid., 
P. 110). 
Small-pox. 
The fever 
byPt pu"ga- 
tives- 
strong 
of cure- 
stimulants 
power of 
dlsease- THE DOCTRINE OE PURGATION. 
Hypochon- 
dria ; — the 
causes indi- 
cate the cure. 
544. Hypochondria.—“ The digestive organs are almost always tor- 
pidT Some kind of acrimony is also almost found in the stomach, and 
particularly that of acidity. The pain in the epigastrium may be re- 
lieved by the pressure of a belt broad enough to support the whole of 
the lower belly. Congestions in one or more of the abdominal viscera 
are a frequent result, and not unfrequently a primary cause. . . 
Hence we see why the bleeding piles are often so serviceable as 
to have obtained the name of “ medicina hypoeliondriacorum ” (vol. 
IY., pp. 158,159). 
Pakis, J. A., M. D., Pharmacology, Qth Ed., London, 1825. 
545. Purgatives.—The extent of their importance and value were, 
however, never justly appreciated until the valuable publication of Dr. 
Hamilton on this subject. . . . Ilis practice has clearly proved that a 
state of bowels may exist in many diseases, giving rise to a retention of 
feculent matter, which will not be obviated by the occasional adminis- 
tration of a purgative, but which requires a continuation of the alvine 
stimulant, until the healthy action of the bowels is re-established. Since 
this view of the object has been adopted, numerous diseases have re- 
ceived alleviation from the use of purgatives that were formerly treated 
with a different class of remedies, and which were not supposed to have 
any connection with the state of alvine evacuations (p. 167, vol. I.). 
Purgatives. 
Hamilton en- 
dorsed. 
Fever. 
The peristal- 
tic motion is 
diminished. 
546. Thus in fever the peristaltic motion of the intestines is dimin- 
ished, and their feculent contents are unduly retained, and, perhaps, in 
part absorbed, becoming of course a source of morbid irritation. This 
fact has been long understood, and the practice of administering cathar- 
tic medicines under such circumstances has been very generally 
adopted. 
Emptying 
only of the 
intestines 
not suffi- 
cient. 
547. But until the publication of Dr. Hamilton, physicians were 
not aware of the necessity of carrying the plan to an extent beyond that 
of merely emptying the pmmae vice, and they did not continue the free 
use of these remedies through the whole progress of the disease (ibid). 
Purgatives 
are good in 
neurosis; 
548. Cathartics are essentially serviceable, also, in several diseases of 
the class neurosis, which are generally intimately connected with a mor- 
bid condition of the alimentary passages (p. 168, ibid). 
in chorea, 
hysteria, 
chlorosis ; 
(“ Emmena- 
gogues.”) 
54:9. Chorea and hysteria have been very successfully treated in this 
manner. The diseases incident to puberty in both sexes are also best re- 
lieved by a course of purgative medicines, and their effects in chlorosis 
have conferred upon many of them the specific title of Emmenagogues 
(ibid). 
550. But the therapeutical utility of cathartics extends beyond the 
mere feculent evacuations which they may occasion. In consequence of 
the stimulating action which some of them exert upon the exhalent ves- 
sels, they abstract a considerable portion of fluid from the general current 
of the circulation, and are, on that account, beneficial as antiphlogistics 
Dr. Paris is sciolistic as to the history of purgatives; their use was better understood in 
the time of Parey (1620) than when Hamilton wrote (1794). 
Also good as 
v antiph lo- 
gistics." THE DOCTRINE OF PURGATION. 
551. For the same reason they may act as powerful promoters of ah- 
sorption, for there exists an established relation between the powers of 
exhalation and absorption, so that when the action of one is increased, 
that of the other is augmented. Certain purgatives, as I have just stated, 
exert their influence upon the neighboring organs, and are calculated 
not only to remove alvine sordes, but to detach and eliminate foul con- 
gestions from the biliary ducts and pores (ibid., p. 169). 
They Pro- 
“oa absorp‘ 
Why not say the truth, and also remove congestions and relieve pain in the most 
distant organs. 
552. There is no principle in physiology better established than that 
which considers vitality as a power engaged in a continual conflict with 
the physical, chemical and mechanical laws to which every species of 
inanimate matter is invariably subject (ibid., p. 209). 
— And yet chemical remedies are constantly prescribed by 
the “ SCIENTIFIC ” physician ! 
Chemical 
remedies in 
conflict with 
vitality. 
Ainsie, Wiiitelaw, M. D., Materia Indica. London, 1826. 
553. Hepatitis.—A viscid and badly prepared bile, producing ob- 
struction and irritation, is the most immediate source of evil, and so 
constantly does neglected constipation precede an attack of hepatitis, 
that we cannot for a moment deny but that it must powerfully contri- 
bute towards hurrying on the organic derangement by binding up what 
should daily be carried off (p. 549). 
Inflamma- 
tion of the 
liver, from 
constipation, 
and in hot 
climates and 
seasons. 
Mon at and Henderson, Surgs., Narrative of the March of the 1 ?>ih 
Regiment of Foot, from Nuddeah to Berhampoor, in 1826. See 
Madras Journal, Vol. Id. 
554. Two individuals who were largely bled became convulsed and 
died, and after death it was found that, though the heart was empty, the 
vessels of the head were loaded with blood. It was thus clearly indicated 
that, whatever it was that excited the heart's inordinate action, blood- 
letting would not subdue it • for, as long as a drop of blood remained, it 
was sent to the head (Journ., p. 327). 
Bloodletting 
kills rather 
than it cures. 
Andral, Jr., G\, M. D., Clinique Medicals. Paris, 1827. 
555. In indigestion (embarras gastrique), consisting of loss of appe- 
tite, bad taste in the mouth, loaded tongue, irregularity of the bowels, 
sensation of constriction or weight at the epigastrium, and occasional 
nausea. This train of symptoms we have often seen to resist the appli- 
cation of leeches to the epigastrium, low diet, diluents, etc., and rapidly 
give way to the exhibition of a brisk purgative. Do purgatives, by ex- 
citing the stomach and bowels together with the auxiliary neighboring 
organs, re-establish the power of digestion ? Do these remedies change, 
in some unknown way, the mode of secretion in the liver and pancreas ? 
We know not. But this we know, that the treatment above mentioned 
is very efficacious, and that the antiphlogistic treatment is useless, if not 
injurious (chap. IV. +). 
Indigestion. 
Symptoms. 
Leeches do 
not lessen the 
irritation; 
purgation 
cures it. 
Antiphlogls- 
tics injuri- 
ous. THE DOCTRINE OF PURGATION. 
556. Andral, in illustration, gives many cases; No. YI. is se- 
lected. A young man entered the hospital with high fever, violent 
pulsating pain in the head, obstinate costiveness, and other symptoms. 
Leeches, the pendiluvium, lavements, and tisans were employed to no 
purpose. On the tenth day the patient was seized with spontaneous 
vomiting of a large quantity of green bile, which was followed by a 
smart purging of yellow liquid matter. Next day every symptom of 
5is malady was gone. The patient was discharged, “cured by Dame 
Nature.”—Andral asks, “ Would not a brisk purgative or two in the 
beginning have cured the disorder f ” 
illustrative 
siiowsUr1ic 
vray to cure. 
Why of course they would. Six Brandreth’s Pills given on the first or second day 
would have done it. 
Purgatives 
the current 
modify 
ofTh™iood. 
557. Purqatives. by revulsion, diminish the acti/vitu with which the 
fluids tend to the part originally irritated and congested. . . But another 
influence which has been less noticed, is that which they may have upon 
Ihe composition of the blood, which they must modify by means of the 
materials which they extract from it. It may be asked, what is the 
nature of their influence upon the blood, according to whether they 
chiefly excite the flow of perspiration, of mucous, or of bile, and what 
changes of composition they may occasion in the blood? This is un- 
doubtedly an interesting subject for investigation (Quoted in Copland’s 
Diet., p. 250, vol. I, Art. Blood, § 160). 
Chambers, William, M. D., Physician to St. George s Hospital. On 
Continued Fever. See Brit, and For. Med. Rev., 1827, Vol. VJ. 
558. Continued Fever.—Those who have been in the habit of treat- 
ing this disease must have observed that in most instances, when pur- 
gatives have been early and steadily administered\ all the symptoms 
have in a short time yielded to them (Rev., p. 161). 
Scudamore, Charles, M. D. A Treatise on the Nature and Cure of 
Rheumatism. London, 1827. See British and For. Mei>. Rev. 
1839, Vol. VII. 
Fever. 
Early and 
steady 
purgation. 
pheuma- 
weeding 
changes 
chronicrheu- 
matisrn. 
559. In no way is a degeneracy into chronic symptoms so certainly 
introduced as by that injudicious employment of general bleeding which 
enfeebles the constitution and still leaves the rheumatic disposition in 
great force (p. 70—Brit, and For. Med. Rev., p. 343). 
560. In proportion as we employ purgatives with judgment, so do 
we diminish the necessity of using the lancet (ibid). 
561. In regard to the freedom and continuance of this treatment, 
we 8}ia]j inform ourselves in great measure by the nature of the excre- 
tions, alvine and urinary; tor, while thejceces are unnaturally dark, and 
the urine is dense, of a deep color, Ac., it is incumbent upon us to make 
dail/y employment of purgative medicines (p. 96—Rev., p. 344). 
Purgatives 
weeding, 
Continue 
purgation 
ations are 
Examine 
st°urineand 
Also continue purgation with Brandreth’s Pills while severe pain continues, even if the 
stools are healthy. 
562. A course of sarsaparilla often proves useful in tliat kind of 
chronic rheumatism which is accompanied by general derangement of 
the constitution, without the particular affection of any internal organ. THE DOCTRINE OF PURGATION. 
We see that, as the health of the system improves, morbid irritability 
lessens, the flesh of the patient increases, his looks and strength improve, 
and the rheumatic pains pass away (p. 370—Rev. 353). 
Abercrombie, John, M. D., Pathological and Practical Researches on 
Diseases of the Stomach, dec. Edinburgh, 1828. 
563. It has become a hind of fashion to refer symptoms to morbid 
conditions of the liver, without any good ground for considering them as 
being really connected with that organ. But as a practical man, anxious 
to be guided by observation alone, there are three classes of facts which 
have appeared to me worthy of much attention in reference to this sub- 
ject, namely: 
1. That I have frequently seen such complaints get well under very 
mild treatment, as regulation of the bowels, and a little attention to diet; 
2. That I have seen such patients put through long and ruinous 
courses of mercury without any benefit, and afterwards found the com- 
plaint removed by a course of mild laxatives j and 
3. That I have known patients die of other diseases while these 
alleged affections of the liver were going on, without being able to dis- 
cover in the liver, upon dissection, the smallest deviation from healthy 
structure (p. 320). 
Dyspepsia 
and supposed 
chronic in- 
flammation 
of the liver 
cured by 
PUP.GATION. 
Mercury 
useless. 
Real chron- 
ic inflam- 
mation of 
the liver— 
PURGE FREE- 
LY AND CON- 
TINUALLY. 
564. Tn chronic inflammation of the liver free and continued purging 
is expressly recommended (p. 361). 
Annesly, James, M. I)., Researches into the Causes, Nature, and 
Treatment of Prevalent Diseases in India. Edinburgh, 1828. See 
Med. Chiu. Rev., 1828, Vol. VIII., Scr. I. 
565. Thus, in recruits and other strangers to the climate, on their 
arrival in India, when the biliary secretion is much increased, the tem- 
porary obstruction produced by exposure, wet, &c., often occasion the 
most formidable symptoms of disease, and when the obstruction is over- 
come, an immense quantity of vitiated bile is passed. It is reasonable 
to suppose, if the gall-bladder and ducts be over-distended with their 
contents, then vital contractility may be weakened, and thus the evil 
will be increased, until some internal or external cause supervenes,which 
shall enable the organ to throw off the load which oppresses it, and dis- 
charge its morbid secretion (Rev., p. 410). 
Fevers in 
the Fast In- 
dies. 
Natural or 
artificial 
purgation 
alone can 
cure. 
566. The accumulation of mucous on the internal surfaces of the 
duodenum may also obstruct the mouth of the common duct, and pre- 
vent the How of bile into the alimentary canal, until the obstruction be 
overcome or removed (p. 307). 
Mucous ob- 
struction a 
cause of fe- 
ver; remove 
it by purga- 
tion. 
Bayle, M., M. I)., On the Influence of Gastric Affections in the Produc- 
tion of Mental Maladies. See Revue Me dig ale. Paris, 1828. 
567. Mr. Bayle proves by numerous cases that chronic in flam mation 
of the mucous membrane of the stomach and bowels produced various 
forms of insanity, and that the form of the mental hallucination was 
often determined by the physical malady in the stomach. 
insanity 
dered stom- 
ach- THE DOCTRINE OF PURGATION. 
Brown, John, M. D., Medical Essays on Fever, doc. London, 1828. 
produces 
muny dis- 
cording to 
dilution. 
568. Malaria produces intermittent and remittent fevers, cholera, dys- 
-mpsia. bilious diarrhoea, liver disease, jaundice; and Dr. McCulloch 
adds, rheumatism and neuralgia (p. 46). 
o \\. j 
Cooke, William, Surg., A Practical and Pathological Inquiry into the 
Sources and Effects of Derangement of the Digestive Organs. Lon- 
don, 1828. 
mutations— 
uponreports 
tion, buTi'af- 
amine. 
569. In disease there will sometimes be fatal accumulation of faeces 
in the intestines, when both the patient and attendants report that the 
bowels are freel/y relieved (p. 129). 
Constipa- 
tion. 
Loose stools 
not sufficient 
— examina- 
tion re- 
quired ; — no 
“half meas- 
ures.” 
Case. 
Fever. 
570. Various diseases arising from constipation cured by full purga- 
tion. 
In cases of constipation we must be careful that the discharge of 
loose motion does not deceive us, for this may happen without the bowels 
being sufficiently acted upon. We ought never to be satisfied, in any 
serious case, without caref ul examination with the hand ‘ for it will fre- 
quently happen, even after fiuid dejections, that a large accumulation of 
faeces shall exist. 
On the 12tli of December, 1818, I was consulted respecting a little 
boy four years of age, who for several days had been unwell. I pre- 
scribed a dose of calomel, which, in the course of the day, affected his 
bowels three times, the motions being loose and yellow. Ilis diet con- 
sisted chiefly of fluid aliment, and of this he took but little. On the 
morning of the 13th he had coiisi<lerable fever remaining. A powerful 
purgation (calomel and jalap) was given. Early next morning he voided 
an excessive quantity of formed and hardened faeces, some parts of 
which were of a black color. After this evacuation the febrile symp- 
toms speedily subsided (p. 129). 
digestbn 
cured by 
gationUK 
571. I was consulted by an elderly gentleman who had been suffer- 
ing under chronic and protracted derangement of the digestive organs, 
and who believed that he had kept his bowels freely open by ordinary 
domestic aperients. A more efficient purgative was, however, prescribed, 
and to his surprise and comfort he voided as much solid excrement of a 
brown color as would more than half fill a large pot-de-chambre (p. 130). 
Active pur- 
gation—its 
usefulness, 
572. Active purgatives are not onl y merely required in eases of accu- 
mulated faeces, but arc sometimes useful by instituting morbid action, 
by setting up a temporary disease through the alimentary canal. 
Something may be attributed, to die increased secretion, but the main- 
tenance of morbid action has sometimes considerable influence in con- 
trolling functional affections which did not originate from gastric dis- 
ease (pp. 131, 132). 
Palpitation 
of the heart 
573. In evidence of this view is given a ease of palpitation of the 
]ieari cured by purgation (p. 132). THE DOCTRINE OF PURGATION. 
574. A case is given of peritoneal inflammation cured by full purga- 
tion, when “ both the practitioner and the nurse informed me that the 
bowels were quite open” (p. 130). 
Peritoneal 
inflamma- 
tion. 
575. In the summer of 1824, I was called upon by a maiden lady 
aged 34. She informed me that for some months she had been in such 
a state of distress, from mental depression, that life had become com- 
pletely burdensome. She had neither inclination for food nor exercise. 
She slept but little and passed restless nights. I prescribed laxatives 
and sea air for a few weeks. She grew worse. On her return to the 
city, powerful purgatives were employed three times a day, and in a 
week she felt quite a different creature (pp. 192, 193). 
Mental 
depression 
cured by 
powerful 
purgation. 
Case. 
576. In 1816, I attended a lady who had “not been well ” for two 
years, during which period she had been under the care of a respectable 
medical gentleman without deriving advantage. She was also subject 
to pains in her right side, appetite impaired, countenance yellow, rest 
disturbed. Employed active purgation (calomel and jalap). The first 
day she had twelve dejections, the others six or seven each. The pain 
soon ceased, appetite wTas good, countenance cheerful, and she was again 
feeling comfortable. 
She was now desired to take half the former dose of opening medi- 
cine every third night. 
In this case the constipation had existed so long that it seemed pru- 
dent to act freely on the bowels at first, and gradually lessen the strength 
of the purgative (pp. 232, 233). 
Amenor- 
rhoea cured 
by full pur- 
gation. 
Case. 
Continua- 
tion of the 
purgative 
treatment. 
577. A lady in the seventh month of pregnancy had been affected 
for some time with what wTas considered a quotidian ague. Every day, 
at nearly the same time, she was attacked with rigor and violent shiver- 
ings wThich continued for half or three-quarters of an hour, and was 
succeeded by hot and sweating stages. On being consulted I deemed it 
expedient to administer some opening medicine before other steps were 
taken. The bowels being freely acted upon in the course of the next 
twenty four hours, the fever did not return (pp. 285, 286). 
Quotidian 
ague 
during 
pregnancy 
cured by 
purgation. 
Case. 
578. A gentleman informed me that he was recently consulted re- 
specting a family with ague. Bark had been frequently given without 
success. Finding that their bowels were much disordered he prescribed 
some opening remedies, intending to give quinine afterwards, but the 
ague had ceased (p. 286). 
An0°f^erucase 
Bark useless. 
Monro, Alexander, M. D., Morbid Anatomy of the Brain. London, 
1828. See Med. Ciiir. Rev., Ser. Z, Vol. filll., 1828. 
579. Hydrocephalus.—Brisk cathartics are to be administered reg-u- 
larly, especially at the outset and during the first period of the disease; 
for the quantity of feculent matter contained within the intestines in 
many cases is really surprising. One instance now occurs to us. The 
patient was a young lady who, after an attack of fever, during which 
IfilirocT\ 
waylpurjl 
and THE DOCTRINE OF PURGATION. 
case. 
Fetid stools 
head symptoms predominated, and had not been opportunely nor sufli- 
ciently overcome, was seized with all the signs of water in the head; 
and as her bowels had been rather disposed to astringency throughout 
the fever, they became exceedingly torpid, indeed almost unmanage- 
able, on the establishment of hydrocephalus. 
Five or six common doses of drastic purgatives were required before 
ie bowels would answer, and fetid' and bulky stools were daily passed 
for three weeks under this stimulation, without any solid food having 
been taken during that time (p. 38—Rev. p. 385). 
580. And instituting a new and healthy action in the secretory appa- 
ratus by a degree of warmth and local remedies adapted to the sensibility 
of the part affected (ibid). 
McKenzie, William, M. D., A Sketch of the Natural Cure of. Dis- 
eases; in Glasgow Medical Journal, February, 1829. See Brit. 
& For. Med. Rev., 1847, Vol. XXIII. 
ever^chang- 
ing and ever 
disease, 
581. The body is almost altogether fluid; nine-tenths of it are so, 
and oniy one-tenth solid. The fluid parts are in a perpetual state of 
change, being decomposed by one set ot functions and recomposed by 
another. . . . Our fluids, by means of digestion, absorption, circula- 
tion, respiration, and secretion, are in a constant revolution. By these 
processes there is effected an uninterrupted decay and restoration of the 
body; and one can not doubt that the natural cure of diseases depends 
very much on the existence and on the perfection of this revolution. 
Hay, it is extremely probable, that one of the principal intentions served 
in this mode of carrying on life is the prevention and removal of dis- 
ease (Rev. p. 587). 
By purgation with Brandreth’s Pills we can change the entire body in from a third to 
half the time it is changed in the ordinary course of nature, and with entire safety. Case 
of 
Stephens, Henry, Surg. Treatise on Inflamed and Obstructed Hernia. 
London, 1829. See Med. Ciiir. Rev. Ser. /., 1S29, Vol. XI. 
strangu- 
tained faeces, 
582. Mr. Lawrence has, under the head of “ slow strangulation,” 
described a state of obstructed hernia from fecal accumulation, and 
without doubt such a state often exists (p. 02—Rev. p. 112). 
Brandreth’s Pills to this poor patient would have been the complete doctor, producing 
certain relief, and, in all probability, would have cured the rupture. 
Stoker, William, M. D. Treatise on Continued Fevers, dec. Dublin, 
1829. 
Typhus 
Jeoer' 
583. Typhus fever is connected with morbid changes that previously 
take place in the fluids, and produce morbid actions, and sometimes 
permanent change of structure in the solid parts. These changes are THE DOCTRINE OF PURGATION. 
distinguishable from those which occur in inflammation, and the morbid 
action excited relatively by these changes in the blood are also distinct. 
In inflammatory fever, increased action; in typhus fever, debility is 
almost the immediate consequence (p. 71). 
The remedies employed by me in mixed and typhoid fevers, and 
arranged according to their relative importance, are : 
Mixed fevers—cleanliness, ventilation, cool regimen, plentiful dil- 
uents, and purgatives. 
Typhoid fevers—yeast, wine, and aperients (p. 113). 
Dr. Stoker's 
definition 
and modus 
procedendi, 
with 
purgative 
medicines. 
584. In both ague and intermittent neuralgia, I believe the disor- 
dered function of digestion, and the consequent morbid condition of the 
chyle and of the other contents of the stomach, whether ultimately 
absorbed or carried into the sanguiferous system, or carried downward by 
the primes vice, become in their transit a chief cause of all the succeed- 
ing symptoms (p. 357). 
Ague and 
neuralgia 
from re- 
tained im- 
purities. 
5S5.' When these periodic diseases become, however, more estab- 
lished, it is probable that not only the fluids are further affected, but 
that consequent changes are excited, and hence the morbid condition of 
the flu ids may be the primary source of organic disease (ibid). 
These impu- 
rities the 
cause of or- 
ganic dis- 
ease. 
The following quotations establish the absolute necessity of having by us a purgative to 
which we may always apply with safety for relief; and we have it in Brand re th’s Pills. 
Copland, James, M. D. Dictionary of Practiced Medicine. London, 
1830. New York Ed. by Dr. Ch. A. Lee, 1846-1852. 
586. A belief is too generally entertained that fecal matters and 
sardes will not accumulate in the colon unless the patient has been con- 
stipated. But they may collect in its cells, the more central part of the 
canal allowing daily evacuation ’ and they may even remain there for 
a considerable period, producing much irritation, and even a relaxed 
state of the bowels, thereby misleading the judgment of the prac- 
titioner as to the pathological state constituting the disorder. . . . In 
many cases, when the morbid collections have become acrimonious, an 
irritative diarrhoea continues for some time, or recurs at intervals, before 
the morbid matters are fully thrown off, owing to spasmodic constric- 
tions of parts of the bowels. . . On these occasions the evacuation is 
often preceded bv gripes, tenesmus, or a scalding sensation in the anus 
(vol. I., p. 450, Art. Colon, § 6). 
Fecal matter 
may 
accumulate 
where there 
is no con- 
stipation— 
watch and 
purge. 
Effects. 
587. Purgations are used in order to occasion a local determination of 
blood, and thus derive it from the seat of disease, to evacuate the vis- 
cera, increase the discharge from the mucous surface, and augment the 
secretions in adjoining organs (ibid., p. 218). 
Pur (/a tires 
—-their ac- 
tion and 
aims. 
588. Tlio, fetor, dec., of the breath, and of the perspiration, &c., eon- 
sequent upon interruption of the abdominal secretions, indicate that im- 
purities have accumulated in tlie circulation, and that they are being 
eliminated by the lungs and the skin. So long as the vital energy is 
interrupted 
secretion— 
action of the 
gamtory or* THE DOCTRINE OF PURGATION. 
sufficient for the due performance and harmony of the functions, inju- 
rious matters are seldom allowed to accumulate in the blood to the ex- 
tent of vitiating its constitution, without being discharged from, it by 
means of one or mox'e organs. But as soon as this energy languishes, or 
is depressed by external influences and agents, and the blood is thereby 
either imperfectly formed or insufficiently animalized and depurated, 
some one of its ultimate elements or proximate constituents become ex- 
cessive, and the chief cause of disorder, which terminates either in the 
removed of the morbid accumxdation, or in a train of morbid actions and 
lesions (vol. I., p. 23 8, Art. Blood, § 116). 
Causes of 
disease. 
Defective 
secretion 
causes ab- 
sorption of 
morbid mat- 
ter vitiating 
the blood 
and produc- 
ing disease. 
589. Thus it will appear that changes in the secretions and in the 
blood itself are most influential in the production, perpetuation, and 
aggravation of disease. . . Thus, also, it will appear not only that hurt- 
ful matters carried into the circulation, and ultimate elements or proxi- 
mate constituents allowed to accumulate in it, owing to the imperfect 
performance of some alimentary function, will be removed from it when 
the vital influence is sufficient for the task, but that both kinds of inju- 
rious agents will, according to their nature, become productive of a viti- 
ated state of the blood, of the secretions formed from it, and even of the 
various tissues themselves, when the state of vital manifestation is insuffi- 
cient to remove them from the frame (ibid., p. 239, § 117, ibid.) 
Defective se- 
cretion, if not 
counteracted 
by vicarious 
action, pro- 
duces vitia- 
ted blood. 
590. I consider the grand pathological inference to be fully estab- 
lished : that the interruption or obstruction of any important secreting or 
eliminating function, if not compensated by the increased or modified 
action of some other organs, vitiates the blood more or less ; and if such 
vitiation be not soon removed, by the restoration of the function prima- 
rily affected, or by the increased exercise of an analogous function, that 
still more important changes are produced in the blood, and ultimately 
in the soft solids, if the energies of life are insufficient to expel the cause 
of disturbance, to oppose the progress of change, and to excite actions 
of salutary tendency (ibid., p. 240, § 124, ibid.) 
591. Miasmata produce a morbid impression on the nerves of organic 
life, followed by depression of th'e vital influence; the functions of diges- 
tion and secretion languish, and, owing to tbe imperfect performance of 
secretion and assimilation, the necessary changes are not fully effected 
in the blood, and thus the irritating and otherwise injurious matters ac- 
cumulate in it. . . The vascular system becomes excited by the quantity 
and quality of its contents; and when the vital energies are not too far 
depressed for its production, the excitement becomes general. The ac- 
celerated circulation has the effect of exciting the organic functions, of 
restoring the secretions which were impeded or interrupted, and thereby 
of removing the morbid state of the circulating fluid, after which the 
return of health is rapid. When, however, salutary reaction is not 
brought about, owing to the morbid depression of the vital energies and 
to changes which had taken place in the blood, the vitiation of the blood 
proceeds', the secretions are also vitiated, the solids affected, one or 
more vital organs suffer in an especial manner, the energies of life are 
exhausted, and various organic lesions are induced, having reference to 
Miasma— 
action on 
organic life, 
impairing 
the matura- 
tion of the 
blood. 
Reaction if 
there is suffi- 
cient energy 
—course of 
disease, if 
not. THE DOCTRINE OF PURGATION. 
the previous state of the system, the kind of changes produced in the 
blood, and the agencies in operation during the progress of the disease 
(ibid., p. 240, § 125, ibid.) 
592. M. Andral states that “ he has often found in the blood-vessels 
a curdy, friable matter, of a dirty-gray color, and resembling either the 
semi-concrete pus of chronic abscesses, or the sanies of malignant ulcers, 
or cephaloid matter, broken down and mixed with blood.” And similar 
instances are recorded by Bichat, Beclard, and Velpeau. In all these 
cases, abscesses, tubercles, or other morbid formations, also existed in 
some part of the body (ibid., p. 246, § 144, ibid.) 
Morbid for- 
mations in 
the body im- 
part morbid 
matters to 
the blood. 
593. Morbid secretions should be frequently evacuated, in order that 
vital power may not be further reduced by their morbid impression on 
the nerves and mucous digestive surface, and that the possibility of the 
absorption of any part of them into the circulation may be thereby 
avoided (ibid, p. 249, § 158, ibid.) 
Evacuate 
morbid secre- 
tions to pre- 
vent absorp- 
tion of impu- 
rities. 
594. In all the alterations of the blood resulting from the introduc- 
tion or absorption of morbid matters from parts previously diseased, 
whatever tends to lower nervous and vital power, or to promote absorption 
—more particularly blood-letting, which operates in both these ways— 
ought to be guarded against, and a diametrically opposite plan of cure 
adopted, not neglecting the promotion of the depurative and excreting 
functions (ibid., § 159, ibid.) 
Bloodletting 
CAUSES AB- 
SORPTION of 
morbid mat- 
ters. 
595. Fecal matters collected in the caecum often induce inflammation, 
or the paroxysms of pain are very acute, sometimes attended by vomit- 
ing and all the symptoms of the most severe colic, or even those of ileus 
(§ 10). The symptomatic disorders, when the viscus is much distended 
either by fecal or by other matters, or by flatus, are numbness of the 
right thigh, oedema of the right foot and ankle, sometimes retraction of 
the testicle, or frequent calls to empty the bladder, and sometimes 
hemorrhoides, uneasiness and pain in the right iliac region, often extend- 
ing to the hypochondrium,various dyspeptic symptoms, costive or irregu- 
lar state of the bowels, occasionally diarrhoea, with scanty, offensive, and 
mucous stools (§ 11). The efforts made to evacuate the bowels are often 
attended by severe tormina and even retching. I have seen several 
cases of varicose veins of the leg, or indolent tdcers, and a case of disease 
of the hones of the foot, the occurrence of which was evidently connected 
with great disturbance and accumulations in the caecum. . . The com- 
plexion is deficient in clearness, and with the surface often covered with 
an oily or dirty moisture ; the perspiration becomes fetid and the breath 
offensive ; the soft solids lose their elasticity, and are slightly emaciated; 
. . . and at an advanced stage the symptoms more clearly manifest that 
the blood is imperfectly depurated, or that it is affected by the absorp- 
tion of a portion of the excrementitious matter retained in the caecum. 
In addition to these symptoms, general debility and disinclination to any 
physical or mental exertion are often complained of (§§ 10, 11, 12 ; Art. 
Colon, p. 330, ibid.) 
Fecal mat- 
ter in the 
caecum. 
Various and 
direful con- 
sequences of 
such accu- 
mulations. THE DOCTRINE OF PURGATION. 
cholera— 
secretions;— 
bfl°ypwga- 
turn, 
596. Even in cholera, in which the eruption of an increased quantity 
of morbid secretions into the duodenum occasions copious discharges 
from the stomach and bowels, with cramps, Ac., we are not justified in 
concluding that any organic change is present beyond simple irritation 
of a temporary kind, excited in the villous surface by the acrid state of 
the secretions passing along it (ibid., p. 624; Art. Digestive Canal, 
§ 17, B). 
ctvorea—its 
597. Among the chief predisposing causes of chorea is a neglected 
state of the bowels, leading to accumulations of deranged secretions in 
the primse vise, torpid functions of the liver, and other secreting and as- 
similating organs. The most exciting causes are tlie irritations of worms, 
of morbid matters accumulated in the bowels (Stoll, Baldinger, and 
Wendt), and fright, improper employment of lead, mercury, Ac. (De 
Ilaen), suppressed eruptions and discharges (Thilenius, Darwin, and 
Wendt.) (Ibid., p. 389; Art. Chorea, § 12, III. 13 B.) 
Cure:—re- 
move the 
cause by 
purgatives. 
598. Purgatives have been recommended in chorea by /Sydenham, 
Whylt, Hamilton, Cheyne, and others (ibid., p. 392, § 23, VI., ibid.) 
The first indication is to remove morbid secretions and fecal accumu- 
lations, the usual cause of the irritation of the organic nerves (ibid. p„ 
394, § 29, B, ibid.) 
599. Idiopathic diarrhoea, when recent, requires demulcents or dilu- 
ents merely, in order to facilitate the discharge of acrid or accumulated 
matter. This having been accomplished, disorder soon ceases. But the 
irritating substances may be partly retained, and keep up a prolonged or 
remittent state of the disease, with griping pains and scanty stools, which 
may be partly feculent, mucous, or serous—the latter predominating, 
when the irritation is considerable. In this case much discrimination is 
requisite in selecting the aperient which is obviously required; for, if it 
be insufficient, the disorder will be prolonged (ibid., p. 609; Art. 
Diarrhoea, § 25, YII.) 
Brandreth’s Pills are all that is needed, and discrimination is not required. 
Diarrhoea. 
The retained 
morbid mat- 
ter must be 
pxirged 
away. 
600. Illustration of Crises.—A person exposed to tlie causes of 
mpUMmai f&ver of a bilious and remittent form, experiences during the 
earlier stages tlie usual symptoms of impeded or interrupted secretion, 
aT1 general vascular excitement. In consequence of interrupted action 
of the emunctories the blood contains an increasing proportion of effete 
materials, particularly of the elements out of which bile is formed. 
