M$


, \ ,'
.V' '' '•*- ..V *H,»\ '.  * '
►'V->'i

TV'"- i'i"!*'''







m$& .*;-■-■
''■".'r.t-'^r'.
 
WB 100 D981m 1892
NLM  Q515imfi  2
     NATIONAL LIBRARY OF MEDICINE
NLM051514182 
 
 
/
\f
MEDICAL  NOTES
PREPARED EXPRESSLY FOR HIS STUDENTS BY
GEORGE DUTTON, A.M., M.D.
DEAN OF THE VERMONT MEDICAL COLLEGE
&XABS
COPYRIGHT SECURED 
\00 
MEDICAL  NOTES.
    i.   Science, to be complete, must necessarily include both the
visible  and the invisible,  or, in other words, physics  and  meta-
physics.
    2.   Physics is  natural science, or that  which pertains to the
material universe ; while metaphysics is mental science, or that
which pertains to the  spiritual universe, and the  latter is the realm
of force or power.
    3.   The  practice  of medicine  embraces something of science
and something of art; and a knowledge of  it must be gained either
by  study and observation,  or by intuition, or both.
    4.   Intuition is the immediate  and spiritual perception of truth.
It is a faculty which may  be  more or less developed in all persons.
    5.   Medicine,  as  generally  taught, includes seven  branches,
viz.:—Anatomy,   physiology,  chemistry,  therapeutics,  surgery,
tokology and medical jurisprudence.
    6.   Pathology is really a branch of physiology.  Both are man-
ifestations  of the  same power  and  governed  by the same laws.
Conditions only, differ; and the different conditions  are what give
different results.   Pathology is physiology  seen  under unfavorable
conditions.
    7.   Anatomy is the science of structure, as  applied to organ-
ized beings.   Its chief divisions are animal  and vegetable anatomy.
The latter belongs to Botany.
    Animal anatomy is divided into human  and comparative.  The
latter investigates the structure of the  lower animals as compared
with  that  of man.   Human  anatomy  embraces  general, surgical,
and morbid  anatomy.  The latter  investigates the structure of dis-
eased parts  and is sometimes called pathological anatomy.  Sur-
gical  anatomy investigates structures more frequently requiring sur-
gical operations.

                                (5) 
   8.  Surgery is a contracted form  of Chirurgery,  and signifies
" hand-work, "  or manual operations.  It requires for  the best
practice the best knowledge and skill  in all  departments  of medi-
cine.
   9.   Physiology is the science of vital action as manifested  in
organized  bodies.  It studies the body in motion and explains the
uses of all  the various parts in a state of health.
    10.   Chemistry is the science of molecular life.  It is based on
what is known as the atomic theory, and investigates the properties
of all known  elementary  substances  of  the  visible or material
universe, both alone and  in combination with each other.
    11.   Therapeutics is the application of remedies for the cure  of
disease.
    12.   Tokology is the science of reproduction.
    13.   Medical jurisprudence  is the legal aspect of medicine.
    14.   Disease is a general term, including pain, distress or incon-
venience, arising from some lesion or injury of the body, or the loss
of some part itself, or of  its perfect use.   An imperfect body is in-
compatible with health.
   Disease has  many  degrees  and manifestations, but  no  plural.
We can speak of diseases as we speak of clouds or  waters, but they
are all essentially one thing, pain or distress.
   The cause of disease is really some error of thought or feeling.
The error  leads  to unsatisfactory  results  in the  body,  and these
results cause distress of mind, known as disease.
   The  cause  of disease  may proceed from  one or many finite
minds.   The universal man is enbodied in many forms.
   In the indissoluble  chain of being, which connects the invisible
primal cause of all things with its ultimate material effects, there are
many links ; and  each link, save the  first and  last of the chain,
is, in human language, called alternately cause and effect; but it  is
manifest that all material things  are only effects of an invisible cause.
The latter  is ordinarily considered beyond the  pale of scientific in-
vestigation.  Such a position  makes science  strictly materialistic.
For the best results we  must be able to connect effects with primal
causes ; and these are  always immaterial, or supernatural; not un-
natural, or contrary to nature, but above or beyond nature.  True
science  will, when fully understood, make it appear that all mate-
rial causes are themselves effects.

                               (6) 
   Force or power cannot be perceived by any outward sense ; we
perceive only its  manifestations or effects.   We reach the primal
cause by logic and intuition.
   The various symptoms of disease  give  rise to many  terms or
names of disease ; but  nosologists differ widely as to number and
name.
   Cullen  makes 149, McBride 180, Sauvages 315, Vogal  560, and
the Royal College of Physicians, in London,  1,146 diseases.
    15.   As to remedies, different schools as well as different physi-
cians, also, differ widely.
   The United States Pharmacopoeia has 1000 remedial agents ; the
German 560; and yet according  to Scudder, in  "Specific Diag-
nosis, " there are only twenty remedies in general use, and of these
only five or ten are in common use ; while one professor  in a medi-
cal college made the following wonderful announcement:   " Armed
with calomel and  the lancet I am prepared to combat all diseases. "
Such practice is now nearly obsolete ;  the true practice will consist
in finding  the  cause of disease and removing it, thus giving  con-
ditions necessary to recovery.
    16.   One of the earliest symptoms  of disease is some abnormal
change or disturbance in the circulation of the blood, and any irrita-
tion, whether of the mind  or body, disturbs the circulation.
    17.   The best protection  against disease  is not disease  itself, in
the form of Vaccina, or any  disease as the result of inoculation for
the same or similar disease ; but the  best possible health secured by
the best possible  manner of living.   To fortify the  mind against
disease  by  a health education is the best  prophylactic.
    18.   Disagreeable impressions  produce nausea with the  same
certainty as ipecac, and erroneous thoughts and feelings in regard
to the physical plane of life are  sure  to  result  in disease.
   The symptoms of disease are many, and in the absence of intui-
tive  perception  constitute the principal  means of diagnosis, aided,
perhaps, sometimes by a  history of the case.   The following  are
some of the leading symptoms with their recognized indications.
   19.   Symptoms:   Cold sweats indicate prostration ; hot and dry
skin, feverish excitement; moist and warm skin, health ; ringing in
the ears, nervous  debility  or use  of quinine  ; inability to rise,  gen-
eral  debility, paralysis, rheumatism,  fractures,  and  dislocations;
inability to lie down, asthma and pleurisy ;  coma, compression of

                               (7) 
 the brain  as  in  apoplexy,  epilepsy,  and poison  of alcohol and
 opium ; deafness, wax in the ear, paralysis of the auditory nerve, or
 effect of quinine; pupil contracted, inflammation  of the  brain, or
 use of opium ; pupil dilated, amaurosis  (obscure vision from paresis
 or paralysis of the optic nerve), apoplexy, and effect of belladonna,
 or stramonium ; muscae  volitantes (floating specks in the field of
 vision  caused by viscid  and impure humors, or media of  the eye),
 dyspepsia; pain in the  right shoulder,  inflammation of the liver;
 pain at the end of the  urethra,  stone  in the bladder; pain in  the
 knee unattended  with soreness  and swelling, inflammation of  the
 hip joint; pain of the abdomen diminished  by pressure, colic; pain
 of the  abdomen  increased  by pressure, peritonitis  or inflammation
 of the  bowels; vertigo  (giddiness), disorder of the liver, nervous
 debility,  and,  if severe,  an attack of apoplexy or  epilepsy ; gums
 and tongue  pale, anasmia  and loss  of  blood ; blue line along the
 gums,  lead  poisoning;  gums prone to  bleed, scurvy or  purpura;
 taste bitter,  liver complaint, or effect of iodide of  potassium ; taste
 metallic, metallic medicines  in  the system or air;  teeth loosened,
 scurvy, or effect  of mercury;  excessive  thirst, high  fever,  diabetes,
 or  effect of hemorrhage; yellow tongue, hepatic diorders ; tongue
 brown or black, effect of medicines or contamination of the blood  ;
 tongue livid or purple, effect of suffocation ;  tongue tremulous, early
 stages of typhoid or typhus fevers ; tongue red, eruptive fever or  in-
 flammation of  the mouth  and throat; tongue whitish, pneumonia
 (inflammation  of the lungs) ; tongue protrudes to  one side, hemi-
 plegia  (paralysis  of one side) ;  tongue   red on  the  tip and edges,
 gastric or typhus fever; excess of fibrin  in the blood, inflammation ;
 excess of red corpuscles,  plethora, sugar in  the blood and urine,
 diabetes; uric  acid  in the  blood  or  urine,  gout  or  rheumatism;
 excess of  urea in the blood, Bright's  disease ;  palpitation of  the
 heart, dyspepsia, exciting mental  emotions or excessive use of nar-
 cotics ; pulse increased in  frequency, fever or some arterial excite-
 ment;  pulse intermittent,  dyspepsia and obstructed  circulation;
 pulse irregular, disturbance of the functions  of the brain ; pulse
small and  rapid, great prostration from  hemorrhage or protracted
and wasting disease ; breath foul,  indigestion, bad  teeth, constipa-
tion, or excessive  carnal  indulgence; hiccough, acrid matter in the
stomach,  or  mortification of some part  connected with the vagus
(8) 
 (pneumogastric)  nerves; stertorous  breathing (relaxation  of the
 velum palati), coma and  cerebral oppression.
    20.   " Congestion" is an engorgement of the part with blood.
    21.   Inflammation is an infiltration and  stagnation of the blood
 in some part owing to an excess of waste matter in the  system, ex-
 cess of fibrin, or lack of vital force.
    The symptoms of inflammation are heat, pain, redness (where
 red blood circulates), and swelling.
    The results of inflammation are various.  We may get resolution
 (subsiding without serious injury), suppuration, gangrene, adhesion,
 effusion, or induration.
    Suppuration is the formation of pus.
    Gangrene is the death of the part.
    Adhesion is the uniting of parts naturally separate.
    Effusion  is the pouring out  of serum into some closed cavity or
 tissue of the  body.
    Induration is the hardening of the part, as when a scar is formed.
    22.   The amount of blood is about of -^ the entire weight of the
 body.
    23.   A saturated solution of common  salt keeps  the blood per-
 manently fluid, thus preventing the formation of fibrin.
    24.   The blood  consist <^f~blood  corpuscles  and  plasma  (or
 liquor   sanguinis).  The  piafcma contains fibrin  (in solution) and
 serum.   The serum consists of water, albumen  and salts.
    25.   The normal specific gravity of the blood is about 1.055.
    26.   The coloring matter of the blood  is  termed haamatin.
    27.   The substance of the corpuscles is termed haemoglobin.
    The corpuscles loaded with oxygen  are termed oxyhemoglobin.
 The globulins do not dissolve in pure  water, but are more  or less
 soluble  in a solution of common salt.
    28.   The number of pulsations per minute is  in the adult about
 72, but  much depends  upon  circumstances.  It is  increased by va-
 rious emotions of  the mind  and by  exercise.  The pulse of  the in-
 fant is  about 130 per minute.   It may be  felt in the  radial artery at
the wrist.
   29.  The  rate of pulsation  to  respiration  is  about 4 to 1.  If
respiration is 18 per minute, the pulse may be 72.
   30.   The fibrin of the blood amounts to 3 to  10 parts in 1000.
It is greater in inflammatory conditions.

                               (9) 
    31.   The water is 79 per cent, of the blood.
    32.   The tension of blood in the aorta is about 6 inches of mer-
cury ; and  it flows in  the  aorta about  one foot per second ; in the
capillaries -^ of an inch per second.
    33.   The capillary is about y^ of an inch in length.
    34.   The blood completes its circuit in about 30 seconds.
    35.   The lungs have a double circulation—the bronchial  and
pulmonic; i: e. two sets of vessels.  The pulmonary  artery carries
blood to the lungs for purification ; the bronchial arteries carry nu-
triment.
    36.   Phlebotomy (vein  cutting) is venesection,  or blood-letting.
Flint and Waring still recommend  it  in  double pneumonia  and
puerperal fever.   Flint and some  others predict it will  again be-
come common.   Robust persons bear  it better than the debilitated.
    37.   Check  hemorrhage  by (1) continued pressure;  (2)  by
torsion ; (3) by ligature.  Hemorrhage from  small vessels may be
checked by some  strong astringent like alum ; or styptic, like tinc-
ture of iron.
    38.   Haemoptysis  is "spitting  of blood."  It generally occurs
between puberty and the age of 35.   The blood may come from the
mouth or throat, but usually  from  the mucous membrane  of the
lungs.  In most  cases it arises from congestion  of the  lungs, and
requires warming and stimulating treatment, with moderatelv full
and deep  inspirations to  air the  blood.  In active hemorrhage
from  some  mechanical injury of the lungs, rest  must be enjoined
and a moderate use of the lungs.
    39.   Hccmatemesis is  "vomiting of blood. "   The blood gen-
erally comes from the mucous membrane  of the  stomach,  but in
case of injury may come from other parts.  Give the  stomach rest.
    40.   Protoplasm (first  formed)   is the name applied to the first
cell, or  matter from which  an organism is  formed.   It contains all
the vital properties of highly organized  bodies.
    The homogeneous matter of protoplasm forms by differentiation
all the various tissues of the body.
    41.   All skin disease is dependent on the abuse of drugs, some
error  of diet, excessive  irritation,  mechanical  injury,  deficient
vitality, or want of oxidation of the blood.   In some cases, the skin
becomes infested  with itch mites   and other animalcules.  These
scavengers can be destroyed with a  weak solution of corrosive sub-
                              (10) 
 limate, two  grains  to an ounce of water.  Label, "For external
 use only. "   Apply twice per day.
    42.   Tetter, Lichen, and Herpes are equivalent terms,
    43.   Lupus  (wolf) is eating tetter,  and is  sometimes called
 " Noli me tangere. "
    44.   Impetigo or Eczema is moist, crusted, or humid tetter.
    45.   Psoriasis is scaly tetter.
    46.   Ringworm is "Herpes  circinatus, " because it d'escribes a
 ring or  circle.  Apply once or twice per day a solution of corro-
 sive sublimate—two grains to the ounce of water.
    47.   Porrigo  favosa is the honeycomb tetter ; so called because
 the scabs are honeycombed.   Porrigo (to spread) is a general term
 including scald-head, baldness in  patches (called Porrigo decalvans),
 and two kinds of tetter,  viz : Porrigo favosa and Porrigo larvalis.
 The latter is  the milky tetter,  and is so named because it sometimes
 covers the  face with  crust, as with a mask.  Tetter is of Anglo
 Saxon origin and signifies "foul."
    48.  Exanthem (to " bloom  out")  is a general term  for  any
 rash or eruption of the skin.   Rash is of French origin and signifies
 itch.  Eruption, from the Latin,  signifies to "break out."
    49.  Erythema (redness)  and Roseola,  or Rose-rash,  is an ef-
 florescence  of the  skin in patches.
    50.   Scabies,  Psora, Pruritus, and Prurigo, are all general terms
 for any itching, or Itch.   Psoriasis also indicates a "scratchy con-
 dition, " but is applied to the scaly tetter or dry scall.
    51.   Urticaria  (" nettle "-rash)   is characterized by a  stinging
 sensation.  In Scotland it is called  Hives.  The cuticle is  elevated
 into wheals that sting and itch.   It is caused by eating of shell fish,
 old cheese, and other acrid matters.
    52.   Acne (of uncertain origin) consists of an eruption of slowly
 suppurating tubercles,  usually appearing upon the face  and skin of
 young persons.
    53.   Pityriasis  is a  " branny " tetter, similar to Psoriasis minus
 the itching.   It is  caused  or aggravated by  the use of  salted  pro-
visions.   An  application  of lanoline improves the appearance of
the skin.
    54.   To cleanse  the  skin from  a greasy  appearance and
make it soft, apply a little lemon juice ; or use the following: pure
(") 
distilled  glycerine  }£ oz., powdered  borax % oz., and camphor
water (obtained of the druggists) one pint.
   Tincture  of benzoin, a teaspoonful  to a  pint of water  makes a
pleasant lotion.
   55.   To whiten the skin, the best powder  is French chalk  (a
fine  variety of soapstone, found  at  Briancon, a  small village  in
France), or French chalk mixed  with  precipitated carbonate  of
zinc.  TTie latter may also be used alone.
   56.   Paleness of the  skin must be  removed by friction, whole-
some food, air, sunlight,  and judicious exercise to improve the red
corpuscles of the blood.
   57.   Lime water and  vinegar, four parts to  one, or Glycerine of
borax are excellent washes for scurf.
   58.   Alopecia (" fox, " said to be sometimes bald) is the general
term for baldness.   For  baldness, apply with friction, once a  day,
a preparation of tincture  of cantharides one  part, and eight parts of
castor oil.
   59.   Lepra (scaly)  includes the  leprosy  of the ancients, and va-
rious other affections.   Healthy nutrition  is its only cure.
   60.   Purpura (a purple  color) takes its name from livid spots
where venous blood has settled.  It is a kind of scurvy, arising  from
the effects of murcury and deficient aeration  of the blood.
   61.   For a medicine  to  purifiy  the blood  make an infusion of
Prince's Pine  (Pipsissewa)  leaves, and preserve with  one-seventh
part of deodorized  alcohol,  or  rectified spirit.   One ounce of the
leaves is sufficient for one quart of water;  may add, if you please,
bark of  Burdock root,  or the fresh root of Yellow Dock.  If you
desire something already prepared,  use the "Compound Syrup of
Sarsaparilla, "  which is  official.  May  give  of  either from  one
spoonful to a wineglassful, two or three times  per day.  The latter
will act slightly upon the bowels ; or  to speak  more  properly  will
be more quickly expelled, as it contains senna.
   62.   Warts are  sometimes charmed away by counting them, and
telling the  patient that in  ten days they  will be gone.  They may be
destroyed by touching repeatedly with  chromic, or glacial  acid, the
colorless tincture of Iodine, or Caustic  Potash.
   63.   Erysipelas  ("I  draw  near," from  its tendency to spread
and  involve other parts,) is  an inflammation  of  the skin, more or
less deeply seated, with general fever and a bad state of the blood.
(12; 
For this condition use, both infernally and externally, camphor water
and boracic acid, 5 grs. of the acid to one ounce of camphor water;
dose of the same a tablespoonful every two hours till the fever sub-
sides.   Give lemonade freely, and if  the bowels are  inactive, give
at night 15 grs. of hyposulphite of soda dissolved in a cup of water.
    64.  Scarlatina (deep red) is Scarlet Fever, simple.  Scarlatina
maligna is " Canker Rash " (canker and rash). Scarlatina anginosa
is sore throat accompanied by scarlet fever.
    65.  The Major Exanthemata include  small pox,  measles  and
scarlet  fever.
    The premonitory systems of  the Major Exanthemata are pain
in the head, neck and back ; nausea and vomiting in bad cases,  and
an eruptive fever.  In small pox the pustules appear in three to five
days, and  in about five days more fill with pus ;  in  measles  and
scarlet  fever the eruption  is not pustular, but  generally causes
desquamation of the cuticle.  In measles the skin is rough, in scar-
let fever smooth.  The period of  incubation is ten to fourteen days.
    66.  Vaccina  (kinepork,  or cowpox)  is small pox  caused  by
voluntary or compulsory  inoculation with matter from an  infected
cow.   It causes more or less disease, injury and loss of life, depend-
ing on the sanitary condition of the  patient and the malignancy of
the matter introduced.
    67.  Law of contagion:   All disease  is  contagious,  directly
as  its malignancy, and  inversely as the soundness of the person
exposed
    68.  In scarlet fever secure perspiration ; ia small pox keep the
patient  in a cool room and give rum punch as an antiseptic.
    69.  Camphor water and boric (boracic) acid is a safe and effic-
ient remedy for all  forms of zymotic disease, including small pox,
measles, scarlet  fever, erysipelas,  diphtheria, typhoid  fever  and
rheumatism.
    70.  A small pox patient should be placed  in the attic or upper
room, for two reasons ; that he may have good air, and that the  air
may more readily remove and oxidize  the infectious matter.  Ozone
and oxvgen are the best deodorizers.   The  eruption appears first on
the forehead and lips the second or  third  day, and in  bad cases
"runs together," forming confluent small pox.  At first the eruption
consists of coarse red spots ; three days later (the 6th day) vesicles
appear, and on the 8th day these  are  changed to pustules; on the

                               (13) 
 nth day, pus 6ozes out, dries and  forms scabs.   Treat with  rurri
 punch, and solution of boracic acid.  Apply the latter, mixed with
 glycerine to keep the skin soft and prevent pitting.   Before vacci-
 nation was practiced the mortality  was  about 16 per  cent.  It is
 now given as 50 per cent, of all persons under 5 and over 40 years.
 Under the usual treatment the malignant cases invariably prove
 fatal.
    The cause of small pox was attributed by Jenner to the "Grease"
 (sore heels of the horse) which according to  him is identical with
 vaccine  matter.   Vaccination is therefore only  another name  for
 small pox inoculation, which was  prohibited in England  by act of
 Parliament.  Varioloid (like  small  pox) is only another  name  for
 small pox occuring in persons known to be vaccinated.  It is com-
 monly assumed  that small pox  is always the  result of contagion,
 that  one  attack protects from a second,  and  that  vaccination is a
 preventive.  These positions of the  profession are incorrect.  The
 first case could not possibly have been a  case  of contagion, and if
 developed once it must always be under the same or similar circum-
 stances, for the laws of nature  are  always uniform.   Second and
 even third attacks of small pox are on record and well known ; and
 vaccination with  matter  identical with  small pox-matter  cannot
 by any possibility prevent small  pox  since it always communicates
 the disease and thus perpetuates  it.  The cause  of small  pox  is
 believed to be the decomposition of urea in the  system, and the only
 permanent remedy against the disease is a wiser mode of living and
 better blood.
    71.   Yellow Fever  is peculiarly a disease of the  digestive  or-
 gans, with contamination of the blood.   It incubates for a week and
 ends  in a  week.  There  is inflammation of the stomach, with severe
 nausea and vomiting; pain in  the back,  and  in the calves of the
 legs; hemorrhage  from  various parts,  and suppression of urine.
 The liver is yellow and  filled  with oil globules.  The remedy will
 be found in correcting the dietetic  habits  and environments rather
 than  in quarantine regulations.
    72.  Hot climates do not require so  much  fuel (carbonaceous
food — fat, sugar  and starch)  as colder climates.
    73.  Dropsy  is a  general  term  including  ascites (dropsy  of
the  abdomen), hydrocephalus (dropsy of  the  head),  hydrothorax
 (dropsy of  the chest),  hydrocele (dropsy of the  scrotum), and

