■^. 
 
 'J 
 
 i-^*-cA 
 
THE LIBRARY 
 
 OF 
 
 THE UNIVERSITY 
 
 OF CALIFORNIA 
 
 PRESENTED BY 
 
 PROF. CHARLES A. KOFOID AND 
 
 MRS. PRUDENCE W. KOFOID 
 
'niversity of ih'-, *Sc/i...' , 
 
 POPULAR 
 MEDICAL DICTIONARY. 
 
DICTIONARY 
 
 OP 
 
 MEDICINE, 
 
 DESIGNED FOR POPULAR USE. 
 
 CONTAINING 
 
 AN ACCOUNT OF DISEASES AND THEIR TREATMENT, 
 
 INCLUDING THOSE MOST FREQUENT IN WARM CLIMATES : 
 
 WITH DIRECTIONS FOR 
 ADMINISTERING THE VARIOUS SUBSTANCES USED AS MEDICINES; 
 THE REGULATION OF DIET AND REGIMEN ; AND 
 THE MANAGEMENT OF THE DISEASES OP WOMEN AND CHILDREN* 
 
 By ALEXANDER MACAULAY, M. D. 
 
 FELLOW OF THE ROITAL COLLEGE OF SURGEONS OF EDINBURGH, 
 
 AND PHVSICIAN-ACCOUCHEUR TO THE EDINBURGH 
 
 NEW TOWN DISPENSARY. 
 
 SECOND EDITION. 
 
 EDINBURGH : 
 
 PRINTED FOR ADAM BLACK : 
 
 AND LONGMAN REES, ORME, BROWN AND GREEN, 
 
 LONDON. 
 
 M.Dccc,xxxr: 
 
 ty 
 
KDINBUROH : 
 PRIXTED BY A. BAT.FOUR AND CO. NIDDnY STa^ET. 
 
HJ5" 
 
 TO 
 
 JOHN ABERCROMBIE, M. D. 
 
 THIS WORK IS INSCRIBED, 
 BY THE AUTHOR, 
 
 WITH SINCERE RESPECT FOR HIS VIRTUES IN PRIVATE LIFE ; 
 AND FOR HIS SUCCESSFUL EXERTIONS 
 
 IN 
 
 IMPROVING PATHOLOGY 
 
 AND 
 
 THE PRACTICE OF PHYSIC. 
 
 
Digitized by the Internet Archive 
 
 in 2007 with funding from 
 
 IVIicrosoft Corporation 
 
 http://www:archive.org/details/dictionaryofmediOOmacarich 
 
PREFACE. 
 
 The object of this Work is to present, in a popular and ac- 
 cessible form, some of the more useful and practical parts of 
 medical science ; not with the intention of making every 
 man his own physician, but of giving such a plain and intel- 
 ligible account of diseases and their treatment, as may con- 
 vey some information to the general reader. Many persons, 
 who would never think of practising either on themselves or 
 others, may be desirous to have some notion of the pheno- 
 mena of disease, and to know the symptoms which indicate 
 danger ; and if such were to apply to our regular and scien- 
 tific treatises, they would find themselves totally bewildered 
 amidst a multitude of terms altogether new to them, and 
 amidst reasonings from data which they had never heard of. 
 The deviations from health which occur in the early periods 
 of life are so numerous, that if a practitioner vf^re called 
 upon to treat them all, he must be almost a daily visitant in 
 the nursery ; and sensible and attentive parents are anxious to 
 know what ailments or symptoms occurring in infancy, may 
 be trusted to a little simple medicine and the regulation of 
 the diet, and what are unsafe to be treated except by a me- 
 dical attendant. 
 
vili PREFACE. 
 
 There are many situations where no practitioner Is at hand ; 
 and where, on the occurrence of accident or disease, the treat- 
 ment of the sufferer must, in the first Instance, be direct- 
 ed by the good sense and kindness of his neighbours. Such 
 situations are to be met with in thinly-peopled districts, in 
 retired villages, in foreign settlements, and commercial out- 
 posts ; where the first who are asked to give advice to their 
 dependants or companions, will be the clergyman or the 
 landlord, the supercargo or the shipmaster. To all these, 
 some knowledge of diseases and their treatment, will prove 
 a valuable acquisition. 
 
 To render the Work useful to such persons, I have been 
 as sparing as possible of technical terms ; and if any words 
 or phrases sometimes occur not sufficiently adapted for com- 
 mon readers, they will generally be found explained in their 
 alphabetical order. By adopting this arrangement, I have 
 not only rendered the Work easily consulted on any disease, 
 medicine, or circumstance of diet and regimen, but have been 
 enabled occasionally to devote an article to some symptom 
 deserving of particular consideration, though it could not 
 with propriety have so much space allotted to it in the de- 
 scription of a disease. 
 
 The uses and doses of the more common medicines have 
 been specified ; the properties of a great variety of aliments 
 and drinks have been carefully stated, and such remarks have 
 been made as may tend to show the propriety, in most cases, 
 of using them or abstaining from them. Much attention 
 has been paid to the various diseases and conditions peculiar 
 to the female constitution ; and particular directions have 
 been given for the management and preservation of (he 
 health of women ; as well as for the care of infants and chil- 
 dren, so long as they are principally under the superintend- 
 ence of their mothers. 
 
PREFACE. ix 
 
 Besides the topics more immediately connected with the 
 practice of physic, diet, and regimen, I have inserted some 
 account of the principal functions of the animal economy, as 
 the circulation of the blood, respiration, digestion, &c. I 
 have also stated fairly, as I hope, the advantages and disad- 
 vantages of wine, spirits, tea, coffee, tobacco, and other arti- 
 cles of luxury. I have added in an Appendix, a list of me- 
 dicines, both for adults and children, with the mode of ad- 
 ministering them ; and have given such directions and cau- 
 tions as will make them in general safe, as well as useful. 
 
 The nature of this Work, and the persons for whom it is 
 intended, render it impossible to go to any great minuteness 
 in its details ; and may make the style on some occasions ap- 
 pear rather concise and peremptory. 
 
 But the importance of any subject is not always to be es- 
 timated by the length of the discussion concerning it. The 
 symptoms and treatment of an insignificant eruption on the 
 skin, may take a great many more words, than what will 
 he necessary to communicate all that is useful for the gene- 
 ral reader to know, about rupture of the bowels or inflam- 
 mation of the lungs. 
 
 Without intending any invidious comparison, I may be 
 allowed to say, that some other works of this description are 
 rendered the worse by their copiousness, and are rather cal- 
 culated to puzzle than inform the unlearned reader ; as they 
 do not simply and shortly state what appears to be the most 
 proper practice, but accumulate in an undigested mass all 
 that has ever been invented or proposed for the cure of any 
 disease. 
 
 In an age like this, when the most abstruse parts of natu- 
 ral philosophy and economical science are brought within 
 
X PREFACE. 
 
 the reach of all classes of men, it can hardly be necessary to 
 make an apology for treating of medicine in a popular style ; 
 as it is a subject in which every individual is personally in- 
 terested, and on which, great multitudes think themselves 
 qualified to give an opinion. Medicine has always been a 
 favourite pursuit with extra-professional persons, who have 
 not scrupled both to teach and to practise it ; from the em- 
 pirical nostrums of the ancient priesthood, down to the no 
 less oracular dictates of the skilful and experienced old 
 women of modern times. Such, in Lord Bacon's opinion, 
 have been the most formidable rivals of the regular physi- 
 cians ; who have been almost tempted in despair to conclude, 
 that it is a matter of little moment, whether they attain per- 
 fection or mediocrity in their art. 
 
 That sagacious and universal observer assigns this as the 
 reason, though not the vindication, why there are to be found 
 among physicians, excellent poets, orators, critics, and anti- 
 quarians ; more profoundly skilled in those pursuits than in 
 their own science. In all professions, there are, no doubt, 
 idlers and theorists ; and of such. Medicine has had its full 
 share : but, without exposing to profane view the lateness of 
 our reformation, we venture to say, that we are now in the 
 right way of investigation ; and that, by an accurate obser- 
 vation of disease, and of the effect of substances taken into 
 the body, whether in health or sickness ; by a careful culti- 
 vation of morbid anatomy, and by an improved pathology 
 resulting from the combined diligence and good sense of 
 many enlightened minds, the attentive practitioner is in pos- 
 session of a stock of sound and useful knowledge, which 
 will justify the confidence reposed in him, and render it 
 disgraceful for any one above the lowest vulgar and igno- 
 ^•ant, to suffer the presumptuous impostor to come in com- 
 petition with him. 
 
PREFACE. xi 
 
 I have endeavoured to show, that the practice of physic 
 is by no means so simple and easy a business as is generally 
 imagined ; and I have given such an account of the various 
 subjects treated, as may tend to correct some of the absurd 
 theory and dangerous practice, so common among the un- 
 educated part of mankind. One of their most frequent mis- 
 takes with regard to medicine, is the belief, that what has 
 done good in one case of disease, is to be equally beneficial 
 when similar symptoms happen in another. When an emi- 
 nent physician has been called in, and has prescribed a medi- 
 cine which has answered the purpose intended, and to all 
 appearance has cured the patient, nothing is more common 
 than for the precious recipe to be kept, and lent to a long se- 
 ries of afflicted friends. Such benevolent quackery proceeds 
 on the supposition, that a disease called by the same name 
 has the same symptoms in every case ; and that a drug pro- 
 duces its effects as infallibly as an operation of mechanics or 
 a process of chemistry. It reduces medicine to the simpli- 
 city so much boasted by the mathematical physicians of the 
 seventeenth century, who thought they had in many cases 
 solved the problem, A disease being given, to find the re- 
 medy. But there is a preliminary problem equally neces- 
 sary and difficult, that should first be solved : A patient 
 being given, to ascertain his disease. 
 
 All makers of Dictionaries, even Johnson himself, borrow 
 freely from their predecessors. I have been considerably 
 indebted to the judicious work of Dr. Parr of Exeter ; and 
 when I have extracted from him or from others, important 
 hints or information, I have generally been careful to ac- 
 knowledge the source from whence I derived them. In a 
 work of such variety and extent, many different authors 
 have necessarily been consulted ; but, although not making 
 
xii PREFACE. 
 
 any pretensions to originality, I may be allowed to state, 
 that what I have written on the common diseases and reme- 
 dies of our own country, and on some of those of tropical 
 climates, is conformable to my own experience. 
 
 I shall be highly gratified if my humble performance shall 
 convey any interesting information on medical subjects to 
 the general reader, or useful hints to parents in the manage- 
 ment of their children ; and I hope the Profession will look 
 with indulgence on a work, which details practical truths in 
 plain language ; but in which, if I have executed my own 
 intention, I have advanced nothing inconsistent with the 
 principles of true science. 
 
 Edinburgh, 20th March, IS28, 
 
ADVERTISEMENT 
 
 TO THE 
 
 SECOND EDITION. 
 
 The Author acknowledges, with gratitude, the favourable manner in 
 which his Book has been received ; and has endeavoured to render this 
 second edition yet more worthy of the public approbation. He has 
 carefully revised the whole, made many corrections and additions, and 
 considerable improvements on the arrangement of various articles. 
 
 Since the first edition of this work, several medical publications have 
 appeared, containing matter calculated not only to inform the Profes- 
 sion, but to interest the general reader. One of the most distinguished 
 of these is a work of Dr. Abercrombie on the Intellectual Powers, 
 from which copious instructive extracts are made on Insanity, Dream- 
 ing, Sleep-walking, &c. We may also mention that we have been 
 greatly indebted to an elaborate treatise on Poisons by Professor 
 Christison ; and to a valuable work on Climate by Dr. Clark. 
 
 The following articles, read consecutively, may be considered as 
 forming distinct treatises : 
 
 On Diet,' Regimen, and the Means of Preserving the Health : — 
 Health, A.ir, Heat, Cold, Night- Air, Habit, Exercise, Regimen, Hun- 
 ger, Thirst, Costiveness, Training, Aliments, Diet, Animal Food, Ve- 
 getable Diet, Digestion ; Meals, Breakfast, Dinner, Supper ; Cook- 
 ery, Condiments, Bread, Water, Fish, Fruits, Pastry ; Malt Liquors, 
 Alcohol, Ardent Spirits, Wine ; Tea, Coffee, Tobacco ; Clothing, 
 Perspiration, Sleep, Cleanliness. 
 
 Of Children, their Management and Diseases : — Infants, Child- 
 ren, Gum, Inward Fits, Weaning, Teething, D wining, or Marasmus^ 
 Fevers of Children ; Scarlet Fever, Measles, Small-Pox, Cow-Pox, 
 Mumps, Croup, Hooping-Cough, Head, Water in ; Convulsion-Fits, 
 Dance of St. Vitus, Ringworm, Scalled Head ; Ears, sore ; Rickets, 
 Scrofula, Hip-Disease, Knee-Joint, White Swelling. 
 
 Of Women, and the Peculiarities ioicident to the Female Sex : — 
 Female Complaints, Monthly Discharge, Chlorosis (Green Sickness), 
 Womb, Pregnancy, Longings, Foetus, Abortion, Labour, After- 
 
xiv ADVERTISEMENT. 
 
 birth, Delivery, Flooding, Lochia, (Cleansings) ; Miliary Fever, Milk 
 Fever, Breasts ; Puerperal, or Child-bed Fever, White Leg, Nipples, 
 Nurses and Nursing, Hysterics, Cancer. 
 
 Of Fevers and Ir^ammatory Complaints: — Contagion, Malaria, 
 Fumigation, Ague, Fever, Plague, Yellow Fever, Hectic Fever, In- 
 flammation; Lungs, Inflammation of; Rheumatism, Rose. 
 
 Affections of the Head and Nervous System : — Head, Headach, 
 Giddiness, Apoplexy, Palsy, Delirium, Sleep and Sleep-walking, 
 Dreaming, Insanity, Nervous Hypochondria ; Brain, Compression 
 and Concussion of; Epilepsy. 
 
 Breast Complaints : — Chest, Water in ; Lungs, Angina Pecto- 
 ris, Asthma, Catarrh or a Cold, Influenza, Spitting of Blood, Con- 
 sumption, Cough, Expectorants. 
 
 Disorders of the Bowels, &c. — Bowels, Inflammation of; Peritonitis, 
 Ihac Passion, Ruptures, Dry Bellyach, Colic, Cholera Morbus, Dy- 
 sentery. 
 
 Sto7nach Complaints : — Alimentary Canal, Aliment, Diet, Animal 
 Food, Vegetable Diet, Digestion, Stomach Complaints, Stomach, In- 
 flammation of; Ulceration of; Acidity, Heartburn, Sick Headach, 
 Nausea, Sickness, Bile, Bitters, Costiveness. 
 
 April, 1831, 
 
 BERLIN BILLS OF MORTALITY FOR 1829. 
 
 The following Table, which could not be conveniently inserted in the body of 
 the Work, is one of much interest, as containing part of the statistics of a great 
 city in the temperate regions of Europe, where the usual rate of increase and 
 mortality is not likely to be disturbed by any peculiarity of climate or situation, 
 or by the temporary stimulus to population in a young and recently colonized 
 country. Addison makes this the topic of one of those delightful essays, 
 {Spectator, 289.) by which he brought philosophy out of closets and libraries, 
 schools and colleges, to dwell in clubs and assemblies, at tea-tables and in coffee- 
 houses. With his usual felicity and genuine English style, he says, " A bill of 
 mortality is, in my opinion, an unanswerable argument for a Providence. How 
 can we, without supposing ourselves under the constant care of a Supreme Being, 
 give any possible account for that nice proportion which we find in every great 
 city between the deaths and births of its inhabitants, and between the number of 
 males and that of females brought into the world ? What else could adjust in so 
 exact a manner the recruits of every nation to its losses, and divide those new sup- 
 
BILLS OF MORTALITY OF BERLIN. 1829. 
 
 Xf 
 
 plies of people into such equal bodies of both sexes ? Chance could never hold tlie 
 balance with so steady a hand. Were we not counted out by an intelligent super- 
 visor, we should sometimes be overcharged with multitudes, and at others waste 
 away into a desert; we should be sometimes apopulus virorum, as Florus elegantly 
 expresses it, a generation of males ; and at others a species of women." 
 
 In Berlin, which, according to Malte-Brun, contains 192,000 inhabitants, the 
 Births in 1829 were 8450, of which 4287 were boys, 4163 girls; 649 boys and 
 666 girls born out of wedlock, or a proportion of 1 to 6| ; 228 boys and 179 girls 
 born prematurely, or still-bom, or a proportion of 1 to 20 of the total births, and 
 (1 to 12 out of wedlock,) — 94 cases of twins, and 1 case of three at a birth. The 
 Marriages were 1988. The Deaths were 6884 , of which 3721 were males, 3163 
 females ; and 3213 under, 3671 above ten years of age. The following table pre- 
 sients a view of the number of deaths at different ages : — 
 
 
 Males. 
 
 Females. 
 
 Total. 
 
 
 Males. Females, 
 
 Total. 
 
 1st year. 
 
 1064 
 
 926 
 
 1990 
 
 From 20 to 30, 
 
 333 
 
 195 
 
 528 
 
 2d do. 
 
 292 
 
 246 
 
 538 
 
 — 30 — 40, 
 
 311 
 
 197 
 
 508 
 
 3d do. 
 
 138 
 
 130 
 
 268 
 
 _ 40 — 50, 
 
 ^53 
 
 211 
 
 564 
 
 4th do. 
 
 66 
 
 86 
 
 152 
 
 — 50 — 60, 
 
 327 
 
 245 
 
 572 
 
 5th do. 
 
 43 
 
 40 
 
 83 
 
 — 60 — 70, 
 
 321 
 
 282 
 
 603 
 
 From 5 to 10, 
 
 99 
 
 83 
 
 182 
 
 — 70 — 80, 
 
 208 
 
 294 
 
 502 
 
 — 10— 15, 
 
 30 
 
 30 
 
 60 
 
 — 80 — 90, 
 
 74 
 
 125 
 
 199 
 
 — 15— 20, 
 
 53 
 
 53 
 
 106 
 
 — 90 —100, 
 
 9 
 
 18 
 
 27 
 
 
 
 Above 100, 
 
 2 women. 
 
 
 
 
 The next table is a very important one, containing the names of the diseases 
 in every case of death, the males and females being distinguished, and also the 
 cases below and above the tenth year of life. 
 
 
 Males. 
 
 Adults. 
 
 Children. 
 
 
 Total. 
 
 
 Females. 
 
 Males. 
 
 Females. 
 
 
 Weakness of old age. 
 
 218 
 
 388 
 
 
 
 
 
 60G 
 
 Weakness at birth, 
 
 
 
 — 
 
 120 
 
 112 
 
 232 
 
 Still & premature births, 
 
 — 
 
 — 
 
 228 
 
 179 
 
 407 
 
 Teething, 
 
 — ■ 
 
 — 
 
 89 
 
 70 
 
 159 
 
 Locked jaw. 
 
 9 
 
 — 
 
 9 
 
 8 
 
 26 
 
 Spasm of stomach. 
 
 1 
 
 4 
 
 — . 
 
 
 
 5 
 
 Convulsions^ 
 
 7 
 
 9 
 
 412 
 
 381 
 
 809 
 
 Scrofula, 
 
 3 
 
 2 
 
 13 
 
 14 
 
 32 
 
 Fungous growths. 
 
 1 
 
 
 
 10 
 
 8 
 
 19 
 
 Water in the head. 
 
 1 
 
 , 
 
 80 
 
 53 
 
 134 
 
 Catarrh and chincough. 
 
 — 
 
 — 
 
 15 " 
 
 18 
 
 33 
 
 Small-pox, 
 
 18 
 
 7 
 
 2 
 
 4 
 
 31 
 
 Measles, 
 
 ^ 
 
 __ 
 
 5 
 
 3 
 
 8 
 
 Red measles. 
 
 — 
 
 
 
 4 
 
 2 
 
 6 
 
 Scarlatina, 
 
 7 
 
 4 
 
 33 
 
 30 
 
 74 
 
 Croup, . _ . 
 
 1 
 
 — 
 
 17 
 
 21 
 
 39 
 
 Rose, (erysipelas) 
 
 1 
 
 2 
 
 1 
 
 3 
 
 7 
 
 Inflammation, brain, 
 
 21 
 
 10 
 
 64 
 
 50 
 
 145 
 
 lungs, - 
 
 belly, - 
 
 35 
 
 44 
 
 64 
 
 50 
 
 193 
 
 15 
 
 29 
 
 10 
 
 4 
 
 58 
 
 
 5 
 
 3 
 
 1 
 
 9 
 3 
 4 
 
 — 
 
 1 
 
 15 
 
 6 
 
 21 
 
 iiiiesiines. 
 
 12 
 
 """" . 
 
 ' larjnx. 
 
 1 
 
 stomach. 
 
 2 
 
 2 
 
 1 
 
 — 
 
 5 
 
 heart. 
 
 2 
 
 1 
 
 1 
 
 
 
 4 
 
 
 
 
 
 __ 
 
 1 
 
 „,^„^i_ 
 
 
 2 
 4 
 
 
 
 2 
 
 18 
 
 
 4 
 
 a 
 
 4 
 
BILLS OF MORTALITY. 
 
 
 Adults. 
 
 
 Children. 
 
 Females. 
 
 Total. 
 
 
 Males. 
 
 Females. 
 
 Males. 
 
 
 Inflammatory fever. 
 
 6 
 
 2 
 
 5 
 
 4 
 
 17 
 
 
 108 
 
 61 
 
 12 
 
 10 
 
 119 
 
 
 5 
 
 2 
 
 — 
 
 1 
 
 8 
 
 Mucous 
 
 4 
 
 3 
 
 2 
 
 1 
 
 10 
 
 Putrid & spotted 
 
 1 
 
 1 
 
 — 
 
 — 
 
 2 
 
 Intermittent ■ 
 
 3 
 
 3 
 
 
 
 2 
 
 8 
 
 
 — 
 
 7 
 
 — 
 
 — . 
 
 7 
 
 Slow 
 
 313 
 
 282 
 
 288 
 
 290 
 
 1173 
 
 Consumption, 
 
 407 
 
 175 
 
 2 
 
 1 
 
 585 
 
 Phthisis laryngea, 
 
 19 
 
 22 
 
 ~_ 
 
 — 
 
 41 
 
 Diseased mesenteric glands, 9 
 
 8 
 
 — 
 
 2 
 
 19 
 
 Chronic hepatitis. 
 
 9 
 
 8 
 
 1 
 
 — 
 
 18 
 
 Ulceration, intestine, 
 
 5 
 
 2 
 
 _«' 
 
 — 
 
 7 
 
 Catarrh of bladder. 
 
 1 
 
 — 
 
 
 
 — 
 
 1 
 
 Dropsy, 
 
 134 
 
 107 
 
 23 
 
 19 
 
 283 
 
 Water in the chest, 
 
 79 
 
 41 
 
 6 
 
 9 
 
 135 
 
 Jaundice, 
 
 2 
 
 1 
 
 4 
 
 2 
 
 9 
 
 Looseness, 
 
 8 
 
 1 
 
 12 
 
 17 
 
 38 
 
 Cholera, - - - 
 
 2 
 
 2 
 
 11 
 
 4 
 
 19 
 
 Haemorrhage, - 
 
 14 
 
 11 
 
 — 
 
 2 
 
 27 
 
 Vomiting of blood, 
 
 13 
 
 3 
 
 1 
 
 . — 
 
 17 
 
 Apoplexy, 
 
 308 
 
 205 
 
 101 
 
 85 
 
 699 
 
 Drunkenness, 
 
 2 
 
 — 
 
 — 
 
 — 
 
 2 
 
 Blue disease. 
 
 — 
 
 1 
 
 — 
 
 2 
 
 3 
 
 Diseased urethra, 
 
 1 
 
 .^ 
 
 — 
 
 — 
 
 1 
 
 Childbed, 
 
 _ 
 
 6 
 
 ... 
 
 _ 
 
 6 
 
 Organic disease of abdomen, 4 
 
 3 
 
 1 
 
 — 
 
 8 
 
 Do. of heart. 
 
 12 
 
 17 
 
 1 
 
 1 
 
 31 
 
 Insanity, 
 
 2 
 
 3 
 
 — 
 
 — 
 
 5 
 
 Rupture, 
 
 3 
 
 10 
 
 — 
 
 _ 
 
 13 
 
 Caries, 
 
 3 
 
 2 
 
 4 
 
 _^ 
 
 9 
 
 Cancer, 
 
 2 
 
 1 
 
 1 
 
 _ 
 
 4 
 
 Cancer of womb. 
 
 — 
 
 38 
 
 — 
 
 __ 
 
 38 
 
 
 
 
 4 
 
 — 
 
 — 
 
 4 
 
 stomach, 
 
 I 
 
 — 
 
 — 
 
 __ 
 
 1 
 
 Gangrene, 
 
 6 
 
 7 
 
 ■— - 
 
 1 
 
 14 
 
 Asthma & breast complaints, 1 2 
 
 15 
 
 4 
 
 11 
 
 42 
 
 Emphysema, 
 
 1 
 
 — 
 
 _ 
 
 — 
 
 1 
 
 Gout, 
 
 3 
 
 3 
 
 — 
 
 __ 
 
 6 
 
 Stone, 
 
 1 
 
 1 
 
 _ 
 
 __ 
 
 2 
 
 Obstructed intestines, 
 
 1 
 
 2 
 
 _ 
 
 
 
 3 
 
 Indurated cellular tissue. 
 
 __ 
 
 ._ 
 
 3 
 
 3 
 
 6 
 
 Tabes dorsalis, (wasting) 
 
 2 
 
 1 
 
 2 
 
 1 
 
 6 
 
 Surgical operations. 
 
 — 
 
 1 
 
 — 
 
 
 
 1 
 
 Softening of stomach, - 
 
 — 
 
 
 
 8 
 
 6 
 
 14 
 
 Scirrhus of ditto. 
 
 7 
 
 4 
 
 1 
 
 __ 
 
 12 
 
 Excessive discharge. 
 
 
 2 
 
 
 
 — 
 
 2 
 
 Suicide, 
 
 39 
 
 13 
 
 _„ 
 
 __ 
 
 52 
 
 Accidents, 
 
 68 
 
 21 
 
 9 
 
 6 
 
 104. 
 
 Unascertained diseases. 
 
 44 
 
 27 
 
 4 
 
 10 
 
 85 
 
 Total, 
 
 2020 
 
 1653 
 
 nO'4 
 
 1509 
 
 6884 
 
POPULAR 
 
 MEDICAL DICTIONAIIY. 
 
 ABDOMEN. 
 
 Abdomen. The name ^ven by ana- 
 tomists to the cavity of the belly. It 
 contains many important organs, as those 
 of dig-estion, viz. the stomach and bowels, 
 with all their appendages, such as the 
 mesentery and its glands, through which 
 the chyle, elaborated from the food, must 
 pass, before it conveys the supplies of 
 nourishment to the body ; also the liver, 
 the pancreas or sweetbread,, the spleen, 
 the kidneys, and various large blood-ves- 
 sels. It is bounded by bones and muscles, 
 and is separated from the cavity of the 
 chest by the diaphragm or midiiff. Its 
 lower part, though not so conspicuously 
 marked off by any peculiar division, has 
 an appropriate name, the pelvis or basin, 
 and is generally described as a distinct 
 cavity. In this lower part are contained, 
 in men, the urinary bladder, the spermatic 
 vessels, and the extremity of the great 
 gut ; and in women, besides the bladder 
 and gut, the womb, and parts belonging 
 to it. 
 
 It will be easily imagined, that from 
 the variety and number of the parts con- 
 tained in the abdomen, and connected 
 with it, tliat cavity and its boundaries 
 must be the seat of many diseases, and 
 the subject of various surgical operations. 
 Its muscular parts are, like those of other 
 similar textuj'es, liable to inflammation, 
 terminating in an abscess, or to that sort 
 of it called rheumatism. The apertures 
 which transmit organs from the inner 
 parts may be enlarged so as to allow the 
 
 bowels to protrude, and form herniae, or 
 what are commonly called ruptures; or the 
 same disease may be produced from sud- 
 den efforts or external injury forcing the 
 bowels through the various openings. The 
 skin and the muscular coverings are often 
 exceedingly distended by dropsical swell- 
 ings, by corpulency, by enlarged ovaries, 
 and by pregnancy. After this last state, 
 they commonly regain the greater portion 
 of their elasticity, but sometimes great 
 relaxation remains ever afterwards ; and 
 requires bandages and artificial supports. 
 The abdomen sometimes requires to be 
 pierced by the surgeon in order to evacu- 
 ate dropsical or other fluids. This opera- 
 tion, from a very obvious allusion, is called 
 tapping. The diseases of the different 
 organs contained within the abdomen, and 
 the method of cui-e, will be found under 
 their respective names. See Stomach, 
 Liver, Bowels, Rupture, Dropsy, &c. &c. 
 It is always proper to keep up sufficient 
 warmth about the abdomen ; and while 
 the feet, the arms and neck are not to be 
 neglected, no considerations of elegance 
 or fashion should induce women to de- 
 prive the abdomen of its due covering 
 and support. It is preposterous to lavish 
 attention on furs at the borders and out- 
 side of the dress, where they can be of no 
 use, while the natural heat is allowed to 
 disperse where nature points out that it 
 should be carefully preserved. Flannels 
 and fleecy hosiery should be worn next 
 the skin. 
 
ABORTION. 
 
 ABORTION, or Miscarriage, (Abor- 
 tus.) The separation of the oflFspring 
 from the mother, at any period before the 
 seventh month ; between which period 
 / and the full time, the same event is called 
 premature labour. 
 
 Symptoms. Abortion may be describ- 
 ed as consisting of two stages, the separa- 
 tion of the embryo from the inner surface 
 of the womb, and its being thrown out of 
 the body by the action of the womb and 
 other expelling powers. For a longer or 
 shorter period before abortion takes place, 
 there is pain in the lower part of the 
 belly or about the back and loins, which 
 gives warning of something wrong being 
 about to happen. Then there is a dis- 
 charge of blood from the external parts, 
 sometimes slight, at other times profuse 
 and alarming ; accompanied or succeeded 
 by sharp pains in the back, the loins, and 
 the lower part of the belly, not constant, 
 but intermitting like those of regular la- 
 bour. Often there is vomiting, sickness, 
 or pains of the bowels, and headach ; and 
 from the quantity of blood lost, fainting 
 fits frequently* occur, and there is com- 
 monly a sense of weakness, much greater 
 than can be accounted for by the copious- 
 ness of the discharge. If, by the efforts 
 of nature or the assistance of art, these 
 symptoms abate or cease, the embryo 
 is retained and continues to grow ; but, 
 in other cases, the discharge of blood 
 continues, and the signs of approaching 
 expulsion of the contents of the womb 
 become more evident. Regular pains en- 
 sue, there is a feeling of bearing down, 
 with a desire to make water, and at last, 
 the foetus comes off, either surrounded 
 with its membranes, if the whole ovum 
 be small ; or the membranes break, the 
 waters are discharged, and the foetus 
 comes away, leaving the after-birth be- 
 hind. If this be long retained, the bleed- 
 ing and other troublesome symptoms con- 
 tinue, with the additional ones of fetid 
 discharge and putrescency. 
 
 Causes. 1. Abortion may be caused by 
 external violence, as kicks or bloM's, a 
 fall, or violent action, as dancing, riding. 
 
 jumping, or much walking. Women in 
 the state of* pregnancy should avoid many 
 of the domestic operations so proper at 
 other times for good housewives to en- 
 gage in. As our aim is to be practically 
 useful, we venture, at the risk of excit- 
 ing a smile, to mention some exertions that 
 ought to be avoided, viz. hanging up cur- 
 tains, bed-making, washing, pushing in a 
 drawer with the foot, careless walking up 
 or down a stair. 2. Straining of the body, 
 as from coughing. 3. Costiveness. 4. Ir- 
 ritation of the neighbouring parts, as from 
 severe purging, falling down of the gut, 
 or piles. 5. Any sudden or strolig emotion 
 of the mind, as fear, joy, surprise. 6. The 
 pulling of a tooth has been knovra to pro- 
 duce a miscarriage ; and though toothach 
 is occasionally very troublesome to wo- 
 men in the pregnant state, the operation 
 of drawing teeth should, if possible, be 
 avoided at that time. 7. Women marry- 
 ing when rather advanced in life, are apt 
 to miscarry. It would be hazardous to 
 name any particular age at which it is 
 too late to marry, but the general obser- 
 vation is worth attending to. 8. Consti- 
 tutional debility from large evacuations, 
 as bleeding, or purging ; or from disease, 
 as dropsy, fever, small-pox. 9. A state 
 the very opposite of this, is sometimes the 
 cause of abortion, viz. a robust and vigo- 
 rous habit, with great fulness of blood, 
 and activity of the vasculai* system. 
 10. The death of the child. 
 
 Treatment. Miscarriage is always an 
 undesirable occurrence, and is to be pre- 
 vented by all proper means, as a single 
 miscarriage may irretrievably injure the 
 constitution, or give rise to continual re- 
 petitions of the accident. Unless we have 
 reason to believe that the <;hild is dead, it 
 is desirable that miscarriage should be 
 prevented, and that the woman should go 
 on to the full time, if possible ; but if the 
 motion of the child should cease, if the 
 breasts of the mother should become soft 
 after disease or great fatigue, and signs of 
 miscarriage come on, it would be impro- 
 per to endeavour to prevent the embryo 
 coming away; and we must direct our 
 
ABORTION. 
 
 3 
 
 efforts to relieve any urgent symptoms, 
 and do what we can to conduct the pa- 
 tient safely through the process. 
 
 When we have determined to attempt 
 checking the discharge and preventing 
 the consequent expulsion, the patient 
 must cease from all exertion in walking, 
 or even sitting upright, and must lie 
 along on a bed or sofa ; all heating food 
 or liquors must be avoided ; whatever is 
 taken should be rather cool, and cold ap- 
 plications must be made to the back, the 
 loins, and neighbouring parts. A lotion 
 useful for this pui'pose, and generally easy 
 to be had, is one part of vinegar to two 
 or three parts of cold water; cloths or 
 towels dipped in this are to be applied as 
 directed above. The fainting which so 
 often occurs, requires to be relieved by a 
 very moderate use of cordials, as a little 
 wine and water, or even brandy and wa- 
 ter ; but in this, much caution is required, 
 lest feverishness or inflammatory symp- 
 toms be brought on, which in a weaken- 
 ed frame are apt to occur, from causes too 
 slight to have the same effect in a healthy 
 one. 
 
 As abortion sometimes takes place from 
 too great fulness of blood, and from that 
 state of the constitution well known by 
 the name of high health, it is right in such 
 cases to employ bleeding, to order a cool- 
 ing diet, as light puddings, preparations 
 of milk, or boiled vegetables ,• and to give 
 gentle laxatives, as castor oil, senna, small 
 doses of purging salts, magnesia and rhu- 
 barb. If, under such treatment, the dis- 
 charge from the womb stops, if the pains 
 cease, and the sickness, headach, and con- 
 stitutional symptoms are relieved, we may 
 hope that the woman Avill not part with 
 her offspring, but bring it to the full time. 
 She must make up her mind to be in the 
 reclining posture for some time, and must 
 consider herself as liable to be affected by 
 the same symptoms and the same danger 
 if she uses the smallest liberty with her- 
 self. 
 
 If the discharge, however, still con- 
 tinues, and if there is little likelihood of 
 the pregnancy going on, every thing must 
 
 be done to assist the woman in the safe 
 completion of the process. We must in- 
 troduce a soft cloth dipped in oil, into 
 the birth, so as to fill the lower part of it. 
 By this means, the blood has time to form 
 into clots, and the contraction of the 
 womb throws down the embryo along 
 Avith them. We should not hastily use 
 any force by the hand to bring it away ; 
 but the time when this may be done is to 
 be left to the judgment of the medical 
 person in attendance. As the after-birth 
 in the early months bears a larger propor- 
 tion to the contents of the Avomb than it 
 does in the later months, it is often re- 
 tained long after the child is expelled ; 
 but it must be remembered, that the 
 womb will not contract till every thing 
 is out of it, and therefore the bleeding 
 will continue till the after-birth is ofl". 
 It may happen to lie partly out of the 
 womb, and if so, the practitioner is to 
 attempt gently to remove it by the hand ; 
 but if it be wholly in the cavity of the 
 womb, its expulsion is to be promoted by 
 clysters of gruel, with the addition of salts, 
 or with senna, or even a little of the tinc- 
 ture of aloes. 
 
 Patients should be careful not to throw 
 away any thing discharged, on the suppo- 
 sition that they know what it is, but 
 should uniformly show every clot to the 
 practitioner, that he may be enabled to 
 distinguish with certainty whether the 
 child and after-birth are thrown off. 
 When the womb is emptied, the belly is 
 to be tied up with a binder, as after deli- 
 very at the full time ; the same rest and 
 quiet is to be ordered ; the diet must be 
 light and nourishing; heating food, al? 
 spirituous and malt liquors, are to b( 
 avoided, till the practitioner judges i 
 proper to allow sulphuric aci'd, bark, ant 
 wine, or porter, to assist in recruiting the ; 
 strength, which in the event of abortion is 
 generally so greatly exhausted. 
 
 A very strong reason for enjoining rest 
 and quietness after a miscarriage is this, 
 that when twins or three children have 
 been conceived, the embryo of one of 
 rthennnay be thrown off, and the other 
 
4 A B S 
 
 may be carried to the full time. Any 
 premature exertion might, therefore, en- 
 danger the life of more than one child. 
 When the woman is in some degree re- 
 cruited, her recovery is to be completed 
 by moderate exercise, by proper diet, by 
 the use of the cold bath or sea-bathing, 
 and by taking stomachic medicines, as the 
 bark, and wine, preparations of iron, or 
 the elixir of vitriol. Few incidents have 
 so pernicious an effect as a miscarriage 
 on certain constitutions ; sometimes the 
 health is irreparably injured, or a habit 
 is begun which prevents the woman from 
 ever carrying a child to the full time. In 
 every future pregnancy particular caution 
 is requisite, especially at the period when 
 the miscarriage foraierly happened, which 
 is very generally between the eighth and 
 twelfth week. For a considerable time 
 before and after this, the woman should 
 lie in the reclining posture, should attend 
 to keeping the bowels easy by such mild 
 laxatives as have been already mentioned ; 
 and if too full, should lose a little blood. 
 
 Sometimes, for wicked purposes, it is 
 attempted to procure abortion, either by 
 strong and acrid medicines, by violent ex- 
 ercises, or by direct application to the 
 parts concerned ; but it should be gene- 
 rally known, that there is no medicine 
 which directly and certainly acts on the 
 womb itself; and that to procure abor- 
 tion by any drug or mechanical violence, 
 is to run the risk of speedy death, of in- 
 ducing madness, or causing irreparable 
 injury to the constitution. 
 
 ABRASION. The destruction of the 
 mucus or slime, M'hich in a healthy state 
 lines various cavities, as the stomach, the 
 bowels, the bladder, &c. Abrasion of the 
 skin signifies when a part of it is struck 
 oiF by violence or any thing rubbing 
 against it. 
 
 ABSCESS. A collection of purulent 
 matter in any part of the body, in conse- 
 quence of previous inflammation. Ab- 
 scesses form after inflammation, both in 
 the internal parts, and in those which are 
 in sight. When inflammation occurs, it 
 would be better if it went off wathout 
 
 A B S 
 
 suppuration or abscess ; but if tliis cannot 
 be prevented, Ave must endeavour to ac- 
 celerate its progress by warm foraenta-^ 
 tions, and by poultices. These are to be 
 made of bread and milk ; oatmeal or lin- 
 seed meal and water, or boiled onions or 
 turnips ; and to promote the ripening of 
 an abscess in the inside of the mouth, a 
 roasted fig or apple may be used. When 
 the tonsils (or almonds of the ear) are 
 tending to suppuration, the patient should 
 draw into the mouth the steam of boiling 
 water, alone, or having a little vinegar 
 added to it. In general, those poultices 
 are best which retain their heat the long- 
 est, and they should be frequently chang- 
 ed, to prevent their becoming cold, and 
 thus having a contrary eflect to what we 
 ■\i'ish them to have. The tendency to 
 suppuration may be known by the inflam- 
 mation continuing long; by the stretching 
 pain becoming less ; by a throbbing sen- 
 sation, and the patient's being affected 
 with cold shiveriiigs. When an abscess 
 forms in a place under our inspection, it 
 is accompanied with swelling, whiteness 
 or yellowness of the skin, and a soft feel, 
 as if there were a thickish fluid in a bag. 
 When matter is formed, it must be dis- 
 charged, and nature endeavours to accom- 
 plish this by causing the matter to have a 
 tendency to the nearest outlet : thus an 
 abscess formed in a fleshy part of the body 
 will point to the skin, one in the lungs 
 will burst into the air cells, and one in 
 the liver, either into the belly or by the 
 side. When the abscess is quite ripe, 
 which is known by the pain being less- 
 ened, and the matter pointing, it is in ge- 
 neral best to give it vent by opening it 
 with a lancet or other clean cutting in- 
 strument ; and this in the position or si- 
 tuation which is lowest, on purpose to let 
 the abscess empty itself by the weight of 
 the fluid. It is better to have a fi*ee vent 
 of our own making than to allow the 
 matter to find its way under the skin to 
 distant and inconvenient parts, or to allow 
 the matter to discharge itself by a ragged 
 and irregular opening. It is almost al- 
 ways proper to make the cut large, as a 
 
A B S 
 
 A B S 
 
 small one is neaiiy as painful, and as it 
 IS liable to close too soon, and thus occar 
 sion the necessity of repeating the opera- 
 tion. When the abscess is large and deep, 
 a small piece of tent should be put be- 
 tween the lips of the wound, that it may 
 close at the bottom ; and this is to be re- 
 newed at each dressing. The poultices 
 are still to be continued, till the thick 
 yellow appearance of the matter changes 
 into a thin watery discharge ; after this 
 it is proper to discontinue them, for fear 
 of relaxing and weakening the parts ; and 
 to dress Aiith cerate or healing ointment. 
 
 In scrofulous abscesses about the neck 
 or face, especially in females, it is a matter 
 of difficulty to determine whether it is 
 best to allow them to burst of themselves, 
 or to raake an opening with the lancet. 
 Whichever of the methods be employed, 
 the discharge is commonly of an un- 
 healthy kind, and continues long ; and a 
 scar remains, for which the surgeon is 
 blamed if he has given vent to the mat- 
 ter. When such abscesses are forming, 
 the surgeon should state the probable 
 course of the aliment, give his advice with 
 prudence and decision, and leave the pa- 
 tient and her friends to decide. 
 
 Another v/ay of letting out matter from 
 an abscess is by caustic, viz. the applica- 
 tion of some acrid substance, which burns 
 or corrodes the skin, and makes an open- 
 ing. Some persons ai-e so afraid of a 
 cutting instrument, that this seems to 
 them a preferable way of opening an ab- 
 scess ; but it should rarely be done, as 
 the pain is greater, and the lilcelihood of 
 deformity is increased. When it is wish- 
 ed, as much as possible to exclude the air 
 from the inside of an abscess, an opening 
 is made by passing a broad cutting needle, 
 for the purpose of bringing through the 
 sides of- the abscess a skein of silk or cot- 
 ton. This is desirable, particularly in 
 lumbar abscesses, or collections of matter 
 coming from the inside of the belly, and 
 pointing at the upper part of the thigh ; 
 as air admitted into them is often found 
 to be the cause of hectic fever, and con- 
 sequent general ill health. See Lumbar 
 Abscess. 
 
 The degree of danger which attends an 
 abscess, depends on its situation and its 
 consequences. If it is situated in the lungs, 
 it may burst into the air cells, and prove 
 fatal by suffocation ; or if in some of the 
 viscera of the belly, it may be effused in 
 the cavity of the peritoneum or investing 
 membrane of the bowels, and excite in- 
 flammation there. Large abscesses are 
 dangerous by the wasting discharge with 
 which they are accompanied ; and by the 
 hectic fever and general symptoms which 
 in certain constitutions follow them. 
 
 ABSORBENT MEDICINES, more 
 properly termed Antacids, seem to de- 
 rive their name from the spunge-like ac- 
 tion of the principal of them, chaUc and 
 magnesia. Their effect is to remove sour- 
 ness and heartburn from the stomach, 
 which they do by combining chemically 
 with an acid existing there. A neutral salt 
 is formed by their union,which finds its way 
 through the bowels, and produces a lax- 
 ative or binding effect according to the 
 absorbent used. Thus if there is sourness 
 of the stomach, known by the disagree- 
 able and painful feeling of heartburn, wa- 
 ter-brash, and sour-belchings, a tea-spoon- 
 ful of magnesia taken into the stomach in 
 water, or any convenient vehicle, will 
 combine A^ith the acid, and a laxative 
 salt will be formed, which will open the 
 bowels gently ; but if, in the same com- 
 plaints, prepared chalk be taken, the ef- 
 fect will be to produce a salt, which has 
 a tendency to occasion costiveness : the 
 state of the bowels is therefore to be at- 
 tended to, in determining our choice of 
 the absorbent to be used. See Chalk, 
 Lime, Magnesia, Carbonate of Potash, 
 Potash. 
 
 ABSORBENT VESSELS. Certain 
 small vessels which take up substances 
 from different cavities or from the sur- 
 face of the body, and convey them into 
 the blood. These substances are, by sub- 
 sequent processes, either removed out of 
 the body, or employed in its nourishment. 
 Those absorbent vessels which carry from 
 the intestines a white fluid, designed in 
 the future stage of its progress to be con 
 verted into blood, are called lacteais 
 
ACE 
 
 A C H 
 
 those which carry a transparent fluid are 
 called lymphatics. It is the absorbent 
 vessels which take into the system medi- 
 cinal substances applied to the surface 
 with the intention of curing diseases, as 
 mercury; and they also introduce acrid 
 or poisonous substances, as the matter of 
 inoculated small-pox or of cow-pox, the 
 poison of some reptiles, and the saliva 
 from the bite of a mad dog. It is the ab- 
 sorbents that carry off the effused blood 
 and other fluids which form the black and 
 blue appearance where a stripe or blow 
 has been inflicted. 
 
 ABSTERGENT. Cleansing or puri- 
 fying ; applied to washes supposed to pu- 
 rify the skin. Not much used by respect- 
 able mtedical writers, though quacks have 
 plenty to say about abstergent lotions. 
 
 ACCESSION. The approach or be- 
 ginning of a disease, or of some particular 
 symptom of it : thus the coming on of a 
 fever, or the beginning of the fit of an 
 ague, is called its accession. 
 
 ACCIDENT. The unexpected and 
 sudden injuries which happen to the body, 
 commonly spoken of by the name of ac- 
 cidents, are so numerous, and may lead to 
 consequences so serious, that every per- 
 son should be a^vare of their probable oc- 
 currence, and should acquire the know- 
 ledge and presence of mind necessary to 
 treat them properly till medical assistance 
 can be procured. Under the following 
 heads will be found directions for treat- 
 ing the most frequent of them : Burns, 
 Scalds, Cuts, Faixs, Fractures, Dislo- 
 cations, Bruises, Contusions, Wounds. 
 
 ACCOUCHEUR. A medical person 
 who attends women in delivery; or who par- 
 ticularly attends to the treatment and dis- 
 eases of women during their confinement. 
 
 ACESCENT. A term applied to food 
 or substances taken into the stomach, 
 which are apt to become sour. 
 
 ACETABULUM. The deep hoUow 
 in the haunch bone, in which the round 
 head of the thigh bone is received and 
 moves. It forms a joint of the ball and 
 socket kind, admitting of free motion in 
 every direction. A strong ligament grows 
 from the summit of the round head of the 
 
 thigh bone, and is attached near the bot- 
 tom of the cup-like cavity. The thigh 
 bone may be dislocated from the cavity 
 in various directions ; and the joint is the 
 seat of the distressing and dangerous af- 
 fection commonly called the hip-disease. 
 See Dislocations and Hip-disease. 
 
 ACETATE. A salt, in which the ace- 
 tic acid or vinegar is combined with an 
 alkali, an earth, or the oxyd of a metaL 
 The acetate of lead, known by the name 
 of the sugar of lead, is composed of the 
 acetic acid and the oxyd of lead. See 
 Sugar of Lead. 
 
 ACETIC ACID. See Vinegar. 
 
 ACHILLIS TENDO. The name by 
 which anatomists designate the strong si- 
 new which is continued from the fleshy 
 part of the back of the leg to the bone of 
 the heel. It is so called from the fabulous 
 story in the Grecian poetry, which re- 
 lates that the mother of AchiUes held him 
 by the heel when dipping him in the Styx 
 to render him invulnerable. This tendon 
 is a conspicuous object in the living body. 
 It is sometimes broken by the action of 
 the muscles, in dancing, leaping, and other 
 violent exertions. The patient seems to 
 hear a crack as of a Avhip, or as if he had 
 broken a nut with his heel. Sometimes 
 awkward reapers cut the tendon of their 
 companion's heel with the sickle. When 
 this tendon is cut or ruptured, the power 
 of extending the foot is lost, and the pa- 
 tient becomes lame. The cure depends 
 on keeping the broken ends together by 
 a contrivance which bends the knee and 
 extends the foot or ankle joint. The fol- 
 lowing, which was used in the case of the 
 first Dr. Monro, will give some idea of the 
 contrivance aUuded to : " A footsock or 
 slipper was made of double-quilted tick- 
 ing, from the heel of which a belt or strap 
 projected, of sufficient length to come up 
 over the calf of the leg. A strong piece 
 of the same materials was prepared, of 
 sufficient breadth to surround the calf, and 
 this was fastened with lacings. On the 
 back part of this was a buckle, through 
 which the strap of the footsock was 
 passed, so that the foot could be extend- 
 ed, and the calf brought down at plea- 
 
A C I 
 
 A C I 
 
 sure." It must be remembered that the 
 bending of the knee joint is partly per- 
 formed by the upper part of the muscles 
 of the calf, which are inserted into the 
 ends of the thigh bone, and therefore if 
 the knee be stretched, this will tend to 
 draw asunder the separated portions of 
 the injured tendon. Much caution is re- 
 quisite for many weeks or even months 
 after the accident ; and even through life 
 it is prudent to abstain from all violent 
 and irregular exercise. 
 
 ACID. A substance possessed of the 
 following assemblage of properties: A 
 sour taste, the power of changing the 
 vegetable blue colours into red, and of 
 combining with alkalis, with earths, and 
 with metallic oxyds. Acids are a class of 
 bodies of great importance in chemistry, 
 in pharmacy, and in medicine. Some 
 acids, as the sulphuric, nitric, and muriatic 
 acids, have a very powerful action, and 
 corrode or destroy animal and vegetable 
 substances. Most acids, when properly 
 diluted and taken internally, are cooling, 
 and obviate the tendency to putrefaction, 
 whicli they also do out of the body. 
 
 Acids may be divided into mineral,^ 
 animal, and vegetable, according to the 
 kingdom of nature from which they are 
 derived. The principal acids from the 
 mineral kingdom are the sulphuric or 
 vitriolic, the nitric, the muriatic, the car- 
 bonic, the fluoric ; from the animal king- 
 dom, the phosphoric, the prussic, and the 
 uric. The vegetable acids are very nu- 
 merous, as the acetic acid or vinegar, the 
 oxalic, the tartaric, the citric, the malic, 
 the benzoic, &c. Under each acid that 
 is used in medicine or for domestic pur- 
 poses, shall be stated such properties as 
 are likely to interest the general reader. 
 
 ACIDITY OF THE Stomach. A disa- 
 greeable sensation as of sour air or liquids 
 discharged upwards from the stomach. 
 Many articles of diet are apt to cause this 
 acidity in stomachs whose powers of diges- 
 tion are impaired; andinsome constitutions 
 otherwise perfectly healthy, certain arti- 
 cles of diet give rise to it. Butter, pastry, 
 fish, vegetables, and astringent wines, as 
 
 also broths, especially those of veal and 
 lamb, are to be avoided by those who have 
 this tendency to acidity. In certain stages 
 of the process of digestion, the food be- 
 comes sour, but being counteracted by the 
 healthy secretions of the stomach, no in- 
 convenience arises from it. If the stomach 
 secrete a vitiated gastric juice, the symp- 
 toms of acidity will show themselves. 
 
 Treatment. As acidity is often con- 
 nected with accumulations in the bowels, 
 it is proper to begin our measures for re- 
 lief by giving a purgative medicine, as 
 three grains of the extract of colocynth, 
 M'ith two or three of calomel. The medi- 
 cines described under the title of absor- 
 bents, are to be used in acidity of the 
 stomach, viz. a tea-spoonful of magnesia, 
 or of prepared chalk in a little water ; and 
 these, combining with the acid in the sto- 
 mach, form a salt either innoxious or 
 salutary. This will remove the evil for 
 the present, but a permanent cure must 
 be attempted by a proper regimen, by 
 avoiding articles of food which have been 
 found to disagree, and by the use of gen- 
 tle laxative medicines. Vegetable bitters, 
 with the addition of an aperient salt, are 
 useful in strengthening the stomach. An 
 infusion of quassia to the extent of half 
 an ounce or six drachms, with a drachm of 
 tartrate of potash, and a drachm of tincture 
 of cinnamon, form a good draught for this 
 purpose ; and may be taken twice a-day 
 for a week or two, till the digestion is 
 mended, and the acidity removed. See 
 Stomach Complaints. 
 
 ACIDITY IN Children. The stomachs 
 of children are peculiarly liable to be dis- 
 ordered with acidity. This is attended 
 with very troublesome laxity of the bow- 
 els, indigestion, and feverish symptoms. 
 See Infants, Diseases of. 
 
 ACIDULOUS. A term applied to cer- 
 tain mineral waters having a soiu-ish taste 
 and sparkling appearance, from the quan- 
 tity of fixed air or carbonic acid gas which 
 is diffused through them. Examples of 
 acidulous waters are to be found in those 
 of Pyrmont, Seltzer, Spa, Carlsbad, and 
 Scarborough. They are tonic and diuretic, 
 
A C 11 
 
 A C U 
 
 and in large doses, they produce for a time 
 a degree of excitement or cxliilaration. 
 
 ACONITE, LARGE BLUE WOLFSBANE, 
 
 Monk's hood, (Aconitum Napellusjy a 
 plant found in different parts of Germany, 
 and cultivated in our gardens. Its ef- 
 fects on the animal body are narcotic or 
 Btupifying ; its active qualities appear to 
 reside chiefly in the root. When chewed, 
 a slight sensation of acrimony is first per- 
 ceived, afterwards the point of the tongue 
 appears to lose its feeling, and a sharp 
 heat of the mouth succeeds, followed by 
 trembling and chilliness. The fatal symp- 
 toms are convulsions, giddiness, loss of 
 reason, violent purging, faintings, cold 
 sweats, and death. If it be soon discover- 
 ed that a person has swallowed any of 
 this poisonous substance, the stomach 
 must be quickly evacuated; and one of 
 the readiest means of doing this is to give 
 thirty grains of sulphate of zinc, (white 
 vitriol) dissolved in water. If this is not at 
 hand, a spoonful of table mustard, or large 
 draughts of warm water may be tried ; but 
 when the poison itself has brought on the 
 vomiting and other bad symptoms, we 
 must endeavour to allay them by brandy, 
 ether, or other cordials, though our hopes 
 of doing so cannot be sanguine. About 
 sixty years ago, this substance was em- 
 ployed in medicine, first by Dr. Storck of 
 Vienna ; and, like most substances newly 
 discovered or newly applied, Mas highly 
 extolled; but it is now less used than for- 
 merly. The extract or inspissated juice 
 is said to have a beneficial effect in some 
 cases of chronic rheumatism, and in some 
 of intermittent fever, connected with dis- 
 ease of the viscera or internal organs. 
 The dose is from half a grain to two grains. 
 ACOUSTICS. The science which 
 treats of hearing, and the propagation of 
 sound. 
 
 ACRID. Sharp, heating, irritating, or 
 corrosive. It is sometimes used as a noun ; 
 thus we speak of chemical acrids. 
 
 ACRIMONY. A quality of a fluid or 
 humour by which it irritates, corrodes, or 
 dissolves any part of the animal body; 
 Thus the discharge from caucerou* •yid 
 
 other sores is distinguished by great acri- 
 mony. 
 
 ACROMION. The top of the shoul- 
 der blade. 
 
 ACTION. A word of pretty various 
 and extensive meaning in medical and 
 physiological science. We talk of the 
 action of remedies, meaning the effect 
 which they produce on the body ; of the 
 action of the muscles, meaning the mo- 
 tions they perform ; and when an ulcer 
 remains long without alteration for the 
 better or worse, we say it wants action. 
 The' word action is sometim.es used as 
 synonymous with function ; thus the ani- 
 mal or vital actionsy mean the animal or 
 vital functions. 
 
 ACTON WATER. A purging water 
 procured from Acton, a village near Lon- 
 don. 
 
 ACTUAL CAUTERY. A method of 
 burning or coiToding by a heated or flam- 
 ing body, as distinguished from potential 
 cauteiy, where the same effect is produ- 
 ced by chemical substances of a corrosive 
 nature. Burning by heated iron, by the 
 burning of moxa or cotton, are instances 
 of the use of the actual cautery. Burn- 
 ing with a hot iron is sometimes neces- 
 sary to stop bleeding in the m.outh, where 
 blood-vessels cannot be reached in the 
 usual way ; and it is often of service in 
 assisting nature to throw off parts of dis- 
 eased bones. The actual cautery has been 
 proposed in rheumatism and other painful 
 affections. 
 
 ACUTE. A term applied to diseases 
 which are attended with severe or pain- 
 ful symptoms, and which generally nm 
 their course in a short time. Distinguish- 
 ed from acute, are chronic diseases, slower 
 in their progress, less alarming in their 
 symptoms. Fevers, croup, and pleurisies, 
 are acute diseases ; stomach complaints, 
 dropsy, consumption, and cancer, ai'e ex- 
 amples of chronic diseases. Rheimiatism 
 is acute at first, but in many instances is 
 apt to become chronic. Acute diseases 
 are never to be neglected, or trusted to 
 nature, but require speedy and activo 
 treatment. 
 
ADI 
 
 AFF 
 
 ADEPT S. A term borrowed from the 
 alchymists, who spent their time, their 
 labour, and their fortune, in seeking for 
 the philosopher's stone. Those who were 
 thought, or who pretended to liave got 
 it, were called adepti. The terra is now 
 used, but somewhat in a ludicrous sense, 
 for those who are skilful in any pursuit. 
 
 AI5HESION. A growing together of 
 parts. The siu*faces of neighbouring parts, 
 when deprived of the skin, and not kept 
 carefully separate in the progress of cure, 
 are apt to adhere or grow together; for 
 instance, if several of the fingers be burnt, 
 they would probably grow together, if 
 not dressed separately. See the next ar- 
 ticle. 
 
 ADHESIVE INFLAMMATION, is 
 that which is followed by the growing 
 together of pai'ts. Certain fine mem- 
 l)ranes of the body, when affected with 
 inflammation, are apt to grow to the 
 neighbouring parts. For instance, the 
 chest is lined with a smooth membrane 
 which also covers the lungs, and in the 
 healthy state, the lungs are quite freely 
 moved within the chest ; but inflamma- 
 tions of this membrane are so common, 
 and so frequently followed by a more or 
 less extensive union of the lungs to the 
 inner surface of the chest, that a great 
 proportion of the bodies examined by 
 surgeons after death, are found to liave 
 adhesions in the chest; and vre therefore 
 conclude that in some period of their lives 
 they had been affected with inflammation. 
 It is on the adhesive inflammation that 
 the modern operation for the cure of 
 aneurism depends. A narrow L'gature 
 being tied round an artery, cuts through 
 its internal and middle coats', and from 
 the inner surface of the vessels a clear 
 lymph is poured out, which joins the two 
 sides of the vessel by the adhesive in- 
 flammation. 
 
 ADHESIVE PLASTER. See Diat 
 
 CHYLON. 
 
 ADIPOCERE. A term invented by 
 the French chemists to signify the sub- 
 stance resembling spermaceti, into whicli 
 animal mii^de is converted, by being ex- 
 
 posed to a stream of running water; and 
 which is also found where large masses of 
 putrefying animal matter are heaped to- 
 gether, as in certain burying-grounds. 
 
 ADIPOSE MEMBRANE. The cel- 
 lular texture of the body, considered as 
 inclosing the fat in its cells. 
 
 ADVENTITIOUS. Any thing that 
 accidentally, and not in the common 
 course or progress of a disease, occurs in 
 the system, is said to be adventitious. 
 
 ^THER. A liquor highly volatile 
 and inflammable, fragrant, and pungent 
 to the taste. It is prepai-ed by adding 
 together acids and spirit of wine, and dis- 
 tilling with great caution. The ether, 
 which is the produce of distillation, varies 
 according to the acid used; hence we 
 have sulphuric, nitric, muriatic, and ace- 
 tic ethers. The ether in most frequent 
 use is the sulphuric. It is used inter- 
 nally as a stimulant and cordial, and to re- 
 lieve cramps, and other uTegular actions of 
 the system. It is given to persons in asth- 
 ma, hysterics, and convulsions ; and when 
 certain vegetable poisons have brought on 
 alarming debility, it is employed to rouse 
 the system into action. The dose inter- 
 nally is half a tea-spoonful in water ; or 
 the like quantity with twenty or twenty- 
 five drops of laudanum, and half a glass 
 of water. By its volatility and rapid 
 evaporation, it may be made to produce 
 a great degi-ee of cold on the sui-face of 
 the body, and it is hence used to allevi- 
 ate the pain of toothach and headach. 
 A portion is placed in the hollow of the 
 hand, and the hand being put on the 
 part affected, great heat is produced ; and 
 by the sudden removal of the hand, the 
 ether is allowed to evaporate, and the 
 cold that follows sometimes relieves the 
 pain. (Jreat care should be taken to 
 keep lighted paper, or candles, at a dis- 
 tance from the vessels in which ether is 
 kept. 
 
 AFFECTION. The state ofbeing af- 
 fected with any morbid condition or ac- 
 tion. Thus we say, a person labom-s un- 
 der a febrile affection^ or has an affection 
 of the skin. 
 
10 
 
 AFF 
 
 AFT 
 
 AFFINITY. A term used in chemis- 
 try to denote the tendency of different 
 substances to combine chemically toge- 
 ther : thus acids and alkalis combine by 
 chemical affinity ^ and form neutral salts. 
 
 AFFUSION. The appUcation of cold 
 to the surface of the body by dashing or 
 pouring cold water upon it. To Dr. 
 Currie of Liveri)ool, chiefly, we are in- 
 debted for the application of the cold af- 
 fusion in the cure of fevers and some 
 other diseases. In the fever commonly 
 known by the name of typhus^ the effects 
 produced are wonderfiilly beneficial ; but 
 it is a remedy of apparent harshness 
 and of real hazard, and requires a dis- 
 criminating judgment to determine the 
 propriety of its employment. The cold 
 ^ fusion must not be attempted during 
 the shivering which commonly com- 
 mences the paroxysm of fever ; it should 
 not be used when the heat of the body, 
 as measured by the thermometer, is un- 
 der 97° or 98°, the natural standard ; and 
 it is exceedingly dangerous when there 
 is general and profiise perspiration. 
 
 The effects of the cold affusion on pa- 
 tients in fever, when used judiciously, 
 are found to be a diminution of the fe- 
 verish and irritating heat, abatement of 
 the thirst, refreshing sleep, and gradual 
 restoration to health. Beneficial, how- 
 ever, as the cold affusion unquestionably 
 proves in various febrile diseases, it is 
 now much seldomer employed than for- 
 merly ; effects nearly as good may be ob- 
 tained by general or partial spimging of 
 the body with water, cold or tepid, either 
 filoue, or mixed with a little vinegar ; and 
 modern experience has considerably al- 
 tered the theory and practice of physi- 
 cians in typhus Avithin the last thirty 
 years. Still, however, the judicious 
 practitioner will not forget that he has, 
 in the timely use of the cold affusion or 
 spunging, a remedy of great efficacy, and 
 of much utility in the abodes of filth and 
 poverty; as also in naval and military 
 practice, where the sufferers are general- 
 ly strong and robust, and where cheap 
 and speedy remedies are of pruna^y im- 
 
 portance. In the scarlet fever, it is still 
 employed with the happiest results; and 
 provided the medical man, or even the 
 sensible parent, or nurse in charge of pa/- 
 tients in this disease, attends to the heat, 
 the dryness of skin, the thirst, and other 
 violent inflammatory symptoms, they may 
 with great safety, and with the most de- 
 cided benefit, either spunge or bathe the 
 sufferer, and will be delighted with the 
 prompt and soothing effects that ensue. 
 Care must be taken not to use the cold 
 bath in the decline of the fever, or when 
 much putrescence of the throat and sys- 
 tem is present, as at that time the powers 
 of nature are feeble, and would probably 
 be overpowered by so active a practice. 
 In a few hours the washing may be re- 
 peated, and the patient, in many cases, 
 will be so sensible of its good effects as 
 to beg its repetition. Internal remedies 
 must be used at the same time. See 
 Scarlet Feveb. 
 
 AFTER-BIRTH. The thick and 
 spungy cake by which the embryo is at- 
 tached to the internal surface of the 
 AAomb, and which in healthy and ordi- 
 nary labour is thrown off by the contrac- 
 tions of the womb in what is called the 
 third stage of labour. When it is retain- 
 ed too long, it may give rise to flooding ; 
 and, therefore, its expulsion is to be gent- 
 ly solicited by rubbing the belly with the 
 hand. If a delay of more than an horn- 
 should take place between the delivery 
 of the child and the coming away of the 
 after-birth, it will be necessary for an ex- 
 perienced practitioner to interfere. 
 
 AFTER-PAINS. In the child-bed 
 state, women are not unfrequently dis- 
 tressed with sharp pains in the belly, back, 
 and loins, recurring at intervals for seve- 
 ral days after delivery. These resemble 
 the pains of labour, being, however, some- 
 what slighter in degi*ee. They i-arely 
 continue above two or three days, and 
 are not attended with any danger. They 
 seldom are troublesome during a first in- 
 lying, but afterwards they are more fre- 
 quent, in proportion to the number of 
 children a woman has had. One great 
 
AG U 
 
 AG U 
 
 n 
 
 matter is, to be sure that the pains com- 
 plained of are after-pains, and not the 
 effect of some more serious disease, as 
 inflammation. After-pains are distin- 
 guished by being alternated with inter- 
 vals of ease, and by being generally at- 
 tended mth the discharge of some coagu- 
 lated blood from the womb ; pain is not 
 excited by pressure on the belly. Other 
 symptoms, along with the pains, indicate 
 the existence of some other disease. Af- 
 ter-pains are alleviated by giving an opiate 
 shortly after delivery, and repeating the 
 medicine in smaller doses every six or 
 eight hours, taking care not to injure the 
 nervous system by too much opium, nor 
 to bring on constipation of the bowels. 
 Warm flannels may be applied to the low- 
 er part of the belly, and in some cases an 
 opiate clyster may be required. 
 
 AGARIC. A spungy substance ob- 
 tained by drying certain excrescences 
 which grow on oak stumps ; sometimes 
 it has been used to stop bleeding. 
 
 AGGLUTINATION. The sticking 
 together of substances or of parts of the 
 body. 
 
 AGRIMONY, Agrimonia Eupatoria. 
 A plant, believed to be slightly astringent, 
 but in this country little used. 
 
 AGUE. The popular English name for 
 Intermittent Fever. Ague is principal- 
 ly applied to the cold stage. The whole 
 disease is vulgarly called Fever and Ague. 
 
 Symptoms. This fever consists of va- 
 rious fits or paroxysms, each of whicli is 
 made up of three stages or successions of 
 symptoms. These stages are the cold, 
 the hot, and the sweating stages. When 
 the sweating stage is finished, the patient 
 is free of complaint, or the disease inter- 
 mits till a future period, when the same 
 stages as before succeed each other. The 
 time during which the patient is free of the 
 tlisease varies in different kinds of intermits 
 tent fever, and gives its nameaiid character 
 to the disease. If the stages run through 
 their course every day, it is called a quo- 
 tidian ague; if they begin again every 
 third day, a tertian; if every fourth day, 
 a quaitan. Several minuter varieties oc- 
 
 cur, with which it is unnecessary to 
 trouble the general reader. 
 
 The following is a description of the 
 paroxysm of an ague. 
 
 Cold Stage. The person is affected 
 first, with a languor, or sense of weak- 
 ness and faintishness, is unwilling to make 
 any exertion, feels uneasiness in doing so, 
 and frequently yawns and stretches him- 
 self. At the same time, the face and 
 other parts of the body become pale, the 
 features shrink, and the skin appears as 
 if cold had been applied to it. At the 
 coming on of these symptoms, some cold- 
 ness of the hands and feet, though little 
 taken notice of by the patient, may be 
 perceived by another person. At length 
 the patient himself feels a sensation of 
 cold, commonly first in his back, but pass- 
 ing thence over the whole body ; and now 
 his skin feels warm to another pereon. 
 The patient's sense of cold increasing, a 
 tremor occurs in all his limbs, with fre- 
 quent shiverings of the trunk of the body. 
 When this sense of cold and its effects 
 have continued for some time, they be- 
 come less violent, and are alternated with 
 Avarm flushings. Vomiting sometimes 
 occurs in the cold stage. 
 
 Hot Stage. By degrees the cold goes 
 off entirely, and a heat greater than na- 
 tural prevails, and continues over the 
 Avhole body. With this heat, the colour 
 of the skin returns, and a preternatural 
 redness appears, especially in the face. 
 Whilst the heat and redness come on, the 
 skin is relaxed and smooth, but for some 
 time continues dry. The features of the 
 face, and other parts of the body recover 
 their usual size, and become even some- 
 what swollen. In this state, it is not un- 
 usual for delirium and other affections 
 of the intellectual functions to come on. 
 
 Sweating Stage. When the heat, red- 
 ness, and fulness have increased and con- 
 tinued for some time, a moisture appears 
 upon the forehead, which gradually be- 
 comes copious, and extends over the whole 
 body. As the sweat flows, the heat of 
 the body abates ; the sweat, after continu- 
 ing some time, gradually ceases ; the body 
 
IS 
 
 AGUE. 
 
 returns to its usual heat, and most of the 
 functions are restored to their ordinary 
 state. 
 
 The Period of Intermission. It is 
 hardly to be expected, however, that after 
 80 much derangement of the system as 
 necessarily occm*s during the three stages 
 of an intermittent fever, matters should 
 return completely to the healthy state ; 
 accordingly, the pei*sou does not feel quite 
 well on the intervening days; and in 
 weakly constitutions there is much de- 
 rangement of the health, and instead of 
 complete intermission, there is only a 
 slight abatement of the feverish sjrmptoms. 
 In general, with wonderful regularity, 
 these symptoms again appear, and again 
 run their course at an interval, varying 
 according to the type or character of the 
 fever; and if not obviated by proper re- 
 medies, they weaken the constitution, lay 
 the foundation for diseases of the inter- 
 nal organs, which lead to dropsy or com- 
 plaints that prove fatal. 
 
 Causes. It is now generally agreed 
 among physicians, that the only cause of 
 intermittent fevers is the bad air arising 
 from marshy grounds, where animal and 
 vegetable remains run into putrefaction, 
 probably by the breathing introduced 
 into the body. Hence agues ai-e rare in 
 dry, well cultivated lands ; and common 
 in marshy, fenny countries, where water 
 is allowed to stagnate, and animal and ve- 
 getable matters are allowed to putrify. 
 So evidently does this disease arise from 
 the air blown from marshes, that in coun- 
 tries where certain winds prevail mu^ch, 
 and blow over fenny tracts of country, 
 agues are common among the inhabitants 
 to leeward of them ; M'hile others equally 
 near to the tainted spots, but to wind- 
 ward of them, continue healthy. In- 
 stances have been known of militia regi- 
 ments, raised in healthy counties of Eng- 
 land, losing their florid and robust look, 
 characteristic of the English peasantry, 
 and sending numbers of their men to hos- 
 pital, ill of ague, when quartered in 
 marshy districts. The ague has been in- 
 troduced into ships at anchor in a river 
 exposed to the land wind of marshes. 
 
 M'hile others in the same situation, have 
 escaped the sickness by taking the pre- 
 caution of shutting the ports on the side 
 whence the wind blew. 
 
 When a person has once had a severe 
 ague, he is very subject to its recurrence, 
 from causes difficult to know or to avoid. 
 A person may have had an ague in Hol- 
 land, or the West Indies, have been per- 
 fectly cured of it; and ten or twenty 
 years after he may be seized again in a 
 country, where agues among the inhabi- 
 tants are hardly known. The east wind 
 seems to have wonderful influence on 
 such occasions; and it is generally a 
 hopeless task to attempt the cure of an 
 ague when the wind blo\^'s from that un- 
 genial quarter. Irregularities in diet, 
 disorder of the bowels, and some obscure 
 causes seem also to render relapses more 
 frequent. Agues are more common in 
 spring and autumn than at other seasons 
 of the year. 
 
 Prognosis. The degree of danger at- 
 tending an ague, is to be estimated by 
 considering a variety of particulars, as 
 the season of the year, the situatioa of 
 the place, the type of the fever, the vio- 
 lence of the attacks, and the postponing 
 or anticipating of the paroxysms. The 
 agues of spring are least dangerous, and in 
 popular opinion, have even been regarded 
 as salutary to th« constitution ; those of 
 autumn are more malignant, and are apt 
 to induce putrescent symptoms, and fatal 
 exhaustion. •The agues of warm climates 
 are more quickly dangerous to life than 
 those of more temperate regions; but 
 even there, cases occur of considerable 
 severity, and relapses are not unfrequent. 
 The fever of the most manageable type is 
 the simple tertian; the quotidian, the quar- 
 tan, the double tertian, and other complica- 
 tions are more difficult of cure. " The at- 
 tack of intermittents is sometimes attend- 
 ed with the most alarming symptoms, 
 such as syncope, apoplexy, a great load 
 on the chest, with threatening suffocation, 
 epileptic paroxysms or violent spasms, or 
 a coldness, which increases till the patient 
 sinks into torpor, soon followed by death. 
 These arc circumstances of peculiar dan- 
 
AGUE. 
 
 13 
 
 ger, and require the most minute atten- 
 tion. The hot fit is also sometimes so vio- 
 lent as to be attended Avith delirium, and 
 occasionally with rupture of the vessels." 
 {Fk-RR^s Medical Dictionary.) When the 
 paroxysms are later of coming on,we hope 
 the disease is abating- ; and the reverse, 
 when they come on earlier. Like most 
 diseases, agues are attended with more 
 danger in aged debilitated constitutions, 
 that in the robust and vigorous. When 
 King James I. was attacked with the 
 ague of whicli he died, in March, 1625, 
 he was reminded that an ague in the 
 spring is physic for a king; but he veiy 
 properly replied, that the proverb was 
 meant of a young king. 
 
 No ague, however slight it may appear, 
 and at whatever season, should be suf- 
 fered, without opposition, to repeat its 
 paroxysms ; as it is apt to lay the founda- 
 tion of disorders in the internal parts, and 
 particularly to induce a swelling and 
 hardness of the spleen, which may lead 
 to dropsy and prove fatal. 
 
 Treatment. \. In the cold stage. When 
 a patient residing near marshy gi'ound, 
 after feeling uuAvell for some time, losing 
 his complexion, looking sallow, and be- 
 coming feeble, is at last seized with the 
 regular coldness and shivering, which 
 usher in the first stage of an ague, means 
 are to be employed to shorten this by 
 giving warm drinks, as gruel, barley water, 
 tea, or the like ; putting him to bed, and 
 supplying sufficiency of bedclothes. It 
 is imprudent to give wine or spirits, as 
 this might make the hot stage violent 
 and alarming. It would, on the other 
 hand, be also highly dangerous to do 
 any thing that would lessen the vigour 
 of the system, as bleeding or gi^dng cold 
 drink. 
 
 2. In the hot stage. When the hot 
 stage is formed, it has been found an ex- 
 cellent practice to give a full dose of lau- 
 danum, as forty drops, in a warm vehicle; as 
 this has the effect of quickly bringing on 
 the sweating stage, which nature employs 
 as the means of quieting the system, and 
 restoring the functions to their ordinary 
 state. In the hot stage, if there is great 
 
 determination to the head, or violent local 
 pain, with much throbbing and strength 
 of pulse, blood-letting for once or twice 
 is allowable and even necessary, but it is 
 not safe to repeat it in various successive 
 paroxysms. 
 
 3. In the sweating stage. The manage- 
 ment of the patient in the sweating stage 
 consists in taking care that the sweat be 
 not suddenly checked ; and that it do not 
 continue too long or too profusely. The 
 bedclothes are to be cautiously reduced 
 in quantity, mild drinks to be given, but 
 not too hot; and if there is an inclination 
 to sleep, it ought to be indulged. 
 
 4. In the intervals of the paroxyms. 
 When one paroxysm is over, the patient 
 must take care not to expose himself to 
 cold or damp, to a fresh application of the 
 marsh effluvia, to any thing likely to dis- 
 order the stomach, nor to any thing likely 
 to agitate or depress the mind. The great 
 business now is to prevent a repetition of 
 the fits, and so to establish a permanent 
 freedom from them. This is hardly to 
 be expected at the first interval ; the 
 most to be hoped for is, that we may 
 make the second attack to be later of 
 coming on, until by gradual successions 
 of postponed paroxysms, the disease abates 
 its severity or ceases its attacks. Many 
 remedies have been proposed for the cure 
 of agues ; many of them, obviously quite 
 unlikely to have any effect on any disease 
 whatever, unless by their influence on the 
 patient's mind, and by that medium on 
 the corporeal frame. Such are the dis- 
 gusting expedients of swallowing a live 
 spider, or holding a toad in the hand till 
 it dies, or splitting a hard boiled e^^^ and 
 applying the portions of it to the wrist, 
 or exciting terror or surprise. Happily, 
 however, there is one medicine of great 
 efficiency in the cure of intermittent fe- 
 vei*s, and M'hich rarely disappoints the 
 hopes of those who employ it. .This va- 
 luable substance is the Peruvian Bark. 
 It is to be given liberally between the 
 paroxysms, in any liquid that may be most 
 convenient for the patient. A spoonful, 
 or even two, given in wine, or milk, or 
 water, every second hour, especially on 
 
14 
 
 AGU 
 
 A IR 
 
 the day previous to the expected fit, will 
 often have the effect of postponing, and 
 ultimately curing the disease. 
 
 The Peruvian bark is in general safe, 
 though in some constitutions it is apt to 
 occasion sickness and vomiting. When 
 this takes place, from five to ten drops 
 of laudanum may be added to each dose ; 
 and a few drops of the elixir of vitriol, 
 or of tae diluted sulphuric acid, have an 
 additional good effect. Modern chemis- 
 try has extracted from yellow bark a sub- 
 stance having some of the properties of 
 an alkali, to which the name of quinine 
 has been given. This, combined with 
 sulphuric acid, forms the sulphate of qui- 
 nine, eight grains of which are equivalent 
 to an ounce of bark. By this happy dis- 
 covery, we get rid of all the inert matters 
 of the bark, which are apt to load the 
 stomach and bowels, and we possess a 
 substance which in small bulk has all the 
 activity of the bark, and which may be 
 given even to very delicate patients, and to 
 children, in many of whose complaints 
 bark is highly necessary, but from its 
 bulk and nauseousness cannot be given 
 in sufficient quantity. Two grains of 
 sulphate of quinine may be given, made 
 with conserve of roses into a pill, or dis- 
 solved in the infusion of roses, or in well 
 diluted sulphuric acid. 
 
 A medicine of great efficacy in the cure 
 of ague is arsenic in certain preparations ; 
 but it is a substance of such virulent acti- 
 vit}'^, that no person should presume to 
 prescribe it except a practitioner of cau- 
 tion and experience. 
 
 The best form of employing it, is what 
 is called Dr. Fowler's solution, an account 
 of which will be found under Arsenic, but 
 there are very few cases indeed of ague, 
 wliich may not be treated successfully by 
 milder and less hazardous remedies. 
 
 Other circumstances, besides the giv- 
 ing of these drugs, must also be attend- 
 ed to ; the bowels are to be kept open 
 by neutral salts, as the sulphate of mag- 
 nesia, the sulphate of soda, or Rochelle 
 salts ; by calomel joined with rhubarb, 
 or with jalap; or by the infusion of ta- 
 
 marinds and senna. lattle progress in 
 the cure can be expected unless the pa- 
 tient be removed from the neighbourhood 
 of marshy ground ; the continuance of an 
 easterly wind will retard the cure ; and 
 for a long period, the same wind will be 
 apt to bring a relapse of the disease. The 
 agues of spring are often accompanied by 
 inflammatory symptons ; for which bleed- 
 ing and the other remedies useful in that 
 state are to be employed ; while those of 
 autumn are more of a putrid and malig- 
 nant nature, and require a very free use 
 of the bark, with wine and other stimu- 
 lants and cordials. 
 
 Means of Prevention. Persons who 
 are exposed to the air of marshes should 
 use yarious measures of precaution to 
 prevent, if possible, the attacks of ague. 
 They should use a diet generous, but not 
 intemperate, with a moderate quantity of 
 wine ; they should not expose themselves 
 to the dews of night, and should be care- 
 ful to keep closed the windows and doors 
 of the sides of their dwellings from whi(;h 
 the wind may blow the effluvia from the 
 marshes. When military or naval expe- 
 ditions are conducted to climates where 
 agues are common, humanity as well as 
 prudence should enforce on the minds of 
 those in command, the duty of preventing 
 by every means the bad effects of the 
 unhealthy place, by choosing a proper si- 
 tuation for their camp, and stationing the 
 ships, M'heu practicable, out of the sphere 
 of the malignant influence. The disease 
 which was so fatal to the British at Wal- 
 cheren, in 1809, was the autumnal ague 
 in its most destructive form. 
 
 AGUE CAKE. The popukr name 
 for a hard swelling on the left side of the 
 belly, which is frequently owing to the 
 enlargement of the spleen after intermit- 
 tent fevers. When the Peruvian bark 
 was first introduced, many bad properties 
 were ascribed to it, and among others it 
 was said to be the cause of this swelling 
 of the spleen ; but that was owing to the 
 disease, and not to the medicine. 
 
 AIR. An invisible elastic fluid, of 
 which there are several kinds, varying 
 
A IR. 
 
 15^^ 
 
 from one another as much in their pro- 
 perties as the josser fluids, oil, water, 
 and mercury, diifer from one another 
 The term airy when used without any 
 addition, is now restricted to mean com- 
 mon ail*, or the air of the atmosphere ; 
 other elastic fluids being called gases, 
 when cold does not condense them j and 
 vapoursy when it does. Thus we have 
 hydrogen ^aSy or inflammable air, perma- 
 nent at all temperatures ; and the vapour 
 of water, or steam, which is condensed 
 by cold. We shall now mention some 
 particulars respecting atmospherical or 
 common air. The researches of modern 
 chemistry have determined that the at- 
 mosphere is not a uniform fluid, but a 
 mixture of two principal elastic fluids, 
 with a few others in veiy minute propor- 
 tions, and that it holds in solution a vary- 
 ing quantity of watery vapour. The com- 
 position of one hundred parts of atmosphe- 
 rical air, freed from all adventitious mix- 
 ture, is seventy-nine parts of a gas called 
 azote, or nitrogen ; and twenty-one parts 
 of another gas, named oxygen gas. At- 
 mospherical air is indispensably necessary 
 for the breathing of animals ; and atmos- 
 pheric air may also be considered as the 
 great supporter of combustion ; though 
 inflammable bodies will bum in some 
 other gases, yet these gases are uncom- 
 mon, except when artificially produced. 
 When, by various methods familiar to 
 chemists, the oxygenous portion of the 
 atmosphere is separated from the azotic, 
 it is found that an animal dies, and a burn- 
 ing body is extinguished in azote j we 
 hence conclude that it is only the oxygen- 
 ous part of the atmosphere that is fit for 
 the purposes of respiration and combus- 
 tion. Air is by these processes continu- 
 ally becoming more and more unfit for 
 breathing. It is a curious, but difficult 
 subject of investigation, by what means pu- 
 rity is restored to the air, and how it conti- 
 nues to be fit for the respiration of animals, 
 though exposed to so many sources of 
 contamination. It is believed, that this 
 'M)wing to the functions of the leaves of 
 When they are exposed to the 
 ht of day, they are continually 
 
 absorbing the carbon of the carbonic acid 
 which exists in the air and water on which 
 they feed, and giving out 'oxygen gas. 
 By this means the purity of the atmos- 
 phere is preserved with wonderfully little 
 variation. 
 
 Change of Am in apartments necessary. 
 Air that has been long unchanged, in 
 which one or more human bodies have 
 been confined, is possessed of qualities 
 highly dangerous and even destructive ; as 
 we see in many instances from the fevers 
 and other ailments which arise in jails, 
 ships, and other confined apartments. 
 Hence the necessity and propriety of free 
 ventilation in houses of every description ; 
 of daily admitting a thorough current of 
 air into sleeping-rooms, and indeed into 
 every room of a house. From the neglect 
 of this ventilation, arise the dangerous 
 and malignant fevers in the confined and 
 ill ventilated dwellings in the closes, al- 
 leys, and courts of large towns. Since 
 attention has been called to this circum- 
 stance, how seldom do we hear of the 
 ship or the jail fevers. Though the fever, 
 which was formerly so fatal in ships and 
 jails, is still lamentably prevalent some- 
 where or other, and though we still hear 
 of towns or tracts of territory being visited 
 with its depopulating scourge, it is not in 
 ships or jails that it is suspected to take its 
 rise, but in the abodes of slothful and 
 squalid poverty, where no judicious and 
 directing mind enforces the necessity of 
 ventilation and cleanliness. 
 
 Even in the apartment where a pa- 
 tient is in bed, the fear of his catching 
 cold should not prevent us from occasion- 
 ally changing the air of it, by opening the 
 doors and windows for a few minutes at 
 a time, taking care not to expose the sick 
 person to the current of air, but closing 
 the curtains and using such other precau- 
 tions as common sense will readily sug- 
 gest. 
 
 Means of purifying the Ai^ from con- 
 tagion. There are various methods practis- 
 ed, to correct the bad air in sick-cham- 
 bers, and if possible, to destroy its power 
 of producing diseases. Morveau in France 
 made many experiments on the best 
 
IC 
 
 AIR 
 
 AIX 
 
 means of disinfecting tlie air, and Dr. 
 Thomson, in his Chemistry, gives the 
 following" as the result of these experi- 
 ments. (Vol. iii. p. 183.) Odorous 
 bodies, as benzoin, aromatic plants, &c. 
 have no effect whatever. There are four 
 substances Avliich have the power of de- 
 stroying contagious matter and of pu- 
 rifying the air, viz. acetic acid, or vine- 
 gar, nitric acid, muiiatic acid, and chlo- 
 rine. Acetic acid cannot easily be ob- 
 tained in sufficient quantity, and in a 
 state of sufficient concentration, to be em- 
 ployed with advantage. Nitric acid may 
 be attended with some inconvenience, 
 because it is almost always contaminated 
 with nitrous gas. Mm-iatic acid and 
 chlorine, are not attended with these in- 
 conveniences ; the last deserves tlie pre- 
 ference, because it acts with greater ener- 
 gy and rapidity. See Fumigation, Con- 
 tagion, and Chlorine. 
 
 Air, considered tvith refo'ence to the 
 cause f the ewe, or the mitigation of dis- 
 eases. 
 
 Many circumstances connected with 
 air, which chemistry is unable to trace 
 or explain, are much to be attended to in 
 a medical point of view. Under the ar- 
 ticle Ague, we have already mentioned 
 the bad air from marshy grounds ; and in 
 the article immediately preceding, we 
 have stated the danger of other fevers, 
 from the malignant effluvia from animal 
 bodies ; we have also to mention that the 
 air seems to carry the infection of other 
 diseases, as small-pox, measles, hooping- 
 cough, scarlet fever, &c. Some of these 
 contagions, as the small-pox, taint the air 
 with a peculiar disagreeable smell ; but 
 in general, the sense perceives nothing 
 different from common air. The air of cer- 
 tain places is justly supposed to have an 
 influence in giving a tendency to certain 
 diseases, or even to bring them on. The 
 CTOup is frequent in cold damp situations, 
 exposed to the east wind, or near the sea. 
 The sea air is unfavourable in certain 
 states of consumption ; or in affections of 
 the breast, which would probably end in 
 that disease. The mild equjible air of the 
 
 country, unloaded with the endless varie- 
 ty of matters mixing with the air in the 
 neighbourhood of large towns, is favour- 
 able to recovery from many ailments, as 
 indigestion, dropsy, jaundice, breast com- 
 plaints, asthmas, the wasting disease of 
 children, as also to tbat feeble state of 
 constitution which has not received any 
 appropriate name. It is remarkable that 
 some persons in asthma are not better in 
 air which we should think the purest. — 
 Change of ai?; e-^^ii to a worse, has been 
 found of service in hooping-cough ; but 
 it is useless to attempt a cure by this at 
 an early period of the disease, as it is 
 hardly possible by any means to prevent 
 it from running on a considerable time. 
 In general, it is hardly worth while to tiy 
 a change of air, till the cough has conti- 
 nued distinctly at least a month or six 
 't^eeks, with the back draught. 
 
 A good deal of the influence of the air 
 on the skin and lungs must depend on its 
 degree of moisture or dryness. When 
 there is much \A'atery vapour in the air, 
 it is less able to receive more ; and the 
 perspirable matter from the skin not be- 
 ing carried off, we shall appear to per^ 
 spire more, though in reality the perspi- 
 ration is less. In like manner, the watery 
 vapour which is continually thrown off 
 by the lungs is not carried away fast 
 enough by a heavy moist atmosphere ; 
 and in certain diseases of the lungs, in 
 colds, consumptions, asthmas, &c. some 
 patients, according to the quantity of 
 vvatery vapour or mucus exhaled from 
 the lungs, will be benefited either by a 
 dry air, or the contrary. It is wrong, 
 therefore, to lay down- any general rule 
 about a particular spot or climate, as its 
 good or bad effects will vary according to 
 the state of the disease in each particular 
 patient. 
 
 AIX-LA-CHAPELLE. A town in 
 Westphalia, where there is a sulphureous 
 water with an unusual quantity of sulphur 
 in it. It is clear, but smeUing of sulphur, 
 and its taste is salt, bitterish, and alkaline. 
 The temperature varies, according to th'» 
 distance from the source, and the ' 
 
ALB 
 
 ALC 
 
 17 
 
 itself. In the hottest bath, it is about 
 140O, at the fountain where it is drunk 
 it is 11 2^, These waters are much fre- 
 quented by the inhabitants of the Con- 
 tinent, and are useful in those disorders 
 of the stomach and digestive organs, 
 which are apt to arise from luxurious 
 living ; and also in certain disorders of 
 the kidneys accompanied by thick, slimy 
 urine. This water is possessed of heat- 
 ing qualities, and must therefore not be 
 used in complaints having any inflamma- 
 tory tendency, nor in cases of haemor- 
 rhage with activity of the circulating sys- 
 tem. The baths at Aix-la-Chapelle are 
 much used externally, and being endow- 
 ed with considerable efficacy from their 
 sulphureous impregnation, they are of 
 great use in diseases of the skin, and 
 foulness of the same. These baths are 
 highly useful in the stiifness of the joints 
 occasioned by rheumatic affections, and 
 in the weakened state left by palsy. The 
 dose for internal use, and the tempera- 
 ture for the bath, are to be regulated by 
 their effects, and by the constitution of 
 the patient ; but it is always proper to 
 begin both at a low rate, and gradually 
 to increase them. The times of drinking 
 these waters are from the beginning of 
 May to the middle of June, and from the 
 middle of August to the latter end of 
 September. 
 
 ALBUMEN. The name given by che- 
 mists to that animal production, with 
 which we are so familiar in the white of 
 an egg. It forms the principal part of 
 the clear portion which remains at the 
 top of the vessel when blood is allowed 
 to congeal. Albumen coagulates by heat, 
 and by the addition of acids. It consti- 
 tutes a considerable proportion of the ani- 
 mal solids ; and one effect of the heat 
 applied in the various processes of cook- 
 ery is to coagulate the albumen, and ren- 
 der it solid. The white of eggs is found 
 to be the best antidote for the poison of 
 corrosive sublimate. The term albumen 
 is also used in botany to signify a farina- 
 ceous, fleshy, or horny substance, which 
 makes up the principal bulk of some 
 seeds. 
 
 ALCHYMY. The art which pretend- 
 ed to confer the power of changing the 
 baser metals into gold, and of discover- 
 ing a medicine which should cure all 
 diseases, and prolong life to an indefinite 
 period. The exact origin of this pursuit 
 is not precisely known ; but it is believed 
 to have been invented in Egypt- It con- 
 tinued very long to be a favourite object; 
 and much knavery and imposture, as well 
 as enthusiasm and credulity, were cur- 
 rent among those who embarked in the 
 search after these wonderful acquisitions. 
 Many spent their fortunes and wearied 
 out their lives in the vain endeavour; 
 while the strange substances which they 
 did produce in their countless operations 
 by fire on various productions of nature, 
 with the deep mystery in which they in- 
 volved themselves and their art, made 
 them be looked upon by the vulgar as 
 magicians, or as dealing familiarly with 
 the powers of darkness. Much as we 
 must pity the delusions of some of the 
 alchymists, and detest the wickedness of 
 others, we should remember that chemis- 
 try, now a science of such dignity and im- 
 portance, is deeply indebted to them; and 
 that many of our most useful medicines 
 are owing to the operations of the alchy- 
 mists. Lord Bacon compares them to 
 the young men who carefully digged 
 and re-digged their father's field in 
 search of a treasure Avhich, they never 
 found ; but whose labour was amply re- 
 paid by the fertility imparted to the 
 soil which they turned up with other in- 
 tentions. 
 
 ALCOHOL, in strictness signifies the 
 pure spirit obtained by distillation, and 
 subsequent rectifying, from all liquids 
 that have undergone the vinous fermen- 
 tation. But the term is commonly ap- 
 plied to the spirit, though imperfectly 
 freed from water. Alcohol is generally 
 obtained in proportion to the quantity of 
 sugar contained in the liquor from which 
 it is distilled. It is found in greatest 
 quantity in the wines of warm countries, 
 some of which yield a third of brandy. 
 The stimulating and intoxicating quali- 
 ties of wines depend on the alcohol which 
 c 
 
18 
 
 ALE 
 
 ALl 
 
 they contain. A very curious and in- 
 teresting table has been constructed by 
 Mr. Brande of London, showing the quan- 
 tity of pure alcohol contained in a variety 
 of wines, and other intoxicating liquors. 
 This table will be found in Appendix, 
 No. IV. 
 
 Alcohol, when firet distilled, has dif- 
 ferent qualities, according to the substance 
 from which it is distilled. In this coun- 
 try alcohol is obtained from an infusion 
 of malt, and is called whisky j in the 
 West Indies from sugar, and called rum ; 
 arrack is produced in the east from rice : 
 and in France and Spain, brandy is pre- 
 pared from wine. Gin is alcohol flavour- 
 ed with the essential oil of the juniper. 
 Spirits are not pure alcohol, but a mix- 
 ture of alcohol and water. Alcohol, either 
 pure or diluted, is of great use in ifiedi- 
 cine and pharmacy, as possessing the pow- 
 er of dissolving resins, oils, and other sub- 
 stances of medicinal virtue ; and in small 
 quantities they are in many cases highly 
 useful, where we want to stimulate or 
 keep up the action of the nervous sys- 
 tem, as their excitement is rapidly com- 
 municated by the nerves of the stomach. 
 See ArdExNt Spirits. 
 
 ALDERBERRY WINE. A home- 
 made wine from the fermentation of the 
 berries of the alder tree and raisins. It 
 is said to keep better than many of the 
 other made wines, and was formerly 
 thought to possess medicinal virtues; but 
 these are now very little regarded. 
 
 ALE. A fermented liquor made from 
 malt and hops, of which last ingredient 
 the quantity used in the making of ale is 
 less than in the making of beer, by which 
 ale is more glutinous and sugary than 
 beer. The addition of the hops renders 
 the liquor valuable by the grateful stimu- 
 lus which it imparts to the stomach and 
 system ; and by the nutritive qualities 
 of ale, its moderate use is far more inno- 
 cent and useful for the laboui'ing classes 
 than the pernicious drinking of ardent 
 spirits, which are now so accessible and 
 extensively ij*(];ilged in. Ale is possess- 
 ed of a stimulating and intoxicating qua- 
 
 lity, from the quantity of spirit of wme 
 which it contains ; and habitual indul- 
 gence in it has a tendency to bring on 
 corpulency, fulness of habit, and a dispo- 
 sition to apoplexy, or other diseases of a 
 kindred nature, proceeding from disten- 
 tion of the blood-vessels. To restore 
 strength after debilitating illness, ale or 
 porter may be prescribed for those whose 
 coarser stomachs have been used to them 
 in health ; but for others they are not so 
 proper, as they rarely agree with the 
 stomach at that time. Mr. Brande, in 
 the examination of ale, found it to con- 
 tain nearly nine parts of spiiits of wine in 
 the hundred. 
 
 ALEMBIC. A chemical utensil, con- 
 sisting of a body to which a conical head 
 is fitted, and from the side of this a beak 
 proceeds, which is inserted into the re- 
 ceiver. It is used for receiving volatile 
 products from retorts. 
 
 ALEXIPHARMACS. Medicines sup- 
 posed to have the power of preserving the 
 body from the effects of poisons, or of 
 correcting the acrimony of febrile or other 
 injurious matter. It is now common to 
 class and name medicines, from some im- 
 mediate and obvious effect, as emetic, ca- 
 thartic, &c. and not to use such vague^ 
 doubtful, and comprehensive appellations 
 as the above. 
 
 ALGAROTH, or Powder of Alga- 
 ROTTi, a preparation of antimony, so call- 
 ed from Algarotti, a physician of Naples, 
 who used and described it. Like other 
 antimonials, it acts as an emetic and pur- 
 gative ; but as we have safer and more 
 manageable preparations, it is now seldom 
 used. See Antimony. 
 
 ALIMENTS. Whatever is capable of 
 being used as food, and of supplying the 
 waste of the animal body, is called ali- 
 ment. The great variety of nutritive 
 substances may be classed and arranged 
 in various ways, as animal or vegetable ; 
 fish, fowl, or flesh ; solid or liquid, &c. 
 or they may be classed according to the 
 particular principles, as they are called 
 by chemists, on which the nutritive qua- 
 lities depend. Some of these principles 
 
ALI 
 
 ALI 
 
 19 
 
 are fibrin, albumen, gelatine, oil, and fat, 
 g-luten, fecula or starch, mucilage, sugar, 
 acids, &c. On this plan Dr. Paris classes 
 aliments in the following way : Class I. 
 Fibrinous aliments. Comprehending the 
 flesh and blood of various animals, espe- 
 cially such as have arrived at puberty, 
 venison, beef, mutton, hare. II. Albu- 
 minous. Eggs : coagulable animal matter. 
 III. Gelatinous ahments* The flesh of 
 young animals, veal, chickens, calf's foot, 
 certain fishes. IV. Fatty and oily ali- 
 ments. Animal fats, oils, and butter; 
 cocoa, &c., ducks, pork, geese, eels, &c. 
 V. Caseous aliments. The different 
 kinds of milk, cheese, &c. VI. Farina- 
 ceous aliments. Wheat, barley, oats, rice, 
 rye, potato, sago, arrow root, &c. VII. 
 Mucilaginous aliments. Carrots, turnips, 
 asparagus, cabbage, &c. VIII. Sweet 
 aliments. The different kinds of sugar, 
 figs, dates, &c. carrots. IX. Acidulous 
 aliments. Oranges, apples, and other aces- 
 cent fruits. 
 
 The numerous substances classed above, 
 vary much both in their nutritive and di- 
 gestible properties. When we talk of a 
 substance being nutritive, we mean that 
 it has the power to supply more or less 
 nourishment to the body, without saying 
 whether the stomach and the other assi- 
 milating organs find much or little dif- 
 ficulty in conducting the process; and 
 when we say that a substance is digesti- 
 ble, we mean that the stomach and its 
 coadjutors take with ease the nutritive 
 portion from it. Thus a substance may 
 be very nutritive, but not very digesti- 
 ble ; and the reverse may also be true. 
 Fat oily aliment is very nutritive, but of 
 difficult digestion. This is what people 
 mean when they say such an article of 
 diet is heavy ; though oil is specifically 
 light, and often floats on the other con- 
 tents of the stomach. The digestibihty 
 of food, considered without reference to 
 the stomach, depends on a variety of cir- 
 cumstances, particularly the state of the 
 food with regard to texture and consist- 
 ence ; and this texture in animal food de- 
 pends on the time that has elapsed since 
 
 the animal was killed, on its age, sex, 
 feeding, and mode of killing ; and above 
 all, on the operations of cookery. In a 
 matter which varies so much in different 
 individuals, it is not easy to lay down any 
 general maxims with regard to the diges- 
 tibility of different kinds of food ; but it 
 is found pretty generally to be the case, 
 that tender mutton is the most digestible 
 food. Beef is not quite so easily digest- 
 ed, but it is equally nutritious. Soups, 
 oils, and jellies, are digested with some 
 difficulty, both on account of their tena- 
 city, and because they are not so easily 
 acted upon by the mechanical powers of 
 the stomach. For some observations on 
 the different aliments. See Beef, Mut- 
 ton, Fish, Cheese, Milk, &c. See also 
 CoojBiRY and Diet. 
 
 ALIMENTARY CANAL. The long 
 and winding passage through which the 
 food proceeds in an animal body. It be- 
 gins at the mouth and ends at the anus. 
 Its principal parts are the following : 
 The mouth, leading to the gullet at its 
 back part, which gullet is closed tightly 
 unless when the food is in the act of be- 
 ing swallowed. The gullet inins down 
 within the chest, and passing through an 
 opening in the diaphragm, ends at the 
 upper opening of the stomach, a large ca- 
 pacious bag. At the lower end of this 
 bag, which stretches to the right side, 
 there is a ring of muscular fibres which 
 prevents the food from passing too quick- 
 ly out of the stomach into the bowels ; 
 and which has the power of repelling, for 
 a time at least, substances which ought 
 not to pass. The portion of the gut be- 
 low this, about twelve inches in length, 
 and called from that circumstance duode- 
 nuniy is not loose and floating, like some 
 other portions of the tube, but fixed, to 
 aJlow certain canals to enter, which 
 convey bile from the liver, and a fluid 
 from the pancreas or sweetbread, which 
 fluids are necessary in the process of 
 digestion. From the important opera- 
 tions which go on in this portion of 
 the gut, it has been called a second 
 stomach. The next portion of the 
 
20 
 
 ALK 
 
 ALK 
 
 gut is called Jejunum^ (fasting) from 
 the circumstance of its being commonly- 
 found empty. Next comes the ileum or 
 small intestines, forming many convolu- 
 tions, turning and winding upon them- 
 selves, admirably attached to a membrane 
 which is fixed to the back bone ; and 
 these small intestines are so constructed 
 in their inner surface as to give a large 
 space for the countless vessels which open 
 into them and proceed from them. The 
 small intestines suddenly expand into a 
 canal of much larger bore, at the com- 
 mencement of which there is a large bag: 
 this is called the caput ccecum colt, or 
 blind gut. Then the intestine proceeds 
 upwards on the right side of the loins, 
 crosses the body a little above the navel, 
 then turns downwards, and at last ends 
 in the straight gut near the anus. From 
 the part where the small intestines end, 
 to the terminations of the whole canal, 
 seems to be the place where the excre- 
 ments assume their shape and character. 
 There is a valve which allows substances 
 and fluids to pass readily from the ileum 
 downwards, but which eflfectually pre- 
 vents any thing from going in a contrary 
 direction, unless in cases of severe dis- 
 ease, as rupture or iliac passion. The 
 greater part of the alimentary canal is 
 in continual motion in one direction, one 
 part propagating its motion to that im- 
 mediately below it, something in the 
 manner in which a worm pushes itself 
 forward. Physiologists call this the pe- 
 ristaltic motion. The different changes 
 that take place on the food in its long 
 passage through this canal shall be stated 
 under the article Digestion. 
 
 ALKALI. A substance endowed with 
 the following properties ; It changes the 
 vegetable blue colours to green, forms a 
 substance with acids having qualities quite 
 distinct from both acids and alkalis, and 
 forms soap when mixed with oils. There 
 are two kinds of alkalis, the fixed and 
 the volatile. 
 
 ALKALI, FIXED. The fixed alkalis 
 that have been long known, are potash and 
 soda ; biit later chemists have added an- 
 
 other alkali to the list, viz. lithia, which 
 does not in its properties essentially dif- 
 fer from those formerly known. Potash 
 is principally obtained by burning cer- 
 tain vegetables to ashes, dissolving in wa- 
 ter the parts which it will melt, which 
 are the alkali mixed with other sub- 
 stances, and allowing this solution to run 
 into iron pots ; hence the names of pot- 
 ashes and vegetable alkali. Soda may 
 also be procured by burning vegetables, 
 particularly those that grow near the 
 sea ; but as a great deal of soda is found in 
 many minerals, as rock-salt, &c. it is com- 
 monly called the mineral or fossile alkali. 
 The volatile alkali is the well known 
 substance called ammonia, or hartshorn ; 
 it is called volatile from its being separat- 
 ed very easily from other bodies by heat. 
 All the alkalis are of much and varied 
 use in the arts and in medicine. At one 
 time a great deal was expected from the 
 power of alkalis to dissolve stone in the 
 bladder; but even when the strongest 
 alkali is applied to a stone out of the blad- 
 der, it is not every stone that can be af- 
 fected by it J and it is quite obvious that 
 undiluted alkali would occasion the most 
 frightful injury to any part of the animal 
 body to which it can be applied. When 
 the alkali is rendered mild, or combined 
 Avith carbonic acid, forming carbonate o- 
 potash, it may be taken into the stomach 
 in a very diluted state ; but before it can 
 pass, with the food and drink, through 
 the various complicated processes and 
 changes which they undergo before they 
 reach the blood, (and it is only from 
 blood that the kidneys separate the urine) 
 its peculiar alkaline properties must be 
 quite lost, and no probability remains 
 that it will act as a solvent when it gets 
 into the bladder. There are, however, 
 some stones which are principally com- 
 posed of an acid, called by chemists the 
 uric acid, which seem, if not to be dis- 
 solved, at least to be kept from increas- 
 ing when the patient is using alkaline 
 medicines ; but this is owing to their cor- 
 recting the faulty digestion which seems 
 to give rise to the formation of the stone. 
 
 22 
 
 33^ 
 
ALK 
 
 ALM 
 
 21 
 
 and not at all to their power of dissolv- 
 ing- it, when formed. 
 
 The fixed alkalis for many centuries re- 
 sisted all the attempts of chemists to de- 
 compose them, and they were, therefore, 
 considered as simple bodies; but about the 
 end of the year 1806, Sir Humphrey Davy, 
 by a skilful application of galvanism, suc- 
 ceeded in demonstrating that they are com- 
 pound bodies ; potash and soda respective- 
 ly being made up of a metallic basis and 
 oxygen. 
 
 ALKALI, VOLATILE, or Harts- 
 horn. See Ammonia. 
 
 ALKALI, CAUSTIC. Alkalis are 
 said to be caustic when they are deprived 
 of all other mixture, or when there is 
 nothing but the metallic oxyd. In this 
 state they act with much violence on ani- 
 mal substances, and bum or corrode them. 
 In this state they are used by surgeons to 
 destroy a portion of skin for the purpose 
 of forming an issue. 
 
 ALKALI, MILD. Alkalis are ren- 
 dered mild by the addition of carbonic acid 
 or fixed air, for which they have great af- 
 finity ; and joined with which, they are 
 always obtained at their first preparation 
 by the burning of vegetables. The car- 
 bonic acid deprives them in a great mea- 
 sure of their acrimony, though it does not 
 totally remove it : the carbonic acid being 
 a mild substance, and easily separated 
 from the alkali, the taste and some other 
 properties of the alkali are still preponde- 
 rant ; but by careful dilution, the carbo- 
 nates may be given internally, and may be 
 employed in washing the skin and other 
 animal substances, without fear of corro- 
 sion. What are sold in the shops by the 
 names of potashes and soda, are the car- 
 bonates of potash and soda. 
 
 ALKALOIDS. The active pro- 
 perties of many vegetables are found to 
 reside in certain substances possessed of 
 many of the qualities of alkalis, to which, 
 therefore, the name of alkaloids has 
 been given. Examples of these alka- 
 loids are found in morphia extracted 
 from opium, quinine from bark, and va- 
 rious others. 
 
 ALKANET ROOT, Anchum Tincto- 
 ria. A root used in pharmacy to impart a 
 red colour to oils and unctuous substances. 
 It is not now used for any medical purpose. 
 ALLOY. When a baser metal is mix- 
 ed with the purer metals, as silver or gold, 
 an alloy is said to be formed. Or when 
 • any number of metals are melted into one 
 mass, they are said to be alloys ; unless 
 when mercury is an ingredient, and the 
 compound is then called an amalgam. 
 
 ALLSPICE, Pimento, Jaaiaica pepper, 
 Myrtus Pimenta. It is a warm, aro- 
 matic stimulant, and much used in dressing 
 food. It is used in medicine as a stimulant, 
 to disguise the taste of other drugs, and to 
 make them sit easily on the stomach. Its 
 smell and taste resemble a mixture of cin- 
 namon, cloves, and nutmegs ; hence it has 
 received the name of allspice, 
 
 ALMONDS, Amygdalus Communis. 
 The kernel or fruit of the almond tree; a 
 tree resembling a peach, which originally 
 came from Syria and Barbary, but is now 
 much cultivated in the south of Europe. 
 There are two kinds of almonds, the sweet 
 and the bitj;er ; it is said that the eye can 
 discern no difference between the kernels 
 of the Uvo kinds, nor between the tree 
 which produces them ; and that the same 
 tree by culture has been made to produce 
 both. ' Almonds are covered with a thin, 
 brown skin; they are apt to become 
 rancid by keeping. Sweet almonds are 
 pretty much used as an article of food, 
 but they are difficult of digestion, and 
 afford little nourishment. Bitter almonds 
 are much used in cookery, to give flavour 
 to puddings and other articles of food; 
 but in some constitutions, a small quanti- 
 ty occasions a troublesome nettle-rash, 
 and has even been said to be poisonous 
 to dogs and some other animals. What- 
 ever acrimony they possess, is considered 
 to be owing to a substance called Prussic 
 acid, which has been detected in them ; 
 it is a virulent poison, and on it the 
 poisonous qualities of the cherry-laurel, 
 and some other vegetables, depend. An 
 oil is obtained from almonds by pressure, 
 and by boiling them in water, when it 
 
22 
 
 ALM 
 
 A LO 
 
 separates, and swims on the surface. 
 When almonds are beat up with watery- 
 fluids, they form a milky softening liquor 
 called an emulsion, which is very useful 
 in diseases where there is acrimony of the 
 fluids, as in tickling coughs, and heat of 
 urine. Two English pints of the emul- 
 sion of almonds may be taken daily. 
 When camphor is wished to be given, it 
 may be formed into an emulsion with al- 
 monds, according to the following pre- 
 scription : Take of camphor one scruple ; 
 sweet ahnonds blanched, two drachms; 
 double refined sugar, one drachm ; water, 
 six ounces ; beat the substances together 
 in a stone mortar, gradually pouring on 
 them the water; then strain off the liquor. 
 Of this a table-spoonful may be given, 
 and may be repeated, according to the 
 quantity of camphor we wish to be taken. 
 ALMONDS OF THE Ear. Certain 
 glands situated at the back part of the 
 mouth, named by anatomists the tonsils, 
 and by common people, from their shape, 
 the almonds of the ear. These glands are 
 very subject to SAvelling from cold, pro- 
 ducing a disease called the quinsy, or in- 
 flammatory sore throat. As the almonds 
 of the ear are pressed upon by the action 
 of swallowing, great pain is produced on 
 them, when in a state of inflammation, 
 even by swallowing the spittle, or liquids. 
 Whenever a person is threatened with 
 this complaint, strong gargles should be 
 used, made of vinegar and water, or sul- 
 phuric acid and water, or hartshorn and 
 water, or strong spirits. A gargle applied 
 in time often prevents the disease from 
 becoming violent. At the same time, the 
 patient should take some cooling purga- 
 tive, avoid exposure to cold, and apply a 
 mixture of eight parts of olive oil, and 
 one part of hartshorn, to the outside of 
 the throat, with an additional covering of 
 flannel. In many scrofulous constitutions 
 these glands are constantly larger than 
 natural, and are very apt to become in- 
 fliamed by exposure to cold and moist air. 
 Frequent strong gargles are necessary in 
 such. The decoction of oak bark, with 
 
 the addition of a little tincture of myiTh, 
 forms a very good gargle. For the con- 
 sequences of inflammation in those parts. 
 See Quinsy and Sore Throat. 
 
 ALOES, Aloe Spicata. A well known 
 and very useful purgative medicine. It is a 
 gum resin, or substance soluble in diluted 
 spirits, and is obtained from a plant which 
 grows in Barbadoes, at the Cape of Good 
 Hope, and at the Island of Socotra in the 
 Indian Ocean. It is prepared by pulling off 
 the leaves, from which thejuice is squeezed 
 out, and afterwards boiled and skimmed. 
 Its taste is intensely bitter and disagree- 
 able, though it has an aromatic flavour. 
 Aloes is a warm, stimulating purgative ; 
 and it acts chiefly on the large intestines, 
 seldom producing any watery or fluid 
 stools, but merely promoting the easy 
 evacuation of the bowels. It generally 
 agrees well with the stomach, and by its 
 bitterness promotes appetite and digestion; 
 and it is remarkable with regard to it, 
 that it operates as beneficially in a small 
 as in a large dose ; one or two grains, 
 says Dr. Cullen, will produce one con- 
 siderable stool, and twenty grains will do 
 no more ; except it be, in the last dose, 
 the operation will be attended with gripes. 
 Aloes is one of the best remedies against 
 habitual costiveness : it is extensively 
 employed by those of studious, sedentary 
 habits, and by females of all classes of so- 
 ciety ; and from its very general use, and 
 from its certainly acting chiefly on the 
 great intestines, it is not wonderful that 
 many instances are known of its seeming 
 to produce piles and other irritations of 
 the lower belly and neighbouring parts. 
 It will . have this effect when frequently 
 used ; and therefore, however useful aloes 
 may be as a mild and certain evacuant, it 
 will be right for those whose constitu- 
 tions require frequent purgatives, to in- 
 terpose occasionally a dose of neutral 
 salts, or compound powder of jalap, or in- 
 fusion of tamarinds with senna. In in- 
 dolent habits, where costiveness is accom- 
 panied by languid circulation, loss of ap- 
 petite, disinclination to exertion of mind 
 
ALO 
 
 ALT 
 
 23 
 
 or body, fretfulness of temper, and those 
 symptoms which the unlearned under- 
 stand so well by the term nervousy aloes, 
 in some of its various combinations, is 
 one of the most valuable medicines we 
 possess. The cases in M'hich aloetics 
 should be avoided are those of persons 
 subject to piles, to discharges of blood, 
 and where inflammation or irritation ex- 
 ists in the boAvels. From their action on 
 the uterine system, they are used in cases 
 where the monthly discharge is obstruct- 
 ed ; and for a similar reason, should be 
 used Avith caution in the state of preg- 
 nancy. The dose of aloes is from three 
 to fifteen grains, but from its disagreeable 
 and bitter flavour it is never given alone, 
 but combined with aromatics or bitters, 
 or made into pills, or dissolved in wine 
 or proof spirits. Tinctiu-e of aloes may 
 be given to the dose of half an ounce, or 
 an ounce, and aloetic wine is a good 
 purgative in doses of from one to two 
 ounces. 
 
 The following are some of the most 
 useful forms in which aloes may be taken, 
 with the particular purposes, and times of 
 the day proper for each. They are kept 
 in the shops of apothecaries, under the 
 name prefixed to each of them. 
 
 Aloetic pillsy for costiveness without 
 any peculiarity of symptoms : two pills 
 for a dose at bed-time. 
 
 Aloetic pills with assafetida, for hys- 
 terical affections, with costiveness and 
 flatulen.ce : two pills every second night 
 at bed-time. 
 
 Aloetic pills with coloct/nth, commonly 
 called colocynth pillSy when the simple 
 aloetic pills are found too weak : two pills 
 or three at bed-time. 
 
 Pills of Aloes with Myrrhy or Pilules 
 Mnfiy in female constitutions, in the full 
 complexion and sluggish habits attendant 
 on the suppression or non-appearance of 
 the monthly discharge : two pills or three 
 may be taken twice or thrice a-day. 
 
 Rhubarb PillSy or Stomachic Pills; these 
 contain a small portion of aloes; they are 
 useful for strengthening the stomach, and 
 gently opening the bowels, and may be 
 
 taken to the extent of two pills every 
 forenoon, and two in the evening. 
 
 The fftr-famed AndersorCs pills consist 
 of Barbadoes aloes, -with a proportion of 
 jalap and oil of aniseed ; one or two for 
 a dose. 
 
 There is another kind of pills, which 
 seem a slight variation of the pills called 
 Dinner Pillsy or Lady Webster' Sy or Lady 
 <^respigny's pillSy made of equal parts of 
 rhubarb, aloes, and mastich. This last 
 ingredient is not of much virtue in itself, 
 but makes the solution of the others in. 
 the bowels gradual and equal. The dose 
 of these pills, which have not received 
 any particular name, is two or three, and 
 the time for taking them is immediately 
 before dinner ; they then mix with the 
 food, prevent flatulency, and are usually 
 found to operate next morning after 
 breakfast. 
 
 ALTERATIVES. Medicines intended 
 gradually and imperceptibly to improve 
 the constitution in some of its functions, 
 without any remarkable evacuation. Al- 
 teratives are employed in diseased states 
 of the fluids, in derangements of the diges- 
 tive organs, and affections of the skin. 
 Doses of rhubarb, so small as not to purge, 
 mineral waters, or imitations of them, 
 drank for a length of time, may be con- 
 sidered as alteratives. The medicine most 
 frequently used for this purpose is mer- 
 cury, in the form of calomel, or the blue 
 pill, or combined with a preparation of 
 antimony, as in Plummer's pill. When 
 calomel is given as an alterative, it should 
 be in the form of pills, containing one 
 grain of calomel ; one of which may be 
 given twice a-day, taking care that the 
 salivating effects of mercury be not in- 
 duced. The dose of rhubarb, for a simi- 
 lar purpose, is about five ^^ins a-day, 
 either alone or combined with, magnesia 
 and ginger. Iron may also be given : one 
 grain of the sulphate, or fifteen drops of 
 what is calUd tincture of steel may be 
 taken twice a-day. Plummer's pills may 
 be given in the dose of two pills every 
 night at bed-time. All these medicines 
 will do but little, if the constitution is not 
 
24< 
 
 ALU 
 
 A MM 
 
 at the same time improved by the judi- 
 cious employment of proper diet, air, and 
 exercise. 
 
 ALUM. A salt composed of sulphuric 
 acid, and a peculiar earth abundant in 
 clay, with a quantity of potassa. It has 
 a sweetish but powerfully astringent 
 taste; and from its astringent qualities 
 it is reckoned useful in restraining dis- 
 charges of blood, or immoderate secre- 
 tions ; but it is highly dangerous to use 
 large doses of it in fluxes from the intes- 
 tines. When it is thought advisable to 
 use alum in discharges of blood, from ten 
 to fifteen grains may be given, and re- 
 peated every hour or half hour, for four 
 or five times ; but there are few bleedings 
 where it would be safe to trust to this ; 
 and in every case attentive discrimination 
 must be employed to ascertain the nature 
 and cause of the bleeding. Burnt alum 
 is used externally in the form of powder 
 as a mild caustic, to prevent the growth 
 of proud flesh ; it is also used in solution 
 as a wash to the skin, and in some cases 
 as a wash for the eye. A styptic wash, 
 of which alum is a principal ingredient, 
 is used for stopping bleedings at the nose ; 
 and for this purpose, cloths or pieces of 
 spunge steeped in the liquor are to be 
 applied to the part. By agitating a grain 
 of alum with the white of an egg, a curd 
 is formed, and this is useful in some cases 
 of inflamed eyes, being applied to the 
 eyelids between two folds of fine linen. 
 Bakers have been suspected of mixing 
 alum with their flour, to increase the 
 whiteness of their bread. Dr. Paris says, 
 it is certain that the inferior kinds of flour 
 will not make bread of sufficient white- 
 ness to please the eye of the fastidious 
 citizen, without the addition of a propor- 
 tion of alum. 
 
 It has been also found, that unless this 
 salt be introduced into the flour, the loaves 
 stick together in the oven. It has been 
 said that the smallest quantity that can 
 be employed for these purposes, is from 
 three to four ounces to two hundred and 
 forty pounds of flour, that is eight grains " 
 to the pound, or thirty-six to the quartern 
 
 loaf. Even a small portion of alum in- 
 troduced into the stomach will be hurtful 
 to those troubled with indigestion, and 
 such persons should endeavour to get 
 their bread made without alum. 
 
 ALUMINA. Pure clay, or the earthy 
 base of alum, from which it derives its 
 name. It is not used in medicine ; and 
 for its chemical properties, and its appli- 
 cation to the arts, especially pottery, we 
 refer to the books which treat of chemis- 
 try and manufactures. 
 
 AMALGAM. A composition of mer- 
 cury with any other metal. 
 
 AMAUROSIS. See Blindness or 
 
 GUTTA SERENA. 
 
 AMBER. A solid brittle bituminous 
 substance, of a white, yellow, or brown 
 colour, sometimes opaque, sometimes 
 transparent ,• often containing in its sub- 
 stance straws, flies, or other insects, which 
 additions prove it to have once been fluid. 
 It sends out an agreeable smell when 
 heated or rubbed; and it also has the 
 power of attracting light substances when 
 heated ; and as the Latin name for amber 
 is electrum, it has had the honour of giv- 
 ing name to the wondrous power of elec- 
 tricity, one of the phenomena of which is 
 the attraction of light substances by am- 
 ber, glass, sealing-wax, and some other 
 bodies. Amber is found floating on the 
 shores of the Baltic, and in Polish Prus- 
 sia, either on the sea shore, or under 
 ground, at about the depth of 100 feet, 
 resting on wood-coal. Amber itself is not 
 used in medicine, but its oil is. 
 
 AMBER, Oil of. By distilling amber, 
 an oil is obtained, of a pungent acrid taste, 
 and of a peculiar, but not very unplea- 
 sant odour. It is seldom used except as 
 a liniment ; and it is one of the ingredi- 
 ents in an empirical remedy called Roche's 
 Embrocation, much used in hooping- 
 cough. Either that or the following may 
 be rubbed on the chest three times a-day : 
 Take equal parts of tincture of camphor, 
 laudanum, and oil of amber, and form a 
 liniment. 
 
 AMMONIA. The pungentvolatile sub- 
 stance known by the name of hartshorn. 
 
AMM 
 
 AMM 
 
 26 
 
 Ammonia in its pure state is a gas 
 or permanently elastic fluid, which may- 
 be separated from sal-ammoniac by mix- 
 ing quick lime with it and distilling, 
 when the ammoniacal gas rises. It must 
 J)e passed through mercury, as water ra- 
 pidly absorbs it. It is composed of three 
 parts of hydrogen and one of azote. Am- 
 monia is usually kept in combination with 
 water, and this solution, commonly called 
 spirit of hartshorn, agrees in its properties 
 with the other alkalis, neutralizing acids, 
 forming soap, and changing the vegetable 
 blues to green. Ammonia, in two at least 
 of its combinations, affords the curious 
 example of two aerial bodies forming a 
 solid when they meet. The muriatic acid 
 gas, and the ammoniacal gas, two invisi- 
 ble transparent fluids, when brought with- 
 in the sphere of each other's influence, 
 form the solid white substance sal-ammo- 
 niac. Carbonate of ammonia also is the 
 production of a gaseous acid, and a gase- 
 ous alkali. It is in the form of carbonate 
 or sub-carbonate, that we find it most 
 convenient to employ ammonia for medi- 
 cinal purposes, as the peculiar properties 
 of ammonia are so little diminished by the 
 addition of the carbonic acid, that it may 
 be disregarded. 
 
 Ammonia is one of the most useful sti- 
 mulants we possess. Ammonia in water, 
 or the carbonate of ammonia, is useful for 
 arousing the suspended faculties in cases 
 of fainting. It is often used with good 
 effect to stop the fits in hysterical women, 
 and it is applied also, though with less 
 certainty of success, in convulsions or 
 epilepsy j and in cases where spirits, wine, 
 or internal stimulants would be dangerous, 
 ammonia to the nose in the form of gas, 
 may be beneficially employed. 
 
 Ammonia is a powerful corrector of 
 acidity in the stomach, even more so 
 than the fixed alkalis, and is useful in 
 those affections of the stomach which 
 are the consequences of irregular liv- 
 ing. In hoarseness, proceeding from 
 a relaxed state of the throat, it is 
 highly useful. It may be taken dropped 
 into syrup, to the amount of ten drops 
 
 four times a-day. When sore throat is 
 threatened, a gargle of properly diluted 
 water of ammonia in the proportion or 
 one ounce of ammonia to six of pui-e 
 water, will often prevent the inflamma- 
 tion from proceeding far; and the same 
 gargle with an additional ounce or two oi 
 water may be used in the relaxed and 
 swelled state of the tonsils, which some 
 people are subject to in damp cold weather. 
 A mixture of hartshorn and oil is a good 
 embrocation in sore throat, and in other 
 cases where a heating liniment is wanted, 
 as in palsy, rheumatism, and internal pains. 
 The dose for internal exhibition is from 
 five to ten drops of the undiluted solution 
 of hartshorn, called aqua ammonicBy or 
 from five to eight grains of the sub-car- 
 bonate made into pills. The ammonia 
 may be increased or diminished accord- 
 ing to the degree of stimulus required. 
 In some cases of headach, the alcohol 
 ammoniatum aromaticumy or ammonia 
 dissolved in spirits, with a proportion 
 of volatile essential oils^ is beneficial, 
 in the dose of from ten to forty drops, 
 three or four times a-day. The beautiful 
 blue colour in the large jars exhibited in 
 the shops of druggists is produced by add- 
 ing a quantity of liquid ammonia to a 
 solution of blue vitriol (sulphate of cop- 
 per) in water. 
 
 AMMONI ACUM. The name of a gum 
 used in medicine as a stimulating expec- 
 torant, either alone, or combined with 
 squill In the coughs to ^vhich aged per- 
 sons are sometimes subject, unattended 
 by inflammatory action, but with some 
 degree of spasm, and the secretion of much 
 tough mucus, difficult to bring up, ten 
 grains of ammoniacum three times a-day 
 seem to have proved of service in allaying 
 the spasm, and causing the mucous 
 matter to be easily spit up. For a simi- 
 lar purpose, the mixture of ammoniacum 
 made by rubbing the gum with water, 
 may be used in doses of from half an 
 ounce to an ounce ; and the same may be 
 given to females in whom it is wished to 
 increase the activity of the uterine sys- 
 tem. In long and obstinate colics, pro- 
 
26 
 
 AMP 
 
 AMP 
 
 ceeding from viscid matter lodg^ed in the 
 intestines, ammoniacum alone, or com- 
 bined with rhubarb, has produced happy 
 effects. Six grains with ten of rhu- 
 barb are a proper dose. The squill pill, 
 which is so useful an expectorant, has 
 ammoniacum as one of its ingredients. 
 It would be as well if this gum had 
 another name, not so similar to ammonia, 
 with which it has no affinity or resem- 
 blance. 
 
 AMMONIURET of Copper is a sub- 
 sulphate of oxide of copper and ammonia. 
 It is tonic and antispasmodic. It has been 
 employed in epilepsy and in St. Vitus's 
 dance, after a course of purgatives. It 
 may be formed into pills with crumb of 
 bread, each pill containing half a grain, 
 beginning with one pill a-day, and gradu- 
 ally increasing the dose to four pills twice 
 a-day. Like many other substances ex- 
 tolled for the cure of epilepsy, it has often 
 disappointed expectation. 
 
 AMNIOS. The soft internal mem- 
 brane which surrounds the foetus. It is 
 very thin in the early stage of pregnancy, 
 but acquires considerable strength in the 
 latter months. It contains a liquor in 
 whi<)h the embryo floats, suspended by 
 the navel string. The coming off of this 
 liquor during labour, is known by the 
 name of the discharge or breaking of the 
 waters. 
 
 AMPUTATION. A surgical opera- 
 tion for the removal of a limb or other 
 part of th« body. Before the great im- 
 provements made by modern surgeons in 
 this very terrible operation, many lives 
 must have been lost by the ignorance of 
 practitioners, as in ancient times the art 
 of stopping bleedings was unknown, and 
 consequently many diseases and accidents 
 which we now can cure and remedy, 
 must have been left to nature. It is the 
 same in ignorant countries to this day : 
 there are no wooden legs in China. On 
 this subject there are two points at least 
 for consideration, whether it is best to 
 lea*ve the case to nature and not to am- 
 putate, and what is the best time to do 
 it. Every case must be judged on its 
 
 own merits ; and what can be said here 
 must be very general. There are vari 
 ous diseases and accidents which would 
 infallibly destroy life if amputation were 
 not performed, and which would pro- 
 bably do well if the patient submitted 
 to it. Such are white swellings of the 
 joints, scrofulous ulcers, fungus haema- 
 todes, or soft cancer, &c. When a heavy 
 weight has crushed the bones of a limb, 
 when there has been much tearing of the 
 muscles and soft parts, the danger from 
 the accident greatly exceeds the danger 
 from an operation ; and this should be 
 performed as soon as possible after the 
 shock of the accident has gone off; for 
 if we wait too long, the constitutional 
 symptoms will come on, and fever will 
 run so high, that it will be hazardous to 
 increase them by the additional irritating 
 effects of an operation. When this fa- 
 vourable period has been neglected, at- 
 tention must be paid to moderate the 
 violent action of the system by bleeding, 
 purging, and the removal of aU causes of 
 excitement ; and then to watch the fa- 
 vourable opportunity of taking off the 
 limb. Without entering into minute de- 
 tails of the manner of amputating any' 
 particular limb or member, for which we 
 refer to books of surgery, we shall state 
 generally what the surgeon has to attend 
 to. In amputating a limb, he must do it 
 at a place sufficiently distant from the 
 disease or injury which has occasioned 
 the necessity of the operation, and at the 
 same time, he must leave as much of the 
 sound part as is consistent with the fu- 
 ture health and convenience of the pa- 
 tient. If there is to be a stump with a 
 bone in the centre, he is to take care to 
 manage his incisions so as to leave enough 
 of flesh to cover it completely, and over 
 all, sufficient skin to cover this again; 
 and for this purpose, it is to be remem- 
 bered, that the skin retracts more than 
 the flesh, and the flesh leaves the bone ; 
 therefore if a cut were made down to the 
 bone at once, the bone would project in 
 the middle, the flesh would be a little be- 
 hind it, and the skin would be shortest of 
 
ANA 
 
 all, rendering it impossible to cover the 
 bone. The skin therefore must be cut 
 through first, and allowed to retract, then 
 the muscles should be cut through and 
 separated from the bone, and last of all 
 the bone sawn through. By this means 
 the bone is completely covered. By other 
 methods of incision, called by surgeons 
 the flap operation, a cushion of flesh is 
 left to cover the end of the bone. The 
 cut surfaces of the stump are then brought 
 to touch each other, and retained in con- 
 tact by adhesive plaster and bandages ; 
 and it cannot be noticed without admira- 
 tion, how soon surfaces unnaturally de- 
 nuded, and brought to touch each other, 
 become united and healthy till the end of 
 a long life. The contrivances for prevent- 
 ing the loss of blood during the operation, 
 are pressure on the large trunks of the 
 arteries by the insti*ument called a tour- 
 niquet, or by the hands of proper as- 
 sistants. The open mouths of the larger 
 vessels are secured by putting ligatures 
 around them. Care must be taken after 
 amputation to prevent fever, to watch 
 for some time lest bleeding should oc- 
 cur, and attend to the dressing of the 
 stump. 
 
 ANALYSIS. The art of decomposing 
 or separating bodies into their component 
 parts. Thus, when a mineral water is 
 examined by a chemist to discover Avhat 
 different bodies are dissolved in it, he is 
 said to analyse the water ; or when he 
 separates the sulphuric acid from the 
 magnesia with which it is combined in 
 Epsom salt, he analyses it. The terra 
 analysis includes every kind of separation, 
 whether by heat, by mixture, by. gal- 
 vanism, or by^ny other means. The re- 
 verse of this is synthesis, or joining bodies 
 together. 
 
 ANASARCA. A species of di'opsy 
 where the watery fluid accumulates in 
 the cellular substance, or between the 
 sldn and the flesh in different parts of the 
 body. It is that species of dropsy which 
 is generally meant when the term is em- 
 ployed without addition in common dis- 
 coiu-se J but it is usually only a symptom 
 
 ANA 
 
 27 
 
 and evidence of some more extensive dis- 
 ease. See Dropsy. 
 
 ANATOMY. The art of exhibiting 
 the structure of organized bodies, either 
 by dissection, injection, boiling or other 
 modes of preparation ; or the knowledge 
 acquired by any of these means. 
 
 The importance of human anatomy as 
 the basis of all true physiology, and of the 
 rational exercise of physic and surgery, is 
 now universally acknowledged. The an- 
 cients having few opportunities of exam- 
 ining the structure of the human body, 
 made comparatively little progress in the 
 knowledge of its functions; and a few 
 facts obtained by the casual inspection of 
 wounded patients, with some analogies 
 gathered from the internal parts of brutes 
 which had been killed in sacrifice or for 
 food, constituted the sum of their anato- 
 mical knowledge. Their opinions of the 
 functions of living animals were still more 
 contemptible. Of the uses of the heart 
 and arteries, the lungs, and the liver, they 
 were totally ignorant ; and the grand dis- 
 coveries of the circulation of the blood, 
 the absorption of the chyle and lymph, 
 the functions of the stomach, the liver, 
 and the other viscera employed in diges- 
 tion or nutrition, are entirely the proper- 
 ty of the skilful and patient anatomists 
 of modern times. Of the absolute, the 
 indispensable necessity of the most minute 
 knowledge of anatomy to the operating 
 surgeon, it is superfluous to speak. By 
 the exact acquaintance which surgeons 
 have now acquired of the relative posi- 
 tion of the various organs, whether mus- 
 cles, nerves or blood-vessels, they are en- 
 abled successfully to perform operations, 
 which formerly would have been regarded 
 as utterly impracticable ; and to cure dis- 
 eases which in ancient times were allowed 
 to wear out the patient in torture and 
 putrefaction. 
 
 It is greatly to be regretted, that any 
 obstacles or discouragements to the acqui- 
 sition of anatomical knowledge should 
 exist in any quarter. There is undoubt- 
 edly an instinctive horror at mutilating 
 the erect form, >vhicb m as so lately the 
 
 1 
 
28 
 
 ANATOMY. 
 
 residence of an intelligent and an immor- 
 tal spirit ; and few could contemplate with- 
 out the deepest anguish the possibility of 
 this being done to the person of those who 
 had nourished their infancy and protected 
 their childhood, or in whose countenance 
 they wore accustomed to discern the 
 benevolent feelings of their heart. Yet 
 the instincts of nature must give way to 
 the calls of duty and necessity. Those 
 who for the acquisition of a useful and 
 necessary profession, devote themselves 
 for a time to the disgusting exercise of 
 dissection, should meet with no obstruc- 
 tion from those who are to benefit by 
 their skill and attainments. If persons 
 in the better ranks of life are afflicted 
 with diseases which require the knife of 
 the surgeon, they very properly demand 
 the assistance of the best that can be pro- 
 cured; but they should remember that 
 they cannot have a skilful surgeon who 
 has not dissected many bodies. This 
 should not be forgotten by judges, magis- 
 trates, and other persons in power ; who 
 by the influence of their character and 
 attainments, should temper and remove 
 the prejudices of the people, instead of 
 inflaming them. Every year there are nu- 
 merous judicial investigations, on the re- 
 sult of which many lives depend. In 
 trials for suspected murder, and in coro- 
 ners' inquests, almost the whole affair de- 
 pends on the evidence of medical men, 
 who are called upon to state their opinion 
 as to the cause of death ; and who can 
 never, with the smallest accuracy, describe 
 what is the consequence of violence, poi- 
 son, or disease in any part of the body, 
 unless, by the frequent practice of dissec- 
 tion, they have been familiar with the 
 appearance of the same part in its usual 
 unaltered state. Some knowledge of the 
 human body, and some information on the 
 importance of anatomy should be com- 
 municated in all Mechanics' Institutions ; 
 and the labouring classes should be im- 
 pressed with a proper sense of the im- 
 portance of good surgeons to them in par- 
 ticular. A rich man when sick or dis- 
 abled can command many alleviations ; 
 
 but to those who must live by the strength 
 of their limbs, and the dexterity of their 
 hands, health and vigour are equivalent 
 to a fortune. Sensible and well-inform- 
 ed masters should take proper oppor- 
 tunities of impressing on their work- 
 men the utility and necessity of human 
 dissections. When the fall of a scaffold 
 precipitates a number of masons to the 
 ground — when the bursting of a steam- 
 engine throws down the walls of a manu- 
 factory, and mangles many of the work- 
 men, or scatters the destructive fragments 
 of a vessel among the passengers and 
 crew — when the carpenter or ship-builder 
 cuts an artery with his tools, nothing but 
 the assistance of a skilful surgeon can 
 give a chance of recovery, and preserve 
 the life and limbs of the wounded for the 
 support of themselves and their depend- 
 ent families. No plates, no models, 
 no descriptions can convey the know- 
 ledge necessary to entitle a man to make 
 the smallest pretensions to operate on 
 the diseased living body. There are 
 means of supplying the materials for a 
 chiiTirgical education, without imparting 
 a skock to the feelings of any, and 
 without demoralizing the character of 
 those who are employed; and we con- 
 fidently trust that the liberality and good 
 sense of the legislature, will take out 
 of the way those obstructions to the 
 attainment of surgical knowledge, which 
 have been long productive, not only 
 of inconvenience, but of profligacy and 
 crime. 
 
 ANATOMY, Comparative. The 
 knowledge of the structure of the bodies, 
 or of the functions of other living crea- 
 tures besides man. The great functions 
 which are common to all living and orga- 
 nized beings, can be known only by the 
 diligent cultivation of comparatii'^e ana- 
 tomy. By this we see what powers or 
 operations of nature are necessary to the 
 existence of animal life, how respiration 
 is performed, and how digestion; how 
 some senses are perfect in some animals, 
 and in others defective, but all conducive 
 to the comfort of the animal in whom 
 
ANE 
 
 they are found. We are thus enabled 
 to distinguish what is essential to ani- 
 mal life, and what is extrinsic or acci- 
 dental ; and in many cases we apply to 
 the use of man, for the cure of diseases 
 and the improvement of his powersj, 
 the knowledge we acquire by observa- 
 tions and experiments made on the lower 
 animals. 
 
 ANCHOVIES.- Little fish obtained 
 in great numbers near Leghorn, which 
 are prepared for sale, by salting and pick- 
 ling. Their principal use is a sauce for 
 seasoning other food. 
 
 ANCHYLOSIS. A stiflf joint, most 
 jfi'equently owing to the smooth gristly 
 covering which tips the ends of bones 
 destined to move on each other, being 
 eroded by disease, and the bones in con- 
 sequence growing together. This may 
 arise from inflammation, and other dis- 
 eased actions, by which the cartilages at 
 the ends of contiguous bones are destroy- 
 ed; and the bony parts grow together. 
 A stiff joint may also be produced by the 
 thickening and adhesion of tendinous 
 parts, but this is not the true anchylosis. 
 When this affection is completed, it is 
 hardly possible to cure it ; but it is to be 
 prevented by removing inflammation and 
 other exciting causes ; and in some cases, 
 it is to be considered as a favourable ter- 
 mination of what would otherwise have 
 produced a wasting discharge, or have 
 required amputation, as in white swell- 
 ings of the knee joint. Stiff joints very 
 frequently occur in old rheumatic and 
 gouty cases. When the stiffness is not 
 complete, attempts may be made by fric- 
 tion with oily and stimulant matters, as 
 cajnphorated oil, oil of turpentine, a 
 strong brine, or neats' foot oil. Water, 
 either warm or cold, poured from a height 
 upon the affected joint is sometimes suc- 
 cessfuL 
 
 ANEUBISM signifies a soft swelling, 
 having a pulsating motion corresponding 
 to the beating of the arteries. To the 
 ignorant observer, it does not seem a very 
 formidable thing to be afflicted with a 
 small colourless swelling, free from pain. 
 
 ANE 
 
 29 
 
 and not hindering the motion or the 
 functions of any part ; but the surgeon 
 knows that it is the commencement of a 
 process, which, unless counteracted by 
 the most skilful treatment, must almost 
 infallibly terminate in the destruction of 
 the unhappy sufferer. He knows that 
 this timiour proceeds from a diseased ar- 
 tery, that the unremitting activity of ar- 
 teries presents obstacles to the recovery, 
 which unassisted nature can seldom over- 
 come ; that the tumour must continue to 
 exist, nay, to increase ; till, finding its way 
 through the skin and other coverings, the 
 blood bursts forth, and thus ends the life 
 of the patient. 
 
 Arteries have three coats, a villous or 
 smooth coat along which the blood 
 moves ; a muscular coat, and outermost 
 of all, a cellular coat. It may happen 
 that the whole of the three coats may be 
 enlarged, and the calibre of the artery in- 
 creased; this is considered by surgical 
 -writers as the only true aneurism ; but it 
 more frequently happens that from some 
 disease of the inner coat, a piece is ulcer- 
 ated and absorbed from it, and the con- 
 stant force of the blood pushes out the 
 muscular coat, and leaves nothing but the 
 cellular coat to contain the blood. This 
 more common form of the disease is call- 
 ed false aneurism. 
 
 This disease of an artery may be in 
 such a situation as to present no external 
 tumour to give any alarm; it may be 
 within the cavity of the chest or of the 
 belly ; and the same fatal progress will 
 go on, till the blood bursting into some of 
 these cavities, will be as much out of its 
 due place, and as fatally lost, as if it had 
 been spilt on the ground. There are 
 some situations where aneurisms occur 
 more frequently than others, and from 
 their situation they derive their names. 
 A few of these shall be enumerated : 1. 
 The popliteal aneurism is that which oc- 
 curs in the ham, and is one of the most 
 frequent that occurs. 2. The carotid in 
 the neck. 3. The axillary in the arm- 
 pit. 4. The subclavian in the artery un- 
 der the collar bone. 5. Internal aneu- 
 
 \ 
 
30 
 
 ANE 
 
 ANG 
 
 risms of the aorta, the large arterial 
 trunk issuing from the heai*t, frequently 
 occur. 
 
 Cure of Aneurism. Several methods 
 have been proposed for the cure of aneu- 
 rism, some constitutional and others local : 
 the principal one acting on the general 
 system is that of extreme low living, 
 which is said to have succeeded in some 
 instances. The only way in which it 
 could act must have been by diminishing 
 the quantity and force of the blood, and 
 so allowing the diseased part of the artery 
 to heal; but it has not often been suc- 
 cessful. It is now universally allowed 
 that a cure of aneurism is rarely to be 
 expected, unless by some means or other 
 the canal of the artery be obliterated in 
 its course nearer the heart than the tu- 
 moui". Sometimes this takes place spon- 
 taneously, from the tumour occasioning 
 a pressure in so favourable a part of the 
 artery, that it occasions an adherence of 
 its sides ; but we do not know when to 
 expect this, and the fewness of the in- 
 stances in which it has happened, does not 
 warrant our waiting for it in any case. 
 We must put in practice the methods 
 which the well directed observation of 
 modern surgery has contrived ; and the 
 best way of effecting the obliteration of 
 the canal of the artery, is by tying a fine 
 ligature tightly round the vessel. The 
 effect of this is to cut through the two 
 inner coats as if a knife had done it ; in- 
 flammation is excited, a clear fluid called 
 coagulable lymph is thrown out, and by 
 this means a plug is formed which pre- 
 vents the blood from going any further 
 along that portion of the artery. The 
 pulsation of the tumour is immediately 
 stopped ; the limb for a short period be- 
 comes colder, but in no long time regains 
 its heat, or increases it. The continual 
 action of the heart and arteries enlarges 
 the smaller collateral branches, and this 
 enlargement continually going on, ren- 
 ders them capable of supplying the limb 
 with blood. The tumour gradually di- 
 minishes by the action of the absorbent 
 vessels, which remove out of the system 
 
 what is decayed or useless, so that it 
 gives no farther trouble. 
 
 When an aneurism is out of the reach 
 of an operation, life may be prolonged by 
 occasional bleeding, a spare diet, and 
 avoiding every thing that would too much 
 stimulate the action of the heart and ar- 
 teries. 
 
 ANEURISM, Varicose, ^ee Blood- 
 letting, ACCIDENTS FROM. 
 
 ANGELICA, Angelica archangelica. 
 A biennial umbelliferous plant, all the 
 parts of whi{;h, especially the roots, have 
 a fragrant aromatic smell, and a pleasant 
 bitter warm taste. It is little used in me- 
 dicine, but a sweet-meat is made of the 
 candied stalks and root by the confec- 
 tioners. 
 
 ANGINA PECTORIS. An acute pain 
 at the lower end of the breast bone, in- 
 clining towards the left side, accompanied 
 with great uneasiness. 
 
 Symptoms. The leading symptoms of 
 the disease are violent palpitations of the 
 heart ; diflieulty of breathing, and a feel- 
 ing as of suffocation. In the first stage 
 of the disorder, the pain is felt chiefly 
 after some exertion, as going up stairs, 
 or up a hill, or walking quickly, parti- 
 cularly when the stomach is full ; but in 
 more advanced stages, slighter exertions 
 are sufficient to cause a paroxysm of pain, 
 as walking, riding, coughing, sneezing, or 
 speaking ; passions of the mind also have 
 the same tendency. In the first stage, the 
 uneasy and threatening symptoms go off 
 soon ; but afterwards they are longer and 
 more distressing, and give the patient the 
 fear of immediate dissolution. During 
 the fit, the pulse is feeble and irregular, 
 the face pale, and covered with a cold 
 sweat, and the patient appears as if in 
 a fit of apoplexy, without the power of 
 sense or motion. The disease makes 
 occasional attacks for years, and at last 
 suddenly puts a period to the patient's life. 
 
 Causes. Angina Pectoris is believed 
 by some to be chiefly owing to an ossified 
 state of the vessels which nourish the 
 heart, by which its powers are weakened, 
 and it is rendered unable to empty itself 
 
ANG 
 
 ANI 
 
 31 
 
 properly; so that, upon auy exertion of 
 body or mind, by which the blood is sent 
 back to the heart more quickly than usual, 
 that organ is unable to send it through 
 the lungs, and hence the distressful symp- 
 toms above noted. But the symptoms of 
 the disease and the examinations of bo- 
 dies after death scarcely warrant this con- 
 clusion, as this state of the arteries has 
 not been found even in very severe cases ; 
 and the manner in which it attacks and 
 goes off by paroxysms, does not seem to 
 be dependent on so permanent a cause as 
 ossification. It rather appears to be of 
 a spasmodic or convulsive nature, as is 
 shown by the manner of treatment, which 
 is sometimes successful by stimulants 
 and antispasmodics. It is found to attack 
 chiefly those who are of the make which 
 has been supposed most liable to apoplexy, 
 viz. those with large heads and short 
 necks, and who lead a sedentary and in- 
 active life, who are disposed to be cor- 
 pulent, or who are of gouty habits. It sel- 
 dom attacks persons under the age of fifty. 
 
 Treatment. The cure and prevention 
 consists in diminishing the quantity of 
 blood in the system, by small bleedings 
 and spai-e diet, and avoiding every thing 
 that would quicken the circulation. In 
 the fit, stimulants must be very cautiously 
 employed, the head and temples are to be 
 bathed with cold water and vinegar; a 
 slight bleeding should be used to relieve 
 the overloaded heart, gentle pressure em- 
 ployed on the left side to empty the heart ; 
 and on the appearance of returning respi- 
 ration, ammonia is to be applied to the 
 nose. The use of wine or spirits seems 
 rather a hazardous practice. The disease 
 has been mitigated by forming issues in 
 some part of the body. Also by blisters, 
 or tartar emetic ointment applied to the 
 chest. 
 
 Those who are subject to this disease, 
 should carefully shun all mental iiTitation, 
 and every gust of passion that would hurry 
 the circulation. Moderate exercise should 
 be daily taken in the open air, but no vio- 
 lent exertion should be ventured on ; and 
 aJl attempts at going up a rising ground 
 
 should be avoided, or if made, it should be 
 with the utmost care. The food should 
 be plain and easily digestible, such as is 
 not liable to occasion flatulence. Fer- 
 mented liquors are improper. On any 
 approach to fulness of blood, animal food 
 should be withdrawn from the diet ; and 
 mild saline purgatives frequently taken. 
 A perpetual blister or other irritation in 
 the region of the heart is useful, and 
 warm bathing to the feet and legs may 
 help still further to prevent the undue 
 flow to the other parts of the body. 
 
 ANGUSTURA BARK is obtained 
 from the Cusparia febrifuga of Linnaeus, 
 the Bonplandia trifoliata of the modern 
 botanists. It is stimulant and tonic to the 
 organs of digestion, but does not cure in- 
 termittents, as was at one time believed. 
 It increases the appetite for food, and does 
 not oppress the stomach as the Peruvian 
 bark is apt to do. It is given in powder, 
 in doses of from five to twenty grains, or 
 in infusion, one drachm to four ounces of 
 water ; or in tincture, in the dose of one 
 or two drachms, or in the form of watery 
 extract. 
 
 There is a substance called fine angus- 
 tura, which is the bark of a different 
 plant, the Brucea antidysenterica, and 
 contains an active poison. Its \-irulence 
 depends on an alkaloid body, to which 
 its discoverers, Pelletan and Caventou, 
 have given the name of Brucea. It is 
 said to produce tetanus, without affecting 
 the intellectual faculties. It is charac- 
 terized by having its outer bark covered 
 with a matter which has the appearance 
 of rust of iron. 
 
 ANIMAL. An organized substance 
 endowed with the power of voluntaiy 
 motion, of sensation, and the power of re^ 
 producing its like. 
 
 ANIMAL FOOD is the aliment procur- 
 ed from the various classes of living be- 
 ings. Under the article AxwrENT Me have 
 given a very general account of the prin- 
 cipal animal substances used as food ; and 
 it only remains here to notice some par- 
 ticulars in which an animal and vegetable 
 diet differ in their effects on the human 
 
32 
 
 ANIMAL. 
 
 body; and to state some cases in which 
 the use of animal food is improper. 
 Thoug^h milk, strictly speaking", is an ani- 
 mal substance, we for the present exclude 
 it from our consideration, but mean not 
 to exclude cheese, which is derived from 
 it. Animal food produces a considerable 
 degree of excitement during its digestion, 
 with much irritation and heat of the sys- 
 tem. It is highly nutritive, and when 
 not tempered with a due mixture of aces- 
 cent vegetables, it oppresses and over- 
 feeds those who use it, especially if they 
 be of sedentary habits ; and when acute 
 diseases occur in such persons, they will 
 probably put on a putrid form. An im- 
 moderate use of animal food predisposes 
 to sea scurvy and cutaneous diseases. 
 Hence the impropriety of indulging child- 
 ren with much butter, cheese, and butcher 
 meat ; and hence the necessity of a very 
 copious allowance of vegetables, especially 
 in the summer months, and in warm cli- 
 mates. Young persons, and such as use 
 abundant exercise, are least injured by a 
 free use of animal food ; those who have 
 attained their full growth require less of 
 it, and old persons should use it still 
 more sparingly. 
 
 The prohibition of animal food in every 
 shape, whether solid food or soups, is one 
 great particular of the antiphlogistic re- 
 gimen. Hence it is absolutely forbidden 
 in the early and acute stages of fevers, 
 inflammations, apoplexy, epilepsy, small- 
 pox, measles, and scarlet fever. It is very 
 difficult to persuade patients or their 
 friends of the importance of attending to 
 this particular. Nothing is more com- 
 mon than to hear lamentations of the 
 total loss of appetite, and of the patient 
 being able to take nothing but beef- 
 tea, not considering that this is really 
 taking a great deal of the most nutritious 
 and stimulating animal food. In some 
 states of the system, animal food is as 
 useful as medicine ; some kinds of sto- 
 mach complaints demand its almost ex- 
 clusive use; and in diabetes, the cure 
 has been attempted not only by exclud- 
 ing vegetables, but by employing pork- 
 
 steaks, and other animal matters in a state 
 of rancidity. 
 
 ANIMAL FUNCTIONS. Certain ac- 
 tions performed in the animal body not im- 
 mediately necessary to life, but which are 
 peculiar to living or animated bodies. 
 These are the senses and voluntary mo- 
 tion. Sleep consists in the suspension of 
 these. 
 
 ANIMAL HEAT. A certain tempe- 
 rature is necessary for the healthy action 
 of all living bodies, whether animal or 
 vegetable. In very low temperatures, all 
 vegetable life dies ; but in most situations, 
 animals have the wonderful power of 
 keeping up a proper degree of heat where 
 all other things would be frozen into in- 
 activity ; and in the burning sultry cli- 
 mates they can reduce their temperatiu-e 
 to a degree fitted for their comfortable 
 existence. It has been an interesting in- 
 quiry, on what this power of equalizing 
 the temperature depends. The following 
 is the explanation most generally acqui- 
 esced in by philosophers, though the late 
 experiments of Mr. Brodie of London 
 have rendered it less satisfactory than it 
 was formerly considered. It has been 
 long known that those animals which do 
 not breathe, have a temperature very little 
 superior to the medium in which they 
 live ; the temperature of fishes and insects 
 is not much above tliat of the water. On 
 the other hand, man, and the quadrupeds 
 who breathe, have a temperature consi- 
 derably higher than the atmosphere ; the 
 usual temperature of the human body is 
 98° of Fahrenheit's thermometer. Birds, 
 which breathe a greater proportional 
 quantity of air in a given time than 
 man, have a temperature equal to 103" 
 or 104°. It has been proved that the 
 temperature of all animals is proportion- 
 al to the quantity of air which they 
 breathe in a given time. These facts 
 seem to demonstrate that the heat of ani- 
 mals depends upon respiration. How 
 this does so. Dr. Crawford attempted to 
 explain in the following manner : — The 
 oxygen gas of the air we breathe, com- 
 bines in the lungs with a portion of car- 
 
ANI 
 
 ANO 
 
 33 
 
 bon emitted by the blood. During this 
 combination, the oxygen gives out a great 
 quantity of caloric, or the matter of heat, 
 with which it had been combined; and 
 this heat is not only sufficient to support 
 the temperature of the body, but also to 
 carry off the new formed water in the 
 state of vapour, and to raise considera- 
 bly the temperature of the air inspired. 
 According to Dr. Crawford, the whole 
 heat necessary to keep up the tempera- 
 ture of the body is evolved in the lungs ; 
 but if this were true, the heat ought to 
 be greatest in the lungs, and to diminish 
 in proportion to the distance from them ; 
 but this is not true. To get rid of this 
 objection, Dr. Crawford says, that as it 
 requires a greater quantity of heat to 
 raise arterial blood to a certain degree 
 of heat than it does to raise venous blood 
 to the same degree, the venous blood 
 being changed into arterial blood in the 
 lungs, much of the new caloric evolved 
 in the lungs is necessary to keep up the 
 temperature in the arterial blood; and, 
 therefore, the temperatiu-e in the lungs 
 is not greater than in the rest of the 
 body. In the course of the circulation 
 through the body, arterial blood is con- 
 stantly in the act of being converted in- 
 to venous ; and having less capacity for 
 retaining heat than the venous, it is 
 given out as it passes along the system, 
 and so the temperature of the extreme 
 parts of the body does not diminish. 
 But every theory, however plausible, 
 and however pleasing to the imagina- 
 tion, must give way to facts. The ques- 
 tion now is not, does it explain the phe- 
 nomena ? but, is it founded on facts ? Dr. 
 John Davy has shown that the difference 
 between arterial and venous blood in the 
 heat they require to raise them to the 
 same temperature, is almost impercep- 
 tible, or at least inadequate to the ex- 
 planation given by means of it ; and the 
 French chemists have shown that the 
 carbonic acid gas has no heat to spare 
 for the lungs, but needs it all for its own 
 gaseous existence. By some experi- 
 ments of Mr. Brodie, he found, that by 
 
 artificial respiration in dead animals 
 whose brain had been removed, the usual 
 proportion of carbonic acid gas is form- 
 ed ; but the heat diminishes more rapid- 
 ly than in a dead animal in which artifi- 
 cial respiration is not kept up. Dr. Thom- 
 son (SyTstem of Chemistry) thinks those 
 experiments have entirely destroyed the 
 foundations on which Dr. Cra^vford's 
 theory was built. But he thinks also, 
 that a connexion is established between 
 respiration and heat, by the fact that ani- 
 mals which respire regularly are hot- 
 blooded, while amphibious animals and 
 fishes are cold-blooded. 
 
 ANIMAL KINGDOM. The whole as- 
 semblage of animal beings, as distinguished 
 from the vegetable and mineral kingdoms. 
 ANIMATION, Suspended. 5ee Drown- 
 ing and Resuscitation. 
 ANISE. See Dill. 
 ANODYNES. Medicines which re- 
 lieve pain. Another name by which they 
 are known is narcotics, from a Greek 
 word, which signifies stupor, which may 
 be considered as the generic term; and 
 the various narcotics have received spe- 
 cific names, according to the effect most 
 strikingly produced by them. If they 
 induce sleep, they are called hypnoticsy 
 or soporifics ; if they diminish the rapi- 
 dity of the circulation, or the activity of 
 the general system, they are called seda- 
 tives ; and from the circumstance of being 
 used to diminish the sensibility to pain, 
 they are called anodynes. The substances 
 possessed of narcotic, and, therefore, of 
 anodyne properties, are very numerous. 
 The following are some of them; and 
 under each separate article we shall state 
 its properties, and the mode of adminis- 
 tering it : Opium, henbane, hemlock, 
 camphor, fox-glove, tobacco, stramonium. 
 Of these, one of the most useful is opium, 
 in some of its various shapes. It may be 
 given in a very simple form, as a draught 
 formed of twenty-five drops of the tinc- 
 ture, commonly called laudanum, with 
 cinnamon or peppermint water; or the 
 opiate piU, or a grain of solid opium 
 Another medicine, very useful for as- 
 
34^ 
 
 ANT 
 
 ANT 
 
 suaging pain, is hyoscyamus, or henbane; 
 the dose is from lialf a drachm to a drachm 
 of the tincture, or from one grain to three 
 grains of the extract. 
 
 Grreat care must be taken not to give 
 anodynes from the mere circumstance of 
 pains being- felt. A person has an acute 
 pain of the side from inflammation of the 
 lungs ; or of the bowels, from inflamma- 
 tion there. In such cases, the true ano;- 
 dyne is a large bleeding; and a dose of 
 opium or gin, so frequently given on such 
 occasions, would be destructive. 
 
 ANOMALOUS. Irregular. Wlien 
 a disease is accompanied by unusual 
 symptoms, which render it difficult to 
 arrange it under any particular class, or 
 when the symptoms of a disease vary 
 from those generally exhibited, the dis- 
 ease or the symptoms are said to be ano- 
 malous. 
 
 ANTACIDS. Medicines which cor- 
 rect acidity of the stomach, being nearly 
 the same as what are called absorbents. 
 Such medicines are useful for removing 
 the present disagreeable symptoms ; but 
 the recurrence of such symptoms is best 
 prevented by restoring the healthy action 
 of the stomach, and of the general system; 
 and by avoiding such articles of diet as 
 one finds by his own experience are apt 
 to produce acidity or heartburn. The 
 principal antacids are magnesia, chalk, 
 lime water, caustic potash, carbonate of 
 potash, or carbonate of soda, ammonia, 
 or its caibonate. For the doses of each, 
 6ee under their respective articles. See 
 Absorbents. 
 
 ANTHELMINTICS. Medicines which 
 have the power of destroying or expel- 
 ling worms. See Worms. 
 
 ANTIDOTE. A medicine which has 
 the power of counteracting the injurious 
 effects of some poisonous substance taken 
 into the stomach, or otherwise introduc- 
 ed into the system. The perfection of an 
 antidote would be, that it would instantly 
 and infallibly prevent all mischief from a 
 poison ; that the poison and the antidote, 
 when both swallowed, should keep the 
 person in the same state as if he had 
 
 swallowed nothing at all ; or that if he 
 persisted in a long course of antidotes, he 
 should, like Mithridates, be incapable of 
 suffering by poison. But, in reality, we 
 possess very few such antidotes. In our 
 laboratories. Or vessels, a poisonous mine- 
 ral or vegetable production may, by the 
 addition of another substance, be so 
 changed, that the new product would be 
 quite harmless to the body ; but too often 
 the poison swallowed has begun to exert 
 its destructive effects before the antidote 
 can be applied, or the living powers of the 
 stomach may prevent the chemical de- 
 composition that would otherwise take 
 place. A metallic acrid substance may be 
 swallowed, and may produce not only the 
 corrosion it would do out of the body, 
 but excite inflammation, spreading exten- 
 sively to the neighbouring parts. It will 
 not do merely to throw in a substance, if 
 such there be, which would produce an 
 inert one in combination with some of the 
 ingredients of the first ; but we must 
 counteract the effects of inflammation, and 
 its consequences. 
 
 Different poisons require different re- 
 medies, and it is right to know such as 
 may be quickly and easily applied in the 
 various accidents which occur in domes- 
 tic life. The substances most frequently 
 swallowed as poisons are from the mineral 
 kingdom, as arsenic, corrosive sublimate, 
 preparations of copper, tin, bismuth, and 
 lead ; or from the vegetable kingdom, as 
 opium, henbane, cheiTy-laurel, stramo- 
 nium, tobacco, hemlock, foxglove, deadly 
 nightshade. The strong acids and alkalis 
 not unfrequently are tlie source of fatal 
 accidents in domestic life, and of late nu- 
 merous instances have occurred of poi- 
 soning- by the oxalic acid, which is em- 
 ployed for the cleaning of boot-tops. By 
 referring to these several articles wiU be 
 seen the most advisable treatment for 
 each. 
 
 ANTIMONY. A metal from which 
 are derived some of the most celebrated 
 and useful substances employed in the 
 practice of physic. The ancients were 
 acquainted with an ore of it, Avhich was 
 
ANTIMONY. 
 
 3d 
 
 called stibium; but it does not appear 
 that they considered this substance as con- 
 taining a metal, or that they knew what 
 modern chemists call antimony, in a state 
 of purity. It is said to have obtained its 
 name, which signifies hostile to monkSy 
 from the alarming and destructive effects 
 it produced among the inhabitants of a 
 certain monastery, to whom it was given 
 by Basil Valentine, one of their brethren, 
 who had observed that some pigs who had 
 eaten of madder, with which some ore of 
 the metal was accidentally mixed, became 
 thriving and fat. He wished to produce 
 the same healthy and respectable appear- 
 ance on his brethren, but the subjects of 
 the experiment not beiug precisely the 
 same, what fattened the swine, killed the 
 monks. Basil Valentine is the first writer 
 who describes the method of extracting 
 the metal from its ore. Towards the end 
 of the fourteenth century, he published 
 the Triumphal Chariot of Antimony, a 
 work memorable for the numerous che- 
 mical fiicts and processes first described in 
 it. To the exertions of Basil Valentine, 
 and of the medical alchymists who follow- 
 ed him, we are indebted, not only for our 
 knowledge of all the properties of anti- 
 mony, but also for the introduction of 
 many chemical remedies, in opposition to 
 the Galenical remedies, which were re- 
 tained ^\dth such obstinacy by the regular 
 practitioners of the time. 
 
 Antimony, as a medicine, is valuable 
 for its emetic powers ; and by skilful ma- 
 nagement it is made a useful sudorific, and 
 is also employed to diminish too great ex- 
 citement of the vascular system. 
 
 No metal, not even mercury itself, has 
 been tortured into such a variety of forms 
 by chemists, no drug has excited more the 
 attention of physicians. Some considered 
 it as a specific for every disease, others 
 contended that it should be detested as a 
 virulent poison. The parliament of Paris 
 condemned it by public authority; and 
 by a singular coincidence, their great mo- 
 narch, Louis XIV. nearly lost his life by 
 an overdose of this medicine ; at least 
 this is told by Guy Patin, who wrote 
 
 against antimony with great virulence. 
 After many plans proposed and rejected, 
 modern pharmacy is contented with a very 
 few preparations of antimony ; and prac- 
 titioners find therii sufficient for every 
 useful purpose, and are freed from the un- 
 certain doses and dangerous forms which 
 annoyed their predecessors. 
 
 The great object with respect to anti- 
 monials is to get a medicine that we can 
 depend upon. The ancient way of pre- 
 paring an emetic wine, was to pour Rhen- 
 ish wine into a cup made of antimony, let 
 it stand some days, and then to use the 
 wine as impregnated with the virtues of 
 the antimony. The uncertainty of the 
 preparation was great. Sometimes five 
 parts in the hundred of the metallic pre- 
 paration were obtained, sometimes twen- 
 ty-seven in the hundred. Antimonials 
 must be dissolved before they act as eme^ 
 tics ; they would dissolve in the stomach, 
 but the acid they would there meet with 
 is uncertain. The preparation of an- 
 timony most to be depended on is tartar 
 emetic, so called because we boil the 
 cream of tartar and crocus of antimony 
 together in water, and thus prepare the 
 salt so generally used in medicine. Its 
 chemical name is the tartrate of antimony 
 and potash. 
 
 Tartar emetic is given in doses of from 
 one grain to three, dissolved in water; 
 and in these doses it proves powerfully 
 emetic, occasioning very complete clear- 
 ing of the stomach, considerable depres- 
 sion of strength, and paleness of the coun- 
 tenance ; and besides, enough is frequent- 
 ly left to i>ass into the bowels, and to 
 prove purgative. Two grains are to be 
 dissolved in four ounces of water ; and a 
 taWe-spoonful of this solution given every 
 ten minutes or quarter of an hour, till 
 vomiting taltes place, is a good way of 
 giving tartar emetic. By giving the same 
 solution in rather smaller doses, and at 
 longer intervals, as of two hours or three 
 hours, instead of vomiting, the effect is 
 produced of bringing out a gentle per- 
 spiration, which is of the greatest benefit 
 in many diseases, especially feverish dis- 
 
36 
 
 ANT 
 
 ANT 
 
 eases. Tartar emetic is also given dis- 
 solved in wine ; an ounce of the antimo- 
 nial wine contains two grains of tartar 
 emetic; but it is not so often given as 
 the watery solution, because in febrile 
 complaints the wine might be improper. 
 Tartar emetic does not often lie on the 
 stomach, but if in large doses it should 
 ^o so, it acts as a virulent poison : its ex- 
 pulsion must be promoted by oil and 
 warm water, or its effects counteracted 
 by taking the decoction of yellow bark, 
 which renders the tartar emetic inert. A 
 cordial is sometimes required after the 
 operation of tartar emetic, even in the 
 smaU doses used in this country. When 
 it has acted too violently, opium may be 
 given to allay the nervous sjTnptoms; 
 and when the exhaustion from vomiting 
 has been great, a little wine or other cor- 
 dial may be given to relieve it. The con- 
 tinental physicians give tartar emetic in 
 doses which appear terrible to a British 
 practitioner : this can be accoimted for 
 only by knowing that its activity is di- 
 minished or destroyed by substances 
 given along with it, especially bitters and 
 the bark. Twenty grains of tartar eme- 
 tic, with an ounce of Peruvian bai'k in de- 
 coction, does not usually excite vomiting. 
 Another antimonial much used with 
 the view of promoting gentle perspira- 
 tion in febrile complaints, is the antimo- 
 nial powder, for which the dose is three 
 or four grains every four hours. A pre- 
 paration of a very similar kind to this, is 
 the celebrated James's Powder, which has 
 maintiiined its reputation for nearly a 
 himdred years. Antimony, conjoined 
 with some narcotic medicine, is a better 
 sudorific even than when employed alone ; 
 the dose for this purpose is thirty drops 
 of laudanum, with forty of antimonial 
 wine, to be given in an ounce of water at 
 bed- time. A mixture of antimonial pow- 
 der, calomel, and opium, in the propor- 
 tion of three grains of the powder, tM^o of 
 calomel, and one of opium, in the form of 
 a pill, with mucilage of gum arabic, 
 crumb of bread, or any convenient sub- 
 stance, is a good sudorific. When an 
 
 emetic is wanted for children, antimonials 
 are seldom those we should employ. 
 
 External use of Antimony. — Tartar 
 emetic, when well mixed with lard, in 
 the proportion of one or two drachms of 
 the substance to an ounce of the lard, 
 forms a very irritating ointment, which 
 occasions a pustular eruption, something 
 resembling the vesicles of cow-pox, and 
 proving very serviceable in deep-seated 
 inflammation. The pustules are very 
 painful, and should they become much ir- 
 ritated, a soft poultice of bread and milk 
 will in general give relief. Frictions 
 with this ointment at the pit of the sto- 
 mach have been much recommended in 
 hooping-cough. 
 
 ANTIPERISTALTIC motion of the 
 intestines, a symptom of the iliac passion, 
 viz. the bowels, instead of propelling their 
 contents dovrawards, drive them in a con- 
 trary direction, so that medicines given 
 by injection, come out at the mouth. 
 
 ANTIPHLOGISTIC. Counteracting 
 inflanmiation, or the inflammatory ten- 
 dency. This epithet is chiefly applied to 
 what is called the Antiphlogistic Begi— 
 men, under which are included all the 
 rules, proliibitions, and observances which 
 are prescribed in cases of fever, inflam- 
 mation, and diseases of excitement. These 
 directions, viewed by themselves, may 
 appear minute, trifling, and beneath the 
 dignity of science ; but, taken together, 
 they form a plan of acting, of which the 
 best recommendation is the safety attend- 
 ing their observance, and the fatal results 
 which ensue when they are rashly, obsti- 
 nately, or secretly disregarded. The en- 
 lightened and upright practitioner does 
 not perplex his patient with the volubility 
 of medical phrases which he cannot un- 
 derstand, nor does he needlessly pour in 
 quantities of nauseous dmgs ; he knows 
 that in many things the patient must mi- 
 nister to himself, and in many, the good 
 sense pf his attendants must ^ ard ofl' the 
 mischief arising from surrounding cir- 
 cumstances of hourly or incessant occur- 
 rence. The antiphlogistic regimen con- 
 sists in the removal or non-application of 
 
ANTIPHLOGISTIC. 
 
 37 
 
 whatever would greatly or unnecessarily 
 employ the powers of either the body or 
 mind. To illustrate what is meant, let 
 us take the case of a patient in inflam- 
 matory fever, or in pleurisy. The medical 
 attendant will, of course, when first called, 
 use the proper remedies, as blood-letting, 
 purging, and determining to the skin; but 
 he will do comparatively little for his pa- 
 tient's recovery, if his directions for his 
 after management are not precise, and accu- 
 rately attended to. The airof the apartment 
 must be kept pure and temperate, there 
 ought to be no unnecessary attendants in 
 the room, fresh air should be admitted 
 jfrom time to time, by a cautious opening 
 of the doors and windows ; and all eva- 
 cuations from the body should be quick- 
 ly removed from the apartment; there 
 should be no glare of light from the sun, 
 or fire, or candles ; the room should be 
 darlcened, and the ciu-tains, at least those 
 next the windows, should generally be 
 closed. No talking or whispering should 
 be kept up in the room; the noise of 
 carts or carriages in the street should be 
 deafened by straw or oak bark, or where 
 this is impracticable, the ears should be 
 slightly stopped with cotton or wool. 
 The regulation of the diet and of the 
 drink is of primary importance, and it is 
 here that physicians have the greatest 
 diflficulties to encounter. The friends of 
 the patient tell with real concern, that he 
 has taken no food for many days, that he 
 must be very weak, and that he surely 
 can never get through if he be kept so 
 low; they do not consider the salutaiy 
 instinct of nature, in loathing the food 
 which the stomach cannot digest; and 
 they venture to give what they think a 
 very little nourishment, in the shape of 
 beef-tea or chicken-broth. The physician 
 at his next visit finds the fever still high, 
 the pulse fuU and strong, the thirst ur- 
 gent, the face flushed ; he suspects or ob- 
 tains a confession of the imprudence 
 which has been committed, and is obliged 
 again to bleed largely to counteract or 
 repair the mischief. When nourishment 
 )£ allowed at all, it should be of the mild- 
 
 est kind, and such as does not heat or 
 stimulate the body, as thin gruel, or pa- 
 nado, sago, rice, or arrow-root. Equally 
 alarming and destructive events follow 
 from too strong drinks. However gene- 
 ral among the lower classes may be the 
 hateful practice of using spirits on all 
 occasions, and their faith in the myste- 
 rious virtues of wine, it is to be hoped 
 that few among the well-informed and 
 educated classes would venture on strong 
 drink in any illness, without the express 
 order of the physician; but even here, 
 injury is sometimes done, especially in 
 the inflammatory diseases of child-bed, by 
 the ignorance or officiousness of nurses 
 and servants. The drink should be of the 
 mildest sort, neither too hot nor too cold, 
 though it is in many cases very proper 
 to allow the patient cold water, for which 
 he often has instinctively a strong and 
 not unsafe desire. The drinks proper in 
 inflammatory diseases are toast-water, 
 barley-water, water-gruel, various pre- 
 serves of fruit dissolved in water, as straw- 
 berry jam, raspberry jam, &c. whey of 
 milk, vinegar and water, sulphuric acid 
 largely diluted with water, water from 
 cream of tartar, lemonade, and the like. 
 Beer may be aUowed when there is no 
 reason against it from the presence of 
 much flatulence. Much irritation will 
 be prevented by frequent changes of linen 
 and bed-clothes. Much of the antiphlo- 
 gistic regimen is to be directed to the 
 mind. Every source of uneasiness and 
 anxiety must be avoided ; there must be 
 no talking about business, no hasty or 
 unguai'ded narratives introduced, no ex- 
 hibition of distress and hurry, of alarm, 
 or mystery, in the faces of friends or 
 attendants. Every thing should be done 
 for the patient's comfort, with calmness 
 and good sense ; and while we cannot 
 sanction any deceiving of his mind with 
 regard to his situation, when there is real 
 danger, we consider it as of great impor- 
 tance to give him no unnecessary agita- 
 tion, by the imprudence of those around 
 liim, or by representing things as worse 
 than they really are. 
 
3S 
 
 ANT 
 
 ANT 
 
 ANTISCORBUTICS. Medicines which 
 prevent or cure the sea-scurvy. In vul- 
 gar and popular usage, scurvy means 
 every disease to which the skin is sub- 
 ject; but it should be restricted to the 
 disease brought on by living on salt pro- 
 visions, without a due mixture of vege- 
 table diet, whether at sea or land. Fresh 
 vegetables are the true antiscorbutics, 
 such as cabbage, cresses, lemons, &c. but 
 as ships in long voyages would be badly 
 off if they were dependent on vegetables, 
 it is fortunate that we are now possessed 
 of an antiscorbutic, cheap, portable, and 
 infallible; this is lime juice. An ounce 
 a-day, given in water or any mild fluid, 
 will prevent or cure the scurvy ; and in 
 the' longest voyages, the mariner may 
 keep his mind free from the smallest 
 dread of that formidable malady, which 
 in former times rendered useless the brav- 
 ery, skill, and perseverance of British 
 seamen, and whose symptoms and conse- 
 quences, both to the individual and to the 
 public service, are so graphically describ- 
 ed in the narrative of Anson's Voyage. 
 
 ANTISEPTICS. Substances which 
 prevent animal and vegetable matters 
 from running into putrefaction. The prin- 
 cipal of these are sea-salt, sugar, vinegar, 
 bark, and hops. These are much used 
 in pickling and preserving meat and 
 vegetables. A tendency to putrescency 
 is characteristic of several diseases and 
 conditions of the body : this is indicated 
 by the fluid discharges being of a very 
 offensive smell, and very quickly under- 
 going decomposition. Such tendency is 
 seen in malignant typhus fever, putrid 
 sore throat, gangrene, and sea-scur\y. It 
 is a very proper measure to give medi- 
 cines or diet to counteract this ; but the 
 medicines to be given as antiseptics, are 
 not those which resist putrefaction in 
 substances out of the body, but tliose 
 which act on the living powei-s of the 
 system, rather than on their chemical 
 composition. The symptoms which are 
 thought to denote putrescency in any 
 disease, arc to be combated in every par- 
 ticular case by appropriate remedies ; in 
 
 some, as fevers, we employ bitters, quas- 
 sia, or the bark ; in others, as sore throat, 
 acids used cM drink or gargles ; or car- 
 bonic acid, from soda powders, or small 
 beer; or powdered charcoal and barm 
 poultices, to fetid and foul ulcers. In the 
 sea-scurvy, which is of so putrescent a 
 nature, the true antiseptic is lemon jtiice 
 or fresh vegetables. 
 
 ANTISPASMODICS. Medicines giv- 
 en to relieve spasm, or irregular and pain- 
 ful actions of muscles, or muscular fibres. 
 Antispasmodics, properly so called, are 
 given rather to put an end to a fit, Or 
 sudden attack of painful convulsions, tlian 
 to cure the disease itself. A patient is 
 seized with epilepsy, and to put a stop to 
 the fit, we administer to him hartshorn, 
 camphor, or ether ; but this will not cure 
 the disease, or prevent its return; we 
 must try to discover its cause, whether 
 it proceeds from worms, from dentition, 
 or from a wound; and we must direct 
 our after practice accordingly. Antispas- 
 modics are useful in cramp of the stomach, 
 in griping pains of the bowels, asthma, 
 hysterics, and some other sudden and 
 violent affections. In griping of the 
 bowels, it is a very common practice 
 among the common people to trust to the 
 antispasmodic powers of ardent spirits, 
 either alone or made into toddy ; but the 
 possibility of the pain being a symptom 
 of inflammation, should in every instance 
 deter from this expedient. If the pain 
 arise merely fi'om spasm or flatulence, a 
 cupful of warm water will be a far bet- 
 ter remedy. Frequently, cold water sud- 
 denly applied to some part of the body 
 relieves the spasm there or even in dis- 
 tant parts. Thus the cramp in the leg is 
 stopped by cold applied to the foot. 
 Sometiines the warm bath relieves spasm, 
 sometimes blood-letting does it. It ap- 
 pears, then, that whatever makes a strong 
 or sudden impression on the nervous 
 system, is to be regarded as an antispas- 
 modic ; but the medicines which com- 
 monly go under that name, and produce 
 a sudden relaxation of the spasm, aro 
 musk, castor, ammonia, assafctida, vale-p 
 
ANX 
 
 APE 
 
 39 
 
 rian, opium, ether, camphor. A good 
 antispasmodic draught in asthma is the 
 following : thirty drops of laudanum, an 
 ounce of water, half a tea-spoonful of 
 ether quickly added, and taken suddenly. 
 
 ANUS. The lowest part of the straight 
 gut, commonly called the fundament. It 
 is surrounded by circular fibres, the as- 
 semblage of which is called the sphincter 
 aniy which keeps the orifice closed, ex- 
 cept when the bowels are to be evacuat- 
 ed. The parts in its neighbourhood are 
 abundantly supplied with blood; hence 
 in operations for fistula in ano, a con- 
 siderable loss of blood sometimes hap- 
 pens. 
 
 As there is also a great deal of fat and 
 cellular substance about these parts, they 
 are not unfrequently the seat of large 
 collections of matter, which, if not skil- 
 fully treated, may give occasion to fistulas, 
 which are both disgusting and trouble- 
 some. The anus is also subject to piles 
 and other exci-escences. When the in- 
 ner coat of the lower intestine is pro- 
 truded out of the body, which it some- 
 times is to a very great length, especially 
 in delicate children, the complaint is called 
 prelapsus ani. It is alarming to those 
 who know not what it is, and in every 
 case should be carefully attended to. The 
 person should not sit long at stool, nor 
 strain much ; children should be watched 
 for this purpose, their bowels should be 
 kept easy, but not too loose, the gut 
 should be carefully replaced by gentle 
 pressure with the fingers, besmeared with 
 sweet oU ; and the parts strengthened by 
 the application of tepid water, and after- 
 wards of cold water, to the loins. 
 
 ANXIETY, in medical language means 
 the restless uneasiness attendant on seve- 
 ral diseases. It may arise from spasm, as 
 in asthma, hysterics, and cholera morbus ; 
 or from uneasiness at the stomach, pro- 
 ceeding either from causes affecting the 
 stomach itself, or acting by sympathy, as 
 a stone in the kidney ; or it may arise 
 from congestion of blood in some parti- 
 cular set of vessels, as in inflammatory 
 affections. It. is to be relieved by the 
 
 removal or mitigation of the original dis- 
 ease. 
 
 AORTA. The name of the large ar- 
 tery, whose branches are distributed to 
 every part of the body. It commences 
 at the left ventricle of the heart, rises in 
 the left side of the chest, gives off several 
 arteries, bends downwards, passes through 
 the diaphragm, proceeds down upon the 
 vertebne, and at the fourth vertebra of 
 the loins divides into two large trunks, 
 for the supply of the parts within the 
 pelvis, and of the two lower extremities. 
 At its commencement, the aorta is fui'- 
 nished with valves, which prevent the 
 blood from being driven back into the 
 left ventricle of the heart. The aorta is 
 subject to various disorders, as inflamma- 
 tion, ulceration, aneurism, ossification, 
 &c. 
 
 APERIENT, signifies opening, and Ls 
 applied to those medicines which pro- 
 cure easy stools without severe or copi- 
 ous purging. Many medicines which in 
 their usual doses act as purges, may in 
 diminished doses be made to act as gentle 
 aperients. An ounce of Epsom or of Glau- 
 ber's salts dissolved in about four ounces 
 of water, and taken pretty warm, will 
 purge strongly j but half an ounce in the 
 same or even a larger quantity of water 
 will operate as an aperient or laxative. 
 Castor oil, in the dose of from half an 
 ounce to an ounce, is a good aperient, or 
 a desert-spoonful of sulphur, or a desert- 
 spoonful of equal parts of sulphur and 
 cream of tartar, taken as an electuary; 
 or an infusion of senna, with or without 
 a small spoonful of tamarinds ; or a tea- 
 spoonful of cream of tartar, or diminished 
 doses of any of the purging salts, may be 
 taken as aperients. The cases in which 
 it is desirable or necessary to use ape- 
 rients and not piu-ges, are in persons of a 
 sedentary life, women in the state of 
 pregnancy, and those who are subject to 
 piles. 
 
 APEX. The ppint or top of a thing ; 
 as the apex of the heart, the apex of the 
 tongue, means the pointed extremity of 
 these parts. 
 
40 
 
 APOPLEXY. 
 
 APHTHA. See Thrush, or Sore 
 Mouth of Children. 
 
 APOPLEXY. A disease in which the 
 patient suddenly falls down, deprived of 
 sense and motion ; and which, in all 
 languages, derives its name from the sud- 
 den manner of its attack, as if the patient 
 were struck down by some invisible hand, 
 by lightning, or some other agent, equally 
 sudden and violent. 
 
 Symptoms. A person seized with apo- 
 plexy in its most perfect form, suddenly 
 falls down, deprived of sense and motion, 
 breathes heavily, and with a snoring 
 sound ; sometimes convulsions occur, and 
 foam issues from the mouth. The pulse 
 is full and strong, a cold clammy sweat 
 breaks out over all the body; and the 
 accumulating saliva, the bloated counte- 
 nance, and the noisy laborious breathing, 
 combine to form a distressing spectacle. 
 The disease is not always so complete 
 and violent, but varies in its symptoms, 
 as is well described by Dr. Abercrombie : 
 " Sometimes the disease begins with a 
 sudden attack of violent pain in the head, 
 the patient becomes pale, sick and faint, 
 generally vomits ; and frequently, though 
 not always, falls down in a state resem- 
 bling fainting, the face very pale, the 
 pulse very small. This is sometimes ac- 
 companied by slight convulsion. In other 
 cases he does not fall down, the sudden 
 attack of pain being only accompanied by 
 slight ajid transient loss of recollection. 
 In both cases he recovers in a few minutes, 
 is quite sensible, and able to walk ; con- 
 tinues to complain of intense headach ; 
 after a considerable time, perhaps some 
 hours, becomes oppressed, forgetful and 
 incoherent, and thus gradually sinks into 
 deep sleep, from which he never recovers. 
 Li some cases, palsy of one side occurs, 
 but in others, there is no palsy. There 
 is another form of the disease, in which 
 the patient is suddenly deprived of the 
 power of one side of the body, and of 
 speech, without stupor j or if the first 
 attack is accompanied with stupor, this 
 soon goes off j he appears sensible of his 
 situation, and endeavours to express his 
 
 feelings by signs. In some cases, the at- 
 tack passes gradually into apoplexy, per- 
 haps after a few hours ; in others, under 
 the proper treatment, the patient recovers 
 perfectly in a few days. In many cases, 
 the recovery is gradual, and it is only at 
 the end of several weeks or months that 
 the complaint is removed." — {Edinburgh 
 Medical Journal.^ 
 
 It is a matter of very great difficulty 
 to determine what is the particular state 
 of the brain, which gives rise to the 
 symptoms of apoplexy. Sometimes, after 
 a fatal case, when the head is opened, Ave 
 find a large quantity of coagulated blood, 
 and we consider the pressure of this ef- 
 fused blood as completely explaining what 
 has happened. But in other cases which 
 have ended fatally, there is only a small 
 quantity of fluid in some part of the brain ; 
 and in others, even after very marked 
 symptoms, no injury whatever, or devia- 
 tion from the healthy appearance can be 
 perceived in the brain. 
 
 There are certain habits of body that 
 seem more peculiarly disposed to this dis- 
 ease. Men with short thick necks, large 
 heads, and corpulent bellies, especially 
 after their thirty-fifth or fortieth year, 
 are very frequently the subjects of this 
 disease ; but very many examples occur 
 of a make directly the reverse of this, viz. 
 tall and slender, being also attacked with 
 apoplexy. 
 
 Warnings of approaching Apoplexy. — 
 Although apoplexy generally comes on 
 suddenly, yet in many cases the patient 
 has previous warnings, which give him 
 reason to dread its approach. He is for 
 some time much troubled vnih. headachs, 
 sometimes acute, but oftener dull and 
 heavy. This sensation of weight or pain 
 in the head is increased by sudden mo- 
 tions of the body, by stooping, or by vio- 
 lent exercise; and the use of wine, of 
 spirits alone or diluted with M^ater, and 
 especially the use of ale and porter, and 
 tobacco in its various fonns, is apt to in- 
 crease the headach. Various disorders 
 of the sight also precede an attack of 
 apoplexy ; a swimming or darkness seems 
 
APOPLEXY 
 
 41 
 
 to overspread the eyes ; specks, motes, or 
 spangles appear to dance before them; 
 and in some cases the patient even squints 
 or sees double. There is a ringing in the 
 ears, a sensation of flushing of the face, 
 and beating of the temporal arteries, with 
 hesitation or defect of speech, and con- 
 fusion of thought or loss of memory. 
 
 Causes of Apoplexy. — We have partly 
 anticipated these when we stated the 
 habit of body, and the time of life most 
 subject to apoplexy; to these observa- 
 tions we now add the following causes. 
 Full living, luxurious idleness, the fre- 
 quent use of strong liquors, of opium, 
 either solid or in the form of laudanum, 
 tobacco. All these circumstances give the 
 tendency to the disease ; and in consti- 
 tutions predisposed to it, the fit is brought 
 on by many occurrences which would 
 not have the same effect on others. Of 
 the things which bring on a fit, the fol- 
 lowing are the chief: 1. Intoxication. 
 Too many cases are known where the 
 drunkard suffers before his revelry is 
 ended. The habitual headach, the livid 
 ■countenance, and the ^inflamed eyes, cha- 
 racteristic of frequent intoxication, indi- 
 cate a dangerous tendency of the blood 
 to the head ; and such flow is, by some de- 
 bauch more copious than usual, convert- 
 ed into a fatal fit of apoplexy. An over- 
 dose of opiimi will have the same effect. 
 2. A full meal. Many instances of the 
 guests falling down in apoplexy have oc- 
 cui-red during city feasts and the ban- 
 quets of clubs. We are sometimes told, 
 with great surprise, of persons found 
 dead in their beds who had eaten a hearty 
 supper the night before, the narrator not 
 suspecting that this supper, in all pro- 
 bability, had been the cause of their 
 death. 3. Violent exercise, or going up a 
 steep place. 4. Much exertion of the or- 
 gans of respiration, as in coughing, vomit- 
 ing, laughing, long or loud speaking. 5. 
 Passions of the mind, especially anger. 
 0. Suppression of evacuations, as of the 
 monthly discharge, or the drying up of 
 bleeding piles, or of an issue, or the sud- 
 den check of salivation. 7. Exposure to 
 
 the sun's rays, which may cause a coup 
 de soleil; or being long in crowded rooms, 
 or. overheated bedchambers. 8. Stooping 
 much or long. 9. Tying any thing tiglit 
 about the neck ; or twisting the neck by 
 sudden turning round of the head, with- 
 out corresponding motion of the body. 
 
 Prognosis q/" Apoplexy. As to the pro- 
 bable event of an apoplectic attack, we 
 must be guided, in every case, by a care- 
 ful consideration of the various symp- 
 toms. If the fit has lasted long, by which 
 we mean from two to three days ; if the 
 breathing is very laborious and loud ; if 
 the patient is far advanced in life, it is 
 probable that the disease will at that 
 time prove fatal. A second attack is al- 
 ways to be considered as of more danger 
 than at first ; and when apoplexy comes 
 upon a patient who has had frequent at- 
 tacks of epilepsy, it very commonly 
 proves fatal. 
 
 Treatment of Apoplexy. The moment 
 a person is seized in the manner above 
 described, it is absolutely necessary that 
 assistance should be given ; he must be 
 raised so as to have the head and shoul- 
 ders higher than other parts of the body, 
 every thing about the neck should be 
 unbuttoned and free ; he should not be 
 surrounded by a multitude of useless by- 
 standers ; and fresh air should be freely 
 admitted. Spirits, cordials, and stimu- 
 lants are destructive. Bleeding from a 
 large wound in the jugular vein, from the 
 temporal artery, or from the arm, should 
 be freely employed ; and the quantity not 
 regulated by any measurement, but by 
 the effect produced. As soon as the pa- 
 tient is able to swallow, some strong, 
 speedy-acting purge should be given him ; 
 for this purpose, a drachm of compound 
 powder of jalap, or the ^ame quantity, 
 with five grains of gamboge, should be 
 given, or eight grains of calomel witli 
 twenty of jalap ; or a full dose of Epsom 
 salts. The head ought then to be shaved 
 and washed with cold Mater, or with 
 vinegar and water; and afterwards, if 
 any appearance of the disease returns, 
 leeches and a blister should be applied. 
 
42 
 
 APO 
 
 APP 
 
 When spontaneous vomitingf has occur- 
 red, the patient has seemed to be the bet- 
 ter for it ; and emetics, when prudently 
 administered, and carefully Avatched in 
 their operation, have done good. There 
 can be little doubt of their propriety, 
 when we know that the stomach is load- 
 ed with a full and varied meal. Apoplexy 
 from coup de soleil does not bear evacua- 
 tion. In some cases, these remedies are 
 successful, and the patient is restored to 
 perfect health ; but in others, a limb, or 
 one half of the body is palsied ; the men- 
 tal faculties are impaired, or the speech 
 is lost or injured. Whether the cure be 
 complete or not, the after-treatment of 
 the patient is a matter of the first im- 
 portance. There is every reason to fear 
 that a fresh attack of the disease will 
 come on ; and every thing must be done 
 to keep the body in the most moderate 
 and quiet state. There should be an 
 issue or seton in the neck, or other con- 
 venient situation ; the bowels should be 
 kept very open by frequent laxative me- 
 dicines ; every article of diet that is 
 heating or indigestible should be avoid- 
 ed; and malt liquors, wine and spirits 
 should be totally abstained from. 
 
 Means of preventing Apoplexy. Hav- 
 ing thus described the disease, with the 
 various causes that excite it, and the treat- 
 ment proper during the attack, it may 
 be useful to give some directions to those 
 who, though in perfect health, have rea- 
 son from their make and habits, to fear 
 an attack of the disease. Such persons 
 ought to live a life of rigid temperance, 
 to a\*oid whatever food and sauces would 
 tempt them to indulge in gluttony, to 
 shun excess in wine and strong liquors 
 of every kind, to guard against attaining 
 a full and corpulent habit of body ; and 
 they should pay particular attention to 
 keeping the bowels open. A due pro- 
 portion of vegetables should form part of 
 the diet ; and plain water, toast water, or 
 small beer, on account of its gently laxa- 
 tive quality, should be the common drink. 
 It is proper to avoid that stupifying drug 
 tobacco. . Regular exercise should be 
 
 taken, but not to the length of inducing 
 fatigue ; and walking should be as much 
 as possible in the open air, and on level 
 ground. When the more urgent symp- 
 toms occur, as giddiness, dimness of sight, 
 ringing of the ears, flushing of the coun- 
 tenance, it is better not to wait for the 
 actual attack, but to lose twelve or six- 
 teen ounces of blood, and to employ free 
 purging. It is proper to use the shower 
 bath on the shaven head, which is also 
 to be frequently spunged with water, or 
 vinegar and water. 
 
 APOTHECARY. A person whose 
 occupation it is to compound and prepare 
 medicines. 
 
 APOTHECARIES' WEIGHT. For 
 the purpose of administering medicines, 
 the common troy pound is divided into 
 ounces, drachms, scruples, and grains: 
 twenty grains, gr. are one scruple, 9 » 
 three scruples are one drachm, 3 > eight 
 drachms one ounce, ^ ; twelve ounces are 
 one pound, lb. 
 
 APPETITE, Loss of, in medical lan- 
 guage, anorexia, is a very common symp- 
 tom of fevers and other disorders. In 
 feverish disorders of all kinds, both those 
 attended A^dth eruptions, as small-pox, 
 measles, &c. and those of the inflamma- 
 tory and nervous kind, it seems to be a 
 salutary instinct of nature to prevent the 
 swallowing of food at a period when it 
 could be of no benefit to the system, but 
 would rather aggravate the disease then 
 present, by loading the stomach with mat- 
 ter which it could not digest, or which 
 would increase the fever by its stimulat- 
 ing qualities. Whatever cures the fever 
 will tend to restore the appetite ; and a 
 moderate desire of food is among the 
 first favourable symptoms of returning 
 health. Here, above most cases, is a ne- 
 cessity for the judicious advice of an in- 
 telligent practitioner ; and here the mis- 
 taken kindness of friends is most apt to 
 produce injurious effects. The diet of 
 convalescents from fever should be very 
 cautiously regulated. See Fever and 
 Diet. 
 
 When loss of appetite occui*s without 
 
ARD 
 
 ARE 
 
 4^ 
 
 loathing of food, and appears to be the 
 principal evil of which the patient com- 
 plains, it is owing generally to previous 
 habitual excess iu eating or drinking, and 
 in some cases to the use of bad diet. Iu 
 old age, it may proceed from weakness. 
 A return to temperance is the first part 
 of the cure ; and it is to be promoted by 
 exercise, cold bathing, tonic medicines, 
 as iron, bitters, and Peruvian bark, -with 
 the choice of such food as the patient 
 finds by trial to agree best with his sto- 
 mach. For those whose circumstances 
 admit, the use of Bath or Buxton waters 
 may be serviceable. See Stomach Com- 
 plaints. 
 
 APPLES. A well known fruit, less 
 watery than some others which are eat- 
 en, and not so apt to pass into a hurtful 
 fermentation in the stomach. Being 
 somewhat firm in their texture, they are 
 retained pretty long in the stomach, and 
 often prove rather indigestible. Apples, 
 when halved, afford a very pleasant article 
 of food, and in some cases may prove use- 
 ful by their laxative properties. Apples 
 should not be eaten after fish ; and they 
 are apt to disagree with the stomachs and 
 bowels of children when their digestion 
 is not perfectly good. 
 
 APRICOT, a very wholesome and ea- 
 sily digestible stone fruit. 
 
 AQUA FORTIS. See Nitric Acid. 
 
 AQUA REGIA, a terra which has 
 found its way from the alchymists into 
 popular use, signifying a mixture of the 
 nitric and muriatic acids in the propor- 
 tion of two parts of the nitric to one of 
 the muriatic ; so called because it is the 
 only solvent of gold, which received from 
 the alchymists the title of rex tnetallorum, 
 king of metals. 
 
 ARDENT SPIRITS. A general 
 name for the spirituous products of dis- 
 tillation from various substances. The 
 principal of these ai'e brandy, rum, gin, 
 whisky, and arrack, obtained respective- 
 ly from wine, sugar, juniper berries, bar- 
 ley, and rice. The pernicious influence 
 exerted by them, both on the moral cha- 
 racter and the bodily constitution of those 
 
 who are addicted to their use, renders 
 the subject interesting to the ethical phi- 
 losopher, as well as the physician ; and 
 affords an excellent specimen of the un- 
 satisfactory nature of sensual indulgences, 
 which, when they have ceased to give 
 pleasure, still leave an unsatiable craving 
 for their gratification. The unhappy 
 drunkard (and we may here include the 
 opium talier, and the person who is con- 
 stantly stimulating his appetite by bitters 
 and cordials) sees in the decline of his 
 health, and the decay of his fortune, the 
 melancholy punishment of his irregulari- 
 ties ; yet, in spite of all the warnings of 
 his friends, of the convictions of his ov>ti 
 mind, and the prospect of want impend- 
 ing over him, he continues the pernicious 
 practice till disease or death overtakes 
 him. A few, but very few, are reclaimed 
 by religious principle from this deplo- 
 rable habit ; but there is hardly any other 
 practice so powerful in removing its 
 victims from all probability of improve- 
 ment. 
 
 The diseases brought on by the use of 
 aj'dent spirits are numerous and intract- 
 able ; and this, whether used without any 
 addition, or in the form of grog, toddy, 
 or punch. Indigestion and stomach com- 
 plaints, dropsy, liver disease, apoplexy, 
 palsy, convulsions, and many others, are 
 traced to dram-drinking. Spirits may 
 occasionally be useful as a medicine. In 
 some complaints, with indigestion, wine 
 and beer disagree M'ith the stomach, and 
 produce acidity ; in such cases, a small 
 quantity of spirits and ^vater may be used 
 with advantage ; but Dr. Paris says its 
 strength should be uniform, and no cir- 
 cumstances should induce the patient to 
 increase the quantity of the spirit. The 
 habit of drinking liqueurs cannot be too 
 loudly reprobated; many of these cordials 
 are impregnated with narcotic substan- 
 ces, which add to the noxious qualities 
 of the spirit. 
 
 AREOLA- A small brown ring sur- 
 rounding the nipples of females. During 
 pregnancy, it becomes larger, and rather 
 darker in colour. The inflamed circle 
 
44 
 
 A R O 
 
 A R R 
 
 round the vesicles of cow-pox is also 
 termed an areola. 
 
 ARM-PIT, called Axilla by anatomists, 
 is the deep cavity of the shoulder-joint, 
 most conspicuously marked out when the 
 arm is held in the extended position. 
 It contains many very important parts, 
 particularly the large veins and arteries 
 of the arm, the nerves which supply the 
 limb, and many lymphatic glands. Some- 
 times, one or more of these glands swell 
 and give rise to abscess, and the forma- 
 tion of great quantities of purulent mat- 
 ter ; and it is these glands which are so 
 apt to become diseased in cancer, giving 
 rise to the lamentable train of symptoms 
 which accompany the latter stages of that 
 deplorable malady. The knowledge of 
 the anatomy of this cavity is of indispen- 
 sable necessity to the surgeon. 
 
 AROMATICS. Substances which 
 have an agreeable spicy scent, and a plea- 
 sant pungent taste. The principal aro- 
 matics are the following : Cloves, nut- 
 meg, mace, cinnamon, pepper, ginger, and 
 the essential oils derived from various 
 plants by distillation, as oil of rosemary, 
 lavender, peppermint, &c. These aro- 
 matics are used in medicine, principally 
 to give flavour to nauseous drugs ; or in 
 small quantities to stimulate the stomach. 
 Aromatics have a great affinity with to- 
 nics, and some vegetables have the pro- 
 perties of the two kinds of substances so 
 blended, that it is difficult to say to which 
 class they belong. Stinmlant aroraatics 
 are chiefly remarkable for the rapidity of 
 their effects, and tonics for their perma- 
 nency. A preparation of aromatics call- 
 ed the Portland powder, composed of 
 equal parts of serpentaria, gentian, cha^ 
 maidrys, and centamy, was once famous 
 in the ciu-e of gout j but it is not likely 
 to be much used by those who recollect 
 what is said by Dr. CuUen, viz. « In 
 every instance which I have known of 
 its exhibition for the length of time pre- 
 scribed, the persons who had taken it 
 were indeed afterwards free from an in- 
 flammatory aff'ection of the joints, but 
 they were affected with many symptoms 
 
 of the atonic gout ; and all, soon after 
 finishing their course of the medicine, 
 have been attacked with apoplexy, asth- 
 ma, or dropsy, which proved fatal." 
 
 AROMATIC VINEGAR. A solu- 
 tion of camphor, and the oils of cloves, of 
 lavender, and rosemary, in very strong 
 vinegar. It is useful in faintings and 
 other debilitating affections- 
 
 ARQUEBUSADE. « A distilled 
 spirit prepared from a great variety of 
 aromatic plants, as thyme, onganura, 
 balm, lavender, &c. The medicinal vir- 
 tues of the distilled aromatic waters and 
 spirits have, perhaps, been much over- 
 rated ; and numerous distinctions between 
 them with regard to their effects, have 
 been made without much foundation. AU 
 of them are cordial and stimulating, and 
 as such, have considerable efficacy in sud- 
 den faintings, sickness, and languor ; but 
 the difference of effect between the simple 
 aromatic waters and the spirituous war 
 ters is so great, that much of the virtue 
 of the latter is to be ascribed to the spi- 
 rit. They are largely used in medicine ; 
 and from their agreeable flavour and fi-a- 
 grancy, they will conceal the nauseous 
 taste and smell of many of the most un- 
 palatable drugs. The consumption of 
 the fragrant aromatic spirits is perhaps 
 still greater as perfumes for the toilet; 
 and the flavoured spirits, more than all, 
 as drams and cordials." — (Rees's Cyclo- 
 pcedia.') — See Eau de Cologne. 
 
 ARRACK. The name of an ardent 
 spirit distilled from rice in China and the 
 East Indies. 
 
 ARROW-ROOT. The root of a tree, 
 Maranta arundinacea^ cultivated in the 
 West Indies. It has its name from being 
 used to extract the poison communicated 
 by poisoned arrows, though it is not easy 
 to believe it to be possessed of that power. 
 A starch is obtained from this plant by the 
 following process: The roots, when a 
 year old, are beaten to a pulp in a large 
 wooden mortar ; this pulp is well stirred 
 in a large tub of clean water, and the 
 fibrous part is Mrung out, and thrown 
 away. The milky liquor being passed 
 
ARSENIC. 
 
 45 
 
 4 through a hair sieve or coarse cloth, is 
 allowed to settle, and the clear water is 
 drained off. The white mass is again 
 mixed with clean water, and drained ; it 
 is then dried in the sun, and is a pure 
 starch, as it is sold in the shops. This 
 arrow-root contains in a small hulk a great 
 proportion of nourishment. Boiled in 
 water, it forms an excellent nutritious 
 jelly, well adapted for invalids and for 
 children. The following is the method 
 of preparing it : Take a dessert-spoonful 
 of the powder, and add as much cold wa- 
 ter as will make it into a paste ; to this 
 add eight ounces of hoiling water, stir it 
 hriskly, and hoil it for a few minutes, 
 when it will become a clear, smooth jel- 
 ly. To this may be added a little milk 
 and sugar; or to debilitated patients a 
 little wine, either port or sherry, with a 
 little nutmeg to make it sit light on the 
 stomach ; and for children, whose sto- 
 machs might be rendered sour by wine, 
 it may be useful to add a little of the su- 
 gar of anise, or a few drops of the essence 
 of caraway seeds, or of cinnamon. 
 
 ARSENIC. A metal famous for af- 
 fording one of the most virulent, and, un- 
 happily, too accessible poisons known. 
 As it is a substance whose fatal effects 
 are too frequently observed, and as it is 
 the instrument with which revenge or 
 malignity often accomplishes its detest- 
 able purposes, we shall give a pretty full 
 detail of what is known concerning this 
 noted mineral. 
 
 Arsenic, in strict chemical language, is 
 a metal of a bluish-white colour, not un- 
 like that of steel, and has a good deal of 
 brilliancy. It is the softest of all the me- 
 tallic bodies, and so brittle that it may be 
 reduced to a fine powder by pounding in 
 a mortar. It has no sensible smell when 
 cold, but when heated it sends forth 
 a strong smell of garlic. Like other 
 metals, it has no effect on the living body 
 in its metallic state ; but when combined 
 with oxygen, its properties are very dif- 
 ferent indeed. When the metal is ex- 
 posed to a moderate heat, in contact with 
 air, it rises in the form (fa white powder. 
 
 and the garlic smell is perceived, not from 
 the oxide, but from the metal in a state of 
 vapour. This white powder is the oxide 
 of arsenic, and is what is generally known 
 in commerce and in common language by 
 the name of Arsenic. It has a sharp acrid 
 taste, which at last leaves an impression 
 of sweetness, and is a very virulent poison. 
 Symptoms produced by swallowing 
 Arsenic. The symptoms produced on the 
 living body by a very small dose of arse- 
 nic are some of the following : Within 
 about half an hour after taking the poison, 
 there occur spasmodic pains of the sto- 
 mach and bowels, with a sensation of 
 heat in the mouth, and tightness about 
 the tliroat, a feeling of tenseness of the 
 skin of the head, and of the eyelids, in- 
 flammation of the eyes, and itching of the 
 face and neck. To these succeed inces- 
 sant vomiting and purging, attended by 
 excruciating pain of almost every part of 
 the body, but especially of the stomach, 
 bowels, and head ; the pulse, which at first 
 was full, hard, and frequent, sinks, and be- 
 comes irregular ; clamminess of the skin ; 
 cold sweats, purple spots, and convulsions 
 precede death ; or if the sufferer does not 
 die, hectic fever, palsy, and weakness of 
 mind and body, distress him during the 
 rest of his life. It is said, that in cases 
 of poisoning by arsenic, the body runs 
 suddenly into putrefaction. 
 
 Treatment of those who have swallowed 
 Arsenic. The great object is to procure 
 its expulsion from the stomach as quickly 
 and easily as possible. If a practitioner 
 be called in before vomiting has come on, 
 it may be proper to excite it by tickling 
 the throat with a feather, or by giving a 
 dose of white vitriol, sufficient to excite 
 instant vomiting. The dose for this pur- 
 pose is from twenty-five to thirty grains, 
 or five grains of blue vitriol, (the sulphate 
 of copper) may be given ; the advantages 
 of those emetics are, that they act quickly, 
 and require little dilution for their action, 
 which is of great importance, as prevent- 
 ing the absorption of the arsenic ,• and as 
 blood-letting favours this absorption, we 
 must be cautious not to employ it while 
 
46 
 
 ARSENIC. 
 
 any portion of arsenic re,raains in the 
 body. But in general the vomiting has 
 begun before a practitioner is called. 
 Lime water then should be plentifully 
 given. The bowels must be emptied by 
 the mildest means, as by castor oil, alone, 
 or with olive oil, or in mutton broth. 
 Opium, in the dose of one or two grains, 
 or forty drops of laudanum, or five grains 
 of camphor, or a glassful of camphor 
 julep, or half a tea-spoonful of ether in 
 water may be given to quiet the nervous 
 irritability; and when the action of the 
 heart is feeble, ammonia in pretty large 
 doses has been found useful. But the 
 probability is, that inflammatory action 
 will take place in the stomach and intes- 
 tines ; and, therefore, we must be very 
 cautious how we treat the patient with 
 stimulating substances. We must, when 
 these inflammatory symptoms appear, have 
 recourse to bleeding, but with great cau- 
 tion, aware of the debility that may ra- 
 pidly follow ; we must give mild laxatives, 
 employ a cooling regimen, and the usual 
 remedies and observances against in- 
 creased arterial action, as detailed in the 
 article Antiphlogistic Regimen. The 
 debility, the palsy, and impaired health, 
 are to be treated with bark and wine, 
 strengthening medicines, sea-bathing, light 
 nutritious diet, and country air, with 
 moderate exercise. 
 
 Notwithstandingthe destructive powers 
 of arsenic, it has been used as an article 
 of the Matei'ia Medica, and employed for 
 the cure of intermittent fevers, periodical 
 headachs, and in several diseases of the 
 skin. The safest form under which it 
 can be employed in the cure of diseases is 
 the arsenical solution of Dr. Fowler of 
 Stafford, beginning with the dose of four 
 drops, and increasing it gradually to thirty 
 di'ops twice a-day. The addition of a 
 few drops of the wine of opium is said to 
 render its operation safer and more efficar- 
 cious. The precise manner of explaining 
 the action of arsenic in the cure of dis- 
 eases is not agreed on by physicians. 
 When there is a tendency to inflammatory 
 action, it should be avoided. When the 
 
 system is under the influence of arseaU ^ 
 thus introduced, the following symptoms 
 appear : Thickness, redness, and stiffness ] 
 of the eyelids, soreness of the gums, saU- j 
 vation, itching of the skin, cough, head- ; 
 ach, and pain of the stomach and bowels. 
 Appearances of the bodies of those who 
 have died in consequence of taking Arse- 
 nic, and method of detecting it in the dead 
 body. — It is a delicate and difficult ques- 
 tion, that frequently comes before courts 
 of law, whether a person dying under 
 suspicious circumstances has been poison- 
 ed by arsenic. The fact of the evidence 
 relating to the body and the nature of the 
 poison, must be determined by the phy- 
 sician and the chemist ; and it is of great 
 consequence that both be fully aware of 
 the appearances on dissection, and of the 
 tests of arsenic. The stomach and bowels 
 show more or less inflammatory appear- 
 ances, but the inflammation is often so 
 slight that we can hardly think death has - 
 arisen from that cause ; and Mr. Brodie, 
 who applied arsenic to wounds in animals, 
 observes that the inflammation of the 
 stomach was commonly more violent and 
 immediate than when the poison was ad- 
 ministered internally ; and he considered 
 the inflammatory appearances as symp- 
 toms of the action of the poison on the 
 system; perhaps of its presence in the 
 blood. Hence, a person must not con- 
 clude, because he sees too little inflamma- 
 tion to cause death, that arsenic has not 
 been taken. But although the affection 
 of the stomach and intestines from arsenic 
 is not commonly the cause of death, it 
 may become so, provided the patient sur- 
 vive the effects produced on organs essen- 
 tial to life, viz. those produced on the 
 nervous system, and the heart. And it 
 must be acknowledged, that without some 
 more direct proof that arsenic has been 
 swallowed, we cannot pronounce this to 
 be the case from any thing we see in the 
 bodies of those who are said to have suf- 
 fered from it. For the methods of detect- 
 ing arsenic by chemical tests, we must 
 refer to the very minute directions given 
 in books of chemistry. These methods 
 
ARSENIC. 
 
 47 
 
 have, by the ingenuity and perseverance 
 ^ of modern chemists, been reduced to a 
 very considerable degree of certainty and 
 simplicity; but they require a great deal of 
 practice and address ; and no one w^ho has 
 not paid particular attention to the sub- 
 ject, and who has not a reasonable confi- 
 dence in his own accuracy and experience, 
 should undertake the investigation of the 
 contents of a suspected dead body in any 
 case AA-hich is to come before a court of 
 justice. The directions and cautions ne- 
 cessary on this subject are so minute, that 
 to the general reader, for whom this work 
 is intended, they would be tedious and 
 unintelligible. Dr. Christison of Edin- 
 burgh, who has greatly distinguished him- 
 self by his researches on this very im- 
 portant subject, has inserted a very valu- 
 able paper respecting it in the Edinburgh 
 Medical and Surgical Journal for July 
 1824, and has treated this and other simi- 
 lar subjects with great ability in his ex- 
 cellent work on Poisons. 
 
 When we reflect that the very lowest 
 and most ignorant are familiar with the 
 name of arsenic as a poison, it becomes a 
 matter of s6rious consideration whether 
 some means should not be devised to 
 keep it from the power of malice and 
 wickedness. We are much disposed to 
 agree with what has been so strongly 
 and properly stated by Mr. Brande, Pro- 
 fessor of Chemistry and Materia Medica 
 to the Apothecaries of London. " It is 
 impossible too strongly to represent the 
 evil of which the retention of arsenic in 
 the pharmacopoeia is productive. To 
 this alone nearly all the mischievous 
 applications of this virulent poison are to 
 be attributed, for its sale is thus facilita- 
 ted ; and as long as its unlicensed use is 
 permitted for medical purposes, so long 
 will it be the prevailing instrument of 
 self-destruction and murder. Nor are 
 there any plausible gi'ounds upon which 
 its employment in pharmacy can be sanc- 
 tioned or defended; for there can be 
 little doubt that more harm than benefit 
 has resulted from its administration ; and 
 the diseases in the cure of which it lias 
 
 been supposed effective, admit in all 
 cases of safer and more effectual treat- 
 ment. But even allowing that in some 
 few and anomalous instances of disease it 
 may have proved decidedly serviceable, 
 this is not sufficient to counterpoise the 
 daily evils to which its present commer- 
 cial circulation gives rise, or to warrant 
 the permission of the unshackled sale of 
 an article of such certain and deadly 
 virulence. The other applications of ar- 
 senic, as a poison, for instance, for vermin, 
 for the dry rot, a means to prevent dis- 
 ease in wheat, and its employment in 
 veterinary surgery, are of such obviously 
 hurtful and dangerous tendency, that the 
 propriety of discontinuing them cannot 
 admit of two opinions ; for it is thus that 
 arsenic finds its way into culinary vessels, 
 that it gets accidentally mixed with ar- 
 ticles of food, that bottles which have 
 contained it are used for beer, wine, 
 vinegar, or medicine ; and, in short, that 
 numerous opportunities are afforded to 
 the evil-minded of possessing themselves 
 without suspicion of this deadly weapon ; 
 and to the ignorant and careless, of caus- 
 ing the most disastrous and distressing 
 accidents upon record." 
 
 Arsenic used externally^ and Quack 
 Medicines containing it. It deserves to 
 be particularly noticed, that arsenic ap- 
 plied externally to parts from which the 
 skin has been rubbed off, kills more ra.- 
 pidly than even w^hen given internally. 
 Hence the danger of using various quack 
 ointments, professedly having great 
 powers in the cure of cancer and other 
 complaints, the most active ingredient of 
 which ointments is known to be arsenic. 
 Many cases of palsy, and even of death, 
 have been recorded from the application 
 of arsenical plasters and ointments for 
 various purposes. And even where the 
 skin is unbroken, poisonous effects may 
 be produced. We shall mention some of 
 the quack medicines containing arsenic, 
 that they may be carefully abstained 
 from ; the tasteless ague-drop, Plunkett's 
 ointment, the arsenical paste of the French 
 surgeons, Davidson's remedy for cancer 
 
48 
 
 ART 
 
 ASC 
 
 Delcroix's poudre subtil for removing an- 
 perilous hair in less than ten minutes. 
 
 ARTERIES. Firm and elastic canals 
 proceeding- from the heart, and gradually 
 diminishing in size as they branch off 
 into numberless divisions through the 
 whole body. They are composed of three 
 coats, a smooth coat internally, a mus- 
 cular coat in the middle, and a cellular 
 coat externally. The name Artery which 
 signifies air-holder, owes its origin to 
 the imperfect observations of the an- 
 cient anatomists. When they opened 
 dead bodies, they found certain tubes 
 always empty, because the elasticity of 
 these tubes forced the blood, during the 
 last struggles of life, into the veins and 
 cavities of the heart ; hence they believed 
 that in the living body they contained 
 air, and named these tubes arteries. By 
 the arteries, the blood is conveyed from 
 the heart to every part of the body, for 
 the purpose of nutrition, secretion of 
 fluids, and preservation of animal heat. 
 Arteries are for the most part continued 
 in minute subdivisions to the equally mi- 
 nute commencement of the veins ; it is 
 probable that there are intermediate cells 
 or follicles between the two sets of ves- 
 sels ; but those are so small as to elude 
 the eye, and even the microscope. At 
 the commencement of the two great ar- 
 teries, viz. that which conveys the blood 
 to the lungs to be purified, and that which 
 transmits it to the whole system, are 
 placed valves to prevent any retrograde 
 motion. The pulse is caused by the ac- 
 tion of the muscular coat, and the elasti- 
 city of the cellular coat of the arteries, 
 and it is correspondent in strength and 
 frequency with the beating of the heart. 
 The blood contained in arteries is of a 
 florid red colour ; and when an artery is 
 wounded, this florid blood is poured out 
 by jerks; and from an artery not very 
 large, the whole blood of the body would 
 flow out in a very short time. ("See 
 Bloodletting, accidents from. J 
 
 Arteries are subject to various dis- 
 eases. They are liable to inflammation, 
 and such an occurrence is attended with 
 
 great danger. They are also liable to 
 ossification, and other alterations of their 
 structure, and to aneurism. See Aneu- 
 rism and Ossification. 
 
 ARTERIOTOMY. Opening an ar- 
 tery to draw blood for the cure of dis- 
 eases. Sometimes it is difficult to get 
 enough of blood from a vein, and some- 
 times in afi'ections of the head it is 
 thought advisable to take blood from 
 some vessel supplying the head; this is 
 commonly done from the temporal artery. 
 Arteriotomy is seldom performed in any 
 other vessel. It is not in general difficult 
 to stop the bleeding from the temporal 
 artery; it is best done by compression, 
 by which the blood is easily sent into 
 some of the communicating branches. 
 
 ARTICHOKE, Cinara scolymus. A 
 plant native in the southern parts of Eu- 
 rope, but cultivated here for the table. It 
 may have the disadvantage of inducing 
 people to take too much butter. The Je- 
 rusalem artichoke, Helianthus tuberosus, 
 is a kind of sun-flower, and quite a differ- 
 ent plant from the common artichoke. 
 It is agreeable for food, but watery and 
 flatulent, requiring a sufficient quantity 
 of salt and pepper to be eaten with it. 
 The word Jerusalem, as applied to this 
 species of sun-flower, is corrupted from 
 gira sole, which signifies turning to the sun. 
 
 ARTICULATION. The form of a 
 joint ; or the method in which the end 
 of one bone is adapted to the part of 
 another, with which it is connected for 
 the purposes of motion. The principal 
 kinds of joints in animal bodies are, 
 1. Those of the ball and socket kind, ad- 
 mitting of motion in every direction ; 
 this is seen in the shoulder joint, and in 
 the hip joint. 2. The hinge joint, as in 
 the fore-arm and ankle. 3. Joints more 
 or less resembling these, or having a 
 combination of them, as the jaw-bone, and 
 the joints of the head, and upper bones of 
 the neck. 
 
 ASCARIDES. Small worms which 
 infest the rectum. They are of a yellow- 
 ish-white colour, resembling thread cut 
 in small pieces. See Worbis. 
 
ASS 
 
 AST 
 
 49 
 
 ASPARAGUS, Asparagus offici- 
 nalis. A plant, the root of which has 
 been supposed to have a diuretic pro- 
 perty, from the smell which it imparts to 
 the urine of those who eat it ,* but its 
 powers in this respect seem to be but 
 small. Asparagus has a creepin<r root, 
 throwing up numerous scaly erect stems 
 which are used as an article of food ; 
 they are quickly dissolved in the stomach, 
 and when sufficiently boiled, are not dis- 
 posed to create flatulence and acidity. 
 Asparagus is said to be wholesome, only 
 when in its early state ; when old, it is 
 remarkably acrid. 
 
 ASSAFETIDA. A gum resin from 
 a plant growing in Persia, the Ferula 
 assafetida; procured by cutting the top of 
 the root across ; and when the juice is ex- 
 uded, it is scraped off, and a second cut is 
 made across. This operation is repeated 
 till the root is entirely exhausted of juice. 
 This drug has a strong disagreeable smell, 
 somewhat like that of garlic, with a bitter 
 acrid taste. It is one oiE" the most valuable 
 and active remedies in spasms, in hysteri- 
 cal complaints, and in irregularities of the 
 monthly discharge. In asthma and other 
 kinds of difficulty of breathing, in hys- 
 terical cases, attended with much flatu- 
 lence and costiveness, assafetida is usefully 
 given J in this last case, joined Avith aloes, 
 in the pills called the pills of aloes with 
 assafetida, of which two may be given 
 every night or every second night. In 
 the lit of hyterics, a draught of the solu- 
 tion of assafetida will sometimes put a 
 stop to it immediately. When there is 
 costiveness, with much distention of the 
 bowels from wind, or colic pains, a drachm 
 or two of assafetida may be added to a 
 clyster, consisting of about a pint of gruel 
 or infusion of senna, with very good 
 effect. In spasmodic cough, the adminis- 
 tration of a mixture composed of thirty 
 grains o£ assafetida, two ounces of the 
 water of acetate of ammonia, and two 
 ounces of peppennint, may be given in 
 doses of one or two spoonfuls ; and the 
 same has also been found of service in 
 hooping-cough. 
 
 ASS'S MILK. This has been much 
 famed for its virtues in consumptions, 
 and other diseases of debility. Its advan- 
 tage arises from its containing a conside- 
 rable portion of nutritious matter easily 
 converted into chyle, and having less 
 cheesy matter than other milk. It bears 
 a stronger resemblance to human milk 
 than any other; and it contains more 
 sugar than that of the cow. Its propor- 
 tion of acid is also very considerable. The 
 quantity taken may be from half an Eng- 
 lish pint to one pint daily. It is very 
 common among the vulgar to recommend 
 rum taken in milk in consumptive cases ; 
 this is by no means a safe practice, as 
 the rum is apt to bring on inflammatory 
 symptoms. 
 
 ASTHMA. The symptoms of difficult 
 breathing which, in popular language and 
 by careless medical observers, are called 
 by the indiscriminate term ^s^/^ma, are ow- 
 ing to very different changes in the struc- 
 ture and actionsof the respiratory organs. 
 Sometimes, asthmatic symptoms arise 
 from diseases of the heart and large ves- 
 sels, sometimes from changes in the struc- 
 ture of the lungs, sometimes from the 
 contaminations of the air we breathe, 
 and sometimes from spasmodic affections, 
 which exceedingly distress the patient, 
 but do not hinder him from attaining to 
 extreme old age. The observations in this 
 article are to be understood as applying 
 chiefly to this last species of asthma. For 
 the other kinds of difficult breathing re- 
 sembling asthma, see Chest, Diseases 
 of ; Heart, Diseases of. 
 
 Symptoms of Asthma. A painful 
 difficulty of breathing, recurring at in- 
 tervals, with a sense of tightness across 
 the breast j a wheezing cough, hard 
 at first, but towards the end of each 
 paroxysm more free, and followed by 
 the discharge of a little mucus. The 
 attacks of astlima are generally in the 
 night-time, though they sometimes come 
 on in the com-se of the day; and at 
 whatever time they come on, it is for 
 the most part suddenly, with a sense 
 of tightness across the breast, impeding 
 
50 
 
 ASTHMA. 
 
 respiration. The person, if in bed, is 
 obliged immediately to get up, and he 
 requires the free admission of air. The 
 difficulty of breathing increases, and is 
 performed slowly, and with a wheezing 
 noise. These symptoms sometimes con- 
 tinue for hours together ; and a remission 
 takes place by degrees; the breathing 
 becomes less laborious, and the patient 
 speaks and coughs more easily; and if 
 there is something expectorated, the re- 
 mission is greater, and sleep comes on. 
 In the morning, and through the day, 
 though the breathing is better than dur- 
 ing the fit, it is not yet free from diffi- 
 culty ; a degree of tightness is still felt, 
 and a very slight motion of the body is 
 apt to bring back the paroxysm. In the 
 evening the breathing is worse, and about 
 the same hoiu- as on the former night, 
 generally between midnight and two 
 o'clock, the same train of symptoms is 
 renewed. After the fits have recurred 
 for several nights in this manner, they 
 suffer more considerable remissions ; and 
 for some time asthmatics may be free from 
 complaint ; but through the whole of life, 
 the paroxysms are ready to return, though 
 in different circumstances in different 
 patients. 
 
 Asthma seldom appears before the age 
 of puberty, and seems to attack men more 
 frequently than women ; and in persons 
 of a full habit whom it continues to at- 
 tack, it commonly causes a great degree 
 of emaciation. Though it does not often 
 destroy life in the paroxysms, it may be- 
 come fatal by passing into other diseases, 
 as into consumption of the lungs, or by 
 occasioning dropsy; and many cases, 
 which have appeared a common spasmo- 
 dic asthma, have been found at last to 
 depend on organic diseases of the heart 
 and great vessels. 
 
 Causes. Some have the fits of spasmo- 
 dic asthma brought on by heat, whether 
 of the weather or of warm apartments ; 
 and frequently by warm bathing. Some 
 are hurt by cold and moist air, or by any 
 thing worn tight about the breast, or by 
 distention of the stomach from a full 
 
 meal, or windy diet ; or from exercise 
 hurrying the circulation of the blood. 
 Sometimes the disease is brought on by 
 causes affecting the nervous system, as 
 passions of the mind; or by particular 
 smells, or irritations of the lungs from 
 smoke or dust. 
 
 Treatment during the Jit. The painful 
 and alarming symptoms of an asthmatic 
 fit, seem to the patient and bystanders to 
 threaten instant dissolution, but it rarely 
 happens that immediate death occurs; 
 yet something must be speedily done to 
 relieve such intense sufi'ering. In cases 
 where the fits have only recently begun 
 to attack, if the patient is strong and full 
 of blood, it may be proper to take away 
 a portion, but it is obvious that this would 
 not do in cases where a fit comes on seve- 
 ral times in a day, or for several succes- 
 sive nights ; and, therefore, other means 
 are to be employed for cutting short the 
 fit. One of the most efficacious means 
 of doing this is, to give a draught con- 
 taining thirty-five drops of laudanum, 
 with an equal quantity of ether, in an 
 ounce of water ; or to inhale the steam 
 of warm water, or an infusion of chamo- 
 mile flowers with the addition of a little 
 ether. In absence of other means, a cupful 
 of very warm water may be drank. Assar 
 fetida may also be administered in the 
 dose of a table-spoonful of a solution 
 made by dissolving ten grains in six 
 ounces of water, and adding a little pep- 
 permint or dill water. Persons liable to 
 asthma should at all times be careful to 
 avoid flatulent articles of food, and never 
 to overload the stomach. Every patient 
 in asthma must observe what kind of air 
 agrees best with him ; and must manage 
 his residence accordingly. Some agree 
 best with the smoky loaded atmosphere 
 of cities, and are made worse by the pure 
 air of the country; while others expe- 
 rience directly the reverse. 
 
 Of late years much has been talked of 
 the virtues of the Datura Stramonium or 
 thorn apple, in the relief and cure of asth- 
 ma. The roots are dried, and beaten so 
 as to separate the fibres ; and these cut 
 
AST 
 
 ATR 
 
 into small pieces are smoked in a common 
 tobacco pipe. It may have given relief 
 in some cases, but it has not justified the 
 hig-h praises bestowed on it at its first 
 introduction. Dr. Bree, one of the latest 
 and best writers on asthma, says, " the 
 indiscriminate use of the smoke of stra- 
 monium has occasioned dangerous or 
 hurtful effects in frequent instances. In 
 some cases of aged or apoplectic subjects, 
 death has been the consequence." It 
 doubtless acts as a narcotic ; and in over- 
 doses, it produces the usual alarming 
 symptoms of this class of poisons. 
 
 ASTRINGENTS. Substances that 
 draw together, or corrugate and con- 
 tract the parts of the body to which they 
 are applied, and which, in many cases, 
 seem by sympathy to extend their action 
 to very distant parts. The chief of these 
 are, alum, catechu, oak bark, logwood, 
 acids when properly diluted, kino, car- 
 bonate of lead, nitrate of potash, dragon's 
 blood, rose water, tamarinds. It will be 
 seen from this enumeration, that astrin- 
 gents are procured from various sources, 
 and that they do not agree in their che- 
 mical properties. The astringencyof many 
 substances is best known by the peculiar 
 harshness and roughness imparted to the 
 palate when they are tasted. Cold 
 appears to act as an astringent. The ac- 
 tion of astringents is useful in checking 
 certain excessive discharges, and in some 
 cases of purging they are useful ; but it 
 requires a skilful director to know in 
 what cases to employ them, as most in- 
 jurious effects have resulted from the ig- 
 norant and indisci-iminate use of them. 
 In the disease called dysentery, there are 
 very frequent slimy discharges from the 
 bowels, or frequent vain attempts at 
 stool ; this appears a prominent distress- 
 ful symptom, and the patient and his 
 friends think all would be well if this 
 could be got the better of; accordingly, 
 logwood has been ordered to stop the 
 looseness; but with the certain effect of 
 aggravating the disease, and probably 
 rendering it fatal. Astringents are use- 
 ful in long continued laxity of the bowels, 
 
 where there is no deficiency of the pro- 
 per excrementitious matter, and where 
 means have been taken to cure the ori- 
 ginal disease. A good form in such cases 
 is the infusion of catechu made by adding 
 a drachm of that substance to a pint of 
 boiling water, allowing it to cool, strain- 
 ing it, and mixing a little cinnamon 
 water; of this mixture, a tea-cupful is 
 to be taken three or four times a day. 
 In some external sores, where there has 
 been a long continued discharge of thin 
 lymph, astringent washes are of good ef- 
 fect. These may be made of a decoction 
 of oak bark, or a solution of two grains 
 of the sulphate of zinc to the ounce, with 
 a few drops of diluted sulphuric acid, or 
 diluted acids themselves. The same ap- 
 plications, made somewhat stronger, are 
 also useful in some bleedings, as those 
 from the nose, and in too great or long 
 continued flow of the menses. 
 
 ATHLETE. See Training. 
 
 ATMOSPHERE. The mixed aerial 
 fluid, which, for a considerable height, 
 surrounds our globe. For an account of 
 the substances contained in it, and its ne- 
 cessity for the breathing of animals. See 
 Air. 
 
 ATONY. A term signifying the loss 
 of tone, or power of contracting in the 
 fibres destined for motion, or the per- 
 formance of any function. The effect of 
 this is weakness and relaxation ; thus we 
 speak of an atony of the stomach, or we 
 say the bowels have lost their tone^ or 
 the tone of the muscles is diminished. 
 
 ATROPA BELLADONNA. See 
 Deadly Nightshade. 
 
 ATROPHY. A disease, of which a 
 very prominent symptom is wasting of the 
 body, from deficiency of nourishment. 
 It is well known to the nurses in Scot- 
 land by the term Dwining. It is very 
 common in children, and proceeds in 
 them from various causes; from teeth- 
 ing, from acidity of the stomach, and dis- 
 order of the bowels, from rickets, from 
 diseases of the glands of the mesentery ; 
 and this last cause is by far the most com- 
 mon. The patient is at first languid and 
 
52 
 
 ATR 
 
 AZO 
 
 inactive ; has a bad appetite, a disagree- 
 able breath, a pale complexion, a large 
 belly ; the bowels are not regular, some- 
 times costive, at other times loose ; the 
 stools smell badly, and are of a whiter 
 colour than natural. When the disease 
 has continued for some time, the body 
 becomes greatly emaciated, the belly still 
 more swelled, and the digestive functions 
 more disordered. The best treatment 
 consists in putting into execution the 
 tonic plan, after directing our curative 
 means to the original disease. Thus, if 
 difficult teething be the cause of the com- 
 plaint, the gums should be scarified, or 
 other proper means taken to relieve them. 
 The bowels ought to be particularly at- 
 tended to. Purges ought to be given of 
 calomel and rhubarb, and of senna oc- 
 casionally, or of castor oil, varying them 
 when they seem to lose their effect. 
 Exercise in the open air, going to the 
 country, sea-bathing, a moderate allow- 
 ance of wine, with nourishing diet in 
 small quantities, frequently repeated, are 
 useful. The belly should be rubbed with 
 camphorated oil, or with warm olive oil ; 
 
 and, in some cases, even mercurial oint- 
 ment might be used with good effect. 
 
 AXILLA. The arm-pit. 
 
 AXUNGE. A name for hog's lard. 
 
 AZOTE. A gas which fonns a large 
 proportion of the atmosphere, 100 parts 
 of which contain 79 of azote. It extin- 
 guishes flame, and is hostile to animal 
 life ; hence the name given to it by the 
 French chemists, which signifies destruc- 
 tive of life. Some later chemists call it 
 nitroc^iiy from its being an ingredient in 
 nitric acid. Though azote is principally 
 described by negative properties, it is a 
 gas of great importance. Mechanically 
 mixed with oxygen in theiair we breathe, 
 it tempers the too great stimulus of that 
 gas ; combining with oxygen in a closer 
 union and in other proportions, it forms 
 nitric acid, and other acids of remarkable 
 properties j and united with inflammable 
 air (hydrogen) it constitutes the volatile 
 alkali. It is an abundant ingredient in 
 the composition of the muscles and some 
 other parts of the animal body. Azote 
 was discovered by Dr. Rutherford in the 
 year 1772. 
 
 B 
 
 B AL 
 
 B AL 
 
 BACK, Pain of. See LusroAGo. 
 
 BALSAM. This term is now gene- 
 rally restricted to signify compounds of 
 resin and benzoic acid; but in the shops, 
 and in common discourse, is applied to 
 some substances that are not strictly so 
 compounded, which is the case with the 
 article next mentioned, as it contains no 
 benzoic acid, but consists of resin and 
 essential oil. 
 
 BALSAM OF COPAIVA is obtain- 
 ed by wounding the bark of a tree, 
 the Copaifera officinalis, which grows 
 in the Brazils, and in some of the 
 West Indian islands. It has the con- 
 sistency of oil, but it is more viscid and 
 glutinous ; it has a pale' yellow colour, an 
 
 aromatic odour, and a pungent nauseous 
 taste. Copaiva has been much used in 
 the cure of gleets, of the whites, and of 
 similar discharges, where there is not 
 much active inflammation. Of late it has 
 been thought of service to those who are 
 troubled with piles. It may be given in 
 dcses of fifteen to forty drops, twice or 
 thrice a-day, in water, or rubbed into an 
 emulsion with gum arabic or the yoke of 
 an egg. When given for the cure of 
 piles, it is in doses of a drachm three 
 times a-day, and in this dose it com- 
 monly purges. A little aromatic water, 
 or a drop or two of some volatile oil, 
 as cinnamon or peppermint, may be 
 taken with each dose, to prevent the 
 
BAN 
 
 BAR 
 
 53 
 
 sickness which copaiva occasions in some 
 people. 
 
 BALSAM OF PERU. This is ob- 
 tained by boiling in water the twigs 
 of a tree which grows in South Ame- 
 rica, the Myroxylon peruiferum. It is of 
 a brown colour, a fragrant aromatic smell, 
 and a pungent bitterish flavour. This 
 balsam has been recommended in doses 
 of from half a drachm to a <lrachm, as a 
 stimulant in chronic rheumatism. It may 
 be given diffused in water bv; means of 
 mucilage, or made into pills with some 
 vegetable powder. It is said also to be a 
 useful expectorant in chronic asthmas, 
 and old dry coughs, but it should not be 
 employed where there is any inflamma- 
 tory action. 
 
 BALSAM OF TOLU. This balsam 
 is also obtained from South America, 
 from the Toluifera balsamiim. It has 
 an agreeable smell and taste, and is 
 supposed . to be expectorant ; but it is 
 now principally used to give a pleasant 
 flavour to syrups, lozenges, and mixtures 
 for coughs. The Balsam of Tolu is one 
 of the ingredients in the vulnerary bal- 
 sams, intended to imitate what was once 
 so famous under the title of Wade's Bal- 
 sam, Friar's Balsan^, Jesuit's Drops, &c. 
 But it is not easy to say what advantage 
 can be got from the application of such 
 compounds to a recent cut, in which the 
 vulgar commonly recommend them. 
 
 BANANA, Musa sapientum. The 
 Plantain or Banana Thee. This tree is 
 cultivated in all the islands of the West 
 Indies, and on a very extensive scale in 
 Jamaica, where it would be difficult to 
 find any species of provision that would 
 supply its place. Even flour, as Dr. 
 Wright says, or bread itself, would be less 
 agreeable, and less able to support the la- 
 borious negro. Plantains also fatten 
 horses, cattle, swine, dogs, fowls, and 
 other domestic animals. The leaves are 
 employed as dressings after blisters ; and 
 the water from the soft trunk is astrin- 
 gent, and used to check diarrhoeas. There 
 is another sort, the IMusa paradisiaca, 
 of which the fruit is shorter, straighter. 
 
 and rounder; the pulp is softer and of a 
 more luscious taste. It is eaten either 
 raw, or fried in slices as fritters. 
 -BANDAGES. Pieces of linen, cotton, 
 or flannel, intended to bind or surround 
 some part of the body for surgical pur- 
 poses, such as the securing of dressings, 
 or confining the motion of parts that 
 would be painful or injurious. Bandages 
 are sometimes used to give a moderate 
 degree of pressure on dropsical limbs. 
 Supposing the inferior extremities are to 
 be bandaged, care must be taken that the 
 pressure be equally begun from the toes, 
 and carefuUy carried up so as not to al- 
 low the limb to swell below the binding, 
 or between its tiu*ns. The surgeon him- 
 self should always put on the bandages 
 for swelled legs. In ulcers, bandages 
 support the dressings, defend the newly 
 formed skin from any force that might 
 separate it, and bring the edges of the 
 ulcers together. Bandages are employed 
 in wounds to keep the parts together ; 
 and in fractures, to retain the limb and 
 splints in their proper position. A ban- 
 dage, called the T bandage, is useful in 
 many cases to be worn round the belly. 
 It consists of a broad bandage to go round 
 the middle, which is crossed by another 
 attached to it before, and brought up be- 
 tween the thighs, to meet it behind. A 
 bandage having turns like the figure 8, 
 is used in binding up the arm after blood- 
 letting. For the various forms of ban- 
 dages, we refer to books of surgery ; and 
 only mention here, the necessity of the 
 young practitioner exercising himself 
 much in putting bandages on a block or 
 other proper figure, to acquire neatness 
 and dexterity in their application. 
 
 BAREGE WATERS. The village of 
 Bai'eges is situated on the French side 
 of the Pjrrenees, half-way between the 
 Mediten-anean and the Bay of Biscay. 
 There are four hot springs, differing -n 
 their 4;emperature, and in the quantity ot 
 sulphur; the hottest containing the strong- 
 est impregnation. The coolest is about 
 73°, and the hottest 120° of Fahrenheit 
 They dissolve soap, and render the skiu 
 
54 
 
 BARK. 
 
 very supple and pliable ; they are resort- 
 ed to for the cure of tumours of various 
 kinds, and of stiffness and contraction of 
 the tendons or joints left by rheumatic or 
 gouty affections. They are highly use- 
 ful in eruptions on the skin. Taken in- 
 ternally, the waters of Barege are use- 
 ful in disorders of the stomach, attended 
 with sourness and heart-bum ; and also, in 
 certain affections of the urinary organs. 
 
 BARK. When used without any ad- 
 dition. Bark signifies the celebrated me- 
 dicine obtained from South America, and 
 known by the name of Peruvian Bark, 
 or Jesuit's Bark. It is the bark of cer- 
 tain trees called by botanists Cinchona ; 
 and of its numerous species there are 
 three more particularly used in medicine. 
 Its medicinal virtues are said to have 
 been discovered by the following circum- 
 stance. Some Cinchona trees being blown 
 into a pool of water, remained there long 
 enough to make the water so bitter, that 
 the neighbouring inhabitants desisted 
 from using it. One of them, in a pa- 
 roxysm of fever, happened to drink of it 
 and obtained a speedy cure. Others who 
 were ill, made use of the same remedy, 
 and foimd it equally successful. A re- 
 markable cure having been performed in 
 1638, on the Countess of Cinchon, wife 
 of the Spanish viceroy at Lima, it came 
 into general notice, and from this lady the 
 plant derived its present generic name. 
 The species now called lancifoliay (former- 
 ly officinalis) is that which furnishes the 
 pale or common Peruvian bark of the 
 shops. It is imported chiefly in rolled 
 up pieces or quills, mixed with larger and 
 flatter pieces. The small and fine quilled 
 pieces are considered as the best. This 
 bark is covered with a grey outer skin, 
 internally it is of a deep cinnamon co- 
 lour. Its smell, when fresh, is peculiar, 
 and slightly aromatic ; its taste is harsh 
 and bitter. This is the species which has 
 always been most esteemed in the cure of 
 agues, and in the treatment of diseases 
 attended with debility ; and it is deserv- 
 edly reckoned superior to all other tonics 
 and bitters. 
 
 In the cure of ague, the Peruvian bark 
 is a medicine nearly infallible. It should 
 be taken in substance, and in sufficiently 
 large doses, in the intervals of the fits ; 
 when given in the paroxysms, it is apt to 
 disagree with the stomach. A large tea- 
 spoonful should be taken every two hours; 
 it may be mixed with water, or with milk ; 
 and this persisted in, till the fits postpone 
 the period of their attack, or cease to re- 
 turn altogether. By some stomachs it is 
 apt to be rejected, and various contriv- 
 ances have been fallen upon to obtain its 
 virtues in a concentrated form, such as 
 would not disagree with the stomach; 
 the tincture has been tried, but it is quite 
 insufficient for the cure of intermittent 
 fever; and, with more confidence, the ex- 
 tract has been employed. This is pre- 
 pared by boiling the powder and evapor- 
 ating to a proper consistence; it is be- 
 lieved that a great proportion of the ac- 
 tive ingre^ents of the bark is obtained in 
 this form, but in all probability there must 
 be much loss of them in the preparation ; 
 the extract may be given in the form of 
 pills, or of bolus, in the dose of from ten 
 to twenty grains. The decoction of bark 
 is made by boiling an ounce of the pow- 
 der of bark for ten minutes in a pint and 
 a half of water, and straining the liquor ; 
 the dose of the decoction is one or two 
 ounces, repeated according to the effect 
 intended ; if for the cure of agues, in the 
 same frequency as the powder ; if for de- 
 bility, it need not be so often used. The 
 infusion of bark generally sits well even 
 on stomachs that will not bear the bark 
 in substance. It is made by pouring a 
 pound of water upon an ounce of bark in 
 powder, and allowing it to stand for twen- 
 ty-four hours. The dose is the same as 
 of the decoction, from one to three or 
 four ounces. The dexterity of modern 
 chemistry has succeeded in obtaining the , 
 virtues of the bark in a very concentrated 
 form. In the pale bark there is found 
 a substance called Cinchonin or Cinchonia, 
 and in the yellow bark a substance called 
 Quinine or Quina, which are analogous 
 to each other, like the alkalis potash and 
 
BARK. 
 
 56 
 
 soda ; and like them ai'e capable of com- 
 bining with acids. Quinine, united with 
 the sulphuric acid, forms the sulphate of 
 quinine, of which eight grains are con- 
 sidered equivalent to an ounce of bark. 
 A wine of quinine may be formed, by- 
 adding five grains of the sulphate to a 
 pint of sherry ; and a tinctiu-e, by dissolv- 
 ing the same quantity in eight fluid ounces 
 of rectified spirit. We have thus a very 
 easy and manageable way of exhibiting 
 the bark ; and it seems to have been 
 ascertained by experiment, that these 
 concentrated preparations of the bark are 
 not, like those of some other vegetable 
 substances, possessed of deleterious pro- 
 perties, but may be safely used in the 
 cure of diseases ; and we are thus enabled 
 to employ the bark in the complaints of 
 children, where formerly it was so diffi- 
 cult to get them to take it in sufficient 
 quantity. Besides intermittent fever, 
 bark has been used in a great variety of 
 ailments ; and another instance of its re- 
 markable efficacy is seen in the treatment 
 of gangrene and other putrid diseases. 
 In gangrene, we can hardly be too desi- 
 rous to get the bark thrown into the sys- 
 tem in large quantities } and unexpected 
 benefits sometimes result from it. In 
 gangrene, accompanied with debility, and 
 in putrescent fevers, port wine should be 
 taken at the same time with the bark. In 
 the high excitement which sometimes 
 co-exists with gangrene, and in typhoid 
 diseases, while the skin is hot and dry, 
 and high inflammatory symptoms are pre- 
 sent, it is dangerous to use the bark, and 
 more especially to conjoin it with wine. 
 In all cases where we intend to continue 
 the bark for some time, it is wise to be- 
 gin with clearing out the stomach and 
 bowels by an emetic and a purgative; 
 then to talce care that it does not disorder 
 the stomach, or pass off by stool, as it is 
 in some constitutions ready to do. Where 
 the bark proves purgative, a small dose 
 of laudanum, as ten drops, or one-fourth 
 or half a grain of solid opium may be 
 given with each dose. 
 
 The diseases in which bai'k is usefully 
 
 employed are very numerous ; chiefly 
 those accompanied by debility and pu- 
 trescency; and for these symptoms the 
 bark is an excellent remedy. In bad 
 small-pox, when there are both typhoid 
 symptoms, and a gangrenous tendency, 
 the bark has been extensively used ,• but 
 as it frequently occurred in children, it 
 was very difficult, before the discovery 
 of quinine, from the disagreeable taste of 
 the bark, to get them to swallow a suffi- 
 cient quantity. It is best given to chil- 
 dren in some sweet liquid ; or in the form 
 of glysters, though with much inferior 
 efficacy. Quinine, however, will render 
 those expedients unnecessary. In con- 
 sumption, it has been given ; but its ten- 
 dency to disagree with the stomach, and 
 to increase inflammatory symptom*, re- 
 quire much caution in its exhibition. It 
 is generally prudent to disconty;iue the 
 use of bark when a cough is present. 
 It has been given in rheumatism, but 
 it is quite necessary to premise bleed- 
 ing and other means for reducing in- 
 flammatory action, before the bark is 
 prescribed. 
 
 In all diseases that appear to come 
 periodically, and to have some of the ha- 
 bits noted in intermittents, the bark is 
 highly useful ; of this nature are certain 
 headachs, pains of the limbs, spasms, and 
 coughs. Jn gangrenous sore throats, the 
 bark should be given internally ; and a 
 gargle made of the decoction is to be 
 used. In passive haemorrhages, and in 
 dropsy, when seeming to arise from gene- 
 ral debility, without any local disease, it 
 is usefully alternated with diuretics, and 
 the other means used for the evacuation 
 of the water. Some form of the bark is 
 useful in stomach complaints, either 
 alone or combined with sulphuric acid or 
 iron. 
 
 BARLEY, Hordeum Distichon, An 
 annual plant, cultivated in almost every 
 country of Europe. Pearl barley is 
 prepared by grinding off the husks of 
 rough barley, and forming the grain 
 into little round granules of a pearly 
 whiteness. In this state, barley con-? 
 
56 
 
 BAR 
 
 BAT 
 
 sists almost solely of starchy matter; 
 it forms an excellent article of nourish- 
 ment, and the decoction, commonly called 
 barley water, is one of the best drinks 
 in feverish diseases. 
 
 BARLEY WATER. As ^ood barley 
 water, however humble it may appear, is 
 one of the most important articles with 
 which the sick are conversant, we give 
 here, from the Cook's Oracle, two re- 
 ceipts for its preparation. *' Take a couple 
 of ounces of pearl barley, wash it clean 
 with cold water, put it into half a pint 
 of boiling water, and let it boil for five 
 minutes ; pour off this water, and add to 
 it two quaj-ts of boiling water ; boil it to 
 two pints and strain it. 
 
 " The above is simply barley water ; to 
 a quart of this is frequently added, two 
 ounces of figs sliced ; ithe same of raisins 
 stoned : half an ounce of liquorice, sliced 
 and bruised ; and a pint of water. Boil 
 till it is reduced to a quart, and strain. 
 These drinks are intended to assuage 
 thirst in ardent fevers, and inflammatory 
 disorders, for which plenty of mild dilut- 
 ing liquor is one of the principal remedies ; 
 and if not suggested by the medical at- 
 tendant, is frequently demanded by honest 
 instinct, in terms too plain to be misun- 
 derstood. The stomach sympathizes with 
 every fibre of the human frame, and no 
 part of it can be distressed, without in 
 some degree offending the stomach; there- 
 fore, it is of the utmost importance to 
 soothe this grand organ, by rendering every 
 thing we offer to it as elegant and agree- 
 ble as the nature of the case will admit 
 of. The barley drink, prepared according 
 to the second receipt, will be received 
 with pleasure by the most delicate sto- 
 mach." 
 
 BARYTA. The name of an earth, 
 remarkable for its great specific gravity, 
 and for furnishing an ingredient of some 
 yalts which have been recommended in 
 the treatment of scrofula. Of these, the 
 principal is the muriate of baryta, the dose 
 of which is from five to fifteen drops of 
 the saturated solution in distilled water, 
 taken twice or thrice a-dav. As all the 
 
 preparations of baryta are acrid and 
 poisonous, their exhibition must be con- 
 ducted with due caution. 
 
 BASILIC VEIN. The large vein that 
 runs in the inner side of the arm. 
 
 BASILICON. The ointment cilled in 
 the Pharmacopoeia, Unguentura resinae 
 flavse ; useful for dressing sores when 
 they continue long getting neither better 
 nor worse, but as surgeons speak, become 
 indolent ; or when it is wished to promote 
 a slight discharge of purulent matter from 
 them. 
 
 BATH. The name of a town in Eng- 
 land, famous for its medicinal waters. 
 The temperature of these waters is higher 
 than any other in this kingdom, being 
 from 1 12° to 1 16°. There are three prin- 
 cipal springs, the King's Bath, the Hot 
 Bath, and the Cross Bath, which differ 
 but little in their sensible and medicinal 
 properties. When the water is newly 
 drawn, it appears clear and colourless, 
 without any sparkling or effervescence. 
 After being exposed for some hours to 
 the open air, it becomes a little muddy, 
 by the subsidence of a pale yellow pre- 
 cipitate. The water has very little smell, 
 but when hot from the pump, it affects 
 the mouth with a strong chalybeate im- 
 pression, without being saline or pungent. 
 When cold, this chalybeate taste is almost 
 entirely lost. The water of the King's 
 Bath, which is commonly preferred for 
 drinking, is about 1 1 6^, when fresh drawn 
 in the glass. In the bathing vessels, it is 
 from 100'=* to 106°; and in the Cross 
 Bath pretty stationary from 92° to 94". 
 There is a slight portion of cai'bonic acid, 
 but no trace of sulphur. 
 
 The medicinal effect of the Bath wa- 
 ters is thought by some physicians to 
 depend merely on then- steady tempera- 
 ture ; but they certainly appear to have 
 some specific effects, which cannot be 
 obtained from any imitations of them. 
 The Bath water, when drunk fresh from 
 the spring, quickens the pulse, increases 
 the heat, and promotes the different se- 
 cretions. One of the most salutary ef- 
 fects of these waters is to increase the 
 
BAT 11. 
 
 .57 
 
 flow of urine, .even when taken in mode- 
 rate doses. Its operation on the bowels 
 varies in different individuals, but its ge- 
 neral tendency is to produce costiveness : 
 probably by its promoting perspiration, 
 and not by any direct undue influence on 
 the bowels. Where it is likely to agree 
 Avith the patient, there is at first a plear- 
 sant glowing sensation in the stomach, 
 followed by increase of appetite, and flow 
 of urine ; but where there occur head- 
 ach, thirst, sickness, without any increas- 
 ed discharge, the use of the water must 
 be discontinued. 
 
 The diseases for which invalids resort 
 to Bath are numerous and important ; 
 and the cases which call for the use of 
 its waters are those in which a gentle, 
 gradual, and permanent stimulus is re- 
 quired; and, on the other hand, those 
 waters are to be avoided in all cases 
 where there is over-action of the system, 
 or tendency to inflammation. Various 
 chronic diseases of great obstinacy are 
 found to yield to a persevering use of 
 the Bath waters. They are commonly 
 used as a bath externally, at the same 
 time that they are drank as a medicine. 
 They are of service in the unhealthy and 
 pallid look, which in young women indi- 
 cates the obstruction of the menstrual 
 discharge. In palsy, which proceeds 
 from previous apoplexy, or when the 
 fulness of the bloodvessels indicates the 
 appi-oach to that disease, the use of the 
 Bath water is improper, on account of the 
 stimulus it imparts. When the plethoric 
 state of the system is removed by proper 
 means, the bath may be used. In gout, 
 great benefit is derived from the water, 
 where irregular affections of the head, 
 stomach, and bowels occur ; and when by 
 the use of the bath, some degree of active 
 inflammation is brought out on any 
 limb, the other symptoms are much re- 
 lieved. But when the tendency to gout 
 is very strong, when its relapse is easily 
 brought back, whether by irregular liv- 
 ing, or by the use of the many nostrums 
 and specifics for gout which are imposed 
 on the credulous; when there is fulness 
 
 of the system, or obstructed liver, the use 
 of the Bath waters, whether internal or 
 external, is to be forbidden. When the 
 water is found to be too stimulating, it 
 may be tried without its chalybeate im- 
 pregnation, which is easily accomplished, 
 by exposing the water to the air for a 
 few hours, and then heating it to any 
 temperature that may be required. In 
 affections of the digestive organs of those 
 who have resided long in warm climates, 
 and where the liver and secretion of bile 
 are deranged ; also in jaimdice, and the 
 colic and palsy arising from the poison of 
 lead, the Bath waters are beneficial. The 
 external use of the waters is prescribed 
 in the same diseases as the internal ; and 
 in some cases the external use alone 
 will be sufficient. When the joints are 
 thickened and stiff from chronic rheuma- 
 tism, the water may be pumped upon 
 them, the number of strokes being in- 
 creased or diminished according to the 
 age, sex, strength, or other circumstances 
 of the patient. This is called dry pump- 
 ing, from the rest of the body being dry, 
 except that part on which the water falls. 
 In chronic rheumatic complaints, much 
 good is done by the waters. 
 
 The activity and power of the Bath 
 waters render it necessary that in every 
 case a medical man be consulted immedi' 
 ately before their use, as such only can 
 judge whether the diseases present, and 
 the state of the constitution at the time, 
 admit their employment. When invalids, 
 who are not greatly debilitated, repair to 
 Bath, much of the improvement of their 
 health no doubt depends on the change 
 of scene and manner of life, on the laying 
 aside of their usual habits and employ- 
 ments, and on the means afforded for ex- 
 ercise and amusement. The best season 
 for using the Bath waters is in the spring 
 and autumn. 
 
 BATH, COLD. Water applied to the 
 body between the temperature 65^ and 
 32", produces the sensation of cold, 
 which gi-adually ceases, and is succeeded 
 by a glow of heat. Shivering is at fii*st 
 brought on, and the skin becomes pale 
 
58 
 
 BAT IT. 
 
 contracted, and covered with little emi- 
 nences, making it resemble the skin of a 
 newly plucked goose ; hence its physio- 
 logical name in that state, cutis anserina. 
 The breathing is rendered quick and ir- 
 regular ; the pulse slow, firm, and small 
 The heat of the internal parts is at fii'st 
 diminished, but gradually returns nearly 
 to its natural standard. The perspiration 
 is suppressed, and the urine is rendered 
 more copious. If the cold be excessive, 
 long continued violent shiverings are in- 
 duced, the pulse ceases at the wrist, the 
 motion of the heart becomes feeble and 
 languid, there is a sensation of faintness 
 and coldness at the stomach, the heat 
 diminishes rapidly, and at last delirium, 
 numbness, and death ensue. If the cold 
 be not so great, and if the application of 
 the bath be not too long continued, or if 
 these circumstances are not dispropor- 
 tioned to the strength of the person 
 bathing, he feels on emerging from the 
 water an agreeable glow of heat over the 
 whole body, and is refreshed and invi- 
 gorated. A person should be careful not 
 to venture into the water while he is 
 much fatigued, or while he is perspiring j 
 but a certain degree of vigour and 
 warmth of the body is necessary to insiu-e 
 that glow of re-action which is one evi- 
 dence of the cold bath being salutary ; 
 and some degree of heat should be felt 
 before going into the water. It is an 
 unwise practice, therefore, though a very 
 popular one, to sit on the brink of a river, 
 or of the sea, in order that the bather 
 may not go into the water too warm. 
 By this he is apt to get chilly and lan- 
 guid, and not in a state to derive benefit 
 from bathing. A very beautiful and sa- 
 tisfactory illustration of the difference 
 between taking the cold bath when one 
 is vigorous, and when one is debilitated 
 or exhausted, is related by Dr. Currie of 
 Liverpool. " On the first of September, 
 1778, two students of medicine at Edin- 
 burgh, set out on foot on a journey, a 
 considerable part of which lay along one 
 of the rivers of Scotland. They started 
 by sunrise, and proceeded with alacrity 
 
 in the cool of the morning. At the end 
 of eight miles they breakfasted, rested 
 for an hour, and then resumed their 
 journey. The day grew warm as it ad- 
 vanced ; and after a march of eight miles 
 more, they arrived, heated, but not fa- 
 tigued, on the banks of the river above- 
 mentioned, about eleven in the forenoon. 
 Urged by the fervour of the day, and 
 tempted by the beauty of the stream, 
 they stripped instantly, and threw them- 
 selves into the river. The utmost re- 
 freshment followed : and when they 
 retired to the neighbouring inn, this 
 was succeeded by a disposition to sleep, 
 whi«h they indulged. In the afternoon 
 they proceeded, and travelling sixteen 
 miles farther at a single stretch, arrived 
 at the inn where they were to sleep, a 
 little after sun-set. The afternoon had 
 been warm, and they sweated profuse- 
 ly ,• but the evening was temperate, and 
 rather cool. They had travelled for 
 some miles slowly, and arrived at the 
 end of their journey stiffened and wearied 
 with their exercise. The refreshment 
 which they had experienced in the morn- 
 ing from bathing, induced, however, one 
 of them to repeat the experiment ; and he 
 went perfectly cool into the same river, 
 expecting to relax his limbs in the water, 
 and afterwards to enjoy profound sleep. 
 The consequences were very different. 
 The Tweed, which was so refreshing in 
 the morning, now felt extremely cold; 
 and he left the water hastily. No genial 
 glow succeeded, but a feverish chill re- 
 mained for some time, with small frequent 
 pulse, and flying pains over the body. 
 Warm liquids and friction brought on, at 
 length, considerable heat; and towards 
 morning, perspiration and sleep followed. 
 Next day, about noon, they proceeded on 
 foot; but the traveller who had bathed 
 was extremely feeble ; and though they 
 had to perform a journey of a single 
 stage only, as some part of it was difficult 
 and mountainous, he was obliged to take 
 the assistance of a carriage which over- 
 took them on the road. It was several days 
 before he recovered his usual vigour." 
 
BATH. 
 
 59 
 
 Application of the Cold Bath to the 
 Cure of Diseases. — The above incident 
 may furnish us with some very useful 
 hints for the use of the cold bath in cases 
 of disease. We see from it that there 
 must be a certain degree of vigour in the 
 system to produce the proper re-action 
 after the cold is first applied, otherwise it 
 is sure to produce bad effects. We have 
 stated very fully, under the article Affu- 
 sion, the use that may be made of the 
 cold bath in the cure of febrile diseases. 
 It has also been employed with success in 
 chronic rheumatism, in some species of 
 mania, and in palsy. In debility of any 
 particular part, partial cold bathing may 
 be applied, by pouring water from a height. 
 As a mode of strengthening the constitu- 
 tion, either when it is feeble by nature, 
 or weakened by previous disease, the cold 
 bath is highly useful. There are some 
 habits of body and some tendencies to 
 disease which render it unsafe to use the 
 cold bath ; some feel a degree of cold and 
 shivering for a long time after coming out 
 of the water ; others have headach for a 
 great part of the day. In such cases, it 
 does not appear that much good is to be 
 expected from bathing. In cases where 
 there is a tendency to apoplexy, or flow 
 of blood to the head, it is unsafe to try 
 cold bathing ; and also when there is any 
 tendency to consumption, or other com- 
 plaints within the chest, it is prudent to 
 abstain from this practice. 
 
 Mode and Time of Bathing. Though 
 it is wrong to apply the feet and lower 
 parts slowly to the water, it is an equally 
 unsafe practice to go in suddenly with a 
 plunge over the head ; as the shock to the 
 nervous system may produce fainting, and 
 in some persons not very vigorous may 
 even be fatal. It is sometimes necessary 
 to prepare the body gradually for a course 
 of sea-bathing, by the use of the tepid 
 bath for a week or two, diminishing the 
 temperature a few degrees each succes- 
 sive time. It is proper at the commence- 
 ment of such a course, that invalids should 
 not go into the sea every day, but every 
 second day. The best part of the day for 
 
 bathing the morning, before break- 
 
 fast ; but when the weather is not very 
 warm, or when the bather is somewhat 
 debilitated, it may be better to bathe in 
 the forenoon. A person in full health 
 and vigour may bathe almost at any 
 period, but those labouring under stomach 
 complaints should not go into the water 
 until they are somewhat invigorated by 
 taking food in moderate quantity. The 
 best time for such persons seems to be 
 about two hours after breakfast. It is 
 bad to use the cold bath soon after a very 
 full meal. It is not right to stay too long 
 in the water; a few immersions, and a 
 few turns by those who can swim, are 
 sufficient. If any feebleness arises from 
 staying too long in the water, some warm 
 wine and water, or some warm gruel, or 
 tea, drank when the patient is laid be- 
 tween blankets, will probably restore the 
 proper heat. 
 
 The best time of the year for bathing 
 is that in which the weather is mild and 
 settled; and hence, in this country, ba- 
 thers ought to wait till the long prevail- 
 ing easterly winds of our spring have 
 decidedly given place to more genial 
 breezes. September seems to be the 
 month that should finish the bathing sea- 
 son. The sea is best for the cold bath, 
 by the uniformity of its temperature, the 
 agitation of the waves, and the stimulus 
 left by the salt on the skin. 
 
 BATHS, MEDICATED. These may 
 be either liquid or vapour, and are made 
 by adding some medicinal substance to the 
 common baths. The fluid ones are chief- 
 ly imitations of the natural mineral wa- 
 ters, of the sulphureous or chalybeate 
 kind; and they are principally used in 
 diseases of the skin and joints, and in 
 rheumatism. The ingredient which is 
 thought most beneficial, whether sulphur, 
 iron, or other substance, may be added in 
 larger quantity, according to the desire of 
 the prescriber and the effect wanted. In 
 some venereal complaints, when it is 
 wished to introduce mercury very speedi- 
 ly into the system, a quantity of cinnabar 
 has been burned, and the patient thus 
 
60 
 
 BATH. 
 
 exposed to a vapour bath ; and for the 
 same, and also for cutaneous affections, 
 the nitro-muriatic acid bath has been used, 
 in the proportion of three or four ounces of 
 acid to twenty gallons of water. These 
 baths should always be prescribed and 
 superintended by a medical man. 
 
 BATH, SHOWER. This is a particular 
 method of applying- the cold bath, by 
 allowing a broken stream of water to fall 
 on the head. The shock is pretty severe 
 at first, but for those who have strength 
 of body and resolution to persevere in it, 
 it acts as an excellent bracer; and is free 
 from many of the dangers likely to arise 
 from the blood being sent to the head, 
 which it is in danger of being, when the 
 lower parts are first immersed in the 
 water. For many people, it is a good 
 practice to raise the water to the tem- 
 perature of 50°. 
 
 BATH, VAPOUR. In this, the patient 
 is exposed to the vapour of water, either 
 alone or medicated with various impreg- 
 nations. It is more used on the Continent 
 than in Great Britain ; but of late years 
 has been more frequently employed in 
 this country than formerly. The first 
 remarkable effect of the vapour bath, 
 is to excite profuse sweating. It is re- 
 commended in the cure of rheumatism 
 and of gout. It has been found of speedy 
 and striking benefit in obstinate diseases 
 of the skin, and it is also recommended 
 in ulcers, in chilblains, and in dropsy j its 
 power in relaxing stiff joints is wonder- 
 fully great. In Russia, it is used as an 
 article of luxury, the vapour being heated 
 so high as 150«; and, what we should 
 think destructive to the constitution, from 
 being exposed to vapour at this high tem- 
 perature, they proceed to roll themselves 
 in the snow, or plunge into cold Avater, 
 which they do with impunity. There is 
 little fear of their example being imitated 
 in this country. 
 
 BATH, WARM. Water of the temper- 
 ature between 97° and 83° applied to the 
 body constitutes the warm bath, which is 
 uniformly to be considered as diminishing 
 the heat of the body, altho\igh the first 
 
 sensation experienced. on going into the 
 bath is that of warmth. The warm bath 
 diminishes the frequency of the pulse, 
 especially when it has been greater than 
 natural ,• and this effect is in proportion 
 to the time of being in the bath. It 
 renders the breathing slower, relaxes the 
 muscles, increases the bulk of the fluids, 
 removes impurities from the surface, pro- 
 motes the scaling off of the scarf skin, 
 and softens the nails, corns, or other hard- 
 nesses of the skin. The warm bath is 
 veiy usefully employed where there is 
 great heat of the surface, and frequency 
 of the pulse. Its relaxing powers ai^ 
 very serviceable in cases of rupture, sup- 
 pression of urine, and spasmodic affec- 
 tions of the bowels. There are m.any 
 other diseases in which the warm bath is 
 very beneficial. In the numberless dis- 
 eases of the skin, it not only does good 
 itself, but prepares the skin for the ap- 
 plication of other remedies. It is good 
 in rheumatic affections, and in palsy. 
 In small-pox, measles, and chicken-pox, 
 where there is much fever, and long 
 delay of the eruption coming out, the 
 warm bath both relieves the fever, and 
 brings out the eruption in a kindly man- 
 ner. When by cold, or by improper treat- 
 ment, the eruption has disappeared, and 
 bad effects are produced on the lungs and 
 other internal parts, the warm bath is our 
 most powerful assistant in bringing out 
 the eruption again, and relieving the dan- 
 gerous symptoms. In the feverish dis- 
 eases of children, arising from teething or 
 disorder of the bowels, the warm bath is 
 an excellent remedy. The child should 
 be immersed in water of a suitable tem- 
 perature, say from 70° to 80°, up to the 
 neck, and kept in the water for about 
 five or seven minutes ; then wiped dry, 
 and put to bed, when it seldom fails to be 
 much relieved of feverish symptoms, and 
 to fall into a refreshing sleep. By pa- 
 tients labouring under stomach com- 
 plaints, and who are too much debilitated 
 to use the cold bath, much benefit may 
 be derived from a prudent use of the 
 warm bath. The temperature at first 
 
BEE 
 
 BEE 
 
 61 
 
 should not be above 94° or 95°, and it 
 should always be regulated by the ther- 
 mometer. The best period for such pa- 
 tients to use it, is an hour or two before 
 dinner. They may remain in the water 
 for about twenty minutes, and may take 
 a little exercise afterwards, but not so 
 much as to fatigue. It is commonly sup- 
 posed that a person on coming out of the 
 warm liath is more than usually suscepti- 
 ble of cold, but experience has satisfied 
 the most accurate observers that such 
 fears are groundless, and that it is unne- 
 cessary either to make any alteration in 
 the clothing, or to avoid the common ex- 
 posure to the air, 
 
 BEAN, Vicia faba. A well known 
 esculent pulse, very nutritious to those 
 whose stomachs are strong and able to 
 digest them, but apt to breed flatulence 
 in delicate stomachs, unaccustomed to 
 strong and coarse food. When young and 
 succulent, they are a favourite accom- 
 paniment to bacon. See Pease. 
 
 BEE, Sting of. Sometimes very 
 painful symptoms arise in consequence of 
 a sting from a bee, such as great swelling 
 extending to the neighbouring parts, and 
 even over a whole limb, thirst, restless- 
 ness, and other feverish symptoms. 
 When an enraged swarm attacks a per- 
 son, the consequences may be very alarm- 
 ing indeed. Such accidents are to be 
 treated by cooling local applications, as 
 solutions of hartshorn in cold Avater, in 
 the proportion of tvi^enty grains of the 
 carbonate of ammonia to six ounces of 
 water ; or what is comjuonly sold by the 
 name of hartshorn, or vinegar and water, 
 may be applied ,• or the muriate of am- 
 monia (sal ammoniac) dissolved in wa- 
 ter, or lime juice. Laxative medicines of 
 the cooling kinds, as Epsom salts, Ro- 
 chelle salts, or cream of tartar, are to be 
 given, and the patient to be kept at rest 
 in a cool place and on a spare diet. 
 
 BEEF, in its various modcc of di'ess- 
 ing, is one of the most commonly used 
 and nutritious articles of diet. It is pro- 
 bably not q;iite so easily digested by the 
 generality of people as mutton is, but tho 
 
 difference between them is not great. It 
 may be used as an article of diet by those 
 who are recovering from debilitating dis- 
 eases, observing the usual precautions 
 about the quantity taken, and the modes 
 of dressing it. Beef-steak seems to be 
 the form in which its nutritious powers 
 are best retained. The unnatural loads 
 of fat which are accumulated on what is 
 called prize beef, add nothing to its good- 
 ness, and are best melted away in the 
 cooking. 
 
 BEEF TEA. As this is one of the 
 most important restoratives for persons 
 recovering from sickness, and for many 
 cases of actual illness, we subjoin from 
 the Cook's Oracle a receipt for making 
 it in perfection : " Cut a pound of lean 
 gravy meat into thin slices, put it into a 
 quart and half a pint of cold water, set it 
 over a gentle fire, where it will become 
 gradually warmj when the scum rises, 
 let it continue simmering gently for about 
 an hour, then strain it through a fine 
 sieve, or a napkin, let it stand ten minutes 
 to settle, and then pour off the clear tea." 
 
 BEER. A liquor used in almost 
 every country, and made in the earliest 
 times. Without describing the process 
 of brewing, we shall merely mention that 
 beer, from its slight bitterness, is a good 
 assistant in digestion. It tends to ob- 
 viate costiveness ; but when it is stale and 
 hard, it is very apt to distui'b the bowels 
 considerably. It may be allowed as a 
 drinlc in many feverish disorders, with 
 the precaution merely of not giving it 
 very cold. When there is much flatu- 
 lence in the bowels, we must be cautious 
 in its use. Good small beer may be al- 
 lowed to childi-en when their bowels are 
 in good order. 
 
 BEES* WAX. It is generally sup- 
 posed tliat bees only collect wax from 
 flowers, but from the experiments of Ru- 
 ber it appears that they make it It 
 forms the cells in which they deposit 
 their honey. After the honey-comb has 
 been completely drained, it is washed, 
 melted in boiling water, and strained, 
 then cast into calves. Fresh wax has a 
 
62 
 
 BER 
 
 BI L 
 
 bright yellow colour, no taste, and a 
 smell like honey. Yellow wax is used 
 in medicine only for the preparation of 
 external applications. Yellow wax is 
 cut into thin cakes, and after being bleach- 
 ed by long exposure to the sun and air, 
 is again melted and sold in the form of 
 thin round cakes. White wax is added 
 to oily applications, to give them consis- 
 tency. 
 
 BEET-ROOT, Beta vulgaris. The 
 root of a plant of a sweet taste and beau- 
 tiful red colour. It forms a good pickle 
 with vinegar, and may be considered as 
 an antiscorbutic. In some parts of the 
 Continent, a considerable quantity of sugar 
 is extracted from this plant ; and it is said 
 that if the roots be dried in the manner 
 of malt, tolerable beer may be made from 
 them. 
 
 BELLY. See Abdo»ien. Wlien we 
 speak of a bound belly, or a loose belly, 
 we mean the state of the intestines with 
 respect to costiveness or laxity; and 
 when we speak of a pendulous belly, we 
 mean that the skin and muscles of the 
 abdomen are relaxed and hang forward. 
 
 BENZOIC ACID, or Flowers of 
 Benjamin. An acid which exists in se- 
 veral balsams, particularly in that called 
 Benzoic, procured from Sumatra, Ben- 
 zoic acid has a strong, pungent, aromatic 
 odour, but is very seldom used as a medi- 
 cine. It is used in some articles of per- 
 fumery. 
 
 BERIBERL A species of palsy ob- 
 served in the East Indies, in which the 
 patients seem to imitate sheep in lifting 
 their legs when they walk. Hence the 
 name, from an Indian word signifying a 
 sheep. The disease sometimes seizes sud- 
 denly, but generally comes on gradually. 
 The symptoms are, a universal lassitude, 
 a wrong motion of the hands and feet, 
 with a tingling sensation in those parts, 
 such as is felt in the toes and fingers in 
 cold weather. The disease softietiraes 
 affects the muscles of the chest, and altei-s 
 the breathing and the voice. It is cured 
 by moderate exercise and frictions, and 
 by bathing the lower extremities in Avarm 
 
 water, in which some aromatic plant has 
 been boiled. The affected parts are rub- 
 bed with a mixture of the oil of mace 
 and roses. Decoctions of guaiacum and 
 sarsaparilla are of service taken internally, 
 and a mild laxatiye is to be occasionally 
 given. 
 
 BETONY, Betonica officinalis. A 
 plant formerly used in medicine, and 
 much celebrated for numerous virtues ; 
 its roots are said to vomit and purge 
 violently, and appear in some respects to 
 resemble hellebore; but betony is now 
 totally neglected. " Antonius Musa, phy- 
 sician to the Emperor Augustus, filled a 
 whole volume with enumerating its vir- 
 tues, stating it as a remedy for no less 
 than forty-seven disorders ; and hence in 
 Italy the proverbial compliment. You have 
 more virtues than hetony^ (Hoopbr's 
 Medical Dictionary.) 
 
 BEZOAR STONES. Concretions 
 found in the stomach and intestines of 
 some of the lower animals, which once 
 had great celebrity for their power of 
 preventing and curing disease, but which, 
 in this country at least, are now justly 
 considered as of no value. Those for- 
 merly used were chiefly of a resinous 
 nature. A pretended bezoar stone made 
 of a mixture of vinegar with absorbent 
 earth, was sold under the name of Gas- 
 coigne's powder, and thought useful in 
 the diseases of children ; but even this 
 composition, worthless as it would be, if 
 the real bezoar were employed, is said to 
 be made of tobacco and pipe-clay, tinged 
 with ox-gall. 
 
 BILE. A fluid of great importance in 
 the animal economy, known in popular 
 language by the name of gall. It is 
 secreted or formed from the blood, by 
 that large and important organ the liver ; 
 and it differs from other secretions in 
 being formed not from arterial but from 
 venous blood. The blood which supplies 
 the stomach and the greater portion of 
 the intestinal canal, flows from the dif- 
 ferent organs to which it is distributed, 
 into several veins ; which, instead of con- 
 veying the blood to the lungs to be again 
 
BILE. 
 
 63 
 
 fitted for circulating^ through the body, 
 are branched out like an artery, and carry 
 the venous blood through the liver, to be 
 employed by that organ in forming the 
 bile. The bile is carried by a canal into 
 the intestines, a few inches below the 
 lower orifice of the stomach; and this 
 canal is made up by the junction of two 
 others, one of which comes from the 
 liver itself, and the other from the gall 
 bladder, in which part of the bile is 
 lodged for some time, and becomes a little 
 thicker than that which goes at once to 
 the intestines. 
 
 The bile is a liquid of a yellowish green 
 colour, a greasy feel, a bitter taste, and 
 peculiar smell. It is an essential requisite 
 to healthy digestion, and to the formation 
 of the milky fluid named chyle, into which 
 the food is changed shortly after passing 
 out of the stomach into the next portion 
 of the intestines. Bile is necessary also 
 to promote the proper action of the in- 
 testines, and to cause them to evacuate 
 their contents sooner than they would 
 otherwise do; for when the bile is de- 
 ficient in quantity, the body is generally 
 costive. 
 
 Influence of the Bile in producing dis" 
 eases. The bile being a fluid of such im- 
 portance, and secreted by an organ of 
 such magnitude as the liver, has attracted 
 much attention both from physicians and 
 the people ; and many diseases are justly 
 ascribed to the irregularity of its produc- 
 tion and distribution, though it is blamed 
 much oftener than it deserves. Nothing 
 is more common than to hear patients 
 ascribe to bile many disorders of the 
 stomach and bowels ; and from the de- 
 scriptions of some, they seem to consider 
 the bile as accumulating in their stomachs, 
 as if in a bag or abscess, on the breaking 
 of which they obtain a discharge of bile, 
 with great relief. In the healthy state, 
 there is no bile whatever in the stomach ; 
 the canal which carries the bile into the 
 intestines being situated several inches 
 below the orifice of that organ ; and it 
 is only when the downward motion of 
 the bowels is by some cause inverted. 
 
 that the bile is forced upward into tlie 
 stomach, and discharged by the mouth. 
 One very common cause of this inverted 
 motion of the commencing portions of 
 the intestines is vomiting, either from 
 the action of emetic medicines, or when 
 it takes place as a symptom of disease. 
 In many febrile maladies, especially in 
 those of warm climates, there is a great 
 discharge of bile by vomiting ; and the 
 bile is believed to be the cause of the 
 disease. Hence the frequent mention 
 of bilious fevers of all descriptions, and 
 the anxiety of patients, and of some 
 physicians, to get rid of the bile, and 
 so to cure the patient. The reason of 
 the bile showing itself so copiously in 
 these diseases, is, that in warm climates, 
 and in warm weather, there is really a 
 great deal more bile formed than in ordi- 
 nary circumstances, and it is also some- 
 what altered in its qualities; but in a 
 person in health, the worst that is likely 
 to happen is a degree of purging, by 
 which the oifending fluid will be carried 
 oiF. But as the poisonous efiluvia giving 
 rise to fever produce great derangement 
 of many functions, first the stomach suf- 
 fers, and throws up its contents ; and the 
 motion of part at least of the intestinal 
 canal being inverted, bile is brought up 
 in abundance, and vitiated in its qualities, 
 by which the stomach is still more irri- 
 tated, and the mischief is protracted for 
 a long time, perhaps till death ensues. It 
 is not wonderful, therefore, that the large 
 quantities of bile discharged, the perpetual 
 distressing vomiting, and the other urgent 
 symptoms, should be considered as arising 
 from the presence of a fluid so copious 
 and so striking in its properties, and so 
 apparently adequate to produce the greater 
 number of the phenomena of the fevers 
 of warm climates. 
 
 Heat increases the secretion of Bile. 
 Similar effects sometimes take place ia 
 more temperate climates, when the sum- 
 mer has been warm ; at the end of such 
 warm seasons, or in autumn, a great dis- 
 charge of bile both upwards and down- 
 wards occurs, producing the disease called 
 
C4 
 
 BIL 
 
 B IL 
 
 cholera morbus. It is admitted that long- 
 continued heat has an influence on the 
 secretion of the bile, both as to quantity 
 and quality, and whether it gets into the 
 stomach or not, something- must be done 
 to discharge it. It is believed that mer- 
 curial medicines have some peculiar power 
 of acting on the outlet of the canal which 
 conveys the bile to the intestines; and 
 that by their action on this canal they 
 encourage the liver to throw out the bile 
 in large quantities, and so to prevent any 
 diseased accumulation. When there is 
 considerable headach, sickness, oppres- 
 sion at the stomach, bad taste in the 
 mouth, and hot hands, from three to five 
 grains of calomel in form of a pill often 
 produce singularly good effects ; this may 
 be taken for two or three successive days, 
 taking care afterwards to use a saline 
 purge, or one of senna, to prevent any 
 portion of the calomel from remaining in 
 the bowels, as that might salivate. The 
 sallow complexion, so common in those 
 who reside in warm climates, and in those 
 who have suffered from agues in more 
 temperate ones, appears to arise from 
 some affection of the biliary system ; and 
 though we can hardly expect to get rid 
 of this unhealthy state altogether, it may 
 be still proper to regulate the bile by 
 prudently directed courses of calomel. 
 When there is an overflow of bile, either 
 actually inducing bilious vomiting and 
 purging, or threatening it, the best prac- 
 tice is largely to dilute its acrimony by 
 copious drinking of mild fluids, as barley- 
 water, thin gruel, weak tea, or toast-wa- 
 ter. The abuse of spirituous liquors is a 
 fertile source of derangement of the biliary 
 system ; this we explain by referring to 
 the sympathy which exists between the 
 brain and the liver; and by the same 
 sympathy Ave explain the irregular secre- 
 tion of bile from strong emotions of the 
 mind. 
 
 Bile is increased hy certain Diet. Cer- 
 tain modes of living and articles of diet 
 are believed to have an influence on the 
 biliary system, and should be careftilly 
 avoided in cases where the stomach and 
 
 bowels are prone to get out of order, and 
 where there is much tendency to corjni- 
 lency; such are butter, pastry, malt li- 
 quors, and especially ale. 
 
 Consequences of the Bile being defi- 
 cienty or not getting into the Intestines. 
 Sometimes the liver is abundantly able 
 to secrete bile, but, from various causes, 
 it does not get into the intestines. In 
 this case, the absorbents carry it into the 
 mass of blood, so that, being mixed with 
 it in every part of the body, it shines 
 through the vessels and the skin, and 
 gives the whole body a j^ellow tinge, very 
 conspicuous in the white of the eyes. 
 This disease is called jaundice ; for the 
 causes and cure of which, see Jaundice. 
 When the bowels are torpid for want of 
 the due quantity of bile, they may be 
 gently -stimulated by calomel, in the dose 
 of one grain, or two grains night and 
 morning ; or one of the blue pills night 
 and morning. 
 
 Among the ancients it was believed 
 that the state of the fluids gave rise to 
 many diseases ; and particularly the bile 
 was supposed to become corrupted and 
 black, and so to be the cause of various 
 diseases. Physicians are now quite per- 
 suaded there is no such thing as black 
 bile ; but in common language this theory 
 remains, and the terra melancholy is de- 
 rived from two Greek words, which sig- 
 nify black bile. 
 
 BILIARY CALCULI, or Gaix Stones. 
 The bile in some cases is apt to concrete, 
 and to forai hard substances of various 
 sizes. They sometimes form in the gall 
 bladder, and sometimes they are found in 
 the duct through which the bile passes 
 into the intestines; and by obstructing 
 the passages, they prevent the bile from 
 getting into the proper place, and cause 
 it to be dispersed through the whole body, 
 giving rise to the disease called Jaundice. 
 When this is the case, the stools are 
 white, from the absence of bile; until, 
 either by mechanical means, or by the 
 gradual dilatation of the canal, or by pro- 
 per medicines, the obstruction is removed, 
 and the passage being cleared, the bile 
 
BIN 
 
 BIT 
 
 65 
 
 again, gets into the intestines, when the 
 disease is relieved, and the gall stones are 
 found mixed with the excrement. Some- 
 times great numbers are found in the 
 gall bladder, not large enough to malce 
 any obstruction. They are found by 
 chemical examination to be composed of 
 different ingredients ; some are like sper- 
 maceti ; some have the addition of a 
 little altered bile. The gall stones of 
 oxen are yellow, and sometimes used by 
 painters, though their colour is not per- 
 manent, but soon changes to a brown. 
 
 BILIOUS. This word, when correctly 
 applied, signifies, containing or conveying 
 bile; but it is used in a variety of meanings 
 by patients when giving an account of 
 their ailments. Those who are affected 
 •with stomach complaints, and who, by 
 vomiting, bring up some portion of bile 
 into their stomach, have some reason for 
 the language they employ when they say 
 they are veri/ bilious. But multitudes 
 use the same phrase who never see or 
 taste that fluid ; and all we are to under- 
 stand by the popular use of the term is, 
 that the patient has symptoms of indiges- 
 tion and stomach complaints. When 
 pastry or butter, or ale and other malt 
 liquors, are said to be biliouSy the physi- 
 cian will admit this, vi^hen he recollects 
 the tendency of such articles to injure the 
 digestive progress, and the various organs 
 destined for it; among which the liver 
 acts a very conspicuous part 
 
 BILIOUS FEVERS signify the re- 
 mittent fevers of warm climates, or of 
 warm seasons ; in the progress of which 
 fevers much bile is discharged upwards 
 and downwards, as explained under the 
 article Bile. 
 
 BINDER. A bandage applied round 
 the abdomen of women newly delivered, 
 in order to give a proper degree of sup- 
 port and pressure to the muscles and in- 
 ternal organs. See Delivery. 
 
 BINDING. A term applied to such 
 medicines or articles of diet as are be- 
 lieved to have the effect of rendering the 
 bowels somewhat torpid. Thus opium 
 is certainly binding ; and rice diet is not 
 
 unfrequently so. Though binding be the 
 literal translation of astringent, it has not 
 precisely the same meaning ; as astrin- 
 gent more frequently means corrugating 
 or contracting. 
 
 BISCUIT. Bread which is much or 
 doubly baked, as its name imports ; it 
 is not fermented, and hence is not much 
 disposed to become acid in the stomach. 
 Biscuits are therefore useful in the diet 
 of children, and of those who are liable 
 to acidity in the stomach. Biscuits keep 
 a long time; hence their utility as a part 
 of sea provisions. Those made with but- 
 ter have all the inconveniences of that 
 article, and should not be used by those 
 who are troubled with stomach com- 
 plaints. 
 
 BISMUTH. A bright metal, of a 
 foliated texture, and having a reddish 
 yellow tint. Its oxide or subnitrate is 
 sometimes used in spasmodic affections 
 of the stomach, and to allay vomiting ; 
 the dose from three to five grains, taken 
 in jelly or honey. 
 
 BITE OF A Mao Dog. See Hydro- 
 phobia. 
 
 BITTERS. There are many vege- 
 table substances possessed of a bitter taste, 
 which are highly useful both in diet and 
 medicine. They produce a powerful ef- 
 fect on the digestive organs, and through 
 them on other parts of the system. Bit- 
 ters seem to be absolutely necessary to 
 promote digestion in animals who live 
 on herbs, as cattle do not thrive upon 
 grasses which do not contain a portion 
 of bitter principle. In man, slight bitters 
 produce invigorating effects on the sto- 
 mach ; and their presence in malt liquors 
 not only renders such liquors less inju- 
 rious to the system, but also, when taken 
 in moderation, assistant to digestion. 
 Bitters stimulate the stomach, correct 
 unwholesome food, and increase the uovu*- 
 ishing powers of vegetables. 
 
 The purest bitters, and those which are 
 most used as medicines, are chamomile 
 flowers, gentian, quassia, and Colombo. 
 Chamomile flowers are used in the fonn 
 of infusion, made by pouring a quart of 
 
 F 
 
66 
 
 BIT 
 
 B L A 
 
 boiling water on a handful of the dried 
 flowers. Of this infusion, a tea-cup- 
 ful may be drank twice a-day. There 
 are different ways of using Gentian. The 
 infusion of the root in hot water is 
 one of the most agreeable bitters we can 
 employ ; and the flavour will be improved 
 by infusing along With the gentian some 
 orange peel or the rind of lemons ; fi'om 
 one to two ounces may be taken twice 
 a-day. The extract of gentian is used in 
 the dose of from ten grains to thirty, 
 made into pills. There is a wine of gen- 
 tian made by macerating for twenty-four 
 hours, in proof spirit, four ounces of the 
 following ingredients : half an ounce of 
 gentian root, an ounce of Peruvian bark, 
 two drachms of dried orange peel, and an 
 ounce of canella bark. After the macera- 
 tion, two pints and a half of white wine 
 are to be added ; of this, one or two des- 
 sert-spoonfuls may be taken twice a-day. 
 The tincture of gentian is also very much 
 employed. The principal objection to 
 using bitters in the form of wine or tinc- 
 ture, is the resemblance which such prac- 
 tices bear to dram-drinking, and the dan- 
 ger of inducing that habit. Quassia is 
 an excellent bitter, used in the form of 
 infusion made by a drachm of the bark 
 and wood of the plant to a pint of water : 
 a cupful may be drank several times 
 a-day. Colombo may be used in powder 
 or in tincture ; ten grains of the former, 
 and a tea-spoonful in a glass of water, of 
 the latter. 
 
 BITTER-SWEET, Woody Night- 
 shade, Solanum Dulcamara. A shrub, 
 the twigs of which were formerly used 
 in medicine, and much esteemed for their 
 power in the cure of cutaneous affections, 
 such as are commonly, though improperly, 
 termed scurvy spots ; in rheumatic affec- 
 tions, scrofula, and ill-conditioned ulcers. 
 Bitter-sweet has principally been used in 
 decoction as a diet drink, in the dose of 
 two or three ounces three times a-day, 
 gradually augmenting the quantity, till a 
 pint be taken daily. The strength of the 
 decoction is an ounce of the twigs to a 
 quart of boiling water. A stronger decoc- 
 
 tion may be used externally as a lotion in 
 the above-mentioned complaints. 
 
 BITUMENS. Fossile bodies, which 
 have a certain resemblance to oily and 
 resinous substances. They may be di- 
 vided into two classes, bituminous oils, 
 and bitumens properly so called. The 
 bituminous oils ' are petroleum, and mal- 
 tha or sea wax. Petroleum is used, in 
 those countries where it abounds, viz. on 
 the shores of the Caspian sea and in Per- 
 sia, as an oil for lamps. When petroleum 
 is distilled at a low heat, the liquid which 
 comes first over is distinguished by the 
 name of naphtha. It is colourless, per- 
 fectly fluid, very volatile, and has a pecu- 
 liar smell. Naphtha bums with a strong 
 yellow flame, and a considerable smoke. 
 Sea wax is a solid substance found on the 
 Baikal lake in Siberia. It is white, melts 
 when heated, and on cooling assumes the 
 consistence of white cerate. The proper 
 bitumens are asphaltum, mineral tar, and 
 mineral caoutchouc or mineral Indian 
 rubber. Bitumen, united in various pro- 
 portions to charcoal, constitutes the nu- 
 merous varieties of pit coal, so much 
 employed in Britain as fuel. 
 
 BLACK DROP. See Laudanum. 
 
 BLADDER, Gall. A membranous 
 bag situated at the under or concave side 
 of the liver, into which a great quantity 
 of bile is sent to be detained for some 
 time, in order to be thickened, or to un- 
 dergo some change not perfectly known. 
 Concretions often form in the gall-blad- 
 der, and by getting into the canal, M-hich 
 is too narrow to allow them to pass, they 
 cause the bile to be dispersed through 
 the body and to produce jaundice. The 
 gall bladder is sometimes much enlarged, 
 and very often is found after death to 
 contain a great number of biliary concre- 
 tions. See Jaundice, and Biliary Cal- 
 culi. 
 
 BLADDER of Urine. A large mem- 
 branous bag situated at the lower part 
 of the belly, into which the urine, after 
 being secreted from the kidney, drops 
 from two canals called ureters. These 
 tubes enter the coats of the bladder in an 
 
ELI 
 
 BLI 
 
 67 
 
 oblique direction, by which means they 
 prevent the urine flowint^ back along* 
 their course. When the bladder is dis- 
 tended, we have the desire to evacuate 
 the urine ; and also when that fluid has 
 much acrimony, although the quantity 
 be not enough mechanically to distend it. 
 When certain concretions are lodged in 
 the urinary bladder, they give rise to 
 most distressing symptoms. See Stone 
 and Urine. 
 
 BLEEDING signifies either the spon- 
 taneous flow of blood from some part of 
 the body, or the artificial taking away of 
 blood by various means for the cure of 
 diseases. In the first sense it will be 
 treated under the article Haemorrhage, 
 and in the second under Blood-letting. 
 
 BLINDNESS may arise from what- 
 ever injures the transparency and perfec- 
 tion of the different parts of the eye, con- 
 sidered as an optical instrument; or it 
 may depend on some fault in the brain or 
 optic nerves, or the expansion of those 
 nerves which is called the retina. When 
 the transparency of the clear part in front 
 of the eye is destroyed, blindness is the con- 
 sequence. This opacity happens from very 
 violent inflammation, and from that spe- 
 cies of ophthalmia which is common to 
 infants, in which a great quantity of pu- 
 rulent matter is discharged. Sraall-pox 
 often destroys the structure of the eye- 
 ball. If there is a thickening of the cap- 
 sule enclosing the crystalline lens, or a 
 loss of the transparency of the lens itself, 
 blindness follows. Pressure of tumours 
 on the optic nerves, orinsensibility of the 
 retina, occasions blindness. In this case, 
 there is no imperfection seen in the eyes, 
 but the pupil does not diminish or enlarge 
 its size according to the quantity of light, 
 as happens when vision is perfect. This 
 last affection is called amaurosis or gutta 
 Serena. See Eye a;nd its Diseases. 
 
 BLISTERS are a useful remedy in va- 
 rious morbid affections, both internal and 
 external; though the manner of their 
 operation is not fully understood. Blis- 
 ters, when applied to the skin, first pro- 
 duce a tingling heat, then a redness, and 
 
 if they are continued long enough, they 
 raise the outer skin in one or more vesi- 
 cles, which contain a clear fluid separated 
 from the mass of blood, and poured out 
 by the exhalant vessels. The substances, 
 most commonly used for blistering, are 
 mustard, hartshorn, or savine ; and most 
 frequently of all, cantharides, or Spanish 
 flies, the Cantharis vesicatoria of the 
 Edinburgh Pharmacopoeia, the Lytta ve- 
 sicatoria of the London. These insects 
 when dried, are powdered and mixed with 
 some unctuous matter, and being spread 
 upon leather, are applied to the surface of 
 the body where we wish the blister to be 
 raised. No substance produces the blis- 
 tering effect with more certainty than 
 cantharides. 
 
 WJien Blisters are useful. The cases 
 in which blisters are usefully applied are 
 the following. In nervous fever, where 
 there is delirium, dimness of sight, deaf- 
 ness, and great debility, blisters may be 
 applied to the neck or between the shoul- 
 ders; but much care must be taken in 
 the after-treatment, lest the blistered part 
 should mortify, from the weakness of the 
 vital powers. In apoplexy, after blood- 
 letting, we may attempt, by blisters to the 
 head and neighboiu-hood, to remove the 
 insensibility; it is also useful in palsy, 
 sometimes when applied to the part, some- 
 times at a distance. In inflammation of 
 the lungs after sufficient bleeding, in va- 
 rious stages of consumption, in obstinate 
 coughs, in asthma, rheumatism, indolent 
 swellings of the joints, and many other 
 cases, blisters are highly useful. 
 
 Cases in which Blisters are impro- 
 per. Their use is hazardous in dropsical 
 habits, in which they sometimes give rise 
 to ulceration and gangrene, although they 
 sometimes occasion the flow of a great 
 deal of watery fluid. In constitutions 
 which are very irritable, it may be pru- 
 dent to abstain from them; and also in 
 cases where there is any tendency to 
 gravel, or to any disease of the luinary 
 organs. Some constitutions are so irrit- 
 able as to render the use of blisters in- 
 admissible. 
 
68 
 
 B L I S T E R S. 
 
 Mode of applying Blisters. They 
 should be fixed in their situation by slips 
 of adhesive plaster at their corners, and 
 the fluid should be let out of the vesicle 
 by a cut with sharp pointed scissors, 
 taking- care not to remove the outer skin 
 along with the dressings, as it is the kind- 
 liest application we can get to the tender 
 surface below. 
 
 The time during which a blister should 
 remain on, is, in general, about twelve 
 hours. 
 
 Mode of counteracting the occasional 
 bad effects q/" Blisters. The use of blis- 
 ters, like that of blood-letting, is some- 
 times directed by those who are little 
 aware of its importance ; and sometimes 
 symptoms follow their use, which are 
 prejudicial instead of salutary. One of 
 their most troublesome effects is to pro- 
 duce a degree of strangury, or even bloody 
 urine ; to prevent, or to cure this, the 
 patient should drink plentifully of mild 
 diluent liquors, as gruel or barley-water, 
 and to each English pint a drachm of salt- 
 ■^etre may be added, to increase the effect 
 of dilution on the urinary organs. In 
 some constitutions, and in certain inflam- 
 matory diseases, blisters excite irritation, 
 restlessness and increase of fever, or they 
 give rise to inflammation of the spreading 
 erysipelatous kind; sometimes they are 
 difficult to heal, and produce extensive 
 ulcerations, or even gangrene. 
 
 The healing of an ulcerated surface 
 from a blister is sometimes very difficult 
 to accomplish. We are obliged frequent- 
 ly to change our applications, and even 
 to use basilicon ointment, or dressings of 
 still greater harshness. Then we are 
 compelled to return again to poultices 
 and simple dressings, and it is only after 
 many days suffering, that the sore ap- 
 pears disposed to heal. The constitu- 
 tional symptoms in such cases must be 
 attended to. 
 
 Other modes of Blistering besides 
 Cantharides. Sometimes we wish to 
 produce an irritation on the skin of a less 
 degree of severity than that produced by 
 cantharides. This may be done by harts- 
 
 horn, move or less diluted, by mustard 
 applied till a proper degree of redness 
 and irritation is produced, which com- 
 monly takes place in about twenty mi- 
 nutes or half an hour. Such stimuli, as 
 well as the common blister, are some- 
 times applied to the feet when the pow- 
 ers of life seem languid. Tartar emetic, 
 made into an ointment in the proportion 
 of One or two drachms to the ounce, forms 
 a very powerful stimulant to the skin, 
 and occasions a pustular eruption, which 
 proves very serviceable in deep-seated in- 
 flammation. The pustules produced by 
 the ointment are very painful. They 
 have some resemblance to those of small- 
 pox, but they are in general much small- 
 er, not so red at the base, and not so 
 tense and white when fully suppurated. 
 Frictions with this ointment have been 
 recommended in hooping-cough, and other 
 disorders of the chest. The ei-uption 
 should be kept up for some time, either 
 by applying some more of the ointment 
 diluted, or some other stimulating oint- 
 ment. When the pustules are very much 
 irritated and painful, a bread and milk 
 poultice wrll give relief. 
 
 BLOOD. A red fluid, of a saltish 
 taste, and urinous smell, which circulates 
 in the heart, arteries, and veins. The 
 blood is a most important fluid in the 
 animal body. It furnishes the materials 
 from which the various parts of the body 
 are famished with nourishment. It is 
 the fluid from which the secretions are 
 formed, it is the source of animal heat, it 
 stimulates the heart to contraction, and 
 by its presence in the blood-vessels it 
 distends them, and gives plumpness to 
 the body ; and by shining through the 
 transparent skin, causes the fine com- 
 plexion, and the shades of colour, which 
 impart so much beauty and interest to 
 the healthy human countenance. 
 ; " Many calculations have been formed 
 of the total quantity of blood in the body; 
 but as the data upon which they have 
 proceeded are extremely uncertain, so the 
 conclusions have been widely different ; 
 and, of course, the greatest part of them 
 
BLOOD. 
 
 remote fi-om the truth. Perhaps, upon 
 the whole, the estimate, which would 
 seem the nearest approximation, is that 
 of Haller, who supposes that the blood 
 may constitute about one-fifth of the 
 weight of the adult body, the proportion 
 of the fluids being greater in youth, and 
 diminishing as age advances. A body 
 weighing one hundred and fifty pounds, 
 would, therefore, contain about thirty 
 pounds of blood, and of this, it is suppos- 
 ed, that three-fourths or more are in the 
 veins, and one-fourth only in the arte- 
 ries." (Bostock's Physiology.) 
 
 The blood in one portion of the heart is 
 of a bright, florid red colour, and is driven 
 by the contraction of this powerful organ 
 into the arteries, large tubes which divide 
 and subdivide into tubes of extreme small- 
 ness, and by which the blood is distri- 
 buted into all parts of the body, for the 
 purposes of growth, assimilation, and se- 
 cretion. When the red blood has reach- 
 ed the extremities of the arteries, it is 
 conveyed into veins, which in their dis- 
 tribution resemble reversed arteries, the 
 small tubes continually going to form 
 larger ones, till by two large trunks, the 
 blood is brought back to the heart. The 
 blood in the veins differs in colour from 
 that in the arteries; it is now dark-co- 
 loured, and incapable of furnishing mate- 
 rials for nourishment or secretion, with 
 the remarkable exception of the venous 
 blood from the intestines, which, circu- 
 lating through the liver, is employed in 
 the secretion of bile. The blood which 
 has circulated through the body and been 
 employed in secretion, is unfit for per- 
 forming a second time the same functions; 
 and in order to repair its salutary powers, 
 and be again rendered fit for the purposes 
 of the animal economy, it passes through 
 the lungs ; in which organs, by the ac« 
 tion of the air, it loses its dark venous 
 colour and injurious properties, and again 
 is fitted, in the state of florid arterial 
 blood, to impart life and vigour to the ani- 
 mal system. 
 
 Blood, when it is first drawn from the 
 body, appears a uniform fluid ; but by 
 
 being allowed to rest, it spontaneously 
 separates into two parts, viz. the crassa- 
 mentum^ or cake, and the serum, or wa- 
 tery part, besides a vapour which exhales 
 when the blood is warm at its first dra\^'- 
 ing off. The crassamentum is thick, and 
 like jelly ; it soon becomes putrid ; it is 
 insoluble in water. The surface of the 
 crassamentum exposed to the air is of a 
 more florid red colour than that which is 
 deeper in the dish, and not exposed to 
 the air. The red globules may be wash- 
 ed away, and they leave what is called the 
 fibrine of the blood. The other part of 
 the blood is the serum, a lymphatic or 
 w atery fluid, with little smell, saltish to 
 the taste, of a yellowish green colour. 
 When blood is drawn from the body 
 while under the influence of inflammatory 
 disease, the crassamentum is covered with 
 a tough leather-looking surface, of vari- 
 ous depths, from the thickness of a shil- 
 ling to a quarter of an inch, known by 
 the name of the bujffy coat. The appear- 
 ance of this huffy coat, in conjunction 
 with other circumstances, gives a very 
 good indication of the inflammatory state 
 of the system. Sometimes this appears 
 cupped in the middle, draM'ing the upper 
 part of the crassamentum from the sides 
 towards the centre. The blood frequent- 
 ly puts on a similar crust in the state of 
 pregnancy. 
 
 BLOOD-LETTING, Sanguinis missiOy 
 signifies the taking away of blood by ar- 
 tificial means, and is either general or lo- 
 cal. General blood-letting is performed by 
 the opening of veins or arteries by the lan- 
 cet; and local blood-letting by the applica- 
 tion of leeches or cupping-glasses. The 
 great power of blood-letting in the cure of 
 diseases cannot be quite satisfactorily ex- 
 plained. Even in pretty lai^e bleedings, 
 the quantity taken away does not bear 
 a great proportion to the whole of the 
 circulating mass ; and blood-letting seems 
 to do good principally by somehow alter- 
 ing that excited state of the system which 
 occurs in robust constitutions, and which 
 is marked by a full, strong pulse, and a flo- 
 rid look, with firmness and activity of the 
 
70 
 
 BLOOD-LETT IN G. 
 
 muscular system. This excited state, 
 pushed a little farther, passes into in- 
 flammation, general or local. When the 
 fulness of the vessels is taken oflF by- 
 blood-letting, their coats contract less 
 strongly, and the excited action is lower- 
 ed. Blood-letting seems to have great 
 effect by its action on the nervous sys- 
 tem, as we see in the fainting which is 
 brought on in many cases by a very small 
 bleeding. 
 
 . The taking away of blood, in whatever 
 way it acts, is ascertained by long and 
 universal experience to be one of our 
 most powerful remedies. The particular 
 cases to which blood-letting is applicable 
 may be considered as ranking under the 
 heads of diseases of excitement, of fulness, 
 and those which arise from tension or 
 irritation. Blood-letting is useful in the 
 following diseases. \. Fever. As there are 
 fevers of various kinds, and as the same 
 disease in its different stages presents 
 very various symptoms, the remedies 
 which would be useful at one period, and 
 in one kind of fever, would be destructive 
 when the circumstances are altered. To 
 no remedy is this remark more applicable 
 than to blood-letting. At one time, it 
 may be the means of a perfect cure j at 
 others, it may occasion a waste of the 
 vital powers which cannot be repaired. 
 It therefore requires much discrimination 
 to determine the kinds of fever, and the 
 periods of the disease, and to guard lest 
 bad consequences follow the loss of blood. 
 2. Intermittent Fever. Under the article 
 Ague, Me have stated the symptoms of 
 that disease which we consider as re- 
 quiring blood-letting. 3. In inflammatory 
 fevery where there is strong, quick, and 
 full pulse, much flushing of the face, 
 throbbing at the temples, delirium, thirst, 
 and heat of skin, we should not hesitate 
 to bleed largely ; but it is greatly doubt- 
 ed by the most judicious practitioners 
 whether such a pure unmixed fever is 
 ever seenj a fever where there is the 
 above assemblage of symptoms, unattend- 
 ed by local inflammation. 4. There is a 
 disease now well known to the people by 
 
 the name of typhus fever, where the 
 pulse is small, weak, and fluttering, the 
 tongue black, the skin dry, the patient 
 delirious and insensible ; in this fever, or 
 to speak more correctly, at this stage of 
 the fever, it would be insanity to bleed. 
 But whatever may be the danger of 
 bleeding at that stage of the disease, or 
 however the physicians of forty years 
 ago M^ould have shuddered at the thought 
 of bleeding a patient in typhus, it is well 
 known that this disease often begins with 
 symptoms of high excitement ; and there 
 is reason to believe that the blood is irre- 
 gularly distributed and accumulated in cer- 
 tain organs. At this early period, blood- 
 letting is one of the most effectual reme- 
 dies we can employ,* and when prudently 
 and moderately employed, it prevents the 
 sinking of that strength which frequently 
 succeeds to high excitement when too 
 long continued. Much caution is requi- 
 site not to bleed too often, nor when the 
 disease has continued for several days; 
 as this would have a tendency to bring 
 on a dangerous and fatal sinking of the 
 strength, or the true typhoid state. 5. In- 
 flammation. Against inflanunation of 
 every organ, bloodletting is the chief, 
 and almost infallible remedy. Other 
 auxiliaries have been found, but our main 
 reliance is upon blood-letting. There are 
 some kinds of inflammation where it 
 would not be so safe as in others ; as ia 
 those which are of the nature of the rose 
 or erysipelas, where much evacuation and 
 lowering of the system is apt to be fol- 
 lowed by great weakness and depression. 
 6. In acute rheumatism, or what is popu- 
 larly called a rheumatic fever, it is gene- 
 rally proper to begin our treatment by a 
 pretty free discharge of blood ; and it is 
 vain to expect success from the sweating 
 practice, unless the high action of the vas- 
 cular system be first reduced by this or 
 other means. 7. Active Hcemorrhages. 
 There are certain states of the system in 
 which, after a period of what is called high 
 health, feverish symptoms come on ; and 
 then a discharge of blood, generally clear 
 and florid, spontaneously takes place from 
 
BLOOD-LETTING. 
 
 n 
 
 some part of the body. Thus we have 
 bleeding at the nose, spitting of blood, or 
 a discharge of blood by stool, or urine. 
 Such discharges of blood are called active 
 hcemorrhaffes ; and, however paradoxical 
 it may appear to cure a discharge of 
 blood by taking away more, yet by this 
 operation the physician has it in his 
 power to relieve the system, and to di- 
 minish the danger which might occur in or- 
 gans liable to be injured by the too great 
 activity of the circulation, or likely to be- 
 come the seat of diseases Trhich may 
 ultimately prove fatal. Instances of ac- 
 tive haemorrhage are seen in bleeding 
 from the nose, and from the lungs. There 
 are bleedings again where the system is 
 in a state quite the reverse of activity and 
 excitement, and where artificial blood- 
 letting would assuredly be improper. 
 These haemorrhages are termed passive. 
 Such are the true sea-scurvy, and the too 
 copious flow of the monthly discharge, 
 when accompanied by weakness and a 
 broken state of health: 8. In apoplexy^ 
 blood-letting is absolutely necessary. 9. In 
 some convulsive diseasesy especially if 
 there is an appearance of any tendency to 
 the head. 10. In certain kinds of dropsy ^ 
 occasionally in asthma ; and, in short, in 
 any disease, by whatever name it may be 
 called, where there is a necessity for 
 quickly reducing feverish action, or di- 
 minishing the quantity of blood circula- 
 ting in the system. 
 