These for a while increase and modify the vascular excitement, or, when 
excessive in quantity, or especially noxious in quality, even tend to ex- 
haust or depress it. But they at the same time being appropriate 
stimuli to the biliary and depuratory viscera, serve to restore their 
impeded functions, to turn the balance of excitement in favor of them, 
thereby to reduce the morbid vascular action, to cleanse the circulating 
fluid from its impurities, and to change in other respects its condition, 
and thus the disease terminates with an apparent collapse, followed by 
a copious discharge from the bowels, consisting of morbid bile and of 
the excretions from the intestinal mucous surface—the products of the 
noxious matters which had accumulated in the blood, but which is now 
Crisis—illus- 
tration of.. 
The removal 
of morbid 
matter out of 
the system. THE DOCTRINE OF PURGATION. 
being eliminated from it, by a renovated as well as an increased secret- 
ing and excreting function. How, this procession of morbid phenom- 
ena shows, that the ancients were not so far wrong as many of the 
moderns suppose, when they believed that critical evacuations were bene- 
ficial, chiefly because they conveyed a morbid matter out of the system 
(ibid., p. 516, Art, Crises, § 15). 
601. As the office of the excreting organs is to expel those elements 
which are effete, and would be injurious to the frame if retained in the 
blood, it must necessarily follow, that any interruption to their function 
must be highly injurious. The dropsical effusions in various cavities 
following interruption to the action of the kidneys, fully illustrate this. 
As a large quantity of ingested matters is carried into the blood, either 
directly from the stomach or along with the chyle, and discharged from 
it by the emunctories, it is evident not only that the kind of ingesta will 
affect very remarkably the properties of the excretions, but that obstruc- 
tion or interruption of any one of them will be followed by serious effects, 
unless some other organ perform an additional office vicarious of that 
which is suppressed, and even in this case disease will generally xdti- 
mately arise (ibid., p. 668, Art. Diseases, § 99). 
In disease 
impurities 
must be re- 
moved by 
the proper 
emunctories 
or VICARIOUS- 
LY ; if not 
FULLY RE- 
MOVED, dis- 
ease quietly 
follows. 
602. What are most diseases, but either suppression or excess in the 
secretions or excretions f (ibid.) 
What disease 
603. Dropsy from Disease of the Kidneys.—In a very great major- 
ity of instances, where effusion proceeds from this cause, the irritating 
nature of the fluid poured out, superinduces inflammation of the mem- 
branes and. cellular tissues containing it, and thereby aggravates the 
disease, and accelerates a fatal issue ’ for if it be considered that when 
the functions of the kidneys are interrupted, excrementitious or serous 
plethora will be the result; and that the watery parts of the blood which 
are effused from this cause must necessarily contain a considerable 
quantity of the injurious matters usually eliminated by these organs, 
the irritating quality of the accumulating fluid here contended for will 
be admitted (ibid., p. 705, Art. Dropsy on the Chest. § 52). 
Dropsy—an 
excrementi- 
tious fluid 
of irritating 
quality the 
essence of 
the disease. 
604. Purgatives are very applicable in dropsies generally, on account 
of their deobstruent operation when uninterruptedly continued, or of 
their influence in deriving from the seat of effusion, in draining the 
fluid parts of the blood from that circulating in the intestinal tubes, in 
thereby lessening excrementitious or serous plethora, and favoring the 
absorption of the effused fluid. They constitute a most important part 
of the treatment of every form and state of the disease (ibid., p. 710, 
§ 66, ibid.). 
In hydrothorax, cathartics and purgatives, especially the hydra- 
gogues, often afford speedy relief (ibid., p. 739, § 172, ibid.). 
Purgatives, 
because re- 
moving the 
cause, appli- 
cable in 
every form 
and state of 
the disease. 
605. Frequently affection of the brain is induced by irritation of the 
gastro-enteric surface. In children this is remarkably common, and 
even in adults a slight degree of disorder of the stomach is often fol- 
lowed by headache, somnolency and incapability of mental exertion. 
The occasional dependence of epilepsy in adults, and of convulsions in 
Stomach- 
disorder 
causes nu- 
merous dis- 
eases of a 
nervous 
character. THE DOCTRINE OF PURGATION. 
children, upon morbid action in the digestive canal is well known. In- 
flammation of the membranes or of the substance of the brain, and acute 
hydrocephalus sometimes also supervene upon gastro-intestine irritation, 
and in the course of their development render obscure, or entirely mask, 
the previous ailment. For, as Lallemand has remarked, as soon as the 
cerebral affection even partially obscures sensibility the existence of dis- 
order in the digestive canal is ascertained with great difficulty. In my 
opinion, the majority of cases denominated “ spinal irritation” are 
caused by gastro-enteric disorder (vol. II., p. 30, Art. (hastro-enteric 
.Disease, | 3). 
Purgatives 
—their judi- 
cious use re- 
moves the 
cause of dis- 
ease, and 
how. 
606. A judicious exhibition of purgatives will frequently remove 
irritation of the digestive canal, especially if it be caused by unwhole- 
some ingesta or morbid secretions, or fecal accumulations; and even 
when it cannot be referred to either of these, but rather to the state of 
vascular action in the digestive surface, the augmented secretion pro- 
cured by refrigerent or mild purgatives may promote its resolution or 
diminish its intensity (ibid., § 4. ibid.). 
Pneumonia 
and diseases 
of the shin 
front the 
same source. 
607. Even the occurrence of pneumonia may be favored by disorder 
of the digestive canal (ibid., p. 31, § 7, ibid.). 
Its connection with diseases of the skin, is much more general than 
practitioners suppose. It is chiefly owing to the irritation of the diges- 
tive mucous surface, that the cutaneous affections resist so long the treat- 
ment prescribed for their removal. I have repeatedly seen arsenical 
and other irritating medicines exhibited in no small quantities; and 
although they were evidently exasperating both the internal and external 
affections they were continued with a perfect belief in their applicability 
(ibid., p. 33, § 15, IY., ibid.). 
Arsenic in- 
jurious in cu- 
taneous dis- 
ease. 
Impure 
blood causes 
diseases of 
the liver, 
kidneys, and 
skin. 
608. When the disorder of the gastrointestinal surface is attended 
with a crowing or morbidly excited appetite, food is taken in larger quan- 
tity than it can be digested, and much imperfectly formed chyle is 
carried into the blood where it excites disorder of the liver, of the kid- 
neys, and often of the skin, in the course of the excretion of the unas- 
similated matters by these organs (ibid., p. 34, § 16, ibid.). 
Many dis- 
eases from 
one cause— 
impurities 
of the BLOOD 
produced 
hyimper/ect 
excreting 
function of 
THE SKIN. 
609. The suppression of the excreting f unctions of the skin may be 
followed—especially if the kidneys do not perform a vicariously increased 
function—by catarrh, or by rheumatism, or by inflammation of the 
lungs or pleura, or by diarrhoea, or by dysentery, or by enteritis, accord- 
ing as the predisposition of parts may determine the morbid action. 
The cause or causes, whether exposure to cold or to influences depressing 
vital power, occasion, first, interruption of the depurating functions of 
the skin, and next, more or less congestion of, or vascular determination 
to, internal viscera or parts; and, in addition to this latter effect, and as 
a consequence of the suppression of the cutaneous function, the blood is 
loaded with these excremeniitious elements which the healthy action of 
the skin eliminates. The resulting conditions of the blood and of the 
circulation are such, in many cases, as kindle diseases, either those above 
mentioned or others of a slighter or severer nature (vol. III., p. 1137, 
Art. Therapeutics, § 41). THE DOCTRINE OE PURGATION. 
610. What has been said respecting the functions of the skin, applies 
likewise to the other excreting and secreting functions. Of all excreting 
or depurating functions, those performed by the kidneys are the most 
rapidly fatal when impaired (ibid., p. 1138, § 47, ibid.). 
The same is 
true of the 
other secre- 
tories and 
excretories. 
Oil. The cure.—It is believed by many that the regular and daily 
evacuation of the bowels is quite sufficient • but this may not always be 
the case, as to either the fecal discharge or the biliary secretion, or even 
as to both. . . Hence the importance of observing accurately the ap- 
pearance of the intestinal excretion, both in health and in disease, and 
of having recourse to such means as those appearances, the frequency 
of the evacuation, and the associated state of the disease will suggest. 
The several substances employed as purgatives and cathartics should be 
suited to the peculiarities of each case, and be conjoined with others of 
the same class, or with such as may either correct or promote their ope- 
ration (ibid., § 48, ibid.). 
With Brandreth’s Pilla you can obtain any desired effect upon the bowels or general 
system. 
Constant ob- 
servation of 
evacuations 
necessary, 
and why. 
This applies 
to 
Bkandrkth’s 
Pills. 
612. The promotion of the several secreting and excreting functions, 
whenever they are torpid or impaired, is requisite to the prevention of 
many contingent evils during states of vital depression, by whatever 
cause produced; but it has a still more general application, for, in all 
circumstances, in states of excitement and increased vascular action, as 
well as in those of depression, these functions are very often either tor- 
pid, or impaired, or even interrupted, and require restoration ; other- 
wise additional or more severe and dangerous changes resrdt, and the 
blood, loaded with excrementitious materials, occasions the most delete- 
rious effects in vital organs (ibid., p. 1137, § 42, ibid). 
fromretained 
‘“Sg3 
ciencyVthJ 
secreting 
excreting 
funf°ns, 
vice versa. 
613. Next to the sedative or depressing effects produced by the 
causes of disease, the impairment of depurating functions closely fol- 
lows, the latter being very frequently the cause of the former. These 
functions are often restored by the same means as are employed to remove 
the primary morbid impression (ibid., § 43, ibid). 
Cure:—by 
impuriSfs!he 
614. In chronic, malignant, and structural maladies, the constitu- 
tional or vital power is impaired, and the blood is altered more or less 
es these maladies advance, especially cancer, tubercle, rickets, Ac., the 
alteration of the blood becomes more or less evident, this fluid being 
thinner, poorer, or deficient in red globules. ITence the necessity of sup- 
porting the powers of life by means which will neither excite nor irri- 
tate them, and of preserving the healthy state of the blood by conjoin- 
ing with those means such as will correct or prevent alterations of this 
fluid, and will, at the same time, promote the conversion of the color- 
less or chyle globules of the blood into red globules—will promote the 
processes of sanguification and nutrition (ibid., p. 1142, § 63, ibid). 
Chronic dis- 
impoverish- 
h^eby 
promotion of 
tion and nu- 
enUse’usTng 
Brapfurgeth’s 
615. A person is exposed to causes, as infections, which depress or- 
ganic nervous energy, and thereby impair or suppress the more import- 
ant depurating and secreting functions. The consequences as respects 
the blood are obvious. This fluid soon abounds in effete and injurious 
elements, increasing both the amount of the vascular contents, and 
in the wood. THE DOCTRINE OE PURGATION. 
Brandreth’s 
times win 
theelysystem 
into a 
ditiou.’Y ton' 
oppressing and irritating the whole vascular system, although certain 
organs may manliest these effects m a more prominent manner than 
others, until ci salutary crisis is observed, and the morbid state of the 
blood is removed, or until the soft solids, are changed, their vital cohesion 
is loosened, and disorganization ensues (ibid., p. 1046, Art. Sympathy, 
§ 102). 
The mutual 
action of the 
excreting or- 
gans ;—re- 
tained excre- 
tions pro- 
duce, among 
other effects, 
organic dis- 
ease—i. e. 
structural 
changes. 
016. There is very intimate connection existing between the state of 
the blood and the depurating offices of the mucous surface of the intes- 
tines, especially of the large intestines. This surface, and more partic- 
ularly the follicular glands, may be considered as eliminating from the 
blood redundant or decomposed blood globules, and much effete mate- 
rials, and as thereby contributing, with the other emunctories, to the 
purity and healthy condition of this fluid. The connection subsisting 
between the functions of excreting viscera, not only as altering the con- 
dition of the blood, but also as affecting each other individually; the 
influence which the state of one depurating function exerts upon the 
others through the medium of the blood, as well as through that of the 
organic nervous system, and the mutual and conjoint operation of all 
these functions, not merely in changing the physical appearance and 
constitution of the blood and the states of vital influence, but also in 
occasioning structural alterations, are among the most important topics 
comprised by a rational system of pathology (ibid., p. 1045, § 96, ibid). 
Worms from 
tenacious 
mucous and 
pituitous 
sordes. 
617. Predisposing causes of worms should, as much as possible, be 
removed or counteracted. In furtherance of this indication, the diet and 
the treatment should be adopted that are most efficacious in promoting 
the organic nervous force and the tone of the digestive organs, and in 
removing tenacious mucous and pituitous sordes, which often adhere to 
the digestive mucous surface, and which often forms the nidus in which 
the ova of parasites are lodged and hatched. It will generally be no- 
ticed that the secretions and excretions which in all persons form the 
principal part of tli o. fecal discharge are seldom thrown off from the se- 
creting surfaces so quickly and entirely in the delicate and debilitated as 
in the robust and healthy, but remain or are retained in the former class 
of subjects, andbecome the soil in which these animals are reared (ibid., 
p. 1547, Art. Worms, § 158, B). 
Spasms. 
618. Spasms of the voluntary or involuntary muscles—Purgatives 
are generally beneficial, more especially when the liver or brain is con- 
gested, and when the spasm is connected with acidity and flatulence of 
the digestive canal, or with accumulation of morbid secretions, excre- 
tions and fecal matters, as when spasms occur in colic, or in the course 
of gout, rheumatism, hysteria, hypochondria, &c. In these, as well as 
in some cases of other diseases, not only are morbid excretions thus 
liable to accumulate, but the blood becomes more or less contaminated by 
effete materials, which the impaired functions of the emunctories fail of 
removing. 
619- l11 ie8e circumstances purgatives should he selected with this 
v‘ew5 11 ot merely of evacuating the contents of the bowels, but also of 
promoting the functions of the excretory organs. When cerebral con- 
evacuating 
b°dfs 
n°rient THE DOCTRINE OF PURGATION. 
gestion is connected with the spasms, then active derivative purgatives 
ought to be exhibited by the mouth and in enema (ibid., p. 931, Art. 
Spasms, § 31, C). 
620. But the most remarkable cause of the slow progress of the ther- 
apeutical science is to be found in the highest and most legitimate ranks 
of the medical profession—in the physicians themselves (% 9) ; in wrong 
estimates of the efficacy of particular medicines and agents (§ 7, D); in 
erroneous, limited, or one-sided views of the causes, seats, nature and 
procession of diseases; of medical doctrine (§ 4,1.); medical jealousies and 
contentions; opposing systems ; plans on means of cure; jarring views 
as to the efficacy or operation of certain medicines; opposite opinions 
in courts of justice, or otherwise appearing in public; the publicity 
given to medical discussions have an unfavorable influence on the pub- 
lic, and prevent many from trusting to medical treatment (ibid., pp. 
1130,1131, Art. Therapeutics, § 12, I). 
dies, and of 
therein.behet 
621. The blood is found altered in disease: 
1. By a change in the proportion of its constituent elements; 
2. By the addition of foreign matters (+) (cf. G. Harvey). 
IIow the 
blood be- 
comes im- 
pure. 
AN HONEST PROFESSOR. 
Marx, K. Z., M. D. Professor in the University of Goettingen. Gen- 
eral Pathology. Goettingen, 1833. 
622. The conscientious practitioner can resort but to few remedies ; 
for whenever the choice lies between what is harmless and what “ heroic,” 
he must unconditionally employ the former (Preface). 
Materia 
Chomel, JVL, M. D., Clinical Lectures on Typhoid Fever. I)aris, 1834. 
See Brit, and For. Med. Rev., 1836, Vol. IT. 
623. In the stools-of patients, at the commencement of recovery from 
typhoid fever, there are always scybalce; on which 
Dr. John Conolly observes: If medicine had produced the same 
effect earlier, which nature did eventually, the symptoms would have 
been milder, although the course of the disease would not have been cut 
short (Rev., p. 40). 
Typhoid 
fever;—the 
stools of con- 
valescents 
always con- 
tain seylala. 
“ The course of the disease would not have been cut short” may admit of a “ perhaps.” 
Laennec, R. T. H., M. I)., A Treatise on Disease of the Chest. Trans- 
lated by John Forbes, M. D. London, 1834. 
624. I would therefore lay it down as a valuable practical rule in 
chronic affections of the heart, that previously to having recourse to any 
remedies intended to act directly on it, we ought to be assured that the 
digestive organs are in a healthy state, that their mucous surfaces are 
chronic 
heart-d.s- 
The first step 
'' THE DOCTRINE OF PURGATION. 
free from irritation, their vascular system not morbidly distended, and 
that the liver is performing its secreting function freely and regularly 
(p. 687). 
Let Brandreth’s Pills be used in accordance with the printed directions, and there will 
be no medicines required to “ act directly on the heart.” The mucous coats will be freed from 
all irritating substances, when the liver and the heart will, as a rule, perform their functions 
freely and regularly. 
Clark, James, M. D., A Treatise on Pulmonary Consumption, and In- 
quiry into Causes, Nature, Prevention, and Treatment of Tuber- 
culous aud Scrofulous Diseases in General. London, 1835. See 
Brit, and For. Med. Rev., 1835. 
625. Dyspepsia is the most fertile source of cachexia in every form; 
it also generates in derangement of the various secretory and excretory 
functions, particularly that condition of them in which the effete mat- 
ter is imperfectly carried off (p. 223). 
Cachexia— 
from dyspep- 
sia and de- 
ranged secre- 
tion and ex- 
cretion. 
626. So long as the constitution remains unimpaired, the ordinary 
exciting causes (catarrhs, inflammations) may come into active play 
again and again, during a whole lifetime, without producing consump- 
tion ; but the moment the tone of the system is seriously lowered by 
sedentary habits, insufficiency of food, impaired digestion, depression of 
mind, excessive study, vitiated atmosphere, a very slight external cause 
will then suffice to induce the deposit of tuberculous matter (Rev., pp. 
71, 72, vol. II.) 
Consump- 
tion. 
Keep the sys- 
tem free from 
impurities, 
and you keep 
off the causes 
of the dis- 
ease. 
Conolly, John, M. D., Editor of the British and Foreign Medical 
Review, On Claris Treatise on Consumption. 1835, Vol. XXI. 
Consump- 
tion always 
from impuri- 
ties in the 
system. 
627. Consumption is invariably the consequence of a pre-existing un- 
healthy state of the constitution, without which the accidental causes 
which call it into being would have been entirely incapable of producing 
it (Rev. p. 71). 
CURE OF CONSUMPTION AND DYSPEPSIA* 
*• Hammonton, N. J., May 7, 1S66. 
“ Dr. Brandreth —Dear Sir: I have long wanted to write to you and express ray grati- 
tude for the beneficial effects that have been experienced in my own family, and in hun- 
dreds, aye, thousands of others, by the use of Brandreth’s Pills. The first year my lamented 
friend Brockway sold your pills in Boston (1838) I called at his office. 1 was then in a de- 
clining state of health, and my friends, as well as myself, supposed iny earthly voyage would 
soon terminate. Mr. Brockway urged me to take the Brandreth Pills, but having used so 
much medicine, with no good effect, I was more inclined to let nature take its course, and 
calmly submit to my fate. Mr. B. offered to give me one dozen boxes if I would try them 
as prescribed. By this I saw he had great faith in them, and I finally consented to take 
them, but not as a gift. I went home and went at it, almost hopelessly. After taking one 
box 1 began to feel better. Well, sir, when I had used up my twelve boxes, I was apparently 
a well, healthy man, my weight having gone from 131 pounds up to 152 pounds. I then 
ordered a supply, and between that time and the present I have retailed three thousand dol- 
lars worth of these invaluable pills, and am quite sure that I have thereby been instrumental 
in saving, not hundreds, but thousands of lives. I have given them to my oxen, horses, 
pigs, fowls, cats, dogs, and always with the desired effect. 1 have a wife and nine children, 
most of them born since I have used the pills. A more healthy family cannot be found THE DOCTRINE OF PURGATION. 
We are frequently asked how it is our children look so healthy. My wife replies that ‘We 
raise them on Brandreth’s Pills.’ Now, my children overload their stomachs, get cold and 
out of order, like others, but they have been taught the remedy, and go and take the pills 
of their own accord. This I consider an important branch of their education, and feel as- 
sured, as they shove off upon the voyage of life, that they know how to take care of them- 
selves. I was in trade at my last residence, North Lincoln, Me., for 29 years. I have been 
here about seven years ; I am, therefore, well known, and my statements can be verified by 
hundreds. “Yours, 
“C. J. FAY.” 
CONTAGION EVEN HARMLESS TO THOSE WHO USE BRANDRETH’S PILLS. 
Each one of us, even the most diseased, has within him a germ or root of that original 
pure blood of our common mother Eve. 
This germ of pure blood supports his life, and constantly struggles to throw out from 
the circulation corrupt humors into the bowels. Brandreth’s Pills assist this regenerating 
process. 
By their powerful aid we constantly make blood of a better quality, until the whole is 
renewed and purified. 
Those who desire to pass untouched by contagious maladies, who wish for soundness of 
body and mind, or to have healthful children, should use Brandreth’s Pills, which cleanse the 
bowels and the blood of all unhealthy accumulations. 
Qombe, Andeew, M. I). Principles of Physiology applied to Preserv- 
ation of Health, dec. Edinburgh, 1835. Letter on the Observation 
of Nature in the Treatment of Disease. See Beit. & Foe. Med. 
Rev., 1855, Vol. XXI. 
628. Experience shows that the physician and the remedy are useful 
only when they act in accordance with the laws of the constitution and 
the intentions of nature. . . If this be done systematically, every 
effort of nature will be towards the restoration of health ; and all that 
she demands from us in addition, is to remove impediments and facili- 
tate her acts (Rev. p. 509, sq.) 
Assist nature 
to remove 
impediments 
629. Instead, therefore, of medicine being superseded, as many sup- 
pose, by taking nature for our guide, it will, on the contrary, only begin 
to take just rank as a science when our allegiance to nature shall become 
practical, enlightened, and complete. . . Nature is truly the agent in 
the cure of disease ‘ and as she acts in accordance with fixed and invari- 
able laws, the aim of the physician ought always to be to facilitate her 
efforts, by acting in harmony with, and not in opposition to, those laws 
(ibid.). 
Medicine 
and the 
“ vis raedica- 
trix naturae- ’ 
Dr. Combe in 1840 was in New Haven, Conn. We had a conversation with him on the 
great importance of purgation as a universal remedy. But the doctor could not understand 
how purgation could be useful after the bowels were emptied of their contents. How long 
a principle is uncomprehended ! and yet this great man might have lived thirty years 
longer, had he but have only investigated this one of purgation, and been governed by the 
lights of experience which he would have found to flow from it. 
Forbes, John, M. D., Editor of the Beitish and Foeeign Medical 
Review, commencing 1835. 
030. Purgation appears to be banished (in continental treatment of 
fevers), from a fear that it may increase the irritation of the follicles of 
Fever. THE DOCTRINE OF PURGATION. 
doesZot'in 
crease intes- 
mation 'flam 
Practice 
vs. 
Theory. 
intestines—a fear which has sprung from too excessive devotion to 
morbid anatomy. That active purgatives, particularly in the early 
stages of fever, will increase the follicular irritation, is a completely theo- 
objection. The reasoning on wdiich it is founded will not bear 
examination, and cnir experience in this country experimentally contra- 
diets it (Rev. 1836, Yol. III., p. 63). 
The Doctoi’ is a friend of Erandreth’s Pills. 
Leeches, 
anToostm- 
ness. 
631. In the treatment of fevers we have witnessed more misery and 
waste of life from leeches, gum water, and costive bowels than from any 
degree of purgation (Rev. 1836, Yol. IY., p. 167). 
Poison* 
destroy the 
through 
toJthTblood, 
632. Physiological researches during the last thirty years have satis- 
factorily proved that most if not all of the agents which exert such 
destructive energy on the nervous system (as poisons) do it through the 
medium of the circulation, as shown by the experiments of Christison 
and Coindet, of Brodie, Viborg, and others. And wre are much mis- 
taken if future researches do not prove this equally of what we term 
the true puerperal fever. . . The entire absence of coagulum, the per- 
fect fluidity of the blood, apparently both in color and consistence to 
thin watery claret, tends to confirm these views (Rev. 1836, Yol. II., p. 
484). 
Themateria 
medica— 
why so large 
and full of 
useless drugs 
—leads to 
dangerous 
results in 
practice. 
633. How many medicinal agents have been indebted for their rep- 
utation to fortuitous circumstances. It would be easy to show from the 
firmer history of diseases that the medicine employed in the treatment 
had no influence whatever in effecting the cure, but that the result was 
entirely owing to the efforts of nature. A physician, for example, ein- 
pl°ys a certain medicine in a few cases and finds his patients recover ; 
hence he concludes that the treatment and the cure stand to one another 
in the relation of cause and effect. Misapprehensions of this sort pro- 
duce a very false and injurious impression upon the minds of students, 
leading them in their future practice to bleeding, blistering, and treating 
“ heroically ” all affections that appear to be violent and intractable 
(Rev. 1842, Yol. XIII., p. 55). 
In tumors, &c., Brandretils Pills affect firstly and chiefly the 
MORBID GROWTH. 
Tu mors. 
AnfnZhfi 
Pats remove 
oniy impu- 
nt*e*' 
034. “ Nature gives up in the first instance that which is extraneous 
and parasitical, in preference to what is normal both in structure and in 
e9ree °f development.v This is an important law, observable in a 
thousand cases, without the auspicious operation of which indeed one- 
half of onr labors would be in vain (ibid., pp. 330, 331). 
Acute,.rhe.u- 
035. These recommendations (continued nurqinq in acute rheuma- 
Usrri) arG m the highest degree important for the speedy removal of the 
disease, whether mild or severe : and the custom of soiiig practitioners THE DOCTRINE OF PURGATION. 
who avoid purging from fear of giving occasion to injurious exposure 
of the person, cannot be too strongly reprobated (ibid., p. 450). 
The only 
remedy pur- 
gation. 
636. It is evident then : 
1. That in a large proportion of the cases treated by allopathic phy- 
sicians, the disease is cured by nature and not by them. 
2. That in a lesser, but still not a small portion, the disease is cured 
by nature, in spite of them; in other words, their interference opposing 
instead of assisting the cure. 
" 3. That consequently, in a considerable proportion of diseases, it 
would fare as well or better with patients, in the actual condition of the 
medical art, as more generally practised, if all remedies, at least all 
active remedies, especially drugs, were abandoned (p. 257, vol. XXI., 
1846). 
The resume 
on medical 
art, nature, 
etc. 
These re- 
marks apply 
to the “reg- 
ular prac- 
tice" of the 
‘ ‘ healing 
art." 
637. This lamentable condition of medicine, regarded as a practical 
art, is in truth a fact of such magnitude—one so palpably evident—that 
it was impossible for any careful reader of the history of medicine, or 
any long observer of the process of disease, not to be aware of it. What 
indeed is the history of medicine but a history of perpetual changes 
in the opinions and practice of its professors, respecting the very same 
subjects—the nature and treatment of diseases? And amid all these 
changes, often extreme and directly opposed to one another, do we not 
find these very diseases, the subject of them, remaining, with some ex- 
ceptions, still the same in their progress and general event ? (pp. 257, 
258.) 
Uistory of 
medicine— 
and what it 
teaches. 
038. To be satisfied on this point we need only refer to the history 
of any one or two of our principal diseases or principal remedies, as 
fever, pneumonia, syphilis—antimony, blood-letting, mercury. Each of 
these remedies has been, at different times, regarded as almost specific 
in the cure of the first two diseases, while at other times they have been 
rejected as useless or injurious. What seemed once so unquestionably, 
so demonstrably true, as that venesection was indispensable for the cure 
of pneumonia? And what is the conclusion now deduced from the 
clinical researches of Louis and others? Is it not that patients recover 
as well, or nearly as well, without it? The experiments prove, far better 
without it (pp. 258, 259). 
Bleeding, 
antimony, 
mercury— 
their efficacy 
doubtful; 
their effects 
rather inju- 
rious. 
639. If the medical god Mercury has lost the domain of syphilis, he 
has gained that of inflammation; and many of our best practitioners 
might possibly be startled and shocked at the supposition that their suc- 
cessors should renounce allegiance to him in the latter domain, as they 
themselves had done in the former. And yet such a result is more than 
probable, seeing that there exists not a shadow of more positive proof, 
if so much, of the efficiency of the medicine in the latter than in the 
former case (p. 259). 
Mercury— 
its reign for 
the future 
questionable 
C40. Truth is good. If the art of medicine, as we profess and 
practice it, cannot bear investigation, and shrinks before the light of 
truth, from whatsoever quarter it may come, it is high time that it 
Truth above 
all. THE DOCTRINE OF PURGATION. 
should cease to be sanctioned and upheld by philosophers and honest 
men (ibid). 
Dr. Forbes deserves weld of ail mankind. 
Louis, Ch. A., M. I)., Physician to the Llbpital de la Pitie. Recherches 
sur les effets de la .saignee dans quelques maladies infiammatoires, 
dec. On the Fffects of Bleeding in Lnfiammatony Diseases. Paris, 
1835. 
proved*to be 
useiMsin/w- 
ofnTvungfs 
641. A volume consisting of numerous cases to test the efficacy of 
blood-letting in pneumony at the Hospital de la Pitie, in Paris. Some 
patients were bled on the first, Some on the second, some on the third day 
attack, and so on; some seldom, others repeatedly, with the periods 
from attack to convalescence duly noted. And from these cases he 
comes to the inevitable conclusion that bleeding is a noxious, not a bene- 
ficial agent, in the disease—that it does not remove pain, and if it at 
all modifies it, in twenty-four hours it is generally as severe as ever ; that 
bleeding seems to produce an effect only when used at a period suffi- 
ciently remote from the origin of the malady to be perhaps coincident 
wi th i m provem ent. 
JUifitp. p $ 
equally use 
efe3' 
642. Mr. Louis applied to the effects of blisters the same experimen- 
tal analysis, and came to the conclusion that in pneumonia they are 
also devoid of utility. 
Brandreth’s Tills are of absolutely certain benefit in every case of pleurisy ; and in all 
inflammations whatsoever they should be used at once. Then they have never been known 
to fail. 
Louis, E. II., M. D., Pathological Researches in Phthisin. London, 
1835. 
only true evi- 
virtue °oftha 
medicine. 
643. The numerical method is, in fact, the only method in our power 
*° Pursue j it w the only control we can possess over assertion, the only 
test for opinion. Its application to a sufficient number of facts, must 
inevitably give us the most exact and best possible knowledge of those 
facts, and we would ask the individual who believes that science is 
founded on facts, what more he would require ? (p. 28.) 
By the numerical method we would be judged. Let this method be applied to effects 
Brandreth’s Pills produce upon disease; and what an amount of suffering and sorrow would 
soon terminate! No inflammation, no cholera, no fever, no pleurisy, no rheumatism, or any 
pain would cause alarm, because it would be known that a few Braudreth’s Pills would soon 
restore any and every organ to health. 
Moobe, G., Surg., An Inquiry into the Pathology, Causes and Treat 
ment of Puerperal Fever; which obtained the Fothergillian Gold 
Medal, March, 1835. London, 1836. 
614. Puerperal Fever.—That early purgation is indeed an essential 
auxiliary in tlie treatment, is amply testified by those who have been 
most successful (p. 223). 
Puerperal 
purgation. THE DOCTRINE OF PURGATION. 
In every case of puerperal fever I have seen, where purgation was used at once when 
the violent pain in the womb admonished that inflammation had commenced, was cured. 
The purgative was Brandreth’s Pills. Every other case where other remedies than purga- 
tive were applied was lost. In fact, forty years ago it was generally understood that puer- 
peral fever meant—death. In 1840 a friend of mine, a physician, lost seventeen cases of 
this fever one after another. I recommended purgation, i. e. Brandreth’s Pills. He followed 
my plan and gave the pills, and never after lost a case. 
P arise, M. R., M. D. Pathology of Rheumatism. See Bulletin 
General de Therapeutique, July, 1835, and Brit, and For. Med. 
Rev., 1836, Vol. 1. 
645. Bheumatism.—Its cliange of situation does not change its na- 
ture, although it goes by different names. Thus it is the same disease 
which in the head is called gravedo, in the neck torticollis (wry-neck), in 
the side pleurodynia, in the loins lumbago, and along the sciatic nerve 
sciatica (Rev., p. 255). 
RUuma- 
The same ais- 
eav3.®rJl0"f'er 
acc“rd7®g t0 
ideation. 
Dr. Beandreth: Sing Sing, Jan. 25, 1867. 
For some years I have been subject to attacks of inflammatory rheumatism, which usually 
come on every three or four months. My physicians were of the highest reputation. By 
their advice 1 took colchicum, citric acid, and other celebrated remedies, but none relieved 
me or shortened the attacks, which lasted for weeks at a time. In my last attack I con- 
cluded to try your famous pills. I was lying upon my bed at the time, suffering the severest 
pains in my feet and ankles, which no pen can describe. 
The first dose of six pills was so effective that in a few hours the pain and swelling sen- 
sibly abated, and in forty-eight hours were all gone, and I was cured and have had no 
return. 
I send you this testimonial for the benefit of others who, suffering in a similar manner, 
may know how they can find certain relief. 
I am respectfully yours, J. D. DUDLEY. 
CURE OF INFLAMMATORY RHEUMATISM. 
To Dr. Brandreth: Brooklyn, Oct. 5, 1866. 
