Sodium sulphate, 75 to 150 grains in a half-glass of water during the meal, recommended. Pills of aloes or of aloes and cinchona are useful. Massage, Nvhich has. for its purpose the emptying of the large intestine, merits further use. Of the mineral waters, Chatel-Guyon, Brides, and Aulus (source Darmagnac) are pre ferred. A. Robin (Bull. G6n. de Th Hie liv., p. 593, '98).
In functional constipation the new lax ative salt of lithia, thialon, has given success. A teaspoonful should be dis solved in a cup of hot water taken in the morning on rising, while, at the same time, excess in nitrogenous foods is to be avoided. The remedy should be gradu ally discontinued as the stools become regular. A. J. Jenkins (Interstate Med. Jour., Oct., '99).
To aid in restoring intestinal peri stalsis a pill or capsule may be given each night containing 1/3 grain of extract of nux vomica, and 1 grain, each, of extracts of cascara sagrada and of hyoscyamus. If no evacuation talces place the follow ing morning an enema of warm water may be used soon after breakfast.
Forty-six grains of powdered boric acid to be applied directly to the rectal mu cosa. In cases where the mucosa cannot be reached, insufflation of the same quan tity of powder should be employed. In from one-half to three 'hours after the application peristalsis occurs, attended with copious ftecal evacuations. Flatau (Deutsche med. Woch., p. 970, '90).
Caffeine - chloral administered hypo dermically is of value; injections of 4 or 5 grains dissolved in water recom mended. Ewald (N. Y. Med. Jour., July 22, '93).
A tablet composed of nux vomica ex tract, podophyllin resin, belladonna ex tract, and aloin, 1/,o grain of each, is excellent for the average cases of long standing constipation. The tablets should be taken before or after each meal, and, if the effect is too strong, half a tablet. more Or less, may be given, never skipping a dose at the regular time. C. E. Boynton (Med. World, Oct., '97).
Beech creasote is one of the best reme dies for habitual constipation. Since em ploying this drug, a single case has not been found where it was not effective or where it was ill borne. It should bc administered pure, twice daily after meals, in doses of 1 to 8 drops, beginning Nvith the smaller and increasing until the desired effect is secured; the vehicle is always water, wine and water, or milk. The result is probably due to neutraliz ing some intestinal toxin which paralyzes the action of the digestive canal. De
Holstein (La Semaine MM.; Lancet, Lond., Oct. 9, '97).
A common source of error is, in many cases, the belief that accumulation of ffecal matter in the large intestine is due to imperfect peristalsis of the bowel, and treatment is directed to it specially, whereas the real need is a modification of the contents of the small intestine. Pfaff (Boston Med. and Surg. Jour., Sept. 9, '97).
Constipation often depends upon the loss of power in the intestinal muscles and lack of secretion of mucus; therefore treatment should consist of massage, proper regulation of the diet, and in the administration of ipecac. TWO and one half drachms of the aqueous extract of ipecac is to be dissolved in 2 ounces of distilled water. One teaspoonful of this is placed in 4 ounces of water and given by rectal injection each morning. Blon del (Jour. de Alkl. de Paris, Feb. 11, 1900).
In some eases of special atony of the sigmoid flexure of the colon and rectum aloin or extract of colocynth may be used with advantage instead of the cascara sagrada in the pill. Treated in accord ance with the foregoing suggestions, a large majority of the cases of ordinary constipation can be relieved just as long as the patients will faithfully continue correct habits of life.
In the form of chronic constipation due to a spasmodic contraction of the colon treatment should consist in hydro therapy, diet, and sedatives. Hot com presses applied to the abdomen and changed every hour or two are the most important remedial agents. For the first few days the compresses should be used also at night. At the same time the pa tient should receive warm sitz- or general baths. Hot douches (2S° to 30° C.) di rected first against the abdomen, along the course of the colon, then the lower and upper extremities, for two minutes, are also useful. Large injections of warm water (37° C.) at a low pressure will be found beneficial. Chamomile or, in cases of ulcerative colitis, 1 pint of olive-oil may be advantageously added to the in jections. The latter should be used at first every night, then every second or fourth day. The diet should be free from any irritating substances. If con siderable intestinal fermentation is pres ent, meat should be restricted and a more liberal vegetable diet allowed. All laxa tives, especially drastic cathartics, are harmful. Romme (La Presse Med., No. IS, 1900).