 Quantity of Blood to be taken. With 
 respect to the quantity of blood to be 
 taken away, no general rule can be given ; 
 different diseases are to be treated with 
 different quantities, and in two persons 
 labouring under wliat might appear to be 
 the same disease, a quantity that would 
 have little effect in the one case would 
 cm*e the other. In an adult of good 
 strength, a pound of blood, or sixteen 
 ounces, is a moderate bleeding ; twenty- 
 four ounces, a full bleeding; and from 
 thirty-two to forty ounces, a large one. 
 Some inflammations are so violent, and 
 demand such active treatment, that in one 
 day the bleeding may require to be re- 
 
 peated from three to six times, the quan- 
 tity taken away in a day varying from 
 sixty to eighty or ninety ounces, and at 
 one bleeding from thirty to fifty ounces. 
 In general, we are not to be regulated by 
 measurement, but by the effect produced 
 on the disease, and on the general sys- 
 tem. 
 
 Mode of Bleeding. The veins from 
 which blood is most commonly taken, are 
 those at the bend of the arm ; there the 
 veins are in general pretty numerous and 
 easily got at, and a ligature is easily put 
 round the limb to fill the veins. In dis- 
 eases of the head, we consider it advisable 
 to take blood from the external jugular 
 vein, or from the temporal artery. In 
 some cases, we find it difficult to get 
 enough of blood from the arms, and we 
 try it from the superficial vein of the foot. 
 In bleeding at the bend of the arm, when 
 the blood appears to run less freely, its 
 flow is increased by the patient squeezing 
 the hand, or grasping something in it, by 
 which the blood is forced from the deep 
 to the superficial veins. Sometimes we 
 are prevented from getting the proper 
 quantity by the patient fainting ; in this 
 case we are to lower the head and shoul- 
 ders, to stop the orifice for a little, and 
 then to let the blood flow when the pa- 
 tient is in the horizontal posture. Some- 
 times the patient, from mental emotion, 
 faints almost immediately on the arm be- 
 ing tied up ; and sometimes we must for 
 the present be content with the diminish- 
 ed action of the system, of which this 
 fainting is the proof. Sometimes the 
 veins are so small, or so imbedded in fat, 
 that it is impossible to get the quantity of 
 blood we wish. This is often the case 
 in children. We are obliged, therefore, 
 to resort to other methods, as opening 
 the temporal artery, or leeches, or cup- 
 ping. 
 
 Accidents that sometimes follow Blood- 
 letting. A dark livid swelling some- 
 times takes place at the wound made in 
 blood-letting. It looks alarming to those 
 who are not familiar with it ; but it is 
 not in general a cii'ciunstance of much 
 
72 
 
 BLOOD-LETTING. 
 
 consequence, as it arises merely from the 
 blood getting under the cellular substance 
 and skin. It sometimes swells so fast 
 that the proper quantity of blood cannot 
 be obtained. In this case, we must take 
 off the bandage, and apply compresses 
 wet with a cooling- lotion, as of vinegar, 
 or spirits and water, to the swelling, re- 
 taining them by a slack bandage. The 
 effused blood will in time disappear; and 
 if we have not got enough of blood, it 
 must be taken from the other arm. 
 Sometimes there is inflammation of the 
 skin in the neighbourhood of the wound. 
 This is to be treated with cooling appli- 
 cations, and rest ; and by a poultice, if 
 there is a tendency to suppuration. Red 
 lines are sometimes seen extending from 
 the wound ; these are inflamed absorb- 
 ents, and are painful on pressure ; some- 
 times the inflammation reaches to the 
 arm-pit, causing the swelling of a gland 
 there, and perhaps suppuration. Inflam- 
 mation may spread along the course of 
 the vein, and produce sjrmptoms of the 
 most alarming and even fatal nature. 
 (See Veins, Inflammation of.) The fas- 
 cia, or membranous expansion on the fore- 
 arm, may become inflamed, and give rise 
 to gi-eat pain, tension, and febrile symp- 
 toms. Poultices are to be applied, and 
 an extensive incision made through the 
 fascia, to relieve the tension, and to give 
 vent to matter. A nerve may be wound- 
 ed, and this may give rise to convulsions, 
 violent pain, and other symptoms of ner- 
 vous irritation. In every puncture of the 
 skin a nerve of some size or other must 
 be wounded ; and it is thought to be in 
 consequence of the partial wound of a 
 nerve of some considerable size that these 
 violent accidents occur after blood-letting. 
 The artery of the arm may be wounded, 
 giving rise either to a dangerous bleed- 
 ing, or to aneurism. 
 
 After enumerating so many accidents 
 that may arise from blood-letting, we may 
 surely be allowed to blame the rashness 
 of those numerous dabblers in surgery, 
 who pretend to be competent to the per- 
 formance of this operation. Farriers, 
 
 gardeners, midwives, and others, not only 
 presume to say when bleeding would be 
 proper, but also operate themselves ; ig- 
 norant of the precautions they ought to 
 observe, and aghast when the painful or 
 dangerous consequences follow. It should 
 be remembered, that as bleeding is one of 
 the most salutary remedies, when timely 
 and properly applied, so it is one of the 
 most deadly and destructive when exhibit- 
 ed in wrong circumstances ; and though, 
 from its frequency, it must be often per- 
 formed by those whose skill and expe- 
 rience is but small, yet it may be attend- 
 ed with accidents which require the ut- 
 most boldness, address, and promptitude, 
 to counteract their fatal tendency. 
 
 Blood-letting should not be employed 
 but for the cure of disease, or for the pre- 
 vention of it when manifestly impending. 
 Many persons who have no particular 
 illness, apply to a surgeon to have blood 
 drawn from them. On the Continent, 
 and among country people, blood-letting 
 is habitually employed at certain seasons, 
 with the view of preserving their health j 
 but it is a practice that should not be fol- 
 lowed, as it is apt to induce a dangerous 
 habit ; and instead of diminishing the 
 quantity of blood, it ultimately rather in- 
 creases it. Fulness of the system may 
 be prevented by safer means, such as 
 purging ; but even this preventive would 
 be wisely superseded by temperance in 
 eating and drinking, and avoiding the 
 provocatives of modern luxury. When 
 apoplexy appears to be likely to make an 
 attack, as indicated by the throbbing of 
 the temples, ringing in the ears, flushing 
 of the face, and headach, then a precau- 
 tionary bleeding will be very proper. 
 Also when feverish symptoms occur in 
 those who are known to be subject to 
 spitting of blood. 
 
 BLUE PILL. ^See Mercury. 
 
 BOHEA. A species of tea, brought, 
 like all the rest, from China. It is of an 
 inferior quality, yet great quantities of it 
 are used in Britain, In its effects, it 
 agrees with the other kinds of tea. When 
 drank in moderate quantity, it iuvigo- 
 
BOL 
 
 BON 
 
 73 
 
 rates the system, and imparts a tempo- 
 rary exhilaration; but if taken too copious- 
 ly, and too frequently, and if idle and 
 luxurious habits are indulged in, it will 
 aggravate hypochondriacal and hysterical 
 complaints, and be accompanied with 
 many of those diseases of the stomach and 
 bowels known by the name of dyspepsia, 
 indigestion, or stomach complaints, and 
 which the common people class under the 
 name of nervous. There are different 
 kinds of Bohea, viz. Souchong, Cambo, 
 Pekoe, Congo, and Common Bohea. See 
 Tea. 
 
 BOIL. A circumscribed inflammation 
 in the external parts, which terminates 
 in a pointed swelling, sometimes as large 
 as a pigeon's egg, attended with redness 
 and pain, and sometimes with a violent 
 burning heat. These inflammations ge- 
 nerally suppurate, but they do so very 
 slowly. They break at first on the upper 
 part, and some drops of matter ooze out. 
 What is commonly called the core is next 
 seen ; it is a purulent substance, but thick 
 and tenacious, almost like a solid body, 
 and may be drawn out of the abscess. 
 Its discharge is followed by a flow of 
 thinner matter, after which the paia 
 ceases, and the part heals. If at any time 
 the sore appears to be stationary, a little sti- 
 mulating dressing, as basilicon, or vulner- 
 ai-y balsam, may be applied. Boils should 
 always be brought to suppuration, for if 
 we attempt to repel them in one place, 
 they will appear in another. Fomenta- 
 tions and poultices are to be applied, 
 sometimes with an onion to increase 
 tlieir stimulating properties, or with hem- 
 lock or opium to allay the pain if it be 
 very violent. A saline purgative may 
 be given. Sometimes young persons 
 in full health and vigour are for a 
 considerable time troubled m ith a suc- 
 cession of boils. Such should avoid but- 
 ter and much animal food; they should use 
 a due proportion of vegetable diet, and 
 take a mild saline purgative pretty fre- 
 quently, once in four or five days. ■ 
 
 BOLE. A dry friable earth, sometimes 
 ^xed with honey, and usc«l as an ap- 
 
 plication to the sore mouths of cliild- 
 ren. It is chiefly of the argillaceous, or 
 clay kind ; and is an ingredient in some 
 tooth powders, with the addition of some 
 aromatic substance. 
 
 BOLUS. A medicine made up into 
 the form of a little ball, larger than a pill, 
 but soft enough to be easily swallowed. 
 
 BONES. The hard and solid parts of 
 an animal body, which determine its 
 shape, contain or defend the various in- 
 ternal organs, and give attachment to 
 muscles. Bones vary in their texture, 
 their shape, and various other particulars. 
 They are either compact, spungy, or reti- 
 cular ; they are long and cylindrical, or 
 broad and flattened. When all the bones 
 of the body are dried, and artificially join- 
 ed together, so as to show in a great mea- 
 sure the various motions which take 
 place in the living body, the assemblage 
 is called an artificial skeleton ; and when 
 the whole is kept together by the drying 
 of its ligaments, it is called a natural ske- 
 letpn. The number of bones in the human 
 body is about 245 or 250 ; reckoning some 
 small bones, which are sometimes present 
 and sometimes not ; these are situated 
 where very frequent motion occui*s, ^s 
 about the thumb and great toe. Bones 
 are composed principally of phosphate of 
 lime. Besides dislocations and fractures, 
 they are subject to cai'ies or rottenness, 
 to necrosis, in which a bone dies, and 
 is replaced by a new one ; to rickets, 
 to distortion and softening of their sub- 
 stance. 
 
 BONES, Caries of. The rottenness 
 or partial mortification of a bone, being 
 to bone what a foul ulcer is to soft parts. 
 This happens, when the bone is deprived 
 of its investing membrane called the pe- 
 riosteum. The bone then becomes yel- 
 low, brown, and at last black. As 
 the disease advances, the bone is cor- 
 roded, and discharges an acrid matter, 
 which consumes the neighbouring soft 
 parts. 
 
 Causes. There are various diseases of 
 which caries of the bones forms a symp- 
 tom, as syphilis, scrofula, scur\y ; and it 
 
74 
 
 BONES. 
 
 may be the consequence of abscesses, 
 wounds, or contusions. 
 
 Cure. Its cure is to be attempted by 
 whatever is proper to be done for the 
 original disease, or exciting cause ; and 
 local applications are to be used to pro- 
 mote what is called the exfoliation or 
 scaling oiF of the diseased bone. The ac- 
 tual cautery, preparations of mercury, spi- 
 rits of wine, or other stimulating applica- 
 tions are sometimes necessary. 
 
 BONES, Death of. Necrosis. A very 
 singular disease of the bones, in which a 
 bone, or part of a bone dies, and is re- 
 placed by a new one. Unless the fact had 
 frequently occurred, we should never have 
 expected that a bone so large as the thigh 
 bone or the shoulder blade should die, and 
 be replaced by a new growth, and the old 
 one be taken away by absorption, without 
 the feeling or motion of the limb being 
 impaired. The following are the symp- 
 toms of necrosis. At its commencement, 
 a deep seated acute pain is felt, which is 
 soon followed by a rapid enlargement of 
 the parts along the course of the bone. 
 An inflammation, and one or more absces- 
 ses take place, which do not heal, but be- 
 come fistulous sores. The openings are 
 generally situated over the most superfi- 
 cial part of the bone. These abscesses 
 are situated within the newly formed 
 bony shell, and a probe can seldom be in- 
 troduced into them, so as to discover any 
 loose pieces of bone ; but sometimes small 
 pieces make their way out through tlie 
 abscesses. Sometimes the abscesses heal 
 up, and the old bone being absorbed, is 
 never seen, but only a permanent thick- 
 ening of the part remains. This is the 
 most favourable way for the case to ter- 
 minate ; but at other times, the old bone 
 makes its way through the new bone, and 
 through the skin, with different degrees 
 of inflammiation, pain, and suppuration. 
 The old part, called the sequestrum^ may 
 be moved by shaking it ; and in some fa- 
 vourable situations may be easily pulled 
 away ; in others, it may be necessary to 
 make an opening to discharge it. The 
 period of life most subject to this disease. 
 
 is from twelve to eighteen years of age. 
 The bones most liable to necrosis are 
 those of the extremities, the clavicle, the 
 scapula, and the lower jaw. In general, 
 there is no external apparent cause for 
 the disease ; but sometimes blows, acrid 
 substances applied to the teeth, and the 
 effects of mercury, give occasion to necro- 
 sis of the lower jaw. 
 
 BONES, Softening OF, i^foZ/eYzes Os- 
 sium. A general softening of the bones ; 
 the consequence of an unhealthy state 
 of the system brought on by a poor diet, 
 cold damp lodging, and sedentary employ- 
 ment, as at manufactories and similar 
 works. One of the most distressing con- 
 sequences of this softening of the bones, 
 is the distortion of the female pelvis, which 
 sometimes takes place, rendering delivery 
 impracticable. When softening of the 
 bones is discovered in time, the persons 
 must use a nourishing diet, with bark and 
 wine ; they must continue in as easy a 
 posture as possible, till the bones get a 
 little hardness and consistency, and then 
 gradually take such exercise as they can 
 bear. See Dislocations, Fractures, 
 Rickets. 
 
 BONES, Decoction of. By long boiling 
 in a very strong Papin's digester, by which 
 a heat much superior to boiling water 
 can be applied, bones part with a great 
 deal, of gelatine, which makes a very nu- 
 tritious diet. 
 
 BORAGE, Borago officinalis. The 
 name of a plant, having a beautiful blue 
 flower ; the leaves are supposed in some 
 countries to be refrigerant and cordial. 
 The principal use of the leaves in Eng- 
 land is in the composition of a summer 
 drink, called a cool tankard. 
 
 BORAX. A salt composed of boracic 
 acid, soda, and water of crystallization. 
 It is found in Thibet in an impure state 
 and is purified by gentle calcination, solu- 
 tion, and crystallization. Its principal 
 use in medicine is in the formation of 
 gargles, and to mix with honey to be ap- 
 plied to the sore mouths of children; 
 equal parts of borax and clarified honey, 
 with the addition of a little tinctiu-e of 
 
BOWELS. 
 
 75 
 
 myiTh, is a good application to the thrush. 
 A good gargle for the mouth and throat, 
 when under profuse salivation, is made 
 by taking two drachms of borax, dissolv- 
 ing it in eight ounces of rose water, and 
 adding a little honey and tincture of 
 myrrh. Modem chemistry has derived 
 some curious facts from the decomposition 
 of the boracic acid. A particular sub- 
 stance of an inflammable nature, called 
 boron, has been extracted from it. Boron 
 is a brown insoluble powder, and burns 
 with much brilliancy when heated to 600." 
 
 BOTANY is the science of plants. It 
 comprehends the classification and no- 
 menclatui-e of plants, an account of their 
 uses in medicine, in diet, and the various 
 arts ; their physiology, and their diseases. 
 It abounds in objects the most beautiful 
 and interesting ; from its being pursued 
 out of doors, and frequently in romantic 
 rural scenes, the pursuit of it ought to be 
 recommended to the sedentary and hy- 
 pochondriacal, as well as to the cultivator 
 of natural science, and those who desire 
 to advance the knowledge of pharmacy 
 and medicine. 
 
 BOUGIE, The name given by sur- 
 geons to a long slender instrument, made 
 of elastic gum, or of linen coated with 
 wax, which is introduced through the 
 urethra into the bladder, or which is ap- 
 plied to strictures in the urethra, to en- 
 deavour to clear that passage. The intro- 
 duction of bougies requires -a considerable 
 degi-ee of address and caution. They 
 should not be kept so long in the urethra 
 at one time as to excite pain and irrita- 
 tion. Their use is to be persevered in for 
 a considerable time, introducing them 
 every day, till the stricture is overcome ; 
 and they should be carried the length of 
 the bladder, to be sure that we have ac- 
 complished our piu^pose. Sometimes 
 bougies are armed with a little bit of caus- 
 tic, in order to destroy the stricture. 
 The case in Avhich this plan answers best, 
 is where there arc one or more strictures, 
 naiTOw, like a thread tied round the ca- 
 nal, so- its to lessen its diameter for a very 
 short space. 
 
 BOWELS, Init^ammation ov, Enteritis, 
 is characterized by the symptoms of ge- 
 neral fever, heat of skin, thirst, restless- 
 ness, quick and hard small pulse ; and by 
 sharp pain in the belly, increased on pres- 
 sure, and accompanied by vomiting and 
 costiveness. 
 
 Causes. Inflammation of the bowels 
 is occasioned by acrid and irritating sub- 
 stances swallowed by the mouth, by har- 
 dened fiEces, by vitiated bile, by long con- 
 tinued costiveness, and by constriction of 
 some part of the canal in cases of ruj)- 
 ture : a very frequent cause of it is cold, 
 especially when applied with damp to the 
 feet. 
 
 Diagnosis. Inflammation of the bow- 
 els is distinguished from colic by the ab- 
 sence of fever in this last, and by the pain 
 in colic not being increased on pressiu*e; 
 and, in every case of severe pain of the 
 bowels, with vomiting and costiveness, the 
 practitioner should make very striet in- 
 quiries, lest a rupture should be the cause 
 of them. This is more especially neces- 
 sary in the iliac passion, or similar vio- 
 lent bowel complaints of females, who, 
 from delicacy, or not knowing the im- 
 portance of the circumstance, are not 
 likely to inform their attendant, of the 
 existence of a tumour in the groin. In- 
 flammation of the bowels is distinguished 
 from that of their investing membrane, 
 or what is called peritoneal inflammation, 
 by this last not being attended with cos- 
 tiveness. 
 
 Prognosis- The disease proceeds with 
 great rapidity, and is attended with great 
 danger. It may soon end in mortifica- 
 tion ; in which event, the patient expe- 
 riences a fallacious remission of the pain 
 and other distressing symptoms ; but the 
 sinking and irregularity of the pulse, the 
 shrinking of the features, the cold sweats, 
 hiccup, and distension of the belly, too 
 plainly indicate approaching dissolution. 
 On the other hand, if the pain gradually 
 abates, if natural stools are passed, if ei- 
 ther perspiration, or a copious flow of 
 urine occurs, with a firm equal pulse, we 
 may hope for amore favourable termination. 
 
76 
 
 BRAIN. 
 
 Treatment. The most prompt and ac- 
 tive measures must be put in practice ; 
 the first and most important of which is 
 blood-h'ttiiiff ; and we must not be de- 
 terred by the small pulse at the beginnings 
 of tlie disease, as a copious bleeding will 
 not make it smaller, but rather improve 
 it The bleeding will probably require to 
 be repeated three or four times ; and we 
 must proportion the quantity taken to the 
 effect produced, and not count by ounces 
 or cupfuls. Besides general bleeding, 
 much benefit may be derived from the 
 application of a very considerable num- 
 ber of leeches to the abdomen, not less 
 than fifty or sixty ; and after the wounds 
 have bled as much as they will, we may 
 apply a lai^e poultice to promote the flow 
 still more. Warm fomentations to the 
 belly may tend to promote the relaxation 
 of the spasm which is sometimes present; 
 and a large clyster of warm gruel may be 
 conjoined, to act as an internal fomenta- 
 tion. A blister over the whole belly is 
 of great service. Meantime, we are to 
 give laxative medicines by the mouth, 
 as soon as we have allayed the vo- 
 miting by the means above directed ; 
 it may be prudent to use at first those 
 medicines which we may hope will eva- 
 cuate the bowels without irritating them; 
 viz. castor oil, or Rochelle salts, or the 
 compound powder of jalap, or calomel 
 and rhubarb. Sometimes an evacuation 
 of the bowels may be produced by sud- 
 denly throwing cold water on the feet 
 and logs.- Very little aliment should be 
 given ; a little barley-water or thin gruel 
 is quite sufficient ; and when the disease 
 is subdued, the diet should be of mild 
 and easily digestible articles, as weak 
 beef-tea, chicken broth, and the like, 
 using old bread, and avoiding flatulent 
 vegetables. 
 
 BOWELS, Obstruction OF. »Scc Con- 
 stipation or CosTivENEss. See also Couc, 
 and Rliture. 
 
 BRAIN. The highly important organ 
 contained within the skull of the more 
 perfect animals, and forming the medium 
 of communication between mind and 
 
 matter. The brain sends out many chords, 
 called nerves, to the various parts of the 
 body, and to the organs of the senses, 
 and it is essential to the perfection of 
 sense and motion, that the communica- 
 tion between the brain and the extremi- 
 ties of the nerves be free and uninter- 
 rupted. Thus, if the large nerve sent 
 to any particular limb or muscle be cut 
 through, the pereon is incapable of using 
 that limb or muscle ; and if the nerve 
 going to be expanded at the back part of 
 the eye, be cut through, the patient is 
 deprived of the power of vision. Much 
 labour and ingenuity have been expended 
 on the dissection and description of the 
 brain, every part of it has been named 
 and minutely drawn and described, its 
 various convolutions and membranes have 
 been noted, and the admirable contrivance 
 of its circulating system fully unfolded ; 
 and both from analogy, and from the con- 
 templation of its wonderful mechanism, 
 we must be assured that so complicated 
 a structure cannot have been formed in 
 vain ; yet all the labours of the most 
 expert anatomists have not succeeded in 
 demonstrating what part of the brain is 
 necessary to the healthy exercise of the 
 various intellectual functions ; and w^e 
 are compelled to acknowledge that of the 
 several parts of this important organ, to 
 us so interesting, we hardly know more 
 than the appearance and the names. 
 
 Whether the particular uses of the 
 several structures found in the brain are 
 to remain among the arcana of physiology, 
 like the functions of the spleen ; or whe- 
 ther a longer and a happier course of ob- 
 servation and experiment is to throw 
 unexpected light on this important sub- 
 ject, w^e know not; but at present, those 
 who have studied the brain and nervous 
 system the most skilfully, are the most 
 ready to confess that they know but 
 little. 
 
 Anatomists have divided the brain into 
 two hemispheres, each hemisphere into 
 three lobes; these divisions are plainly 
 and distinctly made by membranes, and 
 by the form of the bones on which the 
 
BRAIN. 
 
 77 
 
 parts rest, or by which they are contained. 
 The brain is covered on its outer surface 
 by a very strong membrane, metaphori- 
 cally called, from its firmness, and from 
 its being" supposed by the ancients to give 
 origin to all the other membranes of the 
 body, the dura mater. This membrane 
 dips down between the two hemispheres 
 of the brain ; and investing its lower 
 and back part, it forms a covering for 
 another substance called the little brain, 
 composed of exactly the same sort of 
 substance as the large brain. These 
 two organs, tlie brain and little brain, 
 each terminate in two medullary ropes; 
 and uniting at a sort of tubercle near the 
 first vertebra of the neck, they pass down 
 into the hollow formed by various bones 
 of the back, and there constitute what is 
 called the spinal marrow ; agreeing pre- 
 cisely in its functions with the brain, and 
 to be considered merely as a prolongation 
 of it, lodged for convenience in the cavity 
 of the vertebrae, and sending out nerves 
 to various organs. 
 
 The principal disorders to which the 
 brain is subject, are compression, concus- 
 sion from external injury, inflammation, 
 accumulation of fluid in its ventricles, 
 apoplexy, and various growths, which 
 give rise to apoplexy or convulsions. 
 
 BRAIN, Compression of, is the term 
 used to denote that morbid state arising 
 from any thing pressing on the brain, 
 whether from an external or internal 
 cause. When a person has received a 
 violent blow on the head, or a fall or 
 other accident, and in consequence has a 
 part of the skull driven in upon the brain, 
 he becomes affected with the following 
 symptoms : There is general insensibility, 
 the eyes are half open, the pupil is dilated 
 and does not contract when a candle is 
 brought near the eye, the limbs are re- 
 laxed, the breathing is loud and snoring, 
 the pulse is strong, full, and slow ; and not 
 unfrequently vomiting occurs. When we 
 see the bone driven in upon the brain, we 
 consider the compressing cause as ascer- 
 tained; but the same symptoms may occur 
 when the bone is not injured, or when it 
 
 is merely fractured, without any part be- 
 ing beaten in upon the brain. In this case, 
 we believe the compression to arise from 
 some fluid pressing upon the brain internal- 
 ly, either blood shed from its vessels, or clear 
 lymph, or a mixture of both. Now, the vio- 
 lence may either cause a sudden discharge 
 of fluid, in which case the symptoms will 
 come on immediately; or the injury may 
 be less, and the fluids may be poured out 
 gradually, so that the compression will 
 not take place till a certain quantity has 
 accumulated. A person, therefore, who 
 has received a violent blow on the head, 
 is not to be considered as out of danger, 
 because the bad symptoms do not imme- 
 diately show themselves. The brain may 
 be compressed independently of external 
 violence, by diseases of the system; and 
 by referring to the article Apoplexy, it 
 will be seen that the same symptoms are 
 set down as characterizing that disease. 
 In all these cases, our indication is to 
 relieve the brain from the compressing 
 body, whether it be bone or fluid, exter- 
 nally or internally applied. The bone is 
 to be raised from the brain by the appli- 
 cation of adequate force, either manual 
 or instrumental ; a lever or elevator is to 
 be put under the bone, and if there is no 
 proper place for the lever to rest upon^ 
 the operation of the trepan must be re- 
 sorted to, which consists in the removal 
 of a piece of bone near the verge of the 
 injured part, so as to obtain a fulcrum for 
 the elevator. Sometimes the mere re- 
 moval of the depressed bone will alleviate 
 the symptoms; and if blood be effused 
 immediately under the skull, it will be 
 evacuated also ; but if it be in the more 
 internal parts of the brain, its dischai^e 
 will be more difficult, and it requires the 
 utmost exertion of the judgment of a 
 skilful and experienced surgeon to decide 
 on the propriety of fm-ther steps, and what 
 those steps may be. When compression 
 of the brain is removed, the practitioner 
 is to direct his care to the prevention of 
 inflammation, and other untoward symp- 
 toms. For the treatment of Apoplexv, 
 see that article. 
 
78 
 
 BRAIN. 
 
 BRAIN, Concussion of. The name 
 given to the injury supposed to be re- 
 ceived by the brain from great violence 
 inflicted on the head, when there is no 
 org-anic injury discovered, neither fissure, 
 fracture, nor extravasation, either in the 
 living- or dead body. The same symp- 
 toms occur when the head has not re- 
 ceived any external injury, and when the 
 shock has appeared to have been sustained 
 ' by the whole frame. A person may fall 
 from a height, light on his feet, and yet 
 be affected with all the symptoms of con- 
 cussion of the brain. These vary in de- 
 gi-ee, from the slight stunning which fol- 
 lows almost every violence done to the 
 head, to the loss of all sense and motion, 
 which is soon followed by death. Mr. 
 Abernethy thinks that the symptoms of 
 concussion may properly be divided into 
 three stages j thejirst is that state of in- 
 sensibility and derangement of the bodily 
 powers which immediately succeeds the 
 accident. The breathing is difficult, but 
 in general without stertor or snoring; 
 the pulse intermits, and the extremities 
 are cold. This goes off gradually, and is 
 succeeded by the second stage ; in this, 
 the pulse and breathing are better, and 
 though not regular, are sufficient to main- 
 tain life, and to diffuse warmth over the 
 extreme parts of the body. The patient 
 is inattentive to slight external impres- 
 sions, though he feels when the skin is 
 pinched. As the effects of concussion 
 diminish, he replies to questions put to 
 him in a loud tone of voice, particularly 
 if they refer to his own suffering ; other- 
 wise he answers incoherently, and as if 
 his attention was occupied by something 
 else. While the stupor remains, there 
 appears little inflammation of the brain, 
 but as the stupor abates the inflammation 
 increases ; and this constitutes the t?nrd 
 stage. Much caution and prudence are 
 required in the treatment of the first 
 stage. A person is knocked down and 
 becomes insensible ; many have seen or 
 heard of bleeding being employed when 
 a person has fallen down suddenly, and 
 the byestanders impatiently require that 
 
 this shall be the first article of the treat- 
 ment. But the breathing is slow, the 
 pulse intermitting, and the extremities 
 cold ; and to draw blood in such circum- 
 stances as these would be taking the 
 effectual method completely to extinguish 
 life. Again, suppose people were to rea- 
 son from the resemblance of the state in 
 which the patient is in, to that of a person 
 in a faint, and should as in that case give 
 • stimulant liquors by the mouth, or apply 
 pungent substances to the nose, there 
 is danger here, that by such appliances, 
 the subsequent inflammation may be in- 
 creased. The utmost that should be 
 tried, is the endeavouring to restore the 
 heat of the extremities by friction with 
 wprm cloths, or with stimulating embro- 
 cations ; and we are to wait a little till 
 we see whether the patient recovers from 
 the first stunning effect of the blow, and 
 to be regulated in our future treatment 
 by the symptoms that occur. Those that 
 we are principally to look for, are those 
 of an inflammatory tendency ; and to pre- 
 vent the evils arising in the after stages 
 of concussion, we are to employ bleeding 
 and purging, to keep the patient in a 
 darlc room, to enjoin perfect quiet, and to 
 put in force the antiphlogistic regimen. 
 
 BRAIN, Inflammation of. Inflamma- 
 tion of the brain and its membranes is 
 characterized by very violent feverish 
 symptoms, great flushing of the face, red 
 uess of the eyes, intolerance of light, and 
 furious delirium. 
 
 Causes. These symptoms are occa- 
 sioned by passions of the mind, by drink- 
 ing spirituous liquors ; and in warm cli- 
 mates by exposure to the sun, forming 
 what is called coup de soleil. 
 
 Treatment. The treatment consists in 
 large and rapid abstraction of blood, from 
 the arm, the temporal artery, and jugular 
 vein ; in giving saline, cooling purgatives, 
 and applying cold to the head. For this 
 purpose, the head must be shaved, and 
 cloths dipped in vinegar and water, or 
 solution of muriate of ammonia are to be 
 kept wet upon it ; while we attempt to 
 draw away the determination from the 
 
BREAD. 
 
 79 
 
 head, by tepid or warm bathing of the 
 lower extremities. If these means are 
 unsuccessful, the danger is, that suppura- 
 tion may take place somewhere in the 
 brain, or on its surface, giving rise to 
 compression of that organ, and fatal apo- 
 plexy. Or an effusion of lymph may be 
 poured into the ventricles, giving rise to 
 symptoms of water in the head. 
 
 BRAN. The husks or shells of wheat, 
 which remain in the bolting machine. It 
 contains a portion of the mealy matter ; 
 and a decoction of it is used as a drink 
 in febrile diseases. This decoction is 
 made by boiling a pint of water with two 
 ounces of bran, till only three quarters re- 
 main ; and then straining it. It is thought 
 to have something of a laxative quality. 
 
 BRANDY. An ardent spirit obtained 
 by distilling from wine. The properties 
 of brandy, as of the other ardent spirits, 
 depend on the alcohol which it contains, 
 and this is stated by Mr. Brande at 59.39 
 per cent, by measure. The cases in which 
 brandy may be used as a medicine, or per- 
 mitted as an indulgence, may be known 
 by referring to the article Alcohol. 
 
 BRANKS. The Scottish name for 
 the Mumps. See Mumps. 
 
 BREAD. A very important article 
 of diet, made from the farina of various 
 plants. This farina consists of different 
 principles, a mucilaginous saccharine 
 matter, starch, and gluten, which is a 
 peculiar substance having many of the 
 properties of animal matter. This latter 
 ingredient is most abundant in wheat 
 flour, and gives it its gi'eat superiority 
 over that of barley, rye, oats, and other 
 grain. In the making of bread, flour is 
 made into a paste by mixing it with water 
 in the average proportion of two parts 
 of water to three of flour ; and the older 
 and better the flour, the greater quantity 
 of water will be required. If this paste 
 be allowed to remain for some time, a 
 fermentation takes place ,• and by the ac- 
 tion of the ingredients on one another, 
 important chemical changes take place, 
 and alcohol, carbonic acid, and acetic acid, 
 or vinegar, are formed. If the paste be 
 
 now baked, a loaf is fonned, but of a taste 
 very sour and unpleasant. This cold paste 
 is what is called leaven ; and if a portion 
 of it be added to new made paste, the 
 fermentation begins more speedily, car- 
 bonic acid is given off, but the gluten 
 hinders its escape, and expanding like a 
 membrane, forms numerous little cavities 
 in a light and spongy mass. If there be 
 too much leaven put into the paste, the 
 bread has an unpleasant flavour; and if 
 there is too little, it is compact and heavy. 
 JBariUy or the ferment that collects on the 
 surface of fenmenting beer, being added 
 to dough, makes a bread superior to what 
 is made with leaven ; and is in this coun- 
 try generally employed for raising the 
 bread. After the dough has been fer- 
 mented, and properly raised, it is put into 
 the oven, heated to about the tempera- 
 tui*e of 448°, and is there baited. Bread 
 is very different from the flour of which 
 it was made ; the ingredients of the flour 
 cannot be discovered in it ; it mixes more 
 easily with water, and is incomparably 
 more digestible. 
 
 There are three different sorts of bread 
 used in this country, the fine, the wheat- 
 en, and the household. Fine bread is 
 made of flour only; wheaten bread of 
 flour and a mixture of fine bran; and 
 household is made of the whole grain, 
 including both the coarse bran and the 
 fine flour. The finer bread, from its 
 greater quantity of starch, is apt to in- 
 duce a degree of costiveness, which the 
 coarse bread is enabled to counteract by 
 its admixture of bran. Brown bread, or 
 that made with a mixture of wheat and 
 rye flour, is often usefully prescribed 
 with a view to its laxative effect. As an 
 article of diet, bread is of very great im- 
 portance, for its nutritive qualities, and 
 for its utility when joined with other 
 food ; both to correct the bad effects of 
 too much animal diet, and to divide the 
 aliment more completely by being inti- 
 mately mixed with it. The best ob- 
 servations seem to prove, that a cer- 
 tain degree of distension of the sto- 
 mach is necessary to proper digestion ; 
 
80 
 
 BRE 
 
 BRE 
 
 and, consequently, that we could not 
 conveniently feed on essences and jellies, 
 in which the nourishing parts of the food 
 are concentrated into the smallest pos- 
 sible bulk ; and that even very rich and* 
 nutritive soups are much easier for the 
 stomach, wheu a proper proportion of 
 bread is taken along with them. New 
 bread is particularly unwholesome and 
 indig-estible, and should always be avoid- 
 ed, especially by patients troubled with 
 indigestion. The only apparent excep- 
 tion is in the case of new rolls, which 
 healthy stomachs manage to digest pretty 
 well, provided they be well baked, and 
 that the crust bears a considerable pro- 
 portion to the whole. Toasted bread is a 
 very useful article of diet for tender 
 stomachs, and in the diet of invalids. 
 Bread, in some constitutions and diseases, 
 is apt to sour on the stomach, especially 
 in children, in whom it is thought to 
 produce flatulence and costiveness. Where 
 acidity occurs, biscuit without butter 
 should be substituted, or the bread should 
 be toasted. 
 
 In the foregoing remarks on bread, we 
 liave had principally in view leavened 
 wheaten bread; though bread may be 
 made of rye, barley, potatoes, rice, and 
 other substances ; and although, strictly 
 speaking, biscuits, cakes, bannocks, scones, 
 and other unleavened mixtures are en- 
 titled to the appellation of bread. Most 
 of the articles last mentioned are suffi- 
 ciently nutritive, but hard and difficult of 
 digestion, though they are excellently 
 adapted for the powerful stomachs of 
 those who are engaged in laborious and 
 rustic occupations, the dura messorum 
 ilia. The addition of butter to such ar- 
 ticles before they are baked, is very apt 
 to make them disagree with the stomach, 
 and to make them sour. 
 
 A good deal has been said about bread 
 being frequently adulterated. In large 
 communities, some dishonest pei-sons will 
 probably adulterate bread, as well as other 
 articles of food; but the evils of such 
 practices have been much exaggerated. 
 Bean flour, or potato flour, have occasion- 
 
 ally been mixed with wheaten in the 
 making of bread ; and under Alum we 
 have stated the proportions of that sub- 
 stance which are very frequently added 
 to increase the whiteness of bread. 
 
 BREAD-FRUIT TREE, Artocarpus 
 incisa. A tree which grows in the 
 Ladrone islands, in the South Seas, in 
 Otaheite ; and of late, in the West Indies. 
 It is about the size of a middling oak, and 
 yields a fruit about the size of a child*s 
 head, with a reticulated surface, some- 
 thing like the surface of a truffle. It is 
 covered with a thin skin, and has a 
 small core or central pith. The part 
 which is eaten is between the skin and 
 the core ; it is perfectly white, and some- 
 what of the consistence of new bread. 
 It is toasted before it is eaten, and has an 
 insipid taste, with a slight sweetness, 
 like that of wheaten bread and artichokes 
 together. 
 
 BREAKFAST. The first meal taken 
 in the morning. This is of considerable 
 importance, as many hours have passed 
 since the stomach was supplied with 
 food; and as the morning meal is that 
 which is to give strength to the system 
 for the most active part of tlie day. Its 
 time, its materials, and accompaniments, 
 are therefore worthy of being well ad- 
 justed; although from the endless varie- 
 ties of habits, constitutions, and employ- 
 ments, no fixed rules on any of these 
 particulars can be given. During sleep, 
 the whole of the food taken the night 
 before has probably been digested ; and 
 we might expect the appetite to be keen 
 in the morning, from the circumstance 
 of the gastric juice being secreted in 
 abundant quantity and of great activity, 
 during the long interval ; while the mus- 
 cular powers of the stomach are refresh- 
 ed by rest, and ready to resume their 
 functions ; but, in general, it is proper to 
 interpose some time between rising and 
 taking breakfast ; though many feel such 
 inanition and feebleness, that they are 
 unfit for any of the duties of life till they 
 have taken some food. lu this, every one 
 must decide for himself. 
 
BREAST. 
 
 81 
 
 The quality of the food to be eaten at 
 breakfast is to be regulated by the exer- 
 cise and labour to be taken, and by the 
 time that is to elapse before dinner. The 
 physician would be much inclined to in- 
 terdict luncheons ; and therefore to re- 
 commend a considerable proportion of 
 solid food at breakfast. Cold mutton, or 
 beef, or after the Indian custom, fish and 
 rice, or eggs, may be taken at breakfast. 
 Hard boiled eggs, being nutritive and slow 
 of digestion, are a good article of diet for 
 those who are to fast long. Copious 
 breakfasts, however, are apt to be heavy 
 to many stomachs, and to occasion heart- 
 burn, especially when a great deal of 
 liquid has been taken along with them ; 
 but this does not show any cause against 
 a proper quantity of diluting drink at 
 breakfast. The expenditure of fluid by 
 insensible perspiration, which has taken 
 pkwje during the night, m ith the greater 
 acrimony of all the secretions in the 
 morning, point out the propriety of a con- 
 siderable quantity of diluting fluid at the 
 morning meal ; and the choice of this fluid 
 must be left in general to each person's 
 experience of what agrees best with him. 
 Tea agrees well with most people ; but 
 with many it occasions heartburn and aci- 
 dity ; perhaps the fault may not be in the 
 tea, but in the quantity of new bread, or 
 of butter, taken along M'ith it. Trials 
 must be made, by omitting one or more 
 of the articles taken, till it be ascertained 
 which of them is in fault. If tea or coffee 
 are found to disagree, milk or gruel may 
 be substituted. 
 
 BREAST in general, signifies the 
 Chest. Hence we hear of pain in the 
 breast, pectoral medicines, &c. It will 
 be better to treat of Breast Complaints 
 under the article Chest, and to restrict 
 the word Breast to the subject of the 
 following article. 
 
 BREAST, pEaiALE, and the Diseases 
 to which it is subject. — The breasts con- 
 sist of common integuments and fat, 
 with glands and vessels, for the purpose 
 of secreting milk, and discharging it for 
 the first nourishment of the child. On 
 
 the middle of each breast is a small emi- 
 nence, which the child takes into its 
 mouth ; and a vacuum being formed by 
 its suction, the external air pressing on 
 the breast forces the nutritious fluid into 
 the child's mouth. Round each nipple, 
 there is a dark brown circle called the 
 areola. From the variety of parts of 
 which the breast is composed, it is liable 
 to various diseases, as inflammation, sup- 
 puration, and cancer. 1. Inflammation. 
 Like all other parts, the breast may in- 
 flame from external violence, or from 
 internal and unknown causes ; but one 
 of the most frequent causes of inflam- 
 mation there, is the strong rush of blood 
 to the pai't shortly after delivery. Previ- 
 ous to the birth of the child, a great 
 quantity of blood is sent to the womb 
 to supply materials for the growth and 
 nourishment of the embryo ; but when 
 the child is born, and requires food of 
 another sort, the blood then flows in 
 great quantity to the breasts, and occa- 
 sions in some constitutions a smart fe- 
 brile attack, known by the name of the 
 milk fever ; and, in others, severe local 
 pain of the breasts, followed by suppura- 
 tion. Independent of the milk fever, in- 
 flammation and abscess of the breast may 
 arise from checking the flow of milk at 
 too early a period, from exposure to cold, 
 fright, mental anxiety ; too great motion 
 of the arm when the breast is large and 
 distended, blows, and pressure from tight 
 clothes. But the abscess of the breast 
 often occurs, when no obvious cause can 
 be assigned. The pain arising from the 
 inflammation of so large and tender a 
 structure is very great; and, happening 
 in constitutions already enfeebled and ir- 
 ritable from the child-bed state, it occa- 
 sions very severe distress. The breast 
 sometimes puts on the appearance of 
 several distinct swellings, has a knotted 
 feel, and the pain often extends to the 
 arm-pit. At first, we must endeavour, if 
 possible, to put a stop to the inflamma- 
 tion, and to prevent its coming the length 
 of suppuration. This is to be done by 
 giving frequent doses of cooling laxatives 
 
82 
 
 BREAST. 
 
 as of salts; by applying cold or tepid 
 fomentations to the breast, and by at- 
 / temp tin o^ to have the milk regularly drawn 
 off. We are also to apply leeches in great 
 numbers, and to rub the breast gently 
 with a little warm oil. The diet is to be 
 /'/ spare and coolings 
 
 2. Suppuration. K we fail in relieving 
 the inflammatory state, our next endea- 
 vour is, to promote the suppuration by 
 poultices, and to discharge the matter 
 M'hen ripe, by a large opening. When a 
 suppurating breast is left to itself to break, 
 it too frequently allows the matter to 
 work itself into various winding holes, 
 and to make its way out by different 
 openings, occasioning a long and wasting 
 discharge; to prevent this, there is no 
 method so sure as making a large and free 
 incision, and laying open through all their 
 depth, the hollows from which the matter 
 flows. When a hardness remains in the 
 breast after inflammation and abscess, it 
 is to be dispersed by friction with campho- 
 rated oil, or mercurial ointment; atten- 
 tion being paid to the avoiding of exter- 
 nal injury; and the general health and 
 state of the bowels is to be looked after. 
 
 3. Scirrhus and Cancer. The breast is 
 also subject to what is called a schirrous 
 hardness ; and this too often is the com- 
 mencement of one of the most distressing 
 maladies to m hich the human frame is 
 liable. This hardness, after continuing 
 for a length of time, without any apparent 
 tendency to change, sometimes from a 
 slight blow or other injury, sometimes 
 without any obvious antecedent cause, is 
 succeeded by pain, inflammation, ulcera- 
 tion; in short, degenerates into the dis- 
 order too well known by the name of 
 cancer, w^hich has hitherto baflled all the 
 powers of medicine to effect its cure. As 
 cancer may affect other parts of the body 
 as well as the female breast, we shall 
 not detail the particular symptoms till we 
 come to the article Cancer itself, but 
 shall state, that for the prevention of the 
 last and fatal stage of cancer in the breast, 
 with the long train of misery and despair 
 preceding it, it is found that there is no 
 
 certain remedy but cutting off the part. 
 This appears a harsh and terrible pro- 
 posal; but long and melancholy expe- 
 rience has evinced the absolute necessity 
 of it ; and has demonstrated the ignorance 
 or the knavery of those, who, with such 
 unblushing impudence, promise a cure of 
 every case of cancer, without having re- 
 course to the knife. When a breast is 
 affected with scirrhous hardness, and with 
 some other kinds of soft swelling which 
 are known to have a tendency to become 
 cancerous and malignant, we ought to 
 advise the extirpation of the part ; and as 
 the progress is generally unceasing and 
 unrepressible, we ought not to waste time 
 in the use of internal remedies, from which 
 no good has ever been found to result. 
 Here is the opportunity for the candid 
 and skilful surgeon to give his opinion 
 tenderly but decidedly : to discriminate 
 carefully between the various kinds of 
 hardness which may occupy the female 
 breast, Avithout leading to any bad con- 
 sequences; and those which, if left to 
 themselves, will be decidedly fatal. Much 
 also will depend on giving the advice at 
 a proper time. After a certain continu- 
 ance of the disease, it spreads its baneful 
 influence so deep and so extensively, that 
 the operation is likely to do no good, but 
 on the contrary to accelerate the fatal 
 termination of the disease ; and unless the 
 whole of the diseased portion, in all its 
 ramifications, be cut out, the malady will 
 assuredly return ; and it is by such occur- 
 rences that the operation is in too many 
 cases brought into discredit. When the 
 operation is resolved upon, it is a matter 
 of great importance not to rest satisfied 
 with removing merely the tumours, but 
 a considerable portion must be cut away 
 of the surrounding substance. In cutting 
 out a diseased breast, particular care must 
 be taken to remove various white bands, 
 which radiate into the surrounding parts, 
 and which, if left, would infallibly occa- 
 sion a relapse. It is proper also to re- 
 move a very considerable portion of skin, 
 as it is frequently found, that on occasion 
 of a relapse, the disease makes its re-ap- 
 
BRI 
 
 BRI 
 
 8» 
 
 pearance in the slvin. It is reckoned a 
 BGkatter of ])rudence, nay, of necessity, to 
 remove the nipple in every case where it 
 is at all near the scirrhous hardness ; and 
 wherever the skin appears discoloured, 
 puckered, or closely connected with the 
 hardened parts heneath, it should be com- 
 pletely removed. We hear often enough 
 of the operation for cancer being unsuc- 
 cessful, and many pretenders are fond of 
 ever" opportunity of throwing discredit 
 upon it ; but by far the majority of what 
 appear to be relapses, should be considered 
 as mere continuations, the diseased part 
 never having been completely removed. 
 The best posture for the patient to be 
 placed in for the operation, is a recum- 
 bent one ; and this the more especially, 
 when the operation is likely to be long, 
 or attended with much loss of blood, and 
 consequent fainting. The mode of per- 
 forming the operation, however, is not a 
 fit subject for a popular work. The arm 
 of the side from which the breast has 
 been removed, should be kept from mo- 
 tion by being put in a sling ; and this is 
 obviously necessary, as every motion of 
 the pectoral muscle is apt to derange the 
 dressings and plasters of the part. After 
 the operation is over, the patient should 
 be put to bed, and should have a full dose 
 of the tincture of opium, to allay irritation 
 and procure sleep. 
 
 BREASTS OF Infants, Swelling of. 
 A few days after birth, a milk-like fluid 
 forms in the breasts of infants of both 
 sexes, producing swelling and inflamma- 
 tion. The fluid sometimes oozes out, and 
 the uneasy feelings are relieved. Little 
 else is required for these swellings than 
 rubbing them with warm olive oil, night 
 and morning ; or dusting them with fine 
 flour, or bathing them with milk and 
 T^'ater. Forcibly squeezing these delicate 
 parts of a new-born infant, as is often 
 done by ignorant persons, should be strict- 
 ly forbidden j as inflammation and suppu- 
 ration may be the consequence, or per- 
 manent injury may be done to the breasts, 
 especially of female children. 
 
 BRIMSTONE. See Sulphur. 
 
 BRISTOL HOTWELL. A warm» 
 slightly acidulated mineral spring, situ- 
 ated about a mile below Bristol. The 
 fresh water is clear, sparkling, and free 
 from smell. It is agreeable to the patient, 
 but has no very decided taste ; and there 
 seems to be very little admixture of 
 foreign ingredients. The temperature of 
 the waters is about 74°, and continues 
 pretty equable through the whole year. 
 From the various investigations of che- 
 mists, it appears that the principal com- 
 ponent parts of the Hotwell water, are a 
 large portion of carbonic acid gas, and a 
 certain portion of magnesia and lime, in 
 various combinations with the muriatic, 
 sulphuric, and carbonic acids. Almost all 
 common spring-water contains solid mat- 
 ter of the above description ; and as the 
 Hotwell of Bristol contains less than 
 usual, it may be regarded as very pure for 
 a natural fountain. The water of Bristol 
 Hotwell is useful in obstruction and weak- 
 ness of the bowels, and in some complaints 
 of the urinary organs. But it is chiefly 
 in pulmonary consumption that the sana- 
 tive effects of the Bristol waters are 
 celebrated. Much of their apparent good 
 effects may be ascribed to the favour- 
 able situation and mild temperate climate 
 which Bristol enjoys; but it is also as- 
 serted, that the water alleviates many of 
 the most distressing symptoms of that 
 disease. It is said to be very efficacious 
 in moderating the thirst, the burning heat 
 of the hands and feet, and other symptoms 
 denominated hectic ; and thus, in the 
 earlier stages, it may be successful in re- 
 moving bad symptoms, or even in restor- 
 ing to health ; and may contribute, in the 
 latter stages, to mitigate the sufferings 
 of the patient in a disease that cannot be 
 cured. The sensible effects of this water, 
 when di-ank warm and fresh from the 
 spring, are a gentle glow of the stomach, 
 succeeded sometimes by a slight and tran- 
 sient degree of headach and giddiness. 
 It is diuretic, it keeps the skin gently 
 moist and perspirable, and improves the 
 appetite and health. In, some constitu- 
 tions, it disposes the bowels to be rather 
 
84 
 
 BRONCIIOCELE. 
 
 costive J it is, therefore, proper to inter- 
 pose an occasional laxative. Patients g-e- 
 nerally resort to this well during the 
 summer months, and thus enjoy the con- 
 comitant benefits of air and exercise. 
 
 BROCOLI, Brassica Italica. A spe- 
 cies of cabbage, which furnishes a very 
 agreeable article of food. Persons afflicted 
 with indigestion should avoid this, as in- 
 deed they should abstain from the greatest 
 number of vegetables ; as it is apt to 
 induce flatulence, and its effect's, nau- 
 seous eructations and griping of the 
 bowels. 
 
 BRONCHOCELE. The goitre, or 
 swelled neck, which so frequently occurs 
 among the inhabitants of mountainous 
 regions. It is a common disorder in Der- 
 byshire, and among the inhabitants of the 
 Alps, and other hilly countries in their 
 neighbourhood ; also in the valleys of Sa- 
 voy, and at Milan, and among the Pyre- 
 nees, and Ceveunes in France. The swell- 
 ing in bronchocele is at first without pain 
 or any evident fluctuation, and the skin 
 retains its natural appearance ; but as the 
 swelling advances, it grows hard and ir- 
 regular ; the skin becomes yellowish, and 
 the veins of the neck put on a distended 
 and winding appearance ; then the patient 
 complains of frequent flushings of the 
 face, with headach, and pains darting 
 through the tumour. When the disease 
 has continued long, and the swelling is 
 great, the cure is difficult ; and from the 
 largeness of the arteries which supply it, 
 we can hardly venture on its extirpation 
 by the knife ; but in the early stages of 
 the disease, something should be attempt- 
 ed by internal medicines, assisted by fric- 
 tions with camphorated mercurial oint- 
 ment over the tumour. We may also ap- 
 ply blisters, cooling lotions, and soap plas- 
 ters ; but we are also to use internal re- 
 medies ; and of these the most successful 
 is the burnt spunge. It was long a ques- 
 tion, on what ingredient of its composi- 
 tion its virtues depended; but it seems 
 now to be ascertained, that it is owing to 
 the iodine which enters into it; and this 
 iodine may be employed separately under 
 
 the form of solution in alcohol, by which 
 its dose can be accurately divided and as- 
 certained. Thirty-six grains of iodine 
 may be dissolved in an ounce of alcohol, 
 and of this, ten drops may be given three 
 times a-day in any viscid liquid; this 
 dose may be gradually increased to twen- 
 ty drops. This substance may also be 
 used in the form of hydriodate of potassa; 
 forty-eight grains are dissolved in an ounce 
 of water, and from ten to thirty droj^i are 
 given of this solution. Iodine has also 
 been employed externally in the form of 
 ointment, when the stomach has refused 
 it internally. Haifa drachm of hydrio- 
 date of potassa mixed intimately with an 
 ounce and a half of hog's lard may be 
 used as an ointment; rubbing in upon 
 the tumour, night and morning, a piece 
 the size of a garden bean. In decided 
 goitre, the effects of iodine are very re- 
 markable; it softens the tumours, and 
 gradually promotes their absorption ; but 
 it is proper to alleviate any local inflamma- 
 tory action, and to strengthen the consti- 
 tution by tonics. If any feverish symp- 
 toms occur, the iodine should be discon- 
 tinued ; and also where it occasions 
 cough, restlessness, laxity of the bowels, 
 and emaciation. 
 
 It is an interesting subject of inquiry, 
 what circumstances render the inhabit- 
 ants of certain districts more especially 
 liable to this disease. As it has been ob- 
 served, that districts abounding with sa- 
 line and mineral springs exhibit more in- 
 stances of this disease than other places, 
 the impregnated waters of these parts 
 have been supposed capable of producing 
 the disease in question. The use of snow 
 water has been thought to give rise to 
 swelled necks; but this is rendered im- 
 probable, by the frequent occurrence of 
 the disease in Sumatra, where snow and 
 ice are never seen ; and it is remarkable, 
 also, that the disease rarely occurs in Thi- 
 bet, though the rivers there are chiefly 
 supplied by the melting of the snow, with 
 which their mountains are always cover- 
 ed. Bronchocele is believed, like scrofu- 
 la, to be a disease transmitted from the 
 
BRO 
 
 BUB 
 
 85 
 
 parents to their offspring ; and its occur- 
 rence among the inhabitants of certain 
 districts, is ascribed to their being in some 
 measure excluded from the rest of man- 
 kind, and intermarrying with each other. 
 The swelled neck is in very many cases 
 connected with cretinism or fatuity ; al- 
 though in frequent instances, the bron- 
 chocele is totally unaccompanied by any 
 degree of idiotism. 
 
 BRONCHOTOMY. An operation by 
 which an opening is made into the upper 
 part of the wind-pipe. The object of it 
 is to make a passage for the air to and 
 from the lungs, when any thing occurs to 
 prevent it from its usual course. This 
 may happen from an inflamed throat, 
 from a tumour, from a foreign body hav- 
 ing fallen into the wind-pipe; and the 
 operation is sometimes necessary in cases 
 of drowning, to enable the practitioner 
 to inflate and empty the lungs, in order 
 to imitate natural respiration. The man- 
 ner, of performing the operation is to 
 place the neck a little on the stretch, by 
 bending the head backwards ; then to be- 
 gin an incision below the cricoid cartil- 
 age, and to continue it downwards about 
 two inches. The incision of the integu- 
 ments being made, we are then to bring 
 the Avind-pipe fairly into view, and to 
 introduce the knife below the third ring 
 of the wind-pipe, and to cut pei*pendicu- 
 larly downwards. Though the operation 
 is not a difficult one, it is necessary to ob- 
 serve certain cautions. In some persons 
 arteries of considerable size may depart 
 from their usual distribution ; and the 
 knowledge that such irregularities have 
 been met Avith, will put the surgeon on 
 his guard, and malce him aware of the 
 necessity of not using the knife, farther 
 than merely to divide the skin and co- 
 verings. The wind-pipe must be cleared 
 with the fingers, and careful examination 
 made before the knife is introduced into 
 it. 
 
 BROOM, Cytisus scoparius- A decoc- 
 tion of the tops of the common yellow 
 broom has been celebrated in dropsy ; and 
 in some cases, it has done good by its 
 
 diuretic powers ; but we have other diu- 
 retics so much more certain in their ope- 
 ration, that we need not place much re- 
 liance upon the broom. 
 
 BRUISE. See Contusion. 
 
 BRYONY, the Wild Vine, Bryonia 
 alba. A perennial plant, growing on dry 
 banks, under hedges, and climbing upon 
 the bushes. The roots are large, their 
 smell when fresh strong and disagreeable, 
 the taste bitter and acrid. The action of 
 bryony on the body is that of a strong ir- 
 ritating cathartic ; and it has been used 
 with success in cases of mania, and in 
 some kinds of dropsies. From twenty to 
 thirty grains of the powdered root may 
 be given. Half a drachm of the watery 
 extract is said to operate powerfully by 
 urine. It is a medicine not much used 
 by modern practitioners. 
 
 BUBO. A swelling in the glands of 
 the groin ; but the swelling of glands in 
 the arm-pit is sometimes called by the 
 same name. The swelling of these glands 
 arises from different causes, from irritat- 
 ing matter absorbed in some part of their 
 course, by the lymphatics which pass 
 through the glands, from certain diseases, 
 and from local irritation. A remarkable 
 instance of general disease occasioning 
 bubo is seen in the plague ; a conspicuous 
 symptom of which is the inflammatory 
 swelling of the groin, and occasionally of 
 the axillary glands, or of the parotid. Bu- 
 boes sometimes appear on the first day of 
 the complaint, sometimes a few days 
 later ; and it is thought that the cases are 
 worse when no buboes appear. These 
 buboes vary in the rapidity with which 
 they advance to suppuration ; when this 
 takes place, the SAvelling should be open- 
 ed with the lancet, and the matter dis- 
 charged. 
 
 Buboes from the absorption of morbid 
 matter. The most common instance of 
 this, is the swelling of the glands in the 
 groin from the absorption of the venereal 
 virus. Such buboes inflame and suppu- 
 rate, sometimes very rapidly ; but in some 
 constitutions, as the scrofulous, the pro- 
 gress is slower, and it is also retarded by 
 
86 
 
 BUG 
 
 BUR 
 
 mercury, employed for tiio cure of the ve- 
 nereal disease. The/pain is acute, and 
 the skin is of a brig^hl red colour. 
 
 Treatment. When the surgeon sees a 
 bubo not very near to suppuration, he is 
 to attempt the resolution of it, if possible. 
 This is to be done by diminishing inflam- 
 matory action, by purgatives and tepid 
 applications to the swelling, and by a ge- 
 neral bleeding if there is much fever. 
 When we design to cure the original dis- 
 ease by mercury, we are to rub it upon 
 the thigh ; and also, if possible, on the 
 parts between the sore and the inflamed 
 gland; and, generally, when the disease 
 is taken in time, the buboes will disperse, 
 and the sores heal; the mercury being 
 continued prudently for some time after 
 the buboes have disappeared. When they 
 have suppurated, they are to be opened 
 by the lancet, and poulticed for a day or 
 two ; and the mercury must be continued 
 till we have reason to think that the mat- 
 ter discharged is not venereal; but we 
 need not always continue it till the bubo 
 is quite healed. Sometimes buboes dege- 
 nerate into very foul and extensively 
 corroding ulcers. Much doubt is enter- 
 tained whether this is owing to the vene- 
 real poison, or to the combined influence 
 of the poison and mercury. Different 
 methods are to be tried in this instance. 
 The use of mercury must be suspended; 
 poultices of hemlock are to be applied to 
 relieve the pain and irritation ; and sarsa- 
 parilla in powder, or decoction, is to be 
 given internally. Bark, and the pre- 
 parations of iron, with a moderate al- 
 lowance of wine, are to be given Avhen 
 there is much debility. 
 
 BUBONOCELE. A swelling in the 
 groin from that kind of nipture in which 
 some of the contents of the abdomen pass 
 through the ring of the external oblique 
 muscle. See Rupture. 
 
 BUCKTHORN, Rhamnm catharticus, 
 a tree or bush which grows in hedges, 
 flowering in May and June, and ripening 
 its fruit in September or the beginning 
 of October. The berries have a nause- 
 ous bitter taste, and were long in consi- 
 
 derable esteem for their purgative effects, 
 and were celebrated in dropsy, in rheum- 
 atism, and the gout. They produce 
 gripes and sickness, with dryness of the 
 mouth and throat, and long contiimed 
 thirst. A syrup made by adding two 
 parts of the clarified juice of the berries, 
 to one of Avhite sugar, was frequently 
 prescribed to children in the dose of one 
 or two tearspoonfuls ; but buckthorn 
 may easily be dispensed with in any 
 shape ; an4 children will take aloes sus- 
 pended in treacle, and retain it on their 
 stomachs as easily as syrup of buckthorn. 
 
 BURGUNDY. A wine classed among 
 those which are called dry and light, pos- 
 sessed of stimulant properties greater than 
 can be explained from the proportion of 
 alcohol it is found to contain, that being 
 only about 1 1 1 per cent. Burgundy is, 
 therefore, thought to hold dissolved some 
 unknown principle of great activity. A 
 few glasses of this wine will induce head- 
 ach and heat of the system, with flus(hed 
 face, and hardness of pulse. These effects 
 soon subside, and are followed by no in- 
 convenience. In some constitutions, how- 
 ever, this temporary vascular excitement 
 may be very unsafe ; and those who feel 
 themselves troubled with drowsiness, or 
 giddiness, for any length of time after 
 taking Burgundy, should avoid this wine 
 in future. 
 
 BURNS. From the frequency of 
 their occurrence, and the destructive ef- 
 fects they produce, bums and scalds form 
 an interesting subject to every medical 
 practitioner; and from their very fre- 
 quent occurrence in domestic life, and in 
 the ordinary occupations of society, it is 
 highly expedient, that every pei-sou not 
 professional should know what is to be 
 done at the moment of such an accident, 
 in order that neither any thing improper 
 should be applied, nor precious time lost 
 in waiting for the coming of the surgeon. 
 To speak accurately, we should apply the 
 word bur?i to injuries from heated solids, 
 and scalds to injuries inflicted by heated 
 liquids. The first effects of bunis or scalds 
 are, very acute pain, destruction of the 
 
BURNS. 
 
 87 
 
 skin and siibjacent parts, a raising of the 
 outer skin with one or more blisters below 
 it, extensive redness of the skin, followed 
 by suppuration and great discharge of 
 matter, the parts bealing with great diffi- 
 culty. The appearances presented by 
 bums diifer according to their violence 
 and extent. Some may only irritate the 
 skin, while others destroy the skin and 
 parts more deeply seated, as the mus- 
 cles, tendons, &c. The injury from scalds 
 is generally more extensive, though not so 
 deep as that from burns ; and the dan- 
 ger appears to be in proportion to the ex- 
 tent more than to the violence of the in- 
 jury ; or rather it is to be estimated by 
 considering the extent and violence to- 
 gether. The worst burns that occur, 
 arise from the burning of inflammable 
 gases, from gunpowder, from the boiling 
 over of hot fluids, as painters' oil, or fluids 
 in laboratories ; from the dresses of fe- 
 males taking fire, from children pulling 
 over on themselves tea, broth, or boiling 
 water, and such like accidents. Burns 
 which only irritate the skin without des- 
 troying it, are very similar in their effects 
 to the substances used in medicine for 
 blisters and rubefacients. The vessels of 
 the injured part pour out a fluid under 
 the cuticle, which is raised into one or 
 more blisters. But when the skin has 
 been destroyed, no vesicles appear, but a 
 black dead slough. This is detached after 
 some time ; and as ore is seen more or less 
 deep, according to the degree of the in- 
 jury. When a large surface is burnt, 
 mortification sometimes makes its appear- 
 ance with great violence, very quickly 
 after the accident ; but in general, the oc- 
 cuiTence we have to fear, is great inflam- 
 mation, and consecjuent suppuration. In 
 many cases, the inflammation is not mere- 
 ly local, but gives rise to general fever, 
 requiring strong constitutional remedies. 
 Soon after an extensive burn, the patient 
 is affected with great nervous irritation, 
 and trembles violently ; there is coldness 
 of the surface, paleness of the skni, and 
 sometimes vomiting. The extensive sym- 
 pathy between the lungs and the skin as 
 
 excreting organs, renders an asthmatic 
 affection not an unusual attendant on 
 burns ; and from extensive burns the sto- 
 mach also is much affected. 
 
 Treatment. There is no part of sur- 
 gery on which there has been greater 
 difference of opinion, than the treat- 
 ment of bums; and even the remedies 
 popularly trusted to are very various. It 
 must be admitted, however, that while me- 
 dical writers have suggested applications, 
 absolutely pernicious in spite of all the 
 plausible theories with which they have 
 recommended them, the remedies known 
 among the people are only more or less 
 salutary ; and common sense has pre- 
 served them from the improper practice 
 of applying boiling water or turpentine, 
 to an injury requiring to be treated bv 
 far gentler means. It is not our inten- 
 tion to enter into any discussion of the 
 comparative merits of the different ap- 
 plications that have been recommended, 
 but simply to state what in general the 
 most judicious practitioners have found 
 to be successful. We shall first suppose 
 that a person has received a pretty ex- 
 tensive scald, and that assistance is 
 promptly at hand. Supposing the skin 
 unbroken, whether blisters are rising or 
 not, we would strenuously recommend 
 the instant application of cold to the in- 
 jured part. A ready mode of doing this, 
 is by adding one part of vinegar to one 
 part of water, taking a towel or many 
 folds of soft linen, dipped in this mixture, 
 and keeping it constantly wet to the part, 
 continuing this cooling treatment for a 
 longer or shorter period, according to the 
 continuance or abatement of the pain; 
 We have mentioned vinegar and water, 
 as a good means of applying cold, because, 
 besides its intrinsic excellence, it is gene- 
 rally at hand ; but supposing it not to be 
 readily got, we may attempt the same 
 effect by cloths soaked in cold water 
 alone, or spirits and water ; always on the 
 supposition that the injury does not de- 
 stroy the skin, or at most only the outer 
 skin. If there is a deep injuiy, any acrid 
 substance added to tlie water, as vinegar 
 
88 
 
 15 UK 
 
 BUT 
 
 or spirits, would be too painful to be 
 borne, and would only add to the irrita- 
 tion ; it is therefore better to use oily 
 applications, and of these the Carron Oil 
 is one of the most famous. It is made 
 by mixing equal parts of linseed oil and 
 lime water; this is to be plentifully 
 smeared on the place burnt, Avith a fea- 
 ther or hair pencil, and a single fold of 
 linen placed over it to prevent the access 
 of air. Immediately after the first ap- 
 plication of the cooling wash, or oily 
 matter, if the paleness and shivering be 
 great, a full dose of laudanum should be 
 given, proportioned to the age of the pa- 
 tient. During the cure, the diet should 
 be moderate ; and no strong drink allow- 
 ed, except perhaps a little wine and water, 
 or spirits, at first, as a cordial to assist in 
 restoring an equable heat to the system, 
 and to put an end to the depressed and 
 pallid state. In many cases, the applica- 
 tion of cold will accomplish the resolu- 
 tion or cure of the burn without further 
 trouble ; the skin will not rise in blisters, 
 and at the worst the outer skin will dry 
 and peel off. Or supposing blisters have 
 arisen, when the pain has ceased, they 
 may be pricked with a needle, and the 
 fluid allowed to escape, keeping the skin 
 on as long as possible. It may happen 
 that the pain abates, and the skin comes 
 off, leaving the part below in a state of 
 ulceration or suppuration; in this case, 
 emollient poultices are to be applied till 
 the suppuration appears inclined to cease, 
 and then the sores are to be dressed with 
 cerate, lard, Goulard's extract, or the 
 like. In the dressing of burns, care must 
 be taken to keep the raw surfaces from 
 contact, to prevent them from gi-owing to- 
 gether. Thus the fingers must all be dress- 
 ed separately ; joints should be extended 
 so as to prevent them from being perma- 
 nently bent; and the chin must be kept from 
 growing to the breast. It is a disagree- 
 able and frequent characteristic of burns, 
 that they are apt to be accompanied with 
 great rising of proud flesh, and to leave 
 unsightly scars, much above the level of 
 . the sldn. The rising flesh must be eaten 
 
 down by blue vitriol, by lunar caustic, or 
 other escharotics; and the new skin kept 
 to its level by proper bandaging and ad- 
 hesive plaster. When the clothes are 
 set on fire, or when, as too often hap- 
 pens, old persons intoxicated, or incapable 
 of taking care of themselves, fall into 
 the fire, deplorable consequences ensue. 
 Large eschars are formed and drop off, 
 extensive ulceration and exhausting sup- 
 puration take place, and death at a longer 
 or shorter period follows. We must dress 
 the sores with all the care and skill pos- 
 sible ; and support the strength with bark 
 and wine, and nutritious diet, to give the 
 constitution, if possible, the power of 
 supporting the copious discharge. 
 
 A remedy which has in some cases ap- 
 peared to do good, and has of late been 
 much celebrated, is to apply cotton to ex- 
 tensive burns. The good effects of this 
 are owing to its protecting the tender 
 nervous extremities of the injured part, 
 from the contact of the external air. As 
 formerly hinted, some practitioners have 
 adopted a theory to satisfy themselves 
 about the application of turpentine to 
 burns ; but as this practice has not yet 
 made its way beyond the profession, it is 
 unnecessary to caution the general reader 
 against its adoption. 
 
 BUTTER. An unctuous substance 
 obtained from the milk of animals, and 
 most plentifully from that of the cow. 
 It is got by long continued agitation, 
 which operation is called churning. It 
 is universally used as an article of diet ; 
 and when thinly spread upon bread, there 
 are few stomachs with which it disagrees. 
 Butter is used as a sauce to many articles 
 of food, and is frequently added to flour 
 to be baked into paste; and it is in this 
 way that it is too often used to excess ; 
 and though it does not produce effects 
 that are immediately apparent, it lays the 
 foundation of stomach complaints of the 
 greatest obstinacy. Its use is also very 
 apt to give rise to diseases of the skin, 
 very difficult to cure. Persons labouring 
 under stomach complaints should not use 
 much butter, especially when heated, a^ 
 
BUX 
 
 BUX 
 
 89 
 
 in buttered toast, muffins, &c. and those 
 subject to iuilammatory and gouty affec- 
 tions, should be sparing of the use of but- 
 ter in all its forms. It is a bad part of the 
 management of children, to pamper their 
 palates by frequently indulging them with 
 butter ; as it is apt to give rise to a gross 
 and unhealthy habit of body, character- 
 ized by the frequent appearance of boils 
 and other sores, dischai-ges from behind 
 the ears, &c. or eruptions on the head, 
 and other parts of the skin. Its immo- 
 derate use also occasions too great fulness 
 of the system ; and in the numerous ner- 
 vous and inflammatory diseases of child- 
 ren, it is the high fed and plump children 
 that are most frequently the severest suf- 
 ferers. Butter, when rancid, is peculiar- 
 ly unwholesome and disagreeable. 
 
 BUTTER-MILK. > The millc that re- 
 mains in the churn after the butter is ex- 
 tracted. There is not much nutritious mat- 
 ter in it, but it is useful as a cooling drink, 
 and may form a considerable pait of the 
 diet of children. 
 
 BUXTON WATERS. Warm mine- 
 ral springs at Buxton in Derbyshire, 
 which have been long celebrated for their 
 medicinal properties. The temperature 
 is 82°. In this spring there is a large 
 quantity of elastic vapour, that rises and 
 forms bubbles, Avhich pass through the 
 water, and break as soon as they reach 
 the surface. These bubbles have been 
 aiscertained to consist of azotic gas, mixed 
 with a portion of atmospheric air. From 
 
 its temperature, it is used as a bath, al- 
 though probably not much superior in its 
 virtues to common water ; but it forms a 
 bath very proper for delicate and irritable 
 habits. The cases which are said to de- 
 rive the greatest benefit from the exter- 
 nal use of Buxton water, are those in 
 which some limb is affected with loss of 
 action or sensation, from rheumatism, or 
 external injury. The internal use of the 
 water is of service in complaints of in- 
 digestion, and derangement of the ali- 
 mentary canal. The water often relieves 
 the heartburn, flatulency, and sickness ; it 
 increases the appetite, and gradually im- 
 proves the health. When first used, a 
 laxity of the bowels is induced, and this 
 is rather beneficial than otherwise ; but 
 costiveness is a more frequent effect. In 
 disorders of the kidneys and bladder, the 
 Buxton Avater is beneficial ; it is also re- 
 commended in gout ; but with the addi- 
 tion of some aromatic tincture. The 
 waters are not to be taken in cases where 
 tliere is a tendency to active inflamma- 
 tion. The quantity used is about two- 
 thirds of a pint an hour before breakfast, 
 and the same quantity between breakfast 
 and dinner. The water should be drank 
 after, and not before, bathing. Much of 
 the good to be derived from the Buxton 
 waters, is to be ascribed to the purity of 
 the air, to the relaxation from business, 
 to the picturesque scenery in the neigh- 
 bourhood of the Peak, and to the tine 
 season in which the M^aters are drank. 
 
 CAB 
 
 CAB 
 
 CABBAGE. Brassica capitata. A 
 plant, of which the leaves are used at the 
 table. Cabbages contain a peculiar es- 
 sential oil, which is the cause of the bad 
 smell of water in which they have been 
 boiled ; this oil is sometimes offensive to 
 the stomach. Some, therefore, recom- 
 nend to boil them in two waters ; that is, 
 when they aie half done, to take them out, 
 
 and put them directly into another sauce- 
 pan of boiling water. This removes tlie 
 hurtful ingredient, and renders them soft 
 and digestible. In some parts of the Con- 
 tinent, they have a mode of preserving 
 cabbage with salt and cai-away seeds, 
 which renders it very useful as a part 
 of sea-store on long voyages. See Sour 
 Crout. 
 
90 
 
 C AC 
 
 C AE 
 
 CACHEXY. A bad habit of body, 
 consisting of a want of vigour in the solid 
 parts, with an unhealthy state of most of 
 the fluids ; and showing itself in universal 
 languor, bad digestion, diminished heat, 
 strength, and activity. The skin is pale, 
 yellow, or dark ,* and the white of the eye 
 is bluish or pearly. Cachectic persons 
 ai*e easily tired, and have a difficulty of 
 breathing from very slight exercise ; they 
 are oppressed during sleep, and the urine 
 is white and turbid. Those who are 
 most subject to this bad state of body, 
 are those of a soft and lax habit, and of 
 the phlegmatic temperament ; women are 
 more subject to it than men. 
 
 Causes. The symptoms above enu- 
 merated, and some other signs of debility 
 occurring in various degrees, are gene- 
 rally to be considered as the indications 
 of some internal disease, most probably 
 some organic disorder of the parts con- 
 cerned in digestion, diseased stomach or 
 liver, or mesenteric glands. This bad 
 habit of body is often connected M'ith 
 fatal diseases, or passes into them, as 
 jaundice, dropsy, scurvy, or hectic fever. 
 It may be brought on by long continued 
 anxiety, a sedentary life, indulgence in 
 spirituous liquors, and too copious eva- 
 cuations. Sometimes we cannot say 
 that it is connected with any particular 
 disease, nor are we alt*'ays able to trace 
 its cause. 
 
 Treatment. We are to endeavour to 
 correct the bad quality of the fluids, to 
 strengthen the stomach, and to invigo- 
 rate the system. The diet, therefore, 
 should be nourishing and of easy diges- 
 tion, the quantity being proportioned to 
 the powers of the stomach to convert it 
 into wholesome chyle. It is a common 
 and hurtful error, to throw in a gi-eat deal 
 more food than the debilitated stomach 
 can manage. Thus its feeble powers are 
 still farther oppressed ; and the undigest- 
 ed food acts as a stimulant or purgative, 
 or excites vomiting and uneasiness which 
 the patient is ill able to bear. It would 
 ))e improper to specify any particular 
 articles of diet, as applicable to a state of 
 
 the liealth which presents so many dif- 
 ferent symptoms, and which may arise 
 from so many various causes ; what 
 would be good in jaundice or dropsy 
 might be injurious in scurvy, and Ave are 
 therefore to direct such aliments as are 
 suited to each case. (For the general 
 principles on which diet is regulated. See 
 Diet and Digestion.) Exercise should 
 be regular and constant, but never to the 
 extent of fatiguing the patient. The 
 bowels are to be attended to, and kept 
 regular by mild laxatives ; and bitters, 
 aromatics, and chalybeate medicines are 
 to be given. As purgatives, rhubarb and 
 aloes are useful in many cachectic cases ; 
 calomel and other forms of mercury are 
 also of service; especially in those cases 
 where there seems to be a hardness or 
 obstruction of the internal organs. 
 
 There is a species of cachexy, a bad 
 habit of body, incident to females, and 
 connected with irregularities of the 
 monthly discharge. It is commonly 
 known by the name of gre^n sicknesSy 
 and in medical language chlorosis; and 
 as it is an affection that requires great 
 care and skill in its treatment, we have 
 fully detailed its symptoms and manage- 
 ment under the article Chlorosis. 
 
 CADDIS. Scraped linen or lint used 
 for the dressing of sores. See Charpie. 
 
 CAESARIAN OPERATION. An 
 operation performed on parturient wo- 
 men, by which the foetus is taken out by 
 an incision made through the abdomen 
 and the sides of the uterus. There are 
 three cases in which this operation may 
 be necessary. 1. When the foetus is alive 
 and the mother dead, either in labour or 
 during the latter periods of pregnancy, 
 when the child would be likely to live 
 if delivered. 2. When the child is dead, 
 but cannot be delivered in the usual 
 w^ay, on account of the deficiency of 
 space in the passages. 3. When both 
 the mother and child are living, but, 
 from the same deficiency, the child can- 
 not be delivered in the usual way, with 
 safety to the mother. On each of these 
 cases we proceed to make some remarks. 
 
CiESARIAN OPERATION. 
 
 91 
 
 I. We may suppose a case to happen, 
 where sudden death overtakes a woman 
 near the end of her pregnancy. We are 
 sure that one life is gone, but that there 
 is a possibility of the child being pre- 
 served: or we may take the case of a 
 woman who dies in labour, before the 
 child is delivered. There is something 
 so horrid, in proceeding forthwith to cut 
 open the unfortunate woman, that Me 
 ought to be absolutely certain of saving 
 the child before we attempt it ; and this 
 can rarely be the case ; for what causes 
 the death of the mother is pretty sure 
 also to cause the death of the child ; and 
 if so, any operation on the mother would 
 be fruitless. If a woman has died in 
 labour, and if the uterus is in any mea- 
 sure dilated, we must attempt to deliver 
 by the natural passages. And if we de- 
 cide on attempting to extract the child, 
 we must proceed on a woman newly 
 dead, or supposed to be so, (for at least 
 one instance is recorded where the wo- 
 man, though apparently dead, was not so) 
 with the very same precautions as if we 
 were operating on the living body. 
 
 II. A cause which may make it neces- 
 sary to have recourse to the Caesarian ope- 
 ration, is such a contracted state of the 
 various diameters of the pelvis, as renders 
 them ingufficient to allow the head of the 
 child to pass. The size of the head varies 
 much in different children ; and the su- 
 tures of the head being soft and yielding, 
 the bones are allowed to overlap one 
 another in some measure ; but it is ac- 
 knowledged, that unless the head can be 
 forced into a space not more than three 
 inches in one direction, nor more than 
 two inches in another, delivery is impos- 
 sible. Such are the dimensions which can 
 by possibility pass through a pelvis ; and 
 we have to ascertain in each case, whether 
 the pelvis is large enough to allow the 
 head to pass. Various compasses have 
 been invented for making this measure- 
 ment ; but it is a matter of great difficulty 
 to apply them, and the information ob- 
 tained is by no means satisfactory. As 
 the judgment of this point will always be 
 
 left to professional men, we shall not 
 enlarge this article by minute technical 
 details ; but proceed to inquire in what 
 cases we are to perform the Caesarian 
 section if the child be dead. It is not 
 easy to ascertain whether a foetus be dead 
 or not. K after being affected with vio- 
 lent motion, it has ceased to move, it is in 
 all probability dead. But we are not to 
 trust to this, but to employ manual exa- 
 mination. One method of this examina- 
 tion is, to press upon the womb firmly 
 through the Avails of the abdomen; 
 and this pressure will cause the child to 
 move, if it be in life. Another method 
 is, to press upon the uterus externally, at 
 the same time making corresponding 
 pressure with the fingers of the other 
 hand. If no certain indications are given 
 this way, the membranes must be rup- 
 tured, and the hand inti'oduced into the 
 uterus ; a finger or two placed over the 
 region of th« heart to examine whether 
 it be beating; and also to examine whe- 
 ther there is any pulsation in the umbi- 
 lical cord. When we cannot perceive 
 any signs of life by any of these methods, 
 we are to conclude that the -child is dead, 
 and are to extract it; but if the hand 
 cannot be introduced into the uterus, we 
 must, if we deliver at all, do it by the 
 Caesarian operation. 
 
 III. That both mother and child have 
 lived, when the latter has been brought 
 away by the Caesarian operation, has 
 been abundantly ascertained, at least on 
 the Continent ; but in Britain, with only 
 one exception, the operation has uniform-r 
 ly proved fatal to the mother. The 
 causes of the greater success of the Con-: 
 tinental practitioners are supposed to be 
 some of the following: 1. They are not 
 so long of having recourse to the opera- 
 tion. 2. The less frequent use of animal 
 food and of strong liquors, predispose^ 
 women less to inflammatory attacks. 
 When Dr. Hull wrote, 231 cases were 
 recorded of the operation; of which 139 
 were successful. The operation is now 
 commonly performed in the following 
 manner : Some advise the incisioi^ to be 
 
92 
 
 C AL 
 
 CAL 
 
 made in the middle line of the belly; 
 others recommend it to be made trans- 
 versely, in the direction of the fibres of 
 the trans versalis muscle. Mr. Burns of 
 Glasgow prefers the transverse incision. 
 The length ought to be about six inches ; 
 and if there is any large vessel cut, it is 
 proper to tie it before proceeding farther. 
 The uterus is next to be opened by a 
 corresponding incision, and the child is 
 to be extracted, and immediately after- 
 vv^ards, the placenta. One assistant is to 
 take charge of the child, and another to 
 prevent the protrusion of the intestines. 
 As the operation is seldom had recourse 
 to, till there are symptoms of the uterus 
 contracting itself, we may generally 
 trust to those contractions of the uterus 
 to check any bleeding from it ; and we 
 are to bring together the sides of the 
 external wound, and to keep them in 
 contact by a proper number of stitches 
 passed through the skin and muscles, 
 but avoiding the peritoneum. Adhesive 
 plasters are to be applied where there 
 are no stitches; and a bandage with a 
 soft compress is to be put on. An opi- 
 ate in a full dose should be given ; and 
 great care must be taken afterijvards to 
 prevent inflammation, as well as the loss 
 of blood, and the access of the external 
 air. 
 
 CAJEPUT OIL. A volatile oil of a 
 greenish colour, with a smell resembling 
 camphor and turpentine, said to be ob- 
 tained from the Melaleuca Leucodendron. 
 It is a powerful medicine, and much es- 
 teemed in India in painful chronic dis- 
 eases. Taken into the stomach in doses 
 of five or six drops, it is heating and sti- 
 mulating, and also diaphoretic. It is 
 thought useful in various convulsive and 
 spasmodic complaints. It has also been 
 used both internally and externally in 
 palsies, rheumatism, gout, toothachs, deaf- 
 ness, and in hysterical and hypochondri- 
 acal affections. It is said to be destructive 
 to the insects which infest the collections 
 of natural historians. 
 
 CALAMINE, Carbonate of Zinc ; an 
 ore of that metal, and an article of the 
 
 materia medica. It is roasted and calcined, 
 to free it from any arsenical or sulphur- 
 ous particles it may contain ; and, when 
 properly prepared, it is used in certain 
 eye ointments; and dusted on moist 
 ulcers, to prevent the spreading of the 
 acrid matter. It is also the basis of the 
 useful cerate, commonly known by the 
 name of Turner's cerate. 
 
 CALCINATION. When certain metals 
 are exposed to a strong heat, they lose 
 their lustre and metallic properties, and 
 are converted into an earthy-looking sub- 
 stance, formerly called calx, and the metal 
 was said to be calcined. Modem chemis- 
 try has ascertained that the metal in this 
 process attracts oxygen from the air ; and 
 hence the term calcination is changed in 
 the case of metals into oxidation. But se- 
 veral other substances are often exposed 
 to heat, in order to drive oflf some of their 
 component parts ; and to them the term 
 calcination is still applied. Thus, Avhen 
 the carbonic acid is expelled by strong 
 heat from the carbonate of magnesia, the 
 residue is said to be calcined magnesia • 
 or when the water of crystallization is 
 driven off from alum, the alum is said to 
 be calcined. 
 
 CALCULOUS DISEASES. S3e 
 Stone. 
 
 CALENTURE. A name formerly 
 given to a species of fever occun-ing in 
 warm climates ; one celebrated symptom 
 of which is, that seamen affected with it 
 are seized with high delirium; and imagin- 
 ing the sea to be a beautiful extended 
 plain, in their ardour to enjoy the scene, 
 throw themselves overboard. 
 
 CALFS-FOOT JELLY. An article 
 of diet, made by confectioners, and also 
 in domestic cookery, by extracting the 
 gelatinous portions from the tendinous 
 structures of the feet and knee-joints o* 
 the calf, by long boiling ; and adding to 
 the jelly thus obtained, a quantity of su- 
 gar, wine or oil, and spices. It is grate- 
 ful to the palate, and easily digestible; 
 hence it is a useful aj-ticle in the diet of 
 convalescents, and may be taken cold, or 
 dissolved in warm water, according to cir-» 
 
CALOMEL. 
 
 93 
 
 cumstanccs. In inflammatory states of 
 the system it is improper. 
 
 CALLOUS, a term applied tp the hard 
 and insensible edges of sores. 
 
 CALLUS, the substance thrown out 
 by the extremities of broken bones. On 
 this subject, there used to be very strange 
 theories among the older surgeons. They 
 believed it to be an inorganic substance, 
 a fluid poured out from the vessels at the 
 ends of broken bones, which was soon 
 hardened into bone. It was supposed to 
 flow sometimes too sparingly, sometimes 
 too abundantly; and many contrivances 
 were invented to compress, and to keep 
 do^\Ti the exuberant supply. Physiolo- 
 gists have now juster notions on the sub- 
 ject ; and are agreed that callus is a re- 
 production of new and perfect bone, fur- 
 nished with arteries, veins, and absor- 
 bents ; and in which the same processes 
 go on as in the original healthy bone. 
 Many still suppose, that a very slight mo- 
 tion M^ll destroy a callus, which is about 
 to foi-m. But though we would not un- 
 necessarily disturb a broken bone, there 
 is no reason to fear this disunion ; for 
 when callus begins to be formed, the 
 arteries near the fracture pour out a gela- 
 tinous matter, in which the vessels expand 
 and multiply, till they form, between 
 the broken ends, a well organized and 
 animated mass, ready to begin anew the 
 formation of bone by secretion ; in the 
 same way as the various parts of the 
 living system secrete from the circulating 
 fluids, the materials for their own growth 
 and preservation. For some time, though 
 the young bone has the proper organiza- 
 tion, it is soft, delicate, and unconfirmed. 
 The vessels are more numerous in callus 
 than in old bone ; and hence a broken or 
 bent callus unites more readily than a 
 fractui'ed bone. 
 
 CALOMEL. A preparation of mer- 
 cury; and one of the very best products 
 of that remarkable and useful mineral. 
 It is a compound of the black oxide of 
 mercury with muriatic acid, the acid be- 
 ing in less quantity than is sutficient to 
 neutralize the base ; or according to the 
 
 more modem view, it is a chloride of 
 mercury. It may be prepared in either of 
 the two following ways : 1. By taking a 
 quantity of corrosive sublimate and pure 
 quicksilver, and triturating them together 
 till the quicksilver is extinguished, then 
 subliming. The white matter near the 
 neck of the retort, and the red matter at 
 its bottom are to be thrown away; and 
 the rest to be again sublimed, and carefully 
 washed, to free it from any portion of 
 corrosive sublimate; Avhich is easily ef- 
 fected, as the one is soluble in water, and 
 the other not. 2. Calomel may also be 
 prepared by precipitation, first prepai'ing 
 the nitrate of mercury, then dissolving 
 muriate of soda, (common salt) in boiling 
 water, and to this adding the nitrate of 
 mercury. An exchange of component 
 parts takes place, nitrate of soda remains 
 in solution, and submuriate of mercury is 
 precipitated. This is to be very carefully 
 and repeatedly washed. 
 
 Calomel is one of the most useful mer- 
 curial preparations we have. It is prin- 
 cipally used as a purgative ; and there are 
 few purgatives more convenient. It may 
 be administered to patients of every age, 
 and in n great variety of complaints. It 
 is a medicine which, on account of its 
 efficacy in a very small bulk, and having 
 no nauseous taste, is excellently adapted 
 for children. To infants from a few 
 weeks to a year old, it may be given in 
 doses of from half a grain to two grains, 
 according to their age. Though it is thus 
 so safe and manageable a purge, it is to 
 be observed, that it is not to be rashly 
 given nor obstinately persisted in; but we 
 must never forget that it is a preparation 
 of mercury; and as this active mineral, 
 if not carefully administered, may prove 
 a poison instead of a remedy, it ought to 
 be alternated with some purgative of quite 
 a different character ; and given only oc- 
 casionally, and at intervals. Suppose a 
 child six months old to be afllicted with 
 slimy stools, scanty in quantity, and cos- 
 tive; to have occasional vomiting, heat 
 and restlessness ; we might prescribe, for 
 three nights successively, one gi*ain of 
 
94 
 
 C A LOMEL. 
 
 calomel nuxed with a little pounded su- 
 gar, and on the morning- of the fourth 
 day, a tea spoonful of castor oil; if the 
 complaint continues, the same plan may 
 be repeated four or five days after. As 
 mercury is apt to exert its peculiar action 
 on the mouth, we must be careful not 
 to order it in cases of thrush and ulcera- 
 tion of the mouth, to which children are 
 subject. In disorders of the dig'estive 
 organs in children, accompanied with wast- 
 ing, pale colour, picking of the nose, and 
 the symptoms commonly supposed to in- 
 dicate worms, two grains of calomel, with 
 five of rhubarb, given every day, or in 
 some cases twice a-day, for five or six 
 days at a time, and then intermitting for 
 a week, contribute much to bring back a 
 healthy state of the system. When the 
 child is really troubled with worms, espe- 
 cially the long round worm, or the small 
 white ones, three grains of calomel, with 
 six or eight of jalap, form a good vermi- 
 fuge ; this may occasionally have a grain 
 or two of scammony or aloes added to it. 
 In croup, it was at one time thought to 
 be a very efficient practice, to give calomel 
 to the amount of five grains every hour, 
 even till a hundred grains were taken in 
 a day ; but this practice does not seem to 
 have kept its ground ; as croup requires 
 very active treatment for its inflammatory 
 and spasmodic symptoms, and cannot 
 wait for the mercurial action of calomel; 
 nor does there seem any specific power 
 in calomel against croup. In inflamma- 
 tion of the bowels, it has been recom- 
 mended to give doses of calomel so large 
 as twenty or thirty grains; but there 
 seems no peculiar advantage in this 
 plan ; indeed many practitioners have 
 doubts whether any effect whatever re- 
 sults from such doses. When we wish the 
 purgative effects of calomel in an adult, 
 the best way is to combine it with jalap, 
 rhubarb, scammony, or the extract of co- 
 locynth : five grains of calomel to fifteen 
 of jalap or rhubarb, or eight of scammony 
 or aloes, (increasing the quantity of both 
 ingredients if necessary) form a very va- 
 luable purge. In disorders of the stomach 
 
 and bowels, accompanied with a deficiency 
 of bile, small doses of calomel have an 
 excellent effect ; even two grains, in some 
 cases, have power so to stimulate the ex- 
 tremity of the duct which conveys the 
 bile into the intestines, as to bring on a 
 plentiful discharge of bile, by which a sa- 
 lutary evacuation is produced. In what 
 is called sick headach, a dose of calomel 
 one day, followed up by a dose of Epsora 
 salts or compound powder of jalap on the 
 next, gives great relief. Calomel is fre- 
 quently employed with the intention of 
 introducing mercury into the system; and 
 for this purpose, the dose is one grain, or 
 two, taken night and morning ; and it is 
 administered very conveniently in form 
 of a pill. To prevent its passing off by 
 the bowels, as even in this small dose it 
 is in some cases apt to do, it is proper to 
 conjoin a small quantity of opium with 
 each pill, as half a grain ; taking care to 
 obviate costiveness by the occasional use 
 of suitable purgatives. It would be diffi- 
 cult to enumerate the great variety of 
 diseases in which calomel is used ; they 
 may in part b6 understood, from the ge- 
 neral purposes which we have men- 
 tioned it as fulfilling, viz. a piirg-ative 
 and a mercurial effect; but it appears 
 possible to cause it also to act on the 
 kidneys, by combining it with dim-e* 
 tics; hence, it is used in combination 
 with squill, in some species of dropsy. 
 
 In the liver complaints of the East In- 
 dies, calomel is the sheet anchor of 
 practitioners. Much of the good ex- 
 pected from calomel, or any other form 
 of mercury, in this disease, will certainly 
 be frustrated, if it be given in too early 
 a stage of the malady, or when the in- 
 flammation is still of the active kind ; as, 
 from the stimulant effects of mercury, it 
 ■will probably add to the violence of the 
 inflammation, and hasten the process of 
 suppuration. The activity of the inflam- 
 mation must be subdued by bleeding, and 
 the other parts of the antiphlogistic regi- 
 men ; and if there remains a dull heavy 
 pain, with enlargement and hardness of 
 the liver, and derangement of the digestive 
 
e A M P H O R. 
 
 0S 
 
 powers, then is the proper time to com- 
 inence the giving of calomel, in doses of 
 one or two grains ; not however trusting 
 to its powers as if they were specific, hut 
 interposing other purgatives, and palliat- 
 ing febrile or other symptoms as they 
 arise. Some of the Indian practitioners 
 give calomel very early and in large doses, 
 four or five grains every foiu* hours, and 
 as they say with great relief; not in pro- 
 portion to the purgative eft'ects produced, 
 (for the evacuation of the bowels by 
 other means has no such effect,) but in 
 consequence of its procuring the discharge 
 of great quantities of bile, and thus re- 
 lieving the pain and distension of the 
 liver. 
 
 CALORIC. A name invented by the 
 French chemists, to express the cause or 
 matter of heat, Avhatever it is ; and to 
 supply, in philosophical inquiries, a terra 
 different from the sensation excited in 
 living beings, or the effects produced on 
 inanimate substances. Thus we say ca- 
 loric expands bodies, and imparts heat 
 or warmth to our frame. See Heat. 
 
 CALX, the Latin name for lime ; and 
 also a term in the older books of chemis- 
 try, for the state into ^hich most metals 
 are brought, by exposure to a strong heat 
 and the free access of air. See Lime and 
 Calcination. 
 
 CAMPHOR. A substance obtained 
 by distillation from a species of laurel 
 which grows in great abundance, and to 
 a considerable size, in the forests of Japan ; 
 the Laurus Camphora. All the parts of 
 the tree smell strongly of camphor ; and. 
 to procure that substance, they are cut 
 down into small pieces, and put into a 
 still with a quantity of water. After the 
 water has been kept boiling for forty- 
 eight hours, the camphor is found adher- 
 ing to the straw with which the head of 
 the still is lined. In this sta;te it is grey, 
 and mixed with straw and other impuri- 
 ties. It is purified by a second sublima- 
 tion in glass vessels. Pure camphor is 
 lighter than water, white, unctuous to 
 the feel, tough, and with difficulty re- 
 duced to powder. It has a bitter, aro- 
 
 matic, pungent taste, accompanied with 
 a sense of coolness ; its smell is strong, 
 but agreeable ; it is very volatile and in- 
 flammatory. It is soluble in alcohol and 
 ether. It is found in so many different 
 plants, that it is considered as one of the 
 peculiar principles of vegetables. 
 
 Camphor is a substance of considerable 
 activity when taken into the stomach. 
 It increases the heat of the body; and 
 tends to promote perspiration, without 
 producing much effect on the pulse, ex- 
 cept in large doses, when it softens it, 
 and renders it fuller. There has been 
 considerable diversity of opinion as to the 
 effects of camphor ; and this may be ac- 
 counted for by reflecting, that some a.s- 
 sertions refer to its effects in small doses, 
 soon after its exhibition; wliile others 
 refer to its subsequent effects, when 
 given in larger doses. At first it stimu- 
 lates, but afterwards there is depression. 
 It has been used in various diseases of 
 languor and oppression, as in fevers of 
 the typhoid kind; in rheumatic fevers 
 with much debility, in eruptive diseases, 
 as small-pox and measles, when the rash 
 has disappeared too suddenly. It has 
 been used as an antispasmodic in convul- 
 sions, hysterics, and hiccup. Camphor 
 is useful in peritonitis, (inflammation of 
 the membrane investing the bowels,) 
 whether it occurs in men, or in women in 
 the child-bed state ; the antiphlogistic 
 practice, of course, being employed at 
 the commencement of the disease. Per- 
 sons w^ho cannot procure sleep except 
 from large doses of opium, will sometimes 
 succeed by combining smaller doses with 
 camphor. Camphor may be usefully 
 added to various other medicines; to 
 bark, in typhoid diseases; to valerian, 
 musk, assafetida, &c. in spasmodic com- 
 plaints ; and to antimonials, and other 
 diaphoretics. With regard to its dose, 
 and the best way of exhibiting it, as a 
 iey/ drops of alcohol enable us to reduce 
 it to powder, it may be given in the form 
 of pills ; from two to five grains of cam- 
 phor being administered every four hours, 
 till its effect is produced, viz. of allaying 
 
96 
 
 CANCER. 
 
 irritation, rendering the pulse fuller and 
 softer, and occasioning a gentle perspira- 
 tion. In larger doses, as of twenty to 
 thirty grains, it is apt to produce vomit- 
 ing, giddiness, and other unpleasant ef- 
 fects. Camphor may be administered in 
 the form of emulsion, made by rubbing 
 camphor, sweet almonds, and sugar with 
 water, till the camphor is suspended 
 equally through the mixture. A scruple 
 of camphor, with two drachms of sweet 
 almonds, one drachm of sugar, and six 
 ounces of peppermint water, forms au 
 emulsion, of which one or two table- 
 spoonfuls are to be taken every two 
 or three hours. It may be given in 
 powder mixed with sugar or magnesia ; 
 or the tincture njay be used ; half a 
 drachm with an equal quantity of com- 
 pound spirit of lavender, and added to an 
 ounce of mucilage, is a proper quantity 
 for a draught. Oil dissolves camphor, 
 and thus furnishes the means of apply- 
 ing it externally, in cases of rheumatic 
 pains, of indolent swellings, &c. Cam- 
 phor is sometimes added to mercurial 
 ointment, to increase its stimulant and 
 deobstruent effects. 
 
 CAN CER. The subject of this article 
 is one of the highest importance, whether 
 we consider the dreadful sufferings attend- 
 ing the disease, the interesting character 
 of the sex who are the most frequent 
 Tictims of it, or the variety of remedies 
 which have been proposed and abandoned. 
 This is a disorder which above all others 
 has called forth the quackery of nume- 
 rous impostors, who by their extravagant 
 praise of various remedies, have deceived 
 the hopes of the credulous and miserable. 
 With unblushing impudence, empirics 
 have published their success in M'hat ap- 
 pefired the most hopeless circumstances ; 
 and race after race of hapless sufferers 
 have found reason to deplore their bitter 
 disappointment. 
 
 Cancer is of two kinds, the occult or 
 scirrhous, and the open or ulcerated; 
 but these may be more properly regarded 
 as different stages of the same disease. 
 By occult cancer or scirrhus, is meant a 
 
 hard tumour, for the most part accom- 
 panied by sharp darting pains, which recur 
 more or less frequently. This tumour, 
 in course of time, breaks and ulcerates ; 
 and then is more strictly denominated 
 cancer. The parts of the body subject 
 to cancer are the following : The female 
 breast and uterus, (See Womb and its 
 Diseases) the lips, especially the lower 
 one, the tongue, the skin, the tonsils, the 
 lower opening of the stomach, and some 
 other parts chiefly glandular. Chimney 
 sweepers are subject to a cancerous affec- 
 tion of the scrotum. (See Scrotum.) 
 
 Of these organs, it attacks most fre- 
 quently the female breast ,* and, as in this 
 part the disease has been the most accu- 
 rately investigated, the remainder of this 
 article shall be chiefly devoted to the de- 
 scription of cancer as it appears in that or- 
 gan. In general, cancer begins at a small 
 spot, and extends from thence in all direc- 
 tions. Its progress is more or less quick in 
 different instances ; and very able writers 
 think, that when cancer has once begun, 
 it may be checked, though it will not 
 be removed, by the means which are em- 
 ployed to discuss other swellings. Others 
 again believe, that in some cases they have 
 succeeded in completely dispersing tu- 
 mours, which had all the appearance of 
 being cancerous. In general, it is too 
 true, that scirrhus is seldom or never dis- 
 persed ; and that it brings the neighbour- 
 ing parts, whatever their nature may be, 
 to put on the same diseased action ; and 
 thus the skin, the muscles, the cellular 
 substance, are all involved in the same de- 
 structive process. In consequence of this 
 morbid action, the skin above a cancerous 
 tumour becomes attached to it, and the 
 tumour is also attached to the muscles 
 below. The tendency to this unhealthy 
 action begins in the neighbouring parts, 
 even before it can be distinctly seen ; of 
 which the melancholy proof is, that if 
 the tumour be cut out, the disease will 
 reappear in those neighbouring parts ; and 
 hence the necessary rule in operating, to 
 take away a considerable portion of the 
 surrounding substance. As the swelling 
 
CANCER. 
 
 97 
 
 increases, it becomes knotty and unequal 
 on its surface, and this inequality has 
 been considered as characteristic of the 
 disease ; almost in every case, a darting- 
 pain is experienced. The hard swelling- 
 which is likely to terminate in cancer, is 
 attended g-enerally by the following- as- 
 semblage of symptoms : The skin is puck- 
 ered and of a dull livid colour, the part 
 is knotted and uneven, occasional darting 
 pains shoot through it ; it is attached to 
 the skin above, or to the muscles beneath ; 
 and in some cases, there is a peculiar un- 
 healthy look about the patient. When 
 the swelling is moved, the whole breast 
 moves along with it. The structure of 
 the swelling is different in the various 
 stages of the disease. In the first stage, 
 the following appearances present them- 
 selves : The centre is more compact, 
 harder, and of a more uniform texture 
 than the rest of the tumour, and appears 
 almost like gristle. From this centre, 
 naiTow 'white ligamentous bands stretch 
 out like rays in every direction. In the 
 spaces between those bands, the substance 
 is different, and becomes less compact 
 towards the outer edge. When the dis- 
 ease is further advanced, the Avhole of 
 the diseased part has a more uniform 
 structure, there is no conspicuous central 
 point ; the external edge is more defined, 
 and distinct from the surrounding gland, 
 and the ligamentous bands in different 
 directions are very apparent. When the 
 tumour has advanced to that state corre- 
 sponding to suppuration in other sores, its 
 appearance is then totally different from 
 that formerly described. In the centre 
 is a small irregular cavity, filled with a 
 bloody fluid, and the edges of this cavity 
 are ulcerated, jagged and spongy ; beyond 
 these, there is a radiated appearance of 
 ligamentous bands, diverging towards the 
 circumference j but the tumour near the 
 circumference is more compact, and is 
 made up of distinct portions, each of 
 which has a centre, surrounded by liga- 
 mentous bands. 
 
 It is not easy to say, what peculiarity 
 of constitution is most subject to cancer; 
 
 nor why, in some women, a slight blow 
 on the breast should give rise to that fa- 
 tal hardness which is to degenerate into 
 cancer, while in others, an injury much 
 greater shall produce no bad effects. la 
 many cases, no preceding local injury can 
 be traced as the cause of cancer ; but the 
 patient is affected with an irregularity 
 or disappearance of the monthly dis- 
 charge ; and cancer frequently appears at 
 that time of life when the monthly dis- 
 charge ceases. Cancer, however, is not 
 confined to any period of life ; and even 
 children have suffered from it. It has 
 also occurred in the breasts of men. 
 
 There is a disease resembling cancer, 
 which attacks different parts of a glan- 
 dular structure ; as, for instance, the lips 
 and the sides of the nose. It is an eat- 
 ing sore which is uniformly progressive ; 
 but it differs from cancer in not contami- 
 nating the neighbouring parts, nor affect- 
 ing the absorbent glands and skin at a 
 distance from it. Unlike cancer, it in 
 various instances admits of a cure, by 
 several modes of treatment. 
 
 Cancer in the state of ulceration. The 
 diseased skin covering a cancerous tu- 
 mour, generally ulcerates before the tu- 
 mour is very large ; a considerable open- 
 ing ensues, and a discharge of a sharp 
 ichorous matter takes place, with great 
 rapidity. Sometimes it appears as if this 
 diseased action were disposed to stop, and 
 there is a growth of flesh, which in some 
 cases is even cicatrized ; but though there 
 may be occasionally a little mitigation, 
 and the disease may for a time appear 
 stationary, yet it never altogether ceases ; 
 nor do the parts show any tendency to 
 put on a healthy action. In the mean 
 time, the absorbent vessels take up the 
 poisonous matter, and convey it to their 
 glands. These become affected in the 
 same manner as the original sore; and 
 if the patient \i'ere not to be cut oft', we 
 should see in various parts of the body, 
 numerous centres of malignant disease. 
 The pain and irritation are now extreme, 
 the sufferings wearing out and distress- 
 ing; chains of glands are hard, painful. 
 
CANCER. 
 
 and lancinating; and by their swelling-, 
 they obstruct the passage of the fluids 
 through them, and cause the limb to be- 
 come dropsical. A leaden lividness appears 
 in the countenance, the sleep is impaired, 
 emaciation follows, and the long-conti- 
 nued suffering impresses on the face the 
 living picture of anguish and despair. 
 Towards the end of the disease, there is 
 often a cough and difficulty of breathing. 
 The edges of a cancerous ulcer are hard, 
 ragged, and unequal ; very painful, tvu-ned 
 in various directions, sometimes upwards, 
 and at other times towards the sore itself. 
 The surface of the sore is uneven, some- 
 times there are risings, sometimes there 
 are deep hollows. The discharge is com- 
 monly thin, dark-coloured, and ill-smelled, 
 and so acrimonious as even to corrode 
 the neighbouring parts. Sometimes, from 
 the sheath of the blood-vessels and their 
 coats being corroded, a great deal of blood 
 is lost. The darting pains which were 
 present at the beginning of the disease 
 are now still more distressing ; and one of 
 the most painful symptoms is the burning 
 heat felt all over the ulcerated part. 
 
 Treatment. A disease accompanied 
 with such lamentable circumstances, oc- 
 curring so frequently in the female sex, 
 and so frequently baffling all attempts for 
 its cure, has necessarily called forth many 
 anxious inquiries into its nature, and the 
 best method of treating it. Of the mor- 
 bid action which takes place in cancerous 
 swellings and ulcers, there seems to be 
 nothing satisfactory known. It is a sub- 
 ject of considerable interest, whether 
 cancer is an affection of the constitution, 
 or if it is merely local ; as on the decision 
 of this question, will depend the propriety 
 of performing an operation or not. If by 
 cutting out one tumour, we merely re- 
 move one diseased portion, and if the 
 malady is probably only to show itself 
 with greater fierceness in another part, 
 then we should certainly spare our pa- 
 tients the terror of the knife ; but if the 
 constitution be upon the whole sound, 
 we ought surely to remove any tumour, 
 which we have reason to think would, in 
 
 a little time, put on the hoiTid sjinptoms 
 of so destructive a disease. It would be 
 a long and a heartless task, to enumerate 
 all the schemes, proposals, and remedies 
 that hiive been suggested for cancer : the 
 endless list is itself a proof, that nothing 
 has yet been discovered that is entitled 
 to our confidence. Supposing a woman 
 with a hard swelling of the breast, to 
 apply to a surgeon for advice, his opinion 
 will depend on the preceding cause of the 
 swelling, whether it was in consequence 
 of a blow, whether from the suppression 
 of milk, or from cold ; whether it has 
 continued long ; whether it is knotty and 
 unequal ; whether the skin is puck-ered ; 
 whether there are acute and darting pains 
 shooting through it. It is a safe practice, 
 to apply to all tumours on the breast, a 
 number of leeches, and to procure a free 
 discharge of blood by means of them ; to 
 rub the tumour with warm oil, either 
 simple or camphorated, or v»'ith iodine 
 ointment ; to keep the bowels open, and 
 to attend to the general health. These 
 means should be persevered in for some 
 time, and we shall find some tumours at 
 first very unpromising, disappear at last 
 under this treatment. If we find, after conti- 
 nuing our trial a reasonable time, of which 
 the attending practitioner in eveiy indi- 
 vidual case must judge, that no progress 
 towards amendment is made, but that 
 there is every reason to fear, that a scir- 
 rhous tumour and open cancer will ulti- 
 mately be the result, there is no resource 
 left, but to submit to the removal of the 
 part, before the latent mischief has spread, 
 and become irrepressible. As to the 
 method of removing the tumour, two have 
 been proposed, either by the knife or by 
 caustic. The operation by caustic, though 
 it may be agreeable to the timidity and 
 prejudices of some, is in reality a far more 
 fonnidable way of removing the tumour, 
 than the knife is. The pain is indeed much 
 greater ; and the probability is, that it will 
 excite an inflammatory action, which will 
 quickly bring the tumour into the state 
 of ulceration. It often requires repeti- 
 tion, and the great length of time neces- 
 
CANCER. 
 
 99 
 
 sary in some cases, for tlie separation of 
 tlie dead parts, renders it very tedious. 
 Mr. Pott describes, with ^eat indigna- 
 tion, another bad effect from the attempt 
 at removing by caustic, viz. the plausible 
 pretences it g-ives to quacks for sajang, 
 that they have removed the cancer by 
 their applications. He says, that " the 
 ragged appearance which the bottom and 
 sides of the parts make, after having been 
 removed by the application of caustic, is 
 so unlike to the smoothness of that which 
 has been removed by incision, that igno- 
 rant people are easily induced to believe, 
 what the designing always tell them, viz. 
 that the medicine has taken their disease 
 out by the roots, and that the ragged 
 parts which they see, are such roots. 
 When nurses and quacks talk of the 
 fibrous roots of a cancer, and of cancerous 
 fermentations, they are excusable, the one 
 from their ignorance, the other from the 
 nature of their trade ; but when they who 
 pretend to some kind of medical know- 
 ledge use this kind of language, it is 
 shahieful." K we have decided to remove 
 a cancerous tumour, the knife is, of all 
 means, the simplest, the safest, and the 
 best; and though we cannot always se- 
 cure the patient against a return of the 
 complaint, yet if the operation be timely 
 performed, there is reason to hope, that 
 except in very bad constitutions indeed, 
 the patient may get rid of this very de- 
 plorable malady. When it does recur, 
 it is too often in consequence of some of 
 the diseased parts having been left behind, 
 or the too long delay of the operation. 
 Some deny altogether the existence of 
 any constitution which may be termed 
 cancerous ; yet it certainly does happen, 
 that the disease recurs in cases where we 
 have every reason to believe, that the 
 injured parts have been freely and com- 
 pletely removed. When cancer affects 
 any other part than the breast, its re- 
 moval must be attempted by the methods 
 proper for operating on that part. 
 
 Though little good is to be done by 
 any external application, it may not be 
 useless to mention shortly, what has been 
 
 proposed, and to state \^'hat things ought 
 not to be done. Hemlock has been a good 
 deal employed, on the recommendation of 
 Dr. Stoerk, of Vienna. He had great con- 
 fidence in it, but other practitioners have 
 not found it to give even a temporary 
 relief. It may do some little good as a 
 narcotic, in allaying pain, and procuring 
 a slight suspension of the irritation ; but 
 as to any power it has of an ultimate 
 cure, it is utterly worthless. The way of 
 using it has been, to begin with a small 
 dose, and gradually to increase it, till gid- 
 diness is produced. Two grains of the 
 extract, now called the inspissated juice, 
 or three grains of the powder taken twice 
 a-day, is the dose to begin with ; and at 
 last, some patients have been able to take 
 an ounce of the extract daily, but with no 
 good effect. Belladonnuy or the deadly 
 nightshade, has also been used witTi 
 equally bad success. The dose at first is 
 a grain of the dried leaves night and 
 morning. HyoscyamuSy or henbane, be- 
 ginning ^vith two grains of the extract, is 
 another remedy, but equally ineflScacious. 
 Digitalis, or fox-glove, by diminishing 
 vascular action, has some slight effect, 
 merely as bleeding or spare diet has; but 
 has no peculiar power at all over cancer. 
 Opium, in this irritating complaint, is 
 frequently used to allay pain ; though no 
 more capable than any thing else, of ef- 
 fecting a cure. All the articles just men- 
 tioned are of a narcotic quality, and it is 
 probably from their giving some slight al- 
 leviation, that remedies of this class have 
 obtained any notice in this intractable 
 disease. Mercury, so efficacious in a great 
 variety of diseases, has also been tried in 
 cancer ; but so far from doing good, it is 
 sure to aggravate the symptoms, especial- 
 ly in the ulcerated state. Arsenic was 
 at one time thought to have great and 
 specific powers in cancer ; and many prac- 
 titioners yet have hopes, that if a remedy 
 is to be found, it is to be in some prepjj/- 
 ration of this mineral. The mode of ad- 
 ministering this dangerous substance will 
 be found under Arsenic; and the precau- 
 tions necessary even in its application in 
 
 ^ 
 
100 
 
 CAN 
 
 CAN 
 
 the form of plasters, &c. 7/on, in various 
 forms, has heen used and much extolled 
 by Mr. Carmichael of Dublin, for the cure 
 of cancer. He has made much use of the 
 carbonate of iron, what is well known by 
 the name of rust, in the quantity of thirty 
 grains in the course of a day, in divided 
 doses. He has also used the tartrate and 
 phosphate of iron. In many constitu- 
 tions, the preparations of iron are apt to 
 bring on costiveness, with headach and 
 affection of the breathing : these symp- 
 toms are to be obviated by the exhibition 
 of aloes or other purgatives, by with- 
 drawing the iron, and by giving camphor 
 or other antispasmodics. But iron has 
 shared the fate of other anti-cancerous 
 medicines, and has not supported its 
 claims to confidence. Some good has ap- 
 parently been done, by keeping cancer- 
 ous patients on a very spare diet, or on 
 one consisting principally of milk. Can- 
 cerous ulcers have been dressed with a 
 great variety of applications, principally 
 of the narcotic kind j and some of these 
 have abated the pain, and corrected the bad 
 smell; but the carrot poultice has been 
 found as efficacious as any other. A 
 weak solution of the chlorate of soda has 
 been found a useful wash. 
 
 It is now time to bring this long and 
 unsatisfactory article to a close, by re- 
 peating, that for true cancer, no remedy 
 whatever has yet been found but extirpa- 
 tion ; and that in every case^ the earlier 
 this is done, the better. It is improper to 
 waste time by the fruitless exhibition of 
 a variety of remedies, which former expe- 
 rience has shown to be quite unworthy 
 of confidence. In the early stages, bleed- 
 ing by leeches, and even in some consti- 
 tutions, a general bleeding or two, and a 
 low ^et may be tried ; and a prudent at- 
 tempt may for a little be made by arse- 
 nic, hemlock, and iron ; but these should 
 not be long persisted in, as the disease 
 may in the mean time be insidiously ex- 
 tending itself, and rendering even the 
 operation unlikely to effect a cure. When 
 the operation is resolved upon, let it be 
 done effectually, and with the knife ; let 
 
 no timidity prefer the apparently milder 
 but really more cruel means by caustic; 
 which, without removing the disezise, 
 will only aggravate it, and rouse into ac- 
 tion that mischief which would perhaps 
 have long been latent. 
 
 Finally and especially, let the unhappy 
 patients and their friends be on their 
 guard against the false pretences of inte- 
 rested quacks, who, without the slightest 
 portion of medical skill, promise a safe 
 and speedy cure of cancer; who, though 
 scarcely able to read or write, boast of 
 having succeeded where learning and skill 
 have failed ; and who, pretending to be 
 in possession of a secret by which the 
 acutest sufferings of humanity can be al- 
 leviated, mysteriously conceal their nos- 
 trums from the candid practitioner, and 
 deal only with hopeless misery, credulity, 
 and ignorance. 
 
 C A NELL A. The bark of a taU tree, 
 Canella alba, common in Jamaica, and 
 other West Indian Islands. Canella is 
 the inner bark dried in the shade, after 
 being freed from the outer rind, which is 
 thin and rough. It is a pungent aromatic, 
 and is sometimes employed where a warm 
 stimulant to the stomach is necessary. 
 The dose of the powder is from ten grains 
 to twenty. 
 
 CANINE MADNESS. See Hydro- 
 phobia. 
 
 CANINE TEETH. The two eye 
 teeth, or those on each side of the foiu: 
 cutting or front teeth, in both jaws ; so 
 called from their resemblance to the teeth 
 of the dog. Children have sometimes 
 great pain in getting the eye teeth, and 
 require to have the gums scarified, and 
 the various symptoms of irritation and 
 disease attended to. 
 
 CANTHARIDES. Spanish Flies. 
 Melue vesicatoria. They are an insect of 
 the beetle kind, of a shining gold and 
 greenish colour, and a strong and sickly 
 smell. When tasted, they make no impres- 
 sion on the tongue at first, but very soon 
 a degree of acrimony and a flavour of 
 pitch is perceived. The largest and thei 
 best are brought from Italy. They shoul4 
 
CAP 
 
 CAR 
 
 101 
 
 be chosen of a fresh colour, entire, and 
 free "from dust. The principal use of 
 these insects is to form blistering plaster, 
 which they do with great efficacy and 
 success. Under the article Blister, we 
 have given a full account of the cases in 
 which blisters are proper, and also how 
 they are to be managed. Cantharides are 
 also used internally, and are of great 
 -power on the urinary organs. Hence 
 they have been used for the cure of in- 
 continence of urine, or for its suppres- 
 sion ; they have also been used in gleets, 
 and for the cure of the whites ; but their 
 internal use requires great caution, and 
 most of the maladies for which they are 
 used may be alleviated by safer means. 
 The dose to begin with is half a grain of 
 the powder, or from fifteen to thirty drops 
 of the tincture. This may be continued 
 for a day op- two ; but it is apt to have se- 
 vere effects on the urinary organs, and 
 must be withdrawn as soon as the patient 
 complains of pain in making water. The 
 acrimony of the cantharides, when absorb- 
 ed into the system from a blister being 
 put on, is to be obviated by drinking 
 largely of diluents, as gruel, barley water, 
 and the like. It is said, that boiling can- 
 tharides in water deprives them of the 
 power of acting on the kidneys, without 
 in the least diminishing their blistering 
 properties. The symptoms of an over-dose 
 of cantharides are violent retching, with 
 copiojis stools, frequently bloody ; severe 
 colics, and inflammation of the stomach 
 and intestines; sometimes convulsions, 
 .with a horror of liquids, as in hydropho- 
 bia J and delirium. Besides these, there 
 are the peculiar effects on the urinary and 
 genital organs, as heat in the bladder, fre- 
 quent discharges of bloody urine, stran- 
 gury, &c. The treatment must be by co- 
 pious bleedings, the warm bath, fomenta- 
 tions, mucilaginous drinks, and opium in 
 the form of clyster. 
 
 CAPERS. The unexpanded flowers 
 or buds of a plant, Capparis spinosOy 
 growing in Italy, Spain, and the south of 
 France; which are in much use at the 
 table, when pickled with vinegar and salt. 
 
 Like other vegetables, they are possessed 
 of anti-scorbutic virtues. 
 
 CAPILLAIRE. A syrup made of 
 Maiden Hair, a genus of fern, of which 
 there is only one species belonging to 
 Great Britain, the Adiantum capillus 
 Veneris, or true maiden hair ; which is 
 found rarely in Scotland and Wales, on 
 rocks and moist walls, and which is a 
 native of the south of Europe and the 
 Levant. This is a very succulent plant, 
 yielding almost its whole weight of juice; 
 but neither its taste nor smell promises 
 any efficacy. If the syrup of capillaire 
 which is made from it, be good for any 
 thing, it is from the orange flower water 
 that is put into it. The Canadian maiden 
 hair, the Adiantum pedatum, is the best. 
 
 The subject of this article belongs ra- 
 ther to cookery than to medicine; but as 
 many persons think it a useful, as it is 
 certainly a pleasant demulcent to be taken 
 during a cold, we insert a receipt for mak- 
 ing it, from a late high authority. " Put 
 one ounce of the North American maiden 
 hair into a small quantity of boiling 
 water, to infuse like tea; add a pound of 
 sugar to the infusion ; clarify it with the 
 white of an eg^, and boil it to a thick 
 syrup ; strain it through a cloth, and 
 when cold, put in a little orange flower 
 water, and bottle it. That which is com- 
 monly sold as capiUaire in England, is 
 simply syrup flavoiu-ed with orange flower 
 water." (Mrs. Dalgairns's Cookery.') 
 
 CAPSICUM. See Cayenne Pepper. 
 
 CARAWAY, Carum carui. A plant 
 cultivated in gardens, the seeds of T\'hich 
 have an aromatic smell, and a warm pun- 
 gent taste. They are employed as a sto- 
 machic and carminative ; and they assist 
 in forming certain tinctures. Covered 
 with sugar, they are used as a sweetmeat. 
 Caraway seeds are used in dyspeptic com- 
 plaints, in flatulence, and in hysterical 
 and hypochondriacal cases. 
 
 CARBON. A simple inflammable sub- 
 stance, deriving its name from the Latin 
 word carbo, a coal, as carbon is common- 
 ly obtained by burning wood till it puts 
 on the appearance of coal. Carbon is a 
 
102 
 
 CARBONIC ACID. 
 
 substance of great inaportauce in chemis- 
 try. It is one of those substances that 
 have never been decomposed, and which 
 are therefore, in the present state of che- 
 mical science, considered as simple. Car- 
 bon is black, insipid, and free from smell ; 
 it is brittle, and easily reduced to powder, 
 and is insoluble in water. Charcoal re- 
 tards the putrefaction of animal sub- 
 stances. Hence it is used in some dis- 
 eases of a putrid tendency, and also as a 
 tooth-powder. The experiments of mo- 
 dem chemistry have ascertained that the 
 most valuable of precious stones, viz. the 
 diamond, is pure carbon, differing from 
 charcoal merely in the state of aggrega- 
 tion of its particles. Precisely the same 
 product is obtained both from the dia- 
 mond and from charcoal, when they are 
 burned in oxygen gas ; and this product is 
 carbonic acid. Carbon enters largely in- 
 to the composition of the animal and ve- 
 getable kingdoms, and by itself or its pro- 
 ducts is very Tt'idely diffused through na- 
 ture. In its simple state, it is but little 
 employed in medicine. 
 
 CARBONATES are those substances, 
 into the composition of which the carbo- 
 nic acid enters. They form a numerous 
 class ; as all the alkalis, and most of the 
 earths and metallic oxides are united with 
 carbonic acid, and form compounds of im- 
 portance in medicine. Thus we have the 
 carbonates of potash, of magnesia, soda, and 
 ammonia; of iron, of zinc, &c. The proper- 
 ties of these several bodies will be found 
 under the article with which the carbonic 
 acid combines. See Potash, Soda, &c. 
 
 CARBONIC ACID. When charcoal 
 is burned in oxygen gas, provided the ma- 
 terials are in due proportions, the oxygen 
 gas disappears, and in its stead we obtain 
 a gas equally colourless and transparent, 
 but possessed of very different properties. 
 The new formed gas extinguishes flame, 
 and is fatal to men and animals who 
 breathe it. It is this gas which arises when 
 charcoal is burned in small ill-ventilated 
 rooms, and which so often causes the 
 death of persons who occupy them, and 
 which also occasions fatal accidents in 
 
 breweries, and other places where fermen- 
 tation goes on ; being extricated in great 
 profusion during the process of the fer- 
 mentation of vegetable juices. It also taints 
 the air of mines ; and is called by the miners 
 the choak-darap. When a person is exposed 
 to breathe this acid, the first sensation is a 
 slight sense of weakness, and a degree of 
 giddiness, with a glow in the face and neck. 
 Shortly after, he falls doAvn, becomes in- 
 sensible, and breathes loud as. in apoplexy. 
 Unless relief be obtained, death very quick- 
 ly ensues. There is usually foaming at the 
 mouth, with great suffusion of blood over 
 the face and neck, and other marJcs of 
 accumulation of blood in the vessels of 
 the brain. If discovered in time, the 
 person must be brought to the open air, 
 and the chest compressed to expel the 
 noxious air, which will not easily escape 
 of itself, as it is heavier than common air. 
 A quantity of blood must be drawn, and 
 cold water applied to the head. Mustard 
 poultices applied to the feet will assist in 
 the relief of the patient. 
 
 Though carbonic acid applied to the 
 lungs be thus deadly, it has very salutary 
 and beneficial effects when taken into 
 the stomach. The mineral waters com- 
 monly called acidulous, and which sparkle 
 when first drawn, or when poured from 
 one glass to another, owe this property 
 to the carbonic acid which they contain ; 
 and hence not only the natural sources 
 of these waters are resorted to with great 
 benefit in stomach complaints, but artifi- 
 cial imitations of them are in frequent 
 use, under the name of soda water, aerat- 
 ed alkaline water, and the like. The 
 waters sold under the name of soda wa- 
 ter, really contain little or no soda, and 
 are chiefly water impregnated with car- 
 bonic acid. It is carbonic acid that gives 
 the briskness to malt liquors, to cider, and 
 to champagne. 
 
 Carbonic acid is rapidly taken up by 
 lime-water; and as there is always a small 
 portion of carbonic acid in the air, lime- 
 water cannot be kept pure, unless the 
 atmospheric air be completely excluded. 
 Hence a certain ^vay of clearing confined 
 
CARBUNCLE. 
 
 103 
 
 places from carbonic acid, by pouring large 
 quantities of lime-water from one vessel 
 into another, from a considerable height, 
 and in a broken stream. 
 
 Carbonic acid is deserving of the most 
 distinguished notice, as having been the 
 first aeriform fluid that was correctly 
 investigated as possessing properties dif- 
 ferent from common air; and as having led 
 the way to the discovery of a variety of 
 other kinds of gases, and to many of 
 the most interesting facts of the modem 
 chemistry. For this, the name of the 
 philosophic Black will be for ever me- 
 morable in the history of chemical science. 
 
 CARBUNCLE. An abscess or col- 
 lection of matter, of a peculiarly gangre- 
 nous-looking nature. The first symptoms 
 are great heat and violent pain in some 
 part of the body, on which there arises a 
 pimple with great itching ; under this, 
 there is a circumscribed tumour, seeming 
 to penetrate deep into the pai-ts below. 
 This tumour soon puts on a dark red, or 
 puq)le colour. A little blister frequent- 
 ly appears on the top of the tumour, 
 which being broken, a dark-looking mat- 
 ter is discharged, and a slough makes its 
 appearance. Sometimes a little slough 
 of a black colour is seen in the middle of 
 the tumour. The progress of a carbuncle 
 to the gangrenous state is generally ra- 
 pid. The size of carbuncles is various ; 
 sometimes they are eight or ten inches in 
 diameter. Considerable hardness and 
 pain generally attend the disease. As it 
 advances, several openings generally form 
 in the tumour; and through these, a green- 
 ish, fetid, and irritating matter is dis- 
 charged. Carbuncle most commonly oc- 
 curs in constitutions that have been in- 
 jured by luxurious living ; and from this 
 circumstance, and from its occurring not 
 unfrequently in people advanced in life, 
 carbuncle is too often to be considered as 
 accompanied with great danger ; and this 
 danger is to be estimated by the size and 
 situations of the swellings, whether there 
 be few or many of them, and by consider- 
 ing the age of the patient, and the state 
 of his constitution. 
 
 Treatment of Carbuncle. The tu- 
 mour is to be treated with fomentations 
 and emollient poultices, till there be a 
 considerable degree of softness about it ; 
 and when this is the case, it should be 
 very freely opened, to allow the matter 
 and sloughs to escape. Two deep and 
 free incisions, crossing each other, are to 
 be made in the carbuncle from side to 
 side of it ; and it is astonishing to see how 
 soon these extensive wounds heal. Ex- 
 tensive though they be, they are quite 
 necessary ; and nothing can be more in- 
 jurious, or tend more to lengthen out the 
 disease, and even to induce a fatal ter- 
 mination, than the insignificant openings 
 which form of themselves; which only 
 allow the thinner matter to escape, while 
 the sloughs are confined within, and un- 
 healthy actions are going on. Large 
 poultices are to be continued for some 
 time, and as the discharge is copious and 
 filthy, they should be changed three or 
 four times a-day. Thjs treatment is to 
 be continued till all the sloughs have se- 
 parated, and till the sore below puts on a 
 healing action. We are then to apply 
 any mild dressing spread on lint. Atten- 
 tion is to be paid to general symptoms ; 
 we are to keep the bowels open by pro- 
 per laxatives, to give antimonial medi- 
 cines in order to keep the skin moist, and 
 freely to use bark and wine to obviate 
 gangrene and debility. 
 
 The carbuncles which we meet with 
 in this country, though sometimes bad 
 enough, and when occurring in unhealthy 
 constitutions, of great danger, are yet 
 mild when compared with the carbuncles 
 that occur in warm climates In the 
 plague, one of the most characteristic 
 symptoms is the appearance of carbun- 
 cles ; but in such cases it is not j)robable 
 that the mere circumstance of their ap- 
 pearing adds to the danger of the disease. 
 Carbuncles are bad when they occur, as 
 they sometimes do, in the course of putrid 
 and typhoid fevers. 
 
 CARBURETTED HYDROGEN 
 GAS. A gas composed of a mixture of 
 c-aibon and hydrogen, obtained in various 
 
104. 
 
 CAR 
 
 CAR 
 
 ways, and on a large scale by the distil- 
 lation of pit coal. When thus procured, 
 it is generally for the purpose of being 
 used for giving light instead of oil, as in 
 the streets of cities, or in houses, manu- 
 factories, &c. This modern practice, 
 though producing a light both economi- 
 cal and beautiful, is believed to be in 
 some instances prejudicial to the health. 
 Dr. Paris says, " K exercise be useful 
 during the period of sanguification (he 
 means vrhen the process of digestion is 
 nearly completed) pure air is no less so ; 
 and I shall take this opportunity of en- 
 tering my protest against the introduction 
 of gas into the interior of our houses. 
 Carburetted hydrogen is a deadly poison ; 
 and even in a state of great dilution, it is 
 capable of exerting a very baneful effect 
 upon the nervous system. I have been 
 consulted on several occasions for pains 
 in the head, nausea, and distressing lan- 
 guor, which evidently had been produced 
 by the persons inhaling the unburnt gas 
 in the boxes of our theatres." There is 
 probably a good deal of exaggeration in 
 this statement : among the thousands 
 who use gas for illuminating their shops 
 and houses, very few indeed experience 
 the smallest inconvenience ; and the fre- 
 quenters of theatres are exposed to so 
 many other causes of headach, nausea, 
 and languor, that their complaints hardly 
 furnish grounds for so general a con- 
 demnation of the employment of gas. 
 
 CARDAMOM SEEDS, Cardamo- 
 mum minus, are a pleasant, warm and 
 pungent aromatic, and both their tinc- 
 ture and powder are much used to give 
 additional flavour and virtue to other 
 stimulants. 
 
 CARIES. See Bones. 
 
 CARMINATIVES. Medicines that 
 assist in the extrication and expulsion 
 of wind from the intestines. They are 
 commonly of the aromatic or fetid kind. 
 Some of those most in use are cardamom 
 seeds, anise, and caraway seeds ; and anise 
 in powder, or distilled water, is of much 
 service in the griping disorders of chil- 
 djcn, who often obtain great and speedy 
 
 relief by the expulsion of wind, conse- 
 quent on giving this medicine. A little 
 powdered anise seed mixed with white 
 sugar, and put into panado, is a good form 
 of exhibiting this carminative to children ; 
 or a little anise water with simple syrup 
 may be given. We sometimes wish to 
 relieve the larger intestines from disten- 
 tion by wind ; and for this purpose, injec- 
 tions may be used, made of infusion of 
 senna, M'ith a small portion of assafetida 
 dissolved in it. In the distention so fre- 
 quent in stomach complaints, a dose of 
 the compound of tincture of cinnamon, or 
 the tincture of cardamoms, or a little 
 powdered ginger; or the aromatic powder, 
 composed of a mixture of cardamom, 
 cinnamon, and ginger, is of service. In 
 hysterical complaints, a great deal of the 
 disease is owing to wind in the stomach 
 and intestines, and medicines which expel 
 wind are of benefit in such cases. One 
 of the most convenient, as acting like- 
 wise in the removal of costiveness, is the 
 pill of aloes and assafetida; two pills 
 every second or third night. 
 
 CARROT, Daucus carota. An escu- 
 lent root, which contains a good deal of 
 sugary matter, and is in consequence 
 nutritive and slightly laxative ; in some 
 stomachs it is not very easily digested, on 
 account of the fibrous matter which it 
 contains. It should be well boiled, and 
 eaten when young. Carrots when scraped 
 and boiled to the consistence of a pulp, 
 form a very useful poultice for corroding 
 or putrid ulcers, and cancerous sores. 
 
 CARTILAGE, the anatomical name 
 for gristle. It is a white elastic sub- 
 stance, commonly growing at the ends 
 of articulated bones, for the purpose of 
 facilitating the motions of those bones 
 which enter into the formation of a 
 joint. A great portion of the rings of 
 the wind-pipe is formed of gristle, and 
 the lower extremity of the division be- 
 tween the two nostrils is gristle. 
 
 CASCARILLA, Ci'oton cascai'illay the 
 name of a plant, growing in the Bahama 
 Islands and Jamaica. The bark, which is 
 the pait used in medicine, is imported 
 
CAS 
 
 CAS 
 
 105 
 
 either in cuiled pieces, or rolled up into 
 short quills. This bark has an agreeable 
 smell, with a bitterish taste, accompanied 
 with a good deal of aromatic pungency. 
 When taken internally, it produces a 
 sense of heat, and excites the action of 
 the stomach. It was formerly used in 
 intermittent fever, but the Peruvian bark 
 is so much more effectual, that it is now 
 but little resorted to. Cascarilla is best 
 taken in substance, in the dose of from 
 twenty to thirty grains of the powder 
 of the bark. * 
 
 CASHEW NUT, Anacardium occi- 
 dentale. The oil of the cashew nut is an 
 active caustic, and is employed as such 
 in the West Indies ; but it is not used in 
 this country. 
 
 CAS SAD A, Jatropha Manihof. A 
 plant which grows in various warm coun- 
 tries. The plant is poisonous, but the 
 poison consists in a volatile oil, which is 
 easily separated by heat. Cassada bread 
 is made by washing and scraping the 
 roots clean, grating them into a tub, and 
 squeezing out the juice by strong pres- 
 sure through a hair bag ; the thinner part 
 is evaporated, and the remainder dried 
 over the fire in a hot stone basin, and 
 afterwards made into cakes. Cassada 
 root yields also a starch called tapioca, 
 M^hich is much used as a diet for weak 
 and sick persons. 
 
 CASSIA, Cassia fistula. A tree which 
 grows in India and Egypt, and is culti- 
 vated in Jamaica. The fruit is the part 
 of the plant used; and this consists of a 
 cylindrical pod, an inch in diameter, and 
 a foot in length ; and the pulp contained 
 in the pods is obtained by boiling them in 
 water, and evaporating to a proper thicks- 
 ness. It has a sweet mucilaginous taste, 
 and acts as an aperient ; but when given 
 alone, is apt to gripe, though this may be 
 prevented by combining it with aromatics. 
 The dose is from half an ounce to an 
 ounce; but it is not much employed in 
 this country. 
 
 CASTOR. A substance found in oval' 
 pouches situated near the anus of the 
 beaver. In both sexes, near the anus, 
 
 there are four tough membranous folli- 
 cles, the two lai^est and undermost of 
 which are connected and lie close to each 
 other, and contain an oily fluid secretion, 
 which is the substance known by the 
 name of castor. The best kind of castor 
 comes from Prussia, Russia, and Poland, 
 but it is now rarely to be met with ; an 
 inferior kind is got from Canada, in pods 
 which are usually flatter, smaller, and mois- 
 ter than the European; and whose contents 
 are of a very miscellaneous nature. The 
 matter is commonly of a yellow colour, 
 resinous, with a faint nauseous smell. Cas- 
 tor has been much extolled as an anti- 
 spasmodic, especially in uterine com- 
 plaints ; but it is not likely to be much 
 employed now, both on account of its 
 high price and uncertain quality, and be- 
 cause, even in its genuine state, much 
 good is not to be expected from it- 
 It may be given in powder, from ten to 
 twenty grains, or in clysters to the ex- 
 tent of a drachm. It is also used in tinc- 
 ture, from a drachm to two drachms. 
 
 CASTOR OIL, has no relation what- 
 ever with the preceding article, but sig- 
 nifies the expressed oil of the Ricinus 
 communis^ or Palma Christi, a plant 
 which grows in the East and West In- 
 dies, in Africa and the South of Europe. 
 The name Castor oil is said to be an in- 
 stance of verbal corruption in medical 
 botany. This oil, from its supposed effi- 
 cacy in curing and assuaging the unna- 
 tural heat of the body, and in soothing 
 the passions, was called by the French 
 Agnus Castus; whence the inhabitants of 
 St. Kitts, in the West Indies, who were 
 formerly blended with the French in that 
 island, called it castor oil. (Paris's 
 Phai-macologia.J The capsules contain, 
 under a thin, grey husk, a white oily 
 kernel. The skin of the seeds is yery 
 acrid and purgative ; and one or two of 
 the seeds, swallowed whole, act violently 
 as a purgative or emetic. The kernels, 
 when strongly pressed, yield almost a 
 fourth part of their weight of a pale 
 fixed oil, of a slightly nauseous smell and 
 taste. The seeds should always be bruis- 
 
108 
 
 CAS 
 
 CAT 
 
 ed without any assistance from beat ; 
 this is called cold-draivn castor oil, and 
 is always to be preferred. In the West 
 Indies, the oil is sometimes separated by 
 boiling the seeds in water, the covering 
 being first taken off them ; but oil pro- 
 cured in this way is deeper-coloiu-ed, 
 more acrid, and more liable to become 
 rancid. Castor oil is one of the most var 
 luable aperients we possess ; for it, in ge- 
 neral, thoroughly evacuates the bowels 
 with little irritation ; and hence is pecu- 
 liarly useful when we wish the system to 
 be little excited, as in cases of inflamma- 
 tion, and those of a spasmodic tendency. 
 It is exceedingly useful during pregnancy 
 and the child-bed state. Castor oil may 
 be safely given to very young children; a 
 small tea-spoonful may be given to child- 
 ren even of a few days old ; and the dose 
 is to be increased according to the age of 
 the patient, till, for an adult, we come to 
 an ounce. The principal matter requir- 
 ing attention is the way of exhibiting it. 
 To many stomachs it is peculiarly dis- 
 agreeable, especially in Scotland, where 
 the inhabitants are not very fond of oily 
 substances. To infants, it is best given 
 alone ; and by permitting them to suck a 
 little immediately afterwards, they arc 
 scarcely sensible of the taste. Castor oil 
 may be given swimming on water ; a few 
 drops of oil of peppermint may be added; 
 and in cases where inflammatory symp- 
 toms do not forbid it, a little ardent spi- 
 rits. Castor oil may also be given in the 
 form of emulsion, rubbed together with 
 mucilage or the yollc of eg^^ and having 
 a little peppermint-water added. To 
 make a uniform mixture, the oil should 
 be first rubbed with the yolk of eg^;^ and 
 the peppermint-water gradually added. 
 A way of giving castor oil that we have 
 found very convenient is the following : — 
 Take a little chicken-broth, and skim- 
 ming oflF all the fat, add to it, when very 
 hot, the dose of castor oil by minute por- 
 tions, each portion being well diffused 
 through the fluid before another is add- 
 ed ; and when salt is put in, most sto- 
 machs will bear the mixture as easily as 
 
 an article of food. With persons to whom 
 the use of castor oil is peculiarly nause- 
 ous, we must be cautious of exhibiting it, 
 in cases where the strong action of vo- 
 miting would be dangerous, as in rup- 
 tures, and in diseases where there is a 
 tendency of blood to the head. 
 
 CATALEPSY. A species of palsy, in 
 which the patient is unable to move his 
 limbs, but when they are moved by an- 
 other pei-son, they remain in ^ny position 
 in which they are placed. The patient 
 neither sees, hears, nor feels ; he swal- 
 lows greedily whatever is given him ; 
 the countenance becomes florid, the eyes 
 ai'e open, seemingly fixed on some object; 
 at the close of the fit, he fetches a deep 
 sigh, and then recovers. It is said to 
 come on suddenly, being preceded only 
 by some languor of body or mind; and to 
 return by paroxysms. In the fit, strong 
 vinegar, or aromatic vinegar, may be ap- 
 plied to the nose ; the neck and back part 
 of the head are to be rubbed with tur- 
 pentine liniment. Mustard poultices ai-e 
 to be applied to_ the feet, and an assafe- 
 tidii mixture given. The cure is to be 
 attempted on the principle laid down un- 
 der Apoplexy ; by purgatives, by blood- 
 letting, or by stimulants, according to cii'- 
 cumstances. If the disease arises from 
 mental causes, a change of scene and pro- 
 per management of the mind must go 
 along with other remedies. 
 
 CATAPLASMS are external appUca^ 
 tions of a pulpy consistence, and some- 
 what tenacious. They are of various 
 kinds ; either stimulant, as when made 
 with equal parts of common mustard and 
 crumb of bread, moistened with vinegfir ; 
 or when common salt is applied exter- 
 nally M'ith bread or meal : or antisep- 
 tic, and applied with a view to correct 
 putrescency, as the yeast poultice, or the 
 carrot poultice. Anodyne cataplasms 
 made with hemlock, henbane, or fox- 
 glove, are applied to scrofulous or cau- 
 cei'ous sores, to allay irritation and pain. 
 Refrigerant cataplasms are made by mois- 
 tening crumb of bread with a solution of 
 sugar of lead. Emollient cataplasms are 
 
C A T A U R H. 
 
 107 
 
 most commonly known by the name of 
 poultices. See Poultices. 
 
 CATARACT, aScc Eye and its Diseases. 
 
 CATARRH. The disease commonly 
 called a Cold^ of which the following are 
 the ordinary symptoms: The patient is 
 seized with a coldness and shivering-; and 
 sliortly after, there is a degree of difficulty 
 in breathing through the nose, and a sen- 
 sation as if something were stopping that 
 passage; a syinptora well known under 
 the term of a stuffing of the nose or head. 
 There is a dull pain and heaviness in the 
 forehead, and the motion of the' eyes is 
 stiff and obstructed. There soon takes 
 place from the nose, a plentiful discharge 
 of tliin watery matter, so sharp as to in- 
 flame and excoriate the skin of the nose 
 and lips, as with a chemical acrid. There 
 is a sense of weariness over the whole 
 body ; and the patient is unusually sensi- 
 ble to the coldness of the air; and the 
 pulse, especially towards evening, is more 
 frequent than ordinary. These symptoms 
 are very soon accompanied with hoarse- 
 ness, and a sense of roughness and sore- 
 ness in the course of the Avind-pipe, with a 
 difficulty of breathing, and tightness across 
 the chest ; and a cough, seemingly occa- 
 sioned by something tickling or irritating 
 the upper part of the wind-pipe. The 
 cough is at fii*st dry, and causes a good 
 deal of pain in the chest, and about the 
 head ; and at times, there are other pains 
 resembling rheumatism, in various parts 
 of the body. Gradually, the cough be- 
 comes looser ; that is to say, is accom- 
 panied by the discharge of mucus, which 
 is brought up with more ease. The dis- 
 charge from the nose becomes more mild, 
 and also thicker ; the pain of the head 
 diminishes, but there is still a disagreeable 
 sense of fulness about the nose, with a 
 degree of deafness, ringing of the ears, 
 and a wheezing sound when a full breath 
 is drawn. There is also a bad taste in 
 the mouth, with a foul tongue, although 
 the appetite is good. 
 
 Such are the asuaf symptoms of the 
 disease ; and, though occurring very fre- 
 <|uently, there are few diseases about 
 
 which there is so much bad theory, and 
 so much injurious practice. The fluid dis- 
 charged from the nose has been thought 
 to distil from the brain ; and this opinion 
 is evident in the name of the disease, 
 which is derived from two Greek words, 
 that signify to Jlow down. Nothing is 
 so common as to find patients of every 
 class treating themselves during catarrh 
 by a hot and stimulating regimen. To 
 feed a cold has passed into a popular me- 
 dical axiom ; and to accomplish this feed- 
 ing, the patient is dosed with wai-m po- 
 tions, abounding in spirituous liquors and 
 heating spices; while nourishing meats 
 arc given as food. Some again, when 
 they are seized with a cold, endeavour, as 
 they say, to waUc it off; and by taking vio- 
 lent exercise they exhaust their strength, 
 already impaired by the disease, and add 
 to the feverish symptoms which are pre- 
 sent. But if we consider in what this 
 disease consists, we shall see the impro- 
 priety of all such methods of proceed- 
 ing. Catarrh consists in a certain degree 
 of inflammation, excited in the fine mem- 
 brane lining the inner parts of the 
 nose, and continuous to that which lines 
 the mouth, the fauces, the wind-pipe, 
 and the air-cells of the lungs. Now, it is 
 very plain, that an inflammation of these 
 parts may be accompanied with much 
 danger; and, consequently, that every 
 thing tending to increase the inflamma- 
 tion already existing, must be carefully 
 avoided. If a person is affected with 
 catarrh, the best treatment is to take some 
 mild laxative medicine, to drink plenti- 
 fully of diluent liquors ; (and none can be 
 better than water gruel, or barley water) ; 
 and to avoid changes of temperature by 
 confining himself to his apartment. Few- 
 persons who have only a slight cold will 
 submit to being kept in bed ; yet nothing 
 can be a safer or surer remedy. 
 
 Catarrh in its severer form. But colds 
 are sometimes more severe, and require 
 more active and decided treatment. If 
 the pulse be full and strong, the breath- 
 ing difficult, the cough dry, and causing 
 much pain in the side ; if the headach 
 
108 
 
 C A T A 11 R H. 
 
 is. severe, with considerable flushing of 
 the face, the cold is then approaching to 
 another and more acute disease, viz. a 
 pleurisy, and requires to be actively treat* 
 ed by blood-letting, and the antiphlogistic 
 regimen. The patient must keep his bed ; 
 and should take some squill vinegar in a 
 basin of gruel, sweetened with honey ; if 
 any tendency to perspiration comes on, it 
 should be encouraged by the plentiful 
 use of tepid drinks, as gruel or barley 
 vrater; carefully avoiding to put any 
 heating or stimulating liquors into them. 
 Laxative medicines are to be given; and a 
 blister applied to the breast or side, if 
 there he any particular spot affected with 
 pain. Expectorant mixtures are useful 
 and necessary ; and, till more scientific and 
 formal ones can be procured, a very good 
 domestic one may be made of vinegar 
 and sugar-candy boiled together with 
 water. A good expectorant is made, by 
 mixing together an ounce of squill vine- 
 gar, four of cinnamon-water, or pepper- 
 mint-water, two of mucilage of gum ara- 
 bic, and one of simple syrup ; of this, a 
 table-spoonful is to be taken four or five 
 times a-day. At an after period of the 
 disease, when the inflammatory tendency 
 is over, the cough and thick expectora- 
 tion continues for a considerable time; 
 and at night and morning, the cough is 
 particularly troublesome. At this stage 
 of the disease, opiates prudently given ai'e 
 of much service. Either laudanum may 
 be given in the dose of twenty-five or 
 thirty drops at bed-time, in any conve- 
 nient vehicle ; or paregoric elixir, which 
 probably derived its name, which signifies 
 soothing^ from its relief in this very dis- 
 ease. It is to be remarked that the Scotch 
 paregoric differs from the English in con- 
 taining more opium ; so that, to produce 
 the same effects, we must prescribe nearly 
 four times as much of the English as of 
 the Scotch ; a tea-spoonful of the Scotch 
 in a glass of water is to be ordered at bed- 
 time, or half a glass of the English with 
 as much water. It may be proper to take 
 some laxative medicine, to wear flannel 
 next the skin, and some additional cloth- 
 
 ing ; and to avoid exposure to a cold or 
 damp air, especially in the evening. A 
 person who has a cold, is unusually sen- 
 sible to the impression of €old air ; and if 
 he exposes himself to it when the disease 
 is seeming to abate, he wiU probably have 
 it brought back with equal or increased 
 severity. A degree of sore throat fre- 
 quently attends catarrh, and this is pecu- 
 liarly apt to be aggravated by any fresh 
 exposure to cold. When a catarrh has 
 been occasioned by a check to the per- 
 spiration by cold long applied, when it has 
 been improperly treated, and when the 
 patient has been exposed to fresh appli- 
 cations of cold, there is great danger of 
 its passing into an inflammation of the 
 lungs or their investing membrane, and so 
 being attended with the greatest hazard 
 to life. 
 
 We have now given, as we hope, a plain 
 and intelligible account of catarrh in its 
 mild and acute form; but we should leave 
 this article very incomplete, if we did not 
 suggest some other circumstances and 
 precautions, highly proper to be remem- 
 bered by the general reader. Some per- 
 sons, from the slightness of the disease, 
 and its frequent occurrence, are apt to 
 treat it as a very insignificant matter, 
 and to fear little from a common cold ; 
 but in the tickle and inclement m eather 
 of our island, neglected common colds too 
 often put on an alarming appearance, and 
 are the first of a train of ailments that 
 conduct the sufferer to his grave. If a 
 person finds himself, on every trifling ex- 
 posure to cold, affected with cough, run- 
 ning at the nose, and other cataiThaJ 
 symptoms, he must endeavour, by pru- 
 dent precautions, by weiiring flannel next 
 the skin, and by avoiding exposure to 
 currents of air, to prevent the frequent re^ 
 turns of the complaint, which will not al- 
 ways continue mild, but may lead to fatal 
 pulmonary consumption. WTien the dis- 
 ease has come on, let him beware of 
 treating it with hot and spiced drinks; let 
 him refrain from speaking or reading 
 aloud ; and not attempt to walk it off, or 
 drive it away by violent exertion. 
 
CAT 
 
 CAD 
 
 109 
 
 A catarrh is not imfrcquently attended 
 with considerable danger, when it occurs 
 in elderly people. It is not uncommon, 
 in the decline of life, to have a great dia- 
 charge of mucus from the lungs; and 
 when the afflux of fluids to that part is 
 aggravated by cold, it may give rise to 
 a degree of inflammatory action; and 
 this occurring in enfeebled constitutions, 
 which are not able to bear depletion, by 
 blood-letting, purging, or low diet, may 
 prove fatal Catarrh generally appears 
 without any evidence that it is epidemic 
 or contagious; but at times, there is a 
 disease closely resembling catan-h, affect- 
 ing vast multitudes at once, and common- 
 ly known by tlie name of influenza. See 
 Influenz . 
 
 CATECHU. An astringent substance 
 obtained from the Acacia Catechu, and 
 imported to us from Bengal and Bombay. 
 It formerly used to be absurdly called 
 Ten-a Japonica, Japan earth. There are 
 two kinds, whose composition differs a 
 little, but not so as to make any material 
 alteration in their medicinal virtues. The 
 extract is principally prepared from the 
 internal part of the wood, by decoction, 
 evaporation, and drying in the sun. It is 
 a good astringent in fluxes and loose- 
 ness ; but we must be very sure of the 
 propriety of its use before we give it in 
 those complaints of the bowels, as no 
 treatment can be more pernicious in the 
 commencement of dysentery, than medi- 
 fcines to check the discharge. In relaxa- 
 tion of the uvula it is often effectual, 
 either chewed, or the infusion of it used 
 as a gai-gle ; and it is said that public 
 speakers and singers often resort to lo- 
 zenges containing it, as an effectual pre- 
 ventive of hoarseness. In ulcerations of 
 the mouth and gums, it is highly useful. 
 The foUomng are some of the forms in 
 which it may be used. In diarrhoea, a 
 powder may be taken, composed of fif- 
 teen grains of powdered extract of cate- 
 chu, and twenty grains of compound pow- 
 der of chalk, with opium. This is to be 
 repeated three or four times a-day. There 
 will be about half a grain of opium in 
 
 each powder. Oi* an infusion of catechu 
 may be made by taking three drachms, 
 and infusing these in half a pound of 
 water, and sweetening the strained liquor 
 with honey or syrup. A table-spoonful 
 of this is to be taken four or five times a- 
 day. Or we may add half an ounce of 
 the tincture of catechu, to five oimces of 
 the chalk mixture, and give it in the same 
 doses. 
 
 CATHARTICS. Medicines which 
 cleanse or puriiy ; applied more particu- 
 larly to those which act upon the intes- 
 tines, and more commonly known by the 
 names of Aperients, Laxatives and Pur- 
 gatives. See those articles. 
 
 CATHETER. An instrument which 
 is introduced into the bladder in order to 
 draw off the urine, when the natural 
 powers are insufficient. It is a silver 
 tube, with holes at the end to be intro- 
 duced ; and it varies in shape and cur\'a- 
 ture according to the sex of the patient. 
 In general, a large instrument will enter 
 the bladder more easily than a small one. 
 Some catheters are made flexible, and 
 some elastic. Sometimes there is a diffi- 
 culty of passing the catheter, in conse- 
 quence of spasm of the urethra and neck 
 of the bladder. A dose of opium may be 
 administered, and a second attempt made. 
 If there is inflammation in the passage, 
 bleeding may facilitate the introduction. 
 One of the most impoilant maxims is, 
 never to force foi-ward the instrument 
 when it meets with any obstacle. When 
 it is necessary to draAV off the urine fre- 
 quently, and the surgeon cannot attend 
 often enough for this purpose, it is pro- 
 per to leave a catheter in the bladder, 
 till an attendant, or the patient himself, 
 has learned to introduce the instrument. 
 
 CAUL. The membranous pouch which 
 floats loosely over the surface of the in- 
 testines. It is called in anatomical lan- 
 guage the omentum. It contains a consi- 
 derable portion of fat, and furnishes a 
 support for numerous bloodvessels, which 
 supply those parts. A portion of it some- 
 times gets out of its place, and is found 
 in the swelling occasioned by rupture. 
 
no 
 
 CAU 
 
 CA V 
 
 CAULIFLOWER, Brassica florida. 
 A species of cabbag^e, forming a very de- 
 licious article of f9od. Like other vege- 
 tables, it is apt to give rise to flatulencies 
 in those whose digestive organs are not in 
 a healthy state. It will in general re- 
 quire pepper or some other condiment. 
 
 CAUSE. The word cause is used in 
 medical science in a variety of meanings, 
 which are distinguished by an epithet pre- 
 fixed. We have the predisponenty the 
 remoiCy the occasional or exciting, and 
 the proximate cause, of a disease. Thus, 
 in gout, the predisponent cause is heredi- 
 tary peculiarity of constitution ; the re- 
 mote cause is indolence and luxurious 
 living ; the occasional cause is a debauch 
 or over fatigue, and the proximate cause 
 is that morbid state of the body, whatever 
 it is, which gives the sensation of pain 
 and the other symptoms. We have no 
 intention to defend the metaphysical ac- 
 curacy of these expressions ; but the ex- 
 planations given above will assist in the 
 reading of medical discussions. 
 
 CAUSTIC. A term applied to sub- 
 stances which destroy the texture of the 
 skin, or any part of the body to which 
 they are applied. Those principally in 
 use are the stronger mineral acids, po- 
 tassa, and the nitrate of silver, commonly 
 called lunar caustic. They are used for 
 destroying rising flesh, warts, &c. and for 
 destroying a part of the sound skin for the 
 purpose of forming an issue. See Issue. 
 
 CAUTERY. Any thing that destroys 
 the texture of a part, as if by fire. Sur- 
 geons speak of the actual and potential 
 cautery. The actual cautery is the ap- 
 plication of burning bodies or heated me- 
 tals; and the potential cautery is that 
 which effects its purpose by caustics, such 
 as those enumerated in the preceding ar- 
 ticle. The actual cautery was fonnerly 
 much used in surgery; but in modern 
 practice it is rarely employed, except in 
 hsemoirhages from the mouth, which can- 
 not be stopped by other means. There is rea- 
 son to think, that heated metals might be 
 advantageously employed more frequently 
 than they are, especially in diseases of the 
 
 bones ; and the pain of their application 
 is much less than we should expect. 
 
 CAYENNE PEPPER. An agree- 
 able spice procured from the pods of the 
 capsicum, or cockspur pepper, the Capsi- 
 cum annuum, an annual plant, a native of 
 South America, but cultivated in large 
 quantities in the West India islands. 
 Cayenne pepper is the mixture of the 
 powder of the dried pods of many species 
 of capsicum, and it is said to be frequent- 
 ly adulterated with coloui-ed saw-dust and 
 even red lead ; and a large proportion of 
 common salt is often added to it. Cay- 
 enne pepper is chiefly used as a season- 
 ing with food. It prevents flatulence 
 from vegetable food, and has a warm and 
 good effect on the stomach. It is believ- 
 ed to possess all the virtues of the Oiient- 
 al spices, without their tendency to pro- 
 duce complaints of the head. The use 
 of Cayenne pepper in medicine was first 
 begun by Dr. Adair, who found it of ser- 
 vice in that state of the constitution of 
 the slaves called Cachexia Africana ; a 
 bad habit of body in which they are pre- 
 disposed to disease. From five to eight 
 grains may be made into pills with crumb 
 of bread, and given for a dose. Cayemie 
 pepper furnishes a valuable gargle in cer- 
 tain cases of ulcerated sore throat. Twen- 
 ty grains are to be infused in a pint of 
 water, the infusion is to be strained,, and 
 an ounce of the tincture of mjrrrh is to 
 be added; the gargle to be used fre- 
 quently. Poultices of capsicum have been 
 applied in the drowsiness and delii-ium 
 common in the fevers of tropical climates. 
 In ophthalmia from relaxation, the dilut- 
 ed infusion is a good remedy; The tinc- 
 ture of capsicum may be used in those 
 cases where the remedy is judged proper; 
 the dose is from ten to thirty drops; 
 and two drachms of it, added to six ounces 
 of infusion of roses, or of barley water, 
 may be used as a gargle, diluting it if ne- 
 cessary. 
 
 CAVIARE. A food made of the hard 
 roes of sturgeon, formed into cakes, and 
 much esteemed in some of the northern 
 countries of Europe. 
 
CEP 
 
 CHA 
 
 111 
 
 CELERY, Apium graveolens. A pliiiit 
 wliose leaves and stalks are used as a sa- 
 lad. Tlieir digestibility is increased by 
 their bein^ steeped in vineg-ar. 
 
 CELLULAR MEMBRANE. The 
 cellular tissue of the body, composed of 
 plates and fibres variously conjoined, by 
 which the different parts of the body are 
 connected together. The cells over the 
 Avhole body communicate with each other, 
 and this is the reason that in dropsies, the 
 water passes into the different parts of 
 the body ; if the patients are in the erect 
 or sitting posture through the day, the 
 feet and legs are swelled at night ; and 
 by the horizontal posture during the night, 
 the swelling appears in the morning about 
 tlie head and upper parts of the body. 
 Hence also, when a wounded air-vessel 
 in the lungs transmits air into the neigh- 
 bouring cellular substance, that air passes 
 to every part of the body, and produces, 
 over the Avhole surface, an alarming swell- 
 ing, accompanied with a crackling noise, 
 when pressed upon. It is by means 
 of the communication of the cellular 
 membrane that butchers blow up their 
 veal ; and that some beggars produce 
 upon themselves the appearance of enor- 
 mous swellings, to excite compassion. 
 The cellular membmne fills up the 
 spaces between the different organs and 
 textm'es of the body ; it preserves them 
 all in their proper situation, prevents them 
 from unduly pressing upon each other, 
 and from interfering with the motions or 
 other functions they have to perform. It 
 is in particular cells also that the fat is 
 contained; and these are distinct from the 
 cells that allow the communication of air 
 and water. 
 
 CENTAURY. The name of a genus 
 of plants, formerly thought to be of much 
 service as tonics, astringents, and diure- 
 tics ; but now fallen into disuse. The blue 
 bottle, Centaurea Cj/aniis ; the blessed 
 thistle, Centaurea betiedicta, and some 
 others, are examples of this genus. 
 
 CEPHALIC SNUFF. Certain stimu- 
 lant powders used as snuff in cases of ob- 
 stinate headach, and in some diseases of 
 
 the eye. The compound powder of 
 asarabacca taken like snuff, to the ex- 
 tent of five or six grains at bed-time, 
 will operate the next day, producing fre- 
 quent sneezing, and likewise a copious 
 discharge from the nose. During its 
 operation, it is necessary to avoid exposure 
 to cold. 
 
 CEPHALIC VEIN. A large vein 
 which comes over the shoulder, and runs 
 down the back part of the arm ; by the 
 opening of which the ancients thought 
 that disorders of the head were relieved. 
 
 CERATE. A combination of fixed 
 oil or animal fat with some other sub- 
 stances, used as an external application 
 for ulcers, burns, wounds, &c. The most 
 useful of these are, Tui-ner's cerate, or the 
 ceratum lapidis calaminaris of the Edin- 
 burgh Pharmacopoeia, ceratumoxidi zinci, 
 &c. Preparations of lead, of mercury, 
 and other substances, are added to cerates, 
 according to the different intentions of 
 the practitioner. 
 
 CHALK. An abundant production of 
 nature, the combination of the carbonic 
 acid and lime. It forms vast tracts of 
 England. Salisbury Plain and Marlbo- 
 rough Downs form a centre, whence the 
 chalk emanates in a north-eastern direc- 
 tion through the counties of Buckingham, 
 Bedford, and Cambridge, and terminates 
 on the Norfolk coast. In an easterly di- 
 rection it traverses Hampshire, Surrey, 
 and Kent, terminating at Dover ; another 
 arm passing through Sussex, east south- 
 east, forms the South Downs, and the lofty 
 promontory of Beachy Head. (Brande.) 
 Chalk is the principal component of oys- 
 ter-shells, and enters into the composition 
 of other animal substances. 
 
 Chalk is used in medicine to correct 
 acidity in the stomach. Fof this purpose, 
 it is prepared by careful pounding and 
 washing. It may be taken in the dose of 
 from twenty to thirty grains ; but if there 
 be costiveness along Avith the acidity, it 
 will be better to abstain from its use, and 
 to employ some other antacid, as magne- 
 sia. When the chalk meets with an acid, 
 in the stomach, the substance produced 
 
112 
 
 CHA 
 
 CH A 
 
 generally renders the bowels slow, and 
 for this reason chalk is used in looseness 
 of the bowels. A preparatioii called the 
 chalk mixture is kept in the shops ; it is 
 made by triturating together one ounce of 
 prepared chalk, half an ounce of refined 
 sugar, and two ounces of mucilage of 
 gum arabic ; gradually adding two pounds 
 and a half of water, and a little cinnamon- 
 water to disguise the disagreeable taste of 
 the chalk. There is no great nicety re- 
 quired as to the dose ; one or two pounds 
 may be taken in the course of the day ; 
 and in severe cases a drachm of laudanum 
 may be added to each pound of the mix- 
 ture. Chalk is used in pharmacy for ob- 
 taining carbonic acid, and impregnating 
 water with it. When diluted sulphuric 
 acid is poured upon chalk, a great quantity 
 of carbonic acid is disengaged, and by 
 certain contrivances, the water is made to 
 absorb several times its own bulk of it ; 
 it then becomes soda-water, aerated al- 
 kaline water, &c. 
 
 CHALKSTONES. Concretions which 
 appear in joints long affected with gout. 
 When they accumulate, they destroy the 
 motion of the joint ; and when large they 
 sometimes burst through the skin, forming 
 extensive and troublesome ulcers. Chalk- 
 stones do not form, until after the consti- 
 tution is weakened and the tit iri'egular. 
 Physicians long were of opinion, that these 
 concretion* were an evidence that some 
 kind of morbid matter was the cause of 
 gout; but this theory is now given up. 
 They were also supposed to be similar to 
 urinary calculi. Dr. Wollaston subjected 
 them to chemical analysis, and found 
 them composed of uric acid and soda. 
 
 CHALYBEATE, containing some pre- 
 paration of steel or iron. Chalybeate me- 
 dicines are used in various diseases of 
 debility, in stomach complaints, in cases 
 attended with non-appearance or suppres- 
 sion of the monthly discharge in women, 
 in hysterics, and in debility produced by 
 disease, or by excessive discharges of 
 blood. Chalybeates are to be avoided 
 when there is too great quickness of 
 pulse, with too much firmness and rigidity 
 
 of the solids. The general virtues of iron 
 and its several preparations are, to take 
 off flabbiness of the muscular fibre, to 
 quicken the circulation, to promote the 
 secretions, and to prevent too great dis- 
 charges into the intestines. When iron 
 takes effect on the body, the pulse is 
 raised, the colour of the face becomes 
 more florid and healthy, and the discharges 
 by the skin, urine, and bowels, are in- 
 creased. The stools are in this case com- 
 monly of a dark colour. Iron is some- 
 times used in the metallic state : it is in 
 this state given in the centre of sweet- 
 meats ; iron filings are so used ; but as no 
 metal acts on the body till it be oxidated, it 
 is better atonce to give the oxidesof it, than 
 to take our chance of its being oxidated 
 in the stomach. The carbonate of iron 
 is a good and safe chalybeate; and may be 
 given in doses of from five to ten grains, 
 either alone or mixed with some aromatic 
 powder ; and this quantity is to be repeated 
 twice or thrice a-day. This preparation 
 of iron has of late been much recommend- 
 ed in cases of tic douleureux, and in can- 
 cer. The sulphate of iron, or green vi- 
 triol, is another form of giving chalybeates. 
 Two grains may be given tAvice a-day, or 
 a solution may be made of ten grains to a 
 pound of water, and a table-spoonful taken 
 twice or thrice a-day, adding some syrup 
 and some cinnamon-water to disguise the 
 harsh taste of the iron. The tincture of 
 muriate of iron is also an excellent form 
 of administering chalybeates. Ten drops 
 of this tincture are to be given in cold 
 water twice or thrice a-day. From the 
 above preparations of iron, all its good 
 effects may be expected, and it is there- 
 fore unnecessary to encumber the phar- 
 macopoeia or shops with more. 
 
 CHALYBEATE WATERS contain 
 iron, in the form of sulphate, carbonate, 
 or muriate. They have a harsh taste, like 
 ink; and are resorted to for the same pur- 
 poses, and employed in the same diseases, 
 as the preparations of iron. The princi- 
 pal of them are Hartfell, near Moffat, Pe- 
 terhead, Tunbridge, Brighton, Chelten- 
 ham, Bath, Lemington Priors, &c. 
 
CH A 
 
 Oil A 
 
 113 
 
 CHAMBERS of Tiit: Eye. Certain 
 iuipartments of the eye, containing clear 
 uids. See Evr. 
 
 CHAMOMILE, Anthemis nobilis. A 
 [ant indigenous in the south of England, 
 lit cultivated in gardens for the purposes 
 
 ■ medicine. The flowers are the part used, 
 hey have a strong aromatic smell, and a 
 jry bitter nauseous taste. They should 
 i selected fresh, and when rubbed, should 
 rongly exhale their peculiar smell. The 
 rge white flowers are generally preferred 
 ► the smaller kinds, which become brown 
 I drying. Chamomile flowers have long 
 3en famous as an excellent aromatic 
 tter ; the infusion of them is common- 
 ' known under the name of chamo- 
 ile tea, and when taken pretty strong 
 id Vvarm, it either of itself is em- 
 [oyed to empty the stomach, or is used 
 I an auxiliary to other emetics. A cup 
 ill of chamomile tea when cold, taken 
 I the moriiing before breakfast, is a good 
 •omatic, and helps to restore the tone of 
 le bowels. The powder of chamomile 
 >wers was at one time employed in the 
 ire of agues, but it is now disused. Cha- 
 oraile flowers are often used externally 
 i fomentations. The infused flowers are 
 ►lied up in a cloth or flannel, and thus 
 (tain the heat for a long time. 
 
 CHAMPAGNE WINES may be di- 
 ded into two classes, the sweet and 
 (ai'kling, and the dry and still. These 
 iferences arise partly from the mode of 
 anaging the fermentation and bottling 
 • the wine, and partly from the circum- 
 ances of the growth and situation of the 
 nes; the sunny side of a hill yielding 
 uit flt for the production of the sweet 
 ine, and the opposite aspect aifording 
 •apes calculated for the manufacture of 
 
 strong but dry wine. The sparkling 
 irieties of champagne, if not taken in 
 ccess, are the most speedily exhilarating 
 
 ■ all wines; they soon produce an ap- 
 •oach to intoxication, which is very tran- 
 ent, and generally harmless; but, iu- 
 ilged in to any excess, their effects are 
 ore tlian ordinarily pernicious ; and they 
 en stand unrivalled in the headach, 
 
 nausea, sickness, and universal derange- 
 ment of the system, m hich they create. 
 In habits tending to the formation of uric 
 acid, and in constitutions subject to red 
 deposits in the urine, or to affections of a 
 gouty character, champagne, even in mo- 
 deration, is certainly more apt than other 
 wines to create painful sensations in the 
 region of the kidneys, and in the small 
 joints of the hands and feet. It is well 
 known to have brought on fits of gravel 
 and of gout J yet there are some gouty 
 pei*sons who indulge in champagne with 
 at least temporary impunity, though in all 
 such cases prudence forbids its use. So 
 many persons complain of violent head- 
 ach, even after a single glass of good 
 champagne, that it should be interdicted 
 wherever there is a tendency to such af- 
 fections, from whatever cause they may 
 arise. Still, or non-eff'ervescing cham- 
 pagne, is often a strong and very heating 
 wine, very deceitful in these respects to 
 the palate. When of superior quality, it 
 has the singular aromatic flavour of cham- 
 pagne in an eminent degree; a flavour 
 which also exists, but is covered by car- 
 bonic acid, in the sparkling wine. The 
 latter should, therefore, not be drank till 
 the active effervescence has subsided, by 
 those who would relish this characteristic 
 quality. The prevalent notion that a glass * 
 of champagne cannot be too quickly swal- 
 lowed, is very erroneous, and shows great 
 want of taste in respect to the peculiar 
 excellence of this wine : to such persons, 
 a glass of perry or of gooseberry wine is 
 as acceptable as one of champagne : fur- 
 ther, it is no bad test of the goodness of 
 sparkling champagne to leave it exposed 
 for some hours in a wine glass, when, if 
 originally of the higher order, it will be 
 found to have lost its carbonic acid, but 
 entirely to retain its body and flavoui*. — 
 (Brande's Manual of Pharmacy.) 
 
 CHANCRE. A local disease generally 
 arising from the concubitus impurus, pre- 
 senting the following appearances : It be- 
 gins with an itching in the part ; this is 
 gradually converted into pain; in some 
 cases, the surface is excoriated, and after- 
 I 
 
114 
 
 CHE 
 
 CHE 
 
 wards ulcerated ; or a small abscess ap- 
 pears and turns into an ulcer. The parts 
 are affected with a thickening-, which ter- 
 minates abruptly, and does not gradually 
 lose itself, like some other swellings, in 
 the surrounding parts. Its base is hard, 
 and the edges a little prominent. In 
 parts where the skin is somewhat thick, 
 the chancre commonly makes its appear- 
 ance in the form of a pimple, which forms 
 a scab in consequence of evaporation. The 
 first scab is generally rubbed off, after 
 which a second, still larger, is produced. 
 From chancres, the poisonous matter 
 finds its way iuto the system, and in- 
 fects it with many distressing symptoms. 
 Chancres at first are mere local com- 
 plaints ; and in their treatment, our object 
 is to heal the local injury, and if possible 
 to prevent the morbid matter from get- 
 ting into the constitution. The local 
 treatment consists in applying caustic to 
 the sore, dressing it with mercurial or 
 red precipitate ointment, and keeping it 
 free from any accumulation of matter. 
 Merciu-y is to be introduced into the sys- 
 tem by pills or by inun/ition ; and when 
 it begins to affect the mouth gently, the 
 sore will probably be healed, and the 
 constitution secured from any further 
 danger. See Syphilis. 
 
 CHARPIE. Scraped linen or lint used 
 for the dressing of sores. It is called 
 caddis in Scotland. 
 
 CHARCOAL. See Carbon. 
 
 CHEESE. The curd of milk, pressed, 
 salted, and dried, with a portion of butter 
 remaining in it. The chief art of making 
 cheese consists in separating as perfectly 
 as possible the whey, as a very small pro- 
 portion of moisture accelerates fermenta- 
 tion and putrefaction. Cheese made from 
 the milk of sheep digests sooner than 
 that fi'om cows, but it is less nourishing ; 
 that from the milk of goats digests sooner 
 than either, but is the least nourishing. 
 Cheese, especially when new, is very 
 indigestible, except to the stomachs of 
 the strong and robust, and to those who 
 are accustomed to strong exercise. It 
 therefore does not seem a wise measure 
 
 to increase the labour of the stomach, at 
 the end of a copious dinner, by the addi- 
 tion of cheese. Indeed it is then gene- 
 rally used in small quantities, chiefly as 
 a condiment; and it is very commonly 
 old cheese, with abundance of insects, 
 which are generated in it when old, that 
 is used on such occasions. Its acrimony 
 and stimulus may then assist digestion, 
 or perhaps its putrid tendency may check 
 the acid fermentation of other aliments. 
 The toasting of cheese renders it still more 
 indigestible, by increasing its toughness. 
 The use of cheese is a popular remedy 
 in looseness of the bowels, but an im- 
 proper one. 
 
 CHELTENHAM WATER. A very 
 celebrated purging water, found at Chel- 
 tenham, in Gloucestershire, where there 
 is both a saline and chalybeate spring. 
 According to Brande, the saline water of 
 Cheltenham contains the sulphate of soda, 
 of lime, and of magnesia, and muriate of 
 soda. The sulphur spring contains the 
 same salts j and besides, it contains car- 
 bonic acid, sulphuretted hydrogen, and 
 oxide of iron. The chalybeate spring 
 contains the same salts, with a larger 
 proportion of the oxide of iron, also 
 carbonic acid and carbonate of soda. The 
 saline springs contain more salt than most 
 mineral waters, and the greater part of 
 them are of a purgative nature. The 
 sensible effects produced by this water 
 are generally, on first taking it, a de- 
 gree of drowsiness, and sometimes head- 
 ach. A moderate dose acts speedily and 
 powerfully as a cathartic ; without grip- 
 ing, or leaving behind it that faintness and 
 languor which so often folio avs the more 
 active purges. The quantity to be 
 drank as a purge, is from one to three 
 pints ; but in general, from half a pint to 
 a quart is a sufficient dose. Cheltenham 
 water has been recommended in a variety 
 of opposite diseases ; and, as might be 
 expected, has fallen into some degree of 
 discredit where it has failed to do good. 
 It appears to be useful in full habits, 
 where there is a degree of swelling and 
 congestion in the liver, where the secre- 
 
CHEMISTRY. 
 
 115 
 
 tion of bile is inconsiderable, and where 
 there is tendency to slowness of the 
 bowels. It is of more use in sanguine 
 constitutions than in the pallid and en- 
 feebled. When there are merely the com- 
 mon symptoms of stomach complaints, 
 with flatulency and acidity, and where 
 there is no hardness of the liver, Chelten- 
 Iiam water is not very useful. In delicate 
 pale habits, the purging plan is improper, 
 and the chalybeate spring of Cheltenham is 
 recommended. In those who have return- 
 ed from the East or West Indies, whose 
 biliary system is almost always deranged, 
 the purgative plan is very beneficial, and 
 is a good preparation for a more strength- 
 ening treatment; and in such patients, 
 the daily exercise and habits of tempe- 
 rance they practise, or ought to practise, 
 contribute essentially to their recovery. 
 In cases of jaundice arising from some re- 
 sistance to the free discharge of bile, with 
 a sense of heat, distemper, and fulness, 
 increased soon after eating, Cheltenham 
 water is useful. It is also said to be use- 
 ful in jaundice from gall-stones, but in 
 such cases, it should be drank warm. In 
 irritable and feverish habits, with thirst 
 and general languor, arising from some 
 local affection or disease of the bowels, 
 the waters of Cheltenham are less benefi- 
 cial. The season for drinking the Chel- 
 tenham waters is the summer months ; 
 and as they lose their effects by daily re- 
 petition, they must be alternated occasion- 
 ally with other purgatives, as aloes, rhu- 
 barb, jalap, or calomel. 
 
 CHE M 1 STRY. The professors of this 
 splendid and delightful science have been 
 very hard to please with its definitions, 
 ^o fewer than eight different attempts 
 have been quoted from different authors 
 by Mr. Brande in his History of Che- 
 mistry. We shall adopt the one given by 
 Dr. Thomson, who on this subject has an 
 unquestionable right to be heard : " The 
 object of chemistry is to ascertain the in- 
 gredients of which bodies are composed, 
 to examine the compounds formed by the 
 combination of these ingredients, and to 
 investigate the nature of the poAver which 
 
 produces these combinations." (Thom- 
 son's System of Chemistri/, 1820.) 
 
 If we consider the different parts of this 
 definition, we shall be struck with the 
 extent and importance of the science of 
 chemistry. It endeavours to ascertain 
 the ingredients of which bodies are com- 
 posed ; and as there is hardly a substance 
 around us which nature presents in a sim- 
 ple state, it is evident that the boundless 
 variety of plants and animals, minerals 
 and elastic fluids, are all objects of che- 
 mical investigation. 
 
 In ancient times, all bodies were sup- 
 posed to be derived from four elements ; 
 but the more exact analysis of modern 
 times has ascertained, that there are many 
 more undecompounded principles than 
 four ; and instead of elements, has fixed 
 on the term of simple bodies^ meaning by 
 this, only to place them in that class of 
 bodies which have not yet been reduced 
 to any that are more simple. These in- 
 gredients or simple bodies combine to 
 form more complex ones ; and their va- 
 rious compounds found in nature, or form- 
 ed by art, are applied to many purposes of 
 life. Thus we are indebted to chemistry 
 for many valuable medicines, for improve- 
 ments in agriculture, in manufactures, in 
 dying, and in bleaching ; and to chemists 
 we owe the illumination of our cities by 
 gas, the speed and certainty of naviga- 
 tion by steam, and the security of the 
 miner by the safety-lamp. The power 
 by which these combinations are effected 
 is of more difficult investigation ; and after 
 collecting and arranging the phenomena, 
 we say that they are produced by affi- 
 nity ; a term which, like gravitation in 
 natural philosophy, expresses the gene- 
 ralization of many facts, the cause of 
 which we cannot trace. 
 
 The instruments which chemistry em- 
 ploys in her investigations are many and 
 various. Heat is a most important one ; 
 light, electricity, and galvanism, produce 
 many chemical changes ; and to the skil- 
 ful application of the latter power in the 
 hands of Sir Humphrey Davy, are owing 
 not only some of the most brilliant disco- 
 
116 
 
 CUE 
 
 CHE 
 
 veries in chemistry, but a'so such views 
 of the science, as threaten to shake the 
 foundations of that theory, which seemed 
 imraoveably settled by the g-enius of La- 
 voisier. 
 
 We cannot here enter into the details 
 of chemistry, for which we must refer to 
 the treatises composed on the subject ; nor 
 can yve trace the progress of discovery, 
 from the first rude ages of ignorance 
 and imposture, to the world of v/onders 
 which has burst upon our sight within the 
 last fifty years, in consequence of the la- 
 bours of Black and Priestley, Sclieele, 
 and Cavendish. To those who have op- 
 portunities to examine the History of 
 Chemistry, it will afford a high interest 
 to observe the genius and patience which 
 its cultivators have exercised, and the gra- 
 tifying results they have obtained; at 
 once illustrating the wisdom of the Crea- 
 tor in the constitution of the material 
 world, and his goodness in placing v/ithin 
 the reach of human industry, so many 
 materials for the comfort and erabellish- 
 jnent of civilized life. 
 
 CHERRY, Prunus Cerasus. A stone 
 fruit much eaten, and, like other smnraer 
 fruits, cooling and laxative, but possessed 
 also of the bad qualities of stone fruits 
 when taken in excess or unripe ; being 
 difficult of digestion and apt to give rise 
 to dysenteric symptoms. 
 
 CHERRY BRANDY. A fascinating 
 liqueur, made by infusing the pulp and 
 broken kernels of cherries in brandy, and 
 SAveetening the infusion with sugar. It 
 partakes of the properties of ardent spi 
 rits, and when taken as a dram, has the 
 additional danger of inducing its repeti- 
 tion by the pleasantness of its flavour. 
 
 CHESNUTS, from the Castanea vul- 
 garis, are chiefly used as an article of des- 
 sert, but on some occasions they are eaten 
 ■with food. They are to be avoided by 
 dyspeptic patients. As the chesnut af- 
 fords no oil by expression, it is more near- 
 ly allied to farinaceous vegetables than to 
 nuts ; it may even be made into bread, 
 but is heavy and indigestible. Chesnuts, 
 •when eaten after dinner, should be roast- 
 
 ed, and no stomach but the very strong- 
 est should venture upon them. They 
 should not be allowed to children. 
 
 CHEST. The cavity which lies be- 
 tween the neck and the abdomen. It is 
 bounded by the ribs and the intercostal 
 muscles, the spine, and breast-bone ; and 
 below by the diaphragm ; and contains 
 •within it many very important organs. 
 The heart, with the great bloodvessels, 
 both arteries and veins, is contained in 
 it; as also the lungs, the thoracic duct, the 
 eighth pair of nerves, and the intercostal 
 nerve. The windpipe passes into the 
 thorax, and the gullet proceeds through 
 it to terminate in the stomach. The chest 
 is lined by a fine membrane called the 
 pleura, a doubling of which invests the 
 lungs ; and hence in the healthy state, the 
 lungs move freely in the cavity of the 
 chest. The variety and importance of 
 the organs contained within the chest, 
 render it liable to become the seat of 
 many diseases. The varieties of asthma, 
 cough, difficulty of breathing, consump- 
 tion, &c. have their origin in some dis- 
 eased action, structure, or secretion with- 
 in the chest. Severe diseases also occur 
 when the large bloodvessels are enlarged 
 or ossified ; and effusion, whether of blood, 
 pus, or water, produces dangerous symp- 
 toms. See the following Article. 
 
 CHEST, Water in the. An accu- 
 mulation of water in the chest, or, more 
 accurately, between the investing mem- 
 brane of the lungs, and the membrane < i 
 lining the oatsidB of the ribs. The symp- ' -^ 
 toms produced by such accumulation are 
 the foUoM'ing : Difficulty of breathing, 
 especially when lying in the horizontal 
 posture, or when going up a stair or other 
 ascent, inability to lie on one side, name- 
 ly, that opposite to where the water is 
 accumulated, sudden startings from sleep, 
 palpitations of the heart, irregularity of 
 the pulse, pale countenance, scanty urine, 
 and considerable debility. Patients la- 
 bouring under water in the chest some- 
 times die very suddenly; but in other 
 cases, a spitting of blood occurs for a few 
 days before the fatal termination. 
 
CHE 
 
 CHI 
 
 117 
 
 Causes. "Water in the chest is often 
 an attendant of general dropsy, but it not 
 unfrequently appears as a disease by it- 
 self. The same causes which give rise to 
 general dropsy, may occasion water in the 
 chest. It may also follow various dis- 
 eases of the lungs, of the heart, and great 
 bloodvessels ; it also affects persons who 
 have been long confined to sedentary em- 
 ployments, requiring much stooping ; and 
 those who have been addicted to the use 
 of spirits, or who have laboured under 
 asthma. It sometimes presents alarming 
 symptoms rather suddenly, no signs hav- 
 ing previously occurred to denote its ga- 
 thering. 
 
 Treatment. Water in the chest is a 
 disease from which recovery is rare. We 
 are to attempt the cure by active purges, 
 proportioned to the strength of the pa- 
 tient; by medicines which increase the 
 flow of urine, and occasionally by emetics. 
 A medicine which has been thought pecu- 
 liarly applicable in this disease, is the digita- 
 lis or fox-glove; and under that article we 
 have laid down the precautions necessary 
 in its use. Relief has also been attempt- 
 ed, by a surgical operation, to discharge 
 the fluid; this will certainly, in many 
 cases, give great temporary relief, but 
 there will be every reason to fear that the 
 water will again accumulate. The same 
 operation is applicable to the removal of 
 blood or matter from the chest. See 
 Puncturing the Chest. 
 
 It may be proper to mention here, that 
 an instrument has lately been invented in 
 France, by which much important infor- 
 mation is communicated respecting the 
 contents of the chest. It is formed on 
 the principle of sound being conveyed 
 along wood; and the noise made in breath- 
 ing, or by the striking of the heart and 
 vessels on the sides of the chest, is con- 
 veyed along this wooden roller, called a 
 stethoscope^ or inspector of the chest. 
 We cannot in a popular work attempt to 
 give any account of the symptoms of dis- 
 ease explained by means of the stetho- 
 scope. It requires considerable practice 
 
 and attention to that particular branch to 
 be familiar with it ; and, from its recent 
 introduction into the medical art, dexte- 
 rity in its use is as yet confined to a few 
 practitioners. See Stethoscope. 
 
 CHICKEN-POX. A disease of the 
 eruptive kind, in various particulars re- 
 sembling small-pox, and apt to be con- 
 founded with it. At present, there is a 
 considerable difference of opinion among 
 medical men, with respect to the nature 
 and even the existence of chicken-pox as 
 a distinct disease ; some considering it as 
 such, while others consider it only as a 
 modification of small-pox, occasioned by 
 the previous occurrence either of small- 
 pox or of cow-pox. While the matter 
 continues undecided, we shall describe 
 it as a distinct disease, and mention some 
 of the symptoms in which it diff'ers from 
 small-pox. Chicken-pox arises from a 
 peculiar contagion, and attacks persons 
 only once in their lives. It is preceded 
 by chilliness, by sickness, or vomiting, 
 headach, thirst, restlessness, and a quick- 
 ened pulse. After these feverish symp- 
 toms, which are generally slight, pimples 
 appear on different parts of the skin, in 
 the form of small red eminences, not ex- 
 actly circular; having a surface shining, 
 and nearly flat, in the middle of which a 
 small clear vesicle soon forms. On the 
 second day, this is filled with a whitish 
 lymph ; on the third day, the fluid is straw- 
 coloured ; and on the fourth day, the ve- 
 sicles which have not been broken begin 
 to subside. Few of them remain entire 
 on the fifth day ; and on the sixth, small 
 brown scabs appear in place of the vesi- 
 cles. On the ninth and tenth days, they 
 fall off^, without leaving any pits. Chick- 
 en-pox is generally a disease of little or 
 no danger; requiring only some mild lax- 
 ative medicine with diluent drinks, avoid- 
 ing exposure to cold, and attending to the 
 diet, and to the bowels during recovery. 
 If in any case the fever should be moio 
 severe, stronger purgatives may be neces- 
 sary ; and some medicine may be given to 
 promote perspiration, and to diminish fe- 
 
118 
 
 CHI 
 
 C HI 
 
 ver, as small doses of antimonials ; with 
 the spiritus Mindereri, or a little nitre 
 added to the drink. 
 
 The principal marks of distinction be- 
 tween chicken-pox and small-pox are the 
 following : The small-pox commences 
 with a variety of severe symptoms of ap- 
 proaching fever, with vomiting, and even 
 sometimes with convulsions; and at a pe- 
 riod generally well defined, viz. the third 
 day, the fever abates a little, and the erup- 
 tion appears ; but in the chicken-pox the 
 fever is milder, and more uncertain in its 
 duration : the pimples of chicken-pox are 
 more quickly formed into vesicles or pus- 
 tules than those of the small-pox are : the 
 fluid in chicken-pox does not acquire the 
 thick purulent consistence of that in 
 small" pox : and in chicken-pox, the crusts 
 or scabs are formed far earlier than in 
 small-pox : lastly ^ in chicken-pox there 
 is no secondary fever. 
 
 CHIGRES. A kind of sand flea, very 
 troublesome in the West Indies. It most 
 commonly insinuates itself into the soft 
 parts of the fingers and toes, particularly 
 under the nails, where it causes a dis- 
 agreeable itching and heat. In process of 
 time, a bag or bladder is formed, in which 
 thousands of little eggs are deposited ; and 
 these become so many young chigres, 
 which, if not speedily extracted, create 
 running ulcers. Sometimes the limb, and 
 even the life, has been lost, by neglecting 
 to root them out in proper time. As soon, 
 therefore, as any heat or itching is per- 
 ceived in any part affected with a chigre, 
 it will be advisable to extract it. This is 
 done with a needle, and it is always proper 
 to take out the cyst also, as troublesome 
 ulcers are sometimes formed when it is 
 broken. The cavity is then usually filled 
 up with tobacco ashes or snufF; or the 
 parts infected may be rubbed with the oil 
 from the cashew nut, or with a decoction 
 of tobacco, or solution of the sulphate of 
 copper. 
 
 CHILBLAINS. A painful inflamma- 
 tory swelling on the extreme parts of the 
 body, as the fingers, toes, and heels, oc- 
 casioned by cold. A very common way 
 
 of getting chilblains, is by bringing tlie 
 hands and feet neai* the fire in cold frosty 
 weather. The colour of chilblains is a 
 deep purple or leaden hue, the pain is 
 pungent and shooting, and a very disagree- 
 able itching attends. In some instances, 
 the skin remains entire, in others it breaks, 
 and a thin fluid is discharged. When the 
 cold has been great or long continued, 
 tlie parts affected are apt to mortify and 
 slough ofi^, leaving a foul ulcer behind. 
 Whenever «iny part is affected w\th. chil- 
 blains, it should be well rubbed with spi- 
 rits of turpentine, spirit of wine, or tinc- 
 ture of camphor ; and even when the skin 
 is chopped, these stimulating embrocations 
 are the best. When ulcers occur, the 
 dressings should not be of a relaxing na- 
 ture, but have some degree of stimulating- 
 power, such as the basilicon ointment, 
 either alone or having a little turpentine 
 mixed with it. A poultice may be re- 
 quired for a day or two at first, to get 
 rid of the foul matter and sloughs. — 
 Persons who are subject to chilblains 
 should be careful to avoid cold and wet 
 feet, and not to expose the feet suddenly 
 to the heat of a fire when they ai-e cold. 
 It might probably be a good method of 
 preventing chilblains, daily to immerse 
 the feet in cold water, and rub them 
 dry ; or to rub them with snow when it 
 can be procured. Chilblains more fre- 
 quently occur in old and young persons, 
 than those in the vigour of life. 
 
 CHILDBED FEVER. See Puerpe- 
 RAL Fever. 
 
 CHILDBED STATE. See Preg- 
 nancy, Abortion, Flooding, Labour, De- 
 livery, &c. 
 
 CHILDREN, Diseases of. The pe- 
 riod of childhood is considered, by medi- 
 cal authors, to extend from the seventh 
 to the fourteenth year. Though the 
 feebleness of infancy is past, and children 
 are better able to resist many external 
 causes of disease, there are yet many ma- 
 ladies which assail them during those 
 ye,ars ; and which require much attention 
 on the part of those who have the care of 
 them. They are liable to inflammatory 
 
CHILDREN. 
 
 119 
 
 attacks, and the various effects of cold, as 
 fevers, water in the head, sore throat, 
 croup, and swelling^s of the glands ; to all 
 the varieties of eruptive diseases, as mea- 
 sles, small-pox, scarlet fever ; and to va- 
 rious howel complaints, often arising from 
 the indigestible substances they are so 
 fond of eating; to colic, looseness, and 
 worms. Children are also subject to ner- 
 vous disorders, as palsy, epilepsy, St. Vi- 
 tus's dance ; and to various diseases pro- 
 ceeding from bad habit of body, as dropsies, 
 rickets, and scrofula. The symptoms and 
 treatment of these various maladies will 
 be found under their respective names. 
 
 CHILDREN, MANAGE3IENT OF. The 
 period of childhood is of the greatest im- 
 portance, as it is the time when habits 
 are formed, that materially affect the com- 
 fort and usefulness of the individual in 
 after life. Children, in civilized society, 
 cannot be left to the care of nature, like 
 the young of the lower animals; but 
 must be directed and controlled in many 
 things, by the prudence of those who are 
 more experienced than themselves. The 
 principal points demanding attention are 
 the regulation of the diet, bowels, sleep, 
 clothing, cleanliness, and exercise. 
 
 1 . Diet. Between the period of wean- 
 ing and the seventh year, the diet should 
 consist very much of farinaceous food, 
 and milk ; with a moderate allowance of 
 animal food once or twice a-week, al- 
 ways taking care that it be dressed in the 
 most plain and simple way, with the rigid 
 exclusion of all savoury sauces, or heating 
 condiments ; such as would either tempt 
 them to eat too much, or be heating to 
 the mouth and stomach ; and that would 
 raise a feverish excitement, or cause them 
 to drink too much fluid. A soft boiled 
 eir^y rice or bread puddings, sago, panado, 
 or arrow root, will form a pleasing va- 
 riety in the diet of children. Oatmeal 
 porridge has been the food of many a 
 tiealtliy and thriving child. They may 
 be allowed to eat ripe fruit in moderate 
 quantity; but the stone fruits are very 
 apt to produce bad effects on the stomach. 
 The drink should be plain water, good 
 
 small beer, or whey. After the seventh 
 year, when the exercise is more violent, 
 and the rapid growth of the body requires 
 copious nutriment, the allowance of ani- 
 mal food may be a little more liberal; 
 but through the whole period of child- 
 hood, and indeed almost through life, 
 great quantities of butter, pastry, smoked 
 and stimulating food, should be avoided. 
 
 2. Bowels. To keep the bowels of chil- 
 di-en in a healthy and regular state, is a 
 matter of the utmost consequence. They 
 are too apt to neglect the calls of nature, 
 not being aware of the great importance of 
 regularity in this respect ; and those who 
 have the care of them, should very fre- 
 quently inquire about them, and not suf- 
 fer them to go beyond one day without a 
 motion of the bowels. Female children 
 particularly, should be very much attend- 
 ed to by their seniors. Costiveness is 
 one great cause of ill health in females, 
 and the acquirement of regular habits 
 with respect to their bowels is to them 
 exceedingly valuable. Laxative medi- 
 cines should not be given, unless in case 
 of actual sickness, or very evident threat- 
 ening of it ; and for children, it may be 
 useful to give calomel and rhubarb, sen- 
 na, or the compound powder of jalap. 
 Children should be early taught habits of 
 self-command in the taking of medicine, 
 even although nauseous; and it would save 
 them much trouble if they would learn to 
 swallow pills, as very active medicines 
 may thus be introduced into the system 
 in a very easy way. The diarrhoea of 
 children should not be neglected ; it very 
 often arises from cold caught by being too 
 thinly clothed ; or from some article of 
 diet disagreeing with the stomach. An 
 occasional laxity for a day or two at a 
 time, is rather to be considered as salu- 
 tary ; but more than this is to be check- 
 ed, as tending to debility. The safest 
 medicine to check looseness of the bowels 
 in children, is the chalk mixture; to 
 which the tincture of kino may be added, 
 in the proportion of three drachms to the 
 pound of the mixture ; or half a pint of 
 the infusion of catechu to the same quan- 
 
120 
 
 CHILDREN. 
 
 tity. Children are very subject to worms, 
 and this is one reason why the use of 
 fruit should be very sparing-ly allowed 
 them. When we are very sure that 
 worms are present, the child should take 
 powders of jalap and aloes, of calomel 
 and scammony, or other medicines which 
 have been found useful in this disorder. 
 But there are many children who are 
 troubled with disordered bowels, and who 
 exhibit many of the symptoms of hav- 
 ing- worms, when there are really none 
 in the intestines ; these symptoms are, a 
 pale colour, bad breath, defective appetite, 
 and bad digestion, with frequent picking- 
 of the nose ; but, fortunately, a course of 
 medicines, nearly the same as for worms, 
 is proper for that assemblage of symp- 
 toms. 
 
 .3. Sleep. Children generally take a 
 great deal of rough and boisterous bodily 
 exercise,* and during- their education, their 
 minds too are pretty much employed ; all 
 which occasions considerable exhaustion, 
 so that it seems quite proper to allow 
 them a due share of sleep, from eight to 
 nine or ten hours at least. But it should 
 be at sleeping time; and they should not 
 be allowed to dose and saunter during- 
 their waking hours. 
 
 4. Clothing, Children should have their 
 dress accommodated to the season ; and a 
 due degree of warmth should be kept up. 
 It is wrong to expose them to cold in or- 
 der to harden them ; but a proper degree 
 of exercise in the cold air should be taken. 
 The great evils to be avoided are, cold ac- 
 companied with moisture, and any check 
 to perspiration ; which boys too often sus- 
 tain, by throwing themselves down on the 
 moist ground, when heated by their games. 
 Flannel next the skin need not be order- 
 ed for healthy children ; but where there 
 is much tendency to catch cold, or to have 
 loose bowels, or continual paleness of 
 the skin, and weakness of the system, it 
 wiU be prudent to make children wear 
 flannel. Much care should be taken to 
 have the feet always warm and dry ; and 
 to make them change their shoes as well 
 •IS their clothes, whenever they get >vet. 
 
 5. Cleanliness. Cliildrcn should veiy 
 early be taugiit the necessity and import- 
 ance of cleanliness. They should be made 
 to keep their hair, their teeth and naiLs in 
 good order, as it not only promotes their 
 own health and comfort, but renders them 
 agreeable to all around them. It is of the 
 utmost consequence to keep the skin very 
 clean, as this tends to prevent many of 
 the cutaneous diseases which are so com- 
 mon with children, but which are so dis- 
 gusting. Washing with cold water about 
 the chest, will lessen the susceptibility to 
 cold ; and about the feet, will strengthen 
 them, and render them less liable to chil- 
 blains. Sea-bathing and swimming in 
 safe places, are excellent both for health 
 and cleanliness. Cleanliness is not with- 
 out a degree of moral influence, and has 
 been very properly styled one of the mi- 
 nor virtues. 
 
 6. Exercise. Children when in tolerable 
 health, and not of an indolent disposition, 
 seldom require to be urged to take exer- 
 cise ; they are rather inclined to take it 
 too much, and too violently, and need a 
 little regulation and superintendence in 
 this respect. The practice of gymnastics 
 or dancing is a good exercise j and girls 
 should use the skipping ropes. When 
 out of doors, children should be allo^>'- 
 ed to choose their own amusements, and 
 interfered Avith only when they are in 
 danger of doing any thing unbecoming, 
 or hurtful to themselves or their com- 
 panions. Even girls should have ample 
 scope in their play ; time, and their own 
 sense of propriety, wiW. soon enough cor- 
 rect any tendency to improper romping ; 
 their health will be promoted, and their 
 figure expand ; and it is better to possess 
 a sound constitution and an active frame, 
 than to be celebrated for proficiency in 
 drawing or music, before the age of twelve 
 or thirteen. 
 
 Though a prudent direction ought cer- 
 tainly to pervade the whole management 
 of children, yet it ought not to be carried 
 too far; and it is not often observed 
 that they who refiiie the most in educa- 
 tion, are the most successful in attain-t 
 
C H L O It I N E. 
 
 121 
 
 ing theii» object ; or that the subjects of 
 rigid and unbending regularity, are the 
 healthiest or the happiest children. The 
 precise walk of jusi an hour and no more, 
 on a line or circle from which they must 
 not deviate, cannot convey the same health 
 and exhilaration as the cheerful, free, and 
 expatiating ramble which youth would 
 take for themselves. 
 
 We would take this opportunity of re- 
 commending to parents, not to hurry the 
 education of their children, nor on that 
 account to confine them too much in one 
 posture, secluded from the open air, and 
 deprived of the exercise which the salu- 
 tary dictate of nature impels them to 
 delight in. They should often be per- 
 mitted to change their attitudes, and 
 even sometimes to lie down on the rug 
 or sofa. Awkward habits must be check- 
 ed ; and when there is any tendency to 
 deformity, machinery may be requisite ; 
 but it should be simple and light, and al- 
 ways under the direction of a skilful and 
 upright medical man, who has made the 
 mechanism of the bones and joints of the 
 human body an object of careful study. 
 
 CHINCOUGH. ^-ee Hooping Cough. 
 
 CHLORINE. The name of a gas, of 
 a greenish colour, and possessed of very re- 
 markable properties. It is a supporter of 
 combustion, that is, inflammable bodies 
 burn in it. It has a pungent and suffo- 
 cating smell ; and in experiments on it, it 
 should not be suffered to escape into the 
 room, as it is very injurious to the lungs, 
 and may induce inflammation, consump- 
 tion, or other diseases of that organ. It 
 is heavier than common air. It is ab- 
 sorbed by water, and imparts to water 
 the property which itself possesses, of de- 
 stroying vegetable colours. Hence, it is 
 used in bleaching. It is not used in its 
 simple state in medicine, except for fu- 
 migating apartments, in order to destroy 
 contagion. It may be procured for this 
 purpose, from a mixture of eight parts of 
 common salt, three of black oxide of man- 
 ganese, four of water, and five of sulphu- 
 ric acid. 
 
 This gas was formerly called the oxy- 
 
 muriatic acid, because it was believed to 
 be the muriatic acid combined with a 
 quantity of oxygen ; but Sir Humphrey 
 Davy, having failed to decompose the gas 
 by the most powerful chemical agents he 
 could employ, considered chlorine as a 
 simple body ; and his views on that sub- 
 ject are now almost universally acquiesced 
 in by chemists. In consequence, it be- 
 came necessary to change the names of 
 the compound bodies into which chlorine 
 enters, and such substances are now 
 termed Chlorides. Thus, chlorine united 
 in one proportion to mercury was former- 
 ly the submiu-iate of mercury, but now 
 the chloride of mercury, or calomel ; and 
 chlorine in two proportions with the same 
 mineral is called bi- chloride of mercury ; 
 and from its properties and mode of pre- 
 paration, con-osive sublimate. In speak- 
 ing of substances soactive,and aboutwhich 
 mistakes would be dangerous, it is better 
 to dispense with chemical precision of no- 
 menclature, and to prescribe or to pur- 
 chase them by the names of calomel and 
 corrosive sublimate. The chloride of lime 
 and the chloride of soda have been found 
 to ha^e the valuable property of arresting- 
 putrefaction, and destroying the bad smell 
 both of living and dead animal substances. 
 Three or four pints of Mater must be 
 poured on two ounces of chloride of lime, 
 the whole well mixed and strained, and 
 the solution sprinkled over tainted places. 
 The union of chlorine with soda, of which 
 the minute chemistry need not be given 
 here, is of excellent use in all bad-smcllcd, 
 foul, and irritable ulcers, discharges, &c. 
 It is commonly sold by the druggists un- 
 der the name of chlorate of soda, ready 
 for use. 
 
 Chlorine combines with oxygen, and 
 forms chloric acid; and this united to dif- 
 ferent bases, forms Chlorates, formerly 
 termed hyper-oxjonuriates. The chlo- 
 rate of potassa is used in the percussion 
 locks of fire-arms. 
 
 CHLOROSIS, or Green Sickness. A 
 disease of females, generally connected 
 with non-appearance or suppression of 
 the monthly discharge. The most pi*o- 
 
122 
 
 CHLOROSIS. 
 
 minent symptoms of the disease are, hea- 
 viness, disinclination to motion or exer- 
 tion, much fatigue from very little exer- 
 cise, pains of the hack and loins, disorders 
 of the stomach and bowels, as flatulency, 
 acidity, and costiveness ; and in some 
 cases an immoderate appetite for food, or 
 a desire for chalk, cinders, and other dis- 
 gusting and indigestible substances. As 
 the disease advances, the face assumes a 
 pale or yellowish colour, the body also is 
 pale and flaccid, the feet and legs swell, 
 there is rapid breathing on very slight 
 exertion ; the pulse is quick and small, 
 and there is much despondency or change- 
 ableness of mind, great agitation on slight 
 alarm, with the sensation of a ball in the 
 throat and belly, and other symptoms of 
 hysteria. 
 
 Treatment. The symptom which most 
 impresses the mind of the patient and her 
 female friends, is the non-appearance of 
 the menstrual discharge ; and to this their 
 wishes and remedies are anxiously direct- 
 ed. This is a function over which we 
 have no direct controul. We have medi- 
 cines which can act directly and power- 
 fully on the stomach, and some on the 
 kidneys; but we have none that acts di- 
 rectly on the uterus ; and to accomplish 
 the regularity which we desire in its func- 
 tions, we must strengthen the constitution 
 and improve the general health. This is 
 to be done by the use of a nourishing but 
 easily digested diet, by a moderate allow- 
 ance of wine or porter, by regular exer- 
 cise, in small measure at first, and gra- 
 dually increased as the patient is able to 
 bear it ; by a residence in the country, by 
 a prudent management of the mind, keep- 
 ing it cheerful and serene, and not suffer- 
 ing the patient to have anxious forebod- 
 ings about her own health. When the cir- 
 cumstances of the case admit of it, resort- 
 ing to a watering-place should be recom- 
 mended. With respect to means more 
 sti'ictly medicinal, tonic remedies ai-e to 
 be given. Of these, the bark and iron 
 are the chief: a tea-spoonful of bark or 
 three grains of quinine are to be taken 
 every day ; and ten drops of the tincture 
 
 of muriate of iron in cold water ; or one 
 or two grains of the sulphate of iron made 
 into a pill with crumb of bread, or ten 
 grains of the carbonate of iron with a little 
 aromatic powder. The bowels are to be 
 most particularly attended to. It is the 
 opinion of many respectable and expe- 
 rienced physicians, that it is not the ute- 
 rine system, but the alimentary canal that 
 is in fault in chlorosis ; and even if the 
 uterus is the organ to be attended to, 
 there is not a safer or better way of doing 
 it, than by assiduous attention to the re- 
 gular action of the bowels. It is almost 
 universally found, that those young per- 
 sons whose bowels are unusually slow, 
 who from indolence and thoughtlessness 
 pay no attention to their regular evacua- 
 tion, are precisely those who are most 
 troubled with irregularity of the monthly 
 discharge, and all the train of symptoms 
 of languor, indigestion, and impaired vi- 
 gour of their system. It should therefore 
 be an object of sedulous care and vigi- 
 lance on the part of parents, and those 
 with whom the early years of females are 
 spent, to watch over the regularity of 
 their habits in this respect ; and to incul- 
 cate upon them, the necessity of never 
 neglecting a' circumstance so essentially 
 conducive to their health in every period 
 of their lives, but especially at that period, 
 to them the most interesting. The pur- 
 gatives most proper in chlorosis are 
 those of the aloetic kind, which act more 
 especially on the lower parts of the intes- 
 tines, and which by sympathy may also 
 be expected to act on the neighbouring 
 oi'gans. The pills of aloes Avith assafetida, 
 are a good medicine in chlorosis, as they 
 will tend to relieve the flatulence which 
 accompanies it. Two pills every second 
 night, interposing a brisk purge of jalap, 
 or salts, or senna, once in eight or ten 
 days, are a useful remedy. Remedies 
 used in dropsy, as spirit of nitrous ether, 
 cream of tartar, turpentine, and in some 
 cases, mercury, are necessary in chlorosis. 
 Warm bathing of the loins and lower ex- 
 tremities, and fomentations to the back 
 and neighboui'ing regions, are useful aux- 
 
CHOLERA MORBUS. 
 
 123 
 
 iliaries. Electricity applied to the r^ion 
 of the litems is sometimes of great use in 
 exciting its action, and procuring the dis- 
 charge. 
 
 These measures will require to be per- 
 sisted in, perhaps for many months ; and 
 the sex should be cautious how they trust 
 to the multiplied nostrums which are pro- 
 posed for their relief. From delicacy, 
 they are apt to take the advice of the ig- 
 norant and credulous of their own sex, 
 and weary themselves in the fruitless em- 
 ployment of what will never at all answer 
 the end proposed. In general, we may 
 promise, that with care and patience, and 
 the skilful exhibition of proper medicine, 
 aided by nourishing diet, regimen of the 
 mind, and exercise, the constitution will 
 be strengthened, and the disease removed, 
 and the fair sufferers restored to that ala- 
 crity and vigour which is proper to their 
 age. 
 
 CHOKE DAMP. The name given by 
 miners to the destructive gas, carbonic 
 acid, which being heavier than common 
 air, occupies the lower parts of any vessel, 
 and remains at the bottom of mines and 
 caverns. The usual method of trying 
 whether it is present in any place, is to 
 put down a lighted candle, which it im- 
 mediately extinguishes ; and it would be 
 a good way of freeing a small cavern or a 
 brewer's vat from it, to put doM-n a few 
 tubs of lime water, and agitate the 
 water. The carbonic acid will be attract- 
 ed by the lime, and pure air will supply 
 its place. 
 
 CHOCOLATE is prepared by reducing 
 the cocoa-nut to paste, with sugar, milk, 
 or eggs ; it is also frequently mixed with 
 aromatics. Although chocolate abounds 
 with nutritive matter, it contains an oil 
 which is difficult of digestion. It is there- 
 fore improper to be used as a common 
 beverage. Tea or coflfee is to be preferred. 
 The cocoa-nut mentioned above as yield- 
 ing chocolate, is not the large Icernel like 
 a man's head, which is obtained from a 
 species of palm-tree in tropical climates, 
 but the fruit of the Theohroma Cacao of 
 Linnaeus. See Cocoa-nut tree. 
 
 CHOLAGOGUES. Medicines which 
 are supposed to produce an increased se- 
 cretion and discharge of bile, or bilious 
 stools. This appellation seems due to 
 mercurial medicines chiefly, perhaps sole- 
 ly. Rhubarb may be usefully joined with 
 calomel and the other preparations of mer- 
 cury. 
 
 CHOLERA MORBUS. An acute 
 and dangerous disease, arising from a re- 
 dundancy or vitiated secretion of bile. 
 
 Symptoms. There are frequent dis- 
 chai^es of bilious matter, both upwards 
 and downwards. The disease usually 
 comes on with sickness, retching, disten- 
 tion and flatulency of the stomach, grip- 
 ing pain of the bowels ; and there are also 
 heat, thirst, quick breathing, and a fre- 
 quent, but weak and fluttering pulse ; and 
 in very severe cases, cramps of the legs. 
 When the disease is violent, there is great 
 depression of strength, with cold clammy 
 sweats, coldness of the extremities, and 
 hiccup, terminated by death ; and in many 
 cases, these fatal symptoms run their 
 course in four and twenty hours. In 
 more favourable cases, the symptoms 
 pretty severe for a day or two, gradually 
 abate, leaving the patient in a state of 
 great debility. 
 
 Causes. The causes of cholera seem 
 to be, an over-action of the biliary system, 
 occasioned by the heat of the weather or 
 of the climate ; and hence the cholera . 
 most frequently occurs in very hot sum- 
 mers in this country, and more particu- 
 larly when the colds of autumn succeed 
 to a very long-continued tract of drought 
 and heat. Indulgence in fruit or some 
 article of difficult digestion, exposure to 
 the night dews, or fatigue, are some of 
 the exciting causes of cholera. 
 
 Diagnosis. We distinguish cholera 
 from dysentery, by its being an evacua- ' 
 tion of bilious matter only, M'ithout any I 
 mixture of blood or mucus ; and from j 
 looseness, by there being almost no fecu- ) 
 lent matter passed. 
 
 Prognosis. Our judgment of the event 
 is to be regulated by the frequency and 
 violence of the efforts of vomiting and 
 
134 
 
 CHOLERA M O U B U S. 
 
 a.. 
 
 
 
 purging, and by the degree of debility 
 induced. The disorder Mill probably be 
 fatal, when there occur constant cold 
 sweats, short and hurried breathing, hic- 
 cup, and spasms or convulsions. When 
 sleep comes on, when the vomiting abates, 
 and the skin is gently moist, our hopes ai-e 
 better. 
 
 Treatment. In the beginning of the 
 disease, it is almost in vain to give any 
 medicine by the mouth, as it is instantly 
 rejected by vomiting. It is better at first, 
 to attempt to dilute the acrid bile by 
 large draughts of mild liquids, as barley 
 water, linseed tea, rice water, thin gruel, 
 or toast-water, taken in a tepid state. 
 Much of them will be thrown up ; but 
 at the same time, there will be a great 
 discharge of the acrid bile, and what 
 passes downwards will be less irritating. 
 Warm fomentations with cloths M'rung 
 out of the decoction of poppy heads, are 
 to be applied to the pit of the stomach; and 
 the same part may also be rubbed v.ith 
 the tincture of camphor, or with lauda- 
 num. The extremities are to be kept 
 warm by bottles of hot water, by heated 
 bricks, by ^arm flannels, or other proper 
 means. When M'e have reason to think 
 that by the drinks above m.entioned, we 
 have tolerably well cleansed the stomach, 
 and that less acrid bile is transmitted 
 tlirough the bowels, we must endea- 
 vour to allay irritation by proper doses 
 of opium, given in the shape and quanti- 
 ty least likely to be thrown up. A grain, 
 or a grain and a half may be given in the 
 form of a pill, and this repeated every se- 
 cond or third hour till the irritation 
 ceases ; or forty drops of the tincture may 
 be given as often, with very little water, 
 or perhaps better still, in a tea-spoonful 
 of brandy or compound tincture of cinna- 
 mon. The saline draughts may also be 
 given, for the purjiose of checking the 
 vomiting. These are made by dissolving 
 twenty or thirty grains of carbonate of 
 potash in an ounce of water, adding to 
 them quickly an ounce of lemon juice, and 
 drinking the whole while it is efferves- 
 cing; or if lemon juice is not to be had, 
 
 a good substitute is made, by dissolving 
 twenty-five grains of citric acid or essen- 
 tial salt of lemons in water, and using it 
 like fresh juice. If opium given by the 
 mouth be rejected, that medicine must be 
 employed in the form of clyster, made by 
 adding to a tea-cupful of thin starch, a 
 large tea-spoonful of laudanum ; and re- " 
 peating this according to the urgency of 
 the symptoms. Opium and camphor,-^^;' 
 mixed up together in the form of cata- 
 plasm, may be applied to the region of 
 the stomach. When the vomiting and 
 purging have abated a little, we are then 
 to give mild nourishment; and that if 
 possible of a laxative nature, as mutton ''^' 
 broth, chicken broth, and the like. A 1, 
 mild purgative should be administered, 
 such as castor oil, or the neutral salts; 
 
 because the effect of the opium may be, . 
 
 to detain in the bowels some of the vi- ^ 
 tiated bile ; and this accumulating, will 
 give rise to a renewal of the symptoms. 
 To obviate the great debihty and depres- 
 sion consequent on the violent efforts 
 and great evacuations in cholera, we are 
 to give a little of the aromatic spirit of 
 wine; or of the compound tincture of 
 bark or of cinnamon, not much diluted. 
 All irritating and indigestible food is to 
 be forbidden; and all fatigue or expo- 
 sure to the weather, especially when 
 hot and damp, is to be avoided for some 
 time. 
 
 CHOLERA MORBUS OF INDIA. 
 The sudden appearance of new diseases 
 is a remarkable fact in the natural and 
 civil history of our species. As the 
 greater number of diseases have been 
 known from time immemorial, and as we 
 cannot assign any physical cause for the 
 rise of new ones, medical authors have 
 been inclined to doubt the reality of such 
 an occurrence ; and by comparing the de- 
 scriptions left us by the ancients, of some 
 symptoms resembling in their appearance 
 those of small-pox and syphilis, they have 
 attempted to prove that these two ma- 
 ladies, which are almost universally 
 thought to have first appeared long after 
 the Christian era, Mere well known to 
 
 '» 
 
CHOLERA MORBUS. 
 
 125 
 
 the nations of antiquity. Whatever may 
 be decided of these diseases, the Epide- 
 mic or Spasmodic Cholera of India ap- 
 pears to have a just title to be considered 
 as a new disease. We are not to be mis- 
 led by the name cholera ; an affection un- 
 der that appellation has been long known 
 both in Europe and India, and has 
 even been so prevalent in certain seasons 
 as to be called epidemic ; but in the opi- 
 nion of Mr. Annesley, of the Madras Me- 
 dical Establishment, who saw much of 
 the Indian cholera, " we have no satisfac- 
 tory proof of the previous existence of 
 a disease in all respects the same as that 
 which has lately ravaged India ; that this 
 malady is in many respects different from 
 the cholera morbus of Europe, and, in a 
 ieWy from the sporadic cholera of India ; 
 and finally, that the cholera morbus of 
 Europe more certainly, and the common 
 cholera of India, as far as we have the 
 means of judging" furnished us, have ne- 
 ver assumed features which resemble, in 
 every particular^ those possessed by this 
 epidemic." 
 
 The extent and rapidity with which 
 the spasmodic cholera spread, were fright- 
 ful. From Jessore, in Bengal, where it 
 was first noticed in August 1817, it spread 
 along the banks of the Ganges, into the 
 upper provinces of that Presidency. In 
 September following, it made its way to 
 Calcutta, having in a short time traversed 
 tlie whole of the Bengal territory ; in its 
 course it attacked the army then in the 
 field, under the command of the Marquis 
 of Hastings, and compelled him to change 
 his position, and to suspend active opera- 
 tions for a time. The disease subsequent- 
 ly spread over the Peninsula of India, 
 embracing the whole tract of country be- 
 tween the Ganges, the Nerbuddah, and 
 Cape Comorin ; visited the coasts of Co- 
 roraandel and Malabar ; the Presidencies 
 of Madras and Bombay, and also the 
 island of Ceylon. By this terrible epi- 
 demic, provinces were ravaged, and dis- 
 tricts depopulated ; garrisons were de- 
 stroyed, and our triumphant armies para- 
 lysed. No rank, nor nge, nor sex, were 
 
 spared ; the strong and the weak, the ple- 
 thoric and the spare, the debauched and 
 the temperate, were alike its victims. 
 
 Symptoms. The spasmodic cholera for 
 the most part comes on with languor, 
 lassitude, prostration of strength, restless 
 anxiety, great depression of spirits, and 
 with a sense of cold. The pulse becomes 
 quick and weak, and the skin chilly ; the 
 tongue is pale and moist ; vomiting and 
 purging of a watery matter come on at 
 the same time; this matter is whitish, 
 muddy, or glairy, hnt free from bile; 
 there is urgent thirst, cramps of the ab- 
 domen and of the calves of the legs ; the 
 pulse is now hardly perceptible, and there 
 is difficult respiration, with frequent sigh- 
 ing. If blood be drawn at this period, it 
 is black, thick, and oily, and frequently it 
 will not flow from the vein ; the arterial 
 blood resembles the venous. The spasms, 
 which are more remarkable in Europeans, 
 increase and are extremely painful, ex- 
 tending to the thorax and abdomen ; the 
 pulse is imperceptible, the body cold, the 
 skin covered with a clammy sweat, the 
 eyes are sunk in their sockets and turned 
 up, and appear blood-shot; the head droops, 
 the body is at times shaken with convul- 
 sions, at other times lies motionless ; the 
 vomiting ceases, but the stools are passed 
 involuntarily ; a delirium sometimes, but 
 rarely, supervenes ; drowsiness comes on, 
 and in no long time the patient expires. 
 Throughout tne disease, there is a re- 
 markable scantiness of urine ; and also of 
 the saliva and of all the glandular secre- 
 tions. The disease is particularly dan- 
 gerous to infants and old people. What- 
 ever induces debility of the system in- 
 creases the tendency to this disease ; anx- 
 iety of mind, fear, intemperance, previous 
 sickness, exposure to the night air, long 
 fasting and fatigue. 
 
 The degree and duration of the disease 
 varies ; in some, the symptoms are all 
 present ; in some, a few of them are want- 
 ing ; in some cases, the whole series seems 
 to be crowded into a very short space; in 
 others, the patient rapidly expires, almost 
 without a warning. Hence, the duration 
 
126 
 
 CHOLERA MORBUS. 
 
 of the disease cannot be specified in gene- 
 ral, but it is often finished within thirty 
 hours, or even within six hours. The 
 appearances found on opening the bodies 
 of those who have died of spasmodic 
 cholera, exhibit the marks of great con- 
 gestion in the large veins, in the right 
 cavities of the heart, and in the lungs ; 
 the liver, pancreas, and spleen, are gorg- 
 ed with blood; the stomach and intes- 
 tines are red externally, and lined with 
 viscid whitish mucus internally. The 
 urinary bladder in almost every instance 
 is empty and contracted ; the kidneys are 
 in general sound. 
 
 Causes. Like all other epidemics, cho- 
 lera has its causes involved in much ob- 
 scurity. Unusually disturbed seasons are 
 said to have prevailed at Madras and its 
 dependencies, for several years previous 
 to the appearance of cholera ; but the in- 
 formation on this subject is by no means 
 precise. The general opinion of the prac- 
 titioners in India is, that spasmodic cho- 
 lera does not arise from a specific conta- 
 gion. It appeared at the same time, at 
 several stations far distant from each 
 other, while intermediate districts were 
 unaffected by it. Medical officers and 
 attendants on the sick, were not affected 
 by the disease in greater proportion than 
 other classes of persons; and individuals 
 who were in hospital for other diseases, 
 and seized with cholera, did not commu- 
 nicate the disease to other patients who 
 had intercourse with them ; but whether 
 it be contagious or not, it is proper to 
 guard against incautious or unnecessary 
 exposure or intercourse. 
 
 Diagnosis. The epidemic cholera is 
 distinguished from the common cholera 
 by the black, thick and ropy condition 
 of the blood ; by the low and exhausted 
 state of all the vital actions, the depres- 
 sion of the patient's spirits ; the unnatu- 
 ral appearance, and cold dewy condition 
 of the surface of the body ; by the absence 
 of bile from the stools and the matters 
 vomited ; and by the remarkable scanti- 
 ness of the urine and other secretions. 
 The convulsive nature of the spasms dis- 
 
 tinguishes epidemic cholera from teta- 
 nus ; in which last, the contractions are 
 not alternated with relaxations ; and the 
 free evacuation of the stomach and bowels 
 at the commencement of this cholera, with 
 the state of the pulse, and of the surface 
 of the body, distinguish it from colic. 
 
 Prognosis. A favoui'able termination 
 may be hoped for, when the strength and 
 fulness of the pulse are increased, and 
 when warmth returns to the surface and 
 extremities ; when the calls for drink are 
 less frequent ; when the burning sensa- 
 tion about the stomach and navel is less ; 
 and when the spasms, and the vomiting 
 and pm-giiig, abate or cease. It is favour- 
 able also when there is an inclination to 
 void the urine, and especially if any con- 
 siderable quantity be voided ; when tlie 
 breathing is more natural, the uneasiness 
 less, and when there is an inclination to 
 sleep. But if the symptoms increase ra- 
 pidly, if the breathing is either slow and 
 oppressed, or very quick and laborious ; 
 if the pulsation in the extremities ceases, 
 if the features are sunk, and the tongue 
 and mouth cold ; if there is constant toss- 
 ing about, and, at the same time, the 
 spasms, vomiting and purging cease, the 
 recovery of the patient may be considered 
 as hopeless. 
 
 Treatment As the heart seems to 
 be overloaded, and its action in conse- 
 quence impaired, the first thing is to re- 
 lieve it by copious bleeding ; and practi- 
 tioners have now got the better of their 
 unfounded terrors about bleeding largely 
 in tropical climates. The relief obtained 
 by a bleeding is very striking ; and, even 
 during the flowing of the blood, the late- 
 ly imperceptible pulse becomes full and 
 strong. To check the vomiting, a full 
 dose of opium, in pill or in tincture, is to 
 be administered ; and to assist its effect, 
 from ten to fifteen grains of calomel, with 
 three or four of opium are to be given 
 along with it. The patient is to be put 
 into the warm bath, and afterwards to be 
 covered with blankets ; cordial liquors 
 are to be given, as spirituous and aromatic 
 tinctures. The parts affected with spasm 
 
CHOLERA MORBUS. 
 
 127 
 
 are to be rubbed with stimulating em- 
 brocations, as the tincture of camphor, or 
 soap liniment, or warm turpentine. If 
 the heat is still scanty, warm bottles or 
 bricks are to be applied to the feet. 
 Should these applications fail to rouse the 
 energy of the system, still stronger mea- 
 sures must be pursued j mustard poultices 
 are to be applied to the extremities, or a 
 blister to the pit of the stomach ; and elec- 
 tricity or galvanism, if possible, are to be 
 transmitted through the region of the 
 heart. If blood cannot be obtained from 
 the arm, we are to attempt the relief of 
 the burning sensation and pain at the 
 stomach, by the application of twenty or 
 thirty leeches. In favourable cases, these 
 measures have the effect of restoring the 
 heat, strengthening the pulse, and check- 
 ing the diarrhoea. The spasms are miti- 
 gated, and the patient awakes from sleep 
 cheerful and refreshed. The remedies 
 are gradually to be discontinued, and the 
 strength to be husbanded. Should the 
 drowsiness be alarming, the opiates are to 
 be totally withdrawn ; and if there is any 
 headach or giddiness, leeches and cold 
 applications to the head are to be nsed. 
 It is proper to give a mild laxative ; and 
 convalescents should beware of plentiful 
 or indigestible meals ; and should use the 
 best and most prudent means for recover- 
 ing their strength. 
 
 Means of Prevention. Exposure to 
 cold, to the night dews, and other mois- 
 ture should be avoided. The system is 
 to be strengthened by the use of tonics 
 and generous diet ; but the smallest ap- 
 proach to intemperance in the use of 
 wines or spirits is dangerous. Every 
 thing that debilitates or fatigues, excesses 
 of every kind, have a tendency to render 
 the body liable to the attacks of the epi- 
 demic. The bowels are to be regulated 
 and kept easy; but not weakened by salts 
 or active purges. In places where the 
 disease prevails, persons should avoid 
 sleeping in low and ill ventilated apart- 
 ments, and passing through marshy or 
 swampy districts. The regulation of the 
 mind is also of consequence : while un- 
 
 necessary exposure is to be shunned, exr 
 cessive anxiety and dread about taking 
 the disease is to be repressed as much 
 as possible. 
 
 CHOLERIC TEMPERAMENT is 
 that constitution, in which, according to 
 the ancients, the yellow bile predominated. 
 In modern physiology, the doctrine of 
 different temperaments and constitutions, 
 depending on the superabundance or acri- 
 mony of particular fluids, is disregarded ; 
 though the terms are still employed to 
 distinguish the more obvious peculiarities 
 of constitution. Thus persons are still 
 described as being of the choleric, san- 
 guine, melancholic, or phlegmatic tem- 
 perament. Persons of the choleric tem- 
 perament are thought to be irritable and 
 disposed to anger ; their bodies are soft 
 and mobile, their skin smooth and well 
 coloured, their pulse quick and strong. 
 
 CHOKDEE. A painful spasmodic 
 erection of the penis. It occurs most fre- 
 quently in the second stage of gonorrhoea, 
 and takes place chiefly when the patient 
 is wai-m in bed. For this affection, 
 opiates are the most useful remedy ; forty 
 drops are to be given at bed-time, and the 
 parts affected are to be rubbed with lau- 
 danum, or a strong solution of opium id 
 water. In some cases, leeches may be ap- 
 plied, or it may even be necessary to eia 
 ploy general blood-letting. 
 
 CHOREA SANCTIVITL *&«Danck 
 OF St. Vitus. 
 
 CHORION. The external membrane 
 of the foetus, or that which touches th<* 
 internal surface of the uterus. 
 
 CHOROID MEMBRANE, or Cho 
 ROiD Coat. The name of one of the tu- 
 nics of the eye, lying next under the 
 sclerotic, or firm outer coat. The choroid 
 begins at the optic nerve, and passes for- 
 ward to the beginning of the transparent 
 cornea ; where it adheres very firmly to 
 the sclerotic coat, by the means of cellu- 
 lar substance in the form of a white fringe, 
 called the ciliary circle. It then passes 
 directly downwards and inwards, forming 
 a round disk, which differs in colour in 
 different individuals, and gives the clia- 
 
12S 
 
 CII Y 
 
 CID 
 
 ractcr to the eyes of black, blue, grey, 
 &c. This coloured portion is termed the 
 iins. The internal surface of the choroid 
 coat is covered Avith a black pigment. 
 
 CHOROID PLEXUS. An assem- 
 blage or net-ivork of small vessels, situ- 
 ated in the lateral ventricles of the brain. 
 
 CHROME, or Chromium. A metal 
 obtained from a beautiful red mineral 
 with a shade of yellow, found in the mine 
 of Beresof, in Siberia. Its colour is white, 
 its specific gravity about six ; it is very 
 brittle ; and is attracted by the magnet, 
 but less strongly than iron or nickel. It 
 derives its name from the Greek word 
 signifying colonr, as its oxides and pre- 
 parations are remarkable for imparting 
 line colours to the bodies ^\\th which they 
 are mixed. Chromium takes enough of 
 oxygen to become an acid, which has a 
 deep red colour, and a sharp and metallic 
 taste. The chromic acid combines with 
 metallic oxides, forming beautiful pig- 
 ments ; and the chromate of iron, lately 
 discovered in great abundance in Shet- 
 land, promises to be a source of much 
 wealth to that district. 
 
 CHRONIC. An epithet applied to dis- 
 eases that continue for a length of time, 
 opposed to acute. 
 
 , CHYLE. The milk-like liquor which 
 is found in the lacteal vessels and in 
 the thoracic duct, some hours after taking 
 food. It is the last form which the food 
 takes in digestion, before it is mixed with 
 tlie blood. Numerous lacteal vessels 
 open into the intestines, especially into 
 the jejunum and ileum ; these absorb the 
 chyle, and carry it through the glands of 
 the mesentery, whence it passes into the 
 thoracic duct, by which it is conveyed to 
 the left subclavian vein ; at that point it 
 joins the current of the blood, and by its 
 farther mixture with it in the lungs, it 
 repairs the waste of the system, and sup- 
 plies the materials for the various secre- 
 tions, 
 
 CHYLOPOETIC VISCERA. The 
 organs Mhich assist in the formation of 
 chyle, viz. the liver, the spleen, the pan- 
 creas, the stomach, and upper part of the 
 
 intestines. Modern ])ractitioners have be- 
 come sensible of the high influence which 
 those viscera exert on the functions of 
 life, by their action and their products ; 
 and it is now an essential part of the duty 
 of a good physician to pay particular at- 
 tention to these organs, even in diseases 
 apparently local and be3^ond the reach of 
 their influence. 
 
 CHYME. A pulpy mass, into which 
 the food is reduced by the action of the 
 gastric juice, after it has been masticated 
 by the teeth, and mixed with the saliva. 
 It is in the state of chyme when it passes 
 out of the stomach into the intestines ; 
 where, meeting with the bile and pan- 
 creatic juice, it is farther elaborated into 
 chyle, and this chyle is taken up by the lac- 
 teals ; while the rest of the materials 
 swallowed, which are unfit for n^jtrition, 
 pass onward to be changed into excre- 
 mentitious matter, and thrown out of the 
 body. 
 
 Cl C ATRIX. The technical name for 
 a seam or scar left by a wound. When a 
 wound heals, leaving such a mark, it is 
 said to be cicatrized. 
 
 CIDER. A refreshing and delightful 
 drink, made from the fermented juice of 
 apples. It has little spirit ; and hence is 
 apt to become sour in the stomachs of 
 dyspeptic patients, by whom therefore it 
 should be avoided. " When in a good, 
 state, it is a very wholesome drink, though 
 accused of producing rheumatism. Cider 
 drinkers are generally thin, but firm and 
 muscular; certainly subject to rheuma- 
 tism, and occasionally to gout ; but on the 
 whole, healthy and long lived. The sweet 
 ciders of Herefordshire are less whole- 
 some than the strong, more pungent ci- 
 der of Devonshire. Cider, when made 
 early, of unripe fruit, is sharp and acid, 
 apparently able, without any suspicion of 
 lead, to occasion the colica pictonum, 
 (Devonshire colic, or dry belly-ach.) The 
 poison of this metal, however, often in- 
 pregnates, from accident or design, this 
 otherwise Avholesome beverage ; and the 
 most fatal colics and palsies are the con- 
 sequence." (Dr. Parr of Exeter.') 
 
CIR 
 
 CIR 
 
 129 
 
 CINERITIOUS. Resembling aslies 
 ill colour, a term applied to the cortical 
 or external part of the brain, and of the 
 kidneys. 
 
 CINNABAR. A compound of sul- 
 phur and mercury, of a brilliant red or 
 vermilion colour. It is much used as a 
 paint. 
 
 CINNAMON. A well known sweet 
 and pungent aromatic. The best cinna- 
 mon is imported from Ceylon ; but the 
 cinnamon-tree, Launis Cinnamomuniy 
 which is a species of laurel, also thrives 
 in Malabar, Sumatra, and other Eastern 
 islands. Cinnamon is found in trade of 
 very different qualities ; the best is near- 
 ly as thin as paper, of a yellowish brown 
 colour, and breaks splintery ; other va- 
 rieties are coarser and thicker, and are not 
 .so pungent and sweet. The principal use 
 of cinnamon is as an accompaniment to 
 other medicines, to disguise their bad 
 taste, or to prevent their being flatulent 
 on the stomach. The oil of cinnamon is 
 a. powerful stimulant; and is sometimes 
 used as a cordial in cramps of the sto- 
 mach, and in fainting. There is a dis- 
 tilled water obtained from cinnamon, very 
 useful as a vehicle of nauseous medicines. 
 The compound tincture of cinnamon is a 
 very warm aromatic, and is used in some 
 cases of vomiting. In languor and flatu- 
 lency of the stomach, a tea-spoonful or two 
 may be given in water, wine, or any con- 
 venient vehicle. 
 
 CIRCOCELE. An enlargement and 
 distension of the spei-matic vein. It oc- 
 casions considerable pain ; and in some 
 cases, is attended with wasting of the tes- 
 ticle. The pain, which is of a dull kind, 
 andfelt in the back, is relieved by sus- 
 pending the scrotum. When this disease 
 is mistaken for a rupture, and a truss is 
 applied, bad efi'ects may follow, such as 
 great enlargement of the vessels, and 
 shrinking of the testicle. The raethq^\of 
 distinguishing circocele from rupture is 
 the following : Place the patient in a re- 
 cumbent posture, return the swelling into 
 the abdomen by the abdominal ring; 
 make pressure at the ring, and desire the 
 
 patient to rise ; if it be rupture, the swell- 
 ing M'ill not appear, being kept in by the 
 pressure at the ring; and if it be a dis- 
 tended state of the vessels, the blood will 
 not get into the abdomen, owing to the 
 pressure, and therefore the swelling will 
 rapidly increase. This complaint is sel- 
 dom cured ; and is to be palliated by cold 
 lotions applied to the testicle and sper- 
 matic cord, when there is much pain ; and 
 by supporting the parts with a bag-truss. 
 When, the symptoms are severe, leeches 
 should be frequently applied, the bowels 
 should be kept open, and the patient 
 should remain in the horizontal posture. 
 CIRCULATION. In the more per- 
 fect animals, the blood passes into every 
 part of the body, and is returned again to 
 the heart in a certain series. No portion 
 of blood can approach the same part of 
 the body a second time, without first 
 passing through the lungs and the heart. 
 This function is termed the Cirailation 
 of the Blood, It is performed in the fol- 
 lowing manner : The left ventricle of the 
 heart contracts, and throws the blood into 
 the aorta or great artery of the body j and 
 this contraction of the heart, aided by a mus- 
 cular power in the arteries, and by their 
 elasticity, transmits it into every part of 
 the body. The extremities of the arteries 
 are continued into small branches of 
 veins; these gradually increase in size till 
 they form themselves into two large ve- 
 nous trunks, one bringing back the blood 
 from the lower extremities, the other 
 from the head and upper e3:tremities. 
 These large veins meet in the right auri- 
 cle of the heart ; this contracts and sends 
 its blood into the right ventricle ; and the 
 right ventricle propels the blood into the 
 pulmonary artery, which subdivides into 
 numerous branches, and conveys the blood 
 through the lungs, where it is exposed to 
 the influence of the air ; and by the oxy- 
 genous portion of it, is rendered fit for 
 being again sent to the various parts of 
 the body. The extreme branches of the 
 pulmonary artery continue themselves 
 into pulmonary veins, which carry the 
 changed blood into the left auricle ; by 
 
130 
 
 CIT 
 
 CL A 
 
 this it is thrown into the left ventricle, 
 and the same circuit is perpetually re- 
 peated. In a healthy adult person, the 
 heart performs between seventy and eighty 
 contractions in a minute. The pulse is 
 dependent on the heart, and is an index 
 of the number, the force, and the succes- 
 sion of its contractions. See Pulse. 
 
 The function of the circulation, which 
 plays such an important and conspicuous 
 part in the animal economy, was quite 
 unknown to the ancients. Instead of a 
 circulation, they fancied a libration, and 
 compared the motion of the blood to the 
 tide of Euripus. The honour of this great 
 discovery is due to Dr. William Harvey of 
 Dover, afterwards physician to Charles I. 
 When studying in Italy, he learned 
 the structure of the valves in the veins 
 from Fabricius ab Aquapendente ; and, as 
 he himself informed Mr. Boyle, when he 
 took notice that the valves in the veins 
 of so many parts of the body were so 
 placed, that they allowed a free passage of 
 the venous blood towards the heart, but 
 opposed its motion in a contrary direc- 
 tion, he was led to think, that these 
 valves had not been placed in that man- 
 ner without design j and no design seem- 
 ed more probable than that, since the blood 
 could not, because of the interposing 
 valves, be sent by the veins to the limbs 
 and other parts of the body, it should be 
 sent out from the heart through the ar- 
 teries, and return through the veins, whose 
 valves did not oppose its course that way. 
 
 CITRIC ACID. The acid obtained 
 from oranges and lemons. It is also found 
 in many other fruits, as the cranberry, the 
 bird's cherry, and the fruit of the dog- 
 rose. Strawberries, raspberries, and goose- 
 berries also contain it, mixed \Wth the 
 malic acid. The simple expressed juice 
 of lemons will not keep, on account of the 
 syrup, mucilage, and other matters which 
 it contains, and which cause it to ferment. 
 This is much to be regretted, as lemon- 
 juice is the great specific against sea-scur- 
 vy, and is possessed of virtues sufficient 
 to disarm that dreadful scourge of all its 
 terrors. A method was invented by the 
 
 great Swedish chemist Scheele, of obtain- 
 ing the citric acid pure and crystallized ; 
 and by his process, or some similar one, 
 it is manufactured in great quantities, and 
 sold under the name of the concrete salt 
 of lemons. The process is the following : 
 Powdered chalk is added to lemon juice, 
 the carbonic acid is disengaged, and the 
 lime combines with the citric acid, form- 
 ing citrate of lime. To this, sulphuric 
 acid is added, and a sulphate of lime is 
 formed, which being insoluble, falls to 
 the bottom, and the citric acid remains in 
 solution in the water. This is evaporated 
 and crystallized. Lemon juice is used in 
 making the saline effervescing draughts, 
 so useful in many cases of vomiting ; and 
 when lemon juice cannot be procured, 
 the crystallized citric acid, dissolved in 
 water, will answer the purpose. For sea- 
 scurvy, the lemon juice, as nearly pure as 
 possible, is the best ; but in some situations 
 we must be content with the crystallized 
 acid. The citric acid is an excellent 
 refrigerant, and, as such, is given in many 
 feverish disorders. Lemonade, or diluted 
 lemon juice, sweetened with sugar, is a 
 pleasant di-ink in fever, and will both 
 quench thirst and obviate the tendency to 
 putrescency. 
 
 CITRINE OINTMENT. An oint- 
 ment made with lard and the nitrate of 
 mercury; of great utility in diseases of 
 the skin, being stimulant, cleansing, and 
 alterative. This ointment, when weak- 
 ened with an equal quantity of simple 
 ointment, is an excellent application in 
 many diseases of the eyes, especially 
 in that redness of the lids which is habi- 
 tual to scrofulous persons. 
 
 CITRON. The fruit of the Citrus 
 Medictty a tree of the same genus as the 
 orange and lemon, and not differing very 
 much from them in its properties. The 
 fruit is larger and less succulent than the 
 lezuon. 
 
 CLAP, or GoNORRHCEA, is a discharge 
 of yellow fluid from the urethra, in 
 consequence of the application of mor- 
 bid matter, generally following the con- 
 cubitus impurus. The time that elapses 
 
CLAP. 
 
 131 
 
 between the application of the matter and 
 the commencement of the running, varies 
 in different cases, from two days to three 
 or four weeks ; but the most usual time 
 is from six to twelve days. It begins 
 with an itching and soreness about the 
 private parts, with a soreness along the 
 course of the urethra ; soon after which, 
 a slight discharge of whitish matter takes 
 place, and there is heat and pain in mak- 
 ing water. In the course of a few days, 
 the matter discharged is increased in 
 quantity, and becomes of a greenish or 
 yellowish colour ; there is redness and 
 inflammation about the parts, the stream 
 of urine becomes smaller, and the attempt 
 to pass it is attended with much pain and 
 scalding. It sometimes happens, that 
 when the inflammation is considerable, 
 there is a slight discharge of blood. The 
 prepuce swells so much that it cannot be 
 drawn back, which symptom is called a 
 phimosis ; or, being drawn back, it can- 
 not be brought forward again, which oc- 
 currence is termed paraphimosis. The 
 neighbouring parts suffer. The bladder 
 becomes irritable, and there is frequent 
 call to make water; also uneasiness 
 about the rectum. One, or both, of the 
 testicles swell, occasioning great pain, 
 and some degree of fever. Chordee al- 
 so is not an unusual symptom. The 
 time for which a clap will continue, de- 
 pends much on the conduct of the patient 
 himself; on the timely or late use of re- 
 medies ; and in some cases, on the acri- 
 mony of the infecting matter. If the 
 proper means are used, and if the patient 
 is guilty of no excesses, sensuality, or ir- 
 regular living, the matter will, in the 
 course of a fortnight or three weeks, be- 
 come thick, and somewhat viscid; it 
 will then gradually diminish, and at last 
 cease entirely; but if the same riotous 
 living be continued which brought it 
 on, if indulgence in wine and other sti- 
 mulants be persisted in, the symptoms 
 will increase in severity, continue for a 
 long time, and be followed by very un- 
 pleasant consequences, as gleet, warts, 
 and strictures in the urethra. 
 
 Treatment. If there be much inflam- 
 matory action when the patient is first 
 seen, if the pulse be quick and strong, if 
 there be very great heat, pain, and diffi- 
 culty of making water, it may be proper 
 to employ bleeding, both general and lo- 
 cal. The body is to be kept open by the 
 milder purgatives, which do not irritate 
 the rectum and neighbouring parts, such 
 as castor oil, and the neutral salts dissolv- 
 ed in a considerable quantity of water ; 
 the patient is to drink plentifully of mild 
 diluent drinks, as barley water or linseed 
 tea, adding to them some dissolved gum 
 arable; all irritation is to be avoided, 
 the diet is to be spare, no spirituous or 
 fermented liquors are to be used, and 
 quietness and rest are to be enjoined. If 
 the symptoms are more moderate, we 
 may dispense with the bleeding, taking 
 care to observe the other directions given 
 above. When the running has continued 
 for a week or ten days, if there be no 
 other bad symptoms present, it is to b© 
 checked by the prudent use of astringent 
 washes, which are to be thrown by a 
 syringe into the urethra. Such washes 
 may be made by dissolving twenty grains 
 of white vitriol in eight ounces of rose 
 water, or eight grains of blue vitriol in 
 eight ounces of water. It is to be parti- 
 cularly noted, that it is very dangerous 
 to use astringent injections on the first 
 appearance of gonorrhoea, or to use them 
 strong at any time ; there is great risk of 
 inducing inflammation and swelling of 
 the testicle. If this happens, cooling lo- 
 tions are to be applied to the part, and it 
 may be necessary to use even general and 
 local bleeding. A return of the running 
 is to be solicited by warm fomentations, 
 and injections of warm milk into the ure- 
 thra. Without entering into the contro- 
 versy about the identity or difference of 
 the matter of syphilis and gonorrhoea, we 
 may state, that it is not in general neces- 
 sary to make use of mercury in gonorrhoea. 
 Swellings of the groin are to be prevent- 
 ed, if possible, from coming to a suppura- 
 tion, by the use of cold lotions made of a 
 solution of sugar of lead, by a spare diet, 
 
132 
 
 CL A 
 
 CLI 
 
 -and by giving cooling purgatives. We 
 are to attempt the removal of phimosis or 
 paraphimosis by the application of cold, 
 or by diminishing the swelling by means 
 of leeches j and it may be necessary, if 
 the tightness cannot be removed by other 
 means, to cut through the prepuce. Dur- 
 ing the whole of the disease, it will be 
 necessary to pay great attention to keep 
 the parts clean, and to prevent excoria- 
 tion and ulceration by the lodgement of 
 acrid matter. The distressing symptom 
 called chordee is to be obviated by wash- 
 ing the parts with a solution of opium, or 
 the tincture, and keeping cloths wet with 
 them to the parts : a large opiate is to be 
 taken at bed-time. The disease in women 
 requires the same general plan of treat- 
 ment ; but it is less obstinate in them, 
 ■from the greater shortness of the urinary 
 passages. It much resembles what is com- 
 monly known by the name of whites. 
 
 CLARET. A wine brought from Bour- 
 deaux, of a delicate flavour, and distin- 
 guished by a perceptible combination of 
 the acid with the resinous flavour. It is 
 less heating, and more aperient than other 
 wines, and agrees well with the stomach 
 when taken in moderation ; if taken in 
 excess, claret produces acidity and indi- 
 gestion, often rather from the quantity 
 than the quality. But the clarets of wine- 
 merchants are often very substantial 
 wines, compounded in various ways for 
 the English market. They are thus of- 
 ten mixed with hermitage, and with rasp- 
 berry brandy; and if procured through 
 doubtful channels, as we find them at ta- 
 verns, they are too frequently acescent, 
 and apparently composed of some claret, 
 hiixed with faded port, or some other 
 spoiled wines. The clarets, however, de- 
 rived from respectable sources, are agree- 
 able, and comparatively innoxious wines ; 
 they are moderately exhilarant, and have 
 a tendency to relax the bowels, and in- 
 crease the flow of urine. They are the 
 wines fitted for those persons who are 
 easily excited, and hi whom the stronger 
 wines readily produce febrile action ; and 
 in that state of the svstera which is con- 
 
 nected with a tendency in the urine to 
 deposit white sand, claret may be regard- 
 ed as an effective remedy. (Brandk's 
 Manual of Pharmacy.^ 
 
 CLAVICLE. The collar bone. It ex- 
 tends from the top of the shoulder to the 
 upper part of the breast bone, and pre- 
 vents the arms from coming too close to 
 the sides in the various motions of the 
 superior extremity. 
 
 CLEANLINESS. The putrefaction of 
 animal and vegetable substances is one of 
 the chief sources of malignant disease. 
 The effluvia produced during their de- 
 composition, and even those which are 
 exhaled from the skin and lungs of the 
 healthiest animals, when concentrated and 
 allo\^'ed to stagnate, give rise to fevers of 
 the most fatal tendency, and even, in the 
 opinion of some, to the plagne itself. 
 Hence the necessity of cleanliness in every 
 situation ; and, in this respect at least, 
 physical evil is productive of moral good. 
 Hence the necessity of preventing all ac- 
 cumulation of filth in the streets and al- 
 leys of towns ; hence the utility of drain- 
 ing marshes and improving the cultiva- 
 tion of a country ; and, to descend to in- 
 dividuals, hence the beneficial effects of 
 personal and domestic cleanliness, to pre- 
 vent cutaneous and infectious diseases, 
 and to avert the unhealthy state of the 
 system which so often accompanies squa- 
 lid and vicious poverty. If cleanliness be 
 essential to the preservation of health, it 
 is no less so to the comfort and ease of 
 the sick. Unless their debility be very 
 great, and unless it be productive of much 
 pain and suffering to move them, the bed 
 and body linen of the sick should be kept 
 very clean, and frequently changed ; their 
 apartment should be clean and well aired, 
 and all offensive discharges should be very 
 cai'efully and speedily removed. 
 
 CLEAN SINGS of Childbed Women. 
 See Lochia. 
 
 CLIFTON, a village near Bristol; a 
 frequent resort of consumptive patients. 
 See Bristol Hotwell. 
 
 CLIMATE is considered by physicians, 
 not with reference to geographical situa- 
 
CLI 
 
 CLO 
 
 133 
 
 tion, but to the state of regions as to the 
 warmth and steadiness of their tempera- 
 ture, or the dryness or moisture of their 
 atmosphere. The interior of continents 
 and islands is generally mountainous, and, 
 in consequence, cold. From the bracing- 
 qualities of the prevailing winds, the 
 inhabitants are robust, and disposed to in- 
 flammatory diseases : invalids or persons 
 coming from warm climates should there- 
 fore prepare themselves gradually for 
 mountainous regions, by not coming ab- 
 ruptly into those colder parts. Except the 
 eastern parts of Great Britain, during the 
 Spring and early summer months, when 
 the east wind prevails, the climate near 
 the sea is mild and moist. In most coun- 
 tries, consumptive patients are therefore 
 often sent to the sea coast, where the air 
 is more temperate in winter, and the heat 
 more tolerable in summer. Invalids, in 
 various diseases, are generally sent to Lis- 
 bon, Madeira, and the south of France. 
 At Lisbon, the temperature is not always 
 steady, and the cold is sometimes consi- 
 derable. The sick are likely to want 
 many comforts at Madeira, from the cha- 
 racter and manner of its inhabitants; and 
 •there are not very good situations for tak- 
 ing exercise. The south of France is said 
 to be subject to sudden and violent storms. 
 The coast of Devonshire is considered as 
 a very favourable place of resort in vai-ious 
 cases of disease, especially of the chest. 
 The advantages of a mild and equable cli- 
 mate, even were it in our power to point 
 out any that is uniformly agreeable, are 
 counterbalanced by many inconveniencies 
 as hurtful to the sick and debilitated, as 
 the znere circumstance of a lower tem- 
 perature. The being surrounded by stran- 
 gers who cannot sympathize in their cares 
 or feelings, the embarrassment arising 
 from the use of a foreign language, and 
 the ideas of comfort so different from 
 what the inhabitants of Great Britain 
 consider as desirable, combine to produce 
 a state of irritation and a sense of unhap- 
 piness, Avhich will be more injurious to a 
 patient than any thing he must necessa- 
 mlj suffer from the atmosphere of his own 
 
 country. An artificial climate may be 
 made by those in easy circumstances ; 
 and thus they may be spared all the fa- 
 tigue of travelling, and the pain of sud- 
 denly and forcibly altering their condition 
 and habits. See Penzance, Tor Quay, 
 SiDMouTH, Nice, Lisbon, Madeira, &c. 
 
 The diseases most common in cold cli- 
 mates are, catarrh, consumption, scurvy, 
 rheumatism, and the various inflammatory 
 affections ; in warm climates, the plague, 
 remittent fevers, the yellow fever, dysen- 
 tery, inflammation and other disorders of 
 the liver and biliary secretion, are the 
 prevailing maladies. 
 
 CLINICAL is derived from a Greek 
 word signifying a bed ; and it is generally 
 applied to lectures delivered by a physi- 
 cian or surgeon, respecting the cases of 
 patients confined to bed, who are visited 
 by the practitioner and his pupils; to whom 
 he details, at some convenient time and 
 place, the nature of the disease, and the 
 intention and effect of the remedies which 
 he employs. 
 
 CLOTHING. The choice and regular 
 tion of clothing is of great importance 
 both to health and comfort. It will rea- 
 dily be supposed that the physician does 
 not meddle with dress as to its form and 
 decoration, but that his instructions are 
 chiefly confined to what is worn next the 
 skin ; and that he will forbid all such ar- 
 ticles of dress as are likely to prove inju- 
 rious by pressing on tender parts, and al- 
 tering their structure, or impeding their 
 functions. In this variable and uncertain 
 climate of ours. Woollen garments are by 
 far the best kind of clothing. They enable 
 the body to resist the effects of the fre- 
 quent changes of weather; being what 
 the chemists call bad conductors of heat, 
 they both prevent the natural warmth of 
 the body from escaping, and the external 
 heat from reaching it, and thus preserve 
 it in a steady temperature. When sweat- 
 ing occurs spontaneously or is induced by 
 artificial means, flannel does not take up 
 the moisture in a fluid form, but rather as 
 a vapour, and thus the coldness of the 
 sweat is not perceived. J^lannel is some- 
 
134 
 
 CLOTHING. 
 
 times debilitating by the perspiration it 
 excites too constantly ; or, by its rough- 
 ness, it is irritating to some tender skins ; 
 it requires in the first case, either to be 
 worn of a very thin texture, or to be ex- 
 changed for cotton; and in the second 
 case, it must be discontinued, and linen 
 must be used. Flannel which is worn 
 next the skin should be frequently chan- 
 ged ; it should be washed in water not 
 very warm, which prevents its becoming 
 too thick. Cotton has all the good pro- 
 perties of flannel, though in an inferior 
 degree. Chamois is used next the skin 
 by many people, as uniting the advantages 
 of both the former materials. Linen 
 forms inner clothing of great comfort to 
 the strong and healthy, being highly con- 
 ducive to cleanliness ; and if it be fre- 
 quently changed, it renews the air be- 
 tween the linen and the body. Silk 
 should not be worn next the skin, as it 
 has no affinity for water ; and the perspi- 
 ration not being absorbed, is apt to fret 
 the body, and to cause a shivering when 
 it cools. It should be worn above flannel 
 or linen. Fur is necessary in very cold 
 climates, but it is apt to harbour insects, 
 and it is one of the most powerful retain 
 ers of contagion. 
 
 In our climate much caution is required 
 in the changing of dress. The winter 
 clothes should be worn till summer is un- 
 questionably arrived. A few days of 
 sunshine in April or May should not 
 tempt us to lay aside our warm clothing. 
 
 It is of the greatest importance to 
 health, to keep the extremities dry and 
 warm ; and in those who are subject to 
 gout, to any complaint of the head, the 
 chest, or the bowels, particular attention 
 should be paid to the feet. The shoes 
 should be carefully kept from admitting 
 moisture ; the stockings should be warm 
 and frequently changed. The feet should 
 be washed often, and not in very hot 
 water. If we proceed to the more exte- 
 rior parts of our clothing, we shall find 
 that the principal thing to be attended to 
 is to prevent undue pressure on any part 
 by ligatures, bandages, garters or stays. 
 
 The bloodvessels are liable to be com- 
 pressed by injudicious dressing; or the ab- 
 domen and chest, with the important or- 
 gans contained in them, to be hindered in 
 the free exercise of their functions. In 
 the regulation of the female dress, too 
 much is sacrificed to fashion and appear- 
 ance. But the physician ought to be 
 heard, when he warns the delicate young 
 lady of the danger of cold, consumption 
 and sore throat, from the insufficient co- 
 vering of the neck, the breast, and the 
 arms ; and when he points out the danger 
 of stays and tight lacingto induce disorders 
 of the liver and other viscera of the abdo- 
 men, or to cause headachs and spitting of 
 blood by hindering the due performance 
 of the circulation through the lungs,^ 
 
 The clothing of infants and children is 
 to be regulated by the season and by the 
 constitution of the child. Though we are 
 no advocates for indulgence and relaxing 
 management, we consider it as an impro- 
 per practice to expose children to much 
 cold, or to dress them too thinly, for the 
 purpose of making them hardy. See 
 Children and Infants. 
 
 CLOVES. The unexpanded flower 
 buds of the Eugenia caryophyllata^ a 
 beautiful tall tree growing in the Mo- 
 lucca islands. The Dutch, in order to 
 secure the monopoly of the valuable spice 
 produced by it, destroyed all the trees, 
 except in Amboyna. But the clove tree 
 now thrives at the Isle of France, and at 
 other places. Every part of the tree is 
 highly aromatic, especially the leaf stalk. 
 Cloves are the flower buds gathered be- 
 fore they open ; they are exposed to sun- 
 shine for some days, and then dried in 
 the sun. The colour of cloves is of a 
 deep brown ; their smell is strong, pecu- 
 liar, and grateful. Their taste is acrid, 
 aromatic, and permanent. They are used 
 as a spice in various articles of food ; and 
 by their aromatic and stimulant qualities, 
 they diminish the griping which is apt to 
 aaise from other medicines; and when 
 added to bitter and other infusions, they 
 make them sit easier and better on the 
 stomach. Good cloves yield about one- 
 
CLYSTERS. 
 
 135 
 
 sixth of their weight of essential oil, and 
 a little of this oil is used in the making 
 of the compound colocynth pills. It is 
 also used as a local application in tooth- 
 ach. 
 
 CLUB-FEET. Children are some- 
 times born with the feet distorted either 
 outwards or inwards. This deformity is 
 both disagreeable to behold, and incon- 
 venient for walking ; and parents are na- 
 turally very anxious for its removal. 
 The bones being in a soft and grisly 
 state, renders this very often practicable, 
 if the cure be begun very soon after 
 birth. In most large towns, there are ar- 
 tists who form various kinds of machi- 
 nery for this purpose; and very simple 
 means will do to restore the parts to their 
 natural position, and to keep them there. 
 An experienced surgeon should always 
 oversee the operations of the artist. 
 
 CLYSSUS OF NITRE. The alchy- 
 mists used to mix charcoal with nitre, 
 and explode them together in a tubulated 
 earthen retort, to which an apparatus of 
 glass vessels was luted. Their apparatus 
 was generally blown to pieces ; but they 
 sometimes succeeded in obtaining a little 
 acidulated water, which they called clys- 
 sus of nitre, and to which they attributed 
 wonderful medical virtues. 
 
 CLYSTERS. Substances thrown in- 
 to the rectum by mechanical means. The 
 principal clysters are those of the purga- 
 tive, the emollient, and the anodyne 
 kind ; and in some cases, we attempt to 
 convey nourishment into the system by 
 means of a clyster. The instruments used 
 are either a large syringe, or a bladder and 
 pipe ; and the kind and quantity of the 
 matter thrown in, is to be regulated by 
 the age of the patient, and the purposes 
 to be answered. A purgative clyster may 
 be made of the infusion of senna, adding 
 to a pound of such infusion, an ounce and 
 a half of Epsom salts ; or a quantity of 
 gruel with a handful of common salt ; to 
 which a little butter, or sweet oil, or castor 
 oil may be added. Though purgative in- 
 jections are of excellent service in many 
 cases, and produce the evacuation of thi 
 
 rectum, and sometimes of a larger extent 
 of the bowels, yet in iew cases of disease 
 should we rest satisfied with them, but 
 should generally endeavour to give pur- 
 gatives by the mouth. Emollient clysters 
 are made of gruel or barley water, and 
 are used in cases of colic, and in certain 
 stages of inflammation of the bowels, to 
 act as internal fomentations or poultices. 
 A large quantity should be given, and in 
 general as warm as can be easily borne. 
 Emollient clysters are sometimes very 
 useful in quickening the progress of lin- 
 gering labours. Anodyne clysters are of 
 essential benefit in many severe and pain- 
 ful affections. They should be given in 
 small quantity : a tea-cupful of thin starch 
 or gruel, with a tea-spoonful or even more 
 of laudanum, is to be injected, and as lit- 
 tle irritation as possible should be caused 
 in the administration of it j and if the pap 
 tient is of discretion enough, he should 
 make every exertion to retain it. Such 
 a clyster is of excellent benefit in loose- 
 ness, after any offending matter has been 
 cleared away; it is necessary in strain- 
 ing, and allays that most troublesome 
 symptom. In some unhappy cases, when 
 nourishment cannot be taken in by the 
 mouth, an attempt is made to convey it 
 into the system by nutritive clysters ; and 
 the composition of such i& .strong beef tea, 
 yolks of eggs, and a quantity of laudanum 
 to assist the power of retention. Such in- 
 jections may prolong life for a little, but 
 can never be expected to do much. Some- 
 times carminative or antispasmodic in- 
 jections are given ; these are made of the 
 tincture or infusion of assafetida, and give 
 relief in cases of spasm or flatulence of the 
 larger intestines. A very powerful, but 
 very dangerous injection is sometimes ne- 
 cessary in cases of rupture. It is made 
 by boiling a drachm of the cut leaves of 
 tobacco for ten minutes in a pint of wa- 
 ter. One half only of this is to be given 
 in the first instance ; and the patient must 
 be watched on account of its highly de- 
 bilitating effects, and the yiolept vomiting 
 which it excites. The tobacco injection 
 should never be administered, except in 
 
136 
 
 coc 
 
 COF 
 
 the presence of a practitioner of judgment 
 and experience. 
 
 COAGULABLE LYMPH. One of 
 the component parts of the blood, capable 
 of coag^ulation by heat and acids. In cer- 
 tain diseases it is separated from the blood 
 in large quantities, and is found in cir- 
 cumscribed cayities in certain kinds of 
 dropsy. 
 
 COAGULATION. The thickening or 
 curdling of liquors by the application of 
 heat, or admixture of other substances. 
 The white of egg is coagulated by heat ; 
 and milk is coagulated by rennet or infu- 
 sion of the stomach of a calf, and by acids. 
 
 COBALT. The name of a metal of a 
 grey colour with a shade of red. Its 
 oxide is used for giving a blue coloui* to 
 glass. 
 
 COCHINEAL is the dried body of the 
 female of an insect found in Mexico. The 
 male only has wings, the female has none, 
 and remains constantly attached to the 
 leaves of the tree on which it feeds. Their 
 taste is acrid, bitter, and astringent ; they 
 are used only for the sake of the fine red 
 colour which they produce; hence in phar- 
 macy, they are employed to give a beauti- 
 ful red to some tinctures. Their colour 
 is easily extracted both by water and al- 
 cohol. Cochineal has been recommended 
 as allaying the inordinate action in hoop- 
 ing-cough, especially when given with 
 carbonate of potass; but its efficacy is very 
 small, and few practitioners think it worth 
 their while to try it. 
 
 COCCULUS INDICUS. The ber- 
 ries of a plant growing in Malabar and 
 other parts of the East Indies. They 
 are poisonous if swallowed, and bring 
 on sickness, fainting, and convulsions. 
 They have an intoxicating quality, and 
 are supposed to impaii: that quality to 
 some of the London porter made by dis- 
 honest brewers. The Indians are said to 
 intoxicate and kill fish by means of the 
 berries when green, 
 
 COCCYX. The name given to the 
 last bone or two of the vertebral column 
 in the human subject, so called from its 
 resemblance to a cuckoo's beak, It con- 
 
 sists of two small bones, and is in some 
 slight degree moveable. In the lower 
 animals it is composed of many pieces, 
 and forms the tail. 
 
 COCOA, OR Cacao. See Chocolate. 
 
 COCOA-NUT TREE. A tree which 
 grows at Nicaragua, in Mexico, and also 
 in Virginia and Jamaica. The nut is the 
 only part of the tree used ; its shape is 
 nearly that of an almond, but of a much 
 larger size. The shell is dark-coloured, 
 brittle, and thin ; the kernel throughout 
 is of a brown colour. Cocoa nuts have 
 a light agreeable smell, and an unctuous, 
 bitterish, but not ungrateful taste. The 
 principal use of the nut is to form the li- 
 quor called Chocolate. (Parr's Medical 
 Dictionary. J See Chocolate. 
 
 The large nut often brought to this 
 country, and commonly known by the 
 name of cocoa nut, is obtained in the East 
 and West Indies from a species of the 
 Palm tree, and has no analogy with the 
 chocolate nut. See Palm. 
 
 COFFEE. The seeds of a plant, the 
 Coffea Arabica, cultivated in Arabia, 
 Persia, the Isle of Boiu-bon, the West In- 
 dies, and in some parts of America. The 
 best comes from Mocha in Arabia. It 
 possesses astringent qualities, and is of 
 service when the digestion is weak. When 
 drank waini within an hour after dinner, 
 it is of great benefit to those who have 
 headach from M^eakness of the stomach, 
 brought on by sedentary habits and close 
 application or occasional excess; and it 
 enables such patients to digest certain ar- 
 ticles of food, such as fat and oily mattersj 
 which they would probably be unable to 
 do without such assistance. When di'ank 
 too soon after port wine, it often produces 
 a disagreeable acidity in the stomach. 
 Like tea, it has the effect of keeping a 
 person awake ; but any inconvenience of 
 this kind may be prevented by taking it 
 several hours before bed-time. It is 
 thought to counteract the effects of nar- 
 cotic substances ; and hence is much used 
 in Turkey, to prevent the injurious con- 
 sequences of the opium which its iuhabi'- 
 tants use. A strong ixifusion of the best 
 
COL 
 
 Mocha coffee, newly burnt and made very 
 strong-, has been found of service in spas- 
 modic asthma ; it should be drank very 
 warm, and without milk or sugar, and re- 
 peated at the interval of half an hour or 
 less. Its effects in rendering the bowels 
 jslow are probably very little to be re- 
 garded ; indeed it has been known in 
 many instances to prove a quick and easy 
 laxative. Where coffee is directed as a 
 promoter of digestion, it should be care- 
 ifuliy made by infusion, as boiling dissi- 
 pates its fine aromatic taste. 
 
 Coffee has been imitated by the roast- 
 ing of a great variety of grains. That 
 made from rye comes the nearest to real 
 coffee. This was long ago ascertained; 
 and a spurious coffee made of rye, has been 
 for some time sold under the name of 
 Hunt's economical breakfast powder. 
 
 COHESION. The force by which 
 the particles of homogeneous bodies are 
 United together. 
 
 COLCHESTER WATERS. A mi- 
 neral water of the bitter kind, similar to 
 the Epsom water, but not so strong. 
 
 COLCHICUM AUTUMN ALE, Mea- 
 dow Saffron. A perennial, bulbous-root- 
 ed plant, which grows in wet meadow^s. 
 The bulbs are used in medicine. The 
 best time for gathering them is from the 
 beginning of June till the middle of Au- 
 gust. When recent, they have scarcely 
 any odour ; but their taste is bitter, hot, 
 and acrid. A saturated vinous infusion is 
 made, by macerating an ounce and a half 
 of the dried bulb in twelve ounces of 
 white wine ; and this vinous infusion has 
 been, on the recommendation of Sir Ev- 
 erard Home, much used in gout ; in which 
 ^sease it is said to be almost a specific, 
 tis it very rarely fails to oreak up the pa- 
 roxysm, sometimes acting on the bowels, 
 at other times on the kidneys and skin, 
 •and often without any apparent accom- 
 panying effect. The dose is sixty drops, 
 at bed-time, when the paroxysms of paia 
 are violent. The celebrated specific fur 
 igout, known by the name of Eau Mcdi- 
 vinalc d'llusson, is said to be the vinous 
 infusion of colchicum. It is but ri-'-lit to 
 
 COL 
 
 137 
 
 state, that the most judicious writers oii 
 gout consider all these specifics as ulti- 
 mately dangerous. Colchicum is a valua- 
 ble remedy in rheumatism, when the in- 
 flammatory state has been moderated by 
 bleeding. Five grains of the powdered 
 root are to be taken three times a-day ; 
 or from one to two di-achms of the wine " 
 in cinnamon water, with a scruple of the 
 carbonate of magnesia. An infusion or 
 tincture of the seeds is found to have the 
 same virtues as that of the bulb. 
 
 COLD, in natural philosophy, means 
 the diminution or abstraction of heat. lu 
 physiology and the theory of physic, it 
 signifies the effects produced in the body 
 by the abstraction of heat, or the applica- 
 tion of cold to the surface. It is to be 
 observed, that many applications of colcj 
 to the body are productive of much great- 
 er effects than would be expected from 
 the degree indicated by the thermometer. 
 Much of the effect of cold on the body 
 depends on the degree of temperature to 
 which it is previously raised, and especi- 
 ally on the circumstance of the cold 
 checking the perspiration. Cold, when 
 very intense and when long applied, may 
 destroy the vital action of parts of tho 
 body, or may extinguish the life of the 
 whole system. When a part of the body- 
 is frost-bitten, it is a very pernicious prac- 
 tice to bring it near a fire ; a safer way of 
 proceeding, is to rub it with ice or snow, 
 and thus very gradually to restore the ac- 
 tion of the part. Persons on whom the 
 cold is beginning to make a dangerous im- 
 pression, are seized with a very strong 
 "propensity to sleep ; and if they are al- 
 lowed to indulge in this, their lives will 
 infallibly be destroyed. "The effect of 
 low temperature," says Dr. Kellie, " on 
 the nervous system, in producing a tor- 
 pid and lethargic state in certain circum- 
 stances of exposure to a cold atmosphere, 
 is familiarly known by many recorded in- 
 stances ; and the progressive symptoms 
 of this short but fatal disease, if we may 
 so call it, appear to be weariness and faint" 
 ness, debility, languor, lassitude, torpor, 
 jrjesistible drowsiness, lethargy ^profound 
 
138 
 
 COLD. 
 
 coma, and death. (Edinhurgji Medico- 
 Chirurgical Transactions.) Such may- 
 be called the sedative eflfects of cold. 
 
 A less degree of cold acting- on a healthy- 
 frame has a very contrary effect. Who 
 has not felt the bracing, invigorating in- 
 fluence of a bright winter's day, and ex- 
 perienced the healthful glow in his frame, 
 while the face of nature all around appears 
 torpid and locked up in frost ? Contrast 
 the listless apathy of the Indian verandah, 
 with the bustling fervid activity on the 
 hard-frozen northern lake. When the 
 constitution is vigorous enough to obtain 
 the advantages resulting from these stimu- 
 lant and tonic effects of cold, there can- 
 not be a better means of preserving the 
 health and agility of the system. 
 
 Power of QoiA) to induce disease. There 
 is not a more frequent exciter of illness 
 than cold, when applied to the body in 
 certain circumstances. Were we to enu- 
 merate all the diseases to which cold gives 
 rise, we should give a list of all those to 
 which, in our variable climate, the hu- 
 man body is subjected. The numerous 
 inflammations of various parts, as the 
 eyes, the throat, the chest, the lungs, the 
 bowels; the inflammation of tendinous 
 and membranous parts, constituting rheu- 
 matism; catarrh, called by way of emi- 
 nence, a cold ; the rose, fevers of various 
 kinds, consumption ; these and many 
 more, closely follow the application of 
 cold; and whatever may be the distinc- 
 tion we make between pre-disposing and 
 exciting causes, the plain, practical infe- 
 rence to be drawn, is the necessity of 
 guarding against cold, and all those cir- 
 cumstances in its application on which 
 depends its power of affecting the body 
 with disease. 
 
 The circumstances which give to cold 
 the power of producing bad effects on the 
 body, are : 1 . Its degree and intensity : a 
 certain degree of it will either produce 
 gangrene or mortification of a part of the 
 body, or death of the whole. 2. The 
 length of time during which it is ap- 
 plied : a transient exposure will do com- 
 paratively little harm; but long exposiu-e 
 
 is highly dangerous^ as when a person has 
 lost his way on a winter night. 3. When 
 cold is applied with moisture. This is by 
 far the most pernicious way in which cold 
 can be applied. Hence the numerous ail- 
 ments arising from damp clothes, wet feet, 
 wet bed-clothes, and the like ; and the nu- 
 merous sore throats, rheumatisms, &c. that 
 follow such exposure. 4. Cold is very 
 hurtful when applied in a stream or cur- 
 rent of air ; hence the impropriety of sit- 
 ting near an open window, and the danger 
 of cross cunents of air in hot rooms and 
 crowded assemblies. 5. One of the cir- 
 cumstances most hurtful about the appli- 
 cation of cold, is its being a sudden change 
 of temperature from heat to cold. Hence 
 the frequent colds and pleurisies that oc- 
 cur, when cold suddenly comes after hot 
 and moist weather; and hence the nume- 
 rous illnesses which assail those who leave 
 warm and crowded public places, to be ex- 
 posed to the sharp air of a frosty night. 
 Hence the fair votaries of pleasure and 
 dissipation so often fall a sacrifice to the 
 destructive pursuit ; and hence the sorrow 
 for many a lovely youth, who on leaving 
 the dance, receives the chilling blast that 
 proves to be the call to an early tomb. 
 
 There are certain circumstances in the 
 constitution itself, which render it very 
 liable to be affected with cold. 1. Weak- 
 ness and diminished vigour of the circu- 
 lation by previous disease, by evacuations, 
 by intense care or study, by intemperance 
 in living, by drunkenness, by fatigue. All 
 such as are weakened by any of these de- 
 bilitating causes, are more easily brought 
 into a state of disease by cold than others 
 are. 2. When any part of the usual co- 
 verings of the body is awanting, a person 
 is more easily affected with cold. Thus 
 a great many complaints are brought on, 
 when a person accustomed to wear a flan- 
 nel shirt happens to leave it off even for 
 a very short period, or when a thinner 
 dress is used, or when the bed-clothes are 
 thrown off without being replaced quick- 
 ly ; and even from the want of a night- 
 cap, bad consequences often follow. 3. It 
 is bad, when one part of the body is ex- 
 
COLIC. 
 
 >39 
 
 posed to cold while the rest is kept in 
 its usual state, or warmer. 
 
 The circumstances which enable the 
 human body to resist the morbific effects 
 of cold, are a certain vigour of constitu- 
 tion, exercise, activity of mind, and the 
 being- occupied with some exciting pas- 
 sion. Cordials also, as wine, spirits, or 
 other stimulants, prevent the body from 
 suffering by the effects of, cold ; but it is 
 to be noted, that those who are in the 
 habit of dram-drinking, are not those who 
 are best able to resist the action of cold. 
 The temporary stimulus of spirituous li- 
 quors is very often succeeded by great 
 weakness, and susceptibility to external 
 impressions; and the unhappy drunkard, 
 from the combined effects of his debility 
 and exposure, too frequently ends his 
 days, overcome by the sedative effects of 
 cold. Cold is applied as a useful agent in 
 the preservation of health and the cure of 
 disease, as in the use of the cold bath, 
 either general or local. See Bath, Cold. 
 
 COLD. A disease. See Catarrh. 
 
 COLD AFFUSION. See Affusiox. 
 
 COLD BATH. See Bath. 
 
 COLIC. A painful sensation spread- 
 ing over the belly, and accompanied by a 
 feeling of twisting or wringing at the na- 
 vel. It is owing to spasms acting on the 
 intestines themselves; and very frequently 
 the skin and muscles of the belly are also 
 drawn inwards and spasmodically con- 
 tracted. These pains are very violent and 
 permanent, unlike the transient gripings 
 thatoccur in other affections of thebowels; 
 and costiveness is a general attendant. 
 Vomiting is also present ; any thing taken 
 in by the mouth is apt to be rejected, and 
 bile is thrown up. Colic occurs in many 
 instances m ithout any fever ; but in the 
 time of the more violent paroxysms, the 
 pulse may be quickened and the face 
 flushed ; and by long continuance of the 
 spasms, some degree of inflammation may 
 be brought on ; but colic is different in 
 its symptoms from inflammation of the 
 bowels. See Bowels, Inflammation of. 
 
 Causes. The causes of colic are various. 
 It may arise from cold, from flatulence, 
 
 from mechanical obstruction, from acrid 
 matters taken into the stomach, from ac- 
 cumulation of faeces after long costiveness : 
 it may also arise from passions of the 
 mind. 
 
 Treatment. When colic occurs in a 
 strong healthy person, and when the pain 
 is very constant and severe, it is a good 
 practice to employ blood-letting very 
 early ; both with a view to prevent inflam- 
 mation from coming on, and to produce 
 a relaxing or antispasmodic effect Our 
 next object is to remove the spasms of 
 the intestines and of the belly. Opium f-w^^-,-,,^ 
 is our great and efficacious remover of "^ 
 spasms ; but in colic, its use is not with- ■'-e^^P^ 
 out danger, as it has the effect of dimi- Ca-vv»-ia^ 
 nishing the action of the bowels, and so 
 may contribute to retain the offending mat-'^^'^'^*'''^ 
 ter, from which colic often arises. Still as >• t^-y^^yve 
 the pain is so severe, it is difficult to ab- ii^^^f^ijii^fy 
 stain from this soothing drug ; and if we 
 follow up its use with other prudent mearB^^^^.^ 
 sures, we may venture to exhibit it. On 
 account of the vomiting, it must be given 
 in a small bulk ; as the tincture with little 
 addition of other fluids, or the pill in the 
 usual dose of one grain or two. The ap- 
 plication of warm fomentations to the 
 belly, by means of bottles or bladders filled 
 with hot water, or flannels wrung out 
 of hot water, is to be diligently used ; and 
 where it can be conveniently done, the 
 M'arm bath should be had recourse to.- 
 Should these means not succeed, a large 
 blister must be applied over the abdomen. 
 The administration of purgative medi- 
 cines forms an essential pai't of the treat- 
 ment of colic. While the vomiting con- 
 tinues, it is not easy to get them retained 
 on the stomach, so as to pass into the in- 
 testines, and we must therefore early em- 
 ploy clysters ; these, at first, should be of 
 a mild kind, as the common gruel or hot 
 M'ater injection, with the addition of a 
 little oil ; or we may add a little common 
 salt, or Epsom salt, or an infusion of sen- 
 na. These injections, when given in suf- 
 ficient bulk, often act as internal fomen- 
 tations, and excite the bowels to a regular 
 action ; by which they are enabled to di»- 
 
140 
 
 COLIC. 
 
 charge their contents, and relieve the dis- 
 ease ; but they are also too often found in- 
 sufficient ; and until we empty the bowels 
 by purgatives given by the mouth, we can- 
 not flatter ourselves that the disease is re- 
 moved. The more acrid purgatives are 
 to be avoided, as they are apt to be thrown 
 up ; and may do harm by exciting inflam- 
 mation, if they do not remove the obstruc- 
 
 , tion. The oily purgatives seem the most 
 
 proper in colic. A dose of castor oil 
 
 ^i,. given in a basin of weak chicken broth, 
 or warm gruel, appears a kindly medicine 
 in such cases. To some stomachs, mut- 
 ton broth, made of very fat meat, proves 
 purgative. If the neutral salts are to be 
 given, they must be largely diluted; cream 
 of tartar, in a considerable quantity of 
 warm water, answers as well as any of 
 them. There are few purgatives more 
 effectual than jalap ; and either by itself, 
 er mixed with cream of tartar, as in the 
 compound powder of jalap, it is one of 
 the best and safest that can be given. The 
 dose of jalap alone is from ten to fifteen 
 or twenty grains, and of the compound 
 powder of jalap, the dose is one drachm. 
 This last generally opens the bowels very 
 easily, quickly, and effectually ; it may be 
 given in beer, tea, gruel, or any conve- 
 nient liquid. As calomel operates in small 
 bulk, a pretty large dose of it may be given, 
 from five to twelve grains, in the form of 
 a pill or with a little syrup. When we 
 have succeeded in procuring a full dis- 
 ciharge by the bowels, if there is still a 
 •tendency to the return of the pain, opiates 
 -may be used with more safety than at 
 -first. The tincture or extract of henbane, 
 though not nearly so much to be relied 
 •on as opium, is a good auxiliary where 
 -there are reasons against the free use of 
 <opiura. The dose is from five to ten 
 gi'ains of the extract, or a drachm of the 
 vtincture of henbane. After an attack of 
 .colic, much attention must be paid for 
 some time to what the patient uses for 
 food and drink ; he must avoid high 
 dressed or difiicultly digested dishes, and 
 abstain from beer and other fermented 
 liquors. 
 
 COLIC IN INFANTS. A child is 
 known to be affected with colic, when 
 he has frequent fits of fretfulness, a bluish 
 appearance of the upper lip, with start- 
 ings of the body ; and if he draws up his 
 limbs towards the belly. A discharge of 
 wind is another symptom of colic pains. 
 In more violent degrees of this complaint, 
 tliere is excessive and long continued 
 shrieking, fever, heat of skin, flushing of 
 the face; the breathing is oppressed, and 
 slight pressure in the belly occasions pain. 
 
 Causes. The great delicacy of the 
 bowels of infants renders them liable to 
 be deranged by very slight causes. Too 
 much spoon meat, exposure to cold, al- 
 lowing the infant to be too long wet, bad 
 milk, too much sugar, all occasion colic 
 in infants. 
 
 Treatment. In slighter cases, a tea- 
 spoonful of castor oil, or a little sugar of 
 anise mixed with the food, or a drop or 
 two of peppermint water, or Dalby's car- 
 minative, may be given ; and all spirits 
 must be carefully avoided. In more se- 
 vere cases, the child is to be put into the 
 warm bath, and the belly is to be foment- 
 ed ; proper doses of castor oil, or of mag- 
 nesia and rhubarb are to be prescribed. 
 If the bowels be quite open, opiates may 
 be rubbed on the belly ; and with much 
 caution, and under the direction of a pru- 
 dent practitioner, a very small portion of 
 tincture of opium may be given internal- 
 ly. When costiveness attends colic, very 
 active pm'gatives are required, even with 
 young children, as senna, extract of colo«- 
 cynth, or aloes ; and emollient or purgr 
 ing clysters may be combined as auxili- 
 aries. 
 
 COLICA PICTONUM. See Dry 
 Beixy-aciie. 
 
 COLLAPSE. A term proposed by 
 Dr. Cullen to signify that state of the 
 brain, whatever it is, which is indicated 
 by a diminished activity of the functions 
 believed to be immediately dependent on 
 it. Thus fainting, lassitude after fatigue 
 or intemperance, and the imperfect exer- 
 cise of the mental faculties in dreaming or 
 iow delirium, are considered as proofs of 
 
COL 
 
 COM 
 
 141 
 
 collapscy or diminished euergy of the 
 brain. 
 
 COLLIQUATIVE. Wasting or ema- 
 ciating ; applied to the diarrhoea or loose- 
 ness so commonly attending the last stages 
 of consumption. 
 
 COLLYRIUM. An application used in 
 diseases of the eyes, commonly either 
 astringent or stimulant. 
 
 COLOCYNTH, Cucumis Colocynthisy 
 the coloquintada or hitter purging apple. 
 It is an annual plant of the gourd kind, 
 a native of Turkey and Nubia, The fruit 
 is about the size of an orange; the part 
 used in medicine is the pulp, freed from 
 its rind and seeds. It is very light and 
 spongy, almost entirely soluble in water, 
 forming an intensely bitter solution, 
 which, when evaporated, forms the ex- 
 tract of colocynth of the London pharma- 
 copoeia. Colocynth is a very powerful 
 and violent cathartic; producing in an 
 over-dose, inflammation of the bowels, 
 bloody stools, and other untoward symp- 
 toms. It is seldom used alone. The com- 
 pound extract of colocynth is a good com- 
 bination of it with other purgatives, viz. 
 aloes and scammony, and it may be given 
 either alone or combined with calomel. 
 From five to ten grains seldom fail to 
 clear the bowels in two or three copious 
 evacuations. Six grains of the compound 
 extract, with four grains of calomel, will 
 have the like effect. In the Edinburgh 
 pharmacopoeia, we have most useful pur- 
 gative pills, composed of aloes, scammo- 
 ny, and colocynth, known in the shops 
 by the name of colocynth pills, or pills of 
 aloes and colocynth ; the dose of which is 
 two pills or three, at bed-time. 
 
 COLOMBO. Sometimes called Ca- 
 LUMBA, is the root of a plant yet unde- 
 scribed. It is said to be produced in Af- 
 rica, in the country of the Caffres, and 
 sent to Mozambique, from whence it is 
 imported into Europe in bags and cases. 
 It is usually brought in slices, from half 
 an inch to three inches in diameter, hav- 
 ing a thick yellow bark. It is very often 
 brought to this country worm-eaten and 
 decayed„but it should be selected as little 
 
 so as possible. Its smell is slightly aro- 
 matic, its taste is strong bitter, and slight- 
 ly pungent. It is used in medicine as a 
 bitter, and it in general sits weW enough 
 even on delicate stomachs. A weak in- 
 fusion is a good form of exhibiting it, and 
 it may be conjoined with aromatics. In 
 this form it is used in stomach complaints, 
 looseness of the bowels, and to restore the 
 tone of the bowels and of the system in 
 general, after an attack of cholera mor- 
 bus. The powder of Colombo is also a 
 very useful form of administering the me- 
 dicine; from five to fifteen or twenty 
 grains of the powdered root may be taken 
 three times a day. The tincture is given 
 in the dose of from one drachm to three ; 
 and its use is to be continued for some 
 time, like other tonics and bitters. 
 
 COLON. The name of one of the 
 portions of the large intestines. 
 
 COLTSFOOT, Tussilago Farfara, 
 a plant growing wild in moist situations. 
 The flowers are yellow, the leaves large 
 and roundish. The expressed juice and 
 the decoction of the leaves has been re- 
 commended in cough, consiunption, and 
 other disorders of the breast and lungs ; 
 but it has no efficacy, and no claim to be 
 retained in the list of the materia medica. 
 There is a quack medicine sold under the 
 name of Essence of Coltsfoot, which, ac- 
 cording to Dr. Paris, is a solution of Bal- 
 sam of Tolu, in compound tincture of 
 benzoin and spirit of wine. According 
 to the venders, it is an infallible reme- 
 dy in all coughs ; but it is in reality cal- 
 culated to do infinite mischief, iu the 
 disorders for which the ignorant and cre- 
 dulous employ it. 
 
 COMA. A drowsiness or very deep 
 sleep; a common circumstance in apo- 
 plexy, and other aftcctions of the head. 
 
 COMATOSE. In the state of drow- 
 siness or insensibility. 
 
 COMBUSTION. The assemblage and 
 series of phenomena which take place 
 during the burning of certain bodies. A 
 substance is not said to be combustible 
 when it merely acquires heat by any 
 means, and parts with it unchanged; but 
 
142 
 
 COMBUSTION. 
 
 a combustible body is one which, when 
 its temperature is raised to a certain de- 
 gree, becomes hotter itself, emits a great 
 quantity of light and heat, which conti- 
 nues some time, and then diminishes and 
 ceases ; after which the combustible body 
 is found to have undergone a complete 
 change, to be converted into different 
 matter, and to be no longer capable of 
 being burned. Combustion is a phenome- 
 non extremely interesting, on account of 
 its frequency, its utility, and the important 
 substances which result from it. The 
 explanation of the phenomena of combus- 
 tion was for many years attempted in 
 vain ; one theory was supplanted by an- 
 other, till the genius of Lavoisier, combin- 
 ing the various discoveries of modem che- 
 mistry, succeeded in giving an explana- 
 tion more satisfactory than any which had 
 preceded him, and made a total revolution 
 in chemical science. According to La- 
 voisier, combustion consists of a decom- 
 position and a combination. The oxygen 
 of the atmosphere, being in the state of 
 gas, is combined with light and heat. 
 This gas is decomposed during combus- 
 tion ; the oxygen gas combines with the 
 burning body, and light and heat a^e ex- 
 tricated. The product cannot burn, be- 
 cause its base being already saturated 
 with oxygen, can combine with no more. 
 The theory explains well the combination 
 of the burning body with oxygen, but is 
 less happy in accounting for the light and 
 heat. Oxygen combines with several bo- 
 dies, without any extrication of light and 
 heat ; it is thus that it combines with 
 azote and with mercury. A later expla- 
 nation of this phenomenon is as follows : 
 Relatively to combustion, all bodies may 
 be divided into three classes, supporters 
 of combustion, combustibles, and incom- 
 bustibles. Supporters of combustion are 
 substances whose presence is absolutely 
 necessary, in order that combustion may 
 take place. Dr. Thomson is inclined to 
 believe that the supporters of combustion 
 contain heat, because the heat which is 
 evolved during combustion, is always 
 greatest A^hen the quantity of supporter 
 
 which combines with the burning body is 
 greatest. He also thinks it probable, that 
 light constitutes a component part of all 
 combustible substances ; because the quan- 
 tity and colour of the light which appears 
 during combustion, always depends on the 
 substance burned. If we suppose that the 
 supporters contain heat as a component 
 part, while combustibles contain light, we 
 should explain combustion to be a double 
 decomposition; the caloric and light 
 would combine and escape, while the 
 other ingredients would remain as the pro- 
 duct. Thus, when sulphur is burnt in 
 oxygen gas, the light in the sulphur unites 
 to the heat of the oxygen gas, and the two 
 escape in the form of fire, while the oxy- 
 gen unites to the sulphur, and the pro- 
 duct is sulphuric acid. 
 
 COMMISSURE. An anatomical term, 
 signifying a joining. Certain parts of the 
 brain which go across and join one he- 
 misphere to another, are called commis- 
 sures ; and the joining of the lips at their 
 comers also obtains that name. 
 
 COMPARATIVE ANATOMY. The 
 dissection, delineation, and description of 
 the lower animals of all kinds, as com- 
 pared with the anatomy of the human 
 species. 
 
 COMPRESSION OF THE BRAIN. 
 See Brain. 
 
 CONCEPTION. The impregnation 
 of females, or the commencement of that 
 internal process in the ovarium, uterus, 
 and its appendages, by which the young 
 animal begins to be formed- The symp- 
 toms which in many constitutions lead us 
 to believe that conception has taken place, 
 are great irritability of the whole system, 
 particularly of the stomach. There is fre- 
 quent sickness, especially in the morn- 
 ing, and sometimes during a great part of 
 the day. In some women, there is great 
 disturbance of the nervous system, as 
 shown by peevishness, and capricious and 
 irregular longings for various strange arti- 
 cles of food. See Pregnancy. 
 
 CONCOCTION. The term formerly 
 applied to certain periods of the function 
 of diofestion. 
 
CON 
 
 CON 
 
 143 
 
 CONCUSSION OF THE BRAIN. 
 See Brain. 
 
 CONDIMENTS, or seasonings, are 
 those substances which, though not nu- 
 tritive themselves, are taken into the sto- 
 mach along" with the food, to promote its 
 dig-estion, and to correct any injurious pro- 
 perties it may possess. Some such assist- 
 ance is necessary to all animals ; and the 
 lower animals instinctively seek after bit- 
 ters, salt, &c. to take with their food. 
 Condiments are of various kinds, as salt, 
 acids, aromatics, oils. Some of those in 
 most frequent use are, sea-salt, vinegar, 
 lemon juice, pepper, cinnamon, nutmegs, 
 cloves, ginger, parsley, garlick, onions, 
 leeks, horse-radish, mustard. A small pro- 
 portion of these condiments may be used 
 with propriety, especially by the feeble na- 
 tives of the warm climates, where pepper, 
 nutmeg, and other spices grow ; because 
 they live chiefly on rice and other vege- 
 tables ; but they must be injurious to the 
 stomachs of those who indulge in the con- 
 stant use of much animal food, while the 
 fundamental article is disguised, under a 
 hot and fiery load of cayenne pepper. This 
 furnishes a temptation and a pretext for 
 drunkenness ; and the pepper and brandy 
 reciprocally recommend each other ; and 
 ultimately occasion organic disease of the 
 stomach or liver, and permanent injury 
 of the digestive functions. Oils and but- 
 ter are also to be regarded as condi- 
 ments, and their use ought to be sparing. 
 The wine which is drank during dinner 
 is to be regarded as a condiment. See 
 Diet. 
 
 CONDYLE. The rounded eminence 
 of a bone which forms part of a joint. 
 
 CONDYLOMA. A small hard tu- 
 mour, or excrescence about the anus. 
 Such tumours may be removed by caus- 
 tic, or by tying a ligature round their base, 
 or they may be cut off with the knife ; 
 this is the best and speediest method. 
 
 CONFECTION. A pharmaceutical 
 preparation made up with sugar. In the 
 London pharmacopoeia, this term includes 
 conserves and electuaries. In this shape, 
 are principally given the milder altera- 
 
 tive medicin«8, and such as are not dis- 
 agreeable to the taste. The dose of each 
 kind of electuary shall be stated under its 
 proper head. 
 
 CoNFECTio Abomatica is made of cinna- 
 mon, cloves, nutmegs, and cardamon seeds 
 as aromatics, with water, chalk, and re- 
 fined sugar. It is usefully given diffused 
 in draughts or mixtures, in the dose of 
 from twenty grains to a drachm. It is 
 generally agreeable to the stomach, re- 
 lieving flatulence and sickness, and some- 
 times checking obstinate vomiting. 
 
 CoNFECTio Opiata is made of opium, 
 long pepper, ginger root, caraway seeds, 
 tragacanth and syrup. Thirty-six grains 
 of the confection contain about one grain 
 of opium. It is useful in checking diar- 
 rhoea, and in some forms of rheumatism 
 and gout. From ten grains to one drachm 
 are given, diffused through challf mixture, 
 camphor mixture, or any of the aromatic 
 waters. 
 
 CONFLUENT SMALL-POX. That 
 form of the disease where the pustules 
 are numerous, and run into one another, 
 generally marking a severe and dangerous 
 kind of the malady. See Smal1/-Pox. 
 
 CONFORMATION. The state or 
 form of any part, considered as a portion 
 of an organized or complicated system. 
 
 CONGELATION. The passing of a 
 body from the fluid to the solid state, as- 
 certained by modem chemistry to be ow- 
 ing to the extrication of latent heat. Con- 
 gelation as applied to water, is termed 
 freezing. 
 
 CONGESTION. A heaping together, 
 or gathering into one place. This word 
 is much used in modern pathology, to sig- 
 nify an accumulation of blood in the 
 veins, as tending to produce disease ; or 
 an undue afflux of fluids to any organ, 
 producing a diseased alteration in its 
 structure or functions. Thus when the 
 blood is repelled from the surface of the 
 body, it may accumulate or be congested 
 in the veins, giving rise to fever ; if the 
 blood flow in too great quantity to the 
 head, it may produce apoplexy by pres- 
 sui*e or by extravasation ; and when the 
 
144 
 
 C O N S U ^1 P T 1 O N. 
 
 blood is too copiously sent to the liver, 
 chronic infiammation of it, or derang^ement 
 of the digestive organs is the consequence. 
 
 CONGLOBATE GLAND. Around 
 gland, formed of a collection of lymphatic 
 vessels, connected by cellular substance, 
 having no cavity nor excretory duct. The 
 glands in the groin, arm-pit, and mesen- 
 tery, are of this description. 
 
 CONGLOMERATE GLAND. A gland 
 composed of a number of others, brought 
 together like a clue, whose discharging 
 ducts all unite into one common duct; 
 such are the glands that secrete the sa- 
 liva, also the pancreas, and the lacteal 
 glands of the female breast which secrete 
 the milk. 
 
 CONSERVE. A composition of re- 
 cent vegetable matters and sugar, beaten 
 together into a uniform mass. Conserves 
 are chiefly considered as auxiliaries to 
 medicines of greater activity, or they are 
 used as a medium for joining such medi- 
 cines together. They are useful for? giv- 
 ing the heavy powders, as calomel, oxides 
 of iron, or other mineral preparations. 
 The principal conserves now retained are 
 the conserve of orange peel, of roses, and 
 of dog-hips. 
 
 CONSTIPATION. See Costiveness. 
 
 CONSUMPTION, Phthisis. A wast- 
 ing or decaying of any part, now gener- 
 ally used without any addition in English, 
 to signify the wasting of the lungs. No 
 disease can be an object of more painful 
 attention than this, the great scourge of 
 our island, and the destroyer of the most 
 interesting part of the species. Many dis- 
 eases commit their ravages indiscrimi- 
 nately on all ages, or dismiss from this 
 mortal scene those who are advanced in 
 life ; but consumption is found to select 
 its victims from the young and beautiful, 
 from those who have prepared themselves 
 for the business of life, and whose ap- 
 parently healthy and blooming counte- 
 nances seemed to warrant their indulging 
 the hope of long and vigorous maturity. 
 " Consumption, with the diseases resem- 
 bling it, is one of the most interesting 
 subjects that can occupy the attention of 
 
 the British practitioner ; and his utmost 
 exertions will be amply rewarded, if any 
 degree of precision can be introduced into 
 its pathology. At present it. is certainly 
 vague and unsatisfactory in the greatest 
 degree, while in the British islands alone, 
 the annual mortality from consumptive 
 diseases is from fifty-five to sixty thou- 
 sand." (Dr. Abercrgsibie.) 
 
 Symptoms and Progress of CoNSUsnv- 
 TiON. When a person spits up a great 
 quantity of purulent matter, when he is 
 affected with hectic fever, and becomes 
 extremely emaciated ; these ai-e evident 
 and almost unequivocal symptoms of con- 
 sumption of the lungs. But these symp- 
 toms are only the sequel of a long train 
 of others, of which it may be proper to 
 give the detail ; premising that many of 
 them may be parts of other diseases, and 
 many may show themselves without be- 
 ing followed by the plain and aggravated 
 marks of confirmed and fatal consump- 
 tion. There are certain habits of body, 
 that appear more liable to consumption 
 than others. Persons of a slender make, 
 of long necks, narrow chests, and promi- 
 nent shoulders ; with a florid countenance 
 and sanguine temperament, are those par- 
 ticularly referred to. Instead of general 
 descriptions, let us take a single patient, 
 and trace the progress of the disease in 
 him. He is affected Avith a slight and 
 short cough, which becomes habitual to 
 him, which he does not remark in him- 
 self, nor like to hear taken notice of by 
 others. His breathing is easily hurried 
 by any bodily motion, he becomes languid 
 and indisposed for exertion, and also, in 
 some degree, emaciated. This state con- 
 tinues for a year, or more, -without his 
 making much complaint about it ; but 
 he is more easily affected by cold than 
 formerly, his cough is increased by it, and 
 he has some affection of the head, nose, 
 and eyes, as if from catarrh. This may 
 be relieved; the patient and his friends 
 believe he has had a common cold ; and 
 little or no alarm is excited, or precautions 
 taken. At length, a cold appears to have 
 been taken, of more than usual severity. 
 
CONSUMPTION. 
 
 145 
 
 the cough is more troublesome than be- 
 fore, and continues long-er than a common 
 cold generally does. The cough had for- 
 merly been dry; now it becomes more 
 constant, and tliere is some expectoration, 
 which is most considerable in the morn- 
 ings. This becomes, by degrees, more 
 copious, thick, and tough ; at length of a 
 greenish or yellow colour, and puts on 
 the appearance of purulent matter. When 
 these symptoms have come on, the breath- 
 ing is at the same time more difficult, and 
 the debility and wasting are increased. At 
 this time, also, there come on the symp- 
 toms of hectic fever ; of which it may be 
 proper, in this place, to give the descrip- 
 tion, although hectic fever is the accom- 
 paniment of other diseases besides con- 
 sumption of the lungs. A hectic fever, 
 though the febrile symptoms are always 
 present, has exacerbations, or an increase 
 of their severity twice every day. The 
 first of these occurs about noon, sometimes 
 a little sooner or later : a slight remission 
 happens about five in the afternoon. This 
 is followed by another exacerbation, gene- 
 rally increasing till after midnight ; but 
 after two in the morning a remission takes 
 place, and this remission becomes more 
 complete as the morning advances. Some- 
 times these exacerbations are introduced 
 by a degree of cold shivering, or a sensa- 
 tion of cold ; though the patient's skin, if 
 examined by the thermometer, would 
 show an actual increase of heat. The 
 evening exacerbation is the most consi- 
 derable ; and after no long period, it is ac- 
 companied by sweating, which continues 
 through the whole course of the disease, 
 and becomes more and more profuse as it 
 advances. The time of its most distress- 
 ing and harassing flow is between two 
 and four in the morning. The appetite 
 for food is less impaired in hectic than in 
 some other kinds of fever ; but any ap- 
 proach to indulgence, is apt to make the 
 exacerbation more severe. The thirst is 
 not great, and the mouth is commonly 
 moist ; as the disease advances, the tongue 
 is free of fur, and even appears raw ; and 
 towards the very termination, the surface 
 
 of the mouth, tongue, and fauces appears 
 red and inflamed, and covered with white 
 and curdy looking specks, like the most 
 painful form of the thrush in children. 
 The face is commonly pale ; but at certain 
 times, chiefly during the exacerbations, 
 there is a flush, and a bright red spot on 
 each cheek. There is a peculiarly blue 
 or pearly whiteness about the white of 
 the eye. A looseness comes on, which 
 baffles all the attempts of art to check it. 
 The weakness of the system is great 
 and increasing, and the wasting is car- 
 ried to an extent that is almost incredi- 
 ble. Patients have been seen whose 
 countenance looked more ghastly and 
 cadaverous when breathing, than it did 
 when life was extinct. Sometimes wa- 
 tery swellings occur in the feet and legs. 
 The fever is not often attended with 
 headach and delirium ; and the state of 
 the mental faculties is one of the most 
 striking and characteristical features of 
 hectic fever, and especially of that dis- 
 ease of which it is the unfailing attend- 
 ant, pulmonary consumption. While 
 every spectator sees the evident and re- 
 sistless approach of death, the patient 
 himself is, in many cases, confident and 
 full of hope; and while judicious and 
 pious friends wish to direct the mind to 
 M'hat alone can make the future desira- 
 ble, they often find the patient devising 
 favourite schemes for the promotion of 
 his recovery, and for distant visionary 
 happiness. Sometimes the elegant and 
 cultivated genius shines out with more 
 than usual brightness, as life goes down ; 
 and bequeaths to after times, some of the 
 most delicate effusions of the pensive 
 Muse. Sometimes, in more dignified 
 elevation, the soul, looking calmly down 
 on the early wreck of its frail tenement, 
 and, triumphant amidst deploring friends, 
 gives a glimpse of what is to be enjoyed, 
 when its capacities of understanding and 
 affection are satisfied to their fullest ex- 
 tent. 
 
 While the symptoms of consumption 
 already described, the cough, expectora- 
 tion and fever, are going on, there is 
 
lie 
 
 CONSUMPTION. 
 
 g-enerally some pain felt in some part of 
 the diest. At fii'st, this pain is felt un- 
 der the breast bone, and chiefly or solely 
 on coughing'; but very often a pain is felt 
 in some part of the side, and to such an 
 extent as to prevent the patient's lying 
 on that side. These symptoms, pretty 
 nearly in the succession above described, 
 though vaiying a little in their continu- 
 ance and degrees of severity, occupy more 
 or less time before they come to their fa- 
 tal termination. In this climate they of- 
 ten take up some years, the sjnnptoms 
 appearing especially in the winter and 
 spring : in the warm weather of summer, 
 they are mitigated or nearly removed; 
 but on the return of winter, they again 
 appear ; and after a season or two prove 
 fatal, towards the end of spring or begin- 
 ning of summer. 
 
 Causes of Consumption. There are 
 several diseases of the organs contained 
 in the cavity of the chest, which are 
 found to terminate in consumption. A 
 spitting of blood, a common cold, inflam- 
 mation of the lungs or of some of their 
 coverings, asthma, all have been thought 
 to be the cause of that fatal ulceration of 
 the lungs, which destroys their structure, 
 and the life of the patient. Most of the 
 above-mentioned diseases are frequently 
 seen, and are frequently cured, without 
 consumption taking place p but it is un- 
 questionably true, that a spitting of blood 
 in young persons is always to be dreaded, 
 as it is too often the first indication of 
 consumption. At the same time, it is al- 
 so to be remembered, that a spitting of 
 blood is a mark of inflammatory action, 
 that it often yields to judicious employ- 
 ment of bleeding and the antiphlogistic 
 regimen, and though never to be neglect- 
 ed, it need not inspire the patient or his 
 friends with over-anxiety or alarm. It 
 is the same with the other diseases men- 
 tioned ; they are never to be trifled with 
 or neglected ; the most prudent methods 
 are to be taken for their removal, remem- 
 bering the insidious nature of the first 
 symptoms of consumption, and the fatal 
 progress which it makes when once it is 
 
 begun. It is generally agreed by medical 
 men, that by far the most frequent sub- 
 jects of consumption are those who have 
 tubercles in the lungs. By tubercles we 
 mean certain small hard swellings in the 
 lungs : these are inactive at first, but at 
 length become inflamed, and change into 
 little abscesses, which break and pour 
 out their matter, and give occasion to 
 purulent expectoration. It may now be 
 asked. Who have tuberculous lungs ; and 
 how are we to know or suspect the pre- 
 sence of tubercles ? It is admitted that 
 persons of a scrofulous habit are those who 
 are most frequently attacked with con- 
 sumption from tubercles ; or that it occurs 
 most in those who are affected with swell- 
 ings of the external glands, viz. persons of 
 a sanguine temperament, or of a tempera- 
 ment compounded of the sanguine and 
 melancholic, who have smooth fine skins, 
 ruddy complexion, large veins, and soft 
 flesh. Another question of great anxiety 
 is, Are we able to distinguish, by the mat- 
 ter spit up, whether the lungs are in an 
 ulcerated state or not? Different tests 
 have been proposed to ascertain the dif- 
 ference between mucus and pus, but few 
 of these tests can be depended upon ; and 
 very accurate chemists and physiologists 
 have confessed, that the matter expecto- 
 rated in a common cold is, in some of its 
 stages, precisely the same as from wasting 
 lungs; and that the most formidable look- 
 ing matter has in a few days been ex- 
 changed for an improving expectoration, 
 and at last perfect health has been restor- 
 ed. It is from other circumstances than 
 the expectoration, that we are to judge 
 whether the patient is aflfected with 
 consumption or not This is a sub- 
 ject attended with very great difficulty 
 indeed, as several diseases of organs with- 
 in the chest, and foreign bodiesgettingiuto 
 the lungs may give rise to all the symp- 
 toms of incurable ulceration of the lungs, 
 which symptoms may yet get well. In a case 
 of diagnosis, which baffles the most skil- 
 ful and experienced physicians themselves 
 to understand, or to communicate to their 
 own profession any satisfactory marks of 
 

 CONSUMPTION. 
 
 147 
 
 distinction, it would be idle and pernici- 
 ous to pretend to put the pceneral reader 
 in possession of any tests which could be 
 popularly understood. The diseases re- 
 sembling consumption, from which pa- 
 tients have sometimes recovered, are the 
 following- : Sympathetic cough ; irritation 
 of the diaphragm by diseases of the liver, 
 inflammation of the wind-pipe, diseases 
 in certain parts of the lungs themselves, 
 or of their glands and coverings, ulceration 
 in consequence of active inflammation, 
 spitting of blood, and its consequences. 
 
