Bullock's semola, which consists nearly entirely of wheat gluten, would form a nutritious substitute for the arrow-root and sago mucilages. Animal diet is principally to be depended upon for nourishment, and some of the green garden vegetables, such as spinach, are permitted. Distilled water, or boiled water, but not toast water, may be used for drink. Dr. Prout, in some cases, found porter beneficial; and in France, claret has been given with advantage.

The tepid bath, to induce perspiration, is often of service. As regards medicine, its prescription must be left to the medical man. Persons who suffer from any suspected tendency to diabetes cannot attend too strictly to the state of the digestive organs. Wet feet must be particularly avoided, and flannel should be worn next the skin; while all sources of debility, sexual excesses in particular, must be most strictly eschewed.

Refer to-Fermentation- Sugar- Urine, &c.

closely envelope the limb, and give support to the weakened vessels and infiltrated tissues, which have encouraged, and which surround the sore. The diachylon, it is true, passes over the ulcer, but it is prevented exerting any effect upon its surface by the intervening discharge. Sometimes, even when applied to the sound skin, diachylon is found too irritating, in which case soap or lead plaster must be substituted. If diachylon plaster is kept folded up in too warm a situation, it adheres together and becomes useless.

Refer to-Plasters.

DIAGNOSIS is a frequently used medical term, which may be applied either to the "art of discovering the nature of diseases, and of distinguishing them from each other," or to the conclusion arrived at by the exercise of the art. In other words, when a medical man, after investigating a disease, expresses his opinion respecting its nature, it is called his "diagnosis" of the disease. It must be evident to all how much, indeed how everything depends upon a correct diagnosis of the existing disorder; for unless correctness on this point be attained, treatment can scarcely be of much service, and if active, may be worse than no treatment at all. It is true that there are certain general symptoms of disease which may be treated, perhaps with benefit, in a general sort of way, without the medical attendant having any definite idea of the existing derangement. Such is the case with most febrile diseases, and many others, and as the natural powers do much towards the removal of the malady, and to promote restoration to health, a practitioner may practice in this loose sort of way with apparent success; he treats prominent symptoms, attends to diet, &c., and his patients get well. But this is not the true practice of medicine, it is very different from the active, well directed and energetic measures of the man who having both the knowledge and the will to truly investigate his case, and having done so, strikes home at once. The man who does not or cannot make a correct diagnosis is working in the dark; and if he uses edged tools, so much the worse for his patients, whose safety must in some measure depend upon the treatment of their cases being conducted upon the same inert plan as their investigation. At the same time, if there be any efficiency in medical treatment at all—and no man who knows his profession and practices it conscientiously can doubt it-how much passive evil must result from insuffi

DIACHYLON PLASTER is the commonly used adhesive plaster spread on calico. It was formerly prepared by hand, but as now executed by machinery, is a beautifully uniform preparation, and notwithstanding many substitutes, is still the most firmly adhering, and most to be depended upon of the plasters for retaining the edges of wounds in apposition. People in general have a very false idea of the nature and uses of this and of other plasters. They attribute to them some healing power over the wound, whereas their only use is, by keeping the edges of the wound in perfect apposition, to permit them to heal by the natural power with which the living tissues are endowed. This idea of the healing properties of diachylon, however, often leads to mischief, from inducing persons to apply the plaster to abrasions and sores, which it seriously irritates, causing with. some, much increase of inflammation, and troublesome ulceration. The practice is most hurtful, and should never be followed. This idea of the healing powers of diachylon has, too, been probably increased by its known use by surgeons in the treatment of, and for the healing of ulcers. In this case, used as a strapping round the leg, and over the sore, the latter quickly gets well, and it would seem, under the influence of the diachylon plaster, which, however, in this case is used only as

a

cient and slovenly investigation of disease; how much must be and is every day overlooked, which ought not to be so; how often are germs of fatal disease undetected which ought to be detected, until they have ripened into active growth that is not to be repressed. One or two cases will more forcibly illustrate the difference between a loose and ill-defined treatment of disease, and that which is the result of accurate diagnosis. A child is taken ill, becomes feverish, the breathing quickened, and there is frequent cough, along with other symptoms, indicating in a general way inflammatory affection of the lungs, and so far, perhaps, the diagnosis is too plain to be overlooked, even by a very cursory examination, and tartar emetic, mercurials, &c., are remedies so generally useful in such cases, that they will be prescribed with probable success, and it may be that the little patient will get well under their use; but it may not so happen—the disease evidently does not yield, the feverish condition, the quick breathing, and the cough, all shew that it is still active. It is evident that abstraction of blood is called for, but the child will not bear it from the arm, and it must be effected by leeches-where-of course on the chest. But on what part of the chest? Here comes the point of diagnosis, the careless or slovenly practitioner will be content with the general indication of the fore part of the chest, unless indeed there is complaint of pain-which may mislead as well as lead-to direct his aim elsewhere, and the chances are, that blood is taken away, comparatively little good is effected, and the child, not the disease, is weakened. The error may be a fatal one, which a correct diagnosis would have prevented. It may be that the anterior portions of the lungs are free from disease, which is confined to the posterior and lower portion of one or both. If a correct diagnosis has been made, this should be known, the practitioner, by the percussion of his fingers and the application of his ear to the chest, will probably be able to lay his hand upon the skin over the seat of disease, and to mark out with confidence the limits within which blood may be abstracted with the greatest certainty of benefit.