                              (H) 
Anasarca (dropsy of the flesh).  It implies a clogging of the lym-
phatic vessels, which prevents the return of serum—usually called
lymph, transfused  in the  capillaries and lymph spaces — into  the
circulation as in health.  The remedy will be found in clearing  the
system of all impurities by natural means — deep breathing, flush-
ing the colon, moderate exercise, fresh provisions,  and a close diet,
free from any excess of fat, starch and sugar.
   74.   Gout is an inflammation of the joints,  generally of the  fin-
gers and toes, and  is equivalent to  Arthritis.  It took its name from
the French, " goutte" signifying  drop,  which was believed to be
distilled upon the part, " drop by drop."  It is caused by the depo-
sition in the  ligaments and tendons of the joints, of the urate of soda,
which again has its origin in the use  of soda,  or baking powders,
and  derangement of digestion.  Wine  of colchicum  and rhubarb
were the old remedies, but wholesome living is  the only infallible
preventive as well as cure.
   75.   Atheroma of the arteries  is represented by hardness of the
pulse, the " arcus senilis" (ring around the iris of elderly persons),
irregular action of  the heart, partial blindness and loss of memory.
Keep the bowels free with hyposulphite of soda.   Some authors
advis>e  hypophosphir.es.
   76.   In  pneumonia with a full and  bounding  pulse, may give
gelseminum. Put  half a teaspoonful of the tincture in half a goblet
of water and give a teaspoonful  of the mixture every hour  till  the
skin is  moist and the pulse softer.   Pilocarpin  (active principle of
Jaborandi)  is the most  reliable  diaphoretic (produces sweating).
Give  not more than ^ of a  grain, and  repeat if  necessary in six
hours.  Usually one small pill will suffice to break up pneumonia.
Give  hot lemonade freely, and induce the patient  to breathe  deeply
as possible to air the blood.
   Deep breathing, alone, provided  the  patient  be kept warm in
bed, will cure  pneumonia.  The blood which  clogs the  lungs will
resume its usual flow in the arteries as soon as it  is  properly oxi-
dized and  decarbonized  in  the  lungs.
   77.  Pleurodynia (pain of the side)  is a rheumatic affection of
the muscles of the side of the chest.   It  hurts to move the arm,  but
does not hurt to breath  deeply as in pleurisy, and  is  unattended by
fever or cough.   It yields  to hot fomentations,  hot lemonade, mas-
sage,  and good  air  deeply  inhaled.   A little bicarbonate  of soda —

                               (IS) 
 5 to  10 grains — may be  administered  to  neutralize the uric acid
 diathesis, and soda water may be used for bathing.
    78.  Rheumatism (to flow) is an inflammation of the muscles
 or joints,  and is due  to fermentation in the stomach and  bowels,
 which vitiates the blood and secretions.  The inosit of the muscles
 becomes changed to sarco-lactic acid, and urea to uric  acid.
    79.  Neuralgia  (nerve  pain)  is rheumatism of  the  nerves.
 Sunlight and out-door life is the best prophylactic (means  of pre-
 vention.)
    Neuralgia may be caused  or aggravated by drugs,  especially
 mineral poisons and narcotics.  Operations usually performed  for
 neuralgia, such as stretching the nerve and cutting it out, do not
 remove  the cause of the trouble.   It is necessary to eliminate  all
 excess of waste from  the  system, purify the blood, and  invigorate
 the nerves by the use of suitable food and an abundance of pure air.
    80.  Appoplexy (to strike down) is a sudden  loss of  conscious-
 ness and voluntary motion from undue pressure upon  the brain.
 It  is  distinguished from  Epilepsy   (to seize) by  the  absence of
 convulsive movements.  Stertorous  (snoring)  breathing indicates
 heavy pressure  upon  the brain.
    It  is due  to pressure  upon  the  brain  arising from conjestion,
 hemorrhage of the brain, or embolism (plugging of a  blood vessel
 by a clot or coagulum).   An excess of fat, fibrin, or waste in the
 blood  may cause it.  Keep the  patient warm and comfortable as to
 temperature of body and well supplied with pure air to breathe.
    81.   Asthma is difficulty of breathing.  It is similar  to Heaves
 in horses.   It may be  detected,  even during the intervals of  attacks
 by auscultation.  Place the ear over  the lung  upon  the  back, and
 direct  the  patient  to  inhale deeply.   From asthmatic patients you
 will hear a peculiar squeak as the air passes through the constricted
 passages.  It is caused by inhaling nicotine of tobacco, by catarrh
 of  the  lungs,  and by excessive alimentation.    It is  temporarily
 relieved by smoking dried  saltpetre paper.  Constitutional treatment
 is  the only permanent  cure.
    82.  We breathe about 30 cupid inches of air at each inspiration,
 and use 450 cubic feet in 24  hours.   The normal number of respir-
 ations  per minute is  about 18.  Under  excitement or  just after
violent exercise  it  is increased.   If, without any unusual exercise or
(16) 
excitement, the rate of respiration is increased  to 25  or  more  pet-
minute, we may look for disease of the lungs.
    83.   The normal temperature of the body is about 98.6° Fah.
or 370  Centigrade.
    The sources of  heat are oxidation, condensation, friction  and
electricity.
    Animal heat is  sustained chiefly by the oxidation of hydrocar-
bons in the system.
    84.   The weight of the human brain is about 40 ounces, but it
varies from 2 to 4 lbs.
    85.   The voluntary nerves are under the  control of the human
will; the involuntary are controlled by a force or power, of which
we are  not conscious.   The involuntary nerves are termed "sym-
pathetic nerves. "
    The centres of organic life (including the circulation, respiration
and deglutition), reside in the medulla at the base of the brain.
    The heart is governed by nerves from  the  vagi, and the sym-
pathetic and intrinsic ganglia.   The vagi  are  the  pneumogastric
nerves.
    The velocity of nerve impulse is about 100 feet per second.
    The anterior root of the spinal nerves is  motor; the posterior,
sensory.  The motor nerves respond to the  sensory.   The impulse
travel % forward through  the cord.
    Injury of the  third  cranial  (motor  oculi) gives rise to Ptosis
(drooping of the  upper  lid), and also to strabismus  (squinting or
cross-eye).
    The simple directing of the  consciousness  or attention to a part
is often sufficient to  excite action.
    Mental shocks may be as severe and fatal as  those to the body.
    86.  Albuminuria implies that albumen is found  in the urine.
It is by some  considered  synonymous with Bright's disease, and is
divided into acute and chronic.   The acute  is also called nephritis,
and is an  inflammation of the tubules of the  kidneys.   The chronic
is a fatty degeneration of the kidneys.   If any  excess of albumen or
albuminoids is  taken with the food, it is quite likely to appear in the
urine.
    87.  The normal specific gravity of the urine varies from 1.005
to 1.020.   Sugar in  the urine may raise the specific gravity to 1.040
or even to 1.050.

    (B)                         (17) 
    The secretion from the kidneys is about 50 ounces, or something
over 3 pints in 24 hours.
    The urine  is generally  slightly acid, as determined with litmus
paper, but may be alkaline.
    The urine of carnivora is acid; of herbivora, alkaline.
    Urea (chemical  formula H4N2CO)  is the principal secretion
of the kidneys.  It is held in solution in the water, and is the nitro-
genous waste of the tissues.  The decomposition of urea gives rise
to uric (lithic) acid.
    The amount of urea secreted is about  one  ounce in 24 hours, or
200 to 500 grains.
    When sugar is found in the urine the condition is named Dia-
betes Mellitus.
    Diabetes (flow through) is an excessive flow of urine.
    The principal morbid deposits in the urine are urates (lithates),
uric acid, phosphates, pus, mucus, etc.
    The morbid constituents are blood, bile, sugar and albumen.
Bloody urine  is called Haematuria.
    Uric acid,  or urate of soda  in  the urine, may give the  appear-
ance of blood in the urine.
    Uric acid gives rise to gravel and calculus.  It appears as a sedi-
ment, like  powdered cayenne.
    Urate of soda forms the brick dust sediment.
    Uramic (urea in the blood) poisoning leads  to  epilepsy,  and
coma (profound sleep).
    Bright's disease  (degeneration  of the kidney) is attended by
dropsy and uraemia.                                  x
    In nephritis and Bright's disease,  enjoin rest in bed  and use
milk diet,  prohibiting tea, coffee and stimulants.
    The course of  Bright's disease is not continuously downward.
Periods of improvement often follow the most aggravated symptoms,
until a sudden attack of uraemia terminates life.
    In congestion or  inflammation of the kidneys, the urine is scanty,
high-colored and albuminous.
    In Diabetes (both with or without sugar,— two forms)  there is
an increased flow of urine varying from one to five gallons per day.
In diabetes mellitus  (sweet  diabetes) the urine yields from one  to
twenty  ounces of  sugar per day.   Distinguished  from  Bright's
(18) 
  disease by the absence of dropsy, which  always attends Bright's
  disease.
     Diabetes mellitus implies an excess of sugar and  starch in the
  food of the patient.
     88.   Retentio/i of urine implies a  distended bladder, which
  may usually be felt distinctly just above the pubes, and is, in recent
  cases, very painful.  Is generally due to spasmodic stricture.
     If a hot sitz bath does not relieve, a nervine, or relaxant may be
  tried, and, if necessary, use the catheter.   In  cases of disease of the
  kidneys the bladder may be found full and the urine dribbling away
  fast as secreted.  This is  called  retention with overflow.   As  a
  final resort to relieve great pain  the bladder  is  sometimes tapped,
  either from the rectum  or  above  the pubis.  Tapping is  also per-
  formed in cases of hydrocele, and ascites.
     The quantity of urine passed is  decreased by perspiration, and
  increased by chilling of the skin.   The skin is supplementary to the
  kidneys.  Animal food increases the quantity of urea in the system,
  or in the urine.
    89.  DaCosta prefers the  use  of  the Bismuth test  for  sugar  in
 the urine.  Add to equal  parts of urine and liquor potassae a pinch
 of bismuth subnitrate, and boil thoroughly.  If sugar be present the
 powder turns brown or black.
    Another test for sugar is fermentation, hy adding yeast and keep-
 ing in a warm  place for twenty-four hours.  If sugar be present it
 is  changed  to  carbonic dioxide  (which  escapes in bubbles) and
 alcohol.
    If albumen  be  present in  urine  it will be coagulated by heat
 (same as the white of an egg) or by  nitric acid.
    90.   The following are  some of the  more  important tests  of
 uroscopic physicians.  No froth on shaking indicates spinal trouble
 with determination of blood  to  the  head.   Froth settles  immedi-
 ately, pregnancy.  Much froth, lung disease.  Coarse froth, seminal
 trouble.  Bubbles rise from the bottom, disease of the heart. Urine
 filled with little hairs feathered like a goose quill (shown by aid of
 the eye glass), kidney complaint.
    91.   The usual period of dentition of the infant is one to two
years, and for the permanent teeth ten to fourteen years.
    The first,  second and third permanent molars appear soon after,
or about, the 6th, 12th and 18th years respectively.

                               (19) 
   The teeth of the lower jaw generally precede those of the upper.
   The  temporary  teeth usually (though infants have been born
with teeth) begin to appear in the seventh month, and to fall out in
the seventh year.
   Of the permanent teeth, the central incisors, the lateral incisors,
the anterior bicuspids,  and the posterior bicuspids  appear  respec-
tively the 7th, 8th,  9th and  10th years.   The canines  appear the
12th or 13th year.
   92.   The portal circulatioiz is the circulation through the vena
portae and liver for  the secretion of bile.  Hemorrhoids (flow of
blood) consist of livid and painful tumors at the lower  part of the
rectum, sometimes within and sometimes without the external sphinc-
ter muscle.   The common name  is piles.  Sedentary habits, torpor
of the liver, and sluggish circulation of the blood in the portal system
are predisposing causes, and any strain of mind or  body may be the
exciting cause.
   93.   Seven  passages open from the pharynx  (throat).   Name
them.   See Dutton's Anatomy.
   94.   Reflex action is the unconscious or involuntary  action of a
motor centre in response to a sensory  impulse.
   95.   Ataxia signifies disorder  or irregularity.
   Locomotor ataxia is uncertainty of gait, and is an affection of the
posterior columns of the spinal cord.
   96.   Chloroform affects, first, the sensory nerves at the periphery
of the nervous system ;  secondly, the cerebral hemispheres as indica-
ted by loss of consciousness; and third, the organic centres as indica-
ted by stertorous breathing.  Do not push its  effect  beyond the
second stage.
   Whiskey—an ounce or two—taken before inhaling  chloroform
sustains the heart and  prolongs  the  chloroform narcosis.   Remove
false teeth, and allow free access of air with the vapor of  chloroform.
Do not allow the tongue to drop back so as to close the larynx.
   Old drunkards are unfavorable subjects for chloroform.   Do not
give  it after prolonged fasting.  Protect the nose and mouth by  in-
unction with oil.  Do not give chloroform during the first  stage of
labor,  nor when it lessens the force of uterine contractions, nor after
the head has passed the  pubic arch.   The vapor of ether is  inflam-
(20j 
 mable (lights if near should be held above the  level of the ether),
 but chloroform is not.
    97.  Antiphlogistics  (opposed to inflammation)  are  remedies
 or agents that reduce the blood and pulse.   The old remedies were
 bleeding, calomel, and tartar emetic;  the more  modern are aconite
 and Veratrum Viride;  and the new, are diet, air, exercise, and time.
    The term antiphlogistic is now nearly obsolete,  as trie  theory  of
 Phlogiston  (a burner), which was used by Stahl to  account for the
 phenomenon of combustion, has been abandoned, but the old reme-
 dies with which  to fight this imaginary principle are  still to some
 extent retained.
    98.  Water  (H20 ; Latin, "aqua,") turns to ice at 320 Fah. (or
 o° Centigrade), and to steam, which  is invisible, at 2i2°Fah. (ioo°
 Centigrade).  Its  specific gravity is  1.000 or  1,  that  is,  it is the
 standard for liquids and solids.
    Its  greatest density is at  390 Fah., or 40 Centigrade.  At 320  its
 bulk is increased 10 per cent.   It generally extinguishes fire, but sets
 fire to  potassium.   To cleanse water,  boil and filter.  Soft water
 forms  a lather with  soap;  hard  water curdles  and wastes soap.
 Tincture of soap makes hard water turbid, but does  not affect pure
 water.   Water is the common carrier of creation, and a solvent for
 many substances.
    Heart and lung troubles are increased by the use of saline waters.
 The waters of  Saratoga are saline.
    Vichy (of Central France) is  an  alkaline water.  It is taken
 for obesity, gout, and rheumatism.
    The Geyser and Congress (of Saratoga),  and the Carlsbad (of
 Bohemia) are saline waters, and are given in affections  of  the liver
 and portal system,  but are injurious in affections of the heart and
 lungs not dependent on the stomach and liver.
    The  Friedrichshall   (Germany)  and  the Kissingen (Bavaria)
are aperient, or laxative.   The Friedrichshall is a bitter water.
    The  Kreutznach  (Prussia)  is powerful alterative, and is given
in strumous affections.
    99.   The pupil  contracts  under  the influence  of  strong light,
nicotine  and morphia; it dilates in the dark, in asphyxia, and under
the influence of atropine or belladonna.
  Amaurosis (obscure)  is dimness of vision, or complete blindness,
                               (21) 
owing to paralysis of the optic nerve.   Dimness of vision from
opacity of the crystalline  lens constitutes "cataract."  We may get
dimness of vision,  or blindness from opacity of the cornea  due to
inflammation.
    Irregularity of the pupil is due to inflammation  of  the iris (the
colored curtain around the pupil).
    A watery eye is due to obstruction in the tear passages (lachry-
mal canals or nasal duct).
    Gutta serena  (clear drop) gives floating specks in the field of
vision.   It is a symptom  of dyspepsia.
    ioo.  Eye wash  to  allay  pain and  irritation :   One grain of
morphine  dissolved  in  one  ounce  of water.   This  an  excellent
application for an inflamed eye.   Two or three drops will  allay the
pain  and irritation at once.   With the patient in the  recumbent
position the liquid may be easily dropped into the inflamed eye.
    101.  Purulent discharge from the ear is generally due to disease
of the tympanum (drum) or bones of the tympanum.   Fever sores
are really disease of the bone  or periosteum.
    Rupture of the  membrana tympani may be detected by forcibly
expiring with the mouth  and nose closed.
    102.  Tumor  of the  antrum  (superior maxillary sinus)  may
crowd upon the eyeball and cause it to project.
    103.  Polypus  of the nose  is due to  excessive  irritation of the
nasal passages, or to cachexia (bad  condition of the blood) ;  gener-
ally the former.
    104.  Ozcena (fetid  smell)  is an offensive  discharge from  the
nose, due to chronic ulceration of the pituitary membrane and bones
that form the different meatuses of the nose, the superior maxillary,
inferior turbinated, sphenoid, ethmoid, nasal and frontal.
    105.   Epithelioma (mobid condition of the epithelium) is cancer
of the skin, occurring mostly  in the  lower lip of smokers.
    106.   The tongue  has  usually  a  white  coat in  pneumonia,
brown or dark coat in typhoid fever, a brown or dirty color in dys-
pepsia ; is pale from loss  of blood,  and has the appearance of the
surface  of the strawberry  in scarlet fever.
    107.   "Osis"   (as a  termination)  signifies "condition,"  and in
pathology a morbid condition.
    10S.   Itis (as a termination) signifies  inflammation;  as Gastri-
(22) 
 tis, inflammation of the stomach ;  Meningitis,  inflammation of the
 meninges (membranes) of the brain.
    109.   The   Centrigrade  thermometer  has  just  one  hundred
 degrees between the freezing and boiling parts, while Fahrenheit has
 one hundred and eighty ; so one degree of Centigrade is equal to 1 ^
 degrees of Fahrenheit.  The freezing point is marked o on the C.
 and 3 20 on Fahr.   To reduce Fahr. to C. subtract 32 and divide the
 remainder by 1^.   To reduce C. to Fahr. multiply by 1^ and add
 32 : thus  4°X 1.80=7.20, and 7.204-32=39.2° Fahr.
    110.   The water bath may be used for temperatures below 212°
 Fahr. (ioo° C.)   Oil boils at  2600 C. (500° Fahr.), and below this
 the  oil bath  may be used.  For higher temperatures the sand bath
 may be used.
    ill.   A surgeon requires instruments and appliances.  He
 usually carries forceps, ligatures, adhesive plaster, scissors,  catheters
 and an abscess lancet.
    112.  Amputation (cutting off) maybe expedient in  some cases
 of gangrene and comminuted fracture.
    Five   different   operations  upon  the  foot  are   known  as
 Chopart's,  Lisfranc's, Pirogoff's,  Syme's,  and  Hey's.  Chopart's
 operation leaves  only the astragalus  and calcaneum ; Lisfranc's sep-
 arates the metatarsal from the tarsal bones; Hey's saves as much of
 the metatarsal bones as the case will allow;  Pirogoff retains only a
 portion of the calcaneum ; and  Syme removes the foot at the ankle
 joint, cutting off the malleoli.
    113.  Rachitis (inflammation  of the spine) is  more commonly
 called "Rickets."   It is caused by improper  diet.  There  is a defi-
 ciency of  earthy matter in the bones, and deformity in consequence.
 The treatment is wholly hygienic.    Give milk and lime water.
    114.  Pott's Disease is vertebral  disease,  though  commonly
 defined  as angular  deformity of the spine, owing  to caries  of the
 vertebra;.   It  is attended by rigidity  of the spine, pain, soreness and
 abscesses,  and  sometimes paresis   (partial  paralysis)  or complete
paralysis.   The treatment is constitutional, with the recumbent pos-
ture or a plaster  jacket.
   115.   Anchylosis  (crooked)  is a   stiff joint.  It is generally
caused by inflammation after mechanical injuries.  Passive motion
(23) 
will generally prevent this difficulty.  When threatened, the  elbow
should be kept at right angles, the knee straight.
    116.   A fracture is a  breaking of the bone.  It requires ad-
justment with perfect rest for two or three weeks, then slight motion
for one or two  months, depending upon the state of health.  Frac-
tures are simple, compound,  comminuted, oblique,  transverse, and
multiple.
    A fracture is known by deformity, unnatural mobility, and by
crepitus (harsh  grating), which may usually be  felt and  heard on
manipulation.   Crepitus will be  absent unless the broken surfaces
are made  to touch and  move upon each other.   If great swelling
prevents a  diagnosis wait till it  subsides, but enjoin  rest.
   Fractures uniting after six weeks are said to be "delayed," and
if not united in twelve  weeks are " ununited fractures.,"   These
occur from  cachetic conditions of the system, from  undue mobility
of the fragments, or from too  great a  separation.
    Pott's fracture is fracture of the lower fifth of the fibula.   It is
dressed by a splint (like Dupuytren's) that allows of no pressure be-
tween the external  malleolus and head of the fibula.   Dupuytren's
is a straight splint extending from the head of the tibia on the inner
side to a point below the sole of the foot.
    F'or fractures of the leg use  the fracture box, which keeps the
leg in position without compression.
    117.   Callus (hard) is  the secretion of new  bony  matter that
acts as a cement to unite bones.   It is first plastic lymph, then carti-
lage, which becomes ossified  in four  to eight  weeks.   A  " pro-
visional callus" is first formed that serves  to hold the fractured ends
in juxtaposition.  After about one year the provisional  callus  is
removed.
    118.   Laudanum and water — one part to two—forms a good
lotion for bruises (contusions).
    119.   Luxation (displacement)  is a  dislocation, or putting out of
joint.  It  may  be  due  to mechanical  violence or muscular  force.
Luxation gives no crepitus.   There are four dislocations of the hip
and  four of the shoulder.
    120.   Sprain is a  strain or wrenching of  a joint, more fre-
quently of the  wrist  or  ankle, by which  the soft  parts  about it are
stretched or  torn. It is also called subluxation. Immediate rubbing,