 Treatment of those who are supposed 
 liable to Consumption. This has varied 
 much in different periods ; sometimes it 
 has been treated on the stimulant and to- 
 nic plan ; sometimes with exercise ; some- 
 times on the antiphlogistic plan; and a 
 multitude of remedies have been for a 
 time extolled, and then laid aside and for- 
 gotten. Those who are of the»habit and 
 make described in a former part of this 
 article, or whose parents or relatives have 
 either died of consumption, or who are 
 evidently disposed to it, should pay parti- 
 cular attention to the slightest appearance 
 of the symptoms which threaten the dis- 
 ease, and should take every method for 
 their removaL In such persons, we ought 
 never to hear it negligently remark- 
 ed, when they are affected with cough, 
 Oh, it is only a common cold : this is too 
 often the commencement of the long train 
 of illness which is to lead them to the 
 grave. A spitting of blood is never to be 
 trifled with; if florid and frothy, it is 
 to be treated by blood-letting and other 
 antiphlogistic means ; and all richness of 
 living, and every thing tending to keep up 
 too great fulness of blood, or to increase 
 inflammatory action in the system, must 
 be avoided for years after the spitting of 
 blood appears. But the common fore- 
 runner of fatal consumption is the tuber- 
 culous disease ; and to prevent the format 
 tion of tubercles, to discuss or dissolve 
 them when formed, or to prevent them 
 from getting into a state of inflammation, 
 or to heal them up when suppurated, are 
 the great desiderata in this disease. But 
 
 the means of satisfying these indications 
 are by no means easily found. After the 
 long observation of this disease, from 
 Hippoci*ates to the present day, and al- 
 though tens of thousands are every year 
 cut off in Britain alone by this terrible 
 malady, we have not yet succeeded in 
 finding a method accurately to know the 
 existence of tubercles, or to treat them 
 safely when we know them to be formed. 
 One of the first objects to be attended to, 
 is to regulate the diet of consumptive 
 persons ; little animal food is to be used, 
 and a great part of the patient's living if]yT-^~X~{ 
 to consist of milk, in its various forms 
 preparations, and combinations. Ass's 
 milk has long been popular in the treat- 
 ment of consumption, from its containing 
 much nutritious and easily digestible mat- 
 ter. Care must be taken by such persons 
 also, that no undue stress be given to the 
 lungs or to the cavity of the chest ; and, 
 therefore every thing must be avoided* 
 which requires strong exertion of the or- 
 gans of breathing, such as violent or long 
 continued exercise, walking quickly up 
 steep ground : loud or long speaking, or 
 singing, must be avoided; the person 
 should not play on the flute or other wind 
 instruments, and if he has been in the prac- 
 tice of speaking in public, it must be abstai n- 
 ed from. An employment that requires 
 much stoopipg is bad for those threaten- 
 ed with consumption ; they must, there- 
 fore, give up those sedentary occupations 
 which demand stooping at a desk or coun- 
 ter. A point of primary importance in 
 the management of those who are of the 
 consumptive habit, is the avoiding of ex- 
 posure to cold ; in numberless instances 
 this exposure is to be considered as the 
 exciting cause of the disease. In our cold 
 and variable climate, it is not easy for the 
 most robust and cautious persons to pass 
 a winter without some catarrhal affection; 
 and for the phthisical, who are so much 
 susceptible of all impressions fi-om the at- 
 mosphere, it is almost impossible to avoid 
 it. Hence the necessity of preventing as 
 much as possible all changes of tempera- 
 ture from injuring the body,, by the use 
 
 
 <. ^ i 
 
 
18 
 
 CONSUMPTION. 
 
 of flannel or fleecy hosiery worn next the 
 skin ; or what is still more approved, an 
 under jacket of chamois leather. Hence, 
 also the propriety of removing to a warm- 
 er climate, and avoiding the cold and hu- 
 mid air of a northern winter. For con- 
 sumptive patients, there are several places 
 recommended as very salubrious. Ma- 
 deira is an excellent place, but with the 
 disadvaTitage of its not having good conve- 
 niences for walking. In the south of 
 France, and in Italy, there are various 
 places of resort. In England, the coast 
 of Cornwall and Devonshire has a very 
 fine equable temperature, and many pa- 
 ^ O^ , tients have been much benefited by a 
 residence there. Clifton, near Bristol, 
 is also much resorted to. See Climate, 
 and the places there referred to. 
 
 Gestation of various kinds has been 
 much recommended ; and as to the ad- 
 vantage derived from one kind, viz. rid- 
 ing, there is a testimony from Sydenham 
 so strong, that it deserves to be quoted 
 for its singularity. " Neither mercury 
 in syphilis, nor bark in intermittents, is 
 more effectual than riding in consumption ; 
 provided the patient takes care to have 
 his linen well aired, and to continue his 
 journey long enough ; the longer as he 
 is more advanced in life." Concerning 
 such a testimony from such a man, so ac- 
 curate an observer, and so candid a re- 
 lator of what he saw, we must say that it 
 is by far too strongly expressed; and must 
 add gestation to the long list of consump- 
 tive remedies, which have deceived the 
 hopes of both patients and physicians. 
 Without expecting so much from riding 
 as Sydenham did, we may still hold it as 
 true, that riding is a proper and safe ex- 
 ercise, to be tried before patients are too 
 weak to be the better for it; and that 
 many have had their complaints much 
 alleviated, and it would seem even cured 
 by the practice. Riding in a carriage, or 
 u^ing a swing, are also modes of gestation 
 which may be conveniently resorted to ; 
 and a long established practice is to order 
 patients to take a sea voyage. One would 
 naturally prefer doing this in the summer 
 
 season, and recommend going from a cold- 
 er to a warmer climate. With a view of 
 relieving the lungs, blisters have been re- 
 commended ; and an issue in some part of 
 the body may be of use. Such are the 
 measures to be employed in cases where 
 we apprehend a future consumption ; and 
 in the children of consumptive parents, 
 and in young persons who have had spitting 
 of blood, or who seem by their nature and 
 habit likely to fall into the disease, fhey 
 should be early, and diligently, and unre- 
 mittingly employed. 
 
 jTrea^men^q/" Consumption in its latter 
 stages. When we are unsuccessful in pre- 
 venting the advanced stages of the disease, 
 and the expectoration of matter, and when 
 hectic fever is confirmed, it is the part of 
 a humane and skilful practitioner to pal- 
 liate the predominant symptoms as w^ell as 
 he can. We are unhappily as yet with- 
 out any medicine which we knoAV to have 
 the power of curing ulcers in the lungs ; 
 such as have been recommended for this 
 purpose, are certain gums and balsams, 
 which, by their heating qualities, are more 
 likely to add to the evil than to remove 
 it. A mixture, containing myrrh, has ob- 
 tained some reputation, and is at least as 
 innocent as other medicines of the same 
 class. To allay the heat, the thirst, and 
 other symptoms of hectic fever, and to 
 cool the system, acids are usefully em- 
 ployed. We give from ten to twenty drops 
 of the elixir of vitriol in a glassful of wa- 
 ter, three or four times a-day, or we may 
 acidulate the patient's drink with very 
 diluted sulphuric acid : or lemonade may 
 be given, provided it does not produce too 
 great laxity of the bowels, or sourness of 
 stomach. When there occur acute pains 
 referred to some part of the chest, when 
 the skin is hot and dry, and the pains in- 
 creased by drawing a full breath, then, 
 notwithstanding the apparent weakness 
 of the patient, it will be quite necessary 
 to take away a little blood; and though 
 the disease ultimately is to prove fatal, 
 repeated small bleedings give great relief, 
 and on the whole prolong the patient*s 
 life. In those circumstances too, repeat- 
 
CON SUM 
 
 ed blisters are necessary ; and it is better 
 to allow them to heal quickly, and put 
 them on afresh, than to keep up a discharge 
 by an issue. Expectorant and emollient 
 mixtures for the cough, are 1o be given 
 through the whole course of the disease. 
 These are made of squill as the active in- 
 gredient, joined with balsam of Tolu, 
 syrup, and cinnamon-water, or pepper- 
 mint-water ; but large quantities, or many 
 varieties of cough mixtures, as they are 
 called, are unnecessary and improper. 
 The cougli is one of the most distressing 
 and pertinacious of the symptoms of con- 
 sumption ; and for the relief of this, our 
 great dependence is upon the various pre- 
 parations of opium. Ten drops may be 
 given twice or thrice a-day, and also af- 
 ter occasional fits of violent coughing ; or 
 thirty drops may be given at bed-time, in 
 an ounce of any convenient vehicle ; or a 
 tea-spoonful of the paregoric elixir, in 
 cold water at bed-time ; or a proper 
 quantity may be added to the squill or 
 other expectorant mixture. There are 
 some disadvantages in the use of opium ; 
 it has a tendency to induce costiveness, 
 and to check the expectoration ; to in- 
 crease the feverish heat, and the already 
 profuse perspiration ; but the cough, the 
 irritation, and the sleepless nights are the 
 principal sources of pain and suffering ; 
 and as we have not a more soothing drug 
 than opium, we must be content to use 
 it with all its drawbacks, and counteract 
 its injurious tendency by other means. 
 Some practitioners prefer the exhibition 
 of opium in the form of the Black Drop. 
 3aC This is made by boiling opium and some 
 ■o other substances in verjuice. One drop 
 of this preparation is considered equal 
 to about three of the tincture of opium. 
 See Ohum. 
 
 Another very troublesome symptom is 
 the looseness of the bowels, which is both 
 a cause and a sign of great debility ; and 
 which is with great difficulty checked or 
 moderated ; indeed in a great number of 
 instances, is found to be beyond the reach 
 of medicine. We attempt to moderate 
 this symptom, by giving astringent medi- 
 
 P T I O N. 
 
 149 
 
 cines, as catechu, or decoctions of log- 
 wood, or small doses of rhubarb; also by 
 giving opium by the mouth or by injec- 
 tions. The acetate of lead, combined A "P ^ '^ 
 with opium, in the dose of two grains of Oi , 
 
 the acetate to one of the opium in theQ, (V^T ZL, 
 form of pill, given at bed-time, has in somei^^^^ ♦. 
 instances the power of checking the"^ '*^'"3? * 
 looseness. The specks in the mouth are 
 another annoying circumstance in the last 
 stage of phthisis. They are to be treated 
 in the mildest possible way, by very slight 
 astringent applications, as a weak solu- 
 tion of a little honey and Armenian bole. 
 It is difficult to abstain from attempting 
 to counteract the helpless debility which 
 forms so prominent a feature in consump- 
 tion; but we must not, in general, ven- 
 ture on nourishing diet, or wine and other 
 cordials, for fear of increasing the cough, 
 the heat, the thirst, and other hectic 
 symptoms. A decoction of quassia, made 
 by boiling six drachms of the bark in two 
 pounds of water, may be given ; a wine- 
 glassful three or four times a-day, adding 
 eight drops of laudanum to each dose; and 
 one or two grains of the sulphate of iron 
 may be given daily with aromatic powder, 
 or made into pills with crumb of bread. 
 
 It would be wrong to conclude this ar- 
 ticle, without mentioning the strong hopes 
 that were at one time entertained, that 
 consumption would be cured by the use 
 of foxglove. It is certainly a medicine of 
 very surprising powers, and has great in- 
 fluence on the circulating system ; it di- 
 minishes the strength and frequency of 
 the pulse in a most remarkable manner, 
 and may be regarded as a most valuable 
 assistant in lessening the violence of in- 
 flammatory action. It may be given with -^^-^ "^ 
 this view, when such action occurs in any O " • 
 
 stage of consumption, either alone in ^->i" ®»'>^ 
 doses of ten drops in water three times 
 a-day ; or added to the expectorant mix- 
 tures in the proportion of one drachm to 
 six ounces of the mixture, and a table- 
 spoonful given four or five times a-day. But 
 we are not to hope, that any great or per- 
 manent good win aris^ from the use of fox- 
 glove in advanced pulmonary consumption. 
 
150 
 
 CONTAGION. 
 
 To the deeply interesting question — 
 Can consumption ever be cured ? we re- 
 ply: That consideringthe fallacy attending 
 much of our observations and reasonings on 
 disease; considering that there are a variety 
 of affections presenting symptoms not to 
 be distinguished from those exhibited by 
 true pulmonary consumption, which ne- 
 vertheless get well ; considering also that 
 several patients, undoubtedly members of 
 consumptive families, have by proper ma- 
 nagement been relieved of their ailments, 
 and attained a long life, we should not be 
 justified in giving the decided answer that 
 consumption in every instance is incura- 
 ble. But we must judge of every parti- 
 cular case by its own merits, must direct 
 the most prudent precautions where the 
 disease is only threatened ; and aware of 
 the melancholy results obtained in the 
 experience of the most learned, sag-acious, 
 and candid physicians, we must not excite 
 ill founded hopes, where we see the dis- 
 ease decidedly formed. 
 
 CONTAGION. The power by which 
 a disease affecting one person, is propa- 
 gated so as to cause the affection of an- 
 other with a similar disease. We shall not 
 very scrupulously make any distinction 
 between infection and contagion ; in 
 strictness, contagion is applicable only to 
 diseases communicated by contact; but 
 in common language, and even in medical 
 Writings, the two terms are often used 
 indiscriminately. Without entering into 
 any long discussion whether such or such 
 a disease is contagious or not, without 
 discussing the ingenious arguments by 
 which some writers have plausibly sup- 
 ported the doctrine of non-contagion, we 
 shall endeavour simply to state, what 
 long observation and unsophisticated 
 ^ood sense have impressed on the minds of 
 mankind ; and to recommend precautions 
 which, whether diseases are contagious or 
 not, are equally beneficial to the patient 
 and to those who are in health. The fol- 
 lowing remarks are applicable chiefly to 
 typhus fever and th^ plague. When pa- 
 tients are ill of typftus fever, there issue 
 from their bodies certain poisonous efflu- 
 
 via, which being diffused through the air 
 render the persons who are exposed to 
 the breathing or contact of them, liable to 
 the same disease. These effluvia attach 
 themselves to various substances, to 
 clothes, to bedding, to furniture ; and such 
 as receive the effluvia from these articles, 
 are in like manner generally infected with 
 the same disease. Wool, cotton, and fur, 
 carry contagion to a great distance in a 
 very concentrated state. Instances have 
 been known, of persons being struck dead 
 while opening a bale of cotton, which had 
 come from a place infected with the 
 plague. The following dreadful incident 
 is related by Dr. Parr of Exeter, (Medi- 
 cal Dictionary^ Art. Contagion.') " The 
 last plague which infested the town in 
 which we now write, arose from a tra- 
 veller remarking to his companion, that 
 in a former journey he had the plague in 
 the room where they sat. * In that cor- 
 ner,' said he, ' was a cupboard where 
 the bandages were kept ; it is now plas- 
 tered, but they are probably there still.' 
 He took the poker, broke down the plas- 
 tering, and found them. The disease was 
 soon disseminated, and extensively fatal." 
 From the above statements, we see the 
 necessity of thoroughly cleaning every 
 thing connected with the house, and the 
 bed and body-clothes of patients who 
 have fever, and of buraing every thing 
 that cannot be completely cleaned ; and 
 the indispensable necessity of quaran- 
 tine laws, judiciously made, and rigor- 
 ously enforced. 
 
 These poisonous particles do not ap- 
 pear to be very widely diffused through 
 the air, nor do they infect persons in an 
 adjoining street, room, or house, unless 
 they be exposed to the substances to 
 ■\A liich the effluvia adhere, or unless they 
 come too near to the patient himselt". 
 Where one or more persons, ill of typhus 
 fever, are kept in a small ill-aired apart- 
 ment, when their clothes are not cleaned, 
 and their discharges are not duly carried 
 out, the poison acquires a most malignant 
 virulence, and persons going near the 
 apaitnient are almost sure to be infected* 
 
CONTAGION. 
 
 151 
 
 It would appear tliat a healthy person, 
 confined in an ill-ventilated and un- 
 wholesome apartment, generates a con- 
 tagion of the most pernicious kind, which 
 may infect others, though he himself is 
 , not ill of the disease. This was remark- 
 ! ably shown at the Old Bailey in 1750, 
 I when a culprit in good health was 
 I brought out for trial, and the effluvia 
 from his body and clothes infected a 
 number of persons in court, not fewer than 
 * .forty. 
 
 Measures proper for preventing the 
 propagation of Contagion. The precau- 
 tions to be taken for preventing the com- 
 munication of infectious fever are, to have 
 the patient in as large and well aired a 
 room as possible, to open the doors and 
 windows frequently, and allow a complete 
 current of air to pass through the apart- 
 ment ; to have no more furniture in the 
 room than what is quite necessary, to 
 change the patient's linen frequently, to 
 remove all discharges as quickly as pos- 
 sible, and to pay the greatest attention to 
 cleanliness in every respect. Those who 
 must necessarily be much employed about 
 the sick, should not approach too near 
 them, should not draw in the foul air 
 about them, should not bring their clothes 
 in contact with their bed-clothes, should 
 not remain too long in their immediate 
 neighbourhood ,* and should, if possible, 
 not approach the sick-chamber when fast- 
 ing, or when debilitated by cold, fatigue, 
 or any other means. A circumstance 
 that renders persons more particularly 
 liable to be infected with contagious dis- 
 ease, is a certain depression of mind, or 
 fear of catching the infection; while those 
 who are bold and confident commonly 
 escape. Hence the virtue of certain sub- 
 stances, worthless in themselves, but 
 which, being believed by the bearers to 
 be of use, tend to realize the expecta- 
 tions formed of them, by giving courage 
 to those who must have intercourse with 
 the sick. Another circumstance which 
 seems to give contagion a destructive 
 power, is the exhaustion produced by fa- 
 mine and fatigue ; heuce its occurrence in 
 
 besieged towns, and in armies, after fa- 
 tiguing and harassing marches. 
 
 Methods of destroying i^o'ST AGIO'S. To 
 the great benefit of mankind, it has 
 been discovered of late years, that fumi- 
 gation with certain substances has the 
 power of destroying contagion, and ren- 
 dering it comparatively safe to be in the 
 rooms of the sick. One of the most ef- 
 fectual means for this purpose, is to take 
 some common salt and to pour sulphuric 
 acid upon it. There arises the vapour of 
 muriatic acid j and this, properly diffused 
 through the room, has a strong an- 
 ti-contagious power. We may also pour 
 sulphuric acid on saltpetre, by which we 
 shall obtain the vapours of the nitric acid, 
 which are equally efficacious in the de- 
 struction of contagion. Even when there 
 is no typhus apparent, it will be proper 
 to fumigate crowded and close places, in 
 order to prevent fever ; this is necessary 
 in ships, jails, barracks, hospitals, and the 
 like J being careful, at the same time, to 
 pay the utmost attention to cleanliness 
 and ventilation. It is for this reason that 
 we now so seldom hear of the destruc- 
 tive ship and jail fever, since proper at- 
 tention is paid in every well disciplined 
 ship and well regulated jail to the above 
 pai'ticulars ; though we are still distressed 
 by the prevalence of fever in the crov»d- 
 ed, damp, dirty, and close hovels of the 
 poor and profligate. 
 
 The other contagions that produce spe- 
 cific diseases, are those of small-pox, of 
 measles, of scarlet fever, of mumps, of the 
 hoopijig-cough; the general laws of which 
 are not materially different from those of 
 typhus fever, though we are not so sure of 
 destroying them by fumigation. When 
 an infectious disease breaks out where a 
 number of people live together, as in bar- 
 racks, hospitals, boarding-schools, and the 
 like, the sick should be immediately se- 
 parated from the sound ; no superfluous 
 furniture should be kept in the room, and 
 no more attendants than necessary should 
 be about the sick; the doors and win- 
 dows should be opened frequently ; and 
 occasional fumigations, as alcove describ- 
 
152 
 
 CON 
 
 CON 
 
 ed, should be employed. It is a matter of 
 some consequence to know how long- a 
 period may elapse between the patient's 
 receiving the infection and the appearing 
 of the disease. This varies in different 
 cases, but it may be latent from the tenth 
 to the seventy-second day. 
 
 CONTRACTILITY. Thepowerwhich 
 muscles or muscular fibres possess of short- 
 ening- themselves, and so performing their 
 functions. 
 
 CONTRACTION. A drawing to- 
 gether, a shortening or diminution. When 
 a joint, from any cause, loses the power 
 of being fully extended, there is said to 
 be a contraction of that joint ; motions 
 are performed by the fibres of muscles 
 contracting or shortening themselves by 
 swelling in the middle ; and when the 
 pupil of the eye diminishes its size on 
 the application of light, it is said to con- 
 tract. 
 
 CONTRA-INDICATION. The ap- 
 pearance of any symptom which forbids 
 a certain thing to be done, or a remedy 
 to be applied. Thus when any thing oc- 
 curs to render bleeding improper, we say 
 that bleeding is contra-indicated by that 
 circumstance. 
 
 CONTRAYERVA,i)or5^ewm Contra- 
 yerva. A perennial plant, growing in 
 South America and some of the West 
 Indian Islands ; the root of Avhich is used 
 as a gentle stimulant and diaphoretic in 
 typhus and dysentery. The dose is half 
 a drachm ; but it is in no great repute. 
 
 CONTUSION. A bruise or injury 
 inflicted by the impulse of a hard sub- 
 stance. This is not unfrequently a pretty 
 severe affection, as the soft parts are crush- 
 ed between the bone and the foreign body 
 that inflicts the injury. The treatment of 
 a contusion will depend on its severity, 
 and the extent of the injury. The effect 
 of external violence is to excite a degree 
 of inflammation, and this is to be coun- 
 teracted by the application of leeches, and 
 by cold lotions. A solution of sal ammo- 
 niac in water is to be kept on the part till 
 the heat is abated ; if there is a laceration 
 along with the contusion, a poultice of 
 
 bread and milk should be applied ; and 
 when there appears a disposition to form 
 matter, the part is to be treated with emol- 
 lient poultices. When there is no wound, it 
 will be necessary to rub the part with cam- 
 phorated oil or turpentine liniment, or 
 other stimulant embrocation. Sometimes 
 a bruised part is very long of recovering 
 its action ; in this case, it may be useful 
 to pour a stream of tepid water, either 
 piu-e or holding some salt in solution, from 
 a height ; and to rub the part affected with 
 a coarse dry to\^'el. 
 
 CONVALESCENCE. The state of 
 a person who is recovering from illness. 
 
 CONVULSION. A diseased action 
 of muscles, or of muscular fibres, during 
 which they contract violently and irre- 
 gularly, and have alternate relaxations. 
 
 CONVULSION-FITS of CHILD- 
 REN. When we speak of convulsions, 
 or convulsion-fits, we most commonly 
 mean epilepsy ; and principally that spe- 
 cies of it which occurs in very young 
 children ; and of this we shall give an ac- 
 count here, referring to the article Epi- 
 lepsy for the particular symptoms and 
 treatment of those convulsive actions 
 which appear in older persons. 
 
 Symptoms. In some cases convulsions 
 come on suddenly, at other times the at- 
 tack is gradual, and the first symptoms 
 elude the observation of the attendants, 
 In the sudden attack, the child, previously 
 quite well, becomes livid in a moment ; 
 his eyes and features are contorted, and 
 the limbs and whole body are violently 
 agitated. These symptoms end by the 
 patient falling into a state of insensibility, 
 which in some cases proves fatal, and in 
 others goes gradually off. In those cases 
 where the attack is milder and more gra- 
 dual, the child shows some degree of un- 
 easiness ; he suddenly changes colour, his 
 lips quiver, his eyes are turned upwards, 
 and he stretches himself out, or his hands 
 become clenched. Sometimes there is a 
 rapid succession of fits ; sometimes the 
 intervals between them are long. Con- 
 vulsions vary also in their degree of vio- 
 lence. Before the fatal termination of 
 
CONVULSIONS. 
 
 lo3 
 
 many of the diseases of infoncy, convul- 
 sions occur, and appear to be the cause of 
 death. Hence their taking" place after 
 long- or serious illness, may be considered 
 as an indication of approaching death. 
 But a single fit may destroy an infant. 
 " When the return of the convulsions is 
 not suspended within forty-eight hours 
 after active treatment has been adopted, 
 there is reason to dread either a sudden 
 fatal termination, or a long protraction of 
 the disease. In this latter case, if the in- 
 fant do not become emaciated, there is a 
 probability of his eventual recovery, even 
 although he had been blind and insensible 
 for days or weeks. In some rare cases, 
 though the health be restored, imbecility 
 ef mind remains. If emaciation attend 
 tlie protraction of fits, the living powers 
 at last give way." (Professor Hamil- 
 ton on the Diseases of Infants and 
 Children.) 
 
 Causes. Convulsions arise from any 
 thing capable of strongly irritating the 
 nervous system ; hence infants and young 
 childi'en, whose nervous system is so very 
 delicate, and who are exposed to so many 
 causes of irritation, are by far the most 
 frequently affected with convulsions. 
 These may arise from worms in the in- 
 testines, from certain kinds of food dis- 
 agreeing with the child, from acidity, 
 from wind ; and, with remarkable fre- 
 quency, from teething. Another cause 
 of convulsions in children, is the too sud- 
 den disappearance or going in of a rash 
 or eruptive disorder. Children very fre- 
 quently are seized with convulsions just 
 before the appearance of small-pox ; and 
 in some cases, though very rarely, they 
 occur before the appearance of measles. 
 The general irritation arising from want 
 of cleanliness, living in foul air, &c. may 
 give rise to convulsions. Sometimes 
 they are only the symptoms of a more 
 deep and violent disease, as of water 
 in the head, or growth of bone within 
 the skull. In this case, our attention is 
 to be directed to the original disease ; the 
 symptoms and treatment of water in the 
 bead will be detailed in their proper place, 
 
 Treatment. When convulsions sud- 
 denly attack a child, there are certain 
 measures to be pursued in order to put a 
 stop to the fit if possible ; and means must 
 be taken to remove the irritating cause as 
 quickly as we can. One of the best and 
 safest ways of putting an end to the con- 
 vulsion, is to put the patient into the 
 warm bath, and to give a iew drops of 
 the volatile tincture of valerian. The 
 whole of the body is to be very carefully ?>.^ 3* 
 examined, as fits may arise from some 
 injury which the attendants have con- 
 cealed, as from the pricking of a pin. If 
 the irritation be from teething, the gums 
 should be scarified ; and it may be requi- 
 site to do this repeatedly, before the teeth T WKv-i-n 
 get through, and the convulsions cease. -^ 
 If we think that acidity in the stomach V^»-^ 
 and bowels occasions the convulsions, we 
 must correct it by the use of magnesia, 
 alone or with rhubarb ; or by some pre- 
 pared chalk, interposing a few grains of 
 calomel, or giving castor oil or senna. 
 When any improper article of food has 
 been taken, it may be advisable to attempt 
 to clear the stomach by an emetic; al- 
 though, during convulsions, it is not a 
 very safe or practicable measure. If the 
 fits have been preceded by startings, and' "^ 
 if the heat of the skin be great, the face (^^ ' < ^ 
 and neck are to be spunged with cold / ( 
 water and vinegar. In cases of apparent " 
 sudden death from convulsions, after one ■, jH%j 
 or two fits, if the child has been previously 
 in good health, the usual means for restor- 
 ing suspended animation should be very/ — . ^ 
 diligently and perseveringly employed. /?_/>, 
 
 When the fit is over, our object must jf 
 
 be to prevent its return ; and therefore ^ 
 
 we are to dii'ect our treatment to re- 
 move the cause. If there be flushing 
 of the face, insensibility, and frequent 
 starting and oppressed breathing, some 
 blood should be drawn by a few leechea .,^ 
 on the temple, and some purgative medi- ,^'-a , J^ 
 cines are to be given. Worms are of [L 
 
 various kinds; and for children, the safest / ^ . 
 medicines for dislodging them are pnKr ' " *j^ 
 per doses of jalap and aloes : but as these * 
 
 are so very nauseous to young palates, wo 
 
154 
 
 COOKERY. 
 
 are compelled sometimes to give them by- 
 way of injection, and this is a very j^ood 
 way of destroying the small white worms. 
 An infusion of senna to the amount of 
 four or six ounces, with a drachm or two 
 of the tincture of aloes, may be given as 
 a clyster. If a rash has been repelled, we 
 must try to bring it back by warm bath- 
 ing, or by the application of some irritat- 
 ing substance to the skin, as ammonia, or 
 tartar emetic ointment, or a blister. A 
 running behind the ears should not be 
 suddenly stopped, but allowed to heal 
 very gradually ; compensation being made 
 by the bowels being kept easy, or by an is- 
 sue in some other place. When convul- 
 sions continue, as they often do, after the 
 exciting cause is removed, we are to give 
 opiates and other antispasmodics, taking 
 care that the bowels be not injured by the 
 use of opium. Rubbing the spine and chest 
 with oil of amber or opodeldoc, sometimes 
 is of service. 
 
 Children recovering from convulsions 
 should be carefully attended to, with re- 
 spect to their bov/els, their diet, and their 
 general health ; and every means should 
 be employed to strengthen them, without 
 imparting to them a tendency to inflam- 
 matory diseases. 
 
 No reliance can be placed on any of the 
 drugs which have obtained reputation 
 from their fancied powers against fits. 
 Cochineal has no power whatever ; and 
 rue, and musk, though occasionally use- 
 ful, have no title to be considered as spe- 
 cifics in this disease ; and less, if possible, 
 can any trust be put in the boasted quack 
 medicines for convulsions; on the con- 
 trary, being generally preparations of 
 opium, they have all the pernicious pro- 
 perties of that substance when it is given 
 by rash and ignorant persons. 
 
 COOKERY is that application of heat 
 to our various aliments, either single or 
 combined, by which they are prepared in 
 some measure for the stomach; and ren- 
 dered both more agreeable to the palate, 
 and more susceptible of undergoing the 
 various processes of digestion. By cook- 
 cry, the nutritive principles are altered, 
 
 both in their chemical arrangements and 
 their mechanical texture. Its principal 
 operations are boiling, roasting, frying, 
 broiling, and baking. By boilingy the 
 principles not properly soluble are ren- 
 dered softer, more pulpy, and easier of 
 digestion ; but the meat at the same time 
 is deprived of some of its nutritive pro- 
 perties, by the removal of a portion of its 
 soluble contents. The albumen is ren- 
 dered solid, and the gelatine is converted 
 into a glutinous substance. When meat 
 is boiled too long or too fast, if it contains 
 much albumen, as in beef, we shall obtain 
 a hard and indigestible mass, like an over- 
 boiled eg^ ; or in young meats, such as 
 veal, where there is more gelatine, the re- 
 sult wiU be a gelatinous substance, not 
 easily digestible. Young and viscid food, 
 therefore, as veal, chickens, &c. are more 
 wholesome when roasted than when boil- 
 ed, and are easier digested. Many sub- 
 stances would be better cooked by expos- 
 ing them for a longer time to a lower 
 heat than boiling, as for instance mut- 
 ton-tea and beef-tea. The loss occa- 
 sioned by boiling, partly depends on the 
 melting of the fat ; but chiefly from the 
 dissolving of the gelatine and some other 
 animal principles. But in Scotland, 
 we are wise enough to use as food the 
 water in which all meat, except pork, 
 has been boiled; and thus we get the 
 good both of the solid and liquid parts. 
 Boiling is very properly applied to vege- 
 tables ; as it renders them more soluble 
 in the stomach, and deprives them of a 
 quantity of air, so injurious to weak sto- 
 machs. But even in this case, the opera- 
 tion may be carried to an injiu-ious ex- 
 tent ; thus potatoes are frequently boiled 
 to the state of a dry insipid powder; instead 
 of being preserved in that state, in which 
 the parts of which they are composed are 
 rendered soft and gelatinous, so as to re- 
 tain their shape, yet be very easily se- 
 parated. On the other hand, the cabbage 
 tribe and carrots are frequently not boil- 
 ed long- enough, in which state they are 
 highly indigestible. The quality of the 
 water used in boiling requires some at- 
 
coo 
 
 COP 
 
 \->s 
 
 tention ; rauttou boiled in hard water is 
 more tender and juicy than when soft 
 water is used, while hard water renders 
 vegetables harder and less digestible. 
 
 Boasting. By this process, the fibre is 
 corrugated, the albumen coagulated, the 
 fat melted, and the water evaporated. As 
 the operation proceeds, the surface be- 
 comes first brown, and then scorched ; and 
 the tendinous parts are rendered soft and 
 gluey. When underdone, meat may be 
 more nourishing ; but, from the closeness 
 of its texture, it will not be so easily di- 
 gestible. Animal matter loses more by 
 roasting than by boiling ; by boiling, mut- 
 ton loses one fifth, and beef one fourth ; 
 but by roasting, they lose one third of 
 their weight. 
 
 Frying. This process is perhaps the 
 most objectionable of all the operations 
 of cookery. The heat is applied through 
 the medium of boiling oil or fat, which is 
 rendered empyreumatic, and therefore 
 extremely liable to disagree with the sto- 
 mach. 
 
 Broiling. By this operation, the sud- 
 den browning or hardening of the surface 
 prevents the evaporation of the juices of 
 the meat, which imparts a peculiar ten- 
 derness to it. It is the form selected as 
 the most eligible, by those who seek to 
 invigorate themselves by training. But 
 though this may induce a state of body 
 fit for the savage purposes intended, the 
 over-excited health so brought on, is pe- 
 culiarly liable to become changed into dis- 
 ease by very slight causes. 
 
 Baking. The pe€uliarity of this pro- 
 cess depends upon the substance being 
 heated in a confined space, which does 
 not permit the escape of the fumes aris- 
 ing from it ; the meat is therefore, from 
 the retaining of its juices, rendered more 
 savoury and tender. But l)aked meats are 
 not so easily digested, on account of the 
 greater retention of their oils, which are, 
 moreover, in an empyreumatic state. Such 
 dishes, accordingly, require the stimulus 
 of various seasonings to increase the di- 
 gestive powers of the 8toina<;h. As there 
 is commonly much pastry made with but- 
 
 ter, used to confine the odour of the meats 
 baked, such accompaniments render pies 
 of all kinds difficult of digestion, and pc- 
 ctiliarly unfit to form a frequent part of 
 the diet of children. Besides, the use of 
 pastry with children too early teaches 
 them to please the palate at the expense 
 of their health. 
 
 COPAIBA, OR COPAIVA. The bal- 
 sam of copaiba is a liquid resin, obtained 
 by wounding the bark of a tree called the 
 Copaifera officinalis, which grows in 
 South America. It is in a slight degree 
 purgative, and is thought to strengthen 
 the nervous system. It is principally used 
 for its operation on the urinary organs, 
 which it is supposed to clean and heal, 
 when in a state of ulceration. Hence, it 
 is thought beneficial in gleets and in the 
 whites. The dose is from twenty to thirty 
 drops, reduced to the form of emulsion 
 by rubbing it with oil of almonds, or mu- 
 cilage of gum arable, and gradually adding 
 a proper quantity of water. It should 
 not be employed when inflammatory 
 symptoms are present. 
 
 COPPER. A weU known and very 
 valuable metal ; from the various prepa- 
 rations of which, several active and use- 
 ful substances in medicine and the arts 
 are procured. The principal of these are, 
 the ammouiuret of copper, the sulphate 
 of copper or blue vitriol, and the sub-ace- 
 tate of copper or verdigris. The two last 
 salts of copper are principally used by 
 surgeons as external applications. The 
 blue vitriol is used as an escharotic to de- 
 stroy proud flesh ; and ointment, made 
 with verdigris, is useful in dressing indo- 
 lent ulcers. The blue vitriol is also given 
 internally, when an active metallic emetio 
 is wanted. The dose is five or six grains; 
 and it is chiefly when the vegetable nar- 
 cotic poisons have been swallowed, that 
 such emetics are employed. It is au obr 
 ject of much importance when such eme- 
 tics are given, that no portion be left in 
 the stomach, as it will be seen in the sub- 
 sequent part of this article, that the pre- 
 parations of copper are of themselves pcri- 
 soaous. On such occasions, therefore* 
 
•i^ 
 
 156 
 
 COPPER. 
 
 plentiful dilution is required, by chamo- 
 mile tea, tepid water, thin gi'uel, barley- 
 water, or the like. 
 
 Poisoning by Copper. Copper, in its 
 metallic state, exerts no action on the 
 stomach ; as has been proved by the very 
 numerous cases in which children have 
 swallowed copper coins without any bad 
 consequences. But though in general, 
 articles of food meeting wdth copper in 
 the stomach do not render it noxious, we 
 have many instances which show how 
 dangerous are the mixtures produced by 
 cooking the same articles in badly tinned 
 copper vessels. When tin is present, it 
 prevents the copper from being dissolved, 
 and hence the utility of tinning such uten- 
 sils. But any of the above mentioned 
 salts of copper, when taken to a certain 
 quantity, are poisonous ; and it is by the 
 formation of one of these salts in culinary 
 vessels, and its consequent admission into 
 the system, that dangerous and even fatal 
 accidents are sometimes produced. The 
 acid contained in certain pickles and other 
 articles of food, acts upon the copper, and 
 produces a salt which imparts deleterious 
 qualities to the food cooked in such ves- 
 sels. The symptoms induced are, head- 
 ach or dizziness, vomiting, thirst, with a 
 constant taste of the copper remaining in 
 the back part of the mouth ; oppression 
 on the breast, acute pain of the stomach, 
 griping of the bowels, eruptions on the 
 skin, palsy, delirium, and death. The 
 taste of copper is so nauseous, that per- 
 sons are generally put on their guard 
 against swallowing any considerable quan- 
 tity of it ; and it is chiefly when it is great- 
 ly disguised in food or medicine that it has 
 the opportunity of producing its delete- 
 rious effects. 
 
 Treatment of those who have swallowed 
 Copper. The vomiting which is excit- 
 ed when copper has been inadvertently 
 swallowed, renders the exhibition of eme- 
 tics unnecessary ; but should sickness, 
 without vomiting, accompanied with pain 
 at the stomach, ensue, it may be proper 
 to give ten or twelve grains of white vi- 
 triol to promote the speedy evacuation of 
 
 the offending matter ; and sugared water 
 may be given largely to assist in the same 
 purpose. When an emetic is not required, 
 mucilaginous substances, oil, butter, and 
 milk, will be useful j but the latest expe- 
 riments of Orfila induce him to recom- 
 mend the whites of eggs in large quanti- 
 ties, as the best antidote against the poi- 
 son of copper. Another good antidote is 
 the ferrocyanate of potassa, called also 
 the prussiate of potassa. Vinegar, so 
 frequently administered in cases of poison- 
 ing, must, in the instance of copper, be 
 most carefully avoided. 
 
 The experiments of Sir Humphrey 
 Davy, on the sheathing of the bottoms 
 of ships with copper, have furnished a 
 new illustration of the very different ef- 
 fects of copper and its salts on animal life. 
 Where copper is prevented by galvanic 
 influence from being dissolved, the bot- 
 toms soon become covered with every 
 species of sea insect ; but where the cop- 
 per sheathing is not protected by the con- 
 tact of another metal, and a salt of copper 
 is formed, they are uniformly free from 
 marine animals. 
 
 COPPERAS. The name given to 
 white, blue, and green vitriol, or the 
 combinations of the sulphuric or vitriolic 
 acid with the oxides of zinc, copper and 
 iron. 
 
 CORDIALS, Certain substances of a 
 stimulant natui'e, given with a view to ex- 
 cite the action of the heart and arteries. 
 They most commonly consist of alcohol, 
 either simple or diluted, or holding in so- 
 lution some ai'omatic or stimulant sub- 
 stance. They are principally used in cases 
 of fainting, or in diseases attended with 
 great debility ; and their use should not 
 be persisted in after the immediate end of 
 their exhibition is accomplished, as there 
 is considerable danger of inducing a habit 
 of indulging in the use of spirituous li- 
 quors ; which, though grateful at the time, 
 are apt to bring on many unpleasant bodily 
 feelings, and create a craving for their re- 
 petition. The cases in which cordials are 
 proper are such as these : 1. In the ad- 
 vanced stages of fever and other debilit^t?- 
 
CORNS. 
 
 157 
 
 ing diseases. The cordials we may here 
 employ are wine, or wine and water ; di- 
 luted spirits, compound tincture of bark, 
 tincture of cinnamon, tincture of gentian, 
 aromatic spirit of wine holding ammonia 
 in solution. 2. In cases of fainting : we 
 may here employ certain preparations of 
 hartshorn, of ether, or valerian ; giving 
 wine or spirituous liquors if the patient 
 can swallow. 3. After surgical opera- 
 tions. 4. After delivery, but with the 
 utmost caution as to kind, quantity, and 
 continuance. We are to be regulated by 
 the state of the patient, by the length of 
 the labour, and by the degree of exhaus- 
 tion. Sometimes brandy or wine will be 
 required, sometimes a small dose of laud- 
 anum ; at other times a little tea will be 
 quite sufficient ; and as a good general 
 rule, it may be stated, that after a single 
 cordial, every thing stimulating is to be 
 forbidden for many days. 
 
 CORIANDER, Coriandrum sativum. 
 A plant growing in the south of Europe, 
 the seeds of which are considered as sto- 
 machic and carminative, and accordingly 
 are used in certain infusions, tinctures, 
 and electuaries. 
 
 CORN. A hardened part of the skin, 
 with a root, sometimes extending deeply 
 into the cellular substance. Coras are 
 owing to long continued or repeated pres- 
 sure, and occur principally on the toes 
 and soles of the feet. Tight shoes are 
 one of the most frequent causes of corns ; 
 and hence they are often troublesome to 
 females and others, who are particularly 
 attentive to appearance, and who wish to 
 exhibit a neat and small foot. Happily 
 the mutability of fashion has occasioned 
 the disuse of high-heeled shoes ; a most 
 pernicious custom, by which very injuri- 
 ous pressure was made on the anterior 
 parts of the foot, and corns very frequently 
 produced. Corns sometimes exist with- 
 out giving much pain or trouble ; but in 
 other cases they give so much uneasiness, 
 as absolutely to incapacitate for walking. 
 They are made more particularly intole- 
 rable, by every thing that quickens the 
 circulation, or which heats the feet, or 
 
 causes the com to press on the neighbour^ 
 ing parts. Hence, tight shoes, much walk- 
 ing, warm weather, heating liquors, all 
 tend to render the uneasiness of corns 
 very great, and they are generally worse 
 in summer than in winter ; and persons 
 are frequently obliged to sit down to take 
 off their shoes, and rest the foot in a hori- 
 zontal posture. 
 
 Treatment. Corns may often be rea 
 dily cured, by avoiding the above exciting 
 causes, by wearing large soft shoes, and 
 by continuing for some time at rest. 
 Hence ladies frequently get rid of corns 
 during an in-lying. It is useful to take 
 a considerable number of folds of linen, 
 covered with some softening ointment, 
 cut a hole in the middle for the corn 
 to lie in, and to apply them to the foot ; 
 and if it be in the sole of the foot, it 
 may be useful to have an additional 
 moveable sole, with a hole cut in like 
 manner. If, along with this mechanical 
 and palliative treatment, we use the 
 following method, a corn will be easily 
 and quickly eradicated : It is to be touch- 
 ed with lunar caustic, and wrapped round 
 with adhesive plaster ; and generally at 
 the end of a fortnight, the dead cuticle 
 will be removed with the corn adherent 
 to it. If the corn does not come away, 
 the operation is to be repeated. Several 
 other remedies of the same kind are re- 
 commended, of which the principal are, 
 soap plasters, or mercurial plasters, or 
 blistering ointment. The following plan 
 may also be tried ; Every night and 
 morning the foot is to be put into warm 
 water for half an hour, and while there, 
 the corn is to be well rubbed with soap. 
 All the soft white outside of the corn is 
 ^terwards to be scraped off with a blunt 
 knife; but we must not persist in this 
 scraping, if the person complains of pain 
 in any part of it. This treatment is to 
 be continued without interruption till 
 the corn is totally "eradicated, which it 
 will be in about a fortnight. It is ge- 
 nerally a difficult and painful operation 
 to cut out a corn. Unless it be com- 
 pletely taken out, it is apt to grow again 
 
158 
 
 COR 
 
 COR 
 
 and this it does faster than if it had been 
 let alone. In old people it is highly 
 dangerous to cut a corn, as this too 
 frequently excites an inflammation and 
 consequent mortification, which carry off 
 the patient. It is much better to be con- 
 tent with the plasters above described, 
 with bathing, and other palliative means. 
 When a person has once got rid of corns, 
 they are very ready to recur, unless he 
 take particular care to avoid pressure, to 
 wear wide and soft shoes, and not to walk 
 too much, especially in warm M^eather. 
 
 CORNEA, TRANSPARENT. The 
 clear part in the front of the eye, through 
 which the rays of light are transmitted, 
 and through which we see the pupil and 
 iris. This transparent cornea is subject 
 to a variety of diseases. Abscesses may 
 form between its layers and may leave 
 scars, which will prevent the free trans- 
 mission of light; and a more frequent or 
 distressing occurrence still, is its becom- 
 ing opaque, the consequence of which is 
 the blindness of the patient. It is one of 
 the bad sequels of long continued oph- 
 thalmia. Some kinds of this opacity are 
 produced by the blood stagnating in the 
 veins of the cornea; and are to be treated 
 with astringent washes or ointments, or 
 even by cutting across portions of the dis- 
 tended vessels, as they run into the cor- 
 nea. Another very bad kind of opacity 
 is that termed by surgeons staphyloma, in 
 which the cornea loses its transparency, 
 rises above the level of the eye. and even 
 projects beyond the eyelids. It is some- 
 times owing to the purulent ophthalmia 
 with which infants are attacked soon after 
 birth ; and occurs frequently at the latter 
 period of small-poif, when the pustules dry 
 and the scales are falling off. There is 
 no remedy by which this opacity of the 
 cornea can be removed, and if the projec- 
 tion be so large as to protrude before the 
 eyelids, and to prevent them from shut- 
 ting, it may be necessary, by caustic, or 
 by other means, to remove the projecting 
 part, or even the whole of the eye. 
 
 CORONARY VESSELS. The blood- 
 vessels conveying the blood to and from 
 
 the muscular substance of the heart it- 
 self. They are so called from their sur- 
 rounding it like a corona or fillet. Co- 
 ronary ligaments are those uniting the 
 bones of the fore-arm ; and one of the at- 
 tachments of the liver is called the coro- 
 nary ligament. 
 
 CORROBORANTS. Whatever ia 
 believed to give strength to the body, jvhe- 
 ther diet or medicines. It is a term not 
 much used; and to such articles of the 
 Materia Medica we more commonly give 
 the name of tonics. 
 
 CORROSIVE substances are those 
 which have the power of destroying the 
 texture of parts to which they are ap- 
 plied. Of this kind are the stronger mi- 
 neral acids, the alkalis, and some of the 
 metallic salts. 
 
 CORROSIVE SUBLIMATE OF 
 MERCURY. One substance to which 
 the epithet corrosive is more particularly 
 applied, is the bi-chloride of mercury, 
 which goes under the name of corrosive 
 sublimate, from its properties, and from 
 its being prepared by sublimation. It is 
 soluble in water and in spirits of wine; it is 
 also very soluble in sulphuric ether. Its 
 taste is strongly styptic, metallic, and 
 acrid ; and remains very long in the 
 mouth. Corrosive sublimate, from its 
 solubility in water, from its activity, and 
 from being easily disguised, is the active 
 ingredient of almost all the cosmetics and 
 washes for the diseases of the skin, and 
 of those quack medicines of great pre- 
 tensions, which are to cure the venereal 
 disease without the use of mercury. All 
 such should be regarded with great sus- 
 picion, and never employed ; as their use 
 is attended with the greatest hazard of 
 introducing into the body one of the most 
 poisonous substances knoAvn. 
 
 When corrosive sublimate is medicin- 
 ally employed in order to obtain the ef- 
 fects of mercury on the constitution, its 
 dose must be very small indeed, not more 
 than the eighth part of a grain night and 
 morning in solution in distilled water, or 
 made into a pill ^vith liquorice and 
 honey; and that for a very few davs, 
 
CORROSIVE SUBLIMATE. 
 
 159 
 
 and under the most judicious superin- 
 tendence. The sohition is sometimes 
 applied as a wash in cutaneous diseases, 
 in the streag-th of five grains to a quart 
 of water ; but this too must be watched, 
 lest the mercurial effects be occasioned 
 by the absorption from the surface of the 
 body. 
 
 Of Poisoning by Corrosive Sublimate. 
 Not unfrequently, by accident or design, 
 corrosive sublimate is taken into the sto- 
 mach. The symptoms produced are se- 
 vere vomiting-, purging^, and pain in the 
 bell}^ tightness in the throat, dryness and 
 shrivelling of the lips and tongue. The 
 pulse is small, and the breathing oppress- 
 ed, and there is commonly blood in the 
 stools and in the matter vomited. The 
 period within which death occurs from 
 this poison, is from eleven hours to thirty- 
 six or forty. But the alimentary canal is 
 not the only May in which corrosive sub- 
 limate may be introduced so as to act as 
 a poison on the body. It is dangerous 
 when applied to a wound in the cellular 
 tissue ; and when introduced in this way, 
 has, like arsenic, the singular power of in- 
 flaming the stomach and intestines. It 
 also possesses the power of inflaming both 
 the lungs and the heart. Nervous affec- 
 tions, stupor, and convulsions have also 
 occuiTed. 
 
 Treatment. When inflammation of the 
 stomach is very urgent, we must combat 
 that symptom by general or local bleed- 
 ing; aware, however, of the danger of 
 groat subsequent depression; and castor 
 oil or other mild laxatives may be given. 
 Albumen or the white of e^^ has happily 
 been ascertained to h6 a most effectual 
 antidote to corrosive sublimate. The 
 white of one eg^ renders four grains of 
 the poison inert. A few years ago, this 
 discovery of Orfila's was the means of 
 saving the life of M. Thenard, the che- 
 mist. While at lecture, this gentleman 
 inadvertently swallowed, instead of ^va- 
 ter, a mouthful of a concentrated solution 
 of corrosive sublimate; but having im- 
 mediately perceived the fatal error, he 
 sent for the white of eggs, which be was 
 
 fortunate enough to procure in five mi- 
 nutes. Although at this time he had not 
 vomited, he suffered no material harm. 
 Without the prompt use of the albumen, 
 he would almost infallibly have perished."- 
 (Dr. Christison on Poisons.) 
 
 Many examples ai-e recorded of the 
 success of this practice. Vegetable gluten, 
 as contained in wheat flour, is said to an- 
 swer the purpose as well as albumen; 
 and for this purpose we have only to give 
 wheat flour and water; or to mix six 
 parts of fresh gluten with fifty parts of a 
 solution of soft soap. When neither al- 
 bumen nor gluten is at hand, milk is a 
 convenient antidote of the same kind. 
 All the old antidotes, as liver of sulphur, 
 bark, and charcoal, have been tried and 
 found inelQfectual. 
 
 COSMETICS. Cei-tain washes which 
 ladies are induced to use, with the hope 
 of beautifying the skin and adorning the 
 person. Few regular practitioners will 
 give any encouragement to the use of 
 these, as there is always hazard of dan- 
 gerous accidents occurring. The most 
 noted are some of the preparations of 
 mercury, or solutions of the nitrate of sil- 
 ver; and from the use of this last, effects 
 the very reverse of beautiful take place. 
 Ladies have gone into the bath with a 
 fine white skin, and have come out brown 
 or black, from the chemical action of the 
 water or gases on the cosmetic. Go\^- 
 laud's Lotion, a noted cosmetic, is a sol- 
 ution of corrosive sublit^ate in an emul- 
 sion of bitter almonds; and whoever reads 
 the preceding article, will probably not 
 be very ready to meddle v»4th such dan- 
 gerous compositions. 
 
 COSTIVENESS. The usual frequency 
 of evacuating the bowels for persons in 
 good health, is once in twenty-four hours. 
 The constitutions of different people vary 
 in this respect ; some having two or three 
 motions in a day without any inconve- 
 nience or ill health ; others not having 
 above one or two in a week. Wheu a 
 person has habitually fewer motions than 
 the generality of healthy people, he is 
 said to be of a costive habit ; and when 
 
IGO 
 
 C O S T I V E N E S S. 
 
 he has at any time fewer than his ordinary- 
 rate, and when the faeces are hard, dry, 
 and voided with difficulty, he is said to be 
 costive. 
 
 Causes ©/"Costiveness. Independently 
 of medicine, it is not very easy to specify 
 any diet or mode of living that universally 
 predisposes to costiveness. Many articles 
 have been blamed, and yet have been used 
 by thousands without producing that ef- 
 fect. Kice in various modes of cookery ; 
 the finer kinds of bread; roast meat, 
 eaten without a due proportion of vege- 
 tables ; cheese ; port and other dry wines ; 
 an indolent and sedentary life ; and a sea 
 voyage, are all known to occasion costive- 
 ness in certain individuals. In some in- 
 fants, this state is constitutional ; and for 
 some time, at least, appears to do them 
 little harm. It is very apt to occur in 
 children, as their volatility and playful- 
 ness cause them often to disregard the 
 calls of nature, till a great and dangerous 
 mass of feculent matter is accumulated in 
 their bowels. The indolent and sedentary 
 lives of females predisposes them much 
 to costiveness. The structure of their 
 pelvis, also, allows a larger mass to accu- 
 mulate without inconvenience, from which 
 circumstance, the faeces are deprived of 
 almost all their fluid parts, and the re- 
 mainder becomes dry, hard, and difficult 
 to be voided. Persons of the melan^ 
 cholic temperament ; also those who are 
 advanced in life, and those who take little 
 exercise, are liable to become costive- 
 
 Dangers q/" Costiveness. The dangers 
 to be apprehended from excessive cos- 
 tiveness are, a stagnation of blood -in the 
 head, or too much determination to that 
 important cavity j hence giddiness, ring- 
 ing of the ears, and all the symptoms of 
 threatening apoplexy, frequently occur in 
 those who are habitually or occasionally 
 costive. Costiveness is apt likewise to 
 bring on much derangement of the diges- 
 tive functions, and to give rise to flatu- 
 lence, fetid eructations, and all the long 
 train of what are called stomach com- 
 plaintci. Long continued costiveness is 
 often followed by severe colic, even pro- 
 
 ceeding the length of iliac passion. In 
 the case of infants, it may bring on con- 
 vulsions, fever, or other unpleasant symp- 
 toms. In children, costiveness is par- 
 ticularly to be avoided ; in them it is 
 not unfrequently the forerunner, if not 
 the cause, of water in the head. In 
 young ^vomen, especially about the 
 time when the monthly discharge is 
 beginning to be established, much in- 
 convenience and hazard attend a costive 
 habit of body. Costiveness should be 
 carefully avoided during the whole pe- 
 riod of pregnancy, and especially as the 
 time of delivery draws near. It should 
 be very generally inculcated, that costive- 
 ness is a state orjendency of the consti- 
 tution which is Aever to be neglected ; 
 and since the young are so thoughtless, it 
 must be the part of parents and others to 
 think for them, and to pay particular at- 
 tention to the regularity of their alvine 
 discharges. This is particularly necessary 
 for the female sex as they approach the 
 age of puberty. 
 
 Treatment of Costiveness, and modes 
 of preventing it. The first milk taken after 
 bii'th generally proves laxative to the 
 child, and the bowels soon get into a re- 
 gular state; but, should this not happen, a 
 little castor oil, or manna, or magnesia, 
 or the tincture of senna, may be neces- 
 sary once or twice a-week even with very 
 young infants. This costive state is very 
 generally accompanied by wind in the 
 bowels, which distresses the infant very 
 much, occasioning griping pains, which 
 are shown to be present by the infant 
 screaming, and drawing up its legs to the 
 belly. The wind- is expelled by the as- 
 sistance of a little sugar of anise, or a lit- 
 tle magnesia given in anise water, with a 
 drop or two of tincture of valerian or 
 ammonia. The belly may be fomented 
 with chamomile? flowers, and friction with 
 the warm hand may be resorted to. Dur- 
 ing the whole time of teething, costiveness 
 should never be allowed to continue 
 above a single day. 
 
 To counteract costiveness, in general 
 we must use such articles of food as 
 
C O U G II. 
 
 161 
 
 nrc known to promote a proper laxity, 
 of the bowels ; and certain drug^s also 
 are necessary for this purpose. The 
 principal dietetic means, are the use of a 
 due proportion of vej^etable diet, the tak- 
 ing of certain preparations of milk and 
 farinaceous food; ascertaining by expe- 
 rience what sort of drink answers best, 
 and continuing the use of such ; keeping 
 a regulai* temperature of the skin ; and en- 
 deavouring to acquire a certain regularity 
 of time in soliciting the alvine evacuation. 
 
 The substances from the Materia Medica 
 used for the prevention of costiveness, 
 are mild purgative or laxative medicines 
 taken daily, or as often as they may be 
 required ; and as it is far from being agree- 
 able to have recourse to purging medi- 
 cines very frequently, a selection should 
 be made of those, which are most likely 
 to bring quickly into a due efficiency the 
 alimentary canal. For children, we are 
 obliged to employ a considerable vai'iety; 
 and it is often no easy matter so to dis- 
 guise or overcome the nauseous taste, as 
 to get thera to swallow enough for the 
 purpose. Senna, or the infusion of ta- 
 marinds, Gregory's powder, cream of 
 tartar, calomel, either alone or with rhu- 
 barb or jalap, castor oil, small doses of 
 the neutral salts, as sulphate of soda or 
 sulphate of magnesia, are to be used. 
 For those who can take piUs, there are 
 certain kinds well adapted for costive ha- 
 bits. The common aloetic pill, or aloes 
 with colocynth, or the extract of jalap, or 
 Anderson's pill, which are made of Bar- 
 badoes aloes, are good for this purpose. 
 See Aloes. 
 
 COUCHING. The operation for de- 
 pressing the opaque lens out of the sphere 
 of vision, in order to cure a cataract See 
 Eye and its Diseases. 
 
 COUGH is a strong effort to clear the 
 windpipe or air-cells of the lungs from 
 mucus, blood, air, gas, or any substance 
 that irritates thera, either by its bulk or 
 acrimony. Cough is not often a simple 
 and primary complaint, but it is a fre- 
 quent attendant on very many disorders 
 of the chest and lungs. 
 
 In attempting to relieve a cough that 
 is very troublesome, we must direct our 
 chief attention to the disease of which it 
 is a symptom. The principal diseases of 
 which cough is an attendant are the fol- 
 lowing : I . Catarrh or Common Cold. 
 The cough in this complaint is preceded by 
 sneezing, running at the nose, inflamma- 
 tion of the eyes, as described under the 
 article Catarrh. It is at first dry and 
 hard ; but as the disease advances, it be- 
 comes more free, and is accompanied with 
 expectoration, sometimes in a most won- 
 derful quantity. As the complaint is go- , 
 ing off, the cough is most troublesome in 
 the morning and evening, and frequently 
 prevents the patient's sleeping for a great 
 part of the night. It is only when the 
 inflammatory state of the system is re- 
 moved, that we can venture on an opiate 
 to allay this troublesome symptom. For 
 this purpose, twenty-five drops of laudanum 
 or a dz*achm of the Scotch paregoric may 
 be given at bed-time; or if the cough be 
 very annoying in the day-time, fi-om ten 
 to fifteen drops of laudanum may be given 
 three or four times in the course of the day. 
 2. Cough attends pleurisi/ or inflammation 
 of the lungs ; and is one of the greatest 
 aggravations of that painful and danger- 
 ous affection. Here there must be no 
 opiate or other quieter of the cough used, 
 till copious blood-letting and other anti- 
 phlogistic means have brought dowTi the 
 violence of the inflammation. When the 
 cough seems to remain principally from 
 habit or some slight irritation, an opiate 
 may be given ; but should be abstained 
 from as long as possible, lest the salutary 
 expectoration should be checked, and the 
 system too much heated. The squill 
 mixture, with a little syrup of Tolu ; or 
 three ounces of capillaire Avith half a 
 grain of tartrate of antimony, dissolved 
 in three ounces of water; or six ounces 
 of mucilage of gum arable, with an ounce 
 of squill vinegar or common vinegar, and 
 two ounces of simple syrup ; taken res- 
 pectively in the dose of a table-spoonful 
 four times a-day, are as safe remedies as 
 can be used for the cough; but in too 
 
1G2 
 
 COUGH. 
 
 many instances, tliey will not be found 
 sufficient to remove it, but will require to 
 be assisted by blisters, local bleeding, tar- 
 tar emetic ointment, or equally active 
 means. 3. Of measles^ cough is one of 
 the earliest, most prominent, and long 
 continued symptoms, to be combated only 
 by the means useful for treating the pri- 
 mary disease, which vary in different 
 cases ; sometimes requiring blood-letting 
 and other antiphlogistic practice ; and 
 sometimes the warm bath, and other 
 means of promoting perspiration. De- 
 mulcent mixtures, such as those mention- 
 ed above, are proper at all stages of the 
 disease. In scrofulous constitutions, the 
 cough in measles often remains after other 
 symptoms are cured, and passes into, fatal 
 consumption or other disorder, of the 
 lungs. 4. The cough in hooping-cdugh 
 is of a peculiarly violent and hai-assing 
 kind. Unless from experience, we should 
 never believe it possible that the consti- 
 tution could bear the repeated shocks of 
 a paroxysm of hooping-cough, and yet in 
 a great majority of cases, the patients 
 seem to suffer little injury by it. In 
 some cases there is fever, pain, and in- 
 flammatory symptoms, w^hich require to 
 be treated by bleeding and blistering. 
 5. Asthma is frequently accompanied by 
 cough, which is excited by dust, by smoke, 
 and any sort of air that irritates the mor- 
 bidly sensible organs of respiration. 
 Antispasmodics are the best remedies in 
 this case. 6. Many people are subject to 
 what is called a nervous cough, which 
 may subsist for a long time without fever 
 or any organic disorder of the lungs, and 
 proceeds from sympathy with some more 
 distant organ. Thus a nervous cough of- 
 ten accompanies the various states of the 
 monthly discharge, as its non-appearance 
 or obstruction, and the state of preg-nancy 
 or green sickness- Cough also is a fre- 
 quent attendant on diseases of the kid- 
 neys. 7. In the long train of consump- 
 tive symptoms yi\^Q cough is one of the most 
 persistent and troublesome. It may some- 
 times be alleviated by demulcents and 
 opiates, but never cured. 8. .A cough is 
 
 often very troublesome to old people," 
 many of whom ^re affected with a ca- 
 tarrh, catarrhus senilis, in which a great 
 quantity of mucus is constantly expecto- 
 rated. It is not a desirable thing to stop 
 this cough and spitting in old people, as 
 that might lead to more serious and alarm- 
 ing symptoms. A little demulcent mix- 
 ture, as above described, is all that should 
 be used ; with a grain or two of the sul- 
 phate of zinc taken internally, twice a-day, 
 in solution ; or made into a pill or bolus 
 with gum arabic or conserve of roses. 
 
 9. Foreign bodies getting into the wind- 
 pipe occasion severe and violent fits of 
 coughing. A crumb of bread, a particle 
 of salt or pepper, a drop of liquid, even of 
 the mildest kind, as water or milli;, rouso 
 into action a great number of most power- 
 ful muscles, which exert a strong and al- 
 most convulsive action to expel the in- 
 truder. Calcareous substances forming 
 in the lungs themselves, and sometimes a 
 foreign body working its way into them 
 by ulceration of neighbouring parts, occa- 
 sion a cough, which lasts for many years. 
 
 10. Irritations of the upper part of the 
 gullet, and swellings of the t07isils, or po- 
 lypi in their neighbourhood, have been 
 known to occasion violent and long-con- 
 tinued cough, accompanied with purulent- 
 like spitting, emaciation, and all the 
 symptoms of confirmed consumption. 
 When such excrescences have been re- 
 moved by a surgical operation, or dis- 
 cussed by the use of remedies, the whole 
 formidable train of symptoms has disap- 
 peared, and the patient has been restored 
 to perfect health. 
 
 From \i'hat has been stated above, we 
 see how rarely our attention should be 
 directed merely to relieve or stop a cough, 
 and how necessary it is to attend to the 
 disease of which it is a symptom. Oc- 
 curring as it does so very frequently, it 
 lias attracted much of the popular notice; 
 and for no symptom is there so great a 
 number of private and domestic recipes. 
 They are generally pretty harmless, being 
 chiefly decoctions of various herbs, weD 
 sweetened with honey or sugar, and 
 
COW-POX. 
 
 163 
 
 sharpened with a little vinegar; or they 
 are emulsions of oil of almonds or of sweet 
 oil ; of which the worst effect is to load 
 the stomach, and impair digestion, while 
 they mock the hopes of the patient, and 
 are quite inadequate to remove his com- 
 plaint. The venders of patent medicines 
 for cough, assume a bolder attitude, and 
 confidently promise to cure sixty or eighty 
 thousand coughs in a year, by one safe and 
 infallible medicine. Their medicines are 
 generally active enough; but, unfortunate- 
 ly, they ai'e active in a wrong direction. 
 They are opiates or other stimulants, 
 which may foi- a time give relief; but 
 which, if given in some coughs, would 
 increase the inflammation from which 
 they proceed, and add incalculably to the 
 dangers of the patient. Hence it is pro- 
 per to be always very cautious in the use 
 of cough nostrums, Avhether prescribed by 
 the kindness of friends, or forced upon 
 our notice by the interested importunity 
 of quacks. 
 
 COUP DE SOLEIL, stroke of the 
 sun; an affection induced in warm cli- 
 mates by the direct action of the sun's 
 rays. In this disorder, a person falls down 
 suddenly, as if apoplectic; and unless he 
 dies immediately, the attack is apt to ter- 
 minate in inflammation of the brain. Af- 
 ter the first attack has been recovered 
 from, we must turn oiu- attention to the 
 prevention of inflammation, by applying 
 cold to the head, by bleeding, both gene- 
 ral and topical, by purging, and the other 
 parts of the antiphlogistic regimen. At 
 first, when the poAvers of life seem to be 
 low and nearly extinguished, it may be 
 proper to use stimulants, though with 
 great caution. See Brain, Inflammation 
 of. 
 
 COURSES. See Monthly Dis- 
 charge of Females. 
 
 COW-ITCII, Dolichos pruriens. A 
 plant growing in the East and West In- 
 dies. Its fruit is a pod, covered on the 
 outside with reddish-brown hairs, which 
 easily adhere to the fingers and occasion 
 a most intolerable itching. These hairs 
 are formed into an electuary with ielly, 
 
 treacle, or honey, and are used to expel 
 worms, which they do mechanically ; the 
 intestines are protected from their action, 
 and when they reach the worms, princi- 
 pally the long round worm, they occasion 
 great irritation, and cause it to quit its 
 hold, when it is expelled by a purge given 
 shortly afterwards. It is not very often 
 employed now , against worms in this 
 country. 
 
 COW-POX. An eruption of a vesicu- 
 lar nature, which arises from the inser- 
 tion of a peculiar matter into the system, 
 either at a scratched or an abraded part. 
 As this matter is obtained from an erup- 
 tion on the teats and udders of cows in 
 England, and especially in Gloucester- 
 shire, the disease produced is called Cow- 
 Pox ; the matter is frequently denomi- 
 nated iiaccine matter, and the whole aflfair, 
 inoculation and its consequences, is called 
 Vaccination. 
 
 Symptoms and Treatment ©/"Cow-Pox. 
 Instead of a useless affectation of origina- 
 lity, it will be better at once to insert Mr. 
 Bryce's correct and valuable description 
 of the effects of the Cow-pox. 
 
 " About the third day after the inser- 
 tion of the vims of cow-pox, either by 
 puncture or by slight incision in the arm, 
 a small inflamed spot may be observed in 
 the part where the inoculation was per- 
 formed : Next day, this spot appears still 
 more florid, especially if the person be 
 warm ; and by passing the point of the 
 finger over it, a degree of hardness and 
 swelling in the part is readily perceived. 
 On the fifth day, a small pale vesicle oc- 
 cupies the spot where the inflammation 
 was, and the affection begins to assume 
 the characteristic appearance of cow-pox. 
 In place of inflammation, extending aroimd 
 the base of the vesicle, at this period, as 
 is common in small-pox and most other 
 pustular diseases, the whole has a milky 
 white appearance. The vesicle is now tur- 
 gid, but evidently depressed in the centre, 
 while the edges are considerably elevated. 
 For the next two days, the vesicle in- 
 creases in size, and retains the same cha- 
 racter ; so that by the seventh, it has ac- 
 
164^ 
 
 COW-POX. 
 
 quired very considerable magnitude, and 
 is of a circular form if the inoculation was 
 performed by a puncture, or of an oblong- 
 form if done by an incision ; but in both 
 cases the margin is regular and M'ell de- 
 fined, Mhile the centre, becoming still 
 more depressed, and a small crust form- 
 ing there, and the edges becoming more 
 turgid, give the whole a very particular 
 appearance and character, which, in my 
 opinion, may readily serve to distinguish 
 this affection from every other. 
 
 " The structure of this vesicle, as may 
 be perceived at this period, is singular, 
 and very different from the structure of 
 the pustule which occurs in sraall-pox. 
 In small-pox, the whole fluid of the pus- 
 tule is contained in one entire or undi- 
 vided cavity, and may be all readily eva- 
 cuated by one small puncture. In cow- 
 pox, however, it is very different; for here 
 the vesicle is greatly subdivided, or is com- 
 posed of many cells, the whole somewhat 
 resembling a honey-comb, with a general 
 covering from the cuticle. 
 
 " About the eighth day from the time 
 of inoculation, inflammation begins to ap- 
 pear around the base of the vesicle. This 
 increases for two, or perhaps three days 
 more; and when at the height, the in- 
 flamed part is in general quite circular, 
 and fi-om half an inch to two inches or 
 more in diameter. This inflamed circle, 
 or areola, acquires an erysipelatous bright- 
 ness ; and the whole, more especially the 
 part contiguous to the vesicle, feels very 
 hard and tense. At this period also, the 
 vesicle still retains the concave appear- 
 ance; the crust in the centre has consider- 
 ably increased in size, and begins to as- 
 sume a dark or brownish colour, while 
 the turgid edge assumes more of a shin- 
 ing appearance, as if the contained fluid 
 were passing into a purulent state. About 
 the eleventh day, the vesicle has attained 
 its greatest magnitude, and then the sur- 
 rounding inflammation and hardness be- 
 gin to abate ; and it is curious to observe, 
 when this takes place, that the redness 
 generally disappears first from the neigh- 
 bourhood of the vesicle, and thence gra- 
 
 dually towards the edge of the areola, of- 
 ten leaving at the last a complete but 
 slender florid ring or circle of inflamma- 
 tion, marking the circumference of the 
 faded areola, the inner part having chang- 
 ed to a dingy yellow. The fluid in the 
 vesicle, which was before very thin and 
 transparent, is now more viscid and slightly 
 turbid; and, after this period, the whole 
 is quickly converted into a smooth, shin- 
 ing, and somewhat transparent dry crust, 
 of a dark, brownish or red colour. This 
 crust, unless forcibly removed, will re- 
 main upon the part for one, or sometimes 
 two weeks, and then fall off, leaving the 
 parts underneath quite sound and entire. 
 
 " Such, then, is the general course of 
 the affection as it appears at the part in- 
 oculated ; and, in the greater number of 
 instances, especially in children infected 
 with this ailment, little more is to be re- 
 marked ; in some, however, and particu- 
 larly in adults, marks of a constitutional 
 affection are common. 
 
 " About the eighth day from the time 
 of inoculation, the glands in the axilla 
 become a little swelled, occasioning pain 
 and stiffness on moving the arm. Head- 
 ach, shiverings, a frequent pulse, and 
 other febrile symptoms take place ; and 
 these have been observed to continue 
 from a few hours to two or more days. 
 These symptoms, however, are in general 
 so slight and transient as to require no 
 aid from medicine." (IVIr. Bryce ou 
 Cow-Pox. J 
 
 About the twentieth day after the ino- 
 culation, the dry, contracted, and black 
 scab is detached, and leaves a permaneitt 
 circular scar about five lines in diameter ; 
 the surface beir^ marked with very mi- 
 nute pits or indentations, denoting the 
 number of cells of which the vesicle had 
 been composed. When the whole is over, 
 it may be allowable, though it is very 
 seldom necessary, to give the person a 
 little laxative medicine. 
 
 Effects of Cow-Pox. The affection 
 above described derives the highest value 
 and importance, from its operating such a 
 change ou the human constitution as ef- 
 
COW-POX. 
 
 165 
 
 fectiially and permanently to secure it 
 from the danger of small- pox ; and almost 
 universally to render it incapable even of 
 receiving- the contagion of that formidable 
 and loathsome disease. A fact so won- 
 derful, and a result so beneficial, deserves 
 to be established by the strongest evi- 
 dence; and in a learned and inquiring 
 age, a discovery of such vast importance 
 was not likely to be admitted without the 
 strictest investigation. More than thirty 
 years have now elapsed, since Dr. Jenner 
 of Cxloucester announced the discovery 
 that has conferred immortality on his 
 name, that cow-pox is an effectual pre- 
 ventive of small-pox ; and in these years, 
 observation and experiment on the most 
 extensive scale in every quarter of the 
 globe, have assured us, that with as few 
 Exceptions as belong to any research con- 
 nected with the phenomena of living be- 
 ings, our confidence may remain unshaken. 
 On a subject like this, in which mankind 
 of every rank and profession are interest- 
 ed, it is peculiarly the province of a profes- 
 sedly popular work to be full and explicit ; 
 and ^ve shall therefore, in the remainder 
 of Ihis article, give a historical account 
 of the progress and present state of vac- 
 cination ; we shall state the degree of 
 Confidence we are warranted to have in 
 it as a preventer of small-pox ; and assign 
 some reasons why it should be universally 
 adopted. 
 
 History^ Progress^ and Present State 
 o/ Vaccination. It had been long ob- 
 served in several of the dairies in Eng- 
 land, particularly in Gloucestershire, that 
 an eruption frequently appeared on the 
 udders and teats of the cows, which was 
 communicated to the hands of those who 
 milked them; and that those persons who 
 had been thus affected, and who never 
 had undergone small-pox, were after- 
 wards incapable of being infected with 
 that disease, either by inoculation or by 
 exposiu'e to the most virulent contagion. 
 The origin of this disease in the cow has 
 been traced to a thin acrid matter which 
 issues from the heel of the horse, when 
 affected with an inflammation and swell- 
 
 ing, called the grease ; and as the men- 
 servants who have the care of the horses 
 in the dairy farms generally assist in 
 milking the cows, they transfer the mat- 
 ter from the horse to them, and thus pro- 
 duce the cow-pox. The knowledge of a 
 Ikct so curious and important was long 
 confined to those among whom it was a 
 familiar occurrence, till Dr. Jenner ex- 
 amined the subject with care and atten- 
 tion ; and, with the candour and benevo- 
 lence of an enlightened mind, published 
 it for the benefit of mankind. After sa- 
 tisfying himself of the truth and correct- 
 ness of the fact, Dr. Jenner, in the year 
 1798, published an account of this most 
 remarkable affection ; and his description 
 of its causes and effects aroused the at- 
 tention of mankind, and the astonishment 
 of the medical world. It might be sup- 
 posed that those who were best qualified 
 to judge of the subject, would receive the 
 statement with doubt and hesitation. 
 That matter from a brute animal should 
 have the power of operating such a change 
 on the human constitution as to secure it 
 fi'om one of the most wide-spreading ma- 
 ladies ever known — that it should secure 
 youth and beauty from their most for- 
 midable assailant — that tender and an- 
 xious parents should have their families 
 protected from what had appeared for 
 centuries an inevitable and often fatal or- 
 deal through which they had to pass — 
 that the hopeless blindness and the scarr- 
 ed and pitted face, so frequent and la- 
 mentable, might be made a rare or never- 
 seen occurrence — all this seemed passing 
 strange, and too good to be true. Ex- 
 tensive and strict investigation was made; 
 and though many arguments, and some 
 facts were brought forward which seem- 
 ed adverse to the preventive powers of 
 cow-pox, yet its incalculable utility was 
 at last evinced ; and observation and ex- 
 perience furnished evidence enough to 
 satisfy the Baillies and Heberdens, the 
 Monros and Gregorys of Britain, as well 
 as the physicians of Europe, India, and 
 America. 
 When Dr. Jenner began lus».inquiry. 
 
]66 
 
 COW-POX. 
 
 he inoculated with the matter of small- 
 pox many persons who, tliirty or even 
 fifty years befol-e, had undergone the 
 cow-pox; and such persons completely 
 resisted the small-pox. These persons 
 had received the cow-pox without any 
 intention, merely by handling the infect- 
 ed animal ; but Dr. Jenner inserted by in- 
 oculation some of the vaccine matter in 
 another person, that he might more ac- 
 curately observe the progress of the af- 
 fection. It was remarkably slight, but 
 distinctly marked in all its stages ; and 
 having inoculated the person who had 
 undergone it, with small-pox matter, he 
 found that this affection, slight as it Avas, 
 had completely secured him from taking 
 small-pox. Here then was an important 
 discovery, that matter from the cow, in- 
 tentionally inserted into the body, gave a 
 slighter ailment than when received other- 
 wise, and yet had the same effect of com- 
 pletely preventing small-pox. But of 
 what advantage was it to be for man- 
 kind, that the cows of Gloucestershire 
 possessed a matter thus singularly power- 
 ful ? How were persons living at a dis- 
 stance to derive benefit from this great 
 discovery ? Dr. Jenner having inoculat- 
 ed several persons from a cow, took the 
 matter from the human vesicles thus pro- 
 duced, and inoculated others, and others 
 from them again ; thus making it pass in 
 succession through many individuals, and 
 all with the same good effects in prevent- 
 ing small-pox. In the many years that 
 have elapsed since these first experiments, 
 cow-pox matter has probably passed 
 through a succession of above a thou- 
 sand individuals, and preserved its proper- 
 ties undiminished. The period of discus- 
 sion and opposition at first was very short, 
 and the observations and experiments of 
 Jenner and his followers seemed so satis- 
 factory, that cow-pox inoculation was 
 everywhere practised, both by private 
 practitioners and in public establishments ; 
 and this with such success, that from 
 many populous districts all over the 
 world, small-pox was entirely banished ; 
 and many a medical man, for a great part 
 
 of his noviciate and early practice^ knew 
 only ^y reading and report that so horrid 
 and loathsome a disease had ever existed. 
 
 A discovery of so great and general 
 importance was not to be expected to 
 pursue its triumphant career without dis- 
 turbance. When we remember that dis- 
 coveries in natural philosophy, though 
 supported by arithmetic and geometry, 
 have been assailed and contradicted, we 
 cannot wonder that a subject which in- 
 terests persons of every degree and kind 
 of morals and understanding, %^'hich op- 
 poses the prejudices of mankind and the 
 pecuniary interests of the more unworthy 
 members of the medical profession, 
 threatening at once their pudding and 
 their praise, should be assaulted Avith ma- 
 lignant virulence. Instances Avere osten- 
 tatiously brought forward of persons who 
 had been A^accinated, and Avho had taken 
 small-pox in spite of the preventive ; 
 some doubted the utility of the practice 
 altogether, AA^hile others believed that 
 after a certain number of years, the pre- 
 ventive poAvers of coAA'-pox were totally 
 lost. 
 
 In the first eight or ten years after vac- 
 cination Avas introduced, there were many 
 reasons Avhy disappointments should hap- 
 pen. To make a slight scratch on an in- 
 fant's arm, and to insert a little matter, 
 Avithout having any subsequent disease to 
 watch, seemed so trifling and easy a bu- 
 siness, that multitudes of persons became 
 professed vaccinators. Clergymen, mid- 
 wives, parents, and benevolent indivi- 
 duals were ready to inoculate for coaa- 
 pox. But many of them never looked to 
 the vesicle afterwards to ascertain Avhe- 
 ther it had gone through its regular 
 stages ; many prevented the system from 
 being affected, by draAving aAvay the great- 
 er part of the Aaccine matter to inocu- 
 late others; and fcAV were aware that there 
 are certain states of the system and dis- 
 eases of the skin, which prevent the coav- 
 pox from having its usual and proper ef- 
 fect. When all this is taken into ac- 
 count, Ave need not wonder that many 
 Avho are said to have been vaccinated 
 
COW-POX. 
 
 167 
 
 should afterwards be found to have taken 
 sraall-pox ; the wonder rather is, that 
 such sanguine and careless conduct was 
 not followed with more calamitous re- 
 sults. Yet in spite of it all, it is an un- 
 doubted fact, that for a considerable num- 
 btr of years, sraall-pox was hardly ever 
 seen. Some cases of eruptions, however, 
 at length did appear, which candid and 
 unprejudiced physicians could not over- 
 look : persons who in their infancy had 
 been vaccinated to the complete satisfaction 
 of their medical attendant, now having 
 reached the age often, twelve, or fourteen, 
 were seized Avith eruptions very much re- 
 serablingf small-pox in the previous symp- 
 toms, the appearance of the pustules, and 
 the general fever. These eruptions were 
 believed to be chichen-poxya disease v»hich 
 requires considerable accuracy of atten- 
 tion to distinguish it from small-pox, 
 especially at its commencement, and 
 which by no means unfrequently attacks 
 persons who have gone through the regu- 
 lar small-pox. When this explanation 
 could not be adopted, from the complete 
 dissimilarity of the disease in question to 
 chicken-pox, those v^'ho still were unwill- 
 ing to cast away the advantages of vac- 
 cination, acknowledged that if it did not 
 absolutely and universally secure from 
 small-pox, it wrought such a change in 
 the constitution, that the person who 
 was seized with small-pox took the dis- 
 temper in a form greatly mitigated, and 
 nearly free from danger. It was stated 
 also, that it was not so true as it is ge- 
 nerally thought, that a person cannot 
 have small-pox twice ; that many in- 
 stances are on record of its occurring 
 more than once in the same individual ; 
 and that there was reason to think that 
 chicken-pox was not a disease arising from 
 a distinct and specific contagion, but mere- 
 ly a kind of small-pox, changed or modi- 
 fied by various circumstances, either in the 
 constitution of the person attacked, or in 
 the character of the epidemic. If small- 
 pox did not secure from a second attack 
 of small-pox or from chicken-pox, it was 
 possible that cow-pox might not do so ; 
 
 and it remained for medical men to watch 
 narrowly, and report faithfully, the degree 
 of security afforded by raccination. For 
 a considerable niunber of years after the 
 introduction of the new practice, the 
 small-pox had been always very mild, and 
 therefore the efficacy of vaccination had 
 not been very severely tried; but about 
 the year 1816, a small-pox epidemic, of 
 gi-eat extent and virulence, aroused the 
 attention of medical meh anew to a strict 
 inquiry into the preventive powers of 
 cow-pox. So many who were seized with 
 small-pox were found never to have been 
 vaccinated, that it afforded a melancholy 
 proof of the indolence or prejudices of the 
 inhabitants of that country to which man- 
 kind had been indebted for the great dis- 
 covery; but among the multitudes who 
 were affected with eruptive disease dur- 
 ing that wide-spreading epidemic, not a 
 few were found to have been regularly 
 and satisfactorily vaccinated, either by 
 private practitioners or public establish- 
 ments. Medical men now inquired with 
 much anxiety, and with laborious research, 
 into the history of former small-pox epi- 
 demics ; and the following particulars 
 were stated by high authority : Nume- 
 rous examples were pointed out, of per- 
 sons having twice been infected with 
 small-pox. For a long period, it was dis- 
 tinctly and familiarly known even by the 
 most ignorant, that there were different 
 kinds of small-pox, some occasioning a 
 very mild and safe disease, others occa- 
 sioning a disease accompanied by violent 
 fever, numerous pustules, a putrid ten- 
 dency, and death. It was equally well 
 known, that those differences depended 
 chiefly on the constitution of the person 
 affected, and not at all on the variolous 
 matter, whether received by atmospheric 
 contagion, or inserted by inoculation ; as 
 it was quite a common thing to see one 
 person infect the various members of the 
 same family with small-pox of very diffe- 
 rent degrees of malignity; and persons 
 having a very bad small-pox often com- 
 municated a very mild one to others, 
 while the reverse alsQ verv frequently 
 
168 
 
 COW-POX. 
 
 happened. In some years also, the great 
 majority of small-pox cases did well, while 
 in others a very^reat proportion of them 
 proved fatal. It was a very common oc- 
 currence to find persons with a disease 
 heginning very like small-pox, and having 
 an eruption which the most skilful ob- 
 servers could not distinguish from small- 
 pox, get well much sooner than what was 
 usual in that disease ; the pustules speed- 
 ily drying and blackening, or being filled 
 vvdth a watery fluid never suppurating, or 
 being dry or shrivelled and hard. As it 
 was very generally believed that no per- 
 son could take the small-pox tw ice, these 
 irregular eruptions were considered as 
 originating from a totally different conta- 
 gion, and received appropriate names, as 
 chicken-pox, swine-pox, horn-pox, &c. 
 These eruptions were found on persons 
 who had passed through the small-pox, 
 both natural and inoculated ; and persons 
 who had been seized with these eruptions 
 afterwards were found to be susceptible 
 of small-pox j and from these circum- 
 stances it began to be suspected, that all 
 those eruptions arose from one and the 
 same small-pox contagion ; that the pass- 
 ing through even the severest disease of 
 the small-pox kind did not absolutely and 
 universally secure the constitution from 
 passing through the same a second time, 
 or from having some other of the anoma- 
 lous eruptions ; but that any of tlie sub- 
 sequent attacks, whether small-pox, chick- 
 en-pox, swine-pox, or whatever form they 
 might assume, were, with hardly a single 
 exception, so mitigated and modified, as 
 to be almost entirely free from danger. 
 In the historical research and practical 
 observation by which those points have 
 been ascertained, no inquirer is more dis- 
 tinguished than Professor Thomson of 
 Edinburgh, and to no one are we more 
 indebted for the zeal and industry witlia 
 which he investigated a subject so deeply 
 interesting to mankind. Assisted by able 
 and candid coadjutors, he has collected 
 such a mass of evidence on the subject of 
 small-pox, in all its forms and varieties, 
 as must for ever set the question at rest 
 
 as to the degree of security afforded by 
 one attack of the disease against subse- 
 quent or similar ones j and by ascertain- 
 ing the powers of cow-pox, to give not 
 merely the same, bat a far greater degree 
 of security, he has done to humanity the 
 most essential service, by fixing on an im- 
 movable basis the merits of vaccination. 
 
 Besides the immense mass of histoi'ical 
 evidence which Dr. Thomson has brought 
 forward, he states the result of his o^n 
 experience in the course of the epidemic, 
 which he styles varioloid, th^t is, having 
 the nature or resemblance of small-pox, 
 which began in Edinburgh in 1818. Eight 
 hundred and thirty-six cases came under 
 his observation ; of these, two hundred 
 and eighty-one occurred in individuals 
 who had neither had small-pox nor cow- 
 pox, and of these fully more than one in 
 four died ; seventy-one had previously 
 passed through small-pox, and of these 
 two died ; four hundred and eighty-four 
 had undergone the process of vaccination, 
 and of this number only one died. Here 
 was the most triumphant evidence of the 
 beneficial effects of cow-pox in protecting 
 the human constitution from the dangers 
 of small-pox, and the great advantage 
 which would certainly arise were the 
 practice of vaccination universally adopt- 
 ed. 
 
 Extent of the security afforded by Vac- 
 cination. From the ample experience 
 and observation of Dr. Thomson and 
 others, it is now considered as established, 
 that a person may have small-pox twice ; 
 and that a first attack, though it lessens, 
 does not altogether destroy the suscepti- 
 bility of the same individual to a second 
 attack. That a second attack may ap- 
 pear, either in a regular form of small- 
 pox, or in some of its modifications, 
 swine- pox, hives, &c. ; That small-pox, 
 and at least some other eruptive diseases, 
 are produced by the same specific conta- 
 gion, and that the diseases produced by it 
 are modified by various causes, as pecu- 
 liarity of constitution, the severity of the 
 epidemic, or by the patient having under- 
 gone some previous eruptive disease, which 
 
COW-POX. 
 
 1«9 
 
 had power to protect the system from the 
 usual severity of small-pox : That cow- 
 pox possesses this protecting- power in a 
 remarkahle deg-ree, as the hody which has 
 been subjected to it will not receive small- 
 pox by inoculation, though it will some- 
 times receive it when the atmospheric 
 contagion is very active : That when 
 small-pox does occur in the vaccinated, it 
 is generally mild and free from danger ; 
 that small-pox does not protect the con- 
 stitution from small-pox at all so generally 
 or effectually as cow-pox does, siuce the 
 cases of a second attack were found to be 
 more numerous and more severe than 
 those cases which occurred after cow- 
 pox. 
 
 Reasons against inoculating with Small- 
 pox. So slow is the progress of reason and 
 truth, so difficult to conquer prejudices or 
 to alter habits, that many people would 
 rather have their children pass through 
 small-pox than trust to vaccination ; and 
 medical men are yet to be found who 
 will comply with their wishes in this re- 
 spect. Yet there are many reasons 
 against this practice. Though the small- 
 pox is in general rendered milder by ino- 
 culation, yet it is by no means invariably 
 so; many to whom it was imparted in 
 this way have been known to have a se- 
 vere and fatal disease ; and in others who 
 did recover, many marks were left, and 
 the lurking maladies of the constitution, 
 as scrofula, &c. were called into opera- 
 tion, as certainly as after natural small- 
 pox. Inoculated small-pox does not in- 
 fallibly secure the individual from a se- 
 cond attack, either in the regular form or 
 in what is called horn-pox, swine-pox, 
 &c. Of those carefully observed in the 
 epidemic at Edinburgh in 1818, one- 
 twelfth part who had previously passed 
 through small-pox took it again, and two 
 out of seventy-one died. Even although 
 a mild small-pox may be communicated 
 by inoculation to one person, he may in- 
 fect his neighbours with small-pox of the 
 most malignant kind; these may infect 
 others, and thus the security of one may 
 be dearly bought to the community by 
 
 the sufferings and death of thousands. 
 While small-pox inoculation is continued, 
 we can never hope to render general the 
 safe and easy practice of vaccination, 
 which insures a mild and modified dis- 
 ease to any who may be infected' with 
 small-pox contagion. The enlightened 
 and honourable part of the medical pro- 
 fession have, with hardly an exception, 
 refused to inoculate with small-pox mat- 
 ter ; and it is only those who take advan- 
 tage of the ignorance and prejudices of 
 the vulgar, who are active in keeping up 
 the pernicious practice. The Board of 
 the National Vaccine Establishment, in 
 their report for the year 1820, say, " We 
 find that the multitude, in many places, 
 have been so infatuated as to accept the 
 proffered services even of itinerant inocu- 
 lators. Hence a perpetual source of con- 
 tagion is supplied and kept up." Nor is 
 the evil yet likely to be at an end ; for in 
 the London newspapers, at the com- 
 mencement of September 1827, it is 
 stated, that the small-pox is kept up by 
 the more worthless class of apothecaries, 
 who inoculate with that disease for five 
 shillings a-head. Under some of the ar- 
 bitrary governments of the Continent, 
 where po^ver can be exerted for good as 
 well as ill, the practice of vaccination is 
 enforced by legal enactments, and inocu- 
 lation for small-pox is prohibited under 
 severe penalties ; the consequence is said 
 to be, that in some of their states, small- 
 pox has ceased to exist. The spirit of 
 English liberty will hardly tolerate legis- 
 lating on such a subject, though it is not 
 easy to see why it should not be brought 
 under police regulations as well as the 
 plague ; but, till this be done, we can only 
 hope that the superior advantages of vac- 
 cination will commend themselves to the 
 notice and support of the well-informed 
 classes of society, and by their influence 
 be extended to its lowest ranks, and in 
 this way alone will small-pox be extir- 
 pated. 
 
 Reasons for Vaccination. Wore vac- 
 cination some formidable and dangerous 
 operation, attended with certain present 
 
170 
 
 COW-POX. 
 
 suffering-, and communicating only a dis- 
 tant and doubtful advantage, one might 
 feel reluctant to recommend it, and nii^rht 
 consider much argument and persuasion 
 necessary. But when the whole affair 
 consists in two slight scratches, followed 
 by a vesicle or two, which must be very 
 much mismanaged indeed to give the 
 child a moment's uneasiness, and which 
 is all over in fifteen days, we are asharil- 
 ed to waste many words in advising pa- 
 rents to subject their children to so easy 
 a process. A common bleeding, a purge 
 or a blister, which many people submit to 
 in order to preserve health, is far more 
 severe to the constitution than the whole 
 process of cow-pox. 
 
 This simple affection, from vaccination, 
 (for it cannot be called a disease,) has 
 been proved by the experience of thirty 
 years to secure the constitvitiou from 
 small-pox M'ith far greater certainty than 
 small-pox secures from a second attack of 
 that epidemic ; and instead of a crop of 
 fiery pustules and suppurating boils over 
 the whole body, there is no eruption ex- 
 cept at the spot where punctures have 
 been made. This is of itself a most 
 powerful reason for preferring vaccina- 
 tion. Small-pox, when given by inocu- 
 lation, in many cases filled the body with 
 scars, and left the face pitted and dis- 
 figured; and it was observed, that of 
 those who applied to public charities for 
 blindness, two-thirds had lost their sight 
 by small-pox. From all such calamitous 
 circumstances cow-pox is entirely free. 
 In the crowds who frequent public places, 
 or are seen on the streets of great towns, 
 how few who have grown to youth and 
 manhood within the last thirty years, pre- 
 sent the melancholy wrecks of beauty which 
 wpre formerly so often seen. Vaccination 
 then is recommended by the mildness of 
 the practice, by the security it affords 
 against dangerous small-pox, by the few- 
 ness of its vesicles, by its being attended 
 with no risk to others, and by its pre- 
 serving unimpaired the beauty of the 
 countenance. The religious scruples 
 against inoculating with small-pox, M-hiuh 
 
 were entitled io respect, have no founda- 
 tion here. Some might conscientiously 
 consider it as a tempting of Providence, 
 to inflict a severe and dangerous disease 
 wliich it was possible might be escaped ; 
 and a good man would be very unwilling 
 to purchase the possible security of his 
 own child, at the risk of infecting a whole 
 neighbourhood; but all such fears for 
 vaccination are groundless; the patient 
 himself cannot be called ill, his friends 
 may approach him with perfect safety, 
 and he communicates no infection to the 
 atmosphere around him. 
 
 Proofs that Vaccination has been pro- 
 perly performed. It has been said in a 
 thousand instances, that such and such a 
 person has had small-pox after having 
 been inoculated^ meaning by this, inocu- 
 lated for cow-pox. But it does not fol- 
 low, that because a person has been ino- 
 culated, he can be considered as vaccinatedy 
 or endowed with that security against 
 small-pox which vaccination affords. If 
 the puncture at which matter was insert- 
 ed, heals without the formation of a vesi- 
 cle, either from there being too little mat- 
 ter applied, or from its being washed off 
 with the blood, or rubbed off by the 
 clothes, the most ignorant cannot think 
 that in such a case, cow-pox has affected 
 the constitution. Some have inoculated 
 Avith common purulent matter, or with 
 cow-pox matter when the vesicle was be- 
 ginning to turn ; or they have broken all 
 the vesicles too soon, and taken away the 
 matter which should hav6 affected the 
 constitution. Vaccination has been found 
 to fail V; hen there is extensive chronic 
 disease of the skin present. Now, to know 
 whether vaccination is perfect, besides its 
 going through the regular stages describ- 
 ed at page 163, and leaving a distinct and 
 characteristic mark, the following test has 
 been proposed by the late Mr. Bryce of 
 Edinburgh, and very generally adopted as 
 satisfactory. When the vaccine inocula- 
 tion has been performed, and the vesicle 
 is going on properly, a second inoculation 
 is performed on the other arm, in the 
 course of the fifth day cf the process ; and 
 
COW-POX. 
 
 171 
 
 it is found, that when the system is pro- 
 perly affected, the second puncture is co- 
 vered with a vesicle, which, though small- 
 er, g-oes through its stages, and is sur- 
 rounded with an inflamed circle, so as to 
 finish its course at the same time as the 
 first. 
 
 Does the matter of Cow-Pox lose its 
 virtue by being transmitted through a suc- 
 cession of individuals? The length of 
 time that has elapsed since vaccination 
 began, enables us to give a satisfactory 
 answer to this question. At the public 
 establishments, the matter has been trans- 
 mitted from one child to another, through 
 upwards of a thousand individuals; and it 
 has been found that matter taken from 
 the first origin, the grease of the horse, 
 produces an affection in no degree differ- 
 ing from that which is produced by the 
 matter taken from the last vesicle of the 
 long succession. 
 
 The security afforded by Vaccination' 
 is not at all diminished by the lapse of time. 
 Dr. Jenner found, that persons in whom 
 vaccination had been performed thirty, 
 and even fifty yeai's before, resisted com- 
 pletely the infection of the small-pox; 
 and in the extensive epidemic of 1818 and 
 1819, Dr. Thomson found, that the mild- 
 ness of small-pox which occurred after 
 vaccination, was not at all influenced by 
 the more or less remote period at which 
 vaccination had been performed. Those 
 persons, therefore, were mistaken, who 
 asserted that the security against small- 
 pox went on decreasing in proportion to 
 the length of time that elapsed. 
 
 Cow-Pox does not occasion other dis- 
 eases. Another assertion equally ill- 
 founded has been made against vaccina- 
 tion, that other diseases, and especially 
 skin-diseases, particularly measles, have 
 been more frequent and severe, since the 
 introduction of vaccination. Let it be 
 remembered, that all that the most zea- 
 lous advocates for vaccination claim, is 
 its power of preventing almost entirely, 
 and certainly of greatly mitigating, the 
 severity of small-pox. If therefore, a 
 hundred children are saved from dying 
 
 by 8mall-i)0X in the first years of life» 
 there are a hundred more subjects for the 
 other diseases of childhood over which 
 vaccination has no controul; a hun- 
 dred more to be affected by hooping- 
 cough, by scarlet fever, by measles, or 
 by croup. In such a case, other dis- 
 eases will appear on the bills of mor- 
 tality to be more frequent, but this is 
 not the fault of vaccination. Neither are 
 the diseases of children at all more fatal 
 of late years than before cow-pox was 
 heard of. The universal observation of 
 the most experienced practitioners attests 
 the contrary. 
 
 Conclusion. It must appear e\'ident, 
 that in the whole history of the vaccine 
 inoculation, the medical profession have 
 conducted themselves wdth the liberality 
 and candour for which they are so ho- 
 nourably distinguished. As the small- 
 pox generally attacked individuals in 
 the interesting and helpless period of 
 childhood, when parents would spare no 
 cost within their power to bring them 
 easily and safely through that loathsome 
 disease, the conducting of this branch of 
 practice was a certain and lucrative source 
 of revenue to medical men ; yet, when 
 they believed a sure preventive had been 
 found, they did not with cruelty and self- 
 ishness conceal it, but spread it through 
 the world for the benefit of mankind. 
 When the experience of revolving years 
 convinced them that their first hopes 
 were too sanguine, and that they had ad- 
 mitted too unreservedly the efficacy of 
 cow-pox as a complete preventive of 
 small-pox, they were not ashamed to acr 
 knowledge their error, and to rate the va- 
 lue of cow-pox at a lower, but still a most 
 important standard. 
 
 CRAB, Cancer Pagurus. A species of 
 shell-fish frequently used at table. They 
 are nutritive, but to some stomachs very 
 indigestible. Like other shell-fish, they are 
 sometimes known to occasion pain in tlic 
 throat and stomach, with eruptions on 
 the skin. As found in the market, they 
 are generally under-boiled, \vith a view 
 to their keeping, and this renders them 
 
172 
 
 CR A 
 
 CRE 
 
 more indigestible. The same remarks 
 are applicable to lobsters. 
 
 CRAB'S YAWS, a name given in the 
 West Indies to certain ulcers in the sole 
 of the foot, which have a hard, callous 
 edg-e. See Yaws. 
 
 CRAMP. A painful and involuntary 
 contraction of muscles, or muscular fibres. 
 No part of the body which is supplied 
 with muscles or muscular fibres is ex- 
 empt from this affection, and in certain 
 situations, it is accompanied with great 
 danger. It may arise from keeping the 
 limb in an aAvkward or constrained posi- 
 tion, or from turning hastily or moving 
 any part rashly ; but it also occurs where 
 there is no apparent reason for it ; and it 
 occurs in parts distant from those where a 
 strong action is going on, as in the case 
 of women in labour. Cramp not unfre- 
 quently seizes the muscles of the leg ; the 
 remedy is to be found in any thing that 
 makes a sudden and strong impression on 
 the nerves of the part or neighbourhood, 
 as by putting the foot on a cold stone, or 
 on the floor, or applying a cold cloth to the 
 foot or leg. As already hinted, it is a 
 very troublesome adjunct to the other pains 
 and uncomfortable feelings during labour, 
 and requires to be treated by opiates, 
 friction, and the application of cold. 
 When cramp occurs in the stomach, it is 
 to be regarded as an affection accompa- 
 nied with very great danger. It is to be 
 combated by strong stimulants and anti- 
 spasmodics ; opium in full doses, a drachm 
 of ether in water, or the volatile tincture of 
 valerian, or ammonia, or assafetida ; and 
 in the absence of drugs, by draughts of 
 warm water, with hot fomentations ap- 
 plied externally. 
 
 Though the affections we have men- 
 tioned above, are those that most com- 
 monly go by the name of cramp, there 
 are others which are really so, but are 
 more frequently treated of under other 
 names ; thus locked jaw is a cramp, and 
 the convulsive motions in epilepsy and 
 hysteria are of the nature of cramp j and 
 griping of the bowels are also cramps, but 
 the morbid actions above described are 
 
 those which are popularly known by that 
 name. 
 
 CRADLES. Some physicians think 
 it is very doubtful, whether the practice 
 of allowing infants to sleep in cradles, 
 be at all necessary or proper. They sup- 
 pose that rocking favours sleep, merely 
 by inducing a certain degree of giddiness 
 and determination to the head. Nothing 
 certainly can be more absurd or danger- 
 ous than the violent and noisy rocking to 
 which children are often subjected ; and 
 there cannot be the smallest hesitation 
 about condemning this. Yet the cradle, 
 in every nation, and from the remotest 
 antiquity, has been so universally em- 
 ployed, and such countless multitudes of 
 children have been rocked without any 
 injury, that experience does not furnish a 
 sufficient reason for prohibiting a careful 
 use of the cradle wherever it may be 
 thought convenient. All violent rocking 
 on hard and unequal floors should be 
 avoided, and cradles made like the cot 
 used on shipboard are the best that can 
 be employed. 
 
 CREAM. That portion of milk which 
 rises to its surface, when it has stood for 
 some hours ; which may be skimmed off 
 and separated from it. It has many of 
 the properties of oil; when allowed to 
 stand for some days, it becomes thicker, 
 the flavour of cream is lost, and is suc< 
 ceeded by that of cheese. When cream 
 is agitated by churning, it separates into 
 butter and a fluid like skimmed milk. 
 With some stomachs, cream disagrees, as 
 a small quantity of oil or butter would 
 do; but when taken in moderate quantity 
 as an accompaniment to tea, coffee, 
 fruits, &c. it in general gives no inconve- 
 nience. 
 
 CREAM OF TARTAR. Supertar- 
 trate of potash, a most useful medicine, ob- 
 tained from the matter called tartar, in- 
 crusted on the bottom and sides of casks 
 in which wine has been kept. This incrus- 
 tation is purified by dissolving it in boil- 
 ing water, and filtering it while hot; 
 \A hen cooling, the salt is deposited in ir- 
 regular crystals, and is called crystals of 
 
CUE 
 
 CRO 
 
 178 
 
 tartar, or ereara of tartar. This substance 
 is a very effectual diuretic. When given 
 as such in dropsy, it may be taken in 
 doses of a drachm twice a-day, dissolved 
 in a large quantity of water. It is also 
 used as a piu'gative ; in doses of half an 
 ounce made up into an electuary with an 
 equal proportion of sulphur, it is an ex- 
 cellent laxative in case of piles ; and add- 
 ed to jalap in the proportion of two parts 
 of cream of tartar to one of jalap, it fur- 
 uishes one of the best pur^tive powders 
 we possess. It operates mildly and speed- 
 ily, and besides its purgative effect, it is 
 also diuretic. The dose of the compound 
 powder of jalap is from forty to sixty 
 grains, and it may be given in water, tea, 
 beer, or any fluid vehicle, taking care that 
 the cream of tartar be suspended in it, 
 stirring it well immediately before taking 
 it. Cream of tartar is not very soluble in 
 water. The drink called Imperial^ is a 
 solution of cream of tartar flavoured with 
 lemon peel, and is very useful in feverish 
 disorders and other cases where a refri- 
 gerant drink is wanted. It is improper to 
 use it as an ordinary beverage, as it has a 
 tendency to retard digestion. 
 
 CRESSES, Sisymbrium Nasturtium. 
 A plant growing plentifully in brooks and 
 stagnant waters. The leaves have a pun- 
 gent taste, and a penetrating smeU like 
 that of mustard seed. They are an ex- 
 cellent antiscorbutic ; and sailors after a 
 long voyage, when they fall in with them, 
 are much benefited by their use. They 
 may be eaten alone, or as part of a ^lad. 
 
 CRETINISM. That state of imbeci- 
 lity of mind and deformity of body which 
 occurs in some districts of the globe, 
 chiefly in mountainous regions and their 
 coiTesponding vallies. Cretins have a de- 
 formed head, a diminutive stature, sickly 
 complexion, and a vacant countenance. 
 The skin is wrinkled, the muscles loose 
 and flabby, and there is frequently the 
 swelled neck called bronchocele. The fa- 
 culties of the mind are as defective as the 
 bofly is deformed, and are found in all de- 
 grees of imperfection, from stupidity to 
 absolute idiotism. Cretinism is difficult 
 
 to prevent or cure. When an infant is 
 born who appears likely to become the 
 subject of this deplorable malady, it should 
 be removed to a distant quarter and to 
 purer air. The cold bath should be dili- 
 gently employed ; and all means used for 
 strengthening the constitution and giving 
 the proper education to the mind, should 
 be unremittingly employed. The inter- 
 marriages of Cretins should by all possi- 
 ble means be prevented. 
 
 CRISIS. The point of time when a 
 disease comes to a height, and either takes 
 a turn for the better or destroys the pa- 
 tient. In some diseases, this crisis is only 
 to be remarked from the general consti- 
 tutional symptoms ; in others from the ap- 
 pearance of some eruption; in others from 
 the formation of an abscess. Certain days, 
 when it was supposed, and probably with 
 justice, that some crisis or change takes 
 place on the disease, were called critical 
 days. See the following article. 
 
 CRITICAL DAYS. Great attention 
 was paid to certain days, in the progress 
 of acute diseases, by the ancients ; and by 
 the learned and well-informed physicians 
 among the moderns. Dr. Cullen in par- 
 ticular, considers the observations of the 
 ancients as correct ; and in fevers, points 
 out the seventh, ninth, eleventh, four- 
 teenth, seventeenth, and twentieth days 
 as critical. From the writings of physi- 
 cians, the words crisis and critical have 
 got into common language, with the mean- 
 ing a little altered ; thus we talk of a bu- 
 siness being brought to a crisis, or a state 
 in which some material change must take 
 place; and we say, a person has been 
 brought to a critical situation, that is, a 
 situation of difficulty and danger. 
 
 CROCUS SATIVUS. The name of 
 a flower from which saffron is obtained. 
 
 CROCUS or METALS. The name 
 given in old chemical and pharmaceutical 
 books to the oxides of some metals, as of 
 antimon}' and iron. 
 
 CROTON. The name of a genus of 
 plants, of which the most used in medi- 
 cine are the Croton Cascarilla and the 
 Croton Tiglium. See Cascarilla. 
 
174 
 
 CROUP. 
 
 CROTONOIL. The oil expressed 
 from the seeds of the Croton Tiglinm, 
 which has lately been re-introduced into 
 medicine. It is a very powerful cathar- 
 tic ; and is given in cases where a full 
 and rapid evacuation is required, as in 
 cases of long^ and obstinate costiveness, 
 which have resisted other means of relief. 
 It is used in apoplexy and disorders of 
 the head, and in convulsive diseases, low 
 spirits, and madness. The dose is a single 
 drop ; or sometimes, though very rarely, 
 two drops, either on lump sugar, or dif- 
 fused through mucilage ; or it may be 
 made into a pill with crumb of bread. 
 This dose empties the bowels completely, 
 and excites a copious watery secretion 
 from them. Caution must be had in the 
 exhibition of so active a medicine ; and 
 it is to be remembered that different sam- 
 ples of the oil differ in their activity. 
 
 CROTCHET. An instrument used 
 for the extraction of the child in cases of 
 difficult labour. 
 
 CROUP. A disease of great frequen- 
 cy and danger, most commonly attacking 
 children and young persons, and requir- 
 ing the most prompt and decided assis- 
 tance. The symptoms of croup are the 
 following: After exposure to cold or 
 wet, the patient is seized with shivering, 
 restlessness, and a difficulty of breathing, 
 which goes on increasing, and is accom- 
 panied with cough, of a peculiar barking 
 hollow sound, as if air were transmitted, 
 in a broken and convulsive manner, 
 through a brazen tube. Along with the 
 increasing cough and difficulty of breath- 
 ing, febrile symptoms of great severity 
 appear ; the face is flushed, the pulse is 
 strong, the thirst urgent, the anxiety is 
 great, and there is a throwing back of 
 the head to escape suffocation and to fa- 
 vour respiration ; which, besides being 
 much interrupted by the painful fits of 
 coughing, is performed with a hissing 
 sound, as if some soft substance were in 
 part obstructing the windpipe. There 
 is present also a degree of swelling and 
 sore throat, and the pain of this in swal- 
 lowing adds to the sufi'erings of the pa- 
 
 tient. As the disease advances, the face 
 becomes livid and swelled ; there is a con- 
 tinual desire to change place; the respi- 
 ration becomes more shrill, and is per- 
 formed with greater difficulty and at 
 longer intervals, till it at last ceases alto- 
 gether. The cough is commonly dry, but 
 sometimes thick purulent-looking matter 
 is spit up, or pieces of a substance resem- 
 bling a membrane. Croup consists in the 
 inflammation of the mucous membrane of 
 the trachea, by which there is a secretion 
 of a very tenacious matter, and this occa- 
 sions a contraction of the passage for the 
 air. A degree of spasm also not unfre- 
 quently attends ; and this spasm is an ac- 
 tion of the muscular fibres that shut the 
 aperture at the top of the wind-pipe, and 
 a similar contraction is produced as by 
 inflammation. It is very often altoge- 
 ther a spasmodic disease, without inflam- 
 mation ; and this suggests a very important 
 piece of practice, giving an emetic at the 
 commencement of croup of whatever kind. 
 This disease is sometimes alarmingly 
 short, running its course in twenty-four 
 hours ; sometimes it goes on for three or 
 five days. Its favourable cessation is 
 marked by the feverish symptoms abat- 
 ing, the perspiration being moderate, and 
 the cough less frequent, noisy, and dis- 
 tressing. 
 
 Causes, The croup principally attacks 
 young children ; and those who have it 
 once are more liable than others to a se- 
 cond attack. Some families seem more 
 subject to croup than others ; and certain 
 districts of country, sometimes near the 
 sea, sometimes near marshy ground, are 
 more peculiarly apt to be infested with it. 
 The cold easterly winds, accompanied 
 with fog, which occur so frequently on 
 the east coast of Scotland, are very com- 
 monly followed by croup prevailing al- 
 most epidemically. The disease is not 
 contagious, but still it is improper to over- 
 pov/er the sick with superfluous care or 
 too numerous attendants. 
 
 Treatment. When a child, after being 
 unwell for a day or two, and having been 
 previously exposed to cold, is suddenly 
 
C II o u p. 
 
 175 
 
 seized with a hoarse croupy cough, and 
 with difficulty of breathing, the first thing 
 to be given is a pretty active emetic ; and 
 every family where there are young chil- 
 dren should keep by them a safe emetic, 
 viz. from five to ten or twelve grains of 
 ipecacuan. The operation of an emetic 
 is sometimes so favourable, that the breath- 
 ing is relieved, and the patient gets rid of 
 the complaint; the stomach throws off 
 some food which had disagreed with it, 
 and M'hich, perhaps, gave occasion to the 
 spasmodic attack, or at least aggravated it. 
 If the relief is less complete, our next 
 step is to put the child into the warm 
 bath, to apply a number of leeches round 
 the upper part of the windpipe, to give 
 purgative medicines ; and, if the child be 
 full and strong, it may be proper to take 
 a quantity of blood from the arm. Anti- 
 monial medicines are to be given, both 
 with a view to promote perspiration, and 
 to diminish the inflammatory action going 
 on in the system ; the wine of antimony 
 is scarcely admissible, and it is safer to 
 give a watery solution of tartar emetic, 
 in the proportion of two grains of it to 
 four ounces of water, and of this solution 
 a tea-spoonful is to be given e\ery two 
 hours. A blister is to be put on round 
 the fore part of the neck, and the anti- 
 phlogistic plan is to be carefully pursued. 
 In this disease, great reliance was some 
 time ago placed on giving veiy large quan- 
 tities of calomel, which form of mercury 
 was supposed almost to be a specific in 
 croup. Four or five grains were given 
 every hour; large quantities of green 
 stools were brought away; and some 
 thought the separation of the living mem- 
 brane of the trachea was aifected by it; 
 There is no doubt, that some very severe 
 cases of croup get well under this treat- 
 ment; but we trust rather to emetics, 
 bleeding, blistering, and complete evacua- 
 tion of the bowels. 
 
 Sore Throat, endiiig in Croup. There 
 is a peculiar and generally fatal disease in 
 the throat and fauces of children, which 
 frequently ends with the worst symptoms 
 of croup. A clear and accurate descrip- 
 
 tion of it is given by Professor James Ha- 
 milton of Edinburgh. 
 
 Symptoms. " There is a very danger- 
 ous, but fortunately rare, modification of 
 sore throat, which begins in the form of 
 a whitish spot, like that of thrush (though 
 more definite in its shape, being round or 
 oval) on one or both tonsils, unaccompa- 
 nied at first by fever, and attended with 
 only a trifling degree of uneasiness in 
 swallowing. By and by, this spot en- 
 larges, its edges become of a florid colour, 
 fever steals on, and the act of swallowing 
 grows painful. A slough gradually forms, 
 with evident ulceration at its edges ; the 
 fever increases, and headach and restless- 
 ness supervene. The partial separation 
 of the slough, together with the rosy co- 
 lour of the edges of the ulcer, with the 
 moderate degi-ee of fever for some days, 
 promise a favourable issue. But very un- 
 expectedly, slowness of breathing, with- 
 out either difficulty or wheezing, takes 
 place, with excessive and sudden- sinking 
 of the living powers, and it generally hap- 
 pens, that within a day from this change, 
 the fatal event takes place. The breath- 
 ing at first falls to eighteen respirations 
 in the minute, then to sixteen, to twelve, 
 and finally to ten or eight. Sometimes, 
 with the sloughing, the tonsil s\vells, and 
 in some cases both tonsils are affected. 
 Two other symptoms occasionally attend 
 the disease. The one is a most offensive 
 foetor of the breath, and the other is the 
 sudden occurrence of croup. The croup 
 has occurred before the sixth day, and 
 the foetor of the breath from the sixth to 
 the ninth day after the disease is distinct- 
 ly marked." The croup is the natural 
 consequence of the spreading of the in- 
 flammation ; and the remarkable affection 
 of the breathing is considered by Dr. Ha- 
 milton as the consequence of a palsy of 
 the nerves of respiration, by the matter 
 secreted by the ulcers operating upon 
 those nerves as a poison. 
 
 Treatment. This is a very dangerous 
 and unmanageable affection. The ulce- 
 ration in the throat goes on in spite of all 
 tlie varieties of gargles we can employ 
 
176 
 
 CRY 
 
 CUM 
 
 Leeches, purgatives, and blisters have no 
 effect in stopping- the progress of the dis- 
 ease. Indeed blisters are very apt to be- 
 come gangrenous. When the inflamma- 
 tion has proceeded to the windpipe, and 
 brought on the symptoms of croup, three 
 or four gi-ains of calomel have been given 
 every hour, and in some cases this treat- 
 ment has been successful. Dr. Hamilton 
 gave the acetate of lead in a case which 
 terminated favourably, and which he has 
 recorded in the Edinburgh Journal of 
 Medical Science for October 1826. The 
 substance was administered in the form of 
 solution, eight grains being dissolved m 
 eight ounces of rose Avater, to which forty 
 drops of laudanum were added. Half 
 an ounce of this was given every three 
 hours when awake. No inconvenience 
 followed from the use of the acetate of 
 lead; but by referring to the article 
 Lead, it will be seen how cautiously we 
 should administer the preparations of this 
 dangerous metal. 
 
 CRUCIAL. In the form of a cross, 
 or decussating, a term applied to certain 
 ligaments in the knee, and to incisions 
 crossing each other. 
 
 CRUCIBLE. A chemical vessel made 
 of materials capable of bearing a strong 
 heat. 
 
 CRUDITY. Any thing ill digested. 
 
 CRURAL. Pertaining to the thigh. 
 The arch formed between the haunch and 
 share bones, is called the crural arch. A 
 rupture at that place is called crural her- 
 nia; and the large nerves which pass 
 through to supply the lower extremity, 
 are called the crural nerves. 
 
 CRUSTA LACTEA. See Scalled 
 Head and Milk Blotches. 
 
 CRYSTALLINE LENS. The name 
 of one of the humours of the eye. It is 
 situated just behind the aqueous humour, 
 and its use is to refract the rays of light, 
 and to contribute to form the image of 
 objects on the retina. The thickening of 
 this lens, or of its capsule, forms the dis- 
 ease called cataract. See Cataract. 
 
 CRYSTALLIZATION. The tenden- 
 cy of bodies when in a state of solution 
 
 or fusion, to assume certain regular and 
 definite forms when they become solid, 
 either by a reduction of temperature or a 
 diminishing of the dissolving liquor by 
 evaporation. The crystals of each salt 
 have a different specific form ; and this 
 form is one of the particulars of a com- 
 plete definition of a salt. Stony bodies 
 ^'hich have been in the melted state, also 
 assume regular figures when cooled ; but 
 the term crystallization is most common- 
 ly applied in the case of the neutral salts. 
 
 CUBEBS, Java Pepper, Piper Cubeba, 
 has lately been restored to the Materia 
 Medica, principally as a cure for gonor- 
 rhoea. The berries have the appearance of 
 common pepper; but each berry has a 
 sliort stalk attached to it. The best are 
 those which are large, heavy, and fra- 
 grant. Their flavour is aromatic and bit- 
 ter. The form for administering them is 
 in powder, in doses of one or two drachms 
 three or four times a-day in a wine-glass- 
 ful of water. The tincture also may be 
 employed. Cubebs are most advanta- 
 geously giveft in the early and acute form 
 of the disease; and they moderate the 
 pain, and lessen the discharge M'ith con- 
 siderable certainty. The urine is increas- 
 ed, becomes deep-coloured, and acquires 
 an aromatic odour. Dr. Paris suggests a 
 caution necessary during the use of cu- 
 bebs, viz. to keep the bowels open ; for 
 where the hardened stools are allowed to 
 accumulate, the spice insinuates itself into 
 the mass, and produces excoriations at the 
 lower part of the bowels. 
 
 CUCUMBER, Cucumis sativus. A 
 plant, the fruit of which is eaten by way 
 of salad or dessert. It is cooling and ape- 
 rient, but apt to disagree with the sto- 
 mach when the digestive organs are not 
 in a healthy state. It should be eaten 
 with pepper and oil. 
 
 CUCUMBER, WILD. .S-ee Elaterilm. 
 
 CULINARY, belonging to the kitchen, 
 or employed in food, or for the prepara- 
 tion oiit, as culinary salt, culinary vege- 
 tables, culinary utensils. 
 
 CUMIN. The seeds of a plant, Cumi- 
 num. Cyminum, a native of Egypt; but 
 
C UP 
 
 CUT 
 
 177 
 
 tlie seeds which are used in this coun- 
 try are brought chiefly from Sicily and 
 Malta. They have a strong and peculiar 
 odour, and an aromatic and bitter taste. 
 Cumin seeds are one of the ingredients 
 of a plaster retained in the London phar- 
 macopoeia ; but the Materia Medica might 
 quite well be without them for any good 
 they do, either externally or internally. 
 
 CUPEL. The name of a chemical 
 vessel; a kind of crucible or covered 
 earthen plate, for exposing substances to 
 a very strong heat in the fire or furnace. 
 
 CUPELLATION. The operation per- 
 formed by means of a cupel. 
 
 CUPPING. An operation in which 
 glasses exhausted of air are applied to any 
 part of the body ; and the pressure of the 
 surrounding external air forces the blood 
 and fluids to that part. The air may be 
 exhausted, either by heat excited by burn- 
 ing, within the glass, paper or cotton 
 steeped in spirits of wine, or by a syringe 
 acting as an air-pump. When the part 
 upon which the cupping-glasses are ap- 
 plied has been previously scarified, blood 
 may be very conveniently dra^vn from 
 that place ; and as we may have cupping- 
 glasses of any shape, we have it in our 
 power thus to abstract blood from sur- 
 faces, whether they be flat or prominent. 
 Cupping is useful in disorders of the eyes ; 
 and in this case, blood may be taken from 
 the temples, from behind the ears, or at 
 the back of the neck. Cupping is also 
 useful in apoplexy, epilepsy, and other 
 convulsive disorders; and in all cases 
 where there appears too great a determi- 
 nation of the fluids to any particular part. 
 Dry cupping signifies the application of 
 the exhausted glasses to a part, without 
 abstracting blood. Its tendency is to in- 
 cite the fluids from the internal parts to 
 the place where the glass is applied. The 
 operation should be repeated till the part 
 is red and somewhat painful ; its eff*ect, in 
 some measure, resembles that of blisters. 
 
 Cupping is seldom dexterously per- 
 formed, except in the hands of professed 
 irtists. The difficulty consists in ex- 
 bausting the glass only so far as to let 
 
 the vessels under it be filled, but not to 
 suffer its edges to press so firmly round 
 as to impede the circulation. 
 
 CURD. When certain substances are 
 mixed with milk, or when it is allowed 
 to stand till it becomes sour, it is coagu- 
 lated or curdled ; that is, it is separated 
 into a solid substance called curdy and a 
 fluid called whey. Various substances 
 have this coagulating po\ver; spirits of 
 wine, infusion of astringent vegetables, 
 acids, several neutral salts, gum, sugar; 
 and eminently, the gastric juice in the 
 stomachs of animals. When milk is taken 
 into the stomach, the first thing that takes 
 place is its coagulation ; but curd, when 
 prepared out of the body, is sometimes 
 oppressive to the stomach, and has even 
 been known to occasion obstructions in 
 the bowels. 
 
 CURRANTS, the fruit of the genus 
 Ribes. There are three varieties of cur- 
 rants ; all of which are much cultivated, 
 on account of their pleasant and salutary 
 properties, both in their natural state, and 
 when prepared and preserved with sugar 
 in the form of jelly. They possess a 
 grateful acidity; they are cooling and 
 laxative ; and they tend to resist putre- 
 faction. They may be usefully given in 
 fever, and other diseases which are ac- 
 companied with thirst, and dryness of the 
 tongue and throat. The jelly, when di- 
 luted with water, forms an excellent feb- 
 rifuge drink; and the blackcurrant jelly, 
 when taken undiluted, is believed to be 
 peculiarly beneficial in the different kinds 
 of sore throat. The leaves of the black 
 currant are very fragrant, and are thought 
 to be possessed of considerable diuretic 
 virtue. 
 
 CUT. A wound inflicted by a clean 
 cutting instrument, without any bruise or 
 laceration of parts. In the language of 
 surgery, it is called a simple incised 
 wound. Such wounds are most easily 
 healed ; and, in a great many cases, little 
 more is required than to bring the 
 edges of a cut together, and to retain them 
 there by adhesive plaster and proper 
 bandages, and to take care that the parts 
 
 N 
 
178 
 
 CUT 
 
 CYN 
 
 are not disturbed by motion. The most 
 troublesome circumstance is the copious 
 bleeding which sometimes occurs; and 
 while this continues, the sides cannot be 
 kept in proper contact. Sometimes the 
 pressure of the first dressing- is sufficient 
 to stop the bleeding- ; but, in other cases, 
 we must wait till the vessels of the part 
 have l)led freely, and begin to contract 
 themselves. The wound is then to be 
 cleaned with tepid water, and properly 
 bound up. If the cut is deep and long, it 
 may be feared that some artery of con- 
 siderable size has been wounded ; and if 
 the bleeding does not stop by pressure, 
 the artery will require to be secured by 
 a ligature* If the bleeding from a cut be 
 copious and alarming, the patient or by- 
 standers should endeiivour to stop it till 
 the surgeon arrives. This is to be at- 
 tempted by pressing the sides of the 
 ' wound together ; and in the extremities, 
 it may be done by compressing the prin- 
 cipal arteries, at a portion of their tube 
 nearer the heart than the wound is. A 
 handkerchief or other piece of cloth is to 
 be rolled up tightly like a small cushion ; 
 and if placed on the inside of the arm 
 above the elboAV, and tied on with tape or 
 another handkerchief, and this twisted 
 firmly round with a stick, the flow of 
 blood into the limb below will be checked. 
 The same may be done at the inner part 
 of the thigh ; or pressure may be made in 
 the groin, with the whole of the fingers 
 of one hand, inclining a little towards the 
 inner side. 
 
 Wlien a cut runs parallel to the fibres 
 of a subjacent muscle, there is little dan- 
 ger of the lips of the woimd separating 
 from each other ; but if the direction of 
 the cut be across a muscle, their union 
 will be more difficult, and one or two 
 stitches will be necessary. Stitches are 
 also required in wounds of the head, and 
 about the face, where it is of much im- 
 portance to prevent deformity. 
 
 CUTANEOUS, belonging to the skin. 
 
 CUTANEOUS DISEASES form a 
 subj&ct of immense extent and import- 
 ance. It is only within the last twenty 
 
 years, that the diseases of the skin have 
 attracted the attention they deserve ; and 
 Dr. Willan of London, followed by Dr. 
 Bateman, has done much to remove the 
 obscurity, and to disentangle the perplex- 
 ity which was fonnerly connected with 
 this very difficult subject. They have 
 endeavoured to institute a more conect 
 nomenclature, and a more accurate classi- 
 fication; and to point out more appro- 
 priate and effectual remedies than what 
 were formerly employed. A name very 
 generally given to diseases of the skin, 
 and that with very little discrimination, 
 is scurvy ; a term which is quite impro- 
 per, inasmuch as it is the name of a par- 
 ticular constitutional disease ; and also 
 because, by classing all skin-diseases un- 
 der the same name, it leads to the em- 
 ployment of similar remedies, in ailments 
 which are totally distinct from each other. 
 An account of the principal diseases of 
 the skin is given under their respective 
 titles, as Itch, Leprosy, &c. See Erup- 
 tions and EnuFrivE Diseases. 
 
 CUTICLE. The external covering of 
 the body, commonly called the scarf skin. 
 It is thin and semitransparent, has no 
 bloodvessels or nerves that can be de- 
 tected, and exhibits no sensibility. It is 
 frequently destroyed, and quickly repro- 
 duced. In some parts it is thicker than 
 others, as in the soles of the feet, and in 
 the palms of the hands of working peo- 
 ple. The cuticle is the part that retains 
 the matter discharged through the pores 
 of the true skin by the action of a blister. 
 
 CYNANCHE. The name given in 
 medical books to the different kinds of 
 sore throat. The principal of these are : 
 
 Cyna>che Tonsillar rs. Common In- 
 flammatory Sore Throat. 
 
 Cynanche Parotidea. Mumps. 
 
 Cynanche Trachealis, or Laryngea. 
 Croup. 
 
 Cynanche Maligna. Putrid Sore 
 Throat, very generally connected mth 
 Malignant Scarlet Fever. 
 
 The history and treatment of these dif- 
 ferent species of Sore Throat are given 
 under their Eng-lish names. 
 
179 
 
 D 
 
 DAM 
 
 DAN 
 
 DALBY'S CARMINATIVE is a 
 
 quack medicine, which is entitled to a 
 little more regard than the tribe of its 
 pretending and noxious brethren. In 
 proper hmids, it often answers the pur- 
 pose for which it is given, and relieves 
 the flatulence which is so distressing to 
 infants. The dose is from two tea-spoon- 
 fuls to a table-spoonful, mixed with a little 
 sugar and water. 
 
 The ingredients of this medicine are 
 the carbonate of magnesia; the oils of 
 peppermint, nutmeg, and aniseed; the 
 tinctures of castor, assafetida, and opium ; 
 the spirit of pennyroyal, the compound 
 tincture of cardamoms, and peppermint- 
 water. 
 
 Dr. Paris, the great detector of the 
 arcana of quackery, says, " In examining 
 the pretensions of this combination, it 
 must be allowed that it is constructed 
 upon philosophical principles ; this, how- 
 ever, is no reason why the physician 
 should recommend it; the mischievous 
 tendency of a quack medicine does not 
 depend upon its composition, but upon its 
 application. We ought to remember, 
 says an eminent physician, that in re- 
 commending this nostrum, we foster the 
 dangerous prejudices of mothers and 
 nurses, who are unable to ascertain the 
 circilmstances under which it should be 
 given, or even the proper doses. If its 
 composition is judicious, why do not phy- 
 sicians order the same in a regular pre- 
 scription, rather than in a form in which 
 the most valuable remedy will be abu- 
 sed?" 
 
 DAMASK ROSE, Rosa centifolia. 
 The petals of this rose are employed for 
 the distillation of rose-water, which forms 
 
 a very good solvent for those salts which 
 are used as astringents ; the sulphate of 
 zinc, in the proportion of two grains to 
 the ounce of rose water, is an excellent 
 wash for sore nipples, and for the eyes in 
 ophthalmia. These petals also yield an 
 oil, prepared in large quantities and im- 
 ported from the East, under the title of 
 Otto of Roses. 
 
 DAMSON, Prunus domesticay a species 
 of plum, which is cooling and laxative, 
 and when perfectly ripe, affords a whole- 
 some article for pies, tarts, &c. but when 
 not quite ripe, plums are apt to produce 
 colics, diarrhoeas, and other unpleasant 
 symptoms, especially in children. When 
 dried, damsons, as well as the other spe- 
 cies of plums, are called prunes ; and they 
 retain much of their refrigerant and laxar 
 tive properties. They may be talien by 
 themselves when stewed ; or they are of- 
 ten directed to form part of the decoction 
 of senna, of tamarinds, and other purga- 
 tives, given in a liquid form. The pulp 
 of prunes is an ingredient in the electuary 
 of senna. 
 
 DANCE, SAINT VITUS's, called by 
 medical writers Chorea Sancti Viti, or 
 simply Chorea, is a disease attended with 
 convulsive motions, attacking both sexes, 
 chiefly between the years of seven and 
 fourteen, and rarely occurring after the 
 age of puberty. 
 
 The origin of this name is said to be as 
 follows. Some women who were disor- 
 dered in mind, once every year paid a 
 visit to the chapel of St. Vitus near Uhn, 
 and there exercised themselves day and 
 night in dancing, till they were complete- 
 ly exhausted. Thus they were restored, 
 till the return of the following May, 
 
180 
 
 DANCE, SAINT VITUS' S. 
 
 ivhen they were again seized with a rest- 
 lessness and disorderly motion of their 
 limbs, in so great a degree as to be ob- 
 liged, at the anniversary feast of St. Vi- 
 tus, to repair again to the same chapel for 
 the sake of dancing. From this tradition, 
 the convulsive disease now to be describ- 
 ed, took its name. (Dr, Parr, Article 
 Chorea.) 
 
 An excellent description of the disease 
 has been given by Dr. Hamilton, senior, 
 of Edinburgh, in his valuable work on the 
 Utility of Purgative Medicines, which we 
 here insert. 
 
 " Chorea attacks boys and girls indis- 
 criminately ; and those chiefly who are 
 of a weak constitution, or whose natural 
 good health and vigour have been im- 
 paired by confinement, or by the use of 
 scanty or improper nourishment. It ap- 
 pears most commonly from the eighth to 
 the fourteenth year. I saw it in two 
 young women, who were from sixteen to 
 eighteen years of age. 
 
 " The approaches of chorea are slow. 
 A variable and often a ravenous appetite, 
 loss of usual vivacity and playfulness, a 
 swelling and hardness of the lower belly 
 in most cases, in some a lank and soft 
 belly, and in general a constipated state of 
 the bowels, aggravated as the disease ad- 
 vances ; and slight irregular involuntary 
 motions of different muscles, particularly 
 of those of the face, which are thought to 
 be the effect of irritation, precede the 
 more violent convulsive motions, which 
 now attract the attention of the friends of 
 the patient. 
 
 These convulsive motions vary. The 
 muscles of the extremities, and of the 
 face, those moving the lower jaw, the 
 head, and the trunk of the body, are at 
 different times, and in different instances, 
 affected by it. In this state the patient 
 does not walk steadily ; his gait resem- 
 bles a jumping or starting; he sometimes 
 cannot walk, and seems palsied ; he can- 
 not perform the common and necessary 
 motions with the affected arms. This 
 convulsive motion is more or less violent, 
 and ij constant except during sleep, when 
 
 in most instances it ceases altogether. 
 Although different muscles are sometimes 
 successively convulsed, yet in general the 
 muscles, affected in the early part of the 
 disease, remain so during the course of it. 
 *' Articulation is now impeded, and is 
 frequently completely suspended. De- 
 glutition also is occasionally performed 
 with difficulty. The eye loses its lustre 
 and intelligence ; the countenance is pale, 
 and expressive of vacancy and languor. 
 These circumstances give the patient a 
 fatuous appearance. Indeed there is 
 every reason to believe, that when the 
 disease has subsisted for some time, fatuity 
 to a certain extent, interrupts the exer- 
 cise of the mental faculties. 
 
 " Fever, such as arises in marasmus, is 
 not a necessary attendant on chorea ; ne- 
 vertheless, in the advanced periods of the 
 disease, flaccidity and wasting of the mus- 
 cular flesh take place, the consequence of 
 constant irritation, of abating appetite, and 
 impaired digestion, the common attend- 
 ants of protracted chorea; and which, I 
 doubt not, may, in some instances, al- 
 though contrary to the opinion that cho- 
 rea is not fatal, have been the forerunners 
 of death." 
 
 The fits are sometimes preceded by a 
 coldness of the feet and limbs, or with a 
 sensation as of cold air rising along the 
 spine, flatulence, pain of the bowels, and 
 obstinate costiveness. At other times, 
 nausea, yawning, stretching, and giddi- 
 ness, with pains about the teeth and ears, 
 usher in the convulsive motions. These 
 motions assume the form of a sort of 
 lameness and unsteadiness of one of the 
 legs, which the patient draws after him 
 in a ridiculous manner. The arm of the 
 same side cannot be held still, but if it be 
 laid on the breast, it is drawn from it by 
 a convulsive jerk ; if he is desired to 
 thread a needle, it is attempted with many 
 deviations, but rarely accomplished ; if he 
 endeavours to carry any drink to the 
 mouth, it is only after many unsuccessful 
 efforts that he hastily throws the liquor 
 down the throat, as if for the amusement 
 of the bystanders. There are often hys- 
 
DANCE, SAINT VITUS' S. 
 
 181 
 
 terical symptoms, laughing and crying, or 
 passing from one of these to the other, on 
 very slight occasions. 
 
 Causes. Chorea arises from various 
 irritations, as teething, Avomis, disordered 
 bowels, &c. Violent affections of the 
 mind, as fear and anger, have been known 
 to bring it on ; in many cases, it arises 
 from weakness; and sometimes, it first 
 begins from seeing the disease in others. 
 
 Prognosis. " Those who have once 
 suffered under this disease, are very sub- 
 ject to a relapse. However violent the, 
 symptoms, they are never suddenly de- 
 structive. When recent in a young per- 
 son, there is hope of a speedy cure. If 
 the menses are obstructed, their return 
 will mitigate, if not cure the disease. If 
 the temperament is one of great sensibi- 
 lity, or if the disease is hereditary or ha- 
 bitual, the cure is difficult." (Dr. Parr.) 
 
 Treatment. Though this disease is 
 rarely attended with danger to life, unless 
 when conjoined with epilepsy, or passing 
 into it, still it is a very disagreeable dis- 
 ease, and parents are naturally very anx- 
 ious for their children to get rid of it. 
 Various plans have been proposed. By 
 those who consider it a disease of debility, 
 the cure of it has been attempted on the 
 tonic or strengthening plan, by giving 
 preparations of iron, bark, wine, and nou- 
 rishing diet; by others, opium, ether, 
 camphor, musk, and antispasmodics have 
 been given, to allay the inordinate mus- 
 cular motions ; while many, and especially 
 Dr. Hamilton, senior, of Edinburgh, are 
 confident of effecting the cure by purga- 
 tives. Many interesting cases of success 
 by this method have been brought for- 
 ^vard by Dr. Hamilton ; and Dr. Parr, of 
 Exeter, treated more than sixty cases 
 with purgatives, in one of which only he 
 may have been styled unsuccessful. He 
 says, " the choice of the purgative appears 
 of little importance ; but it must be ac- 
 tive, for no other will produce the neces- 
 sary discharge, and the saline purgatives 
 are ai)parently less adapted to the com- 
 plaint. The author knows no distinction, 
 i)ut in their power ; the most active are the 
 
 most useful. We have had no reason to 
 follow the purgatives by tonics. The 
 constitution has restored the general 
 health with rapidity and effect." It is 
 to be particularly attended to, that the 
 purgative plan requires to be persevered 
 in for a considerable time, and that the 
 bowels often show themselves to be ex- 
 ceedingly loaded. The plan of treatment 
 by purgatives is also decidedly approved 
 of by Professor Hamilton, in his work on 
 the Management of Children. 
 
 DANDRIFF. A slight whitish scurf 
 which appears along the top of the fore- 
 head and temples in infants ; on the back 
 part of the head, the scales are large, flat, 
 separate, and semi-transparent. Old per- 
 sons sometimes have a similar affection 
 on their scalp. The head must be regu- 
 larly washed with soap and water, or with 
 a weak alkaline or spirituous lotion, and 
 the hair must be kept very thin, or re- 
 moved altogether. It should not be ne- 
 glected, lest it degenerate into scaUedhead. 
 
 DAPHNE MEZEREUM, Spurge 
 Olive. See Mezereon. 
 
 DATE. The fruit of a species of palm, 
 the Phcenix dactylifera^ which is culti- 
 vated in the southern parts of Europe. 
 The date is oblong, larger than an acorn, 
 and includes a stone. The best dates are 
 those which are soft, large, and not much 
 wrinkled, of a reddish yellow colour on 
 the outside, and a whitish membrane be- 
 tween the flesh and the stone. They are 
 moderately astringent, particularly when 
 unripe, yet are eaten as foo4 iu Africa. 
 (Parr.) 
 
 DATURA STRAMONIUM, Thorn 
 Apple. See Stramonium. 
 
 DAWLISH. A village on the coast 
 of Devonshire ; a place of resort for in- 
 valids in pulmonary complaints, and 
 others, which require a residence in mild 
 air and among pleasant scenery. It re- 
 sembles in its good properties the other 
 residences on that cojast. See SipMOUTH 
 and Tor Quay. 
 
 DEADLY NIGHTSHADE, Atropa 
 belladonna. A perennial plant, with a 
 herbaceous stem ; growing- in mountain- 
 
182 
 
 DEAFNESS. 
 
 ous and woody situations, and often cul- 
 tivated in gardens. Tiie whole plant is 
 poisonous ; and the berries, which are 
 A'ery beautiful, and of a fine red colour, 
 sometimes tempt children to eat them ; in 
 consequence of which, they are seized 
 with very dreadful symptoms, as a trem- 
 bling of the tongue, dryness of the mouth, 
 distressing thirst, difficulty of swalloyving, 
 fruitless efforts to vomit, and great anx- 
 iety. Delirium and convulsions come on : 
 the pupil is dilated, and the eye is insen- 
 sible to light. The face becomes swollen 
 and of a dark red colour. Inflammation 
 attacks the stomach and intestines ; and 
 the stomach becomes insensible to stimu- 
 lants, so that it is in vain to give emetics 
 to evacuate the poison, which is therefore 
 very conoanonly fatal. Sulphate of zinc, 
 to the extent of thirty grains, should be 
 tried, or sulphate of copper, six grains ; 
 and it is said that vinegar and other ve- 
 getable acids, honey, milk, and oil, are 
 useful auxiliaries in the cure. In some 
 children who recovered by this treatment, 
 the delirium was succeeded by deep sleep, 
 and starting of the tendons ; the face and 
 hands became pale and cold, and the pulse 
 was small, hard, and quick. Blindness 
 continued a considerable time, but at last 
 went off. The part of the plant used in 
 medicine is the leaf, which has a nauseous 
 bitterish taste, and is giVen at first in the 
 dose of a grain a-day in powder. Besides 
 its narcotic power, it is thought to possess 
 considerable influence on the excretions 
 of sweat, urine, and saliva; but as an 
 overdose of it is so dangerous, and as we 
 have other safer medicines which produce 
 similar effects, it seems very doubtful 
 whether its internal use should be recom- 
 mended. A plaster, composed of equal 
 parts of extract of belladonna and com- 
 mon plaster, is often of effectual relief in 
 the case of local pains arising from chronic 
 rheumatism; and the powdered leaves, 
 sprinkled upon unhealthy sores, or an in- 
 fusion of them employed as a fomentation, 
 has allayed the pain of such sores. 
 
 Half a drachm of the dried leaves, in- 
 fused in half a pint of water, furnishes a 
 
 liquor, which, when dropped into the eye 
 causes the pupil to dilate for a consider- 
 able time; and those who operate upon 
 the eye, take advantage of this circum- 
 stance to facilitate their operations. Per- 
 sons M'ho are afflicted with a beginning 
 cataract may, by having the pupil dilated 
 by this infusion, have their sight improved 
 for a time, as the dilated pupil will allow 
 some of the rays of light to fall on the 
 retina. 
 
 DEAFNESS means the loss or im- 
 paired state of the sense of hearing. 
 
 Causes. Deafness, more or less com- 
 plete, is brought on by various circum- 
 stances. In palsy and in fever, deafness is 
 common ; and also when the brain is in- 
 jured by a blow, by concussion, or by tu- 
 mours Vv ithin the skull. Nothing is more 
 usual than for deafness to attend a common 
 cold, and to continue long after its other 
 symptoms are removed- Hearing is often 
 injured by long-continued headachs, by 
 loud shrill noises, and by thunder. It is 
 injured by inflammation arising in conse- 
 quence of repressed eruptions, of repelled 
 gout, or the stopping of hsemorrhages and 
 issues. The imprudent use of mercury and 
 of cosmetics is thought also to hurt, the ear, 
 and to bring on deafness. A violent shock 
 given to the head by going hastily into the 
 cold bath, is a very frequent cause of deaf- 
 ness, which sometimes lasts for a consi- 
 derable time, even for days or weeks. Lo- 
 cal aflfections of the ear itself are a very 
 frequent cause of deafness. The loss of 
 the external ear greatly injures hearing. 
 If any thing obstructs the outer passage, 
 as a growth, or any solid body getting in, 
 or the wax accumulating, deafness follows. 
 Too little wax is also injurious. Diseases 
 of the membrane of the drum, and of the 
 drum itself, produce deafness. Inflamma- 
 tions, abscesses, and scrofulous ulcers in 
 the inner portion of the ear, are apt to oc- 
 casion incurable deafness. 
 
 Treatment. When deafness proceeds 
 from any general affection of the head or 
 body, our treatment must be directed to 
 the original disease. Inflammation from 
 repelled eruptions will require discharges 
 
DEAFNESS. 
 
 183 
 
 from the neighbourhood of the ear, by 
 leeches, cupping-, or blisters. Saline pur- 
 gatives, diaphoretics, and fomentations, 
 will also be necessary. If we can restore 
 suppressed discharges, it ought to be done. 
 Deafness, from injuries of the external 
 passage, is pretty much within our power. 
 If there is an accumulation of wax, warm 
 water, or M'arm soap and water, is to be 
 thrown in with a syringe ; and the sur- 
 geon is carefully to break down and ex- 
 tract all the wax he can reach with a 
 small scoop. People should not venture 
 to pick their own ears with pointed in- 
 struments. If there is a suppuration or 
 scrofulous cfischarge, the passage is to be 
 kept clean by the injection of warm wa- 
 tery fluids. In scrofulous constitutions, 
 where deafness is threatened, it is of ser- 
 vice to have an issue or drain externally ; 
 as there is great danger of inflammation 
 and ulceration extending to the inner 
 parts of the ear, and destroying the small 
 bones there ; the consequence of which 
 would be incurable deafness. Other re- 
 medies proper in scrofulous constitutions 
 are also to be employed, as exercise, sea- 
 bathing, nourishing diet, and attention to 
 the state of tlie bowels. When there is 
 a deficiency of the wax, stimulant oils are 
 recommended, as turpentine and the oil 
 of amber. Onions and garlic have also 
 been applied. 
 
 Deafness in old people is frequently ac- 
 companied with ringing of the eai*s, and 
 other disagreeable sensations. If the deaf- 
 ness in such persons has been gradually 
 increasing, very violent means or strong 
 remedies are not to be ventured upon. 
 The strength is to be supported by gene- 
 rous diet and tonic medicines, while much 
 attention is to be paid to the state of the 
 bowels; and care taken to prevent any 
 excessive determination of blood to the 
 head. But if the symptoms of giddiness, 
 headach, and ringing of the ears have 
 come on suddenly, if there be flushing of 
 the face and any tendency to fever, these 
 arc the marks of impending apoplexy or 
 palsy, and must be counteracted by blood- 
 letting and other depleting measures, with- 
 
 out regarding the age or previous appa- 
 rent feebleness of the patient. Many ot 
 the imperfections of the sense of hearing 
 are beyond the reach of medicine. An 
 ear-trumpet is our next best resource. 
 
 DEATH may either be the effect of 
 old age, or it may occur at an earlier pe- 
 riod as the consequence of disease. As 
 life advances, the various functions, and 
 what are called the various systems of 
 man, the vascular, the nervous, and the 
 digestive, become languid and impeded 
 in their operations. The arteries, which, 
 in the earlier stages of life, were supe- 
 rior to the veins in the density of their 
 coats, and the energy of their actions, 
 gradually lose their activity and power ; 
 the nervous system is feeble and torpid ; 
 and motion is less easily excited in 
 the muscles by stimuli or by the will. 
 The extremities become cold, and feeling 
 is blunted ; the circulation languishes, and 
 the veins are fullest. Ossification takes 
 place in many of the arteries ; and mor- 
 tification from this cause closes the 
 scene. In other circumstances, the acti- 
 vity of the circulating system flags, the 
 blood is confined to the larger vessels, 
 and the heart can no longer contend with 
 the increasing load; or the vital power 
 is gradually sunk in sleep; and at last 
 in death, assuming the form of a deeper 
 slumber. Suffocation, or the rupture of 
 vessels in the head sometimes suddenly 
 extinguishes life. When death occurs 
 at an earlier period, as the consequence 
 of disease, it is from the destruction of 
 some organs essential to life; from the 
 supply of nourishment being totally ob- 
 structed, or from the gradual introduc 
 tion of poison, either undermining the 
 vital powers, or exhausting the strength 
 by the regularly returning paroxysms of 
 hectic. In continued fevers, we cannot 
 distinctly see what particular circum- 
 stance causes death ; but the most fre- 
 quent is exhausted strength or an op- 
 pressed brain. 
 
 The signs of approaching death are, a 
 rapid and very small, scarcely distinguish- 
 able pulse, cold extremities, clammy sweats. 
 
184 
 
 DEC 
 
 DEL 
 
 the eyes dim, the features sunk, the ex- 
 pression lost, and a hollowness, particu- 
 larly at the temples ; the three last cha- 
 racters constitute the fades Hippocratica, 
 so called from its heing admirably described 
 by the Father of Physic. All these are 
 signs of a total loss of activity and power 
 in the circulating and nervous systems. 
 
 DECLINE. A term very often ap- 
 plied, in popular language, to those dis- 
 eases which wear out life by long suffer- 
 ing, hectic fever, and great emaciation. 
 Consumption is very frequently called a 
 decline ; and the wasting of infants from 
 mesenteric fever, from the dregs of the 
 measles, from diseased liver, and impaired 
 digestion, M'ith various other chronic af- 
 fections of a similar nature, are called by 
 the same name. 
 
 DECOCTIONS are certain prepara- 
 tions of medicines and drinks, made by 
 boiling substances in water for a consi- 
 derable time. On account of the active 
 principles of vegetables being of difficult 
 solution, decoction is necessary at times; 
 but where infusion will extract the vir- 
 tues we want, it is preferable to decoc- 
 tion; because long continued heat pro- 
 duces a chemical change in some of the 
 substances, and dissipates volatile matter; 
 while substances which are held in solu- 
 tion when the decoction is hot, fall down 
 when it cools. Decoctions should not be 
 boiled longer than is necessary to extract 
 the soluble parts of vegetables ; and they 
 should be strained when hot, in order that 
 their active principles may not be lost or 
 deposited during straining. Vegetables 
 should be cut in slices, or bruised into a 
 coarse powder, to facilitate the solution. 
 The decoctions of particular substances 
 will be found under the names of those 
 substances. 
 
 DECOMPOSITION. The separation 
 ofthe parts of a compound substance by 
 the action of other substances, or by heat. 
 
 DECREPITATION. A crackling 
 noise made by certain salts when they 
 are put into the fire, or upon hot iron. 
 It is owing to the water of crystallization 
 which they contain. 
 
 DECUSSATION. The crossing of 
 nerves or muscular fibres. 
 
 DEFLAGRATION. The burning of 
 any substance with an explosion, as nitre, 
 gunpowder, &c. 
 
 DEFLUXION. A flowing down of 
 humours, a term scarcely used in modern 
 physiology or pathology. 
 
 DEGLUTITION. The act of swal- 
 lowing. See Swallowing and Gullet. 
 
 DELETERIOUS, destructive or poi- 
 sonouSy applied either to noxious gases, or 
 to substances taken into the stomach. 
 
 DELIQUESCENT. A term applied 
 to a salt, which, by attracting moisture 
 from the air, melts ; thus, potash, and the 
 carbonate of potash, &c. are deliquescent 
 salts. 
 
 DELIQUIUM ANIMI, Syncope. See 
 Fainting. 
 
 DELIRIUM. The temporary aberra- 
 tion of mind occurring in certain diseases, 
 as fever, and affections of the brain; and 
 the concomitant of various accidents, par- 
 ticularly injuries of the head. It likewise 
 attends diseases of extreme debility ; and 
 often arises from intemperance in drink- 
 ing, and other habits of dissipation. 
 
 The following excellent account of the 
 gradations of this disordered state of the 
 intellectual functions, is given by Dr. 
 Abercrombie : 
 
 " The first mental function which is 
 impaired by bodily disease is usually the 
 power of attention; — this we see illus- 
 trated in all febrile affections. The pa- 
 tient, in the eai'ly or milder stages, is in- 
 capable of fixing his mind upon any thing 
 that requires much attention, of following 
 out an argument, or of transacting busi- 
 ness which calls for much thought or con- 
 sideration. He is acute and intelligent 
 as to all common occurrences, and shoves 
 no want of recollection, or of the power 
 of reasoning when his attention is excit- 
 ed; but he feels it an exertion that is 
 painful to him. In a higher degree of 
 this condition, he is still intelligent as to 
 what is said or done at the time, or in re- 
 cognising persons ; but in a short time 
 forgets every thing- in regard to the per« 
 
DELIRIUM. 
 
 185 
 
 son or the occurrence. He is incapable 
 of that degree of attention which is neces- 
 sary for memory, though the powers of 
 perception are entire. In the next stage, 
 he becomes incapable of receiving the 
 full impression from external things; 
 and, in consequence of this, he mistakes 
 the objects of his own thoughts for real- 
 ities. This is delirium, and there are va- 
 rious degrees of it. In some cases, the 
 attention of the patient can be roused for 
 a time, and directed to the true relations 
 of external things, though he relapses in- 
 to his delirious impressions when he is 
 left undisturbed ; in others, the false im- 
 pression is constant, and cannot be cor- 
 rected by any effort which is made to di- 
 rect the attention ; and, in a third modi- 
 fication of this remarkable condition, he 
 mixes up his liallucinations with external 
 impressions in a most singular manner. 
 He is still capable, however, of describing 
 his impressions, that is, of talking so as to 
 be understood, though what he speaks of 
 relates only to his erroneous conceptions. 
 Or mere bodily feelings. In the next 
 stage, he either does not attempt to ex- 
 press himself at all, or is entirely unintel- 
 ligible. He is now cut off from commu- 
 nication with external things, and with 
 other sentient beings; and the highest 
 degree of this is what we call coma, or 
 stupor, which resembles profound sleep. 
 
 " This description refers chiefly to the 
 gradations in the state of the mental func- 
 tions which we observe in continued fe- 
 ver. It is particularly interesting to trace 
 them in this disease, because we see the 
 various grades passing into one another ; 
 and thus showing, in a connected series, 
 the leading peculiarities, which, in other 
 affections, we have to contemplate sepa- 
 rately. These peculiarities may be chiefly 
 referred to the following heads ; 
 
 " I. A state in which the attention can- - 
 not be steadily directed to a long and con- 
 nected train of thought, or to any thing 
 requiring a continued effort of mind. This 
 takes place, as already stated, in the ear- 
 lier stages of all febrile diseases. It like- 
 wise occurs in connexion with the debi- 
 
 lity which succeeds acute diseases; in 
 persons broken down by intemperance; 
 and in the first approaches of old age. It 
 is also often observed in a remarkable de- 
 gree in connexion with a disordered state 
 of the stomach. 
 
 " II. A state in which the impression 
 made by external things is not sufficient 
 to produce remembrance, though there 
 appears to be, at the time, a perfect per- 
 ception. A person so affected understands 
 what is said to him, and answers correct- 
 ly, but very soon forgets what has passed; 
 he knows a friend, and is happy to see 
 him, but in a short time forgets the occur- 
 rence. This is met with in a more ad- 
 vanced state of febrile diseases, in the 
 higher degrees of the condition which re- 
 sults from habitual intemperance, and in 
 the more advanced periods of age. It also 
 occurs in diseases of the brain, and in 
 cases of injuries of the head. A lady, 
 whom I attended some time ago, on ac- 
 count of an injury produced by a fall from 
 a horse, lay, for the first v^ eek, in a state 
 of perfect stupor; she then gradually re- 
 vived, so as to be sensible to external im- 
 pressions, and after some time to recog- 
 nise her friends. But afterwards, when 
 she was entirely recovered, she had no re- 
 collection of this period of her convales- 
 cence, or of having seen various friends 
 who then visited her, though, at the time, 
 she recognised them, conversed wiiYi them 
 sensibly, and was very happy to see them. 
 " III. The third condition is that in 
 which external impressions are either not 
 perceived at all, or are perceived in a 
 manner which cannot convey any distinct 
 notion of their relations to the mind. On 
 this account, the conceptions or trains of 
 ideas existing in the mind itsplf are be- 
 lieved to be realities. This remarkable 
 condition occurs in various forms of deli- 
 rium, and constitutes the peculiar charac- 
 ters of insanity and dreaming. The ideas 
 or conceptions which occupy the mind in 
 this condition are various. They may bo 
 trains of thought excited by some passing 
 event, or some bodily sensation ; and fre- 
 quently the patient repeats something 
 
186 
 
 DELIRIUM. 
 
 which is said in his hearing, and then 
 branches off into some other train to 
 which that has given rise. In other 
 cases, the impression is one which has 
 been brought up by some old associations, 
 even relating to things which the person 
 when in health had not recollected. Of 
 this kind there are various remarkable 
 examples on record, especially in regard 
 to the memory of languages. A man, 
 meutioacd by Mi*. Abernethy, had been 
 born in France, but had spent the greater 
 part of his life in England, and, for many 
 years, had entirely lost the habit of speak- 
 ing French. But when under the care of 
 Mr. Abernethy, on account of the effects 
 of an injury of the head, he always spoke 
 French," A similar case occurred in St. 
 Thomas's Hospital, of a man who was in 
 a state of stupor in consequence of an in- 
 jury of the head. On his partial recovery, 
 he spoke a language which nobody in the 
 hospital understood, but which was soon 
 ascertained to be Welsh. It was then 
 discovered that he had been thirty years 
 absent from Wales, and, before the acci- 
 dent, had entirely forgotten his native 
 language. On his perfect recovery, he 
 completely forgot his Welsh again, and 
 recovered tlie English language. A lady 
 mentioned by Dr. Prichard, when in a 
 state of delirium, spoke a language v, hich 
 nobody about her understood ; but which 
 also was discovered to be Welsh. None 
 of her friends could form any conception 
 of the manner in which she had become 
 acquainted with that language ; but, after 
 much inquiry, it was discovered, that, in 
 her childhood, she had a nurse, a native 
 of a district on the coast of Brittany, the 
 dialect of which is closely analogous to 
 the Welsh. The lady had at that time 
 learnt a good deal of this dialoct, but had 
 entirely forgotten it for many years before 
 this 9.ttack of fever. The case has also, 
 been communicated to me of a lady who 
 was a native of Germany, but married to 
 an English gentleman, and for a consider- 
 able time accustomed to speak the Eng- 
 lish language. During an illness, of the 
 nature of whicU I am not informed, she 
 
 always spoke German, and could not 
 make hen^elf understood by her English 
 attendants, except when her husband act 
 ed as interpreter. 
 
 " A case has been related to me of a 
 boy, Avho at the age of four received a 
 fracture of the skull, for which he under- 
 went the operation of trepan. He was 
 at the time in a state of perfect stupor, 
 and, after liis recovery, retained no recol- 
 lection either of the accident or the ope- 
 ration. At the age of fifteen, during the 
 delirium of a fever, he gave his mother a 
 correct description of the operation and 
 the persons who were present at it, with 
 their dress, and other minute particulars. 
 He had never been observed to allude to 
 it before, and no means were known by 
 which he could have acquired the circum- 
 stances which he mentioned." (Dr. Aber- 
 CROMBiE on the Intellectual Powers.) 
 
 There are certain cases in which delirium 
 portends very great danger ; at all times, 
 it is an unpleasant symptom; and one 
 which is very distressing to the friends of 
 the patient. It is a very common symp- 
 tom of low nervous fever ; and, in severe 
 cases, it pervades all the later periods of 
 that disease. In agues, it does not often 
 occur, though in the severer cases there 
 is considerable confusion of thought. 
 When it occurs in inflammation of the 
 lungs, at an early period, it is one of the 
 worst symptoms that can happen. It is 
 a symptom that occurs in diseases of high 
 excitem.ent, and also in diseases of debili- 
 ty ; Avhether this debility be a prominent 
 syraptom from the first, or be the sequel 
 of a strong inflammatory action. There 
 ai-e few cases in which we should attend 
 to the delirium as a primary symptom ; 
 the leading disease must be cured, and the 
 delirium will cease of itself. In various 
 kinds of fever, aud in various stages of 
 the same fevers, the cessation of the de- 
 lirium is the consequence of very different 
 applications and modes of treatment In 
 the early stages of fever, in inflammation 
 of the brain, delirium may be expected to 
 cease on the vigorous employment of the 
 antiphlogistic plan, copious blood-letting 
 
DELIRIUM. 
 
 I:i7 
 
 the application of cold, purging, and the 
 strictest attention to rest and quietude- 
 On the other hand, at the advanced pe- 
 riod of continued fever, with low mutter- 
 ing delirium, the patient may be roused 
 from his stupor, by questions distinctly 
 put to him, by being allowed to see the 
 objects in the room about him ; and by 
 the use of strong stimulants, as wine, spi- 
 rits, ether ; and opium so managed as to 
 produce not its narcotic, but stimulating 
 effect. In the diseases of childbed, deli- 
 rium is always an occurrence much to be 
 deprecated ; and the mode of dealing with 
 it in such cases, may be gathered from 
 what has been mentioned above. We must 
 try to diminish excitement where it is 
 too great; to rouse and interest the feel- 
 ings where the debility is evident ; and it 
 may be wise to admit the short visits of 
 judicious friends ; and to present the 
 child to the mother in the melancholy 
 case, when the instinct of maternal affec- 
 tion appears for the time suspended. The 
 delirium of typhus sometimes lasts long 
 after every other bad symptom is removed, 
 so that we might be led to fear there is 
 permanent derangement ; but in time, the 
 intellect is completely restored ; and the 
 same may be said of the derangement 
 which sometimes follows delivery; though 
 the period of recovery is often delayed, 
 and many months of anxious expectation 
 are passed by the friends of the patient. 
 
 DELIRIUM TREMENS. This is a 
 singular affection, which has but lately 
 been accurately described by medical 
 writers, and has not yet got an English 
 name. Physicians term it Delirium 
 Tremens, from the aberration of mind, 
 .and the universal shaking of the body 
 M'hich characterise it. 
 
 Symptoms. " The attack of this com- 
 plaint is more or less sudden in different 
 instances. Sometimes for a few days at 
 its commencement, the patient is merely 
 incapable of his ordinary duties and ex- 
 ertion ; a constant restlessness, debility, 
 and inappetency, and occasional vomiting 
 lake place, with dulncss and dejection of 
 spirits, and headach ; in a short time, con- 
 
 fusion of intellect, a staring wildness of 
 the countenance, tremor of the hands, 
 and in some degree of the whole body, 
 succeed. The pulse is not so frefjuent as 
 in the delirium of fever, nor so full and 
 strong as in inflammation of the brain ; it 
 seems to participate in the universal hur- 
 ry and tremor. The tongue is usually 
 moist ; and there is little thirst or heat 
 of skin. The bowels are generally, though 
 not invariably, open. Occasionally the 
 patient recovers without farther aggra- 
 vation of symptoms : but too frequently, 
 the disorder becomes more violent, the 
 countenance becomes more anxious and 
 wild ; the tremors assume the aggravated 
 character of twitching of the tendons, and 
 the confusion of ideas is displayed in to- 
 tal forgetfulness, in complete alienation of 
 mind, and unrestrained delirium. The 
 pulse is at length very frequent, but can- 
 not be distinctly felt on account of the 
 general tremor. Still the tongue remains 
 moist, there is little thirst, and the skin 
 is quite cool, sometimes with a clammy 
 pei^piration. In the violence of the 
 symptoms, there are sometimes involun- 
 tary evacuations. The duration of these 
 symptoms is various; they rarely con- 
 tinue in the degree of violence described 
 for more than a few days; but in a mild- 
 er form, they sometimes endure for some 
 weeks." — (Edinburgh Medical Journal, 
 
 Diagnosis. Delirium tremens is dis- 
 tinguished from inflammation of the brain 
 by the violence of the fever being less, 
 and by its not being attended with the 
 same intolerance of light and sound ; the 
 tremor, and the state of the pulse and 
 skin further distinguish it from inflamma- 
 tion of the brain. Nearly the same cir- 
 cumstances distinguish deliriuju tremens 
 from nervous fever with delirium. There 
 is greater difficulty in making the dis- 
 tinction between this complaint and mar 
 nia. The exciting cause, and the length 
 of its duration, are our chief, but uusatiSf 
 factory marks. 
 
 Causes. Delirium tremens occurs pri n- 
 cipally in those >vho are addicted to tho 
 
188 
 
 DELIVERY. 
 
 use of spirits, in consequence of excess or 
 habitual indulgence in them. ^ 
 
 Treatment. Opium is the remedy on 
 which we chiefly rely. It soothes the 
 agitation of body and mind ; and when 
 sleep is induced, the patient awakes re- 
 freshed and composed. It is to be given 
 in full doses every second hour, till it 
 produces its effect ; fifty drops of the 
 tincture, or two grains of the solid opium, 
 and this repeated four or five times. For 
 some nights after the disorder is abated, 
 opium is necessary at bed-time. Cold 
 may be applied to the head. Blood-let- 
 ting rs seldom proper ; and even very ro- 
 bust patients seem to be the worse for it. 
 Purgatives may be required to counteract 
 the constipating effects of the opium, but 
 not as a means of curing the disease. 
 Blistering should be totally avoided, as it 
 only adds to the irritation. 
 
 DELIVERY. When the different 
 stages of labour are completed, and the 
 child and afterbirth are expelled from the 
 womb, the woman is said to be delivered. 
 There are many things to be done, and 
 many to be avoided at this period ; and as 
 much of them will require both to be di- 
 rected and executed by non-professional 
 persons, it may be useful to give some di- 
 rections for the treatment of women af- 
 ter delivery. 
 
 Treatment of Women after Delivery. 
 When the afterbirth has been expelled, 
 and when the practitioner has ascertain- 
 ed, by putting the hand upon the belly, 
 that the womb is emptied and is contract- 
 ing properly, the woman should be al- 
 lowed a few minutes of repose; and, unless 
 there be any feverish or other unfavour- 
 able circumstances, a little cordial made of 
 wine and water, or spirits much diluted, 
 or twenty-five drops of laudanum in cin- 
 namon-water, may be allowed. If she 
 be not greatly fatigued, she is to turn 
 slowly on her back, a broad bandage is to 
 be put under her, and pinned evenly on 
 the belly, with such a degree of tightness 
 that she may feel a moderate support to 
 the body. This is necessary to compen- 
 sate for the great distension which she 
 
 has borne so long, and -which is now so 
 suddenly withdrawn. Whatever is wet 
 and uncomfortable, and can be easily taken 
 away, is to be removed ; and when this 
 is difficult, some dry flannel is to be placed 
 next the body. An open flannel petticoat 
 is to be put in, and fastened like the bind- 
 er. A soft cloth is to be applied to the 
 parts, and the woman may lie in any pos- 
 ture she finds most comfortable. A little 
 panado without wine or spirits, may be 
 allowed if she desires it ; and she may be 
 left to rest, after the practitioner has made 
 himself sure that there is no flooding, ex- 
 ternal or internal; that the after-pains 
 are not very severe, and that the binder is 
 of a proper tightness. It is desirable that 
 the urine should be passed within twelve 
 or fourteen hours after delivery ; and if 
 it is not done naturally, assistance must 
 be given, either by diuretic medicines or 
 otherwise. It is always proper to attend 
 to the state of the bowels, and to take 
 care a motion be procured not later than 
 forty-eight hours after delivery. If me- 
 dicines be required, there is nothing bet- 
 ter than cold-drawn castor oil ; and a dose 
 of this may be necessary every two days, 
 till the bowels become regular. 
 
 There are some things which attend- 
 ants, friends, and patients, are too apt to 
 do, but which should be carefully avoid- 
 ed. The patient should not be complete- 
 ly shifted, as is too often done, by raising 
 her to the erect posture. Fainting or 
 flooding may be the result of this impru- 
 dent conduct. A very moderate cordial, 
 as a little wine and water, may be allowed 
 after the necessary fatigues of labour, but 
 it is an injurious practice to give brandy, 
 strong spirits, and heating spiced liquors. 
 The temperature of the room should be 
 kept moderate, and large fires and loads 
 of bed-clothes should be avoided. A 
 crowd of people, noise, whispering, talk^ 
 ing, and officious meddling with the pa- 
 tient, should be strictly forbidden. 
 
 I>iet. The diet of women, after deli- 
 very, should be particularly attended to. 
 For the first five or six days, all heating 
 and stimulant food, and in general, all so* 
 
DELIVERY. 
 
 189 
 
 lid food should be forbidden, as such diet 
 is very apt to bring on inflammatory com- 
 plaints. If the woman is not to nurse^ 
 she should avoid liquids as much as pos- 
 sible, and rather take a little fruit, ripe 
 or preserved, to quench the thirst. If 
 she is to nurse, she may have a little tea 
 and panado for breakfast, and a little weak 
 chicken-broth or beef-tea with toasted 
 bread for dinner ; but for some time malt 
 liquor should be avoided. In the course 
 of a few days, a little wine may be allow- 
 ed ; but not red wine, as it is apt to stop 
 the cleansings. lu about a fortnight the 
 patient may have a little ale or porter, if 
 she suckles the child; and by degrees 
 may return to her ordinary diet. All 
 drink taken in the first days after delivery 
 should be somewhat heated. 
 
 Rest and quiet should be strictly en- 
 forced ; no visitors should bo admitted for 
 a fortnight or three weeks, both to secure 
 the mother from fatiguing herself by talk- 
 ing, and from hearing anything that might 
 agitate or distress her mind. The air of the 
 room should be kept cool and fresh, by 
 opening the bed- curtains, excluding vi- 
 sitors, and removing every thing that 
 would taint the air. The bed should not 
 ife made too soon, seldom before the end 
 of the third day ; and at first, it will be 
 better that the woman be not allowed to 
 sit up, but kept half sitting, half lying, 
 when she is out of bed, for the first two 
 or three times of rising. While the cleans- 
 ings continue, very little exertion should 
 be used ; no going about the house, and 
 hardly from one room into another ; but 
 after the second week, she may be out of 
 her room for a considerable portion of 
 every day, provided she very frequently 
 uses the reclining posture. Great care 
 should be taken on the first going out ; it 
 should be for a very short walk, or for an 
 airing in a carnage ; and the time and ex- 
 tent of exercise should be gradually en- 
 larged as the patient becomes conscious 
 of returning strength. See Labour. 
 
 DELIVERY, Injuries from. 1. The 
 womb, in former times of ignorance, was 
 sometimes inverted by rashly pulling at 
 
 the navel-string before the afterbirth was 
 sufficiently detached. If assistance be 
 procured in time, it may be replaced ; but 
 when this is too long delayed, the case 
 may prove fatal very soon, or a bloody 
 discharge may continue for a considerable 
 time, and at last destroy the patient. When 
 the inversion of the womb is so complete 
 that it is torn away from its internal at- 
 tachments, immediate death is generally 
 the consequence. But inversion of the 
 womb may always be prevented by avoid- 
 ing all rash attempts to extract the after- 
 birth, before it be completely separated. 
 2. Great stretchiag of the parts. This 
 occasions great soreness, and uneasy feel- 
 ings, which are best removed by bathing 
 with warm milk and water. If there be 
 much swelling, an emollient poultice of 
 bread and milk, or linseed meal may be 
 applied, and frequently renewed. If there 
 be general uneasiness, with heat and throb- 
 bing pain in the part, leeches may be ne- 
 cessary. 3. Laceration. The division 
 between the vagina and rectum is some- 
 times torn. When this is not very ex- 
 tensive, it generally gets better merely by 
 rest and the ordinary management after 
 delivery ; but when more considerable, a 
 communication is formed between the gut 
 and the vagina; this requires the assistance 
 of a skilful surgeon. 4. Sometimes the 
 urinary bladder is injured, either by the 
 use of instruments, or by allowing the 
 child's head to be wedged too long in the 
 bones. The disease may be mitigated if 
 taken in time ; but, when long delayed, 
 the consequences are very deplorable. 
 Contrivances must be adapted to prevent 
 the continual draining off of the urine. 
 
 DEMULCENTS are those medicines 
 or drinks of an oily or mucilaginous na- 
 ture ; which are given with the intention 
 of applying a smooth protection to parts, 
 which are likely to be irritated by the 
 presence of acrid matters. Thus the throat 
 and passage to the windpipe are intend- 
 ed to be shielded by demulcents, from the 
 thin sharp matter which excites the tick- 
 ling cough in a common cold ; and oily 
 demulcents are given to protect the bowels 
 
190 
 
 DENTIST. 
 
 from irritating substances passing from 
 the stomach, when we have reason to fear 
 that the natural mucus which lines them 
 is deficient in quantity. The principal 
 demulcents in use are, the solution of 
 gum arabic, either alone or with some 
 cinnamon-water to diminish its insipid- 
 ity ; solution of gum tragacanth, linseed- 
 tea, liquorice-water, decoction of marsh- 
 mallows, isinglass ; or the oily substances, 
 olive oil, almond oil, &c. formed into 
 emulsions. Water-gruel, barley-water, 
 and similar mattere are also to be reckon- 
 ed as demulcent drinks. 
 
 DENTIFRICES. Substances used for 
 cleaning the teeth, most commonly those 
 which are in the form of powder. Of 
 these, there is a great variety, as almost 
 every dentist has his own favourite tooth- 
 powder. Charcoal is much esteemed by 
 some, as it not only cleans the teeth, but 
 is supposed to assist in removing the bad 
 smell from the mouth. In the East In- 
 dies, the betel nut is burned to procure a 
 very fine powdered charcoal. It has, how- 
 ever, the disadvantage of producing a blu- 
 ish discolouration of the gum, which ex- 
 tends along the edge, and has somewhat 
 the appearance of tattooing, as practised 
 on the skins of the savages of the islands 
 in the Southern seas ; like tattooing, it is 
 quite indelible. Charcoal seems also to 
 act too severely on the enamel; for we 
 have seen many cases where, after the 
 continued use of it and of hard brushes, 
 the enamel has been cut into grooves as 
 with a file ; and it is well known that, 
 from its triturating power, it is used by 
 blacksmiths in polishing steel, to take out 
 the file marks. Magnesia, prepared chalk, 
 powder of cuttle-fish bones, orris-root, 
 and similar substances, may be used with 
 safety and advantage, either singly or 
 combined. The following is one of the 
 best receipts for tooth-powder : Take of 
 prepared chalk six ounces, cassia powder 
 hall' an ounce, orris-root an ounce. These 
 are to be M^ell mixed, and may be coloured 
 with red lake, or any other innocent sub- 
 stance, according to the fancy of the apo- 
 thecary or the user. This dentifrice is to 
 
 be used with a firm brush every moming, 
 and the teeth should also be brushed be- 
 fore going to bed ; but it is seldom neces- 
 sary to use powders more than once a- 
 day. 
 
 DENTIST. A medical practitioner, 
 whose attention is chiefly directed to the 
 teeth and neighbouring parts. There are 
 many circumstances relating to the growth 
 and preservation of the teeth, which are 
 highly conducive to health, comfort, and 
 personal appearance. Physicians and ge- 
 neral practitioners commonly disregard 
 this branch of the medical art, and leave 
 it to those who devote themselves exclu- 
 sively to it. As it is a province very 
 tempting, and thought to be easily acces- 
 sible, it has, more than any other division 
 of surgery, been invaded by ignorant pre- 
 tenders, who endeavour to make up, by 
 their forwardness and confidence, for their 
 M'ant of knowledge and medical skill. Li- 
 raited as the task of the dentist appears, 
 it ought never to be undertaken by any 
 who have not received a full medical edu- 
 cation ; as the disorders occasioned in dif- 
 ferent parts of the system by maladies of 
 the mouth, the fauces, and the teeth, require 
 great skill and judgment in their treat- 
 ment ; and the operations on the mouth, 
 and their consequences, frequently require 
 the promptitude and boldness of an ex- 
 perienced surgeon. Patients, therefore, 
 should be careful to whom they entrust 
 the care of those important parts. 
 
 Much evil may be prevented to the 
 youthful constitution, by frequently sub- 
 mitting the teeth and gums, during the 
 coming in of the second set, to the inspec- 
 tion of the dentist. Sometimes the first 
 set of teeth remain too long, and do not 
 allow space enough for the second set to 
 come in regularly. Sometimes these grow 
 too fast, and crowd upon each other; and 
 sometimes, from constitutional or local 
 disorders, the teeth have an unpleasing and 
 unhealthy appearance. Of the propriety 
 of the removal of obstructions, or of me- 
 chanical contrivances to keep the teeth in 
 the proper direction, or of administering 
 remedies for the constitution, the skilful 
 
DEO 
 
 DI A 
 
 dentist is the proper judge. Another cir- 
 cumstance which is to be corrected by the 
 dentist, is the deposition of the crust 
 called tartaty which seems to have its 
 origin from the salts contained in the sa- 
 liva, and Avhicli in some persons covers 
 the teeth to a great thickness. When 
 the mouth has been long neglected, it fre- 
 quently collects to such an extent as to 
 separate the gums from the teeth, and 
 render these loose and tender : it should 
 therefore be removed by instruments, and 
 its growth must be prevented by frequent 
 washing, brushing, or spunging of the 
 teeth, with water or proper dentifrices. 
 To the dentist also, peculiarly belongs the 
 management of the very distressful dis- 
 ease, toothach ; and this, whether it arises 
 from decaying of the teeth, or from rheu- 
 matic affections of the parts in the neigh- 
 bourhood. A great deal may in many 
 cases be done by art, to arrest the progress 
 of decay, by cutting out the diseased part 
 of the tooth, and by filling up the hollow 
 with metalh(; substances ; which operation 
 is called Stopping. Much grievous suf- 
 fering might be avoided, and many valu- 
 able teeth preserved, by a timely applica- 
 tion to the dentist ; but the bulk of pa- 
 tients think it time enough to apply to 
 him when they have suffered from pain, 
 whereas it is only at the commencement 
 of decay, and before severe pain has been 
 felt, that stopping can be of use ; but Avhen 
 it is performed under favourable circum- 
 stances by a skilful operator, it is a most 
 satisfactory operation. We have seen 
 many teeth that have been preserved by 
 it for upwards of twenty years. Much 
 may be done also for the front teeth, by 
 the judicious use of the file. When ex- 
 traction is necessary, it should be done 
 by a practised hand. See Teeth. 
 
 DENTITION. See Teething. 
 
 DEOBSTRUENTS. Medicines that 
 are supposed capable of removing the thick- 
 ened state of certain organs, which ob- 
 structs the free passage of blood through 
 them. If there is such a thing as a de- 
 obstruent medicine, mercury alone seems 
 entitled to the appellation ; as it often 
 
 displays a remarkable power of removing 
 hardness of the liver and other organs, 
 M'hen the system is brought under its in- 
 fluence. 
 
 DEPILATORY. An application that 
 removes haiis from any part of the body, 
 as the pitch-cap removes the hairs of the 
 scalp. Certain quack medicines, chiefly 
 of arsenic, are sold for removing super- 
 fluous hairs, but they are very dangerous. 
 
 DERIVATION. A term formerly 
 much used in medical speculations, but 
 now discontinued. It signifies the with- 
 drawing of humours or of disease from 
 one part, by causing a discharge at a more 
 distant one. 
 
 DESQUAMATION. The falling off 
 of the cuticle like small scales. This 
 takes place at the termination of scarlet- 
 fever, measles, and some other diseases of 
 the skin. 
 
 DETERGENT. Having the property 
 of cleansing or purifying ; sometimes ap- 
 plied to lotions for the skin, but without 
 just cause ; and in old surgery, applied to 
 medicaments which were thought to have 
 the property of cleaning ulcers, and bring- 
 ing them to a healing state. 
 
 DETONATION. The term applied 
 by chemists to the exploding of certain 
 substances, with a loud noise, as the deto- 
 nation of fulminating gold, &c. 
 
 DIABETES. The name of a disease 
 in which the urine is exceedingly increas- 
 ed in quantity, becomes of a sweet taste, 
 and contains a great portion of sugar. 
 There is great thirst and a voracious ap- 
 petite, with wasting of the body ; and the 
 quantity of the urine far exceeds the food 
 and drink taken in. Young persons are 
 rarely attacked with this disorder. The 
 most frequent subjects of it are those in 
 middle age or in the decline of life, or 
 who have made a free use of wine in 
 their" earlier years. It happens to per- 
 sons of both sexes ; and it is not easy to 
 point out any particular constitution that 
 is subject to it, or to say that any other 
 disease is a foreimnner of it. Dissection 
 throws little light on the nature of thia 
 complaint; but it is believed to be owing 
 
192 
 
 DIABETES. 
 
 to a diseased action of the kidneys. Dia- 
 betes comes on insidiously without any 
 previous disorder ; it may continue for a 
 long time without much emaciation ; and 
 it is commonly the great thirst and vora- 
 cious appetite, that first call attention to 
 the disorder that is going on in the system. 
 Sometimes, in the progress of the disease, 
 the stomach is considerably deranged, and 
 the skin becomes dry, parched, and scaly j 
 and there is a sense of weight and pain 
 in the urinary passages. When the dis- 
 ease has continued long, there is extreme 
 emaciation, debility, and the usual symp- 
 toms of hectic fever. 
 
 Treatment. The plan of cure in this 
 disease is as difficult and uncertain as its 
 theory; and many methods have been 
 proposed, and abandoned for others. One 
 plan has been, to procure a discharge from 
 other organs than the kidneys; hence 
 emetics and diaphoretics have been re- 
 commended, and blisters have been ap- 
 plied to the lower part of the back. To- 
 nic medicines have been advised, as iron, 
 myrrh, and bark ; and some have been 
 thought to derive much benefit from the 
 Bristol Hot-w ell ; and where these cannot 
 be used, lime-water has been given. Some 
 have employed large doses of opium ; and 
 though this is not to be depended upon 
 alone, it may assist more promising me- 
 thods of treatment. Riding on horse- 
 back, and friction over the region of the 
 kidneys, have also been recommended. 
 All these remedies very often fail; and 
 the most approved plan at present is to 
 throw in as much animal matter as pos- 
 sible into the system, to withdraw the 
 materials for the large production of su- 
 gar, to prevent the skin from absorbing 
 fluids, and to diminish the secretion from 
 the kidneys. For this purpose, the diet 
 is to be composed entirely of animal food, 
 and this even approaching to rancidity ; 
 large quantities of pork, smoked beef, 
 salt herrings, dried fish, eggs, &c. and a 
 total abstinence from all vegetable diet. 
 The skin is to be anointed with hog's 
 lard ; exercise is to be avoided ; an issue 
 is to be made in the region of the kid- 
 
 neys, and the bowels are to be kept open 
 by the common aloetic pill. Water im- 
 pregnated with the hepatic gas or hydro- 
 sulphuret of ammonia is to be given, in 
 the dose of four drops three or four times 
 a^day, and this is to be gradually increas- 
 ed till a slight giddiness is produced. The 
 use of the nitric acid, in the quantity of 
 one to three drachms, in two pounds of 
 water daily, is also recommended. Un- 
 der this method of treatment, several 
 unpromising cases have got well ; but it 
 is necessary that the diet, however dis- 
 gusting, be rigidly persevered in. When 
 the excessive appetite and thirst abate, 
 when the urine is diminished, and its sac- 
 charine properties disappear, we know the 
 disease to be yielding ; and a gradual ad- 
 mixture of animal and vegetable food may 
 now be ventured upon, with an allowance 
 of wine or porter. The use of bark and 
 other tonics must be continued, and at- 
 tention paid to the bowels. The disease 
 has very rarely been cured; the cases 
 which seemed to do best, were those 
 which were treated with the animal diet, 
 and the frequent exhibition of Dover's 
 powder. 
 
 Another plan of a very different kind 
 has been proposed for the cure of dia- 
 betes, on the supposition that the in- 
 creased secretion from the kidneys is a 
 proof of inflammation taking place in 
 them. This plan is to employ copious 
 blood-letting. Certainly cases have oc- 
 curred in which this treatment has ap- 
 peared to do good ; but it seems one of 
 considerable hazard, especially in the en- 
 feebled subjects, who are sometimes at- 
 tacked with this singular and intractable 
 disease. 
 
 DIACHYLON. The plaster known 
 in the pharmacopoeia by the name of 
 Emplastrum oxydi plumbi semi-vitrei, 
 and Emplastrum lythargyri. It is made 
 of litharge and olive oil. It is a common 
 application in excoriation of the skin, and 
 for retaining the edges of fresh cut wounds 
 together. It keeps the part warm and 
 defends it from the air. Diachylon forms 
 the basis of various other plasters, as those 
 
Dl A 
 
 DI A 
 
 193 
 
 of assafetida, o^ium, galbanum, aiid tlie 
 adhesive plaster. 
 
 DIAGNOSIS. The power of distin- 
 guishing one disease from others resem- 
 bling it. A very slight "reflection will 
 show the importance of making an accu- 
 rate distinction between similar diseases. 
 Without sagacity and attention to this 
 point, the practitioner may be guilty of 
 the most fatal blunders, and may prescribe 
 opium and stimulants where depletion 
 and sedatives are necessary. Empirics 
 and non-professional people, by their in- 
 attention to diagnosis, prescribe the same 
 remedies in a great variety of different, 
 and even opposite diseases. To form an 
 accurate diagnosis is often one of the 
 most difficult duties which the physician 
 has to perform ; and one which is calcu- 
 lated to call into exercise all the skill he 
 has acquired by his learning, talents, and 
 experience. 
 
 DIAMOND. This precious stone has 
 been ascertained by modern chemists to 
 consist of pure carbon, and to form carbo- 
 nic acid by being burned in oxygen gas. 
 
 DIAPHORETICS. Medicines which 
 promote the perspiration gently, without 
 going the length of sweating ; the medi- 
 cines which promote this being more cor- 
 rectly termed sudorifics. These last, by 
 being given in smaller doses, may be made 
 to act as diaphoretics. In many diseases, 
 restoring the perspiring functions of the 
 skin, and bringing out a gentle moisture, 
 is both an evidence and a cause of the 
 disease yielding. In febrile cases, the 
 skin is dry and parched, and the stomach 
 will retain nothing ; but if we can pro- 
 cure a gentle perspiration, the fever will 
 abate, and medicines will no longer be re- 
 jected by vomiting. We are to be direct- 
 ed in our choice of diaphoretics by the 
 particular symptoms present; thus, if 
 there is great sickness, we would attempt 
 to promote our object by giving medicines 
 in small bulk, as opium and camphor in a 
 pill or small bolus, one grain of opium to 
 three of camphor ; or we would give the 
 saline effervescing draughts, which we 
 expect both to stop the vomiting and to 
 
 determine to the skin. If there be no vo- 
 miting, we may give very small doses of 
 tartar emetic, as one grain dissolved in 
 three ounces of water, of which solution a 
 table-spoonful is to be given every two 
 hours ; and another diaphoretic is, small 
 doses of Dover's powder, as five grains 
 every three or four hours. Keeping warm 
 in bed, and drinking frequently of warm 
 gruel, is an effectual and safe method of 
 procuring perspiration in many cases. A 
 good diaphoretic draught may be made 
 with twenty-five drops of tincture of 
 opium, with forty drops of wine of an- 
 timony or ipecacuan, in an ounce of 
 any convenient fluid, and given at bed- 
 time. 
 
 DIAPHRAGM. The muscular and 
 tendinous expansion which divides the 
 cavity of the chest from that of the abdo- 
 men ; and which is one of the principal 
 agents in respiration. When the breath 
 is drawn in, the diaphragm is brought to 
 a flattened position, and nearly horizon- 
 tal; and when the air is expelled, the 
 contents of the abdomen push the dia- 
 phragm so as to make its middle part con- 
 vex towards the chest. There are cer- 
 tain perforations in the diaphragm, to 
 allow a passage for the tube that conveys 
 the food to the stomach, for the great 
 bloodvessels, and for certain nerves. On 
 the abdominal side, the liver is closely at- 
 tached to a part of the diaphragm. The 
 diaphragm is subject to inflammation and 
 other diseases ; it is a convulsive motion 
 of it that gives rise to hiccup ; and in 
 some rare cases, part of the abdominal 
 bowels have been pushed through the dia- 
 phragm, giving rise to an internal hernia. 
 
 DIARRHOEA, or Looseness of the 
 Bowels. A disease consisting in more 
 frequent and liquid evacuations by stool, 
 than usual. It is distinguished from dy- 
 sentery, by the absence of painful and in- 
 effectual straining, and by the stools not 
 being of a raucous kind ; and from cho- 
 lera, by the feculent nature of the evacu- 
 ations in diarrhoea, by the absence of vo- 
 miting, and by the circumstance of cho- 
 lera being generally brought on by the 
 
194 
 
 D 1 A 11 R II (E A. 
 
 whole system having been long exposed 
 to great heat of weather. 
 
 Causes. The causes of diarrhoea are 
 many and various. 1. Cold applied to the 
 whole body is not an unfrequent cause, 
 and cold applied to the feet alone, in very 
 many cases, produces diarrhoea. 2. Dis- 
 eases of other parts of the body give rise 
 to diarrhoea, as happens to infants while 
 teething, and to persons who have a pa- 
 i-oxysm of gout. 3. Certain emotions of 
 the mind are knoAvn to cause diarrhoea. 
 4. Certain articles of food taken into the 
 stomach produces looseness. 5. Certain 
 secretions of the body itself poured into 
 the intestines, cause a laxity of them. 
 
 Looseness should not be rashly checked. 
 From the great variety of causes induc- 
 ing diarrhoea, it must be obvious that it 
 would be impossible to lay down any plan 
 of cure that would apply to all cases, and 
 it is often a matter of doubt whether it 
 should be meddled with at all : thus, 
 when from a surfeit, either in quantity, 
 or from taking improper articles of food, 
 a diarrhoea is produced, a wise physician 
 will consider it as a salutary effort of na- 
 ture to get rid of what would be noxious 
 if retained ; and he will allow it to go 
 on for a time, taking care to watch that 
 it do not come to excess. Thus, too, if 
 a plump full child, getting its teeth with 
 difficulty, should be seized with looseness, 
 no prudent person would hastily check 
 this, knowing that it is highly salutary in 
 taking off irritations from the brain, and 
 in preventing an undue flow of blood to 
 that important organ. Thus, too, if a 
 person labouring under inflammation of 
 the eyes, or subject to disorders of the 
 head, should be seized with diarrhoea, so 
 far from thinking to check it, we should 
 be inclined to make a. diarrhoea by the use 
 of medicines. 
 
 Treatment of Looseness. Still, how- 
 ever, there are cases where diarrhoea is 
 troublesome, dangerous, and requiring to 
 be stopped ; and of these we are to give 
 some accoimt. If a person finds himself 
 affected with diarrhoea from cold, he is to 
 use warmer clothing, to avord cold to the 
 
 feet, especially with damp; and after a few 
 evacuations, to take some of the chalk 
 mixture, with or without a little of the 
 tincture of opium. If the disease does not 
 yield to this, he is to take some mild but 
 effective purgative medicine, as castor oil, 
 sulphate of magnesia, or compound pow- 
 der of jalap, in order to remove any acri- 
 mony that may be keeping up the dis- 
 charge J and after its operation, he is to 
 quiet the whole by a full dose of opium, 
 either in the form of pill or tincture. 
 When diarrhoea arises from improper food, 
 it is still more necessary to get rid of the 
 offending matters ; and purgatives are to 
 be given, if the body does not seem able to 
 relieve itself, which may be known by the 
 disagreeable putrid belchings, continuing 
 for some days after the improper food has 
 been taken. When the bowels have been 
 sufficiently evacuated, either by their own 
 efforts or when aided by medicine, it will 
 be proper to give opiates, or the chalk 
 mixture, or the tincture or infusion of 
 catechu ; and where there is great laxity 
 of the bowels, long continued, and occa- 
 sioning considerable debility, it may be 
 proper to give the powder or tincture of 
 rhubarb, to endeavour to restore the tone 
 of the bowels. In diarrhoea, we are not 
 unfrequently obliged to have recourse to 
 sedative and astringent injections, com- 
 posed of a small tea-cupful of thin starch, 
 and a tea-spoonful of laudanum, or four 
 ounces of the infusion of catechu, or of 
 kino. In the diarrhoea of children, the 
 chalk mixture is perhaps the safest thing 
 we can employ ; but we must likewise, 
 in obstinate cases, have recourse to tinc- 
 ture of opium and rhubarb, and also to the 
 anodyne injections. 
 
 When diarrhoea is symptomatic of other 
 diseases, we must consider whether it be 
 most prudent to attend to the primary 
 disease, or to use remedies to check the 
 diarrhoea ; and there are certainly many 
 diseases in which this symptom requires 
 to be checked. We should not suffer a 
 patient in dropsy, in diabetes, or in fever, 
 to have his strength irreparably injured 
 by a wasting diarrhoea ; and at the melan • 
 
DIET. 
 
 1»5 
 
 choly close of consumption, it is one of 
 our principal objects, though too often 
 unsuccessful, to stop what has been called 
 the colliquative diarrhoea. A great va- 
 riety of methods have been tried for this 
 purpose ; all have failed ; but the acetate 
 of lead with opium, in the dose of two 
 grains of the acetate to one of opium, has 
 seemed to answer better than any thing 
 else, and no particular inconvenience has 
 followed from the lead. 
 
 DIARRHCEA OF INFANTS. See 
 Looseness. 
 
 DIASTOLE. The action of the heart 
 when its cavities expand to receive the 
 blood ; opposed to systole^ the motion by 
 which they expel it again. 
 
 DIATHESIS. The state of the con- 
 stitution : we speak of the inflammatory 
 diathesis^ or that state in which the sys- 
 tem is prone to inflammation ; or the hy- 
 dropic diathesis^ when there is a tendency 
 to dropsy. 
 
 DIET. Under the term Diet are to 
 be considered those articles, both solid 
 and liquid, which furnish nourishment to 
 mankind; and also those substances 
 which, though in themselves incapable of 
 nourishing, are useful and even necessary 
 to be added to the food, as salt, spices, 
 and other seasonings. It may appear su- 
 perfluous to lay doAvn any rule respecting 
 diet, when we reflect on the countless 
 millions who, led by instinct, or deter- 
 mined by situation and circumstances, use 
 every variety of food, both with respect 
 to kind and quantity ; but it is neverthe- 
 less of consequence to know the effect of 
 particular plans of diet, and even of indi- 
 vidual substances, as much good or evil 
 may be induced on the constitution by 
 certain modes of living. 
 
 If it is necessary to be exact and parti- 
 cular about the kinds and quantities of 
 medicines, it is not less so, to be exact with 
 respect to the diet both in health and 
 sickness. As Huxham observes, it is 
 preposterous to be minute in what we 
 swallow by grains and scruples, while we 
 are incautious in what we swallow by 
 ounces and pounds. A patient may be 
 
 admirably treated by his physician, and 
 yet lose all the benefit of his skill and 
 care, by the ignorance and obstinacy of 
 himself or his attendants, with respect to 
 diet. 
 
 Diet may be considered as including all 
 that part of the medical art which gives 
 directions respecting food and drink, whe- 
 ther for the preservation of health, or the 
 cure of diseases. The diet is derived from 
 the animal and vegetable kingdoms, from 
 each of which a numberless variety of ar- 
 ticles is procured. By the art of cookery, 
 these are varied and combined in an infi- 
 nite diversity of ways. It is sufl&ciently 
 evident by the structure of the teeth of 
 man, of his stomach and bowels, and of all 
 his organs subservient to digestion, that 
 nature intended him to live on food of 
 both kinds, vegetable and animal ; and his 
 limitation or abstinence from the one or 
 the other, is to be regulated solely by his 
 convenience, and by the effect which he 
 finds the different sorts of food to pro- 
 duce on his constitution. Animal food, i 
 being already in great measure prepared | 
 and rendered similar to our blood, re- > 
 quires less exertion of the digestive 
 powers ; but it is found to be heating and 
 stimulating, and hence it should never be j 
 used in inflammatory diseases, or made ( 
 the principal diet in hot climates. Hence 
 the northern nations are benefited by a 
 considerable proportion of animal food, 
 and the nations between the tropics live 
 much on vegetables. There may be certain 
 diseases and habits of body where it may 
 be useful to take a great deal of animal food, 
 but this should be considered as a neces- 
 sary remedy, and be always under the di- 
 rection and superintendence of the physi- 
 cian. With respect to the solid or fluid 
 nature of diet, we may remark, that it is 
 necessary to healthy digestion, not only 
 to have a proper quantity of nutritive 
 matter given to the stomach, but that 
 there be a considerable bulk to give that 
 organ a proper degree of distension ; it is 
 therefore necessary to add to soups and 
 jellies, some bread and other matter to 
 give them bulk. 
 
193 
 
 DIET. 
 
 Of the T>iET proper for different ages. 
 The infant is provided by nature with 
 milk for its nourishment, and farinaceous 
 food may be properly conjoined with it. 
 Little else is required till after the ninth 
 or tenth month. Preparation may now 
 be made for weaning, by giving the child, 
 with his farinacea, a little animal food, as 
 the juices of veal or chicken, or lean beef. 
 If the mother's milk evidently disagrees, 
 and if the farinaceous food produces sour- 
 ness and flatulence, the nurse must either 
 be changed, or a proportion of animal food, 
 as gravy or beef, must form a great part 
 of the diet. When the teeth have come 
 in, children have a desire for other food, 
 and are pleased to exert their powers 
 on soft bread or a bit of meat ; and this 
 may be safely allowed to healthy children. 
 While children are growing, they have 
 very frequent craving for food, and 
 their stomachs have wonderful powers 
 with respect to the quantity they are able 
 to digest. The best proof of the quantity 
 not being excessive, is the growth and 
 healthy appearance of the child, his being 
 lively and active at play soon after his 
 meal, and his sleep being easy and unin- 
 terrupted. It may be plausibly urged as 
 the dictate of nature, that we should not 
 hinder children from eating as often as 
 they choose, and at whatever periods. 
 But as the mind and body must be brought 
 under many restraints, if we wish for our 
 oifspring either good morals or a good 
 constitution, we are inclined to recom- 
 mend the early formation of regular har 
 bits in the period of taking food. If 
 children are allowed to call for food and 
 drink at every half hour when they are 
 idle, and fancy they want them, a very 
 bad habit of indulgence will be induced; 
 and as we can never be sure of the quan- 
 tity and kind of the food which they take 
 in, we may expect some morbid changes 
 to take place in the digestive powers. 
 The regulation of the quality of children's 
 food is of the utmost importance. It is 
 there, more than in quantity, that indul- 
 gent parents are apt to eiT. Sweet meats, 
 butter, pastry, high-seasoned dishes, and a 
 
 great variety of them, ought not to be al- 
 lowed to children. Their unsophisticated 
 instincts do not desire these things, and 
 if they were carefully kept from them, or 
 resolutely denied them, we should consult 
 at once their health and their character. 
 Water, or occasionally small beer, should 
 be their only drink. A habitual allow- 
 ance of wine, except as a medicine, 
 should be strictly forbidden ; and much 
 more, ardent spirits in every shape. Sauces 
 and condiments should rarely be taken 
 by children and young people. 
 
 At a more advanced period, as from 
 eighteen to sixty, if the health be good, 
 there is scarcely any rule to be given for 
 diet, except to enjoin moderation. It has 
 been plausibly enough inculcated, that we 
 should confine ourselves at dinner to one 
 dish only, whether it be of fish or other 
 animal food. Undoubtedly, this is an ex- 
 cellent advice, conducive both to health 
 and temperance, provided a person finds 
 that his digestion goes on properly ; but 
 many experience, that their stomachs 
 agree best with some variety in the ar- 
 ticles of their food, provided that the quan- 
 tity taken be not too copious. The drinks 
 that may be used by adults are very nume- 
 rous ; some of them have their advantages, 
 others their inconveniencies. Water, for 
 the healthy and active, is the drink prescrib- 
 ed by nature, and will never injure them ; 
 and it is happy for any individual to be 
 quite independent of any other drink. But 
 amid the great variety of other fluids 
 which Providence has bestowed on the 
 industry of man, there are many that 
 agree well both with the palate and the 
 constitution, and which, when not taken 
 in excess, or at improper times, contribute 
 much to his health and comfort. Good 
 small beer is an excellent drink; its 
 slight bitterness assists digestion, it is 
 cooling and antiseptic, and it, in some 
 cases, tends to keep the bowels easy. By 
 those who are troubled with flatulence it 
 should be avoided. Ale and porter are 
 considerably nutritious, and should be 
 avoided by those who are inclined to be- 
 come corpulent, and who take little ex- 
 
DIET. 
 
 197 
 
 ercisc. Wine is to be preferred to spi- 
 rits, even when they are much diluted. 
 Though there is much spirit in some 
 wines, yet they contain extractive mat- 
 ter and mucilage, which hinders the spirit 
 from producing" the bad eflfects which it 
 would do in the same quantity obtained 
 by distillation. Though we cannot wish 
 to encourage the use of ardent spirits, we 
 admit that with very many persons, they 
 do no harm when taken in small quantity ; 
 but the compendious drunkenness which 
 they produce, presents an overpowering 
 temptation to the vacant and unprincipled 
 mind to exceed the bounds of moderation ; 
 and when these are habitually passed, the 
 character and health may be regarded as 
 being in the most imminent danger. The 
 different kinds of spirits, brandy, rum, 
 gfin, &c. agree in their general effects; 
 brandy is best for weak stomachs, and gin 
 for those who require the kidneys to be 
 stimulated; but when those or the neigh- 
 bouring organs are irritable, gin is bet- 
 ter avoided. 
 
 In old age, the diet ought to be less 
 heating than in the vigour of life. The quan- 
 tity of animal food should be diminished, 
 and the stomach should not be overloaded 
 with a variety of high-seasoned food and 
 dressed dishes. Though the relish for 
 wine is less, it should be continued, in 
 moderate quantity, for its cordial effects. 
 
 Diet in different Climates. In tropi- 
 tal climates, the perspiration is abundant, 
 and the fluids are acrid. A copious diet 
 of animal food would therefore be im- 
 proper, and would predispose the system 
 to inflammatory and putrid diseases. Na- 
 ture has therefore bountifully supplied 
 Avarm climates with the most delicious 
 cooling fruits, as the orange, the lemon, 
 the pine-apple, the mangostein; and as 
 the heat debilitates the digestive powers, 
 she has also made the tropical regions the 
 birth-place of the spices and aromatic 
 condiments, which so materially assist in 
 the process of digestion. A caution has 
 very properly been suggested on this sub- 
 ject by Dr. Pair. " If the stranger to 
 tropical regions indulges in fruits when 
 
 he first goes to them, he will find himself 
 in error. Old habits are not easily con- 
 quered, and the constitution will not 
 change at once with the climate. The 
 bile soon becomes more acrid ; and this, 
 with fruit in excess, occasions cholera or 
 bilious fevers. Some proportion of the 
 usual stimuli are also essential, and the 
 spices, T^'ith a moderate proportion of 
 wine, are at first necessary. When the 
 constitution is more accustomed to the- 
 climate, he may indulge more freely, but 
 excess in hot climates should be avoided.'* 
 From personal experience, we can bear 
 testimony most cordially to the truth and 
 judiciousness of these observations. The 
 diet in colder climates should be more 
 generous and nourishing ; spices and wine 
 are proper ; and in the bleak and moun- 
 tainous parts of our Caledonian regions, 
 the inhabitants use with impunity a quan- 
 tity of ardent spirits, which appear enor- 
 mous to their southern visitants. 
 
 Of the Times of taking Food. The 
 various occupations and circumstances of 
 mankind, render it impossible and useless 
 to lay down any general rules for the pe- 
 riods of taking food. Reason would dic- 
 tate very different modes and times from 
 those which fashion and custom have pre- 
 scribed. The hour of rising should be six 
 or seven, and brealifast should be taken 
 about two hours afterwards. With many 
 persons the powers of the constitution 
 are languid and feeble ; and even at the 
 end of two hours they have little appe- 
 tite for breakfast ; while others are re- 
 cruited and invigorated by a moderate 
 meal very soon after rising. The break- 
 fast should be substantial, in proportion to 
 the labour to be undergone during the 
 early pai't of the day ; and in proportion 
 to the time that must elapse before food 
 can again be taken. The best time of 
 taking the principal meal is between one 
 and two ; but the necessities of business, 
 and the mandate of fashion, have render- 
 ed this impossible for any but the labour- 
 ing classes; while those employed in all 
 the varieties of mercantile occupations, 
 and who must make t^eir hours to suit 
 
198 
 
 DIET. 
 
 the convenience of the big-her ranks, are 
 oblig-ed either to fast till four or five 
 o'clock, or be content with a hasty lun- 
 cheon. Those who have their time more 
 at their own disposal, make their lun- 
 cheon a plain but copious meal ; and in 
 such, it would be a wise plan to dispense 
 with the late dinner altogether. As it is, 
 they either make it a supper, for which 
 it is by far too copious and too stimulat- 
 ing- ; or if they do not retire to rest for 
 five or six hours after dinner, they are 
 over-excited by the wine and stimulants 
 they use, or by the hot and crowded 
 rooms which they frequent : hence the 
 constitution is exhausted, and the orderly 
 and healthful plan of life is totally invert- 
 ed. Retiring to rest with the stomach 
 loaded with a hearty meal, is a sure way 
 of occasioning feverish restlessness. Co- 
 pious suppers are therefore to be avoided ; 
 and some light food near bed-time is to be 
 preferred. 
 
 Consequences of Errors in Diet. To 
 enumerate all these, would be to give a list 
 of the greater nimiber of diseases which 
 afflict humanity. In early life, the state 
 of the stomach, of the chylopoetic viscera, 
 and of the bowels, is so delicate and easily 
 disordered, that a great proportion of the 
 diseases of children may be traced to er- 
 rors in their diet. To these we ascribe 
 their green and sour stools, their flatu- 
 lence and griping pains, their skin-dis- 
 eases, and sometimes water in the head 
 and convulsions. In more advanced life, 
 irregularities in diet, and habitual indul- 
 gence in too much and too luxurious food 
 and drink, lay the foundation for gout, 
 liver-disease, dropsy, apoplexy, palsy, 
 stomach complaints, and the long train of 
 what are called nervous diseases. Occa- 
 sional excesses in eating occasion colic, 
 diarrhoea, sick headach, apoplexy ; and a 
 debauch in drinking too often destroys 
 life, or brings on madness. 
 
 Of the Diet in Sickness. The regu- 
 lation of the diet in disease is a matter of 
 primary importance. In many diseases, 
 health may be restored by abstinence, or 
 a properly regulated diet; and in others, 
 
 the resources of physic will be unavailing 
 if the diet be not carefully attended to. 
 In fever, there is commonly an aversion 
 to food, which the stomach could not di- 
 gest, and which would only act injurious- 
 ly on the system. In many inflammatory 
 diseases, the same salutary instinct oc- 
 curs : but in some there is no dislike to 
 food ,* and the friends of the patient sup- 
 posing him to be weak, give food or sti- 
 mulating drinks, with the certainty of 
 aggravating the disease. In the great 
 majority of diseases having febrile symp- 
 toms, a spare diet and abstinence from 
 wine, porter, spirits, and the like, are ab- 
 solutely necessary. In chronic diseases, 
 and those attended with debility, a more 
 generous diet is to be allowed. In sto- 
 mach complaints, the most important part 
 of the physician's office is to regulate the 
 diet. In the puerperal state, the recovery 
 is essentially aided by avoiding all irregu- 
 larities in food and drink ; while the most 
 dangerous and fatal disorders are brought 
 on by imprudent indulgences. We have 
 given, under the various diseases in dif- 
 ferent parts of the work, particular direc- 
 tions for diet in those cases where the 
 consideration of this subject is essential. 
 
 Diet of Convalescents' Great atten- 
 tion is necessary in regulating the diet of 
 those who are recovering from sickness. 
 After a long and debilitating ilhiess, the 
 convalescent's appetite is sometimes keen, 
 and even voracious ; but it is highly dan- 
 gerous to indulge this appetite, or to com- 
 ply with the kind wishes of his friends, 
 who are desirous to see him quickly re- 
 stored to health and vigour. The sto- 
 mach is unable to digest the quantity of 
 food taken, and its over-stimulated 
 powers become exhausted; some other 
 disease, or a relapse of his former one, 
 comes on ; and he finds it unsafe to tax 
 nature beyond her strength. A sudden 
 transition from full and luxurious living 
 to great abstinence is not a safe measure. 
 Some have resolutely made the change 
 suddenly and with impunity ; but it suc- 
 ceeds better when established habits are 
 not too hastily broken in upon. 
 
DIET. 
 
 199 
 
 Of the Seasonings used with Diet. It 
 IS ascertained, even by the instincts of the 
 lower animals, that various substances, 
 which themselves afford no nourishment, 
 are necessary to be taken along vdth the 
 food. They correct the putrid tendency 
 of the aliments, and they materially assist 
 the stomach in the function of digestion. 
 Many of them afford an agreeable flavour 
 to what would otherwise be insipid : but 
 often also, they lead to the consumption of 
 an immoderate quantity, by " tickling the 
 palate when the stomach is sufficed." 
 The condiments in most frequent use are 
 those which are used to prevent the pu- 
 trefaction of meat, or which are added to 
 food while cooking, or which are eaten 
 at table. The putrefaction of meat is-re- 
 tarded by vinegar, by salt, by nitre, by 
 sugar, and by being smoked ; and meat 
 preserved by any of these means is not 
 rendered difficult of digestion, unless the 
 process is carried so far as to dry and 
 harden it; and salt assists in digestion 
 whether the meat be preserved by it, or 
 it be added to the food when it is eaten. 
 The condiments added in cookery, or 
 eaten at the table, are chiefly salt, vine- 
 gar, pickles, spices, ketchup, mushrooms, 
 oil and sugar, with some sharp-tasted 
 roots, and other parts of plants. Salt is 
 the universal and necessary seasoner, in- 
 dispensable alike to man and animals. Its 
 excess or long continued use, (at least with 
 provisions in long sea-voyages,) brings 
 on sea-scurvy. Vinegar is a good condi- 
 ment, and rarely hurts the stomach if it be 
 taken in moderate quantity and in a good 
 state. It is a natural, but a groundless 
 fear, that it will increase the tendency to 
 acidity ; for though itself sour, it prevents 
 the acetous fermentation of the alimentary 
 mass, and with animal food it does no 
 harm. With vegetables it does not seem 
 to do so well. Vinegar renders shell- 
 fish less easily digestible. Pickles are 
 vegetable substances preserved by salt and 
 vinegar. Such a combination renders the 
 vinegar more indigestible, and the vege- 
 tables are not improved by it. Different 
 vegetables used as salads, ttre to be class- 
 
 ed with condiments. The quality of let- 
 tuces is slightly soporific ; endive and ce- 
 lery are sharp, but are corrected by blanch- 
 ing. Salads are very wholesome to the 
 young and robust, but must be avoided 
 by dyspeptic patients. The sliced cucum- 
 ber requires the aid of pepper and spices, 
 even in very powerful stomachs. Spices 
 have the effect of rendering the food 
 pleasant to the palate, and by their action 
 on the stomach enable it to digest more 
 easily. A moderate use of spices is not 
 to be forbidden j but when they tempt to 
 long continued gluttony and drunkennessi, 
 fever, gout, or apoplexy may be the con- 
 sequence. The spices in most common 
 use are common pepper, Cayenne pepper, 
 ginger, mace, and pimento. Common 
 pepper seems to be a very safe spice, and 
 ginger is an excellent addition to melons 
 and such fruits, or to cold and flatulent 
 drinks. The nutmeg is very popular, 
 especially among the female sex, but 
 should be used cautiously in the puerpe- 
 ral state. There are various vegetables 
 of our own country, which ai'e used with 
 food as condiments ; such are horse-ra- 
 dish, cresses, the capsules and seeds of 
 the nasturtium, and the flour of mustard 
 seed. They are in general very whole- 
 some. Wines and Spirits are also taken 
 as condiments. We have in more places 
 than one stated their advantages and in- 
 conveniencies. 
 
 On the subject of diet, and especially 
 on provocatives, the moralist has some- 
 thing to say as well as the physician. In- 
 dustry and temperance have their reward 
 in active vigour, refreshing sleep, and easy 
 digestion; when the stomach is neither 
 overloaded by excess, nor bribed by spices. 
 On the other hand, when the pleasure of 
 eating is made a primary object, and in- 
 dolence and sensuality neglect the due ex- 
 ercise of the body, the stomach is tardy 
 and irregular in performing its functions, 
 and needs to be solicited by all the arts of 
 the cook, and by condiments, for which 
 all the kingdoms of nature have been ran- 
 sacked. The powers of digestion are im- 
 paired, the body becomes bloated and un- 
 
200 
 
 DIGESTION. 
 
 healthy ; and diseases of various kinds ex- 
 act a rigorous compensation for the M'aste 
 of those resources of the constitution, 
 which have been so improvidently and 
 prematurely expended. 
 
 DIGESTER, PAPIN'S. An iron ves- 
 sel for boiling bones and other substances, 
 in order to extract completely some of 
 their ingredients. It is furnished with a 
 strong covering fixed down with a power- 
 ful screw, which prevents the steam from 
 escaping, and enables us to apply heat at 
 a much greater degree than 212", the tem- 
 perature beyond which boiling water can- 
 not rise in common vessels. 
 
 DIGESTION. This term is used in 
 an extended sense to signify the whole of 
 that process by which the food, taken in- 
 to the stomach, whether liquid or solid, is 
 fitted for nutrition ; and by which those 
 parts of the food that are unnecessary are 
 thrown out of the body. The organs des- 
 tined for those purposes are numerous and 
 important. They consist of a long canal, 
 called the alimentary canal, extending 
 from the mouth to the anus ; of various 
 glands or organs, which secrete or form 
 from the blood, certain fluids which are to 
 act upon or to be mixed with the alimen- 
 tary matters ; of vessels of various dimen- 
 sions, to convey to the current of the cir- 
 culation the nourishing fluid formed by 
 the preceding operations which the food 
 has undergone ; of the lungs, one of whose 
 functions is to mix thoroughly with the 
 blood the nutritious fluid, and to complete 
 its assimilation; and of the kidneys and 
 skin, by which a portion of the excremen- 
 titious matter is carried oiF. Digestion is 
 sometimes employed in a more limited 
 sense, to mean that part of the process 
 which goes on in the stomach, or at most 
 in the alimentary canal ; and both in me- 
 dical and popular language it seems to be 
 used in this restricted sense. Thus, when 
 a person is troubled with sourness of sto- 
 mach, heartburn, and flatulence, we say 
 his digestion is bad. 
 
 The various organs concerned in diges- 
 tion are not only intimately connected to- 
 gether, but exert a very general influence 
 
 over the whole system. The stomach, in 
 particular, has a most universal sympathy, 
 as there is hardly an organ of the body 
 ^vhich is not affected, directly or indirect- 
 ly, by its operations ; either food or medi- 
 cine put into it has an influence on the re- 
 motest parts of the body; and many dis- 
 eases are brought on, and cures effected, 
 through the m^ans of its sympathies. On 
 the other hand, the stomach is affected by 
 the injuries and diseases of other parts, as 
 is frequently seen in the diseases brought 
 on by injuries of the head; in sprains 
 and other injuries of tendinous parts ; and 
 in the long train of dyspeptic symptoms 
 brought on by uterine complaints. 
 
 We shall proceed to give a slight de- 
 scription of the parts above enumerated, 
 and then mention the processes which take 
 place in digestion. 
 
 I. The alimentary canal. As we liave 
 stated above, this term means the whole 
 extent from the mouth to the anus, but is 
 more commonly used to express the sto- 
 mach and intestinal tube. The length of 
 the intestines is about six times the length 
 of the subject to which they belong. They 
 are a long canal twisted upon itself, of 
 various dimensions in different parts, and 
 having a peculiar motion arising from the 
 successive contraction of longitudinal and 
 circular muscular fibres, by which the 
 contents are kept moving onwards in one 
 direction, in the healthy state. This mo- 
 tion is called the peristaltic motion. The 
 stomach is a membranous bag resembling 
 the pouch of a bagpipe, having two open- 
 ings, one at the termination of the gullet, 
 just below the diaphragm or midriff, which 
 separates the chest from the belly, and an- 
 other at the commencement of the intes- 
 tines. By the first, matters are introduced 
 into the stomach, and by the second they 
 are discharged from it. This bag, as is 
 well known, is capable of receiving into it 
 a very large quantity of matter, and it must 
 vary in its position according to the de- 
 gree of its distension. When the stomach 
 is dilated, its large extremity is pushed a 
 good deal to the left side, the belly pro- 
 jects out, the breathing is a little difficult, 
 
DIGESTION. 
 
 201 
 
 from the stomach pressing upon the dia- 
 phragm. Tlie inner surface of the sto- 
 mach has a whitish red appearance, and 
 has numerous folds, hy which its capacity- 
 is accommodated to the hulk of its con- 
 tents, and by which likewise it retains 
 the food till it he properly prepared for 
 its next stage. The stomach is abun- 
 dantly supplied with bloodvessels and 
 nerves, for the transmission of nourish- 
 ment and vital energy. At its right extre- 
 mity is a ring of fibres called the pylorus^ 
 a term signifying a porter ; metaphorically 
 applied to denote the sagacious refusal 
 of that part to transmit alimentary mat- 
 ters from the stomach, before they have 
 been properly elaborated. The portion of 
 intestines next the stomach is called the 
 duodenuniy and is about twelve inches 
 long. The changes which the aliment 
 here undergoes, are very important. 
 There are two openings into it, by which 
 the bile and pancreatic juice are admit- 
 ted ; its inner membrane has many circu- 
 lar folds which increase its surface, and 
 prevent the too r.npid passage of its con- 
 tents. The Jefunum is the portion of in- 
 testine next in continuation to the duo- 
 denum, and is followed by the ileum, the 
 last and the longest division of the small 
 intestines. Next come the large intes- 
 tines, whose diameter greatly exceeds that 
 of the others, but whose length is much 
 less. At the beginning of the large in- 
 testines, is a valve so placed as to allow 
 the matters to be propelled from the 
 small intestines, but not to regurgitate ; 
 though in very severe attacks of the iliac 
 passion, this valve fails to perform its 
 usual ofiSce. The commencing portion of 
 the great intestines is called the ceecum, or 
 caput ccecum of the colon, which colon is 
 situated in the cavity of the haunch-bone 
 on the right side ; thence it ascends by 
 the kidney on the same side, passes un- 
 der the concave side of the liver ; it runs 
 across the belly, under the stomach, to the 
 left side, thence passes down, and termi- 
 nates in the rectum, or straight gut. The 
 longitudinal muscular fibres of the colon 
 form three straight bundles, and the cir- 
 
 cular fibres also form bands, which are 
 pretty numerous. This structure puckers 
 the colon into distinct cavities, called its 
 cells ; these occasion the gradual descent 
 of the excrement, and give it figure ; but 
 in a torpid state, the cells give occasion 
 to an undue retention and accumulation of 
 feculent matter. When the colon is thus 
 distended, it gives rise to many bad effects, 
 by its pressing on the numerous and im- 
 portant organs with which it is in contact. 
 The rectum is the last portion of the in- 
 testinal tube ; at its termination it is close- 
 ly connected with the bladder in men, and 
 with the vagina in women ; and there is 
 a remarkable sympathy between all these 
 contiguous parts. The rectum is capable 
 of very great distension, even to the size 
 of a large bladder, and the quantity of 
 stool which accumulates is sometimes 
 enormously great. 
 
 II. The second division of the organs 
 necessary for digestion, is that of the va- 
 rious glands, which prepare fluids to be 
 employed in that process. The first fluid 
 necessary in the process of digestion is the 
 saliva, or fluid formed in the mouth. This 
 is not only necessary when we are chewing 
 the food, but also to be swallowed at other 
 times, both to lubricate the passage and to 
 be mixed with the food in the stomach. 
 Thus we see that those who spit much, 
 as maniacs, have their digestion impaired. 
 During a meal, the quantity of this fluid is 
 much increased, both from the stimulus 
 imparted by the food, and from the mecha- 
 nical force exerted in chewing. The saliva 
 is a compound fluid, being composed of 
 mucus and a peculiar matter; and several 
 conspicuous effects are produced on it by 
 disease. Hence the disagreeable taste 
 frequently complained of by patients, and 
 hence the various appearances of the 
 tongue, most of which are to be referred 
 to changes in the chemical character of 
 the saliva. The next fluid which the food 
 meets with, is that formed in the stomach, 
 commonly called the gastric Juice. This 
 liquor is mixed in the stomach with the 
 saliva and mucus; but itsow^n powersareof 
 a very surprising nature. It differs in diffe- 
 
202 
 
 DIGESTION. 
 
 rent animals, and probably in the same sto- 
 mach at different times. It acts as a solvent 
 on a great variety of substances, and in the 
 dog it acts upon bones. It has the poM'er 
 of coagulating- milk and some other fluids 
 in a remarkable degree. A few grains of 
 the inner coat of the stomach, infused in 
 water, produce a fluid capable of coagu- 
 lating several pounds of milk. It is thus 
 that milk is curdled by rennet, or the in- 
 fusion of a portion of the stomach of the 
 calf. The gastric juice has the power of 
 resisting and correcting putrefaction. The 
 small intestines secrete a peculiar liquid, 
 the properties of which are little knoAvn. 
 Another very important and conspicuous 
 fluid engaged in digestion is the bile, 
 which is secreted by the liver, the largest 
 gland in the body. The liver is situated 
 principally under the ribs, on the right 
 side ; it has arterial blood for its nourish- 
 ment; and the venous blood which has 
 circulated through the greater part of the 
 intestines, goes into the liver for the pur- 
 pose of the bile being secreted from it. 
 From the liver, there proceeds one duct 
 conveying bile into the intestine, and 
 from this a duct branches off, leading to 
 a receptacle called the gall-bladder; so 
 that when the bile does not get into the 
 intestine, it can regurgitate into the gall- 
 bladder; and when pressure is made on the 
 gall-bladder by the distended stomach, bile 
 can pass along the common duct to the 
 duodenum. The duct perforates that in- 
 testine obliquely, and the bile is thus pre- 
 vented from flowing out of the intestine 
 again. Bile is of a yellowish green, and 
 sometimes of a brown colour; its consist- 
 ence is viscid, and its taste bitter and 
 pungent. The fluid secreted by the pan- 
 freas flows into the duodenum by a duct 
 situated close to the gall-duct. Its nature 
 ^nd uses are not distinctly known. In 
 the large intestines, there is very little 
 fluid secreted. 
 
 Having thus mentioned the organs and 
 fluids prepared for digestion, we shall now 
 give some account of the process. The 
 food being ijoasticated by the teeth, and 
 y\'e\l mixed with saliva, passes into the 
 
 stomach, the glands of which sympathize 
 with those of the mouth, and pour out the 
 fluids in greater quantities, when the sti- 
 mulus of the food is applied to them. 
 When the food reaches the stomach, it 
 seems to remain there for a short time 
 without undergoing any change ; but after 
 a time, which varies according to the food 
 and other circumstancies, the superfluous 
 watery portion is thought to be separated 
 by the large extremity of the stomach, 
 while the more solid portions are trans- 
 mitted to the other part of the stomach, 
 there to be converted into a substance 
 called chyme -, a kind of homogeneous 
 paste, greyish, of a sweetish taste, slightly 
 acid, and retaining some of the properties 
 of the food. During the conversion of 
 the food into chjrme, both orifices of the 
 stomach are closed. The principal means 
 employed for this conversion, are the sol- 
 vent powers of the gastric juice and the 
 motions of the stomach. The period ne- 
 cessary for the formation of chyme varies 
 according to the nature and volume of the 
 food, the degree of mastication and mix- 
 ture with the saliva, and the activity of 
 the stomach. The whole of the aliment 
 is not changed at once, but successive 
 portions are passed through the pylorus 
 into the duodenum, where farther changes 
 take place. The sensibility of the pylo- 
 rus is such that it refuses egress to those 
 portions of the food which are not con- 
 verted into chjmae. After the chyme has 
 passed into the duodenum, it mixes with 
 the peculiar fluid secreted by that portion 
 of the intestine, and passing on a little fai'- 
 ther, it is mixed with the bile and pan- 
 creatic juice. It now assumes a yellow 
 colour and a bitter taste, its sharp odour 
 is diminished, and it is converted into 
 chyle, a substance more nearly approach- 
 ing the animal nature ; while the useless 
 and excrementitious part of the chyme is 
 separated. When perfectly formed chyle 
 is extracted from a living animal, it be- 
 comes firm, and almost solid ; gradually se- 
 parates into three distinct parts, the one 
 solid, which remains at the bottom of the 
 vessel ; the second liquid, and a third that 
 
DIGESTION. 
 
 2()J 
 
 forms a very thin layer at the surface. 
 Of the three parts into which the chyle 
 separates, that on the sui*face is of an 
 opaque white ; it imparts to the fluid the 
 appearance of milk, and is of a fatty na- 
 ture. This fatty part is very ahundant 
 when the food has contained grease or 
 oil. The more solid part of the chyle 
 contains a mixture, intermediate between 
 albumen and fibrin. Some species of 
 chyle contain very little of this, and then 
 the liquid part of the chyle resembles the 
 serum of the blood. When the chyle is 
 formed, it is taken up from the intestines 
 by innumerable vessels called lactealsy 
 from the milky looking- fluid which they 
 convey; by them it is carried through 
 certain glands situated in the mesentery, 
 or that fine membrane to which the long 
 intestines are attached. It is thought 
 probable, that those glands operate some 
 important though unknown change on 
 the chyle. Hence it is carried by the 
 same sort of vessels to the thoracic duct, 
 which also receives the lymphatic fluid, 
 or that taken up from various cavities, 
 as broken down and useless, to be dis- 
 charged from the system. The chyle being 
 mixed with this absorbed fluid, they are 
 carried together to the lungs, where the 
 supply of new matter is incorporated with 
 the circulating blood, and the useless part 
 is exhaled along with the vitiated air. 
 
 The part of the aliment which is fit for 
 repairing the waste of the body being 
 thus applied, the excrementitious part 
 which the lacteals refused to take up, is 
 pushed onward by the peristaltic motion 
 of the intestines, into the coecum above 
 mentioned ; its return being prevented by 
 the valve of the colon. Here is acquired 
 the peculiar smell of excrement ; here it 
 accumulates for some time, and often to 
 a considerable bulk, owing to the delay 
 occasioned by the cells and compartments 
 of the large intestines ; till having entered 
 the rectum, and by its bulk distending 
 that portion of the gut, or ii-ritating it by 
 its acrimony, there is an uneasy sensation, 
 and a desire of its relief. On many occa- 
 sions, this uneasy feeling is not so great 
 
 but it may be resisted ; and the intestine 
 ceasing to feel the distension, the desire 
 of evacuation ceases, and may not recur 
 for some time. The consistence of the 
 excrement has considerable effect here; 
 we are less able to retain thin or fluid 
 stools than solid ones. There is great 
 variety in the intervals at which different 
 persons evacuate their bowels. The most 
 usual and healthy period is once in twenty- 
 four hours, but some persons do it only 
 every second day; others once a-week. 
 The regularity of the bowels also depends 
 much on habit, and it is of great benefit 
 to solicit nature at a certain time ; wheu 
 this habit is established, the inclination 
 will generally return at the usual hour. 
 
 The process of digestion above described 
 is applicable chiefly to solid food ; but a 
 great deal of our aliment is taken in, in 
 the form of liquids, as milk, broths, &c. 
 When a liquid having nutritive matter 
 dissolved in it, is introduced into the sto- 
 mach, it is either coagulated by the gas- 
 tric juice, or its watery part is absorbed ; 
 and the solid matter is deposited, and 
 changed in both cases into chyme. JVIilk 
 is coagulated before being changed into 
 chyme, and broths have their watery part 
 absorbed ; and the gelatine, fat, and other 
 solid parts they contain, are then changed 
 into chyme. Wine and fermented liquors 
 undergo a similar change; their alcohol 
 coagulates a portion of the joiices found 
 in the stomach, and this, with the other 
 portions of the liquid, is digested. Oil, 
 though fluid, is not absorbed, but is en- 
 tirely transformed into chyme. But it is 
 not every stomach, nor the same stomach 
 at all times, that can digest oil; the quan- 
 tity also that it can manage is limited, ancl 
 the overplus getting down into the bowels, 
 proves laxative. Hence the utility of cas- 
 tor oil as a medicine, and hence many 
 stomachs throw it up at first. These are 
 the principal circumstances connected with 
 the important function of digestion. The 
 inconveniences arising from its diseased 
 state, with the methods of relief, will be 
 found fully detailed under the article Sto- 
 mach Complaints, or Dvbpivpsa. 
 
sol 
 
 DIL 
 
 DIN 
 
 DIGESTION, in chemistry and phar- 
 macy, signifies the subjecting of bodies to 
 the action of dissolving fluids, and aiding 
 the extraction of some of their principles 
 by a gentle heat, between 60" and 90° of 
 Fahrenheit's thermometer. 
 
 DIGESTIVES. A term applied by 
 the older surgeons to substances which 
 were believed to have the power of pro- 
 moting suppuration in wounds and ulcers. 
 It is now disused. 
 
 DIGITALIS PURPUREA. The bo- 
 tanical name for a plant which furnishes 
 a very remarkable and powerful medicine. 
 See Foxglove. 
 
 DILL, Anethum graveolens^ is an um- 
 belliferous plant, the taste of whose seeds 
 is moderately warm and pungent ; their 
 smell is aromatic ; and they are used as a 
 carminative. The distilled water is a va- 
 luable medicine for this purpose, in the 
 flatulent colics of children. A little of 
 the powder of the seeds is also given to 
 them in their food. We may mention 
 here a kindred medicine, the Anise, from 
 the Pimpinella Anisum. The seeds are 
 warm and carminative ; rectified spirit 
 extracts the whole of their' flavour ; wa- 
 ter takes but little of it. Anise is used 
 for the same purposes as dill. 
 
 DILUENTS. Watery liquoi-s which 
 are believed to increase the fluidity of the 
 blood, and to diminish the acrimony and 
 viscidness of several of the secreted or 
 excreted fluids. Simple water-gruel, weak 
 tea, and a great variety of such liquors, 
 are much used as diluents. Such drinks 
 are especially required in febrile diseases, 
 both as removing the irritation caused by 
 thirst, and as diluting the acrimony of the 
 contents of the stomach and bowels, and 
 as facilitating the perspiration. In various 
 diseases of the stomach and bowels, di- 
 luents are very useful, by mixing with 
 the bile and other fluids, and rendering 
 them more mild. They may also assist 
 in digestion, by rendering the chyme and 
 the chyle thinner and more easily ab- 
 sorbed by the lacteals. As watery fluids 
 pass ofi* readily by the kidneys, they aie 
 of great utility in diseases of the urinary 
 
 organs and of tlie bladder. Though it 
 may seem a good rule, to let the salutary 
 instinct of nature for diluents in feverish 
 disorders be gratified, yet, as a large quan- 
 tity of fluid will, for a time, distend the 
 bloodvessels, and so increase the action of 
 the heart and arteries, it may be prudent to 
 restrain the appetite of thirst in those in- 
 flammations where we combat the disease 
 by large bleedings. It will be better, in 
 such cases, to allay thirst by very small 
 quantities of fluid, or by eating fruits 
 either fresh or preserved. The tempera- 
 ture of diluting fluids is to be regulated 
 by the state of the body at the time of 
 giving them. In the cold or shivering 
 stage of a ^disease they should be hot ; 
 when the heat is great and the skin dry, 
 they should be cold ; and in most other 
 cases they should be tepid. See Drinks. 
 DINNER is the principal meal in mo- 
 dem times, and the one at which luxury is 
 chiefly indulged in. Much disease arises 
 from the mismanagement of dinner, both 
 as to time, and to the quantity and variety 
 of food that is taken. Physicians cannot 
 lay down any general rule for the time at 
 which persons should dine; the hour 
 vrhen nature requires it, and the period 
 which is most adapted for it, as furnishing 
 a supply of aliment before the exhaustion 
 of the powers has proceeded too far, would 
 seem to be two hr tliree o'clock -, but in- 
 dividuals vary in their habits, in the kind 
 of breakfast they take, and in their powers 
 of digestion ; all which are to be taken 
 into account by the medical man who 
 gives his advice on the subject. Some 
 persons much troubled with indigestion, 
 are relieved by the simple expedient of 
 taking their dinner sooner or later, as 
 they find upon trial what time agrees 
 best ; and much may be done to relieve 
 stomach complaints by diminishing the 
 quantity of food and drink taken at din- 
 ner. Late copious dinners are really no- 
 thing else than heavy suppers, and in all 
 likelihood will produce restlessneSvS, night- 
 mare, and various unpleasant symptoms. 
 The dinners of children should always be 
 in the middle of the day. 
 
DISLOCATION. 
 
 205 
 
 DIPLOE. The skull is not composed 
 of bones simple and uniform throughout 
 their thickness, but of two plates, between 
 which is interposed a cellular texture, 
 called the diploe. 
 
 DIPLOPIA. Double vision; common- 
 ly the effect of accident, injuring- either 
 the brain, or the eye and its appendages ; 
 sometimes the consequence of internal 
 disease about the optic nerves ; not unfre- 
 quently one of the symptoms of water in 
 the head. It is to be cured, by curing, if 
 we can, the original disease. 
 
 DISCUSS. To occasion the disap- 
 pearance of a tumour, without wound or 
 ulceration. Medicines supposed to have 
 this power are called discutients ; but 
 this last term is not very commonly ap- 
 plied in modern surgery. 
 
 DISLOCATION. When the articu- 
 lar surfaces of bones are forced out of 
 their proper place, the accident is term- 
 ed a dislocation or luxation. The loose 
 joints which admit of motion in every 
 direction, as the shoulder-joint, and the 
 hip-joint, are those which are most fre- 
 quently dislocated; while those which 
 move like a hinge, as the knee-joint and 
 elbow, are more rarely dislocated, and 
 require an Unusual degree of violence to 
 accomplish it. Dislocation may be com- 
 plete, as when the ar^culating surfaces 
 are quite separated ; or incomplete, when 
 a part still remains in contact with its 
 neighbouring bone. The dislocation of 
 the round-headed bones may take place 
 in every direction, that is, they may be 
 pushed backward, forward, up wai'd, down- 
 ward, or in any part of the circumfer- 
 ence. The other kinds of joints are ca- 
 pable of dislocation only backward, for- 
 ward, and to either side. When a dislo- 
 cated bone has been restored to its place, 
 it is said to be reduced; and the ease 
 with which this is accomplished depends 
 much on the length of time which has 
 elapsed since the accident. When bones 
 have been out of their place for a few 
 days, their reduction becomes very diffi- 
 cult ; and when the time is very long, it 
 is impossible. The soft parts and the 
 
 bone accommodate themselves to the al- 
 tered position. In several cases, the open- 
 ing in the capsular ligament becomes clos- 
 ed, and will not allow the bone to return 
 into its place ; or adliesions may be form- 
 ed between the bones and the place to 
 which it has come. For this reason, 
 when a person has had the misfortune to 
 dislocate a joint, he should immediately 
 apply for assistance to have it reduced if 
 possible, before swelling and inflamma- 
 tion of the parts, or any other untoward 
 consequence, render reduction difficult or 
 impossible. In cases of very great exter- 
 nal violence, it sometimes happens that 
 not only is the joint luxated, but an ex- 
 ternal wound is inflicted, by which the 
 danger and severity of the symptoms are 
 exceedingly increased ; and in some cases, 
 so great is the danger of a wounded joint, 
 and of the air getting admission into its 
 cavity, that immediate amputation of the 
 limb is advisable. 
 
 A bone is known to be dislocated by 
 there being a loss of the usual motion iu 
 the joint, by the limb being altered in its 
 length, or distorted; by there being great 
 pain in the surrounding parts, and this 
 pain increased on motion or pressure. 
 The head of the dislocated bone is some- 
 times distinctly felt in a wrong place, and 
 a vacuity or depression is perceived where 
 there ought to be a fulness. 
 
 The causes of dislocation are either in- 
 ternal or external. The internal causes 
 are, diseases of the joint or its append- 
 ages, relaxation of the ligaments, palsy of 
 the muscles, any morbid affection that de- 
 stroys the cartilages, the ligaments, or ar- 
 ticular cavities. A white swelling some- 
 times partially dislocates the knee; and 
 scrofulous disease of the hip-joint is the 
 cause of dislocation there. External 
 causes of dislocation are such as blows, 
 falls, violent wrenches or twists, and the 
 like. Dislocations from the last set of 
 causes are more easily reduced than others. 
 
 Treatment. The treatment of dislo- 
 cations, though a branch of surgery re- 
 quiring great skill and dexterity as well 
 as anatomical science, has very frequent- 
 
206 
 
 DISLOCATION. 
 
 ly been in the hands of those who had 
 no pretensions to either, and who were 
 possessed only of brute strength, or of a 
 certain knack empirically acquired, of 
 which they knew not the mechanism nor 
 the reason. " Many people (says Mr. 
 Pott) regard bone-setting, as it is called, 
 as no matter of science ; as a thing which 
 the most ignorant farrier may, with the ut- 
 most ease, become soon and perfectly mas- 
 ter of; nay, that he may receive it from 
 his father and family as a kind of heri- 
 tage." In the former practice of sur- 
 gery, too much was expected from mere 
 force, either of the human arm alone, or 
 assisted by machinery ; and too little was 
 allowed to the powers of nature, which 
 might be brought into action by a proper 
 knowledge of the muscles which favour 
 or oppose the reduction. The muscles 
 which move the joints in a sound state, 
 do not lose their power when the joint 
 is luxated ; but, on the contrary, are of- 
 ten spasmodically affected, and draw the 
 bone out of the direction most favourable 
 for its reduction. It becomes, therefore, 
 a matter of accurate consideration, what 
 muscles are likely to oppose the reduc- 
 tion of a joint ; and these muscles will 
 vary according to the direction in which 
 the bone is luxated. In the MTitings of Mr, 
 Pott are some of the best and most judi- 
 cious observations on dislocations ; and 
 much of what follows is extracted .from 
 that eminent surgical author. Although 
 a joint may have been luxated by means 
 of considerable violence, it can by no 
 means follow that the same degree of vio- 
 lence is necessary for its reduction. When 
 a joint has been luxated, at least one of 
 the bones is kept in that unnatural situa- 
 tion by the action of some of the muscu- 
 lar parts in connexion with it. We can- 
 not know whether the ligaments of the 
 joints are broken or not, and this circum- 
 stance need not influence our methods 
 for reduction. All the force used in re- 
 ducing a luxated bone, be it more or less, 
 be it by hands, towels, ligatures, or ma- 
 chines, ought always to be applied to the 
 other extremity of the said bone, and as 
 
 much as possible to that only, hk the 
 reduction of the shoulder and hip-joint, 
 the whole body should be kept as steady 
 as possible. In order to make use of an 
 extending force with all possible advan- 
 tage, and to excite thereby the least pain 
 and inconvenience, it is necessary that all 
 parts serving to the motion of the dislo- 
 cated joint, or in any degree connected 
 with it, be put into such a state as to give 
 the smallest possible degree of resistance. 
 In the reduction of such joints as consist 
 of a round head, moving in a socket, no 
 attempt ought to be made for replacing 
 the head, until it has by extension been 
 brought forth from the place where it is, 
 and nearly to a level with the socket. All 
 that the surgeon has to do, is to bring it 
 to such level; the muscles attached to 
 the bone will do the rest for him, and 
 that whether he will or not. Whatever 
 kind or degree of force may be found ne- 
 cessary for the reduction of a luxated 
 joint, that force must be employed gra- 
 dually ; the lesser degree must always be 
 first tried, and it must be increased by 
 degrees. They who have not made the 
 experiment, will not believe to how great 
 a degree a gradually increased extension 
 may be carried without any injury to the 
 parts extended, whereas great force ex- 
 erted hastily, is productive of very ter- 
 rible and lasting mischief. Extension 
 may either be made by means of assist- 
 ants, who are to take hold of napkins or 
 sheets, put round the part at which it is 
 judged proper to make the extension, or 
 else a multiplied pulley may be used. The 
 first is the preferable method. The ex- 
 tension should always be first made in the 
 same direction into which the dislocated 
 bone is thrown ; but in proportion as the 
 muscles yield, the bone is to be gradually 
 brought back into its natural position. 
 The extension \^'ill prove quite unavail- 
 ing, unless the bone, ^vith which the dis- 
 located head is naturally articulated, be 
 kept motionless by counter-extension, or 
 a force at least equal to the other, but 
 made in a contrary direction. When the 
 attempts at reduction fail, the M'ant of 
 
DISLOCATION. 
 
 207 
 
 success is sometimes owing to the exten- 
 sion not being powerful enough, and to 
 the great muscular strength of the pa- 
 tient, whose muscles counteract all the 
 eiforts to replace the bone. In the latter 
 case, the warm bath, bleeding, and other 
 means of relaxation are to be employed ; 
 and some have even recommended intox- 
 ication; but though a drunken man is 
 sometimes quite incapable of resisting any 
 force applied to him, the propriety of this 
 is very questionable, as the same effect 
 may be produced by more scientific and 
 less immoral means. Long continued, 
 unremitting, gradual extension, will at 
 last weary out the most powerful mus- 
 cles ; and this practice is the most to be 
 recommended. A dislocation is known 
 to be reduced by the limb recovering its 
 natural length, shape, and direction, and 
 by the patient being able to perform cer- 
 tain motions, which he could not do when 
 the bone was out of its place. There is a 
 great and sudden diminution of pain ; and 
 sometimes the bone is heard to give a loud 
 crack when going into its natural position. 
 
 After the reduction of a dislocated 
 bone is effected, care must be taken to 
 prevent a recurrence of the accident, by 
 retaining the limb steady by appropriate 
 bandages, which should be put as far as 
 possible from the centre of motion. To 
 the ankle and the wrist, splints may 
 sometimes be necessary. After luxa- 
 tions of the shoulder-joint, the arm is to 
 be kept in a sling. If there is any ap- 
 pearance ot inflammation or swelling 
 taking place from the accident, or from 
 the force employed in reduction, a cold 
 lotion is to be kept to the place, and even 
 leeches may be necessary, with a saline 
 purgative. The patient must for some 
 time be cautious in using the limb. 
 
 Compound luxations are those which 
 ai'e attended with a wound communicat- 
 ing with the cavities of the injured 
 joints. These injuries are often attend- 
 ed with very great danger, and much 
 skill and judgment are required to de- 
 cide upon the treatment immediately 
 after the accident. So much injury may 
 
 be done, that any attempt to cure it 
 would soon be frustrated by violent fever, 
 gangrene, and death ; all of which may 
 be prevented by the amputation of the 
 limb. At the same time, it is to be re- 
 marked, that by proper care and judici- 
 ous treatment, many apparently untoward 
 cases may do well. The reduction of 
 compound dislocations must be effected 
 as gently and as quickly as possible. The 
 wound is to be cleared from dirt or any 
 extraneous matter, and its lips are to be 
 brought together by adhesive plaster. The 
 limb is to be bound with the proper 
 splints and bandages, and to be kept cool 
 by refrigerant lotions; and if there is 
 much constitutional excitement, bleed- 
 ing, large and general, is to be put in 
 practice ; and internal means are to be 
 used for the diminution and cure of fe- 
 verish symptoms, should any such pre- 
 sent themselves. Saline di-aughts and 
 antimonial medicines must be resorted to, 
 and purgatives also, provided they do not 
 subject the patient to too much motion 
 of the injured part. If the febrile symp- 
 toms abate, and the local inflammation 
 does not run to any great extent, we may 
 hope that the injury is to pass over with- 
 out bad consequences; but the revei-se 
 may happen, violent inflammation may 
 attack the joint, and be followed by sup- 
 puration, and all the dangers and debili- 
 tating symptoms of hectic fever. While 
 these continue it w^ould be dangerous to 
 attempt amputation ; but we must wait 
 till these symptoms abate, and then give 
 the patient the only chance of saving his 
 life. Having made these general obser- 
 vations on dislocations, and shown the 
 principles on Avhich they should be treat- 
 ed, it can hardly be considered necessary 
 or proper, in a popular work, to enter on 
 the minute details of the symptoms and 
 cure of every particular dislocation. For 
 these we must refer to books of Surgery. 
 Dislocations or fractures of the limbs of 
 infants sometimes happen in delivery. 
 They ought never to be concealed or ne- 
 glected, but the proper measures should 
 be taken for their replacement and cure. 
 
208 
 
 DIURETICS. 
 
 DISPENSARY. A place where the 
 poor are supplied gratis with medicines 
 and advice. 
 
 DISPENSATORY. A book which 
 treats of medicines, and the methods of 
 compounding them. 
 
 DISSECTION. The cutting of dead 
 animals, or of plants, with the intention 
 of exhibiting their structure. 
 
 DISTENSION. A stretching of any 
 pai't, as of the stomach or bowels from 
 wind, or of the muscles from any yioleut 
 extension. 
 
 DISTILLATION. The operation by 
 which volatile substances are raised in 
 the state of vapour, and condensed by cold. 
 Many important articles are procured by 
 distillation. It is thus that alcohol in all 
 its forms is obtained ; and many substan- 
 ces when distilled with water, impart 
 their propertiesj^ their taste, and their 
 smell, to the vapour which rises and is 
 condensed. Thus rose-water, pepper- 
 mint-water, &c. are obtained. 
 
 DIURETICS. Medicines which in- 
 crease the secretion by the kidneys, and 
 by consequence the flow of m-ine. This 
 is an effect which in many cases of dis- 
 ease we are very anxious to accomplish, 
 and which has a very salutary tendency. 
 In dropsy it is always very desirable to 
 increase the flow of urine, and in several 
 species of that complaint, it is the chief 
 indication of cure. The principal diu- 
 retic medicines are the following ; cream 
 of tartar, squill, foxglove, acetate of pot- 
 ash, nitrate of potash, carbonate of soda, 
 spirit of nitrous ether, turpentine, juni- 
 per, tobacco, and mercury. 
 
 These various diuretics have their pe- 
 culiar modes of operating. Some, as po- 
 tash and its combinations, nitre and cream 
 of tartar, squill, juniper, and turpentine, 
 seem to act by directly stimulating the 
 kidneys, being carried, more or less de- 
 composed, to these organs. Others, as 
 mercury, stimulate the absorbents pri- 
 marily, and secondarily the kidneys ; 
 others appear to act first on the stomach 
 and digestive organs, or the bowels, and 
 afterwards on the absorbents; such are 
 
 digitalis, tobacco, jalap, elaterium ; while 
 tonics, by strengthening the whole body, 
 strengthen also the absorbents. 
 
 The diuretic powers of cream of tartar 
 are much promoted by drinking plenti- 
 fully; and a good way of giving that medi- 
 cine, is to give a dessert-spoonful of cream 
 of tartar in a tumbler of tepid water 
 every morning. Squill may be given in 
 the form of the common squill pill, or 
 one or two drachms of the vinegar of 
 squill, in a convenient vehicle, twice a- 
 day. Under Foxglove, we have given 
 minute directions for the administration 
 of that powerful medicine. The acetate 
 of potash is used in the dose of from one 
 to two drachms ; it should be given pretty 
 largely diluted in tepid water. The ni- 
 trate of potash is a good diuretic, and 
 must be given in large quantities of mild 
 diluents, as barley-water or linseed-tea, 
 two drachms to an English quart. The 
 juniper is given in the form of its essen- 
 tial oil, made into an emulsion with the 
 spirit of nitrous ether. The diuretic ef- 
 fects of gin are owing to its impregnation 
 with the essential oil of juniper j hence 
 gin-toddy in moderate quantity may be 
 allowed in cases where a diuretic drink 
 is wanted. The spirit of nitrous ether is 
 an excellent diuretic, in doses of a table- 
 spoonful in a cupful of warm water eveiy 
 two hours. Much may be done by a skil- 
 ful combination of diuretics, as uniting 
 squill and foxglove, or foxglove and the 
 spirit of nitrous ether; or gin with cream 
 of tartar to form punch. Their effect is 
 to be aided by moderate cold to the sur- 
 face of the body, and we therefore prefer 
 giving them during the daytime. It is 
 to be remarked, however, that we are by 
 no means certain of always procuring a 
 diuretic effect by any medicine whatever, 
 and that even those which in general have 
 the highest character, frequently fail. 
 
 DOGMATISTS. A sect of physicians 
 among the ancients, who professed to be 
 regulated in their practice by pro[)er rea- 
 soning from facts previously discovered 
 respecting the causes of disease, the action 
 cf remedies, and the structure and func- 
 
DOGMATISTS. 
 
 200 
 
 tions of the living body. The professors 
 of this medicina rationalise as Celsus calls 
 it, considered it necessary to knOw the 
 elements of which onr bodies are com- 
 posed, and what it is that constitutes 
 health and sickness. The dogmatists seem 
 to have had as many theories and doubt- 
 ful speculations as their more modern suc- 
 cessors. Some of them thought that dis- 
 ease depended on an excess or deficiency 
 of some of the four elements, hot, cold* 
 moist, and dry ; others, as Herophilus, that 
 every disease was in the fluids; Hippo- 
 crates thought the breathing was gene- 
 rally in fault ; Erasistratus ascribed in- 
 flammation and its concomitant fever to 
 the blood finding its way into vessels 
 destined for the transmission of air; 
 Asclepiades attributed disease to the 
 blocking up of the way by which the atoms 
 flow through the invisible pores. They 
 thought that he who had traced the original 
 cause of sickness, would be the fittest to 
 treat it. They did not deny that expe- 
 riments were necessary, but they thought 
 that no one could institute the proper ex- 
 periments without previous reasoning. 
 They inquired into the nature of respira- 
 tion, of digestion, and assimilation, the 
 pulsation of the arteries, the cause of sleep 
 and watchfulness ; and, as much of the 
 ancient practice was founded on their 
 theories of dietetics, the function of diges- 
 tion attracted their peculiar regard, and 
 the various opinions on that subject gave 
 rise to abundance of controversy and sub- 
 tilty of discussion. They considered 
 the knowledge of the structure, position, 
 and colour of the internal organs as quite 
 necessary to a knowledge of the causes 
 and- the cure of inward pains and dis- 
 eases; they were therefore fully aware 
 of the importance of anatomy, and even 
 thought it allowable to apply the knife of 
 the anatomist to criminals when alive, 
 that by the punishment of the guilty, and 
 those i'dw in number, remedies might be 
 discovered for the benefit of the innocent 
 of every nation in all succeedisg ages. It 
 is to be hoped that the milk of human 
 kindness would render this cruel mode of 
 
 acquiring kno^i'ledgey an expedient rarely 
 if ever, practised. The dogmatist whose 
 writings have outlived those of all his 
 sect, and whose name will ever be held 
 in deserved veneration, is Hippocrates, 
 the Father of Physic. The dogmatists 
 were analogous to the regular physicians 
 of modern times; and like them, they 
 had formidable antagonists and rivals in 
 the Empirics ; who despised their princi- 
 ples, theories, and discussions, and main- 
 tained that the practice of physic should 
 be guided by experience alone. See Em- 
 pirics. 
 
 DOG-EOSE, Rosa canina. A con- 
 serve is made of the fruit of this bush, 
 namely of dog-hips, but it is not of any 
 consequence. 
 
 DOVER'S POWDER. The powder of 
 opium and ipecacuan. The acknowledg- 
 ed excellence of this combination, and its 
 having been admitted into all the pharma- 
 copoeias, induces us to mention it under 
 the name of its inventor, though he pub- 
 lished it at first with an air of mystery, and 
 though he hitches in a rhyme of Pope :— 
 
 " See, desperate Misery lays hold on DoV^r." 
 
 The ingredients of this medicine are, in 
 ten grains of the powder, one grain of 
 opium, one grain of ipecacuan, and eight 
 of the sulphate of potash ; the use of this 
 last substance being chiefly mechanical, to 
 effect the more complete trituration and 
 mixture of the others. It is a most valu- 
 able sudorific, and affords a good example 
 of one medicine so altering the properties 
 of another, as to produce a third substance 
 possessed of new powers. It is much used 
 in rheumatism, in dropsy, in catarrh, and 
 in many other diseases where perspiration 
 is required. The soothing effects of opium 
 seem to be greatly increased by its com- 
 bination with the ipecacuan. In inflam- 
 mation of the bowels, after the free use of 
 blood-letting; and in puerperal fever, 
 when there is much restlessness and in-i- 
 tability, Dover's powder is an excellent 
 medicine. When we wish to promote 
 perspiration by means of it, it is proper to 
 abstain from drinking much till after the 
 sweat begins to flow. See Rheumatism. 
 
210 
 
 D R E A M I N G. 
 
 DRAUGHTS. When a medicine is 
 administered in a small portion of liquid, 
 either singly or with other suhstances, 
 such combination is called a draught. 
 There are various kinds of draughts ac- 
 cording to the purpose we have in view : 
 there are sleeping or anodyne draughts, 
 sweating draughts, purgative draughts. 
 This is a good form of giving a medicine 
 Avhen we intend to be very exact in the 
 dose ; thus, the tincture of opium, of fox- 
 glove, and some other active medicines 
 are given in draughts. They are also a 
 good form when the mixture is liable to 
 spoil by keeping or by exposure to the air. 
 The quantity of a draught should not ex- 
 ceed an ounce and a half, or about three 
 ordinary table-spoonfuls. 
 
 DREAMING is that well known con- 
 dition of the mind in sleep, during which 
 the ideas of the imagination are mista- 
 * ken for realities, the mistake not being 
 corrected by the exercise of the senses ; 
 and in which the body is exempted from 
 the influence of volition. 
 
 In a work like this, it would be out of 
 place to discuss the metaphysics of dream- 
 ing; and we only propose to mention a h^y 
 particulars relative to the connexion of 
 that wonderful subject with the state of 
 the bodily organs. When the stomach is 
 overloaded with a heavy supper, persons 
 are apt to be troubled with the night- 
 mare, and frightful di'eams ; in the disease 
 called water in the chest, the patient of- 
 ten fancies himself in danger, and awakens 
 with a start, in consequence of his efforts 
 to escape it ; and the bodily sensations of 
 pain, of heat, and cold, when they are not 
 strong enough to break the sleep, fre- 
 quently excite a train of images, or a se- 
 ries of adventures, of which these sensa- 
 tions seem to form a conspicuous part. 
 On this very curious and interesting sub- 
 ject, w^e quote the following illustrations 
 from Dr. Abercrombie. " In a paper by the 
 late eminent Dr. Gregory, he mentions of 
 himself, that having on one occasion, gone 
 to bed with a vessel of hot water at his 
 feet, he dreamt of walking up the crater 
 oi" Mount Etna, and of feeling the ground 
 
 warm under him. He had, at an early 
 period of his life, visited Mount Vesuvius, 
 and actually felt a strong sensation of 
 warmth in his feet, when walking up the 
 side of the crater ; but it was remarkable, 
 that the dream was not of Vesuvius, but 
 of Etna, of which he had only read Bry- 
 don's description. This was probably from 
 the latter impression having been the more 
 recent. On another occasion, he dreamt 
 of spending a winter at Hudson's Bay, 
 and of suffering much distress from the 
 intense frost. He found that he had 
 thrown oiF the bedclothes in his sleep ; 
 and a few days before, he had been read- 
 ing a very particular account of the state 
 of the colonies in that country during 
 w^inter. Again, when suffering from 
 toothach, he dreamt of undergoing the 
 operation of toothdrawing, with the addi- 
 tional circumstance, that the operator 
 drew a sound tooth, leaving the aching 
 one in its place. Dr. Reid relates of him- 
 self, that the dressing applied after a blis- 
 ter on his head, having become ruffled so 
 as to produce considerable uneasiness, he 
 dreamt of falling into the hands of sava- 
 ges and being scalped by them." 
 
 Dreams are very frequently produced 
 by a noise, which gives occasion to a train 
 of ideas, but is not sufficient to awake the 
 person. " The most striking anecdote in 
 Dr. Gregory's interesting paper is one in 
 which similar dreams were produced in a 
 gentleman and his wife, at the same time, 
 and by the same cause. It happened at 
 the period when there Aias an alarm of 
 French invasion, and almost every man 
 in Edinburgh was a soldier. All things 
 had been arranged in expectation of the 
 landing of an enemy; the first notice of 
 which was to be given by a gim from the 
 Castle, and this was to be follow^ed by a 
 chain of signals calculated to alarm the 
 country in all directions. Farther, there 
 had been recently in Edinburgh a splen- 
 did military spectacle, in which five thou- 
 sand men had been dra^n up in Prince's 
 Street, fronting the Castle. The gentle- 
 man to whom the dream occuired, and 
 who had been a most zealous voluntt er 
 
» R E A M I N G. 
 
 211 
 
 was in bed between two and three o'clock 
 in the morning, when he dreamt of heai'- 
 ing- the signal gun. He was immediately 
 at the Castle, witnessed the proceedings 
 for displaying the signals, and saw and 
 heard a great bustle over the town, from 
 troops and artillery assembling, especially 
 in Prince's Street. At this time he was 
 roused by his wife, who awoke in a fright, 
 in consequence of a similar dream, con- 
 nected with much noise and the landing 
 of an enemy, and concluding with the 
 death of a particular friend of her hus- 
 band's, who had served with him as a vo- 
 lunteer during the late war. The origin 
 of this remarkable concurrence was as- 
 certained, in the morning, to be the noise 
 produced in the room above, by the fall 
 . of a pair of tongs, which had been left in 
 some very awkward position, in support 
 of a clothes-screen. 
 
 " To this part of the subject, are to be 
 referred some remarkable cases, in which, 
 in particular individuals, dreams can be 
 produced by whispering into their ears 
 when they are asleep. One of the most 
 curious, as well as authentic examples of 
 this kind, has been referred to by several 
 writers ; I find the particulars in the pa- 
 per of Dr. Gregory, and they were related 
 to him by a gentleman who witnessed 
 them. The subject of it was an officer in 
 the expedition to Louisburg in 1758, who 
 had this peculiarity in so remarkable a 
 degree, that his companions in the trans- 
 port were in the constant habit of amus- 
 ing themselves at his expense. They 
 could produce in him any kind of dream, 
 by whispering into his ear, especially if 
 this was done by a friend with whose 
 voice he was familiar. At one time, they 
 conducted him through the whole pro- 
 gress of a quarrel, which ended in a du( 
 and, when the parties were supposed to 
 be met, a pistol was put into his hand, 
 Mhich he tired, and M'as awakened by the 
 report. On another occasion, they found 
 him asleep on the top of a locker or bun- 
 ker in the cabin, when they made him 
 believe he had fallen overboard, and ex- 
 horted him to save himself by swimming. 
 
 He immediately imitated all the motions 
 of swimming. They then told him that 
 a shark was pursuing him, and entreated 
 him to dive for his life. He instantly did 
 so, with such force as to throw himself 
 entirely from the locker upon the cabin 
 floor, by which he was much bruised, and 
 awakened of course. After the landing 
 of the army at Louisburg, his friends 
 found him one day asleep in his tent, and 
 evidently much annoyed by the cannon- 
 ading. They then made him believe that 
 he was engaged, when he expressed great 
 fear, and showed an evident disposition to 
 run away. Against this they remon- 
 strated, but, at the same time, increased 
 his fears, by imitating the groans of the 
 wounded and the dying; and when he 
 asked, as he often did, who was down, 
 they named his particular friends. At 
 last they told him that the man next him- 
 self in the line had fallen, when he in- 
 stantly sprung from his bed, rushed out 
 of the tent, and was roused from his dan- 
 ger and his dream together by falling over 
 the tent ropes. A remarkable circum- 
 stance in this case was, that, after these 
 experiments, he had no distinct recollec- 
 tion of his dreams, but only a confused 
 feeling of oppression or fatigue ; and used 
 to tell his friends that he ^vas sure they 
 had been playing some trick upon him. 
 A case entirely similar is related in Smel- 
 lie's Natural History, the subject of which 
 was a medical student at the University 
 of Edinburgh. 
 
 " A singular fact has often been ob- 
 served in dreams which are excited by 
 a noise; namely, that the same sound 
 awakes the person, and produces a di-eam 
 which appears to him to occupy a consi- 
 derable time. The following example of 
 his has been related to me. A gentle- 
 man dreamt that he had enlisted as a sol- 
 dier, joined his regiment, deserted, was 
 apprehehended, carried back, tried, con- 
 demned to be shot, and, at last, led out 
 for execution. After all the usual pre- 
 pai'ations, a gun was fired ; he a\^oke 
 with the report, and found that a noise 
 in an adjoining room had both produced 
 
212 
 
 BRINKS. 
 
 the dream and awaked him. The same 
 Mant of the notion of time is observed in 
 dreams from other causes. Dr. Gregory- 
 mentions a gentleman, who, after sleeping 
 in a damp place, was for a long time liable 
 to a feeling of suffocation whenever he 
 slept in a lying posture ; and this was al- 
 ways accompanied by a dream of a skele- 
 ton which grasped him violently by the 
 throat. He could sleep in a sitting pos- 
 ture without any uneasy feeling; and, 
 after trying various expedients, he at last 
 had a sentinel placed beside him, with 
 orders to awake him whenever he sunk 
 down. On one occasion, he was attacked 
 by the skeleton, and a severe and long 
 struggle ensued before he awoke. On 
 finding fault with his attendant for allow- 
 ing him to lie so long in such a state of 
 suffering, he was assured that he had not 
 lain an instant, but had been awakened 
 the moment he began to sink. The gen- 
 tleman after a considerable time recovered 
 from the affection." (Dr. Abercrombie 
 on the Intellectual Powers.^ 
 
 Though dreams are not always under 
 our controul, we may avoid some of their 
 exciting causes, by retiring to rest with 
 the stomach not oppressed by too much 
 food, and the mind if possible, free from 
 care ; and cliildren should not be dis- 
 tressed with frightful or disgusting sto- 
 ries ; nor allowed to associate terror with 
 darkness, that their days may be cheer- 
 ful, and their slumbers unbroken by 
 frightful dreams. 
 
 " In diseases, when the dreams are hur- 
 ried and violent, we have reason to expect 
 delirium; when the mind in fevers is 
 gloomy and distressed, and the dreams 
 frightful, the fever soon becomes danger- 
 ous; but when in sleep, the fancy is 
 soothed J)y pleasing images, the disease is 
 seldom alarming." (Dr. Parr.) 
 
 DRINKS. We are warned by the ap- 
 petite of thirst to take in a certain quan- 
 tity of fluid to dilute our solid food, and 
 to supply the \^"aste of those fluids which 
 are continually expended during the con- 
 tinuance of life. So urgent is this neces- 
 sity, that we are able to bear hunsrer 
 
 more quietly than thirst, and to live 
 longer when deprived of food, than when 
 deprived of drink. Of drinks there is a 
 great variety. Water is certainly the 
 proper and natural drink of man and 
 other animals ; but there are many others 
 furnished both by nature and by art, as 
 beer, porter, cider, whey, milk, toast-wa- 
 ter, &c. which may very properly be 
 used, provided they be not taken to ex- 
 cess, and provided each individual takes 
 what he finds best to agree with him. 
 The quantity of drink required will vary 
 according to the climate, the nature of 
 the food, and the peculiarity of each indi- 
 vidual. The effects of fluids on the body 
 vary also according to their temperature, 
 their volume, and the time when they 
 are drank. Persons in good health gen- 
 erally take a great portion of their drink, 
 especially at dinner, of the temperature 
 of the air ; but in weaker stomachs, it 
 may be required to be a little warmed, 
 though it is seldom safe for dyspeptics 
 to have them very hot; and far less 
 should they chill the energies of the 
 stomach by cold or iced drinks. The 
 quantity of drink taken is also of much 
 consequence to good digestion; a large 
 volume of fluid will prevent the food from 
 being properly acted upon by the sto- 
 mach ; and if there be too little, the mass 
 will be dry and hard. Different kinds of 
 food require different quantities of liquid ; 
 animal food requires more than vegetable, 
 roasted more than boiled ; and baked 
 meat more still than roasted. The time 
 of drinking may be generally left to the 
 individual. To load the stomach with 
 drink before a meal is unwise ; but to 
 drink more or less during a meal, accords 
 ing to the nature of the food, assists di- 
 gestion. To eat too fast causes thirst, 
 in order to supply the saliva which would 
 have been poured out, had mastication 
 been properly performed. During the 
 intervals of our solid meals, there is an 
 instinctive desire for drink, and hence the 
 good effects of tea, coffee, and such beve- 
 rages, when taken in moderation some 
 hours after a solid meal. 
 
DROPSY. 
 
 213 
 
 DROPSY. A disease, of which a very- 
 conspicuous symptom is the effusion and 
 stagnation of a watery fluid in certain ca- 
 vities and cells, where it is not percepti- 
 ble in the healthy state. Thus water 
 may be accumulated in the ventricles of 
 the brain, in the chest, in the belly, and 
 the cellular texture generally, giving rise 
 to a train of symptoms, different in each 
 particular case, and requiring particular 
 modes of cure. Water effused in the 
 ventricles of the brain is commonly the 
 consequence of previous inflammation ; 
 and gives rise to a variety of distressing 
 symptoms, which generally prove fatal ; 
 this disease is usually called water in 
 the head, and is treated of under that 
 litle. See Head, Water in. 
 
 Dropsy in the chest, or water effused 
 between the investing membrane of the 
 lungs a«d the lining membrane of the 
 ribs, is not so conspicuous by its external 
 appearance as it is distinguished by the 
 dangerous symptoms to which it gives 
 rise. See Chest, Water in. 
 
 The disease to which the term Dropsy 
 is most usually applied, is that general 
 swelling over the whole body, of a soft 
 and doughy feel, accompanied with great 
 weakness, and other symptoms to be here- 
 after described ; or it is that swelling of 
 the beUy from the accumulation of fluid, 
 which often distends it to a prodigious 
 size. It is the two last mentioned kinds 
 of the disease that we mean to treat of 
 under the title of Dropsy. 
 
 General Dropsy, or Anasarca, is a 
 swelling chiefly under the skin, at 
 first appearing on particular parts only, 
 but at length gradually extending to the 
 whole surface. The reason of this pro- 
 gressive swelling is the free communica- 
 tion between all the parts of the cellular 
 substance ; anotlier illustration of which 
 is to bfi foimd, in the free passage of air 
 into all the surface of the body, when it 
 has escaped from the lungs in conse- 
 quence of a wound. The swelling in 
 dropsy is always soft and uniform over 
 any member ; and when pressure is made 
 ■with the finger, a pit or hollow is formed 
 
 by the water being pressed out of some 
 of its cells, into the neighbouring ones. 
 Soon after the pressure is removed, the 
 swelling returns to its former fulness. 
 This is technically called pitting on pres- 
 sure. Generally, the swelling appears 
 first on the lower extremities, and that 
 only in the evening ; it is not very per- 
 ceptible in the morning. The more that 
 a person has been in the erect posture 
 through the day, the greater is the swell- 
 ing towards evening. It is easy to be 
 seen, that this is owing to the water mak- 
 ing its way downwards by its own weight; 
 M'hile the recumbent posture during sleep 
 allows it either to diffuse itself equally 
 over the whole body, or if the quantity 
 be great, and the disease far advanced, to 
 accumulate in the upper parts of the bo- 
 dy, and to occasion the swelled face, and 
 closed up eyes, which some dropsical pa- 
 tients exhibit in the morning. Sometimes 
 the fluid which is accumulated in the cel- 
 lular texture immediately under the skin, 
 oozes out through the pores of the cuti- 
 cle ; sometimes being too thick to do so, 
 it raises the outer skin in blisters. Some- 
 times again, the skin not allowing the 
 water to pass through it, is hardened by 
 distension, and gives the swelling an un- 
 usual degree of fiimness. If, from any 
 cause, an inflammation should come upon 
 a dropsical limb, it is of a bad kind, 
 spreading along a great extent of surface, 
 like the rose, and too frequently ending 
 in gangrene. General dropsy is almost 
 ^IvA^ays attended with scantiness of urine, 
 which is generally high-coloured, and af- 
 ter cooling, lets fall a copious reddisli 
 sediment. There is also an unusual de- 
 gree of thirst ; and both these last symp- 
 toms are to be ascribed to the watery 
 parts of the blood passing into the ceUu- 
 lar texture, whereby they are prevented 
 from diluting the acrimony of the urine, 
 and from moistening the mouth, the 
 fauces, and the other parts which in the 
 healthy state are dependent on the action 
 of the salivary or other similar glands. 
 The appetite is generally bad ; and there 
 is a feeling of debility, with sluggishness. 
 
214. 
 
 DROPSY. 
 
 drowsiness, and disinclination to motion. 
 Dropsy is very often a very tedious dis- 
 ease ; and the patient dies, after long 
 suffering, sometimes from the respiratory 
 organs becoming oppressed with the 
 load of watery fluid; at other times, 
 life sinks exhausted from a universal 
 failing of the digestiye and nervous 
 powers. 
 
 Causes q/* Dropsy. As dropsy consists 
 in the preternatural accumulation of a 
 watery fluid in various parts of the bodyj 
 the first step in our inquiry is to ascer- 
 tain whence this unusual quantity of fluid 
 proceeds. In health, a watery fluid is 
 poured out from what are termed exhal- 
 ant arteries, into every caWty of the bo- 
 dy, and into every cell of the cellular 
 substance, to moisten the parts, to 
 render motion easy, and to diminish 
 friction. The absorbent vessels carry 
 off' the effused fluid ; and by the pro- 
 per enei^ of these two sets of vessels, a 
 well balanced action is kept up, and all 
 accumulation is prevented. Now, if the 
 watery fluid is poured out in greater 
 quantity than natural, the absorbents will 
 not be able to take it up : and if the 
 power of the absorbents is by any cause 
 weakened, they will not take up the quan- 
 tity effused, though it should not be larger 
 than natural Increased effusion may be 
 owing, either to a preternatural increase 
 of the ordinary exhalation, or from ves- 
 sels which carry watery fluids being rup- 
 tured. Exhalation may be increased by 
 whatever prevents the free return of the 
 blood from the arteries into the veins. 
 The blood not getting, easily into the 
 veins from the extremities of the arteries 
 which open into the veins, and the ac- 
 tion of the heart and arteries still conti- 
 nuing behind, the blood is pressed with 
 force into the exhalant arteries, and more 
 watery fluid is poured out by them. This 
 obstruction to the free entrance of the 
 blood from the terminating arteries into 
 the commencing veins, may exist very 
 far from these extremities, even in the 
 heart itself; and hence diseases of the 
 heart and great vessels are often known 
 
 to occasion dropsy. Formerly, dropsy 
 was believed to be universally a disease of 
 debility, or diminished action; but iuflani- 
 raatory action in some part of the cheit 
 is now acknowledged to be a cause of 
 dropsy, from its impeding the free action 
 of the heart and great vessels. Hence, 
 also, a tumour pressing on the vessels of 
 a limb, causes a watery swelling of that 
 limb ; and a tight ligature or garter, or 
 even the difficult passage of the blood 
 from its own weight, causes a limb to 
 swell towards evening. Hence, also, dis- 
 eases of the liver, by obstructing the free 
 circulation of the immense quantity of 
 blood, which should pass through it, oc- 
 casion an exhalation into the cavity of the 
 abdomen, and produce dropsy of the bel- 
 ly. On the same principle, also, we ex- 
 plain the dropsical swelling which takes 
 place in the legs and thighs of preg- 
 nant women, from the bulk of the uteres 
 pressing on the great vessels which re- 
 turn the blood from the lower extremi- 
 ties. Another cause of increased exhala- 
 tion is believed to be a laxity or weakness 
 of the exhalant vessels ; a symptom and 
 a part of that general weakness which 
 sometimes pervades the whole system. 
 Hence fevers of various kinds, copious 
 and long continued discharges of blood, 
 or any other weakening causes, produce 
 a debility of the system, which leads to 
 dropsy; and hence, also, that frequently 
 occurring circumstance, intemperance in 
 the use of strong liquors, especially dram- 
 drinking, produces the most intractable 
 and fatal cases of dropsy. Dram-drink- 
 ing has a doubly injurious effect; it re- 
 laxes and totally debilitates the Mholo 
 system, thus producing general dropsy; 
 and it occasions hardness of the liver, 
 and that obstruction in it which lays the 
 foundation for dropsy of the belly. If 
 there be a greater proportion than there 
 ought to be of the eatery parts of the 
 blood, this may give rise to an increased 
 exhalation ; and sometimes, though rare- 
 ly, dropsy is produced in this way, by 
 drinking much watery fluids, which fluids 
 pass off by the exhalants. Large bleed- 
 
DROPSY. 
 
 916 
 
 iag hiXH b(»ea already mentioned m caus- 
 ing geucral debility, and an producing 
 droptsy ; but it may uIho do no by cauM- 
 ing a dinainution oi" tUc proper proportion 
 of the red globules and ti brine of the 
 blood, which are not 80 easily repaired as 
 the watery portion. There loay not only 
 be increased exhalation, but dirainitdied 
 absorption, depending ou the same gene- 
 ral caoges of debility. 
 
 Treatment of Dbopsv. From the ac- 
 count given of the causes of dropsy, it is 
 evident that while they continue to act, 
 it will be oseless to attempt carrying off 
 the effused fluid, and therefore one of our 
 first objects must be to put a stop to those 
 causes. lu that species of dropsy which 
 is accompanied by a strong and fuU pulse, 
 we are to lessen the inOammatory ac- 
 tion and give freedom to the lieart and 
 bloodvessels, by copious bleeding; and 
 we must divest ourselves of the prejudice 
 so long maintained, that dropsy in every 
 case is a disease of debility. When the 
 inflammatory action is over, the swelling 
 800Q disappears. In a dram-drinker, or 
 an indolent debilitated person, it will be 
 in vain to give drugs, or to direct any par- 
 ticular regimen however salutary, till 
 these bad habits are given up. We are 
 next to attempt to get rid of the water al- 
 ready accumulated. If the patient has 
 strength enough to go through a course 
 of mercury, that powerful medicine in in 
 many cases found to have a most excel- 
 lent effect in stimulating the whole sys- 
 tem, and exciting powerfully the action 
 of the absorbents. When the water has 
 been carried off by the effects of mercury, 
 we are to stop the medicine, and to at- 
 tend to keeping up the strength by bark 
 and wine, and proper nourishment; and 
 to r^olate the bowels and any other func- 
 tions that require it Sometimes Tery 
 ttmng poipitires procure a very copious 
 imharge ot watery fluid ; of this kind 
 ai« tb« renooos piui^et, as gambogevMEUD- 
 BMMiy, and the like; or jaiap in eoiiibia»' 
 tion wttk aloesy fcanunony, gambog^e, or 
 cream of tartar. A powder for tjiis pur- 
 pose may consist et eight grains of aloes, 
 
 ten of julap, and six of gamb^fi'lf PflfMI^ 
 mony, to be taken in a boluS) or tmpoai^ 
 ed in syrup or mucilage. A purgative of 
 great but dangerous efficacy in dropny, if 
 the ekterium or wild cucumber; a me- 
 dicine of great activity, but rather uncer- 
 tain, and requiring the greatest caution in 
 its administration ; the dose at first is 
 not more than the eighth part of a grain 
 of the extract. Another chtss of reme- 
 dies much used in dropsy, are diuretic 
 medicines ; and could we insure the suc- 
 cess of their operating, we should l>e bet- 
 ter pleased to carry off the dropsical war 
 ters in this way, than by any other me- 
 thod whatever. Under the article Diu- 
 retics, we have enumerated pretty fully 
 the remetlies of this class, with their mode 
 of administration ; and therefore need not 
 resume the discussion here ; we shall 
 merely mention, that cream of tartar is 
 thought a good diuretic in general drop- 
 sy; squill, alone or combined, in dropsy 
 of the belly; and foxglove, in water of 
 the chest. Another method of evacuat- 
 ing dropsical water, is by making a num- 
 ber of small punctures in the skin, reach- 
 ing to the cellular substance ; and a great 
 quantity of water often runs off in this 
 way; but from the unhealthy state of 
 the constitution, such punctures are very 
 liable to run into mortification ; and eren 
 the spontaneous bursting of the skin is 
 followed by the same bad effect, so that 
 practitioners are by no means fond of at* 
 tempting to let off the water by punc- 
 ture. The dread of the same coiis»> 
 quences from wounds in dropsical pa- 
 tients, renders us unwilling to adrise se- 
 tonsy issues, or blisters, which have been 
 recommended for the discharge of the 
 water. Cabbage le^^v^^, applied to a 
 limb, have at times appeared to encon- 
 rage a very copious exudation of fluid 
 from the suriace. Emetics and sudorifics 
 have been recommended, but are not now 
 ntocb trusted to for prtnaoting the ^ia^ 
 durge or absorption oi dropuead waten. 
 It is an important improvement ia tb« 
 cure of dropsies, that the {patient is M>t 
 restricted in the quantity of fluid whsclt 
 
216 
 
 DROPSY. 
 
 he chooses to drink, but that a plentiful 
 allowance of watery liquors is considered 
 as rather conducive to a cure, by convey- 
 ing to the kidneys any diuretic we mean 
 to employ, and even as of itself great- 
 ly promoting- their action. In ancient 
 times, as Celsus informs us, dropsy was 
 more frequently cured in slaves than in 
 freemen, as they could not be prevailed 
 upon to submit to the severe restraints 
 which were imposed upon slaves. Fric- 
 tion is another means of promoting the 
 action of the absorbents ; and exercise, if 
 the patient can take it, may have the 
 same effect; and when the swelling is 
 abated in the morning, skilful and equa- 
 ble bandaging m^U prevent the swelling 
 of the legs towards night. When by these 
 or other means, we have managed to get 
 rid of the water already effused, our next 
 object is to prevent its re-accumulating ; 
 and by strengthening the system, to com- 
 plete the cure of the disease. Exercise, 
 and the proper regulation of the diet, are 
 great ingredients in this plan ; and are to 
 be accompanied by tonic medicines, as 
 Peruvian bark, bitters, and the prepara- 
 tions of iron. Great attention is to be 
 paid to the state of the bowels ,- and we 
 must not neglect to keep up a proper ac- 
 tion of the skin and of the kidneys. 
 
 Dropsy of the Belly is of two diffe- 
 rent kinds, and may occur either in the 
 general cavity, or as connected with par- 
 ticular organs. 
 
 Dropsy in the cavity of the abdomen 
 is frequently only a part of a very gene- 
 ral disease, in which the water is effused 
 also into the cellular texture of the whole 
 body. It is very often the attendant or 
 the consequent of disease of the liver, in 
 which that organ is very much enlarged, 
 hardened, and altered in its minute struc- 
 ture. This is one of the most usual con- 
 sequences of the habitual and intemperate 
 use of strong liquors. It is accompanied 
 with considerable debility, an unhealthy 
 appearance of the countenance, much 
 thirst, scanty urine, loss of appetite, and 
 other marks of what may be called the 
 hydropic diathesis. We are to attempt 
 
 the cure by diuretics, by purgatives which 
 bring off a great quantity of watery fluids; 
 by mercury, when we have reason to be- 
 lieve that a hardened liver is the cause 
 of dropsy, taking care to support the 
 strength, as it is so generally a disease of 
 debility ; and in cases where it is proper 
 drawing off the water by puncture. 
 
 Another species of dropsy in the belly 
 is that in which the fluid is collected in 
 some particular cyst or bag ; of which Ave 
 have a very frequent instance in females, 
 whose ovaries become distended with 
 fluid in a most remarkable degree, re- 
 quiring, for the ease and accommodation 
 of the patient, to be very often let off by a 
 surgical operation. It is a matter of con- 
 siderable difficulty to ascertain the situa- 
 tion of the water in this species of dropsy ; 
 and the cure or permanent removal of it 
 is generally impossible. Mercury, as a de- 
 obstruent, has been tried ; but all that we 
 can expect is occasional relief by tapping. 
 When the dropsy is of this encysted kind, 
 the derangement of the general health is 
 much less than in the other kinds. The 
 strength and appetite are little impaired, 
 the flow of the menses continues as usual ; 
 tliere is little paleness or sallowness of 
 the countenance, and the thirst, scanti- 
 ness of urine, and other symptoms of ge- 
 neral dropsy, are less urgent. Encysted 
 dropsy is frequently a very protracted af- 
 fection, and for a long time the general 
 health suffers but little. The strength is 
 to be supported by proper diet, assisted 
 by bark, iron, and other tonic medicines ; 
 and tapping is to be had recourse to when 
 the fluid is collected in great quantity. 
 Sometimes inflammation comes on, and 
 much purulent or glairy matter is collect- 
 ed in various compartments of the swelled 
 ovarium ; and fever, with great debility, 
 at last carries off the patient. 
 
 DROWNING. Death from drowning 
 does not ensue from the lungs being filled 
 with the fluid swallowed, but is the con- 
 sequence of their being prevented from 
 receiving the atmospheric air, which is 
 necessary for the performance of the 
 function of respiration ; a function whicli 
 
DROWNING. 
 
 217 
 
 cannot be suspended in man and the more 
 perfect animals, for even a very short pe- 
 riod, without the most severe suffering 
 and consequent death. While, on the 
 one hand, we must, in the case of persons 
 apparently dead from drowning- or other 
 accidents, omit no proper means for their 
 recovery, and persevere long, even in very 
 hopeless circumstances ; we must, on the 
 other hand, remember, that it is of the 
 utmost moment, as speedily as possible, 
 to remove the body from the water ; and 
 we should distrust all the stories of bodies 
 having been recovered, after being twenty 
 minutes or half an hour under water. 
 That great physiologist, the second Mon- 
 ro, used to declare, that if a body had 
 been five minutes without breathing, re- 
 covery was impossible. 
 
 Methods to be employed for Recovery 
 of the Drowned, and in other cases of 
 Suspended Animation. Before proceed- 
 ing to state the methods proper to be 
 tried for this pui"pose, it may be right to 
 caution the unprofessional reader against 
 -what should not be done. It is improper 
 to suspend the body by the heels, or to 
 use any violent agitation of it, with the 
 view of getting rid of the water supposed 
 to be in it. It is improper to have imme- 
 diate recourse to the lancet, as the blood 
 is repelled to the internal parts, and can- 
 not be easily made to floAV from a vein at 
 the surface, so as to unload those parts. 
 When the body is taken out of the water, 
 it should be wrapped in dry clothes, and 
 carried on a door, or by the help of as- 
 sistants, in Such a manner as not to dis- 
 tort the neck, or bring the chin on the 
 breast, or the head too far back. It should 
 be carried to the nearest convenient place, 
 and well rubbed with warm and dry flan- 
 nel, while a warm bath is preparing. In 
 houses appropriated for the purpose of 
 resuscitation, the water should be always 
 ready. The patient is to be put com- 
 pletely in the warm bath, an assistant 
 keeping the head out of the water. There 
 should be no crowd of people in the room, 
 as they both render the air impure, and 
 cmb^ra^s those who are actively employed 
 
 about the patient. An essential part of 
 the duty of assistants, is to inflate the lungs, 
 and imitate natural breathing. If this can 
 be accomplished, and a little stimulus im 
 parted to the overloaded right side of the 
 heart, we may hope that it will be enabled 
 to propel the blood in the proper direc- 
 tion, and that life may begin again to show 
 itself. It is not thought very safe or ne- 
 cessary to rub any acid or stimulating 
 substance on the body. Some harts- 
 horn mixed with oil is all that is neces- 
 sary. When any sign of life appeai-s, a 
 little hartshorn to the nostrils may sti- 
 mulate the breathing. Some stimulus 
 applied to the stomach may give much 
 assistance. If the person can swallow, a 
 little brandy or warm wine and water is 
 one of the best we can give ; and by some 
 of the ingenious contrivances of modern 
 art, something may be thrown in even 
 when the power of swallowing is sus- 
 pended. When any signs of pulsation 
 begin to appear, they may be aided by 
 slightly irritating the nostrils, by the ap- 
 plication of hartshorn or mustard. When 
 other means have failed, electricity has 
 sometimes been known to rouse the ac- 
 tion of the heart, when the shocks have 
 been skilfully sent through that organ. 
 The measures adopted for the recovery of 
 drowned persons must be persevered in 
 for a considerable time; and they must 
 not be left to themselves when signs of 
 reviving appear, till we are quite confi- 
 dent that matters are in a prosperous 
 train. They should be put to bed, their 
 feetbeing well warmed, and their shoulders 
 raised ; they should take pretty frequent- 
 ly, for the first few hours, some warm 
 drink without spirits; and it will be neces- 
 sary to watch, lest any tendency to inflam- 
 mation and fever should manifest itself, 
 when it will be proper to bleed according to 
 the urgency of the symptoms. In attempt- 
 ing to restore animation to persons who 
 have been hanged, pretty nearly the same 
 measures are to be pursued ; with the ad- 
 ditional one, of taking a small quantity 
 of blood from the head, by opening the 
 jugular vein or the temporal artery. We 
 
218 
 
 DROWNING. 
 
 should be unwilling- to say any thin^ to 
 discourage the most assiduous and perse- 
 vering" exertions to restore suspended ani- 
 mation ; but it is right to mention, that 
 the accounts of recovery after very long 
 continuance under water, as hours or days, 
 are totally fabulous. The late Dr. Fo- 
 thergill published the following popular 
 directions, approved by the Humane So- 
 ciety : 
 
 I. The body should not be rolled on 
 the ground, or over a barrel, nor lifted up 
 by the heels, or be any other way roughly 
 handled, or violently shook ; but be re- 
 moved to a convenient place, lying as on 
 a bed, with the head a little raised, in as 
 natm-al a position as possible. 
 
 II. The body, well wiped with a cloth, 
 should be placed in a warm bed or blan- 
 ket, but not too near a large fire. Bottles 
 of hot water should be laid to the bot- 
 toms of the feet, joints of the knees, and 
 under the arm-pits. A warming-pan 
 moderately heated, or hot bricks wrapped 
 in cloths, should be nibbed over the body, 
 particularly along the back. The natural 
 w^armth of a healthy person, especially a 
 child, lying close to the body, has been 
 found very efficacious. The room should 
 be kept open and airy, with few persons 
 in it. The shirt of an attendant, or skin 
 of a sheep fresh killed and warm, may be 
 used to advantage. Should the accident 
 happen in the neighbourhood of a warm 
 bath, brewhouse, bakehouse, glasshouse, 
 saltern, soap mauufactoiy, or any fabric 
 where wann lees, ashes, embers, grains, 
 sand, water, &c. can be easily procured, 
 it will be veiy proper to place the body 
 in any of these, moderated to a degree 
 of heat very little exceeding that of a 
 healthy person. 
 
 III. The body being placed in one or 
 other of the above advantageous situa- 
 tions, various stimulating means should 
 be immediately employed. The most 
 efficacious are, bloAving with force into 
 the lungs, by applying the mouth to that 
 of the patient, closing at the same time 
 his nostrils, throwing the smoke of to- 
 lacco up the fundament into the bowels. 
 
 by means of a clyster-pipe or fumigator 
 a pair of bellows may be employed until 
 the others can be procured ; rubbing the 
 belly, chest, back, and arms with a coarse 
 cloth, or dry salt, so as not to rub off the 
 skin, or with a flannel dipped in brandy 
 rum, or gin ; applying spirit of hartshorn, 
 volatile salts, or the like, to the nostrils, 
 and rubbing them on the temples fre- 
 quently ; tickling the throat \\'ith a fea- 
 ther to excite a propensity to vomit, and 
 the nostrils also with a feather or snuff 
 to provoke sneezing. The body should 
 at intervals be shaken, and varied in its 
 position. 
 
 IV. If there be any signs of returning 
 life, such as sighing, gasping, twitching, 
 beating of the heart, return of natural 
 warmth or colour, a spoonful of water 
 may be administered, to try if the power 
 of swallowing be returned; if it be, a 
 spoonful or two of warm wine, or of 
 brandy and w ater, may be given to ad- 
 vantage, but not before. 
 
 Early bleeding has been found perni- 
 cious, and even fataL It is seldom appli- 
 cable, though it may sometimes be em- 
 ployed by a person of skill to remove or 
 prevent symptoms of inflammation. 
 
 The above methods of restoring life are 
 applicable to various other cases of appa- 
 rent sudden death, whether from hang- 
 ing, apoplectic and convulsive fits, cold, 
 suffocation by damps, or noxious vapours 
 proceeding from coal mines, confined air 
 of wells, caves, cisterns, or from the must 
 of fermenting liquors. 
 
 DRUNKENNESS. See Intoxica- 
 tion. 
 
 DRY BELLY-ACHE. A particular 
 species of colic, called also the Devon- 
 shire colic, or the colic of Poitou, from its 
 occurring frequently at these two places. 
 
 Symptoms. It is preceded by an un- 
 easy sense of weight in the abdomen, 
 chiefly about the navel, then come colic 
 pains, not very severe or continued, but 
 increased chiefly after taking food ; after- 
 wards the pains become more sharp and 
 almost constant ; there is severe pain of 
 the arms, legs, and back, m ith palsy and 
 
 i 
 
DRY B E L L Y - A C II E. 
 
 ID 
 
 wastinnf of these parts ; and a remarkable 
 falling away of the fleshy part called the 
 ball of the thumb. Obstinate costiveness 
 accompanies the disease, and there is 
 sometimes a degree of strangiiry. Those 
 who have had the disease are liable to 
 relapses, which are generally more vio- 
 lent than the first attack ; and their re- 
 covery becomes every time more slow 
 and less complete. In some cases, where 
 the disease is very bad, it may be eight 
 or ten days before stools are procured. 
 The pulse is not quicker than natiu'al, 
 and there is not much heat of skin at 
 the beginning of the complaint; but from 
 the violence of the pain, some feverish 
 symptoms may occur, and the agony is 
 sometimes so great as to bring on con- 
 ^^llsions. 
 
 Causes. This very singular, painful, 
 and troublesome disease, is owing to the 
 introduction of lead into the body. The 
 ways in which this may be done are very 
 numerous. It may be introduced in the 
 form of vapour, as among smelters ; or as 
 an oxide, in those who work with it in 
 that form, as paintei*s, and those M^ho 
 make white lead ; or in a saline state, as 
 in those who are unfortunate enough to 
 get it in adulterated wine or cider, or in 
 spirits, in whose distillation an ill-cleaned 
 leaden worm has been used. This is the 
 reason why lead, in its various prepara- 
 tions, though we should expect so much 
 from its refrigerating powers, is so rarely 
 employed internally by physicians. 
 
 Treatment. The great object is to pro- 
 cure free passage of the bowels, but it is 
 often a business of great difficulty. The 
 spasm is very obstinate^ and ^ve must 
 have recourse to the paradoxical expe- 
 dient of giving nearly at the same time 
 something to open the bowels, and some- 
 thing that has usually the effect of clos- 
 ing them. An infusion of senna with 
 tamarinds is to be given, a tea-cupful 
 every hour; and after the iirst cupful a 
 large opiate, which frequently has the 
 effect of putting a stop to the spasm, and 
 allowing the purgative to act. Blisters, 
 as in the common colic, often relieve the 
 
 pain, and finish the spasm ; and in many 
 instances, very soon after the blister rises, 
 the bowels are opened. The purging 
 must be regularly kept up for some time ; 
 and the strength must be restored by bark 
 and wine, and a nomishing diet; while 
 the palsied limbs are to be rubbed with 
 some suitable embrocation, as the vola- 
 tile liniment, or turpentine and oil, or 
 opodeldoc. 
 
 DUCTS, the passages by which se- 
 creting glands pour their prepared fluids 
 into the cavities for which they are in- 
 tended. Thus, there are gall-ducts, sa- 
 livary ducts, &c. for the conveyance of 
 their respective fluids. 
 
 DULCAMARA, See Bitter-Sweet. 
 
 DUODENUM. That portion of the 
 intestines which comes next to the sto- 
 mach, so called from its length, being 
 generally about twelve inches. Some of 
 the most important parts of the process 
 of digestion are performed here, viz. the 
 intermixture of the chyme with the bile 
 and pancreatic juice, and its formation 
 into chyle. See Digestion. 
 
 DWININU. The Scottish name for 
 the bad health and wasting T^hich very 
 often occur in children. See Atrophy. 
 
 DYSENTERY. A very painful af* 
 fection of the bowels, in which the pa- 
 tient is distressed with frequent calls to 
 stool, with a scanty discharge of mucus, 
 alone or mixed with blood. " The stools 
 are accompanied with copious discharges 
 of wind, they generally exhibit a frothy 
 appearance, and ai-e often attended with 
 a sense of scalding about the anus ; the 
 l)atient, after each evacuation, feels con- 
 siderably relieved, and hopes, but in vain, 
 to enjoy an interval of ease." Along 
 with this affection of the bowels, there 
 is great dejection of spirits, prostration 
 of strength, thirst, griping pains, and loss 
 of appetite. The febrile symptoms are 
 not so urgent as might be expected; 
 there is sometimes great quickness of 
 pulse, but no distinct local inflammation. 
 The natural stools do not appear; and 
 when we succeed in procuring a dis- 
 charge of these, they arc sometimes in 
 
220 
 
 DYSENTERY. 
 
 the form of hardened balls. The disease 
 varies in its duration, sometimes the pa- 
 tient sinks very rapidly, at other times 
 lingers on for a long period, the slimy 
 stools continuing, and being mixed with 
 purulent and bloody matter from the ul- 
 ceration of the bowels. 
 
 Causes q/* Dysentery. It is a disease 
 very common in warm climates, and is 
 therefore to be ascribed to some peculi- 
 arity of the air or water in these places ; 
 and it is also not uncommon in camps 
 and armies, though it may be questioned 
 whether it occurs in these, except in si- 
 tuations and seasons resembling the cir- 
 cumstances of warm climates. It is very 
 liable to attack Europeans who go to 
 warm climates, especially those of the 
 northern countries of Europe, or who, 
 leaving Europe in the winter, are expos- 
 ed within a few months to fatiguing ser- 
 vice in a hot climate, or who indulge in 
 fruit or other food that disagrees with 
 the bowels. Exposure to cold air, drink- 
 ing cold fluids when heated, and intem- 
 perance, are also found to be occasional 
 causes of dysentery. The great numbers 
 of patients affected at the same time, as 
 in camps and ships, seems to have given 
 rise to the opinii)n that dysentery is con- 
 tagious ; this was the opinion of Sir John 
 Pringle, of Dr. Cullen, and others ; but it 
 is not admitted by the modern practition- 
 ers who have had so great experience of 
 this disease in the East and West Indies. 
 At the same time, every precaution should 
 be taken to promote cleanliness, to re- 
 move from the sick every thing putrid 
 and offensive, and to give as little unne- 
 cessary disturbance as possible. 
 
 Such are the symptoms and pauses of 
 the disease commonly known by the 
 name of dysentery or flux ; but the more 
 accurate observers who have had much 
 opportunity of seeing the bowel affec- 
 tions incident to Europeans in warm cli- 
 mates, have noticed a complaint which 
 occurs soon after they arrive in those 
 climates, and which they think should 
 be carefully distinguished from the hepa- 
 tic dysentery, or that form of flux which 
 
 is common to those who have been long 
 enough in India to feel the effects of the 
 climate on the liver and other viscera. 
 The acute disease they consider as an in- 
 flammation confined chiefly to the large 
 intestines, not necessarily accompanied 
 with any flux, and often making consi 
 derable progress in an insidious manner 
 before any urgent febrile symptoms take 
 place. " It begins in general with much 
 of the appearance of a common diarrhoea, 
 occasional griping and pains in the bow- 
 els; frequent and unseasonable calls to 
 stool, with an irresistible inclination to 
 strain over it. The evacuations are gene- 
 rally copious, of a fluid consistence, and 
 without any peculiar foetor; they are 
 sometimes streaked with blood, and at 
 other times, a small quantity of blood is 
 voided in a separate form. The pulse, in 
 this stage of the disease, is seldom alter- 
 ed; and, indeed, in many of the bowel 
 complaints prevalent in India, the state 
 of the pulse gives us but an imperfect 
 idea of the extent of the disease. The 
 heat of the skin is not much increased, 
 and the tongue is frequently but little 
 changed in its appearance. The patient 
 generally complains of great prostration 
 of strength and depression of spirits, with 
 loss of appetite and urgent thiret. 
 
 " To these symptoms succeeds a fixed 
 pain in the lower part of the belly, more 
 or less acute, sometimes extending to- 
 wards each side, and sometimes to be 
 traced along the whole course of the 
 large intestines ; with a sense of fulness, 
 tension, and tenderness upon pressure ; 
 and on applying the hand to the surface 
 of the belly, a preternatural degree ot 
 heat is frequently perceptible. The eva- 
 cuations now become more frequent and 
 less copious, they consist chiefly of blood 
 and slime, or are composed of a peculiar 
 bloody serum, which has been very aptly 
 compared to water in which beef had 
 been washed or macerated. A suppres- 
 sion of urine and distressing tenesmus 
 now become ui'gent symptoms, the indif- 
 ference to solid food increases, while there 
 js an uncontroulable desire for liquids. 
 
DYSENTERY. 
 
 221 
 
 particularly cold water, which the pa- 
 tient prefers to any drink that may be 
 offered to him, and from which he pro- 
 fesses his inability to refrain, although 
 prepossessed with the idea of its being 
 injurious. The tongue is now, for the 
 most part, white and furred ; sometimes, 
 however, exhibiting a florid, smooth, and 
 glassy appearance, with a tremulous mo- 
 tion when thrust out ; the skin is either 
 parching hot, so as to render it even 
 painful to retain the hand in contact with 
 it ; or covered with profuse perspiration, 
 often standing in large drops on the sur- 
 face. The pulse is still frequently but 
 little affected ; sometimes, however, it as- 
 sumes a febrile quickness, without any 
 other remarkable feature ; at other times, 
 it will be found without any great in- 
 crease of velocity, but full, and bounding 
 with a peculiar thrilling sensation under 
 the fingers. 
 
 " This state of the pulse, whenever it 
 takes place, always denotes extreme dan- 
 ger, and shows that the disease is rapidly 
 hurrying on to that final stage in which 
 the lassitude and dejection so conspicu- 
 ous throughout its course, are now con- 
 verted into the utmost degree of anxiety, 
 depression, and fear of death. The pa- 
 tient frequently shows an inclination to 
 dwell upon symptoms, which, to a spec- 
 tator, would appear of minor importance. 
 lie evinces the greatest reluctance to part 
 with his medical attendant, although fully 
 sensible how unavailing the efforts of 
 medicine are likely to prove. The dis- 
 charges by stool, which are frequently 
 involuntary, are now accompanied with 
 the most intolerable fuetor ; they are fre- 
 quently mixed with shreds of membrane 
 and quantities of purulent matter. The 
 pulse sinks, the pain ceases, and delirium 
 supervenes; a frequent hiccup, accom- 
 panied with vomiting, becomes distress- 
 ing to the patient ; the features change ; 
 his skin is covered with a cold clammy 
 sweat, a cadaverous smell is emitted from 
 the body, and death soon closes the scene. 
 The disease frequently proves fatal within 
 a week, and at other times its duration is 
 
 protracted to two or three weeks." (Sir 
 George Balling all on the Diseases of 
 India.) 
 
 The appearances found on examining 
 the bodies of those who had died of this 
 form of dysentery, were principally in- 
 flammation of the large intestines, with- 
 out the smallest trace of disease in the 
 structure of the liver. In some cases, 
 parts of the gut are found to have given 
 way, so as so permit the escape of air, 
 and even of faeces into the cavity of the 
 beUy. 
 
 Sir George Ballingall observes, that dur- 
 ing the first years of his service in India, 
 the two foi-ms of dysentery were often 
 met with in practice, perfectly distinct ; 
 but latterly they were often more and 
 more blended together, and were to be 
 found in all possible varieties of combina- 
 tion. The two forms of the disease were 
 often found co-existent and running in- 
 sensibly into each other; and it was by 
 no means uncommon to find them exist- 
 ing alternately for weeks or months, and 
 destroying the patient by a form of flux, 
 tlie symptoms of which alternately bore a 
 nearer relation to one or other of the dis- 
 eases above described. 
 
 Treatment. When we are called to 
 treat dysentery in its early stages, and 
 when it occurs in young and healthy 
 Europeans on their first arrival in India, 
 putting on the form of inflammation of 
 the large intestines, general bleeding is 
 highly necessary; but in other circum- 
 stances, the employment of this remedy 
 does not seem to be called for. If there 
 be a fixed pain in any part of the abdo- 
 men, increased on pressure, the applica- 
 tion of numerous leeches is very proper. 
 The earliest and most important indica- 
 tions, in the cure of dysentery, are to re- 
 store, if possible, the free discharge of na- 
 tural stools, and to relieve the distressing 
 gripes and straining. This is to be attempt- 
 ed by mild but effectual purges, which are 
 of considerable bulk in themselves or in 
 the modes of their administration, such as 
 castor oil, and the neutral so Its, Calomel 
 alone, or calomel and jalap in full purgar 
 
222 
 
 DYSENTERY. 
 
 live doses, given twice on an early day of 
 the disease, and followed up on the next 
 by a dose of sulphate of magnesia, or of 
 senna, will sometimes put an end to the 
 disease. Indian practitioners seem to 
 trust a ,^ood deal to calomel, g^ven so as 
 to produce its mercurial effect on the 
 mouth ; and they even think the patient 
 safe when the mouth begins to be affect- 
 ed. It is necessary however to interpose 
 effectual purgatives, and to procure a free 
 discharge, if we can, from the bowels. It 
 is not uncommon too, to introduce mer- 
 cury into the system, by giving the blue 
 pill three or four times a-day, and 
 by rubbing mercurial ointment on the 
 surface of the body. A gentle salivation 
 has certainly appeared to do good in dy- 
 sentery, but we must not trust to it, to 
 the exclusion of other articles which act 
 more directly on the bowels. The severe 
 tenesmus tempts to the use of opiates, 
 but it is almost solely in the forraof glys- 
 ters that they can be safely administered. 
 Opitira and ipecacuan, in the form of Do- 
 ver's powder, or opium with an antimo- 
 nial, seems to do good by allaying pain, 
 and producing a copious perspiration. 
 When sudorifics are employed in wai-m 
 climates, smaller doses are found to pro- 
 duce the desired effect, than what are ne- 
 cessary in colder regions. The use of 
 astnngents of every kind, in the early 
 stage of dysentery, it is to be hoped, is 
 completely exploded. The w^arm bath 
 and warm fomentations are to be used for 
 the gTJping pains j and even a large blister 
 over the abdomen is advisable in certain 
 cases. If the disease does not yield to 
 th.e above treatment, there is much rea- 
 son to fear that it Avill go into the chro- 
 uic state, and prove a source of much em- 
 barrassment to the physician, and much 
 suffering and danger to the patient. In 
 chronic dysentery, the patient is still 
 greatly troubled with pain of the bowels, 
 with scanty stools, discharge of much mu- 
 cus, and now more distinctly streaked 
 ■with blood and pus ; the food is ill digest- 
 ed, and passes off very little changed ; he 
 becomes much emaciated, his strenjrth 
 
 yiuks, and he is gradually induced to a 
 great degree of weakness, ending in death. 
 The plan of treatment is to support the 
 strength by mild nourishment j to keep 
 up a regular action of the bowels by cas- 
 tor oil, and other mild laxatives, to give 
 mucilaginous drinks; and cautiously to 
 venture on some mild astringent medi- 
 cines, if we succeed in having a pretty 
 free dischai'ge from the bowels. The 
 bark and other tonics are advisable, and 
 those who have been long ill in warm cli- 
 mates, should remove to a more tempe- 
 rate one. In camps, there ought to be 
 great care taken to prevent all accumula- 
 tion of filth, to keep the sick by them- 
 selves ; and as far as possible to take the 
 disease under our care in its earlier 
 stages ; as it is very unlikely that it will 
 be got the better of, if it passes into the 
 chronic state. 
 
 DYSMENORRHCEA. Difficult or 
 painful menstruation. See Monthly Dis- 
 charge. 
 
 DYSPEPSIA. A term signifying in- 
 digestion or stomach complaints in all 
 their varieties. See Stomach Com- 
 plaints. 
 
 DYSPNCE A. Difficulty of breathing ; 
 rather a symptom of other diseases, than 
 to be treated as a primary one. See 
 Asthjia, Catarrh, Pleurisy, Consump- 
 tion, &c. 
 
 DYSURIA. Pain or difficulty of pass- 
 ing urine. This may arise from various 
 causes, and requires to be treated accord- 
 ingly. If from inflammation of the pas- 
 sages, this is to be removed by local 
 bleeding, by purging, and the other re- 
 medies proper in such cases; if from 
 spasm, this is to be relieved by opium, 
 the warm bath, or other antispasmodics ; 
 if from stone in the bladder, this is to be 
 primarily attended to. Dysuria is often 
 very troublesome to children. The pain 
 appears to be very great, as they shriek 
 long and violently, and seem ready to go , 
 into fits, but on getting the urine passed 
 they instantly become quiet. The preju- 
 dices of nurses are in favour of giving gin 
 on such occasions, and its diuretic powers 
 
E AR. 
 
 223 
 
 may be useful, provided the quantity 
 given be only a few drops, and those 
 larg'ely diluted. A little very thin gruel, 
 with a few grains of the carbonate of po- 
 tash, and a drachm of the spirit of sweet 
 nitre, may be taken. The bowels are to 
 
 be kept open by manna or castor oil ; and 
 in the paroxysms of pain, the child is to 
 be put into the warm bath up to the 
 waist, or to have warm fomentations and 
 gentle friction applied to the lower part of 
 the belly. 
 
 E 
 
 EAR 
 
 EAR 
 
 EAR. The organ of the sense of hear- 
 ing is composed of an external and inter- 
 nal part. The extremely complex, though 
 beautiful structure of the ear, could not 
 be described in such a way as to convey 
 much information to the general reader ; 
 our account of it shall therefore be very 
 brief. The external part, or conch, is 
 what we see at the side of the head, com- 
 posed of various folds and depressions ; in 
 the middle is a passage leading to the 
 membrane ot the drum, which divides the 
 external from the internal parts of the or- 
 gan. In this passage is contained the 
 cerumen or wax of'the ear, bitter and te- 
 nacious, to bar it against the intrusion of 
 insects. Behind the membrane is the 
 drum, an irregular cavity, containing four 
 little bones, and having four openings. 
 The drum is terminated by the labyrinth, 
 in which are situated the cochlea, the ves- 
 tibule, and the semicircular canals. The 
 whole of the cavities are situated in the 
 hardest part of the temporal bone ; they 
 •are lined with a thin membrane, and filled 
 with a limpid fluid. The vibration of this 
 liquor is the last corporeal occurrence in 
 the function of hearing. The nerves are 
 the soft portion of the seventh pair. 
 
 EAR, Diseases OF. " An organ so va- 
 luable and necessary to the perfection of 
 our existence as the ear, should have all 
 the resources of surgery excited for the 
 preservation of its integrity, and the re- 
 moval of the diseases with which it may 
 be affected. What, indeed, would have 
 
 been our lot, if nature had been less libe- 
 ral, and not endued us with the sense of 
 hearing? As Leschevin has observed, 
 we should then have been ill qualified for 
 the receipt of instruction ; a principal in- 
 let of divine and human knowledge would 
 have been closed ; and there being no re- 
 ciprocal communication of ideas, our feeble 
 reason w^ould never have approached per- 
 fection. Even our life itself, being, as it 
 were, dependent upon all such bodies as 
 surround us, would have been incessantly 
 exposed to dangers. The eyesight serves 
 to render us conscious of objects which 
 present themselves before us ; and when 
 Ave judge them to be hurtful, we endea- 
 vour to avoid them. But, to say nothing 
 of our inability of looking on all sides at 
 once, our eyes become of no service to us 
 whenever we happen to be enveloped in 
 darkness. The hearing is then the only 
 sense that watches over our safety. It 
 warns us not only of every thing which 
 is moving about us, but likewise of noises 
 which are more or less distant. Such are 
 the inestimable advantages vi'hich we de- 
 rive from this organ. Its importance 
 when healthy, makes it worthy of the ut- 
 most efforts of surgeiy Avhen diseased." 
 (Cooper's Surgical Dictionary.') 
 
 I . The external ear may be lost by vio- 
 lence, as by cutting, or the bite of an ani- 
 mal. If we see it soon after an accident, 
 and find it much lacerated, we are to en- 
 deavour its reunion by plasters, and even 
 by sutiu*es, if necessary. When a band- 
 
224. 
 
 EAR, DISEASES OF. 
 
 ajre is applied, it should be moderately- 
 tight, as pressure in this place gives con- 
 siderable uneasiness. Wounds, and loss 
 of a part, or even the whole, of the exter- 
 nal ear, do not always occasion deafness. 
 If this occurs from such a cause, an ear- 
 trumpet or similar contrivance must be 
 used. 2. Sometimes the external ear is 
 not perforated, and deafness is the conse- 
 quence, at least in general. This is to be 
 remedied by a surgical operation, varying 
 according to the nature of the obstruc- 
 tion. If it be merely a membrane stretch- 
 ing across the passage, it is simple enough 
 to remove the obstruction; but if the car- 
 tilaginous or bony sides cohere, the cure 
 is of much greater difficulty. When the 
 obstruction is not quite close to the mem- 
 brane of the drum, it has been proposed 
 to touch it with caustic, and to introduce 
 a little tent to keep the passage open for 
 some time afterwards. 3. Foreign bodies, 
 as pease, bits of glass, or cherry-stones, 
 may get into the ear, and occasion great 
 pain of the part, as well as impaired hear- 
 ing. Such bodies have been known to 
 occasion for many years excruciating pain 
 of the head, palsy, convulsions, and other 
 distressing symptoms ; all which have 
 ceased when a skilful hand has extracted 
 the offending body. Such bodies should 
 be forced out, if possible, by the injection 
 of warm water, and the application of 
 a small scoop or bent probe. Worms 
 have been known to produce very violent 
 symptoms by being hatched in the ear. 
 When there is disease, as ulceration or 
 suppuration in the ear, insects are attract- 
 ed by it, and deposit their eggs, which in 
 time produce worms. Patients so affect- 
 ed should take care to stop the ear when 
 they go to sleep in summer and autumn, 
 as Morgagni advises. A slight infusion 
 of tobacco in oil of almonds may be 
 dropped into the ear; and this proves 
 fital to worms. 4. A very frequent cause 
 of deafness or impaired hearing, is the 
 obstruction of the passage by thickened 
 or hardened wax. The symptoms arising 
 from this cause are deafness, a sensation 
 as of a noise or clash when eating, or of 
 
 heavy sounds as of a hammer. This kind 
 of deafness is not very difficult of cure. 
 A little olive oil, or oil of almonds is to 
 be dropped into the ear, and retained 
 there by a piece of cotton ; and when the 
 wax is softened, it is to be taken out with 
 a small scooped instrument. Injecting 
 warm water with a little soap by a sy- 
 ringe, is a method of getting rid of the 
 hardened wax, equally simple and effica- 
 cious. 5. A deficiency of the wax may 
 occasion a degree of deafness. When this 
 is the case, we are to drop in two drops 
 every night of the following mixture : 
 pyroligneous acid, sulphuric ether, oil of 
 turpentine, equal parts ; three drachms of 
 the tincture of meadow saffron in six 
 ounces of distilled water are to be taken 
 at the time. The bov.els must be kept 
 easy. When the wax is of bad quality, 
 which is known by its deviation from the 
 healthy colour and consistence, it may be 
 improved by frequently washing the pas- 
 sage ; and giving, once or twice a-day, 
 a wine-glassful of the infusion of quassia, 
 with a tea-spoonful of equal paits of 
 rhubarb and magnesia. (Buchanan's 
 Acoustic Surgery.) 6. Discharges of 
 matter take place from the passage, 
 in consequence of inflammation going 
 on to suppuration, from scrofulous ul- 
 cers, from abscesses after fevers, from 
 small-pox, measles, and other causes. 
 These discharges not unfrequently are 
 attended with the loss of the small bones ; 
 and in general total deafness is the con- 
 sequence. Exposure to cold frequently 
 produces inflammation about the ear, 
 attended with very acute pain, (com- 
 monly termed ear-ache) which continues 
 very troublesome and even alarming, 
 till the patient is relieved by the dis- 
 charge of matter. This inflammatory 
 state is to be treated by local bleeding, 
 the injection of tepid water, and by fo- 
 mentations; and the passage should be 
 protected from cold air, by the introduc- 
 tion of wool or cotton. 7. Sometimes 
 there is disease in the drum, attended 
 with a fetid, purulent discharge, which, 
 making its appearance at the internal 
 
E A K, DISEASES OF. 
 