It gives me pleasure to state the good I have experienced from your pills. Since I com- 
menced their use I have felt in all respects like a new man, and the rheumatism I took them 
to relieve has entirely disappeared. At first I was prejudiced against them, because their 
operation was attended with severe griping; but on a further experience I am convinced 
such pains were only caused by the medicine struggling with and removing certain obstruc- 
tions in the bowels. 1 commenced with taking five pills every night on going to bed, and 
by an increase of one pill every evening ran the quantity up to twelve pills, which number 
I continued to take for ten days, and then gradually reduced to five pills at a dose. With 
the exception of the first three doses I have experienced no pain or griping, but the opera- 
tion was both easy and pleasant. I took the pills for twenty-four days, and noticed that I 
passed a great quantity of black, bilious-looking, offensive matter, which I am glad to have 
got clear of. The Brandreth Pills take right hold of all that is deleterious in the bowels; 
and, as I said before, I now feel like a new man, and deem it my duty to express my grati- 
tude to you. Sincerely your friend, 
FRANKLIN L. HAWLEY, 238 Classon Avenue. 
FURTHER PROOF. 
McIlwain, George, Surg., Remarks on the Unity of the Body, die. 
London, 1836. See Brit, and For. Med. Rev., 1836, Vol. II. 
646. The whole of the body sympathizes with all its parts (Rev., p. 
180). 
Axiom. THE DOCTRINE OF PURGATION. 
Williams, Robert, M. D., Physician to St. Thomas Hospital. Elements 
of Medicine. London, 1836. 
ritythesomthe 
disease, 
of the mala- 
upondthc”ds 
p fityojthe, 
blood. 
647. Certain diseases—as typhus, scarlatina, varioli, erysipelas, &c., 
are produced by morbid poisons. These have definite specific actions— 
latent periodicity—the phenomena varying according to the dose and 
predisposition of the individual. Generally these poisons act with an 
intensity proportioned to the feebleness of the patient (Preface). 
Bleeding 
d°niove°thee 
cause of dis- 
eascarlet- ’ 
fecer, etc. 
648. Bleeding.—From a careful comparison of such evidence as 
exists, Dr. Williams concludes, that since the evidence against bleeding 
in fever so greatly outweighs that in its favor, it seems demonstrated, 
and by the most practical experience as yet before the public on any 
cjjSp0seq medical question, that bleeding in the cure of fever is the ex- 
ception, not the rule ‘ . . that the cause of the disease being a poison, it 
is necessary to remove the poison from the body in order to stop the dis- 
ease (p. 171). 
649. The most effective treatment was found to be as follows: 
Ten grains of rhubarb, or a scruple, at whatever stage the patient 
wag a(]mitted, and barley-water enemas, night and morning, with half 
an ounce of syrup of poppies added. Success is the only criterion in 
medicine, and certainly this practice has effected the cure of a much 
larger proportion of cases than any other mode I have witnessed (p. 93). 
The benefit 
and injec- 
turns. 
How infinitely superior Brandreth’s Pills are to this treatment, as all who know them 
will admit. 
flariet/ever 
proved to be 
byl'ac cases. 
650. The results obtained by the practice of bleeding in scarlet fever, 
as well as by abstracting from it, are given in the following table: 
Of 12.1 per sons, treated in the Foundling Hospital, in 1786, by bleed- 
ing, 19 died, being about one in six. 
Of 60 persons, treated at the London Fever Hospital in 1829, by 
bleeding, 10 died, being the same average ; whilst 
Of 125 persons, treated by purgatives and emetics, only 10 died. 
And if Brandreth’s Pills had been the purgative, not five out of a hundred would have 
died. 
Lawrence, William, Surg., Treatise on Hernia. London, 1838. 
Strangula- 
ted hernia. 
Purgatives 
are indicated 
and never 
injure. 
651. Strangulated Hernia.—The notions that purgatives are capable 
of exciting the mucous membrane of the alimentary passages, and thus 
producing an aggravating inflammation of the stomach and bowels, is 
groundless; and the practical precepts founded on this theoretical and 
imaginary foundation, have always appeared to me a signal triumph of 
doctrine over the most unequivocal results of experience and the plain- 
est dictates of common sense (p. 323). 
If the bowels should not be relieved three or four hours after the 
operation, a pill of calomel, or of calomel and extract of colocynth, may THE DOCTRINE OF PURGATION. 
be given, followed by a drachm or two of sulphate of magnesia in mint 
or plain water, and this repeated every three or four hours until the 
bowels are freely relieved. If this do not succeed, a large common 
injection, with four or six ounces of infusion of senna, or an ounce of 
castor-oil, should be administered (ibid.) 
Give six or eight Brandreth’s Pills; they will certainly relieve the bowels, and if given 
early will probably save the pain and danger of the operation. 
Kennedy, Henry, Surg., Editor Dublin Medical Press. Sept. 23,1840. 
652. As soon as a quantity of blood is abstracted, that moment the 
system commences to supply the deficiency. So impatient is nature at the 
loss, that if the food taken is insufficient for her purpose, she takes back 
whatever may have previously been poured out—such as serum, lymph, 
or possibly even pus. (Cases in proof are given from Drs. McDowell, 
Stoker, and by the author.) 
Nature, ai>- 
stea? of .re_ 
purities, it 
them to the 
circulation. 
Never bleed. “ Thou shalt not kill.” 
Morgan, G. F., M. A. First Principles of Surgery. London, 1840. 
653. The influence of fhe blood on the vital functions is proved by 
the fact that the vigor and activity of animal life depend principally on 
the condition of the circulating fluid; and according to the qualities of 
the mass, when inflammation sets in after severe injuries, are the subse- 
quent constitutional phenomena in a great measure regulated (p. 179 +). 
Good blood 
greatly as- 
sists the re- 
covery from 
accidents. 
654. There are two principal morbid varieties of constitution in 
which local injuries produce peculiar and extraordinary effects. The 
one is that of general plethora, attributable to over-repletion of the vas- 
cular system; the other arises from an impoverished state of the blood, 
coupled, in the worst cases, with a disturbed condition of the nervous 
system (p. 144). 
Morbid 
blood from 
two cause8, 
655. Nothing at the commencement (of inflammation) will suffice 
but free and general depletion with purgatives; and we have by these 
means known consciousness restored after an unfavorable prognosis had 
been passed (p. 147). 
injiamma- 
free and 
SSSS 
656. If we regard the morbid alterations in the composition of the 
blood as the primary source of fevers, we can easily explain the subse- 
quent derangement in the functions of the organs, and the vitiation of 
the different secretions during their continuance. In all cases the in- 
creased discharge has the effect of relieving the congested state of the 
mucous membrane (p. 179 +). 
Fevers 
and vitiated 
secretions 
from impure 
blood. 
The believer in the efficacy of purgatives will thank Dr. Morgan for this testimony. THE DOCTRINE OF PURGATION. 
Caxstadt, Charles, M. D., Professor in the University of Erlangen. 
Special Pathology and Therapeutics founded on Clinical Observa- 
tions. Erlangen, 1841. See Brit. & For. Med. Rev., 1842, 
Vol. XIII. 
iodine-its 
action. 
657. The modus operandi of iodine consists in undermining the uni- 
versal process of nutrition (vol. I., p. 11—Rev., p. 331). 
A8theblood, 
so the nerv- 
ous system. 
658. An asthenic condition of the nervous system is an affection 
always coincident with anemia’ since, on the one hand, a normal con- 
dition of that system is indispensable to a rfoht formation of the blood, 
as on the other normal blood is essential to a healthy state of the nervous 
system (ibid., p. 33—Rev., p. 332). 
Blood and 
pus' 
659. Severe suppuration produces precisely the same effects as ex- 
cessive venesection; while precisely the same means which improve the 
condition of the blood produce a similar effect on that of the pus (ibid., 
p. 87—Rev., p. 336). 
inflamma- 
Nature’s at- 
—™het0 may 
overdo it. 
660. The phenomena of inflammation are not morbid movements, 
but consist chiefly of energetic endeavors of nature to oppose or rid her- 
self of an injurious agent or influence. Death may in this way inci- 
dentally occur from salutary efforts of nature herself, as when hemor- 
rhagic apoplexy of the brain or lungs ensues from the reaction instituted 
to repel or extrude some morbific agent or influence operating on these 
organs or elsewhere (ibid., p. 96—Rev., p. 337). 
producing" 
salivation— 
butTpoison 
ulTnfl'am? 
mation. 
661. Dr. Alison of Edinburgh (Library of Medicine) denies “ that 
mercury administered so as to affect the gums possesses any power of 
controlling inflammation and its consequences.” And on this point the 
present writer, after considerable experience, reiterates an opinion he 
formerly expressed, that he has more frequently seen infiammatory 
symptoms aggravated or transferred to other parts, on that event {saliva- 
tion) taking place, than relieved by it (ibid., p. 3—Rev., 338). 
crisis—an- 
other view. 
662. The discharges {sweats) which occasionally signalize the crisis 
G(mgain raateria peccans. The crisis itself is the recovery, the 
discharges being nothing but the effects and proof of the regeneration 
of the unhealthy functions (ibid., p. 260—Rev., p. 342). 
Hypertro- 
vhv- 
Bieeding in- 
jurious. 
663. Hypertrophy.—Blood-letting, if practised in moderation, is apt 
to pro\e fruitless ’ if energetically employed, it is more likely to pro- 
mote anemia, dropsy, and debility than to cure hypertrophy (ibid., p. 10 
_Rev>5 p> 331). 
Chlorosis 
from.11 imper- 
664. The multifarious symptoms of chlorosis do not require separate 
attention; since, depending on a common lesion, to wit, the deficient THE DOCTRINE OF PURGATION. 
crasis* of blood, they simultaneously disappear when that fluid is brought 
, a r\ ~r> J nn0\ 
to its normal state (ibid., p. 40; Rev. p. o33). 
fectiy eiabo- 
rated blood. 
Huenefeldt, F. L., M. D., Chemistry and Medicine in Close Co-operation. 
Berlin, 1841. 
665. In the caecum there is carried on to a certain extent a repetition 
of what takes place in the stomach and small intestines. In the colon 
are found the insoluble matters of the food, the bronze coloring matter 
of the bile, mucous, fat, soluble and insoluble salts, various azotized 
matters, etc., besides fetid volatile productions (p. 110). 
Digestion 
continued in 
the caecum. 
These matters being retained and reabsorbed through constipation, what an amount of 
evil is produced ! Let those who are costive beware. The bowels must be evacuated once 
at least in the day, or there can be no health and no safety. 
Mttnneley, Thomas, Surg. A Treatise on the Nature, Cause and Treat- 
ment of Erysipelas. London, 1841. 
666. It is an easy thing for the purpose of producing an immediate 
effect, or “ knocking the disease on the head,” as it is often termed, to 
take from a man two, three or four pounds of blood ; but should he sur- 
vive, the probability is that he will not for several years, if forever, 
be the sound man he was before the shock his system has had inflicted 
upon it by such heroic proceedings (p. 220). 
667. Purgatives, in by far the majority of cases, if properly used, 
completely obviate the necessity of venesection, especially if they have 
been preceded by an emetic (p. 230). 
Erysipelas. 
Bloodletting 
and purga- 
tion com- 
pared. 
This is sound doctrine. 
Crichton, Sir Alexander, M. D., Commentaries on some Doctrines of 
a Dangerous Tendency in Medicine, and on the General Principles 
of safe Practice. London, 1842. See Brit, and For. Med. Rev., 
1843, Pol. ATT7! 
668. In typhus, hleeding is useless and reprehensible. Nature’s prin- 
ciple of curing this disease is the same as that by which the paroxysm 
of an intermittent is terminated ; she reduces the quantity of circulating 
fluids until she brings about an equilibrium between them and the en- 
feebled moving powers by excrementitious evacuations (Rev., p. 465). 
Typhus. 
Bleeding 
useless. 
Nature’s 
cure— 
another 
view. 
669. The Liebig theory of the action of contagious and other animal 
poisons is, that if the exciting; agent be a compound body, it will repro- 
7 •# 1 p 7 . n ° . -O _ 1 n 7 . , JT 
(luce %tself ad mjimtum, provided the compound body on which it acts 
contains elements fitted for such an end. This theory accounts for nu- 
merous cures of syphilis without mercury by Dr. Fmcke in the hospital 
of Hamburg. From low diet and continued purgation the parts of the 
syphm*. 
Cure without 
any mercury 
—merely by 
purgatlon- 
* Blood globules. Brandreth’s Pills not only take away impurities, but they make the 
blood richer in Crassamentum or blood globules. THE DOCTRINE OF PURGATION. 
blood are not supplied which are susceptible of the metamorphosis. 
Thus the poison becomes starved and purged out; the same result being 
produced as is effected in fever, by the annihilation of the desire for 
food and consequent suspension of the process of chymification (con- 
densed from pp. 210 to ult. of Crichton). 
Gully, James M., M. D., On the Simple Treatment of Diseases. Lon- 
don, 1842. 
Nature's 
m(^fluff 
view- 
670. The constant tendency of the diseased body is towards cure, and 
this for the most part by the erection of certain modes of vital action in 
other parts of the frame than that which is morbid, and by the elimina- 
tion of certain matters from the emunctories. . . Thus a fever usually 
declines just as the kidneys, the lower bowels, or the skin pour out their 
respective excretions copiously (p. 32). 
These " certain matters ” have been obtained from morbid parts invariably. 
Jones, Henry Beale, M. D., On Gravel, Calculus, and Gout, chief y 
an Application of Professor Liebig''s Philosophy to the Preven- 
tion and Cure of Diseases. London, 1842. 
Gout- 
671. We may diminish the proportion of the gouty material in the 
Uooi: _ . 
1. By stopping the supply—that is, by change of diet; and 
2. By causing an increase of secretion from the liver and intestinal 
glands through the action of purgatives. 
These medicines will have the further effect of causing the secreted 
products to be discharged from the intestinal canal, instead of remaining 
to undergo partial reabsorption (pp. 70 to 74). 
Lanza, V., M. D., Professor of Physio in the University of Naples. 
Positive Nosology. Naples, 1842. See British and For. Med. 
Rev., 1846, Vol. XXIII. 
672. The chief obstacles which impede the advance of experimental 
-i. • ,i j? n A L 
medicine are the following : 
][ The extreme variety which prevails in different countries in plans 
of cure, popular remedies, medical usages, <fec., whereby all common 
grounds of comparison are wanting. 
2. The monster-abuse of polypharmacy—the . injury it has caused, 
alike to humanity and to uthe art,” being notorious. 
3. The number of compound remedies still in vogue, a clear relic of 
barbarism, which should long ago have been banished by the profes- 
sion. 
leaving all these behind, medicine must commence anew to determine 
the true power and value of remedies (Rev., p. 63). 
673. We first find that therapeutics must be founded on experience. . . 
The method of treatment to be adopted in any particular case must be 
what retards 
the true 
knowledge in 
medicine. 
?RtrnuN 
Justified THE DOCTRINE OF PURGATION. 
that which has most frequently been found effectual in some previous 
and analogous case (Rev., p. 15). 
MacLeod, Radcliffe, M. D., Physician to St. George's Hospital, On 
Rheumatism in its Various Forms. London, 1842. 
674. Acute Rheumatism.—Purgatives.—This discipline ought gen- 
erally to be repeated on several successive days ; indeed, throughout the 
whole course of a case of acute rheumatism, the due evacuation of the 
bowels ought to be an indication never lost sight of; and in many cases, 
where the attack is comparatively mild, this is the only form of deple- 
lion required (p. 34). 
Acute. Gen- 
matism- 
purgation 
the only de- 
qufred. 
Richter, 0. A. W., M. D., Contributions to Scientific Medicine. Leip- 
zig, 1842. 
675. The Yis Medicatrix Nature.—This power both organizes un- 
organized matter, and disorganizes vitalized matters, separating vitalized 
matter from the system after it hasfulfil lied its 'uses in the organism, and 
has become, if detained, a hurtful agent (sect. 1). 
Important Article. 
Vis medica- 
trix. 
The theory 
of disease;— 
effete matter 
retained in 
the system. 
676. If the recomposing and decomposing processes are in equi- 
librium, there is health / but if the effete matter be not cast off, or a 
hurtful agent enters the system from without, the equilibrium is de- 
stroyed, and the innate vital force sets up an action to restore it—the re- 
sulting phenomena being the phenomena of disease, So that morbid 
action consists in an interruption of the renewing or reformative pro- 
cess, concurrently with alterations in the quality of the blood, and a 
reaction of the innate vital force to restore the normal state (ibid.) 
Nature’s way 
to cure:—by 
removing im- 
purities from 
the system. 
677. The hurtf ul agent is eliminated from the system through the 
secreting and excreting organs, or not being fully eliminated, is localized 
in some one or more special structures, thus giving rise to various con- 
stitutional and chronic local diseases (ibid.) 
Localization 
of effete mat- 
ters causes 
local dis- 
eases. 
678. Fever is a healthy process. The innate vital force, feeling the 
presence of a hurtful agent in the system, attempts its removal after the 
same manner as it removes effete matter. If the hurtful agent is not elim- 
inated, it is localized in an organ, and the innate vital farce attempts its 
removal by colliqnation of that organ, giving rise to various changes of 
structure, and to the general symptoms of local diseases. 
Hectic fever is in reality a healing process, set up to expel the hurtful 
power from the organ to which it has retreated y and it is injurious only 
because the hurtful power is of such a nature, or so situated, as to re- 
quire for its expulsion a greater effort than the vital machinery will bear; 
so that the recomposing process is never re-established, and the colliqua- 
tion goes on until the dissolution of the organism, or death, takes place 
(sect. ii). 
Fevers—na- 
ture’s effort 
at a cure;— 
why she 
often fails. 
Hectic fever. TITE DOCTRINE OF PURGATION. 
How medi- 
cines ought 
to act. 
679. Medicines only assisting the healthy action of nature in throw- 
ing off the hurtful pcnver (ibid.) 
And this is what Brandreth’s Pills produce. No more: no less. 
Schultz, C. II., M. I)., Professor in the University of Berlin. On the 
Renewal of Human Life. Berlin, 1842. See Brit, and For. Med. 
Rev., 1845, Vol. XVIII. 
The blood— 
its develop- 
ment. 
680. It is necessary that the organic constituents of the blood pass 
through their embryo state, j’ust as the embryo itself, before they can be 
perfectly developed; and as the lymphatic glands are the gills and pla- 
centae of the system, if these perform their functions imperfectly, as in- 
scrofulous constitutions, a deposit from the unripe blood takes place. 
Hence the development of chlorosis and phthisis (p. 142; Rev., p. 392). 
Chlorosis 
and 
phthisis. 
Elements of General Pathology. Berlin, 1844-45. See Brit, and 
For. Med. Rev., ibid. 
681. The state of the blood circulating through the secreting organs 
influences their diseases. (Predispositions in the glandular and secreting 
systems.) (Rev., p. 345.) 
By a stoppage of the depurative process in the liver the whole mass 
of the blood gets charged with impurities. The dead vesicles show a 
tendency even to chemical decomposition, as in stinking secretions, nau- 
seous cutaneous affections, &c. . . The blood acts injuriously on the 
nervous and muscular system; it is deficient in the stimulating property 
of healthy blood. Thus the brain, nerves of the senses, and muscles, 
are imperfectly acted on, are weakened, and at last paralyzed. Apoplexy, 
intermittent fever, spectral illusions, and even paralysis of the senses, 
are the result of this state. (Predispositions of the blood.) (Rev., p. 
343.) 
Blood—im- 
purities and 
varieties of 
diseases. 
Williams, Charles J. B., M. D., Principles of Medicine. London, 
1843. See Brit. and. For. Med. Rev., 1844, Vol. XVII. 
682. The excretions are defective in many idiopathic and symptom- 
atic fevers, and there can be little doubt that many of the constitutional 
effects of these fevers are, in a great measure, due to this important ele- 
ment. The positively noxious properties which excrementitious matters. 
retained in the blood are known to possess, must be taken into• account, 
when we attempt to explain the state of constitutional irritation and de- 
pression, wdtli perversion of functions, which fevers so generally present. 
The changes in the blood may also be in part ref erred to defective elimi- 
nation of effete matter • and it is when the secreting organs recover their 
power, and a diarrhoea occurs, or a copious discharge of highly-colored 
urine, that these appearances cease (p. 81; Rev., p. 479). 
Defective 
excretion;— 
a fruitful 
source of dis- 
ease. 
Morbid mat- 
ters, etc., re- 
tained. 
Disease from 
changeinthe 
983. The causes of disease are changes in the due proportions of the 
blood, and otherwise, by respiration, secretion, nutrition, and by foreign 
matters (ibid.) THE DOCTRINE OE PURGATION. 
684. In the treatment of this element of disease—foreign morbid matters 
e/ ts 
in the blood—the two indications which present themselves are, first, to 
counteract the injurious operation of these matters ; and second, to expel 
them from the system. We do not possess chemical antidotes which 
CAN ACT ON THE FOREIGN MATTER IN THE BLOOD WITHOUT INJURING THE 
blood itself. The other indication is more generally pursued, although 
little recognized by practitioners, to expel the offending matter from the 
system. The excretory organs, especially the kidneys and the alimentary 
canal, are the natural emunctories through which foreign and offending 
matters are expelled from the blood. Let us bear in mind how often 
fevers and other serious ailments seem to be carried off by spontaneous 
diarrhoea, diuresis, or perspiration (ibid., p. 122; Rev., p. 485). 
An c7t.emieai 
cmt'idotes 
INJURE THE 
aithoughtW 
ters from it. 
af nature 
d06S‘ 
Cozzi, L., Professor of Chymistry. Analysis of the Blood in a Case of 
Lead Colic, in Journal de Pharmacie. Paris, February, 1844. 
See Edinburgh Medical and Surgical Journal, 1844, Vol. LXII 
685. Professor Cozzi, in analyzing the blood of a person severely 
affected with lead colic, discovered that the lead existed in the state of a 
salt, or of an oxyde of the metal, in the albumen of the blood (Ed. 
Journ., p. 553). 
Pafffcrs’ 
Poison0' of 
leabi0lod.the 
Houston, John, M. D., Introductory Lectxwe in Surgery. Dublin 
1844. 
686. The great mind of John Hunter saw and believed that the 
blood possessed in itself an independent life even while circulating 
loosely in the blood-vessels, but he knew not the nature and the seat of 
that vitality. The discovery was reserved for the physiologists of our 
days. There are particles, called globules, floating in this liquid, about 
the 3000th part of an inch in diameter, or so small that myriads of them 
are contained in a single drop. It has been ascertained respecting these 
globules that they are, each and all, endowed with a definite and uni- 
form shape, and with a development, in virtue of which they pass by 
successive transitions from a condition of origin to one of final evolu- 
tion—a veritable organization, in other words—properties which give 
them a claim to the title life, as much as those which justify the appli- 
cation of that term to the ovum, from which proud man himself dates 
his being. The atomic particles of which the blood is composed being 
thus individually alive, collectively they form a mass of wliich it may 
literally, as well as allegorically be said: “ For it is the life of all flesh • 
the blood of it is for the life thereof; for the life of the flesh is in the 
blood” 
The globules are themselves, each and all, possessed of an independ- 
ent life. I have repeatedly watched them, and have shown them to 
others, when burst from their cell-membrane, performing sundry inde- 
pendent and apparently voluntary evolutions in the field of the micro- 
scope, until to the eye the whole looked like a moving mass of creeping 
things. In this view, then, the blood is doubly alive as exhibited—first 
in its forming and taking part in the repairs of the animal machine, and 
The Hood. 
Physiology. 
Bed corpus- 
cles. 
Description 
of their indi- 
vidual vital- 
ity ; proved 
by micro- 
scopical ob- 
servation. 
The globules 
possessed of 
independent 
motion. THE DOCTRINE OF PURGATION. 
secondly, in the independent movements possessed by the ultimate par- 
ticles of its matter (Lancet, Amer. Edit. 1845, vol. I., p. 214, +). 
Pidduck, John, M. D., On the Treatment of Lndolent and Lrritable 
Ulcers. London, 1844. See Lancet, 1841, Vol. LL 
681. I regard the ulcer as a natural outlet or issue for the escape of 
certain morbid principles from the blood, the retention or suppression of 
which would have occasioned diseases of a more dangerous tendency. . . 
If the ulcer or the issue emit a disgusting odor and discharge freely, the 
necessity for such a drain is unequivocal; it cannot be closed without 
risk of a worse disorder. But when the odor of the ulcer, or the issue, 
ceases to be disagreeable, and the discharge is moderate in quantity, and 
of a healthy quality, it admits of cure with perfect safety (Lane., p. 
405). 
uicer*- 
natTets. °ut" 
p 6 tm 
thedischarge 
whene‘they 
ly’heaL11™1 
Bartlett, Elisha, M. D., Professor of Medicine in the University of 
Maryland / Philosophy of Medicine, Philadelphia, 1845. On 
the recent Progress and future Prospects of Practical Medicine. 
See Brit, and For. Med. Rev., 1846, Vol. JtXIL. 
688. The Articles of the Materia Medica.—There is probably no 
man more entirely sceptical in regard to their alleged properties and 
virtues than I am. There is no man who has been in the habit of 
using a smaller number of them. My own opinion is, that the number 
of substances endowed with active and peculiar or characteristic reme- 
dial properties is small. . . In many cases of disease all medicines, using 
the word in its co7nmon signification, are evils, and that they may be 
dispensed with, not merely with negative safety, but to the actual bene- 
fit of the subjects. . . The golden axiom of Chomel—that it is only the 
second law of therapeutics to do good, its first law being this, to do no 
ha/rm—is gradually finding its way into the medical mind, preventing 
an incalculable amount of positive ill (Rev. p. 237). 
The materia 
medica. 
Assist nature 
ease alonels" 
689. It is coming every day to be more clearly seen that perhaps the 
most universal and beneficial function of medical art consists in the 
removal and avoida/nce of those agents the action of which is to occasion 
or to aggravate disease, thus giving the recuperative energies of the sys- 
tem their full sc pe and action, and trusting to them when thus unem- 
barrassed and free for the cure of disease (ibid). 
Budd, George, M. D., Professor of Medicine, King's College, London. 
On Diseases of the Liver. London, 1845. 
690. In this country mercury lias generally been resorted to, when 
the local symptoms have led to the suspicion that the liver was dis- 
eased ; but I fear with no benefit to the patients. It lias been well ob- 
served by Abercrombie: “ On the liver-diseases of this country, mercury 
Liver-dis- 
mercury. THE DOCTRINE OF PURGATION. 
is often used in an indiscriminate manner, and with very undefined 
notions as to certain specific influence which it is supposed to exert 
over all the morbid conditions of this organ. If the liver be supposed 
to be in a state of torpor, mercury is given to excite it; if in a state of 
acute inflammation, mercury is given to moderate the inflammation and 
reduce its action ” (p. 99). 
Ambiguous 
notions as to 
the action of 
mercury. 
Copeman, Edward, Surg., A Collection of Cases of Apoplexy, with an 
Explanatory Introduction. London, 1845. See Lancet, 1845, 
Vol. I 
691. The following collection of cases is published with the view of 
furnishing sufficient data for determining the comparative merits of dif- 
ferent modes of treating apoplexy, and for judging of the expediency 
of resorting to bleeding for the cure of that disease (Introduction). 
Here follow 250 cases. 
The conclusion is, that bleeding, generally speaking, is so ineffectual 
a means of preventing the fatal termination of apoplexy, that it scarcely 
deserves the name of a remedy for this disease; that the treatment 
without loss of blood was attended with the most success, and that 
the mortality of the disease increased in proportion to the extent to which 
the Heeding was carried ; the more copious the loss of blood the more 
fatal the disease (pp. 198, 199 ; Lane., p. 533). 
Apoplexy. 
Bleeding 
fatal. 
The more 
blood is ab- 
stracted, the 
fewer are 
the chances 
of recovery. 
Mackin, Charles T., M, D., On the Acute form of Gout, with Remarks 
on its similarity to Acute Rheumatism. In Lancet, American Edi- 
tion, Vol. Z, 1845. 
692. In a well-defined attack of gout, the pre-existing and gradually 
progressing derangement of all the organs which subserve the purposes 
of digestion and nutrition, coupled with the very remarkable increase 
of nervous irritability observable (as far as my experience goes) inva- 
riably antecedent to a paroxysm, are sufficient, in a great measure, to 
warrant the conclusion that it is one of the most prominent examples of 
a local disease, depending solely for its origin on constitutional disturb- 
ance (p. 312). 
Gout; — a 
local disease 
from 
derangement 
of the digest- 
ive organs. 
693. It is, in the established rides of modern practice, to be taken 
by storm, to be driven from the system “ vi et armis,” and all the means 
which an already overgrown materia medica places within our reach, 
have been and are brought to bear against it. Patients are cured ; 
“ they get well.” . . . From the first recipe traced on sand by the staff 
of Anaximander or Therecydes (the inventors of writing) up to the last 
“ fiat mistura,” have we one which we can positively say will produce a 
certain and definite effect? No, not one. Medicine is then, as yet, 
nothing save a nice balance of contingencies (pp. 312, 313). 
Modern 
practice. 
A physi- 
cian’s opin- 
ion of his art. 
A knowledge of Brandreth’s Pills would have changed this opinion. 
694. The premonitory signs of its approach are generally to he found 
of a well-marked and definite character, so much so that in many in- 
stances he who has undergone a previous attack, can foretell with uner- 
The precur- 
sory symp- 
toms as indi- 
cating the 
seat of evil THE DOCTRINE OE PURGATION. 
to be the 
stomach 
and intes- 
tines, and 
removal of 
the morbid 
matter in 
them to con- 
stitute the 
Cl'RE. 
ring certainty the coming of a “fit” as it is termed, some time anterior 
to the appearance of the unwelcome visitor. The first symptom which 
excites observation, is a considerable increase of nervous irritability, 
and a general peevishness and hastiness of manner. The sleep is restless 
and unrefreshing, disturbed with f rightful dreams, tossing of the limbs, 
etc. The appetite (though not in variably) of. There is gastroin- 
testinal derangement, with a sense of fullness and oppression subsequent 
to meals; dyspepsia and heartburn are pretty constantly present. As 
the symptoms become aggravated, the patient is annoyed with 
accompanied with sour eructations. . . . 
There is a bitter, or at all events, a vitiated taste in the mouth, espe- 
cially on first rising in the morning; headache in those of plethoric 
habit; the bowels are costive or relaxed—in either case the secretions 
are dark and offensive. The urine is of a saffron tinge, often scanty in 
quantity, and charged with lithic acid. These form the more remarka- 
ble prodromata, and, curiously enough, are observed to possess a distinctly 
intermittent character (p. 313). 
— These are, as the author expresses himself in another place, 
“ not the ‘ hints] but the ‘positive directions,’ laid down for the man- 
agement of the disease, for our guidance and instruction, by Dame Na- 
twre” (Lancet, A. E., Yol. I., p. 672). 
The last 
warning. 
695. Of the near approach of the “fit” the patient is warned by 
being seized at intervals with flying or transitory pains in different 
parts of the body, mostly affecting those portions of the frame already 
weakened by previous illness (ibid.). 
The parox- 
ysm a salu- 
tary process 
of natural 
cure. 
696. A most remarkable fact connected with the disappearance of 
the paroxysm is that the patient, with the exception of being more or 
less crippled for a time, experiences a sort of general renovation of the 
system, and his state of health is better and more vigorous subsequently 
than prior to the fit. It seems as if the localization of this disease were 
a salutary process instituted by the “ vis vitae ” for the more effectual 
and complete removal of the cumulative disturbance of the general 
economy (ibid). 
The disease 
is general; 
its appear- 
ances local. 
697. I have also observed that very slight causes will bring about the 
development of the elements of gouty inflammation, with which the sys- 
tem appears to be charged. I have known so trivial an accident as 
striking the great toe against a stone in walking produce a paroxysm. 
This peculiarity is often witnessed in those who are of confirmed gouty 
diathesis. Indeed, a man constitutionally subject to the disorder ap- 
pears “ to wear his heart upon his sleeve,” slight accidents, otherwise of 
no moment, being sufficient to induce an attack of this extraordinary 
disease (p. 314). 
Sara, Roberts, Professor of Medicine in the University of Milan. 
Sui Pregi e Doveri del Medico. Milan, 1845. 
simple REMK- 
DI ' 
698. A physician of no great reputation would positively compromise 
his interests, if he limited himself to the prescription of simple remedies. THE DOCTRINE OF PURGATION. 
The general ignorance obliges him to be a proselyte of the polyphar- 
macia ; and indeed it is very easy to unite to any medicine a greater or 
less number of substances which are quite incapable of modifying its 
properties. And it is also useful frequently to vary the medicines, 
because the public readily disbelieves in the knowledge of a physician 
who always prescribes the same remedies (p. 115). 
Humbug es- 
“proftLVon.” 
699. The principal means of obtaining success in practice is to limit 
one’s self to a reasonable system of expectation, and to prescribe in cases 
in which no active medicine is clearly indicated, substances incapable of 
exciting remarkable changes in the animal economy (p. 120). 
Success in 
practice— 
how to 
obtain. 
Taylor, J., M. D., Clinical Pemarks on Cancer. See Report of the 
University College Hospital in Lancet, 1845, Vol. II. 
700. The commonest way in which cancer is propagated is by the circu- 
lotion of the cancer-cells in the blood, and the arrest of them in the capil- 
laries, when they multiply and form tumors. In this case (the reported 
one) there was no ulceration. The organs that are secondarily affected 
by cancer have always some connection with the seat of the primary 
disease. We can easily see the connection between cancer in the breast 
and lungs. In passing through the pulmonary capillaries the cancer- 
cells are arrested, and thus the cancer is formed (p, 602). 
cancer— 
ceils in the 
Purge and 
ries. 
Vogel, Julius, M. D., The Pathological Anatomy of the Human Body. 
