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The chief vegetable purgatives are aloes, colocynth, gamboge, jalap, scammony, seeds of castor-oil plant, croton-oil, elaterium, the hellebores, and colchicum. All these have, either alone or combined, proved fatal. The active principle in aloes is aloin; of jalap, jalapin; of white hellebore, veratria; and of colchicum, colchicin.
Laxatives in some form are generally indicated, and one of tile best is agar- agar. Of course aloin and cascara are always good laxatives, with an occasional dose of calomel or saline, if such seem indicated.
The bowels should be moved by vegetable laxatives, as aloin, cascara sagrada, or some simple combination of either or both of these drugs. Diuretics are often not satisfactory in cardiac insufficiency. The cardiac tonics which are given the patient, and the improvement of the heart from the rest in bed generally start the kidneys to secreting properly.
If the bowels are known to be in excellent condition and not loaded with fecal matters, brisk catharsis is not needed simply because endocarditis has developed. If the bowels have been neglected, a small dose of calomel, aided by a compound aloin tablet, is necessary and good treatment.
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