                               (24) 
 or massage, by the patient himself or by another is  the best treat-
 ment.   If the pain and swelling are severe,  apply hot fomentations
 or evaporating lotions.
     121.   Arthritis  is  inflammation of a  joint,  including  all the
 structures about it.  If only the syonvial membrame is  inflamed  it
 is  synovitis.
     122.   Coxalgia (hip pain) is arthritis of the hip joint.  It occurs
 more frequently  before  the  hip bone becomes  consolidated (about
 the 14th year).   It may occur from injury,  but is  generally con-
 nected with some cachexia,  like scrofula.
     123.   Psoas  (loin)  or  Lumbar  abscess  is  an  abscess of the
 psoas muscle.   It generally points  in  the  groin below Poupart's
 ligament.  The lumbar plexus of nerves is situated in the back part
 of the psoas mucle, and an  abscess here may be  confounded with
 rheumatism.   If  discovered before any swelling appears in the groin,
 it may be opened above Poupart's ligament, where its progress is apt
 to be arrested.  The treatment is antiseptic and constitutional.
     124.   ]\liite swelling is a swelling of  the  knee or other part
 destitute  of red blood.  It is curable like other swellings, but re-
 quires time—several weeks or months.
     125.  Inflammation of the  bones  may  affect the membrane
 around the bone,  the bone itself, the marrow, or the epiphyses, giv-
 ing rise to periostitis, osteitis,  osteomyelitis,  and epiphysitis.   A
 diseased  bone  usually gives rise to  '•'•fever sore,"  which  may be
 called an abscess  upon the bone.  Treat constitutionally, and when
 the bone becomes sound  the fever sore will be cured.
    126.  Hemorrhoids (bloody flux) or piles,  are swellings about
 the  anus, due  to  a varicose  condition  of the  hemorrhoidal veins.
 They are either internal or external in relation to the external sphinc-
 ter muscle.   The  i7ite.rnal sphincter lies about an inch within the
 anus; and is formed by  a band of circular  fibres of the intestine.
 Give mild laxative diet and remove all strain  of mind or body.  For
 temporary relief insert  a cocaine suppository  (^  grain.)   For itch-
 ing, wash thoroughly and apply twice per day  a  solution  of boracic
 acid, 5 or 10 grains to  the ounce.
    127.   For Anal Fissure  and Ulcers  of the Rectum keep  the
bowels  free  by laxative diet, invigorate  the vital forces, and  use
night and morning a warm injection of boracic acid and  water.   If

                                (25) 
 there is pain let the evening injection be an  ounce of starch water
 with twenty drops of laudanum, to be retained if possible.
    128.   Sarcocele (fleshy tumor) is applied to any solid enlarge-
 ment of the testis, malignant or non-malignant.
    129.   Carcinoma  is the  technical term for cancer  (a  crab).
 Scirrhus is a  "hard" cancer.   Sarcoma is a "fleshy"  excrescence.
 Haematodes  is a  "bleeding fungus."   In  all  cases  of cancer  the
 blood must be cleansed and the vital forces  restored in order to cure.
 The knife may remove a troublesome wen,  or non-malignant tumor,
 but cannot reach a malignant sore ; it comes from the blood.
    130.  Bronchotomy  (cutting the bronchus) includes  laryngot-
 omy (cutting the larynx)  and tracheotomy  (cutting of the  trachea).
 (See Trachea and Larynx in Anatomy).  It is performed to admit
 air to the lungs, and to extract foreign bodies.
    131.  In opening a mamillary abscess make the incision  in  the
 direction of the radii from the nipple, injuring few as possible of  the
 lacteal ducts.   Cancer of the breast  generally occurs  after the 40th
 year.  It is very hard at  first, soon becomes fixed to the  ribs,  the
 nipple is retracted, and there are sharp  darting pains.
    132.  Paronychia  (near the nail) is an inflammatory  tumor of
 the fingers and  toes.  It may be quite superficial or deep, and is
 better known as whitlow or felon.   A free  incision is generally con-
 sidered good surgery.   Before cutting or opening a felon it  is well
 to try immersing it  for twenty minutes in  a strong  alkaline  bath
 which may arrest it if not too far  advanced or too  deep.   Ma)- use
 soda water, or lye of wood ashes.
    133.   Sarcoma (tumor  of the  flesh)  includes malignant and
 non-malignant growths.
   134.   A small, hard mass, in the abdomen slightly changing  its
position from time to time, is probably  a mass of faeces  impacted in
the colon.
   135.   A fluid tumor in the loin or groin may be due to  pus from
a psoas, or lumber abscess.
   136.   Tympanites (drum)  is the name  given  to the  abdomen
when distended with gas.  The gas is usually the result  of fermen-
tation and decomposition of  matters in  the intestine.
   137.  Great pallor and faintness  following an injury, may be due
to internal hemorrhage.
(26) 
    138.  For ingrowing toe-nail apply on cotton wool a solution of
 two drams of liquor potassae to an ounce of water, to the margin of
 the nail till it is softened;  it can then be cut away without pain.
    139.  Afstula (pipe) is a suppurating  canal, or sinus, leading
 to or  from a mucous  cavity.   A "fistula in ano," is a sinus (pus
 canal) leading from the lower part of the rectum into or through the
 adjoining tissues.   It is generally caused by constipation and a slug-
 gish circulation of  impure blood.
    140.  In the absence of other satisfactory evidence the explor-
 ing needle will enable you  to determine the character of  the fluid
 filling an abnormal cavity.
    141.  Poultice for gangrene and phagedenic  (eating) ulcers:
 ground flaxseed 4 oz., pulverized slippery elm  1 oz.,  and one tea-
 spoonful each of powdered charcoal, sulphur and carbonate of soda.
    142.  A sinapism (" mustard" poultice) should be made of two
 parts of rye flour to one of mustard,  and  not allowed to blister.  In
 old and debilitated persons extensive sloughing may follow the use
 of blisters.
    143.  A shock, or  concussion, is the effect  upon the body of a
 blow or violent emotion that reaches and more  or less paralyzes the
 nerve centres.   Keep the patient warm and wait for reaction, unless
 some wound to the body requires immediate surgical aid, like tying
 an  artery or removing some depressed portion  of the cranial bones.
    144.  In case of hemorrhage avoid all stimulants.
    145.  Sutures, for  closing  deep wounds,  are the  continuous
 (glover's stitch), the interrupted, pin suture, quill suture, Lambert's,
 Czerny's, etc.   Lambert's  and  Czerny's  are used for  wounds of
 the intestine.   Sutures may usually be  removed about the fourth
 day.   Avoid sutures of the face so far as possible, and  remove the
 second day.
    146.   For antiseptic  dressing surgeons generally  use carbolic
 acid 1 : 20 or 1 :40, bichloride of mercury  1 :500  or  weaker,  and
 dust of iodoform.   Boracic  acid may be used in solution, or deo-
 dorized alcohol; also tincture of Myrrh.
   147.   Hcematoma  (blood  tumor)  often quickly follows  contu-
 sion of the scalp.   Apply collodion.
   148.  To set the clavicle, stand behind  the  patient, place the
knee  between the  shoulders  and draw both  shoulders backward
(27) 
until the clavicle comes to its place, then apply a bandage.   Keep
on the dressing for five or six weeks.
   149.  To set the  shoulder, extend  the  limb  forcibly in  the di-
rection of the glenoid cavity, or place the unshod heel in the axilla
and pry over it.   Place a pad in the  axilla with the  arm to the side
for a week, make passive motion for two weeks, and then allow the
the patient to use his arm.
   150.  To set the elbow, flex the forearm forcibly over the knee,
or make extension from the hand.
   151.  Dislocations of the wrist, fingers and toes  are reduced
by simple extension.   Prof.  Crosby, of Dartmouth, set the thumb
by pushing it back till it stood  perpendicularly on  the metacarpal
bone.
   152.  There are four dislocations of the hip-joi?it.  The head
of the femur may be  on the  dorsum  (back)  of the ilium,  on  the
pubis, in the obturator foramen,  or in the sciatic notch.  The first
and last are backward luxations, and the others  forward luxations.
To  reduce backward luxations, flex the leg on the thigh and  the
thigh on the abdomen, adduct  (carrying  toward the other  limb),
circumduct  (upward  and  outward), and  extend.   Briefly  stated,
"Flex, adduct, lift up, bend out, roll out."  The  operation  will be
best understood by taking the hip bone and femur in the hands and
observing that  the hip bone serves as a fulcrum, to bring the head
of the femur to its place in the socket.
   The forward luxations are somewhat difficult, especially when
the  head  is  above the pubis.   For this latter kind of dislocation
make extension backward and outward.   When the head is in the
thyroid (or obturator) foramen the pubis will serve as a fulcrum if
we carry the flexed limb high and inward over the body.  After  re-
duction bandage the knees together with a  towel between them  for
one  week, use  passive motion  in bed for two  weeks, and wear
moulded support for two  months.
   153-  To set the knee, flex the thigh, make extension, and push
the bone into place.   Not difficult.
   154.  Lateral  dislocation of  the  patella  is easily  adjusted  by
direct pressure when  the limb is extended (straight).  If necessary,
forcibly depress the margin of the patella furthest from  the centre of
the joint.  In  upward  displacement of the  patella the  ligament
below is torn, and must be treated as a fracture,  keeping  the  leg
(28) 
 extended and  the  sundered parts contiguous.  Inflammation  may
 follow all  injuries.   Dislocation  of the ankle is frequently compli-
 cated with fracture.
    !55-   Aneurism (distended)  is  a pulsating arterial tumor,
 caused by rupture of the inner coats of the artery  and dilatation of
 the outer coat.  It  is either filled with  blood or  coagulum.   It is
 always soft at first and grows hard, if at all, afterwards.
    Valsalva's  treatment was spare diet to  diminish the tension of
 the blood.   Others treat by compression, ligature, and injection of
 the sac.
    156.   In  dislocation of the  jaw, one  or  both  condyles are
 advanced and  the mouth is open as  in yawning.   Press down the
 posterior molars, or place  a cork between  the posterior molars as a
 fulcrum, and raise the chin.
    157.  A poison is a  material  substance whose nature  is hostile
 to animal life.  There  are over 100 inorganic poisons, 140 vegeta-
 ble poisons,  and of animal poisons we have over twenty kinds of
 poisonous  fish, and several  poisonous serpents, flies and insects.
 (See Dunglison's Med. Dictionary).
    There are very  few  perfect antidotes to poisons.  Vinegar or
 oil  will generally neutralize an alkali.  In any case olive oil or new
 milk is a safe remedy ; albumen, like the white of  eggs, will mollify
 the action of many acrid substances in the stomach ; but the general
 treatment is to eject the poison, or dilute it.
    158.  For  convenience  the  abdomen  is  divided  into   nine
 regions by four  artificial lines—two  perpendicular and two   hori-
 zontal.   (See Dutton's Anatomy, p. 368, middle and bottom.)
    159.  The principal regions of the chest are  the anterior, lateral
 (side),  posterior,  above  the  clavicle, below7 the clavicle to the
 third rib, mammary (3d to the 6th  rib),  above  the  sternum, and
 under or beneath the sternum,  above and below the third rib.
    160.   Percussion is striking or rapping upon the chest  or other
parts  to  ascertain  by  the sound the character  of   the  structure
beneath or within.   One or two fingers pressed  against  the  chest
 make a  convenient  pleximeter  (percussion  measure).  The reson-
ance is  described as "clear" or normal  in health  ; and as  " tympa-
nitic"  (drum-like),  "dull,"  or "flat" in  disease.  The "flat"
sound is  the  entire want of resonance.  "Dullness"  is the partial
or imperfect resonance.

                               (29) 
    161.  Ausculation is "listening" by applying the ear directly,
 or by using the stethoscope (breast-viewer).   The  normal sound of
 respiration  is called the "vesicular murmur."  It  resembles the
 wind among the pines.  The adventitious sounds heard in ausculta-
 tion are termed " rales" (rattles).
    162.  Rales are divided into " dry " and " moist" rales.  Moist
 rales are produced by air passing  through fluids in the air passages,
 and may be due to mucus,  blood or  pus.  Instead of rale, the word
 " rhonchus " (snorting) is sometimes  used.   Cavernous  respiration
 is due to a cavity in the lung not filled with fluid, but communicat-
 ing with a bronchial tube  ; cavernous rales  (or gurgling rales) are
 due to a large cavity containing fluid through which the  air passes.
    163.  Fremitus (murmur)  is  the vibration or thrill of the chest
 as determined by palpation (" touching" with the hands).
   Vocal fremitus is the thrill, or vibration, produced by the voice;
 tussive  fremitus, by coughing; friction fremitus, by friction of the
 pleurae ; and  bronchial  fremitus by the air in the bronchial tubes as
 it passes through mucus, blood or  pus.   In hepatization of the lung,
 the vocal fremitus is increased ;  in feeble persons diminished.
   164.  A wound is a solution of continuity usually attended with
 hemorrhage.
   Wounds are incised when made by a cutting instrument; punct-
 ured by a pointed instrument; lacerated,  when  torn; contused,
 when bruised;  and poisoned  when some  virulent  substance  has
 been  introduced.
   165.  To retain parts  in apposition use adhesive straps, and if
 necessary,  sutures, except on  the scalp, which is very firm  and
 liable to erysipelas.
   166.  In  dissection  wounds apply  antiseptic dressing and give
 milk punch.
   167.  Hemorrhage from sloughing of a ligature usually occurs
 between the tenth and fifteenth day.
   168.  Arteries must be tied at both ends.
   169.  Extract all foreign substances  in dressing wounds unless
 to find and remove would be  more dangerous than  to  leave  the
work to the healing power inherent  in the system.
   170.  Catgut is  sometimes  used as a  ligature  and allowed to
remain.
   171.  Hernia (sprout or shoot)  is the protrusion of some inter-

                               (30) 
 nal organ or part, from its natural cavity.   The three great cavities
 of the body  are those of the skull, chest and abdomen.  Abdomi-
 nal hernia is most common, and is  named from the  aperture by
 which the hernia escapes—inguinal, femoral and umbilical.
    Inguinal  hernia  is  a protrusion  of  the  bowel or omentum,
 through the  inguinal canal  (see p. 426 and the  three following of
 Dutton's Anatomy).
    To reduce hernia, put the patient upon his back with the lower
 limbs flexed, give large clysters of gruel or warm water, and apply
 hot fomentations.
    Avoid  active purgation.  Lobelia  enemata may  be  useful  to
 relax the muscles.
    172.   Pus is the product  of  suppuration.   A collection of pus
 in any part of the body constitutes an abscess.   An abscess  may be
 known by fluctuation  elicited by palpation.
    173.   To destroy an insect in the  external car passage, fill  the
 passage  with oil.  The oil  closes  the  spiracles  of the insect and
 kills it.
    174.   Laparotomy (cutting into  the abdomen)  is  sometimes
 performed for  the removal of tumors, hernia, intussusception  (or
 invagination), etc.   The incision is made in the linea  alba midway
 between the  umbilicus and pubes.
    175-   The  abdomen  may be distended by gas,  serum, faecal
 matter, and tumors, and, in the female, by the gravid uterus.
    176.   Hunter's canal contains the femoral artery and vein, and
 the saphenous nerve at the middle of the thigh.
    177.   The  abdominal  aorta has been tied eight times without
 success,  and  the innominate  artery sixteen times  with fifteen fatal
 cases.  In 789 cases of ligature of the  common carotid, 324 died ;
 4/^ per cent, died when the  external carotid was tied.   Ligation of
 the common  iliac artery has been performed 39 times, and only 10
 successful.   Of 124 cases of popliteal  aneurism, pressure succeeded
 in 66 and failed in 58.  Of the 58, the artery was tied in 44, 8 were
amputated.
    178.   Sphacelus,  or slough,  is the  term  applied  to the part
disorganized  by mortification.
    179.  In  the hand and foot let nature amputate; she gives a
better stump.
    180.  Dr. Abernethy,  of London, declared  that  it is owing to

                              (30 
our ignorance that  instruments  and operations are necessary ; and
Dr. W. Beach adopted as a maxim " Seldom or never operate."
    181.   Monsel's solution is a solution of the sub-sulphate of iron.
It is an excellent styptic  (stops hemorrhage from small vessels) and
will destroy the syphilitic vegetations  of the glans and prepuce.
    182.   Bacteria,  Micrococci  and  Vibriones  are  synonymous
terms.  They are microscopic living creatures in the form of jointed
rods.  Microbes is another more recent term for  microscopic life.
They cannot propagate in healthy tissue.
    183.   When the blood and  tissues reach  a  certain state of de-
composition, then,  and then only, isger?n-life possible.
    184.   Conception  (receiving  or bringing together)  is  the im-
pregnation of the ovum.
    185.   The signs of pregnancy are changes in the  uterus, mam-
mae, and menses ; morning sickness in pathological cases ; immedi-
ate settling of the froth upon the urine after agitation in a vial; sen-
sible motion of the  foetus ; " ballottement; " and sounds of the foetal
heart.
    186.   The period of gestation  is, generally, ten lunar months
(280 days,)  but may, occasionally, be protracted  to ten calendar
months (300 or more days).
    187.   The three stages of labor are  (1) dilatation of the cervix
uteri, so that the head passes into the vagina, (2)  expulsion of the
child, and (3) expulsion of the placenta, or afterbirth.
    188.   Of 12,633 children  born at the Maternity  Hospital,  in
Paris, 12,120 were  head presentations,  with  the face posteriorly.
    189.   Symptoms of approaching  labor are (1) subsidence  of
the uterine tumor,  (2) increased  moisture and  laxity of the vulva,
and (3) in many cases, mental anxiety.   Subsidence  may continue
from 12 hours to 2 weeks.
    190.   Symptoms of labor  (parturition) are  clearing  of  the rec-
tum and  bladder, and sometimes of the stomach;  "Show;" and
regularly  recurring pains, or uterine contractions.
   191.   Be sure that the bladder and rectum are empty  during the
second stage of labor.
   192.   Twins, ox plural births, are not more frequent than one
case in eighty.
   193.   Anaesthesia  (privation of sensation) is induced by spirits
of chloroform.   It is a great relief in many cases during the close of

                               (32) 
the second stage of labor, and also in  case the placenta is removed
by surgical aid.
    194.   The ovum has two membranes, amnion and chorion, and
the uterus one  extra membrane  during gestation,—the " membrana
decidua."  The latter is a product of the uterus.   The  amnion  is
the inner membrane of the ovum,  and the  embryo  floats  in the
liquor amnii.
    Sometimes  there  is water or  serum between the  amnion and
chorion, constituting  " false waters. "
    195.   The  liquor amnii varies from  a few ounces to one or
more quarts ; and from a  clear and inodorus fluid in health to one
viscid and foul.
    196.   The placenta (a  cake)  is the " afterbirth, " and  weighs
about a  pound.  It is connected  to the umbilicus  of the foetus by
the funis, or umbilical cord.  The placenta has two  faces, foetal,
connecting with the cord, and a maternal face, connecting with the
inner surface of the uterus (womb).
    197.  The finis (cord or rope) has  an average length of 20 inches,
but varies from 6 to 60 inches.  It consists of a vein (the  umbilical)
and two arteries (hypogastric).   The latter come off*from the inter-
nal iliac arteries of the foetus.   They  are longer than the umbilical
vein  and wind around it.  The vein of the  cord  carries  arterial
blood, and the arteries venous blood.
    198.   Lochia is the  discharge of  serum, which is  more  or less
bloody, for two or three weeks following the birth.
    199.   Primipara  is the term  applied to the mother  who bears
her first child.   The plural is primiparae.
   Afterpains are rare in primiparae ; much more so than in subse-
quent births, in multipara? (those who bear many children).
   For excoriated  nipples keep the parts clean and apply tincture
of myrrh twice per day.
   200.   Ergot is dangerous.  Use warm fomentations, or sitz bath
if need be.  " Arte non vi" (by  art not by force) is the maxim in
childbirth.
   201.   Induction of premature  labor may be accomplished by the
hot and cold douche,  or by rupture of the membranes.  Ask consul-
tation before resorting to it.
   202.   Abortion is "miscarriage," or expulsion  of  the  foetus
(c)
(33) 
before it is  viable (sufficiently developed to live,  which occurs
about the seventh month).
   203.   The causes of abortion are mechanical  injury, disease of
the mother or fcetus, and rupture  of the membranes inclosing the
liquor amnii.
   204.   Phlegmasia dolens  (swelled leg)  is due to venous ob-
struction, or poisoning of the blood.
   205.   Milk  Fever  is caused by  overdistension of the mammae,
and stagnant condition of the blood.
   206.   A lacerated perineum, if  severe, may require a  surgical
operation ; but if slight may be left to heal with proper  care of the
patient.
   207.   The tumefied  scalp  and malformed head  (caput succe-
daneum)  of the  new-born infant, is caused by pressure in the birth
and naturally disappears in a day or  two.
   208.   A mother's mark (Naevus materni) is due to the increased
vascularity of the capillaries of  the  part, caused by  nervous impulses
during gestation.
   209.   Cancerous tumors are  not composed of any  definite or
characteristic elements that at once stamp  their  nature.   Soft  can-
cer is made up almost  entirely of cells and nuclei—only enough
fibre tissue to hold  these cells  together.  Cancer usually infiltrates
the surrounding tissues.   A soft cancer filled with  blood is a htma-
toid variety (Fungus haematodes).
   Epithelioma (epithelial  cancer)  affects the skin  and  mucous
membrane—lip, tongue, rectum, os uteri, and genitals.  It consists
of cells, and may be destroyed  by the galvanic cautery.   Cancer is a
disease of degeneracy like the decay of fruit.
   210.   Abscess is a collection of pus in a cavity formed by  the
breaking down of the tissues.   The pus is generally, sooner or later,
discharged from the suiface either directly or through some  mucous
canal.   When situated  beneath some firm membrane, or  fascia, it
requires the aid of the knife.
   211.   Hectic (habitual, or  consumptive) fever often  attends the
formation of a deep-seated abscess, especially of the lungs.
   212.   Polypus  (many footed)  is a term  applied  to  tumors of
mucous membranes, as those of the nose, throat,  uterus, and more
rarely stomach,  bladder and vagina.
   213.   A fibrous tumor, or  " fibroid "  is of a dense texture  and