Leipzig, 1845. See Brit, and For. Med. Rev., 1846, Vol. XXII. 
701. Gases may be developed in the human body from two distinct 
sources—from food in the intestinal canal in the act of decomposition 
and from decomposition of the tissues of the body itself. The gases 
produced in the intestinal canal occasionally permeate through its walls 
into the peritoneal cavity (Rev., p. 324). 
< Foul gases 
from decom- 
' position. 
3 
Waddy, J. M., M. I)., On Puerperal Fever. See Lancet, 1845, Vol. I. 
702. When the intestines are burdened with fecal accumulations the 
constitution becomes affected in various ways; thus cerebral and vis- 
ceral congestions, phlebitis, &c., may he the result of pressure on the 
larger vessels. The intestines are distended beyond their tone, and give 
rise to flatulency, anorexia, indigestion, and there is probably absorption 
of putrid matters, which may all tend to promote a highly unfavorable 
state of the general system (p. 674). 
Effects of re- 
tained faeces. 
703. The phenomena of the typhoid and ataxic {nervous) fevers, 
whether common or puerperal, will be best explained as the consequences 
of poison—either generated within or introduced from without—the 
fever being strictly an effort of nature to throw off injurious matter 
from the living body (pp. 698, 699). 
Few-the 
nate poison. THE DOCTRINE OF PURGATION. 
Remittents. 
704. Remittent and intermittent fevers—the consequence of nature's 
endeavors to eliminate a poison from the system by the biliary organs 
(ibid.) 
IMPORTANT QUESTIONS. 
Rapidity of 
the pulse. 
705. Does the rapidity of pulse (in fever) depend upon a law of na- 
ture to make up, by rapidity of distribution and change, for a deficiency 
of vital principle in the blood, or is the heart directly stimulated into 
increased action by morbid matter in the blood, f (Ibid.) 
Clendtnning, Hr., Report to the Royal Medical and Chirurgical Soci- 
ety, January 13, 1846. See Lancet, 1846, Yol. 1. 
Hydroceph- 
alus from 
suppressed 
DIARRHCEA. 
706. T. S. .Allen, Surgeon to St. Marylebone Infirmary, has seen in 
more than 500 cases of diarrhoea in children, whose ages varied from 3 
months to 3 years, that in at least 6 to 1 the diarrhoea was symptomatic 
—a salutary effort of nature to relieve the system—to suppress which, 
by opiates and absorbents, was to invite head-symptoms, hydrocephalus, 
convulsions, and death (p. 101). 
IIall, Marshall, M. D., Practical Observations and Suggestions. 
London, 1846. (-+-) 
Bleeding a 
refuge of ig- 
norance. 
707. That invariable refuge of the timid and ignorant—the lancet! 
708. I am of opinion that what is designated “ milk-fever” is fre- 
quently symptomatic of the condition of the mammae. The remedy for 
this febrile state is therefore depletion of the milk-ducts. As a preven- 
tion of milk-abscess and milk-fever, and with other hygienic objects, the 
infant should be put to the breast at the moment it is born. If, in spite 
of this,* the breasts become in the slightest degree tumid, or febrile action 
is set up, another and a stronger infant should be applied without delay. 
This is nature's mode of relief , and infinitely more efficacious than the 
application of leeches. . . The patient must take barley-water as her 
sole nourishment, and the bowels must be freely purged. 
Milk-fever— 
cure by de- 
pletion with 
nature’s 
mode and by 
purgation. 
Harrison, J. B., Surg., Essays on General Pathology. London, 1846- 
47. (+) 
709. In the first place, it is manifest that the presence of foreign 
matter in the blood must induce a state of derangement. In the next 
place, it is equally clear that if the blood do not undergo those changes, 
which it is destined to receive during its transmission through the lungs, 
it can no longer preserve its healthy constitution. In the third place, 
the blood itself may be imperfectly elaborated (No. V.) 
The blood 
may become 
impure in 
three differ- 
ent modes. 
710. It is well known that the faculty do not themselves take medi- 
cines in the same manner that they prescribe them to be taken. They 
have not, it must be owned, that large credence which they require from 
others. There is not with them the regular taking of spoonfuls at stated 
intervals, and the expectancy and confidence of the forthcoming result, 
which they ask of others. 
Medical men 
have small 
faith in their 
own reme- 
dies. THE DOCTRINE OF PURGATION. 
Leeson, John, M. R. C. S. E. Liebig's Philosophy applied in the 
Treatment of Functional Derangement and Organic Disease. 
London, 1846. 
711. There are about four hundred and ten preparations in the 
pharmacopoeia of the Royal College of Physicians. Now, any practical 
man of ten or twenty years’ standing must have found that four hund- 
red of these preparations are of little or no value whatever in the treat- 
ment of any form of disease, and that about the remaining ten might have 
assisted him in reducing, at one time or other, cases occurring in every 
department of his practice. Nearly all the waters, confections, decoc- 
tions, extracts, infusions, liquids, mixtures, essential oils, spirits, tinctures, 
have little or no influence over any form of disease, when used as inter- 
nal or external remedies. Many of the mineral preparations are abso- 
lutely injurious in their effects under every circumstance, while the 
retention of other remedies is burlesque and nonsense (pp. 10, 11). 
The phar- 
macopoeia. 
712. Fancy aluminum, antimony, silver, arsenic, barium, bismuth, 
calcium, copper, iron, mercury, magnesia, lead, potassium, sodium, zinc 
(all of which are to be found in the London pharmacopoeia of one hund- 
red years’ standing, wflth the exception of barium and bismuth), as 
medical agents which are yet authoritatively retained, and which have 
been at one time or other plied as sovereign remedies for many invet- 
erate forms of disease, although most of them, if not all, are abandoned 
by every practitioner of standing and experience as the most dangerous 
applications for any kind of medical purposes (pp. 12, 13). 
Metallic 
remedies. 
Magendte, M., JVf. D. Introductory Lecture in the College de France, 
1846. See Lancet, 1846, Yol. L 
713. When disease requires assistance, we may still by well-judged 
intervention assist nature in overcoming the functional derangements 
which gave rise to the disease (p. 238). 
Assist nature 
by art. 
714. Tartar emetic, when brought into contact with the blood, has 
the power of dissolving the globules (p. 363, citation in the paper of 
Butler Lane, Surgeon). 
Tartar- 
emetic. 
Wilson, J. A., M. I)., On the True Character of Acute Rheumatism ; 
in Lancet. 1846. (+) 
715. Inflammation is Init an expression of the nutritive f unction 
endered difficult for the time in particular structures. Inflamma- 
tion originates no movement, creates no function, brings no new 
elements into operation; it is not an acquired principle, but an innate 
faculty held in trust by every living structure from the beginning, for 
the means of self-protection, and as a security under injury for redress. 
Thus considered the arthritis of acute rheumatism is respected by the 
physicians as salutary under circumstances, and as working with the 
fever to a cure. 
Inflamma- 
tion—not a 
disease, but 
nature’s 
warning. 
Ji/ieuma- 
tlsm. THE DOCTRINE OF PURGATION. 
71(3. Opium in acute rheumatism..—The healthy relations of this 
drug with the blood (and it is prescribed on no other indication) are not 
such as to authorize its employment in a disease whose principle of cure 
is one of unrestrained spontaneous action. 
Acute rlieu- 
opium and 
poison64’and 
woodshed 
enounce . 
717. These approved principles of cure by poison and bloodshed rest 
professedly on more than conjectural science for their authority ; they 
are not set forth diffidently, as the experimental misgivings, by small 
inquc^ 0f a theory yet to be realized, but are proclaimed as the 
dicta of a bold and successful experience ; they are blazoned as heroic 
mottoes above the vulgar host, that seeing them we may know our 
leaders and be prepared to follow them. 
Localization 
of fevers 
according to 
t he poisonous 
matter in the 
general cir- 
culation. 
718. As the scarlet-fever localizes itself especially in the throat, the 
measles in the mucous lining membrane of the lungs, the epidemic 
typhus in the caecum and lower ilium, and the erysipelas fever in the 
integuments of the head and face, so is the rheumatic fever determined 
by special effects of inflammation to the larger joints of the body and 
the surrounding articular structures; but the heat, swelling, and redness 
thus induced are no more the cause of the constitutional disturbance in 
acute rheumatism than the scarlet-rasli, or the small-pox pustule of the 
fevers that bear their respective names. They are but the partial 
expression, by impaired nutrition, of a disorder that is general to the 
system. 
Disease from 
viTpropnr- 
In- 
ments °f the 
719. Assuming the evil was in the blood, not so much from impuri- 
ties as a change in the relative proportions of its necessary elements, we 
mb?ht rationally expect the composition of some structures or products 
to be more influenced than others by an excess or deficiency of prin- 
ciples important to their very existence, since the greater frequency 
with which particular parts are affected only indicates that the tissues of 
which they are composed, and the fluids which permeate to them, are such 
as to be especially affected by a morbific cause which prevails to a 
greater or less degree throughout the system. 
The blood 
lues.and 
720. There is in the, blood an independent facility of sensation 
which by physiologists is not as yet acknowledged. In disease, as in 
health, it is sentient of its own states, as it is inceptive of its own actions, 
and through it we feel much of what, in idle phrase, is made exclusive 
to the nerve. 
Acute rhcu- 
mat sin can 
cure itself. 
Bleeding, 
opium, and 
calomel, if 
they do not 
kill, compli- 
cate the dis- 
order. 
721. The fever of acute rheumatism is competent to the task of its 
own cure. Yet the patient is made to pay by the lancet for its acuteness, 
and swallows every specific for gout and neuralgia in right of his rheu- 
matism. . . From this practice, there is reason to believe that many of 
the dangerous complications so frequent of late years in the pathology 
of acute rheumatism do in truth proceed. In the well known combin- 
ation of opium and calomel, this mischievous diligence of treatment 
receives its most frequent illustration. The objects proposed in this 
heroic formula are the immediate and complete extinction of fever, pain, 
and inflammation. 
It is a rude and empirical practice which seldom succeeds, and fail- 
ing of success is most injurious to the patient; it has destroyed very THE DOCTRINE OF PURGATION. 
many who, under less popular and energetic methods of treatment, 
would have recovered. . . 
There is more wisdom, for there is less cruelty, in homoeopathy, hydro- 
pathy, or animal magnetism. Yet the courage is with those who refuse 
to prescribe. 
patient0 the 
Let young medical men ponder. 
722. Purgation.—Its simplicity ill accords with the impatient vio- 
lence and affected combinations of modern therapeutics; yet of consti- 
tutional methods of cure, no one, by long practical experience, has been 
more thoroughly approved. 
Par gat i or, 
—its simplic 
ity. 
723. To secure effects by perspiration, opium, antimony, ipecacuanha, 
ammonia, have been unsparingly added to the system, already tasked by 
an active disturbing principle, to its utmost means of resistance. 
Hence, from undue haste, violence, and inconsistency of action, a great 
loss of the credit which would otherwise have attached to the sweating 
practice in rheumatic fever. 
Imperfect sweating causes offensive matters to remain in the ducts 
and pores. 
Forced 
sweat. 
Sweating to be beneficial must come on spontaneously, with no aid from drugs.. 
Dick, Eobert, M. D., The Treatment of Dyspepsia. See Lancet, 
1847. Vol. I. 
724. Caecum.—In all cases of constipation or torpor of the bowels, 
attention to the caecum is important. It is here that fecal accumulations 
are, on several accounts, apt to take place. The circumstance of the large 
bowel here forming a cul-de-sac, out of which, moreover, the fecal mat- 
ter, during 14 or 16 out of the 24 hours, can only escape by a course 
counter to gravity, disposes not a little to the collection there of excre- 
ment. And indeed, in most cases of constipation, in cases of chlorosis, 
Ac., we shall generally both see and feel a fullness of this part, some- 
times of remarkable and even alarming extent and hardness. . . . And 
I have no doubt that in not a few cases a state of chronic irritation of 
(sub-) inflammation and even of ulceration of the mucous membrane of 
the caecum, is induced from the long contact with hardened faeces which, 
moreover, have become preternaturally fetid and undergone certain irri- 
tating chemical decompositions. In such circumstances either round or 
irregular masses of a fatty looking substance may often be detected in 
the evacuations. This consists of inspissated mucus, secreted by a sur- 
face highly irritated or {sub-) inflamed. A slight prolongation or 
increase of such irritation will convert this inspissated discharge into a 
purulent one (Lane., p. 32). 
Consti- 
pation ;—its 
c.iuse in the 
caecum ; su- 
perveningin- 
flammation 
from har- 
dened faces. 
725. In impure states of the fluids we prescribe purgatives on the 
following assumption, namely, that if we, by artificial means, afford 
nature the opportunity, she will, by emunctories whose action we excite, 
discharge herself of morbid principles, retaining those that are healthy. 
This, indeed, is the grand general law, in faith of which we venture, %n 
any case, artificially to meddle with nature (ibid. p. 88). 
The 
Brandreth’s 
Pills. THE DOCTRINE OF PURGATION. 
Sherwood, John Burdett, M. D., On Dyspepsia. London, 1847. 
Unity of dis- 
edte' 
726. I am of opinion that the proximate cause of all diseases con- 
sists in some alteration in the force, quantity, or quality of the circulat- 
ing fluid; and that, of those affecting the general system, vitiation of 
the blood is an invariable accompaniment (Preface). 
Johnson, Edward, M. D., On Life, Health, and Disease. American 
Edition. New York, 1850. 
727. Purgation, like exercise, accelerates what Liebig calls the change 
of matter—that is, the daily disorganization and reorganization of the 
elements of the blood and vital organs, by more rapidly expelling the 
old and worn out material and supplying its place with new (p. 96). 
Purgation 
accelerates 
the change 
of matter. 
Old age the 
only legiti- 
mate cause 
of death. 
728. There is but one legitimate cause of death, and that is old age. 
If any man die while any of his organs is unimpaired, he dies pre- 
maturely. and before he has fulfilled the final cause of his existence 
(P- 98)- 
He dth and 
disease. 
All the legiti- 
mate effects 
of medicine 
attained by 
purgatives. 
729. The health of the body depends upon the healthy performance 
of the nutritive actions, and disease consists in the unhealthy perform- 
ance of these actions, or of one or more of them. Medicines, therefore, 
have no real value nor power over disease, excepting as they have the 
power of increasing or diminishing the activity of the nutritive actions, 
absorption, secretion, circulation, &c. (p. 88). 
If from indi- 
gestion or 
overfeeding 
our food does 
not become 
blood, the 
system is 
filled with 
gases, etc. 
730. We cannot derive any benefit from what we eat except from that 
portion of it which in due course becomes blood. All that we eat, there- 
fore, beyond what can be converted into blood, is either changed into fat, 
or is left in the stomach and bowels to run into fermentation, serving no 
other purpose than to distend these organs with all sorts of pernicious 
and offensive gases (pp. 81, 82). 
Imperfect 
digestion— 
(constipa- 
tion)—how 
it impover- 
ishes and 
poisons the 
blood. 
731. The result of improper digestion is that the necessary change 
which should be wrought upon the food in order that it may nourish our 
bodies, is very imperfectly effected—the chyme is of unsound quality. 
The next result is this: the chyme, by admixture with certain other 
juices which it meets with in the bowels, is destined to become chyle. 
But the chyme being of vicious quality, the chyle which is formed from 
it must also be vicious. At all events it must be deficient in quantity; 
certainly it is impossible to suppose that as much perfect chyle can be 
elaborated out of bad chyme as of good. You might as well hope to 
make as much good butter out of bad cream, or out of cream and water, 
as out of pure cream. The chyle, therefore, is deficient in quantity; 
but this chyle is destined to become blood. The chyle, therefore, being 
deficient, the blood resulting from it must also be deficient (p. 125). 
Good illus- 
tration. 
The blood 
the nutri- 
ment of the 
body. 
732. But the blood is in fact the real food on which the body feeds, 
and this food being scantily supplied, the strength of course is ill-sup- 
ported. But there is another mischievous result of this condition of the 
stomach and bowels, beyond that of unhealthy and deficient gastric THE DOCTRINE OF PURGATION. 
juice. In that condition of the health which I am endeavoring to 
describe, the stomach and bowels actually secrete air. It is a thoroughly 
established fact that air-wind—flatus—is actually formed from the blood, 
and poured into the stomach and bowels by those arteries which ought 
to form only gastric juice. Now, this wind not only does no good in 
the stomach and bowels, but it does a vast deal of harm. For, besides 
the evil effects which it produces by its pernicious qualities, it violently 
distends these organs, stretching and separating, and thus greatly weak- 
ening and destroying the firmness and compactness of their ultimate 
tissue (pp. 125, 126). 
Wind secret- 
ed, and its 
effects. 
Wegg, William, M. I)., Observations Relating to the Science and Art 
of Medicine. London, 1851. 
733. A highly important action of medicines upon the intestinal sur- 
face remains to be noticed, as affecting its excretory function. I do not 
mean the process which eliminates from the villous surface a fluid largely 
composed of water, containing the remains of the epithelium, &c., and 
which almost any irritating cause may excite, but the excretory f unction 
of the glands which thickly stud the surfaces of the bowels, and espe- 
cially those of the large intestines. Although the lungs, liver, kidneys, 
and skin contribute largely to the depuration of the body, there is little 
doubt that these glands contribute greatly to the same result, very proba- 
bly by expelling matter different from that which those other depurating 
organs eliminate (p. 213). 
Purgative 
medicines— 
their action 
on the colon. 
IIaspel, A., M. H., Medical Staff of the Algerian Army. Maladies de 
VAlqerie. Paris, 1852. See Med. Cuik. Rev., New Ser., 1852, 
Vol. X. 
734. In this season of the year (autumn in Algiers) every individual 
seems to be endowed with an especial susceptibility to the development 
of typhoid symptoms, when he becomes the subject of dysentery, inter- 
mittent or remittent fever. But these accessory phenomena, the stupefied 
countenance, the restlessness, heat of the belly, &c., guickly disappear, 
at the same time with the principal disease, under the influence of an 
evacuating plan of treatment, life must distrust the fulness of pulse, 
the false plethora, which manifest themselves during the prevalence of 
the great heats, and which seem to call for bleeding. If we yield to this 
perflclious indication, we find our patients fall into a state of adynamia, 
without the dysentery undergoing any amendment; or, if the abstraction 
of blood produce any relief, it is but temporary, to be speedily followed 
by a sensible aggravation of all the symptoms (p. 58). 
Malignant 
fevers 
abound. 
Purgation 
the cure. 
Bleeding 
kills. 
735. Mr. Ilaspel refers to the advantages derivable from purgatives, 
reeorded by the old writers, and considers that their disuse in recent 
times has arisen rather from the prevalence of theoretical views of the 
inflammatory nature of diseases than as a result of experience. 
He speaks highly of emetics at the very outset of these diseases (pp. 
9, 11, 39 ; Rev., pp. 106 sq.) 
Theory and 
practice. THE DOCTRINE OF PURGATION. 
Carpenter, C. William B., M. D., Principles of Human Physiology. 
London, 1853. 
Pure Vlood 
contagions. 
736. I firmly believe that if the blood of a person of sound constitu- 
ti°n kept in a state of perfect purity by the moderate use of whole- 
some food and drink, by the respiration of pure air, by adequate exer- 
cise not pushed to over-fatigue, and by personal cleanliness, he is as 
completely pi'otected against the invasion of cholera as he who has been 
effectually and recently vaccinated is proof against small-pox. . . The 
same is true of all contagions and diseases, and lienee the universal value 
of purgatives, which quickly restore the above conditions, if any aber- 
ration lias taken place (chap. IY.) 
Dickson, Samuel II., M. D., Professor Med. College of South Carolina. 
Elements of Medicine. Philadelphia, 1855. 
737. The blood is often indirectly poisoned by the influence of con- 
tingencies which present the elimination of such effete matters as must 
be got rid of to keep it in a normal condition. We have reason to infer 
the existence within it of injurious ingredients, whose presence we can- 
not demonstrate by the ultimate results. The blood may thus become, 
so to speak, passively diseased (p. 111). 
The blood— 
how it be- 
comes im- 
pure (pas- 
sively dis- 
eased). 
tives. 
738. In the cure of influenza, purgatives aid in reducing to its proper 
level the vascular excitement; while we “ derive” from the head and 
throat by determining to the gastric intestinal surface (p. 313). 
The blood— 
in what way 
it becomes 
impure. 
739. The blood is found altered in disease: 
1. By a change in the proportion of its constituent elements; 
2. By the addition of foreign matters (p. 111). 
Demands careful attention. 
What for- 
chymists 
\nthe Mood, 
740. A great variety of foreign matters may be absorbed into, mixed 
with, and detected m the blood. Kramer round m it silver, alter the 
nitrate and chlorate had been taken. (Esterlein discerned globules of 
mercury in it, as well as in the saliva and urine of persons who had been 
taking mercurials. Heller found iodine and bromine in the blood of 
patients to whom these remedies had been administered. Nitrate, hy- 
driodate, and carbonate of potass, antimony, and carbonate and sulphate 
of iron have been found in similar circumstances. Quinine may be dis- 
covered in the urine, which it must reach through the vessels • and lead 
is shown in the gums and in the brain of those poisoned by that metal 
(p. 111). 
CONSEQUENCES. 
otheri impii- 
r le8’ 
741. Tliq foreign matters which, as causes of diseases, enter the blood, 
are not always, however, to be thus exhibited by chemical tests and re- 
agents; but their presence can be inferred as indisputably though less 
palpably. . . Blood thus poisoned becomes in its turn poisonous. The 
glands are irritated by it, and the secretions and excretions become mor- 
bid (p. 112). THE DOCTRINE OF PURGATION. 
742. The sugar excites the kidney into diabetes, the carbon and urea 
oppress the brain with coma. Its chemico-vital relation to the tissues 
undergoes essential changes, and infiltration and exudation, congestion, 
dropsy, and hemorrhage follow. It ceases to be nutritious, and atrophy 
and marasmus follow, or its nutrition is perverted and morbid, and we 
have hypertrophy, or deposition of scrofulous, tubercular, typhus or 
cancerous matter (ibid.) 
fori^ri0°fu(sii3 
ease induced 
't!fimpurt' 
Bennett, John Henry, M. D., Editor of Edinburgh Medical and 
Surgical Journal. 
743. The mortality from pneumonia has diminished since large 
bleedings have been abandoned. (Present state of theory and practice 
of medicine. Journ., Yol. I., 1856, p. 19.) 
meeding in 
pneumonia. 
744. Pericarditis.—Some few years gone by, the practice was to 
meet the violence of the inflammation by the extremest antiphlogistic 
measures; the lancet was plied with a most unsparing hand, and with 
the most unhesitating faith in the propriety of its use. But where are 
the believers in, or imitators of, such a practice now ? This “ heroic and 
certain method,” as it was called, of arresting the destructive agent—of 
exterminating the disease—has been convicted of error, and condemned 
by a late authority as “ uncertain and very dangerous.” Again: “ after 
blood-letting, rapid induction of the mercurial influence is of the greatest 
consequence,” wrote an authority in a most unhesitating style some fif- 
teen years ago. But now we find one of the most observing and practical 
physicians* among us admitting, that the firm faith which he himself 
once reposed in the efficacy of the remedy had been undermined by the 
truth-telling effects of further experience. In short, “ the errors and 
absurdities,” says Dr. Markham, “ into which men have been led through 
this hastening to be wise—the fallacious and extraordinary proceedings 
in practice it has involved them in—he who is desirous of learning will 
find recorded on every page of the history of medicine. By thus casting 
dust in the eyes of others, and perverting our own wisdom, we raise up 
positive barriers to the advance of true knowledge; for now the mist of 
delusion which our faulty haste has generated must be swept away 
before the honest face of the simple fact can be made available to light 
our slow steps along the difficult passes of new knowledge (Journ., vol. 
I., 1856, pp. 1038, 1039). 
Pericar- 
ditis. 
Bloodletting 
and mercury 
condemned. 
745. The very discordant opinions which equally honest and equally 
skilled' observers maintain—observers not living in separate ages, or in 
different countries, or in separate cities, but exercising their art upon 
the same disease, under the same roof, in the same public hospitals— 
must have a meaning. Is it not one which is oftener than we care for 
to confess, responded to by our consciences at the bedside of the patient ? 
(ibid., p. 1039). 
Medical 
ignorance or 
prejudicial 
stubborn- 
ness. 
* W. 0. Markham, M. D., in his “ Diseases of the Heart, their Pathology, Diagnosis, 
and Treatment.” London, 1856, THE DOCTRINE OF PURGATION. 
inftamma- 
ther ’bleed- 
cur"cures!"" 
746. None but men ignorant of pathology now talk of “ knocking 
down ” inflammation with blood letting, or with mercury. Indeed, why 
these remedies are employed at all, has, to use the word of Dr. Mark- 
ham, u yet to be shown ” (ibid., p. 1042). 
Bennett, J. Hughes, M. D., Professorof Medicine in the University 
of Edinburgh. Observations on the Results of an Advanced Diag- 
nosis and Pathology, etc. Edinburgh, 1856. See Edinb. Med. and 
Surg. Journ., Yol. I., 1856. 
rie,nct6XPnd 
theories— of 
"medical" 
theafSty— 
begin “ de 
. Medicine is not a scientific art, which is dependent for its 
principles on the study of and commentary on the older writers. . . On 
the contrary, it is the book of n/itune, which is open to all, that we ought 
t’° peruse and study; and why should we read it through the eyes of the 
sages of former times, when the light of science was comparatively 
feeble and imperfect ? . . . The lesson which a caref ul study of the 
history of medicine has forced upon me, is the necessity of reinvestigating, 
with all our improved modern appliances, the correctness or incorrect- 
ness of existing dogmas, in order to establish an improved practice for 
the future (Propos. I.; Journ., p. 773). 
Smaii-pox. 
The pustules 
—the matter 
creted from 
tUe 0,ood" 
Bloodletting 
is injurious, 
748. Dr. Wm. Addison (Cell-therapeutics, 1856) correctly points out 
thal hi the distinctive eruptive fevers, such as small-pox, the numerous 
small abscesses in the shin eliminate the morbid poison, which formerly 
existed in the blood, and are in this way essential to the cure. This 
provident action he denominates “ Cell-therapeutics.” In all such cases 
experience has shown that time and a natural sequence of changes is 
necessary for a restoration to health, and that the idea of cutting short 
such changes by bleeding is alike erroneous in theory and injurious in 
practice (Propos. III. ; Journ., p. 777). 
~thcf theory 
far more ap- 
purgation" 
749. Large and early bleedings have been practiced under the idea 
that by diminishing the amount of the circulating fluid— 
1. Tlic materies morbi in the blood would be diminishedf 
2. less blood would flow into the inflamed parts ; 
3. That the increased quantity of blood in the parts would lie les- 
sened ; and 
4. That the character of the pulse was the index as to the amount 
of fluid that ought to be drawn (ibid.; Journ., p. 776). 
BmovisgthT 
Slows athe 
bad to re- 
750. The carefnl investigations of chemists, and especially those of 
Andral and Gawarret, Simon, Becqueril and Rodier, and others, have 
further shown us, that whilst venesections greatly deteriorate the blood, 
rendering it poorer in corpuscles and richer in water, they have no effect 
in eliminating morbid products, and that in the vast majority of cases 
elimination is impeded by blood-letting (ibid.; Journ., p. 778). 
afn -—ih'c 
natwai and 
umcarflthe 
8ame- 
751. Inflammation having occurred, the great work now to be accom- 
plished is to break up the exudation tliat lias poured out, to remove the 
pressure it exerts on the nerves and blood-vessels, and render the whole 
capable of being eliminated f rom the economy, either directly, by dis- 
charge externally, or indirectly, first, by passage into the blood, and 
secondly, by excretion through the emunctories (ibid.; Journ., p. 779). THE DOCTRINE OF PURGATION. 
752. Now, it requires to be shown that draining the body of blood 
cannot in the slightest degree influence the congestion in the inflamed 
part. There the vessels are enlarged, the current of blood is arrested, 
the blood-corpuscles are closely aggregated together and distend the 
vascular tube, and are in no way affected by the arterial current, even 
when increased in its neighborhood. That opening a vein can alter this 
state of matters is scarcely to be conceived; and if it could, how would 
this assist in removing the exudation which has coagulated outside the 
vessels? (ibid.; Journ., p. 780.) 
Inflamma- 
tory action 
described — 
bloodletting 
useless—in 
dication for 
purgatives. 
753. So far from getting rid of inflammation by weakening the pulse, 
we not only fail to do so, but prolong the time for the transformation of 
the exudation. This, indeed, is acknowledged by Louis, Chomel and 
Grisolle, who distinctly show that the progress of a pneumonia is never 
shortened by ble'eding (ibid. ; Journ., p. 781). 
Bleeding 
prolongs 
disease. 
754. It is injurious to diminish by bleeding the nutritive processes 
themselves, when they are busily engaged in operating on the exudation, 
and eliminating the morbid products (ibid.; Journ., p. 781). 
Bleeding 
retards 
recovery. 
755. The phenomena of fever and excitability following inflamma- 
tion, have been wrongly interpreted. In themselves they are sanative, 
and indicate the struggle which the economy is engaged in, when at- 
tempting to get rid of the diseased processes; and we only diminish the 
chances of that struggle terminating favorably, by lessening the vital 
powers at such a critical juncture (ibid.; Journ., p. 782). 
The crisis 
must not be 
interrupted 
by bleeding. 
756. Assuming it as granted that in some cases the pain is fen' a time 
relieving by bleeding, and that in pneumonia the respiration tempora- 
rily becomes more free—at what cost are these advantages obtained, 
should the patient be so weakened as to be unable to rally ? Even if he 
does rally, a large bleeding almost always prolongs the disease (ibid.). 
Bleeding a 
dangerous 
palliative 
which pro- 
longs the 
disease. 
757. Clinical Lectures on the Principles and Practice of Medicine. 
Mew York Ed., 1860. 
Hepatiza- 
tion of the 
lungs. 
In all hepatization, the object of nature is to reconvert the solid exu- 
dation once again into fluid, whereby it can be partly evacuated from 
the bronchi, but principally absorbed into the blood, and excreted from 
the economy. Gradually the solid amorphous mass is converted into a 
fluid crowded with cells. This is pus. The cells, after passing through 
their natural life, die and break down, whereby the exudation is again 
reduced to a condition susceptible of absorption through the vascular 
walls, and once again mingles with the blood, but in an altered chemical 
condition. After undergoing various changes in the blood, the exudation 
is finally removed from the economy (pp. 265, 266). 
The natural 
and the pur- 
gative cure 
the same. 
Pickforo, J. H., M. D. Hygiene. London, 1858. 
758. Malaria is modified by altitude. If the elevation be consider- 
able, the temperature will necessarily restrict the fever to the intermit- 
Dilute the 
imPurityand THE DOCTRINE OF PURGATION. 
the*disease 
terd f°rm > whilst in the plain beneath, the same noxious emanations 
would produce, in tropical climates, remittent or yellow fever, plague 
or pestilential cholera (§ 966, p. 172. Cf. Brown). 
,, (f7C,000for 
purgation 
epidemics, 
'malarious' 
influences, 
759. A healthy adult respires twenty times in a minute, and takes 
into his lungs, at each respiration, twenty cubic inches of air, or 576,000 
cubic inches in twenty-four hours. This respired air comes into contact, 
each inspiration, with 201,600 square inches of mucous surface of 
air-passages and cells. Is it, therefore, matter of surprise that atmos- 
pheric air, contaminated by infectious or contagious matter, or poisoned 
by malarious, miasmatic or paludal emanations, should exert its baneful 
influence on the blood and on the organic nervous system, through the 
nerves distributed to the enormous superficies with which it comes in 
contact at each inspiration ? The wonder is, that any of us escape! 
(§932, p. 165.) 
Insensible 
perspira- 
tion—its 
amount;— 
analogy with 
wine. 
760. The sum of the cutaneous and pulmonary secretions amounts, 
according to the best authorities, to two pounds, eleven ounces, three 
drachms, and twelve grains in twenty-four hours. The cutaneous 
exhalation is a true secretion from the blood, somewhat analogous to that 
of the urine, of those matters which, at the temperature of the body, 
are capable of assuming the gaseous form, as carbonic acid and water 
(§§ 1101, 1102, p. 206). 
Hazard, Thomas R., of Vaucluse, R. I. Purgatives. 
761. Doctors’ and undertakers’ fees are so high that it is very incon- 
venient for persons of small means to be sick or die in these times. 
That most of the maladies that prevail in our climate may be prevented 
by proper care I have no doubt; and that most of the sicknesses that 
do occur may be cured at a trifling expense and loss of time, I am, after 
half a century’s observation and experience, equally certain. I think 
men and women would now survive to the average age of seventy, 
instead of half that term of years, if they would live and practice in 
harmony with the laws of their being; which, like all Nature’s works, 
are ever found to be as simple as they are grand, when understood. 
762. Moses was inspired to utter a great truth when he declared 
that “ The life of the flesh is in the blood.” Action is life; and the 
blood is the organ by which it is communicated to every member of the- 
body. It follows that if the organ be out of tune, the music or har- 
mony of life cannot be complete, however cunningly it may be piped 
upon. If there is discordancy in the instrument, it is not the fault of 
the law—which is ever perfect in itself—but it is the fault of man’s 
animal propensities that transgress the law. 
763. The blood that imparts life and nourishment to the system 
feeds upon the food we eat, the fluids we drink, and the air we breathe. 
To preserve its purity we should eat to live, rather than live to eat. 
Eat slowly, chew the food well, drink sparingly, even of water, and be 
temperate in all things, and one half of the primary causes of disease THE DOCTRINE OF PURGATION. 