 225 
 
 t 
 
 openiug, sliows that the membrane of 
 the drum is destroyed ; and so much dis- 
 ease is in the internal parts, that the 
 small bones are discharged externally. 
 In time, a continual discharge from the 
 ear takes place, and the disorganization 
 is so complete, that a total loss of hear- 
 ing is the consequence. If this disease 
 be noticed in its early stage, if there is 
 acute pain, followed by a dischargee of 
 matter, we know it is from inflammation, 
 and we are to palliate or remove this by 
 topical bleedings, and other antiphlogistic 
 means; and are on no account to inject 
 stimulating spirituous fluids. When the 
 disease threatens to be more chronic, we 
 are to use blisters and setons as auxiliar- 
 ies to our cure ; to employ laxative me- 
 dicines, and to foment the part ; and 
 when there is little active inflammation, 
 to throw in astringent injections, as of 
 sulphate of zinc. If there are fungous 
 growths, they are to be touched with 
 caustic. 8. Sometimes there is deafness 
 from insensibility of the nerves of hear- 
 ing, though the structure of the parts may 
 be perfect. If we can ascertain this to 
 be the case, we are advised to put the 
 patient on low diet, and to give saline 
 purgatives once or twice a-week, apply- 
 ing blisters occasionally behind the ears. 
 The application of electricity may be 
 tried. 
 
 EAR-ACHE is a very common and 
 painful complaint, occui-ring often to 
 adults, and also to infants and children 
 from teething, and from exposure to 
 cold. When a child is feverish, and 
 cries much, putting the hand frequent- 
 ly to the ear, we may suspect this com- 
 plaint ; and may sometimes check it by 
 applying a large poultice of bread and 
 milk, with a little oil, and renewing it 
 every three or four hours. A purgative 
 is also to be given. If suppuration takes 
 place, the matter is commonly discharged, 
 and considerable relief is experienced. 
 Some warm milk and water should be 
 carefully thrown in by a syringe three or 
 four times a-day, to wash out the matter. 
 In some cases, there is a discharge of iU- 
 
 smelled matter for weeks or months, with 
 a degi-ee of deafness. This is best treat* 
 ed by the frequent injection of warm 
 milk and Mater, and by applying a suc- 
 cession of blisters to the back. The 
 strength is to be improved by tonic medi- 
 cines, as some of the preparations of iron 
 or bark. 
 
 EARS, Sore, of Children. This is 
 conmionly meant to express those run- 
 nings from behind the eai-s of children, 
 which are so frequent with them. They 
 are sometimes very painful, and attended 
 with a great discharge of matter ; but it 
 is not safe to check this running sud- 
 denly J and when it occurs abouf the 
 time of teething, it is salutary, as lessen- 
 ing the irritation produced by that pro- 
 cess. It is sometimes even useful to make 
 sore ears, by inserting behind them a piece 
 of tape, spread with blistering plaster. 
 But, provided we are not too hasty in 
 checking the discharge, and provided we 
 relieve the system by proper attention to 
 purging, we may heal up the sore ears, 
 by washing with an astringent wash, 
 made of sulphate of zinc and rose-water, 
 or Avith a little alum and water; and 
 when the acrid matter is likely to fall 
 down, and excoriate the neck and neigh- 
 bouring parts, we are to prevent it by 
 tutty or other absorbent powders ; and to 
 make a discharge at some distance, by 
 dressing a portion of the sound skin with 
 blistering ointment. If the inflammation 
 about the ear is considerable, with fiery- 
 looking pustules, we are to apply emollient 
 poultices ; and when the inflammation is 
 abated, we are then to use an astringent 
 or cooling wash. 
 
 ITMI^DE COLOGNE. An aromatic 
 tincture of great fragrance and pungency, 
 much used at the toilet all over Europe, 
 and sometimes given internally where a 
 powerful stimulus is required. It receives 
 its name from the city where it has been 
 manufactured for more than a century, by 
 the members of a family of the name of 
 Farina. The Cologne water is, of course 
 loudly vaunted by its proprietors, as su- 
 perior to all other imitations of it made 
 
226 
 
 ECLECTICS. 
 
 in Paris, London, and elsewhere ; though 
 these are sometimes so well made, as to 
 receive the approbation even of those who 
 think themselves judges of the matter. 
 The following receipt is said to make a 
 spirit which some have preferred even to 
 the genuine Eau de Cologne. Take of 
 spirit of wine half a pound ; lavender wa- 
 ter, one pound ; balsam of Peru, fifteen 
 drops; essence of lemons, six drachms; 
 camphor, fifteen grains; spirit of rosemary, 
 half a drachm ; bergamot, half a drachm. 
 Digest for seven days, and strain. 
 
 EAU DE LUCE. A nostrum used in 
 nervous diseases; as a substitute for which 
 the London college direct the spirit of 
 hartshorn wdth amber. The dose is twen- 
 ty or thirty drops in an ounce of camphor 
 mixture. In India, it is believed to have 
 some efficacy in the bites of snakes, in 
 those cases where stimulants are used. 
 
 EAU MEDICINALE d' HUSSON. 
 A vinous infusion oiColchicum autumnale, 
 or meadow-saffron, which has obtained 
 great celebrity in the cure of gout. Mr. 
 Brande says, that in gout, colchicum may 
 almost be called a specific, for rjt very 
 rarely fails to break up the paroxysm ; 
 sometimes acting upon the bowels, at 
 other times, upon the kidneys and skin, and 
 often without any apparent accompanying 
 effect. The dose is from half a drachm to 
 a drachm of the vinous infusion. Sir 
 Everard Home recommends the wane of 
 meadow-saffron as a substitute for the 
 Eau Medicinaie, in rheumatism, gout, and 
 dropsy ; and there is no doubt that it pro- 
 duces similar, and sometimes even fatal 
 effects. Dr. Scudamore has ably treated 
 of these pretended specifics in gout, and 
 condemns them as ultimately injurious. 
 We must therefore again caution patients 
 not to be led away by the boasted virtues 
 of any nostrums. 
 
 ECLAMPSIA. A name applied by 
 some nosologists to acute epilepsy. It is 
 now chiefly appropriated to that very 
 violent and alarming form of it which oc- 
 curs in pregnant women. See Pregnancy. 
 
 ECLECTICS. These were a class of 
 ancient physicians, who refused to ac- 
 
 knowledge the exclusive authority of any 
 masters in the practice of physic ; and se- 
 lected alike from Dogmatists and Empi- 
 rics, whatever knowledge they thought 
 consonant to truth, and whatever practice 
 they thought would be beneficial to their 
 patients. In this they certainly acted 
 more wisely than any of the other sects, 
 although much of the advantage of this 
 mode of proceeding depends on the know- 
 ledge, sagacity, and good sense of those 
 who profess to make such selection. The 
 physiologist who undertakes to explain 
 the actions of the living body, is quite in- 
 competent to the task, unless he be an Ec- 
 lectic in the most comprehensive mean- 
 ing of the term. From most of the phy- 
 sical sciences must he draw his principles, 
 for the explanation of the different func- 
 tions of the animal economy. Without 
 the knowledge of optics he cannot ex- 
 plain the bodil)'- part of the sense of sight; 
 without dynamics he cannot explain mus- 
 cular action ; and without chemistry, tlie 
 various component parts of the solids ai^.d 
 fluids cannot be described, nor the nature 
 of the urine and urinary calculi be inves- 
 tigated. To all those sciences, the phy- 
 siologist must add an intimate acquaint- 
 ance with the structure and functions of 
 the living body, and to attain this he 
 must select his illustrations from many de- 
 partments of nature. If such variety be 
 necessary for the physiologist, it is no 
 less so for the pathologist and physician. 
 He must cull his knowledge from many 
 quarters, and must be fully resolved, nul- 
 liusjurare in verba magistriy whether that 
 master be Galen or Paracelsus, Cullen or 
 Brown. He must be neither a partisan 
 of the humoral pathology nor of the me- 
 chanical, the chemical nor the nervous ; 
 and must not ascribe too much to atony 
 or spasm, to gastric irritation, to sym- 
 pathy, nor to derangement of the chy- 
 lopoetic viscera. Selecting from the best 
 authors and from kindred sciences, what- 
 ever accurate investigation has adjudged 
 to betrue,he must furnish himself with the 
 principles of sound philosophy, and then 
 observe nature for himself in the various 
 
ECZ 
 
 EFF 
 
 227 
 
 workings of tlie animal economy, both in 
 health and sickness. In modern times, the 
 illustrious Boerhaave was long thought 
 the model of a genuine Eclectic. 
 
 ECTROPIUM, a disease of the eyelid, 
 in which it is turned out. See Eyelid. 
 
 ECZEMA. A cutaneous disease, for 
 which there is no popular name; but 
 which is characterised by an eruption of 
 smaU vesicles on various parts of the skin. 
 These arise principally from some irrita- 
 tion, as from the heat of the sun or air in 
 the summer season and in warm climates, 
 as we see on the back of the hands and on 
 the face ; also on the neck and forearms 
 in women. The eruption continues for 
 two or three weeks, and there is not 
 much internal disorder. Little can be 
 done by medicine ,- much washing and 
 nibbing is hurtful, and ointments and sti- 
 mulants are to bo avoided. Simple wash- 
 ing ^\ith tepid water relieves the smart- 
 ing and tingling. Some persons have an 
 eruption of this kind and even more se- 
 vere, by the application of acrid substan- 
 ces ; thus it occurs sometimes in grocers 
 from handling sugar, and is then called 
 the grocer's itch ; and masons and brick- 
 layers may have it from the touching of 
 lime. Similar eruptions are also produ- 
 ced by the irritation of blistering oint- 
 ment, not only where the blister has been 
 applied, but at some distance from it, and 
 the eruption has a number of hard swell- 
 ings and boils intermixed with it. The 
 irritating cause must be removed, and 
 emollient poultices applied to diminish the 
 heat and uneasiness, and to bring the boils 
 to a suppuration. Even a common bread 
 and milk poultice often or long applied to 
 a place, has sometimes a similar eflfect. 
 In this case, the poultice must be left off, 
 and simple dressing applied. 
 
 Eczema jTrom Mercury. Another erup- 
 tion of this kind is produced by the irri- 
 tation of mercury, applied in any way to 
 the system. In some cases, this is a very 
 severe affection, and the skin is exceed- 
 ingly tender and irritable. This is to be 
 allayed by frequent washing or fomenta- 
 tion, with warm gruel or strained bran 
 
 and water, as Bateman recommends ; and 
 the warm bath is an important remedy. 
 If the outer skin has peeled off, a little 
 cerate of litharge is to be applied thickly 
 spread on linen. All stimulating food and 
 drink is to be avoided, and the bowels are 
 to be kept open by mild laxatives. A gentle 
 perspiration during the night is to be pro- 
 moted by antimonial medicines ; and the 
 sulphuric acid or elixir of vitriol may be 
 given through the day, as cooling and re- 
 freshing to the patient. 
 
 EFFERVESCENCE. The frothing 
 occasioned by the escape of an aeriform 
 body, when substances are mixed toge- 
 ther, whose chemical action is to unite 
 some of the ingredients, and to allow the 
 whole or part of the others to escape in 
 the form of gas. Instances of efferves- 
 cence may be seen when vitriol or vinegar 
 is poiu-ed on chalk or marble, or when 
 lemon-juice is mixed with carbonate of 
 soda, or of potash. 
 
 EFFERVESCING DRAUGHTS are 
 made by dissolving a drachm, or a drachm 
 and atk half of carbonate of soda, of potash, 
 or of ammonia, in an ounce of water, and 
 mixing with this an ounce of lemon-juice, 
 with a little water and sugar; or if lemon- 
 juice cannot be procured, dissolving a 
 drachm of crystallized citric acid or tar- 
 taric acid in an ounce of water, and add- 
 ing this to the allialine solution. The 
 two solutions when they meet, occasion 
 by their mutual action, an effervescence 
 by the escape of carbonic acid ; and should 
 be swallowed while this action is going 
 on ; or the one may be swallowed before 
 the other, that the action may take place 
 in the stomach. The medicinal virtues of 
 the effervescing draughts are to check vo- 
 miting, and to determine to the skin; hence- 
 they are very useful in a variety of dis- 
 eases, especially feverish and dyspeptic 
 complaints. The materials for making 
 effervescing draughts are kept in the shops 
 under the name of soda powders, and di- 
 rections are given for their use. They ar^ 
 thought to give relief in the symptoms of 
 indigestion whicli follow over-indulgence 
 in eating or drinking. 
 
228 
 
 EL A 
 
 ELE 
 
 EGGS. Besides the shell, and an in- 
 vesting membrane, eggs contain the white, 
 consisting" principally of albumen and wa- 
 ter; and the yoke, consisting of water, 
 oil and albumen, destined for the food of 
 the chicken before it leaves the shell. The 
 eggs in most common use are those of the 
 common dung-hill fowl, of ducks, and of 
 turkeys. 
 
 As an article of food, eggs are very 
 much used, as they contain in a small 
 bulk a great deal of nutritious matter. 
 When soft boiled, eggs are very easily di- 
 gested, but when hard boiled, they form 
 a very indigestible mass, requiring very 
 strong powers of the stomach. If a per- 
 son in health is going on a journey, where 
 he will be long of getting food, one or 
 two hard-boiled eggs, taken before set- 
 ting off, will keep off the sensation of 
 hunger for a considerable time. 
 
 If the stomach be out of order, eggs are 
 apt to disagree, and either alone or in pud- 
 dings they are to be abstained from. An 
 eggy for a healthy child, is a good article 
 of diet, but in many of the disorders of 
 the stomach and bowels to which child- 
 ren are so liable, eggs, and puddings made 
 with eggs, are inadmissible ; and for child- 
 ren, eggs ought to be soft boiled, and a due 
 quantity of bread eaten along with them. 
 
 ELATERIUM, a substance that sub- 
 sides from the juice in the fruit of the 
 wild cucumber, Momordica Elateriuniy 
 surrounding its seeds. It is remarkable 
 for its powers as a cathartic, producing 
 copious watery stools ; hence it is used 
 in dropsy ; and in many cases, evacuates 
 the water, when other cathartics and diu- 
 retics have failed. It is a medicine of much 
 uncertainty in its operation, and requires 
 therefore to be given with the greatest pos- 
 sible caution ; an over-dose of it occasions 
 violent purging, attended with great de- 
 bility. Dr. Paris has lately examined very 
 particularly the elaterium of commerce, 
 and considers its active properties to re- 
 side in a vegetable proximate principle, 
 not hitherto noticed, to which he gives 
 the name of elatin. The dose of good 
 elaterium, as it occurs in commerce, he 
 
 says, is about one grain ; but it is bet- 
 ter to give it only to the extent of half a 
 grain, or a quarter of a grain at a time, 
 and to repeat that dose every half hour 
 until it begins to operate. It is probably, 
 when thus managed, the best hydragogue 
 cathartic which we possess; it differs, 
 however, from the class of remedies to 
 which it belongs, for it excites the pulse 
 and whole system so as to produce a 
 considerable degree of febrile action. 
 
 ELDER, Sambucus Ebulus. A water 
 distilled from elder-flowers, acquires their 
 peculiar odour, and is sometimes used to 
 compose part of an eye-wash. 
 
 ELECTRICITY. For the physical 
 properties of electricity, and the method of 
 its manifestation, with the description of 
 the various electrical machines, we *efer 
 to the books of natural philosophy. With 
 respect to its powers on the human body, 
 they are those of high excitement ; and 
 when applied in too great a quantity, or 
 too much concentrated, electricity de- 
 stroys life, as we see in persons killed by 
 lightning. Electricity is employed in the 
 form of sparks or shocks in various cases 
 of debility and want of nervous action ; 
 as in those cases of blindness which arise 
 from want of sensibility of the optic nerve, 
 or its expansion of the retina. It is used, 
 in palsy of the various parts of the body, 
 and in rheumatism after it has long exist- 
 ed, and when it has passed into the chronic 
 stage. It has also been used in those dis- 
 eases of the uterine system, which are ac- 
 companied with want of action, as the non- 
 appearance or suppression of the monthly 
 discharge ; and it has been known to im- 
 part a healthy action, and the power of 
 conception even to females who had long 
 been barren. In all diseases attended 
 with any inflammatory symptoms, elec-^ 
 tricity would be improper. 
 
 ELECTUARY. A form of giving 
 certain medicines, chiefly powders, which 
 are mixed with syrups and other sub- 
 stances into such a consistence, that the 
 mass shall neither be too stiff to swallow, 
 nor so thin as to allow the powders to 
 separate; and that a dose can be. easily 
 
ELEPHANTIASIS. 
 
 229 
 
 taken upon the point of a knife. The 
 principal electuaries at present in use are 
 those of senna, of catechu, of scamraony, 
 and of opium, the particular virtues of 
 which may be learned from the respective 
 articles whose name they bear. 
 
 ELEPHANTIASIS. A disease so 
 jiamed from the leg's of the patient be- 
 <oraing scaly, rough, and very large, like 
 the legs of an elephant. It is called the 
 Barbadoes leg, or the glandular disease of 
 Barbadoes, from its being very common 
 in that island. It sometimes comes on 
 gradually, but more generally with a slight 
 fever, and a pain in one of the glands of 
 the groin, which after a time becomes 
 swelled, hard, and inflamed. A red streak 
 is seen running down the thigh to the 
 leg; though the fever abates, the swelling 
 increases, and the fever may even return 
 at uncertain periods, leaving the leg with 
 many swelled veins, the skin rough and 
 rugged, and the cellular substance thick- 
 ened. The disease may continue many 
 years, without the patient's health being 
 jtfected, though he has great inconve- 
 nience in drawing the affected leg after 
 him. At the first attack, an emetic and 
 purgative may be given, and afterwards 
 medicines to promote perspiration. The 
 diet and medicines employed should be 
 such as contribute to the strength of the 
 vital powers. Mercury has been thought 
 rather injurious, but sometimes it has 
 done good. When the disease has tho- 
 roughly affected the leg, there is little 
 hope of a cure, the organization of the 
 skin being completely altered. 
 
 " In this state the swelling is hard and 
 firm, and entirely free from pain. The 
 skin is thickened and much hardened; 
 its blood-vessels are enlarged, particularly 
 the external veins, and the lymphatics 
 distended ; the cellular substance is flac- 
 cid, and sometimes thickened, and its cells 
 much loaded with a gelatinous fluid. The 
 muscles, tendons, ligaments, and bones are 
 generally in a sound state. In this ad- 
 vanced stage, the disease is altogether ir- 
 remediable; and, indeed, little success 
 spems to have attended the practice cm- 
 
 ployed in the earlier stages, which has 
 been chiefly directed to alleviate the fe- 
 brile paroxysms by laxatives and diapho- 
 retics, and subsequently to strengthen the 
 system by bark. Local bleeding has never 
 been employed, for there are no leeches 
 in Barbadoes, according to Dr. Hendy ; 
 but after the fever and inflammation have 
 subsided, he strongly recommends the 
 binding of the limb in a tight bandage, as 
 the means of exciting absorption and of 
 reducing the swelling." (Dr. Bateman.) 
 
 It may be useful to mention, that the 
 term Elephantiasis is confined by prac- 
 titioners of the present time to the local 
 affection of the leg above described ; but 
 that the Greek writers applied it to a tu- 
 bercular disease of the skin. Through the 
 inaccuracy of translators, the term has 
 been applied to Lepra, which should be 
 confined to a scaly disease ; and much con- 
 fusion has been introduced into medical 
 writings on these subjects by these inac- 
 curacies. (^See Bateman's Synopsis of 
 Cutaneous Diseases.') 
 
 ELIXIR. A term formerly applied to 
 many preparations resembling compound 
 tinctures. It is now but little used* We 
 have the Elixir of Vitriol, a compound of 
 sulphuric acid and aromatics, a good sto- 
 machic in the dose of ten drops, or twenty 
 in a glass of cold water ; and the Pare- 
 goric elixir, or ammoniated tincture of 
 opium, or camphorated tincture of opium, 
 useful in coughs and catarrhal affections. 
 See Catarrh. 
 
 EMBROCATION. A fluid applica- 
 tion for rubbing any pained or diseased 
 part of the body. Embrocations are made 
 with spirits, or by decoction or infusion. 
 Embrocations are useful for sprain s, bruises, 
 rheumatism, chilblains ; and rubbing the 
 breast with certain stimulant embroca- 
 tions, often does good in hooping-cough. 
 
 EMETICS. Medicines which have 
 the power of evacuating the contents of 
 the stomach, independent ol their quan- 
 tity or any nauseousness in their taste or 
 odour. Vomiting is now regarded by the 
 most accurate physiologists as depending" 
 not only on the stomach, but also on the 
 
230 
 
 EMETICS. 
 
 nervous energy transmitted by the brain 
 to the several muscles concerned in that 
 evaaiiatlon. Certain states of the brain 
 are well known to hinder the action even 
 of the strongest emetics. When the energy 
 of the brain is suspended by complete in- 
 toxication, or by violent blows or contu- 
 sions on the head, repeated doses of strong 
 emetics will not produce vomiting; but 
 it is ciu*ious to remark, that a less degree 
 of violence applied to the head, and the 
 beginning of intoxication, have the effect 
 of rendering the stomach more irritable, 
 and vomiting is then easily excited. Cer- 
 tain narcotic poisons, as the deadly night- 
 shade, diminish the nervous energy to such 
 a degree, that it is not transmitted to the 
 muscles of the belly and to the diaphragm, 
 so as to enable them to excite vomiting ; 
 and hence very large doses of emetics are 
 in such cases resisted ; but if the narcotic 
 poison be counteracted by the draught of 
 a large quantity of some vegetable acid, 
 then the energy of the brain is restored, 
 and vomiting takes place. We must be 
 carefal in such cases not to continue 
 throwing in additional quantities of the 
 emetic, for the fault is not in the stomach, 
 which may retain all its sensibility, and, 
 by the substances applied, may have fatal 
 inflammation brought upon it. Anotherin- 
 stance of the action of vomiting being caus- 
 ed by some influence first excited in the 
 brain, is that induced by certain motions, 
 as swinging, whirling, and sailing, and by 
 the recollection of disgusting objects. 
 
 When an emetic is taken into the sto- 
 mach, some time, from ten to twenty mi- 
 nutes, elapses before any effect is percep- 
 tible ; then an uneasy feeling, termed 
 sickness or nausea, which increases till 
 the vomiting begins. The duration and 
 severity of this preliminary stage varies 
 ■with different emetics ; sulphate of zinc 
 acts without occasioning much nausea, 
 while tobacco produces a distressing de- 
 gree of sickness, much greater in propor- 
 tion than its emetic power. In some cases, 
 the nausea is more likely to do good than 
 the vomiting, and the proper emetics are 
 to be selected accordingly. During nau- 
 
 sea, the countenance is pale and shrunk, 
 the pulse is feeble and irregular, and there 
 is a feeling of cold ; when vomiting com- 
 mences, the face is flushed, and the pulse 
 is quicker and stronger. When the vo- 
 miting has ceased, there is a degree of 
 languor, an inclination to sleep, and a ge- 
 neral moisture on the skin. When the 
 time of giving an emetic is in our power, 
 it is best to do it in the evening, and to let 
 the patient retire to bed soon after its ope- 
 ration. At whatever time of the day an em- 
 etic is administered, cold should be avoid- 
 ed. The action of an emetic is promoted, 
 and also rendered less painful, by the drink- 
 ing of copious draughts of warm water, 
 chamomile tea, or any other warm liquid. 
 
 Emetics are beneficial either by their 
 primary effect of unloading the stomach, or 
 by the eff'ects which they produce on dis- 
 tant parts by sympathy, as on the lungs or 
 kidneys ; and sometimes the mere con- 
 cussion of the body during their operation 
 is the circumstance which is of service. 
 
 Of the various diseases in which the 
 giving of Emetics is useful. The ad- 
 ministration of an emetic is a very proper 
 and necessary proceeding in a great va- 
 riety of cases. When any disorder arises 
 from the presence of too great a quanti- 
 ty of matter tal:en in, or from the pre- 
 sence of acrid indigestible matters, or 
 when poison has been swallowed, vomit- 
 ing gives speedy relief. Emetics are use- 
 fully given, at the commencement of fe- 
 verish diseases^ and they are stiU more 
 useful if we can so regulate them as to 
 procure not only an emetic, but also a 
 purgative effect. Emetics are also given 
 in catarrh, and various disorders of the 
 chest; and they are found to promote 
 expectoration, and otherwise to alleviate 
 these disorders. Nature seems to have 
 pointed out vomiting as a mode of reKef 
 in hooping-cough ^ and in imitation of 
 this salutary effbrt, emetics are freely ad- 
 ministered in that complaint. From the 
 mechanical effect of vomiting in pressing 
 various parts of the cavity of the belly, 
 emetics are sometimes given in jaundice^ 
 with a viev,- to force into the bovt'els thai 
 
EMETICS. 
 
 tat' 
 
 concretions which choke up the bile- 
 ducts ; but this is a practice too hazardous 
 to be often repeated. Emetics have been 
 known to promote the cure of dropsy y 
 probably by the agitation which they 
 give, tending to promote the action of 
 the absorbents. By diminishing the doses 
 of emetics, we may produce only sick- 
 ness, without going the length of full 
 vomiting ; and in this way we can pro- 
 mote perspiration and diminish inflam- 
 matory action. There are certain states 
 of the system in which it would be un- 
 safe and improper to use emetics. Thus 
 in plethoric states of the body, and where 
 there is great determination to the head 
 or lungs, vomiting is not free from danger; 
 and in the advanced stages of pregnancy, 
 in rupture, and in falling down of the 
 womb, emetics are to be avoided. 
 
 Many substances are famed for possess- 
 ing emetic powers, but being in posses- 
 sion of a i^vf good and certain ones, it is 
 needless to trouble ourselves in the search 
 of a useless variety. Those in most com- 
 mon use are the powder of ipecacuan, the 
 preparations of antimony, and the sul- 
 phates of zinc and copper. Ipecacuan is 
 a mild and safe emetic, which may be 
 given to the youngest subjects. The dose 
 for an adult is from fifteen to twenty 
 grains ; and should we, by any accident, 
 give too much, the worst that can hap- 
 pen, is to produce vomiting a little more 
 speedily than we wish. For children, 
 the dose may vary from six grains and 
 upwards, according to the age ; or when 
 no inflammatory symptoms forbid, they 
 may get it infused in wine, a tea-spoonfnl 
 every ten minutes till it operates. The 
 best and most manageable antimonial is 
 the tartar emetic, of which two grains 
 are a full dose. It is seldom we give this 
 quantity at once ; the best way is to dis- 
 solve two grains in four ounces of warm 
 water, and of this solution, to give a table- 
 spoonful every ten or fifteen minutes till 
 it operates. Tartar emetic acts even 
 when introduced into the veins of an 
 animal. Tartar emetic is also soluble in 
 >yine, in the proportion of two grains to 
 
 the ounce. The dose of this antimonial 
 wine is from two to four drachms. Fifteen 
 grains of ipecacuan combined with one 
 of tartrate of antimony, make a very 
 effectual emetic ; and the action of vo- 
 miting may be promoted by drinking co- 
 pious draughts of warm water or chamo- 
 mile tea. The sulphate of zinc is a use- 
 ful emetic when we wish a very speedy 
 and effectual one, as in cases where poi- 
 son has been swallowed, especially lau- 
 danum ; though perhaps emetics in such 
 cases may be superseded by the lately re- 
 invented stomach-pumps, orthe syphon 
 of Mr. Bryce. The dose of sulphate of 
 zinc as an emetic, is thirty grains. For 
 the same purpose, the sulphate of copper 
 is used, but in much smaller doses, viz. 
 from six to ten grains ; but as being itself 
 rather poisonous, its use is more rare. 
 When metallic poisons have been swal- 
 lowed, there is commonly so much vomit- 
 ing, that no emetic is needed ; and we 
 are rather to use diluents and the sub- 
 stances proper to neutralize such poisons, 
 or to counteract the succeeding symp- 
 toms which are likely to occur ; whether 
 they be debility, affections of the nervous 
 system, or inflammation. 
 
 EMMENAGOGUES. Medicines sup- 
 posed to have the power of acting on the 
 womb, and promoting the menstrual dis- 
 charge. It is now acknowledged by all 
 judicious physicians, that we know of no 
 substance which has a direct and specific 
 action on the womb ,* and that whatever 
 success any means may appear to have 
 had, in producing the monthly discharge, 
 this is owing to some action on the whole 
 system, or on the neighbouring parts, 
 from which that action has been commu- 
 nicated by sympathy to the womb. The 
 non-appearance of the menses in young 
 women, or their obstruction in those who 
 have had them established for some time, 
 is generally owing to some disorder of 
 the system ; and whatever removes this, 
 and produces the Avished-for discharge, 
 may be styled an emmenagogue. Some- 
 times tonics, sometimes purgatives, have 
 this effect ; or if the system be too pie- 
 
EMPHYSEMA. 
 
 tlioric, bleeding may contribute to bring- 
 the discharge. Electricity, aloes, cantha- 
 rides, turpentine, cupping on the loins, 
 or warm fomentation, may all be useful, 
 when directed by a practitioner of skill 
 to know the proper time and manner of 
 their exhibition. Sometimes good air, 
 exercise, and a regulation of the diet, are 
 all that is required to establish the month- 
 ly discharge. Women are very apt to 
 lay a great stress on the importance of 
 this function, and to be very uneasy if it 
 be too long of becoming regular; but 
 there is no fixed period for its beginning, 
 and while the health is uninjured, they 
 should not take strong medicines with 
 the view of forcing on the discharge. 
 
 EMOLLIENTS are those remedies 
 which, when applied to the solids of the 
 body, render them more soft, lax, and 
 flexible. These are principally oily sub- 
 stances applied by friction in a warm 
 state, or they are the various forms of fo- 
 mentations and poultices. 
 
 EMPHYSEMA signifies a swelling 
 from the presence of air, and is generally 
 applied to the diffused swelling which 
 happens from air getting into the cellu- 
 lar substance. Emphysema is known by 
 a soft puffy swelling ; the skin is glossy ; 
 the tumor yields to pressure, but returns 
 as soon as the pressure is withdrawn, and 
 a crackling noise is heard when any part 
 of the swelling is pressed. Emphysema 
 most commonly arises in consequence of 
 injuries to the pleura investing the lungs, 
 as by a sharp-pointed instrument, or by a 
 fractured rib. It is sometimes brought 
 on by the strong exertions of respiration 
 during labour. When the lungs are 
 wounded, there is troublesome cough, and 
 the expectoration is sometimes mixed 
 with blood ; and when air escapes into 
 the cavity of the chest, forming the dis- 
 ease now called pneumo-thorax, there is 
 great difficulty of breathing, anxiety, a 
 sense of suffocation, lividness of the coun- 
 tenance; and death ensues unless relief 
 is speedily obtained. 
 
 Treatment. If a wound be the cause 
 -of emphysema, it njust be closed up and 
 
 healed in the usual way, and it may be 
 necessary to lessen inflammatory action 
 by blood-letting, which will require to be 
 repeated if there is much pain, or if the 
 breathing is quick and laborious. The 
 air is to be evacuated from the cellular 
 substance by a number of small incisions 
 or punctures ; and this is also to be done 
 in those cases where emphysema occurs 
 in consequence of the efforts of labour, 
 if the breathing be much affected ; but in 
 general this emphysema disappears with- 
 out much trouble. When air has got 
 into the cavity of the thorax, as well as 
 into the cellular substance, and occasions 
 great difficulty of breathing, an opening 
 is made into the cavity of the chest to 
 give it vent. The best place for perform- 
 ing the operation, if the disease is on the 
 rif '^ side, will be on the fore part of the 
 chest, between the fifth and sixth ribs, 
 for there the integuments are thin ; and 
 in the case of air, no depending drain is 
 required. But if the disease is on the 
 left side, it will be more advisable to make 
 the opening between the seventh and 
 eighth, or eighth and ninth ribs, that we 
 may be sure of avoiding the pericardium. 
 As large penetrating wounds are incon- 
 venient on account of the air entering by 
 the aperture in such a quantity as to 
 prevent the expansion of the lungs, a 
 small wound will be eligible, especially as 
 air does not require a large one for its 
 escape. It is better to dissect cautiously 
 with a knife, than to employ the coarse 
 and hazardous method of thrusting in a 
 trocar. (Mr. Hewson.) 
 , EMPIRICS. The name of a sect of 
 physicians in ancient times, who professed 
 to be guided in the practice of physic by 
 experience alone, and who discarded as 
 unnecessary all acquaintance with the 
 structure of the body, or reasoning ou 
 its functions. Obvious and indisputable 
 causes of disease, they admitted as ne- 
 cessary to be known ; but they consider- 
 ed as superfluous, all inquiry into ob- 
 scurer causes, or natural actions, as re- 
 spiration, digestion, and assimilation. If 
 patients treated themselves, some in one 
 
EMPIRICS. 
 
 233 
 
 way and some in another, they observed 
 which plan succeeded best, and treasur- 
 ed up the result of the experiment as 
 the rule for their practice in similar cases. 
 They said, it was of no moment what 
 caused a disease ; our business is to know 
 what cures it ; we need not inquire into 
 the manner of dijifestion, but observe 
 what is best digested ; nor into the mode 
 of respiration, but how we may best re- 
 store its healthy state when it is oppress- 
 ed. Dogmatists may argue plausibly on 
 both sides of a question ; genius and elo- 
 quence may gain the victory; but dis- 
 eases are cured not by fine talking, but 
 by remedies. Anatomy they held in great 
 contempt; they considered the appear- 
 ances in the dead body as totally differ- 
 ent from' the living ; and therefore use- 
 Jess to be known. If accident presented 
 to them the internal parts of a man, as 
 when a gladiator fell in the amphitheatre, 
 or a soldier in the field, they condescend- 
 ed to look at them ; and maintained that 
 a sagacious physician, by seeing a variety 
 of such cases, would acquire a sufficient 
 knowledge of the position, arrangement, 
 and shape of those parts ; and this, while 
 engaged in the benevolent purpose of re- 
 storing health, and not in the butchery 
 of anatomizing the living body. Dissec- 
 tion of the dead subject they thought to 
 be unnecessary ; though not cruel, it was 
 disgusting ; and they were satisfied with 
 what knowledge could be gained from 
 the living in the progress of their cure. 
 
 The term Empiric is applied in modern 
 times to those who practise physic with- 
 out a competent education or knowledge 
 of their profession, and who pretend to 
 wonderful cures by the use of some nos- 
 trum which they sell for their own ad- 
 vantage. 
 
 EMPYEMA signifies a collection of 
 purulent matter within the cavity of the 
 chest. This suppuration is generally the 
 consequence of pleurisy, and is suspected 
 to be present, when there is an abatement 
 of the previous pain, with continuing 
 difficulty of breathing, cough, and hectic 
 fever; while the patient in general can- 
 
 not lie easily, except on the side on which 
 the collection of matter is. Sometimes 
 the chest on that side is expanded, the 
 ribs are a little elevated, and a fluctua- 
 tion of a fluid can be perceived. When 
 we are satisfied of the existence of mat- 
 ter in the cavity of the chest, it is almost 
 always proper to discharge it by an open- 
 ing. The safest and most convenient 
 situation for making an opening into the 
 chest, is between the sixth and seventh 
 true ribs on either side, as circumstances 
 may render necessary. If there be a col- 
 lection of matter on both sides, the two 
 operations should not be done at the same 
 time. The operation consists in making 
 an incision about two inches long, through 
 the integuments which cover the space 
 between the sixth and seventh ribs. The 
 patient is to be so placed that the open- 
 ing may be in a dependent position. The 
 surgeon is to avoid the lower edge of the 
 upper rib, as the intercostal artery lies in 
 a groove running along that part. He is 
 then cautiously to divide the layers of the 
 intercostal muscles, till he brings the in- 
 vesting membrane of the lungs into view, 
 which membrane is to be very carefully 
 divided with a lancet. The instrument 
 should never be introduced at all deeply, 
 lest the lungs should be injured ; and the 
 size of the opening should never be larger 
 than necessary. If requisite, a little tube 
 maj be introduced into the >vound for 
 facilitating the evacuation of the fluid. 
 This tube should not be too long, and 
 should have a broad rim to prevent it 
 from slipping into the chest, and may be 
 kept in its place with sticking plaster. 
 It may be stopped with a cork if it should 
 be thought convenient to let the matter 
 run off at intervals. 
 
 EMP YREUMATIC. Having a burnt 
 or singed smell or flavour. Oils or other 
 matters which have been subjected to too 
 strong a heat, are said to have an empy- 
 reumatic odour. 
 
 EMULSION signifies a composition 
 in which oils and oily fluids, or other sub- 
 stances which are not soluble in water, 
 are suspended in watery fluids by means 
 
234. 
 
 EPIDEMIC. 
 
 of viscid substances, such as mucilages or 
 syrups. The principal emulsions in use 
 are the emulsion of sweet almonds, and 
 of gum arabic, ^hich are used to the 
 quantity of half a pint pretty frequently 
 in the course of a day, when there is 
 heat of urine and strangury ; either from 
 disease, or from the introduction of can- 
 tharides, when applied to the skin for the 
 purpose of blistering, or when they are 
 given internally. Camphor is also given 
 in the form of an emulsion, by means of 
 almonds and sugar. Camphor emulsion 
 is sold in the shops by that name, and is 
 used in doses of a table-spoonful every 
 three or four hours, in fevers of the kind 
 approaching to typhus, or low nervous 
 fever. 
 
 ENAMEL OF THE TEETH. The com- 
 pact outer bony shell covering the teeth. 
 It is liable to be incrusted with tartar in 
 those who are not careful to keep their 
 teeth cleati. Strong acids are apt to in- 
 jure the enamel, and dentists therefore 
 discourage their use. 
 
 ENEMA. See Clyster. 
 
 ENTERITIS. See Bowrls, Infiam- 
 mation of. 
 
 ENTROPION. A turning in of the 
 eyelids, by which the eyelashes are made 
 to irritate the eye. See Eyelids. 
 
 ENURESIS. Inability to retain the 
 urino. See Urinary Organs, Diseases of. 
 
 EPHEMERA. A fever lasting only 
 for a day, or a very short period. This 
 term might be applied with great pro- 
 priety to the febrile illnesses which so 
 commonly affect children, on any slight 
 derangement of the stomach and bowels, 
 as they, in general, do not last longer 
 tlian till the bowels are relieved by some 
 liixative medicine. 
 
 EPIDEMIC. A disease affecting great 
 numbers at once ; thus we speak of an 
 epidemic fever, and an epidemic catarrh 
 or influenza ; or we say that the measles 
 or scarlet fever is the prevailing epidemic. 
 
 " Epidemics are very often owing to 
 the eflQuvia of neighbouring marshes ; and 
 their occasional appearance is connected 
 with the prevailing wind which passes 
 
 from the marsh to the habitations. An<i 
 other cause of their prevalence, is the wind 
 from the marsh coinciding with the time 
 when the moist ground begins to appear, 
 from the water subsiding. This is the 
 period of sickness ; for the marsh, while 
 covered wdth water, is innocuous. An- 
 other cause of epidemics is the weather. 
 A long continued warm season, suddenly 
 interrupted by a cold piercing wind, will 
 produce a violent and extensive epidemic, 
 which particularly attacks in the highe&t, 
 and apparently the most healthy situa- 
 tions ; for this reason, that the inhabi- 
 tants are there most exposed to cold. 
 But if this interchange of weather occurs 
 to the inhabitants of a crowded city, the 
 epidemic will be highly putrid, and often 
 fatal. Should contagion of a malignant 
 kind concur, the devastation of the epi- 
 demic will increase in proportion. These 
 are the concurring causes of the Ameri- 
 can yellow fever, and the fatal epidemics 
 in Spain, in 1804 and following years. 
 
 " There are, however, causes which we 
 cannot investigate. Extensive epidemics 
 appear, and travel in succession, with 
 different severity, through every part of 
 the globe that we are acquainted with. « 
 We often find these inexplicable epidemics 
 without much danger, influencing the ap- 
 pearance of diseases, and their treatment. 
 Thus, while some epidemics prevail, eva- 
 cuations from the bowels are necessary 
 in almost every complaint ; even where, 
 in appearance, unnecessary, or contra- 
 indicated. In others, they are with diflH- 
 culty borne in any disorder. This neces- 
 sary attention to the prevalence of the 
 constitution merits very particular at- 
 tention. 
 
 " Epidemics connected with the sea- 
 sons, or prevailing temperature, may b^ 
 easily traced, and we shall find them oc- 
 casionally mitigated or severe ; sometimes 
 apparently stopped, at others exerting 
 their power with increased viruleiice. 
 The peculiar treatment, however, suggest- 
 ed by a general epidemic, should not at 
 once be discontinued. The human con- 
 stitution does not soou change ; the alte- 
 
EPILEPSY. 
 
 2^i 
 
 ration is gradual, and almost impercepti- 
 ble ; nor sliovdd the medical plans be al- 
 tered, till they are decidedly injurious. 
 
 " When an epidemic has continued for 
 some time, the body is habituated to the 
 influence of the morbid cause, suffers less 
 from it, and the health is more readily 
 restored. At this time, remedies, before 
 useless, are found to produce some salu- 
 tary effects, and at the end of an epidemic 
 we usually are told of a plan which never 
 fails. On its return, these boasted plans 
 are as ineffectual as before. In fact, they 
 only combated with success a disease of 
 reduced power." (Dr. Parr.) 
 
 ^ EPIGLOTTIS. The cartilaginous lid 
 Avhich shuts up the entrance into the 
 windpipe during the action of swallow- 
 ing, so that, although the whole of our 
 food passes over the tube which conveys 
 air to the lungs, it is exceedingly rare 
 for the smallest particle to go the wrong 
 way, where it would be productive of 
 great inconvenience and danger. This 
 is so admirably contrived that the very 
 act of swallowing shuts the epiglottis. A 
 case mentioned in Cooper's Dictionary 
 from Baron Larrey, shows how much we 
 are benefited by this simple and beautiful 
 mechanism. It is that of a French sol- 
 dier, who had the epiglottis shot away at 
 the battle of Alexandria, on the 21st of 
 March, 1801. The ball entered at the angle 
 of the jaw, crossed the throat obliquely, 
 and came out at the opposite side of the 
 neck. The base of the tongue was grazed, 
 and the epiglottis shot away. The pa- 
 tient was not in much pain ; but his voice 
 was hoarse, feeble, and scarcely audible. 
 When he first attempted to swallow, he 
 was seized with a convulsive suffocating 
 cough, attended with vomiting. Annoyed 
 by thirst, which the extreme heat of the 
 weather and the irritation of the wound 
 excited, he incessantly repeated his at- 
 tempts to drink; but always with the 
 (same result. Four days were passed in 
 this deplorable condition. He already 
 experienced violent complaints in his sto- 
 mach ; continued loss of sleep ; he had a 
 woaall quickened pulse, and was beginning 
 
 to look thin. When Larrey saw him on 
 the fifth day, the most urgent indication 
 was to appease his hunger and thirst, 
 which was done by introducing into the 
 gullet an elastic gum tube ; by means of 
 which some drink was given to the patient, 
 which relieved him much; and afterwards 
 some rich broth. He was fed in this 
 manner for six weeks, at the end of which 
 time he was able, without the assistance 
 of the tube, to swallow thick panado, and 
 thickened rice, made into little balls. Thd 
 powers of speech and deglutition in time 
 became much more perfect, in conse- 
 quence, probably, of the enlargement of 
 the neighbouring cartilages; and of the 
 expansion of the base of the tongue, hav- 
 ing formed a sort of substitute for the 
 epiglottis. This patient must have been 
 starved to death, but for the use of the 
 elastic gum tube. 
 
 EPILEPSY, Convulsions, or Fall- 
 ing-sickness. A disease of frequent oc- 
 currence, and arising from many various 
 causes, consisting of convulsions of more 
 or fewer of the muscles of voluntary 
 motion, accompanied with a loss of sense, 
 and ending in a state resembling deep 
 sleep. Epilepsy suddenly attacks per- 
 sons seemingly in perfect health; and 
 going off after a certain time, the patients 
 are left in their usual state. In some 
 patients, there is a very curious warning 
 of the approach of an epileptic fit. From 
 some point on the surface of the body, 
 perhaps one of the fingere or toes, a sen- 
 sation begins, as of a cold wind, or the 
 creeping of an insect ; which appears to 
 proceed to the head, and when it reaches 
 that part, the patient is convulsed. This 
 is called the aura epileptica. In other 
 cases, the patient fancies he sees a spectre 
 approaching him, and the contact of this 
 figure is the commencement of the con- 
 vulsions. Whether there be any warn-;- 
 ing or not, a person thus attacked loses 
 all power of sense and motion, and either 
 falls or is thrown with convulsions to the 
 ground. In that situation, violent con- 
 vulsions variously move his limbs an(|i 
 the trunk of the body, and frequently 
 
236 
 
 EPILEPSY. 
 
 with more violence on one side than the 
 other. In almost all cases, the muscles 
 of the face and eyes are much affected, 
 giving a very distressing and alarming 
 distortion to the countenance. The tongue 
 is often affected, and thrust out of the 
 mouth ; and by the convulsive action of 
 the muscles which shut the jaw, the tongue 
 is not unfrequently severely wounded, 
 and has been known to be almost bitten 
 through. During the continuance of the 
 convulsions, as the patient has not the 
 power of swallowing, the spittle issues 
 from the mouth, worked into a frothy 
 gtate by the action of respiration. This 
 is always an unseemly appearance, though 
 by itself it is not to be greatly regarded. 
 The convulsions remit for a few minutes, 
 and are then renewed, perhaps with in- 
 creased violence. In a little time, the 
 convulsions cease altogether, and the per- 
 son is in a state of complete insensibility, 
 which remains for a considerable time. 
 Gradually he recovers his senses, but has 
 no distinct remembrance of what has 
 passed from the first attack of the parox- 
 ysm. The pulse and breathing are some- 
 what irregular and hurried during the fit, 
 but soon return to their natural state. 
 
 Causes of Epilepsy. In this, as in all 
 nervous diseases, the explanation of causes 
 is very difficult. The opposite causes of 
 over-excitement and of debility are both 
 known to produce epilepsy. Every thing 
 that irritates the brain, or the mental fa- 
 culties, which we, in our imperfect know- 
 ledge, believe to be dependent on the ac- 
 tions of the brain, has been known to pro- 
 duce epilepsy ; thus an injury done to the 
 skull, the growth of tumours in the inter- 
 nal parts of that cavity, splinters of bone 
 scaling oflf in consequence of disease, and 
 various alterations of structure which 
 have been discovered after death in pa- 
 tients afilicted with epilepsy, give us just 
 grounds for reckoning mechanical irrita- 
 tion among the causes of epilespy. Vio- 
 lent emotions of the mind, as joy, fear, 
 anger, are well known to produce epilep- 
 sy. Hence the propriety in all cases, of 
 being veiy cg^utioifs in communicating in- 
 
 telligence likely to produce a strong im- 
 pression ; as even the most joyful tidings, 
 suddenly and rashly imparted, have been 
 known to produce convulsions, madness, 
 or death. It is a singular fact, that the 
 sight of a person in convulsions affects by- 
 standers with similar symptoms ; and me- 
 dical men express the fact, though they 
 cannot explain the cause, by ascribing it 
 to the principle of imitation ; by which 
 great numbers of persons are affected in 
 the same way as one begins to be, whe- 
 ther by enthusiasm, fear, rage, or the more 
 corporeal affections of hysterics and epi- 
 lepsy. Another cause which is referable 
 to the brain, is over-fulness or determina- 
 tion of blood to that organ ; of this we 
 are convinced by the frequent occurrence 
 of apoplexy and convulsions in the same 
 person, and the interchange and alterna- 
 tion of these symptoms with each other. 
 Acute pain in distant parts of the body, 
 as from a stone passing through the ure- 
 ter, gives rise to epilepsy ; and irritations 
 of the bowels, by acrid matters lodging 
 in them, by costiveness, or by worms, oc- 
 casion convulsions, though no great un- 
 easiness is felt in the bowels themselves. 
 Children, when teething, are very fre- 
 quently affected with convulsions, and 
 also when their stomach and bowels are 
 out of order. Many causes, the opposite 
 of excitement, produce epilepsy. Thus, 
 a person when weakened by a large 
 bleeding, is sometimes seized with epilep- 
 sy ; and debilitating causes, which in some 
 produce fainting, in others cause convul- 
 sions. The depressing passion of terror 
 sometimes produces epilepsy. Many of 
 the vegetable poisons produce convul- 
 sions before they prove fatal. In many 
 instances, epilepsy seems somehow con- 
 nected with the state of sleep. The causes 
 above enumerated being often applied to 
 the majority of mankind with impunity, 
 there must be some reason why certain 
 persons only are so affected by them; 
 and the nearest approach to explanation 
 that we can give, is that this tendency to 
 convulsions exists in persons of a deli? 
 cate and irritable habit, who are easijy 
 
EPILEPSY. 
 
 237 
 
 susceptible of impressiojis on their ner- 
 vous system ; and hence it so frequently 
 occurs in children, in young persons of 
 both sexes, and in the natives of warm 
 climates. Convulsions of the most vio- 
 lent kind not unfrequently attack women 
 when pregnant. (^See Pregnancy.) 
 
 Diagnosis. The affections which epi- 
 lepsy most resembles, are apoplexy, and 
 hysteria. It resembles apoplexy in the 
 suddenness of the attack, and sometimes 
 in the preceding symptoms; but is dis- 
 tinguished by the want of the stertorous 
 breathing, and of the slow and laborious 
 pulse which occiu* in apoplexy. Epilep- 
 sy is distinguished from hysteria, by this 
 last occurring chiefly in females, and be- 
 ing attended with much flatulence and 
 other disorders of the bowels, and with 
 variable and irregular emotions of the 
 mind. 
 
 Prognosis. Epilepsy seldom destroys 
 the life of the patient by a single fit ; but 
 it is a matter of much anxiety to judge 
 whether the disease is likely to be cured, 
 that is, to cease from recurring upon the 
 patient. It is seldom cured when it is 
 hereditary; and the longer it has been 
 habitual, the less is the probability of a 
 cure. In young persons subject to epi- 
 lepsy, we hope that some of the great 
 changes which take place in the consti- 
 tution, the approach of puberty, the ap- 
 pearance of the monthly discharge, or the 
 delivery of the first child, will operate a 
 permanent cure ; but if those events pass 
 over without this favourable result, we 
 are compelled to think badly of the case. 
 Epilepsy which is owing to mental emo- 
 tions, and especially to frights, is rarely 
 cured. 
 
 Treatment of Epilepsy. In epileptic 
 patients, we have three very distinct in- 
 dications to fulfil : to prevent a fit, to 
 shorten its duration, and to hinder its re- 
 currence; but unhappily our resources 
 are very inadequate to our wishes. In 
 cases where a fit is expected, we should 
 endeavour to prevent its occurrence ; and 
 where any warning is given for some 
 time previous, as by headach, flushing of 
 
 the face, or ringing of the ears, in per 
 sons of a full habit, we are to employ 
 evacuation of the bowels, or a bleeding 
 either general or loc;\l, taking care to 
 avoid all sources of irritation. In those 
 persons in whom debility is evident, we 
 follow a different plan, and give camphor, 
 bark, chalybeates, or other tonics. In 
 epileptic cases accompanied with the aura, 
 it has been proposed to stop the fit by 
 applying a tight ligature in some part of 
 its course between the extremity and the 
 head ; and to effect a permanent cure by 
 cutting the nerve across which is believ- 
 ed to transmit the nervous energy to the 
 part ; but neither of these plans have suc- 
 ceeded often enough to warrant our con- 
 fidence in the practice. 
 
 Our second indication is to shorten the 
 fit if possible. But however distressing 
 to friends and bystanders may be the ap- 
 pearance of a person in a fit of epilep- 
 sy, it is not often that the most skilful 
 attendant can do much to shorten its du- 
 ration, or that friends can do more than 
 take care, that the unhappy patient does 
 not injure himself by the violence of the 
 convulsions. A roll of silk, or some 
 such soft substance, should be put into 
 the mouth, to protect the tongue from 
 being bitten; and the arms or legs are 
 to be held with some degree of firmness, 
 to prevent them from being dashed about 
 with violence. The patient should be 
 placed on a bed or couch, or have some 
 soft things put under him; he should 
 have the head and temples rubbed with 
 vinegar, or some other cold application ; 
 and ammonia or other stimulants are to 
 be applied to the nostrils. It is in gene- 
 ral impossible to give any thing by the 
 mouth ; and the choice of any thing, when 
 it can be swallowed, must be determined 
 by the state of excitement or debility 
 which appears to predominate. If there 
 is great flushing of the face, heat of skin, 
 and evident marks of great flow of blood 
 to the head, it is quite proper to bleed, 
 and even largely too, during the fit, which 
 will probably be shortened by the prac- 
 tice ; but if there is a feeble pulse, with 
 
238 
 
 EPILEPSY. 
 
 clammy sweats, and other marks of debi- 
 lity, it would be the height of imprudence 
 to detract blood ; and we should rather, 
 if possible, restore the heat of the skin by 
 gentle rubbing with.warra dry flannel, and 
 giving some cordial by the mouth. In the 
 convulsions of children from teething, it 
 is necessary, along with other remedies, 
 to scarify the gums ; and in many cases 
 this should be done to prevent a fit from 
 taking place. 
 
 Our last indication is, when a fit of 
 epilepsy is over, to do what we can to 
 prevent another. This is not always 
 practicable, but it is to be attempted by 
 correcting the system in general, and the 
 nervous system in particular. If the per- 
 son shows marks of fulness and determi- 
 nation to the head, we are to diminish 
 these dangerous tendencies by purgative 
 medicines, by a low diet, and by avoiding 
 all occasional excess. An issue in the 
 neck is a prudent measure. Few medi- 
 cines can be trusted to, as having any 
 power to prevent the return of epilepsy. 
 Such as have had any reputation at all 
 are some metallic preparations, and some 
 strong smelling vegetable productions, as 
 valerian, assafoetida, and other antispas- 
 modics. It was the opinion of Dr- Fo- 
 thergill, that the good effect apparent 
 from the preparations of copper and some 
 other metals used in epilepsy, was merely 
 from their deranging the stomach in some 
 degree, and thus preventing people from 
 eating too much, by which the fulness of 
 the system was diminished, and the irrita- 
 bility lessened, which brought on the fits 
 of epilepsy. The ammoniuret of copper 
 in the dose of half a grain twice a-day, 
 increasing it gradually to three grains, or 
 the oxide of zinc in the dose of from 
 three to six grains, or the nitrate of silver 
 in the dose of an eighth or a quarter of a 
 grain, have been frequently used, but in 
 too many cases without any great success. 
 When there is reason to consider debility 
 as the cause of epilepsy, such measures 
 are to be adopted as strengthen the con- 
 stitution ; and for tliis purpose we em- 
 ploy bark, steel, and cold bathing, with 
 
 regular exercise and attention to tlie sto? 
 mach and bowels. 
 
 EPISPASTICS. A name for blisterr 
 ing and drawing ointments. 
 
 EPiSTAXIS. The nosological imne 
 for bleeding at the nose. See Nose, 
 Bleeding from. 
 
 EPSOM SALTS. One of the most 
 useful of the purgative salts. It is com- 
 posed of sulphuric acid combined with 
 magnesia, and is procui-ed by the evapo- 
 ration of mineral waters, in Avhich it is 
 the chief ingredient, as those of Epsom in 
 SuiTey ; and likewise by the evaporation 
 of the bittern remaining after the extrac- 
 tion of salt from sea-M^ater. It is one of 
 those purges v/hich are almost universally 
 proper ; and it has nearly superseded the 
 use of Glauber's salt, as being less coarse 
 and disagreeable. The dose for a grown 
 up person is from one ounce to an ounce 
 and a half, dissolved in half a pint of wa- 
 ter, and drank lukewarm. The morning 
 is the best time for taking saline purges. 
 Epsom salt may also be given in the in- 
 fusion of senna leaves; a quarter of an 
 ounce being dissolved in four or six ounces 
 of the infusion. The same mixture of 
 increased strength may be given as a 
 purgative glyster. 
 
 ERGOT OF RYE. An excrescence 
 sometimes found on rye, Secale cereale ; 
 said to have powerfully poisonous effects, 
 and occasionally used in labour and ute- 
 rine complaints. See Rve. 
 
 ERRHINES are those substances 
 which, when applied to the nose, stimu- 
 late the vessels opening on the fine mem- 
 brane which lines that cavity, and occa- 
 sion a discharge of serous or mucous mat- 
 ter from it. Various acrid vegetables, re? 
 duced to powder, have that effect ; as asa- 
 rabacca, white hellebore, and the most 
 noted of them all, tobacco and snuff. 
 These substances seem at times to relieve 
 toothach and headach, by the discharge 
 they occasion; and some have thought 
 them useful in apoplexy and palsy; but 
 the violent shock they give to the body, 
 and the delay of* the blood in the brain 
 which they occasion, have been known 
 
ERUPTIONS. 
 
 239 
 
 to give rise to a fatal attack of the dis- 
 ease. When snufF has been long^ used, it 
 ceases to excite any discharge from the 
 nose, and therefore no ill consequences 
 can ensue from its discontinuance, as there 
 might, by stopping an habitual discharge ; 
 but if such discharge has become consti- 
 tutional, it will be dangerous to. check it 
 suddenly, by abruptly laying aside the use 
 of snuff. 
 
 ERUPTIONS. A general terra for 
 every appearance on the skiu, different 
 from its natural and healthy appearance. 
 The variety of eruptions is very great, 
 and it is only within a few years that any 
 attempt has been made to classify and 
 name them. The arrangement of Dr. 
 Willan, and his pupil Dr. Bateman, is that 
 which has been almost universally adopt- 
 ed. Eruptions are arranged in eight or- 
 ders : Pimples, scales, rashes, blebs, pus- 
 tules, vesicles, tubercles, spots. 1. Pim- 
 .PLES, papulcBy have a very small and point- 
 ed elevation of the cuticle, with an in- 
 flamed base, very seldom containing a 
 fluid, or suppurating ; and commonly ter- 
 minating in scurf. The principal erup- 
 tions of this first order are the red gum or 
 tooth eruption, the lichen, and the prurigo, 
 an eruption attended with severe itching. 
 
 2. Scales, squamcBy layers of diseased 
 «kin, hard, thickened, and opaque. Scales, 
 when they increase into irregular layers, 
 are denominated crusts. Instances of 
 scaly diseases are found in the leprosy, as 
 described by the Greeks, not that kind 
 mentioned in Scripture ; the scaly tetter, 
 the dandriff, and the fish-skin diseases. 
 
 3. Rashes, exanthemata, are superficial 
 red patches, variously figured, and diffused 
 irregularly over the body, leaving inter- 
 stices of a natural colour, and terminating 
 in a scaling off of the outer skin. Seve- 
 ral very important diseases are included 
 in this order, as measles, scarlet-fever, net- 
 tle-rash, rose-rash, purple specks and 
 patches ; erythema, or continuous redness 
 of some portion of the skin, attended with 
 disorder of the constitution, but not con- 
 tagious. 4. Blebs, bullce, lai*ge portions 
 
 \of the outer skiu detached from the true 
 
 skin by the inteq)osition of a transparent 
 watery fluid. Blebs occur in erysipelas, 
 commonly called the rose, and in some 
 other febrile affections ; they also occur 
 suddenly in some patients without any 
 fever. 5. Pustules, pustulce, are eleva- 
 tions of the cuticle, with an inflamed base, 
 containing pus or thick yellow matter. 
 The small-pox is a pustular disease ; and 
 so is the itch, in its various forms, rank, 
 watery, and pocky. The pus is formed in 
 the progress of the above diseases, but at 
 the commencement, the fluid in the erup- 
 tion is clear. Other instances of pustular 
 disease are to be found in the running 
 tetter, ringworm of the scalp, scalled head, 
 milk-blotches, &c. 6. Vesicular Erup- 
 tions, vesicul^, are such as have a small 
 round elevation of the skin, containing 
 lymph, which is sometimes clear and co- 
 lourless, but often opaque and whitish, or 
 pearl-coloured. It is succeeded either by 
 scurf, •r by a scab formed of different 
 layers. In this order are placed the cow- 
 pox, the chicken-pox, and the variety of 
 eruptions seen in those whose constitu- 
 tions have been modified by the occur- 
 rence of small-pox or vaccination, when 
 they have been exposed to small-pox con- 
 tagion. Sliingles, miliary eruption, hei-pes 
 of the lips, heat-spots, and the thrush, are 
 vesicular diseases. 7. Tubercles, tuher- 
 culay as applied to skin diseases, signify 
 small, hai'd, superficial tumours, circum- 
 scribed and permanent, or suppiu-ating 
 partially. Boils and warts are tubercular 
 eruptions ; and there are several others 
 which have no English names, such as 
 those which for a succession of months 
 or years infest the faces of young persons, 
 and which have a black spot in the mid- 
 dle, vulgarly supposed to be the extremity 
 of a worm. The knotted and enlarged 
 nose is a tubercular affection. 8. Spots, 
 macula, signify a permanent discoloura- 
 tion of some portion of the skiu, often 
 with a change of its texture. This order 
 includes freckles, moles, flesh-raaiks, mo- 
 ther-spots ; and the vai-ious marks which 
 are thought to resemble grapes, straw- 
 benies, &c. It is vulgarly supposed 
 
240 
 
 ERUPTIONS. 
 
 that these last are owing to the imagi- 
 nation or lon^ngs of the mother; but 
 this is altogether contradictory to every 
 principle of physiology, and to all cor- 
 rect sober observation. Such fruit-like 
 appearances get brighter in the spring 
 and summer, not in sympathy with the 
 ripening fruit, but in consequence of the 
 heat of the weather increasing the deter- 
 mination of the blood to the surface. 
 Moles should not be meddled with, as no 
 advantage is gained by any kind of treat- 
 ment, and when suppuration is induced 
 on them, it is tedious and painful. We 
 cannot recommend any cosmetics for the 
 removal of freckles. 
 
 On looking back to the foregoing list of 
 affections of the skin, it will be seen that 
 many diseases of very different kinds and 
 degrees of danger are included under the 
 title of Eruptions, from the slight freckle 
 or transient tooth-rash, to the deadly ery- 
 sipelas or malignant small-pox. Some of 
 them are attended with febrile symptoms, 
 while others are entirely free from them j 
 some depend on disorders of the stomach, 
 while others are the effects of a complete 
 corruption of the fluids of the body. The 
 diseases which are ushered in by feverish 
 and other constitutional symptoms, and 
 in whose progress, sometimes pretty long, 
 eruptions appear on the skin, are of very 
 great importance; as under this class, 
 called by physicians exanthematous dis- 
 eases, are included those affections which 
 generally attack persons only once in 
 their lives, small-pox and chicken-pox, 
 measles, and scarlet fever; though it is 
 somewhat doubtful whether this last does 
 not attack more than once. See Erup- 
 tive Diseases. 
 
 ERUPTIVE DISEASES, termed by 
 Dr. CuUen and former nosologists Exan- 
 thematay signify those contagious affec/-, 
 tions which attack persons only once in 
 their lives, which begin with fever, and 
 which at a precise period of their course 
 are accompanied by small inflammatory 
 eruptions on various parts of the skin. 
 Of such diseases, small-pox, chicken-pox, 
 and measles, are the best marked and 
 
 most perfect specimens. Along with 
 these, there are classed under the exan- 
 themata, other diseases to which the 
 above characters do not so well apply. 
 Scarlet fever is an eruptive disease, but 
 the period of the eruption is not so dis- 
 tinctly marked as in the former three, 
 nor is it so certain that it affects a person 
 only once in his life. The plague, on 
 account of its contagious nature, and the 
 breaking out of buboes and carbuncles, 
 has also been called an eruptive disease ; 
 but it is better classed with the malignant 
 fevers. The miliary eruption is to be 
 considered merely as the consequence of 
 profuse sweating, and of a heating regi- 
 men, and by no means as an original dis- 
 ease. See Small-pox, Measles, &c. 
 
 ERYSIPELAS, the Rose, or St. An- 
 tony's Fire. See Rose. 
 
 ESCHAR. A hard crust or scab upon 
 the flesh, occasioned by the application 
 of heated metal, or corrosive substances. 
 It also signifies a slough formed on a 
 wound or ulcer. When an issue is to be 
 made in any part of the body, the first 
 step is to destroy the life of a portion of 
 the skin by applying some acrid sub- 
 stance ; this mortified portion is the es- 
 char, which in time is detached from the 
 parts below, and leaves them in a state of 
 ulceration, from which a discharge can be 
 kept up by proper dressings. 
 
 ESCHAROTICS. Substances used 
 to destroy any portion of the body by the 
 formation of a slough or eschar, or to 
 keep down rising flesh or diseased parts. 
 Though the contact of heated metals has 
 this effect, the term escharoties is more 
 generally applied to caustic or corrosive 
 substances, the chief of which are the 
 nitrate of silver (lunar caustic) : and 
 caustic potash, either alone or combined 
 with lime ; blue vitriol, red precipitate of 
 mercury, and burnt alum. The mineral 
 acids are escharoties, but are less used 
 on account of their fluidity. Escharoties 
 are sometimes used to open abscesses, 
 when there is great dread of a cutting in- 
 stnunent ; but it is in general by far the 
 best way to open them by the knife or 
 
EXC 
 
 EXE 
 
 241 
 
 lancet. The greatest inconvenience in 
 the application of escharotics is their 
 tondenc}'^ to spread beyond the part which 
 ^ve wish to be acted upon. The most 
 usual Avay of preventing this, is to protect 
 the neighboiu-ing parts by leather or ad- 
 hesive plaster. 
 
 ESSENCE. Certain volatile and fra- 
 grant matters which rise in distillation, 
 and either yield a volatile oil or impreg- 
 nate water with their peculiar flavour, po- 
 pularly go by the name of Essences. 
 
 ESSENCE OF MUSTARD. A com- 
 position much famed for the cure of rheu- 
 matism, sprains, &c. which is chiefly com- 
 posed of oil of turpentine, camphor, and a 
 portion of spirit of rosemary, to which is 
 added a small quantity of the flour of 
 mustard. 
 
 ETHER. See ^Ether. 
 
 EXACERBATION. The increase of 
 the severity of any disease ; thus we say 
 of certain fevers, that they have an exa- 
 cerbation towards evening. 
 
 EXCITEMENT signifies that state of 
 the body in which the actions, especially 
 of the circulating and nervous systems, 
 are increased. Thus, all feverish diseases 
 are considered as diseases of excitement. 
 
 EXCITING CAUSE. The circum- 
 stance immediately preceding an attack 
 of disease. Thus, if a person, from a full 
 habit of body or tendency of blood to the 
 head, is disposed to apoplexy, a full meal 
 or a walk on rising ground often brings 
 on tlie fit, or proves the exciting cause of 
 that disease. 
 
 EXCORIATION. A loss of the cu- 
 ticle or scarf skin. Excoriation or chaf- 
 ing of the skin is very liable to happen, 
 especially iu infants, at those places of 
 the skin that are often in contact with 
 each other, as the ears, neck, arm-pits, 
 and groins. The best way to prevent 
 this tendency, is to dust the parts with 
 prepared tutty or chalk finely powdered. 
 If there be a discharge of matter from the 
 excoriated pai'ts, great care and attention 
 are requisite in the healing of them. If 
 the running has continued long, there is 
 some danger in checking it too suddenly; 
 
 but if proper precautions are taken to 
 prevent this, and to relieve the system 
 by purging, there is no reason why they 
 should not be healed up quickly, as there 
 is always risk of the inflammation spread- 
 ing to some internal part. When chafing 
 appeai-s worse than can be checked by 
 the tutty, a wash of white vitriol is to be 
 used ; eight grains of the vitriol to four 
 ounces of rose water. If this does not 
 prevent the excoriations, the parts are to 
 be washed pretty frequently with some 
 weak stimulant lotion, as brandy and wa- 
 ter, and they are to be covered with brown 
 cerate or spermaceti ointment, or a lini- 
 ment made of equal parts of olive or lin- 
 seed oil and lime-water. 
 
 EXCREMENT. Whatever is destined 
 to be discharged out of the body. See 
 Stools. 
 
 EXERCISE. The necessity of exer- 
 cise to the health and comfort of the ani- 
 mal body, is demonstrated by the instinc- 
 tive desire for it which appears both in 
 man and in the lower animals ; as also by 
 the pernicious and lamentable conse- 
 quences of sedentary habits and a life of 
 indolence. Even from the moment of 
 birth sorrie exercise is necessary, and this 
 is supplied to the infant by the washing 
 and dressing to which it is subjected; and 
 its vigorous crying, when we are sure it 
 is not from the feeling of pain, is to be 
 regarded as a salutary mode of dilating 
 its chest, and of putting many muscles 
 into action. In the progress of its days, 
 the dandling of the nurse, and then its 
 own exertions, succeeded by the active 
 play of the schoolboy, conduce, by the 
 motion given to the limbs, to the diges- 
 tion of the food, the circulation of the 
 fluids, and to the growth and health of 
 the body; while the bad effects of the 
 want of exercise are seen in the ill health 
 of the imprudent student, the plodding 
 merchant, and the indolent and luxurious 
 man of wealth. As exercise is of the most 
 essential use in preserving the health, so 
 it is a very important agent in the cure 
 of disease. The disorders of digestion re- 
 ceive most decided benefit from exercise. 
 
242 
 
 EXERCISE. 
 
 The feeble constitution which scrofula 
 attacks, is invigorated by exercise, and 
 enabled to resist that very prevailing ma- 
 lady. Even hereditary gout may be mi- 
 tigated or kept off, if the subject of it has 
 fortitude to resist the blandishments of 
 luxury and indolence. The modes of 
 exercise are various, and, in the case of 
 disease, a choice is necessary. That ex- 
 ercise is the best which employs the 
 greatest number of muscles; and as the 
 most useful objects are, by the kindness 
 of Providence, the most easily attained, 
 so walkiug, which is the best of all ex- 
 ercises, is in the power of all. Walking, 
 in a degree proportioned to the strength 
 of those who employ it, is useful in the 
 cure of various diseases, as in those of the 
 stomach, in gout, and some others ; but 
 there are other complaints in which it is 
 unsafe, as in inflammatory affections, and 
 in those where there is a tendency of 
 blood to the lungs. It is therefore a ha- 
 zardous plan to drive away a cold by 
 walking it off; instances have been known 
 where violent inflammation of the lungs 
 has been brought on by such an attempt. 
 All the more violent exercises, as fencing, 
 dancing, running, wrestling, and the like, 
 are to be avoided in diseases of excite- 
 ment ; and in those of debility, exercise 
 is to be prescribed at first with the great- 
 est caution, and to be taken very gi'adu- 
 ally ; and thus, by prudence and perse- 
 verance, veiy feeble persons have become 
 able to take exercise of the most active 
 kind. When a patient for whom exer- 
 cise is good, is unable to take it by his 
 own exertions, we must direct some mode 
 of gestation, as riding on horseback, or in 
 a carriage, sailing, or swinging on an elas- 
 tic board. Riding on horseback has been 
 much celebrated in consumptive diseases ; 
 and provided it be taken in fine weather, 
 and before the disease has advanced too 
 far, it will assist the other means of 
 attempting to arrest its progress ; but we 
 must not expect from it the great and 
 signal benefit which Sydenham ascribed 
 to it. Sailing also has been much famed 
 as a remedy in consumption, and though 
 
 it has failed in numberless instances, it is 
 worth a trial. The sea-air appears to be 
 beneficial,- and the sickness and vomiting 
 which accompany a voyage, have the ef- 
 fect of improving, in many cases, the ac- 
 tion of the stomach and bowels, in remov- 
 ing tumours, and stopping discharges of 
 blood. Riding is to be avoided in diseases 
 of the kidneys, as it is apt to occasion 
 much pain and a discharge of blood. Rid- 
 ing in a cairiage is an exercise of body 
 and mind, well adapted for a variety of 
 chronic ailments, stomach complaints, and 
 low spirits. The exercise is good, and 
 the change of scene prevents the patient 
 from brooding over his real or fancied 
 maladies. Exercise should generally be 
 taken in the best and purest air; and a 
 moderate degree of cold, provided it be 
 not attended with moisture, adds to the 
 strengthening effects of exercise. In some 
 cases of disease, neither exercise nor ges- 
 tation are in the patient's power, and we 
 must substitute for them rubbing with 
 the flesh-brush, or with the hand. Such 
 treatment is sometimes necessary in rheu- 
 matism, sprains, tumours, white swelling, 
 and dropsical limbs. 
 
 EXFOLIATION signifies the separa- 
 tion of a dead piece of bone from the liv- 
 ing. One part of a bone is never sepa- 
 rated from another by the rotting of the 
 dead part, for that which comes away is 
 as sound as it ever was- Exfoliation 
 takes place soonest in bones which have 
 the fewest cells, and whose texture is 
 the closest. Before any part of a bone 
 can be thrown off by exfoliation, it must 
 be dead. But even then, till the process 
 of exfoliation begins, the bone adheres as 
 strqngly as ever, and would remain for 
 years before it could be separated by pu- 
 trefaction alone. A dead bone acts on 
 the system in the same manner as any 
 extraneous body. It stimulates the ad- 
 jacent living parts, in consequence of 
 which such a process is begun, as must 
 terminate in its being thrown off. Nei- 
 ther caustics, nor the actual cautery hasten 
 exfoliation ; they only produce death in a 
 part of the bone, which is the first step to- 
 
EXPECTORANTS. 
 
 243 
 
 wards exfoliation. Ex foliation is not a ne- 
 cessary consequence of a bone being laid 
 bare, and being- deprived of its investing 
 membrane. If the bone be in other re- 
 spects healthy, it may heal without the 
 smallest exfoliation being thrown off, es- 
 pecially in young subjects. But if caustic 
 or stimulating applications be made use 
 of, the circulation in the surface of the 
 bone will be disturbed and destroyed, and 
 that part will be separated and cast off 
 by the process of exfoliation. The best 
 mode of attempting to prevent an exfoli- 
 ation from occurring at all on a bone 
 that has been exposed by a wound, is to 
 cover the part again, as soon as possible, 
 with the flesh which has been detached. 
 When the exposed bone cannot be cover- 
 ed, it should be dressed with the mildest 
 and simplest applications, with plain lint, 
 or lint spread with spermaceti ointment. 
 (Mr. John Hunter.) 
 
 EXPECTORANTS. Those medicines 
 which have the power of promoting the 
 discharge of mucus from the lungs. They 
 are of great service in many diseases of 
 the chest. The greater number of ex- 
 pectorant medicines are those which in 
 larger doses prove emetic, viz. squill, ipe- 
 cacuan, ammoniacum, and antimony. Be- 
 sides those medicines which are more 
 commonly called expectorants, there are 
 various other remedies which indirectly 
 have the same effect in another way. 
 Thus bleeding, blistering, and nauseating 
 doses of emetics have the effect of pro- 
 moting expectoration; and some sub- 
 stances, by stimulating the top of the 
 wind-pipe, act as expectorants ; hence the 
 benefit derived from stimulating lozenges, 
 jellies slowly dissolved in the mouth, 
 and the inhaling the steam of hot vine- 
 gar or other stimulant vapours. When 
 the mucus is scanty and acrid, mucilagi- 
 nous and demulcent substances prove 
 good expectorants. Gum arabic, liquorice, 
 or honey dissolved in water, linseed tea, 
 thin starch, barley-water, gruel, or oily 
 emulsions, are useful on^such occasions. 
 
 Tlie most useful of expectorant drugs 
 is the squill or root of the sea-onion, 
 
 either in powder, or infused in vinegar, 
 or given in the form of tincture. The 
 powder of squill is combined with ammo- 
 niacum in the squill pill of the Edinburgh 
 pharmacopoeia; and this is a very good way 
 of exhibiting it. Two pills at night and 
 one in the morning, or one pill four times 
 a-day may be taken, or half a tea-spoonful 
 of the vinegar of squill in a little syinip, 
 twice a-day; or an ounce of the vinegar, 
 of squill, with three or four of mucilage, 
 and two of some aromatic A^'ater, may be 
 made into a mixture, and of this a table- 
 spoonful is to be taken three or four times 
 a-day. Squill may be combined with calo- 
 mel, to promote its expectorant effects; 
 half a grain of calomel may be added to 
 each grain of squill. Ipecacuan, in doses of 
 three or four grains, proves expectorant. 
 
 Emetics, even in full doses, have been 
 given with the view of promoting expec- 
 toration ; and it is probable that, in hoop- 
 ing cough, they not only enable the sto- 
 mach to get rid of the mucus which has 
 been swallowed, but also promote the 
 discharge from the lungs. We may here 
 meiition, that in diseases of the chest, it 
 is an unfavourable symptom when emetics 
 do not empty the stomach. 
 
 Some old people are troubled with a 
 habitual cough and expectoration, which 
 they are very anxious to get rid of; but 
 it is not advisable to stop this discharge 
 suddenly, especially by opiates, as it too 
 often happens that derangement of the 
 bowels, or headach, or some more alarm- 
 ing symptom, attacks old people when 
 their cough and spitting are much check- 
 ed The sulphate of zinc, in the quantity 
 of one grain twice a-day, and in the form 
 of lozenge, is a medicine that may be giv- 
 en with more safety, to check the exces- 
 sive expectoration of old people. 
 
 EXPECTORATION. The discharge 
 of mucus, pus, or other matters from the 
 lungs ; a symptom of catai-rh, asthma, and 
 various other disorders of the chest. 
 
 EXTIRPATION. The removal of a 
 part by a surgical operation, when no por- 
 tion is left beliiud ; as the extirpation of 
 the eye, or of the female breast. 
 
$44 
 
 EYE. 
 
 EXTRACT. The name given to sub- 
 stances procured by dissolving certain 
 parts of vegetables or animals, and evar 
 porating the fluid M'hich has dissolved 
 them. In this way, dissolving the root, 
 leaves, bark, or whatever part of the 
 plant contains the active principles, we 
 obtain the extract of bark, of gentian, of 
 colocynth, and a great vanety of others, 
 c EXTRACTION. The removing from 
 the body any part or substance fixed in 
 it; as the extraction of a tooth, of a bul- 
 let or other foreign body, or of the lens 
 and its capsule, for the cure of cataract. 
 
 EYE. The globe of the eye is com- 
 posed of various coats and humours. 
 Without entering into minute anatomi- 
 cal details, we may mention the follow- 
 ing as the principal parts of the eye. 
 1. A strong membranous coat called the 
 sclerotic coat, forms the outer covering or 
 circumference of the globe of the eye. 
 At the anterior part it is transparent, to 
 admit the rays of light, and the clear 
 part projects a little forward from the 
 rest of the globe. 2. The cJioroid coaty 
 a dark coloured delicate membrane, which 
 does not come farther forw^ard than the 
 posterior half of the sphere. 3. The 
 inner coat is called the retina, and is 
 formed by the expansion of the optic 
 nerve, which, entering at the back part 
 as a thick nervous cord, spreads out into 
 a soft pulpy greenish cup, forming about 
 half of the shell of the eye. By the va- 
 rious refracting powers of the humours, 
 an image or picture of visible objects is 
 formed at the back part of the eye upon 
 this retina; and the distinctness of this 
 picture is essential to accurate vision. 
 Behind the clear part in front, is seen the 
 coloured circle or i7'is, which, from its 
 different colours, gives the distinctive 
 appellations of black, blue, grey, hazel, 
 &c. to the eyes ; and this is perforated in 
 the middle by a circular hole, called the 
 pupil. The iris has the power of con- 
 tracting its dimensions all round, and so 
 making the pupil larger or smaller. When 
 too much light is thrown upon the eye, 
 the pupil becomes smaller, to exclude the 
 
 superfluity of it ; and the reverse when 
 the light is scanty. If the anterior part 
 be not clear, if the humours do not re- 
 fract properly, if the retina be insensible; 
 in all these cases vision is more or less 
 impaired. The humours are, the watery 
 humom\ which, in small quantity, is situ- 
 ated at the fore part of the eye. (^lose 
 to it is the crystalline lens, and the rest 
 of the globe is composed of the vitreous 
 humour, v/hicli is by far the largest of 
 the whole, and composed of a clear liquor 
 contained in cells. Referring to books 
 of anatomy, optics, and natural theology 
 for the exact description of this wonder- 
 ful organ, for the mathematical princi- 
 ples of its construction, and the admirable 
 and beneficent adaptation of it to every 
 purpose of beauty and utility which man 
 can desire, we proceed to mention the 
 symptoms, causes, and treatment of some 
 of the diseases to which this delicate and 
 complicated structure is liable. 
 
 Principal Diseases of the Eye. 
 
 I. iNFLAMai ATION' Or OPHTHALMIA. All 
 
 the parts and appendages of the eye are 
 subject to inflammation, a disease not 
 only attended with present pain and in- 
 convenience, but which may lay the foun- 
 dation of such derangements of the struc- 
 ture as will lead to the irreparable injury 
 of vision. Of the various modifications of 
 this affection, and of the method of cure, 
 we shall now treat. To save circumlocu- 
 tion, M^e shall employ tlie term ophthal- 
 mia or ophthalmy, to signify inflammation 
 of the eye. Ophthalmia is divided, into 
 the acute and chronic ; and it is of conse- 
 quence to make this distinction, as they 
 require different treatment- 
 
 Acute Ophthalmy is characterised by 
 the whole or part of the white of the eye 
 being covered with blood-vessels, being 
 what is commonly called blood-shot; 
 the lining of the eye-lids participates in 
 the same appearance, there is a sensation 
 of great heat, uneasiness and shooting 
 pains, and as if sand or dirt had got into 
 the eyes. The presence of light is in- 
 tolerable ; the patient instinctively keeps 
 the eye-lids closed. There is a very co- 
 
EYE, DISEASES OR 
 
 245 
 
 pious flow of tcai-s. Sometimes the con- 
 stitution is a little affected, and the patient 
 has feverish symptoms; but this rarely 
 happens, unless he is very irritable, or the 
 disease is very violent. 
 
 Causes of Ophthalmia. Exposure to 
 cold piercing- winds, or sudden changes of 
 temperature, a blow upon or near the 
 eye-ball, smoke or irritating- vapours, 
 dust, sand, or moats getting into the eye, 
 exposure to light, very bright or long 
 continued, looking much at small objects, 
 reading by candle-light, and spontaneous 
 determinations of blood to the head, or 
 that excitement which arises from habi- 
 tual drunkenness. 
 
 Cure. It is proper in all cases of oph- 
 thalmia, to be very sure that there is no 
 foreign body irritating the eye ; and to 
 examine the eye for this purpose, is the 
 first thing the surgeon ought to do. He 
 is to take blood from the arm if there is 
 much fever present ,• or if the inflamma- 
 tion appears more local, a number of 
 leeches are to be applied in the neigh- 
 bourhood of the eye, or the temporal ar- 
 tery is to be opened. The eyes are to 
 be frequently bathed with tepid milk and 
 water ; and the bowels are to be opened 
 by saline purgatives. A blister behind 
 the ear, or on the nape of the neck, is a 
 very excellent remedy in ophthalmy. If 
 the inflammation be not very obstinate, 
 and if there be no peculiar irritability of 
 constitution, these measures will com- 
 monly put an end to the acute state of 
 ophthalmy in a few days ; at the end of 
 which time, the pain and intolerance of 
 Kght, the watery discharge, and other 
 uneasy symptoms are abated, though the 
 eye still looks red and inflamed. The 
 ophthalmy has now passed into the 
 chronic stage, and the bathing with warm 
 water must be now exchanged for appli- 
 cations of an astringent nature, and such 
 as are fitted to strengthen the parts. A 
 useful application of this kind, is a solu- 
 tion of twelve grains of sulphate of zinc 
 or white vitriol in three ounces of rose 
 water and three ounces of spring water ; 
 tjie eye is to be frequently washed v>'ith 
 
 this, taking care that a portion of the 
 wash gets inside. 
 
 Though ophthalmia may appear a com- 
 plaint very easily managed, we are too 
 often completely baffled, and the patient 
 suffers a very long time. In this chronic 
 stage, we have not only inflammation and 
 redness of the ball of the eye, but a raw 
 and inflamed state of the eye-lids. This 
 chronic ailment is very often the accom- 
 paniment of an unhealthy constitution, 
 and general as well as local remedies are 
 to be applied. An ointment composed 
 of five grains of red precipitate to one 
 drachm of fine lard, very intimately mix- 
 ed, is to be put at the inner corner of the 
 eye, particularly at bed-time, that the 
 motion of the lid may diffuse it over the 
 ball. Such cases are peculiarly apt to 
 be aggravated by exposure to cold or 
 any irregulaiity. Bark and wine, and 
 nourishing diet, are to be given to 
 strengthen the constitution. 
 
 There is a kind of ophthalmy in which 
 the severity of the symptoms is very 
 great indeed, where light is absolutely 
 intolerable, where there is the feeling of 
 great tightness in the ball of the eye, 
 and severe pains in the head. Such se- 
 verity of symptoms demands the most 
 active and prompt employment of the 
 means for reducing inflammation. Larffe 
 general bleedings are to be directed, with 
 active purges, and scarifications from the 
 inner surface of the eye-lids, and even 
 cutting across the distended vessels of 
 the ball itself. Blisters are in this case 
 also of service, and emetics are thought 
 to have much efficacy in diminishing 
 inflammation of the eye. The dropping 
 into the eye of the vinous tincture of 
 opium, is here also strongly recommend- 
 ed, but it seems principally usefiil when 
 the violent acute stage is over. 
 
 Chronic Ophthalmia. Insomeconsti 
 tutions, particularly the scrofulous, there 
 is a continual redness of the eye-lids, and 
 frequent tendency to inflammation of the 
 eye itself. In this case, we are to en- 
 deavour to strengthen the system by bark 
 and wine and generous diet, to avoid ex- 
 
246 
 
 EYE, DISEASES OF. 
 
 posure to damp and cold, to use an oint- 
 ment at bed-time composed of the nitrate 
 or the red precipitate of mercury ; and 
 when by any accidental cause it is chang-ed 
 into the acute, we are to resort to bleed- 
 ing and the other remedies already men- 
 tioned. 
 
 Purulent Ophthalmia. There is a 
 species of ophthalmy which has been 
 termed the purulent ophthalmy, which 
 occurs very frequently in very young 
 infants ; and, if not treated with the ut- 
 most skill and care, is apt to end in a 
 projecting and untransparent state of the 
 cornea, producing total blindness. There 
 is a very remarkable and abundant dis- 
 charge of thick yellow matter from the 
 eye-lids, the lining membrane of which 
 appeal's wrinkled, and presents a soft red 
 surface. Should the surgeon be called 
 in early enough, he must direct blood to 
 be taken fi'om the neighbourhood of the 
 eye by leeches, must use an astringent 
 wash, which he is to apply himself vrith 
 a syringe, previously Mashing out the 
 collected thick matter by the same in- 
 strument, filled with tepid M^ater. This 
 operation should not be trusted to the 
 attendants, as the disease is so rapid and 
 malignant that the unfortunate little pa- 
 tient runs the risk of total blindness, 
 from the cornea becoming quite opaque. 
 This treatment, when diligently put in 
 practice, generally succeeds ; the matter 
 diminishes in quantity, and the eye-lids 
 put on a more natural and healthy ap- 
 pearance. We then gradually discontinue 
 our washing, taking care not to expose 
 the eyes too soon to a strong light This 
 kind of ophthalmia is what the common 
 people mean when they say the gum has 
 got into the eyes. 
 
 Egyptian Ophthalmia. Another kind 
 of ophthalmia with which we have be- 
 come acquainted of late years, is the 
 Egyptian ophthalmia, which is remarka- 
 ble for its being of a contagious nature ; 
 many examples having occurred of its 
 spreading in ships, regiments, and other 
 assemblages of persons. It varies in its 
 continuance and severity, from the acute 
 
 but rapid kind, which is over in forty- 
 eight hours, to the long protracted kind, 
 which, after harassing the patient for 
 years, leaves him in total blindness. The 
 treatment does not differ from that of the 
 other kinds already mentioned. Tepid 
 washes at first, astringent ones after- 
 wards, and local or general bleeding, 
 when the fever is high, with the proper 
 ointments and washes, and scarifications 
 according to the judgment of the surgeon, 
 constitute the practice in the Egyptian 
 ophthalmia. 
 
 II. Iritis. Inflammation of the deep- 
 seated parts of the eye, and especially of 
 the iris, has had the name of iritis given 
 to it. This inflammation is accompanied 
 with violent pain, intolerance of light, 
 headach, and all the more violent symp- 
 toms of ophthalmia. " It appears," (says 
 Mr. Travers,) " in company ^v\\\\ rheu- 
 matism of the chronic form, sometimes 
 with the gout; with the constitutional 
 signs of syphilis, and during or following 
 the action of mercury upon the system." 
 The conjoined operation of mercury and 
 syphilis is one of the most frequent causes 
 of iritis; but it occurs in persons who 
 have not been using mercury, and who 
 are free from all syphilitic taint. 
 
 Treatment. Besides the usual methods 
 of diminishing inflammation of the eye by 
 bleeding, general and partial,and the otlier 
 parts of the antiphlogistic plan ; and at the 
 proper period dropping into the eye a little 
 of the wine of opium, the best May of 
 arresting the inflammation is, rapidly to 
 saturate the system to full salivation by 
 the use of mercuiy. This is to be done 
 by giving from four to six grains of ca- 
 lomel daily, two grains at a time, com- 
 bining it with half a grain of opium, to 
 prevent its going off" by the bowels ; fric- 
 tion with mercurial ointment is to be di- 
 ligently employed at the same time. It 
 will appear strange, that the same agent 
 which frequently contributes to the pro- 
 duction of the disease should also be the 
 most certain and effectual means of cure ; 
 but of the fact there can be no question ; 
 and British surgeons are highly indebted 
 
EYE, DISEASES OF. 
 
 247 
 
 to Dr. Farre for this most important im- 
 provement in the treatment of ophthal- 
 mic inflammation. " Mr. Saunders of 
 London, in 1805, was accidentally led to 
 the employment of mercury in one case 
 and with success; but as he considered 
 the patient to be syphilitic, mercury does 
 not seem to have been used by him in his 
 subsequent cases. The use of mercury 
 iu idiopathic, as well as in syphilitic iritis, 
 was first in this country recommended by 
 Dr. Farre, in the second edition of Dr. 
 Saunders's Treatise, of which he was the 
 editor. But while we acknowledge our 
 oblig-ations to Dr. Farre, we must perform 
 an act of justice to the oculists of Vienna, 
 who certainly anticipated us in this im- 
 provement. In 1800, Professor Beer of 
 Vienna, in a tract entitled " Selections 
 from the Journal of a Practical Oculist," 
 speaks in very decided terms of the use 
 of mercury in various inflammations of 
 the eye, unconnected with syphilis. In® 
 phlegmon of the eye, that dreadful in- 
 flammation, which, when not corrected 
 in time, with the most violent intolerable 
 pain, converts the whole eye into pus, so 
 that only a small shapeless lump remains 
 in the orbit, I know no remedy which so 
 quickly and certainly checks the suppu- 
 ration as mercurial friction. Even when 
 fever is present, this active remedy can 
 be used without any fear, according to 
 my experience. When, in these oph- 
 thalmias which follow small-pox, an ab- 
 scess or staphyloma begins to form on the 
 cornea, the friction wath mercurial oint- 
 ment is so sure a remedy, that with cer- 
 tainty, opacity or destruction of the cor- 
 nea M ill very rarely occur." (^Edinburgh 
 Medical Journal^ Nov. 1818.) 
 
 III. Cataract, a species of blindness, 
 arising from an opacity of the crystalline 
 lens or of its capsule, the effect of which 
 is to prevent the rays of light from pass- 
 ing through the different coats and hu- 
 mours of the eye, to form an image on 
 the retina, w^iich circumstance is neces- 
 sary for perfect vision. The cataract ap- 
 pears as a spot or speck on the pupil of 
 4he eye, sometimes occupying the \^'hole, 
 
 sometimes only a part of it. It is com- 
 monly of a grey or whitish colour, some* 
 times of a very pure white. The disease 
 at first shows itself by a weakness or im- 
 perfection of the sight, and it ahnost al- 
 ways teiTuinates in the total loss of that 
 sense. While the disorder is in progress, 
 the patient sees better in a moderate light 
 than in a strong one, as the greater ex- 
 pansion of th^upil allows a few rays of 
 light to enter. A mist seems to cover 
 objects, and to confuse small ones. This 
 affection often comes on without any as- 
 signable cause ; and some imperfection of 
 vision is perceptible by the patient him- 
 self, before any thing wrong is visible to 
 another person. Without repeating the ge- 
 neral description of the eye in this plac-e, 
 we shall satisfy ourselves with stating, 
 that the lens is a round crystalline body, 
 clear and viscid, and contained in a little 
 case or capsule, and cataract is produced 
 by a thickening or dimness either of the 
 containing membrane or of the lens it- 
 self. When the contents are hard and 
 solid, it is called a hard cataract, when 
 fluid and milky, a fluid cataract, and when 
 the contents are like a jelly, or curd, it is 
 called caseous or cheese-like. 
 
 Causes of Cataract. It is believed to 
 occur most frequently to persons who are 
 much exposed to strong fires, as glass- 
 workers and blacksmiths. Cataract rare- 
 ly appears before the age of forty, but 
 children are sometimes affected by it, and 
 some are even bom with it. In general, 
 cataract arises spontaneously, and no cause 
 can be assigned for it- Sometimes it 
 arises from external violence, from blows 
 on the eye or neighbouring parts, and 
 these cases are in general more likely to 
 get w^ell than those which begin without 
 any evident cause. 
 
 I'reatment. No cure is to be expected 
 till the obstruction to the passage of the 
 rays of light is removed. This is the pur- 
 pose to be effected, and the means are 
 either constitutional remedies, and exter- 
 nal applications, or the removal of the 
 opaque body from the sphere of vision by 
 an operation. 
 
24.8 
 
 EYE, DISEASES OF. 
 
 General or local means of removing 
 Cataract. Various remedies have been 
 recommended, of which the principal are 
 bleedings, cupping-, and scarifying, as also 
 issues, setons, and blisters. The juices of 
 some plants have also been in vogue. 
 Cataracts from external violence have 
 sometimes dispersed spontaneously; and 
 in other cases a blow on the eye has been 
 followed by the sudden disappearance of 
 cataracts. Mr. Ware prefers to other re- 
 medies the application to the eye itself of 
 one or two drops of ether, and the occa- 
 sional rubbing of the eye over the lid with 
 the point of the finger, fii'st moistened 
 with a weak volatile or mercurial liniment. 
 
 Of the Operation, and in what cases 
 it is to be recommended. The best .ocu- 
 lists place very little reliance on any of the 
 above means in a fully formed cataract; 
 and consider the only successful method of 
 removing the opaque lens or capsule to be 
 by an operation. But there are certain cases 
 in which the completest removal of the 
 obstruction would not restore sight, and 
 in which, therefore, it Avould be improper 
 to have recours'e to an operation. The 
 retina, the expansion of the optic nerve, 
 may be quite insensible, and, of course, 
 the freest passage for the rays of light 
 would contribute nothing to the restora- 
 tion of vision. We have reason to fear 
 this insensible state of the retina when 
 there has been a long continued inflam- 
 mation of the eye, peculiarly affecting the 
 inner parts of it, when there has been 
 headach, with great pain of the eye and 
 eye-brow, and when the patient is quite 
 unable to distinguish a bright light from 
 total darkness. In such cases the re- 
 moval of the cataract would be of no ser- 
 vice, and the operation is unadvisable. 
 The operation is not to be hastily advised 
 in cases of cataract arising from external 
 violence, as these often disappear sponta- 
 neously; and some general and internal 
 remedies may be employed, as blood-let- 
 ting and mercurials. Some have advised 
 that there should be no operation, where 
 only one eye is affected with cataract, on 
 the ground that one eye is sufficient for 
 
 the purposes of life, and that there is a 
 danger of the sight being imperfect from 
 the two eyes not pei'forming their func- 
 tions correctly alike. This last objection 
 is disproved by numerous cases where the 
 vision was perfect, when one of the eyes 
 had been operated upon; and th6 first 
 might be a good reason for letting the ca- 
 taract alone, were we certain that the 
 other eye would keep well ; but, from the 
 vronderful sympathy between the two 
 eyes, there is reason to fear that some 
 morbid action may take place in the other ; 
 Avhereas it is not uncommon for a dis- 
 eased action to be checked in one eye, 
 Avhere the operation for cataract has been 
 performed in the other. When there is 
 a cataract on both eyes, it is not advan- 
 tageous to operate on one immediately 
 after the other, as the inflammation ex- 
 cited even by the operation on one eye is 
 apt to be too great both in the eye ope- 
 «rated upon, and also to cause inflamma- 
 tion in the other by sympathy ; and an 
 operation performed nearly at the same 
 time on both eyes is likely to increase 
 manifold the chance of hurtful excite- 
 ment. ' It is a question of considerable 
 importance, whether it is proper to ope- 
 rate for a cataract on children of a very 
 early age, that is, before they have dis- 
 cretion to understand the propriety of an 
 operation, and firmness to submit to it. 
 There are many argimients conclusive of 
 the propriety of an early operation, as 
 arising both from the nature of cataract, 
 and from the important collateral ques- 
 tions connected with the subject. Child- 
 ren must be subjected to many restraints, 
 and must have many things done to them 
 very disagreeable to their feelings, and 
 even inflicting much present pain ; but 
 when we consider that the purpose of the 
 operation is to give the exercise of a sense 
 so necessaiy both for enjoyment and edu- 
 cation, it must at once appear a cruel con- 
 duct, to deprive them of the use of it for 
 so many of the early years of life. All that 
 is required is to keep the little patient's 
 body, and especially the eye, steady. Be- 
 sides, in the lapse of years, there is no 
 
EYE, DISEASES OF. 
 
 249 
 
 knowing what untoward circumstances 
 may take place in the cataract ; it may 
 contract adhesions . to the neighhouring- 
 parts, and so be dilBcuit or impossible to 
 be removed by any operation whatever. 
 The state of the cataract in infants is ge- 
 nerally more favourable for an operation 
 than at any future period. The cataract 
 is generally fluid, and requires merely the 
 free lupture of the capsule; and this cap- 
 sule, though opaque, is tender, and easily 
 removed ; and the milky fluid is soon re- 
 moved by absorption. If the cataract 
 should be soft, it is commonly of that 
 pulpy softness that is easily dissolved by 
 the aqueous humour after the capsule has 
 been lacerated. Even if the cataract 
 should be hard, it is as easily depressed 
 as in an adult. Mr. Gibson, of Manches- 
 ter, who strongly urges tlie propriety of 
 couching, even in very young subjects, 
 thinks that even if a surgeon had diificul- 
 ties to encounter which do not occur in 
 adults, the invaluable benefit coufeiTed by 
 enabling an infant to become an intelli- 
 gent being, like other children, instead of 
 remaining in a state approaching to idiot- 
 ism, would incline him to run some risk 
 of failure, and to make more than com- 
 mon exertion, especially as there is little 
 chance of injuring the eye when proper 
 precautions are used. As additional ar- 
 gmiients for couching infants, it has been 
 urged, that in all probability the eye when 
 long allowed to lie passive, without any 
 exercise of its powers, is apt to lose them, 
 so that the patient is little benefited by 
 au operation ; and also, that the eye of 
 those born blind is apt to acquire a rest- 
 less and rolling motion, and the patient 
 loses all controul over it. It is not thought 
 advisable to use any instrument for fixing 
 the eye, as the pressure occasioned by all 
 such contrivances is apt to cause a sud- 
 den protrusion and loss of what is called 
 the vitreous humoiu* of the eye. Wheu 
 the patient is to undergo the operation, 
 he should be seated in a low chair, before 
 a light, but not too bright a one, as this 
 makes the pupil to contract too much. 
 Xhe sound eye is to be covered with a 
 
 compress, and an assistant placed behind 
 must hold the patient's head, and support 
 it on his breast. With the finger of the 
 hand that is free, the assistant must gent- 
 ly press the eye-lid against the upper part 
 of the orbit, carefully avoiding all pressure 
 on the eye. 
 
 Mode of Operating. I. Extraction. 
 This consists in removing the opaque 
 leras and its capsule from the eye, by an 
 opening at the lower part of the cornea, 
 or clear prominence in front. In a popu- 
 lar work like this, as it would be out 
 of place to give minute directions for 
 the shape of the instruments, and the 
 method of performing this very delicate 
 operation, we shall refer to books of sur- 
 gery for these particulars, and we shall 
 only give a very general sketch of the 
 manner of accomplishing the great pur- 
 pose of removing the opaque body from 
 the axis of vision. A knife, not unlike a 
 common lancet, is the instrument used by 
 the most expert oculists. The operator 
 is to be seated in a chair, a little higher 
 than that of the patient, whose head is to 
 be placed obliquely at a window, so that 
 the eye to be operated upon may be in- 
 clined towards the outer angle of the or 
 bit. The eye being properly fixed by the 
 fingers of the opei'ator and his assistant, 
 the point of the knife is to enter the out- 
 side of the cornea, a little above its trans- 
 verse diameter, and just before its con- 
 nexion with the sclerotica. Thus intro- 
 duced, it is to be pushed on slowly but 
 steadily, without the least intermission, 
 and in a straight direction, with its blade 
 parallel to the iris, so as to pierce the cor- 
 nea towards the inner angle of the eye 
 on the opposite side to that which it first 
 entered, and till about one-third is seen 
 to emerge beyond the inner margin of the 
 cornea. The aqueous humour now es- 
 capes, and the cornea is rendered flaccid. 
 Tlie edge of the blade is to be pressed 
 slowly downv\'ards, till it has cut its way 
 out, and separated somewhat more than 
 half the cornea from the sclerotica. After 
 the knife has pierced through the cornea, 
 and while it is cutting its way downwarcL 
 
250 
 
 EYE, DISEASES OF. 
 
 the assistant, to whose care the upper 
 eye-lid is entrusted, is ^dually to let it 
 drop, in order to prevent the lens from 
 escaping- too hastily. The operator hav- 
 ing- opened the capsule, is to make gentle 
 pressure on the upper part of the globe 
 of the eye, to promote the expulsion of 
 the lens. It is advisable, after the ope- 
 ration, gently to rub the anterior part of 
 the cornea over the lids, to remove from 
 the centre of the pupil any small frag- 
 ments of opaque matter. After the ope- 
 ration, the patient should lie continually 
 on his back, in order to prevent as much 
 as possible the escape of the humours. A 
 dossil of lint, steeped in plain water, or 
 brandy and water, and covered with ce- 
 rate, is the most convenient dressing. 
 Care must be taken not to suffer the ban- 
 dages for retaining this dressing to press 
 too much on the eye, for fear of exciting 
 inflammation, or forcing out some of the 
 vitreous humour; and, on the other hand, 
 it must be tight enough to prevent its 
 slipping off, and irritating the eye by un- 
 equal and injurious pressure. This should 
 not only be avoided from the bandage, but 
 from any foreign substance whatever; and 
 M'e are pai-ticularly to guard against any 
 irritation from the edge of the lower eye- 
 lid coming between the sides of the di- 
 vided cornea ; from the edge of the lower 
 lid being turned inwards, and so fretting 
 the eye with its eye-lashes, or from any 
 detached eye-lash getting upon the globe 
 of the eye. We must be particularly 
 careful not to expose the eye too soon to 
 a strong light. For two or three days we 
 inust not open the eye-lids, as the light 
 may increase the tendency to inflamma- 
 tion ; and the violence may disturb the 
 wound in the cornea, l)efore it is properly 
 healed. The best treatment is to keep 
 the patient wholly in bed, and to direct 
 him to move his head as little as possible 
 during the first three days after the ope- 
 ration. During this time the wet lint 
 and plaster, as formerly described, is to be 
 kept on the eye. The dressing to be re- 
 newed once a-day, and the outside of the 
 eye-lids to be Avashed once a-day with 
 
 tepid or cold water, according to the sea- 
 son. Abstinence from heating and sti- 
 mulating food and drink is to be enjoined, 
 and no exertion of mind or much talking 
 is to be allowed. About the fourth day, 
 he may be allowed to sit up a little, and, 
 if necessary, a laxative medicine should 
 be ordered. About the fifth day he may 
 sit up longer ; and the eye may be cau- 
 tiously examined. If matters be going on 
 right, the patient may sit in a darkened 
 room, having a shade on his forehead ; 
 and he may look a little at large objects. 
 Unless some unexpected untoward acci- 
 dents should occur, he may gradually 
 make the proper use of his recovered eye. 
 2. Couching. The operation of couch- 
 ing consists in removing the opaqxie lens 
 and its capsule out of the axis of vision, 
 not by removing it from the l)ody alto- 
 gether by an instrument, but lodging it 
 in the vitreous humour of the eye, from 
 which, in prosperous cases, it M'ill be re- 
 moved by absorption. This is done by a 
 needle made on purpose, very slender, but 
 having sufficient firmness to enter the eye 
 without risk of breaking, and having a 
 point which is slightly curved. A couch- 
 ing needle should not be longer than an 
 inch ; this alBfords the operator sufficient 
 command over the motions of the point, 
 and enables him to judge acciu-ately how 
 far it has penetrated into the globe of the 
 eye, before he has an opportunity of see- 
 ing it through the pupil. In general, the 
 only preparation necessary for the patient 
 before couching, is to abstain from animal 
 food for a few days, and to take some 
 laxative medicine the day before the ope- 
 ration. If there is any particular disease, 
 or train of symptoms, as hysteria or 
 hypochondriasis, it may be as well to 
 strengthen the system a little, previously ; 
 and if the eye-lids are diseased, we may 
 attempt, by proper ointments, to restore 
 them to as sound a state as possible. The 
 operator desires the patient to turn his 
 eye towards the nose, and then introduces 
 the instrument through the sclerotic coat, 
 at the distance of two lines from the mar- 
 gin of the cornea, and at the height of one 
 
EYE, DISEASES OF. 
 
 2ol 
 
 line below the transverse diameter of the 
 pupil. The extremity of the instrument 
 is next to be directed immediately over 
 the opaque lens, and this is to be depressed 
 a little downwards, in order to make room 
 for the safe conveyance of the instrument 
 in front of the diseased crystalline and its 
 capsule. The capsule is to be lacerated 
 in front, and conveyed with the lens 
 deeply into the vitreous humour. A cir- 
 cumstance which is sometimes to be fear- 
 ed, is the appearance of some portion of 
 the capsule of the lens in the way of the 
 rays of light, forming- what is called the 
 secondary membranous cataract; in the 
 operation for couching, the capsule being 
 wounded on its anterior part, this seldom 
 happens ; but if it should, it will generally 
 be absorbed again, and the patient need 
 not undergo a second operation. After 
 the operation, the patient ought for some 
 time to be kept in bed, in a cool and quiet 
 room, and on the following morning a sa- 
 line pm-gative should be administered. If 
 there be much inflammation of the eye, 
 it is to be treated on general principles, 
 as that arising from any other cause. It 
 may happen that at one operation for 
 couching, comparatively little may be ef- 
 fected. In til is case, it may be repeated 
 again and again, with no greater incon- 
 venience than blood-letting; but if much 
 violence be used in order to accomplish a 
 great deal at first, or to show dexterity 
 and speed in the operation, it may easily 
 be believed, from the delicate structure 
 of the eye, that irrep&rable mischief may 
 be done. Mr. Hey, of Leeds, operated on 
 the same patient twelve times. The pain 
 and inconvenience is so much less than 
 might be expected, that patients, when 
 made sensible of the necessity of the re- 
 petition, find no difficulty in submitting 
 to it. Itinerant oculists, whose business 
 requires haste, are too apt to injure the 
 sight, even when the operation has been 
 well performed, by presenting various 
 objects to the patient to try if he knows 
 them. It would be foreign to our pur- 
 pose to enter into a detail of the various 
 kinds and degrees of consistence of cata- 
 
 ract, and the various management neces- 
 sary for their removal. Neither do W6 
 consider it expedient to state minutely 
 the long list of contending arguments in 
 favour of the methods of curing cataract 
 by couching or extraction. Both have 
 had eminent surgeons as their advocates ; 
 but it seems to be generally thought that 
 couching is preferable, on account of the 
 ease, the safety, and the efficacy with 
 which it is performed. 
 
 IV. Closure of thk Pupir,. The ope- 
 rations of depression or extraction of the 
 lens for the cure of cataract, are sometimes 
 followed by a vehement inflammation of 
 the membranes of the eye, especially of 
 the iris, terminating in adhesion ; which 
 occasions the pupil to be almost or en- 
 tirely shut, of which the necessary conse- 
 quence is a diminution, and afterwards a 
 total loss of sight. There is no remedy 
 for this, but making an artificial opening 
 in the iris, as a substitute for the pupil, 
 either by a simple division of the fibres 
 of the iris, or by cutting out a portion of 
 that membrane, or by detaching the iris 
 from the ciliary processes. The cases in 
 which operations are advisable, and the 
 modes of performing them, are subjects 
 for the consideration of the most skilful 
 oculists, and by far too subtle to be treat- 
 ed of in a popular work. 
 
 V. Opacity of the Cornea is a conse- 
 quence of obstinate chronic ophthalmia. 
 The pupil and iris are discernible through 
 a kind of cloudiness, and the patient is 
 not quite deprived of sight, but sees things 
 as it were through a mist. The veins of 
 the anterior part of the eye being relaxed 
 by the long continuance of the inflamma- 
 tion, become turgid and prominent; they 
 afterwards become irregular and knotty. 
 Soon after, some reddish streaks are perr 
 ceiyed, and in the spaces between these^ 
 a thin milky fluid is eflFused. Tlie whitish 
 superficial speck which results, is called a 
 nebula. There may be either one speck, 
 or several distinct ones. Though this 
 opacity may at first occupy only a small 
 part of the cornea, yet, if left to itself, it 
 advances towards the centre of it, and a 
 
252 
 
 EYE. DISEASES OF. 
 
 dense opaque membrane is formed, which 
 obstnicts the sight partially or totally. 
 
 Treatment. Our first object is to make 
 the turgid veins contract, by the use of 
 astringent ointments or washes. There 
 is an ointment called Janin's ophthalmic 
 ointment, which has been found effectual 
 when the opacity is recent, and not very 
 extensive. This ointment is made by 
 mixing thoroughly together two drachms 
 of prepared tutty, two drachms of Arme- 
 nian bole, one drachm of the grey oxide 
 of mercury, and half an ounce of hog's 
 lard. When first used, the quantity of 
 hog's lard must be doubled. A similar 
 purpose is served by the diluted citrine 
 ointment. If these applications fail, the 
 enlarged veins which run to the opaque 
 part must be cut across ; they should be 
 allowed to bleed freely, and fomentations 
 should be used to encourage this. The 
 eye should not be opened for twenty-four 
 hours. A tepid wash of rose-water and 
 milk should be applied two or three times 
 a-day. The nebula often disappears very 
 quickly after this operation- But the use 
 of astringents and ophthalmic ointments 
 for some time, will be proper for prevent- 
 ing the recurrence of the complaint. 
 
 VI. Leucoma denotes a white opacity 
 of the cornea, not superficial like the ne- 
 bula, but owing to a dense coagulating 
 lymph poured out from the arteries into 
 the substance of the cornea, in conse- 
 quence of violent acute ophthalmy. When 
 i-ecent, this opacity is of a clear milky co- 
 lour, but when of older date it becomes 
 pearl-coloured. If the organization of 
 the cornea be not destroyed, the leucoma 
 may be expected to disperse by the means 
 employed for the cure of the infiamraa- 
 tion ; by general and local blood-letting, 
 with other antiphlogistic remedies, and 
 emollient applications to the eye in the 
 first stage of ophthalmia, and slightly 
 astringent Avashes in the second: these 
 astringent applications cause the absor- 
 bents to remove the deposited lymph, and 
 thus restore the transparency of the cor- 
 nea. In cases of longer standing, our 
 hopes of a cure are not at all sanguine ; 
 
 stimulating applications may be tried, and 
 must be persevered in for ten or twelve 
 weeks. Operations on the part for the 
 cure of leucoma are generally unavailing. 
 
 VII. Staphyloma. A disease of the 
 eye-ball, in which the clear part of the eye, 
 loses its transparency, rises above the level 
 of the eye, and sometimes even projects 
 beyond the eye-lids. It is attended with 
 complete loss of sight, and is y^x-^ often 
 the consequence of that species of oph- 
 thalmy which occurs in very young child- 
 ren, accompanied with a profuse dis- 
 charge of pui-ulent matter, and called by 
 the common people the gum. It is also 
 produced by the sraall-pox, and that 
 chiefly when the pustules are dry, and the 
 scabs fall off. As this disease of sight is 
 incurable, it is best to let it alone, unless 
 it grows so fast as to come out between 
 the eye-lids, and occasion great pain and 
 deformity to the patient. When this 
 takes place, it is one of the most alarm- 
 ing maladies that can happen to the eye- 
 ball, for Avhen it can no longer be cover- 
 ed by the eye-lids, it is exposed to the air, 
 and to the friction of the eye-lashes ; the 
 eye becomes painful and inflamed, the 
 tears flow down the cheeks; the other 
 eye is affected by sympathy, and the dis- 
 eased one ulcerates. It has been at/- 
 tempted to reduce the size of the staphy- 
 loma by an issue or artificial ulcer at the 
 bottom of the swelled part, but this has 
 not been found to answer, and it is ra- 
 ther recommended to cut off the top of 
 the projecting part, by which some of the 
 humours of the eye are evacuated, and 
 the swelling subsides, so as to allow the 
 eye-lids to cover the ball. A degree of 
 inflammation follows, on which the eye is 
 to be covered with a poultice df bread 
 and milk. Purulent matter is formed; 
 the edge of the surface from which the 
 projection was cut becomes red, con- 
 tracts and daily diminishes, so that at last 
 the wound is entirely closed, and an op- 
 portunity is given for the insertion of au 
 artificial eye. 
 
 VIII. ExoPHTHALMiA signifies the pro- 
 trusion of the eye from its socket, while. 
 
EYE, DISEASES OF. 
 
 253 
 
 the g-Iobe is of the natural size, and free 
 from disease. It lies towards the temple 
 or on the chcelc, and vision is quite lost. 
 This occurrence may arise from violent 
 concussion of the head, from a thrust 
 with a stick or instrument passing be- 
 tween the orbit and the eye-ball, or from 
 tumoui-s within the orbit, which, as they 
 gradually enlarge, push the eye-ball from 
 its socket. There is generally no great 
 difficulty in replacing the eye, when the 
 proti-uding body is removed ; and when 
 the eye is replaced, inflammation is to be 
 kept down by cooling topical applications, 
 and by general or local blood-letting. If 
 there should be any suppuration, care 
 must be taken to procure a free and early 
 vent for the matter. When a gradually 
 increasing tumour has occasioned the dis- 
 placement of the eye, the tumour must be 
 removed by the proper surgical means, 
 before it can be put back into its place. 
 Whatever be the cause of the injury,its cure 
 is always the easier the more recent it is. 
 IX, Dropsy op the Eye. In some 
 cases, the vitreous humour of the eye is 
 disorganized and broken down, and the 
 aqueous humour is increased in quantity, 
 causing the eye-ball to assume an oval 
 shape, ending at the point of the cornea; 
 it then enlarges to such an extent, that it 
 projects from the orbit and cannot be co- 
 vered by the eye-lids. This disease is 
 sometimes preceded by blows on the eye, 
 or on the adjoining temple, sometimes by 
 an obstinate internal ophthalmia. Pro- 
 fessor Beer of Vienna has seen the di'opsy 
 of the eye brought on by too long con- 
 tinuance of the use of mercury in the 
 ophthalmia of gouty subjects. The cure 
 consists in evacuating the fluid contents 
 of the eye by a puncture, removing a 
 small portion of the cornea, and exciting 
 a slight degree of inflammation and sup- 
 puration ; taking care that the inflamma- 
 tion does not go too far. When the opera- 
 tion is successful, the eye-ball diminishes 
 in size, and gradually returns into the or- 
 bit. It is hardly .necessary to mention, 
 that vision has, long before this, been ir- 
 recoverably gone. 
 
 X. Cancer of the Eye. There is an 
 affection of the eye which is thought to 
 be of a cancerous nature, which is pro- 
 ductive of great pain, and at last of death, 
 unless the eye is completely extirpated. 
 This complaint sometimes occurs after ob- 
 stinate ophthalmy, sometimes after a blow 
 on the eye, or after wounds, or staphy- 
 loma; and often after fungous excrescen- 
 ces, which form on the surface, or in the 
 interior parts of the eye. The disease is 
 said to be sometimes caused by irritating 
 applications; but very often the causes 
 ai'e constitutional. It is most frequent in 
 childhood. This disorder of the eye is 
 commonly preceded by headachs, and an 
 unusual heat in the organ, with an itch- 
 ing about it and the neighbouring parts. 
 There is a considerable flow of tears ; 
 light is borne with difficulty at first, and 
 soon becomes quite intolerable. To the 
 itching succeeds a pricking sensation, and 
 afterwards pains which are acute and lan- 
 cinating. The eye enlarges and assumes 
 a dull and livid hue, and its surface is 
 rough and irregular. The cornea at length 
 ulcerates and bursts ; fungous growths 
 project from the opening, which discharge 
 a purulent fetid matter. As the disease 
 advances, the fungous growths increase, 
 and become livid. There are frequent 
 discharges of blood. The pains are now 
 incessant; the neighbouring bones and 
 other parts become carious or ulcerated ; 
 and a miserable death ensues. As we 
 have stated above, there is no way of sav- 
 ing the life but by extirpating the eye. 
 For the method of doing this, we refer to 
 books of surgery. The extirpation should 
 be complete ; and the lacrymal gland 
 should also be removed. The antiphlo- 
 gistic plan is to be continued for some 
 days after the operation. 
 
 XI. Amaurosis, called also Gutta Se- 
 rena or Black Cataract This signifies 
 a decay or loss of sight, when no defect 
 is visible in the eye, except an enlarge- 
 ment of the pupil, and its being insensible 
 (o the stimulus of light. The approach 
 of amaurosis is generally attended with 
 pain in the head, which troubles the pa- 
 
254 
 
 EY E-LID& 
 
 tieiit for a considerable length of time ; 
 there are various depravations of sight, as 
 the appearances of stars or bright spots 
 dancing before him ; or he is sensible of 
 something wrong about the sight when 
 the candles are lighted. The patient feels 
 as if some dirt or dust were upon his 
 eyes, and is frequently wiping them. 
 Sometimes he complains of a tension of 
 the eye-ball, ^vhich is particularly trouble- 
 some. Whenever this sensation is ex- 
 perienced, the eye-sight becomes weak, 
 and when it goes off, the patient is again 
 able to see better. Amaurosis commonly 
 attacks both eyes at once, and in those 
 cases where the one is affected before the 
 other, the interval is but short. Before 
 the blindness is quite complete, patients 
 can sometimes see when an object is pre- 
 sented at the side of the eye. 
 
 Causes. Amaurosis is owing to a 
 palsy of the retina, or injury of the optic 
 nerve in some part of its course, from a 
 tumour, or from a fulness of the adjacent 
 blood-vessels. It may arise from exter- 
 nal injuries done to the head, from the 
 suppression of periodical habitual evacua- 
 tions, from the effects of deadly night- 
 shade and other sedative poisons, from 
 the absorption of the venereal virus, from 
 great exertions of strength when the bo- 
 dy is plethoric ; and it is sometimes a se- 
 quel of certain fevers. In many cases, 
 no cause can be assigned. 
 
 Prognosis. It is in general unfavour- 
 able. When amaurosis has been preced- 
 ed by frequent headachs, with much pain 
 in some part of the eye ; when it occurs 
 after fevers, or when it happens to the 
 aged and intirm, a cure is hardly to 
 be expected. If it occurs in connex- 
 ion with pregnancy or hysteria, or in 
 young subjects, our hopes are somewhat 
 l)etter. 
 
 Treatment. If a patient makes known 
 his ailments early, he is to be treated, if 
 at aU plethoric, by evacuants, by leech- 
 ing and cupping about the temples, and 
 by an issue in the neck. Some cases 
 have been treated by electricity or gal- 
 vanism, and some by a course of mercu- 
 
 ry; others seem to have derived some 
 advantage from frequent emetics, or from 
 acrid powders which occasioned a dis- 
 charge from the nose ; but in the greater 
 number of cases, the gutta aerena has 
 proved incurable. 
 
 EYE-LIDS. These are subject to va- 
 rious diseases, which are commonly men- 
 tioned along with the diseases of the eye, 
 &c. fSee Inflammation of the Eye.) 
 1. The inner surface of the eye-lids is often 
 a good indication of the state of the dis- 
 ease of the eye itself; while a certain gra- 
 nulated condition of their surface exists, 
 the eye is to be considered as still in a 
 bad state, and when this is removed by- 
 blue vitriol, or other caustic or astrin- 
 gent applications, the eye begins to get 
 well. 2. The habitual redness of the 
 eye-lids so prevalent in scrofulous ha- 
 bits, is to be cured by astringent oint- 
 ments, and general strengthening reme- 
 dies. 3. Sometimes a hard warty substance 
 grows under the skin of the upper 
 eye-lid, which is hardly to be removed 
 but by being cut out. 4. A troublesome 
 and painful growth, known commonly 
 by the name of stye, very frequently at- 
 tacks the eye-lids ; it is a kind of boil, in 
 which is slowly formed a thick yellow 
 matter ; it may be hastened forward by 
 bread and milk poultices, and discharged 
 by a small puncture when it is ripe. 
 Those who have once had stye, are very 
 liable to frequent returns of it. 5. Ee- 
 tropium signifies a turning out of one or 
 both of the eye-lids. It may arise from 
 elongation or swelling of the membran- 
 ous lining of the eye-lids, or from a con- 
 traction of the outer skin of the eye-lids. 
 The first kind may be the consequence of 
 obstinate chronic ophthalmia, in scrofulous 
 and relaxed constitutions ; or it may hap- 
 pen after small-pox. The second species, 
 or that turning out of the eye-lids which 
 is owing to a contraction of the skin, 
 may arise from the pits and scars left by 
 small-pox, or by burns ; or from the cut- 
 ting out of a tumour when sufficient skin 
 has not been left. The effects of this 
 turning out of the eye-lids are very trou- 
 
E Y E . L I D S. 
 
 255 
 
 blesome. There is a continual discharge 
 of tears over the cheek, a dryness of the 
 eye-ball, frequent attacks of ophthalmia, 
 intolerance of light, and opacity or ulcer- 
 fition oftheconiea. When the first species 
 is slight and recent, the best method is to 
 destroy the elongated and relaxed skin 
 on the inner surface of the eye-lid, by 
 completely turning it out and rubbing it 
 wi):h lunar caustic, taking care to protect 
 tW eye from suffering by the caustic, by 
 washing the eye with new milk. It will 
 be necessary to use the caustic for seve- 
 ral days, till there be a sufficient destruc- 
 tion of the internal membrane of the eye- 
 lid, and of its inner surface. In favour- 
 able cases, this treatment is follo\\'ed by 
 the gradual return of the eye-lid to its 
 natural position. The cure of the second 
 species is more difficult. As it sometimes 
 happens from the contraction occasioned 
 by a cicatrix, it has been proposed to cut 
 this through ; but no great success has 
 attended this operation. The cutting out 
 of a portion of the membrane lining the 
 eye-lid is the method most likely to suc- 
 ceed in remedying the eversion of that 
 part. 6. Entropiiim is the reverse of 
 the former case, and is a turning in of 
 the eye-lids ; it is also called trichiasis, 
 from a Greek word signifying a hair, on 
 account of the irritation produced by the 
 eye-lashes fretting the ball of the eye. 
 This turning in of the eye-lids is a fre- 
 
 quent consequence of ulcers and scars of 
 their margin, which is called the tarsus ; 
 or of ophthalmia arising from scrofula or 
 small-pox. The cure consists in remov- 
 ing a certain portion of the skin of the 
 affected eye-Ud, near the tarsus. The 
 lips of the wound are to be brought to- 
 gether by slips of adhesive plaster. A 
 cicatrix forms, and the lid is turned out 
 to its natural position. There is ano- 
 ther kind of trichiasis, in which one or 
 more hairs are turned in, without any al- 
 teration in the position of the eye-lid. It 
 is difficult to accomplish a cure, as it is 
 found that neither the pulling out of the 
 hairs, nor burning the situation of the 
 roots can be at all depended on. 7. Some- 
 times the upper eye-lid falls down, and 
 cannot be raised or kept up by the action 
 of the voluntary muscles. This may arise 
 from a redundancy of the skin, or from 
 palsy of the muscles destined to raise the 
 eye-lid. When it proceeds from the first 
 cause, a portion of the redundant skin is 
 to be removed ; and when palsy is the 
 cause, the eye and surrounding parts are 
 to be bathed frequently with very cold 
 water ; and the eye-brow and eye-lid are 
 to be rubbed with the camphor liniment, 
 or with a liniment containing a little of 
 the tincture of cantharides. The shower 
 bath, and bark, as correctors of debility, 
 may be conjoined with the other methods 
 employed. 
 
 FAH 
 
 FAH 
 
 FiECES. The excrement from the 
 belly. 
 
 FAHRENHEIT' S THERMOME- 
 TER. The divisions of the thermome- 
 ter most in use in this country are those 
 adopted by Fahrenheit, the assistant of 
 Boerhaave. The zero is that point at 
 which the mercury or spirit of wine 
 staPkds in the tube when the bulb of the 
 thermometer is plunged into a mixture of 
 
 salt and snow; the freezing point is at 
 32" above 0" ; and boiling water at 212" : 
 thus the space between the points of boil- 
 ing and freezing water is divided into 
 180°. In the centigrade thermometer, 
 the freezing point of water is zero; and the 
 space between that and the boiling point is 
 divided into 100°; in Reaumur's, the zero 
 is the same, and the division between the 
 freezing and boiling points is into 80°. 
 
^56 
 
 FAINTING. 
 
 FAINTING. A temporary weakness 
 or stoppage of the circulation and of 
 breathing". Soraetiines a faint comes on 
 suddenly, but at other times gi-adually, 
 with a feeling of languor and oppression, 
 with giddiness, dimness of sight, and 
 sounding in the ears. Along with these 
 symptoms, the pulse and breathing be- 
 come weak, and sometimes both these 
 actions cease altogether. The face and 
 the surface of the body become pale and 
 cold. A cold sweat comes out on the 
 forehead, and on some other parts of the 
 body. During the faint, the patient is 
 deprived of sense and motion. After a 
 little time, he recovers, and the recovery 
 is attended with a feeling of much anxiety 
 about the heart. In many cases, vomit- 
 ing is present, and sometimes the fit ends 
 with convulsions or epilepsy. 
 
 Causes. Fainting is occasioned by de- 
 pressing passions of the mind, by fear, 
 horror or disgust : thus some faint at the 
 sight of a sore in another person, or at 
 the remembrance of any thing disgusting 
 that they may have seen. Some faint at 
 the approach of certain smells, even those 
 which to most other persons would not 
 occasion such an accident. Loss of blood 
 occasions fainting, and a very small loss 
 will sometimes do so even in a strong 
 person. The alteration in the distribu- 
 tion of the blood occasions fainting, as we 
 see in those who have it altered by the 
 diminution of swelling, as by the letting 
 off of dropsical waters; and in women 
 soon after delivery; and this, independent 
 of flooding. Disorders of the bowels, 
 articles of food that disagree with the 
 stomach, fatigue and weakness, confine- 
 ment in crowded places w here the heat 
 is great, over-exertion in weak persons, 
 are all found to occasion fainting. Organic 
 diseases of the heart and great blood- 
 vessels, ossification, or polypi, occasion 
 fainting in those who are afflicted with 
 them. 
 
 Treatment. In common cases, it is 
 proper to place the person \^'ho is in a 
 faint, in the horizontal posture, to allow 
 the free circulation of air, to sprinkle the 
 
 face with cold water, and to apply to the 
 nostrils some volatile salts. When the 
 patient faints daring a bleeding, the flow 
 of blood should be stopped, and the pa- 
 tient, if sitting up, should be allowed to 
 lie down. If further bleeding be neces- 
 sary, it often may be got when the patient 
 is lying, but it is not unusual for the faint 
 itself to diminish the action of the system 
 as much as a large bleeding would do. 
 When a person is subject to fainting fits 
 from general weakness, the strength is 
 to be restored if possible by bark, wine, 
 nourishing diet, and tonic medicines. But 
 w^hen it arises from organic diseases of 
 the heart, a permanent cure is not to be 
 expected. The faintness that takes place 
 after delivery in general goes off, merely 
 by lowering the patient's head, and by 
 giving a little warm wine and water ; but 
 when the fain tings are accompanied "with 
 a quick, irregular, and feeble pulse, with 
 the hands and feet cold, great danger is 
 to be apprehended, as such a state is the 
 consequence of serious injury or of the 
 loss of blood. The cause is instantly, if 
 possible, to be ascertained by the practi- 
 tioner, and the proper remedies to be 
 applied ; but caution is requisite in the 
 use of stimulants applied to the nostrils, 
 lest suffocation ensue, or lest the patient, 
 by coughing or sneezing, induce a dange- 
 rous or fatal flooding. See Flooding. 
 
 FALLS. Sometimes persons fall from 
 a considerable height with very little 
 injury, at other times much mischief en- 
 sues from what v^ould be considered a 
 very trifling fall. Sometimes concussion 
 of the brain or injury of the spinal mar- 
 row occm-s, although no external injury 
 is to be perceived. A fall may be at- 
 tended with contusion, dislocation, frac- 
 ture, or wound ; and must be treated 
 according to the varieties of the effects 
 produced. A person who falls from a 
 height is very commonly stunned by doing 
 so ; and a little time must be allowed for 
 this to go off, without the sui^eon or by- 
 standers being too urgent in the appli- 
 cation of stimulating remedies, w of 
 blood-lettino-. 
 
FAT 
 
 FEM 
 
 257 
 
 FALLING SICKNESS. See Epi- 
 lepsy. 
 
 FARINA, meal or flour obtained from 
 various vegetables, as wheat, barley, oats, 
 rice, rye, potatoes, &c. 
 
 FARINACEOUS ALIMENTS, are 
 those which abound in the mealy portion 
 above mentioned. The most eminent and 
 universal of farinaceous food is that made 
 from wheat-flour, or bread. Under the 
 article Buead, we have given an account 
 of the particulars worthy to be known and 
 remembered on that important subject. 
 
 FAT. An oily matter contained in 
 the cellular substance of animals, of a 
 white or yellowish colour. It seems to 
 answer several important purposes; it 
 facilitates the motion of the vai'ious parts 
 where it is lodged ; it fills up interstices 
 m different situations ; and as it is a bad 
 conductor of heat, it appears to contribute 
 to the preservation of the temperature of 
 animals. It is used with other animal 
 substances as an article of food ; and where 
 the digestive powers are strong, it proves 
 highly nutritious. Those animals which 
 sleep all the winter, are generally fat at 
 the commencement of their long slumber, 
 and come out of it very lean, owing to 
 the fat having been absorbed and carried 
 into their system for the purpose of nu- 
 trition. Fat has a tendency to accumu- 
 late very much in some persons who live 
 luxuriously, using great quantities of 
 animal food, with porter and other malt 
 liquors, and who take little exercise. 
 Others, without such causes, seem to get 
 corpulent from peculiai'ity of constitu- 
 tion. It sometimes proceeds to such an 
 extent as to be a real disease, incapacitat- 
 ing the individual from exercise and from 
 performing the duties of life, besides ren- 
 dc'ring him liable to apoplexy and the 
 other diseases analogous to it. Such 
 overgrowth of fat is to be counteracted 
 by abridging the quantity of food taken, 
 by abstaining from malt liquors, and by 
 taking constant and regular exercise. 
 Instances are upon record, of persons 
 who have made a sudden and total change 
 in their manner of life, in order to dimin- 
 
 ish their corpulency ; and this without 
 any bad effects ; but such sudden transi- 
 tions from one mode of life to another 
 are not advisable, and it is better to make 
 them gradually, but steadily. 
 
 FAUCES. The name given to the 
 back part of the mouth, and commence- 
 ment of the gullet and wind-pipe. 
 
 FEBRIFUGE. A medicine or remedy 
 supposed to have the power of curing 
 fever. The correctness of modern pa- 
 thology does not admit of any appellation 
 so vague as a febrifuge: medicines are 
 named from their more immediate effect, 
 as emetic, purgative, diaphoretic, &c. al- 
 though their subsequent effect be to cut 
 short a fever, or to render it milder. 
 
 FEMALE COMPLAINTS. There 
 are many disorders incident to the female 
 sex, from the peculiarity of their struc- 
 ture, their functions, and their mode of 
 life. The organs appropriated for the 
 production and nourishment of their off- 
 spring, are themselves the seat of many 
 diseases ; and by their strong and general 
 sympathy with other parts, they may oc- 
 casion many disorders in the constitution. 
 The periodical discharge is subject to 
 many varieties, in its periods, regularity, 
 quantity, and the ease or difficulty with 
 which it is performed ; and the periods of 
 life when this discharge is begun, and 
 when it terminates, are justly considered 
 as very critical for the female constitu- 
 tion. Pregnancy, too, with all its attend- 
 ants and consequences, is an occurrence 
 of the most interesting nature to women. 
 It is in many cases attended with pain, 
 inconvenience, and danger ; and lays the 
 foundation of maladies which afflict them 
 both during its coui-se, and long after- 
 wards. The manner of living, also, in wo- 
 men, gives rise to many disorders. Though 
 the female in savage life, who shares in 
 all the labours and dangers common in 
 that state of society, becomes athletic and 
 hardy, and brings her constitution to a 
 level with that of the male, in vigour and 
 the power of resisting external impres- 
 sions, yet in civilized life the case is widely 
 different; the luxurious habits, the se- 
 
258 
 
 F E V E R. 
 
 dentary lives, the susceptibility to impres- 
 sions which women there acquire, render 
 their constitution altogether unlike what 
 it would be under another regimen, and 
 give rise to numberless ailments and dis- 
 eases. In different articles of this work; 
 we have enumerated the disorders of 
 many parts, and of the functions per- 
 formed by women, for which the follow- 
 ing may be consulted : Womb and its 
 Diseases, Cancer, Monthly Discharge, 
 Pregnancy, Hysteria, Dropsy of the 
 Belly, "Whites, Abortion, &c. 
 
 FERMENTATION. « Vegetables un- 
 dergo spontaneous changes, by which their 
 nature is completely altered, and new sub- 
 stances are formed. This process is called 
 fermentation^ and is divided into three 
 kinds, the vinous, acetous, and putrefac- 
 tive ; the first so called, because, during 
 it, vinous or spirituous fluid is formed; 
 the second, because vinegar or acetic acid 
 is produced; and the third, because the 
 vegetable undergoes putrefaction, being 
 almost entirely dissipated in the form of 
 gaseous products. Sugar is the substance 
 that undergoes the spirituous fermenta- 
 tion most easily, and by converting other 
 bodies to the saccharine state, it causes 
 them to undergo this change more readily. 
 When sugar is dissolved in water, and a 
 little yeast is added, the mixture soon be- 
 comes muddy, bubbles of gas rise through 
 it, and it acquires a thick scum on its sur- 
 face. When these processes have gone 
 on for some time, the scum falls to the 
 bottom, and the fluid again becomes trans- 
 parent ; its properties are also altered, it 
 has lost its sweetness, acquired a hot pun- 
 gent taste, and produces intoxication." 
 (Dr. Fyfe's Elements of Chemistry.^ 
 There are two kinds of intoxicating li- 
 quors produced by the vinous fermenta- 
 tion ; the different kinds of wine obtained 
 from the juices of plants, and the different 
 kinds of beer procured from the infusion 
 of seeds. In common language, the first 
 kind is termed simply wine ; and the se- 
 cond, malt liquors or fermented liquors. 
 For their effects on the body, see Wine, 
 Ale, Beer, Porter, &c. 
 
 FERN. The powder of the male fern, 
 Aspidium Filix mas, has been supposed 
 to be good for expelling the tape-worm. 
 The inner solid part of the root is the 
 part used, in the dose of one or two 
 drachms; but as strong purgatives ai-e 
 generally given either along with it, or 
 immediately after it, it is not unlikely 
 that when the worm is discharged, the 
 good effect is owing to the purgatives. 
 The powder of the male fern Avas an im- 
 portant ingredient in the celebrated worm 
 powder of Madame NoufFer. 
 
 FETID. Putrid or ill-smelled. 
 
 FEVER. No subject in medicine is 
 of greater importance than this, because, 
 either as a primary disease, or an attend- 
 ant and symptom of others, fever forms a 
 great part of the maladies to which the 
 human body is subject. When a person 
 has a quick and strong pulse, with much 
 heat of the skin, and great thirst, he is said 
 to be feverish, or to have the symptoms 
 of fever. Certain diseases present a long 
 train of symptoms, in which those above 
 enumerated are constant and predominant, 
 though accompanied with very many 
 others ; these are denominated Fevers, 
 with some distinguishing epithet to mark 
 their character, or what physicians call 
 their type, as inlei'mitting, remitting, or 
 continued. There are various epithets 
 applied to fevers both in books and in 
 common language, taken from some symp- 
 toms which have attracted particular at- 
 tention, as putrid fever, low nervous fever, 
 brain-fever, &c. Or from the supposed 
 causes and places of their origin, as ship- 
 fever, jail-fever, hospital-fever. In other 
 diseases, though tne symptoms of fever 
 are very conspicuous, yet they are only 
 regarded as indicating another affection, 
 viz. inflammation ; and the disease takes 
 its name, not from the fever, but from 
 some other circumstance, as inflammation 
 of the eye, pleurisy, rheumatism. Many 
 eruptive diseases have strong feverish 
 symptoms, as measles, small-pox, and 
 scarlet fever. We shall in this article 
 give some account of the different kinds 
 of fever, properly so called. 
 
FEVER, REMITTENT. 
 
 259 
 
 I. Intermittent Fever. See Ague, 
 under which the 83Tiiptoms and treatment 
 have heen fully detailed. 
 
 II. Remittent Fever. This fever dif- 
 fers from the ague in the circumstance, 
 that instead of complete intermission be- 
 tween the attacks, there is only an abate- 
 ment of it at uncertain intervals. Remit- 
 tent fevers occur principally in warm cli- 
 mates, or in warm and moist situations, 
 or in those that are marshy and abound 
 with wood and water, furnishing organ- 
 ized matters for putrefaction. Before the 
 attack of remittent fever, the patient is 
 heavy and languid, and is troubled with 
 frequent yawnings or sighings, and alter- 
 nations of heat and cold. When the fit 
 comes on, there is pain in the head and 
 back, thirst, and difficulty of . breathing, 
 the spirits are dejected, the tongue is 
 white, there is a yello\niess about the 
 eyes and skin, sickness, and vomiting of 
 bilious matter, with a small and frequent 
 pulse. Sometimes the symptoms above 
 enumerated are very severe, and accom- 
 panied with headach, violent flushing of 
 the face, and delirium ; the tongue is co- 
 vered with a dark bro\vn fur, the breath- 
 ing is laborious, the pulse quick and throb- 
 bing. In mild cases, the symptoms abate, 
 or a remission takes place, though the pa- 
 tient does not, as in ague, become quite 
 free from complaint; in cases more severe, 
 the remission is indistinct or impercep- 
 tible, the symptoms continuing always pro- 
 sent with considerable severity. Remit- 
 tent fevers generally run their course in 
 five or six days, but sometimes they are 
 protracted to a longer period. A favour- 
 able termination may be hoped when the 
 remissions are distinct and the symptoms 
 mild ; but when there is little or no re- 
 mission, and the putrid symptoms prevail, 
 the recovery is very doubtful. Remit- 
 tents in hot and moist climates, and dur- 
 ing the autumnal months, have much ten- 
 dency to the putrid form, and are conse- 
 quently of the greatest danger. 
 
 T/ea^/wen^q/" Remittent Fever. On 
 the first attack, if there be not very gr/eat 
 irritability of the stomach, and tendency 
 
 to vomiting, it may be useful to give a 
 gentle emetic, for the purpose of remov- 
 ing any undigested food which might af- 
 terwards prove a source of irritation. Vo- 
 miting, however, is in many cases so vio- 
 lent, that we are rather called upon to check 
 it. The saline effervescing draughts prove 
 highly useful in allaying this troublesome 
 symptom. For a long time, bleeding was 
 considered as a remedy totally inadmis- 
 sible in the fevers of warm climates ; and, 
 indeed, when their exhausting influence 
 has continued for some time, the abstrac- 
 tion of blood would hasten a fatal termi- 
 nation ; yet in vigorous Europeans, in the 
 very early stages, blood-letting to a consi- 
 derable extent is highly useful. The 
 bowels are to be most diligently attended 
 to. Purges, wholly or in part composed 
 of calomel, are much celebrated by the 
 practitioners of warm climates ; but we 
 are also to give other kinds, as saline 
 purges, or senna with tamarinds, the com- 
 pound powder of jalap, or castor oil. 
 When the bowels have been thoroughly 
 emptied, if there is considerable restless- 
 ness and irritation, and if no delirium be 
 present, an opiate v^'ill prove of signal ser- 
 vice in allaying irritation, and producing 
 a salutary moisture on the surface of the 
 body. When there is a remission, ad- 
 vantage should be taken of it to give the 
 Peruvian bark, or the sulphate of qui- 
 nine, which often has the good effect of 
 making a complete intermission; and 
 such intervals, when successfully improv- 
 ed, may gradually be multiplied and 
 lengthened till the fever abates altogether. 
 Other symptoms as they arise must be 
 palliated ; the dry parched skin may be 
 spunged with tepid or cold vinegar or 
 water ; the thirst quenched by lemonade, 
 by barley-water, by small beer, or the 
 like ; if there be much debility and threat- 
 ened sinking, wine, ammonia, nourishing 
 diet in light form and moderate quantities 
 are to be administered; the bowels are 
 to be kept open, all irritation is to be 
 avoided, cool and pure air is to be ad- 
 mitted, and the bed and body-linen to be 
 often renewed. During convalescence. 
 
260 
 
 FEVER, CONTINUED. 
 
 care miist be taken to avoid all exposure 
 to foul and unhealthy air, all indig-estible 
 food must be abstained from, the bowels 
 kept regular, and a due proportion of 
 wine and nourishing diet must be allowed. 
 Tonic medicines, particularly the bark, 
 are to be freely used ; and in many cases, 
 it may be advisable to leave the place 
 where the fever has been prevalent, and 
 to remove to a healthier climate. 
 
 III. Continued Fever. This is the 
 fever with which we in this island are 
 most familiar; and from the earliest re- 
 cords till the present day it appears to 
 have prevailed in almost every country, 
 and in every class of society. It i& called 
 Continued Fever, because there is no com- 
 plete intermission, or even no distinct re- 
 mission, from the commencement of the 
 fever to its close ; and from various cir- 
 cumstances connected with the fever, 
 or A^'hich have attracted particular at- 
 tention, it has obtained a great variety 
 of names. It is called the low nervous 
 ieyer, the slow fever, the brain-fever, the 
 putrid fever; the jail, ship, or hospital 
 fever; the spotted fever; and from the 
 writings and conversation of physicians, 
 one of its technical names. Typhus, has 
 passed into common discourse, and has 
 lately become the popular name for the 
 worst and most fatal forms of it. A phy- 
 sician might, with the most correct use of 
 nosological language, pronounce a patient 
 to be aifected with typhus, while there is 
 no symptom to excite any just alarm; 
 but it may be proper, when speaking to 
 persons not professional, to confine the 
 term to their interpretation of it, and to 
 use some of the other phrases, such as low 
 or nervous fever, in order to avoid giving 
 unnecessary alarm. 
 
 During the same epidemic, and from 
 the same contagion, continued fever may 
 assume a great variety of forms in diifer- 
 ent cases, and in the same patient in the 
 progress of the disease ; from the mildest 
 symptoms of heat, thirst, and anxiety, to 
 the furious delirium which gets it the title 
 of brain-fever; or the spotted skin, the 
 black and parched tongue, and twitching 
 
 of the tendons, which accompany malig- 
 nant and fatal typhus. 
 
 Symptoms of Mild Continued, Slow, 
 or Nervous Fever, the Typhus Mitior 
 of Physicians. A person feels himself 
 seized with languor, lassitiide, and a 
 disinclination to motion ; he is aflfect- 
 ed with chills, alternating with flushes 
 of heat ; he feels pain in his back and 
 limbs, as if tired or bruised ; he has 
 thirst, headach, and a tendency to vomit; 
 his thoughts are confused, and he talks 
 incoherently, especially towards evening. 
 It is not uncommon for one who is really 
 ill of fever, to go about for some days 
 in a listless, languid state ; but at last 
 he is obliged to give up the fruitless 
 struggle, and betake himself to bed. An 
 experienced person, even before the pa- 
 tient himself complains, may detect in his 
 manner, and in the sunken countenance 
 and unhealthy eye, the malady which is at 
 work upon him. The pulse is quick, weak, 
 and irregular, the heat of some parts of 
 the surface is diminished, and there is a 
 cold clammy sweat on the forehead. The 
 urine is commonly pale, often limpid, or 
 of a whey colour, or like vapid small- 
 beer. The tongue at first is covered with 
 a thin whitish fur, at length it becomes 
 dry, red, and chapped, or covered with a 
 brownish crust j and similar foulness ga- 
 thers about the teeth. In a few days the 
 giddiness, pain, or heaviness of the head 
 increase, and there is a ringing of the 
 ears which very frequently is the forerun^ 
 ner of delirium ; in many instances, this 
 delirium is not violent, but seems rather 
 a confusion of thought ; the patients mut- 
 tering continually to themselves and fal- 
 tering in their speech ; yet when a ques- 
 tion is distinctly put to them, they can be 
 roused from their delirium and give a ra- 
 tional answer, but soon fall back into their 
 dozing state. Sometimes this delirium 
 abates a little through the day, but haras- 
 ses the patient the whole night, the natu- 
 ral sleep departing from him for very 
 many successive nights. The tongue now 
 grows very parched, and yet the patientj 
 from his insensibility, does not complain 
 
FEVER, TYPHUS. 
 
 261 
 
 of thirst ; tbe skin sometimes continues 
 dry, at other times is covered with a cold 
 clammy sweat, and fainting is apt to come 
 on if the patient attempts to sit up. The 
 sinews of the arms and legs are seized 
 with convulsive twitches and starting^ ; 
 there is a gulping or choaking in the 
 throat, and also hiccup, all which are in- 
 dications of very great danger. Profuse 
 cold sweats break out, and thin watery 
 stools are discharged, both of which tend 
 greatly to weaken the patient. As the 
 fatal termination approaches, the extre- 
 mities grow cold, the nails pale and livid, 
 and the pulse weak and fluttering. The 
 delirium passes on to complete insensi- 
 bility, from which external impressions 
 cannot rouse the patient ; his stools and 
 urine pass off involuntarily ; and the fre- 
 quent twitchings of the tendons are a pre- 
 lude to strong general convulsions, which 
 put an end to life. 
 
 It is one of the remarkable circumstan- 
 ces of fever, that it has a tendency to run 
 a -certain course, and to terminate either 
 iu death or health within a certain pe- 
 riod, and on particular days of the fever, 
 which physicians have therefore termed 
 critical days. The duration of fever de- 
 pends on a variety of circumstances, on 
 the constitution of the patient in general, 
 or on the particular state of it at the time 
 of attack ; it depends also on the malignity 
 of the contagion, on the way in which the 
 patient has been treated from the first, 
 and on the situation where he is confined 
 bxjing more or less favourable. The pe- 
 riod of duration varies from a very few 
 days to twenty, or even thirty or forty ; 
 and sometimes, when the fever or excite- 
 ment is over, many untoward symptoms 
 may continue for a long time, especially 
 debility, and in some cases a degree of 
 aberration of mind. See Critical Da vs. 
 
 Prognosis. When the termination is 
 not in death but recovery, there are cer- 
 tain favourable symptoms which occur. 
 The tongue becomes gradually moister 
 and cleaner ; the perspiration, instead of 
 being cold, clammy, and partial, is gene- 
 ral, warm, and kindly; the pulse dimi- 
 
 nishes in frequency, the delirium abates, 
 and the patient enjoys refreshing sleep. 
 In these circumstances it is commonly 
 said that " he has got the. turn." The 
 appetite improves, the urine becomes na- 
 tural, and sometimes a salutary looseness 
 comes on. A degree of deafness is ra- 
 ther a good symptom. Sometimes boils 
 form in some part of the body, as behind 
 the ear ; and from their appearing to have 
 some share in removing the fever, such 
 abscesses, or any other discharge, are 
 called critical. How to induce those fa- 
 vourable symptoms shall be afterv/ards 
 mentioned. Such are the more usuaij 
 symptoms of the common continued fever, 
 the slow, nervous, or mild typhus fever. 
 The epithet mild may appear much mis- 
 applied when used to designate a disease 
 so frequently terminating fatally, but it is 
 to be considered as contrasting that form 
 of fever with another of a more deeply 
 malignant and rapidly fatal nature. Such 
 a form is now known to the people at 
 large by th« term Typhus, and it is also 
 called the putrid, malignant, pestilential, 
 or spotted fever. 
 
 Symptoms of Malignant Continued 
 Fever, the Typhus of popular discourse, 
 the Typhus Gravior of Physicians. The 
 malignant typhus attacks with more vio- 
 lence than the other ; the pulse is some- 
 times tense and hard, but commonly quick 
 and small ; the headach, giddiness, sick- 
 ness and vomiting are very considerable 
 even at the beginning. The eyes appear 
 full and heavy, and even a little inflamed. 
 There is a throbbing of the arteries of 
 the temples and of the neck, even though 
 the pulse at the wrist be very small ; and 
 this is a pretty certain indication of an 
 approaching delirium. The weakness, 
 faintness, and dejection of spirits are \ ci^ 
 remarkable and sudden, the breathing is 
 laborious and interrupted with sighing, 
 and the breath is hot and offensive. 
 There is pain of the back and loins, with 
 universal weariness and soreness of the 
 limbs; much heat, pain and oppression 
 at the pit of the stomach, with vomiting 
 of black offensive matter. The tongue 
 
262 
 
 FEVER, TYPHUS. 
 
 becomes quickly dark and dry, sometimes 
 of a shining livid colour, or stiflF and black, 
 Mobile the teeth and lips are furred with a 
 black tenacious crust. The thirst is at 
 times great and unquenchable; but in 
 other cases, the jjatient seems insensible 
 to the dry state of his mouth and tongue, 
 and though in the utmost need of drink, 
 does not ask for it. The stools are for 
 the most part extremely fetid ; they are 
 green, black, and otherv/ise discoloured. 
 The body is covered with petechice or 
 innumerable spots like flea-bites, or with 
 spots larger, greenish and livid; some- 
 times with purple marks like those left 
 by stripes or blows inflicted on the body. 
 The inside of the mouth and throat is 
 covered with aphthce, or small white ul- 
 cers, which are soon succeeded by great 
 difl&culty of swallowing, pain and ulcera- 
 tion of the throat, and gullet, probably 
 extending to the bowels, and producing 
 there destructive ulceration, as shown by 
 the discharge of bloody, fetid stools, which, 
 when not instantly removed, prove high- 
 ly infectious. The extremities become 
 cold and livid, and for many hours before 
 death, a cadaverous smell issues from the 
 body. Sometimes the contagion produc- 
 ing the disease is so virulent, or meets 
 with a constitution and circumstances so 
 disposed to receive its influence, that the 
 patient is cut off within three or four 
 days; sometimes the fever lasts longer, 
 but in general it has not the protracted 
 duration which occasionally marks the 
 milder form. These are the general ap- 
 pearances exhibited by continued fever 
 in our climate, though sometimes in dif- 
 ferent epidemics, peculiar symptoms may 
 be noticed. Thus it may happen, that 
 a great many patients whose primary 
 and undoubted disease is typhus, evi- 
 denced by its contagious nature, shall have 
 much detei-mination to the chest, marked 
 by cough, pain of the side, and difficulty 
 of breathing ; or to the head, marked by 
 more than usual disturbance of the intel- 
 lectual functions ; or there may be great 
 tendency to complaints in the bowels, 
 marked by griping or diarrhoea. In such 
 
 cases, these symptoms must be attended 
 to in proportion to their urgency. 
 
 Causes of Typhus. The most experi- 
 enced and judicious physicians are agreed, 
 that the chief, if not the only cause of 
 the fevers above described is contagion, 
 or the poisonous matter exhaled from the 
 human body, when long confined in one 
 place without ventilation or cleanliness, 
 or when numbers of men are crowded 
 together under similar circumstances. 
 This accumulated and undispersed mat- 
 ter excites the fever in one person, and 
 from him a matter is exhaled capable of 
 infecting great numbers more. Under 
 the article Contagion, we have given an 
 account of the principal facts relative to 
 the propagation of infection; and shall 
 only remark here the necessity of attend- 
 ing most particularly to the prevention of 
 its spreading; and warn every person, 
 whether professional or not, against be- 
 ing deceived by any arguments however 
 plausible, or any assertions however con- 
 fident, so as to omit the most rigorous 
 precautions. As we have no intention 
 of entering upon controverted points in 
 any part of this work, M^e shall not state 
 what has been said for or against the in- 
 fectious nature of fever ; but shall simply 
 remind the reader, that the precautions 
 which are necessary for the healthy, are 
 those which tend most to the proper ma- 
 nagement of the sick ; and that all those 
 means which have been thought to de- 
 stroy contagion, when they are put in 
 practice where it is not, can do no harm, 
 but have the most salutary effect on the 
 air and cleanliness of the sick-chamber, 
 ship, or barrack. When the infectious 
 matter is generated, there are certain cir- 
 ciunstances which favour its action, and 
 certain persons are more subject to that 
 action than others. Every thing of a de- 
 bilitating and depressing nature renders 
 the contagion more likely to take effect. 
 When men are debilitated by fatigue, 
 watching, and scanty food, the contagion 
 rapidly seizes them ; as has too often 
 been shown on a lai'ge scale, from the 
 wide-spreading epidemics which folloAved 
 
FEVER, TYPHUS. 
 
 263 
 
 the sieges or the famines of ancient times, 
 down to the fatiguing retreat of the Bri- 
 tish to Corunna, and the destructive fever 
 which, in 1819, so fearfully thinned the 
 numbers of the starving and dispirited 
 people of Ireland. Hence, exposure to 
 cold, and the exhaustion that follows a 
 debauch, so often are the immediate pre- 
 cedents of a fever ; and hence the very- 
 fear of infection renders one more espe- 
 cially liable to be seized with it. Hence 
 also may be explained some of the appa- 
 rent good effects of amulets, and sub- 
 stances said to protect against infection ; 
 they may do so by the confidence which 
 the person has in their efficacy, however 
 absurd and superstitious that confidence 
 may be. Persons who have suffered 
 great evacuations, whether by bleeding, 
 by purging, or by salivation, who have 
 been long under the influence of depress- 
 ing passions, who have been weakened 
 by intemperance or by much study, whose 
 diet has been poor and scanty, and who 
 have been long confined in damp un- 
 wholesome air; all such are peculiarly 
 susceptible of the contagion of fever. It 
 can hardly be necessary to state the op- 
 posite of all this, as the proper means of 
 guarding against contagious fever. Per- 
 sons should keep the body well clothed ; 
 should avoid exposure to cold, fatigue, 
 and intemperance ; should guard against 
 fear and other depressing passions, should 
 avoid protracted and unnecessary pre- 
 sence in the chambers of the sick, should 
 not visit them when fatigued or fiisting, 
 and should abstain from food difficult of 
 digestion. 
 
 Treatment and Cure of Fever. The 
 subject of fever has furnished the de- 
 bateable ground for the contests of physi- 
 cians in many succeeding ages; on this 
 they have shown how defective their 
 philosophy has been ; and have increased 
 the difficulties of an art which many have 
 regarded as conjectural at the best, by 
 seeking an explanation of phenomena, 
 not in the sober realities confirmed by 
 observation and experiment, but in hypo- 
 theses which had no other foundation than 
 
 the contrivances of an ingenious fancy. 
 To give a new theory of fever seemed to 
 be the grand object of every successive 
 writer of a system of physic ; and much 
 eloquence was employed in subverting 
 the works of their predecessors, and en- 
 deavouring to establish their own. If 
 the theories of fever have been numerous, 
 the modes of practice have hardly been 
 less so ; and it has been treated at diffe- 
 rent periods by the most opposite and 
 contradictory means. At one time, par- 
 tients in fever were treated with the most 
 stimulant and heating substances, fresh 
 air was excluded with the most cruel 
 accuracy, and the patient was loaded with 
 blankets to procure a sweat. At another 
 time, the reverse of all this was practised, 
 the application of cold was employed, 
 with bleeding, abstinence, purging, and a 
 rigorous system of depletion. The method 
 most commonly adopted in the treatment 
 of fever, by the judicious and enlightened 
 practitioners of modern times, is nearly 
 the following. When a person has been 
 exposed to fever infection, and complains 
 of weariness, pains of the back and limbs, 
 with headach, thirst, or tendency to vo- 
 mit, and more or fewer of the symptoms 
 above eniunerated, there are some means 
 of cutting short the fever, and not allow- 
 ing it to be fully formed. Two of the 
 most certain of these are, the immersion 
 of the patient in cold water, or dashing it 
 over him, and the giving of an emetic. 
 The numberless cases recorded by Dr. 
 Currie of Liverpool and others, of the 
 success of the cold affusion in cutting 
 short the progress of typhus, are ample 
 proofs of its efficacy and utility ; and war- 
 rant all medical men who have to dfeal 
 with the rougher classes of society, to 
 resort to it with the utmost confidence, 
 and to regard it as a valuable remedy in 
 barraclvs, prisons, ships and hospitals ; but 
 in private practice, and among more de- 
 licate subjects, we are obliged to use cold 
 in a milder form, and rarely attempt to 
 cut a fever short by this means. Emetics, 
 however, are a safe and less alarming way 
 of endeavouring the same thing; and if 
 
264 
 
 FEVER, TYPHUS. 
 
 antimonials form either the whole or part 
 of an emetic, we expect much good both 
 from the shock given to the body, from 
 the freeing of the stomach from undigest- 
 ed matters, and from part of the medicine 
 getting down to the bowels, and acting 
 as a purge. If the fever is not cut short, 
 we may soon expect the excited state of 
 the system, the quickened pulse, the 
 throbbing temples, the headach, thirst, 
 and hot and dry skin. In this state, how- 
 ever rash it would have been considered a 
 few years ago to bleed in typhus, we find 
 that it is a safe and salutary practice; it 
 bridles the circulation, lessens the danger 
 of the disease, and prevents the patient 
 from getting into that cadaverous state, to 
 which the name of typhoid was applied, 
 in which it certainly would be destruction 
 to bleed ; and from which former physi- 
 cians drew their inferences to the early 
 period of Jthe disease, but to which period 
 they were quite inapplicable. Bleeding, 
 then, in the early stages of typhus, is 
 proper and necessary ; but if the disease 
 goes on, we are to be cautious as to the 
 frequency of its repetition. To allay the 
 heat of the surface, frequent spunging 
 with cold water, or vinegar and water, is 
 highly salutary and refreshing; and the 
 thirst is to be allayed by means of thin 
 gruel, toast and water, jelly and water, 
 small beer, cider, or spring-water. To 
 promote a gentle perspiration, which is 
 always salutary, antimonials are given in 
 small doses, and at intervals of three or 
 four hours. For this purpose, the patent 
 medicine contrived by Dr. James, has 
 acquired a lasting reputation, and though 
 it is believed to be very much the same as 
 the antimonial powder of the Edinburgh 
 Pharmacopoeia, (called oxide of antimony 
 with the phosphate of lime,) still there 
 seems to be something about the genuine 
 James's powder, which entitles it to the 
 preference. The dose is three or four 
 grains every four hours, till a gentle per- 
 spiration is brought on. The same may 
 be attempted by giving the solution of 
 tartar emetic ; of which two grains are to 
 be dissolved in four ounces of water, and 
 
 a table-spoonful to be fcikcn every two 
 hours. Camphor may also be given for 
 the same purpose, the camphor julep, ia 
 doses of a table-spoonful every hour. It 
 is hardly advisable to give any sudorific 
 containing opium, in the early part of the 
 disease ; for fear of increasing the tendency 
 to the head, and of shutting up the 
 bowels. These must be carefully attend- 
 ed to ; laxative medicines must be given 
 frequently ; and we must not be deterred 
 by the consideration of the almost total 
 suspension of the appetite for food. The 
 quantity of feculent matter, which re- ^ 
 quires to be brought away, is surprisingly 
 great; and much credit is due to Dr. 
 Hamilton of the Royal Infirmary of Edin- 
 burgh, for the care with which he attend- - 
 ed to this piece of practice, and inculcated 
 it, at a time when its use in typhus ap- 
 peared a dangerous innovation. We may 
 administer any of the varieties of purga- 
 tive medicines we choose, there being no 
 reason for very nice selection. It shoukl 
 be a matter of strict attention quickly to 
 remove from the patient's chamber all 
 the alvine and urinary discharges ; if the 
 physician desires them to be kept for his 
 inspection, they should be kept where 
 they will be harmless. The delirium is 
 a very distressing symptom ; it is to be 
 palliated by applying cold to the head, 
 by avoiding as much as possible all irrita- 
 tion, and occasionally a gentle opiate will 
 answer the purpose; but we must stu- 
 diously avoid opiates when the heat is 
 ardent, and the pulse quick and strong. 
 If the vomiting continues long, it is to be 
 checked by giving effervescing draughts, 
 which are made with what are called 
 soda powders in the shops. They are 
 made by adding a drachm of crystallized 
 citric acid or concentrated salt of lemons 
 dissolved in an ounce of water, to a drachm 
 of carbonate of potash dissolved in a like 
 quantity of water; and when the two 
 solutions meet, a frothing or effervescence 
 takes place ; and this may be done in the 
 stomach, by swallowing the solutions se- 
 parately very quickly one after the other. 
 The effect generally is to allay the vomit- 
 
FEVER, TYPHUS. 
 
 205 
 
 ing, and to produce a gentle moisture on 
 the skin. Drink should be given to the 
 patient; and preserved fruits, jellies, or 
 the like, put into the mouth, although 
 he does not complain of thirst, which 
 from the stupor and delirium he is not 
 able to do. When in the advanced period 
 of the disease, the patient gets into the 
 low, depressed state, even though the 
 delirium continues, we are to proceed on 
 a stimulating plan ; and this without any 
 fear of increasing the heat, thirst, and 
 delirium. Very great quantities of wine 
 may be taken; and indeed what would 
 produce intoxication in a healthy person, 
 has only the eifect, in the low, putrid 
 typhus, of stopping the delirium, and 
 keeping the patient alive. Of course, we 
 are not to begin suddenly to give large 
 doses of wine, but try the effect of one or 
 two glasses a-day, mixed with water, and 
 gradually increase the quantity according 
 as we deem it proper and necessary. We 
 may also give the bark in substance, or 
 in tincture or extract, or in the foi-m of 
 sulphate of quinine, of which five grains 
 are a full dose, equal to an ounce of the 
 common powder. Huxham's tincture of 
 bark, which contains a considerable pro- 
 portion of aromatics, is an excellent sti- 
 mulant and cordial in typhus. In cases 
 of extreme debility and apparent sinking, 
 it may be advisable to apply mustard 
 poultices to the feet. We have said little 
 about the diet of patients in fever, because 
 by a salutary instinct of nature, they have 
 no desire for food, M'hich, in the suspen- 
 sion of digestion, and the assimilating 
 powers of the system, would be an in- 
 jurious load rather than a benefit. The 
 returning appetite for food is one of the 
 earliest signs of the fever declining ; and 
 we are then, with great caution, to allow 
 a little light pudding, or weak chicken- 
 broth, and to judge by its effects whether 
 it would be proper to repeat it. 
 
 These are some of the more remarkable 
 features of typhus fever, both mild and 
 malignant, with the modes of treatment 
 which the judicious practitioners of our 
 day adopt ; and thoug^i it is still a disease 
 
 of gi-eat danger, especially when it occurs 
 in combination with poverty, filth, and 
 wretchedness of every description, yet we 
 are inclined to think that an epidemic 
 typhus is not nearly so much to be dreaded 
 as in former years ; provided the public 
 authorities duly second the cares of the 
 physicians in separating the sick, and in 
 promoting ventilation and cleanliness, 
 and whatever may dilute the contagion, 
 and render it less virulent. 
 
 Fever, at Edinburffhy in 1828-29. Such 
 was the opinion which considerable ex- 
 perience justified, respecting the compa- 
 rative mildness of typhus, within the last 
 thirty years ; but since the first edition 
 of this work was published, Edinburgh 
 was visited by an epidemic fever, which 
 taught us anew the necessity of being 
 very cautious in making general asser- 
 tions on medical subjects. The epidemic 
 of winter 1828-29 was extensive and for- 
 midable; and the sufferers were princi- 
 pally among that class of people who had 
 the power of procuring every comfort, 
 and who were well accustomed to attend 
 to ventilation and cleanliness. It began 
 about the middle of November, and con- 
 tinued till far on in March. No poverty 
 of living, no squalid wretchedness could 
 be blamed as inducing the disease ; as it 
 frequently occurred in the most airy 
 situations, and among those who had 
 every means of health at command. It 
 happened often in children ; and was ge- 
 nerally long and tedious in tliem, leaving 
 great weakness for a considerable time, 
 even when recovery took place. There 
 was no general and predominant symp- 
 tom that could be said to characterise the 
 epidemic. It was a slow and mild ty- 
 phus ; but its safety was in no propor- 
 tion to its mildness. Many lingered on 
 for several weeks, not very ill, but died 
 at last- The province of the physician 
 seemed to be rather that of watching 
 symptoms, and aiding the operations 
 which nature pointed out as salutary, 
 than of directing and forcing any plan of 
 cure. Blood-letting was not in general 
 of much service ; but it was always pro^ 
 
2G6 
 
 FEVERS OF CHILDREN. 
 
 por to attend particularly to the bowels, 
 and to keep up a due discharge from them. 
 The g^eat debility in some, early led 
 to the use of wine and other stimulants, 
 which for a while appeared to do good ; 
 but, in others, had very soon to be with- 
 drawn ; while a third class seemed to be 
 kept alive principally by the judicious 
 use of wine and cordials. It was of much 
 service when we could succeed in procur- 
 ing a moderate perspiration by antimo- 
 nial medicines; and acids were very 
 beneficial in allaying the tliirst and fe- 
 verish action. Though the epidemic 
 spread very M'idely, the contagion did not 
 seem very virulent or active. Proper 
 precautions to prevent unnecessary in- 
 tercourse, and to promote due ventilation, 
 proved sufficient to hinder its spreading 
 through whole families, although more 
 than one individual living in the same 
 house were ill at the same time. 
 
 FEVERS OF CHILDREN. From the 
 irritability of infants, and the delicacy of 
 their frame, few of the disorders to which 
 they are subject are without feverish 
 symptoms ; as quickness of pulse, heat of 
 skin, thirst, and restlessness. Such symp- 
 toms occur from teething, disordered 
 bowels, worms, diseases of various glands, 
 ei-uptive disorders, and affections of the 
 chest, or a cold ; and according to the 
 violence of the fever, and its cause, and 
 also the disease accompanying it, bleed- 
 ing, purging, antimonials, or the warm 
 bath, are to be directed, as we have de- 
 tailed under the various complaints of 
 children. 
 
 Fever, Co^Tiy\jED,qf Children. Though 
 the feverish disorders of children are very 
 frequent, they are in general short in 
 their duration, except when they arise 
 from some internal organic cause-; and 
 infants and children seem not to be 
 very apt to take those disorders strictly 
 denominated fever. Infants have conti- 
 nued with their mothers during all the 
 stages of a fatal typhus, without being 
 seized with it; but Professor Hamilton 
 of Edinburgh mentions, that the common 
 low fever sometimes prevails as an epi- 
 
 demic among children. It begins more 
 frequently with languor and fatigue, than 
 with a distinct chilly or cold fit. At the 
 commencement, sickness at stomach oc- 
 curs, which is followed by heat, thirst, 
 pain in the head and back, and restless- 
 ness. Within thirty-six hours, there is 
 in many cases a very remarkable remis- 
 sion of the fever, followed by a great 
 exacerbation. If the fever do not abate 
 on the fourteenth day, it is apt to last till 
 the twenty-first, or twenty-eight, or even 
 the thirty-ninth day. Where it is much 
 protracted, insensibility, with inability to 
 swallow, sometimes occurs for a conside- 
 rable time before the crisis ; and after the 
 original disease has ceased, there is always 
 hazard of hectic fever, or dropsical com- 
 plaints, succeeding. 
 
 Treatment. On the first appearance 
 of illness, a full dose of ipecacuan should 
 be given, and as soon after as the sto- 
 mach can retain it, some poA^erful laxa- 
 tive medicine. If the heat of skin is not 
 relieved, the body is to be spunged with 
 c-yld water, to which a little vinegar has 
 been added ; and cooling drinks, as toast- 
 \^'ater, good small beer, cold water, &c. 
 should be allowed. If there is fixed pain 
 in any particular part, or bleeding at the 
 nose, a few leeches should be applied to 
 the temples, or to the pained part. If 
 the remission takes place after this treat- 
 ment, a little wdne and water prudently 
 given, may prevent the retui-n of the fe- 
 ver. If the fii'st symptoms have been ne- 
 glected, the emetic had better be omitted, 
 but the other means are to be employed. 
 When the fever is protracted, the chief 
 things to be attended to, are scrupulous 
 attention to cleanliness, proper ventila- 
 tion, and the admission of cool air into 
 the apartment ; spunging the body wdieu 
 the heat is greater than usual, giving cool- 
 ing drinks, and such laxative medicines 
 as will procure two or more stools daily. 
 When the low stage begins, the strength 
 must be supported by the use of wine, 
 pure or diluted, with cordials, and bai'k 
 in the form of sulphate of quinine. When 
 considerable oppression, tendency to vo- 
 
FEVERS OF CHILDREN. 
 
 2G7 
 
 miting, or much restlessness, with great 
 frequency of pulse, and hot skin, with a 
 parched tongue, take place pretty early 
 in the course of the fever, some antimo- 
 nial preparation, joined with calomel and 
 jalap, or aloes, has been found to occasion 
 the free discharge of a great quantity of 
 bilious matter which had resisted other 
 means, and to produce a very unexpected 
 and rapid cessation of all the alarming 
 symptoms. There is nothing more re- 
 markable in the low fever of children, as 
 well as of adults, than the astonishing re- 
 coveries that sometimes take place from 
 the utmost degree of exhaustion and 
 death-like torpor. Persevering efforts 
 are to be made till the last, by giving 
 wine and other cordials by the mouth ; 
 and in the long protracted weakness, 
 nourishment is to be supplied by clysters, 
 containing beef-tea, wine, or milk. Blis- 
 ters or mustard poultices applied to the 
 ,8oles of the feet, have seemed to rouse 
 the vital powers, after they had been sup- 
 posed nearly extinct. Great attention 
 must be paid when recovery begins, not 
 to overload the stomach, nor to allow 
 the bowels to go into a bad state *; exer- 
 cise and country air, with cold bathing, 
 are to be directed. 
 
 Fever, Mesenteric, ©/"CAz Wren. There 
 are certain glands situated in the mesen- 
 tery, or that membrane connected with 
 the small intestines, through which glands 
 the nourishing fluid called chyle passes. 
 These glands are apt to be obstructed in 
 scrofulous subjects. When this obstruc- 
 tion is just beginning, various feverish 
 symptoms occur, like those arising from 
 worms. It attacks children from the age 
 of three or four years, is accompanied 
 with fever, which remits or intermits, but 
 without any regularity ; there is loss of 
 appetite, swelled belly, and pain of the 
 bowels, which are irregular, sometimes 
 costive, at other times too open. There 
 occur flushed cheeks or a total loss of co- 
 lour, impaired strength and spirits, a hard 
 and swelled belly, with emaciated limbs. 
 The lungs are very frequently affected. 
 This fever sometimes takes place in in- 
 
 fants at the breast, and it is often a con- 
 sequence of long protracted bowel com- 
 plaints, and of difficult dentition, and of 
 measles. Among the poor, it frequently 
 is owing to coarse and imwholesome diet, 
 and the want of exercise and cleanliness. 
 
 Treatment. Preparations of mercury 
 seem to be often useful, not by their de- 
 obstruent power, but by their favourable 
 action on the bowels. Calomel in small 
 doses, combined with rhubarb or some 
 other purgative medicine, given once or 
 twice a-day, is of great service in keeping 
 up a proper action of the digestive organs; 
 and this is to be further assisted by tonic 
 medicines, and a nourishing diet, with 
 warm bathing. The use of the calomel 
 must be persevered in for a long time. 
 The tonic medicines are preparations of 
 steel, as the tincture, or some chalybeate 
 water. An emetic occasionally is proper. 
 Friction with anodyne balsam, on the 
 belly, the spine, and the limbs, is to be 
 daily employed. The cold bath may be 
 directed when there is any appearance of 
 convalescence. The diet should be light 
 and noiu-ishing j good broth, with a little 
 animal food or jelly, avoiding fat and 
 greasy aliments, pastry, and all indigest- 
 ible substances ; and watching the effect 
 of the food given, that it do not occasion 
 heat and feverish symptoms. The purg- 
 ing which too often occurs towards the 
 fatal period, is to be checked by opiates 
 and the chalk mixture. 
 
 FIBRES. The fine and minute threads 
 into which muscular flesh and nervous fi- 
 laments can be divided, so as to be seen 
 with the naked eye. We have reason to 
 believe that these fibres are composed of 
 fibrils, divided so minutely as to evado 
 the eye, and even the microscope. 
 
 FIBRINE is a substance obtained by 
 washing clotted blood repeatedly iu wa- 
 ter, till it ceases to give out any colour 
 or taste to the liquid. It is also procured 
 from flesh by maceration in water for 
 many days, and subjecting it to pressure, 
 to squeeze out the ^later. When fibrine 
 is exposed to heat, it contracts very sudr 
 denlv, and moves like a bit of horn, ex-» 
 
268 
 
 F 1 S II. 
 
 haling at the same time the smell of burn- 
 ing' feathers. " Fibrine," says Dr. Thom- 
 son, '* exists only in the blood and the 
 muscles of animals ; but it is a genus 
 which includes as many species as there 
 are varieties in the muscles of animals ; 
 and the great diversities of these sub- 
 stances is well known. The muscles of 
 fish, of fowl, and of quadrupeds bear 
 scarcely any resemblance to each other." 
 Those articles of food which abound much 
 in fibrine, as hare-soup, venison, beef, 
 mutton, &c. are therefore called fibrinous 
 aliments. 
 
 FIGS. The fruit of the Ficus Carica, 
 a tree of a middling size, with large leaves 
 cut into five segments. It grows sponta- 
 neously in the warmer climates, and is 
 cultivated in our gardens. The best figs 
 are brought from Turkey ; many from 
 the south of France, where they dry them 
 by exposure to the sun, after dipping them 
 in hot ley, made of the ashes of the fig- 
 tree. The recent fruit, completely ripe, 
 is soft, succulent, and easily digested, un- 
 less eaten in immoderate quantities, when 
 it is apt to occasion flatulency, pain of the 
 stomach, and diarrhoea. Figs are very 
 nutritious, as their sugar is united with 
 a large portion of mucilaginous matter; 
 grateful to the stomach, and easier to di- 
 gest than many other of the sweet fruits. 
 Figs are used in medicine as emollients, 
 and as an ingredient in pectoral decoc- 
 tions ; they are also used as cataplasms 
 to promote suppuration. They ai'e ap- 
 plied as warm as can be borne, to gum- 
 boils, and other parts where poultices can- 
 not be confined. (Parr.) 
 
 Fl SH. A great variety of the different 
 species of fish is used as articles of diet ; 
 but without enumerating all these, we 
 shall mention in general, in what respects 
 fish differs from the food derived from 
 land animals, and in what kinds of disor- 
 ders it is most allowable. Fish has gene- 
 rally been considered as holding a middle 
 rank between the flesh of warm-blooded 
 anunals and vegetable food. Though not 
 so nourishing as beef or mutton, it is suf- 
 ficiently so for all the purposes of active 
 
 life ; but a larger quantity is required to 
 satisfy the appetite, which returns sooner 
 after fish than after meat. Fish gives less 
 excitement during digestion than meat or 
 other nourishing food, and is therefore a 
 useful article of diet to persons recover- 
 ing from acute diseases ; but though re- 
 puted light and nourishing, it is not so 
 proper for patients labouring under sto- 
 mach complaints, with whom it very ge- 
 nerally disagrees. Turbot, cod, whiting, 
 haddocks, flounders, and sole, are the least 
 heating of the more nourishing kinds j and 
 the flakiness of the fish, and its opaque ap- 
 pearance after being cooked, are proofs of 
 its being good ; but when it is bluish, and 
 has a degree of transparency after being 
 sufficiently boiled, it shows it to be of an 
 inferior quality, or not in season. The 
 whiting is well adapted for weak sto- 
 machs, and the haddock resembles it, but 
 is of a firmer texture. Cod is an excel- 
 lent food, but not quite so digestible as 
 whiting or haddock. Turbot, though ex- 
 cellent in itself, is often rendered indi- 
 gestible by the quantity of lobster or oys- 
 ter sauce eaten along with it. Salmon is 
 perhaps the most nutritive of the fish 
 that are eaten ; it is, however, heating, 
 oily, and not very digestible; the best 
 condiment for it is vinegar. Salmon is 
 in the highest perfection for some time 
 previous to its spawning ; this takes place 
 at certain seasons of the year; and this 
 is one reason, among others, why the pe- 
 riods of catching salmon in this country 
 are fixed by law. Salmon, when taken 
 at a time when the fish is unfit for food, 
 has been known to produce disease. Her- 
 ring is worthy of great commendation, 
 though it is oily and apt to disagree with 
 many stomachs. In many instances, se- 
 vere cutaneous affections have been known 
 to follow the use of fish of different kinds; 
 this probably depends on peculiarity of 
 constitution, and in general goes off when 
 the process of digestion is finished ; but 
 in some cases there is reason to suspect 
 a poisonous quality about the fish. 
 
 Fish invariably require some condi-- 
 ment or other ; and a very common one 
 
FISH-POISONS. 
 
 269 
 
 is butter, which is one of the worst, ex- 
 cept for very strong stomachs. 
 
 The seasonings that are eaten with fish 
 are various ; some of them oily and indi- 
 gestible ; others of a stimulating nature, 
 may assist the stomach to digest them the 
 better; but vinegar and salt are the most 
 universally applicable. 
 
 Boiling seems to be the best way of 
 cooking fish ; frying them with oil and 
 other fat substances is not so proper. 
 Potatoes are almost the only vegetable 
 that should be eaten with fish. Fruit 
 should not be eaten at the same meal 
 M'ith fish, and milk also should be avoid- 
 ed; severe bowel complaints have fol- 
 lowed such mixture. 
 
 FISH-POISONS. We have mentioned 
 in the preceding article, that cutaneous 
 eruptions sometimes follow the use of fish 
 as a part of the diet. This may arise 
 from peculiarity of constitution in the 
 person using them ; but many instances 
 have occuri'ed in which fish, especially 
 shell-fish, have produced such deleterious 
 effects on the constitution as can hardly 
 be accounted for, except on the supposi- 
 tion of an absolute poison being generated 
 in some parts of the fish. Dr. Thomas, 
 who writes from actual observation in 
 the West Indies, mentions several fish 
 possessed of a very deleterious quality, as 
 the " barracouta (perca major), king fish 
 {xiphias)y cavallee (^scamber), rock fish 
 {pcrca marina), smooth bottle fish {os- 
 tracion glabellum), the conger eel, and 
 the yellow-bill sprat. From eating this 
 last-mentioned fish, certain and rapid 
 death is almost sure to ensue ; but irova^i, 
 a use of most other kinds of poisonous 
 fish, the person is seized after a few hours 
 with languor, heaviness, and faintness, 
 succeeded by great restlessness, flushings 
 in the face, giddiness in the head, heart- 
 burn, nausea, griping pains in the bowels, 
 and a severe vomiting and purging. The 
 burning which was felt at first only in 
 the face and eyes, is at length extended 
 over the M'hole body, but more particii- 
 larly the palms of the hands and soles of 
 the feet. With the heat of the skin, there 
 
 is invariably a prickly sensation in the 
 hands when immersed in cold water. In 
 some cases the neck of the bladder, ure- 
 tlira, and sphincter ani are likewise af- 
 fected with "heat, and the patient expe- 
 riences a difficulty of making water, to- 
 gether with a considerable degree of te- 
 nesmus." When poisonous fish have 
 been eaten, our first object is to discharge 
 them from the stomach and bowels by vo- 
 miting and purging; and to counteract 
 the bad effects that follow: this seems 
 best accomplished by spirituous liquors 
 and strong cordials. 
 
 There have been several cases recorded 
 of very dangerous effects from the use of 
 the mussel, (Mytilus edulis.) In the 
 month of June 1827, a considerable num- 
 ber of cases occurred at Leith, and an 
 excellent account of the incident has been 
 given by Dr. Combe of that place, in the 
 Edinburgh Medical Journal. Two per- 
 sons died, and about thirty cases occur- 
 red, With great uniformity of symptoms, 
 but varying very much in severity ; none, 
 however, left any permanent bad effects. 
 " The weak and aged suffered most, but 
 no age from two to seventy was exempt 
 from the effects. The mussels had been 
 taken in various forms and various quan- 
 tities. By one or two, they had been 
 eaten raw ; and these persons seemed to 
 escape from their fatal effects only by the 
 smaller number which they ate. Most of 
 them got them boiled with salt, pepper, 
 and other condiments; and eight or ten of 
 the sufferers had made a hearty meal of 
 them* None complained of any thing pe- 
 culiar in the smell or taste of the animals, 
 and none suffered immediately after tak- 
 ing them. In general, an hour or two 
 elapsed, sometimes more, and then the 
 bad effects consisted rather in uneasy 
 feelings and debility than in any distress 
 referable to the stomach. Some children 
 suffered from eating only two or three, 
 and one patient, a young and healthy man, 
 only took five or six. In two or three 
 hours, they cojnplained of a slight tension 
 at the stomach. One or two had heart- 
 burn, nausea, and vomiting, but these 
 
«ro 
 
 FISTULA. 
 
 were not general or lasting symptoms. 
 They then comj)laiued of the prickly feel- 
 ing of their liands, heat and constriction 
 of the month and fauces, difficulty of 
 sw{ill()\ving and speaking freely ; numb- 
 ness about the mouth, gradually extend- 
 ing to the arms, with great debility of the 
 lower limbs. The degree of muscular de- 
 bility varied a good deal, but was an in- 
 variable symptom. In some, it merely 
 prevented them from walking firmly, but 
 in most of them it amounted to perfect 
 inability to stand. While lying in bed, 
 they could move tlieii* limbs with toler- 
 able freedom ; but on being raised to the 
 perpendicular posture, they felt their 
 limbs sink under them. In some the se- 
 cretion of urine was suspended, in others 
 it was free, but passed with pain and great 
 effort. The action of the heart was feeble, 
 the breathing unaffected, the face pale, 
 expressive of much anxiety ; the surface 
 rather cold, and the mental faculties un- 
 impaired. The practice adopted was uni- 
 form, and attended with evident good ef- 
 fects. In some, the stomach was emptied 
 by an emetic, and a few discliarged some 
 of the undigested mussels. In others 
 brisk laxatives Avere administered, and 
 followed by stimuli, such as spirits, am- 
 monia, or nitrous ether." The mussels 
 which produc^ed these poisonous effects 
 were got solely from the bar at the dock- 
 gates. This bar, which was formed of 
 two beams of fir, had floated there for fif- 
 teen or twenty years, and when hauled 
 up was found to be thickly incnisted with 
 nnissels, which being scraped oft' were 
 thrown on the quay, and there found by 
 the poor people who had suffered so se- 
 verely. The wood was found to be per- 
 fectly sound. Large quantities of mussels 
 had been procured from the walls of the 
 dock, from which the water had been 
 discharged for the purpose of its being 
 cleaned, and of these nnissels many people 
 ate with impunity. The explauatijon of 
 the facts is very difficult ; and we cannot 
 give any better account than by consider- 
 ing them as owing to a peculiar poison ; 
 it was not in consequence of the mussels 
 
 being putrid, for they were perfectly fresh 
 when eaten, and some of them were even 
 living on the day subsequent to that on 
 which the beam was pUiccd on the quay. 
 For other judicious remarks on this sub- 
 ject, and also for the appearances observ- 
 ed on the bodies of the two persons who 
 died at Leith, we refer to the interest- 
 ing paper of Dr. Combe. (Edinburgh 
 Medical and Surgical Journal, January 
 1828.) 
 
 FISTULA. A name applied to a sore 
 which runs some way under the skin, and 
 discharges a thin matter from its sides, 
 which are converted into secreting sur- 
 faces. A fistula may occur in any part 
 of the body, but it is chiefly fr-equent and 
 troublesome in the neighbourhood of the 
 anus, where one or more of such sores 
 run a long way under the surface, and pe- 
 netrate within the gut. This is a very 
 disagreeable, though not a dangerous af- 
 fection, and peoj)le are naturally very 
 anxious to get rid of it. The cure con- 
 sists in making such an incision through 
 the internal surfaces of the fistula and 
 neighbouring substance, as shall induce a 
 degree of inflammation, and so cause the 
 sides to grow together, and obliterate the 
 fistula. When the sore communicates with 
 the gut, the surgeon must pass his finger 
 into the gut, and use it for a director to 
 introduce a cutting instrument, by which 
 he is to lay open the whole extent of the 
 fistula; and then by proper dressings to 
 encourage such a suppuration as shall 
 end in a union of the parts. The opera- 
 tion is not particularly dangerous or pain- 
 ful, but in unhealthy constitutions, as in 
 those which have been broken down by 
 intemperance, or in old people, there is 
 such a degree of inflammation produced as 
 to bring the patient into very great dan- 
 ger. Fistula is sometimes connected with 
 diseases of the bladder and other neigh- 
 bouring parts, and this adds to the incon- 
 venience and danger. There are many 
 diseases that may take place near the 
 anus, that are apt to be dreaded by the 
 ignorant as fistula, but the tiue fistula is 
 as we have described it. 
 
F L GO DING. 
 
 271 
 
 FISTULA LACRYMALIS. See 
 Weeping Eye. 
 
 FIXED AIR, the name given to car- 
 bonic acid by Dr. Black, its discoverer. 
 See Carbonic Acid. 
 
 FLANNEL, worn next the skin, is of 
 great utility in a variety of cases. It 
 gently stimulates the surface, keeps up an 
 equal temperature, promotes perspiration, 
 and absorbs the moisture as it is thrown 
 out. It is useful in those who are pre- 
 disposed to complaints in the chest, who 
 easily catch cold, or who are of a con- 
 sumptive tendency ; it is of great benefit 
 also to those Avho are rheumatic or gouty, 
 and from the sympathy between the sto- 
 mach and skin, dyspeptic ailments are 
 benefited by it. To some persons the ir- 
 ritation pi'oduced by wearing flannel next 
 the skin is quite intolerable, and such may 
 substitute for it chamois leather. It is ( 
 unnecessary to >vear the flannel during 
 the night, as it keeps up too great a de- 
 gree of warmth ; and is more likely to ir- 
 ritate the skin, from the increased sensi- 
 bility of the latter during sleep. To some 
 it may be necessary to wear flannel, co- 
 vering the whole body, and having sleeves; 
 to others, as those having lumbago or sto- 
 mach complaints, a broad bandage or flan- 
 nel round the body will perhaps be suffi- 
 cient. 
 
 FLATULENCE, or Wind in the Sto- 
 mach awe? Bowels. A troublesome symp- 
 tom, occasioned by the extrication of air 
 from the food when the digestion is in on 
 unhealthy state. Sometimes the eructa- 
 tions are very ofFensive,having the smell of 
 rotten eggs ; this indicates very great de- 
 rangement of the digestion. This is sup- 
 posed to arise from the decomposition of 
 animal matter, and has been relieved by 
 the use of farinaceous diet. In general, 
 wind arises from the fermentation of ve- 
 getable substances in the stomach and in- 
 testines, and is lessened by avoiding ve- 
 getables which are found to disagree with 
 the patient. The wind makes its way 
 both upwards and doi^nwards, and often 
 causes an uneasy feeling of distension in 
 the stomach and bowels. It is to be per- 
 
 manently got rid of, only by restoring the 
 digestion to a healthy state ; but some- 
 thing may be done to palliate it when it 
 is urgent. The medicines commonly call- 
 ed carminative, such as peppermint-water, 
 or anise, or cardamoms, or ginger, may all 
 be used to dispel flatulence, and this ci- 
 ther in a fluid fonn or in substance. A 
 little rhubarb and magnesia with ginger, 
 taken in peppermint-water, is one of the 
 most efficacious. Also a drop of the oil 
 of }>eppermint on a bit of loaf sugar will 
 have the like effect ; or the pills of aloes 
 with assafetida, two for a dose. Some- 
 times flatulence causes many uneasinesses, 
 not so much from the distension it occa- 
 sions, as from the great irritability of the 
 stomach and intestines; and is relieved 
 by medicines which calm this irritability, 
 as opium or henbane, with small doses of ^ 
 ipecacuan. i 
 
 FLOODING. A sudden and copious 
 discharge of blood from the vagina. It 
 may take place at any period of preg- 
 nancy, but it is most commonly applied 
 to those discharges which take place im- 
 mediately either before or after delivery. 
 It is an occurrence of genei-al and just 
 alarm, and requires the most prompt and 
 decided assistance. When it occurs at 
 the early periods of pregnancy, it is a 
 symptom of threatening miscarriage, and 
 under the article Abortion we have giv- 
 en a full statement of the measures pro- 
 per to be pursued. When it happens 
 shortly before delivery, it is most com- 
 monly owing to the after-birth being si- 
 tuated near the neck of the uterus, and 
 when this begins to expand, some of the 
 large vessels by M'hich the after-birth is 
 there attached, are broken, and pour out 
 blood in great quantity. As the after-birth 
 is the connecting substance between the , 
 mother and child, and as nearly the whole 
 of the blood of the child is deposited in 
 it, it is obvious that the child is exposed 
 to the greatest hazard of bleeding to 
 death, and that the mother also is in im- 
 mediate danger of Jin irreparable loss of 
 blood. If the woman be not come to the 
 full time, we must try to suspend the ac- 
 
272 
 
 FLOODING. 
 
 tion of the utenis for some time, by en- 
 joining the utmost quietness, by taking- a 
 little blood from the arm, or by giving 
 opiates. If this does not succeed, or if 
 the patient is at the full time, the only 
 means of safety to the mother and to the 
 child, (though to the child the probabili- 
 ty of life is very small,) is to accelerate 
 the delivery as much as possible ; and the 
 accomplishment of this is, of course, to be 
 entrusted only to an experienced practi- 
 tioner. When flooding occurs after de- 
 livery of the child, and before the after- 
 birth has come away, this also is of dan- 
 gerous tendency ; and if it appears to go 
 to too great an extent, is to be checked 
 by getting the after-birth expelled ; and 
 for accomplishing this purpose, no rougher 
 methods are to be used at first than very 
 gentle rubbing of the belly with the hand, 
 or soliciting the extrusion of the placen- 
 ta, by pulhng very tenderly at the cord. 
 When the after-birth is away, the uterus, 
 in general, contracts into a small bulk ; 
 and by so doing, shuts up the bleeding 
 vessels, and puts a stop to the flooding. 
 This contraction is to be assisted by again 
 rubbing the abdomen, and putting a broad 
 roller round the body to give a proper 
 support and moderate pressure. Another 
 and more alarming- kind of flooding: is 
 that which happens after the womb has 
 been completely emptied. Instead of the 
 proper contraction of the womb, by 
 which the waste of blood is prevented, it 
 retains a large size, and numerous vessels 
 continue to discharge their blood. The 
 patient's ears ring, the head becomes 
 giddy, she is insensible to suiTounding 
 objects, and it is only by the alarming 
 medium of a fainting fit, that the flow of 
 blood is stopped for a short time, but only 
 to return again when the powers of life 
 begin to rally a little. When the gentle 
 methods of obtaining contraction of the 
 womb do not succeed, (and there is little 
 time to lose iu making the attempt,) we 
 must have recourse to such as are more 
 suited to the impending danger, however 
 rough they may appear. The abdomen 
 of the patient is to be more strongly com- 
 
 pressed, and cold water is to be suddenly 
 dashed upon it in large quantities, or wet 
 cloths to be laid upon it. If still we do 
 not succeed in stopping the flow of blood, 
 it will be necessary to introduce the hand 
 into the uterus, and by gentle but skilful 
 pressure to solicit the uterus to contract 
 upon the hand ; which is to be withdrawn 
 with the uterus pressing it, or as it were 
 expelling it, and closing behind it. In 
 some cases of flooding, the mouth of the 
 womb being closed, there is no appear- 
 ance of blood externally, but it is not the 
 less lost to the patient, as it is out of its 
 proper vessels, and fills up the internal 
 cavity of the uterus. The occurrence of 
 this accident is known by the same con- 
 stitutional symptoms as the former, by 
 the dizziness, the fainting, and debility ; 
 and by the belly speedily rising to a size 
 almost as large as before delivery. Means 
 must be immediately taken to empty the 
 womb of the clotted blood which fills it, 
 and to induce contraction to stop any 
 farther discharge. It is seldom that the 
 womb can be properly emptied of that 
 blood without the introduction of the 
 hand. When the coagulated blood has 
 been removed, the same means of induc- 
 ing contraction, as above described, arc 
 to be resorted to. Sometimes the non- 
 contraction of the uterus is owing to part 
 of its fibres being seized with cramp, by 
 which there is a contraction in the middle, 
 while the upper and lower parts are ex- 
 panded, forming what is called the hour- 
 glass contraction. To overcome this 
 spasm, pretty large doses of opium are to 
 be given, forty or fifty drops of the tinc- 
 ture, or a grain and a half of the solid 
 opium repeated at a short interval, till it 
 has been three times taken. 
 
 The management of the patient after 
 the flooding has ceased, is of a very de- 
 licate and difficult nature. The powers 
 of the constitution seem nearly quite ex- 
 hausted ; and to attempt recovering them 
 by stimulants, would be attended with 
 considerable hazard. The best cordial 
 that can be given in the first instance, is 
 a dose of laudanum to the extent of forty 
 
FLO 
 
 F(ET 
 
 273 
 
 or fifty drops, in a little weak spirits and 
 water; but sometimes the debility and 
 feeling- of siziking- are so urgent, that 
 stronger stimulants must be had recourse 
 to, as brandy or other spirits undiluted, 
 or hartshorn with spirit of wine and a 
 little water, or wine, either alone, or mix- 
 ed with water. If the collapsed state is 
 thus counteracted, and if sleep comes on, 
 we may hope that the feeble pulse will 
 acquire a firmer beat, and the exhausted 
 strength be recruited by degrees. In the 
 couree of an hour or two, some nourish- 
 ment of the simplest kind should be giv- 
 en, as a little calf's foot jelly dissolved 
 in water, or a little panado with a small 
 portion of wine, or very weak chicken 
 broth ; most particular care being taken, 
 that the quantities given be very small 
 and frequently repeated ; and that there 
 be nothing given indigestible or over-sea- 
 soned. The patient must on no account 
 be allowed to rise up hastily or to make 
 any exertion ; every occasion of alarm or 
 agitation should be carefully kept from 
 her; her diet must be light and nutri- 
 tive, gradually increasing as the powers 
 of digestion recruit ; and a little wine and 
 bark may be given. Much injury is often 
 done to the female constitution by flood- 
 ing ; and in many instances the debility 
 and pallid countenance remain till the end 
 of life, even though that is protracted for 
 many years. It is, therefore, an accident 
 that should in every case be assiduously 
 guarded against. Even after a common 
 and easy delivery, there should be as 
 little disturbance of the woman as pos- 
 sible for many hours ; no shifting of her 
 dress beyond what is absolutely necessa- 
 ry for her comfort ; and even a degree of 
 discomfort, which at another time would 
 not be tolerated, must now be suffered to 
 remain; and rather some dry clothes 
 placed next the woman, than any part 
 of her dress be removed, at the expense 
 of her own exertions in getting up and 
 assisting in her adjustment. 
 
 FLOWERS. A popular name for 
 the monthly discharge of women. See 
 Monthly Discharge. 
 
 FLOWERS OF SULPHUR or Brim- 
 stone ; the soft light form into which sul- 
 phur is sublimed. See Sulphur. 
 
 FLUCTUATION. The perceptible 
 motion communicated to any collection 
 of purulent matter, or other kind of fluid, 
 by. applying some of the fingers of each 
 hand, at a certain distance from each 
 other, to the surface of the tumour, and 
 pressing with them alternately in such a 
 manner, that the fingers of one hand are 
 to be employed in pressing, while those 
 of the other hand remain lightly placed 
 on another part of the swelling. This 
 pressure or tapping, when skilfully ap- 
 plied, communicates a sensation to the 
 fingers of the surgeon, which is one of 
 the principal means by which he is en- 
 abled to discover the presence of fluid, in 
 a great variety of cases. WTien the col- 
 lection of fluid is very deeply situated, 
 the fluctuation is frequently very obscure, 
 and sometimes not at all distinguishable. 
 In this circumstance, the presence of the 
 fluid is to be ascertained by the consider- 
 ation of other symptoms. (Cooper's 
 Surgical Dictionary.) 
 
 FLUX. /See Dysentery. 
 
 FLY-POWDER, the protoxide of ar- 
 senic, is a familiar poison in France and 
 Germany. It ought to be a fine greyish- 
 black powder, as formed by exposing 
 powdered arsenic for a long time to the 
 air; but it also frequently contains frag- 
 ments of the metal. It is usually consi- 
 dered by chemists to be a mixture of me- 
 tallic arsenic and its white oxide. It is 
 acted on by water, the white oxide being 
 found before long in solution by its pro- 
 per tests. (Christison on Poisons.) Of 
 course, this substance is possessed of all 
 the poisonous and dangerous qualities of 
 arsenic. See Arsenic. 
 
 FCETUS. The young of animals while 
 in the womb. The uterine foetus is con- 
 tained in a bag composed of different mem- 
 branes, which is styled the ovum. This 
 ovum, as soon as it becomes visible, ap- 
 pears like a small vesicle, attached to some 
 part of the uterus, genei-ally to its upper 
 part ; and all the organs of which it con* 
 
 M.m,^. 
 
274 
 
 F CE T U S. 
 
 sists, seem to be confusedly blended. By 
 degrees they appear more distinct, and in 
 the advanced periods we observe the mem- 
 branes called the amnios, the chorionjaud 
 the decidua. The decidua lines the inner 
 surface of the uterus, and is reflected over 
 the ovum ; the amnios is next to the foe- 
 tus, and the chorion lies between flie 
 other two membranes. In the early pe- 
 riods of gestation, the bag" or external 
 parts of the conception are large in pro- 
 portion to the foetus, but afterwards they 
 are in a smaller ratio, the foetus increas- 
 ing- more rapidly than its contents and 
 accompaniments ; the latter seldom be- 
 come more bulky after the seventh month. 
 The foetus is for a time invisible, on ac- 
 count of its minuteness and transparency. 
 A foetus of four Aveeks is nearly the size 
 of a common fly ; soft, mucilaginous, and 
 in appearance suspended by the belly ; its 
 bowels covered by a transparent mem- 
 brane. " At six weeks, it is of a some- 
 what firmer consistence, nearly the size of 
 a small bee ; the extremities then begin 
 to shoot out. At three months, its shape 
 is tolerably distinct, and it is about three 
 inches long. At four, five, and six 
 months, it is five, near seven, and near 
 nine inches respectively. In the succes- 
 sive mouths, it increases in length to ten, 
 fifteen, and tw^enty, or twenty-two inches, 
 though varying in different women, and 
 in different births. Indeed, all these mea- 
 surements are rather approximations than 
 accurate representations. Between the 
 chorion and amnios in the early months, 
 a collection of gelatinous matter is found ; 
 and in the latter months, this space is oc- 
 casionally filled by a serous fluid styled 
 the false waters ; so that every discharge 
 of water in pregnant women is not dan- 
 gerous. If not attended with a discharge 
 of blood it is apparently harmless." The 
 navel string, which is composed of two 
 arteries and a vein, proceeds from the na- 
 vel of the foetus, and passes into the pla- 
 centa, a thick spongy substance, which is 
 most commonly attached to the fundus or 
 upper part of the womb. It consists of 
 two parts, one of which contains nume- 
 
 rous blood-vessels that can be injected 
 exclusively from the arteries of the mo- 
 ther. The remaining part of the placenta 
 is an organ of the foetus, and the vessels 
 can be injected only from the umbilical 
 cord. The two arteries wnich form part 
 of this umbilical cord are a continuation 
 of the hypogastric arteries of the foetus ; 
 and they are thought to convey to the pla- 
 centa the blood which has circulated in 
 the child, that some change may be pro- 
 duced in it, analogous to the change pro- 
 duced on the venous blood of the adult 
 by respiration. Numerous vessels take 
 up the purified blood from the placenta, 
 and carry it into the umbilical vein, which 
 transmits it to the liver, in which organ 
 one half of the whole mass circulates. 
 The remainder of the blood is carried by 
 a vessel called the ductus venosus to the 
 vena cava^ or large vein terminating in 
 the right auricle of the heart, where also 
 the blood, after having circulated through 
 the liver, arrives. As the lungs are not 
 yet expanded by air, they cannot receive 
 the whole of the blood, and one part 
 passes through ihe foramen ovale, an aper- 
 ture in the partition which divides the 
 right from the left side of the heart. The 
 rest proceeds to the right ventricle ; and 
 of this portion, only a part enters the pul- 
 monary artery to go to the lungs, the rest 
 being conveyed directly to the aorta, by 
 a duct called the ductus arteriosus. Thus 
 the entire mass of fluids is conveyed to the 
 aorta, to be circulated through the whole 
 machine. It is difficult to explain how 
 the foetus is nourished. The blood pro- 
 bably undergoes some change in the mo- 
 ther, which fits it for furnishing materials 
 for growth and nourishment when it 
 reaches the foetus. 
 
 There are some other peculiarities 
 of the foetus which may be mentioned. 
 The head is very large in proportion to 
 the rest of the body ; the bones of the 
 head are soft and yielding; the sutures 
 not yet formed, and a triangular space is 
 left at the union of the coronal and sagit- 
 tal sutures. This is what nurses call the 
 opening of the head. The bones of the 
 
F (E T U S. 
 
 275 
 
 trunk, the extremities, and the articula- 
 tions are very flexible. All the protube- 
 rances of the bones are distinct portions, 
 united by cartilage to the bone of which 
 they are afterwards to form a part. The 
 brain and spinal marrow, the glands, and 
 the sanguiferous system are larger in pro- 
 portion than in the adult. The cavity of 
 the chest is less than it is after respiration 
 has commenced ; the lungs are smaller, 
 more compact, and of a red colour like the 
 liver. The belly is disproportionately large, 
 and the extremities particularly small. 
 
 When the child is born, and respiration 
 has begun, the peculiarities of the foetus 
 begin to disappear. In consequence of 
 the expansion of the lungs, a larger por- 
 tion of blood is carried into that organ ; 
 the foramen ovale soon closes, and the 
 ductus arteriosus is lessened, and gradu- 
 ally contracted into a ligament ; while the 
 whole of the blood brought by the veins is 
 now carried through the lungs. When the 
 supply from the umbilical cord is cut oif, 
 the ductus venosus contracts in the same 
 way. 
 
 It seems now to be admitted, except by 
 the very credulous and ignorant, that the 
 imagination of the mother has no power 
 over the infant in her womb, either to al- 
 ter its structure, to mutilate its limbs, or 
 to impress any mark on its surface. A 
 few remarkable coincidences have cer- 
 tainly happened, but many falsehoods and 
 misrepresentations have given currency 
 to the stories which have been adduced, 
 in proof of the influence of the mother's 
 imagination on the foetus. But honest 
 inquiry and sound philosophy alike put a 
 negative on the assertion. But though 
 the imagination and longings of the mo- 
 ther cannot aiFect the foetus, her diseases 
 have done so. In fever, we see it possi- 
 ble from the increased heat of the blood, 
 which may affect the irritable frame of 
 the foetus J and the matter of small-pox 
 which pervades all the fluids may be ab- 
 sorbed from the maternal part of the after- 
 birth, and conveyed to the embryo. 
 
 Sometimes the foetus is lodged, and 
 grows, not in the womb, but in some of its 
 
 appendages, and even in the cavity of the 
 abdomen. Such extra-uterine conceptions 
 are generally fatal to the mother; but 
 in some instances, when the foetus dies, 
 adhesions having taken place to the sides 
 of the belly, an abscess is formed, and 
 the child comes away in parts, the mother 
 eventually getting well. 
 
 FOMENTATION. The application 
 of heat, generally accompanied with mois- 
 ture, to any part of the body, for medi- 
 cinal purposes. Thus in swellings of a 
 part, we foment it with chamomile flowers, 
 boiled, and ^Tapped in flannel; or in 
 spasms of the bowels we apply fomenta- 
 tions by means of cloths dipped in hot 
 water. Sometimes clysters are given 
 warm, and in large quantity, with a view 
 of acting as an internal fomentation. 
 Sometimes a more penetrating or stimu- 
 lating substance is added to increase the 
 power of the fomentation, as brandy, cam- 
 phor, or ammonia. 
 
 FOMITES. The matter of the con- 
 tagion of several diseases, as the plague, 
 and typhus fever, is well known to ad- 
 here to various substances, especially wool 
 and cotton, and thus to be carried to a 
 great distance in a very concentrated 
 state. Such substances are called ^wiiYe*. 
 Instances have been knox^Ti, of persons 
 being struck dead while opening a bale 
 of cotton, which had come from a place 
 infested with the plague. Hence the 
 necessity of thoroughly cleaning every 
 thing connected with the house, and the 
 bed and body-clothes of patients who 
 have fever, and of burning every thing 
 worthless, or that cannot be completely 
 cleaned. See Contagion. 
 
 FOOD. SeeVHF.T. 
 
 FOWLS. There are many different 
 kinds of fowls used as articles of food, 
 and these vary much .in their different 
 degrees of nourishment, digestibility, and 
 the stimulus they give to the system. 
 Many of them, as the goose, duck, &c. 
 contain much oily matter, which rendere 
 them very nutritive, but of difficult di- 
 gestion ; while the whiter parts of the 
 common domestic fowls, chickens, tiu*- 
 
276 
 
 FOXGLOVE. 
 
 keys, &c. contain less fatty matter, but 
 are still not so dig^estible as the parts of 
 game, partridges, grouse, &c. Wild birds, 
 however, are more heating than the 
 others. We are to consider the state of 
 the patient, and the effect intended, when 
 we direct any particular kind of fowl for 
 diet. The broth made from the common 
 dunghill foAvl, with a little rice, is an 
 excellent article for convalescents from 
 various diseases, and for women in child- 
 bed, when animal food is first to be ven- 
 tured upon. 
 
 FOXGLOVE, Digitalis purpurea. A 
 plant A^'hich grows in many places of 
 Great Britain, producing purple or white 
 bell-shaped flowers. Foxglove furnishes 
 a medicine of great celebrity, and possess- 
 ed of remarkable powers on the human 
 body. The part of the plant which is 
 used, is the dried leaves, either in the 
 form of powder, of tincture, infusion, or 
 decoction. On account of their great 
 hazard and uncertainty, we rarely pre- 
 scribe either the infusion or decoction, 
 but find the powder and tincture more 
 manageable. The effects of foxglove are 
 those of a sedative and a diuretic. As a 
 sedative, it seems better entitled to that 
 name than any other medicine which has 
 received it ; as it has little appearance of 
 previously stimulating, and as it is not 
 followed by the stupifying effects common 
 to opium and other narcotics. Indeed, 
 at one time, physicians had high hopes 
 that digitalis was to prove a specific in 
 consumption, and to bring down the pulse 
 and diminish the hectic excitement with 
 unerring certainty. Though it does not 
 do this, yet when the pulse is full, hard, 
 and frequent, it diminishes the intensity 
 of all these states, and reduces the num- 
 ber of beats in a wonderful manner, at 
 the same time rendering the pulse inter- 
 mitting. The pulse has been known to 
 fall in the course of six hours from 130 
 beats to 60 in a minute j and in a hectic 
 patient, it fell from 125 to 45 beats in the 
 minute, in the course of forty-eight hours. 
 With this reduction of the hardness, ful- 
 ness, and frequency of the pulse, the re- 
 
 markable circumstance attends, that if 
 the patient gets up suddenly, the pulse 
 becomes alarmingly frequent, he is seiz- 
 ed with fainting fits, and sometimes dies 
 very suddenly. Hence the necessity of 
 extreme caution in the exhibition of 
 this powerful substance ; hence the ne- 
 cessity of the utmost vigilance on the 
 part of the medical attendant, lest, before 
 he is aware, there be such a quantity of 
 digitalis accumulated in the system, (or, 
 what is the same, lest the effects of one 
 dose be so backed by following ones,) 
 as to give rise to the fatal result above 
 specified. What has appeared a very small 
 quantity indeed, has proved fatal to some ; 
 and the symptoms indicating an over-dose 
 are these : sickness of the most dread- 
 fully distressing kind, vomiting, purging, 
 cold SM^eats, great prostration of strength, 
 faintiugs, convulsions, and death. When 
 these alarming symptoms have come on, 
 strong stimulants must be given, wine, 
 spirits, or ether, or the volatile tincture 
 of valerian ; external warmth must be 
 applied to the extremities, and a blister 
 to the pit of the stomach. The remark- 
 able effect of digitalis in diminishing the 
 action of the heart and arteries, suggests 
 the inquiry, whether, in inflammatory 
 diseases, its powers might not be so ma- 
 naged as to render large bleedings un- 
 necessary. The ansAver to this must^be 
 in the negative. No judicious or candid 
 person aaIU ever say, that digitalis will 
 cure acute pleurisy, or phrenzy, or rheu- 
 matism. The abstraction of blood by the 
 lancet is a means of cure in such diseases, 
 sanctioned and confirmed by the uniform 
 experience of ages ; and whatever auxi- 
 liaries it may admit, it must never be 
 superseded by any of them. After co- 
 pious bleedings in acute diseases, digitalis 
 may be used to lessen still farther the 
 action of the circulating system, but we 
 must never ti-ust to it alone. 
 
 As a diuretic, foxglove has been cele- 
 brated more particularly for its effects in 
 dropsy of the chest, than in any other 
 affection. Perhaps this may be owing to 
 the circumstance, that many of the symp- 
 
FOXGLOVE. 
 
 277 
 
 toras believed to be characteristic of water 
 in the chest, are connected with some 
 disease of the heart and great vessels; 
 and as digitalis certainly does some good 
 in such diseases, it is thought to have 
 done good in the dropsy of the chest. 
 Digitalis, when used as a diuretic, should 
 be combined with other diuretics, as 
 squill, or the spirit of nitrous ether. 
 
 With respect to the doses of foxglove : 
 at first, we are to give, of the powdered 
 leaves, one grain in the form of pills 
 twice a-day, increasing the dose gradually 
 by a quarter of a grain each time, till 
 some effect is produced ; recollecting that 
 if any effect is long of manifesting itself, 
 there is a possibility of the medicine ac- 
 cumulating in the system, and at last 
 showing its alarming effects with violent 
 rapidity. Of the tincture, ten drops 
 twice a-day ai'e enough to begin with, 
 increasing the dose gradually by four 
 drops at a time, or directing ten drops 
 to be taken three times a-day. The best 
 way is to give the tincture carefully 
 dropped in cold water, or to join equal 
 parts of the tincture of foxglove and of 
 the compound spirit of lavender, and to 
 order twenty drops of the mixture in 
 water. When given as a diuretic, we may 
 add a drachm of the tincture to an ounce 
 of the spirit of nitrous ether, with five 
 ounces of cinnamon or peppermint-water, 
 and give a table-spoonful of this every 
 three hours. 
 
 The following remai-ks of Mr. Brande 
 are well worthy of being particularly at- 
 tended to. " It is sometimes customary, 
 in pharmaceutical laboratories, to leave 
 tinctures upon the dregs, after they have 
 stood a due time, and gradually to pour 
 off the clear part for use ; the dregs are 
 afterwards pressed out, and the last por- 
 tion of tincture acquires, by this careless 
 proceeding, double the strength of the 
 first. A person suffering under water in 
 the chest, who had been in the habit of 
 taking forty drops of tincture of digitalis 
 every night, went from home without his 
 medicine, and was obliged to send to an 
 apothecary in the country for an ounce 
 
 of the tincture, of which he took the 
 accustomed dose ; its effects were much 
 more violent than usual, and he died, 
 exhausted by repeated faiutings, in the 
 morning. Very particular inquiries were 
 made, respecting the quality of the tinc- 
 ture, when it appeared that the leaves 
 had been shaken out of the bottom of 
 the bottle in nearly a dry state, since an 
 ounce of the tincture was with much 
 difficulty squeezed out of them. Here, 
 therefore, the strength of the tincture 
 was not only increased by long standing, 
 but probably very greatly augmented by 
 evaporation ; and there is little doubt that 
 the patient died of the over-dose, and not 
 of his disease. Doses of digitalis are 
 borne by persons who have long used it, 
 which could not have been given to them 
 with impunity in the first instance. Hence 
 persons often do themselves mischief by 
 resuming their medicine, after some in- 
 terval, in the same doses they had pre- 
 viously used it. This observation par- 
 ticularly applies to patients who under- 
 take the management of their own cases, 
 and who erroneously suppose that a dose 
 once taken may always with impunity 
 be repeated." 
 
 Upon the whole, foxglove is one of our 
 most powerful instruments ; but it is one 
 which must not be tampered with, nor 
 trusted in rash or unskilful hands. 
 
 FRACTURE. A broken bone is said 
 to he fractured. Fractures ai-e either sim- 
 ple or compound. A fmcture is termed 
 simple when the bone alone is broken, 
 without any accompanying wound of the 
 skin, muscles, or soft parts ; and it is 
 called compound, either when the same 
 violence which has broken the bone has 
 injured the soft parts, or the l)one itself 
 has been pushed through any of them. 
 A fracture being compound, adds very 
 much to its danger ; and the degree of 
 danger is to be estimated by the violence 
 which inflicts the injury, and the extent 
 or importance of the soft pai'ts injured. 
 When a person has, either by a fall, a 
 bfuise, or any other accident, broken a 
 bone, great care should be t^kcn in re- 
 
278 
 
 FRACTURE. 
 
 moving' him from tlie place of the acci- 
 dent ; he should be carried in the easiest 
 manner possible, and this seems to be by 
 the strength of men, while the patient is 
 lying- on a flat board. A carriage, or even 
 a litter with springs, is not so good. The 
 patient, unless under the influence of 
 drunkenness or insensibility, generally 
 finds out the position which is easiest 
 for himself. The plan of cure in simple 
 fractures, is to place the injured limb in 
 such a way that the broken ends of the 
 bones may be kept as near each other as 
 possible ; a certain matter is thrown out 
 from the ends of the bone, which gra- 
 dually hardens, and the bone becomes as 
 strong as before. To keep the limb in 
 the proper position, it is to be firmly 
 bound with splints, flat pieces of wood 
 or iron, lined with cotton or quilt to keep 
 the soft parts from being chafed, and 
 fastened with tape or rollers. When the 
 fracture is compound, the state of the 
 soft parts requires attention. If there is 
 much crushing of the bone, so that it is 
 broken down as it were into fragments, 
 or when there is much laceration of the 
 soft parts, it is very unlikely that the 
 cure will go on well ; and it is generally 
 necessary at once to amputate the limb, 
 in order to preserve the life. When the 
 surgeon sees this to be absolutely neces- 
 sary, it is better to perform the opera- 
 tion without delay, as there is a likeli- 
 hood of fever and other symptoms of great 
 constitutional irritation soon coming on, 
 which will probably render it impossible 
 to perform the operation. It may appear 
 a very harsh and rapid mode of proceed- 
 ing, to propose at once cutting off a limb 
 which has been subjected to a severe ac- 
 cident ; but it affords the only probable 
 means of preserving life, and in that view 
 it is really merciful. If the compound 
 fracture have a sharp projection of bone, 
 pushing through the skin, it will be im- 
 possible to place the bone in a favourable 
 position for healing, till this impediment 
 is removed by the bone-nippers. A blood- 
 vessel may be wounded, and this must be 
 secured either at tljie place of the accident 
 
 or nearer the heart, and the blood cleaned 
 out from the wound ; the limb is then to 
 be secured in the usual way. 
 
 We do not think it necessary to detail 
 the symptoms and cure of particular frac- 
 tures, but shaU mention a few circumstan- 
 ces respecting fractures of the skulL Every 
 injury of the head, more especially those 
 inflicted with such violence as to fracture 
 the skull, is to be considered as of an 
 alarming nature; yet the mere circum- 
 stance of a fracture, and even a pretty 
 extensive one, is not to be considered as 
 the most formidable concomitant. Unless 
 the soft parts are very much torn, there 
 may be a long fissure of the bones of the 
 skull, without much danger ; but if there 
 is not only fracture, but also depression, 
 or beating in of the skull upon the brain, 
 then the danger is unquestionably more 
 urgent. See Skull and Trepan. 
 
 FRICTION. It is useful, in many 
 cases, to rub diseased parts of the body 
 with the hand or with the flesh-brush. 
 Sometimes liniments or embrocations are 
 rubbed upon such parts ; sometimes no- 
 thing is interposed between the hand and 
 the skin. In palsy and in rheumatism, 
 stimulant applications are used, as harts- 
 horn and oil, camphorated oil, turpen- 
 tine, oil of amber, or cajeput oil. In 
 swellings of the glands, or in the thick- 
 ening of the cellular substance which re- 
 mains after an abscess, gentle rubbing 
 with oily matters contributes to discuss 
 them. In oedema or watery swelling of 
 the limbs, rubbing with the hand in the 
 direction of the returning veins and lym- 
 phatics assists their action. In white 
 swelling of the knee-joint, a cure has 
 been accomplished by rubbing, alone. It 
 must be vigorous and long continued ; 
 and in some towns, persons gain a liveli- 
 hood by undertaking this operation. A 
 little flour is put in the palms of the 
 hands, and the rubbing is continued for 
 an hour or tAvo at a time. Medicines 
 are introduced into the system by fric- 
 tion, of which we have a frequent ex- 
 ample in the rubbing in of mercury in 
 the forni of blue ointment. 
 
FRUITS. 
 
 279 
 
 FRUITS are much used as an article 
 of luxury ; and from the effects they are 
 too frequently seen to produce, they 
 would seem to he hy no means of a salu- 
 tary nature. Looseness, vomiting-, indi- 
 gestion, and even inflammation of the 
 bowels, have been seen evidently to pro- 
 ceed from the use of various fruits. Yet 
 it is pretty certain that the fault has Lain 
 not with the fruit, but with the con- 
 sumer. When fruit is eaten in large 
 quantity, and in an unripe state, when it 
 is forced into the stomach, already load- 
 ed with a plentiful dinner of soup, meat, 
 pudding, and all the items of a luxurious 
 table, there is nothing wonderful in the 
 subsequent intestine Avar. But when fruit 
 is taken in moderation, of a proper qua- 
 lity, and at proper seasons, no bad effects 
 are to be dreaded. Fruits are evidently 
 useful, and they are kindly sent at the 
 very season, when the system, heated and 
 excited by the warmth of summer, stands 
 in need of something cooling and laxative 
 to be taken with the food. 
 
 The fruits in most common use may 
 be classed under the heads of stone-fruits, 
 the apple kind, berries, (without affecting 
 botanical accuracy in the use of this term,) 
 and farinaceous fruits. The stone-fruits 
 are those which are of most difficult di- 
 gestion. Plums and cherries are pai'ticu- 
 larly so. The ripe peach is both delicate 
 in its flavour and easily digestible ; the 
 apricot is also very wholesome ; but the 
 nectarine is liable to disagree with some 
 stomachs. The fruits of the apple kind 
 are somewhat firm in their texture, and 
 therefore rather indigestible, and liable 
 to be detained in the stomach. Pears are 
 rather more allowable, as their texture is 
 softer. The white skin of the orange 
 should be carefully rejected, but the inner 
 pulp is grateful to all stomachs, whether 
 in health or sickness. The fruits of the 
 ))erry kind are the most wholesome of all. 
 The strawberry or raspberry are particu- 
 larly good ; the grape is cooling and lax- 
 ative, but the husks and seeds are to be 
 rejected; the gooseberry is not so diges- 
 tible, especially if the skin be swallowed. 
 
 It is only the pulp of these fruits that is 
 digested ; the seeds always pass through 
 the body undigested, unless they be chew- 
 ed. Other berries are generally baked 
 in pies, but the pastry should be sparing- 
 ly used. The melon^ a farinaceous fruit, 
 is almost sure to disiigree with weak sto- 
 machs J and when eaten after dinner, al- 
 ways requires abundance of salt, pepper, 
 ginger, or other condiment to be eaten 
 with it. Many fruits, otherwise unsafe, 
 are much improved by cooking. Baked 
 apples are an excellent article of food, 
 and may even be of benefit to dyspeptic 
 patients. Dried fruits are generally es- 
 teemed very safe, but they are apt to run 
 into fermentation from the quantity of 
 sugar which they contain. 
 
 FUMIGATION. The method of ap- 
 plying the smoke or vapour of certain 
 substances for salutary or medicinal pur- 
 poses. Some preparations of mercury 
 have been burned, and patients have been 
 exposed to their fumes, for the purpose 
 of producing on the body the peculiar ac- 
 tion of mercury ; and fumigation is much 
 employed to destroy the contagious mat- 
 ter of several diseases. One of the most 
 beneficial instances of this, is the employ- 
 ment of the fumes of nitric or muriatic 
 acid, to destroy the contagion of fever. 
 This is done by pouring sulphuric acid 
 on saltpetre ; the sulphuric acid combines 
 with the potash of the saltpetre, and the 
 nitric acid fumes thoroughly mixing with 
 the air, destroys the contagious matter of 
 which it is the vehicle. The best way to 
 fill the chamber, the ward, or the ship, 
 where contagion is suspected, is to place 
 a number of saucers in different parts of 
 the room, to put saltpetre in each of 
 them, and to pour on the sulphuric acid. 
 The dooi*s and windows should be shut 
 for some time, and then a current of fresh 
 air admitted. Another gas which has 
 been employed to destroy contagion, is 
 the muriatic; acid gas, or vapour from sea- 
 salt. This is to be extracted from sea- 
 salt by nearly the same process, pouring 
 sulphuric acid upon it ; the vapour which 
 rises is probably equally effectual, but it 
 
280 
 
 FUMIGATION. 
 
 is more irritating and offensive to the 
 lungs of those who are exposed to it. 
 Fumigation with sulphur may also be 
 practised. The clothes of those who have 
 been ill of fever should be carefully fumi- 
 gated, and the walls of their apartment, 
 and the furniture, should be completely 
 exposed to the disinfecting vapour. In 
 the small-pox, there is a most peculiar 
 odour in the apartments of the sick, 
 which continues many weeks or months 
 
 after their recovery; and the contagion 
 of fever, though less obvious to the senses, 
 may reasonably be supposed to lurk as 
 long, if not carefully destroyed. The 
 sprinkling of the sick-chamber with heat- 
 ed vinegar, or throwing it upon hot coals, 
 though it may not have the power of de- 
 stroying contagion, is nevertheless a very 
 good practice, as it encourages ventila- 
 tion, is refreshing to the sick, and gives 
 confidence to the necessarv attendants. 
 
 G 
 
 GAL 
 
 GAL 
 
 GALBANUM. A gum obtained from 
 the Bubon Galbanuniy imported from 
 Turkey and the East Indies ; supposed to 
 agree in expectorant virtues with ammo- 
 niacum, but not much used. Externally, 
 gum galbanum is applied to promote the 
 suppuration of inflammatory and indo- 
 lent tumours, and also as a stimulating 
 plaster. 
 
 GALL. The fluid secreted by the liver. 
 See Bile. 
 
 GALL-BLADDER. A membranous 
 bag attached to the concave surface of the 
 liver, into which part of the gall flows, 
 and becomes a little thickened, before it 
 passes into the intestines by the common 
 gall-duct. It is in the gall-bladder that 
 gall-stones sometimes form. 
 
 GALL-NUTS. Excrescences upon a 
 kind of oak common in Asia Minor, which 
 are produced by the puncture of an insect 
 to deposit an egg. When the young in- 
 sect comes to maturity, it eats its way out 
 of the excrescence, which is from a quar- 
 ter to an inch in diameter; hence gall- 
 nuts are generally found with a hole in 
 them. They abound in astringent mat- 
 ter, or tannin ; a decoction of them may 
 be used as a gargle, and one part of 
 finely powdered galls added to eight parts 
 of any simple cerate or ointment^ is a good 
 application for piles. 
 
 GALL-SICKNESS. A popular name 
 for the remittent fever which takes place 
 in marshy countries, derived from the 
 very prominent symptom of the discharge 
 of great quantities of bile. It is this fever 
 that is so common in certain parts of the 
 Netherlands, and which was so destruc- 
 tive to our troops at Walcheren. See 
 Fever, Remittent. 
 
 GALL-STONES. Concretions which 
 form in the gall-bladder, and by their get- 
 ting into the passage leading from it to 
 the intestines, prevent the bile from get- 
 ting into them; hence jaundice is fre- 
 quently produced. These gall-stones, 
 when the obstruction is overcome, get 
 down into the bowels, and are discharged 
 by stool; then the disease abates, pro- 
 vided there is no other cause for it. 
 
 GALVANISM is a species of electri- 
 city, and derives its name from Galvani, 
 Professor of Anatomy at Bologna, one of 
 its earliest cultivators. With the view of 
 proving the truth of some opinions re- 
 specting muscular motion, Galvani sus- 
 pended a dead frog, by means of a metal- 
 lic hook, on an u'on railing, and he found 
 that at certain times, convulsive motions 
 were excited in the limbs of the animal. 
 " When also the nerve of the extremity 
 was covered with a metallic leaf, and the 
 leg laid on another piece, on establishing 
 
GALVANISM. 
 
 281 
 
 a communication between them by means 
 of wire, the convulsions become stronger. 
 From the different experiments which 
 Galvani performed, he was inclined to 
 suppose that the action was the same as 
 takes place in electrical animals, as the 
 torpedo or gymnotus electricus, and that 
 the metal or metals served merely as con- 
 ductors. Hence he gave it the name of 
 animal electricity. Volta gave a different 
 view of the subject. He supposed that 
 it was merely common electricity evolved 
 by the metiils ; the animal being the con- 
 ductor, and showing its effects. He has 
 shown, for instance, that particular sen- 
 sations are excited in the human body by 
 a similar adjustment. If we take two 
 pieces of metal, of different kinds, as zinc 
 and silver, and apply one above, the other 
 beneath the tongue, no particular sensa- 
 tion is excited ; but if they be made to 
 touch each other, a peculiar metallic taste 
 is perceptible. When we put the zinc 
 between the upper lip and gum, and the 
 silver between the under lip and gum, 
 and bring them together, a flash of light 
 darts across the eyes, provided the expe- 
 riment be performed in the dark. It oc- 
 curred to Volta, that the convulsions 
 might be greater by using more pieces of 
 metal He at;cordingly took a number of 
 plates of zinc and silver, and arranged 
 them in pairs, putting moist card between 
 each pair, and following the same order 
 throughout, as zinc, silver, card; zinc, 
 silver, card, &c. &c. When the legs were 
 touched by means of wires,- the effects' 
 were much greater than when only two 
 pieces were used ; and he also found that 
 they were invariably in proportion to the 
 number^ fully proving the truth of his 
 opinion, that the electricity was given out 
 by the metals, and not by the animal. 
 The apparatus above described is termed 
 a Voltaic pile. Another apparatus for 
 exhibiting galvanism was contrived by 
 Mr. Cniickshank. It consists of a- M'ooden 
 trough, in the sides of which, grooves are 
 <;ut, at about the distance of a quarter or 
 half .an inch from each other, according to 
 its size; and into which arc placed a plate 
 
 of copper and zinc soldered together, fol- 
 lowing the same arrangement as in the 
 construction of the pile, copper, zinc; 
 copper, zinc, &c. This is called the gal- 
 vanic battery. It is not a matter of in- 
 difference what metals we employ in con- 
 structing a battery; they must possess 
 different powers of oxidation, or of being 
 acted on by acids. One must be easily 
 affected; while, the more the other resists 
 their action, the better. For the former, 
 zinc is generally used ; copper, which is 
 not easily acted upon,answei*s well enough 
 for the latter. Different liquids are used 
 for the excitation of galvanism. The best 
 are the acids, and the nitric is commonly 
 preferred ; it is diluted with twenty or 
 thirty parts of water. When we wish the 
 galvanism to be strong, we rather use a 
 large battery than increase the strength 
 of the acid, which would act too power- 
 fully on the plates, and destroy them." 
 This is not the place to detail the astonish- 
 ing chemical effects produced when the op- 
 posite ends of the battery are made to com- 
 municate by means of a conductor. If 
 the wires are terminated by charcoal, and 
 brought into contact, a brilliant light is 
 produced, and this even under water. 
 Galvanism produces an intense heat, suf- 
 ficient to ignite and fuse the hardest me- 
 tals, and even the most refractory earths. 
 " Galvanism is a most powerful agent in 
 causing decomposition. By increasing 
 the strength of the battery, substances 
 held together by the most powerful affi- 
 nity are easily separated. We have thus 
 been enabled to ascertain the composition 
 of some, till then reckoned simple; and 
 new bodies have also, by its aid, been dis- 
 covered, which have themselves proved 
 powerful means of analysis. About the 
 beginning of this century, Sir Humphry 
 Davy subjected a number of substances 
 to the action of a powerful battery, by 
 which h^ discovered the compound na- 
 ture of many ; and illustrated, by nume- 
 rous instances, the chemical changes pro- 
 duced by this wonderful agent. 
 
 " The sensations excited on the human 
 body by the battery are very peculiar. 
 
2B2 
 
 GALVANISM. 
 
 If a ball be placed at each end, and the 
 hands, after being wetted, are put on 
 them, there is a thrilling in the fingers 
 and arras, which becomes painful, if the 
 battery be large ; at the same time, con- 
 vulsions are excited. The greater the ex- 
 tent of moistened surface of the hands, 
 the more powerful are the effects. Gal- 
 vanism has been employed in the cure of 
 diseases, as palsy, rheumatism, deafness, 
 involuntary contraction of the muscles, 
 asthma, and some others ; and it has been 
 recommended in cases of suspended ani- 
 mation. The method of applying it is 
 very simple. The part to be subjected 
 to its influence is wetted with a solution 
 of salt, or with very much diluted muria- 
 tic acid, and having tied a ball to each 
 wire, they are to be applied at the same 
 time to the moistened skin ; the person 
 holding them having on gloves, to prevent 
 the transmission of the influence through 
 his body. In many respects, galvanism 
 is preferable to electricity. The appara- 
 tus is less liable to injury; besides, we 
 are altogether independent ^ the wea- 
 ther, which is often a bar to the use of 
 an electric machine." (Dr. Fyfe's Ele- 
 ments of Chemistry.) 
 
 " Galvanism," says Dr. Parr, " has been 
 employed like electricity in discussing in- 
 dolent tumours, and in cataracts, but with 
 no very marked or decided success. A 
 few boasted cures have raised our expec- 
 tations J but the little permanency of the 
 benefit received, has again depressed our 
 sanguine hopes. After repeated experi- 
 ments about the head, inflammation about 
 the eyes, a catarrhal inflammation of the 
 membrane lining the nose, an insensibi- 
 lity of the organ of taste or vertigo have 
 followed; and galvanism has been un- 
 doubtedly injurious where there was con- 
 siderable irritability. On the whole, then, 
 we have not yet received very encourag- 
 ing accounts of the success of galvanism 
 in diseases, and we fear that we must re- 
 sign it, with electricity, as a remedy that 
 promises to be beneficial, but \^'hose ad- 
 vantages have not yet answered the flat- 
 tering expectations first raised." 
 
 GAMBOGE. A gum resin brought 
 from the East Indies, obtained from the 
 Stalagmitis cambogioides. It is of a 
 bright yellow colour, has no smell and 
 little taste. It acts strongly on the bow- 
 els, not only evacuating them of feculent 
 matter, but occasioning the discharge of 
 much watery fluid ; hence it is reckoned 
 a drastic and hydragogue cathartic : and 
 in certain cases of dropsy, either alone or 
 combined with other purgatives, it occa- 
 sions very copious watery stools. The 
 dose of this active substance, when no 
 other purgative is taken along with it, is 
 from two to four grains of the powder, 
 taken in a little syrup or gruel, with a 
 grain or two of aromatic powder. Gam- 
 boge is apt to cause vomiting; but if it 
 does not, it clears the bowels very effec- 
 tually. When there is much torpor in 
 the system, as in apoplectic cases and 
 other diseases of the head, a strong purge, 
 composed of six grains of gamboge, ten of 
 aloes, and as much jalap, will have a good 
 eflfect in opening the bowels, and relieving 
 the stupor. One grain of gamboge with 
 two of calomel may be given in the obsti- 
 nate costiveness of children. 
 
 GANGLION, in anatomy, means a little 
 knot found in certain parts of the nervous 
 system. In surgery, it is a bunion, or 
 hardened growth on the surface of a ten- 
 don. When it happens on any of the ten- 
 dons of the foot, it is painful and trouble- 
 some like a corn. The best treatment is 
 to rub them frequently with some stimu- 
 lating application, or to put a small blister 
 over them ; and when it is healed, to ap- 
 ply a piece of sheet lead, and to make 
 firm and continued pressure. 
 
 GANGRENE. See Mortification. 
 
 GARGLE. A wash for the mouth 
 and throat. This is highly useful and 
 necessary in many diseases of these parts. 
 In the common inflammatory sore throat, 
 astringent gargles should be used at the 
 very commencement, and in many cases 
 a threatened sore throat is prevented by 
 their timely use. They may be made of 
 vinegar and water sweetened with honey 
 or sugar ; or of diluted sulphuric acid and 
 
GAS 
 
 GEL 
 
 283 
 
 water, or the infusion of red rose leaves, 
 into which some drops of sulphuric acid 
 have heen poured. This makes a very 
 elegant and iiseful gargle. Hartshorn 
 much diluted may be used, or Port Mane, 
 or strong spirits. The inflammation of 
 the tonsils is generally of that kind that 
 requires astringent and stimulant appli- 
 cations. In the ulcerated and putrid sore 
 throat which accompanies scarlet fever, 
 the gargles must be of a very stimulant 
 nature. An infusion of cayenne pepper, 
 with vinegar, is to be frequently employ- 
 ed as a gargle; it is made by taking a 
 table-spoonful of cayenne pepper, and a 
 like quantity of common salt, infusing 
 them in a pint of boiling water, then 
 straining the liquor, and adding half a 
 pint of vinegar. Much of the benefit of 
 a gargle is derived from its being used 
 frequently, and the patient should be en- 
 couraged to do so, notwithstanding the 
 temporary inconvenience it puts him to. 
 
 GARLICK, Allium sativum. A plant 
 whose root consists of five or six small 
 bulbs called cloves, inclosed in one com- 
 mon membranous root, but which can be 
 easily separated from each other. It has 
 a strong, offensive, and penetrating smell, 
 and a very acrid taste. Mr. Brande says, 
 that if it is used with more judgment 
 than belongs to ordinary cooks, garlic 
 improves the flavour of a numerous class 
 of spices, but entirely spoils them if added 
 in such proportions as to become promi- 
 nent. It is sometimes used by the lower 
 classes as a seasoning. It is of little use 
 in medicine. Like numerous other sub- 
 stances, it has been thought to cure the 
 ague; and it is sometimes employed to 
 heighten the stimulant quality of some 
 poultices. Taken moderately, it may 
 promote digestion, but in excess it is said 
 to produce flatulence, heat, thirst ; and to 
 occasion a discharge of blood from the 
 vessels near the anus. 
 
 GAS. An elastic fluid which is not 
 condensed by the application of cold. 
 The bodies of this class are numerous 
 and important, both in chemistry and the 
 arts ; but as applied to the cure of diseases, 
 
 though at one time much was hoped frora 
 directing patients to breathe certain kinds 
 of airs, the gases are not of much conse- 
 quence. The very ingenious application 
 which has been made of certain inflam- 
 mable gases for the purpose of lighting 
 the streets, public places, and interior of 
 houses, renders it necessary to say a little 
 respecting their effects on the human 
 body. As they are introduced into apart- 
 ments, they must necessarily enter the 
 lungs of the inhabitants either before or 
 after being burned, and being burned in 
 a limited space, they must have considera- 
 ble influence on those who breathe them. 
 The gas most commonly burned is that 
 called carburetted hydrogen, a poisonous 
 gas, which, even when diluted, has bad 
 effects on the nervous system ; and pains 
 in the head, nausea, and languor have 
 been known to occur in persons who had 
 inhaled this gas. Probably, however, 
 they were delicate subjects, as multitudes 
 daily inhale this gas in shops and houses, 
 without any bad effects. 
 
 GASTRIC JUICE. A fluid secreted 
 by the exhaling arteries of the stomach ; 
 one of the most important agents in diges- 
 tion. It is a most powerful solvent ; and 
 aided by the heat, the motion, and other 
 concomitant circumstances, it reduces the 
 aliment swallowed to a soft uniform pulp. 
 Its quantity is considerable, and is in- 
 creased, at the time it is wanted, by the 
 stimulus of the food. After death it cor- 
 rodes the coats of the stomach itself. The 
 gastric juice has been thought likely to 
 cure dj^spepsia and intermittent fever, 
 and to do good when applied to scrofu- 
 lous ulcers ; but the difficulty of procur- 
 ing a quantity of it, and the disgusting 
 circumstance of swallowing such a fluid, 
 must render it very unlikely to be applied 
 to the purposes of medicine. 
 
 GASTRITIS. See Stouach, Injlamr 
 mation of. 
 
 GELATINE, or animal jelly, is an 
 abundant ingredient of the animal body, 
 both of its fluid, and hard and solid parts. 
 By long continued boiling, gelatine is 
 procured from the skin, the membranes, 
 
284 
 
 GE S 
 
 GID 
 
 the gristle, and even from the bones. 
 When this solution cools, it concretes into 
 the well kno^Ti, tremulous, half-trans- 
 parent substance called jelly, which forms 
 a light, easily digestible, and nutritious 
 food. With this jelly can be combined, 
 by good housewives, a little ale, wine, or 
 spices, which both add to its nutritious 
 qualities, and give it a flavour agreea- 
 ble to the palate ; rendering it also lighter 
 for the stomach. This is a good form of 
 giving nourishment to invalids and con- 
 valescents. Jelly may be dissolved in a 
 little warm water and used as a drink, 
 or taken cold and unmixed ; or if this is 
 thought unadvisable, it may be dissolved 
 by heat and taken without any addition. 
 Gelatine is most abundant in the bodies 
 of young animals; hence it manifests itself 
 on the cooling of lamb, veal, and the like. 
 . GENTIAN, Gentiana lutea. A plant 
 abundant in the Alps, and in the moun- 
 tainous forests of Germany. The root is 
 used in medicine; it is of an intensely 
 bitter taste, accompanied by a slight sweet- 
 Mess, and is one of the best bitters we can 
 employ. It may be given in the form of 
 tincture or infusion; and according to the 
 state of the stomach and bowels >vhich 
 we wish to rectify, it may be combined 
 S^'ith magnesia and other absorbents ; or 
 with kxatiye medicines. Of the infusion 
 of gentian, from one ounce to four may 
 be taken twice a-day ; or a tea-spoonful 
 of the tincture in a glass of cold water. 
 Gentian is an excellent" tonic and bitter, 
 and has not the astringency which ren- 
 ders some other bitters inconvenient. 
 There is an extract of gentian, but it is 
 less used thau the other forms mentioned 
 above. An extremely bitter spirit is dis- 
 tilled from gentian, M'hich is highly re- 
 lished by the common people of S^vitzer- 
 land. 
 
 GESTATION signifies the exercise 
 given to the body by foreign means, while 
 itself seems to be at rest. The principal 
 modes of gestation are riding in a cai- 
 riage oi' on horseback, being carried in a 
 litter, sailing, or swinging either in a 
 suspended seat, or on an elastic board. 
 
 For the different kinds of exercise and 
 gestation, and some diseases in M'hich 
 gestation is useful, we refer to Exercise, 
 Consumption, Stomach Cobiplaints, &c. 
 
 GESTATION or Pregnancy is the 
 period during which a woman carries the 
 foetus, from conception to the time of its 
 birth. See Pregnancy. 
 
 GIDDINESS, Vertigo. An affection 
 of the head in which the patient is una- 
 ble to direct his motions, from the appa- 
 rent unsteadiness of external objects. It 
 is accompanied M-ith dimness and un- 
 steadiness of sight, with soimding in the 
 ears, and other disagTeeable sensations 
 referred to the head. It is an attendant 
 on various morbid affections, in some of 
 which it indicates great danger; and in 
 others the mere unpleasantness of the 
 feeling is the worst circumstance, as it 
 only shows a diseased action of some 
 other part not immediately necessary to 
 life. In fever, \^hen there is giddiness, 
 it is the mark of considerable tendency 
 to the head, and generally is followed by 
 delirium ; and in this case, the practitioner 
 is to be guided by circumstances, and to 
 use his best judgment whether to pay 
 particular attention to the head-symp- 
 toms, or to attend to the general progi-ess 
 and character of the disease. In inflam- 
 mation of the brain, the vertigo is bad 
 itself, and the forerunner of increased 
 excitement; and is to be treated boldly 
 and decidedly by copious blood-letting, 
 by purging, and the application of cold to 
 the head. Vertigo is a very frequent de- 
 nouncer of apoplexy and palsj', and should 
 be regarded by the patient as a warning 
 to take instant precautions against the 
 impending danger. In affections of the 
 stomach, vertigo is a most distressing 
 symptom ; but when Me can be assured 
 that the stomach only, or its functions 
 are deranged, vre need not regard the 
 affection of the head as an object of great 
 alai'm. In indigestion, accompanied by 
 Avhat is called sick headach, vertigo is 
 one of the most urgent of the symptoms ; 
 and is to be treated by calomel or other 
 purges, with a vioM' to relieve the sto- 
 
GL A 
 
 GLE 
 
 285 
 
 roach by carrying the offensive matters 
 downwards. 
 
 GIN, Geneva, or Holl,4nds. Au ar- 
 dent spirit, distinguished from others by 
 being impregnated Avith the essential oil 
 of the juniper, by which it is rendered 
 diiu*etic. lu dropsical cases, when we 
 think it prudent to allow a little spirits 
 and water, gin is the spirit which we 
 prefer, as giving a little assistance in in- 
 creasing the urine. Gin is a favourite 
 nursery remedy in the gripes of infants, 
 accompanied with difficulty of making 
 water ; and the sensible practitioner will 
 not quarrel very vehemently with the 
 practice, provided the spirit be given only 
 by a few drops at a time, and not too fre- 
 quently repeated. 
 
 GINGER. The root of a plant which 
 grows in the East and West Indies, the 
 Amomum Gingiber. Its powder is a 
 good carminative stimulant, and was at 
 one time thought to be very serviceable 
 in gout ; it entered into the composition 
 of the celebrated Portland powder. It 
 prevents griping and flatulence, and there- 
 fore is a good addition to senna, or jalap, 
 or rhubarb. When chewed, the root pro- 
 motes the flow of saliva, and excites con- 
 siderable heat in the mouth, by which 
 the pain of toothach is sometimes alle- 
 viated. 
 
 GLANDS are organs destined for the 
 alteration or secretion of some particular 
 fluid. They are distinguished according 
 to the fluid they secrete ; and they vary 
 in structure and in size, from the liver to 
 the minutest points which secrete the 
 fatty matter of the skin. Glands are be- 
 lieved to be peculiarly disposed to that 
 sort of inflammation which ends in scir- 
 rhus and hardness, and is apt to end in 
 cancer. The hard knots and swellings 
 w^hich we see in the necks and other 
 parts near the surface, are glands; and 
 they are, in scrofulous constitutions, apt 
 to suppurate, to form unhealthy curdy- 
 looking matter, and to turn to sores very 
 difficult to heal. Swelled and hardened 
 glands should be protected from the cold 
 air by proper clothing. 
 
 GLAUBER'S SALT. Glauber was 
 a chemist at Amsterdam, about the year 
 ICGO. There is much originality in his 
 experiments, and he often reasons sensi- 
 bly and acutely on their results. His in- 
 ventions and discoveries are numerous 
 and important ; and among them are some 
 sagacious anticipations of the improve- 
 ments of modern chemistry. Having dis- 
 tilled common salt with sulphuric acid, he 
 termed the residue sal mirabile ; and to 
 this day it retains the name of Glauber's 
 salt. In the modem nomenclature, it is 
 called sulphate of soda, and it is one of 
 the most frequently used, of the saline 
 purgatives. Its crystals are six-sided 
 prisms ; their taste is strongly saline and 
 bitter. The dose is from an ounce to an 
 ounce and a half, dissolved in warm wa- 
 ter, and taken in the morning. Of late 
 years, its use in medicine has been much 
 superseded by Epsom salts, or the sul- 
 phate of magnesia. 
 
 GLEET, Gonorrhcea. A continued 
 running or discharge, after the inflamma- 
 tory symptoms of a clap have ceased. 
 The discharge is commonly thin and 
 clear, and is not accoznpanied with pain 
 or scalding in making water. It pro- 
 ceeds from relaxation or debility of the 
 parts, and is best cured by some astrin- 
 gent or stimulant application to them; 
 and at the same time, the-general health- 
 is to be promoted by the use of bark, 
 iron, and cold bathing. The best local 
 applications are those made of the sul- 
 phate of zinc, in the proportion of two 
 grains to the ounce, or one grain of cor- 
 rosive sublimate to six ounces of water ; 
 and they require to be pretty frequently 
 thrown up. They ought to excite a little 
 pain on their first being used. If we do 
 not succeed by astringent injections, we 
 may be obliged to use bougies, either 
 clean, or lightly touched with a little ba- 
 silicon ointment. Balsam of Copaiba in 
 the dose of a drachm three or four times 
 a-day, or the tincture of cantharides, ten 
 drops as often, may be given internally. 
 If we find no benefit from the treatment 
 above recommended, we judge tliat the 
 
28G 
 
 GL U 
 
 GOU 
 
 gleet does not arise from mere relaxation 
 of the parts or from habit, but from un- 
 healthy action of the glands in the uri- 
 nary passage, and we attempt the cure of 
 this by bougies, and by blisters to the 
 perineum. Jf the constitution is scrofu- 
 lous, the remedies for that disease must 
 be conjoined with our local applications. 
 Another cause of gleet is strictures in 
 the urethra. In such cases our attention 
 is to be directed to the cure of the stric- 
 tures, for which we refer to that article. 
 
 GLOBUS HYSTERICUS. The sen- 
 sation of a ball felt by hysterical women. 
 It appears to roll about in the bowels, 
 and to make its way to the stomach and 
 throat, where it produces a feeling of 
 choking. It is owing to wind, and is to 
 be cured by medicines which strengthen 
 the constitution and digestive system. 
 It is strongly characteristic of the disease. 
 
 GLUTEN. When w^heat flower or 
 other farinaceous powders are put into a 
 coarse bag, and kneaded with water, that 
 fluid carries off" their starch suspended in 
 it, and a tough substance is left in the 
 bag, which is called vegetable gluten. It 
 is a soft viscid substance, tenacious, elas- 
 tic, and very adhesive, having a fibrous 
 texture, and a faint peculiar odour. 
 When exposed to a dry air, it becomes 
 hard and brittle, resembling a piece of 
 glue. In a moist atmosphere, it swells, 
 and undergoes putrefaction, emitting an 
 offensive odour. Yeast or barm, which 
 is employed to excite fermentation, par- 
 ticularly by bakers, is found to have 
 many of the properties of gluten. Glu- 
 ten is contained in greatest quantity in 
 wheat; it is also found in other sub- 
 stances, though in small quantity, as in 
 barley, rye, pease, beans, chesnuts, and 
 many others. It does not, however ex- 
 ist in potatoes. Gluten, from its close 
 resemblance to the principles of the ani- 
 mal kingdom, is supposed to be very nu- 
 tritious. From the changes which it so 
 easily excites in other bodies, it is em- 
 ployed largely in distilling, and also in 
 the making of bread. (Fyfe's Elements 
 of Chemistry.^ See Bread. 
 
 GOITRE, or Swelled Neck, occurs 
 frequently in the Alps and other moun- 
 tainous districts. See Bronchocele. 
 
 GOOSE. A M'ell-known domestic 
 fowl Its flesh is a favourite, though 
 strong article of diet ; and as it abounds 
 in oily matter, some stomachs find it dif- 
 ficult of digestion. 
 
 GOOSEBERRY, i2i*€s Grossularia. 
 Avery wholesome fruit, either in its natural 
 state or preserved. The only thing about 
 gooseberries likely to offend the storaadi 
 is their being taken in too great quantity, 
 or the husks being swallowed. They are 
 to be avoided by those in whose stomach 
 there is much tendency to acidity. 
 
 GOULARD'S EXTRACT of LEAD. 
 A favourite preparation of lead, recom- 
 mended by a French apothecary of that 
 name. It is made by adding a gallon of 
 vinegar to two pounds of seraivitrified 
 oxide of lead. These are to be mixed and 
 boiled down to six pints, keeping con- 
 stantly stirring. The impurities are al- 
 lowed to subside, and the liquor is strained. 
 It is employed chiefly as a dressing to re- 
 pel local external inflammations; and is 
 best applied by keeping cloths wet with 
 it to the part aff^ected. 
 
 GOUT. This long known and cele- 
 brated disease is one of the few maladies 
 and infirmities of which men are disposed 
 to be proud. As it is a disease chiefly 
 brought on by rich and luxurious living; 
 and as it rarely occurs among the poor 
 and plebeian, to be afflicted with the gout 
 is supposed to imply a degree of opulence 
 and rank in the patient, which the vanity 
 of man converts into a ground of conso- 
 lation and pleasure. The paroxysms of 
 gout, however, are sometimes so severe, 
 that patients would be glad to have the 
 reputation without the pain; and the 
 sudden and fatal termination which it 
 sometimes has, render its presence in the 
 constitution by no means enviable. Gout 
 is one of the diseases obviously transmit- 
 ted by inheritance, and the facts observed 
 on this subject are curious and important. 
 A parent who, by high living, has made 
 himself the subject of gout, transmits the 
 
GOUT. 
 
 287 
 
 gouty tendency to his temperate son, who 
 may suffer severely by it ; or, by rigid ab- 
 stinence and care continued through a 
 long life, may escape its violence ; and in 
 his turn may transmit it to his descend- 
 ants, of whom, not the immediate, but a 
 subsequent race may become the innocent 
 victims of the disease. 
 
 Symptoms. The symptoms considered 
 as characterising gout are the following : 
 The patient has a peculiar uneasiness 
 about the stomach, there is a degree of 
 fever ; pain and inflammation attack the 
 joints of the hands and feet, and princi- 
 pally the ball of the great toe ; the fever- 
 ish symptoms abate after some days, and 
 at distant and uncertain intervals, the 
 same series of symptoms again occurs. 
 Such is the general outline of the gout, 
 but it will be necessary to go a little more 
 into detail. The paroxysms of gout ge- 
 nerally come on in spring, when the ver- 
 nal heat succeeds to the winter's cold; 
 and according as this takes place sooner 
 or later, and according as the patient is 
 exposed to the changes of temperature, so 
 the period of attack will vary. The pa- 
 tient is affected with a degree of languor 
 or heaviness, the functions of the stomach 
 are disturbed ; there is loss of appetite, 
 flatulence or indigestion, and those feel- 
 ings continue for some days before the 
 fit. There is an unusual coldness of the 
 feet and legs, with a numbness or prick- 
 ing sensation of the lower limbs, some- 
 times cramps of the legs or swelling of 
 the veins. The attack is sometimes felt 
 in the evening, but more commonly about 
 two or three o'clock in the morning. The 
 pain affects one foot, commonly in the ball 
 or first joint of the great toe. When the 
 pain comes on, there is more or less shi- 
 vering, and this is followed by a degree of 
 fever. The pain becomes more violent, 
 and continues, with great restlessness, for 
 four and twenty hours, when it consider- 
 ably abates, a gentle perspiration breaks 
 out, and the patient falls asleep. In the 
 morning, the pained part is affected with 
 redness and swelling, which in a few days 
 gradually abate. During those days, the 
 
 patient, though the pain be less, still has 
 a good deal of it, with feverishness during 
 the night; but at length the symptoms 
 all go off, leaving the health of body and 
 mind much improved ; nor do they return 
 till after a long interval. This interval 
 may be three or four years, that is, when 
 the disease is recent ; but unless certain 
 measm-es are taken, and a proper course 
 of life is led, those intervals diminish, the 
 patient may be attacked once in two 
 years, or once every year, or may be 
 brought to such a state as never to be 
 entirely free from some gouty symptom 
 or other. At first, one foot only is af- 
 fected; afterwards, in each paroxysm, 
 both feet are affected, the one after the 
 other; and at length it not only affects 
 both feet at once, but often, when it has 
 abated in one, it suddenly darts into it 
 again, and changes place not only from 
 one foot to the other, but also from the 
 feet to the other joints. When the dis- 
 ease has returned often, the pains are 
 commonly less violent than at first, but 
 the sickness and certain other symptoms 
 hereafter to be described, are worse. Af- 
 ter a paroxysm of gout, the joints recover 
 their motion; but after repeated parox- 
 ysms, they become weak and stiff"; and 
 in violent and oft repeated attacks, they 
 lose the power of motion altogether. In 
 many persons, chalky concretions form 
 on the outside of the joints, immediately 
 under the skin. They are composed of 
 uric acid and soda. The uric acid is the 
 principal ingredient in various calculous 
 concretions in the kidneys and bladder ; 
 and we find that gouty persons are sub- 
 ject to affections of the kidneys; and that 
 in gouty families it is not unfrequent for 
 the males to be affected with gout, and 
 the females with diseases of the kidneys. 
 The symptoms above described may be 
 regarded as a general view of the Regular 
 Gout ; but physicians have distinguished 
 several other forms of the disease, which 
 they term the Irregular Gout. It may 
 happen to a gouty patient, that from some 
 cause or other, he may not have the in- 
 flammatory affection of the joints, but va- 
 
€88 
 
 GOUT. 
 
 rioiis morbid actions of the stomach, as 
 flatulency, loss of appetite, indigestion, 
 and pain. These symptoms are accom- 
 panied by pains and cramps in different 
 parts of the body, which are relieved by 
 the discharg-e of wind from the stomach. 
 Sometimes there is costiveness, sometimes 
 the belly is loose. Such symptoms are 
 attended with great depression of spirits, 
 and with an anxious and fearful attention 
 to the slig-htest feelings of pain. Some- 
 times the chest is affected, and palpitations 
 of the heart, faintings, or asthma, occur ; 
 and the head is affected with giddiness, 
 pain, and a tendency to apoplectic symp- 
 toms. These symptoms are to be consi- 
 dered as gouty, when they occur in a gouty 
 constitution, and especially when there is 
 mixed with them some inflammatory ten- 
 dency to the parts usually affected, or 
 when they are relieved by the inflamma- 
 tion coming on. 
 
 Another form of gout is, when there has 
 been inflammation in the joints as usual, 
 but when it has suddenly receded, and 
 some internal part has become affected. 
 This is most commonly the stomach ; and 
 this may be attacked with such violence 
 as to occasion the most acute symptoms, 
 vomiting, pain, or sudden death ; and 
 other internal parts may be affected, oc- 
 casioning fainting, or asthma, or apoplexy. 
 In some cases, instead of inflammatory af- 
 fections of the joints, inflammation of 
 some other parts may come on ; and in 
 such cases the inflammation must be treat- 
 ed as it would be when arising from any 
 other cause. 
 
 Diagnosis. There are many symptoms 
 of gout which bear a great resemblance 
 to those of rheumatism j and it is not at 
 all unusual for the two diseases to attack 
 the same individual ; but the habit of the 
 patient, the season of the year, and the 
 recurrence of the attack, will generally 
 determine whether it is the gout or not. 
 
 Who are most subject to Gout. The 
 gout attacks chiefly men of large and ro- 
 bust bodies, of large heads, of corpulent 
 habits, wlio lead an indolent life, and in- 
 dulge in the pleasures of tlie table. It 
 
 seldom attacks persons who live by bodily 
 labour, or who are temperate in their diet, 
 either from choice or necessity- It rare- 
 ly makes its appearance before the age of 
 thirty-five, except in those who have an 
 exceedingly strong hereditary tendency 
 to it. Females are more rarely subject to 
 gout, and it is chiefly those whose consti- 
 tutions resemble that of the other sex, or 
 Avho are born of gouty parents, that are 
 thus subject. 
 
 Causes of Gout. In those who, by he- 
 reditary constitution or luxurious living, 
 have a tendency to gout, it is brought on 
 by various circumstances which induce 
 debility, as excessive bodily indulgence, 
 gluttony, or intoxication; much appli- 
 cation to study or business, depress- 
 ing passions, as grief or fear, great eva- 
 cuations, as by bleeding or purging, too 
 sudden an abridgement of the diet; a 
 cessation from the laboiu* or exercise to 
 which a person has been accustomed; cold 
 or damp applied to the feet- The proxi- 
 mate cause of gout, or what it is in the 
 body that constitutes gout, has been the 
 subject of much discussion among physi- 
 cians. It would be unprofitable to detail 
 their various opinions here, but we may 
 remark, that it seems now to be generally 
 agreed, that the gout is not owing to any 
 acrid matter always existing in the sys- 
 tem, and thrown out on particular parts 
 by certain causes ; but that it is a disease 
 affecting the nervous system or moving 
 powers ; though the further explication 
 of it may be difficult or impossible. 
 
 Cure of Gout. As the gout depends 
 on an original conformation ; as it is ge- 
 nerally the visitor or attendant of its vic- 
 tims during a long life ; as one drug af- 
 ter another has enjoyed and lost the re- 
 putation of curing it, the opinion is very 
 general that it is incurable, and notwith- 
 standing all that has been done, and done 
 for those classes of society who ai'e best 
 able to reward the restorers of their 
 health, we must still say, that mere me- 
 dicine can do but little for the gout. The 
 sensible observations of Dr. CuUen, made 
 fifty years ago, are applicable in all their 
 
GOUT. 
 
 289 
 
 force to the present day. " It would per- 
 haps have been happy for g-outy persons, 
 if the opinion of the impossibility of a 
 cure had been implicitly received by 
 them ; as it vrould have prevented their 
 being so often the dupes of self-interest- 
 ed pretenders, who have either amused 
 them with inert medicines, or have rashly 
 employed those of the most pernicious 
 tendency. I am much disposed to believe 
 the impossibility of a cure of the gout by 
 medicines; and more certainly still, incline 
 to think, that whatever may be the possible 
 power of medicines, yet no medicine for 
 curing the gout has hitherto been found. 
 Although almost every age has presented 
 a new remedy, yet all hitherto offered 
 have very soon been either neglected as 
 useless, or condemned as pernicious." 
 The cure of gout, if it be curable at aU, 
 is to be effected solely by the early prac- 
 tice of activity and labour, joined with 
 temperance and moderation both in eat- 
 ing and drinking. That even this Mill 
 do, in the strongly predisposed, is by 
 no means certain ; but it is undoubtedly 
 true, that free living will, in such, ensure 
 the attacks of this painful disease. Could 
 the occasional use of any drug, however 
 nauseous, dispense with the necessity of 
 abstinence and temperance, multitudes 
 would willingly compound on these terms; 
 but no such di'ug has yet been found, 
 and for much of the treatment, the pa- 
 tient must minister to himself. But as 
 paroxysms of the gout will occur in many 
 individuals, and require whatever aid the 
 medical art can afford them, we must 
 not spend our pages in moralizing, but 
 proceed to state what can be done for 
 their relief. In the time of the paroxysm, 
 all excitement must be avoided, and the 
 antiphlogistic plan is to be put in practice ; 
 and though the application of cold is ra- 
 ther of a hazardous nature, some modern 
 physicians have had the boldness to at- 
 tempt it. It has not come into very gene- 
 ral use ; and when we consider how very 
 fatal the gout commonly is, when it re- 
 cedes spontaneously towards the internal 
 parts, we shall certainly be very cautious 
 
 how we repel it by cold in any form. All 
 irritation should be kept from the patient, 
 and the temper should be soothe-d as 
 much as possible. He should remain in 
 bed, and keep the pained parts moderate- 
 ly warm by the application of flannel or 
 fleecy hosiery. Animal food should for 
 the time be avoided, and the drink should 
 be mild and diluent, as barley-water, gruel, 
 or tea. In those who are weak, and who 
 have been in the habit of using a gene- 
 rous diet, it might not be safe to retrench 
 too much; and therefore they, even in 
 the paroxysms, are to be allowed a diet, 
 in some degree nourishing and stimu- 
 lant. Madeira and sherry are the wines 
 most proper to be used. To lessen the 
 fever, blood-letting, rarely general, but 
 sometimes topical, has been recommend- 
 ed. In this practice, regard must be had 
 to the state of the patient's constitution, 
 and the degree of inflammatory symptoms 
 that may be present, and to the import- 
 ance of the part so affected ; and bleed- 
 ing, general or local, is to be employed 
 accordingly. Warm bathing and poul- 
 tices to the part have been tried, but 
 they are not always safe ; and these, as 
 well as some other external applications, 
 have too often the effect of driving the 
 gout to the internal parts. It appears, 
 therefore, that upon the whole, our prac- 
 tice during the paroxysm consists chiefly 
 in negatives ; and that rest and patience, 
 and gentle warmth, constitute the whole 
 of the solace that art can furnish or pre- 
 scribe. Opium, the ready reliever of pain, 
 naturally suggests itself; but it is not safe 
 till the first violence of the pain sub- 
 sides ; and then it may be given to allay 
 the restlessness and irritation which pre- 
 vent sleep. If the parts affected remain 
 swelled and stiff, the flesh brush and mo- 
 derate exercise are to be employed to dis- 
 cuss these swellings. 
 
 Such is the safest treatment during a re- 
 gular fit of the gout; we must now mention 
 what is to be done, when its attacks assume 
 a different form. When the gout affects 
 the stomach and intestines with cramp and 
 griping, active stimulants must be imme- 
 u 
 
290 
 
 GOUT. 
 
 diately used, as strong wine, taken warm 
 or mulled ; and if these are not powerful 
 enough, brandy, or other ardent spirits, 
 must be freely given. Opiates, joined 
 M'ith hartshorn or camphor, are useful ; 
 and musk also may be given. Tf vomit- 
 ing comes on, it may be encouraged till 
 the stomach is emptied ; we are then to 
 employ opiates and the other remedies 
 mentioned above. If there be a loose- 
 ness, it may be encouraged by drinking 
 warm gruel or weak broth; and when 
 the bowels are quite unloaded, opiates 
 are to be given. Purging must be 
 avoided at the end of a fit, as it often 
 brings on a return. When there is asth- 
 ma in gouty patients, a blister to the 
 back or breast is to be put on. If the 
 head be affected, the danger is great ; but 
 we are to try what can be done by blis- 
 ters to the head, or bleeding, as we think 
 the patient can bear it. When the gout 
 makes its appearance as an inflammatory 
 affection on some of the internal parts, 
 we are to lay aside the consideration of 
 its being gout, and to treat the inflamma- 
 tion as if it arose from any other cause ; 
 taking care not to weaken the patient 
 too much by violent evacuations, espe- 
 cially by purging. When the gout, at its 
 usual time, does not assume the regular 
 form, but only some imperfect actions of 
 the system mark the effort which is mak- 
 ing to throw it out, care must be taken 
 to avoid every thing of a weakening na- 
 ture, and to strengthen the stomach and 
 system in general by nourishing digesti- 
 ble diet, by a moderate allowance of wine, 
 and by the use of chalybeates, the Peru- 
 vian bark, and bitters. 
 
 It would not be easy to enumerate all 
 the drugs and compositions which have 
 been fashionable for the cure of gout. 
 One very famous article, some time ago, 
 in England, was the Portland Powder, 
 a compound of equal parts of the roots 
 of round birth wort and gentian ; of the 
 leaves of germander and ground pine, 
 and of the tops of the lesser centaury, 
 all dried. Of this powder, composed of 
 various bitters. Dr. Cullen has this very 
 
 alarming notice. " In every instance 
 which I have known of its exhibition for 
 the length of time prescribed, the persons 
 who had taken it were indeed afterwards 
 free from any inflammatory aflfection of 
 the joints, but they were affected with 
 many symptoms of the atonic gout, (that 
 is, of gout in which there did not appear 
 to be strength enough to produce a regu- 
 lar fit, and in which, therefore, some of 
 the internal parts were affected) ; and 
 all, soon after their finishing their course 
 of the medicines, have been attacked 
 with apoplexy, asthma, or dropsy, which 
 proved fatal." The remedy at present 
 most in vogue is the Eau medicinale 
 d'Husson; and this has the commenda- 
 tions of so high authority as Sir Everard 
 Home. But the most judicious physi- 
 cians seem to be convinced, that whatever 
 may be the present apparent benefits 
 derived from the use of those specifics 
 in gout, they at last bring on the most 
 pernicious effects. 
 
 There are many curious incidents re- 
 corded of the gout having been cured by 
 strong mental emotions ; as when a person 
 in gout thinking himself unable to move, 
 has been alarmed by his house taking fire ; 
 and having made successful exertions to 
 escape, has continued free from gout ever 
 after ; or when there has been a call for ac- 
 tivity and usefulness in repelling the at- 
 tacks of an enemy, the pain of gout has 
 been overpowered by a more animating 
 and generous feeling. 
 
 Management of Gouty Persons dur- 
 ing the interval of the paroxysms. Our 
 great object should be to prevent their 
 return, or to render them less severe and 
 less frequent; and for this purpose, va- 
 rious observances are to be attended to. 
 As already often inculcated, abstinence 
 and temperance are the great preventives 
 of gout ; and in those who know them- 
 selves to have a hereditary tendency to 
 it, or who have already had one or more 
 attacks, such abstinence must be steadily 
 persevered in. Labour or exercise is also 
 of essential importance; but care must 
 be taken that it is not too violent, as the 
 
GRE 
 
 GRU 
 
 291 
 
 consequent fatigue is likely to brin<f on 
 the g-ont. The diet should consist of 
 such articles as convey sufficient nourish- 
 ment, without g"iving a tendency to the 
 plethoric or inflammatory state. For 
 this purpose, if an abstemious course be 
 ,early begun, the proportion of animal 
 food should be very small ; but in those 
 who have accustomed themselves to pretty 
 full living, too great a diminution of ani- 
 mal food may induce a debility that will 
 make the gout worse. Fermented and 
 spirituous liquors are unnecessary, unless 
 where the patient has been long in the 
 habit of taking them ; and where the con- 
 stitution and digestion are good, water is 
 the most proper drink. It is found that it 
 will not promote the desired object, if a 
 person only for a short time practises 
 the labour and abstemiousness enjoined; 
 but that it must be begun early, and per- 
 severed in through life. 
 
 GRAVEL. See Stone and Gravel. 
 
 GREEN SICKNESS. .See Chlorosis. 
 
 GREGORY'S MIXTURE, or Grego- 
 ry's Powder. A useful laxative powder, 
 composed of equal parts of calcined magne- 
 sia, powdered rhubarb, and ginger ; a fa- 
 vourite prescription of the late Dr. Grego- 
 ry of Edinburgh. He considered it as pos- 
 sessing various good properties, the magne- 
 sia correcting acidity, the rhubarb acting 
 as a tonic and laxative, and the ginger be- 
 ing a good aromatic for the stomach, and 
 preventing griping of the bowels. The 
 dose of this compound powder is one or 
 two drachms, or a heaped tea-spoonful ; 
 and it may be taken in water, in gruel, 
 milk, or any vehicle that may be most con- 
 venient. It generally operates easily and 
 effectually, and may be taken at anytime of 
 the day. The dose may be repeated after 
 an interval of four or six hours, if the first 
 does not produce its proper effect. Some- 
 times it may be advisable, especially for 
 children, to omit the ginger, and to give 
 simply a mixture of rhubarb and magne- 
 sia, in the dose of a small tea-spoonful. 
 
 GRIPES. Painful spasmodic twitches 
 of the bowels, which accompany various 
 disorders, and also the operation of some 
 
 purgative medicines. They are attend- 
 ants on colic, of which, indeed, they are 
 the principal symptom; in looseness of 
 the bowels, the frequent stools are com- 
 monly preceded by severe gripes ; and a 
 great part of the sufferings of children 
 proceed from griping in the bowels. As 
 gripes are to be regarded rather as a 
 symptom of disease, than a disease itself, 
 our attention is to be directed to the cure 
 of the primary affection ; but sometimes 
 the severity of the pain is so great, that 
 we are compelled to do something for its 
 relief, even at the risk of aggravating for 
 a time the original complaint. For this 
 purpose, we may cautiously give an opiate, 
 or some carminative medicine, apply fo- 
 mentations to the belly, or give anodyne 
 injections. To children, when scream- 
 ing from the pain of gripes, which we 
 judge to be the case when they twist 
 about the body and draw up the feet, at 
 the same time crying much, we may give 
 a few drops of laudanum, or a little ^veak 
 gin and water, or a little sugar of anise. 
 To prevent the griping which accompa- 
 nies the operation of senna and some 
 other medicines, M'e may combine with 
 them some aromatic powder, as ginger 
 or cinnamon. 
 
 GRUEL. A decoction of some of the 
 farinaceous vegetables in water,much used 
 as a mild and diluent drink in a great va- 
 riety of diseases. Though insipid to those 
 who are in robust health, it is a very plea- 
 sant beverage to those who are sick, and 
 it is a pity that many of them tire of it 
 so soon. It is very useful in all feverish 
 disorders, in catarrh or common cold, and 
 in diseases of the boAvels. To secure the 
 excellence of this valuable article, we give 
 from Dr. Kitchener the best recipe for 
 preparing it. " Ask those who are to eat 
 it, if they like it thick or thin ; if the lat- 
 ter, mix well together by degrees, in a 
 pint one table-spoonful of oatmeal, with 
 three of cold water ; if the former, use 
 two spoonsful. Have ready in a stewpan 
 a pint of boiling water or milk, pour this 
 by degrees to the oatmeal you have mix- 
 ed, return it into the stewpan, set it on 
 
292 
 
 GUA 
 
 GUL 
 
 tlie fire, and let it boil for five minutes, 
 stirring it all the time to prevent the oat- 
 meal from burning at the bottom of the 
 stewpan. Skim and strain it through a 
 hair sieve." {Cook's Oracle.) Water- 
 gruel, as the Doctor quotes from an old 
 book, is the king of spoon-meats, and the 
 queen of soups, and gratifies nature be- 
 yond all others. 
 
 GUaIAC, Guaiacum officinale. The 
 name of a plant, from which there exudes 
 in the form of tears, a resin M^hich has 
 been long esteemed a good remedy in 
 chronic rheumatism, in certain syphilitic 
 symptoms, as foul indolent ulcers, in some 
 diseases of the skin, and scrofulous affec- 
 tions of the membranes and ligaments. 
 The resin excites a sense of warmth in 
 the stomach, and a thirst and dryness of 
 the mouth ; and produces perspiration if 
 the patient be kept warm. It may be given 
 in the form of pills, in the dose of ten to 
 twenty grains in the day : Or one or two 
 drachms of the tincture may be given, 
 but not in water, as from its resinous qua- 
 lity it immediately becomes white and 
 thick when it reaches the water, to the 
 great surprise and disgust of the patient ; 
 for this reason, it had better be given in 
 a little milk. The decoction of the wood 
 of guaiac is a form of giving it, much used 
 in foul ulcers. The dose of the decoction 
 is from two to four ounces. There is 
 also a tmcture of guaiac combined with 
 hartshorn, which possesses more of the 
 stimulant and sudorific properties, and 
 may be talien to the extent of a drachm 
 or two; when the dose of guaiac is larger 
 than those above mentioned, it proves 
 purgative. Mr. Brande says that combi- 
 nations of guaiac are at all times liable to 
 change their colour, especially when com- 
 bined with sweet spirits of nitre; and 
 they are often prescribed together, form- 
 ing a perfect vegetable cameleon, a cir- 
 cumstance which should be explained to 
 the patient, who may otherwise be alarm- 
 ed at the non-identity of his medicine. 
 Mr. Brande thinks but lightly of the 
 power of the decoction in ulcers or cuta- 
 neous cases. 
 
 GUINEA WORM, Gordius medinen&is. 
 A small white worm, with a black head, 
 which is found in different parts of the body, 
 between the muscles and cellular mem- 
 brane. The disease chiefly occurs in ne- 
 groes who are brought from the coast of 
 Africa, or Europeans who have lately re- 
 turned from that place, and is supposed to 
 arise from bathing in the ponds or wells, or 
 drinking of the water in which the small 
 worms are deposited. They are probably 
 caused by the embryo worms getting into 
 different parts of the body, and forming a 
 nest for themselves till they acquire a con- 
 siderable size. The Guinea worm does not 
 at first occasion any acute pain, but rather 
 an itching, and on inspection a small blis- 
 ter is perceived. At length, as it advances, 
 the part becomes swelled, inflamed, and 
 painful to the touch, and breaks at last, 
 when the head of the worm protrudes, 
 and in a little time it may be laid hold of. 
 By breaking the worm, from being in too 
 great a hurry to extract it, ulcers are 
 sometimes formed. When the swelling 
 is hard, a poultice should be applied. 
 When it breaks, and the head of the worm 
 can be taken up, it is proper to make a 
 small roll of cotton, to which the worm 
 is to be tied, and this twisted round a 
 little every day, till the whole is brought 
 out. The sore is then to be dressed in 
 the usual way, as from any other cause. 
 
 GULLET, called in anatomy (Esopha- 
 gus. At the back part of the mouth 
 there are two passages downwards; the 
 anterior is that which leads into the 
 wind-pipe ; and the posterioris the pha- 
 rynx or commencement of the gullet^ 
 by which the food and other substan- 
 ces pass into the stomach. The gullet 
 consists of several coats, one of which 
 is muscular, being furnished with orbicu- 
 lar fibres, and above those, with longitu- 
 dinal ones ; in consequence of whose ac- 
 tion, the different portions of the gullet 
 contract successively, and the passage is 
 for the time closed above the descending 
 morsel. The innermost coat is covered 
 with mucus, secreted by numerous glands 
 whose orifices open on its surface. This 
 
GULLET. 
 
 293 
 
 mucus frequently concretes during the 
 liight, and is with difficulty brought up. 
 It may proceed from improper diet or 
 heavy suppers ; and diluent drinks, alter- 
 ation of the offending diet, with absti- 
 nence from supper, or taking a very light 
 one, will probably correct this trouble- 
 some occurrence. 
 
 Of Swallowing, The morsel is col- 
 lected on the upper surface of the tongue, 
 is squeezed against the bony palate, and 
 then carries the soft palate backward and 
 upward ; the pharynx meets it, the tongue 
 keeps close to the soft palate, and by this 
 action, the epiglottis shuts the chink of 
 the larynx. May we here be indulged 
 in the following quotation from Dr. Pa- 
 ley ? " Both the weight of the food, and 
 the action of the muscles concerned in 
 swallowing, contribute to keep the lid 
 close down upon the aperture, whilst any 
 thing is passing; whereas, by means of 
 its natural cartilaginous spring, it raises 
 itself a little, as soon as the food is passed, 
 thereby allowing a free inlet and outlet 
 for the respiration of air by the lungs. 
 Such is its structure : And we may here 
 remark the almost complete success of the 
 expedient, viz. how seldom it fails of its 
 purpose, compared with the number of 
 instances in which it fulfils it. Reflect 
 how frequently we swallow, how con- 
 stantly we breathe. In a city-feast, for 
 example, what deglutition, what anhela- 
 tion ! Yet does this little cartilage, the 
 epiglottis, so effectually interpose its of- 
 fice, so securely guard the entrance of the 
 wind-pipe, that whilst morsel after mor- 
 sel, draught after draught, are coursing 
 one another over it, an accident of a crumb 
 or a drop slipping into this passage (which 
 nevertheless must be opened for the breath 
 every second of time), excites in the whole 
 company, not only alarm by its danger, 
 but surprise by its novelty. Not two 
 guests are choked in a century." 
 
 The power of swallowing is impeded or 
 lost, from various causes, as from an ul- 
 ceration of the gullet destroying the con- 
 tinuity of the circular fibres ; thickening 
 pf the mucus, strictures of the passage 
 
 from spasms or from growths in it, or 
 from bronchocele or other tumours press- 
 ing against its sides. 
 
 Gullet, Strictures of: Stricture is a 
 contraction of part of a tube or canal. The 
 most remarkable symptom of such contrac- 
 tion in the gullet is the difficulty of swal- 
 lowing, which is greater or less in propor- 
 tion to the obstruction. Sometimes no so- 
 lid food can pass down, and fluids only with 
 great difficulty, and in very small quanti- 
 ties. Sometimes there is pain extending to 
 the ear, returning at intervals, and conti- 
 nuing for a considerable time, even where 
 there is no effort made to swallow. If 
 the stricture be from a permanent cause, a 
 bougie passed downwards is stopped ; and 
 such strictures sometimes occasion ulce- 
 ration at a distance from themselves and 
 nearer the orifice of the stomach. Some- 
 times strictures are so complete, that it is 
 impossible for the patient to swallow any 
 thing whatever ; nourishment can be con- 
 veyed only by clyster ; and in general he 
 soon dies emaciated for want of food. 
 The only treatment possible is the passing 
 of a bougie through the stricture, if it will 
 admit of this, and employing one of larger 
 size in proportion as the dilatation of the 
 stricture will allow. Some surgeons ven- 
 ture on the introduction of a bougie 
 armed with some caustic substance. Li- 
 quid nourishment may be conveyed by a 
 hollow bougie. 
 
 Gullet, Strictures of from Spasm. 
 This is a very common symptom of hys- 
 terics; and when violent, must be relieved 
 by antispasmodics and anodynes, applied 
 both internally and externally. Mustard 
 poultices, ammonia, or other rubefacients 
 ai'e to be employed, and a blister may be 
 required; but if the threatening symp- 
 toms of apoplexy or of violent pain be pre- 
 sent, it may not be prudent to wait for its 
 operation, and we must open the jugular 
 vein or temporal artery. If the spasm be 
 occasioned by acrid or poisonous substan- 
 ces having been swallowed, the parts must 
 be sheathed by mucilages, oil, or milk ; and 
 we must guard against inflammation. The 
 bowels must be kept very open. 
 
294 
 
 GUM. 
 
 Gullet, Foreign bodies in. It is not 
 at all an uncommon occurrence for foreign 
 bodies to stick in the gullet, as pieces of 
 crust or meat not completely chewed, or 
 small bones, beans, stones, pins, or pieces 
 of money. Some of these would produce 
 a very bad effect if not quickly removed 
 from the gullet ; and perhaps still worse, 
 if pushed down into the stomach ; but 
 sometimes pretty large bodies have passed 
 downwards into the stomach, and have 
 been discharged by stool in a few days, 
 without any inconvenience. The con- 
 trivances for removing bodies which have 
 stuck in the gullet, must be left to the in- 
 genuity of the medical man who sees the 
 case. " Pins and other sharp bodies, 
 when they have stuck in the throat, have 
 been returned by swallowing a piece of 
 tough meat tied to a strong thread, and 
 then pulled up again. If the detained 
 body may be more safely pushed down, 
 the probang, a flexible piece of whale- 
 bone, with a pieee of sponge secured to 
 its end, is a safe instrument. If the bo- 
 dies cannot be easily moved up or down, 
 endeavours should not be continued long, 
 lest inflammation come on. When endea- 
 vours fail, the patient must be treated as 
 if labouring under an inflammatory dis- 
 ease, and the same treatment will be re- 
 quired if an inflammation take place in 
 the part, after the obstructing body is re- 
 moved. A proper degree of agitation has 
 sometimes succeeded in removing the ob- 
 structing body, better than instruments. 
 Thus, a blow on the back has often forced 
 up a substance that stuck in the gullet or 
 wind-pipe. Pins which have stuck in 
 the gullet have been discharged by riding 
 on a horse or in a carriage. In the Lon- 
 don Medical Transactions, is an account 
 of a crown-piece which a man swallowed. 
 An emetic was given, but without dis- 
 charging the piece, which, after twenty 
 months, was brought up by spontaneous 
 vomiting." (Dr. Parr.) If the respira- 
 tion is dangerously impeded, it will be ne- 
 cessary to make an opening into the wind- 
 pipe ; the method of doing which is stat- 
 ed under the article Bronchotomy. 
 
 GUM. A thick, transparent, tasteless 
 fluid, which exudes from certain species 
 of trees. It is adhesive, and hardens with- 
 out losing its transparency, and is again 
 easily softened by the application of water. 
 The cherry-tree of this country exudes a 
 good deal of gum ; but what is known 
 by the name of gum arable is fur- 
 nished by various trees of the species 
 called Mimosa by Linnaeus, and Acacia 
 by Willdenow and later botanists. Gum 
 dissolved in water is an excellent mucila- 
 ginous demulcent, and is useful when we 
 wish to supply a deficiency of mucus in 
 the intestines, or to lessen any acrimony 
 in the wind-pipe during a cold, accompa- 
 nied with hoarseness and cough. For 
 these purposes, it may be given with a 
 little sugar to take away its insipidity, or 
 added to diluent drinks or cough mixtures. 
 Gum may be allowed to dissolve gradual- 
 ly in the mouth, by being taken in the 
 form of troches or lozenges, with a little 
 sugar and starch. 
 
 GUM. The name given to various af- 
 fections of the skin of infants. These 
 most commonly noticed are the red gum 
 and the yellow gum. 
 
 The Yellow Gum appears on a great 
 many children about the second day after 
 birth, and is in reality a species of jaun- 
 dice, from the absorption of bilious mat- 
 ter. It generally goes off in a few days 
 by the assistance of a mild purgative, as 
 a little castor oil or manna. Sometimes 
 the yellow gum is a more severe and dan- 
 gerous ailment. The skin is of a deep 
 yellow colour, there is great drowsiness 
 and insensibility, and the child is unable 
 to suck. Very active treatment is ne- 
 cessary. An emetic of ipecacuan is to be 
 given, and laxatives of castor oil, or jalap, 
 with frequent doses of manna. The child 
 may be put into the warm bath, and the 
 spine and abdomen rubbed with a stimu- 
 lating embrocation. 
 
 IRed Gum. This name is applied to an 
 eruption of numerous little pimples, in- 
 termixed with red dots, and sometimes 
 with large red patches. There . are seve- 
 ral varieties of the gum which require 
 
GUMS. 
 
 29b 
 
 nearly the same general treatment. Some- 
 times it is very general over the whole 
 body like the measles ; in other cases, it 
 appeal's only on the face or extremities. 
 The infant does not seem to suffer a great 
 deal of uneasiness from this eruption, 
 which distinguishes it from measles, in 
 which there is much fever and general 
 disorder of the system. There is one va- 
 riety of the gum where the spots are of a 
 yellowish or pearly colour, much resem- 
 bling the itch, but certainly distinguished 
 from it by the disease not being commu- 
 nicated to those who are about the child. 
 The gum proceeds from an irritable state 
 of the bowels, and little medical treatment 
 is required, except to regulate the evacua- 
 tions. Tepid bathing may be employed, 
 and cold air and the cold bath are to be 
 avoided. The great danger to be dreaded 
 from the gum, is its being suddenly re- 
 pelled. This is followed by violent dis- 
 orders of the bowels, screamings, and in 
 some cases with fits. It is to be brought 
 back by warm bathing, and the bowels 
 are to be kept open by castor oil or other 
 mild purgatives. 
 
 There is a severe and dangerous inflam- 
 mation of the eyes, which the vulgar ac- 
 count for by saying the gum has fallen 
 into them. This explanation is altogether 
 absurd. The nature and treatment of the 
 disease will be found under Purulent 
 Ophthalmia, Art. Eye, Diseases of. 
 
 GUMS. The red compact substance 
 which covers both sides of that part of the 
 upper and lower jaw, in which the teeth 
 are fixed. This fleshy-like substance in- 
 sinuates itself between the teeth, and ad- 
 heres to them. The gums are well sup- 
 plied with nerves and blood-vessels. Hence 
 their sensibility and bright red appearance. 
 Gums, Diseases of. The gums are 
 apt to become soft and spungy, and to 
 separate from the teeth. This is parti- 
 cularly the case, when the tartar which 
 is deposited from the saliva is in great 
 quantity, and incrusts the teeth. When 
 this is removed, the gums soon get well ; 
 and their firmness is promoted by pro- 
 per washes, as of the tmcture of myrrh, 
 
 or infusion of roses. A good wash for the 
 gums may be made by dissolving a drachm 
 of alum in a pint of water, and adding two 
 or three ounces of the infusion of roses. 
 Sea-scurvy, orthat disease which is brought 
 on by the long continued use of salt pro- 
 visions without a due admixture of ve- 
 getables, exerts its influence very conspi- 
 cuously on the gums; and frequently when 
 no other symptom of the disease is mani- 
 fest, it is to be detected by its appearance 
 there. They become soft and spungy, 
 and bleed on the slightest touch. Appli- 
 cations to the gums are of no avail, unless 
 vegetables, lime-juice, or other antiscor- 
 butics, are used for the cure of the con- 
 stitutional disease. As assistants to them, 
 tincture of myrrh, or diluted muriatic 
 acid, may be employed as a wash for the 
 gums. 
 
 Of scarifi/ing the Gums of lisFATiTS. As 
 the gums are firm and compact, and com- 
 pletely cover the teeth in early infancy, 
 the stretching of the gums, as dentition 
 advances and the teeth are near cutting, 
 is productive of much irritation to the 
 tender constitution of the young subject. 
 To be convinced of this, we have only to 
 think of the distress occasioned by a thorn 
 in the cellular substance of grown-up 
 people, when it occasions inflammation 
 and suppuration to throw itself off, and 
 imagine how painful ten or a dozen such 
 instating bodies must be in the mouth of 
 a delicate infant. Many ailments are the 
 consequence of this state of the gums, fe- 
 ver, convulsions, looseness, swellings of 
 the neighbouring parts ; and many other 
 troublesome and dangerous symptoms are 
 often seen to attend it. Great relief is ob- 
 tained by cutting thoroughly down upon 
 the gum, till the teeth are touched by the 
 instrument ; and this must be completely 
 done by incisions crossing each other. 
 Generally the most urgent symptoms 
 quickly disappear ; and there is no occa- 
 sion to be afraid, that if the gum should 
 again grow over the teeth, the scar will 
 be peculiarly hard and firm, or that it will 
 be at all difficult to repeat the operation 
 if necessary. See Tkething. 
 
296 
 
 GUM 
 
 GUT 
 
 GUM-BOILS very generally arise 
 from toothach, occasioned by cold pro- 
 ducing inflammation in the hollow of 
 a spoiled tooth. Gum-boils are very 
 painful, and their inflammation extends a 
 considerable way, and produces much 
 swelling of the cheek or of the whole 
 face. Sometimes this complaint originates 
 in the socket of the tooth, or in the jaw, 
 without any connexion with the tooth. 
 The pain is somewhat relieved by keep- 
 ing warm fluids in the mouth, as boiled 
 milk or barley-water ; and if suppuration 
 cannot be prevented, we are to hasten it 
 by the application of a roasted fig or onion 
 to the gum, and bread and milk in a bag, 
 by way of poultice to the outside of the 
 cheek. When the abscess is formed, it 
 should be opened as soon as convenient j 
 and the poultice should be applied a day 
 or two longer j and the mouth is to be 
 washed three or four times a-day with 
 
 warm infusion of roses. If a decayed 
 tooth be the cause, the complaint will be 
 apt to return on any exposure to cold; 
 the tooth should therefore be stopped by 
 the dentist, or extracted if it is not likely 
 to be serviceable. 
 
 GUNSHOT WOUNDS, ^ee Wounds. 
 
 GUTTA SERENA, Suffusio nigra, 
 are names for that species of blindness 
 described under the diseases of the Eye, 
 termed Amaurosis or Black Cataract; 
 which is owing not to any apparent de- 
 fect of the eye as an optical instrument, 
 but to insensibility of the retina or optic 
 nerves. See page 253. 
 
 The above definitions will enable the 
 readers of poetry to understand what 
 Milton means, when, in the celebrated 
 complaint on his Blindness, he says, 
 
 So thick a drop sei'ene hath quenched their orbs. 
 Or dim suffusion veiled. 
 
 Paradise Lost, III. 25. 
 
 H 
 
 HAB 
 
 HABIT. This term, when applied to 
 corporeal subjects, signifies the effect of 
 frequent repetition in facilitating the per- 
 formance of certain motions or trains of 
 actions. A conspicuous illustration of 
 the power of habit, is seen in the practice 
 of musicians on various instruments. To 
 play on any of these, required at first 
 the closest attention to exert the power 
 of volition in directing the various mus- 
 cular motions required; but by habit, 
 those motions return in their proper or- 
 der, without the slightest apparent effort ; 
 and even while the performer can think 
 and talk on other subjects. When a child 
 begins to learn the art of reading, the 
 form of every letter, and the power of 
 every syllable demands his attention; 
 but in maturer years, the eye glances 
 over the page with the rapidity and cer- 
 tainty of instinct, and seizes the -words 
 before it, without the consciousness of 
 
 HAB 
 
 an effort. The effects of custom or 
 habit on the mind and body are interest- 
 ing in a metaphysical, ethical, and phy- 
 siological point of view. We are all the 
 creatures of habit, and our circles of ac- 
 tions, as Dr. Darwin calls tliem, return 
 with astonishing and noiseless regularity. 
 When the time of meals or of sleep ar- 
 rives, though the stomach be not empty, 
 nor the limbs fatigued, though the mind 
 be occupied with other things, the usual 
 sensation of hunger or oscitancy comes, 
 and we feel the want of something to 
 which we have been accustomed. The 
 repetition of certain motions renders the 
 muscles that perform them quick and 
 strong, or delicate and steady in their ac- 
 tion ; hence the strength of the arm of the 
 blacksmith and back of the porter, the dex- 
 terity and skiU of the watchmaker or phi- 
 losophical instrument maker ; hence the 
 ease of the mechanical part of their art to 
 
HABIT. 
 
 297 
 
 the painter or sculptor ; and the steadiness 
 of the limbs and acuteuess of vision of the 
 mason and sailor, in th5 execution of their 
 perilous occupations. 
 
 Good habits, early begun, contribute 
 much to the preservation of the health. 
 Early rising, temperate meals, and regular- 
 ity in the alvine discharge, when early 
 practised, and diligently persevered in, will 
 give a degree of comfort and vigour, un- 
 known to the irregular and careless liver. 
 Infants can very soon be taught the habit 
 of feeding at regular times, and of per- 
 forming the usual evacuations. The ac- 
 tion of medicines on the living body is 
 much influenced by habit. A person who 
 is accustomed to take emetics or purga- 
 tives, requires after a time to have their 
 quantity increased ; and the opium-taker 
 and dram-drinker require their poison to 
 be increased either in quantity or activity, 
 to produce the usual effects. By habit, 
 the most nauseous substances lose their 
 disagreeable effects, and contagions lose 
 their power ; thus, the use of tobacco is 
 a luxury ; and the culprit has been known 
 to occasion fever in others, by bringing 
 contagion from his cell, where he himself 
 had been in the habit of inhaling it with 
 impunity. 
 
 The power of habit in prolonging 
 diseases, is remarkably seen in the case 
 of intermittent fevers, epilepsy, hysteria, 
 and hooping-cough ; and great part of 
 the cure consists in breaking the morbid 
 habits, and inducing healthy ones. This 
 is to be done in various ways, accord- 
 ing to the disease; in hooping-cough, 
 by change of air, by opiates, and eme- 
 tics ,; in hysterics, by furnishing interest- 
 ing employment for the mind and body 
 by conversation, reading, exercise, and 
 going on a journey; in epilepsy, by a 
 total change of diet, and a course of laxa- 
 tives, or other alterative medicines ; and 
 in intermittent fever, by postponing the 
 fits, and breaking the regular returns, by 
 bark, or other medicines; and by remov- 
 ing entirely from the neighbourhood of 
 places where marsh effluvia are known 
 to be prevalent. 
 
 HiEMATEMESlS. See Vomiting of 
 Blood. 
 
 HiEMATURIA. See Urine, Bloody, 
 
 H^MOPTOE, or Haemoptysis. See 
 Spitting of Blood. 
 
 HAEMORRHAGE, or Hemorrhagy. 
 A discharge of blood, either from the 
 rupture of blood-vessels, or the conse- 
 quence of accidental injuries, or of surgi- 
 cal operations. Though the word, strictly 
 speaking, signifies bleeding of any kind, 
 or by any means, it is more commonly 
 used to denote such discharges as are 
 attended with danger, and which we 
 would always stop if it were in our power. 
 
 Of Spontaneous ILemorrhagies. There 
 are many diseases of which the discharge 
 of blood is the most prominent and alarm- 
 ing symptom ; and immediately before 
 and after this article will be found the 
 medical names of several of them, with 
 reference to the places where their symp- 
 toms and treatment are detailed. 
 
 Physicians distinguish two kinds of 
 Haemorrhagies, the active and the passive ; 
 the first being chiefly from arteries, and 
 accompanied with feverish symptoms; 
 the latter being generally from veins, and 
 attended with general or partial debility. 
 The active hzemorrhagies are those which 
 are known in popular language by the 
 bursting of a blood-vessel ; and they occur 
 at particular periods of life. Thus a 
 Jbleeding of the nose, or a spitting of blood 
 from the lungs, is very common between 
 fourteen and twenty ; while haemorrhoids, 
 or bleeding piles, and the rupture of a 
 vessel within the skull occasioning fatal 
 apoplexy, are the affections of a later 
 period, as from thirty-five to sixty. These 
 discharges, taking place from particular 
 organs at certain periods of life, are be- 
 lieved to be connected with the circum- 
 stances attending the growth and develop- 
 ment of the different parts of the body. 
 " This growth consists, in a great mea- 
 sure, in the increase of the quantity of 
 fluids, and a proportional enlargement of 
 the containing vessels. But, at the same 
 time, the quantity of solid matter is also 
 gradually increased ; and it is probable, 
 
2m 
 
 HAEMORRHAGE. 
 
 that the progress depends upon the ex- 
 tension of the arterial system ; and the 
 motion of the blood in the arteries has 
 a constant tendency to extend them in 
 every dimension. As the state of the 
 animal solid is, at the first formation of 
 the body, very lax and jaeldin^, so the 
 extension of the system proceeds at first 
 very fast ; but as the extension gives oc- 
 casion to the apposition of more matter 
 to the solid parts, these are, in proportion 
 to their extension, constantly acquiring 
 a greater density, and therefore giving 
 more resistance to their farther extension 
 and growth. Accordingly, we observe, 
 that as the growth of the body advances, 
 its increase, in any given time, becomes 
 proportionably less and less, till at length 
 it ceases altogether. This growth does 
 not proceed equally in every part of the 
 body, it being requisite for the economy 
 of the system, that certain parts should 
 be first evolved, and should also acquire 
 their full bulk sooner than others. This 
 appears particularly with respect to the 
 head, the parts of which appear to be first 
 evolved, and soonest to acquire their full 
 size. As the vessels of the head grow 
 fastest, and soonest acquire their full size, 
 so they will soonest also acquire that 
 density which will prevent their further 
 extension." (Dr. Cullen.) The force 
 of the heart and the quantity of the fluids 
 with respect to the whole system remain- 
 ing the same, the distending powers con- 
 tinue to operate till they are brought 
 nearly to a balance with the resistance of 
 the solids; and after this, any increase 
 of the distending powers will readily 
 produce a rupture of vessels which do 
 not easily yield to extension. If there 
 be a plethoric state or excitement, while 
 the head is yet growing, the increased 
 quantity of blood will be especially deter- 
 mined to the head; and as the balance 
 between the distending and resisting 
 powers is there most nicely adjusted, the 
 determination of blood will most readily 
 produce a rupture of the vessels. Hence a 
 bleeding from the nose so frequently hap- 
 pens in yonng persons ; and in these more 
 
 readily, as they approach nearer to their 
 full growth. The reason why the haemor- 
 rhagy takes place from the nose rather 
 than from any other part of the head, is, 
 that a considerable net-work of vessels 
 is expanded on the internal surface of the 
 nostrils, and covered only with a thin 
 and weak membrane. In other persons 
 at the time of their body approaching its 
 acme, a spitting of blood or hsemorrhagy 
 from the lungs, takes place, when the 
 system of the aorta, or great vessel which 
 sends the blood through the body, has 
 reached its utmost extension and resist- 
 ance, and when the plethoric state of the 
 body especially affects the lungs ; although 
 these important organs are also in num- 
 berless instances affected from a faulty 
 proportion between their capacity and that 
 of the rest of the body, though there be 
 no general fulness of the system. 
 
 Symptoms of Active HrEMORRHAGV. 
 Perhaps these physiological remarks are 
 already too tedious and minute for the 
 general reader. We shall therefore pro- 
 ceed to describe the phenomena of haemor- 
 rhagies in general, from Dr. Cullen, to 
 whom we are indebted for much of the 
 preceding observations : " Haemorrhagies 
 happen especially in plethoric habits, and 
 to persons of a sanguine temperament. 
 They appear most commonly in the 
 spring, or in the beginning of summer. 
 For some time, longer or shorter in dif- 
 ferent cases, before the blood flows, there 
 are some symptoms of fulness and tension 
 about the parts from whence tlie blood 
 is to issiie. In such parts as fall under 
 our view, there are some redness, swell- 
 ing, and sense of heat or of itching; and 
 in the internal parts, from which blood 
 is to flow, there is a sense of weight and 
 heat; and in both cases, various pains 
 are often felt in the neighbouring parts. 
 When these symptoms have subsisted for 
 some time, some degree of a cold stage of 
 fever comes on, and a hot stage is formed, 
 during which the blood flows of a florid 
 colour, in a greater or lesser quantity, 
 and continues to flow for a longer oi 
 shorter time ; but commonly, after some 
 
HEMORRHAGE. 
 
 t99 
 
 time, the effusion spontaneously ceases, 
 and together with it, the feverishness 
 also. During the hot stage which pre- 
 cedes an haemorrhagy, the pulse is fre- 
 quent, quick, full, and often hard; hut, 
 as the blood flows, the pulse becomes 
 softer and less frequent. In haemorrhagies, 
 blood drawn from a vein, does, upon its 
 concreting, commonly show the gluten 
 separated, or a crust foraied, as in the 
 case of inflammations. Haemorrhagies, 
 from internal causes, haying once hap- 
 pened, are apt, after a certain interval, to 
 return ; in some cases very often, and 
 frequently at stated periods." 
 
 Occasional Causes. In those who are 
 predisposed to haemorrhagy, it is brought 
 on by external heat, violent exercise, 
 especially that which requires much exer- 
 tion of the function of respiration j anger, 
 and other exciting passions ; by postures 
 increasing the determination of the blood 
 to any weakened blood-vessels, or liga- 
 tures which cause its accumulation there. 
 Cold, by determining the blood to the 
 internal parts, may be the cause of 
 haemorrhagy. 
 
 Prevention and cure of Active Hae- 
 morrhagy. We are to prevent it by pre- 
 venting a plethoric state of the body, 
 which is to be done by abridging the 
 diet as to its quantity and stimulating 
 properties; the bowels are to be kept 
 open; and when disease seems impend- 
 ing, a bleeding may be taken from the 
 arm, but not repeated. When haemorrha- 
 gy has actually come on, we are to deal 
 with each particular kind of it, by its 
 appropriate remedies. In some haemor- 
 rhagies, the feverish symptoms are re- 
 lieved by the bleeding that occurs; but 
 we cannot always be sure that this will 
 happen, and the bleeding may take place 
 from a part so dangerous, that it is better 
 to take blood copiously from the arm. 
 This is particularly the case in haemor- 
 rhage from the lungs. In this, astrin- 
 gents also are useful, as the diluted sul- 
 phuric acid in cold water or in the in- 
 fusion of roses ; ten drops to fom- ounces 
 oH the liquid, a small winc-glassfiil to be 
 
 taken three times a-day. Solutions of 
 sugar of lead or alum may sometimes be 
 applied externally, as in bleeding at the 
 nose. Cold applied by means of cloths 
 soaked with some cooling lotion, is a pow- 
 erful means of repressing haemorrhage. 
 The bleeding stops when a person faints ; 
 and this occurrence, therefore, in profuse 
 haemorrhagies, is not to be prevented from 
 taking place. 
 
 O/* Passive HuHMORBHAGY. The month- 
 ly discharge of blood from the female 
 uterus is not to be considered as a dis- 
 ease ; but when it is much too copious, 
 and returns irregularly, or becomes con- 
 stant, it is the mark of a debility either 
 of the constitution or of the uterine sys- 
 tem ; and is to be treated as a passive 
 haemorrhagy. Habitual bleeding from 
 piles, discharges of blood by stool from 
 vessels bursting into the upper parts of the 
 intestinal canal, and the profuse bleed- 
 ings which sometimes take place in scur- 
 vy, are examples of passive haemorrhagy. 
 They are to be cured by strengthening 
 the system, and relieving the original 
 disease. 
 
 Of HEMORRHAGE from Wounds and 
 Surgical Operations. As profuse bleed- 
 ing is a conspicuous and dangerous oc- 
 currence, whether induced by accident or 
 by the instruments of the surgeon, it has 
 in all ages attracted much attention. *« An 
 instinctive terror," says a French author, 
 " is associated with the idea of the loss of 
 blood; a terror of which the infant just 
 beginning to speak, and the most deter- 
 mined man, are alike susceptible. One 
 cannot say that this fear is chimerical. 
 Of those who perish on the field of battle, 
 three-fourths die in consequence of hae- 
 moiThage ; and in all the great operations 
 of surgery, this accident is the most for- 
 midable that occurs." The fear of hae- 
 morrhage was the great obstacle to the 
 improvement of surgery among the an- 
 cients. As they were unacquainted with 
 the method of stopping the flow of blood 
 from arteries of any considerable size, 
 they used caustic and ligatures for the 
 performance of operations, M'hich aro 
 
300 
 
 II iE M O 11 R H A G E. 
 
 now easily and safely executed with the 
 knife. Blood may flow profusely either 
 from a wounded artery or a M^ounded 
 vein ; but the danger of arterial hsemor- 
 rhage is far greater than that of venous, 
 on account of the rapidity and force with 
 which the blood is propelled through the 
 arteries; a wounded artery, not larger 
 than a crow-quill, is sufficient to evacuate 
 all the blood of the body in a few minutes. 
 When the artery is wounded, blood of a 
 bright scarlet colour issues from it by 
 jerks, with great rapidity. The blood 
 flows from a vein in an even and unbroken 
 stream, and of a dark purple colour. 
 
 Process of Nature iji suppressing H^> 
 MORRHAGE. When an artery of no very 
 great size is cut across, after the blood 
 has flowed some time, it ceases, in con- 
 sequence of the diminished force of the 
 circulation allowing a clot to be formed, 
 which shuts up the mouth of the ves- 
 sel. The cut end of the artery next in- 
 flames, and a lymph is poured out which 
 fills up its extremity, and is firmly united 
 all round to the internal coat of the ves- 
 sel. The impervious extremity of the 
 artery gradually contracts till its cavity 
 is completely obliterated, and its coats as- 
 sume the appearance of a ligament. When 
 an artery is merely punctured or partially 
 divided, the bleeding is less likely to stop 
 spontaneously than when cut fairly across. 
 
 Surgical Methods of suppressing Hae- 
 morrhage. 1. Applying the actual cau- 
 tery to the cut vessel, and part of the 
 surrounding flesh. An eschar was form- 
 ed, which blocked up the opening of 
 the vessel. If this eschar separated too 
 soon, there was great danger of a re- 
 newal of the haemorrhage, in a degree 
 more dangerous and difficult to suppress 
 than before the cautery was applied. 
 This method of stopping bleeding was a 
 good deal employed by the ancients ; but 
 is now scarcely used, except in bleed- 
 ings from the mouth and neighbouring 
 parts, which cannot be checked by any 
 other means. 2. Styptics and astrin- 
 gents, as blue vitriol, alum, solutions of 
 the salts of iron, diluted acids, turpen- 
 
 tine, have all been employed with the 
 view of checking haemorrhage. They 
 are quite inefficient when any consider- 
 able artery is wounded ; but they may be 
 useful when there is merely an oozing of 
 blood from the minute vessels of a large 
 surfoce. The same remark applies to 
 cold, which is a powerful astringent. 
 Agaric, a spongy substance which grows 
 on old oaks, and sponge itself, have also 
 been employed ; they probably do not act 
 as astringents, but by forming a plug to 
 the vessel when they swell from the im- 
 bibing of moisture. 3. Compression of 
 the sides of the bleeding vessel, of course 
 stops the bleeding for the time ; and 
 could it be continued long enough, would 
 frequently accomplish a permanent clo- 
 sure of the vessel. It is tried sometimes, 
 M'hen we can press the artery against a 
 bone ; as at the hand or the arm, when 
 an artery has been woundrd in phleboto- 
 my; but the instances of success have 
 not been so numerous as to warrant 
 much confidence in the practice. 4. A li- 
 gature, or thread of silk of various thick- 
 ness tied round an artery, effects a per- 
 manent closure of it in the following 
 manner. The arteries are composed of 
 three coats; of which the internal and 
 middle are cut through by the ligature as 
 if it had been done with a knife. The 
 wounded surfaces are brought together, 
 a clot of blood commonly forms just with- 
 in the artery, inflammation is excited on 
 the internal and middle coats, lymph is 
 poured out, by which the wounded sur- 
 faces are united, and the canal rendered 
 impervious ; in short, the same process 
 takes place as already described, the only 
 difference being, that the ligature origi- 
 nates the process with more certainty 
 than the spontaneous efforts of nature. 
 Ligatures are made of silk or strong 
 threads, joined together with white wax. 
 They should not be too broad, otherwise 
 they will not cut the internal coats of the 
 artery as they ought to do. Ligatures 
 drop off from the largest arteries within 
 a fortnight or three weeks after they ai'e 
 applied; and the artery continues shut 
 
II A I R. 
 
 301 
 
 for ever after. The force of the heart 
 impels the hlood into the neig^hhouring' 
 vessels, and enlarj^es them sufficiently for 
 all the purposes of growth and nourish- 
 ment, and the limb or stump suifers no 
 permanent inconvenience from the obli- 
 teration of the original artery. 
 
