The state which the great intestines fall into in old dysenteries seems to have something in it peculiar to itself: the several coats become thick and spongy; their texture is obliterated and destroyed; and they become of a black or very dark purple colour. This, however, cannot be called mortification; for the fibres of the gut do not lose their tenacity, nor is there that putrid and dissolved state in which gangrene consists; but it advances in time to such an extreme state of disease as to be entirely incapable of recovering its natural appearance and functions, and proves therefore the cause of death. The greater frequency and obstinacy of these chronic fluxes in hot than in cold climates seems to be owing to the same weakening of the powers of life which make recovery in general so tedious, and particularly that of wounds and ulcers. The greater quantity of acrid bile will also tend to keep up the ulceration. Dysenteries have this disadvantage, that the Peruvian bark, which is the most powerful restorative in other complaints of this climate, is here found to be inadmissible on account of the heat, thirst, and other febrile symptoms, which it seldom fails to induce in all stages of this disease. TREATMENT of FLUXES. There are few diseases in which a prudent employment of art is more useful, or in which early means of relief are more requisite than in this[114]. Where the dysentery is the original disease, and when the patient is robust and plethoric, with acute pain and a strong pulse, blood-letting may be practised with advantage in the beginning of the complaint. But there is no part of the practice in this disease in which the climate and manner of life makes a greater difference than in this; for in a temperate climate it frequently happens that repeated blood-letting is necessary; but in a hot climate, where the fibres are relaxed, and in the constitutions of seamen, whom we seldom or never find plethoric, the inflammatory symptoms requiring this evacuation do not run so high, nor continue so long. It is in all cases of the utmost consequence to administer as early as possible a brisk saline purgative. An ounce and a half or two ounces of purging salts may be dissolved in a quart of barley water or water gruel, and given warm in cupfuls, at small intervals, till a free and copious evacuation is produced. If there should be much fever, or sickness at stomach, two grains of emetic tartar will be a great improvement of this medicine; and there will be this farther advantage from its use, that if the stomach should be loaded with bile, in which state it is more irritable, an evacuation upwards will also be excited to the great relief of the patient.