175 
will be removed. Hilarity and cheerful conversation whilst at the table 
greatly assists digestion. A hearty, prolonged, explosive laugh will 
well nigh split a pine-knot on its passage to the stomach. 
See to it, as far as is practicable, that you breathe uncontaminated 
air; for every breath we draw comes in contact with the blood, and 
imparts to it its own quality, whether it be the savour of life to life or 
of death to death. Look especially to your sleeping-rooms that they 
are daily (and if small nightly) ventilated. Avoid beds, and particu- 
larly pillows, that are filled with blood-shotten feathers. Keep the 
pores of the body open and clean by frequent bathing, for each of these 
are pipes that gives tone to life’s organ. Above all things look to it 
that there is no decaying vegetable matter of any kind near or under 
your sleeping apartments, for probably more sickness occurs from this 
cause than any one other. If at any time you begin to feel dull and 
heavy and good for nothing—if you lose animation, and your flesh feels 
numb and sore; if your mouth grows clammy, and your tongue f urs; 
if your eyes feel as if they had sticks in them, or your head, or side, 
or back begins to ache, or old sores and weak points of the system 
grumble • if you snuffle, or your voice grows husky, accompanied with 
a hacking as if to clear the throat—lose no time in ascertaining and 
removing the local cause, if possible, before you are stricken down by 
disease. Proceed first to your cellar, especially if you sleep on the 
ground-floor. Examine it well in every nook and corner. You may, 
in your researches through its dark labyrinths, perchance stumble upon 
a dead cat, and perhaps some festering rats ; but heed them not. Their 
aroma is not pleasant, but it is not deadly poisonous; but, if you should 
fall in with a rotten turnip or potato, or cabbage, or any other decom- 
posing vegetable, eject it at once a stone’s-throw from your house, with 
every vestige of its remains, even to the earth it has impregnated; for 
the miasma that arises from a peck of decomposing vegetables of any 
kind, if inhaled into the lungs, and consequently blood, especially 
during sleep, is sufficient, with the aid of the lancet or of a little 
morphine, to kill a regiment of hardy men, and the stronger and more 
robust they are the more certain will be their doom. I have myself 
known, many years since when the lancet was in vogue, scores of hardy 
young men and women perish under such circumstances in a single 
country town of this State, whose lives might have been easily saved, 
I am entirely confident, under a different mode of treatment. I have 
now in my recollection a certain Doctor Sangrado, who then practiced 
in that town, of whom it might with truth be said “ Death followed 
after him.” He seldom entered a family at the season of year when 
these morbid attacks were most rife, without sending one, two, or three; 
and even five in one instance, to their graves. Weakly patients, whose 
strength of constitution was not competent to carry any considerable 
portion of morbid matter in their blood before it gave way, stood some 
chance of life under the bleeding treatment of that day, but those of 
strong constitutions stood but little. These, when attacked, generally 
kept about until their blood became so thick and sluggish that it 
coursed with difficulty through the thousands of little ducts and vessels 
that carry life to the surface and extremities of the body, and were 
unconscious of their danger until the morbid matter in the blood— 
precipitated perhaps by the scratch of a briar or pin, or a draft of cold 176 
THE DOCTRINE OE PURGATION. 
air or other trifling exposure—began to clot or congest in the intricate 
recesses of the brain, the liver, the pleura, or some other weak or deli- 
cate point, accompanied, of course, with pain or distress. Dr. Sangrado 
was then called, who proceeded at once to draw a heavy portion of the 
best blood from the system in order to relieve the suffering; and, 
having thus paralyzed the vital forces, they were next stimulated by a 
dose of mercury and expected to perform double duty, with their 
instrument (the blood) just crippled by the lancet. In other words, the 
horse that was striving, with all his might, to extricate a heavy load 
from the mire was first knocked on the head to prevent his injuring the 
wagon by his efforts, and then a shoulder was placed to the wheel in 
the vain expectation that the additional stimulus would enable the 
dying steed to drag it through the mud. The loss of the best blood 
the system could afford neutralized the otherwise good effect of the 
mercury, gave momentary relief to the patient just so far as life had 
been obstructed, relaxed the efforts that Nature was making to dispel 
the poisonous miasma from the blood which, in its weakened flow, went 
on congesting or clotting with accelerated speed. The pain or distress 
soon returned, and again the lancet was resorted to, alternately with 
doses of calomel, until the patient’s whole body, deprived of its life- 
principle, became a mass of inert and putrid matter; and “Died of 
typhus fever ” was generally the verdict of Death’s coroner. 
764. The practice of blood-letting has been, finally, pretty much 
abandoned, and one less revolting, but little less fatal in its operation, 
has been substituted by many physicians in its place, viz.: that of 
relieving effects at the expense of aggravating the cause by the use of 
opium. Instead of knocking the horse on the head under the circum- 
stances before narrated, his efforts are paralyzed before the shoulder is 
put to the wheel by dosing him with poison. 
765. To illustrate by another homely comparison: If a piece of 
cloth be run through water saturated with fustic, logwood, or other 
dye-wood, it will come out stained or colored. Rinse this in a brook, 
and the coloring-matter will quickly disappear; but drop a small lump 
of alum, vitriol, or other mordant in the dye-vat before the cloth is 
passed through it, and all the water of the lakes will not suffice to wash 
it white again. So, when the blood, by neglect, exposure, or abuse, has 
become surcharged with unhealthy matter, sufficient to interrupt its 
healthy flow, and begins to clot or congest, a little stimulus applied in 
the same direction that the law of our nature is already striving to 
impel the vital forces, will enable them to dislodge the congestion and 
expel the morbid matter from the blood. But introduce an opium pill 
or the smallest portion of morphine into the blood, and all the mercury 
or other cleansing stimulants on earth will scarcely purge it clean. 
766. A bullock’s hide once accidentally lodged on a shoal (weak 
point) in the River Tiber—the great artery of Rome. Against this the 
impurities and drifts of the river gradually congested, until it became a 
ast-anchored island. When first deposited it is probable a housewife THE DOCTRINE OF PURGATION 
177 
might, with a mere swash of her broom in the direction of the current, 
have so far stimulated its force as to have removed the hide (congestion) 
and prevented the formation of the island. 
767. Before applying such a mercurial remedy, to be consistent 
with his practice as applied to the cleansing the channels of the blood, 
Dr. Sangrado would have first withdrawn from the Tiber sufficient 
water to have left the bullock’s hide high and dry in the sand, and then 
set the woman to work with her broom; whilst Dr. Morphina should 
have advised that the swashing process should be deferred until the 
waters of the river were congealed by frost, or thickened by some 
ingenious process to the like consistency imparted to the blood by opium 
or other narcotics. 
768. What I have said so far is mostly theory, which readers will, of 
course, estimate at what it is worth. What I am now about to say is 
fact, derived from more than thirty years’ observation and experience 
applied to multitudes of cases with, as far as I am advised, uniform 
success, including bilious colic, bilious fevers, and all that class of mala- 
dies that, under the ordinary medical treatment, end in slow fevers 
called in the books Typhus or Typhoid, Pleurisy, common colds and 
sore-throat, Indigestion, and its first-born child Headache, Croup (if ap- 
plied in an early stage), Dysentery, Diarrhoea, Fever Sores, and running 
sores generally (the fountain of which is ever the blood), cuts and bruises 
of the flesh (if applied immediately after the accident occurs), and, in 
fact, almost every acute ailment common to our climate, that commences 
with pain in the head, body, or limbs, or at the commencement of which 
the patient remarks, in a languid tone, “ I don't feel well,” with the 
exception, perhaps, of scarlet and lung fevers, which the remedy I shall 
describe greatly benefits, and lays the foundation for a certain cure, as 
far as my limited experience in these complaints extends, by applying 
additional simple treatment, viz., packing in the former, and certain 
vegetable cordials or decoctions in the latter complaint. 
769. At a period when the reputation of the blood-letting physician 
I have referred to was at its height (and it was great in proportion to 
the scores of his victims that died, those that recovered being held in 
popular estimation that his skill had miraculously rescued from an other- 
wise mortal distemper), a hired girl living in my father’s family was 
smitten with the usual symptoms of the prevailing malady, and Doctor 
Sangrado was sent for. He told my father that the girl’s case was ex- 
ceedingly dubious, that her organization was unfavorable, and that he 
had but little hopes of her recovery; still he would do all that medical 
skill could do to save her life. My father was opposed to blood-letting, 
and the doctor deferred the use of the lancet until the next day. In 
the meantime my father gave the girl a dose of what was then known 
as Aldrich?s Pills, accompanied with a sweat. The next afternoon the 
doctor called again, and, after sitting a little while, inquired after the 
girl’s health. My father told him what had been done, and that she 
was then apparently well and at work in the kitchen. Upon this an- 
nouncement the doctor mused a few moments, and after remarking in 
a soliloquizing tone that “ those pills are devilish things,” he took up his 178 
THE DOCTRINE OF PURGATION. 
saddle-bags, lancet, blue pills (sure to be followed by rheumatism), 
opium, mercury, blisters and all, and departed, “ never to return.” 
770. About this period manufacturers in the town alluded to, of 
which I was one, were seriously incommoded by the annual prevalence 
of the complaint, dubbed by Sangrado as typhus, but popularly known 
as fall feoer. Business was sometimes brought nearly to a stand-still 
from the number of hands that were taken out of employ in consequence 
of long, and, in very many cases, fatal sickness. A young man or 
woman would leave the mill, complaining, perhaps, of a pain in the 
head, neck, shoulders, back, or side, or difficulty in breathing, send for 
Doctor Sangrado, experience momentary relief from the free use of the 
lancet, and, in consequence, he prostrated on a bed of languishing for 
weeks or months, and probably die. I was fully satisfied, in my own 
mind, that both the sicknesses and deaths were, in a great majority of 
cases, the result of improper treatment, rather than the normal character 
of the malady, and greatly to the disgust of Dr. Sangrado, gave free 
and wide utterance to my convictions. I finally resolved to practice 
medicine myself, so far as I could obtain patients, from among those in 
my immediate neighborhood and employ, gratis; and from that day to 
this, a period of more than thirty years, out of many hundreds of cases 
of almost every type of disease, I have never known a death to occur 
among those who have relied solely on the simple remedies I have fur- 
nished, nor have I known of a serious case among them all of Dysentery, 
Pleurisy, Typhus or Typhoid, Brain, Congestive, Bilious, or any other 
fever, except scarlet or lung fevers, of which last, as before said, my 
experience has been slight, and confined to my own family, in which 
there has been five cases of scarlet fever ; one of which was treated by 
two of the most renowned physicians in New York, and died in great 
apparent agony on the seventh day. Two of the other cases were 
equally severe, but all recovered without the interference or aid of the 
faculty. 
771. For some time I relied on the “ devilish pills” only in light at- 
tacks, and gave from 12 to 15 grains of calomel, with a good sweat in 
severe cases. I generally attended to the sweating process (which I shall 
hereafter describe) myself; and never, to my recollection, failed to obtain 
the desired sweat. The mercury stimulated the interior powers of the 
system, whereby the morbid matter is (as I suppose) forced from the blood 
into the bowels, and thus passes off; whilst the sweat, operating on the 
external pores of the body, in like manner as the stimulating mercury 
acts on the internal pores or ducts, the two forces sympathize and assist 
each other; and the congestion and other causes of disease (unless it has 
become chronic) are wholly expelled at one operation, leaving the system 
as free from poisonous or unhealthy matter as is that of a new-born 
babe. 
772. It is now nearly thirty years since I entirely abandoned the use 
of calomel, for which I substituted “Brandreth’s Pills” which I have 
found, after long and varied experience, produce all the good effects of 
mercury, with none of its bad. Too much care cannot, however, be ob- 
served in obtaining them, as a large proportion of the pills sold in New THE DOCTRINE OF PURGATION. 
179 
England are spurious, notwithstanding their close resemblance to the 
genuine and the oaths of the unprincipled men who vend them. To 
make sure of the genuine, I always obtain them from Dr. Benjamin 
Brandreth’s own office, which is at the “ corner of Broadway and Canal 
Street, New York,” and who sends them to order, free of charge for ex- 
press, for two dollars per dozen boxes. One or two boxes (or not over 
twenty-five cents’ worth) sufficing generally to keep a family of ordinary 
size in health for a year. 
773. Thus any man, by an expenditure of two dollars, may keep his 
own family, and those of some five or six of his neighbors, in health for 
a year, and that with very little if any loss of time, and not a farthing’s 
expense for medical aid. This, as a general rule, I pledge my word I 
know to be true by actual practice and observation—although 1 suppose 
it will not be so regarded by most readers. These pills are as efficacious 
in cases of hurts, bruises, cuts, sores, Ac., as in other maladies. By im- 
mediately cleansing the blood they remove all danger of lock-jaw, fester- 
ing sores, or congestion of the blood, at the wounded or ailing points— 
and nature speedily restores the injured parts. Not unfrequently, from 
the use of opium in some of its varied forms, or other malpractice, the 
morbid matter in the blood seeks to escape through vents called fever- 
sores. I have known instances of this kind wherein, after the patient 
has been in acute pains for weeks, a few doses of Brandreth’s Pills have 
turned this current of morbid matter from the sores to the bowels, 
through which it has been passed off, and the patient healed almost at 
once. But I do not mean to be understood to say that this is the rule; 
as when the system has been surcharged and weakened by poisonous and 
stupefying drugs, nature’s vital forces cannot always be rallied by any 
treatment that "I am acquainted with. 
774. I will close this long (and, as doctors will doubtlessly say, ab- 
surd and foolish) article, with a simple recipe, which, if adhered to in all 
its requirements, I know will heal at one operation a great majority of 
the ills we are liable to in this country, and I believe in all other coun- 
tries. 
775. I know that it has been used with entire effect in cases of yel- 
low fevers; and I now have in my possession a certificate, signed by 
every member of a company who were nine months in the Army of the 
Potomac, at a time when thousands were dying around them with 
small-pox, and swamp fevers, and dysentery—the health of every one of 
whom (without an exception) was preserved, without the aid of a physi- 
cian, simply by relying solely on “ Brandreth’s Pills,” a quantity of which 
had been presented to the Company, with directions for using them, by 
their fellow-townsman, Dr. Benjamin Brandreth. 
RECIPE. 
776. In cases of slight hurts, cuts, bruises, punctures, Ac., or slight in- 
disposition, take from one to six Brandreth’s Pills, according to age and 
constitution; say one pill for a child one year old, two for a child of 
three years old, and four or more for adults. 180 
THE DOCTRINE OF PURGATION. 
777. Where any malady has made such progress as to cause difficulty 
of breathing, oppression, or severe pain in any part of the body, head or 
limbs, place the feet of the patient in water as liot as it can by any pos- 
sibility be borne, and throw a blanket over the knees to keep in the 
steam. Do not let the feet remain in the bath to exceed four minutes. 
Wipe the feet dry as quickly as possible, and rub them hard with a dry 
towel. Then get at once to bed, and take from one to six pills as above. 
(In cases of intense bilious colic or pleurisy, give six, eight, or even 
more, until relief is obtained, but by no means attempt to remove the 
pain at the expense of the life by blood-letting or narcotics.) After 
swallowing the pills, drink a glass of weak lemonade (or molasses and 
water, if lemonade is not to be had) made almost boiling, and so hot that 
it can only be taken in sips; then cover warm and a sweat will shortly 
ensue. This treatment will set all the vital forces of life to work, both 
internal and external, and not only remove the effects but the cause of 
the distemper, as the most ignorant cannot fail to perceive, not only by 
the relief that will be experienced, but from the offensive character of 
the matter that passes from the bowels, a large portion of which proceeds 
from the blood, liver, or other vital intestines. Water-gruel alone should 
be taken for eighteen hours after taking the pills, after which, as far as 
my experience has extended, patients, as a general rule, will be restored 
to complete health, and in a situation to eat and exercise as usual, with- 
out danger of relapse, for the simple reason that the blood, the seat and 
organ of life, is freed from all impurities, and consequently there is 
nothing in the system to cause a relapse; nor can sickness again ensue 
until the blood again becomes surcharged with extraneous and morbid 
matter. 
778. Some readers may possibly suppose that, in accordance with 
general usage, I may have some interest other than that of a desire for 
the good of others in recommending “ Brandreth’s Pills ” (which, by the 
by, are always inclosed in a certificate and directions folded around each 
separate box, with a government stamp on the envelope). For the benefit 
of such readers I will just say, that I have never received from Dr. 
Brandreth or any other person a farthing for anything done by me in 
relation to his pills; that I have always paid full price for every box I 
have had; that I have never received a farthing for any disposition I 
have made of them, although I have probably administered and given 
away hundreds of boxes—that I esteem a judicious distribution of them 
in a charitable point of view as of more value than an hundred-fold of 
the same value bestowed in money; that in case of leaving my family 
for any considerable season, I should do it with an easier mind if satis- 
fied that they would on any and all occasions—of accident or disease— 
resort to the foregoing prescription for cure, than I should were they left 
in a position to command the best medical advice (apart therefrom) in 
the world; and this assurance has been derived from a long and varied 
experience, that has fully satisfied me that there is no necessity that one 
life should be lost in New England, where there is now ten by what is 
called Typhus or Typhoid Fever—which, in fact, as a general rule, is but 
the ebbing away with a slow fever of the life from the blood in conse- 
quence of the impurities it is forced to consort with, first engendered by 
breathing foul air, gluttonous and hasty feeding, and other causes and THE DOCTRINE OF PURGATION. 
181 
exposures, and subsequently aggravated by tbe malpractices of physi- 
cians—among the most prominent of which was the former practice of 
bleeding and parching to death with thirst, which practices were only 
abandoned by the faculty in consequence of an outside popular pressure, 
since which morphines and other narcotics have been substituted for the 
lancet with almost equal fatal elfect, and which will be doubtlessly per- 
severed in so long as ignorant patients measure the doctor’s skill by his 
ability to relieve effects at the expense of aggravating the disease, instead 
of working them off by removing their cause. APPENDIX. 
CURES BY PURGATION. 
Cure of Abram Van Wart, of Sing Sing, of Bright’s Disease of the 
Kidneys. 
Sing Sing, Oct. 14th, 1863. 
Dr. Brandreth, 
My Dear Sir: I was taken sick two years ago with a most severe 
pain in my right arm and elbow. Dr. A. K. Hoffman, of this place, pronounced 
it neuralgia. He treated me for some time, but getting no better, advised 
electricity ; I consented, but the shock nearly killed me, and I received no ben- 
efit whatever. After this my legs became numb and paralyzed, and my back 
and kidneys were tormented with most intense and continued pain. Dr. A. K. 
Hoffman and other physicians told me I had Bright’s Disease of the Kidneys. 
They treated me for a long time, but finally pronounced my case hopeless. 
Other eminent physicians then treated me but did me no good, and gave my 
friends to understand that my case was incurable. So, at length, I gave up all 
hope, the lower half of my body being totally paralyzed and much swollen; 
and I suffered terrible pain in the upper part of my body. My bowels were 
completely constipated from the paralysis, and no medicine produced a passage, 
and my urine was full of albumen. This was my condition five months ago, 
when my wife’s sister, Sally Ann Storms, begged me to take Brandreth’s 
Pills, as she had used them herself and in her family for many years with the 
best effect. Induced by her and my wife, 1 swallowed nine Brandreth’s Pills. 
They operated twelve hours afterward, slightly. I continued taking nine every 
day for several weeks, their operation constantly improving. Finding myself 
a great deal better, I diminished the dose one pill a day, until I got to five. 
One afternoon, at 3 o’clock, about three months ago, I took five pills; at 9 they 
commenced operating vigorously; suddenly I felt as if something gave way 
inside, and the stools were like egg and water mixed, several quarts of which 
came away, of a most disagreeable odor. The next day I felt very faint, and 
my neighbors came to see me die; but as soon as the faintness passed I was 
much better, and, for the first time in nearly two years, I was able to move and 
stand upon my legs. I continued taking the pills, and, in a very few days, was 
able to walk across my room, and now am able to walk quite a distance. I 
have taken altogether nineteen boxes of Brandreth’s Pills, and now one pill a 
day is all I require. My health is nearly restored, my appetite is good, and I 
suffer hardly any pain anywhere, and every day I grow stronger. My neigh- 
bors look upon me as one risen almost from the dead, and 1 desire you to pub- 
lish my case, that those suffering from paralysis and kidney diseases may know 
how easily they may be cured by Brandreth’s Pills. 
ABRAM VAN WART. 184 
CURES BY PURGATION. 
We, neighbors and relatives, certify that the foregoing statement of Abram 
Van Wart is true. 
A. B. REYNOLDS, Supervisor of the Town of Ossining. 
DAVID McCORD, Ex-Loan Commissioner. 
J. MALCOLM SMITH, Justice and Clerk Board of Supervisors. 
ABRAM HYATT, United States Assessor, Tenth District. 
JAMES McCORD, Loan Commissioner. 
RACHEL CYPHER, 
WILBUR F. FOSHAY, 
SARAH A. CYPHER, 
RACHEL ANN SLATER, 
LETITIA VAN WART, 
WM. SNIFFIN. 
The Methodist Society have heard the above facts stated in meeting from 
the mouth of Mr. Van Wart. 
Mr. John Archer, Ticket Agent at the Hudson River Railroad Station at 
Sing Sing, permits reference, he being fully acquainted with Mr. Van Wart and 
all particulars. 
In Epilepsy Brandreth’s Pills Seldom Fail 
to cure, because they purify the blood. If we are sick from any cause we owe 
it to ourselves to use this remedy which Providence places within the reach of 
all. 
Dr. Brandretii, 
Sir : A boy of mine was subject to fits from his infancy—his case was con- 
sidered hopeless by the doctors, who thought he would be subject to them for 
life. After they had given him up, I was recommended to try your Pills-,%nd 
without much faith did try them, using them according to your printed direc- 
tions. Four years ago I commenced giving them to him, and to my great joy 
and relief he has had but one return only of his affliction since. I consider 
him now perfectly cured. 
The extraordinary benefit they did him makes me always recommend them 
to my friends, and I would be glad if everybody knew their value. The cause 
was the worst possible; he would have been helpless and almost uselessly unfit 
for any kind of business from the length and severity of each attack—often 
lasting a whole night, and leaving him, for two or three days afterwards, en- 
tirely prostrate from weakness. Every kind of treatment was also externally 
applied that was professionally advised. You may, therefore, judge what good 
reason I have for letting you have this statement in acknowledgment for the 
benefit received, and for the purpose of letting those who may be hesitating 
under similar circumstances have my testimony in confirmation of the relia- 
bility of the other certificates, and perfect confidence like myself in the value of 
the Pills. 
Yours respectfully, 
JOHN WEBB, 
18 Beekman Street. 
New York, July 8, 1861. CURES BY PURGATION. 
185 
Letter from General Paez, the Washington of Venezuela, / 
in favor of Brandreth’s Pills. 
New York, May 30, 1865. 
Hon. B. Brandreth, 
My Dear Sir: I have received the supply of your invaluable Pills which 
you have so kindly sent me. I have not only used them myself in South 
America, as well as in this country, for the last thirty years, never allowing 
myself to be without them, but have purchased them by the gross to distribute 
to persons upon my estates and elsewhere, having found them efficacious in 
almost every variety of disease, especially those peculiar to the Southern con- 
tinent. I esteem, therefore, very highly the supply you now send me, and 
thank you very cordially for the kind words in which you convey your generous 
and friendly sentiments. 
I am, very respectfully, your obedient servant, 
JOSE A. PAEZ. 
Debility and Costiveness Cured. 
This certifies that I have used Benjamin Brandreth’s Vegetable Universal 
Pills more than three years, and I do affirm that having used a great deal of 
medicine of various kinds I have found none so beneficial to my health as the 
above-mentioned pills. 
I have been unhealthy from a child, and have had the advice and attention 
of the most eminent physicians, who did for awhile alleviate my sufferings, but 
at last their skill proved unsuccessful, and I was sinking into rapid decay, given 
up by my physicians, and bending over the tomb without a jot of a pi’ospect 
for recovering. While in that condition a friend recommended Brandreth’s 
Pills to me. I sent immediately and got a box, and the first dose gave me so 
much relief that I repeated it, and after several doses, finding my health im- 
proving, I continued to take them two or three times a week for twelve months. 
At the expiration of six months I thought that my health was perfectly restored, 
but still my bowels were irregular and dormant, so I continued to take them as 
before, until the expiration of six months more, when I found, by gradually 
quitting, I did not need them more than once a month ; and since I betook my- 
self to the use of Dr. Brandreth’s Pills, I have had no need of a physician, 
except in two cases, both of which needed skill more than medicine. 
During the first year after I commenced using these Pills I was very cau- 
tious both in the quality and quantity of my diet, but since that time I have 
generally eaten what was set before me. The Pills are the mildest in their 
operation of any medicine that I have ever taken ; they also produce the most 
powerful and free discharges of any medicine that I have ever used. And I 
speak from experience, that continued use will not render them ineffectual in 
their operation. If I take a dose and they do not operate, I continue to take 
them, increasing the number of Pills in each dose, until powerful discharges 
ensue without any pain, and in a few hours I feel perfectly well and able to 
attend to business. 
Having derived so much benefit from the use of Brandreth’s Pills, I would 
recommend them to all who are sick, whatever may be their diseases or com- 
plaint; for it is manifest that nothing is more important in any case of 
illness than to keep the bowels regular, and it is also evident, in my own opin- 
ion, that no better medicine than Brandreth’s Pills can be obtained to keep the 
system in a healthy condition. 
R. DUNN, 
Wo. 22 Third Street, Cincinnati, 
June 1, 1860. 186 
CURES BY PURGATION. 
Remittent Fever, of the Island of St. Thomas, Cured by Bran- 
dreth’s Pills, 
New York, May 31, 1856. 
Dr. Benjamin Brandreth, 
Dear Sir: It seems to me to be a duty to say that, when I was United 
States Consul at St. Thomas, in 1849, I used your Pills with very great advan- 
tage. I was taken with the fever peculiar to that island; the doctor bled me, 
and I was in very great danger of dying from that fever and the depleting. 
The inward fever was so great that no quantity of drinks seemed to relieve it. 
I was considered in very great danger, and I felt that my hold of life was really 
very feeble. In this condition I was recommended to use your pills. I at once 
took eight. Their effect was surprising. They seemed to be actuated by intel- 
ligence. I could feel them searching all round my stomach, even up to my 
throat; every recess of the body was aroused to action. I continued to use 
them daily until I had taken two boxes, containing twenty-five pills each, when 
I was quite recovered to my usual health. 
Governor Oxholm expressed to me the opinion that the Brandreth Pills 
were the best medicine he had ever known ; that he entirely relied upon them 
when he or his family were sick. He would not be without them for any 
money; that he believed you had been the means, by introducing them, of 
saving many valuable lives—a sentiment in which I concur most cordially. I 
desire, my dear Doctor, if you deem the above of any service, you will not be 
afraid to publish it. 
I am, very truly, your friend, 
CHARLES H. DELAVAN, 
Late United States Consul for the Island of St. Thomas, West Indies. 
Cure of Dyspepsia of Ten Years’ Standing by Brandreth’s Pills. 
Bushwick, Kings Co., L. I., March 1, 1843. 
This is to certify that I was taken ill during the season of the cholera, in 
the year 1832, and continued ailing until the spring of 1842, during which time 
I was severely troubled with dyspepsia, and all its various train of suffering. 
I became extremely emaciated, melancholy, and worn out with suffering, so 
that life itself seemed burdensome. I, in the meantime, applied to a number 
of the best physicians, who prescribed for me ; and many were the bitter doses 
of medicine that I took, but without avail. At last I yielded to despair. The 
idea of taking the prescriptions of physicians any longer was useless, and I was 
bitterly opposed to taking pills. My friends became alarmed ; often solicited 
me to try Brandreth’s Pills, asserting that they had derived great benefits from 
their use. At last I was tempted to give them a trial, and it is but just to say 
that, after using them a short time, I began to recover, and soon was entirely 
restored to health: and I think it a duty I owe to the world, and to Doctor 
Brandreth, to make this public acknowledgment. 
N. BLISS. 
f Mr. Bliss will be pleased to testify as to the merits of Brandreth’s Pills, 
after an acquaintance with them of twenty-three years. 
July, 1866. B. B. CURES BY PURGATION. 
187 
Cure of Consumption and Dyspepsia. 
“ IIammonton, New Jersey, May 7th, 1866. 
“ Dr. Brandreth, 
“ Dear Sir: I have long wanted to write to you and express my gratitude 
for the beneficial effects that have been experienced in my own family, and in 
hundreds, aye, thousands of others, by the use of Brandreth’s Pills. The first 
year my lamented friend Brockway sold your pills in Boston (1838) I called at 
his office. I was then in a declining state of health, and my friends, as well as 
myself, supposed my earthly voyage would soon terminate. Mr. Brockway 
urged me to take the Brandreth Pills, but having used so much medicine, with 
no good effect, I was more inclined to let nature take its course, and calmly 
submit to my fate. Mr. B. offered to give me one dozen boxes if I would try 
them as prescribed. By this I saw he had great faith in them, and I finally 
consented to take them, but not as a gift. I went home and went at it, almost 
hopelessly. After taking one box 1 began to feel better. Well, sir, when I 
had used up my twelve boxes, I was apparently a well, healthy man, my weight 
having gone from 131 pounds up to 152 pounds. I then ordered a supply, and 
between that time and the present I have retailed three thousand dollars worth 
of these invaluable pills, and am quite sure that I have thereby been instru- 
mental in saving, not hundreds, but thousands of lives. I have given them to 
my oxen, horses, pigs, fowls, cats, dogs, and always with the desired effect. I 
have a wife and nine children, most of them born since I have used the pills. 
A more healthy family cannot be found. We are frequently asked how it is 
our children look so healthy. My wife replies that ‘ We raise them on Brand- 
reth’s Pills.’ Now, my children overload their stomachs, get cold and out of 
order, like others, but they have been taught the remedy, and go and take the 
pills of their own accord. This I consider an important branch of their educa- 
tion, and feel assured, as they shove off upon the voyage of life, that they 
know how to take care of themselves. I was in trade at my last residence, 
North Lincoln, Me., for 29 years. I have been here about seven years ; I am, 
therefore, well known, and my statements can be verified by hundreds. 
“ Yours. 
“ C. J, FAY, P. M.” 
Certificate of Twenty-eight Years’ Use. 
Newcastle, Westchester Co., N. Y., Aug. 11, 1861. 
Dr. B. Brandreth, 
My Dear Sir: I am now seventy-nine years old, and for the last twenty- 
eight years have been a constant user of your Vegetable Universal Pills when 
sick, fully realizing the advantage of enforcing purgation with a medicine, 
which, while harmless in its nature, removes all impurities. I can safely say 
that the vigorous old age I now enjoy has been caused mainly by the timely 
use of Brandreth’s Pills. I have had, in these last twenty-eight years, several 
fits of sickness, and occasionally some infirmity of age would press upon me. 
At these times I have always found your Pills a sure remedy, giving me not 
only health but strength. I consider them, therefore, invaluable as a tonic, 
with qualities possessed by no other medicine known to me. I have never, 
during these last twenty-eight years, used any other medicine whatever, being 
convinced, by experience, that none was as good. Brandreth’s Pills have also 
been freely used by my neighbors in every kind of sickness, and have never 
been known to fail when promptly administered. 
Yours truly, 
NATHANIEL HYATT, 
Justice of the Peace for Forty Years in Westchester County, N. Y. 188 
CURES BY PURGATION. 
A Man Saves His Leg. 
Sing Sing, Westchester Co., N. Y., Aug. 24, I860. 
Dr. B. Brandreth, 
Dear Sir: Some years since a bad swelling appeared on my knee, and sev- 
eral physicians attended me. 1 kept growing worse and worse, until I was 
confined to my bed, a helpless cripple. Large quantities of matter kept 
coming from my leg, from six deep holes, together with pieces of bone. I lay 
in bed over one year, when the doctor came to me and said I had a very bad 
white swelling, and that the leg must be cut off or I would die. They wanted 
to cut it off then, and had brought all their instruments. I said, “ No; 1 
would die first.” So they left me. Despairing of cure, I took your pills. I 
began with four a day, and took them every day for a month, when my knee 
appeared a little better. This encouraged me, and though still in bed, I con- 
tinued taking your pills for four months more. I was now able to get up and 
go about a little with a crutch. I used the pills for three months more, when 
the sores all healed, and pain ceased, and I was well. I threw away my crutch, 
and now for the last four years I have been a well and healthy man, my leg 
being strong and my body sound. Words fail to express my gratitude to 
you. 
Yours truly, 
RICHARD T. BAKER. 
Westchester County, ss.: 
Richard T. Baker, being duly sworn, says, that the foregoing statement of 
his cure by Brandreth’s Pills is true in every particular. 
RICHARD T. BAKER. 
Sworn before me, this 24th ) 
day of August, 1860. f 
A. Jackson Hyatt, 
Justice of the Peace, 
Dyspepsia Cured. 
“Bennington, Vt., Dec. 5th, 1843. 
“ Dear Sir: I wish you to add my testimony to the host of others that 
you have in favor of your valuable pills. In the year 1838, I was attacked 
with that disagreeable complaint, the dyspepsia, which so affected me that I 
could not take the least particle of food without the most unpleasant and un- 
comfortable sensations in my chest, head, and bowels. My chest was so sore 
that I could not bear the slightest pressure without giving me pain. My health 
was most miserable; many physicians told me they thought I was in the con- 
sumption, and that if I did not give up my business, and change climate, I 
could live but a short time. 
