From the partial packing with towels she got on to the general packing in the sheet; and from the dripping sheet to the shallow bath, at first at sixty-five degrees, and for half a minute; and subsequently at fifty degrees, and for three to four minutes. The assiduous employment of these means began to tell upon the patient, after the lapse of five weeks, by inducing relaxation of the bowels. The character of the fæces was still the same as before-that is, unhealthy; but their copiousness gave undoubted evidence that the treatment had roused the nervous system to effort, and that this effort was being thrown upon the lower bowel, whence the hope was, that a transference might be made to the uterus. This did not happen; the relaxation went on to profuse diarrhoea, especially in the night, and the fœces became more and more natural in appearance.

Meantime, the patient had gained appetite, and even ate voraciously. She also slept all night; and her walking power was on the increase. I stopped the packing and the fomentations, in consequence of the great increase of the diarrhea; and ordered short cold sitz baths four and five times a day to restrain it. Nevertheless, it went on; and, spite of the recruiting by the appetite and the sleep, caused immense prostration of strength and farther emaciation of flesh.

I here judged it best to desist from all treatment, except a short ablution in chilled water in the morning. She was kept on the sofa; and her food was restricted to the farinacea. There was no sweating, however, in all this weakness; and there was infinitely more calmness of body and cheerfulness of mind. So that, although the weakness was very greatalmost alarmingly so-yet I never had any real dread of the result.

The patient had now been under my care, nearly three months; and, apparently, as far from restoration of the menses as ever. But I am convinced that, even at this period of the treatment, a process was going on upon which the hope of a cure was to be erected. This diarrhoea was, in

point of fact, the crisis of a highly-diseased condition of the digestive organs, the latter throwing off, by the bowels, an immense amount of irritation, which had long interfered with the formation of a due quantity of blood of a due quality. The want of this blood had been the immediate cause of the menstrual suppression; for nature cares for that secretion only when there is more than sufficient for the organs which minister to the preservation of the individual.

In spite, therefore, of the weakness, and the continuance of its cause, the diarrhoea, I had a belief that all was tending to the release and more healthful re-establishment of the digestive organs; that, as a consequence of this, more and better blood would be formed; and that, supplied with that, the organism would send it towards the uterine organs in due time. Regarding the purging, therefore, as a critical action, I only recommended the cessation of all treatment for a while. She had nothing but a short morning ablution, and was enjoined perfect rest.

At the end of five weeks, the bowels had quieted down to two actions in the day. The result upon the countenance was striking, all yellowness, puffiness, and prominence of the eyes having subsided, and the waxiness of the flesh, of the lips and cheeks, having given way to a wholesome clearness. All the mucous secretions, too, were in good order; the sleep was good; the thirst (which, previous to and during the diarrhoea, had been great) was nearly gone; and the whole symptoms were those of a digestive canal re-assuming its natural function.

Having this to rely upon, it was only necessary in the treatment to keep the mucous surfaces from becoming again the seat of irritation and congestion, and to draw the blood, which we might reasonably expect would now be formed by the digestive, towards the uterine organs. In accordance with these aims, I recommenced the treatment by sitz baths of fifteen or twenty minutes' duration-once at first, and then twice in the day. Foot baths were also employed; the free use of animal food was renewed; and abundance of air, without exertion, enjoined. As these were all tonic and deriva

tive measures, which might, in so delicate a person, renew excitement and consequent internal congestion, I caused the wet sheet packing to be used occasionally once, twice, or three times in a week-as the pulse and state of the skin indicated. Every now and then, too, a pause in the treatment was made for two or three days, so as to avoid all chance of meddling with the healthy process nature was engaged in. She drank only four or five tumblers of water in the day.

