They are particularly recommended by Dr. Hasty, of Dublin.
3036. In Colica Pictonum, the utility of purgatives is undoubted; but some care is necessary in the selection of the medicine to be employed. The Sulphate of Magnesia, Croton Oil, Oil of Turpentine, and Castor Oil, are those which appear the most appropriate; and in many cases, their action is rendered more certain and efficacious by being combined with Opium and antispasmodics. They are only to be regarded as adjuncts - valuable ones, it must be admitted - to other treatment. In Ileus, purgatives have been advised; but, unless they afford speedy relief, they should not be persisted in; Opium, in such cases, should be substituted. (See Opium, sect. Colic.) In some Spasmodic Affections of the Bowels, Flatulent Colic, &c., a purgative of Castor Oil or Oil of Turpentine, or of both these oils, often affords immediate relief.
3037. In Dysentery, mild cathartics, if given judiciously, are most beneficial; but if ill chosen, or given in inappropriate cases, they are productive of the worst effects, increasing, in a marked degree, the severity of the symptoms. The oleaginous purgatives, particularly Castor Oil, are very valuable, but are inferior to the Bitartrate of Potash, which, either alone or with Jalap, in the form of Pulv. JalapAe Co., or with Sulphur, is the best purgative which can be resorted to.
3038. In Congestion of the Liver, active cholagogue purgatives must be had recourse to, and repeated frequently, so as to keep up a free flow of bile. In Jaundice, depending upon hepatic derangement, Dr. Gravest observes, that after you have succeeded in producing bilious evacuations, you should never omit prescribing an active aperient every second or third day, for the space of ten days or a fortnight, with the view of carrying off the remains of the disease, so as to prevent the occurrence of a relapse. He adds, that this is a simple but successful practice, and one which should never be omitted.
* Lond. Med. Gaz., 1825. Lib. of Med., vol. v. p. 305.
Clin. Lect., vol. ii. p. 524.
3039. In Diabetes, when the patient is not much weakened and the disease is recent, aperients may be given with advantage. Free alvine evacuations appear to reduce considerably the amount of fluid discharged, and also to correct in a measure its mellitic character. Rhubarb or Magnesia, or both these medicines combined, may be used with advantage.
The neutral salts, particularly the Sulphates of Magnesia or Potash, are the best which can be employed. They should be combined with other remedies, as the strength of the patient and the character of the disease require. The combination of the Sulphate of Magnesia with the Sulphate of Quinine often proves useful. In Gangrene, previous to the exhibition of tonics, purgatives should be administered; they should be of a warm, carminative character, and conjoined with remedies of the latter class.
3041. Hypochondriasis, particularly when connected with derangement of the digestive organs, is often benefited by the judicious use of mild aperients. If the liver or biliary secretion be deranged, mild mercurials with carminatives should be given; if acidity of the primAe viAe be present, the alkalies, particularly Magnesia; and if the stomach be weakened by disease, &c, Rhubarb or Castor Oil, with stomachics, should be employed.
3042. In Croup, purgatives (Calomel, Scammony, or Jalap) prove highly serviceable, not only as a means of removing any crude, ill-digested matter, worms, &c, from the bowels, but as derivatives from the seat of disease. They need not interfere with the other necessary remedial measures.