“ I tried everything in the shape of medicine, and consulted the most skill- 
ful physicians, but found no permanent relief. 1 became discouraged, gloomy, 
sad, and sick of life; and probably, ere this, should have been in my grave, 
had I not fell in with your precious medicine. A friend of mine, who had been 
sick of the same complaint, advised me to try your pills: but, having tried 
most other medicines without obtaining any relief, I had but little faith that 
your pills would be of benefit to me; but at his earnest solicitation, I pro- 
cured a box and commenced taking them. 
u The first box produced little or no effect, and I began to despond, for fear CURES BY PURGATION. 
189 
that your medicine would prove like others that I had taken; but my friends 
urged that one was not a fair trial, and I purchased a second, and before I had 
taken the whole box I began to experience a change; the pain in my chest began 
to be less painful, and my food did not distress me as much as formerly. I 
went on taking them until I had taken six boxes, and my Dyspepsia was gone, 
and my expectation of an early death vanished, and I felt like a ‘ new 
creature.’ I was then, and am now, a healthy man ; I have never since been 
troubled with Dyspepsia. I have administered your pills to the members of 
my family, and to my friends, and in all cases with good success. You can 
publish this if it will be of any use to you. 
“ I am, dear sir, truly yours, 
“ J. L. COOK, 
“ Publisher of the State Banner.” 
Remarkable Case in which Fifty-two Pills were Used before the 
Bowels were Opened. 
John Pickett, living at 553 First Avenue, New York, aged 27, of robust 
constitution, from a severe wrench was laid up. His back pained him as if the 
muscles were torn. His bowels, kidneys, and bladder seemed paralyzed. For 
seven days nothing passed his bowels, spite of all the remedies administered 
by his three doctors, who told his wife they could do no more, and he would 
die. She was advised, as a last effort to save him, to give him Brandreth’s 
Pills. So she procured a box, and gave him four pills every four hours. She 
rubbed the pills down to powder under a knife on a plate, and then mixed with 
molasses. She continued this treatment until she had administered Jifty-two 
pills, when they operated, and the man’s life was saved. 
Observation Particular in respect to above Case. 
It is right here to call attention to the fact that while, in the first instance, 
this great quantity of Brandreth’s Pills were required to produce a thorough 
cleansing of this man’s 
two pills every day thereafter were all-sufficient to keep them open until his 
health was established. 
Thus we see how important a medicine Brandreth’s Pills are ; suitable for 
the most trying emergencies of bodily affliction, as for the most simple disorder. 
Always safe yet always sure. 
They are indeed a century in advance of all other purgatives. 
PARALYZED BOWELS, 
Fever and Ague Cured. 
Mr. John Y. Haight, Supervisor of New Castle, Westchester County, New 
York, desires the attention of those interested. He says : “ I was, about two 
years ago, attacked with fever and ague, which, notwithstanding the best medi- 
cal advice, continued to sorely afflict me for six tedious months; I became yel- 
low as saffron, and reduced to skin and bone. Medicine and physicians were 190 
CURES BY PURGATION. 
abandoned in despair. As an experiment, I concluded to try a single dose of 
six of Brandreth’s Universal Vegetable Pills on an empty stomach, early in the 
morning. The first dose seemed to arouse all the latent energies of my ex- 
hausted frame. Their purgative effect was different from anything I had ever 
used or heard of. At length this effect ceased, and I seemed lighter and. 
breathed freer. That evening I was indeed sensibly better and slept soundly 
all night. The next day I followed the same course and took the same number 
of pills. I continued to take the pills in this way about three weeks, when I 
found myself entirely cured. It was two years ago, and I have had no return. 
My health has been surprisingly good, and I have used no medicine since. 
Mr. Carpenter, of Gouverneur, New York, sixty-four years of age, says 
he has used Brandreth’s pills for thirty-four years ; administered them first to 
his coachman, who had Fever and Ague; gave eight the day after the chill; 
chill and fever less severe; gave eight more the next day, and so every other 
day, until the chill and fever did not return, wrhich was in about eight days 
from the first attack. He then gave four every other day another week, wThen 
the man was entirely restored to his usual good health. 
He was himself attacked, took them in the same way, and was cured in less 
time; has used no other medicine for thirty-four years; found them always 
every way reliable for himself and for his family when sick; has recommended 
them to thousands with the best results; feels confident that every family 
would have a larger average of health if these pills were used in the place of 
calomel and other hurtful remedies. 
The following is an extract of a letter from Hon. Caleb Lyon, of Lyons- 
(3ale, now Governor Lyon of Idaho, to Dr. Brandreth: 
“ My sincere thanks are due you for the boxes of Brandreth’s Pills that you 
were so kind as to send me previous to my departure for the East; and a more 
efficient medicine as a preventive of disease upon the miasmatic shores of the 
Danube, or the plague-stricken cities of Egypt and Asia Minor, I do not believe 
was ever used. My whole party took them freely, and while others were ill 
and delayed, we kept well. Enclosed you will find the translation of a letter 
from Achmet Hallilla, an Arab Sheik, to whom I presented several boxes. 
“ ‘ Peace be unto you and length of days; thy medicine (Brandreth’s Pills) 
was a fierce foe to Azrael, both in pestilence and caravan sickness; the little 
orbs were rich with the wine of health ; let the maker wear this golden circle, 
that he may know I was wounded with the arrows of disease, but am now 
healed. 
“ ! May he grow in the sunshine, and dispensing blessings be the most blest. 
(Signed) “ ‘ ACHMET HALLILLA.’ ” . 
Brandreth’s Pills are both sugar-coated and plain. 
Paralysis of the Legs, of Seventeen Years’ Duration, Cured by 
Brandreth’s Pills Alone. 
Extract of Consul Graham’s Letter to Dr. Brandretli, on file at 294 Canal 
■ Street. 
General T. has a brother over forty years of age, whose legs have been 
paralyzed for seventeen years, so that he could not walk a step. He has tried 
all sorts of remedies, and been under the care of various physicians, all of CURES BY PURGATION. 
191 
whom have pronounced his case incurable. I gave my friend a box of Bran- 
dreth’s Vegetable Universal Pills, with the printed instructions; his brother 
took them, and was so pleased with the effect that he prevailed upon Messrs. 
Zimmerman & Frazer to let him have a few dozen boxes. He has now taken 
some thirty or forty boxes, and is so far recovered that he can walk with a 
cane, and has full faith that he will recover entirely. He is so enthusiastic in 
favor of the pills, that he has cut your likeness from some of the package-labels 
and has posted it over his table, and frequently burns a candle before it (he is 
a Catholic); and when his friends come in he points to it, saying that this is 
the true “saint,” “my saint; all the rest I value nothing in comparison.” 
This gentleman entirely recovered the use of his limbs, and is now one of the 
healthiest and soundest men in Buenos Ayres. 
Captain Berry, formerly of the New York Custom House, had also lost the 
use of his legs, and was obliged to use crutches. He resorted to Brandreth’s 
Pills; three months’ vigorous use cured him of his rheumatism entirely. 
Cancer Cured. 
Mary H., wife of L. D. Grosvenor, of the United Society, Harvard, 
Mass., was cured of a cancer of many years’ standing. “ The prospect of ter- 
minating my life by the ravages of that insufferable scourge of humanity, the 
cancerous tumor, was certainly prevented by the timely and persevering use of 
Dr. Brandreth’s Medicine, and a wonderful cure effected.” 
Isaac W. Briggs, of 145 Suffolk Street, New York, says he has used Bran- 
dreth’s Pills for thirty years, having commenced to use them in February, 
1836, for dyspepsia and affection of the kidneys. He took Brandreth’s Pills 
every day for thirteen months, and in March, 1837, became a perfectly sound, 
healthy man. Mr. Briggs will be pleased to answer any questions on this 
subject. 
July, 1866. 
United States Sanitary Commission, ) 
Wethersfield, Wyoming County, N. Y., June 27, 1865. j 
Doctor Brandreth :—This certifies that I have used your celebrated Pills 
for over twenty years, personally and in my family. When we are sick, in- 
stead of sending for a doctor, we use Brandreth’s Pills. I believe if every one 
would adopt the same course, the doctors would have but little to do. I have 
traveled in fifteen States, and been in the army sixteen months, and necessarily 
exposed to much disease, yet by the use of your Pills occasionally, have secured 
my health through the biting winter’s frost and the scorching summer’s heat. CURES BY PURGATION. 
In fact, Doctor, I feel, with your Pills in my pocket, safe from the attacks of 
disease. They seem to cleanse the blood and regulate the system, whether it 
be troubled with dizziness, diarrhoea, or costiveness. When out of sorts, I use 
them, and they always cure me. I would not be without them for four times 
their cost. 
I send this to you that others who know me may profit by it, wishing to do 
good to my fellow-beings. 
N. HIGLEY. 
Dyspepsia and Costiveness Cured. 
D. J. TENNY’S CASE.—New York Mentor, January 14, 1860.— 
Whether the Brandreth’s Pill is ever convertible into blood we will not now 
discuss. But our chief object at this time is to give a statement of a gentleman 
who says he has taken one of the Brandreth Pills for at least sixteen months, 
daily, or about 480 days in succession, and who says that at the end of that 
time he considered himself cured of Dyspepsia, attended by a constant costive 
state of the bowels, which had troubled him for a long time. 
This gentleman, Mr. Daniel Tenny, resides at the Astor House, in this city, 
and has been in the enjoyment of excellent health ever since he was cured by 
this treatment. He is an intelligent man, and there is no doubt of the truth of 
his statement. This proves, at least, that as many as one of the Pills prepared 
by Dr. Brandreth can be taken for nearly 500 days in succession without harm, 
and at the end of that time a dyspeptic and costive habit of body may be per- 
fectly cured. This could not be said of any of the cathartics in use by those 
who style themselves the Regular Faculty. 
Asthma Cured by Dr. Brandreth’s Pills. 
The following cure of Asthma by the use of Dr. Benjamin Brandreth’s 
Pills is authenticated by seventeen well-known respectable citizens of Green- 
wich, Conn.: 
This will certify that Thomas S. Brown, who had been for some time pre- 
vious much affected with asthmatical symptoms, was taken suddenly worse on 
the 12th of June last: he began to cough and raise phlegm, and in the course 
of twenty-four hours expectorated nearly two quarts of thick white jelly-looking 
matter. Three physicians pronounced it a nervous humid spasmodic Asthma, 
and after prescribing for some time, to no effect, the three consulted together, 
and finally declared that they could, do him no good; it would and must result 
in consumption, and death would ensue, and that in a very short time. The 
pain was excessive in all parts of his body; and the difficulty of breathing was 
such as almost to cause strangulation. He was reduced to a mere skeleton, 
and finally gave himself up to death. After being in this miserable state nearly 
two months, he saw an advertisement of Dr. Brandreth’s Vegetable Universal 
Pills, and immediately sent by Captain J. Waring, of Greenwich, for a 25-cent 
box, and found relief in the course of a few days. It is proper to say that he 
commenced with two pills at night, and two in the morning; he found relief the 
second day, and encouraged thus to persevere with larger doses, he was soon 
able to sleep comfortable, and now, having taken them for about four months, 
according to the directions, is entirely recovered, and so far as we can judge, CURES BY PURGATION. 
193 
entirely in consequence of taking the above Pills, which we have also used in 
our families, and have found them invaluable. 
James R. Mean, 
Daniel S. Betts, 
John H. Reynolds, 
Abel Palmer, 
Rev. R. Palmer, 
John R. Palmer, 
Henry Bewsley, 
Samuel Jessup, 
James Moore, 
Hannah Hitchcock, 
James Mead, 
Thomas Bertram, 
Isaac Olmsted, 
P. V. T. Jessup, 
Stephen Waring, 
Augustus Lyon, 
John Limpry. 
Mrs. Mary Blanchard, 206 Clermont Avenue, Brooklyn, was cured of 
Asthma of long standing by 
BRANDRETH’S PILLS. 
She is acquainted with other cases of persons cured of Asthma by the same 
remedy, and kindly permits reference. 
Dr. Brandreth, 
Sir:—I am a painter by trade, and have frequently been troubled with 
slight attacks of colic, arising from contact with lead in the forms it is used in 
my business. My eyes have also been made somewhat weak from the same 
cause. Your pills have been my only medicine, and they have never failed to 
restore my health. For all the diseases incident to a painter, I think Bran- 
dreth’s Pills a certain remedy. My journeymen, by my advice, always take 
them whenever their arms become paralyzed, or their bowels constipated, and 
they have been cured by a few doses. Painters will find your pills invaluable. 
Yours, &cM DENNIS NORTON. 
Sing Sing, March 23, 1865. 
Painters’ Colic Cured. 
Saint Vitus’ Dance Cured, of Twenty-five Years’ Standing, with Brand* 
reth’s Vegetable Universal Pills. 
Sir: With the most grateful feelings and the highest consideration for you, 
I sit down to state one of the most remarkable cures perhaps you have ever 
received, and effected, sir, entirely with your never-to-be sufficiently praised 
Vegetable Universal, and, I might add, life-restoring Pills. 
The gratitude I feel makes me scarcely able to state the case, which would 
not, I am sure, be believed, were it not universally known in the town of Ware- 
ham, where we reside, and the miserable condition my dear wife, Lucy Hooker, 
has been in for the last twenty-five years, now restored to health and to her 
family, when for so many years she was considered to be beyond all human 
aid. 
For the last twenty-five years my wife has suffered from Saint Vitus’ Dance, 
and a complication of diseases which the doctors only seemed to continue to 
make worse instead of better. Calomel and bleeding, tonics and blisters, then 
calomel and bleeding, tonics and blisters again. Every doctor round the coun- 
try at all famed was tried, until finally, she receiving no benefit, I thought I 
would try the mineral doctors no more, and therefore took her to Boston to 
Dr. Thomson. She went through several courses of his treatment, and ap- 
peared to gain some thereby. But alas ! she soon became as sick as ever. I 194 
CURES BY PURGATION. 
then was obliged, she becoming suddenly worse, to send for two of the Ware- 
ham doctors again. They told me candidly she was beyond the powers of 
medicine, and that she must soon sink under her diseases. What was I to do ? 
I had often been recommended your pills, but always held them in contempt. 
One medicine and one disease I could not understand. I told your agent, 
Abishia Barrows, of Wareham, what the doctors said. Again he strongly 
recommended the pills. I talked to my wife about them; she said she would 
try, if there was any hope—hoped they might be blessed to her, but that she 
was resigned. I went for a box, and when I returned one of her doctors was in 
the room. He made a deal to do about it, said she could not bear them, they 
were too strong for her, she could not bear any kind of physic, that she would 
die in all probability from the effects of the first dose. The more he said in 
opposition the more Lucy was determined to try them, and actually took a dose 
of four pills in his presence, and while he was holding forth against them. Away 
went the doctor and reported through the town that J was killing my wife by 
giving her those Brandreth’s Pills—those Prince of Quack’s Pills—those Im- 
postor’s Pills—and created quite an excitement. In the meantime she was 
receiving the benefit. 
The first dose of four had a most wonderful effect—no wonder at the state 
she was in. The corruption was indeed dreadful. She took six the next night, 
and the same results. Instead of their causing weakness, she became stronger, 
and able to sit up a little. She persevered, sometimes taking as many as twelve 
at night and seven in the morning. When her pains were severe she took 
larger doses, and she did the same if the appearance of the evacuations was bad 
—in fact we followed your printed directions most carefully. 
Sometimes she became worse—all the worst symptoms of the disorder pre- 
sented themselves. Often at such times have I trembled lest she should die; 
but by persevering with the pills she soon recovered; and after every attack of 
this kind she seemed to be more firmly established in the recovery of her 
health, or rather her health seemed stronger after each of these attacks. At 
first, not only the doctors opposed her using the pills, but all her friends and 
relations; they all considered that the pills would surely accelerate her death. 
But long since the tide of opinion has changed, and those who most opposed 
now most strongly recommend them. 
It is about sixteen months since she took the first dose. She has used in all 
one hundred and fifty-two boxes, all purchased of your agent in this place, Abi- 
shia Barrows. I consider that she is like one raised from the grave, to bless 
myself and family, and give your pills and a kind Providence all the praise. 
She has not enjoyed so good a state of health since she was a child, certainly 
not since we were married. 
The doctor who saw her take the first dose, I understand is entirely con- 
verted to your principles of curing diseases by continued purgation, and is try- 
ing to find out what your pills are made of. But I believe he uses your pills 
in his practice—in fact I feel sure of it. 
The cures which have been made in our region since my wife’s recovery are 
truly surprising. Every one that feels sick thinks of no other medicine than 
Dr. Brandreth’s Pills. I hope, sir, you will come and favor our town by a 
visit; you will find many grateful hearts to welcome you. 
In the hope that you will live long to benefit mankind, I and my wife join in 
our mutual kind wishes and grateful feelings, and remain, 
Very respectfully, 
WILLIAM HOOKER, 
LUCY HOOKER. 
Wareham, Barnstable Co., Mass., May 23, 1838. CURES BY PURGATION. 
195 
Yellow Fever Cured. 
A gentleman, with whom I am well acquainted, writes as follows: “ In 
1838, at New Orleans, at the St. Charles Hotel, while at table taking dinner, 
before the soup was removed, I was taken with dizziness, dimness of sight, and 
confusion of ideas; in short, all the symptoms of yellow fever, though well five 
minutes before. I asked a waiter to lead me up to my room, for the confusion 
of mind and dizziness was so great, that I could never have found the way 
alone. When there, I took eight Brandreth’s Vegetable Universal Pills, and 
laid down. I was watched carefully, and for three or four hours was partly 
delirious; but in four hours the pills began to work, and my mind was clear 
enough to know my danger. Bleeding was recommended. ‘ Do you think,’ 
said I to the doctor, ‘ I want depleting V 1 Your life is not safe without it,’ was 
the reply. ‘ Then I will take eight more Brandreth’s Pills,’ said I. Those on 
the top of the first eight, with plenty of Indian meal gruel, carried me out of 
all danger, and half a dozen medium doses cured me entirely in less than a 
week. Those who want to be safe, should take a few doses of pills as a pre- 
ventive.” 
Tenea, or Tapeworms, Entirely Eradicated with Brandreth’s Pills. 
Reading, Fairfield County, Conn. 
Dr. Benjamin Brandreth : 
Dear Sir—I have been troubled with the tape worms for twelve years; 
many have come from me, from twenty to thirty feet long—more or less every 
day of shorter ones—every two or three weeks 1 had a sick time from them— 
pressure at stomach—heavy load—many have crawled from me while at work 
—injured my health so much that I was not able to work one half the time— 
spent a great deal of time and money in consulting physicians and taking their 
prescriptions—have been reduced very low by taking medicine, without effect 
—last fall heard of Brandreth’s Pills as a Cure All—had but little faith in them, 
but was determined to try any, everything, I could find at all probable to cure, 
thinking that without some remedy I must be destroyed by them. I procured 
one box, took one dose, and one worm came from me ten feet long; took the 
second and third, which cleaned them all out, and I have not had one since. I 
have, however, taken several boxes of pills since, but have seen no appearance 
of worms. It is now ten months since, and I have gradually recovered my 
health, and am now able to attend to my business as usual, and have no doubt 
that they are all extinct. When I was afflicted with worms, I wanted to con- 
sume three times as much food as I would if in good health. Now I take my 
regular meals, and am hearty and enjoying good health, and able to do a good 
day’s work. The last worm that came from me was twelve feet long. I have 
not the least doubt that it was Brandreth’s Pills (your valuable Vegetable Med- 
icine) that effected the cure, as everything else that I could hear of was tried 
without effect. 
Yours very respectfully, and grateful servant, 
AARON T. DIMON. 
June 20, 1838. 
The above person is well known in Fairfield County. John B. Sanford, of 
Bridgeport, Conn., has assured me of his respectability. 196 
CURES BY PURGATION. 
Cure of Pimples on the Face of Three Years’ Continuance. 
Dr. Brandreth : 
Bear Sir: For some considerable period I have been troubled with an 
impurity or acridity of the blood, which seemed to be past cure. My face, 
in consequence, presented an unseemly collection of pimples. I was abstemious, 
and seldom tasted any beverage stronger than water, and yet, with all my care 
as to diet, my blood got no better, and my appearance continued the same. My 
face all the time seemed as if it was held near a fire ; it seemed as if something 
was on it that might be brushed off. It was very annoying, and caused me 
much anxiety, not because it interfered with my personal appearance, which it 
did, but because it more or less affected my health, which was beginning to 
break down. I took very little medicine; but when the above state of things 
had remained about the same for three years, I was induced to use your pills. 
I took them, in all, about one month—every day, or nearly so—taking no higher 
dose than five pills, and sometimes only one. I think, altogether, I did not use 
over four boxes. They cured me completely. My face is free from all pim- 
ples and inflammation, and my complexion perfectly clear. Gratitude has in- 
duced me to render this account, which you may publish. 
I am, with respect, yours, &c., 
N. H. BAKER. 
Sing Sing, March 30, 1855. 
The following modest note from Mr. Bemis, of Dudley, Mass., for a supply, 
tells its own story : 
Dudley, December 7, 1853. 
B. Brandreth : 
Bear Sir—I have sold all the Pills I had of yours, and the money is ready 
when you will send my receipt. Please to send more Pills as soon as you can 
—send to Webster Station. I have sold $117 worth of your Pills, and they 
give universal satisfaction. 
Yours, with respect, 
PHINEAS BEMIS. 
Brandreth’s Pills Never Failing in Diarrhoea and Dysentery. Read. 
Battery Anderson, Sept. 9, 1864. 
Dr. Brandreth, New York: Please find one dollar enclosed, for which 
send me that worth of your Pills, as I have used and given all I had. These 
Pills have cured all who took them for the diarrhoea in a few days. Some had 
the disease two or three months. The army doctors had failed to cure in all 
of these cases. 
I have found your Pills to be never-failing in diarrhoea, bilious affections, 
headache, and costiveness. How is it the Sanitary people do not give out your 
Pills ? 
Yours, with great respect, 
PAUL P. DUFOUR, 
Co, A, Thirteenth Heavy Artillery, Bermuda Hundred, Va. CURES BY PURGATION. 
Captain Isaac Smith, of Sing Sing, says, thirty of Brandreth’s Pills, taken 
according to directions, cured him of a very severe bronchial affection, after 
other means had failed, and he wishes his numerous friends to know the fact. 
Axtract from a letter dated Dawson, Iowa, April 24, 1866, to Dr. Brand- 
reth, from Andrew Logan, Esq.: 
“ My wife became an invalid. Our physician represented her case as in- 
curable. I then called two other physicians, and the three held a consultation 
and pronounced her case consumption. I then discharged all the physicians 
and determined to trust to your Pills. I got five boxes, which she took accord- 
ing to the printed directions. By the time these were used up, there appeared 
a change in her condition for the better. I then bought fifteen boxes, and she 
continued to take them for three months, when her health was entirely re- 
stored.” 
Original letter at 294 Canal Street. 
Persevere in the Good Work. 
The Rev. Ezra Wilmarth, East Wilson, N. H., says: “He has seen the 
salutary effects of Brandreth’s Pills in many cases, and is fully convinced of 
their great valuethat he “ thinks it his duty to recommend them wherever 
he knows there is sickness, and is confident that they are calculated to promote 
the general health of mankind.” 
Nervous Debility and Bilious Headache. 
Mr. Webber, whose case is mentioned below, is still living, a fine healthy 
man of over 67 years: 
William Wood Webber, of Grigg Street, Southsea, in the Borough of 
Portsmouth, England, bell-hanger, voluntarily cometh before me and maketh 
oath and saith, that he was for five years and upward dreadfully afflicted with a 
nervous debility of his whole system, attended with a bilious headache which 
prevented him (deponent) from attending to his business the greater part of 
that time. He (deponent) has sometimes been so violently affected as to fall 
down senseless, which had nigh once put an end to his existence. In this mel- 
ancholy state he was recommended to take Brandreth’s Vegetable Universal 
Pills, and after taking them for four or five weeks, according to the directions, 
he was perfectly cured. It is necessary and essential to observe that after 
taking them six or eight times he was much worse; but Hr. Brandreth informed 
him that such would be the symptoms, and prevailed upon him (deponent) to 
persevere, which he did; he therefore went on, as above stated, and the most 
beneficial results followed. It is now six months since deponent was quite 
cured, and he has had no return of the said disorder, but keeps in the enjoyment 
of perfect health, which he entirely attributes to Brandreth’s Pills, the Vegeta- 
ble Universal Medicine. 
WILLIAM WOOD WEBBER. 
Sworn at Portsea, in the said borough, this 15th } 
day of December, 1831, before me, ) 
D. Spicer, Mayor, 198 
CURES BY PURGATION. 
Indigestion and Disordered Liver. 
Brandreth’s Pills are warranted free from all mercury or other mineral. 
A gentleman writes: 
“ I have for years been afflicted with disordered liver and indigestion, and 
have been restored after years of suffering, merely by the use of some fifteen 
boxes of the Brandreth Pills. For several years I have been more dead than 
alive ; I have crawled about, for my locomotion could not be dignified by say- 
ing I walked. I had the best advice, but was blistered, bled, took blue pill and 
calomel until my mouth was sore, dieted, and drank mineral waters. At last 
I saw hope wiped out of my doctor’s and relatives’ looks—it was clear I was 
doomed. In fact this was to be expected; for when I did get up in the morn- 
ing, I was more dead than alive ; I was unable to attend to any business, and 
exertion of any kind seemed too much for me to endure. In this sad state I 
read J. W. Webber’s case, and also Mr. Cooke’s, of Bennington; these letters, 
with the advice of a friend, induced me to give the Brandreth Pills a trial. I 
began with only two pills, which purged gently; in a few days I took two 
more, they also operated mildly ; then I took four, feeling some apprehension 
about my bowels; they operated finely, bringing away very slimy stools. I 
rested for a day or two, and then took two more ; then I took six, and at last 
I became fully convinced of the efficacy of purgation, as a cure for disease. I 
have taken as high as eight pills in twelve hours—but the dose must be in pro- 
portion to the sickness—inflammatory cases require strong doses, and all 
serious sickness where pain is present, the same. But with weak persons the 
plan is to begin easily, and sort of feel your way, taking larger doses as you 
proceed. This method in the use of Brandreth’s Pills has cured me, and re- 
stored to health one who had prepared himself for the grave.” 
Letter from Arnold Buffum, 
THE PHILANTHROPIST. * 
Cincinnati, Ohio, April 15, 1843. 
Dr. Brandreth: 
In the course of my life I have suffered often and much from sickness; I 
think I have been under the care of physicians more than twenty different times, 
for weeks at a time. But for the last five years I have employed a physician 
but once, and then only for a single day; not, however, because I have been 
exempt from frequent illness, but because I have found a far more speedy and 
effectual remedy in thy Pills, than I ever found in the medicines administered 
to me by my physicians. Wherever I go, I constantly carry a box of them with 
me, or at least a few of them wrapped in a paper in my vest pocket; and 
whatever illness comes upon me, I invariably find relief from the use of 
them. 
Having been much occupied in travelling and public speaking, I have 
frequently taken severe cold, which before I used these pills, invariably resulted 
in soreness of the throat and chest, and a severe cough; but latterly, though 
more exposed than ever, when I have taken a cold, by taking one or two pills 
at a time for two or three nights, I have invariably succeeded in removing all 
soreness of the throat and chest, and in effectually preventing the cold from set- 
tling on my lungs so as to produce a cough. 
Once during last winter, while travelling on horseback, and subject to 
much exposure, I was suddenly seized with a very sore throat, high fever, and 
entire prostration of strength and spirits,—by the use of two doses of the pills, CURES BY PURGATION. 
199 
and drinking freely of cold water, a copious perspiration was kept up, and in 
forty-two hours one of the most severe attacks which I ever experienced gave 
way ; and in two days more I was able to pursue my journey. At another 
time, continual exposure and daily exercise in public speaking brought on a 
severe lameness in the small of the back and kidneys, which became so 
exceedingly painful that I was forced to speak sitting ; not being able to stand 
on my feet; at length the soreness extended quite through me, and the pain 
became so severe that I never closed my eyes during a whole night, and 
several times during that night I had serious doubts whether I would live till 
morning. I took seven pills, which went to the seat of the disease, and as by 
magic, seemed to lay hold of it, and carried it all off, so that I attended a 
meeting on the same evening, and spoke without pain for more than two 
hours, and the pain has not returned since. I regard this as one of the most 
extraordinary cures that I have ever known, and I can truly say that, in a 
similar case, I would not exchange Brandreth’s Pills for all the medicine of 
the drug store. I have used the Pills, and administered them to others on 
various other occasions, and, as far as I know, in no case without complete 
success. Especially have I found them altogether superior to any other 
medicine I have ever tried for colds, coughs, and soreness of the lungs. I 
consider that the maker of them especially serves the great cause of humanity, 
and I shall recommend them wherever I go. 
Thine respectfully, 
A. BUFFUM. 
In October 1843, Aaron Hamilton of Sing Sing, Westchester county, was 
taken suddenly sick in the night with great pain in his bowels and stomach. 
He took six Brandreth Pills, and in two hours took four more. In a little 
time he threw up two worms, and passed several downwards. He has enjoyed 
good health since. 
St. Vitus’ Dance and Scrofula Cured. 
Sing Sing, 3d January, 1843. 
Dear Sir : 
It is with gratitude and esteem that I address you for the purpose of in- 
forming you of the beneficial effects which your Pills and External Remedy have 
had in restoring one of my sons to health, who had been sorely afflicted 
winter before last with St. Vitus’ Dance, and for a period of ten months he 
was entirely helpless from the terrible disorder. He was also subject to the 
Scrofula in his neck. By the use of your Pills freely, and also applying the 
the External Remedy to the enlargements upon his neck, he has become en- 
tirely cured. He has been now well over a year ; and I trust, by the blessing 
of Divine Providence, he will continue so. 
You are at perfect liberty to make what use you please with this commu- 
nication. I consider it a duty I owe to you to make it, and hope it may be the 
means of extending the usefulness of your most excellent medicines. 
I remain yours, respectfully, 
H. M. REQUA. 
To Dr. Benjamin Brandreth, 
Spring Hill, Sing Sing. 200 
CURES BY PURGATION. 
Indigestion and Bilious Affection Cured. 
Sing Sing, January 14, 1843. 
Dear Sir : 
This will certify that I have used your Vegetable Universal Pills for in- 
digestion and bilious complaint which had almost proved fatal to me. I had 
been under what was supposed good medical treatment, and used various 
advertised remedies, but without any good effect. I then made trial of your 
celebrated pills, which gave me immediate reltef, and soon effected a perfect 
cure. I have since used them in my family with the best effect. They are 
the best and easiest purgative we ever used. 
1 am, respectfully, yours, 
NICHOLAS FOWLER. 
Dr. B. Brandreth, 
Spring Hill, Sing Sing. 
Sing Sing State Prison, Feb. 4, 1843. 
Dr. Brandreth, 
Dear Sir : About four years since, I had a very severe attack of the piles. 1 
tried almost every remedy, but without any good effect upon my painful disease. 
I thought I would try one box of your Vegetable Universal Pills. I done so ; 
and before I had taken all the pills it contained, I began to feel the good effects 
of them; and by the time I had taken four boxes of pills, I was entirely cured, 
and have never since been troubled with the painful and truly unpleasant 
disease. I entirely attribute my cure to your valuable and inestimable 
pills. 
Very truly yours, 
R. LENT, 
Architect, Sing Sing State Prison. 
Sing Sing, Jan. 24th, 1843. 
Dr. B. Brandreth, 
Dear Sir : If you alone were concerned in the present statement, the greater 
inducement for making it would be removed, for of course no testimony can 
strengthen you in your convictions in relation to the value and efficiency of 
your Pills, which have already proved such a blessing to the thousands who 
have used them ; but 1 have looked out upon this vast expanse of creation, en- 
circling in its arms, as it does, thousands bowed down with sufferings similar 
to my own, who would gladly hasten to the same source that restored my 
health, if they were persuaded that they would meet with the same happy 
result. Therefore, Sir, it is that those thousands may be convinced, and profit 
by their conviction, as I have done, that induces me to state before the world 
a period of suffering, such as few have, and I hope few ever will know, and 
the permanent relief I received from your Pills; but how to begin, I hardly 
know, to describe those extreme tortures that seized upon my arms, shoulders, 
side and face, having about ten years since contracted a very severe cold, 
causing a very severe fit of sickness, attended with an affection of the Liver, as 
was supposed, which was the consequence of my taking a great quantity of 
medicine—and I must say, I have not seen a well day since, until I commenced 
taking Brandreth’s Pills. For the last ten years I have been afflicted with CURES BY PURGATION. 