 Without inquiring into the guesses and 
 approximations of the ancients on this 
 subject, we may claim for Ambrose Pare 
 (1572) and the surgeons who have suc- 
 ceeded him, the entire merit of all that is 
 now known and practised for the suppres- 
 sion of hsemorrhagy, especially the liga- 
 ture. It is the admirable effects of that 
 contrivance, and the complete command 
 which it gives us over haemorrhage, that 
 has emboldened the modern surgeons to 
 perform the most hazardous operations, 
 and to apply their ligature to the largest 
 artery, with as much confidence as the 
 ancients applied their styptics to the most 
 insignificant bleeding surface. Amputa- 
 tions are successfully performed even at 
 the hip and shoulder joints ; and aneu- 
 risms are now cured in a few days with 
 very little pain and no danger, which, 
 forty years ago, would have occasioned 
 the loss of a limb or of life. 
 
 O/* Venous Hjemorrhagy. This is far 
 less dangerous than the ai'terial. Haemor- 
 rhage is known to be from a vein by its 
 dark colour, and by its not issuing by 
 jerks. It is in general easily stopped by 
 compression, which must be applied far- 
 ther from the heart than the wound in 
 the vein. 
 
 HAEMORRHOIDS. See Piles. 
 
 HAIR. "The hair is hollow, and 
 grows from a bulbous root, resembling in 
 many respects a vegetable substance. The 
 root itself seems to be composed of very 
 fine filaments, and a glutinous substance, 
 probably secreted from its vessels. These 
 filaments unite to form the stem, M'hich 
 usually passes between the little eminences 
 in the skin. When the cuticle is porous, 
 as in the scalp, the hair seems to pass out 
 in a cylindrical form ; but where it is less 
 so, and particularly where the bulb is bu- 
 ried iu fat, it passes in a serpentine direc- 
 
 tion, with great difficulty, as in the arm- 
 pit, &c., and it is then tortuous and irre- 
 gular. The hair is nourished by the glu- 
 ten of the root ; and as this is more co- 
 pious or more fluid, it is more succulent. 
 When in a smaller quantity, or more dense, 
 the hair is dry, crisp, and soon falls off. 
 When not carried to the extremities, these 
 split and become brittle. The roots or 
 bulbs of hair are found over the whole 
 body ; nor is it easy to say why they con- 
 tinue to vegetate on some particular parts 
 only. The hair evidently partakes of the 
 nature of the simple solid, corresponding 
 with it in firmness or softness. The bulb 
 is nourished by arteries, and supplied with 
 nerves ; and the hair chiefly grows by gra- 
 dual addition at its extremity. The cir- 
 culation through it is probably carried on 
 by capillary attraction, or in the manner 
 in which the sap of vegetables is propelled. 
 By combing, we free the fluid from those 
 obstructions which must arise in conse- 
 quence of its being bent in all directions. 
 We promote also the circulation through 
 the bulb, and relieve the head from accu- 
 mulations. A fluid seems to exude through 
 the hair, at its basis, and is probably the 
 black matter which unites with the per- 
 spiration, producing the scales that soon 
 form on the scalp, if combing is neglected. 
 Chemists have discovered that hair con- 
 tains an oil, a mucous substance, iron, ox- 
 ide of manganese, phosphate and carbo- 
 nate of lime, flint, and a large proportion 
 of sulphur. White hair contains also 
 phosphate of magnesia, and its oil is near- 
 ly colourless. When hair becomes sud- 
 denly white from terror, it is probably 
 owing to the sulphur absorbing the oil, 
 as in the operation of whitening woollen 
 cloths. Long hair has always been es- 
 teemed an ornament, but it has been 
 doubted whether it was not injurious, by 
 the quantity of blood which it exhausted 
 in its nutriment, and the consequent de- 
 bility which it would produce. When 
 very thick, it is uncomfortable from its 
 warmth ; but we have never known it to 
 be a cause of weakness, except from the 
 perspiration which a large mass of hair 
 
S02 
 
 II A R R O W G A T E. 
 
 must occasion. Cutting off the hair has, 
 within our own knowledge, been often 
 injurious, and attended M-ith every appear- 
 ance of local plethora. As usual, mode- 
 ration is the best; and if it hang over the 
 shoulders, it is long enough, unless it 
 grows at the same time thinner, and in 
 that case it must be cut shorter. To in- 
 crease the growth of hair, various prepa- 
 rations have been employed, and each per- 
 fumer has his secret; though we know 
 not that any are particularly successful. 
 They chiefly consist of warm, stimulating 
 oily substances, to increase apparently the 
 circulation through the bulb, and proba- 
 bly to check the perspiration." (Parr's 
 Medical Dictionary.^ 
 
 HARE AND HARE-SOUP are classed 
 among the fibrinous aliments j and being 
 nutritious in themselves, and generally 
 cooked with the addition of various sti- 
 mulant condiments, they should be avoid- 
 ed in diseases of excitement, and used 
 cautiously in the diet of convalescents. 
 
 HARE-LIP. A division in the upper 
 lip, with which some children are born. 
 The division is sometimes confined to the 
 skin and muscles of the lip, but in other 
 cases it extends to the palate-bone and 
 the soft parts of the mouth. It is a de- 
 formity which parents are very anxious 
 to get rid of, and it is done without a great 
 deal of pain or difficulty ; but it is proper 
 to wait till the child is a few years old 
 and able to give a little assistance by its 
 own steadiness. The operation consists 
 in removing the skin from the two sur- 
 faces, and bringing and keeping the tw^o 
 raw edges in contact ; when the opposite 
 sides grow together perfectly, and hardly 
 a scar remains. Adhesive plaster will not 
 do to keep them in contact, but it must 
 be done by two or three gold pins pushed 
 from one side to the other, and kept firm 
 by thread or silk twisted round them in 
 the figure of 8. In three days they may 
 be removed, and the cure will be com- 
 plete. This is the course of things in fa- 
 vourable circumstances; but sometimes 
 there are two or more clefts which re- 
 quire separate operations, and one should 
 
 be healed before the cure of the other is 
 attempted. When the palate bone is di- 
 vided, the cure cannot be accomplished, 
 and the voice is defective from the wrong 
 conformation of the roof of the mouth, 
 and swallowing is difficult on account of 
 the food getting up into the nose. 
 
 HARROWGATE WATER. Harrow- 
 gate in Yorkshire possesses two kinds of 
 valuable springs, chalybeate and sulphu- 
 reous. The smell of the sulphureous is 
 strong and fetid, like bilge water. The 
 taste is bitter, nauseous, and strongly sa- 
 line. It contains sulphur, sulphuretted 
 hydrogen, carbonic acid, and azotic gas. 
 The water excites a headach and giddi- 
 ness when it is first drank, then a pur- 
 gative operation, which is speedy and 
 mild, without griping. This water is 
 used in various diseases, particularly of 
 the alimentary canal, and irregularity of 
 the biliary system. ITnder its use, the 
 health and appetite improve ; and both 
 from its purgative effects, and the cir- 
 cumstances in which it is drank, it is very 
 beneficial in costiveness and hypochon- 
 driasis. Harrowgate water has been much 
 employed in cutaneous diseases, both in- 
 ternally and externally ; and from its ape- 
 rient qualities it is good in hsemorrhoidal 
 affections. The quantity to be used is a 
 half pint taken in the morning, and repeat- 
 ed three or four times a-day, till some 
 sensible effect is produced on the bowels, 
 and it is in many cases necessary to con- 
 tinue this course for several months. The 
 patient, on his arrival at Harrowgate, 
 should follow certain measures prepara- 
 tory to drinking the water. A person of 
 sanguine temperament, or who is pletho- 
 ric, should lose a little blood, and should 
 take a dose of calomel, with the extract 
 of colocynth, followed up by senna or sul- 
 phate of magnesia. The patient should 
 rise early and drink the water at the well. 
 If its aperient effect is wished to take 
 place speedily, it is better the whole quan- 
 tity should be drank before breakfast; but 
 if it is to be used as an alterative, part 
 may be taken before breakfast, and part in 
 the middle of the day. To render the 
 
HEAD. 
 
 303 
 
 water less nauseous to the palate, a little 
 spiced gingerbread or brown bread may 
 be eaten at the time of using it. A full 
 course of the water requires from four to 
 six weeks ; and its good effects on those 
 who have suffered fk*om torpor of the 
 bowels, continues for a considerable time 
 after they have left off drinking the wa- 
 ter ; and as it is capable of being cai-ried 
 to a distance without losing its virtues, its 
 use may be resumed when it is thought 
 proper. The use of the water in gravel 
 is likely to be attended with advantage. 
 Harrowgate water is not only much used 
 internally, but also as a bath. The same 
 preparation is necessary as before the in- 
 ternal use of the water, as it stimulates 
 the siu-face and excites the system more 
 than the common bath. It is in general best 
 to take the bath at night, shortly before 
 going to bed; and if a good degree of per- 
 spiration is. wanted, some warm diluent 
 drinks, as tea or gruel, may be taken. If 
 a less degree of action of the skin is wish- 
 ed, the bath may be taken earlier ; but 
 exposure to the night air should be avoid- 
 ed. When used for gout or rheumatism, 
 or for the improvement of the general 
 health, the time of bathing may be an 
 hour and a half before dinner. Besides 
 wiping the skin perfectly dry, it should 
 be weU rubbed, especially when it is the 
 seat of complaint. The heat should be 
 about 95°, and be regulated by the ther- 
 mometer. The time of remaining in the 
 bath should be twenty-five minutes for 
 skin diseases, and ten for other piu'poses. 
 The saline chalybeate spring at Har- 
 rowgate possesses an excellent combina- 
 tion of saline ingredients, and of oxide of 
 iron held in solution by carbonic acid. It 
 should be used entirely for its chalybeate 
 effects, and the bowels must be kept open 
 by other laxative medicines, as an aloetic 
 pill or two at bed-time. There is a good 
 deal of interesting scenery about Harrow- 
 gate and its vicinity ; the air is bracing, 
 and well fitted to improve the health of 
 invalids ; and the sulphuretted and chaly- 
 beate springs seem worthy of the reputa- 
 tion they have acquired. 
 
 HARTFELL WATER. HartfeU is a 
 mineral well near Moffat ; it contains iron 
 dissolved by sulphuric acid, and is much 
 celebrated in scrofulous and cutaneous 
 diseases. It is used as an external appli- 
 cation, as well as drank internally. The 
 effects of this water at first, are a degree 
 of drowsiness, giddiness, and pain in the 
 head, which soon go off. The dose of the 
 water should not be very large, as it is 
 apt to be rejected by the stomach when 
 taken in too large quantity, and may oc- 
 casion griping of the bowels. About an 
 English pint a-day will be sufficient. 
 When the stomach is very delicate, the 
 water may be a little warmed. 
 
 HARTSHORN or Aawioma, the vola- 
 tile alkali, so called because one way of 
 procuring it is to burn the horns of the 
 hart or deer. It is an excellent pungent 
 and diffusible stimulant, and in various 
 shapes and combinations is much used in 
 medicine. In feinting-fits, the carbonate 
 of ammonia is used as smelling salts ; in 
 sore throat, united to oil, it forms the vo- 
 latile liniment, an excellent external ap- 
 plication ; and in circumstances of great 
 lowness and debility, it is to be given in- 
 ternally in combination with alcohol and 
 aromatics. See Ammonia. 
 
 HEAD, The head, besides possessing 
 muscular parts and integuments in com- 
 mon with the rest of the body, is the seat 
 of the organs of the external senses, and 
 of the bony cavity in which the brain is 
 placed. This variety of structures and of 
 the functions which ai'e performed by 
 them, renders the head liable to many 
 diseases, of which some affect the skin, 
 muscles, and cellular texture, others the 
 organs of sense, and others the brain and 
 internal parts of the skull. The head is 
 liable to aU the varieties of external in- 
 jury, of wounds of the scalp, and fractures 
 of the skull ; the organs of sense to their 
 peculiar maladies ; and the brain and the 
 internal parts to vciy many diseases. In 
 an important work with which our pro- 
 fession has been favoured by Dr. Aber- 
 crombie, he classes the diseases of the 
 internal parts of the head under the in^ 
 
304- 
 
 HEAD, WATER IN. 
 
 flammatoiy, the apoplectic, and the or- 
 ganic. See Apoplexy ; Buain, Injlam- 
 rnation of; Compression and Concussion 
 of; Epilepsy ; Headach ; Skull, &c. 
 
 HEAD, Water in the, Hydrocephalus 
 Intemus. A frequent disease in young 
 suhjects, of a very fatal and melancholy 
 termination; or rather, the concluding 
 symptoms of a previous disease, which 
 symptoms, from their frequency, from the 
 severity of suffering which they occasion, 
 and from the hopeless state into which 
 they bring the patient, constitute one of 
 the most dangerous diseases to which 
 children are liable. The commencement 
 of the disease is marked by a considerable 
 degree of fever, by thirst, restlessness, and 
 vomiting; and when the patient is old 
 enough to give an account of his sensa- 
 tions, by complaint of very severe pain of 
 the head. He utters frequent piercing 
 screams ; he appears flushed in the face, 
 there is redness of the eyes, but delirium 
 is less frequent than we might expect. 
 If these symptoms are not relieved by the 
 remedies employed, they are succeeded 
 by those which more decisively show the 
 presence of water in the ventricles of the 
 braiu. The patient is now dull and heavy, 
 has a constant desire to keep the head in 
 a reclining posture, or rolls it about from 
 side to side, or frequently puts up the 
 liand to the head ; the breathing is heavy, 
 the pulse intermitting and very slow, the 
 eyes squint and are insensible to the im- 
 pression of light, the bowels are costive, 
 the urine scanty, and the discharges are 
 made involuntarily ; the patient lies in a 
 dosing state, interrupted only by occa- 
 sional lamentable shrieks. This distress- 
 ing hopeless state may continue for seve- 
 rifl weeks ; towards the fatal termination 
 the pulse becomes again exceedingly fre- 
 quent, feverish heat of the skin again pre- 
 vails ; and convulsions of the whole body 
 or of some particular muscles, or palsy of 
 one half of the body, give notice of the 
 near approach of death. From the pre- 
 ceding description of symptoms, it ap- 
 pears that the commencement of the dis- 
 ease is of an inflammatory nature j and 
 
 the subsequent symptoms, combined with 
 the knowledge acquired by examination 
 of the bodies of those who have died of 
 the disease, show that there is pressure 
 on the brain, from fluid accumulating in 
 certain parts of it, which, in the healthy 
 state, are free from such fluid. 
 
 Causes. The delicacy of the consti- 
 tution in childhood, renders it liable to be 
 affected by a very great variety of causes, 
 which grown up people are exposed to 
 with impunity ; and certain circumstances 
 peculiar to early life increase the number 
 of these hurtful agents. The extreme 
 readiness with which the stomach and 
 bowels of children are put out of order, 
 their susceptibility to all mental emotions, 
 and the relative largeness of their heads, 
 with the quantity of blood sent to the 
 head in order to its speedy growth, all 
 give a tendency to disease in the brain, 
 and its appendages. There are certain 
 temperaments and hereditary peculiarities 
 which seem to predispose to water in the 
 head. Children of a delicate make, of 
 ingenious talents and amiable character, 
 whose early advances in knowledge and 
 in virtue give the fairest hopes of mature 
 and distinguished excellence, are too often 
 those, who, by this fatal disorder, disap- 
 point the fondest hopes of their friends. 
 An eruption behind the ears too sudden- 
 ly dried up, an occasional irregularity in 
 diet, neglect of the bowels, a fall or blow 
 upon the head, teething, and many other 
 circumstances are exciting causes of the 
 disease. A scrofulous habit seems more 
 especially liable to water in the head. 
 
 Treatment. In the acute or commen- 
 cing stage, we are to use with great dili- 
 gence the means for lessening inflamma- 
 tory action. Leeches are to be applied to 
 the head, purging is to be actively em- 
 ployed ; and cold water, or vinegar and 
 water, to wash the head and temples. If 
 there is any appearance of stupor or palsy 
 coming on, the head must be shaved and 
 a large blister applied. When the dis- 
 ease has got to the stage where there is 
 reason to fear that the eff'usion of water 
 has taken place, many remedies have been 
 
HEAD, WATER IN. 
 
 3y,. 
 
 applied, but unhappily they are in ge- 
 neral attended with very bad success. 
 Mercury has been pushed to a great ex- 
 tent, both by rubbing in, and in the form 
 of calomel. A succession of blisters, or 
 an issue has also been tried. To relieve 
 the pain and restlessness, opiates may be 
 cautiously given, remembering the dan- 
 ger that there is, of increasing the cos- 
 tiveness and inclination to stupor. 
 
 We must not be induced, by the sup- 
 posed incurable nature of water in the 
 head, to be negligent in the use of reme- 
 dies, when the symptoms of that disease 
 appear. It is an undoubted fact, that 
 children have been afflicted with headach, 
 with stupor, dilated pupils, squinting, and 
 every bad symptom, and yet, by very ac- . 
 tive treatment, especially by repeated 
 strong purging, they have recovered. All 
 our knowledge of the brain, both in its 
 healthy and morbid state, forbids us to 
 suppose that when water is effused in 
 such quantity as to press upon the brain, 
 and produce the foregoing symptoms, it 
 will ever be carried away by absorption ; 
 and, therefore, though we cannot say that 
 water in the head has been cured, we may 
 say, that symptoms very like it may be 
 got the better of. In such cases, our most 
 rational hope is in blistering and purg- 
 ing; and the quantity and strength of 
 medicine necessary in such cases is truly 
 astonishing. From three to five grains of 
 aloes may be given night and morning for 
 two or three days ; this is to be worked 
 off by a full dose of senna, or tamarinds 
 and senna, or by a dose of Epsom salts. 
 
 When one or two children of a family 
 have died of water in the head, it natu- 
 rally begets a very anxious solicitude 
 about the rest; and it is found to be a very 
 useful precaution, to begin at a very early 
 age, to make an issue in the neck or other 
 convenient place. Many families have 
 brought safely up to manhood, numerous 
 children, who in all probability would 
 have died in infancy, had not this expe- 
 dient been resorted to. Great care should 
 be taken of the health of ingenious, de- 
 licate, and sensible children. If their 
 
 parents' fortune admit of it, no expense 
 should be spared in procuring for them 
 the most virtuous, well-informed, and sen- 
 sible persons that can be procured, for di- 
 recting their education, and watching over 
 their minds ; their treatment should be 
 tender, yet firm and consistent ; no harsh 
 usage, and especially no blows about the 
 head, should be permitted ; and every in- 
 dulgence that will not injure the health, 
 the temper, or the character, should be 
 allowed them. 
 
 HEADACH. Pain, heaviness, or op- 
 pression about the head is a very frequent 
 occurrence, and arises fi'om a great va- 
 riety of causes. It is symptomatic of 
 disorders of the stomach and bowels; and 
 in such cases it often proceeds to a very 
 distressing height. We judge headach to 
 arise from disorders of the stomach when 
 the tongue is whitish, and slightly coated, 
 with the edges of a pale red colour. The 
 patient has a dimness and indistinctness 
 of sight ; he has a dull pain or weight in 
 the head, with some confusion, and he is 
 somewhat giddy. The pulse is languid 
 and feeble, but not very frequent. There 
 is a degree of sickness and irritation about 
 the stomach. There is a coldness and 
 numbness about the fingers ; and the 
 patient becomes, what, in common lan- 
 guage, is called nervous- This kind of 
 headach commonly occurs in the early 
 stages of digestion. It is best relieved 
 by an emetic, but this is a remedy which 
 should not be employed very often. 
 
 There is an oppressive illness, called 
 Sick Headach, which occurs rather longer 
 after taking food, and when the disordered 
 digestion is principally in the upper part 
 of the bowels, beyond the stomach. The 
 tongue, in this case, is covered with a 
 yellowish white fur. The pulse is lan- 
 guid, but of the natural frequency : vomit- 
 ing rarely occurs, though there is sick- 
 ness. The pain of the head is very severe ; 
 there is the appearance of bright objects 
 before the eyes ; there is also giddiness, 
 weight and stiffness of the eye-balls. 
 The body is chill, and the hands and feet 
 are cold and damp. There is usually 
 
306 
 
 H E A D A C IT. 
 
 flatulence, and a sensation of inactivity 
 iu the bowels, as if there were a weight 
 and stoppage in them. The stools vary 
 much in their appearance ; sometimes 
 there seems to be too much bile, at other 
 times they are of a faint yellow colour, 
 or a dark greenish brown. Purgatives 
 of calomel, aloes, jalap, colocynth, fol- 
 lowed up by doses of neutral salts, com- 
 monly give relief in this kind of headach. 
 See Stomach Co3IPLaints. 
 
 Headach is the forerunner or warner 
 of apoplexy, of epilepsy, and of other dis- 
 orders arising from too great a flow of 
 blood to the head. We judge the head- 
 ach to be of this kind, when there are 
 marks of fulness present in the system, 
 when the pulse is full and oppressed, 
 when there is throbbing in the arteries 
 generally, and especially in thos« about 
 the head; when the eyes are red and full. 
 All these symptoms are loud admonitions 
 that blood must be taken away, cooling 
 purgatives administered, and full living 
 altogether avoided. Costiveness very fre- 
 quently induces this kind of headach. 
 
 Headach, and that of the most distress- 
 ing kind, accompanies organic disease 
 within the brain, or in the bones of the 
 skull. We suspect this to be the case, 
 when the pain is constant, confined to one 
 spot, and accompanied at times by darting 
 pains. Little can be done beyond pal- 
 liating symptoms, preventing too great 
 fulness or flow of blood to the head, and 
 keeping off all exciting or agitating oc- 
 currences ; at the same time, attending 
 carefully to the bowels and the diet. 
 
 But many persons are subject to head- 
 ach as an original complaint, uncombined 
 with fever, fulness of blood, costiveness, 
 stomach complaints, or any other affec- 
 tion that we can detect. Some are af- 
 flicted for very great periods with head- 
 ach, rendering their life a long disease. 
 Few disorders are more unmanageable 
 tlian this habitual nervous headach; and 
 he must be a bold or rather rash practi- 
 tioner who will undertake to cure it. 
 Numberless are the remedies which have 
 been tried ; and in the present state of 
 
 our knowledge, we are obliged to go the 
 round of many articles, and that M'ith 
 very little success. Some general direc- 
 tions may be given. Great attention 
 should be paid to the bowels and diges- 
 tive oi^ans ; occasional purgatives should 
 be taken; and it is a useful one to begin 
 with, to take a grain or two of calomel or 
 of the blue mercurial pill. The food ta- 
 ken by those subject to headach, should 
 be nutritive, but easily digestible; and 
 attention must be paid to keep the tem- 
 perature of the body in an equable state, 
 and to avoid having the feet exposed to 
 cold and damp. When the headach has 
 come on severely, ammonia, or musk, or 
 ether may be tried ; and sometimes re- 
 lief, at least temporary, is obtained by 
 holding ether close to the head with the 
 pahn of the hand, and then allowing it to 
 produce a great degree of cold by evapo- 
 ration. In periodical headachs, the use 
 of bark has been recommended, from its 
 success in intermittent fevers ; and an- 
 other medicine, also useful in intermit- 
 tents, has been given, notwithstanding its 
 dangerous activity. The medicine to 
 which we allude is arsenic ; which, of 
 course, no patient would think of taking 
 at his own hands, nor from any but a pru- 
 dent and skilful physician. Sometimes 
 the headachs whioh have tormented a per- 
 son for many years, return no more ; pro- 
 bably from some change spontaneously 
 taking place in the nervous system, the 
 nature and causes of which change we 
 are unable to explain. 
 
 HEALTH is that state of the human 
 body, whether its growth be completed 
 or not, in which the structiu-e of the 
 parts is sound, and their functions pro- 
 perly performed ; rendering the individual 
 fit for all the duties and enjoyments of 
 life. When a person has received a sound 
 constitution from nature, its health is to 
 be preserved by a proper regulation of 
 the various circumstances, internal and 
 external, on which animal life is depen- 
 dent. These are principally food and 
 drink, the excretions and discharges, 
 air and exercise, sleep and waking, and 
 
HEALTH. 
 
 307 
 
 the luanageraent of the passions of the 
 mind. 
 
 The variety of temperaments or con- 
 stitutions renders it possible for the phe- 
 nomena of health to be very different in 
 different persons ; and what M^ould pre- 
 serve the health of one would occasion 
 disease in another. Persons of a sanguine 
 temperament, whose vessels are full, and 
 whose fibres are firm and active, easily 
 excited to motion, and often to irre^lar 
 actions, bear evacuations well ; and have 
 their health best promoted by abstinence 
 and low living, by avoiding excess of every 
 kind, and particularly guarding against 
 cold after active bodily exertions. The 
 bilious temperament is distinguished by 
 equal strength and activity with the san- 
 guine, but by a yellow hue on the skin, 
 and red hair; with a constitution often 
 more acutely sensible, always more irri- 
 table. They require the same precautions 
 as the sanguine ; but the evacuations 
 best adapted, which are indeed almost 
 indispensable to this kind of constitution, 
 are the free and frequent use of the milder 
 laxatives. To preserve the health of the 
 melancholic, whose complexion is dark, 
 and whose powers are torpid, whose mind 
 is dull, but persevering, they should use 
 exercise to assist digestion and to deter- 
 mine to the skin ; they should occasionally 
 aid the torpor of the bowels by purgatives 
 of the aloetic kind ; their occupations and 
 amusements, should be varied and inte- 
 resting to the mind. The phlegmatic 
 temperament is pale in complexion, lan- 
 guid in its exertions ; the vessels, if full, 
 are torpid, the constitution inactive ; the 
 mind not easily excited to exertion. Their 
 diet requires to be nutritive and some- 
 what stimulating, though it ought not to 
 go the length of what would be called 
 high living ; a suitable proportion of wine 
 should be allowed to them, but never to 
 excess ; and their health is merely pre- 
 served by what would excite fever in the 
 sanguine or bilious. They should keep 
 the bowels easy, but not be much purged, 
 for they do not bear evacuations well, 
 especially of blood ; and they should use 
 
 constant, regular exercise in the open 
 air. These observations may appear to 
 savour too much of the exploded patho- 
 logy of other times, when all the pheno- 
 mena of health and disease were consi- 
 dered to depend on the predominance of 
 certain humours, as the phlegm, the blood, 
 the yellow and the black bile. In all these 
 speculations the ancients were unques- 
 tionably wrong ; but the different tempe- 
 raments and appearances of men are suffi- 
 ciently obvious to the most careless ob- 
 server ; and the terms which are em- 
 ployed t^ express these varieties may now 
 be used without regard to their original 
 derivation, and without occasioning any 
 material error. 
 
 The health of women has some pecu- 
 liarities arising from the delicacy cf their 
 frame, the monthly discharge, the state 
 of pregnancy, and of nursing. All these 
 circumstances constitute a condition very 
 different from the robust and vigorous 
 strength of man in the prime of life ; yet 
 equally perfect, relatively to the sex and 
 the individual. Such functions require, 
 for their healthy performance, the atten- 
 tions peculiar to themselves. The irrita- 
 bility of infants, and the mobility of boy- 
 hood are consistent with good health, 
 though they would be unsuitable at a more 
 advanced period of life. 
 
 Health varies in people of different 
 occupations. The acuteness of the senses 
 which is necessary in some employments, 
 would be morbid in persons otherwise 
 engaged. There is a state of vigour and 
 perfection of the different faculties, with 
 great muscular strength, which is often 
 spoken of as a state of high health ; but, 
 as Celsus says, a person so circumstanced, 
 should look with a jealous eye on his 
 attainments. Such a state is incapable 
 of remaining at its acme ; the balance is 
 so nicely poised that a very little exter- 
 nal agency or incautious conduct readily 
 excites some disease. This state of ex- 
 treme muscular vigour is sometimes arti- 
 ficially induced for the brutal piirpose of 
 prize-fighting, and the method of doing 
 this is called training. 
 
308 
 
 HEART. 
 
 The foi-egoing remarks on what con- 
 stitutes health in different individuals, are 
 principally applicable to those whose con- 
 stitutions, thoug-h varying from one ano- 
 ther, may all be considered as sound. But 
 some have various diseases or predisposi- 
 tions to diseases, either derived from pa- 
 rents or acquired in the progress of life, 
 which render health with them only a 
 .comparative tenn. The scrofulous can 
 Jiardly be said in strictness ever to be in 
 perfect health ; but their disease may be 
 dormant ; and in favourable circumstances, 
 may permit the subject of it to enjoy an 
 exemption from pain and inconvenience, 
 to the end of a long life. Gouty patients 
 may also enjoy good health during the in- 
 tervals of their attacks. The rules for 
 preserving health will be found under a va- 
 riety of articles throughout this work, as 
 Air, Exercise, Diet, Meals, Sleep, Cos- 
 
 TIVEKESS, &c. 
 
 HEART. The heart of man and of 
 the more perfect animals is composed of 
 two cavities, one of which is destined to 
 propel the blood into the lungs, and the 
 Other to distribute it to the system at 
 large. It is contained within the peri- 
 cardium, a strong membranous bag, 
 smooth and lubricated by fluid on the 
 inside, having its inner lamina reflected 
 over the heart itself. The heart is situ- 
 ated obliquely in the middle of the breast, 
 its posterior surface is flat, and lies upon 
 the diaphragm : its apex is turned for- 
 wards, and towards the left side, so that, 
 in the living body, it is felt striking be- 
 tween the fifth and sixth ribs, a little to- 
 wards the side of the breast-bone. The 
 pulmonic pai-t of the heart is composed 
 of an auricle and a ventricle. The auricle 
 is a muscular bag, very thin, and having 
 a dark appearance, from the blood shin- 
 ing through its coats. Into this cavity 
 the two large veins which have collected 
 the blood from the upper and lower parts 
 of the body empty themselves; the auricle 
 contracting sends the blood into the right 
 ventricle, which propels it through the 
 pulmonary artery into the lungs. There 
 circulating in innumerable vessels, and 
 
 exposed to the influence of the air we 
 breathe, the dark purple blood is changed 
 to a bright scarlet colour, loses the noxious 
 properties it acquires by flowing through 
 the system, and becomes again fitted ^o 
 circulate as before. The blood proceeds 
 from the lungs by four vessels into the 
 left auricle, which, like its fellow, is a 
 muscular bag that contracts and sends 
 the blood into the left ventricle, by which 
 it is sent into the aorta and its branches 
 through the body. To prevent the blood 
 from regurgitating, and to keep it flow- 
 ing in the proper direction, both the 
 auricles are furnished with valves, or 
 little membranous folds, Avhich allow the 
 blood to pass one way, but are accurately 
 closed when any of it attempts to pass in 
 the opposite. At the mouths of the pul- 
 monary artery and of the aorta, there are 
 also valves, for the same purpose. The 
 valves of the right auricle are called the 
 tricuspid valves, those of the left the mi- 
 tral ; those at the beginning of the ar- 
 teries are called semilunar valves. The 
 walls of those various cavities are strong 
 and muscular, and are furnished with 
 bundles of muscular fibres, which pass 
 from one part of them to another, and 
 whidi, independent of our will, contract 
 when they receive the stimulus of the 
 blood. When the auricles are fully dis- 
 tended by the returning blood, they throw 
 it into the ventricles ; which, when they 
 are filled, throw the blood into theii' re- 
 spective arteries. The contractions are 
 called the systole, and the dilatations the 
 diastole of the heart. The beating of the 
 pulse corresponds with the force and fre- 
 quency of the movements of the heart. 
 This astonishing organ contracts and di- 
 lates upwards of a hundred thousand 
 times in a day, and can continue its action 
 unimpaired and unwearied for seventy or 
 eighty years, 
 
 HEART, Diseases of. The heart is sub- 
 ject to various diseases both of the struc- 
 ture and function. Indeed the alteration 
 of its structure necessarily leads to irre- 
 gularity of its action : " The most se- 
 vere and the most frequent diseases of 
 
HEART, DISEASES OF. 
 
 309 
 
 the heart, are dilatation of the ventricles, 
 thickening^ of their walls, and the com- 
 bination of these two states. The con- 
 tinuance of the foramen ovale after birth, 
 perforation of the ventricular septum, os- 
 sification of the sigmoid valves of the 
 aorta, or of the mitral valve, excres- 
 cences growing from these valves, pro- 
 ductions of different nature which may 
 be formed in the heart, are affections 
 much less frequent ; and which generally 
 disorder the health, only when they at- 
 tain a degree of intensity sufficient to 
 produce hypertrophy or dilatation of the 
 ventricles. Dilatation or hypertrophy of 
 the auricles, still less frequent, are per- 
 haps, always consecutive affections, pro- 
 duced by a morbid state of the valves, 
 or of the ventricles. Of all these dis- 
 eases, the general symptoms are nearly 
 the same. Respiration habitually short 
 and constrained; palpitations and stiflings 
 invariably produced by the motion of as- 
 cent, by rapid walking, by mental emo- 
 tions, and returning even without known 
 cause ; frightful dreams, and interruption 
 of the sleep by sudden startings; occa- 
 sionally the symptoms described under 
 the name of angina pectoris ; and, lastly, 
 a cachectic paleness, with tendency to 
 leucophlegmatic effusion, which eventu- 
 ally appears, are all symptoms which, to 
 a greater or less extent, occur in persons 
 affected with disease of the heart. In an 
 extreme degree, the symptoms are still 
 more obvious. Incapable of bearing the 
 horizontal position, the patient seated ra- 
 ther than lying in bed, with his head 
 inclined on his chest, or thrown back on 
 the pillow, retains this position night and 
 day; his face, more or less swollen, is 
 sometimes pale, but, most generally, has 
 a deep violet tint, diffuse, or confined to 
 the cheeks ; the lips, swelled and promi- 
 nent like those of the negro, are most in- 
 tensely livid, even when the face is pale ; 
 the lower extremities, the scrotum, the 
 labia in females, the integuments of the 
 trunk, the arms and the face even are 
 successively affected with (edematous in- 
 filtration. Great derangement of the ca- 
 
 pillary circulation is denoted by dyspnoea, 
 oppressed breathing, and haemoptysis ; 
 racking pains of the stomach, amounting 
 sometimes to vomiting; and finally lethar- 
 gic stupor, coma, and apoplectic seizure, 
 which too often terminates at once the 
 disease and the life of the patient." (Ed- 
 inburgh MedicalJournal, October 1826.) 
 I. Alteration of the structure of the 
 Heart. 1. Hypertrophy, or excessive 
 nutrition, (active aneurism of the heart,) 
 consists in increased thickness of its mus- 
 cular substance, without enlargement in 
 the capacity of the cavities. The sub- 
 stance of the organ is in general firmer 
 than natural. It may exist in one ven- 
 tricle only, or extend to both, and it may 
 be general or partial. This disease very 
 frequently induces apoplexy. 2. Dilata- 
 tion of the ventricles (passive aneurism) 
 consists in enlargement of the cavities of 
 the heart, with thinning of their walls. 
 The muscular substance is at the same 
 time unusually soft, sometimes of a violet 
 colour, in other instances pale, and almost 
 yellowish. The most general and pow- 
 erful cause of this is original conforma- 
 tion. 3. The substance of the heart is al- 
 tered in its texture, sometimes becoming 
 peculiarly firm, at other times soft and 
 flabby. 4. Ossification of the tricuspid 
 and semilunar valves is very rare, but 
 that of the mitral or semilunar aortic 
 valves is very common. It appears in 
 general, first in the substance of the base 
 of the valve, and then pierces the cover- 
 ing membrane, so as to render the sur- 
 face of the valve rough and prominent. 
 Eventually it may affect the margin of 
 the valve, when it produces extreme con- 
 traction of the opening. A slight de- 
 gree of this disease may occur without 
 much derangement in the action of the 
 heart, and serious disorder of the health. 
 5. Inflammation of the Heart or Peri- 
 cardium, It occurs in various forms, 
 sometimes M'ith acute pain referred to 
 the pit of the stomach, quick and shoj-t 
 breathing, with extreme anxiety and rest^ 
 lessness, pulse very quick; sometimes 
 cough attends. 
 
310 
 
 H E A T- 
 
 Diseases of the heart are difficult to be 
 distinguished, or to be cured when they 
 are known to be present. Modern phy- 
 sicians consider themselves as having the 
 means of ascertaining- their presence by 
 the stethoscope, a wooden cylinder, which, 
 when placed upon any part of the chest, 
 gives a different sensation to the ear of 
 the examiner, according as it is in a 
 healthy state or affected with varieties of 
 disease. By comparing these different 
 sounds imparted in health, with the ap- 
 pearances observed when there is an op- 
 portunity of examining the dead body, 
 they hope in time to obtain a tolerably 
 correct pathology of th? diseases of the 
 lungs and heart. 
 
 II. Irregularities in the Action of the 
 Heart. These are principally irregular- 
 ities of pulsation, intermission, and palpi- 
 tation. \. Irregularity of Pulsation. Tliis 
 may consist either in variation of the fre- 
 quency of the beats, or in one or more 
 very strong beats, in the midst of regular 
 ones. 2. Intermission may either be ow- 
 ing to an actual cessation of the heart's 
 action, or to the contractions being too 
 feeble to communicate their impulse to 
 the arteries. S. Palpitation. This is an 
 affection in which the motion of the heart 
 is performed with greater rapidity, and 
 more force than usual ; and the patient is 
 affected with difficulty of breathing, with 
 great anxiety, and various uneasy and 
 painful sensations. It arises from various 
 causes, as from violent exercise, from dis- 
 eases of the heart itself, or of the great 
 vessels ; from emotions of the mind, and 
 from the circumstances which occasion 
 fainting fits. The cure must be very 
 much regulated by what we judge to be 
 the cause. Many of these are quite be- 
 yond our reach ; and all that we can do 
 is to direct a careful avoidance of what- 
 ever tends to quicken the circulation, as 
 violent exercise, or going quickly up a 
 height, or over distending the stomach ; 
 and also to prescribe occasional small 
 bleedings, and such diet as will not occa- 
 sion fulness of the habit, or give any ten- 
 dency to inflammatory symptoms. Some- 
 
 thing may be done by moral management ; 
 endeavouring not to let the mind be eas- 
 ily ruffled or harassed, by the sudden and 
 often small accidents, that arc so apt to 
 overset the tranquillity of those who do 
 not exert themselves to keep a wcll-ba-» 
 lanced mind. 
 
 HEARTBURN. A disagreeable sen- 
 sation proceeding from acidity in the sto- 
 mach, from which there are frequent 
 belchings of sour flatulence, or discharges 
 of water with a burning heat at the pit 
 of the stomach. It is a very pertinacious 
 symptom, and is not easily removed; it 
 has its chance of abatement or cure like 
 the other symptoms of indigestion, by air, 
 exercise, and proper diet ; but it is also 
 to be palliated by giving such substances 
 as will combine with an acid in the sto- 
 mach, and form a tasteless and innoxious 
 salt. These consist of Avhat are called 
 absorbent earths, principally lime, in the 
 form of lime-water or chalk, and magne- 
 sia either calcined or united \>dth car- 
 bonic acid. The linje is to be preferred 
 if the bowels be too open, and the mag- 
 nesia if they be costive. The articles of 
 diet, which are found by experience to 
 produce heartburn, will be avoided by a 
 patient Avho prefers long ease to transient 
 gratification; and therefore butter, pas- 
 try, port wine, cheese, and various articles 
 which every one must ascertain for him- 
 self, are to be avoided. 
 
 HEAT. The investigation of the ef* 
 fects of heat on inanimate bodies, as also 
 the mode of its production in animals, 
 comes within the province of the chemist. 
 (^See Animal Heat.) The heat of the 
 human body in ordinary circumstances, is 
 generally 97° or 98" of Fahrenheit's ther- 
 mometer ; and as different substances re- 
 ceive heat with different degrees of ce- 
 lerity, the choice of clothing in different 
 climates, for the purpose of keeping the 
 temperature of our bodies in an equable 
 state, is to be regnilated by the conducting 
 power of the materials used. Fine lint, 
 cotton, wool, down, and fur, are bad con- 
 ductors of heat, and therefore are used as 
 clothing J they do not possess warnUU 
 
HECTIC FEVER. 
 
 311 
 
 themselves, but merely prevent the air 
 from taking caloric from our bodies. In 
 feverish diseases, the heat rises several 
 degrees higher than in health, and in 
 Scarlet fever it has been observed so high 
 as 109'. The effects of heat, when long 
 continued, are to induce relaxation and 
 debility ; and in warm climates and sea- 
 sons, heat seems to act very powerfully 
 on the biliary system, giving rise to liver 
 diseases, both acute and chronic, diarrhoea, 
 cholera, and remittent fevers. 
 
 Heat is usefully applied in a variety of 
 ways for the mitigation of pain and disease. 
 It acts as an antispasmodic, and, as such, is 
 applied in griping and pain of the bowels, 
 either by hot dry flannels, by fomenta- 
 tions, or the warm bath. Poultices act 
 in the ripening of abscesses, principally 
 by keeping up an increased heat in the 
 part ; and therefore, they should be put on 
 as warm as the patient can bear, and be 
 frequently renewed. 
 
 HECTIC FEVER. This is a slow, 
 long continued fever, attended with wast- 
 ing and great debility. It is commonly 
 symptomatic of some other disease, and 
 is believed to be connected with suppura- 
 tion, and the absorption of purulent mat- 
 ter. Intemperate drinkers, and those who 
 indulge in excess of any kind, are very 
 subject to it ; and disordered glands, ab- 
 scesses, or ulcers in the internal parts, 
 generally induce it; but these abscesses 
 sometimes exist without a hectic ; and the 
 liver, sometimes even the lungs, are found 
 ulcerated, when no fever had been ob- 
 served. The matter producing hectic may 
 be formed in any part of the body, though 
 perhaps in the lungs, and the glands of 
 the mesentery, its source may be most 
 commonly traced. The hectic arising 
 from external inflammations and suppu- 
 rations is longer in its attack, and slower 
 in its progress, in proportion to the mag- 
 nitude and importance of the part. Thus, 
 in the joints, the usual seats of the dis- 
 ease, suppurations of the ankle, wrist, el- 
 bow, and even the shoulder, have often 
 continued long before the constitution has 
 suffered. On the contrary, when the knee, 
 
 the hip-joint, or the loins, are the seat of 
 the disease, hectic soon comes on. Dur- 
 ing the continuance of wounds, it some- 
 times comes on, and is then attended with 
 every mark of debility. Many authors 
 have contended, that hectics are not ow- 
 ing to the absorption of pm*ulent matter ; 
 and their arguments are entitled to con- 
 siderable attention. The connexion be- 
 tween hectic and suppuration is, however, 
 apparently so close, that we are unwilling 
 to give up our former opinion ; and we 
 can perceive, we think, some clue to con- 
 duct us through the labyrinth of discor- 
 dant facts. We would conclude, there- 
 fore, that hectic is owing to suppuration 
 of any considerable magnitude, arising 
 from constitutional disease ; and these 
 constitutional diseases are such as are 
 usually attended with increased irritabi- 
 lity, or a broken constitution. As hectic 
 is so universal an accompaniment of con- 
 sumption of the lungs, we have described 
 its symptoms under that article, in page 
 145. " In most cases of hectic fever, the 
 principal intention is to relieve the symp- 
 toms, to moderate the heat, prevent cos- 
 tiveness, or its opposite, check the night 
 sweats ; and at the same time assist the 
 general health, by exercise, air, and a 
 proper diet; in other words, to support 
 the strength without adding any stimulus. 
 (Dr. Parr.) See Consumption. 
 
 " A distinction should be made between 
 a hectic fever arising entirely from a local 
 complaint in a good constitution, which 
 is only disturbed by too great an irrita- 
 tion; and a hectic fever arising princi- 
 pally from the badness of the constitution, 
 which does not dispose the parts to heal. 
 In the first species, it is only necessary 
 to remove the part (if removable), and 
 then all will do well ; but in the second, 
 nothing is gained by a removal of the part, 
 unless the wound made in the operation 
 is much less, and more easily put into a 
 local method of cure, by reason of which th c 
 constitution sinks less, under this state, and 
 the operation together, than nnder the for- 
 mer one. Here the nicest discrimination 
 is requisite. (Mr. John II(;nter.) 
 
312 
 
 HEM 
 
 HIC 
 
 HELLEBORE, Helleborus nujer, a 
 medicine famous in classical antiquity for 
 being used in the cure of madness. It is 
 the root of a plant that grows in the Py- 
 renees and Appenines. It is a violent 
 purgative and emetic ; but whatever may 
 be its powers, we can produce equal ef- 
 fects by milder and more manageable sub- 
 stances, and hellebore accordingly is, nei- 
 ther in madness nor for any other pur- 
 pose, in much estimation in modern prac- 
 tice, though some think it useful in pro- 
 moting the monthly discharge, and in pro- 
 curing a copious flow of water in dropsi- 
 cal cases. 
 
 HEMICRANIA. See Megrim. 
 
 HEMIPLEGIA, a species of palsy, in 
 w^hich one half of the body, in a line from 
 head to foot, is palsied. It very frequent- 
 ly follows a stroke of apoplexy. The 
 cure is to be cattempted by bleeding, by 
 purging, by blistering, by stimulating li- 
 niments, as detailed under the articles 
 Apoplexy and Palsy. 
 
 HEMLOCK, Conium maculatum, a 
 plant growing very commonly about the 
 sides of fields, under hedges, and in moist 
 shady places. It is very poisonous, but 
 more so in spring than in autumn. When 
 taken in an over-dose, it produces giddi- 
 ness, dimness of sight, sickness, tremors, 
 and palsy. But in small doses it may be 
 used safely, and it is capable of being so 
 managed as to prove a valuable anodyne 
 and narcotic. It is a good palliative in 
 pulmonary irritation, and is much used in 
 cases of schirrus and cancer, but with no 
 good effects beyond those of a narcotic. 
 When applied externally, in the form of fo- 
 mentation or cataplasm, it affords consider- 
 able relief in irritable ulcers. It is used in- 
 ternally in the form of inspissated juice 
 or extract as it is called, in the dose of 
 one graiu to five ; and the powdered 
 leaves have been given in the dose of two 
 grains, gradually increasing to twenty. 
 It is thought to have the narcotic, with- 
 out the constipating effects of opium; but 
 this valuable property belongs more indis- 
 putably to the plant which forms the sub- 
 ject of oui' next article. 
 
 HENBANE, Hyoscyamus niger. A 
 common plant, whose leaves have a pe^ 
 culiar nauseous odour, and a bitter taste. 
 Its properties are those of an anodyne, 
 and it has great resemblance to opium in 
 all its effects, with the favoiu-able excep- 
 tion, that it does not, like opium, render 
 the bowels costive. Its doses require to 
 be a little larger than those of opium ; of 
 the tincture, from half a drachm to a 
 drachm may be given, and of the extract 
 from five grains to fifteen. In over doses, 
 it brings on symptoms like those brought 
 on by hemlock. The infusion, or the so- 
 lution of the extract, when applied to the 
 eye, causes the dilatation of the pupil. 
 Mr. Brande says he has found henbane of 
 much service in allaying the irritation oc- 
 casioned by red sand in the kidneys ; and 
 it is found that hyoscyamus, combined 
 with colocynth, takes off the griping ten- 
 dency of the latter, M'ithout impairing its 
 purgative effects. 
 
 HERNIA. See Rupture. 
 
 HERPES, a disease of the skin. See 
 Ringworm and Shingles. 
 
 HERRINGS. A fish found in great 
 abundance in our northern seas, and form- 
 ing a very plentiful and excellent article 
 of diet. Herrings are eaten either fresh 
 or salted ; or dried in smoke, when they 
 are called red herrings. They abound iu 
 oily matter, and some stomachs find con- 
 siderable difficulty in digesting them. 
 
 HICCUP. A convulsive action of the 
 diaphragm. It occurs very frequently, 
 and goes off without any inconvenience ; 
 it is sometimes troublesome as a symptom 
 of hysterics ; but at the end of fevers or 
 other diseases, or when accompanying in- 
 juries of the head or wounds any M'here, 
 it is to be regarded as a sign of extreme 
 danger. The common hiccup may be re-, 
 moved by a draught of cold water, cr vi- 
 negar and water or a little hartshorn, or 
 a fright or other sudden mental emotion. 
 In hysterics, a solution of assafetida or 
 any thing having a strong smell and taste 
 will relieve it; but in the symptomatic 
 hiccup, little can be done, as it is too fre- 
 quently the forerunner of death. 
 
HI P - D I S E A S E. 
 
 313 
 
 HIP-JOINT. The hip-joiut is formed 
 between the broad flat bone at the lower 
 part of the trnnk and the thio^h-bone. 
 The thigh-bone has a Large smooth round 
 head, which is received into the acetabu- 
 lum, a deep socket in the haunch-bone ; 
 here it has a secure and extensive play, 
 and can be moved to every side ; but is 
 restrained in its motion outwards by the 
 high brims of the cavity, and by the round 
 ligament, which is extended from a rough 
 spongy pit in the head of the thigh-bone, 
 to the lower internal part of the receiv- 
 ing cavity. The hip-joint is liable to dis- 
 location, and to the disease which forms 
 the subject of the following article. 
 
 HIP-DISEASE. This affection is at- 
 tended with considerable suffering; and, 
 in many cases, it ends either in death or 
 lameness. It most frequently attacks 
 children under the age of fourteen ; and 
 generally, though not always, seems con- 
 nected with scrofula. It comes on in a 
 very insidious manner, beginning Avith a 
 slight weakness and limping of the affec- 
 ted limb. These symptoms for a time at- 
 tract but little attention ; and are passed 
 by as growing pains or rheumatic affec- 
 tions, and as there is often an uneasiness 
 at the knee, it is supposed that the prin- 
 cipal complaint is there, and remedies are 
 there applied accordingly. These reme- 
 dies, though in themselves they do little 
 harm, are bad, as they lead to the neglect 
 of those measures which would be of ser- 
 
 patient complains of pain about the knee, 
 he can bear to have it moved about, but 
 cannot suffer the same motion of the 
 thigh without very great pain. The 
 patient instinctively finds out the posture 
 which gives hijn least pain, and this is 
 by leaning the weight of the body chiefly 
 upon the opposite limb, while the thigh 
 of the affected side is bent a little for- 
 ward. The symptoms above detailed in- 
 dicate the presence of inflammation ; and 
 if this is not checked, tlie next stage, or 
 the formation of matter comes on. Some- 
 times there is swelling and redness of the 
 skin, and a degree of inflammatory fever ; 
 at other times, matter forms Avithout any 
 very evident inflammatory symptoms, 
 and without showing itself by any fulness 
 externally. The limb after some time is 
 not longer, but shorter than the other ; 
 the toes are turned inwards, and the leg 
 is bent ; while the thigh-bone is pushed 
 upwards and outwards in consequence of 
 the destruction of the cartilages and liga- 
 ments, which should keep it in its proper 
 cavity. When the disease of the hip- 
 joint has existed for some time, it very 
 generally brings on hectic fever ; though, 
 in some cases, the health remains unaf- 
 fected for a considerable period. 
 
 Causes. The disease of the hip-joiat 
 may be occasioned by external violence, 
 as blows or falls ; by exposure to cold or 
 damp, or by lying on the damp ground; 
 it occurs in scrofulous constitutions, but 
 
 vice in the first stage of the hip-disease\ often appears without its being possible 
 
 but which would do little good at a 
 more advanced period. Besides this pain 
 in the knee, there is often a pain in the 
 groin.; and this contributes to mislead 
 the inexperienced practitioner still fur- 
 ther from the real state of the disease. 
 The symptoms which characterise the 
 disease of the hip-joiut when fairly pre- 
 sent, are, a degree of emaciation of the 
 leg and thigh, great pain v^hen pressure 
 is made on the front of the joint; the 
 patient limps in wallcing, and there is a 
 remarkable lengthening of the limb. The 
 buttocks lose their natural fjilness, and 
 i§|;pear somewhat flattened. Though the 
 
 '^to assign any cause for it. 
 
 Treatment. In the early part of the 
 disease, we are to enjoin complete rest, 
 fomentations to the part, topical bleedings, 
 especially cupping. Such treatment is 
 more particularly proper, when the symp- 
 toms of active inflammation are present j 
 but when these have abated, the best 
 treatment is to form an issue with caustic, 
 behind and below the part of the thigh- 
 bone which is felt to project at its upper 
 part. The issue should be of the size of 
 a half crown-piece, and will require to be 
 kept open a very long time. Attentioa 
 is to be paid to the g^encral health ; bark. 
 
211 
 
 HOOPING-COUGH. 
 
 wine, and nourishing diet are to be given 
 as the strength requires, and the digestive 
 organs and bowels are to be carefully 
 regulated. Sometimes, after long and 
 tedious confinement, the disease is re- 
 moved ; but at other times, either death, 
 from wasting hectic fever, and destruc- 
 tive ulceration, takes place ; or the joint 
 becomes stiff and contracted, and the par 
 tient is lame for life, though the consti- 
 tution in general may be in a healthy 
 state. 
 
 HOME-SICKNESS, iVbste/^m. That 
 train of symptoms which occui's in per- 
 sons at a distance from home, when they 
 are seized with a strong desire of return- 
 ing to their native land. The Swiss and 
 the inhabitants of other mountainous 
 countries, on whose infant minds the 
 romantic scenery around them has made 
 a strong impression, are generally found 
 to be much affected with this nostalgia; 
 the symptoms of which are, dejection of 
 mind, loss of appetite, emaciation, and 
 derangement of the digestive powers. 
 The cure consists in gratifying, if possi- 
 ble, their desire of revisiting their native 
 place, or of diverting their mind to other 
 objects; attending to the state of the 
 bowels, to proper regimen and exercise, 
 and whatever tends to pi'omote the gene- 
 ral health both of body and mind. 
 
 HONEY. The production of the bee, 
 which to some persons proves purgative. 
 As this happens but rarely, it is to be 
 ascribed to peculiarity of constitution, 
 and it must be avoided by those in whom 
 it has this bad effect. It is a good vehicle 
 for heavy powders. 
 
 HOOPING-COUGH. AwellknoAvn 
 disease, which attacks persons only once 
 in their lives, and which arises ff-om a 
 peculiar contagion. It begins very gene- 
 rally like a common cold, which, how- 
 ever, does not go off so early as a cold 
 does ; but, at the end of a fortnight or 
 three weeks, is accompanied with long 
 and violent fits of coughing, and almost 
 always with vomiting. The long cough- 
 ing empties the lungs so completely, that 
 the air rushes in, in a convulsive manner. 
 
 accompanied with a loud crowing noise, 
 called a hoop, from which the disease 
 derives its name. In Scotland, the sound 
 is called a kink, and the disease kink- 
 cough. The worst cases of hooping-cough 
 are those in which the feverish symptoms 
 continue long, where the breathing is 
 difficult and painful, and where the cough 
 is dry, and as it were unformed, without 
 any tendency to vomit at the termination 
 of the fits. In more favourable cases, 
 though the agitation of the body is con- 
 siderable, though the cough is so violent 
 as even to occasion discharges of blood 
 from the nose, the ears, and even in the 
 eyes, yet so little are children the worse 
 for it, that they return with undiminished 
 alacrity to their play or occupations ; and 
 when they get rid of the contents of the 
 stomach by vomiting, the craving for food 
 is strong, and is gratified eagerly. The 
 fits of coughing do not observe any stated 
 intervals for their return. They hap- 
 pen frequently both in the day and night ; 
 and as the patient commonly has some 
 warning of their coming on, he seizes 
 hold of any person or thing near him, 
 to support his body during the severe 
 concussion that accompanies the cough. 
 Though the fits of coughing are generally 
 owing to the disease itself, yet they are 
 liable to be brought on by various excit- 
 ing causes, by any thing irritating the 
 lungs, by violent exercise, by disorders 
 of the stomach, and by emotions of the 
 mind. 
 
 Treatment. If the disease is attended 
 by highly inflammatory symptoms, con- 
 tinuing more than four or five days, it 
 will be necessary to resort to active anti- 
 phlogistic treatment ; taking away blood 
 by leeches or from the arm, according to 
 the age of the patient, and the severity 
 of the symptoms ; giving smart purgatives, 
 and avoiding every source of irritation. 
 Blisters are to be applied to the chest, or 
 bet^veen the shoulders, and demulcent 
 cough mixtures are to be given. Though 
 the violence of the inflammatory symp- 
 toms be subdued, and the disease assume 
 a milder form, yve are not to expect it to 
 
HOO 
 
 II O R 
 
 315 
 
 be very speedily removed ; but must pal- 
 liate symptoms, and imitate one of the 
 salutary processes of nature which take 
 place in hooping-cough, viz. excite vo- 
 miting by occasional emetics. According 
 to Dr. Paris, the sulphate of zinc is ad- 
 ministered in spasmodic coughs with the 
 best effects, especially when combined 
 with camphor or myrrh: he gives this 
 formula for its exhibition, ten grains of 
 the sulphate of zinc, powdered myrrh a 
 drachm and a half, made into twenty pills 
 with conserve of roses ; two pills to be 
 taken twice a-day. He says that the vari- 
 ous quack medicines advertised for the cure 
 of tie hooping-cough, are either opiates, 
 or medicines composed of the sulphate of 
 zinc. The nostrum sold under the name 
 of anti'pertussisy contains this metallic 
 salt as its principal ingredient. The sto- 
 mach and bowels are to be carefully 
 regulated ; to Avealily children, the bark 
 and wine, with nourishing diet, are to be 
 given ; and in most cases, it is a necessary 
 measure to change the air, and this very 
 frequently, removing not only from a 
 worse to a better, but even from a better 
 to a worse air. This gives relief to the 
 difficulty of breathing; but a change of 
 air cannot be expected to remove the 
 complaint till after it has lasted a con- 
 siderable time. It is a very beneficial 
 practice to rub the breast and back with 
 some stimulant or anodyne substance, as 
 camphorated oil, opodeldoc, or some of 
 the preparations of ammonia. 
 
 The contagion of hooping-cough affects 
 even very young children, and to them 
 the disease is peculiarly severe and dan- 
 gerous. The contagion is capable of being 
 carried by the medium of a third person, 
 and appears to be communicable as lono- 
 as the child has the cough. When the 
 disease has seemingly gone off, it is very 
 easily brought back in all its severity, by 
 exposure to cold, or by an unfavourable 
 turn of the weather ; and even for years 
 after, the child, whatever be the nature 
 of its pectoral complaints, has the crow- 
 ing sound and back-diaught of the hoop- 
 ij)g-cough. 
 
 HOPS, Humulus lupulus. A- creep- 
 ing plant, much cultivated in the county 
 of Kent for its leafy catkins, which are 
 used in the brewing of ale and porter. 
 Hops are bitter, aromatic, and astringent 
 Their effects, when added to malt liquors, 
 are to impart an aromatic bitter, and to 
 prevent their becoming sour. Some 
 think that the bitterness given to malt 
 liquors by hops, prevents the bad effects 
 of the sweet wort on the stomach ; and 
 that they have also a narcotic tendency. 
 Certainly some kinds of ale and porter 
 dispose many persons to great drowsi- 
 ness. Hops have been introduced into 
 the Materia Medica for their anodyne 
 virtues, but without any necessity. Some 
 have said that an ointment into which 
 hops enter in the form of tincture or ex- 
 tract, has been of use in allaying the pain 
 of cancer in its last stages, when all other 
 applications have failed. A pillow stuffed 
 with hops has been laid under the head 
 to ensure repose. 
 
 HOREHOUND, Marruhium vulgare, 
 is a plant of very little use; but there is a 
 patent medicine known by the name of 
 Ford's Balsam of Horehound, which con- 
 sists of a watery infusion of horehound 
 and liquorice root, with double the pro- 
 portion of proof spirit or brandy, to which 
 is then added opium, camphor, benzoin, 
 squills, oil of aniseed and honey. It pro- 
 fesses to be a remedy for coughs and colds, 
 but, from the number of its stimulating 
 ingredients, its use in the hands of the ig- 
 norant must be very dangerous ; and re- 
 gular practitioners have better modes of 
 allaying cough, when they judge it neces- . 
 sary to do so. 
 
 HORSE-RADISH, Cochlearia armo. 
 racia, is a stimulant root, which is some- 
 times brought to the table grated, to bo 
 used as a condiment. It has been applied 
 externally as a rubefacient in palsy and 
 rheumatism ; and the infusion taken in- 
 ternally is a good stimulant, and some- 
 times proves diuretic. By its action on 
 the fauces it relieves hoarseness. It Avas 
 formerly thought a valuable antiscorbutic, 
 but its properties in this respect are very in* 
 
316 
 
 HUNGER. 
 
 ferior to cresses and other fresh vegeta- 
 bles. 
 
 HUNGER. The well known sensa- 
 tion which is experienced when the sto- 
 mach is in a healthy condition, and has 
 remained empty for some time. This 
 sensation does not depend on mere emp- 
 tiness of the stomach ; for in various dis- 
 eases the stomach remains long empty 
 without the sensation being produced ; 
 and hunger is allayed by various ways, 
 although no food has been taken. If the 
 usual time of eating is passed, it is not 
 uncommon for the feeling of hunger to go 
 off; and it is quite a familiar occurrence 
 to have the appetite spoiled by the com- 
 munication of bad news. A narcotic sub- 
 stance applied to the stomach removes 
 the sensation of hunger. The juice of 
 tobacco will have this effect in those who 
 are not accustomed to it. Ardent spirits 
 take away the appetite of those Avho are 
 not used to them. Hunger does not seem 
 to recur till the aliment already thrown 
 in has been assimilated in the body. It 
 does not, therefore, appear to have a par- 
 ticular reference to the state of the sto- 
 mach, and in some diseases of the mesen- 
 teric glands through which the chyle 
 passes, the appetite is never satisfied, 
 though there is plenty of food in the sto- 
 mach. Excessive and voracious appetite 
 may depend on some morbid state of the 
 pylorus, by which the food is allowed to 
 pass out of the stomach before it is chan- 
 ged into chyme. The inference drawn 
 from the above facts by Dr. Paris, one of 
 the latest writers on digestion, is, that the 
 several processes by which aliment is con- 
 verted into blood caimot be performed at 
 the same time, without such an increased 
 expenditure of vital energy as weak per- 
 sons cannot, without inconvenience, sus- 
 tain, and that proper time should be al- 
 lowed for the food to go through all its 
 changes ; that the stomach should not be 
 set to work during the last stages of di- 
 gestion, otherwise the processes will, in 
 weak persons, be much disturbed. It is 
 a well known fact, that if a person be in- 
 terrupted in his meal for a (juaiter of an 
 
 hour, he finds, on resuming it, that his 
 appetite is gone, although he may have 
 not eaten half the quantity which he re- 
 quired. This is explained by supposing, 
 that during the suspension of the meal 
 the food had entered on its ulterior 
 changes, and that the energies of the sto- 
 mach had therefore declined. The sub- 
 sidence of appetite is not produced by the 
 quantity, but by the quality of the food ; 
 thus showing, that it is not the mere vo- 
 lume of the aliment alone that is neces- 
 sary to pacify the cravings of the sto- 
 mach. At the same time, it is equally 
 true, that a certain bulk must be intro- 
 duced into the stomach for the purposes 
 of good digestion ; and hence even the 
 most nutritive soups must have some so- 
 lid or bulky vehicle or accompaniment, 
 <vhen they are taken into the stomach. 
 Besides the peculiar sensation referred to 
 the stomach when a person is hungry, 
 other symptoms at the same time occur 
 in the constitution. There is a univei-sal 
 lassitude, a sensation of pressure at the pit 
 of the stomach, and much air is heard 
 passing from one part of the intestines to 
 another. When a certain quantity of 
 food has been taken in, the feeling of wea- 
 riness gives place to that of renewed 
 strength, and all the other phenomena of 
 hunger cease. 
 
 HYDATID. An animal formed like 
 a bladder, and filled with a w^atery fluid. 
 They are found in various cavities of the 
 body of man and other animals, and in 
 different organs, particularly the liver and 
 uterus, and they give rise to a species of 
 encysted dropsy. There does not appear 
 to be any cure for this disease. 
 
 HYDRAGOGUE PURGE S,such me- 
 dicines as procure a copious watery dis- 
 charge by stool. Of this kind are what 
 are called resinous purges, as scamraony, 
 gamboge, and the like; also jalap and 
 cream of tartar are hydragogucs ; and 
 some preparations of mercury may be so 
 managed as to have the same effect. 
 Elaterium is an active, though hazardous 
 hydragogue. The diseases in which me- 
 dicines of this class are most useful, are 
 
HYDROCELE. 
 
 317 
 
 the various kinds of dropsy, especially of 
 the belly ; and the relief obtained by seve- 
 ral copious watery stools is often surpris- 
 ingly great. 
 
 HYDROCELE. A collection of wa- 
 ter in the scrotum, or in the membranes 
 investing the testicle and its vessels. Hy- 
 drocele is to be distinguished from the 
 watery swelling which takes place in the 
 cellular substance of the scrotum in ge- 
 neral dropsy, and which ought not to be 
 considered as hydrocele at all, but to be 
 treated as part of a more general aflfec- 
 tion, by the remedies appropriate to that 
 particular disease. Water may be col- 
 lected in the cells of the spermatic ves- 
 sels ; and while this collection is not very 
 large, the scrotal bag has little or no ap- 
 pearance of disease. If the water accu- 
 mulates, there is a knotted appearance 
 along the course of the spermatic cord ; 
 and the size may become so large and in- 
 t;onvenient as to require the water to be 
 evacuated by an incision. Sometimes, in- 
 stead of several cells being thus filled with 
 water, it collects in a large one, and re- 
 quires similar treatment. The more com- 
 mon form of the disease is, when there is 
 an accumulation of water in the common 
 coat of the testicle. 
 
 Diagnosis. The gradual collection of 
 this fluid distinguishes the disease from 
 rupture, which forms suddenly; the swell- 
 ing in rupture disappears on pressure and 
 change of postui-e, which hydrocele does 
 not ; the swelling begins at the upper part 
 in rupture, but from the lower part in 
 hydrocele ; besides, if a candle be held be- 
 hind the swelling, there is a degree of 
 transparency visible. 
 
 Cm-e, The cure of hydrocele is tem- 
 porary or permanent. The water may be 
 easily evacuated, but it will readily accu- 
 mulate again, and means must be taken 
 to prevent this. The means most eflfec- 
 tual, were it always in our power to exe- 
 cute them, is to excite such a degree of in- 
 flammation in the parts, as will cause the 
 outer covering of the testicle to grow to 
 the inner suH'ace cf the bag ; thus to ob- 
 literate the cavity altogether, and leave no 
 
 space for the accumulation of fluid. Such 
 inflammation is excited by introducing 
 through a syringe, port wine diluted with 
 water to a proper strength, generally two 
 parts of wine to one part of water ; but 
 if the liquor be too strong, it may excite 
 so much inflammation as to give rise to 
 general fever, which will require to be 
 treated by blood-letting, both general and 
 local, with purgatives, and cooling lotions. 
 HYDROPHOBIA, the dread of water. 
 A remarkable symptom, which gives its 
 name to the whole train of painful affec- 
 tions, which arise from the poison intro- 
 duced by the bite of a mad animal. This 
 poison is commonly inoculated into the 
 body by a small portion of the saliva of 
 the animal. In order to this, the skin 
 must be broken ; and a wound incredibly 
 small is sufficient for this purpose. A 
 quantity of saliva so small as to elude our 
 senses, thus introduced by a broken sur- 
 face, will occasion the whole succession 
 of fatal symptoms which ensue. The ani- 
 mals whose bite most commonly occa- 
 sions hydrophobia, are the dog and cat ; 
 and they can impart the disease both to 
 man and other animals. In the warm 
 season of the year, the hydrophobia most 
 commonly appears ; and though nothing 
 should be said to make people negligent 
 of what may prevent the horrid effects 
 of canine madness, yet it may be right to 
 spare unnecessary alarm to any, by re- 
 marking, that out of many persons who are 
 bit by dogs, but few are affected with the 
 disease. The bite of a mad dog may not 
 pierce the skin, or the teeth may be dried 
 and cleaned in passing through the clothes, 
 or the saliva may have been expended 
 for a little by attempts at biting other 
 men or animals ; or from some peculiari- 
 ty of constitution, even a person who has 
 really been bit, may not take the disease ; 
 of which a remarkable instance is given 
 by Mr. Hunter, who relates, that of twen- 
 ty persons who were bitten by the same 
 dog, only one was seized with hydropho- 
 bia. When the popular terror is excited, 
 every dog, whether mad or not, is sup- 
 posed to be so, when he shows any signs 
 
318 
 
 HYDROPHOBIA. 
 
 of ano'er; but although such dogs bite, 
 they do not inflict a poisonous wound. 
 The time which elapses between the in- 
 fliction of the wound and the appearance 
 of the disease is various, but is in some 
 cases astonishingly long; instances, though 
 very rare, have been recorded where a 
 yeai- has elapsed ; but from six weeks to 
 two months is a period by no means un- 
 common. 
 
 Sijmptoms. The symptoms of hydro- 
 phobia are the following: The bitten 
 part begins to be painful, then there en- 
 sue uneasiness, restlessness, heaviness, a 
 desire to be alone, sudden starting, pain, 
 spasms, disturbed sleep, and frightful 
 dreams. These symptoms increase, pains 
 dart from the wounded place to the throat, 
 with a sensation of choking, and a horror 
 and dread at the sight of liquids. The 
 person can swallow solids, but any thing 
 in a fluid form causes him to start back 
 with horror ; and the most painful con- 
 vulsions are excited by any application 
 of it to his throat or lips. In the course 
 of the disease, vomiting comes on, with 
 mucli fever, great thirst, dryness and 
 roughness of the tongue, hoarseness, and 
 a continual discharge of saliva. There is 
 great watchfulness, a dislike of light and 
 air, difficult breathing ; in some cases, 
 delirium, but in others the judgment is 
 imimpaired. The pulse becomes tremu- 
 lous and irregular, convulsions arise, and 
 the patient sinks exhausted, about the 
 tliird or fourth day from the first appear- 
 ance of the symptoms. 
 
 Treatment. Hydrophobia is one of 
 those diseases in which the resources of 
 the medical art almost universally fail. 
 To enumerate all the remedies that have 
 been tried, would be to give a list of the 
 most various and contradictory articles. 
 Cases have got well under several plans, 
 but those applied to others have altoge- 
 ther failed. Lai'ge bleedings, cold bath- 
 ing, warm bathing, wine, opium, musk, 
 and other antispasmodics, ipecacuan, 
 turpentine, potash, vinegar, and a copious 
 assortment of quack medicines, have all 
 been tried in vain. From this view of 
 
 the case, it must be obvious, that our 
 most anxious care should be directed to 
 the prevention of the disease, since, in 
 the present state of our knowledge, it is 
 absolutely hopeless of cure. For this 
 purpose, nothing is so effectual as com- 
 pletely cutting out the bitten part, and 
 some portion of the surrounding sub- 
 stance, as soon as possible after the in- 
 jury, wherever the situation of the part 
 will allow of this. The inoculation of 
 the poisonous matter is exactly similar 
 to what takes place in sraall-pox and cow- 
 pox. A little matter is introduced at an 
 open wound, this excites an action at the 
 part, certain fluids are there formed in 
 consequence, and particular vessels carry 
 these fluids from the part, to the heart 
 and other organs where the fluids are 
 elaborated, and sent to the diff'erent parts 
 of the body; and thus any particular 
 taint mixing with the general mass, pro- 
 duces its peculiar disease. But this is not 
 done instantaneously. Some poisons dart 
 with inconceivable rapidity through the 
 body; the viper, the rattlesnake, or the 
 cobra de capello kill with frightful velo- 
 city ; but the small-pox, the cow-pox, 
 and the poisonous saliva of the dog, take 
 more time to produce their effects on the 
 system. If there be too much blood 
 from the wound made for inoculation, 
 the matter will be Avashed away, or if it 
 be "wiped off, the disease will not follow ; 
 and on the same principle, we try to pre- 
 vent the absorption of the poisonous 
 matter introduced by the dog, by a free 
 cutting out of the wounded part, and by 
 exciting a flow of blood, and discharge of 
 matter. If this be freely and properly 
 done, we have every reason to hope that 
 no bad effects will follow from the bite of 
 the animal. If, notwithstanding, hydro- 
 phobia should come on, however hope- 
 less, something should be done ; and we 
 must attempt, in the best way we can, to 
 palliate the distressing symptoms. If the 
 patient be furious, care must be taken to 
 prevent him from injuring himself or 
 others ; and for this purpose, the best re- 
 straint is the strait waistcoat; as the 
 
HYPOCHONDRIA. 
 
 319. 
 
 struggle with other meu is always hurt- 
 ful. Nourishment of a light kind must 
 be given as long as he can swallow, and 
 when this po>ver fails, animal broths must 
 be given by clyster. Costiveness is to 
 be obviated by laxative injections, or by 
 purgative medicines in the form of pills. 
 
 As it may sometimes be of consequence, 
 in connexion with this disease, to know 
 whether a dog be really mad, we shall sub- 
 join a few of the marks of the rabid state. 
 There is an alteration in the usual habits 
 of the dog ; his appetite is depraved, he is 
 very irritable and treacherous, allowing 
 himself to be fondled, but suddenly snaps 
 or bites without any provocation. The 
 eyes become inflamed, and matter is dis- 
 charged from the eye-lids. His bark is 
 changed into a howl; he becomes very 
 restless, and desirous to gnaw every thing 
 around him. If he gets loose, he bites 
 all animals that come in his way, espe- 
 cially his ow^n species. He often appears 
 palsied behind, he becomes feeble, his 
 jaws drop, saliva runs from his mouth, 
 and he dies exhausted on the fourth or 
 fifth day. 
 
 HYPOCHONDRIA, Vapours, or 
 Low Spirits. Though this may be con- 
 sidered principally as a wrong state of 
 the mind, yet as there are certain bodily 
 symptoms conjoined with it, it requires a 
 place in a Dictionary of Medicine. The 
 malady is distinguished by a languor and 
 inactivity of the patients in every pur- 
 pose or mode of action, a sadness, timidi- 
 ty, and despondency about every subject 
 of thought ; and especially a dread of im- 
 pending evil, and an over anxiety in 
 every thing regarding their own health. 
 They are disposed to attend to the slight- 
 est ailment, and obstinately take the most 
 gloomy view of their own case. Persons 
 of this melancholic temperament are ge- 
 nerally of torpid bowels ; and it is always 
 found, that this state of the boAvels has a 
 bad effect on their health and spirits. 
 Their breathing is somewhat slow; they 
 are troubled with flatulencies, and various 
 spasmodic affections. The disease is sel- 
 dom fatal, but if neglected or improperly 
 
 treated, it may bring on melancholy, 
 madness, jaundice, vertigo, palsy and apo- 
 plexy. 
 
 Those who are most suhj ect to hypochon- 
 driasis are those of a firm texture of body, 
 of aspai-e habit, with black hair and eyes; 
 whose mental faculties are grave and re- 
 flective; who are timid, and not easily 
 moved, but w hen any object engages their 
 attention, thoroughly occupied with it. 
 
 Diagnosis. Hypochondriasis is nearly 
 allied to several other affections, both of 
 tlie mind and of the digestive powers. 
 Indigestion, hysterics, and a certain kind 
 and degree of mental derangement have 
 all of them some symptoms in common 
 with iti It is to be distinguished from 
 dyspepsia by this last occurring in persons 
 of every temperament, both the sanguine 
 and the melancholic, by its being often 
 accompanied with suflicient cheerfulness, 
 except under the immediate pressure of 
 suffering ; whereas, hypochondriasis is to 
 be considered as a disease chiefly of the 
 melancholic temperament, and depression 
 and gloom of mind is one of its essential 
 symptoms. Hypochondriasis resembles 
 hysteria, in the flatulence, indigestion, and 
 terrifying apprehension with which they 
 are attended. When a person has certain 
 obstinate and absurd notions of himself, 
 as that his legs are made of glass, or that 
 he is hermetically sealed, or that he has 
 no soul, he is to be considered as partially 
 deranged, and not as hypochondriacaL 
 Treatment. It is a matter of great dif- 
 ficulty properly to treat persons afflicted 
 with low spirits. Physicians who see 
 that there is little or nothing materially 
 wrong in their bodily frame, are too apt 
 to listen with impatience to their long and 
 dismal stories of their own maladies, to 
 treat their complaints with disbelief or 
 ridicule, and to neglect any attempt to 
 relieve them. Hence a characteristic of 
 hypochondriacs is, that they often change 
 their physicians, till they either find one 
 who indulges their fancy, or who is for- 
 tunate enough to succeed in curing them. 
 Their complaints should be listened to 
 with sympathy and attention ; medicines 
 
320 
 
 HYSTERICS. 
 
 ought to be given adapted to any appear- 
 ance of disease about them ; and if there be 
 any harmless medicine or piece of practice 
 in which they have confidence, it should 
 be permitted them. It is of great conse- 
 quence to keep their mind occupied Avith 
 some other object than their own health; 
 Lusiness, when it is not of a kind that 
 deeply interests or agitates the mind, by 
 involving the risk of large sums, may be 
 continued ; but the bold adventures and 
 gambling speculations in which the mo- 
 dern merchants so much indulge, are of a 
 pernicious tendency. The expedient of 
 change of scene, by going on a journey, 
 is as good as can be devised ; taking care 
 to avoid damp, fatigue, and all unneces- 
 sary anxiety. The bowels of hypochon- 
 driacal patients must be very carefully 
 attended to. Aloes, or aloes -with colo- 
 cynth orscaramony, should be taken every 
 night, and occasionally a smart purgative 
 of salts or compound powder of jalap 
 should be interposed in the morning. 
 Notwithstanding the complaints Avhich 
 such patients make of weakness, it is dan- 
 gerous to give them bark, iron, or the 
 usual tonic medicines ; or to direct cold 
 bathing. The warm bath is a more pro- 
 bable means of relief. 
 
 HYSSOP, Hysopus officinalis. A plant 
 growing wild in Germany, the leaves of 
 which contain an essential oil, which may 
 be obtained by distillation with water or 
 spirit of wine. Its preparations were 
 thought to be of use in asthmas, coughs, 
 and disorders of the breast j but in regu- 
 lar practice they are but little trusted to. 
 
 HYSTERIA, Hysterics, or the Fits. 
 A disease presenting many alarming ap- 
 pearances, though the danger to life is by 
 no means in proportion to the violence of 
 the symptoms. It is chiefly confined to 
 the female sex; and of them it principally 
 attacks the high fed, the luxurious, and 
 the idle ; also those who are addicted to 
 the use of malt liquor or distilled spirits. 
 It chiefly occurs between the age of fif- 
 teen and forty ; though in those who are 
 peculiarly disposed to it, it may continue 
 beyond the latter period. Hysteria is 
 
 more frequent at the monthly period than 
 at other seasons. In those who are sub- 
 ject to hysteria, it is very readily brought 
 on by emotions of the mind, and especially 
 by any surprise ; and by long continuance 
 of the disease, persons are brought to so 
 morbid a state of sensibility, that the 
 slightest noise or external impression agi- 
 tates and alarms them. 
 
 Hysteria attacks in paroxysms or fits. 
 A sensation is felt as of a ball moving 
 about with a murmuring noise in different 
 parts of the belly, from which it seems to 
 rise into the throat, threatening the suf- 
 focation of the patient. While tliis is go- 
 ing on, the patient is affected with stupor 
 and insensibility ; and various convulsive 
 movements take place in the body. The 
 trunk is twisted, and the limbs are agi- 
 tated ; and a very common motion is for 
 the patient to beat the breast with the 
 hand, with great violence and frequency, 
 as if in severe mental distress. There are 
 indications of a great fickleness of mind ; 
 laughing vi'ildly, and crying, succeed each 
 other, with great frequency and without 
 any apparent cause; and false imagina- 
 tions, and a degree of delirium sometimes 
 occur. In a longer or shorter period, the 
 patient gradually returns to her senses, 
 with much sighing and sobbing, with a 
 murmuring noise in the belly; but she 
 has commonly no recollection of what 
 takes place in the fit. In different indi- 
 viduals, these paroxysms vary somewhat 
 in their degree of violence, in the number 
 of the symptoms, and in their duration. 
 Sometimes vomiting occurs, sometimes 
 great difficulty of breathing, sometimes 
 palpitation of the heart ; sometimes there 
 is a very copious flow of clear urine ; or 
 a discharge of flatus. It appears from re- 
 peated experience, that this disease, though 
 it attacks with such violence, is consider- 
 ably under the command of the patient 
 herself, differing in this respect from epi- 
 lepsy, which assails its unhappy victims 
 with rapid and irresistible force. But 
 while women make a merit of taking fits, 
 while they think it renders them more 
 interesting, while they take no pains to 
 
HYSTERICS. 
 
 321 
 
 fortify their minds against the countless 
 sources of irritation which occur in com- 
 mon life ; while they expect every incon- 
 venience and uneasiness to give way be- 
 fore them, and allow their tempers to be 
 fretted Avith every trifle, they certainly 
 have themselves to blame for the hysteri- 
 cal passion ; and till their minds are better 
 regulated, they will continue to be subject 
 to it. When serious business, or domestic 
 and personal affliction withdraws the mind 
 of such patients from their accustomed 
 ailments, the hysteric paroxysms are much 
 less frequent. Hence the impropriety of 
 bringing up children in ease and indo- 
 lence, and with too constant attention to 
 the gratification of their feelings and ca- 
 price ; and the happiness of those who 
 are early taught to find rational occupa- 
 tion for themselves, and to keep an even 
 temper amidst the ruffling accidents of 
 life. 
 
 Causes. " Among the causes of hy- 
 steria may be mentioned, excessive eva- 
 cuations, particularly of the monthly 
 discharge, late hours, depressing passions, 
 continued anxiety, hope delayed, violent 
 excitement, fulness of blood, excess of 
 drinking, &c. Frequently, the causes of 
 a tit are surprise, apprehension, sudden 
 grief, anger, indigestion ; but the parox- 
 ysms occasionally recur without any 
 obvious cause, particularly when occa- 
 sioned by plethora, which, in a constitu- 
 tion where the balance of the circulation 
 is nicely poised, often occasions convul- 
 sive paroxysms." 
 
 Treatment of Hysteria. The symp- 
 toms during the fit are so like those of 
 epilepsy, that the same remedies are na- 
 turally suggested in this disease. We 
 are to try to shorten the fit by strong 
 impressions on the senses, by dashing cold 
 water on the face, by applying hartshorn, 
 assafetida, burnt feathers, or the like to 
 the nostrils ; and by putting some stimu- 
 lant or fetid substance into the mouth, 
 though it is but rarely that the patient 
 
 at that time can swallow. Much of our 
 attention in hysterical cases must be 
 directed to the prevention of the return 
 of the fits. For this purpose, we are to 
 endeavour to diminish the fulness of the 
 system so commonly the attendant of 
 hysterical patients ; and this, by frequent 
 purgatives, by diminishing the quantity 
 of nourishing food consumed, and by 
 directing constant regular exercise. Those 
 purgatives are best, which tend to im- 
 prove the digestive powers, and to dimi- 
 nish flatulence ; hence the compound pills 
 of rhubarb are of great benefit, two being 
 taken every forenoon ; and the pills of 
 aloes with assafetida are so useful in this 
 disorder, that they are popularly known 
 by the name of hysteric pills. They may 
 be taken to the extent of two pills every 
 night, or every second night, for a week 
 or ten days at a time, according to their 
 effect on the bowels. As hysteria is al- 
 most peculiar to the female sex, and much 
 connected with the monthly discharge, 
 much of our attention is to be directed to 
 keeping this as regular as possible, both 
 as to time and quantity ; and, as we have 
 said frequently, this is best done by at- 
 tending carefully to the general health, 
 keeping the bowels open, and using a 
 tonic, but not a heating diet, with bark, 
 iron, cold bathing, country air, and regular 
 exercise. Much must be done to lessen 
 that mobility of the system, that readiness 
 to be affected with slight impressions, 
 that unbalanced mind that is filled with 
 joy or sorrow, gloom or anger, on every 
 trivial passing occurrence, and that is al- 
 most happy at the power of being thrown 
 into a fit when any thing crosses its will. 
 Religious principle, rational employment, 
 the steady pursuit of useful knowledge, 
 and the peaceful practice of domestic 
 duties, will be found most powerful anti- 
 dotes to the irritable, starting, querulous 
 excitement which so often usher in the 
 unseemly train of symptoms that consti- 
 tute the hysterical fits. 
 
:J22 
 
 ICE 
 
 ICE is sometimes used in medicine, 
 for the purpose of contracting the ves- 
 sels of the stomach in cases of vomiting- 
 of blood ; it is applied externally in rup- 
 tures to diminish the bulk of the swell- 
 ing by reducing the temperature; and 
 in cases of delirium and madness, it is 
 added to water, or pounded, and so ap- 
 plied to the head, to lessen the flow of 
 blood to it, and to stop delirium, convul- 
 sions, and inflammatory action. 
 
 ICHOR. A thin acrid discharge of a 
 pale bloody-looking fluid from the surface 
 of certain bad ulcers, as the cancerous, 
 and some others. The adjective derived 
 from it, is ichorous. The origin of the 
 term is to be found in the heathen my- 
 thology, which describes the vital fluid 
 of the gods, as not blood, but something 
 paler and more refined. 
 
 ICHTHYOSIS, Fi^A ^SAm. A disease 
 of the skin, having a thick, hard, rough 
 and scaly texture. At first, the skin is 
 discoloured and muddy-looking; at length 
 the hardness and roughness become 
 greater, and the colour is nearly black. 
 There are innumerable hard prominences, 
 sometimes flat, large, and overlapping 
 each other like the scales of fish ; at other 
 times, they are separate, and intersected 
 by whitish furrows. The whole skin is 
 dry, and perspires with difficulty. The 
 disease often commences in childhood, 
 and even in infancy. It is troublesome 
 and unmanageable, and has been known 
 to continue for several years. Dr. Willan 
 recommended to pick the scales oflf care- 
 fully with the nails from any part of the 
 body, while it is immersed in hot water. 
 Dr. Bateman has known the skin cleared 
 by bathing in sulphureous waters, and 
 rubbing it with a flannel or rough cloth, 
 after it had been softened by the bath ; 
 but the skin below was bright and shin- 
 
 ICT 
 
 ing, and the eruption returned. Pitch 
 pills have been taken with advantage, and 
 to a great extent: Four pills of five 
 grains each have been taken three times 
 a-day, and this quantity has been gra- 
 dually augmented, till three drachms have 
 been taken in a day. 
 
 ICTERUS. See Jaundice. 
 IDIOSYNCRASY, a peculiarity of 
 constitution, so that a person is affected 
 by certain agents, differently from the 
 generality of mankind. Thus some per- 
 sons are incapable of using butter or 
 cheese; some are purged by honey; 
 others cannot wear flannel without in- 
 tolerable irritation ; some have a violent 
 fever and eruption by the use of certain 
 kinds of fish, or certain fruits, or malt 
 liquor. Some people have idiosyncrasies 
 with respect to medicines; thus, opium 
 has so very distressing effects on some 
 patients, that it cannot be used by them 
 as by others. Idiosyncrasies are to be 
 discovered only by experience in each 
 individual case ; and where they are mat- 
 ters of indifference, it is needless to waste 
 time in combating them ; but where they 
 may lead to disease, or interfere with 
 methods of cure, a prudent physician will 
 endeavour to correct them. 
 
 ILIAC PASSION. A severe and pain- 
 ful affection of the bowels, in which the 
 patient is racked vnih most acute pain, 
 accompanied with costiveness and vomit- 
 ing, and this not only of the contents of 
 the stomach, but also of bile, and even of 
 matters proceeding from some portion of 
 the intestinal tube yet farther from the 
 stomach. So completely is the down- 
 ward progressive motion of the bowels 
 inverted, that articles which have been 
 given by way of clyster, have been known 
 to be vomited by the mouth. Costive- 
 ness sometimes precedes the disease for 
 
ILIAC PASSION. 
 
 333 
 
 some d^;9» and the pain is felt very much 
 about the navel. These symptoms may 
 occur without fever, but it is unlikely 
 that so violent suffering and such disor- 
 dered action of the intestines should not 
 both excite much irritation in the ner- 
 vous system, and also induce inflammation 
 in the bowels ; and therefore, if the iliac 
 passion be not very quickly relieved, we 
 may expect soon to find heat, thirst, rest- 
 lessness, quickened pulse, and pain in 
 some part of the abdomen on pressure. 
 We are informed by examination of the 
 bodies of those who have died of this dis- 
 ease, that a spasmodic action or cramp 
 takes place on some part of the intestines, 
 or that one part of the gut is drawn 
 within the other ; and the knowledge of 
 this circumstance leads us at once to be 
 cautious in our prognostics, and to see the 
 necessity of prompt and decided treat- 
 ment. 
 
 Causes. Iliac passion arises from food 
 that disagrees with the stomach and 
 bowels, long continued costiveness, har- 
 dened stools, some metallic poisons, and 
 cold applied to the feet or other parts of 
 the surface. 
 
 Cure. In cases of iliac passion, it is 
 always advisable to bleed, and that even 
 largely and repeatedly, both to prevent 
 inflammation coming on, and to take off 
 the spasm of the bowels. This removal 
 of spasm is to be further promoted by the 
 application to the belly of flannels wrung 
 out of hot water, or by putting the pa- 
 tient in the warm bath. It would be a 
 most desirable object to give purgative 
 medicines by the mouth, in order to re- 
 store the downward action of the intes- 
 tines, and to discharge any irritating mat- 
 ter ; but unhappily the stomach is apt to 
 reject them all, and to frustrate our pur- 
 pose. In this state, we must have re- 
 course to the seemingly dangerous and 
 unsuitable practice of giving opium, which 
 frequently relieves the pain, stops the vo- 
 miting, and permits us to use the proper 
 purgative medicines. For this purpose, 
 the tincture is not so good as solid opium, 
 one or two grains of which will remain 
 
 on the stomach, when thirty or forty 
 drops of the medicine in a liquid form 
 would be rejected. Patients should en- 
 deavour to refrain from drinking any 
 thing till the opium has allayed the irri- 
 tation. A large blister may be applied to 
 the abdomen ; it will probably be an ef- 
 fectual remedy, with the only disadvan- 
 tage that we have to wait some time for 
 its good effects. If the opium and blister 
 diminish the irritability of the stomach, 
 we are to try the exhibition of calomel, 
 giving four grains every hour ; and it is 
 bettei' retained when given dry or with a 
 little brown sugar, than when mixed with 
 jelly or any similar substance. A dose of 
 senna, or castor oil, or sulphate of mag- 
 nesia, may be given an hour after the third 
 or fourth dose of the calomel. From half 
 an ounce to an ounce of turpentine often 
 proves a most effectual purgative. Clys- 
 ters should never be omitted ; at first the 
 milder kinds should be tried, as a large 
 quantity of warm gruel, with a little oil, 
 or salt, or an infusion of senna, with a 
 portion of sulphate of magnesia. These 
 should be thrown in with considerable 
 force. If these remedies fail, a very effec- 
 tual, but a very hazardous one must be 
 tried, the injection of an infusion of to- 
 bacco, in the proportion of a drachm of 
 the leaves to an English pint of water. 
 This is very generally followed by the 
 most remarkable sickness, relaxation of 
 the system, and depression of etrength, 
 and must never be given but under the 
 direction and personal superintendence of 
 an experienced practitioner. It was at 
 one time thought a proper piece of prac- 
 tice to remove the obstruction of the bow- 
 els by mechanical means, as by the weight 
 of large quantities of quicksilver ; but a 
 moment's reflection must show, that from 
 the numerous convolutions of the intes- 
 tines, and the numerous changes of their 
 direction, no column of mercury can make 
 the direct pressure requisite to remove 
 the obstructions that may be in various 
 parts of the bowels. Metallic quicksilver 
 generally passes through the bowels, with- 
 out undergoing any change. 
 
324 
 
 INFANTS. 
 
 IMPERIAL. A drink made by dis- 
 solving-, or at least suspending cream of 
 tartar in water, and flavouring it with 
 lemon-peel. It ought never to be used 
 except as a medicine, being apt to retard 
 digestion, when used as common drink. 
 
 IMPETIGO. A disease of the skin, 
 applied in the advertisements of quacks to 
 a considerable variety of skin diseases ; 
 but in the more accurate language of Wil- 
 lan and Bateman, to certain pustular erup- 
 tions, of which the ringworm is one. See 
 Ringworm and Tetter. 
 
 INCUBUS. See Nightmare. 
 
 INDIGESTION. See Stomach Com- 
 plaints. 
 
 INDIAN CHOLERA. See Cholera 
 Morbus. 
 
 INFANTS, Diseases or. The period 
 of infancy may be considered as extending 
 from birth till all the milk or shedding 
 teeth are advanced through the gums. 
 The delicacy and peculiarity of the struc- 
 ture of infants at that period render them 
 susceptible of many disorders, and de- 
 mand unremitting and skilful care in their 
 management. It has been a long-prevail- 
 ing and general error, to suppose that 
 physicians are ignorant of the diseases and 
 management of infants, and that it is bet- 
 ter to leave them to the care of nurses land 
 old women, whose skill and experience ren- 
 der them far better qualified for the task. 
 Such notions, it is to be hoped, are now 
 almost extinct, even amongst the lowest 
 vulgar. The ill-informed and prejudiced 
 minds of such persons totally unfit them 
 for the discrimination and tenderness re- 
 quired in those who treat the diseases of 
 infants ; and these diseases present such 
 marked symptoms, that an attentive me- 
 dical man is more at home in prescribing 
 for them, than he is with many adults, 
 whose unskilful and sophisticated ac- 
 counts of their ailments are likely to dis- 
 turb his views of their case. 
 
 Why Infants are peculiarly susceptible 
 of Disease. At the time of birth, the 
 bones of the infant are soft and spongy ,• 
 many of those which in the adult are but a 
 single piece, are in the infant composed of 
 
 several pieces ; and the ends of the bones 
 which form the joints are as yet mere- 
 ly gristle. Their flesh is soft and flabby, 
 and there is a great proportion of cellular 
 substance. Their vessels of all kinds are 
 numerous, and act very frequently : thus, 
 the pulse of the infant is almost double 
 the quiclcness of that of an adult. Their 
 nerves are numerous, and easily receive 
 impressions. The skin is very delicate, 
 easily acted upon by external impres- 
 sions, and apt to have various morbid 
 affections induced upon it, by disorders 
 of the digestion, or other irregular ac- 
 tions of the internal organs. The head 
 of infants is large in proportion to their 
 body, their bones are thin, and not con- 
 nected together by indentations or su- 
 tures, as anatomists call them, but by 
 membrane; and the soft and vascular 
 brain, therefore, may be easily bruised 
 and injured. The eyes are very delicate, 
 and easily hurt, and the nose is peculiarly 
 susceptible of cold. The lungs also are 
 weak and irritable. The liver, which is 
 large at first, diminishes after birth. These 
 various peculiarities, and the delicacy of 
 their constitutions, especially in the di- 
 gestive organs, render them liable to va- 
 rious diseases. 
 
 To enumerate all the diseases of the 
 infant state, would be to present a long 
 and melancholy catalogue ; but parents 
 must console themselves with the thought 
 that every child is not liable to every dis- 
 ease, and that however numerous and for- 
 midable their complaints may be, there is 
 often a wonderful power in their frame, 
 enabling them to resist many noxious cir- 
 cumstances under which an adult would 
 sink. The principal diseases to which in- 
 fants are peculiarly liable are the follow- 
 ing: 1. Diseases which appear imme- 
 diately after birth, or imperfections of 
 structure, hare-lip, rupture of the navel, 
 division of the lower part of the spine 
 called spina bifida^ deformed feet, tongue- 
 tied, swelling of the breasts, purulent run- 
 ning from the eyes. 2. Their skin dis- 
 eases are wonderfully numerous, the gum, 
 white and red, chafing or scalding, scabby 
 
INFANTS. 
 
 eruption on the cheeks and forehead, itch, 
 eruptions resembling itch; mealy tetter, 
 wild-fire, dandriff, porrigo or scabbed 
 head, boils and pustules, purple spots, the 
 rose, sore ears, nettle-rash, spongy gums, 
 thrush, skin-bound, small-pox, measles, 
 cow-pox from inoculation, chicken-pox, 
 scarlet fever; roseola, a disease resembling 
 measles. 3. Teething and its numerous 
 maladies. 4, Various other diseases, wa- 
 ter in the head, convulsions or fits, palsy, 
 croup, hooping-cough, vomiting, looseness; 
 or its opposite state, costiveness; colic and 
 griping pains, inflammation of the bowels, 
 rickets, worms, jaundice, fevers of various 
 types, snuffles, fainting, difficulty of mak- 
 ing water, &c. 
 
 The greater part of these various ma- 
 ladies are treated of under their several 
 names. We shall here mention some par- 
 ticulars respecting the state of the bowels 
 of infants. 
 
 Costiveness of Infants. The bowels 
 of some infants are slower than others, 
 without this going the length of disease, or 
 requiring any interference. There should 
 not be less than one copious stool in the 
 twenty-four hours. If a longer period 
 than this should pass over without an 
 evacuation, a pretty smart laxative is to 
 be given for three or four successive days, 
 of manna, or magnesia, or castor oil, or 
 jalap, or syrup of senna. If these means 
 fail, there is reason to think that the 
 nurse's milk is in fault ; and if we cannot 
 correct it by altering her diet an.d keep- 
 ing her bowels open, it will be necessary 
 to change the milk. 
 
 Looseness o/" Infants. The number of 
 evacuations daily passed by infants with- 
 out prejudice to their health, is more than 
 those passed by adults; and wheu they 
 amount to four or five, it is not to be re- 
 garded as prejudicial, unless the health be 
 ijnpaired, or some symptom appear of the 
 child not thriving. When looseness hap- 
 pens in infants, the appearance of the 
 stools is very various. 1. They are light 
 green, and have a sour smell, forming 
 what is called in common language the 
 ^'een scour. Such stools are accompanied 
 
 with fretfulness and griping, but are rea< 
 dily cured by a purge of rhubarb and 
 magnesia, or of syrup of senna and rhu- 
 barb. The diet of the child should bo 
 arrow-root, and the diet and the bowels 
 of the nurse should also be regulated. 
 
 2. Sometimes the stools are slimy^ either 
 from exposure to cold or irritation of the 
 bowels, and they are also streaked with 
 blood. If there be great pain or fever, 
 we have reason to fear that one part of 
 the gut has been taken within another. 
 The warm bath, fomentations to the belly, 
 and a dose of castor oil are the proper 
 remedies. If the child be teething, it is 
 possible that the increased quantity of 
 acrid saliva swallowed may be the cause 
 of the looseness, and therefore it may be 
 useful to begin with giving an emetic. 
 
 3. The stools may be very liquid and of a 
 dark colour, occasioning what are called 
 watery gripes. This form of looseness 
 very speedily brings down the infant's 
 strength, and must be carefully attended 
 to. It is an attendant on teething, and 
 arises also from bad milk, or some mis- 
 management of the child. The cure is to 
 be attempted by an emetic of ipecacuan, 
 followed by a laxative of rhubarb or cas- 
 tor oil ; and the irritation of the bowels is 
 to be allayed by giving a clyster of starch 
 with a little laudanum, for three or four 
 successive nights. The state of the teeth 
 is to be attended to, and warm clothing 
 should be worn by the child. 4. Sometimes 
 large quantities of clay-coloured stooh are 
 passed, not liquid, but rather consistent ; 
 by these the strength is greatly reduced 
 m a very short time. Rhubarb and mag- 
 nesia, with a grain or two of calomel, fol- 
 lowed by purgatives of senna, opiate fric- 
 tions, and attention to the diet, are the 
 means to be tried; but the disease in 
 question is frequently fatal in spite of 
 them all. 5. The stools are sometimes of a 
 dark-green colotir, and resemble chopped 
 spinnage. Such stools are passed in the 
 course of croup and other acute diseases ; 
 they are also occasioned by frequent doses 
 of calomel Aloes, senna, and other pur- 
 gatives are the remedies to be employed. 
 
INFANTS. 
 
 6. At times, the stools consist principally of 
 the food in an unchanged state. This must 
 obviously be a very weakening and dan- 
 gerous affection. If it occurs after other 
 illnesses, it indicates that the powers of 
 life are nearly exhausted ; but if it arises 
 from teething, or other temporary irrita- 
 tion, it shows that the parts concerned in 
 digestion require some stimulus. Rhu- 
 barb in small doses, either of the powder 
 or tincture, alterative powders of calomel 
 and rhubarb, and a proper change of the 
 diet, are to be had recourse to. The va- 
 rious kinds of looseness may pass into one 
 another, and the particular causes of the 
 complaint may be difficult to distinguish. 
 Whatever be the original form of loose- 
 ness, when it is continued any length of 
 time, certain symptoms are induced which 
 indicate great danger. Such are a con- 
 stant fretfulness of temper, with an alter- 
 ed appearance of the countenance, uneasy 
 breathing, dryness of the skin, swelling 
 of the glands in the groin, great looseness 
 of the skin, of the thighs especially, and 
 distension or shrinking of the belly. A 
 voracious appetite or loathing of food are 
 both very dangerous symptoms. 
 
 Original Imperfections of Infants. In- 
 fants are sometimes born with parts defi- 
 cient, superfluous, or misplaced; some- 
 times the natural passages are closed, or 
 they have marks on different parts. 
 Many of these imperfections admit of no 
 remedy, others may be easily rectified. 
 Those which occur most frequently arc 
 the hare-lip; the fixing down of the 
 tongue so that the child cannot suck; 
 club-feet, ruptures. See Hare-lip, 
 Tongue-tied, Ruptures, &c. 
 
 " The natural passages of infants are 
 sometimes shut up, and prevent the usual 
 excretions. This is known by examining 
 the cloths and parts affected. In some 
 cases, slime alone proves the obstacle ; but 
 in others, membranous substances close 
 up the passages. In every instance where 
 any thing uncommon is observed, the in- 
 fant should be carefully examined by a 
 skilful surgeon, that the proper means for 
 affording relief may not be too long de- 
 
 layed. In some rare cases, it unfortu- 
 nately happens that no assistance can be . 
 given. It is, however, generally proper to 
 try the effect of an operation." (Pro- 
 fessor Hamilton.) 
 
 Infants, Management of immediate' 
 Itj after Birth. 1. Navel-String. When 
 the infant is separated from tlie mother, 
 and the navel-string is tied, the part at- 
 tached to the child should be almost three 
 fingers breadth ; and a little piece of linen 
 rag is to be wrapped round it, to keep it 
 from fretting the skin of the neighbour- 
 ing parts. In five or six days after birth, 
 this portion of the cord drops off, leaving 
 the part below a little tender, but this 
 goes off in a week or two merely by the 
 application of a singed rag. A split raisin, 
 by its succulence and astringency, makes 
 the process of healing quicker. But 
 sometimes a tedious ulceration takes 
 place, and a small fungous growth springs 
 up, or there may be erysipelatous inflam- 
 mation ; often a few fiery pustules show 
 themselves round the navel. The treat- 
 ment of these disorders is to be varied 
 according to circumstances, by astringent 
 washes, or by cooling lotions, or dry pow- 
 ders. Sometimes it may be necessary to 
 touch the rising flesh with a little caustic. 
 2. Washing. It is very proper to Mash 
 the new-born infant with tepid water, as 
 there may be various impurities about its 
 surface, and frequently a thick layer of 
 white viscid matter covers a great part of 
 its body. This washing should be very 
 gently performed, and we need not be 
 anxious to have every part of the sliin 
 quite clean. What does not come off at 
 the fiirst washing, m ill readily come off at 
 the next. No spirits should be put on 
 any part of the body. For the fii-st two 
 or three weeks, the water used for bath- 
 ing the child should be a little warmed, 
 and afterwards it should be bathed morn- 
 ing and evening in cold water. The 
 morning washing should be of the whole 
 body; in the evening it will be sufficient to 
 bathe the lower parts. The infant should 
 be always kept quite dry. 3. Clothing. 
 The good sense of modern times has abo- 
 
INFANTS. 
 
 327 
 
 lished the absurd and dangerous practices 
 of swathing and binding infants in the 
 tight manner it was formerly done. Their 
 dress should be light and easy, adapted to 
 the climate and season ; and in the night, 
 they should not be kept too warm. The 
 dress should be fixed with tapes, and not 
 with pins ^ and though a considerable ex- 
 tent of motion should be allowed to in- 
 fants, their hands should not be suffered 
 to scratch their face and eyes ; and a flan- 
 nel roller should be kept round the belly 
 for a protection to the navel, at which 
 there is apt to occur a rupture from their 
 violent crying. 4. Purging of Infants. 
 The bowels of new born infants contain 
 a large quantity of a dark, viscid, tena- 
 cious matter, which medical men call 
 meconium. In general, it comes off either 
 spontaneously, or with the help of a little 
 sugar and water, which is very common- 
 ly given to infants soon after birth ; but 
 if there be no black stools within six or 
 eight hours after birth, it will be neces- 
 sary to give a little castor oil, or a solu- 
 tion of manna, or to use a small piece of 
 yellow soap as a suppository. This black 
 matter will come off for a few days ; and, 
 in general, the first portion of milk which 
 the child sucks, acts as a purgative, and 
 cleans the bowels of all that remains of 
 the meconium. When it is retained too 
 long, it may be productive of consider- 
 able inconvenience ; and in the West In- 
 dies, is thought sometimes to give occa- 
 sion to the locked jaw in infants. 5. At?- 
 and Exercise for Infants. Nothing is of 
 more consequence to infants than good 
 air, but they must not be exposed to the 
 open air too soon j not for three weeks 
 or a month, unless the weather be unu- 
 sually fine. When infants are first taken 
 out of doors, they should not be kept out 
 long at a time ; the person who has charge 
 of them should walk gently, and be care- 
 ful to avoid standing still, especially in a 
 current of air. Exercise, as we have 
 mentioned under that article, is also es- 
 sentially necessary. At first, the common 
 operations of washing, and being dressed, 
 morning and evening, are sufficient exer- 
 
 cise; then the playfulness of a healthy 
 infant so delightful to its mother, and so 
 readily indulged by her, accomplish the 
 same purpose ; as the limbs get stronger, 
 the exercise may be extended still fur- 
 ther. All constrained postures and long 
 confinement in any one situation should 
 be avoided ; and the infant should not al- 
 ways be carried on the same arm, nor 
 be laid always on the same side. " A 
 healthy infant," says Dr. Parr, " is fond 
 of exercise. He should be moved gently 
 up and down, but without any shocks. 
 On this account, the modern cot is pre- 
 ferable to the cradle, for the child may be 
 shook by the latter into a stupor, which a 
 nurse (or keeper) will take care to do, as 
 it saves her the trouble of attending to 
 the infant's play. In dandling the child, 
 great inconveniences arise from com- 
 pressing the breast. The child sits on the 
 left hand, and, to prevent accidents, leans 
 forward against the right, placed on its 
 breast. If the nurse is timid, or if the 
 child starts, the only security is to clasp 
 the breast, by which the ribs are often 
 compressed. If, however, the right hand 
 is placed under the arm, with the thumb 
 over the shoulder, an active child may 
 even start from the other hand without 
 danger. The right hand will support it 
 or convey it gently to the ground. 
 Swinging seems to give children an un- 
 easy feeling J and even being carried 
 quickly down stairs, will make them 
 shrink to the nurse's breast. This is al- 
 most the only instinctive feeling, that, 
 after much observation of children, has 
 occurred to us. Gentle friction is an ex- 
 cellent addition to exercise, and peculiar- 
 ly grateful to infants. 
 
 " A healthy child scarcely ever cries. 
 This position, we know, will be disputed ; 
 and a child is said to be peevish, fretful, 
 and uneasy, when the nurse is careless 
 and inattentive. Dispositions undoubt- 
 edly differ ; but the parent who finds a 
 child constantly crying, should suspect 
 her nurse, and even herself. One cause 
 of this fretfulness is- the opinion that the 
 nurse knows when the child should sleep. 
 
3^ 
 
 INFLAMMATION. 
 
 or eat, better than itself. It is forced to 
 feed when not hungry, and to sleep when 
 eager for play or amusement. We have 
 often cured this disease, by correcting- the 
 attendant. It indeed happens, that some 
 children will not sleep by night, but even 
 this may be conquered by management ; 
 for the healthy child may be amused dur- 
 ing the day, and his amusements may be 
 gradually protracted till night approaches. 
 Disposition and fancies show themselves 
 very early to the attentive observer; and 
 when reason has not yet attained its 
 power, to correct them with violence, ir- 
 ritates without amending. Even at an 
 early age, children may be soothed into 
 regularity and obedience ; they cannot be 
 forced. If a child screams suddenly, he 
 is undoubtedly ill, and should be care- 
 fully attended to." (Parr's Medical Dic- 
 tionary.') 
 
 INFECTION. See Contagion and 
 Fever, page 262. 
 
 INFLAMMATION. A part of the 
 body is said to be inflamed^ when it is af- 
 fected with heat, swelling, redness, and 
 pain. We judge the same symptoms to 
 be present in parts not subject to our in- 
 spection, when, along with pain in an in- 
 ternal part, and an incapacity to perform 
 with ease its functions, there is a degree 
 of fever occurring throughout the system. 
 An inflammation may be so slight and 
 limited as to produce no derangement in 
 the system at large ; but if the inflamma- 
 tion be extensive, or if it attack certain 
 parts, the most violent general fever is 
 excited. In such a case, there is great 
 heat and dryness of skin, thirst, strength 
 and fulness of pulse, and other fever- 
 ish symptoms. When blood is drawn 
 from the body while in a state of in- 
 flammation, after the blood coagulates, 
 it appears covered with a tough lea- 
 thery looking surface, known by the 
 name of the inflammatory crust or buffy 
 coat. This is to be understood Aiith some 
 latitude, as even in strong inflammation, 
 certain circumstances may prevent the 
 buffy coat from showing itself; and in 
 pregnancy, Avhen no disease is present, 
 
 the bufly coat appears on blood drawn 
 from the veins. 
 
 Inflammation, Nature of. What it is 
 in the body that constitutes inflammation, 
 has been always a copious source of me- 
 dical controversy. It is yet the grand 
 problem to be resolved in pathology, and 
 the ready topic for the young and aspir- 
 ing disputant to show his powers at theo- 
 retical discussion. Some have thought it 
 is owing to a thickened state of the fluids 
 in the extreme vessels ; some to a con- 
 striction on the extremities of those ves- 
 sels ; some think there is an overaction 
 in the part inflamed ; some that the re- 
 verse, viz. diminished action, takes place. 
 But instead of occupying time by stating 
 unconfirmed opinions, it will be more 
 profitable to state the exciting causes of 
 inflammation, that we may be led to 
 avoid them, or to gather from them indi- 
 cations of cure. 
 
 Causes. 1. The application of heat by 
 burning or scalding ; of chemical acrids, 
 as the strong acids and alkalies ; and of 
 certain vegetable substances, as nettles. 
 2. Substances lodged in any part of the 
 body, either irritating by their acrimony, 
 or hurting by their being sharp or rough, 
 or by their bulk ; hence thorns, splinters, 
 bullets, excite inflammation. 3. Wounds, 
 bruises, lacerations, strains, afl^ect a part 
 with inflammation. 4. Cold applied is 
 a very frequent cause of it. 5. An un- 
 usual violence of the blood directed to 
 any particular part, has a tendency to in- 
 flame that part. 6. Inflammations of 
 greater or less extent arise in the body, 
 without our being able to assign any ex- 
 ternal cause. 
 
 Inflammation, Terminations and Con- 
 sequences of. When a part that has been 
 inflamed returns, either spontaneously or 
 in consequence of remedies, to its healthy 
 and natural state, the inflammation is said, 
 in surgical language, to end in resolution. 
 This is the most desirable way of its end- 
 ing, and is to be promoted by the various 
 means to be afterwards mentioned. Very 
 frequently, instead of resolving, inflamma- 
 tion proceeds till a new action is induced 
 
INFLAMMATION. 
 
 329 
 
 in the inflamed part; and a peculiar fluid 
 is formed, whitish, opaque, and in some 
 degree viscid, known by the name of pus 
 or matter. If we cannot obtain resolu- 
 tion of the inflammation, this is the next 
 best termination of it Pus may either 
 be thrown out by inflamed surfaces, or it 
 may collect in cysts or bags, which when 
 small are termed pustules, or when of a 
 larger size, abscesses. When the inflam- 
 mation is of extreme violence, it some- 
 times terminates in the mortification or 
 complete destruction of the parts; and 
 this may either be a death of a part only, 
 or it may be the forerunner of dissolu- 
 tion. Sometimes a consequence of in- 
 flammation is a thickening of the parts, 
 a hardness, a loss of transparency, as in 
 diseases of the eye ; or, parts naturally 
 separate may grow together, as happens 
 very frequently indeed when there is in- 
 flammation in the chest ; the membrane 
 covering the outside of the lungs form- 
 ing adhesions with that lining the inside 
 of the ribs. In the inflammation and sup- 
 puration arising from burns, wounds, &c. 
 care must be taken to keep asunder parts 
 which are included in the accident, but 
 which ought to be separate ; thus if the 
 fingers be tied up without something be- 
 ing interposed, they will grow together ; 
 and a stifi^ elbow-joint has been known 
 to be induced by unskilful dressing after 
 a bum. In glandular parts of the body, 
 as the liver, the breasts, and some of the 
 smaller glands, inflammation induces a 
 hardened unhealthy state, termed schir- 
 rus ; which renders it liable to an imper- 
 vious state or cancerous action, which may 
 ultimately prove fatal, though, for a time, 
 the functions may imperfectly go on. 
 
 Inflammation, Treatment ofy in gene- 
 ral. We are to endeavour, in almost eve- 
 ry case, to accomplish the resolution of 
 inflammation; and for this purpose, to 
 check the overaction of the system, or 
 of any particular part. This is to be 
 done by withdrawing blood, either from 
 the whole system, by opening a vein or 
 an artery ; or from any particular part by 
 jjceches, or by cupping : active purgatives, 
 
 particularly the neutral salts, are to be 
 given, and the depressing powers of anti- 
 mony, in its various shapes, are to be em- 
 ployed. Lotions are to be applied ia 
 some cases, either to the part, or as near 
 it as possible ; these are generally cold, 
 made by dissolving sal-ammoniac in wa- 
 ter, or mixing vinegar and water toge- 
 ther; but in some inflammations, as in 
 those of the eye, it is found better to apply 
 the lotion warm or tepid at first. When 
 these means fail, we are to try to pro- 
 mote the formation of matter ; and this 
 is to be done by increasing the heat of 
 the part by something soft and warm, as 
 poultices of bread and milk, linseed meal 
 or oat-meal, beat turnips, or boiled on- 
 ions or figs, or any thing of that nature 
 which will retain the heat long. A great 
 matter to be attended to in poultices, is 
 to make them large, and of such matters 
 as will keep the heat for a considerable 
 time. When an abscess is formed, and 
 the matter points, or seems ready to break 
 the skin, it should be discharged by aa 
 opening made by a lancet or sharp in- 
 strument. This is in general advisable ; 
 but cases may occur in which it might 
 be imprudent to risk the mark that may 
 be left by a cutting instrument, though it 
 is just as frequent for a mark to be left, 
 and even a worse one, when such ab- 
 scesses are allowed to break of themselves. 
 When the matter is discharged from an 
 abscess, the inflammation does not imme- 
 diately subside, but remains for some 
 time; and the poultice must be continued 
 for some days longer. Among the seve^ 
 ral varieties which inflammation exhibits, 
 two are remarkably distinguished from 
 each other : that which occurs in a com- 
 mon boil, and that which characterise? 
 the rose. The first, denominated by me- 
 dical writers the phlegmonous inflamma- 
 tion, is generally circumscribed, and 
 though very painful for the time, forms 
 an abscess and passes off without any dan- 
 ger ; the second, the erysipelatous, oft«a 
 spreads to a great extent, and is liable 
 to run into gangrene, and be attended 
 with the greatest hazard. The inflam- 
 
330 
 
 INFLUENZA. 
 
 mation of particular organs is attended 
 with its respective train of symptoms, dif- 
 ferent in each organ ; these are detailed 
 under various heads. See Eye, Brain, 
 Bowels, Lungs, &c. Inflammation of- 
 
 INFLUENZA. A name borrowed from 
 the Italians, and applied to the catarrh or 
 cold, which arises from a specific conta- 
 gion or aerial influence. There is no 
 epidemic that spreads more generally and 
 more widely. It has seldom appeared, 
 says CuUen, in any one country of Europe 
 without appearing successively in every 
 other part of it, and in some instances it 
 has been transferred even to America, 
 and has been spread over that continent, 
 so far as we have had opportunities of 
 being informed. The two latest epidemics 
 of this description occurred in 1782 and 
 1803 J and about twenty others are re- 
 corded, beginning at 1323. Influenzas 
 have occurred in all states of the atmos- 
 phere, with respect to its weight, its 
 moisture, or its temperature ; and the 
 previous state of the air, with respect to 
 heat or cold, damp or dryness, seemed to 
 have little power in the production of the 
 disease. 
 
 Symptoms. The symptoms of influ- 
 enza are in general more severe than those 
 of the common catarrh. " The attack is 
 remarkably sudden, and at first attended 
 with considerable debility. A few mi- 
 nutes have often interposed between the 
 feelings of high health and extreme weak- 
 ness. The head, especially the forehead 
 over the eyes, is particularly loaded ; all 
 exertion is painful, a tickling of the nose, 
 with frequent and violent sneezing, often 
 suddenly comes on. A load, rather than 
 pain, in the chest, is very troublesome, 
 cough is severe and dry, the tongue 
 parched, thirst often intense. A sore 
 throat is not a common symptom, yet a 
 bright efflorescence is sometimes observ- 
 ed on it. Pulse is low and frequent, sel- 
 dom hard, the skin constantly dry. In 
 the progress of the complaint, the breast 
 is sometimes more affected, and pleuritic 
 pains are observed in the young and ro- 
 bust. As the skin becomes softer, the 
 
 tickling acrid mucus from the nose be- 
 comes thicker, the head more free ; but 
 a considerable debility remains, often for 
 several months." Though the fever at 
 first is high, on its subsidence, alarming 
 debility and typhoid symptoms frequent- 
 ly come on, and in many cases the patient 
 is suddenly and unexpectedly carried off. 
 In more favourable circumstances, the in- 
 flammatory stage quickly passes off, but 
 the cough and other symptoms long con- 
 tinue troublesome, and en any exposure 
 to cold are very ready to return. In an 
 epidemic so widely spreading, it is to be 
 expected that it will occur in many young 
 persons disposed to pulmonary consump- 
 tion, and by its effects on the tubercles 
 in, the lungs give rise to suppuration in 
 them. 
 
 The middle-aged, the strong and ro- 
 bust, are in general soonest affected, and 
 suffer most severely. Children at the 
 breast generally escape, nor do any seem 
 to suffer within the first year. All be- 
 yond early infancy are indiscriminately 
 attacked. The influenza is very often fa- 
 tal to elderly people. 
 
 Treatment. Though the pain of the 
 side and difficulty of breathing are very 
 urgent, and may seem to call loudly for 
 bleeding, yet there is much doubt about 
 the propriety of this measure in the in- 
 fluenza. In the inflammatory stage, in 
 young and vigorous subjects, it may be 
 necessary for once j but this stage is soon 
 over, and that of debility commences; 
 and we must take care not to bleed at 
 too late a period, lest we induce a degree 
 of debility from which the patient will 
 not recover. The pains in the side are 
 better relieved by a blister ; and the bow- 
 els are to be kept easy, but the system is 
 not to be weakened by strong purgatives. 
 Emetics are often of great service in pro- 
 moting expectoration and relieving the 
 symptoms, but we must be on our guard 
 that the vomiting go not too far, and in- 
 duce dangerous weakness. Ipecacuan is 
 one of the best and safest emetics we can 
 employ. It may be given in smaller doses 
 so as to act as an expectorant ; and with 
 
INF 
 
 IN J 
 
 sai 
 
 the same intention, ^um ammoniacum, 
 and squill may be given. The squill pill 
 of the Edinbui^h Pharmacopoeia is as con- 
 venient a form as any other. Emulsions 
 are also of advantag-e. A most important 
 part of the treatment is keepings the body 
 clothed with flannel, and avoiding all ex- 
 posure to cold and damp air ; and gentle 
 perspiration is to be kept up by Dover's 
 powder, camphor, and warm liquids. Par- 
 ticular care is to be directed to keeping 
 up the strength. Wine in moderate quan- 
 tity at first, and afterwards more freely, 
 is to be allowed ; and the diet is to be 
 uourisliing and easily digestible. The 
 debility that remains after the disease, is 
 to be obviated by proper diet, good air, 
 exercise, particularly riding on horseback, 
 and the cold bath. 
 
 INFUSION. The extraction of the 
 virtues of vegetable or animal matters, 
 by allowing them to stand for a certain 
 period in water, either hot or cold, with- 
 out the assistance of boiling. The water 
 thus impregnated with these virtues is 
 called an infusion. The principal infu- 
 sions used in medicine arethose of senna, 
 as a purgative, of rose leaves as a gargle, 
 of catechu as an astringent, of rhubarb 
 as a stomachic, of bark as a tonic. " In 
 making infusions, whether in cold or hot 
 water, the ingredients are only steeped 
 in it without boiling. It is the same 
 whether proof spirit, rectified spirit, or 
 any other menstruum is employed, though 
 these preparations have a different title, 
 that of tinctures. This form is preferred 
 where the medicinal portion is soluble 
 and easily separated, when it is volatile 
 and would fly off by boiling, or where it 
 would be lost or destroyed by long ma- 
 ceration. For nervous disorders, infu- 
 sions are best made in a vinous, a spirit- 
 uous, or an alkaline menstruum. Sto- 
 machic infusions should be moderately 
 spirituous. Cathartic ones, whether sa- 
 line or resinous, if for extemporaneous 
 use, are best made with cold water. In- 
 fusions should not, if possible, be so fully 
 impregnated with the ingredients as to 
 make the medicines unpalatable, though 
 
 the infusion of many of the fetid plants 
 must be necessarily unpleasing. Many 
 infusions are most agreeable when made 
 with cold water, though probably weaker 
 than when heat is employed." In some 
 cases the M-^ater must be fully up to the 
 boiling point, as we see by the weakness 
 of tea which is made by water not quite 
 boiling. 
 
 INHALATION. When the dry fumes 
 or watery vapoui's of certain substances 
 are taken in by the breath with a view 
 to some medicinal effect, they are said to 
 be inhaled. To produce a very speedy 
 salivation, patients have been made to in- 
 hale the vapour of mercurial preparations. 
 Some bodies, by the very minute state to 
 which their particles are divided by heat, 
 are thus applied to organs which they 
 could not otherwise reach, the lungs par- 
 ticularly. On this principle, the vapour 
 of tar is recommended to be inhaled in 
 consumption and other pulmonary com- 
 plaints. When any tendency to inflam- 
 matory symptoms, or to spitting of blood 
 exists, inhaling the vapour of tar cannot 
 be very safe ; and it is chiefly in chronic 
 cases that it is admissible. The smoking 
 of stramonium may be considered as an 
 instance of inhalation. Many have boasted 
 its efficacy in relieving asthma, but its vir- 
 tues have been greatly over-rated. In 
 catarrhal affections, in sore throat and 
 croup, inhaling the steams of vinegar and 
 water is very beneficial; and in inflam- 
 mation of the chest, the same practice 
 will promote the expectoration, after the 
 proper bleedings and other evacuations 
 have been employed. For the applica- 
 tion of such vapours. Dr. Mudge has in- 
 vented an inhaler j but the spout of a tea- 
 pot, or a common basin with an inverted 
 funnel, will answer the purpose well 
 enough. 
 
 INJECTION. This word in popular 
 use is generally considered as sjmonymous 
 with clyster ; but it would be better to li- 
 mit the use of the term injectioUy to sig- 
 nify those liquids which are thrown into 
 the urethra and vagina, for the purpose 
 of lessening the discharges from those 
 
332 
 
 INOCULATION. 
 
 passages. The most common injections 
 for this purpose are made of sulphate of 
 zinc, or acetate of lead, or nitrate of lead, 
 or nitrate of silver, dissolved in more or 
 less of water, according^ to the intentions 
 of the surgeon. Injections into the urethra 
 are attended with a considerable degree 
 of hazard, and should never be employed 
 by the young and ignorant at their own 
 hand. Astringent decoctions, as those of 
 oak-bark, chamomile, and some others, 
 are used for injections in the whites,* 
 and as the astringent matter has the 
 power of coagulating animal mucus, this 
 combination comes away in the form of 
 whitish or ash-coloured flakes; the pa- 
 tient is under great apprehension that 
 she is discharging some of the internal 
 parts of the body; and it has therefore 
 been very properly recommended to pre- 
 pare her mind for such an occurrence, 
 by previous explanation. Sometimes the 
 harshness of astringent injections is use- 
 fully corrected by mixing them in some 
 demulcent fluid, as the infusion of lin- 
 seed. 
 
 INOCULATION. The introduction 
 of a small quantity of morbid matter into 
 the body at a wounded or abraded part. 
 This matter being carried into the sys- 
 tem by the absorbents, occasions specific 
 diseases according to its kind. Of this 
 we have examples in the insertion of the 
 saliva of the mad dog producing hydro- 
 phobia ; of the venereal poison producing 
 syphilis, and of the morbid matter which 
 is so dangerous to anatomists in dissect- 
 ing some dead bodies. In common lan- 
 guage, inoculation is generally applied to 
 the insertion of matter into the body with 
 the view of inducing certain diseases, 
 either for the purpose of rendering these 
 diseases, from which few of the human 
 race are exempt, more safe and manage- 
 able, or of occasioning a disease of a mild 
 nature, which has the effect of incapaci- 
 tating the body from receiving another 
 of a dangerous tendency. The inocula- 
 tion for the small-pox and for the cow- 
 pox are the instances most familiar. 
 
 The inoculation for the sraall-pox was 
 
 first practised among the natives of Cir- 
 cassia and Georgia ; and was introduced 
 into this country about the year 1721, by 
 Lady Mary Wortley Montague. It was 
 observed that fewer died of the small- 
 pox, who had been inoculated, than of 
 those who took them in the natural way ; 
 and the reason of this seems to be, that 
 inoculation was performed on children 
 in the most favourable circumstances, 
 vk^hen they were free from any other 
 disease either of an inflammatory or 
 debilitating tendency, when they were 
 prepared by cooling medicines, and be- 
 cause it was done at a favourable season 
 of the year. It is to be remarked, how- 
 ever, that although all this might be in 
 favour of the individual inoculated, it was 
 highly dangerous to his neighbours, as 
 it put them in the way of receiving the 
 infection of small-pox in the natural way; 
 and from a disease of the mildest and 
 most favourable kind, those living near 
 the patient might be seized with a most 
 malignant and fatal malady. It is, there- 
 fore, no wonder, that the discovery of 
 the power of cow-pox to unfit the con- 
 stitution for receiving the infection of the 
 small-pox, was received by the greater 
 part of the world with the highest satis^ 
 faction, as it inflicts on the individual pa- 
 tient a disease not only so slight as to be 
 absolutely insignificant, but one vkhich 
 has no danger of communicating to others 
 even this slight ailment, without some 
 pains being taken to procure its insertion 
 into the body at an abraded part. See 
 Small-Pox and Cow-Pox. 
 
 INOSCULATION or Anastomosis, 
 signifies, in anatomy, the running of the 
 arteries and veins into one another. 
 
 INSANITY, Mental Diseases; Ma- 
 nia, or Madness. It is difficult to give 
 a definition of mental disorders, that will 
 be satisfactory to the various classes of 
 persons who have to deal with the hu- 
 man mind. The metaphysician, the mo- 
 ralist, and the medical practitioner would 
 probably all differ in the degree of vice, 
 folly, absurdity, or fury, that they would 
 consi.der as constituting the state of mad-^ 
 
INSANITY. 
 
 333 
 
 ness ; while the infinitely diversified cha- 
 racters of men, and the changing intellect 
 and views of the same person at different 
 periods, tend still further to perplex the 
 subject, and require a great latitude to 
 be allowed in all our discussions on the 
 derangements of the understanding. In 
 a plain and practical work like this, we 
 shall not attempt the strictness of meta- 
 physical accuracy, but shall state some of 
 the more remarkable symptoms of mad- 
 ness, which are expected to be taken care 
 of by the medical attendant. Medical 
 writers, in treating on this subject, com- 
 monly adopt the following distinctions : — 
 I. Manitty or MadnesSy as it occurs either 
 in the sanguine or melancholic tempera- 
 ment. II. Fatuity y or Idiotism. III. Me- 
 lancholia, by which is meant, not what 
 we commonly understand in English by 
 the word melancholy ,- but the condition 
 of the mind of those who, on all sub- 
 jects but one, reason and act like other 
 men. 
 
 I. Mania. Madness is distinguished 
 by the patient having false and incorrect 
 views of things, especially shown by the 
 wrong opinions he entertains of his near- 
 I est friends ; suspecting them of the most 
 I malignant intentions towards him, and 
 treating them with the bitterest abuse 
 ' and hatred; he talks incoherently and 
 ' ravingly, and often with prodigious ra- 
 pidity, and for a long continuous period ; 
 the passions are not under the control 
 of the will, and there is, for the most part, 
 ' great violence of action, and furious im- 
 patience of restraint. 
 
 Insanity in the melancholic tempera- 
 ment has some variety in the symptoms. 
 Such patients are sad, dejected, and dull, 
 without any apparent cause ; gloomy and 
 fond of solitude. They are cowardly, 
 prone to anger, and changeable in their 
 tempers ; when the disease is at its height 
 they are very furious, and some tear and 
 mangle their own bodies. Their coun- 
 tenance is pale, and their pulse is slow ; 
 their bowels are generally costive. As 
 the paroxysm goes off, they are stupid, 
 calm, and mournful; and much griev- 
 
 ed on account of their unhappy situation. 
 Patients of this description are often la- 
 mentably prone to suicide. 
 
 A striking circumstance in maniacal 
 patients is their power of resisting im- 
 pressions from external things, which per- 
 sons in health feel so acutely. A maniac 
 will endure, for instance, an intensity of 
 cold, which would destroy a person in 
 health ; the ordinary doses of medicine , 
 have little or no effect upon them, and 
 they are capable of enduring hunger for 
 a very long time. The muscular strength ; 
 of maniacal persons is prodigiously in- j 
 creased ; and it is a difficult matter to re- j 
 strain them by the strength of other men / 
 in the violence of their paroxysms. 
 
 Persons of every different tempera- 
 ment are subject to madness, but it prin- 
 cipally attacks the exquisitely sanguine, 
 or the exquisitely melancholic. In many 
 cases of mania, it is not a permanent af- 
 fection, but there are what are called lu- 
 cid intervals, during which the patient 
 is in good health of mind and body. 
 Mania comes on at different periods of 
 life. It is not at all certain that the moon, 
 in any part of its course, has any influ- 
 ence on madness. Sometimes mania lasts 
 during the whole of the life of the pa- 
 tient, or degenerates into idiotism. The 
 immediate accession of a paroxysm of 
 madness does not show itself by the same 
 symptoms in different patients. Not un- 
 frequently they complain of uneasiness . 
 about the stomach, costiveness, heat, and 
 want of sleep. Soon after, the language 
 and conduct become incoherent, and the 
 motions and gestures wild and irregular ; 
 some are gloomy and sullen, while others 
 are good-humoured and disposed to laugh- 
 ter. In some cases the conduct is violent 
 and furious; there is grinding of the 
 teeth, rolling of the eyes, loud roarings, 
 great exertion of muscular strength, a de- 
 sire of hurting those around them, and 
 especially those who were formerly most 
 dear to them. 
 
 Causes of Insanfty. Though the ex- 
 amination of the bodies of maniacs has 
 as yet thrown no light on the causes of 
 
334 
 
 I N S A N I T Y. 
 
 madness, nor enabled us to say what part 
 of the brain or nervous system is prin- 
 cipally interested, yet we cannot doubt, 
 but in our present state of being, there is 
 the most intimate connexion between 
 mind and body, and that the disordered 
 intellect is connected with some remark- 
 able changes in the bodily functions. 
 
 It is very often a hereditary disease, 
 and there can surely be none of a more 
 afflicting nature. It is brought on by sud- 
 den and violent emotions of the mindj 
 jealousy, anger, love, pride, joy, disap- 
 pointment J though it is remarkable, that 
 an unexpected flow of prosperity, or a 
 sudden communication of joyful intelli- 
 gence, is more frequently known to up- 
 set the mind than the reception of disas- 
 trous news. Madness is often the sequel 
 of frequent intoxication, of violent ex- 
 ercise, of the sudden drying up of accus- 
 tomed drains or evacuation from the bo- 
 dy. The injudicious use of mercury, and 
 the occurrence of some febrile diseases, 
 has been known to excite madness ; and 
 some circumstances in parturition, though 
 we cannot say in what constitutions these 
 circumstances occur, seem to give rise 
 to madness ; but sometimes this last spe- 
 cies, though it lasts very long, is at last 
 got the better of. 
 
 Treatment. In the early and furious 
 stage of madness, something is to be at- 
 tempted by medical means, to allay the 
 violent excitement. The head is to be 
 shaved, and cold applied, either by pour- 
 ing on cold water and vinegar, by laying 
 on wet cloths, or, as has been sometimes 
 done, a clay cap. Blood may be drawn, 
 and purgative medicines of great activity 
 given, as gamboge, jalap, and scammony. 
 The remarkable resistance of the system 
 to the powers of medicine renders it ne- 
 cessary to increase the doses given, and 
 to persist in them for some time. To 
 prevent the maniac from injuring him- 
 self or others, the best expedient is the 
 strait waistcoat; and it is always dis- 
 tressing and hurtful to make the patient 
 contend with the strength of other men. 
 However painful to the feelings of friends 
 
 it may be to have recourse to the strait 
 waistcoat, it is in reality the most lenient 
 method we can employ ; it gives no pain 
 to the patient ; and very commonly when 
 he finds that his exertions are unavail- 
 ing, he gives them over, and continues 
 quiet. 
 
 The first period of the attack, when the 
 body is much disordered, is soon overl- 
 and then comes the difficult part, the 
 management of the mind. This has too 
 often been left to persons of rude habits 
 and unfeeling hearts, who have thought 
 to govern their unhappy charge by "brute 
 force, to restrain their violence by bolts 
 and chains, or to quell their passions by 
 blows and stripes. Of late years, a more 
 humane and rational practice has pre- 
 vailed. Persons of education, of prin- 
 ciple, and of humanity, have undertaken 
 the managem.ent of the insane; and though 
 they must necessarily employ meaner 
 hands in the details of their duty, their 
 superintendence has been faithfully ex- 
 erted to prevent any improper conduct 
 in their subordinate agents. When a 
 person becomes decidedly insane, it is 
 unquestionably the most prudent and 
 humane measure, to put him under the 
 care of persons who have devoted them- 
 selves to this occupation ; and to remove 
 them from their usual homes, to places 
 where security is combined with as much 
 comfort as their situation will admit of. 
 It is of great consequence to acquire an 
 influence over the minds of maniacs, and 
 this is to be done by the exercise of pru- 
 dence and firmness; by showing them 
 that their violent and outrageous conduct 
 does not lead them to the attainment of 
 their purposes. Coercion is in very many 
 cases absolutely necessary, and this should 
 be employed in the most peremptory and 
 effectual manner. It should be remember- 
 ed that the muscular strength of maniacs 
 is great, and therefore the force employed 
 in securing them should be amply suffi- 
 cient, and such as not only to prevent 
 the patient from being successful in his 
 resistance, but such as to show him in- 
 stantly that resistance is vain, Wlien the 
 
INSANITY. 
 
 335 
 
 keeper has established in the mind of the 
 maniac, the awe and respect necessary 
 for his management, the patient is to be 
 treated with all possible lenity and atten- 
 tion, conformable to his . station in life, 
 and to his former habits ; and every in- 
 dulgence consistent with his health and 
 security should be allowed. It is of great 
 moment to keep maniacs employed ; and 
 many establishments engage their patients 
 in constant and regular field-work or 
 exercise. This may be repugnant to the 
 former habits, and to the rank of some 
 patients, who are therefore deprived of a 
 resource and a means of cure, possessed 
 by their more humble fellow-sufferers. 
 Females are to be allowed their usual 
 occupations, drawing, music, sewing, knit- 
 ting, or the like. There is frequently a 
 degree of cunning about maniacs which 
 is very apt to deceive the ignorant and 
 inexperienced. They appear to conduct 
 themselves with great propriety when in 
 confinement, but whenever they return 
 to their families, their disorder returns. 
 Their relations should therefore be very 
 cautious about removing them. 
 
 The diet of insane persons should be 
 light, nourishing, and easy of digestion, 
 and in proper proportion to their bodily 
 strength, and the exercise they are accus- 
 tomed to take. Even of wine, a moderate 
 quantity is not to be prohibited to those 
 who have been accustomed to it, so long 
 as it does not heat the patient, or aggra- 
 vate his disease. With respect to medi- 
 cine and all its auxiliaries, drugs, warm 
 and cold bathing, and other appliances, 
 insanity seems to be quite beyond their 
 reach ; and the utmost we should attempt 
 in this way should be to obviate costive- 
 ness, and occasionally to administer the 
 warm bath. Some have thought a blister 
 or issue to the back or neck may be use- 
 fiil, but the dressing of such sores would 
 be so difficult that such expedients are 
 better let alone. In the melancholy or 
 depressed kind of madness, a little varia- 
 tion of the treatment is to be adopted. 
 Instead of withdrawing stimuli altogether, 
 we are to admit light and free air, to suffer 
 
 the patient to look out on green fields 
 and cheerful objects, and to permit every 
 healthful and safe amusement of which 
 they are capable. Every instrument of 
 destruction must be carefully kept out of 
 their way. Insane patients, when con- 
 fined in cold weather, are subject to a 
 mortification of the toes and feet, and 
 when helpless and bed-ridden, are liable 
 to ulcerations of different parts of the 
 body. To prevent these melancholy acci- 
 dents, the apartments of asylums should 
 be warmed by heated air ; and the parts 
 likely to become affected are to be rubbed 
 with emollient or stimulating liniments, 
 and soft substances should be put under 
 them to lessen the effects of pressure. 
 
 II. Fatuity or Idiotism is a very hope- 
 less kind of mental disease. It often 
 arises from original imperfection of the 
 faculties of memory and judgment, and 
 sometimes forms one of the sad train of 
 evils that beset the path of closing life. 
 It sometimes arises from epilepsy or or- 
 ganic diseases within the skull ; or it is 
 the consequence of disorders in which 
 the mind and body have been long debili- 
 tated. In the last cases only, is there 
 the smallest encouragement to attempt a 
 cure; and this is to be tried by cheerful 
 company, gentle exercise in the open air, 
 change of scene, a generous diet, and 
 attention to the bowels. 
 
 III. Melancholia is the technical terra 
 adopted by Cullen and other writers, for 
 that species of insanity in which, on all 
 subjects but one, the patient thinks and 
 acts correctly; No better example can 
 be given of this disorder, than one with 
 which all Europe is familiar, the case 
 of the Hero of La Mancha, the Cham- 
 pion and Flower of Chivalry. On all 
 subjects but one, Don Quixote displays 
 good sense and virtue of the highest or- 
 der; but Avhen knight-errantry and ro- 
 mance come across his disordered ima- 
 gination, he is betrayed into the most 
 absurd reasoning, wild adventures, and 
 ludicrous distresses. The treatment of 
 patients affected with this partial insanity, 
 scarcely belongs to the physician, unless 
 
336 
 
 INSANITY. 
 
 when there is considerable derangement 
 of the health, or when he is consulted as 
 to the propriety of putting them under 
 restraint. He can only recommend atten- 
 tion to what is likely to promote the 
 general health, especially the diet, and 
 the regularity of the alvine discharge; 
 and it is right to comply with the more 
 harmless fancies of the patient, and mildly 
 and unobtrusively to combat those which 
 are more dangerous. Precautions should 
 of course be taken, that those who labour 
 under partial insanity neither injure their 
 OAvn persons, nor those of others. Much 
 of the treatment is applicable here, 
 which we have detailed under Hypochon- 
 driasis. 
 
 In a late work, on the Intellectual 
 Powers, by Dr. Abercrombie, he has some 
 observations on the subject of Insanity, 
 which he discusses like a Christian moral- 
 ist as well as a physician ; and we are hap- 
 py to add to the foregoing very imperfect 
 sketch of the different kinds of insanity, 
 and their treatment, a large quotation 
 from his useful and judicious pages. 
 
 The principal distinction he makes of 
 mental diseases, is into insanity in its va- 
 rious kinds and degrees, and idiotism. 
 ** There is a peculiar power which is pos- 
 sessed by the mind in a healthy state, of 
 arresting or changing the train of its 
 thoughts at pleasure, — of fixing the at- 
 tention upon one or transferring it to an- 
 other, — of changing the train into some- 
 thing which is analogous to it, or of dis- 
 missing it altogether. This power is, to 
 a greater or less degree, lost in insanity, 
 and the result is one of two conditions. 
 Either the mind is entirely under the in- 
 fluence of a single impression, without the 
 power of varying or dismissing it, and 
 comparing it with other impressions ; or 
 it is left at the mercy of a chain of im- 
 pressions which have been set in motion, 
 and which succeed one another according 
 to some principle of connexion, over 
 which the individual has no control. In 
 both cases, the mental impression is be- 
 lieved to have a real and present existence 
 iu the external world ; and this false be- 
 
 lief is not corrected by the actual state of 
 things as they present themselves to the 
 senses, or by any facts or considerations 
 which can be communicated by other sen- 
 tient beings. Of the cause of this re- 
 markable deviation from the healthy 
 state of the mental functions, we know 
 nothing. We may trace its connexion 
 with concomitant circumstances in the 
 bodily functions, and we may investigate 
 certain effects which result from it ; but 
 the nature of the change, and the manner 
 in which it is produced, are among those 
 points in the arrangements of the Al- 
 mighty Creator which entirely elude our 
 researches. 
 
 " It appears, then, that there is a re- 
 markable analogy between the mental 
 phenomena in insanity and in dreaming ; 
 and that the leading peculiarities of both 
 these conditions, are referable to two 
 heads. 
 
 " 1. The impressions which arise in the 
 mind are believed to be real and present 
 existences, and this belief is not corrected 
 by comparing the conception with the ac- 
 tual state of things in the external world. 
 
 " 2. The chain of ideas or images which ^ 
 arise, follow one another according to 
 certain associations, over which the in- 
 dividual has no control : he cannot, as in- 
 a healthy state, vary the series or stop it 
 at his will. ( 
 
 " In the numerous forms of insanity, we 
 shall see these characters exhibited in va- 
 rious degrees; but we shall be able to trace 
 their influence in one degree or another 
 through all the modifications ; and, in the 
 higher states, or what we call perfect 
 mania, we see them exemplified in the 
 same complete manner as in dreaming. 
 The maniac fancies himself a king, pos- 
 sessed of boimdless power, and surround- 
 ed by every form of earthly splendour ; 
 and, with all his bodily senses in their 
 perfect exercise, this hallucination is in 
 no degree corrected by the sight of his 
 bed of straw and all the horrors of his 
 cell. 
 
 " From this state of perfect mania, the 
 malady is traced through numerous gra«> 
 
 w. 
 
 
INSANITY. 
 
 337 
 
 dations, to forms which exhibit slight de- 
 viations from the state of a sound mind. 
 But they all show, in one degree or an- 
 other, the same leading characters, namely, 
 tliat some impression has taken posses- 
 sion of the mind, and influences the con- 
 duct in a manner in which it would not 
 affect a sound understanding ; and that this 
 is not corrected by facts and considera- 
 tions which are calculated immediately to 
 remove the erroneous impression. The 
 lower degrees of this condition we call 
 eccentricity; and, in common language, 
 we often talk of a man being crazed upon 
 a particular subject. This consists in giv- 
 ing to an impression or a fancy, undue 
 and extravagant importance, without tak- 
 ing into account other facts and conside- 
 rations which ought to be viewed in con- 
 nexion with it. The man of this charac- 
 ter acts with promptitude upon a single 
 idea, and seems to perceive nothing that 
 interferes with it; he forms plans, and 
 sees only important advantages which 
 would arise from the accomplishment of 
 them, without perceiving difficulties or 
 objections. The impression itself may be 
 con-ect, but an importance is attached to 
 it disproportioned to its true tendency ; 
 or consequences are deduced from, and 
 actions founded upon it, which would not 
 be warranted in the estimate of a sound 
 understanding. It is often difficult to 
 draw the line between certain degrees of 
 this condition and insanity ; and in fact 
 they very often pass into each othen 
 This will be illustrated by the following 
 example. 
 
 " A clergyman in Scotland, after show- 
 ing various extravagances of conduct, was 
 brought before a jury to be cognosced ; 
 that is, by a form of Scotch law, to be 
 declared incapable of managing his own 
 affairs, and placed under the care of trus- 
 tees. Among the acts of extravagance 
 alleged against hira was, that he had burnt 
 his library. When he was asked by the 
 jury what account he could give of this 
 part of his conduct, he replied in the fol- 
 lowing terms : * In the early part of my 
 life, I had imbibed a liking for a most un- 
 
 profitable study, namely, controversial 
 divinity. On reviewing my library, I 
 found a great part of it to consist of 
 books of this description, and I was 
 so anxious that my family should not 
 be led to follow the same pursuit, 
 that I determined to bum the whole.' 
 He gave answers equally plausible to 
 questions which were put to him, re- 
 specting other parts of his conduct; 
 and the result was, that the jury found 
 no sufficient ground for cognoscing him ; 
 but, in the course of a fortnight from 
 that time, he was in a state of decided 
 mania. 
 
 ** It is, therefore, incorrect to say of in- 
 sanity, as has been said, that the maniac 
 reasons correctly upon unsound data. 
 His data may be unsound, that is, they 
 may consist of a mental image which is 
 purely visionary, as in the state of perfect 
 mania lately referr^ to; but this is by 
 no means necessary to constitute the dis- 
 ease; for his premises may be sound, 
 though he distorts them in the results 
 which he deduces from them. This was 
 remarkably the case in the clergyman 
 now mentioned. His premises were sound 
 and consistent, namely, his opinion of the 
 unprofitable nature of the study of con- 
 troversial divinity, and his anxiety that 
 his family sliould not prosecute it. His 
 insanity consisted in the rapid and partial 
 view which he took of the means for ac- 
 complishing his purpose, — burning his 
 whole library. Had he sold his librafi-y, 
 or that part of it which Consisted of con- 
 troversial divinity, the measure would 
 have been in correct relation to the ob- 
 ject which he had in view; and if we 
 suppose that, in going over his library, 
 he had met with some books of an im- 
 moral tendency, — to have burnt these, to 
 prevent them from falling into the hands 
 of any individual, would have been the 
 act both of a wise and a virtuous man. 
 But to burn his whole library, to prevent 
 his family from studying controversial 
 divinity, was the suggestion of insanity ; 
 distorting entirely the tnie relation of 
 things, and carrying an impression, iu it- 
 
338 
 
 INSANITY. 
 
 self correct, into consequences wliicli it 
 in no degree warranted. 
 
 " A remarkable peculiarity, in many- 
 cases of insanity, is a great activity of 
 . mind, and rapidity of conception, — a ten- 
 dency to seize rapidly upon incidental or 
 partial relations of things, — and often a 
 fertility of imagination, which changes 
 the character of the mind, sometimes 
 without remarkably distorting it. The 
 memory, in such cases, is entire, and even 
 appears more ready than in health ; and 
 old associations are called up with a ra- 
 pidity quite unknoAvn to the individual 
 in his sound state of mind. 
 
 " It is this activity of thought, and rea- 
 diness of association, that gives to maniacs 
 of a particular class an appearance of great 
 ingenuity and acuteness. 
 
 " The peculiar character of insanity, in 
 all its modifications, appears to be, that a 
 certain impression has fixed itself upon 
 the mind, in such a manner as to exclude 
 all others ; or to exclude them from that 
 influence which they ought to have on 
 the mind in its estimate of the relation 
 of things. This impression may be en- 
 tirely visionary and unfounded; or it may 
 be in itself true, but distorted in the ap- 
 plications which the unsound mind makes 
 of it, and the consequences which are de- 
 duced from it. Thus, a man of wealth 
 fancies himself a beggar, and in danger of 
 dying of hunger. Another takes up the 
 same impression, who has, in fact, sus- 
 tained some considerable loss. In the 
 one, the impression is entirely visionary, 
 like that which might occur in a dream. 
 In the other, it is a real and true impres- 
 sion, carried to consequences which it 
 does not warrant. 
 
 " There is great variety in the degree 
 to which the mind is influenced by the 
 erroneous impression. In some cases, it 
 is such as entirely excludes all others, 
 even those immediately arising from the 
 evidence of the senses, as in the state of 
 perfect mania foraierly referred to. In 
 many others, though in a less degree than 
 
 this, it is such as to change the whole 
 character. The particular manner in 
 which this more immediately appears, 
 Avill depend of course upon the nature of 
 the erroneous impression. A person, for- 
 merly most correct in his conduct and 
 habits, may become obscene and blas- 
 phemous; accustomed occupations be- 
 come odious to him; the nearest and 
 most beloved friends become objects of 
 his aversion and abhorrence. 
 
 " The uniformity of the impressions of 
 maniacs is indeed so remarkable, that it 
 has been proposed by Pinel, as a test for 
 distinguishing real from feigTied insanity. 
 He has seen melancholies confined in the 
 Bicetre, for twelve, fifteen, twenty, and 
 even thirty years ; and, through the whole 
 of that period, their hallucination has been 
 limited to one subject. Others, after a 
 course of years, have changed from one 
 hallucination to another. 
 
 " The sudden revival of old impres- 
 sions, after having been long entirely sus- 
 pended by mental hallucinations, presents 
 some of the most singular phenomena 
 connected with this subject. Dr. Prich- 
 ard mentions an interesting case of this 
 kind from the American journal of science. 
 A man had been employed for a day with 
 a beetle and wedges in splitting pieces of 
 wood for erecting a fence. At night, be- 
 fore going home, he put the beetle and 
 Medges into the hollow of an old tree, 
 and directed his sons, who had been at 
 work in an adjoining field, to accompany 
 him next morning to assist in making the 
 fence. In the night he became maniacal, 
 and continued in a state of insanity for 
 several years, during which time his mind 
 was not occupied with any of the sub- 
 jects with which he had been conversant 
 when in health. After several years his 
 reason returned suddenly, and the first 
 question he asked \^'as, whether his sons 
 had brought home the beetle and wedges. 
 They, being pfraid of entering upon any 
 explanation, only said, that they could 
 not find them ; on which he rose from his 
 bed, went to the field where he had been 
 at work so many years before, and found, 
 
INSANITY. 
 
 339 
 
 where he had left them, the wedges, and 
 the iron rings of the heetle, the wooden 
 part being entirely mouldered away. — A 
 lady, mentioned in the same journal, had 
 been intensely engaged for some time in 
 a piece of needle-work. Before she had 
 completed it, she became insane, and con- 
 tinued in that state for seven years, after 
 which her reason returned suddenly. One 
 of the first questions she asked related to 
 her needle-work, though she had never 
 alluded to it, so far as was recollected, 
 during her illness. I have formerly al- 
 luded to the remarkable case of a lady, 
 who was liable to periodical paroxysms 
 of delirium, which often attacked her so 
 suddenly, that, in conversation, she would 
 stop in the middle of a story, or even of 
 a sentence, and branch off into the subject 
 of her hallucination. On the return of 
 her reason, she would resume the conver- 
 sation in which she was engaged at the 
 time of the attack, beginning exactly 
 where she had left off, though she had 
 never alluded to it during the delirium ; 
 and, on the next attack of delirium, 
 she would resume the subject of hallu- 
 cination, with which she had been occu- 
 pied at the conclusion of the former par- 
 oxysm. 
 
 " Among the most singular phenomena 
 connected with insanity, we must reckon 
 those cases in which the hallucination is 
 confined to a single point, while, on every 
 other subject, the patient speaks and acts 
 like a rational man ; and he often shows 
 the most astonishing power of avoiding 
 the subject of his disordered impression, 
 when circumstances make it advisable for 
 him to do so. 
 
 " Lord Erskine gives a very remark- 
 able history of a man, who indicted Dr. 
 Munro for confining him without cause 
 in a mad- house. He underwent the most 
 rigid examination by the counsel of the 
 defendant, without discovering any ajv 
 pearauce of insanity, until a gentleman 
 came into coui't, who desired a question 
 to be put to him respecting a princess 
 with whom he had corresponded in cherry- 
 
 juice. He immediately talked about the 
 princess in the most insane manner, and 
 the cause was at an end. But this having 
 taken place in Westminster, he com- 
 menced another action in the city of Lon- 
 don, and, on this occasion, no effort could 
 induce him to expose his insanity ; so 
 that the cause was dismissed only by 
 bringing against him the evidence taken 
 at Westminster. Several years ago, a 
 gentleman in Edinburgh, who was brought 
 before a jury to be cognosced, defeated 
 eveiy attempt of the opposite counsel to 
 discover any trace of insanity, until a gen- 
 tleman came into court, who ought to 
 have been present at the beginning of the 
 case, but had been accidentally detained. 
 He immediately addressed the patient by 
 asking him what were his latest accounts 
 from the planet Saturn, and speedily eli- 
 cited ample proofs of insanity. 
 
 " Of the nature and cause of that re- 
 markable condition of the mental facul- 
 ties which gives rise to the phenomena 
 of insanity, we know nothing. We can 
 only observe the facts, and endeavour to 
 trace among them some general principle 
 of connexion ; and even in this, there is 
 great difficulty, chiefly from the want of 
 observations particularly directed to this 
 object. 
 
 " When the mental impression is of a 
 depressing character, that modification 
 of the disease is produced which is called 
 melancholia. It seems to differ from 
 mania merely in the subject of hallucina- 
 tion, and accordingly we find the two 
 modifications pass into each other, — the 
 same patient being, at one time, in a state 
 of melancholic depression, and at another, 
 of maniacal excitement. It is, however, 
 more common for the melancholic to 
 continue in the state of depression, and 
 generally in reference to one subject ; and 
 the difference between him and the exalt- 
 ed maniac does not appear to depend upon 
 the occasional cause. For we sometimes 
 find persons who have become deranged, 
 in connexion with overwhelming calami 
 
340 
 
 INSANITY. 
 
 ties, show no depression, nor even a re- 
 collection of their distresses, but the high- 
 est state of exalted mania. The differ- 
 ence appears to depend chiefly upon 
 constitutional peculiarities of character. 
 
 " The most striking peculiarity of me- 
 lancholia is the prevailing propensity to 
 suicide ; and there are facts connected 
 witli this subject, which remarkably il- 
 lustrate what may be called the philoso- 
 phy of insanity. When the melancholic 
 hallucination has fully taken possession 
 of the mind, it becomes the sole object of 
 attention, — without the power of vary- 
 ing the impression, or of directing the 
 thoughts to any facts or considerations 
 calculated to remove or palliate it. The 
 evil seems overwhelming and irremedi- 
 able, admitting neither of palliation, con- 
 solation, nor hope. For the process of 
 mind calculated to diminish such an im- 
 pression, or even to produce the hope of 
 a palliation of the evil, is precisely that 
 exercise of mind which, in this singular 
 condition, is lost or suspended ; — namely, 
 apower of changing the subject of thought, 
 of transferring the attention to other facts 
 and considerations, and of comparing the 
 mental impression with these, and with 
 the actual state of external things. Un- 
 der such a conviction of overwhelming 
 and hopeless misery, the feeling naturally 
 arises of life being a burden, and this is 
 succeeded by a determination to quit it. 
 When such an association has once been 
 formed, it also fixes itself upon the mind, 
 and fails to be corrected by those consi- 
 derations which ought to remove it. 
 That it is in this manner the impression 
 arises, and not from any process analo- 
 gous to the determination of a sound 
 mind, appears, among other circumstances, 
 from the singular manner in which it is 
 often dissipated ; namely, by the acciden- 
 tal production of some new impression, 
 not calculated, in any degree, to influence 
 the subject of thought, but simply to give 
 a momentary direction of the mind to 
 some other feeling. Thus, a man men- 
 tioned by Pinel, had left his house in the 
 night, with the determined resolution of 
 
 drowning himself, when he was attacked 
 by robbers. lie did his best to escape 
 from them, and, having done so, return- 
 ed home, the resolution of suicide being 
 entirely dissipated. A woman, mention- 
 ed, I believe, by Dr. Burrows, had her re- 
 solution changed in the same manner, by 
 something falling on her head, after she 
 had gone out for a similar purpose. 
 
 " Attempts have been made to refer 
 insanity to disease of bodily organs, but 
 hitherto without success. In some in- 
 stances, we are able to trace a coiniexion 
 of this kind ; but, in a large proportion, 
 we can trace no bodily disease. On this 
 subject, as m ell as various other points 
 connected with the phenomena of insani- 
 ty, extensive and careful observation will 
 be required, before we are entitled to ad- 
 vance to any conclusions. In regard to 
 what have been called the moral causes 
 of insanity, also, I suspect there has been 
 a good deal of fallacy, arising from consi- 
 dering as a moral cause, what was, really 
 a part of the disease. Thus, we find so 
 many cases of insanity referred to erro- 
 neous views of religion, so many to love, 
 so many to ambition, &c. But, perhaps 
 it may be doubted whether that which 
 was in these cases considered as the cause, 
 was not rather, in many instances, a part 
 of the hallucination. And even when 
 the mind does give way under a great 
 moral cause, such as overwhelming mis- 
 fortunes, we often find that the halluci- 
 nation does not refer to them, but to 
 something entirely distinct : — striking ex- 
 amples of this are mentioned by Pinel. 
 
 " Insanity is, in a large proportion of 
 cases, to be traced to hereditary predis- 
 position ; and this is often so strong, that 
 no prominent moral cause is necessary 
 for the production of the disease, and 
 probably no moral treatment would have 
 any effect in preventing it. We must, 
 however, suppose, that, where a tenden- 
 cy to insanity exists, there may be, in 
 many cases, circumstances in mental ha- 
 bits or mental discipline, calculated either 
 to favour or to counteract the tendencv. 
 
INSANITY. 
 
 3^1 
 
 " The higher dogroes of insanity are in 
 j[»^eneral so distinctly defined in their cha- 
 rjicters, as to leave no room for doubt in 
 deciding upon the nature of the affection. 
 But it is otherwise in regard to many of 
 the lower modifications; and great dis- 
 cretion is often required, in judging whe- 
 ther the conduct of an individual, in par- 
 ticular instances, is to be considered as 
 indicative of insanity. This arises from 
 the principle, which must never be lost 
 sight of, that, in such cases, we are not 
 to decide simply from the facts them- 
 sehes, but by their relation to other cir- 
 cumstances, and to the previous habits and 
 <iharact€r of the individual. There are 
 many peculiarities and eccentricities of 
 character which do not constitute insani- 
 ty ; and the same peculiarities may afford 
 reason for suspecting insanity in one per- 
 son and not in another; — namely, when 
 in tlie former, they have appeared sud- 
 denly, and are much opposed to his pre- 
 vious uniform character; while, to the 
 latter, they have been long known to 
 be habitual and natural. Thus, acts of 
 thoughtless prodigality and extravagance, 
 may, in one person, be considered entire- 
 ly in accordance with his uniform cha- 
 racter; while the same acts, committed 
 by a person formerly distinguished by se- 
 date and prudent conduct, may give good 
 ground for suspecting insanity ; — and in 
 fact constitute a form in which the affec- 
 tion very often appears. In ordinary 
 cases of insanity, a man's conduct is to be 
 tried by a comparison with the average 
 conduct of other men ; but, in many of 
 the cases now referred to, he must be 
 compared with his former self. 
 
 " Another caution is to be kept in mind, 
 respecting the mental impressions of the 
 individual in these or suspected cases of 
 insanity ; — that an impression, which 
 gives reason for suspecting insanity in 
 one case, because we know it to be en- 
 tirely unfounded and imaginary, may 
 allow of no such conclusion in another, 
 in which it has some reasonable or plausi- 
 ble foundation. Insane persons indeed 
 
 often relate stories which hang together 
 so plausibly and consistently, that we 
 cannot say whether we are to consider 
 them as indicative of insanity, until we 
 have ascertained whether they have any 
 foundation, or are entirely imaginary. 
 The same principle applies to the anti- 
 pathies against intimate friends which are 
 often so remarkable in the insane. They 
 may be of such a nature as decidedly to 
 mark the hallucination of insanity, — as 
 when a person expresses a dislike to a 
 child, formerly beloved, on the ground 
 that he is not really his child, but an evil 
 spirit which has assumed his form. This 
 is clearly insanity ; but if the antipathy 
 be against a friend or relative, without 
 any such reason assigned for it, we re- 
 quire to keep in view the inquiry, whe- 
 ther the impression be the result of hal- 
 lucination, or whether the relative has 
 really given any ground for it. In all 
 slight or doubtful cases, much discretion 
 should be used in putting an individual 
 under restraint, and still more in imme- 
 diately subjecting him to confinement in 
 an asylum for lunatics. But there is one 
 modification in which all such delicacy 
 must be dispensed with, — namely, in those 
 melancholic cases which have shown any 
 tendency to suicide. Whenever this pro- 
 pensity has appeared, no time is to be 
 lost in taking the most effectual precau- 
 tions ; and the most painful consequences 
 have very often resulted, in cases of this 
 description, from misplaced delicacy and 
 delay. 
 
 " Some of the points which have been 
 briefly alluded to, seem to bear on the 
 practical part of this important subject, — 
 the moral treatment of insanity. Without 
 entering on any lengthened discussion, 
 some leading principles may be referred 
 to the following heads :• — 
 
 " I. It will be generally admitted, that 
 every attempt to reason with a maniac is 
 not only fruitless, but rather tends to fix 
 more deeply his erroneous impression. An 
 important rule, in the moral management 
 
s^t 
 
 INSANITY. 
 
 of the insane, will therefore probably be, 
 to avoid every allusion to the subject of 
 their hallucination, to remove from them 
 every things calculated by association to 
 lead to it, and to remove them from scenes 
 and persons likely to recall or keep up the 
 erroneous impression. Hence, probably, 
 in a g-reat measure, arises the remarkable 
 benefit of removing the insane from their 
 usual residence, friends and attendants, 
 and placing them in new scenes, and en- 
 tirely under the care of strangers. The 
 actual effect of this measure is familiar 
 to every one, who is in any degree con- 
 versant with the management of the in- 
 sane. That the measure may have its 
 full effect, it appears to be of importance 
 that the patient should not, for a con- 
 siderable time, be visited by any friend 
 or acquaintance ; but should be separated 
 from every thing connected with liis late 
 erroneous associations. The danger also 
 is well known which attends premature 
 return to home and common associates; — 
 immediate relapse having often followed 
 this, in cases which had been going on 
 for some time in the most favourable 
 manner. 
 
 " II. Occupation. This is referable to 
 two kinds, namely, bodily and mental. 
 The higher states of mania, in general, 
 admit of no occupation ; but, on the con- 
 trary, often require coercion. A degree 
 below this may admit of bodily occupa- 
 tion, and, when this can be accomplished 
 in such a degree as fully to occupy the 
 attention, and produce fatigue, there is 
 reason to believe that much benefit may 
 result from it. On a similar principle it 
 is probable, that in many cases much be- 
 nefit might result from moral manage- 
 ment calculated to revive associations of a 
 pleasing kind, in regai-d to circumstances 
 anterior to the occurrence of the malady. 
 
 " III. Careful classification of the insane, 
 so that the mild and peaceful melancholic 
 may not be harassed by the ravings of the 
 maniac. The importance of this is ob- 
 vious ; hut of still jrreater importance it 
 will probably be, to watch the first dawn- 
 ings of i-cason, and instantly to remove 
 
 the patient from all associates by whom 
 his mind might be again bewildered. 
 
 " Cases of decided insanity in general 
 admit of little moral treatment, until the 
 force of the disease has been broken in 
 some considerable degree. But among 
 the numerous modifications which come 
 under the view of the physician, there 
 are various forms in which, by judicious 
 moral management, a great deal is to be 
 accomplished. Some of these affections 
 are of a temporary nature, and have so 
 little influence on a man's general con- 
 duct in life, that they are perhaps not 
 known beyond his own family or confi- 
 dential fiiends. In some of these cases, 
 the individual is sensible of the singular 
 change which has taken place in the state 
 of his mental powers, and laments the dis- 
 tortion of his feelings and affections. He 
 complains, perhaps, that he has lost his 
 usual interest in his family, and his usual 
 affection for them ; and that he seems to 
 be deprived of every feeling of which he 
 Mas formerly susceptible. The truth is, 
 that the mind has become so occupied by 
 the erroneous impression, as to be inac- 
 cessible to any other, and incapable of 
 applying to any pursuit, or following out 
 a train of thought. 
 
 " A most interesting affection of this 
 class often comes under the observation 
 of the physician, consisting of deep but 
 erroneous views of religion, — generally 
 accompanied with disturbed sleep, and 
 considerable derangement of the system, 
 and producing a state of mind closely 
 bordering upon insanity. It occurs most 
 commonly in young persons of acute and 
 susceptible feelings, and requires the most 
 delicate and cautious management. Two 
 modes of treatment are frequently adopt- 
 ed in regard to it, both equally erroneous. 
 The one consists in hurrying the indi- 
 vidual into the distraction of company, 
 or a rapid journey ; the other, in urging 
 religious discussions, and books of pro- 
 found divinity. Both are equally injudi- 
 cious, especiall}' the latter ; for every at- 
 tempt to discuss the important subject, to 
 which the distorted impression refers. 
 
INSANITY. 
 
 343 
 
 only serves to fix the hallucination more 
 deeply. The mode of treatment, which 
 I have always found most beneficial, con- 
 sists of regular exercise, with attention 
 to the general health ; and in enforcing a 
 course of reading of a nature likely to 
 nx the mind, and carry it forward in a 
 connected train. Light reading or mere 
 amusement will not answer the purpose. 
 A regular course of history, as formerly 
 mentioned, appears to succeed best, and 
 fixing the attention by writing out the 
 dates and leading events in the form 
 of a table. When the mind has been 
 thus gi'adually exercised for some time in 
 a connected train of thought, it is often 
 astonishing to observe how it will return 
 to the subject which had formerly over- 
 powered it, Avith a complete dissipation 
 of former erroneous impressions. A com- 
 mon complaint at the commencement of 
 such an exercise is, that the person finds 
 it impossible to fix the attention, or to re- 
 collect the subject of even a few sentences : 
 this is part of the disease, and, by perse- 
 verance, gradually disappears. This ex- 
 periment I .have had occasion to make 
 many times, and it has always appeared 
 to me one of extreme interest. I do not 
 say that it has uniformly succeeded, for 
 the affection frequently passes into con- 
 firmed insanity ; but it has succeeded in 
 a sufficient number of instances to give 
 every encouragement for a careful repe- 
 tition of it. The same observations, and 
 the same mode of treatment, apply to the 
 other forms of partial hallucination. The 
 plan is, of course, to be assisted by regu- 
 lar exercise, and attention to the general 
 health, which is usually much impaired. 
 The affections are particularly connected, 
 in a very intimate manner, with a disor- 
 dered state of the stomach and bowels, 
 and with derangements in the female con- 
 stitution. Means adapted to these be- 
 come, therefore, an essential part of the 
 management. 
 
 " In that remai'kable obliteration of the 
 mental faculties, on the other hand, which 
 MC call idiocy, fatuity, or dementia, there 
 is none of the distortion of insanity. It 
 
 is a simple torpor of the faculties, in the 
 higher degrees amounting to total insen- 
 sibility to every impression ; and some 
 remarkable facts are connected with the 
 manner in which it arises without bodily 
 disease. A man mentioned by Dr. Rush, 
 was so violently affected by some losses 
 in trade, that he was deprived almost in- 
 stantly of all his mental faculties. He 
 did not take notice of any thing, not even 
 expressing a desire for food, but merely 
 taking it when it was put into his mouth. 
 A servant dressed him in the morning, 
 and conducted him to a seat in his par- 
 lour,^ where he remained the whole day, 
 with his body bent forward, and his eyes 
 fixed on the floor. In this state, he con- 
 tinued nearly five years, and then recov- 
 ered completely and rather suddenly. The 
 account which he afterwards gave of his 
 condition during this period was, that 
 his mind was entirely lost ; and that it 
 was only about two months before his final 
 recovery, that he began to have sensa- 
 tions and thoughts of any kind. These 
 at first served only to convey fears and 
 apprehensions, especially in the night- 
 time. 
 
 " The most striking illustration of the 
 vai-ious shades of idiocy, is derived from 
 the modifications of intellectual condition 
 observed in the Cretins of the Vallais. 
 These singular beings are usually divided 
 into three classes, which receive the names 
 of cretins, semi-cretins, and cretins of the 
 third degree. The first of these classes, 
 or perfect cretins, are, in point of intellect, 
 scarcely removed above mere animal life. 
 Many of them cannot speak, and are only 
 so far sensible of the common calls of na- 
 ture, as to go, when excited by hunger, 
 to places where they have been accus- 
 tomed to receive their food. The rest of 
 their time is spent, either in basking in 
 the sun, or sitting by the fire, without 
 any trace of intelligence. The next class, 
 or semi-cretins, show a higher degree of 
 intelligence ; they remember common 
 events, understand what is said to them, 
 and express themselves in an intelligible 
 manner on the most common subjects. 
 
344 
 
 INSANITY. 
 
 They are taught to repeat prayers, but 
 scarcely appear to annex any meaning to 
 the words which they employ ; and they 
 cannot be taught to read or write, or 
 even to number their fingers. The cre- 
 tins of the third degree learn to read and 
 write, though with very little under- 
 standing of what they read, except on 
 the most common topics. But they are 
 acutely alive to their own interest, and 
 extremely litigious. They are without 
 prudence or discretion in the direction of 
 their affairs, and the regulation of their 
 conduct ; yet obstinate, and unwilling to 
 be advised. Their memory is good as to 
 what they have seen or heard, and they 
 learn to imitate what they have observed 
 in various arts, as machinery, painting, 
 sculpture, and architecture; but it is 
 mere imitation without invention. Some 
 of them learn music in the same man- 
 ner; and others attempt poetry of the 
 lowest kind, distinguished by mere rhyme. 
 It is said, that none of them can be taught 
 arithmetic, but I do not know whether 
 this has been ascertained to be invariably 
 true ; — there is no doubt that it is a very 
 general peculiarity. 
 
 " The imbecile in other situations, show 
 characters very analogous to these. Their 
 memory is often remarkably retentive; 
 but it appears to be merely a power of 
 retaining facts or words in the order and 
 connexion in which they have been pre- 
 sented to them, without the capacity of 
 tracing relations, and forming new asso- 
 ciations. In this manner, they sometimes 
 acquire languages, and even procure a 
 name for a kind of scholarship ; and they 
 learn to imitate in various arts, but with- 
 out invention. Their deficiency appears 
 to be in the powers of abstracting, recom- 
 bining, and tracing relations ; consequent- 
 ly they are deficient in judgment, for 
 which these processes are necessary. The 
 maniac, on the other hand, seizes rela- 
 tions acutely, rapidly, and often ingenious- 
 ly, — ^but not soundly. They are only in- 
 cidental relations, to which he is led by 
 some train of association existing in his 
 own mind; but they occupy his attention 
 
 in such a manner, that he does not admit 
 the consideration of other relations, or 
 compare them with those which have 
 fixed themselves upon his mind. 
 
 " The states of idiocy and insanity, 
 therefore, are clearly distinguished in the 
 more complete examples of both ; but 
 many instances occur in which they pass 
 into each other, and where it is difficult 
 to say to which of the affections the case 
 is to be refen-ed. I believe they may also 
 be, to a certain extent, combined ; or that 
 there may be a certain diminution of the 
 mental powers existing along with that 
 distortion which constitutes insanity. 
 They likewise alternate with one another ; 
 maniacal paroxysms often leaving the pa- 
 tient in the intervals in a state of idiocy. 
 A very interesting modification of another 
 kind is mentioned by Pinel. Five young 
 men were received into the Bicetre, whose 
 intellectual faculties appeared to be really 
 obliterated; and they continued in this 
 state for periods of from three to up\^'ards 
 of twelve months. They were then seized 
 with paroxysms of considerable violence, 
 which continued from fifteen to twenty- 
 five days, after which they all entirely re- 
 covered. 
 
 " Idiocy can seldom be the subject ei- 
 ther of medical or moral treatment; but 
 the peculiar characters of it often become 
 the object of attention in courts of la>v, 
 in relation to the competency of imbecile 
 persons to manage their own affairs ; and 
 much difficulty often occurs in tracing the 
 line between competency and incompe- 
 tency. Several years ago, a case occurred 
 in Edinburgh, which excited much dis- 
 cussion, and shows in a striking manner 
 «ome of the peculiarities of this condition 
 of the mental faculties. A gentleman of 
 considerable property having died intes- 
 tate, his heir-at-law was a younger bro- 
 ther, who had always been reckoned very 
 deficient in intellect; and consequently 
 his relatives now brought an action into 
 the Court of Session, for the purpose of 
 finding him incompetent, and obtaining 
 the authority of the Court for putting 
 him under trustees. In the investigation 
 
INSANITY. 
 
 316 
 
 of this case, various respectable persons 
 deponed, that they had long- known the 
 individual, and considered him as decided- 
 ly imbecile in his understanding, aiid in- 
 capable of managing his affairs. On the 
 other hand, most respectable evidence was 
 produced, that he had been, when at 
 school, an excellent scholar in the lan- 
 guages, and had repeatedly acted as a pri- 
 vate tutor to boys ; that he was remark- 
 ably attentive to his own interest, and 
 very strict in making a bargain ; that he 
 had been proposed as a candidate for holy 
 ordei's, and, on his first examination in 
 the languages, had acquitted himself well; 
 but that, in the subsequent trials, in which 
 the candidate is required to deliver a dis- 
 course, he had been found incompetent. 
 The Court of Session, after long plead- 
 ings, decided that this individual Avas in- 
 capable of managing his affairs. The case 
 was then appealed to the House of Lords, 
 where, after further protracted proceed- 
 ings, this decision was affirmed. I was 
 well acquainted with this person, and was 
 decidedly of opinion that he was imbecile 
 in his intellects. At my suggestion, the 
 following experiment was made, in the 
 course of the investigation. A small sum 
 of money was given him, with directions 
 to spend it, and present an account of his 
 disbursement, with the addition of the 
 various articles. He soon got rid of the 
 money, but was found totally incapable 
 of this very simple process of arithmetic, 
 though the sum did not exceed a few 
 shillings. This individual, then, it would 
 appear, possessed the simple state of 
 memory which enabled him to acquire 
 languages, but was deficient in the capa- 
 city of combining, reflecting, or compar- 
 ing. His total inability to perform the 
 most simple process of arithmetic, was a 
 prominent character in the case, analo- 
 gous to what I have already stated in re- 
 gard to the Cretins. In doubtful cases of 
 the kind, I think this might be employed 
 as a negative test with advantage ; for it 
 probably will not be doubted, that a per- 
 son who is incapable of such a process, is 
 incompetent to manage his affairs. 
 
 " It is a singular fact, that the imbecile 
 are, in general, extremely attentive to 
 their own interest, and perhaps most com- 
 monly cautious in their proceedings. Ru- 
 inous extravagance, absurd schemes, and 
 quixotic ideas of liberality and magnifi- 
 cence, are more allied to insanity ; — the 
 former may become the dupes of others, 
 but it is the latter, who are most likely 
 to involve and ruin themselves. 
 
 " Before leaving the subject of Insanity, 
 there is a point of great interest, which 
 may be briefly referred to. It bears in a 
 very striking manner upon what may be 
 called the pathology of the mental pow- 
 ers; but 1 presume not to touch upon 
 it, except in the slightest manner. In 
 the language of common life, we some- 
 times speak of a moral insanity, in which 
 a man rushes headlong through a course 
 of vice and crime, regardless of every 
 moral restraint, of every social tie, and of 
 all consequences, whether more immedi- 
 ate or future. Yet if we take the most 
 melancholy instance of this kind that can 
 be furnished by the history of human de- 
 pravity, the individual may still be recog- 
 nised, in regard to all physical relations, 
 as a man of a sound mind ; and he may 
 be as well qualified as other men, for the 
 details of business, or even the investiga- 
 tions of science. He is correct in his 
 judgment of all the physical relations of 
 things, but, in regard to their moral rela- 
 tions, every correct feeling appears to be 
 obliterated. If a man, then, may thus be 
 correct in his judgment of all physical 
 relations, while he is lost to every moral 
 relation, we have strong ground for be- 
 "lieving, that there is in his constitution a 
 power, distinct from reason, but which 
 holds the same sway over his moral poM'- 
 ers, that reason does among his intellec- 
 tual ; and that the influence of this power 
 may be weakened or lost, while reason 
 remains unimpaired. This is the moral 
 principle, or the power of conscience. It 
 has been supposed by some to be a modi- 
 fication of reason, but the considerations 
 DOW referred to appear to favour the opi- 
 
346 
 
 INTOXICATION. 
 
 nion of their being distinct. That this 
 power should so completely lose its sway, 
 while reason remains unimpaired, is a 
 point in the moral constitution of man 
 which it does not belong to the physician 
 to investigate. The fact is unquestion- 
 able ; the solution is to be sought for in 
 the records of eternal truth." (Da. Aber- 
 CROMJBiE o/j the Intellectual Powers, page 
 302, etseq.J 
 
 INTERMITTENT Fever. See Ague. 
 . INTOXICATION. The phenomena 
 of intoxication are too well known to 
 need any description. They are induced 
 by a variety of substances; many of which 
 may be so combined and modified, as to 
 produce effects on the body, useful for the 
 cure or mitigation of disease. The prin- 
 cipal intoxicating substances are opium, 
 which is much used in the east to pro- 
 cure serenity and cheerfulness ; bang, 
 prepared from the Indian hemp ( Canna- 
 bis Indicajy stramonium, tobacco, hen- 
 bane ; above all, fermented liquors, wine 
 and, spirits. " Spirituous liquors animate, 
 and for a time, the natural vigour is more 
 active ; but this effect is fleeting. If they 
 are often repeated, or too freely used, 
 their excess of action enervates the con- 
 stitution ; the appetite and the digestion 
 are impaired, the spirits fail, and a gene- 
 ral feebleness ensues. To relieve the ef- 
 fects of ebriety, we must employ mode- 
 rate stimulants and tonics, particularly 
 those which contain no portion of ardent 
 spirits. The most effectual are the Bath 
 waters, carbonate of ammonia, or even 
 the pure alkali, light bitters, with aroma- 
 tics. The action of the liver should be 
 assisted by calomel and other purgatives. 
 The most diflScult, but the most essential 
 part of the cure, is to prevent the continu- 
 ance of the practice. This can be seldom 
 obtained." The beginning of the practice, 
 therefore, should be carefully guarded a- 
 gainst. We feel some reluctance to quote 
 the passage immediately subjoined, lest 
 we should even seem to give any encou- 
 ragement to the vice which demands such 
 remedies. "When the over night's po- 
 tation has been too liberal, a wet napkin 
 
 should be bound round the head ; a quan- 
 tity of cold water should be placed at the 
 bed-side, and if a restlessness comes on, 
 with heat, a dryness of the tongue, &c. 
 this water should be drunk as freely as 
 the thirst requires ; thus, by degrees, a 
 perspiration is produced, and the most ef- 
 fectual relief obtained. On the succeed- 
 ing day, abstemiousness is requisite ; and 
 such a regimen is to be pursued, as is con- 
 sistent with the nature of the constitution. 
 A man of a strong healthy plethoric habit 
 should drink plentifully of thin, warm di- 
 luting liquids, mixed with vegetable acids; 
 keep in bed, and promote pei*spiration. 
 The weak, delicate, and relaxed, besides 
 abstinence from solid diet, should ride on 
 horseback, or talce some other gentle ex- 
 ercise in the pure air ; a glass or two of 
 generous wine, as a cordial, may be al- 
 lowed, or such other means pursued as 
 are calculated to invigorate the system, 
 and keep up an increased state of insen- 
 sible perspiration. To the most violent 
 effects of fermented spirits, vinegar is an 
 antidote. A sponge dipped in vinegar 
 should be frequently applied to the mouth 
 and nose ; an emetic that operates quickly 
 should be given ; a clyster, and after it, a 
 purging draught, may be administered; and 
 a gentle sweat promoted." (Dr. Parr.) 
 INTUS-SUSCEPTION means, that 
 one part of the intestinal canal is received 
 within another part as in a sheath, by 
 which the inclosed portion is strictured, 
 and great pain of the bowels, and danger 
 to life ensue, in consequence of inflamma- 
 tion thus excited. It is not very easily 
 distinguished from similar disorders of the 
 bowels, but it is to be treated on the same 
 principles, viz. reducing inflammation, 
 bringing about relaxation of the bowels 
 by the warm bath, or by clysters of in- 
 fusion of tobacco. Infants are not un- 
 frequently attacked with intus-susception 
 of the bowels, from exposure to cold, from 
 worms, and from the operation of too 
 violent purgative medicines. When this 
 disease is discovered in time, leeches, fo- 
 mentations, and some active purge are to 
 be resorted to. 
 
IPECACUAN. 
 
 347 
 
 IN UNCTION. The rubbing in of sub- 
 stances on the surface of the body for me- 
 dicinal purposes. Thus mercury is often 
 introduced into the system by inunction. 
 
 INWARD FITS of Infants. We 
 have placed this title, principally to intro- 
 duce the following quotation from E^r, 
 Underwood : ■** I know of no complaint 
 that ought to be termed inward fits ; and 
 I mention this, because nurses are con- 
 tinually talking to us about them when 
 children are perfectly well; and often 
 give the fond parent needless distress, as 
 well as many an unpleasant medicine to 
 the child. They are at the same time 
 treating the true convulsion, whilst slight, 
 in the same way, bein^led into the error 
 by the idea of inwam fits, a term they 
 are ever using, but have no precise ideas 
 of. It were therefore better, perhaps, the 
 term were altogether abolished; as the 
 child is either evidently convulsed, or has 
 no kind of fit, at least none for which any 
 remedy can be offered," {Diseases of 
 Children.^ 
 
 IODINE. A chemical substance dis- 
 covered at Paris in 1812, obtained by cer- 
 tain processes from the ashes of marine 
 plants, and introduced into medicine with 
 considerable advantage, in the case of 
 swellings of the glands of the neck. The 
 burnt sponge was formerly prescribed for 
 such swellings, and had totally lost its re- 
 putation ; till the discovery that it con- 
 tained iodine, restored hope of its being of 
 some benefit, and showed the grounds on 
 which such a hope rested. The forms in 
 which iodine is used, are the tincture, of 
 which the dose at first is ten drops a-day 
 in any viscid liquor, as gum, syrup, or 
 gruel ; or the hydriodate of potassa, of 
 which the dose is about the same quanti- 
 ty. Ointments arc also made with iodine, 
 in the proportion of one drachm of hy- 
 driodate of potassa to three drachms of 
 lard ; and of this ointment, a piece about 
 the size of a hazel nut is to be rubbed in 
 upon the swelling night and morning. 
 Very unexpected diminution of enlarged 
 glands has followed the use of this sub- 
 stance. In some cases, it produces fever- 
 
 ish symptoms, thirst, restlessness, and 
 diarrhoea; in which event, it should be 
 discontinued, and the proper remedies ap- 
 plied to the injurious symptoms. 
 
 IPECACUAN, Callicocca Ipecacu- 
 anha. The root of a plant found in Bra- 
 zil, which furnishes us with one of the 
 best and safest of our emetics. The in- 
 troduction of this celebrated root into 
 medical practice was chiefly owing to 
 Helvetius, grandfather of the celebrated 
 author of the work De VEsprity who 
 came from Holland to Paris very young- 
 to practise medicine. He attended and 
 cured a drug merchant, who paid him with 
 a packet of the root from Brazil called 
 Ipecacuanha. After some experiments 
 in the hospitals, Helvetius found it pos- 
 sessed the virtue of curing the dysentery. 
 Before the end of thirty-two years, he 
 had made 100,000 crowns by the cure of 
 that disease. Louis XIV. gave him a 
 thousand louis for his secret. So famous 
 was the success of the root, that it ob- 
 tained the name of Radix anti-dysen- 
 terica. If it did good in pure dysentery, 
 it must have been by maintaining a steady 
 motion of the intestines downwards, and 
 perhaps by determining to the skin ; but 
 in modern practice, we employ medicines 
 of greater certainty in that very distress- 
 ing, and, in warm climates, dangerous dis- 
 ease. For every purpose for which an 
 emetic is advisable, no better than ipeca- 
 cuan can be desii*ed. Even an overdose 
 hjis merely the effect of producing too 
 hasty an evacuation of the stomach, but 
 without any bad effects. It may be given 
 as an emetic to very young children, and 
 is not followed by the debilitating ex-^ 
 haustion induced by metallic and other 
 emetics. The root is reduced to powder, 
 and the dose for a gromi-up person is 
 from fifteen to twenty grains, for a child 
 above a few weeks old, from six to 
 twelve grains according to the age. 
 White wine extracts the emetic proper- 
 ties of ipecacuan ; and the ipecacuan wine 
 is a very good form of administering it, 
 provided there be no great degree of 
 fever present. To a child, a tea-siM>onful 
 
SiS 
 
 I R () N. 
 
 of the wine may be given every ten mi- 
 nutes till it operates. Like other emetics, 
 or perhaps with virtues superior in this 
 respect, it proves an excellent expectorant; 
 and may be taken for this purpose, in doses 
 of three or four grains three times a-day ; 
 or made up into lozenges, with some sweet 
 or aromatic substance ; the ipecacuan lo- 
 zenges contain half a grain each. In nau- 
 seating doses, ipecacuan is very useful in 
 hasmorrhagies from the lungs and uterus. 
 In dysentery, it may be used as an auxi- 
 iliary to other means. Combined with 
 opium, it forms the celebrated Dover's 
 powder, now called the powder of ipeca- 
 cuan and opium, a very effectual sudorific; 
 and for its soothing effects in colds, rheu- 
 matisms, and various instances of disor- 
 dered bowels, one of the most salutary 
 compositions of the pharmacopceia. 
 
 IRIS. The coloured circle at the an- 
 terior part of the eye, which by its con- 
 tracting in a bright light, and dilating in 
 a moderate one, regulates the admission 
 of light according to varying circumstan- 
 ces. The iris is subject to inflammation, 
 producing very violent symptoms; it is 
 cut to form an artificial pupil. See Eye 
 and its Diseases. 
 
 IRIS. The botanical name for the 
 Florentine orris. The root, dried and 
 powdered, enters into the composition of 
 some dentifrices. 
 
 IRON. This metal, so* widely diffused 
 through nature, so essential in its metal- 
 lic form, and its larger aggregations, to 
 the comfort, and even to the existence of 
 civilized society, is capable of entering 
 into various chemical combinations, which 
 render it fit to be taken into the body, 
 and capable of producing various salutary 
 effects. These are principally of a tonic 
 or strengthening nature. The prepara- 
 tions of iron most in use, are the car- 
 bonate, the sulphate, and the tincture 
 of muriate of iron ; steel filings are 
 also used, in the view of their being 
 oxidated in the stomach and intes- 
 tines in consequence of the minuteness of 
 their division. The doses of the various 
 preparations of iron, M'hen used as tonics. 
 
 are the following : Of the carbonate, from 
 ten to fifteen grains may be taken in any 
 tenacious substance, as jelly, honey, oi 
 the like ; of the sulphate, one or tw'o 
 grains may be rubbed together with aro- 
 matic powder, and taken at first once, 
 then twice a-day ; of the tincture of mu- 
 riate qf iron, ten drops may be given in 
 water twice a-day, increasing them to 
 twenty or thirty. The metallic iron for 
 internal use is commonly inclosed in 
 sweetmeats, and known by the name of 
 steel caraways, the dose of which is a 
 matter of no great nicety. The carbonate 
 of iron has of late been celebrated for 
 other virtues than those of a mere tonic, 
 and has been thought serviceable in the 
 painful afi'ection of the face called the 
 tic douleureux, and also in cancer. The 
 dose for this purpose is ten grains four 
 times a-day. A watery solution of the 
 tartrate of potass and iron is recommend- 
 ed as a chalybeate, particularly suited to 
 children from its tasteless quality. Pa- 
 tients who are using any of the prepara- 
 tions of iron are apt to be very much 
 alarmed at the black appearance of the 
 stools ; but it is merely a consequence of 
 the iron, and will go off when it is dis- 
 continued. 
 
 IRRITABILITY is that poAver inhe- 
 rent in muscular fibres, by which they 
 are susceptible of contraction, either in 
 consequence of volition or the applica- 
 tion of stimuli. On the nature of irrita- 
 bility there have been many disputes 
 among physiologists, which it would be 
 tedious and unprofitable to enumerate 
 here. Irritability, according to Haller, 
 differs greatly from sensibility ; for many 
 irritable parts are not sensible, and or- 
 gans which are both irritable and sensible 
 have by no means those qualities in the 
 same or any proportional degree. The 
 intestines, he remarks, are less sensible 
 than the stomach, though more irritable ; 
 and the heart is an organ peculiarly irri- 
 table, though by no means sensible. Ir- 
 ritability, or the power of contraction, is 
 exhausted by exercise and recruited by 
 rest. Muscles which act slowly and re* 
 
ISSUE. 
 
 349 
 
 gularly, preserve their irritability longer 
 than tliose which act with violence. 
 
 Irritability is applied in a sense half 
 medical half ethical, to that mobile, fret- 
 ful state, which is morbidly alive to every 
 impression. Persons in this state are also 
 called nervous. See Nervous. 
 
 IRRITATION. This term has been 
 used ambiguously in medical writings, 
 but its most obvious meaning is to ex- 
 press that state of uneasiness or excite- 
 ment from which we are anxious to be 
 freed, which is produced by some me- 
 chanical or chemical acrid, as a thorn un- 
 der the skin, or hartshorn in the nose. 
 Constitutional irritation is produced by 
 substances applied to the body, as can- 
 tharides, by matters disagreeing with 
 the stomach, by poisons, by surgical 
 operations, by burns, fractures, wounds, 
 and other injuries. Several morbid 
 actions are considered as arising from 
 ii'ritation, -though that may not be ob- 
 vious to the senses at the place where 
 it is applied ; thus, convulsions are ow- 
 ing to worms irritating the intestines, 
 or to the irritation of the gums in teeth- 
 ing. It has been properly observed, that 
 privations occasion symptoms of irritation. 
 Thus hunger produces restlessness and 
 anxiety ; and the sudden emptying of any 
 cavity, the want of the usual tension 
 either from external pressure or internal 
 fulness, will occasion uneasiness, which 
 has been styled a symptom of irritation. 
 
 ISINGLASS, or Fish Gluk is pre- 
 pared from several species of the stur- 
 geon, and imported from Russia. A nu- 
 tritious jelly may be formed from it. A 
 solution of it in water is used to clarify 
 spirituous liquors. Isinglass is employed 
 in the preparation of English court plaster. 
 
 ISSUE. A method of forming an ar- 
 tificial dischai-ge from the body, for the 
 prevention or cure of diseases. This is 
 done by the inti'oduction of foreign bodies 
 or of irritating dressings, which occasion a 
 discharge of purulent matter. The princi- 
 pal methods of effecting this, are the 
 pea-issue, the seton, and the issue by 
 slough or eschar. The way to make the 
 
 pea-issue, is to pinch up, and cut through 
 a portion of the skin, of such a size as 
 to hold one or two peas according to the 
 extent of the issue we want ; the peas are 
 then introduced into the wound, and are 
 covered up with adhesive plaster for three 
 or four days, by which time the discharge 
 of matter is fairly begun; the peas are 
 then taken out, fresh ones are put in, and 
 this is continued every day while we 
 wish to keep the issue open. To make 
 an issue by a seton, we introduce a skein 
 of silk into a broad needle, and push the 
 needle through the skin, bringing it out 
 at a greater or less distance from the 
 place of its insertion, according to the 
 quantity of matter we wish to be daily 
 discharged. When the needle is pushed 
 through the skin, we fasten the silk so as 
 to allow a fresh portion to be applied to 
 the internal surface of the wound every 
 day. The issue by eschar is made by ap- 
 plying some acrid or caustic matter to de- 
 stroy a portion of the skin, and when this 
 dead portion is destroyed and has fallen 
 out, the ulcerated surface below is to be 
 dressed with any irritating ointment pro- 
 per to keep up the discharge. Care must 
 be taken not to destroy more of the skin 
 than Ave want. A piece of leather, co- 
 vered with adhesive plaster, is to have a 
 hole cut in it of the size we wish the 
 issue to be ; this is to be applied to the 
 place intended, and the skin opposite to 
 the hole to be rubbed with caustic potash 
 moistened with water, till the whole part 
 which we wish to be destroyed puts on a 
 dark and corroded appearance. Any su- 
 perfluous caustic is to be carefully wash- 
 ed off; the plaster is to be removed, and 
 a poultice to be put on the part. In a 
 few days, the eschar drops off, and leaves 
 a raw surface, which may either be filled 
 with peas, beads, or similarly formed 
 substances ; or may be dressed with 
 savine ointment, or basilicon, to pro- 
 mote the discharge of matter- The 
 employment of issues in the cure of dis- 
 eases, or in the prevention of various 
 morbid affections, is sanctioned by Jong 
 experience ; and the casts in which they 
 
350 
 
 , ITCH. 
 
 are useful are very numerous. In i^'^id- 
 diness, rin^ng- of the ears, flushed coun- 
 tenance, and other symptoms showing too 
 much tendency to the head, and threat- 
 ening apoplexy or palsy, an issue in the 
 neck, combined with other means, may 
 not only remove the impending danger, 
 but, if persisted in, may secure the patient 
 from any future attack of the kind, and 
 even restore health when the attack has 
 been suffered. In diseases of the spine, 
 of the hip-joint, and of the knee-joint, 
 issues are one of the principal remedies 
 on which we rely. In scrofula, by keep- 
 ing up a discharge from a place that is 
 usually covered, we may prevent run- 
 nings and unsightly scars about the neck 
 and face. 
 
 The benefits arising from the use of 
 issues, form a counterpart to what we 
 see of the bad effects of healing an 
 ulcer, to which a person has been long 
 accustomed. In such cases, it is not un- 
 common to find the drying up of old sores 
 followed by headach, or by affections of 
 the chest, or other symptoms of ill health ; 
 and it is always a matter of prudence to 
 provide some other drain, before we at- 
 tempt to cure such habitual sores. 
 
 ITCH. A M^ell known cutaneous dis- 
 ease, supposed to be peculiarly prevalent 
 in Scotland, but by no means unknown 
 in other countries. It commonly arises 
 from infection communicated by touching 
 the body or clothes of a person already 
 infected, or by using the same bed-clothes 
 as those who have it. It is greatly owing 
 to the want of cleanliness, and seems 
 much to affect the inhabitants of cold 
 countries ; but the use of oatmeal, which 
 has been blamed as occasioning the itch, 
 does not deserve this reproach. The itch 
 is shown in small pimples about the fin- 
 gers, the wrists, the thighs, and the mid- 
 dle of the body ; it atiacks every place 
 except the face : the itching is very 
 
 troublesome, and the scratching, by break- 
 ing the pustules, causes the disease to 
 spread still more. Sometimes the pus- 
 tules are large, and filled with purulent 
 matter like boils. This purulent kind 
 principally occurs in children between the 
 age of seven and fourteen. The irritation 
 of itch is almost entirely local, and does 
 not produce general fever. In some spe- 
 cies of itch, but not often, minute insects 
 arc found in the reddish streaks or fur- 
 rows near the pustules, but not in them ; 
 but in the vast majority of cases the com- 
 munication of the disease does not depend 
 on the transference of insects, but on 
 that of matter. 
 
 Cure. For this filthy disease, sulphur 
 is an effectual and long established re- 
 medy. It may be taken internally, or 
 applied to the skin, formed into an oint- 
 ment with lard or butter. The parts af- 
 fected are to be well rubbed every night; 
 or if they are very extensive, one half 
 may be rubbed in the morning, and the 
 other in the evening. Five or six appli- 
 cations commonly cure the disease ; but 
 it is prudent to continue the rubbing for 
 a few days after the cure is apparently 
 completed. The only objection to the 
 sulphur is its disgusting smell and appear- 
 ance. These may be disguised by the ad- 
 dition of strong smelling perfumes com- 
 posed of essential oils, and other sub- 
 stances ; and in order to cure the disease 
 without sulphur, various other remedies 
 have been tried. The root of the white 
 hellebore made into an ointment, or a de- 
 coction, has been known to cure the itch; it 
 is said to be one of the ingredients, along 
 with sal-ammoniac, in the Edinburgh itch 
 ointment, (not, however, made in Edin- 
 burgh, but in London.) Sulphuric acid 
 has also been recommended, and corrosive 
 sublimate. But for common and general 
 use, nothing ought to supersede the al- 
 most unfailing powers of sulphur. 
 
•351 
 
 J AL 
 
 JALAP, Convolvulus Jalapa^ a plant 
 growing at Xalapa in Mexico, the po^vder- 
 ed root of which is a very useful and much 
 employed purgative. The dose is from ten 
 to twenty grains, but it is not often used by 
 itself, but commonly conjoined with calo- 
 mel, in the proportion of one part of calo- 
 mel to two of jalap j the dose of such a purge 
 for an adult of good strength is five grains 
 of calomel to sixteen of jalap, to be taken 
 in jelly, honey, or any viscid substance, to 
 prevent the calomel falling down by its 
 great weight. To fonn a very drastic or 
 active purge, as may be desirable in some 
 affections of the head, or with the view 
 of bringing otF a large quantity of water 
 in dropsies, a purge may be formed by 
 joining together six grains of aloes, ten of 
 jalap, and five of scammony or gamboge ; 
 the watery stools produced by such a dose 
 are sometimes of a surprising quantity, 
 and give very gi'eat relief. 
 
 JALAP, Compound Powdeu of. An- 
 other most useful form of employing jalap, 
 is by combining it with cream of tartar ; 
 constituting the compound powder of ja- 
 lap, one of the most manageable of purga- 
 tives, which with most persons acts very 
 speedily and safely, and not only evacu- 
 ates the bowels, but for the time increases 
 the flow of urine. The proportions are 
 one part of jalap to two of cream of tar- 
 tar ; and the dose of the compound powder 
 is from forty grains to sixty. It may be 
 taken in plain water, gruel, beer, or any 
 liquid most convenient for the patient. 
 
 JAMES'S POWDER. Dr. James, the 
 contriver of the celebrated antimonial 
 powder which bears his name, pubhshed 
 a Medicinal Dictionary in 1 743, which he 
 dedicated to Dr. Mead. He was the 
 early friend of Samuel Johnson, at Lich- 
 field, before he came to settle in the 
 metropolis. As his character Avas re- 
 
 JAL 
 
 spectable, it is with regret we see his 
 name associated with a nostrum. " The 
 pulvis antimonialis, (oxide of antimony 
 with phosphate of lime, of the Edin- 
 burgh Pharmacopoeia,") says Dr. Paris, 
 " was introduced into the pharmacopoeia 
 as the succedaneum for the celebrated fe- 
 ver-powder of Dr. James, the composi- 
 tion of vA'hich was ascertained by Dr. 
 George Pearsou. It consists of 43 parts 
 of the phosphate of lime, mixed, or per- 
 haps chemically combined, with 51 parts 
 of oxide of antimony, of which a portion 
 is vitrified; and it is probable that the 
 difference of the two remedies depends 
 principally upon the quantity of oxide 
 which is vitrified : the specification of 
 the original medicine is worded with all 
 the ambiguity of an ancient oracle, and 
 cannot be prepared by the process as it 
 is described. Experience has establish- 
 ed the fact, that James's powder is less 
 active than its imitation ; it affects the 
 stomach and bowels very slightly, and 
 passes off more readily by perspiration ; 
 in general, however, the diflerence is so 
 inconsiderable, that we need not regret 
 the want of the original receipt. As it 
 is quite insoluble in water, it should be 
 given in powder, or made into pills. It 
 is diaphoretic, alterative, emetic, or pur- 
 gative, according to the extent of the 
 dose and the state of the patient ; in com- 
 bination it ofi'ers several valuable re- 
 sources to the intelligent practitioner. 
 The dose is from three to five grains. 
 But it may be fairly questioned whether 
 this remedy has not been far too highly 
 appreciated. • Dr. James was certainly 
 very successful in its use ; but it must 
 not be forgotten that he usually combin- 
 ed it with some mercurial, and always 
 followed it up with bark." (Dr. Paris'i 
 Pharmacoloyia.) 
 
352 
 
 JAUNDICE. 
 
 JAUNDICE. A disease characterised 
 by a universal yellowness of the skin, 
 and of the white of the eyes ; itching- of 
 the surface of the body, a white or clay- 
 like appearance of the stools ; while the 
 urine tinges linen of a yellow colour. 
 The disease is attended by a sense of wea- 
 riness and languor, a feeling of pain or 
 uneasiness about the pit of the stomach, 
 and there is sometimes a slight difficulty 
 of breathing. There is also sickness, vo- 
 miting, sourness of stomach, and various 
 other symptoms of indigestion. There 
 is sometimes an acute pain on the right 
 side, below the margins of the ribs. There 
 is not, in general, much fever. It is a 
 vulgar error to believe that patients in 
 jaundice see objects of a yellow colour. 
 
 Causes. The liver is a very large 
 gland, which secretes a great quantity of 
 bile for the purposes of digestion. This 
 fluid, ^lell known by the name of gall, 
 passes into the intestines not many 
 inches below the lower opening of the 
 stomach, it there mixes with the food, 
 passes on, stimulates the intestines, and 
 imparts their usual colour to the excre- 
 ments. When any thing prevents the 
 bile getting into the intestines after it 
 is formed in the liver, certain vessels 
 absorb it, carry it into the mass of blood 
 with which it mixes, and giving it the 
 yellow colour, is seen through the skin 
 and vessels ; and more particularly shows 
 itself in those vessels where there is 
 usually not red blood, but clear lymph, 
 as in the eyes. The bile not going 
 where it should, to assist digestion, that 
 function is disordered ; and the stools, de- 
 prived of bile, put on the appearance of 
 whitish clay. The circumstances which 
 prevent the bile from getting into the 
 intestines are various; one of the most 
 frequent is the formation of concretions, 
 or what are called gall-stones, either in 
 the passage leading from the gall-bladder, 
 or that from the liver itself; these stones 
 get into the common passage leading into 
 the intestines, and so obstruct the entrance 
 of the bile. Or there may be a spasm or 
 irregular contraction in the tube itself. 
 
 and this may contii^ie long enough to al- 
 low the bile to be absorbed into the blood, 
 and so give rise to jaundice ; or there may 
 be a degree of inflammation, causing a 
 thickening of the sides of the tube, and 
 this may be temporary or permanent. 
 Other organic diseases may take place 
 about the liver itself or the neighbouring 
 organs, and whatever obstructs to a great 
 degree, or totally obliterates the passage 
 into the intestines, w ill occasion jaundice. 
 The cases Avhich are most frequently re- 
 covered from, are those in which the 
 obstruction is caused by gall-stones ; when 
 these, by dilating the tube, open for them- 
 selves a passage into the intestines, and 
 allow one also for the bile to the same 
 place, the disease very quickly subsides. 
 But if there be any invincible organic ob- 
 struction, the disease is incurable. 
 
 Treatment. If "we have reason to 
 think that gall-stones are the cause of 
 jaundice, which we do, among other 
 reasons, from finding occasionally some 
 small ones mingled with the faeces, we 
 are to try to dislodge them by a prudent 
 use of emetics. We not unfrequently 
 succeed by the use of antimonials, but 
 we must be careful not to repeat them 
 too frequently, lest we do harm by fix- 
 ing the gaU-stones more than before, and 
 lest we weaken further the powers of 
 digestion already impaired. We are to 
 give chamomile tea with a little tincture 
 of aloes, or soap pills with rhubarb, as 
 bitters, to endeavour to supply the defi- 
 ciency of bile. As calomel is particularly 
 efficacious in stimulating the extremity 
 of the gall-duct, and causing it to dis- 
 charge its contents into the bowels, it is 
 to be given with the view of soliciting 
 the descent of the stone ; and for the same 
 purpose, exercise, especially on horseback, 
 is to be recommended. The itching of 
 the skin is to be alleviated by the warm 
 bath ; and when there is much pain with- 
 out fever, an opiate will be useful ; but 
 when there is heat, thirst, fixed pain, and 
 difficulty of breathing, blood-letting, purg- 
 ing, blistering, and antiphlogistic remedies 
 will be proper. When the acute symp- 
 
JAW 
 
 JUN 
 
 353 
 
 toms last mentioned accompany jaundice, 
 they probably indicate not the passing 
 of a gall-stone, but inflammation in that 
 region, which indeed may be owing to 
 the excitement caused by the passage of 
 too great a calculus. Our treatment in 
 that case, must not be by emetics, bitters, 
 and exercise, but by the remedies calcu- 
 lated to subdue inflammation. When the 
 pain is not constant, but intermits occa- 
 sionally, it is probably owing to spasm, 
 and must be treated by opiates and the 
 warm bath. In the organic affections, 
 which we suspect when the disease is 
 obstinate and protracted, we can only 
 palliate symptoms, attending to the bow- 
 els, and giving bitters, soap, and alkalis ; 
 trying a course of mercury, if we judge 
 the patient has strength to bear it. The 
 severe and sometimes fatal jaundice of 
 infants, called the yellow gum, has been 
 treated of under the article Gum. 
 
 JAWS. Anatomists describe the bones 
 of the face as composed of the upper and 
 lower jaws. In the margin of these, the 
 teeth are placed. The upper jaw consists 
 of thirteen bones ; the lower jaw of a 
 single bone. The upper jaw is immove- 
 able ; the under one is articulated with the 
 temporal bone ; and has several muscles 
 attached to it, M'hich enable it to move 
 with great force upwards and downwards, 
 while too much motion to either side 
 is prevented by strong ligaments. The 
 lower jaw is the principal agent in chew- 
 ing, swallowing, and speaking. The lower 
 jaw is sometimes dislocated, and this ge- 
 nerally when the mouth is open. The 
 accident, of course, impedes the functions 
 of chewing, of speaking, and of retaining 
 the saliva; and no time should be lost in 
 attempting the reduction. The surgeon 
 is to wrap some coarse linen round his 
 thumbs, to introduce the thumbs thus 
 guarded, back upon the grinding teeth; 
 to push them downward, while with his 
 ifingers he endeavours to push the jaw 
 
 upward at the chin. This generally re- 
 places it. The luxation is to be prevented 
 from recurring by a proper bandage, and 
 by avoiding for some time the use of food 
 requiring mastication. 
 
 JELLY. A substance which coagu- 
 lates when we press out the juice of ripe 
 currants, gooseberries, and many fruits, 
 and allow it to rest for some time. The 
 jelly of different fruits is preserved with 
 sugar for domestic purposes; and its 
 grateful acidity renders it of signal be- 
 nefit in many feverish disorders, and dis- 
 eases of the throat and mouth. When 
 dissolved in water, jelly forms a cooling, 
 pleasant drink. Animal jelly is more 
 correctly termed gelatine, under which 
 article we have given an account of its 
 properties and uses. See Gelatine. 
 
 JESUITS' BARK. The Peruvian- 
 bark is so called, because the Jesuits im- 
 ported large quantities of it from South 
 America into Europe. See Bark. 
 
 JUGULAR VEINS, the large veins 
 running along the sides of the neck, which 
 convey back to the heart the blood col- 
 lected after circulating in the head. In 
 disorders of the head, and in inflammatory 
 affections of the throat and neighbouring 
 parts, in croup, and some other disorders, 
 it is sometimes of considerable conse- 
 quence to take a^'ay blood quickly from 
 the neighbourhood of the part; and in 
 such cases, this is successfully accom- 
 plished by opening the jugular vein. 
 
 JUNIPER, Juniperus communis. The 
 fruit of the juniper contains an essential 
 oil, possessed of diuretic powers ; and it is 
 this oil that gives to gin its diuretic proper- 
 ties, and renders it the best spirituous li- 
 quor to allow, if any be allowed at all, to 
 patients labouring under dfopsy. The 
 essential oil of juniper may be given to 
 promote the flow of urine, in the dose of 
 from two to ten drops upon white sugar, 
 or formed into an emulsion with a drachm 
 or two of the sweet spirit of nitre. 
 
 2 A 
 
354 
 
 K 
 
 KID 
 
 KAJEPUT OIL. See Cajeput. 
 
 KALI. The oldnarae for potash. See 
 Potash. 
 
 KIDNEY. An organ situated at the 
 back part of the loins, one on each side, 
 in which the urine is secreted. From 
 the kidneys, it passes by two long tubes, 
 called the ureters, into the bladder. The 
 kidneys are subject to various diseases of 
 a very painful kind, to inflammation, and 
 to the formation of calculous concretions 
 in them, giving rise to many distressing 
 symptoms. 
 
 Kidney, Inflammation ofy is known 
 by a severe pain in the back part of the 
 loins, the urine is of a deep red colour, 
 and voided in small quantity at a time, 
 and very frequently j thirst, heat, quick- 
 ened pulse, and the usual symptoms of 
 fever attend. A pain stretches from the 
 kidney to the bladder, and vomiting is 
 very frequently present. 
 
 Causes. The principal causes of in- 
 flammation in the kidneys are external 
 violence applied near the part, strains of 
 the back and loins, hard riding, exposure 
 to cold, certain acrid substances taken 
 into the stomach, as cantharides, and some 
 of the balsams : the presence of sand or 
 gravel may also give rise to inflammation. 
 There are certain habits of body pecu- 
 liarly disposed to inflammatory affections 
 of the kidney, especially the gouty ; and 
 it is a well known observation, that the 
 females of gouty families are subject to 
 diseases of the kidneys, while the males 
 have the gout in its regular form on the 
 extremities. 
 
 Prognosis. The danger of the disease 
 is to be estimated from the severity of 
 the symptoms, and from the quantity and 
 appearance of the urine which is passed. 
 If there be a remission of the pain and 
 fever, a copious flow of urine and gene- 
 
 KID 
 
 ral perspiration, we may have hopes of a 
 favourable termination of the case. If 
 the disease continues seven or eight days, 
 if the pain in the part becomes dull and 
 heavy, if the patient is affected with fre- 
 quent shiverings, there is reason to fear 
 that suppuration has taken place. Some- 
 times, in fatal cases, the kidney has been 
 found converted into a bag of matter. 
 If one of the kidneys remains sound, it 
 may perform the functions of both, and 
 comparatively little inconvenience may 
 ensue ; but in other cases, the kidneys 
 may be unable to secrete the urine, and 
 so to clear the blood of its acrimonious 
 parts ; death, therefore, must be the con- 
 sequence. 
 
 Diagnosis. Some of the symptoms of 
 inflammation resemble those of a stone 
 in the kidney or bladder, which last affec- 
 tion is known by pain in the region of 
 the kidney, which is not at first accom- 
 panied by fever ; there is a numbness of 
 the thigh and a drawing up of the testicle 
 of the affected side, with almost constant 
 sickness and vomiting. If the stone is too 
 large to pass from the kidneys into the 
 ureter, or if it sticks in any part of that 
 passage, it may excite violent pain, and 
 at length inflammation and suppuration. 
 If it passes into the bladder, it will pro- 
 bably be the nucleus of a larger stone, 
 and give rise to the long train of painful 
 and dangerous symptoms of stone in the 
 bladder. See Stone. 
 
 Treatment. We are to endeavour to 
 remove inflammation of the kidney by 
 bleeding, both from the system, and from 
 the neighbourhood of the part, by cup- 
 ping or by leeches ; by purgatives chiefly 
 of the saline kind, and by giving such 
 diuretics as do not irritate the kidneys 
 very much ; such are the acetate of po- 
 tash, given in the dose of twenty or 
 
KNEE-JOINT. 
 
 355 
 
 thirty grains twice a-day, adding to each 
 dose half a drachm of squill vinegar, and 
 the same quantity of spirit of nitrous 
 ether, administering 'them in half a pint 
 of infusion of quassia, and half a pint 
 of cinnamon-water. Warm fomentations 
 should be applied to the region of the 
 kidneys, emollient clysters may likewise 
 be thrown up, and, as a similar remedy, 
 the warm bath may be employed. Per- 
 spiration may be induced by the various 
 preparations of antimony. Blisters are 
 improper, as the cantharides might be ab- 
 sorbed, and irritate the urinary passages. 
 
 KING' S EVIL. Scrofula was so call- 
 ed, from the superstitious notion, that it 
 could be cured by the royal touch. Queen 
 Anae seems to have been the last of our 
 monarchs who endeavoured to impart a 
 cure in this way ; but that fancy prevail- 
 ed so lately as the coronation of Louis 
 XVI. and he is said, on that occasion, to 
 have touched two thousand persons afflict- 
 ed with that malady. See Scrofula. 
 
 KING'S YELLOW is an impure sul- 
 phuret of arsenic, which is a good deal 
 used in painting, and a favourite poison 
 in this country for killing flies ,* hence it 
 has often been the cause of fatal accidents ; 
 and has sometimes been used intentionally 
 as a poison ; producing the usual symp- 
 toms occasioned by arsenic. 
 
 We take this opportunity of mention- 
 ing that it is a mistake to believe that 
 arsenic has an acrid taste when in the 
 act of being swallowed. Dr. Christison 
 has not been able to discover any actual 
 case where this sensation was perceived ; 
 and says we may rest assured that it often 
 makes no impression at all, as it has been 
 swallowed unknowingly with articles of 
 food. The mistake has probably arisen, 
 from the impression in the act of swal- 
 lowing having been confounded with the 
 inflammation in the throat, subsequently 
 developed along with the other inflamma- 
 tory symptoms. 
 
 KINO. An astringent substance ob- 
 tained from an African plant. It was 
 long uncertain what plant furnished kino, 
 but it is thought now to be proved, that 
 
 it is the Pterocarpus erinacea. It is used 
 to check diarrhoea, and for the other pur- 
 poses for which astringents are employ- 
 ed, in the dose of twenty or thirty grains 
 of the powder, or two drachms of the 
 tincture. One part of powdered kino to 
 four of alum forms a styptic powder, 
 which in the dose of from ten to twenty 
 grains twice a-day is recommended in 
 menorrhagia and the whites. 
 
 KNEE-JOINT. This joint admits of 
 flexion and extension ; it is made up of 
 the thigh bone, the large bone of the 
 leg, and the knee-pan. It is surrounded 
 by a large capsular ligament, in which 
 a fluid is sometimes collected. There 
 are two ligaments within the joint, 
 which cross each other; these ligaments 
 are stretched when the leg is extended, 
 and relaxed when the leg is bent, allow- 
 ing at this time a little lateral motion. 
 Between the thigh bone and that of the 
 leg are two semilunar cartilages, thick 
 on their external edges, and thin at the 
 centre ; they alter their figure according 
 to the situation of the bones, to make 
 the shape of one correspond to that of the 
 other. 
 
 Knee-Joint, Loose Cartilages in. 
 Sometimes one or two pieces of cartilage, 
 or of bone covered by cartilage, are 
 found in the cavity of the knee-joint. 
 They are generally flat and oblong, and 
 have their edges rounded. They are 
 commonly about the size of a horse-bean, 
 often much smaller, and sometimes con- 
 siderably larger ; when very large, they 
 do not give so much trouble to the pa- 
 tient as the smaller kind. From the irri- 
 tation of these bodies, the fluid which 
 lubricates the joint is secreted in greater 
 quantity, the capsular ligament is dis- 
 tended, a degree of stiffness of the joint 
 takes place, with more or less of external 
 inflammation. Sometimes the symptoms 
 are so mild as not to need an operation; 
 but often, that is the only means oi relief. 
 Sometimes the operation succeeds ; but 
 in other cases, severe inflammation and 
 lameness ensue. As the danger of in- 
 flammation to the joint is very great. 
 
356 
 
 KNEE-JOINT. 
 
 some have proposed to try a laced knee- 
 cap, or a roller and compress, wlien the 
 loose cartilage is so situated as not to occa- 
 sion pain. In one case, this method was 
 tried for ten years with complete success. 
 
 Knee- Joint, White Swelling of. This 
 is a very formidable disease, to which 
 oints, but more especially the knee- 
 oint, are liable. It is called white swell- 
 ing, from the circumstance of the colour 
 of the skin not being altered, notwith- 
 standing the increased size of the joint. 
 It occurs most frequently in scrofulous 
 constitutions. At the commencement of 
 the disease, the swelling is inconsiderable, 
 and there is merely a fulness at the de- 
 pressions on each side of the knee pan, 
 which gradually spreads over the joint. 
 Pain soon begins, and increases till the 
 patient is unable to bear the weight of 
 the body on the diseased joint ; he, there- 
 fore, gets into the habit of touching the 
 ground only with his toes, keeping the 
 knee-joint bent, so that it at last becomes 
 incapable of being straightened. The 
 joint in time, acquires a very great size, 
 but the skin retains its natural colour, 
 distinguished only by its shining appear- 
 ance, and by the large veins running 
 through it. As the disease advances, 
 collections of matter form round the 
 joint, and burst. Sometimes the ulcers 
 heal, but more commonly, other collec- 
 tions succeed. The constitutional dis- 
 turbance is now great. The health is 
 impaired, the appetite and sleep are bad, 
 the pulse is small and frequent, there is 
 obstinate diarrhoea, and profuse night 
 sweats. Death, in no long time, hap- 
 pens, unless some means be taken to free 
 the constitution from all this disease and 
 irritation. 
 
 Treatment. If the swelling should be 
 seen by the surgeon when there is a de- 
 gree of inflammation present, it is to be 
 treated by topical bleeding, and cooling 
 lotions, accompanied by the antiphlogis- 
 tic regimen, and saline purgatives. Cup- 
 ping is a very good way of abstracting 
 blood in this state of the disease; but 
 when the inflammation and tension are 
 
 very great, probably thirty or forty leeches 
 are preferable. These measures are to be 
 considered as applicable only to the in- 
 flammatory condition of the joint ; but 
 when that state is not present, such prac- 
 tice has no beneficial tendency, and no in- 
 fluence on the principal disease. A me- 
 thod of discussing white swellings has 
 been in many cases very successfully 
 practised, viz. friction with the hand, 
 using no other medium than dry flour. 
 This is to be done with considerable force, 
 and for one or two hours at a time. An- 
 other essential measure is to keep up a 
 discharge from the surface of the joint by 
 blisters or by issues. It is advisable to 
 begin with a very large blister, complete- 
 ly enveloping the whole circumference 
 of the joint; when the blister heals, the 
 part is to be strongly rubbed with some 
 stimulating liniment, three or four times 
 a-day. If we prefer the employment of 
 issues, one about the size of half-a-crown 
 is to be made with caustic, on each side 
 of the joint, and kept running by the ap- 
 plication of stimulating ointments, as di- 
 rected under the article Issue, Pressure 
 also by adhesive plaster, and by oUed silk, 
 has been recommended. During all our 
 local treatment, much attention is to be 
 directed to the constitutional symptoms, 
 especially to the hectic fever, which is so 
 commonly present. When the disorder 
 of the constitution is so great as to threat- 
 en life, or to produce long and tedious ill 
 health, it becomes necessary to amputate 
 the limb ; and the good effect of this oper- 
 ation is in many cases very wonderfuL 
 The irritation from the diseased joint is 
 no sooner removed, than the constitution 
 rallies ; and the patient, who but lately 
 seemed within a few days of his death, re- 
 covers his health completely, and has 
 every prospect of a long life. 
 
 KNEE-PAN, called by anatomists pa- 
 tella or rotula, is the small flat bone situ- 
 ated at the fore-part of the joint of the 
 knee. Its shape resembles the common 
 figure of the heart, with its point down- 
 wards. The anterior convex surface of the 
 rotula is pierced by a great number of 
 
KNEE-PAN. 
 
 357 
 
 holes, into which fibres of the strong li- 
 gament that is spread over it enter. Be- 
 hind, its surface is smooth, covered with 
 cartilage, and divided by a middle con- 
 vex ridge into two cavities, of which the 
 external is largest ; and both are exactly- 
 adapted to the pulley of the thigh bone, 
 on which they are placed in the most or- 
 dinary unsti'aining postures of the leg; 
 but when the leg is much bended, the ro- 
 tula descends far down on the condyles ; 
 and when the leg is fully extended, the 
 rotula rises higher in its upper part than 
 the pulley of the thigli bone. The sub- 
 stance of the rotula is cellular, with very 
 thin external firm plates ; but then these 
 colls are so small, and such a quantity of 
 bone is employed in their formation, that 
 scarce any bone of its bulk is so strong. 
 Besides, it is covered all over with a thick 
 ligament to connect its substance, and is 
 moveable to one side or other ; therefore it 
 is suflficiently strong to resist the ordinary 
 
 actions of the large muscles that are in- 
 serted into it, or any common external 
 force applied to it ; while a fixed process, 
 such as the projection at the elbow, would 
 not have been sufficient to bear the whole 
 weight of our bodies, which frequently 
 falls on it, and would have hindered the 
 rotatory motion of the leg. Notwithstand- 
 ing these precautions to preserve this 
 bone from such injuries, yet I have seen 
 a transverse fracture in it, when, by the 
 report of the patient, and of the people 
 about him, and by the want of swelling, 
 discolouring, or other mark of bruise or 
 contusion, it was plain the bone was bro- 
 ken by the violent straining effort of the 
 muscles. Though my patient recovered 
 the use of the joint of the knee, yet I 
 think it reasonable to believe, that this 
 sort of fracture is commonly attended 
 with difficulty of motion after the broken 
 parts of the rotula are reunited. (Dr. 
 Monro, Primus.) 
 
 LAB 
 
 LAB 
 
 LABOUR. The efforts of the womb, 
 assisted by the abdominal muscles, to ex- 
 pel the foetus and after-birth, when the 
 child is able to live independently of the 
 mother. The general period of labour is 
 about nine calendar months, or from 
 thirty-nine to forty weeks, or from 273 
 to 280 days, after conception. Occasion- 
 ally labour may be a little sooner, and at 
 other times, a little later, than the above- 
 mentioned period. The time at which 
 labour may be expected, is reckoned either 
 from the time that the monthly discharge 
 has been obstructed, or from the period 
 of quickening. If the reckoning be taken 
 fiom the obstruction, it should be from a 
 fortnight after the last appeamnce of the 
 discharge ; and if from the period of quick- 
 ening, five months from that may be al- 
 lowed for the time of labour 
 
 The process of labour is far from being 
 uniform in every instance ; and from this 
 circumstance, writers on Midwifery have 
 distinguished different classes of labours, 
 of which the principal are, natural, labo- 
 rious, preternatural, and complex. As 
 child-bearing is a function co-extensive 
 with the species, it might be thought im- 
 proper and unnecessary either to describe 
 it with such variety and minuteness, or 
 to interfere at all with the process ; but 
 experience shows that it is a subject de- 
 manding the most careful and discrimi- 
 nating investigation ; and that on a pro- 
 per management of women during labour, 
 depends the future comfort and health, or 
 even the life, of themselves and their off- 
 spring. 
 
 L Natural Labour is that which takes 
 place at the full time, the head of the child 
 
358 
 
 L ABO UR. 
 
 presenting- properly, the pains being re- 
 gular and effective, the whole process be- 
 ing completed within twenty-four houi-s. 
 Labour consists of three stages; in the 
 first, the mouth of the womb and the 
 passages are opened and prepared ; in 
 the second, the child is expelled from the 
 body and separated ; and in the third, the 
 after-birth and membranes are excluded. 
 1. First Stage. The approach of la- 
 bour is indicated by pain in the back and 
 loins, occurring at irregular intervals, and 
 giving many teasing and disagreeable 
 sensations. When these have continued 
 for some time, a discharge of slimy matter, 
 ^ ^ tinged with blood, occurs, which is com- 
 
 /.t^j^" /' rnonly known by the name of the shoivs. 
 
 yl/mAAjt y After a number of hours, more or fewer 
 in different cases, the uneasiness becomes 
 considerable ; there are alternate hot and 
 cold fits ; there is a desire to pass water, 
 and the patient is restless and uncom- 
 fortable. The pains now increase in re- 
 gularity and force, returning every ten or 
 twelve minutes, and leaving the w^Oman 
 comparatively easy in the intervals. In 
 many cases, the woman is troubled for 
 some time, even for days, with ineffective 
 pains, resembling those of labour, before 
 the true pains commence. These false 
 pains are occasioned by the pressure of 
 the enlarged womb on the neighbouring 
 ; parts : they occur mostly towards the 
 evening, and during the night ; they are 
 slight and irregular; they are not at- 
 tended by shows, and they are generally 
 mitigated by a change of posture. If 
 they are occasioned by costiveness, this 
 must be removed by laxative medicines. 
 When the pains occur every five or six 
 minutes, and the opening of the mouth of 
 the womb is pretty well advanced, the bag 
 containing the child, with a little portion 
 of the waters, is pushed forward, and this 
 contributes in a gentle and easy manner 
 to complete the opening, and to enlarge 
 the parts sufficiently to admit the progress 
 of the child's head. After the passages 
 are prepared, the membranous bag bursts, 
 the waters are discharged, and the pains 
 commonly increase in violence. Some- 
 
 times the membranes burst when the 
 womb is very little opened, and the water 
 drains slowly off" for one or two days ; 
 occasioning what is often called in the 
 lying-in room, a dry labour. In favour^ 
 able cases, this first stage is completed 
 within twelve or fourteen hours from the 
 time it fairly begins. 
 
 2. Second Stage. In the second stage, 
 the infant is expelled. The pains now 
 are somewhat different; they are felt 
 lower down, they continue longer, and 
 are attended with a straining and bearing 
 down. The pulse becomes quicker, the 
 patient feels hot, and often a strong per- 
 spiration breaks out. The head comes 
 down and stretches the parts, tiU at length f^* 
 it is expelled, with very severe pain,'''"^ 
 which commonly ceases immediately af- 
 terwards. But it very soon returns, and 
 the rest of the body is pushed forward, 
 the proper turns being made during the 
 whole process, so as to bring the broadest 
 parts of the child to pass through the 
 widest parts of the mother. The pressure 
 made upon the head of the child by the 
 contractions of the womb, deprive it for 
 the time of sensibility, so that it does not 
 disturb the mother by any struggles of its 
 own. In general the pains succeed each 
 other very rapidly in this stage, and their 
 force is so great, as to complete the de- 
 livery in a period from a few minutes to 
 half an hour. But various causes to be 
 afterwards noticed, sometimes render this 
 stage a great deal longer. 
 
 3. Third Stage. There now only re- 
 mains the after-birth with the continuous 
 membranes, to be thrown off"; which con- 
 titutes the third stage of labour. Some 
 time after the child is born, the patient 
 rests a little, but by and bye she feels 
 pains, not quite so severe, but rather M'hat 
 may be termed grinding. These are oc- 
 casioned by the contractions of the womb, 
 by which the after-birth is expelled, the 
 cavity of the womb greatly diminished, 
 and the large blood-vessels by Avhicli the 
 placenta was attached, are closed. TIio 
 non-performance of this contraction gives 
 occasion to dangerous floodings. If the 
 
LABOUR. 
 
 359 
 
 after-birth is not thrown off within an 
 hour, some assistance will be required. 
 
 Having briefly stated some of the more 
 common circumstances of natural and 
 » easy labour, we shall mention a few va- 
 riations which sometimes occur. The 
 alternate flushes of heat and sensations of 
 cold are sometimes so strong, as to shake 
 the body violently, and even the bed; 
 they do not indicate any thing very bad. 
 Vomiting is another occurrence, which, 
 M'hen it happens alone, need not give any 
 disquietude. Anxiety and fretfulness 
 sometimes seize the patient's mind during 
 the first stage, but these are to be dispell- 
 ed by encouraging language and sympa- 
 thizing attentions. 
 
 Labour, Management of. There are 
 various particulars to be avoided, and 
 several things to be done, in the manage- 
 ment of women during labour. The 
 good sense of modern accoucheurs has 
 swept away a great deal of useless and 
 pernicious practices, which really make it 
 wonderful that so many women got over 
 the process with safety. The crowds of 
 gossips talking or regaling themselves in 
 the patient's room, one group succeeding 
 as another retires, the cordials and sti- 
 mulants poured into the patient, are now 
 scarcely tolerated amongst the lowest 
 vulgar. A cheerful and prudent friend, 
 with the practitioner and nurse, are all 
 the persons proper to be in the room ; a 
 greater number only exhausts the wo- 
 man's strength, and heats and contami- 
 nates the air of the apartment. When 
 the practitioner is called, if the pains are 
 pretty frequent and regular, an examina- 
 tion should be made to ascertain the pro- 
 gress, but it should not be repeated fre- 
 quently and unnecessarily. The woman 
 need not be confined to one posture, but 
 she should not use violent agitations of 
 the body, nor bear down much in the 
 early stage- No method should be tried 
 to increase the force of the pains, as it is 
 much better for the passages to be gra- 
 dually enlarged. When the bowels are 
 known to be loaded, an injection is very 
 proper, and the urine should be regularly 
 
 passed. The bed is to be so prepared, 
 that the moisture from the waters and 
 other discharges, may not add to the 
 discomfort of the woman. The mattress 
 is placed uppermost, and a dressed skin 
 or oiled cloth, or folded blanket, is to be 
 placed on that part on which the body of 
 the woman is to rest. A clean sheet 
 should be laid on in the usual way, and 
 another in the form of a roller, across 
 the bed, having the ends folded in at the 
 sides. A coarse blanket folded within a 
 sheet ought to be laid immediately be- 
 neath the patient. This is to absorb the 
 moisture, and is to be removed after de- 
 liveiy. The rest of the bed-clothes are 
 to be put on in the ordinary way ; but it 
 is convenient to have the edge of the 
 sheet at the side of the bed to which the 
 patient's back is to be placed, pinned or 
 sewed over the blanket and bed cover. 
 The woman is to be on her left side, and 
 the practitioner behind her. The bed 
 ought to be placed in such a situation, 
 that the room may be properly aired, 
 without the patient being exposed to a 
 current of air; at a little distance from 
 the wall, when it can be done. The bed-* 
 curtains should be of cotton or linen, and 
 never drawn so close as to prevent the 
 free circulation of air. The dress of wo- 
 men in labour should be light and simple, 
 both to keep themselves from being over- 
 heated, and to prevent any thing from 
 being in the way of what assistance is 
 necessary. The patient should be put to 
 bed when the first stage is nearly com- 
 pleted ; the best posture is lying on the 
 left side, and a pillow or small bundle is 
 to be put between the knees. The 
 bearing down pains should be those of 
 the womb alone, and should not receive 
 any assistance from the voluntary ef- 
 forts or forcing of the mother ; as these 
 violent exertions are apt both to in- 
 jure the passages, and to wear out her 
 strength. At the last pains, when the de- 
 sire to force down is almost irresistible, 
 the utmost attention on the part of the 
 practitioner is necessary, to prevent la- 
 ceration of the parts. The patient may 
 
360 
 
 LABOUR. 
 
 be allowed to rest a little after the head 
 is expelled, and the body of the child 
 should not be hastily drawn forth. In 
 some cases, this may be necessary when 
 the child seems livid and in danger of in- 
 jury, or when the cord is twisted round 
 its neck. When the child cries stoutly, 
 the navel-string is to be tied at two parts, 
 and separated by cutting between them. 
 The child may then be lifted from the 
 mother, and the proper attentions paid to 
 it. The after-birth is not to be taken 
 away till the pains return in a slight de- 
 gree to effect this; all rash or strong 
 pulling is attended with the greatest dan- 
 ger. Neither should the woman use 
 much exertion by straining, coughing, or 
 the like, to hasten the throwing off of the 
 after-birth. The belly may be gently 
 rubbed Avith the hand. When no un- 
 toward symptoms take place, we may rest 
 from a quarter to three quarters of an 
 hour; but may occasionally, by gently 
 pulling at the cord, try if the after-birth 
 is disengaged. When more than an hoiu* 
 elapses, the assistance of a proper prac- 
 titioner will be required; and at any 
 time, if flooding takes place, assistance 
 will be instantly necessary. 
 
 II. Lahorious Labours. We now pro- 
 ceed to mention some cases, in which 
 matters do not go on so favourably as 
 above detailed. The labour may be more 
 tedious or difficult than usual, from vari- 
 ous causes. The pains may be less effec- 
 tive from weakness of the system, but 
 more frequently from weakness of the 
 womb itself. Sometimes, though less 
 effective, they are severe enough ; but 
 generally they are slighter than proper 
 pains, and come seldomer. Sometimes 
 this inefficient contraction is owing to the 
 waters coming away too soon, or the 
 womb being over distended, as by twins, 
 or too great quantity of water ; or it may 
 be owing to debility, induced by fear or 
 other depressing passions, or general 
 weakness. This is a state of suffering and 
 anxiety, and requires patience and forti- 
 tude on the part of the patient, and ten- 
 derness and prudence on the part of the 
 
 assistants. No measures must be taken 
 for forcing matters, no stimulants, nor 
 strong purgatives, nor vomits, as was too 
 much the case in times of ignorance, not 
 very remote. Tranquillity of mind and 
 body are to be enjoined, a little mild 
 nourishment and drink may be allowed, 
 and a saline clyster is often of service. 
 When the pains are prevented from do- 
 ing their office, by rigidity of the mouth 
 of the uterus, accompanied by fulness of 
 pulse, Avith heat of skin, thii-st, and rest- 
 lessness, drawing blood from the arm is 
 often of very signal benefit. In casps of 
 exhaustion and weakness, it must be ob- 
 vious that bleeding would be quite im- 
 proper, and that we are rather to give 
 something cordial and stimulant, as a lit- 
 tle wine and water. If the rigidity of 
 the membranes be the cause of the delay, 
 it is proper to break them, though in 
 usual cases this should not be done. The 
 circumstances above detailed are those 
 which render the labour tedious chiefly 
 in its first stage, and at this period it is not 
 necessary to confine the woman to any par-, 
 ticular posture ; she may sit or lie as she 
 feels most easy, and if she has any incli- 
 nation for food, a little may be allowed. 
 The urine should be regularly evacuated. 
 
 If the labour is tedious in the second 
 stage, it is generally owing to the state 
 of the external parts, or to a disproportion 
 between the size of the child's head and 
 the passages. In th6se women Avho are 
 advanced in life before they have chil- 
 dren, the parts often yield with difficulty, 
 A wrong shape of the bones may occasion i 
 resistance, or diseases within the parts, 1 
 or uncommon size of the child's head, 
 or swelling of it from water distending 
 the brain and its coverings. 
 
 When there is long protracted pressure 
 of the head on the soft parts, much suf- 
 fering and danger may ensue. As it is 
 of the most essential moment to have as- 
 sistance in time, we subjoin some of the 
 symptoms which indicate danger. Great 
 tenderness and swelling of the belly, hur- 
 ried breathing, inability to make water, 
 greait tightness within the haunch-bones^ 
 
LABOUR. 
 
 3GI 
 
 thirst, quick pulse, and other feverish symp- 
 toms, great restlessness, headach, and a de- 
 gree of wandering of the mind; such symp- 
 toms warn us that the powers of nature 
 are not to be depended on, and that no- 
 thing but immediate delivery can save the 
 life of the woman. The method of doing 
 this must be left to the judgment of the 
 prudent and skilful practitioner. There 
 are certain instruments which, in proper 
 hands, are fitted to accomplish the deli- 
 very without injury to the child, and with 
 hardly any additional suffering to the 
 mother ; though no practitioner of edu- 
 cation and experience will rashly or unne- 
 cessarily use them. Indeed, in several cases 
 it requires great firmness on his part, to 
 resist the importunity of some women to 
 be delivered by instruments, who have 
 either in their own case foniierly, or in 
 those of others, been satisfied of their uti- 
 lity and safety, and w^ho are impatient to 
 have their sufferings terminated. 
 
 III. Preternatural Labours, or cross- 
 births, are those in which some other 
 part of the child than the head presents. 
 We cannot, in general, assign any rea- 
 son for such occurrences, nor can the wo- 
 man, by any sensation of her own, be as- 
 sured that the presentation is unusual. 
 Apprehensions of this kind should not be 
 indulged in. If the feet or the breech 
 present, the delivery is to be accomplish- 
 ed by properly accommodating the turns 
 of the child to the capacity of the pelvis, 
 hut no force should ever be employed; 
 and though there is always some risk to 
 the life of the infant, there is none to the 
 mother. If the arm, shoulder, or sides of 
 the child present, the delivery is impos- 
 sible until the infant be turned, and the 
 feet brought down into the passage. This 
 is an operation which may be done with 
 comparative ease aud safety, if the wrong 
 position of the infant be discovered be- 
 fore the waters are off; but otherwise, 
 both mother and child are in considerable 
 danger. The womb being closely con- 
 tracted round the body of the infant when 
 the water is drained away, and being soft 
 and spongy in its texture, is liable to be 
 
 torn if much force be employed ; and then, 
 either the child may escape into the ca- 
 vity of the belly, or if it be extracted by 
 the feet, blood may be effused from the 
 womb into that cavity, and such injury be 
 done as to prove fatal. Women too fre- 
 quently add to the danger of the opera- 
 tion of turning, by their restlessness aud 
 impatience. They should remember 
 how much is at stake, and exert all 
 their fortitude so as not to embarrass the 
 practitioner. 
 
 IV. Complex Labours. Twin Cases. 
 There are no symptoms during preg- 
 nancy, by which it can be certain that a 
 woman has conceived two or more chil- 
 dren. This is put beyond doubt only 
 after the birth of one. K there is a se- 
 cond child, the womb does not appear to 
 be diminished in size, as it does in cases 
 where there is only one. The birth of 
 one child is not prevented in general by 
 the interference of another, though this 
 sometimes happens. Each infant is con- 
 tained within a distinct sac; but as the 
 head of one infant is generally opposed 
 to the breech of the other, one of them 
 most commonly is a cross-birth. It often 
 happens that twins are small, and the 
 delivery is thus rendered more easy. 
 Twin cases, however, always require 
 much attention, both for the sake of the 
 infants, and because the recovery of the 
 mother is more uncertain than in the 
 cases of single children. The second 
 child is usually delivered soon after the 
 first ; but if there be a long cessation of 
 the pains after the first, there is consider- 
 able danger. The patient may be allowed 
 to rest a little ; but the practitioner should 
 extract the second child before the pas- 
 sages become contracted, or the after-birtii 
 of the first-bom be separated. As a ge- 
 neral rule, we may say, that not more 
 than an hour should be suffered to elapse 
 between the birth of the first and second 
 child. We must guard against the flood- 
 ing which is apt to occur in such cases ; 
 and give very little disturbance to the 
 woman in binding up the belly. The 
 fii*st-boru child should be marked. Whca 
 
362 
 
 LAC 
 
 L AU 
 
 there are more than two children, they 
 seldom all live. 
 
 Falling down of the Navel-String. — 
 If the cord be pressed upon for a very- 
 short time, the consequence will be the 
 death of the infknt. It is not a common 
 occurrence, but it may happen if the cord 
 be uncommonly long-, or if the infant be 
 in a cross position. It happens sometimes 
 from mismanagement, when the waters 
 break before the passag-es are properly 
 prepared. If the cord be felt through the 
 membranes before they break, the woman 
 should be kept very quiet, and as much 
 as possible in one posture, till the womb 
 be fully opened ; at which time it is pos- 
 sible, by turning, to save the infant's life. 
 But when the coming down of the cord 
 has been owing to the too early evacua- 
 tion of the waters, the life of the infant 
 is to be considered as in great danger; 
 and any attempts to save it, by turning, 
 would be attended with more risk to the 
 mother than it would be justifiable to 
 incur. 
 
 For other circumstances of labour, of 
 a more unusual and dangerous kind, and 
 for the management of women after the 
 whole process is completed, see CiESAR- 
 lAN Operation, Flooding, After-birth, 
 Abortion, Delivery, &c. 
 
 LACRYMAL GLAND. A gland situ- 
 ated at the upper portion of the orbit of 
 the eye, for the purpose of secreting the 
 tears. Its functions are increased by any 
 thing irritating the ball of the eye, and 
 also by mental emotions, as grief or joy. 
 
 LACTEALS. A set of vessels which 
 convey a milky fluid, whence they derive 
 their name. They arise from the cavity 
 of the intestines, from minute beginnings 
 which elude the eye. The milky fluid 
 which they carry is the chyle, elaborated 
 ft'om the food after it has passed the sto- 
 mach, and has been mixed in the duo- 
 denum with the bile and pancreatic fluid. 
 The lacteals charged with chyle pass 
 through the glands of the mesentery, 
 where some change is probably made 
 upon it ; thence it is conveyed by the 
 lacteals into the receptacle of the chyle, 
 
 then to the thoracic duct, by which it is 
 carried to the left subclavian vein, to be 
 afterwards incorporated with the blood 
 in the lungs. 
 
 LACTUCA and LACTUCARIUM. 
 See Lettuce. 
 
 LARYNX. The upper part of the 
 wind-pipe, on which an operation called 
 laryngotomy is sometimes necessary, to 
 enable the patient to perform the function 
 of breathing, when the upper part of the 
 passage is obstructed ; or for the extrac- 
 tion of foreign bodies, which have gone 
 down the wrong passage, as beans, but- 
 tons, pieces of glass, &c. See Bron- 
 chotomy. 
 
 LATERITIOUS SEDIMENT. The 
 sediment resembling brick-dust, which 
 sometimes occurs in the urine of patients 
 labouring under certain diseases, princi- 
 pally feverish ailments. It is considered 
 as a certain mark of a salutary termina- 
 tion of a gouty paroxysm. 
 
 LAUDANUM. The tincture of opium, 
 so called in the jargon of Paracelsus, from 
 its soothing and praiseworthy qualities. 
 It is one of the best and most manageable 
 forms of administering opium, whose nar- 
 cotic and other virtues render it so essen- 
 tial in the practice of physic. Under 
 the article Opium, is a very full account 
 of the source from whence it is derived, 
 of its various preparations, of their effects, 
 and the cases in which they are useful; 
 and it will therefore be necessary to do 
 little more in this place, than to state the 
 doses of laudanum proper to be given on 
 various occasions, and the methods to 
 be pursued when an overdose has been 
 swallowed. 
 
 Laudanusi, Uses and Doses of. When 
 we Avish to procure sleep, the dose for a 
 grown up person is from twenty-five to 
 forty drops, taken in a little water, either 
 plain, or sweetened, or in peppermint- 
 water, cinnamon-water, gruel, or the like. 
 To allay griping pains in the bowels, from 
 fifteen to twenty drops ; but not repeated 
 above once, or at the most twice, at an 
 interval of half an hour. When there is 
 a harassing, tickling cough, and no in- 
 
LAUDANUM. 
 
 JC3 
 
 flammatory symptoms forbid its use, ten 
 or twelve drops may be very cautiously 
 ^ven, and repeated after an hour or two, 
 till the second or third time. 
 
 It is to be most particularly noticed, 
 that although we consider it as right that 
 every person, especially those who have 
 the care of families, should know the 
 doses of laudanum which are proper on 
 various occasions, we would urge most 
 strongly, tiiat it should never be given 
 except in cases of absolute necessity; and 
 if possible, always under the sanction of 
 a medical man ; and we would caution 
 parents never to allow it a place in the 
 nursery ; nor to put it in the way of ser- 
 vants or others, whose ignorance or rash- 
 ness might render it productive of the 
 most baneful eflfects. 
 
 Laudanum, Treatment of those who 
 have swallowed an Overdose of. " The 
 primarj' object," says Dr. Christison, " is 
 to remove the poison from the stomach. 
 This is proper, even in the rare cases in 
 which vomiting takes place spontaneously. 
 The removal of the poison is to be accom- 
 plished in one of three ways, by emetics 
 administered in the usual way, by the 
 stomach-pump, or by the injection of 
 emetics into the veins. By far the best 
 emetic is the sulphate of zinc in the dose 
 of half a drachm or two scruples, which 
 may be repeated after a short interval, 
 if the first dose fails to act. In order to 
 insure its action, it is of groat use to keep 
 the patient roused as much as possible — 
 a point which is often forgotten. The 
 sulphate of copper is^by no meaiis so cer- 
 tain as the sulphate of zinc. Besides, as 
 it is a much more virulent poison, it may 
 prove injurious if retained too long in the 
 stomach. Tartar emetic, from the un- 
 certainty of its action when given in con- 
 siderable doses, is even worse adapted for 
 such cases. Emetics should be preferred 
 for removing the poison from the stomach, 
 provided the case be not urgent. Even 
 then, however, they sometimes fail alto- 
 gether. The best practice in that case, 
 is to endeavour to remove the poison 
 with the stomach-pump j and this, in ur- 
 
 gent cases, should be the first remedy 
 employed. 
 
 " The last method for removing opium 
 from the stomach, is a desperate one. 
 It is the injection of an emetic into the 
 veins. Tartar emetic answers best for 
 this purpose, and its effect is almost cer- 
 tain. A grain is the dose. While inject- 
 ing it, care must be taken by the opera- 
 tor not to introduce air into the vein. 
 
 " The next object in conducting the 
 treatment of poisoning with opium, is to 
 keep the patient constantly roused. This 
 alone is sufficient when the dose is not very 
 large, and the poison has been discharged 
 by vomiting ; and in every case it fornjs, 
 next to the evacuation of the stomach, 
 the most important part of the treatment. 
 The best method of keeping the patient 
 roused is to drag him up and down be- 
 tween two men, who must be cautioned 
 against yielding to his importunate in- 
 treaties and occasional struggles to get 
 free and rest himself. The duration of 
 the exercise should vary according to cir- 
 cumstances, from three or six to twelve 
 hours. When he is allowed at length to 
 take out his sleep, the attendants must 
 ascertain that it is safe to do so by rous- 
 ing him from time to time ; and if this 
 should become difficult, he must be turn- 
 ed out of bed again, and exercised as be- 
 fore. 
 
 " When the opium has been completely 
 removed, the vegetable acids and infusion 
 ^of coffee have been found useful in reviv- 
 ing the patient, and subsequently in sub- 
 duing sickness, vomiting, and headach." 
 (Dr. Christison on Poisons.) 
 
 LAUROCERASUS. The leaves of 
 the cherry-laurel, Prunus laurocerasuSy 
 have a flavour resembling that of bitter 
 almonds or other kernels ; and from this 
 circumstance, an infusion of the leaves 
 has been employed to give flavour to cus- 
 tards, puddings, and other articles for the 
 table. But as it is undoubted that the 
 cherry-laurel has poisonous qualities, such 
 dangerous seasoning should never bo 
 used. One Moman who had lost her life 
 by drinking of laiu'el- water, thinking it 
 
3G4. 
 
 LEA 
 
 LEE 
 
 to be a cordial, in a quarter of an hour 
 after drinking two-thirds of two ounces, 
 complained of a violent disorder in her 
 stomach, soon after lost her speech, 
 and died in about an hour, without vo- 
 miting- or purging, or any convulsion. 
 By experiments on brute animals, it ap- 
 pears that this poison is destructive to 
 life, not only when taken into the sto- 
 mach, but also on being injected into the 
 intestines, or applied externally to diffe- 
 rent organs of the body. The discoveries 
 of modern chemistry render it probable, 
 that the destructive properties of cherry- 
 laurel water are owing to its containing 
 pnissic acid. And after the well au- 
 thenticated proofs of its deleterious effects, 
 it is to be hoped that it will never find a 
 place in the arrangements of housewifery. 
 See Prussic Acid. 
 
 LAVENDER, Lavandula spica. A 
 fragrant plant from which an essential oil 
 is distilled, but it is to be regarded rather 
 as a perfume than as a medicine ; what 
 medicinal virtues it has are of a stimu- 
 lant nature. The compound spirit of la- 
 vender is principally used to give colour 
 and flavour to other medicines of a more 
 active nature. 
 
 LAXATIVES, are those medicines 
 which promote a discharge from the 
 bowels with considerable ease, without 
 very copious discharge or pain during 
 their operation, and without any general 
 excitement of the system. They may be 
 said simply to empty the bowels, and to 
 carry off superfluous matter, which is al- 
 already out of the eourse of the circula- 
 tion. Most purging medicines may be so 
 diminished in their dose, and modified in 
 their form of being administered and 
 combined, as to act merely as laxatives ; 
 but there are others which, in as consi- 
 derable a bulk as it is convenient to take 
 them, do little more than procure easy 
 stools. Such are, sulphur, alone or com- 
 bined with cream of tartar ; manna, castor 
 oil; Rochelle, and some other neutral salts. 
 
 LEAD. Like other metals, lead must be 
 oxidized or combined with an acid, before 
 it exerts any action on the body. When 
 
 tlie salts of lead are introduced into the 
 system, their effects are of a very singular 
 and injurious nature, occasioning the se- 
 vere and painful affection of the bowels 
 called Colica Pictonum or Devonshire 
 colic. There are a variety of ways in 
 which lead may be introduced into the 
 body, so as to be injurious, viz. by a per- 
 son being exposed to the fumes of lead in 
 the various operations performed on that 
 metal; by rum or other spirituous li- 
 quors being drank, that have passed 
 through stills with leaden worms ; and 
 in some cases, though we should hope 
 rarely, by sugar of lead being employed 
 to adulterate wine. The disease induced 
 by the poison of lead is characterised by 
 griping, costiveness, sickness, and a wast- 
 ing of the muscles of the thumbs, and of the 
 calf of the leg. These symptoms, and the 
 mode of treating them, are fully detail- 
 ed under the article Dry Belly-Ache. 
 Though lead is therefore sparingly used 
 internally, it is an excellent and useful 
 refrigerant when applied externally, as in 
 the form of Goulard's extract, or the so- 
 lution of sugar of lead. This last prepa- 
 ration has even been used internally ; and, 
 in the hopeless diarrhoea of consumption, 
 it seems, when combined with opium, in 
 the proportion of two grains of sugar of 
 lead to one of opium, to check it a little, 
 though it cannot cure it. 
 
 LEAMINGTON PRIORS, in War- 
 wickshire, has various springs both of a 
 saline and sulphureous nature. The same 
 observances with respect to preparation and 
 management are proper here, as with 
 the waters of Cheltenham and Harrow- 
 gate. 
 
 LEECH, Hirudo medicinalis. A well 
 known species of worm that lives in wa- 
 ter, and is applied to various parts of the 
 body to di-aw blood for the cure of dis- 
 ease. 
 
 There is only one species of leech used in 
 medicine. It has a flat and slimy body, 
 composed of rings, tapering towards the 
 head ; it is commonly about two inches 
 long, about the thickness of a goose quill, 
 but it can lengthen and shorten itself 
 
LEECHES. 
 
 365 
 
 very much. The bite of those leeches 
 which are found in stagnant waters and 
 marshes is said to cause pain and inflam- 
 mation ; such leeches, therefore, as well 
 as the horse-leech, are not used, and those 
 are preferred which are taken in the sum- 
 mer season, in waters having- a clear 
 sandy bottom. A leech attaches itself to 
 any substance to which it wishes to fix, 
 by an apparatus constructed on the prin- 
 ciple of a leather-sucker, which it has at 
 both ends ; the one at the head being like 
 a horse-shoe, with a triangular mouth in 
 the centre, and that at the other end being 
 circular. When they fix on the body, 
 they inflict a small wound of three little 
 flaps, from which they suck blood until 
 they are gorged, or till they are forced to 
 quit their hold; this is best done by 
 sprinkling on them a little salt. 
 
 The cases are very numerous in which 
 leeches are useful ; and in children, where 
 it is so difficult to get blood from a vein, 
 leeches furnish an excellent resource. 
 Leeches are useful in the various inflam- 
 matory diseases, as ophthalmia, sore 
 throat, rheumatism, toothach, inflamma- 
 tion of the bowels and uterus ; in measles 
 and scarlet fever, in chincough, in head- 
 ach, in bruises, and in piles. 
 
 It is sometimes difficult to get leeches 
 to fix ; they should be kept hungry and 
 taken out of the water for some minutes 
 before they are to be used, and should be 
 dried with a soft cloth immediately be- 
 fore they are applied. The part should 
 he well washed with soap and water, 
 then with milk and water, and wetted 
 with blood or syrup, and if there be many 
 strong hairs they should be shaved oflP. 
 A large leech will draw about an ounce 
 of blood, that is about a table-spoonful ; 
 and when they come off, the bleeding 
 may be encouraged to a considerably 
 greater extent, by bathing the parts with 
 warm water, or by applying large poul- 
 tices of bread and milk, or applying cup- 
 ping glasses. It is sometimes difficult to 
 stop the bleeding, and the surgeon is sent 
 for in great alarm, especially M'hen leeches 
 have been applied to young children. The 
 
 bleeding may generally be stopt by proper 
 pressure with a little lint or similar downy 
 substance for a due length of time, though 
 this is sometimes very difficult when 
 there is no bone to press against ; touch- 
 ing the wound with lunar caustic will 
 almost certainly succeed ; but we must 
 take care that the flowing blood do not 
 wash the caustic down about the neigh- 
 bouring parts. Sometimes the wounds 
 made by leeches give rise to a good deal 
 of pain, swelling, and extensive inflam- 
 mation. The best application is a cool- 
 ing lotion of Goulard's Extract, or di- 
 luted spirits and water, or vinegar and 
 water. If the pain and tension continue 
 long, an emollient poultice of bread and 
 milk will be useful. 
 
 " Salt has been thrown on the animal 
 to make it disgorge the blood which it 
 has sucked, but the leech is generally 
 killed in the experiment. A more easy 
 way to discharge the blood and save the 
 animal is to bold it in the hand and 
 gently squeeze it in a napkin from the 
 head downward ; the blood flows copious- 
 ly from M'hat may appear the anus, or 
 through the ruptured extremity of the 
 intestinal canal, and the worm is not es- 
 sentially injured." — Dk. Parr. 
 
 Leeches are best kept in a bottle half 
 filled with pure spring or river water, 
 covered with gauze or fine muslin. It 
 is better not to put bran or any other 
 substance into the water, but to change 
 it pretty frequently. Leeches are said 
 to be very sensible to the electrical 
 changes of the atmosphere. 
 
 LEEK, Allium porrum. A savoury 
 vegetable of the garlic kind, excellent for 
 healthy stomachs, but apt to disagree with 
 such as are dyspeptic. 
 
 LEGUMEN. The Latin name for 
 pulse, as pease, beans, &c. 
 
 LEMON, Citrus medica. A fiiiit 
 growing *in warm climates, possessed of 
 the most grateful acidity, and of the most 
 admirable virtues in sea-scurvy. This 
 fruit furnishes a very cooling acid drinlc 
 in fevers ; and its juice, when preserved, 
 is one of the most pleasant and infallible 
 
3G6 
 
 LEPROSY. 
 
 guardians of the health of seamen during 
 long voyages. Its powers in this respect 
 render it one of the most important arti- 
 cles of provision for ships which are go- 
 ing on distant expeditions. It is an ex- 
 cellent corrector of the acrimony neces- 
 sarily engendered hy the use of salt pro- 
 visions, and may he given to the extent of 
 an ounce, with the daily allowance of 
 water or spirits issued to the crew. As 
 lemon-juice is an excellent preventer of 
 sea-scurvy, so it is the certain cure of it, 
 unless the disorder be very long and in- 
 veterate, or the health and strength of 
 the constitution quite gone. Another 
 very important application of lemon-juice 
 in the practice of physic is in the forma- 
 tion of effervescing draughts, which are 
 of excellent use in the sickness at sto- 
 mach attendant on many feverish diseases, 
 and also in promoting a gentle perspira- 
 tion. See Effervescing Draughts. 
 
 LENITIVE ELECTUARY, an elec- 
 tuary composed of senna, prunes, and ta- 
 marinds, which acts as a gentle laxative, 
 when taken in the bulk of a nutmeg or a 
 dessert-spoonful. 
 
 LENS. The clear convex substance 
 behind the pupil of the eye, which, in 
 conjunction with the other humours, re- 
 fracts the rays of light in order to form 
 a picture on the retina at the bottom of 
 the eye. It is inclosed in a capsule or 
 membrane ; and a thickening or opacity 
 either of the lens or its capsule is the oc- 
 casion of the disease of vision called a ca- 
 taract. See Eye, and its Diseases. 
 
 LENTIL, Ervum Lens. A kind of 
 pnlse used to give flavour to soup. 
 
 LEPROSY. The term leprosy is in 
 familiar use, from the celebrated disease 
 of that name occurring among the Jews, 
 the various symptoms of which are so 
 minutely detailed in Scripture, as well as 
 the strict and severe regulations under 
 which those were placed who were afflict- 
 ed with it. Probably it is from this cir- 
 cumstance, that in common language we 
 hear the very frequent mention of lepro- 
 sy and leper, as applied to any extensive 
 and disgusting eruption on the skin ; 
 
 though there is every reason to consider 
 the Jewish leprosy as quite unknown in 
 this country. 
 
 In the more accurate nomenclature of 
 cutaneous diseases, introduced by Willan 
 and Bateman, the terms lepra and leprosy 
 are meant strictly to apply to diseases of 
 the skin characterised by scaly patches 
 of different sizes, but having always near- 
 ly a circular form. Of leprosy thus de- 
 fined, there are different kinds. The or- 
 dinary form of the disease in this country 
 commences with small, round, reddish, 
 and shining elevations of the skin, at first 
 smooth, but within a day or two exhibit- 
 ing thin scales on their tops. These, says 
 Dr. Bateman, gradually, sometimes ra- 
 pidly, dilate to the size of half-a-crown, 
 still retaining their oval or circular form, 
 and are covered with shining scales, and 
 encircled by a dry, red, and slightly ele- 
 vated border. In some cases, these scales 
 accumulate, so as to form thick promi- 
 nent crusts. If the scales or crusts are 
 removed, the skin appears red and shin- 
 ing, being very smooth, and free from the 
 cuticular lines in the beginning ; but 
 marked, in the advanced stage, with long 
 deep lines and reticulations, not always 
 coinciding with those of the adjoining 
 surface. The lepra commonly begins be- 
 low the elbow and knee, and extends to 
 other parts of the body, but happily the 
 face is seldom the seat of large patches. 
 When the disease is moderate in degree 
 and extent, it has merely a slight itching 
 when the patient is heated by exercise, 
 or by the warmth of bed ; and in moist 
 weather it has a slight tingling sensation. 
 When it is more extended, and has a con- 
 siderable degree of inflammation of the 
 skin, there is great pain and stiffness of 
 the joints ; but all this suffering and un- 
 easiness lasts sometimes for years, without 
 the production of much constitutional 
 derangement. 
 
 Causes. The causes of this disease 
 are various, and not easily ascertained; 
 it is not contagious ; it is produced oc- 
 casionally by some articles of food and 
 drink, having effects on certain iudivi- 
 
LEPROSY. 
 
 367 
 
 duals which they have not on other people. 
 Some have attributed it to cold and mois- 
 ture, and a neglect of cleanliness ; but it 
 occurs in the better ranks of life, among 
 persons who are very attentive to per- 
 sonal cleanliness. 
 
 Treatment. The insignificant reme- 
 dies which have been recommended for 
 the cure of leprosy are very numerous, 
 probably arising from the circumstance, 
 that there is no single application or plan 
 of treatment that will be uniformly suc- 
 cessful, even where we are attentive to 
 the nature of the disease, and the circum- 
 stances of each case j but where we mere- 
 ly take up the name, and indiscriminate- 
 ly apply to every case we call leprosy, 
 some one medicine or plan, we may be 
 certain of being repeatedly altogether dis- 
 appointed. In the milder and less irri- 
 table form of leprosy, the diet should be 
 light and moderate, and all heating liquors 
 should be avoided, especially malt liquors 
 and spirits. The warm bath, with mo- 
 derate friction, removes the scales, and 
 softens the skin. The sulphur waters of 
 Harrowgate and other springs, used both 
 internally and externally, are of service ; 
 and also the warm sea-water bath. But 
 if the scales £u-e gathered into thick crusts, 
 and adhere firmly, we are to employ some 
 active stimulating lotion, as diluted alco- 
 hol, or sulphuretted potash, or diluted 
 aqua potassae, or muriatic acid. When we 
 have succeeded in removing the scales, 
 we are to apply the pitch ointment, or 
 diluted citrine ointment. These oint- 
 inents should be applied at night, and 
 M^ashed off in the morning with soap and 
 water. Pitch pills, and the preparations 
 of ii'on may be given internally. A me- 
 dicine, which some think of great service 
 in lepra, is the decoction of the solarium 
 dulcamara^ the bitter-sweet, or woody 
 nightshade, given in doses of two or three 
 ounces tlu-ee times a-day. It is to be 
 carefully remembered, that the fretful in- 
 flammatory kind of lepra is always injur- 
 ed by any lotions or external applications 
 except the very mildest; and in such 
 cases, tepid water, or decoction of bran, 
 
 or thin gruel, should alone be used : and 
 where the heat, pain and itching are very 
 troublesome, the parts are to be gently 
 besmeared with cream, or a little fresh 
 lard, or butter. 
 
 We have been thus particular in giving 
 an account of the symptoms and cure of 
 leprosy, as the skin diseases which we 
 understand by that name, are those which 
 the common people denominate scurvy ; 
 and under that name, they include almost 
 every disease of the skin, even those of 
 the most different appearance and cha- 
 racter. But the term scurvy should be ap- 
 propriated to that disease which arises in 
 circumstances similar to those of long 
 voyages, viz. where there is a long con- 
 tinued use of salt provisions, without a 
 due proportion of vegetable aliment ; 
 where there is exposure to cold and 
 moisture, and where the depressing pas- 
 sions are frequently exercised. But of 
 late years, more attention has been paid 
 by physicians to distinguishing the va- 
 rieties of skin disease^ and in giving the 
 different species appropriate names ; and 
 we trust that in time, the people also will 
 observe and speak with greater accuracy. 
 
 LETHARGY. In the more accurate 
 language of modem physicians, lethargy 
 is seldom used as the name of a distinct 
 disease, but the deep sleep and insensibi- 
 lity which occur as a symptom of apo- 
 plexy, are what is meant by the term Zc- 
 thargy. See Apoplexy. 
 
 LETTUCE, Lactuca sativa. A plant 
 whose leaves are generally eaten with 
 other herbs, in the form of a salad, dressed 
 with oil and vinegar. Lettuce contains a 
 narcotic principle ; and those who use it 
 with a view to procure sleep, should not 
 use vinegar with it, as vinegar counteracts 
 its soporific power. Lettuce has lately 
 been brought into notice as an article of 
 the materia medica, by its affording an 
 extract having some of the properties of 
 opium, and capable, in some cases, of being 
 substituted for it. This extract is called 
 lactucarium or lettuce-opium, and its dose 
 is from three to five grains, and of the 
 tincture from fifty to eighty drops. It is 
 
368 
 
 L IC 
 
 LIG 
 
 thought to have the anodyne, without the 
 constipating, effects of opium. 
 
 LEUCOMA. A white opacity of the 
 cornea of the eye, the result of severe 
 acute ophthalmia, impeding vision, and 
 not admitting of a cure. The existence 
 of this and other diseases of the eye, fur- 
 nishes a strong reason for paying the 
 most early and scrupulous attention to all 
 ailments of that organ, where the mischief 
 is so rapid, and often incurable. See Eye 
 and its Diseases. 
 
 LEUCOPHLEGMASIA. An old term 
 for the pale bloated habit, indicative of a 
 dropsical tendency. 
 
 LEVIGATION. The act of pound- 
 ing substances, or reducing them to a fine 
 powder. 
 
 LICHEN. The name of a genus of 
 plants of the class cryptogamia ; familiar 
 to the sight, by at least one species of it 
 forming the green or grey covering of 
 old walls or ruins. There is one species 
 called the Lichen Islandicus, which has 
 obtained some reputation as a remedy in 
 consumptions, coughs, dysenteries, and 
 diarrhceas. It is principally at Vienna 
 that these good effects have been cele- 
 brated ; but the article has been admitted 
 into the London Pharmacopoeia. It 
 consists of a bitter matter, and a kind of 
 mucilage, by which it acts as a tonic and 
 an article of nutrition ; but it has no title 
 to any estimation as being a remedy in 
 consumption. The form in which it is 
 used is the decoction, to the extent of one 
 or two ounces ; the bitter part being first 
 extracted by steeping it in warm water. 
 
 LICHEN is the name of a disease of 
 the skin, thus defined by Dr. Willan ; 
 " An extensive eruption of pimples, af- 
 fecting adults, connected with internal 
 disorder, usually terminating in scurf, re- 
 current, not contagious." There are se- 
 veral varieties of this eruption, not very 
 easy to distinguish or describe; but in 
 general, little medicinal treatment is neces- 
 sary for the milder kinds. It is sufficient 
 that patients avoid heating themselves by 
 much exercise, or by stimulants, and that 
 they take a light diet, with diluent drinks, 
 
 and a gentle laxative occasionally. All 
 strong external applications are improper, 
 especially preparations of mercury and 
 sulphur, which produce severe irritation. 
 Lotions of lime-water, or a weak solution 
 of the acetate of ammonia, afford relief. 
 The prickly heat of tropical climates is a 
 species of lichen. This consists of a small 
 red rash, chiefly upon such parts of the 
 skin as are covered. It scarcely appears 
 to the eye to be raised above the skin, 
 though it gives a slight roughness to the 
 feel. It is attended with a disagreeable 
 sensation of heat and prickling in the 
 skin, as is well expressed by its name. 
 Some are troubled with it all the year 
 round, others only during the warmer 
 months. Such as have fair and delicate 
 complexions, are more subject to it than 
 others, insomuch that they are not free 
 from it at times, either night or day. 
 Some are incommoded by it only when 
 exposed to the heat of the sun, or on mak- 
 ing bodily exertions. When a cold fluid 
 is drank, there is a sensation as of innu- 
 merable needles running into the skin. 
 No medicine is required, and its trouble- 
 some effects are best remedied by quiet 
 and rest. 
 
 LIGAMENTS. Strong, tendinous, in- 
 elastic, glistening bodies, which surround 
 the joints, and connect bones together, or 
 strengthen the attachments of various or- 
 gans, or keep them in their places. Every 
 joint is surrounded by a capsular liga- 
 ment; the tendons at the wrist and ankle 
 are bound down by what are called the 
 annular ligaments; and we shall after- 
 M'ards mention the ligaments of the liver. 
 Poupart's ligament, under which the 
 great nerves, artery, and vein pass out 
 from the cavity of the abdomen to the 
 fore part of the inferior extremity, is 
 merely the lower border of the descend- 
 ing oblique muscle of the belly ; which 
 tendon is stretched from the fore part of 
 the haunch-bone to the share-bone. In 
 dislocations of joints the capsular liga- 
 ment is often broken. 
 
 LIGHTNING. When persons are 
 struck by lightning, the effects produced 
 
L IM 
 
 LIN 
 
 369 
 
 arc commonly those of high excite- 
 ment, sometimes so great as to extin- 
 guish life instantaneously ; at other times 
 to produce mortification, apoplexy, or 
 epilepsy. Such cases are to be treated in 
 the usual way. " With regard to per- 
 sonal security in time of a thunder-storm, 
 if a person be in a house which is not 
 furnished with a conductor, it is advisa- 
 ble not to stand near any metallic articles, 
 viz. near gilt frames, chimney-grates, bell- 
 wires, iron casements, and the like. In 
 the middle of a room, upon a dry chair, 
 or table, or mattresses, or other insulating 
 articles, is the safest situation. Should a 
 storm happen when a person is in the 
 open fields, and far from any building, 
 the best thing he can do is to retire with- 
 in a small distance of the highest tree or 
 trees he can get at ; he must not, how- 
 ever, go quite near them, but he should 
 stop at about fifteen or twenty feet 
 from their outermost branches: for if 
 the liglitning happen to strike about the 
 place, it will in all probability strike the 
 trees in preference to any other much 
 lower object; and if a tree happen to be 
 split, the person will be safe enough at 
 that distance from it." (Cavallo's Natu- 
 ral Philosophy.) 
 
 LIME. A substance greatly abound- 
 ing in nature, but generally found in 
 combination with some other substances. 
 Chalk, or lime-stone, is lime combined 
 with carbonic acid ; and when this acid 
 is expelled by heat, the lime is left in 
 the state of what is called quick lime. 
 This is possessed of acrid, alkaline pro- 
 perties, having a harsh taste, and acting 
 as an escharotic- Lime was the active 
 ingredient of Mrs. Stephens's remedy 
 for the stone, the secret of which was 
 purchased by Parliament for ^65000. It 
 was made into pills with soap. 
 
 LIME-WATER. Lime is soluble in 
 water, though it takes a great quantity 
 to dissolve it, and this solution is called 
 lime-water, and has been a good deal em- 
 ployed in the cure of diseases. It has 
 been used in various symptoms of indi- 
 gestion, as acidity combined with looseness, 
 
 and in calculous complaints. The quan- 
 tity may be from a pint to two pints 
 daily. In the complaints of infants con- 
 nected with disordered bowels, lime-wa- 
 ter mixed with an equal quantity of milk 
 may be given in doses of a tea-spoonful 
 three or four times a-day. Lime-water 
 has great effect in dissolving the slimy 
 mucus with which disordered bowels are 
 infested. It is on this principle that it 
 has been used against the stone, with the 
 view of dissolving the animal mucus 
 which cements the parts of the concre- 
 tion together. 
 
 LIME, a fruit. See Lemon. 
 
 LINIMENT, an oily or spirituous pre- 
 paration for external use, of a consistence 
 not so thick as an ointment. There are 
 various useful liniments employed in me- 
 dicine ; the volatile liniment, of various 
 strength, made of ammonia and oil, and 
 applied very beneficially in sore throats, 
 and other cases where an external sti- 
 mulus is required ; and the carron oil, a 
 liniment of great efficacy in burns and 
 scalds, made of olive-oil and lime-water 
 equal parts. The tincture of soap, alone 
 or with opium, is called anodyne liniment 
 or opodeldoc, and is used to rub parts of 
 the body affected with rheumatic or 
 other pains. Stimulant liniments are use- 
 ful in chronic diseases of the viscera, both 
 by their own powers exciting the skin to 
 action, and by relieving the internal parts ; 
 and also by the friction itself. 
 
 LINSEED. The seeds of the Lirmm 
 usitatissimuniy or common flax, when in- 
 fused, yield a very useful mucilaginous 
 drink, known by the name of linseed-tea ; 
 and of great use, when mild diluents are 
 wanted. It is useful in disorders of the 
 urinary bladder, in dysentery, in colic, and 
 similar affections. Linseed meal forms 
 an excellent emollient poultice. 
 
 LINT. In surgical language means 
 the soft spongy substance with downy 
 surface, applied to sores and ulcers as a 
 diessing, with a view to the absorption 
 of matter. It is sometimes applied dry, 
 or various ointments may be spread up- 
 on it. 
 
 2b 
 
370 
 
 L I T H O N T R I P T I C S. 
 
 LIQUORICE. The root of the Gly- 
 cyrrhiza glabra, a plant growing- in 
 Spain, which yields a great quantity of 
 a very sweet suhstance called liquorice ; 
 which is advantageously employed hoth 
 to sweeten nauseous drugs, and by itself, 
 as a good demulcent. As such, it is much 
 used in coughs, colds, and other ajffections 
 of the wind-pipe and lungs; and when 
 formed into lozenges of a convenient size, 
 containing each about the sixth part of a 
 grain of opium, it forms a very soothing 
 application to the throat and larynx. These 
 lozenges may be given to the extent of six 
 or eight in the day. They are known by the 
 name of troches of liquorice with opium. 
 
 LISBON. It was at one time very 
 common to send consumptive patients to 
 Lisbon, probably from its being easily ac- 
 cessible, on account of the commercial in- 
 tercourse between this country and Por- 
 tugal, as much as for the warmth of the cli- 
 mate. Such persons must have suffered 
 much inconvenience from the bigotry 
 and filthiness of the inhabitants. As the 
 weather is not always steady, and the cold 
 sometimes considerable, and as we have 
 now a greater choice of places to which 
 invalids can resort, medical men are not 
 so much in the practice now of directing 
 a residence in Lisbon. Yet the beauty of 
 the scenery, and the deliciousness of the 
 fruits, are highly extolled; and many, when 
 sent in proper time, have derived much be- 
 nefit from the change; especially those who 
 have resided at Cintra, a romantic and 
 beautiful place, a few miles from Lisbon. 
 
 LISBON DIET-DRINK. A decoc- 
 tion of various plants, which was at one 
 time much employed in the cure of sy- 
 philis, and for the strengthening of the 
 constitution after a course of mercury. 
 The plants used were sarsaparilla, sassa- 
 fras, guaiac, liquorice, and mezereon. 
 What is called in the pharmacopoeias the 
 compound decoction of sarsaparilla, is now 
 commonly proscribed instead of the Lis- 
 bon diet-drink, 
 
 LITHIASIS. The tendency to form 
 calculous concretions in the kidneys or 
 bladder. See Stone. 
 
 LITHONTRIPTICS. Medicines sup- 
 posed to have the power of dissolving 
 stone in the bladder. The perfection of 
 a lithontriptic medicine would be, that it 
 could be easily taken into the stomach, 
 pass through the various organs of the 
 body, till it reaches the kidneys and blad- 
 der, and there dissolve the stone, or 
 break it down into particles small enough 
 to pass by the urethra. But the exist- 
 ence of such a substance is against all 
 probability. Even when a stone is thrown 
 into a very active fluid, out of the body, 
 it is not easily nor totally dissolved; 
 and the fluid which has power on one 
 stone has no power on others; and 
 it is against all the known laws of the 
 animal economy, to suppose that any such 
 dissolving fluid could reach the bladder, 
 without destroying many parts ; and if it 
 did get there, it would infallibly destroy 
 the bladder itself. The only medicine 
 having the most distant pretensions to do 
 good in stone, is potash or its carbonates ; 
 and this they do, not by reaching the 
 calculus in such a state as to dissolve it in 
 the same way as muriatic acid would dis- 
 solve a lump of marble, but by prevent- 
 ing that acidity in the stomach and first 
 passages on which the formation of stone 
 seems in many cases to depend. This 
 takes place in the following way: In 
 healthy urine, there is a considerable pro- 
 portion of an acid, called lithic or uric 
 acid, which is so combined with the other 
 ingredients, that the whole continue in 
 solution. But if the digestion is bad, 
 another acid is formed, and being carried 
 to the kidneys, combines with the mate- 
 rials there, and the uric acid is precipi-< 
 tated in an insoluble form. This may 
 happen in the kidney or ureter, and ac- 
 cordingly uric acid calculi are often found 
 there. If the uric acid Le deposited in the 
 bladder, other matters may gather round 
 it, and form a large stone. In order, there- 
 fore, to hinder the formation of unheal thy 
 acid, and the consequent deposition of the 
 uric acid, we aid the digestion by bitters 
 and tonics, and correct acidity by alkalis 
 and lime-water. As several salts are dis- 
 
LITHONTRIPTICS. 
 
 371 
 
 charged by sweat and insensible perspira- 
 tion, so if the functions of the skin are 
 not duly performed, these salts may find 
 their way to the kidneys, and occasion 
 the deposition of the uric acid. The per- 
 spiration, therefore, is to be regulated 
 by diaphoretic medicines, by exercise, 
 and proper clothing. We judge of 
 the presence of an excess of uric acid, 
 by examining the sediment deposited 
 from the urine, or the small fragments 
 Mhich are sometimes passed with it. The 
 uric acid generally gives a red deposit. 
 In this state of the system, alkalis are the 
 best remedies. Ten drops of the solution 
 of caustic potash (aqua potassae, Edin. 
 Pharmacopoeia) are to be given three or 
 four times a-day, in a cup-full of beef-tea, 
 or other convenient liquid. It is found 
 that the carbonates of the alkalis answer 
 the purpose of counteracting the tendency 
 to form uric acid, equally well with the 
 pure alkalis, and they are not so apt to 
 disagree with the stomach. The carbon- 
 ate of potash may be given in the dose of 
 a drachm four times a-day, dissolved in 
 two ounces of water, and flavoured with 
 liquorice or cinnamon-water. 
 
 The carbonate of magnesia has been 
 given as a lithontriptic, or as a counter- 
 actor of the tendency to stone ; but it 
 is not to be recommended, as it is rather 
 insoluble, and though it may correct a- 
 cidity in the stomach, no part of it will 
 be absorbed to reach the kidneys or blad- 
 der. Lime-water has also been much 
 recommended as fulfilling the same indi- 
 cations. When calcareous or magnesian 
 salts prevail in the urine, acids are to be 
 given; and we judge them to be proper, 
 when the phosphates are deposited as a 
 white sediment. The muriatic acid is as 
 conveniesjt as any other. But some cal- 
 culi are composed alternately of acid and 
 alkaline layers; in these, neither acids 
 nor alkalis alone will be the proper 
 lithontriptics. We are to give some- 
 times acids and sometimes alkalis, as the 
 deposits of the urine may direct us. The 
 proposal which has been made, of inject- 
 ing solvents ot the stone into the bladder, 
 
 would be an excellent one, could we in- 
 sure the bladder from injury; but the 
 irritable state of that organ renders it 
 quite impossible to keep the solvent long 
 enough in contact with the stone to do 
 any service. 
 
 LITHOTOMY. The surgical opera- 
 tion for removing stone from the bladder. 
 See Stone. 
 
 LIVER. The liver, which is the 
 largest gland in the human body, is des- 
 tined for secreting the bile. It is situ- 
 ated within the cavity of the abdomen, 
 partly in the right hypochondrium, un- 
 der the cartilages of the true ribs; it 
 fills up this region and reaches as low as 
 the kidney of that side ; part of it is in 
 the middle region called the epigastrium, 
 and a small portion in the left hypochon- 
 drium. It has a superior convex surface 
 adapted to the edge of the diaphragm, an 
 inferior concave one resting on the sto- 
 mach ; its thick edge behind lies against 
 the vertebrae, and its thin margin before 
 corresponds to the lower edge of the chest. 
 The liver is divided into three lobes ; the 
 right, which is by far the largest; the left, 
 and a small one on its under surface, called 
 the lobulus Spigelii from one of its first 
 describers. This large organ is kept in 
 its place by four ligaments ; the middle 
 or suspensory ligament between the right 
 and left lobe ; the coronary ligament by 
 which its upper surface is connected to 
 the diaphragm ; and the broad ligaments 
 of the right and left side. In the right 
 lobe is a depression in which is situated 
 the gall-bladder, which receives a por- 
 tion of the bile for a time, when it is not 
 wanted for the intestines. There are two 
 ducts, one from the liver and one from 
 the gall-bladder, by which the bile enters 
 the duodenum for the purposes of di- 
 gestion. See Bile. 
 
 The liver is subject to inflammation, 
 both acute and chronic ; to enlargement 
 and hardness, M'hich is a frequent cause 
 of dropsy; and to obstructions of the 
 ducts from spasm or gall-stones, occasion- 
 ing jaundice. See Dropsy, Gall-Stones, 
 and Jaundice. 
 
'J12 
 
 LIVER, INFLAMMATION OF. 
 
 LIVER, Inflammation of. I. Acute 
 Hepatitis. The symptoms of this dis- 
 ease are the following : General fever, 
 heat, thirst, pain in the right side, under 
 the margin of the lower ribs, generally 
 acute, but sometimes dull, difficulty of 
 lying on the left side, sometimes difficulty 
 of breathing, with a dry cough ; occasion- 
 ally a degree of jaundice ; and very fre- 
 quently a pain at the top of the right 
 shoulder. This pain at a place so far 
 from the inflamed part, is one of the most 
 remarkable instances of sympathy be- 
 tween distant places, which are supplied 
 with 'energy from the same nervous 
 trunk. The same nerves which supply 
 the muscles and organs at the top of the 
 shoulder, send branches to the diaphragm; 
 the convex part of the liver is connected 
 immediately, almost by adhesion to the 
 diaphragm, and, therefore, Avhen this part 
 of the liver is affected with inflammation, 
 the pain is propagated by nervous sym- 
 pathy to the top of the right shoulder. 
 
 Causes. The various causes of inflam- 
 mation in general, may produce inflamma- 
 tion of the liver ; such as a check to perspir- 
 ation, blows, and other external injuries ; 
 but there are certain circumstances which 
 dispose the patient to this inflammation 
 more than to any other ; and these are 
 especially, intemperance in the use of 
 strong liquors, and much external heat, 
 more particularly the heat of the sun, and 
 residence in a tropical climate ; this last 
 is aided in its injurious tendency by free 
 living, whether in the food, or in the 
 quantity and kind of strong liquors used. 
 
 Treatment. The cure of inflammation 
 of the liver is to be conducted on the 
 same principles as that of inflammation 
 in general j by bleeding proportioned to 
 the urgency of the case, and the strength 
 of the patient ; remembering, in tropical 
 climates, to make allowance for the great 
 debility which so rapidly follows high 
 excitement. Purgatives are to be given ; 
 and it is a good practice to begin with 
 the mercurial ones, Avhich, by promoting 
 ^he excretion of bile, relieve the liver of 
 the distension which may be supposed to 
 
 accompany the increased flow of blood to 
 it. If the pain continues after one or 
 two bleedings, a very large blister is to 
 be put on the right side. The usual an- 
 tiphlogistic regimen is to be vigorously 
 enforced ; great quietness, spare diet, and 
 abstinence from strong liquors, and from 
 beer or porter. Wlien the acute symp- 
 toms have gone oflF, provided the strength 
 be not much impaired, it is a prudent 
 measure to give mercury in a moderate 
 quantity, and to keep the mouth in a slight 
 degree sore for a fortnight or three weeks, 
 as this will probably prevent the harden- 
 ed thickened state of the liver, which so 
 frequently comes on after inflammation 
 of that organ. If acute inflammation of 
 the liver does not end in resolution, it 
 may proceed to suppuration, and one or 
 more abscesses may form in the liver; 
 these may burst into the thorax, when 
 the abscess is near the part of the liver 
 attached to the diaphragm ; in this case 
 there is great risk of suffocation ; or the 
 matter may make its way into the abdo- 
 men, w^hich is equally hazardous. Some- 
 times matter has found an outlet by the 
 intestines, and the patient has recovered ; 
 or if the abscess points externally, it may 
 be opened by puncture or by a seton. 
 But in every case, acute or chronic, we 
 should do all in our power to prevent 
 suppuration. 
 
 11. Chronic Hepatitis. Besides the 
 acute hepatitis above described, the liver 
 is subject to further disorder, of a more 
 insidious and dangerous kind, known by 
 the name of chronic hepatitis. This is 
 the disorder so prevalent and so perni- 
 cious to health, if not to life, which oc- 
 curs in M'arm climates, more especially 
 in the East Indies, where it is known by 
 the name of " the liver" or liver-com- 
 plaint, and from which the name and the 
 disease are so familiarly known to British 
 practitioners. The chronic hepatitis 
 comes on very gradually, and in many 
 cases, without any very prominent symp- 
 tom to give warning of the danger ; the 
 countenance becomes sallow, the appe- 
 tite is bad, the strength declines, and there 
 
LIVER-DISEASE. 
 
 373 
 
 is great depression of spirits. So insi- 
 diously does chronic hepatitis proceed, 
 tliat frequently, on dissection, the liver 
 is found in a state of suppuration, though 
 the patient had hardly complained of any 
 pain near the liver during his life. A 
 g-reat proportion of Europeans, in warm 
 climates, are victims of this disease. In 
 temperate climates, where affections of 
 the liver are more rare, the symptoms of 
 this chronic inflammation are often as- 
 cribed to indig-estion, which it certainly 
 has a tendency to produce ; but in India, 
 whenever a person complains of pain at 
 the pit of the stomach, or of any symp- 
 toms of indigestion, a practitioner should 
 always suspect some disorder of the li- 
 ver. The patient generally complains of 
 pain, which he supposes to be in the sto- 
 haach ; this pain may be relieved by dis- 
 charge of wind upwards, and thus the 
 opinion is confirmed, that it is owing to 
 an affection of the stomach ; but the true 
 i explanation is, that the stomach, when 
 \ distended with air, presses upon the liver, 
 and this organ being in some degree in- 
 ;■ flamed, feels pain on pressure, and is re- 
 l lieved when that pressure is taken off. 
 Pain is felt when any degree of pressure 
 js made by the hand near the stomach ; 
 and as the disease advances, tfiere is heat, 
 quickness of pulse, thirst, and other fe- 
 verish symptoms, especially towai-ds night. 
 The urine is scanty, and the stools, at 
 first, are less frequent and copious than 
 natural ; sometimes remarkable for a 
 darker, and sometimes for a lighter co- 
 lour than usual ; those colours frequent- 
 ly alternating for some length of time, 
 and eventually terminating in flux. The 
 structure of the liver becomes more solid 
 and compact, and though there is not al- 
 ways an increase of bulk, yet in very 
 many cases, both the hardness and an in- 
 creased size may be felt externally. So 
 important an organ as the liver cannot be 
 long affected without producing very in- 
 jurious effects on the system ; first on the 
 function of digestion, then on the gene- 
 ral health and strength ; and in veiy 
 many cases, the hardened liver gives rise 
 
 to dropsy of the belly, and of the cellular 
 membrane in general. 
 
 Treatment. The principal means of 
 cure in chronic hepatitis, consist in en- 
 deavouring to restore the healthy struc* 
 ture and action of the liver, and till this 
 is accomplished, we aid the digestive or- 
 gans by the exhibition of bitters aud pur- 
 gatives. Mercury, in its various prepara- 
 tions, especially calomel and the blue pill, 
 has been much resorted to, especially in the 
 East ; and there is certainly not a more ef- 
 fectual disperser of hardened morbid struc- 
 tures than this very active mineral. In the 
 use of so powerful a remedy, there is need 
 of caution and discernment ; it is a re- 
 medy that will not suit every constitution, 
 nor every stage of the disease ; and who- 
 ever, with rash empiricism, prescribes it 
 in every case, of real or supposed hepatitis, 
 will bring discredit on himself and on the 
 favourite remedy. If at any time the 
 symptoms become more acute, and the 
 pain more urgent, it may be proper to 
 take away blood from the arm or by 
 leeches, to apply a blister to the side, and 
 even to repeat a blister more than once. 
 Very often, in the Indian form of the 
 disease, no good can be done for the pa- 
 tient, unless he removes to a colder cli- 
 mate ; and a voyage to the Cape, to St. 
 Helena, or to Europe, is found absolutely 
 necessary. Akin to this necessity for a 
 complete change of circumstances, is that 
 of totally renouncing the use of spirituous 
 liquors; and also avoiding fermented li- 
 quors of every description, especially the 
 very strong beer commonly exported to 
 India. The strength is to be supported 
 by tonic medicines, and proper nourish- 
 ment. 
 
 LOBSTERS, Astacus marinus. A 
 kind of shell fish a good deal used at table. 
 They are very nutritive, but not very 
 digestible, and on some constitutions they . 
 have such an effect as to give rise to a 
 suspicion of their containing poisonous 
 matter. They sometimes occasion pain 
 of the throat, eruptions on the skin, and 
 pain in the stomach. These symptoms 
 are relieved by a cordial, followed by 
 
374 
 
 LOCHIA. 
 
 laxative medicine. Lobsters are fre- 
 quently to be found in the market under- 
 boiled, and are then very indigestible. 
 
 LOCHIA, the Cleansings, or the dis- 
 charge vrhich takes place from the uterus 
 for some time after child-bearing. Im- 
 mediately after delivery, the discharge is 
 of blood, which in a few days gradually 
 diminishes, and is followed by a discharge 
 of a greenish fluid of a peculiar odour. 
 The flow of the lochia continues in dif- 
 ferent women from a week to a month ; 
 in some women, the red colour disappears 
 and comes back again for some time, till 
 the womb is reduced to its original size. 
 It is a desirable thing that this flow should 
 proceed with regularity, as many unto- 
 ward sjonptoms take place, either when 
 it is checked suddenly, or when the flow 
 is greater than usual. Various circum- 
 stances occasion the suppression of the 
 lochia, as passions of the mind, cold drink, 
 or cold air applied; and the symptoms 
 consequent are very alarming. Great 
 fever, heat, and restlessness, pain of the 
 head, back, and loins, delirium, inflamma- 
 tion of the uterus, colic pains, costiveness, 
 are a few of those symptoms. The mea- 
 sures to be pursued for counteracting 
 them, and for restoring the flow of the 
 lochia, are the warm bath, if the patient 
 can bear it ; fomentations to the abdomen, 
 large emollient clysters, and sudorific 
 medicines, as antimony, or the acetate of 
 ammonia, assisted by copious diluent 
 drinks. When a profuse and general 
 perspiration breaks out, the relief is \ery 
 rapid and unexpected, and a practitioner 
 will find a patient whom he left at his 
 last visit in the most alarming distress, 
 at his next in a great measure relieved 
 and free from danger. 
 
 When the patient too soon attempts to 
 get up, there is great danger of renewing 
 the flow of the red lochia, by which a 
 great degree of debility is induced, and 
 the health in consequence is materially 
 injured. It should be strongly inculcated 
 on women in childbed, that it is highly 
 imprudent to use any great exertion dur- 
 ing the cleansings, and that they should 
 
 not presume on their feeling soon M'ell. 
 When this immoderate flow has occurred, 
 it is to be checked by confining the pa- 
 tient to the horizontal posture, by keep- 
 ing the bowels easy by mild laxatives, by 
 giving dry diet, and some astringent julep, 
 made with sulphuric acid. Bark and port 
 wine are to be given to keep up the strength, 
 provided there be no fever present. 
 
 LOCKED JAW. A conspicuous symp- 
 tom of a very dangerous spasmodic disease, 
 called Tetanus. See Tetanus. 
 
 LONGINGS. In the early stages of 
 pregnancy, the minds of women are often 
 fretful and impatient, and cannot bear 
 any contradiction. Among the vulgar 
 and self-indulgent, it is an opinion, that 
 if they do not get whatever they desire, 
 whether any article of food or other ob- 
 ject of attention, something very bad 
 will happen either to themselves or to 
 the child, particularly that the child will 
 bear the mark of the object longed for, 
 however loathsome and disgusting; and 
 hence they are at no pains to restrain 
 their capricious fancies, but expect the 
 most ready compliance on the part of all 
 around them. It should be known that 
 all fears of imparting any marks to their 
 offspring are utterly groundless ; and 
 though no person of common good nature 
 would think of thwarting any harmless 
 inclination or longing women might hap- 
 pen to take, yet it ought to be their 
 own care not to be discomposed by every 
 trifle, and not to occasion unnecessary 
 distress or trouble to those about them. 
 There is no doubt that in the state of 
 pregnancy, the nervous system is with 
 many in so irritable a state that the most 
 prudent management is required; and 
 by neglect or harshness, such symptoms 
 may be induced, as will occasion both 
 alarm and danger; and a prudent phy- 
 sician or friend will therefore be always 
 disposed to err rather on the side of in- 
 dulgence than of opposition, and will 
 rather suffer the harmless longings of 
 women to be indulged in all their absur- 
 dity, than run the risk of hurting their 
 health by an injudicious sternness. 
 
LUMBAGO. 
 
 375 
 
 LOOSENESS of the Bowei^, see 
 Diarrhea, pa ffe 193, and Lnfants, joa^e 
 325. 
 
 LOTION. A wash for medicinal pur- 
 poses. These of course must vary, accord- 
 ing- to the purpose for which they are 
 intended; but it should be a matter of 
 great deliberation whether the numerous 
 lotions vaunted for their power in beauti- 
 fying the complexion should ever be ven- 
 tured on. They must either be totally 
 insignificant, and have nothing but their 
 fragrance to recommend them; or if they 
 have more activity, it must be by the 
 metallic preparations they contain, which 
 are of too hazardous a nature to be used 
 without the superintendence and direction 
 of an experienced and respectable practi- 
 tioner. " Gowland's lotion is a solution 
 of corrosive sublimate in an emulsion 
 formed of bitter almonds, in the propor- 
 tion of about a grain and a half to an ounce. 
 A solution of this mercurial salt in spirit 
 of rosemary is also sold as an empirical 
 cosmetic." (Dr. Paris.) 
 
 LOUSY DISEASE, Morbus Pedi- 
 cularis. In some cases of what Willan 
 calls prurigo, an unusual number of lice 
 infest the body, and adhere with. great 
 obstinacy, in spite of every attempt to 
 destroy them. Mercurial frictions, to- 
 bacco lotions, and other acrid applications, 
 are the means most likely to get rid of 
 them; the utmost attention being paid 
 to cleanliness in all respects. It is be- 
 lieved by the best informed physicians, 
 that the marvellous stories on record of 
 persons who have been destroyed by the 
 lousy disease, are fabulous or exaggerat- 
 ed; and, at the worst, that the insects 
 have been the maggots arising from the 
 ova of the common domestic fly, or of the 
 flesh fly. Unquestionably these ova, when 
 deposited about the ear, the nose, or very 
 near the brain, may allow the insects 
 to get into situations where they are 
 productive of the greatest pain and dan- 
 ger. 
 
 LOZENGES are composed of pow- 
 ders made up with glutinous substances 
 into little cakes, and afterwards dried. 
 
 This form is principally made use of for 
 the more commodious exhibition of cer- 
 tain medicines, by fitting them to dis- 
 solve slowly in the mouth, so as to pass 
 by degrees into the stomach, or to act 
 upon the pharynx and top of the wind- 
 pipe ; and hence these preparations have 
 generally a considerable proportion of su- 
 gar, or other materials grateful to the 
 palate. The lozenges of the confection- 
 er are so superior in elegance to those of 
 the apothecary, that they are almost 
 universally preferred. {Edinburgh Neio 
 Dispensatory.^ 
 
 LUMBAGO. A painful aff"ection of 
 the loins, of a rheumatic nature. It 
 sometimes occurs as a part of general 
 rheumatism, sometimes without any 
 other part of the body being affected. 
 It is situated at the lower part of the 
 back and round the loins, is much in- 
 creased by any attempt at motion, and 
 not uncommonly is rendered worse by 
 the warmth of the bed-clothes. If there 
 be general fever, it will be proper to 
 begin the cure by taking some blood 
 from the arm ; then to apply leeches, or 
 cupping-glasses to the loins, to foment 
 the parts, and to rub them frequently 
 with camphorated oil, or with volatile 
 liniment, or the tincture of soap with 
 opium. If these remedies do not suc- 
 ceed, a mustard poultice, or a blister, 
 must be applied. Lumbago is a very 
 obstinate form of rheumatism, and often 
 baffles, for a long time, all attempts to 
 relieve it ; it is also liable to return very 
 frequently, and even to infest a person 
 more or less, to the end of life. Those 
 who are subject to it should wear a flan- 
 nel or leathern bandage round the loins, 
 should avoid all exposure to cold and 
 damp, should not fatigue the muscles of 
 the back by long standing in the erect 
 posture, but rather strengthen them by 
 moderate and regular exercise, as by rid- 
 ing ; and when the pain is completely off, 
 should use topical cold bathing, well as- 
 sisted by repeated rubbing with a flesh- 
 brush, or a warm dry towel, several times 
 in the day. 
 
376 
 
 LUMBAR ABSCESS. 
 
 LUMBAR ABSCESS. A collection 
 of matter forming in the loins internally, 
 and making its appearance along- the 
 psoas muscle, at the upper part of the 
 thigh. At the commencement of the dis- 
 ease, there is some difficulty of walking, 
 and uneasiness is felt about the loins ; 
 but, in general, there are large collec- 
 tions of matter formed without much pre- 
 vious pain, and without any indication of 
 disease till it begins to show itself by an 
 external swelling. 
 
 Causes. It is sometimes connected 
 with disease of the bones of the vertebral 
 column, but in many cases there is no 
 such combination. It very often occurs 
 in scrofulous constitutions without any 
 obvious cause, and it may proceed from 
 blows on the back and loins, and from 
 exposure to cold and damp, as by lying 
 on the ground when wet. 
 
 Treatment. If we have any s}Tnptoms 
 to lead us to suspect the complaint com- 
 ing on, we are to endeavour to prevent it 
 by the application of leeches, by blisters, 
 and purgative medicines. The great dif- 
 ficulty in the treatment of this disease, is 
 to determine on the mode of opening the 
 abscess, when we have decided that such 
 a measure is proper. It is found by very 
 general experience, that when these large 
 collections of matter are freely opened, 
 and admission is given to the external air, 
 very terrible consequences ensue ; and that 
 there are produced hectic fever, wasting 
 discharges of matter, and at length, death. 
 Apian which has been adopted with success 
 for opening them, is to make a puncture 
 large enough to discharge the flakes of 
 matter and clots of blood from the cavity, 
 then to cover the wound, and get it to 
 heal as quickly as possible. When the 
 matter collects again, a fresh opening is 
 made, and the same methods pursued as 
 before. When the abscess has been 
 opened, or when it has burst, which we 
 must always endeavour to anticipate and 
 prevent, the strength of the patient is to 
 be supported by nourishing diet, and by 
 a liberal allowance of bark and wine ; at 
 the same time, moderating the hectic fe- 
 
 ver, by sponging the body with vinegar and 
 water, and paying the proper attention to 
 the action of the stomach and bowels. 
 
 LUMBRICI, the long round worms 
 like earth worms, found in the intes- 
 tines. See Worms. 
 
 LUNAR CAUSTIC. See Nitrate 
 OP Silver. 
 
 LUNCHEON. See Meals. 
 
 LUNGS. The organs of respiration, 
 situated in the cavity of the chest. They 
 are divided into lobes, of which the right 
 side contains three, and the left only two, 
 in order to allow room for the heart and 
 great vessels. All the blood of the body 
 passes through the lungs, in order to be 
 there exposed to the influence of the ex- 
 ternal air, by which it undergoes a change 
 necessary to make it salutary for the 
 body, which it is not, after having once 
 circulated through it. The blood circu- 
 lates through the lungs always contained 
 in vessels, and it is believed to be ex- 
 posed to the action of the air not directly, 
 but through the medium of thin vesicles, 
 as the windpipe is continued by branches 
 continually getting smaller and smaller, 
 till at last they end in points too minute 
 for sight. 
 
 An organ of such importance as the 
 lungs, so close to the moving centi% of 
 action, so abundantly supplied with blood, 
 and so delicate in their own ultimate 
 structure, may be easily supposed to 
 be liable to very numerous diseases, and 
 those of the most dangerous kind. Ac- 
 cordingly a very large proportion of fa- 
 tal diseases are those which occur in the 
 chest, either in the substance of the lungs 
 themselves, in the membranes that line 
 them, or in the numerous vessels that 
 ramify through them. 
 
 Pleurisy, asthma, catarrh, consumption, 
 spitting of blood, are some of the dange- 
 rous or painful diseases of the lungs ; but 
 the question often asked by non-medical 
 persons with so much anxiety, about 
 themselves or friends, whether the lungs 
 are aff'ected, seems to have reference prin- 
 cipally to the symptoms of consumption. 
 A medical man knows, that even in the 
 
LUNGS, INFLAMMATION OF. 
 
 377 
 
 mildest cough of a common cold, the 
 lung« are affected ; and with perfect truth, 
 he mig-ht give very alarming answers to 
 unskilful inquirers: but restricting the 
 terms to mean, whether that fatal ulcera- 
 tion has begun, which never stops, but 
 ultimately destroys the patient, it is well 
 worth our while to endeavour to ascertain 
 whether a correct answer can be given 
 to the question. Under the article Con- 
 su»iPTioN, we have confessed the difficul- 
 ty of giving a proper decision in the early 
 stages of the disease ; and have shown 
 that the mucus expectorated in certain 
 stages of catarrh, which is to go off with- 
 out leaving any bad effects, is not to be 
 distinguished from the purulent matter of 
 fatal consumption. We are therefore to 
 judge by the matter, only in conjunction 
 with the other symptoms. When there 
 is considerable pain and difficulty of 
 breathing, -when there have appeared 
 streaks of blood in the spitting, when 
 there is a frequent copious discharge of 
 yellow and thick matter, with a bad smell, 
 then we have reason to fear that the lungs 
 are affected \^'ith that fatal malady which 
 is at last to end the patient's life. 
 
 LUNGS, Inflammation of. This dis- 
 ease, known by the name of Pleurisy ^ 
 may be situated either in the substance 
 of the lungs themselves, or in the lining 
 membrane investing them, and covering 
 the inner surface of the ribs. For all 
 practical purposes, the inflammation of 
 these various parts may be included under 
 one common name. The symptoms of 
 inflammation of the lung-s are the follow- 
 ing : The disease comes on with coldness 
 and shivering, and other symptoms of 
 beginning fever, then the heat of the body 
 is increased, the pulse becomes more fre- 
 quent, full and strong, and there is very 
 marked difficulty of breathing, especially 
 when the patient attempts to draw in a 
 full breath. The pain is generally greater 
 ■when the patient lies on the side affected, 
 but sometimes the contrary is the case. 
 The pain is felt most commonly on one 
 side, and some have supposed that the 
 left side is more frequently attacked thau 
 
 the right, but this does not appear to be 
 correct. Sometimes the pain is felt at 
 the lower part of the breast, sometimes 
 in the back, between the shoulders ; the 
 pain is commonly fixed in one spot, but 
 sometimes shoots from the side to the 
 shoulder, back or breast, and such shoot- 
 ing pains are called in common language 
 stitches. The disease is always accom- 
 panied by cough, and this cough, in every 
 case, is attended with very considerable 
 pain at the beginning of the disease ; it 
 is dry, but soon becomes somewhat moist, 
 and the matter spit up is streaked with a 
 little blood. 
 
 Causes. The most common cause of 
 pneumonic inflammation is cold applied 
 to the body when heated, especially when 
 there is perspiration on the surface. Such 
 check to the perspiration is most likely 
 to be followed by inflammation, when 
 there is peculiar vigour in the system, or 
 what physicians call the inflammatory 
 diathesis ; hence it occurs most frequent- 
 ly in the robust and young, in cold cli- ^ /) 
 mates, and towards the end of winter or ^/x^-'c*^ < 
 
 beginning of spring, when the changes of'^^ *^ 
 
 temperature are sudden and frequent. '' 
 
 #^ 
 
 Besides ..posuve to cold, there are v.- H-^ 
 rious other causes of pneumonic inflam-'^ '^^■"'^^^ 
 mation. Intemperance may excite gene- / *'.^^^ 
 ral fever, and also inflammation of the 
 lungs; violent exercise may do it; and 
 great exertions of voice and breathing, 
 as long and loud speaking, or playing 
 on wind instruments, may do it ; a blow 
 on the breast may occasion it; and in 
 measles, it is a symptom of the greatest 
 danger. 
 
 TerminaticmsofV\.YK^\%Y. The most 
 desirable termination is that of resolution ; 
 and it is to accomplish this that our most 
 strenuous efforts should be directed. It 
 is known to be taking this favourable 
 turn by the abatement of the pain and 
 difficulty of breathing, by a gentle per- 
 spiration coming out, and by the strength 
 and fulness of the pulse ceasing. Though 
 the disease terminates in resolution, it is 
 often found, on examination of the bodies 
 of those who at one time or other of their 
 
378 
 
 LUNGS, INFLAMMATION OF. 
 
 lives had been affected with inflammation 
 in the chest, that adhesions had been 
 formed between the investing membranes 
 of the lung^ and ribs. These adhesions 
 are very common, and frequently occa- 
 sion no inconvenience. If the disease 
 does not terminate in resolution, but goes 
 on to suppuration, the matter may burst 
 into the lung^s, and may destroy the pa- 
 tient by suffocation. 
 
 Prognosis. We consider the attack 
 as being one of great danger, when the 
 difficulty of breathing is very great, when 
 the patient can lie only on one side, or 
 on his back, or when he is obliged to be 
 in the erect posture, and when there is 
 much bloatedness and flushing of the face. 
 It is also a bad symptom, when the cough 
 is frequent, exciting much pain, when it is 
 with very little expectoration, when the 
 pains increase, and are in more places 
 than at first; and especially when, in the 
 early stage of the disease, a delirium 
 comes on. 
 
 Treatment. Our grand and certain 
 remedy, if any can be called so, is blood- 
 letting to a very large extent ; and though 
 attempts have been made to prove these 
 large bleedings unnecessary, or by the 
 aid of certain medicines to diminish the 
 quantity of blood drawn, yet there does 
 not appear any just ground to depart from 
 the practice sanctioned by the successful 
 experience of ages, and of which the ap- 
 parently debilitating effects are in general 
 so soon recovered from. The quantity 
 of blood to be drawn must not be limited 
 by ounces or pounds, but be regulated by 
 the constitution of the patient, by the 
 violence of the disease, by the appearance 
 of the blood drawn, and by the relief 
 which is afforded by the bleeding. Six- 
 teen ounces of blood, or an English pint, 
 is a very moderate bleeding from an adult ; 
 and more frequently, pneumonic inflam- 
 mation will require three times that quan- 
 tity to be taken at once. It is in this 
 disease that M^e see very conspicuously 
 what is called the buffy coat, on the 
 blood. This is a thick tough leathery 
 <;rust which shou'S itself on the surface 
 
 of blood drawn in inflammatory diseases 
 when it has been allowed to rest and 
 coagulate; and from the thickness and 
 firmness of this crust, we form a judgment 
 of the degree of inflammation present; 
 and its appearance satisfies us that we 
 have been quite authorized to take away 
 blood, though we are by no means, as 
 some have advised, to continue our bleed- 
 ing till the inflammatory crust ceases to 
 show- itself. If our first large bleeding 
 does not give the relief that we desire, 
 in the course of four or five hours, we 
 are to repeat the bleeding, and to give 
 a very smart purgative of salts, or of 
 jalap and calomel, and to apply a large 
 blister over the seat of the pain. It may 
 be necessary to repeat the bleeding five 
 or six times, before any relief is obtained. 
 The quantity of blood necessary in the 
 cure of pleurisy is often very great indeed, 
 amounting to no less than twelve or fif- 
 teen pounds in the course of three or 
 four days. But sometimes the pain con- 
 tinues severe, the symptoms urgent, and 
 the danger great; and that, when any 
 further bleeding would be more hazar- 
 dous than the disease. In this case, we 
 must try leeches or cupping, and repeat 
 the blister. To promote the expectora- 
 tion, we may give squill, mucilaginous 
 mixtures, or calomel in small doses, com- 
 bined with antimonials ; as two grains of 
 calomel, with half a grain of tartar eme- 
 tic, or with three grains of the antimo- 
 nial powder, or James's powder, in jelly, 
 every four hours. Formidable and pain- 
 ful as this disease is, these remedies are 
 in a very great proportion of cases suc- 
 cessful in removing it ; and we consider 
 our purpose as in a fair way of accom- 
 plishment, when we find the pain and 
 difficulty of breathing diminished, and 
 the other favourable symptoms occurring 
 as above mentioned. We also consider it | 
 as a favourable symptom, when the pa- \ 
 tient spits up an orange-coloured mucus, 
 and that even though there should be 
 some streaks of blood in it. It is also good, 
 when a fiery pustular eruption breaks 
 out in some parts of the body, as about 
 
L UN 
 
 L YM 
 
 379 
 
 the mouth. We judge that the disease 
 is about to proceed to suppuration, wlien 
 it is protracted beyond six or eight days, 
 in spite of the proper remedies actively 
 employed, when the difficulty of breath- 
 ing continues, though the acute pain is 
 removed ; and when the patient has been 
 seized with frequent shiverings ; and we 
 conclude that an abscess has actually 
 formed, when there is a sense of fulness and 
 weight, where formerly there was pain ; 
 and even in some cases we are made sure 
 of this by a swelling pointing outwardly, 
 and giving a sense of fluctuation. The 
 patient is now said to have empyema. 
 The danger to be apprehended from sup- 
 puration within the chest is very great, 
 though the degree of danger may vary 
 a little according to the place where it 
 bursts. If it bursts into any of the two 
 great branches of the wind-pipe, it may 
 prevent the free passage of the air, and 
 suffocate the patient ; or if it breaks into 
 the smaller divisions, it may give rise to 
 a gradual discharge of purulent matter, 
 continuing for a long time, and proving 
 the commencement of consumption of the 
 lungs. The matter spit up is often of a 
 most off*ensive smell. If the matter points 
 outwardly, it is to be let out by a surgi- 
 cal operation, a small puncture being 
 made slightly transverse, and rather nearer 
 the upper margin of the rib, in order to 
 avoid an artery which runs along a groove 
 in the lower mai-gin of each rib. Care 
 
 must be taken to prevent the admission 
 of the external air, as this might both be 
 apt to occasion hectic fever, and to im- 
 pede the free expansion of the chest by 
 counteracting the weight of the air drawn 
 in by the mouth. See Empyema. 
 
 LUXATION. See Dislocation. 
 
 LYMPH. A clear fluid poured out 
 by the extremities of the arteries into 
 various cavities of the body, and into the 
 cellular substance. 
 
