It will be readily imagined that, in numerous instances coming under the vulgar denomination of empacho, the subtraction of blood will be a necessary measure before purgatives can be properly or safely resorted to, with a view to remove from the bowels the irritating cause lodged there, and affecting the general system. But to avoid the unjust criticism of uncharitable members of the profession, who are always ready to turn to their private advantage, any popular prejudice which can be called in to humble the name of fellow-practitioners more respectable than themselves, and also as a mean either to acquire or to preserve the confidence of the sick, the prudent physician will not overlook the natural effects of any known prepossession regarding blood-letting. He will so far accommodate his practice to the ideas of those who are most interested in the issue of his treatment, as to order at least one enema, when the empacho is firmly believed to exist, before he proceed to the further discharge of his professional duty, and fulfilment of the indication of the case, by ordering the lancet to be applied. No time or advantage is lost by such a concession to the preconceived and inflexible opinion, that bleeding is particularly hurtful in those cases of illness connected with undue accumulations in the bowels: but one very important end is gained by it; since, by agreeing with the sick and their friends on an indifferent point of practice, they will more willingly submit to the application of other remedies necessary for the safety of the patient. VI. _Cosas frias y calientes._—All articles of diet, and medicaments, are by the Peruvians vulgarly divided into cold and hot; or, as the words on which we are about to comment express it, into “cosas frias y calientes.” When the physician prescribes any particular diet or physic to a patient in Lima, he must be ready to answer many inquiries regarding the qualities of the things prescribed.