201 
what is commonly called Salt Rheum and Erysipelas, at times covering and 
seeming determined to devour my whole body, and by making use of various 
means was enabled to check the disease from time to time, until early in June, 
1841, my disease assumed a very different appearance; and unpleasant as the 
task now is to me, I will, for the sake of spreading light and knowledge in the 
world, give a few of the particulars of my case : swelling and painful affections 
of the joints, tumors formed under the skin with burning lacerating pains, and 
finally coming out in horrible sores, covering nearly the whole of the right 
arm, and penetrating almost to the bone, and spreading to my face, covering 
nearly half including the nose, making for the time an entire wreck of that 
organ; from thence to my shoulder and side, and my whole body and limbs 
swollen in the most frightful manner. Residing at this time in one of the 
western cities of New York State, I had recourse to most of the eminent Phy- 
sicians of that part of the country; and the most that they could do was to 
pronounce the disease a scrofulous affection, which it seems they were not pre- 
pared to combat. A change of air and climate was recommended, and in travel- 
ing I became acquainted with a lady from Sing Sing. She advised the use of 
Brandreth’s Pills—but supposing that they could be of no use to me, as I had 
tried so many things, I thought little more of them at that time ; but after having 
endured the most excruciating tortures, and incurring great expense, I was, 
thank God, about six months since, by reading one of Dr. B.’s advertisements, 
and what I had heard about them, induced to purchase a box of Brandreth’s 
Pills. Jealous of the article, 1 resolved not to have my imagination at all 
busy, but nevertheless to give them a fair trial, which I did, by taking accord- 
ing to the directions accompanying each box, as far as my feeble state would 
admit, two or three boxes. Overjoyed at the discovery of an article which I 
well knew improved my health, used them secretly for a few weeks, but be- 
coming convinced that Brandreth’s Pills would cure me, I made bold to declare 
it. 
Sir, are you alone concerned to know it ? I think not, for I know that the 
medicine that possesses the power to cure me is capable of conferring the same 
blessings upon thousands of others suffering, perhaps dying; therefore, these 
are all concerned to know that they can be cured. In fact, all are concerned in 
the discovery of anything that tends to promote the happiness of the human 
race, for we are social beings and cannot suffer alone. Persons may doubt this 
statement as I have doubted similar ones, but be assured it is but too true; 
and in giving it, I have unsolicited, to you, sir, and the world, if you choose to 
publish it, discharged a duty which I felt incumbent upon me in making it known 
for the benefit of those who choose to believe it, as I believe that I have been 
cured of a scrofulous affection of the worst possible character and of long stand- 
ing, by the use of less than twenty boxes of Brandreth’s Universal Vegetable 
Pills, at an expense of less than Five Dollars, instead of chasing phantoms at a 
greater advance in fees, without any good results; and when I look into the 
past, upon these solitary days and sleepless nights, I thank a kind Providence 
that it is as well with me as it is, and 1 thank you, sir, that you are enabled by 
your scientific researches to minister to our infirmities. 
RACHEL TURRELL. 
Fits Cured. 
This may certify that my son, of five years old, was attacked with epileptic 
fits, in 1837, and continued to be troubled with them for more than one year. 
After every other remedy had failed I tried the Brandreth’s Pills, which effected 
a cure in about six months, and he has not been troubled with them since. 
DAVID CHAFFEE. 
Grafton Street, August 2, 1843. CURES BY PURGATION. 
Mr. Wilson, of 135 Christie Street, for twelve years was afflicted with 
Chronic Rheumatism, and for the last three years was not able to walk; has 
taken twelve boxes, the pain has entirely left his feet and knees, so that he is 
able to walk with comfort. 
Miss W*****, a young lady residing in Hubert Street, had a severe pain in 
her knee, from which she suffered excruciating pains for upwards of three years, 
which confined her to bed almost all the time. Dr. Mott and several others of 
the faculty had bled, leeched, and blistered to no effect; by taking Brand- 
reth’s Pills she has perfectly recovered the use of her knee. Observations on 
the above would be superfluous. 
Mr. G. Miller, of Harlaem, in September last, was dreadfully afflicted with 
Fever and Ague; the attack generally came on him every day about 12 o’clock; 
the disease had debilitated him in such a manner that his recovery was doubt- 
ful. A gentleman who has tested the goodness of Brandreth’s Pills, in his own 
family, persuaded him to try the medicine. After the first box the Fever was 
perfectly cured, and by continuing taking the medicine for about six weeks, per- 
fect health was restored. 
Benj. Weeks, of Westchester, was violently afflicted with Dyspepsia; he 
could not take any food without the most unpleasant sensations in his chest, 
head, and bowels. His chest was so sore that the slightest pressure gave him 
pain; his life was most miserable; numerous were the medicines used; and the 
skill of the first physicians tried in vain; as a last recourse he took Brandreth’s 
Universals, and in two months they effected a perfect cure. 
A young woman a short time since took these Pills for a violent pain in her 
side. After three doses she parted with a worm fourteen inches in length and 
one inch round; she has since been perfectly well, and has kindly allowed Dr. 
B. to refer any one to her. 
Worms: 
It is a fact that there are good remedies, but it is very doubtful whether 
there are many good physicians. Extraordinary cures in which Brandreth’s Pills 
have effected a perfect cure after the most eminent medical men had altogether 
failed: 
Mrs. Luther, of North Third Street, near Second Street, Williamsburg, for 
seventeen years was seriously afflicted with a violent pain in her left side, which 
often became very bad. The side was wearing to all appearance away, and just 
over the seat of the pain was a place you might have laid an egg in. Extreme 
debility and general bad feelings were the consequence; she could do nothing 
for herself and family with pleasure; no relief was experienced from anything 
used until July last, when Brandreth’s Universals were recommended, and im- 
mediate relief was experienced, and on the 31st of December she assured Dr. 
B. the Pills had perfectly restored her health, and that her side was become like 
unto the other. Mrs. L. stated many other particulars, which, were there space, 
would be mentioned. CURES BY PURGATION. 
203 
Cure of Terrible Ulceration. 
Second House from Tenth Avenue, Twenty-eighth Street, ) 
New York, Nov. 2, 1842. [ 
Dear Sir: Last January I was taken suddenly with pain in my left side in 
the night, and my wife had to get up and steam it, but the pain got no better ; I 
then sent for Dr. Adams. He ordered a poultice of bread and yeast, and then a 
lump began to form about six inches from my arm-pit. Dr. Adams gave me pills 
which did me no good, and the pain still became more severe. At this period 
Dr. Adams brought another doctor with him, but I still continued to get worse, 
and although several other physicians came to see me, yet I continued to grow 
worse and worse. Dr. Adams opened at one time the abscess which first com- 
menced under my arm, and which had extended to my hip-bone and thence to 
the small of my back, and from thence to my shoulder-blades. Being poor, I 
sent for the dispensary doctors, and they attended me, but I continued to get 
worse, and the ulcers were some of them, such as I could see, more than half an 
inch deep. The doctors, both dispensary and the others who visited me, only a 
few days before you called upon me, told me it was ten thousand to one whether 
I recovered or not—that I might not live through the night. This was in the 
early part of February. I had not been out of bed since the beginning of Jan- 
uary. At this time, the latter part of February, my wife went to see you, and 
beg you to come and see me. You dressed my ulcers for me that night—it 
took a yard of linen to dress them once. You left me two boxes of pills, which 
I used as you directed me, and my wife dressed me with your Universal Salve, 
and rubbed the callous places with the Liniment. In two months I walked to 
your office in Broadway, from Twenty-eighth Street, corner of Tenth Avenue. 
I came after that, seven or eight times for you, to see how my back got on, and 
to receive your further advice. I went on getting better every day, and my 
ulcers one after another got well, until the latter part of July, when I wrent to 
work, being a sound man, with the exception of having nearly lost the sight of 
my right eye, during my sickness, which, however, gradually gets better and 
better from the use of your pills. I send you this letter that you may publish 
it; and should any one wish to inquire any particulars of my extraordinary cure, 
they can see me where I live, which is the second house from the corner of 
Tenth Avenue, in Twenty-eighth Street. 
I remain, dear sir, 
Yours very respectfully, 
PATRICK BEALLEY. 
To Dr. Benj, Brandreth, 241 Broadway, New York. 
Edmeston, Otsego Co., Jan. 4, 1830. 
Bit. Brandretii : 
Dear Sir : I feel it a duty I owe to tne public, as well as yourself, to inform 
you of the astonishing efficacy of your truly valuable pills, I was attacked 
about the 1st of November last with the prevailing bilious or typhus fever, 
violently. The pain in my head and back was most excruciating. I took first 
six of your pills, then eight, ten and twelve at a dose twice a day, yet found 
no relief. My wife then read your directions to me, after which I took 
seventeen, then twenty and twenty-two. I continued to take twenty morning 
and evening for four days, when I found the disease yielding and the fever liter- 
ally broken up; I then gradually diminished the quantities according to your 
directions. In two weeks I was out again.* I used no medicine but the pills. 
* Others who pursued the ordinary course were confined from six to twelve and fourteen 
weeks. CURES BY PURGATION. 
There has since been a number of cases of the same fever in my neighborhood, 
where the patients have followed the same course. J. E. used no medicine 
except your pills, according to your directions in “ violent diseases,” with the 
same happy effect. I took fifteen boxes; another twelve, and others ten and 
down to four. Some used drafts upon the feet. 
Yours truly, 
WATERMAN BURLINGHAM. 
Melbourne, Victoria, 1st June, 1858. 
Mr. Blandforb, Agent for Brandretli s Pills, Melbourne : 
Dear Sir : Having had a severe attack of inflammatory rheumatism, by 
which l was confined to my bed for several days, during which time I suffered 
the most agonizing pains in my side, back and limbs, and was fearful that I 
should be confined to my bed for a long time, my husband brought me one of 
Dr. Brandreth’s pamphlets; after reading it carefully, I concluded that I would 
try the pills, which I used as directed. I have been using them three weeks, and 
1 am happy to say that to Dr. Brandreth’s Pills I owe my recovery to health 
and strength. I feel stronger and better than l have done for a long time, and 
I am convinced that the disease is eradicated from my system. 
If you deem this letter of any use, please publish it. 
I am, dear sir, 
Very respectfully yours, 
MANDY WAYMAN. 
Little Bay Street, SandidGE. 
Melbourne, 1st Aug., 1858, 
Mr. J. T. Blandford : 
Dear Sir: I am a mason by trade, and for some time past have felt almost 
unable to attend to my business. Three weeks ago, on my way home 
in the evening, I stepped into a water hole and got quite wet, from the effect of 
which I took a severe cold, my whole body became much swollen, my breath- 
ing became very difficult. I had sharp pains in my chest, and in fact when I 
called on you at your office I considered myself in very great danger. I bought 
two boxes of Dr. Brandreth’s Pills, and took six pills in the office and six more 
on my return home. In about five or six hours I discharged several quarts of 
water, and felt greatly relieved. I have continued to take the pills, and am 
happy to say am quite well. I consider the Brandreth Pills the means of sav- 
ing my life. I have heard them called the Poor Man’s Medicine of America, 
where they are so celebrated. I trust they will be known as such here. I will 
never be without Brandreth’s Pills as long as I can obtain them. 
Please publish this letter. I am anxious that the people here snouid know 
where to get a medicine that they can rely on. 
I remain, dear sir, 
Yours respectfully, 
JOHN FLANNIGAN. 
Howard Street, North Melbourne. 
Park Street, South Yarra, Aug. 20th, 1858. 
Sir : This morning, having mislaid my spectacles when the morning’s Age 
arrived, I took it up merely to endeavor to read the large type of the leading 
article, but judge my astonishment when I could, with facility, peruse the small- 
est type. This extraordinary fact I attribute to the use of Dr. Brandreth’s 
Vegetable Universal Pills. Make any use you please of this communication. 
Yours very truly, 
JOHN HARRISON. CURES BY PURGATION. 
205 
Letter of the Rev. Ezra Wilmarth, in favor of the Brandreth Pills. 
t 
East Wilton, N. II., July 27, 1836. 
Dr. Brandreth : 
My Dear Sir: Having recently become acquainted with your valuable 
pills, and seen their salutary effects in a great variety of cases, I take the liberty 
of addressing you, stating my conviction of their value. Although I have 
heretofore been unfavorable to nostrums, 1 am fully convinced of the value of 
yours. 
I am a minister of the Gospel, of the Baptist denomination, in this town, and 
pastor of a church, and am well known; therefore, I hope my recommendation 
of your Pills will be of some use in causing those who know me to make 
trial of them, as I feel confident they are calculated to promote the general 
health of mankind. 
Wishing you abundant success in your attempts to benefit the world, 
I am, with high respect, 
Your obedient servant, 
EZRA WILMARTH. 
Bilious Remitting Fever and Dysentery Cured. 
Paterson (New Jersey), Aug. 18th, 1836. 
Sir: I write this out of respect to you for your excellent Pills, for both I 
and my family think it a great blessing that we have met with them again in 
this country, because we knew them to be excellent and good; when at Leeds, 
in England, there it was always said if any person was sick, get a box of Bran- 
dreth’s Pills and they will cure you. 
Sir, I have been sick of a bilious and remitting fever, for which I got three 
boxes, and they have done me more good than all the physic ever I took in my 
life ; for before I took them I was almost gone with a liver complaint; and now 
I am as well as ever 1 was in my life. In my family we have had three attacked 
with the dysentery; they (the Pills) cured them in two days, so that we have 
all of us great occasion to praise Dr. Brandreth’s Pills. 
I am, sir, yours very truly, 
And greatly obliged, 
RICHARD HAMPSHIRE. 
Asthma Cured. 
Mr. John Benist, of No. 69 Chapel Street, New York, was afflicted with a 
dreadful asthma for nine years, during which time he was unable to lie down in 
bed, and frequently was gasping for breath, expecting every coming hour would 
be his last. He applied to several of the first physicians in New York, none 
of whom gave him the least relief. At last, Brandreth’s Universals were 
strongly recommended, and in the course of a short time he found great benefit, 
and by continuing the Pills, he is now quite well, and able to attend to his 
business ; indeed he is perfectly restored to health. CURES BY PURGATION. 
Dyspepsia Cured. 
Newburgh, N. Y., Feb. 14, 1836. Dr. Brandreth—Sir: The many flatter- 
ing notices you have received from respectable individuals, of the success of 
your Vegetable Universal Pills, render it unnecessary for me individually to 
eulogize, or those who are ignorant of the specific to censure. Having had 
ocular demonstration as well as bodily, I cannot refrain from expressing and 
publicly acknowledging the signal result and final cure of that dreadful disease 
known as Dyspepsia; hoping such persons as may be afflicted with the above 
disease, this notice may influence some to make the experiment. You are at 
liberty to refer them to me voluntarily on my part. 
I remain your friend, 
JOHN A. STEVENS. 
Rheumatism. 
A gentleman who had lost the use of his limbs with Inflammatory Rheu- 
matism, and was so miserably afflicted that he could not turn in bed without 
assistance—the pains were violent in all parts of his body, but especially in 
his breast, back, arms and feet. This person took no other medicine than 
Brandreth’s Pills—for two weeks he took 12 pills per day, and often as many 
as 20, and in three weeks he was able to get out; and now, having persevered 
with them so as to produce copious evacuations every day, is at this time per- 
fectly cured; it is not two months since he was first taken ill. Now, Dr. 
Brandreth would ask, would this have been the case with your bled man ? with 
the man to whom mercury has been administered h No ! he would have been 
in bed months, and his convalescence would have been tedious. The above 
gentleman is highly respectable, and can be referred to. 
A Running Ulcer of Three Years entirely removed with Eight Boxes of 
Brandreth’s Pills. 
Edward Brown, son of Mr. James Brown, St. James Street, Kingston, 
Ulster County, for three years had a running ulcer in his hip, wThich obliged 
him to be carried about; the doctors were in daily attendance, and the best 
advice was had from New York. All did not relieve the poor child, who was 
not expected to recover. Brandreth’s Pills were commenced with four months 
ago, and a decided change was effected before the third box was finished, and 
now, having taken eight boxes, is quite well. 
A little boy, aged four years, swallowed a pin, and, as a matter of course, 
his parents were much alarmed. His father called on Dr. Brandreth, wh'o 1 
recommended him to give the child five or six pills per day, and no bad con- 
sequence would arise. This advice was taken, and on the fourth day powerful 
evacuations having been kept up, the pin was discharged, and not in the least 
corroded. Reference will be given to the parents, who are highly respectable. 
Mrs. S., in East Broadway, has been afflicted for nearly eight years with a 
bad leg, which prevented her going about. The sore was larger than the palm 
of the hand—she had had recourse to various doctors, who frequently healed it 
up, but in a few weeks was as bad as ever. Brandreth’s Pills were recom- 
mended, and in a short time her leg was perfectly healed, and she is again able 
to walk with pleasure and comfort, and the leg has every appearance of being 
perfectly sound. Reference as to the above can be made to Mr. Aaron Swartz, 
grocer, corner of Pike Street and East Broadway. CURES BY PURGATION. 
207 
Difficulty of Breathing Cured. 
Danbury, Conn., March 8, 1836.—Dr. Brandreth—Sir: Will you be good 
enough to send us some more of your Vegetable Universal Pills? there are 
many persons here taking them for every complaint, and all find relief. I can 
say they are the best medicine I ever took, and I have tried almost everything, 
but found no relief until I took your Pills. My difficulty of breathing is greatly 
relieved, and I am getting well. Many are taking them here for the same com- 
plaint, and find them very good. 
Yours, respectfully, ELIZA MORRIS. 
Piles Cured. 
Messrs. Coggershali & Walters, of New Bedford, have forwarded me the 
following facts of that most painful and unpleasant disease,*the Piles. The 
original letter can be seen at 187 Hudson Street. Mr. McFarlane, of New 
Bedford, has been laboring under that most dreadful disease, the Piles ; he has 
had them upwards of two years—has tried various things from different doc- 
tors, to no effect. Brandreth’s Vegetable Universal Pills were had recourse to, 
and a complete cure is effected. He is now quite well. 
(From the Louisville Enquirer.) 
Liver Complaint Cured. 
Newark, Dec. 25, 1830. 
Dr. B. Brandreth. 
Dear Sir: Having been afflicted for ten years with a most dreadful liver 
complaint and dropsy, and tried every remedy that could be thought of, 1 gave 
up all hope, went into the country, left my business, to die in peace; but hear- 
ing of your invaluable medicine, I was induced to try it, not expecting to be 
any better. To my surprise, I had scarcely taken one box *before I felt relief. 
I have since taken three boxes, and now I am well, by the blessing of God and 
the use of your medicine. If you think this will be any service to let suffering 
people know this fact, you are at liberty to publish the above. 
Yours, with kind respect, 
(Signed,) LEWIS TOMPKINSON. 
Dysentery and Deafness Cured. 
August 20th, 1835. 
Sir: Allow me to express my grateful feelings for the benefit I have expe- 
rienced in your Vegetable Universal Pills in the cure of Deafness, which I have 
been subject to nearly thirty years. I have frequently been under eminent 
aurists in London, who have invariably syringed me, and who have all said no 
other mode of treatment would be of service. The latter part of May I again 
lost my hearing, with continual unpleasant noises in my head. It was with 
difficulty I could hear any one speak; knowing you were an English surgeon, I 208 
CURES BY PURGATION. 
applied to you to be syringed, thinking that w as the only remedy; you refused 
to operate, but told me a box of your pills would have the desired effect, and I 
was induced to try them, especially when I found that many persons had been 
cured of the same complaint. I have taken two boxes, which cost me fifty 
cents, and am happy to say, am completely cured. The dose 1 took was two 
or three at night, and twice during the time I took five. They never incon- 
venienced me in the least, and were remarkably easy in their operation—I 
certainly can recommend them to any one laboring under the same unpleasant 
disease. 
Permit me likewise to say my eldest daughter, two weeks since, had a 
dreadful Diarrhoea or Dysentery on her, which in two or three days reduced 
her frame, and I thought would have sent her to the grave. I immediately 
applied to you to know if the Vegetable Universal Pills would have the same 
beneficial effect on her as they had on myself; you told me to persevere and 
they would make a cure—I had confidence in them, and am happy to say, by 
her taking from four to eight pills every night, the dreadful disease left in about 
a week. She is now well, and getting up her strength very fast. She took no 
other medicine whatever; she continues occasionally one or two pills at night. 
My family had used the Hygeian Medicine for upwards of twelve months, and 
found they could not leave them off, as Costiveness and Piles were sure to fol- 
low. Thank God, your Pills leave no such enemies behind them. I have no 
hesitation in saying, that your Vegetable Universal Pills are the safest and best 
medicine myself or family ever took. Make what use you think proper of 
this communication, and you are at liberty to refer any one to me, and I think 
I am only doing my duty in thanking you, through divine mercy, for the benefit 
received. 
I am, sir, yours very truly, 
JAMES LANCE, 
250 Eighteenth Street, near Broadway. 
Certificate of Joseph Goulden, who has known the above Pills forty years: 
I hereby certify, that I have known Brandreth’s Vegetable Universal Pills 
for upwards of forty years; they were used in my family connections, in the 
County of Dorset, England, since the year 1796, many of whom they cured of 
old standing complaints. 
JOSEPH GOULDEN. 
Bridgeport, Feb. 18, 1836. 
Disease of the Prostate Gland Cured. 
Henry Lathrop, of Edmonston, Otsego County, New York State, a respect- 
able farmer, was afflicted for more than a year with this most painful, and gen- 
erally incurable disease. Some of our highest medical men pronounced his 
case incurable, and advised him to settle his affairs, and patiently await the 
result, as it was not in the power of medicine to save him. Mr. Lathrop, 
before he went home, called upon me, and having stated his symptoms, I told 
him what his disease was, and in this I agreed with the doctors who had said he 
was incurable. But I also told him I felt confident that if he would persevere 
with my Pills they would cure him. Mr. Lathrop proved his confidence by 
purchasing six dozen boxes, which he took home with him, and in about three 
months he returned to me in New York City a cured man, having used the Pills CURES BY PURGATION. 
209 
as I directed. In fact, he said he never was better in his life. This was in 
1835. Since that period Mr. Lathrop has administered the pills to upward of 
a thousand persons, all of whom, he assures me, have derived the most aston- 
ishing benefit from their use. 
New Bedford, Nov. 7, 1835. 
Dr. Brandreth— 
Sir: About eight weeks past I saw some of your Pills, and read one of 
your wrapping-papers, but thought it was, as thousands of such things are now- 
a-days, a mere speculative, money-catching thing—still I was advised to try 
them by persons who said they were most righteous Pills. I was, however, 
faithless of their value; but my complaint grew so violent that I purchased two 
boxes, took them according to the directions, and found that they helped me 
much. My neighbors, knowing how long I had been afflicted, were anxious to 
know the result, and I informed them that T had received great benefit from the 
two boxes, which would induce me to purchase more. My wife for a long time 
had been in a poor state of health. She also took some, and found great ben- 
efit. And now, sir, excuse me while I detail some of my complaints, the main 
body of which seem as though the main springs of life were all fettered. 
DYSPEPSIA or INDIGESTION, Weakness of the Lungs, Nervousness, 
Rheumatism, SICK-IIEADACHE, ASTHMA, GREAT LOSS OF APPE- 
TITE, LANGUOR, TREMOR, COSTIVENESS, etc., etc. Such have been 
my varied symptoms, but I must and will say, that I never took such medicine 
as your Pills, which seem to touch all parts of my complaints. I intend to 
persevere with them, and you may send me 500 boxes, which you must charge 
at the wholesale price. 
I am, sir, yours respectfully, 
SAMUEL S. ALBRO. 
Piles Cured. 
Messrs. Coggershall & Walters, of New Bedford, have forwarded me the 
following facts of that most painful and unpleasant disease, the Piles—the 
original letter can be seen at 187 Hudson Street. Mr. McFarlane, of New Bed- 
ford, has been laboring under that most dreadful disease, the Piles. He has had 
them upward of two years—has tried various things from different doctors to no 
effect. Brandreth’s Vegetable Universal Pills were had recourse to, and a 
complete cure is effected—he is now quite well. 
Newburgh, N. Y., Noy. 4, 1835. 
Dr. Brandreth— 
Sir: I was induced some time since, by the persuasion of a friend, to try a 
box of your Pills. From the immediate relief and happy result I have re- 
ceived from the same, I cannot but recommend them to my friends, and par- 
ticularly to all invalids who may be afflicted with costiveness, not to despair 
until they have given your Vegetable Medicine a trial. 
Hoping you may be the means of making us poor creatures happy, and add 
to Your popularity and wealth, I remain your friend, 
J. W. SWIFT. 
You may refer, or make what use you please of this letter.—-J. W. S. 210 
CURES BY PURGATION. 
Extraordinary Cure of Rheumatism, Diarrhoea, and Affection of the Lungs. 
John Shaw, of Pembroket, Washington County, Maine, being duly sworn, 
says that he was taken violently sick about six months since. The pains in his 
head, breast, back, left side, and instep being so bad that he was unable to help 
himself, and was taken into the Chelsea Hospital in the City of Boston. That 
after being in said hospital five weeks, Dr. Otis said he did not know what was 
the matter with him, and that he could do nothing for him, nor could he prescribe 
any medicine. That he, therefore, was conveyed from the Chelsea Hospital to 
the Sailor’s Retreat on Staten Island. That he was there physicked with all 
sorts of medicine for a period of four months, suffering all the time the most 
heart-rending misery. That, besides the affection of his bones, he was troubled 
much with a disease of the lungs. Sometimes he would spit a quart of phlegm in 
the day. Besides this affection he had a bad diarrhoea, which had more or less 
attended him from the commencement of his sickness. That at times he dreaded 
a stool worse than he would have dreaded death. That he can compare the 
feeling to nothing save that of knives passing through his bowels. After suffer- 
ing worse than death at the Sailor’s Retreat on Staten Island, the doctor told 
him that medicine was of no use to him—that he must try to stir about. At 
this time he was suffering the greatest misery. That his bones were so tender 
he could not bear the least pressure upon the elbow or upon the knee ; that his 
instep was most painful; that, as the doctor said he would give him no 
more medicine, he determined to procure some of Dr. Brandreth’s Pills, which 
he did from 241 Broadway, New York. That he commenced with five pills, 
and sometimes increased the dose to eight. The first week’s use so much ben- 
efited him that the doctor, not knowing what he was using, said, “ Now, Shaw, 
you are looking like a man again. If you improve in this way you will soon 
be well.” That he found every dose of the Brandreth Pills relieved him ; first, 
they cured him of the pain when at stool; that they next cured the diarrhoea, 
and finally the pain in his bones. That the medicine seemed to add strength 
to him every day. He told the doctor yestei’day, the 11th inst., that he felt 
himself well, and also that he owed his recovery to Brandreth’s Pills, under 
Providence—that he had taken the medicine every day for nineteen days. 
That the doctor told him if he had known he had been taking that medicine, 
he should not have stayed another day in the house. He considers it his duty 
to make this public statement for the benefit of all similarly afflicted, that they 
may know where to find a medicine that will cure them. 
JOHN SHAW. 
John Shaw, being by me duly sworn this 12th day of April, 1842, did 
depose and say, that the foregoing statement is true. 
JOHN D. WHEELER, 
Commissioner of Deeds. 
Cure of Insanity. 
i Newark, March 8, 1838. 
Respected Sir : I have long felt it resting on my mind as a duty, to com- 
municate by way of letter to you, sir, the great benefit I have received from 
using your invaluable Pills; they have proved a great blessing to my health. 
For the last two years 1 have had my health renewed by taking them after 
other physicians had failed in their efforts to relieve me of a disease that was 
fast tending to dropsy, and bordering on to madness of mind—insomuch I was 
pronounced insane by most all who saw me. As I was incapable of having CURES BY PURGATION. 
211 
any charge of my family for nearly one year, a number of times I made an 
effort to take my life, but was prevented from so doing by that ever-watehful 
Eye that never slumbers nor sleeps. I am a living monument of the free 
mercy of the Lord to all who were witnesses of the disordered state that I was 
in when your medicine was thrown within my reach, and faith was given me to 
believe that it would relieve. 1 commenced taking it every night, and the first 
change 1 perceived about me was on the night after taking three doses. I felt 
a singular sensation in my ear, and on rubbing it, something gave way, that 
proved to be hard congealed wax. I felt such a relief of distress from my 
head, that I knew not what it could mean for some time, for the sound of my 
own voice appeared like another, and all sounds seemed different to my hear- 
ing from what they had for years past; and for two weeks following the quan- 
tity of wax that came from out my ears would to many be pronounced too 
incredible to be relied on, unless they had seen for themselves, and my blood 
began to circulate more freely through my system, by gradually taking the 
pills which before had nearly ceased to move through my veins, and it appeared 
to me that my life was at times departing from the body. I could find nothing 
that animated or cheered my mind; any way life had become a burden to me, 
but as my confidence strengthened in persevering with the pills, I found my life 
daily returning, and invigorating both body and mind, to the unspeakable joy 
of my family and friends; and since they have proved such a blessing to me, I 
have felt it my duty to recommend them to all with whom I have intercourse. 
Standing myself as a witness of their virtue in producing health of body, which, 
beyond a shadow of doubt, will give clearness of mind and ideas, which can- 
not be clear if those organs where knowledge lies are obstructed by disease, 
which thousands of our fellow-creatures are suffering under, and are still made 
worse by the treatment of our most popular physicians of the present day, by 
taking blood, and giving many things that are daily undermining and ruining 
the constitution forever, from having that strength that is natural for us, if we 
pursue the right course to obtain it by simple remedies instead of those of 
another kind, which is so unnatural as bleeding. The argument you lay before 
the public, and the experience I have had for myself on this important subject 
wherein life is at stake, has thoroughly convinced me that bleeding is injurious, 
and can and ought to be dispensed with, as it has been ascertained to a certainty 
that other means have been discovered that have the desired effect in producing 
health without proving so pernicious to the constitution as those mentioned. 
I have been instrumental of convincing many to take them, but the most 
are bound by that strong cord of prejudice which will not so much as admit 
plain facts to be true, but endeavor to paint them in a different color from the 
original ones given; but I am encouraged that the time is nigh at hand, that 
people are awaking from their slumbers, and seeking after truth in all things 
respecting this life, as well as the life to come. It is true that error abounds 
on all sides, but we know that truth is of divine origin, and will prevail in spite 
of all opposition that is thrown in its way by all who love not our Lord Jesus 
in sincerity of heart, and are making every effort to amass wealth by imposing 
on the public in various ways to deceive the unwary ; but let them beware and 
take heed to themselves, that the curse of the Lord is upon their riches if their 
eye is not single to His glory and the good of their fellow-men. It is love that 
has urged me to speak in so plain a manner to one who is an entire stranger to 
me, and I hope it may be received by you, sir, as coming from one whose mind 
has been freed from prejudice, knowing that the motive I have in view is the 
good of my fellow-beings, whose welfare I feel deeply concerned in. Although 
moving in a very humble and obscure sphere of life, to which many are placed, 
may the Lord greatly bless and strengthen your efforts in the cause that you 
are engaged in, is the prayer of my heart. 
You are at liberty to make use of these lines as you think best. 
MARGARET E, A. SHATLAND, 
Dr." Brandreth, New York. 212 
CURES BY PURGATION. 
St. Louis, November 28th, 1837. 
Gentlemen : I deem it a duty which I justly owe, not only to you, but to 
the whole community, to acknowledge the beneficial effects which have resulted 
to myself from the use of that highly serviceable medicine, Dr. Brandreth’s 
Vegetable Universal Pills. 
About eight months since I was suddenly taken with the Dropsy in my feet, 
the surface of which was likewise covered with the Tetter. 
I had repeatedly taken the advice, and followed the prescriptions of several 
eminent physicians of St. Louis, but derived no benefit therefrom. 
I had also tried many experiments, and used every medicine that could be 
suggested, but without any visible abatement of the swelling, and they remained 
in this unnatural situation until my sufferings were alleviated by the aid of Dr. 
Brandreth’s Pills. Shortly after 1 had commenced taking your medicine I dis- 
covered a visible alteration for the better; the swelling gradually subsided, the 
Tetter entirely left, my bodily health daily improved, and my feet once more 
returned to their natural size. 
Two months have elapsed since my cure, and my feelings now warrant me 
in saying that through your instrumentality I have exchanged a painful disor- 
der for a good sound state of health. 
That suffering humanity may read, and benefit from this disclosure, 
I beg to subscribe myself, yours gratefully, 
MARGARET BROWN, 
St. Charles Street, St. Louis. 
To Messrs. Tousey & Michael, St. Louis, Mo. 
Carrolton, Greene County, 111., Oct. 5, 1837. 
Gentlemen : I beg leave to inform you that my sister was taken about three 
weeks since with a violent intermittent fever ; at my request she took two of 
Dr. Brandreth’s Pills, which did not affect her otherwise than by creating a 
faint sickness at the stomach. The next day she increased the dose, which 
operated powerfully. She took the third and fourth doses, after which she had 
no return of the fever, her strength increased rapidly, and her health has been 
good since. 
A sister of my wife had been in a decline for several months with strong 
symptoms of a confirmed consumption. She commenced taking Dr. Brand- 
reth’s Pills, and before she had taken two small boxes in doses of three and 
four per day, a decided change for the better appeared. She still continues 
their use, and the glow of health is fast taking the place of her late consump- 
tive expression of countenance. She will persevere in their use from a positive 
conviction that her health will be perfectly re-established thereby. Other indi- 
vidual cases I could mention. Suffice it to say, that all who have used the Pills 
to my knowledge praise them. 
Very respectfully yours, 
Messrs. Tousey & Co., * Louis. ' ' LUCIUS S- N0RT0N' 
New Orleans, 14th Jail., 1838. 
“He that is wise is wise for himself, and he that scoffeth (at Dr. Brand- 
reth’s Pills) alone must hear it.”—Listen, oh, ye incredulous! hearken unto 
the voice of your friend, and neglect not the counsels of those who have learned 
wisdom from experience. Know, you that are slow of heart to believe, that I 
am a man who has sulfered many afflictions from a hereditary diseased system. CURES BY PURGATION. 
213 
From my youth up I have never known what it was to enjoy a moment of 
health, till lately. My disease has been a chronic headache and a severe de- 
bilitating weakness and faintness at the pit of the stomach, which diseases have 
been in a great measure removed by taking only TWO BOXES of Dr. 