                               (34) 
 Whitish color.   They are chiefly found in the utertts.  When found
 on a nerve it is called "neuroma."  A subcutaneous fibrous tumor
 is a hard, movable tumor  beneath the skin.  When troublesome
 they may be easily removed by the surgeon.
    214.   A cartilaginous  tumor (Enchondroma)  is  commonly
 met with in connection with bone.  They sometimes grow within
 the bone and expand it into a shell.
    215.   Epulis (upon the gum) is an excrescence sometimes end-
 ing in cancer.   It grows from the bone.
    216.    Chancre is a canker sore, or ulcer, on the genital organs ;
 generally caused  by impure sexual commerce.  It is the first phase
 of syphilis, or pox.   If the poison is malignant or the blood bad, it
 often causes an abscess  of the groin—called  bubo ("groin, " or in-
 guinal gland) .   The  terrible symptoms known to  the profession as
 tertiary ("third stage, " bubo being the second) syphilis are largely
 due to the effects of mercury so generally  administered for this com.
 plaint.   Two or  three  applications  of tincture of bloodroot (san-
 guinaria)  will  quickly  cure  chancre  in ordinary  cases.  If the
 blood is bad give  constitutional treatment and  improve  the general
 health.
    The indurated chancre  (called, also, Hunterian chancre)  is a
 thickening and  hardening of the part  from the effects of the poison
 and inflammation.  Apply  antiseptic washes, but no caustics unless
 to destroy  excrescences.
    217.   Urethritis  (inflammation  of the  urethra)  is generally,
 but improperly, called Gonorrhoea (flow of sperm).  It is generally
 the effect of impure sexual commerce.   The period of incubation is
 usually four or five days. It is characterized by a mucous discharge,
 ardor urinae (scalding of the urine), and sometimes by Chordee in
 the male, by gleet, stricture, balanitis, or phimosis.
    218.   Orchitis (inflammation of the testicle) is also a  possible
 symptom.   Gleet  is the name given to the watery discharge that
 attends the subsidence of the inflammation.  Stricture rarely occurs,
 or orchitis, unless from the  use of caustics.
   219.  Sebaceous cysts are  tumors found  on the scalp.  They
 may be solid or liquid.
   220.  Bronchocele (bronchial tumor)  wen, or goitre is hyper-
trophy, or  enlargement of the thyroid gland.   It is  attributed to the
(35) 
habitual use of hard water, at the base of lofty mountains. See Dut-
ton's Anatomy, p. 391.
   221.   Leucoma is a "white " opacity  of the  cornea and is the
result of inflammation.  A similar condition of the  crystalline lens
is called " cataract. "
   222.   An ulcer is a solution of continuity of  the mucous mem-
brane, or skin,  caused by  cachexia (bad state of  the blood).   They
frequent the alimentary canal, ankles,  and  sometimes  other parts.
Apply tincture  of  myrrh, or a solution of boracic acid, while you
treat constitutionally.
   223.    Gangrene (mortification) takes place from permanent ob-
struction of the  circulation, or from withdrawal of the vital force, or
spirit.   The sloughing eschars (disorganized portions)  may be hast-
ened by poultices.
   224.   Anthrax (a coal) is a carbuncle, or malignant boil.  It is
the " Charbon" of the French, and is sometimes  called a malignant
pustule, or "anthrax malignus."   It is  the effect of septicaemia, or
blood poisoning, and was formerly supposed to arise from the malig-
nant matter of hides of animals, but is known to  arise,  also,  prima-
rily,  in the human.  Use, both  internally and externally,  camphor
water in which  is dissolved boracic acid, 10 grs. to the ounce.
   225.    Calculi  (small stones)  are earthly concretions  found in
the human body.   The " tartar " on the teeth  is of this nature.  Cal-
culi are generally found in mucous cavities and  canals—the  mucus
serving as a nucleus—and are  most common in the biliary and urin-
ary passages.   The concretions in the joints of gouty persons  are a
compound of uric acid and soda.
   226.  There are six varieties of urinary calculi, viz. :  Uric (or
Lithic), Mulberry, Bone-earth (Phosphate of Lime), Triple,  Fusi-
ble,  and  the  Cystic.  The latter  is rare,  only  six or  seven having
been  observed.   The Mulberry is  dark  brown, very hard and nod-
uled.  It is oxalate of lime.
   The uric acid calculus is most common of all, and the Mulberry
second in frequency.
   Calculi when small are called sand or gravel.
   227.  Biliary  calculi  are   generally   called  "gall-stones."
They choke up the cystic and biliary ducts and thus  cause  jaundice.
The base of gall-stones is either cholesterine  (solid bile) or adipocere

                               (36) 
 (fatty wax).  They  are often only  inspissated (thickened)  bile.
 The human body left some weeks  in water assumes the appearance
 of adipocere.
    228.    Concretions  are sometimes found  in the  stomach and
 bowels.   They come  from  the food  and consist of  woody fibre,
 plumb stones, seeds and skins of fruit,  magnesia, and in the intestine
 of hairy  animals, balls of hair.
    229.    Cancer of the stomach gives pain of a sharp, burning na-
 ture and fetid eructations.   Dark grumous matter is vomited.   Give
 mild antiseptics like boracic acid, milk, soups and raw egg.
    230.    Gastritis (inflammation of  the stomach) is manifest by
 pain and tenderness in the  epigastrium, thirst,  nausea and vomiting.
 Give the stomach rest  for a season, then  mucilaginous drinks, milk
 and lime water, cream and raw eggs.   In ulceration  of the stomach
 food must be taken in small quantities at  short intervals, thus giving
 the ulcers  a chance to heal.
    The  " coffee-grounds"  vomit is altered blood.
    231.   Iodide of potash  is given to eliminate mercury from the
 system.
    232.    Cholera  is not a highly contagious  disease.   It is caused
 by  debilitating circumstances, unripe fruit, putrid meat, or decaying
 vegetables.  The  remedies are  antiseptics  and  stimulants.  It is
 quite amenable to treatment in the early  stage.  Give  hyposulphite
 of soda,  and rum or brandy.  For cramps,  hot  applications.  The
 opium treatment is extolled by some authors.   Boric  acid is prefera-
 ble.
    233.   Dyspepsia gives a great variety of symptoms ; viz., anor-
 exia (want of appetite), nausea, pyrosis (hot sensation in the stomach
 with acrid eructations), bad taste in  the mouth, irregularity of the
bowels,  headache,  palpitation of  the  heart  and other sympathetic
 affections of the most diversified character.
    234.    Cardialgia (heartburn) is a  pain  at the cardiac orifice
from acidity of the stomach and fermentation.   It is relieved by  al-
kaline remedies—alkaline infusion of rhubarb.    A bitter taste  with
white fur on the tongue is removed by vegetable acids (lemon juice)  ;
and  fermentation may be checked by hyposulphite of soda.   Of the
latter the average dose is 15 grs. in a glass of water.
    235.   Stercoraceous (faecal) vomiting indicates some serious ob-

                               (37) 
struction of the intestine.  It may arise  from  strangulated  hernia?
hardened faeces, foreign bodies, intussusception, cancer, and possibly
from nervous action.
    236.  Stones in the bladder  of the male are generally removed
by a surgical operation, either cutting or crushing.   Cutting for
stone is called Lithotomy.  It proves fatal one time in three in aged
persons and about half as often in youth.
    In females dilatation of the urethra has nearly succeeded  lithot-
omy (cutting for stone).
    237.  The remedy for jaundice is an active  course of  cathartic
treatment—Epsom Salts taken in cider.   For  permanent cure, cor-   ,
rect the diet, state of the mind, and exercise.
    238.  Hiccough is a spasmodic  contraction of  the  diaphragm
with simultaneous closing of the glottis.  It is a symptom of iritation
of the vagus (pneumogastric  nerve), caused  by acrid matter in the
stomach or by gangrene.
    239.  Sighing is a long and deep inspiration, and indicates the
need of more air to oxidize the blood.
    240. The atmospheric air contains about 21 per cent, of Oxygen,
and 79 per cent, of Nitrogen, with a trace (.04 per cent.)  of carbon
dioxide  (C02).  Ten per cent, of C02  in the air  respired proves
rapidly  fatal.
    241.  Asphyxia (pulseless) is suspended animation from  want
of  air.
    242.  Tetanus  (stretched) is the long continued  and involuntary
contraction of one or more muscles,  caused by  a rapid succession of
nerve stimuli.
    243.   Rigor mortis (stiffness  of  death) usually  comes on  from
seven to twenty-four hours after death and lasts one  or more days.
It affects first the jaw, then the neck, trunk,  arms and legs.
    244.  Laryngitis (inflammation of the larynx) affects the voice,
which is hoarse, or suppressed.  It is often called  " sore  throat."
Proper attention to the feet, and a dry flannel placed loosely around
the neck at night will  generally cure.
    245.  (Edema of the glottis is also called submucous laryngitis.
It consists of the effusion of serum into the submucous tissue, and is
often associated  with  erysipelas,  scarlatina,  and Bright's  disease.
The voice is  suppressed, and we get dyspnoea, and a harsh, stridu-

                                (38) 
lous cough.   It requires constitutional treatment and invigorating
measures.
    246.   Bronchitis (inflammation of ,the  bronchi)  is a " cold on
the chest."   It  is  made manifest by dyspnoea,  cough, and, later,
expectoration.
    When inflammation affects the terminal  bronchial tubes  it takes
the name of  "capillary bronchitis;"   and when  false membrane
forms  in the bronchial tubes  it is  called "croupous  bronchitis."
    247.   Epilepsy is a loss of consciousness  with convulsions.   It
may be caused by dyspepsia, worms, and nervous exhaustion.  What-
ever drains  the system of vitality or violently disturbs the  mental
equilibrium may give rise to it.  It is an "electrical storm."  Urae-
mia is sufficient cause.  In convulsions the brain is overcharged with
mental stimuli.  It expends its surplus upon the  convulsed muscles,
and thus temporarily  clears  the cerebral  atmosphere.   Each  fit
usually lasts  from  five to  twenty minutes,  and returns irregularly.
In all cases it is cerebral debility and spasmodic action of the brain.
Bromides and many other remedies have failed  to produce perma-
nent cures.
    248.   Emphysema (inflation) is an escape of air into the areolar
tissues, from injury of the air passages.
    249. . Pneumothorax (air in the chest)  is the escape of  air into
the pleural  cavity  around the lung.
    250.   Epistaxis (dropping  upon) is  nosebleed.    Stand erect,
hold the nose with  one hand and  raise  the other arm perpendicular.
This allows the blood to return readily to the heart, and relieves the
oppressed schneiderian membrane.  Avoid all  violent blowing of the
nose,  and if bleeding is habitual, adopt a light and laxative diet.
    251.   F'or stomatitis (inflammation of the mouth) and  canker,
correct the diet  and apply tincture of myrrh,  or  a  weak solution of
boracic acid.
    252.   Stricture of the oesophagus is  usually  associated with
hysteria.
    253.   Breathing the fumes of mercury, nitric and hydrofluoric
acids  invites  disease of  the  mucous membranes.
    254.   Chlorine often  destroys the  sense  of smell, and invites
coughs, pneumonia, and death.  It is  a poisonous  gas.
(39) 
   255-   Siuinine produces  cutaneous eruptions like  eczema  and
erythema.   Quinine also produces deafness.
   256.   Mercury produces ulcers and canker sores, enlarged ton-
sils and glands of the neck, caries of the bones, fetid breath, drop-
ping of the teeth, and tubercular consumption.
   257.   Phosphorous used  in making matches produces  mental
dulness, catarrh of the  stomach, loss  of  appetite, pain  of the arms
and wrists, and  necrosis of the jaws.
   258.   Arsenic produces pustular eruptions and leaves permanent
marks and stains.
   259.   Arsenic acts especially  on the mucous membranes.   It
produces oedema (swelling) of the eyelids, itching, eczema, and fall-
ing of the hair.   One-half grain has caused symptoms of poisoning,
and 2 grs.  may prove fatal.
   260.   The hypnotic (sleeping)  effect of opium  is promoted by
alcohol and chloral; its sudorific (sweating) effect by ipecac.  The
excretions are locked up by opium, and  the mucous secretions  les-
sened ; the pupils contract; the pulse at first  rising, becomes slow
and relaxed;  respirations are deep  and  slow, sometimes  stertorous
(snoring) ;   unconsciousness  ensues;  its  effect  resembles  alcohol
narcosis  (drunken stupor),  cerebral  hemmorrhage, and  uraemic
coma.
   Morphine is less constipating and less diaphoretic, but more hyp-
notic,  and produces more  itching (pruritus) than opium.   Opium
does manifest harm when there is  a  deficiency of the  secretions of
the liver and kidneys, and in  vomiting from cerebral origin.  Per-
sonal idiosyncrasy greatly determines the effect.  The young and  the
aged  are  most susceptible.  A single drop of laudanum (tinct. of
opium), or a medicinal dose  given to the  mother, may prove fatal
to the nursing infant.  In diarrhoea and dysentery,  laxatives should
precede the use of opium.   In chronic  dysentery opium  is  consid-
ered by the profession indispensable.  Its highest utility is in inflam-
mations of the serous membranes,  e.g., peritonitis, pleurisy, etc.,
but when  effusion (or  dropsy) takes place and  stupor ensues,  the
utility of opium  is ended.  Dose of morphine, \ of a grain; of av-
erage opium one grain.   A full dose should  never  be  given to one
who has never taken any.
    Strong coffee is given to antagonize  opiates.

                               (40) 
    261.   Chloral (5 to  10 grs.) is a  hypnotic (puts to sleep), but
is not anaesthetic (to destroy pain) like morphine.  Morphine deep-
ens its effect, and alchoholic stimulants  antagonize it.  It is given
in full doses for sea-sickness every four hours.   It is better to regu-
late the diet and reduce plethora before taking the voyage.
    Chloral  is given  also for tetanus, cholera, and for  rigidity of the
os uteri in parturition.  It is antiseptic and arrests fermentation.
    262.   For ernes is (vomiting) use ipecac and lobelia, equal parts.
Wine of ipecac and tincture of lobelia are most convenient.  Put a
teaspoonful of each in a goblet of warm water, and give the whole
every ten minutes till the stomach is cleared.  The sympathy between
the stomach  and other parts of  the system  is very extensive.   For a
quick  emetic, stir a  teaspoonful of ground mustard in a cup  of
warm  water. A little soda in the water is a great aid if the stomach
is sour; and warm  hands and feet must  be  secured for the  best
effect.   Nothing but an  emetic will effectually cleanse the stomach
of phlegm in case of catarrh.
    263.   Lime juice and lemon juice are important anti-scorbutics
(against scurvy).
    264.   Sulphurous acid  is  reported  an efficient  application  to
chilblains.   Use  three parts acid to one part each of  glycerine and
water.
    265.   One grain of calcium sulphide once in two hours for a day
or two may cause boils and abscesses to abort.
    266.   A saturated (dissolve all you  can) solution of borax  in
rose-water removes freckles, and allays  pruritus  '(itching)  of the
vagina.
    267.   To clear the bowels give  "liquorice powder,"  butter-nut
bark pills,  hyposulphite of  soda, rhubarb, senna, epsom salts  in
cider, or tincture of  aloes.   Sprudel salts and  Carlsbad  water  act
finely on some persons.   The Alkaline infusion of rhubarb and fluid
extract of senna may be combined. Aloes sometimes  causes piles.
   268.   Elaterium is a powerful hydragogue cathartic.  Used in
ascites.   Dose of  the elaterium \ gx.   Use with  caution  in debil-
itated subjects.  An excessive dose causes blindness.
   269.   Bartholow says  that Quinine  is a "protoplasmic  poi-
son ; "  that it diminishes  the  reflex action of the spinal cord.  Dr.
(40 
A. H. Smith, of Philadelphia, considers it  oxytocic (hastens deliv-
ery) and gives 15 grs. at the outset of labor.
    15 to 20 grs. given early, arrests, it is said, the inflammatory  pro-
cess in its formative stages.
   In septic disease it is given in 10 gr.  doses every four hours.   In
intermittents,  Bartholow advises 10 gr.  in  the sweating stage, and
again 5 hours before the time of the next paroxysm.   He combines
it with  morphine.   Such  is regular practice in relation to quinine.
We  do not depend  upon it in any of these cases.
  '  270.   Poke root is the common  name for two distinct plants—
Phytolacca decandra and veratrum viride.   They  must not  be  con-
founded.   The phytolac dec. is the garget, and is used in scrofula to
act  on the glandular system.  The veratrum vir. is used by some to
depress the pulse,  but  it  reduces it only while the patient reclines.
It is a poison.
    271.   Lobelia  is used  as an enema,  cylster, or injection in stran-
gulated hernia, intussusception, and faecal  impactions of the colon.
For  habitual constipation give of the tincture two drops  even' hour,
or ten drops  at bed-time.   For asthma, a teaspoonful every 15 min-
utes until  nausea is induced.
   272.   jVervous vomiti?tg and  sick-headache are sometimes re-
lieved by giving one drop,  every  half hour, of wine of ipecac.
    273.   Ipecac or  lobelia given to nausea,  arrest hemorrhage
(bleeding)  of all  kinds  except from the  injury of large vessels,
which must be tied.
   274.   Coca first excites, then paralyzes, the respiratory center.
   275.   Deodorized alcohol,  whiskey or rum, may  be  used  to
counteract the effect of sunstroke, the poison of venomous  serpents,
and  as an antiseptic in summer  complaint, vomiting, and in zymotic
(causing  fermentation)  disease—typhoid fever, diphtheria, small
pox, erysipelas, and dysmenorrhoea.
   276.   Laudanum (tincture  of opium) becomes  very much  con-
centrated by age; while tincture of aloes becomes milder to the taste
with age.
   277.   Iodine administered internally for a longtime  destroys the
mammae and testicles; and Iodide of Potash causes sores and ulcer-
ations of the skin.
   27S.   Aqua rcgia  (royal water)  is  an  efficient temporary rem-

                             (42) 
 edy for chronic hepatic (liver)  disorders, like jaundice.   It is  com-
 posed of Nitric  acid four parts, and  Hydrochloric acid fifteen parts,
 and is given in doses of 3 to 5 drops in half a goblet of water  twice
 a  day for two  or three days.   For permanent cures bad  dietetic
 habits must be corrected.
     279.   Hamburg tea.   Senna leaves, eight parts ;  manna, four
 parts  ; bruised coriander seed, two parts ;' and cream"of tartar, one
 part.   Mix.   Esteemed among the Germans as a cathartic.
     2S0.   Hydrophobia (fear of water) is the supposed  effect of  rabid
 virus.  It is a rare affection, and greatly aggravated by fear.  Inocu-
 lation is as bad as the bite.   The remedy is vapor baths and tincture
 of lobelia to  produce emesis (vomiting).   Repeat  the process, or
 continue it till the patient is thoroughly relaxed.   The  recent wound
 of a rabid animal may be washed with weak ammonia  water, or
 spirit  of camphor.   A poultice of  onion, tobacco and  salt has  been
 said to effect cures.
     2S1.   Tetanus  of  the jaw] is  called  trismus (gnashing), or
 locked jaw.   Traumatic (wound) tetanus  is  that which follows an
 injury.  Emprosthotonos bends  the  body forward;  opisthotonos,
 backward, and plurothotonos to one side.  The remedy must be one
 that reaches the mental  stimuli, or nervous influence; — psychologic
 power, nervous sedatives, or powerful relaxants.
    282.   Insensibility after injury may be due to the effects of  alco-
 hol.   Notice the  breath  and  history of the patient,  and see whether
 the pupil changes in  size when you endeavor to rouse the  patient.
 In complete  insensibility from injury the pupil will remain fixed.
    283.    The effects of mercury, arsenic, digitalis, strychnine and
 iodine are cumulative in the system.
    284.    The bile is composed chiefly of two  acids  (Taurocholic
 and Glycocholic)  united  with soda.   It has  also  mucus, coloring
 and fatty  matters, cholesterin and salts.
    285.   The coloring matter of  the bile depends  upon the nature
 of the food.   In  man and the carnivora it  is called Bilirubin  (red
 bile) ;  in  herbivora,  Biliverdin (green bile).
    The  colororing matter of plants is called Chlorophyl  (green
 leaf).
    286.   Dextrose (or Glucose) is a variety of sugar found in many
vegetable juices, especially the grape.   It was so named because  in