 LYMPHATIC VESSELS. Asetof 
 vessels in the animal body, numerous and 
 important, which open into the cellular 
 texture and into the various cavities, and 
 absorb the lymph and other watery fluids, 
 convey them through glands situated in 
 different parts of the body, till they pour 
 the fluid into the thoracic duct, the same 
 to which the lacteals convey the chyle ; 
 and from which the two fluids are carried 
 into the lungs, there to be completely 
 fitted for the purposes of the body. When 
 the lymphatic glands are diseased or any 
 way obstructed, they give rise to hard 
 knotty swellings in various parts of the 
 body ; and they are thought to be pecu • 
 liarly the seat of scrofulous inflammation. 
 Such swelled glands are often seen in the 
 neck and groin. The best way to pro- 
 mote the healthy action of the lympha- 
 tic vessels and glands, is to wear m arm 
 clothing, to use moderate and constant 
 exercise, to pay attention to diet, and to 
 the regular action of the bowels. 
 
 M 
 
 MAC 
 
 MACE. The external covering of the 
 nutmeg. By drying, it acquires a red- 
 dish yellow colour. It has a strong agree- 
 able smell, and an aromatic bitter taste. 
 It yields an expressed oil, and its medi- 
 cinal properties are those of an aromatic 
 and stimulant ; though it is rather to be 
 regarded as an aromatic spice, than as an 
 article of medicine. 
 
 MAD 
 
 MACERATION. The separation of 
 one part of the body, or of one layer of 
 a texture from another, by long steeping 
 in water. 
 
 MADDER, Rubia tinctoi'um. A plant, 
 the root of which yields a fine red dye, 
 and which has the remarkable property 
 of tinging, of a red colour, the urine, 
 milk, and bones of animals which are fed 
 
380 
 
 MADEIRA. 
 
 with it. It has been celebrated for its 
 powers of promoting the menstrual dis- 
 charg-e, but without the smallest reason. 
 
 MADEIRA. Thisislandhaslongenjoyed 
 a high character as a resort for consump- 
 tive patients, from the equality of its tem- 
 perature, and the salubrity of its climate. 
 The mean annual range of temperature 
 is only 14'^, and the heat is distributed 
 through the year with surprising equali- 
 ty, the winter is only 20° warmer than 
 at London, while the summer is only 
 7° warmer. The equality of temperature 
 between the night and day is remarkable, 
 and also between the different seasons, 
 and between one day and another. It is 
 exempt from keen cold winds; the rains 
 generally fall at regular and stated periods. 
 
 The benefit derived from a removal to 
 Madeira, in those cases for which it is 
 principally recommendeil, viz. the con- 
 sumptive, depends entirely on its being 
 adopted at a proper time before the symp- 
 toms are confirmed and the disease far 
 advanced. Dr. Clark quotes the obser- 
 vation of medical men Avho have resided 
 on the island, and regards them as show- 
 ing, " in a striking point of view, the ne- 
 cessity of discrimination in sending pa- 
 tients to Madeira; and how deeply im- 
 pressed medical men ought to be, with 
 the heavy responsibility which they take 
 upon themselves in deciding on a ques- 
 tion of such importance. By far the 
 greater number of the patients referred to 
 should never have left their own country ; 
 the advanced period of their disease could 
 leave no reasonable prospect of benefit 
 from such a measure. The result of those 
 cases sent to Madeira at the proper pe- 
 riod is very different. The effects of the 
 climate on incipient cases, and those 
 threatened with the disease from here- 
 ditary or acquired predisposition, are high- 
 ly encouraging, and should lead medical 
 men to recommend such a measure at the 
 only time when it promises benefit." 
 
 The principal disadvantage of Madeira is 
 the want of opportunity to take regular ex- 
 ercise in the most beneficial way. " The 
 steepness of the whole island renders wheel 
 
 carriages useless. Invalids must therefore 
 ride, or be carried in palanquins or ham- 
 mocks. There is abundance of horses, sure- 
 footed, and accustomed to the roads, the 
 steepness of which is less objectionable to a 
 class of invalids who ought to take their 
 exercise chiefly on horseback at a moder- 
 ate pace. Invalids intending to pass the 
 winter in Madeira should leave this coun- 
 try in the end of September, or the be- 
 ginning of October. The beginning of 
 June is sufficiently early to leave the 
 island to return to England." (Clark 
 on Climate.) 
 
 MADEIRA. A wine brought from 
 the island of that name. It is more sti- 
 mulant than port ; it agrees well with the 
 stomach, and is excellently adapted for 
 debilitated constitutions, and for rousing 
 the nervous energy in the weakness of 
 typhoid diseases. But good Madeira wine 
 is difficult to be procured ; it is no longer 
 made of the same excellence as formerly ; 
 and the trade, according to Mr. Brande, 
 overflows with a variety of inferior and 
 mixed wines, of all prices and denomina- 
 tions, to which the name of Madeira is 
 most undeservingly applied. In its purest 
 form, Madeira generally is more acid than 
 either port or sherry, and is consequently 
 not so well adapted to stomachs inclined 
 to acidity, where it is generally found pe- 
 culiarly heating and irritating. 
 
 MADNESS. See Insanity. 
 
 MADNESS, CANINE. See Hydro- 
 phobia. 
 
 MAGNESIA. A species of earth, of 
 great benefit in con-ecting acidity of the 
 stomach. It is of the class of whai are 
 called alkaline earths ; and having an af- 
 finity for acids, it attracts to itself what- 
 ever acid it finds in the stomach, and 
 forming with it a purgative salt, it pro- 
 duces several easy motions of tlie bowels 
 and so removes the acidity, heai-tbum, 
 and other unpleasant symptoms. Mag-- 
 nesia may be taken to the extent of a tea- 
 spoonful twice or thrice a-day, accordino' 
 to the urgency of the symptoms ; and it 
 may be mixed with water, or peppermint- 
 water, or any similar fluid, to diminish 
 
MALARIA. 
 
 381 
 
 its insipidity. Mag^nesia may be safely 
 and usefully given to children, even when 
 very young, mixed with. their panado or 
 thin gruel. The best magnesia is what 
 is called burnt or calcined magnesia. 
 Magnesia is either found in nature, com- 
 bined with the carbonic acid, or it is ob- 
 tained in that combination in the process 
 of preparing it from Epsom salts, which 
 are magnesia combined with sulphuric 
 acid. This carbonate of magnesia answers 
 the puqjose of correcting acidity, and is 
 cheaper, but in some cases may be dis- 
 advantageous, on account of there being 
 an escape of carbonic acid, which gives 
 rise to flatulency in the stomach and 
 bowels. By exposing the carbonate of 
 magnesia to a strong heat for a proper 
 length of time, the carbonic acid is driven 
 off, and the pure magnesia remains, which 
 is then termed pure, calcined, or burnt 
 magnesia. Double the quantity of the 
 carbonate is required to produce the same 
 eiFect as the calcined magnesia. 
 
 MAGNESIA^ SULPHATE OF. See 
 Epsom Salts. 
 
 MAGNETISM. The attraction of the 
 loadstone for iron. At one time, 1780-84, 
 there was a very great sensation excited 
 by the report of surprising effects pro- 
 duced on the human body, both in health 
 and sickness, by the action of magnetism ; 
 but after a very full and patient exami- 
 nation of the subject, by some of the 
 greatest philosophers of the age, it was 
 universally acknowledged to be the mere 
 effect of a credulous imagination deceived 
 by artful imposture. Since that time, 
 animal magnetism has ceased to be talked 
 of, and- has given way to other objects of 
 popular credulity. 
 
 MALARIA is that property of the air 
 or other circumstances about particular 
 places, which gives rise to the prevalence 
 of dangerous fevers, principally of the re- 
 mitting form. Though these fevers are 
 prevalent in many different regions of the 
 globe, the term Malaria is chiefly applied 
 to Rome and its vicinity, or at least to the 
 South of Europe. For the description of 
 the fevers produced by the malaria of dif- 
 
 ferent countries, we refer to Ague, page 
 \\y et seq. and Fever, Remittent, page 
 259 ; and from the work of Dr. Clark on 
 Climate, we extract some of those cir- 
 cumstances respecting malaria, which it 
 is important for travellers to know, with 
 the view of enabling them to avoid its 
 effects. 
 
 " In the first place," says Dr. Clark, 
 I may observe, that the malaria fevers 
 of Rome are exactly of the same nature, 
 both in their origin and general charac- 
 ters, as the fevers which are so common 
 in the fens of Lincolnshire and Essex in 
 our own countiy, in Holland, and in cer- 
 tain districts over the greater part of the 
 globe. The disease is the same, from the 
 fens of Lincolnshire, or the swamps of 
 Walcheren, to the pestilential shores of 
 Africa; only increased in severity, ccete- 
 ris paribus, as the temperature of the 
 climate increases. 
 
 " These fevers have generally been at- 
 tributed to the direct action of something- 
 extracted from the soil ; but of the na- 
 ture of this agent, we are quite ignorant, 
 and its existence is even doubted by 
 many. It is singular, that this opinion, 
 which originated with Lancisi, should be 
 wearing away in Italy, whilst it may be 
 said to be extending itself in England. 
 (We are inclined to believe Lancisi and 
 the English in the right.) 
 
 " It would appear, that under ordinary 
 circumstances, a certain period of resi- 
 dence in the malaria site is necessarytto 
 prepare the body for an attack of this 
 fever ; and that there is no reason for the 
 fear commonly entertained, of a sudden 
 attack of malaria, from simply passing 
 quickly through a malaria district. I 
 found that the German, French, and 
 English artists, and others who reside a 
 considerable time in Rome, were more 
 frequently attacked with fever the second 
 or third years of their residence, than 
 the first. The malaria fever at Rome 
 seldom appears before July, and ceases 
 about October, a period during which few 
 strangers reside there. The fevers of 
 this kind, which occur at other seasons. 
 
382 
 
 MALARIA. 
 
 are generally relapses, or complicated with 
 other diseases. One of the most frequent 
 exciting causes of this fever is exposure 
 to currents of cold air, or chills in damp 
 places, immediately after the body has 
 been heated by exercise, and is still per- 
 spiring. Exposure to the direct influence 
 of the sun, especially in the spring, may 
 also be an exciting cause ; it has certain- 
 ly appeared to me to produce relapses. 
 Another cause of this disease is improper 
 diet. An idea prevails, that full living, 
 and a liberal allowance of wine, are ne- 
 cessary to preserve health in situations 
 subject to malaria. This is an erroneous 
 opinion, and I have known many per- 
 sons suffer in Italy from acting on it. In 
 regulating the diet of persons living in a 
 malaria country, regard should be had to 
 the nature of the climate. The same sti- 
 mulating regimen which might be borne, 
 and e^en prove useful in the damp chilly 
 atmosphere of Holland, will not be suited 
 to the exciting climate of Italy. Sleep- 
 ing with open windows, either during the 
 day or night, more especially, in a place 
 kno^vn to be subject to those fevers, is 
 very dangerous, and I have known re- 
 peated instances of fevers produced in 
 this way. Towns are always safer than 
 villages, and the latter, than country 
 houses, and the central parts of a town 
 are also safer than the suburbs. 
 
 ** Much has been said about the healthy 
 and unhealthy quarters of Rome ; and in 
 this respect, there is certainly a material 
 difference in the summer; but in the 
 season during which strangers reside 
 there, this circumstance deserves mu( li 
 less consideration. More is to be feared., 
 from currents of cold air in the winter 
 than from a confined humid atmosphere, 
 which last is the evil to be avoided dur-f| 
 ing the summer. Thick and lofty tre 
 close to a house tend to maintain the 
 in a state of humidity, by preventing 
 free circulation, and by obstructing V 
 free admission of the sun's rays. Tre^* 
 growing against the walls of houses, aii4 
 shrubs in confined places near dwellings, 
 are injurious also as favouring humidity ; 
 
 at a proper distance, on the other hand, 
 trees are favourable to health. On this 
 principle, it may be understood how the 
 inhabitants of one house suffer from 
 rheumatism, headach, dyspepsia, nervous 
 affections, and other consequences of liv- 
 ing in a confined humid atmosphere, 
 while theii' nearest neighbours, whose 
 houses are more openly situated, enjoy 
 good health. Dryness, with a free cir- 
 culation of air, and a full exposure to the 
 sun, are the material things to be attended 
 to in choosing a residence. 
 
 " It has been repeatedly asserted, that 
 the influence of the malaria is increasing 
 rapidly around Rome, and that from this 
 cause, at no very distant period, the place 
 will become uninhabitable. I could not, 
 however, discover any good grounds for 
 this opinion. Indeed, the malaria fevers 
 were much less prevalent during the last 
 five years of my residence at Rome, than 
 they had been previously. This was 
 attributed, and I believe justly, to the 
 unusual dryness of the seasons. 
 
 " Persons attacked by this fever should 
 be strictly confined to the house until the 
 disease has been completely checked ; 
 and as soon as this is fairly effected, the 
 sooner they change the air, ,the more 
 likely will they be to avoid relapses, and 
 to prevent a disposition to a return of the 
 disease being fixed on the constitution-— 
 a circumstance ojfereat consequence to 
 
 the future he 
 ing the autu 
 may go to 
 advani^^' 
 plape J^"" itfi 
 MALE F 
 
 the individual. Dur- 
 r winter, such persons 
 s ; if the spring is far 
 nee will be the better 
 on Climate. J 
 N, Polifpodium filix mas, 
 4ip.w called A^ndium. A fern which has 
 teined some reputation by the powder 
 ;s leaf being employed with occasional 
 in the cure of tape-worm. The 
 iier in which it is used is the follow- 
 One or two drachms of the pow- 
 root of the fern are to be taken at 
 night, and a brisk purgative of senna, 
 jalap, or gamboge to be given next morn- 
 ing. This is further assisted by a con- 
 siderable quantity of green tea. Probably 
 
MALT LIQUORS. 
 
 383 
 
 when these measures are successful, it is 
 not the fern that deserves the credit. 
 
 MALIC ACID. The acid obtained 
 from apples and other fruits. It is not 
 used in medicine in its separate state. 
 
 MALIGNANT FEVER. See Fever. 
 
 MALIGNANT SORE THROAT. See 
 Scarlet Fever. 
 
 MALT LIQUORS contain a consi- 
 derable portion of nutritive matter, and 
 a less proportion of spirit than wines; 
 and they also contain a bitter principle 
 derived from the hop, with some soporific 
 properties. Those who use much malt 
 liquor generally grow fat. They have 
 the muscular strength increased, and the 
 general health for a time improved ; but 
 if carried to excess, and if proper exercise 
 be not taken, a fulness of the system is 
 induced, and it is rendered liable to all 
 the diseases which such a state brings on. 
 As very concentrated nourishment will 
 not be well digested, because the stomach 
 requires a certain bulk as \^ ell as quality of 
 food in order to the production of good 
 chyme, malt liquors agree best with those 
 in the poorer walks of life, whose food, 
 though bulky, is not very nutritive, but 
 whose stomachs are enabled by the sti- 
 mulus of the hop to extract a good 
 deal of nourishment from what they eat. 
 Malt liquors are infinitely preferable to 
 spirits for the labouring classes ; but 
 those who live well, and indulge in a 
 variety of dishes, have no need of the 
 stronger kinds of malt liquors ; though 
 table beer would assist their digestion 
 very considerably. The principal kinds 
 of malt liquor in use are, Beer, Ale, and 
 Porter. 
 
 MALVERN WATER. The water of 
 a spring near the village of Great Mal- 
 vern in Gloucestershire, of considerable 
 efficacy in various diseases. It contains 
 some carbonic acid, and some lime or 
 magnesia, and it soon acquires a fetid 
 smell by standing in open vessels. It is 
 a good deal employed as an external ap- 
 plication, and is very useful in deep ul- 
 ceration of a scrofulous nature, and at- 
 tended with much irritation. Scrofulous 
 
 ophthalmia is also much benefited by 
 Malvern water. Cutaneous diseases are 
 also much relieved, and the itching of 
 herpetic eruptions is greatly allayed by 
 it; it is in the irritable state of the skin 
 that it is of more benefit than in the 
 state where the skin is cold and the cir- 
 culation languid. Malvern water is used 
 internally iit tfases of discharge of bloody, 
 fetid, or purulent urine, and in the fever- 
 ish state which accompanies large scrofu- 
 lous ulcers on the surface of the body. 
 It is said, at its first use, to occasion head- 
 ach and drowsiness, with slight vertigo, 
 which however soon go off, or may be 
 removed by a purgative. It almost al- 
 ways increases the flow of urine, and im- 
 proves the health of the patient, though it 
 has no very decided effect on the bowels. 
 
 MANDRAGORA, Atropa mandra- 
 gora. A plant formerly supposed to have 
 the property of inducing sleep, but now 
 quite neglected. 
 
 MANGEL WURSEL, a species of beet, 
 a plant of some importance, as being a 
 substitute for bread in times of famine. 
 It has succeeded better in Germany than 
 in this country. It is sometimes culti- 
 vated to be given to cows. 
 
 MANGO, Mangifera Indica. Thfl 
 fruit of an Indian tree, cultivated all over 
 Asia. Mangoes are of a fragrant odour^ 
 juicy, and of a good flavour, and are eaten 
 either raw or preserved with sugar. 
 Their taste is very luscious. The unripe 
 fruits are sometimes used as a pickle, be- 
 ing preserved with salt, capsicum, or other 
 spices. 
 
 MANGO STEIN. Garcinia Mangos- 
 tana. A fniit about the size of an 
 orange, which grows plentifully in the 
 Asiatic islands. It is a fruit of the most 
 delicious flavour, having an exquisite 
 mixture of sour and sweet in its taste. 
 It is white, juicy, and transparent; and 
 this white part is surrounded by a rind 
 of very great astringency, which may be 
 used in those cases of dysentery and 
 diarrhoea where astringents are proper. 
 A decoction of the rind makes a good 
 gargle in sore thro.il s. 
 
384 
 
 MARASMUS. 
 
 . MANNA. A substance which exudes 
 spontaneously in dry and warm weather, 
 from a species of ash, the Fraxinus or- 
 nus, which grows in the South of Eu- 
 rope, especially in Calabria and Sicily. 
 It concretes upon the bark. Several va- 
 rieties of manna occur in commerce ; the 
 purest is called flake manna, others are 
 smaller frag-ments, having a great many 
 impurities mixed with them. The smell 
 of manna is slightly disagreeable, its taste 
 is sweet and nauseous. It is chiefly used 
 as a mild aperient for children, either by 
 itself for very young infants, or to sweet- 
 en the infusion of senna for those of a 
 more advanced age. The dose is a drachm 
 or two. For adults it is not to be de- 
 pended on as a purge. In some consti- 
 tutions it produces flxitulency and disten- 
 sion of the bowels, which effects are to 
 be obviated by giving some aromatic, as 
 ginger or the like. 
 
 MANNA CROUP, or Semolina is be- 
 lieved to be the powder of a Russian grain. 
 It affords a good article of farinaceous 
 food, and may form part of the diet of 
 very young children. It is boiled like 
 porridge, and may be eaten with milk and 
 a little sugar. 
 
 MARASMUS. Blight, or Atrophy. A 
 wasting of the body, rather to be consi- 
 dered as a symptom of some other dis- 
 ease, than as a disease of itself, and, ac- 
 cordingly, it is not applied by medical 
 writers, to designate any particular dis- 
 ease; but it answers pretty exactly to 
 what Scottish mothers mean to express 
 by the word dwining ; viz. that state of 
 protracted ill health, during which a child 
 ceases to thrive, and loses flesh and 
 strength with considerable rapidity. This 
 gradual wasting of the body may be ow- 
 ing to various causes, a bad state of the 
 stomach and bowels, teething, scrofula, 
 or an original weakness of constitution. 
 It is a common symptom of diseased me- 
 senteric glands. We are to endeavour to 
 find out the particular exciting cause, 
 and to direct our treatment accordingly. 
 Jilarasmus most commonly arises from a 
 derangement of the digestive powers, and 
 
 an irregular action of the bowels. We 
 are to correct acidity by chalk or mag- 
 nesia, to strengthen the stomach by giv- 
 ing rhubarb in powder or tincture, to pro- 
 cure a steady and regular determination of 
 the bowels downwards by purges of calo- 
 mel, alone or combined with other purga- 
 tives ; and those assisted by the interpo- 
 sition of purgatives of a different nature, 
 as senna, castor oil, or neutral salts. 
 When a patient has continued to use pur- 
 gative medicines for ten days or a fort- 
 night, we arc to stop for an equal time, 
 and then begin again, always remember- 
 ing that it is not the intention, by giving 
 these purgative medicines, to produce 
 watery, frequent, and weakening dis- 
 charges, but merely to solicit a regular 
 and free evacuation of excrementitious 
 matter ; and we are, therefore, to regu- 
 late our doses and their frequency ac- 
 cordingly. The general health is to be 
 improved by regular exercise, by being 
 much in the open air, not confining the 
 child too much to crowded school-rooms; 
 by cold bathing and sea bathing in the 
 proper season, and by the most scrupu- 
 lous attention to diet ; giving only such 
 food as is nourishing and easily digested, 
 avoiding butter, pastry, and sweetmeats, 
 especially almonds ; orange-peel, and un- 
 ripe fruit. These measures may be as- 
 sisted by frequent rubbing of the spine 
 and belly with camphorated oil or soap 
 liniment, or with plain sweet oil, conti- 
 nuing the rubbing for a quarter of an 
 hour or twenty minutes at a time. 
 
 MARMALADE. A sweetmeat made 
 by preserving the rind of oranges cut 
 into small pieces, and boiled Avith sugar. 
 It is an excellent stomachic with some, 
 but with others it proves rather indiges- 
 tible. 
 
 MARROW. The oily substance con- 
 tained in the hollow tube of the long 
 bones, contained in cells. The marrow 
 in the bones of beef is eaten at table, and 
 is highly nutritious. 
 
 MARSHMALLOW. Althcea offici- 
 nalis. A plant found on the banks of 
 rivers, the whole of which, and especially 
 
M E A L 8. 
 
 385 
 
 the root, abounds with mucilage. It 
 is used as a demulcent, in various pul- 
 monary complaints, and in affections of 
 tlie urinary organs. From one to two 
 pints of the decoction may be taken daily. 
 
 MASTICH. A resinous exudation 
 from the Pistacia lentiscus. It is prin- 
 cipally obtained in the island of Chios ; 
 and is used in Turkey to preserve the 
 teeth, and to give a pleasant smell to the 
 breath. Its medical virtues are insignifi- 
 cant, but it is a useful addition to some 
 pills, as it renders them more slowly so- 
 luble in the fluids of the stomach and 
 bowels, and, therefore, more progressive 
 in their operation. The principal pills 
 into which mastich enters are those made 
 of aloes, and intended to act as a gradual 
 laxative, and promoter of digestion. They 
 are called Dinner Pills. Three are a pro- 
 per dose. * 
 
 MATERIA I^EDICA. « Every sub- 
 stance employed in the cure of disease, 
 whether in its natural state, or after hav- 
 ing undergone various preparations, be- 
 longs to the Materia Medica, in the ex- 
 tended acceptation of the words. But 
 in most pharmacopoeias, the Materia Me- 
 dica is confined to simples, and to those 
 preparations which are seldom prepared 
 by the apothecary himselfj but commonly 
 purchased by him, as articles of com- 
 merce, from druggists and others. Sys- 
 tematic authors on this branch of medical 
 knowledge have bestowed much pains in 
 contriving scientific arrangements of these 
 articles. Some have classed them accord- 
 ing to their natural resemblances ; others 
 according to their active constituent prin- 
 ciples ; and others according to their real 
 or supposed virtues. Each of these ar- 
 rangements has its particular advantages. 
 The first will probably be preferred by 
 the natural historian, the second by the 
 chemist, and the last by the physiologist. 
 But every scientific classification hitherto 
 proposed is liable to niunerous objections. 
 Accordingly, in the pharmacopoeias pub- 
 lished by the Colleges of Physicians of 
 London, Dublin, and Edinburgh, the ar- 
 ticles of the materia medica are arranged 
 
 in alphabetical order ; and the same plan 
 is now almost universally adopted." (Dr. 
 Duncan's Edinburgh New Dispensa- 
 tory,) 
 
 MATLOCK. A village in Derbyshire, 
 famous for yielding a mineral water of 
 the acidulous class. Some of the Mat- 
 lock springs have a temperature of 66'. 
 It forms a proper tepid bath for those of 
 irritable, weak, constitutions ; and is ge- 
 nerally recommended after the use of 
 Bath and Buxton waters ; and as prepa- 
 ratory to sea-bathing. 
 
 MEADOW-SAFFRON. See Colchi- 
 
 CUM AUTUIvrNALE. 
 
 MEALS. The quantity of food taken 
 at regular intervals is commonly under- 
 stood by the term meal. On this subject 
 there are several particulars to be consi- 
 dered ; with respect to the kind and quan- 
 tity of food that ought to be taken, the 
 interval between each meal, and the con- 
 duct to be pursued previous to meals, and 
 after them. It may appear ridiculous to 
 make any formal remarks on what may 
 be supposed level to the capacities of all 
 mankind, and directed by the sure in- 
 stinct of nature ; but the luxurious ha- 
 bits, and the artificial modes of civilized 
 life, in those who are any degree above 
 the class that is doomed to toil and po- 
 verty, render it a subject of very ge- 
 neral interest. The importance of at- 
 tending to the diet of invalids and conva- 
 lescents, makes it a matter of primary 
 moment to know the best mode of regu- 
 lating the time, the quantity, and the 
 quality of the meals. On a subject where 
 there must be such a variety of circum- 
 stances in different individuals to be ta- 
 ken into account, it is obvious that no 
 set of rules, applicable to every case, can 
 be laid down. Whatever may be said, is 
 to be considered as the result of observa- 
 tion and experience, which can only fur- 
 nish general truths and maxims, to be ac- 
 commodated to particular cases, accord- 
 ing to circumstances. 
 
 One of the most important circum- 
 stances about meals is their regularity, 
 both as to number, and the periods at 
 2 c 
 
386 
 
 MEAL S. 
 
 which they are takeu. ILibit has such 
 an influence on the appetite of hunger, as 
 well as on many other of our sensations, 
 that it will return at the stated hour of 
 eating ; and if it be not appeased, the sto- 
 mach will cease its cravings, though no 
 aliment has been supplied. But hunger 
 will in many persons recur before the 
 time usually allotted for the regular meal ; 
 and it ^vill often be necessary to take 
 some food, to enable the stomach to hold 
 out till its accustomed period. In a 
 healthy person whose digestion is good, 
 who has taken sufficient exercise, and 
 who in a morning has taken no very sub- 
 stantial or copious repast, the Luncheon 
 will probably be a matter of indispensable 
 necessity ; but many of those who take 
 luncheon find it to spoil the digestion 
 both of itself and of their dinner ; much 
 more will this be felt by the dyspeptic 
 patient, "w^ho needs his stomach to be un- 
 disturbed during the digestion of his re- 
 gular meals, and who should not exhaust 
 his powers by calling them too frequent- 
 ly into action. If additional food be ta- 
 ken before the fonner portions are assi- 
 milated, the process will be disturbed; 
 and however plausible maybe the maxim, 
 that the stomach will be best managed 
 and the strength improved, by taking 
 small quantities of food very frequently, 
 yet this is not found to be true ; in fact, 
 the invalid thrives much better by regu- 
 lar meals at proper intervals, than by that 
 constant throwing in of supply as fast as 
 a morbid cniving calls for it, or as a false 
 theory says it should be swallowed. 
 
 The number of meals to be taken can- 
 not be subjected to any constant rule. 
 Most people take three in the day; one 
 copious and substantial, the others more 
 sparing, and with a larger proportion of 
 fluid. Some hardly consider tea as a 
 meal, and some dispense altogether with 
 supper. Those who dine plentifully, and 
 dine late, that is to say any time after 
 five, may well dispense with supper ; but 
 those who dine before three, will find it 
 for their comfort to take a light supper 
 before going to bed. 
 
 The quantity of food to be taken at 
 each meal, it is quite impossible to limit 
 by weight or measure. It is a moral 
 duty to stop short at the point where na- 
 ture is satisfied, as indicated by a certain 
 feeling of satiety that few persons may 
 not be conscious of experiencing at every 
 meal ; and those who are at all in bad 
 health, especially with dyspeptic symp- 
 toms, ought to be still more watchful of 
 the coming on of this sensation. There 
 is a moment, says Dr. Philip, when the 
 relish given by the appetite ceases; a 
 single mouthful taken after this, op- 
 presses a weak stomach. If a patient eats 
 sloM'ly and attends to this feeling, he vnM 
 never overload the stomach. But eating 
 sloivly is essential to this matter : when 
 one eats fast, hunger may continue for 
 some time after the stomach has received 
 more than sufficient. This rule will be 
 found universally to apply; when the 
 stomach is enfeebled, the feeling of sa- 
 tiety will the sooner come on ; M'hen by 
 exercise its powers are invigorated, it 
 will be enabled, without repletion, to take 
 in a larger quantity. Though it is bad to 
 exceed in quantity of food, and though a 
 great proportion of people might do with 
 a great deal less than they commonly use, 
 yet it is equally certain that under-feed- 
 ing both diminishes the strength, and ren- 
 ders liable to diseases. This is seen in 
 the poorer classes, and in certain districts 
 of our country where the food is princi- 
 pally composed of vegetables. It is pro- 
 per for those mIio in general feed to the 
 full, to practise abstinence occasionally, 
 by avoiding solid food, and taking some 
 weak broths. By incessant copious feed- 
 ing, that state will be induced which is 
 called high health, but from which the 
 transition is e^sy and probable, to fevers 
 and various other complaints. 
 
 Convalescents should be very cautious 
 not to urge too hastily their return . to 
 strength and vigour. After an acute 
 disease, the person, weak and emaciated, 
 has a good appetite ; but it is dangerous 
 to indulge this, lest he bring his system 
 too rapidly to that state which, relatively 
 
MEALS. 
 
 387 
 
 to him, is that of higfh excitement, and 
 liability to inflammatory diseases. 
 
 When habits are once formed with 
 respect to the quantity and quality of 
 food, they should not be suddenly ^ter- 
 ed. Some have no doubt been success- 
 ful, in rapidly changing from a nutri- 
 tious and stimulant diet to a spare on3 ; 
 but it is generally safer to alter the ha- 
 bits by degrees, proA-ided it be really and 
 steadily done. On the other hand, it is 
 equally well known, that those who have 
 been long fasting run the greatest risk of 
 suffering, even fatally, by the sudden use 
 of too much nourishing food. 
 
 Mixture of different kinds of Food at 
 one Meal. The late Dr. Gregory, when 
 lecturing on the gluttonous habits which 
 so certainly give occasion to the gout, 
 gave a strong and indignant description 
 of the luxury of a modern dinner ; and 
 every practitioner who is more anxious 
 to benefit than to please his patients, wiil 
 agree in his condemnation of the quan- 
 tity and variety of dishes which are too 
 commonly swallowed. First, the stomach 
 is distended with soup, of richness and 
 quantity sufficient to be a dinner of it- 
 self; then fish, with its various stimulat- 
 ing and indigestible sauces ; then solid 
 beef or mutton, fowls, tongue, game, 
 puddings ; then pastry, confectionary, 
 cheese, and fruit. These various sub- 
 stances differ so much in the ease with 
 which the stomach can digest them, that 
 while some have passed out of that or- 
 gan, it has still a great deal more to dis- 
 pose of; and the various mixtures are 
 productive of heartburn, flatulence, and 
 all the symptoms of indigestion. All per- 
 sons of weak stomachs should eat but one, 
 or at most, two kinds of food at one meal ; 
 and even those who are in health, will be 
 likely to continue so, the more carefully 
 they follow this maxim as a general rule. 
 
 Directions for Invalids before and af- 
 ter Meals. Exercise is undoubtedly ne- 
 cessary for promoting the health of all, 
 and of signal advantage in regulating the 
 digestive powers ; but the time and quan- 
 tity of exercise to be taken, must vary 
 
 w^ith the circumstances and habits of each 
 individual. To walk before dinner fcfr an 
 appetite is a very common practice, but 
 if this be carried the length of fatigue, it 
 will hurt the digestion instead of aiding 
 it. No dyspeptic patient should take a 
 full meal while he is in a state of fatigue ; 
 but moderate exercise in the open air, 
 when not pushed the length of exhaus- 
 tion, is an excellent preparative for a 
 temperate dinner. Exercise, a few hours 
 after dinner, is a very good promoter of 
 digestion. Hence one disadvantage of 
 very late dinners, that there is no proper 
 opportunity after them for taking exer- 
 cise and inhaling pure air. Sleeping af- 
 ter dinner, the siesta^ as the Spaniards 
 call it, is very common in warm climates, 
 and it certainly appears there to be very 
 refreshing; but is less necessary in our 
 temperate regions. Debilitated persons 
 may with propriety indulge it for a little. 
 
 MEASLES. An eruptive disease aris- 
 ing from contagion, attended with catar- 
 rhal and pneumonic symptoms, from which 
 few individuals of the human race are 
 exempt, but which attacks them only 
 once in the course of their life. As it is 
 generally children who are affected with 
 measles, and as it is a disease accom- 
 panied with very dangerous symptoms in 
 many cases, it becomes an important ob- 
 ject of domestic attenti<5n ; and we shall, 
 therefore, give a pretty full description 
 of the symptoms and treatment of measles. 
 
 Symptoms. Wlien the contagion of 
 measles has been received into the body, 
 the patient, for some time feels indisposed 
 at intervals, and then appears well again. 
 At last, a shivering and coldness come on, 
 soon followed by increased heat, thirst, and 
 other feverish symptoms, with sickness, 
 loss of appetite, vomiting, and in some rare 
 cases, with convulsion-fits ; but these are 
 by far more common in the commencement 
 of small-pox. Sometimes the fever is sharp 
 and violent from the fii-st ; sometimes it 
 is more obscure and mild, but it general- 
 ly is very violent before the measles show 
 themselves on the skin, which generally 
 happens on the fourth day from the at- 
 
MEASLES. 
 
 tack of shivering and cold stage of fever. 
 From the very commencement, there are 
 all the symptoms of catarrh, hoarseness, 
 a very frequent rough cough, difficulty 
 of breathing, swelling and redness of the 
 eyes and eye-lids, and a running of sharp 
 acrid matter from the eyes and nose. 
 With all this, there is often severe head- 
 ach, throbbing at the temples, and great 
 drowsiness. The eruption generally ap- 
 pears on the fourth day, first about the 
 face and under the chin, and then on 
 other parts of the body. It first appears 
 in small red points; but a number of 
 those come together, and form themselves 
 into semicircular patches, in the intervals 
 of which the skin is not very much dif- 
 ferent from its natural appearance. It 
 is by this, that the eruption is distinguish- 
 ed from that of scarlet fever, where the 
 skin is uniformly of a bright red colour. 
 The eruption is very slightly prominent, 
 and appears a little rough to the touch. 
 The eruption continues pretty bright for 
 two days, but about the third it fades a lit- 
 tle, and becomes of a brownish hue ; and in 
 a short time, about two days more, it to- 
 tally disappears, and a powdery scaling 
 off of the outer skin takes place. A 
 looseness of the bowels occasionally comes 
 on when the eruption is subsiding. The 
 fever is sometimes of alarming violence, 
 and it does not, in general, subside when 
 the eruption comes out ; on the contrary, 
 its violence is occasionally increased till 
 after the fading of the eruption. Whe- 
 ther the fever subsides or not, the cough 
 commonly continues w ith great severity 
 for a considerable time ; and the difficulty 
 of breathing increases, and is accompa- 
 nied with pain and other symptoms mark- 
 ing a degree of inflammation of the chest. 
 This tendency to inflammation of the 
 chest and disorder of the lungs, is what 
 renders the measles so troublesome and 
 dangerous a disease; and in too many 
 cases brings on a protracted illness, or 
 causes sudden death, when the disease 
 appeared to be going entirely off. 
 
 The danger in measles is owing to the 
 tendency they have to end in acute catarrh 
 
 or inflammation of the lungs ; but in some 
 rare epidemics, they have been known to 
 assume a putrid or malignant form. The 
 time when measles generally make their 
 appearance as an epidemic, is about the 
 month of January, and they continue till 
 some time in May ; though, from parti- 
 cular circumstances, there may be cases 
 at any time ; and, from the numbers that 
 generally take them in one epidemic, the 
 measles are not very prevjilent each suc- 
 cessive year, but intermit for a year or 
 two, till a new succession of subjects for 
 the disease comes into existence. 
 
 Treatment. It is a matter of high 
 importance to regulate the temperature 
 in which patients should be kept during 
 measles. Happily the absurd and de- 
 structive practice of loading the patient 
 with bed-clothes, and heating his system 
 by hot rooms and large fires, and by giv- 
 ing strong aromatics and stimulants, is 
 now almost universally exploded ; and 
 in no class of diseases, has a return to 
 better plans been more beneficial, than 
 in eruptive diseases. When natural or 
 inoculated small-pox occur, which they 
 can do, only from the most unpardon- 
 able obstinacy in resisting vaccination, 
 the patient is now kept cool, with the 
 most evident mitigation of the disease. 
 In measles, we should be inclined to 
 adopt the same lenient and cooling me- 
 thod, but here we are deterred by the 
 fear of repelling the eruption, and occa- 
 sioning a determination to the lungs and 
 chest. The safe and rational plan, there- 
 fore, is to keep the patient in measles in 
 an equal moderate temperature, avoiding 
 all unnecessary, artificial, and external 
 heat, and taking care that the patient, 
 on the other hand, be not exposed to 
 cold. In the early stages of measles, the 
 fever, is sometimes of the most alarming 
 appearance; but in general, even then, 
 it is not necessary tp do any thing more, 
 than to supply the patient plentifully with 
 mild diluent drinks, to administer a gen- 
 tle laxative, and to sponge the head and 
 temples with tepid vinegar and water; 
 or if the eyes be much affected, to apply 
 
 
MEASLES. 
 
 389 
 
 tepid milk and water to them. If the 
 oppression and difficulty of breatliing be 
 great, before the eruption comes out, it 
 is of great service to put the patient into 
 the warm bath, and to repeat this once or 
 twice, if the urgency of the symptoms 
 continues. In general, this helps out the 
 eruption, and relieves the patient; but 
 the fever and cough not unfrequently 
 continue after the eruption comes out; 
 and we are then to give antimonial and 
 other medicines to promote perspiration, 
 mucilaginous and sweet mixtures, with 
 squill or Tolu Balsam, to allay the tick- 
 ling cough; and if the pain and other 
 pectoral symptoms still continue severe, 
 we are to have recourse to bleeding and 
 other means for reducing inflammation, 
 proportioned to the age and strength of 
 the patient, and the violence of the dis- 
 ease. . The subjects of measles are ge- 
 nerally so young, that it is not easy to get 
 blood from a vein ; we are therefore com- 
 pelled to get blood by leeches. We are 
 not to be understood as saying, that 
 blood-letting is universally or even very 
 frequently necessary in children; but 
 the practice is highly proper when the 
 cough and pain of the chest are urgent. 
 This very frequently is owing to the 
 eruption being repelled by cold, in which 
 
 L?>tj case, the warm bath is exceedingly bene- 
 ficial. In adults, we are to draw blood 
 speedily and copiously by the lancet. A 
 blister, too, may be requisite, as also ac- 
 tive purging; but this last we must not 
 be too hasty in employing, for fear of 
 driving back the eruption. 
 
 Subsequent attentions requisite. With 
 these precautions and methods of cure, pa- 
 
 I tients who for a long time seemed in great 
 danger, get well with unexpected rapidity; 
 but, unhappily, measles are a disease too 
 often found to be followed by very bad 
 consequences, and to give trouble and 
 danger when the patient and friends 
 thought the process was happily over. In 
 constitutions tainted with scrofula, we 
 generally find, that measles waken into 
 activity that scourge of our climate ; and 
 many date their swelled necks, theii* dis- 
 
 eased eyes, their hopeless consumption, 
 from the time they had the measles. One 
 way to endeavour, at least, to prevent 
 these bad consequences, is to continue our 
 cares for a long time after the patients' . 
 
 seeming recovery, warning them to avoid '^ 
 
 exposure to cold, to damp, or to the east r..^c{^ , ^ 
 wind; not to expose the eyes to a bright :^ ^ * . 
 light, especially of the fire ; to avoid much 
 reading or sewing ; we are also to give 
 frequent purgative medicines, and to pay 
 attention to the diet of the convalescent. 
 It is a safe and proper practice to give 
 plenty of laxative medicine, whatever we 
 may say of the theory of its carrying oflF 
 the dregs of the measles. At the same 
 time, we are to be aware that debility is 
 a very common and dangerous sequel of 
 the measles; and while the bowels are 
 not neglected, we are to employ all pru- 
 dent means to strengthen the constitution, 
 by the use of country air, tonic medicines, 
 nourishing diet, and even a little wine. 
 
 MECONIUM is the dark coloured 
 stuff, like moistened opium, which is ac- 
 cumulated in great quantities in the 
 bowels of new born infants. They ge- 
 nerally begin to evacuate it soon after 
 birth ; but if it is retained too long, it is 
 apt to become acrid, and to irritate the 
 tender infant. A little sugar dissolved in 
 Mater is usually given soon after birth ; 
 and this answers the purpose of bringing 
 off the meconium ; but if it should not do 
 so mthin five or six hours, a little man- 
 na, or castor oil, or a suppository made 
 of a bit of yellow soap will generally ac- 
 complish it. 
 
 MEDICATED BATHS. See Bath, 
 page 59. 
 
 MEDICINES are those substances 
 introduced into the stomach, with the 
 intention of producing certain effects, for 
 the cure of disease or the preservation of 
 health. Substances applied externally 
 are more generally termed applications 
 or remedies. Medicines are obtained 
 from all the various kingdoms of nature, 
 and are used either simply or combin- 
 ed together. Their doses are to be regu- 
 lated according to the circumstances of 
 
390 
 
 MEDICINES. 
 
 each individual, with respect to age, sex, 
 temperament, strength, peculiarity of 
 constitution, &c. The doses of medicine 
 for children under twelve are to be dimi- 
 nished to }, I, \, ^, at two years, four, six 
 eight, and upwards ; from sixteen, in ge- 
 neral, the full dose may be given. Some 
 medicines, as calomel, do not make the 
 same impression on children as on adults, 
 and therefore need not be diminished so 
 much. Women in general require smaller 
 doses than men ; but of purgative medi- 
 cines, many require a good deal more. 
 When a person has been accustomed to a 
 medicine, he in general loses his suscepti- 
 bility of being moved by it ; but some ca- 
 thartics appear to have their action more 
 easily excited by habit ; and lead, instead 
 of losing its influence on the constitution 
 by the long continuance of its use, is ren- 
 dered more active by it. Emetics also 
 become more powerful by repetition. 
 When a person has been weakened by 
 the long duration of a disease, medicines 
 must be ordered in smaller doses than at 
 the commencement of it. Some medi- 
 cines only act more certainly when given 
 in large doses, but not more violently ; 
 this is the case with ipecacuan. Medi- 
 cines vary in their activity ; aud this must 
 be taken into the account when a fresh 
 parcel of such medicines is commenced ; 
 thus, if we are giving fox-glove, it will 
 be right to begin with a diminished dose 
 of the new portion. The effects of 
 some medicines seem to accumulate in 
 the system; this is remarkable of fox- 
 glove, and sometimes of mercury ; we 
 must not therefore always continue to 
 give the medicine till we have some proof 
 ©fits entering the constitution. Some 
 persons have very remarkable peculiari- 
 ties with respect to the operation of cer- 
 tain medicines. When this can be known 
 before-hand, we of course avoid the use 
 of these medicines with such patients. 
 The doses of medicines are sometimes 
 nfluenced by climate. Thus, Indian 
 wractitioners give much larger doses of 
 calomel, and other forms of mercury, than 
 could be borne in England : but of sudori- 
 
 fic medicines, the dose is less, oh aecount 
 of the constant determination to the sur- 
 face from the heat of the climate.. 
 
 Medicines, Times of admiiiistering. 
 There are certain times of the day 
 more convenient than others for giving 
 some medicines. Purgative medicines 
 should be given late at night, or early 
 in the morning. The bowels are not 
 so easily acted upon during the time of 
 sleep; and hence pills and other medi- 
 cines M'hich do not act speedily, have 
 time to dissolve fully, and to produce 
 their due effect on the bowels. Saline 
 purgatives are best given in the morn- 
 ing. Diuretic medicines are best given 
 in the day-time, that the cooler state of 
 the surface may determine their action 
 to the kidneys. Emetics, in slight fever- 
 ish disorders, are best given in the even- 
 ing, as they produce tendency to sleep 
 and perspiration, which are best encou- 
 raged by retiring to bed. Medicines for 
 perspiration should not be given during 
 the process of digestion. 
 
 MEGRIM. A very painful kind of 
 headach, principally on one side of the 
 head, generally above the temple. It is 
 commonly considered as a rheumatic af- 
 fection, and may proceed from cold, from 
 a spoiled tooth, from the state of the sto- 
 mach ; and is to be treated by attention 
 to the exciting cause, by extracting the 
 tooth, by giving purgative medicines, by 
 promoting perspiration ; and in general 
 a small blister is required to be put be- 
 hind the ear or on the temple. 
 
 MELON, Cucumis melo. A fruit of 
 the cucumber kind, having a delicious 
 cooling taste ; but it is apt to disagree 
 with those stomachs that have not their 
 digestive powers in good order, and re- 
 quires therefore to be eaten with pepper, 
 ginger, or other aromatics. The seeds 
 are very mucilaginous. 
 
 MEJNIBRANE. An expanded thin 
 substance, lining and covering different 
 parts of the body. Membranes are of 
 various kinds, and are named from the 
 fluid they are supposed to secrete, se- 
 rous, raucous, &c. The most remark<a- 
 
MERCURY. 
 
 391 
 
 ble serous membranes are, the perito- 
 neum, lining the abdomen and covering 
 the bowels ; and the pleura, performing 
 the same offices to the lungs and contents 
 of the chest, &c. Serous membranes are 
 exceedingly prone to inflammation, which 
 commonly terminates in the throwing out 
 of clear lymph, by which contiguous sur- 
 faces ai*e glued together ; and thus, after 
 inflammations of the lungs and pleura, 
 when the patient has died of another 
 disease, adhesions have been found in 
 various parts within the chest. Mucous 
 membranes are those that line the nose, 
 mouth, stomach and bowels, &c. 
 
 MENORRHAGIA. An excessive 
 flow of the monthly discharge in females. 
 See Monthly Discharge. 
 
 MENSTRUATION. The monthly 
 discharge. 
 
 MENSTRUUM. A substance having 
 the power of chemically dissolving other 
 substances ; applied by the alchymists to 
 those solvents which were supposed to 
 take a month . to perform the solution, 
 and now used to signify any solvent. 
 MENTAL DISEASES. iSee Insanity. 
 MERCURY or Quicksilver. A fluid 
 metal, of great importance in the arts, 
 in chemistry, and iu the Materia Medica. 
 It furnishes a variety of medicines of the 
 most active kind, and has been employed 
 with success iu a great number of dan- 
 gerous and frequent diseases. The con- 
 spicuous eflPect of mercury, when intro- 
 duced into the system, is to increase the 
 flow of saliva ; and when this eflfect is 
 produced, or when the glands w^hich se- 
 crete the saliva are evidently affected, 
 we judge the mercury to be pervading 
 the whole system, producing a change on 
 the whole of its fluids, as well as on the 
 nervous and muscular systems. 
 
 M ERCU RY, Method of introducing. The 
 modes of introducing mercury into the 
 body, so as to produce its peculiar effect, 
 are various. Like all other metals, it is 
 inert in the metallic state, and requires 
 to undergo vainous preparations to fit it 
 for acting upon the animal economy. If 
 mercury be thoroughly mixed with con- 
 
 serve of roses, equal parts of each being 
 taken, the globules disappear, and the 
 metal is probably converted into an oxide ; 
 and by the addition of a little starch and 
 water, is fit for internal use ; it is made 
 up into pills, known by the name of the 
 blue pills, each containing a grain of mer- 
 cury. These pills are given to the extent 
 of two in the day ; or four, two at night 
 and tw^o in the morning, provided they 
 have not too great a purgative effect on 
 the bowels ; and if this should take place 
 it must be counteracted by opium. An- 
 other vay of introducing mercury into the 
 system so as to produce its specific eflfect, 
 is to give calomel, the submuriate of 
 mercury, preventing its purgative effect 
 either by diminishing the dose, or by 
 combining it with opium. A pill con- 
 taining two grains of calomel may be given 
 night and morning, till the mouth is af- 
 fected; or the muriate of mercury, in 
 doses of an eighth of a grain, may be 
 given in solution, or in pill made with 
 crumb of bread. Or a little of the mu- 
 riate may be rubbed on the inside of the 
 cheek night and morning, till the mer- 
 curial effect appears. It is more than sus- 
 pected, that many of the nostrums which 
 are said to cure some diseases where | 
 mercury is useful, without any of that ( 
 mineral, contain a portion oC the muriate ; 
 as this, from its activity in a small bulk, 
 is easily disguised. Mercury may also 
 be introduced into the system by rubbing 
 it on the skin. The ointment for this 
 purpose is made by rubbing the mercury 
 with some unctuous body, generally mut- 
 ton-suet and lard, till the globules dis- 
 appear, using one part of mercury to four 
 of the fat ; and rubbing in upon some 
 convenient part of the body, apiece about 
 the size of a hazel-nut, morning and even- 
 ing. It is generally directed to be rubbed 
 in upon the inside of the thigh, till it 
 almost completely disappears; and to 
 prevent chafing and eruptions, the hair 
 should be shaved, and one thigh nibbed 
 at the alternate times. It has sometimes 
 been thought of couseqiience to introduce 
 mercury into the system with great ra- 
 
 ^^ 
 
 
 -^ 
 
392 
 
 MERCURY. 
 
 g pidity ; and this is done by burning cin- 
 
 ^^^^fi-^/lfc^jnabar, which is a combination of sulphur 
 
 # /; ^ and mercury, and exposing the patient to 
 
 A^* ^^'4 receive the vapour, both by the skin and 
 
 the lungs. 
 
 Mercury, Effects of. By v^^hatever 
 method mercury is got into the sys- 
 tem, its effects are those of a strong 
 and general stimulant; it increases the 
 activity of the circulating system, and 
 brings on a degree of feverishness ; it 
 increases the quantity of all the secre- 
 tions, and especially that of the saliva, 
 producing an evident enlargement of 
 the glands that open into the mouth, 
 and when it has been pushed too far, 
 occasioning very painful swellings and 
 ulcerations of the mouth and fauces. The 
 breath has a peculiar fetid smell, the flow 
 of saliva is exceedingly increased, and a 
 very restless and uncomfortable feeling is 
 produced in the body. Sometimes an 
 eruption takes place on the skin, of a very 
 painful description, for which the greatest 
 attention must be directed to avoid all 
 irritation, to keep the patient in a cool 
 but dry air, to give mild laxative medi- 
 cines, and to use the sulphuric acid. {See 
 Eczema.) In some constitutions, mer- 
 cury suddenly produces very pernicious 
 effects. There ensue, from a very small 
 quantity of the medicine, great depression 
 of strength, anxiety about the chest, fre- 
 quent sighing, trembling, a small quick 
 pulse, vomiting, pale countenance, and 
 such debility that a very small exertion 
 of muscular strength is sometimes sud- 
 denly fatal. In such cases, all farther 
 administration of the mercury is to be 
 suspended, the patient is to be exposed 
 to a cool and free air ; tonic medicines 
 are to be given, with light but nourishing 
 diet; and if the disease for which mer- 
 cury was given be still going on, it must 
 afterwards be resumed with the utmost 
 caution, that we may judge whether it 
 be safe to go on with it, or to change our 
 plan of cure altogether. 
 
 Mercury, Use of in Syphilis. So many 
 active medicinal preparations are furnish- 
 ed by mercury, and their combinations 
 
 are capable of effecting so many different 
 purposes, that there are few diseases in 
 which it may not be employed ; but we 
 do not mean here to speak of any of its 
 preparations or effects as purgative, diu- 
 retic, diaphoretic, &c. but only of those 
 peculiar to itself, and which are known by 
 their appearances on the salivary glands 
 and their secretions. The most remark- 
 able and celebrated instance in which 
 mercury has been used, has been in the 
 cure of the venereal disease. Very soon 
 after the introduction of this disease, 
 when the nations of Europe were filled 
 with horror at its rapidly destructive pro- 
 gress, several persons afflicted with it, 
 happened at the same time to be using 
 mercury for diseases of the skin, in which 
 complaints it had been employed by the 
 chemical physicians ; and finding they 
 were cured of the syphilitic ailments 
 while under the influence of mercury, 
 physicians were induced to try that ac- 
 tive mineral for the cure of syphilis, in 
 which it succeeded to their utmost ex- 
 pectation. For above three hundred 
 years, experience has uniformly attested 
 the almost unvarying success with which 
 mercury has been attended in this disease, 
 with the exceptions which may be looked 
 for in every disease and every remedy, 
 from the ever varying peculiarities of the 
 human constitution in different men, 
 and in the same individual at different 
 times. We can truly say, that in the 
 great majority of syphilitic cases, mer- 
 cury is a safe and certain antidote ; al- 
 though in some constitutions, it cannot 
 be employed, and although in some it 
 may produce effects of an alarming na- 
 ture. 
 
 Profuse Salivation not necessary. Mer- 
 cury was too often rashly and super- 
 fluously employed in the cure of syphilis ; 
 such quantities were thrown into the 
 system as to produce the most lamenta- 
 ble effects ; in short, it was too often 
 managed so as to become a poison in- 
 stead of a remedy. A mercurial course, as 
 it was called, was a terrible thing, botli 
 in its preparation and its continuance. 
 
MERCURY. 
 
 3!)a 
 
 and too frequently left the constitution 
 shattered beyond recovery. To procure 
 all the salutary efifects of mercury, it 
 is not necessary to throw in so much 
 as to occasion the wasting- salivations 
 formerly in use, but merely to keep the 
 mouth tender for the proper period, as an 
 indication that the system is under its 
 influence ; and we judge of the length of 
 time during Avhich ^ve are to continue 
 this, by the effects produced on the dis- 
 ease for which we ai-e giving it. The 
 great tenderness of the mouth and of all 
 the neighbouring glands, rendei*s them 
 peculiarly liable to be affected by cold ; 
 and it is therefore proper to be on our 
 guard against exposure to cold during a 
 mercurial course, lest the glands should 
 be seized with inflammation and swelling ; 
 but this precaution and fear are carried 
 too far by the common people, who are 
 afraid to take a calomel purge lest they 
 should be injured by being exposed to 
 cold. When the mouth is very sore from 
 mercury, with profuse salivation, much 
 ulceration, general fever and irritation, 
 the best treatment is to give saline purges, 
 or castor oil, with a solution of borax as 
 a gargle for the mouth; and if it be deem- 
 ed advisable to keep the system under the 
 influence of mercury, a little more is to 
 be given when the mouth is beginning to 
 heal, and so continuing it till our pur- 
 pose is attained. 
 
 In diseases of the liver, mercury has 
 been employed ; and indeed, in the hard- 
 ness of that organ, it is the only deob- 
 struent we can depend upon. In dropsy, 
 a course of mercury is frequently an ex- 
 cellent plan of cure. In chronic dysen- 
 tery, it lias been sometimes found advan- 
 tageous to bring the system under the in- 
 fluence of mercury. In certain obscure 
 and unexplained cases of bad health, 
 what is called an alterative course of 
 medicine is often a good way of inducing 
 a better action in the system ; and mer- 
 cury cautiously given is unquestionably 
 one of the best of alteratives. It has per- 
 haps been too indiscriminately used as 
 such ; but in proper cases, and when 
 
 not pushed too far, it is of essential be- 
 nefit. 
 
 MESENTERY. A doubling of the 
 peritoneum or lining membrane of the 
 abdomen, by which the long convolutions 
 of the small intestines are kept in their 
 place. In the folds of the mesentery, 
 there are numerous glands, which in scro- 
 fulous constitutions are apt to become 
 diseased ; and as great part of the chyle 
 which is destined for the nourishment of 
 the body passes through those 'glands 
 when in their healthy state, if by any 
 means they become impervious or diseas- 
 ed, the waste of the body is not supplied, 
 and emaciation and hectic fever take 
 place. See Marasmus. 
 
 METASTASIS. The translation or 
 removal of a disease from one part of the 
 body to another, as when the gout sud- 
 denly shifts from the toes to the stomach 
 or chest. 
 
 METEORISMUS. a dangerous 
 symptom which sometimes comes on sud- 
 denly in acute disease, viz. a tense state 
 of the belly from the bowels being dis- 
 tended M ith flatulence, accompanied wixh 
 great pain and tendency to inflammation. 
 We are to attempt its relief by, stimulat- 
 ing frictions on the abdomen, by giving 
 carminatives that are not likely to 
 heat too much, and by such other treat- 
 ment as is not pernicious in the original 
 disease. 
 
 MEZEREON. Daphne Mezereon, 
 Spurge Olive- A plant cultivated in gai- 
 dens for its flower. The bark of the root 
 has asweetish taste, and when chewed, it oc- 
 casions a sensation of burning in the mouth 
 and throat. The bark contains an acrid 
 sap, which irritates the skin. It was for- 
 merly used in the Lisbon diet drink, and 
 had some reputation for curing nodes and 
 some other venereal symptoms which had 
 resisted the use of mercury. It is now very- 
 little esteemed in medicine. The berries are 
 very acrid, and have produced fatal effects 
 on children who have been tempted by 
 their beauty to eat them. When it is disco- 
 vered in time that they have done so, an 
 emetic should be given immediately, fol- 
 
394^ 
 
 MILK. 
 
 lowed by copious diluent and demulcent 
 drinks. 
 
 MIASMA. The noxious vapour which 
 arises from putrescent matter, chiefly ve- 
 getable, and which has the j)ower of pro- 
 ducing disease. Contagion is generally 
 applied to that infecting matter which 
 issues from the human body when under 
 the influence of disease. Thus intermit- 
 tent fevers are Icnown to be produced by 
 marsh miasmata, and fevers and hooping- 
 cough by contagion. See Malaria. 
 
 MIDRIFF. See Diaphragm. 
 
 MILIARY FEVER. A fever accom- 
 panied by great debility, perspiration, and 
 a copious eruption of little white pustules 
 like millet-seed. It was believed to oc- 
 cur very frequently to women in child- 
 bed, and to be one of the diseases that 
 proved most fatal in that state. Since 
 the absurd heating plan of management 
 has been exploded, we hear but little of 
 miliary fever ; and it is now universally 
 considered as by no m.eans entitled to 
 consideration as a separate and distinct 
 disease, but to be entirely the consequence 
 of profuse perspiration, and easily pre- 
 vented by abstaining from such mcas^ures 
 as bring out too long continued or copi- 
 ous a sweat. By carefully regulating the 
 temperature, and piu-suing the proper 
 measures for women in the childbed state, 
 by giving mild diluent and cooling drinks, 
 and not overloading the patient with bed- 
 clothes, by giving bark and other tonics un- 
 less circumstances forbid their use, all anxi- 
 ety about miliary fever may be dismissed. 
 
 MILK. The fluid secreted in the 
 breasts of females for the nourishiuent of 
 their young. That of the cow being fur- 
 nished in greatest abundance, is of much 
 importance as an article of diet. By boil- 
 ing milk, its albuminous part is not coa- 
 gulated into a mass like the white of an 
 eg^y on account of the lai'ger quantity of 
 water through which it is diffused; but a 
 thin film rises to the surface, which, if re- 
 moved, is replaced by another, and if this 
 be continued, the whole of the albumen 
 will be removed. This renders the milk 
 less nutritive, but more easily digestible ; 
 
 and hence many delicate stomachs can 
 taJie boiled milk, M'ho could not take it 
 in its natural state. As milk is sufficient- 
 ly nourishing, and holds a just medium 
 betv/een the spare nutriment of vegeta- 
 bles and the stimulant nature of animal 
 food, it is directed with great benefit to 
 patients labouring under various diseases. 
 One of those in which we find it advisa- 
 ble to direct a milk diet most frequently, 
 is consumption, as nourishment enough 
 is supplied by it to the body without any 
 tendency to increase the inflammatory 
 diathesis, which we so much dread in 
 this disease. When consumption is fur- 
 ther advanced, the milk of the ass has 
 been considered not only as nutritive but 
 medicinal ; and, in conjunction with other 
 observances, should be directed, when 
 there is the means of procuring it in suf- 
 ficient quantity. With respect to milk, 
 considered as the food designed by nature 
 for the early periods of infancy; in ge- 
 neral, the miik of most parents agrees 
 well with their offspring, but in some 
 cases, it proves too purgative, or too fla- 
 tulent, and the child is not properly 
 nourished. In some cases, it may be ne- 
 cessary for the woman to desist from 
 suckling her child, or to make a complete 
 alteration in her diet, manner of living, 
 and place of abode ; by which the milk 
 may perhaps become more congenial to 
 the stomach of the child. Human milk 
 is of easy digestion, light, and very nu- 
 tritious, requiring little labour from the 
 stomach, and easily convertible into chyle. 
 It contains a larger proportion than other 
 milks, of the fat or buttery part; and 
 having less of the curdy or cheesy part, 
 it is more digestible. 
 
 MILK-BLOTCHES. This is a white 
 or dusky scabby eruption, principally on 
 the brow, or some part of the head and 
 face, sometimes appeai-ing in distinct 
 patches, at other times spreading in one 
 continued crust. These scabs are always 
 superficial, and they do not leave any 
 scar. Though they continue long, they 
 are attended with no fever nor derange- 
 ment of the system. They chiefly occur 
 
MILK-FEVER. 
 
 >95 
 
 in gross infants/ and are thought to arise 
 from too rich milk. The diet of the 
 nurse is therefore to he regulated, and she 
 is to abstain from much animal food, and 
 from malt liquors. 
 
 Treatment. Though the appearance 
 of the eruption is by no means agreeable, 
 it is seldom necessary or prudent to inter- 
 fere. Some evil might arise from 
 its being suddenly checked ; and it is use- 
 ful to give some laxative medicine before 
 applying any astringent or cooling wash, 
 which may sometimes be necessary where 
 there is great itching. At a later period 
 of the infant's age, about the time of 
 teething, there occurs an eruption similar 
 to the above ; but more obstinate and 
 troublesome, from the heat, itchinjr. and 
 irritation that attend it. Greasy appli- 
 cations are bad for this eruption. Pur- 
 gative medicines are to be used. It may 
 be necessary to detach the scabs by poul- 
 tices of barley-meal, or bread and millf, 
 and then to wash with tar-water, or the 
 acetate of ammonia dilated with four 
 parts of water. 
 
 MILK-FEVER. A feverish state of 
 the system which occurs during the first 
 days of childbed, occasioned by the rapid 
 determination of blood to the breasts, and 
 the change of its course from the lower 
 parts of the uterine system. It is not 
 to be considered as a disease, unless its 
 violence be extreme; and indeed we 
 rather expect some indications of the new 
 action going on in the system, about the se- 
 cond day after delivery, and from that to the 
 fourth or fifth. It may require to be mo- 
 derated by a gentle laxative, by putting 
 the child to the breast, and by giving an- 
 timonial- medicines; avoiding all fatigue 
 of body or anxiety of mind, and giving 
 the woman as little fluid as possible. The 
 symptoms of milk-fever generally termi- 
 nate after twenty-four or thirty-six hours, 
 ^ i by a copious sweat having a sour smell, 
 ^^ by a gentle looseness, or an abundant flow 
 of milk from the breasts. Any cold or 
 stimulating substances applied to the 
 breasts to prevent altogether the forma- 
 tion of millc, and the accompanying fe- 
 
 rerish symptoms, are likely to be attend- 
 ed with the most injurious effects, as in- 
 flammation of the lungs or of the brain. 
 It is proper to rub the breasts gently 
 with a little warm sweet oil, and to keep 
 them covered by rags soaked with some 
 simple liniment. The distension is great- 
 ly relieved by rendering the passages for 
 the milk clear, by drawing off a spoonful 
 or two ; but strong drawing or emptying 
 of the breasts by an adult sucking, or by 
 mechanical means, may induce inflamma- 
 tion and all its troublesome consequences. 
 See Breasts. 
 
 MINERAL WATERS. Those waters 
 which, by running over certain soluble 
 substances in their course, become im- 
 pregnated with the, taste, smell, and other 
 properties of these substances, and there- 
 fore are of service in the cure of diseases, 
 or in the regulation of the health. The 
 most celebrated waters are those of the 
 following classes ; cold, hot, sulphureous, 
 chalybeate, saline and purgative. The 
 places of most note where such waters 
 are found, are Aix, Barege, Bath, Bristol, 
 Buxton, Cheltenham, Carlsbad, Epsom, 
 Harrowgate, Hartfell, Holywell, Malvern, 
 Matlock, Moffat, Pitkeathly, Pyrmont, 
 Scarborough, Spa, Seidlitz, Seltzer, Tun- 
 bridge, Strathspeffer. The principal of 
 these places are mentioned under their 
 respective names, with the particular 
 kind of water found at each place, and 
 the diseases in which they are found most 
 useful ; but it may be proper here to men- 
 tion some particulars which are common 
 to all, and to detail some reasons why 
 mineral waters are so often recommended 
 by physicians. The diseases in which 
 mineral waters are directed, are chiefly 
 those which are well known by the name 
 of nervous ; and they generally occui' in 
 those who are of a superior rank in life, 
 who alone have it in their power to go 
 to watering places. Their complaints 
 generally arise from the want of active 
 and interesting employment, from defi- 
 ciency of exercise, and from indulgence 
 in easy and luxurious living. Placed by 
 their fortune above the need of bodily er 
 
396 
 
 MINERAL WATERS. 
 
 montal labour, and in early life having 
 had ample means of sensual or boisterous 
 enjoyment, they have acquired no taste 
 for the cheap and easy enjoyments of 
 learning and virtue; and are therefore 
 fain to indulge in the pleasures of the 
 table, to wear away the tedious hours for 
 which they cannot find a proper use. 
 Hence arise indigestion, flatulence, cos- 
 tiveness, obesity, gout, hypochondriasis, 
 and all the uncomfortable and alarming 
 feelings which originate from such af- 
 fections. ^VTien such patients are sent 
 to a watering-place, they are benefited in 
 a variety of ways. Their usual indolent 
 habits are broken in upon, they see other 
 scenery, the unhealthy air of the town is 
 exchanged for the pure air of the coun- 
 try ; they must make some personal exer- 
 tion, were it merely to walk to the spot 
 where the water is drawn ; and however 
 powerful money may be, there are many 
 of their former accommodations which 
 they cannot procure in their new abode. 
 Add to this, that the physical effects of 
 various waters are of the most salutary 
 kind, promoting the regular discharge 
 from the boM'els, strengthening the sto- 
 mach by their coldness or their chalybeate 
 properties ; or even in some cases, a nau- 
 sea or disgust at food is created, which 
 prevents patients from taking in more 
 than the stomach can digest, and thus 
 gives that important but over wrought 
 organ time to recover the tone and acti- 
 vity it had lost. 
 
 MINT, Mentha piperita, Spearmint. 
 A fragrant plant, Avhich, on account of 
 its agreeable flavour, is sometimes used 
 for culinary purposes. There is an es- 
 sential oil, and a distilled water obtained 
 from mint, which are sometimes used to 
 flavour medicines. 
 
 MISCARRIAGE. See Abortion. 
 
 MIXTURE. A combination of me- 
 dicines in a liquid form, or when solid 
 substances are diflfused through liquids 
 by means of mucilage or syrup. Powders 
 may be given in mixtures, Avhen they do 
 not act chemically on each other. They 
 should not run together in masses, but 
 
 should be divisible and miscible with the 
 fluid ; they must not be too heavy, nor 
 must they render the vehicle too viscid 
 and thick. The appeai-auce, the taste, 
 and the smell, should be made as agree- 
 able as possible; hence the infusion of 
 roses, turmeric, lavender, and aromatic 
 and essential oils, when they are harm- 
 less, and do not interfere with the pur- 
 poses for which the mixture is intended, 
 may be added to give an elegant colour 
 and smell to the whole. The dose of 
 mixtures is generally directed by tea or 
 table-spoonfuls, or a Avine-glassful. This, 
 though not very accurate, does not lead 
 to any error in medicines that are given 
 in mixtures; but for more preciseness, 
 active medicines should be accurately 
 measured in proper graduated vessels, and 
 given in the form of draughts. Liquid 
 medicines are generally given of the tem- 
 peratiu-e of the air, but in some cases, 
 they sit easier on the stomach when given 
 tepid. 
 
 MOFFAT WATER. A cold sulphu- 
 reous water obtained at Moffat, a village 
 in the south of Scotland. When drawn, 
 the water is milky, and has a smell simi- 
 lar to that of Harrowgate. It contains 
 muriate of soda, carbonic acid gas, azote, 
 and sulphuretted hydrogen. The princi- 
 pal effect of Moffat water is to increase 
 the flow of urine ; and it does not purge, 
 unless taken in very large quantities. 
 It is chiefly useful in cutaneous erup- 
 tions, in irritable ulcers, and in scrofula 
 in its eai-ly stage, when used externally, 
 and somewhat heated; it is also recom- 
 mended in some stomach complaints, and 
 disorders of the alimentary canal. 
 
 MOLE. A mark on the skin, gener- 
 ally brown, sometimes very large, and 
 covered with long hairs. Moles ai-e com- 
 monly on the subject at birth, but in- 
 stances have been seen of their growing 
 suddenly. However disfiguring they may 
 sometimes be, it is dangerous to meddle 
 with them ; as they are apt, when much 
 irritated, to become the source of a very 
 destructive ulceration of the skin and 
 neighbouring parts. 
 
M O N S T E II S. 
 
 307 
 
 MOLE. A false conception, or a 
 sliapeless mass in the uterus, without a 
 placenta. In many cases, what is styled 
 a mole, is merely a clot of blood. The 
 proper use of the term should be restricted 
 to sig:nify those irregular productions 
 which are the consequences of concep- 
 tion. When hastily viewed, moles have 
 the appearance of a shapeless mass, but 
 when examined more closely, various 
 parts of a child may be discovered, as also 
 something like a placenta and umbilical 
 cord. " The signs of a mole are, in ge- 
 neral, the same as pregnancy. It is said, 
 indeed, that in the former case the belly 
 increases more rapidly than in pregnancy, 
 and after the third month, it generally 
 produces floodings. Women of expe- 
 rience, however, always feel some variety 
 in their symptoms and sensations, and 
 generally suppose they are not with child- 
 A mole is also distinguished from preg- 
 nancy by its exciting no motions in the 
 womb like those of a living child, and 
 by changing its situation in the belly 
 according to the posture of the mother. 
 The general health is commonly worse 
 after the fourth month, while in preg- 
 nancy it improves. Should the existence 
 of a mole be ascertained, assistance is 
 necessary ; the finger may be gradually 
 introduced into the uterus, and its action 
 excited by a slight irritation. As there 
 is no placenta, so if after the discharge of 
 the mole, the flooding ceases, the whole 
 is at an end, except another may remain, 
 (a circumstance peculiarly rare) which 
 however will soon follow. See La Motte, 
 Smellie, and Hamilton." (Park's Medi- 
 cal Dictionary/. J 
 
 MOLLITIES OSSIUM. A soften- 
 ing of the bones. See Bones. 
 
 MONSTERS. The offspring of ani- 
 mals when there is any remarkable devia- 
 tion from the natural and usual structure. 
 Such deviation may consist in there being 
 a redundance of parts, as when there are 
 two heads, or four arms, or more fingers 
 and toes than usual; or there may be 
 some parts awanting, or parts out of their 
 usual situation, or the bodies of two chil- 
 
 dren, at least the greater part of them, 
 may be growing together. We are quite 
 ignorant of any circumstance that can be 
 considered as the cause of monsters being 
 produced. We are perfectly certain that 
 no voluntary effort on the part of the 
 mother, no exercise of her imagination, 
 can have the smallest effect in this way ; 
 and in spite of the strange stories appa- 
 rently well authenticated, in spite of the 
 remarkable coincidences that have un- 
 questionably occurred, we are compelled 
 to acknowledge the deep obscurity in 
 which the subject is involved. The long- 
 ings of pregnant women, or the accidents 
 and injuries to which they have been 
 exposed, were believed to have much 
 influence in the production of monsters ; 
 but hardly in a single instance has the 
 mother been able to say beforehand 
 what blemish or monstrosity she expects ; 
 and it is not till after birth, and till she 
 has been told what is wrong, that she 
 sets herself to recollect the accidents and 
 imaginations that occurred during preg- 
 nancy, and with credulity and supersti- 
 tion to account for the monstrous appear- 
 ances. Since we see by experience the 
 possibility of monstrous births, we may 
 wonder that thei-e are so few of them ; 
 and must admire the wisdom and good- 
 ness of Providence, which not only re- 
 gulates the proportion between the num- 
 bers of the two sexes, but takes care, 
 that among the countless millions which 
 are born into the world, a monstrous 
 birth is as wonderful for its rarity as for 
 its unnatural appearance. 
 
 MONTHLY DISCHARGE, called 
 also the Courses, Menstruation, or the 
 Menses. The regularity, permanence, 
 and universality of this discharge from the 
 uterus of the human female, is certain- 
 ly one of the most curious facts in phy- 
 siology and natural history. It occurs in 
 the female of none of the inferior animals, 
 and m no climate of the globe is the nu- 
 man race exempt from it. It commences 
 at different ages, according to the heat of 
 the climate, being earliest in the warmer 
 regions. lu our climate, and in the more 
 
393 
 
 MONTHLY D 1 S C II A U G E. 
 
 temperate regions, it beg^ins about the ag-e 
 of fourteen, at which time also the breasts 
 beg-in to form, and the whole appearance 
 of the person is more interesting and ma- 
 ture. The discharge continues each month 
 for a few days at once, and the average 
 quantity is about four or six ounces. This 
 discharge returns with great regularity 
 for many years, till about the age of from 
 forty-two to forty-six. With some the 
 period is shorter, being every three weeks. 
 There are some women who do not men- 
 struate at all, and such universally are 
 barren. Menstruation, therefore, seems 
 necessary to the capability of conception. 
 Menstruation is suspended during preg- 
 nancy, and for some time after delivery, 
 while the woman is giving suck ; but if 
 the nursing be continued too long, the 
 discharge returns, and the milk is less fit 
 for the nourishment of the child, or it 
 ceases altogether. Some women men- 
 struate easily, without any particular 
 change or inconvenience, but in most wo- 
 men there is some irritation of the whole 
 system, or the stomach and bowels are 
 affected; and costiveness and flatulence, 
 or spasmodic pains occur, before and at 
 ;s the time of menstruation. It is proper 
 to avoid the exhibition of all medicines, 
 particularly those of any activity, during 
 the lioAV of the menses ; and the sex, in 
 general, have a prejudice against taking 
 medicine at that period ; but in cases of 
 alarm or danger it may be necessary to 
 depart from |he general rule, and this 
 may be done without much injury. It is 
 proper for women to avoid every thing 
 that disagrees with the stomach, or that 
 is indigestible; they should avoid also 
 exposure to cold, violent exercise, as also 
 strong or sudden mental emotions ; as all 
 these circumstances are apt to produce 
 bad effects, either deranging or stopping 
 the menstrual discharge, or occasioning 
 menorrhagia, or much pain and spasmo- 
 dic action. 
 
 I. Non-appearance of the yiE^^E^. We 
 have briefly described the natural and 
 healthy state of menstruation, but the 
 fanction is liable to irregularity and de- 
 
 rangement of various kinds. It may be 
 too long of appearing, it may be sudden- 
 ly checked, it may be too scanty or too 
 copious, or it may be accompanied with 
 much pain and suffering. Though the 
 general period of the commencement of 
 menstruation is about fourteen, it may, 
 from particular circumstances, and in cer- 
 tain constitutions, not make its appear- 
 ance for some time after that period. 
 Provided the health does not suffer, there 
 is in reality no occasion for alarm or 
 anxiety, although the term should be 
 later by a year or two in one girl than in 
 another ; but it is difficult to persuade 
 women themselves of this, and they are 
 apt to ascribe every illness or uneasy 
 feeling to the non-appearance of this dis- 
 charge. It sometimes indeed happens, 
 that a very great degree of sickness and 
 loss of health occurs in young women 
 who are long of menstruating ; and under 
 the article Chlorosis, we have detailed 
 the symptoms and treatment of persons 
 in that situation. The non-appearance 
 also gives rise to cough and various sym- 
 pathetic affections ; so that both the pa- 
 tient herself and her friends and medical 
 attendants, are always very glad when the 
 constitution puts on its healthy action; and 
 they look forward to the establishment 
 of this as affording hope of relief from 
 many ailments that afflict females about 
 that age. Every means, therefore, that 
 is consistent with prudence and proprie- 
 ty, ought to be used to bring on healthy 
 menstruation, when it seems too long 
 delayed. Of those, the best are such 
 as contribute to the general health and 
 vigour of the system, such as bark and 
 wine, iron, and other tonics, cold bath- 
 ing, gentle exercise, either on horseback, 
 or on foot, &c. The bowels are to be 
 particularly attended to ; and strong pur- 
 gatives are sometimes, by sympathy, very 
 effectual in bringing the uterus into ac- 
 tion : of these, none are more beneficial 
 than aloes, and the various pills of which 
 aloes forms a principal ingredient. Symp- 
 toms must be palliated as they arise. 
 The cough is to be treated by squill, by 
 
 rjruriu'^cyr^'^z^^ .aO;4k.e^-:»^>-5S:^;^^^"^''^*^ • - 
 
MONTHLY D I S C II A R G E. 
 
 399 
 
 bleeding, or a blister ; we are to discri- 
 minate as accurately as we can between 
 it and consumption, and apply the proper 
 remedies as before directed. In the treat- 
 ment of su^h cases, every practitioner of 
 character and respectability will be aware 
 of the delicacy •\A'hich such patients are 
 entitled to, and will make his in(j[uiries 
 and give his directions accordingly. 
 When the menses do begin, it may be a 
 year or two before they go on in a pro- 
 per manner; the interval may be two, 
 three, or four months, the quantity va- 
 riable ; and this, for some time, may con- 
 sist with good health, and at last, the re- 
 gular monthly period may be established. 
 Matrons should pay particular attention 
 to the conduct and management of their 
 young friends at this period. Any irre- 
 gularity which at another time might have 
 passed with impunity, will now be pro- 
 ductive of serious consequence, and may 
 lay the foundation of ill health, and give 
 a shock to the constitution from which 
 it will not recover. Wet feet are to be 
 considered as peculiarly dangerous ; 
 sometimes they check the discharge al- 
 together, sometimes they give rise to a 
 copious and debilitating flow. 
 
 II. Obstruction of the Menses. Inde- 
 pendent of pregnancy, the menses may be 
 checked or suppressed after their first 
 establishment. The most frequent causes 
 of this obstruction are cold, passions of 
 the mind, or debilitating diseases. We 
 are to endeavour to bring them back by 
 kn^ . remedies adapted to the occasion, by 
 warm fomentations, purgative medicines, 
 opiates, or tonics ; varying our plan ac- 
 cording to circumstances, and using means 
 more especially about the time when we 
 may expect the efforts of nature to co- 
 operate with our endeavours. The ef- 
 fects produced by suppression on the 
 constitution are various : in many cases 
 it may give rise to fulness of blood ; and 
 relief is sometimes got by a spontaneous 
 cr artificial bleeding. When accompa- 
 nied with great debility, we must follow 
 the tonic plan in obstruction, as we do in 
 non-appearance of the menses. 
 
 in. Immoderate flow of the Menses. 
 On the other hand, the flow may be too 
 copious J it may continue for a much 
 greater number of days than it ouglit to 
 do, or its quantity may be excessive. 
 This is a state of menstruation very dif- 
 ficult to cure, and productive of very de- 
 bilitating effects on the body. The coun- 
 tenance of the woman becomes pale and 
 haggard ; there is a dark circle round the 
 eyes, an aversion to motion, and great 
 susceptibility of fatigue on slight exer- 
 tion. The stomach is out of order, the 
 bowels are slow, the lymphatic system is 
 torpid, and symptoms of threatening 
 dropsy appear. We are to order the pa- 
 tient to observe the utmost quietness, to 
 keep in the horizontal posture ; we are 
 to give gentle laxatives, in order to pre- 
 vent all straining at stool ; to direct some 
 mild astringent medicine, as the infusion 
 of rose-leaves with a little sulphuric acid, 
 or the elixir of vitriol. If there be much 
 heat and strength of pulse, we may sup- 
 pose that there is too great determination 
 of blood to the uterine system, and we 
 shall give great relief by using the lancet. 
 When one period of copious discharge is 
 got over, our care should be to prevent 
 the next from being equally so. This is 
 to be done by avoiding fatigue in the in- 
 terval, by moderation in diet, by avoiding 
 costiveness, by losing a little blood from 
 the arm, if there be too great fulness or 
 inflammatory tendency in the system, and 
 by a prudent use of sulphuric acid and 
 other astringents. Alum whey is a very 
 useful form of giving astringents. A 
 drachm of alum will curdle a pint of 
 milk; the whey is to be sweetened to 
 render it palatable, and a few ounces to 
 be taken as often as the stomach will bear 
 it. 
 
 IV. Dysbtenorrhcea. Difficult Men- 
 struation. A state of menstruation dif- 
 ferent from the two former, consists in a 
 very difficult and painful perfoi*mance of 
 that function. It is to be treated by fo- 
 mentations of the belly, back, and loins, 
 by giving opiates during the severity of 
 the pain, by avoiding cold, by giving me- 
 
400 
 
 MONTHLY DISCHARGE. 
 
 ■"-'^ dicines which promote perspiration, and 
 -—«i^-f encouraging it by giving diluent drinks, 
 / ./{5 and keeping in bed. If the bowels be af- 
 ^, j^';!^lected with colic pains, laxative medicines 
 '/f^^^,~ ^ g/r clysters are to be administered ; and if 
 ./ ^ ' Iherc be sickness and vomiting, with 
 ^*.l headach, we are to give tinctures in mo- 
 *^ '/ derate quantity, with laxative medicines, 
 " --^"^'-and opiates during the severity of the 
 > WiS^ pain. 
 
 ||>!^-«^/^yIn some cases, instead of a fluid dis- 
 Sm. <^^^rg6 every month, there is formed a 
 , membranous substance, which is expelled 
 fr!t.v<-'^^ -with great pain, and which, when care- 
 ^^ lessly looked at, has the appearance of an 
 ^*^*^'^*aW'tion. It is of great consequence for 
 ^' practitioners to know this, as an inno- 
 y4*>jlJt/oeiit and vii-tuous person might be sus- 
 
 , J? .> j)ected unjustly. When the uterus has 
 
 ^ •* put on this irregular action, it is believed 
 ^,^ci- *^^* *^^ woman cannot conceive ; but 
 i-^ there are some cases that show this not 
 ' h to hold universally. A great variety of 
 7^~rr- "f'^^^Jcines have been tried for the cure of 
 '^^' this affection, but none are to be depend- 
 'Y*^- ' ed upon. If curable at all, it is in gene- 
 's *^i^ ral by the efforts of the constitution it- 
 ^^■-£ <■ ---self. Medicines are to be given to palli- 
 ate pain, debility, costiveness, or any other 
 urgent symptom. 
 
 V. Cessation of the Mo>rrHLY Dis- 
 charge. The time of life at which this 
 discharge ceases, differs in different wo- 
 men, but it usually does so between the 
 age of forty-two and forty-six. The symp- 
 toms which occur also vary much; in 
 some it stops at once, without any disor- 
 der of the constitution ; in others, it re- 
 turns after uncertain and irregular inter- 
 vals, and in variable quantity, for months 
 or years, before it finally stops. Though 
 many women, at this period, have a great 
 variety of ailments, these are rather to be 
 considered as indications of a change oc- 
 curring in the constitution, than as de- 
 pending altogether on the diminution or 
 absence of the discharge. Those who 
 have not enjoyed regular good health, 
 those who have not borne children, or 
 who have been weakened by frequent 
 miscaiTiages, generally suffer most at this 
 
 period of life. To others, again, who, 
 during that part of their lives when men- 
 struation went on regularly, had much 
 pain, or were troubled with nervous dis- 
 orders, the cessation of the discharge is 
 an era which brings them better health 
 than they ever enjoyed before. If no 
 bad symptom occur at this time, there is 
 no call for any interference by regimen, 
 by evacuations, or any other way ; but if 
 there be symptoms of fulness or tendency 
 to feverish complaints ; if there be head- 
 ach, flushings of the face, or of the palms 
 of the hands, with restlessness in the 
 night, pains in the loins or belly, or erup- 
 tions on different parts of the body ; such 
 fulness must be brought down by spare 
 living, proper exercise, laxative medi- 
 cines, and occasional blood-letting, taking 
 care not to give a habit of using this last 
 evacuation. 
 
 MORTIFICATION. The death of 
 a portion of the body, while the rest con- 
 tinues alive, often in a sound state. When 
 any part of the body loses all motion, 
 sensibility, and natural heat, and becomes 
 of a brown, livid, or black colour, it is said 
 to be affected with sphacelus, that is, com- 
 plete mortification. As long as any sen- 
 sibility, motion, and warmth continue, the 
 state of the disorder is termed gangrene. 
 
 Mortification is the sequel of diseases 
 both of excitement and of debility. In 
 inflammations of the external parts, which 
 terminate in mortification, the process ob- 
 served is as follows : the pain ceases, the 
 purulent matter becomes acrid and sani- 
 ous ; air-bubbles ai-e set at liberty, collect- 
 ing in small vesications under the skin, 
 or distending the whole organ by an em- 
 physematous swelling. The blood is coa- 
 gulated in the vessels of the gangrened 
 part, and the circulation cannot be re- 
 stored. A slight deliriiun comes on, fol- 
 lowed either by dejection of spirits or calm- 
 ness of mind ; but in each case, attend- 
 ed with a peculiarly wild expression of 
 countenance ; though sometimes with a 
 very peculiar expression of serenity, with 
 a blackness under the eyes. The pulse 
 is usually quick, low, and often intermit- 
 
 i 
 
MORTIFICATION. 
 
 401 
 
 ting-. Ill the earliest stages, deep inci- 
 sions are attended Avith a discharge of 
 blood, still florid ; but the skin, the mus- 
 cles, and the cellular membrane, soon melt 
 down into a brownish offensive mass. We 
 conclude that similar processes take place 
 in the internal parts when they become 
 mortified. When this occurs in strangulat- 
 ed hernia, or in inflammation of the bowels, 
 a remission of the violent pain takes 
 place, and the patient and his friends are 
 deluded with the hope of complete re- 
 lief; but the experienced physician knows 
 the treacherous symptom, and must not 
 deceive them with false hopes. There is a 
 peculiar kind of mortification called dry 
 gangreney wliere the disease begins in one 
 of the toes, and very often after a person 
 has been paring a corn or toe-nail. It 
 sometimes stops spontaneously, and de- 
 prives the patient of some of his toes, or 
 even of his foot and leg, as cleanly as if it 
 had been amputated by a surgical opera- 
 tion : at other times it has been success- 
 fully treated by giving large doses of 
 opium. 
 
 Causes. The causes of mortification 
 are general or local. Those which affect 
 the general system, are the violent in- 
 flammatory fevers, or the jail and hospi- 
 tal fever ; as also diseases of debility, as 
 scurvy and dropsy, long continued or in- 
 tense cold, and some internal changes, 
 which we cannot trace or explain. The 
 local causes of mortification are numer- 
 ous. Some of them are, burns, excessive 
 cold, the application of caustics, the stran- 
 gulation of a part, as in hernia, or the 
 tying of tumours ; severe contusions, as 
 gun-shot wounds, bad fractures, violent 
 inflammation, urine effused in the cellular 
 substance, pressure on large blood-vessels, 
 by a ligature or by tumours, wounds of 
 large vessels. Long continuance in one pos- 
 ture, as when a person is confined to bed, 
 gives occasion to gangrene of the parts 
 where the bones have least flesh upon 
 them, and which are therefore much ex- 
 posed to pressure ; as the shoulder-blades, 
 the haunch-bones, and the lower part of 
 the spine. The hospital gangrene is 
 
 produced by some indescribable state of 
 the air in hospitals, jails, and ships. Dur- 
 ing its prevalence, the smallest scratch or 
 ulcer is apt t.o turn to a fatal gangrene. 
 In dropsy, which occurs in broken down 
 and debilitated constitutions, if a few 
 punctures be made to let out the eff*used 
 fluid, these are too apt to run into gan- 
 grene, and a prudent surgeon will there- 
 fore not risk the .experiment; although 
 it is not unusual for spontaneous vesica- 
 tions to form and break on such dropsi- 
 cal limbs, and to go on to gangrene. The 
 local mortifications Avhich happen in old 
 people, are generally owing to ossification 
 of the arteries. 
 
 Prognosis. This is generally as bad as 
 possible. When mortification arises from 
 great debility, from ossification of the ar- 
 teries, of obstructions that we cannot re- 
 move, a cure is not to be expected. In- 
 ternal mortifications are generally beyond 
 the reach of medicine ; but as very threat- 
 ening symptoms have sometimes disap- 
 peared, we must attempt all that art can 
 suggest. 
 
 Treatment. When inflammation is so 
 violent and strong as to give reason to 
 fear that it Mill end in mortification, it is 
 a call for us to use with great diligence 
 the means for abating it, which have been 
 already detailed under Inflammation ; tak- 
 ing care that we do not continue them too 
 long, lest we add to the debility and exhaus- 
 tion which are to follow. When the morti- 
 fication has fairly begun, our remediesmust 
 be very different from those which counter- 
 act inflammation. We are now to prevent 
 debility by giving cordials, stimulants, and 
 tonics. Of the class of tonics, the most effi- 
 cacious are bark and wine; and in a great 
 vai'iety of cases, the good effects of the Pe- 
 ruvian bark are very remarkable. The pa- 
 tient's strength is to be supported by nou- 
 rishing diet, and a proper and even ample 
 allowance of wine, either Sherry or Madei- 
 ra. Small quantities of opium and calomel 
 combined, may be given at frequent in- 
 tervals. When the weakness is very 
 great, spirituous liquors may occasionally 
 be required, as also hartshorn, and gin- 
 2 D 
 
 ^am 
 
402 
 
 MOX 
 
 MUM 
 
 ger, pepper, and aromatics. We must be 
 careful not to g-ive these remedies when 
 there is much strength of pulse and many 
 inflammatory symptoms remaining. When 
 our remedies are successful, and the mor- 
 tification is about to cease, a separation 
 takes place at the verge of the sound 
 part, by means of a slight degree of in- 
 flammation. But, on the contrary, it very 
 often happens that the disease spreads, 
 and death ensues. 
 
 Of Local Applications. Some have 
 advised cold lotions near the verge of the 
 mortified part, to check the further pro- 
 gress of inflammation ; but fomentations 
 and emollient poultices are commonly 
 preferred. To the common poultices, in 
 some cases, are added powdered charcoal, 
 or yeast, or beer, to correct the fcetor, and 
 to counteract putrefaction. Stale beer 
 grounds, or port wine, with linseed meal, 
 make a good poultice. Stimulating bal- 
 sams, hot oils, and the actual cautery, are 
 now disused in the dressing of mortified 
 parts. It is necessary to give vent to pu- 
 trid matter, and for this purpose pretty 
 deep incisions are required. With a view 
 of allowing dressings to reach the sound 
 part, and to excite inflammation, which 
 commonly takes place at the verge of the 
 mortified part Avhen it does favourably, 
 and separates from the sound, scarifica- 
 tions have been recommended j but they 
 are always attended with risk of increased 
 inflammation, and we never can be sure 
 how much the disease extends below the 
 surface. We may, therefore, be cutting 
 a superficial part, while the evil is extend- 
 ing close to the bone. 
 
 When a part is frost-bitten, it is a very 
 dangerous practice to bring it suddenly 
 into a higher temperature ; and in winter 
 campaigns of armies, it has been found, 
 that soldiers who have been exposed to 
 intense cold, have not complained of be- 
 ing frost-bitten, till a thaw came on. The 
 proper treatment is by frictions with cam- 
 phorated spirit of wine. 
 
 MOXA. (Japanese.) " A soft, downy 
 substance, prepared from the young leaves 
 of a species of mug wort, Artemisia Chinen- 
 
 sis. It is used in the following way : A little 
 cone of the moxa is laid upon the part, pre- 
 viously moistened, and set on fire at the top. 
 It burns down with a temperate glowing 
 heat, and produces a dark-coloured spot, 
 the exulceration of which is promoted by 
 applying a little garlic. The ulcer is left 
 to discharge, or is healed up, according to 
 the object in view. The moxa is famous 
 in the East for curing several diseases ; 
 and the French are in the habit of using 
 it ; but whenever English surgeons wish 
 to produce a slough, they have recourse 
 to caustics in preference to actual fire." 
 (Cooper's Surgical Dictionary.) 
 
 MUC1LA(tE. a soft glutinous sub- 
 stance made by dissolving diiFerent kinds 
 of gum; or the roots, leaves, or other 
 parts of plants that abound with it. Mu^ 
 cilaginous drinks and mixtures are very 
 useful in disorders of the bowels, and in 
 catarrhs, where our object is to cover any 
 acrid matter, so as to prevent its irritat- 
 ing the parts over which it passes. A 
 solution of gum arabic, an infusion of 
 linseed, or water gruel, are all to be con- 
 sidered as mucilaginous drinks. 
 
 MUCUS. A tough, viscid substance, 
 secreted in different cavities of the body^ 
 to defend them from the sharpness of 
 their contents. Thus the stomach and 
 intestines are copiously furnished with 
 mucus to defend their delicate internal 
 coats from the great variety of sharp sub- 
 stances which pass through them ; and the 
 nose and windpipe are also defended by 
 mucus from the keenness of the external 
 air. 
 
 MUMPS. A disease known in Scot- 
 land by the name of the Branksy and con- 
 sisting in a feverish attack, with swelling 
 of the large gland below the ear, and of 
 some other glands in the neighbourhood. 
 It chiefly affects children, and is conta- 
 gious ; a good many are to be found la- 
 bouring under it at the same time. The 
 swelling is commonly on both sides of the 
 neck, but sometimes only on one ; and 
 from the inflamed gland being just at the 
 place where the lower jaw is articulated, 
 the action of chewing is painful and diffi- 
 
MUSCLES. 
 
 403 
 
 cult. The swellings are pretty large and 
 hard, and for some days the usual fever- 
 ish symptoms are present. The swelling 
 and fever increase till about the fourth 
 day, Avhen they abate ; and in some cases 
 a remarkable translation of the swelling 
 seems to take place, by parts of a similai- 
 glandular structure being attacked, as the 
 testicles in males and the breasts in fe- 
 males. The disease is commonly mild, 
 of short duration, and of no danger; re- 
 quiring merely confinement to the house, 
 some mild purgative, rubbing the swelled 
 parts with a little camphorated oil, and 
 using spoon-meat to save the pain of 
 chewing. Sometimes, in bad constitu- 
 tions, suppuration and extensive slough- 
 ing ensue, requiring poultices, and the use 
 of bark and wine to support the strength; 
 and when the glandular parts above-men- 
 tioned become affected, we are to try to 
 bring back the swelling to the neck, by 
 fomentations and poultices to it, and by 
 applying cooling washes to the other parts. 
 
 MURIATE OF AMMONIA. Sal Am- 
 moniac. A salt of much use as a refri- 
 gerant or cooling application in diseases 
 of the inflammatory kind, as burns, con- 
 tusions, and the like. A drachm of it is 
 to be dissolved in a chopin of water, and 
 kept to the place affected by means of 
 wet cloths. 
 
 MURIATE OF LIME. A solution of 
 this salt, prepared according to the direc- 
 tions of the pharmacopoeia, is used in 
 scrofulous cases, in the dose of from 
 twenty drops to two drachms in water or 
 syrup. 
 
 MURIATIC ACID is generaUy in a 
 liquid form, having a strong and pungent 
 smell, and a taste very sour and caustic ; 
 exposed to the air, it emits white fumes. 
 It is a solution of the muriatic acid gas 
 in water, which deserves attention in a 
 medical point of view, as being employed 
 in fumigation for destroying contagion. 
 It is extricated for this purpose by pour- 
 ing sulphuric acid on common salt, by 
 Avhich the fumes of muriatic acid are dis- 
 engaged, and sulphate of soda is formed. 
 Muriatic acid has been successfully ad- 
 
 ministered in typhus and scarlet fever, in 
 the proportion of a drachm to a pint of 
 gruel or barley-water, with sugar or syrup 
 to correfct its acidity, and to render it 
 more palatable. This mixtui-e is to be 
 used for common drink ; but must not be 
 put into a leaden or pewter vessel or 
 spoon. It is recommended as good against 
 worms, in the dose of from five to twenty 
 drops in a strong infusion of quassia, fre- 
 quently repeated. 
 
 MUSCLES « are the organs which 
 change, regulate, and fix the positions and 
 attitudes of the system, and which are di- 
 rectly or indirectly concerned in all the 
 more conspicuous motions of the solids 
 and fluids. In these numerous and im- 
 portant operations, they exhibit pheno- 
 mena peculiar to themselves, and which 
 cannot be traced to gravity or impulse, to 
 elasticity or to chemical attraction. They 
 produce their eflfect, whether it be a state 
 of motion or rest, bi/ contracting their 
 fibres in consequence of stimulants ; while 
 the stimulants, whether chemical, me- 
 chanical, or vital, seem to act through the 
 medium of a nervous energy. 
 
 " They are not restricted to any length, 
 breadth, or thickness ; to any form, mag- 
 nitude, or colour ; though every one be- 
 longing to a pair resembles its fellow. 
 They are not found of any one homoge- 
 neous substance,but composed of carneous 
 and tendinous fibres, interspersed every 
 where with cellular membrane, and the 
 ramifications of arteries, veins, absor- 
 bents, and nerves, all of them alive, and all 
 of them irritable. 
 
 " The carneous fibres constitute flesh. 
 They seldom or never appear single, but 
 are collected into small fasciculi, or bun- 
 dles, that unite to form larger ones ; which 
 larger fasciculi being united, form the col- 
 lections which with their tendinous fibres, 
 &c. we call muscles, and which we dis- 
 tinguish by proper names. 
 
 " The carneous fibres are all sensible to 
 stimulants of one kind or another ; and 
 being the only parts that contract in obe- 
 dience to the will, or in consequence of 
 stimulants operating regularly, they con- 
 
401 
 
 MU SHllOOM. 
 
 stitute the distrnguishing character of 
 muscles. As they derive their priucipal 
 power from a vital source, the change pro- 
 duced upon them by death is sudden and 
 obvious. Hence the muscles that when 
 living could have ruptured their tendons, 
 luxated the bones, or broken them to 
 pieces, can scarcely, when dead, if it were 
 not for their tendons, their cellular mem- 
 brane, and the ramifications of the san- 
 guiferous and absorbent systems, support 
 their own weight. In the living state, it 
 is obvious, however, that their strength 
 must vary, and in a great measure depend 
 on the nature and degree of the energy 
 communicated. In the voluntary muscles, 
 that energy, to a certain extent, is A^aried 
 at pleasure. Yet the influence of the will 
 is nothing, compared to the influence of 
 instinct, emotion, and passion, to which 
 the will is frequently subservient. These 
 often affect the whole of the muscles, and 
 through their medium, alter the secre- 
 tions. It is this connexion between mus- 
 cular action and the vital powers that 
 explains how our muscular strength is 
 varied by the states of sickness and 
 health ; and how our exertions are more 
 or less vigorous and extensive, continued 
 for a longer or a shorter period, and at- 
 tended with greater or with less fatigue, 
 in proportion as the mind happens to be 
 influenced by the exhilarating or depress- 
 ing passions. 
 
 " Of the ultimate fibres composing a 
 muscle, of their connexion with conti- 
 guous fibres, of their form, their struc- 
 ture, and that series of processes occasion- 
 ing their contraction, much has been said, 
 conjectured, and reasoned; but nothing 
 of importance added to our stock of au- 
 thentic information." (Dr. Barclay on 
 Muscular Motions.') 
 
 MUSHROOM. A plant remarkable 
 for the quickness of its growth and de- 
 cay, for the remarkable bad smell it dif- 
 fuses when in a state of decay, and for 
 yielding a nutritive article for the table. 
 Care must be taken that those eaten are 
 of the right sort, as there are several fun- 
 guses rej^embling them that are highly 
 
 poisonous. The raai-ks of good esculent 
 mushrooms are the following. " The 
 true mushrooms (Agaricus campestris,) 
 are known by their external whiteness, 
 and by being of a pale red within when 
 young, and of a deeper red, or dark, when 
 older; they are at their first appearance 
 of a round figure, and not much larger 
 than a small nut ; after they have a little 
 unfolded their membranes, they appear 
 red, full, and close ; on the top is a dis- 
 agreeable softness, equal, and white ; the 
 matter within is very white, with short 
 and thick stalks. They grow in fertile 
 ground, and should be gathered for eating 
 as soon after springing up as possible, for 
 they then contain an oily and a saline 
 part, and if they stay long before they 
 are gathered, their salts become more ac- 
 tive and hurtful. Another species of 
 mushrooms, is that kind which produces 
 the circular appearances in fields, called 
 fairy rings. Its substance is tough, and 
 consequently it is used only to make 
 catchup, or in po\^'der. 
 
 The deleterious effects of eating mush- 
 rooms seem to arise from mistaking the 
 species, which, from the similarity of tlve 
 poisonous to the esculent kinds, is easy. 
 The following are some of the symptoms 
 produced : Sickness, swelling of the sto- 
 mach or of the belly, restlessness, giddi- 
 ness, a palpitation of the heart, heartburn, 
 colic, hiccup, diarrhoea, with tenesmus ; 
 heat and redness of the skin, swelling of 
 the face ; a difficulty of breathing comes 
 on, and the mind is strangely confused ; 
 delirium, trembling, watching, fainting, 
 cold sweats, apoplexies, and convulsions, 
 have followed the eating of bad muslin 
 rooms. The stomach is to be. emptied 
 by twenty or thirty grains of white vi- 
 triol dissolved in warm water. Afterwards 
 a large spoonful of vinegar, in a glass of 
 water, should be frequently taken. Pur- 
 gative medicines and clysters are to be 
 employed. If symptoms of palsy appear, 
 sinapisms or blisters are necessary." 
 (Parr's Medical Dictionary.) 
 
 MUSK. A very fragrant substance, 
 obtained from an animal of the deer trib^. 
 
MUSTARD. 
 
 405 
 
 ■which inhabits the inland parts of Asia. 
 Musk had at one time great reputation 
 as an antispasmodic, a stimulant, and 
 cordial; and as such, was employed in 
 various nervous diseases, and in the last 
 stages of typhus fever and other diseases 
 of debility. The dose is from five to ten 
 grains. It may put an end to spasms by 
 its strong and fragrant odour, and furnish 
 a little stimulus, alone or combined with 
 other medicines ; but it has no particular 
 virtues worth its high price and the 
 trouble of procuring it genuine ; and the 
 physician has so many more powerful 
 drugs to answer the purposes which musk 
 has been thought good for, that he may, 
 without regret, allow the perfumer the 
 entire monopoly of this costly sub- 
 stance. 
 
 MUSQUITOES. Small insects which 
 abound in countless multitudes in the 
 East and West Indies, and are particu- 
 larly annoying, especially to new-comers. 
 They inflict a small wound, A\hich is 
 soon suiToundcd by a pimple, accompa- 
 nied by troublesome itching ; and in some 
 cases so numerous are those annoying 
 yvcra". bites, that a degree of general fever is 
 l,«ek.e induced. The best application is lemon- 
 juice. It is fortunate that the bites of 
 these insects seem to produce a certain 
 change in the blood, which renders it 
 disagreeable to them afterwards, as those 
 wlio have occasion to visit warm coun- 
 tries often, are rarely attacked by them 
 with much violence on their second or 
 subsequent voyages. The young and 
 sanguine Europeans are most liable to 
 their attacks. 
 
 MUSS ILL, Mytilus edulis. A shell- 
 fish found in great abundance on our 
 coasts, often used as food. Mussels have, 
 in various cases, been known to produce 
 poisonous effects, of which we have given 
 a remarkable instance in page 269. See 
 
 FiSII-PoiSONS. 
 
 MUSTARD, Sinapis alba. A plant 
 of the class Tetradynamia, growing in 
 Britain, whose seeds when bruised form 
 a powder of a pungent smell and acrid 
 taste; this, when mixed with water, is 
 
 used as a seasoning with our food, and 
 when taken in considerable quantity it 
 proves an emetic ; hence it is often use- 
 ful in domestic practice, when any poi- 
 sonous substance has been SAvallowed, 
 Another useful purpose to which we ap- 
 ply mustard, is to act as a kind of blister, 
 to stimulate the skin for the cure of in- 
 ternal diseases in a manner quick and ef- 
 fectual, without the tedious waiting, and 
 the destruction of the outer skin which 
 follow the application of common blis- 
 ters. To use it in this way, equal parts 
 of table mustard and crumb of bread may 
 be mixed with vinegar and water, and 
 applied to the place till the patient feels 
 it becoming hot and itchy, which will ge- 
 nerally be in about a quarter of an hour 
 or twenty minutes. Mustard poultices 
 are also applied to the feet, to quiet de- 
 lirium, and remove the tendency of blood 
 to the head, and to act as a stimulant 
 when the powers of life seem much di- 
 minished in their energy. Such applica- 
 tions are called Sinapisms. 
 
 The seeds of the white mustaj'd taken 
 whole, have been long used in a variety 
 of complaints, and some persons have 
 been very sanguine as to their powers in 
 a great many more. They have been given 
 as a stimulant to the stomach, and to the 
 system in general, in cases of palsy. They 
 act as a tonic and mild laxative; pro- 
 bably very much from their mechanical ef- 
 fects, as like other seeds, they pass through 
 the intestines unchanged ; only the outer 
 covering being somewhat softened, and 
 parting with a quantity of mucilage. Mus- 
 tard-seed is certainly very harmless, and 
 may be tried in various diseases of debility 
 and indigestion. It may betaken to the ex- 
 tent of a tea-spoonful three times a-day, 
 in a little milk, gruel, or water. It is to 
 be swallowed whole, and not broken or 
 masticated. 
 
 MYRRH. A gum-resin obtained 
 from a plant not yet described. The 
 best myrrh is brought from Abyssinia, 
 but it is also produced on the east coast 
 of Arabia Felix, whence it comes to us 
 by the East Indies. Myrrh is a heating 
 
^ 
 
 M Y R R II. 
 
 and stimulant medicine. It sometimes 
 occasions a perspiration, and it is sup- 
 posed to be beneficial in diseases of the 
 uterine system. It may be given in pow- 
 der, or made into pills, in doses of fiora 
 ten to forty grains ; or in the form of 
 tincture, in doses of one or two drachms; 
 but it must not be given in water, as it 
 will not continue in solution in that fluid ; 
 it should be given in milk or mucilage. 
 The tincture is a good addition to some 
 gargles, and is also a favourite application 
 to the teeth. Myrrh, when combined 
 with aloes, forms a good tonic, as in the 
 pills called pills of aloes with myrrh, of 
 which the dose is from two to foiu- pills 
 taken at bed-time. A mixture with some 
 myrrh in it, called Griffith's Myrrh Mix- 
 
 ture, had at one time great reputation in 
 the cure of consumption, but it has not 
 maintained its ground. Some object to it 
 as not founded on chemical principles, 
 but Dr. Paris thinks it affords an instance 
 of a valuable composition of drugs which 
 experience has ascertained to be of great 
 value, though theory would lead us to re- 
 ject it. He thinks the mistura ferri com- 
 posita of the London Pharmacopoeia is 
 neai'ly the same as the antihectic mixture 
 of Dr. Griffith, and that it is permanently 
 serviceable in chlorosis, and the numerous 
 sympathetic affections connected with it. 
 In the painful swellings which infest the 
 breasts of chlorotic young women, it has 
 been found almost a specific. The dose is 
 from one to two ounces. 
 
 N 
 
 N AR 
 
 NAPHTHA is a liquid bitumen, or 
 compound inflammable substance. It is 
 a pale yellowish coloured volatile oil, 
 found on the shores of the Caspian Sea 
 and in Persia. It has a pungent disagree- 
 able smelL When air is present, it bums 
 with a white flame, giving out much 
 smoke. Its component parts are carbon 
 and hydrogen, and as it contains no oxy- 
 gen, it is useful for keeping the metallic 
 bases of the alkalis. (Fyfe's Chemistry.) 
 
 NARCOTIC MEDICINES are those 
 which have the property of diminishing 
 the action of the nervous and vascular 
 systems, and of inducing sleep. These 
 medicines are also called sedatives, ano- 
 dynes, and soporifics. They appear to act 
 by first exciting the energy of the nervous 
 and vascular systems, and this excitement 
 is followed by a degree of collapse alto- 
 gether disproportioned to the excitement. 
 This depression is so rapid, that the pre- 
 vious excitement is not perceived, and 
 hence many physicians regard certain 
 substances as direct sedatives. The prin- 
 
 NAU 
 
 cipal substances possessed of narcotic 
 properties are opium, hyoscyamus, (hen- 
 bane,) belladonna, cami)hor, hemlock, 
 foxglove, stramonium. Each of these 
 substances seems to have some peculiar 
 manner of operation ; and when one nar- 
 cotic fails, another will often induce 
 sleep. See Opium, Henbane, Hemlock, 
 Foxglove, &c. 
 
 NASTURTIUM. The Latin name for 
 cresses. There are three kinds used, 
 water cresses, garden cresses, and Indian 
 cresses. These plants form an excellent 
 pungent salad, good as a seasoner of food, 
 and good for curing or preventing sea 
 scurvy, when it can be had in sufficient 
 quantity. The Indian cress is the Tro- 
 pasolum majusy whose showy and elegant 
 appearance occasions it to be much cul* 
 tivated as an ornament for arboui-s and 
 gardens. It is often called, in common 
 discourse, the nasturtium. 
 
 NAUSEA. Sickness and inclination 
 to vomit, so called from its identity with 
 the feeling occasioned by sailing in a ship 
 
N A V 
 
 NEC 
 
 407 
 
 or boat. The lowest degree of this af- 
 fection is called loathing^. This proceeds 
 to nausea, retching-, and vomiting. Nau- 
 sea is accompanied with a quivering mo- 
 tion of the lips, and often with a dis- 
 charge of clear mucus from the mouth or 
 gullet. Nausea is occasioned by various 
 circumstances not connected with the 
 stomach, as by emotions of the mind, in- 
 juries of the brain, or inflammation in 
 the kidneys. It is a common symptom 
 of fevers, dui-ing a great part of their 
 course. It is to be removed by curing 
 the original disease; but relief is often 
 obtained by the use of the eflfervescing 
 di'aughts, by an opiate, or by bitters. 
 
 In some affections, it is useful to intro- 
 duce nausea without going the length of 
 full vomiting. This is accomplished by 
 diminishing the doses of emetics usually 
 given, and administering those smaller 
 doses at lengthened intervals. One of 
 the most manageable substances for this 
 purpose is antimony, in the form of tar- 
 tar emetic, of which two grains are dis- 
 solved in six ounces of water ; and of this 
 solution, a tea-spoonful is given every two 
 haurs, which induces a degree of nausea, 
 and consefi[uently diminution of the ac- 
 tion of the vascular system, highly desir- 
 able in febrile complaints, whether simple 
 fever, or fever accompanied by inflamma- 
 tion. In strangulated hernia, we induce 
 nausea and the consequent relaxation 
 which we consider as necessary to relieve 
 the patient, by the use of tobacco clys- 
 ters, made by infusing for ten minutes a 
 drachm of tobacco leaves in a pint of boil- 
 ing water ; and of this infusion we throw 
 up about a fourth part. It is a remedy of 
 great potency and hazard, and must not 
 be resorted to, unless under the direction 
 df persons of skill and experience. 
 
 NAVEL. At this place entered the 
 vessels of the cord by which the commu- 
 nication between the foetus and the mo- 
 ther was kept up. It is sometimes the 
 seat of rupture, especially in infants who 
 cry much. See Rupture. 
 
 NAVEL-STRING. See Infants, 
 Management of. 
 
 NECK. There are a great variety of 
 important parts situated in the neck, 
 which in consequence becomes the seat 
 of a great number of diseases. Swellings 
 of different parts about the neck are very- 
 common. In the fore part, there is a 
 gland which is liable to swell, constitut- 
 ing the disease termed goitre or broncho- 
 cele, of which an account has been already 
 given; and the different kinds of sore 
 throat have also symptomatic swellings 
 in different parts of the neck. Scrofula 
 is a very frequent and troublesome cause 
 of swellings and ulcerations of the neck. 
 The neck sometimes loses its power on 
 one side, by which it is drawn to the op- 
 posite, constituting the disease calkd wry 
 neck; the cure of which consists in fric- 
 tion to the weakened muscles, supporting 
 the head in the proper position, and giv- 
 ing such aid as is necessary to the general 
 system. Sometimes the neck is shorter 
 than common, having six instead of seven 
 vertebrae ; and this, with other peculiari- 
 ties of the make, shows a predisposition 
 to apoplexy. For the treatment of Swell" 
 ed Necky see Bronchocele, Sore Throat, 
 Scrofula. 
 
 NECROSIS. A very singular disease 
 of the bones, in which a bone or part of a 
 bone dies, and is replaced by a new one. 
 Unless the fact had frequently occurred, 
 Ave should never have expected that a 
 bone so large as the thigh-bone or shoul- 
 der-blade should die, and be replaced by 
 a new growth, and the old one be taken 
 away by absorption, without the feeling 
 or motion of the limb being impaired. 
 The following are the symptoms of ne- 
 crosis. At its commencement a deep- 
 seated acute pain is felt, M'hich is soon 
 followed by a rapid enlargement of the 
 parts along the course of the bone. An 
 inflammation and one or more abscesses 
 take place, which do not heal, but become 
 fistulous sores. The openings are gene- 
 rally situated over the most superficial 
 part of the bone. These abscesses are 
 situated within the newly formed bony 
 shell, and a probe can seldom be intro- 
 duced into them, so as to discover any 
 
 mm 
 
408 
 
 NERVES. 
 
 loose pieces of bone ; but sometimes small 
 pieces make their way out through the 
 abscesses. Sometimes the abscesses heal 
 up, and the old bone being absorbed, is 
 never seen, but only a permanent thicken- 
 ing of the part remains. This is the most 
 favourable way for the case to terminate ; 
 but at other times, the old bone makes its 
 way through the new bone, and through 
 the skin, with different degrees of inflam- 
 mation, pain, and suppuration. The old 
 part, called the sequestrum, may be moved 
 by shaking it, and in some favourable 
 situations may be easily pulled away; 
 in others, it may be necessary to make 
 an opening to discharge it. The period 
 of life most subject to this disease, is from 
 twelve to eighteen years of age. The 
 bones most liable to necrosis are those of 
 the extremities, the clavicle, the scapula, 
 and the lower jaw. In general, there is 
 no external apparent cause for the disease ; 
 but sometimes blows, acrid substances 
 applied to the teeth, and the effects of 
 mercury, give occasion to necrosis of the 
 lower jaw. 
 
 NEPHRALGIA awe/ Nephritis. Pain 
 or inflammation of the kidney. See 
 Kidney. 
 
 NERVES, and Nkrvous System. 
 " Nerves are whitish cords, of various 
 thickness, which are found distributed to 
 every part of the system. Every nerve 
 that has yet been discovered in an animal 
 body regularly formed, has proceeded 
 directly or indirectly from a brain, a little 
 brain, or a spinal marrow ; the two for- 
 mer are what principally constitute the 
 brain. The nerves distributed to the 
 organs of sense and voluntary motion 
 are, compared to the parts on which they 
 are ramified, proportionally the largest 
 in the whole system. Any of the trunks 
 of the nerves of the arm, are larger than 
 the middle or great sympathetics, that 
 supply the viscera of the thorax and ab- 
 domen ; and the branches, at the points 
 of the fingers, are larger than those which 
 are seen entering the basis of the heart. 
 All nerves have been divided into those 
 >»'hich are sensible or insensible, voluntary 
 
 or involuntary ; the sensible being those 
 which obviously and suddenly communi- 
 cate intelligence to the vital principle, 
 of the injuries or changes that take place 
 in the system, or of the impressions that 
 are made from without; the i7isensible, 
 those which perform their operations 
 obscurely and secretly, unknown to the 
 senses, and without in general awakening 
 our consciousness ; the voluntary, those 
 ivhicli are either subservient, or at least 
 partly subservient, to the will ; the invol- 
 untary, those, whose functions are ob- 
 vious to the senses, but on which the 
 will has no direct or immediate influence. 
 This division, although it be useful on 
 certain occasions, is far from accurate. 
 The sensible nerves gi'ovv often insensible, 
 and the voluntary nerves often involun- 
 tary, in consequence of palsy ; while in- 
 sensible nerves, on the other hand, are 
 often observed to become sensible from 
 the diseased state of the parts on which 
 they are ramified. Voluntary nerves, 
 though generally sensible, do not appear 
 to be necessarily so. There are voluntary 
 nerves which are either insensible, or 
 next to insensible, in some insects. When 
 a gadfly has once fixed on the hand and 
 tested of the blood, its wings, its legs, its 
 antennae, and even abdomen, may be 
 amputated without interrupting, at least 
 apparently, the pleasure which it seems 
 to derive from the suction. Involuntary 
 nerves, although exempted from any 
 direct influence of the will, are seldom 
 exempted from the effects of fear, of an- 
 ger, or any of the violent mental emotions 
 which affect indiscriminately both the 
 voluntary and involuntary nerves. We 
 see the nerves not immediately subjected 
 to the influence of the will, distinguished 
 not only by a proportionally smaller size, 
 but likewise by certain swellings or knots 
 that are named ganglions; and as all 
 these nerves are subservient to functions 
 that are constant and uniform, it has been 
 supposed that their ganglions are both 
 reservoirs and sources of the nervous 
 energy ; and that by affording a regular 
 supply, and resisting those occasional 
 
NERVES. 
 
 409 
 
 commotions excited by volition, they are 
 calculated to preserve that uniformity 
 in point of function by which the invo- 
 luntary nei*ves are distinguished. 
 
 " Nerves also form plexuses or net- 
 works, whose use is less obscure than 
 that of the ganglions. In the large plexuses 
 formed by the nerves of the superior and 
 inferior extremities, M^e see a number of 
 communicating branches passing between 
 one trunk and another; and which, like 
 the inosculating branches of blood-vessels, 
 contribute to secure a more regular sup- 
 ply of that sort of energy \\ hich nerves 
 convey to the diiFerent parts on which 
 they are ramified. Physiologists are ac- 
 customed to trace particular connexions 
 among the organs that, distant or near, 
 derive their nerves, not merely from the 
 same ganglions or plexuses, but the same 
 trunks, or the contiguous corresponding 
 parts of the brain and its prolongation. 
 It is thus they explain the sympathy 
 between the eyes and the nose, when a 
 strong light impinges on the one, or a 
 pungent odour is applied to the other." 
 (Dr. Barclay.) See Sympathy. 
 
 The accurate researches of modern 
 anatomists have made considerable addi- 
 tions to our knowledge of the nerves. 
 It has been discovered, that what is com- 
 monly called a nerve, may contain in one 
 sheath nervous filaments possessed of very 
 different properties, some conveying sen- 
 sation from the external world or the 
 surface of the body, to the brain j others 
 transmitting muscular motion by voli- 
 tion, to the external organs. Thus, in a 
 part of the body, as the face, the sensa- 
 tion may be entire, while the muscles are 
 paralyzed, or the reverse may take place, 
 the motions being perfect, but the sensi- 
 bility gone. Hence many anomalous 
 symptoms are explained ; and paralytic 
 affections which were formerly thought 
 to indicate great derangement of the 
 brain, are now easily traced to a tumour 
 pressing upon a particular nerve ; and 
 very bad symptoms disappear from the 
 spontaneous cure of the tumour, or by 
 an easy sui^ical operation. 
 
 NERVOUS. In this article we are 
 to be considered rather as explaining a 
 term which is in popular use, than as 
 speaking in correct medical language. 
 When a person is said to be nervous, it 
 means that his sensibility is too acute, 
 and the mobility of his moving fibres is 
 increased. Hysterical patients exhibit a 
 strongly marked example of this nervous 
 constitution ; but there are many of both 
 sexes who ajjproach it without coming 
 the length of hysteria, or any decided 
 disease. In such, the pulse is unusually 
 rapid from the slightest excitement ; the 
 heart palpitates, the face is flushed, while 
 the extremities are cold, and a sensation 
 is felt as of cold water pouring down the 
 back. The breathing is irregular, there 
 is panting and sighing, and occasionally 
 death-like faintness occurs. The impres- 
 sions made on the senses by surrounding \ 
 objects, though indifferent or agreeable 
 to others, are irritatinof and offensive to 
 them. The muscles often contract, inde- 
 pendent of the will, and sometimes epi- 
 lepsy seizes them. The appetite of the 
 nervous is capricious, irregular, and de- 
 praved; the stomach and bo\vels often 
 distended with flatulence, and the urine 
 irregularly secreted. " These symptoms 
 recur at irregular intervals, and sometimes 
 vanish spontaneously, leaving the usiuil 
 delicacy of infirm health, but no particular 
 inconvenience. They are induced and 
 carried ofi" by causes equally slight, and 
 leave the patient subject to the charge 
 of caprice, fancy, or dissimulation. Thus 
 they are brought on by a shai-p noise, a 
 fetid odour, a disagi-eeable object, and 
 carried off by similar means. Nervous 
 patients, in this way, suffer acutely with 
 little commiseration, and few attempts at 
 relief. They are told that they must bo 
 their own physicians ; and are left to the 
 pity, often to the ridicule of the world. 
 Yet though not diseased, they nearly 
 approach disease." 
 
 Nervous Patients, Treatment of . They 
 should keep their bodies in an equable 
 warmth, and by friction or by exercise, 
 prevent the feet from being cold. As » 
 
 mmmm 
 
410 
 
 NERVOUSPATIENTS. 
 
 very little exercise fatij^ues them, it must 
 be tak«n with caution. A journey and a 
 chantre of scene are useful. Laxative me- 
 dicines are highly proper, especially those 
 made with aloes and rhubarb, combined 
 with asafetida or myrrh. " Too great sen- 
 sibility is blunted by various narcotics and 
 carminatives, and by every stimulus. It 
 is painful to be obliged to add, that what 
 was first resorted to as a medicine, is of- 
 ten continued from habit, and the officinal 
 tincture is exchanged for common spirits. 
 Let therefore every nervous female be 
 cautious in this respect, for thousands 
 have been thus incautiously enticed to 
 their ruin ; the ruin of their constitution 
 and of their moral character. Let them 
 recollect that aqua ammonise is less dan- 
 gerous than brandy, and that infusions of 
 peppermint, of rosemary, or the warmer 
 aromatics of the east, though injurious in 
 excess, are fai' less so than what are styled 
 indirect stimulants, which lull, rather than 
 relieve pain ; which intoxicate the senses, 
 rather than remove the disease. In such 
 cases, for this purpose, opium is often 
 a useful remedy, but it should be con- 
 fined to medical exhibition. In excess 
 it acts only as a dram; and we fear, 
 like spirit of lavender, is often used as 
 such, under the name of medicine." (Dr. 
 Parr.) 
 
 The management of the mind of ner- 
 vous patients requires a delicate but steady 
 hand. They should not be ridiculed, nor 
 treated with harshness and insensibility. 
 They should, for a time at least, be in- 
 dulged in trifles, but regulated when they 
 show a tendency to any hurtful extra- 
 vagance of conduct. Their errors, and 
 the consequences of them, should be 
 pointed out with mildness and affection; 
 and their treatment, from those around 
 them, should be varied according to the 
 circumstances, temper, and habit of the 
 patient. 
 
 NERVOUS DISEASES. In Dr. Cul- 
 len's arrangement of diseases, he gives 
 the title of nervous to all those preterna- 
 tural affections of sense or motion which 
 are without fever as a part of the primary 
 
 disease, and which do not depend on any 
 local aflfection of particular organs, but 
 upon a more general affection of the ner- 
 vous system. Under nervous diseases, 
 are comprehended apoplexy, palsy, epi- 
 lepsy, tetanus, St. Vitus's dance, cohc, 
 looseness, hysteria, asthma, hooping-cough, 
 mental diseases, &c. 
 
 NERVOUS FEVER, is one of the 
 many names which have been given to 
 the common Continued Fever, called by 
 medical writers synochus or typhus. See 
 Fever. 
 
 NETTLE-RASH. An eruption which 
 takes place in various parts of the body, 
 accompanied by a raising of the skin in 
 what are called wheals, having a white 
 top, and often surrounded by redness of 
 the other parts of the skin. Some kinds 
 of the nettle-rash are introduced by fe- 
 verish symptoms continuing for a day or 
 two, with headach, pain and sickness at 
 stomach, wath languor, anxiety, drowsi- 
 ness, and sometimes fainting. The enip- 
 tion is sometimes accompanied with a 
 great degree of itching, especially during 
 the night. The patches are often elevate 
 ed and hard ; and when numerous, occa- 
 sion the face or limb to appear tense and 
 enlarged. The nettle-rash continues about 
 a week, and the stomach is relieved when 
 the eruption comes out, but is apt to be 
 again disordered, if the eruption be check- 
 ed. The nettle-rash occurs principally 
 in warm weather; and in children, is 
 often connected with teething, and disor- 
 dered bowels ; and among grown up per- 
 sons, it affects those of a full habit, and 
 who indulge at the table. In some con- 
 stitutions, various articles of food give oc- 
 casion to the nettle-rash, especially shell- 
 fish, as lobsters, crabs, and mussels. In 
 some peculiarities of constitution, various 
 substances taken into the stomach, very 
 speedily, almost instantaneously, produce 
 the nettle-rash, though by the generality 
 of people they may be eaten without in- 
 jury. Among these substances, are the 
 kernels or seeds of fruits, as of apples, 
 almonds, raspberries, strawberries, mush- 
 rooms ; honey, porter. 
 
N IGHT-AIR. 
 
 411 
 
 Treatment. The nettle-rash is to be 
 treated by exhibiting an emetic of ipeca- 
 cuan, and giving a laxative medicine af- 
 terwards. The diet is to be light and 
 cooling ; all fermented liquors are to be 
 avoided. When the disease is on the de- 
 cline, bark and sulphuric acid are useful. 
 
 NEUTRAL SALTS. Those salts 
 formed by the union of an acid and an 
 alkali, in which neither the properties of 
 the one nor of the other predominate, but 
 a substance is formed quite distinct from 
 both. The neutral salts furnish some 
 very useful articles in medicine, chiefly 
 purgatives and diuretics ; the principal 
 are the sulphate of soda, the acetate of 
 potash, the tartrate of potash and soda, 
 the phosphate of soda, the nitrate of po- 
 tash J and in this view we may also add 
 the sulphate of magnesia, though in very 
 strict chemical language it is an earthy 
 neutral salt. For the properties, uses, 
 and doses of the neutral salts, see under 
 their respective names. 
 
 NICE, and Villa Franca, a village 
 seven miles from Nice, are continental si- 
 tuations for consumptive patients, wliich 
 appear to have numerous advocates at pre- 
 sent; particularly Villa Franca. It is 
 more sheltered than Nice from the cold 
 north wind, which, coming down the val- 
 ley of the Paglia, is often felt with consi- 
 derable severity during the winter and 
 spring months. In both these situations 
 the climate is dry, and remarkably steady 
 during the winter ; but in spring, there 
 are very cold winds, sweeping over the 
 Alps and Appennines, which are covered 
 with snow. The inhabitants of Nice are 
 said to be extremely liable to catarrhal 
 affections; and pulmonary consumption 
 is by no means unfrequent. Upon the 
 whole, there is much diversity of opinion 
 as to the salubrity of Nice, as a residence 
 for consumptive patients. Dr. Clark, who 
 resided for some time at Rome, and who 
 wrote on the climate, &c. of France, 
 Italy, and Switzerland, and on the effects 
 of residence in the south of Europe in 
 consumptive cases, is decidedly unfavour- 
 able to Nice ; an4 in corroboration of his 
 
 own opinion, he gives that of Professor 
 Fodere of Strasburg, who had resided six 
 years at Nice. This distinguished physi- 
 cian considers Nice as an improper resi- 
 dence for consumptive patients ; and con- 
 cluded a conversation with Dr. Clark ou 
 the subject, by saying, " One thing is cer- 
 tain. Sir, you may safely assure your 
 countrymen, that it is a very bad practice 
 to send their consumptive patients to die 
 at Nice." Villa Franca, we have stated, 
 is much more sheltered than Nice ; and 
 by many who have good opportunities 
 for judging, this spot is considered to af- 
 ford the best winter climate in Europe. 
 (Dr. Abercrombie. ) 
 
 NIGHT- AIR. Many diseases are 
 brought on by imprudent exposure of the 
 body to the night-air; and this, at all 
 seasons, in every climate, and variety of 
 temperature. The causes of this bad pro- 
 perty of the night-air, it is not difficult 
 to assign. The heat is almost universally 
 several degrees lower than in the day- 
 time; the air deposits dew and other 
 moistures; the pores of the body are 
 open, from the exercise and fatigues of 
 the day; the evening feverishness leaves 
 the body in some degree debilitated and 
 susceptible of external impressions ; and 
 from all these concurrent causes, are pro- 
 duced the various effects of cold acting 
 as a check to perspiration ; such as ca- 
 tarrhs, sore throats, coughs, consump- 
 tions, rheumatisms, asthmas, fevers and 
 dysenteries. In warm climates, the night- 
 air and night-dews, with their tainted 
 impregnations, act with much malignancy 
 on the unwary European, who too often, 
 after an imprudent debauch, still more 
 absurdly lays himself down in the woods 
 or verandahs, to receive the full attacks of 
 the morbific powers then unusually active. 
 In civilized life, and in crowded towns, 
 how many fall victims to their own im- 
 prudence, in exposing themselves to the 
 cold, the damp, and the frostiness of the 
 night-air. Issuing from warm apart- 
 ments with blazing fires, or from crowd- 
 ed churches, theatres, or ball-rooms, with 
 exhausted strength, profuse perspiration. 
 
 «te 
 
412 
 
 NIPPLES. 
 
 thin dresses, and much of tlie person un- 
 covered, how many are arrested with the 
 benumbing cold and the universal shiver- 
 ing, which prove the forenmners of dan- 
 gerous inflammation of the brain, of the 
 lungs, or of the bowels, which either cut 
 them off in a few days, or lay the foun- 
 dation of consumption or other lingering 
 illness-es. Such being the dangers of ex- 
 posiu"e to the night-air, it ought to be 
 inculcated on all, both young and old, to 
 guard against them, by avoiding all rash 
 and hasty changes of place and tempera- 
 ture, by hardening the frame by due ex- 
 ercise and walking in the open air in the 
 day-time; and on occasions where the 
 night-air must be braved, taking care to 
 be sufficiently clothed; and to avoid 
 drawing in the cold air too strong or has- 
 tily with the m.outh open. 
 
 NIGHTMARE. A certain uneasy 
 feeling during sleep, as of great anxiety 
 and difficulty of breathing, and of strong 
 but ineffectual efforts to shake off some 
 incumbent pressure, or to relieve one's- 
 self from great inconvenience. The ima- 
 gination is generally at work to find some 
 cause for the unpleasant feeling, and pic- 
 tures some monstrous shape as the author 
 of the mischief. It commonly arises from 
 an imperfect and unhealthy digestion, 
 from flatulence, from heavy suppers, and 
 from a constrained uneasy posture of the 
 body. Such persons as are subject to 
 nightmare should not take supper, should 
 pay attention to the state of their bowels, 
 and should sleep with the head and shoul- 
 ders raised. 
 
 NIPPLES. Women who are nursing 
 are very subject to excoriation and cho})- 
 ping about the nipples, and the pain is 
 often so severe when the infant is put to 
 the breast, that it is with great difficul- 
 ty they can continue to nurse. Some- 
 thing may be done before delivery to 
 prevent this coming on, by a frequent use 
 of astringent washes, as brandy, tincture 
 of myrrh, or infusion of oak-bark ; and 
 when it has come on, the same washes 
 are to be applied ; or a solution of white 
 vitriol in rose-water, taking care to wash 
 
 off with a little milk and water, any fo- 
 reign substance before the child begins 
 to suck. Sometimes great pnin is occa- 
 sioned by the child capriciously or play- 
 fully, seizing the nipple often, and letting 
 it go again. This is said to be prevented 
 by sprinkling on the nipple, when the 
 child has done sucking, equal parts of 
 powdered gum arable and sugar-candy. 
 The sweetness induces him to keep his 
 hold ; and the powder absorbs the sharp 
 fluid which comes from the clefts, and 
 also defends the part. In some cases, it 
 may be necessary to suspend nursing for 
 a short time, till the chops and excoria- 
 tions are healed, drawing off the milk by 
 nipple-glasses contrived for the purpose. 
 Or the child may be made to suck through 
 a coAv's teat, properly prepared and adapt- 
 ed to the nipple of the mother. Some 
 women have very small nipples, and such 
 as scarcely project from the breast; and 
 it is extremely difficult for a first child, 
 especially if it be weakly, to perform the 
 function of sucking. In such cases, the 
 nipple is to be drawn out by the suction 
 of an elder child, or of some adult who 
 is capable of doing it ; but if much vio- 
 lence be used in this way, inflammation 
 may be induced. By perseverance, some 
 unlikely nipples will be so formed as ea- 
 sily to nourish the child. 
 
 NITRATES are those salts formed by 
 the combination of the nitric acid with a 
 base. The nitrates most used in medi- 
 cine are the nitrate of potash, commonly 
 called nitre, or saltpetre, and the nitrate 
 of sUver or lunar caustic. 
 
 NITRATE OF POTASH, Nitre, or 
 Saltpetre. A salt of a cooling, refrige- 
 rant, and diuretic quality. It forms a 
 very safe and excellent addition to drinks 
 in feverish cases, in the dose of tMenty 
 to thirty grains to the pint of water ; or 
 it may be a little increased, and so given 
 as a diuretic, dissolved in a considerable 
 quantity of Avater. Or it may be given 
 in doses of three or four grains four 
 times a-day, and assisted by large draughts 
 of toast- water, or barley-water, linseed- 
 tea, and the like. Sometimes an ounce 
 
N IT 
 
 NOD 
 
 413 
 
 or more of this salt has been given hy 
 mistake for some purg-ativo salt, and the 
 effects have been very dreadful. Severe 
 griping-, bloody stools, vomiting, and 
 death have ensued. The best way to 
 counteract this, is to give carbonate of 
 soda in large quantities of fat mutton 
 broth, or to give a dose of castor oil, fol- 
 low ed up by copious draughts of gruel. 
 Opium and aromatics are also to be given. 
 
 NITRATE OF SILVER or Lunar 
 Caustic, is formed by dissolving silver in 
 nitric acid, evaporating the solution to the 
 consistence of oil, and then pouring it in- 
 to iron tubes, greased on their inside with 
 tallow. When the cylinders of nitrate of 
 silver are cooled, they have a dark grey 
 colour, and when broken across, present 
 a crystalline structure. The taste of ni- 
 trate of silver is very bitter, harsh, and 
 metallic. It tinges the skin black, and 
 is one of the most active and manageable 
 caustics we possess; it is employed to 
 remove fungous growths, the callous 
 edges of sores, strictures in the urethra, 
 and the like. It is employed frequently 
 to tinge the hair bkck, and it forms the 
 basis of indelible marking ink. A solu- 
 tion of it is applied to indolent ulcers and 
 fistulous sores, and has appeared to do 
 much good in ringworm. It is also used 
 in certain stages of chronic ophthalmia. 
 A strong solution has been injected into 
 the urethra in gonorrhoea, but this is a 
 practice by no means to be followed. The 
 nitrate of silver has been given internal- 
 ly for the cure of epilepsy, but it has not 
 been attended with very remarkable suc- 
 cess. The dose, at first, is the eighth of a 
 grain, increased gradually to one grain. 
 Several cases ai-e recorded, where the co- 
 lour of the skin was altered to a dark hue, 
 by long continuance of its internal use. 
 
 NITRIC ACID, or Aquafortis, A 
 strong mineral acid, highly corrosive. 
 When applied to the skin, it gives a yel- 
 low stain. It has been used in medicine 
 largely diluted, and with reported good 
 success, in a variety of diseases. In low 
 nervous fever, it may be used to acidulate 
 the drink ; and in the liver complaint of 
 
 the East Indies, and in syphilis, it has 
 been thought capable, by some, of even 
 superseding the use of mercury. Though 
 this is certainly conceiving too high hopes 
 of it, the nitric acid is to be considered 
 as a good auxiliary in the cure of these 
 diseases, taken " to the amount of two 
 drachms daily in water, or any other ve- 
 hicle that may be agreeable to the pa- 
 tient. In some obstinate diseases of the 
 skin, it is used as a vesicatory, to a small 
 portion at a time. The fumes of nitric 
 acid have been employed to destroy fe- 
 brile contagion, by pouring sulphuric 
 acid on nitrate of potash ; the nitric acid 
 is disengaged, and rises in vapour through 
 the apartment. It is thought that the 
 caustic quality of undiluted nitric acid 
 would render it a good means of destroy- 
 ing the poison introduced by the bite of 
 a mad animal. 
 
 NITRO-MURIATIC acid, a mixture 
 of two parts of muriatic acid, and one 
 of nitric acid, famous under the name 
 of aqua regia, as having the power of 
 dissolving gold. Of late years, a bath 
 of nitro-muriatic acid has been recom- 
 mended as an alterative, in the hepatic 
 affections so common to those who have 
 resided long in warm climates. The 
 acid should be diluted so as to have 
 nearly the acidity of strong vinegar, and 
 is to be applied to the body by a spunge, 
 or used as a bath to the feet and legs ; it 
 generally produces a little heat of skin, 
 thirst, and a peculiar taste in the mouth ; 
 the bowels, after a time, become affected, 
 and the headach, the irritability, and 
 pain of the side, gradually give way. 
 
 NOCTAMBULISM. Walking in 
 one's sleep. See Somnambulism. 
 
 NODE. A hard circumscribed tu- 
 mour on a bone, occasioned by a swell- 
 ing of the periosteum, appearing com- 
 monly on those bones, which are thinly 
 covered with soft parts, as the forehead, 
 the forearm, and the shin-bone. They 
 are commonly symptomatic of old syphi- 
 litic complaints, and when they continue 
 long, tUey are apt to occasion a casies 
 of the bone. They aie to be treated 
 
414. 
 
 ?JOSE, BLEEDING FROM. 
 
 by mercury ; and it is generally neces- 
 sary to give at the same time decoction 
 of sarsaparilla, and to keep up the 
 strength by nourishing diet, bark and 
 wine. 
 
 NOLI-ME-TANGERE, Touch me 
 not. A species of disease affecting the 
 skin and cartilages of the nose ; very dif- 
 ticult of cure, as most applications seem 
 to make it worse. It generally begins 
 by small ulcerations on the side of the 
 nose, which spread, and sometimes de- 
 stroy a great part of it. A similar disease 
 has been seen on the pectoral muscle ; 
 and in a few cases of long duration, with- 
 out much inflammation, the internal use 
 of arsenic has seemed to be of some slight 
 advantage. 
 
 NOSE, Bleeding from. The inner 
 part of the nose is lined Avith a very tine 
 and delicate membrane, below and upon 
 which numerous blood-vessels are rami- 
 fied. This membrane and its delicate 
 vessels are easily broken by any violence, 
 Avhether that be external, as by a bloAV, 
 or from too rapid and strong an action of 
 the circulation itself. Hence a bleeding 
 at the nose is so common an occurrence, 
 and takes place so readily from external 
 injury, and from the state of the circula- 
 tion at various periods of life. When a 
 person is young, and the successive 
 growth and evolution of the various parts 
 of the body is going on, it is very common 
 for bleeding to happen at the nose or 
 lungs; and of the two, that from the 
 nose is incomparably the safest, and when 
 it does take place, it often relieves the 
 system ; and when it does not go too far, 
 it is very salutary. A bleeding from the 
 arm might in these circumstances be use- 
 ful, but people are apt to get into a habit 
 of letting blood from the arm, which is 
 both unnecessary and hurtful. It is bet- 
 ter to supersede the necessity for this, 
 by abridging the diet, by using vegetable 
 food, and by taking frequent cooling lax- 
 atives. When bleeding from the nose is 
 excessive or long continued, we are to 
 takft the proper means to check it. One 
 of the most powerful of these is the appli- 
 
 cation of cold to the face and back, by 
 means of cloths dipped in some cooling 
 lotion, as of vinegar and water, or a so- 
 lution of sal ammoniac. We are to give 
 the neutral salts ; and to solicit a deter- 
 mination of blood elsewhere by tepid 
 bathing to the feet. The patient must 
 endeavour to abstain from blowing the 
 nose, and it may be necessary to introduce 
 a piece of sponge by the back part of the 
 mouth, tied to a piece of thread, by which 
 it is to be brought out at the nostrils, 
 and so to be pushed against the passage 
 from the nose into the mouth. When the 
 bleeding from the nose occurs in plethoric 
 elderly persons, it is to be regarded as 
 one of the strongest warnings of coming 
 apoplexy; and we are to take our pre- 
 cautions accordingly, by general bleeding, 
 by purging, and a spare diet, to lessen the 
 fulness of the system. 
 
 NOSOLOGY is the arrangement and 
 classification of diseases. The advantages 
 of a skilful arrangement in botany and 
 some other departments of natural his- 
 tory, have been so obvious, that physi- 
 cians have been anxious to extend a 
 similar plan to the science and practice 
 of medicine. But the metaphysical and 
 abstract nature of the olyects of their 
 attention, presents great and insuperable 
 obstacles to the completion of any such 
 plan. Animals, minerals, and vegetables 
 are tangible and visible objects, which 
 possess a uniformity of properties suffi- 
 cient for the purposes of classification ; 
 but fever, drops?/, or apoplexy/, are mere 
 conventional terms for a certain train or 
 assemblage of actions in a living body, 
 which may vary in every individual iu 
 Avhom they occur. Yet nosology is of 
 great utility ; always in the study, often 
 in the practice of physic. Many diseases 
 are evidently related together, and essen- 
 tially different from others. Fevers and 
 inflammation present different symptoms, 
 and require different treatment, from 
 spasmodic diseases, or passive hsemorr- 
 hagies. The great advantage of nosology 
 is, that it requires attentive observation, 
 and leads to accurate distinction of disease. 
 
NURSING. 
 
 41; 
 
 But in actual practice, the enlightened 
 physician, while he takes the help which 
 artificial arrangement gives him, will 
 never be led away by the name of a dis- 
 ease, but be guided in every case by its 
 own attending symptoms. 
 
 NOSTALGIA. See HoaiE Sickness. 
 
 NOSTRUM. A medicine prepared by 
 a secret process, and sold for the private 
 advantage of an individual. Such medi- 
 cines may sometimes be effectual, but 
 in general their pretensions are far too 
 pompous. 
 
 NURSES, Hired, Quaufications of. 
 In very many cases, a woman is unable 
 to nurse her own child, from deficiency 
 of milk, from weakness, or other circum- 
 stances ; and many women in the higher 
 ranks of life decline the task from a dis- 
 like of the drudgery. In these cases, it 
 becomes necessary to bring up the child 
 with the spoon, or to hire a woman who 
 is nursing. It is a difficult matter to 
 bring up a child without suckling it, and 
 therefore the qualifications of a hired 
 nurse are of great consequence. She 
 should not be too young or inexperienced, 
 she should be of a healthy appearance, 
 with good teeth, without any disease or 
 weakness of the eyes ; her milk should 
 be plentiful, and her own child, when it 
 can be seen, should be ascertained to be 
 thriving, and to have been nourished 
 chiefly by its mother's milk. The milk 
 should not be too old, as compared with 
 the child she is to suckle ; it is wrong to 
 give a new born infant to be suckled on 
 milk ten or twelve months old. Nurses 
 should be of a cheerful temper and plea- 
 sant countenance, and of an active oblig- 
 ing disposition ; they should take a share 
 of the work of the house, that they may 
 not become coi*pulent or lazy. It is a 
 great recommendation to a hired nurse 
 when she has already been employed 
 with credit in that capacity ; and it should 
 be a general rule, though not without 
 exceptions, that women should not be 
 hired as nurses when suckling their first 
 child. It should be a stipulation in every 
 engagement of a nurse, that if the child 
 
 does not thrive, and if her milk does not 
 prove sufficiently nourishing and laxative, 
 her engagement is to be at an end. 
 
 NURSING. As nature has prepared 
 in the parents of all animals of a certain 
 form, a mild and wholesome fluid for the 
 nourishment of their young, so it is evi- 
 dently her dictate that each mother should 
 suckle her own child. The advantage of 
 this practice both to mother and child, 
 have been eloquently insisted upon by a 
 variety of writers ; and excepting those 
 who are absorbed in luxury and dissi- 
 pation, almost every mother is anxious 
 to nurse her own child. But there are 
 many causes which prevent this from be- 
 ing done. Peculiar delicacy of constitu- 
 tion in some, or wrong conformation of 
 the breasts or nipples in others, may ren- 
 der it impossible to nurse their children ; 
 the residence or avocations of others, 
 whether voluntary or constrained, may 
 be such as to render it art act of great 
 cruelty to the child to attempt supporting 
 it by the mother's milk. No substitute 
 for milk is to be found in spoon-meat or 
 other expedients, and therefore the child 
 must be fed either in whole or in part by 
 the milk of another woman. When cir- 
 cumstances admit of it, if a delicate wo- 
 man is desirous to suckle her infant, (and 
 in n\any cases it may be necessary she 
 should do so, to prevent too rapid a suc- 
 cession of child-beaiing,) an active and 
 healthy assistant should be procured, who 
 will relieve the mother of all the fatiguing 
 part of the duty. There are some com- 
 plaints induced by nui-sing, in those avo- 
 men who are weak and debilitated, and 
 in some women who do not show any 
 marks of weakness in other respects. 
 The symptoms brought on by nursing, 
 are inflammation or weakness of the eyes, 
 with much discharge of gummy matter 
 from them ; thirst, and loss of appetite, 
 weakness of the back, languor, great 
 sweatings, especially during the night. 
 To prevent these bad effects of niu'sing, 
 care should be taken very early to teach 
 the child regularity in the periods of its 
 getting suck, and not to allow it to fill it- 
 
416 
 
 NURSING. 
 
 self at all times, or to go to sleep with the 
 nipple in its mouth. When it can be ac- 
 complished, the woman should get assist- 
 ance in nursing-, especially during- the 
 night ,• but if these measures are ineffec- 
 tual, she must altogether give up the at- 
 tempt at nursing the child herself. 
 
 When a Moman in health nurses either 
 her own child or another, the best way 
 of ensuring a plentiful and regular sup- 
 ply of milk, is to follow the mode of life 
 best adapted to promote good health at 
 any time ; by being regular and temper- 
 ate in her diet, not eating at irregular 
 times nor in undue quantity, and by no 
 means indulging in drinking large quanti- 
 ties of beer, porter, ale, or gruel. Exer- 
 cise should be taken, and all inactivity 
 and indolence are to be avoided. The 
 child should not be allowed to sleep with 
 the breast in its mouth, nor to overload 
 its stomach by sucking too much at a 
 time. It is of great utility to begin very 
 early to teach the child regularity in the 
 periods of taking the breast. It is pro- 
 per, at a very early time of life, to accus- 
 tom the child to take a little spoon-meat, 
 as panado, or the finer part of oatmeal 
 boiled and sweetened. This renders the 
 change of diet at weaning not so abrupt. 
 At first such food should be given once a- 
 day, and afterwards twice; and before 
 weaning, three meals may be allowed. 
 To delicate infants some other kinds of 
 food may be given, as arrow-root or sago, 
 and occasionally very weak beef tea or 
 chicken broth. No spirituous liquors to 
 be added to their food, on any of the fool- 
 ish pretences so commonly brought for- 
 ward, such as removing gripes, relieving 
 flatulence, or promoting the How of urine. 
 
 NUTMEGS are obtained from the My- 
 ristica moschata^ a native of the Molucca 
 Islands. The nut is inclosed by the mace^ 
 ^vhich is a soft membrane, of a dark red co- 
 lour, an unctuous feel, and an aromatic fla- 
 vour. The mace, by drying, acquires a red- 
 dish yellow colour. It has a strong agree- 
 able smell, and an aromatic, bitterish, acrid 
 taste. It yields an expressed oil, which 
 on cooling, is of the consistence of mar- 
 
 row. Nutmegs are oval, greyish bro«Ti, 
 and furrowed on the outside, of a yellow 
 colour within, varied with brown saving 
 lines. Their activity is confined to the 
 dark coloured veins. Nutmegs yield by 
 distillation an essential oil, a few drops of 
 which are carminative and stomachic. 
 Mace and nutmeg are rather to be consi- 
 dered as agreeable spices than as articles 
 of medichie. They are heating and sti- 
 mulant, and are added to other medicines 
 for the sake of their agreeable flavour. 
 The powder of the nutmeg is a favourite 
 condunent in the lying-in chamber, but 
 must be used with caution, lest it stimu- 
 late too much. 
 
 NUTS. There are several kinds of 
 nuts used as articles of diet; but the}'^ are 
 not in general to be much recommended. 
 They abound in oily matter, are viscid 
 and glutinous, and are apt with many 
 people to prove very difficult of digestion. 
 Dr. Paris thinks it would be wise to ba- 
 nish nuts from our tables, for there is a 
 fascination in them, which will lead most 
 persons who begin to eat them, to take a 
 quantity which the best disposed stomach 
 cannot bear with impunity. Hoffman ob- 
 serves, that dysenteric complaints are al- 
 ways more common in those years in 
 which the harvest of nuts is plentiful ; and 
 there is not a physician in any practice 
 who w^ill be inclined to doubt his state- 
 ment. 
 
 NUX VOMICA is a flat roundish seed 
 or kernel, about an inch broad and a quar- 
 ter of an inch thick, the produce of a large 
 tree in the East Indies, the Strychnus 
 Nux Vomica. These seeds contain a viru- 
 lent poison, which, according to the French 
 physiologist Majendie, seems to exert its 
 influence on the spinal marrow, without 
 directly involving the functions of the 
 brain. The symptoms produced, are great 
 anxiety, convulsions, paralytic symp- 
 toms, retching, and increased action of 
 the heart and lungs. " Nux vomica has 
 been said to produce benefit in the plague ; 
 the German writers have strongly recom- 
 mended it in mania, epilepsy, and hydro- 
 phobia, as Avell as iu chronic rheumatism, 
 
N UX 
 
 NUX 
 
 417 
 
 gout, scrofula, syphilis, and cutaneous 
 eruptions. In the French hospitals it has 
 been employed in palsy. The dose is 
 four or five grains of the powder, in pills, 
 during the day. 
 
 " The French chemists have discover- 
 ed in this substance a peculiar proximate 
 principle, to which its virulence is ow- 
 ing. This they have called Strychnia. 
 It is highly alkaline, and so powerful as 
 
 even to be perceptible when a grain is 
 dissolved in eighty pounds of water. In 
 doses of half a grain, it occasions serious 
 effects, and in larger ones, convulsions and 
 death. It is perhaps the most powerful, 
 and next to prussic acid, the most rapid of 
 poisons.'* It has been given in epilepsy 
 in doses of one-twelfth of a grain, but 
 is a most dangerous remedy. (Paris's 
 Pharmacologia.J See Strychnine. 
 
 o 
 
 (E so 
 
 OLD 
 
 OAK, Quercus Rohur. The bark of 
 the oak contains a gi'eat deal of very a- 
 stringent matter, which renders it valu- 
 able as an ingredient in various gargles ; 
 and also in moderate doses internally, 
 when astringents are necessary, as in ob- 
 stinate diarrhoeas. The infusion or decoc- 
 tion of oak bark is also used for the same 
 purpose in the way of clyster. 
 
 OATS, Avena sativa. Were it for 
 no other reason, oats would deserve a 
 place in our work, from its furnishing 
 us with that salutary diluent, water gruel. 
 (^See Gruel.) Though oats be the food 
 of horses in England, yet the human spe- 
 cies in Scotland live much upon the meal 
 of it, and thrive too ; nor is it found to 
 be the cause of the cutaneous diseases 
 which are erroneously ascribed to its use. 
 
 OBESITY, Fatness or Corpulency. 
 See Fat. 
 
 OBSTRUCTION. A term principal- 
 ly employed to denote the non-appearance 
 of the monthly discharge of females. It 
 is also applied to the state of the bowels 
 when there is great costiveness ; and 
 when the perspiration is checked, we say 
 it is obstructed. 
 
 (EDEMA. Asoftswellingin the cellular 
 substance, a symptom of dropsy. Hence, 
 dropsical limbs are said to be (edematous. 
 
 (ESOPHAGUS, the pas-sage for the 
 food from the mouth to the stomach. 
 See Gullet. 
 
 OIL. A fluid of a fat or unctuous na- 
 ture, insoluble in water, inflammable, 
 forming a soap with alkalies. Oils are 
 divided into the fixed and volatile. Vo- 
 latile oils are such as ai*e dispersed into 
 the surrounding atmosphere when expos- 
 ed to heat ; fixed oils are such as do not 
 so volatilize. The principal oils used in 
 the practice of medicine and pharmacy, 
 are olive-oil, oil of almonds, castor oil, 
 oil of turpentine, oil of cloves, and vari- 
 ous aromatic oils, the properties and uses 
 of which will be found under their re- 
 spective articles. 
 
 OLD AGE. The great English lexi- 
 cographer, near the close of life, when 
 writing to a friend, says, " My diseases are 
 an asthma and a dropsy ; and what is less 
 curable, seventy-Jive.'* A few precepts 
 how to lessen the inconveniences of this 
 last disease, may not be without their 
 use. In old age, the sensibility of the 
 nervous system is diminished, the mus- 
 cular fibres are less irritable, and many 
 of the arteries are ossified and obliterat- 
 ed. The body is bent ; and those who 
 have been tall and graceful in their youth, 
 stoop forward in old age, more than 
 others, from the shrinking of the cartil- 
 ages that lie between the vertebne. The 
 body is lean, and tremulous on any exer- 
 tion. The torpor of the system, and the 
 fulness of the veins, ai-e the chief pre- 
 disposers to disease in old age. The per- 
 2 E 
 
418 
 
 OLIVE-OIL. 
 
 spiration is checked, probably from the 
 obstruction of the smaller arteries; and 
 old people are, accordingly, subject to 
 asthma, habitual catarrh, and water in the 
 chest. These are to be treated by the 
 appropriate remedies ; and prevented, if 
 possible, by warm clothing-, and regulat- 
 ing the temperature of their apartments. 
 From the venous plethora, arise apoplexy 
 and palsy, piles, and obstructions in the 
 liver, which may end in dropsy. These 
 dangers are to be obviated by scrupulous 
 attention to the alvine and urinary dis- 
 charges. The principal support of old 
 age is to be found in nourishing and cor- 
 dial diet, with a proper allowance of 
 wine ; but to many old persons, wine 
 becomes unpleasant, while sweet things 
 are often remarkably grateful. The ap- 
 petite for solid food is frequently lessen- 
 ed, but many old people eat heartily, 
 without any inconvenience. Long lying 
 in bed is proper, both on account of its 
 promoting the perspiration, and sparing 
 the exertions of the enfeebled frame. 
 But a time will come, when all these 
 cares must prove unavailing : " it is ap- 
 pointed unto men once to die ;" and hap- 
 py are they who shall exchange the in- 
 firmities of old age for the life and im- 
 mortality brought to light by the Gospel. 
 
 OLIBANUM. A gum resin from the 
 Juniperus Lycia, which, when burned, 
 diffuses a very agreeable fragrance ; sup- 
 posed to have been the frankincense of 
 the ancients. It was once employed as an 
 expectorant, but is now of little estima- 
 tion as an article of the Materia Medica. 
 
 OLIVES. The fruit of the olive tree, 
 Olca Europetty when pickled, is consid- 
 ered by many as an agreeable article of 
 diet, and is supposed to promote appetite 
 and assist digestion. They are prepared 
 from the green unripe fruit, which is 
 steeped in water impregnated with quick- 
 lime or alkali ; and they are afterwards 
 preserved in a pickle, made of common 
 salt and v^ater. With dyspeptic patients 
 they generally disagree. 
 
 OLIVE-OIL. This is prepared from 
 the fruit of the olive when fully ripe, by 
 
 pressing it gently; it then yields the 
 purest oil, but an inferior kind is pro- 
 cured by heating the remainder, and 
 squeezing the fruit more strongly. Olive- 
 oil enters largely into the diet of many 
 nations, and is much used in medicine 
 and pharmacy. When good, it is of a 
 pale yellow colour, of a bland taste, and 
 without smell; when long kept, it be- 
 comes rancid. When taken internally, 
 it acts as a mild laxative, but not many 
 stomachs can retain enough for this pur- 
 pose. It is sometimes given in pretty 
 large doses for the expulsion of worms, 
 particularly some kinds of taenia or tape- 
 worm. And it may also be given inter- 
 nally in small doses, with mucilage and 
 other additions, as an emulsion in cases 
 of catarrh and sore throat. In cases 
 where certain poisons have been swal- 
 lowed, large quantities of oil are given 
 to correct the acrimony of the substance 
 swallowed. When applied externally, 
 it acts as an emollient, and forms a good 
 medium for frictions which are designed 
 to promote absorption, and to discuss in- 
 dolent swellings. Waiin oil rubbed on 
 the belly, gives much relief in dysentery 
 and other abdominal complaints ; and 
 the same application is one of the best 
 means for dispersing the knots in the 
 breasts of child-bed women, in the first 
 days of their confinement. Olive-oil is 
 an ingredient in many plasters and oint- 
 ments. Combined with hartshorn, it 
 forms the volatile liniment, so useful as 
 an external stimulant. Some have said 
 that anointing the body with oil prevents 
 a person from receiving the infection of 
 the plague. 
 
 OMENTUM. SeeQwu 
 
 ONION, Allium Cepa. An esculent 
 root, which is used both as an article of 
 food and as a condiment. Its stimulant 
 matter is useful to the stomach, and it 
 contains a good deal of nourishment. 
 When skilfully mixed with soups and 
 other dishes, it forms a very favourite 
 seasoning. It has also diuretic qualities. 
 With some stomachs it altogether disa- 
 grees ; and it gives an unpleasant smell to 
 
OPIUM. 
 
 419 
 
 the breath of those who eat it. Garlic, 
 leeks, and shallot, have the same proper- 
 ties and uses as onions. 
 
 OPHTHALMIA. Inflammation of 
 THE Eye. See Eye and its Diseases. 
 
 OPIATE. A medicine into whose 
 composition opium enters, in some of its 
 forms. 
 
 OPIUM. A medicine of inestimable 
 value, and indispensable for the successful 
 practice of physic. Speaking generally, 
 we may say it is a narcotic medicine, but 
 may be so managed as to procure various 
 other salutary effects in a great variety of 
 diseases. Opium is obtained from the 
 white poppy, Papaver somnifemm ; and 
 is chiefly prepared in Turkey, Persia, and 
 India. The plant grows also in many 
 parts of Europe, but the opium obtained 
 in the places first mentioned, is what is 
 chiefly valued in medicine. Opium is 
 procured in the following manner : When 
 the seed capsules are about half grown, 
 two or three longitudinal incisions are 
 made at sunset in each capsule, but so as 
 not to reach the internal cavity ; a juice 
 exudes, which is removed as fast as it con- 
 cretes ; this is put into earthen pots, and 
 afterwards dried in the sun. Opium 
 should be of a rich brown colour, a tough 
 consistency, and rather smooth and uni- 
 form in its texture. Its heavy narcotic 
 smell should be strong, and free from all 
 mustiness ; and there should be no burnt 
 odour. Its taste is bitter, and a little 
 acrid. Opium has been produced in Eng- 
 land, of a very good quality ; but the moist 
 and changeable nature of our climate ren- 
 ders it impossible to procure it good and 
 abundant enough to supply the demand 
 for it. Forty thousand pounds weight of 
 opium are annually imported into the port 
 of London. 
 
 Opium, Preparations of. The prin- 
 cipal forms in which opium is used, or 
 prepared for combination with other 
 substances, are the crude opiuniy and the 
 tincture, which is made with proof spirit. 
 It is commonly called Laudanum, an ap- 
 pellation bestowed by Paracelsus, from 
 the commendable efficacy of the medicine. 
 
 There is an extract procured by dissolv- 
 ing sixteen ounces of opium in a gallon 
 of water, allowing the dregs to subside, 
 then straining the liquor, and evaporating 
 to a proper consistence. But, says Mr. 
 Brande, we are no advocates for med- 
 dling with crude opium, which, if origi- 
 nally good, cannot be improved ; and al- 
 though in the process much of the active 
 matter of the drug is dissolved, and exists 
 in the extract, much also remains behind. 
 The preparation also has the disadvan- 
 tage of uncertainty, so that it is sometimes 
 equally active with, and sometimes less 
 active, than opium. We have never been 
 able to trace in it any increase of power. 
 The wine of opium is a spirituous solu- 
 tion of the extract, combined with various 
 aromatics. The dose is the same as that 
 of the tincture. It is sometimes locally 
 applied to the eye, when the vessels re- 
 main turgid after active inflammation has 
 been subdued; two or three drops are 
 dropped into the eye, night and morning. 
 
 Chemists have discovered in opium, 
 among other substances, a peculiar alka- 
 line body, to which the soporific virtues of 
 the drug are owing ; and which has re- 
 ceived the name of morphia, from Mor- 
 pheus, the god of sleep. 
 
 There are two other preparations of 
 opium whith deserve to be mentioned. 
 1 . Black Drop, the Lancaster or Qua- 
 ke)-' s Black Drop. This preparation has 
 been long known and esteemed, as being 
 more powerful in its operation, and less 
 distressing in its effects, than any tincture 
 of opium. The manner of preparino- it 
 has been published by Dr. Armstrong, 
 from the papers of the late Edward Wal- 
 ton of Sunderland, one of the near rela- 
 tions of the original proprietor. Take 
 half a pound of opium sliced, three pints 
 of good verjuice, (juice of the wild crab) 
 and one and a half ounce of saffron. 
 Boil them to a proper thickness, then add 
 a quarter of a pound of sugar, and two 
 spoonfuls of yeast. Set the whole in a 
 warm place near the fire for six or eight 
 weeks, then place it in the open air until 
 it becomes a syrup ; lastly, decant, filter. 
 
420 
 
 OPIUM. 
 
 and bottle it up, adding a little sugar to 
 each bottle. One drop of this prepara- 
 tion is considered equal to about three of 
 the tincture of opium ; it is probable that 
 an acetate of morphia is formed. 2. Bat- 
 tley's Liquor Opii Sedativus. Dr. Paris 
 thinks favourably of this preparation, 
 which is the acetate of morphia, provided 
 we can ensure recently prepared portions 
 as often as they may be required. It is 
 thoug-ht to be devoid of exciting, and al- 
 most of constipating properties, and to be 
 mild and uniform in its effects. The dose 
 is twenty drops in those cases where the 
 sedative effects of opium are wanted. 
 
 Opium, Effects of. The effects of opium 
 on the human body are those of a narco- 
 tic, anodyne, or sedative. Some medical 
 writers assert its powers to be stimulant, 
 others as strenuously maintain that they 
 are exclusively sedative. The truth is, that 
 by diminishing the quantity of opium ta- 
 ken at one time, it may be made to pro- 
 duce a stimulant or at least an intoxicat- 
 ing effect ; and it is on this principle we 
 are to explain the fondness of the Turks 
 and other eastern nations for opium, who 
 being, by the religion of Mahomet, pre- 
 cluded from the use of wine, are glad to 
 seek in the consumption of opium a me- 
 thod of inspiring courage, dissipating care, 
 and procuring all the effects of intoxica- 
 tion. By this, also, we are to account for 
 the lamentably increased use of opium 
 among the lower orders of this country j 
 who, cheap as ardent spirits unhappily 
 are, find the excitement and dozing pro- 
 duced by opium, even more cheap and 
 more pleasant. 
 
 " The symptoms and mode of action 
 of opium have been long made the sub- 
 ject of dispute, both among physicians 
 and toxicologists ; and in some particulars 
 our linowledge is still vague and insuffi- 
 cient. The effects of opium, through 
 whatever channel it may produce them, 
 are exerted chiefly on the brain and ner- 
 vous system. The effect of a small dose 
 seems to be generally in the first instance 
 stimulating. The action of the heart and 
 arteries is increased, and a slight sense 
 
 of fulness is caused in the head. This 
 stimulus differs much in different indivi- 
 duals." By repeating doses of thirty to 
 a hundred drops when the usual torpor 
 is coming on, the stimulus may be kept 
 up for a considerable time in some people. 
 " In this way are produced the remarka- 
 ble effects said to be experienced by 
 opium-eaters. These effects are always 
 in the first instance stimulant, the ima- 
 gination being rendered brilliant, the 
 passions exalted, and the muscular force 
 increased, and this state endures a con- 
 siderable time before the usual state of 
 collapse supervenes. A very poetical, 
 but I believe also, a very faithful, picture 
 of the phenomena now alluded to, is 
 given in the Confessions of an English 
 Opium-eater j a work published not long 
 ago, by a gentleman who writes from 
 personal experience. It is singular that 
 our profession should have observed 
 those phenomena so little, as to be ac- 
 cused by the author of having wholly 
 misrepresented the action of the most 
 common drug in medical practice. In 
 reply to this charge, the physician may 
 simply observe, that he seldom adminis- 
 ters opium in the way practised by the 
 opium-eater ; that when given in the 
 usual therapeutic mode, it rarely causes 
 material excitement; that some profes- 
 sional people prefer giving it in frequent 
 small doses, with the view of procuring 
 its sedative effect with greater certainty, 
 and undoubtedly do succeed often in 
 attaining their object; that in both of 
 these medicinal ways of administering it, 
 excitement is occasionally produced to a 
 very great degree, and of a very disagree- 
 able kind; that the latter phenomena 
 have been clearly traced to idiosyncrasy ; 
 and therefore that the effects on opium- 
 eaters are probably owing either to the 
 same cause, or to the modifying power of 
 habit. This much at all events is certain, 
 that opium seldom produces a material 
 excitement in a single small dose; and 
 does not always cause continuous excite- 
 ment when taken after the manner ot 
 the opium-eaters. The effect of a full 
 
OPIUM. 
 
 421 
 
 mediciual dose of three grains of solid 
 opium, or a drachm of the tincture, is to 
 produce in general a transient excitement 
 and fulness of the pulse ; but in a short 
 time afterwards torpor and sleep, com- 
 monly succeeded in six, eight, or ten hours 
 by headach, nausea, and dry tongue." 
 (Dr. Christison on Poisons.) 
 
 Opium, Uses of. Neglecting all the dis- 
 putes and theories which have had their 
 day, we proceed to mention the purposes 
 for which opium is employed in the prac- 
 tice of physic, and to enumerate a few of 
 the diseases, or other states of the system, 
 in which it may be given. In combination, 
 says Dr. Paris, the medical powers of 
 opium are wonderfully extended, so that 
 there is scarcely a disease in which it may 
 not, during some of its stages, be rendered 
 useful. Opium is very generally given 
 when we wish to procure sleep. Its dose 
 for this purpose is from twenty-five to 
 forty drops of laudanum, or ten of the 
 black drop, given in water either plain or 
 sweetened with syrup, or flavoured with 
 peppermint or cinnamon ; or one grain of 
 crude opiuin, alone or joined with liquor- 
 ice and pepper, as in the Edinburgh for- 
 mula. It is frequently prescribed to pro- 
 cure rest in fever, in agues, in bums, in 
 small-pox, in dyspepsia, and in a great va- 
 riety of cases of watchfulness and irrita- 
 tion ; taking care that it be not adminis- 
 tered, or at least very cautiously, when 
 there is fulness of the system, an inflam- 
 matory state of the body, costiveness, or 
 a tendency of the blood to particular or- 
 gans. Opium is much employed to mi- 
 tigate pain, and there is no substance 
 whatever, which has such extensive and 
 seldom-failing powers as this. As an 
 anodyne, it is employed in griping of the 
 bowels, in cramps, in gall-stones, jaun- 
 dice, dysentery, and diarrhoea ; and in 
 the pain from wounds, fractures, burns, 
 and poisons, and even in some inflam- 
 mations, provided we have premised pro- 
 per blood-letting. Opium is given to 
 check immoderate discharges in diar- 
 rhoea, in dysentery, in cholera, in water- 
 Vrash. It is used to allay inordinate ac- 
 
 tion, and so to act as an antispasmodic in 
 convulsions, in tetanus, in asthma, in hys- 
 terics, in colic; and as a relaxant, it is 
 used with other means in the attempt to 
 relieve the urgent symptoms of strangu- 
 lated hernia. Opium can be absorbed 
 from the surfaces of sores, and so exert 
 its peculiar powers on the system. 
 
 Opium, Disadvantages of. With all 
 its excellencies, opium has some proper- 
 ties, which requii-e to be watched and 
 corrected. When continued too long, it 
 is apt to induce costiveness, a flow to the 
 head, and dyspeptic symptoms. These 
 are to be counteracted by proper laxa^ 
 tives, or by discontinuing the medicine, 
 or substituting some other substance, 
 which will answer the purpose as nearly 
 as possible. Thus henbane will sometimes 
 answer the purpose of opium in procur- 
 ing sleep, but its dose is larger, and it is 
 more uncertain. It is very daugerous to 
 get a habit of taking opiiun, as its effects 
 on the moral character are of the most 
 pernicious tendency ; and on the body, a 
 complete destruction of its powers is too 
 frequently induced. All the symptoms 
 of the worst dyspepsia, hollow sunk eyes, 
 tremors of the whole body, a vacant look, 
 and exhausted strength, characterise the 
 hardened opium-taker. Medical men 
 should consider it strictly as a necessary 
 medicine, and never give it merely to in- 
 crease the comfortable bensations of thei?" 
 patients. 
 
 With some persons, opium does not 
 produce sleep, but induces a mild and 
 pleasing delirium, in which unreal objects 
 are vividly pictured to the mind's eye. 
 With others, the, deliriuni presents no- 
 thing but scenes and figures of terror and 
 impending dangelk as rocks ready to fall, 
 or torrents about to overwhelm them. 
 
 Opium, as Mr. Brandc very properly 
 observes, if ever administered to child- 
 ren, requires to be given with more than 
 ordinary caution ; it should never be re- 
 sorted to in any form, except upon emer- 
 gencies ; and all opiates, especially syrup 
 of poppies, and some nostrums containing 
 opium, which are but top frequently usei 
 
422 
 
 OPIUM. 
 
 to quiet children, should be imperiously 
 excluded from the list of nursery medi- 
 cines. 
 
 Opium, in combination with other sub- 
 stances. There are several most useful 
 medicines, in the composition of Avhich 
 opium is the principal ingredient. As an 
 external application for allaying pain, the 
 tincture of soap and opium is an excel- 
 lent remedy. To allay irritation in coughs 
 and other diseases of the chest, when all 
 fear of inflammation is gone, the medi- 
 cines known by the name of paregoric 
 elixir are given with advantage. It is to 
 be noted that the Scotch differs from the 
 English paregoric in its composition, and 
 as the active ingredient, opium, is in larger 
 proportion in the Scotch than in the Eng- 
 lish, respect is to be had to this in pre- 
 scribing either the one or the other. The 
 Scotch paregoric is a combination of 
 opium and ammonia, and is to be pre- 
 scribed in the dose of a tea-spoonful in 
 cold water at bed-time. The English is 
 combined with the tincture of camphor, 
 and may be taken in doses three or four 
 times as great. A narcotic medicine com- 
 bined with an emetic is found to make 
 one of the most effectual sudorifics, and 
 not a more powerful and certain sweating 
 medicine can be contrived, than that which 
 is known by the name of Dover's powder, 
 which consists of one part of opium and 
 one of ipecacuan, joined with eight parts 
 of an innoxious neutral salt to aid their 
 mechanical division and intimate union ; 
 of this powder, ten or twelve grains are 
 to be given, and the perspiration to be 
 promoted by drinking warm gruel or 
 other diluent liquors, but not immediate- 
 ly after the powder, for fear of exciting 
 vomiting. A liquid sudorific may be 
 5/ ■ ' -^ made of twenty-five drops of laudanum 
 'A <.^U :^ ^^^ thirty drops of ipecacuan or antimo- 
 nial wine ; but if there be inflammatory 
 symptoms present, opium must be avoid- 
 ed, and other sudorifics employed. Opium 
 with prepared chalk, is given to check 
 diarrhoea. Twenty-five drops of laudanum 
 with half a drachm of ether, often relieve 
 (spasmodic asthma. 
 
 Opium, Effects of an over-doF.e of. By 
 mistake or design, opium is sometimes 
 swallowed in such a qiumtity as to pro- 
 duce very alarming effects. The princi- 
 pal of these are giddiness, a bloated and 
 flushed appearance of the face, a slow full 
 pulse, and oppressed breathing as in apo- 
 plexy. There are also troublesome 
 dreams, startirjg, or convulsions, cold 
 sweats, vomiting, hiccup, and fainting. 
 As soon as this accident has been disco- 
 vered, the stomach should be emptied by 
 the stomach-pump, or by a speedy eme- 
 tic, as thirty grains of the sulphate of 
 zinc, or eight of the sulphate of copper, 
 dissolved in three or four ounces of warm 
 water ; and its operation is to be assisted 
 by drinking chamomile tea. When the 
 stomach is evacuated, drowsiness must be 
 prevented by keeping the patient in con- 
 tinual motion; strong coffee has been 
 found to diminish the headach and stu- 
 por; and bleeding, especially from the 
 jugular vein, should be resorted to, for the 
 purpose of relieving the apoplectic symp- 
 toms. After this, ammonia and other 
 stimulants are to be tried. If the patient 
 cannot swallow, or if the emetics do not 
 empty the stomach ; if the pupils are di- 
 lated, the breathing stertorous, and the 
 system in a state of torpor from which it 
 cannot be roused, there is every reason to 
 fear that death will be the consequence of 
 the poison. See Laudanum. 
 
 " The ordinary duration of a fatal case 
 of poisoning with opium, is from seven to 
 twelve hours. Most people recover who 
 outlive twelve hours. The dose of opium 
 requisite to cause death, has not been de- 
 termined. The dose required to prove 
 fatal is very much altered by habit. 
 Those who have been accustomed to eat 
 opium, are obliged gradually to increase 
 the dose, otherwise its usual effects are 
 not produced. Some extraordinary, but 
 I believe, correct information on this 
 subject, is contained in the Confessions 
 of an English Opium-eater. The author 5^'^.,^ 
 took at one time eight thousand drops *^.J^ 
 daily, or about nine ounces of laudanum.*' 
 (Dr. CiiKisTisoN.) 
 
OSS 
 
 OXA 
 
 423 
 
 OPODELDOC. A substance used 
 for external application to bruises and 
 pained parts. The tincture of soap and 
 opium is as g-ood a one as can be used. 
 Steer's opodeldoc is made of Castile soap, 
 rectified spirit, camphor, oil of rosemary, 
 oil of origanum, and solution of ammo- 
 nia. 
 
 ORANGES, Citrus Aurantium. A 
 well known and pleasant fruit growing 
 plentifully in China, and in the south of 
 Spain. Oranges are gratefully acid, and 
 of much utility in feverish disorders for 
 quenching thirst, and cooling the system. 
 The seeds and tough white rind are to be 
 rejected ; and probably the way to take 
 them with least injury to the stomach 
 and digestive powers, is to squeeze the 
 juice, and to take it a little diluted; with 
 the addition of sugar, if necessary. An 
 essential oil may be obtained from the 
 rind ; and the tincture of the dried rind 
 is a good tonic, and enters into the com- 
 position of Huxhara's tincture of bark. 
 Oranges, when they can be preserved in 
 sufficient quantity, are an excellent pre- 
 ventive and cure of sea-scurvy. 
 
 ORANGE-FLOWER-WATER is an 
 agreeable and harmless perfumed water 
 got by distilling the flowers of the orange 
 tree. It is one of the favourite remedies 
 for disease in France, and may probably 
 do good on the principle of their diceta 
 aguea, by enforcing abstinence, and keep- 
 ing away injurious stimuli. 
 
 OSSIFICATION. The formation of 
 bone, or the conversion of a soft part in- 
 to bone by the deposition of osseous mat- 
 ter. This often takes place in arteries, 
 especially about the valves of the larger 
 arteries, and by altering their structiu-e 
 and interfering with the proper perform- 
 ance of the functions, it lays the founda- 
 tion for many dangerous and fatal dis- 
 eases. Aneurism, angina pectoris, asth- 
 ma, difficulty of breathing, are all found, 
 in many instances, to be accompanied by 
 ossification of the arteries. We cannot 
 pronounce with certainty that this ossi- 
 fication hjis taken place, and if we could, 
 there is no means of cure ; all we can do 
 
 is to palliate symptoms, and to relieve, as 
 we are able, those that are most oppres- 
 sive. 
 
 OVARIUM. An appendage of the 
 female uterus, of which there is one on 
 each side. Their substance is spungy, 
 and very frequently the seat of disease. 
 They are liable to become hard and 
 swelled to a very astonishing size, and 
 either themselves to contain a watery 
 fluid, or by pressing on the vessels and 
 other parts contained in the abdomen, 
 to occasion the accumulation of water in 
 the belly. It is in ovarian dropsy that 
 most relief is got by tapping, and many 
 patients have lived long under this com- 
 plaint, and been repeatedly relieved of 
 great quantities of fluid. The ovarium 
 has sometimes been cut out, even when 
 prodigiously swelled j but it is an operar 
 tion hazardous in itself, important in its 
 consequences, and by no means to be 
 rashly ventured upon. 
 
 OVUM, in physiology, signifies the 
 whole contents of the impregnated uterus, 
 the membranes, with the embryo and 
 waters contained in them. 
 
 OXALIC ACID. The acid of wood 
 son'el, obtained from many vegetables 
 by certain processes. It is obtained in a 
 concrete form, and becomes an object of 
 considerable interest from the resemblance 
 of its crystals to Epsom salts. From its 
 being employed to clean boot tops it is 
 kept for domestic use, and is too often 
 mistaken for salts, and acts as a virulent 
 poison. The symptoms produced are those 
 of great pain, and a burning sensation at 
 the stomach, vomiting, inflammation, and 
 bloody stools. When a person is disco- 
 vered in time to have swallowed oxalic 
 acid, the most likely means of relief is to 
 give very plentifully of lime-water or 
 chalk, by which an oxalate of lime is 
 formed, that will be comparatively innoxi- 
 ous. The danger and the frequency of 
 this accident caU strongly for the most 
 minute attention on the part of apothe- 
 caries and druggists. There is no test so 
 good as the taste, which should always be 
 exercised when there is any doubt. Th« 
 
424 
 
 OYSTERS. 
 
 Epsom salts are crystallized in large crys- 
 tals, which the druggists very proi3erly say 
 cannot be mistaken for oxalic acid ; but 
 it would be still better if they could im- 
 part some striking distinction to the oxa- 
 lic acid, as there is no great danger to 
 life though the salts should be used, 
 where the acid is intended; but very 
 great risk when the acid is taken as sul- 
 phate of magnesia. 
 
 OXYGEN is a substance of such gene- 
 ral and important operation, that though 
 it strictly belongs to chemistry, we may 
 be allowed to say a little of it here. Oxy- 
 gen gas, or vital air, is one of the compo- 
 nent parts of our atmosphere, of which 
 it forms about twenty-one parts in the 
 hundred. It is that part of the air by 
 which it is rendered fit for the breathing 
 of animals, and for the combustion of 
 burning bodies; in oxygen gas, inflam- 
 mable bodies burn with great brilliancy. 
 Oxygen enters into combination Avith a 
 very great variety of bodies ; with several 
 combustible bodies it forms acids; with 
 two metals it forms the two fixed alkalis, 
 and with the majority of metals it forms 
 oxides or earthy looking substances, 
 which combination is necessary before 
 these oxides unite with acids to form the 
 metallic salts. Oxygen entering into com- 
 bination with hydrogen or inflammable 
 air, forms water, 
 
 OXYMEL. Vinegar and honey boiled 
 together to the consistence of syrup. It 
 is used as an aperient and expectorant, 
 and given as such, in aSliima and other 
 diseases of the chest. The dose is one or 
 two drachms, and it may be added to any 
 diluent fluid or tepid water. 
 
 OXYMEL OF SQUILLS is made by 
 boiling honey and vinegar of squills in- 
 stead of common vinegar, and has virtues 
 of the same kind as the last substance, 
 but higher in degree. If given in too 
 great quantity, it wiU prove emetic. To 
 prevent its having any nauseating ef- 
 fect, it may be given with a little 
 cinnamon water; or a little powdered 
 ginger or nutmeg may be sprinkled in the 
 (Jraught, 
 
 OYSTERS. A shell-fish which has 
 enjoyed a long and general reputation, 
 greater. Dr. Paris thinks, than -they de- 
 serve. When eaten cold they are fre- 
 quently distressing to weak stomachs, and 
 require the aid of pepper as a condiment ; 
 and as they are usually swallowed without 
 chewing, the stomach has an additional 
 labour to perform. They are still less di- 
 gestible when cooked. They are, no 
 doubt, very nourishing, and contain a 
 considerable quantity oif nutritive matter 
 in a small compass ; but this latter cir- 
 cumstance affords another objection to 
 their use. Oysters have sometimes pro- 
 duced injurious effects, which have been 
 ascribed to their having lain on coppery 
 beds ; but this idea arose from the green 
 colour which they often acquire, not from 
 copper, but by their being placed where 
 there is a great deposit from the sea, con- 
 sisting of the vegetating germs of marine 
 plants, confervcB and fuci, m hich impart 
 the colour to the oyster. The Dutch used 
 to carry oysters from our coasts and de- 
 posit them on their own, on purpose to 
 obtain this colour. The evils produced 
 by eating oysters seem not to depend on 
 any peculiarity in them, but on the state 
 of the stomach and their indigestible na- 
 ture together; and the stomach would 
 have been in the same way disordered by 
 any other food equally indigestible. At 
 cert?iin times of the year, oysters are out 
 of season. In May, they cast their spawn, 
 after which they are sick and unfit forfood; 
 but in June and July, they begin to mend, 
 and in August, they are perfectly well. 
 
 OZjENA. An ulcer in the nose, noted 
 for its abominable smell, probably a dis- 
 ease of the turbinated bones in a scrofu- 
 lous constitution. It is to be treated by 
 frequently throwing in astringent solu-s 
 tions, as of sulphate of zinc or copper, or 
 applying these substances in the form of 
 powder, by blowing them through a tube 
 so as to reach the diseased part ; which is 
 also to be kept clean by frequent washing 
 with milk and water, or tepid water ren- 
 dered slightly astringent by a little white 
 yitriol, and thro^Ti "P hy a syringe. 
 
PAIN. 
 
 4S5 
 
 PAL 
 
 PAIN. An uneasy sensation, which 
 generally accompanies diseases of struc- 
 ture, and which occurs in many cases, 
 where no alteration of parts can be de- 
 tected. It is a constant attendant on in- 
 flammation, and forms one of the marks 
 by which that state of action is character- 
 ised. It is a common attendant also of 
 spasm or irregular action. It is one of 
 the symptoms by which we are led to 
 know the diseased state of internal parts, 
 which are removed from the cognizance 
 of our senses. It is one of those sensa- 
 tions which irresistibly claim our atten- 
 tion, and from which we shrinli with in- 
 stinctive horror. Pain is of many diffe- 
 rent kinds and degrees, from the sharp 
 lancinating pain of cancer or the stone, 
 to the dull obscure uneasiness of schir- 
 rous liver. When there is great destruc- 
 tion and alteration of parts without pain, 
 it is a symptom of the death or mortifi- 
 cation of the part. In the treatment of 
 diseases and pain, we must not always be 
 led away by that urgent symptom, but we 
 should always endeavour, if possible, to 
 discover the cause, and prescribe for the 
 primary disease. For the relief of mere 
 pain, we have in opiates and other narcotics, 
 very powerful remedies; but we must 
 take care lest our relief be only tempo- 
 rary, and lest we be seduced by the hope 
 of present ease, to lay the foundation for 
 permanent mischief. 
 
 PAINS OF LABOUR. See Labour. 
 
 PALATE. The arch of the mouth, 
 surrounded before by the teeth and gums, 
 jjnd extending backward as far as the 
 great opening of the gullet. This arch 
 is partly hard and immoveable, and partly 
 soft and moveable. The solid part is 
 formed by the two upper maxillary bones 
 fipd the two palate bones. The soft part 
 
 PAL 
 
 lies behind the other, and it is lined by a 
 membrane full of small glands, which 
 pour their fluid into the mouth. The 
 palate is sometimes divided by one or 
 more fissures, in cases of hare-lip; and 
 the uvula, or pap of the throat, is cleft in 
 two; in consequence, the child cannot 
 suck properly; and the voice is broken 
 and unnatural. In common language, the 
 palate is used for the taste, from its being 
 a principal seat of that sense. 
 
 PALLIATIVES. Medicines which 
 ai-e given, or remedies which are applied, 
 not with the view of radically or com- 
 pletely curing a disease, but in order to 
 give relief to certain urgent symptoms. 
 
 PALM. A family of plants which 
 generally grow within the tropics ; and 
 which furnish, with little trouble, cloth- 
 ing, food, and habitations. The fruit of 
 the palm is commonly a dry berry, whose 
 shell is formed of numerous fibres closely 
 compacted; varying in its form, and 
 sometimes equalling in size a man's head. 
 The cocoa-nut is the fruit of a species 
 of palm, the Cocos nucifera. From the 
 seeds, or the nut-like kernel, sweet oil, 
 or a kind of butter, may be pressed out. 
 The milky fluid found in the cavity yields 
 a refreshing draught ; by evaporating it, 
 sugar may be obtained ; and, by the usual 
 processes, wine, spirit, or vinegar. The 
 spirit obtained is called toddy^ in India. 
 
 PALM-OIL is produced from the 
 palm, which in Jamaica is called the 
 Mackaw Tree. It is used alone, or mixed 
 with some stimulating substance, to rub 
 on parts affected with chronic pains. 
 
 PALPITATION. A violent and irre- 
 gular action of the heart, in which the 
 patient is made sensible of violent beating 
 of that organ, alternated with a sense of 
 faii^tucss and sinking, and often accom* 
 
426 
 
 PALSY. 
 
 panied with a difficulty of breathing, a 
 purple colour of the lips and cheeks, and 
 other symptoms that attend on imperfect 
 circulation. 
 
 Causes. Palpitation is very frequent- 
 ly occasioned by fear, surprise, and other 
 emotions of the mind ; and is a frequent 
 symptom of hysteria, and other nervous 
 disorders ; it is sometimes brought on by 
 costiveness and indigestion. It occurs in 
 constitutions that are plethoric, irritable, 
 and easily moved ; it is often owing to 
 organic diseases of the heart and great 
 vessels, or to a faulty make of the chest. 
 IVIany of the things that induce fainting, 
 as heated rooms, bad smells, disgusting 
 sights, also induce palpitation. 
 
 Treatment. This altogether depends 
 on our knowing the causes of the palpi- 
 tation. If it be organic disease, the most 
 we can hope is to palliate symptoms by 
 keeping down plethora, and by avoiding 
 every thing that would disturb the mind, 
 or quicken the circulation. If it is owing 
 to too great fulness, that is to be reduced 
 by a spare diet, and by occasional small 
 bleedings. If palpitation be connected 
 with debility, with hysteria, or with any 
 nervous disease, the patient must employ 
 tonics, as bark and wine, or steel ; must 
 try to get the hysterical tendency lessened 
 or cured ; and occasionally ether, or other 
 antispasmodics may be employed. Those 
 subject to palpitation must keep out of the 
 way of the occasional causes, of sudden 
 surprises, exciting passions, or violent ex- 
 ercises. See Heart, Hysteria, Nervous. 
 
 PALSY. A disease in which some 
 part of the body is affected with the loss 
 of sense and motion. It may be of all 
 degrees, from a universal attack of the 
 whole body, or a complete palsy of one 
 of the sides, to the palsy of a single fin- 
 ger, or a few fibres of a muscle. It pro- 
 ceeds from the same causes as apoplexy, 
 and is in reality often a modification or 
 partial attack of that disease. When a 
 patient, by proper remedies, or the powers 
 of nature, recovers a little from an attack 
 of apoplexy, it is very common for him 
 to be seized with palsy. 
 
 Palsy sometimes comes on, suddenly, 
 at other times there is numbness, cold- 
 ness, and paleness of the part about to 
 be affected. Sometimes the judgment 
 and memory are impaired ; the speech is 
 imperfect from the disease of both body 
 and mind ; the mouth and cheeks are dis- 
 torted, and the countenance is expressive 
 of much anxiety. When the lower ex- 
 tremities are partially affected, the pa- 
 tient drags them after him. 
 
 Causes. The same causes that excite 
 apoplexy, when applied in a less degree, 
 occasion palsy ; therefore tumours, wrong 
 determination of blood, bruises, pressure 
 on nerves, the drying up of usual evacua- 
 tions, are often found to induce palsy. 
 Certain sedative substances, long applied, 
 produce palsy of some parts of the 
 body, as we see in those who work 
 among lead, who are affected with the 
 Devonshire Colic ; one remarkable symp- 
 tom of which is the palsy of the thumbs 
 and calves of the legs. Palsy is not un- 
 frequently produced gradually by some 
 tumour, or other disease which presses 
 on the vertebrae of the back ; and this is 
 commonly the cause of the palsy of young 
 people. 
 
 Prognosis. It is generally unfavour- 
 able. Palsy does not suddenly prove 
 mortal. Its cure is the more difficult the 
 more the senses are injured; and such 
 cases commonly continue till the end of 
 life, often very remote. When palsy fol- 
 lows apoplexy, or happens in old people, 
 it is seldom cured. The palsies of young 
 people are sometimes recovered from. 
 If convulsions occur in the parts oppo- 
 site to those that are palsied, the danger 
 is great. When palsy occurs from pres- 
 sure or blows on the spinal man'ow, or 
 on any large nerves, it is generally hope- 
 less, and the dragging of the limb is sel- 
 dom got completely the better of. 
 
 Treatment. When palsy comes on 
 suddenly, it is proper to treat it as we 
 do apoplexy, by bleeding, by purging, 
 by blisters to the head ; and when the 
 acute symptoms are in some measure re- 
 lieved, to apply stimulants to the limbs. 
 
PALS Y. 
 
 427 
 
 or parts weakened, if they are within our 
 reach. When the case is of longer stand- 
 ing, and the constitution is in a state of 
 debility, these evacuating measiu'es would 
 be improper; and instead of them we 
 must be contented with stimulating ap- 
 plications, aided by such exercise as the 
 patient is able to tal^e. It is surprising 
 how much may be done in cases appa- 
 rently very hopeless. The patient must 
 not be discouraged at the apparent bad 
 success of his first eflforts at motion, but 
 ' must persevere, and his perseverance Avill 
 probably at last be rewarded. The appli- 
 cations proper for palsied limbs are such 
 as the foUowing : Ammoniated oil, cam- 
 phorated oil, cajeput oil, when it can be 
 got ; turpentine and oil, warm sea-water, 
 warm salt, stinging with nettles, mustard, 
 &c. Electricity and galvanism are also 
 frequently had recourse to ; also the use 
 of the Bath or other mineral waters pump- 
 ed upon the palsied limbs. Our choice 
 of internal medicines must be determin- 
 ed by the state of the constitution. If 
 there be any excitement, or inflamma- 
 tory tendency, or any probability that 
 the palsy may be followed by apoplexy, 
 all internal stimuli must be avoided ; and 
 it is only in old cases, unattended by fe- 
 ver, that we are to give such medicines 
 as guaiac, iron, aromatics, or the like. 
 Paralytic limbs should be kept warm, 
 and well covered with flannel. The 
 diet should be light and nutritive. The 
 patient should take what exercise he 
 can ; and if he is unable to do it by his 
 own exertions, he must have it by a car- 
 riage, or by sailing, or by a swing. In 
 the palsy of the lower limbs from dis- 
 eases of the spine, issues to the back, or 
 to the neighbourhood of the diseased 
 vertebrae, are of great service. See Pa- 
 
 BAPLEOIA. 
 
 Palsy in Childreriy occurs pretty fre- 
 quently, and attacks infants and young 
 pei-sons in different degrees. It often 
 attacks one side at first, and gradually 
 comes on the other side. It is generally 
 attended with costiveness and deranged 
 state of the bowels ; and, accordingly, a 
 
 course of purgative medicines of consi- 
 derable activity, as jalap and calomel, or 
 rhubarb and calomel, in no long time ef- 
 fects a cure. Blistering on the head, or 
 on the palsied limb, may be tried ; and 
 leeches to the temples, when the head is 
 much affected. If the palsy is owing to 
 water in the head, it is to be feared the 
 case is hopeless. Tonic medicines and 
 external stimulants are proper, when 
 there is no fever present. Electricity is 
 often a valuable assistance to other re- 
 medies. 
 
 PANACEA. A fancied medicine, of 
 power to cure aU diseases. 
 
 PANADO. The crumb of wheaten 
 bread softened with boiling water; an 
 excellent diet for children, for those in 
 febrile diseases, and for women in the 
 first days after delivery. It is to be 
 sweetened with sugar, and at proper 
 times may have an addition of milk, or 
 wine. 
 
 PANCAKES are in general very 
 agreeable to the palate, but difficult of 
 digestion, from the quantity of greasy 
 matter they contain, and also from this 
 matter being fried. Pancakes should, 
 therefore, not be allowed to dyspeptic 
 patients; and children should rarely be 
 indulged with them. 
 
 PANCREAS. One of the abdominal 
 viscera, situated near the liver, believed 
 to secrete a fluid like the saliva, useful 
 in digestion; for which purpose it is 
 poured into the upper part of the intes- 
 tines, nearly at the place where the bile 
 is conveyed into them. 
 
 PARAPLEGIA, a species of palsy, in 
 which one half of the body is deprived of 
 sense or motion, but in which the line 
 dividing the unhealthy from the sound 
 part is not from head to foot as in hemi- 
 plegia, bnt across the body. Generally 
 the lower extremities and the viscera of 
 the pelvis are concerned in this affection. 
 Besides the loss of motion, great incon- 
 venience is felt, from inability to retain 
 the water and stools. It arises from di*. 
 tortion, from a violent shock, or from 
 long continued cold. Blisters and warm 
 
428 
 
 PASSIONS. 
 
 stimulants, both internal and external, 
 are necessary ; and the Bath waters, sea 
 bathing, and warm and cold bathing may- 
 be freely employed. A blister at the 
 lower part of the back may assist in the 
 retention of the usual evacuations ; and 
 a cautiovis use of cantharides may be tried 
 for restoring the tone of the bladder. 
 
 PAREGORIC ELIXIR. A composi- 
 tion of opium with camphor or ammo- 
 nia, useful to allay irritation and tick- 
 ling cough after inflammation has sub- 
 sided. The usual dose is a large tea- 
 spoonful in a glass of water. We have 
 already, under the article Opium, given 
 an account of the composition, uses, and 
 doses, of paregoric elixir, and have also 
 remarked the difference between the 
 Scotch and English paregoric. 
 
 PAROTID GLAND. A large gland 
 situated in the neighbourhood of the ear, 
 for the purpose of secreting the saliva, so 
 necessary for digestion and for moisten- 
 ing the mouth. Its duct opens into the 
 mouth near the third of the grinding 
 teeth ; and the gland is so placed as to 
 be a good deal agitated by the motion of 
 the lower jaw ; so that during mastica- 
 tion, when the greatest quantity of saliva 
 is wanted, we have the greatest supply. 
 Like other glands of the neck, it is not 
 unfrequently the seat of inflammation, 
 and sometimes swells to a great size af- 
 ter fevers. Such swellings are to be 
 treated by poultices and fomentations. 
 
 PAROXYSM. A fit, or sudden and 
 violent attack of disease, as of fever, 
 asthma, hysterics, &c. 
 
 PARSNIP, Pastinaca sativa. A vege- 
 table used at table ; it is nutritious and 
 easily digestible ; but its sweet flavour is 
 disagreeable to many persons. A wine 
 can be made from it. 
 
 PARTURITION. The bringing forth 
 of a child. See Labour. 
 
 PASSION. This term is in common 
 language applied to one or two diseases, 
 which attack with great suddenness and 
 violence, as the Hysteric passion, the 
 Iliac passion ; for the account of these 
 diseases, See Hysteru and Iuac Passion. 
 
 PASSIONS. The passions of the 
 mind, considered medically, are divided 
 into the exciting and depressing passions. 
 Some of the exciting are anger, joy, emu- 
 lation, hope ; of the depressing, fear or 
 terror, grief, envy, jealousy. The effects 
 of anger, are flushing of the countenance, 
 quickening of the circulation, and in some 
 cases, apoplexy or epilepsy ; in those af- 
 flicted with organic diseases of the heart 
 or great vessels, the excitement produced 
 by anger has occasioned sudden death. 
 Joy has been known to occasion mad- 
 ness; and in periods when the rage for 
 commercial speculations seemed epidemic, 
 the flush of sudden prosperity brought on 
 more cases of insanity, than the grief for 
 disappointment and ruin. The depress- 
 ing passion of fear, though it is not an 
 exciting cause, is certainly a predisposing 
 one of several morbid affections. When 
 continued for some time, it may induce 
 indigestion, and diseases of debility ; and 
 it renders persons peculiarly susceptible 
 of the contagion of fever, and other infecr 
 tious diseases. Hence the good of ara^- 
 lets and preservatives, which, though use- 
 less in themselves, inspire confidence; 
 and thus fortify the mind and body 
 against infection. Strong and sudden 
 terror noay at once extinguish life, or it 
 may produce madness or epilepsy. Grief, 
 when deep and long indulged, produces a 
 languor and debility of all the functions, 
 which appears particularly in the digestive 
 powers. Besides the proper moral treat- 
 ment, the diseases produced by any pas- 
 sion are to have such remedies ajiphed as 
 would be employed in any other case. The 
 passions are more likely to produce in- 
 jurious effects when the mind and body 
 are weak : hence, during child-bed, most 
 particular care should be taken not to 
 agitate the minds of women. All dis- 
 tressing intelligence should be withheld ; 
 no stories should be told of bad cases 
 that have occurred elsewhere, and nothing 
 hastily said about the illness or defects of 
 the child. The looks and manners of the 
 friends and attendants should be those of 
 tranquillity, if not of cheerfulness ; ^nd 
 
PEA 
 
 PEN 
 
 429 
 
 every occasion of surprise, fear, or anger, 
 should be studiously kept out of view. 
 Suppression of the lochia, repulsion of the 
 milk, various fevers, and even madness it- 
 self, may be tlie consequence of misma- 
 nagement of the mind during the period 
 of confinement. 
 
 PASTRY, or dough mixed with butter, 
 is used in a great variety of forms, and is 
 grateful to the taste but injurious to the 
 health. It is a fertile source of all the 
 varieties of stomach complaints, and is apt 
 to occasion plethora and the apoplectic 
 . tendency, as well as many skin diseases. 
 At dinner, in the shape of tarts and con- 
 fectionary, pastry is thrown into the al- 
 ready loaded stomach, and its overtaxed 
 powers are unable to digest what is diffi- 
 cult to manage at its most vigorous times. 
 To children, pastry is peculiarly unsuit- 
 ble. Its taste is pleasant, and injudi- 
 cious fondness is apt to indulge them with 
 it ; but those children who use it much, 
 are subject to runnings from the ears, dis- 
 orders of the bowels, eruptions on the 
 skin, and inflammatory complaints of 
 vaiious kinds. Pastry should be almost 
 totally excluded from the nursery table. 
 
 PATENT MEDICINES. See Quack 
 Medicines. 
 
 PATHOLOGY is that division of the 
 Institutions of Medicine which investi- 
 gates the causes of disease in general, or 
 the morbid alteration of the structure or 
 functions of any particular part. The 
 bases on which pathology rests, are a 
 careful observance of the circumstances 
 that precede a disease, of its symptoms 
 when present, and, above all, the exami- 
 nation of the internal parts of the body 
 after death. 
 
 PEACH, Amygdalus PersicOy a deli- 
 cious stone-fruit, salutary when used in 
 moderation, but not when the stomach 
 has already a copious dinner to digest. 
 
 PEAR, Pyrus. An agreeable fruit, 
 of many species, from which the liquor 
 called perryy is obtained by expression. 
 It is cooling and agreeable, but too acid 
 for weak stomachs. Pears, when good 
 and ripe, may be freely eaten. 
 
 PEASE form a wholesome and light 
 food when green and young ; but when 
 full grown and dry, they are very indi- 
 gestible ; and in this state they are very 
 liable to produce a great deal of wind in 
 the intestines. When made into pud- 
 ding, they are still worse, as the difficulty 
 of digestion is increased by the toughness 
 of the mass. The flour of pease, beans, 
 and other leguminous plants, commonly 
 called pulse, is of an unctuous nature, and 
 forms a milky solution with water, owing 
 to the presence of an oily matter. Pulse 
 is highly nutritive, but difficult of diges- 
 tion, and when made into bread they are 
 apt to occasion flatulence, and to lie heavy 
 on the stomach. It is principally the 
 strong labouring classes that are able to 
 digest this sort of bread. Those troubled 
 with stomach complaints should carefully 
 avoid them; flatulence and colic very 
 commonly follow their use in such per- 
 sons, and even more alarming symptoms. 
 
 PELVIS or BASON, the lower part 
 of the abdomen. See Abdomen, 
 
 PENNYROYAL, Mentha Pulegium. 
 A species of mint, which, on distillation 
 with water, aflfbrds a pungent aromatic 
 oil ; this oil is occasionally added to an- 
 tispasmodics, and is thought to be em- 
 menagogue ; but its virtues in this way 
 are but small. Pennyroyal water is used 
 as a vehicle for other medicines. 
 
 PENZANCE. By referring to our ar- 
 ticles on Climate and Consumption, it 
 will be seen that, in the advanced stages 
 of that disease, our hopes of benefit from 
 a change of climate are but small, and 
 that residence in a foreign land, as the 
 south of France, is attended with many 
 inconveniences. We have stated also, 
 that on the coasts of Devonshire and 
 Cornwall, are some good stations for in- 
 valids. We now mention, that Penzance 
 and the district of the Land's End, seem 
 to promise advantages of very consider- 
 able importance. This district appears to 
 possess, in a great degree, the qualities 
 most desirable for consumptive patients ; 
 not a high temperature, but a high mean 
 temperature, and a short range ; the tern- 
 
430 
 
 PERIPNEUMONY. 
 
 perature being considerably higher in 
 winter than that of any part of this coun- 
 try, and lower in summer than in the 
 warmest parts of it ; and in regard to the 
 mean of the cold months, bearing a com- 
 parison with the best parts of the south 
 of Europe. At Penzance, the extreme 
 heat in summer is considerably less than 
 in London. For some years past. Dr. 
 Abercrombie has sent several patients 
 with affections of the chest, to spend the 
 winter at Penzance, or at a place called 
 Tor Quay on the coast of Devonshire, 
 which presents still greater advantages. 
 See Tor Quay. 
 
 PEPPER. An aromatic and stimu- 
 lant production of several plants of warm 
 climates, which is pretty extensively used 
 both in cookery and medicine. There 
 are different kinds of pepper, the princi- 
 pal are Cayenne pepper, Jamaica pepper 
 or allspice, long pepper, black pepper, and 
 Java pejjper. Cayenne pepper, as well 
 as the other kinds, forms an excellent 
 gargle in sore throats, especially those 
 proceeding from relaxation, and in the 
 putrid sore throat and scarlet fever. Pep- 
 per is a useful article in cookery, as it 
 stimulates the powers of the stomach, and 
 prevents the flatulence which is apt to 
 arise from the use of vegetables. With 
 such diet, pepper is almost universally ne • 
 cessary. 
 
 PEPPERMINT, Mentha Piperita. 
 A plant whose leaves have a strong and 
 somewhat agreeable smell, a pungent aro- 
 matic taste, with a peculiar sensation of 
 coldness. Its qualities depend on an es- 
 sential oil and camphor, both of which 
 rise in distillation, and are combined in 
 oil of peppermint. This plant is princi- 
 pally used as a carminative and antispas- 
 modic. The distilled water is sometimes 
 given in flatulent colic, and it is a good 
 vehicle for administering other medicines. 
 A drop or two of the oil of peppermint 
 on loaf sugar, is often given with advan- 
 tage in cramps of the stomach. 
 
 PERICRANIUM. The thin mem- 
 brane immediately investing the bones of 
 the skull. 
 
 PERINEUM, the space betw^een the 
 verge of the anus and the genitals, ex- 
 tending about an inch laterally. It is 
 of great importance for surgeons to be 
 perfectly well acquainted with the muscles 
 and blood-vessels which are situated there, 
 as they are much concerned in various 
 operations j and in cases of labour the 
 perineum requires to be carefully sup- 
 ported, to prevent laceration. 
 
 PERIPNEUMONY. The correct de- 
 finition of this word is an inflammation 
 of the substance of the lungs, as dis- 
 tinguished from pleuritis or pleurisy, the 
 inflammation of the membrane which in- 
 vests the lungs, and lines the cavity of 
 the chest. In practice it is difficult to 
 make the distinction, and for all useful 
 purposes it is needless to do so ; as the 
 same assemblage of symptoms marks the 
 inflammation of both parts, and the same 
 plan of treatment is required in both. We 
 have already detailed the symptoms and 
 treatment of pleurisy and peripneumony. 
 See Lungs, Inflammation of. 
 
 There is an affection of the chest called 
 Spurious or Bastard P*eripneumony, 
 which we now proceed to describe. Those 
 who are advanced in life, or of a phleg- 
 matic constitution, are they who are 
 principally subject to this disease ; it at- 
 tacks those who have been formerly sub- 
 ject to catarrhal affections. It is apt to 
 be brought on by cold, or changes of tem- 
 perature ; and therefore like other affec- 
 tions of the chest, is common in spring. 
 It comes on with shiverings, alternating 
 with flushes of heat; there is flushing of 
 the face, pain or giddiness in the head, a 
 sense of Aveariuess, difficulty of breath- 
 ing, oppression and dull pain of the chest, 
 with a cough and slight expectoration, 
 and sometimes the discharge of viscid 
 mucus from the stomach. The disease is 
 occasionally slight like a catarrh, and goes 
 off with a little expectoration ; at other 
 times it is so severe as to indicate a con- 
 siderable degree of inflammation, and this, 
 giving rise to the effusion of much fluid 
 into the air cells, carries off the patient, 
 sometimes suddenly. 
 
PERITONITIS. 
 
 431 
 
 Treatment. When the inflammatory 
 symptoms are high, with much difficulty 
 of breathing and great pain, it may be 
 proper to try a small bleeding; but we 
 must be cautious not to carry it too far, 
 remembering that spurious peripneumony 
 is commonly a disease of aged and infirm 
 people, and that the expectoration may 
 be checked, and the patient be suddenly 
 carried off by effusion into the lungs. It 
 is a safer practice, in general, to apply a 
 large blister over the part affected; and 
 if the disease does not soon yield, a suc- 
 cession of blisters may be tried. An eme- 
 tic is sometimes beneficial, and antimo- 
 nials in small doses may be given, to pro- 
 duce a moderate perspiration ; and diluent 
 drinks, as of gruel or toast-water, are to 
 be freely used. Expectorant medicines, 
 as the squill mixture, are to be given. 
 Costivcness is to be prevented by proper 
 mild laxatives; and to obviate debilfty, 
 we must give nourishing diet and a little 
 wine, avoiding heating and stimulant food 
 and drink. 
 
 PERISTALTIC MOTION of the in- 
 testines. That motion by which one small 
 part of the intestines contracts successive- 
 ly after the part above it, by which the 
 food, chyme, chyle, faeces, or other con- 
 tents are kept moving towards the ter- 
 mination of the alimentary canal, without 
 any retrograde motion. When this mo- 
 tion is inverted by disease, as in rupture 
 or the iliac passion, matters given by way 
 of clyster, are seen to be rejected by the 
 mouth. 
 
 PERITONEUM. The fine membrane 
 which lines the inside of the abdominal 
 cavity, and which also envelopes every 
 portion of the intestines. It is liable to 
 inflammation from various causes, and all 
 wounds of it, or acrid substances applied 
 to any part of it, are apt to excite this in- 
 flammation. 
 
 PERITONITIS, Inflammation of 
 the Peritoneum, is characterised by great 
 tenderness of the whole of the belly, ac- 
 companied by heat, thirst, and other fe- 
 brile symptoms. It is very often a sequel 
 of child-bearing, but by no means exclu- 
 
 sively so, as it often occurs in males. It 
 is distinguished from inflammation of the 
 bowels, principally by there not being 
 complete costiveness; the rest of the 
 symptoms are pretty much the same. The 
 treatment is to be conducted on the ge- 
 neral plan of relieving inflammation, by 
 copious bleeding, by purgatives, especial- 
 ly the saline, by blisters, by antimonials, 
 and the avoidance of all instating circum- 
 stances. 
 
 Peritonitis of Childbed Women. As 
 peritonitis is so frequent a disease of child- 
 bed, we shall be a little more particular 
 in mentioning its symptoms and causes in 
 that state. The patient is seized with shi- 
 verings, succeeded by heat, thirst, a quick- 
 ened pulse, and pain or soreness in some 
 part of the belly. This is much aggra- 
 vated by motion or pressure, and even the 
 weight of the bedclothes is insufferable. 
 The abdomen often becomes swelled, al- 
 most to the size it was before delivery. 
 To obtain some slight ease, the patient 
 lies on her back, with the feet drawn up, 
 and the knees bent. There is often great 
 sickness at stomach, with constant vo- 
 miting of bilious matter. Sometimes 
 there is costiveness, at other times a 
 looseness, or frequent straining at stooL 
 The lochia are sometimes suppressed, but 
 not invariably so. The skin is hot and 
 dry, the pulse small and quick, 130 in a 
 minute ; the thirst is great, the appetite 
 diminished, and the patient is restless and 
 unable to sleep. 
 
 CkLunes. The causes which are apt to 
 induce this inflammation in the puerpe- 
 ral state, are tedious or difficult labour, 
 ofiiciousness in the practitioner, the use of 
 instruments, cold checking the perspira- 
 tion, and the improper use of spirituous 
 or other heating liquors. 
 
 Prognosis. When the symptoms above 
 described persist and go on to worse, 
 when cold sweats break out, and the na- 
 tural discharges take place involuntarily 
 and when the extremities are cold, the 
 disease may be regarded as about to ter- 
 minate fatally. We have better hopes 
 when a gentle perspiration comes out, 
 
432 
 
 PEHSPI RATION. 
 
 when the pulse hecomes fuller, the breath- 
 ing easier, and when the flow of milk re- 
 turns, or that of the lochia, if they have 
 been suppressed. 
 
 Treatment. Bleeding-, although our 
 principal remedy, is to be employed with 
 great caution. In the robust and ple- 
 thoric, Avho have not been weakened 
 by a long and painful labour, or by great 
 loss of blood after delivery, we may 
 bleed pretty largely, if the inflammation 
 has come on early ; but we must be cau- 
 tious how we repeat a general bleeding ; 
 and must be content to abstract blood to- 
 pically by means of leeches. We need 
 not be very limited in the numbers we 
 put on, from one dozen to four may be 
 applied, according to the urgency of the 
 case ; and when they come ofl^, we may 
 cover the whole abdomen with a poul- 
 tice of bread and milk, after foment- 
 ing with hot Avater, or the decoction of 
 chamomile flowers. The action of the in- 
 testines may be promoted, and the irrita- 
 tion and restlessness allayed, by giving at 
 intervals of four or five hours, three grains 
 of calomel with five of Dover's powder, 
 interposing a smart dose of the compound 
 powder of jalap, or of castor oil, or a sa- 
 line purgative. When the disease appears 
 to abate a little, we are to give nourish- 
 ment, being very cautious both with re- 
 spect to the quantity and quality of it. 
 Much care is requisite to avoid a relapse. 
 
 PERSPIRATION. Through the in- 
 numerable pores of the skin, there is a 
 continual discharge of watery vapour, 
 which may be easily perceived by apply- 
 ing the finger to the surface of a bright 
 polished piece of metal, or of a looking- 
 glass, when a dimness will be seen which 
 quickly evaporates into the sun*omiding 
 air. This vapour having answered its 
 purpose in the animal economy, becomes 
 useless and noxious, and requires to be 
 thrown out of the body. Much of this 
 vapour is discharged by the lungs, but a 
 great deal also by the skin, either in a 
 gaseous form, or as a vesicular vapour, or 
 in the more fluid form called sweat. Tlie 
 discharge by the skin sympathizes also 
 
 very much with the secretion by the kid- 
 neys ; and these three organs, the lungs, 
 the kidneys, and the skin, are the three 
 great emunctories of the body, and divide 
 among them the task of throwing oif the 
 superfluous fluids that have circulated 
 through it. In some constitutions, as 
 compared with the generality of man- 
 kind, there is a habitual deficiency of per- 
 spiration; in others, it goes to excess; 
 and as long as these differences do not 
 produce ill health, they need not be much 
 regarded. Great inconvenience and dan- 
 ger arise from the perspiration being 
 checked ; and as cold is one of the most 
 powerful agents in doing this, exposure 
 to cold air, or cold in any other way, is 
 one of the most common causes of dis- 
 ease. It is not easy to enumerate the 
 great variety' of diseases which originate 
 in cold producing a check to perspiration. 
 Difi'erent persons are subject to different 
 diseases from tliis cause. In some, it pro- 
 duces feverish disorders of all their vari- 
 ous forms, inflammations, sore throats, 
 colds, swelling of the glands, and many 
 others : in some it occasions derangement 
 of the stomach and bowels, gripes, loose- 
 ness, or dysenteric symptoms. In our va- 
 riable and uncertain climate, the keeping 
 up of an equable perspiration is one of 
 the principal things to be attended to in 
 th6 preservation of health ; and much of 
 the sufferings from rheumatic complaints, 
 and the multiplied fatal consumptive cases 
 so common in this country, are to be 
 traced to the neglect of this salutary pre- 
 caution. This is to be accomplished by 
 proper clothing, as wearing of flannel 
 next the skin, or chamois, or fleecy ho- 
 siery, or the like; being careful not to 
 expose the body suddenly to cold air, 
 which is often done by persons going 
 from warm rooms, or crowded assemblies, 
 when the perspiration is abundant ; and 
 probably every person that reads this, 
 vnll remember many, and perhaps some 
 fatal cases of diseases brought on, either 
 in his own person or those of his fi-iends, 
 by the unguarded passing from the crowd- 
 ed church or other assembly to the keen 
 
PERSPIRATION. 
 
 i33 
 
 air of a frosty evening. Another very 
 common and pernicious way of checking 
 perspiration is by sitting or standing in a 
 current of air ; hence smoky rooms which 
 require occasionally to have a chink of 
 the window open, are among the exciting 
 causes of colds, toothachs, and sore 
 tliroats ; and hence the merciless button- 
 holder, who keeps you standing at the 
 corner of a street, with the keen north or 
 east wind blowing upon you during his 
 long harangue, is to be avoided, as you 
 value your health and comfort. All di- 
 minution of the usual quantity of cloth- 
 ing must.be made very gradually and ju- 
 diciously. The bedclothes or coverings 
 of the head must not be hastily thrown 
 off or changed ; one fine day in the spring 
 or beginning of summer, must not tempt 
 us to lay aside our flannel clothing, or to 
 adopt the thin Indian dress, which is al- 
 lowable only in confirmed sultry weather ; 
 and our capricious climate often warns 
 us, by an attack of rheumatism or sore 
 throat, that a British May is not entitled 
 to the same panegyric as that month has 
 received, from the pens of the southern 
 poets. It may possibly be objected to the 
 above hints and precautions about the 
 check to perspiration, that their tendency 
 is to encourage a timid and valetudinary 
 spirit, to foster the selfishness so common 
 in those who make their own health and 
 ea.se a primary object, and to make them 
 unfit for the active and regular discharge 
 of the duties of life, which ought to be 
 the purpose of every man. But these pre- 
 cautions are useful and necessary ; good 
 sense must prevent them from being car- 
 ried to excess. It would certainly be a 
 most desirable attainment to be strong 
 and hardy, to be able alike to meet the 
 winter's frost and the summer's heat, to 
 be proof against the numerous privations 
 and inconveniences to which life is sub- 
 ject ; but this independence must be ac- 
 quired at an early age, and our plans must 
 be regulated by the constitution of the 
 child whom we thus propose to harden. 
 A considerable number of children may 
 be thus seasoned ; but there are a great 
 
 many who will require a different ma- 
 nagement, whose clothing must be warm, 
 whose diet must be nourishing, and who 
 must not be unnecessarily exposed to vi- 
 cissitudes of weather. 
 
 In some diseases, especially fevers, the 
 dryness of the skin and the want of per- 
 spiration, is one of the symptoms we are 
 most anxious to remove ; as it is found, 
 that on the restoration of the moisture of 
 the skin, depends the cessation of the 
 sickness and vomiting which are present, 
 and also a diminution of the febrile heat. 
 Excessive perspiration is one of the great 
 signs of hopeless debility in hectic fever, 
 and in some other complaints; and we 
 try to moderate this symptom by regulat- 
 ing the clothing and the temperature in 
 which the body is kept. Astringent 
 medicines, as the sulphuric acid or the 
 elixir of vitriol, are to be given ; but if 
 the sweats be partial, the checking of 
 them by any means, external or internal, 
 is injurious, and not without danger. 
 
 PERUVIAN BARK. See Bark. 
 
 PESSARY. A substance introduced 
 into the vagina, to prevent the falling 
 down of that cavity, or of the uterus, 
 chiefly by giving a mechanical support, 
 and in some measure filling up the pas- 
 sage. They in many cases afford great 
 relief, and by the support they give to 
 the parts, enable them to recover their 
 tone, and so accomplish a permanent 
 cure. Pessaries are of diffierent shapes 
 and materials. They are globular or 
 circular, with all corners rounded off", and 
 a hole in the middle for the convenience 
 of withdrawing it for the purpose of clean- 
 ing. They are made of boxwood, or of 
 metal (but rarely) ; of elastic gum, of cork 
 or linen, covered with a layer of wax. 
 
 PESTILENCE. See Plague. 
 
 PETECHIiE. Dark coloured small 
 spots, like flea-bites, which appear on the 
 skin, but do not rise above it, in bad cases 
 of typhus fever. They always indicate 
 a disease of much malignity, and from 
 their appearance the term spotted fever 
 has been applied to typhus. They show 
 the necessity of plentiful stimulants and 
 2 F 
 
434 
 
 PHLEGM ATI A D O L E N S. 
 
 cordials, as mne, or even brandy, with 
 the use of the Peruvian bark, and aro- 
 matics. 
 
 PETROLEUM. A bituminous sub- 
 stance ; one species of which, the Barba- 
 does tar, is sometimes used as an external 
 application in palsies. 
 
 PHAGEDENIC. A term applied to 
 ulcers, which spread fast, and consume 
 a great deal of the neighbouring- parts. 
 
 PHARMACOPCEIA. A book which 
 contains directions for the preparing and 
 compounding of medicines. Such books 
 are generally published under the sanc- 
 tion of the Colleges of Physicians or 
 Surgeons in the different nations of Eu- 
 rope. 
 
 PHARMACY. The art of preparing 
 and compounding substances to be used 
 for medicinal purposes. Pharmacy in- 
 cludes a great many operations necessary 
 to be used on the various drugs we pos- 
 sess, such as drying, pounding, mixing, 
 boiling, dissolving in spirituous, or other 
 solvents, combining with certain sub- 
 stances, either those of an active kind, 
 or with others, merely to serve for con- 
 veying into the system those which are 
 active. It also includes the art of pre- 
 paring the various plasters and ointments. 
 PHARYNX. The upper part of the 
 gullet, or the back part of the mouth. 
 
 PHLEBOTOMY. Venesection. The 
 act of opening a vein. See Blood-let- 
 ting. 
 
 PHLEGMATIA DOLENS, or White 
 Leg. The swelled leg which often occurs 
 to women after child-birth. It is a tense, 
 clear swellingof one of the limbs, generally 
 beginning at the upper part, and increas- 
 ing pretty quickly ; the pain is considera- 
 ble, and accompanied with fever. It 
 occurs a few days after delivery, and com- 
 monly begins at the groin, the hip, or top 
 of the thigh, being preceded by shiverings, 
 and some feverish symptoms. There is 
 pain, weight, and stiffness, and difl&culty 
 of moving either the body or lower limb. 
 The part complained of is generally hot- 
 ter than natural, a little swelled, but not 
 discoloured ; at length the pain and swell- 
 
 ing increase, and extend to the leg and 
 foot : at which time the pain diminishes, 
 except on motion. The whole extremity 
 is now swelled ; but it does not, like a 
 dropsical swelling, change its bulk by 
 posture, nor does it pit upon pressure, 
 being tense, elastic, and very painful when 
 touched. After continuing for some days, 
 the pain and swelling abate ; at first in 
 the upper part of the limb, and afterwards 
 in the leg and foot. When the acute 
 symptoms are over, the patient feels much 
 weakened, and the limb is stiff, heavy, 
 and weak. It seldom returns to its for- 
 mer size, but remains through life stiff 
 and enlarged, and easily susceptible of 
 cold. Phlegmatia dolens is tedious in its 
 progress, and diflficult of cure; but it 
 rarely goes on to suppuration or gangrene, 
 though instances sometimes occur of 
 these troublesome or fatal terminations. 
 
 Treatment. We are to observe whe- 
 ther the disease be alone, or accompanied 
 with any feverish, or other affection, and 
 to proceed accordingly. If the inflam- 
 matory symptoms are high, a general 
 bleeding may be proper, as also purging, 
 and antimonials ; but such evacuations 
 would evidently be misapplied, if the pa- 
 tient be debilitated by floodings, or pre- 
 vious illness. If the swelled leg be the 
 primary object of our care, one of the 
 best applications at the beginning, is to 
 foment the parts with flannels wrung out 
 of hot vinegar, continuing this for many 
 hours together J assisting its effects by 
 giving purgative medicines of consider- 
 able activity. Other fomentations may 
 be used, as the muriate of ammonia, or 
 solution of sugar of lead. Leeches may 
 be applied in considerable numbers, and 
 their bites covered with an emollient 
 poultice, to encourage the bleeding 
 When the acute symptoms are over, wi 
 are to attempt the diminution of th 
 swelling by frictions with camphorated 
 oil, or other stimulant liniments; and 
 when the general health and strength 
 will admit of it, a brisk purgative may 
 be given, such as jalap, gamboge, or 
 scammony, which have a tendency to aiCt 
 
 M. 
 
 'I 
 
 I 
 
 dl 
 
PHYSIOLOGY 
 
 435 
 
 oil tlie lympliatic system. When the 
 swelling- continues long and obstinately, 
 mercurial ointment may be rubbed on 
 the limb, both for the sake of the local 
 effect, and to brings the system in some 
 measure under the influence of mercury. 
 
 PHLEGMATIC. See Tempera- 
 ments. 
 
 PHOSPHATE OF SODA. A neutral 
 salt of a purgative quality, valuable on 
 account of its not having- the nauseous 
 taste of some other purgative salts ; and, 
 therefore, being fitter for delicate sto- 
 machs. It may be given in broth or 
 beef-tea ; and if we season these liquids 
 with it instead of common salt, it will 
 scarcely be perceived that we are giving 
 medicine. To compensate for this use- 
 ful property, we must add, that its price 
 is considerably greater than Glauber's 
 salts, or Epsom salts. The dose of phos- 
 phate of soda, is from four drachms to an 
 ounce. 
 
 PHRENITIS. Phrenzy. .S'eeBKAiN. 
 Inflammation of. 
 
 PHTHISICAL. Consumptive. 
 
 PHTHISIS PULMONALIS. Wast- 
 ing of the lungs. See Consumption. 
 
 PHYSIOLOGY. If we consider this 
 word according to its derivation, it means 
 a discourse concerning Nature ; but it is 
 now generally employed to denote that 
 science which explains the functions of 
 organized beings, whether animal or ve- 
 getable. Hence we have animal and 
 vegetable physiology. The physiology 
 of man signifies any discussion concerning 
 the animal, vital, or natural functions of 
 the human body. It endeavours to ex- 
 plain the manner of digestion, with the 
 changes Avhich the food undergoes in the 
 stomach and intestines ; the way in which 
 the prepared chyle is conveyed to the 
 mass of blood, and incorporated with it 
 in the circulation through the lungs. 
 It describes the modes and uses of respi- 
 ration, the circulation of the blood, se- 
 cretion, and growth or assimilation. Phy- 
 siology describes also the impressions 
 made on the organs of the senses by ex- 
 ternal objects ; it attempts to trace the 
 
 effects of the mind on the corporeal 
 frame ; and to explain the phenomena 
 of sleep and waking, of sympathy and 
 habit. Muscular motion, as well in its 
 hidden causes, as in its striking effects, 
 furnishes a fruitful topic to the physio- 
 logist. All the above functions pertain 
 to man as an individual ; but those which 
 are connected with the preservation of 
 the species, present a train of investiga« 
 tion which has occupied, but not reward- 
 ed, the researches of the greatest physio- 
 logists. The history of the embryo, of 
 gestation, of labour, and of the nourish- 
 ment of the child by the milk secreted in 
 the breasts of the mother, nearly com- 
 plete the objects of physiology. 
 
 It will be readily seen, of how great 
 importance the science of physiology is, 
 to the general philosopher, as well as to 
 the surgeon and physician. As compris- 
 ing the natural history of the most im- 
 portant of living beings that inhabit our 
 globe, as furnishing the natural theolo- 
 gian with the most beautiful and instruc- 
 tive illustrations of wisdom and design in 
 the Author of nature, physiology ranks 
 high among the objects of human know- 
 ledge; while the physician who is not 
 intimately acquainted with the manner 
 in which the body performs it functions 
 in health, cannot be competent to under- 
 stand the phenomena of disease. 
 
 PILE S. Painful tumours in the neigh- 
 bourhood of the anus. Sometimes they 
 are situated externally, and are found in 
 clusters, hard, painful, and giving great 
 inconvenience by their preventing the 
 person from sitting ; at other times they 
 are within the gut, and are forced out- 
 wards with great pain when the patient 
 goes to stool. Sometimes they are si- 
 tuated so far up, that they do not appear 
 externally at all, but indicate their pre- 
 sence by very great pain, or by the dis- 
 charge of blood. Sometimes the pain 
 attending piles is less, and the principal 
 inconvenience attending them is the dis- 
 charge of blood, either pretty constant, 
 or when a person goes to stool. In some 
 cases, very large quantities of blood are 
 
,^e.^./, 
 
 436 
 
 PILES. 
 
 
 lost in this way. Sometimes, instead of 
 blood, a whitish fluid is discharged. 
 
 Causes. It is not easy in every case 
 to say M'hat is the cause of piles. Few 
 persons who have attained middle age 
 are totally free from them, but in some 
 they are more troublesome, and require 
 more attention than in others. Those 
 who are frequently in a standing- pos- 
 ture, who are subject to costiveness, and 
 those who are much in the habit of tak- 
 ing purgative medicines, especially of 
 aloes, are very liable to have piles. 
 Pregnant women are very often troubled 
 with piles. 
 
 Treatment. When persons have very 
 suddenly got rid of piles, it has not un- 
 frequently happened, that they have ex- 
 perienced various symptoms of ill health, 
 particularly those arising from fulness of 
 blood, as apoplexy, and the like. It has 
 in consequence been a maxim with some 
 physicians, that it is salutary for a per- 
 son to be affected with piles, and that 
 they should not be meddled with, unless 
 the discharge of blood be so profuse as to 
 endanger life, or to bring on a debilitated 
 habit and dropsical tendency. But as piles 
 are both painful and disagreeable, as an 
 overfulness of the system may be pre- 
 vented by other means more safe and 
 more cleanly, as we cannot regulate dis- 
 eases, and make them produce just the 
 change in the system we want, and stop 
 when we wish them, it is better to in- 
 clude piles in the catalogue of maladies, 
 which we are to cure as speedily and as 
 safely as we can. When piles are not so 
 bad as to require the assistance of the 
 physician, but still so troublesome as to 
 annoy the patient, he should be taught 
 to moderate their symptoms by avoiding 
 costiveness, by abstaining from long con- 
 tinuance in the erect posture, from rid- 
 ing, and all other violent exercise, that 
 requires much exertion of the muscles of 
 the trunk of the body. As costiveness is one 
 of the most common causes of piles, this is 
 to be very carefully obviated ; and one of 
 the mildest and safest medicines for this 
 purpose is an electuary composed of equal 
 
 paiis of sulphur and cream of tartar, 
 mixed up with syrup or treacle ; a tea- 
 spoonful of which is to be taken every 
 evening. The saline purgatives, in small 
 and much diluted doses, may answer bet- 
 ter with some ,• and it is to be remember- 
 ed, that we do not M'ant full purging, but 
 merely such a degree of laxity of the in- 
 testines as shall prevent the patient from 
 having hard and large faeces to evacuate. 
 The aloetic purgatives are considered as 
 likely to irritate the parts about the anus, 
 and therefore they are to be avoided. A 
 very essential particular to the comfort of 
 the patient is, that he learn the way of 
 replacing the portion of the gut which is 
 almost always protruded, and that with 
 great pain; and it often happens, that 
 very numerous piles may be kept inside 
 of the rectum without giving much un- 
 easiness, while by neglecting their re- 
 placement, they will be for many hours 
 strangled, and perhaps not cease their 
 smarting till the next stool brings a re- 
 newal of the acute pain and bleeding, 
 with all their inconvenience- When the 
 pain and s\velling about the anus are very 
 severe, we are to apply leeches to the 
 neighbourhood of the part, or to open 
 some of the largest of the tumours by the 
 lancet ; and by squeezing out a quantity 
 of black coagulated blood, their bulk is 
 diminished, and considerable relief ob- 
 tained. When the system in general is 
 affected, as with feverish symptoms, dys- 
 pepsia, gout, fulness, headach, giddiness, 
 and a tendency to apoplexy, it may be 
 proper to take a bleeding from the arm, 
 to purge smartly by saline purgatives, and 
 to open an issue in some convenient place. 
 When a great quantity of blood is lost, 
 it will be proper to confine the patient to 
 the recumbent posture, to evacuate the 
 bowels by castor oil or some mild but ef- 
 fectual laxative, or by a clyster ; and as 
 soon as we have accomplished this, to 
 give an astringent mixture made with ca- 
 techu and mucilage of gum arabic, add- 
 ing such a quantity of tincture of opium 
 as we judge convenient. It may be pro- 
 per also to use astringent clystera, and 
 
PISA, 
 
 437 
 
 when ^\e liave for the present succeeded 
 in restraining the bleeding-, we must take 
 particular care so to manage the food and 
 medicines of the patient as not allow of 
 the accumulation of hardened stools, the 
 difficult evacuation of which would re- 
 new the bleeding from the tender vessels 
 in the neighbourhood of the anus. If 
 the patient has unfortunately been so 
 long of applying for help that a dropsical 
 tendency has taken place, we are to com- 
 bat the debility by nourishing diet, by 
 bark and wine, by elixir of vitriol, pre- 
 parations of iron, and other tonics. 
 
 The piles of pregnant women general- 
 ly go off after delivery ; but as they give 
 a great deal of uneasiness before that pe- 
 riod, and add to their sufferings during 
 labour, it is always proper to pay great 
 attention to the state of the bowels dur- 
 ing the latter periods of gestation. 
 
 PILLS. Such medicines as are of an 
 activ« quality in small bulk, and of a very 
 bitter and nauseous taste, are administer- 
 ed in the form of pills. Sometimes the 
 substance itself is of such consistence that 
 it can be formed into a pill, as opium, or 
 the extract of gentian ; at other times we 
 may add something else to give it bulk 
 and consistence; thus we add soap to 
 form aloetic pills, or liquorice powder 
 and mucilage of gum arabic, or crumb of 
 bread, to other active substances. Pills 
 in general keep their virtues a long time, 
 but some of them become so very hard 
 that they are dissolved with great diffi- 
 culty in the stomach ; and consequently, 
 either do not act at all, or take long time 
 to do so. A number of very useful pills 
 are directed in the Pharmacopoeia, and 
 are kept ready made in the shops, as the 
 aloetic pills, or the pills of aloes and 
 colocynth, for opening the bowels; the 
 compound rhubarb pills, commonly call- 
 ed stomachic pills ; the pills of aloes and 
 assafetida, known by the name of hyste- 
 ric pills, from their utility in the flatulent 
 state of the bowels, which generally at- 
 tends hysteria ; and the squill pills, useful 
 as an expectorant. The common weight 
 of pills is five grains, and in general two 
 
 are taken for a dose. Some people have 
 an unconquerable reluctance to take pills, 
 and we are compelled to give their com- 
 ponent parts in other forms. 
 
 PIMENTA. Allspice, Jamaica pep- 
 per. See Pepper. 
 
 PINE-APPLE, Bromelia Ananas. A 
 delicious fruit growing between the tro- 
 pics, and cultivated in hothouses in this 
 country on account of its supereminent 
 excellence. It has the common virtues 
 of tropical fruits, being juicy and refrige- 
 rant ; as such it may be allowed in cer- 
 tain fevers, at least in their inflammatory 
 stage ; but where there is a tendency to 
 looseness or dysenteric symptoms, it is 
 prudent to avoid its use ; and new comers 
 to the tropical regions must be on their 
 guard against its temptations, as an indul.< 
 gence in the use of the pine-apple very 
 often brings on dysentery. 
 
 PISA, in Tuscany, " has long had the 
 reputation of being one of the mildest 
 and most favourable climates in Italy for 
 consumptive patients. The town is built 
 on the banks of the Aruo, about five miles 
 from the sea-shore. The surrounding 
 country is flat, except towards the north, 
 where a range of hills shelters Pisa in 
 some measure from the winds of that 
 quarter. It is also protected, in a consi- 
 derable degree, from easterly winds, by 
 the lower Tuscan hills. The Arno, in 
 flowing through Pisa, makes a semicircu- 
 lar sweep to the north, so that the build- 
 ings on the northern bank of the river 
 {Lung' Arno) assume the form of a cres- 
 cent facing the south, and shelter the 
 greater part of the broad space between 
 them and the river from northerly winds. 
 This is the principal, and certainly the 
 best residence for delicate invalids. Pisa 
 is not so vj'arm as Rome in winter, and is 
 hotter in summer. In winter^ it is 7" 
 warmer than Loudon, and 2° warmer than 
 Penzance. In springy it is 8° warmer 
 than London, and about 7" warmer than 
 Penzance. For invalids who are almost 
 confined to the house, or whose power 
 of taking exercise is much limited, Pisa 
 offers advantages over either Rome or 
 
438 
 
 PLAGUE. 
 
 Nice; the Lung' Aruo aflfords a warm 
 site for their residence, as well as a shel- 
 tered terrace for their walks. But they 
 must he careful to confine themselves to 
 it. They should not venture into the 
 cross streets before April. (Dr. Clark 
 on Climate.^ 
 
 PITCH is obtained from the pinus or 
 fir-tree. A conical cavity being- dug in 
 the earth, communicating at the bottom 
 with a reservoir, biUets of fir-wood are 
 placed both to fill the cavity and to form 
 a conical pile over it, which is covered 
 with turf and kindled at the top. This 
 wood is made to burn downwards, and is 
 converted into charcoal, and the smoke 
 and vapours are made to descend into the 
 excavation in the ground where they are 
 condensed, and pass into the receiver 
 with the melted matters, and this mix- 
 ture is called Tar. By long boiling, tar 
 is deprived of its volatile ingredients, and 
 then denominated Pitch. Pitch is used 
 as an external application in scalled head, 
 and some other diseases of the skin, either 
 by itself or mixed with the citrine oint- 
 ment ; and pills of pitch have been given 
 in certain stages of consumption, with 
 strong assertions of their utility. The 
 vapour also of pitch or tar has been dif- 
 fused through the apartments of con- 
 sumptive patients, and the inhaling of 
 this vapour has also been thought of ser- 
 vice in such cases. 
 
 PITCH, Burgundy. A resinous mat- 
 ter obtained by exudation from various 
 kinds of fir-trees, when an incision is 
 made through the bark into the wood. 
 Burgundy pitch gives its name to a plas- 
 ter, composed of itself and various other 
 resinous and aromatic substances. It is 
 a very common popular application in 
 pectoral complaints, in disorders of the 
 liver, and in rheumatic affections. Its' 
 good effects, which are unquestionable, 
 are to be ascribed to its keeping a degree 
 of warmth, and so acting the part of a 
 mild stimulant and blister, without going 
 the length of either reddening the skin or 
 occasioning a collection of serum, as mus- 
 tard-poultices or Spanish flies do. 
 
 PLACENTA. See Afterbirth. 
 
 PLAGUE. A febrile disorder of great 
 malignity, prevailing in various countries 
 of the world, and spreading by contagion, 
 which affects more especially the nervous 
 and glandular systems. Soon after the 
 infection is received, the patient is seized 
 with rigors, succeeded by heat, great 
 sinking of the spirits, loss of strength, 
 trembling, fainting, giddiness, headacli, 
 and delirium, with a weak and irregular 
 pulse. Soon there ensues vomiting of a 
 dark matter ; the breath is uncommonly 
 fetid ; and as the disease advances, fiery 
 carbuncles make their appearance, various 
 glands swell, as those in the groin, the 
 neck, and under the arm-pit ; numerous 
 spots or livid marks, as of stripes, appear 
 in different parts of the body, or a dis- 
 charge of blood, or a wasting looseness 
 takes place, with other marks of weak- 
 ness and putrescency. The above symp- 
 toms do not all occur in the same pa- 
 tient. 
 
 Prognosis. The plague is a disease of the 
 utmost danger. The extreme fatality with 
 which it used to be attended in this country 
 and in France, is supposed to be owing to 
 the patients havingbeen neglected through 
 the terror of their neighbours ; as a con- 
 siderable proportion of those who are 
 attacked in the East are said to recover. 
 In the French army in Egypt, about a 
 third recovered. The duration of the 
 complaint is various ,* sometimes the ma- 
 lignant contaffion is so concentrated, that 
 persons have been knocked down and 
 killed, on opening bales of goods which 
 have come from infected places. Some 
 have died in a few hours, others have 
 lived a week or a fortnight. The earlier 
 that buboes appear, the disease is likely 
 to be the milder. When they suppurate 
 kindly, they appear to be critical, or to 
 carry off the disease. A general perspi- 
 ration breaking forth, has appeared salu- 
 tary. When the carbuncles put on a 
 gangrenous appearance, the event will 
 probably be fatal ; as also when there are 
 signs of great putrescency, as petechise, 
 bleedings, and diarrhoea. 
 
PLAGUE. 
 
 Treatment. When a pereon who has 
 been exposed to the conta^on of plague 
 begins to feel unwell, it is proper to re- 
 move all undigested aliment from the sto- 
 mach by giving an emetic, taking care 
 that it do not produce excessive and ex- 
 hausting nausea after the evacuation ; 
 and this, if it happens, is to be allayed 
 by giving eifervescing draughts, or" a 
 small quantity of laudanum. It will be 
 proper also to empty the bowels by some 
 mild, but effectual purgative, avoiding 
 diarrhoea, on account of the great weak- 
 ness which we may expect in the course 
 of the disease. Some have proposed and 
 practised bleeding, but with very bad 
 success. A gentle perspiration has ap- 
 peared in some cases to carry off the dis- 
 ease ; and we may attempt this by anti- 
 monial medicines, or the diluted acetate 
 of ammonia J but profuse debilitating 
 sweats are highly pernicious, and must by 
 all means be avoided. The experience of 
 late years, and the happy terminations of 
 some unintentional experiments made by 
 patients, who in delirium or despair made 
 their escape from camps and hospitals, 
 and were exposed to cold air or cold wa- 
 ter, have occasioned a proposal to treat 
 patients in the plague by the application 
 of the cold affusion, as in typhus fever. 
 Instances have occurred, where persons 
 in delirium have thrown themselves into 
 the sea or a river, and been taken up 
 nearly free from complaint; and others 
 have wandered about, exposed to the 
 €0ld dews of the night, and returned to 
 the camp in health. The other remedies 
 proper to be given in the plague, seem to 
 be p-retty nearly the same as those for the 
 bad kinds of continued fever, viz. the mi- 
 neral and vegetable acids; diminishing 
 the heat of the body by prudent spunging 
 with vinegar and water; giving medicines 
 to allay irritation and procure sleep, as 
 camphor or opium ; frequently changing 
 the bed and body-linen of the patient, 
 and quickly removing all offensive mat- 
 ters from his apartment. The buboes 
 and carbuncles must be treated in the 
 *vay described under those ai'ticles. 
 
 Preventioji of the Plague. It is a 
 matter of extreme importance in every 
 country, to prevent the plague from 
 breaking out among its inhabitants ; and 
 happily this is in a considerable degree 
 within the power of legislation, except in 
 those Eastern regions which are its birth- 
 place. The great means of spreading the 
 plague, is by the contact with infected 
 persons, or the contact of substances to 
 which the pestilential infection adheres, 
 as clothes, cotton, furniture, papers, and 
 the like. The introduction of these from 
 countries where the plague is known to 
 be, is prevented by shutting out all com- 
 munication ; in inland countries, by guards 
 or cordons of troops; and in maritime 
 states by the quarantine laws, interdict- 
 ing all communication with vessels com- 
 ing from those countries for a certain 
 number of days, and carefully fumigating 
 every letter, and piece of goods that comes 
 out of them. When the plague has broken 
 out in a place, every effort must be made 
 to destroy the contagion, and to prevent 
 its spreading. For this purpose, lazaret- 
 toes, or plague hospitals should be formed, 
 to make a complete separation between 
 the sick and the healthy. Those who 
 must of necessity be employed about the 
 sick, should avoid unnecessary contact or 
 nearness to them, should pay much atten- 
 tion to cleanliness, and should often 
 change their clothes, and wash their hands 
 with warm wate;* and vinegar. Much 
 attention should be paid to ventilation, 
 and the sound should, on such occasions, 
 keep to windward of the sick. All putrid 
 matter, and discharges from the bodies of 
 patients should be immediately removed 
 from their apartments, and dead bodies 
 should be very speedily buried or com- 
 mitted to the deep. All debilitating 
 agents should be avoided, as intemper- 
 ance, depressing passions, violent exer- 
 cise, night watching, poor diet, and 
 weakening evacuations. Any thing worn 
 about the person, however insignificant 
 in itself, if it gives confidence to the pa- 
 tient, will be of service in enabling him 
 to resist contagion; hence, camphor. 
 
440 
 
 PLASTERS. 
 
 vinegar, or any aromatic, may sometimes 
 act as a preventer of the plague. Fric- 
 tion of the body with oil, has obtained 
 the reputation of a positive antidote, and 
 some have gone so far as to say that there 
 is no instance of a person who has dealt 
 much in the handling of oil, who has 
 been attacked with the plague. It is 
 certainly a very innocent measure of pre- 
 caution, and as such it ought not to be 
 neglected. It has been said, that friction 
 with oil has cured the plague when the 
 infection has been received, but this is 
 by no means probable. Inoculation with 
 the matter of carbuncles has been in some 
 rash instances attempted, but with fatal 
 results; and as persons may take the 
 disease twice, inoculation, even if it ren- 
 dered the disease in the fii-st case mild, 
 would not deserve to be practised. The 
 serious inconvenience of ships and pas- 
 sengers being obliged to perform quaran- 
 tine, renders it an interesting inquiry 
 how far quarantine laws are necessary ; 
 and though the unjustifiable assertions 
 of some medical men with regard to the 
 non-contagious nature of the plague should 
 be totally disregarded, it may be allow- 
 able in some instances to make the period 
 of quarantine less than forty days, using 
 the fumigation and all the proper precau- 
 tions that experience has shown to be 
 necessary in such cases. 
 
 PLANTAIN-TREE, Musa Paradi- 
 siacoy grows in India and South America. 
 It is a herbaceous tree, growing to the 
 height of fifteen or twenty feet. The 
 fruit are nearly of the shape and size of 
 ordinary cucumbers; and when ripe, of a 
 pale yellow colour, of a mealy substance, 
 a little clammy, with a sweetish taste, 
 and will dissolve in the mouth without 
 chewing. When they are brought to 
 table by way of dessert, they are either 
 raw, fried or roasted ; but if intended for 
 bread they are cut before they are ripe, and 
 are then either roasted or boiled. (Hoop- 
 ER*s Medical Dictionary.) 
 
 PL Asters are combinations of oily 
 and resinous matters of considerable te- 
 nacity and consistence ; which may have 
 
 various substances combined with them, 
 according to the use for which they are 
 intended. Some plasters are applied to 
 the sound skin, as the Burgundy pitch 
 plaster, or the strengthening plaster; 
 where they produce their effects, what- 
 ever they be, without breaking the skin, 
 probably by the support they commu- 
 nicate to the skin and internal parts. 
 Thus, though the oxide of iron enters 
 into the corapositiou of the Etnplastrum 
 rohorans or strengthening plaster, it is 
 impossible that any good can result 
 •from the tonic virtues of the iron. The 
 blistering plaster is intended to raise the 
 cuticle in a blister; and the adhesive 
 plaster is fixed on sound skin, and pass- 
 ing over a wound or ulcer, is intended 
 to bring its sides together, and to sup- 
 port the neighbouring parts. The mode 
 of treating ulcers of the legs by straps 
 of adhesive plaster, has been found very 
 successful. Other plasters are applied 
 over indolent sores, being spread with 
 some irritating substance to excite a pro- 
 per healthy action. 
 
 PLETHORA. The medical term for 
 fulness of the system. This is a state 
 which is not desirable, as it disposes the 
 body to many diseases. A plethoric 
 state is marked by plumpness, fulness of 
 countenance, a high colour, frequent 
 dimness of sight, ringing of the ears. It 
 is often accompanied by corpulency, and 
 a great accumulation of fat about the 
 belly. It is generally the consequence of 
 high living, of indolence and want of ex- 
 ercise, with much indulgence in sleep 
 and luxury. There are some who, with- 
 out any fault of their own, become ple- 
 thoric ; but, in general, it may be avoid- 
 ed by moderate living, by taking suffi- 
 cient exercise, and by keeping up the re- 
 gular employment both of body and mind. 
 Plethoric people are liable to a long train 
 of dangers and inconveniences. They 
 are apt to lose breath, or to perspire on 
 the slightest exertion; they are subject 
 to headach, vertigo, palsy, and apoplexy ; 
 to bluntness of all their faculties, to sto- 
 mach complaints, to low spirits, and a 
 
PLI 
 
 POI 
 
 411 
 
 variety of other uncomfortable sensa- 
 tions. It is not a good plan for a person 
 of a full habit of body to attempt to get 
 rid of it by bleeding. This rather tends 
 to increase the evil, and begets a necessity 
 for its own repetition. Plethoric persons 
 are apt to faint, even after a very small 
 bleeding. In addition to regimen and the 
 care of the general health, frequent pur- 
 gatives are proper, and a course of mine- 
 ral waters is often very salutary. 
 
 PLEURA. The membrane which in- 
 vests the lungs, and which is reflected 
 to line the inside of the ribs, and other- 
 parts of the parietes of the chest. It is 
 a serous membrane, and is very liable to 
 acute inflammation. Of the symptoms 
 and treatment of this disease, we have 
 given an account under Lungs, Inflam- 
 mation of . 
 
 PLEURITIS. Inflammation of the 
 Pleura. See the preceding definition. 
 
 PLICA POLONICA, Plaited Hair. 
 A disease in which the hairs are thicker 
 than usual, and so. entangled that it is 
 impossible to separate them. It is en- 
 demic in Poland, Lithuania, Hungary, 
 and some of the neighbouring countries. 
 There appears to have been a great deal 
 of ignorance and prejudice respecting 
 this disease ; it has been said to be con- 
 tagious, that the discharge by the canals 
 of the hair is critical, and cannot be 
 checked without danger. Baron Larrey, 
 when at Warsaw with the French army, 
 carefully investigated the nature of this 
 disease, and was fully satisfied that it is 
 a local and factitious complaint, produced 
 by dirt and neglect ; likewise, that it is 
 not contagious, and may be cured with 
 safety, notwithstanding the absiu-dities 
 which prejudice has set forth to the con- 
 trai'y. The head is to be shaved, and 
 an ointment applied, made of equal parts 
 of sulphur ointment and pitch ointment, 
 and the head is to be frequently washed 
 with soap and water. Mercury, rubbed in 
 with haii'-powder, is good for destroying 
 the vermin. Internal remedies, as Plum- 
 mer's pill, or small doses of calomel, may 
 in some cases be necessary. 
 
 PLUiMMER'S PILLS. A medicine 
 composed of antimony and mercury, 
 contrived by Dr. Plummer of Edin- 
 burgh, and used as an alterative in ge 
 neral derangement of the health. The 
 dose is one or two pills night and morn- 
 ing. 
 
 PLUMS, Prunus domestica. A stone 
 fruit, pleasant to the taste, much used for 
 tarts and pies, but unwholesome and in- 
 digestible with many, even when ripe. 
 When unripe, they almost certainly pro- 
 duce colic, looseness, cholera, or dysen- 
 teric symptoms. When dried, they are 
 called prunes ; and these, when boiled, 
 alone or with senna, are used as a laxa- 
 tive. 
 
 PNEUMONIA. See Lungs, Inflame 
 mation of. 
 
 POISONS may be defined to be sub- 
 stances, which, applied to the animal 
 body in very small quantity, with consi- 
 derable certainty destroy life. The in- 
 vestigation of the numerous substances 
 Avhich have this power, and their chemi- 
 cal and medical history, with the means 
 of counteracting their effects, forms a 
 very extensive and important branch of 
 science, known by the name of Toxico- 
 logy ; which has of late years been dili- 
 gently cultivated, and which has given 
 us juster views than we formerly had, 
 of the action of various poisons and their 
 remedies. Different poisonous substances 
 produce their effects on the body in very 
 different modes, and those effects are to 
 be explained in almost every case by the 
 operation of the vital powers ; sometimes 
 by chemical laws, and very rarely by me- 
 chanical action. Poisons differ in their 
 action according to the parts to which 
 they are applied. The poison of the vi- 
 per and other snakes, will kill in a very 
 short time, when introduced into a wound, 
 but may be taken into the stomach with- 
 out any injury ; while others, as the caus- 
 tic alkalies and acids, corrosive subli- 
 mate of mercury, and some chemical 
 substances, exhibit their deleterious ac- 
 tion on the stomach. Other poisons are 
 equally destructive to whatever part thc^ 
 
442 
 
 POISONS. 
 
 may l>e applied, whether to the stomach, 
 the lower part of the bowels, the mouth, 
 the eye, or to an abraded portion of the 
 skin. There are poisons also which ex- 
 ist in the form of gas, and can be receiv- 
 ed by the breath or by the saliva ; the 
 most remarkable instance of this is the 
 very concentrated contagion of certain 
 diseases, as the plague or other fevers. 
 
 Various classifications of poisons have 
 been proposed. A very obvious one is 
 that which arranges them, according as 
 they are derived from the three king- 
 doms of nature, animal, mineral, or ve- 
 getable ; or they may be classified from 
 their apparent and most obvious effects. 
 
 Dr. Christison, in his late excellent 
 Treatise on Poisons, arranges them in 
 three classes : L The IrritantSy which in- 
 clude all those poisons whose sole or pre- 
 dominating symptoms ai'e those of irrita- 
 tion or inflammation. 11. T\ve NarcoticSy 
 those which produce stupor, delirium, and 
 other affections of the brain and nervous 
 system. III. The Narcotico-acridsy those 
 which cause sometimes irritation, some- 
 times narcotism, sometimes both together. 
 
 I. The class of irritant poisons com- 
 prehends both those which have a pure- 
 ly local, irritating action ; and, like- 
 wise, many which also act remotely, but 
 whose most prominent feature of action 
 is the inflammation they excite wherever 
 they are applied. This class comprehends 
 five orders : 1. The acids and their bases, 
 as the sulphuric, nitric, muriatic and phos- 
 phoric, with their bases, phosphorus, sul- 
 phur, and chlorine ; with these may be 
 likewise arranged iodine and its com- 
 pounds, and also oxalic acid. 2. The 
 alkalies and their salts, potash and its 
 carbonate, nitre, lime, ammonia, and sul- 
 phuret of potash. 3. The compounds of 
 the metals, viz. the oxides and salts of 
 arsenic, mercury, copper, antimony, tin, 
 silver, gold, bismuth, zinc, and lead. 
 4. Various genera from the vegetable king- 
 dom, as some of the drastic purgatives, 
 elaterium, gamboge, colocynth, savine ; 
 and some animal matters, as cantharides, 
 fish-poisons, the poison of serpents, and 
 
 animal matters become poisonous by dis- 
 ease or putrefaction. 5. Mechanical ir- 
 ritants, as copper, iron, glass, and the 
 stones of fruit, which sometimes produce 
 inflammation and death, tliough they are 
 often swallowed with impunity. 
 
 II. The narcotic class contains opium, 
 henbane, cherry-laurel, peach-blossoms, 
 bitter almonds, and the prussic acid, on 
 which the bad properties of several of 
 these vegetables depend. Some of the 
 poisonous gases are comprehended under 
 this head, as carbonic acid gas, chlorine, 
 ammonia, and sulphuretted hydrogen gas, 
 which last sometimes proves fatal to 
 those employed in cleaning out drains. 
 
 III. The narcotico-acrids possess a double 
 action, the one local and irritating, the 
 other remote, and consisting of an im- 
 pression on the nervous system. They 
 are all derived from the vegetable king- 
 dom. The principal of them are deadly 
 night-shade, thorn-apple, {datura stra- 
 monium) and tobacco ; hemlock, water- 
 lock, monks-hood, black hellebore, nux 
 vomica, poisonous mushrooms, foxglove, 
 &c. camphor, cocculus indicus, &c. An- 
 other arrangement has been proposed, 
 according to the different primary ope- 
 rations by which they produce their ef- 
 fects ; whether as acting through the me- 
 dium of the nerves without being ab- 
 sorbed, or as entering the circulation, or 
 as producing a direct local action on the 
 alimentary canal. The details of this 
 classification Avould be too subtile for the 
 general reader. 
 
 The subject of poisons was long in- 
 volved in great mystery, and was the 
 object of much credulity among man- 
 kind. Many superstitious terrors were 
 connected with, it, and the ^vriters of 
 poetry and romance lent their helping 
 hand to confirm the popular delusions 
 regarding poisons. It was believed that 
 it was possible to introduce into the sys- 
 tem, a poison so nicely adjusted, that it 
 would procure the death of an individual 
 at any given moment, weeks, or months, 
 after it had been administered; that it 
 could be conveyed by means of snuff, or 
 
Poisons. 
 
 443 
 
 letters, or g-love^, or various other ways 
 equally unsuspected. Some atrocious 
 occurrences which happened in France 
 during ten years of the most splendid part 
 of the reig-n of Louis XIV. spread great 
 alarm on the suhject of poisons. Many 
 persons of rank connected with the pro- 
 fligate court of that monarch, were be- 
 lieved to have employed poison to accom- 
 plish their purposes of love, ambition, or 
 revenge. The secrets appear to have 
 been first vended by a ruined alchymist 
 of the name of Exili; and from 1670 to 
 1680, so many crimes were perpetrated, 
 and so many persons accused, that a par- 
 ticular tribunal was erected for the trial 
 of poisoning, and obtained the name of 
 the Chamhre Ardente. Several persons 
 who were convicted of selling succession- 
 powder were burned at the Place de 
 Greve. Several individuals of rank also, 
 suffered by the hand of the executioner, 
 for poisoning some of their relations 
 and others. Before leaving this horrible 
 subject, we may state, from Dr. Christi- 
 son, the supposed effects of " the cele- 
 brated Aqua Toffantty or Acquetta di 
 Napolif a slow poison, which in the six- 
 teenth century was believed to possess 
 the property of causing death at any 
 determinate period, after months, for 
 example, or even years of ill health, ac- 
 cording to the will of the poisoner. The 
 most authentic description of the Aqua 
 Toffana ascribes its properties to arsenic. 
 Hahnemann gives the following account 
 of the symptoms. They are a gradual 
 sinking of the powers of life, without any 
 violent symptom; a nameless feeling of 
 illness, failing of the strength, slight fe ver- 
 ishness, want of sleep, an aversion to 
 food and drink, and all the other enjoy- 
 ments of life ; lividity of the countenance. 
 Dropsy closes the scene, along with black 
 miliary eruptions and convulsions, or col- 
 liquative perspiration and purging. 
 
 ** Whatever were its real effects, there 
 appears no doubt that it was long used 
 secretly io Italy to a fearful extent, the 
 monster who has given her name to it, 
 having confessed that she was instrumen- 
 
 tal in the death of no less than six hun- 
 dred persons. She owed her success, 
 however, rather to the ignorance of the 
 age than to her own dexterity. At all 
 events, the art of secret poisoning cannot 
 now be easily practised. Indeed, even 
 the vulgar dread of it is almost extinct." 
 
 A similar credulity existed with respect 
 to antidotes, or substances that had the 
 power of rendering poisons harmless. It 
 was believed that every poison had its 
 own antidote, which was certain of coun- 
 teracting it ; and that a person by taking 
 an antidote in the morning, was secured 
 from danger by poison during the whole 
 day. Much of this credulity about poisons 
 and their antidotes is now done away; 
 and when noxious substances have been 
 swallowed, remedies are applied, with 
 juster views of the animal economy. The 
 cases in which an antidote may be most 
 plausibly suggested is that in which a 
 substance has been swallowed, whose 
 chemical nature is so well known and so 
 much under our power, that we can de- 
 compose or neutralize it in our labora- 
 tories ; thus, if an acid has been swal- 
 lowed, what is more likely to do good, 
 than giving an alkali ? or when a com- 
 pound salt has been taken, than giving 
 some other to decompose it ? But when 
 a substance has once got into the stomach, 
 it is not so easily under our command as 
 if it were in our mortal's or vials ; some 
 mischief may have been done before our 
 remedy is applied, or the product of our 
 decomposition may be as virulent as the 
 original substances. We are therefore 
 not to trust to chemical, but to vital 
 ag-ents, in our treatment of those who 
 have swallowed poison. 
 
 Poisoning, Treatment in cases of. 
 When a poisonous substance has, either 
 by accident or design, been introduced 
 into the alimentary canal, three important 
 indications are to be fulfilled. 1. Throw- 
 ing the substance out of the body as 
 quickly as possible, by vomiting and purg- 
 ing. 2. Decomposing any remaining 
 portion, and endeavouring to prevent its 
 being absorbed. 3. Endeavouring to 
 
444 
 
 POISONS. 
 
 prevent the consequences we have reason 
 to fear, whether these be inflammation, 
 stupor, or exhaustion of the nervous 
 energy. 1. To eject the poison from the 
 body is in all cases to be done as speedily 
 as possible. If a mineral acid or a caus- 
 tic alkali has been swallowed, we may 
 give such agents as will have a chance of 
 neutralizing it; and then vomiting is to 
 be excited by thrusting the finger down 
 the throat, or tickling the back part of 
 the mouth with a feather; or by using 
 the stomach-pump, A^hich, though uewly 
 brought forward, is said to have been 
 proposed by Boerhaave. If we can have 
 our choice of emetics, those are the best 
 which act quickly, and do not require 
 to have much diluting fluid taken with 
 them; the white vitriol (sulphate of zinc) 
 given in the dose of thirty grains, or the 
 blue vitriol (sulphate of copper) in the 
 dose of eight grains, in general operate 
 very speedily. If we cannot get these, 
 we must take such as are at hand, anti- 
 mony or ipecacuan, or mustard, or com- 
 mon salt. 2. To decompose any sub- 
 stance that may not be vomited, and to 
 prevent its absorption, we are to consider 
 whether the substance is in a solid form, 
 and whether it acts by being absorbed ; 
 if so, it may not be safe to assist its action 
 by administering to the sufferer any fluid 
 which will dissolve it ; and if it be liquid, 
 our plan is to render its active portion in- 
 soluble. Hence the necessity of knowing 
 the various agents which exert a chemi- 
 cal effect on the substance swallowed. 
 Corrosive sublimate, and other substances 
 which act locally on the stomach and are 
 not absorbed, are best treated by copious 
 dilution, and afterwards by vomiting. 
 Arsenic is aided in its deleterious effects 
 by magnesia and alkaline solutions, be- 
 cause these render it more soluble; but 
 lime or the carbonate of lime (chalk) 
 forms with arsenic an insoluble substance. 
 When verdegris has been swallowed, 
 vinegar will increase its destructive pow- 
 ers by forming a soluble poisonous salt. 
 If opium has been taken in too great 
 quantity, vinegar and lemonade will assist 
 
 to dissolve it, and render its operation 
 more speedily fatal; but if the opium 
 has been thoroughly ejected from the 
 stomach, the same or other vegetable 
 acids will counteract the stupor which 
 is almost sure to follow. When we have 
 done all in our power by the use of eme» 
 tics, their continuance in nauseating doses 
 is to be avoided, as this encourages ab- 
 sorption ; and modern experiments have 
 demonstrated that blood-letting also pro- 
 motes absorption ; hence we must not 
 be induced by the appearance of symp- 
 toms of inflammation to bleed in cases of 
 poisoning by arsenic. 3. The probable 
 consequences of poisons are to be coun- 
 teracted according to their peculiar cha- 
 racters. If we anticipate great exhaus- 
 tion of the nervous energy, most assuredly 
 we must not bleed, but apply ammonia, 
 external M^armth, and other stimulants. 
 If we anticipate inflammatory symptoms, 
 our views must be directed to prevent 
 them by purgatives or blood-letting; and 
 if stupor is to be dreaded, vegetable acids, 
 tea, or coffee, may be useful ; while high 
 nervous excitement or spasms require the 
 use of opiates. 
 
 The substances whose deleterious ef- 
 fects most frequently come under the 
 care of the medical practitioner, are the 
 following : the mineral acids, vitriol (sul- 
 phuric acid), aquafortis (nitric acid), 
 oxalic acid, and saltpetre, which two are 
 sometimes given by mistake for purging 
 salts ; corrosive sublimate, arsenic, opium, 
 night-shade, preparations of copper, prus- 
 sic acid in the shape of laurel-water, or in 
 simple solution, or very concentrated; 
 also the salts of lead ; hemlock, tobacco. 
 We refer for the treatment of poisoning 
 by the individual substances, to their res- 
 pective names. See Viper, Hydropho- 
 bia, Prussic Acid, &c. 
 
 POLYPUS. An excrescence grow- 
 ing in certain cavities of the body, most 
 commonly in the nose, or the uterus and 
 vagina. They are often very trouble- 
 some and painful, altering the shape, and 
 impeding the functions of the part in 
 which they are found. They are some- 
 
PORTER. 
 
 445 
 
 times with a broad base or attachment, 
 at other times they arise by a narrow- 
 neck, and are very subject to bleeding ; 
 when cut, unless it be done very com- 
 pletely, and even a portion of the healthy 
 structure taken along- with it, they are 
 apt to g-row faster than before. They are 
 often in such a situation that they cannot 
 safely be cut, or have caustic applied to 
 them ; and the polyi^i most likely to be 
 safely removed, are those which, having 
 narrow bases or necks, allow of a ligature 
 being put upon them, by which the influx 
 of nourishment being prevented, they 
 drop off. 
 
 The clots of blood found in the cavi- 
 ties of the heart after death are called 
 Polypi. 
 
 POPLITEAL ANEURISM is situat- 
 ed in the artery at the ham. It is believ- 
 ed to occur very frequently in postilions, 
 from the bent position of their knee-joint. 
 This species of aneurism is worthy of 
 mention, as being the one for the cure of 
 which the great modem improvement in 
 the treatment of aneurism was proposed. 
 This consists in putting a ligature on the 
 vessel, at a place far from the aneurismal 
 sack, by which the current of blood is 
 prevented from reaching the sack, and a 
 cure of the disease is effected. See Aneu- 
 rism. 
 
 POPPY, WHITE, Papaver somnife- 
 rum. The plant from which opium is 
 procured. (See Opiuai.) A strong decoc- 
 tion of dried poppy heads mixed with as 
 much sugar as is su.>lcient to reduce it to 
 the consistence of a syrup, becomes fit for 
 keepinj^ in a liquid form, and is called 
 syrup of poppies. It has some of the nar- 
 cotic and anodyne properties of opium, 
 and is sometimes given to infants in the 
 dose of one or two tea-spoonfuls ; but it 
 is a very unequal preparation, and the 
 real quantity of opium which it contains 
 is uncertain ; and as Dr. Duncan, junior, 
 observes, it is by no means equal to sy- 
 rup, to which a certain quantity of solu- 
 tion of opium is added. 
 
 An anodyne cataplasm is made of white 
 poppy heads, and it may be rendered more 
 
 sedative, if necessary, by adding a solu- 
 tion of opium or of the extract. For fo- 
 mentation with the white poppy, four 
 ounces of the heads are added to six Eng- 
 lish pints of water, which are reduced, by 
 boiling, to a quart. This is a good appli- 
 cation in painful ophthalmia. 
 
 PORRIGO, Ringworm of the Scalp, 
 Scalled Heady &c. A contagious disease, 
 unaccompanied by fever, principally cha- 
 racterised by an eruption of pustules con- 
 taining a straw-coloured matter, succeed- 
 ed by a thin, brown, or yellowish scab. 
 See Scalled Head. 
 
 PORTLAND POWDER. A compo- 
 sition of vegetable bittei*s, viz. gentian, 
 centaury, and germander, once famous 
 for its supposed virtues in the cure of 
 gout, but now laid aside from experience 
 of its useless, and even pernicious pro- 
 perties. See Gout. 
 
 PORTER is made from high dried 
 malt, and differs from other malt liquors 
 in the proportions of its ingredients, and 
 the peculiar manner in which it is manu- 
 factured. It agrees with other malt li- 
 quors, in its nutritive properties, in its 
 tendency, when moderately taken, to as- 
 sist digestion; and when too much in- 
 dulged in, to occasion corpulency. Dr. 
 Paris thinks, that the accounts, so com- 
 mon of its being adulterated, are very- 
 much exaggerated ; and that it is at least 
 certain, that such adulterations are not 
 carried on in the caldrons of the brewer, 
 but in the barrels of the publican. We 
 certainly hear a great deal about the quan- 
 tities of opium, quassia, cocculus Indicus, 
 and other noxious herbs used by the 
 brewers ; and it is satisfactory to be in- 
 formed by such authority, that these use- 
 ful tradesmen are unjustly accused. Dr. 
 Paris gives the following piece of history 
 respecting porter. " Before the yeai* 
 1 730, the malt liquors in general use in 
 London were ale, beer, and twopenny, 
 and it was customary to call for a pint or 
 tankard of half and half, i. e. half of ale 
 and half of beer, half of ale and half of 
 twopenny. In course of time it also be- 
 came the practice to call for a pint or 
 
UG 
 
 POTATO. 
 
 tankard of three threads^ meaning a third 
 of ale, beer, and twopenny, and thus the 
 publican liad the trouble to go to three 
 casks and turn three cocks, for a pint of 
 liquor. To avoid this inconvenience and 
 waste, a brewer of the name of Harwood, 
 conceived the idea of making- a liquor 
 which should partake of the same united 
 flavours of ale, beer, and twopenny. He 
 did so, and succeeded, calling it entire, or 
 entire butt, meaning that it was drawn en- 
 tirely from one cask or butt; and as it 
 was a very hearty and nourishing liquor, 
 and supposed to be very suitable for por- 
 ters and other working people, it obtain- 
 ed the name of Porter." 
 
 PORT WINE. The red wine brought 
 from Portugal, which, when new and un- 
 mixed, is rough, strong, and slightly sweet; 
 but when kept in bottle for a proper 
 length of time, loses some of its astrin- 
 gency, and most part of its sweetness ; its 
 flavour is improved, and its strength con- 
 tinues. Almost all the port wine which 
 comes to this country, has various pro- 
 portions of brandy added to it; and to 
 this brandy is to be ascribed much of the 
 heating properties of port wine, discover- 
 ed both by the palate and the constitu- 
 tion. Port wine loses almost all its good 
 properties when too long kept in bottle. 
 When port wine of good quality is taken 
 in moderation, it is very wholesome ; it 
 imparts strength to the muscular system, 
 quickens the circulation, and exhilarates 
 the spirits. When taken in excess, it is 
 one of the worst of wines, and produces 
 most of the pernicious effects of distilled 
 spirits, viz. disorders of the digestive or- 
 gans, a dull state of the mental faculties, 
 and obstinate organic affections of the 
 liver and other parts. 
 
 POTASH. The name of one of the 
 alkalis, which class of bodies are distin- 
 guished by their peculiar taste, their power 
 of changing the vegetable blues to green, 
 of neutralizing acids, and forming soaps 
 with oil. As a medicine, potash is of con- 
 siderable importance. When pure, and 
 deprived entirely of water, it is used as a 
 caustic to destroy the skin for the forma- 
 
 tion of an issue ; or its solution of a defi- 
 nite strength, as directed in the pharma- 
 copoeia, given in the proportion of twenty 
 drops to two ounces of water, may be 
 given internally in cases of a tendency to 
 stone or gravel. 
 
 POTASH, Carbonate of. Potash is 
 more generally used in combination with 
 the carbonic acid ; by which it is render- 
 ed milder, and still the alkaline proper- 
 ties to a considerable degree preserved. 
 The carbonate of potash is given in dys- 
 peptic cases, in the dose of a drachm three 
 or four times a-day, in water, or infusion 
 of chamomile flowers ; and in cases of 
 stone, ten grains may be given as often. 
 The carbonate of potash is used in com- 
 bination with lemon-juice, to form the 
 effervescing draughts useful for stopping 
 vomiting, and for determining to the sur- 
 face of the body. 
 
 POTATO. A well known vegetable, 
 the roots of which form so great a pro- 
 portion of the food of the people of this 
 kingdom. There are some stomachs to 
 which it is rather indigestible, especially 
 when not properly boiled ; and in the de- 
 ranged state of the bowels of children, it 
 should be avoided, whether solid, or 
 boiled down into potato-soup. It is very 
 apt to occasion looseness of the bowels in 
 children, or to increase it when already 
 present ; and in such cases we must- lay 
 aside the use of potatoes, and give them 
 old bread to eat with the small portion of 
 animal food allowed them. Bread and 
 milk, or sago, or ari»^w-root, with milk, 
 or a little port wine, must be their prin- 
 cipal diet while their illness lasts. . Mash- 
 ing potatoes, does not make them more 
 easily digested; they are thus less inti- 
 mately mixed with the saliva, when mas- 
 ticated ; and it adds to their bad qualities 
 for invalids when they are much soaked 
 with the fat of roast meat. Potatoes 
 should not be overboiled, as this deprives 
 them greatly of their nourishing qualities. 
 
 POULTICES are emollient applica- 
 tions applied warm to a part, with a view 
 to relax and soften it, and to promote 
 suppuration by the continuance of a due 
 
POWDERS. 
 
 447 
 
 degree of heat. One of the best applica- 
 tions of this kind is the common bread 
 and milk poultice, of a consistence thick 
 enough to prevent its spreading farther 
 than we intend, but not so hard as to fret 
 or irritate the skin. In some cases, as 
 when applied over the eye, it may be use- 
 ful to inclose the poultice between folds 
 of fine linen. Poultices should be applied 
 as warm as the patient can easily bear, 
 and should be changed frequently when 
 it is our object to bring on suppuration 
 quickly. Sometimes the skin round the 
 place where a poultice is put on, is so 
 much irritated as to become covered with 
 fiery pustules. In this .case, the poultice 
 must either be changed or discontinued, 
 and dry powders or simple ointment ap- 
 plied to the pustules. 
 
 POWDERS. Many medicines are 
 prepared in the form of powders, both 
 vegetable and mineral. The roots of 
 plants, their bark, their resins, their dried 
 leaves, are all capable of being reduced to 
 powder; and many of the alkaline and 
 metallic salts, and earthy bodies, are kept 
 by the apothecary in that form. It is 
 rare, however, that they can be adminis- 
 tered in the form of powder, and there 
 are therefore various ways of dispensing 
 powders. When their taste is very nau- 
 seous, and when a small quantity acts 
 strongly, they are formed into pills ; when 
 any portion of them is heavy, as calomel, 
 it may be given mixed in jelly, honey, or 
 conserve of roses; when it does not 
 greatly exceed the weight of water, it 
 may be given in water or tea, or beer, or 
 thin gruel, stirring it before it is drank. 
 Some medicines are given in the form of 
 powder,, because, to obtain their full ef- 
 fects, a combination of all their principles 
 is necessary. This is the case with Pe- 
 ruvian bark, jalap, ipecacuan, and some 
 others. Some medicines answer best 
 when they are not reduced to the utmost 
 degree of fineness, as bark, rhubarb and 
 guaiac, with some aromatic substances, 
 which seem to lose some essential part by 
 a very minute division. There are some 
 substances used in medicine, which are 
 
 best reduced to powder by the addition 
 of some other substance. Thus opium is 
 powdered with ipecacuan and a salt called 
 the sulphate of potash, to form the sweat- 
 ing powder known by the name of Do- 
 ver's powder. The salt is of no virtue 
 in itself, but answers well by the hardness 
 and insolubility of its particles to divide 
 the viscid opium more completely. The 
 compound powder of jalap is composed of 
 one part of jalap and two of cream of 
 tartar ; and one use of the latter ingre- 
 dient is to obtain a perfect division of the 
 particles of the jalap. Myrrh, gamboge, 
 and some other vegetables not easily 
 powdered, have this operation much faci- 
 litated by being mixed with sugar or 
 some hard gum. Camphor is easily re- 
 duced to powder by the addition of a few- 
 drops of spirit of wine. 
 
 There are several salts which it might 
 be desirable to mix together and reduce 
 to powder, but which, when beat in a 
 mortar, become moist and are dissolved. 
 The cause of this is the escape of what 
 chemists call the water of crystallization. 
 Thus if we mix carbonate of ammonia 
 and sulphate of copper together, both dry 
 powders, the result will be a fluid mass, 
 and the extrication of gaseous matter. 
 Those who direct the combinations of 
 medicine should therefore be aware of 
 their chemical changes, that their pur- 
 poses in joining medicines may not be 
 disappointed. 
 
 There are certain powders frequently 
 used in medicine which are not soluble in 
 the stomach. Magnesia is an example. If 
 it meets with an acid in the stomach, it 
 forms a soluble salt which acts properly 
 enough on the bowels ; but if given in too 
 great quantities, it may form concretions 
 in the bowels, and be attended with dan- 
 ger. Powdered bark has been attended 
 with the same effect. The bowels should 
 therefore be carefully attended to in all 
 cases where insoluble powders are used, 
 especially in children. On this subject 
 it has been remarked, that the sugared 
 plums sold to children, consist very fre- 
 quently of plaster of Paris, or stucco, au 
 
448 
 
 PREGNANCY. 
 
 insoluble substance, which, introduced in- 
 to their tender bowels, may be productive 
 of much mischief. 
 
 PRECIPITATE. When a chemical 
 mixture is made among several substances 
 held in solution, and one of them being 
 insoluble, after the mixture, falls to the 
 bottom, it is called a precipitate. The 
 substance commonly called Red Precipi- 
 tatCy is an oxide of mercury, which is used 
 as an escharotic, and is a very common 
 application to chancres. When mixed 
 with lard, in the proportion of five grains 
 of the precipitate to a drachm or a drachm 
 and a half of lard, it forms a very valuable 
 stimulating ointment, which is useful in 
 various kinds of ophthalmia. For what- 
 ever purpose it is used, it should be very 
 finely powdered. 
 
 PREDISPOSING CAUSE, or Pre- 
 disposition. The circumstance which 
 produces in the constitution a tendency 
 to any particular disease. Thus, the j9?*e- 
 disposing cause of pleurisy is a certain 
 degree of health and vigour in the sys- 
 tem, which may be pushed to disease by 
 cold as an exciting cause. 
 
 PREGNANCY. The state of preg- 
 nancy is that condition of the female con- 
 stitution from the time of conception to 
 that of delivery. Though it is a state the 
 very reverse of disease, many changes 
 take place, and various uneasy feelings 
 arise, which in some constitutions are ex- 
 ceedingly troublesome; and incapacitate 
 the individual from all enjoyment of 
 health, or performance of the duties of 
 life. It may not be superfluous to enu- 
 merate the principal circumstances de- 
 manding attention or medical aid, as also 
 the method of management for women 
 during pregnancy. Before proceeding to 
 this, we may enumerate some of the signs 
 which indicate a woman to be in that 
 state, premising at the same time, that no 
 single symptom can be relied upon, and 
 that even their combination does not en- 
 sure certainty. 
 
 Pregnancv, Signs of. It is an almost 
 invariable fact, that while the monthly 
 flux is regular, the woman is not with 
 
 child ; and therefore one of the first signs 
 of pregnancy is the cessation of that dis- 
 charge. It is to be remembered, however, 
 that obstruction of the discharge may of- 
 ten happen from many other causes, and 
 therefore it cannot be depended on as a 
 sign of pregnancy unless other symptoms 
 follow. Some derangement of the diges- 
 tive organs takes place, sickness or vo- 
 miting, especially in the morning ; heart- 
 burn, costiveness, disturbed sleep, and in 
 some cases, irritability of mind and fret- 
 fulness of temper. The dark circle round 
 the nipple becomes of a deeper shade, the 
 breasts afterwards become enlarged and 
 harden, and towards the end of the period 
 of gestation, a milky fluid is secreted in 
 them. Sometimes the woman becomes 
 pale, and has a livid line at the lower eye- 
 lid. Some become rheumatic, and take 
 headach, toothach, or other kindred symp- 
 toms. There is a progressive increase of 
 the size of the belly ; but it has not unfre- 
 quently happened, that women have sup- 
 posed themselves pregnant when they 
 were not so, and yet that the belly has 
 gone on increasing in size ; sometimes 
 from their getting fat by good living and 
 the want of exercise, at other times from 
 dropsical or other diseases, and occasion- 
 ally from causes quite undiscoverable. 
 Towards the end of the fourth month, the 
 woman perceives a fluttering sensation, 
 occasioned by the motion of the infant. 
 In common language, the child is said to 
 quicken ; but we are not to suppose, that 
 this is the first moment of its becoming 
 alive. It had been so, long before, though 
 the smallness of its size and its limited 
 degree of motion had rendered the signs 
 of life indistinct and imperceptible. This 
 fluttering motion may be imitated by 
 flatulence, which often causes mistake 
 and disappointment. Fainting sometimes 
 seizes the mother about this period. The 
 appearance of the blood drawn from 
 pregnant women, after it has stood for a 
 time, in a degree resembles the blood 
 drawn in inflammatory diseases ; but this 
 appearance is by many circumstances 
 rendered a fallacious test of pregnancy. 
 
PREGNANCY. 
 
 U9 
 
 It appeai-s, therefore, that in the early 
 mouths, it is very difficult to ascertain, 
 beyond a doubt, whether a woman be 
 pregnant or not ; and practitioners should 
 always be extremely cautious in giving 
 their opinion. A rash announcement 
 that the woman has been deceiving her- 
 self, may give such a shock to the feel- 
 ings, as to be productive of the most lar 
 mentable consequences ; and with respect 
 to the management of doubtful cases, it is 
 always safest to treat them as if the wo- 
 man were pregnant, till time puts the 
 matter out of question; as fatal conse- 
 quences might result both to the mother 
 and child, by an attempt to get rid of tu- 
 mours or any apparently morbid symptom, 
 by violent medicines, or other means. 
 
 1. Disoj'ders in the Early Months. 
 Vomiting, sickness, heartburn, and other 
 symptoms of indigestion very often re- 
 quire attention in the early months. 
 "When the woman is otherwise healthy, 
 the sickness is not to be treated with any 
 very powerful remedy ; no brandy or lau- 
 danum should be allowed, but it must be 
 moderated by abridging the diet, by taking 
 little at a time, and by confining the pa- 
 tient to those articles of food which she 
 has experienced to agree with her. If 
 the heartburn is attended with a constant 
 desire to hawk up phlegm, it may be ad- 
 visable for once to clear out the stomach 
 by an emetic. Afterwards, the bowels 
 are to be cai-efully attended to; and a 
 little bark and sulphuric acid to be taken 
 twice a-day. When the heartburn is ac- 
 companied by a sour taste in the mouth, 
 with sour belchings, it is to be palliated 
 by magnesia, or prepared chalk, or lime- 
 water, and the bowels are to be kept easy 
 by castor oil, by senna, rhubarb, or other 
 mild laxatives. 
 
 Swelling and Pain in the Breasts. 
 Sometimes in the early months, the 
 breast* become swelled and very painful, 
 especially in those who are in good health, 
 and of a full habit of body. Great care 
 should be taken that no part of the dress 
 be tight over the breasts, and that the 
 stays Ao not press upon them. The 
 
 breasts are to be rubbed with a little 
 warm oil, twice or thrice a-day, and they 
 are to be covered with soft flannel. The 
 bowels are to be kept open, and in those 
 who are very full, a little blood may be 
 taken from the arm. 
 
 Longings. Women in the early stage 
 of pregnancy, sometimes have capricious 
 longings for unusual and improper food, 
 and other things. Many of them know 
 the absurdity of their wishes; others 
 think they should be gratified, lest the 
 child bear the marks of the thing longed 
 for. This fear is groundless ; but it is 
 prudevi^t as well as good-natured, to in- 
 dulge women, while in the pregnant state, 
 with whatever is not likely to be preju- 
 dicial to their health. 
 
 II. Disorders in the Latter Months. 
 Costiveness is a state that ought to be 
 most carefully guarded ag-ainst; and in 
 the state of pregnancy, no person should 
 allow two days to pass without an eva- 
 cuation. The bowels may be kept easy 
 by attention to diet, using a considerable 
 proportion of vegetable food; and by 
 taking some laxative medicine. An occa- 
 sional clyster, after long costiveness, may 
 be useful, but women should never allow 
 their bowels to get into this torpid state ; 
 as it is productive of much general de- 
 rangement to their health, occasioning 
 heat and flushing, feverishness and irrita- 
 bility ; and may demand very unpleasant 
 manual interference to break down the 
 hardened mass. When laxative medi- 
 cines are taken, their effect may be to in- 
 crease the slimy discharge from the 
 bowels, while their feculent contents are 
 not dislodged; this must be cai-efuUy 
 looked after, and purgative medicines that 
 act slowly but effectually, must be resorted 
 to, such as aloes alone, or with rhubarb, 
 scammony, or colocynth; and those fol- 
 lowed up by neutral salts, by senna, or 
 the compound powder of jalap. 
 
 Looseness. If the bowels are very 
 loose, the appropriate remedies for diar- 
 rhoea must be applied. It will be right to 
 give a laxative medicine to clear the 
 bowels of any irritating substance, and 
 2g 
 
450 
 
 PREGNANCY- 
 
 afterwards to give small doses of rhubarb 
 or catechu J taking- care that we do not 
 bring on again the opposite state of cos- 
 tiveness. 
 
 Piles. These are small tumours at the 
 end of the rectum ; when seen out of the 
 body they are called external ; when they 
 keep within the gut they are said to be 
 internal. These last generally give most 
 pain. We judge that there are internal 
 piles, when there is great pain at the lower 
 part of the gut on going to stool, or when 
 the person walks. Piles are called blind 
 when they do not bleed, and these are al- 
 ways the most painful. Pregnant women 
 not unfrequently suffer much inconveni- 
 ence from piles. They are to be pre- 
 vented and mitigated by avoiding costive- 
 ness, by the use of mild laxatives, as sul- 
 phur and cream of tartar, and by avoiding 
 the standing posture or much walking. 
 An ointment made of two parts of li- 
 tharge ointment and one of powdered 
 galls, may be rubbed on the piles ; and if 
 there be much swelling, with great pain 
 and feverish symptoms, leeches may be 
 applied to the parts, and the bleeding en- 
 couraged by fomentations. The bleeding 
 piles seldom require much attention, ex- 
 cept when the discharge is too profuse. 
 Such attentions are of very great impor- 
 tance, as it not unfrequently happens, 
 that some of the most troublesome symp- 
 toms after delivery, proceed from the irri- 
 tation excited by piles, which have been 
 much pressed upon during labour. 
 
 Palpitation of the Heart. When this 
 affection occurs during pregnancy, it is 
 generally the effect of disordered stomach. 
 It is to be relieved by an emetic, Avhen no 
 circumstance forbids this; by laxatives, 
 by lowering the diet, and avoiding every 
 article of food that is likely to cause fla- 
 tulence or to overload the stomach. Hys- 
 terical symptoms occiu* chiefly about the 
 period of quickening ; they are alarming 
 to those who do not know their nature, 
 but they do not last long. The best 
 treatment is to strengthen the body by 
 diet, air, exercise, and attention to the 
 atate of the bowels ; and to regulate the 
 
 mind, and keep away those sudden im- 
 pressions that may agitate or alarm it. 
 When the fit is on, it is to be shortened 
 by camphor, or valerian, or assafetida; 
 but opium in all its forms is to be avoided. 
 
 Cough and BreathlessnesSy occurring 
 at the latter periods of pregnancy, with- 
 out fever or inflammation, are to be as- 
 cribed to the bulk of the enlarged womb 
 and its contents, pressing on the dia- 
 phragm; thus diminishing the space in 
 which the lungs move, and irritating them 
 in the exercise of their functions. A 
 half-sitting posture gives some relief; 
 but nothing will remove it but delivery ; 
 although, when it is particularly trouble- 
 some, small bleedings may give some mi- 
 tigation. Blisters are not to be employed. 
 
 Pains of the Side, Belly, Back, and 
 Loins, are very frequent complaints of 
 pregnant women. In some cases, they 
 may arise from distension and flatulence 
 of the bowels; such are to be treated 
 by giving rhubarb, castor oil, and other 
 mild laxatives. Or they may arise from 
 the stretching of the muscles, when they 
 are to be treated Avith anodyne balsams, 
 by a bandage which gives some support 
 to fhe parts, and by changing the posture 
 of the body frequently in the course of a 
 day. When they are more severe, small 
 bleedings may be necessary. 
 
 The Bladder is sometimes in an i7'ri~ 
 table state ; in which case, the patient 
 should use mucilaginous drinks and gruels, 
 and be attentive to evacuate it frequently. 
 Towards the end of pregnancy, there is 
 sometimes an inability to retain the wa- 
 ter, which is forced away by any exer- 
 tion, especially by coughing. It is 
 thought rather a good sign, of the head of 
 the child being well down; and there- 
 fore, though inconvenient, it need be no 
 cause of alarm. 
 
 Retention of Urine is a symptom that 
 should never be neglected at any period 
 of preg-nancy, especially at the latter part 
 of it ; as it might be productive of very 
 bad consequences, were labour to come 
 on while the bladder is full. 
 
 Jaundice sometimes happens in preg- 
 
PREGNANCY. 
 
 451 
 
 nancy, and in general there is no cure for 
 it but delivery; the uneasy 8)rraptoms 
 are to be palliated by attending to the 
 bowels, giving infusions of chamomile to 
 assist digestion, and aloes to stimulate 
 the intestines. If the yellow colour of 
 the skin is very deep, with violent pain 
 in the side, and great sickness and vomit- 
 ing, we judge the complaint to be owing 
 to the formation of gall-stones, by some 
 of which the entrance of the bile into the 
 bowels is prevented. Relief is to be at- 
 tempted by blood-letting, by fomentations 
 to the side, by opiates ; and by laxatives 
 to prevent the constipation arising both 
 from the disease and from the opiate. 
 
 Swelling of the Legs, and Enlargement 
 of the Veins of the lower extremities, are 
 very frequent accompaniments of preg- 
 nancy. They are owing to the enlarged 
 uterus pressing on the great blood-ves- 
 sels; and but little can be done for the 
 relief of these symptoms, which, without 
 any measures of art directed to them, go 
 off spontaneously soon after delivery. 
 But when the swelling rises above the 
 knee, or appears on the upper parts of 
 the body, and does not disappear after 
 some hours rest in the horizontal pos- 
 ture, it seems to indicate a too great ful- 
 ness and inflammatory tendency in the 
 system, and requires large bleedings, and 
 repeated purgatives. K the swellings 
 arise from a debilitated state of the con- 
 stitution, and a dropsical habit, the strength 
 of the patient is to be supported by diet 
 and tonics, while we give what relief we 
 can, by medicines that increase the flow 
 of urine. 
 
 Toothach. Some women during preg- 
 nancy are much troubled with toothach. 
 It is to be palliated by anodyne applica- 
 tions externally, by small blisters behind 
 the ears, and by fomentations ; but very 
 rarely by drawing any of the teeth ; in- 
 deed it sometimes has happened, that 
 abortion has been produced by drawing 
 a tooth ; and surgeons and dentists are 
 not fond of performing this operation 
 during pregnancy. 
 
 Cramp is a common occurrence to- 
 
 wards the end of pregnancy. It is relieved 
 by change of posture, and by rubbing 
 with anodyne balsam ; but delivery alone 
 completes the cure. 
 
 Headach. This is never to be ne- 
 glected in pregnant women, especially 
 towards the later periods. If it proceeds 
 from slight causes, as from disordered 
 stomach, it wdll be the more easily re- 
 moved ; but if it proceeds from previous 
 mental agitation, or from peculiarity of 
 constitution determining the flow of blood 
 to the head, it may occasion apoplexy 
 or convulsions of the most alarming na- 
 ture. 
 
 Convulsions. Wlien a woman com- 
 plains of violent excruciating pain in the 
 head, if she has swelling and redness of 
 the face when in the erect posture, or 
 cramps in the stomach with oppressive 
 sickness, the approach of a convulsion is 
 to be suspected- When it does come 
 on, there is violent agitation of the body 
 and limbs, the face is flushed or bloated, 
 the tongue is moved frequently back- 
 wards and forwards w ith a hissing noise, 
 and there is a little bloody froth about 
 the mouth. The duration of the fit varies 
 from a minute or two to half an hour. 
 The woman is quite insensible while the 
 fit lasts, and when sensibility retiu-ns, she 
 has no remembrance of what has hap- 
 pened. Sometimes, long after the fit, 
 there is loud breathing and continued 
 insensibility, from which the unhappy 
 sufferer is roused by another convulsion. 
 Sometimes the fits bring on labour pains. 
 
 Convulsions of the above alarming 
 description are owing to circumstances 
 both of mind and body, connected with the 
 state of pregnancy. The greater quantity 
 of blood then formed in the body, and the 
 increased susceptibility of the nervous 
 system, may be stated as the predisposing 
 causes. In this state, many things that 
 would have little effect at other times, give 
 rise to convulsions ; such are irritation of 
 the stomach or bowels, of the urinary 
 organs; fatigue, sudden agitation of mind. 
 It is very frequently observed, that fe- 
 males who are very anxious about their 
 
452 
 
 PREGNANCY. 
 
 situation, are those who are seized with 
 couvulsions. 
 
 When the threatenings of a fit have 
 
 shown themselves, it is to be prevented 
 
 by large bleedings; and if the fit has 
 
 actually come on, the quantity of blood 
 
 necessary to be taken, exceeds that 
 
 M'hich is required in the cure of any 
 
 (i\^.„.c4,^' other disease. The head is to be shaved, 
 
 jpP t>^ x(. ^^^ cold applied in the most eiFectual 
 
 ". ^ '„ "^"^way, as by iced cloths, or vinegar and 
 
 ' "^ water, or muriate of ammonia dissolved 
 
 in water. The feet are to be bathed in 
 
 tepid or in warm water; and if the 
 
 '^''^' V-^ delivery has begun, it must be assisted 
 
 •<'... ' by proper means, and accomplished as 
 
 ^ speedily as possible. 
 
 Pregnant women often experience a 
 degree of anxiety and despondency ap- 
 proaching to disease; more especially 
 when they have been in the way of hear- 
 ing untoward histories of other women 
 in that state, or Avium there is much sick- 
 ness in the place where they reside. Much 
 depends on their natural temper and 
 character, and on the prudent conduct of 
 their friends, either by diverting their 
 over-anxious thoughts from their own 
 situation, or showing them that their 
 fears are groundless. 
 
 . We may lay it down as a general 
 maxim, with regard to the great variety 
 of ailments which occur to women in 
 the pregnant state, that they are all to be 
 listened to with patience and attention ; 
 that they are never to be ridiculed as 
 affected or capricious; that though we 
 are not to have recourse to violent medi- 
 cal or surgical treatment on every trivial 
 complaint, we are yet to examine care- 
 fully whether any mild and safe remedy 
 can be applied, and to encourage the 
 patient by the assurance, that though art 
 can in many cases do but little, these ail- 
 ments have no tendency to make the 
 delivery more difficult; and that they 
 may confidently look forward to that 
 event, as likely to put a period to all their 
 annoyances. 
 
 ^ PROGNOSIS. The anticipations which 
 i*'e lorra by symptoms, of the progress and 
 
 event of a disease. There are various 
 particulars in the structure and functions 
 of the animal economy, which enable us 
 to judge of the issue of a disease. Each 
 disease is to be judged by its own symp- 
 toms, and every individual case is always 
 to be decided on its own merits. We 
 may, speaking generally, say that a fever 
 is dangerous ; or a pleurisy, or a dropsy is 
 so ; but this will give little useful infor- 
 mation in any particular case. Our judg- 
 ments are to be formed by comparing 
 the functions as performed in the disease, 
 with the manner in which they should be 
 done in health. The circulation, as indi- 
 cated by the strength, the frequency, and 
 the regularity of the pulse, and by the 
 complexion of the face and the colour of 
 the surface, gives important ground for 
 our prognosis. Respiration, also, as to 
 its ease or difficulty, its force and rapidi- 
 ty ; the state of the stomach as affected 
 with sickness or not, with hunger or with 
 loathing ; the tongue, the sight, and other 
 senses, delirium, sleep, muscular strength 
 or weakness ; the appearance of the urine, 
 and other excretions, and a great variety 
 of symptoms, alone or in combination, 
 influence the judgment of the practitioner 
 concerning the event of a disease. Much 
 reputation and confidence may be gained 
 by a correct and faithful prognosis ; and 
 every physician should exert himself to 
 be able to give his judgment decidedly 
 and candidly, when asked, whether the 
 event is to terminate in death or return- 
 ing health. • 
 
 PROSTATE GLAND. A gland si- 
 tuated at the neck of the urinary bladder 
 in the male. It is subject to various dis- 
 eases, especially to enlargement ; the con- 
 sequence of which is a degree of difficul- 
 ty in expelling the urine, in some cases 
 so great, as to require the introduction of 
 the catheter repeatedly. The enlarged 
 prostate is difficult of cure; and when 
 much pain and irritation are present, they 
 are to be allayed by opiates or other nar- 
 cotics, as hemlock, &c. which have been 
 known to do good also when introduced 
 by the anus. This gland is liable to in- 
 
PRUSSIC ACID. 
 
 453 
 
 flammation from the sudden checking of 
 a g-onorrhoea. Every means must be ta- 
 ken to remove this by bleeding, general 
 or local, and by restoring the discharge 
 from the urethra. 
 
 PROUD FLESH. The granulations 
 which arise in the progress of a sore 
 healing, sometimes project much beyond 
 the level of the surrounding parts, and 
 form a red excrescence very irritable, 
 easily made to bleed, and sometimes grow- 
 ing fast in spite of all that can be done 
 to prevent it. Caustics of various kinds, 
 as lunar caustic, or the blue vitriol, are 
 to be applied, or red precipitate of mer- 
 cury ; and occasionally, pressure by straps 
 of adhesive plaster or other bandages, is 
 found useful. 
 
 PROXIMATE CAUSE is a medical 
 phrase for that morbid state of the body, 
 or any part of it, which gives rise to the 
 visible phenomena of disease. Thus in 
 inflammation, we wish to know what 
 action of the blood-vessels or of the nerves 
 occasions the heat, swelling, redness and 
 pain ; or in fever, what organ or function 
 is in fault ; in short, the proximate cause 
 in the body is the disease itself. This is 
 most commonly of difficult investigation, 
 and too often eludes our inc^uiry alto- 
 gether. 
 
 PRUNES. The dried fruit of the 
 Prunus domesticOy or plum. When stew- 
 ed, they are of a laxative quality; and 
 when taken pretty copiously, often su- 
 persede the necessity of having recourse 
 to purgative drugs. 
 
 PRURIGO. The name for a trouble- 
 some itching of the skin, which is of va- 
 rious species, and arises from various 
 causes. In some, it occurs in the spring 
 and early part of summer, probably from 
 the increasing temperature. Diligent 
 washing with tepid M'ater, and the use of 
 sulphur internally, will, after a time, re- 
 lieve this. There is another species of 
 prurigo, which, in some constitutions, pro- 
 ceeds from the use of certain articles of 
 diet, as some kinds of fish, vinegar, and 
 cider. Where it arises from disordered 
 stomach, it is to be treated by laxatives 
 
 and a change of diet ; when it occurs in 
 debilitated habits, a course of tonics must 
 be employed ; and the use of tepid bath- 
 ing externally is necessary ; or still bet- 
 ter, the sulphureous waters externally. 
 The most troublesome kind of prurigo, is 
 that which occurs in old people ; it is to 
 be relieved by the warm bath, and by 
 Harrowgate water internally and external- 
 ly. A warm sea-water bath has been 
 found of service. 
 
 PRUSSIC ACID. A colourless trans- 
 parent liquid, but occasionally having a 
 yellow tinge ; it has a peculiar odour, 
 which, when diffused through the air, re- 
 sembles that of bitter almonds ; its taste 
 is bitterish and peculiar, but its proper- 
 ties are soon lost by exposure to air and 
 light. Modern chemists have ascertained, 
 that prussic acid contains a gaseous and 
 highly iuflammable compound of carbon 
 and azot, which they term cyanogen, and 
 which is rendered acid by combination 
 with hydrogen. Its composition is indi- 
 cated by its name of hydrocyanic acid. 
 It obtained the name of prussic acid, from 
 its being one of the constituent parts of 
 the dye called Prussian blue. Prussic 
 acid is one of the most virulent and rapid 
 poisons known. According to the French 
 physiologist Magendie, if a single, drop of 
 the concentrated acid be put into the 
 throat of a dog, the animal makes two or 
 three deep hurried respirations, and in- 
 stantly drops down dead ; it causes death 
 almost as instantaneously when dropped 
 under the eyelid ; and M'hen it is injected 
 into the jugular vein, the animal drops 
 do^\n dead at the very instant, as if struck 
 with a cannon-ball, or with lightning. 
 The effects of the diluted acid are the 
 same when the dose is large, but some- 
 what different when smaller doses are 
 given. Nausea, salivation, hurried pulse, 
 giddiness and convulsions ensue. " It is 
 probable that very large doses occasion 
 death in a feAV seconds, and at all events, 
 a few minules will suffice to extinguish 
 life when the dose is considerable ; but if 
 the individual survive thirty or forty mi- 
 nutes, he will very generally recover 
 
454 
 
 PUERPERAL FEVER. 
 
 Pnissic acid acts strongly in all its chro- 
 nical combinations, as for instance, prus- 
 siate of potash or of ammonia; but the 
 triple prussiates are not poisonous. 
 
 The proper treatment of a case of poi- 
 soning with prussic acid consists in the 
 use of the cold affusion, and the inhala- 
 tion of diluted ammonia or chlorine. Ve- 
 nesection is also probably indicated by 
 the signs of congestion in the head. It 
 is right to remember, that on account of 
 the dreadful rapidity of this variety of 
 poisoning, it will rarely be in the physi- 
 cian's power to resort to any treatment 
 soon enough for success ; and farther, 
 that his chance of success must generally 
 be feeble even when the case is taken in 
 time, because when hydrocyanic acid is 
 swallowed by man, the dose is generally 
 so large as not to be counteracted by any 
 remedies." (Dr. Christison.) 
 
 This peculiar acid exists in a great va- 
 riety of native combinations in the ve- 
 getable kingdom, as in bitter almonds, 
 cherry-laurel, the kernels of the peach- 
 tree, and of various fruits, especially in 
 the thin skin which covers the kernel; 
 and the distilled water and essential oils 
 of some of them are nearly as rapidly 
 destructive as the acid itself. 
 
 Prussic acid has been introduced into 
 medicine in pulmonary and other inflam- 
 mations, and in heartburn and other sto- 
 mach complaints, and as a lotion in some 
 diseases of the skin ; but it has not been 
 found very useful, and is not much em- 
 ployed. The dose is from two to four or 
 six drops of the diluted acid, in any con- 
 venient vehicle. 
 
 PSOAS ABSCESS. See Lumbar 
 Abscess. ^ 
 
 PSORA. See Itch. 
 
 PTISAN. A diluent drink which 
 makes a great figure in the dietetic pre- 
 cepts of the ancients. Ptisan strictly signi- 
 fies an extract, and was originally applied 
 to barley which was boiled till it began 
 to swell, then was dried in the sun, bruis- 
 ed, cleared of the husks, and again bruis- 
 ed. A decoction was made of this pre- 
 pared barley, and used as a drink in fe- 
 
 verish disorders. Other drinks of a si- 
 milar kind were called ptisans, though 
 not made of barley ; and Horace tells his 
 rich miser that he requires a ptisan of 
 rice, ptisanarium oryzcB. The term is 
 not much used by medical men in this 
 country. In France it seems to be a ge- 
 neral name for diluent drinks. 
 
 PUBERTY. The age of puberty in 
 both sexes, is about fourteen or fifteen. 
 
 PUDDINGS. Certain articles of diet 
 prepared by reducing some of the farina- 
 cea to a solid form. The most digestible 
 pudding is that made with boiled bread ; 
 flour or batter pudding is not so easily di- 
 gested ; rice forms a very good pudding, 
 when there are not too many eggs put 
 into it. Suet pudding is very hurtful 
 to weak stomachs. The indigestibility, 
 indeed, of these forms of diet, is to be 
 estimated by the quantity of oily and 
 fatty matters that enter into their compo- 
 sition. 
 
 PUERPERAL or Childbed Fever. 
 So many diseases accompanied with fe- 
 verish excitement, occur in the puerperal 
 state, that the appellation at the head of 
 this article might be supposed to apply to 
 a great variety of ailments ; but medical 
 men wish it to be restricted to a disease 
 of peculiar sjonptoms, and of great ma- 
 lignity; though they are not all agreed 
 either upon the exact train of symptoms 
 which occur, or upon the method of treat- 
 ment most successfully pursued in them. 
 In treating of a disease which has been 
 the occasion of much controversy among 
 physicians, it would be quite inexpedient 
 to bring disputed points before the gene^ 
 ral reader; but we may say a little to 
 quiet the minds, and inform the judgments 
 of those, who are likely to consult this 
 work. When a woman, within three or 
 five days after delivery, is seized with 
 shivering, followed by heat of skin, thirst, 
 flushing, headach, &c. she need not be 
 apprehensive that she is seized v^ith puer- 
 peral fever ; it may be the milk-fever, 
 which soon abates when the bowels are 
 opened, and when the child sucks freely; 
 it may be from suppression of the cleans- 
 
PUERPERAL FEVER. 
 
 4^ 
 
 iugs, \A'hich are often restored by warm 
 fomentations and a dose of castor oil ; or 
 a little cold or imprudence in fancying 
 herself too well, may have occasioned the 
 unpleasant symptoms, which, although 
 really febrile, do not constitute true puer- 
 peral fever. But when a woman has had 
 a comparatively easy labour, when the 
 discharge is moderate, when the milk has 
 begun to flow, when, between forty-eight 
 hours and six days after delivery, she is 
 seized towards evening with cold and 
 shivering, Vhen she afterwards becomes 
 hot and restless, when she loses all care 
 about her child, lately so interesting to 
 her ; when she has a fixed pain over the 
 eye-brows, or a feeling of tension, as if 
 a cord were forcibly bound round the 
 forehead, when the pulse is small and 
 quick, when the belly is tender — then it 
 is time for the friends of the patient to 
 take the alarm, and to get prompt assist- 
 ance, taking care not to agitate or distress 
 the patient herself, by showing their an- 
 xiety or apprehensions. 
 
 Symptoms. Puerperal fever is distin- 
 guished by frequency of pulse, oppression, 
 sickness, and headach, by want of sleep, 
 sometimes with delirium j by pain in the 
 belly, slight at first, and afterwards increas- 
 ing, so that the patient cannot bear the 
 weight of the bedclothes. The eyes are 
 without animation, the countenance is pale 
 and ghastly, and the whole appearance in- 
 dicates great oppression and anxiety. The 
 patient commonly lies on her back, and if 
 laid on her side, soon returns to her for- 
 mer posture. Vomiting sometimes occurs 
 very early ; and as the disease advances, 
 it is so severe that nothing will remain 
 on the stomach ; and there is a discharge 
 of dark coloured fetid matter, resembling 
 coffee-grounds. The heat of skin is not 
 very great, the pulse soon becomes feeble, 
 the tongue is brown, but the patient does 
 not complain much of thirst. At first, 
 the bowels are bound, but there is soon 
 a discharge of fetid frothy stools. In 
 many cases, neither the milk nor the 
 cleansings ai-e suppressed. The patient 
 inquires but little after her child. Soon 
 
 the strength sinks, the natural evacua- 
 tions are made involuntarily, the mouth 
 and tongue become foul, delirium takes 
 place, and the patient dies, generally about 
 the fifth day of the disease, though some 
 linger on a little longer. The fever ge- 
 nerally attacks on the second or third 
 day after delivery. 
 
 Causes. No particular circumstance 
 in the labour seems to be instrumental 
 in producing this disease. It comes on 
 after the most natural and easy delivery ; 
 it also may come on after a flooding, 
 which has weakened the patient so much, 
 that we might suppose inflammation or 
 fever impossible. The disease in many 
 cases is brought on by exposure to cold, 
 pi;emature exertion, irregularities in diet, 
 and agitation of mind. 
 
 Puerperal fever occasionally prevails 
 as an epidemic in particular districts; 
 and it has occurred in hospitals, even 
 when well regulated, at a time when it 
 has not been prevalent in the city where 
 the hospital was situated. It has also, 
 in some districts, appeared to follow the 
 practice of individual midwives or ac- 
 coucheurs ; all those who have been 
 delivered by certain practitioners for 
 some weeks, having been seized with the 
 disease ; while other practitioners, in the 
 same town, of equally extensive practice, 
 have not had any case under their care. 
 Some physicians think the progress of 
 the complaint is so decidedly that of 
 typhus with local inflammation, that they 
 have not a doubt about considering it as 
 a typhoid peritoneal inflammation ; for 
 the peritoneum has often been found in- 
 flamed and covered with an albuminous 
 effusion, which has induced the French 
 physicians to call it un depot laiteitx, a 
 deposition of milk, though it has no 
 connexion with that secretion. 
 
 Diagnosis. We have partly, in our 
 introductory remarks, anticipated the 
 mention of some of the particulars which 
 distinguish the true puerperal fever from 
 other febrile affections of childbed. It 
 is distinguished from inflammation of the 
 peritoneum, by there bein^ more despoH » 
 
456 
 
 PUERPERAL FEVER. 
 
 dency, debility, and headach ; while the 
 thirst, heat of the skin, and flushing of 
 the face are less. In the peritoneal in- 
 flammation, the pain increases rapidly 
 when it has once begun, and is very 
 much increased by pressure ; the attend- 
 ing fever is more inflammatory than ty- 
 phoid. In inflammation of the womb, 
 there is much pain when that region is 
 pressed ; also pain in the back, shooting 
 to the groins ; difficulty of voiding urine, 
 and suppression of the cleansings. In 
 puerperal fever, the pain and swelling are 
 most remarkable over the pit of the sto- 
 mach, and when pressure is made there, 
 a doughy feel is communicated to the 
 hand of the examiner. 
 
 Prognosis. In hospitals, the disease, 
 with hardly an exception, is fatal. The 
 earlier the attack, the more tense the 
 belly, and the less complaining the patient 
 makes, the danger is the greater. If the 
 pulse continues at its first frequency, or 
 if it increases, the disease will likely prove 
 mortal. If the fomentation of the belly 
 does ^ood, if the pain on pressure is less, 
 if there be an equal, warm, and copious 
 perspiration, our hopes are somewhat 
 better. 
 