Brandreth’s Pills. I can now say, and with truth too, that I know what health 
is by experience; and I would that I could raise my voice so high that all the 
earth might hear. Then would I proclaim the virtues of this invaluable medi- 
cine. But what is my aim in all this? Is it that I am interested in the sale of 
Dr. B.’s Pills ? Most assuredly, no ; I am in no way connected with their 
rise or downfall; but I recommend them for the benefit of mankind, and 
especially to those who are to receive the most benefit from their use, my fellow- 
citizens of the South. 
S. FRIEND. 
Grand Gulf, March G, 1838. 
Mr. Joseph B. Brockway, 
Dear Sir: We wish you to send us some more of Dr. Brandreth’s Pills, 
for we are entirely out. Since the people have found out we keep them they 
are called for every day. Send them by the first opportunity, and 
Oblige yours, &c., 
WHITEMAN & McFARREN. 
Warrenton, Miss., March 1, 1838. 
Mr. J. B. Brockway, 
Agent for the sale of BrandretKs Pills. 
Dear Sir: Enclosed we hand you ten dollars, the amount of the bill with 
which you furnished us some time since. The pills we find very saleable, and 
the demand for them is very great; in fact, so great is their reputed efficacy 
and virtue here, that we should feel ourselves in some degree guilty of crime, 
if we were to deprive them of so valuable a medicine. We wish you to send 
to us by some safe conveyance—by the captain or clerk of some boat in the 
trade—fifty dozen boxes Brandreth’s Pills, and forward your bill to us on the 
usual terms. 
Very respectfully, your obedient servants, 
JOS. TEMPLETON & CO. 
Port Gibson, Feb. 27, 1838. 
Mr. Joseph B. Brockway, 
Dear Sir; Enclosed you have ten dollars in payment for fifty boxes of 
Brandreth’s Pills, left with me some time since by your agent. 
For some length of time after receiving the agency, there was but little 
demand for the article, as people were afraid of some deception; but since it 
has become known, the demand for it is rapidly increasing. I am now nearly 
destitute of the article, and as I have daily calls for it, wish you would send me 
a supply by Mr. O’Neilly—20 doz. boxes would not be too large a quantity. 
Respectfully yours, 
D. Y. THOMAS. 
Mrs. Elwell’s Case. 
MRS. ELWELL, then of Middlefield, Otsego Co., N. Y., was seriously 
attacked with inflammation of the stomach and bowels. She was given over 
by her physician, and a consultation of doctors was called. The decision was 
that she must die. She, however, partially recovered, but her stomach was in 214 
CURES BY PURGATION. 
a very deranged state. Very little action could be produced on the bowels by 
the most skillful of the profession. She continued for many months under the 
treatment of one doctor after another, gradually growing worse, and so truly 
deplorable was her situation for four months before she tried the Brandreth 
Pills, that nothing passed her bowels except by the aid of the most powerful 
cathartics. Sometimes eighteen of one kind of pills were given to her, then say a 
dozen of another, and a portion of some other medicine, before action could be 
produced, and then so great was her distress that, for the whole of the four 
months above alluded to, she invariably fainted when anything passed her 
bowels. In January, 1837, she thought she would try Brandreth’s Pills, and 
sent to my office in Cooperstown for a box. She took four pills. On going to 
bed, her husband enquired as to the effect of her new medicine. She replied, 
“ that she did not feel any effect at all.” He then said, that in the morning, if 
she took a dozen more, he guessed they would operate like all the rest of her 
medicine. She answered, she did not know but it would, for she did not expect 
anything would cure her. However, early in the morning her bowels were 
moved, and without pain or distress, and consequently without fainting, to the 
utter astonishment of Mr. Elwell, and the great joy of. his wife. In the course 
of a few hours, they operated four times equally easy, and the consequence was 
she did not lie down through the day more than one hour. She had not for 
months been able to sit up one hour in a day. The next evening she took 
another dose of four pills with the same happy effects. On the third evening 
Mr. Elwell called on me and purchased a large supply of the pills, related the 
above facts, and said he never would be without the pills in his house if they 
could be obtained. It is now two years since the above facts occurred, and 
Mr. Elwell informs me that his wife soon recovered her health, that he has 
never had occasion to call in a doctor for her since, and that her health is now 
very good. 
ELISHA FOOTE. 
Cooperstown, Feb. 22, 1839. 
Annual Report of Mr. Sinclair Tousey, General Brandrethian Agent. 
Louisville, October 18, 1837. 
Dr. Brandreth : 
Dear Sir: It is now one year since I opened an office in this city for the ex- 
clusive sale of your Vegetable Universal Pills, the sale of which since that period 
has increased beyond my most sanguine expectations; I have been compelled 
to establish an additional office in the city of St. Louis, Missouri, for the more 
convenient supplying of that section of country. I was induced to become your 
agent here in consequence of being convinced of the unrivalled health-producing 
qualities of your pills. My aunt they effectually cured of what is commonly 
called a Sick Headache, of about thirteen days’ standing, which had cften con- 
fined her to her bed for several weeks at a time. My mother they entirely 
cured of a violent pain in her side, with which she had been afflicted for several 
years ; myself they completely cured of habitual costiveness. These, together 
with numerous other cases that came under my observation while at New York, 
convinced me of their efficacy in every form and symptom of the only one 
disease, for I am a firm believer now in Brandrethianism. The pleasure I feel 
in making them known to my fellow-beings is more than I can well describe. 
I presume, sir, that you are aware that your Pills were not known to any extent 
anywhere to the West of the Alleghany Mountains previous to my introducing 
them in Louisville; taking this into consideration, together with the fact that I CURES BY PURGATION 
215 
am located in a fortress of M. D.’s (there is a medical college here) it makes 
my success and their unprecedented sale appear truly surprising. 
It affords me great pleasure to state that in every town where I have intro- 
duced these valuable pills that they have generally been received favorably, and 
their sale and popularityJiave invariably increased beyond all precedence, until 
scarcely any other medicine is used or thought of. 
The thousands of cures that have been effected by their use, together with 
thousands of testimonials received in their favor, have not only gone beyond 
my expectations, but they have perfectly astonished the bigoted enemies of the 
Brandrethian theory, and has, I am very happy to inform you, caused many, 
very many, who were formerly its bitterest enemies, to become its most zealous 
advocates. More than thirty-seven hundred of the most respectable of our 
citizens have voluntarily come forward and testified to the virtues of your medi- 
cine from their own experience. 
It now becomes my duty (which I think a pleasure), as your general agent for 
this section of country, to transmit you testimonials of a few of the very nu- 
merous cures effected by the use of your pills which have come under my own 
observation, and had I the liberty to use the name of every individual who has 
testified to their extraordinary virtues, it would not only astonish the Regulars, 
but it would cause the foundations of Esculapian practice to quake with fear, 
besides filling at least one large volume. This, however, is not at all necessary, 
as the fame of the medicine is now spreading with such unparalleled rapidity 
that ere long its happy influence will be universally appreciated throughout the 
civilized world, and the only question invalids will ask will be, “Where can I 
get Dr. Brandreth’s Genuine Pills?” 
Case I.—BILIOUS FEVER. 
Louisville, November 16, 1837. 
Mr. S. Tousey—Sir: I feel it a duty which I owe, not only to you but to the 
public generally, to acknowledge the great benefit which I have derived from 
the use of the Pills for which you are agent. I was attacked about six weeks 
since with chills and fever, from which I recovered in about three weeks, when 
I was almost immediately attacked with a bilious fever, from which I had great 
doubts of ever recovering. Fortunately, I was induced by some of my friends 
to give Brandreth’s Pills a trial; and I now find myself, after the free use of 
these Pills for a few days, perfectly restored in health and able to attend to my 
business as usual. After finding the happy effects of these Pills upon myself, 
I was induced to give them to one of my children—a girl eight years old—who 
had been ill for some time, apparently in a decline. It gives me pleasure to 
inform you that she is gradually getting better since we first used the Pills, and 
I hope in another week to apprise you of her complete recovery. 
I am, sir, very respectfully yours, 
FELIX WOOD. 
Case II.—DISEASE OF THE LUNGS. 
Mr. Summers, City Pump Maker, has been afflicted with the above com- 
plaint for seven years; he tried a great many medicines before commencing 
with Brandreth’s Vegetable Universal Pills, but never derived any benefit com- 
pared to what he received from them. He strongly recommended them to all 
as the best family medicine he ever used. Mr. Summers is well known in 
Louisville. 216 
CURES BY PURGATION. 
Case III.—FEVER AND AGUE. 
Mr. LI. Humphrey was violently attacked with the Fever and Ague, and 
after using but four boxes of the Pills he found himself perfectly cured and able 
to attend to his business right off. Such is the extraordinary efficacy of your 
health-restoring medicine, which makes friends of, and Creates health in, all who 
use it. Long life to its maker. N. B.—Mr. H. resides in Third Street. 
Case IV.—ERUPTION OF THE SKIN. 
Mr. James Conklin was afflicted with an eruption of the skin, together with 
severe pains in all parts of his body. He used several highly recommended 
medicines previous to trying our Pills, but all to no purpose; he has used only 
a few boxes of them, and is now entirely free from all eruptions, his skin being 
now perfectly cured, and his body is quite healthy in every respect—no pains, 
appetite good, sleeps well. As many as fifty or sixty cases of eruptions of the 
skin have occurred where your Pills have been used and cures effected in this 
city. 
Case V.—GENERAL DEBILITY. 
Mr. John Downing’s wife has been troubled wnn a general debility for a 
length of time; she has tried a few boxes of Brandreth’s Vegetable Universal 
Pills, and finds them of great benefit. She is encouraged to persevere with 
them, being convinced that they are the best medicine she ever tried—the 
opinion of all. 
Mr. James Allen, residing in Clark Co., Indiana, has been afflicted with 
Dyspepsia for several years ; he has tried but three 25-cent boxes and is much 
better, his appetite being restored, and his chest is free from pain with which 
he was troubled so much. His digestive organs are become healthy—that is all, 
but that is everything. 
Case VI.—DYSPEPSIA. 
Mr. Stockton, the writer of the following letter, 's well known in this quar- 
ter of the country. 
Case VII.—CHILLS AND FEVER 
Mr. S. Tousey : I am compelled by an impulse of gratitude to acknowledge, 
not only to you, but to the public generally, the beneficial effects produced upon 
my son by the free use of Ur. Brandreth’s Vegetable Universal Pills, for which 
you are agent. About six months since, my son, 15 years of age, was very 
suddenly attacked by that vile disease called Chills and Fever. He was occa- 
sionally so violently stricken with it, that I had given him up, and thought all 
medical aid was useless. I was prevailed upon by my friends and acquaint- 
ances to give Brandreth’s Pills a trial, but it was a long time ere I was con- 
vinced of their efficacy ; I almost detested the idea, but my friends perse- 
veringly persuaded until I was compelled to yield, and I am happy to inform 
you that after the free use of these pills only thirteen days, he was thoroughly 
cured and restored to sound health, and I am now nerfectly convinced that they 
are the best medicine extant. 
Very respectfully yours, 
E. F. STOCKTON. 
Louisville, 20th September, 1837. CURES BY PURGATION. 
217 
Case VIII.—SWELLED LIMBS. 
Mr. H h has been afflicted for about 5 years with swelled limbs, accom- 
panied by very violent pains in every part of his body; he was unable to 
attend to any business or obtain any rest by night. These symptoms were pro- 
duced by an excessive use of calomel. He used several bottles of Swain’s 
Panacea and other remedies, but to little or no effect. He commenced with 
your Pills a short time since, and a few days ago he informed me the swellings 
had subsided, and the pain entirely left him. The Pills, to use his own words, 
“ made him feel like a new man.” 
In addition to the above, I would state, I have known a great many other 
cases similar to the above, where Brandreth’s Pills have been used with the 
same happy results, all of which go to prove the extraordinary power of your 
medicine in removing the most inveterate diseases from the system. 
Case IX.—LIVER COMPLAINT. 
Morgan County, Kentucky, Aug. 19, 1837. 
Mr. L. Tousey, 
Sir : It becomes my duty to acknowledge to you, and through you to the 
public, the great benefit my wife has derived from the use of Brandreth’s Vege- 
table Universal Pills. About three years since my wife was brought very low 
with an attack of the Liver Complaint. A physician was employed, and after 
prescribing some time to no effect, he gave us this consoling information, that 
he could do her no good, and he thought nothing else Avould. After continuing 
in this miserable state some months, I was induced, from an advertisement 
which I read in the Louisville Journal, to give her some of Brandreth’s Pills, 
thinking they could do her no harm if they done her no good ; and it gives me 
pleasure to inform you that, contrary to our expectations (for we considered her 
beyond the reach of medicine), she began to recover, and is now quite well. 
Should you consider this of any service to you, you are at liberty to publish 
it. 
Respectfully yours, &c., 
T. SMITH. 
Case X.—INFLAMMATORY RHEUMATISM, LOSS OF APPETITE, &c. 
Mr. James Johnson, residing in Grant County, Indiana, suffered for about 
three years with Inflammatory Rheumatism ; at times his feet were so much 
swollen that he could not get on his shoes ; besides this he was troubled with 
costiveness, being sometimes three or four days without a passage. In addition 
to this he had scarcely any appetite ; he had advice and medicine from several 
physicians, but without any benefit, except for a short time. lie expected he 
never would again be blessed with good health. After reading numerous testi- 
monials in favor of Brandreth’s Pills, and hearing them very highly recom- 
mended by some of his neighbors who had used them, he was persuaded to give 
them a trial, and now, after having used them about five weeks, he finds him- 
self able to put his shoes on and walk about as he used to do. Besides this his 
appetite is perfectly restored, his bowels also being regular and healthy. He 
says that he has an excellent appetite, and thinks Hr. B. should have a monu- 
ment erected to his memory for discovering so good a medicine. 
The following letter, from the Rev. M. W. Sellers, will no doubt be read 
with interest. Mr. Sellers is well known to numbers of our citizens here: 218 
CURES BY PURGATION. 
Case XI. 
Mr. S. Tousey, 
Dear Sir: I send you the following account of my case, and hope it may 
be of service to you in prevailing upon other persons to give Dr. Brandreth’s 
Pills a trial. In the fall of 1833 I was attacked with a severe pain in my 
breast, which continued to increase until a pain in my stomach and side took 
place, which brought me very low. I took different medicines to remove it, 
but to no effect. I then applied to Drs. Luster and Constant, of Louisville. 
They pronounced it a severe case of Dyspepsia and Liver Complaint. I com- 
menced using their medicines, and found great relief in my side and stomach. 
I was in hopes a cure was effected, but the pain in my breast still remained. 
They then tried external applications to great length, with no success; and 
last winter the pain had become more violent. Mr. R. Barnett, of your city, 
informed me of Brandreth’s Pills. I told him I had tried the Hygeian Pills 
without deriving any benefit; he told me BRANDRETH’S PILLS were the 
best. I then applied to you, as you may recollect, for some of these pills. It 
appeared to me at the time that my strength was so fast declining that I could 
not live long without some relief. I commenced using the Pills, and shortly 
afterwards 1 was attacked with the pleurisy; and as bleeding had become such 
a habit I was persuaded to be bled, but mended slowly, and at length I was 
more violently attacked with the same complaint again. It seemed to me that 
I could not live long. However, I took eight of Brandreth’s Pills, and in the 
course of a few hours I felt better. I then took twelve more, and have had no 
pain in my side since. This encouraged me to continue their use for the pain 
in my breast, and I mended very fast. In one month l gained ten pounds in 
weight. I enjoy good health at present, and feel myself perfectly restored. I 
can say that Brandreth’s Pills were the first medicine that appeared to relieve 
the pain in my breast, and in any case of sickness 1 would rather use these val- 
uable pills than any other medicine that 1 know of. By experience of said pills 
in my family, particularly in my own case, I know them to be good. My 
mother who lives with me, nearly seventy years of age, has been afflicted with 
a urinary complaint for about ten years, and by using these Pills during the last 
summer is now entirely well. I have known several cases of fever and ague, 
two or three cases of scarlet fever, and other diseases that the human family is 
daily subject to, cured by the use of these pills; several of my neighbors are 
using them for the breast complaint, and all find relief. I have no doubt but 
a great many other cures would have been effected by perseverance with the 
pills, but there is one great difficulty they labor under—timid purchasers com- 
mence using them and take one or two small doses, just about enough to make 
them feel a little queer, and get frightened and then away to the doctor, who 
takes great care to cry down the pills, knowing it stands them in hand to do so. 
I reside in Lettersburgh, Clark County, Indiana; I have been a resident of 
said county more than twenty years, eleven years of that time I have been a 
minister of the Gospel, of the Baptist denomination. I am aware of the great 
opposition these pills labor under; but let me ask one question, viz.: What 
food is best suited to our nature and health I 1 think the answer is, the vege- 
table. Then do not let us be opposed to the vegetable kingdom for our 
medicine. 
October 22, 1837. 
M. W. SELLERS. 
Annexed I send you extracts from letters received from my agents, which 
make the proof in favor of your Vegetable Universal Pills almost over- 
whelming. CURES BY PURGATION. 
219 
The following extract is from the Postmaster at Henderson, Kentucky, 
dated 
Henderson, October 14, 1837. 
The fame of Brandreth’s Pills is on the inorease here, and I am daily 
receiving assurances of their efficacy in every complaint—fever and ague of a 
most aggravated nature has been in almost every case speedily and effectually 
cured. Yours, &c., &e., 
(Signed,) P. H. H. 
The following is from the Postmaster at Hutsonville, a small village in 
Illinois, dated August 16th, 1837: 
As regards Brandreth’s Pills, I believe they give universal satisfaction; at 
all events, I cannot keep them on hand long—almost every person who has 
bought of them recommend them to their friends and continue themselves to 
use them—the last lot you sent me of fifteen dozen boxes did not last sales of 
two weeks. I have sold upwards of ten dollars’ worth in one day, at retail. 
The above speaks volumes in their praise. Another agent writes : They are 
deservedly becoming so popular that I shall be able to vend a great quantity 
of them. I could furnish you a valuable receipt of their efficacy from expe- 
rience in my own family. Not only this, but the whole neighborhood bear 
testimony of their beneficial effects. 
In conclusion, I send you the annexed letter from H. Foster, Esq., my 
agent at New Albany, five miles below Louisville : 
New Albany, November 23d, 1839. 
Case XII. 
Mr. S. Tousey: Your favor of 20th ult. was duly received as to the success 
of Dr. Brandreth’s Pills; I can state, in general terms, that I have sold about 
160 dozen boxes of these pills, and have made a great deal of inquiry of those 
that have used them, and find they have been very beneficial to this community. 
I can recommend them with the utmost confidence. I can here state that last 
fall, when I became an agent, my wife was in a very low state of health, and had 
a very distressing cough; she was apparently on the eve of going into a con- 
sumption—the use of ten boxes of the pills entirely restored her, and she has 
never failed since that time, whon indisposed, to receive benefit from a single 
dose. I am yours, &c., 
HUGH FOSTER. 
You will perceive by the above, testimonials that your medicine' is justly 
in high repute in this part of the country, as it must be everywhere where it 
is introduced. I could, as I stated above, had I time and space, extend the list 
of testimonials of its efficacy to several hundred pages. 
I would state that I have sold, during the year past, nearly eighty-five 
thousand boxes of your Vegetable Universal Pills, and have not the least doubt 
but I shall be able to dispose of more than double this quantity during the 
coming year, as those that have been sold have established a reputation for 
them that will last as long as the body of man is subject to indisposition. 
My office in Louisville is 99 Fourth Street, near Jefferson ; and in St. Louis 
at 56£ Market Street, near Third. 
Wishing you every success, I remain, sir, 
Respectfully yours, 
S. TOUSEY. 
To Dr. Benjamin Bkandretk, New York, CURES BY PURGATION. 
Pleasantville, Mt. Pleasant, Westchester Co., June 10, 1859. 
Dr. B. Brandretii, 
My Dear Sir: I have long been a friend of yours, because I verily believe 
your valuable pills saved my life. I have recommended them for nearly twenty 
years, and don’t want any others in my store. In 1849 I took a heavy cold, 
and being much exposed for some days afterwards, it settled on my lungs. 
For three months I was terribly troubled with a hacking cough and profuse 
night sweats, and reduced almost to a skeleton. I took various syrups and cor- 
dials, but found no relief. At last a friend, Jesse Baker, of Miles’ Square, 
Westchester Co., said, “ Hammond, why don’t you try Brandreth's Pills, they 
may help you.” I bought a box, and took some. They purged me freely—my 
last dejection being a thick, viscid, yellow matter. I found myself greatly 
relieved at once, and within a week got entirely well. I recommend your pills 
to everybody, and they always do good. I shall always sell them, and I think 
they are the best medicine in the world for coughs, colds, consumption, and all 
kinds of sickness, for I know them by experience, having administered them to 
over one hundred cases of disease, and always cured. 
Yours truly, 
W. IT HAMMOND. 
Jaundice Cured. 
Mr. Benj. J. Stebbins, a highly respectable and well-known farmer of 
Pawlina, Dutchess County, N. Y., writes July 9th, 1859, that he was? pros- 
trated with jaundice every spring and fall for years, in spite of all the efforts of 
physicians; that he was cured by a few doses of Brandreth’s Pills, and “has 
never suffered from the disease since.” 
See page 21 for testimonial from Supervisor Bissell, of Newcomb, as to 
cures of small pox; also, page 46, from sixty soldiers; and page 151 as to 
cures of rheumatism. 
These testimonials are selected running through a period of nearly forty 
years, and to those who would learn have significance. 
B. BRANDRETH. INDEX OF DISEASES. 
PARAGRAPHS. 
Abscesses 28, 30, 140, 67, 97, 329 
Acute Disease 4, 20, 69, 191, 220 
Ague 577, 678 
Amenorrhea 576 
Anemia 658, 668 
Angina Pectoris 522 
Anorexia 344, 702 
Apoplexy 41, 143,144, 181, 256, 278, 332, 
354, 484, 652, 691 
Asthma 209 
Autumnal Disease 17,112, 160, 221 
Blindness 41, 99 
Buboes 90, 109, 240 
Bright’s Disease Preface. 
Cseliac Passion 129. 135 
Cachexia 114, 625 
Cancer 71, 614, 700 
Carbuncles 109 
Cardialgia , 524 
Carus 144 
Catarrh 609 
Cerebral Diseases 514, 619, 702 
Chlorosis 307, 315, 664, 680 
Cholera 162, 484, 568, 596 
Chorea 311, 321, 508, 549, 597 
Chronic Diseases 155, 159, 317, 485, 614 
Colic 65, 82, 138, 255, 418, 526, 428,618, 685 
Concussion of Brain 99 
Constipation 291, 292, 487, 527, 528, 570, 724 
Consumption. 323, 370,382, 626, 627 
Convulsions 41, 428, 706 
Costiveness 246, 305, 307, 524 
Cramps 210, 217 
Croup, .218 
Deafness 27 
Debility 169, 223, 234, 241, 246, 279, 303, 
323, 344, 409, 454, 585, 663 
Delirium 183, 452 
Diabetes 81, 362 
Diarrhea.. .2, 13, 69, 135, 142, 215, 252, 362, 
397, 435, 530, 699 
Dropsy 35, 38, 73, 211, 304, 362, 374, 603, 663 
Dysentery 38,136,198, 214, 221,253, 285, 
352, 453, 641 
Dyspepsia 244, 507, 563, 131, 333, 555, 
568, 731 
Enteritis. 609 
Enterocele. 83 
Epilepsy 150, 231, 306,355, 440, 447,486,488 
Erysipelas 77,474, 492, 667 
Eruptions of the Skin .247, 642 
Eruptive Fevers 274, 543 
Eye Disease ,36,80 
PAPA ftP A PTT3 
Fever.... 30, 81, 37, 45, 51, 67, 87,106, 114, 
152, 153, 159, 182, 190, 191, 194,196, 
202, 203, 204, 208, 212, 245, 280, 282, 
301, 349, 362,363, 368, 369,370,387, 
419,422, 423,424, 452, 455,463, 466, 
493, 518, 637, 538, 546, 647, 558, 565, 
630, 632, 638, 644, 656, 668, 678,703, 
708,718, 734. 
Fits ; 350 
Flatulency 73, 82, 85 138, 151 
Fractures 100, 222, 228 
Foul Gases, 701 
Gangrene 78 
Gastritis 370 
Gastrodynia 417 
Gout,, 40, 84, 85, 86, 158, 377, 378, 379,420, 
436, 439, 495, 522, 671, 692 to 697 
Gravedo 645 
Gravel 524 
Gripings. 21, 24,599 
Headache 181, 605 
Head Disease 132,442 
Heart Disease 464 
Hemiplegia 201, 332 
Hemorrhoides 71, 180 
Hepatic Complaint 216 
Hepatitis 653 
Hernia 230, 326, 343, 582, 651 
Hydrocephalus,, 225, 227, 232, 238, 353, 579 
706 
Hydrophobia. 95, 313 
Hypertrophy 663 
Hypochondria 544 
Hysteria, 310, 649, 618 
Iliac Passion 137 
Indigestion 131, 333, 555, 731 
Infantile Diseases 226, 235, 428 
Inflammation.. .72, 81, 89, 114, 141, 136, 218, 
482, 639,653,655, 660, 715, 746, 751, 
564, 574, 641. 
Influenza 257, 258, 738 
Insensible Perspiration. 102,105, 706 
Insanity 567 
Intestinal Inflammation .482 
Jaundice 254, 535, 536, 568 
King’s Evil , 192 
Leprosy. . . .94 
Lethargy ............ 144 
Lientery .38, 128, 135 
Liver Disease 568,690 
Local Disease. 331,440 INDEX OF DISEASES. 
PARAGRAPHS. 
Lumbago, 472, 645 
Malaria 568 
Malignant Diseases. 383, 384, 385 
Malignant Fever 67, 106, 229, 399, 400 
Mania 41, 148, 448 
Marasmus 305, 315 
Measles 64, 92, 271, 379, 479 
Melancholy 147 
Menorrhagia 362 
Menstruation 33 
Mental Depression 576 
Mercurial Diseases 226, 242, 243 
Mesenteric Affection 141,223 
Miasmata 281, 691 
Milk Fever ,336, 606, 632 
Nausea 138, 240, 344 
Nephritis .! 370 
Nervous Diseases 120, 447, 459, 489 
Neuralgia 460, 490,568 
Neurosis, 448-548 
Obstruction 413 
Ophthalmia 36, 80, 239, 274 
Pains 22, 62, 137, 138,184 
Pains in the Back 138, 141 
Palpitation . .314,464, 573 
Palsy 76, 151, 159, 181, 201, 497 
Paralysis 341 
Paraplegia 201 
Paraphrenitis 146 
Pericarditis 744 
Peripneumonia 
Peritonitis 505 
Phthisis 18 
Phrenitis 146 
Piles 180, 633 
Plethora 15, 50,104 
Pleurodynia 645 
Pleurisy 92, 166, 480, 521 
380, 381, 607, 638, 743, 753 
PARAGRAPHS. 
Prickly Heat 262 
Purpura 433 
Plague 96, 109, 240 
Puerperal Fever 208, 632, 644 
Rheumatism 370, 379,419,467-471, 509, 559- 
562, 568, 609, 636, 645, 674, 715, 716, 721 
Ringworm .91, 517 
Scarlet Fever 164, 277,303,416 
Sciatica 88,472, 645 
Scrofula 498 
Scirrhus 73 
Small Pox 64, 92, 379,431, 643, 748 
Spasmodic Diseases 217,350,366, 618 
Squinancy 92 
Sore Throat 72, 475 
Strangury 89, 285 
Structural Diseases 
Syphilis 638, 639, 668-9 
Sweats, 43, 105, 182, 190, 193, 195, 205, 206, 
207, 398, 723 
Synoeha 218, 237 
Tetanus 76, 312, 340, 365, 367 
Toothache 523 
Torpor of Intestines 134, 345 
Torticollis 
Tumors 34, 67, 70, 634 
Tetters 91, 517 
Typhus,,218,233,297, 358,428 430, 434,454, 
300, 303 483, 520, 539, 540, 583, 
623, 647, 668. 
Ulcers 49, 79, 140, 329,481, 687 
Vertigo .145 
Vitiated Blood 122 
Worms 93, 355, S56, 357, 632, 617 
Yellow Fever, 229, 249, 260, 261, 262, 263. 
264, 370, 385, 402 INDEX OF AUTHORS QUOTED. 
PARAGRAPH. 
Abercrombie 563, 564 
Abernethy 315, 341 
Addison 749 
African Savage 383 
Ainsie 553 
Allen 
Alison 661 
Andral 550, 555, 556, 557, 592 
Annesly 565, 566 
Aretseus 256 
Armstrong 430, 432 
Asclepiades 63 
Auld 245, 246 
Avicenna 65 
Badger 247, 248 
Bancroft 640 
Bardsley 257 
Barlow 410, 421 
Bartlett 688,689 
Bayle 567 
Bache 209 
Beclard 692 
Bell, Benj 228 
Bell, John 228 
Bennet, J. Henry 743-746 
Bennet, J. H’ghs 747-757 
Bennion 282-284 
B. G. B 422,423 
Bichat 592 
Blegborough .342 
Boyle 494 
Bradley 343 
Briggs 365-367 
Brown, John 568 
Bryce 408 
Buchan 417 
Budd 690 
Burserius 434 
Canstadt 657-664 
Carpenter 736 
Caristo 
Carson .226, 227 
Chambers 558 
Chapman, John N 228 
Chapman, N 495-497 
Cheyne 350-353 
Chomel 623 
Clark, Dr 397 
Clark, Thomas 285 
Clark, James 625, 626 
Clark, Joseph 428, 429 
Cleghorn 384 
Clendenning. 706 
Collins 127-151 
Combe 628, 629 
PARAGRAPH. 
Connoly 627 
Conradi 210 
Cooke 569-578 
Copeman 691 
Copland ' 586-621 
Cozzi 685 
Crampton 517 
Crichton 668, 669 
Cullen 202 
Currie 249, 251 
Denman 211 
Dick 724, 725 
Dickson, D. J. H 450, 454 
Dickson, S. H 737-742 
Dropes 455-458 
Forbes 630-640 
Fowle 229 
Frank 538 
Franklin 385 
Friend 423 
Fricke. . » 559 
Galen 79 
Gregory 218 
Gay 354 
Geoghegan 230 
Good 623-544 
Gully , 670 
Halliday 355-358 
Hall 707,708 
Hamilton, James 286, 319 
Hamilton, John 480, 481 
Harrison 709, 710 
Hartz 433,434 
Harvey, William 121-126 
Harvey, Gideon 167-182 
Harvey, James 183-191 
Haspel 734, 735 
Haygarth 540 
Hazard .761-776 
Heherden 252-255 
Heller 740 
Henderson 212-217 
Hillary . 397 
Hippocrates 1-62 
Hosack 618-522 
Houston 686 
Huenefeldt 665 
Huggan 218 
Humboldt 399 
Hunter 325 
Jones 671 
Johnson. Ed 727-732 INDEX OF AUTHORS QUOTED. 
PARAGRAPH. 
Johnson, Jas 482, 493 
Kennedy 652 
Kingslake 258, 259 
Kirkland 396 
Kramer 740 
Laennec 624 
Lane 
Lanza 672-673 
Lawrence 651 
Leeson 711, 712 
Lemazurein 467 
Liebig.. 727 
Lind 403 
Lloyd 498 
Louis, Ch. A 641, 642 
Louis, E. H 643 
Mackin 692-697 
Magendie 713, 714 
Markham. 
Magennis 231 
Marx 622 
Martin 424,426 
Mcllwain 646 
McCullock 568 
McKenzie 581 
McLeod - 674 
Mead 543 
Meterius 87 
E. Miller 219, 220 
Mitchell * 390 
Moore, I 237 
McMullen 320-324 
Medicus, Pathology 435-446 
Medicus 277 
Miller 205-207 
Monat and Henderson 579, 580 
Moore, G 644 
Morgan, Chas 344-348 
Morgan, G. F 653-656 
Mosely 396 
Manneley 666, 667 
Nickoll 499 
Nooth 221 
O’Berne 260-279 
Gisterlein 740 
Parey 66-100 
Paris 545-552 
Parise 645 
Patterson 278 
Pearson. 279-281 
Pennington 391 
Philip 
PARAGRAPH. 
Pickford 758-760 
Pidduck 687 
Pott 228 
Potter 271-273 
Power 274, 276 
Pring 605—616 
Pringle 193-201 
Pricards 238 
Pritchard 447-449 
Redman 396 
Reeve 232 
Rhazes 64 
Richter 675-679 
Robertson 203, 204 
Rush 368-409 
Sanctorius 101-120 
Sara .698, 699 
Savaresi 239 
Say 396 
Schultz 680, 681 
Scudamore 559-562 
Selle 208 
Shaw 500, 504 
Sherwood 726 
Skimshire 222 
Stephens 582 
Stoker 583, 585 
Strack 434 
Sutton 223, 224 
Sydenham 152-166 
Taylor 700 
Tuomey 424-426 
Tainsh . 240 
Tyro 256 
Unwins 323, 324 
Yage 241, 244 
V andeswieter 256 
Yelpeau 592 
Vogel 701 
Waddley 276 
Waddy 702, 705 
Walsh 349 
Watt 359-364 
Wegg 733 
White 225 
Whydt 598- 
Willan , .192 
Williams, C. J. B 682-684 
Williams, Robert 647-650 
Wilson, Andrew 459-479 
Wilson, J. A 715-723 
Woodward 235, 236