                               (43) 
the polarization of light it refracts the rays to the right  (dexter).  It
does not  crystallize so readily,  nor dissolve  in water  so  quickly
as cane sugar.   Milk sugar is called Lactose from the Latin "Lac"
(milk).
    287.   Inosit (from a  word signifying "fibre")  is muscle sugar,
and is found only in muscle.
    288.   Glycogen (sweet producing) is  a substance found  in the
liver.  It is isomeric ("equal measures" of the same elements) with
starch, and the sugar produced by its transformation is identical with
grape sugar (C6H1206).
    289.   Grape  sugar, milk sugar, inosit, and  glycogen are termed
carbohydrates, because formed of carbon and water (general formu-
la CmH2llOn).
    290.   Grape  sugar ferments readily with yeast and forms alchhol
and carbon dioxide (C02).
    291.   Milk sugar does not undergo direct alcoholic  fermentation.
    292.   Stearine  (stiff fat), margarine (pearly), and oleine  (oil),
are the neutral fats. They are regarded as salts composed of stearic,
margaric, and oleic acids  united to a common base glycerine.
    293.   CO2 (carbon dioxide) is a product of combustion, of fer-
mentation, and of oxidation of the tissues.
    294.   Hydrochloric acid  (possibly formed  from the chlorine of
common salt) is found in the stomach.
    295.   The cell of frogs' blood is spherical;  birds  and fishes
oval.
    296.   The average specific gravity of milk  is 1.030, maximum
1.042 ; 10 per cent, of H20 (water) reduces the gravity three units.
    Chalk in milk may be detected with the microscope, and starch
with a solution of iodine.   It forms a blue color if starch be present.
    Good milk is 10 per cent, cream; may be known by standing 24
hours in a tall, graduated vessel.
    297.   Common salt taken with the food causes an increase of
urea in the urine.   Salt  also interferes with endosmosis and exos-
mosis (the passing  in and out of fluids through animal membranes).
It shrivels the corpuscles of the blood.
    298.   The lymphatics drain the tissues of serum, and any ob-
struction  of the lymphatics causes dropsy.   The lymphatics are
(44) 
furnished with numerous valves, arid exercise  of the body promotes
their activity.
    299.   Diastole (to place apart) implies dilatation of the heart;
and Systole (to place together)  contraction of  the heart.   The  heart
begins to  contract at the upper part of the auricles  and  extends
downward over the auricles  and ventricles.  The blood enters the
pulmonary artery from the right ventricle at the same time that an-
other portion enters the aorta from the  left ventricle.
    300.   Nitrate of potash, or )iitre, 3 to 10  grs., repeated  if nec-
essary in four hours, has a powerful influence to oxidize the blood
and is given in fevers and rheumatism ; but it is a poison and should
not be long continued.
    301.   The serous  (secreting serum)  membranes are those sur-
rounding  the  brain, heart,  lungs,  bowels, and  testes; and they are
named respectively the meninges (we regard the dura and pia mater
as serous, not recognizing any arachnoid), pericardium, pleura, per-
itoneum, and tunica vaginalis.   The latter is originally a part of the
peritoneum.
    302.   Fatty degeneration  of  the  liver is liable to  ensue from
excessive consumption of fats.
    303.   Leucocytes (white cells) are the white  corpuscles found
in both blood and pus.
    304.   " Ubi irritatio ibi fluxit. "   (Where any irritation  is there
it  [the blood] flows).
    305.   Ergot produces gangrene of the extremities.
    306.   Salted provisions produce scurvy.
    307.   Sedentary habits invite dyspepsia,  vertigo, piles and ap-
oplexy.
    308.   It is not what we cat but what we digest and assimilate
that makes us strong.   We can only use  in the system so much  of
fats and carbonaceous matter as we are able to  oxidize.   Food can-
not keep up the flame of life  without oxygen.   Expand and use the
lungs.
    309.   The blood corpuscles of  the seal, wolf, and guinea pig are
only  slightly  smaller  (size -g^iyo)  than those of man  (size  3 2\) 0 )
about y1^ smaller and both are microscopic.
    310.   Fever " runs  down " or subsides, for two reasons — want
of waste or fuel, and want of vitality to carry on the work.
(45) 
    311.   In Asiatic cholera, and usually in  dancer, the temperature
falls, sometimes to 8o° Fah.
    312.   Digestion is not a process of fermentation but of distribu-
tion.   Normally the bile is found only in the portal circulation, liver,
gall bladder and bowels.
    313.   Hysterical amaurosis is real but is the  result of some
emotion or state of the mind, and not of any organic lesion.
    314.   A  suppository of fine cut tobacco (10 or 15 grs). is an
efficient remedy in  hernia.   It  should be held together by  a cord
which protrudes for the removal of the suppository, soon as the mus-
cles are properly relaxed.   In about an hour the hernia may be re-
duced easily or even spontaneously when the patient lies in a proper
position on his back  with the lower limbs drawn up.
    315.   The official Dovers Powder contains opium and ipecac, of
each one part, and sugar of milk eight parts.
    316.   Soda  and  cream of tartar, used in making biscuits, form
Rochelle salts and carbonic acid gas, and the Rochelle salts  are left
in the biscuit.   Such bread is therefore medicated.
    317.   Fusel-oil  (Amylie alcohol)  should be by  law  excluded
from all beverages.    It is found in all unrectified spirits made from
grain, starch, or potatoes in any form, and is poisonous even in small
quantity.
    318.   That fats are formed  from  proteids  is proved by the cow
that makes butter from grass.
    319.   Fractures of the olecranon and coronoid processes  usually
unite by ligament.
    320.   The motions of the wrist are chiefly at the radio-carpal
joint,  where the radius articulates with three  of the  proximal, or
first row of carpal  bones, viz.,  the scaphoid, semilunar and cunei-
form.
    321.   The distal row of carpal bones—those nearest  the meta-
carpal—are the trapezium, trapezoid, os magnum, and  unciform.
    322.   The bones of the wrist, fingers,  and toes,  are  counted
from  the side of the thumb and  great toe.
(46) 
TABLE  OF  ARTERIES.
    i.  Aorta—origin, left ventricle of the heart.
    Gives off'about 60 branches to all parts of the system.  For full
description of the aorta seepages 209-211 of Dutton's Anatomy.
    2.  Axillary — origin, Subclavian.
    Becomes the brachial. The 7 branches of the Axillary are distri-
buted chiefly to the  muscles of the chest, side, and arm.  They are
the subscapular, 2 circumflex, and 4 thoracic.
    3.  Brachial — origin, axillary.
    Supplies the arm.  The 7 branches of the brachial are the up-
per, and lower profunda (deep) ; the nutrient, that feeds the shaft of
the humerus ;  anastomotica magna (great anastomosing) ; muscular,
radial, and ulnar.
    4.  Right Common Carotid — origin, innominate.
    Divides into the internal and external carotid.
    5.  Left Common Carotid — origin, arch of aorta.
    Internal and external carotid.
    6.  External Carotid — origin, common carotid.
    External parts of the head and  neck.  The 8 branches of the
external carotid are the ascending pharyngeal, superior thyroid, lin-
gual, occipital,  facial, posterior  auricular and its  two  terminal
branches — the temporal, and internal maxillary.  (These are men-
tioned in their order from below upward).
    8.  Carotid, Internal — origin, common carotid.
    Supplies largely the encephalon (or brain) and parts of the eye
and nose.  The principal branches  of the internal carotid  are the
tympanic (to  the drum  of  the  ear),  the ophthalmic,  the anterior
meningeal (to the membranes  of the brain), and the  anterior, and
middle cerebral.
    9.  Cceliac Axis — origin, from the aorta.
(47) 
   Stomach, liver and spleen.  The 3 branches of the coeliac axis
are the gastric, the hepatic, and the splenic.
   10.  Coronary, 1st branches of the aorta.
   Supply the heart.
   11.  Dorsalis Pedis — origin, anterior tibial.
   Upper part of the foot.
   12.  Epigastric.
   There  are  three epigastric arteries.  The superior epigastric
arises from  the internal  mammary  and  supplies  portions of  the
abdominal wall over the  stomach; the superficial, that arises from
the femoral artery ; and  the  deep epigastric which arises from the
external iliac just as  it passes beneath Poupart's ligament to become
the femoral.  The  deep epigastric ascends  in the wall of the ab-
domen and communicates with the superior epigastric.
   13.  Facial — origin, external carotid.
   Supplies  parts of the face,  mouth  and fauces.  The principal
branches of the  facial are  the tonsillar,  muscular, inferior labial,
inferior and superior coronary,  (to the  lips), lateralis nasi, and an-
gular.   Through the facial and ophthalmic, the  external and  inter-
nal carotid arteries communicate.
   14.  Femoral — origin,  is a continuation of the external iliac.
   Supplies some of the  organs of generation and  lower extremity.
Its principal branches are the superficial epigastric, the deep  (pro-
funda) femoral, two pudic,  muscular, the circumflex  iliac,  anas-
tomotica magna, and the popliteal, which is  only a continuation of
the femoral.
   15.  Iliac, Common — origin, from the aorta.
   Internal and external iliacs.   These are short vessels— ordinarily
three or four  inches long.   They divide  into the  internal, and ex-
ternal iliac.  They give  off some small branches to  the psoas mus-
cles and other parts, but these branches have  no  anatomical names.
   16.  Iliac, External—origin, common iliac.
   Passes beneath Poupart's ligament and becomes the femoral ar-
tery.   The  deep epigastric  is  an important branch  considered in
connection with hernia.
   17.  Iliac, Internal — origin, common iliac.
   Pelvic organs and  inner side of the  thigh.  The  internal iliac
divides into  the  anterior  and posterior  trunks.   The middle
hemorrhoidal,  three vesical  (to the  bladder), the internal pudic,

                               (48) 
sciatic, uterine and  vaginal (in the  female), and the obturator, are
branches of the anterior trunk of the internal iliac.  The posterior
trunk supplies some of the muscles of the hip.
    17.  Innominate—origin, arch of aorta.
    This is a large but short trunk — one or two inches long—and
divides into the right subclavian, and  right common carotid.   It
sometimes sends a branch to  the thyroid body ; and is  sometimes
entirely absent.
    18.  Lingual — origin, from external carotid.
    To the longue, sublingual gland, and mouth.   The ranine, sub-
lingual,  hyoid, and  dorsalis  linguae  are branches of the  lingual
artery.
    19.  Mammary,  Internal — origin, subclavian.
    To the walls and structures of the thorax.   The internal mam-
mary gives off the  superior phrenic, called, also,  the  comes nervi
phreniei (companion of the phrenic nerve), mediastinal (to parts be-
tween  the lungs), pericardiac, sternal, anterior intercostal, perfo-
rating  (to the mammary gland and great pectoral muscle), the mus-
culo-phrenic,  and superior epigastric.  See page 231 of Dutton's
Anatomy.
    20.  Mesenteric, Superior — origin, from the aorta.
    Supplies  the small intestine, caecum, and ascending  and trans-
verse colon.
    21.  Mesenteric, Inferior — origin, aorta.
    Rectum and the lower parts of the colon.   The superior  hemor-
rhoidal is a branch  of the inferior mesenteric artery.  The  two
mesenteric arteries communicate through the colica media.
    22.  Maxillary. Internal.
    One of the terminal branches of the external carotid.   It feeds
structures indicated by the names of its branches, viz : posterior pal-
atine, vidian,  nasal,  inferior dental, pterygoid, masseteric,  buccal,
tympanic, small meningeal, and middle meningeal.  It has, in all,
fourteen branches.
    23.  Obturator — origin, internal iliac.
    To parts of the pelvis and thigh.
    24.  Occipital — origin, external carotid.
    Muscles of the neck and  back part of the  head.   Its principal
branches are  the  sterno-mastoid, muscular,  meningeal  and auric-
ular.

    (D)                        (49) 
    25.  Ophthalmic — origin, internal carotid.
    To the  eye and parts  adjacent.  Its principal branches are the
lachrymal, nasal,  frontal,  ciliary, supra-orbital, ethmoidal,  palpe-
bral,  and arteria  centralis retinae (central  artery  of the retina).
    26.  Palmar Arch, Deep.
    Formed  by the radial,  and deep communicating of the  ulnar.
It gives off the radialis indicis (to the  fore  finger),  and digital
branches to the palm  and fingers.
    27.  Palmar Arch, Superficial,
    Formed  by the  ulnar  artery and  the  superficialis  volae.   It,
also, gives off digital  branches to the palm and fingers.
    28.  Pharyngeal, Ascending—origin, external carotid.
    To the neck, throat, and dura  mater.   It gives oft' the external
pharyngeal and meningeal branches.
    29.  Two Plantar Arteries.
    Terminal branches of the posterior tibial.  They supply the sole
of the foot and toes.  The  external plantar divides  into the anterior
and posterior perforating.
    30.  Popliteal — origin, continuation of the femoral.
    It supplies parts  about  the knee.  It divides into the anterior
and posterior tibial.  Its principal branches are the articular (to the
joint), muscular, cutaneous, and the terminal (two tibial).
    31.  Deep Femoral (Profunda femoris) .
    Already mentioned, supplies muscles of the thigh.
    32.  Pudic, Internal — origin, internal iliac.
    Generative organs.  Its principal branches are the perineal, in-
ferior hemorrhoidal, the dorsal  artery of the penis, and the artery of
the corpus cavernosum of the male.  In the  female the terminal
branches supply the clitoris.
    33.  Pulmonary — origin, right ventricle of the heart.
    Supplies the lungs.  It divides into right and left pulmonary.
    34.  Radial — origin, brachial.
    Fore-arm, wrist and hand.   The radial  has  numerous branches.
The radial artery lies  on  the  thumb side of the wrist, and  is  the
one usually felt to ascertain the state of the pulse.
    35.  Sciatic—origin, internal iliac.
    Muscles of the back of the pelvis.   The principal branches of
the sciatic  ate the muscular, vesical, gluteal, articular,  and  comes
(5°) 
 nervi ischiatici (companion of the sciatic nerve).  The latter pene-
 trates the sciatic nerve and runs along within it.
    36.   Subclavian.
    Usually from the innominate artery on  the right, and from  the
 arch of the aorta on the left side of the body.  It sends blood to the
 chest, neck, brain, etc., and has  four  branches, viz :  the  vertebral,
 internal mammary, thyroid axis, and superior intercostal.
    37.   Suprascapular — origin, thyroid axis.
    Muscles of shoulder.
    38.   Temporal — origin, external carotid.
    Forehead, ear, parotid  gland, and masseter muscle.   It divides
 into the anterior and posterior  temporal, to communicate with  the
 frontal and occiptal arteries.
    39.   Thyroid Axis—origin, subclavian.
    Supplies the shoulder, neck, chest, and  spinal cord.  It gives off
 the inferior thyroid, suprascapular, and the transversalis colli  (trans-
 verse of the neck).
    40.   The  inferior  thyroid  gives off branches  to the larynx,
 trachea, oesophagus, and  thyroid gland.
    41.   Thyroid, Superior.
    Branch of the external  carotid.   It supplies the  thyroid gland
 and the omo-hyoid, sterno-hyoid,  and sterno-thyroid muscles.
    42.   Tibial, Anterior — origin, popliteal.
    Leg, ankle and dorsum  of foot.   Its principal branches are the
 recurrent tibial,  muscular, malleolar, and dorsalis pedis.
    43.   Tibial,  Posterior — origin, popliteal.
    Leg, heel and sole  of the foot.   Its principal branches are  the
 peroneal, muscular, nutrient, internal calcanean, and the internal
 and external plantar.
    44.   Transversalis Colli — origin, thyroid axis.
    To muscles of the neck and back.   Its branches are the cervical
 and posterior scapular.
   45.  Ulnar — origin, brachial.
   Together with the radial supplies the fore-arm, wrist, and hand.
The principal branches are the  anterior and posterior ulnar  recur-
rent, anterior and posterior carpal, deep, and digital.
   46.   Vertebral — origin,  from the subclavian.
   Supplies  parts of the neck  and brain.   The two vertebral  ar-
(50 
teries enter the skull  through the foramen  magnum of the occipital
bone, and uniting form the basilar artery.
   47.  The  basilar gives  off  branches  to  the  cerebellum,  and
divides into the two posterior cerebral arteries.   The latter commu-
nicate  with the middle  cerebral  arteries by means of the posterior
communicating, and  thus assist in forming at the base of the brain
the circle of Willis.   (See pages 230-31.  The figures  of pages
refer to Dutton's Anatomy).
   Besides the pulmonary artery, the  aorta,  the  innominate, the
coeliac axis, the superior and inferior mesenteric, the three  hemor-
rhoidal, the gastric, hepatic, splenic, the basilar, the colica media,
dextra  and   sinistra  (the  three colics),  and   perhaps  a  few
others  which are single, the arteries are in pairs, and a description
of the artery on one side is supposed to  answer for both. 
CHEMISTRY.
    The modern  science of  chemistry dates from the discovery  of
 oxygen in 1774.  It was born of Alchemy,  which comes to us from
 Arabia—the land of Mahomet.  It signifies the hidden art, and was
 one of the occult sciences.  Magic and  Astrology were its  sister
 occult sciences.   Alchemy claimed to transmute the baser metals into
 gold and to prepare an elixir by which disease and even death might
 be avoided; but this claim must be  considered as a figure of speech
 only, which served to convey to the minds of the ignorant the  great
 value  of true scientific attainments.  Well,  Alchemy was beheaded
 by cutting off  the first syllable, which in Arabic signifies "the,"
 and thus chemistry rose to life.
    One author derives chemistry from a Celtic  word that signifies
 " fire, " and it is true that fire is often resorted  to in chemical experi-
 ments.   The  true object of  chemistry is to discover  the secrets  of
 nature  in  molecular life and apply  them  for  the  improvement and
 happiness of mankind.
    Chemistry may be defined as the  science of molecular life,  i. e.,
 if we allow life to minerals  and elements, for chemistry  deals with
 matter on  all its planes—mineral, vegetable, and animal.  And why
 should we not allow life to minerals, since there is an invisible force
 that governs their atoms as truly as  the human will governs our vol-
 untary  muscles?  The  property of  polarity, and the  crystallization
 of minerals are  evidences of mineral life.
    Polarity is that property by which the magnetic needle turns  to
the  plane  of the meridian ;  and  crystallization is the property by
which  minerals, in the liquid form, produce a great variety of  crys-
tals, each of its  own kind.   To a thinking mind these properties are
evidence of some  intelligent  force  or power which is synonymous
with life.
(53) 
   Indeed, there is but one life, though manifest in an infinite vari-
ety of forms.  Well, Chemistry investigates elemental life ;  and each
distinct kind of matter which cannot be  split up into two or more
essentially  different materials, is called a simple substance, or  ele-
ment,  while all  other substances are  compounds.   In all nature the
chemist finds only 73  elements; and it  may yet appear that  all of
these are only modifications of one invisible substance out  of  which
all things are made.
   The  elements  are  represented  in  chemistry  by symbols.   The
first letter of the element,  written as a  capital,  is generally used as
the symbol of that element.   Thus O represents  oxygen ; C,  car-
bon ;  N,  nitrogen;  and  II,  hydrogen.   These  four elements are
termed essential elements because  they are all necessary for the for-
mation of  any  organic  compound whatever.   Besides  these four
essential elements, there  are usually found in the human  body ten
other  elements,  viz : calcium, chlorine, phosphorus, potassium, iron,
fluorine, magnesium, sodium, silicon, and sulphur.   Now here we
have three different elements commencing with  S, two with P, and
two with C, besides  carbon previously mentioned, so we see we can-
not always represent an element by its  initial letter.   We therefore
write with the capital one of the small letters following, or, use the
initial of its Latin term.  Kalium is  the Latin for potassium and so
K is taken as the symbol for potassium ; and Na  (for natrium) is the
symbol for  sodium;  CI  represents  chlorine;  and  Ca,  calcium.
S  stands for sulphur,  and  Si, for  silicon.   Magnesium, because
another element begins with Ma  (manganese), is wrritten Mg.  P
stands  for  phosphones, F  for  fluorine, and Fe (Ferrum), for iron.
Ferrum is the Latin  term for iron.
   Besides the fourteen elements usually found  in the human body,
there are about eighteen more that the student in  chemistry  should be
familiar with.   The following are their names  and  symbols, viz  :
Br. (bromine),  I.  (iodine),  As.  (arsenic),  Sb.  (antimony,  Latin
stibium), B.  (boron), Zn. (zinc), Pb. (lead, Latin plumbum), Cu.
(copper, Latin  cuprum), Ag.  (silver, Latin argentum), Hg.  (mer-
cury,  Latin  hydrargyrum), Al.  (aluminum),  Mn.  (manganese),
Co. (cobalt), Ni. (nickel), Sn. (tin, Latin  stannum),  Bi. (bismuth),
Au. (gold, Latin aurum), Pt. (platinum).   The  remaining  forty-
one elements are comparatively unimportant, and are here omitted