 Treatment. This is a subject of great 
 difficulty; the actite pain of the belly 
 would strongly urge us to employ blood- 
 letting, but several practitioners of great 
 experience have declared this practice to 
 be very pernicious. In the early part of 
 the disease, when the strength is not yet 
 greatly impaired, blood-letting should be 
 employed ; but the cases in which large 
 bleedings have been successful, were pro- 
 bably inflammatory cases, and not the 
 true puerperal fever. When the disease 
 has lasted two days, and symptoms of 
 debility have come on, then in all proba- 
 bility bleeding would only hasten on the 
 fatal event. An emetic of ipecacuan, on 
 the very first appearance of the disease, 
 has seemed in some instances to check 
 its progress, arid in others to render it 
 milder ; but on the second, or any subse- 
 quent day, emetics are attended with no 
 l^enefit whatever. From the earliest period 
 
 of the disease, we are to pay attention 
 to the bowels, and procure regular and 
 free evacuation of them, even by medi- 
 cines of considerable activity; taking 
 care to prevent and check any exhaust- 
 ing diarrhoea. The laxatives we employ 
 are the compound powder of jalap, calof 
 mel in frequently repeated and pretty 
 large doses, from three to six grains, 
 three times a-day, working it off" by infu- 
 sion of senna, or by neutral salts. A 
 clyster should be early thrown up, and 
 the bowels fomented. We also expect 
 good from an equable and gentle perspi- 
 ration, which in this disease we may at- 
 tempt to bring out by Dover's Powder, 
 by camphor, or warm sudorifics. The 
 strength is to be supported by light and 
 easily digested food, by animal jejlies, by 
 sago with a little wine, and by chicken- 
 broth with rice. A little wine and water 
 may be allowed, and as the debility seems 
 to gain ground, the stimulus must be in- 
 creased both in quality and quantity; 
 and, if the stomach will retain it, even 
 bark and wine, or the sulphate of qui- 
 nine, must be administered very freely. 
 Such seems to be the safest practice, and 
 in some cases it is successful ; but puer- 
 peral fever is always to be regarded as a 
 very dangerous disease. When the wo-? 
 man is to recover, the unfavourable symp- 
 toms abate but slowly, and the weakness 
 continues long. In this convalescent 
 state, the bark and wine must be given in 
 large quantities, and the diet must be as 
 nourishing as the stomach and digestive 
 powers of the patient will admit. 
 
 When the disease has occurred in hos- 
 pitals, the lying-in wards should be shut 
 up for some time, after being completely 
 fumigated and white-washed. 
 
 PULSE. The pulse consists in the 
 alternate contraction and dilatation of 
 the heart and arteries, by which contrac- 
 tion, aided by the force of the heart, the 
 blood is propelled through every part of 
 the body. As the beats of the arteries 
 correspond with the motions of the heart, 
 we judge, by the pulsation of the arteries, 
 of the state of the circulation, and from 
 
PULSE. 
 
 457 
 
 this we derive many important indications 
 in disease. The frequency of the pulse 
 in health is about 12 beats in a minute, 
 or it ranges between CO and 80 ; but in 
 some it is slower, without any derange- 
 ment of the health. The pulse is quicker 
 in women than in men ; it is quicker in 
 the sanguine than in the melancholic tem- 
 perament; in youth, than in age. The 
 pulse of an infant in the first days of its 
 life, is from 130 to 140. During the firs^. 
 year, it is from 108 to 120. From the 
 state of thie pulse, taken in conjunction 
 with other symptoms, we judge of the 
 existence of inflammatory complaints, of 
 the state of debility, and of the effects of 
 certain medicines. In feverish com- 
 plaints, it rises to 100, 120, 168, or even 
 to be uncountable. In certain diseases, 
 as water in the chest, it intermits and 
 becomes irregular, and the same effect is 
 produced by the use of the foxglove. In 
 some persons the pulse is naturally inter- 
 mitting, in others it intermits from dis- 
 orders of the stomach and bowels, and 
 also from emotions of the mind. The 
 artery generally chosen to ascertain the 
 state of the circulation, is the radial ar- 
 tery, where it is superficially seated in 
 the wrist ; but when this is inconvenient, 
 it may be done in the temporal artery, or 
 at the comer of the lower jaw. In feel- 
 ing the pulse, some attentions are requi- 
 site. In many the circulation is quick- 
 ened by any mental agitation ; and, there- 
 fore, the entrance of the physician, or his 
 questions and remarks on the patient's 
 case, may quicken the pulse, which should 
 be felt, therefore, both at the commence- 
 ment and termination of the visit. 
 
 PUNCTURING THE Belly is fre- 
 quently practised as a means of letting 
 off dropsical waters from that cavity, or 
 from the ovarium. It is commonly call- 
 ed Tapping^ from a very obvious allu- 
 sion. When we have determined on this 
 operation, the best place for doing it is 
 in the middle of a line reaching from the 
 navel to the share-bone. The instru- 
 ments employed are a trocar and canula. 
 fhe trocar is a perforator or stilctte with 
 
 a triangular point, and the canula or tube 
 is so adapted to the instrument, that when 
 the puncture is made, they both enter 
 the wound together with perfect ease ; 
 after which, the stilette being withdrawn, 
 the canula remains in the wound, and 
 gives a ready passage for the fluid out- 
 ward. The surgeon should always have 
 a probe ready, to clear the canula of any 
 viscid or fatty matter that may obstruct 
 it. When a great quantity of water ij» 
 suddenly let off, the removal of the pres- 
 sure sometimes produces swooning, con- 
 vulsions, or even sudden death. We are 
 to be on our guard against this, and to 
 have cordials ready j and supply the usual 
 pressure by passing a sheet round the 
 belly, which is to be gradually tightened 
 by two assistants, in proportion as the 
 water is evacuated. Tapping is not often 
 the means of a permanent cure of dropsi- 
 cal complaints, but it gives great tempo- 
 rary relief. Many patients, especially fe- 
 males, have it done repeatedly; some, 
 twenty or thirty times. 
 
 PUNCTURING THE Chest. The 
 method of this is fully detailed at p. 232, 
 233. See Emphysema and Ebipyema. 
 
 PUPIL OF the eye. The aperture 
 seen through the transparent part on the 
 front of the eye, by which the rays of 
 light are let into the retina. It is some- 
 times irregular in its shape; sometimes 
 from disease it is obliterated ; and ocu- 
 lists have had the address to make an ar- 
 tificial pupil. It is through, or near the 
 pupil, that instruments are passed for the 
 extraction or depression of cataract. 
 
 PURGATIVE MEDICINES are those 
 substances wliich increase or quicken the 
 evacuation 'from the intestines. As dis- 
 tinguished from laxatives in their effects, 
 they may be said to produce a consider- 
 able influx of fluids from the exhalant 
 vessels which open into the intestinal ca- 
 nal, and hence to extend their action to 
 the system in general. When very vio- 
 lent in their action, they are called drastic 
 purgatives. The effects of a purgative 
 depend either on their stimulating tho 
 miLscular fibres of the intestines to 9, 
 
458 
 
 PURGATIVES. 
 
 quicker motion, by which the contents 
 of the bowels are more speedily and com- 
 pletely discharged ; or on their stimulat- 
 ing the exhalant vessels and the mouths 
 of the mucous glands, which open into 
 the bowels, by which there is an increas- 
 ed discharge both of serous and raucous 
 fluids ; or purgatives may so stimulate 
 the neighbouring viscera, as to occasion 
 a more copious discharge of the bile and 
 pancreatic liquor. Different purgatives 
 have different powers of producing these 
 several effects. Sulphur, magnesia, and 
 manna, evacuate the bowels without any 
 great increase of serous discharge ; while 
 others, as the neutral salts, and some ve- 
 getable purgatives, as gamboge and elate- 
 riura, produce large watery evacuations, 
 and are thence denominated hydragogues. 
 The mercurial purgatives, as calomel, 
 seem to act chiefly by promoting an in- 
 creased flow of the bile, and hence are 
 called cholagogues. 
 
 The use of purgative medicines is of 
 great importance in the preservation of 
 health, and the cure of disease. They 
 can be so managed and selected, as either 
 simply to promote the discharge of the 
 feculent matter, or to cool the system by 
 abstracting watery fluid, and withdraw- 
 ing the action from the upper parts of the 
 body ; or to promote the flow of dropsi- 
 cal water by stimulating the absorbents 
 and exhalants, which open in such pro- 
 digious numbers on the inner surface of 
 the intestines. 
 
 The neutral salts furnish many use- 
 ful purgative medicines ; as the sul- 
 phate of soda, the sulphate of magne- 
 sia, the phosphate of soda, the tartrate 
 of soda ; these are commonly given to 
 purge and to cool the system, and are use- 
 ful in inflammatory disorders. The usual 
 dose of them is an ounce, dissolved in 
 about four ounces of tepid water : they 
 should be taken in the morning, and not 
 too warm, as in that case they will either 
 be thrown up, or pass off too quickly by 
 the bowels. The purgatives from the ve- 
 getable kingdom are very numerous, as 
 aloes, jalap, rhubarb, gamboge, scaramony, 
 
 colocynth, and others; and in addition 
 to these, we have calomel, and perhaps a 
 few more, from the mineral kingdom. 
 Castor oil is a mild and safe purgative, 
 more commonly ranked as a laxative ; and 
 there is another vegetable oil, the croton, 
 famous for its activity in doses so small 
 as a single drop or two. 
 
 Purgatives are combined together with 
 great and manifest utility ; not vidth the 
 result of adding the powers of one to an- 
 other, but of making the desired effect 
 more complete, certain, and advantageous. 
 Thus five grains of calomel will purge, 
 and twenty grains of jalap will purge se- 
 parately ; but by giving in one dose, five 
 grains of calomel and twent}-- grains of 
 jalap, we do not produce a double evacu- 
 ation, but the one modifies the other, and 
 produces the effect intended with certain- 
 ty and expedition. It is unnecessary in 
 this general article, to speak of the differ- 
 ent kinds of purgatives, as we have detail- 
 ed under each of them, their properties, 
 and the reasons of preferring any. of them 
 in particular cases. We may say here, 
 that it is not a good habit to take fre- 
 quent purgatives; they relax the intestines 
 and debilitate the digestive system, as 
 well as the whole body; but in some 
 constitutions, the bowels are so torpid, 
 that it is absolutely necessary for the pre- 
 servation of health, to take some medi- 
 cine or other pretty constantly ; directed, 
 not so as to produce copious thin stools, but 
 gently to stimulate the intestines, and excite 
 them to evacuate only the proper faeces. 
 
 PURPURA. In Dr. Willan's arrange- 
 ment of cutaneous diseases. Purpura 
 means an efilorescence consisting of small, 
 distinct, purple specks and patches, at- 
 tended with general debility, but not al- 
 ways with fever. These specks and patches 
 are occasioned by an extravasation of 
 blood, under the cuticle, from the extre^ 
 mities of the cutaneous vessels. The pe- 
 techise, or spots like flea-bites, which oc- 
 cur in bad typhoid fevers, and the appear- 
 ances of stripes in similar cases ; and the 
 livid marks common in sea-«curvy, are in- 
 stances of purpura. 
 
PURPURA. 
 
 439 
 
 There is one species of purpura, of con- 
 siderable severity and danger, to which 
 no English or popular name is given: 
 Medical writers call it Purpura Hcemor- 
 rhagicGy from the profuse discharges of 
 blood which sometimes occur, and en- 
 danger, if not destroy the life of the pa- 
 tient. We shall give the description of 
 the disease from Dr. Bateman, and add 
 any remarks that may appear useful. 
 
 Symptoms, The petechias are often of 
 a large size, and are interspersed with 
 livid stripes and patches resembling the 
 marks left by the strokes of a whip, or 
 by violent bruises. They commonly ap- 
 pear first on the legs, and at uncertain 
 periods afterwards, on the thighs, arms, 
 and trunk of the body ; the hands being 
 more rarely spotted with them, and the 
 face generally free. They are usually of 
 a bright red colour when they first ap- 
 pear, but soon become purple or livid. 
 In the spots which appear on the tongue, 
 gums, palate, and inside of the cheeks 
 and lips, where the cuticle is extremely 
 thin, it breaks from the slightest force, 
 and the eflfused blood is discharged. The 
 gentlest pressure on the skin, even such 
 as is applied in feeling the pulse, will 
 often produce a purple blotch, like that 
 which is left after a severe bruise. 
 
 The same state of the habit which gives 
 rise to the effusions under the cuticle, 
 produces likewise copious discharges of 
 blood, especially from the internal parts, 
 which are defended by more delicate co- 
 verings. These haemorrhagies are often 
 very profuse, and not easily restrained; 
 and therefore sometimes prove suddenly 
 fatal. 
 
 This, singular disease is often preceded 
 for some weeks by great lassitude, faint- 
 ness, and pains in the limbs, which ren- 
 der the patient incapable of any exertion j 
 but, not unfrequently, it appears sudden- 
 ly in the midst of apparent good health. 
 It is always accompanied with extreme 
 debility and depression of spirits : the 
 pulse is commonly feeble, and sometimes 
 quickened; and heat, flushing, perspira- 
 tion, and other symptoms of slight febrile 
 
 irritation, recurring like the paroxysms 
 of hectic, occasionally attend. 
 
 The disease is extremely uncertain in 
 its duration : in some instances it has ter- 
 minated in a few days ; while in others it 
 has continued not only for many months, 
 but even for years. When the disease 
 terminates fatally, it is commonly frotti 
 the copious discharge of blood, either sud- 
 denly eflfused from some important organ, 
 or more slowly from several parts at the 
 same time. 
 
 Causes. The causes of this disease are 
 by no means clearly ascertained, nor its 
 pathology well understood. It occurs at 
 every period of life, and in both sexes. 
 The rapidity of the attack, the acuteness 
 of the pains in the internal cavities, the 
 actual inflammatory symptoms that some- 
 times supervene, the occasional removal 
 of the disease by spontaneous haemor- 
 rhage, the frequent relief derived from ar- 
 tificial discharges of blood, and from purg- 
 ing, all tend to excite a suspicion that 
 some local visceral congestion or obstruc- 
 tion is the cause of the symptoms in dif- 
 ferent instances. 
 
 Treatment. When purpura is accom- 
 panied with a white and loaded tongue, 
 a quick and somewhat sharp, though 
 small pulse, occasional chills and heats, 
 and other symptoms of feverishness, how- 
 ever moderate ; and if at the same time 
 there are fixed internal pains, a dry cough, 
 and an irregular state of the bowels, 
 blood-letting to a considerable extent, but 
 cautiously employed, and free and repeat- 
 ed evacuations of the bowels, by medi- 
 cines containing some portion of the sub- 
 muriate of mercury, will be found most 
 beneficial. The continuance or repetition 
 of these evacuants, must, of course, be re- 
 gulated by their eflfects on the symptoms 
 of the complaint, or on the general con- 
 stitution; and by the appearance of the 
 excretions from the intestines, and espe^ 
 cially of the urine ; to which last excre- 
 tion. Dr. Combe of Leith has very pro- 
 perly directed our attention. In a case, 
 which he treated successfully by blood- 
 letting, he found the urine contained 
 
460 
 
 PUS 
 
 PUT 
 
 abundance of albumen, as happens in in- 
 flammatory dropsies. When the urgency 
 of tlie haemorrhagic tendency has been di- 
 minished by these means, the constitution 
 rallies, though not rapidly, with the as- 
 sistance of the mineral acids, and the de- 
 coction of bark, or cascarilla, or some 
 preparation of iron, together with moder- 
 ate exercise, and nutritious diet. 
 
 The similarity of the spots and patches 
 to those which occur in sea-scurvy, and 
 the discharges of blood from the mouth 
 in both diseases, have led some to con- 
 found them together, and to consider pur- 
 pura haemorrhagica as a disease of debi- 
 lity, to be treated by the mineral acids, 
 tonics, bark, and wine ; but there seem to 
 be " two species of purpura haemorrha- 
 gica, the one accompanied by fever, and 
 a disease of increased action ; the other a 
 chronic affection, and not attended by 
 fever, inflammatory blood, or serous urine. 
 Our practice must be regulated by the in- 
 dividual cases, and not a little, perhaps, 
 by the state of the urinary secretion." 
 {Edin. Med. Journal, Jan. 1821.) 
 
 PURULENT OPHTHALMY of In- 
 fants. See Eye, and its diseases. 
 
 PUS. The matter which forms in a 
 part when it has been seized with inflam- 
 mation, and when the inflammation has 
 not gone off spontaneously, or been sub- 
 dued by proper remedies. In this case, 
 suppuration, or the formation of matter, 
 seems to be a necessary step in the pro- 
 gress to a cure ; and the formation of it 
 is to be promoted by the application of 
 warm fomentations or poultices, when the 
 inflamed part is within our reach. Good 
 or healthy pus is of a yellowish colour, 
 of the consistence of cream, smooth and 
 equal to the feel, and without any heavy 
 or fetid smell. When it is dark-coloured, 
 it is owing to its being mixed with blood ; 
 and in scrofulous abscesses, it is unequal, 
 curdy, and often of a bad smell. When 
 pus is forming, there often occur shiver- 
 ings of the whole body. Under Consump- 
 tion, we have acknowledged the diffi- 
 culty of distinguishing between pus and 
 inucus. See Abscess a^id Inflammation. 
 
 PUSTULE. An elevation of the 
 cuticle, with an inflamed base, containing 
 pus. There are different kinds of pus- 
 tules, some of a large size, raised on a 
 hard, circular base, of a vivid red colour, 
 and succeeded by a thick, hard, dark- 
 coloured scab; others are small, often 
 irregularly circumscribed, producing but 
 a slight elevation of the cuticle, and ter- 
 minating in a laminated scab. Sometimes 
 several of the elevations of the skin arise 
 upon a common inflamed surface; but 
 most frequently the inflammation of the 
 base of each is distinct and circumscribed. 
 Dr. Willan reckons five genera of pus- 
 tular diseases, having in their character 
 nothing in common, except the appear- 
 ance of pustules in some stage of their 
 progress ; some are contagious, and others 
 not ; some are acute, and others chronic. 
 The tetter, the scalled head, and the itch 
 are pustular diseases ; but the most con- 
 spicuous and formidable of them all is 
 small-pox. 
 
 PUTREFACTION. A process by 
 which animal and vegetable substances 
 lose their contexture, change their com- 
 position, and become useless or noxious. 
 Certain diseases are considered as having 
 a tendency to putrefaction, as some fevers, 
 sore throats, mortification, &c. In fevers, 
 the discharges are very much unlike the 
 natural ones, have a very fetid smell, and 
 seem also to have the power of exciting 
 diseases of the same kind as those under 
 which the patient labours. When those 
 putrefactive symptoms occur, they are 
 to be combated by acids, refrigerants, and 
 such substances as are known to be op- 
 posed to putrefaction ; small beer, porter, 
 cider, and malt liquors are to be given. 
 The carbonic acid, as extricated from car- 
 bonate of soda, or obtained from barm, 
 is to be applied ; all evacuations are to 
 be quickly removed from the chambers 
 of the sick, and the utmost attention paid 
 to ventilation and cleanliness. 
 
 To retard the putrefaction of animal 
 matter intended for provisions, is some- 
 times of great consequence. 
 
 " Various means are resorted to for 
 
PUTREFACTION. 
 
 461 
 
 retarding animal putrefaction; a reduc- 
 tion of temperature is by far the most 
 efficacious. Meat, when put into snow 
 or ice, may be kept almost any time, and 
 hence the common practice of sending" 
 fish to a distance packed in it. In cold 
 countries also, a store of provisions is 
 laid up, surrounded by snow; in which 
 state it remains till required for use. 
 Depriving animal matter of its moisture 
 is another mode of preventing putrefac- 
 tion. We find, accordingly, that dried 
 fish may be kept for a long time. In some 
 countries, it is also the custom to cut 
 flesh into thin slices, and dry it gradually, 
 by which it may be preserved till pro- 
 visions can be otherwise procured. 
 
 " There are many substances that re- 
 tard putrefaction, some of which, it is 
 supposed, act merely by absorbing the 
 moisture of the animal matter. The 
 most powerful of these is common salt, 
 which is used in great quantity for pre- 
 serving butcher meat, fish, butter, and 
 many other articles. Of late, pyrolig- 
 neous acid has been highly recommended 
 for this purpose. It is even said that it 
 will render sweet, animal matter that has 
 become putrid. In using it, the meat is 
 merely dipped in, and almost instantly 
 removed. Should it have become putrid, 
 it may be left in for a few minutes. 
 
 " Other means have also been practised 
 for preventing putrefaction. The com- 
 plete exclusion of air, it is well known, 
 retards it ; hence the custom of rubbing 
 eggs with salt butter, and of keeping them 
 in lime-water. Flesh is also sometimes 
 preserved in this way , for which purpose 
 it is put into a cask, afterwards made as 
 air-tight as possible. It has been found 
 
 also, that by boiling meat for some time, 
 and then putting it into barrels, it may 
 be kept long without putrefying; and 
 hence a practice often resorted to in 
 long voyages.'* (Fyfe's Elements of 
 Chemistry.) 
 
 PUTRID FEVER. See Typhus. 
 
 PUTRID SORE THROAT. See 
 Scarlet Fever. 
 
 PYLORUS. The extremity of the 
 stomach, communicating with the intes- 
 tines ; surrounded with a ring of mus- 
 cular fibres of great sensibility, which 
 for some time refuse egress to such mat- 
 ters as are not fitted to undergo the next 
 changes in the function of digestion. 
 Thus, ill-masticated food, coins, stones 
 of fruit, and other bodies are not at once 
 suffered to pass from the stomach into 
 the next portion of the gut. The pylorus 
 is subject to alteration of structure end- 
 ing in cancer, and giving rise to very 
 painful and distressing symptoms. See 
 Stomach Complaints. 
 
 PYRMONT WATER. The water 
 of a spring at Pyrmont, in Westphalia. 
 It is of an agreeable, strongly acid taste, 
 and emits a large portion of gas. It is 
 useful in cases of debility, and in disor- 
 ders of the alimentary canal, in diarrhoea, 
 and in complaints connected with difficult 
 or obstructed menstruation. It is gene- 
 rally drank in the morning, in the quan- 
 tity of two English pints. It has some 
 effi3ct in increasing the urine, but acts 
 very slightly on the bowels, unless the 
 quantity taken be pretty copious. 
 
 PYROLIGNEOUS ACID. A strong 
 vinegar procured by the distillation of 
 wood in the process of preparing charcoal 
 for the manufacture of gunpowder. 
 
QUACK MEDICINES. 
 
 Q 
 
 QUA 
 
 QUACK. The appellation of Quack, 
 says Dr. Parr, arose from quacksalbeVy the 
 German name for quicksilver; since on the 
 first appearance of syphilis, the irregular 
 practitioners only, employed this reputed- 
 ly dangerous medicine. At present, the 
 term Quack is confined to those who sell 
 a pretended nostrum, the preparation of 
 which is kept secret ; but may be applied 
 to every practitioner who, by pompous 
 pretences, mean insinuations, and indirect 
 promises, endeavours to obtain that con- 
 fidence, which neither success nor ex- 
 perience entitles him to. 
 
 QUACK MEDICINES. The vision- 
 ary projects in which the alchymists, for 
 so many centuries, spent their time and 
 fortune, were the art of transmuting the 
 baser metals into gold, and the discovery 
 of a medicine which was to secure health 
 and immortality upon earth. The first of 
 these is now given up as hopeless ; but if 
 we may credit the lofty pretensions of 
 our medicine venders, the latter is ob- 
 tained, if not by one, at least by the com- 
 bined or successive use of several, of their 
 nostrums. There is no disease of dreaded 
 name for which these oracles cannot fur- 
 nish a cure. Asthma and consumption 
 are disarmed of their terrors, gout is now 
 but a harmless bugbear ; and if any suffer 
 or die of cancer, it must be the fault of 
 their own obstinacy or incredulity. The 
 diseases of childhood need give little con- 
 cern ; there are anodynes which allay the 
 pain of teething ; there are worm lozenges 
 which no reptile can resist, and there are 
 washes which infallibly cure and beautify 
 the skin. Laborious investigation of dis- 
 ease is unnecessary ; the doctor does not 
 need to see his patient, who has only to 
 send a letter describing his case, with the 
 usual fee ; and the remedy will come to 
 
 QUA 
 
 the remotest corner of the kingdom. 
 Even this trouble may often be dispensed 
 with; a patient has merely to consider 
 for himself, whether he is bilious or nerv- 
 ous, whether his skin or his bowels are 
 in fault; whether he needs stimulants 
 or evacuants ; and piUs, and cordials, and 
 balsams of unerring efficacy, are to be 
 found in every town, ready to his hand. 
 Of the truth of these statements there 
 cannot be a doubt, as numberless cures 
 are attested by those who have tried 
 them; and whose benevolence prompts 
 them to publish, for the benefit of man- 
 kind, the advantage they have experienced 
 in themselves or their families. 
 
 The credulity and confidence of those 
 who give their testimony to the benefits 
 which they think they have seen to arise 
 from patent medicines, is equalled only 
 by the large promises of those who sell 
 them. These attestations, though hon- 
 estly given, are given in ignorance. A 
 person is afflicted with a certain combin- 
 ation of symptoms, to which medical men, 
 or the common people, assign a distinctive 
 name, as fever, dropsy, scurvy ; he reco- 
 vers his health after the use of some par- 
 ticular medicine, and is perfectly con- 
 vinced that that medicine cured him. 
 He rejoices in his success, and confidently 
 recommends the same drug to his friend, 
 who is said to labour under the same dis- 
 ease. But there is here a double fallacy. 
 The first patient cannot be sure that he 
 had the disease which he supposes, and 
 he cannot be certain that the remedy 
 cured him. As it is doubtful whether 
 the second patient is afflicted in a similar 
 way, the same medicine may not be ap- 
 plicable to him. 
 
 When we consider the endless variety 
 of the hiunan constitution, its delicate 
 
QUACK MEDICINES. 
 
 463 
 
 and almost evanescent changes in health 
 and disease, it must be obvious, that a 
 remedy which will suit one person may- 
 be very unfit for another, and that a me- 
 dicine which to-day is salutary, may be 
 attended with disastrous results if repeat- 
 ed to-morrow. In popular languag-e, and 
 even in the language of physicians, it may 
 be said with truth, that ten persons have 
 the same disease, as small pox, fever, or a 
 cold ; but it will require correct and ac- 
 curate observation, to discriminate the 
 differences in the case of each, and to ap- 
 ply the remedies which are proper to 
 them. But by the same patent medicine, 
 and in the same dose, eighty thousand 
 cases are said to be cured in a year ; and 
 patients indiscriminately are invited to 
 apply a composition, in a case which they 
 call a disease of some particular name, 
 though a skilful physician would consider 
 a totally opposite remedy as necessary. 
 
 There is something in the moral aspect 
 of a secret remedy that ought to put man- 
 kind on their guard against it. The pos- 
 session of health is to all so valuable, and 
 to the poor so necessary ; pain and suffer- 
 ing are so dreadful, that it is the duty of 
 every one to communicate every assist- 
 ance in his power to relieve it. With all 
 the industry and accumulated knowledge 
 of ages, there are too many diseases which 
 baffle all the skill of the profession ; and 
 there must be something suspicious about 
 those who, affirming themselves to be in 
 possession of a remedy for cancer or con- 
 sumption, conceal the knowledge of it in 
 their own bosoms. 
 
 There are some useful and esteemed 
 medicines, which at first appeared in the 
 disreputable form of secret remedies. 
 Such were Dover's powder, James's pow- 
 der, and most of the internal and external 
 remedies which bear the name of Ward. 
 This man was originally a footman, and 
 during his attendance upon his master on 
 the Continent, obtained from the monks 
 those receipts which afterwards became 
 his nostrums. Some patent medicines 
 are harmless and insignificant, and com- 
 monly their only effect is to amuse the 
 
 patient with delusive hopes, and to trifle 
 away the time during which the consti- 
 tution could bear the employment of ac- 
 tive remedies. In other cases, by the ala- 
 crity and hope which they inspire, they 
 may impart a salutary energy to the 
 mind; and hypochondriacs may be 
 brought to use rational methods of cure, 
 while they expect every thing from their 
 boasted specific. Some patent medicines 
 are merely those which every physician 
 prescribes, and every druggist sells ; but 
 which quacks disguise, and multiply the 
 price of, manifold. Drugs of the same 
 composition as Anderson's pills, and Bar- 
 clay's antibilious pills, and James's ana- 
 leptic pills, could all be purchased at a 
 much cheaper rate. But there are other 
 kinds of quack medicines of a more dan- 
 gerous tendency, and against which the 
 ignorant and credulous should be put on 
 their guard. Such are all those which 
 profess to be an infallible cure for cancer, 
 which promise to cure syphilitic com- 
 plaints without the use of mercury, and 
 those which cure colds and consumptions. 
 Arsenic is the basis of all the anti-can- 
 cerous remedies ; and under Arsenic and 
 Cancer we have stated the danger of 
 using this mineral, which, even when ap- 
 plied externally, is often fatal. The anti- 
 syphilitic drops, gutta salutaris, solar tinc- 
 ture, Spilsbury's drops, and a host more 
 of such compositions, contain, as their ac- 
 tive ingredient, the corrosive sublimate 
 of mercury ; which, from its being easily 
 disguised, and of great activity, is very 
 convenient for the purposes of empirics, 
 but proportionally dangerous for the ig- 
 norant to employ. The cures for colds 
 and consumptions are almost all composi- 
 tions containing opium, the quack's sheet- 
 anchor, as Dr. Paris calls it. There is 
 what is called Balsam of Horehound, said 
 to cure colds, coughs, and disorders of the 
 lungs ; which consists of a watery infu- 
 sion of horehound and liquorice root, 
 with double the proportion of proof spirit 
 or brandy, to which is then added, opium, 
 camphor, benzoin, squills, oil of aniseed, 
 and honey. This enumeration is surely 
 
464 
 
 QUARANTINE. 
 
 enoug-h to show the absurdity of the pre- 
 tensions of this and similar medicines j 
 and it shows the danger run by those 
 who venture to use them, without a 
 knowledge of the tendency to inflammation 
 of the lungs, which accompanies a great 
 proportion of the colds of this country. 
 
 Credulity with respect to quack medi- 
 cines is peculiarly dangerous in the nur- 
 sery. Parents should rarely prescribe 
 medicines themselves, and should rigor- 
 ously prohibit the administration of them 
 by servants. No patent medicine, how- 
 ever excellent, should form any part of 
 the nursery store; and the ailments of 
 children, however slight, should, as soon 
 as possible, be put under the care of the 
 medical attendant. Parents should know 
 Avhat is proper to be done on any sudden 
 emergency, as in the case of burns 
 wounds, or contusions ; they should un- 
 derstand the most useful measures to be 
 pursued in convulsions, or screaming 
 from pain of the'bowels j but they should 
 not suflfer many hours to elapse without 
 consulting the family physician or surgeon. 
 
 QUARANTINE. The period of /wYy 
 days, during which a ship which has come 
 from countries infected with the plague, 
 is debarred from all intercourse with the 
 people of the country at which she has 
 arrived, for fear of spreading the disease. 
 The experience and investigations of late 
 years seem to have established the fact, 
 that the plague is not so rapidly and cer- 
 tainly contagious as is commonly believ- 
 ed ; and that although the enforcement of 
 the quarantine laws is a measure of pru- 
 dence, and even of necessity, the period 
 might be shorter than forty days. Before 
 a vessel is released from quarantine, cot- 
 ton and woollen goods, and those made 
 of animal hair, should be ventilated and 
 fumigated ; and the same should be done 
 with wearing apparel, books, and papers. 
 It has been remarked that it would be 
 less expensive, and infinitely less vexati- 
 ous, than waiting the long period com- 
 monly prescribed, if all the wearing appa- 
 rel of the crew ^vere destroyed, in case of 
 the slightest appearance of infection. 
 
 QUARTAN AGUE. A species of in- 
 termittent fever, in which the paroxysm 
 comes on eyery fourth day ; or in which 
 the interval from the commencement of 
 one attack to that of the next, is seventy- 
 two hours. See Ague. 
 
 QUASSIA. Quassia Simarouba. A 
 species of wood imported from the West 
 Indies, the infusion of which forms a very 
 useful tonic bitter. The strength of the 
 infusion is two drachms of the rasped 
 wood to a pint of boiling water, infused 
 for four hours, and strained. As it does 
 not, like many vegetable infusions, black- 
 en the preparations of iron, chalybeates 
 may be joined with it very commodious- 
 ly. The dose of the infusion is from half 
 a pint to one pint in the day. There is 
 also a decoction made by boiling six 
 drachms of the bark in two pounds of 
 water. A wine-glassful may be taken 
 three times a-day. 
 
 QUICKSILVER. The fluid metal 
 commonly called Mercury. See Mercury. 
 
 QUININE or QUINIA, is a vegeta- 
 ble alkaloid body, discovered by modern 
 chemistry in the yellow Peruvian bark, 
 (Cinchona cordifolia.) "It is a white 
 powdery substance, sparingly soluble in 
 water, but dissolved by warm alcohol, 
 from which it is not deposited in crys- 
 tals. Quiuia unites with acids, and forms 
 salts, the most important of which is the 
 sulphate. It is soluble in water, and 
 crystalizes. It is now much employed 
 in medicine, being found to answer all 
 the purposes of bark ; and as a small 
 dose is necessary, it does not produce the 
 unpleasant effects of the bark powder or 
 infusion. Eight grains are considered equal 
 to an ounce of the powder." (Dr. Fyfe.) 
 
 QUINSY. The English name for in- 
 flammatory sore throat, and other affec- 
 tions of that part. See Throat, Sore. 
 
 QUOTIDIAN. A species of ague, 
 whose paroxysms return every day, and 
 go through all their three stages. Such 
 agues approach the character of remit- 
 tent or continued fevei-s, and are more 
 difficult of cure than tertian agues. See 
 Ague. 
 
REGIMEN. 
 
 465 
 
 R 
 
 REG 
 
 RADISHES, Raphanus sativusy are 
 esculent roots, which have a pung-ent and 
 acrid taste. They are not very nutritive, 
 but they may be useful as a stimulant. 
 With some stomachs they disagree en- 
 tirely. 
 
 RASH. Superficial red patches, va- 
 riously figured, and diffused irregularly 
 over the body, leaving spaces between of 
 a natural colour, and terminating in a 
 scaling off of the outer skin. The nettle- 
 rash, measles, and scarlet fever, are ex- 
 amples of what are called rashes. 
 
 RASPBERRY, Rubus Mcbus. A 
 very pleasant fruit, which, either taken 
 Avhen ripe, or preserved, and its jam di- 
 luted in water, forms a grateful beverage 
 in feverish diseases. 
 
 REFRIGERANTS. Medicines or ap- 
 plications intended to diminish the mor- 
 bid heat of the body. Cold water, or 
 other cooling lotions, as vinegar and wa- 
 ter, or a solution of sugar of lead, or sal- 
 ammoniac, or cool air, are well entitled 
 to the appellation of refrigerants ; but the 
 term is more generally applied to sub- 
 stances taken into the stomach, as the 
 vegetable acids, vinegar, lemon-juice, tar- 
 taric acid, cream of tartar, nitrate of pot- 
 ash. Blood-letting and purgatives may 
 also, with reference to their ultimate ef- 
 fects, be accounted refrigerants, though 
 they are rarely called so. 
 
 REGIMEN. The mode of managing 
 the various appliances necessary for the 
 human body, with a view to the cure of 
 disease, and the preservation of health. 
 Under regimen, we include the various 
 particulai*s connected with diet, sleep, 
 exercise, air, excretions, and the manage- 
 ment of the passions of the mind. The 
 regimen must vaiy with the varying con- 
 stitutions of individuals, and with the 
 
 RES 
 
 particular disease, which it is wished to 
 prevent or cure. To prevent apoplectic 
 attacks, for example, and too great a flow 
 of blood to the head, the regimen must 
 be such as to hinder the over-nourishing 
 of the body, consisting of a large propor- 
 tion of vegetable food, abstinence from 
 butcher meat, butter, rich sauces, wines, 
 and malt liquors ; taking constant and 
 regular exercise on level ground, but 
 without fatigue ; breathing, if possible, a 
 pure and free air, sleeping with the head 
 and shoulders raised, and not protracting 
 the time of sleep too long. In scrofulous 
 subjects, the regimen must be different; 
 our object there, is to strengthen the sys- 
 tem by moderate but nourishing diet, by 
 a prudent allowance of wine and tonic 
 medicines, by exercise and the pure air of 
 the country. In stomach complaints, 
 the principal part of the cure consists in 
 proper regimen; and under that article 
 we have given a full detail of what is ne- 
 cessary to be attended to. Under that of 
 the Antiphlogistic Regimen, we have 
 mentioned the numerous observances ne- 
 cessary in fevers and inflammatory com- 
 plaints. 
 
 RESINS. Certain vegetable produc- 
 tions soluble in alcohol, but not in water 
 or proof spirit. Many resins are used in 
 medicine, as guaiac, myrrh, scammony, 
 aloes ; and from the circumstance of their 
 insolubility in certain fluids, we are to 
 take care in what vehicle we administer 
 them. Thus, if we prescribe tincture of 
 guaiac, should we direct it to be taken in 
 water, the appearance it would assume 
 when thrown into water, Avould probably 
 startle our patient ; but it must be given 
 in milk or some mucilaginous fluid. Re- 
 sins are often used in the composition of 
 plasters, and are brought to the proper 
 2h 
 
4-66 
 
 RESPIRATION. 
 
 consistence by having a quantity of Avax 
 or oil melted with them. 
 
 RESOLUTION. A term used to 
 signify the cessation of inflammation in 
 any part of the body, without the forma- 
 tion of pus, or any visible alteration of 
 structure. This is the most desirable 
 termination of inflammation; and to ef- 
 fect this, is the purpose of all our bleed- 
 ing, purging, and antiphlogistic practice 
 in the treatment of internal inflamma- 
 tion, and of our cold and repellent appli- 
 cations where we can apply them. See 
 Inflammation. 
 
 RE SPIR ATION, that important func- 
 tion performed by the lungs and auxiliary 
 organs, by which we constantly draw in 
 and breathe out air, for the purpose of 
 producing certain changes in the blood, 
 which is subjected to the action of the 
 air in the lungs. This is one of the vital 
 functions, which begins at the moment of 
 birth, and ends only with life itself; 
 which cannot be suspended even for a 
 very short period, without great uneasi- 
 ness and danger. The number of respi- 
 rations in a minute, differs in different in- 
 dividuals. The average number in a 
 healthy person is about twenty, but in 
 disease they may amount to double that 
 number. It diff'ers from the circulation, 
 in being in some measure under the go- 
 vernment of our will, as it is subservient 
 to the formation of speech ; it can be ren- 
 dered deeper, and more or less quick as 
 we wish it. During sleep, it goes on in- 
 dependent of us ; and though the mouth 
 be shut, the air finds its way to the lungs 
 by the ever open passage of the nostrils. 
 The motions of respiration consist of an 
 alternate contraction and dilatation of the 
 chest. When the chest is expanded, a 
 vacuum is formed in the lungs, and the 
 air rushes in. The dilatation of the chest 
 is eff'ected by the actions of the two 
 layers of muscles that extend from one 
 rib to another, and which elevate the 
 ribs, and also turn them a little on their 
 OAVii axis ; but still more does the dia- 
 phragm contribute to this expansion, by 
 changing its position from being convex 
 
 towards the chest, to a flattened form. 
 In strong efforts of inspiration, and in 
 diseases of the chest, other muscles are 
 brought into action, especially those of 
 the back and shoulders ; and this is one 
 reason why the shoulders of consumptive 
 and asthmatic patients are generally rais- 
 ed. The contraction of the chest, or ex- 
 piration, is effected by the action of the 
 abdominal and other muscles, assisted by 
 the elasticity of the cartilages between 
 the ribs and the breast-bone. 
 
 It is not every species of air that is fit 
 for respiration. Some gases cannot be 
 breathed at all, as the epiglottis shuts at 
 their approach, and will not admit them. 
 Such are carbonic acid, and probably all 
 the other acid gases, and ammonia. Some 
 gases kill by preventing the entrance of 
 proper air ; such are hydrogen and azote. 
 Others instantly kill, but at the same 
 time produce some change in the blood, 
 as carburetted hydrogen, and carbonic 
 oxide. Some may be breathed for a 
 while, but death ensues at last ; as in the 
 case of oxygen, and nitrous oxide. At- 
 mospheric air alone can be breathed for 
 an unlimited time with impunity. It is 
 the oxygen which enters into its compo- 
 sition, that fits it for the support of ani- 
 mal life. This oxygen, too pure and too 
 stimulant to be breathed alone, when 
 combined in the proportion of 2 1 parts in 
 the hundred to 79 of azote, constitutes 
 the salutary mixture which is necessary 
 to respiration. 
 
 The capacity of the chest, the quantity 
 of air taken in at each inspiration, and 
 that remaining after complete expiration, 
 have been differently estimated. Dr. 
 Bostock, whose Essay on Respiration 
 has obtained high approbation from the 
 best chemists, thinks that about forty cu- 
 bic inches of air are taken in at each in- 
 spiration ; that the lungs in their natural 
 condition contain about 280 cubic inches ; 
 and that about 109 cubic inches are left 
 after an ordinary expiration. 
 
 The changes produced on the atmos- 
 pheric air by breathing, are the folloAv- 
 ing: 1. Pai't of the oxygen of the air 
 
RESPIRATION. 
 
 407 
 
 inspired disappears. If an anim.al be con- 
 fined in a limited portion of air, and if 
 this air be not renewed, it becomes, after 
 a certain time, unfit for being breathed, 
 and the animal dies. When chemically 
 examined, the air is found to have lost its 
 oxygenous portion. 2. A quantity of 
 carbonic acid gas, exactly equal to the 
 oxygen which has disappeared, is found 
 in its place. The disengagement of car- 
 bonic acid during respiration, is easily 
 seen by breathing through a tube into 
 lime-water; which being perfectly clear, 
 becomes muddy, in consequence of the 
 chalk which the carbonic acid forms with 
 the lime. 3. The air breathed is return- 
 ed loaded with watery vapour, which is 
 calculated to amount to nearly twenty 
 ounces in a day. 
 
 The principal use of respiration being 
 to effect certain changes on the blood, it 
 becomes an important subject to ascertain 
 what these changes are. The whole of 
 the blood circulates through the vessels 
 of the lungs, and during that circulation, 
 it is exposed to the influence of the air 
 which is constantly drawn in. The space 
 over which the air vesicles extend in the 
 lungs, is believed to be at least equal to 
 the surface of the body. The venous 
 blood which has circulated through the 
 system is of a dark purple colour ; and at 
 one of the veins, shortly before it enters 
 the heart, the chyle prepared from the 
 food is poured in. By circulating through 
 the lungs, the blood acquires a florid red 
 colour, and the chyle disappears, being, in 
 a way, as yet unknown, converted into 
 blood. A considerable quantity of carbon 
 is abstracted from the blood, and water 
 also is emitted. 
 
 Animal Heat, though not yet perfectly 
 explained, seems manifestly to depend on 
 respiration. Man, and the animals who 
 resemble him, have their heat much above 
 the atmosphere which surrounds them ; 
 amphibia and fishes, whose mode of breath- 
 ing is different, have their temperature 
 little raised above the medium in which 
 they live. It has been proved, that the 
 temperature of all animals is pro])ortiou- 
 
 ate to the quantity of air which they 
 breathe in a given time. 
 
 Another most important use of respira- 
 tion, though not a vital one, is the forma- 
 tion of the voice of man and other ani- 
 mals. It is for this purpose, that respira- 
 tion is partly a voluntary function ; the 
 air being transmitted through an aperture 
 varying in its shape and size, produces a 
 sound, which, being in man directed by 
 reason, and modified by the tongue, the 
 lips, the teeth, and neighbouring parts, 
 produces all the variety of articulate 
 sounds, by which we communicate our 
 ideas to one another. Laughing and cry- 
 ing, sobbing and hiccup, are modifications 
 of respiration. 
 
 The disorders of respiration are of great 
 importance, and many other diseases of 
 different parts, have the respiration affect- 
 ed by sympathy. The disorders of res- 
 piration are asthma, pleurisy, cough, &c. ; 
 and in fever, dropsy, and many other dis- 
 eases, the respiration comes also to suffer, 
 although in the cure of these, we are not 
 to consider, in the first place, the respira- 
 tion, but the original disease. 
 
 RESUSCITATION is the art of re- 
 viving persons apparently dead, most 
 commonly applied to the recovery of the 
 drowned. See Drowning. 
 
 RETE MUCOSUM. A mucous sub- 
 stance expanded between the outer and 
 true skin. It gives the colour to the 
 body, and therefore is black in the negro. 
 
 RETINA. The expansion of the optic 
 nerve at the back part of the eye, on 
 which are painted images of objects, and 
 which is the immediate organ of vision. 
 
 RHEUMATISM is a painful affection 
 of tendinous and muscular parts, affecting 
 principally the larger joints, and places 
 covered by muscles; thus it affects the 
 wrists, the elbows, the knees and hip- 
 joint, and the back and loins. The inter- 
 nal parts also, as the heart and diaphragm, 
 are considered to be capable of being af- 
 fected by rheumatism. When the joints 
 about the back and loins are affected, the 
 complaint is called lumbago; when the 
 pain is in the hip-joint, it is called sda^tca; 
 
468 
 
 RHEUMATISM. 
 
 and pleurodyncy or pain \\\ the side, 
 when the muscles of the chest are affect- 
 ed. Rheumatism may occur either with 
 fever or without it ; in the first case it is 
 termed acutCy and in the second chronic 
 rheumatism. 
 
 Not long after the application of the 
 exciting- cause, the patient feels pain and 
 stiifness in one or more joints when he 
 attempts to move them ; this quickly in- 
 creases, till motion becomes almost im- 
 possible, from the excessive pain attend- 
 ing- it. Along M'ith this local, and often 
 very general pain, there occurs very strong 
 fever, much thirst, heat, and dryness of 
 skin, strength, fulness, and hardness of 
 pulse. The state of the stomach is not 
 much altered, and the bowels are in their 
 natural condition. The feverish symp- 
 toms are somewhat increased towards 
 evening ; and when the patient gets warm 
 in bed, the pains are more severe. In a 
 short time some of the affected joints 
 swell, and the pain is a little relieved, 
 but by no means removed. The pain is 
 apt to shift from one joint to another, or 
 at least several joints in succession are at- 
 tacked ; and when the pain seemed to be 
 going off, it sometimes unexpectedly re- 
 curs. 
 
 Causes. Rheumatism is commonly the 
 consequence of cold applied to the body, 
 
 %^:.^* especially when accompanied with mois- 
 
 ture. Thus it is not an unfrequent dis- 
 ease with sportsmen, who, when hot and 
 
 -y • >, perspiring, are too apt to throw them- 
 
 jJL/ 4^'^^- selves down on the wet grass ; and with 
 /f ^/ travellers who sleep in damp and ill-dried 
 
 IT i^^^^ -f^ ^Jieets. Persons who get their clothes 
 wet, and neglect to change them, are 
 often seized with rheumatism. 
 
 Diagnosis. " Rheumatism is often so 
 blended with gout as to prevent our see- 
 ing which is the principal complaint. In 
 general, rheumatism occurs in conse- 
 quence of an evident cause, as cold ; the 
 gout without any such cause. Rheuma- 
 tism has no preceding complaints ; gout is 
 preceded by languor, flatulency, and indi- 
 gestion ; rheumatism is the disease of the 
 strong and active ; gout, of those advanc- 
 
 ed in life ; rheumatism attacks the larger, 
 gout the smaller joints; rheumatic limbs, 
 though swollen, are not red like gouty. 
 The fever of gout remits irregularly; that 
 of rheumatism has exacerbations in the 
 evening, and remissions in the morning. 
 These circumstances will contribute to 
 the distinction; but the cases so often 
 run into each other, and differ by shades 
 so transient and minute, that the greatest 
 difficulty is found in the distinction of 
 particular complaints. Rheumatic pains 
 in the chest resemble pleurisy, and in 
 the abdomen, resemble inflammation of 
 the bowels. In each case, the soreness 
 to the touch, the pain felt at the origin 
 or insertions of the muscles, while the 
 more appropriate symptoms of the real 
 inflammation of the part are absent, will 
 sufficiently mark the nature of the dis- 
 ease." (Dr. Parr.) In lumbago, there is 
 great difficulty of bending the body, which 
 distinguishes it from affections of the kid- 
 ney, as from stone or inflammation. 
 
 Acute Rheumatisji, Treatment of. 
 Acute rheumatism is to be considered as 
 an inflammatory and febrile disease, and 
 as such, to be treated in the first instance 
 by blood-letting, in quantity proportioned 
 to the violence of the disease, and the 
 strength and constitution of the patient. 
 There is, however, need of some caution, 
 as a large bleeding or two, if they do not 
 prove effectual in the removal of the 
 disease. Mill probably have the effect of 
 inducing debility ; and of converting the 
 disease into that loug continuing and pain- 
 ful state, called chronic rheumatism. It 
 is desirable that the stomach and bowels 
 should not be loaded, and the diet must 
 be spare and far from stimulating. Though 
 the fever would induce us to give purga- 
 tive medicines, yet the great pain felt on 
 motion, renders it rather desirable not to 
 open the bowels much. One of the most 
 successful modes of practice in rheuma- 
 tism, is to bring out a copious sweat, and 
 to continue that sweat over the whole 
 body for thirtj'^-six or forty-eight hours. 
 The most effectual and approved method 
 of this is to employ the compound powder 
 
RHEUMATISM. 
 
 469 
 
 of ipecacuan and opium, commonly called 
 Dover's powder; of this >ve give ten 
 grains or twelve grains in a morning, 
 having put flannel next the patient's skin, 
 and put him in blankets. When this dose 
 has brought out a sweat, it is to be en- 
 couraged by drinking plentifully of warm 
 gruel or baHey-water ; but if it should 
 fail to occasion perspiration, another dose 
 must be given at an interval of four houi-s, 
 and this repeated every four hours till a 
 cdpious sweat breaks out over the whole 
 body. It is proper to abstain from drink- - 
 ing till the sweat does break out, as drink- , 
 ing too soon after taking the powder is: 
 apt to occasion vomiting. When the 
 perspiration has continued general and 
 copious for the time we judge proper, 
 the load of bedclothes is to be gradually 
 diminished ; the body is to be rubbed 
 dry with warm flannel, and great care 
 taken for some time, not to expose it to 
 cold. This sweating regimen not unfre- 
 quently carries off the disease entirely ; 
 but on the other hand, it sometimes fails, 
 perhaps from the high fever attending ; 
 this must be reduced by bleeding; and 
 indeed the sweating process is both diffi- 
 cult and ineJSfectual if we do not premise 
 blood-letting. When the pain and stiff- 
 ness of the joints continue after the sweat- 
 ing, some stimulating embrocation is 
 proper, as turpentine ointment, or vola- 
 tile liniment, or camphorated oil. If the 
 pain still continues obstinate, it may be 
 necessary to apply a blister to any of the 
 joints or muscular parts that require it. 
 Other sweating medicines have been re- 
 commended in rheumatism, as gum guaiac, 
 either in powder or tincture. The Es- 
 sence of Mustard, which has gained some 
 reputation as an external application in 
 rheumatism, is composed of oil of tur- 
 pentine, camphor, and a portion of rose- 
 mary, to which is added a small quantity 
 of flour of mustard. Such are the symp- 
 toms and treatment of acute rheumatism ; 
 but this treatment is too often unsuccess- 
 ful, and the complaint degenerates into 
 chronic rheumatism, a disease tedious, 
 painful, and intractable. 
 
 O/'Chronic Kheumatism. The chronic 
 rheumatism is distinguished by the pained 
 parts being cold and stiff, and not easily 
 made to perspire, something like palsied 
 limbs ; by being worse in cold weather, 
 and relieved by warmth, whether of the 
 atmosphere or when the patients are in 
 bed, by their being very sensible to the 
 changes of weather, and by the general 
 health being not very greatly impaired, 
 at least till the disease has continued 
 many months. The cure of chronic 
 rheumatism is verj' difficult. Many ex- 
 pedients have been tried, and there is a 
 necessity for varying the treatment in 
 almost all instances of it. Sweating and 
 friction are proper commencements, and 
 these must be foUovAed up by warm bath- 
 ing, warm pumping, the use of the Bath 
 waters, or sometimes by sea-bathing, by 
 electricity and the frequent use of the 
 flesh-brush. The system is to be invigor- 
 ated by bark, wine, iron, and other tonics. 
 The ammoniated tincture of guaiac, in 
 the dose of two or three drachms, has 
 been employed with success ; also the oil 
 of turpentine, from ten to thirty drops 
 mixed with honey, or what has been a 
 good deal employed of late, cod-liver oil, 
 from half an ounce to an ounce. The 
 above doses ai-e to be taken twice a-day, 
 and persevered in for some time. Much 
 attention is to be paid to the wearing of 
 proper clothing, and not to expose the 
 body to the vicissitudes of the weather, 
 and especially to avoid cold and damp. 
 
 RHUBARB, Rheum palmatum. A 
 plant, the root of which is much used in 
 medicine. All the rhubarb of commerce 
 grows on the mountains of Chinese Tar- 
 tary. It is imported into Russia; and 
 what comes to us from thence is always 
 good, as much attention, both in purchas- 
 ing and transporting it, is paid by order 
 of the government. It is improperly 
 called Turkey rhubarb. Rhubarb has 
 been cultivated in Britain for medical use, 
 but it has not been produced by any 
 means equal to the foreign. 
 
 ** Medical use. Rhubarb is a mild 
 cathartic, which operates without violence 
 
 'j^ 
 
 t^; 
 
 V /y.Au.iLJZ ^-^ t^:£'^^ €>u^'^J:^* 
 
 a 
 
470 
 
 RHUBARB. 
 
 or irritation, and may be given with 
 safety even to pregnant women and to 
 children. In some people, however, it 
 occasions severe griping. Besides its 
 purgative quality, it is celebrated as an 
 astringent, by which it increases the tone 
 of the stomach and intestines, and proves 
 useful in diarrhoea and disorders proceed- 
 ing from laxity. 
 
 " Rhubarb is exhibited, 1. In sub- 
 stance, in the form of powder. It ope- 
 rates more powerfully as a purgative in 
 this form than in any other. The dose 
 for an adult is about a scruple or upwards. 
 On account of its great bulk, it is some- 
 times unpleasant to take a sufficient dose ; 
 its laxative effects are therefore often 
 increased by the addition of neutral salts, 
 or other more active purgatives. In 
 smaller doses, (from three to six grains) 
 it often proves an excellent stomachic. 
 
 2. In infusion. Rhubarb yields more of 
 its purgative property to water than to 
 alcohol. The infusion is, however, con- 
 siderably weaker than the powder, and 
 requires double the dose to produce the 
 same effect. It is well adapted for chil- 
 dren, but must be always fresh prepared. 
 
 3. In tincture. On account of the sti- 
 mulating nature of the menstruum, this 
 preparation frequently cannot be exhibit- 
 ed in doses large enough to operate as a 
 purgative. Its principal use is as a tonic 
 and stomachic. 
 
 " The virtues of rhubarb are destroyed 
 by roasting, boiling, and in forming the 
 extract." — (Edinburgh Neiv Dispensa- 
 tory.) 
 
 Rhubarb is one of the medicines most 
 usefully given to children. As a laxa- 
 tive, it may either be given to them 
 alone in doses of from five grains to ten, 
 in water, gruel or jelly ; or tivp grains of 
 calomel with six of rhubarb may be given ; 
 or it may be combined with magnesia, 
 four grains of rhubarb to ten or fifteen of 
 magnesia; or in the form of Gregory's 
 mixture, one part of rhubarb to two of 
 magnesia, with a fourth part of ginger. 
 
 The compound rhubarb pills are com- 
 posed of rhubarb, aloes, and myrrh, fla- 
 
 voured with a little oil of peppermint. 
 They are an excellent stomachic, and 
 may be taken to the extent of two pills 
 every forenoon, while there is weakness 
 of the digestive powers. 
 
 RIBS. The series of crooked bones, 
 which form so large and important a part 
 of the walls of the chest- They are 
 twelve in number on each side, varying 
 in length, curvature, and extent of mo- 
 tion ; they are articulated with the back- 
 bone, and move upon it as an axis, in 
 performing the function of dilating and 
 contracting the chest. The ribs are 
 divided into true and false. The true 
 ribs are those which by their cartilages 
 are united to the breast-bone, and are 
 seven in number; the false touch one 
 another, or float loosely, but do not come 
 so far forward. 
 
 The ribs are subject to be broken by 
 external violence, as falls, blows, or the 
 like ; and when a splinter of a rib wounds 
 one or more air-cells, air is admitted into 
 the cellular texture of the whole surface 
 of the body, producing the disorder termed 
 emphysema. The best treatment for 
 broken ribs consists in preventing motion 
 by skilful bandaging with broad stripes 
 of flannel; and keeping down inflammation 
 by blood-letting and purgative medicines. 
 
 RICE, Oryzasativa, An esculent grain 
 much used in the Eastern countries, and 
 answering the same purposes as bread with 
 us. When mixed with other food, it fur- 
 nishes a wholesome article of diet, as it is 
 not disposed to become sour or to ferment 
 in the stomach ; but if it be taken in large 
 quantities, as it is not very stimulant, it 
 is apt to remain long on the stomach, 
 especially if it has been much boiled. 
 When the stomach is weak and relaxed, 
 it requires something stimulant to be 
 taken along with it; and hence in the 
 East, it is generally taken with pepper, 
 curry-powder, or some other aromatic 
 condiment. It is supposed to be in some 
 degree astringent ; and in looseness, rice 
 water, called conjee in India, A^ill be of 
 service, by its mild mucilage protecting 
 the intestines from acrid fluids. 
 
RICKETS. 
 
 4ftl 
 
 RICKETS. The disease called rick- 
 ets is chiefly incident to infants between 
 the ninth month and second year of their 
 age, but sometimes appears between the 
 second and sixth year. The children 
 who are affected with rickets are mostly 
 those who live in moist and damp places, 
 who are poorly fed, and who are not 
 kept cleanly. Since the labouring clas- 
 ses have been collected in large manu- 
 facturing towns, it appears to be on the 
 increase. The disease comes on slowly, 
 with a flabbiness of the flesh, wasting of 
 the body, paleness of the countenance, 
 and some degree of swelling of the face. 
 The head appears large in proportion to 
 the body, and the joinings of the bones, 
 are more incomplete than usual; while 
 the opening of the head is very large. 
 The forehead becomes unusually promi- 
 nent, and the neck appears small. The 
 teeth are long of cutting, and soon spoil 
 and drop out. The ribs get flattened, 
 and the breast-bone rises, the spine is 
 bent, the bones at the joints are large, and 
 the long bones between the joints, being 
 smaller and unable to support the weight 
 of the body, bend and continue crooked. 
 In many cases, the child is weak, dis- 
 inclined to exertion, or unable to wallf. 
 The appetite continues pretty good, but 
 the stools are frequent and loose, and the 
 belly is much swelled. Children affected 
 with rickets, in general have their men- 
 tal faculties very acute, even premature- 
 ly so ; but in a few cases, they are mor- 
 bidly dull. Sometimes the disease abates, 
 and the child recovers its health ; but the 
 deformity and bending of the bones re- 
 mains through life. One of the most dis- 
 tressing cases of rickets is that which 
 leaves the female pelvis distorted and 
 contracted, and hence subject to difficult 
 labour, or even rendering labour imprac- 
 ticable. 
 
 Rickets, Treatment of. The reme- 
 dies proper in the ciu-e of rickets are 
 those of a strengthening kind, applied to 
 the whole system, and to the stomach in 
 particular. Cold bathing, when the child 
 is able to beai* it, the pure air of the 
 
 country, removal from damp and moihjt 
 places, and attention to cleanliness, are 
 among the first requisites. The diet is 
 to be noiu*ishing, and wine is to be given, 
 with bark or quinine. A proper degree 
 of exercise is to be given by carrying the 
 child in a horizontal posture, avoiding all 
 attitudes that might add to the deformity. 
 The digestion is to be assisted by the 
 tincture of rhubarb, or by its powder 
 with a little calomel, and an occasional 
 emetic. The belly and back are to be 
 rubbed Avith some stimulating liniment 
 or anodyne balsam, as camphorated oil, 
 or the soap liniment. When the teeth- 
 ing of rickety children is difficult, we 
 are to apply the appropriate remedies; 
 and in every instance, to pay most parti- 
 cular attention to the stomach and bow- 
 els. A rising of one shoulder sometimes 
 occiu-s in young women between twelve 
 and fourteen, and is to be regarded as a 
 degree of rickets. The arm of that side 
 should be tied up, and the other alone 
 employed for some months. Steel stays, 
 very accurately fitted, should be worn for 
 a long period. 
 
 RING-WORM. A disease of the skia 
 appearing in small circular patches, or 
 rings of vesicles round the circumference 
 of a circle of apparently healthy skin : 
 these vesicles are small, and contain a 
 transparent fluid, which is discharged in 
 three or four days, when little dark scabs 
 form over them. Sometimes there is a 
 succession of the circles on the upper 
 parts of the body, as the face and neck, 
 and the arms and shoulders. Dr. Bate- 
 man thinks that though the ring-worm 
 has been observed in several children in 
 one school or family, at the same time, 
 it is not contagious, but probably to be 
 attributed to the season or some other 
 common cause. There is another dis- 
 ease of the scalp, popularly termed ring- 
 worm, and manifestly contagious, to 
 which we shall advert, when we have 
 spoken of the treatment of the true ring- 
 worm. The ring-worm is not unfre- 
 quently, by the common people, besmear- 
 ed with ink ; and by the use of this, or 
 
472 
 
 R I N G - W O R M. 
 
 other astring-ent and stimulant applica- 
 tions, the pain and itching are much re- 
 lieved; and other solutions of the salts 
 of iron, copper, or zinc, or alum, or 
 ointments into which the same injrre- 
 dients enter, wiU answer the same pur- 
 pose. 
 
 Of the Infectious Ring- Worm. The 
 more formidable and infectious species 
 of ring-worm appears in distinct patches 
 of an irregularly circular figure, on the 
 scalp, head, and neck. It commences 
 with clusters of small light yellow pus- 
 tules, which soon break and form thin 
 scabs over each patch ; and these, if ne- 
 glected, become thick and hard by ga- 
 thering on one another. If the scabs 
 are removed, however, the surface of 
 the patches is left red and shining, but 
 studded with white elevated points, in 
 some of which, minute globules of pus 
 again appear in a few days. As the 
 patches extend, the hair covering them 
 becomes lighter in its colour, and some- 
 times breaks off short; and as this pro- 
 cess is repeated, the roots of the hair are 
 destroyed, and at length, there remains 
 uninjured, only a narrow border of hair 
 round the head. It generally occurs in 
 children of three or four years old and 
 upwards, and often continues for several 
 years. It can be considered as about to 
 terminate, only when the redness and ex- 
 foliations disappear together, and the hair 
 begins to grow of its natural colour and 
 texture. The disease seems to originate 
 spontaneously in children of feeble and 
 flabby habit, or in a state approaching to 
 marasfhus ; who are ill fed, uncleanly, 
 and not sufficiently exercised; but it is 
 principally propagated by the actual con- 
 veyance of the matter from the diseased 
 to the healthy, by the frequent contact of 
 the heads of children, but more generally 
 by the use of the same towels, combs, 
 caps, and hats. 
 
 Treatment. While the patches are in 
 an inflamed and irritable condition, we 
 must be content with regular washing 
 or spunging with warm water, or some 
 emollient fomentation. Even the ope- 
 
 ration of shaving, which is necessary to 
 be repeated at intervals of eight or ten 
 days, produces a temporary increase of 
 irritation. At this time, all stimulant 
 lotions and ointments should be avoid- 
 ed. The disease assumes various forms, 
 and these require a corresponding va- 
 riety in the treatment; so that no single 
 application can be said to possess any 
 unfailing power against the ring-worm. 
 When the inflammatory state subsides, 
 a dry scabbing and exfoliation ensues, 
 but again the pustular eruption breaks 
 out, and the patches again become red 
 and tender. In other instances, the 
 surface becomes inert and torpid, while 
 a dry scaly scab constantly appears, 
 and active stimulants are requisite to 
 effect any change in the disorder. In 
 more irritative states, the milder oint- 
 ments, with calomel, oxide of zinc, ace- 
 tate of lead, should be employed, or seda- 
 tive lotions, or decoctions or infusions of 
 poppy heads or tobacco. When there is 
 an acrimonious discharge, the ointments 
 of zinc and lead, or the milder mercurial 
 ones, or a lotion of lime-water with calo- 
 mel, are advantageous. In a very dry 
 and inert state of the patches, caustic 
 substances are often very successful. 
 Sometimes a solution of nitrate of silver, 
 six grains to the ounce, or the mineral 
 acids slightly diluted, or the application 
 of a blister, removes the diseased skin, 
 and the new one assumes a healthy action. 
 But in the varying forms and degrees of 
 ring-worm, the remedies must be varied, 
 and combined, according to the degree of 
 irritation which prevails. Dr. Bateman 
 disapproves of the rough methods of 
 practice, by which the hairs are forcibly 
 removed ; as he thinks they inflict great 
 injury on the scalp, and retard, rather 
 than expedite the progress to recovery. 
 In general, the system at large is not af- 
 fected, and little internal medicine is ne- 
 cessary; but in weakly constitutions, 
 bark and the preparations of iron, with 
 nourishing diet, are to be prescribed ; and 
 attention must be paid to the patient's 
 diet, clothing, and exercise. 
 
ROSE. 
 
 473 
 
 ROCHELLE SALTS, Tartrate of 
 Potass and Soda, a purg-ative salt of great 
 utility, as being an excellent cooi'ing lax- 
 ative, without the nauseous taste that 
 some others of the neutral salts possess. 
 The crystals are large and beautiful ; the 
 dose is from six drachms to an ounce or 
 an ounce and a half. They get their 
 name from having been originally made 
 at Rochelle, by an apothecary of that 
 town named Seignette, whence they are 
 also called Sal Seignetti- 
 
 ROSE, Erysipelas, or St. Antony's 
 Fire. The rose is a complaint, which 
 comes on with shivering, thirst, and other 
 feverish symptoms ; and which after- 
 Wards affects some part of the skin with 
 swelling, and redness of an uncertain ex- 
 tent, on which blisters very commonly 
 rise. It attacks various parts of the body, 
 and very frequently the face. At the be- 
 ginning of the disease, there is confusion 
 of head, and some degree of delirium; 
 and there is not unfrequently considera- 
 ble drowsiness. About the second or 
 third day, a slight redness appears, which 
 gradually spreads till it has occupied the 
 whole of the face, and from the face it 
 extends to the scalp, and down the neck. 
 The redness does not continue equally 
 bright on all the parts affected, but fades 
 a little on those where it began. The 
 swelling is considerable, and sometimes 
 so great as to disfigure the countenance, 
 and to shut up the eyes. Blisters of va- 
 rious sizes, containing a thin yellowish 
 liquor, rise on several parts of the face. 
 Where blisters do not rise, the skin scales 
 /--J :) offal the conclusion of the disease. The 
 ' fever and inflammation usually continue 
 from eight to ten days. The severity and 
 danger of the disease is to be judged 
 from its effects on the brain. If there is 
 much delirium and drowsiness, it portends 
 great danger, especially when they appear 
 early in the disease ; but the absence of 
 these symptoms is to be accounted fa- 
 vourable. When the rose attacks other 
 parts of the body, there is seldom any de- 
 lirium, but the inflammation very fre- 
 quently ends in the formation of matter, 
 
 ■y/- 
 
 which, indeed, is sometimes the case in 
 the swelling of the eye-lids. Those who 
 have once or oftener had rose, are liable 
 to frequent returns of it. 
 
 Causes. It arises in many cases with- 
 out any obvious cause ; sometimes it is 
 owing to exposure to a strong heat, or 
 intemperance ; it is often a symptom of 
 wounds and punctures, and of the appli- 
 cation of poisons, as the stings of insects. 
 The worst kind is that which arises in 
 debilitated constitutions or dropsical ha- 
 bits, and in those who are addicted to the 
 use of strong liquors. 
 
 Treatment. As the rose is evidently 
 a febrile and inflammatory complaint, our 
 method of cure must be by the means of 
 lessening inflammation ; but the delirium 
 and drowsiness in some cases, and the 
 putrescent and debilitating symptoms in 
 others, have rendered the use of bleeding 
 and copious evacuations a very doubtful 
 piece of practice. Unquestionably, if the 
 pulse be full and hard, with great heat of 
 skin and thirst, and if the other feverish 
 symptoms are high at the commence- 
 ment, we are to judge by these symp- 
 toms, and not by the name of the disease, 
 and to bleed and purge accordingly ; but 
 we must be cautious to what extent we 
 carry those practices, and especially be 
 cautious how we repeat them. We are 
 to enjoin rest and quietness, to give lax- 
 ative medicines, to encourage a gentle 
 perspiration by diluent drinks, or sweat- 
 ing medicines that do not stimulate. 
 Sinapisms applied to the feet, are of greai 
 advantage when the head is much affect- 
 ed. The diet is to be very sparing; and 
 it is not till the disease abates, or signs of 
 weakness come oit, that we are to ven- 
 ture upon nourishing diet, bark, or wine. 
 In rose, it has not been thought safe to 
 make use of any watery or oily applica- 
 tions, as they seem rather to occasion the 
 spreading of the infljimmation ; and the 
 application most commonly employed is 
 some dry powder, as being the most in- 
 nocent. It is not to be too thickly laid 
 on, lest we increase the heat and inflam- 
 mation, and prevent any tendency there 
 
474. 
 
 ROSE. 
 
 may be to perspiration; and when the 
 blisters break, it may occasion inconveni- 
 ence by the matter forming crusts with 
 the flour. It is still the safest applica- 
 tion, and may always be put on in domes- 
 tic medicine; but it should be left to a 
 medical man to determine whether any 
 cooling- lotion may be advisable. When 
 there is evident tendency to suppuration, 
 
 . aJ ^^ ^^® ^^ ^PPb' poultices to bring it for- 
 ward, and when the abscess is formed, to 
 treat it in the common way; but M^e 
 must, in many cases, expect an ulcer deep 
 and difficult to heal. 
 
 " If a gangrene is threatened, besides 
 the inward use of camphor and the bark, 
 spirituous and astringent applications 
 should be employed externally, such as 
 mixtures of lime-water with camphorated 
 spirit, or camphorated spirit mixed with 
 tincture of myrrh, or an infusion of the 
 bark. 
 
 " Erysipelas is sometimes of the ner- 
 vous or low kind ; appearing with a puffy 
 redness in the skin instead of a swelling; 
 the pain is more acute, but the throbbing 
 of the vessels less ; no circumscribed tu- 
 mours appear, but the parts are more in- 
 flumed ; at the decline of the disease, the 
 redness of skin becomes of a purple hue ; 
 it is very liable to terminate in a mortifi- 
 cation. The habit from the first, and 
 throughout, is very irritable, and the 
 strength depressed. It is generally ac- 
 companied with heartburn, itching, in- 
 flammation of the skin, painful ulcera- 
 tions, and small lucid pustules. 
 
 " In some strong habits, both a phleg- 
 monous and the low erysipelatous inflam- 
 mation occur together ; in which case, a 
 moderate evacuation of blood may be al- 
 lowed, but should be cautiously attempt- 
 ed. If the patient labours under great 
 depression of strength, irritability, &c. 
 we must support his strength with wine, 
 i and the warmest cordials ; when blisters 
 
 *M/f» rise, the bark may be freely given, from 
 six drachms to an ounce, or more if the 
 stomach will bear it, in twenty-four hours, 
 (or proportionate doses of the sulphate of 
 quinine, three grains every four hours). 
 
 When the eruption is apparently com- 
 plete, and the pustules ripened, snip the 
 blisters, and absorb the fluid with soft 
 rags, then apply spermaceti ointment, or 
 Turner's cerate." (Parr's Medical Dic- 
 tionary^ 
 
 Infantile Erysipelas. This affection 
 was first distinctly described by Dr. Un- 
 derwood. It never appears after the 
 month, but most frequently shows itself a 
 few days after birth. Children are some- 
 times born with it ; in a few instances, it 
 is preceded by jaundice, or a locked jaw. 
 It attacks suddenly the most robust as 
 well as the most delicate children, and its 
 progress is rapid; the skin turns of a 
 purplish hue, and soon becomes very hard. 
 The milder species appears often on the 
 fingers and hands, or the feet and ankles, 
 and sometimes upon or near the joints, 
 suppurating very quickly. The more 
 violent kind is almost always situated at 
 the lower part of the belly, extending up- 
 wards, and down the thighs and legs; 
 though it sometimes begins in the neck. 
 The swelling is moderate ; but after be- 
 coming hard, the parts turn purple, and 
 very often sphacelate, especially in boys, 
 when it falls on the scrotum. 
 
 Various means have been used with 
 little success, though for a time benefit 
 was apparently received from saturnine 
 fomentations and poultices, applied on the 
 very first appearance of the inflammation ; 
 but it soon spread, and a gangrene came 
 on. When matter is formed, the tender 
 infant soon sinks under the discharge. 
 Bark and camphor are recommended when 
 mortification threatens. The greatest 
 number of infants attacked with this dis- 
 order are carried off; many of them in a 
 very few days. (See Parr, Article Ery- 
 sipelas.) 
 
 ROSE, Hosa Gallica. A well known 
 fragrant flower, principally used in phar- 
 macy to obtain rose-water, which forms 
 an elegant solvent for astringent salts, 
 that are employed as washes. A solution 
 of sulphate of zinc in rose-water, in the 
 proportion of two grains to the ounce, 
 forms a good wash for sore nipples. Au 
 
RUPTURE. 
 
 475 
 
 infusion of rose-leaves is turned to a beau- 
 tiful red colour by the addition of a little 
 sulphuric acid, and in this form is em- 
 ployed as a gargle in sore throat. 
 
 ROSEMARY, Rosmarinus officinalis. 
 A large shrubby plant, with flowers of a 
 pale, bluish colour. It is a native of the 
 southern parts of Europe, but is cultivat- 
 ed in our gardens. Rosemary has a warm, 
 pungent, aromatic, bitter taste, and a 
 smell approaching to that of lavender, 
 joined with the odour of camphor; crys- 
 tals of which last are deposited when the 
 plant is long kept. What virtues it has 
 are of a stimulant nature ; and it is some- 
 times used in nervous headach, and hys- 
 teria. The leaves and tops yield an es- 
 sential oil, the dose of which is from three 
 to five drops. From this oil and rectified 
 spirit, a spirit of rosemary is prepared ; 
 of which the dose is from half an ounce 
 to an ounce. Hungary water, when ge- 
 nuine, is a pure spirit distilled from the 
 rosemary, and is strongly scented with 
 the rich perfume of the plant. 
 
 ROVING. See Delirium. 
 
 RUBEFACIENTS. Substances em- 
 ployed to give to the skin a degree of ir- 
 ritation less than what is given by a blis- 
 ter. This is done by mustard, by harts- 
 horn, more or less diluted, and by some 
 other substances. The effect of rubefa- 
 cients is to relieve internal pain, without 
 producing the excoriation or watery dis- 
 charge that a blister does. 
 
 RUE, Ruta graveolens. A small shrub- 
 by plant, a native of the south of Europe, 
 and cultivated in our gardens. It has a 
 strong, unpleasant smell, and a bitterish 
 taste. The leaves are very acrid, and 
 blister the skin when much handled. It 
 has been said to be a powerful stimulant ; 
 serviceable in hysterical complaints, and 
 uterine obstruction ; but it is merely an 
 antispasmodic of no great powers. It is 
 used in the form of extract, from ten to 
 twenty grains, or the volatile oil, from 
 five to ten drops. 
 
 RUM. The ardent spirit obtained by 
 distilling the fermented juice of the sugar 
 cane. Its general properties agree with 
 
 those of other distilled spirits, but from 
 its peculiar flavour it is less agreeable to 
 some stomachs and palates than others. 
 
 RUPTURE, called in sui^ical language 
 Hernia, signifies the displacement of any 
 of the internal organs from their natural 
 situation ; but it is more commonly appli- 
 ed to that disesi-.e, which arises from the 
 bowels getting through some of the aper- 
 tures designed for the transmission of 
 other organs. When the parts of the 
 bowels or omentum which have protrud- 
 ed can be replaced by change of posture 
 or by the hand, the hernia is said to be 
 reducible ; when it is not, it is called ir- 
 reducible hernia ; and when dangerous or 
 painful symptoms are brought on by its 
 being constricted, it is said to be strangu- 
 lated. 
 
 Ruptui'es are inconvenient and danger- 
 ous in proportion to their bulk, to the 
 place where they occur, and to the strio- 
 ture or pressure they undergo ; and with- 
 out entering upon the discussion of the 
 more uncommon and obscure kinds, we 
 shall mention those which are generally 
 met with, and which, by -their frequent 
 occurrence, demand attention. 1. Ingui- 
 nal Hernia, or that which occurs in the 
 groin. There is, at the lower part of the 
 belly, and towards the middle line, a pas- 
 sage through the muscles of the belly for 
 the transmission of certain organs, which 
 in the male sex are lodged in the scro- 
 tum, and in the female are distributed 
 among the skin at the sides of the labia. 
 Through these openings, the bowels are 
 sometimes protruded, either by the aper- 
 tures being unusually large, or by some 
 stress or violent exertion of the body. 
 Some portion of the bowels is thus forc- 
 ed downwards in the direction of the 
 scrotum, occasioning a greater or less 
 swelling in that part ; or the bowels may 
 be pushed out so very little, as to form 
 merely a small and hardly perceptible 
 swelling in the groin. 2. Femoral Hernia 
 is that which appears at the upper part 
 of the thigh, or at the opening by which 
 the great blood-vessels enter into and 
 pass out of the abdomen. 3. Umbilical 
 
476 
 
 RUPTURE. 
 
 Hernia signify those niptures which oc- 
 cur at the navel. Ruptures also occur at 
 various other parts, but much more rare- 
 ly than at those above mentioned. 
 
 When a rupture comes on suddenly, in 
 consequence of any violent exertion, the 
 patient has the sensation as if something 
 had given way, and the pain is conside- 
 rable. But many persons are afflicted 
 with rupture, in whom it has come on 
 gradually, and in whom there are large 
 swellings, giving no inconvenience but 
 what arises from their bulk. But a per- 
 son who is ruptured, can never be sure 
 that things will remain in a quiet state ; 
 because from external violence, from un- 
 usual exertion, or from causes unknown, 
 dangerous symptoms may speedily come 
 on. Sometimes ruptures return iuto the 
 cavity of the belly when the patient is in 
 the horizontal posture, or they can be 
 replaced wdth a little manual assistance ; 
 but in other cases, irom the great quan- 
 tity of intestine that is down, from ad- 
 hesions having been formed between it 
 and the neighbouring parts, its reduction 
 is impracticable. When a rupture can 
 be replaced, it is proper for the patient 
 to wear a truss, which, when well made, 
 gives the necessary support to the bowels, 
 and prevents their being pushed out of 
 the cavity : the wearing of it is attended 
 with no inconvenience ; and even very 
 young children may wear a truss if it be 
 properly fitted. When a truss cannot be 
 worn, or when the rupture cannot be put 
 up, all that remains is for the patient to 
 take as much care as possible, that no 
 injury or blow be inflicted on the tumour, 
 to guard against costiveness, and to avoid 
 violent exertions of every kind ; and in 
 children, care must be taken to prevent 
 crying, and al} such motions as are apt 
 to increase or occasion rupture. 
 
 Causes. There are some persons in 
 •\A'hom rupture takes place more easily 
 than in others, and in whom it is con- 
 stant. The reason seems to be, that the 
 ])arietes of the abdomen, or the neigh- 
 bourhood of the openings in it, are more 
 lax and yielding in them than in others. 
 
 It is common in warm climates, in old 
 people after long illnesses or debilitating 
 fevers, and in the poor who have laboured 
 hard and been ill fed. The circumstance 
 which immediately occasions ruptures, 
 is generally some violent exertion, which 
 implies a strong action of many muscles, 
 especially those of respiration ; hence 
 ruptures are brought on by lifting or 
 carrying heavy weights, jumping, run- 
 ning, vomiting, straining at stool, the 
 efforts of women in childbed; or by 
 coughing, sneezing, crying, laughing. As 
 the whole of the human race are conti- 
 nually exposed to some one or other of 
 these exertions, and as ruptures are com- 
 paratively rare, we infer that those to 
 whom they occur, have some peculiar 
 laxness in the structure of the parts 
 through which the bowels protrude. 
 
 Rupture, Symptoms of, when it is re- 
 ducible and not strangulated. A swelling 
 in some part of the belly ; this diminishes 
 a little on pressure, but returns when the 
 pressure is withdrawn ; it goes off when 
 the patient lies down, and is increased 
 by coughing. Patients with rupture are 
 sometimes troubled with indigestion; but 
 frequently, all the functions of the ali- 
 mentary canal are quite regular. When 
 we succeed in getting up the bowels, 
 there is commonly what is called a gug- 
 gling noise. 
 
 Rupture, Strangulated, Symptoms of. 
 When either an old rupture from some 
 cause has become strangulated, or when 
 some sudden exertion has at once pro- 
 duced rupture and strangulation, the fol- 
 lowing symptoms occur: There is a 
 swelling at the place of the rupture, pain- 
 ful to the touch, and increased by cough- 
 ing, sneezing, or by the upright posture. 
 These symptoms are followed by sick- 
 ness, retching, costiveness, Mith a fre- 
 quent hard pulse, and other attendants 
 of fever. The cause of these symptoms 
 is the stricture made on the bowel, by the 
 part through which it protrudes. The 
 object of cure, is therefore to relieve the 
 bowel from this pressure, which is to be 
 effected either by returning the intestine 
 
RUPTURE. 
 
 477 
 
 into the belly, by the same aperture 
 through which it canie out, or enlarging 
 the aperture by an operation. 
 
 Treatment. We are tii-st to endeavour 
 to replace the bowel by the hand, if pos- 
 sible ; and various methods are to be put 
 in practice, to produce the relaxation 
 necessary for that purpose. The surgeon 
 is to place the patient with the thighs 
 bent; and he is to make pressure on the 
 tumour in a direction upwards and out- 
 wards. In a young and strong- person, 
 bleeding is very proper, both to induce 
 relaxation, and to prevent inflammatory 
 symptoms. The warm bath may be tried 
 also to induce relaxation. With a view to 
 diminish the bulk of the swelling, and so to 
 render it more easily replaced, cold has 
 been applied to the extenial parts, by 
 means of ice or of ether. An injection of 
 the infusion of tobacco produces an ex- 
 treme relaxation of the whole system, and 
 so has conduced to the replacement of 
 protruded bowels. The strength of the 
 infusion is a drachm of the leaves to an 
 English pint of boiling water; this is 
 infused for ten minutes ; one half is in- 
 jected at first, and the other a little after- 
 wards, if no proper effect is produced by 
 the first. The tobacco injection is a re- 
 medy of the greatest danger, and must 
 never be administered, except by an ex- 
 perienced practitioner. These attempts 
 to reduce the bowel, must be made for a 
 longer or shorter period according to the 
 symptoms of each case. Much handling 
 will add to the danger of inflammation 
 which is already so great ; and too long 
 delay will allow the boAvels to get into a 
 state of mortification. When we have 
 decided that an operation is necessary, 
 it is to be performed by making an in- 
 cision through the skin and other cover- 
 ings, till we reach the sac containing the 
 gut ; we are then to ascertain the situar 
 tion of the part that causes the stricture, 
 and, guided by the finger, or by an instru- 
 ment called a director, we are to divide 
 with a bistoiu-y in the proper direction. 
 It is unnecessary to trouble the general 
 r4?ader with more than the plan and out- 
 
 line of the operation, and what is intend- 
 ed by it. If the bowels are in a fit state 
 to be replaced, and the operation is suc- 
 cessful, the first favourable symptoms 
 will be a cessation of the vomiting, and 
 a free discharge by stool ; and after the 
 w^ound is dressed, we are to watch lest 
 inflammation come on. Rest and quiet 
 are to be enjoined, and occasional mild 
 laxatives are to be given. After the cure 
 is completed, the patient should wear a 
 truss, probably for life ; and ever after be 
 cautious not to use any violent exertion. 
 
 Ruptures in Infants. " Ruptures in 
 different parts, especially at the navel, are 
 not unfrequent occurrences ; fortunately, 
 they are not attended with so much dan- 
 ger as similar disorders in grown people. 
 When the disease is confined to the nave!, 
 a broad piece of flannel, in the form of a 
 roller, together with pieces of adhesive 
 plaster applied over the pai-t with a ball 
 of cotton, forming what has been termed 
 by surgeons a graduated compress^ by 
 affording a safe and firm support, prove 
 so useful, that as the infant acquires 
 strength, the rupture commonly disap- 
 pears. The other varieties of rupture are 
 often cured by the natural increase of 
 size and strength of the body, and require 
 chiefly attention to the due regulation of 
 the bowels, and the daily use of the cold 
 bath. No truss ought to be employed 
 for at least the first two years of life/' 
 (Professor Haaiilton.) 
 
 HYE, Secale cereaie. A sort of grain 
 much used for food in the northern coun- 
 tries of Europe. It is less nourishing 
 than wheat, but sufficiently nutritive and 
 wholesome. It is a good deal disposed 
 to turn sour on the stomach, and to open 
 the bowels, vhen people first begin to 
 use it. 
 
 There is a black morbid excrescence, 
 curved like the spur of a fowl, which i« 
 found on the spikes of rye. This is sup- 
 posed to be occasioned by the depreda- 
 tions of an insect. It is called the ergot 
 of rye, and when powdered and mixed 
 with rye-flour, or taken into the stonuw-li 
 alone, it produces poisonous effects. Tho 
 
478 
 
 RYE. 
 
 symptonis produced are intoxication, las- 
 situde, a sense of something- creeping- on 
 the skin, with convulsive movements oc- 
 cuiTing- periodically. This affection is 
 called raphania. Some have epileptic or 
 maniacal symptoms ; some, unquenchable 
 thirst ; and livid eruptions and cutaneous 
 ulcerations are not uncommon. The dis- 
 ease continues from ten days to two or 
 three months, or long-er. Sometimes the 
 skin in the neighbourhood of the fing-ers 
 and toes becomes dry, hard, and black. 
 Milk is the best corrector of the bad ef- 
 fects of ergot, in the mouth. Emetics, 
 
 purgatives, and clysters, are to be given 
 for the convulsions and other symptoms j 
 and afterwards stimulants, as ammonia, 
 camphor, and ether. The diseased skin 
 is to be dressed with oil of turpentine, 
 and afterwards warm stimulating fo- 
 mentations and poultices are to be 
 applied. 
 
 The erg-ot has been used for medicinal 
 purposes, and is said to act powerfully on 
 the uterine system. But it has not been 
 long enough employed to ascertain exact- 
 ly its effects, or to be properly brought 
 under the notice of the general reader. 
 
 SAG 
 
 SABINE or S A VINE, Juniperus sa- 
 hina, is a plant of a strong and peculiar 
 odour, and of an acrid and bitter taste. 
 It has been thought a powerful stimulant 
 of the uterus, and as such has been occa- 
 sionally employed in obstructed menstru- 
 ation. It is used in the form of extract 
 to the extent of ten grains, or five drops 
 of the essential oil twice a-day. The 
 powdered leaves are used in ointments to 
 render them stimulant, and are thus ap- 
 plied to indolent sores, and to keep up the 
 discharge from issues. 
 
 SAFFRON is the summits of the pis- 
 tils of the crocus. Crocus sativuS' The 
 smell is pleasant and aromatic ; their 
 taste is an aromatic bitter, and they tinge 
 the saliva of a deep yellow colour, when 
 chewed. Saffron had formerly consider- 
 able reputation in uterine obstructions ; 
 but its medicinal powers are very small, 
 and it is now used merely for its aroma- 
 tic flavour, and to impart its bright yel- 
 low colour to other substances. 
 
 SAGE, Salvia officinalisy is a plant 
 having a warm aromatic taste and smell, 
 with some degree of bitterness and as- 
 tringency. It is taken in the form of in- 
 fusion, and drank like tea for its stimu- 
 
 S AL 
 
 lant, carminative, and tonic effects. With 
 a little lemon-juice, sage tea is used as a 
 diluting drink in feverish disorders. 
 
 SAGO. An article of food, pretty 
 commonly used for the diet of children 
 and invalids, resembling starch in many 
 of its properties, and forming a bland, 
 mucilaginous, and nutritive substance. 
 It is obtained from the pith of several 
 species of palm, and is shaped into grains 
 by being passed through a coarse sieve 
 when half dry. A dessert-spoonful of 
 these grains, by being boiled, will form a 
 pretty large bason of mucilage ; and may 
 be taken with, wine, milk, or sugar, as we 
 find convenient for the patient. 
 
 SAINT ANTONY'S FIRE. See'Ro^z. 
 
 SAINT VITUS' S DANCE. See 
 Dance, &c. 
 
 SALADS are those leaves and stalks 
 which are eaten at table, not for nourish- 
 ment, but as condiments. The chief of 
 these are lettuce, water-cresses, endive, 
 and celery. Some of them are blanched, 
 and so deprived of their acrimony. Oil, 
 vinegar, and salt, are generally mixed 
 with salads. Vegetables eaten in this 
 way are very refreshing, in the heats of 
 summer; and temper the feverish ex- 
 
SALIVATION. 
 
 470 
 
 citement which fiill meals of animal food 
 are apt to occasion. Persons troubled 
 with indigestion should rarely touch any 
 of them, except the water-cresses. 
 
 SALIVA. Tlie spittle, or liquor se- 
 creted by various glands which open in- 
 to the mouth, and pour in the fluid so 
 necessary in the mastication of the food, 
 and in digestion. The saliva is poured 
 into the mouth in the greatest abundance 
 at the time when it is most ^vanted, that 
 of eating ; and this is owing both to the 
 motion of the jaws, and to the stimulus 
 imparted by the food and seasonings which 
 we use. The saliva is increased by va- 
 rious acrid substances applied to the 
 tongue and parts within the mouth, as 
 ginger, pellitory, and very many others. 
 
 The saliva sometimes becomes very 
 viscid, occasioning continual hawking ; 
 sometimes it is very thin and copious, 
 and flows from the mouth in great quan- 
 tities. Thirst does not seem to be very 
 dependent on the quantity or nature of 
 the saliva; sometimes, when the tongue 
 and fauces are black and parched, little 
 complaint is made of thirst ; and again, 
 the most abundant flow of it, does not 
 impart the moist sensation of health. The 
 state of the digestive powers seems to be 
 the cause of these vitiations of the saliva. 
 When the saliva is not swallowed as it 
 ought to be, the digestion becomes injur- 
 ed; as is sometimes seen in those who 
 chew tobacco, and in some maniacs who 
 are constantly spitting. 
 
 SALIVATION. The flow of saliva, 
 and the action of the glands, which se- 
 crete it, is increased in a wonderful de- 
 gree by the action of mercury, introduc- 
 ed in various ways into the system. Whe- 
 ther it be rubbed in, in the form of oint- 
 ment, or slowly given by the mouth in 
 the form of blue piU, or calomel, it pro- 
 duces salivation ; and it is by this effect 
 that we judge the mineral to have enter- 
 ed the system, and to be there exerting 
 its peculiar power. When the salivary 
 glands appear swelled, when the breath 
 becomes tainted with a peculiar fetor, we ' 
 consider the patient to be under the in- 
 
 fluence of mercury, or to be salivated. In 
 the practice of physic, not many years 
 ago, long and severe salivation was 
 thought necessary for the cure of several 
 diseases ; and the effects were so debilitat- 
 ing, that not a few had their constitution 
 irretrievably ruined, not by their disease, 
 but by the mercury. It is now admitted 
 by all intelligent practitioners, that such 
 a severe exhibition of mercury is not ne- 
 cessary, and that all the good effects to be 
 expected from it, may be prociu-ed by 
 keeping the mouth and gums a little ten- 
 der for the time we think necessaiy, 
 withdrawing or resuming the mercury as 
 the mouth is more or less affected. See 
 Mercury. 
 
 When salivation is excessive, and the 
 mouth and tongue sore and ulcerated, we 
 are to use the solution of borax and ho- 
 ney, as a topical application, and to dimi- 
 nish the irritation of the system by laxa- 
 tive medicines, chiefly the neutral salts. 
 Dover's powder is a good way of exhi- 
 biting opium in profuse salivation. A 
 person under salivation should beware of 
 exposiure to cold, as it is apt to induce 
 painful swellings of the salivary glands 
 and tonsils. 
 
 SALMON may perhaps be considered 
 as the most nutritive of our fish ; but it 
 is heating and oily, and not very digesti- 
 ble ; and persons even with strong sto- 
 machs are frequently under the necessity 
 of taking some stimulant to assist its di- 
 gestion. The addition of lobster-sauce 
 renders it still more unwholesome; the 
 best condiment that can be used is vine- 
 gar. As connected with the time of 
 spawning, the season of the year has the 
 most decided influence upon the quality 
 of salmon. It is in the highest perfec- 
 tion some time previous to its spawning; 
 the flesh is then firm and delicious; where- 
 as, after this event, it is for some time 
 unfit for food. The eating of the fish at 
 such times has been often found to be 
 productive of disease. Hence the legis- 
 lature has fiLXcd the periods at which sal- 
 mon fishing is lawful. Salmon trout is 
 not so rich and oily as the salmon. Al- 
 
480 
 
 SALT. 
 
 though, therefore, it is less nutritive, it 
 is, at the same time, less heating, and 
 more digestible. (Dr. Paris on Diet.) 
 
 SALT, in strict chemical language, 
 means any thing which is soluble in wa- 
 ter, and which has a taste; but when this 
 term is used without any addition, we 
 commonly mean the Muriate of Soda, or 
 Common Salt; that which gives its salt- 
 ness to the ocean, and which is so uni- 
 versally taken as a seasoning to the food. 
 It is justly reckoned a necessary of life, 
 and few stomachs could digest their food 
 without its assistance. When salt is not 
 used in sufficient quantity; or when, from 
 any circumstance, it cannot be procured, 
 very bad effects follow. The digestive 
 powers are weakened, the body becomes 
 emaciated, and worms are generated. 
 This is said to occiu* frequently in Ire- 
 land, where the lower classes are much 
 infested with worms, from the bad qua- 
 lity of their food ; and a draught of salt 
 and water is found very useful in expell- 
 ing them. An illustration is also given 
 of the bad effects of wanting salt, in the 
 punishment once inflicted on criminals in 
 Holland, by feeding them on bread made 
 without salt ; the consequence of which, 
 was the production of numerous worms, 
 and the death of the unhappy sufferers in 
 consequence. 
 
 Salt is a great preventer of putrefac- 
 tion, and as such is employed in the cur- 
 ing of animal food, fish, &c. Food which 
 has been thus prepared, smoked, and 
 dried, is, in some measure, difficult of di- 
 gestion, and should not be indulged in by 
 those M'ho are troubled with stomach 
 complaints, or who are subject to inflam- 
 matory and erysipelatous disorders. 
 
 Though a certain proportion of salt is 
 indispensably necessary as a condiment 
 to our food, it is well known that an 
 excess of it is extremely injurious. It 
 is thought by the latest inquirers, that 
 when meat is preserved by being salted, 
 a chemical effect is produced on such 
 meat ; and that it is a very different thing 
 to take salted meat, and the same quan- 
 tity of salt and meat which have not 
 
 entered into this chemical combination. 
 The principal and most fatal disease oc- 
 casioned by living on salt provisions, is 
 the sea-scurvy ; and the tendency to this 
 is to be checked by vegetable diet, or 
 when this cannot be procured, by lemon- 
 juice. See Scurvy. 
 
 SALTS. In common language, when 
 we talk of Salts, we mean the neutral, al- 
 kaline, or earthy salts, commonly used as 
 laxatives. Of these, there are several of 
 great utility in medicine, as the sulphate 
 of soda, or Glauber's salts, which has 
 been nearly superseded by the sulphate 
 of magnesia, or Epsom salts. We also 
 use very frequently the Rochelle salts, 
 and the phosphate of soda, or tasteless 
 salts. The general dose of each is about 
 from six to ten drachms, dissolved in four 
 ounces of tepid water, and taken in the 
 morning. 
 
 SAMPHIRE, Crithmum maritimum. 
 A plant that grows about the sea-coast 
 in several parts of Great Britain. It has 
 a spicy aromatic flavour, and when pickled 
 with vinegar, it makes an elegant condi- 
 ment, much esteemed. 
 
 SARCOCELE. A scirrhous disease 
 of the testicle, of which the first appear- 
 ance is an enlargement and hardness of 
 the body of the testicle, without pain or 
 inequality of surface, and occasioning 
 little uneasiness except by its weight. 
 Sometimes, very soon after its appear- 
 ance, it becomes unequal and knotty, 
 with acute pains darting to the loins and 
 back, but the skin still remains entire. 
 Sometimes, the disease produces a large 
 foul ulcer with hard edges. 
 
 Treatment. Though the disease in 
 some cases remains quiet for a length of 
 time, yet, in many others, it becomes 
 suddenly worse, and even fatal. It is 
 now pretty generally admitted, that as 
 soon as a patient is quite ascertained to 
 have a scirrhous testicle, the only safe 
 plan is to have it removed. This, in 
 general, relieves the patient; though in 
 some cases, the same disease may seize 
 on other parts, and render the operation 
 unavailing. 
 
S C A L L E D HEAD. 
 
 481 
 
 SARDONIC LAUGHTER. A con- 
 Tulsive action of the diaphragm and other 
 parts, giving the appearance of ghastly 
 and unnatural laughter. It is a closing 
 symptom of several fatal diseases. 
 
 SARSAPARILLA, Smilax sarsapa- 
 rilltty a plant growing in South America, 
 the roots of which had great celebrity 
 many years ago, for their power of curing 
 syphilis. It is now agreed, that sarsapa- 
 rilla has no power whatever in the cure 
 of true syphilis, though it has some good 
 effects in certain cutaneous disorder. It 
 is of service to those anomalous pains 
 in the bones and joints, the sore throat 
 and other symptoms, which appear to 
 be owing to the combined effects of 
 mercury and syphilis. In spreading 
 sores, in some forms of scrofula, and in 
 debilitated constitutions, it has done 
 good. The best way of using it is in 
 decoction, of which a pint is to be taken 
 daily, or an ounce of the powder. It 
 produces a pretty copious perspiration, 
 and in weak constitutions this may 
 require to be checked by the addition 
 of a little sulphuric acid or elixir of vi- 
 triol. 
 
 SCALD is the term used to signify the 
 injury inflicted by heated fluids, as boil- 
 ing Avater, oil, &c. Under the article 
 Burns, we have mentioned the proper 
 treatment of the injuries occasioned by 
 the application of too great heat, whether 
 in a dry or liquid form. 
 
 SCALDING, or Chafing of the Skin 
 of Infants. See Excoriation. 
 
 SCALLED HEAD, the Porriffo fa- 
 vosa of Willan. An eruption on the 
 head, of large flattened pustules, with an 
 irregular edge, and surrounded by a slight 
 inflammation. They most commonly 
 spread from the scalp, especially from be- 
 hind the 6ai-s, to the face ; or from the 
 lips and chin to the scalp. They are 
 usually accompauied with considerable 
 itching, and occur most commonly in 
 children. The pustules, especially on 
 the scalp, appear at first distinct, though 
 near together ; but on the face and 
 extremities, they generally rise in ii'- 
 
 regular clusters, becoming confluent when 
 broken, and discharging a viscid matter, 
 which gradually concretes into green- 
 ish, or yelloAvish semi-transparent scabs. 
 The disease extends by the successive 
 formation of new blotches, which some- 
 times cover the chin, or surround the 
 mouth, and spread to the cheeks and 
 nose ; and the ulceration spreads in a si- 
 milar manner over the head, by which 
 the hair and moist scabs are matted toge- 
 ther. Vermin are often generated in 
 great numbers, and increase the itching 
 and irritation of the disease. Children, 
 by picking and scratching at the edges of 
 the scabs, occasion a similar aggravation 
 of the disease on the face, and extend the 
 ulceration. These ulcerating blotches 
 give occasion to swellings in different 
 parts, as the neck and behind the ear; 
 these inflame, suppurate with much pain, 
 and give rise to tedious discharges. Acrid 
 matter also comes from behind the ears, 
 or from the ears themselves, and there is 
 inflammation of the eyes, or obstinate ul- 
 cerations of the edges of the eye-lids. 
 The discharge sends forth an offensive va- 
 pour, which affects not only the organs 
 of smell and taste, but the eyes of those 
 who examine the diseased parts ; and this 
 matter inoculates sound parts of the body 
 by touching them; and the ai-ms and 
 breasts of nui-ses are liable to be affected 
 in the same manner. 
 
 Treatment. Small doses of calomel 
 may be given internally; and the diet 
 and exercise should be carefully attended 
 to ; fruits and raw vegetables should be 
 avoided, as well as heating stimulating 
 food; and the diet should consist of milk, 
 puddings, and a little plain animal food 
 or broth. If the patient be weak, and 
 much troubled with glandular swellings, 
 the bark and chalybeates will be of ser- 
 vice. It is very seldom proper to use 
 stimulant applications externally, as there 
 is commonly some inflammation present. 
 An ointment of oxide of zinc, or sugar of 
 lead, is best, when the discharge is co- 
 pious; and the citrine ointment, with 
 equal parts of simple cerate and cerate of 
 
 i 
 
482 
 
 SCALP. 
 
 litharge, is generally beneficial. Dr. Bate- 
 man disapproves of all stiff coverings, as 
 of oiled silk, and of the popular applica- 
 tion of cabbage leaves or the like-, as he 
 has seen very hurtful irritation, inflamma- 
 tion, and copious discharge of matter in- 
 duced by this practice ; which symptoms 
 are best subdued by the application of 
 an emollient poultice for a day or tvro ; 
 and then the mild applications above men- 
 tioned. 
 
 SCALP, and Injuries done to it. The 
 scalp is the integuments of the head, co- 
 vered by the hair. These consist of com- 
 mon skin, which in the head is very dense 
 and firm; of the tendons of a muscle 
 which corrugates the forehead ; and close 
 to the bone is the pericranium. The 
 scalp is subject to a variety of diseases; 
 to the one detailed in the preceding arti- 
 cle, and many others. From the firm, 
 unyielding texture of the scalp, if inflam- 
 mation takes place in it, that inflamma- 
 tion is not of the kind that suppurates 
 and forms a circumscribed abscess; but 
 it is of the erysipelatous kind, which 
 spreads to a great extent, and is apt to 
 end in gangrene. (See Rose.) From 
 the communication which is kept up by 
 blood-vessels between the parts within 
 and outside of the skull, it must be obvi- 
 ous that all diseases, wounds, or other 
 injuries of the scalp may be attended 
 with more serious consequences, than a 
 similar injury done to the skin at any 
 other place. When a clean cutting in- 
 strument has inflicted a wound on the 
 scalp, the lips are to be brought together 
 by plaster, or by a suture, if the plaster is 
 not sufficient; and inflammation is to be 
 kept down by cooling lotions, purgatives, 
 and the antiphlogistic regimen. Small 
 wounds made with an instrument that 
 punctures rather than cuts, are more apt 
 than larger ones to become inflamed, 
 and to be troublesome. Thfe treatment 
 in such cases is to be directed to the pre- 
 vention of general fever ; and to relieve 
 the local disorder, sometimes by enlarging 
 the wound, sometimes by applying leeches 
 and emollient poultices. The constitu- 
 
 tion of the patient has much influence on 
 the nature and progress of wounds of the 
 scalp. Jn constitutions subject to the 
 rose, or weakened by intemperance, the 
 case is generally bad. 
 
 When a smart blow has been received 
 on the head, and mischief has ensued to 
 the brain or its coverings, an indication 
 of that mischief is very commonly fur- 
 nished by the scalp, whether it has been 
 wounded by the original blow, or has 
 been left entire. Some days after the 
 accident, the part which was struck 
 swells, and becomes puffy and tender, 
 but not painful; the swelling does not 
 rise to any considerable height, nor 
 spread to any great extent ; if this tumid 
 part of the scalp be divided, the pericra- 
 nium will be found of a darkish hue, and 
 either quite detached, or very easily se- 
 parable from the skull, between which 
 and it will be found a small quantity of a 
 dark-coloured matter. (Pott on Injuries 
 of the Head.) See Skull. 
 
 SCAMMONY. A resinous substance 
 of a purgative quality, obtained from a 
 plant which grows in Syria and other 
 countries of the East, Convolvulus scam- 
 monia. Its purgative qualities are pretty 
 strong and effectual ; it may be given in 
 powder from three to eight grains, com- 
 bined with caWmel or with jalap ; and it 
 forms an active ingredient of the very 
 useful pills, termed the compound colo- 
 cyuth pills. Scammony is good for 
 cleaning the bowels of children when 
 loaded with slime ; for this purpose it is 
 given combined with calomel ; and a com- 
 pound of equal parts of calomel, jalap, 
 and scammony, much used for this pur- 
 pose, is known by the name of pulvis 
 basilicus. 
 
 SCARBOROUGH WATER. A cha- 
 lybeate water, with an admixture of a 
 saline purgative water, found at Scar- 
 borough, on the coast of Yorkshire. It 
 is thought to be beneficial in the same 
 class of complaints as those of Chelten- 
 ham; while the additional advantage of 
 sea-bathing may contribute to the efficacy 
 of the mineral water. 
 
SCARLET FEVER. 
 
 489 
 
 SCARLET FEVER, Scarlatina, 
 either mild, or malignant with putrid sore 
 throat, exhibits diflFerent forms of a disease 
 which is propagated by a specific conta- 
 gion, like small-pox or measles, and like 
 them is believed by the best observers to 
 attack a person only once during life; 
 though the apparent exceptions to this 
 remark are more numerous in scarlet 
 fever, than in the other two diseases above 
 j.^*i-mentioned. On the third or fourth day 
 ;^^ after exposure to the contagion of scarlet 
 ^fever, a feverish attack occurs; and about 
 •^ t, the second day of this fever, a bright 
 /^scarlet rash appears on the surface of the 
 //body, and within the mouth and about 
 the fauces. The scarlet fever varies 
 much in its degree of malignity and dan- 
 ger, even during the same epidemic ; in 
 some cases being so slight as to go off 
 without the aid of medicine ; in others, 
 being accompanied with symptoms of 
 great and fatal putrescency. It will be 
 proper to notice separately, the mild and 
 fatal scarlet fever; and to notice some 
 cases, in which the symptoms are irregu- 
 larly combined. 
 
 Mild Scarlet Fever. The milder 
 form of scarlet fever is distinguished by 
 the rash, with a moderate degree of fe- 
 ver, and with very little affection of the 
 throat. The rash first appears in innu- 
 merable red points about the neck and 
 face, and by the next day they are seen 
 over the whole surface of the body. 
 About the fourth day, the eruption is at 
 its height, and on the fifth it begins to 
 decline. The surface of the mouth and 
 fauces appears red, and little red points 
 appear on the tongue rising up through 
 the white crust which covei-s it, and when 
 this crust comes off, the whole is red and 
 sore, an4 the points are still prominent, 
 giving an appearance like a strawberry. 
 There is sometimes considerable swelling 
 of the face, and of the throat. 
 
 This is the mild form of the disease, 
 so mild as hardly to require the aid of 
 medicine, but which by mismanagement 
 and officiousness, may have the feverish 
 symptoms increased, and some inconve- 
 
 nience, if not danger, induced. The 
 patient should be kept cool and quiet, 
 should not be overloaded with 'bed- 
 clothes ; his diet should be sparing, and 
 cooling drinks and mild laxatives should 
 be recommended. 
 
 Scarlatina, with severer Fever. la 
 other cases of scarlet fever, the febrile 
 symptoms at the commencement are more 
 severe; there is a sensation of stiffness 
 and pain on moving the neck, and it is 
 also painful to swallow; the voice is 
 thick, and the throat feels rough and 
 straitened. The heat of the surface rises 
 in a most remarkable manner ; not only 
 to the sensations of the patient or ob- 
 server does the heat seem greater, but 
 the thermometer shows it to be 108° or 
 110''; that is more than ten degrees above 
 the natural standard. There is sickness, 
 headach, great restlessness, and delirium ; 
 the pulse is frequent, but feeble, and there 
 is great languor and faintness. The 
 tongue is of a bright red colour, especially 
 at the sides and extremity, and the rising 
 points are very conspicuous. The rash 
 does not appear so early as in the milder 
 scarlet fever, and is seen in patches, very 
 frequently about the elbows. Sometimes 
 it vanishes and appears again, at uncer- 
 tain times, without any corresponding 
 change in the general disorder. When 
 the rash is slight, or goes off eai'ly, there 
 is little scaling off of the skin; but in 
 severer cases, large pieces of the skin 
 come off, especially from the hands and 
 feet. The sM'elliug and inflammation of 
 the throat sometimes go off without any 
 ulceration; but, at other times, slight 
 ulcerations form at the tonsils, and at the 
 back of the mouth ; and whitish specks 
 are seen, intermixed with the redness, 
 from which a tough phlegm is secreted, 
 which clogs the throat, and is very 
 troublesome. This kind of scarlet fever 
 is not uufrequently followed by great 
 debility, or the occurrence of other dis- 
 eases, as inflammation of the eyes, or 
 dropsy, or an inflammatory state of thQ 
 whole system, or by water in the 
 brain. 
 
 U^^*/^--* 
 
484 
 
 SCARLET FEVER. 
 
 Treatment. It is in general proper to 
 begin with giving an emetic, especially if 
 M'e at all suspect the stomach to be load- 
 ed with undigested matter ; and we are 
 very soon after to exhibit laxative medi- 
 cines, which are truly one of our most 
 important remedies in this disease. A 
 dangerous and exhausting looseness, which 
 takes place towards the fatal termination 
 of an ill-managed scarlet fever, for a long 
 time excited great fears and prejudices 
 against the use of laxative medicines in 
 this disease; but better observation has 
 convinced us, that so far from being de- 
 trimental, laxative medicines, early and 
 prudently begun, have the best effect in 
 mitigating the disease, and in preventing 
 the collection of that putrid and offend- 
 ing matter in the bowels, which is so 
 sure to produce wasting diarrhoea when 
 it is suffered to accumulate. To lessen 
 the burning heat of the skin, nothing is 
 at all comparable to the free affusion of 
 cold water, which, when employed pru- 
 dently and at the proper time, cools the 
 surface; and from a state of the most 
 painful and restless irritation, brings the 
 patient to comparative ease and tranquil- 
 lity. It is in this disease that the power- 
 ful remedy of the cold affusion has main- 
 tained its ground, and though the experi- 
 ence of thirty years has amply confirmed 
 the carefulconclusions of Dr.Currie in most 
 of the diseases to which he applied it, yet 
 as it has certainly an aj)pearanee of harsh- 
 ness, and as equally good effects may be 
 produced by other means, the cold affu- 
 sion is now less insisted on ; but in the 
 true scarlet fever it should never be 
 omitted, as its salutary effects are speedy 
 and certain, and nothing else with which 
 we are acquainted, is capable of affording 
 such immediate relief. Nor is this to be 
 considered merely as a temporary expe- 
 dient ; it has the best effect in shortening 
 the disease ; and in some cases where a 
 long and tedious illness might have been 
 expected, the cold affusion has seemed to 
 put a very early period to it. If the timi^ 
 dity of practitioners or friends still re- 
 fuses the cold affusion as too formidable. 
 
 they must not object to the washing or 
 spunging of the whole body with cold 
 water, or vinegar and water; and till 
 the heat of the body is reduced by 
 these means, it is in vain that we give 
 internal medicines to procure perspira- 
 tion, or to allay restlessness and induce 
 sleep. After washing, it is not at all un- 
 usual for the formerly harassed patient 
 to fall into a gentle and refreshing sleep ; 
 and a mild and breathing sweat comes 
 out over the whole body. This super- 
 sedes the necessity of sudorific and ano- 
 dyne medicines ; and provided we at- 
 tend to the bowels, keep away stimu- 
 lant and nourishing food, give the drink 
 cold or acidulated, and employ proper 
 gargles for the mouth and throat, the 
 drugs we administer may be very few 
 indeed. 
 
 The inflammatory state of the system 
 which often follows scarlet fever, is not 
 unfrequently accompanied with a swell- 
 ing resembling dropsical swelling ; but we 
 are not to regard this last as a sign of de- 
 bility, or to be deterred from the use of very 
 active remedies. Bleeding to a consider- 
 able extent is necessary, both by leeches, 
 and from the arm, if the patient be old 
 enough ; brisk purgatives are to be free- 
 ly administered, and the inflammatory 
 and dropsical tendency to be combated 
 by the use of foxglove and other diure- 
 tics. When the inflammatory action has 
 subsided, and the dropsy appears to be 
 the principal malady, we are to give tonic 
 medicines and nourishing diet, along with 
 such medicines as increase the flow of 
 urine. If there seems a determination to 
 the head, our practice must be decided 
 and active ; bleeding and purging accord- 
 ing to the urgency of the symptoms. 
 
 Malignant Scarlet Fever, it'iTA Putrid 
 Sore Throat. There is yet another and 
 more fatal form of scarlet fever, where the 
 malignant and putrescent symptoms are 
 more rapid and severe, where the gene- 
 ral system is much oppressed, and the 
 throat and neighbouring parts affected 
 with rapidly spreading ulcerations. It is ffl 
 this which has obtained the name of ^^ 
 
SCARLET FEVER. 
 
 485 
 
 Putrid Sore Throat. This form of scarlet 
 fever begins like the preceding, but in a 
 day or two shows symptoms of jjeculiar 
 sevei'ity. The rash is usually faint, and 
 the whole skin soon assumes a dark or 
 livid red colour. The heat is not so great 
 nor so permanent as in the other kinds ; 
 the pulse is small, feeble, and irregular, 
 there is delirium and coma, with occa- 
 sional fretfulness and violence. The eyes 
 are suffused with a dull redness, there 
 is a dark red flush on the cheek, and the 
 mouth is incrusted with a black or brown 
 fur. The ulcers in the throat are cover- 
 ed with dark sloughs, and surrounded by 
 a livid base ; there is a large quantity of 
 tough phlegm w^hich impedes the breath- 
 ing, occasioning a rattling noise, and in- 
 creasing the pain and difficulty of swal- 
 lowing. A sharp discharge comes from 
 the nostrils, producing soreness, chops, 
 and even blisters. There is severe diar- 
 rhoea, spots on the skin, bleedings from the 
 mouth, bowels, or other parts, all of which 
 portend a fatal termination to the disease. 
 Sometimes the patients die suddenly about 
 the third or fourth day ; at other times 
 in the second or third week; gangi-ene 
 having probably arisen in the throat 
 or some parts of the bowels. Those 
 who recover have often long illnesses 
 from the ulceration spreading from the 
 throat to the neighbouring parts, occa- 
 sioning suppuration of the glands, cough, 
 and difficulty of breathing, with hectic 
 fever. 
 
 Treatment. The active remedies for- 
 merly mentioned are quite inadmissible 
 here. Unnecessary heat is to be avoid- 
 ed, but we are not to think of the cold 
 washing or of purging, lest we oppress 
 the powers of life and bring on a fatal 
 diarrhoea. Gentle emetics are useful, as 
 carrying off the acrid phlegm, which by 
 getting into the bowels would occasion 
 bad symptoms; and the throat must be 
 often cleaned with very sharp and hot 
 gargles. The infusion of Cayenne pep- 
 per, or the decoction of bark, acidulated 
 >vith sulphuric or muriatic acid, or gar- 
 gles to which a little tincture of myrrh 
 
 or of camphor is added, may be usefully 
 employed. When the debility is great, 
 the patient is to be supported by the mo- 
 derate use of wine and other cordials, 
 with light nourishment. Bark is to be 
 prescribed, but it is not likely to be use- 
 ful when the face is flushed, the skin 
 parched, and the tongue loaded. 
 
 There is an ulcerated sore throat of 
 peculiar malignity, distinct from scar- 
 let fever, which commonly terminates 
 with the worst symptoms of croup ; of 
 this we have given an account at page 
 175. 
 
 Of Preventing tJie Infection of Scar- 
 let Fever. As scarlet fev€r is one of 
 the most contagious of diseases, it is high- 
 ly necessary, where many individuals live 
 together, as in families and schools, to 
 make a separation between the infected 
 and the sound, as soon as the disease ap- 
 pears. In numerous schools, such as are 
 common in England, there should always 
 be apartments in which children who are 
 ill, especially of infectious disorders, 
 should be kept. If a child, on the very 
 first appearance of disease, be sent to the 
 sick-room; if there be no uimecessary 
 intercourse ; if there be proper attention 
 to ventilation and cleanliness ; if the at- 
 tendants be careful to wash their hands, 
 and to be a little in the open air before 
 they approach the rest of the family, there 
 is every reason to hope that the infection 
 will not spread. The proof of this may 
 be found in the experience of medical 
 men, who rarely, if ever, are transporters 
 of contagious diseases. All alarm and 
 agitation should be repressed; and even 
 fumigation, as tending to excite appre- 
 hension, may be dispensed wdth, provided 
 the utmost care be taken to produce a 
 thorough ventilation through the house. 
 The time is uncertain how long the dis- 
 ease may be communicated ; it has been 
 known to be given by a patient a fort- 
 night after the rash had disappeared ; and 
 Dr. Batemau says there is little doubt, 
 that so long as the least scaling of the 
 skin continues, the contagion may be pro- 
 pagated. 
 
486 
 
 SCROFULA. 
 
 SCIATICA, or Hip-Gout. A painful 
 rheumatic or gouty affection, chiefly con- 
 fined to the hip-joint and lower extremi- 
 ties. The symptoms are chiefly the fol- 
 lowing- ; There is a pain and stiffness of 
 the joint, preventing motion, and render- 
 ing it difficult to stand upon that limh ; 
 there is swelling and pain, often very 
 distressing in the night ; the limh, in bad 
 cases, seems to shrink a little, and the 
 muscles are wasted. 
 
 Treatment. When the pain is very 
 severe, accompanied with general fever, 
 it will be proper to apply leeches or the 
 cupping-glass j to give cooling purga- 
 tives, and a diaphoretic draught. Fric- 
 tion is to be directed, with stimulant em- 
 brocations ; or a blister is to be applied. 
 The use of the Bath water has been found 
 Tery beneficial in sciatica. The patient 
 is directed to use the bath at the temper- 
 ature of 105°, and to remain in it from 
 fifteen to twenty-five minutes, and this 
 repeated twice or thrice a-week. Some- 
 times water is pumped upon the part, 
 without bathing, 
 
 SCIRRHUS. A hardening of the 
 structure occurring in certain parts of 
 the body, especially glands, which much 
 deranges their functions, and which, pass- 
 ing on to inflammation and ulceration, 
 gives rise in many instances to cancer. 
 The removal, or rather the prevention 
 of this is to be attempted as easily as pos- 
 sible, by general remedies, and by topical 
 applications ; taking care not to acceler- 
 ate the inflammatory action. The prin- 
 cipal remover of hardness and obstruc- 
 tion is mercury, but it requires to be ad- 
 ministered with much caution in scirrhus. 
 When scirrhous tumours can be safely 
 removed from the body, it should be 
 done. 
 
 SCLEROTIC COAT, the name of the 
 tough and strong coat of the eye which 
 contains the Ipns, the humours, and some 
 of the finer and more 4elicate textures of 
 that organ. 
 
 SCROFULA, King's Evil, or the 
 Crewels, are different names for a tedi- 
 ous and multiform disease, of which one 
 
 of the most characteristic marks is a ten- 
 dency to a swelling of glandular parts, 
 which, when they come on to inflamma- 
 tion and suppuration, discharge an un- 
 healthy, curdy, mixed matter, and form 
 ulcers very difficult to heal. 
 
 Of the Scrofulous Constitution. 
 This tendency to glandular swelling is 
 the mark of a peculiar constitution, de- 
 rived from parents or ancestors; and in 
 such constitutions, the diseases and acci- 
 dents that happen with comparatively 
 little inconvenience to others, are pro- 
 ductive of very troublesome and alarming 
 consequences to them. A child of a 
 healthy constitution may have small-pox 
 or measles severely enough, but they will 
 run their course, and leave no trace be- 
 hind them ; whereas, in a scrofulous child, 
 the same diseases very frequently prove 
 the commencement of permanent and in- 
 curable ulcers, runnings, ophthalmia, deaf- 
 ness, debility, consumption, and a long 
 train of other ailments. Scrofula does 
 not always show itself very early in life, 
 nor is there always present any unhealthy 
 peculiarity of look which readily discovers 
 itself; on the contrary, many a plump 
 thriving child needs but the imtation of 
 teething, or an attack of cold or sore 
 throat to bring into action this destruc- 
 tive malady ; and many persons of appa- 
 rent high health and delicate beauty, 
 when they reach a certain age, or are ex- 
 posed to certain accidents, as cold or 
 damp, or over-exertion, give fatal proof 
 of having carried in them the seeds of this 
 troublesome disease. Scrofulous persons, 
 though frequently very beautiful, are sel- 
 dom robust or able to endure much far 
 tigue. 
 
 Of the Subjects of Scrofula. The 
 children most commonly attacked, are 
 those of a soft fine skin, fair hair, and 
 delicate complexion ; but it is sometimes 
 seen in those of a darker temperament. 
 Children having a tendency to rickets, 
 as marked by a large belly, large joints, 
 and prominent forehead, veiy frequently 
 show tl^e scrofulous habit. Those who 
 live in damp, uncomfortable dweUiugs, 
 
SCROFULA. 
 
 487 
 
 exposed to many privations, who are 
 badly clothed, who live on scanty and 
 unwholesome food, deprived of exercise 
 in the open air, and who are inattentive 
 to cleanliness, are those who are most 
 subject to the disease. The countries 
 where scrofula is most prevalent, are 
 those of a moist atmosphere, where the 
 seasons are variable, and the weather 
 unsteady. Such seasons and weather, 
 cold and humid for a considerable time, 
 often prove the occasion of an attack of 
 scrofnla. Scrofula occurs very generally 
 in this country ; indeed some go so far as 
 to say, that few persons are perfectly ex- 
 empt from it, although it is only those 
 individuals that show severe symptoms of 
 it, that get the appellation of scrofulous. 
 Of the Prevention of Scrofula. Scro- 
 fula is one of the diseases that are mani- 
 festly hereditary; and families that are 
 scrofulous, ought to be particularly care- 
 ful as to the way in which they bring up 
 their children. Since the malady is not 
 always in active operation, it becomes a 
 matter of great importance to know 
 whether it can be kept from appearing 
 and committing its destructive ravages, 
 whether any management in early life, or 
 in more advanced years, will protect the 
 lively child or the beautiful youth from 
 the dangerous enemy which has attacked 
 their fellows, and whether an early and 
 assiduous care may not counteract the 
 hereditary constitution of scrofulous fa^ 
 milics. Long and anxious inquiries have 
 satisfied medical men, that scrofula is 
 a disease of debility; and that while 
 every thing is to be avoided which has a 
 tendency to over-stimulate and inflame 
 the system, such diet and regimen are to 
 be adopted, as have the tendency to 
 strengthen and invigorate it. Children 
 who show any predisposition to scrofnla, 
 should be brought up on plain, but nour- 
 ishing and easily digestible food ; such as 
 good broth, with a moderate allowance of 
 solid meat ; but pastry, heavy puddings, 
 and the like, should be avoided. They 
 should get a little M-ine every day at 
 times, but it should be interrupted occa- 
 
 sionally, that they may be taught to con- 
 sider it strictly as a medicine, and not 
 acquire a liking for it. Their clothing 
 should be warm, and they should be much 
 in the open air when the weather is tem- 
 perate and dry ; and in the proper season, 
 they should use the cold bath, or sea- 
 bathing. 
 
 Symptoms of Scrofula. Having made 
 those introductory remarks, we proceed 
 to give some account of the general ap- 
 pearances and treatment of scrofula. The 
 disease generally first shows itself be- 
 tween the third and seventh year of a 
 child's age ; but it may arise at any pe- 
 riod before the a^e of puberty, after 
 which, it rarely makes its first appear- 
 ance, at least externally. 
 
 The attacks of scrofula usually begin 
 some time in winter or spring, and get 
 better, or disappear in summer or au- 
 tumn. The first appearance of the disor- 
 der is the occurrence of small round tu- 
 mours under the skin of the neck, about 
 the ear, or below the chin, without any 
 pain or discoloui-ing. In some cases, the 
 joints of the elbows or ankles are the 
 parts first affected. In this case, the 
 swellings surround the whole joint, and 
 impede its motion. After some time, the 
 tumours acquire a larger size, the skin 
 which covers them becomes more purple 
 and livid; and they inflame, suppurate, 
 and break into little holes, from which a 
 mixed pus-like fluid, intermixed with 
 curdy-looking matter, at first proceeds, 
 which soon changes into a thin serous 
 discharge. These ulcers spread unequal- 
 ly in various directions; some of them 
 heal, but other tumours form, followed 
 by other ulcers. In this way, the disease 
 continues a number of years, and at last 
 the ulcers heal up, leaving behind them 
 very disagreeable scars. In some scrofu- 
 lous habits, the eyes and eye-lids are the 
 principal seat of the disease, shown by 
 the incessant inflammation of the ball, 
 and the raw and painful state of the eye- 
 lids. The bones of scrofulous persons 
 are liable to disease, namely to partial or 
 general enlargement, to inflammation, 
 
488 
 
 SCROFULA. 
 
 suppuration and exfoliation. Diseased 
 spine is also much connected with a scro- 
 fulous constitution. Many internal parts 
 are subject to disease in scrofulous habits. 
 The glands of the mesentery, through 
 which the fluid destined for the nourish- 
 ment of the body has to pass, become ob- 
 structed, inflamed, or suppurated; the 
 consequence of which is, a swelling of 
 the belly, while the rest of the body is 
 wasting ; hectic fever, disordered bowels, 
 and gradual decay. The lungs of scro- 
 fulous persons have, almost universally, 
 tubercles or little knots in them, which 
 inflame and suppurate, and are the com- 
 mencement of fatal consumption. Water 
 in the head, which so often carries off 
 many children of a family, is believed to 
 be connected with a scrofulous taint. 
 Scrofula does not spread by contagion; 
 however obstinate scrofulous sores may 
 be, the matter discharged from them is by 
 no means acrid, nor does it infect other 
 persons, or other parts of the same body 
 when applied to them. 
 
 Treatment. Our first consideration 
 shall be directed to the management of 
 the tumours which appear externally. 
 It is certainly proper, as far as we can, 
 to prevent their coming to a suppura- 
 tion; and for this purpose, we are to 
 endeavour to promote their dispersion by 
 the prudent use of gentle friction, aided 
 by proper diet and regimen, with occa- 
 sional purgatives ; taking care to avoid 
 all exposure to cold and moisture, and to 
 keep the swelled parts covered with flan- 
 nel or warm clothing. When we find 
 oui- attempts to promote resolution of 
 the tuirffyurs to be unavailing, we must 
 apply emollient poultices ; and at the 
 same time give nourishing diet to invigo- 
 rate the system, and bring on a kindly 
 suppuration. It becomes a matter of 
 importance, how to treat the abscesses 
 when matter is formed; Avhether to let 
 them break, or to open them with the 
 lancet. Whichever way they be opened, 
 there is a probability of a long continued 
 discharge ; and the surgeon should state 
 to the friends of the patient, that by al- 
 
 lowing the matter to be discharged by a 
 lancet, he has it in his power to make a 
 small and effectual opening ; whereas the 
 matter, if the swelling be left to itself, will 
 perhaps break out in several different 
 places; and nothing be gained with res- 
 pect to the continuance of the after-dis- 
 charge, or the prevention of unseemly 
 scars. When the ulcers remain open 
 and spread, a variety of applications will 
 be necessary. Sometimes a stimulant 
 dressing is required, as ointment of ver- 
 digris, or basilicon; at other times, simple 
 dressing, as lard, or cerate, is all that can 
 be borne. Sometimes a degree of inflam- 
 mation Avill suggest the propriety of a 
 poultice, but this must not be continued 
 long, lest we induce a relaxation of the 
 parts around. We must vary our treat- 
 ment also by the application of different 
 washes, astringent or cooling, as sulphate 
 of zinc, or sugar of lead. Sea-water 
 sometimes is of service. But under every 
 treatment, scrofulous ulcers disappoint 
 our hopes, and continue open for a te- 
 dious time ; and, at length, in many cases, 
 without any perceptible cause, they sud- 
 denly put on a healthy action, and heal 
 up, not to break out any more. 
 
 The constitutional treatment during 
 this period, should be as healthful and 
 invigorating as possible; good diet, air, 
 and exercise are necessary ; a residence 
 in the country, or sea-bathing, are use- 
 ful auxiliaries. Some practitioners have 
 spoken with great commendation of the 
 warm bath for scrofulous patients. It 
 is to be persevered in for a considerable 
 time. With respect to medicines givei^ 
 internally for the cure of scrofula, the 
 list is long, and therefore unsatisfactory. 
 One drug after another has been tried, 
 and found not to answer. Among 
 others, iodine, muriate of lime, and the 
 preparations of iron have been tried, 
 and have been found as beneficial as 
 any thing else. In some cases, it may 
 be advisable to open an issue in some 
 other part of the body, at a distance 
 from the ulcers or glands which we fear 
 may come to suppuration. It will be 
 
SCURVY. 
 
 483 
 
 seen, that in the foregoing account of 
 the symptoms and treatment of scrofula, 
 we have confined ourselves to the ex- 
 ternal form of it, principally shown by 
 the ulcerations and swelling's of parts 
 within our sight ; but there are many in- 
 ternal diseases which occur in scrofulous 
 habits. See Marasmus, Head, Water in ,- 
 Consumption, &c. 
 
 SCROTUM. The bag containing the 
 testicles. It is liable to be distended 
 with water, forming the disease termed 
 hydrocele. The scrotum is subject to a 
 troublesome prurigo^ for which friction 
 with mercurial ointment is the best ap- 
 plication. Chimney-sweepers are some- 
 times afflicted with a cancerous sore of 
 the scrotum, from soot lodging in its 
 folds. Mercurial applications do harm ; 
 and there is no way of preventing a pain- 
 ful and fatal illness, but extirpating the 
 diseased portion. 
 
 SCURF. A term rather vaguely used 
 for any dry thin scale on the surface ; 
 but properly signifying small exfoliations 
 of the cuticle, which occur after slight 
 inflammation of the skin, a new cuticle 
 being formed underneath during the ex- 
 foliation. The best application for what 
 is commonly called scurf, or dandriff, is 
 the zinc ointment, or the citrine oint- 
 ment much diluted; washing off the 
 grease occasionally with a little soft soap, 
 or a solution of the carbonate of soda. 
 
 SCURVY. This also is a term which 
 has been very generally misapplied, both 
 in popular discourse and in the writings 
 of medical authors. By such inaccura- 
 cies, it has been used to signify a great 
 number of very dissimilar disorders of 
 the skin ; and indeed it became quite ge- 
 neral to give the name of scurvy to any 
 eruption, or long continuing scaliness, for 
 which there was no appropriate name at 
 hand. By medical writers, and by the 
 well-informed non-professional man, the 
 term scurvy is now applied to that dis- 
 ease which is produced by a long absti- 
 nence from fresh vegetable food, and 
 which is therefore frequently observed in 
 Jong voyages, and in besieged towns. 
 
 Symptoms. It comes on gradually, 
 with heaviness and aversion to motion, 
 with dejection of spirits, anxiety, and 
 great debility. The countenance becomes 
 sallow and bloated, the breathing is easily 
 hurried, the teeth become loose, the gums 
 are spongy, and bleed when slightly 
 touched ; and livid spots appear on differ- 
 ent pai-ts of the body. A very curious 
 circumstance sometimes occurs in scurvy, 
 old wounds which have been long healed, 
 break out afresh ; in Anson's ship, about 
 1740, a wound broke out in one of his 
 marines, which he had received at the 
 battle of the Boyne, fifty years before. 
 If the disease is not checked, the joints 
 become swelled and stiff, the tendons of 
 the legs are stiff and contracted ; blood 
 issues from the nose, the eai-s, the anus, 
 and other parts ; fetid stools are discharg- 
 ed, and the patient dies with symptoms 
 of diarrhoea or dysentery. 
 
 Causes. The great predisposing cause 
 which, when long continued, needs no 
 other to excite the disease, is the being 
 prevented from having a due admixture 
 of vegetable food with the diet; hence 
 its frequent occurrence in long voyages, 
 where the people are compelled to live 
 much on salt provisions, and in besieged 
 towns, where the provisions are scanty 
 and bad ; and in cold, damp, and poor si- 
 tuations, where human life is with diffi- 
 culty supported. Among other very 
 powerful exciting causes, we are to 
 reckon want of cleanliness and ventila- 
 tion, a damp and cold atmosphere, and 
 above all, depressing passions. On the 
 large scale of observation afforded in 
 fleets and armies, it is invariably found, 
 that whenever any thing occurs to damp 
 the spirits of the men, the scurvy uni- 
 formly becomes worse ; whereas any 
 thing that tends to increase their alacrity, 
 has as conspicuous an effect in rendering 
 it milder and less frequent. 
 
 Prevention of Sea-Scurvy. The de- 
 structive ravages of the scurvy iu fleets 
 and armies render it an object of atten- 
 tion to the statesman and commander as 
 well as to the physician ; and it has been 
 
490 
 
 S C U 11 V Y. 
 
 very properly remarked, that all tlie im- 
 provements in navigation and nautical 
 astronomy, by which a ship can keep the 
 sea for so long a period, would have been 
 utterly useless, had there not been found 
 out some method of preserving the health 
 of seamen during those long voyages. 
 Happily it has at length been ascertained, 
 that by taking to sea a proper supply of 
 lime or lemon-juice, and distributing to 
 the ship's company a portion of it every 
 day, when their fresh provisions begin to 
 fail, they may be kept from scurvy, as 
 effectually as any number of persons liv- 
 ing on shor,e, and using fresh vegetables 
 every day. This has for a considerable 
 number of years been ascertained on a 
 very extensive scale of experience. Dur- 
 ing the long voyages of Captain Cooke, 
 he kept his men quite free from scurvy. 
 In the numerous and extensive arma- 
 ments which were made during the wars 
 of the French Revolution, and in the 
 long voyages to India and China, it was 
 only in ships where the supply of lime- 
 juice was neglected, that any symptoms 
 of the scurvy appeared. From one to 
 two ounces a-day are a sufficient quanti- 
 ty for this salutary purpose ; and they 
 may be given diluted with water, or mix- 
 ed with the grog, so as to form a health- 
 ful and refreshing beverage. When in 
 any individuals, the tendency to scurvy 
 appears stronger than in others, as indi- 
 cated by the spungy and easy-bleeding 
 gums, by stiffness of the ham-string, by 
 laziness and dejection of spirits, it will 
 be proper to give an ounce, three or four 
 times a-day, till the tendency is dimi- 
 nished. Lime-juice is apt to ferment and 
 not to keep properly, owing to the quan- 
 tity of pulp and mucilage squeezed out 
 along with it j to prevent this it is pro- 
 per to mix with it a little alcohol or car- 
 bonate of lime. 
 
 Cure of Scurvy. Having said this 
 much respecting the prevention of scurvy, 
 we now proceed to say something con- 
 cerning its cure. And happily, so fur as 
 our experience goes, the same powerful 
 yet simple agent which prevents scurvy. 
 
 is also fully able to cure it. When cir- 
 cumstances admit of it, and we are able 
 to procure for a ship's company an abun- 
 dant supply of fresh meat and vegetables, 
 this is the natural and appropriate reme- 
 dy ; but in the last stages of the disease, 
 when the debility is great , it is a matter 
 of much danger to take the sick on shore, 
 as they not unfrequently die in the boat 
 that carries them thither ; and instances 
 have even occurred of the land-air being 
 too oppressive for the lungs of those, who 
 did not previously show marks of so 
 great feebleness. It is by far the safest 
 way to attempt the cure of the men on 
 board their ships ; and when the disease 
 abates a little, and the strength is begin- 
 ning to return, it may then be accelerat- 
 ed by a removal on shore, and by the 
 usual diet and exercise to be found there. 
 Many auxiliary circumstances are to be 
 called into action, both in the cure and 
 prevention of scurvy ; the greatest atten- 
 tion to ventilation and cleanliness, fre- 
 quent washing of the ship in fine wea- 
 ther, fumigation between decks by the 
 vapours of the nitric or muriatic acid ; 
 attention to increase the real comfort of 
 the men, and to check all intemperance ; 
 to promote regularity of discipline and 
 cheerfulness of mind. Various articles 
 are to be used in diet which counteract 
 the pernicious tendency of a long conti- 
 nued use of salt provisions, as spruce, or 
 treacle-beer, preparations of groats or 
 oatmeal occasionally, parboiled vegetables 
 and the like. But it is obvious, that the 
 expense and trouble of all these expe- 
 dients must, in some measure, hinder 
 their universal adoption ; it is satisfac- 
 tory, therefore, to think, that in the plea- 
 sant fruits of the tropical climates, we 
 have a safe, an effectual, and a portable 
 remedy, easily applied, and easily provid- 
 ed, by every navigator. 
 
 It is unnecessary to enumerate all the 
 vegetables to be used for the cure or pre- 
 vention of scurvy. Water-cresses, ra- 
 dishes, scurvy-grass, lettuces, and the like, 
 ^^'hich may be eaten raw; or cabbage, 
 turnips, spinagc, cauliflowers, boiled; or 
 
SCURVY-SPOTS. 
 
 49) 
 
 ripe fiTiits, as oranges, pumpkins, pine- 
 apples, plantanes, when they come in the 
 way, as they not unfrequently do in the 
 long voyages to the Indian and Pacific 
 oceans. It is indeed a grateful vicissi- 
 tude, when a crew, long exposed to dead 
 calms and burning skies, with scanty al- 
 lowance of water, and with their fresh 
 provisions expended, arrive in China, 
 where abundance of fresh provisions, and 
 a profusion of oranges and other fruits, 
 accessible to every person on board, soon 
 remove the spungy gums, the stiffened 
 sinews, and the unhealthy look with which 
 they reached their desired haven. 
 
 SCURVY-SPOTS. This is a term 
 popularly applied to those scaly spots 
 which appear in different parts of the 
 body ; a large proportion of the surface 
 being free from any disease. They some- 
 times are troublesome for a long time, 
 and are with difficulty removed by any 
 medicine or external application. These 
 scurvy-spots are what medical men now 
 designate by the name of lepruy and a 
 particular description of them has been 
 given under that article. The term 
 seems also frequently applied to the scaly 
 tetter and some varieties of the fish-skin 
 disease. 
 
 The best remedies for scurvy-spots, 
 when they are thinly scattered and not 
 in a state of active inflammation, or in- 
 clined to discharge matter, are washes 
 slightly stimulant, as sulphate of zinc in 
 rose-water, or solution of muriate of am- 
 monia; or ointments of red precipitate, 
 half a drachm to the ounce of lard ; or 
 the diluted citrine ointment, gradually 
 using it of the full strength. These are 
 to be applied night and morning, and the 
 greasy matter to be occasionally washed 
 off with a little soap and water. The 
 more extensive and formidable kind of 
 spots will require general as well as local 
 applications, the warm bath, rubbing 
 with vai'ious ointments of which some 
 pf the preparations of mercury are ingre- 
 dients ; accompanied by the use of Har- 
 rowgate, Leamington, or other mineral 
 waters ; the warm sea- water bath ; atten- 
 
 tion being paid to the state of the stomach 
 and bowels, and of the health in generaL 
 
 SEA-AIR. The air upon the sea and 
 in its neighbourhood is generally distin- 
 guished by its greater coldness, purity, 
 and sharpness ; and is therefore in many 
 cases directed to patients, whose com- 
 plaints do not hurt their respiration, and 
 who have vigour of constitution enough 
 to derive benefit from the stimulus which 
 such air occasions. A residence by the 
 sea-side is beneficial to persons of a scro- 
 fulous and debilitated constitution, pro- 
 vided they take care not to expose them- 
 selves to cold and damp ; and in the fine 
 season, when there is no reason against 
 it, they ought to bathe. In complaints 
 of the chest, the use of bathing, and a 
 residence near the sea is more question- 
 able ; and we rather recommend an inland 
 rural situation. A sea-voyage has long 
 been famous for its good effects at the 
 commencement of consumptive com- 
 plaints; and these good effects may be 
 ascribed partly to the good air at sea, 
 partly to the affection of the stomach and 
 skin induced by sea-sickness. 
 
 SEA-WATER is principally a solution 
 of muriate of soda, with a small portion 
 of muriate of magnesia, muriate of lime, 
 and sulphate of soda. Its effects on the 
 body, when taken internally, are of a 
 purgative nature ; but it is seldom pre- 
 scribed, as we have many pui'gatives more 
 agreeable and effectual. As a cathartic, 
 a pint is the usual quantity, which should 
 be taken in the morning, at two doses, 
 with an interval of half an hour between 
 each. See Bathing, for its effects when 
 applied to the surface. 
 
 SECONDARY FEVER. The fever 
 which takes place in small-pox about the 
 eleventh day, when the matter in the 
 pustules is beginning to thicken, and to 
 be absorbed into the system. It is rather 
 unfavourable, when this secondary fever 
 is violent. 
 
 SECRETION. The process by which 
 certain organs of the body secrete or se- 
 parate from the mass of blood, certain 
 fluids which are to be of use in tiie ani- 
 
492 
 
 SED 
 
 SEM 
 
 mal body, or which require to be thrown 
 out of it. The nature of this process is 
 quite unknown. The secreted fluids can- 
 not be detected in the blood. Passions 
 of the mind, and diseases, have much in- 
 fluence on the secretions. 
 
 The term secretion is also applied to 
 the fluids separated ; thus, the tears, the 
 wax of the ears, the bile, the urine, and 
 various other fluids separated from the 
 blood by their appropriate organs, are 
 called secretions. 
 
 SECUNDINES. The after-birth and 
 membranes, which are usually thrown ofl' 
 after the fcetus. See After-birth. 
 
 SEDATIVES. Medicines which have 
 the power of allaying action in general, 
 or of lessening the exercise of some par- 
 ticular function. It has been a matter of 
 keen controversy among speculative writ- 
 ers, whether there be really any sedative 
 medicine ; it being contended, that medi- 
 cines which apparently have that effect, are 
 in reality stimulants, and that it is only the 
 debility remaining after the preceding ex- 
 citement, that gives them the appearance 
 of having acted as sedatives. Whatever 
 may be the correct philosophical explan- 
 ation, we have some substances with 
 which we can allay inordinate action, 
 and can produce a sedative effect. Under 
 Narcotics and Opium, we have given an 
 account of the most powerful of these, on 
 which we can chiefly depend ; and under 
 Foxglove will be found the remarkable 
 effects produced by that powerful plant, 
 which, at one time, was believed by many 
 medical men to be possessed of an un- 
 doubted direct sedative effect. 
 
 SEDATIVE SALT of Homberg, a 
 name for borax, See Borax. 
 
 SEDIMENT. Any substance heavy 
 enough to fall to the bottom of a fluid in 
 which it has been suspended, or with 
 which it has been mixed. The principal 
 sediment to which we pay attention in 
 the practice of physic, is that in the urine; 
 which, in certain diseases gives some in- 
 dication of what is going on in the sys- 
 tem. A thick sediment like brick-dust, 
 indicates fevers and inflammatory action. 
 
 In fits of stone, or where there is a ten- 
 dency to gravelish complaints, the sedi- 
 ment of the urine is chiefly uric acid. 
 
 SEIDIJTZ WATER. A saline mine- 
 ral water, having a strong impregnation of 
 sulphate of magnesia, with a small quan- 
 tity of muriate of magnesia ; hence its 
 bitter taste and purgative qualities. It 
 is recommended in complaints attend- 
 ed with indigestion, in hypochondriasis, 
 in suppressed menses, and in the com- 
 plaints incident to women at the time of 
 life. 
 
 Patent Seidlitz Powders. *' These 
 consist of two different powders; the 
 one, contained in a white paper, consists 
 of two drachms of tartarized soda, and 
 two scruples of carbonate of soda ; that 
 in the blue paper, of thirty-five grains of 
 tartaric acid. The contents of the white 
 paper are to be dissolved in half a pint of 
 spring water, to which those of the blue 
 paper are to be added ; the draught is to 
 be taken in a state of eff'ervescence. The 
 acid being in excess renders it more 
 grateful, and no less efficacious as a pur- 
 gative. This preparation cannot be said 
 to bear any other resemblance to the mi- 
 neral water of Seidlitz, than in being 
 purgative." (Dr. Paris's Pharmacolo^ 
 gia.J 
 
 SELTZER WATER. A water slight- 
 ly alkaline, highly acidulated mth carbo- 
 nic acid. It is thought to remove many 
 of the symptoms of hectic fever, erup- 
 tions of the skin, disorders of digestion, 
 acidity and heartburn, and spasmodic 
 pains of the bowels. It is much recom- 
 mended in diseases of the urinary organs, 
 especially those in which gravel is form- 
 ed. The dose is from half a pint to a 
 pint. 
 
 SEMOLINA. The fkrina obtained 
 from a certain Russian grain, which, boil- 
 ed with water to the consistence of thin 
 porridge, makes an excellent article of 
 diet for childi-en and for invalids. It may 
 have the addition of sugar, and milk or 
 wine, according to circumstances. It is 
 also called Manna Croup. See Manna 
 Croup. 
 
SENNA. 
 
 493 
 
 SENNA. The leaves of the Cassia 
 Senna, which grows in Upper Egypt, ai-e 
 brought to Alexandria, whence the Euro- 
 pean market is supplied with them, but 
 they are frequently adulterated with the 
 leaves of other plants. It is difficult, 
 says Mr. Brande, to describe the charac- 
 ters which should guide us in the selec- 
 tion and purchase of senna ; among them 
 we may enumerate a bright fresh colour, 
 and an agreeable smell, somewhat resem- 
 bling that of green tea. It should not be 
 too largely mixed with stalks, seed-pods, 
 and other extraneous matter, nor very 
 much broken, nor very dusty. Senna is 
 a very useful purgative, which operates 
 mildly, but effectually. Its principal in- 
 convenience is, that it is apt to gripe 
 pretty severely ; but this may in general 
 be corrected by the addition of ginger^ 
 cinnamon, cardamoms, or any such warm 
 aromatic. Senna is most conveniently 
 given in the form of infusion, which is 
 generally made by pouring about six 
 ounces of boiling water, on three or four 
 drachms of senna-leaves, or more, accord- 
 ing to the strength we want ; and letting 
 it stand an hour : a common tea-pot will 
 do very well for this infusion. A cupful 
 or more of this, sweetened with sugar, 
 may be given even to children. A dessert- 
 spoonful of tamarinds added to the leaves 
 before infusion, adds both to the elegance 
 and efficacy of the infusion. The boiling 
 of senna lessens its purgative virtues ; 
 and the tincture cannot be taken in suffi- 
 cient quantity to purge, on account of 
 the spirit 
 
 • SENSATION is the function by which 
 we obtain information of the nature and 
 properties of external objects, and of the 
 state of our own organs. When any im- 
 pression is made on the organs of the 
 senses, that impression is conveyed by 
 the nerves to the brain, or sensoriiim com- 
 mune. To produce sensation, a certain 
 force of impression is necessary, corre- 
 sponding to the sensibility of the organ 
 on which it is made. If the impression 
 be too weak, no sensation follows ; if it 
 be too strong, it produces either pain or 
 
 an indistinct idea. Sensations also de- 
 pend on the previous state of the organs. 
 Thus the very same water will convey 
 different sensations to the two hands, if 
 one of them has previously been kept in 
 warmer, and the other in colder water. 
 Some duration of the impression is also 
 necessary to convey a distinct sensation. 
 When the same impression is frequently 
 repeated, the sensation produced is less 
 lively; and the impression must be in- 
 creased in quantity or intensity, to pro- 
 duce the same sensation. Hence spiritu- 
 ous liquors and opium produce less vivid 
 sensations when a person has got the habit 
 of using them ; and hence, to produce the 
 same sensation, he goes on increasing their 
 quantity to the certain ruin of his health. 
 
 Various derangements of the bodily 
 structure, or irritating or distending sub- 
 stances, occasion certain sensations in us, 
 by which we are warned to take mea- 
 sures for our own relief, or for the re- 
 storation of the healthy state. Under 
 this we include pain from spasm, inflam- 
 mation, or obstruction ; and the sensations 
 by which we are excited to the usual 
 evacuations. 
 
 SENSIBILITY, in medical language, 
 means the capability of receiving im- 
 pressions and conveying sensations to 
 the brain. In health, almost every part 
 of the body is sensible, except the hair, 
 the outer skin, and the nails ; but in cer- 
 tain states of disease, parts which were 
 formerly devoid of feeling, become ex- 
 quisitely sensible ; such is found to be the 
 case with the bones, and the cartilages. 
 
 SETON. An issue which is made by 
 introducing through a portion of the skin 
 and cellular substance, a skein of silk or 
 cotton, by which a constant irritation is 
 kept up, and matter discharged. It is 
 employed in the various cases where is- 
 sues or drains are thought useful, as in 
 the neck, when there is threatening of 
 apoplexy ; or the side, when the liver is 
 diseased. A seton is introduced by 
 means of a broad needle made for the 
 purpose; the silk should not be moved 
 for a few days after the operation, %» hea 
 
494. 
 
 SHINGLES. 
 
 it will be found loosened by the suppura- 
 tion. 
 
 SHARE-BONE. The bone at the 
 lower part of the belly, forming the ante- 
 rior boundary of the pelvis or bason. 
 Behind and above it lies the urinary 
 bladder. It has been absurdly proposed 
 to divide the juncture of the share-bones 
 in cases of difficult labour ; but a very lit- 
 tle reflection on the plan by those who 
 understand the subject, and know how 
 little space would be gained by any prac- 
 ticable enlargement there, will satisfy 
 them, that it never should have been 
 thought of. 
 
 SHELL-FISH have been considered 
 by some as very nutritive and easily di- 
 gestible ; but these good properties have 
 been assigned to them without sufficient 
 reasons. The principal shell-fish used in 
 this country are oysters, lobsters, crabs, 
 shrimps, and mussels. Some of them oc- 
 casionally produce eruptions on the skin, 
 and even worse effects. See Oysters 
 and FisH-PojsoNs. 
 
 SHERRY WINE comes from Xeres 
 in Spain. When of a due age and good 
 condition, it is a very fine and wholesome 
 wine, free from any excess of acid matter, 
 and possessing a dry aromatic flavour and 
 fragrancy, which renders it a fit stimulant 
 for delicate stomachs, and therefore a va- 
 luable medicine. 
 
 SHINGLES. A disease characterised 
 by a number of vesicles, most common- 
 ly round the waist, like half a sash ; but 
 sometimes like a sword-belt across the 
 shoulder. It very rarely surrounds the 
 body completely ; hence a popular, but 
 groundless apprehension, that if the dis- 
 ease goes round, it will be fatal. The 
 disease is usually preceded, for two or 
 three dap, by languor and loss of appe- 
 tite, rigors, headach, sickness, and a fre- 
 quent pulse ; with a heat and tingling in 
 the skin, and shooting pains through the 
 chest, and at the pit of the stomach. 
 After these symptoms, more or less se- 
 vere, there appear, on some part of the 
 trunk, red patches of an irregular form, 
 at a little distance from each other; upon 
 
 each of which numerous small elevations 
 appear, clustered together. In the course 
 of twenty-four hours, they enlarge to the 
 size of small pearls, and are filled with a 
 limpid fluid. The clusters are surround- 
 ed by a narrow red margin. During 
 three or four days, other clusters con- 
 tinue to rise in succession, and with con- 
 siderable regularity. About the fourth 
 day, the vesicles acquire a milky or yel- 
 lowish hue, which is soon followed by a 
 bluish or livid colour of the bases of the 
 vesicles, and of the contained fluid. Se- 
 veral of them run together; and those 
 which are broken, dischai-ge a small 
 quantity of a serous fluid for three or 
 four days ; this concretes into thin dark 
 scabs, which soon become hard, and fall 
 off about the twelfth or fourteenth day. 
 Where there has been considerable dis- 
 charge, numerous pits are left. The fe- 
 verish symptoms commonly subside when 
 the eruption is completed ; but sometimes 
 continue much longer, probably from the 
 itching and smarting of the vesicles. 
 Though resembling some other eruptive 
 diseases, in its rise and decline, it is not 
 contagious, and persons may have it more 
 than once. The disease, in general, is 
 slight and free from danger. 
 
 Causes. It chiefly attacks young per- 
 sons. It is most frequent in the sum- 
 mer and autumn, and arises not unfre- 
 quently from exposure to cold after vio- 
 lent exercise. It has come on after bowel 
 complaints, and after the pains of the chest 
 following acute affections of the lungs. 
 
 Treatment. It does not require severe 
 or active treatment. Gentle laxatives 
 and diaphoretics Avith anodynes when the 
 deep-seated pains are severe, and a light 
 diet, contain all that is requisite in the 
 cure. A little simple ointment is to be 
 applied to the ulcerated surfaces, to pre- 
 vent their being injured by the clothes 
 rubbing or sticking in to them. 
 
 SHIVERINGS, or Biffors as they 
 are called in medical works, are a very 
 frequent symptom of suppiu-ation having 
 begun, in the course of some inflammatory 
 disease. They are a very common fore- 
 
SICK HEADACH. 
 
 495 
 
 runner of feverish diseases. They occur 
 during the progress of labom* in many- 
 women, and also after delivery. Shiver- 
 ings are not a very bad symptom in la- 
 bour; and when they occur after deli- 
 very, they are to be relieved by a little 
 brandy and warm water, or forty drops 
 of laudanum, with the application of warm 
 flannel to the pit of the stomach, and to 
 the feet, and putting on additional bed- 
 clothes. When a woman, from former 
 experience, has reason to expect shiver- 
 ings, they are to be prevented by giving 
 proper cordials, as a little camphor julep, 
 or a little wine and water, immediately 
 after the birth of the infant. 
 
 SHOWER BATH. See Bath, p. 60. 
 
 SIALAGOGUE. A medicine which 
 has the power of increasing the flow of 
 the saliva. This may be accomplished 
 by chewing various acrid substances, as 
 ginger, pellitory, &c., which, by stimu- 
 lating the termination of the ducts, ex- 
 cite the glands to the production and 
 throwing ou.t of more saliva; but the 
 principal sialagogue is to be found in 
 mercury and its pi*eparations, which, 
 taken into the stomach, or introduced 
 into the system by inunction, act on the 
 salivary glands, with peculiar energy, and 
 cause the excretion of a very great quan- 
 tity of saliva. See Mercury and Sali- 
 vation. 
 
 SIBBENS or SIVVENS. A disease 
 of which the fii*st appearances are super- 
 ficial ulcerations on the tonsils and uvula, 
 with an aphthous eruption in the inside 
 of the mouth, cheeks, and lips. Some- 
 times a hoarseness attends, and excres- 
 cences like a raspberry arise from them. 
 Soon after the affection of the mouth", 
 small pustules arise on the skin, which 
 break and leave behind them a dry crust, 
 beneath which, ulcers form, which cor- 
 rode pretty deep. Sometimes, collections 
 of matter, like boils, appear in different 
 parts, which degenerate into sores of a 
 superficial kind, discharging a thin acrid 
 secretion. These are soon filled up with 
 fungous excrescences, which shoot up in 
 the foiTii of a raspberry. 
 
 It occurred at one time very much on 
 the west coast of Scotland, and was sup- 
 posed to be owing to infection received 
 by drinking from the same cup as an 
 infected person, smoking from the same 
 pipe, or handling the sores of such as 
 labour under it. It is supposed to be 
 syphilitic in its nature, and to partake 
 of the character of yaws, a disease com- 
 mon in Africa and the West Indies. It 
 is to be treated by diaphoretic medicines, 
 with warm bathing ; and when the erup- 
 tion begins to dry off, it will be neces- 
 sary to put the patient under a gentle 
 course of mercury, and interpose occa- 
 sionally some mild purgative. 
 
 SICK HEADACH. A very painful 
 and distressing illness, generally the con- 
 sequence of disordered stomach from an 
 excess in drinking the day before. The 
 pain is severe, the depression of spirits 
 great, the skin hot and dry, and S3rmp- 
 toms of bad digestion, heartburn, flatu- 
 lence, and putrid belchings occur. The 
 treatment consists in procuring a free 
 discharge of the crudities contained iu 
 the stomach and fii-st passages ; with one 
 or two copious evacuations from the 
 bowels. Emetics are not very proper; 
 and it is safer to trust to purgative medi- 
 cines ; of which, calomel or the blue pill 
 should be one of those first employed. 
 Two or four grains of calomel, or a blue 
 pill, followed by a drachm of the com- 
 pound powder of jalap, or an ounce of 
 Epsom or Rochelle salts four hours after- 
 wards, will give much relief, though not 
 instantaneously ; as the stomach and the 
 sympathizing brain will require some 
 time to recover their former state. Two 
 drachms of the tincture of Colombo in a 
 glass of cold water, or tliree grains of the 
 sulphate of quinine in a like quantity of 
 cold water, with ten drops of elixir of 
 vitriol, taken the following day, wiU be 
 of service. 
 
 SICKNESS. The uneasy sensations 
 experienced in different parts of the body, 
 when the stomach is disordered, and in- 
 clined to throw up its contents. This 
 arises from a very great variety of causes. 
 
496 
 
 SICKNESS. 
 
 some of which proceed from the state of 
 the stomach itself, or from substances 
 put into it, or from sympathy with other 
 diseased parts ; it occurs very often after 
 the commencement of feverish disorders. 
 Certain motions of the body, as swinging-, 
 sailing-, &c., occasion sickness. In com- 
 plaints of the lungs, sickness is a very 
 common attendant. 
 
 Sickness is to be relieved according to 
 the cause of it, so far as it can be disco- 
 vered. An emetic is to be given, if we 
 know it to arise from acrid or indiges- 
 tible matter in the stomach ; if it is a 
 symptom of other diseases, the primary 
 disease is to be attended to; and in fe- 
 verish complaints, and the beginning of 
 eruptive diseases, as small-pox, measles, 
 &c., it commonly goes off when the erup- 
 tion comes out, which event may be 
 sometimes a little accelerated by bath- 
 ing the whole body, or the feet and legs 
 only. When there is no fever or cos- 
 tiveness, a small dose of laudanum, as 
 twenty-five or thirty drops, or half a 
 grain of opium may be of use. The effer- 
 vescing draughts are also good. When 
 headach and sickness occur, a dose of 
 calomel, followed by a purge of Epsom 
 salts, is to be administered. For sea-sick- 
 ness we know of no remedy, but it goes 
 off as a person gets habituated to the 
 motion of the ship. 
 
 Sickness in Infants. This occasions 
 very alarming appearances. The coun- 
 tenance changes, the limbs are relaxed, 
 the child seems low and torpid, and the 
 breathing is oppressed. There are some- 
 times slight efforts to vomit. Sickness 
 in infants is occasioned chiefly by the 
 presence of some indigestible substance 
 in the stomach, or by an alteration in 
 the qualities of the milk. Violent emo- 
 tions of the mind in the nurse, or her 
 being out of order, produce a morbid 
 change in the milk. Children are also 
 very often sick during teething. When 
 we see sickness in the child, we are to 
 relieve it by an emetic of ipecacuan, 
 which is by far the safest we can employ. 
 The powder may be given to infants 
 
 under five weeks, m the dose of three or 
 four grains; and after that period, the 
 ipecacuan wine, in doses of a tea-spoonful 
 or two may be given. Tartar emetic, 
 and antimony in all its forms are very 
 hazardous for children and infants. 
 
 SIDMOUTH. A viUage on the coast 
 of Devonshire, a favourite place of resort 
 for consumptive and other invalids. It 
 is situated between two romantic hills at 
 the mouth of the little river Sid, at the 
 bottom of an immense bay between Ex- 
 mouth and Lyme Regis. It is well shel- 
 tered from the east; and towards the 
 north are several hills which shut it 
 in that direction. The climate is very 
 mild. Till Christmas, nothing like win- 
 ter is felt ; and even after that date, the 
 weather is never very severe. Myrtles 
 flourish all the year in the open air ; and 
 evergreens of all sorts attain great luxu- 
 riance. There is occasional dampness 
 of the atmosphere, but without cold ; this 
 warm moisture is soothing and relaxing. 
 Although patients labouring under pul- 
 monary complaints have got well by a 
 residence at Sidmouth, the disease is not 
 unknown among the natives. Relatively 
 to the stranger, the climate may have 
 been a warm one ; though the native, to 
 obtain the same advantage, would have 
 required a removal still farther south. 
 The diseases to be benefited by a residence 
 at Sidmouth are those of a chronic in- 
 flammatory nature, nervous and stomach 
 complaints accompanied with dry skin ; 
 and cases of difiicult menstruation. But 
 catarrhs with copious expectoration, and 
 the relaxed state of the female constitu- 
 tion, with considerable debility, are not 
 so likely to derive advantage from the 
 air and climate of Sidmouth. 
 
 SIGHT. There are various deprava- 
 tions of this sense, some of which may 
 be benefited by skilful treatment, others 
 are without remedy. Some persons are 
 incapable of distinguishing certain co- 
 lours; others see objects of a different 
 colour from what they really are. Some- 
 times this last defect may be owing to 
 the improper light in which things are 
 
SKIIJ. 
 
 497 
 
 seen, at other times to certain fluids 
 effused in the eye, as bile in jaundice, or 
 the milky fluid in cataract, or when blood 
 is effused either by external violence or 
 by some inward disease. Some very for- 
 midable irregularities or deficiencies of 
 sight, arise from disorders of the stomach 
 Or abdominal viscera, and are cured by 
 evacuations, by tonics, or by anodynes. 
 Other causes may give rise to these de- 
 fects, as passions of the mind, terror, 
 delirium, and the like. In the decline 
 of life, vision becomes impaired, from the 
 deficiency of the humours, and is to be 
 remedied by the use of convex glasses ; 
 or if the eye is too prominent, glasses 
 of a different form must be used. See 
 Spectacles. 
 
 SILVER. This metal, dissolved in 
 nitric acid, becomes oxidated, and com- 
 bined with the acid, forming lunar caustic, 
 an active corroding substance, of con- 
 siderable importance in surgery as an 
 escharotic. It is also occasionally given 
 internally for the cure of epilepsy, in 
 doses of the eighth of a grain. See 
 Nitrate of Silver. 
 
 SINAPISMS, mustard poultices ap- 
 plied to any part of the body. They are 
 employed with the same intention as the 
 common blister, to produce a counter- 
 irritation; and they often give relief very 
 speedily in internal pains. They act 
 much more quickly than blisters; and 
 except when they have been too long 
 on, or when they are put on very irrita- 
 ble skins, they are free from the incon- 
 venience of any sore following. Sina- 
 pisms are made by taking a portion of 
 the flour of mustard, such as is used for 
 the table, mixing it with water and a 
 little of the crumb of bread, and apply- 
 ing it on the part by means of linen or 
 muslin, till a smarting or burning sensa- 
 tion arises, which will generally be in 
 about fifteen or twenty minutes. Sina- 
 pisms are often applied to the soles of 
 the feet, to remove the drowsiness and 
 delirium which happen in various dis- 
 eases, and especially towards the end of 
 fevers. As auxilifu-ies, they may be of 
 
 considerable service when united with 
 other means; and sometimes seem to 
 revive the functions of the brain, when 
 they are apparently suspended. 
 
 SINUS. In surgery, a long hollow 
 narrow track leading from some abscess 
 or diseased bone, by which matter con- 
 tinues to be discharged externally. In 
 anatomy, sinus means a hollow part of a 
 bone, or sometimes a cavity in a soft part, 
 as about the heart or great vessels. 
 
 SKIN. The outer covering of the 
 body, of various texture and thickness in 
 different parts^ according to their func- 
 tions and uses. It is composed of the 
 cuticle or scarf-skin, which constantly 
 decays and is renewed ; the second layer 
 is called the rete mucosum, and under- 
 neath this is the true skin. In the rete 
 mucosum is situated the colouring matter 
 which determines the race, as the negro, 
 the copper-coloured, &c. The skin varies 
 in thickness according to the part on 
 which it is spread, and the uses to which 
 that part is destined ; from the thin trans- 
 parent covering of the lips, to the hard 
 and horny covering of the labourer's 
 hands, ai\d the soles of the feet. The 
 skin is one of the great outlets by which 
 the matter which is no longer wanted, 
 is discharged from the body. This is 
 done by insensible perspiration. The 
 quantity of fluid discharged in this way 
 is of considerable amount in the twenty- 
 four hours, but cannot be accurately cal- 
 culated. When this is checked, the bur- 
 den of freeing the system from the ex- 
 crementitious matter is thrown upon 
 the lungs, the kidneys, or the digestive 
 organs. Hence a very important part of 
 the treatment of dyspeptic patients con- 
 sists in regulating the discharge by the 
 skin; and long continued indigestion 
 imparts to the countenance a peculiar 
 unhealthy appearance. 
 
 Diseases of the Ski\. The skin is of 
 a very complex and delicate structure ; 
 countless millions of nerves terminate 
 there, blood-vessels are sent to it, it is 
 pierced by exhalant pores, and absorb- 
 ents take their rise from it. From these 
 2 K 
 
498 
 
 SKULL. 
 
 circumstances, it is subject to a great 
 variety of diseases; at least is the seat 
 of many, which not only affect the skin 
 itself, but being generated in the system 
 either by the influence of contagion or 
 morbid action, manifest their principal 
 violence on the skin. Of late years, 
 much attention has been paid to observ- 
 ing, classifying, and naming the various 
 diseases of the skin; by which means, 
 we are enabled to distinguish them with 
 more accuracy, and to apply with more 
 certainty the proper means of cure. While 
 all eruptions, of whatever kind, were 
 ranked under the common name ofscurvi/y 
 and one or two remedies were thought 
 to be good against scurvy, these remedies 
 would be often used in cases to which 
 they were quite inapplicable, and where 
 they would of course disappoint the hopes 
 confided in them. See Eruptions. 
 
 SKIN-BOUND or Hide-Bound Dis- 
 ease, a malady which principally affects 
 children, and has been observed in some 
 of the large hospitals of London and Pa- 
 ris. There are two kinds, the acute and 
 chronic ; the acute generally appears soon 
 after birth, and proves fatal in a few days. 
 In hospitals, several children were attack- 
 ed at the same time, particularly those 
 who had been much weakened by bowel 
 complaints, and whose stools were of the 
 consistence of clay. The skin was of a 
 yellowish white colour, like wax, and 
 was hard and resisting to the touch. It 
 seemed fixed to the subjacent flesh, and 
 would not slide upon it, nor could it be 
 pinched up like healthy skin. The cliild 
 was cold, made a moaning noise, and was 
 apparently just dying. In the French 
 hospitals, the disease was frequently at>- 
 tended by erysipelatous symptoms. The 
 more chronic form of the skin-bound dis- 
 ease is described by Mr. Burns, as affect- 
 ing children of a delicate habit. The 
 skin, from birtli, was not so pliable as 
 usual, and was most rigid about the 
 mouth. The skin gradually becomes 
 tight, hard, and shining, and of a colour 
 a little inclined to yellow. The scalp is 
 often bald and shining, and the veins of 
 
 the head very large and distinct The 
 appetite, at first, is not greatly impaired, 
 and the bowels are sometimes pretty re- 
 gular. The child soon becomes dull and 
 listless, moans often, and gradually sinks, 
 or is carried off by fits. The complaint 
 lasts for several weeks. 
 
 Treatment. There is no treatment 
 known on which we can depend. Mer- 
 cury, laxatives, the warm bath, and emol- 
 lient frictions, have all been tried in vain. 
 Calomel powders have sometimes ap- 
 peared to do good ; and the most likely 
 means are the warm bath, and medicines 
 which promote perspiration. 
 
 SKULL. The skull or cranium, as 
 anatomists term it, is the vaulted bony 
 cavity which lodges and defends the 
 brain, and its prolongations ; with their 
 membranes, vessels, and nerves. Its shape 
 is determined by the soft parts within, 
 and by the action of the muscles which 
 are situated at its sides. It is composed 
 of eight bones, six of which are peculiar 
 to itself, and two common to the skull 
 and the face. These bones are joined to 
 one another by sutures, or indentations of 
 one bone, which receive the projections 
 of another. These sutures are incom- 
 plete at birth ; and hence, during labour, 
 the shape of the child's head may be al- 
 tered considerably, and accommodated to 
 the passages. Another advantage of the 
 sutures of the skull is, that when a frac- 
 ture happens from external violence, this 
 crack is commonly stopped at the su- 
 tures, instead of extending unliraitedly 
 over the head. In children, the sutures 
 ai'e incomplete for a considerable time ; 
 and particularly at the top of the head, 
 there is a pretty lai-ge opening for a year 
 or two. In old skulls, the sutures are 
 sometimes nearly obliterated. The skull 
 is not composed of bones of a uniform 
 structure and thickness throughout ; but 
 there are two bony plates, or tables as 
 they are called; and a spongy cellular 
 substance termed the diploe, is interposed 
 between them. The outside of the skull j 
 on its upper part, is smooth and equal,] 
 and like other bones is covered with 
 
SLEEP. 
 
 499 
 
 tluM membrane, which, in this place, is 
 called the pericraniu7n, and by the parts 
 which compose the hairy scalp. At the 
 lower part of the skull, there are " nu- 
 merous risings, depressions and holes, 
 which afford convenient origin and inser- 
 tion to the muscles that are connected to 
 it ; aiid allow safe passage for the vessels 
 and nerves that run through and near it." 
 The inner surface of the upper part of 
 the skull is commonly smooth ; it lies 
 close on the strong membrane which in- 
 vests the brain, and is connected to that 
 membrane by numerous blood-vessels, 
 which also form a communication m ith 
 the external parts. 
 
 The skull is subject to the same dis- 
 eases as other bones; and especially to 
 the effects of the venereal poison. When 
 sharp points of bone project from the in- 
 ternal part of the skull, and injure the 
 brain, severe headach, epileptic fits, pal- 
 sy, or apoplexy, may be the consequence. 
 Tumours may also grow within the skull, 
 and produce pressure on the brain, or 
 on the nerves of sense or motion ; occa- 
 sioning various morbid states, according 
 to the parts which are pressed upon. 
 
 The skull is also liable to dangerous 
 injuries from external violence. The 
 most noted of these injuries is fracture. 
 This may be merely a fissure, or crack, 
 so fine as hardly to be perceptible ; or it 
 may be accompanied by much shattering 
 of the bone, part of which may be di'iven 
 in upon the brain. Whether the injury 
 appear great or small, it should never be 
 neglected; the important organs which 
 the skull contains can hardly fail to suf- 
 fer when it is broken ; and the connex- 
 ion of the parts within and without the 
 skull, renders it probable that external 
 violence will be followed by inflammation 
 of the brain or its membranes ; apoplexy, 
 occasioned by blood poured out from the 
 vessels ; or compression or concussion of 
 the brain. See Brain, Inflammation of; 
 Compression and Concussion ofy kc. 
 
 While there is merely a fissure, and no 
 bad symptoms ensue, ^e are not Avar- 
 ranted to perform any operation on the 
 
 skull; but when the bone is depressed, 
 and dangerous symptoms appear, we are 
 to remove the pressure by raising up the 
 bone which is beaten iu upon the brain. 
 A lever, which surgeons call an elevator, 
 is to be put under the piece of the skull 
 Avhich we mean to raise ; but it often 
 happens that we have no sound spot to 
 serve as a fulcrum for the lever, or that 
 Ave cannot get in its point ; and in such 
 cases, one or more pieces of sound bone 
 must be removed by the operation of tre- 
 panning. See Trepan. 
 
 SLEEP. That state in which the 
 powers of sense and voluntaiy motion are 
 suspended, in order to recruit the powers 
 of the system, exhausted by the continu- 
 ed actions Avhich they exert. All ani- 
 mals generally sleep in the night, when 
 the silence and darkness remove the ordi- 
 nary impressions on the senses ; and the 
 continuance of sleep varies much accord- 
 ing to the age, constitution, habit, and 
 other circumstances of the individual. 
 New-born children sleep a great deal, and 
 thus their nutrition in the very early pe- 
 riods of life is favoured, Avhile the parent 
 in her Aveakened state is less fatigued. 
 It is impossible to specify a period for the 
 duration of sleep, Avhich shall be adapted 
 to all constitutions; but, in an adult 
 healthy person, from six to eight hours 
 may be reckoned sufficient. Too much 
 sleep blunts the faculties, and predisposes 
 to listlessness and inactivity of mind and 
 body ; it also gives rise to a flabby, cor- 
 pulent, and unwieldy habit. A disturbed 
 and unsound sleep arises from a A^ariety 
 of causes ; from the presence of feverish 
 and other diseases, from disordered boAvels, 
 from too great fulness of stomach with 
 meat or drink. Sleep is also prevented 
 by uneasiness of mind, by a certain de- 
 gree of cold ; by light, noise, and other im- 
 pressions on the senses ; and in some per- 
 sons, by the use of green tea, or of coffee. 
 
 To bring on sleep is often an es- 
 sential object in several diseases. The 
 medicines Avhich have this poAver are 
 called narcotics, and are of primary im- 
 portance in the practice of physic. Of 
 
500 
 
 SLEEP. 
 
 these, the most generally useful are 
 opium and its various preparations, hen- 
 bane, and hemlock. 
 
 The morbid or imperfect kinds of sleep 
 are of vai-ious kinds, and present some 
 very remarkable phenomena, interesting 
 both to the metaphysician and to the me- 
 dical observer. The most noted of these 
 occurrences is dreaming, and walking in 
 one's sleep. See Dreaming. 
 
 Sleep, Walking in, or- Somnam- 
 bulism. The propensity M'hich some 
 people have to walk in their sleep. 
 This very dangerous and morbid incli- 
 nation is observed in different degrees. 
 Sometimes persons merely get out of 
 bed, and repeat the actions of the day, 
 or go to the places they usually fre- 
 quent at other times; sometimes they 
 climb to the tops of houses, or go to 
 places which, in their waking hours, 
 they would shudder to approach. Like 
 dreaming, and various mental operations, 
 we are ignorant of the cause of sleep- 
 walking. To cure it, we should correct 
 whatever bodily ailment we can discover, 
 whether it be a state of debility, or what 
 is considered as more particularly indicat- 
 ing derangement of the nervous system. 
 Precautions should always be taken to 
 prevent sleep- walk ei*s from hurting them- 
 selves ; by having a person to watch them 
 while asleep, and apply proper restraint 
 when they rise to walk ; or by putting a 
 vessel of water by the bed-side, into 
 which they will step, and be immediately 
 awakened. The windows should be pro- 
 perly secured. Perhaps altering the time 
 of taking the last meal, or the time of go- 
 ing to bed, might contribute to break the 
 habit- 
 
 *' Somnambulism," says Dr. Abercrom- 
 bie, " appears to differ from dreaming 
 chiefly in the degree in which the bodily 
 functions are affected. The mind is fix- 
 ed in the same manner as in dreaming, 
 upon its own impressions, as possessing a 
 real and present existence, in external 
 things ; but the bodily organs are more 
 under the control of the will, so that the 
 individual acts under the influence of his 
 
 erroneous conceptions, and holds conver- 
 sation in regard to them. He is also, to 
 a certain degree, susceptible of impres- 
 sions from without through his organs of 
 sense ; not however so as to correct his 
 erroneous impressions, but rather to be 
 mixed up with them. A variety of re- 
 markable phenomena arise out of these 
 peculiarities, which will be illustrated 
 by a slight outline of this singular affec- 
 tion. 
 
 " The first degree of somnambulism ge- 
 nerally shows itself by a propensity to 
 talk during sleep; the person giving a 
 full and connected account of what passes 
 before him in dreams, and often revealing 
 his own secrets or those of his friends. 
 Walking during sleep is the next degree, 
 and that from which the affection derives 
 its name. The phenomena connected 
 with this form are familiar to every one. 
 The individual gets out of bed ; dresses 
 himself; if not prevented, goes out of 
 doors ; walks, frequently over dangerous 
 places in safety ; sometimes escapes by a 
 window, and gets to the roof of a house ; 
 after a considerable interval, returns and 
 goes to bed ; and all that has passed con- 
 veys to his mind merely the impression 
 of a dream. A young nobleman, men- 
 tioned by Horstius, living in the citadel 
 of Breslau, was observed by his brother, 
 who occupied the same room, to rise in 
 his sleep, wrap himself in a cloak, and 
 escape by a window to the roof of the 
 building. Lie there tore in pieces a mag- 
 pic's nest,.wi-apped the young birds in his 
 cloak, returned to his apartment, and 
 Avent to bed. In the morning, he men- 
 tioned the circumstances as having oc-; 
 curred in a dream, and could not be per- 
 suaded that there had been any thing 
 more than a dream, till he m\is shown 
 the magpies in his cloak. Dr. Pritchard 
 mentions a man who rose in his sleep, 
 dressed himself, saddled his horse, and 
 rode to the place of a market which he 
 was in the habit of attending once every 
 week; and Martinet mentions a man who 
 was accustomed to rise in his sleep, and 
 pursue his business as a saddler. There 
 
SLEEP. 
 
 501 
 
 are many instances on record of persons 
 composing during the state of somnambu- 
 lism ; as of boys rising in their sleep, and 
 finishing their tasks which they had left 
 incomplete. A gentleman, at one of the 
 English Universities, had been very in- 
 tent during the day in the composition 
 of some verses which he had not been 
 able to complete ; during the following 
 night he rose in his sleep, and finished 
 his composition; then expressed great 
 exultation, and returned to bed. 
 
 ** In these common cases the affection 
 occurs during ordinary sleep ; but a condi- 
 tion very analogous is met with, coming 
 on in the day-time, in paroxysms, during 
 which the person is affected in the same 
 manner as in the state of somnambulism, 
 particularly with an insensibility to ex- 
 ternal impressions; this presents some 
 singular phenomena. These attacks, in 
 some cases, come on without any warn- 
 ing ; in others, they are preceded by noise 
 or a sense of confusion in the head. The 
 individuals then become more or less ab- 
 stracted, and are either unconscious of 
 any external impression, or very confus- 
 ed in their notions of external things- 
 They are frequently able to talk in an 
 intelligible and consistent manner, but 
 always in reference to the impression 
 which is present in their own minds. 
 They, in some cases, repeat long pieces 
 of poetry, often more correctly than they 
 jcan do in tlieir waking state, and not un- 
 frequently things which they could not 
 repeat in their state of health, or of which 
 they were supposed to be entirely igno- 
 rant. In other cases, they hold conver- 
 sation with imaginary beings, or relate 
 circumstances or conversations which oc- 
 curred at remote periods, and which they 
 were supposed to have forgotten. Some 
 have been known to sing in a style far 
 superior to any thing they could do in 
 their waking state ; and there are some 
 well-authenticated instances of persons 
 in this condition expressing themselvei? 
 correctly, in languages with which they 
 were imperfectly acquainted. I had 
 lately under my care, a young lady, who 
 
 is liable to an affection of this kind, which 
 comes on repeatedly during the day, and 
 continues from ten minutes to an hour 
 at a time. Without any warning, her 
 body becomes motionless, her eyes open, 
 fixed, and entirely insensible ; and she 
 becomes totally unconscious of any ex- 
 ternal impression. She has been fre- 
 quently seized while playing on the piano, 
 and has continued to play over and over, 
 a part of a tune, with perfect correctness, 
 but without advancing beyond a certain 
 point. On one occasion, she was seized 
 after she had begun to play from the 
 book a piece of music which was new 
 to her. During the paroxysm, she con- 
 tinued the part which she had played, 
 and repeated it five or six times with 
 perfect correctness ; but, on coming out 
 of the attack, she could not play it with- 
 out the book. 
 
 " During the paroxysms, the individuals 
 are, in some instances, totally insensible 
 to any thing that is said to them ; but in 
 others, they are capable of holding con- 
 versation with another person with a 
 tolerable degree of consistency, though 
 they are influenced to a certain degree 
 by their mental visions, and are very 
 confused in their notions of external 
 things. In many cases, again, they are 
 capable of going on with the manual oc- 
 cupations in which they had been en- 
 gaged before the attack. This occurred 
 remarkably in a watchmaker's apprentice 
 mentioned by Martinet. The paroxysms 
 in him appeared once in fourteen days, 
 and commenced with a feeling of heat 
 extending from the pit of the stomach to 
 the head. This was followed by confusion 
 of thought, and this by complete insen- 
 sibility; his eyes were open, but fixed 
 and vacant, and he was totally insensible 
 to any thing tlijit was said to him, or to 
 any external impression. But he con- 
 tinued his usual employment, and was 
 always much astonished, on his recovery, 
 to find the change that had taken place 
 in his work since the commencement of 
 the paroxysm. This C4ise afterwards 
 passed into epilepsy. 
 
502 
 
 S M A L L - P O X. 
 
 " Some remarkable phenomena are 
 presented by this singular affection, espe- 
 cially in regard to exercises of memory, 
 and the manner in which old associations 
 are recalled into the mind; also in the 
 distinct manner in which the individuals 
 sometimes express themselves, on sub- 
 jects with which they had formerly shown 
 but an imperfect acquaintance. In some 
 of the French cases of epidemic "extase," 
 this has been magnified into speaking 
 unknown languages, predicting future 
 events, and describing occurrences of 
 which the persons could not have pos- 
 sessed any knowledge. These stories 
 seem in some cases to resolve themselves 
 merely into embellishment of what really 
 occurred, but in others there can be no 
 doubt of connivance and imposture. 
 Some facts, hoAvever, appear to be authen- 
 tic, ^nd are sufficiently remarkable. Two 
 females mentioned by Bertrand, expressed 
 themselves during the paroxysm very 
 distinctly in Latin. They afterwards 
 admitted that they had some acquain- 
 tance with the language, though it was 
 imperfect. An ignorant servant girl, 
 mentioned by Dr. Dewar, during parox- 
 ysms of this kind, showed an astonishing 
 knowledge of geography and astronomy ; 
 and expressed herself, in her own lan- 
 guage, in a manner Avhich, though often 
 ludicrous, showed an underetanding of 
 the subject. The alternations of the sea- 
 sons, for example, she explained by say- 
 ing, that the earth was set a-gee. It was 
 afterwards discovered that her notions 
 on these subjects had been derived from 
 overhearing a tutor giving instructions 
 to the young people of the family. A 
 woman who was, some time ago, in the 
 Infirmary of Edinburgh, on account of 
 an affection of this kind, during the par- 
 oxysms mimicked the manner of the 
 physicians, and repeated correctly some 
 of their prescriptions in the Latin lan- 
 guage." (Dr. Abercrombie on the Intel- 
 lectual Powers. 
 
 SLOUGH. A mortified portion of 
 animal body, which separates from the 
 sound pai'ts. Sloughs may either consist 
 
 of the skin, and more or less thickness of 
 the parts beneath ; or they may be the 
 condensed cellular substance in the heart 
 of a boil, stye, or other abscess. 
 
 SMALL-POX. The universality of 
 small-pox, and the severity of its symp- 
 toms, rendered it fonnerly an object of 
 extreme interest, especially to parents ; 
 and although from the discovery of cow- 
 pox, its ravages on life and beauty have 
 been less general and fatal, it must still 
 remain a matter of importance accurately 
 to distinguish and successfully to treat it. 
 
 It is unnecessary to enter here into the 
 question, whether the disease was known 
 to the ancients, or whether it first made 
 its appearance among the Arabians. Some 
 plausible reasons have been adduced to 
 show that the ancients did know it; 
 while, on the other hand, we cannot but 
 think, that a disease which entere much 
 into the personal and domestic history of 
 every individual, which fills every parent 
 with anxiety either for the life or beauty 
 of his offspring, would have found its way 
 into popular language, and into the wiit- 
 ings of historians and poets. 
 
 There are two forms assumed by small- 
 pox, termed by physicians distinct and 
 conjluent, and popularly, though with less 
 accuracy, a good and bad kind; which 
 are so varied in their symptoms and ge- 
 neral termination, as to require a separate 
 description. 
 
 Of the Distinct Smau^Pox. The pa- 
 tient is seized with coldness, or shiver- 
 ings, which soon abate, and are followed 
 by a hot stage, which lasts for two or 
 three days ; during which, children are 
 liable to sickness and vomiting, to start- 
 ing in their sleep, or to epileptic fits; and 
 adults are disposed to sweating. Towards 
 the end of the third day, the eruption ap- 
 pears, and increases during the fourth 
 day. It commonly appears first on the 
 face, then on the lower parts, and is com- 
 pleted over the whole body on the fifth 
 day. The fever commonly abates about 
 the coming out of the eruption ; the sick- 
 ness, vomiting, fits, and other oppressive 
 symptoms go off; and the patient is, for 
 
S M A L L - P O X, 
 
 503 
 
 tlie time, free of uneasiness. The erup- 
 tion appears in small red spots, hardly 
 risinj^ above the skin, but which by de- 
 grees form pimples. On the fifth or sixth 
 day, a small vesicle, containing- a colour- 
 less fluid, appears on the top of each 
 pimple. These get broader on the se- 
 venth day; and about the eighth, are 
 raised into round pustules. These pus- 
 tules are surrounded with a cir(5ular in- 
 flamed border; and as they increase in 
 size, about the eighth day, the face is 
 considerably swelled, and the eyo-lids are 
 sometimes completely closed. The mat- 
 ter in the pustules now becomes thick 
 and white, or yellowish, exactly resem- 
 bling the matter of an abscess. On the 
 eleventh day, the swelling of the face 
 subsides, and the pustules appear quite 
 full. " On the top of each, a darker spot 
 appears ; and at tliis place, the pustule, 
 on the eleventh day, or soon after, is 
 spontaneously broken, and a portion of 
 the matter oozes out ; in consequence of 
 which the pustule is shrivelled and sub- 
 sides ; while the matter oozing out, dries, 
 and forms a crust upon its surface. Some- 
 times a little only of the matter oozes 
 out; and what remains in the pustule 
 becomes thick, and even hard. After 
 some days, both the crusts and the hard- 
 ened pustules fall off, leaving the skin 
 which they covered of a brown red co- 
 lour ; and it is only after many days, that 
 the skin in these places resumes its na- 
 tural colour. In some cases, the parts 
 covered suffer a scaling off of the skin, 
 and a small pit or hollow is left. This is 
 the course of things on the face, and suc- 
 cessively, the pustules on the rest of the 
 body take the same course." (Dr. Cul- 
 LEis.) On the tenth and eleventh days, 
 a swelling arises in the hands and feet, 
 but this goes off as the matter ripens. 
 When the pustules on the face are nu- 
 merous, there is some degree of fever 
 about the tenth and eleventh days ; but 
 in distinct small-pox, it soon abates. An 
 uneasiness in the throat, with a hoarse- 
 ness of the voice, comes on about the 
 gixth or seventh day, and much saliva 
 
 flows from the mouth. This soon be- 
 comes thick and tough, and being with 
 difficulty spit out, is productive of great 
 imeasiness. The inside of the mouth and 
 throat has numerous pustules ; and in all 
 probability, the whole internal surftice of 
 the bowels is affected in the same man- 
 ner. In the apartment of those affected 
 with small-pox, there is in many cases a 
 strong, peculiar, and nauseous smell, which 
 remains even for months after the disease 
 has entirely subsided. When the pus- 
 tules blacken, the whole appearance is 
 very loathsome, and presents a striking 
 contrast to the blooming health and 
 beauty which existed but a few days be- 
 fore. 
 
 Confluent Small-pox. This kind of 
 the disease is marked by the greater vio- 
 lence of the feverish symptoms in the 
 first attack, by the strength of the con- 
 vulsions, which sometimes destroy the 
 patient even before the eruption appears ; 
 and by the very great number and chis- 
 tering together of the pustules, especially 
 on the face. The w^hole tendency of the 
 disease is to a putrid, malignant, and debi- 
 litating kind ; bearing the same analogy to 
 the distinct small-pox that typhus fever 
 does to pure inflammatory fever. After 
 the eruption, the fever abates a little, but 
 never goes off entirely; and soon after 
 returns with severity, and continues 
 through the whole course of the disease. 
 The vesicles appear sooner on the tops of 
 the pimples ; they are not of a round 
 figure, but irregular; and numbers of 
 them run together, forming large patches. 
 The matter does not become thick and 
 yellow as in the distinct small-pox, but 
 the vesicles appear flat and shrivelled; 
 and where the skin is to be seen, it is pale 
 and flaccid. The secondary fever about 
 the eleventh day is renewed with con- 
 siderable violence. 
 
 It is not any difference in the conta- 
 gion, or in the matter inserted, if the dis- 
 ease be communicated by inoculation, 
 that causes the difference in the malig- 
 nity of the disease ; as it not unfrequeutly 
 happens, that a child with small-pox of a 
 
504 
 
 SMALL-POX. 
 
 very bad kind, imparts the disease to an- 
 other, who takes it in a very mild and 
 favourable way ; and the reverse of this 
 also very often happens. The cause seems 
 to be in the greater inflammatory or pu- 
 trid state of the constitution receiving 
 the infection. 
 
 After the small-pox has gone off, there 
 is great tendency to boils and inflamma- 
 tory symptoms in diff'erent parts of the 
 body ; and, like the measles, it often calls 
 into energy various unhealthy action, 
 producing swelling of the glands of the 
 neck, ophthalmias, and the like. Many 
 lose their sight by injuries done to the 
 eyes, during the inflammatory period of 
 the disease. Another unpleasant conse- 
 quence is the pittings which occur after 
 small-pox, totally disfiguring the coun- 
 tenance, and altogether altering its ex- 
 pression. 
 
 Treatment in Small-pox. We are not 
 to expect the sickness, vomiting, heat, 
 thirst and fever, which occur before the 
 eruption appears, to be totally escaped by 
 any mode of practice whatever; but they 
 may certainly be very much alleviated, 
 and their influence on the subsequent 
 disease much diminished. One very 
 alarming symptom, especially in children, 
 is the occurrence of convulsions- This 
 symptom, as well as the very severe fe- 
 verish ones, used to be much aggravated 
 by the hot regimen formerly in vogue ; 
 and they are materially alleviated, or even 
 prevented by the free admission of cold 
 air, and of tepid or even cold bathing. 
 The same heating plan was undoubtedly 
 the cause of the abundant confluent small- 
 pox, so general under that practice j by 
 which such numbers lost their life, or 
 their eye-sight, and were otherwise so 
 much pitted and scarred. It is found that 
 a cooling plan of treatment is by far the 
 best, in the early stages of the disease ; 
 that it renders the eruptive fever moder- 
 ate, and prevents many of the inflamma- 
 tory and putrid symptoms which would 
 otherwise occur afterwards. So confinn- 
 ed is it by experiment, that the confluent 
 nature of the small-pox is very much oc- 
 
 casioned by heat, that on any particular 
 portion of the body we can, by covering 
 it with plasters, bring out a more plenti- 
 ful crop of pustules than on others ; and 
 since the more rational and cooling pbin 
 has been in use, fewer persons appear 
 with the numerous pits that formerly 
 were left, both on the face and other parts 
 of the body. Li an adult person, if the 
 fever be very violent, it will be proper to 
 admit cold air very freely, to give purga- 
 tive medicines and cooling drinks ; and in 
 those of a full and plethoric habit even 
 blood-letting may be necessary ; bearing 
 in mind the possibility of the disease as- 
 suming a debilitating typhoid form, and 
 being cautious as to the repetition of it. 
 Dr. Currie of Liverpool even employed 
 the affusion of cold water, with the effect 
 of evidently rendering the disease milder. 
 The giving of an emetic at the commence- 
 ment of small-pox is a good practice, both 
 as determining to the skin, and freeing 
 the stomach and first passages from undi- 
 gested aliment, which would aggravate 
 future symptoms. The irritation during 
 the ripening of the pustules is so great, 
 that we are compelled to alloAV anodyne 
 medicines, taking care to prevent costive- 
 ness by laxative medicines and clj'stei-s. 
 For the swelling of the throat and the 
 salivation, we apply blisters externally, 
 and employ cleansing gargles of various 
 acids, and preserved fruits. When the 
 secondary fever occurs in the distinct 
 small-pox, it is to be considered as of an 
 inflammatory tendency, and to be treated 
 by purgatives, cool regimen, and prudent 
 blood-letting ; but in the confluent form, 
 it will probably be a fever of a putrid 
 kind, where these remedies are improper ; 
 and where, with the other means of cur- 
 ing fever, we must employ bark, wine, 
 and other cordials to support the strength. 
 It is often a distressful thing to have to 
 treat children in bad small-pox, as it is 
 diflBcult, if not impossible to get them to 
 swallow the bark in sufficient quantity ; 
 in such cases, we have reason to be pleas- 
 ed with the modern discovery of the sul- 
 phate of quinine. Opiates aie very n^- 
 
SMALL-POX. 
 
 50j 
 
 cessary, as also the usual stren^hening 
 mediciues and cordials, as tincture of bark 
 and cinnamon, camphor julep, and the 
 like. The convalescence is sometimes 
 very tedious ; and like measles, small-pox 
 excites scrofula and other disorders of 
 the constitution. Sometimes large boils 
 form in different parts of the body j these 
 are to be treated with poultices and the 
 usual dressings ; and in many cases these 
 boils, even when large and painful, may 
 be considered as salutary, and having a 
 tendency to diminish unhealthy action in 
 other parts of the body. No means have 
 yet been devised to prevent the pitting 
 left by small-pox. 
 
 Of Inoculation. It having been dis- 
 covered that among the natives of Geor- 
 gia, where pereonal beauty is, for certain 
 reasons, of much importance, it had 
 been the practice to communicate the 
 small-pox by the introduction of a small 
 portion of matter, and that a greater pro- 
 portion of the inoculated were restored 
 to health unmarked, than when the dis- 
 ease was taken in the natural way, the 
 practice was adopted by the physicians 
 ©f Europe, and with very evident advan- 
 tage. It was found that though many 
 died who took the small-pox by inocula- 
 tion, the number was much fewer than 
 of those who took it naturally ; that phy- 
 sicians had it in their power to choose 
 the most favourable state of the constitu- 
 tion, and the most proper seasons of the 
 year, and to adopt any other precaution 
 against the violence of the disease, that 
 experience had shown to be necessary. 
 At the same time, although the inocu- 
 lated had the disease generally rendered 
 safer to. themselves, they still had the 
 power of spreading the infection, and 
 thus of increasing the risk to others. 
 This was, therefore, one very important 
 advantage of cow-pox, that while it se- 
 cured the patient, it added nothing to 
 the danger of his neighbours. So few 
 respectable practitioners in the present 
 day will consent to inoculate for smallr 
 pox, that it is rather as a piece of his- 
 
 the practice of inoculation for small-pox, 
 that we now mention a few of the cir- 
 cumstances which were foiinerly thought 
 to recommend it. The subject chosen 
 for inoculation could be taken when in 
 good health in other respects, and free 
 from any inflammatory tendency; he 
 could be prepared by prudently lowering 
 any feverish state by purgatives or low 
 diet ; a proper season of the year might 
 be chosen, when we could avoid either 
 extreme cold, or extreme heat ; and after 
 the matter had been inserted, which pru- 
 dence would direct to be done from as 
 healthy a subject and as good a pock as 
 possible, we could still keep the patient, 
 with respect to diet, air, and regimen, in 
 a state favourable for an easy progress 
 through the disease. Matter for inocu- 
 lation should be taken at an early period 
 of the pustule. 
 
 SMELLING. The sense by which 
 we perceive the various odours of bodies; 
 a very useful auxiliary to our acquiring 
 the knowledge of what substances are 
 salutary or otherwise, and it is therefore 
 placed near the organ of taste, that the two 
 senses may assist each other. Smelling 
 is impaired by various disordei-s, especially 
 by a common cold, but it returns when 
 the disease goes off. Some persons are 
 naturally without the sense of smelling. 
 
 SNEEZING. A strong spasmodic ac- 
 tion of the muscles used in expiration, 
 by which the air is forcibly expelled from 
 the lungs with a loud noise- It is excit- 
 ed by snuff, and other acrid substances 
 applied to the nose, and by a strong light 
 suddenly thrown upon the eyes. It 
 aids in the expulsion of substances stick- 
 ing in the wind-pipe or gullet. Sneez- 
 ing is a .very common symptom of ca- 
 tarrh, and at the commencement of 
 measles. 
 
 SNUFF. See Tobacco. 
 
 SNUFFLES. A catarrhal complaint 
 in very young infants, by which their 
 breathing is rendered difficult, and is per- 
 formed with a considerable sound through 
 the nose. It proceeds from imprudent 
 
 lovy, than a^s giving any directions for exposure of the child to cold at a xetf 
 
 I' J A 
 
 ^ 
 
50G 
 
 SNUFFLES. 
 
 earl}' period after birth, and is attended 
 M'ith most of the symptoms which cha- 
 racterise a cold in older people. The 
 child is feverish and un^vell, its bowels 
 are disordered, and it has congh or sneez- 
 ing. The cure consists in its being- kept 
 in a moderate degree of warmth, bathing 
 in tepid water, and giving a little castor 
 oil or other laxative medicine, taking 
 care, at the same time, that the mu- 
 cus do not obstruct the nostrils. If the 
 disease is obstinate, an emetic may be 
 tried. 
 
 Bad Snuffles, or Coryza Maligna. 
 There is a more severe and even malig- 
 nant kind of snuffles, to which some in- 
 fants are liable. The discharge is puru- 
 lent from the beginning, and afterwards 
 becomes bloody ; the children breathe 
 with difficulty, especially when asleep. 
 This difficulty of breathing is not con- 
 stant; sometimes the children are free 
 from it; at other times, it is necessary 
 to watch them sleeping and waking, in 
 order to open their mouth when requi- 
 site. There is generally a purple streak 
 at the verge of the eye-lids, and a ful- 
 ness about the throat and neck external- 
 ly ; the almonds of the ear ai'e swollen, 
 and of a dark-red colour, with ash-colour- 
 ed specks ; and in some cases, extensive 
 ulcerations. The patients generally die 
 with convulsions or marks of debility. 
 The disease consists in an inflammation 
 of the membrane lining the back part of 
 the nostrils and contiguous parts. Hence 
 the plentiful secretion of purulent mat- 
 ter, part of which descending into the 
 stomach and bowels, disordei-s them, and 
 occasions great weakness. 
 
 Treatment. Particular attention is to 
 be paid to the bowels, both for the sake 
 of reducing the inflammation about the 
 nose and throat, and to carry off the 
 acrid matter swallowed, that it may not 
 injure the bowels. The nose and throat 
 are to be washed with milk and Avater ; 
 or if the complaint continues for some 
 weeks, a weak decoction of oak-bark may 
 be used as a M^ash. The strength is to 
 be supported by diet; and by cordial me- 
 
 dicines, such as the little patient can be 
 made to take, with the sulphate of quin- 
 ine. If convulsions come on, opium, and 
 other antispasmodics are to be used. 
 
 SOAP. A mixture of alkali and oil, 
 of great utility as a cleanser, the aci-i- 
 mony of the alkali being blunted by the 
 blandness of the oil, and so rendered fit 
 to be applied to the skin. There aie va- 
 rious kinds of soap ; the hard soap, com- 
 posed of soda and olive-oil, and the soft, 
 composed of oil and potass. The hard, 
 or Castile Soap, is used in the forma- 
 tion of several pills; and the alkaline 
 properties of soap have occasioned it to 
 be given as a medicine for the alleviation 
 of calculous complaints. A tincture of 
 soap, or solution of soap in alcohol, either 
 alone or with opium, is a good application 
 for sprains, swellings, and other external 
 uses ; and answers the pm'pose of what 
 is called embrocation or opodeldoc. 
 
 SODA. One of the fixed alkalis, 
 commonly called the mineral alkali, as 
 distinguished from potash, the other fix- 
 ed alkali, which is usually obtained from 
 vegetables. Soda is very seldom used in 
 a separate state ; but more commonly 
 combined with carbonic acid, from which 
 it is easily disjoined, as the carbonic acid 
 readily quits it when a stronger acid is 
 brought into contact with it. 
 
 SODA POWDERS, as they are call- 
 ed, are useful in various disorders of the 
 digestive organs. Their good properties 
 are owing not to the «oda, but to the cai- 
 bonic acid, which is disengaged from the 
 carbonate of soda by the application of a 
 stronger acid, either the citric or the tar- 
 taric. The method of using them is this. 
 Dissolve the carbonate of soda, about one 
 drachm in two ounces of water ; and an 
 equal quantity of the tartaric acid in an- 
 other glass ; put the two solutions toge- 
 ther, and when they are in the act of ef- 
 fervescing, let them be drank speedily ; 
 or they may be taken separately, and the 
 effervescence or disengagement of cai'bo- 
 nic acid will go on in the stomach. 
 
 SODA WATER is water strongly 
 impregnated with carbonic acid, disengag- 
 
SPAS M. 
 
 507 
 
 ed from the carbonate of soda. By pro- 
 per pressure, water can be made to take 
 up six times its bulk of carbonic acid. 
 Soda water is brisk and sparkling^, of a 
 pleasant sub-acid taste, but should not he 
 drank during dinner or immediately after 
 it ; as the great quantity of carbonic acid 
 (fixed air) which it contains, being dis- 
 engaged, inflates the stomach, and pre- 
 vents those muscular actions of it which 
 are necessary for the conversion of the 
 food into chvme. 
 
 SOL ANUM DULCAMARA, SeeBir- 
 
 TER-SWEET. 
 
 SOLID FOOD, all kinds of food that 
 require mastication, opposed to liquid or 
 spoon-diet. 
 
 SOLIDS, the bones, ligaments, mem- 
 branes, muscles, nerves, and vessels. 
 
 SOLUTION. When a solid body is 
 capable of intimate commixture with a 
 liquid, so as to be completely diffused 
 through every part of it, it is said to be 
 soluble, or capable of solution. 
 
 SOMNAMBULISM, walking in sleep. 
 See Sleep. 
 
 SORE EARS OF Children. See 
 Ears, Sic, page 225. 
 
 SORE MOUTH. See Thrush. 
 
 SORE NIPPLES. See Nipples. 
 
 SORE THROAT. See Throat. 
 
 SOUND. An instrument which sur- 
 geons introduce through the urethra into 
 the bladder, in order to discover whether 
 there is a stone in that cavity or not. 
 The sound is usually made of very high- 
 ly polished steel, that it may be well cal- 
 culated for conveying to the surgeon's 
 fingers the sensation of any thing against 
 which its end may strike. 
 
 SOUR CROUT. A preparation of 
 cabbage, which has been found useful as 
 a preservative from sea-scui'vy, iu long 
 voyages. The soundest and most solid 
 cabbages are selected, and cut very small. 
 The cabbage thus minced is put into a 
 barrel iu layers, six inches deep, and over 
 each layer is strewed a handful of salt 
 and cara\^'ay seeds ; it is tlien rammed 
 down with a rammer, layer after layer, 
 till the barrel is full, when a cover is put 
 
 over it, and it is pressed down with a 
 heavy Aveight. After standing some 
 time in this state, it begins to ferment ; 
 and it is not till the fermentation has en- 
 tirely subsided, that the head is fitted to 
 it, and the barrel is shut up and preserv- 
 ed for use. No vinegar is employed in 
 this preparation. 
 
 SPASM. An irregular action of mus- 
 cles or muscular fibres, without the direc- 
 tion of the win, generally attended with 
 some degree of pain, and when extensive 
 or general, giving rise to many, and even 
 to fatal, diseases. Some diseases consist 
 almost entirely of spasms, as the locked 
 jaw, and the painful distortions of the 
 body accompanying it. Other diseases, 
 as hysterics, epilepsy, and some others, 
 have a variety of symptoms complicated 
 Avith the spasm. The disorders of the 
 stomach and bowels, accompanied with 
 spasm or irregular action, are very nume- 
 rous and important ; cramp in the stom- 
 ach, griping iu the bowels, the iliac pas- 
 sion, are instances of this. 
 
 Causes. Spasm is owing either to ir- 
 ritation or debility. The irritation of 
 worms in the intestines, of hurtful matter 
 in the stomach; of teething, sharp or 
 acrid substances hurting the skin, tu- 
 mours pressing upon nerves, are known to 
 occasion spasm by irritation. Spasm from 
 debility is seen in hysteria, and in those 
 who have been weakened by long diseases, 
 or by large bleedings. 
 
 Treatment- If we discover, and can 
 remove the irritating cause, this is the 
 first thing to be done. The spasm is to 
 be put an end to, if possible, by the 
 means after mentioned ; and if it has been 
 owing to debility, the proper measure^ 
 are to be resorted to for strengthening 
 the body. 
 
 The medicines and appliances wliicli 
 relieve spasm, are called antispasmodics \ 
 and they are chiefly remarkable for mak- 
 ing a strong impression on the senses, 
 and for quickly putting an end to the 
 spasm. Thus in the paroxysm of asthma, 
 a draught of ether and laudanum, iu 
 many cases, gives almost instjint relief; 
 
508 
 
 SPECTACLES. 
 
 and in the griping and violent spasms of 
 the bowels, the warm bath, or cold water 
 daslied suddenly on the lower extremi- 
 ties, or laudanum or hot drinks, allay the 
 spasm. 
 
 SPASMODIC, of the nature of spasm, 
 applied to those diseases in which spasm 
 is a principal symptom ; thus we speak of 
 spasmodic cough, spasmodic asthma. 
 
 SPECIFIC. A medicine is said to be 
 a specific^ when it almost universally cures 
 a particular disease, without our being 
 able to trace the manner in which it does 
 this. Thus, the Peruvian bark is said to 
 be a specific in intermittent fever, and 
 sulphur in the cure of the itch. 
 
 SPECKS on the eye, are small opaque 
 spots on the clear pai-t of that organ, 
 generally the consequence of severe pre- 
 vious inflammation. If they do not dis- 
 perse by a continuance of the methods 
 employed for the cui-e of the original dis- 
 ease, some have recommended to touch 
 them carefully with very diluted lunar 
 caustic, on the point of a camel's hair 
 pencil, or to use a wash made by dissolv- 
 ing three grains of lunar caustic in aa 
 ounce of water. Mercurial medicines 
 may be given internally, and ophthalmic 
 ointments applied. When specks are not 
 numerous, and not near the centre of the 
 clear cornea, they occasion no inconveni- 
 ence except the deformity. See Eye, 
 Diseases of, page 25 1 . 
 
 SPECTACLES « are either convex, 
 concave, or plain. The first are adapted 
 to old persons ; the next to those who see 
 with distinctness only at a small distance ; 
 and the third, formed of glass with a light 
 green or blue shade, are designed to de- 
 fend weak eyes from too strong a light. 
 Those who wear spectacles should be very 
 cautious to have the glasses ground with 
 the most perfect accuracy, and should ap- 
 ply to opticians of credit, rather than to 
 itinerant Jews ; for the aberrations of the 
 rays produced by an imperfect figure of 
 the glass, strain the eye to distinguish {he 
 image, from this cause indistinct. For a 
 similar reason, the glasses of old people 
 should be not at all, or very slightly 
 
 tinged ; and the glare which arises from 
 a candle, or a strong sun, may be better 
 avoided by a shade against the former ; 
 or over the eye, to guard against the lat- 
 ter. 
 
 " It has been doubted whether specta- 
 cles should be used to preserve the sight. 
 We think that in old persons they will 
 be useful : with the near-sighted, who 
 are usually young, they should be dis- 
 couraged. Old people will save their 
 eyes, and there is little danger of exhaust- 
 ing the degrees of convexity; indeed 
 none. The young will not indeed ex- 
 haust the degrees of concavity ; but the 
 other senses should be kept on the 
 alert, while they can supply the place of 
 distinct vision. The hearing, the feeling, 
 even the facility of conjecture, are kept 
 alive by disusing spectacles; and we 
 should iraj)rove all our powers. As we 
 have already hinted, the near-sighted per- 
 son should use the number next below 
 that of distinct vision, and he will soon 
 attain it. Habit, in this way, will coin- 
 cide with the change which age induces; 
 and not to see with the utmost acuteness, 
 is still an advantage to those who could 
 otherwise see very imperfectly. All this 
 is, however, refinement; for spectacles 
 used with little caution or discrimination 
 have seldom done harm, if the glasses are 
 good. Pebbles, which admit not of 
 scratches, should be, in every instance, 
 preferred." (Parr's Medical Dictionary y 
 Art. Conspicillum.) 
 
 SPERMACETL An unctuous sub- 
 stance obtained from a cavity in the head 
 of a certain species of whale. It is some- 
 times used internally in the form of emul- 
 sion, and agrees with the concrete fixed 
 oils ; but for plasters and ointments, oil 
 and wax are equally good with sperma- 
 ceti. 
 
 SPHACELUS. When the mortifica- 
 tion of a part has proceeded to such a de- 
 gree that the part is black, putrid, and 
 has its texture completely destroyed, such 
 state is called spfiacelus. 
 
 SPINAGE, Spinacia oleracea. A 
 plant whose leaves ai-e used at table. They 
 
SPINE. 
 
 509 
 
 are not very nourishing^, but they are 
 laxative, diuretic, and cooling. Spinage, 
 when well boiled, seems one of the most 
 easily digested of vegetables. 
 
 SPINE. The bony column, of which 
 the back-bone is a conspicuous part, and 
 gives its name to the whole, from the 
 spinous or thorn-like projections of it. 
 The spine is composed of twenty-four 
 bones, separable from each other and 
 moveable, which are called true vertebrcs ; 
 and at the lowest of the true vertebi-se is 
 situated the sacrum or rump-bone, which, 
 with its terminating appendage, the coc- 
 cyx, are called /«/se vertehrcB. The whole 
 spine is so constructed as to furnish a ca- 
 nal for the prolongation of the brain, 
 called the spinal marrow; which sends 
 out nerves, and is in all respects analo- 
 gous l^the brain. The spine is subject 
 to various diseases, to caries, and distor- 
 tion or curvature. 
 
 SPINE, Curvature of. This is a 
 very common complaint in early youth. 
 It arises sometimes from debility, or 
 rickets, sometimes from blows or other 
 accidents, and frequently from sedentary 
 employments, or being too much confined 
 to one posture, as frequently happens to 
 children whose education is forced on 
 with too great rapidity. It is also a con- 
 sequence of too rapid growth of the trunk 
 of the body. 
 
 Symptoms. The patient at first has 
 listlessness, languor, and want of appe- 
 tite ; no complaint is made of any parti- 
 cular part ; but, in a short time the legs 
 begin to fail. On standing, the knees in- 
 voluntarily bend forward, and in wallt- 
 ing, the legs cross each other. There 
 are now cramps or pains in the thighs 
 and legs, and afterwards the powers of 
 sense and motion are lost. These symp- 
 toms, at first, are supposed to arise from 
 debility ; but when more particular exa- 
 mination is made, the spine is found to 
 be in some degree distorted. " The cur- 
 vature is most commonly from within 
 outwards, but sometimes on one side. 
 In the latter case, however, there is ge- 
 nerally a double curvature : for, if the 
 
 fii*st deviation is unnoticed, the patient, 
 to relieve himself from an uneasy posi- 
 tion, rests chiefly on the opposite side, 
 and this posture produces the second cur- 
 vature. The complaint originates from a 
 disease of the cartilages and ligaments, 
 communicated to the bones; it appears 
 to be the languid inflammation of scrofu- 
 lous habits, and to terminate in caries. 
 The starting of the vertebrae from their 
 proper line seems to be owing to the un- 
 equal erosion, and, of course, to the want 
 of a uniform support. 
 
 Treatment. « While the state of the 
 general health is attended to by general 
 remedies, not only with a view to the de- 
 bility, but to tUe scrofulous habit, the 
 particular care of the surgeon must be di- 
 rected to the curvature; and the best 
 means of relieving it is the plan suggest- 
 ed by Ml-. Pott, in procuring a considera- 
 ble local discharge on each side, as near 
 the curvature as possible, but beyond the 
 spinal processes of the protruded bone. 
 Tenderness in this case is cruelty; and 
 the issue made either with the knife or 
 the caustic, should be large enough to 
 contain a horse-bean. If the curvature 
 be considerable, the size of the issue 
 should be increased. The discharge 
 should be continued till the complaint is 
 in a great measure relieved, and the de- 
 gree of amendment may be judged of by 
 that of the general health. During the 
 continuance of the discharge, the com- 
 plexion becomes clearer, the appetite is 
 improved, the general strength is in- 
 creased ; sensation and motion are gradu- 
 ally restored. It has been supposed that 
 the curvature may be reduced by this 
 measure ; we dare not deny that it will 
 be lessened, but we have never found it 
 so in any considemble degree. The chief 
 eflfect is to relieve the inflammation of the 
 bones and cartilages. The curvature may 
 be prevented from increasing during the 
 actiijn of the drains, and possibly, at last 
 diminished by the use of machines, con- 
 structed by artists on proper principles. 
 After the inflammation is checked, sea- 
 bathing may be ordered; during M-hich 
 
510 
 
 SPIRIT. 
 
 the issues are to be covered with leather, 
 secured by a margin of sticking plaster." 
 (Dr. Parr.) 
 
 8P1NE, Divided, Spina Bifida. A 
 swelling on the spine of new-born chil- 
 dren, at the lower part of the loins, at 
 first of a bluish colour, but at length be- 
 coming paler, and then transparent. It 
 is generally attended with a weakness or 
 palsy of the lower extremities. Some 
 have opened the tumour, but with very 
 bad success, as the infants have died im- 
 mediately. Whether the tumour be 
 opened or not, it is a very fatal disease, 
 few children affected with it living above 
 three years. The only method that ap- 
 pears to have been at all serviceable, is 
 pressure gradually and permanently em- 
 ployed ; or evacuating the fluid by small 
 punctures, and afterwards inducing such 
 a degree of inflammation as to obliterate 
 the cavity. 
 
 SPIRIT. When fermented fluids 
 abounding with saccharine matter are 
 subjected to distillation, there comes over 
 the active, pungent liquor called alcohol^ 
 or ardent spirits. These receive various 
 names, according to the substances em- 
 ployed. Erandy is procured from wine, 
 rum from the fermented juice of the 
 sugar-cane, whisky and gin from the fer- 
 mented infusion of malt or grain. All 
 ardent spirits consist of three ingredients, 
 water, pure spirit, and a little oil or resin, 
 to which last they owe their peculiar 
 colour and flavour. Ardent spirits when 
 taken into the body excite every part of 
 the system, render the pulse full and 
 quick, exhilarate the mind, and increase 
 the muscular strength ; hence as a medi- 
 cine, they may be useful in diseases of 
 debility and languor, and may furnish a 
 useful stimulus in a variety of cases. 
 But from their extraordinary and con- 
 centrated activity, from their furnishing 
 a rapid mode of drunkenness, from their 
 easily producing a pernicious and deceit- 
 ful exhilaration, they are apt to prwduce 
 a craving for their own repetition, and to 
 produce bad efl'ects on the character and 
 coiistitution of those who indulge in them. 
 
 A very frequent consequence of indulg"- 
 ing in spirituous liquors, is a disorder of 
 the digestive powers. Hence the long 
 train of stomach complaints of which 
 dram-drinkers are the subjects ; flatulence, 
 indigestion, gnawing pains, which tempt 
 them to recur to the fatal dose. They 
 are subject to various aflFections of the 
 liver, particularly that hardened state of 
 it which often ends in dropsy, and other 
 symptoms of a broken constitution. The 
 use of spirits predisposes also to inflam- 
 matory attacks of various organs, to ery- 
 sipelas ; and also to disorders of the head, 
 ending in apoplexy and palsy. Ardent 
 spirits are not rendered any safer by 
 dilution with water, or the mixtui-e of 
 acids and other ingredients ; and the 
 habitual use of grog, toddy, punch, and 
 all the varieties of luxurious intoxication, 
 are equally pernicious. See Alcohol, 
 and Ardent Spirits. 
 
 Spirits are excellent solvents of many 
 substances ; these solutions are called 
 tinctures. In pharmacy, we use the 
 word spirit in a different sense, as when 
 we speak of the spirit of caraway, of 
 cinnamon, of nutmeg, of aniseed, of juni- 
 per, &c. This means, that by distilling 
 proof spirit, or alcohol diluted with an 
 equal part of water, along with certain 
 parts of the plants which yield their oil, 
 the spirit becomes impregnated wdth the 
 smell and flavour of the substance. Spirits 
 have the same virtues as the substances 
 from which they are distilled, with the 
 additional stimulus of the alcohol; and 
 their use is to be avoided as much as 
 possible, on the same principle as we 
 avoid the use of drams. 
 
 The spirit of salt, the spirit of am- 
 monia, the spirit of nitre, are merely 
 incorrect names bestowed on certain 
 preparations of these substances, which 
 names they get partly because of their 
 pungency, and partly because spirit is 
 used in some part of the process for pre- 
 paring them. 
 
 SPITTING OF BLOOD, Haemoptysis, 
 signifies the discharge of frothy blood 
 from the lungs. It is dangerous in itself, 
 
SPITTING OF BLOOD. 
 
 511 
 
 and too often lays the foundation of com- 
 plaints that will ultimately prove fatal. 
 The disease comes on mth a sense of 
 weig-ht and anxiety in the chest; some 
 dilliculty of hreathing-, and a sense of heat 
 at the fore-part of the breast; and not 
 unfrequently a saltish taste is perceived 
 in the mouth. A tickling sensation is 
 felt at the upper part of the windpipe, 
 and to relieve this, the person hawks a 
 little, and this brings up a quantity of 
 blood, florid and frothy. The irritation 
 returns, and the same thing is again re- 
 peated; and occasionally a considerable 
 quantity of blood is discharged for many 
 days together. In a case of this kind, it 
 is of great consequence to ascertain from 
 ij'hat source the blood proceeds ; it may 
 be from the cavity of the mouth itself, 
 from the nose, from the stomach; but 
 we conclude it to come from the lungs 
 when frothy bright-looking blood is dis- 
 charged by young persons from the age 
 of fifteen to thirty ; whose chests are 
 narrow, whose shoulders are high, who 
 are of quick parts, and of a delicate struc- 
 ture ; in short, who are of the exquisitely 
 sanguine temperament. There is com- 
 monly a degree of fever at the commence- 
 ment of haemoptysis. 
 
 Cuie, As a flow of blood from the 
 lungs may be dangerous from its quan- 
 tity, or from its occasioning other dis- 
 eases, it is a necessary measure to take 
 blood from the arm, if there be any de- 
 gree of fever present; as it is far safer to 
 lose blood in this way, thari by the lungs. 
 Rest and quietness are to be enjoined; 
 all exertion of the organs of respiration, 
 as in speaking, singing, playing on wind- 
 instruments, is to be carefully avoided; 
 as also all heating diet and strong liquoi"S. 
 The sulphiu-ic acid is to be ttiken ; and if 
 ^ there be pain in the chest and difficulty 
 
 ^^^■' of breathing, a blister may be applied. 
 
 t./ij/^ Exposure to cold and fatigue must be 
 ^ avoided, and the feet must be kept dry 
 and warm. 
 
 SPLEEN. A Large organ situated at 
 the back part of the stomach, so well 
 supplied with blood, tliat it appears quite 
 
 purple. Notwithstanding the largeness 
 and probable importance of this organ, its 
 use is as yet unknown. It is liable to be- 
 come greatly enlarged in those who have 
 often been ill of intermittent fever ; and 
 frequent instances of very great altera- 
 tion of structure have been found on dis- 
 section, though the individuals had shown 
 no sign of any disease in that part when 
 alive. As certain parts of the body M'ere 
 anciently supposed to be more pai-ticular- 
 ly concerned in the intellectual functions, 
 the spleen was thought to be the seat of 
 melancholy or peevishness ; hence the 
 terra splenetic^ which is still used in that 
 sense. 
 
 SPLINT. A piece of wood, iron, or 
 pasteboard, placed along a fractured limb, 
 in order to keep it in its situation. It 
 must be lined or covered with some soft 
 substance to prevent it from chafing the 
 sound parts. 
 
 SPONGE, BcRNT. Is used in medi- 
 cine for tlie cure of wens and other swel- 
 lings of the neck ; and though for some 
 time it was thought quite insignificant, 
 the discovery of iodine in its composition, 
 explains the reason of its having any in- 
 fluence, and has occasioned its being re- 
 tained in the Materia Medica, with con- 
 siderable confidence of success. If we 
 prefer the burnt sponge to the more un- 
 mixed iodine, the dose is from one to four 
 di-achms, in the form of an electuary or 
 lozenges. See Iodine. 
 
 SPRAIN. " A sprain Is an injury done 
 to the neighbourhood of a joint, general- 
 ly the wrists, knees, or ankles, and usual- 
 ly occasioned by a slip or some sudden 
 and violent exertion. Sprains are com- 
 monly productive of a painful and inflam- 
 matory swelling. There is generally an 
 effusion of serous fluid, from the rupture 
 of exhalant vessels; but sometimes the 
 swelling is discolouied, from blood being 
 effused. In sprains, we are to endeavour 
 to prevent the parts from swelling much, 
 and to check the inflammatory tendency. 
 Both of these ends may be in a great de- 
 gree obtained, by the application of cold 
 and astringent lotions, .such as vinegar 
 
512 
 
 SQUILL. 
 
 and water, spirits and water, solution of 
 muriate of ammonia, or of sugar of lead, 
 cold water, &c. We are • also to apply 
 leeches to the part ; and to give cooling- 
 laxatives. If the injury has been very se- 
 vere, and has induced general fever, Me 
 may take a bleeding from the arm, and 
 employ active purgatives; continuing the 
 cold applications. When the inflamma- 
 tory symptoms of sprain have gone off, 
 the place is to be rubbed with some lini- 
 ment, as camphorated oil or volatile lini- 
 ment ; and it is in many cases useful to 
 pour warm water in a stream from a 
 height on the joint which remains stiff. 
 
 SPRUCE-BEER. " An antiscorbutic 
 drink, highly esteemed by the northern 
 sailors, particularly the Newfoundland 
 men, and esteemed useful in many cuta- 
 neous complaints of this climate, chronic 
 rheumatism, &c. It derives its whole vir- 
 tues from the turpentine it contains. An 
 extract of the black or white spruce is 
 imported ; two or three table-spoonfuls of 
 which, added to sixteen gallons of water 
 in which as many pounds of molasses 
 have been previously dissolved, is fer- 
 mented with a due proportion of yeast. 
 When the fermentation is a little abated, 
 it is bottled for use ; and as this process 
 still goes on, it soon becomes a very brisk, 
 and not unpleasant drink. In America, 
 Newfoundland, Sweden, Denmark, and 
 Lapland, the branches of the spruce fir 
 are boiled in the water previous to the 
 fermentation." (Parr's Dictionary.) 
 
 SQUILL, Scilla maritima. The root 
 of the sea-onion, or squill, is used in me- 
 dicine as an expectorant, and to give re- 
 lief in complaints from the lungs ; it is 
 also used as a diuretic. It is apt to occa- 
 sion sickness and vomiting ; and in too 
 lai-ge a dose, the vomiting is followed 
 by bloody stools, vertigo, syncope, and 
 death. The dose of squill, as a diuretic, 
 or expectorant, is from one to two grains, 
 twice a-day ; and it is conveniently given 
 in the form of the squill pill of the Edin- 
 burgh Pharmacopoeia ; in Avhich one 
 grain of squill is united to three of am- 
 raoiiiacum, three of caraway seeds, and 
 
 three of extract of liquorice. The dose 
 is two pills, morning and evening. They 
 are useful in catarrhal complaints in asth- 
 ma, in several dropsical cases, and other 
 diseases. Squill imparts its virtues to 
 vinegar ; and the vinegar of squills is a 
 convenient mode of giving- it in a liquid 
 form ; a pectoral mixture may be made 
 by adding an ounce of squill vinegar to 
 three ounces of the syrup of Tolu, and 
 three or four of cinnamon-water, or pep- 
 permint-water. With common syrup, it 
 makes syrup of squill. 
 
 SQUINTING. This unseemly de- 
 formity frequently occurs as a symptom 
 of various diseases, particularly of those 
 affecting the head ; but it goes off when 
 the disease abates, and does not require 
 any particular attention. But when it 
 is merely a local disease, or a bad habit, 
 much may be done to cure or to palliate 
 it, if it be taken notice of in time, and 
 treated with care and skill. In infants, 
 the eye Avhich squints should be closed 
 for some time, more or less, according to 
 the effect ; or some bright-coloured ob- 
 ject, as a piece of silk, should be applied 
 two or three times a-day, to attract the 
 notice of the child, and to induce him to 
 turn his eye in the proper direction. 
 Children who squint, should wear con- 
 stantly, for some months, light wooden 
 goggles, which prevent their seeing with 
 both eyes, unless the pupils of both be 
 directed straight forwards. If this be un- 
 successful, the sound eye may be tied up, 
 and the goggle adapted carefully to the 
 other eye. Sometimes children squint 
 from imitation, and know they are doing 
 so. The habit must be broken, by the 
 child being carefully watched, and forc- 
 ed by all proper methods to avoid indulg- 
 ing it. 
 
 STABS are generally inflicted with 
 swords or bayonets. In the language 
 of surgery, they are called punctured 
 wounds. The external opening is very 
 small, in proportion to the depth. Stabs 
 are always more dangerous than clean 
 cutting wounds, as the parts, besides 
 being divided, generally suffer some de- 
 
STETHOSCOPE. 
 
 513 
 
 j»roe of bmising from the injury ; and, 
 Irom their depth, some important organs 
 M'ill probably be hurt. Stabs are very 
 likely to be followed by inflammation, 
 fevers, and abscesses, and by those nai'- 
 row windin«»;s under the skin, called si- 
 nuses. The bad consequences of stabs are 
 best prevented by emollient applications; 
 and in many cases, the previous employ- 
 ment of leeches to the neighboui'hood of 
 tlie wound, followed by a large poultice 
 over the whole, prevents any violent in- 
 flammation, and allows the wound to heal 
 without any further trouble. In other 
 cases, suppuration comes on, but it does 
 well. In some punctured wounds, an ex- 
 tension of the opening is necessary ; but 
 of this the surgeon is to judge. 
 
 STAPHYLOMA. See Eye, and 
 its DiseaseSy page 253. 
 
 STARCH is obtained from wheat-flour, 
 and a variety of other vegetable sub- 
 stances. It forms a large proportion of 
 the nutritious part of the farinaceous ve- 
 getables ; and as they are much used in 
 the diet and drink of patients, starch be- 
 comes an important article in pharmacy. 
 It is an excellent demulcent in various 
 disorders of the bowels, and is a good 
 vehicle for administering anodyne clys- 
 ters. A small tea-cup of thin starch, 
 with a tea-spoonful of laudanum, is a good 
 injection to allay pain and tenesmus, or 
 to check looseness. 
 
 STEEL MEDICINES are those form- 
 ed from the preparations of iron. Set Iron. 
 
 STERN UM. The breast-bone. 
 
 STERTOR, a sonorous breathing, 
 like snoring; one of the symptoms of 
 compressed brain, either from an injury 
 of the skull, or from an internal cause, 
 as apoplexy. 
 
 STETHOSCOPE. A wooden cylin- 
 der about eighteen inches long, used by 
 modern practitioners to ascertain the 
 healthy or morbid condition of the or- 
 gans within the chest. It is well known 
 that wood is an excellent conductor of 
 the vibrations that give the sensation of 
 sound ; and that if a person scratch one 
 4)ud of a log of Avood many yards in 
 
 length, another peraon, by putting his 
 ear to the other extremity, will distinctly 
 hear every sound emitted. On this prin- 
 ciple, the stethoscope has been invented. 
 The heart, by its violent and incessant 
 action, imparts a motion and thrilling to 
 the walls of the chest, which an observer 
 can loudly hear by applying the ear to 
 the left side ; and the stethoscope enables 
 him to obtain the same information with 
 less trouble to the patient, and without 
 any thing offensive to the most delicate 
 feelings. Hence, those who are well 
 practised in the use of the stethoscope, 
 and who have compared their observa- 
 tions on the living body, with the appear- 
 ances found in the dead bodies of those 
 who have died of diseases of the heart, 
 are enabled often to detect enlargement 
 of that organ, ossification of its valves, 
 or aneurism of the great vessels ; and, al- 
 though unfortunately this knowledge 
 does not lead to great practical utility 
 in curing those diseases, it is still a great 
 matter to be enabled to give a correct 
 diagnosis, and to know beforehand the 
 probable issue of the case. 
 
 The lungs having the air-cells, or ul- 
 timate branches of the wind-pipe, pervad- 
 ing every portion of them when in a 
 healthy state, the air rushing into them, 
 and being again expelled, is easily detect- 
 ed by the ear or the stethoscope. If any 
 part of the lungs be thickened and har- 
 dened, or impede the entrance of the aii* 
 to the very limit of the investing mem- 
 bi-ane, the sound imparted is materially 
 altered, or there is no sound whatever ; 
 and hence some are able to point out the 
 very spot where the lungs are unhealthy. 
 The presence of water or matter in the 
 chest, of mucus in the air-cells, and va- 
 rious other deviations from the healthy 
 structure, action, or secretions, may be 
 detected by the skilful and practised use 
 of the stethoscope. The honour of this 
 invention belongs to M. Laeunec of 
 l^aris. 
 
 STILL-BORN INFANTS. In gene- 
 i*al, the child, as soon as it is born, cries 
 stoutly, giving proof that its respiration 
 •2 L 
 
514 
 
 STILL-BORN INFANTS. 
 
 has fairly begun, and that it is capable 
 of living, detached from its parent. But 
 in other cases, no sign of life appears for 
 some time, and the child is said to be 
 still-horn. By proper means, it may some- 
 times be brought from that state. When 
 there is any pulsation felt in the navel- 
 string, the child should not be detached 
 from the mother, but warmth should be 
 applied to its body by flannels ; the nos- 
 trils should be touched with a little harts- 
 horn, the breast should be rubbed with 
 spirits, and the buttocks and soles of the 
 feet should be gently slapped with the 
 open hand. If the after-birth should in 
 the meanwhile be detached, which is 
 known by the cord becoming longer, the 
 infant is to be separated entirely, and the 
 cord being secured by a slip-knot, the 
 child is to be put into water, warmed 
 nearly to the heat of the human blood, 
 keeping the head uppermost, and the 
 mouth and nostrils out of the water. Ar- 
 tificial breathing is to be practised by 
 some person who understands the way of 
 doing it, either by the mouth or by a 
 syringe. If the pulsation of the heart 
 be not restored, the infant is to be taken 
 out of the ^vater, placed before the fire, 
 carefully rubbed, and wrapt in A^arm 
 flannel. A clyster, made of a few table- 
 spoonfuls of warm water with a tea- 
 spoonful of spu'its, is to be thrown up 
 with moderate force. The apparent 
 death may arise from a cause analogous 
 to that of apoplexy in adults; and we 
 therefore sometimes allow a little blood 
 to drop from the end of the cord. We 
 do this the more freely, when the shape 
 of the head is altered from what is na- 
 tural, when the colour of the face is dark 
 and livid, and when the pulsation in the 
 cord is oppressed. The quantity of blood 
 ■which we may allow to flow, is from one 
 table-spoonful to two. If the child does 
 not breathe after this discharge, the cord 
 is to be tied, and artificial breathing at- 
 tempted. All stimulating and irritating 
 means are to be avoided. Sometimes, 
 though a child breathes and cries at first, 
 it very soon becomes pale, and the pulsa- 
 
 tion of the heart becomes feeble. Sti- 
 mulants are applied to the surface, as 
 brandy or hartshorn: occasionally we 
 succeed in restoring the breathing and 
 circulation, but generally we fail. Some 
 children are born, having a purple colour 
 of the extremities, and with the breath- 
 ing unnatural. This probably arises from 
 mal-conformation of the heart or lungs, 
 and the infant soon dies. 
 
 STIMULANTS. Medicines or other 
 circumstances capable of exciting the vi- 
 tal energy, whether as exerted in sensa- 
 tion or motion. These are of various 
 kinds. 1. They are such as are applied 
 to the stomach, alcohol, tinctures, wine, 
 &c. In certain states of debility and dis- 
 ease, a very small portion of the mildest 
 food will act as a stimulant. 2. Diffusi- 
 ble stimulants, or such as are easily ex- 
 tended over the whole frame, hartshorn, 
 the shock of the cold bath, or the warm 
 bath, heat, electricity, and galvanism. 
 3. Tonics, mustard, cantharides. 
 
 It will be seen from the above slight 
 enumeration, that in speaking of sub- 
 stances of the first class, we use the term 
 stimulants to denote nearly the same 
 thing as cordials; and that the other 
 classes are arranged along with them on 
 account of the similarity of their action. 
 The cases in which general stimulants 
 are useful are those of torpor and debili- 
 ty ; but the power of some stimulants is 
 so great, and the constitution is at times 
 so easily affected by them, that much 
 skill and caution is required in their ex- 
 hibition. Suppose a person debilitated 
 and torpid after a long continued fever or 
 other illness; it would be desirable, no 
 doubt, to restore his strength as quickly 
 as possible. But this is not to be effected 
 by strong stimulants : to him, the use of 
 such in any considerable quantity would 
 probably be fatal. In all diseases of ex- 
 citement, as inflammations and fevers, sti- 
 mulants are to be avoided ; yet we must 
 not be misled by a name ; for at certain 
 periods of typhus fever, wine and the 
 strongest stimulants are necessary. 
 
 A more extended meaning is given to 
 
STOMACH. 
 
 515 
 
 sliinulants by some writers on tlie Mate- 
 ria Medica, who make it the generic term 
 for all medicines that increase the action 
 of any particular part. Under stimulants, 
 they class emetics, as rousing the stomach 
 into action ; cathartics, diuretics, siala- 
 gogues, and blisters, are all stimulants to 
 certain organs. But having treated of 
 these remedies separately, it is unneces- 
 sary to resiune them here. 
 
 STITCHES, a term in popular use to 
 signify acute and sudden darting pains in 
 any part of the trunk of the body, most 
 commonly applied to pains in the side. 
 Such stitches may arise from inflamma- 
 tion of the lungs and their covering, from 
 rheumatism, and from spasm; and the 
 appropriate remedies, according to each 
 exciting cause, are to be employed. 
 
 STOMACACE. A disorder of the 
 mouth, in which the gums are livid, 
 spungy, and easily made to bleed; a 
 symptom ot sea-scurvy. Stomacace is 
 often used for scurvy itself. 
 
 STOMACH. A large membranous 
 bag, into which the gullet leads, situated 
 under the diaphragm, and opposite to 
 that hollow called the pit of the stomach. 
 In the human subject, it is composed of 
 three coats ; the outermost or the perito- 
 neal, the middle or muscular coat, and 
 the innermost or villous coat, covered 
 ■with mucus, and containing numerous 
 absorbing and exhaling vessels, and a va- 
 riety of glands which secrete the fluids 
 useful in digestion. The nerves of the 
 stomach are numerous, and come from 
 the eighth pair and intercostals. The 
 stomach is destined to receive the food ; 
 and to perform upon it the fii-st, and a 
 very important part of the process of di- 
 gestion ; and this it does, as Dr. Paris 
 quotes from Dr. William Hunter, not as 
 a mill, a fermenting vat, or a stew-pan ; 
 but as a stomach. Under Digestion, we 
 have given a full account of that impor- 
 tant function ; and as indigestion and its 
 train of symptoms are diseases peculiai'ly 
 connected with the stomach, we refer to 
 Stomach Complaints for the history and 
 cure of those affections. 
 
 " Abscesses and cancers of the stomach 
 are not uncommon. The symptoms of 
 these disorders are commonly, however, 
 vague and uncertain. A general pain, 
 not always confined to the organ, but ap- 
 parently wandering to different sides of 
 the chest, without any marked shivering, 
 or evening exacerbation, point out gene- 
 ral disease, without fixing any particular 
 seat of the complaint." (Parr.) 
 
 The sympathy of the stomach with 
 other organs renders it one of the most 
 important parts of the animal economy. 
 Hence the great majority of medicines, 
 which are intended to act on various parts 
 of the body, are first applied to the sto- 
 mach. By wine, spirits, or opium, and 
 other substances, introduced into the sto- 
 mach, we can make astonishing changes 
 on the functions of the brain; and not qn- 
 ly act upon the corporeal frame, but en- 
 tirely transform or suspend the intellec- 
 tual operations ; and produce every shade 
 of mental excitement, from the cheerful- 
 ness inspired by a temperate draught, to 
 the boisterous violence of intoxication 
 ending in madness. By medicines taken 
 into the stomach, we can increase the 
 action of the heart and arteries ; we can 
 aid the functions of the skin, we can allay 
 the pain of gout or stone ; nor do we now 
 stop to inquire whether those sympathies 
 be direct, or whether the action of the 
 brain must intervene between the appli- 
 cation of the substance to the stomach 
 and the ultimate effect. 
 
 STOMACH COMPLAINTS, ^irfi;^e5- 
 tion. Dyspepsia. This is not a disease 
 which runs a regular course, and quickly 
 terminates either in health or death ; but 
 it is long aud obstinate, and presents a 
 great variety of symptoms, varying in 
 their degree, aud in the order of their 
 succession, in different individuals. Some 
 of the most noted of these symptoms are 
 the following : loss of appetite, sickness, 
 vomiting, flatulence, heartburn, pain or 
 cramp in the stomach. The state of the 
 bowels is very various ; sometimes there 
 is great costiveness, at others profuse 
 diarrhoea. AU these symptoms aie owing 
 
516 
 
 STOMACH COMPLAINTS. 
 
 to the unhealthy and irregular actions of 
 the stomach ; either the various fltiids 
 poured into it are vitiated, or its muscu- 
 lar motions are perverted, or hoth these 
 deviations from health occur together. 
 Hence the griping pains, the vomiting, 
 or the transmission of undigested aliment, 
 or its long retention, or its reaching the 
 bowels in such a state as to act as a 
 purge; and hence also a deficiency of the 
 fluids M'hich in health stimulate the 
 bowels to regular evacuation, as the bile. 
 Along with unhealthy action of the sto- 
 mach, other causes of indigestion concur. 
 The liver is frequently diseased ; and both 
 its structure and functions become unfit 
 for the purposes of healthy digestion. 
 The appetite is not always bad, but is 
 rather in some cases vftry keen ; but pa- 
 ( tients should not indulge it, as the sto- 
 mach is unable to digest the quantity of 
 I food they are inclined to take. Flatulence 
 I arises from the air which is disengaged 
 ; from the food during the process of di- 
 gestion. The heartburn is caused by the 
 presence of acid matter irritating the sto- 
 mach. This acid is jwoduced during di- 
 gestion, and certain articles of food, as 
 vegetables, butter, oil, &c. are apt to 
 cause the whole mass in the stomach to 
 become sour. The small quantities of 
 vinegar, or other acids Avhich we take in, 
 have not this acescency in general, but 
 rather tend to help digestion, by their 
 tonic power, and by their checking the 
 fermentation that produces acidity. The 
 cramp and pain, distinct from heartburn, 
 is owing to a spasmodic action of the 
 muscular fibres, well known by the name 
 of cramp in the stomach. Sometimes 
 dyspepsia in all its symptoms is an occa- 
 sional and transient disorder, from ovei'- 
 loading the stomach or taking food in too 
 great variety. Such fits occurring after 
 a surfeit may go off in a few days, but 
 sometimes they last unexpectedly long, 
 even for many weeks. In general, dys- 
 pepsia lasts for years, and even to the end 
 of a long life. Though it is attended 
 with great pain, inconvenience, and sut- 
 I fering, it is seldom fatiil of itself, but it 
 
 may lead to diseases in the structure of 
 the stomach, or, by wearing out the 
 strength, may give rise to dropsy. Many 
 dyspeptic patients thrive well and get fat, 
 in spite of their bad digestion ; and they I 
 may infer from this circumstance, that 
 they take a great deal more into their 
 stomach than is necessary. The mouth 
 is either dry, or it has an increased flow 
 of vitiated saliva thrown into it ; and cor- 
 responding to this, are the vitiated secre- 
 tions of the stomach. Many patients 
 think, that to get rid of this secretion by 
 a vomit would relieve them greatly ; but 
 the probability is, that such an expedient 
 would only increase it. Some of the 
 most distressing and alarming of the 
 symptoms that attend dyspepsia are those 
 which occur in the head ; there is head- 
 ach more or less acute, ringing of the 
 ears, giddiness, dimness of sight, various 
 odd depravations of that sense, as seeing 
 objects aslant, or only one half of them. 
 Such affections of the head and of the 
 sight arise from the wonderful but unex- 
 plained connexion between the stomach , 
 and brain. In dyspepsia, the liver and ^ 
 the secretion of bile are affected; and \ 
 when the bile, by the action of vomiting, 
 is brought up from the intestines and 
 forced out by the mouth, it is believed by 
 the patients that bile is the cause of their 
 disease. Hence the grievous complaints 
 that patients make of their being bilious, 
 or having the bile on their stomach. 
 Those who have been long resident in 
 Alarm climates are liable to derangement 
 of the biliary system, and in them dys- 
 pepsia is a symptom of their original dis- 
 ease. Those who are intemperate in the 
 use of spirituous liquors, have also great 
 derangement of the liver and its func- 
 tions; and have dyspepsia in a double 
 right, by the disease of the liver and by 
 that of the stomach. Sometimes in dys- 
 pepsia, the kidney is affected, and there is 
 a tendency to gravel. 
 
 Stomach Complaints, Causes of. The 
 knowledge of these is of great importance, 
 as without attention to them it is vain to 
 attempt a cure ; but by proper attention 
 
STOMACH COMPLAINTS. 
 
 517 
 
 to these causes, we may alleviate the 
 disease very miich, even if we do not 
 obtain a perfect cure. Under tlie article 
 Digestion, we have given an account 
 of that process, and therefore shall only 
 siiy here, that a great quantity of food 
 taken in, to which people are tempted by 
 the variety set before them, and by the 
 arts of cookery, is more than the gastric 
 juice can act upon ; and that the food 
 not acted upon loads the stomach ; that 
 a great deal of air is extricated from the 
 fermenting mass, that the gastric juice 
 is unable to check this fermentation as 
 it does in proper digestion, and the flatus 
 and distension thus produced give rise to 
 many dyspeptic symptoms. Many arti- 
 cles of food are of an indigestible or diffi- 
 cultly digestible quality, independent of 
 quantity ; thus, oil, butter, pastry, are in 
 general of difficult digestion. Some sto- 
 machs are unable to digest certain arti- 
 cles, which others digest without peculiar 
 difficulty; thus, milk, honey, eggs, sal- 
 mon, cheese, disagree with some. There- 
 fere, in regulating the diet of patients, 
 we must make particular inquiries about 
 their peculiarities and habits in this 
 respect. Various substances not intended 
 for nourishment, when habitually taken 
 into the stomach, weaken its powers, 
 both muscular and solvent, and so give 
 rise to dyspepsia. Among these, we are 
 I to reckon many luxuries and indulgences, 
 tobacco, wine, fermented liquors, spirits, 
 opium. From the list of accused articles, 
 %v« are strongly inclined to except tea 
 and coffee, as they seem by no means to 
 merit the reproaches that have been 
 thrown upon them ; but, on the contrary, 
 in the moderate way in which they are 
 generally taken, they appear to be highly 
 beneficial. They do not produce the 
 boisterous exhilaration of intoxicating 
 liquors, and it is therefore not from this 
 quality that they have obtained their 
 general and long-continued celebrity ; 
 and nothing but a conviction of their 
 salutary, or at least innocent tendency, 
 would have extended their reputation 
 among the temperate and the vjrtuous. 
 
 Spirits, whether raw, diluted with water, 
 or made into punch, are very pernicious 
 to the stomach, and the whole system. 
 Numerous are the train of evils to which 
 they give origin ; and dyspepsia is none 
 of the least severe. Some procure in- 
 toxication by opium, which in many of 
 its bad qualities resembles strong liquors, 
 producing diseases of the stomach and 
 liver, debility of mind and body ; and thus 
 a medicine of the most salutary and use- 
 ful kind, is perverted to the most in- 
 jurious purposes. Aromatics and bitters 
 taken too freely produce dyspeptic symp- 
 toms ; thus highly seasoned food will 
 bring it on. Acescent food, as too much 
 vegetables, or fermented liquor, will do 
 so. Another cause of dyspepsia is fre- 
 quent vomiting; a person finding his 
 stomach disorderied, takes an emetic, and 
 obtains great temporary relief; from this, 
 he is induced to repeat the remedy on the 
 next similar occasion ; but the powers of 
 the stomach are thus exceedingly impair- 
 ed, and the foundation laid for many 
 symptoms of dyspepsia. 
 
 The causes of dyspepsia above enu- 
 merated, act directly on the stomach; 
 but there are others no less powerful and 
 frequent which act on the whole body. 
 Of these, one of the most noted is a 
 sedentary life. Hence the great fre- 
 quency of dyspepsia in literary men, and 
 in men of business who are confined the 
 whole day to their desk. By thus in- 
 temperately pursuing study, however 
 rapidly at first literary acquirements may 
 appear to be made, in no long time, it is 
 evident that the ends of study are frus- 
 trated, and the mind and body, alike 
 depressed, are incapable of any exertion. 
 Depressing passions have a great in- 
 fluence on the digestive powers, and in 
 those who indulge them, dyspeptic symp- 
 toms frequently prevail. Cpld moist air, 
 when persons do not take proper exer- 
 cise, is. apt to in jive digestion. Hence 
 dyspeptic patients are frequently woree 
 in winter. 
 
 Cure of Dyspepsia. By attending to 
 the circumstances above mentioned, and 
 
Me 
 
 STOMACH COMPLAINTS. 
 
 avoidinj^ the various hurtful articles of 
 food and modes of living which have 
 been pointed out, much may be done to 
 assist in the ciu"e ; whereas, if the causes 
 of the disease continue to act, no advan- 
 tage is to be expected from drugs. When 
 a person with dyspepsia puts himself 
 under treatment for the disease, the first 
 object is to get rid of any ill-digested or 
 crude matter that the stomach contains ; 
 but it is not safe to attempt this by 
 vomiting ; it ought rather to be done by 
 purges. If spontaneous vomiting be very 
 violent, it may occasionally be advisable 
 to expedite the evacuation of the stomach 
 by an emetic. 
 
 There are certain symptoms which give 
 great uneasiness, and which require to be 
 attended to. Patients are particularly 
 annoyed with the flatulence which at- 
 tends their disease, and are very urgent 
 to get medicines to dispel it ; they should, 
 if possible, bear it for a time, remember- 
 ing that it is a consequence of their slow 
 and imperfect digestion, and that the re- 
 lief from flatulence is to be properly ob- 
 tained by the improvement of their di- 
 gestive powers. When we must use car- 
 minatives or medicines to expel wind, one 
 of the safest is peppermint-water, having 
 a few drops of hartshorn added to a wine- 
 glassful of it. Assafetida pills, or the so- 
 lution of assafetida, may also be employed. 
 The heartburn is to be relieved by ab- 
 sorbents, the cramp by antispasmodics; 
 and when vomiting is very violent, we 
 may be obliged to have recourse to opium 
 by the mouth or by a clyster, or to give 
 a little brandy or strong aromatic tinc- 
 ture, or ten grains of the oxide of bis- 
 muth. 
 
 The headach which occui-s in dyspep- 
 tic patients is thought to depend either 
 on a faulty digestion in the stomach, or 
 in the upper part of the bowels. In the 
 first case, the pulse is languid and feeble, 
 but not very frequent, the tongue whit- 
 ish, and slightly coated ; the edges are of 
 a pale red colour. There is indistinctness 
 of sight, a dull pain or weight in the 
 head, attended with some confusion ; the 
 
 patient is slightly giddy, and he is fearful 
 of falling. There is slight nausea, and 
 a sense of irritation in the stomach, a 
 feeling of tightness about the fauces, and 
 a watery secretion from the back part of 
 the mouth. This headach generally oc- 
 curs in the earlier stages of digestion, and 
 is best relieved by an emetic. The other 
 kind of headach, that arising from bad 
 digestion in the upper part of the bowels, 
 is remarkable for the appearance of bril- 
 liant objects before the eyes ; there is 
 chillness of the body, and coldness and 
 dampness of the hands and feet ; the pain 
 in the head is very severe, attended with 
 a sensation of coldness and tightness of 
 the scalp, slight giddiness, weight, disten- 
 sion and stiffness of the eye-balls. The 
 tongue is usually covered with a yellow- 
 ish-white fur. The pulse is of the natu- 
 ral frequency, but languid. There is sick- 
 ness, but seldom vomiting ; commonly 
 flatulency, and a sensation of dryness and 
 inactivity of the bowels. A calomel pur- 
 gative, followed up by compound powder 
 of jalap, or neutral salts, generally relieves 
 this kind of headach. In all complaints 
 of the head, it is of great importance, to 
 be sure, if we can, whether they proceed 
 from sympathy with other organs, or from 
 diseases in the head itself. These last are 
 generally accompanied by plethora, throb- 
 bing at the temples, redness of the eyes, 
 and constitutional excitement. An acute 
 fixed pain, with a quick, irritable, and 
 sometimes irregular pulse, indicate great 
 disorder in the head itself. See Head- 
 ach, page 305. 
 
 Another symptom requiring to be pal- 
 liated, is acidity, and this is to be done 
 by the various substances called absor- 
 bents. If patientsare costive, we neutralize 
 the acidity by magnesia, which forms a 
 laxative salt with the acid which it meets 
 in the stomach; and if the bowels are 
 too loose, we prefer chalk, which has an 
 astringent effect, by the salt which it 
 forms in like circumstances. Vegetables 
 certainly tend to acidity, but a total ab- 
 stinence from them is not to be recom- 
 mended : as a due mixture of well-boiled 
 
 1 
 
STOMACH COMPLAINTS. 
 
 519 
 
 vegetables is highly useful. Costiveness 
 is another symptom to be much avoided, 
 as aggravating stomach complaints when 
 they are present, and occasioning them 
 where they are not. To obviate this, pa- 
 tients should take laxative medicines, 
 even every night if necessary, as rhubarb 
 and magnesia, or pills of aloes, or of aloes 
 and colocynth, or the compound pills of 
 rhubarb. In general, the resinous purga- 
 tives do better with dyspeptic patients 
 than the saline : though the use of Chel- 
 tenham and Harrowgate waters is benefi- 
 cial to many of them, whether it be owing 
 to the salts in the water, or to the ac- 
 companying advantages of air and exer- 
 cise, combined with temperance and the 
 freedom from their usual cares. Dyspep- 
 tic patients should be most pointedly di- 
 rected, on no account to suffer themselves 
 f. to go two days without a motion of the 
 bowels, but to take at bed-time some lax- 
 ative medicine ; and, in all probability, 
 the habit of regularity will be in time 
 formed. 
 
 In attempting the cure of dyspepsia, 
 we are to give remedies which act on the 
 stomach, or on the whole system. Of 
 those which act on the stomach, the prin- 
 cipal are, 1. Acids, which in moderate 
 quantity are excellent stomachics; the 
 sulphuric acid much diluted, as ten 
 di'ops of the acidum snlphuricum dilutum 
 of the Edinburgh Pharmacopoeia in a 
 glass of cold water twice or thrice a-day, 
 or the elixir of vitriol, in a like quantity. 
 2. Bitters, as the tincture of gentian, a 
 tea-spoonful in a glass of cold water daily ; 
 or the decoction of quassia, a small tum- 
 bler twice a-day, or the powder of Co- 
 lombo ten grains twice a-day, or the tinc- 
 ture of Colombo, a spoonful as often. The 
 only disadvantage attending the use of 
 tinctures habitually, is the danger of in- 
 ducing a habit of using spirituous liquors, 
 thus demoralizing the character, and ul- 
 timately making the stomach complaints 
 worse. Bitters, therefore, should be ta- 
 ken in the least tempting form, as in sub- 
 stance or decoction. PeruWan bark or 
 quinine is one o^ the best we can employ. 
 
 3. AromaticSy as pepper, and other spices ; 
 but they at last are apt to do more harm 
 than good. 4. Chalybeates, or the vari- 
 ous preparations of iron. The carbonate 
 of iron, six or eight grains every day, or 
 the sulphate of iron made into pills with 
 the extract of gentian, one grain of the 
 sulphate to four of the extract, may be 
 taken three times a-day. Though these 
 medicines are useful and proper as auxi- 
 liaries in the cure of dyspepsia, our chief 
 reliance is to be placed on remedies act- 
 ing on the system in general. Exercise 
 in the open air is of primary importance ; 
 the kind to be regulated by the strength 
 and habits of the patient. Walking on 
 level ground, riding in a carriage, garden- 
 ing or farming; dancing, from its effect 
 on the spirits as well as the exercise of 
 the body; going on a journey or to a wa- 
 tering place, are various modes, out of 
 which the patient or physician is to choose 
 what is most expedient. Cold bathing 
 by the shower-bath is a good tonic ; and 
 it may be proper to accustom the patient 
 gradually to the degree of cold we wish 
 him to be exposed to. Sea-bathing is of 
 excellent tendency. 
 
 We are happy to confirm the foregoing 
 observations on Indigestion, published in 
 oui' first edition, by the results of the ex- 
 tensive experience of Dr. Abercrombie ; 
 and from 'his work on the Diseases of 
 the Stomach, &c. we extract the follow- 
 ing rules : — 
 
 " I. It appears that the muscular ac- 
 tion of the stomach is both more vigorous 
 and more extensive when its contents are 
 in small quantity, than when it is much 
 distended ; and if we suppose the fluids 
 of the stomach to be secreted in nearly a 
 uniform quantity, their action must also 
 be greatly regulated by the quantity of 
 matter which they have to act upon ; 
 hence the indispensable importance, in 
 dyspeptic cases, of restricting the food to 
 such a quantity as the stomach shall be 
 found capable of digesting in a healthy 
 manner. This is unquestionably the first 
 and great principle in the treatment of 
 indigestion; and without invariable at- 
 
520 
 
 STOMACH COMPLAINTS. 
 
 tention to it, no otlier means will be of 
 the smallest avail. 
 
 " II. It appears that various articles 
 of food are of various dej^rees of solubi- 
 lity in the stomach. When, therefore, 
 digestion is apt to be easily impaired, it 
 will be of the greatest importance, not 
 only to avoid articles which are of diffi- 
 cult solution, but also to avoid mixing 
 various articles which are of different de- 
 grees of solubility. Attention to this 
 rule will probably favour in a great mea- 
 sure the process of chymification going 
 on in a regular and healthy manner, by 
 avoiding a state in which the solution of 
 one article may be more advanced than 
 that of another. The articles of most 
 easy solution appear to be solid animal 
 food, and white fish, both plainly dress- 
 ed ; vegetables are less soluble ; and, 
 among the articles of more difficult solu- 
 tion, appear to be fatty substances, ten- 
 dinous and cartilaginous parts, concrete 
 albumen, the epidermis of fruits, and, ac- 
 cording to some, mucilaginous and sweet 
 vegetables. From some experiments of 
 Sir Astley Cooper, it is supposed, that 
 the solubility of animal food is in the or- 
 der of pork, mutton, veal, beef. Arti- 
 cles in small pieces are much more speed- 
 ily dissolved than in larger, the action 
 being found to begin at the circumfer- 
 ence of the portion ; and hence the im- 
 portance of careful mastication. 
 
 " III. If digestion go on more slowly, 
 and more imperfectly, than in the healthy 
 state; another important rule will be, 
 not to take in additional food until full 
 time has been given for the solution of 
 the former. If the healthy period be 
 four or five hours, the dyspeptic should 
 probably allow six or seven. The inju- 
 rious infringement of this rule by a break- 
 fast, a meat lunch, and a dinner, all with- 
 in the space of seven or eight hours, is 
 too obvioiLS to require a single observa- 
 tion, 
 
 " The rules now briefly referred to, I 
 conceive to be of more importance in the 
 treatment of dyspepsia than any means 
 whatever. I believe, that eyery stomach, 
 
 not actually impaired by organic disease, 
 will perform its functions if it receive 
 reasonable attention ; and when we con- 
 sider the manner in which diet is gene- 
 rally conducted, both in regard to quan- 
 tity, and to the variety of articles of food 
 and drink which are mixed up into one 
 heterogeneous mass, instead of being as- 
 tonished at the prevalence of indigestion, 
 our wonder must rather be, that in such 
 circumstances, any stomach is (-apable of 
 digesting at all. In the regulation of diet, 
 much, certaialy, is to be done in dj'spep- 
 tic cases, by attention to the quality of 
 the articles that are taken ; but I am sa- 
 tisfied that much more depends upon the 
 quantity ; and I am even disposed to say, 
 that the dyspeptic might be almost inde- 
 pendent of any attention to the quality 
 of his diet, if he rigidly observed the 
 necessary restrictions in regard to quan- 
 tity. It is often, indeed, remarkable, how 
 articles, which cannot be borne as a part 
 of mixed diet, agree perfectly, when 
 taken alone ; how a person, for example, 
 who fancies that milk disagrees with 
 him, will enjoy sound digestion upon a 
 milk diet ; and how another, who cannot 
 taste vegetables witljout being torment- 
 ed with acidity, will be entirely free from 
 acidity on a vegetable diet. The fol- 
 lowing case occurred to me some time 
 ago, in which this experiment M'as made 
 in the most complete and satisfactory 
 manner. 
 
 " A gentleman, accustomed to mode- 
 rate, but very comfortable living, had 
 been for many years what is called a 
 martyr to stomach complaints, seldom a 
 day passing in which he did not suffer 
 greatly from pain in his stomach, with 
 flatulence, acidity, and the usual train of 
 dyspeptic symptoms ; and, in particular, 
 he could not taste a bit of vegetable, 
 without suffering from it severely. He 
 had gone on in this manner for years, 
 when he was seized with complaints in 
 his head, threatening apoplexy, which, 
 after being relieved by the usual means, 
 showed such a constant tendency to re- 
 cur, that it has been necessary ever since 
 
STOMACH COMPLAINTS. 
 
 521 
 
 to restrict him to a diet almost entirely 
 of vegetables, and in very moderate quan- 
 tity. Under this regimen, so different 
 from his former mode of living, he has 
 continued free from any recurrence of 
 the complaints in his head, and has never 
 been known to complain of his stomach. 
 
 " In the regulation of the diet for all 
 affections of the stomach, however, strict 
 attention must always be paid to the n.i- 
 ture and source of the disease. Animal 
 food is, in general, the most digestible ; 
 but there are many oases which depend 
 upon an irritable state of the mucous 
 membmne, in which the diet found to be 
 beneficial, or even necessary, is one re- 
 stricted to farinaceous articles and milk. 
 The higher degrees of this affection, in 
 which the disease amounts to inflamma- 
 tion of the mucous membrane, have al- 
 ready been referred to ; but there appear 
 to be modifications of it, which, without 
 assuming this formidable character, have 
 a similar effect on the functions of the 
 stomach, and require similai' treatment, 
 especially in regard to diet. The subject 
 is one of great interest, and opens a most 
 important field of observation to him who, 
 renouncing a mere empirical treatment 
 of dyspeptic affections, shall direct his 
 attention to the important varieties in 
 the nature and source of the disease. 
 Such a person will be astonished to find 
 the improvement which is made in cer- 
 tain cases, under a diet restricted entire- 
 ly to rice, arrow-root, or bread and milk, 
 with total abstinence from all stimulating 
 liquors, after the patient had spent years 
 of wretchedness upon animal diet, with 
 wine or brandy and water, and the ustial 
 round of stomachic remedies. Other 
 cases again agree better with animal diet 
 in very small quantity, and the moderate 
 use of stimulating liquors. The diagno- 
 sis is often difficult, and must be guided 
 more by the judgment and attention of 
 the practitioner, than by any general rule. 
 This subject has been well illustrated by 
 Dr. J.-imes Johnson, in his treatise on 
 Morbid Irritability of the Stomach. 
 
 ** In the medical treatment of dyspep- 
 
 tic complaints, it is impossible to advance 
 any thing new. One thing, however, 
 has always appeared to me to be of the 
 utmost importance in regard to the regu- 
 lation of the ])owels, which, in general, 
 are habitually slow. It consists in regu- 
 lating them by the daily use of very small 
 doses of laxatives combined with tonics ; 
 so as, without ever purging, to imitate at 
 all times, that moderate but regular ac- 
 tion, which constitutes the most healthy 
 state of the bowels. For this purpose 
 various combinations will be found to 
 answer; such as columbo powder with 
 carbonate of potass, and a few grains of 
 rhubarb, taken once or twice a-day ; sul- 
 phate of iron with aloes; sulphate of 
 quinine with aloes ; oxide of bismuth with 
 rhubarb or aloes, &c. Lime-water is of- 
 ten useful, and the mineral acids. The 
 nitric acid, in particular, is often found 
 one of the best tonics, and one of the 
 best con-ectoi-s of acidity. 
 
 " This kind of mild treatment, with a 
 proper regulation of diet, and regular ex- 
 ercise without fatigue, appears to be the 
 plan best adapted to the ordinary cases of 
 dyspepsia. Injury is done by the free 
 use of stimulants, and by active purging; 
 and I must also express my apprehension 
 that no small injury is done by the in- 
 discriminate use of mercury. There are, 
 indeed, some affections of the stomach, 
 probably connected with derangements 
 of the liver, in which a very cautious use 
 of mercury appears to be beneficial ; but 
 in many others, it is decidedly hurtful ; 
 and I conceive, that in all disorders of 
 the stomach, mercury in any form, or in 
 any quantity, ought not to be employed 
 when the desired effect can be accom- 
 plished by any other means." ( Dr. Aber- 
 CROMBiE on Diseases of the Stomach, In- 
 testinal Canal, &c.) 
 
 Dr. Paris, who has written a useful 
 and intelligible work on Diet, lays down 
 the following rules for patients troubled 
 with indigestion. 
 
 " The dietetic code of the dyspeptic 
 patient may be summarily included under 
 the following precepts : — 
 
522 
 
 STOMACH COMPLAINTS. 
 
 " A. Precepts in relation to the Qua- 
 lity of Food. 
 
 a. Animal food is more digestible, but 
 at the same time more stimulant and less 
 flatulent, than vegetable diet? A dyspep- 
 tic invalid may be restricted to meat and 
 bread with advantage, until his digestive 
 powers have gained sufficient energy to 
 enable him to convert vegetable matter 
 into healthy chyle ; after which, a due 
 mixture of both species of aliment will 
 be essential. 
 
 " b. The wholesome quality of food 
 depends as much, or even more, upon its 
 mechanical condition, than upon its che- 
 mical composition ; and as this is influ- 
 enced by various circumstances under our 
 own control, we may render food, natu- 
 rally indigestible, of easy digestion. The 
 digestibility of any species of aliment, as 
 well as its nutritive qualities, are influ- 
 enced by the different modes of cookery. 
 The addition of condiments is also ca- 
 pable of producing the same effects. See 
 the articles Diet and Drink in this work. 
 " B. Precepts in relation to the Quan- 
 tity of Food. 
 
 " This must, in every case, be regulat- 
 ed by the feelings of the patient : let him 
 eat slowly, masticate thoroughly, and, on 
 the first feeling of satiety, dismiss his 
 plate, and he will not have occasion for 
 any artificial standard of weight and mea- 
 sure. But he must, in such a case, re- 
 strict himself to one dish ; an indulgence 
 in variety provokes an ai'tificial appetite, 
 which he may not readily distinguish 
 from that natural feeling which is the on- 
 ly true indication. 
 
 " C. Precepts, with regard to the Pe- 
 riods best adapted for Meals, and on the 
 Intervals which should elapse between 
 each. 
 
 « I have, upon every occasion, endea- 
 voured to impress upon the practitioner, 
 the high importance of these considera- 
 tions. In every situation of life, we too 
 frequently pass unheeded, objects of real 
 importance, in an over-anxiety to pursue 
 others of more apparent, but of far less 
 -ntrinsic value ; so is it with the dyspep- 
 
 tic invalid in search of health: Wliat shall 
 I eat ? Is this or that species of food di- 
 gestible ? are the constant queries which 
 he addresses to his physician. He will 
 religiously abstain from whatever medi- 
 cal opinion or even popular prejudice has 
 decried as unwholesome; and yet the 
 period at which he takes his meal is a 
 matter of comparative indifference with 
 him : although he will refuse to taste a 
 dish that contains an atom of vinegar, 
 with as much pertinacity as if it held ar- 
 senic in solution, he will allow the most 
 trifling engagement to postpone his din- 
 ner for an hour. So impfortant and se- 
 rious an error do I consider such irregu- 
 larities, that 1 have frequently said to a 
 patient labouring under indigestion. " / 
 will wave all my objections to the quality 
 and quantity of your food, if I were 
 sure that such a sacrifice of opinion 
 would ensure regularity in the periods of 
 your meals^^ 
 
 " a. The principal solid meal should 
 be taken in the middle of the da3^ 
 
 " b. Four hours after which, a liquid 
 meal should be indulged in. 
 
 " c. The digestion of one meal should 
 be always completed before fresh labour 
 is imposed upon the stomach. 
 
 " d. The intervals at which food is to 
 be taken, must be regulated by the di- 
 gestive powers of the individual, and the 
 rapidity with which they are performed. 
 " e. The patient should never take his 
 meal in a state of fatigue. 
 
 " /. Exercise should always be taken, 
 three or four hours after dinner." (Dr. 
 Paris on Diet.) 
 
 In concluding this article, we are anx- 
 ious to inculcate, that exercise and 
 temperance are at once the great pre- 
 venters and curers of indigestion. They, 
 who in their extreme anxiety to fit 
 themselves for the duties of a learned 
 profession, imprudently overstrain their 
 powers, and neglect that exercise which 
 nature requires, should be warned by the 
 sad experience of others to reflect, that 
 such ill-timed avarice of learning may 
 by the foundation of long and painful 
 
STOMACH, INFLAMMATION OF. 
 
 >23 
 
 disease; and when their talents and 
 acquirements have placed them in stations 
 of usefulness, they may be, from languor, 
 pain, and weakness, utterly incapable of 
 discharging- their duties. It is only by 
 a due mixture of study and relaxation, 
 of mental diligence and bodily activity, 
 that we can hope to obtain the sound 
 mind in the sound body; which, when 
 directed by true principle, in whatever 
 profession, can alone make us useful to 
 ourselves or beneficial to others. As for 
 those who, in the pursuit of gain, sacrifice 
 to it their health as well as their peace, 
 we cannot but deplore that melancholy 
 aberration of mind so frequently met 
 with, by which men mistake the means 
 for the end; and which impels them to 
 procure ample materials for the ease and 
 enjoyment of life, while their enfeebled 
 powers preclude the possibility of using 
 the wealth they have acquired with so 
 much solicitude. 
 
 STOMACH, Inflammation of. The 
 symptoms of inllaramation of the sto- 
 mach are, acute pain, heat, and tension 
 in the region of that organ, great increase 
 of pain when any thing is swallowed, 
 vomiting, great and sudden depression of 
 strength, a small pulse, thirst, restless- 
 ness, anxiety, continual tossing of the 
 body. As the disease increases, there is 
 great loss of strength, faintings, short 
 respiration, clammy sweats, hiccup, cold- 
 ness of the extremities, an intermitting 
 pulse, death. Inflammation of the sto- 
 mach is always to be regarded as a very 
 dangerous disease. 
 
 Causes. It arises most frequently 
 from matters introduced into it, either 
 inflaming or irritating from their poison- 
 ous and acrid character; or from the 
 previous state of the stomach being un- 
 fit for their reception, as when cold water 
 is swallowed when the body is much 
 heated. It rarely, if ever, occure spon- 
 taneously or from constitutional causes. 
 
 Treatment. The first remedy to be 
 tried is blood-letting, to a considerable 
 rxtont ; and we must not be deterred by 
 the sraallness of the pulse. If, by this 
 
 means, we render the stomach able to 
 retain M'hat is swallowed, we are to give 
 purgatives of the mildest kind, as castor 
 oil ; to apply a blister to the pit of the 
 stomach, and afterwards to give sudorifics 
 to determine to the skin. The food 
 should be in small quantity, and of the 
 mildest nature ; and after the inflamma- 
 tion is subdued, the strength must be 
 recruited by tonics and nourishing diet, 
 taking care for a long time not to eat any 
 thing acrid or difficult of digestion. 
 
 STOMACH-PUMP. An instrument 
 for speedily evacuating fluids upwards 
 from the stomach. On this subject we 
 beg to quote the following remarks from 
 Dr. Paris's Pharmacologia, where he is 
 speaking of antidotes: " The practice 
 of emptying the stomach by means of a 
 syringe, as proposed by Boerhaave, has 
 lately been revived, with all the con- 
 fidence of a new invention. There are 
 cases of narcotic poisoning, in which 
 there can be no doubt it would furnish 
 the practitioner with a valuable resource ; 
 but I much fear that it will be found 
 to be less successful than its more san- 
 guine advocates have anticipated ; for 
 where the stomach has so far lost its 
 power, as to be insensible to the stimulus 
 of a potent emetic, the chances of re- 
 covery are small ; the practice, however, 
 in such cases, ought never to be neglect- 
 ed, for it cannot possibly do harm, and 
 may perhaps be beneficial." 
 
 STOMACH, Ulceration of. There 
 are some severe and fatal cases of diseased 
 stomach from organic derangement, dur- 
 ing the progress of which, the most pro- 
 minent symptoms resemble those of in- 
 digestion. " This organic disease exists 
 in two conditions ; namely, chronic in- 
 flammation of a defined portion of the 
 mucous membrane of the stomach, or the 
 mucous follicles ; and the termination of 
 this by ulceration. In both these condi- 
 tions, it may probably be the subject of 
 medical treatment; for we have reason 
 to believe, that the inflammation may be 
 arrested and prevented from passing into 
 ulceration, and that the ulceration may 
 
5?* 
 
 STOMACH, ULCERATION OF. 
 
 heal before it has become connected with 
 any permanent change in the organiza- 
 tion of the part. Hence appears the im- 
 portance of minutely watching the pro- 
 gress of the disease in its early stages, in 
 which only it is likely to be treated with 
 success. The difficulty here is in the 
 diagnosis ; the disease often assuming 
 the character of a mere dyspeptic affec- 
 tion through a great jjart of its progress ; 
 while, in fact, a morbid condition of a 
 very seiious nature is going on, Vrhich 
 would require treatment in many respects 
 very different from that adapted to dys- 
 pepsia. 
 
 " The disease may be suspected, when 
 there is pain in the stomach occurring 
 with considerable reguLirity immediately 
 after meals, and continuing for a certain 
 time during the process of digestion, espe- 
 cially if the pain be distinctly referred to 
 a particular spot, and if there be at that 
 spot tenderness on pressure. It may be 
 farther suspected, if the pain continues 
 severe until the patient is relieved by 
 vomiting; but we have seen that the 
 disease may go on to a very advanced 
 period without vomiting ; and, on the 
 other hand, that it is sometimes indicated 
 by vomiting occurring occasionally, with- 
 out any regular periods, and with very 
 little pain. When this feeling occurs 
 with great intensity after food of all sorts, 
 taken even in the most moderate quanti- 
 ties, we have reason to suspect disease 
 of the mucous membrane of the stomach. 
 The feeling appears to be in some cases 
 connected ^ith the formation of an acrid 
 fluid, which we often see brought up in 
 considerable quantities ; and in others, 
 seems to depend merely upon the morbid 
 condition of the mucous membrane itself; 
 in consequence of which, ordinary articles 
 produce that peculiar feeling of irritation, 
 which in the sound state of the parts is 
 produced by matters of an acrid quality. 
 It is common to hear such patients say, 
 that attention to diet makes little diffe- 
 rence in their feelings, but that every 
 thing turns immediately to intense acid- 
 ity, even a bit of meat or a glass of cold 
 
 water. The disease may be also suspect- 
 ed, when, along with any of the above- 
 mentioned symptoms, though in a mild 
 and obscure form, the patient is becoming 
 weakened and emaciated in a manner 
 which a mere dyspeptic affection could 
 not account for. The affection, again, 
 is sometimes accompanied and character- 
 ised by a raw and tender state of the 
 tongue and throat ; in some cases, with 
 minute ulcers, and in others, v^ith the 
 formation of slight aphthous crusts. One 
 gentleman lately stated to me that liis 
 complaint began with minute ulcers and 
 a burning sensation on the tongue, and 
 that he afterwards distinctly felt the same 
 state of disease extending gradually along 
 the oesophagus, and at last into the sto- 
 mach. 
 
 " Amid such a diversity of symptoms 
 as occur in connexion with this disease, 
 our chief reliance in the diagnosis must 
 probably be on a careful examination of 
 the region of the stomach itself, with the 
 view of discovering the existence of ten- 
 derness referred to a particular pai*t. This 
 examination should be made with the 
 most minute attention, at various times, 
 both when the stomach is full and when 
 it is empty. If induration be discoveredj 
 the character of the case will be obvious ; 
 but we have seen, that most extensive 
 ulceration may exist without any indura- 
 tion; and likewise, that extensive indura- 
 tion may exist without being discovered 
 by external examination. 
 
 " There are other important cautions 
 with regard to the diagnosis. In parti- 
 cular, we should not be deceived, either 
 by the pain having remarkable remissions, 
 and the patient enjoying long intervals of 
 perfect health, or by remarkable allevia- 
 tion of the symptoms taking place under 
 a careful regulation of the diet ; for these 
 circumstances we have found occurring 
 in a very striking manner, while the dis- 
 ease was making progress to its fatal ter- 
 mination. 
 
 " When the disease is detected at an 
 early period, the treatment must consist 
 chiefly of free and repeated topical bleed? 
 
IS T O N E. 
 
 525 
 
 ing, followed by bliistering, issues, or the 
 tartar eujctic ointment. The food nmst 
 bo in very small quantity, and of the 
 mildest quality, consisting" chiefly or en- 
 tirely of fiirinaceous articles and milk, 
 with total abstinence from all stimulat- 
 ing liquoi-s ; and it would appear to bo 
 of much consequence to guard against 
 any degree of distension of the stomach, 
 that can possibly be avoided even by the 
 mildest articles. The patient should ab- 
 stain, in a great measure, from bodily ex- 
 ertions, and hence the importance of en- 
 deavouring to distinguish the disease from 
 mere dyspepsia, as the regimen and ex- 
 ercise which are proper and necessary in 
 a dyspeptic case, would, in this case, be 
 highly injurious. 
 
 " In the early stages, little probably is 
 gained by medicine given internally, be- 
 yond what is required for the regulation 
 of the bowels. In the more advanced 
 stages, or when there is reason to suspect 
 that the disease has passed into ulceration, 
 the same observations will apply in re- 
 gard to external applications and regi- 
 men ; and benefit may now be obtained 
 by some internal remedies, such as the 
 oxide of bismuth, lime-water and nitric 
 acid ; and, in some cases, small quantities 
 of mercury appear to be useful. Small 
 opiates, combined with articles of a mu- 
 cilaginous nature, appear frequently to 
 be beneficial ; likewise articles of an as- 
 tringent nature, such as kino, alum, and 
 the rhatany root. The arsenical solution 
 has also been recommended, and small 
 doses of the nitrate of silver ; and in se- 
 veral instances in which I suspected this 
 disease to be going on, I have found re- 
 marliable benefit from the sulphate of 
 iron. "Whether the disease can be cured, 
 after it has advanced to ulceration, must 
 indeed remain in some degree a matter of 
 doubt ; because, in a case which has ter- 
 minated favourably, we have no means of 
 ascertaining with certainty that ulcera- 
 tion had existed. In some of the cases, 
 however, which have been described, we 
 have seen every reason to believe that 
 some of the ulcers had cicatrized, though 
 
 the disease bad afterwards gone on to a 
 fatal termination ; and from what we ob- 
 serve in the intestinal canal, we can have 
 little doubt that simple ulceration of the 
 mucous membrane may cicatrize. 1 am 
 satisfied that I have seen the cicatrices 
 of such ulcers when the patient lias died 
 of another disease, after having been for 
 a considerable time free from any symp- 
 tom in the bowels." (Dr. Abercrombie 
 on. Diseases of the Stomach and Intestinal 
 Canal.) 
 
 STOMACHICS. A term used to de- 
 note those medicines which are believed 
 to be beneficial to the stomach, and to 
 promote the powers of digestion. This 
 is a vague term, and is rather used in po- 
 pular discourse, than by medical writers, 
 who prefer more appropriate and definite 
 terms, as bitters, tonics, aromatiqs, &c. 
 Pepper, ginger, and various condiments, 
 may be reckoned stomachics ; rhubarb is 
 a very good one ; and the compound pills 
 of rhubarb, aloes, and myrrh, are often 
 called stomachic pills. Two may be ta- 
 ken every day for some time. 
 
 STONE AND GRAVEL, are the names 
 applied to the diseases which are occa- 
 sioned by concretions in the urinary pas- 
 sages. Gravel signifies small stones that 
 pass from the kidneys through the ure- 
 ters in a few days; hence the disorder 
 induced in such cases is called a Jit of 
 gi-avcl. Stone is a calculous concretion 
 in the kidneys or in the urinary bladder, 
 which is too large to pass, or at least, 
 without great difficulty. The symptoms 
 to which such concretions give rise are 
 of the most painful kind, and occur so 
 frequently, as to become objects of very 
 considerable interest. There are so many 
 diiierent salts contained in the urine, that 
 it does not appear wonderful that occa- 
 sionally they should fail of being kept in 
 complete solution. Whea this is the 
 case, and when a nucleus is formed, they 
 concrete around it, and by their getting 
 through narrow passages, or pressing upon 
 delicate organs, they occasion the severe 
 symptoms of stone or gravel. A Fit of 
 the Gravel is accompanied by a fixed 
 
526 
 
 STONE. 
 
 pain in the loins, a numbness of the thigh 
 on the side affected, sickness and vomit- 
 ing-, and sometimes slight diminution of 
 the quantity of urine. Sometimes the 
 acuteness of the pain occasions faintings 
 and convulsive fits. These violent and 
 painful affections are generally terminat- 
 ed by the passage of small stones through 
 the urethra; and the patient is for the 
 time easy. In those who are much pre- 
 disposed to gravel, these attacks may be 
 expected again, at uncertain intervals. 
 
 When there is Stone in the Bladdery the 
 symptoms are, a frequent inclination to 
 make water, which flows in small quan- 
 tity, and is often interrupted ; and there 
 is generally pain at the extremity of the 
 passage, especially as the last drops are 
 expelled, and for some time afterwards. 
 Rough and violent motion excites a good 
 deal of pain ; exercise, and especially rid- 
 ing, brings on bloody urine. There is 
 also a dull pain about the neck of the 
 bladder, frequent desire to go to stool, a 
 sense of weight or pressui'e at the lower 
 part of the pelvis ; and a quantity of mu- 
 cus is mixed with the urine. The pain 
 is not in proportion to the size of a 
 stone ; sometimes very small stones ex- 
 cite violent pain, Avhile large ones occa- 
 sion little inconvenience. The pain is by 
 no means constant, but comes on in vio- 
 lent paroxysms, in the intervals of which 
 the patient is perfectly easy. In many 
 instances, the patient can lie most easily 
 on one side, and when he turns to the 
 other has the sensation of a weight roll- 
 ing to the opposite side. These symp- 
 toms give pretty certain indication of the 
 existence of a stone in the bladder ; but 
 it is put out of doubt only by the intro- 
 duction of a sound, or catheter, into the 
 bladder, which, on striking the stone, im- 
 parts a certain feeling to the hand of the 
 surgeon. Sometimes a small stone eludes 
 the instrument; sometimes by getting 
 into folds, or pouches, it cannot be disco- 
 vered by the catheter. 
 
 Causes. The period of life from in- 
 fancy to about fifteen years, is that most 
 subject to the formation of urinary cal- 
 
 culi ; and it is said that the children of 
 the poor are most liable to be afflicted 
 with this disease. It occurs also in old 
 persons who have been used to a seden- 
 tary life. Foreign bodies getting into the 
 bladder have become the nucleus of a 
 stone. Some constitutions more than 
 others seem disposed to the formation of 
 gravel ; and particularly in gouty families, 
 it is observed, that while the males are 
 liable to the pain and swelling of the ex- 
 tremities, the females are subject to cal- 
 culous affections. Certain states of the 
 stomach and digestive organs seem to 
 give a tendency to the formation of cal- 
 culi ; and these are the cases which are 
 most benefited by the use of alkalis, 
 lime, and magnesia. 
 
 Treatment. It is now admitted that it 
 is difficult, if not impossible, for any me- 
 dicine taken by the mouth to reach the 
 kidneys and bladder so much unchanged, 
 as to dissolve the stone or calculous mat- 
 ter ; and any good that appears to have 
 been done by such medicines, has been 
 owing to their preventing the formation 
 of the acid, which in many cases is some- 
 how or other connected Avith stone. The 
 medicines proper in gravel are such as 
 the following : fine soap, as containing 
 carbonate of soda, may be given in the 
 form of pills, ten grains twice a-day ; the 
 solution of potash to the extent of ten 
 drops may be given in a little broth, and 
 the dose gradually increased : soda-water, 
 or as it is commonly called in the shops, 
 aerated alkaline water, to the extent of 
 four ounces three times a-day. Magne- 
 sia has also been found to be a medicine 
 of considerable service in that species of 
 calculous disease, dependent on the for- 
 mation of uric acid. When the pain is 
 violent, fomentations are to be applied 
 externally ; and by the use of emollient 
 clystei-s, an internal fomentation is ap- 
 plied. The warm bath also may be used ; 
 and, to prevent or remove inflammation, 
 leeches may be applied to the region of 
 the kidneys. An opiate also may be at 
 times necessary. From their tendency 
 to act on the urinary organs, blisters are 
 
STOOLS. 
 
 527 
 
 improper ; and no diuretic of an irritating 
 nature, as oil of juniper or turpentine, 
 should be employed. The diet of persons 
 subject to gravel should be much attend- 
 ed to. Their food should be light and 
 nourishing ; they should avoid wines con- 
 taining much acid, and abstain from acids 
 in generaL 
 
 We have mentioned under Lithon- 
 TRiPTics, the method of attempting relief 
 for the stone by internal remedies; but 
 when a stone is fairly formed, all such 
 means are likely to be unavailing ; and a 
 surgical operation is the only resource. 
 About no operation has there been more 
 discussion than about this ; the place for 
 performing it, the manner, and the in- 
 struments, have been varied repeatedly, 
 and the descriptions and arguments res- 
 pecting them, have furnished materials 
 for many volumes. The operation of 
 lithotomy consists in making an inci- 
 sion into the bladder, and bringing out 
 the stones, whether one or more, by the 
 fingers, by a scoop, or by forceps. As 
 we despair of being able to give any such 
 description as would be intelligible to the 
 general reader, we must refer those who 
 are curious on the subject, to books of 
 surgery. 
 
 Though the patient may be relieved 
 and recover well after the operation, yet 
 if the tendency in the constitution to 
 form stone is strong, other calculi may 
 succeed, and occasion a renewal of his 
 suiFerings. 
 
 STONE-FRUITS. A considerable va- 
 riety of these are eaten, and are highly 
 agreeable ; but experience has proved 
 them to be less easy of digestion than 
 other species of fruits. The ripe peach 
 is very delicious, and pretty easy of di- 
 gestion ; but the pulp of plums and cher- 
 ries is often managed by the stomach 
 with much difficulty ; and we are to judge 
 whether they are allowable to any parti- 
 cular patient or not, by his digestive 
 powers with respect to the formation of 
 acids. Much of the bad character of stone- 
 fruits has been owing to their being taken 
 when unripe. 
 
 STOOLS. The discharge from the 
 body by stool has a certain appearance 
 in health perfectly well known, and any 
 deviation from this appearance is consi- 
 dered as an indication of something wrong 
 in the digestive functions. But various 
 substances taken by the mouth have the 
 power of altering the appearance of the 
 stools, without producing any very bad 
 consequences on the digestive powers. 
 The stools also are changed in their co- 
 lour by the action of the air, especially 
 those of infants, which cliange so often 
 from yellow to green ; and therefore the 
 excrement should be examined almost as 
 soon as passed. Spinage tinges the stools 
 green, and a great quantity of milk will 
 render them pale-coloured ; where the 
 food has been very various, the stools will 
 appear mixed ; and after much perspira^ 
 tion, long fasting, or strong liquors, the 
 stools appear very hard. The skin and 
 seeds of fruits are seen entire in the stools, 
 and sometimes aliments get very hard, 
 and pass undigested ; this is the case with 
 cheese, curd, and oat-seeds. Certain me- 
 dicines often have a very conspicuous ef- 
 fect on the stools ; iron renders them 
 black, and magnesia gives them a whitish 
 appearance. The appearance of the stools 
 in jaundice being pale and clay-coloured, 
 from the want of bile, is one of the most 
 remarkable symptoms of that disease. 
 See CosTivENESs, and Purgative Medi- 
 cines. 
 
 STORAX. A gum from the Slyrax 
 officinalis^ formerly used in medicine as 
 a stimulating expectorant, but now quite 
 neglected. 
 
 STRAMONIUM. The name now in 
 general use for the Datura Stramonium^ 
 or Thoj-n-ApplBy a plant having narcotic 
 properties, very poisonous when taken in 
 an over-dose ; and which has of late years 
 been much extolled for its virtues ia 
 asthma, when smoked like tobacco. The 
 leaves and the lower part of the plant are 
 thus used; the patient falls asleep, and 
 awakens recovered from the paroxysm. 
 In some cases, a perfect cure is effected ; 
 but in general the relief is only temporary. 
 
»28 
 
 STRANGURY. 
 
 Dr. Brce, who writes on disordered Res- 
 piration, says that the indiscriminate use 
 of the smoke of stramonium has occar- 
 sioned dangerous and hurtful effects in 
 frequent instances. In some cases of 
 aged or apoplectic suhjects, death has been 
 the consequence. In chronic diseases, at- 
 tended with acute pain, the extract, from 
 an eighth of a grain to a grain, is said to 
 lessen powerfully, and almost immediate- 
 ly, sensibility and pain ; but its place may 
 well be supplied by more safe narcotics. 
 STRANGURY signifies a frequent de- 
 sire of making Avater, attended with much 
 difficulty and pain in voiding it. It arises 
 from various causes, as inflammation of 
 the urethra, of the neck of the bladder, 
 or other neighbouring parts, the applica- 
 tion of a blister when the matter of the 
 cantharides is taken into the body, the 
 internal use of cantharides in powder or 
 in tincture, excess in drinking vinous or 
 spirituous liquors, or from gravelly parti- 
 cles in the passage. It is sometimes a 
 symptom of gout, and very often arises 
 from disease of the prostate gland. When 
 strangury is owing to the application of 
 a blister, the patient should drink plenti- 
 fully of diluent liquors, as barley-water 
 or thin gruel, to which a little nitre or 
 other diuretic medicine may be added. 
 In severe cases, fomentations to the ure- 
 thra and neighbouring parts may be re- 
 quired ; and it will be proper to use clys- 
 ters to evacuate the bowels, as the accu- 
 mulation of feculent matter must increase 
 the strangury, from whatever cause it 
 originates. If the strangury is an atten- 
 dant on inflammation of these parts, it 
 must be treated by local blood-letting, by 
 leeches, by cooling purgatives, by fomen- 
 tations ; and if from spasm, an opiate by 
 the mouth or by clyster, will be proper. 
 If the strangury proceeds from organic 
 disease, it must be the business of the 
 surgeon to ascertain the cause, and to ap- 
 ply the proper remedies ; while care 
 must be taken not to add to the disease, 
 by the use of improper drinks or articles 
 of diet, as harsh wines, acrid salts, aroma- 
 tics, or the like. 
 
 STRAWBERRY, Fragaria vesca. A 
 very pleasant fruit, laxative and cooling 
 when taken in moderation, but, like other 
 vegetables, to be avoided by weak and 
 acid stomachs. 
 
 STRICTURE. A contraction of the 
 diameter of any passage, most generally 
 applied to such contractions of the gullet 
 and of the urethra. See Gullet and 
 Urethra. 
 
 STRYCHNINE or STRYCHNIA is 
 an alkaloid discovered in several species 
 of Stri/chnos, as the Strychnos Nux-vo- 
 inica^ S. Sancti Ignatiiy S. Colubrina, 
 and S. Tiente, which yields an Indian 
 poison, the Upas Tiente. " Strychnine 
 has an intensely bitter taste, which is 
 perceptible, it is said, when a grain is dis- 
 solved in eighty pounds of water. It is 
 very sparingly soluble in Avater, but easily 
 soluble in alcohol and the volatile oils. 
 Except the prussic acid, no poison is en- 
 dowed with such destructive energy as 
 the strychnia. There is little doubt that 
 half a grain thrust into a wound might 
 kill a man in less than a quarter of an 
 hour. It acts in whatever way it is in- 
 troduced into the system, but most ener- 
 getically when injected into a vein. The 
 symptoms produced are very uniform and 
 striking. The animal becomes agitated 
 and trembles, and it is then seized with 
 stiffness and starting of the limbs. These 
 symptoms increase, till at length it is at- 
 tacked with a fit of violent general spasm, 
 in which the head is bent back, the spine 
 stiffened, the limbs extended and rigid, 
 and the respiration checked by the fixing- 
 of the chest. The fit is then succeeded 
 by an interval of calm, during which the 
 senses are quite entire. But another pa- 
 roxysm soon sets in, and then another, till 
 at length a fit takes place, more violent 
 than any before it ; and the animal pe- 
 rishes suflocated. The first symptoms 
 appear in sixty or ninety seconds when 
 the poison is applied to a wound. 
 
 Precisely the same symptoms are pro- 
 duced by the nux-vomica ; half a drachm 
 of the powder killed a dog in forty-five 
 minutes, and a grain and a half of the al- 
 
STYE. 
 
 599 
 
 coholic extract thrust into a wound, kill- 
 ed another in seven minutes. The cause 
 of death appears to be prolonged spasms 
 of the muscles of respiration ; the dia- 
 phragm partakes in the spasm of the ex- 
 ternal muscles. 
 
 Strychnine and the alcoholic extract of 
 the nux-vomica have been used for the 
 cure of diseases of debility, for palsies, and 
 amaurosis. The commencing dose is half 
 a grain of the extract in the evening, 
 fonned into a pill, and gradually increased 
 to foiu* or six grains. Of strychnine, the 
 dose is one-twelfth of a grain, or six drops 
 of the tincture." (Dr. Curistison.) 
 
 STUPE. A piece of cloth, usually of 
 flannel, dipped in a fluid, and applied to 
 an affected part. 
 
 STUPOR. The deep sleep or insensi- 
 bility which accompanies many disorders 
 of the head. 
 
 STYE. A little sMcUiug on the eye- 
 lid, or a boil projecting from the edge of 
 the eye-lids, generally near the corner of 
 the eye. It is of a dark-red colour, much 
 inflamed, and a great deal more painful 
 than might be expected from its size. 
 This is owing to the violence of the in- 
 flammation, to the sensibility of the part 
 inflamed, and to the stretching of tiie 
 dense skin in that part. A stye often 
 excites general fever in delicate and irri- 
 table habits. It is best for a stye to sup- 
 purate, and discharge the matter, and the 
 dead slough connected with the abscess ; 
 and an emollient poultice should be laid 
 on, inclosed in a bag, and frequently re- 
 newed, till the matter points and is dis- 
 charged by a free vent. It may be pru- 
 dent in some cases to let it out by an 
 opening with a lancet, and this should be 
 done on the inner side of the eye-lid. 
 Gentle pressure may be necessajy, and 
 when the matter is out, the part heals 
 very quickly. Some people are very of- 
 ten troubled with the stye ; and that 
 seems in many cases to be connected with 
 a disordered state of the stomach and 
 bowels; and often with irregularity and 
 intemperance in eating and drinking. 
 Sometimes a hard swelling remains on 
 
 the eye-lid, occasioning deformity, and re- 
 quiring to be removed by a small surgi- 
 cal operation. 
 
 STYPTIC. An application having 
 the power of corrugating, or causing to 
 shrink; generally made of some astrin- 
 gent or corroding liquor, as tiu^)entine, 
 or a solution of blue or white vitriol or 
 alum. A styptic wash is used to stop 
 the bleeding from surfaces where there is 
 no large vessel. 
 
 SUBCUTANEOUS, immediately un- 
 der the skin. 
 
 SUBLUXATION, a sprain. 
 
 SUBMURIATE of MERCURY, a 
 name for Calomel. See Calomel. 
 
 SUBSULTUS TENDINUM. Tlie 
 Latin term for that twitching and start- 
 ing of the tendons which takes place at 
 the close of bad fevers, and from wound- 
 ed tendons. 
 
 SUCCORY, Cichorium IntybuSy a plant 
 of which the decoction is slightly purga- 
 tive ; it is now hardly used. 
 
 SUDORIFIC S are those medicines 
 which increase the exhalation by the 
 skin in such quantity that it appears on 
 the surface in a liquid form. Diaphore- 
 tics are those which promote the same 
 discharge, but in smaller quantity and 
 more gradually, when it passes off into 
 the air in the state of vapour. The state 
 of the atmosphere with respect to mois- 
 ture or dryness lias much influence on 
 the apparent quantity of our perspiration- 
 When the air is loaded with moisture, 
 the perspirable matter is not carried off, 
 and collecting about the body, we appeal* 
 to be drenched in perspiration ; while in 
 the dry and keen air, when the wind is 
 from the north or east, even much exer- 
 cise will not produce sensible perspira- 
 tion, though the actual exhalation from 
 the skin is talking place in very great 
 quantity. Sometimes the perspiration 
 may be diminished by too great action of 
 the heart and arteries, at other times by 
 debiUty of the system, and a slow and 
 languid circulation. 
 
 As the pei-spiration is obstructed by 
 very different causes ; so, very ditterent 
 2 m 
 
530 
 
 S U D O R I F I C S. 
 
 means may act as sudorifics. Sudor ifics 
 may act by stimulating the skin, or by 
 increasing- vascular action, or by remov- 
 ing that constricted state of the vessels 
 of the skin which is the consequence of 
 too violent action of the heart, and of the 
 increased heat of the system. 1. Of the 
 first kind of sudorifics, or those which 
 promote sweat by stimulating the vessels 
 of the skin, are external heat, friction, or 
 medicines which, taken into the circula- 
 tion, exert their influence on the skin, as 
 mercurial medicines and sulphur, or those 
 which being applied to the stomach act 
 on the skin by its sympathy with that 
 organ : thus cold drinks sometimes prove 
 powerful sudorifics. 2. By increasing the 
 general action of the vascukir system, 
 sweating is produced, as we see by the 
 use of the warm bath, violent exercise, 
 and certain substances swallowed, as al- 
 cohol, ammonia, and guaiac. 3. Those 
 means which relax the constriction of 
 the perspiiing vessels, are antimonial me- 
 dicines, the cold affusion, and saline dia- 
 phoretics. 
 
 A consideration of the way in which 
 various remedies act in^ producing sweat, 
 will lead us to those which are proper in 
 various diseases. Thus we should not 
 prescribe opium and its combinations 
 when we wish to produce sweating in fe- 
 ver, or at the commencement of eruptive 
 diseases ; but should rather use the saline 
 diaphoretics, as solution of acetate of am- 
 monia, called Spirit of Mindererus, or the 
 citrate of potassa in the form of efferves- 
 cing draughts. Almost all sudorifics re- 
 quire to be aided in their operation, by 
 the plentiful use of warm or tepid dilu- 
 ents, as gruel, barley-water, tea, or the 
 like. In rheumatism, sweating is one 
 great means of cure, but it is generally 
 proper to begin with blood-letting. See 
 IhAPiiORETics, Perspiration, and Rheu- 
 matism. 
 
 SUFFOCATION is the extinction of 
 life by the function of breathing being 
 violently stopped. This may happen 
 from hanging and drowning ; from blood 
 or matter bursting from the lungs into 
 
 the branches of the wind-})lpe ; from in- 
 flammation or croup, producing a false 
 membrane or obstructing mucus in the air- 
 passages ; from foreign bodies sticking in 
 the same ; from large pieces of meat in 
 the gullet pressing on the back of the 
 wind-pipe; and many similar incidents. 
 Where the suffocation is complete, no- 
 thing can be done ; but where it is only 
 threatened, the proper means of relief are 
 to be had recourse to, varying, of course, 
 according to circumstances. Foreign bjig 
 dies are to be extracted, if possible, froBP ;, 
 the wind-pipe; and vomited from the \ 
 gullet, or pushed down into the stomach; 
 and the means for restoring suspended 
 animation to be employed in the case of 
 hanging and drowning. See Drowning. 
 
 SUFFUSION. When fluids are pour- 
 ed out from their proper vessels, but re- 
 main under the skin, they are said to be 
 suffused. Thus blood or lymph may oc- 
 casion a suffusion of the eyes ; and tlie 
 term is often used when the blood-vessels 
 are merely distended, producing a dull 
 redness of that part of the eye which is 
 usually white. It is a symptom of vari- 
 ous feverish disorders ; and often a sign 
 of coming delirium. The blindness from 
 palsy of the optic nerve or of the retina, 
 commonly called, by medical men, amau' 
 rosis, was anciently believed to be owing 
 to the pouring out of certain fluids, and 
 obtained the name of suffusio nigra. 
 
 SUGAR. A well known substance 
 obtained by boiling the expressed juice 
 of the sugar-cane, which grows in both 
 the Indies, and is particularly cultivated 
 in the West Indies. The portion of the 
 juice which ciystallizes is called raw su- 
 gar, and that which does not crystallize 
 is molasses. Raw sugar is refined by 
 certain processes, and is then loaf or 
 lump sugar. Sugar is very nutritive, as 
 is seen by the improved health and fat- ' 
 ness of the negroes in crop-time ; though 
 in Europe it is not used as an article of 
 diet, but as a condiment. In pharmacy, 
 it is used to form syrups, and to disguise 
 the taste of nauseous medicines. Mo- 
 lasses answer these purposes very well. 
 
SUGAR OF LEAD. 
 
 531 
 
 The coarser kinds of sugar are slightly 
 purgative. 
 
 SUGAR OF LEAD. The compound 
 of acetic acid and lead, so called from its 
 sweet tasle. It is of great use as an ex- 
 ternal application in inflammations, bruises, 
 and diseases of the skin. It is generally 
 applied in solution by means of cloths 
 soaked in it, or mixed with crumb of 
 bread. A drachm to five ounc(^s of wa- 
 ter is a strong solution, and with double 
 ^ that quantity of water a weak one. A 
 ' « little vinegar should be added, if the wa- 
 ter be not quite pure. It is thought that 
 the value of the applications of lead in 
 common inflammation, arises from a pai- 
 tial palsy of the nerves of the part, pro- 
 duced by the sedative power of the lead. 
 It should not be applied to recent wounds, 
 nor to ulcers where there is nluch debili- 
 ty or any tendency to gangrene. Though 
 the internal use of the salts of lead is a 
 circumstance attended with very consid- 
 erable danger, yet, under careful manage- 
 ment, the acetate of lead given internal- 
 ly has been found a very valuable atid 
 manageable remedy, especially in haemor- 
 rhagy from the lungs and uterus, and from 
 the bowels. Tlie diarrhoea which attends 
 the closing stage of consumption has beefl 
 greatly mitigated by its use. The dose 
 is from half a grain to a grain, Mith half 
 a grain of opium ; and it is recotniiien ded 
 that nothing but a little cold water, or 
 vinegar and water, be swallowed for at 
 least an hour after the pill is taken. 
 Sugar of lead with lard, forms an excel- 
 lent cooling ointment. 
 
 SUGARED PLUMS. This article is 
 mentioned here, merely for the sake of 
 observing, that by Dr. Paris's account, 
 those sweetmeats sold to children often 
 contain a gieat deal of sulphate of lime 
 (stucco,) which being insoluble, must be 
 dangerous if it accumulates in the bowels. 
 
 SULPHATES are neutral salts com- 
 posed of sulphuric acid, and an alkaline, 
 earthy, or metallic oxide b«ise. There 
 are several sulphates of great importance 
 in medicine, as the sulphate of soda 
 (Glauber's salt,) and the sulphate of 
 
 magnesia (Ejjsom salt.) An account of 
 these has been given under their com- 
 mon names ; and the next two articles 
 relate to two of the metallic sulphates, 
 which are useful in the practice of physic 
 and surgery. 
 
 SULPHATE o/COPPER, Blue Vi- 
 triol or Blue Stone, is used as an escha- 
 rotic, to destroy proud flesh, or to induce 
 a better action on diseased surfaces. It 
 is given internally as a violent emetic, iii 
 cases where poison has been swallowed, 
 and where it is desirable to empty the 
 stomach very quickly. The dose for this 
 purpose is five grains; but as it is itself 
 poisonous, it should tiot be resorted to, 
 if we suspect the stomach to be in any 
 degree insensible, and likely to retain it 
 too long. We should rather employ the 
 article next mentioned. 
 
 SULPHATE o/ ZINC, White Vitriol, 
 is principally used as an astringent wash, 
 in whites ; and for eye-water, in the pro- 
 portion of two grains to the ounce of wa- 
 ter ; and as an emetic, very speedy in its 
 operation, and, therefore, useful w hen ve- 
 getable poisons have been swallowed. 
 The dose for this purpose is thirty gi-aius. 
 In spasmodic coughs, it is given with very 
 good eiFect, combined with camphor and 
 myrrh ; and it is said that various quack 
 medicines for the cure of hooping-cough 
 are composed of sulphate of zinc. The 
 dose for this purpose is from one to two 
 grains daily. In complaints of the chest, 
 with great expectoration, t he same has done 
 good when given in the form of lozenge. 
 It does not possess so complete sedative 
 powers as the sugar of lead, when applied 
 in solution to inflamed surfaces. 
 
 SULPHUR. An inflammable sub- 
 stance found in volcanic countries. Sul- 
 phur, or brimstone, as it is generally call- 
 ed, is procured in the form of cylinders, 
 and in fine powder. It has neither taste 
 nor smell ; but when rubbed it has a faint 
 peculiar odour. It is of a yellowish co- 
 loui*; but Xvh6n procured by precipita- 
 tion it is white, probably owing to its 
 containing water. It is purified by sub- 
 limation; and Mhen thus purified, it is 
 
532 
 
 SULPHUR. 
 
 called flowers of sulphur, in which form 
 it is used as a mild purgative, which pur- 
 pose it completely answers. The dose is 
 about one or two drachms. It may be 
 given in syrup, treacle, or conserves; and 
 when combined with an equal portion of 
 cream of tartar, it forms one of the mild- 
 est and best laxatives for those who are 
 troubled with piles. Sulphur has lon<j 
 been famous for its poAver of curing- dis- 
 eases of the skin, and for being a specific 
 in the itch. For this purpose, it is applied 
 in the form of ointment ; the sulphur 
 being mixed with some greasy substance, 
 and rubbed over the parts affected, or as 
 much of them at a time as may be judg- 
 ed proper. At the same time, the pa- 
 tient may take a little sulphur internally. 
 The rubbing for the itch may be conti- 
 nued for four or five days, when the dis- 
 ease is commonly removed. There are 
 gi-eat popular apprehensions about expo- 
 sure to the air when using sulphur. It 
 no doubt shows itself to pervade the pores 
 of the body, by the smell it exhales, and 
 by blackening silver in the pocket ; but 
 while under its influence, there is no 
 more needed, than the usual precautions 
 against taking cold. Sulphur is a fa- 
 vourite remedy with the common people 
 in measles, and other eruptive diseases. 
 It is very harmless ; and may, by acting 
 gently on the bowels, be of some service 
 in the commencement of these diseases, 
 though it will not answer the purpose for 
 which they intend it, that of bringing 
 out the eruption more speedily and com- 
 pletely. Sulphur counteracts the activity 
 of mercuiy, and should, therefore, never 
 be used to assist the apothecary in ex- 
 tinguishing it, in order to make the blue 
 ointment. 
 
 SULPHURIC ACID. The acid com- 
 posed of sulphur and oxygen, obtained by 
 huming sulphur in the presence of oxy- 
 i gen gas. It is commonly called Oil of 
 Vitriol. It is possessed of highly corro- 
 sive qualities ; but when properly dilut- 
 ed, it is a very useful cooling and astrin- 
 gent medicine. It is kept in the shops 
 diluted with seven times its weight of 
 
 water ; and of this diluted acid, ten dro|>s 
 in a glass of cold water may be taken 
 tvnce a-day, in discharges of blood from 
 the stomach or lungs. Or it may be 
 mixed with simple syrup, or syrup of 
 Tolu, in the proportion of one drachm of 
 the acid to four ounces of syrup, and the 
 patient's drink may be acidulated with 
 the mixture. To prevent it from injur- 
 ing the enamel of the teeth, it may be 
 sucked through a quill, and the mouth 
 must be carefully washed after taking 
 it. The infusion of red rose leaves, aci- 
 dulated and coloured red by this acid, is 
 an elegant form for administering it, either 
 internally or as a gargle. 
 
 When sulphuric acid has been swal- 
 lowed by mistake, the consequences are 
 inflammation of the stomach, and all its 
 attendant dangers and sufferings. Little 
 can be done, but we may try large dilu- 
 tion with carbonate of potash dissolved 
 in warm water, and then endeavour to 
 excite vomiting by irritating the fauces 
 with a feather, or by thrusting a finger 
 down the throat. The after-treatment 
 must be directed by the symptoms. 
 
 SUPPER. The meal taJien just be- 
 fore going to bed. As the powers of the 
 body, and digestion among the rest, ai-e 
 diminished in their activity during sleep, 
 it is an unsafe measure to load the sto- 
 mach at bed-time ^vith a large quantity 
 of various kinds of food. When this is 
 done, there is great distension both from 
 the load thrown in, and from flatulence ; 
 the person is liable to be disturbed with 
 restlessness, or nightmare, and frightful 
 dreams. A slight and moderate repast 
 only is allowable ; an egg, or some pre- 
 paration of milk, or oatmeal pottage, 
 which last, however, is apt to become 
 sour on some stomachs. For dyspeptics, 
 suppers, and late hours, are peculiarly 
 unsuitable. 
 
 SUPPOSITORIES, are medicinal 
 substances, introduced in a solid form in- 
 to the rectum. Some are given to pro- 
 duce a discliarge from the boM^els, and 
 may be applied even to very young in- 
 fants. A little bit of soap may be used 
 
SWELLINGS. 
 
 533 
 
 for them. Suppositories are also employ- 
 ed to destroy the worms called ascarides; 
 aloes and soap are good in this case. 
 Opium may be introduced as a supposi- 
 tory, to relieve pain and imtation arising 
 from diseases of the bladder, the womb, 
 and parts in the neighbourhood. 
 
 SUPPURATION. T\ie formation of 
 pusy or matter. See Inflammation, 
 paffe 328. 
 
 SURFEIT. An overloading of the 
 stomach, with too great a quantity or 
 mixture of food. The effect of this, if it 
 be not got rid of by the vomiting which 
 it sometimes excites, is, acid or putrid 
 eructations, continuing for some days ; a 
 disinclination to food, sickness, and fla- 
 tulence. Sometimes a looseness comes 
 on ; this is the way nature takes to re- 
 lieve herself of the superfluous load ; and 
 if such looseness does not occur, some 
 smart purgative should be administered. 
 Till the unpleasant symptoms are gone, 
 the diet should be very spare and simple. 
 
 SUSPENDED ANIMATION. See 
 Drowning. 
 
 SUTURES. In anatomy, sutures sig- 
 nify the corresponding indentations and 
 projections which unite the bones of the 
 skull to each other ; and in surgery, they 
 mean the various kinds of stitches used 
 to bring wounded parts into contact or 
 apposition. 
 
 SWALLOWING, how performed. See 
 Gullet. 
 
 SWEAT. When the insensible per- 
 spiration is increased by exercise, or by 
 any substance taken into the stomach, or 
 by any internal action in the body itself, 
 and gathers into di'ops so as to become 
 visible, it is called Sweat. " This eva- 
 cuation is sometimes wanting, and per- 
 sons enjoy good health, who hardly per- 
 spire at all ; in many, no art can excite 
 it ; in others, it is free, particularly when 
 the heat is most slightly increased, or af- 
 ter very inconsiderable exercise." Sweat- 
 ing is sometimes a salutary effort of the 
 constitution to throw off noxious matter; 
 sometimes by the evaporation, it relieves 
 the bufnipg heat of a paroxysm of fever, 
 
 while in other diseases it marks a relaxa- 
 tion and sinking of the powers of the 
 system, and is a symptom of bad omen. 
 In consumption, it is called colliquative, 
 as if melting down the bulk and strength. 
 A copious and general sweat is one of 
 the best means employed for the cure of 
 rheumatism ; and this is effected by giv- 
 ing certain medicines which have the 
 power of increasing the perspiration. 
 See Rheumatism. 
 
