WE have placed the diseases of the secretory organs in a separate class, under the title of Parcccriscs, and have divided them into the two orders of Apocenoscs and Epischeses, according as they produce an excess or a defect in the quantity of the secreted fluid. In the first order we have the following genera, depending upon the organs which they immediately affect, Diarrhce.i, Cho lera, Hyperuresis, Blennorrhcea vesicx, Lithiasis, Mc norrhagia, Leucorrlicea, Ptyalismus, Ephidrosis. These diseases may be considered as, in a great measure, local in their origin, and during their progress are not essen tially productive of any constitutional disturbance ; they are not necessarily attended with fever, they have no ef fect upon the nervous system, except upon those parts of it. with which they are in immediate contact, and they may frequently be removed by remedies that seem to act locally, or without the intervention of any organ be sides that to which they are directly applied.
The first genus of this order is Diarrhoea, a very com mon disease, which consists in an increased discharge from the alimentary canal, the evacuations being hut little affected, except in their assuming a more liquid consistence ; they are generally preceded or accompa nied by flatulence and a griping pain in the bowels, and frequently by sickness ; but this should perhaps rather be attributed to the same cause which produces the Diarrhoea, than be considered as a part of the disease itself. The symptoms of this complaint are so obvious as seldom to leave any doubt respecting its existence ; but there are two diseases that resemble it, and from which it is important to distinguish it, Dysentery and Cholera. For the most part an attention to the nature of the evacuations is sufficient to point out the distinc tion, or if, as occasionally happens, the diseases appear to nil into each other, our remedies must be adminis tered accordingly, always adapting them rather to the symptoms than to a technical nomenclature. The ex citing causes of Diarrhea are various ; perhaps the most frequent is repletion of the stomach, or the reception in to it of some kind of indigestible food ; cold applied to the surface of the body', and especially to the legs and feet, is also an exciting cause of Diarrlicea ; and it is oc casionally produced by impressions upon the nervous system, or even by mere mental emotions. In children, the peculiar irritation produced by teething seems to be a frequent exciting cause of Diarrhcea, as well as that which arises from the presence of worms in the alimen tary canal. Although the evacuations in Diarrhoea es sentially consist of fxculent matter, they vary consider ably in their appearance ; and from observing these va riations, we have it in our power, in some cases, to judge of the state of the parts which immediately give rise to it. Diarrhoea is alien symptomatic of some other disease, many instances of which have been stated above ; of these, one of the most violent is the coltiquative dis charge from the bowels which occurs in the latter stages of hectic fever. It is also a frequent attendant or sequel of the affections of the liver that come on after a resi dence in hot climates, and is then found to be one of the most unmanageable symptoms of these diseases.
In its simple form Diarrhoea is not difficult of cure, and, perhaps, in a great majority of cases, would be re lieved by the mere efforts of nature, as it is a com plaint for which a direct remedy is provided in the constitution of the living body, so as to afford one of the strongest arguments in favour of the doctrine, which was once so generally adopted, that all diseases are salutary efforts of the system, expressly intended to ward off some greater danger, which they effect with out the intervention of art. In most cases, however,
the aid of medicine may be advantageously had re course to, either to mitigate the violence of the disease, or to prevent it from degenerating into some affection of a more injurious tendency. The obvious indications are, first to remove the exciting cause, if it still remains' applied ; and, 2dly, to obviate that state of the system which is induced by the immediate action of the com plaint.
The proximate cause of Diarrhoea appears to be an increase of the peristaltic motion of the intestines, which. may depend either upon a stimulating substance applied to them, or upon an increased sensibility in the part, rendering it more easily affected by the ordinary stimuli. When the disease depends upon the first of these causes, there can be no doubt of the method to be followed in the cure ; and as cases of this descrip tion constitute a great majority of those that fall under our observation, we shall generally find it necessary to direct our chief attention to this object. For this pur pose we shall find the most effectual remedies to be mild purgatives, given in small doses, and frequently repeated, by which the offending matter is discharged more effectually, and with less pain and distress to the system, than if left to act upon the part without assist ance. Along with the purgatives large quantities of mild diluents will be found serviceable ; and the food should be of the least stimulating kind, and be com posed as much as possible of liquids. The choice of the purgative will depend upon the state of the sto mach, and various other circumstances; neutral salts, castor oil, rhubarb, and magnesia, are perhaps among those that are the most generally applicable; the last will be especially proper when we have reason to sus pect an acid state of the alimentary canal. After the due exhibition of purgatives, we shall generally find the complaint to subside without the use of any other re medies ; and, by a proper regulation of the diet, the parts resume their healthy action. Occasionally, how ever, the Diarrhoea continues after all the offending mat ter seems to be removed, and the digestive process re mains much impaired, while the patient is, at the same time, harassed with griping pains and flatulence. Un der these circumstances, we have recourse to astrin gents and tonics, together with the occasional use of sudorifics and opiates. The employment of astringents in Diarrhoea we do not, however, conceive to be very frequently necessary ; and it is found, both with re spect to the class of remedies and to opium, that if they do not check the complaint by the exhibition of a few doses, no considerable benefit is to be expected from them. The valuable compound of opium and ipe cacuanha, which we have so frequently referred to un der the title of Dover's powder, is a very useful reme dy in long protracted Diarrhoea, especially when in con junction or alternating with purgatives. Considerable advantage has been gained by the use of warm cloth ing, and particularly of flannel worn next to the skin, in those who are subject to frequent attacks of Diarrhoea ; and sometimes it has appeared that the warm bath, or even the removal to a milder climate, has been of per manent utility.