The colic should be distinguished from a fit of the gravel; stones passing through the ureters; rheumatic pains in the muscles of the belly; a beginning dysentery; the blind piles; from a stone passing through the gall-duct; and from the more transitory flatulent pains, styled flatulent colic. Gravel in the kidney produces often colic pains, not easily distinguishable; but,when stones pass through the ureters, the testicle on that side is often retracted, the leg is benumbed, a pain shoots down the inside of the thigh; symptoms occasioned by the stone passing through the ureter over the spermatic chord, or the sacro sciatic nerve. Rheumatic pains in the muscles of the belly rarely affect so accurately the umbilical region, but dart, in various directions, to the chest or to the pelvis, and are attended with soreness, not con-fined to the abdomen. A beginning dysentery differs little from colic,and the remedies are the same. The pain from the blind piles is confined to the rectum; and that from a stone in the gall duct is felt in the pit of the stomach, occasionally shooting through the body to the back.

Of the remarkable symptoms that sometimes come on in consequence of this disorder, a palsy is the chief. Dr. Thierry says, that it is the natural crisis of a colic; but, in general, it accompanies the colic from lead, though it sometimes follows colic where this cause is not suspected. It sometimes comes on during the fit, but more generally follows.

When the colic attacks with a shivering, and the pain is very violent, great danger attends it, for an inflammation usually follows. A sweat, a salivation, an haemorrhage at the nose, or from the haemorrhoidal veins, spontaneously occurring, is said sometimes to terminate the colic: though, if after the strength is exhausted a colliquative sweat come on, the danger is considerable. If the violence of the pain continues to increase, and the pains suddenly cease, fatal consequences are to be expected.

As preventatives of this complaint, those who are at times afflicted with pains in the belly, should be careful to keep from all violent agitations of the mind; shun exposures to the northern winds; keep the feet dry and warm; abstain from flatulent food and spirituous liquors; and attend carefully to the bowels, to prevent constipation. Those whose occupation subjects them to the fumes of lead, or to the influence of any of its preparations, should breakfast on fat broth, or eat bread that is spread with sweet lard, before they begin their work; and frequently interpose oily purgatives.

As a spasm is the immediate cause, its resolution is the chief indication of cure; for this purpose, relaxing and antispasmodic medicines, with purges, which, while they solicit the internal discharge, will not greatly increase the morbid irritation, are the more proper means.

If the pains are violent, and the pulse full, some blood may be taken, in proportion to the strength: vomits must be carefully avoided; for, if any irritability of the stomach, afterwards so troublesome, be induced, it will not be easily quieted.

Opium should be next given; and the dose, which may be more or less, according to the violence of the pain, must be repeated every two or three hours, until ease is obtained.

As soon as, by a due use of opium, the sickness and pain abate, 3 ii. of the sal catharticum amarum may be taken in warm water: if repeated every two hours, it will operate sometimes with sufficient efficacy; though the ol. ricini should be preferred, if the stomach will bear it, because its repetition need not be so frequent. The ol. ricini may be given to Colica 2300 ss. with any warm agreeable mixture. If the ol. ricini is not to be procured, any other purgative, not painful in its operation, may be used. When a free passage is obtained downwards, laxatives must still be continued, until all danger of a relapse is removed.

It often happens, however, that these and every purgative are rejected; and, in the continuance of the disorder, the obstruction is too firmly fixed to be removed by such gentle medicines. We must then apply to more active ones; and the infusion of sena Colica 2301 iv. with manna, sal rupellens, tinct. senae and jalap, aa. ss. will form a mixture, of which two or three spoonfuls may be given every two hours. Should this fail, two scruples of the colocynlh pill, with 15 grains of calomel,may be formed into ten pills, two of which may be given every two hours till stools arc procured. At the same time, the bowels must be solicited downwards by clysters. A convenient one is half an ounce of common soap, or as much black soft soap, dissolved in three quarters of a pint of water, to which an equal quantity of milk should be added. If this fails, three drachms of colocynth, boiled in a pint and half of water, adding two ounces of oil, and as much common salt, given as a clyster, will seldom fail.

If doses of a grain or two of opium, repeated every six hours, fail to relieve, from 100 to 120 drops of the tinct. opii may be mixed with four ounces of warm olive oil, injected as a clyster; and repeated as often as the pain returns.

In case of a relapse, after the relief from purges, the medicines should be repeated; but the previous use of opium is unnecessary.

Fomentations and warm baths may prove auxiliaries, but no great dependence is to be placed on them. It is true, that while the patient sits in the warm bath the pain abates; but when he is taken out it returns. In this disorder, the pain must be allayed during some hours before the intestines will be disposed to perform their office; and few, if any patients can continue in the bath so long as ease is required. In general, as we have before mentioned, we think, we have found gangrene a more frequent consequence when the warm bath has been freely and frequently employed, than when it has been omitted.