                               (54) 
for that reason.  Two of the elements — Bromine and  Mercury
— are liquid at ordinary  temperature;  four of  them — oxygen,
hydrogen,  nitrogen  and chlorine.—and probably also fluorine, are
gases ; the rest are solids.   (Gases are compressible  fluids,  while
liquids are practically  incompressible).   Fluorine  has such strong
affinity  for other  substances  that  it cannot be obtained free.  It is
found combined with calcium—as fluoride of calcium—in the en-
amel  of the teeth, and in bones.  Its principal compound is hydro-
fluoric  acid  (written  chemically   HF)   which  is a permanently
elastic fluid like air  (gaseous) and  which  when dissolved in water
gives us a colorless,  very corrosive  liquid,  used for etching glass.
    We  have spoken of molecular life, or the life of molecules (little
masses of matter). .  A molecule is the smallest quantity of any sub-
stance that can exist in a  free state;  i.e., the  smallest quantity of
any substance that can be taken or  used as such.  To divide a mole-
cule of  any substance is to change or destroy the peculiar nature of
that substance.   A  molecule of sugar is sweet,  but the  separate
atoms composing the molecule  are not sweet.
    The molecule is  supposed to be composed of atoms, though no-
body has ever seen an atom (the ultimate  unit of an element).  The
molecule is a real thing;  the  atom is something conceived only.
    Atom signifies  "uncut"  or  undivided;  and all matter is sup-
posed by chemists  to  be made up of  minute particles, or atoms,
which are indivisible.  All the atoms of any one element are alike ;
but the atoms of different  elements are unlike.  A  molecule can  be
divided  (split up into its atoms)  by chemical but not by mechanical
means.   As  we reckon seventy-three elements in nature, so we have
seventy-three different kinds of atoms.   The  actual  weight of  an
atom nobody knows, but  only  the relative weight.
    The relative weight of an atom of  hydrogen  (the  lightest of  all
known  substances)  is taken as  the standard for the  weight of  all
other atoms.   Oxygen is sixteen  times  as heavy as hydrogen, or
about that  (15.96),  and so the  weight (the relative weight) of oxy-
gen is put down in chemical formulas as 16.   Carbon is  nearly
twelve (n.97) times as heavy as hydrogen, and so the atomic weight
of carbon is  12 ; nitrogen  14  (14.01) ;  chlorine 35  (35.37)  ; sodium
23  (22.99) ;  sulphur 32 (31.98), etc.
(55) 
    As a science chemistry is not exact, like mathematics, and  the
 Atomic theory may ultimately prove to be erroneous.   The atomic
 weight of an element is  also called  the combining number of that
 element, because an atom being supposed to be indivisible, the pro-
 portion of any one  element in a given molecule, or compound, will
 always be the weight of one or  more atoms ; in other  words it will
 be the weight of one atom, or a multiple of that weight.  The num-
 ber of atoms taken of each element in any chemical formula  is rep-
 resented  by a small figure placed a  little  below and just after  the
 symbol of  the  element; thus  H20  is the formula for water, and
 represents that two atoms of hydrogen are combined with one atom
 of oxygen.
    The approximate atomic weight of any atom of oxygen being 16,
 and the weight of hydrogen i, two atoms  of hydrogen and one of
 oxygen united make  18, which is said to be the weight of a mole-
 cule of water.  A  molecule of  hydrogen is said to contain two
 atoms.  The heavy irrespirable and poisonous gas (carbon dioxide,
 or  carbonic  acid  gas),  which  we  are constantly exhaling in our
 breath, is composed of one atom of carbon and two atoms of oxygen,
 and is l'epresented by the chemical formula C02.
   Ca is the symbol for  an atom of calcium, and CaO is the for-
 mula for a molecule of quicklime.  It shows that one atom of cal-
 cium was combined with one atom of oxygen to form quicklime.
   To find the absolute weight of any atom by its atomic weight  we
 should need to know the  absolute weight of an atom of hydrogen,
 for the atomic weight is only the relative weight as compared with
 an atom of hydrogen.  A molecule of hydrogen is supposed  to be
 composed of two atoms, because hydrogen  unites with half its vol-
 ume of oxygen, to  form  water; and equal volumes of gases under
 like  conditions are supposed to contain an equal number of mole-
 cules ;  /. e.,  it always takes two atoms of hydrogen, or two volumes,
 to unite with one volume of oxygen.
   There  are no permanent gases.   All  gases  can be reduced  to
 liquids, and even to solids by pressure at low temperature.
   All bodies in chemistry  are  either simple  or compound.   A
simple body is an element; one  that cannot be separated into two
or more different substances.   A known  compound can  be  sepa-
rated  into two or  more different substances, or elements.   A com-
pound, or molecule, composed of only two elements is a  binary mole-

                              (56) 
cule ; of three,  a  ternary molecule.   A molecule of any substance
has all the qualities of  the substance itself.  HF  (Hydrofluoric
acid)  is a binary molecule.
   Matter is elementary when composed  of like atoms, and com-
pound when made up of dissimilar atoms.   That any kind or quan-
tity of matter, even  an atom, is  absolutely indivisible is quite  un-
likely ; indeed the  divisibility of matter is one of its essential proper-
ties, and one which distinguishes it from spirit which is indivisible ;
but spirit is indivisible  not because of its minuteness but because of
its essential unity and universality.  To destroy the unity of spirit is
to destroy its spirituality.  To push matter beyond the limit of divi-
sibility is to push it into the realm of spirit and beyond the bounds of
matter.  A fraction is  divided in arithmetic by  multiplying its de-
nominator ; and, the longer  we thus  divide, the  larger the denom-
inator becomes.  In this  way there  is absolutely no limit to the
divisibility of a fraction ; but the  numerator, which is a unit when
we begin, remains a unit forever, or so long as we continue the pro-
cess.   So matter may likely be divided indefinitely so long as it re-
mains matter.
    The  Atomic theory, on  which chemistry is  now based, is inge-
nious and convenient, though hardly consistent with philosophy ; but
until  we have  something  better in  its place we must continue to
use it.
    When oxygen (acid generator) was named,  it  was supposed to
be  necessary to the  formation  of an  acid ; now we know at least
two acids—hydrochloric, and hydrofluoric—that contain  no oxygen ;
and the term " acid" has so far lost its distinctive character as to be
almost discarded in  science.
    Most of the  acids are  soluble  in  water, have a sour taste,  and
redden blue litmus paper, but silicic acid  has none of these proper-
ties.  Oleic acid does not redden litmus.   Palmitic and stearic acids
are both  insoluble in water.  Uric acid  is so nearly  insoluble  in
water as to require 15,000 times its bulk of water for solution.
    "  Salt" is another term loosely used  in chemistry  and has no
technical meaning.   It is defined by some authors  as the union  of a
base with an acid  ; but common salt (NaCl) is composed of  sodium
and chlorine, neither of which  is an acid.   Sodium is a metal, and
chlorine is a greenish-yellow, poisonous gas.
    Alkalies and acids react on litmus paper.  Acids as a rule  turn

                                (57) 
blue litmus paper, and litmus solutions, red; and  alkalies  turn
them back to blue again ; and this is what is meant in chemistry by
reaction.   If a substance does not react on litmus it is said  to be
neutral.   Potash, soda, and ammonia are strong alkalies.   They
convert fats to soap.
   An oxide is a combination of oxygen with  some other element.
The metallic oxides are an  important class of  bodies.   Iron-rust is
an oxide of iron ; quicklime, an oxide of calcium.
   A sulphide is a compound of sulphur with some other element.
The sulphide of calcium  (CaS), when pure,  is a  union of sulphur
and  calcium.   The sulphide of calcium used as a medicine to pre-
vent the formation of pus,  boils, and abscesses, is not strictly  a sul-
phide  of calcium, but a  mixture of sulphide  and sulphate and is
often called "sulphide of  lime,"  or " sulpurated lime."  It is a
gray powder.
   A chloride is a compound of  chlorine  with some  other sub-
stance.   The  chloride  of calcium, pure, has  the  formula, CaCl2 ;
but  the  chloride of  lime,   known  as  " bleaching powder, " or
"chlorinated  lime," is  of uncertain  formula, and  is used in  medi-
cine as a disinfectant.  Lime (CaO) is an oxide of calcium.
   An iodide is  a compound of iodine with some other substance.
Iodide of  potassium  (KI) has formerly been considerably used—as
an alterative—in medicine.    (An alterative is  supposed to produce
some change).   K (kalium) stands for potassium.
   A base in  chemistry is  a leading or  basic  constituent in  many
chemical compounds, and usually consists of some  oxide, alkali, or
metal.   Perhaps the best definition is this :   "  A base is a substance
which replaces the hydrogen of an acid and thus forms a salt "
   A salt  is defined as an  acid in  which the hydrogen has  been
partly or entirely replaced by a metal or  metals.  An  anhydride
(dry) is an oxide which will unite with water  to form an acid.
   A nitrate is a salt formed by the  union of nitric  acid with a
base.  The direct union of two elements forms " ide " salts.  Acids
ending in  " ous " unite with bases to form " ite" salts.  Acids end-
ing  in " ic " unite with bases to form " ate " salts.  Nitrate of silver
has  the  formula, AgN03.    Ag (argentum)  represents the silver,
and  N03, the nitric acid.   N stands for nitrogen, and 03 for three
atoms of oxygen.  The silver nitrate (more modern expression for
nitrate of silver), when melted and cast in  sticks, goes by the name

                               (58) 
 of lunar caustic.  A nitrite is  a  salt formed by the union of ni-
 trous acid with a base ; a sulphite is a salt consisting of sulphurous
 acid and a base.  The ous  acid which forms nitrites is weaker in
 oxygen than the ic acid that forms nitrates.
    A hydrate (from a Greek word signifying zvatcr) is, according
 to Brande, a  compound formed by the union of water with a me-
 talic oxide ; and according to Witthaus is a substance derived from
 water by the substitution of an  element, or radical, for  one half its
 hydrogen.  Acids and alkalies are called hydrates (Prof. Cooke).
    A compound radical is a compound which acts like an elemen-
 tary body, forming  the base of other compounds.  Ammonium  is a
 compound radical.  There  is no  such element or metal known as
 ammonium.   It is a quasi-meta\ and has the formula, NH4, but is
 treated as a metal.  It is a compound, but as a metal is purely  hy-
 pothetical.
    Chemical  phenomena are  usually divided into two groups called
 inorganic, and organic chemistry.   The latter considers only organ-
 ized beings—animals and plants.
   The various  operations of chemistry consist largely  of analysis
 and synthesis; the splitting up of compounds into their elements, and
 the combining of elements, or radicals, to form compounds.  Heat,
 light, and electricity, are the  usual  means employed to bring about
 composition  and  decomposition in the chemical laboratory.   The
 special attraction that one atom, or  element, has for another, or  one
 compound for another, is  known as chemical affinity.  It might
 perhaps  be considered spiritual  energy.   Chemical  union always
 evolves heat.
   Air, water, and the diamond,  contain the four essential elements
 that enter into the composition of all organic forms.   Air contains
 nitrogen  and oxygen ; water oxygen  and hydrogen ; and the diamond
 is almost pure  carbon.
   Water is the standard weight for solids, as hydrogen is for gases.
   Gold is 19.3 heavier than water; and the relative weight  is  what
 we mean by specific gravity.  It is the weight as compared with
 water.  The specific gravity of gold is 19.3.  The specific  gravity
of the diamond is 3.3, a(id sometimes 3.5,  because it is  about  three
and one half times heavier than water.   Water freezes at a temper-
ature  which is marked o on the  centigrade thermometer,  and 320 on
the scale  of Fahrenheit; and boils at ioo° Centigrade, or 2120 Fah.

                               (59) 
Water is most dense at the temperature of 40 Centigrade, or 390 Fah.
A cubic  centimeter  of water  (a  cube whose side is about f of an
inch) at  its greatest density, weighed in a vacuum  (so as to get its
absolute  weight) weighs one gramme  (about 15^2  grains),  and
1000 grams (a kilogram) of water makes a litre.   The litre  contains
2.1135 pints; nearly 6 per cent more than an American quart.  A
litre is a  cube of water whose side isy1^ of a metre, or one decimetre.
The metre is 39.37 inches—nearly 40 in.  It is one  ten-millionth of
the distance from the equator of the earth to either pole.
    In cooling below 40 (390 Fah.) water increases  in  volume  and
at o (320 Fah.)  freezes  and  floats as ice.  Above ioo° C.  (2120
Fah.)  water turns  to steam.   Steam is transparent and invisible.
The formula for water, ice, and steam (since they  are all composed
of the same elements) is  H20 (two atoms  of hydrogen in combina-
tion with one atom of oxygen).   Hydrogen and oxygen form one
other compound  besides  water.  It  is H202 (hydrogen dioxide) a
liquid of syrupy  consistence.   It has been used as  a test for  blood
stains.  With  freshly prepared tincture of guaiacum  and  blood it
strikes a  blue color.  With  other bodies water unites to form hy-
drates.   CaO  is lime (oxide  of calcium), and  H20 is water.
These  unite, when put  together, as when  water  is  poured upon
quicklime  (CaO),  and  form  hydrate  of lime  (CaO-f-H20=
CaOH20, or  again CaH202).   Here  we  have  one  molecule of
water  (H20) combined  with  one molecule  of lime (CaO) to form
hydrate of lime.   Water of crystallization  is the water necessary
to hold certain  salts in  crystalline  form,  and when  the  water  is
driven off'by heat the salt falls into  a powder.   Salts which absorb
water from the  atmosphere are deliquescent salts—as acetate of pot-
ash ; and those  that lose  water— like phosphate of soda—are
efflorescent.  A salt which undergoes no change is a permanent salt.
    Oxygen is a colorless and odorless gas like the atmosphere, but
a little heavier, its specific gravity being 1.1056 while that of the air
is 1.  Oxygen is the great supporter of combustion and of animal
life.  It is necessary to respiration, germination, and equally to de-
cay or putrefaction.   These processes cannot go on without it.  It
forms about ^ of the air,  •§■ of all the  water on the globe, and nearly
^2 of the solid earth.   Ozone is only another term for condensed
oxygen.   It has  the formula  020  which  only   shows that  three
volumes, or three atoms of oxygen are condensed  into two.  Ozone
(60) 
is the safest and  best disinfectant of the air, and  is developed by
electric sparks (lightning) passing through air, or by allowing  a
stick of phosphorus to hang in a bottle  filled with moist air, and
also by the  action of strong sulphuric acid upon  permanganate of
potash, or barium peroxide.  The atmosphere contains  more ozone
just after  a  thunderstorm.  Oxygen is set free by the action of sun-
light  upon the leaves of plants.
    Hydrogen is a colorless and odorless  gas, but very much lighter
than air, its specific gravity being only .069.   It forms A, by weight,
of water.   If you wish to pour it from one vessel to another, the re-
ceiving vessel must be inverted (bottom upwards) .  By great pressure
and cold  it is reduced  to a  steel-blue fluid  resembling  mercury.
Hydrogen is used for inflating balloons, and can be prepared by the
action of zinc or iron, on sulphuric, or hydrochloric, acid.
    Nitrogen is  also a colorless and odorless gas, with a specific
gravity of .97, being slightly lighter than air.  It is not combustible
nor a supporter of combustion.  No animal can live in it if deprived
of oxygen.   It forms nearly 4 of the air, by bulk, and is found in all
organic substances.   Nitrogen unites with hydrogen to  form ammo-
nia (NH3).  Ammonia,  also  called  "hartshorn," is  an  irrespira-
ble gas.  It is very soluble in  water, forming "aqua ammonia"
(water of ammonia).  In a similar  way  it forms spirit of ammonia.
It is an alkali, turning reddened litmus paper blue  again. On this
account 'tis said to  have an alkaline reaction.  It is found in the
horns and hides of animals, but is now largely prepared from the
ammoniacal liquor of gas works.
    Nitrogen writh oxygen forms several compounds, but only two of
them  are  important—"laughing gas," and nitric acid.   The  latter
has three  elements—thus: HN03 ; but the base  of nitric acid is the
nitric anhydride  (N205) which is a compound of nitrogen and oxy-
gen.   Bv adding water to the nitric anhydride, which is, as } ou see
by the formula, an oxide of nitrogen, we get nitric acid, as follows,
viz : N20- + H20=H2N206 ; or by dividing by 2, because there are
two atoms of each element, or a multiple of  two,  we have HN03,
which is the formula (ox nitric  acid —  a fuming corrosive  liquid,
called "aqua fortis"  (strong water).   It is colorless when pure, but
usually slightly yellow from the presence  of other oxides of nitrogen.
It is liable to contain sulphuric acid and chlorine.
   Nitric acid alone is  extremely corrosive and soon  eats up the
                              (61) 
 cork of a bottle in which  it is kept.   It is  commonly kept in  glass
 stoppered bottles.  It stains the  skin yellow.  It is sometimes used
 for destroying excrescences, but must be handled with care.  Mixed
 with hydrochloric  acid it  forms  the famous '•'■Aqua Regia" (royal
 water) that dissolves gold.  The proportions  as lately prepared are
 four  parts nitric,  to  fifteen of the hydrochloric, acid.   Nitric acid
 alone does not attack gold, or platinum, and is used for testing gold
 by jewellers.
    The dilute aqua regia has been given as a medicine in liver  com-
 plaints.   It  is  technically called nitro-muriatic,  or nitro-hydro-
 chloric acid.  5 drops of the dilute acid is given in a wineglass of
 water, and  taken  through a straw, or glass tube, to prevent injury
 of the teeth,   It is a \Tery searching remedy.
    Nitric acid forms  various  salts called nitrates.   They are all
 soluble in water (H20).
    Laughing gas (N20)  is the nitrous oxide.  Its specific gravity
 is about the same as that of carbon dioxide  (C02) ; one half heavier
 than atmospheric air, or, more exactly, 1.52.
    Carbon  exists  in three forms.  1.  The diamond.   2. Graphite,
 plumbago, or black  lead, which  is  used  for  making  lead  pen-
 cils, so-called, although  they contain no  lead, but only carbon.
 3. Amorphous (shapeless) carbon,  the product of incomplete,  or
 smothered combustion.  This form of carbon  has  several varieties,
 viz : soot or  lampblack, which is only finely divided charcoal ; ani-
 mal coal or  boneblack ; bituminous or soft coal ; cannel-coal (a  hard
 coal that burns with a bright flame) ; coke (the  residue  of the gas-
 works) ; gas carbon (deposited  in gas retorts  and used in  galvanic
 batteries ) ;  common  charcoal; and anthracite (hard mineral coal).
 The specific gravity of each form of carbon differs from the others :
 that of the diamond which is most dense is about 3.5 ; that  of black-
 lead (graphite) is 2.18 to 2.38  ; and that of charcoal  1.6 to 2.  Char-
 coal floats upon  water only by reason of its porosity.  If reduced to
 a powder it  sinks.
   The diamond is insoluble in  all media, and infusible, but is de-
 stroyed by great heat.  It is used for ornaments,  and for cutting
glass.
   Carbon forms  two compounds with oxygen, viz: CO (carbon
monoxide) and  C02  (carbon dioxide).   The former is produced
when carbon burns with a limited supply of oxygen.   It is a color-
                              (62) 
 less gas, but burns with a lambent blue flame and may be seen Com-
 ing oft from the top of the coal in  coal stoves soon after fresh coal
 has been added to the fire.   It is a strong poison when  inhaled,
 and fatal effects have often been observed of the fumes from burning
 charcoal  or from  limekilns.  The latter  (C02) is  the  principal
 waste product  from our lungs.  It is  also  given off in  the  pro-
 cesses of fermentation, combustion, germination, putrefaction, and
 decay of organic  substances.  It is  injurious to man when  inhaled
 butuseful to plants.  It is the "coke-damp" of mines.   It is heavier
 (sp.  gr. 1.529)  than common air and  accumulates at the bottom
 of  wells and pits where it is  sometimes fatal to life.   It is, as we
 believe, the  principal material agent in the production  and fatality
 of  pulmonary consumption.  Being heavier than  common air it
 must be carried from our rooms by registers  or flues  opening near
 the floor of the room, at the bottom  of  low windows, or by aid of
 a forcible draft.  This C02  is the product  of oxidation  of  the
 hydrocarbons in the body, and is held  in solution in  the plasma
 of  the venous blood till it reaches the lungs,  where in  good health
 it is eliminated.  The atmosphere usually contains about .04 of one
 per cent, of this gas, i. e., four parts of gas to ten thousand parts of
 air (4 to 10,000).
    Asphyxia (suspended animation)  is  the  result of an excess of
 this gas in the blood.   Six  per cent, of this gas in the air of a room
 will cause asphyxia, and  12 per cent,  will  extinquish a  candle.
 The candle will burn  dimly in an atmosphere where man cannot
 live.   Pure carbon dioxide, when inhaled, produces at first spasm
 of the glottis.  Ten per cent, of this gas in  the air is rapidly fatal.
    The compounds of carbon with hydrogen are numerous.  CH4
 is the "marsh  gas."  It is known in  coal  mines as "Fire-damp."
 It becomes explosive when mixed with ten times its volume of air
 or  twice its volume of oxygen.   Coal gas for illujniuating pur-
poses is procured by heating the coal in closed retorts.
    The volatile bodies, ammonia water, tar and gas, are driven off,
 leaving a residue of impure carbon, called coke.  From the coal tar
 the analine colors are produced, and the  ammonia water is the chief
 source of ammoniacal salts.  The gas  itself is not a simple chemical
 compound but a mixture of various substances called hydrocarbons,
 luminous  and  non-luminous,  some of which  are  withdrawn  by a
 system of purification.   The non-luminous gases from  coal are H

                               (63) 
 (hydrogen),  CO  (carbon monoxide), and CH4  (fire-damp,  of
 marsh gas).
    Flame is gas  highly  ignited.  Luminosity depends upon the
 presence  of solid matter heated to whiteness.
    Carbon with nitrogen forms cyanogen  (CN), a poisonous gas
 with the odor of peach blossoms.
    An atom of hydrogen added to cyanogen forms  hydrocyanic,
 or  Prussic acid  (HCN).   It is  a volatile liquid with  a specific
 gravity of .7 (.700).   A small quantity inhaled produces giddiness
 and headache, and a  single drop on the tongue of a  dog is quickly
 fatal.  The dilute acid of the British Pharmacopoeia contains 2% of
 the  poison.   Chlorine,  bromine,  iodine  and fluorine have  been
 termed "Halogens"  (salt producers) .
    Chlorine (Cl) is  a greenish yellow poisonous gas,  and is one of
 the elements of common salt.  With hydrogen it forms hydrochloric
 acid (HC1), called also muriatic acid.
    Bromine is a reddish  brown liquid and emits  an  irritating
 poisonous vapor.
    Iodine is a dark gray solid, with metallic lustre.  It is obtained
 from the ashes of sea  weeds, and is used in medicine as an alterative
 discutient, and in the form of iodide of potassium, to eliminate lead
 and other metals from the system.   It is generally given in the form
 of  iodides.  It is  an  irritant poison,  and  when  given  in small
 medicinal doses for some length of time produces coryza, inflamma-
 tion of the eyes, frontal headache, and an eruption of die skin which
 is sometimes mistaken for the effects of syphilis.  Fluorine has been
 already mentioned.
    Sulphur is a hard and brittle, light, yellow solid ; of'a faint pe-
 culiar  odor.   It is commonly called brimstone.  It is found combined
 with various metals, forming sulphides, and  free in certain volcanic
 countries,  especially Sicily and Iceland.   Galena  (an ore of lead)
 is the sulphide of lead.   Gypsum (Plaster of Paris) is a sulphate of
 calcium.   Iron pyrites (FeS2) contains two atoms of sulphur com-
bined with one of iron.  Glauber's Salts are sulphate  of soda, and
 Epsom Salts, sulphate of Magnesium.  Flowers of sulphur is the
powder formed  by the vapor of sulphur when it solidifies.   Sulphur
is soluble in disulphide of  carbon,  and, sparingly, in fixed  and
volatile oils.
    Carbon Disulphide is a volatile liquid with an odor of cabbage