 SWELLED LEG of Women in Child^ 
 bed. See Phlegmatia Dolens. 
 
 SWELLINGS are of various kinds, 
 eithei* of the whole body, or of particu- 
 lar members, or local and circumscribed. 
 Watery swellings of the whole body are 
 seen in general dropsy ; and the same 
 disease in its commencement occasions 
 partial swellings, as of the lower extremi- 
 ties, or of the arms or face, according to 
 the position of the body. Circumscribed 
 swellings occur in various glands, as 
 those of the neck, arm-pit, or groins, 
 chiefly in scrofulous constitutions ; or 
 they may arise from inflammation, the 
 consequence of cold. The tonsils swell 
 in sore throat, and occasion a fulness of 
 the external parts of the throat ; gum- 
 boils form during toothach, and swell the 
 cheeks ; and the bronchocele, or goitre, 
 is an instance of a still more permanent 
 swelling. The face, head, and limbs of- 
 ten swell exceedingly from rose. The 
 treatment of those different swellings 
 must vary according to their symptoms 
 and causes, and has been fully detailed 
 under different articles in this work. — 
 See Scrofula, Bronchocele, Guai- 
 BoiL, Rose, &c. 
 
 SWEET SPIRIT OF NITRE is an 
 excellent diuretic medicine, obtained by 
 distilling alcohol and nitrous acid. It is 
 useful in childbed cases, when the water 
 is passed scantily and with diflSculty ; and 
 is used in doses of two drachms in a small 
 cupful of tepid water every two hours, 
 till the effect is produced. Sweet spirits 
 of nitre are useful also as a gentle stimu- 
 lant, which moderately strengthens the 
 stomach, and at the same time quenches 
 
534 
 
 SYMPATHY 
 
 thirst. It may be given in a mixture, 
 consisting of one ounce of spirits of nitre, 
 three of cimiamon water, three of springs 
 water; adessert^spoonful to be taken eveiy 
 three hours ; and if a further diuretic and 
 sedative action be wanted, two drachms 
 of the tincture of fox-g-love may be add- 
 ed to the above mixture. 
 . .. SWINE-POX, or Hives. A popular 
 
 ^>ft«,^£^i j^me for one of the varieties of Chick en- 
 .^^f^ Pox. In the swine-pox, the vesicles are 
 |Ur lai'ge and globated, but their base is not 
 
 ^ exactly circular. There is an iuilamma- 
 
 "^^. tiou round theni, and they contain a trans- 
 parent lymph, whicli, on the second day 
 of the eruption, resembles railk-whey. 
 On the tliird day, tlie vesicles subside, 
 and become puckered and shrivelled ; they 
 likewise appear yellowish, a small quan- 
 tity of pus being- mixed with the l^Tuph. 
 Some of them remain in the same state 
 till the followin;^ morning ; but before the 
 conclusion of the fourth day, the cuticle 
 separates, and thin blackish scabs cover 
 the bases of the vesicles. The scabs dry 
 and fall oli" in four or five days. Some 
 degree of fever generally precedes the 
 eruption of swine-pox, and the other 
 varieties of chicken-pox, for a couple of 
 days; and occasionally continues to the 
 thii'd day of the eruption. This fever some- 
 times is very slight, so that it is only re- 
 collected after the eruption appeared, as 
 having been previously indicated by fret- 
 fuhiess. When the globated vesicles of 
 the swine-pox appear, they afford a ready 
 distinction from the smali-pox, to the 
 pustule^ of which they bear little resem- 
 blance. In the treatment of this disease, 
 nothing in general is requisite beyond an 
 attention to the state of the bowels, and 
 abstinence from animal diet for two or 
 three days. (Dr. Bateaian on Cutaneous 
 Diseases.) See Chicken-Pox, page 117. 
 SYMPATHY, in medical language, 
 means, the consent of two or more parts 
 of the body in one common action or suf- 
 fering. The various parts of the body in 
 some degree all sympathize with each 
 other, but there are some whose actions 
 are more particularly connected together. 
 
 The stomach has a very general sympa- 
 thy with the whole system, so that scarce- 
 ly any organ can be affected with disease, 
 without the stomach suffering with it. 
 Thus, calculous disorders in the kidneys 
 or bladder occasion vomiting ; the condi- 
 tion of pregnancy, and various states of 
 the womb, also occasion sickness and vo- 
 miting. The brain, the liver, the intes- 
 tines, the joints, and the surfajee of the 
 body, sympathize with the stomach. A 
 disgusting smell excites vomiting, and 
 any thing irritating the fauces or the up- 
 per part of the wind-pipe, brings a great 
 many sympathetic organs into action, to 
 produce the cough or the sneezing ne- 
 cessary for its expulsion. The womb 
 sympathizes particularly with the breasts, 
 and with other parts peculiar to the fe- 
 male system. When a person has cold 
 feet, and is standing in a damp place, he 
 feels a pain at the pit of the stomach ; 
 and so complete is the sympathy esta- 
 blished here, that by changing the shoes 
 or drying the feet, the pain is almost in- 
 stantaneously removed. A bright light 
 thrown on the eye occasions sneezing; 
 and a pungent odom- in the nostrils pro- 
 duces a flow of tears. The uniform and 
 parallel motion of the two eyes is to be 
 ascribed to sympathy. The relief obtain- 
 ed in diseases of the internal pai-ts from a 
 blister applied to the skin, is by some ex- 
 plained on the principle of sympathy. 
 
 SYNCOPE. See Fainting. 
 
 SYNOVIA. « The liquor which prin- 
 cipally serves to moisten the ligaments 
 and cartilages of the articulations. It is 
 supplied by glands which are commonly 
 situated in the joint, after such a manner 
 as to be gently pressed, but not destroyed 
 by its motion. By this means, when 
 there is the greatest necessity for this li- 
 quor, that is, when the most frequent mo- 
 tions are performed, the greatest quantity 
 must be separated. If the synovia is se- 
 parated in too small a quantity, the joint 
 becomes stiff; and when with difficulty 
 it is moved, a crackling noise is heard, as 
 people advanced in years frequently ex- 
 perience." (Dr. Monro, Primus.) 
 
SYPHILIS. 
 
 535 
 
 SYPHILIS, Lues Venerea, the Vene- 
 real Disease. This formidable and loath- 
 Bome disease is generally the consequence 
 of impure sexual intercourse ; but in the 
 various and complicated relations of so- 
 ciety, it may be in many cases received 
 very innocently. This disease is owing 
 to a poisonous matter introduced into the 
 system by absorption, and thus producing 
 more poisonous matter, which in time 
 corrupts the fluids, and occasions many 
 disordei*s in the various parts of the body. 
 The symptoms of syphilis are either pri- 
 mary or secondary. 
 
 I. Primary Symptoms. The primary 
 are those which appear in the near vici- 
 nity of the place to which the matter has 
 been applied, and which appear not long 
 after its application: the secondary are 
 those which occur in distant parts, and 
 wliich in some instances do not show 
 themselves for a very long period. As 
 the infectious matter is commonly receiv- 
 ed by impure connexion, the first symp- 
 toms generally show themselves on the 
 genital organs, in the form of chancre; 
 by which is meant, an ulcer considerably 
 iiitlamed and painful, unequal at the bot- 
 tom, with prominent edges of an ash co- 
 loiu', having little tendency to heal, but 
 i-ather continuing to spread, if left to it- 
 self. The matter being taken up by the 
 absorbents, is carried by them to the near- 
 est glands ; these glands are irritated, be- 
 come inflamed, swelled and painful ; and 
 go on to suppuration : when in the groin, 
 these swellings are termed buboes. If 
 the syphilitic matter be applied to the 
 hand, as may happen when a surgeon 
 having a slight cut or scratch, gets some 
 of it from dressing a venereal sore i or to 
 a patient, from being bled with a lancet 
 which has opened a bubo, or to those who 
 wash the clothes of infected patients ; in 
 all those cases, the same symptoms ensue, 
 and the glands in the arm-pit are the seat 
 of swelling and suppuration. Sometimes, 
 nurses get the syphilitic infection from 
 suckling children who have been born 
 \n\.\v the disease, and in them it appears 
 on the nipples ; aud the glands of the 
 
 arm-pits swell. If the matter be applied 
 to the lips, the glands of the neck swell. 
 The symptoms above mentioned, viz. 
 chancre and bubo, are to be regarded as 
 the primary and local symptoms of the 
 venereal disease, and the constitution may 
 be still uninfected ; but unless these are 
 checked by the proper remedies, the poi- 
 son may pervade the system, and produce 
 other bad eflfects. 
 
 II. Secondary Symptoms. In what- 
 ever way the matter has entered, it is 
 particularly ready to attack the throat. 
 In this kind of sore throat, some uneasi- 
 ness is felt in swallowing ; and there is a 
 sensation of fulness and tenderness, with- 
 out much pain. When the throat is ex- 
 amined, an ulcer is in most cases observed, 
 generally on one of the tonsils or almonds 
 of the ear, but sometimes on the uvula. 
 These ulcers are small at first, but some- 
 times quickly spread, and destroy a por- 
 tion of the contiguous parts; from the 
 first, they are foul, and have a degree of 
 fuhiess and swelling, with an erysipelat- 
 ous redness of the neighbouring parts. 
 Sometimes there are dark copper-colour- 
 ed spots on the throat, continuing for 
 >^'eeks. A troublesome attendant of the 
 sore throat is the constant heat and in-i- 
 tation of the parts, with the formation of 
 acrid tough mucous, which gives the pa- 
 tient much trouble to get it thrown off. 
 Deafness is not an unfrequent accompa- 
 niment of the sore throat. Sometimes, 
 when the disease has been neglected, or 
 when the remedies do not succeed, the 
 ulceration spreads beyond the soft parts, 
 and destroys the bones of the palate, and 
 back parts of the nose. 
 
 Next to the throat, the nose is most 
 liable to be attacked by the venereal dis- 
 ease. The patient complains of a stop- 
 page in one of the nostrils, with tender- 
 ness and pain at a particular point. When 
 this point can be seen, it is found to be 
 covered with a slough or crust, with a 
 foul sore beneath. There is a discharge, 
 which increases, as it continues, and is 
 thin and ill smelled. If the thin spongy 
 bones of the nose become aireck*d, the 
 
536 
 
 SYPHILIS. 
 
 matter becomes blackish, and the smell 
 is very offensive. Portions of the bones 
 come away, and, in time, the %iire of the 
 nose is changed ; at first by the external 
 parts becoming red and swelled, over 
 the ulcerations ; and then by the bones 
 coming away, it loses its prominency, to 
 the great disfiguring of the patient. Ul- 
 cers also take place on the palate and 
 other parts of the mouth ; and the de- 
 struction occasioned by their progress in 
 the parts necessaiy for the formation of 
 the voice, occasions a total loss of the 
 power of modulating it. 
 
 The skin is the part next most liable 
 to be affected by syphilis. On the skin, 
 there appear eruptions or blotches, chiefly 
 on those parts which are generally kept 
 covered, as the breast and arms ; and suc- 
 cessively, on the shoulders, thighs, legs, 
 feet, and hands. These blotches are not 
 painful at fii'st, but have a slight degree 
 of itchiness. They are of a pale red co- 
 lour ; and sometimes disappear for a time, 
 and again either attack the same parts, or 
 go to others. The skin is now inflamed 
 and tender, and a scab or crust forms on 
 the parts. When ulcers attack a person 
 who is tainted with the syphilitic poison, 
 they are generally of a bad and eating na- 
 ture, destroying a great deal of the sur- 
 rounding parts. In advanced stages of 
 syphilis, the bones of the extremities and 
 of the foreliead are liable to be affected 
 with swelling, and hard unequal knotted 
 appearances. The hair falls off, blindness 
 attacks the patient, and a variety of mala- 
 dies assail him, which destroy life in mi- 
 sery and putrefaction. 
 
 Of the Cure of Syphilis. Nothing 
 could exceed the alarm and dismay occa- 
 sioned in Europe, by the wide-spreading 
 ravages occasioned by this disease, shortly 
 after its appearance in 1493 ; and it was 
 not till a considerable number of years af- 
 terwards, that the casual coincidence of 
 its occurring in certain persons, who 
 were treated by mercury for diseases of 
 the skin, and who were cm-ed of both 
 complaints by that mineral, led to the 
 discovery that it was capable of safely and 
 
 completely curing lues venerea. From 
 that time, this dreadful scourge was di- 
 vested of the terrors excited on its first 
 appearance j and physicians, till within 
 these few years, have been quite confi- 
 dent of safely curing the vast majority of 
 syphilitic cases by the prudent use of 
 mercury; but of late, it has been sug- 
 gested, that the dreadful havoc made on 
 the constitution is not the effect of the 
 venereal poison, but of the combination of 
 it with mercujy. It has been proposed 
 in consequence, and it is said that many 
 cases have done well, to cure syphilis 
 without mercury at all. It is not easy to 
 get rid of the conviction impressed on the 
 mind, by the recorded experience of able 
 and upright physicians during three hun- 
 dred years ; nor to forget what we have 
 observed in our own practice ,- we cannot, 
 therefore, as yet, discard mercuiy as un- 
 necessary, or condemn it as pernicious. 
 
 We must here premise, that there are 
 some constitutions to which mercury is 
 peculiarly adverse, and in which syphUis 
 appears to gain ground under almost 
 every manner of administering it; and 
 also, that the rapid, violent, and long- 
 continued salivations, at one time too 
 common, were exceedingly likely to in- 
 flict irreparable injury on the constitu- 
 tion. But the skilful and prudent exhi- 
 bition of that active and important mine- 
 ral is calculated with ease and safety to 
 cure syphilis in every stage, both primary 
 and secondary ; and to guard the consti- 
 tution from all those hateful effects, of 
 which the early writers give such just 
 and affecting details, in works which 
 were written before mercury was em- 
 ployed in its cure. 
 
 1. Chancre. If a chancre has been 
 seen by the surgeon when recent, it is to 
 be treated by local applications ; it is to 
 be di-essed with mercurial ointment, and 
 if it be touched with lunar caustic, it will 
 the sooner put on a healthy action. It 
 may happen, that the application of the 
 caustic will cause a swelling in the groin, 
 which may be mistaken for true bubo ; 
 but this \^dll go off when the irritation 
 
SYPHILIS. 
 
 537 
 
 from the caustic subsides, or it may be 
 kept back by cooling- lotions. Nearly the 
 same treatment Avill answer even some- 
 what later; but it will be a matter of 
 precaution to bring the system in a slight 
 degree under the influence of mercury, 
 and to keep the mouth sore for a week 
 after the chancres have healed. 
 
 2. Bubo. When we find that we can- 
 not prevent the formation of a bubo, our 
 best plan is to bring- it forward to a kindly 
 suppuration by emollient poultices ; and 
 when it is ripe, to open it with a lancet, 
 like a common abscess. It will be still 
 more necessary now, to put the system 
 under the influence of mercury, and to 
 keep it so for a longer time ; though 
 there is no occasion to use it with the 
 rapidity and violence formerly too com- 
 mon. In scrofulous constitutions, buboes 
 are sometimes the commencement of ex- 
 tensive ulcerations, which are very pain- 
 ful, and discharge a very acrid matter. 
 The pain is to be alleviated by washing 
 the parts with a decoction of poppy heads, 
 and afterwards applying some emollient 
 ^plaster. If there be a tendent;y to fung- 
 ous growth, it may be proper to sprinkle 
 a little red precipitate of mercury, and to 
 dress with basilicon or other stimulating 
 ointment, till a better action is put on by 
 the parts. Internal medicines are neces- 
 sary, as sarsaparilla, or the nitric acid ; 
 and unless there are urgent symptoms of 
 the original disease threatening the de- 
 struction of important parts, it will be 
 prudent to suspend the use of mercury 
 by the mouth, or rubbing in. If the con- 
 stitution be feeble, bai-k and wine, and 
 other tonics are to be given ; and irrita- 
 tion is to be allayed by the use of opium 
 or hemlock. 
 
 3. Constitutional Symptoms. These 
 are so many and so various, that it is need- 
 less to enumerate them again, since for 
 each of them, mercury is the principal 
 remedy ; and the skilful exhibition of it, 
 and the application of appropriate reme- 
 
 dies to local s)Tnptoras, are the great in- 
 struments we employ. Gargles and 
 washes are to be used for the throat, 
 di'essings for ulcerations, and sudorifics 
 for the skin ; all in addition to the mer- 
 curial course, which, in different cases, 
 will require to be continued for various 
 lengths of time. 
 
 Under tiie article Mercury, we have 
 mentioned the symptoms occasioned by 
 its use, and the proper method of con- 
 ducting a mercurial course ; and it is one 
 mark and evidence of the improved con- 
 dition of medical science and practice, 
 that the tedious, debilitating, and danger- 
 ous coui-ses of mercury formerly in use, 
 are now altogether laid aside. The un- 
 pleasant consequences arising from mer- 
 cury improperly administered, naturally 
 excited many a wish that some other me- 
 dicine might be discovered, free from the 
 inconveniences of mercury ; and accord- 
 ingly many articles of the Materia Medi- 
 ca have been successively brought for- 
 ward, and many virtues ascribed to them 
 in the cure of syphilis. Some of them ) 
 may no doubt be useful auxiliaries, and 
 some of them may give relief in certain 
 symptoms, as opium, sarsaparilla, the ni- 
 tric acid, and some others ; but for real 
 curative powers, nothing can be compared 
 with mercury. Whether the modern 
 method of curing syphilis without mer- 
 cury at all, will be found to answer, must 
 be left to time. 
 
 SYRUP. A saturated solution of su- 
 gar in water. Sometimes other sub- 
 stances are added; and from these, the 
 whole derives its name, as the syrup of 
 squill, from the addition of the vinegar 
 of squill ; or the syrup of Tolu, from the 
 tincture of the Balsam of Tolu. Syrups 
 are useful for disguising the bad taste of 
 nauseous medicines. 
 
 SYSTOLE. The contraction of the 
 ventricles of the heart,by which the blood 
 is propelled out of them into the great ar- 
 teries of the hujgs and of the body. 
 
538 
 
 TAMARINDS. 
 
 T 
 
 TAR 
 
 TAR 
 
 T^NIA, a name for the tape-worm. 
 See Worms. 
 
 TAMARINDS, Tamarindus Indica. 
 The tamarind-tree grows both in the East 
 and West Indies. The fruit is a broad 
 pod ; and the pulp of this, which contains 
 the agreeable acid of the tamarind, is pre- 
 served by putting alternate layers of ta- 
 marinds and powdered sugar in a stone 
 jar. Copper vessels should not be em- 
 ployed in any stage of the preservation or 
 use of tamarinds, as the acid is apt to occa- 
 sion their being contaminated by that 
 poisonous metal. Preserved tamarinds 
 should be fresh and juicy, and should 
 have an agreeable acid taste, without any 
 musty smell. The pulp, taken in the 
 dose of two or three drachms to an ounce, 
 acts as a laxative ; and when infused with 
 senna leaves it is one of the best and mild- 
 est that can be given. A dessert or table- 
 spoonful of tamarinds, with four drachms 
 of senna leaves infused in a pint of water 
 for fifteen minutes, and strained, may be 
 given in doses of a tea-cupful every four 
 hours, till the bowels are moved, and is a 
 very safe domestic remedy. In febrile 
 diseases, tamarinds by their acidity are 
 very agreeable ; and a pleasant cooling 
 drink is made by simply pouring water 
 over them. 
 
 TANSY, Tanacetum vulgar e, A strong- 
 smelling plant, thought in some cases to 
 be good for the gout, and hysteria pro- 
 ceeding from obstructed menstruation; 
 but now hardly ever used in medicine. 
 
 TAPE-WORM. See WoRAis. 
 
 TAPIOCA. A kind of starch made 
 into grains, strained from the roots of the 
 cassada, and much used as a diet for sick 
 «^nd weak persons. 
 
 TAR is obtained by condensing the 
 smoke and vapours which issue from fir- 
 wood when it is burned. The vapour of 
 
 tar is recommended to be diffused through 
 the apartments of those afflicted with 
 consumption and other disorders of the 
 lungs ; and in some cases this inhalation 
 has appeared to do good. We may men- 
 tion here, what we should have stated 
 under Pitch, that that substance, accord- 
 ing to Dr. Bateman, has in some instances 
 been benefitcial in ichthyosis^ or fish-skin 
 disease, having occasioned the rough cu- 
 ticle to crack and fall off, leaving a sound 
 soft skin underneath. This medicine 
 made into pills with flour, or any farina- 
 ceous powder, may be taken to a great 
 extent, not only without injury, but with 
 advantage to the general health ; and af- 
 fords one of the most effectual means of 
 improving the languid circulation, and the 
 inert and arid condition of the skin. The 
 quantity to begin with may be ten grains 
 three times a-day. The unpleasant pitchy 
 flavour of the pills is materially diminish- 
 ed, if they are kept for some time after 
 being made up. 
 
 TAR-WATER. Water impregnated 
 with the smell and taste of tar, by infus- 
 ing tar in water, stirring it from time to 
 time, and pouring off the clear liquor. It 
 was once a remedy in great vogue, and 
 the learning and genius of Bishop Ber- 
 keley were employed to recommend it as 
 an almost universal medicine. It is now 
 used occasionally as a drink, in chronic 
 affections of the lungs. 
 
 TARANTULA. A venomous spider 
 found near Naples, whose bite is said to 
 excite a kind of madness, accompanied 
 with an irresistible propensity to dancing, 
 and to be cured only by music ; but Dr. 
 Cerillo declares, " that he never could 
 make the tarantula bite him, nor any 
 other person, though provoked." ( Paur). 
 
 TARTAR. The substance deposited 
 in the inside of wine casks, consisting of 
 
TEA. 
 
 539 
 
 a jMurticular salt much mixed with colour- 
 ing^ and «xtracti^Te matter. When these 
 are removed, the purified substance is 
 called cream of tartar, the properties of 
 which are detailed under that article. 
 
 TARTAR EMETIC. See Antimonv. 
 
 TARTAR OF THE TEETH. The sa- 
 liva contains, among- other matters, a mu- 
 cus which is deposited ou the teeth, prin- 
 cipally durinj? sleep. It is there decom- 
 posed, and its colour changes from white 
 to yellow, and often to a darker shade- 
 It attaches itself very much to the teeth 
 of people who have delicate stomachs, 
 and of those who have the saliva tough 
 and viscid, and who have their gums pale, 
 soft, and bleeding. Tartar accumulates 
 in the intervals of the teeth, especially of 
 the lower front teeth ; and ^vhen long ne- 
 glected, it separates the gums from the 
 teeth, and renders them loose and tender. 
 It is to be prevented from accumulating, 
 by constant attention to washing the 
 mouth, and using proper dentrili(^s. 
 When very thick and inconvenient, it 
 will require to be removed by the instru- 
 ments of the dentist. See Teeth. 
 
 TARTARIC ACID is obtained from 
 cream of tai'tar by a chemical process de- 
 scribed in the Pharmacopoeias. Its taste 
 is acid, and very agreeable. It is used as 
 a cheap substitute for the concrete salt of 
 lemons in the formation of soda-powders 
 and Seidlitz powders. The white papers 
 of the sodar-powders in the shops contain 
 tartaric acid, and the blue contain bi-car- 
 bonate of potass. 
 
 TASTE. That sense residing chiefly 
 in the tongue, by which we acquire the 
 knowledge of the sapid properties of bo- 
 dies, and by which we are in general 
 taught, with great certainty, whether 
 substances are proper to be taken into the 
 stomach or not. In general, noxious bo- 
 dies have a disagreeable taste, and are 
 immediately rejected; at least in animals, 
 and in the unsophisticated human subject, 
 this is commonly the case. Vicious in- 
 dulgence and excess may produce veiy 
 pleasant sensations on the palate, though 
 *he good food swallowed is soon to be 
 
 hurtful ; and many dnigs w hich are to 
 have the most beneficial effects, are by 
 no means grateful to the taste. In fevers 
 and various other disorders, the taste is 
 depraved or lost. 
 
 TEA, Thea. A plant of various spe- 
 cies, which grows in China and Japan, of 
 which great quantities are imported in 
 the state of the dry leaves from China. 
 In Europe, and especially in Britain, the 
 infusion of these leaves has become one 
 of the necessai'ies of life ; and from its fra- 
 grant and agreeable properties it is likely 
 for ever to maintain its universal estima- 
 tion. The principal kinds of tea used in 
 this country, are the green and bohea ; of 
 which there are three kinds of the first, 
 and five of the second. The green tea is 
 the most remarkable for its sleep-repelling 
 properties. The bohea is that in the 
 most general use. 
 
 The properties of tea seem to be those 
 of an astringent and narcotic; but like 
 some other narcotics, in small quantity, 
 its firet effect is that of a very gentle sti- 
 mulant and certain kinds of it, when 
 taken pretty sti'ong aisd near the usual 
 time of going to rest, have the effect of 
 keeping off sleep ; but when taken mo- 
 derately, and tempered with cream and 
 sugar, it acts merely as a grateful diluent, 
 and conveys a slight exhilaration. 
 
 At its first introduction, and for more 
 than fifty years afterwards, tea was vio- 
 lently assailed, and many frightful disor- 
 ders were attributed to its use ; it was 
 said to produce indigestion, lassitude, me- 
 lancholy, and a long train of nervous 
 complaints. Such apprehensions, or at 
 least inquiries indicating such, are some- 
 times to be met with still ; but the long 
 and universal experience of this country 
 has decided, that from the use of tea, as 
 generally practised, there result no bad 
 consequences whatever. It should not be 
 taken too soon after dinner, as it may 
 interfere with digestion from its distend- 
 ing the stoma(-h, and from its astringent 
 and narcotic properties ; but w hen taken 
 three or four hours after the principal 
 meal, it assists the latter stages of diges- 
 
540 
 
 TEA. 
 
 tion, and promotes the insensible perspi- 
 ration. There are peculiarities of consti- 
 tution in some which render tea very 
 hurtfiil to them ; but the same is true of 
 many substances used both in diet and 
 medicine. 
 
 Those who are fixed down to a seden- 
 tary employment, who must work at 
 night, and who take tea to keep them- 
 selves awake ; who, from the want of 
 exercise are unable properly to digest 
 animal food, will no doubt exhibit many 
 symptoms of indigestion, and that feeble 
 tremulousness, known by the epithet ner- 
 vous ; but the tea ought not to bear the 
 blame of all those disorders, which are 
 more justly to be ascribed to the confine- 
 ment and inactivity of the patient. In 
 enumerating the advantages of tea, says 
 Dr. Paris, it must not be forgotten that it 
 has introduced and cherished a spirit of 
 sobriety ; and it must have been remark- 
 ed by ^\^YY physician of general practice, 
 that those persons who dislike tea, fre- 
 quently supply its place by spirits and 
 water. We may add, that for one patient 
 whose general frame, or whose digestion 
 is weakened by the use of tea, ten thou- 
 sand are irretrievably injured by the use 
 of alcohol, however diluted and disguised. 
 
 Amidst the variety of topics discussed 
 in this work, we have been rarely tempt- 
 ed to indulge in any quotation, not strict- 
 ly scientific ; but on tlie subject of tea, 
 we recollect with pleasure the hearty de- 
 fence of that much opposed beverage, by 
 Dr. Samuel Johnson, in the year 1756. 
 He warns Mr. Han way, the writer of an 
 Essay on Tea, who considered it " as 
 pernicious to health, obstructing indus- 
 try, and impoverishing the nation ;" that 
 he is to expect little justice from a har- 
 dened and shameless tea-drinker, who 
 has for twenty years diluted his meals 
 with only the infusion of this fascinating 
 plant ; whose kettle has scarcely time to 
 cool ; who, with tea, amuses the evening, 
 with tea solaces the midnight, and with 
 tea welcomes the morning. 
 
 " That the diseases commonly called 
 nervous, tremors, fits, habitual depres- 
 
 sion, and all the maladies which proceed 
 fi-om laxity and debility, are more fre- 
 quent than in any former time, is, I be- 
 lieve, true, however deplorable. But 
 this new race of evils will not be expelled 
 by the prohibition of tea. This general 
 languor is the effect of general luxury, of 
 general idleness. If it be most to be 
 found among tea-drinkers, the reason is, 
 that tea is one of the stated amusements 
 of the idle and luxurious. The whole 
 mode of life is changed ; every kind of 
 voluntary labour, every exercise that 
 strengthened the nerves, and hardened 
 the muscles, is fallen into disuse. The 
 inhabitants are crowded together in popu- 
 lous cities, so that no occasion of life re- 
 quires much motion; every one is near 
 to all that he wants; and the rich and 
 delicate seldom pass from one street to 
 another, but in carriages of pleasure. Yet 
 we eat and drink, or strive to eat and 
 drink, like the hunters and huntresses, 
 the farmers and the housewives of the 
 former generation; and they that pass 
 ten hours in bed, and eight at cards, and 
 the greater part of the other six at the 
 table, are taught to impute to tea all dis- 
 eases, which a life unnatural in all its parts, 
 may chance to bring upon them." 
 
 In the seventy years which have elaps- 
 ed since those remarks were written, the 
 use of tea has extended far beyond the 
 idle and luxurious ; but it has neither 
 unfitted the husbandman for labour, nor 
 the hero for war. It has been the beve- 
 rage of the soldier in his camp, of the 
 seaman on his voyage; yet neither Gre- 
 cian activity nor Roman steadiness sur- 
 passed the warlike virtues recently exhi- 
 bited by British valour, in every climate 
 of the globe. 
 
 TEAR. A saltish fluid secreted by the 
 lachrymal gland in the upper eyelid, des- 
 tined to flow over the eye, for the purpose 
 of keeping it moist. Certain passions of 
 the mind cause an increased flow of tears, 
 as joy and grief. Violent laughter has 
 the same effect. 
 
 TEETH. The teeth of a person at 
 maturity are iyi general thirty-two in 
 
TEETH. 
 
 541 
 
 number, sixteen in each ja^v. They are 
 of different forms, according to their 
 uses ; thus, in the front of each jaw, 
 there are four teeth for cutting or di- 
 viding our food, called incisors; two in 
 each jaw at the sides of the former, for 
 tearing or laying hold of the food ; and 
 the rest on each side of these are grind- 
 ers, for bruising and comminuting it. 
 The teeth which first appear in children 
 are twenty iu number; but as their 
 small size would not suffice to fill up 
 the jaw, as it increases to its proper 
 bulk in the adult, the first set of teeth, 
 by an admirable provision of nature, fall 
 out, and are succeeded by teeth of a larg- 
 er size, which are permanent till the pe- 
 riod of old age. Each tooth has a crown 
 or body; this is the part which projects 
 from the gums ; also roots, or fangs, the 
 number and direction of \vhich vary in 
 the different kinds of teeth ; and a neck 
 between the other two portions. The 
 whole of the part which is out of the 
 socket is covered by a thin, but exceed- 
 ingly compact and firm crust, called the 
 enamel: so hard and solid, says the first 
 Monro, that saws or files can with diffi- 
 culty make impression on it. Notwith- 
 standing its great hardness, it is in time 
 wasted by chewing; hence, the rough 
 surfaces of some teeth are made smooth 
 and flat, as people advance in life. A 
 little to the side of the extremity of each 
 root of a tooth is a small canal, by w hich 
 blood-vessels and nerves enter to convey 
 life and nourishment. When in old 
 people this hole is obliterated, the nerves 
 and vessels cannot enter, and the teeth 
 loosen, and drop out. The teeth are very 
 sensible to impressions from cold and acid 
 fluids. Besides being necessary for mas- 
 tication, the teeth assist in the pronunci- 
 ation of several letters. 
 
 Diseases of the Teeth. The teeth 
 are liable to caries or wasting, and when 
 a tooth is so much decayed that the cold 
 air, and cold or acrid fluids reach the 
 nerv^es within, the painful disease called 
 toothach is the consequence. Carious 
 teeth render the breath fetid, and may in- 
 
 jure digestion by vitiating the saliva. See 
 Toothach. 
 
 Care of the Teeth. Much may l)e 
 done to promote the health and beauty of 
 the teeth. At the time of the growth of 
 the second set, great attention should be 
 paid to them ; and as children are thought- 
 less of futurity, those who are their pro- 
 tectors and guardians should think for 
 them ; and take care both of their general 
 health, and of the proper advancement of 
 the teeth. Under Dentist, we have men- 
 tioned a variety of particulars, which 
 come under the cognizance of his branch 
 of surgery. 
 
 By attention to cleanliness, the prudent 
 use of proper dentifrices, and being care- 
 ful not to allow particles of food to lodge 
 about the teeth, much may be done to 
 further a person's own health and com- 
 fort, to prevent the encrusting of the 
 teeth with tartar, and to counteract the 
 tendency to rottenness. 
 
 TEETHING, or Dentition. As in- 
 fants are destined for some time to live on 
 milk, or food that requires little or no 
 mastication, the teeth in the first months 
 of life are covered by the gums ; and as 
 they advance, they push the gum before 
 them, till, by the process of inflammation 
 and ulceration, the gum is eroded, and 
 the tooth projects from the socket. This 
 process does not begin in every child at 
 the same age. In general, the fiirst pair 
 of teeth appear before the seventh month, 
 and the last before the end of the second 
 year. Those teeth which are to droi> 
 out are called the milk-teeth or shedding 
 teeth ; they are twenty in number, ten ia 
 each jaw. They generally appear in pairs, 
 and those iu the lower jaw are cut before 
 the corresponding ones in the upper. 
 The order of succession is most usually 
 this : the two middle front teeth or inci- 
 sors, then the two next to them, the an- 
 terior grinders, the eye-teeth, or canine,, 
 and lastly, the posterior gi-inders. There 
 is an interval of one, two, or more weeks 
 between each successive pair. The vari- 
 ety is great in different individuals, with 
 respect to the commencement and pro- 
 
512 
 
 TEETHING. 
 
 gress of teethiiio^. In some, not a tooth 
 appears before the tiftoenth or eighteenth 
 month ; in others, the first pair are 
 throug-h by the end of the third month. 
 Sometimes those of the upper jaw come 
 first; sometimes, several pairs come very 
 rapidly, and thou there is a considerable 
 interval before the rest advance. From 
 the great irritability and tenderness of 
 constitution of infants, they are liable to 
 many disorders in the course of teething- ; 
 from a simple and salutary looseness to 
 severe and fatal convulsions. Few chil- 
 dren get their teeth without suffering 
 more or less ; and during the whole pro- 
 cess, their health must be particularly at- 
 tended to. " An estimate of the danger 
 attending dentition is to bo formed, chief- 
 ly from the nature of the symptoms. 
 Experience proves, that puny, delicate 
 infants often suffer less than the most 
 healthy and robust. lu this climate, it 
 has been found that summer is a more fa- 
 vourable season for teething than winter. 
 Some infants cut their fore-teeth without 
 any pain or difficulty, but are much dis- 
 tressed vt'hile cutting the grinders or eye- 
 teeth. It is well known, that during 
 teething, every acute disease is more than 
 usually dangerous ; and it is also a well 
 established fact, that infants in a crowded 
 city are more liable to pain and alarming 
 symptoms at that time of life, than those 
 reared in the country." 
 
 We shall here give a short account of 
 the most frequent diseases to which chil- 
 dren are liable during the time of teething. 
 
 Uneasiness about the Mouth. The pres- 
 sure of the teeth on the gums occasions 
 pain, and au increased How of saliva; 
 the infant is fretful, is restless during the 
 night, has great desire to rub his gums, 
 and frequently thrusts his hands into his 
 mouth for that purpose, slavers continual- 
 ly ; and has occasionally sickness, griping 
 and looseness. 
 
 Looseness. This last is a very frequent 
 symptom ; and it is in many cases to be 
 considered as rather salutary, by dimi- 
 nishing the feverish irritation ; and it 
 should not be hastily interfered with. 
 
 Bat, on the other hand, most particular 
 care must be taken, that the looseness do 
 not go too far, as a dangerous and even 
 fatal disorder of the bowels may be »- 
 duced. To prevent this, we are to at- 
 tend to the gums ; and even though the 
 teeth should not be very near, we may 
 scarify them, by which the tension will 
 be taken oft" for the time ; and this may 
 be repeated when the teeth are nearer. 
 The bowels are to be regulated by proper 
 purgatives at first, to remove any irritat- 
 ing matter, and to correct the acrimony 
 of the dischai-ges ; and then the looseness 
 is to be checked by opiate clysters, or by 
 the tincture of opium, or astringents pru- 
 dently given by the mouth. Magnesia 
 may be given to correct acidity. 
 
 Fever. In many strong healthy child- 
 ren, the appearance o-f every tooth is pre- 
 ceded by violent fever. The gums ai'e 
 inflamed and swelled ; the eyes are affect- 
 ed, the skin is hot and dry, and the belly 
 bound ; the child screams much, and is 
 unable to suck, and the sleep is disturbed. 
 This feverish state is to be alleviated by 
 tepid bathing, by giving a little cream of 
 tartar, or other purgative medicine; and 
 by scarifying the gums when this is ne- 
 cessary. 
 
 4. Spasmodic Affection of the Wind- 
 Pipe, " The most formidable symptom, 
 except convulsions, which occurs during 
 dentition, remains to be noticed : it is a 
 kind of convulsive stricture of the upper 
 part of the wind-pipe, producing a pecu- 
 liar crowing sound as if from threatening 
 suffocation. This affection is quite mo- 
 mentary, and generally happens on awak- 
 ening from sleep, on taking food or di-ink, 
 or on the infant being teazed or irritated, 
 Sometimes the fits are redoubled, but 
 more often they are single. The disease 
 is unaccompanied by fever, or any mate- 
 rial derangement of the general health. 
 When cough attends, Avhich is not always 
 the case, it is not hoarse, and the breath- 
 ing during the intervals is perfectly free. 
 Those circumstances distinguish it from 
 the croup, which it resembles in the 
 crowing sound. 
 
TEETHING. 
 
 543 
 
 " It has appeared in the roKust, as well 
 as the most delicate infants, and it some- 
 times continues for montlis, occasionally 
 decreasing- in violence, and suddenly be- 
 coming" again aggi-avated ; so that for a 
 week or two, the infant shall have forty or 
 fifty attacks within tlie twenty-four hours, 
 and then the number shall be diminished 
 to eight or ten. The event to be dreaded 
 is sudden suffocation, or a severe convul- 
 sion from which the infant cannot be re- 
 covered. In several cases this has hap- 
 pened at the distance of many months 
 from the first attack, and after the infant 
 had seemed almost perfectly relieved 
 from the disease. 
 
 ** For the successful treatment of this 
 complaint, the utmost attention on the 
 part of the practitioner is required, as no 
 reliance is to be placed on any apparent 
 remission or mitigation of the character- 
 istic symptoms ; for so long as these con- 
 tinue to recur in any degree whatever, 
 till all the milk-teeth be proti-uded, dan- 
 ger is to be apprehended. The plan of 
 cure which has hitherto seemed success- 
 ful, has been, to watch the state of the 
 gums, so as never to allow much local ir- 
 ritation from the pressure of the tooth ; 
 to open the bowels very freely by means 
 of varied purgatives, with which absorb- 
 ents or antacid medicines are combined ; 
 to regulate the diet ; to direct some sti- 
 mulant substance to be rubbed every six 
 hours on the outside of the throat, and 
 to give frequently some antispasmodic. 
 After having tried the effects of prepara- 
 tions of opium, of hyoscyamus, of vale- 
 rian, and of assafetida, without any appa- 
 rent benefit, Dalby's carminative, in 
 doses, repeated every four or five hours, 
 or oftener, according to the urgency cf 
 tlie case, has appeared preferable to every 
 other medicine. Blisters on the throat 
 or breast are to be used as auxiharies ; 
 and the warm bath, and preparations of 
 antimony, and even of foxglove are to 
 be occasionally advised, for tlie purpose 
 of palliating symptoms. Change of air 
 has in several cases appeared to have an 
 almost immediate effect in arresting the 
 
 progress of the disease, but in all such 
 cases, the healthy action of the boweU 
 had been previously restored." (Profes- 
 sor Habiilton on the Management of 
 Children.^ 
 
 Convulsions. These are very alarming, 
 and require prompt assistance. The gums 
 are to be scarified, and the teeth liberat- 
 ed. The warm bath is to be applied to 
 the lower part of the body, and a little 
 valerian or antispasmodic tincture to be 
 given. It may be prudent also to take 
 away a little blood by leeches, in order to 
 prevent too great a flow of blood to the 
 head, which frequently occurs, and in- 
 duces inflammation and consequent cffu- 
 sioQ. 
 
 Water in the Head. See Head, Wa- 
 ter in. 
 
 Sickness. In weakly infants, when the 
 teething is dij0&cult, there is much sickness, 
 loathing of the food, and continual fret- 
 fulness; also looseness and great emacia- 
 tion. Opiates combined with calome 
 should be given ; and the diet must be 
 light and nourishing, as ass's milk, weak 
 beef-tea, with rice and arrow root, pre- 
 pared Avith a considerable proportion of 
 boiled milk. 
 
 A variety of other complaints are oc- 
 casionally the effects of teething, as 
 cough, eruptions on the skin, inflamma- 
 tion of the eyes, affections of the urinary 
 organs. In such cases, it is good to at- 
 tend to a general rule, laid down by Mr. 
 Burns ; which is, to treat the diseases of 
 children, when teething, as we would do 
 in any other case, with the additional 
 practice of scarifying the gum. 
 
 This operation of scarifying the guni> 
 which we have recommended in the va- 
 rious morbid affections occurring in the 
 course of teething, is one of great safety 
 and utility. The pain it inflicts is but 
 small and momentary, and in many cases 
 the child hardly even cries for it; and 
 the relief which is speedily afforded, is 
 frequently very striking. A train of 
 painful and alarming symptoms, and 
 even convulsions, subside almost imme- 
 diately on the teeth being liberated. It 
 
5U 
 
 TEMPERAMENTS. 
 
 is necessary that the operation be com- 
 pletely done, by incisions crossing each 
 other. There is no scar or hardness left, 
 so that the same gum may be scarified 
 three or four times if necessary. During 
 teething, the infant should have some- 
 thing put into his hands, to rub his gums 
 with, which will both please him, and 
 tend to promote the absorption of the 
 parts which cover the teeth. 
 
 TEMPERAMENTS. A word used 
 to signify the varieties of constitution 
 in different individuals. These were 
 noticed and described by the ancient phy- 
 sicians; and though their names were 
 founded on a false theory, and were de- 
 rived from different fluids or humours, 
 which they supposed to predominate in 
 the body, these names are still retained, 
 though we reject their explanation. 
 The great variety of constitutions ob- 
 servable among mankind may be re- 
 duced to two, the sanguineous and the 
 melancholic ; and these blended in various 
 proportions, constitute other varieties, 
 w hich may be termed the choleric or the 
 phlegmatic. 
 
 1. Persons of the sanguine tempera- 
 ment have considerable laxity of the so- 
 lids, their hair is soft and light coloured, 
 their skin is delicate, their eyes blue or 
 grey, their arteries are large, their com- 
 plexion florid. The mobility and sensi- 
 bility of their nervous system is great, 
 and their moral character partakes of this 
 mobility. Persons of sanguine tempera- 
 ment are easily elated and quickly de- 
 pressed; unsteady in their pursuits; ar- 
 dent and full of hope ; pursuing their ob- 
 jects keenly for a time, but soon changing 
 them for others. The sanguine tempera- 
 ment is more peculiarly liable to diseases 
 of excitement, fevers, inflammation, hae- 
 morrhagies, consumption. 2. The melan- 
 cholic temperament has greater rigidity 
 of the solids ; the hair is coarse and black, 
 the arteries are small, and the persons are 
 dry and lean. They are not easily rous- 
 ed ; but when they are so, tliey keep to 
 their purpose with great steadiness. Their 
 strength is commonly great. The bowels 
 
 of such persons are slow. They are subject 
 to hypochondriasis, to apoplexy, and dis- 
 eases of the liver. 3. The choleric tempera- 
 ment is distinguished by a profusion of 
 black curly hair, a hard, lean, slender body; 
 a brown complexion, large veins, a full 
 quick strong pulse; obstinacy and vio- 
 lence. 4. The phlegmatic temperament 
 is distinguished by great smoothness of 
 the skin, white thin hair, growing spar- 
 ingly; a white, soft, full, plump body, 
 small and almost imperceptible veins. 
 
 Some have written with great minute- 
 ness on the different temperaments, and 
 have talked of hot and cold, moist and 
 dry, serous, temperate, cacochymic, and 
 other useless distinctions. The four which 
 we have mentioned are tolerably well 
 marked, and sufficient for every practical 
 purpose. 
 
 TEMPORAL ARTERY. The artery 
 which runs across the temple, and which 
 is frequently opened in cases of apoplexy 
 and other diseases, where it is reckoned 
 of importance to get blood from vessels 
 about the head. The bleeding generally 
 stops easily enough ; but if it should not, 
 we may employ compression, or cut the 
 vessel across. 
 
 TENESMUS. A frequent ineffectual 
 straining at stool; a painful symptom 
 of dysentery and other diseases of the 
 the bowels. When it is judged prudent 
 to relieve this symptom particulaiiy, it is 
 chiefly by opiate clysters that we expect 
 to accomplish it ; but opium is also given 
 by the mouth. 
 
 TENT. A small piece of lint, or linen 
 put into a wound to prevent its healing 
 too suddenly, or to hinder its closing at 
 the top while the bottom is unsound. In 
 very large abscesses, there should always 
 be a tent put in when they aie opened^ 
 and kept in for a few days, that they may 
 fill up from the bottom, and that no si- 
 nuses or lodgement of matter may be 
 formed. In the old surgery, tents were 
 frequently besmeared with irritating oint- 
 ments, and absurdly crammed into recent 
 gun-shot wounds, and even into simple 
 incised wounds, or clean cuts. 
 
TESTICLE. 
 
 545 
 
 TERTIAN AGUE. An intemiittent 
 fever, the paroxysms of which recur every 
 other day ; or the time from the begin- 
 ning of one cold stage to the beginning 
 of the next is forty-eight hours ; two days 
 being occupied \vith the various parts of 
 the attack and intermission, and the third 
 day being that on which the same series 
 recurs. See Ague. 
 
 TESTICLES. The two organs for se- 
 creting the seminal fluid, situated in the 
 scrotum or bag at the lower part of the 
 belly. They are subject to a considerable 
 variety of diseases. 
 
 1. Inflammation of the Testicle is a 
 very common symptom of clap, especially 
 when the running is attempted to be 
 checked by too astringent injections, or 
 when the urethra is irritated by strictures 
 or by bougies. The first appearance of 
 swelling is generally a fulness and tender- 
 ness of the body of the testicle, which in- 
 creases to a hard tumour, accompanied 
 with considerable pain. There is a pain^ 
 in the loins, and a sense of weakness 
 there, and in the neighbouring parts. 
 There is also occasionally uneasiness or 
 pain in the stomach and bowels, with 
 sickness and vomiting. The swelling and 
 inflammation sometimes appear suddenly, 
 and disappear in the same manner, or go 
 from one testicle to the other. Some- 
 times, on the coming on of the swelling, 
 the pain and heat in making water are 
 removed, and the discharge of matter is 
 suspended ; sometimes, however, the dis- 
 charge becomes greater, though the tes- 
 ticle has swelled. 
 
 Treatment. Inflammation of the tes- 
 ticle is to be treated as inflammation in 
 general, by rest, by bleeding and purg- 
 ing, and by fomentations and poultices. 
 Leeches in considerable numbers are to 
 be applied to the parts. Emetics some- 
 times produce a cure in a very speedy 
 manner ; opiates are also useful to allay 
 irritation. The swelling subsides quick- 
 ly at first, but some degree of it remains 
 for a long time, and may do so for life ; 
 but the mere hardness is not a very great 
 inconvenience. 
 
 2. Sarcocele or Fleshy Enlargement of 
 the Testicle, is a disease in which the 
 structure is changed from the delicate 
 vascular texture peculiar to it in the 
 healthy state, to a substance resem- 
 bhng hard flesh. Sometimes the first ap- 
 pearance is a mere enlargement and hard- 
 ness, without any inequality of surface, 
 and producing no pain or uneasiness ex- 
 cept what proceeds from its weight ; and 
 in this harmless state, it sometimes conti- 
 nues for a good while. But, on the con- 
 trary, it sometimes happens that it sud- 
 denly becomes unequal and knotty, at- 
 tended with acute pains, darting up to the 
 loins and back. At other times, the mem- 
 brane enveloping the testicle becomes 
 diseased and ulcerated, and either a large 
 foul offensive sore ensues, or a fungous 
 growth shoots out, very painful, with a 
 thin acrid discharge, and subject to fre- 
 quent bleeding. Sometimes it is entirely 
 a local complaint; at other times it is 
 shown that the constitution is unhealthy, 
 by a pallid, leaden countenance, sickness, 
 and indigestion. The probability of the 
 painful and fatal termination of such an 
 affection of the testicle, renders it always 
 a great object, if possible, to arrest this 
 hardened state in its early progress. A 
 very little time may be employed in at- 
 tempts to remove hardness by such me- 
 thods as are sometimes found to remove 
 the hai'dness in other glands, by leeches 
 and by friction, by mercury with a view 
 to its deobstruent powers, and by atten- 
 tion to the general health ; but in the 
 confirmed hardness nothing can secure 
 the patient from the worst cancerous ter- 
 minaitiou of the disease, except the re- 
 moval of the diseased testicle. 
 
 .3. Another affection of these parts is 
 Hydrocele, which is not, strictly speak- 
 ing, a disease of the testicle itself, but an 
 accumulation of fluid in the bag contain- 
 ing it. This fluid sometimes accumulates 
 in very great quantity. It is very easily re- 
 moved by puncturing the bag, but it is apt 
 to gather again in as great quantity as be- 
 fore. The method employed by surgeons 
 to prevent the re-acciunulation of the 
 2 N 
 
546 
 
 TETANUS. 
 
 fluid, is to excite such a degree of iuflam- 
 mation in the inside of the cavity, as will 
 cause the effusion of lymph, which makes 
 the testicle with its fine covering to grow 
 to the inside of the containing bag, and 
 so to leave no cavity in which the water 
 can accumulate. This curative inflamma- 
 tion is produced by injecting equal parts 
 of port wine and water, and retaining it 
 till some degree of irritation is produced. 
 The fluid is then allowed to run ofi^, and 
 our attention is to be directed to prevent- 
 ing the inflammation from becoming too 
 violent. Should this be threatened, we 
 are to apply cooling lotions internally, to 
 take away blood either generally or local- 
 \y, and to give laxative medicines. 
 
 TETANUS. A painful and dangerous 
 disease, often called the Locked Jaw, 
 from one of its most conspicuous symp- 
 toms. Tetanus occurs chiefly in warm 
 climates, though it is by no means confin- 
 ed to them. It occurs as an idiopathic 
 disease ; but it not unfrequently fol- 
 lows wounds inflicted on some parts of 
 the body, especially lacerated or punctur- 
 ed wounds. It also is a consequence of 
 cold and moisture applied to the body 
 when it is heated. In this case, the dis- 
 ease commonly makes its appearance - 
 within a few days of such application 
 of cold; and the symptoms are the fol- 
 lowing. There is a sense of stiffness in 
 the back part of the neck, which gradu- 
 ally increases, and renders the motion of 
 the head difficult and painful. As this 
 stiffness comes on and increases, there is 
 an uneasy feeling about the root of the 
 tongue, Avhich uneasiness gradually be- 
 conaes a difficulty of swallowing, and at 
 last prevents it altogether. There fre- 
 quently occurs a violent pain at the lower 
 part of the breast-bone, stretching from 
 thence to the back. When this pain 
 arises, a strong spasm, especially of the 
 muscles at the back part of the neck, 
 draws the head strongly backwards. At 
 the same time, the lower jaw is so strong-. 
 ly pulled up, that the teeth are closely 
 set, and do not admit of the smallest open- 
 ing between them; this is the locked Jaw, 
 
 and it is often the principal part of the 
 disease. The spasms are now more fre- 
 quently repeated, with great pain ; and 
 sometimes so many muscles are thrown 
 into violent spasms, that the whole body 
 is bent forcibly backwards. The mus- 
 cles of the abdomen are also strongly con- 
 tracted, causing the belly to feel hard, 
 like a piece of board. The disease going 
 from bad to worse, the muscles of the 
 body both before and behind are so equal- 
 ly affected, and so strongly contracted, 
 that the body remains stiff an,d immov- 
 able. The spasms are attended with the 
 most severe pain ; and though the spasm 
 and pain occasionally abate a few minutes, 
 yet every ten or fifteen minutes they are 
 renewed ; and any attempt at motion of 
 any kind gives occasion to the renewal of 
 the spasms. In this violent and painfiil 
 disease, there is most commonly little or 
 no fever ; the face is not flushed nor the 
 pulse raised ; there is not a great degree 
 of thirst or heat of skin; often, indeed, 
 the extremities are cold, and there is a 
 cold clammy sweat over the whole body. 
 There is not much affection of the head 
 nor delirium, till towards the termination 
 of the disease, M'hen every function of 
 the body is weakened. Vomiting some- 
 times appears at the beginning of the dis- 
 ease, but it is not a frequent nor a mark- 
 ed symptom. The bowels are generally 
 torpid. 
 
 Treatment. Various have been the 
 remedies employed in the ciu-e of tetanus, 
 but it is a disease of so formidable and 
 dangerous a nature, that every plan has 
 too frequently been known to fail. Bleed- 
 ing to a large extent has been tried un- 
 successfully ; and the same may be said 
 of the warm and cold bath, of blistering, 
 the use of mescury, and a great variety 
 of antispasmodics, all of which have been 
 unavailing, with the exception of opium. 
 This last substance has been given to an 
 incredible extent, but too often without 
 any benefit ; it seems, however, to have 
 retained its reputation beyond any thing 
 else, and practitionei-s are stiD fain to 
 have recourse to it. When a patient is 
 
TETTER. 
 
 547 
 
 fairly seisced with tetanus, the proper plan 
 to follow is this. If he be young and 
 strong-, and be seen at the commencement 
 of the disease, he ought to lose a consi- 
 derable quantity of blood, to be put into 
 the warm bath, and to have a strong pur- 
 gative ; as soon as the bowels have been 
 thoroughly purged, he should begin to 
 take opium, either solid or in the form of 
 tincture, one grain every hour, or forty 
 drops, increasing the quantity or the fre- 
 quency of repetition according to the ur- 
 gency of the symptoms. The remedies 
 are to be vigorously applied without loss 
 of time, as the jaws may soon be locked, 
 so as totally to prevent the admission of 
 any thing into the mouth, unless by the 
 severe expedient of drawing some of the 
 front teeth. Indeed, this is frequently 
 quite necessary, in order to admit wine, 
 broth, or other nourishment. If there is 
 no possibility of getting food or medicine 
 by the mouth, we are obliged to have re- 
 course to clyster. Some have thought 
 that tobacco clysters have the power of 
 relaxing the severe spasm which consti- 
 tutes tetanus ; and like many other reme- 
 dies, it has had its instances of success 
 and failure ; and where the danger is so 
 great, and our means so uncertain, we are 
 glad to try many expedients. 
 
 In warm climates, especially in the 
 West Indies, children at a very early 
 period after birth, from the fifth to the 
 ninth day, are affected with locked jaw. 
 The disease, as may be expected, is in 
 them very dangerous. The warm bath, 
 opium, and pui^ing, are the principal re- 
 medies to be attempted. It is believed 
 •^often to be owing to rude management of 
 the navel-string ; but this cause is proba- 
 bly not the true one. 
 
 TETTER. There are two kinds of 
 what ai-e called tetter, the dry and the 
 humid, and of each of these there are se- 
 veral varieties. 
 
 I. The Scaly Tetter^ the Psoriasis of 
 Willan, exhibits more or less roughness 
 and scaliness of the cuticle, with a red- 
 ness underneath. Sometimes the erup- 
 tion is difiTuse and continuous, and some- 
 
 times in separate patclies, of various sizes, 
 and of an irregular figure. The surface 
 under the scales is tender and irritable, 
 and the skin is often divided by deep fis- 
 sures. It is commonly accompanied by 
 some constitutional disorder, and is liable 
 to cease and return at certain seasons. 
 
 Causes. Some have a hereditary pre- 
 disposition to tetter ; women of a dry skin 
 and languid circulation are subject to it ; 
 and it affects them more particularly after 
 lying in, or during a state of chlorosis. 
 In children, it is not unfrequcntly pro- 
 duced by the many sources of irritation 
 to which they are exposed. It is ob- 
 served in both sexes, connected with 
 gout ; and in those who are predisposed 
 to this eruption, slight occasional causes 
 appear to excite it ; such as being over- 
 heated by exercise, the unseasonable em- 
 ployment of the cold bath, a copious use 
 of acid fruits, vinegar, or crude vegeta- 
 bles, and some peculiar mixtures of food. 
 
 Treatment. In the commencement of 
 the eruption, when it appears suddenly, 
 and the constitution is obviously disor- 
 dered, a moderate antiphlogistic treatment 
 must be pursued. A gentle purgative 
 should be administered, and the diet 
 made light, by abstracting every thing 
 stimulant. This regimen, indeed, is re- 
 quisite throughout the course of this dis- 
 ease, which is immediately aggravated in 
 sympathy with irritation of the stomach, 
 whether by spices, fermented liquors, 
 pickles, or vegetable acids; whence the 
 disuse of these articles contributes mate- 
 rially to its cure. In the early and in- 
 flammatory stages, even the mildest sub- 
 stances iiritate the skin and aggravate 
 the distress of the patient. A decoction 
 of bran, a little cream, or oil of almonds, 
 sometimes produce ease ; but the admix- 
 ture of the preparations of zinc or lead is 
 commonly detrimental. If the constitu- 
 tional disturbance has subsided, the inter- 
 nal use of carbonate of potash, with an 
 infusion of bark, together with tepid 
 washing with simple water, or milk and 
 water, will gradually remove the com- 
 plaint. 
 
548 
 
 THIRST. 
 
 II. The Humid or Running Tetter^ the 
 Impetigo of Willan, is characterised by 
 the appearance of small pustules. It is 
 not accompanied by fever ; it is not con- 
 tagious, nor communicable by inocula- 
 tion. It occurs chiefly on the extremi- 
 ties ; the most common variety appears 
 in circumscribed patches, which are usu- 
 ally small and somewhat circular on the 
 upper, and large, oval, and iiTegular on 
 the lower extremities. The patches at 
 first consist of clusters of yellow pustules, 
 set close together, and surrounded by a 
 slight inflammatory border; in a few 
 days, the pustules break, and discharge 
 their fluid ; the surface is red and shining, 
 as if it were stretched, but exhibiting nu- 
 merous minute pores, from which a con- 
 siderable thin discharge is poured out, 
 accompanied with much troublesome itch- 
 ing, heat, and smarting. This discharge 
 concretes partially into thin greenish 
 scabs, from under which it still continues 
 to ooze. In the course of three or four 
 weeks, the scabs fall off, but are liable to 
 be renewed, as well as the discharge. 
 
 Causes. It cannot often be traced to 
 any obvious cause. A predisposition to it 
 appears to be connected with the sanguine 
 temperament, with a thin soft skin, and a 
 relaxed and bloated habit of body. Cer- 
 tain seasons appear to have great influ- 
 ence on the disease, in those who are 
 predisposed to it. 
 
 Treatment. At the commencement of 
 humid tetter, it is useful to administer 
 flowers of sulphur internally, in such quan- 
 tities as not to induce purging; and if 
 there is much irritability of the skin, a por- 
 tion of soda, nitre, or carbonate of potash 
 may be combined with it. Diligent wash- 
 ing with tepid water is at the same time 
 to be employed. When more inveterate, 
 it requires mercurial alteratives, as Plum- 
 mer's pill, or calomel and rhubarb. The 
 best ointments are those made with oxide 
 of zinc or acetate of lead. When the 
 irritability is less, the pitch ointment, 
 or citrine ointment, diluted with five 
 or six times its weight of lard, is often 
 found to be very beneficial, 
 
 THEBAICA TINCTURA, and Lau- 
 danum Liquidum, are old names for what 
 is now called Vinum Opii^ Wine of 
 Opium. It is made thus: Take of ex- 
 tract of opium, one ounce ; cinnamon and 
 cloves, both bruised, of each one drachm ; 
 sherry wine, sixteen ounces; macerate 
 for eight days, and filter. Mr. Ware, the 
 oculist, considers it as superior to every 
 other solution of opium as an application 
 in chronic inflammation of the eyes. 
 
 THERAPEUTICS. The general doc- 
 trines respecting the cure of diseases, and 
 the action of classes of remedies, without 
 discussing the properties of individual 
 substances. 
 
 THERMOMETER. The weU-known 
 instrument which measures the intensity 
 of heat by the property which that agent 
 has of expanding bodies. The substances 
 used in thermometers are mercury or 
 spirits of wine. The degrees of heat are 
 marked on a scale ; and the division of 
 the scale in most common use in this 
 country is that of Fahrenheit of Leyden ; 
 in which, zero indicates the heat evolved 
 during the melting of a mixture of salt 
 and snow ; 32° is the freezing point, and 
 212° the boiling one. The degrees of 
 heat at which certain phenomena occur 
 which are interesting in physiology or in 
 the treatment of disease will be found in 
 the Appendix, No. HI. 
 
 THIRST. The instinctive feeling by 
 which we are admonished of the necessi- 
 ty of taking liquids into the system, to 
 repair the waste which the body has sus- 
 tained, and to assist in the solution of the 
 aliment. Hence, we are thirsty after ex- 
 cessive perspiration, and after the use 
 of dry and salt food. The state of the 
 stomach and its contents have much in- 
 fluence on thirst. It is also caused by ner- 
 vous sympathy, as in severe pain or great 
 terror. This sensation appears to reside in 
 the throat and fauces ; but it is not always 
 connected with the dryness of these parts; 
 as, in many cases, the tongue is perfect- 
 ly dry, while little thirst is felt. In such 
 cases, drink should be frequently offered, 
 although the patient does not ask for it. 
 
THROAT, SORE. 
 
 549 
 
 Thirst is borne with much greater dif- 
 ficulty than huug-er. It is evidently 
 much under the power of habit ; those 
 who frequently indulge in drink, increase 
 the craving for liquids. Children should 
 not be suffered to take drink every time 
 the fancy strikes them. 
 
 The intensity of this sensation is mor- 
 bidly increased in a great variety of dis- 
 eases, especially in feverish complaints, of 
 which it is one of the distinguishing 
 symptoms. It is best relieved in fevers 
 and other ailments by gruel, toast-water, 
 or the vegetable acids or fruits. 
 
 THORACIC DUCT. A tube, into 
 which the lacteals carry the chyle intend- 
 ed for the nourishment of the body. The 
 greater part of this tube runs on the right 
 side of the spinal column, within the 
 chest; and it pours its fluid into the left 
 subclavian vein, which crosses the upper 
 part of the chest, to throw its blood into 
 the great vessels near the heart. 
 
 THORAX. The anatomical name for 
 the chest. See Chest. 
 
 THORN-APPLE, the Datura Stra- 
 monium, celebrated of late for its power 
 of curing asthma, when smoked like to- 
 bacco. See Strasionium. 
 
 THROAT, Im<xa>imation of. Quinsy, 
 Sore Throat, Cynanche Tonsillaris, An- 
 gina, are all names for an acute disease, 
 of which the seat is in the mucous mem- 
 brane of the upper part of the throat, and 
 all the surrounding parts of the muscles 
 which move the jaws. The tonsils, or 
 almonds of the ears, are especially affect- 
 ed, and the inflammation extends to the 
 pendulous velum of the palate, and to the 
 uvula. Commonly, shiverings and other 
 symptoms of approaching fever precede 
 the affection of the throat, which is at- 
 tended with pain and difficulty of swal- 
 lo^ng, the pain sometimes shooting to 
 the e«. . there is also troublesome clam- 
 miness yp t]^e mouth and throat ; a fre- 
 quent, huvijfli^^it, discharge of mucus; 
 and at an ea,v eriod of the disease, the 
 fever is fully fo.,^^ ^,^^ inflammation 
 and swelhng are ..^^^^jy ^^^^ ^^^:^^^ 
 ejrable at first on o. ^^^^^. ^^^ ^^^^^ 
 
 wards, abating in that, they increase in 
 the other. The disease is not contagious. 
 When the disease is actively treated at an 
 early period, it abates gradually, or is said 
 to end in resolution ; but very often it 
 goes on to suppuration; and the pus 
 which is evacuated is of the most fetid 
 and nauseous kind. Very soon after the 
 abscess breaks, great relief is obtained, 
 and the pain and difficulty of swallowing 
 
 Causes. The most frequent cause is 
 cold, externally applied, particularly about 
 the neck. It is chiefly the young and 
 sanguine who are affected; and when a 
 person has had sore throat once or more, 
 he is very liable to frequent repetitions of 
 it, so that the slightest exposure to cold, 
 or getting wet feet, will bring on an at- 
 tack of the disease. It occurs especially 
 in spring and autumn, when vicissitudes of 
 heat and cold are frequent. 
 
 Diagnosis. The principal point in the 
 diagnosis of this disease is to distinguish 
 it from the sore throat which attends 
 scarlet fever ; in some varieties of which 
 the rash is inconsiderable, although the 
 disease of the throat goes rapidly on to 
 gangrene, accompanied with a destructive 
 fever of the typhoid kind. The distinc- 
 tion between the two kinds of sore throat 
 is of great importance, as it most materi- 
 ally influences our practice. It is, in ge- 
 neral, easily made by proper attention. 
 The smart fever, the difficulty of swal- 
 lowing, and the bright florid redness of 
 the parts, mark out the inflammatory 
 sore throat with sufficient distinctness ; 
 and we are, in many cases, assisted, by ob- 
 serving the person affected to be often 
 subject to the disease, which occurs soon 
 after the application of cold. The dan- 
 gerous and malignant sore throat is 
 known by the dark and livid colour about 
 the fauces, by the appearance of specks 
 on the part, which rapidly spread and 
 form sloughs ; and by the circumstance 
 of scarlet fever being the prevailing epi- 
 demic. The treatment proper in inflam- 
 matory sore throat would be destructive 
 here. And it is probably the knowledge 
 
550 
 
 THROAT, SORE. 
 
 that some sore throats are so dang^ierous, 
 that makes many people much alarmed 
 when a quinsy seizes themselves or any 
 of their family. 
 
 Treatment. When sore throat is 
 threatened, it may in many cases be pre- 
 vented from coming forward, by using a 
 strong astringent gargle. Of these, there 
 is a great variety. As useful a one as can 
 be made is that with diluted vinegar, a 
 little sweetened with honey or sugar. 
 The infusion of red rose leaves, acidulat- 
 ed with a few drops of sulphuric acid, 
 forms a very elegant gargle. The same 
 purpose may be served by gargling with 
 strong spirits, or with the decoction of 
 oak-bark, or diluted spirit of hartshorn 
 not so strong as to hurt the mouth. A 
 blister from behind the ear, extending un- 
 der the lower jaw to the wind-pipe, will 
 almost certainly prevent the internal dis- 
 order of the throat ; but .it must be put on 
 at the early part of the disease, or it will 
 do no good. If this is not done, the vol- 
 atile liniment should be rubbed on the 
 under jaw, below the chin. Sometimes 
 leeches may be useful, but rarely a gene- 
 ral bleeding is required. An emetic may 
 be given at the commencement of the 
 disease, but a saline purgative is better. 
 Gargles must be used with incessant dili- 
 gence as long as the disease continues. 
 Jellies of preserved fruits, vegetable acids, 
 or good sharp small beer, may assist the 
 gargles in keeping the mouth clean and 
 allaying the thirst ; but the difficulty of 
 swallowing is so great, that the patient is 
 very apt to save himself the pain, and let 
 the throat get diy. However, a resolute 
 draught occasionally to quench tlie thirst, 
 gives little more pain than swallowing 
 the spittle. A little bit of sal ammoniac, 
 or sal prunella, allowed slowly to dissolve 
 in the mouth, is useful. Much relief is 
 got by inhaling the steam of hot water, 
 which may be impregnated with vinegar 
 or any aromatic ; and if there is a tendency 
 to suppuration, this is a good way of rip- 
 ening the abscess, which often forms in 
 the tonsils. As the sore throat and fever 
 are sometimes relieved by perspiration. 
 
 the patient should keep his bed for a few- 
 days. Sometimes the swelling is so gi-eat 
 that nothing can be swallowed, and the 
 breathing is impeded. The tonsils have 
 been scarified, or the abscess has been 
 opened, and the operation of opening the 
 wind-pipe may be sometimes required. 
 Happily those very violent cases are of 
 rare occurrence. 
 
 THROAT SOB.'E, Malignant and Pu- 
 trid. See Scarlet Fever. 
 
 THROMBUS. A dark-coloured swell- 
 ing under the skin, occasioned by the 
 blood getting out of the vein in blood- 
 letting, and diffusing itself a little way 
 round in the cellular substance. 
 
 THRUSH, Sore Mouth, or AphtJtce. 
 A disease very common to infants with- 
 in the first month, though it may occur 
 later. It consists in small white specks 
 on the tongue, inside of the cheeks and 
 fauces, with more or less derangement of 
 the stomach and bowels. There are 
 two forms of this disease ; a milder one, 
 in which the affection of the mouth is 
 slight and the constitutional symptoms 
 not severe ,• and another form, in which 
 both the local and constitutional symp- 
 toms are rather violent. In the milder 
 form, a few scattered spots appear on the 
 tongue, in the mouth, or within the lips, 
 like little bits of curds ; these soon be- 
 come yellowish and fall off, leaving the 
 parts below of a red or pink colour. The 
 spots may be renewed several times. 
 The bowels are somewhat deranged, grip- 
 ing or purging occiu-s, the stools are green- 
 ish, ill smelled, and containing portions 
 of undigested milk. The child is fretful, 
 and the mouth is rather warmer than 
 usual, but there is no general fever. 
 
 The other vai'iety of the disease begins 
 with great oppression and feverishness. 
 sometimes with fits and violent screp**- 
 ing. When the spots begin to a«'^^^> 
 the feverish symptoms are nii>^*^d a 
 little, but do not go off entire-// ^"^ it 
 would appeal- that the u^^^ations are 
 not confined to the mouth ^"* 8'^ through 
 the whole alimentary f°*'' <^a«ising .se, 
 vere pain, vomiting "^J*'"^""' ''^"'^ m^^^Sk 
 
THRUSH. 
 
 551 
 
 and the matter discharged is so acrid, as 
 even to produce excoriation of the parts 
 about the anus. The mouth is very ten- 
 der, and the child sucks with pain and 
 difficulty. The aphthae in a little time 
 fall off, but they may be renewed, and 
 the affection oiF the bowels often gets 
 much worse. 
 
 Prognosis. When the vomiting is 
 frequent, when the stools are thin and 
 the belly is tender, we regard the case 
 as very unfavourable; and drowsiness, 
 spasms, and languor, with frequent pulse, 
 are also dangerous symptoms. With re- 
 spect to the mouth, if the spots are few 
 and separate from each other; if they be- 
 come yellowish and fall off in three or 
 four days, leaving the parts below clean 
 and moist, we may expect that the erup- 
 tion will not be renewed. But if the 
 aphthae turn brown or black, the prospect 
 is not so favourable. 
 
 Causes. The disease appears to be 
 sometimes brought on by gi^^ng to very 
 young infants food or liquids too sweet, 
 and too hot. The stomach and bowels 
 of infants are peculiarly delicate, and 
 the mouth sympathizes very readily 
 with the derangements of those parts. 
 Exposure to cold and damp has also a 
 tendency to bring on this disease; and 
 aphthae occur in the adult inhabitants 
 of northern climates, where there is con- 
 tinual moisture of the aii', or where the 
 soil is marshy. 
 
 Treatment. As the disease frequently 
 arises from acidity of the stomach, a little 
 magnesia should be given as a corrective, 
 or the chalk mixture, in the dose of a 
 tea-spoonful every two hours, to infants 
 within the year, or larger doses to those 
 who are farther advanced. No force 
 must be used to displace the curd-like 
 specks ; and the patient must not get any 
 thing too warm, salt, or otherwise pun- 
 gent. Mild cooling substances may be 
 applied to the mouth, as powdered borax 
 mixed with a little honey, or a weak so- 
 lution of alum, Aveaker than what a sound 
 mouth could bear. In bad cases, when the 
 aphtha appear dark, and the strengfh is 
 
 much diminished, we must use port wine 
 and the decoction of bark as a wash for 
 the mouth ; and bark should be given in- 
 ternally in the form of the sulphate of 
 quinine ; from one to two grains may 
 be taken every four hours. The strength 
 must be supported by nourishing clysters 
 of milk or soup, if the patient is unable 
 to suck, or to take food properly by the 
 mouth. We cannot pronounce confident- 
 ly on the patient's safety, till he is again 
 able to suck. From the tendency of 
 mercury to affect the glands of the mouth, 
 it is better to avoid giving any form of it 
 as a purgative. 
 
 THYMUS. A gland situated on the 
 fore-part of the wind-pipe, the uses of 
 which are not known. It is larger in the 
 embryo than in the adult, and in Alpine 
 regions is often swelled, forming the 
 goitre, or wen of those countries. 
 
 TIC DOULOUREUX. A very pain- 
 ful affection of the nerves of the face, 
 chiefly those branches of the fifth pair, 
 which are distributed on the forehead, 
 cheeks, and upper and lower jaw; and 
 the po7'tio dura of the seventh pair, which 
 is ramified on the face and adjacent 
 parts. Other nerves of the body are 
 sometimes affected with tic douloureux, 
 as in the thigh, leg, arm, and female breast. 
 The face is by far the most generally af- 
 fected. There is very acute, pain below 
 the eye of one side, at the nose, the up- 
 per lip, and the teeth and gums. Some- 
 times the pains are sharp from the first ; 
 in other cases, there is a dull and con- 
 stant pain till the disease is fully formed. 
 The pain comes on in paroxysms of the 
 most violent kind, sometimes without any 
 precedent cause to awaken the fit, at other 
 times the attempt at shaving, eating, or 
 speaking, or a slight gust of wind, or even 
 drawing the hand along the face, will ex- 
 cite it. The pain is of the most exqui- 
 site and agonizing kind. The duration 
 of each paroxysm is from a quarter to 
 half a minute ; several of them may oc- 
 cur in the course of five minutes, but in 
 general the respite is longer. Women 
 are more frequently attacked than men ; 
 
552 
 
 TIC DOULOUREUX. 
 
 and it most frequently occurs m persons 
 of middle age. 
 
 Causes. The causes are unknown. 
 Mr. Abernethy thinks it a disorder as 
 much constitutional as gout or rheuma- 
 tism. He says, " I have known patients 
 recover either spontaneously, or in con- 
 sequence of remedies which were calcu- 
 lated only to relieve or counteract ner- 
 vous irritability." It is probable, that 
 tic douloureux is sometimes a sympa- 
 thetic affection, and sometimes a primary 
 disease. 
 
 Diagnosis, This affection is distin- 
 guished from rheumatism, by the ex- 
 treme violence of the pain, and by the 
 shortness of its duration, by its being 
 excited by very unlikely causes ; and by 
 the absence of fever. From megrim, it 
 is distinguished, by its following the 
 course of certain nerves almost entirely ; 
 and from toothach, it may be known by 
 the paroxysms being short, and succeed- 
 ing each other rapidly, by the freedom 
 from pain during the interval, and by the 
 pain of tic douloureux being superficial 
 and lancinating, while that of toothach 
 seems to strike deeper. 
 
 Treatment, Many plans have been 
 proposed, and as yet there is none on 
 which we can certainly rely. Frictions 
 with stimulating or anodyne liniments 
 are to be tried in the first instance. The 
 nerve has been divided below the eye, 
 where it passes out through the infra- 
 orbitary hole. Of late it has been thought, 
 that the carbonate of iron is useful in the 
 tic douloureux. It is given in the dose 
 of one drachm three times a-day ; in 
 some cases recorded by Mr. Hutchinson 
 of London, who first employed it, twenty 
 grains were administered every third 
 hour, day and night j and in one instance, 
 it was taken to the extent of seven scru- 
 ples, thrice a.day. Some cases yielded to 
 the carbonate of iron in three or four 
 days ; but others required its use for six 
 months, before any impression was made 
 on the disease. The carbonate of iron, 
 like all other means, sometimes fails; but 
 there are sufficient instances of success to 
 
 warrant our confidence in it as a valuable 
 remedy in this very painful malady. 
 
 TIN is sometimes used for the pur- 
 pose of expelling worms from the intes- 
 tines. It is used in its metallic form, re- 
 duced to a very fine powder. The dose 
 is from one to two drachms, and it is 
 thought to act merely by its mechanical 
 properties disturbing the worms, and by 
 its bulk and roughness carrying them be- 
 fore it. It is now very little used. 
 
 TINCTURE. Certain active ingre- 
 dients, chiefly of various vegetable sub- 
 stances, are imparted to alcohol either 
 entire or diluted, and these spirituous 
 solutions are called tinctures of the sub- 
 stances employed. Thus, a sohition of 
 gum guaiac in alcohol is called tincture 
 of guaiac ,- and opium dissolved in proof 
 spirit is called the tincture of opium. 
 Tinctures are an excellent mode of admi- 
 nistering a great variety of medicines; 
 only we must take care that the spirit 
 have not a contrary effect to that pro- 
 duced by the medicine. Thus we may 
 wish to lessen the action of the system 
 by purging, and perhaps may think of 
 employing the tincture of senna ; but the 
 spirits necessary to form the tincture, 
 may do more harm than we could get 
 good, by the evacuation produced by the 
 senna. 
 
 TINEA CAPITIS. See Scalled 
 Head. 
 
 TO A ST- WATER is water impregnat-. 
 ed with the soluble part of toasted bread, 
 and it agrees frequently with persons 
 whose stomachs do not relish pure water. 
 Hard biscuit reduced by fire to a coffee-^ 
 colour, has been recommended as the best 
 for making toast- water. It should be 
 drank as soon as it has cooled, as it ac" 
 quires an unpleasant flavour by keeping. 
 It has a slightly nutritive quality, and may 
 be allowed in all the feverish and other 
 cases, where diluents are proper. 
 
 TOBACCO, Nicotiana Tabacum. A 
 well known plant, which derives its go-, 
 neric name from Nicot, a French ambas- 
 sador, and its specific name from the island 
 of Tobago, whence it was brought in 15CQ. 
 
 f 
 
TOBACCO. 
 
 55S 
 
 It is at first nauseous and disgusting ; but 
 in one or other of its forms, it has be- 
 come one of the most generally used ar- 
 ticles of luxury, exhibiting a remarkable 
 illustration of the wonderful power of 
 custom, in reconciling us to those things 
 which are at first most disagreeable. To- 
 bacco has fascinated all ranks of men, 
 and the natives of every climate. An 
 English monarch assailed it with a 
 " Counterblast;" but it is now one of the 
 most copious sources of revenue to the 
 governments of Europe. After the deci- 
 sive battle, which terminated the public 
 career of the Great Captain and Legisla- 
 tor of our age, it is amusing to observe 
 how carefully it was stipulated in the 
 treaty with France, that she should sup- 
 ply tobacco to the victors who Avere to 
 occupy her territory. 
 
 The attractions of tobacco seem to be 
 owing to its narcotic properties, by which 
 irritability is soothed, and serenity in- 
 duced, as by opium and some other sub- 
 stances. In large quantities, and in those 
 who are unaccustomed to it, stupor, gid- 
 diness, nausea, and vomiting are pro- 
 duced. Like other narcotics, when much 
 indulged in, it weakens the digestive 
 powers; but candour obliges us to say, 
 that the instances in which it is seen to 
 produce this effect, are much fewer than 
 what we might from theory expect. 
 Thousands of the consumers of tobacco 
 live totally exempt from all dyspeptic 
 symptoms. 
 
 The chewing of tobacco increases the 
 flow of saliva, and the tobacco thus dis- 
 solved in it is pretty copiously swallow- 
 ed. In smoking^ the oil of tobacco is se- 
 parated, and is applied to the fauces and 
 lungs in a very active state. The same 
 slight intoxication is produced by smoking 
 as by the other forms of using tobacco. 
 Smoking is still forbidden in the drawing- 
 room ; but in the form of segars, or the 
 leaf in perfection, rolled up, it is now be- 
 ginning to be used by those who think 
 they have a right to be there. 
 
 Snuff, or the powder of tobacco, is 
 said to have numerous additions made to 
 
 it in the manufacture, which are kept se- 
 cret. When taken into the nostrils, it 
 increases the flow from the mucous mem- 
 brane, and may thus relieve some disor- 
 der of the head. Part of the snuflF usu- 
 ally taken, probably gets down into the 
 stomach, by the back part of the nose and 
 mouth. The violent sneezing which 
 snufF, and other errhines, sometimes oc- 
 casion, may obstruct the return of the ve- 
 nous blood from the head, and so produce 
 inconvenience or danger. 
 
 It has been a subject of popular in- 
 quiry, says Dr. Paris, how far the habit- 
 ual use of snuff may prove beneficial or 
 injurious ; and whether the habit, when 
 once fully established, can be discontinued 
 with impunity? It may be remarked, 
 that snufF, by habitual use, soon ceases to 
 produce the effect of an errhine, or pro- 
 moter of the discharge of fluid from the 
 nose; for which reason, its discontinu- 
 ance cannot generally be regarded as 
 likely to be attended with any danger; 
 in those cases, however, in which the 
 discharge is perpetuated, a contrary judg- 
 ment should be pronounced, for all artifi- 
 cial discharges become constitutional by 
 long continuance, and can therefore be 
 seldom checked with impunity. Dr. 
 CuUen states, from experience, that when- 
 ever the nasal discharge has been consi- 
 derable, the laying aside the custom of 
 taking snuff" has been productive of evil. 
 
 As an article of medicine, tobacco is 
 chiefly remarkable for its nauseating and 
 relaxing effects ; and to obtain tliese ef- 
 fects as a means of reducing the bowels 
 in cases of rupture, tobacco is given in the 
 form of clyster, in the strength of one 
 drachm infused in an English pint ; one 
 half of which is employed at once, very 
 commonly with the effect of producing 
 very great relaxation ; favourable indeed 
 to the reduction of the rupture, but often 
 occasioning very dangerous, and some- 
 times fatal depression of the system, es- 
 pecially if the patient has been wealien- 
 ed by severe suffering. For these rea- 
 sons, tobacco should never be administer- 
 ed for this purpose, except in the pre- 
 
554 
 
 T O N G U E. 
 
 sence, and under the directiou, of an ex- . 
 perienced medical man. 
 
 An oil of tobacco, of a most powerful 
 nature, may be obtained by distilling the 
 leaves, and separating it from the water, 
 on the top of which it floats. The leaves 
 applied to the pit of the stomach as a ca- 
 taplasm, produce vomiting. The pow- 
 der mixed in butter has been used in 
 some skin diseases^ but even applied ex- 
 ternally, has occasioned giddiness, vo- 
 miting, and fainting. The juice of the 
 green leaves instantly cures the stinging 
 of nettles. The smoke has been thrown 
 into the rectum m ith advantage, in iliac 
 passion and hernia; but although the 
 same practice has been advised in the re- 
 covery of the drowned, it is more likely 
 to extinguish life than to restore it. The 
 smoke kills the small Avhite worms within 
 the anus, called ascarides. 
 
 TONICS. Medicines which are 
 thought to increase the tone or strength 
 of the moving powers. The muscles and 
 muscular fibres, as also the blood-vessels, 
 cannot act unless they are in such a state 
 of temper or tone^ as it is technically call- 
 ed, that if cut asunder, the two ends 
 would retract from each other ; and when 
 this tension is wanting, debility ensues. 
 Tonics are those medicines which, by 
 their continued use, restore this healthy 
 state. Some of the most remarkable to- 
 nics, as the vegetable bitters, do good by 
 their influence on the digestive organs, 
 and by sympathy with these, on the whole 
 system. The bitter piiueiple of vege- 
 tables is absolutely necessary for the 
 health of animals which feed on them, 
 as is shown by the debility and death 
 which cattle suffer when confined to food 
 which has not a sufficiency of it. The 
 good effects of some malt liquors oa the 
 human stomach are owing to the bitter 
 contained in them. Tonics are chiefly 
 useful in chronic weaknesses, and in re- 
 coveries from debilitating diseases. The 
 chief of them are, the vegetable bitters, 
 baa-k, and the various preparations of iron. 
 
 TONGUE. The tongue is subject to 
 vajious diseases, as tumours, ulcerations, - 
 
 and affections resembling cancer. Some* 
 times very troublesome ulcerations pro- 
 ceed from ragged or sharp projections of 
 the teeth, and will not heal under any 
 application till the teeth be extracted, 
 or till the irritating parts be filed down. 
 Tumours occasionally arise in the tongue, 
 from the morbid enlargement of some of 
 the nervous papillae ; they are to be re- 
 moved by putting a ligature round their 
 base, or by cutting them out. Sometimes 
 the bleeding, from such operations, is very 
 alarming, and requires to be stopped by 
 the application of a hot iron. In affec- 
 tions of the tongue, which are truly can- 
 cerous, there is no remedy to be depend- 
 ed on, except the complete removal of 
 the part, if practicable. 
 
 The appearance of the tongue gives 
 pretty certain indications of the state 
 and action of the stomach and digestive 
 powers. When it is white and milky, 
 it announces general irritation. Wlien 
 brown or dark-coloured, we judge that 
 there are congestions in the first pas- 
 sages, or that the secretions are vitiated j 
 and when it is unusually bright and 
 shining, it indicates a degree of fever, 
 probably connected with some diseased 
 state of the inner coat of the stomach 
 and intestines. There are some cases 
 where the tongue appears pretty clean, 
 but the skin has not its natural colour 
 and transparency; this generally hap- 
 pens when the secretions have been for 
 a considerable time in an unnatural state. 
 
 TONGUE-TIED. The tongue is fix- 
 ed down to the lower part of the mouth 
 by a membranous cord, which prevents 
 too great a degree of motion. Sometimes 
 the cord ties down the tongue of infants 
 so much that they cannot suck. This is 
 supposed by the common people to be the 
 case much oftener than it really happens ; 
 and they very often request the surgeon 
 to remove the inconveuience ; but so long 
 as the patient sucks, there is no occasion 
 for any operation. But it happens some- 
 times that the tongue is not perceived to 
 be tied till the child begins to articulate, 
 and is prevented from forming cei'tain 
 
TOOTHACII. 
 
 55(5 
 
 letters for which a free motion of the 
 tong-ue is requisite. At whatever time 
 the operation may be necessary, it is easi- 
 ly done with a pair of scissors ; but the 
 surgeon must be careful not to wound any 
 of the neighboiu-ing large vessels. 
 
 TONSILS. Glands situated at the back 
 part of the mouth ; when inflamed, they 
 are the seat of the common inflammatory 
 sore throat. Sometimes the tonsils be- 
 come enlarged, obstructing the breathing, 
 and requiring to be extirpated by a surgi- 
 cal operation, either by the knife or by 
 ligature. In some persons, especially those 
 who are scrofulous, the tonsils are habitu- 
 ally larger than common ; and are apt to 
 swell and be painful on the slightest ex- 
 posure to cold or damp. They should fre- 
 quently use astringent gargles. 
 
 TOOTHACH. A painful aflfection, 
 generally arising in a carious tooth, from 
 the air getting admission to the nerve. 
 The pain is not confined to the tooth 
 where it originates, but extends to other 
 branches of the nerves, and frequently af- 
 fects the whole of one side of the head. 
 Toothach seems to partake of the nature 
 of rheumatism, and it is one of the most 
 annoying and distressful ailments to which 
 we are subject. It commonly arises from 
 cold, or from some sweet or acrid substance 
 getting into a hollow tooth, or from the 
 patient incautiously using the affected 
 side in chewing. 
 
 Expedients for the relief or cure of 
 Toothach. If the disease originates in a 
 hollow tooth, we may put in a bit of solid 
 opium, or a little laudanum, or camphor- 
 ated spirits of wine, upon cotton; or 
 sti'ong spirits. The following may also 
 sometimes be of use : camphor dissolved 
 in nitric acid ; burnt alum in nitrous 
 ether ; essential oil of cloves or thyme ; 
 tobacco steeped in whisky. A blister 
 behind the ear, orscai'ifying the gums, or 
 applying a leech to them, often gives relief 
 in tootliach. If the tooth be not very 
 much decayed, the nerve should be de- 
 stroyed by the application of hot iron ; and 
 the hollow part being filled up with tinfoil, 
 the tooth may long continue serviceable. 
 
 The effectual and permanent cure of 
 toothach consists in pulling out the tooth ; 
 but as it may happen that many are af- 
 fected at the same time, and as it would 
 be inconvenient to part with them all, it 
 becomes necessary to employ blisters, 
 stimulants, and other palliative means, to 
 try if we can relieve the disease without 
 stronger measures. Sometimes toothach 
 is an affection symptomatic of pregnancy ; 
 and in that case we must be very cautious 
 how we advise the extraction of the 
 teeth, as it occasionally happens from the 
 irritable and delicate state of the frame at 
 that time, that miscarriage is the conse- 
 quence of drawing a tooth. 
 
 TOR QUAY is a large village on the 
 coast of Devonshire, situated in a cove of 
 Torbay. The climate of Tor Quay is 
 drier than that of the other places on 
 the south-west coast of England; it 
 is almost entirely free from fogs, and 
 has a pleasant bracing air. Persons 
 intending to confine themselves to the 
 town, and to the cove in which the town 
 and harbour are situate, may lay their 
 account with being as entirely sheltered 
 from all the piercing winds of winter as 
 they can be anywhere. Nervous patients 
 would probably derive much benefit from 
 a residence at Tor Quay. The varied 
 scenery, the opportunities of enjoying 
 boat-exercise and sea-breezes in safety, 
 which is not the case at Sidmouth, the 
 objects of cjiriosity, as well as of natural 
 beauty to be seen in the neighbourhood, 
 and the interest given to the walks along 
 the beach, from the variety of interesting 
 specimens of fossils and ore to be met 
 with at every step, render it a situa- 
 tion very desirable for invalids, for whom 
 change of air and a succession of agree- 
 able objects are recommended as pro^ 
 bable means of cure. In summer, the 
 heat at Tor Quay is generally sup- 
 posed to be intolerable ; but this ob- 
 jection may be obviated by removing 
 from Tor Quay to the village of Tor, 
 about a mile and a half distant, where 
 accommodation may easily be had. For 
 some yours pjist, Dr. Abercrombic has 
 
556 
 
 TRAINING. 
 
 sent several patients, with affections of 
 the chest, to spend the winter at Tor 
 Quay, where there is excellent accom- 
 modation for invalids, and which is easily 
 accessible. The journey is not long- in 
 crossing- the country from Bath or Bris- 
 tol ; and the access by sea from the Chan- 
 nel is easy. He has had much reason to 
 be satisfied ivith the result ; and, he ob- 
 serves, that should farther observation 
 show that the climate of these districts 
 will really bear a comparison with the 
 climates of the south, it is always to be 
 kept in mind that it presents other ad- 
 vantages to the invalid, in which none 
 of them can compare with it for a mo- 
 ment; an easy journey, British accommo- 
 dations and comforts, British society, and 
 British physicians. 
 
 TOUKNIQUET. An instrument for 
 compressing an artery, so as to prevent 
 the flow of blood into it for a time, till 
 some surgical operation is performed, or 
 till other methods are taken to obliterate 
 the artery, if the closing of it is wished to 
 be permanent. It is only to the limbs 
 that the tourniquet can be applied. The 
 first tourniquet proposed was a very sim- 
 ple contrivance: it was the same that 
 carriers employ to tighten the ropes that 
 fasten the goods on their carts. A small 
 pad was placed on the artery which was 
 intended to be compressed, and a band 
 was applied over it so as to encircle the 
 limb twice. A stick was introduced be- 
 tween the two circles of the band and 
 twisted ; thus any degree of compression 
 could be applied to the limb and to the 
 artery. Tourniquets of this description 
 having a pad to press on the ai'tery, are 
 useful in actions by sea and land, for 
 stopping dischai'ges of blood, till more re- 
 gular and deliberate measures can be fol- 
 lowed, for the relief of the wounded. 
 The tourniquet Mas much improved by 
 M. Petit, a French surgeon, who, in the 
 year 1718, presented to the Academy of 
 J^ciences a tourniquet, in which he com- 
 bined the circular band with a screw, so 
 that the greatest pressure is not made on 
 the w hole limb, but on the principal ar- 
 
 tery. In modern times, the tourniquet 
 has been still farther simplified and im- 
 proved. Expert surgeons, when they 
 can procure skilful assistants, prefer their 
 manual aid to the use of the tourniquet. 
 
 Many years ago, Dr. Kellie, by placing 
 the tourniquet over the iliac arteries, for 
 a time altered the distribution of the 
 blood, so as to produce the shortening of 
 the cold stage of intermittent fever. 
 
 TRACHEA. The anatomical name 
 for the M^ind-pipe. 
 
 TRAGACANTH. A sort of gum 
 employed in pharmacy for making pow- 
 ders into troches, and for some other pur- 
 poses. It is not so extensively used as 
 gum arable, though it forms a more tena- 
 cious mucilage. 
 
 TRAINING. Among the nations of 
 antiquity, distinguished by their genius 
 and political sagacity, it was a great ob- 
 ject with their lawgivers and statesmen, 
 to direct the education of youth, so as to 
 produce in them the greatest possible ap- 
 titude for war. To this end, most of 
 their celebrated games were directed ; 
 and the combatants in these, while they 
 afforded to the moral philosopher exam- 
 ples of patriotic and generous emulation, 
 furnished also to the painter and the sta- 
 tuary the finest models of the human 
 form, and to the natural historian some 
 curious results of the effect of external 
 agents, in promoting the growth and ac* 
 tivity of the animal economy. It may be 
 stated in general terms, that tiie efforts of 
 the athletcR were directed to regulate 
 their diet, exercise, and sleep, in such » 
 way as to produce the greatest possible 
 strength of action and power of endur- 
 ance ; and we have the testimony of an 
 inspired writer, that they who were am- 
 bitious of a crown in the Grecian games, 
 " were temperate in all things." In our 
 own country and time, this art of bring- 
 ing up the human constitution to its 
 highest pitch of muscular vigour, and ca- 
 pability of enduring fatigue, pain, and 
 hardship, has been brought almost to a 
 science; and though the ends are far 
 from sublime or virtuous, being principal* 
 
TRAINING. 
 
 557 
 
 ly tliose of prize-fighting, or walking for 
 a wager, the whole process, and its re- 
 sults, present some curious facts in phy- 
 siology. 
 
 It is hardly necessary to say, that a 
 pei-son whose original stamina are feeble 
 or diseased, cannot, by any course of 
 diet or regimen, bring himself up to the 
 athletic standard ; and that the subjects 
 of tiaining must have already some con- 
 siderable degree of health and vigour. 
 At the commencement of a course of 
 training, it is generally thought advis- 
 able to clear the coast for further opera- 
 tions, by an emetic of ipecacuan in pow- 
 der, and by a purgative medicine repeat- 
 ed two or three times in the first week. 
 The Golocynth pills, or two grains of ca- 
 lomel with five of the extract of colocynth, 
 answer very well. The great point is to 
 regulate the diet, and to give such food, 
 as is at once nutritive and easily digesti- 
 ble. As we have repeatedly stated in 
 different parts of this work, animal food 
 is the most nourishing, but requires a due 
 proportion of vegetable aliment, to pre- 
 vent bad effects on the constitution. Beef, 
 mutton, and venison are the most easily 
 digestible kinds of meat; the young of 
 animals, as veal and lamb, and fat oily 
 food, as pork, are deficient either in their 
 powers of nutrition or digestibility. The 
 vegetables to be taken are potatoes, bro- 
 coli, or turnips. Stale bread is preferable 
 to new. Pastry, pies, and puddings are 
 to be avoided, and all the varieties of 
 spices and sauces. Vinegar and salt are 
 the only condiments allowed. The quan- 
 tity of food cannot be specified ; it must 
 vary with the constitution of every in- 
 dividual. 
 
 The drink allowed in training is home- 
 brewed malt liquor, as being nutritive in 
 itself, and assisting digestion by its ve- 
 getable bitter. If wine is taken, it is in 
 moderate quantity, and white is preferred 
 to red. Spirits in any shape, either plain 
 or diluted, are never allowed. 
 
 The most essential particular in the art 
 of training, is to regulate the exercise, 
 and to take plenty of it. Both within 
 
 and without doors, exercise of various 
 kinds must be taken. Walking, riding, 
 fencing, quoits, tennis-ball, the dumb- 
 bells, may all be practised. As long as 
 the perspiration is moderate and not de- 
 bilitating, exercise may be persevered in 
 from four to six hours a-day, with the 
 most decided increase of general health 
 and muscular vigour. Pure air is an es- 
 sential requisite. The noviciate in train- 
 ing is recommended to go to bed early 
 and to sleep from seven to eight hours. 
 
 The above precepts contain the princi- 
 pal means for raising the body to its high- 
 est health and perfection ; and the dili- 
 gent practice of them must, as experience 
 testifies, have the best effects on the ex- 
 pansion and motions of the chest, on the 
 function of digestion, and on all the se- 
 cretions and excretions of the body. The 
 purposes for which training is generally 
 employed, viz. to fit the subject of it for 
 boxing or pedestrianism, naturally cause 
 it to be regarded with disgust by every 
 virtuous and well-regulated mind; and 
 the brutal habits and gladiator-like pro- 
 pensities of the pugilist, are not calcu- 
 lated to recommend his education to those, 
 who have better objects of pursuit than 
 the mere possession of health and strength. 
 Even when the highest health is attained, 
 it is a point at which the constitution 
 will probably not continue ; but by causes 
 apparently very slight it may fall into in- 
 flammatory or other diseases. The strict 
 and regulated exercise and temperance 
 necessary during a course of training, 
 cannot be continued for a very long time ; 
 and for those whose health is an object, 
 not for its own sake, but as the means of 
 duty and usefulness, the advice of Celsus 
 is very judicious. He recommends a 
 person in health to bind himself by no 
 rules, but to be independent altogether 
 of the regular physician, and the anointer 
 of the body with oil. Such a one should 
 be sometimes in the city, sometimes ia 
 the country; should vary his exercises, 
 and use all kinds of food ; should some- 
 times abridge his diet, and sometimes 
 enlarge it ; and thius, in the ever-chang* 
 
558 
 
 TREPHINE. 
 
 ing- circumstances of humanity, he is 
 fitted for bearing" whatever inconveni- 
 ences external accidents may brinj^ upon 
 him. This is certainly far better than 
 li\ang in a balance like Sanctorius, or 
 cutting- our mutton into triangles like the 
 philosophers of Laputa ; and we may say 
 on this, as on every other occasion, 
 
 Nunquam aliud Natura, aliud Sapientia dixit. 
 
 TREPHINE OR TREPAN. An in- 
 strument used in surgery to remove a 
 portion of the skull. " It consists of a 
 simple cylindrical saw, with a handle 
 placed transversely like that of a gimb- 
 let; and from the centre of the circle 
 which the teeth of the saw describe, a 
 sharp little perforator projects, named 
 the centre-pin. Its use is to fix the tre- 
 phine, when it is first applied ; that is, 
 before the teeth of the instrument have 
 made a sufficient circular grove, in which 
 they can steadily work. When this has 
 been accomplished, the centre-pin must 
 always be removed ; because, if left, it 
 would now retard the operation, and 
 wound the brain and its membrane, when 
 the teeth of the saw had cut to a certain 
 depth through the skulk" (Cooper's 
 Surgical Dictionarif). 
 
 By removing a portion of the skull by 
 means of the trephine, an outlet is afford- 
 ed for blood or matter effused within the 
 skull, and lying upon the membrane of 
 the brain. By this operation, we also get 
 a fulcrum for our elevator, when it is ne- 
 cessary to raise any depressed portion of 
 bone, which is driven in upon the brain. 
 After the operation is completed, the flfjps 
 of the scalp are to be laid down, and the 
 whole is to be covered with a little lint, 
 spread with simple ointment. The dress- 
 ings should be very light, and the ban- 
 dages should make no injurious pressure. 
 We must be on our guard against the com- 
 ing on of inflammation, and must prevent 
 it by using purgatives and antimonials ; 
 or employing blood-letting, if necessary. 
 
 TROCAR. The name of a surgical 
 instrument having three sides and a sharp 
 point, used for perforating. 
 
 TROCHES, and lozenges are com- 
 posed of powders made up vrith. glutin- 
 ous substances into little cakes, and after- 
 wards dried. This form is principally 
 made use of for the more commodious 
 exhibition of certain medicines, by fitting 
 them to dissolve slowly in the mouth, so 
 as to pass by degi'ees into the stomach, 
 or to act upon the pharynx and top of the 
 trachea ; and hence these preparations 
 have generally a considerable proportion 
 of sugar, or other materials grateful to 
 the palate. The lozenges of the confec- 
 tioner are so superior in elegance to 
 those of the apothecary, that they are al- 
 most universally preferred. (Dr. Dun- 
 can's Edinburgh hispensatory). 
 
 TRUSS. An apparatus or bandage, 
 with a spring or other contrivance, to 
 press upon the openings where a rupture 
 appears, and so keep it from coming 
 down. Trusses are of great utility when 
 they are properly fitted, and when they 
 do not press where they ought not. 
 Many persons pass through a long life 
 without any inconvenience, M'ho, but for 
 the aid of a truss, would in all probabili- 
 ty have been afflicted with irreducible or 
 strangulated hernia. Trusses must be 
 fitted by the artist to the shape of the 
 person who is to wear them, and accord- 
 ing to the place which is to be guarded. 
 Even children, when they are not very 
 young, may be made to wear them. See 
 Rupture, j9a^6 477. 
 
 TUBERCLE. A smaU swelling which 
 occurs in various parts of the body. The 
 nature and formation of tubercles is not 
 well understood. The most noted are 
 those which are found in the substance 
 of the lungs. See Consumption, page 
 146. 
 
 TUMOURS, swellings of various 
 kinds. See Wen, and Swellings. 
 
 TUNBRIDGE WATER. A chaly- 
 beate water found at Tunbridge in Kent. 
 Its general operation is to increase the 
 secretions in a gradual uniform manner, 
 and to impart tone to the system. It is 
 serviceable in complaints accompanied by 
 indigestion and flatulence ; and in the vari- 
 
T U U P E N T I N E. 
 
 5o9 
 
 ous complaints of debility incident to the 
 female sex. On the first use of the wa- 
 ter, there sometimes occui-s flushing of 
 the face, drowsiness, and an uneasy dis- 
 tension of the stomach. Thesfr effects 
 .ire to be prevented by previous atten- 
 tion to the state of tlie stomach and 
 bowels. Active exercise should be taken 
 immediately after the water, as this occa- 
 sions a general glow of warmth, pre- 
 vents it from oppressing the stomach, 
 and also tends to produce its rapid ab- 
 sorption, and promote its good effects. 
 The bowels generally become bound, and 
 require the assistance of medicine. Such 
 medicine is best taken in pills, at bed- 
 time, as those of aloes with myrrh or co- 
 locynth. Tunbridge water is taken at 
 two or three times, beginning at eight 
 o'clock in the morning, and ending at 
 noon ; the dose each time is from half a 
 pint to three quarters, varying according 
 to the age, sex, and constitution of the 
 patient, and according to the length of 
 time during which the waters have been 
 drank ; as, like many other things, their 
 efficacy is diminished by use. The ex- 
 ternal use of the Tunbridge water is re- 
 commended in various cutaneous dis- 
 eases, especially those of a scaly kind, 
 and which are connected with disorders 
 of the stomach and digestion; The most 
 favourable period of the year for visiting 
 Tunbndge Wells is from May to No- 
 vember. 
 
 TURMERIC, Curcuma longa, the 
 plant from which curry powder is obtain- 
 ed. It is now disused in medicine. 
 
 TURNIPS, Brassica rapa. A well 
 kno>yn and useful esculent root ; forming 
 an agreeable article of diet, to be taken 
 along with animal food, and furnishing 
 to invalids an excellent mild nourishment, 
 when there is nothing in the state of the 
 stomach and bowels to forbid vegetable 
 diet. Turnips should be well boiled, and 
 have the water pressed out of them. 
 
 TURPENTINE. A liquid resinous 
 substance, obtained from various species 
 of the pine tribe. The oil of turpentl^ 
 is obtained by distilling turpentine, when 
 
 this volatile oil rises. The oil of turpen- 
 tine has of late been successfully used for 
 expelling the tape-worm. The dose is 
 from an ounce to an ounce and a half; 
 it has even been given to the extent of 
 four ounces at once, without any percep- 
 tible bad effects, or more inconvenience 
 than would follow from an equal quanti- 
 ty of gin. It generally acts as a speedy 
 purgative, and discharges the worm, in all 
 cases dead. In obstinate constipation, it 
 is of singular benefit. In inflammation 
 of the bovrels, colic, and various spasmo- 
 dic affections of the viscera of the abdo- 
 men, oil of turpentine has been given with 
 excellent effect, both by the mouth and 
 by way of clyster. Turpentine is given 
 in affections of the urinary organs, in 
 doses of from ten drops to a drachm. Oil 
 of turpentine is applied exteraally either 
 alone or mixed with olive oil, to indolent 
 tumours and paralytic limbs. It is appli- 
 ed also as a styptic to stop bleeding ; and 
 some practitioners use it in burns and 
 scalds, which last use we are certainly 
 not inclined to recommend. In cases of 
 deafness from deficiency of wax, a portion 
 of a mixture, made by adding ten drops 
 of turpentine to an ounce of almond oil, 
 may be introduced into the ear upon a 
 little cotton. 
 
 TUTTY. The oxide of zinc, a dry 
 powder, used to prevent excoriation in 
 children, at the folds where siu^aces are 
 apt to come in contact, as the groin, the 
 arm-pits, behind the ears, &c. 
 
 TYMPANY. A swelling of the abdo- 
 men, occasioned by wind in the intes- 
 tines, or in the cavity of the belly. In- 
 testinal tympany is supposed to arise from 
 the sudden suppression of diaiThoea or 
 dysentery, from the striking in of cutane- 
 ous diseases, and from the use of vegeta- 
 ble aliment occasioning flatulence. It 
 sometimes comes on suddenly, at other 
 times insidiously; and is preceded by 
 rumbling in the bowels, and dischai-ges of 
 wind upwards and do^vnwards ; it is ge- 
 nerally attended with colic pains. The 
 belly retains its figure under eveiy change 
 of poMnre; and the swelling docs not 
 
560 
 
 TYMPANY. 
 
 yield much to pressure. In the advanced 
 stage of the disease, there is sometimes 
 suppression of u^ne, and sometimes re- 
 tention of it. The body is generally cos- 
 tive, the appetite impaired ; and heat, 
 thirst, and other febrile symptoms attend. 
 At length the breathing becomes difficult, 
 the strength is exhausted, the belly very 
 much distended, and the patient is earn- 
 ed oft' by mortification supervening. 
 
 Treatment. We are to attempt to pro- 
 cure the discharge of wind from the in- 
 testines, by giving carminative medicines, 
 as the oil of anise or of peppermint, or 
 powdered cinnamon with camphor, and 
 employing clysters with assafcetida and 
 the oil of caraway. Purgative medicines 
 are to be given, always adding some- 
 thing which will have the tendency to 
 expel wind. If we do not succeed in 
 getting the bowels opened, and wind dis- 
 charged, and if there be heat, thirst, and 
 
 threatening of fever, we must have re- 
 course to bleeding, in order to prevent 
 inflammatory symptoms. To renew the 
 healthy peristaltic motion of the bowels, 
 which is suspended in tympany, cold has 
 been applied externally, and in some in- 
 stances with good effect. If we succeed 
 in removing the disorder, the patient 
 must be very cautious afterwards not to 
 use flatulent and indigestible food. 
 
 Tympany of the cavity of the belly 
 commonly arises from some erosion of 
 the intestines, allowing the escape of air 
 from them into the general cavity, and is 
 to be considered as a hopeless case. 
 
 TYPE. The character or distinctive 
 circumstances of certain diseases, as of 
 fevers and agues. Thus we speak of a 
 fever being of ffhe intermittent, remittent, 
 or continued type^ 
 
 TYPHUS. One of the names of con- 
 tinued fever. See Fever. 
 
 u 
 
 ULC 
 
 ULCER. A chasm or vacancy form- 
 ed on the surface of a part, whether ex- 
 ternal or internal, by the absorbent ves- 
 sels removing parts back into the system. 
 Ulceration takes place more readily in 
 the cellular and fatty substance, than in 
 muscles, tendons, blood-vessels, and 
 nerves. There are many vai-ieties of 
 ulcers, requiring a corresponding variety 
 of treatment. 
 
 Simple Purulent Ulcer. Some ul- 
 cers are covered with matter of a white 
 colour, of a thick consistence, and which 
 readily separates from the surface of the 
 sore. There is a number of little emi- 
 nences called granulations, which are 
 small, florid, and pointed at the top. As 
 soon as they have risen to the level of 
 the surrounding skin, those next the old 
 skin become smooth, and are covered with 
 a thin film, which afterwards becomes 
 opaque, and forms skin. The principal 
 
 ULC 
 
 thing to be done in the treatment of this 
 kind of ulcer, is to keep the surface clean, 
 by putting on a little dry lint, and a pled- 
 get over it, covered with very simple 
 ointment. In some patients, ointment 
 irritates and inflames the neighbouring 
 skin. Bandages sometimes irritate the 
 sore, and disturb the healing process; 
 but when they do not, they are useful in 
 giving a moderate support to the parts, 
 and in defending those that are newly 
 formed. 
 
 Ulcers m Weakened Parts. Other ul- 
 cers are in parts which are too weak to 
 carry on the actions necessary to their 
 recovery. In them, the granulations are 
 larger, more round, and less compact than 
 those formed on ulcers in healthy parts. 
 When they have come up to the level of 
 the healthy parts, they do not readily 
 form skin, but rising still higher, lose al- 
 together the power of forming it. When 
 
ULCERS. 
 
 561 
 
 the parts are still weaker, the granula- 
 tions sometimes fill up the hollow of the 
 ulcer, and then are suddenly absorbed, 
 leaving the sore as deep as ever. Ulcers 
 are very much under the influence of 
 whatever affects the constitution; and 
 change of weather, emotions of the mind, 
 and some other agents, quickly occa- 
 sion a change in their condition. Such 
 ulcers as we have been describing, re- 
 quire general as well as local treatment; 
 bark, wine, porter, and other cordials and 
 tonics are to be given ; and the granula- 
 tions are to be kept from rising too much, 
 by the prudent application of blue vitriol, 
 lunar caustic, and the like, weakened suf- 
 ciently by proper admixture of ointment 
 to act as stimulants, and not as caustics. 
 This will give a proper and healthy action 
 to the granulating surface; whereas the de- 
 stroying of the rising parts by escharotics 
 seems rather to encourage the growth. 
 Bandages and proper support to the parts, 
 are highly useful. These ulcers, in weak 
 parts, do not seem to be the better of 
 poultices, or other relaxing applications ; 
 powders rarely do good, and perhaps the 
 best dressing is the citrine ointment, more 
 or less diluted. 
 
 Irritable Ulcers. There are certain 
 ulcers, which may be called Irritable Ul- 
 cers. The margin of the surrounding 
 skin is jagged, and terminating in an edge 
 which is sharp and undermined. There 
 is no distinct appearance of granulations, 
 but a whitish spongy substance, covered 
 with a thin ichorous discharge. Every 
 thing that touches the surface gives pain, 
 and commonly makes the ulcer bleed. 
 The pain sometimes comes on in pa- 
 roxysms, and causes convulsive motions 
 of the limb. Such ulcers seldom do well, 
 without a frequent change of treatment. 
 Fomentations with poppy heads, chamo- 
 mile flowers, or hemlock leaves, are some- 
 times of use in irritable ulcers. When 
 poultices are prescribed, they should ne- 
 ver be allowed to rest or bear weight on 
 the sore limb. Powdered applications 
 are generally too stimulating for irritable 
 ulcers, and bandages also prove hurtful. 
 
 Indolent Ulcers are those which have 
 the edges of the surrounding skin thick, 
 prominent, smooth, and rounded. The 
 surface of the granulations is smooth 
 and glossy ; the matter is thin and wa- 
 tery, and the bottom of the ulcer is near- 
 ly level. A great proportion of the ul- 
 cers in hospitals are of the most indolent 
 kind. Indolent ulcers form granulations, 
 but frequently they are all of a sudden 
 absorbed, and in four and twenty hours, 
 the sore becomes as much increased in 
 size as it had been diminished for many 
 weeks. The principal applications re- 
 quired for indolent ulcers are those of a 
 stimulating nature, as the basilicon oint- 
 ment, and occasional sprinkling with red 
 precipitate. Pressure is to be made by a 
 roller, and by slips of adhesive plaster. 
 Scrofulous, syphilitic, and cancerous ul- 
 cers are to be treated according to the 
 methods laid down under these various 
 diseases. 
 
 UPAS, the famous poison of Java, con- 
 cerning which, and the wide-spreading 
 desolation of the tree that produces it, 
 so many fabulous stories have been re- 
 ported. " The Strychnos Tieute, is the 
 plant which yields the Upas Tieute, one of 
 the Javanese poisons. It has been ana- 
 lysed and found to contain strychnia, and 
 to be almost as energetic as strychnia it- 
 self. Dr. Darwin has given an account 
 of its effects on the Javanese criminals, 
 who used formerly to be executed by 
 darts poisoned with the Tieute. I believe 
 the account is not very authentic ; yet it 
 accords precisely with what would be 
 expected from the known properties of 
 the poison. He says, that a few minutes 
 after the criminals are wounded with the 
 instrument of the executioner, they 
 tremble violently, utter piercing cries, 
 and perish amidst frightful convulsions, 
 in ten or fifteen minutes." (Christison 
 on Poisons). 
 
 The Upas Antiar is another Javanese 
 poison, ar bitter milky juice, which acts 
 violently on the heart. In small doses it 
 acts as an irritant; in large ones, it causes 
 convulsions and coma. 
 2 o 
 
562 
 
 URETHRA. 
 
 URETER. The tube or canal which 
 conveys the urine into the bladder, after 
 it has been fonned in the kidney. There 
 is one on each side, and they enter the 
 bladder at its lower part. By their per- 
 forating- the coats of that receptacle ob- 
 liquely, the effect of a valve is produced, 
 and though the bladder is full, there is no 
 flowing back of the urine. A stone pass- 
 ing' throug^h this canal, if too large, gives 
 great pain, and general uneasiness, pro- 
 ducing- what is called a fit of the gravel. 
 See Stone and Gravel. . 
 
 URETHRA. The membranous canal 
 continuous to the neck of the bladder, by 
 which the urine is evacuated from the 
 body. It is very short in women. In 
 men, it passes through the prostate gland 
 which surrounds the neck of the bladder; 
 there are openings into it from the pros- 
 tate gland, and the receptacles of the 
 seminal fluid. The passage is lined with 
 a smooth and sensible membrane. 
 
 The urethra is liable to various dis- 
 eases. It is affected with pain and scald- 
 ing diu-ing the acute stage of gonorrhoea ; 
 and there is a considerable discharge of 
 thick yellow matter from it. This, in 
 many cases, afterwards degenerates into 
 gleet, which is best removed by astrin- 
 gent injections. See Clap. 
 
 Strictures in the Urethra. These 
 are of three kinds. 1. That which arises 
 from an alteration of the structure of the 
 passage. 2. That arising partly from al- 
 tered structure, partly from spasm. 3. 
 That arising from spasm. In all these 
 cases, the stream of water becomes small, 
 in proportion to the obstruction. As the 
 disease advances, the urine is voided more 
 frequently, with considerable effort, with 
 pain, and a straining sensation after the 
 bladder is emptied. Cold is very apt to 
 increase the symptoms which occur when 
 a part is strictured, and to obstruct the 
 flow of urine altogether for a time. If 
 the stricture be not relieved, a swelling 
 may take place from the lodging of the 
 water behind it ; and this, by the pres- 
 sure and acrimony, may give rise to in- 
 flammation and ulceration, and the for- 
 
 mation of fistulous openings in the peri- 
 neum. 
 
 Treatment. Various methods have 
 been proposed for the cure of strictures. 
 The one most proper to begin with is to 
 attempt to dilate the passage by the in- 
 sertion of bougies, or cylindrical waxed 
 rolls of linen, beginning with one of a 
 small size, and gradually coming to use 
 one of a larger size. These bougies 
 either dilate the stricture, or make it ul- 
 cerate. Their use must be persevered in 
 for a considerable time. But it may hap- 
 pen that the urethra is contracted at dif- 
 ferent parts of the passage, in which case 
 the cure is of course more difficult and 
 uncertain. Another method of destroy- 
 ing strictures has been, to introduce a 
 small portion of some kind of caustic, in 
 order to act as an escharotic. Differ- 
 ent caustics have been proposed, but none 
 of them should be employed except un- 
 der the superintendence of a skilful sur- 
 geon. In the pain of passing water which 
 accompanies stricture, as well as some 
 other affections of the urinary organs, the 
 tincture of muriate of iron, given in doses 
 of ten drops every ten minutes, till some 
 sensible effect is produced, has seemed 
 to act as a specific. 
 
 A stone sticking in the Urethra is at- 
 tended with very painful symptoms ; in- 
 flammation, swelling, and a suppression 
 of urine, more or less complete. If the 
 stone does not pass, or if it is not ex- 
 tracted, there is ulceration of the ure- 
 thra, the urine escapes into the cellular 
 substance, and great swelling or gan- 
 grene of the parts may be the conse- 
 quence. The removal of a stone from 
 the urethra is to be attempted by re- 
 laxing the parts, and the whole body, by 
 the use of the warm bath, or by general 
 or topical bleeding, and by opium applied 
 externally, or taken by the mouth. In 
 this way, a stone may be sometimes 
 made to pass, when aided by skilful pres- 
 sure from behind. If these methods do 
 not succeed, it is necessary to cut down 
 upon the stone, and so remove it. The 
 female urethra is very dilatable, and large 
 
U R I N A 11 Y C A L e U L I. 
 
 563 
 
 stones have been known to be broug^ht 
 throuofh it. 
 
 URINARY CALCULI. In page 525, 
 we have given a detail of the symptoms 
 and treatment of stone and gravel. The 
 examination of urinary calculi out of the 
 body, belongs to the chemist; and as a 
 short notice of their composition may be 
 iiiteresting', we extract the following from 
 Dr. Fyfe's recent work on Chemistry : — 
 " The calculi found ij the human urinary 
 bladder, are very various in their compo- 
 sition. They have occupied the attention 
 of chemists and physicians since the ear- 
 liest times ; and numerous opinions have 
 been thrown out concerning their nature ; 
 all of ^^'hich, ho^^^ever, M'^ere vague and 
 unsatisfactory till Scheele undertook the 
 investigation of them. The best accounts 
 yet published are by Wollaston and Mar- 
 cet. The classification of Wollaston, 
 though perhaps rather simple, is, with a 
 slight addition, sufficiently minute, at 
 least in a medical point of view. 1. Uric 
 acid calculi are of a brown colour, simi- 
 lar to that of recently sawn fir-wood. 
 They are in general smooth, but occa- 
 sionally rough. They have a fibrous and 
 radiated texture, are round, sometimes 
 compressed or elongated. When heated, 
 they give out the odour of ammonia, and 
 of burning animal matter. They are in- 
 soluble in cold, but soluble in hot wa- 
 ter. They are soluble in caustic alkaline 
 solutions. The red sand or gravel passed 
 along with urine is of the same composi- 
 tion, being merely the uric acid thrown 
 down by some excess of acid generated in 
 the system. 2. Phosphate of lime, or 
 hone-earth calculus^ When calculi are 
 composed entirely of phosphate of lime, 
 they have a smooth surface, are of a pale 
 brown colour, and formed of lamina; 
 slightly adhering. When exposed to the 
 blow-pipe, they at first blacken, from the 
 destruction of the animal matter; but 
 soon become white, and if the heat is in- 
 tense, are fused. Thoy are soluble in di- 
 luted nitric and muriatic acid. 3. Phos- 
 phate of magnesia and ammonia, or triple 
 calculus. Calculi very rarely occur com- 
 
 posed entirely of triple phospliate. It in 
 general surrounds those of uric acid, or it 
 is in alternate layers with phosphate of 
 lime. It is easily cut with a saw. It is 
 soluble in acid, even though much dilut' 
 ed. 4. Oxalate of lime, or mulberry cal- 
 culus. This is distinguished from the 
 others, by its colour and surface being ex- 
 ternally dark brown, internally light 
 brown, and composed of concentric layers. 
 It is very rough in appearance, resem- 
 bling the fruit of a mulberry ; and it is 
 sawed with great difficulty. Mulberry 
 calculi occasion the most painful symp- 
 toms ; but happily they are by no means 
 so frequent as the other kinds. 5. Cal- 
 culi of carbonate of lime have been met 
 with very rarely. They are generally 
 white, and easily broken. In some cases, 
 however, they had the appearance of 
 mulberry calculi. 6. Cystic oxide calculi 
 are composed of a peculiar substance, dis- 
 covered by Wollaston. They are of a 
 pale yellowish colour, with considerable 
 lustre, and a certain degree of transpa- 
 rency. They differ from the preceding 
 in not being composed of layers, but of a 
 uniform compact structure throughout. 
 They are insoluble in water and in alco- 
 hol ; but easily dissolved by the mineral 
 acids, by the alkalis, and lime-water. 
 7. Two other calculi have been discover- 
 ed by Dr. Marcet. One was of a reddish 
 colour, soluble in alkalis and in acids; 
 the solution in nitric acid leaving on eva- 
 poration a bright yellow stain on the 
 glass ; and hence he has proposed to call 
 it xonthic oxide, from a Greek word sig- 
 nifying yellow. The other was found to 
 possess the properties of fibrine ; and he 
 has, therefore, proposed that it should be 
 called ^^rmo?/5 calculus.^* 
 
 Though urinary calculi have been ar- 
 ranged into a few different classes, yet the 
 varieties presented must be numerous, 
 since a change of diet and other circum- 
 stances alter the deposit from urine. 
 Thus, when there is in the system a 
 tendency to the formation of uric acid, 
 the calculus is composed of it; but if 
 this be checked, the separation of the 
 
564 
 
 URINE. 
 
 earthy phosphates commences, and the 
 concretion will become covered with 
 them. When the tendency to the depo- 
 sition of the phosphates ceases, uric acid 
 may be deposited, so that the calculus 
 may thus consist of layers of different in- 
 gredients. 
 
 URINE. The fluid secreted by the 
 kidneys, for the purpose of being- thrown 
 out of the body. It contains a great 
 many different salts, which have been 
 very carefully examined by chemists. 
 The principal of these are, urea, uric 
 acid, salts of soda, of ammonia, lactic 
 acid, &c. The purpose of the secretion 
 and excretion of urine is to separate from 
 the blood certain principles which, if re- 
 tained in the body, would be hurtful j 
 and to carry off certain portions of the 
 aliments, which cannot be assimilated 
 with the blood. In the urine, chemists 
 can trace certain substances which exist 
 in the blood, viz. water, lactic acid, and 
 its accompanying- animal matters, the 
 fixed alkalis, and lime. They also find 
 in the urine certain substances formed by 
 the acidifying action of the kidneys on 
 some parts of the blood; the sulphuric 
 and phosphoric acids, urea, and uric acid. 
 Sometimes, from disease, the kidneys 
 form too much acid, as the nitric and 
 oxalic acids ; or their acidifying power is 
 superseded, and they allow to pass un- 
 changed, albumen, blood, sugar, or am- 
 monia. Where acids are generated in 
 excess, the disease is commonly of the 
 inflammatory kind, and the urine is small 
 in quantity, and high-coloured; but in 
 diseases of debility and irritation, or hys- 
 teria, the urine is pale-coloured, and large 
 in quantity. The state of the digestive 
 functions has a remarkable effect on the 
 character of the urine. Much valuable 
 information will be obtained in dyspeptic 
 cases, by a careful examination of the 
 urine, both with respect to the seat of 
 the disease, and the operation of reme- 
 dies ; indeed, in the diseased state, very 
 slight changes in diet will produce cor- 
 responding effects on the urine. When 
 uric acid is deposited from the urine in a 
 
 crystallized state, it is generally uncom- 
 bined ; but when it is deposited without 
 any regularity of form, it is frequently 
 combined with ammonia. There is uric 
 acid in all urine ; but in the healthy state, 
 it is kept in solution at all temperatures ; 
 but when it is in excess, it subsides as 
 the urine cools. This precipitation shows 
 a derangement of the digestive functions ; 
 very slight errors in diet will occasion it 
 in delicate constitutions. Sometimes in 
 the urine, there is so much albumen that 
 it coagulates on the application of heat. 
 This is the case in certain kinds of drop- 
 sy, and in them there is a tendency to in- 
 flammatory action somewhere in the sys- 
 tem ; for the counteracting of which, 
 bleeding will be necessary; contrary to 
 the common species of dropsy, which is 
 generally a disease of debility. The 
 urine is sometimes in enormous quantity, 
 and of a sweet taste, yielding great quan- 
 tities of sugar by evaporation. This state 
 constitutes the disease called diabetes. 
 See Diabetes. 
 
 Urine, Bloody, Hematuria. Voiding 
 of blood along with the urine may be 
 occasioned by external violence, as blows 
 or bruises; or may be the consequence of 
 violent exercise, as in riding, or jumping ; 
 or it may be occasioned by the irritation 
 of a stone in the kidney or bladder ; it 
 may also take place without any cause 
 that we may be able to assign. In some 
 cases, the quantity of blood lost is very 
 large indeed, and the debility induced is 
 of the most alarming kind. In the treat- 
 ment of the disease, we are to be guided 
 by the cause. When it is occasioned by 
 external violence, we are to diminish in- 
 flammatory symptoms by general or topi- 
 cal bleedings, by giving mild purgatives, 
 and directing the patient to drink largely 
 of diluent liquors, to which a little nitre 
 may be added, in order to dilute the con- 
 tents of the bladder. If the symptoms 
 lead us to believe that stone or a gravel- 
 ish complaint is the cause of the disease, 
 the primary affection must be attended to, 
 for the treatment of which, see Stone and 
 Gravel, The spontaneous voiding of 
 
URINE. 
 
 565 
 
 blood is to be checked by the application 
 of cold to the region of the bladder, and 
 even by injecting- cold water into the 
 rectum. Small doses of opium may be 
 given to allay irritation ; and acids are 
 to be employed with a view to their re- 
 frigerant effect. When blood is discharged 
 by urine, mixed with purulent matter, 
 twenty grains of the powder of the whor- 
 tleberry may be given three time* a-day. 
 Urine, Incontinence of, signifies the 
 flowing out of the urine without the pa- 
 tient being able to prevent it. This may 
 arise from weakness induced by various 
 causes, as old age, palsy, the abuse of acid- 
 ulous mineral waters, hysterical and epi- 
 leptic paroxysms, injuries of the head, 
 and comatose diseases. The cure in this 
 case is to be attempted by tonics given 
 internally, and by cold applications to the 
 parts. The tincture of cantharides may 
 be given, in the dose at first of ten drops 
 twice arday, gradually increasing it, till 
 some pain is felt at the neck of the blad- 
 der. A blister applied to the perineum, 
 or to the lower part of the back, is often 
 very serviceable. 
 
 Incontinence of urine may also arise 
 from irritation, as that produced by a 
 stone in the bladder, by the pressure of 
 the child's head in the latter months of 
 pregnancy, or from hardness and enlarge- 
 ment of the prostate gland. The remov- 
 al of this diseased state must depend on 
 its causes. When it arises from pregnancy, 
 it will go off upon delivery ; but when it 
 is from stone in the bladder, nothing will 
 do good but the extraction of the stone. 
 In schirrus of the prostate, the cure is 
 probably impossible. Relief may occa- 
 sionally be given by mucilaginous or 
 opiate medicines; or other narcotics, as 
 hemlock, especially when given in clyster. 
 When no relief can be obtained, contriv- 
 ances must be made to prevent the con- 
 stant discharge of urine, and to protect 
 the neighbouring parts from being 
 scalded. 
 
 Urine, Retention of. There are two 
 different states of disease in which the 
 urine is not passed as usual ; either when 
 
 it is not secreted in the kidneys ; or when, 
 although secreted in those organs, and 
 conveyed into the bladder, it is not dis- 
 charged from that cavity. It is this last 
 aflFection that is denoted by Retention of 
 Urine. The distinguishing symptom is a 
 swelling at the lower part of the belly, 
 occasioned by the distended bladder, and 
 this accompanied by pain on pressure, fe- 
 ver, and deficiency of urine, either total 
 or partial. Sometimes, the bladder may 
 be distended although there be a partial 
 flow of urine, and without great care the 
 practitioner may be deceived by this cir- 
 cumstance. If violent efforts take place, 
 some portions of urine may be expelled, 
 and the patient may be supposed merely 
 to labour under a strangury. By exami- 
 nation of the lower belly, and the intro- 
 duction of the catheter, the disease may 
 almost always be ascertained. Retention 
 of the urine may arise from palsy of the 
 bladder, which is not an unusual occur- 
 rence in advanced life. Palsy of the 
 bladder may be owing to a person not 
 evacuating the bladder when nature 
 prompts him to do so. Retention of 
 urine occurs also in bad typhus fevers. 
 It comes on sometimes gradually, with a 
 degree of debility which hinders the pa- 
 tient from completely emptying the blad- 
 der, so that he still feels a desire to do so. 
 The inconvenience increases ; at length, 
 the patient is unable to discharge any 
 urine, and the bladder rises above the 
 pubes. The urjne is to be drawn off by 
 the catheter, and when this relief is giv- 
 en, it is not unusual for the bladder to re- 
 cover its tone ; pretty speedily, when the 
 complaint has come suddenly on, and 
 more gradually, when it has been gradual 
 in its progress. In addition to the regu- 
 lar emptying of the bladder, we are to 
 try the effect of cold applications to the 
 parts, with the internal use of cantharides, 
 and of blisters to the sacrum. The urine 
 may be retained by inflammation of the 
 neck of the bladder. Hpre the symptoms 
 are acute and urgent, and demand the 
 employment of the antiphlogistic regi- 
 men ; bleeding, general ^nd local, clysters 
 
566 
 
 U V U L A. 
 
 emollient drinks and anodynes, with the 
 introduction of the catheter; and if the 
 urine is not drawn off by it, we must 
 puncture the bladder. For the method 
 of doing this we refer to books of surgery. 
 
 Urine, Suppression of . This signifies, 
 that the kidneys do not secrete the urine 
 in the same quantities as formerly. The 
 remedies adapted to this complaint, when 
 it is an original one, are diuretics, as 
 cream of tartar, the sweet spirit of nitre, 
 squill, &c. If the suppression of urine 
 arises from fever or other complaints ; 
 our attention is to be directed to the 
 primary disease, as well as to that parti- 
 cular symptom. 
 
 Urine, Sweet. See Diabetes. 
 
 UTERUS, the womb. The organ in 
 which the embryo is contained and 
 nourished, till the time when it is brought 
 forth, and is able to live, in some mea- 
 sure, independently of the mother. See 
 Womb, and its Diseases. 
 
 UVA URSI. ,966 WlIORTLEBERUV. 
 
 UVULA, the projection seen at the 
 back part of the mouth, commonly called 
 the pap of the throat. From the middle 
 of the soft palate, the uvula hangs down 
 into the throat, acting as a valve, by 
 means of whose different actions we can 
 breathe either through the mouth or the 
 nose. It is of an irregular conical shapa, 
 and in part apparently glandular. It is 
 sometimes awanting, sometimes double or 
 cleft. It is liable to be inflamed and re- 
 laxed, occasioning a troublesome cough 
 by its length, irritating the upper part of 
 the wind-pipe; or a vomiting when it 
 lies back on the gullet. It is sometimes 
 swelled, apparently from a scrofulous ha- 
 bit. In inflammation, and relaxation, the 
 strongest astringents are occasionally ne- 
 cessary ; but if they fail, the uvula may be 
 punctured ; and a part or the whole may 
 require to be removed. It is sometimes 
 lost by syphilitic diseases. 
 
 V 
 
 VAL 
 
 VACCINATION. See Cow-Pox. 
 
 VAGINA. The birth, or passage to 
 the womb. 
 
 VALERIAN. Valeriana sylvestris. 
 The root of the wild valerian is cele- 
 brated as an antispasmodic and tonic re- 
 medy, and as such is used in various 
 nervous and hysterical affections. It 
 is given in powder to the extent of 
 twenty or thirty grains, but it is more 
 advisable to give it in infusion or decoc- 
 tion ; or, as it is kept in the shops, in the 
 form of the volatile tincture, in which 
 the valerian is combined with ammonia. 
 The odour of valerian is particularly at- 
 tractive to cats. 
 
 VALVES. Certain doublings of the 
 lining of vessels and cavities, intended to 
 act so as to prevent the passage of a fluid 
 one way, while it is free in the opposite 
 
 VEG 
 
 direction. They are chiefly found in the 
 course of the veins of the extremities, 
 where the free course of the blood would 
 be impeded by the various motions of the 
 body ; and at the commencement of the 
 great arteries of the lungs and of the sys- 
 tem, where it is necessary to prevent the 
 blood from regurgitating back to the 
 heart. 
 
 VAPOUR BATH. See Bath. 
 
 VEAL, like the flesh of other young 
 animals, abounds in gelatinous matter ; it 
 is more stringy, and less easy of digestion 
 than beef. It is, however, a very excel- 
 lent and useful article of food. 
 
 VEGETABLE DIET. The effects 
 of vegetable diet, as compared with ani- 
 mal food, are, that it requires a greater 
 bulk and quantity to supply an equal pro- 
 portion of nourishment, that it takes a 
 
VEGETABLE DIET. 
 
 567 
 
 longer period and more complex process 
 for its diofcstion, but that it is less stimu- 
 lant to the stomach and less heating to 
 tlie system. These properties render a 
 large proportion of vegetable food useful 
 in certain constitutions and habits of 
 body ; well adapted for warm seasons and 
 climates ; and proper for individuals who 
 either naturally, or from their modes of 
 life, are liable to inflammation and other 
 diseases of excitement. 
 
 In tropical climates, the great majority 
 of the inhabitants live principally on ve- 
 getable food ; and some nations and sects 
 arc forbidden by their religion the use of 
 any other. Such nations require to use 
 a good deal of spices and other condi- 
 ments; and, accordingly, these articles 
 are native in warm climates. Those who 
 use vegetable food exclusively, are feeble 
 and relaxed; incapable of long bearing 
 fatigue, or of continued active exertion. 
 In northern climates, animal food is more 
 abundantly used ; as the inhabitants re- 
 quire a greater proportion of stimulating 
 as well as digestible aliment. If proper 
 exercise be not taken by those who use 
 a full diet of animal food, it will nourish 
 80 much, that they will become oppress- 
 ed, corpulent and diseased ; but much of 
 this bad tendency will be corrected by a 
 due mixture of acescent vegetables, as 
 potatoes, greens, carrots, turnips, &c. It 
 has been remarked, that putrid diseases 
 and scurvy have not raged nearly so 
 much in large towns, and especially in 
 London, since vegetables were more co- 
 piously used in diet ; and so much had 
 the consumption of them increased, that 
 Mr. Miller, the celebrated gardener at 
 Chelsea, informed Sir John Pringle in 
 1760, that a cabbage, which then sold for 
 a halfpenny, cost threepence at the begin- 
 ning of the century; and that those who 
 now used vegetables every day, at the 
 former period, used them only once a- 
 week, by way of dainty. From which 
 circumstance, and the great extent of 
 ground laid out in kitchen-gardens, he 
 inferred, that there was at least six times 
 more garden-stuff used at the time he 
 
 spoke, than about the time of the Revo- 
 lution. In our climate, a due mixture of 
 animal and vegetable food is necessary, 
 to impart nourishment and vigour to the 
 system ; although it is found, that the al- 
 most exclusive use of vegetable aliment 
 is productive of far less evil than what 
 follows if animal food be too much in- 
 dulged in. 
 
 There are some diseases in which the 
 use of vegetables is improper. In those 
 afflicted with stomach complaints, they 
 are almost certain to occasion flatulence, 
 distension, and spasms of the bowels. 
 Their use in dyspeptic cases must there- 
 fore be almost interdicted; at least till 
 proper remedies have brought the sto- 
 mach to some degree of vigour. In the 
 disease called diabetes, accompanied with 
 an immoderate flow of sweet urine, one 
 plan of cure has been, a total abstinence 
 from vegetables of every description. 
 There are other diseases again, in which 
 vegetables alone are permitted ; such are 
 all febrile and inflammatory complaints ; 
 consumptions, when there is much fever 
 present ; fulness of the system, threaten- 
 ing apoplexy or palsy ; or when after one 
 attack has been suffered, we wish to pre- 
 vent another. 
 
 VEINS are those vessels which bring 
 back to the heart the blood which has 
 circulated in the arteries. The blood 
 which is in the veins is of a dark purple 
 colour, and is no longer fit for the pur- 
 poses of the animal economy. When it 
 reaches the right side of the heart, it is 
 sent through the lungs, where, by the 
 a( tion of the respired air, it again puts on 
 its bright florid red colour ; and is again 
 fitted to circulate through the system. 
 
 It is by opening one or more veins, 
 that blood-letting is commonly perform- 
 ed ; and the veins which are most conve- 
 nient for that purpose, are those which 
 are situated near the bend of the arm. 
 By tying a ligature pretty tightly round 
 the arm, the circulation in the superficial 
 veins is checked, and they swell and come 
 into view. Having made choice of the 
 vein we intend to cut, and ascertained 
 
568 
 
 V E I N S. 
 
 that we are not too near an artery, avc 
 proceed as directed under the article 
 Blood-letting. 
 
 Velns, Inflammation of. Sometimes, 
 when a vein has been opened for the pur- 
 pose of blood-letting-, or has been wound- 
 ed with a lancet during the opening of 
 an abscess, inflammation extends along- its 
 course towards the heart, and proves fa- 
 tal. It is difficult to say what peculiari- 
 ty of constitution, or what other cause 
 gives rise to this very lamentable event. 
 Some have thought that poisonous mat- 
 ter must have been introduced; but it 
 has followed the use of the very cleanest 
 lancets ; and among the countless subjects 
 of venesection, it is comparatively a rare 
 occurrence. Our only resource is to di- 
 minish inflammatory action by the usual 
 remedies, abstracting blood, giving purga- 
 tives and antimonials ; but often there oc- 
 curs such debility, that we are obliged to 
 go on a totally opposite plan, giving wine 
 and strong stimulants, which in their 
 turn have to be withdrawn; while we 
 are forced, in our struggle with a hopeless 
 disease, to combat the symptoms which 
 for the time appear most formidable. 
 
 Veins Knotted, or Varicose. In differ- 
 ent parts, especially of the lower extre- 
 mities, there are sometimes seen a num- 
 ber of unequal knotty swellings, of a deep 
 blue colour, occasioned by portions of 
 the veins being dilated. The cause of 
 these swellings is the obstruction to the 
 free passage of the blood through the 
 veins; hence tumours in the groin may 
 cause varicose veins of the legs; and the 
 appearance of such veins is frequent in 
 pregnant women, from the enlarged ute- 
 rus and its contents pressing on the large 
 trunks of the veins. Semetimes the 
 complaint arises from general debility, 
 and from a sedentary life. When the 
 distension is great, there is considerable 
 pain ; and the veins may be eroded, and 
 cause a great discharge of blood, or 
 troublesome and obstinate ulcers may 
 be produced. The pain and inconveni- 
 ence of varicose veins are not great at 
 first, and hence they are too often neglect- 
 
 ed till they become very difficult of 
 cure. 
 
 Treatment. The varicose veins of 
 pregnant women go oflf when they are 
 delivered, and require very little treat- 
 ment, except attention to posture. In 
 other cases, a moderate pressure by ban- 
 dages, and diminishing the force of the 
 circulation by small bleedings, is requi- 
 site. A laced stocking makes a good and 
 equal pressure. It has been proposed to 
 cut varicose veins across, by introducing 
 a bistoury behind them ; and in some in- 
 stances this plan has succeeded; but the 
 instances of failure, and of death in con- 
 sequence of the operation, have been so 
 numerous, that Sir Astley Cooper says it 
 must be considered as wilful murder to 
 attempt it. 
 
 VENEREAL DISEASE. See Sy. 
 
 PHILIS. 
 
 VENISON. The flesh of the deer is 
 reckoned a great delicacy; it is savoury 
 and easy of digestion ; and the animal 
 being commonly heated by the chase be-^ 
 fore being killed, the flesh is on that ac- 
 count the more tender. It is commonly 
 eaten with jelly, or other sweet sauce. 
 
 VENTRICLE. Various little cavities 
 in the body have the name of ventricles. 
 The most remarkable are those in the 
 brain, which in the state of health are 
 scarcely to be considered as cavities, but 
 rather as surfaces in contact ; but in dis- 
 ease they become distended with fluid, 
 and are the seat of that formidable mala- 
 dy called water in the head. See Head, 
 Water in. 
 
 VERDIGRIS is the subacetate of cop- 
 per, and is prepared by corroding plates 
 of that metal, by means of the husks and 
 stalks of the grape, whicl> have been 
 made to ferment after the juice has been 
 expressed from them. It is seldom or 
 never used internally, as it is an active 
 poison ; and it is this which renders it so 
 dangerous to employ copper vessels in 
 cookery where vinegar is to be used. It 
 is applied externally to indolent sores, 
 made up into an ointment. Mr. Brando 
 thinks the verdigris unnecess^y in phar* 
 
VINEGAR. 
 
 569 
 
 raacy ; and Dr. Paris says, that powdered 
 verdigris is the active ingredient in the 
 quack medicine called Smellome's Kye 
 salve. 
 
 VERTEBRAE. The hones which 
 compose the column containing the spi- 
 nal marrow. See Spine. 
 
 VERTIGO. See Giddiness. 
 
 VESICATIONS. Little bladders, or 
 blisters, raised on the skin by iiTitating 
 substances applied to it. 
 
 VESICATORIES. Substances which 
 have the power of raising blisters on the 
 skin, as cantharides, miistard, &c. 
 
 VESICLE. A small round eleva- 
 tion of the outer skin, containing lymph, 
 which is sometimes clear and colourless, 
 but often opaque, and whitish, or pearl- 
 coloured. It is succeeded either by scurf, 
 or by a laminated scab. A pustule, which 
 much resembles a vesicle, differs from it 
 in containing pus ; we speak of the vesi- 
 cles of cow-pox, and the pustules of small- 
 pox. 
 
 VINEGAR. The product of liquors 
 which have undergone two processes of 
 fermentation. Vinegar is a grateful acid, 
 much used as a condiment with food. In 
 small quantities, it is a grateful and 
 wholesome stimulant ; it checks the fer- 
 mentation of certain substances in the 
 stomach, and prevents raw vegetables 
 from inducing flatulence ; it seems also to 
 render fatty and gelatinous substances 
 more easily digestible j but bad effects 
 follow from too great a quantity of it. 
 
 Vinegar is well known as a preventer 
 of putrefaction in animal and vegetable 
 matters. Hence its use in pickling. 
 Vinegar is a useful addition to the drink 
 of patients in inflammatory fevers. Its 
 odour is applied to the nostrils in faint- 
 ing and hysterical complaints ; and it is 
 very useful as a fomentation in headach, 
 and in various swellings. Its vapour is 
 beneficially applied to the throat by being 
 inhaled ; and the same vapour diffused 
 through the chambers of the sick, though 
 it may not destroy contagion, gives a 
 pleasant fragrance, which renders the air 
 l.oss offensive to the necessary attendants. 
 
 Vinegar is very useful also when applied 
 externally as a refrigerant. Many prac- 
 titioners apply it to burns and scalds, 
 when the skin is not broken. For this 
 purpose, it is used diluted with two parts 
 of water. 
 
 VIPER, Bite of. The S3rmptoms 
 which arise from the bite of a viper are 
 the following ; acute pain in the wounded 
 part, with a considerable degree of swell- 
 ing, at first red, but afterwards livid, and 
 diffused over the neighbouring parts. 
 Shortly after, the constitutional symptoms 
 appear, the person becomes faint, the 
 pulse is small and intermitting, sickness 
 and vomiting come on, the skin becomes 
 yellowish, and death not unfrequently 
 succeeds. 
 
 Treatment. We must rub the wound 
 with olive-oil, and endeavour if possible 
 to prevent the poison from getting into 
 the system, by putting a ligature round 
 the part bitten, when it can be done ; and 
 by cutting out a portion of the neigh- 
 bouring substance, and by promoting a 
 discharge by the use of irritating applica- 
 tions, as caustic, acids, and ammonia. 
 We are to give medicines that will pro- 
 duce a sweat ; and if great sinking of the 
 strength comes on, ammonia, brandy, and 
 other stimulants are to be liberally ad- 
 ministered. 
 
 VITRIOL. The name of several me- 
 tallic salts. The sulphuric acid with 
 oxide of iron forms green vitriol ; with 
 oxide of copper, blue ; and with oxide of 
 zinc, white vitriol. The sulphuric acid 
 having formerly been obtained by distil- 
 lation from green vitriol, is called Oil of 
 VitrioL See Sulphuric Acid and Sul- 
 phates. 
 
 VITUS. For the spasmodic disease 
 called Saint Vitus's Dance, See Dance. 
 
 VOICE. The voice of man and other 
 animals depends on the form and struc- 
 ture of the larynx or upper part of the 
 wind-pipe, and on the opening into it, 
 called the glottis. Articulation, which is 
 peculiar to man, is produced by the mus- 
 cles of respiration, the tongue, the teeth, 
 the palate, and the lips. The glottis has 
 
570 
 
 VOICE. 
 
 been proved to posses the properties both 
 of a wind and of a stringed instrument, as 
 its opening or chink can be enlarged or 
 contracted ; and the ligaments attached 
 to it can be more or less stretched. But 
 the voice can be so varied and complicat- 
 ed in its tones, that no physiologist is 
 able sufficiently to explain it. 
 
 The following specimen of inquiry on 
 this subject is given in the printed Lec- 
 tures of Mr. Abernethy : — 
 
 " It is questioned how the tone of the 
 voice is produced by the muscles of the 
 throat that I have described; for that 
 it is produced by those muscles, is mani- 
 fest by the division of the recurrent nerve 
 that supplies them. I said, in speaking 
 of that nerve, that experiments had been 
 made on that most noisy of all animals 
 when under torture, namely, a pig; that 
 when that nerve was divided, no sound 
 was induced. Then, I say, how is this 
 done ? Does the tone depend upon the 
 enlargement or diminution of the aper- 
 ture, or does it depend upon the tension 
 of the strings ? Now, for my own part, I 
 am not competent to say; and when I 
 cannot make up my own mind on any 
 subject, I always form my opinion from 
 the opinions of those who are sound- 
 headed, and inclined to labour ; and I find 
 that Haller affirms that it entirely de- 
 pends upon the tension of the strings, 
 and not in the enlargement or diminution 
 of the aperture. You know, on wind 
 instruments, you blow an octave higher 
 with the same aperture, only by shorten- 
 ing the tube ; and this also takes place 
 in the larynx, as I shall afterwards men- 
 tion ; but this relates to the note, and 
 not to the tone of the voice. As to the 
 tone, there is no tone if the muscles do 
 not act ; and the muscles seem to produce 
 tone by tightening the strings. A two- 
 gtringed instrument — how can this pro- 
 duce tone ? Now here, you know, you 
 must attend to the construction of musi- 
 cal instruments in general. The strings 
 are not the cause of the tone ; the tone 
 arises from the vibration of the wood by 
 ^^ hich those strinn^s are surrounded. la 
 
 the harpsicord, do the stringy give the 
 sound, or the vibration of the wood ? 
 Every one knows that it is the vibration 
 of the wood. So it is also with the fiddle. 
 It is the wood, then, that gives the vibra- 
 tion, and this communicates with the air, 
 as the material which communicates 
 sound to us. It is in this way, too, that 
 the tone of the voice is produced ; and it 
 is very curious that such results should 
 take place from such simple mechanism ; 
 but you are already apprised of how these 
 results do take place. Then, again, the 
 current of tone is split and subdivided, 
 and so are particular sounds. "With re- 
 gard to this splitting and subdivision of 
 the current of sound, necessary for arti- 
 culation of words and communications of 
 feelings, I would have you study that, to 
 a certain extent, at any rate. It is a very 
 curious thing, that from this study there 
 has resulted an effect, which is the great- 
 est that we can imagine to have been 
 produced by human labour and observa- 
 tion, that of teaching the deaf to speak — 
 teaching a man who never heard a sound 
 to communicate his sentiments to an- 
 other, and be capable of understanding, 
 merely by the observation of the lips. 
 Now, then, the outlines of the study are 
 formed in the following manner : All 
 voivels seem to be but notes of the voice ; 
 they ai'e all done in the lai-ynx. Then 
 consonants are divided into labial, lin- 
 gual, dental, and so on. The labial con- 
 sonants called b, p, and m, are produc- 
 ed simply by the closing of the lips; 
 and this being a motion which a child 
 might perform without volition, the first 
 thing a child pronounces is ba, ba, papa, 
 papa. Lingual, d, t, I, and so on, ta, ta, 
 la, la ; <7 is a lingual, it is done by the 
 back part of the mouth, and is certainly 
 the very first sound a child utters, ga, ga, 
 ga ; 5 and z are dental, or compound, and 
 are pronounced by a sort of hissing 
 through the teeth." 
 
 The voice is injured by various dis- 
 eases. A catarrh or common cold pro- 
 duces inflammation of the larynx ; and 
 the voice is altered both by the elasticity 
 
V O M I T 1 N G. 
 
 571 
 
 of the ligaments being diminished, and 
 by the quantity of mucus secreted, pre- 
 venting their vibrations. In fevers, and 
 diseases of debility, the voice is affected 
 from the weakness of the muscles sub- 
 servient to it. In hysterical complaints, 
 the voice is sometimes lost; it is occa- 
 sionally recovered for a few minutes or 
 a few hours, without any evident cause, 
 and then lost again. In palsy, the voice 
 is weakened, and the power of articula- 
 tion lost. The passion of fear has the 
 same effect. The treatment of this un- 
 pleasant defect must vary with the cause 
 producing it. Inflammation is to be sub- 
 dued by the proper means ; and palsy and 
 other nervous affections are to be treat- 
 ed with repeated blisterings. 
 
 When the delicate structure of the 
 parts concerned in the formation of the 
 voice is considered, it will not appear 
 surprising that various organic changes 
 should take place, and cause an almost 
 constant, or even a permanent loss of 
 voice ; and from the great exertions of 
 public speakers and singers, they are often 
 the subjects of disease in those parts. 
 Persons who speak in public require to 
 have something to moisten the mouth ; a 
 little sal prunella will answer the pur- 
 pose. 
 
 VOMITING is the expulsion of the 
 contents of the stomach by the mouth. 
 It is a symptom of a great variety of dis- 
 eases ; and to relieve the vomiting, v.c 
 must, if we can, remove the disease it- 
 self. In several stomach complaints, it 
 is the most distressing symptom, and 
 requires to be checked by opium, or by 
 effervescing draughts, or, in very obsti- 
 nate cases, by a blister on the pit of the 
 stomach. 
 
 Vomiting is resorted to as a remedy in 
 a variety of diseases. At the commence- 
 ment of several fevers and eruptive dis- 
 eases, vomiting occurs ; and by a sa- 
 lutary effort, nature relieves herself of 
 undigested aliment, which the body could 
 not retain without the certainty of suf- 
 fering much by it; and this process is 
 imitated by the intelligent physician. 
 
 In dropsy, when the patient is not much 
 weakened, the exertion of vomiting sti- 
 mulates the lymphatics into action, and 
 tends to carry off the water. Vomit- 
 ing is of great service in various disor- 
 ders of the wind-pipe and lungs, and is 
 an excellent promoter of expectoration. 
 In the croup, we should almost invari- 
 ably begin our treatment by the exhibi- 
 tion of an emetic ; and if we use the tar- 
 trate of antimony, we may at once obtain 
 the good effects of an emetic, and dimi- 
 nish inflammatory action. In catarrh and 
 hooping-cough, an emetic is of the great- 
 est service; and when vomiting is not 
 produced by the usual emetics, we justly 
 regard this resistance as an indication of 
 a dangerous state of disease. 
 
 Vomiting in Infants. This occurs 
 very frequently, as their stomachs easily 
 reject any load or indigestible substance. 
 When it does not continue long, or go to 
 excess, it does them very little harm, and 
 they continue to thrive well ; but other- 
 wise, it is to be checked by suitable 
 means. An emetic is to be given, to get 
 rid of any indigestible substance in the 
 stomach. K the vomiting is owing to ir- 
 ritation kept up after the cause has been 
 removed, gentle stimulants, as a little 
 tincture of rhubarb or of cinnamon, or 
 even of opium, may be taken inwardly ; or 
 a small mustard poultice, or volatile lini- 
 ment, or a blister put on the pit of the 
 stomach. Infants should not be allowed 
 to overload their stomachs by sucking 
 too much, or by large quantities of spoon- 
 meat. 
 
 Vomiting may follow the suppression of 
 a discharge from behind the ears ; in which 
 case, the discharge must be brought back, 
 by blistering ointment. Vomiting is a 
 very common symptom at the commence- 
 ment of eruptive diseases, as small-pox 
 and measles, and it generally ceases when 
 the eruption comes out. Other erup- 
 tions, when suddenly repelled, very often 
 occasion vomiting. Warm bathing and 
 mild laxatives are the best remedies in 
 such cases. The foregoing instances of 
 vomiting are in general easily managed, 
 
572 
 
 VOMITING. 
 
 and productive of no danger ; but if vo- 
 miting occurs in weakly children, from 
 too great irritability of the stomach, it 
 is accompanied with great danger. To- 
 nics and bitters are then to be directed, 
 and spirituous fomentations are to be ap- 
 plied externally. 
 
 Vomiting of Blood or HoBmatemesis. 
 A disorder of a very alarming appearance, 
 but of less dangerous tendency than some 
 others of a more insidious nature. Much 
 of the hazard of the disease will depend 
 on the rapidity with which the blood is 
 lost. Suppose one or more blood-vessels 
 on the inner surface of the stomach to 
 burst, and discharge blood into that organ. 
 It will accumulate, will become black and 
 clotted, and when it reaches a certain ex- 
 tent will excite vomiting, and be thrown 
 up in a large quantity, mixed with food 
 and other contents of the stomach, pro- 
 bably tilling several basons ; and exciting 
 the greatest apprehension by its enormous 
 quantity, and disgusting appearance. The 
 patient, however, is by this discharge re- 
 lieved of a sense of fulness and oppres- 
 sion, till after a day or half a day more, 
 the same thing recurs. The pulse is not 
 raised, nor are any feverish symptoms 
 present. On the other hand, there may 
 be a frequent discharge of clear unmixed 
 florid blood, accompanied with a degree 
 of feyer, and great faintishness at times, 
 from the loss of blood. This is an in- 
 stance of what is called active haemor- 
 rhage, is more dangerous, and requires 
 more prompt and decided assistance. A 
 bleeding from the stomach is distinguish- 
 ed from a bleeding from the lungs, by this 
 last being frothy from the admixture of 
 ^ir, and being of a more bright red colour. 
 
 Treatment. In the acute and febrile 
 state of the disease, bleeding from the arm 
 must be resorted to, in order to lessen the 
 inflammatory action of the vessels in ge- 
 neral ; and those of the stonjach will pour 
 out less blood, or the discharge will stop 
 altogether. Other parts of the antiphlo- 
 gistic plan are to be enforced, as purga- 
 tives and cooling drinks ; a little sulphu- 
 ric acid properly diluted will both tend 
 
 to cool the system, and being directly ap- 
 plied to the bleeding vessels, will tend to 
 constrict their mouths. 
 
 Vomiting of blood is thought in some 
 females, to supply the place of the 
 monthly discharge ; but, there is a species 
 of the disease incident to females who 
 are regular, and which is thought by Dr. 
 Hamilton, senior, to depend on a slow 
 state of the bowels. In this kind of vo- 
 miting of blood, purgative medicines have 
 been found the most effectual remedy; 
 and are to be followed up by tonics, if 
 the strength seems impaired. 
 
 " This vomiting of blood, which we 
 have seen as the result of ulceration, also 
 occurs without any such disease ; and I 
 have seen it fatal where no organic dis- 
 ease could be discovered, and even the 
 source of the haemorrhage could not be 
 detected. In other cases, a varicose state 
 of the veins is observed in the mucous 
 membrane of the stomach. The quantity 
 of blood brought up is often immense, so 
 that the patient is reduced to the last de- 
 gree of exhaustion ; and yet the disease 
 is not often fatal. Some persons, espe- 
 cially women, are liable to frequent or 
 almost periodical attacks of it, sometimes 
 in connexion with retention of the menses. 
 When the patient is much exhausted, it 
 is necessary to give small quantities of 
 brandy at short intervals. For settling 
 the stomach, and restraining the haemor- 
 rhage, the acetate of lead is often very 
 useful, and may be given in doses of one 
 or two grains, repeated every three or 
 four hours, for thirty-six or forty-eight 
 hours, if necessary; also the acids, the 
 muriated tincture of iron, bismuth, alum, 
 and kino in poAvder or tincture. The 
 blood is apt to pass into the bowels, froni 
 which it must be discharged by the mild- 
 est means, as injections repeated two or 
 three times a-day. The patieqt must be 
 supported by farinaceous nourishment in 
 small quantities, or by millv, or fresh-made 
 soft curd." (Dr. Abercrombie on the 
 Stomachy ^c.J 
 
 VULNERARY BALSAM is a po- 
 pular name lor the compound tinpture of 
 
VULNERARY BALSAM. 
 
 573 
 
 benzoin, called also Wade's Balsam, and 
 the General's Balsam ; a favourite appli- 
 cation to a recent cut. The stimulant 
 nature of this balsam renders it rather 
 improper for the purpose to which it is 
 ^plied; and the great benefit is, that it 
 
 persuades people to tie up the cut, and 
 keep its edges together for a immber of 
 days without disturbing it ; which allows 
 it to heal, as surgeons say, by the fiist 
 intention ; without the formation or dis- 
 charge of matter 
 
 w 
 
 WAS 
 
 WARM BATH. See Bath, page 60. 
 
 WARTS are excrescences from the 
 skin, having their surface pointed or gra- 
 nulated, sometimes being very painful 
 when rubbed, and liable to bleed when 
 touched. Young people are sometimes 
 much infested with them, and as they ap- 
 pear in great numbers about the hands, 
 they are very anxious to get rid of them. 
 Sometimes they go olF of themselves, and 
 leave the skin quite clean ; but it is ge- 
 nerally necessary to adopt some means 
 for their speedier removal. This is not 
 rery diflScult; some stimulant application, 
 as savine ointment, or blue vitriol, or 
 lunar caustic, or potash, will answer the 
 purpose ; and it is proper first to pare off 
 the tops of them to let the stimulant 
 reach the sensible surface. When they 
 are removed by the knife, it is necessary 
 to apply caustic to destroy their roots 
 completely. When warts have a narrow 
 neck, a silk thread or horse-hair may be 
 tied round it, and they will drop off in a 
 few days. Warts are often a sequel of 
 renereal complaints. They are to be 
 cured by the remedies suited to the ori- 
 ginal disease; and they may be rubbed 
 with red precipitate ointment, or some 
 other stimulant application. 
 
 WASP, Sting of. These insects sel- 
 dom sting unless irritated; but when 
 they do, the injury they inflict is accom- 
 panied with a sharp pain, followed by 
 inflammatory swelling in the neighbour- 
 hood, which occasionally extends over the 
 
 WAT 
 
 whole limb. It generally ceases of it- 
 self, but may be relieved by the applica- 
 tion of hartshorn, or spirits of wine, or 
 other cooling lotion. K a person has been 
 stung by a great many wasps, as some- 
 times happens when they are irritated by 
 the destruction of their nest, a considera- 
 ble degree of fever may be excited, and 
 this will require some cooling medicine, 
 and the application of oil to the inflamed 
 parts of the body. 
 
 WASTING, OF CHILDREN. See 
 Marasmus, and Atrophy. 
 
 WATCHFULNESS in INFANTS. 
 Sometimes infants do not take what ap- 
 pears a due proportion of sleep. This 
 may arise from various causes. If it is 
 owing to any disease, as teething or dis- 
 ordered bowels, costiveness, worms, or 
 fever, or a tendency to a complaint in the 
 head, we must not fly to opium or narco- 
 tics to induce sleep, but must direct our 
 attention to the primary disease. If it is 
 chiefly in the night that the child is 
 wakeful, something may be done by in- 
 creasing its exercise, and abridging its 
 sleep in the daytime. 
 
 WATER is interesting in a dietetic 
 point of view, as the natural drink of 
 man and other animals. It quenches 
 thirst; and, when moderately taken, as- 
 sists digestion ; it corrects the acrimony 
 of our fluids, and assists the secretions 
 and excretions, especially those by the 
 skin and kidneys. But there is no pro- 
 pi'iety in restricting man exclusively to 
 
i74 
 
 WATER. 
 
 this drink, as his tastes and hahits are 
 modified hy civilized life, and as he is 
 found to live and thrive, even when using 
 a great variety of liquids. Of all of 
 them, however, water is the basis and 
 the largest portion. 
 
 The qualities of water differ consider- 
 ably according to the source whence it has 
 been derived, and the matters which it 
 holds dissolved or suspended in it. Wa- 
 ter may be very safely used, although it 
 has not the perfect purity obtained by 
 distillation ; but water impregnated with 
 dissolved minerals, or contaminated with 
 putrescent animal or vegetable substances, 
 should be generally abstained from. 
 
 The different kinds of water, as de- 
 pending on its various sources, are rain- 
 water, spring-water, river-water, well- 
 water, snow-water, lake and marsh-wa- 
 ter. 1. Ilain-ivater is the purest of all; 
 but when collected by dropping from 
 houses, near or in large towns, it is con- 
 taminated by the smoky atmosphere 
 through which it falls, and may contain 
 calcareous matter j on which account it 
 should be boiled and strained before drink- 
 ing. 2. Spi'ing-water often contains some 
 saline matter, and sometimes is what is 
 called hard. This means that it con- 
 tains certain salts which unfit it for dis- 
 solving soap, and prevent it from acting 
 on vegetable matters. Hence hard-water 
 will not do for washing clothes, and is 
 well known to be unfit for making good 
 tea. The salt which imparts those bad 
 qualities to water is generally sulphate 
 of lime, (gypsum, or plaster of Paris). 
 Five grains to a pint of water will make 
 it hard. Weak stomachs feel this hard 
 w^ater to be oppressive ; and some of the 
 inferior animals, as horses, dislike it much, 
 and have their bowels injured by it. 
 3. River-icatei- is generally pretty pure, 
 but it may be muddy from foreign bo- 
 dies suspended in it, from which it will 
 be freed by mere rest and filtration. Dr. 
 Paris says that there exists a popular 
 belief that the water of the Thames is 
 peculiarly adapted for the brewing of 
 porter J but he says such water is never 
 
 used in the London breweries. 4. Well- 
 water is nearly the same as spring-water. 
 5. Snow-water has got a bad name, as 
 producing the swelling of the neck called 
 goitre or bronchocele, so common in the 
 Alpine regions. The same disease, how- 
 ever, occurs at Sumatra, where there is 
 neither snow nor ice. The water obtain- 
 ed from melting the ice of the sea in high 
 latitudes was found to be quite sweet, 
 soft, and salutary. As air is expelled 
 from water during the act of freezing, the 
 water obtained from melting snow or ice 
 is somewhat insipid from the absence of 
 air, but it quickly recovers it by expo- 
 sure to the atmosphere. 
 
 Various methods have been proposed 
 for the preservation and purifying of 
 water. Mechanical impurities may be 
 got rid of, by filtering it through sand or 
 porous stone. Hardness of water may be 
 removed by adding to each pint from ten 
 to fifteen grains of an alkaline carbonate 
 twenty-four hours before it is used. Char- 
 coal has a wonderful power of correcting* 
 putrescency, and therefore water will be 
 purified by passing it through alternate 
 layers of sand and charcoal. When any 
 water is suspected, it is a good plan to 
 boil it, before it its being used. To pre- 
 serve water sweet in long sea-voyages, 
 was formerly a great desideratum. When 
 long kept in casks, it is partially decom- 
 posed; and carburetted hydrogen being 
 evolved, imparts its peculiar smell and 
 taste to the water. This decomposition 
 may be prevented by charring the inside 
 of the casks; and in the navy, with the 
 view of preventing it, iron tanks are sub- 
 stituted for wooden vessels. The Thames 
 water is very apt to become black and ex- 
 ceedingly offensive during a long voyage, 
 as it contains mud and vegetable and ani- 
 mal remains, which occasion it to under- 
 go a violent change when kept ; but on 
 drawing it off in earthen vessels and ex- 
 posing it to the air, a quantity of black 
 slimy matter is deposited, and the water 
 becomes clear and sweet, 
 
 WATER IN THE CHEST. See Chest. 
 
 WATER IN THE HEAD. See Head. 
 
WEANING. 
 
 575 
 
 WATER-BRASH signifies the dis- 
 charge of a thin watery fluid from the 
 stomach, with helchings, and a sense of 
 heat at the region of the stomach. It is 
 not unfrequently one of the symptoms 
 attending indigestion or stomach com- 
 plaints, but it sometimes occurs as an 
 original disease. It comes on in pa- 
 roxysms, usually when the stomach is 
 empty. The patient perceives a pain at 
 the pit of the stomach, with a sense of 
 tightness, and this is increased by the 
 erect posture. When the pain has con- 
 tinued for some time, it is succeeded by 
 helchings, and the discharge of a tiiin 
 watery fluid, sometimes acid, but gene- 
 rally tasteless. The helchings are repeat- 
 ed for a time, and then the fit goes off. 
 When the disease has once happened, it 
 is apt to recur fi-equently for a long time 
 afterwards. It is most incident to persons 
 of middle age ; and to females, sometimes 
 during pregnancy, sometimes when they 
 are afflicted with the whites. It is not al- 
 ways connected with any particular diet ; 
 but is excited often by cold applied to 
 the feet, and by emotions of the mind. 
 
 This disease is difficult both of explan- 
 ation and of cure. The paroxysms are 
 to be treated with opium and other anti- 
 spasmodics, as musk, ether, and ammonia. 
 To prevent the return of the fits, ^e give 
 bark and sulphuric acid, and occasional 
 purgatives. Magnesia, lime water, nitric 
 acid, and the alkalis may be given. The 
 oxide of bismuth, in the dose of five 
 gi'ains three times a-day, has been recom- 
 mended. Blistering and mild farinaceous 
 food are of service. 
 
 WATERY GRIPES, in Infants. « A 
 discharge of dark-coloured liquid stools 
 like moss-water, which very rapidly oc- 
 casion emaciation and prostration of 
 strength, and require very serious atten- 
 tion. This variety of looseness often at- 
 tends teething, and is also not unfrequent- 
 ly occasioned by the depraved quality of 
 the nurse's milk, or by some error in the 
 ordinary management of the infant. The 
 means of cure must be varied according 
 to the causes ; but in general an ipecacuan 
 
 vomit, one or more doses of some mild 
 laxative, with an opiate clyster at bed- 
 time for three or four times, attention to 
 the state of the teeth, warm clothing, a 
 change of milk if the infant be still on the 
 breast, and if otherwise, a due regulation 
 of the diet, are the chief means which are 
 found useful." (Professor Hamilton.) 
 
 WAX is the honeycomb of the bee 
 melted with boiling water, pressed 
 through cloth bags, and cast into round 
 cakes. It is supposed to be a product of 
 the bee, and not merely collected by it 
 from the flowers. Its smell is like that 
 of honey. It is chiefly used in the com- 
 position of cerates and plasters. It can 
 be rendered white by bleaching. 
 
 WEANING. The change of an in- 
 font's diet from his mother's or nurse's 
 milk to solid and liquid food, is a circum- 
 stance of great importance with respect to 
 his future health. The period of wean- 
 ing will depend on the consideration of 
 various particulars, as the state of the 
 child's health, and of that of the nui-se : 
 the condition of the infant with respect 
 to teething, the season of the year, the 
 prevalence of epidemic diseases, &c. 
 When both mother and child are in good 
 health, there is no advantage gained by 
 suckling the child above nine or ten 
 months. If she is in delicate health, or 
 is suffering from the effects of nursing, 
 as ophthalmia, hectic fever, or debility, 
 the child may be weaned before that age. 
 The winter is an inconvenient time for 
 Ai'eauing, as the infant cannot be amused 
 in th<} open air through the day, and is 
 likely to be fretful during the long nights. 
 If the child is teething, and feverish, and 
 uneasy in consequence, it is not proper to 
 wean him, or to add the loss of his accus- 
 tomed gratification to the other sources 
 of his annoyance. If the child is of a 
 feeble constitution, or if the pai'ents arc 
 scrofidous or otherwise unhealthy, the 
 child should be nursed for sixteen or 
 eighteen months, and that not by its mo- 
 ther, but by another woman of a healthy 
 and sound constitution. 
 
 The great point to be attended to in 
 
576 
 
 W E A N I N G - B R A S H. 
 
 weaning is, that it be not done abruptly, 
 and that the child he duly prepared for 
 being deprived of his milk, by having his 
 stomach, for a considerable time before, 
 accustomed to different kinds of food. 
 For some weeks previous to weaning, he 
 should receive spoon-meat in great quan- 
 tity, and the milk allowed should be gra- 
 dually diminished. No harsh or disgust- 
 ing methods should be used to make the 
 child loathe the breast. If he be in good 
 health, and be taken out to the open air, 
 and amused, if his diet and his bowels be 
 attended to, he will soon be independent 
 of the milk ; of which we suppose, he has 
 for some time been daily more and more 
 deprived. If the weaning be ill manag- 
 ed, if it be too abrupt, and if the food we 
 give do not agree with the infant, he may 
 be seized with weaning-brash, a danger- 
 ous affection, which shall be the subject 
 of our next article. 
 
 When an infant is weaned, it is impro- 
 per and unnecessary to give medicines, 
 unless some urgent symptoms demand 
 attention. The bowels should not be 
 teazed with laxative drugs, nor should 
 opiates ever be given merely to stupify 
 the child, and keep him quiet during the 
 night. As Dr. Hamilton recommends, 
 M'hen restlessness occurs, the infant ought 
 to be taken out of bed, and carried about 
 through an airy room. The child should 
 early be accustomed to regularity in the 
 periods of his taking meat and drink; 
 and of those, very little should be given 
 during the night. Spirits and water for 
 children, should always be avoided. 
 
 " After weaning, the food of infants 
 should consist of weak beef-tea, panado, 
 light pudding, and the various pre2)ara- 
 tions of milk. Rusk biscuit ought gene- 
 rally to be used instead of ordinary bread. 
 The common preparation of oatmeal 
 (called pottage or porridge,) till within 
 these few years, much used in this part 
 of Great Britain, is in general too diffi- 
 cult of digestion for infants, unless a pro- 
 portion of barley-meal be mixed with the 
 oatmeal. Frequent exposure to the open 
 air when the weather is favourable, and 
 
 an increased degree of exercise, are high- 
 ly beneficial to newly weaned infants." 
 (Professor Hamilton.) 
 
 WEANING-BRASH. The assem- 
 blage and succession of symptoms known 
 by this name, appears in children after 
 weaning; generally when this is attempt- 
 ed too soon, or too abruptly, or when 
 the child is brought up by the hand. It 
 begins with frequent griping and purg- 
 ing, in which the stools are of a green 
 colour, and often attended with vomiting 
 of bilious matter. Wasting of the body 
 succeeds, and the child is carried off by 
 con.vulsions. These symptoms seem to 
 be owing to the sudden change of diet. 
 
 Treatment, An attention to the diet 
 is the chief thing to be trusted to for the 
 removal of the disease; and, if posBible^ 
 the child should be again put to the 
 breast; in some cases it may be advis- 
 able to give even younger milk than the 
 mother's or nurse's, which it has lately 
 left off. When good milk cannot conve- 
 niently be obtained, a little animal food, 
 in the form of broth or jelly, is to be gi- 
 ven, and a little wine or wine-whey. All 
 vegetables, and butter, and much sugar 
 are to be prohibited. The clothing is a 
 matter of very great importance. Flan- 
 nel is to be worn next the skin, and all 
 irregular application of cold is to be 
 avoided. When the child is able to bear 
 it, exercise in good air, and frequent 
 washings of the body with tepid water, 
 are good auxiliaries. With respect to the 
 medicines proper in the weaning-brash, 
 the best are those of a laxative kind, as 
 rhubarb, alone, or with a grain or two of 
 calomel ; to which last, ipecacuan, in the 
 proportion of three grains to one of ca- 
 lomel, forms a good addition. Magnesia 
 is useful to correct acidity. 
 
 WEED, Epheinera. A feverish at- 
 tack M'hich runs through all its stages in 
 twenty-four or thirty-six hours. A weed 
 very frequently occurs in the child-bed 
 state. It begins with cold and shivering, 
 headach, pain in the back, and sickness. 
 This stage continues for a short time, and 
 is then succeeded by great heat, which is 
 
W v. E D. 
 
 »77 
 
 followed by profuse sweating', with wliich 
 the ilhiess is finished, but considerable 
 M eukness is left behind. The causes ol" 
 Tweeds are exposure to cold, irregularities 
 in diet, sudden emotions of the mind, and 
 various instances of imprudence or mis- 
 ma nsig-emcnt in the puerperal state. 
 These transient febrile attacks are rarely 
 or never fatal ; but they are inconvenient, 
 and may lead to some other worse dis- 
 ease. Many women understand by weed, 
 the shivering Avhich introduces a g-reat 
 variety of febrile diseases ; and think they 
 have only got a weed, when in reality in- 
 flammation of the bowels, of the lungs, or 
 of the breasts, has begun. Shivering fits 
 therefore should never be neglected. If 
 theye be shiverings foUoAved by a fixed 
 pain in a particular spot, with heat, thirst, 
 and a full and strong pulse ; there is in 
 all probability inflammation of some or- 
 gan going on. 
 
 Treatment. In the cold fit, we are to 
 give mild warm diluents, as barley-water, 
 gruel, or wliite A^ine whey very weak. 
 Violent methods must not be used to put 
 an end to the cold fit; no cordial drinks 
 with wine or spirits, no overloading with 
 bed-clothes. Wai-rath is to be applied to 
 the feet or to the pit of the stomach by 
 M'arm flannels or bottles filled with hot 
 water. When the hot stage has com- 
 menced, the diluent drinks may be con- 
 tinued, but no means used to keep up the 
 heat ; the air of the room should be free, 
 and the bed-clothes light ; and a draught 
 made of teu grains of the carbonate of 
 potass, and lemon-juice, or the salt of le- 
 mons, may be given ; or a julep made with 
 nitre ; a drachm to a pint of gruel. When 
 these means have relieved the burning 
 heat and thirst, and brought out a gentle 
 perspiration, the uneasy feelings go off; 
 but care must be taken not to check the 
 perspiration too suddenly, lest a second 
 atta<;k be brought on. If the sweat be 
 suffered to be profuse, or long continued, 
 there nray be miliary fever, or great 
 weakness. W^arm diluent drinks are to 
 be given, and the sweating is to be kept 
 up for six or eight hours, after which the 
 
 drinks are to be gradually discontinued. 
 The patient is to have the bed-clothes 
 and the linens shifted, taking care to have 
 the dry clothes properly aired. From the 
 weakness generally felt, it is necessary 
 to give a little wine before the patient is 
 shifted. Bark and wine, and nourishing 
 diet, avoiding stimulation and excess, are 
 to be used to prevent the return of weeds. 
 
 WEEPING EYE, Epiphora or Fis- 
 tula Lacrymalis. An involuntary and 
 constant flow of tears over the cheek. 
 At the upper part of the orbit of the 
 eye is situated the lacrymal gland, which 
 secretes the tears. In the healthy state, 
 these are diffused over the surface of the 
 eye-ball by the motion of the lids. The 
 quantity above what is necessary for 
 keeping the eye clean and moist, is 
 taken up at two little points, Avhich may 
 be seen in the living subject, one on each 
 lid, near the inner corner of the eye. 
 These points are the commencement of 
 a little sack and canal, through which 
 the superfluous tears are carried into the 
 nose, where they moisten the lining 
 membrane, or are evaporated by the air 
 we breathe, A disease, or oostruction in 
 any part of this canal hinders the passage 
 of the tears into the nose; and they, 
 therefore, accumulate on the lids or fall 
 over upon the cheek. 
 
 jMi'. Pott, who wrote with great accu- 
 racy on the Fistula Lacrymalis, divides 
 the disease into four stages. 1. A simple 
 dilatation of the sack, aad obstruction of 
 the passage to the nose, which, upon 
 pressure, discharges a mucus, either ouite 
 clean, or a little cloudy ; the skiu cover- 
 ing the bag being entire, and perfectly 
 free from inflammation. 2. In the se- 
 cond stage, the tumour is somewhat 
 larger, the skin is inflamed, but entire ; 
 and the discharge is of a pale yellow, 
 or purulent colour. 3. In the third 
 stage, the skin covering the sack has 
 become sloughy, and buret, by which 
 the swelKng is lessened ; but the mucus 
 which used to discharge itself through 
 the lacrymal points, now comes through 
 the new. opening; the passage to the 
 2 V 
 
578 
 
 WEN 
 
 WH E 
 
 nose is yet not otherwise diseased, than 
 by the thickening- of its lining. 4. The 
 passage is totally obliterated, its inside 
 being either ulcerated or filled up with 
 a fungus, and attended sometimes with a 
 caries of the bone underneath. 
 
 Treatment In the first stage, we at- 
 tempt to remove the obstruction of the 
 passage by introducing a probe, or by in- 
 jecting a fluid through a very fine sy- 
 ringe, into the inferior lacrymal points. 
 Warm water is best at first ; and if this 
 does not succeed, a solution of sulphate 
 of zinc or wine of opium may be tried. 
 The healthy state of the neighbouring 
 parts is to be attended to, and to be re- 
 stored by leeches, and the ointments re- 
 commended in diseases of the eye or eye- 
 lids. In the second and third stages, 
 when the parts are inflamed and swelled, 
 a proper opening should be made with a 
 lancet ; or if the skin has broke, the open- 
 ing, if necessary, should be dilated. A 
 silver probe is to be pushed into the na- 
 sal duct, with force sufficient to over- 
 come the obstruction ; and afterwards a 
 silver style, a little smaller than the probe, 
 having a head like a nail, but placed 
 obliquely, is to be left in the passage. It 
 is to be removed for cleaning, once every 
 day for about a week, and afterwards 
 eveiy second or third day. A little warm 
 water should be injected each time into 
 the nose. In many cases, the watering 
 of the eye ceases as soon as the style is 
 introduced. Some wear this style for 
 years, others leave it off" in a month or 
 six weeks, and the parts continue well. 
 In the worst cases of the disease, or the 
 fourth stage, an opening must be made 
 through the bones of the nose; and by 
 wearing a style, as above, an artificial pas- 
 sage will be formed. 
 
 WEN is the common popular name for 
 any excrescence or tumour, growing on 
 any part of the body, most frequently ap- 
 plied to tumours about the throat and 
 neck. Tumours are distinguished, by sur- 
 geons, according to the nature of their 
 contents ; and they require treatment va- 
 ried accordinsf to circumstances. Some- 
 
 times wens are attached by a narrow 
 neck, and may be removed by the knife, 
 or by ligature ; at other times they have 
 a broad base, and are so supplied with 
 large blood-vessels, that they cannot be 
 removed at all, or cut without the utmost 
 risk. Sometimes tumours are filled with 
 a curdy or cheese-looking matter, and are 
 contained in a cyst, or bag, which may 
 be dissected out along with its contents, 
 and the cut skin will heal, and leave very 
 little deformity; in other cases, the tu- 
 mour is fungus JicEinatodeSy or bloody 
 cancer, which pretty certainly destroys 
 the patient. The bronchocele, or goitre, 
 is to be treated with iodine ointment, 
 and the tincture of iodine internally ; the 
 vessels that go into it are so large and nu- 
 merous, that an operation can rarely be 
 performed there. Sometimes very large 
 wens contain a mixed substance resem- 
 bling fat marrow; they have a firm fleshy 
 feel, and sometimes attain an enormous 
 size. Sir Astley Cooper removed from 
 the abdomen of a man, a fatty swelling, 
 M'hich weighed, independently of the 
 blood in it, thirty-seven pounds, tea 
 ounces. See Swellings, Bronchocele, &c. 
 
 WHEAT. « The Triticum Hyber- 
 num (and other species) of botanists, has 
 been cultivated from time immemorial in 
 Europe, and the northern parts of Africa, 
 and the seeds of it employed as one of 
 the most important articles of food. In- 
 deed wheat-flour is the only substance 
 known, from which good loaf-bread can 
 be made. The seeds, when ripe, ai'e 
 ground to a fine powder, and by passing 
 this powder through cloth sieves of va- 
 rious degrees of fineness, it is separated 
 into distinct portions. The fine flour 
 constitutes the greatest portion ; and the 
 bran, which consists of the outer coat of 
 the seed, and which is the coarsest of all, 
 constitutes the next gi-eatest portion." 
 (Thomson's Chemistry.) See Bread. 
 
 WHEY. When milk is curdled by the 
 addition of rennet, or any other coagulating 
 substance, the thin part is of a yellowish 
 green colour, and has a pleasant sweetish 
 taste, in which the flavour of milk may 
 
W II I T E S. 
 
 579 
 
 be distinguished. It generally contains 
 a little oil, and always some curd. Whey 
 is less nutritious than milk; but it af- 
 fords an excellent mild demulcent drink, 
 highly useful in fevers and inflammatory 
 complaints; in coughs, hectic, and con- 
 sumption. 
 
 WHITE LEG of Childbed Women. 
 See Phleomatia Dolens. 
 
 WHITE SWELLING. See Knee- 
 Joint, page 355. 
 
 WHITES. A disease to which wo- 
 men are liable, consisting in the discharge 
 of a thin, white, or yellow matter, from 
 the uterus and vagina, sometimes possess- 
 ed of great acrimony, accompanied by 
 smarting in making water, pains in the 
 back, great debility, pallid countenance, 
 and loss of appetite. When the disease 
 continues long, the general health is 
 greatly impaired, the wom.an becomes 
 pale and emaciated, there is a dull un- 
 healthy appearance in the eyes, a livid 
 circle surrounds them, and at length a 
 dropsical a.fection takes place, aud pro- 
 tracted illness and death ensue. 
 
 Causes. Irregularity in the monthly 
 discharge, injuries done to the parts, fre- 
 quent miscarriages, poor diet, a seden- 
 tary life, are among the causes M'hich 
 give rise to this very disagreeable and 
 obstinate disease. 
 
 Treatment. The whites are best re- 
 moved by tonics, both general and local, 
 which last should never be omitted. 
 Astringent lotions, made of the sulphate 
 of zinc and rose-water, or the decoction 
 of oak-baik, or infusions of catechu, or 
 solutions of alum, are to be frequently 
 injected. Cold bathing about the back 
 and loins is beneficial ; and at the same 
 time, we may give the diluted sulphuric 
 acid, or the elixii'of vitriol, or tlie tinc- 
 ture of catechu, by the mouth. Every 
 means must be employed to improve 
 the general health, the patient is to be 
 much in the open air, if she b-? able to 
 take exercise ; and the bowels must 
 be kept regular. Various medicines, 
 which are believed to have aji influence 
 on the urinary passages, ai*e prescribed 
 
 to patients with whites, with the view 
 of their influence being exerted on the 
 neighbouring parts ; and they frequently 
 prove of great service. Turpentine, the 
 balsam of copaiba, uva ursi, and the tincture 
 of cantharides, may be mentioned. Great 
 attention must be paid to cleanliness; 
 and the dress, the diet, and the mode of 
 life should not be those of the idle, luxu- 
 rious, and relaxed, but of the healthy, la- 
 borious, and active. 
 
 WHITLOW. An inflammation or 
 suppuration at the last joint of the fin- 
 gers ; but the toes may also be the seat 
 of whitlow. There are several kinds of 
 whitlow, the peculiarities of which are 
 owing to the different depths of the parts 
 which are the subjects of the disease. 
 1 . The suppuration may take place mere- 
 ly beneath the outer skin, in which case, 
 the disease spreads a considerable way 
 round the joint. If the abscess takes 
 place under the nail, the pain is veiy se- 
 vere. Emollient poultices^ and giving 
 vent to the matter, seem to be alone re- 
 quired in this kind of whitlow. 2. The 
 inflammation may occur in the cellular 
 substance of the point of the finger ; in 
 this case, the pain is considerable, and the 
 swelling advances more slowly. The 
 pain may extend a considerable way up 
 the arm. Sometimes constitutional symp- 
 toms arise in this kind of whitlow; and 
 it is necessary to use bleeding, and the 
 other parts of the antiphlogistic regimen. 
 Bleeding by leeches, and dividing the 
 skin over the pained part by a crucial in- 
 cision, may sometimes relieve the pain, 
 and prevent the suppuration. If we find 
 that we are not likely to do this, wq 
 must promote it by emollient poultices 
 and fomentations, and open the abscess 
 as soon as it is ripe. 3. A third kind of 
 whitlow is marked by the most acute 
 pain, which extends to the hand, the 
 wrist, the elbow, and even the shoulder. 
 With all this severe pain, there is little 
 swelling in the affected finger ; and even 
 when matter is foniied, the fluctuation of 
 it cannot be perceived at the finger, 
 though it may sometimes be felt at other 
 
580 
 
 WIND. 
 
 parts of the hand and arm. This is ow- 
 ing to the inflammation of the finger be- 
 ing seated in the sheath of the tendons, 
 which, being strong and unyielding, are 
 painfully stretched, but do not allow the 
 matter to be felt under them. In this 
 case, Ave must not wait till we can feel 
 the fluctuation of matter; but we must 
 cut deeply down through the sheaths of 
 the tendons ; and also in other parts of 
 the hand and arm, we must miike inci- 
 sions, if the pain in those parts is not re- 
 lieved by the opening we first made. 
 4. The fourth species of whitlow is that 
 in which the periosteum, or the mem- 
 brane covering the bone, is inflamed. The 
 pain is here very acute ; and as the dis- 
 ease advances, the bone itself is affected 
 with caries. Here early incisions, quite 
 down to the bone, are necessary ; and 
 when these have not availed to prevent 
 the caries of the bone, it will be neces- 
 sary to amputate one or two joints of the 
 finger. 
 
 WHORTLEBERRY, Arbutus uva 
 ursi. A small evergreen shrub, the green 
 leaves of which, when picked from the 
 twigs, and dried by a moderate heat, yield 
 a powder whose taste is at first smartly 
 astringent and bitterish, and at length 
 leaves a flavour like liquorice. The ef- 
 fects of this powder are astringent and 
 tonic; and it is used in whites, and in 
 diseases of the urinary organs, attended 
 with a flow of mucus along with the 
 urine. The dose of the powder is from 
 twenty to sixty grains in water, milk, or 
 gruel, three or four times a-day. 
 
 WIND IN THE BOWELS. In the 
 process of digestion, a considerable quan- 
 tity of gaseous matter is extricated from 
 the food, which, in the state of health, is 
 productive of no inconvenience from its 
 quantity. But when the digestion is 
 impaired, or when the bowels have lost 
 their tone, as physicians speak, then the 
 symptoms occasioned by flatulence be- 
 come very distressing, and require atten- 
 tion either as being themselves a disease, 
 or a prominent symptom of other dis- 
 eases. Flatulence is one of the most 
 
 teasing accompaniments of stomach com- 
 plaints, of hysteria, &c. Though it is al- 
 ways best to cure, if we can, the original 
 disease, and not merely to combat certain 
 symptoms, yet when this last indication 
 can be fulfilled without diminishing our 
 attention to the first, we may attempt to 
 give relief by palliative remedies. Wind 
 or flatulence is sometimes very much 
 within the reach of remedies, that give 
 at least a temporary relief. These con- 
 sist chiefly of aromatic or fetid substances, 
 which, from their speedy operation, ssem- 
 ing to work like a charm, are called car- 
 minatives. Of these, the principal are, 
 cardamoms, cinnamon, ginger, valerian, 
 assafcetida, for the administration of 
 which, directions are given under each 
 article. The same tinctures or infusions 
 are also given in the way of clyster. See 
 Flatulencii;. 
 
 Wind in Infants. Infants are occa- 
 sionally much distressed by flatulence ; 
 and in them it is quite proper to attempt 
 its discharge, provided y\e are, at the 
 same time, attentive to correct the disr 
 order of the bowels, from which it arises. 
 The best carminatives for children are 
 the water and sugar of anise, with a little 
 of the tin(;ture of cardamoms, and solu- 
 tion of assafcetida. See Children, Dis- 
 eases of. 
 
 W IND-PIPE. The tube which begins 
 at the root of the tongue, and is continu- 
 ed into the cavity of the chest, for admit- 
 ting air for the purposes of respiration. 
 To keep this passage always open, it is 
 composed principally of cartilaginous 
 rings, which are not easily compressed, 
 and is lined with a mucous membrane. 
 At the upper part of the chest, the 
 wind-pipe divides into two large branches, 
 one to each lung ; these branches divide 
 and subdivide, till they end in minute 
 air-cells, composed of a fine delicate mem- 
 brane, through which the influence of the 
 inspired air is communicated to the ve- 
 nous blood to convert it into arterial. 
 
 As all the food we eat and drink passes 
 into the gullet, which lies at the back of 
 the wind-pipe, that important tube is ad- 
 
 I 
 
W I N E. 
 
 581 
 
 mirably protected by a car tilHg;inous lid, 
 called the epiglottis; >vhicli, by the action 
 of swallowing, is pressed upon the open- 
 ing of the larynx, so that it is very rare 
 indeed for any thing swallowed to go the 
 wrong way. When this does happen, 
 severe convnlsive actions are produced. 
 
 The wind-pipe is subject to a variety 
 of diseases. It is the seat of croup, either 
 when its aperture is spasmodically con- 
 tracted, or M'hen the mucous membrane 
 Is impaired, and partially or totally chok- 
 ed up with mucus or a fjilse membrane. 
 The branches of the wind-pipe going to 
 the lungs are not unfrequently obstructed 
 in croup, and cause it to end by suffocat- 
 ing the patient. The wind-pipe is affect- 
 ed with inflammation in catarrh or com- 
 mon cold; and the pain may be felt deep 
 in the chest, or at the back or sides. 
 Coughing is a s^nnpathetic effort of the 
 diaphragm, abdominal muscles, and many 
 others, to free the branches of the wind- 
 pipe from the mucus that is oppressing or 
 irritating them. See Cough. 
 
 Ao operation on the front of the wind- 
 pipe is occasionally necessary in cases of 
 threatened suffocation, or of foreign bo- 
 dies getting into the passage. It consists 
 in a cut betv\'een the thyroid and cricoid 
 cartilages, or dividing one or two rings at 
 the upper part of the wind-pipe. 
 
 WINE is the produce of the fermenta- 
 tion of the juice of the grape, but the 
 terra is frequently applied to the product 
 of the fermentation of any sub-acid fruits. 
 The grape is remarkable for containing 
 within itself all the substances necessary 
 for the production of wine; but the juices 
 of other fruits must have the addition of 
 sugar and other ingredients, and in the 
 proportions and management of these ad- 
 ditions consists the art of making home 
 wines. Another circumstance in which 
 the juice of the grape differs from other 
 vegetable juices, is its containing a large 
 proportion of tartar; Avhile the others 
 have more of the malic acid, or that which 
 abounds in apples; and hence many of 
 the wines of this country partake of the 
 properties of cider, and are apt to become 
 
 sour. The characteristic ingi-edient of 
 all wines is alcohol, or spirit of wine; on 
 this depend their stimulating properties, 
 and the quantity and state of combination 
 in which it exists in wines, are the most 
 interesting points for the consideration of 
 the physician. Under the article Alco- 
 hol, we have mentioned its highly stimu- 
 lating properties ; and when we know by 
 the experiments of modern chemistry, that 
 many wines in common use contain from 
 a fourth to a fifth of their bulk of alcohol, 
 we at first might expect very intoxicating 
 effects to be produced by such win^s. 
 Thus a person who takes a bottle of port, 
 Madeira, or sherry, takes nearly half a 
 pint of pure alcohol, or a pint of pure 
 brandy ; but it is by no means unusual, 
 for a bottle of wine to be taken without 
 very great inconvenience, by a person 
 who would be exceedingly disordered 
 both in body and mind, by swallowing a 
 few glasses of brandy. We infer, there- 
 fore, that the alcohol in v^ine is both 
 more intimately mixed with water, and 
 exists in combination with extractive 
 matter, Mr. Brande has constructed a 
 table, showing the quantity of alcohol 
 contained in different kinds of liquors, 
 which will be found in the Appendix, 
 No. IV. 
 
 But, besides the alcohol naturally con- 
 tained in wines, the stronger wines of 
 Spain and Portugal are rendered market- 
 able in this country, by the addition of 
 brandy ; and it is to this additional spirit, 
 in a free state, as chemists call it, and not 
 to the combined alcohol, that the injuri- 
 ous effects of these wines ai-e to be as- 
 cribed. Liver complaints very often fol- 
 low the use of ardent spirits ; and the in- 
 temperate wine-di'inkers of this country 
 are also affected with liver complaints; 
 while on the Continent these affections 
 ai'e comparatively rai-e, owing to their 
 wine not being adulterated by the addi- 
 tion of brandy. 
 
 There is a distinction of wines arising 
 from their colour, into white and red. 
 This colour is derived not from the juice, 
 but from tlie husk of the grapes. It l? 
 
582 
 
 WINE. 
 
 in general highly astringent, and abounds 
 most in the red wines. Though the quan- 
 tity of astringent matter is so very small, 
 yet delicate stomachs are much affected 
 by it. Many persons get heartburn by 
 drinking port; and in others, its astrin- 
 gency does good. Every person must 
 find out for himself which wines agree 
 best with him ; but in general, the white 
 wines are to be preferred. 
 
 The flavour peculiar to different wines, 
 depends on some very delicate principle, 
 •which chemists have not been able to de- 
 tect ; in some wines it produces a remark- 
 able effect on the nervous system, as in 
 Burgundy; the excitement produced by 
 this wine being very peculiar, and not at 
 all in proportion to the alcohol contained 
 in it. Some wines have an artificial flavour 
 imparted to them, by the introduction of 
 foreign ingredients, as almonds and tur- 
 pentine. Such admixtures are rather to 
 be regarded as injurious to the Avine ; and 
 occasion in some cases indigestion, giddi- 
 ness, and other bad effects, which the un- 
 mixed wines do not produce. Wines also 
 contain a small portion of acid, but so 
 very small, as to be in all likelihood in- 
 capable of causing any bad effects to those 
 who drink them. Acidity of stomach 
 may unquestionably follow the drinking 
 of wine, but from other causes than the 
 mere portion of uucombined acid. This 
 same acid has also been blamed with equal 
 injustice, for giving rise to a fit of gout. 
 Claret has been particularly suspected of 
 this bad tendency ; but when a person is 
 predisposed to gout, excess of any kind, 
 either in diet, exercise, or wine, will pro- 
 duce the paroxysm. 
 
 Wine is well known to improve by 
 keeping, and to exert less injurious action 
 on the stomach Avhen old, than when new. 
 In red wine, this is owing to its parting 
 with a quantity of cream of tartar, in 
 combination with extractive and colour- 
 ing matter ; which deposition is common- 
 ly called the crust ; and thus is removed 
 a considerable portion of matter, that 
 Avould be likely to disagree with the sto- 
 mach. Madeira is very frequently sent a 
 
 voyage to the East Indies, and the mo- 
 tion and increased temperature thus im- 
 parted to it, certainly improve its flavour. 
 
 The general effect of wine on the 
 healthy body, when taken in moderation, 
 is to strengthen tlie muscular system, to 
 assist digestion, to quicken the circula/- 
 tion, to exhilarate the spiints, and to 
 sharpen the mental energies. But at the 
 same time, it must be inculcated, that 
 these strengthening and exhilarating ef- 
 fects are of the most insidious nature, 
 that when carried beyond moderation, 
 they pervert the faculties, degrade the ra- 
 tional nature, create a morbid craving for 
 the repetition of the indulgence, and lay 
 the foundation for a long train of suffer- 
 ings and disease. The use of wine, 
 though certainly not to be stoically pro- 
 scribed, requires to be carefully regulat- 
 ed ; and the utmost vigilance will be ne- 
 cessary, to prevent the formation of in- 
 temperate habits- 
 
 As a medicine, wine is one of the most 
 valuable ever imparted by Providence to 
 man. In many diseases of debility, . and 
 in the state of convalescence, it supplies 
 a restorative for which no substitute can 
 be found ; and excepting in inflammatory 
 and apoplectic cases, there are few dis- 
 eases in which some kind of wine may 
 not be useful. In the debilitated state 
 which follo\vs the high excitement of 
 fever, of small-pox, and various other 
 complaints, the quantity of wine, which 
 is absolutely necessary, is really great; 
 but in the letter practice of modern 
 times, a more j udicious treatment in the 
 beginning of the disease, has rendered the 
 marvellous potations of wine so celebrat- 
 ed in former days, a very rare occur- 
 rence. The quantity of wine that may 
 be taken with impunity, says Mr. Brande, 
 and the proportion requisite to fulfil cer- 
 tain indications in disease, is entirely de- 
 pendent on their quality; and they ac- 
 cordingly either produce the genial effects 
 of genuine fennented liquors, or the more 
 boisterous excitement of the products of 
 the still, even when taken with due mo- 
 deration. Thus it is, that a single glass 
 
W I N E. 
 
 58.1 
 
 of tavern-wine often heats and creates 
 lieadach, and disturbs dicrestion, in per- 
 sons Avho are not habitually accustomed 
 to the compounds which, at such places, 
 are distributed under the name of wine. 
 A mixture of different wines is a com- 
 mon source of indigestion, and the sto- 
 mach is often hurt by the use of a wine 
 to which it has not been accustomed. 
 The stronger wines, as Port, may be in 
 many instances usefully diluted with wa- 
 ter, but the lighter wines do not require it. 
 
 Wines, with respect to their dietetic 
 properties, have been arranged as follows. 
 1. Sweet wines. 2. Sparkling or effer- 
 vescing wines. 3. Dry and light wines. 
 4. Dry and strong wines. Sweet wines 
 contain a great proportion of extractive 
 and saccharine matter; and generally the 
 least portion of ardent spirit. A propor- 
 tion of sugar has remained unchanged 
 during the formation of the wine ; which 
 is therefore to be considered as a mixture 
 of wine and sugar. This sugar renders 
 them liable to become sour on weak sto- 
 machs; but Avhere this effect does not 
 take place, they are generally beneficial 
 to invalids. The principal sweet wines 
 are Frontignac, Canary, Tokay, Tent, and 
 Malmsey. Sparkling wine^ are indebted 
 for this property to the carbonic acid 
 which they contain. Such wines intoxi- 
 cate rapidly, from the alcohol in combina- 
 tion with the gas being applied suddenly, 
 and in a very divided state, to a large ex- 
 tent of nervous surface ; their effects ge- 
 nerally soon pass off. Champagne is a 
 notable instance of a sparkling wine. 
 Dry and light wines are the more es- 
 teemed German wines, as Hock, Rhe- 
 nish, Mayne, Moselle, Necker, and El- 
 sass; and the highly flavoured wines, 
 Burgundy, Claret, Hermitage, &o. The 
 first named combine the effect of an acid, 
 with that of a spirit. They are to be 
 preferred as not containing any uncom- 
 bined alcohol. Dry and strong wines are 
 Madeira, Port, and Sherry. 
 
 Home-made wines are generally inju- 
 rious to delicate stomachs, as they are 
 apt to ferment, and so to promote indi- 
 
 gestion; owing to their containing a 
 large quantity of unfermented sugar, or 
 becoming sour in consequence of the pro- 
 duction of a little vinegar. The acidity 
 and indigestion which are induced by 
 wine, may be corrected in some measure 
 by the use of a little magnesia at bed- 
 time, which saturates the acid in the sto- 
 mach, and passes off by the bowels. 
 
 WOMB, Uterus. The organ in the female 
 body, in which the embryo lives and grows 
 till the time of birth. It is shaped some- 
 thing like a pear, with the broad end up- 
 permost. Its broadest part is called its 
 fundus ; it has also a body and a neck : its 
 mouth opens into the vagina. In the 
 unimpregnated state, it would hardly 
 contain a kidney-bean, but at the full 
 time, it expands sufficiently to contain 
 one or more children, with their waters, 
 membranes, and after-births. At the up- 
 per part of the womb, two broad mem- 
 branous expansions arise, and are the 
 means of its attachment to the sides of 
 the pelvis ; in the doublings of these ex- 
 pansions are situated the ovaria, believed 
 to be the receptacle of the vesicles, which 
 are afterwards animated ; and also the 
 tubes, first described by an anatomist 
 named Fallopius, through which one or 
 more vesicles pass down into the uterus, 
 there being an opening at each side of 
 the fundus. Sometimes the embryo grows 
 in one of these tubes, instead of getting 
 into the uterus. Such extra-uterine con- 
 ceptions are generally fatal to the mother 
 and child. From the womb proceeds the 
 monthly discharge. 
 
 The sympathies of the womb with 
 other parts are of the most general and 
 extensive kind. Not even the stomach 
 itself has more influence on the rest of 
 the system. When the state and con- 
 tents of the womb are altered by preg- 
 nancy, the stomach, the bowels, and di- 
 gestive functions are in very frequent 
 instances exceedingly deranged. The brain 
 and nervous system, the function of res- 
 piration, and the state of the breasts are 
 all very much influenced by the condition 
 of the womb. 
 
584 
 
 WOMB. 
 
 The womb is subject to a variety of 
 disorders, the most common and import- 
 ant of which are as follow. 
 
 1 . Bearing down or falling down sig-- 
 nifies that the womb is lower than it 
 ought to be. The first symptom is an 
 uneasy feeling in the lower part of the 
 back, while the patient is standing' or 
 "walking- ; with a sense of pressure or bear- 
 ins^ down. As the complaint increases, 
 a swelling appears to come in the way of 
 the discharge of urine,' which the patient 
 cannot pass, without lying down, and 
 pushing aside the tumour which prevents 
 it. In more advanced and severe cases, 
 the Avomb is forced altogether out of the 
 parts, as a hard and bulky substance 
 hanging between the thighs. In many 
 cases, the protruded parts are ulcerated, 
 and give great uneasiness by tlieir being- 
 fretted. Many complaints arise in other 
 parts of the system from this local dis- 
 ease. There is sickness, and other dis- 
 orders of the stomach and bowels, with 
 hysterics and nervous affections ; while 
 the inability to take exercise is itself a 
 great evil, and tends to impair still more 
 the general health. 
 
 Causes. Every woman should know 
 these, and avoid them as far as possible. 
 Whatever tends to weaken the general sys- 
 tem or the passage to the womb, may give 
 occasion to its falling down. In the un- 
 married state, all violent or long continued 
 exercise when the person is unwell, has a 
 tendency to bring on the complaint; hence 
 young women, at these times, should 
 avoid dancing, riding, and long walking 
 or standing. Married women have it 
 brought on by frequent miscarriage, im- 
 proper treatment during labour, and tak- 
 ing much exercise too soon after delivery. 
 Treatment. When the disease has oc- 
 curred recently, and is not very bad, the 
 system is to be strengthened by nourish- 
 ing diet, by the cold bath, by moderate 
 
 Zi %4Vt«<exercise ; and a mild astringent fluid is 
 ^yj to be thrown into the passage. This may 
 ^^ be made of twenty grains of white vitriol 
 
 ^ "J** ^^5to a pint of rose-water. But when the 
 complaint is of longer standing and more 
 
 severity, the patient must be confined to 
 the horizontal posture ; baik and wine, 
 and chalybeate medicines must, be era- 
 ployed, and a stronger astringent, as a de- 
 coction of oak-bark, with some acid add- 
 ed to it, must be thrown up. Sometimes 
 these means are all ineffectual, and an in- 
 strument of wood or ivory, called a pes- 
 sary, must be worn, to fill the outer pas- 
 sage and prevent the womb from falling 
 down. This instrument should be remov- 
 ed every two or three days, and cleaned. 
 Sometimes this soon effects a cure ; but, 
 in general, it requires to be worn for 
 years. If a person, liable to this disease 
 become pregnant, it disappears about the 
 third or fourth month ; and if proper 
 measures be taken after delivery, the re- 
 turn of the complaint may be prevented 
 in many instances. 
 
 2. Tumours or Poli/pi in the Womb 
 and Vagina. These are of various sizes 
 and consistency ; they are sometimes 
 broad and flat at their base, sometimes 
 they have a narrow neck. They occa- 
 sion a discharge of blood at times ; but 
 when small, they are not productive of 
 much inconvenience. But if they be- 
 come large, they give rise to symptoms 
 both troublesome and dangerous. There 
 is violent bearing dov>'n pain, discharges 
 of blood, or of fetid dark-coloured matter 
 from the vagina, pain or difficulty of 
 making water, irritation of the rectum, 
 and a frequent desire to go to stool. When 
 very large, the polypus hangs out from 
 the passage. If the disease be notrelievr 
 ed, the pains become more violent, the 
 constitution is affected, and the continual 
 discharge greatly weakens the patient. 
 
 Treatment. As the patients themselves 
 cannot distinguish tumours from other 
 diseases producing similar symptoms, 
 their existence nuist be ascertained by the 
 examination of a practitioner ; and their 
 removal effected by a surgical operation, 
 either by the knife or by ligature, per- 
 formed by a surgeon well acquainted 
 VI ith the stnicture and connexions of the 
 parts. No internal remedies will do any 
 good till the tumour is removed. When 
 
WOMB. 
 
 585 
 
 this is accomplished, the general health 
 is to be improved by proper diet and to- 
 nic medicines. 
 
 3. Womb, Cancerous affections of. 
 These, when in a state of ulceration, con- 
 stitute one of the most deplorable diseases 
 which can afflict humanity. Cancer of 
 the womb most generally attacks at the 
 decline of life, though not exclusively so. 
 At first, the patient has an uneasy feel- 
 ing of weight at the lower part of the 
 belly, with heat or itching. Afterwards, 
 shooting p:uns occur; then a pain, giving 
 a gnawing burning sensation, seems fixed 
 in the region of the womb. This pain is 
 attended by the discharge of ill-coloured, 
 sharp matter, which irritates and corrodes 
 the neighbouring parts. As the disease 
 continues, almost every function of the 
 body becomes disordered. Sickness and 
 vomiting come on, the boAvols are torpid 
 and irregular, hectic fever, and great 
 emaciation ensue, and the spirits are de- 
 jected and desponding. Swellings of va- 
 rious glands, and watery swellings of the 
 limbs not unfrequently occur. Similar 
 symptoms as in the early stages of can- 
 cer, may arise from other complaints in 
 the womb, as from polypous giowths ; 
 the nature of the disease should there- 
 fore be, if possible, ascertained at an early 
 period, that the one may be removed, 
 and the other kept from rapid advance- 
 ment and ulceration, so far as we are 
 able. Cancer in the Avomb appears to 
 begin with a thickening and hardne&s of 
 that organ ; which we suspect, when 
 there ai'e pains in the thighs and back, 
 a bearing down when the patient is using 
 exercise, and occasional discharge of clot- 
 ted blood. Our directions to the patient 
 in such cases, are to use a milk and ve- 
 getable diet, to abstain from animal food 
 and fermented liquors, to lose a little 
 blood occaiiionally, to take frequently a 
 dose of laxative cooling salts, and to use 
 the warm bath. 
 
 Treatment. Of the nature of cancer 
 of the womb, we are as ignorant as of 
 cancer in any other part of the body ; 
 and when t!ie disease is established, we 
 
 are as destitute of any remedy. In the 
 periods of deplorable sufiering which ter- 
 minate the life of the patient, we can do 
 little more than palliate symptoms ; and 
 the whole tribe of narcotic medicines 
 have been brought into requisition on 
 such occasions. Opium, belladonna, hem- 
 lock, and various others, have been tried , 
 and failed. Mercury, in every shape, is 
 absolutely pernicious in cancer. 
 
 The melancholy distress to which pa- 
 tients are reduced by cancer of the 
 M'omb, disposes the minds both of them- 
 selves and their friends to listen with 
 eagerness to the promises of relief, which 
 ignorant and interested empirics so libe- 
 rally make to them. But all such pro- 
 mises must be met with the most obsti- 
 nate incredulity. Tiie learned, the expe- 
 rienced, and the candid members of the 
 medical profession declare, that, as yet, 
 no drug has been found capable of curing 
 cancer by acting on the constitution; and 
 whoever suffers herself to be deluded by 
 the boasts of those whose only aim is to 
 vend their nostrums, loses the time that 
 might be better employed, and neglects 
 those suggestions which might palliate, 
 though they cannot cure her complaints. 
 4. Womb, Injiammation of. This sel- 
 dom happens, except in the puerperal 
 state. It may occur at different periods 
 from delivery, to the fifth or sixth day, 
 but it sometimes happens later. Like 
 other inflammations, it is ushered in by 
 shivering, followed by great heat, thirst, 
 quick hard pulse. Pain is felt in the 
 womb from the beginning, with a sensa- 
 tion of fulness and weight ; also a burn- 
 ing heat, and throbbing. The exact spot 
 where the pain is felt, varies according 
 to the part of the womb that is inflamed; 
 it may be towards the navel, or over the 
 share-bones, or shooting backwards, or 
 down the thighs ; or it may affect the 
 bLidder with pain and suppression af 
 urine, or diiliculty of passing it. 
 
 Diagnosis. It is distinguished from aT- 
 ter-pains by the constancy of the pain, by 
 the heat and tlirobbingof the part, and by 
 the pain being much increased on pressure 
 
586 
 
 WORMS. 
 
 at the region of the womh. Causes. In- 
 flammation of the womb is induced by 
 difficiilt or tedious labour, by officious 
 interference during labour, or by Avrong 
 methods of forcing the expulsion of the 
 child and after-birth ; by too much strong 
 food or heating drinks ; by exposure to 
 cold during perspiration, or by using 
 cold drinks. Treatment. It requires 
 very prompt and active interference, as 
 its progress is very rapid, and its event 
 uncertain and dangerous. If assistance 
 is procured in time, it may be stopped 
 by blood-letting, both general and local, 
 by leeches, low diet, diluent drinks slight- 
 ly acidulated ; with laxative medicines or 
 clysters, and fomentations to the belly. 
 A copious sweat, and a flow of the lochia, 
 with relief from pain, mark the success 
 of this plan of treatment. But we are 
 not always so successful, for the pain 
 sometimes becomes more acute, with 
 throbbing, and an increase of fever, sick- 
 ness, delirium, and restlessness. In these 
 cases there is risk of mortification ; and 
 this is shown to have come on by a lan- 
 guid pulse, low delirium, and cold clammy 
 sweat. Such termination happens chiefly 
 in bad constitutions, or in those who are 
 much debilitated. When suppuration is 
 to take place, the pulse continues firm, 
 and the throbbing is more violent. The 
 matter is discharged by various outlets ; 
 the most favourable of which is the mouth 
 of the womb, but sometimes it is dis- 
 charged by the rectum, or by an opening 
 in the groin. When the discharge is 
 going on, the strength of the patient is to 
 be supported by nourishing diet, the 
 bowels are to be kept open, and bai-k and 
 wine to be given. Much attention must 
 be paid to cleanliness. 
 
 WOMEN, Diseases of. See Female 
 Complaints. 
 
 WORM S. The production and growth 
 of living animals in the various parts of 
 the bodies of others, is one of the most 
 curious facts in natural history. There 
 |s a mystery and strangeness about it, 
 that secure a ready and popular accept- 
 apco of the fact as a sufficient reason for 
 
 a great variety o^ maladies, especially 
 those which occur in children; and an 
 unhealthy look, a voracious appetite, and 
 picking of the nose, though frequently 
 originating from other diseases, or mere- 
 ly the effects of bad habit, are considered 
 as quite explained, by saying the child 
 has worms. This is so far a fortunate 
 circumstance, for like the giving of wine, 
 we never find any resistance to purgative 
 medicines, provided they are called worm- 
 powders; and attention to the bowels, 
 with occasional purging, is one of the best 
 modes of preserving the health of child- 
 ren, and of adults also. There are three 
 different kinds of worms with which the 
 body is principally infested ; the ascarides 
 or small white worms ; the teres or long 
 worm, like an earth worm ; and the taenia 
 or tape- worm. 1. The ascarides or small 
 white worms, generally, are lodged about 
 the extremity of the rectum, involved 
 in the slime which abounds in that part. 
 2. The long worm is found in the small 
 intestines, and sometimes in the stomachj 
 and, 3. The tape-worm in the whole of 
 the intestinal tube. 
 
 Symptoms. The symptoms which lead 
 us to suspect the presence of worms in 
 the intestines are the following : The ap- 
 petite is variable and capricious, there is 
 pain in the stomach, stinking breath, 
 grinding of the teeth, picking of the nose, 
 a pale countenance, hard and swelled 
 belly. The stools are slimy and irregu- 
 lar, there are griping pains in the bowels, 
 heat and itching about the anus. The 
 general health suffers ; and there is some- 
 times a short dry cough, iiTegular pulse, 
 evening exacerbations, and wasting of the 
 body ; convulsions not unfrequently are 
 occasioned by worms. Worms infest 
 persons of every age, but children are 
 chiefly liable to them. Their principal 
 cause seems to be, unwholesome diet 
 and bad digestion. The tape-worm is 
 more common in adults than in children, 
 but in them it sometimes occurs. 
 
 Treatment. Many of the symptoms 
 above described occur in the bowel com- 
 plaints of children, though there are no 
 
WOUNDS. 
 
 587 
 
 worms present ; and nearly the same ge- 
 neral plan of treatment is to be pursued. 
 There are various methods in use for dis- 
 lodging- and expelling the long worms 
 from the intestines, some intended to act 
 mechanically, as the powder of tin, which 
 is sometimes given to the amount of one 
 or two ounces ; or the hairy pod of cow- 
 itch, which, enveloping the worms, carries 
 them along by the motion of the intes- 
 tines. Other remedies are intended to 
 act by their purgative quality, as turpen- 
 tine, aloes, rhubarb, scammony, jalap, ca- 
 lomel, and the like. A powder compos- 
 ed of three grains of aloes, six of rhubarb, 
 and five of aromatic powder, may be giv- 
 en every night for four times ; and work- 
 ed off on the fifth morning with a dose 
 of senna or salts. Three grains of calo- 
 mel, with eight of jalap, may be given 
 every second night for a week. The best 
 medicines for destroying the ascarides are 
 preparations of aloes, either by the mouth 
 or by clyster; a powder composed of 
 aloes and jalap, in quantities proportion- 
 ed to the age and strength of the patient, 
 may be given every second night at bed- 
 time, or a clyster may be thrown up, in 
 which a drachm or two of the tincture of 
 aloes is mixed. Other bitter purgatives 
 and tonics, as rhubarb, wormwood, and 
 the bke, may be employed. The tape- 
 worm is very difficult to remove. It has 
 been attempted by the powder of the 
 male fern, followed up by large draughts 
 of green tea, and purgative powders. 
 This plan certainly often proved effectu- 
 al, but of late we have succeeded very 
 well, by giving the oil of turpentine, in 
 the dose of an ounce, or an ounce and a 
 half. When the disease abates, or the 
 worms are expelled, such measures are to 
 bo pursued as tend to restore health and 
 strength ; the patient is to be sent to the 
 country, to live on a nourishing diet, and 
 great attention is to be paid to the 
 bowels. 
 
 WORMWOOD, Artemisia Absinthi^ 
 unit a plant having a strong and peculiar 
 odour, and au intensely bitter and disa- 
 greeable taste. Infused in ale, it forms 
 
 the drink called purl. It may be used 
 as a tonic and stomachic from its bitter- 
 ness, and had its reputation and its name 
 from being supposed to be good against 
 worms. The dose is from one to two 
 drachms of the powder of the stalk, or 
 an ounce of the infusion made by an 
 ounce of the plant to a pint of water. 
 
 WOUNDS are divided into various 
 classes according to the nature of the in- 
 strument with which they are inflicted, 
 and the effect produced. They may be 
 all included under the head of gun-shot 
 wounds, simple incised wounds, lacerated 
 or contused wounds, and punctured 
 wounds. 
 
 1. Gun-Shot Wounds. These include 
 not only the injury inflicted by bullets, 
 balls, and the like, but those also which 
 are occasioned by the bursting of bombs, 
 shells, and the flying about of splinters, 
 fragments of stone, &c. It is now ac- 
 knowledged, that the violent injuries in- 
 flicted by firearms, depend solely on the 
 weight, bulk, and velocity of the sub- 
 stance impelled, and have no connexion 
 whatever with burning or poisoning from 
 the explosion of the powder. A shot 
 may occasion merely a contusion, or it 
 may penetrate the surface and lodge in a 
 part; or it may pierce through and 
 through, or a large shot may tear off a 
 limb. These different effects may be 
 combined with the shattering of bones 
 or the wounding of vessels, or the lodg- 
 ment of foreign bodies. 
 
 Treatment. When a shot has been re- 
 ceived on any of the extremities, the first 
 thing for the surgeon to consider is, whe- 
 ther he will attempt to save the limb, or 
 whether it be necessary to amputate. 
 He is then to consider the propriety of 
 immediate amputation, or if it should be 
 delayed ; and the skill and too ample ex- 
 perience of modern surgeons has ascer- 
 tained, that in a great majority of cases, 
 if amputation is necessary at all, immedi- 
 ate amputation gives the patient the best 
 chance for his life. The following are 
 some of the cases in which immediate 
 amputation is necessary. 1. When a 
 
588 
 
 WOUNDS. 
 
 limb is torn off. 2. When the bone and 
 other parts .are much shattered. 3. When 
 much of the flesh and soft parts are torn 
 avvay, or when the large artery of the 
 Urab is wounded. 4. When the muscles 
 and nerves are much injured. There are 
 other circumstances to be taken into con- 
 Kiderati.>n, as whether the patient is like- 
 ly to be taken with proper care to an 
 hospital, whether the wounded must be 
 left on the field, &c. 
 
 When amputation is not to be per- 
 formed, the Avound is to be treated on ge- 
 neral principles ; foreign bodies are to be 
 extracted, and incisions made where ne- 
 cessary, to get either at the ball or at 
 any foreign body. It was at one time 
 recommended, uniformly to make inci- 
 sions to dilate gun-shot wounds ; but this 
 is found not to be at all necessary as a 
 general rule, as these incisions must add 
 to the pain and irritation which are al- 
 ready very great. We must not even be 
 too anxious about getting out every fo- 
 reign body, or even the ball, when to do 
 this is very difficult ; as it is probable 
 that a suppuration will come on, and 
 contribute to their discharge. The 
 course and contents of the wound, when 
 it is large enougli to adnn't the finger, are 
 better examined by it than with a probe 
 or other instrument. When extraneous 
 substances do not bring on suppuration, 
 so as to bring them into view, and render 
 them easily extracted, they often give 
 rise to a fistulous ulcer. Sometimes balls 
 and other bodies get into a place where 
 they do no injury, and remain during the 
 patient's life. It is an improper practice 
 to put tents into gun-shot wounds ; the 
 first dressings should be mild, unirritat- 
 ing, and superficial ; and to promote the 
 separation of the bruised and dead parts, 
 and to assist in removing the tension and 
 swelling, emollient poultices and fomen- 
 tations are to be employed ; the applica- 
 tion of leeches is also very proper, and 
 for the general system, we must observe 
 the antiphlogistic regimen. From the 
 bruising and compression of the parts, 
 there is often but little bleeding at the 
 
 first, and we are to watch for a more sud- 
 den bleeding when the sloughs drop off; 
 and therefore when the wound is near the 
 tract of any large vessel, we should be 
 prepared for this event, and have every 
 thing in readiness for stopping bleeding. 
 Care should always be taken not to re- 
 move the dressings too hastily. If the 
 wound does not heal, but continues long 
 to discharge matter, occasioning a wast- 
 ing of the body, with hectic fever and 
 other dangerous symptoms, amputation 
 then becomes necessary to save the life of 
 the patient. 
 
 The following remarks on gun-shot 
 wounds, from the lectures of INIr. Aber- 
 nethy, are judicious and sufficiently cha- 
 racteristic. 
 
 " I now come to speak of gun-shot 
 wounds, and this is a kind of wound at- 
 tended with the greatest possible contu- 
 sion. The practice in' France in Louis 
 the Fourteenth's time, was to slit open 
 the wound in its whole length, in order 
 to give exit to any blood or matter — nay, 
 they put setons through the M'ound. 
 Mr. Hunter very much simplified the 
 surgical practice in gun-shot wounds, and 
 used, as well as recommended in his lec- 
 tures, a soothing plan of treatment. Of 
 course they are to be treated upon the 
 common principles of surgery. In speak* 
 ing of gun-shot wounds, the question 
 is whether the ball has gone through or 
 not, and this creates considerable anxiety 
 to the relatives — if with a probe you can 
 feel wadding, clothes, or the ball, why 
 common sense would tell you to take it 
 away; but common sense will equally 
 tell you, not to be poking about and 
 being over curious, for you cannot tell 
 where the ball is gone to. It is really 
 curious the course which balls will some- 
 times take ; and it is founded on the laws 
 of projectiles — a ball may strike on the 
 abdominal muscles, and go out through 
 the other side. It is within the compass 
 of possibility that the ball may pass in at 
 the belly, and by passing quite round, 
 may come out at the same wound. When 
 I Avas an apprentice, I recollect u case 
 
WOUNDS. 
 
 589 
 
 which made some impression on me. My 
 master was gone out of town, and I w^s 
 called up from my bed one night to a 
 man who had shot himself through the 
 temple. When I arrived, there was a 
 hole in the right temple, where the ball 
 had gone in, and one on the opposite side, 
 where, I took it for granted, it had come 
 out. I of course thought the man was 
 shot clean through the brain ; but he re- 
 tained his senses, and had all his faculties 
 about him. This was puzzling enough 
 in all conscience, but as I wished to be 
 doing what I thought right and proper, I 
 bled him, and ordered his head to be 
 shaved — the course which the bullet had 
 taken was then apparent enough, for it 
 had travelled under the scalp, and had 
 passed out at the opposite side, and the 
 track of the bullet Avas indicated by a 
 red line running all over the scalp. One 
 of the strangest cases of bullet-travelling 
 was related by Sir James Earle — the bul- 
 let went in under the bladebone and came 
 out at the loins on the opposite side. 
 Great stress is always laid on the neces- 
 sity of extracting the ball. Nay, in al- 
 most every novel, where a duel is often 
 the consequence of rivalry in love, do we 
 not read that * Sir Harry has been 
 wounded, but the ball was extracted, and 
 that Sir Hany was expected to recover.* 
 
 " All gun-shot wounds being very 
 likely to produce sloughing, you should 
 guard yourself by a double prognostic ; 
 for although no injury may be apparent 
 at fii-st, yet sloughing of an artery may 
 happen, and destroy the patient by sudden 
 haemorrhage. A sailor M'as found dead in 
 his bed one night, and the bed half full 
 of blood — the femoral ai'tery had been 
 slightly grazed, and had sloughed — at first, 
 however, the case to all appearance was 
 going on favourably, being a slight and 
 ti'ivial gun-shot wound. 
 
 " Poultices ai'e good in gun-shot wounds 
 — and great care is to be taken that the 
 digestive organs are tranquillized. In 
 superficial gun-shot wounds, as a line of 
 demarcation is set up, it will not be so 
 difficult to trace out the bullet; but in 
 
 deep-seated wounds of this nature, I again 
 caution you not to be poking for bullets, 
 as great irritation is brought on thereby." 
 
 II. SiMPLK IxcisEDi Wounds, or Cuts^ 
 are those which are inflicted with a clean 
 cutting instrument, and they are to be 
 considered as the most favourable kind 
 of wound. When the bleeding has stop- 
 ped, the edges of the wound are to be 
 brought together, and kept so by straps 
 of adhesive plaster, or in some situations 
 by one or two stitches ; and when this 
 apposition has been carefully made, such 
 wounds generally heal very quickly, with- 
 out any suppuration taking plaoe. 
 
 III. Lacerated and Contused Wounds 
 are those where there has been much 
 tearing and bruising of the soft parts; 
 they heal less kindly, and suppuration is 
 almost always a stage of the process. 
 When a part is torn we are to place it 
 in its natural situation, and retain it there 
 if possible ; but if there appears little like- 
 lihood of its uniting again to the neigh- 
 bouring parts, it is better to remove it ; 
 and we are to diminish the swelling and 
 inflammatory symptoms which commonly 
 attend contused wounds, by cooling lo- 
 tions, or by emollient poultices. 
 
 IV. Punctured Wounds are such as 
 are inflicted with a pointed instrument, 
 as a thrust from a bayonet, a short sword, 
 a graver's tool, or the like. The first 
 thing to be guarded against in such 
 wounds, is the coming on of inflamma- 
 tion. If there has not been much bleed- 
 ing from the wound, we may take blood 
 both generally and locally, and we are 
 to employ the antiphlogistic regimen. 
 Punctured wounds on the scalp, over 
 tendinous places, or parts which are thin- 
 ly covered, as the bones of the leg, are 
 apt to be followed by an erysipelatous in- 
 flammation of the skin. It may some- 
 times be necessary to enlarge the wound 
 a little, in order to remove the stretch- 
 ing of the parts; and to lessen the in- 
 flammation, leeches and fomentations are 
 proper. 
 
 WRY NECK. A long-coutiimed or 
 permanent turning of the head to one 
 
590 
 
 WRY NECK. 
 
 side. It is different from the pain and 
 stiffness which occur from cold and rheu- 
 matism, and which prevent the free mo- 
 tion of the head ; and arises from various 
 morbid conditions of the part, either from 
 distortions of the vertebine, from palsy of 
 some of the nerves going- to the muscles 
 that move the head, or from some altered 
 structure of the muscles themselves. The 
 removal of this affection, when possible, 
 is accomplished by treatment adapted to 
 the particular cause inducing it. The 
 
 bones of the neck may be aided by ma- 
 chinery, if the subject is young ; blister- 
 ing, friction and shampooing long perse- 
 vered in have been of service in the pa- 
 ralytic affections of the nerves and mus- 
 cles ; and at one time it was a favourite 
 practice to cut across the large muscle 
 extending from the ear to the breast-bone, 
 which was generally supposed to be in 
 fault. This severe measure very often 
 was unsuccessful, and is hardly ever to be 
 recommended. 
 
 YAW 
 
 YAM. " An esculent root, obtained 
 principally from three species of Diosco- 
 rea, the alata, hiilbifera, and saliva. 
 They grow spontaneously in both Indies, 
 and the roots are eaten, as the potato is 
 with us, promiscuously. There is great 
 variety in the colour, size, and shape 
 of yams ; some are generally blue or 
 brown, round or oblong, and weigh from 
 one pound to two. They are esteemed, 
 when dressed, as being nutritious and 
 easy of digestion, and are preferred to 
 wheaten bread. Their taste is somewhat 
 like the potato, but more luscious. The 
 negroes, whose common food is j^aras, 
 boil and mash them. They are also 
 ground into flour, and made into bread 
 and puddings. V/hen they are to be 
 kept for some time, they are exposed 
 upon the ground to the sun, as we do 
 onions ; and when sufficiently withered, 
 they are put into dry sand in casks, and 
 placed in a dry garret, where they re- 
 main often for many seasons, without 
 losing any of their primitive goodness." 
 (Hooper's Medical Dictionary). 
 
 YAWS, a tubercular disease; the 
 Frambcesia of Willan ; it is accompanied 
 with small, hard, superficial tumours. The 
 nature of this disease, which is indige- 
 nous in Africa, and has been thence con- 
 
 YAW 
 
 vcyed to the West Indies and America, 
 has been imperfectly investigated by Eu- 
 ropean practitionei-s. The eruption of 
 the yaws sometimes commences without 
 any precursory sjinptoms of ill health ; 
 but it is generally preceded by slight fe- 
 ver, with languor, debility, and pains of 
 the joints, resembling those of rheuma- 
 tism. After several days, minute protu- 
 berances appear on various parts of the 
 skin ; at first smaller than the head of a 
 pin, but gradually enlarging to the size 
 of a sixpence ; they are most numerous 
 and large in the face, arm-pits, groins, 
 and about the anus. The crop is not 
 completed at once ; new eruptions appear 
 in different places, while some of the 
 earlier ones dry off. When the cuticle 
 is broken, a foul crust is formed on the 
 surface, from under which, red fungous 
 growths often spring up, from the size of 
 a small raspberry to that of a large mul- 
 berry, which fruit they sometimes resem- 
 ble from the granulated surfaces. In child- 
 ren, the duration of the yaws is from six 
 to nine months; in adults it is seldom cur- 
 ed in less than a year, and sometimes con- 
 tinues during two or three. The tubercles 
 are not painful except on the soles of the 
 fect> where they are compressed by the 
 hard skin ; here they render walking 
 
YELLOW FEVER. 
 
 591 
 
 painful, or hinder it altojrether. They 
 never suppurate kindly. When they ap- 
 pear on any part of the hody covered with 
 hair, this gradually changes in its colour 
 from hlack to white. The tubercles leave 
 no depression of the skin. When they 
 no longer increase in size, the disease is 
 supposed to have attained its acme ; and 
 at this period, one of the pustules be- 
 comes much larger than the rest, equal- 
 ling or surpassing a half-crown piece ; its 
 surface is foul and sloughy, and pours out 
 an ill-conditioned matter which corrodes 
 the surrounding sound skin ; this is call- 
 ed the mastery or mother-yaw. 
 
 The yaws is propagated solely by the 
 matter being applied to the wounded or 
 broken skin of another person, who has 
 not previously undergone the disease. 
 The complaint is sometimes inoculated 
 by flies, in those hot countries Avhere the 
 skin both of the diseased and the healthy 
 remains uncovered. Hence, Dr. Ban- 
 croft says, few ever receive it, whose 
 skins are whole, for which reason the 
 whites are rarely infected ; but the bo- 
 dies of the negroes being often raw by 
 whipping, and suffered to remain caked, 
 they scai-ce ever escape it." (We may 
 here observe, that this incidental notice, 
 this unintentional glimpse of West Indian 
 manners, occurs in a merely medical de- 
 scription.) Like the feverish eruptions, 
 the yaws affects the same person only 
 once during life ; but unlike them, it is 
 not propagated by efliuvia. 
 
 Treatment. Active evacuations re- 
 tai'd the natm'til progress of the disease ; 
 and mercurials, although they suspend 
 it, and clear the skin of the eruption, yet 
 leave the patient still impregnated with 
 the vijus, which speedily shows its pre- 
 sence, by a re-appearance of the symp- 
 toms more severe and tedious than be- 
 fore. Unless any urgent symptom should 
 require alleviation, it is advisable to dis- 
 pense with the administration of medi- 
 cine, and restrict the patient to a moder- 
 ate and temperate regimen, duriiio^ the 
 first stage of the disease. When the 
 eruptions begin to dry, the disease re- 
 
 quires a light, but nutritious diet ; dry 
 and wholesome air, warm clothing, mo- 
 derate exercise, and a course of tonic 
 medicine, as sarsaparilia and bark, with 
 the mineral acids. If the master-yaw 
 remains large and troublesome, it is to 
 be treated with gentle escharotics. (Dr. 
 Bateman). 
 
 YEAST. The scum which collects on 
 beer while fermenting, and which has the 
 property of exciting fermentation in va^ 
 rious other substances. Yeast has the 
 property also of preventing putrefaction ; 
 and it is added to poultices which are ap- 
 plied to gangrenous sores. 
 
 YELLOW FEVER. A dangerous fe- 
 ver, of the typhoid kind, common in th« 
 West Indies and America ; and, with 
 some little variety, occurring too often in 
 Spain and Gibraltar. The yellow iexor^ 
 like many others, attacks with lassitude 
 and chilly fits, faintness, giddiness, and 
 flushing of the face, thirst, pain in the 
 eye-balls or forehead, pain in the back, 
 scanty and high-coloured tmbid urine ; 
 iiTcgular and diminished perspiration; 
 the tongue is covered with a dark fur; 
 the bile is secreted in unusual quantity, 
 and being forced up into the stomach, is 
 vomited; the skin is hot and dry. Am 
 the disease advances, the eyes become of 
 a deep yellow, and the face and breast ai-e 
 of the same colour ; there is an incessant 
 vomiting of frothy bile ; great costiveness 
 prevails, and delirium comes on. The 
 fever sometimes remits so much about the 
 end of thirty-six hours, that the paticjit 
 thinks himself compai-atively well, but 
 the symptoms soon return with great ag- 
 gravation, and extreme debility. In tlie 
 last stage of the disease, the debility la 
 \&:Y great, and symptoms* of universal 
 putrescency occur, large livid i)atches ixra 
 observed, the tongue becomes dry and 
 black, the teeth are incrusted with dark 
 fur, the body exhibits a livid ydlow, 
 blood flows from the mouth, ears, and 
 nostrils, dark and fetid stools are dis- 
 charged, hiccups.come on, the pulse sinks, 
 and death soon follov>s. The order and 
 severity of the symptoms vary in differ- 
 
5fJ2 
 
 YELLOW F E V E R. 
 
 ent cases ; some are seized veiy sudden- 
 ly, and fall down insensible ; others, for 
 a few days have the warning- sigiis of cos- 
 tiveness, defect of appetite, pain in the 
 head, yellowness of the eyes, hoarseness 
 and sore throat, lowness of spirits. In 
 the great majority of cases, there are evi- 
 dent remissions or intermissions. All 
 kinds of persons are affected by it, but 
 those principally who are in the prime of 
 life; men more frequently than Avomen. 
 People of colour have the disease milder 
 than others. 
 
 Causes. " The violence and fatality of 
 this disease have directed very powerful- 
 ly the attention of physicians to its na- 
 ture. As it obviously occurred at the pe- 
 riod when the autumnal remittents Avere 
 common on the American continent, and 
 in the southern parts of Europe, it was 
 highly probable that this was only the 
 usually returning epidemic, from acci- 
 dental circumstances rendered more vio- 
 lent and fatal. But when its nature was 
 more closely examined, it seemed highly 
 probable that it was a typhus attended 
 with bilious symptoms, rather than a re- 
 mittent of a peculiarly malignant kind. 
 
 " When the violence and malignity of 
 the disease were ascertained, no country 
 was willing to claim the destructive visi- 
 tant. It was supposed to be an impor- 
 tation, and probably was so. At Mar- 
 tinique it was the fever from Siara ; in 
 America from Bulam. From a careful 
 examination of all the facts, it appears 
 probable that some contagion, uniting 
 with the epidemic tendency of the bilious 
 autumnal remittent of the country, has 
 produced the destructive monster. The 
 observations in Philadelphia seem to 
 trace the yellow fever to some foreign 
 importation. At Martinico, at Grenada, 
 and Jamaica, there appears always to 
 have been a concurring cause. It is 
 doubtful, however, whether this is con- 
 stantly contagion. The putrefaction of 
 vegetable and animal substances, which 
 in any situation may occasion ague or ty- 
 phus, in concurrence with the autumnal 
 remittent, may produce the yellow fever. 
 
 Diagnosis. " These views will discri- 
 minate it from the caitsus, (or violent 
 tertian remittent), from the jail and hos- 
 pital, as well as from the common bilious 
 fever. In the jail fever, there is little 
 accumulation and discharge of bile : in 
 the others, little of the debilitated and 
 putrefactive state. The yellow fever and 
 the plague are, we think, referable to pu- 
 trefaction ; and the distinction is not an 
 object of curiosity and refinement only, 
 for it assists in directing the cure, parti- 
 cularly the exhibition of the Peruvian 
 bark. Much idle — it is an improper 
 word — many highly pernicious di^-qui- 
 sitions have been indulged, whether this 
 fever is contagious. The existence of a 
 doubt shows that it may not be highly 
 so. Yet it has, in so many instances, been 
 communicated from an infected person, 
 that the utmost caution is requisite. 
 It has been even doubted whether the 
 plague is contagious ; but those who have 
 suggested and disseminated the doubts, 
 are answerable for the lives of thousands, 
 and in some instances have paid the for- 
 feit with their own." (Dr. Parr.) 
 
 Some of the circumstances in which 
 yellow fever differs from typhus are 
 these : the yellow fever prevails only 
 during or after hot seasons, and is stop- 
 ped by the coming on of winter ; the re- 
 verse of which is true of typhus. The 
 yellow fever attacks principally the young 
 and robust, but typhus is most formidable 
 to the debilitated ; its symptoms are dif- 
 ferent from those of typhus, and it re- 
 mits or intermits, which typhus does not 
 do. Yellow fever, among other marks of 
 difference from the plague, has no car- 
 buncles or glandular swellings. 
 
 Prognosis. We are to judge of the 
 degree of danger in yellow fever, by the 
 nature of the symptoms, the violence of 
 the attack, and the age and habits of the 
 patients. The young and plethoric are 
 always in the greatest danger. When 
 the various functions are oppressed at 
 once, when the debility is great, when 
 the pulse is weali and irregular, when 
 there is severe vomiting of dark matter, 
 
YELLOW FEVER. 
 
 593 
 
 fointing on very slight exertion, dilated 
 pupils, and great drowsiness, these are 
 signs of extreme danger. It must, how- 
 ever, be borne in mind, that though the 
 disease may exhibit more favourable 
 symptoms, yet these may suddenly change 
 for the very worst. 
 
 Treatment. Unhappily there has been 
 much controversy respecting the most 
 proper treatment in yellow fever. Some 
 employ bleeding at the commencement ; 
 but the great majority of practitioners 
 decidedly condemn this practice; and 
 even in cases in which, if any where, it 
 would appear proper, viz. in young and 
 ])lethoric Europeans, at the first stage of 
 the disease, it has not seemed to be of 
 any service. In a disease of so much 
 danger, where so many are attacked, and 
 such numbers die under every treatment, 
 it is to be supposed that there will be 
 much diversity of opinion. An inflam- 
 matory tendency at the beginning is ob- 
 vious, and this is to be counteracted by 
 purgatives, principally by calomel, as its 
 much smaller bulk renders it less likely 
 to be rejected by the stomach than other 
 medicines. If the purgatives do not act 
 speedily, we are to give a clyster. Eme- 
 tics are very dangerous, as the stomach is 
 so irritable ,* and in the course of the dis- 
 ease, a vomiting too often comes on, 
 which is beyond our power to check. 
 It is beneficial to promote a discharge 
 from the skin by Dover's powder, by the 
 warm bath, and fomentations to the beUy. 
 Some have placed great reliance on mer- 
 cury, either given in the form of calomel, 
 or introduced into the system by rubbing 
 in the blue ointment ; and though some 
 hftve too highly extolled this plan, there 
 is no doubt, that in most of the febrile 
 diseases in the tropical climates, mercury 
 is one of the principal remedies. If the 
 vomiting at the commencement of the 
 disease relieves the stomach of the indi- 
 gested aliment, it is so far well j but too 
 often the vomiting does not stop ; and to 
 check it, we must employ effervescing 
 draughts, opium to the pit of the sto- 
 mach, or a blister. Mustard poultices ap- 
 
 plied to the feet sometimes stop the vo- 
 miting. The cold affusion may be ser- 
 viceable; but probably still better, the 
 spunging of the body with some cooling 
 lotion. Several West Indian and Ame- 
 rican practitioners speak very favourably 
 of the cold affusion, with which they 
 conjoin the use of calomel. When the 
 symptoms of debility and putrescence are 
 apprehended, our remedies must be of the 
 stimulant and antiseptic kind; as wine, 
 bark, Jamaica pepper, ripe fruits, and the 
 muriatic acid. The same attention to 
 cleanliness about the beds, the chambers, 
 and the persons of the sick, as we have 
 recommended in Fevkr, is to be attended 
 to here ; and the patient's strength is to 
 be supported by such mild and easily di- 
 gestible nourishment as his stomach can 
 bear, such as sago, tapioca, rice, arrow- 
 root, with a little wine. 
 
 Conduct to be pursued hy Europeans 
 for the Prevention of Yellow Fever. 
 The fatality of yellow fever to new-com- 
 ers in the West Indies, renders it a high- 
 ly interesting inquiry, how Europeans 
 should conduct themselves on arriving in 
 these climates, and during their residence 
 there. Some advise that the plethoric 
 and robust should lose blood when they 
 arrive in tropical climates; but there is 
 too much reason to fear subsequent debi- 
 lity, and it will be better to diminish the in- 
 flammatory tendency, by attention to ke«p 
 the bowels open, and by prudence and 
 temperance in eating and drinking. All 
 unnecessary exposure to the sun and the 
 night-dews should be avoided, intoxication 
 carefully shunned, and irregularity of every 
 kind abstained from. When a person has it 
 in his power, he should endeavour not to 
 arrive in the rainy unhealthy season. 
 He should prefer a situation for his house 
 elevated and dry, and not exposed to the 
 effluvia from stagnant waters and marshy 
 grounds. The diet of Europeans should 
 have a considerable proportion of vegeta- 
 ble food; spirits and water should be 
 avoided ; but a moderate use of wine may 
 be necessary from former habits, and will 
 prevent the relaxation and debility which 
 
 2(4 
 
594 
 
 ZINC. 
 
 the enervating climate is apt to produce. 
 The bowels should be kept regularly 
 open ; but the frequent and indiscriminate 
 use of calomel is wrong. Persons should 
 go to bed early, and rise early in the 
 morning, which is the best time for tak- 
 ing gentle exercise. Cotton should be 
 
 worn next the skin, or thin flannel, if 
 there is any tendency to rheumatic affec- 
 tions. When the body or feet have got 
 wet, the clothes should be changed as 
 soon as possible. 
 
 YELLOW GUM, of Children. See 
 Gum. 
 
 ZIN 
 
 ZINC or SPELTER is a metal of a 
 bluish white colour. When it is rubbed 
 for some time between the fingers, they 
 acquire a peculiar taste, and emit a very 
 perceptible smell. As zinc is one of the 
 most easily oxidized metals, it is em- 
 ployed in the formation of galvanic bat- 
 teries. When zinc is alloyed witli cop- 
 jper, in different proportions, it forms 
 brass, pinchbeck. Prince Rupert's metal, 
 &c. 
 
 Zinc, Acetate of, A solution of this 
 salt is used as a wash in ophthalmia, and 
 as an injection in gonorrhoea. 
 
 Zinc, Carbonate of Calamine, Lapis 
 Calaminaris, is usually of a greyish, yel- 
 lowish, or pale reddish colour. One part 
 of this substance very finely powdered, 
 and added to five paits of simple cerate, 
 forms an excellent application for cutane- 
 ous ulcerations and excoriations ; and is a 
 good dressing for burns, after the first 
 violence of their symptoms is over. This 
 cerate resembles that called Turner's 
 cerate. The powder of calamine is some- 
 times sprinkled on ulcerating surfaces. 
 
 Zinc, Oxide of This oxide has been 
 used in epilepsy, in the dose of from two 
 
 ZIN 
 
 to ten grains, two or three times a-day ; 
 but with no very remarkable effects. 
 An impure oxide of zinc, well known by 
 the name of tuttify is dusted upon the 
 parts of infants which are liable to be 
 chafed by rubbing against each other, as 
 the groins, neck, arm-pits, &c. 
 
 Zinc, Sulphate of White Vitriol, is 
 tonic and astringent, and in large doses, 
 acts as an emetic. It produces very 
 speedy vomiting ; and is, therefore, used 
 to evacuate the stomach when an over- 
 dose of laudanum, or other vegetable poi- 
 son, has been swallowed. The dose for 
 this purpose is thirty grains. In doses of 
 two grains, twice a-day, it is used in in- 
 digestion. In hooping-cough, and other 
 spasmodic coughs, one grain of the sul- 
 phate of zinc, and four grains of myrrh, 
 twice a-day, have a good effect. It is 
 used, of the strength of two grains to the 
 ounce of spring-water, or rose-water, as 
 a wash for the eyes; also for sore nipples, 
 and as an injection in the whites. The 
 white vitriol of commerce should not be 
 used in medicine, as it generally contains 
 impurities, principally the sulphate of 
 copper. 
 
595 
 
 APPENDIX, 
 
 No. I. 
 OF THE USES AND DOSES OF MEDICINES. 
 
 In giving an account of diseases and their remedies, we have endeavoured to be 
 as distinct and intelligible as possible; and to put it in the power of any sensible 
 parent to know what should be done, in most of the usual diseases to Avhich children 
 are liable. But, on the other hand, we have been careful to give no encourage- 
 ment to nursery or domestic quackery. When it is considered, what, unexpected 
 diflSculties present themselves to the most experienced, even in the management 
 of complaints apparently very simple, no prudent person, not brought up to the 
 medical profession, would venture to treat a case of any severity ; and in a large 
 town, there can be no motive or tempfktion to do so, where professional assistance 
 can immediately be had; and where drugs can be readily procured, almost at any 
 hour of the day or night. But there are many conceivable situations, where ad- 
 vice cannot be easily procured, yet something must promptly be done. In the 
 smaller class of vessels which must go to sea, often on distant voyages, without a 
 regular surgeon ; in the lonely glens or retired hamlets in the country, in the dis- 
 tant missionary station, or the small commercial factory, some knowledge of the 
 powers and quantities of medicines is highly useful. It is for the sake of persons 
 in these, and similar situations, that we here subjoin a short notice of the uses and 
 doses of some of the safer medicines. 
 
 The doses of medicines mentioned in the following list, are those which are 
 sufficient for a grown-up person of moderate strength. For young persons un- 
 der foiui;een years of age, they must be diminished in nearly the following pro- 
 portions. If the dose for a person of twenty j'^ears be twenty gi*ains, then for 
 one of 
 
 14 years it will be 14 to 16 grains. 
 7 . 10 grains, or about one-half. 
 
 5 . 7 to 8 grains, one-third. 
 3 . 5 grains, one-fourth. 
 
 1 . 3 grains, one-seventh. 
 
 6 months 2 grains, one-tenth. 
 
 We shall mention separately the doses of medicines proper for infants and very 
 young children. 
 
 The doses of medicines should always be weighed or measured, not guessed. 
 Those who are likely to be engaged in administering them, should have a gra- 
 duated measure, for minims, (two drops), for drachms, and for ounces. Sixty 
 drops are considered equal to a drachm ; but the size of drops varies, according to 
 the size of the phial containing the liquid, the shape of the rim, and the quantity 
 contained in it. A tea-spoonful is considered equal to a drachm, and a table-spoon- 
 ful to half an ounce. A set of apothecaries' weights should be kept. 
 
596 USES AND DOSES OF MEDICINES. 
 
 EMETICS, Medicines to produce Vomiting. 
 
 FOR GROWN-UP PERSONS. 
 
 Powder of IpecacuAn. — Dose from ten to twenty grains ; may be given in any fluid. 
 When there is any choice of time, the best time is the evening. 
 
 Tartrate of Antimony called Tartar Emetic. — Two grains dissolved in four ounces 
 of hot water : a table-spoonful every ten minutes, till vomiting occurs. 
 
 Wine of Antimony. — Dose two tea-spoonfuls every fifteen minutes, till vomiting is 
 produced. 
 
 Sulphate of Zinc, White Vitriol. — Thirty grains, when a speedy emetic is wanted, 
 as in cases of poisoning. 
 
 A dessert-spoonful of Mustard may be taken when other emetics are not at hand ; 
 or the stomach may be emptied by tickling the fauces with a feather, or the stomach- 
 pump may be used. 
 
 for infants and young children. 
 
 Ipecacuan in powder. — From three to twelve grains. 
 
 Wine of Ipecacuan.— From one to two tea-spoonfuls every quarter of an hour, till 
 vonaiting occurs. 
 
 LAXATIVES AND PURGATIVES, to open the Bowels. 
 
 FOR GROWN-UP PERSONS. 
 
 Saline Purgatives, as the sulphate of soda (Glauber's salts); sulphate of magnesia 
 (Epsom salts) ; tartrate of potash and soda (Rochelle salts) ; dose of each, an ounce, dis- 
 solved in four ounces of tepid water, and taken in the morning. 
 
 Phosphate of Soda, (tasteless salts,) six drachms ; may be taken in broth or beef- 
 tea, instead of common salt. 
 
 Castor Oil. — From half an ounce to an ouncet 
 
 Senna Leaves. — Three drachms infused in half a pint of water, like tea; a spoonful 
 of preserved tamarinds adds to its efficacy, and renders the medicine more pleasant. 
 
 Sulphate of Potash with Sulphur, (sal polychrest,) from one to two drachms. 
 
 ScAMMONY, in powder, from three to eight grains. 
 
 Jalap, in powder, from ten to twenty grains. 
 
 Gamboge, from two to five grains. 
 
 Rhubarb in powder, from ten to twenty or twenty-five grains. 
 
 The above medicines may be usefully combined with from three to five grains of calo- 
 mel. Two of them may be also combined together, as jalap and scammony, or gamboge 
 and rhubarb. 
 
 Aloes. — An excellent purgative; dose five grains; may be taken in pills, with various 
 combinations. See page 23. 
 
 Calomel is seldom used alone as a purgative ; but in some persons, a few grains, from 
 two to five, move the bowels freely/ 
 
 Compound Powder of Jalap, from forty grains to a drachm. 
 
 Oil of Turpentine, in obstinate cases, an ounce or two. 
 
 FOR infants and YOUNG CHILDREN. 
 
 We may here repeat, what we have said under Weaning, that tlie bowels of infants 
 are not to be teazed with medicines at that period ; and we may extend the prohibition 
 
USES A:ND doses of medicines. 597 
 
 both before and after, and recommend that they should never be given except on occa-' 
 sions of real and obvious necessity. The bowels of children certainly require to be 
 watched with the utmost attention by those who have the care of their early years. In 
 the jilayfulness and vivacity of youth, they are apt to neglect the calls of natiu-e, and are 
 in much danger of hurting themselves by the mixture of articles which they eat j but, in 
 general, they may be kept right by a very taoderate allowance of drugs ; and the delicacy 
 of their bowels and other parts of the digestive organs is so great, that parents and nurses 
 should be very cautious how they tamper with them. It was at one time very much the 
 fashion in domestic medicine, to use Calomel on every trifling occasion ; but however 
 convenient it may appear from its small bulk and insipidity, we have (page 93) given 
 what we consider as a proper caution against its indiscriminate use. 
 
 Castor Oil. — From a tea- spoonful to a dessert-spoonful. 
 
 Manna. — From half a drachm to tAvo drachms. 
 
 Gamboge. — From one to two grains. 
 
 ScAMMONY. — From one to three grains. 
 
 Jalap. — From four to eight grains. 
 
 Rhubarb — From two to twelve grains. 
 
 Magnesia. — From five to fifteen grains. 
 
 Infusion of Senna, of different strength, according to circumstances. 
 
 Two of the above medicines may, on some occasions, be usefully conjoined, as rhu- 
 bai-b and magnesia, or jalap and scammony ; or the infusion of senna may be sweetened 
 wth manna. 
 
 LAXATIVE AND PURGATIVE CLYSTERS. 
 
 FOR GROWN-UP PERSONS. 
 
 Take of Common Salt, a dessert-spoonful. 
 
 Tepid Water, or Water- Gruel, an English pint. 
 
 Add a table-spoonful of Sweet Oil, or Melted Butter. 
 A more active clyster is made as follows :— 
 Take of Strong Infusion of Senna, an English pint, 
 
 Glauber's Salt, or Epsom Salt, an ounce and a half. 
 Sometimes, to increase the purgative effect, a spoonful of oil of turpentine, may be 
 added. 
 
 FOR infants and CHILDREN. 
 
 Clysters may be made in the same way as for adults, diminishing the quantity of fluid, 
 and keeping out a portion of the stimulating iHgredient, whether salt or senna. 
 
 CARMINATIVES, to expel Wind. 
 
 FOR GROWN-UP PERSONS. 
 
 Ten or fifteen drops of the Essence of Peppermint, on a small bit of sugar. 
 AssAFETiDA PiLLs, three at bed-time. 
 Carminative Clyster: 
 
 Take of Infusion of Senna, eight ounces ; dissolve in this infusion 
 Assafetida, a drachm and a half; add 
 Peppermint Water, one ounce. 
 
 To be mixed together ; and thro^vn up, pretty warm. 
 
 FOR INFANTS AND CHILDREN. 
 
 Sugar of Anise, two grains. 
 
 Barley- Cinnamon Water, one or two tea-spoonfuls. 
 
 Essence of Peppermint, from one to three drops. 
 
598 USES AND DOSES OF MEDICINES. 
 
 DIURETICS, or Medicines that promote the flow of Urine. 
 
 FOR GROWN-UP PERSONS. 
 
 Take of Cream of Tartar, one drachm, 
 Borax, half a drachm. Mix. 
 Dissolve in three ounces of tepid water ; this quantity to be taken tliree times a-day. 
 
 Sweet Spirit of Nitke.— A tea-spoonful in warm water, four or five times a-day. 
 
 Acetate of Potash From twenty grains to a drachm three times a-day. 
 
 Nitrate of Potash, (saltpetre.) — Twenty or thirty grains in a pint of gruel. This, 
 quantity to be used as common drink in the twenty-four hours. 
 
 Oil or Juniper. — Four drops on white sugar. 
 
 Squill. — One grain in powder mixed with powdered cinnamon, three times a-day. 
 
 Decoction of Bboom-tops. — A pint a-day. 
 
 for infants and children. 
 Nitrate of Potash, (saltpetre) one drachm. 
 Water, eight ounces. Dissolve and sweeten with refined sugar. 
 Dose. From a dessert to a table-spoonful every three hours, till the water flows 
 freely. 
 
 Sweet Spirit of Nitre, one drachm. 
 
 Water, three ounces. To be mixed together, and a little syrup added ; 
 A table-spoonful every two hours. 
 
 A drink made by dissolving a drachm of cream of tartar in a quart of boiling water, 
 and sweetening it mth sugar, may be used, to increase the urine. 
 
 DIAPHORETICS AND SUDORIFICS, to produce Perspiration or Sweating, 
 
 FOR GROVFN-UP PERSONS. 
 
 By regulating the doses of these medicines, and the drink of the patient, as also the 
 quantity of his bed-clothes, we can produce a perspiration more or less copious. 
 
 Antimonial Medicines are excellent diaphoretics. A grain of the tartrate of anti- 
 mony may be dissolved in five ounces of hot water ; and a table-spoonful of this solution 
 given every two hours, will probably occasion perspiration. • The antimonial powder, 
 three grains in a little jelly, every three hours, will have the same effect. Or James's 
 powder, three or four grains, in honey, jelly, or marmalade, every three hours. 
 
 A mixture of narcotic and emetic medicines, makes an excellent sudorific. Such are 
 Dover's Powder, and the diaphoretic draught, made by adding thirty drops of laudanum 
 to forty drops of antimonial wine, to be taken in an ounce of cinnamon or peppermint 
 water. 
 
 These combinations of opium should be avoided when the skin is very hot and dry j 
 but may be used in rheumatism and other feverish disorders, after the violent excitement 
 is in some degree removed by bleeding or purging. 
 
 Camphor. — Four grains of camphor reduced to powder by the help of a little spirit 
 of wine, with half a grain of opium, made into a bolus j repeated once or twice at the in- 
 terval of four hours. 
 
 Diluted Acetate of Ammonia, Spirit of Minderenis. — From two drachms to half an 
 ounce, in an equal quantity of water. 
 
 Diminished doses of Ipecacuan may also be used as diaphoretics. 
 
 for infants AJND CHILDFtEN. 
 
 Tartrate of Antimony, { Tartar Emetic) one grain, carefully dissolved in four 
 ounces of boiling water. 
 
USES AND DOSES OF MEDICINES. ,599 
 
 Dose of the solution, from one to two tea spoonfuls every three hours. 
 Antimonial Wine. — From four to ten drops, in a tea-spoonful of tepid water, every 
 two hours. 
 
 Take of Tartaric Acid one drachm, 
 
 Carbonate of Potash, four scruples. 
 Dissolve each of them separately in an ounce of water, add them together, and, when 
 the efFen^escence is over, add 
 Syrup, two drachms, 
 Cinnamon water, half an ounce, 
 Water, foiu* ounces. 
 Dose, a dessert- spoonful every two houi*s. 
 
 EXPECTORANTS, to bring up Phlegm from the Lungs. 
 
 Sqotll.- — The powder of the dried root, one grain night and morning, made into pills 
 with powdered cinnamon or ginger. — Or vinegar of squill, a small tea-spoonful, with 
 simple syrup, in a little peppermint water three times a-day. 
 
 IrECACUAN. — One grain three timeS a-day, made into lozenges. 
 
 Sulphate of Zinc. — One grain, with powdered ginger, twice a-day. 
 
 The Steam of Hot Water inhaled into the mouth. 
 
 The same may be used for children, diminishing the doses. 
 
 ABSORBENT MEDICINES, or Collectors of Acidity in the Stomach, 
 and of Heartburn. 
 
 FOR GROWN-LP PERSONS. 
 
 Carbonate of Potash, or Carbonate of Soda, from ten to thirty grains, in any fluid 
 vehicle, not spirituous. 
 
 Prepared Chalk, when the bowels are loose ; from twenty grains to two drachms in 
 cinnamon-water, or milk. 
 
 Calcined Magnesia, when the bowels are costive ; to be taken in the same way. 
 The above two articles meeting with an acid in the stomach form a neutral salt : that 
 with chalk is binding ; with magnesia laxative. 
 
 Water of Super-carbonate of Potash, or 
 
 Water of Super. carbonate of Soda. — A wine-glassful, three or four times a-day. 
 
 Lime Water. — A wine-glassful, with a table-spoonful of milk, three times a-day. 
 
 FOR INFANTS AND CHILDREN. 
 
 Calcined Magnesia, or Prepared Chalk may be given in any liquid, or mixed 
 with the food, in doses of from three to ten grains. 
 
 ANODYNES, Medicines to allay Pain, and procure Sleep. 
 
 FOR GROWN-UP PERSONS. 
 
 Opium One or two grains. It can be made into a pill without any addition. 
 
 Opiate pills may be made by taking equal weights of opium and aromatic powder, or 
 powdered cinnamon, and forming them into a mass with simple syrup. This mass may 
 be divided, so as to make the pills to contain each one grain of opium. . 
 
 The Paregoric Elixir may be given as an anodyne. The English in the dose of 
 four drachms in a little water, the Scotch in the dose of one drachm. 
 Anodyne Draught. Take of 
 Laudanum, thirty drops. 
 Cinnamon-water, an oimce . 
 To be sweetened with dissolved jelly or syrup, and taken at once. 
 
600 USES AND DOSES OF MEDICINES. 
 
 Anodyne Clyster. Take of 
 
 Thin Starch, a small tea-cupful ; 
 Add to it 
 
 A drachm of Laudanum. 
 This is given to allay tenesmus and pain in the neighbourhood of the rectum ; and al- 
 so to check looseness. The patient must be made to understand, that he is to make 
 what efforts he can to retain it. 
 
 When opium binds the bowels too much, Henbane in extract or tincture may be 
 used in larger doses than opium ; three grains of the extract, or a drachm of the tincture. 
 
 FOR INFANTS AND CHILDREN. 
 
 These are so hazaidous, that we feel reluctant to sanction the use of any one of them 
 intemaUy. 
 
 The Dose of Laudanum is from three to eight drops. 
 
 For external use. Anodyne Balsam, or the Tincture of Soap with Opium, nibbed 
 on the belly or along the spine, in the quantity of a dessert or table-spoonful, in many 
 cases allays pain very effectually. 
 
 ASTRINGENTS, or Medicines to lessen Discharges of Fluids. 
 
 FOR GROWN-UP PERSONS. 
 
 I . In Looseness of the Bowels ; after being sure that they are cleared of all irritating 
 matter, as much as possible. 
 Astringent Drops. Take of 
 
 Tincture of Rhubarb, two drachms, 
 Tincture of Opium, one drachm. 
 Mix them together. 
 Thirty-six di'ops to be taken four times a-day in a little water. 
 Chalk Mixture. Take of 
 Prepared Chalk, one ounce, 
 Refined Sugar, half an ounce, 
 Mucilage of Gum Arabic, two ounces. 
 
 Triturate together, and then gradually add, of 
 Water, t^vo pints and a half. 
 Spirit of Cinnamon, two ounces. 
 Of this, a small cupful may be taken four times a-day ; and if it be thought neces- 
 sary to increase its astringent power, ten drops of tincture of opium, or half a drachm 
 of the tincture of kino, may be added to each dose. 
 
 2. Astringents, in discharges of Blood from the^ Stomach or Lungs. 
 
 Elixir of Vitriol, or diluted Sulphuric Acid, fifteen drops in cold water, four 
 times a-day. 
 
 Infuse a handful of dried Red Rose Leaves in a quart of boiling water. Strain off 
 the liquor, and add of diluted sidphuric acid thirty drops ; simple syrup, two ounces. A 
 table-spoonful to be taken every two hours, when necessary, during a discharge of 
 blood. Other measures at the same time being employed for the cure of the disease. 
 
 3. Astringents, to be thrown into the Vagina for the cure of Whites. 
 Thirty grains of White Vitriol dissolved in an English puit of water. 
 
 Or : Take of Oak Bark, two ounces. 
 
 Water, two English pints ; 
 
 BoU into one pint ; to which, when strained, add 
 One drachm of Aliun. 
 
USES AND DOSES OF MEDICINES. 601 
 
 ASTRINGENTS to check Looseness in Children. 
 Astringent Mixture. 
 Take of best Turkey Rhubarb, twenty grains, 
 Prepared chalk, one drachm, 
 Dover's Powder, ten grains, 
 Simple Cinnamon Water, half an ounce, 
 Spring Water, two ounces and a half. 
 Mix them carefully. 
 Dose from one to four tea-spoonfuls every six hours. This is found particularly use- 
 ful in some cases of habitual looseness. 
 Stronger Astringent Mixture. 
 Take of Electuary of Catechu, two drachms, 
 Prepared Chalk, half an ounce. 
 Simple Cinnamon Water, one oimce, 
 Spring Water five ounces. Mix them. 
 Dose, from two tea-spoonfuls to a table-spoonful every three or four hours. This 
 may be rendered still more powerful in checking debilitating looseness, by the addition 
 of a small proportion of laudanum to each dose. 
 
 ( The above two prescriptions are from Professor Hamilton. ) 
 
 To CHECK VOMITING. 
 
 The Effervescing Draughts. See page 227. 
 When there is not much fever present : 
 
 Compound Tincture of Cinnamon, a tea-spoonful, without any addition ; or a tea- 
 spoonful of brandy. 
 
 Oxide of Bismuth. — Ten grains every two hours. 
 An Opium Plaster to the pit of the stomach. 
 
 TONICS AND BITTERS /or Strengthening the Stomach. 
 Peruvian Bark — A tea-spoonful every day, in milk or port wine. 
 Powdered Gentian Root.— -Ten grains to twenty. 
 Colombo. — Ten grains of the powder twice a-day. 
 D,ecoction of Quassia — A tea-cupful twice a-day. 
 Infusion of Chamomile. — An English pint in the course of the day. 
 The stomachic tinctures should not be taken, unless by the prescription of a medical 
 practitioner, for fear of inducing a habit of dram-drinking. 
 
 WORM MEDICINES. 
 
 Except the Neutral Salts, almost any purgative may be used to expel worms. 
 
 Take of Calomel, four grains, 
 
 Powder of Jalap, eight grains, 
 Powder of Aloes, three grains, 
 
 To be mixed together and given in jelly, honey, or conserve of roses. 
 
 Five grains of Aloes, with three of Gamboge taken at bed-time, and followed next 
 morning by a tea-cupful of strong infusion of Senna. 
 
 A small tea-spoonful of Common Salt, taken in the morning when the stomach is 
 empty. 
 
 Two or three cloves of Garlic may be swallowed in a morning for a length of time. 
 
 Or three grains of Assafetida, made into a pill. Clysters made of senna, with a 
 dessert-spoonful of tincture of aloes, may be thrown up, to destroy the small white worms. 
 
 A dcssert-spoonfid of Oil of Turpentine will in many cases carry off the tape-worm. 
 
*• 
 
 602 USES AND DOSES OF MEDICINES. 
 
 WORM MEDICINES, ae in page 537. 
 Diminishing the dose in proportion to the age. 
 
 FOR BURNS AND SCALDS. 
 
 On the very first occurrence of the accident, Cold is to be applied. Cold water is 
 always at hand. A little vinegar may be added, if the skin is not broken ; or we may 
 apply sal ammoniac dissolved in water ; or weak spirits and water. When the outer 
 skin is destroyed, the Carron Oil must be lightly applied, and the parts defended from 
 the air. It is made by mixing together equal parts of linseed oil and lime-water. Cot- 
 ton, when there is no danger of its sticking in the injured part, is an excellent protector 
 for burnt surfaces. 
 
 EYE-WATERS. 
 
 Twelve grains of the Sulphate of Zinc dissolved in six ounces of Rose Water. 
 Twelve grains of Sugar of Lead dissolved in six ounces of Spring Water ; with the 
 addition of a drachm of distilled Vinegar. 
 
 The quantity of Sugar of Lead may be increased if necessary. 
 
 GARGLES. 
 
 A good domestic Gargle for sore throats is made by using Vinegar, diluted with 
 warm water, and sweetened with honey or sugar. 
 
 Infusion of Red Rose Leaves, acidulated with diluted "Sulphuric Acid. 
 
 Or a Gargle may be made with Port Wine and a little Vinegar. 
 
 Gargles should always be of such a degree of sharpness as to cause a temporary smart- 
 ing of the throat. 
 
 DRESSINGS AND BLASTERS for various pu7'poses. 
 
 For dressing blisters. Hog's lard, or spermaceti ointment. 
 
 For ulcers. Turner's cerate ; or when a stimulating action is wanted, basilicon or 
 red precipitate or verdigris ointment. 
 
 For scrofulous sores, iodine ointment, varied occasionally with cerate, or simple oint- 
 ment made of wax and oil. 
 
 Adhesive plaster is used for keeping cut surfaces in contact ; but in some situations, 
 one or two stitches will be necessary accompaniments. Straps of adhesive plaster are 
 used for giving support to the skin of ulcerated legs j and to make an equal pressure on 
 dropsical swellings. 
 
PATENT MEDICINES. fi03 
 
 No. II. 
 
 OF PATENT MEDICINES. 
 
 Dr. Paris, has published a work on the Materia Medica and Pharmacy, entitled 
 Phannacologiay which is highly esteemed. In that work, he has stated the 
 ingredients of a number of the most celebrated quack medicines ; and as this is 
 not only a matter of some curiosity, but as it may occasionally prevent serious 
 injury, by showing the danger of being credulous with respect to the efficacy or 
 safety of such compositions, we have taken the liberty of inserting the ingredients 
 of some of the more noted of them; and shall occasionally subjoin a few remarks 
 and cautions. * 
 
 On this subject, it is but candid to publish the following remarks by Dr. Han- 
 cock, StaflFord Place, Pimlico, which appeared in the Edinburgh Medical and 
 Surgical Journal for January, 1831. — " I have learned to place but little confi- 
 dence in the pretended examination of quack remedies. We see in several late 
 works a display, or professed disclosure of such secrets ; and in Avhich the com- 
 ponents are mentioned without the least doubt, as being indicat-ed by chemical ana- 
 lysis. The reports we have hitherto seen published in some magazines, and re- 
 peated in the Pharmacologia of Dr. Paris, Rennie's and Gray's supplements, &c. 
 are little worthy of regard ; they have, for the most part, been got up merely un- 
 der a show of science. The old nostrum, for instance, called Spilsbury's Drops, 
 is said in those reports to contain two drachms of cori'osive sublimate to a pint 
 of the menstruum ; but several samples I have examined showed no traces of 
 this mineral ; one of those I bought expressly for examination from the proprie- 
 tors in Soho Square ; but the sense of taste alone would show this absurdity. If 
 it contained sublimate, although but a twentieth part so much as alleged, it would 
 even then be sensible on the tongue. Gentlemen who give publicity to such mis- 
 statements, are not aware they are entailing much greater evils on society, than 
 could arise from all the quackery which they are desirous to defeat. They should 
 consider that the more saleable nostrums are prepared by many other persons be- 
 sides the proprietors, and that the prescriptions thus published will be followed 
 by numerous imitators. Let us suppose then, that a person who has been in the 
 habit of taking large doses of Spilsbury's Drops, gets a bottle of that prepared 
 with two drachms of sublimate to a pint of menstruum, and takes his usual dose ; 
 the result, it is plain, might prove fatal." 
 
 We are quite willing that the above remarks should have their due weight; but 
 allowing for the few blunders that may be expected in a long and varied work like 
 that of Dr. Paris, and for the vegetable mixtures, which defy all detection, we think 
 the Doctor's remarks particularly valuable ; and are sui'e that with every person of 
 reflection and common sense, the circumstance of the double knavery of quackery 
 in the original secret, and by the unprincipled imitators, will be quite sufficient, 
 when made known, to put him on his guard against all such inegular physic. 
 
 Ague Drop, or Tastkless Ague Drop, extolled for the cure of intermittent fever, 
 is ascertained to be a solution of arsenic. The simple mention of thisj it is to be hoped. 
 
COS , PATENT MEDICINES. 
 
 sugar nine pounds, mucilage of tragacanth as much as is sufficient. Each lozenge should 
 contain half a grain of panacea. 
 
 The above statement is a very good specimen of the unnecessary complication, and of 
 the hazardous operation of quack medicines. Surely every species of worm, and every 
 kind of constitution is not to be indiscriminately dosed with jalap and calomel ; and the 
 medical man who attends a family, is certainly the best judge whether these medicines 
 are in any case proper or not. The vulgar ascribe a great many of children's complaints 
 to worms, without any evidence that the child is troubled wdth them at all ; and it re- 
 quires but the simple statement, to show to any sensible parent the impropriety of fan- 
 cying her child to have worms in his bowels, and then throwing in mercury in the form 
 of Ching's Lozenges, or Story's Worm Cakes. A great proportion of the diseases of 
 cliildren are owing to the derangement of the digestive functions ; and a prudent and 
 skilful use of calomel, combined with rhubarb or other medicines, is the most likely 
 means to restore their healthy action. This the regular practitioner is much better qua- 
 lified to direct, than those who announce one medicine as applicable to all cases, seen or 
 unseen. 
 
 Corn Plaster. The green coloured plaster sold under this title is usually compos- 
 ed of three parts of wax, four of burgimdy pitch, and two of common turpentine, to which 
 is added one part of verdegris. 
 
 Cough Drops. The various nostrums advertised as " Cough Drops for the Cure of 
 Colds, Asthmas, Catarrhs," &c. aie preparations of opium veiy similar to Paregoric 
 Elixir. Pectoral Balsam of Liquorice, and Essence of Coltsfoot are combinations of 
 this kind j Grindle's Cough Drops are a preparation of the same description, only 
 made with rectified instead of proof spirit, and consequently more highly charged with 
 stimulating materials. " The mischief," says Dr. Fothergill, " that has proceeded from 
 the healing anodynes of quacks can be scarcely imagined; for in coughs arising from sup- 
 pressed perspiration, or an inflammatory diathesis, opiates generally do harm." 
 
 Court Plaster. Sticking Plaster. — Black SDk is strained and brushed over ten 
 or twelve times with the following preparation : Dissolve half an ounce of benzoin in 
 six ounces of rectified spirit ; in a separate vessel, dissolve an ounce of isinglass in half 
 a gallon of water ; strain each solution, mix them, and let the mixture rest, so that the 
 grosser parts may subside j when ihe clear liquor is cold it will form a jelly, which must 
 be warmed before it is applied to the silk. When the plaster is quite dry, in order to 
 prevent its cracking, it is finished off with a solution of foiu: ounces of Chian tiuTpentine 
 in six ounces of tincture of benzoin. 
 
 Daffy's Elixir. Is the compound tincture of senna, or that made by the tincture, 
 in proof spirits, of senna and jalap. In Daflfy's Elixir, there is the substitution of treacle 
 for sugar-candy, and the addition of anise-seed and elecampane root. — Different kinds of 
 this nostxum are sold under the names of Dicey's Daffy, and Swinton's Daffy ; but they 
 differ merely in some subordinate minutise, or unimportant additions. Like other tinc- 
 tures, this should not be prescribed by the inexperienced and ignorant. 
 
 Daley's Carminative. This consists of carbonate of magnesia two drachms, oil of 
 peppermint one drop, of nutmeg two drops, of anise-seed three drops, tincture of castor 
 thirty drops, tincture of assafetida fifteen drops, tincture of opium five drops, spirit of 
 pennyroyal fifteen drops, compound tincture of cardamoms thirty drops, peppermint wa- 
 ter two fluid ounces. There are cheaper compositions sold imder this name. The dose 
 is from a tea-spoonful to a table-spoonful. See Daley's Carminative, page 179. 
 
 Davidson's Remedy for Cancer is arsenious acid and powdered hemlock. Un- 
 der the article Arsenic, it will be found that even the external application of that pois- 
 onous mineral is often fatal ; and surely, with the knowledge of this fact, no one in his 
 senses would venture on this application to a cancerous sore, or one supposed to be so ; 
 merely from the interested boastings of medicine venders. 
 
PATENT MEDICINES. 607 
 
 De La Motte's Golden Drops. An ethereal solution of tincture of iron. 
 
 Dplcroix's PouDftE SuBTiL, " For removing superfluous hair in less than ten minutes." 
 Substances supposed to have the power of destroying hairs which are not wanted, are 
 called Depilatories ; and the fashionable one mentioned at the head of this article, ap- 
 pears to consist of quick lime and sulphiuret of arsenic, with some vegetable powder. 
 It is, however, so unequally mixed, that on submitting it to analysis, no two portions af- 
 forded the same results. It can scarcely be necessary to state, that such a composition 
 is incapable of fulfilling the intention for which it is so confidently vended. 
 
 Dinner Pills. Called also Lady Webster's, or Lady Crespigny's Pills. — 
 These are made by taking of the best aloes six drachms, mastich and red roses two 
 drachms of each, as much syrup of wormwood as will form the whole into a mass, v»'hich 
 is to be made into pills of three grains each. These pills are certainly useful, as they 
 produce a copious evacuation. The mastich probably acts by dividing the particles of 
 the aloes, and thereby modifying its solubility. 
 
 Dixon's Antibii.ious Pills are made of aloes, scammony, rhubarb, and tartarized 
 antimony. 
 
 Dutch Drops. The basis of this nostrum consists of the residue of the re-distilla- 
 tion of the oil of turpentine, which is a thick, red, resinous matter, to which the name 
 of Balsam of Turpentine has been given ; a preparation, however, is frequently vended as 
 Dutch Drops, which is a mixture of oil of turpentine, tinctiure of guaiacum, spirit of 
 nitric ether, with small portions of the oils of amber and cloves. These drops are given 
 in diseases of the urinary organs. 
 
 Eau Medicinale d'Husson. See page 226. 
 
 Economical Breakfast Powder is nothing more than roasted lye, which comes 
 nearer to true coffee than the preparations made from other European grain or pulse. 
 
 Edinburgh Ointment. This name must be given by the English, for we are not 
 acquainted with any ointment that bears the name of Edinburgh, par excellence. The 
 piincipal ingredients are the white hellebore and muriate of ammonia. 
 
 Elixir of Longevity, of Dr. Jemitz of Sweden. This is certainly a very imposing 
 title, which is applied to an aromatic tincture with aloes ; and as attention to the bowels 
 is really an essential point in the care of one's health, it may contribute so far to longe- 
 vity. 
 
 Essence of Coffee. The Cassia pulp is said to form the basis of this article. 
 
 Essence of Coltsfoot. " This preparation consists of equal parts of the Balsam of 
 Tolu, and the compound tincture of benzoin, to which is added double the quantity of 
 rectified spirit of wine, and this, forsooth, is a Pectoral for Coughs ! If a patient with a 
 pulmonary affection should recover during the use of such a remedy, I should certainly 
 designate it as a lucky escape, rather than as a skilful cure." (Dr. Paris) 
 
 Essence of Mustard. This medicine, much vaunted as an external application in 
 rheumatism, consists of oil of turpentine, camphor, and a portion of spirit of rosemary, 
 to which is added a small quantity of flour of mustai'd. In cases of rheumatism, where 
 an external application is proper, this substance may do good ; but medical men often di- 
 rect a liniment of turpentine and oil, without giving it the title of mustard, vnth which it 
 has no connexion. So far does quackery go in this case, that pills are made, called Pills 
 of Essence of Mustard, which are made of Balsam of Tolu with resin. 
 
 Essence of Peppermint, a spirituous solution of the essential oil of peppermint, co- 
 loured green by spinage leaves. 
 
 Essence of Senna. A concentrated infusion of senna, in combination with an alkali. 
 
 Essential Salt of Lemons. The preparation sold under this name, for the purpose 
 of removing iron moulds from linen, consists of cream of tartar and super-oxalate of po- 
 tass, or salt of sorrel,' in equal proportions. 
 
 Ford's Balsam of Horehound consists of a watery infusion of horehound and liquo- 
 
COS PATENT MEDICINES. 
 
 sugar nine pounds, mucilage of tragacanth as much as is sufficient. Each lozenge should 
 contain half a grain of panacea. 
 
 The above statement is a very good specimen of the unnecessary complication, and of 
 the hazardous operation of quack medicines. Surely every species of worm, and every 
 kind of constitution is not to be indiscriminately dosed with jalap and calomel ; and the 
 medical man who attends a family, is certainly the best judge whether these medicines 
 are in any case proper or not. The vulgar ascribe a great many of children's complaints 
 to worms, without any evidence that the child is troubled with them at all ; and it re- 
 quires but the simple statement, to show to any sensible parent the impropriety of fan- 
 cying her child to have worms in his bowels, and then throwing in mercury in the form 
 of Ching's Lozenges, or Story's Worm Cakes. A great proportion of the diseases of 
 cliildren are owing to the derangement of the digestive functions ; and a prudent and 
 skilful use of calomel, combined with rhubarb or other medicines, is the most likely 
 means to restore their healthy action. This the regular practitioner is much better qua- 
 lified to direct, than those who announce one medicine as applicable to all cases, seen or 
 unseen. 
 
 Corn Plaster. The green coloured plaster sold under this title is usually compos- 
 ed of three parts of wax, four of burgundy pitch, and two of common turpentine, to which 
 is added one part of verdegris. 
 
 Cough Drops. The various nostrums advertised as " Cough Drops for the Cm-e of 
 Colds, Asthmas, Catarrhs," &c. aie preparations of opium veiy similar to Paregoric 
 Elixir. Pectoral Balsam of Liquorice, and Essence of Coltsfoot are combinations of 
 this kind ; Grindle's Cough Drops are a preparation of the same description, only 
 liiade with rectified instead of proof spirit, and consequently more highly charged with 
 stimulating materials. " The mischief," says Dr. Fothergill, " that has proceeded from 
 the healing anodynes of quacks can be scarcely imagined ; for in coughs arising from sup- 
 pressed perspiration, or an inflammatory diathesis, opiates generally do harm." 
 
 Court Plaster. Sticking Plaster. — Black Silk is strained and brushed over ten 
 or twelve times with the following preparation : Dissolve half an ounce of benzoin in 
 six ounces of rectified spirit ; in a separate vessel, dissolve an ounce of isinglass in half 
 a gallon of water ; strain each solution, mix them, and let the mixture rest, so that the 
 grosser parts may subside ; when the clear liquor is cold it will form a jelly, which must 
 be warmed before it is applied to the silk. When the plaster is quite dry, in order to 
 prevent its cracking, it is finished off with a solution of four ounces of Chian turpentine 
 in six ounces of tincture of benzoin. 
 
 Daffy's Elixir. Is the compound tincture of senna, or that made by the tincture, 
 in proof spirits, of senna and jalap. In Daffy's Elixir, there is the substitution of treacle 
 for sugar-candy, and the addition of anise-seed and elecampane root. — Different kinds of 
 this nostjum are sold under the names of Dicey's Daffy, and Swinton's Daffy ; but they 
 differ merely in some subordinate minutias, or unimportant additions. Like other tinc- 
 tures, this should not be prescribed by the inexperienced and ignorant. 
 
 Daley's Carminative. This consists of carbonate of magnesia two drachms, oil of 
 peppermint one drop, of nutmeg two drops, of anise-seed three drops, tincture of castor 
 thirty drops, tincture of assafetida fifteen d.-ops, tincture of opium five drops, spirit of 
 pennyroyal fifteen drops, compound tincture of cardamoms thirty drops, peppermint wa- 
 ter two fluid ounces. There are cheaper compositions sold under this name. The dose 
 is from a tea-spoonful to a table-spoonful. See Daley's Carminative, page 179. 
 
 Davidson's Remedy for Cancer is arsenious acid and powdered hemlock. Un- 
 der the article Arsenic, it will be found that even the external application of that pois- 
 onous mineral is often fatal ; and surely, with the knowledge of this fact, no one in his 
 senses would venture on this application to a cancerous sore, or one supposed to be so ; 
 merely from the interested boastings of medicine venders. 
 
PATENT MEDICINES. 607 
 
 De La Motte's Goldhm Drops. An ethereal solution of tincture of iron. 
 
 Dj<lcroix's PouDiiK SuBTiL, " For removing superfluous hair in less than ten minutes." 
 Substances supposed to have the power of destroying hairs which are not wanted, are 
 esilled Depilatories ; and the fiishionable one mentioned at the head of this article, ap- 
 pears to consist of quick lime and sulphm-et of arsenic, with some <^egetable powder. 
 It is, however, so unequally mixed, that on submitting it to analysis, no two portions af- 
 forded the same results. It can scarcely be necessary to state, that such a composition 
 is incapable of fulfilling the intention for which it is so confidently vended. 
 
 Dinner Pills. Called also Lady Webster's, or Lady Crespigny's Pills. — 
 These aie made by taking of the best aloes six drachms, mastich and red roses two 
 drachms of each, as much syrup of wormwood as will form the whole into a mass, which 
 is to be made into pills of three grains each. These pills are certainly useful, as they 
 produce a copious evacuation. The mastich probably acts by dividing the particles of 
 the aloes, and thereby modifying its solubility. 
 
 Dixon's Antibilious Pills are made of aloes, scammony, rhubarb, and tartarized 
 antimony. 
 
 Dutch Drops. The basis of this nostrum consists of the residue of the re-distilla- 
 tion of the oil of turpentine, which is a thick, red, resinous matter, to which the name 
 of Balsam of Turpentine has been given ; a preparation, however, is frequently vended as 
 Dutch Drops, which is a mixture of oil of turpentine, tincture of guaiacum, spirit of 
 nitric ether, with small portions of the oils of amber and cloves. These drops are given 
 in diseases of the urinary organs. 
 
 Eau Medicinale d'Husson. See page 226. 
 
 Economical Breakfast Powder is nothing more than roasted lye, which comes 
 nearer to true coffee than the preparations made from other European grain or pulse. 
 
 Edinburgh Ointment. This name must be given by the English, for we are not 
 acquainted with any ointment that bears the name of Edinburgh, par excellence. The 
 principal ingredients are the white hellebore and muriate of ammonia. 
 
 Elixir of Longevity, of Dr. Jemitz of Sweden. This is certainly a very imposing 
 title, which is applied to an aromatic tincture \vith aloes ; and as attention to the bowels 
 is really an essential point in the care of one's health, it may contribute so far to longe- 
 vity. 
 
 Essence of Coffee. The Cassia pulp is said to form the basis of this article. 
 
 Essence of Coltsfoot. " This preparation consists of equal parts of the Balsam of 
 Tolu, and the compound tincture of benzoin, to which is added double the quantity of 
 rectified spirit of wine, and this, forsooth, is a Pectoral for Coughs ! If a patient with a 
 pulmonary affection should recover during the use of such a remedy, I should certainly 
 designate it as a lucky escape, rather than as a skilful cure." (Dr. Paris.) 
 
 Essence of Mustard. This medicine, much vaunted as an external application in 
 rheumatism, consists of oil of turpentine, camphor, and a portion of spirit of rosemary, 
 to which is added a small quantity of flour of mustai'd. In cases of rheumatism, where 
 an external application is proper, this substance may do good ; but medical men often di- 
 rect a liniment of turpentine and oil, without giving it the title of mustard, with which it 
 has no connexion. So far does quackery go in this case, that pills are made, called Pills 
 of Essence of Mustard, which are made of Balsam of Tolu with resin. 
 
 Essence of Peppermint, a spirituous solution of the essential oil of peppermint, co- 
 loured green by spinage leaves. 
 
 Essence of Senna. A concentrated infusion of senna, in combination with an alkali. 
 
 Essential Salt of Lemons. The preparation sold under this name, for the purpose 
 of removing iron moulds from linen, consists of cream of tartar and super-oxalate of pu- 
 tiiss, or salt of sorrel,' in equal proportions. 
 
 Ford's Balsam of Horehound consists of a watery infusion of horehound and liquo- 
 
608 PATENT MEDICINES. 
 
 rice root, with double the proportion of proof spirit or brandy ; to which is then added 
 opium, camphor, benzoin, squills, oil of aniseed, and honey. This enumeration is surely 
 enough to show the absurdity of the pretensions of this medicine to cure colds, coughs, 
 and diseases of the lungs ; and it shows the danger run by those who, without a know- 
 ledge of the tendency to inflammation of the lungs which accompanies a great proportion 
 of the colds of this country, venture to use it. 
 
 Ford's Laudanum is similar to the vinum opii, or spirituous solution of the extract 
 of opium, combined with various aromatics. 
 
 Fothergill's Pills, are aloes, scammony, colocynth, and oxide of antimony. 
 
 Freeman's Bathing Spirits. Compound Soap liniment, coloured vaih Daffy's 
 Elixir. 
 
 Friar's Balsam. The compound tincture of benzoin. There does not seem any 
 good surgeiy in the practice of applying this substance to recent cuts or wounds. 
 
 GoDBOLD's Vegetable Balsam. " In the specification of the patent for this nos- 
 trum, forty-two different vegetables are directed to be distilled ' for the purpose of ex- 
 tracting their essences, which are to be preserved separately and apart from each other, 
 in syrups, and are to be mixed with the following gums and drugs, viz. gum dragon, gum 
 guaiacum, gum arable, and gum Canada, these being dissolved in double distilled vinegar, 
 with a quantity of storax dissolved in spirits of wine and oil of cinnamon. It is to be 
 bottled off", and kept three years before it is fit to be administered for the Cure of Con- 
 sumption, or any asthmatic complaint.' It is hardly necessary to observe, that no such 
 directions ever are, or indeed ever could be followed ; in short, the Balsam is little else 
 than simple oxymel." (Parts.) On this subject, Dr. Parr remarks: " We have 
 reason to believe that this balsam was first prepared from the various supposed expecto- 
 rants of an old herbal ; since Godbold (the elder) though an ignorant, seemed an honest 
 man ; and he professed that he had given us the receipt. At present, however, it is cer- 
 tainly only vinegar and honey, with a proportion of laudanum and some aromatic, vaned 
 apparently at different times." 
 
 (jrODFREY's CoRDiAL. — " The following receipt for this nostrum was obtained from a 
 wholesale druggist, wlio makes and sells many hundred dozen bottles in the course of a 
 year. There are, however, several other formulae for its preparation, but they are not 
 essentially different. Infuse nine ounces of sassafras, and of the seeds of caraway, cori- 
 ander, and anise, of each one ounce, in six pints of water ; simmer the mixture until it 
 is reduced to four pints ; then add six poimds of treacle, and boil the whole for a few 
 minutes ; when it is cold, add three fluid ounces of the tincture of opium. The exten- 
 sive and indiscriminate use of this nostrum in the nursery, is a subject of national oppro- 
 brium, and is so considered by foreign writers. See Fodere', Medicine Legale, Vol. iv. 
 p. 22." (Paris.) We are happy to say, that the reproach of using this nostrum to 
 stupefy infants, is not applicable to Scotland, where quackery thrives in a very inferior 
 degree. The mischiefs arising from the use of Godfrey's Cordial must have been going 
 on for many ye^s, as we find it enumerated in 1756, among the medicines employed by 
 the nurses at the early periods of the Foundling Hospital, to give a long and effectual 
 quieting to the children committed to their care. 
 
 Godfrey's Smelling Salts. This highly pungent preparation is obtained by re- 
 subliming the common sub-carbonate of ammonia with pearl-ash, and a proportion of 
 rectified spirit. 
 
 Golden Ointment. Under this name is sold a preparation, which consists of sul- 
 phuret of arsenic with lard, or spermaceti ointment. The ointment of the red precipi- 
 tate of mercury is also sold under the same title. 
 
 Gout Tincture, Wilson's. This is merely an infusion of colchicum or meadow 
 saffron. Since the discovery of this plant being the active ingredient of the Eau medi- 
 
PATENT MEDICINES. G09 
 
 cinale, numerous empirical remedies have started up, containing the principles of the 
 plant in different forms. 
 
 Gowland's Lotion is a solution of corrosive sublimate of mercury in an emulsion 
 formed of bitter almonds, in the proportion of about three grains to two ounces. A so- 
 lution of this merciuial salt in spirit of rosemary, is also sold as an empirical cosmetic. . 
 
 Green's Drops. Corrosive sublimate is the basis of these drops ; and of all the 
 drops and lotions which are said to cm-e syphilis without mercury. 
 
 Grindle's Cough Drops. See Cough Drops. 
 
 GuESTONiAN Embrocation for Rheumatism. Oil of turpentine three ounces, olive- 
 oil three ounces, diluted sulphuric acid six drachms. 
 
 Hannay's Lotion, or Preventive Wash. This famous nostnim for the preven- 
 tion of syphilitic infection, was nothing more than a solution of caustic potash. 
 
 Hatfield's Tincture. Guaiac and soap, of each two drachms ; rectified spirit, a 
 gallon and a half, used as a diaphoretic. 
 
 Hooper's Pills. The pills of aloes with myrrh, sulphate of iron and canella bark, 
 to which is added a portion of ivoiy black. 
 
 Ipecacuanha Lozenges. Each lozenge contains half a grain of ipecacuanha. They 
 may be used in colds and other breast complaints as an expectorant, one every four or 
 five hours. 
 
 James's Powder. /Seepage 351. 
 
 James's Analeptic Pills. These consist of James's powder, gum ammoniacum, 
 and the pill of aloes wdth myrrh, (Pilulse Rufi) equal parts, with a sufficient quantity of 
 the tincture of castor to make a mass. 
 
 Jesuit's Drops. The same as Friar's Balsam. 
 
 Lardner's Prrpared Charcoal consists of chalk finely powdered, rendered grey 
 by the addition of charcoal or ivory black. This is meant for a tooth-powder ; but by 
 referring to page 190, it will be seen that charcoal dentrifices are by no means to be re- 
 commended. 
 
 Liquor Opii Sedativus. See Opium, page 420. 
 
 Lynch's Embrocation for Hooping- Cough. Olive-oil impregnated with bergamot, 
 and some other essences, and coloured with alkanet root. 
 
 Madden's Vegetable Essence is little else than the compound infusion of the pe- 
 tals of the red rose, with an increased proportion of acid. 
 
 Marsden's Antiscorbutic Drops. A solution of sublimate in an infusion of gentian. 
 Diseases of the skin are certainly often benefited by the preparations of mercury, al- 
 though these are quite inapplicable in the true sea-scurvy. 
 
 Marshall's Cerate. Palm oil five ounces, calomel one ounce, acetate of lead half 
 an oimce, nitrate of mercury two ounces. Used for piles. 
 
 Matthew's Pills. Of the roots of black hellebore, liquorice, and turmeric, equal 
 parts ; piuitied opium, Castile soap, and syrup of saffron, the same quantity, made into 
 pills with oil of turpentine (Paris.) The active ingredient in these pills is the black 
 hellebore, so famous among the ancients in the cure of madness ; it is to be considered 
 merely as a drastic purge. 
 
 Matthew's Injection. This once celebrated remedy for fistula in ano, ^vas nothing 
 more than a diluted tincture of cantharides. 
 
 Moseley's Pills. The stomachic pills which are sold under this name, consist mere- 
 ly of rhubarb and ginger. 
 
 Norton's Drops, a disguised solution of corrosive sublimate. 
 
 Opodeldoc, Steer's. Castile soap one ounce, rectified spirit eight ounces, camphor 
 three drachms and half, oil of rosemary half a drachm, oil of origanum one drachm, solu- 
 tion of ammonia six drachms. 
 
 Oxley's Concentrated Essence x)F Jamaica Ginger. A mere solution of ginger 
 in rectified spirit. 
 
610 PATENT MEDICINES. 
 
 Peter's Pills. Aloes, jalap, scamraony, and gamboge, equal parts, two dracbms ; ca- 
 lomel, one drachm. 
 
 Pectoral Balsam of Honey is merely the tincture of benzoin or that of Tolu. 
 
 Pectoral Balsam of Liquorice. The proprietor of this nostrum gravely affirms, 
 that an ounce and a half contains the virtues of a whole pound of liquorice root ; but up- 
 on investigation, it will be found to consist principally of paregoric elixir, very strongly 
 impregnated with the oil of anise-seed. 
 
 Plunkett's Ointment for Cancer. This ointment consists of arsenious acid, sul- 
 phur, and the powdered flowers of the ranunculus flammula and cotula fetida, levigated 
 and made into a paste with the white of an egg, and applied on a piece of pig's bladder, 
 to the surface of the cancer. We have in many places stated the danger of using arse- 
 nic to an open sore. 
 
 Quaker's, or Lancaster Black Drop. See Black Drop, page 419. 
 
 Refined Liquorice. This article, which is sold in the form of cylinders, is made by 
 gently evaporating a solution of the piu-e extract of liquorice vdth half its weight of gum 
 arable, rolling the mass and cutting it into lengths, and then polishing, by rolling them 
 together in a box. Many impurities, however, are fraudulently introduced into this ar- 
 ticle, such even as glue, &c. (Dr. Paris.) 
 
 Riga Balsam, Beaume de Carpathes, from the shoots of the Pinus Cimbra, previously 
 bruised, and macerated for a month in water. 
 
 Roche's Embrocation for the Hooping- Cough. Olive-oil, mixed with about 
 half its quantity of the oils of cloves and amber. Such external applications may be of 
 service in hooping-cough, on the same principles as blisters or other counter-irritations. 
 
 Rymer's Cordial Tincture is an infusion of capsicum, camphor, cardamom seeds, 
 rhubarb, aloes, and castor in proof spirit, mth a very small quantity of sulphuric acid. 
 
 Senna, Prepared Essence of. This is a concentrated infusion of senna in combi- 
 nation \nth an alkali. 
 
 Singleton's Eye Salve. See Golden Ointment, page 608. 
 
 Smellome's Eye Salve consists of half a drachm of verdegris finely powdered and 
 rubbed with oil, and then mixed with an ounce of yellow basilicon. 
 
 Solomon's Anti-impetigines. A solution of corrosive sublimate. 
 
 Solomon's Balm of Gilead. An aromatic tincture, of which cardamoms form a lead- 
 ing ingredient, made ^\^th brandy. Some practitioners have asserted that cantharides 
 enter into its composition. When we consider the very general propensity to di-am- 
 di-inking, and how easily it is fostered by the pretence of taking cordial and nervous me- 
 dicines, we shall not wonder at the celebrity of the far-famed Liverpool Balm of Gilead, 
 
 Speediman's Pills. Aloes, myrrh, rhubarb, extract of chamomile, and some essen- 
 tial oil of chamomile. 
 
 Spilsbury's Antiscorbutic Drops are said to consist of con-osive sublimate, pre- 
 pared sulphuret of antimony, gentian root and orange peel, equal parts ; shavings of red 
 Saunders, made with proof spirit into a tincture, which is to be digested and strained. 
 
 Squire's Elixir. Opium, camphor, serpentaria, sub-carbonate of potash, anise and 
 fennel seeds made into a tincture, and coloured with cochineal. 
 
 Storey's Worm Cakes. Calomel and jalap made into cakes, and coloured with cin- 
 nabar. See page 387. 
 
 Stroughton's Elixir is a tincture of gentian, with the addition of serpentaria, 
 orange peel, cardamoms, and some other aromatics. 
 
 Struve's Lotion for Hooping- Cough. This once famed nostrum consisted of a 
 drachm of tartarized antimony, dissolved in two ounces of water, to which was added an 
 ounce of the tincture of cantharides. 
 
 Sulphur Lozenges. Sublimed sulphur one part, sugar eight parts, mucilage of 
 gum tragacanth as much as requisite to form lozenges ; used in asthma and for piles. 
 
PATENT MEDICINES. 611 
 
 Taylor's Red Bottle, commonly called the Whitworth Doctor. British brandy 
 coloured with cochineal, and flavoured with oil of origanum. 
 
 Taylor's Remedy for Deafness. Garlic infused in oil of almonds, and coloured 
 by alkanet root. 
 
 ToLu Lozenges. Sugar eight ounces, cream of tartar one ounce, starch two drachms, 
 tincture of the balsam of Tolu one fluid drachm, mucilage of gum tragacanth, q. sufficit. 
 
 Velno's Vegetable Syr*up. There has been a good deal of obscurity with respect 
 to the genuine composition of this nostrum. Its active ingredient seems to be some pre- 
 paration of mercuiy. 
 
 Wade's Drops, or the General's Balsam, is the compound tincture of benzom. 
 
 Walker's and Wessel's Jesuit's Drops. This is nothing more than the Elixir 
 Anti- venereum of Quincy, consisting of guaiacum, balsam of copaiba, and oil of sassa- 
 fras, made into a tinctm-e by spirit. 
 
 Ward's Essence for the Headach. The name of Wai'd is one of the most fa- 
 mous in the annals of quackery. It has even found its way into poetry : "Ward tried 
 on puppies and the poor, his drop." Dr. Paris says he was originaDy a footman, and 
 during his attendance upon his master on the Continent, obtained from the monks those 
 receipts which afterwards became his nostrums. That for the headach is nothing more 
 than the compound camphor liniment of the London Pharmacopoeia. It is highly sti- 
 mulating, and is composed of camphor two parts, liquor ammonias six, spirits of lavender 
 sixteen parts. 
 
 Ward's Paste for Fistula and Piles. Dr. Paiis having given the formula for 
 this composition, the Committee of the College of Physicians of London directed the 
 preparation to be introduced into the Pharmacopoeia, at the suggestion of several emi- 
 nent practitioners who have experienced its utility in certain cases of piles. It is called 
 the confection of black pepper j and Dr. Paris says it is well adapted for the cure of 
 that species of piles which probably attended the sedentary and luxurious habits of the 
 monks. It is made as follows. — Take of black pepper and of elecampane root of each 
 one pound, fennel seeds three pounds, honey and purified sugar, of each two pounds. 
 Triturate the dry substances together into a very fine powder, then add the honey, and 
 beat the whole into a uniform mass. 
 
 Ward's White Drops. This once esteemed antiscorbutic was prepared by dissolv- 
 ing mercury in nitric acid, and adding a solution of carbonate of ammonia ; or frequently 
 it consisted of sublimate with carbonate of ammonia. 
 
 Ward's Red Drop. A strong vinous solution of tartarized antimony. 
 
 Ward's Sweating Powder. A combination of white hellebore, (veratrum album) 
 and opium. It was used in the cure of gout. 
 
 Warner's Cordial. Rhubarb bruised one ounce, seima half an ounce, saffron one 
 drachm, powdered liquorice four drachms, pounded raisins one pound, brandy three gal- 
 Ions ; digest for a week and strain. 
 
 Whitehead's Essence of Mustard. See Essence of Mustard. 
 
 Wilson's Gout Tincture. See Gout Tincture. 
 
 Worm Cakes. See Storey's Worm Cakes, page 610, and Ching's Lozenges, 
 page 605. 
 
612 OCCURRENCES AT CERTAIN TEMPERATURES. 
 
 No. III. 
 
 Table showing the degrees of heat on Fahrenheit's Thermometer, at which se- 
 Teral natural .and physiological phenomena take place. 
 
 Below Zero, or the temperature ofeqwd parts of snow and salt, 
 
 — 90 Greatest artificial cold produced. 
 
 — 55 Strongest nitric acid, (aquafortis), freezes. 
 
 — 50 Natural cold observed at Hudson's Bay. 
 
 — 46 Ether freezes. 
 
 — 39 Mercury freezes. 
 
 — 36 Sulphuric acid (vitriol) freezes. 
 
 — 23 Cold observed on the surface of the snow at Glasgow, 1780. 
 
 — 7 Brandy freezes. 
 
 Above Zero. 
 
 + 16 Oil of turpentine freezes. 
 20 Strong wines freeze. 
 25 Human blood freezes. 
 28 Vinegar freezes. 
 32 Water freezes. 
 43 Phosphorus bums slowly. As the heat of the body is much above this, phos- 
 
 phoms cannot be touched without injury, and must be kept in cold water, the 
 
 heat of the air being frequently above 43. 
 59 Vinous fermentation begins. 
 66 to 135 Animal putrefaction occm-s. 
 76 to 80 Summer heat in Britain. 
 85 to 97 Temperatures for the warm bath. 
 
 96 to 98 The heat of the human body ; the heat of birds is a little higher. 
 
 97 Lard melts. 
 
 98 Ether boils. 
 
 104 to 106 Feverish heat. 
 
 109 Heat observed in scarlet fever. 
 
 11 Of The heat at which tea and other warm drinks are taken. 
 
 114 The heat of water in which the feet may be bathed. 
 
 165 Albumen, or the white of egg, coagulates. 
 
 176 Alcohol boils. 
 
 212 Water boils. 
 
 304 Oil of turpentine boils. 
 
 600 Linseed oil boils. To extinguish burning oil, cold oil should be thrown upon 
 
 it ; but not water, as this is instantly converted into steam, and scatters the 
 
 flaming oil about in all directions* 
 
ALCOHOL IN VARIOUS LIQUORS. 
 
 C13 
 
 No. TV. 
 
 As the intoxicating qualities of wine and fermented liquors depend on the pro- 
 portion of alcohol which they contain, it is a matter of considerable interest to 
 compare different liquoi"s together with respect to this point ; and Mr. Brande of 
 London has constructed a Table, showing the alcohol contained in a hundred parts 
 of the different liquors which he has examined. 
 
 The relative strength of the different wines, &c. in common use, may be judged 
 of from this Table ; but it must always be remembered that what is commonly 
 called the strength of wine, which is a direct product oi fermentation, depends 
 upon alcohol in chemical combination with its other ingredients ; and that the ef- 
 fects of wine upon the constitution are very different from those of diluted spirits, 
 such as bi-andy, rum, gin, and other similar products of distillation. 
 
 It may be useful to mention, that the proportion of spirit per cent, in the fol- 
 lowing Table, means the pure unmixed alcohol, not the ardent spirits which are 
 commonly drank. By looking at the five last articles of the Table, it will be 
 seen, that they contain somewhat more than half their measure of alcohol, or they 
 are above proof. A mixture of equal bulks of alcohol and w^ater is called proof 
 spirit. Therefore, if a person drinks a bottle of port, (see Table, No. 4), he 
 drinks more than a fourth of it as alcohol, or more than a half as proof spirit ; or, 
 every bottle of port contains of intoxicating liquor, such as is commonly used un- 
 der the name of brandy, gin, or whisky, an English pint. The same is true of 
 Madeira, (No 5,) and in an inferior degree of Sherry, (No. 7 j) and even Currant 
 Wine, (No. 6,) thought so harmless, contains forty per cent, or near one half, of 
 proof spirit. 
 
 Proj)ortion of 
 Spirit per cent, 
 by measure. 
 
 1. Lissa 26-47 
 
 Ditto 24-35 
 
 Average 23-41 
 
 2. Raisin wine 26-40 
 
 Ditto 25-77 
 
 Ditto 23-20 
 
 Average 25-12 
 
 3. Marsala 2603 
 
 Ditto 25-05 
 
 Average 25-09 
 
 4. Port 25-83 
 
 Ditto 24-29 
 
 Ditto 23-71 
 
 Ditto 23-39 
 
 Ditto 22-30 
 
 Ditto 21-40 
 
 Ditto 19-00 
 
 Average 22 96 
 
 5. Madeira 2442 
 
 Ditto 23-93 
 
 Ditto (Sercial) 21-40 
 
 Ditto 19-24 
 
 Average 22-27 
 
 6. Currant wine... 20*55 
 
 8. 
 
 9. 
 10. 
 11. 
 12. 
 13, 
 14. 
 15. 
 
 16. 
 17. 
 
 18. 
 19. 
 
 Proportion of 
 Spiritpercent. 
 by measure. 
 
 Sherry 19-81 
 
 Ditto 19.83 
 
 Ditto 18-79 
 
 Ditto 18-25 
 
 Average 19-17 
 
 Teneriffe 19-79 
 
 Colares 19-75 
 
 Constantia, white 19-75 
 
 Ditto, red 18.92 
 
 Lisbon 18.94 
 
 Malaga (1666). 18-94 
 
 Bucellas 18-49 
 
 Red Madeira 2-2'30 
 
 Ditto 18-40 
 
 Avei-age 20-35 
 
 Cape Muschat 18-25 
 
 Cape Madeira 2-2-94 
 
 Ditto ;. 20-50 
 
 Ditto 18-11 
 
 Average 20-51 
 
 Grape wine 18-11 
 
 Calcavella. 19-20 
 
 Ditto 1810 
 
 Average 18-65» 
 
614. 
 
 ALCOHOL IN VARIOUS LIQUORS. 
 
 20. 
 2L 
 22. 
 23. 
 24. 
 
 25. 
 
 26. 
 
 27. 
 28. 
 29. 
 30. 
 31. 
 
 32. 
 
 33. 
 34. 
 35. 
 30. 
 
 Proportion of 
 Spiritpercent. 
 by measure. 
 
 Vidonia 19-25 
 
 Alba Flora 17-26 
 
 Malaga 17'26 
 
 White Hermitage 17-43 
 
 Rousillon 19-00 
 
 Ditto 17-26 
 
 Average 18-13 
 
 Claret 17.11 
 
 Ditto 16-32 
 
 Ditto , 14-08 
 
 Ditto 12-91 
 
 Average 15-10 
 
 Malmsey Madeira 16-40 
 
 Lmiel 15-52 
 
 Sheraz 15'52 
 
 Syracuse 15-28 
 
 Sauteme 14-22 
 
 Burgundy 16-60 
 
 Ditto 15-22 
 
 Ditto 14-53 
 
 Ditto 11-95 
 
 Average 14*57 
 
 Hock c 14 37 
 
 Ditto 1300 
 
 Ditto (old in cask) 888 
 
 Average 12-08 
 
 Mce...., 14-63 
 
 Barsac 13 86 
 
 Tent 13-30 
 
 Champagne (still) 1380 
 
 Ditto (sparkling) 12-80 
 
 Proportion of 
 Spiritpercent. 
 by measure. 
 
 Ditto (red) 12-56 
 
 Ditto (ditto) 11-30 
 
 Average 12-61 
 
 37. Red Hermitage 12-32 
 
 38. Vinde Grave. 13-94 
 
 Ditto 12-60 
 
 Average 13-37 
 
 39. Frontignac 12-79 
 
 40. Cote Rotie 12-32 
 
 41. Gooseberry wine 11-84 
 
 42. Orange wine, — average of six 
 
 samples made by a houdou 
 
 manufacturer 11-26 
 
 43. Tokay 9-88 
 
 44. Elder wine 8-79 
 
 45. Cider, highest average 9-87 
 
 Ditto, lowest ditto 5-21 
 
 46. Perry, average of four samples 7-26 
 
 47. Mead 7-32 
 
 48. Ale (Burton)... 8.88 
 
 Ditto (Edinburgh) 6-20 
 
 Ditto (Dorchester) 5-56 
 
 Average 6-87 
 
 49. Brown stout 6-80 
 
 50. London porter (average) 4-20 
 
 5i. Ditto small beer (ditto) 1-28 
 
 52. Brandy 53-39 
 
 53. Rum 53-68 
 
 54. Gin 51-60 
 
 55. Scotch Whisky- 54-32 
 
 56. Irish ditto 53-90 
 
 FINIS. 
 
 F'HINTKD nV A. B.\LrOta A>D CO. NIDDRY STREET. 
 
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