to give a degree of acrimony to the secretions, sufficient to I excite inflammatory action in the colonic glands, and thus ' ) s produce dysentery and hepatitis. As in the greater number of cases of hepatic abscess, in tropical climates, consequent of dysentery, it is not easy to explain satisfactorily why the hepatic affection rarely occurs until the dysentery has ceased; or, at least, until it is temporarily suspended. Dr. Parkes has hazarded an hypothesis, " that it is owing to the alliance,

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... in point of excretion or secretion, between the large intestines and the liver; the nonaction of the former organ, by chemically altering the blood, might give rise to that condition of the liver which ultimately, if unchecked, produces abscess."* A clinical lecture does not admit of the examination of hypotheses, but I merely mention it as an ingenious idea; and there can be no doubt, that the sympathy between the colon and the liver is so great that morbid states of the one produce morbid states of the otherthey both sympathize in a remarkable degree. 'reatm.—With regard to the treatment in this case, as the prognosis, from the moment of the admission of the patient into the hospital, was unfavourable, indeed, of the worst description, little advantage could be anticipated from any plan. i , The object was rather to soothe and abate the sufferings of the poor man than to cure. In the early stages of such cases, the object is, to allay inflammatory action, to improve the intestinal and biliary secretions, to abate the tenesmus, and to moderate the purging, whilst, at the same time, the powers of the habit are sustained. As soon as the dysenteric symptoms appear, the first indication to be fulfilled is to subdue the inflammation. If this be accompanied with fever, the bloodletting should be general, and followed by leeches, and the topical bleeding may require to be repeated, should the purging, griping, and tenesmus continue. Purgatives are too often resorted to, and these symptoms, especially the tenesmus, are better managed by demulcent enemas, containing large doses, say from eight to twelve grains or a scruple of ipecaouanha, combined with extract of gentian, which prevents the ipecacuanha from nauseating, and in this combination exerts a powerful sedative influence. This manner of exhibiting ipecacuanha, either by the mouth or per anum, in dysentery, was, I believe, first employed by Mr. Twining, a practitioner in India, and recommended by him in the Calcutta Tra2zsactions. It does not operate by diaphoresis; and, indeed, I have little confidence in diaphoretics, even in acute dysentery, unless in combination with mercurials, upon the influence of which the profession justly places much reliance. As subsidiary to local and general bloodletting, mercury has a powerful influence in changing morbid into healthy action. When the dysenteric symptoms subside, and the hepatitis is formed, mercurials are invariably prescribed, in larger or smaller doses, according to the climate in which the disease occurs, and the particular views of the practitioner. In my own practice I have never carried the administration of mercurials to ptyalism, but have ordered them merely in alterative doses. Mercury was ordered in this case. TO THE WESTMINSTER GENERAL DISPENSARY. Mucir attention has of late years been devoted to the subject of oxalate of lime deposit in the urine, and practitioners have been led to regard its occurrence as generally connected with severe dyspepsia, or hypochondriac melancholy. Various hypotheses have in consequence been framed to explain the origin of oxalic acid in the animal economy, some writers considering it as a derivative from the urea, others as emanating from the uric acid. According to Dr. Prout, " the presence of oxalic acid in the system, as far as the primary assimilating processes are concerned, arises from one of two causes, which, for want of a better name, we term proznzate causes-viz., the nonassimilation of oxalic acid taken as food, and the mal-assimilation of saccharine aliments, and in some extreme cases, pert-aps, of) albuminous and oleaginous aliments."t The tl>rmer condition applies to individuals in whom the converting function of the stomach is deficient in power; the latter, * Remarks on the Dysentery and Hepatitis of India, p.114. & d a g g e r ; On the Nature and Treatment of Stomach and Urinary Diseases, p.71. to those in whom there is positive derangement of that function. Dr. Prout observes, further, that diet has great influence in exciting the oxalic diathesis. Now, while I agree with