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Certain Purgatives, as I have just stated, exert their influence upon the neighbouring organs, and are calculated not only to remove alvine sordes, but to detach and eliminate foul congestions from the biliary ducts and pores.

With such facts before us, it is impossible to concede to the opinion of Dr. Hamilton,^[155] that the different species of purgative medicines do not possess distinct powers over the different species of matter to be evacuated; on the contrary, there is reason for reviving the ancient theory, too inconsiderately abandoned, and which acknowledged these different distinctions in the operations of cathartic medicines, under the appropriate names of Hydragogues, Cholagogues, &c.

The importance of cathartic medicines having been shewn, and the distinctions in their modes of operation established, it only remains to say a few words upon the subject of their abuse. All the remedies of this class, but more especially those of considerable power, require caution in their administration, even in those diseases where they are indicated by peculiar symptoms, especially if there be any tendency to inflammation, or to extreme debility, although this latter symptom is often rather apparent than real, and is at once removed by the brisk operation upon the bowels; during pregnancy and immediately after delivery, and during the flow of the menses, the prudent practitioner will use a discretionary caution in their exhibition. The too frequent use of these medicines will induce marasmus, and render the bowels so morbidly irritable, that purging is easily excited by the ordinary stimulus of our aliments; while in some habits the contrary obtains, and the resource to which the valetudinarian flies for relief only increases the torpor of the intestines, and confirms his costiveness.