                               (64) 
 water, possessing an acid, pungent taste, and is very inflammable.
 It  disolves sulphur,  caoutchouc, many  resins,  gums,  fats,  etc.
 Written also  "Bisulphide."  S02  (sulphur dioxide), with water,
 forms sulphurous acid,  largely used for bleaching purposes.  The
 dioxide, which can bt condensed to a liquid, is employed to put out
 fires.  S03 (sulphur trioxide) forms, with  water, sulphuric acid;
 thus S03-f-H20=H2S04.   (In combining formulae we write the
 letters and sum up the exponents, or atoms, of each).   Sulphuric
 acid is a heavy, oily  liquid, and is often called " Oil of Vitriol.''
 It quickly burns or chars organic bodies, and  is one  of the  most
 powerful acids known.  Mixed with water it gives out heat.
   H2S (sulphuretted hydrogen)  is a colorless gas having the odor of
 rotten eggs.   It is produced by the  decomposition or fermentation
 of albuminous food and helps to  constitute the flatus  of the bowels.
 It is found in  sewer gas, and when breathed gives rise to headaches
 and typhoid fever.   It acts as a poison  in the  blood, destroying the
 blood globules.
    Phosphorous is  a  waxlike solid which  exists in two states  or
 forms, yellow and red.   The yellow modification is luminous in the
 dark, and more poisonous than the red.  It has a strong affinity for
 oxygen,  and  for  that Teason   is kept under  water.  Is used
 in making matches.  The operators are  more or  less poisoned
 by breathing its fumes, and have, as a result of poisoning, necrosis
 of the jaw.  It is a violent  poison, and  has been  used to kill rats;
 and in medical practice as a stimulant to the  nerves.   Of course all
 such stimulants are dangerous.
    Arsenic.   This is  another deadly poison that has  been  much
 used in regular practice.   One of its compounds, Arsine, is  a  gas,
 and so deadly  that  its discoverer, Gehlen, was killed  by inhaling a
 single bubble  of the gas.   Two grains of arsenic (or arsenious acid)
 is  considered a fatal dose.    Orpi?nent, or King's yellow, is a com-
 bination of sulphur and arsenic.  Scheele's green  and Paris  green
 are compounds of arsenious acid and copper.
   Fowler's  Solution is a  common  form  for  givin^  arsenic to
 patients.   Arsenic is used as coloring matter  in various prints  and
 wall paper.  The chemical antidote for arsenic is magnesio-ferric
hydrate,  every ten minutes in tablespoonful doses.   Also  raw eggs
and milk.
   Antimony  is a tin-white heavy  metal.   Tartar ei?ietic is  a

    (E)                         (65) 
tartrate of antimony and potassium, and is well known  in  the pro-
fession as an emetic.   Not so much used now as formerly.
   Boron  is a greenish-brown solid body or element.  Combined
with oxygen and sodium it is known as borax, which  is used in the
arts.  The principal  boron compound of medical  interest  is boric
acid (H3B03) which is a valuable antiseptic.  The latter is soluble
in 25 parts of water.
   Silicon is an elementary  solid.   It is used in making glass which
is a silicate.
   Potassium is a waxy bluish-white metal, having  a  very strong
affinity for oxygen.   If thrown on  water it decomposes the water,
setting  fire  to  the  hydrogen which  it  liberates.   It is found in
minerals and plants.   When  obtained by  evaporating  the lye of
wood ashes it is called potash, or pearlash.   It is  one of the alkali
metals, and is grouped with sodium,  lithium,  and the compound
radical known as ammonium.  ItssymbolisK (kalium). Potassium
hydrate is known as  caustic potash, (KOH).  The latter belongs
to a  class of poisons known as alkaline caustics.  They dissolve and
destroy the tissues.   The best antidote for alkaline  caustics  are mild
vegetable acids, milk, or oils.
   Potassium cyanide is a very poisonous compound  much used in
photography for dissolving  the unaltered  silver salts, and  also for
cleaning the hands from nitrate of  silver stains.
   Potassium chlorate is a poisonous salt used to make oxygen, and
also  as a gargle.   It is often  found  in the kidneys after death.
   Potassium nitrate is known as nitre, or saltpetre.   It is used in
the  manufacture of  gunpowder,  and also  as  a diuretic and re-
frigerant in rheumatism and fevers.  The books say it is poisonous
in over doses, but we submit that its character is the same  in small
doses as  large and that its injury will be proportionate.
   Potassium permanganate forms, when dissolved in water, Condy 's
fluid.  A single grain of the crystals imparts to a goblet of water a
beautiful purple color.   It is a disinfectant.
   Potassium oxalate resembles Epsom Salts in appearance and is
liable to be mistaken for it.   It is  very poisonous.  It is known as
salt of lemon, or salt of sorrel.  Beware of it.
    Cream of tartar is  an impure potassium  tartrate, deposited  in
the casks during the  fermentation of wine made from  grapes.   It is
(66) 
 Used as a diuretic and purgative in fevers, rheumatism and dropsies,
 in doses of 20 to 120 grains.
    Sodium is  a  silvery-white metallic element.  Like potassium
 it has a strong affinity for oxygen and has to be  preserved like
 potassium  under  some  hydrocarbon  like  wood-naptha.   It  is
 abundant, as a  chloride, in  rock salt,  sea water and saline springs.
 Symbol Na (natrium).  Chloride  of sodium  (NaCl)  is  common
 salt.   Taken into the system it shrivels the blood corpuscles, hardens
 the  tissues and interferes with  the process of endosmosis and ex-
 osmosis.   A saline fluid will not pass so readily through an animal
 membrane as fresh water.   This is easily shown by experiment.
    The two principal carbonates of sodium are sal soda, or washing
 soda (Na2C03).  also  called sodium carbonate; and  the sodium
 bicarbonate (NaHC03).   The latter enters into the  preparation of
 soda powders  and  also of  Seidlitz powders.  The  soda  powders
 are  mixed with  cream of tartar,  or tartaric acid,  and  used  as
 " baking powder, to raise bread.
    Lithium is the lightest metal known (sp. gr. .59).  It  is found
 in the waters of some  mineral springs.  Lithium salts and  Lithia
 water are  used in medicine to dissolve uric acid.  They change the
 insoluble uric acid into soluble lithium urate.   The citrate, and sal-
 ic} late of lithium are  preferred as medicines  on account of their
 greater solubility.   Dose of either, 1 to 5 grains.
    Calcium  is a  light  yellow metal.   Its  specific gravity is  1.58.
 It is abundant chiefly as the carbonate which forms coral, limestone,
 marble and  chalk.   When  heated in  the air calcium burns with a
 bright light.  With  oxygen it forms  lime  (CaO).   Pure  lime  is
 called quickli?nc.  or caustic lime.  Quicklime combines with water
 readily and forms what is  known as slaked lime which  is mixed
 with  sand  in making mortar.
   Calcium  carbonate  exists in  crystalline  form as Iceland spar.
 Hard water deposits calcium carbonate on boiling.
   Calcium  sulphate combined  with  water forms gypsum.  Pow-
 dered and  mixed with water gypsum forms plaster of Paris, much
 used by dentists and others for making casts and moulds.
   Fluor  Spar is calcium fluoride.
    Calx sulphurata,  commonly called  calcium sulphide  is a mix-
ture  of calcium  sulphide and calcium sulphate, and is used  in medi-
(67) 
cine to  Cause boils to  abort, and  prevent  the formation of pus and
abscesses.  Dose Jy, to one grain, three times per day.
    Magnesium is a silver white  metal, and is one  of  the elements
of Epsom salts (magnesium sulphate).
    Zinc is a bluish-white metal.  Zinc  oxide  (ZnO)  is  largely
used for painting white.
    Zinc chloride  (ZnCl) is a painful caustic.
    Zinc sulphate (ZnS04) is commonly known as white vitriol.
    Lead  (Plumbum) is one  of the  heavy  metals.   Its  specific
gravity  is 11.37.   Lead and tin together form soft  soldo-, used by
tinmen.  Lead  and   antimony  together  make  type-metal.  The
principal source  of lead  is a native lead  sulphide called,  Galena.
Lead is much used for water pipes but is always more or less a source
of poisoning.   Lead chromate is chrome yellow.   It is a deadly poi-
son.  Lead acetate (sugar of lead) has been used in medicine as an
astringent  and sedative, and in hair restorers.  It is always  poison-
ous.  It enters into the formation of Goulard's extract, and  may be
used as an external application in ivy poisoning  when largely dilu-
ted.  Lead carbonate is used in  oil  paints,  by  plumbers to  form
joints of water pipes, for  glazing paper, etc.   It is the most  poison-
ous of  the lead compounds.   The principal  symtoms of  lead poi-
soning are colic pain,  obstinate constipation,  palsy, usually of  the
forearm and called wrist-drop, blue line on the  gums, foul breath,
convulsions, coma  and death.   Antidotes—Epsom salts  and lemon-
ade, to  produce an insoluble lead  sulphate.
     Copper occurs in the  metallic state  and in ores.  The principal
alloys of copper are brass  (copper and zinc), bronze  (copper and
tin,  or lead),  and   German   silver   (copper, zinc  and  nickel).
Scheele's green, and Paris green  are  compounds  of copper and ar-
senic.  The copper of commerce is rarely free from arsenic.   The
solder  with  which copper vessels are usually made may  prove a
source of poisoning in copper  cooking utensels.   Food standing in
copper  vessels may generate poisonous pi"oducts.   The  symptoms of
copper  poisoning  are vomiting and  purging, metallic  taste in  the
mouth, colic pains, suppression  of urine and jaundice.  Best anti-
dotes are raw eggs and  milk.   Pickles, peas, and sweetmeats  are
sometimes colored with poisonous copper salts.
    Mccury (Hydrargyrum)  is a metallic liquid with a  sp. gr. of
                               (68) 
  13.6.  It sometimes  occurs  in  the  native state,  but its chief ore is
  cinnabar (mercuric  sulphide)  which is  found in Spain, California
  and China.
     The two chlorides of mercury are calomel,  and  corrosive subli-
  mate.   Calomel contains one atom  of chlorine with  one of mercury,
  while corrosive sublimate has two atoms  of  chlorine to one of mer-
  cury.  One  is the  chloride,  and the other the bichloride.   Calomel
  ma}- be converted into corrosive sublimate by the simple addition of
  more chlorine, which is abundant in common salt.   Corrosive sub-
  limate  is a violent corrosive  poison, and  is  used, largely diluted, as
  an antiseptic, and  parasiticide  (parasite-killer).  3  grains taken in-
  ternally may prove fatal.  The antidote  is raw eggs.  Mercury as a
  medicinalj]agent produces  salivation, fetid breath, anaemia,  inflamed
y g^Dns  and canker sores.
     Silver (argentum) is  a  white brilliant  metal with  a sp. gr. of ■./
  10. v  It forms alloys with  other metals and  is employed as coin,
  alloyed with copper.   The English coinage contains 7.5 per cent, of
  copper.   The principal salt  of  silver used in medicine  is the  silver
  nitrate (Ag. NOa) or lunar caustic.   When  taken internally it  is
  a corrosive poison and produces indelible stains of the skin.  It makes
  an indelible ink for marking linen.   The antidotes for lunar caustic
  are common table salt and raw eggs.
     Aluminum is a valuable silver-white metal, very light, very duc-
  tile,  and does not tarnish in  the air.  It  is  abundant  in clay,  marl,
  slate, and in man}-  crystalline minerals.  Combined  with  oxygen
  (forming an oxide  of aluminum) it forms the ruby,  sapphire and
  corundum.   The  aluminum sulphate with the alkaline  sulphates
  forms alums.  The alum of the Pharmacopoeia is now  a potassium
  alum.   (Ammonium alum  was formerly  used.)   The potassium
  alum when calcined forms "burnt alum."   The latter is a powerful
  astringent and escharbtic.  It is employed to suppress fungoid  gran-
  ulations and  to check hemorrhage.
     Iron is the most useful of all the metals.  It is  obtained mostly
  from iron ores, pure  metallic iron  being confined almost wholly to
  meteoric stones.  The iron of commerce exists in three  forms : cast
  iron, wrought iron  and steel.  Cast iron is granular in structure ;
  wrought iron, fibrous.   Cast iron contains from 3 to 6  per cent, of
  carbon ; the other kinds less  than 2  per cent.  Long  continued vibra-

                                 (69) 
tion reduces fibrous iron  to  its original crystalline condition;  and
many accidents of  breaking axles occur on  account of this change.
Steel is refined iron;  and  is  made by burning out the carbon and
silicon in cast iron  by passing through the  molten metal  a blast of
air till the iron is pure, and then adding  a small percentage of car-
bon and manganese.                  ^
  C*This process makes Bessemer steel.] Magnesio-Ferric  hydrate,
called also hydrated oxide of  iron with  magnesia, is  the chemical
antidote,  when freshly prepared,  for arsenic.  It  can be quickly
prepared  by  mixing  the  two following  solutions kept  for  this
purpose.
    i st.   Two ounces solution  of tersulphate of iron in six ounces
of  water, and  kept in a five-pint bottle.
    2nd.   Magnesia milk, made by rubbing up 150 grains of light
calcined magnesia with eight ounces of water.
    When wanted shake well  the magnesia milk and pour  into solu-
tion No.  1.  Shake all together and give a tablespoonful  every five
to ten minutes.
    AYckel is a silver-white metal used in alloys, and as a  coating to
steel and iron instruments to prevent them from  rusting, because
nickel does not  readily tarnish in  the air.
    Tin  (stannum)  is another silver-white metal.   As  a metal it is
not poisonous, but its soluble  compounds are irritant poisons.  Best
antidotes  for tin are milk and eggs.
    Bismuth  is a reddish-white metal.   With nitric acid it forms
two nitrates—bismuth nitrate, and bismuth  sub-nitrate.  Its different
preparations have been given  in dyspepsia.   It is  generally more or
less contaminated with arsenic.
    Gold (aurum) is a soft yellow metal with a  sp. gr. of 19.3.  The
chloride of gold has occasionally been given in neuroses (disease of
the nerves).  A proper state  of the will is a better remedy for dip-
somania.   When a person  once makes up his mind that  alcohol or
other substance is bad for him he ceases to want it.
    Platinum is a rare metal  of greyish-white  color, untouched by
all  acids  except a  mixture of  nitric and  hydrochloric, known as
Aqua regia, which  also dissolves  gold.
    We are not aware that platinum is ever prescribed  as  a remedy
for disease.  It is a rare and expensive metal.

                               (70) 
     Carbohydrates are compounds  of  water and carbon  in which
 water is a prominent part;  /. e., carbon united with hydrogen  and
 oxygen in right proportion to form water: viz., two  atoms of hydro-
 gen to one of oxygen.   Their general chemical  formula is  CniH2n
 On;  in which you see there is always just twice as  many  atoms of
 H as of O.  The "m" and  "n"  stand  for unknown quantities.
 The carbohydrates contain all the essential elements  except nitrogen
 (N).  They include starch (Amylu/u) and  sugar (Latin, Saccha-
 rum; French,  Sucre).
    There are two distinct kinds of sugar and several varieties.  The
 two kinds are cane sugar  and grape sugar.  They are also  known
 as sucrose and  glucose.   Grape  sugar is a glucose  (C6Hio06).
 The formula for cane  sugar (sucrose)  is C^HooOu, and consists
 of two molecules of glucose with the elimination of  one  molecule
 of water (H20)   If  we double the molecule of glucose we  have
 Cj-jHoiOio, and bv taking away one molecule of water (H20) we
 have left CioH^On (sucrose or cane sugar).  Cane sugar is made
 from sugar cane, the maple tree (sugar or rock maple), and the beet
 root.  Grape sugar (glucose) is found in  raisins, honey and manna,
 and  is also  manufactured  by boiling starch with dilute sulphuric
 acid.  The artificial glucose is liable to be impregnated with sulphu-
 ric acid  or lime.  Cane sugar changes to glucose before it undergoes
 fermentation.
    Artificial glucose is used as a substitute  for syrup  at the table.
 It looks  to be very nice but the taste is  sharp  and acrid.
    A glucoside is a substance which  is  converted  into glucose by
 boiling with  acids.
    The  carbohydrates form an  important class of  foods for supply-
 ing  muscular force and animal heat.   They are not  supposed to
 nourish  the  tissues of the  body because they contain  no nitrogen;
 are  ;/<?//-nitrogenous.
    Milk  sugar  is sometimes called lactose,  because  derived from
 milk (lac).
    Cellulose and glycogen have the same chemical formula as starch
 (C6H10O5).   Cellulose is the substance that makes up the  woody
fibre of  plants and trees, and is indigestible because  insoluble.  Cot-
 ton is almost pure cellulose.
    Gun  cotton  is produced by the action  of nitric and sulphuric

                                (70 
acid on cellulose.   It  is highly explosive  by percussion.   Dissolved
in ether and alcohol it forms collodion.   By dissolving camphor in
collodion and evaporating the ether we get celluloid, which is  hard
at an ordinary temperature but plastic when warm.
    Glycogen  (sugar maker) is a kind of  animal starch found in the
liver, in oysters, and in embryonic  structures.
    Wheat  flour contains about  70 per cent, of starch and  10 per
cent, of gluten.  The  outer surface of the grain is cellulose.  Starch
is insoluble in cold water, and requires cooking for nearly three hours
to make it digestible.
    Hydrocarbons are compounds composed  mainly of  hydrogen
and carbon.   They include oils  and fats, and  a multitude of other
inflammable  bodies like gas, rock oil, etc.  Fats in the  body are
derived not only  from fats ingested, but  from  carbohydrates  and
proteids.   The cow eats no  fat but produces butter.
    Petroleum, or rock oil, is a mixture of various  hydrocarbons.
Kerosene,  paraffine, benzine, naphtha, gasolin and cosmoline, are
some of its components.  Cosmoline is also known as vaseline  and
petrolatum.
    Alarsh gas is  a hydrocarbon, and is known  as the "fire-damp''
of mines;  also as light carburetted hydrogen  or  methane.  It is
a colorless  and tasteless gas.  Its presence in the mines is announced
by the safety lamp which is perfectly shut in by wire gauze.  The
gas, when  present, burns inside the gauze with  a blue flame, but
the gauze cools the heat and prevents  the  fire-damp from  becoming
ignited.
    Paraffine  (small affinity)  is  a  white,  tasteless,  inodorous,  solid
hydrocarbon  used in  the manufacture of  candles,  and for coating
corks and  bottle stoppers to  prevent the  action of  corrosive fluids.
Fats and oils are mixtures of  palmitic or margaric, stearic and  oleic
acids, united to a  common base — glycerine.
    Oils are divided into fixed and volatile, or  essential, oils.  The
latter evaporate and leave no  stain  on paper. The essential oils used
for flavoring  extracts  can be produced  artificially, and made to
closely  resemble the  natural  flavors.  Unmedicated food  is  usually
most wholesome  for  all persons in health.
    Oleic (oil) acid is  a liquid;  stearic and palmitic acids  are solids.
(72) 
 Stearin (stiff fat),  margarine  (pearly) and oleine (oil)  are  the
 neutral fats.
     Glycerine  is a  colorless,  odorless, syrupy liquid  of  sweetish
 taste, and mixes with, or  is soluble in water and  alcohol.   To be
 pure it must be distilled  or crystallized.   With strong nitric  acid
 glycerine forms uitro-glyccriue, and reduces chromic  acid,  chlori-
 nated lime,  and  permanganate of potassium  with  great  violence.
 When used alone as a medicine glycerine  is  often  irritating,  especi-
 ally to chapped hands, on  account of its power to absorb water; and
 for this reason should not  be used  alone, but diluted with water or
 other liquids.   Diluted with water it  may be  used  to saturate tam-
 pons to be employed in  leucorrhoca.   It is  antiseptic in its nature.
    Xitro-glycerine (glonoin) is a heavy viscid liquid, very poisonous
 (has been used as  a medicine),  and  explodes  with terrific  force.
 Mixed with earthy matter  to give it consistence it  forms dynamite,
 or giant powder.
    Alcohols  are hydrates of hydrocarbon  radicals  (hypothetical
 compounds).   There are  several forms of  alcohol — the methylic,
 ethylic, amylic  alcohol, and others.   Methylic alcohol  (methyl  hy-
 drate) is known as wood spirits,  or  wood  naphtha, and is procured
 by the dry distillation of  wood.  This form of  alcohol is very poi-
 sonous, and is sometimes mixed with 90 per cent, of ordinary alcohol
 to prevent, it is said, the latter from  being used for drinking pur-
 poses.   When thus  contaminated it is sold for manufacturing and
 scientific purposes.
    Ethylic, or ethyl alcohol (C^II^O), is the ordinary alcohol or
 spirits of wine.   This is the ethyl  hydroxide and the intoxicating
 principle of all  spirituous liquors, though  not so poisonous  as  the
 amylic alcohol, better known as  "fusel oil."   Brandy and  whiskey
 contain from 40 to 50 per cent, of ethyl alcohol, and unless aged or
 rectified, they also contain  more or  less fusel  oil (amylic alcohol).
 Wines contain from  17 to 7 per cent, of alcohol, and strong ale and
 porter 6 to 8 per cent. ;  lager beer 2 to 3 per cent.   The alcohol of
 the United States Pharmacopoeia contains 94 per cent, of  absolute
 alcohol.
   The fusel  oil (amylic alcohol) of young and poor whiskey rap-
 idly produces intoxication,  gastric disturbance, and  headache.  The
effect of ordinary alcohol upon the  tissues is to harden  them and