this eminent physician as to the fact of the non-assimila,tion of oxalic acid under particular circumstances, I believe that numerous examples are to be met with, where oxalate of lime is excreted simply in virtue of a morbid transformation implicating the effete organic elements of the mucous lining of the urinary passages, independently of any notable disorder in the stomach, and apparently uninnuenced by saccharine articles of diet. It is then not unfrequently associated with an excited or irritable state of the mucous membrane. I take leave to submit to the profession a few cases illustrative of this view, together with an abstract of some recent researches by Dr. Schmidt, of Dorpat," which tend to elucidate this important and intricate subject. A fine, healthy-looking youth, with florid complexion, aged fifteen, was admitted under me in May, 1846. He complained of pain, the moment of commencing to void urine, at the lower part of the abdomen and the extremity of the penis, attended with retraction of the testicles. The urine was pale and limpid, very acid, specific gravity 1.01T. It contained the ordinary proportion of uric acid and of earthy phosphates. When examined by the microscope, the octahedral crystals of oxalate of lime, first accurately described by Dr. G. Bird, were perceptible. His appetite and digestion were excellent, and had never been otherwise. The bladder was carefully sounded, but no calculus could be detected. The pain at the extremity of the penis, and retraction of the testicles, were relieved by the introduction of the instrument, but not that of the abdomen. However, every symptom yielded, after three weeks' time, to the exhibition of half-ounce doses of solution of acetate of ammonia, taken in conjunction with ten grains of bicarbonate of potash twice daily, and five grains of compound gamboge pill on alternate nights. Here the effect of the treatment was to diminish the acidity of the urine, and remove the morbid sensibility of the mucous membrane. A gentleman, aged fifty-six, of spare make, was placed under my care by his medical attendant, in October, 1846, on account of difficulty in passing urine. He suffered from heavy pain and sensation of tightness at the lower part of the abdomen, and in the situation of the neck of the bladder, together with occasional dragging and darting pain, shooting down the thigh in the track of the ischiatic nerve. The urine is discharged with hesitation, in a very small stream, which is at times spiral. He is obliged to get out of bed about twice every night, to make water; hence, on arising in the morning, he feels tired and weary in his limbs. The above ailments are of two years' standing. He was treated for stricture twenty-five years previously. His appetite and digestion have been always good. The urine passed at night was very acid, and contained crystals of oxalate of lime; that voided in the morning was neutral to test-paper, free from oxalate of lime, but on exposure to heat a white precipitate appeared, which vanished upon the addition of nitric acid. A No. 5 yellow wax bougie was cautiously introduced, and exhibited, when withdrawn, an annular indentation, demonstrative of coarctation, at a point corresponding to the junction ot the bulbous and membraneous portions of the urethra. This gentleman, having an insuperable objection to drugs, was enjoined merely to abstain from sugar, in any form, potatoes, salt, and pickled meats, and to drink only watery diluents. By undergoing, during two months, the treatment of gradual dilatation, with white wax bougies, the urinary irritation subsided, the stream of urine attained its normal size, and he was enabled to take his usual walking exercise without being exhausted as formerly. Still, in spite of his attention to diet, his forbearance from saccharine aliments, oxalate of lime continued to be excreted in his evening urine. In this case, the pain in the sciatic nerve may be referred to irritation of the vesical nerves, since both are given off from the sacral plexus, agreeably to the principle laid down by Sir Charles Bell-viz., " that irritation on the internal branch of a nerve, by disorder of function in the viscera, will be felt or attributed to the external branch of the same nerve." (" Practical Essays," p. 95.) The circumstance of the morning urine depositing phosphates, when heated, would seem to point to a cachectic tendency, not uncommon in persons worn by protracted suffering, referable to the urinary organs. * On the occurrence of oxalate of lime in the simplest cell-plants, and in the secretion of mucous membranes. Annalen der Chemie u. Pharmacie.