Under this regime the general health of this patient speedily returned. An excellent appetite, and complete and painless digestion, were the means of rapid restoration of walking power, the exercise of which tended to obviate all internal congestion; while it came in aid of the sitz baths in producing uterine activity. Firm flesh soon re-appeared on her frame, and no part of her had the least puffiness. Such a combination of favourable circumstances was certain to lead to the recurrence of the menstrual discharge; and this accordingly made its appearance in the latter end of March, 1847, five months after the patient had come under the water treatment. At first it was scanty and watery; but it continued for four days. It came again after an interval of four weeks, and was more highly coloured: showing the gradually improving character of the digestion and blood-making. After this double proof of the restoration of so important an excretion, the patient had permission to return home. Her abode being in a flat country, her frame at first experienced the want of the bracing Malvern air, and the menses were retarded until nearly the sixth week. This might have been in part owing to negli gence of sitz baths, or the want of a little packing; for application to these immediately produced the desired effect; and the uterine evacuation has since then been perfectly regular.

This is one of the numerous instances of arrested menstruation in which the digestive organs are altogether to blame. The drugs which the patient had taken for the throat, and especially the iodine, had totally deteriorated the digestive and blood-making processes; so much so as to prevent the forma

tion of sufficient blood for the uterine excretion as well as for the supply of the organs pertaining to the preservation of the individual. Besides this, the irritation set up in the digestive organs by the drugs, did in itself counteract the free function of the uterus; just as the same irritation prevents the proper secretion of faces in the lower bowel. Want of blood and want of proper direction to be given to it were the two immediate causes of this amenorrhoea.

To apply tonics to the stomach would have been to augment the irritation there, upon which the morbid uterine condition. was based. The administration of aloes and other purgatives might have, for a brief period, transferred the irritation of the upper digestive to the lower digestive organs, and in the tumult thus excited in the pelvic viscera, have induced a shortlived menstrual appearance. But how long could such a state of forced and unnatural tumult last without materially injuring the organisation generally? Or how long would the frame, which had already too little blood, bear this forced drain from it? Or, finally, when the time came, as come it must, when the purgative could no longer be continued with safety to the nervous system and the strength of even the strongest woman, what becomes of the irritation thus artificially maintained in the lower bowel? It is thrown back upon the old peccant point, the stomach, and things are worse than ever. The stomach has been worried by the physic, and has not made blood out of its food; the uterus has drained the frame of the blood it could ill spare; the nervous system has been kept in a state of agitation by the constant forcing of the drugs; and thus a complicated state of neuropathy is set up, and sometimes never abolished.

Contrast with this the plan upon which the water treatment proceeds to deal with such a case. With internal circulatory irritation and external circulatory languor to overcome, it endeavours to balance the circulation, by giving tone to the skin by soothing its nerves, which are weak and excitable, in consequence of their want of nutrition; and by thus releasing the digestive organs, from, the evils attendant on a want of equilibrium in the vital activity. These the wet

4

sheet packing, the fomentations, and the dripping sheet, effected. The digestive organs, having a diversion made in their favour by the skin, were enabled to throw the greater part of their irritation upon the lower bowel, whither it was solicited by the sitz baths. The diarrhoea commenced; but what was the state of the stomach? Jaded, worried, loathing, as when drugs are applied to it? No; but hungering for food, and, digesting it rapidly. The transfer to the lower bowel was a natural one; and natural appetite came to the organ that had been relieved. But the stomach disorder must have been excessive which required so excessive a diarrhoea to remove it; and as nature was sufficiently intent upon its removal by that process, it was no longer necessary to aid her by the water treatment, which was, therefore, discontinued. The diarrhoea at length abated; but the appetite and digestive activity continued.

She was now making blood-at first, enough for the full nutrition of the organs of self-preservation, for she grew plump and hard in flesh; and, subsequently, enough also for the organs which minister to the preservation of the species, for the menstrual flux returned.

THE PRESENT FEVER.

"Water, when its properties and modes of application are well known, will be worth all other remedies put together."-DR. MACARTNEY, formerly Professor of Medicine, S.C.D.

Ts is the time for the public to call upon the members of the medical profession to put the water cure to the test in acute diseases; for have we not, in every city, and in every populous district in England and Ireland, a fever raging which is slaying our brother men by the hundred? They have no excuse. If they have one, what is it? The profession confesses itself paralysed for any good it can do in the present, and they have done the same in all former epidemics. If not in just so many words, they have done so at least most emphatically by published statistics, and by the