                               (73) 
produce atrophy of  the organs, and prevent the elimination  of C02
from the  lungs.
    Sweet wines  contain undecomposed sugar,  while  dry  wines
have all their sugar converted  into alcohol;  champagne and  spark-
ling wines are bottled before  fermentation ceases,  so as to retain
much CO 2 (carbonic acid gas) in solution.   The only property  of
alcohol  that  is  valuable in  sickness  is its  antiseptic  property.
Rightly used in cases of Zymotic disease it may be serviceable, as an
antiseptic, to arrest fermentation; but it must be free from amylic  or
methylic alcohol.    Rectified spirit, or deodorized alcohol, is the
safest for medicinal  preparations, if it must be  used.
    Ether (improperly called  sulphuric ether) is a volatile, color-
less, highly inflammable liquid ; and when mixed with air, explosive.
It is used as an anaesthetic.   Chloroform alone is not inflammable,
but  requires a large admixture of atmospheric air  for safe  breath-
ing as  an anaesthetic.
     Vinegar  (sour wine) is an impure very dilute acetic acid derived
from wines, cider, etc., by fermentation.  It usually  contains about
5 per cent, of radical or  pure acetic acid.   It is valuable as an anti-
septic when properly  made.  It is sometimes made  or contaminated
with sulphuric  acid and is then very unwholesome.  The  purest
acetic acid is known as glacial (icy)  acetic acid, because  it partially
solidifies to an ice-like mass.   It  forms salts termed acetate.  It  is
prepared  in a crude  form by  the  dry distillation of  wood and  is
then called pyroligcuous  acid.  (Dry distillation is distilling with-
out the addition of water.)
    Glacial acetic acid has  a pungent smell  and is  often put up  in
smelling bottles; it is also caustic in full strength and may be used
to destroy warts, corns  or  fungous growths.   For this purpose  it
may be diluted with an equal weight of glycerine.
    Butyric acid is the  product of decomposing butter and other
fatty substances.  It is found in  rancid butter, and is  often  present
in the stomach of despeptics.
     Valerianic acid is  also  a  product of  decomposition and  is
found  in the secretions  during the  progress of  zymotic disease —
typhus  fever, small pox, etc.
    Oxalic acid  is a white,  crystalline, irritant poison, derived from
the  action of  nitric acid on  sugar or starch.   It exists in some
(74) 
 plants,  notably in the sorrel and pie-rhubarb.   If the latter is to be
 eaten, 'tis well to scald it and  pour off the  first water,  so as to re-
 move some of this acid.
     Oxalic acid, and potassium oxalate are both used for removing
 ink and  iron stains.  The  latter  has, unfortunately,  been called
 "salts of lemon," but it has no connection with lemon, and is a dan-
 gerous poison.    The same salts have  sometimes been mistaken for
 Epsom salts with fatal results.
     Citric acid is found in lemons and  limes.   It is a crystalline
 solid, very soluble in water, and often used as a substitute for lemon
 juice.  The fresh juice of the  lemon is preferable  to the prepared
 acid.
    Caoutchouc (pronounced Koo-chook) is a resinous substance from
 trees of  South America and the East Indies.   It is also called gum
 elastic and India rubber.    When melted with  sulphur it forms
 hard rubber.
    Menthol is a camphor contained in  the oil of peppermint.
    Nitrobenzine is a yellow oily liquid having the odor  of  bitter
 almonds, and for this reason is sometimes used in perfumery.  It is
 very poisonous.   It produces difficulty of the heart  and  lungs, con-
 vulsions,  coma, and death.
    Phenol has been  improperly called carbolic acid.  It is corrosive
 but not an acid.   It acts when given or breathed like a protoplasmic
 poison.   It is much used as a germicide, and in  surgery as an  an-
 tiseptic, though  it is now being replaced by  dilutions  of corrosive
 sublimate, peroxide of hydrogen, etc.
    Resorcin  is a new product resembling phenol.  It is used as an
 antipyretic and powerful germicide.  It is given in  doses of 5 to 20
 grains.  All these powerful germicides and antipyretics are poisonous
 in proportion to  their power.
    Salicylic  acid is manufactured from  phenol, although  it  is
 also found in  the bark of the white willow (Salix).   The pure acid
 is in fine, white, needle-shaped  crystals.  It is  antiseptic,  anti-
 pyretic, and antiperiodic.   It is  sometimes added to cider  and milk
 to prevent souring.   It is at the  present time much used in rheuma-
tism, fevers and zymotic disease.  Dose 5 to 20 grains suspended in
the infusion of gentian compound, or some pleasant syrup, as it has
a disagreeable taste.   It is very irritating  to mucous surfaces and for
(75) 
this reason should not be given in pill form or powder.   The inhala-
tion of the dust causes coughing and sneezing.
   Cholesterin  (solid bile) is a fusible and crystallizing substance
that forms part of certain biliary calculi, or gall stones.
   Alkaloids (resembling alkalies)  are  nitrogenous  compounds
that combine with acids to  form s;dts.   They are generally the active
principle of the drug from  which they are  obtained and include the
most violent poisons with which we are acquainted.   They form in-
soluble tannates with tannin, and for that  reason tannin is given as
an antidote for them.  They are divided into  two classes : amines,
which are gases or liquids, and amides, which are  solids.   They
include morphine, coniine, nicotine,  quinine,  apomorphine, strych-
nine,  atropine,  etc.  Nicotine  and coniine are liquid,  the  others
mentioned are solid.   Nicotine is  obtained  from  tobacco;  coniine
from conium (poison hemlock)  ; quinine from  Peruvian bark ; mor-
phine from opium ; apomorphine  from morphine and hydrochloric
acid ; atropine from belladonna; and strychnine from  nux vomica.
   Ptomaines (corpse or  dead body)  are  putrefactive alkaloids;
many of them are septic poisons.  They are derived from organized
bodies during the  process of decomposition.  They are really  un-
stable  compounds.   They  have been found in  oysters,  sausage,
canned  meats, etc.
   Leucomaines are products  of  fermentation  found in the  living
body.   Xanthin hypoxanthin, creatin and creatinin are leucomaines.
Nurine, muscarine, cadaverine, sepsine, putrescine, t) photoxine and
tyrotoxine are ptomaines.   Tyrotoxicon is the poisonous ptomaine
of putrid cheese.
   Proteids are albuminous bodies, or albuminoids.  They nourish
the tissues of the body when taken as food.  They contain the four
essential elements united with sulphur.
   A peptone  is a soluble albuminoid.  The latter  is changed to
peptone in the stomach by the action of the gastric juice.
   Mucin is  the  essential matter of mucus  (the secretion  of the
mucous membrane).  It diflers from albuminoids  in not containing
sulphur.
   Fibrin  is a white elastic  substance  formed  from the blood by
coagulation.  It forms the element for the tissues of the body.
   Casein is a milk albuminoid ; found in milk.
(76) 
    Gelatine is a substance found in cartilage and tendons.  It forms
glue.
   Hemoglobin is a contraction of haemato-globulin.  It forms the
red corpuscles of the blood, and carries oxygen from the lungs to the
tissues.  When loaded with oxygen 'tis called  oxyhaemoglobin, and
when  returning in the  veins deprived  of its oxygen  'tis called
reduced haemoglobin, or simply haemoglobin.
   The coloring matter of the  bile is called bilirubin (red bile) and
biliverdin (green bile).   The color depends upon the nature of the
food.  In the  herbivora  it is  green.   The   coloring  matter  of
plants  is termed chlorophyl (green leaf).


                         SYNONYMS.
   Sulphate of magnesia is Epsom Salts.
   Sulphate of iron is Copperas, or Green Vitriol.
   Sulphate of copper is Blue Vitriol,  or Bluestone.
   Sulphate of zinc is White Vitriol.
   Sulphuric  acid is Oil of Vitriol.
   Mercurial  ointment is Unguentum (sometimes but improperly
called  Anguintum).
   Mercurial  pill is Blue Pill.
   Mercurial  nitrate ointment is Citrine Ointment.  It is so called
because of its yellow color, like lemon.
   Potassium  bitartrate is Cream Tartar, or Cr. of Tartar.
   Potassium  nitrate is Nitre or Saltpetre.
   Poke is Garget unless otherwise distinguished.
   Indian poke  is Veratrum Viride.
   Powder of aloes and canella is Picra (bitter).
   Powder of ipecac and opium is Dover's Powder.
   Carbonate  of soda is Sal Soda or Washing Soda.
   Bicarbonate of soda is Baking  Powder.
   Camphorated tincture of opium is Paregoric.
   Treacle is  Theriaca or Molasses.
   Hydrastis is Golden Seal.
   American  hellebore is Veratrum Viride  (Indian Poke).
   Bearberry  is uva ursi.
   Blue flag is Iris.

                               (77) 
    Black snake root is Cimicifuga.   (Black Cohosh).
    Bloodroot is Sanguinaria.
    Croton oil is Oleum Tiglii.
    Lard is Adeps.
    Licorice is Glycyrrhiza.
    Ox gall is Fel  Bovis.
    Pleurisy Root  is Asclepias.
    Indian hemp is Cannabis Indica.
    Henbane is Hyoscyamus.
    Gum Arabic is Acascia.
    Elder is Sambucus.
    Sage is Salvia.
    Pipsissewa is Chimaphila.
    Thoroughwort is Eupatorium (Boneset) .
    Wintergreen is Gaultheria.
    Witchhazel is  Hamamelis.
    Wahoo is Euonymus.
    Fowler's solution is Liquor Potassii Arsenitis.
    Fox glove is Digitalis.
    Aqua fortis (strong water) is Nitric Acid.
    Aqua regia (royal water) is  Nitrohydrochloric Acid.
    Calomel is the Chloride of  Mercury, or Hydrargyri Chloridum
Mite (mild), and
    Corrosive sublimate  is the Bichloride of Mercury or Hydrargyri
Chloridum Corrosivum.
   A minim is the sixtieth of a drachm.   Of most fluids 'tis less than
a drop, but of some more.
   Gr. stands for grain ; Gtt.  (gutta) stands  for a drop ; M (misce)
signifies mix; O (octarius) stands for one pint; R (recipe) signifies
take;  S or Sig. (signa)  means write; Ss or ss (semisse) signifies
one half; Chart,  (chartula— a little paper) stands for a powder.
   The term "Dover's Powder" has been changed to Powder of
Ipecac aud Opium.  It is composed of powdered opium  i  part,
Powdered  Ipecac i part,  and Sugar of Milk 8 parts.   Used in
fevers.  We think it may be  improved still further by  substituting
(78) 
 powdered camphor for One half the  opium.  Dose of the  mixture
 i  to 5 grains.
    Compound Liquorice Powder contains the following :  Senna,
 Licorice, and Fennel  (all in  No.  60 powder), 18, 16, and 8 parts
 respectively, washed sulphur 8, and sugar 50 parts ; mix.   Used as
 a  laxative.  Dose—a teaspoonful at bedtime.
    A litre is a little less than an English quart, but is more (about
 5  per cent.) than the U. S.  quart.
    A pint of water will dissolve 5 grains of camphor.   Camphor
 may  be powdered by  first  adding  a  small quantity  of alcohol
 (enough to moisten it) then rubbing in a mortar.
    Eleven minims of tincture of opium  (Laudanum)  represents
 one grain of opium.  A grain  is a  very large dose  of opium for  an
 adult not accustomed to it.  A full dose of opium  is not to be re-
 peated for at least four hours.  A good and simple rule for grad-
 ing the dose  is to give to a child such a proportion of the adult dose
 as the age of the child bears to 20 yrs.
    The No. of a powder(20 to 60, or 80) designates the fineness of
 the sieve through  which the powder  must pass.   No. 20 (a coarse
 powder) signifies that the sieve contains 20 meshes, or wires to the
 linear inch.   60 is a fine powder; 80 very fine.
    White  lead, which is poisonous, is sometimes used to adulterate
 beeswax.  Such wax should not be put in the mouth.
    Chlorate  of potash (Potassium  chlorate) is liable to explode if
 mixed with organic or combustible bodies.
    Permanganate of potash and glycerine are almost sure to explode
 if  mixed  together.  Permanganate of potash,  alcohol  and water
 make a dangerous compound.
    The specific gravity of alcohol of the new Pharmacopoeia (1880)
 is  .820; absolute  alcohol .794; dilute alcohol .928.  Dilute alcohol
 contains 54^  parts of water to the  100.
    The best solvent for myrrh is alcohol ; for boric acid, glycerine
 and hot water; for resins, alcohol ; for gzims, water; for  camphor,
 alcohol ; and for sulphur,  bi-sulphide of carbon.
    The active principle of Cimicifuga is  macrotin; of Culver's root,
 leptandrin;   of Cinchona,  quinia;  of  Belladonna, atropine;  of
 opium, morphine; and of Podophyllum, podophyllin.
    Fowler's  solution contains 1 per  cent, of arsenic.  Powder of
ipecac and opium contains 10 per cent, of opium.

                               (79) 
   An ounce avoirdupois Contains 437-5 gramSi
   The Apothecaries' ounce  contains  480 grains ; but  the pound
avoirdupois is the larger (by 1240 grains) because it has 16 ounces,
while the apothecary pound has only 12 ounces.  The  apolhecary
ounce is divided into 8 drachms ;  each drachm  into 3 scruples ; and
each scruple into 20 grains; making 5760  grains in the  apothecary
pound, while the avoirdupois has  7000 grains.  The Troy or Apothe-
caries' ounce is 42^ grains heavier than the avoirdupois ounce.
   The Apothecaries' table for liquid measure  is 60 minims make
one drachm ; 8 drachms, one  ounce; 16 fluid ounces, one  pint; 2
pints, 1 quart; and 4 quarts one gallon.
   A teaspoonful is equivalent to a drachm ; a dessertspoonful  to
2 drachms; a tablespoonful to half an ounce; and  a  wineglass to 2
ounces.
   The litre is equivalent to 38.82 ounces,  or 2.11  pints.
   A gram (Yxench ^gra?nme") contains about  15^ grains.   In
the metric  system all weights are  in grams or decimals of a gram ;
and in writing a prescription the  whole grams are  written to the left
of a straight vertical line and the  decimals  on the right of the same
line.
   Abstracts are preparations containing  the soluble  principles of
the drug,  mixed with sugar of milk, evaporated to dryness and
powdered.  They  are twice  the  strength of the  drug  itself, more
permanent and portable.  There  are eleven official abstracts.   The
four most  prominent and reliable are aconite root, podophyllu?n,
nux vomica, and jalap.  The dose  is one half that of the drug
itself.
   Aqua: (waters), in pharmacy, are  aqueous  solutions irf volatile
substances.                                         '
    Carbolic  acid water is made  by mixing one fourth of an ounce,
each, of carbolic acid crystals and glycerine in a mortar and then
adding a pint of distilled water.   Used as a gargle, wash or spray.
   Aqua   Ammonia   (ammonia  water)  contains 10  per  cent  of
ammonia ;  aqua ammonia fortior (stronger ammonia water) has 28
per cent of ammonia.
   The best  orange flower  water  is imported from France  as
" Triple Orange Flower Water."  To the French preparation the
Pharmacopoeia allows  to be added two thirds its volume of  distilled
(80) 
 water.   It  cannot be made  from the oil  of orange flowers (oil of
 neroli).   Is used for flavoring medicated syrups.
     Lime water contains a small fraction  (.15) of one per cent, of
 lime.  It is used to neutralize acidity of the stomach ; in rickets to
 supply lime to the bones ; and as a spray or vapor in diphtheria.
     Camphor water is an  aqueous solution of camphor.   Each pint
 contains from 3 to 5 grains of camphor.  It may be quickly made by
 putting a teaspoonful of spirits of camphor into a pint of water and
 straining the mixture.  It  is  more nicely made by saturating  clean
 cotton with spirits of camphor, allowing the cotton to  dry or nearly
 so, which it quickly does,  and then percolating through  it,  packed
 into a percolator, distilled water.  One drachm  of camphor gum
 dissolved in twice its weight of alcohol is sufficient  for one  pint  of
 camphor water.  It is  a  most  valuable  medicine in all zymotic
 fevers—scarlatina, typhoid fever, diptheria, erysipelas,  small pox,
 measels, etc.  Dose, a tablespoonful several times a  day, and in bad
 cases every hour for one or two  days.
     There are 14 or  15  official  aquae.   Only two are prepared by
 distillation—orange  flower, and rose water.   The  others are pre-
 pared by simple  solution,  or by  filtration.
    There are four official  vinegars (aceta) prepared  by dissolving
 the drug  in dilute acetic acid.   The four vinegars are opium  (aceta
 opii), squills (scillae), lobelia and bloodroot.  The vinegar of opium
 contains a little nutmeg and sugar besides the opium and acid.  For-
 merly cider vinegar, or wine vinegar, was used ; now dilute acetic
 acid is used.
    There are two official balsams—Balsam of Tolu, and Balsam
 of  Peru.   Balsam  of Tolu is chiefly used in cough  medicines to
 make them  more agreeable to the taste.   Balsam  of Peru  is  a
 general stimulant and expectorant.  It is used to check an excessive
 discharge of mucus in bronchitis  and catarrh (a disease  of mucous
 membranes), and, externally,  as  an application to chilblains, ulcers
 and sore nipples, and as an ointment to cure the itch.  It is  nearly
 insoluble  in water, and is given in emulsion or mucilage.  Rubbed
 up  with the white of an egg it is  used as an application to bed sores.
 Dose, 5 to 15 minims.
    Medicated wines are vinous  liquid preparations.   The Wine of
Ipecac is  less disagreeable than other preparations of that drug.   Vi-
(F)
(8l) 
num Album Fortius (stronger white wine) is white wine containing
one pint of alcohol to a gallon.  If rectified alcohol is used it makes
a good antiseptic.
   There are  16 official troches (lozenges) composed  of sugar and
mucilage, medicated, and intended to dissolve slowly in  the mouth.
They contain morphine, opium, ipecac, tannin, peppermint, chlorate
of potash, etc.  There are 73 official tinctures.  They are generally
prepared with dilute alcohol, but tinctures of myrrh and cayenne
are prepared in nearly pure alcohol in order to make  them clear.
Glycerine is sometimes  added to prevent tinctures from precipitation
on standing.  Tinctures are made by maceration, percolation, solu-
tion or dilution.  Tincture of iodine is made by dissolving the iodine
in alcohol.
   Simple  Syrup is 65 parts white sugar dissolved in 35 parts pure
water;  or, 13 to 7 of sugar and water, dissolved by the  aid of heat
and strained while hot.
   Simple  Cerate (cera,  wax) is made by melting together white
wax and lard, 3 and 7 parts each.   Yellow wax might be used.   It
is applied to raw surfaces to protect them;  and is used as a vehicle
for more active medical applications.   There are  8 official  cerates.
Among them are  Goulard's, and Camphor Cerate.
   Fluid extracts are  alcoholic solutions, representing one grain of
the drug to each minim.   They are uniform,  and more  definite
and  concentrated   than tinctures.   Glycerine  is  sometimes used
to prevent  precipitation.    There  is  a   great  number   of  fluid
extracts, but  only otte compound fluid extract  (Sarsaparilla).
The  latter  contains  sarsasparilla,  licorice, sassafras,  mezereum,
glycerine, alcohol and water.  Used as a blood purifier  in scrofula,
etc.
   Mezereum is  a powerful  sialogogue,  and irritant  poison.   It
forms about 3  per cent, of  the medicinal  ingredients in the above
compound.
  The Compound Decoction of Sarsasparilla also contains  me-
zereum.  There are in the Pharmacopoeia i2decotions.  Sarsaparilla,
Iceland  Moss (Decoctum  cetrariae),  Pipsissewa  (Chimaphila),
Cinchona (yellow and red), Senega (Rattlesnake  root), and Uva
Ursi,  are the more important of the decoctions. 
NAMES  OF  THE  ELEMENTS.
COMPLETE  TO THE PRESENT TIME.
   Aluminum, Antimony, Arsenic,  Barium, Beryllium, Bismuth,
Boron, Bromine, Cadmium,  Caesium, Calcium,  Carbon,  Cerium,
Chlorine, Chromium, Cobalt, Columbium, Copper,  Decipium, Di-
dymium, Erbium, Fluorine, Gallium, Glucinum,  Gold,  Holmium,
Hydrogen,  Indium, Iodine, Iridium, Iron, Lanthanum, Lead,  Lith-
ium,  Magnesium,  Manganese, Mercury,  Molybdenum,  Nickel,
Niobium, Nitrogen,  Norwegium, Osmium,  Oxygen,  Palladium,
Phosphorus,  Platinum,  Potassium, Rhodium, Rubidium,  Ruthen-
ium,  Scandium,  Selenium,  Silver,  Silicon,  Sodium,  Strontium,
Sulphur, Tantalum,  Tellurium,  Terbium,   Thallium,  Thorium,
Thulium, Tin, Titanium, Tungsten,  Uranium, Vanadium,  Ytter-
bium, Yttrium, Zinc, Zirconium.   Total, 73- 
 
WV25B70
 
NLM051514182