In congestions of the spleen, this property of emetics will sometimes answer a good purpose; and they are among the remedies which may be resorted to in enlargements of that organ, supposed to be of a congestive nature.

Sometimes there is a collection of bile in the ducts of the liver, and in the gall-bladder, which interferes with the proper performance of the hepatic function; while, from the absence of the bile in the primae visa, the function of digestion is impaired. The compression to which these parts are subjected causes the ducts and gall-bladder to be emptied, and this source of disorder to be at least temporarily relieved. Hence the frequent appearance of bile in the matters ejected by vomiting, when the effort is repeated several times, and with some degree of violence. The bile, forced out of the liver and the gall-bladder into the duodenum, ascends partly into the stomach, and escapes along with its contents.

Sometimes there is reason to think that this bilious accumulation is owing to tenacious mucus, collected in the excretory ducts of the liver, which tends to close them against the passage of the bile. if this be the case, the emetic operates favourably by bringing the whole great power of the muscular walls of the abdomen to bear upon the obstruction, and thus forcing a passage of the ducts.

That these ducts are occasionally closed by biliary calculi is well known; and the idea formerly prevailed that jaundice was essentially connected with an impediment of this or some other nature in these passages. Emetics, having been found useful in jaundice, were supposed to operate by forcing forward the calculus, or otherwise removing the impediment. Though I do not believe that jaundice usually depends on such a cause, yet it is sometimes associated with the obstruction, and is relieved by its removal; and it is probable that the mechanical action of emetics may prove useful in aiding the passage of biliary calculi, especially when associated with the general relaxation attendant on the state of nausea.

The simple shock given by these powerful movements to the contents of the abdomen generally, may tend to rouse them from any state of torpor into which they may have fallen, and thus serve as a stimulant to all their functions.

3. Reduction of Arterial Action. During the existence of nausea, it has already been stated that there is a general depression of the circulation, the pulse becoming small and weak; and sometimes a condition approaching to syncope is induced. This diminished movement of the blood is useful in the relief of active congestion and commencing inflammation; and, could it be maintained, without great inconvenience, and perhaps danger, would serve as a most powerful antiphlogistic agency. Even temporary as it is, it sometimes serves a very useful purpose by suspending the course or diminishing the violence of inflammation, while other measures of a more permanent character may be used to sustain the impression made. One of the greatest drawbacks to the advantages of this influence of emetics is the subsequent reaction which is apt to take place; and which, after the disease has become fixed, so as not to be eradicated by any temporary measure, will probably do as much harm as the previous depression might have done good. it is best, therefore, when emetics are employed as such, in inflammations, to restrict them to the earlier stage; at least in reference to the present indication, that, namely, of reducing arterial action.

4. Muscular Relaxation. During the same state of nausea, there is a universal muscular relaxation, which often answers an admirable purpose in disease. Few agencies are more powerful than this in relieving spasm. Hence emetics are often extremely useful in spasmodic diseases. in the paroxysm of spasmodic asthma, they are among the most efficient remedies. Their occasional repetition has been highly recommended in hooping cough. They are above all other remedies effective in relaxing the spasm of the glottis in the paroxysm of croup, and are among the standard means of cure in that disease. Through the same agency, they often exercise a powerful influence over the convulsive paroxysms of hysteria. They may indeed be employed in any case of spasm; where no contraindication exists, as cerebral congestion or abdominal inflam mation; and when a strong immediate impression is desired. Even in eclampsia or occasional convulsions, with signs of cerebral congestion, if measures have been previously taken for relieving the brain by the abstraction of blood, purging, cold applications, etc., and the convulsions still persist, emetics may generally be given with safety, and will often be found of great benefit.

Another application of them, upon this principle, has been made by the surgeons, for the purpose of relaxing the muscles in the reduction of dislocations.

5. Promotion of Secretion. During the continuance of the nausea, there is a strong and general tendency to secretion. The saliva usually flows copiously. The skin is almost always cool and moist. The bile flows more freely; and the same is probably the case with the pancreatic fluid. The mucous secretion is obviously increased, especially that of the stomach and duodenum, and of the air-passages. The last is among the most influential therapeutic effects of emetics; rendering them of great use in inflammatory affections of the air-passages, and especially in pseudomembranous croup, in which they act favourably much more, I believe, by promoting mucous secretion, and thus loosening the false membrane, than by any merely expulsive effort. indeed, it is difficult to conceive how this latter effect can be produced upon the air-passages, when, as one of the very conditions of the emetic act, the rima glottidis closes, and does not relax till the abdominal muscles cease to contract.

But, besides the general promotion of secretion from the relaxation everywhere of the blood-vessels, the hepatic and pancreatic secretions are probably increased upon other principles. The mere agitation of the viscera would have some effect of the kind by rousing them into increased action. There is, moreover, a certain sympathy between glands and the surfaces upon which their excretory ducts open, by which an irritation applied to the latter produces an increase in the function of the former. A familiar illustration of this principle we have in the increased flow of saliva which follows the introduction of food into the mouth. The irritation of the emetic upon the gastric and duodenal mucous membrane may be supposed to operate upon this principle, in promoting the secretion of bile and pancreatic liquor.