Again, a patient suffers from indigestion, from weakness, pain in the back, and general symptoms of bad health; the spirits are depressed; a general diagnosis is perhaps made, and the round gone of various tonic remedies, alterative remedies, &c.; but the urine, if thought of at all, is passed over with a cursory glance: to the unassisted eye it looks all right, and perhaps is pro

claimed so, but place a drop of it under the invaluable microscope, and it is found laden with crystals of oxalic, or phosphatic, or some other deposit. The correct method of diagnosis affords at once, the key to the main points of the disorder, and probably to its successful treatment, which might have been groped after in vain, or if stumbled upon by accident, and found successful, the success would give but little clue in the next case of the kind which might occur, or it may be that false ideas of the nature of the disease, a false diagnosis having been formed, the success itself will constitute an abundant source of evil and error, not only to the individual practitioner, but to others. The fact being a false one, leads to false conclusions. The above cases which might be multiplied to any extent have been brought forward to show, how much success in treatment must depend upon the correctness of the diagnosis which the attendant practitioner forms of the disease of his patient. They have also been brought forward to show, that this correct diagnosis can only be attained by time and patient attention and investigation, even by the greatest in science. In many cases, no extent of knowledge will enable a physician to say what portion of a lung is affected, unless his sense of hearing conveys the exact information to his mind in a physical examination. A physician may suspect from symptoms, that his patient is suffering from disease which tends to the formation of oxalic gravel, but he cannot positively assure either himself or others that such is the case, unless he actually see with his eye-through the microscope-the peculiar crystal which marks the disease. From what has now been said, it must be evident that the highest attainments in medical knowledge will not compensate for a hurried examination of cases; there must be time; people forget this: attracted by some great name, and in all probability a really and truly great one, they crowd the reception rooms, and are passed in quick succession through the consulting room of the fashionable practitioner, who cannot give time to the full investigation of the cases which come before him. Few, perhaps, attain the meed of popularity without having well deserved it, or retain it without deserving to retain it by their progressive attainments; but, withal, they are not gifted with intuition, and if the public will compel them to see ten cases in the time they ought to take to two or three, the public must suffer, and they do suffer, for many a case overlooked is unravelled by the patient investigation of some less occupied practitioner.

this work-which produce sweating of the part to which they are applied. The most useful diaphoretics for domestic purposes are

Refer to-Advice, Medical-Disease, &c. DIAPHORETICS-are agents used in the practice of medicine which "determine to the skin" or produce perspiration or sweating. When it is considered how extensive the surface of the skin is, how largely it is supplied with blood, and how abundantly with means for exhaling moisture-see Skin-it must be evident how powerful an influence its excitation or depression must exert upon the condition and functions of the body. This influence is so undoubted, and so marked, that in all ages, and in almost all nations, even the most uncivilized, the cure by promoting the flow of the sweat has been a common and favourite mode of treatment. Among the tribes of North American Indians, it is employed, as described by Mr. Catlin, both as a curative and as a sanitary agent. The most general mode of exciting perspiration, particularly among the more uncivilized portions of mankind, is by means of hot vapour or the vapour-bath, but they also employ abundantly, decoctions of various herbs, as assistants to the process.

The effect which the constant insensible perspiration from the body exerts in diminishing its temperature, must, of course, be augmented as the excretion and evaporation of fluid from the surface is increased, furnishing an active agent for lowering the temperature of the body in states of fever. Every one knows how much and distressingly the dry heat of the skin is felt, and how grateful the sensation of moisture upon the surface. In addition to the reduction of temperature, however, the action of diaphoretics must tend powerfully to relieve congestion or collection of blood, or inflammatory action in internal organs, and, indeed, the fact is every day manifest in the treatment of disease, not as regards general perspiration only, but also as a consequence of the effect of local agents-such as the bran poultice so often mentioned in

ANTIMONY. In the form of the tartrate of antimony, in small doses, when fever is excessive, and the true James's powder, which is the safest form for children.

BATHS. Tepid, warm or vapour, or used as in hydropathic establishments by means of the wet sheet and blankets.

IPECACUANHA. In any of its combina

tions.

OPIUM. Particularly in its combination with ipecacuanha, named Dover's powder. To the above may be added, sweet spirit of nitre, gin, and diluent drinks of all kinds, sometimes cold, but generally warm, and exercise. There are many other agents employed in medicine as diaphoretics, but they are not likely to be used domestically, unless, indeed, we except the Dulcamara, or bitter-sweet, also called woody night-shade, which, being a common native plant, might be used in the absence of other remedies of the class.-See Dulcamara. For information respecting the other diaphoretics mentioned, the reader is referred to their respective articles.

When perspiration is thought to be desirable, it is immaterial what agent is selected to produce it; thus, if there is very hot dry skin, and quick hard pulse, antimony will generally be most useful; if there is depression, spirit of mindererus, sweet spirit of nitre, or carbonate of ammonia will be most suitable, and with any of these ipecacuanha or opium may be combined. To form one of the most useful and certain sweating draughts, take of spirit of mindererus half an ounce, of antimonial or ipecacuanha wine fifteen to thirty drops, and water four table-spoonfuls, adding or not, as circumstances dictate, ten drops of laudanum, or a teaspoonful of paregoric.

As there is always a degree of uncertainty, especially in some constitutions, in the action of diaphoretic medicines, when they are taken, every means should be used to assist and promote the desired effect. Confinement to bed is absolutely necessary, and before retiring there, it is always well to put the feet in hot water for twenty minutes; the diaphoretic medicine should be used on getting into bed, and nothing more for three quarters of an hour, when the warm diluent drinks are to be